The Gray Journal
Audio Summaries

Analyzing the stagnation of cesarean delivery rates in the United States over the past 15 years

Mar 23, 2026

The authors investigate the factors contributing to the stagnation of cesarean delivery rates in the United States over the past 15 years, utilizing the modified Robson classification to analyze trends in cesarean rates across different categories. While cesarean rates decreased in several categories, they increased in others, particularly among women with previous cesareans and those undergoing induced labor. The study suggests that improved risk management may be influencing these trends, but highlights the need for further research to understand the impact of maternal comorbidities and neonatal outcomes.

The association between first trimester iron deficiency without anemia and the development of iron-deficiency anemia prior to childbirth

Mar 21, 2026

The authors aimed to investigate the relationship between first trimester iron deficiency without anemia (IDWA) and the subsequent development of iron-deficiency anemia (IDA) before childbirth. Their findings indicate that individuals with IDWA are nearly twice as likely to develop IDA compared to those who are iron-replete and non-anemic, highlighting the importance of early identification and treatment of IDWA to prevent adverse maternal outcomes.

Deep learning for Evaluation and Prediction of TecHnical Skills in robotic-assisted vaginal cuff closure (DEPTHS) study

Mar 21, 2026

The authors aimed to develop deep learning models to predict technical errors and assess surgical skills during robotic-assisted vaginal cuff closures in hysterectomies. By analyzing video segments of surgeries, they demonstrated that these models could objectively score surgical skills and identify errors, achieving strong correlations with established assessment tools. This proof-of-concept suggests that deep learning could enhance quality monitoring and credentialing in minimally invasive gynecological surgery, although further research with larger datasets is needed.

The impact of first birth by cesarean delivery on subsequent reproductive outcomes - a population cohort study

Mar 20, 2026

This study aimed to investigate the impact of having a first birth by cesarean delivery on subsequent reproductive outcomes, specifically the likelihood of a second live birth and the use of assisted reproductive technologies (ART). The findings revealed that women who had their first birth via cesarean were 11% less likely to have a second live birth and showed a 28% increase in the use of IVF or other ART methods for their second birth. The authors suggest that factors leading to cesarean deliveries may influence these reproductive outcomes and require further exploration.

Comparing NIH Funding for Cancer Survivorship: A Spotlight on Breast and Gynecologic Cancer

Mar 19, 2026

The authors aimed to evaluate the distribution of National Institutes of Health (NIH) funding for survivorship research in breast and gynecologic cancers from 2017 to 2021. Their findings revealed a significant disparity, with breast cancer research receiving $188.35 million for 4.1 million survivors, compared to only $15.41 million for 796,000 gynecologic cancer survivors, highlighting a critical need for more equitable funding and research efforts to support gynecologic cancer survivorship.

Asthma in pregnancy: Contemporary management

Mar 16, 2026

The authors aim to address the management of asthma during pregnancy, emphasizing that uncontrolled asthma poses significant risks for both maternal and fetal health. They review the biological mechanisms linking asthma to adverse outcomes and provide updated guidance on proactive management strategies, including the importance of maintaining asthma control to optimize pregnancy outcomes. Additionally, the paper highlights areas for future research, such as precision-guided care and biologic therapies.

Umbilical Artery Doppler Deterioration, Time to Delivery, and Risk of Fetal Death in Early-Onset Severe Fetal Growth Restriction Progressing to Absent or Reversed End-Diastolic Flow

Mar 16, 2026

The authors aimed to quantify the rate of progression of umbilical artery (UA) Doppler abnormalities, the time to delivery, and the risk of fetal death in a homogeneous cohort of singleton pregnancies with severe placenta-mediated early-onset fetal growth restriction (FGR). They found that the progression of UA Doppler abnormalities occurred over a mean of 7 days, with fetal death risk increasing significantly with the severity of Doppler abnormalities, highlighting the importance of monitoring and timely intervention in these high-risk pregnancies. The study provides critical data to guide clinical management and surveillance strategies for affected patients.

Parvovirus B19 Infection in Pregnancy: Perinatal Outcomes Derived from a Systematic Review and Meta-Analysis

Mar 12, 2026

This systematic review and meta-analysis aimed to evaluate the perinatal outcomes of Parvovirus B19 infection during pregnancy, particularly comparing the recent outbreak (2023-2024) with previous waves. The study found high rates of intrauterine demise and other complications associated with fetal infections, but no significant differences in these rates between the recent and earlier outbreaks. The findings underscore the need for improved prenatal management strategies and further research on therapeutic interventions and neuroimaging in affected cases.

Comparative effectiveness of intravenous remifentanil, epidural anesthesia and a two-step analgesic approach for external cephalic version: a large prospective single-center cohort study

Mar 7, 2026

This study aimed to compare the effectiveness and safety of three analgesic strategies—intravenous remifentanil, epidural anesthesia, and a two-step approach—during external cephalic version in singleton pregnancies. The results indicated that epidural anesthesia provided the highest success and vaginal delivery rates, along with better maternal pain control, although it was associated with a higher incidence of complications compared to the other methods. These findings can aid in informed decision-making regarding analgesic options for this procedure.

Venous Thromboembolism with Combined Oral Contraceptives Based on Estrogen and Progestin Content: A disproportionality analysis of the United States Food and Drug Administration Adverse Event Reporting System database

Mar 6, 2026

The authors aimed to compare the rates of venous thromboembolic adverse events associated with different combined oral contraceptives (COCs) based on their estrogen and progestin content, specifically focusing on body-identical estrogens versus ethinyl estradiol (EE). Their analysis of the FDA Adverse Event Reporting System revealed that COCs containing estetrol and 17β-estradiol had lower reporting rates of thromboembolic events compared to EE-based pills, indicating a potentially safer thrombotic profile for these body-identical estrogen formulations.