False-Positive Mammography Results Linked to Reduced Rates of Future Screenings

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Changed
Mon, 09/09/2024 - 14:43

 

TOPLINE:

Women who received false-positive mammography results were less likely to return for future screenings.

METHODOLOGY:

  • Researchers analyzed more than three million screening mammograms from more than one million women aged between 40 and 73 years at nearly 200 facilities in the Breast Cancer Surveillance Consortium between 2005 and 2017.
  • Mammography results were classified as true negative or false positive; women who received false-positive results were either asked to come back for additional imaging, a short interval follow-up or biopsy recommendations.
  • The primary outcome was the probability of returning for routine screening within 9-30 months after a false-positive or true-negative result, adjusted for race, ethnicity, age, and time since the last mammogram.
  • Women with two screening mammograms within 5 years were also analyzed to evaluate the probability of returning for a third screening based on combinations of true-negative and false-positive results.

TAKEAWAY:

  • Nearly 10.0% (95% CI, 9.1%-10.5%) of women who received screening mammograms got a false-positive result, 5.8% (95% CI, 5.5%-6.2%) of whom needed immediate additional imaging, 2.7% (95% CI, 2.3%-3.2%) needed short-interval follow-up, and 1.3% (95% CI, 1.1%-1.4%) were recommended for a biopsy.
  • Women were more likely to return for screening after a true-negative result (76.9%) than after a false positive to obtain more data through additional imaging (72.4%), short-interval follow-ups (54.7%), or biopsy (61.0%).
  • Asian and Hispanic/Latinx women who received a false-positive result were much less likely to return for a screening than women of the same groups who received a true-negative result, with recommendations for short interval follow-up (decrease of 20-25 percentage points) or biopsy (decrease of 13-14 percentage points).
  • For women who had two screening mammograms within 5 years, receiving a false-positive result on the second was linked to a lower likelihood of returning for a third screening, regardless of results for the first.

IN PRACTICE:

“Physicians should educate their patients about the importance of continued screening after false-positive results, especially given the associated increased future risk for breast cancer,” study authors wrote.

SOURCE:

The study was led by Diana L. Miglioretti, PhD, of the Department of Public Health Sciences at the University of California, Davis, and published online on September 3 in Annals of Internal Medicine.

LIMITATIONS:

Women could receive care at facilities outside of the trial, which may have affected the accuracy of return rates. The study did not track a complete history of false-positive results. The study did not have information about how often physicians recommend screenings and did not account for other health conditions.

DISCLOSURES:

One coauthor reported receiving grants from the National Institutes of Health and the American Cancer Society, as well as consulting fees from the University of Florida, Gainesville.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

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TOPLINE:

Women who received false-positive mammography results were less likely to return for future screenings.

METHODOLOGY:

  • Researchers analyzed more than three million screening mammograms from more than one million women aged between 40 and 73 years at nearly 200 facilities in the Breast Cancer Surveillance Consortium between 2005 and 2017.
  • Mammography results were classified as true negative or false positive; women who received false-positive results were either asked to come back for additional imaging, a short interval follow-up or biopsy recommendations.
  • The primary outcome was the probability of returning for routine screening within 9-30 months after a false-positive or true-negative result, adjusted for race, ethnicity, age, and time since the last mammogram.
  • Women with two screening mammograms within 5 years were also analyzed to evaluate the probability of returning for a third screening based on combinations of true-negative and false-positive results.

TAKEAWAY:

  • Nearly 10.0% (95% CI, 9.1%-10.5%) of women who received screening mammograms got a false-positive result, 5.8% (95% CI, 5.5%-6.2%) of whom needed immediate additional imaging, 2.7% (95% CI, 2.3%-3.2%) needed short-interval follow-up, and 1.3% (95% CI, 1.1%-1.4%) were recommended for a biopsy.
  • Women were more likely to return for screening after a true-negative result (76.9%) than after a false positive to obtain more data through additional imaging (72.4%), short-interval follow-ups (54.7%), or biopsy (61.0%).
  • Asian and Hispanic/Latinx women who received a false-positive result were much less likely to return for a screening than women of the same groups who received a true-negative result, with recommendations for short interval follow-up (decrease of 20-25 percentage points) or biopsy (decrease of 13-14 percentage points).
  • For women who had two screening mammograms within 5 years, receiving a false-positive result on the second was linked to a lower likelihood of returning for a third screening, regardless of results for the first.

