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 and joined the MJH Life Sciences team in December 2019. She graduated from Youngstown State University in 2019 with a bachelor's degree in journalism and a minor in political science. Prior to graduating, Morgan worked as the editor-in-chief of her college newspaper. She went on to work as an assignment editor at a broadcast news station in Youngstown, Ohio before joining 

 You can reach her at mpetronelli@mjhlifesciences.com.

Articles

Find out the top 5 latest updates and headlines in fertility research in honor of National Infertility Awareness Week (April 20-26, 2025).

Top 5 recent updates in fertility research 

A new study found that older women experiencing persistent or changing social isolation are at higher risk of unhealthy eating habits.

Social isolation linked to poorer diet in older women

A new survey highlights gender differences in knowledge and attitudes toward GLP-1/GIP receptor agonists.

Women show greater awareness and understanding of obesity medications

Review some of the top stories from the Contemporary OB/GYN website over the last week, and catch up on anything you may have missed.

Contemporary OB/GYN week in review: Menstrual symptoms, cognitive decline, and more

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A Psychedelic to Treat Postpartum Depression?

CMV: In the Know

RSV Roundtable

STIs

Supplement: Closing the Gap in Cervical Cancer Screening

Vaginismus: Managing a Misunderstood and Underdiagnosed Condition

Why vNOTES Make Sense for My Patients

1rem

Authors

Dr. Komkwuan Paruchabutr, DNP, WHNP-BC, FNP-BC, CNM, FACNM, FNAP, is president of the National Association of Nurse Practitioners in Women’s Health.

Read our latest Letter to the Editor, focusing on health plans and the ACA contraceptive requirements.

Your Voice: Why can’t we get health plans and PBMS to comply with the affordable care act contraceptive requirements?

Saying "obstetrician-gynecologist" is a mouthful for most people, and it's probably the most abbreviated specialty in medicine, both spoken and written. However, there doesn't seem to be a consensus on how to pronounce OB-GYN. First, is it the two-syllable "O-B" or the monosyllabic "Ob"? Second, is it "gin" or "gyne" (like "Lyme")? I wonder if you have a preference. I know I do.

Almost nobody says "obstetrician-gynecologist" when speaking about these specialist physicians. But what's the "correct" way to pronounce OB/GYN?

Is It Ob-Gin or Ob-Gyne?

Breast cancer is often diagnosed at an earlier stage among women with a history of screening mammography, reducing associated mortality, according to a recent study published in 

Screening recommendations and evidence gaps

The US Preventive Services Task Force (USPSTF) recommends women aged 40 to 75 years receive biannual screening to improve the odds of early breast cancer detection.

 However, the USPSTF has also stated the evidence to recommend screening in women aged over 75 years is currently insufficient.

“Identifying this potential difference in health outcomes based on screening history may facilitate a more accurate evaluation of screening effectiveness,” wrote investigators.

The cohort study was conducted to determine the link between screening history and breast cancer outcomes among older US women. Data was obtained from the Surveillance, Epidemiology and End Results-Medicaid linkage between January 1, 2005, and December 30, 2020.

This data included screening history, demographics, biology, cancer diagnosis, and treatment for breast cancer patients. Women aged at least 70 years with estrogen receptor-positive or human epidermal growth factor receptor 2–negative breast cancer determined by screening mammogram were included in the analysis.

Additional eligibility criteria included continuous Medicaid coverage from 5 years before diagnosis through 1 year following diagnosis. Receiving 1 or more screening mammogram within 5 years before diagnosis was defined as the exposure, with patient categories including no vs any screening before diagnosis.

The stage at diagnosis was reported as the primary outcome, classified as either very early or later stage diagnosis. Diagnoses were made based on American Joint Committee on Cancer TNM stages. Demographic, socioeconomic, tumor, and treatment-related covariates were obtained during diagnosis.

There were 13,028 patients included in the analysis, 3.6% of whom were Asian, 4.2% Hispanic, 6.2% non-Hispanic Black, 84.3% non-Hispanic White, and 1.7% other or unknown race and ethnicity. Of women, 38.5% were aged 70 to 74 years and 30.9% were aged 75 to 79 years.

Prior screening was reported in 77.5% of participants overall. Those with at least 1 primary care physician or annual wellness visit, aged 70 to 74 years, and non-dual eligible had increased rates, at 78.1%, 79.1%, and 79.9%, respectively.

