Obstetrics and gynecology最新文献

{"title":"Neighborhood-Level Socioeconomic Vulnerability and Perioperative Complications in Hysterectomy for Benign Indications.","authors":"Liron Bar-El,N Brandon Barba,Ernie Shippey,Pamela Garcia-Filion,Rosanne M Kho,Megan S Orlando","doi":"10.1097/aog.0000000000006086","DOIUrl":"https://doi.org/10.1097/aog.0000000000006086","url":null,"abstract":"OBJECTIVETo evaluate the association between neighborhood-level socioeconomic vulnerability, measured by the VVI (Vizient Vulnerability Index) and perioperative complications after hysterectomy for benign conditions.METHODSThis retrospective cohort study analyzed patients who underwent hysterectomy for benign indications (2015-2024) using the Vizient Clinical Database. Patients were categorized into VVI quartiles (quartile 1, least vulnerable; quartile 4, most vulnerable) based on census tract data across nine socioeconomic domains: public safety, transportation, social cohesion, environmental quality, housing, neighborhood resources, health care access, education, and income. The primary outcome was the occurrence of perioperative complications, classified as major, minor, or any complication, with the Clavien-Dindo scale. Logistic regression was used to estimate the association between neighborhood vulnerability and surgical complications. Additional analyses evaluated the association of specific individual- and neighborhood-level social determinants, with race included as a marker of structural racism exposure, and perioperative outcomes.RESULTSAmong 1,055,338 patients, 18.4% (n=194,002) experienced complications, including 4.4% (n=46,356) major and 16.0% (n=169,361) minor complications. Complication rates increased proportionally across VVI quartiles (P<.001). Major complications rose from 3.6% in quartile 1 to 5.7% in quartile 4; minor complications increased from 13.8% to 19.8%; and any complications increased from 15.9% to 22.5%. Higher VVI quartiles were associated with increased odds of major, minor, and any complications compared with quartile 1, with the strongest effects in quartile 4. After adjustment, the association remained significant for quartiles 3 and 4. Comorbidities were the strongest individual-level predictor. Black race, as a marker of structural racism exposure, was independently associated with complication risk across all VVI quartiles.CONCLUSIONWe demonstrate that VVI, a measure of neighborhood-level social vulnerability, is associated with perioperative complications at the time of hysterectomy for benign indications independently of individual-level factors. Patients in the two most vulnerable quartiles experienced poorer outcomes compared with those in the least vulnerable quartile. Racial disparities, particularly affecting Black patients, persisted across VVI categories, reflecting the compounded influence of structural racism and neighborhood inequities.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"68 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Characterization and Clinical Implications of Endometrial Cancer.","authors":"Angeles Alvarez Secord,Matthew A Powell,Jessica McAlpine","doi":"10.1097/aog.0000000000006080","DOIUrl":"https://doi.org/10.1097/aog.0000000000006080","url":null,"abstract":"The classification of endometrial cancer (EC) has diverged from traditional histologic features based on microscopic appearance to objective molecular characterization. Molecular characterization of EC is pivotal to inform prognosis and to guide therapeutic recommendations. First described by the Cancer Genome Atlas, molecular profiling was later revised by the Proactive Molecular Risk Classifier for Endometrial Cancer and TransPORTEC algorithms to create clinically applicable and relatively easy-to-implement molecular classification systems. Since 2020, the World Health Organization recommended molecular classification of EC into four distinct prognostic subtypes: ECs with polymerase ε (POLE) pathogenic mutations assessed by gene sequencing, mismatch repair deficiency determined by immunohistochemistry or microsatellite instability assay, and p53 abnormalities determined by immunohistochemistry or next-generation sequencing. The final molecular subtype without any of these defining features is called \"no specific