IN PRACTICE:

“Physicians should educate their patients about the importance of continued screening after false-positive results, especially given the associated increased future risk for breast cancer,” study authors wrote.

SOURCE:

The study was led by Diana L. Miglioretti, PhD, of the Department of Public Health Sciences at the University of California, Davis, and published online on September 3 in Annals of Internal Medicine.

LIMITATIONS:

Women could receive care at facilities outside of the trial, which may have affected the accuracy of return rates. The study did not track a complete history of false-positive results. The study did not have information about how often physicians recommend screenings and did not account for other health conditions.

DISCLOSURES:

One coauthor reported receiving grants from the National Institutes of Health and the American Cancer Society, as well as consulting fees from the University of Florida, Gainesville.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

 

TOPLINE:

Women who received false-positive mammography results were less likely to return for future screenings.

METHODOLOGY:

  • Researchers analyzed more than three million screening mammograms from more than one million women aged between 40 and 73 years at nearly 200 facilities in the Breast Cancer Surveillance Consortium between 2005 and 2017.
  • Mammography results were classified as true negative or false positive; women who received false-positive results were either asked to come back for additional imaging, a short interval follow-up or biopsy recommendations.
  • The primary outcome was the probability of returning for routine screening within 9-30 months after a false-positive or true-negative result, adjusted for race, ethnicity, age, and time since the last mammogram.
  • Women with two screening mammograms within 5 years were also analyzed to evaluate the probability of returning for a third screening based on combinations of true-negative and false-positive results.

TAKEAWAY:

  • Nearly 10.0% (95% CI, 9.1%-10.5%) of women who received screening mammograms got a false-positive result, 5.8% (95% CI, 5.5%-6.2%) of whom needed immediate additional imaging, 2.7% (95% CI, 2.3%-3.2%) needed short-interval follow-up, and 1.3% (95% CI, 1.1%-1.4%) were recommended for a biopsy.
  • Women were more likely to return for screening after a true-negative result (76.9%) than after a false positive to obtain more data through additional imaging (72.4%), short-interval follow-ups (54.7%), or biopsy (61.0%).
  • Asian and Hispanic/Latinx women who received a false-positive result were much less likely to return for a screening than women of the same groups who received a true-negative result, with recommendations for short interval follow-up (decrease of 20-25 percentage points) or biopsy (decrease of 13-14 percentage points).
  • For women who had two screening mammograms within 5 years, receiving a false-positive result on the second was linked to a lower likelihood of returning for a third screening, regardless of results for the first.

IN PRACTICE:

“Physicians should educate their patients about the importance of continued screening after false-positive results, especially given the associated increased future risk for breast cancer,” study authors wrote.

SOURCE:

The study was led by Diana L. Miglioretti, PhD, of the Department of Public Health Sciences at the University of California, Davis, and published online on September 3 in Annals of Internal Medicine.

LIMITATIONS:

Women could receive care at facilities outside of the trial, which may have affected the accuracy of return rates. The study did not track a complete history of false-positive results. The study did not have information about how often physicians recommend screenings and did not account for other health conditions.

DISCLOSURES:

One coauthor reported receiving grants from the National Institutes of Health and the American Cancer Society, as well as consulting fees from the University of Florida, Gainesville.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

A version of this article first appeared on Medscape.com.

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How Intermittent Fasting Could Transform Adolescent Obesity

Article Type
Changed
Thu, 08/29/2024 - 11:34

 

TOPLINE:

Intermittent energy restriction (IER) and continuous energy restriction (CER) reduced body mass index (BMI) in adolescents with obesity after 52 weeks, with no major differences found in body composition or cardiometabolic outcomes.

METHODOLOGY:

  • Researchers conducted a 52-week randomized clinical trial at two pediatric centers in Australia that involved 141 adolescents aged 13-17 years with obesity and at least one associated complication.
  • Participants were divided into two groups: IER and CER, with three phases: Very low-energy diet (weeks 0-4), intensive intervention (weeks 5-16), and continued intervention/maintenance (weeks 17-52).
  • Interventions included a very low-energy diet of 3350 kJ/d (800 kcal/d) for the first 4 weeks, followed by either IER intervention (2500-2950 kJ [600-700 kcal 3 days/wk]) or a daily CER intervention (6000-8000 kJ/d based on age; 1430-1670 kcal/d for teens aged 13-14 years and 1670-1900 kcal/d for teens aged 15-17 years).
  • Participants were provided with multivitamins and met with dietitians regularly, with additional support via telephone, text message, or email.

