Eatonsonne3468

, vertex pregnancies undergoing labor, those with mild thrombocytopenia (platelet count 100-149 k/microliter) had a twofold greater likelihood of postpartum hemorrhage compared with those with normal platelet count.Objective To compare the effect of same-day discharge on 30-day readmission risk after minimally invasive pelvic reconstructive surgery. Methods This retrospective cohort study included all minimally invasive pelvic reconstructive procedures with and without concomitant hysterectomy performed within a large managed care organization of 4.5 million members from 2008 to 2018. We queried the system-wide medical record for Current Procedural Terminology and International Classification of Diseases, Ninth and Tenth Revision codes for all included procedures and patient perioperative data. Our primary outcome was 30-day hospital readmission, and our secondary outcome was 30-day emergency department (ED) visits. Perioperative data and 30-day outcomes were compared using χ for categorical variables and Kruskal-Wallis for continuous variables. We performed a multivariate logistic regression adjusting for perioperative variables and their potential effect. Results Of the 13,445 patients undergoing pelvic reconstructiverative characteristics, there was no statistically significant difference in the readmission risk for individuals with same-day discharge compared with next-day discharge among those with (adjusted odds ratio [aOR] 0.91; 95% CI 0.61-1.36; P=.63) and without (aOR 0.86; 95% CI 0.58-1.27; P=.45) a concomitant hysterectomy. For the secondary outcome of 30-day ED visits, we found no statistically significant differences when comparing same-day with next-day discharge for the entire cohort, those with concomitant hysterectomy, or when controlling for patient and perioperative characteristics. Conclusion In women undergoing minimally invasive pelvic reconstructive surgery within a large managed care organization, there is no difference in 30-day readmission or ED visit rates between those discharged the same day and those discharged the next day. When considering patient factors, same-day discharge after minimally invasive pelvic reconstructive surgery may be safe and play an important role in value-based care.Objective To investigate the safety and efficacy of elagolix, an oral gonadotropin-releasing hormone antagonist, with hormonal add-back therapy for up to 12 months in women with heavy menstrual bleeding associated with uterine leiomyomas. Methods Elaris UF-EXTEND was a phase 3 extension study that evaluated an additional 6 months (up to 12 months total) of elagolix 300 mg twice daily with hormonal add-back therapy (estradiol 1 mg and norethindrone acetate 0.5 mg once daily) in women who completed an initial 6 months of the same treatment in one of two preceding phase 3 studies. The primary endpoint was the percentage of women with both less than 80 mL menstrual blood loss during final month and a 50% or greater reduction in menstrual blood loss from baseline to final month. Safety evaluations included adverse events and bone mineral density changes. The planned sample size of UF-EXTEND was based on estimated rollover and discontinuation rates in the two preceding studies. Results From September 2016 to March sociated with an additional 6 months of elagolix with addback therapy. Clinical trial registration ClinicalTrials.gov, NCT02925494. Funding source AbbVie Inc funded this study.Objective To evaluate the association of different contraceptive methods on the incidence and severity of acne. Methods Using a de-identified commercial claims database, we performed a retrospective cohort study evaluating the incidence of clinical encounters for acne in the first year after initiation of contraception among female patients aged 12-40 years who were new contraceptive users. To evaluate the association of contraception class with acne severity, a subgroup analysis was performed among a cohort of patients with a history of acne examining the incidence of treatment escalation from topical acne medications to an oral tetracycline-class antibiotic in the year after initiation of contraception. DPCPX clinical trial Results Among new contraceptive users with no history of acne (N=336,738), compared with combined oral contraceptives (OCs), the copper intrauterine device (IUD) (hazard ratio [HR] 1.14; 95% CI 1.01-1.29) and levonorgestrel IUDs (HR 1.09; 95% CI 1.03-1.16) were associated with increased risk of clinical encounters with acne. Among those with a history of acne (n=21,178), compared with combined OCs, the copper IUD (HR 1.44; 95% CI 1.00-2.06) and levonorgestrel IUDs (HR 1.34; 95% CI 1.10-1.64) were associated with increased risk of treatment escalation from topical acne medications to an oral tetracycline class antibiotic. Conclusion Combined OCs appear to be associated with a modest (or small) protective effect with respect to incident acne and treatment escalation compared with other contraceptive methods. However, absolute differences between contraceptive methods were small.Objective To evaluate the prevalence and features of policies regulating abortion in U.S. teaching hospitals. Methods In this mixed-methods study, we conducted a national survey of obstetrics and gynecology teaching hospitals (2015-2016) and qualitative interviews (2014 and 2017) with directors at obstetrics and gynecology residency programs. We asked participants about hospital regulations on abortion and their perceptions of the nature and enforcement of these policies. Interview analysis was conducted with a grounded theoretical approach and informed development of the survey. The prevalence of policies was described using survey data; differences in policy structures by region were analyzed using a series of logistic regression models. Results Directors from 169 of 231 eligible training programs responded to the survey (73%). Institutional policies limited abortion beyond state law in 57% of teaching hospitals, most commonly in the Midwest and South (odds ratio [OR] 4.3, P less then .01 for Midwest; OR 4.e law to the detriment of abortion access and training opportunities. Vague or unwritten abortion policies, although difficult to navigate, gave health care providers some agency and flexibility over their practices.