Contemporary OB/GYN week in review: Heart health, medication abortion, and more

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, November 04 - Friday, November 08, 2024), and click each link to read and watch anything you may have missed.

Women’s heart health: Risk, prevention, and management

Women face unique cardiovascular risk factors compared to men, such as reproductive health factors and early menopause. However, detection and treatment options are available to ensure women with breast cancer live full, healthy lives.

While both men and women face an increased risk of cardiovascular disease from smoking, the vascular damage is increased in women vs men for the same number of cigarettes smoked. Additionally, women face sex-specific risk factors for cardiovascular health.

Women-specific factors linked to cardiovascular health include age at menarche, age at first period, early menopause, and premature ovarian failure. Additionally, conditions that occur during pregnancy such as preeclampsia, gestational diabetes, and preterm birth further increase the risk of cardiovascular disease.

Click here for the full article.

Safety and efficacy from very early medication abortion reported

Medication abortion is safe and effective even when performed prior to the sixth week of pregnancy, according to a recent study published in The New England Journal of Medicine.

Of the 1504 participants, 754 were in the early-start group and 750 were in the standard group. A successful abortion rate of 95.2% was reported in the early-start group during the intention-to-treat analysis, vs 95.3% in the standard group. This indicated an absolute between-group difference of -0.1%.

In the early-start group, 1.3% of patients developed ectopic pregnancy, vs 0.8% of the standard group. One case of rupture before diagnosis was reported in the early-start group. Rates of serious adverse events were 1.6% in the early-start group and 0.7% in the standard group, with most being uncomplicated hospitalizations for ectopic pregnancy or incomplete abortion.

Click here for the full article.

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

In a recent interview with Contemporary OB/GYN, Kameelah Phillips, MD, a board-certified obstetrician and gynecologist, 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.

Click here for the full video.

Vasomotor symptoms associated with diabetes risk

There are associations of frequent vasomotor symptoms (VMS) and vasomotor symptom trajectory with diabetes risk, according to a recent study published in JAMA Network Open.

The Study of Women’s Health Across the Nation was a prospective cohort study including premenopausal or early perimenopausal women in the United States. Participants were evaluated across up to 13 annual follow-up visits.

An association was reported between more frequent time-varying VMS and incident diabetes, with a hazard ratio (HR) of 1.45 among patients with frequent VMS vs those with relative to no VMS. For patients with infrequent VMS, the HR was 1.30.

VMS trajectories included consistently low probability of VMS in 26% of patients, persistently high probability in 31%, early-onset initial high probability decreasing over time in 25%, late-onset initial low probability increasing over time in 19%, and unknown in 0.2%.

Click here for the full article.

Understanding the pathology of the placenta and associated outcomes

In a recent review, investigators described the pathological findings of the placenta and how communication should be performed between obstetricians, neonatologists, and pathologists diagnosing placental disorders.

Placental function may be impacted by a variety of conditions, including genetic, metabolic, maturation, and circulatory disorders. Understanding the pathology of the placenta is crucial for proper treatment, with multiple organizations publishing guidelines for placental examination.

In 2016, a group of placental and perinatal pathologists published criteria for diagnosing placental lesions. A normal placenta has low-velocity, high-volume blood flow, which changes to accelerated villous maturation during maternal vascular malperfusion. This presents as increased syncytial knots and intervillous fibrin causing villous paucity.

Click here for the full article.