TAKEAWAY:

  • Teens in both the IER and CER groups showed a 0.28 reduction in BMI z-scores at 52 weeks with no significant differences between the two.
  • The researchers observed no differences in body composition or cardiometabolic outcomes between the IER and CER groups.
  • The occurrence of insulin resistance was reduced in both groups at week 16, but this effect was maintained only in the CER group at week 52.
  • The study found no significant differences in the occurrence of dyslipidemia or impaired hepatic function between the IER and CER groups.

IN PRACTICE:

“These findings suggest that for adolescents with obesity-associated complications, IER can be incorporated into a behavioral weight management program, providing an option in addition to CER and offering participants more choice,” the authors of the study wrote.

SOURCE:

The study was led by Natalie B. Lister, PhD, of the University of Sydney in Australia and was published online in JAMA Pediatrics.

LIMITATIONS:

The COVID-19 pandemic and subsequent lockdowns limited the sample size. Some dietitian visits were conducted via telehealth.

DISCLOSURES:

Dr. Lister received grants from the National Health and Medical Research Council of Australia. A coauthor, Louise A. Baur, MBBS, PhD, received speakers’ fees from Novo Nordisk and served as a member of the Eli Lilly Advisory Committee.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

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TOPLINE:

Intermittent energy restriction (IER) and continuous energy restriction (CER) reduced body mass index (BMI) in adolescents with obesity after 52 weeks, with no major differences found in body composition or cardiometabolic outcomes.

METHODOLOGY:

  • Researchers conducted a 52-week randomized clinical trial at two pediatric centers in Australia that involved 141 adolescents aged 13-17 years with obesity and at least one associated complication.
  • Participants were divided into two groups: IER and CER, with three phases: Very low-energy diet (weeks 0-4), intensive intervention (weeks 5-16), and continued intervention/maintenance (weeks 17-52).
  • Interventions included a very low-energy diet of 3350 kJ/d (800 kcal/d) for the first 4 weeks, followed by either IER intervention (2500-2950 kJ [600-700 kcal 3 days/wk]) or a daily CER intervention (6000-8000 kJ/d based on age; 1430-1670 kcal/d for teens aged 13-14 years and 1670-1900 kcal/d for teens aged 15-17 years).
  • Participants were provided with multivitamins and met with dietitians regularly, with additional support via telephone, text message, or email.

TAKEAWAY:

  • Teens in both the IER and CER groups showed a 0.28 reduction in BMI z-scores at 52 weeks with no significant differences between the two.
  • The researchers observed no differences in body composition or cardiometabolic outcomes between the IER and CER groups.
  • The occurrence of insulin resistance was reduced in both groups at week 16, but this effect was maintained only in the CER group at week 52.
  • The study found no significant differences in the occurrence of dyslipidemia or impaired hepatic function between the IER and CER groups.

IN PRACTICE:

“These findings suggest that for adolescents with obesity-associated complications, IER can be incorporated into a behavioral weight management program, providing an option in addition to CER and offering participants more choice,” the authors of the study wrote.

SOURCE:

The study was led by Natalie B. Lister, PhD, of the University of Sydney in Australia and was published online in JAMA Pediatrics.

LIMITATIONS:

The COVID-19 pandemic and subsequent lockdowns limited the sample size. Some dietitian visits were conducted via telehealth.

DISCLOSURES:

Dr. Lister received grants from the National Health and Medical Research Council of Australia. A coauthor, Louise A. Baur, MBBS, PhD, received speakers’ fees from Novo Nordisk and served as a member of the Eli Lilly Advisory Committee.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

 

TOPLINE:

Intermittent energy restriction (IER) and continuous energy restriction (CER) reduced body mass index (BMI) in adolescents with obesity after 52 weeks, with no major differences found in body composition or cardiometabolic outcomes.

