Clinical Scorecard: 10 widely used sources informing ObGyn care

At a Glance

Key Highlights

• ASCCP risk-based guidelines use current and prior HPV and cytology results to estimate cervical precancer risk and support management decisions.
• SMFM fetal growth restriction guidance covers diagnostic criteria, ultrasound evaluation, umbilical artery Doppler assessment, fetal surveillance, and timing of delivery.
• In the CHAP trial, targeting blood pressure below 140/90 mm Hg in pregnant patients with mild chronic hypertension was associated with a lower primary composite outcome, with no increase in small-for-gestational-age birth weight.
• In the ARRIVE trial, induction at 39 weeks in low-risk nulliparous patients was associated with a lower cesarean delivery rate; the composite adverse perinatal outcome did not differ significantly between groups.
• The Menopause Society statement supports tailoring hormone therapy to patient circumstances and regular reassessment over time.

Guideline-Based Recommendations

Diagnosis

• Use current and prior HPV and cytology results to estimate cervical precancer risk under the ASCCP risk-based framework.
• Apply SMFM diagnostic criteria for fetal growth restriction and its recommended ultrasound evaluation.
• The ASRM guidance addresses infertility testing, timing of evaluation, circumstances warranting earlier assessment, and concurrent evaluation of both partners when male factor may contribute.
• The Tyrer-Cuzick model estimates a woman’s likelihood of developing breast cancer using family history, genetic predisposition, reproductive factors, and benign breast disease history.

Management

• ACOG guidance addresses diagnosis and management of gestational hypertension and preeclampsia.
• SMFM guidance includes recommendations for umbilical artery Doppler assessment, fetal surveillance, and timing of delivery in fetal growth restriction.
• In the CHAP trial, targeting blood pressure below 140/90 mm Hg in pregnant patients with mild chronic hypertension was associated with a lower primary composite outcome than reserving treatment for severe hypertension.
• In the ARRIVE trial, induction at 39 weeks in low-risk nulliparous patients was associated with a lower cesarean delivery rate than expectant management.
• ACOG guidance reviews candidate selection and key aspects of incorporating contraceptive implants and intrauterine devices into clinical practice.
• The Menopause Society statement addresses hormone therapy for menopausal symptoms and bone health and supports tailoring treatment to patient circumstances.

Monitoring & Follow-up

• SMFM fetal growth restriction guidance includes fetal surveillance.
• The Menopause Society statement supports regular reassessment of hormone therapy over time.

Risks

• Gestational hypertension and preeclampsia are associated with substantial maternal and perinatal morbidity and mortality.
• The CHAP trial reported no increase in small-for-gestational-age birth weight with active treatment targeting blood pressure below 140/90 mm Hg.
• The ARRIVE trial found no statistically significant difference between groups in its composite adverse perinatal outcome.
• The Women’s Health Initiative randomized trials evaluated health effects of menopausal hormone therapy, including outcomes related to menopausal symptoms, cardiovascular disease, cognition, bone health, and other long-term outcomes.

Patient & Prescribing Data

The source addresses ObGyn care broadly; specific study populations include pregnant patients with mild chronic hypertension, low-risk nulliparous patients, and postmenopausal women.

The source describes the CHAP trial strategy of targeting blood pressure below 140/90 mm Hg, ARRIVE trial induction at 39 weeks, ACOG considerations for contraceptive implants and intrauterine devices, and Menopause Society guidance on individualized hormone therapy with regular reassessment.

Clinical Best Practices

• Use the ASCCP risk-based framework to manage abnormal cervical screening results using current and prior HPV and cytology results.
• Follow SMFM guidance for fetal growth restriction diagnosis, ultrasound evaluation, Doppler assessment, fetal surveillance, and timing of delivery.
• Follow ASRM guidance on infertility evaluation, including concurrent evaluation of both partners when male factor may contribute and assessment timing, including circumstances warranting earlier evaluation.
• The Menopause Society statement supports tailoring hormone therapy to patient circumstances and regular reassessment over time.
• The Tyrer-Cuzick model estimates breast cancer likelihood using family history, genetic predisposition, reproductive factors, and benign breast disease history.

Related Resources & Content