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In a recent study, mothers and fathers with simultaneous parental leave after birth were more likely to utilize mental health care services than those without simultaneous parental leave.

Increased mental health service use reported from simultaneous postpartum leave

Elinzanetant, a non-hormonal drug, shows promising results in reducing hot flashes and night sweats, offering a new option for women seeking effective and safe treatment for vasomotor symptoms.

JoAnn Pinkerton discusses elinzanetant's crucial role in VMS therapy

Review some of the top stories from the Contemporary OB/GYN website over the last week, and catch up on anything you may have missed.

Contemporary OB/GYN week in review: Elinzanetant, breast cancer, and more

Joshua Fitch is an editor for Contemporary Pediatrics. Previously, he worked at 21 WFMJ as a sports anchor and videographer, as well as a national content writer for Weigel Broadcasting Company. 

Research reveals that over a third of adolescents in pediatric emergency departments struggle with access to menstrual products, highlighting the need for improved public health measures.

Study reports period poverty in 1 in 3 adolescents

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Supplement: Closing the Gap in Cervical Cancer Screening

Vaginismus: Managing a Misunderstood and Underdiagnosed Condition

Why vNOTES Make Sense for My Patients

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Obstetric emergencies require quick and decisive action to save the life of the mother and the child. Severe hypertensive disorder, haemorrhage and embolism all threaten the life of the mother. The fetus is directly threatened by umbilical cord accidents, other forms of hypoxia and mechanical delivery problems.

Obstetrics Case Report: Shoulder Dystocia

Very few women have received counseling about the warning signs of endometrial cancer from a health care professional, according to a recent study published in 

Experts have estimated 67,880 new cases of uterine cancer in 2024, as well as 13,250 associated deaths. Nearly all racial and ethnic groups have experienced an annual 2% increase in incidence, caused in part by rising rates of obesity in the United States.

Endometrial cancer is one of the most common female reproductive organ cancers. Associated deaths have also increased over time, with an annual increase of approximately 1.1% reported between 1999 and 2006.

A screening test has not been established for cervical cancer, but detectable symptoms allow diagnosis to occur at an early stage. These symptoms include abnormal and postmenopausal bleeding.

Diagnosis of endometrial cancer at an early stage is associated with a 5-year survival rate of nearly 95%. However, delayed diagnosis has been linked to a significantly reduced 5-year survival rate of 19%, as the disease has time to progress and metastasize.

A survey was conducted to determine the rate of women who recognize postmenopausal bleeding as a symptom of endometrial cancer. There were 650 participants in the final analysis, 145 of whom were postmenopausal. Of these women, 37% did not recognize postmenopausal bleeding as a key symptom of endometrial cancer.

While even a single episode of postmenopausal bleeding is a symptom of endometrial cancer, 41% of participants states they would not report only 1 episode of bleeding to their health care professional. Notably, only 46.5% of women recognized menopause as not having a period for 1 year or more, likely contributing to the low rate.

Adequate education is also lacking among health care professionals, as under 50% of participants reported receiving counseling about postmenopausal bleeding from their health care professional. This indicated a critical need to improve the education of patients and clinicians. Additionally, patient counseling about endometrial cancer and symptoms to be aware of must be improved.

“This survey study highlights opportunities for improved patient counseling about abnormal and postmenopausal uterine bleeding as an early warning sign of uterine cancer,” said Stephanie Faubion, MD, MBA, medical director for The Menopause Society.

“This is especially important given that the incidence and mortality rates of uterine cancer continue to increase and are notably highest in women of color,” Faubion added.

This information may be especially relevant among Black patients, who face racial disparities in endometrial cancer care compared to their White counterparts.

 A study found that race was not associated with willingness to seek care for endometrial cancer, but the odds of receiving guideline-concordant evaluation were greatly reduced among Black patients vs White patients.

Pretreatment was also significantly delayed among Black patients, with an increased wait of 3 to 5 days vs White patients. Additionally, the risk of waiting more than 6 weeks for surgery compared to White patients was increased by 30% to 40% among Black patients, vs 2% to 40% for Hispanic and Asian patients.

