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A new study highlights the association of maternal soluble Fms-like tyrosine kinase 1 and endothelin 1 with preeclampsia severity, offering insights into the pathogenesis of early- and late-onset forms of the condition.

Maternal sFLT1 and EDN1 linked to late-onset preeclampsia

A recent study highlights the release of chemoattractants from human fetal membranes at term, driving leukocyte activation and migration, with implications for labor and postpartum recovery.

Chemoattractants in fetal membranes enhance leukocyte migration near term pregnancy

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: IUD placement, UTI misinformation, and more

A new study highlights the efficacy of couple-based reproductive genetic carrier screening in improving reproductive decisions and outcomes, emphasizing its growing availability and acceptance among diverse populations.

Reproductive genetic carrier screening: A tool for reproductive decision-making

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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 Carlos is a resident in the Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.

EPF diagnosis can cause harm, so 100% specificity is the goal.

When a pregnancy fails early

A 27-year-old woman presents with an 18-month history of vulvar irritation. She is otherwise healthy except for episodes of depression. She has tried multiple agents for her condition including topical steroids, Vagisil, antibiotics, and fluconazole. She used oral steroids but developed knee pain. Tacrolimus has not helped. A biopsy revealed lichen simplex chronicus. Immunofluorescent studies were negative.

A 27-year-old woman presents with an 18-month history of vulvar irritation. She has tried multiple agents for her condition including topical steroids, Vagisil, antibiotics, and fluconazole without relief. What's your diagnosis?

Vulvar irritation in a 27-year-old woman

What structure or anomaly is the arrow pointing to in this image of a 20-week fetal spine?

Challenge your anatomy skills: Can you identify the spinal structure?

Clinical

Image IQ: Anatomy of the Fetal Spine

Postpartum hemorrage

In a recent interview with Contemporary OB/GYN, Kameelah Phillips, MD, a board-certified obstetrician and gynecologist, founder of Calla Women’s Health and Organon Health Partner, discusses the crisis related to postpartum hemorrhage (PPH) and how doctors may treat this condition in their patients. 

PPH is a leading cause of maternal morbidity and mortality, particularly in the United States, where maternal health outcomes have fallen behind those of other developed nations. Phillips attributed the ongoing challenges with PPH to factors such as difficulty in accurately quantifying blood loss, lack of uniform progress in managing PPH, and a disproportionate impact on women in low-resource settings with limited access to health services.

Phillips highlighted the increased risks for women residing in maternity care deserts, defined as often rural regions where obstetrical care is sparse or unavailable. Approximately 2 million women in the United States live in these areas, which lack critical maternal health care services and screenings, increasing their vulnerability to complications such as PPH, preterm birth, and other severe maternal health issues.

According to Phillips, the current standard of care for PPH involves using uterotonic medications to slow bleeding. If these do not suffice, a balloon tamponade is often employed, or in some cases, surgical procedures to block blood flow to the uterus. However, she noted that guidance from leading organizations may vary, and medical training and protocols differ, resulting in inconsistent approaches to managing PPH.

For more effective PPH treatment, Phillips emphasized the importance of timely intervention. In her own practice, she has implemented the JADA system, a device designed to manage abnormal postpartum bleeding by using low-level vacuum technology to encourage natural uterine contraction. Clinical studies on the JADA system have shown a median control time for bleeding of only 3 minutes, with minimal adverse events.

Phillips concluded by stressing the need for preparation and communication with patients before delivery to optimize maternal health and ensure that both health care providers and patients are equipped to handle potential complications such as PPH.

Learn why postpartum hemorrhage remains a critical maternal health issue in the United States and discover effective treatment approaches and preventative strategies shared by expert ob-gyn Kameelah Phillips, MD.

Understanding and managing postpartum hemorrhage: Insights from Kameelah Phillips, MD

These are 3D ultrasound images of a 14-week fetus. What is your diagnosis?

occipital meningocele and umbilical hernia

DailyDx: 3D Images of a 14-week fetus

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?

This middle-aged woman has severe dysmenorrhea and pelvic discomfort. Ultrasound images of the uterus are shown. What is your diagnosis?

Daily Dx: Dysmenorrhea and Pelvic Discomfort

Lauren Hibler Carlos, MD

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