molecular profile\" (NSMP). This is further stratified by estrogen receptor (ER) immunohistochemistry status. Patients with cancers identified as POLE pathogenic mutations have the best prognosis with almost no recurrence or death events, followed by those with strong ER-positive NSMP cancers. Mismatch repair deficiency ECs have intermediate prognosis, whereas p53 abnormalities and ER-negative NSMP have the worst prognosis. Other molecular and pathologic biomarkers of interest include tumor mutational burden, human epidermal growth factor receptor 2, L1 cell adhesion molecule, β-catenin (CTNNB1), and lymph vascular space invasion, which may have prognostic and predictive implications. The current guidelines will continue to evolve; however, at minimum, it is recommended that all patients undergo testing for mismatch repair, p53, and ER, and POLE testing may be prioritized in select circumstances. Molecular classification provides the critical framework to deliver effective, personalized, high-quality care and informs clinical trial design. Molecular assessment ensures consistent diagnosis and provides prognostic information and predictive data to guide appropriate management.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"37 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mpox Among Pregnant Women and Their Infants in the U.S. Outbreak, 2022-2023.","authors":"Nicole M Roth,Hailee M Hutcherson,K Meryl Davis,Khue Nguyen,Hanvit Oh,Suzanne M Newton,Varsha Neelam,Emily O Olsen,Anthony Merriweather,Teri' Willabus,Umme-Aiman Halai,Grace Lee,Joyce Chou,Erin Ricketts,Kathryn Aveni,Amanda Shinall,Ayomide Sokale,Marco Tori,Rose Devasia,Andrea M McCollum,Victoria Shelus,Patricia A Yu,Yon Yu,Van T Tong,Alison Fountain,Dana Meaney-Delman","doi":"10.1097/aog.0000000000006072","DOIUrl":"https://doi.org/10.1097/aog.0000000000006072","url":null,"abstract":"OBJECTIVETo describe pregnancy and treatment outcomes among pregnant and recently pregnant women with mpox and their infants reported during the clade II mpox outbreak in the United States.METHODSMaternal, pregnancy, and infant outcomes related to mpox were monitored through the use of the enhanced methods of SET-NET (Surveillance for Emerging Threats to Mothers and Babies Network), a pregnant woman-infant-linked surveillance program. Thirteen state and local health departments collected data on pregnant or recently pregnant women with laboratory-confirmed mpox reported during August 1-December 31, 2022. Demographics, maternal health history, laboratory results, treatment, and pregnancy and infant outcomes were abstracted from medical records and linked data sources such as birth certificate data and Investigational New Drug registries.RESULTSTwenty-six pregnant or recently pregnant women with mpox in the United States were reported to the Centers for Disease Control and Prevention. Trimester of infection was known for 23 women: six (24.0%) infections occurred in the first trimester, nine (36.0%) in the second trimester, and eight (32.0%) in the third trimester. Among 23 pregnant women with known outcome, 19 had live births, three of whom delivered preterm, and four had pregnancy losses. Fourteen pregnant women received tecovirimat to treat mpox under an Investigational New Drug protocol with no adverse effects reported. Two neonates were diagnosed with mpox within 2 weeks of life; in these cases, the mothers tested positive for mpox at 2 and 12 days after delivery. Both neonates received tecovirimat, and one neonate also received vaccinia immune globulin intravenous. No adverse effects were reported after neonatal tecovirimat administration except for a suspected drug-related rash in one neonate. The association between tecovirimat and outcomes could not be evaluated because of insufficient sample size.CONCLUSIONIn this descriptive report of pregnant and recently pregnant women with clade II mpox, there were no adverse maternal outcomes. Two neonates were diagnosed with mpox among 23 pregnancies with known outcomes. There were no reported adverse events related to tecovirimat administration in pregnant mothers.