Contemporary OB/GYN week in review: Contraceptive trends, STI assay, and more

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, January 20, 2025 - Friday, January 14, 2025), and click each link to read and watch anything you may have missed.

Contraceptive trends indicate reduced hormone use and rise in natural methods

In a recent interview with Contemporary OB/GYN Rosie McNee, MFPH, a public health registrar at NHS Forth Valley, discuessed trends in contraceptive use over the 5 five years.

McNee shared insights from a study that analyzed data from the first 6 months of 2018 and 2023. The data, gathered in collaboration with the British Pregnancy Advisory Service, examined contraceptive methods used by individuals seeking abortion care in the United Kingdom. During abortion consultations, patients were asked about the contraception they were using at the time of conception.

The study found notable shifts in contraceptive trends. There was a significant increase in individuals reporting no use of contraception and a rise in the use of fertility awareness-based methods, commonly referred to as natural family planning. At the same time, there was a decline in the use of hormonal contraceptives, particularly the combined oral contraceptive pill. This pattern reflects broader research trends and coincides with rising abortion rates.

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FDA grants 510(k) clearance to cobas liat STI multiplex assay panels

The FDA has granted 510(k) clearance and Clinical Laboratory Improvement Amendments of 1988 (CLIA) waiver to the cobas liat sexually transmitted infection (STI) multiplex assay panels, according to Roche.

The clearance allows the panels to be available in US markets in the near future. Following this increase in availability, commercialization under CE mark is also expected. These panels will allow clinicians to differentiate between various STIs with a single sample.

“The tests use highly sensitive, gold-standard [polymerase chain reaction] technology, providing results in 20 minutes to allow health care providers to confidently diagnose and determine appropriate treatment in the same visit,” wrote Roche authors.

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How embryo testing reduces miscarriages and enhances IVF success

In a recent interview with Contemporary OB/GYN, Daniel Potter, MD, FACOG, medical director at HRC Fertility in Newport Beach, California, discussed how embryo testing, particularly pre-implantation genetic diagnosis (PGD), can significantly improve the prediction and reduction of miscarriages.

Potter began by highlighting the unpredictable nature of miscarriage because of complex biological, genetic, and environmental factors. Aneuploidy, characterized by an abnormal number of chromosomes in embryos, is a leading cause of miscarriage, particularly in the first trimester where 30-50% of spontaneous pregnancy losses result from this condition.

Embryo testing at HRC Fertility involves creating embryos through in vitro fertilization (IVF), biopsying them, and analyzing their DNA to detect chromosomal abnormalities. This process helps eliminate embryos with aneuploidy, thus significantly reducing the chances of miscarriage.

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New guidelines show better outcomes for managing hematological malignancies in pregnancy

In a recent interview with Contemporary OB/GYN, Giselle Kitson-Gerber, MD, a hematologist with expertise in obstetric hematology, shared insights into new guidelines for managing hematological malignancies during pregnancy, specifically acute leukemia and aggressive lymphomas.

These conditions pose significant risks to maternal and fetal health, but advancements in management provide hope for better outcomes. Acute leukemia is life-threatening if untreated, with symptoms such as anemia, infection, and bleeding, although it is often detected through routine blood work during pregnancy. Aggressive lymphomas, on the other hand, may present with masses in the neck, chest, or abdomen, often identified through obstetric ultrasounds, or symptoms such as shortness of breath, fevers, or night sweats.

The guidelines emphasize the importance of delaying birth to optimize fetal neurocognitive development. Evidence shows that gestational age at delivery has a greater impact on long-term outcomes than in utero exposure to chemotherapy. Women diagnosed in the second or early third trimester are encouraged to undergo chemotherapy during pregnancy rather than opting for early delivery. PET scans, critical for diagnosing and monitoring lymphomas, are now considered safe during pregnancy when proper modeling of fetal radiation exposure is conducted. The guidelines also address breastfeeding and include data on the limited use of newer treatment agents during pregnancy.

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Timely surveillance reported in under half of HPV-positive patients

A surveillance cotest within the guideline-recommended time frame is only provided to under half of patients with human papillomavirus (HPV)-positive results and negative for intraepithelial lesion or malignancy (NILM) cytological findings, according to a recent study published in JAMA Network Open.

There were 13,158 patients with positive findings included in the analysis, representing 17.2% of all index abnormal results. Of patients, 24.5% were Hispanic, 15.1% non-Hispanic Black, 5.7% non-Hispanic Asian, 49.8% non-Hispanic White, 3.1% other or multiple races, and 1.7% unknown race and ethnicity.

Testing by the end of round 1 surveillance was only reported in 43.7% of patients, with 18.2% having a negative finding and 25.5% an abnormal result. Overall, 49.4% were untested despite remaining enrolled, while 6.9% exited the cohort without being tested.

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