Later-stage disease was reported in 29.3% of women at diagnosis, with a rate of 25.1% among women with prior screening. Among those without prior screening, the prevalence of later-stage diagnosis was 43.4%. This indicated a 54% reduced chance of being diagnosed at a later stage when having prior screening, with an adjusted odds ratio (aOR) of 0.46.

Being dual eligible and living in regions with higher poverty and lower education were also linked to later-stage diagnosis, with aORs of 1.17, 1.21, and 0.83, respectively. In patients with grade 3 or grade 4 tumors vs grade 1 tumors, the aOR for later diagnosis was 4.90.

The odds of breast cancer mortality were also significantly reduced among women with prior screening, at a rate of 3.3% vs 8% among women with no prior screening. This indicated an aOR of 0.63 for breast cancer-specific death among this population.

These results indicated earlier stage of diagnosis for breast cancer and reduced mortality among women aged at least 70 years with prior screening mammography. Investigators noted limitations in the data because of residual cofounding.

“Our findings support the potential for routine screening to improve breast cancer outcomes,” investigators concluded.

Huang S, Westvold SJ, Soulos PR, et al. Screening history, stage at diagnosis, and mortality in screen-detected breast cancer. 

. 2025;8(4):e255322. doi:10.1001/jamanetworkopen.2025.5322

Nicholson WK﻿, Silverstein M﻿, Wong JB﻿, et al; US Preventive Services Task Force.Screening for breast cancer: US Preventive Services Task Force recommendation statement.﻿

. 2024;331(22):1918-1930. doi:10.1001/jama.2024.5534

A new study found that routine mammography significantly reduces late-stage diagnoses and mortality in women aged 70 years and older.

Clinical

Screening mammograms linked to earlier breast cancer detection

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, April 14, 2025 - Friday, April 18, 2025), and click each link to read and watch anything you may have missed.

Mitchell Creinin, MD, reports estetrol pill eases menstrual symptoms

 Mitchell Creinin, MD, professor at University of California Davis Health, discussed a study evaluating the impact of estetrol combined with drospirenone, a novel oral contraceptive, on premenstrual and menstrual symptoms.

This was a planned secondary analysis of a phase 3 trial conducted in the United States and Canada, designed to assess not only contraceptive effectiveness but also the impact on menstrual complaints using the Menstrual Distress Questionnaire. A similar study had already been conducted and published in Europe and Russia. Due to demographic and clinical differences in the participant populations, the results were not pooled but analyzed separately.

The results showed that switchers generally reported low levels of menstrual distress at baseline, and those levels remained stable, indicating that switching to estetrol/drospirenone maintained their symptom relief. In contrast, starters showed a significant decrease in symptom intensity across key domains, particularly pain, water retention, and negative affect. Symptoms such as cramps, headaches, back pain, fatigue, swelling, tender breasts, anxiety, and irritability notably improved, with many showing at least a 40% reduction in severity.

Early menopause linked to increased risk of cognitive decline

Women with early menopause are at an increased risk of 2-year follow-up cognitive decline, according to a recent study published in 

Alzheimer's & Dementia: The Journal of the Alzheimer's Association.

Women are disproportionately impacted by dementia compared to men, highlighting potential sex-specific risk factors. A link has also been established between early menopause and depression, which increases the risk of dementia. This led investigators to evaluate the association between early menopause and cognitive function.

“Since early menopause increases the risk of depression, which then increases the risk of dementia, we had to control for this factor to determine if early menopause in of itself was a direct risk factor,” said Miharu Nakanishi, PhD, lead author from the Tohoku University Graduate School of Medicine.

Contraception for patients with mental health conditions

Mental health conditions affect about 1 in 7 people globally. Anxiety and depressive disorder account for most cases. 

Reproductive-age females are more likely to be affected by depression and anxiety disorders than men, with an age-standardized prevalence of 24% among women vs 13.3% among men in the US. Those who are pregnant or who are recently in the postpartum period are increasingly at risk; depressive disorders diagnosed during US delivery hospitalizations increased 7-fold from 4.1 diagnoses per 1000 hospitalizations in 2000 to 28.7 diagnoses per 1000 hospitalizations in 2015.

Perinatal mental health conditions are associated with adverse outcomes for the pregnant or postpartum person as well as fetus, infant, partner, or family. Additionally, perinatal depression may signal a trajectory for chronic depression and its lasting implications.

Outpatient cervical ripening with a Foley catheter

Labor induction is a common obstetric practice in the United States, occurring in 31.9% of deliveries in 2022. Elective induction rates have continued to rise since the publication of the results of the ARRIVE trial (NCT01990612) in 2018, which demonstrated a reduction in cesarean delivery and hypertensive disorders of pregnancy for low-risk nulliparous patients undergoing induction at 39 weeks.

