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She joined the MJH Life Sciences team in December 2019. She graduated from Youngstown State University in 2019 with a bachelor's degree in journalism and a minor in political science. Prior to graduating, Morgan worked as the editor-in-chief of her college newspaper. She went on to work as an assignment editor at a broadcast news station in Youngstown, Ohio, before joining 

 You can reach her at mebert@mjhlifesciences.com.

A new study finds that cefazolin significantly reduces infection risk after planned cesarean delivery compared to clindamycin plus gentamicin.

Cefazolin proven effective in reducing post-cesarean infections

A study found that 11% of intrauterine device removals have complications, with greater rates among Spanish-speaking patients.

Complicated IUD removals linked to age and language barriers

Biennial HPV testing and higher vaccination rates could help South Korea eliminate cervical cancer up to a decade earlier than current policy.

HPV screening and vaccination accelerate cervical cancer decline

Epigenetic aging raises colorectal cancer risk in postmenopausal women, but higher fruit and vegetable intake may help offset this risk.

Epigenetic aging linked to increased colorectal cancer risk in postmenopausal women

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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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Marina Sirota, PhD, is the Acting Director at the Bakar Computational Health Sciences Institute at the University of California, San Francisco.

By analyzing electronic health records, researchers such as Marina Sirota, PhD, and Umair Khan have uncovered hundreds of conditions linked to endometriosis.

New research aims to transform endometriosis diagnosis

Barriers continue to limit access to timely, specialized vulvar care among US patients, according to a recent study published in 

Despite significant morbidity associated with vulvar lichen sclerosus (LS), diagnosis is often delayed by 5 to 15 years. Approximately 22 per 100,000 individuals are impacted by this condition per year, risking exacerbating disease and cancer because of these delays. Restrictions may include clinician shortages, long wait times, and insurance restrictions.

“Moreover, continuity of care is crucial for managing vulvar LS, yet clinics with wait times exceeding 1 month are less likely to provide it,” wrote investigators.

The study was conducted to assess new-patient wait times, geographic disparities, and insurance acceptance across vulvar specialty clinics in the United States. These clinics provide diagnostic and treatment services to patients with vulvar LS.

Clinics were identified from the International Society for the Study of Vulvovaginal Disease and Lichen Sclerosus Support Network clinician lists and contacted by 1 of 2 researchers. These researchers recorded earliest available new-patient appointment days across these locations.

Analyses of wait times were performed based on location, insurance, and clinic features. Investigators analyzed data in SPSS v29.020.

There were 246 clinics contacted for the study, 67.1% of which were accepting new patients. Of clinics, 85.5% were gynecology clinics while 14.5% were dermatology clinics. Additionally, while most accepted commercial insurance and Medicaid, 8.5% accepted cash payment only. New-patient appointment fees ranged from $275 to $1880, with an average of $860.

When including all clinics, a median wait time of 55 days was reported. However, this time was significantly reduced in cash-pay clinics, at 15 days vs 63.5 for those accepting commercial insurance. Referral was required for all patients in 24.8% of clinics.

Being affiliated with academic centers was reported by 38.8% of clinics, with a longer median wait time of 85 days reported in academic medical centers. In comparison, the media wait time was 44 days in nonacademic and private clinics.

Investigators highlighted that 20.7% of clinics were closed or had a retired clinician. Additionally, 7.3% reported not accepting new patients and 4.9% not treating vulvar LS. Overall, the data highlighted barriers to timely, specialized care from US vulvar specialty clinics, alongside substantial geographic disparities, such as 13 states lacking clinicians.

“Improved clinician and trainee education and interdisciplinary collaboration are vital to reducing financial and geographic obstacles, decreasing morbidity, enhancing patient outcomes, and increasing equitable care,” wrote investigators.

According to Mayo Clinic, the odds of LS are increased among postmenopausal women.

 Medicated ointment has been proven effective for returning the skin to its usual color and reducing the risk of scarring among patients, but high recurrence risks highlight a need for long-term follow-up care.

Mayo Clinic also recommends patients see a health care provider once symptoms appear. These may include discolored or blotchy skin, itching, soreness or burning, easy bruising, fragile skin, changes in the urethra, bleeding or open sores, and painful sex. Patients with an LS diagnosis should undergo follow-up visits every 6 to 12 months to assess possible skin changes.