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"16 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145036008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Disparities in Patients Undergoing Surgery for Pelvic Floor Disorders: A Systematic Review.","authors":"Cecilia K Wieslander,Cara L Grimes,Ethan M Balk,Ankita Gupta,Tamara G Grisales,Ruchira Singh,Amanda B White,Deslyn T G Hobson,Nancy E Ringel,Francisco Orejuela,Tatiana V D Sanses,Lioudmila Lipetskaia,Monica L Richardson,Kate V Meriwether,Danielle D Antosh, ","doi":"10.1097/aog.0000000000006061","DOIUrl":"https://doi.org/10.1097/aog.0000000000006061","url":null,"abstract":"OBJECTIVETo explore how patient characteristics related to health care disparities are associated with access to care and clinical outcomes among patients receiving surgical treatment for pelvic floor disorders in the United States.DATA SOURCESWe searched MEDLINE, EMBASE, and ClinicalTrials.gov through March 25, 2024.METHODS OF STUDY SELECTIONPatient characteristics related to health care disparities included race, ethnicity, geographic location, and insurance status, among others. Outcomes included access to surgery, surgical outcomes, and patient-reported outcomes. Eligible studies reported multivariable regression analyses that included at least one patient characteristic related to health care disparities and an included study outcome. For each outcome, we describe the consistency (in direction), strength of association, and number of studies of the patient characteristic related to health care disparities. Meta-analysis was not performed because of study heterogeneity. This review was conducted by the Systematic Review Group of the Society of Gynecologic Surgeons.TABULATION, INTEGRATION, AND RESULTSOf 6,853 abstracts screened, 42 studies with a total of 84 multivariable analyses were included. Characteristics associated with decreased access to apical suspension during prolapse surgery included being from a rural area or of Hispanic ethnicity, and Black racial identity was associated with decreased access to mesh augmentation. Black racial identity and Hispanic ethnicity were also associated with decreased access to reconstructive prolapse repair compared with obliterative procedures and hemorrhage during prolapse repair; older age and having Medicare insurance were associated with increased risk of overall complications. Not being from the Northeast was associated with increased risk of overall complications after prolapse surgery. Patients from a minority race were less likely to undergo reoperation after stress urinary incontinence (SUI) surgery. Black race was not associated with complications after SUI surgery.CONCLUSIONPatients in minoritized groups in the United States, those with Medicare insurance, and those not from the Northeast were more likely to have health care disparities related to surgical treatment for pelvic floor disorders.SYSTEMATIC REVIEW REGISTRATIONPROSPERO, CRD42021234511.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"35 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intervention Counseling for Return to Sex After Urogynecologic Surgery: A Randomized Controlled Trial.","authors":"Shunaha Kim-Fine,Lauren Caldwell,Jaime Long,Kate V Meriwether,Shilpa Iyer,Christine A Heisler,Patricia Hudson,Katherine Husk,Svjetlana Lozo,Veronica Demtchouk,Beili Huang,Danielle D Antosh,Rebecca G Rogers, ","doi":"10.1097/aog.0000000000006064","DOIUrl":"https://doi.org/10.1097/aog.0000000000006064","url":null,"abstract":"OBJECTIVETo compare the effect of intervention on patients' postoperative preparedness to return to sexual activity after pelvic organ prolapse (POP) or urinary incontinence (UI) surgery compared with the usual counseling regarding the first sexual encounter.METHODSThis multicenter randomized clinical trial recruited individuals who were planning to be sexually active after surgery for POP or UI; the patients who were randomized to intervention or usual counseling at 6 to 8 weeks postoperatively. The primary outcome was preparedness to return to sexual activity. Patients were considered prepared if they answered \"strongly agree\" or \"agree\" on a 6-point Likert scale to the statement, \"Overall, I feel prepared for resuming sexual activity after my surgery.