The American College of Obstetricians and Gynecologists states that mechanical methods of outpatient labor induction may be an appropriate option in selected patient populations. Although a formal recommendation was not made, recent findings suggest this is a safe and effective alternative to inpatient practices. 

Cervical ripening balloons apply direct pressure to the internal cervical os, causing endogenous prostaglandin release. A bladder catheter (Foley) or a commercial intracervical balloon (eg, Cook Cervical Ripening Balloon) can be used with similar efficacy, although the Foley catheter is often more readily available and considered more cost-effective.

First baby born via fully automated ICSI system

The first baby was born using a fully automated, digitally controlled intracytoplasmic sperm injection (ICSI) system on April 10, 2025, as reported in 

Jacques Cohen, PhD, embryologist at Conceivable Life Sciences, led a multidisciplinary team of specialists alongside others to develop the automated system. It was developed to automate all 23 steps of ICSI, with either artificial intelligence (AI) or a remote operator independently performing the steps.

“With AI, the system autonomously selects sperm and precisely immobilizes its midsection with a laser ready for injection - executing this rapid, precise process with a level of accuracy beyond human capability,” said Mendizabal-Ruiz, PhD, lead engineer professor and an additional study head.

What is your diagnosis based on these images of the ovary?

Challenge your diagnostic skills with this image quiz: Is this ovarian lesion cystic in nature or something else?

Image IQ: Ovarian Cyst or Something Else?

Those of us in management have come to recognize meetings as an inevitable part of our workday. The greater your administrative to clinical time, the greater the amount of time you will spend in meetings both as a meeting participant and as a leader. the increased number of remote meetings has had a negative impact as the threshold for creating a meeting decreased and the ease of inviting participants to meetings increased. The cost of meetings is rarely considered, but the next time you are at meeting, think about this: It is not unreasonable to estimate that an hourlong meeting of clinicians may cost close to $1000 in missed clinical revenue. It is imperative that meetings are managed as effectively as any common clinical scenario.

Whillans et al describe 6 pitfalls that lead to excessive meetings

1. Meeting FOMO (fear of missing out): What will our colleagues, or worse, our bosses think of us declining an invitation for a meeting of marginal necessity? this is rooted in the belief that just being present is being productive.

2. Selfish urgency: As leaders, not everything that we think is important justifies disrupting others’ days or adding an extra hour to the workday.

3. Meeting as a commitment device: using a meeting solely to establish a deadline is not a great use of time.

4. The mere urgency effect: This is where we feel better for completing a task, no matter what the value is. An example is low-value regular meetings. If we complete a series of meetings, we feel we have accomplished something, even if we have not.

5. Meeting amnesia: this is the meeting to review what was accomplished (or not) at the previous meeting. A much better tactic would be real-time debriefs or distribution of meeting summaries.

6. Pluralistic ignorance: Chances are we are not the only one who recognizes that a standing meeting is a waste of time. Open dialogue can remove a standing meeting from our calendars. Action plans and end goals are neededthere is a lot of science around effective meetings. 

A review of 100 articles on the subject came up with some tips

: Do you really need a meeting? Can a quick call or email suffice? Invite the smallest number of people required. This not only makes the meeting easier to manage and more effective but will greatly facilitate its scheduling in a timely manner. Build an agenda and stick to it. This seems so simple yet is probably the most common reason a meeting succeeds or fails. Everyone should know the end goal of the meeting. An agenda describes the process, but an end point will drive efficiency. It is a great tool for refocusing those who may be derailing the meeting. End with an action plan and a follow-up deadline for items on the agenda. this will effectively reduce the frequency of a second, less valuable meeting. Allow participants to leave a meeting if they feel that they are not contributing or that the meeting is not of value. After evaluating whether a meeting is necessary, deciding who needs to attend, and establishing an agenda and goals, the next decision point is the duration of the meeting. Meeting content seems to follow the laws of natural gas: It will expand to fill the available allotted time. scheduling your meetings for shorter periods of time will force discipline around roles and agendas and will free your teams up to be more productive in other spaces. 

Lucy Handley takes the 30-minute meeting 1 step further and promotes a 15-minute meeting.

 The purpose of the 15-minute meeting is 2-fold. The 15-minute meeting is not just about going more quickly. It is about prework. The foundation of this prework is asynchronous communication. A shorter meeting requires individuals to read materials sent prior to the meeting so they need not be reviewed. 