McAleer L, Powers CM, Abraham O, Rixera Dixon S, Mauskar MM. Barriers to care for vulvar lichen sclerosus: an analysis of US specialty clinic access. 

2(4): p e099. doi:10.1097/og9.0000000000000099

Lichen sclerosus. Mayo Clinic. Accessed August 8, 2025. https://www.mayoclinic.org/diseases-conditions/lichen-sclerosus/symptoms-causes/syc-20374448

A new study reveals long wait times, clinician shortages, and geographic gaps continue to delay diagnosis and treatment for patients with vulvar lichen sclerosus.

Clinical

Barriers to vulvar lichen sclerosus care persist

Racial and ethnic disparities remain in adverse maternal and birth outcomes among physicians, according to a recent study published in 

Researchers continue to document significant racial and ethnic disparities in obstetric outcomes despite increased federal focus on improving reproductive health. In California, state-wide disparities have been observed, including greater decreases in preterm birth prevalence among White patients vs Black patients.

“Several factors likely contribute to these disparities, including variation in the quality and quantity of health care, underlying health conditions, and social determinants of health, particularly those related to the historical and contemporary forms of structural and institutional racism,” wrote investigators.

The study was conducted to compare adverse pregnancy and birth outcomes between racial and ethnic groups among practicing physicians in California from 2012 to 2019. Data was collected from hospitalization records provided by the Department of Health Care Access and Information and from vital statistics records.

Data about a patient’s usual occupation and usual type of business or industry were obtained from birth records. Patients with missing data about the date last worked before delivery or having a last day of work that did not overlap with pregnancy were excluded from the analysis.

Self-reported race and ethnicity was the primary exposure, obtained from neonatal birth records. These included Hispanic, non-Hispanic White, non-Hispanic Black, Asian, Native American, and Pacific Islander. Health records from prenatal or up to 6 weeks postpartum visits were assessed for relevant maternal outcomes.

Primary outcomes included preeclampsia, gestational diabetes, maternal morbidity, and severe maternal morbidity. These outcomes were based on 

International Statistical Classification of Diseases, Tenth Revision

 codes, and severe maternal morbidity included 21 CDC indicators.

Birth outcomes were also included, such as small for gestational age (SGA), birth weight, preterm birth, and neonatal intensive care unit (NICU) admission. Covariates included age at delivery, prepregnancy body mass index, source of payment for delivery, and prenatal smoking.

There were 14,878 singleton children born to physicians included in the analysis, 42.5% of whom were Asian, 40.8% non-Hispanic White, 8.9% Hispanic, 5.3% other races, and 3.2% non-Hispanic Black. Mothers were aged a mean 35 years at delivery and most had private insurance. Prenatal tobacco use was reported in under 1%.

Asian physicians had the highest rate of gestational diabetes at 14.2%, vs 10.2% for physicians of other races, 8.9% for Hispanic physicians, and 6.4% for non-Hispanic Black physicians. Adjusted risk differences (aRDs) when compared with non-Hispanic White physicians were 8%, 3%, 2%, and –5%, respectively.

Non-Hispanic Black physicians had the highest rates of severe maternal morbidity alongside other races, at 2.8%. Other rates of severe maternal morbidity included 2.4% for Asian physicians, 2% for non-Hispanic White physicians, and 1.1% for Hispanic physicians.

SGA was also the most prevalent in Asian physicians, with a rate of 14.3%. This was followed by non-Hispanic Black, other races, Hispanic, and non-Hispanic White physicians, with rates of 12.9%, 10.9%, 9.1%, and 8.9%, respectively. Compared with those for non-Hispanic White physicians, aRDs were 5% for Asian and non-Hispanic Black physicians.

Preterm birth rates were 13.9%, 8.6%, and 8.5% among non-Hispanic Black, Asian, and physicians of all other race and ethnicity categories, respectively. NICU admission was reported in 8.8% of neonates from non-Hispanic Black physicians, 7% other races, 6.9% non-Hispanic White, 5.9% Asian, and 4.7% Hispanic.

These results highlighted racial and ethnic disparities for pregnancy complications among physicians in California. Investigators concluded this highlights the impact of sociostructural factors on pregnancy and birth outcomes.