\" Participants were contacted at 1-month intervals up to 6 months postoperatively; when they reported return to sexual activity, they completed preparedness and pain scales and the PISQ-IR (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, IUGA-Revised).RESULTSOf 186 patients, 170 (91.4%) completed follow-up and were included in the analyses. There was no difference in preparedness to return to sexual activity, at the time of returning to sexual activity within 6 months. However, there were differences noted 6 to 8 weeks after the intervention counseling. Patients randomized to intervention counseling reported higher preparedness to return to sexual activity (odds ratio [OR] 2.42, 95% CI, 1.03-5.65), lower likelihood of experiencing dyspareunia (OR 0.27, 95% CI, 0.09-0.86), and an earlier return to sexual activity (hazard ratio 1.46, 95% CI, 1.06-2.01). Before the intervention, 57 (33.5%) patients returned to sexual activity. In sensitivity analysis of the remaining 113 participants, intervention counseling remained associated with greater preparedness at 6-8 weeks postoperatively (81.0% vs 56.9%, adjusted OR 4.82, 95% CI, 1.66-13.99).CONCLUSIONIntervention counseling regarding return to sexual activity after surgeries for POP or UI was not associated with improved patient preparedness at the time of return to sexual activity but did improve preparedness and decrease dyspareunia at 6-8 weeks, compared with usual counseling. Despite counseling otherwise, nearly a third of participants returned to sexual activity before 6-8 weeks postoperatively.CLINICAL TRIAL REGISTRATIONClinicalTrials.gov, NCT05342090.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"84 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic Floor Trigger Point Injections in the Management of Myofascial Pelvic Pain.","authors":"Jaya Prakash,Prashila Amatya,Golnaz Namazi","doi":"10.1097/aog.0000000000006059","DOIUrl":"https://doi.org/10.1097/aog.0000000000006059","url":null,"abstract":"","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"58 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic Disparities in Obstetric Care Access in the United States.","authors":"Valerie Chen,Xiaohan Ying,Elleana Majdinasab,Regan Theiler","doi":"10.1097/aog.0000000000006069","DOIUrl":"https://doi.org/10.1097/aog.0000000000006069","url":null,"abstract":"Understanding the distribution of obstetrician-gynecologists (ob-gyns) is crucial to combatting inequities in care access throughout the United States. In this cross-sectional study, we used data from the Health Resources & Services Administration to characterize counties with and without ob-gyns. Of the 3,143 U.S. counties analyzed, 1,473 (46.9%) did not have a single ob-gyn. Counties without ob-gyns were more likely to be nonmetropolitan (57.5% vs 44.6%, P<.01), have a lower median household income ($52,989 vs $59,470, P<.01), and have a greater proportion of White residents (87.6% vs 79.0%, P<.01). Notably, only 103 (7.0%) counties without an ob-gyn had any midwives. Inequities in maternity care provision remain a significant issue in the United States, creating a need for creative policy solutions to improve access.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"18 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications and Recurrence After Pelvic Exenteration for Gynecologic Malignancies: Survival Analysis From the COREPEX Study.","authors":"Nicolò Bizzarri,Denis Querleu,Giulio Ricotta,Diana Giannarelli,Mihai Emil Cãpîlna,Santiago Domingo,Vito Chiantera,Hüseyin Akıllı,David Cibula,Zoltan Novák,Diana Zach,Andrea Miranda,Porfyrios Korompelis,Enrique Chacon,Ignacio Zapardiel,Björn Lampe,Valentyn Svintsitskyi,Olga Matylevich,Gabrielle H van Ramshorst,Cagatay Taskiran,Fuat Demirkıran,Tibor Lengyel,Giuseppe Vizzielli,Matteo Loverro,Gwenael Ferron,Alejandra Martinez,Elodie Gauroy,Emmanuel Ladanyi,Szilard Leo Kiss,Victor Lago,Manel Montesinos-Albert,Mariano Catello Di Donna,Giuseppe Cucinella,Ali Ayhan,Jiri Slama,Viktória Rosta,Sahar Salehi,Mustafa Zelal Muallem,Ali Kucukmetin,Giovanni Scambia","doi":"10.1097/aog.0000000000006051","DOIUrl":"https://doi.org/10.1097/aog.0000000000006051","url":null,"abstract":"OBJECTIVETo collect data from patients undergoing pelvic exenteration in recent clinical practice. The primary aim was 5-year disease-free survival. Secondary aims were 5-year overall survival, patterns of recurrence, identification of subgroups at higher