Contemporary OB/GYN week in review: HPV genotyping, menopause burden, 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 13, 2025 - Friday, January 17, 2025), and click each link to read and watch anything you may have missed.

ASCCP guidelines highlight critical information for extended HPV genotyping

In a recent interview with Contemporary OB/GYN, Jeff Andrews, MD, FRCSC, vice president of medical affairs at BD Life Sciences, discussed the updated 2024 American Society for Colposcopy and Cervical Pathology (ASCCP) Risk-Based Management Guidelines for cervical cancer screening.

Andrews highlighted how the ASCCP initially shifted to risk-based guidelines, leveraging patient characteristics and test results to inform clinical actions such as colposcopy referrals. The 2024 update incorporates extended genotyping, enabling clinicians to account for additional human papillomavirus (HPV) genotypes beyond HPV 16 and 18 when assessing risk.

The extended genotyping allows for a more tailored approach to managing cervical cancer risks. For example, HPV genotypes such as 56, 59, and 66, which carry low CIN3+ risk, now only require a repeat test in a year. On the other hand, HPV 16 or 18 positives can proceed directly to colposcopy without intermediary steps. This innovation is particularly relevant for self-collected samples, where cytology data may not be available at the time of testing.

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Worse menopause symptom burden reported in rural women

In a recent interview with Contemporary OB/GYN, Susan Reed, MD, MPH, MS, professor emeritus of obstetrics and gynecology at the University of Washington, discussed the findings of a study examining menopause symptom burdens among women in rural, urban, and suburban areas.

The study involved 1,531 participants, focusing on those identifying as female and categorized by their place of residence. It explored symptom prevalence, access to care, and disparities in menopause experiences across different demographics.

The study found that rural women, especially those in late perimenopause or late menopause transition, reported higher rates of muscle aches, pains, and panic attacks compared to their urban and suburban counterparts. Among postmenopausal women, mood swings, urinary problems, and vaginal dryness were more commonly reported. A notable finding was that only 11% of respondents across all regions were using hormone replacement therapy (HRT), despite significant rates of hot flashes at 71% during late transition and 20% post-menopause. Rural participants often opted to endure their symptoms without treatment, citing concerns about HRT risks and limited access to care.

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Dr. Thomas outlines the future of the Safe Baby Safe Moms program

In a recent interview with Contemporary OB/GYN, Angela D. Thomas, DrPH, MPH, MBA, vice president of health care delivery research at MedStar Health discussed expansion efforts for the Safe Baby Safe Moms program.

Safe Baby Safe Moms, initiated at MedStar Washington Hospital Center, is a comprehensive maternal health program aimed at addressing the needs of expecting mothers, particularly in underserved communities. Over its first 5 years, the program has implemented impactful interventions, such as high-risk obstetrics co-location and providing ultrasonography at community clinics.

Moving forward, the goal is to scale these interventions across MedStar Health’s 6 other obstetric hospitals in Maryland and Washington, DC. This expansion will involve identifying each community's unique needs and establishing partnerships with local organizations, akin to the program’s collaboration with Community of Hope and Mamatoto Village in DC. By addressing local gaps in care, such as the absence of high-risk obstetric services, and ensuring services such as care navigation, behavioral health screening, and medical-legal support, the initiative seeks to provide holistic care tailored to each community.

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Multidisciplinary care found key to managing blood cancers during pregnancy

Evidence-based, multidisciplinary care is vital for the management of blood cancers in pregnancy, according to recent guidelines published in The Lancet.

The guidelines detailed the importance of consistent, multidisciplinary communication across teams. This includes early referral to specialized centers experienced in managing cancer in pregnant patients, as recommended by the Cancer Institute of New South Wales and the European Society of Medical Oncology.

Considerations for management during pregnancy include parental wishes, physiological changes in pregnancy, and natural history of the malignancy. Additionally, the guidelines recommended women be able to access nursing and midwifery specialists and a comprehensive counseling service.

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High reintervention rates observed after surgical myomectomy

Reintervention is often necessary following surgical myomectomy for uterine leiomyomas, according to a recent study published in the American Journal of Obstetrics & Gynecology.

Women with reintervention had a significantly increased median number of leiomyomas removed during the index operation vs those without reintervention. Reintervention rates for open abdominal myomectomy and laparoscopic myomectomy were 26% and 19%, respectively, which investigators did not consider statistically significant.

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