This data indicates significant racial disparities in endometrial cancer care. Increasing patient and provider awareness about obvious symptoms may help reduce these disparities.

What you don’t know about endometrial cancer could kill you. The Menopause Society. July 31, 2024. Accessed August 9, 2024. 

https://www.menopause.org/docs/default-source/press-release/postmenopausal-bleeding-and-endometrial-cancer.pdf

Krewson C. Racial disparities reported in endometrial cancer care. Contemporary OB/GYN. September 25, 2023. Accessed August 9, 2024. 

https://www.contemporaryobgyn.net/view/racial-disparities-reported-in-endometrial-cancer-care

A recent study found that 37% of women do not recognize postmenopausal bleeding as an early symptom of endometrial cancer, indicating a lack of knowledge among patients and providers.

Clinical

Knowledge about early endometrial cancer symptoms lacking

A 27-year-old woman presents with an 18-month history of vulvar irritation. She is otherwise healthy except for episodes of depression. She has tried multiple agents for her condition including topical steroids, Vagisil, antibiotics, and fluconazole. She used oral steroids but developed knee pain. Tacrolimus has not helped. A biopsy revealed lichen simplex chronicus. Immunofluorescent studies were negative.

A 27-year-old woman presents with an 18-month history of vulvar irritation. She has tried multiple agents for her condition including topical steroids, Vagisil, antibiotics, and fluconazole without relief. What's your diagnosis?

Vulvar irritation in a 27-year-old woman

Saying "obstetrician-gynecologist" is a mouthful for most people, and it's probably the most abbreviated specialty in medicine, both spoken and written. However, there doesn't seem to be a consensus on how to pronounce OB-GYN. First, is it the two-syllable "O-B" or the monosyllabic "Ob"? Second, is it "gin" or "gyne" (like "Lyme")? I wonder if you have a preference. I know I do.

Almost nobody says "obstetrician-gynecologist" when speaking about these specialist physicians. But what's the "correct" way to pronounce OB/GYN?

Is It Ob-Gin or Ob-Gyne?

At the 2024 Menopause Society meeting, JoAnn Pinkerton, MD, highlighted phase 3 long-term safety data of elinzanetant from the OASIS 3 trial.

Elinzanetant long-term safety data with JoAnn Pinkerton, MD, FACOG, NCMP

At the 2024 Menopause Society meeting being held in Chicago, Illinois through September 14, 2024, JoAnn Pinkerton, MD, FACOG, NCMP, joined us to discuss phase 3 data of elinzanetant from the OASIS 3 trial.

The trial sought to evaluate the safety and efficacy of elinzanetant in postmenopausal women with moderate-to-severe vasomotor symptoms (VMS).

"OASIS 3 is a clinical trial that built on OASIS 1 and 2, which were 26-week trials that were just published in 

," said Pinkerton, who is a professor of Obstetrics and Gynecology at The University of Virginia Health System in Charlottesville, Virginia.

"OASIS 3 was a longer clinical trial, 52 weeks, that took primarily women who are having bothersome menopausal symptoms of moderate to severe, and they observed them over a year for safety and efficacy. The primary endpoint was the reduction in hot flushes from baseline to 12 weeks, but then we really wanted to look at the safety and efficacy across 52 weeks," Pinkerton said. 

"The good news was that Oasis met its primary objective," she added. "Hot flashes were significantly reduced at 12 weeks in this population of women who were not as severe as those in OASIS 1 and 2—more like you would see in your clinical practice—significantly reduced compared to placebo at 12 weeks, and then maintained that efficacy throughout the 52 weeks.

Click here for more coverage from The Menopause Society Meeting.

Panay N, Joffe H, Maki P, et al. Efficacy and Long-term Safety of Elinzanetant for the Treatment of VMS Associated with Menopause: A Phase 3 Randomized Trial (OASIS 3). Abstract. Presented at: The Menopause Society 2024 Annual Meeting. September 10 - September 14, 2024. Chicago, Illinois.