METHODOLOGY:

  • Researchers conducted a 52-week randomized clinical trial at two pediatric centers in Australia that involved 141 adolescents aged 13-17 years with obesity and at least one associated complication.
  • Participants were divided into two groups: IER and CER, with three phases: Very low-energy diet (weeks 0-4), intensive intervention (weeks 5-16), and continued intervention/maintenance (weeks 17-52).
  • Interventions included a very low-energy diet of 3350 kJ/d (800 kcal/d) for the first 4 weeks, followed by either IER intervention (2500-2950 kJ [600-700 kcal 3 days/wk]) or a daily CER intervention (6000-8000 kJ/d based on age; 1430-1670 kcal/d for teens aged 13-14 years and 1670-1900 kcal/d for teens aged 15-17 years).
  • Participants were provided with multivitamins and met with dietitians regularly, with additional support via telephone, text message, or email.

TAKEAWAY:

  • Teens in both the IER and CER groups showed a 0.28 reduction in BMI z-scores at 52 weeks with no significant differences between the two.
  • The researchers observed no differences in body composition or cardiometabolic outcomes between the IER and CER groups.
  • The occurrence of insulin resistance was reduced in both groups at week 16, but this effect was maintained only in the CER group at week 52.
  • The study found no significant differences in the occurrence of dyslipidemia or impaired hepatic function between the IER and CER groups.

IN PRACTICE:

“These findings suggest that for adolescents with obesity-associated complications, IER can be incorporated into a behavioral weight management program, providing an option in addition to CER and offering participants more choice,” the authors of the study wrote.

SOURCE:

The study was led by Natalie B. Lister, PhD, of the University of Sydney in Australia and was published online in JAMA Pediatrics.

LIMITATIONS:

The COVID-19 pandemic and subsequent lockdowns limited the sample size. Some dietitian visits were conducted via telehealth.

DISCLOSURES:

Dr. Lister received grants from the National Health and Medical Research Council of Australia. A coauthor, Louise A. Baur, MBBS, PhD, received speakers’ fees from Novo Nordisk and served as a member of the Eli Lilly Advisory Committee.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

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Identifying Child Abuse Through Oral Health: What Every Clinician Should Know

Article Type
Changed
Tue, 08/27/2024 - 13:34

 

TOPLINE:

Researchers detail best practices for pediatricians in evaluating dental indications of child abuse and how to work with other physicians to detect and report these incidents.

METHODOLOGY:

  • Approximately 323,000 children in the United States were identified as having experienced physical abuse in 2006, the most recent year evaluated, according to the Fourth National Incidence Study of Child Abuse and Neglect.
  • One in seven children in the United States are abused or neglected each year; craniofacial, head, face, and neck injuries occur in more than half of child abuse cases.
  • Children with orofacial and torso bruising who are younger than age 4 years are at risk for future, more serious abuse.
  • Child trafficking survivors are twice as likely to have dental issues due to poor nutrition and inadequate care.

TAKEAWAY:

  • In cases of possible oral sexual abuse, physicians should test for sexually transmitted infections and document incidents to support forensic investigations.
  • Pediatricians should consult with forensic pediatric dentists or child abuse specialists for assistance in evaluating bite marks or any other indications of abuse.
  • If a parent fails to seek treatment for a child’s oral or dental disease after detection, pediatricians should report the case to child protective services regarding concerns of dental neglect.
  • Because trafficked children may receive medical or dental care while in captivity, physicians should use screening tools to identify children at risk of trafficking, regardless of gender.
  • Physicians should be mindful of having a bias against reporting because of sharing a similar background to the parents or other caregivers of a child who is suspected of experiencing abuse.

IN PRACTICE:

“Pediatric dentists and oral and maxillofacial surgeons, whose advanced education programs include a mandated child abuse curriculum, can provide valuable information and assistance to other health care providers about oral and dental aspects of child abuse and neglect,” the study authors wrote.

SOURCE:

The study was led by Anupama Rao Tate, DMD, MPH, of the American Academy of Pediatrics, and was published online in Pediatrics.

LIMITATIONS:

No limitations were reported.

DISCLOSURES:

Susan A. Fischer-Owens reported financial connections with Colgate. No other disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

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TOPLINE:

Researchers detail best practices for pediatricians in evaluating dental indications of child abuse and how to work with other physicians to detect and report these incidents.

METHODOLOGY:

  • Approximately 323,000 children in the United States were identified as having experienced physical abuse in 2006, the most recent year evaluated, according to the Fourth National Incidence Study of Child Abuse and Neglect.
  • One in seven children in the United States are abused or neglected each year; craniofacial, head, face, and neck injuries occur in more than half of child abuse cases.
  • Children with orofacial and torso bruising who are younger than age 4 years are at risk for future, more serious abuse.
  • Child trafficking survivors are twice as likely to have dental issues due to poor nutrition and inadequate care.