“Further, the results highlight that in addition to the well-documented disparities in adverse birth outcomes of Black individuals, disparities also are present and deserve attention for birthing individuals who are Asian and for those of more than one race or of unknown race,” wrote investigators.

Caesar MA, Baer R, Bandoli G. Persistence of racial and ethnic disparities in adverse maternal and birth outcomes among physicians. 

2025;2(3):p e086. doi:10.1097/og9.0000000000000086

Nicole Teal E, Baer RJ, Jelliffe-Pawlowski L, Mengesha B. Racial disparities in cesarean delivery rates: do hospital-level factors matter? 

2024;41(4):375–382. doi:10.1055/s-0043-1776346

A new study reveals significant racial and ethnic differences in maternal and neonatal outcomes among physicians.

Racial disparities in birth outcomes persist among physicians

Risk factors of patients with hepatitis C virus (HCV) not receiving direct-acting antiviral (DAA) prescriptions when entering opioid use disorder (OUD) treatment include female sex and recent pregnancy, according to a recent study published in 

A 16-fold increase in HCV infections was observed in US patients from 1998 to 2018, increasing the prevalence of associated adverse outcomes such as perinatal transmission. DAAs have a success rate of more than 95% for curing this condition, but only 39% of affected adults and 9% of reproductive-aged women receive DAA prescriptions.

“Sex and gender disparities in access to DAAs have been described,” wrote investigators.

 “For example, among people who inject drugs, HCV incidence is higher among women, but men are 24% more likely to access DAAs.”

Comparing DAA prescriptions between men and women

The study was conducted to compare DAA prescriptions between men and women and to determine the impact of past-year pregnancy on DAA prescription. Data for inpatient and outpatient claims were obtained from the Merative MarketScan Commercial and Multi-State Medicaid Databases.

Inpatient, outpatient, and prescription data were linked, and deidentification was performed. Participants were aged 18 to 64 years and were diagnosed with any OUD and HCV based on 

 codes. The date of OUD treatment initiation was reported as the index date.

Participants were organized by treatment episodes, beginning after a period of at least 45 days without a record of OUD treatment. Treatment episodes had a duration of 360 days, and subsequent treatment episodes following this period were also evaluated. Prescription DAAs were reported as the primary outcome of the analysis.

HCV treatment initiation was defined as a first-time prescription for a DAA. These included velpatasvir, sofosbuvir, grazoprevir, daclatasvir, elbasvir, paritaprevir, ombitasvir, ritonavir, dasabuvir, simeprevir, ledipasvir, telaprevir, glecaprevir, boceprevir, and pibrentasvir.

Sex and pregnancy status were reported as exposure variables. Categories of sex included male and female as recorded in claims data. A recent pregnancy was determined by more than 1 claims data for any pregnancy-related condition within the prior 360 days.

Year of enrollment, age, health insurance type, psychiatric comorbidities, and race and ethnicity were reported as covariates. Investigators also collected information about co-occurring substance use disorders, hospitalization for drug-related poisoning, type of OUD treatment, and Charlson Comorbidity Index score.

There were 22,347 episodes from 19,668 patients included in the final analysis, 45.1% of whom were men, 38.5% women without recent pregnancy, and 16.5% women with recent pregnancy. Most of these patients were aged at least 35 years, but women with recent pregnancy were more often aged 26 to 30 years.

Of patients, 90.8% were enrolled in Medicaid, 89.2% were non-Hispanic White, and 76% received psychosocial treatment without medications for OUD. The remaining received medications, with 12.6% prescribed buprenorphine, 6.7% methadone, 1.5% oral naltrexone, and 3.3% extended-release naltrexone.

The odds of being prescribed DAAs were significantly higher among men vs women, with rates of 40.6% for men, 35.7% for women without recent pregnancy, and 31.8% for women with recent pregnancy. Additionally, a HR for receiving HCV treatment of 1.19 was reported among men vs women.

When compared with women with recent pregnancy, men and women without pregnancy had adjusted HRs of 1.18 and 1.09, respectively, for receiving HCV treatment. Similar results were reported in a sensitivity analysis restricting the cohort to women with a pregnancy code at least 9 months before enrollment.

Overall, the results highlighted recent pregnancy as a barrier to HCV treatment, alongside potentially contributing to sex-based disparities in treatment. Investigators recommended additional research to determine optimal care delivery strategies in this population.