risk of recurrence and death, survival associated with lymph node metastasis, and development of a prognostic score.METHODSThis was a retrospective, multicenter, international study conducted in tertiary national gynecologic oncology referral centers. Inclusion criteria included cervical, vaginal, vulvar, or endometrial cancer; anterior or total pelvic exenteration performed between January 2005 and March 2023; curative or palliative intent; and with or without laterally extended endopelvic or pelvic resection. Patients were excluded if they underwent posterior pelvic exenteration only or if preoperative computed tomography (CT), positron emission tomography (PET)-CT, or PET was not performed. A prognostic score was developed that was based on multivariable analysis.RESULTSEight hundred sixty-two patients were included. Surgical margins were tumor free in 676 (78.4%). In patients treated with curative intent, total pelvic exenteration, positive surgical margins, and presence of lymphovascular space invasion were independently associated with worse disease-free survival. Performance of lymphadenectomy was associated with better disease-free survival. Total pelvic exenteration, positive surgical margins, and presence of lymphovascular space invasion were factors independently associated with decreased overall survival. Performing pelvic exenteration at time of persistent (instead of recurrent) disease negatively affected overall survival. Prognostic score identified four risk groups with a 5-year disease-free survival of 43.7%, 24.9%, 22.2%, and 8.0% (P<.001). The 5-year overall survival in the four risk groups was 54.3%, 40.4%, 24.0%, and 4.3% (P<.001). The most frequent sites of recurrence were distant in 166 patients (32.1%). The 5-year disease-free survival and cancer-specific survival in patients with para-aortic lymph node metastasis were significantly worse compared with those in patients with pelvic-only metastatic nodes or with negative nodes (P=.002 and P<.001, respectively).CONCLUSIONIndependent factors associated with worse disease-free survival and overall survival and subgroups of patients at higher risk of recurrence and death were identified. A multivariable prognostic score was developed that can be used for patient counseling and surveillance strategies and for future prospective studies.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"51 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decline in Rate of Radical Hysterectomies Performed by Gynecologic Oncologists in the United States.","authors":"Isabela Covelli Velez,Alicia Youssef,Siguo Li,Allison Gockley,Amy Bregar,Varvara Mazina,Alexander Melamed","doi":"10.1097/aog.0000000000006068","DOIUrl":"https://doi.org/10.1097/aog.0000000000006068","url":null,"abstract":"Trends in cervical cancer epidemiology and physician workforces have converged to make radical hysterectomy an increasingly rare procedure for gynecologic oncologists practicing in the United States. Using data from the National Cancer Database and the Centers for Disease Control and Prevention's United States Cancer Statistics and published gynecologic oncology workforce data, we assessed trends in radical hysterectomy performed in the United States from 2004 to 2020. Over this period, the annual rate of radical hysterectomies per gynecologic oncologist declined significantly, by an average of 6.9% per year (95% CI, 6.4-7.5), corresponding to a decrease from 4.5 to 1.5 cases per oncologist per year. The increasing rarity of radical hysterectomy may pose a challenge to those seeking to acquire and maintain competency in this complex operation.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"214 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elimination of the DATA-Waiver Program.","authors":"","doi":"10.1097/AOG.0000000000006066","DOIUrl":"https://doi.org/10.1097/AOG.0000000000006066","url":null,"abstract":"<p><p>This Clinical Practice Update provides revised guidance related to an update to the requirements related to the elimination of the DATA-Waiver program. This document is a focused update of related content in Committee Opinion No. 711, Opioid Use and Opioid Use Disorder in Pregnancy (Obstet Gynecol 2017;130:e81-94).</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}