Contemporary OB/GYN week in review: Ulipristal for abortion, genetic testing, and more

Thank you for visiting the Contemporary OB/GYN® website. Take a look at some of our top stories from last week (Monday, February 03, 2025 - Friday, February 07, 2025), and click each link to read and watch anything you may have missed.

Ulipristal plus misoprostol shows promise for medication abortion

Ulipristal acetate followed by misoprostol is effective and acceptable for use as medication abortion, according to a recent study published in the New England Journal of Medicine.

Under 4% of participants reported side effects after taking ulipristal. After taking misoprostol, the most common side effect was chills in 77.4% of patients. This was followed by diarrhea in 66.9%, nausea in 48.1%, fever in 38.1%, and vomiting in 27.1%.

Of participants, 97.7% reported the treatment as satisfactory or very satisfactory. Additionally, 85% reported the pain level as being acceptable or very acceptable. Only 6% reported the pain as unacceptable or very unacceptable, while the remainder reported neutral pain acceptability.

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How early genetic testing empowers parents and improves outcomes

In a recent interview with Contemporary OB/GYN, Dallas Reed, MD, an OB-GYN and medical geneticist, discussed prenatal genetic screening and its impact on patient care.

To increase prenatal genetic screening adoption, Reed advised clinicians to direct patients to educational resources such as the Know More Sooner website and encourage family discussions about genetic conditions. She also recommended OB-GYNs collaborate with maternal-fetal medicine specialists, genetic counselors, and geneticists to integrate screening into patient care effectively. Genetic testing companies, including Myriad, offer support through cost transparency, detailed reports, and access to prenatal genetic counseling, making the process more accessible for both providers and patients.

Reed encouraged providers to stay informed, seek guidance from genetics professionals, and engage in continuous learning to better serve their patients in navigating genetic screening and reproductive decision-making.

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How the cobas liat assay panels improve STI detection

In a recent interview with Contemporary OB/GYN, Denise Heaney, PhD, chief medical partner for molecular solutions and infectious diseases at Roche Diagnostics, discussed the cobas liat STI multiplex assay panels and their significance in improving sexually transmitted infection (STI) testing.

Heaney emphasized the importance of expanding STI testing accessibility, particularly given the high prevalence of infections in the United States, where 1 in 5 individuals may have an STI. By making testing available in non-traditional settings, these assays help reduce barriers to care, improve patient outcomes, and contribute to antibiotic stewardship by ensuring that infections are accurately diagnosed and treated with the appropriate medication.

The FDA 510(k) clearance and CLIA waiver of these tests mark a significant shift in STI testing capabilities. Historically, molecular diagnostic tests were considered complex and restricted to specialized laboratories. However, with these approvals, such advanced testing can now be conducted in point-of-care settings, making diagnostics more accessible and reducing the time to treatment.

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Identification and management of patients at increased risk for breast cancer

Breast cancer is the most diagnosed invasive cancer in the United States, with 1 in 8 people assigned female at birth (AFAB) being affected. It is imperative that health care practitioners remain current and well-versed in identifying individuals at high risk for developing breast cancer. This article outlines an approach for obstetrics/gynecology practitioners to identify high-risk patients and to counsel on appropriate breast cancer screening, prevention, and risk-reduction options.

According to the National Comprehensive Cancer Network and the American College of Radiology, all AFAB people should undergo lifetime risk assessment for breast cancer by the age of 25. In many practices, however, lifetime risk assessment for breast cancer is not routinely performed. While there is no established or universal clinical scenario in which risk assessment should be performed, routine health maintenance visits and visits for which patients present specifically with breast complaints represent opportune times. It should also be understood that risk assessment is an ongoing process that can be repeated, as risk can change over time.

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Fasting glucose at GDM diagnosis may predict postpartum glucose abnormalities

Abnormal fasting glucose levels at gestational diabetes mellitus (GDM) diagnosis may be a predictor of postpartum glucose abnormalities in pregnant women, according to a recent study published in Archives of Gynecology and Obstetrics.

Normal fasting glucose levels at the 6-week postpartum visit was reported in 87% of GDM women, vs abnormal fasting glucose levels in 12.5%. Fifty seven percent of the latter group had abnormal fasting glucose levels at GDM diagnosis, which was significantly more common when compared to those with normal fasting glucose levels.

Abnormal 1-hour glucose levels at GDM diagnosis were reported in 55% patients with abnormal postpartum levels vs 47% with normal postpartum levels, indicating no statistically significant differences. Abnormal fasting glucose levels the day before delivery was reported in 64% vs 32%, respectively, indicating a significant difference.

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