“Given the challenges described regarding postpartum linkage to HCV care, we suggest that pregnancy could be a window of opportunity for HCV treatment that must be further studied,” wrote investigators.

Cary CB, McCrary LM, Marks LR, et al. Association between sex and recent pregnancy and hepatitis C virus treatment in people with opioid use disorder. 

. 2025;2(4):p e096. doi:10.1097/og9.0000000000000096

Biondi BE, Munroe S, Lavarin C, et al. Racial and ethnic disparities in hepatitis C care in reproductive-aged women with opioid use disorder. 

 2024;79(6):1428–1436. doi:10.1093/cid/ciae426

A new study finds women are significantly less likely to receive curative hepatitis C treatment than men while undergoing opioid use disorder care.

Sex and pregnancy linked to reduced HCV treatment odds in OUD patients

The FDA has accepted for priority review a supplemental new drug pplication (sNDA) for gepotidacin (Blujepa; GSK) as an oral treatment option for uncomplicated urogenital gonorrhea in patients aged 12 years and older weighing at least 45 kg, according to GSK. The Prescription Drug User Fee Act action date is December 11, 2025.

Recently, gepotidacin received FDA approval in March 2025 as an oral treatment for uncomplicated urinary tract infections (uUTI) in female adult and pediatric patients aged 12 years and older weighing at least 40 kg. Regulatory review for the uUTI indication is also underway in the United Kingdom and Australia.

In 2023, more than 600,000 cases of gonorrhea were reported in the US, making it the second most frequently reported STI in the country. If untreated or inadequately treated, infection can result in infertility and other reproductive health complications. There is currently no licensed vaccine in the US, and standard treatment involves injectable therapy, which may be unsuitable or unavailable for some patients.

The sNDA is supported by findings from the phase 3 EAGLE-1 trial, published in 

, which evaluated gepotidacin as a noninferior oral alternative to the current leading treatment combination of intramuscular ceftriaxone and oral azithromycin. EAGLE-1 enrolled participants aged 12 years and older with suspected uncomplicated urogenital gonorrhea. Participants were randomly assigned to receive either gepotidacin (2 oral doses of 3000 mg administered 10 to 12 hours apart) or ceftriaxone (500 mg intramuscular) plus azithromycin (1 g oral).

The primary end point was microbiological success at test-of-cure (days 4–8), defined as culture-confirmed eradication of 

 from the urogenital site. In the microbiological intention-to-treat population (n=406), microbiological success was achieved in 92.6% (187/202; 95% CI, 88.0–95.8) of patients receiving gepotidacin and 91.2% (186/204; 95% CI, 86.4–94.7) receiving ceftriaxone plus azithromycin, meeting the noninferiority margin. No bacterial persistence at the urogenital site was reported in either treatment group.

Gepotidacin demonstrated a safety and tolerability profile consistent with prior clinical studies. The most common adverse events were gastrointestinal, primarily mild to moderate in severity. “No treatment-related severe or serious adverse events occurred in either group,” the investigators reported.

GSK noted that this is the second major US regulatory submission for gepotidacin. “The FDA’s acceptance of our application for priority review reflects the potential of gepotidacin to address a significant unmet need in gonorrhea treatment,” the company stated.

Gepotidacin is a bactericidal, first-in-class triazaacenaphthylene antibiotic. It inhibits bacterial DNA replication through a novel mechanism of action involving a distinct binding site and, for most pathogens, balanced inhibition of 2 different type II topoisomerase enzymes. This mechanism provides activity against 

 and most target uropathogens, including 

, even in strains resistant to current antibiotics.

If approved, gepotidacin would represent the first oral treatment option for uncomplicated urogenital gonorrhea in the US and could reduce reliance on injectable regimens, potentially improving access to care and adherence.

Gepotidacin accepted for priority review by the US FDA for the oral treatment of uncomplicated urogenital gonorrhoea. News release. GSK. August 11, 2025. Accessed August 12, 2025. https://www.gsk.com/en-gb/media/press-releases/gepotidacin-accepted-for-priority-review-by-the-us-fda-for-the-oral-treatment-of-uncomplicated-urogenital-gonorrhoea/

Ross JDC, Wilson J, Workowski KA, et al. Oral gepotidacin for the treatment of uncomplicated urogenital gonorrhoea (EAGLE-1): a phase 3 randomised, open-label, non-inferiority, multicentre study. 