TAKEAWAY:

  • In cases of possible oral sexual abuse, physicians should test for sexually transmitted infections and document incidents to support forensic investigations.
  • Pediatricians should consult with forensic pediatric dentists or child abuse specialists for assistance in evaluating bite marks or any other indications of abuse.
  • If a parent fails to seek treatment for a child’s oral or dental disease after detection, pediatricians should report the case to child protective services regarding concerns of dental neglect.
  • Because trafficked children may receive medical or dental care while in captivity, physicians should use screening tools to identify children at risk of trafficking, regardless of gender.
  • Physicians should be mindful of having a bias against reporting because of sharing a similar background to the parents or other caregivers of a child who is suspected of experiencing abuse.

IN PRACTICE:

“Pediatric dentists and oral and maxillofacial surgeons, whose advanced education programs include a mandated child abuse curriculum, can provide valuable information and assistance to other health care providers about oral and dental aspects of child abuse and neglect,” the study authors wrote.

SOURCE:

The study was led by Anupama Rao Tate, DMD, MPH, of the American Academy of Pediatrics, and was published online in Pediatrics.

LIMITATIONS:

No limitations were reported.

DISCLOSURES:

Susan A. Fischer-Owens reported financial connections with Colgate. No other disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

 

TOPLINE:

Researchers detail best practices for pediatricians in evaluating dental indications of child abuse and how to work with other physicians to detect and report these incidents.

METHODOLOGY:

  • Approximately 323,000 children in the United States were identified as having experienced physical abuse in 2006, the most recent year evaluated, according to the Fourth National Incidence Study of Child Abuse and Neglect.
  • One in seven children in the United States are abused or neglected each year; craniofacial, head, face, and neck injuries occur in more than half of child abuse cases.
  • Children with orofacial and torso bruising who are younger than age 4 years are at risk for future, more serious abuse.
  • Child trafficking survivors are twice as likely to have dental issues due to poor nutrition and inadequate care.

TAKEAWAY:

  • In cases of possible oral sexual abuse, physicians should test for sexually transmitted infections and document incidents to support forensic investigations.
  • Pediatricians should consult with forensic pediatric dentists or child abuse specialists for assistance in evaluating bite marks or any other indications of abuse.
  • If a parent fails to seek treatment for a child’s oral or dental disease after detection, pediatricians should report the case to child protective services regarding concerns of dental neglect.
  • Because trafficked children may receive medical or dental care while in captivity, physicians should use screening tools to identify children at risk of trafficking, regardless of gender.
  • Physicians should be mindful of having a bias against reporting because of sharing a similar background to the parents or other caregivers of a child who is suspected of experiencing abuse.

IN PRACTICE:

“Pediatric dentists and oral and maxillofacial surgeons, whose advanced education programs include a mandated child abuse curriculum, can provide valuable information and assistance to other health care providers about oral and dental aspects of child abuse and neglect,” the study authors wrote.

SOURCE:

The study was led by Anupama Rao Tate, DMD, MPH, of the American Academy of Pediatrics, and was published online in Pediatrics.

LIMITATIONS:

No limitations were reported.

DISCLOSURES:

Susan A. Fischer-Owens reported financial connections with Colgate. No other disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

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Uterus Transplants in Women With Uterine-Factor Infertility Show High Rate of Live Births

Article Type
Changed
Tue, 08/20/2024 - 12:19

 

TOPLINE:

Uterus transplants in women with absolute uterine-factor infertility resulted in a 70% success rate of women later giving birth.

METHODOLOGY:

  • The study included 20 women with uterine-factor infertility, a condition in which women do not have a uterus or have one that is not functional; each patient had at least one functioning ovary and uterine abnormalities.
  • All patients underwent womb transplantation at a large US specialized care center between 2016 and 2019.
  • The transplant was performed using grafts from 18 living donors and two deceased donors.
  • Patients received anti-rejection medication until the transplanted uterus was removed following one or two live births or graft failure.
  • Researchers measured uterus graft survival and subsequent live births.

