Objective:

The article examines the objective, findings, and clinical context described in Top 10 evidence-based essentials in ObGyn.

Approach:

• Cervical screening: ASCCP risk-based guidelines use current and prior HPV and cytology results to estimate precancer risk and guide management.
• Hypertensive disorders of pregnancy: ACOG’s practice bulletin provides guidance on diagnosing and managing gestational hypertension and preeclampsia.
• Fetal growth restriction: SMFM Consult Series #52 addresses diagnosis, ultrasound and umbilical artery Doppler assessment, fetal surveillance, and delivery timing.
• Infertility evaluation: ASRM guidance covers evaluation timing, indications for earlier assessment, diagnostic testing, and concurrent evaluation of both partners when relevant.
• Chronic hypertension trial: The trial compared targeting blood pressure below 140/90 mm Hg with reserving treatment for severe hypertension during pregnancy.
• ARRIVE trial: The trial compared induction at 39 weeks with expectant management in low-risk nulliparous patients.
• Women’s Health Initiative: Randomized trials evaluated menopausal hormone therapy and outcomes including symptoms, cardiovascular disease, cognition, and bone health.
• Long-acting reversible contraception: ACOG guidance reviews candidate selection and clinical use of contraceptive implants and intrauterine devices.

Key Findings:

• In the Chronic Hypertension and Pregnancy trial, targeting blood pressure below 140/90 mm Hg was associated with a lower incidence of the primary composite outcome than reserving treatment for severe hypertension; active treatment did not increase small-for-ge…
• In ARRIVE, induction at 39 weeks was associated with a lower cesarean delivery rate than expectant management; the groups did not differ significantly in the composite adverse perinatal outcome.

Interpretation:

The framework brings together clinical guidance, trial findings, and risk-assessment tools relevant to multiple areas of ObGyn care.