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Choosing Wisely®

Society for Maternal-Fetal Medicine

Although in some studies, women with two prior cesarean deliveries who attempt a trial of labor after cesarean have a higher rate of complications than women with one prior cesarean delivery, the absolute risk of any major complication remains low and the chance of achieving a vaginal birth are similar to those who have one prior cesarean. Given the risk of maternal morbidity and placenta accreta spectrum associated with multiple repeat cesarean deliveries, a trial of labor should remain an ...

Choosing Wisely®

American Academy of Pediatrics – Section on Dermatology

Vitiligo is a depigmenting disorder believed to have an autoimmune origin. It is well-established that patients with nonsegmental vitiligo have an increased risk of other autoimmune conditions, with subclinical hypothyroidism being the most common. There is also a higher risk of having antithyroid antibodies (TPOs). Other autoimmune conditions have been associated with vitiligo but less commonly. Recognizing the risk of associated autoimmune conditions has led physicians to screen patients ...

Choosing Wisely®

Society for Maternal-Fetal Medicine

Group B streptococcus (GBS) bacteriuria at levels of 105 CFU/mL or greater, either symptomatic or asymptomatic, warrants acute treatment during pregnancy and indicates the need for intrapartum antibiotic prophylaxis at the time of birth, and thus no additional rectovaginal culture later in pregnancy is necessary. Identification of asymptomatic bacteriuria with GBS during pregnancy at a level less than 105 CFU/mL does not require maternal treatment during the antepartum period but is an ...

Choosing Wisely®

American Academy of Pediatrics – Section on Dermatology

Although systemic corticosteroids can lead to rapid clearing of disease and improvement in pruritus, many short- and long-term adverse effects limit their use, including significant growth retardation, adrenal suppression in more than 90%, and rebound flaring and/or worsening of disease at the time of corticosteroid discontinuation. Atopic dermatitis treatment guidance put forth by the American Academy of Dermatology specifically advises against the use of systemic steroids in children with ...

Choosing Wisely®

American Academy of Pediatrics – Section on Neurological Surgery

Routine imaging for the evaluation of infant head shape is not necessary. It exposes the child to unnecessary radiation. Positional plagiocephaly can be diagnosed on clinical examination. Most craniosynostosis presentations can also be discerned on clinical examination. Imaging may be obtained by specialists to make the diagnosis in complex cases and, if necessary, for surgical planning.