TAKEAWAY:

  • Out of the 20 participants, 14 (70%) had successful uterus transplants and all 14 gave birth to at least one healthy infant.
  • Half of the successful pregnancies had complications, which included gestational hypertension (14%), cervical insufficiency (14%), and preterm labor (14%).
  • None of the 16 live-born infants had congenital malformations, and no developmental delays were observed as of May 2024.
  • Four of the 18 living donors experienced grade 3 complications, including ureteral obstruction and thermal injury to the ureters.

IN PRACTICE:

“Uterus transplant was technically feasible and was associated with a high live birth rate following successful graft survival,” wrote the authors of the study. “Adverse events were common, with medical and surgical risks affecting recipients as well as donors.”

SOURCE:

The study was led by Giuliano Testa, MD, MBA, of Baylor University Medical Center in Dallas, Texas, and was published online in JAMA Network.

LIMITATIONS:

The findings are based on data from a single center. The sample size was small. The high cost of uterus transplants limits generalizability.

DISCLOSURES:

No disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

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TOPLINE:

Uterus transplants in women with absolute uterine-factor infertility resulted in a 70% success rate of women later giving birth.

METHODOLOGY:

  • The study included 20 women with uterine-factor infertility, a condition in which women do not have a uterus or have one that is not functional; each patient had at least one functioning ovary and uterine abnormalities.
  • All patients underwent womb transplantation at a large US specialized care center between 2016 and 2019.
  • The transplant was performed using grafts from 18 living donors and two deceased donors.
  • Patients received anti-rejection medication until the transplanted uterus was removed following one or two live births or graft failure.
  • Researchers measured uterus graft survival and subsequent live births.

TAKEAWAY:

  • Out of the 20 participants, 14 (70%) had successful uterus transplants and all 14 gave birth to at least one healthy infant.
  • Half of the successful pregnancies had complications, which included gestational hypertension (14%), cervical insufficiency (14%), and preterm labor (14%).
  • None of the 16 live-born infants had congenital malformations, and no developmental delays were observed as of May 2024.
  • Four of the 18 living donors experienced grade 3 complications, including ureteral obstruction and thermal injury to the ureters.

IN PRACTICE:

“Uterus transplant was technically feasible and was associated with a high live birth rate following successful graft survival,” wrote the authors of the study. “Adverse events were common, with medical and surgical risks affecting recipients as well as donors.”

SOURCE:

The study was led by Giuliano Testa, MD, MBA, of Baylor University Medical Center in Dallas, Texas, and was published online in JAMA Network.

LIMITATIONS:

The findings are based on data from a single center. The sample size was small. The high cost of uterus transplants limits generalizability.

DISCLOSURES:

No disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

 

TOPLINE:

Uterus transplants in women with absolute uterine-factor infertility resulted in a 70% success rate of women later giving birth.

METHODOLOGY:

  • The study included 20 women with uterine-factor infertility, a condition in which women do not have a uterus or have one that is not functional; each patient had at least one functioning ovary and uterine abnormalities.
  • All patients underwent womb transplantation at a large US specialized care center between 2016 and 2019.
  • The transplant was performed using grafts from 18 living donors and two deceased donors.
  • Patients received anti-rejection medication until the transplanted uterus was removed following one or two live births or graft failure.
  • Researchers measured uterus graft survival and subsequent live births.

TAKEAWAY:

  • Out of the 20 participants, 14 (70%) had successful uterus transplants and all 14 gave birth to at least one healthy infant.
  • Half of the successful pregnancies had complications, which included gestational hypertension (14%), cervical insufficiency (14%), and preterm labor (14%).
  • None of the 16 live-born infants had congenital malformations, and no developmental delays were observed as of May 2024.
  • Four of the 18 living donors experienced grade 3 complications, including ureteral obstruction and thermal injury to the ureters.

IN PRACTICE:

“Uterus transplant was technically feasible and was associated with a high live birth rate following successful graft survival,” wrote the authors of the study. “Adverse events were common, with medical and surgical risks affecting recipients as well as donors.”

SOURCE:

The study was led by Giuliano Testa, MD, MBA, of Baylor University Medical Center in Dallas, Texas, and was published online in JAMA Network.

LIMITATIONS:

The findings are based on data from a single center. The sample size was small. The high cost of uterus transplants limits generalizability.

DISCLOSURES:

No disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. A version of this article first appeared on Medscape.com.

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