Top 5 gynecology articles of 2024

Thank you for visiting the Contemporary OB/GYN website throughout 2024. Below, take a look at the top gynecology stories published this year, and catch up on anything you may have missed.

1. FDA warns of false positive HSV-2 test risks

In a recent statement, the FDA reminded health care providers and clinical laboratory staff about the risk of false positive genital herpes simplex virus type 2 (HSV-2) serological test results.

To reduce the risk of a false positive HSV-2 serological test result, the FDA provided information on risk factors and recommendations for health care providers and clinical laboratory staff. Additionally, the FDA has stated it will provide new information as it becomes available.

According to the FDA, health care providers and clinical laboratory staff should review CDC guidelines prior to ordering HSV-2 serological testing and to be aware of the chances for a false positive result. Providers should also counsel patients about testing limitations before testing, and results should undergo performative testing in accordance with professional guidelines.

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2. Cesarean deliveries linked to reduced fecundability and increased infertility risk

Fecundability ratio is reduced among women with more than 1 children reporting a previous cesarean delivery (CD) vs vaginal delivery, while the risk of infertility is increased, according to a recent study published in the American Journal of Obstetrics & Gynecology.

Women with a prior CD had a lower fecundability ratio than those with prior vaginal delivery, with absolute infertility risks of 9.9% and 7.3%, respectively. This indicated a corresponding risk ratio of 1.21 for women with previous CD.

Similar results were reported when excluding women aged 35 years or older or pregnancies with a time to pregnancy of 3 or more months. Planned and emergency CDs also had similar fecundability patterns.

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3. Adverse outcomes of hysterectomy with bilateral salpingo-oophorectomy

The addition of bilateral salpingo-oophorectomy (BSO) alongside hysterectomy is associated with multiple adverse outcomes, according to a recent study published in the American Journal of Obstetrics & Gynecology.

Hysterectomy with BSO was associated with increased colorectal cancer risk compared to hysterectomy only or no surgery. In patients aged under 45 years, a hazard ratio (HR) of 1.27 was reported, vs an HR of 1.25 in patients aged 50 years and older.

Colorectal cancer mortality also had an increased association in patients aged under 50 years, with an HR of 1.78. Kidney cancer risk had an HR of 1.23 in patients with hysterectomy and BSO, indicating increased risk.

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4. A deep dive into devices for sexual health

Many women are dissatisfied with their sex lives, and reports suggest they feel discouraged as their doctors often fail to inquire about sexual health concerns.

Gynecologic providers should feel more comfortable proactively addressing the sexual well-being of their patients. Low libido, lack of arousal, diminished or absent orgasm, and painful sex are common complaints. Can sex toys or devices such as dildos, vibrators, or graduated dilators be part of the solution? Is this a data-free zone best left to the internet or the marketplace, or can health care providers help guide and support their patients who are seeking better sex?

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5. Diabetes linked to altered long-term inflammatory response in mesh implantation

There is a link between diabetes and altered long-term inflammatory response in complicated mesh implantation, according to a recent study published in the American Journal of Obstetrics & Gynecology.

Of the 32 cytokines/chemokines and 7 growth factors associated with inflammatory response, most did not have differentially expressed genes. Exceptions included C-C motif chemokine ligand 13 (Ccl13), C-C motif chemokine ligand 24 (Ccl24), and interleukin 1 alpha (Il1a).

In the diabetes vs nondiabetic groups, Ccl13 and Ccl24 expressions were upregulated by 1.5-fold and 1.8-fold, respectively, while Il1a expression was downregulated by 2.2-fold. This indicated patients with diabetes had a dysregulated inflammatory response to mesh.

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