One highly creative approach is a brief video sent premeeting by the organizer. this shows that the organizer values the participants’ time and will lead to greater focus. Although the 15-minute meeting is not for every subject, it can be a great strategic tool. Make the most of online meetingsAlthough the foundation of meetings remained unchanged when they moved online via Zoom, Microsoft teams, etc, there still are special considerations. 

 discussed the potential for remote meetings to be draining rather than energizing to those working remotely, along with reasons and tactics for mitigating the risk of disengagement. Although the discomfort of constantly being on display and having to look at a screen of others throughout a meeting is something we can get used to, other issues such as multitasking during meetings will always hinder the productivity of a session. Although some have advocated mandatory “cameras on,” constantly being present on screen can increase the fatigue of a remote workday.

 Suggestions for improving appearance on remote video calls include both technical and physical strategies. Computers’ imbedded microphones and cameras rarely compare in quality to many inexpensive combined apparatuses, which are easy to install. Individuals should be aware of posture and facial expressions, watch out for lighting mishaps, and make sure they are well lit from the front. Unlike an add-on camera/microphone, which is essential, professional lighting is not something everyone needs. But it is important to ensure there is not an intense light source behind you, which can cause you to appear as a silhouette.

In a recent Harvard Business Reviewarticle,

 Rae Ringel wrote that “I’m going to give you 10 minutes of your life back” is a phrase to stop using. Ringel points out that if a meeting is run properly, one might be able to say, “Because everyone was so productive, we’re done 10 minutes early. Thank you so much for your presence and participation.” That’s the kind of meeting you should be aiming for.  

1. Whillans A, Feldman D, Wisniewski D. The psychology behind meeting overload. Harvard Business Review. November 12, 2021. Accessed June 29, 2022. https://hbr.org/2021/11/the-psychology-behind-meeting-overload

2. LePage E. Tips for effective meetings we learned from reading 100 articles. Unito. January 13, 2020. Accessed June 29, 2022. https://unito.io/blog/running-effective-meetings-tips/

3.Handley L. The rise of the 15-minute meeting —and how to run one. CNBC. January 25, 2022. Accessed June 29, 2022. https://www.cnbc.com/2022/01/25/the-rise-of-the-15-minute-meeting-and-how-to-run-one.html 

4.Discovery RSM. How to have effective zoom meetings—and make them less boring. Forbes. March 4, 2021. Accessed June 29, 2022. https://www.forbes.com/sites/rsmdiscovery/2021/03/04/how-to-have-effective-zoom-meetings-and-make-them-less-boring/

5.Gabriel AS, Robertson D, Shockley K. Research: cameras on or off? Harvard Business Review. October 26, 2021. Accessed June 29, 2022. https://hbr.org/2021/10/research-cameras-on-or-off

6.Ringel R. Please stop using these phrases in meetings. Harvard Business Review. January 11, 2022. Accessed June 29, 2022. https://hbr.org/2022/01/please-stop-using-these-phrases-in-meetings4 / 466%

Tips to avoid wasting time and optimize meetings you do need.


How much money are you losing in unnecessary meetings?

Many practices struggle day to day to get by and survive. Truly superior practices prepare for the future to ensure the best opportunities to survive and thrive. How do you prepare? What is the next big thing in medicine? What if you predict wrong and make a mistake? One of the worst mistakes is to stay static. Trust the trends you can see and make investments in your practice to move forward.


Adopting and implementing new technology can help practices, streamline processes, improve efficiency, and reduce costs. A clear technological process that is moving forward now is telemedicine platforms. These help improve care by increasing the provision of care where providers are limited. However, telemedicine can also be performed in a multioffice practice to allow employees to be in multiple sites. The use of telemedicine in this manner may improve scheduling, increase efficiency, and reduce scheduling conflicts when various types of providers work within a practice.

Consider purchases of other technology when they improve practice potential and efficiency. Ultrasound machines are expensive, but if they allow you to keep your practice at the forefront of diagnostic capability, what does that mean to your patient outcome, satisfaction, and referrals? Do new machine capabilities decrease scanning time and improve efficiency as well?

Forming alliances and partnerships with other practices, hospitals, or organizations can help practices attain economies of scale. Smaller practices may get assistance from joining a group purchasing organization (GPO). The most obvious benefit of joining a GPO is improved purchasing power. Vendors provide discounts to larger groups of physicians rather than to individual offices. Hence, GPOs may leverage negotiations to improve pricing or upgrade supplies that are usually unavailable to smaller practices. Also, in this time of shrinking supplies, a GPO has more extensive scale and may assist with procuring supplies, allowing a steadier inventory while reducing cost.