.  2025;405(10489):1608-1620. doi:10.1016/s0140-6736(25)00628-2

FDA accepts priority review of gepotidacin, a first-in-class oral antibiotic, for treating uncomplicated urogenital gonorrhea in patients 12 years and older.

FDA accepts gepotidacin for priority review for gonorrhea oral treatment 

This week at Contemporary OB/GYN®, we covered topics ranging from BD's new HPV self-collection device to knowledge gaps in pregnancy health. Click the links below to read anything you might have missed from Monday, August 4, to Friday, August 8, 2025.

Jeff Andrews, MD, FRCSC, discusses BD's new HPV self-collection device

 Jeff Andrews, MD, FRCSC, vice president of medical affairs, Diagnostic Solutions, at BD, discussed current challenges and potential advancements in cervical cancer screening, with a focus on underscreened populations and self-collection human papillomavirus (HPV) testing.

He introduced BD's new self-collection HPV testing method, which has been submitted to the FDA for approval. This procedure allows a clinician to order a test that is mailed to the patient’s home. The patient collects their sample using a simple swab, seals it in a tube, and returns it by mail. In the lab, the sample is processed using BD’s automated COR system, which runs a DNA PCR test called Onclarity. A unique feature of this test is its extended HPV genotyping, which enables precise follow-up steps based on the HPV type detected.

ACOG guideline update linked to drop in neonatal GBS cases and deaths

 (GBS) early-onset disease and deaths have declined among US patients following updates to the American College of Obstetricians and Gynecologists (ACOG) guidelines in 2019, according to a recent study published in 

Joinpoint regression software was used to calculate the annual percent change (APC) in GBS early-onset disease incidence and deaths per 1000 births. Comparisons based on race were performed in the secondary analysis, with race categories including Black, White, and Other.

Neonatal GBS early-onset disease and death were reported in 2640 neonates during the prechange period and 2120 in the postchange period, with means of 0.24±0.01 and 0.20±0.02 cases per 1000 births, respectively. An APC of 2.1% was reported during the prechange period, but -9.6% in the postchange period, indicating a sharp decline.

A decrease in APC during the postchange period was reported in all race categories during the secondary analysis. However, Black patients presented with a significant decline in APC during both the prechange and postchange periods.

100-g OGTT found to predict future diabetes risk in pregnant women

The 100-g oral glucose tolerance test (OGTT) has a strong predictive value for diabetes mellitus, according to a recent study published in 

A correlation was found between an increasing number of OGTT values and the prevalence of abnormal lipid metabolism. Patients with a single abnormal value had a HR of 3.2 for future DM, vs 4.89 in those with 2 abnormal values, 8.18 in those with 3, and 15.46 in those with 4.

In a subanalysis evaluating the impact of timing for a single abnormal result, investigators reported an HR of 7.12 for diabetes diagnosis from abnormal fasting glucose. At 1 hour, 2 hours, and 3 hours postglucose ingestion, these HRs were 3.84, 2.15, and 6.03, respectively. An optimal cutoff threshold of 86.5 mg/dL was reported for fasting glucose.

Survey reveals persistent knowledge gaps about pregnancy health, vaccination safety

A new survey conducted by the Annenberg Public Policy Center of the University of Pennsylvania in April 2025 revealed significant gaps in public understanding of pregnancy-related health recommendations, including misconceptions about weight gain, supplement use, and vaccine safety.

“Because those around us influence our health decisions, persons of childbearing age and their families and friends should know the risks of smoking and alcohol use before, during, and after pregnancy and which vaccines should and should not be taken during pregnancy,” said Patrick E. Jamieson, director of the Annenberg Health and Risk Communication Institute.

Nearly all respondents (91%) agreed that health during pregnancy affects a baby's health, and 86% recognized the importance of preconception health. However, this dropped to 75% among women aged 18 to 49 years, compared with 86% in 2023. Eighty percent of all adults surveyed knew that testing for diabetes during pregnancy is recommended, while 73% acknowledged the stroke risk associated with untreated hypertension.

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

Marina Sirota, PhD

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