Contemporary OB/GYN week in review: Endometriosis diagnosis, cannabis use, and more

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, December 30, 2024 - Friday, January 03, 2025), and click each link to read and watch anything you may have missed.

Persistent diagnostic delays for endometriosis reported

Despite improved endometriosis guidelines, diagnostic delay is still present, according to a recent study published in BJOG.

Diagnosis times ranged from 0.3 to 12 years, with an overall range of 5 to 12 years. For the primary time to diagnosis and the clinical time to diagnosis, ranges were 1 to 4 years and 0.3 to 8.6 years, respectively.

In the 11 cross-sectional studies reporting a mean or median diagnosis time, the overall mean time to diagnosis ranged from 5.4 to 11.4 years. In comparison, the median time ranged from 5 to 12 years. For retrospective cohort studies, clinical diagnosis times were reported. This included a mean range of 2.1 to 3.7 years and a median range of 0.3 to 1.5 years.

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Prenatal cannabis use ineffective for reducing stress and depression

Prenatal cannabis use (PCU) is not associated with significantly decreased stress or depression symptoms, according to a recent study published in JAMA Network Open.¹

There were 504 participants aged a median 26 years included in the analysis, 46.8% of whom reported PCU while 53.2% reported no PCU. First trimester PCU was linked to increased second trimester depression and third trimester stress. Age, race, mental health history, and psychotropic medication use did not differ based on PCU.

A decrease in depression, stress, and cannabis use was noted across trimesters. However, no association was reported between PCU and change in depression or stress. Additionally, a significant reduction in depression and stress was only found in the second trimester when compared to the first trimester.

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Pap Talk S4E15: MIRA surgical system for hysterectomy with Jean Dubuisson, MD, PhD

Contemporary OB/GYN:

So, to get started, can you discuss how the device improves the performance of doctors performing a hysterectomy?

Dubuisson:

Yes, so the MIRA surgical system is the world's first miniaturized robotic-assisted surgical device. We call it minibot as well. It's used to perform soft tissue surgeries through only one single incision through the abdomen, and the main advantage of this mini bot is its unique portability and small design. That's why the mini MIRA device is compact, I think probably less than 1 kilogram, it’s extremely useful, and the framework is portable as well. So, it's a little bit to sum up the benefits of the MIRA robot, and what is new in this field of gynecology.

Contemporary OB/GYN:

That's great. So, what's the significance of the first successful hysterectomy being performed with this device?

Dubuisson:

So, for us, it's very important, because today, for example, in the United States, hysterectomy is the second most common surgical procedure performed in gynecology, after C-section, of course, accounting for over half a million procedures per year. So, it's huge, even now, and the proportion of laparotomy, invasive surgery, is still very high. That's why I think, and we think with Virtual Incision, there is still significant room for improvement in increasing adoption of the mini procedures, and the mini bot MIRA surgical system will help us to improve this rate, this proportion of minimally invasive surgery. So, we did this first procedure in Geneva. It was an absolute privilege for me to participate to this project, of course, and the hysterectomy went well, so it's important for us to have the first case and to know that it's possible and safe to do it.

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Top 5 Contemporary OB/GYN videos of 2024

In a April 2024 interview, Mitchell Creinin, MD, director of the Complex Family Planning Fellowship at the University of California Davis Health, discussed the association between combined oral contraceptive use and breast cancer risk.

In an interview from ACOG, JoAnn Pinkerton, MD, highlighted new phase 3 data about the safety and efficacy of elinzanetant in managing menopausal symptoms presented at the 2024 ACOG Annual Clinical & Scientific Meeting.

In an interview with Contemporary OB/GYN, Amanda Williams, MD, MPH, interim chief medical officer for the March of Dimes, discussed the 2024 March of Dimes report card on preterm birth in the United States.

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Increased hybrid prenatal care use during COVID-19 pandemic reported

Hybrid prenatal care use significantly rose during the COVID-19 public health emergency (PHE), according to a recent study published in JAMA Network Open.

A median 14 visits were reported in the study sample. This included a median 13 in-person visits in the overall population and a median 2 telehealth visits among telehealth users. Prenatal PHE exposure was linked to a slight reduction in the number of prenatal care visits over time, from a median 15 visits without PHE exposure to 13 with prenatal PHE exposure.

An increase in telehealth visits was also reported alongside the decrease in overall visits, from an average of 0.4% to 2.2% in the total study population. Telehealth visits comprised a mean under 1% of visits in pregnancies without PHE exposure, vs 1.9% in the partially overlapping group and 2.2% in the fully overlapping group.

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