While often asymptomatic, uterine fibroids affect 70 to 80% of women in the U.S. by age 50 and can significantly impact their quality of life. AHN Women’s Institute has a highly specialized team that provides patients with options tailored for their condition and individual needs.

The team offers a full array of diagnostic and therapeutic procedures for uterine fibroids and treatment plans based on a patient’s symptoms. AHN’s fibroid specialists include gynecologists, urogynecologists, diagnostic radiologists, interventional radiologists, and nurse practitioners. They work collaboratively to streamline patients’ care, so they receive coordinated, comprehensive treatment.

“Early detection and intervention can considerably improve outcomes and minimize the potential complications associated with uterine fibroids,” said Noah Rindos, MD, an AHN minimally invasive gynecologist. “We encourage women to seek medical attention if they experience any concerning symptoms. Our goal is to deliver the safest, most effective treatments so patients can stay healthy.”

A common condition with diverse presentations

Uterine fibroids are the most common benign tumors in women of childbearing age. These growths run the gamut of presentations. Fibroids grow in and around the muscular wall of the uterus as a single tumor or as several. They can be as small as an apple seed or as big as a grapefruit, and they can grow or stay about the same size over time.

Fibroids can also manifest in a variety of ways, ranging from mild discomfort to severe pain and debilitating symptoms. Common symptoms include heavy menstrual bleeding, pelvic pain, and pressure on the bladder and rectum, which cause frequent urination or constipation. In some cases, fibroids can interfere with conception, impacting a patient’s reproductive goals.

For asymptomatic or minimally symptomatic patients, watching and waiting may be the most appropriate option because fibroids are rarely cancerous. This involves close monitoring and observation, with intervention only if symptoms worsen or become intolerable.

For patients experiencing mild to moderate symptoms, medical management can be effective. This may include hormonal therapy, including oral contraceptives to regulate menstrual cycles and reduce bleeding. Certain types of intrauterine devices (IUD) can also reduce heavy bleeding.

When medical management fails or symptoms are severe, patients may consider interventional procedures.

AHN Women’s Institute offers a range of minimally invasive and noninvasive procedures that result in fewer incisions and help patients recover faster. These approaches ease fibroid symptoms without affecting surrounding healthy tissue.

Uterine fibroid embolization (UFE) is a valuable treatment option for women with symptomatic fibroids who are not candidates for surgery or who prefer a less invasive approach. Doctors insert a catheter through an artery in the groin or wrist and guide it to the arteries supplying the fibroids with blood. The catheter releases small particles that cut off blood supply to the fibroids, so they shrink. This procedure also preserves the uterus.

“UFE has a high success rate in reducing fibroid size and alleviating symptoms. This is a great option for women who want to preserve their fertility and avoid major surgery,” Dr. Rindos said.

If nonsurgical treatments fail to resolve symptoms, the team may recommend surgery, including myomectomy and hysterectomy. AHN surgeons perform both as a minimally invasive procedure or an open surgery, depending on the patient’s case.

Committed to patient education and support

AHN’s comprehensive approach to uterine fibroids ensures patients receive the highest quality care, truly focused on their situation and needs. AHN offers support groups for women with uterine fibroids, providing a safe space to share experiences and connect with others. The team also has convenient scheduling options and multiple locations throughout the region, ensuring patients have easy access to care.

“Our team-based approach provides timely and effective relief,” Dr. Rindos said. “By combining advanced technology, expert physicians, and a commitment to patient education and support, we strive to empower women to manage their fibroids and live healthy, fulfilling lives.”

To refer a patient to AHN Women’s Institute, call 412-DOCTORS.

NOINDEX

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AHN Women’s Institute delivers optimal outcomes for patients with uterine fibroids

These are 3D ultrasound images of a 14-week fetus. What is your diagnosis?

occipital meningocele and umbilical hernia

Bhavini Lad

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