Joining a larger practice or alliance of practices can also assist with contract negotiations with payers. It is no secret that larger practices have more negotiating leverage with players during contracting. However, a larger group also can pool physician time in negotiation or share assets to hire an organization to assist in the process.

Foster a culture of continuous improvement

Practices should encourage providers and staff to identify inefficiencies and bottlenecks within a practice. Thereafter, a practice should implement continuous improvement processes to ensure that a practice works at peak efficiency. Providers should meet with staff regularly to listen to concerns and develop plans among staff to enhance implementation. Provider-led initiatives without other frontline staff input can be perceived as tone-deaf or forced and reduce the chance of implementation and change.

Physicians also should constantly work to improve. Providers should work to attain continuing medical education credits and attend in-person courses that enrich knowledge or skills in a specific key area of interest.

Organizations are moving away from traditional fee-for-service–based models towards value-based care. The standard definition of value care is outcomes divided by cost. Payers and governmental entities believe that providers should be incentivized on the quality of care they provide and the cost of how they provide this care.

1. Structural measures refer to
the characteristics of the care provider or the place where the care is given. An example is ultrasound accreditation.

2. Process measures focus on the series of events that take place during an episode of care, the appropriateness of care, timeliness of service, and providers’ proficiency. An example would be using a low-dose aspirin checklist in pregnancy to enhance the possibility of following the US Preventive Services Task Force guidelines for pregnancy.

3. Outcome measures evaluate whether the health care goals were realized. Mainly these focus on the patient’s health status but can also include health care costs or patient satisfaction. One example is cesarean delivery rates. This specific example has some controversy and requires risk adjustment but may be best followed via nulliparous, term, singleton, vertex rates or Society for Maternal-Fetal Medicine cesarean delivery rates, which make some mild or moderate risk adjustments, respectively. Almost all outcome measures may be affected by patient risk factors or medical conditions. Alternative measures for gynecologic procedures are postoperative surgical bed days and readmissions. The measurement of neonatal intensive care unit days for deliveries has a large effect on payer bottom line.

Practices should strive for improved quality of care as a sign of providing value. Specific quality initiatives should be highlighted by practices as a constant effort to improve and be shared
with payers.

Practices that build strong relationships with patients can foster trust and improve patient engagement. These factors may lead to increased adherence, better outcomes, and lower cost. Practices should keep patients informed about their health and treatment plans and encourage them to ask questions and express concerns. Listening to patients’ concerns and ensuring understanding demonstrates your concern for their well-being. Providers should involve patients in their care to enhance the probability of improving outcomes. Patients should be invited to assist in their care and treatment plans and involve them in goals and self-management strategies so they would be more likely to attain adherence.

Practices should make substantial use of patient portals, which allow patients to access their medical records, communicate with their health care providers, and schedule appointments in some circumstances. Utilizing patient portals, practices make it easier for patients to stay connected and engaged in their care.

You can’t teach nice. One of the most essential characteristics of a good physician or employee is a pleasant personality. People often can learn information, but changing character and teaching qualities of respect, friendliness, and work ethic is challenging.

For providers, time is often your most valuable commodity. Providers should have durable workplace relationships with their partners, demonstrating a devotion of time and thought to one another. Would you want to join a practice where people do not enjoy working and spending time during work with each other? In the book 

, Peter Thiele presents the converse: Why would you hire somebody who would not be excited about spending time with others in your business?1 When someone joins you for the culture of your practice, you are not fighting the war of perks and salary. The provider who joins your practice should want to do irreplaceable work in a unique specialty with great people.

Providers should stay involved in their professional organizations, which offer resources and educational events to keep up to date with industry trends. Physicians should also attend conferences and educational events that can provide a wealth of information about new technology and changes. Organizations also have online communities and discussion groups, which can provide information on industry trends and changes.

An alternative means of staying informed is to follow thought leaders and experts on social media. Many leaders and experts share their insights and perspectives on social media, which can be a helpful way for physicians to stay informed about upcoming industry trends. Platforms like LinkedIn allow networking with colleagues, which can be a valuable way for physicians to stay informed and share ideas and
best practices.

Trust the trends you can see and make investments in your practice to move forward.

Komkwuan Paruchabutr, DNP, WHNP-BC, FNP-BC, CNM, FACNM, FNAP

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