Monthly obstetrics and gynecology bulletin — October 1, 2026
Period covered: August 30 to October 1, 2026. A thin month: 10 verified items, none of them a major new randomized trial. The most solid are a meta-analysis with consensus on GLP-1 receptor agonists in pregnancy and three regulatory decisions in platinum-resistant or maintenance-setting ovarian cancer. Several journals (NEJM, JAMA, the Green Journal, AJOG, BJOG) blocked automated access, so the absence of items on a topic reflects what could be verified, not necessarily that nothing was published. Regions with nothing verifiable this month: China, Korea, Russia, Turkey, Brazil and the Dominican Republic.
Obstetrics and maternal-fetal medicine
1. GLP-1 receptor agonists before, during and after pregnancy: meta-analysis and international consensus
[Meta-analysis] [Guideline] [United Kingdom]
The Lancet Obstetrics, Gynaecology & Women's Health released on September 30, 2026 a systematic review, meta-analysis and international expert consensus, coordinated from the University of Leicester, on GLP-1 receptor agonists in women with type 1, type 2 or gestational diabetes. It pooled 7 studies with more than 43,000 exposed women and found no significant association with preterm birth, stillbirth or neonatal death, cesarean delivery, hypertensive disorders or preeclampsia, or small-for-gestational-age infants. Early pregnancy loss (before 14-22 weeks) was 31% more common among exposed women (2 studies; n = 41,046). The consensus supports use for preconception metabolic optimization, especially in type 2 diabetes, and maintains the advice to stop before a planned pregnancy.
Why it matters: It helps counsel calmly the patient who conceives while on semaglutide or similar agents, an increasingly common situation, but it does not license continuing them in pregnancy. All the evidence is observational, 6 of the 7 studies assessed first-trimester exposure, and the early-loss finding combines miscarriage and elective termination in the study contributing 99% of the women. Funding includes a Novo Nordisk Foundation award. We could not open the full text: the figures come from the journal press summary, without confidence intervals.
https://www.thelancet.com/journals/lanogw/article/PIIS3050-5038(26)00266-9/fulltext
https://www.scimex.org/newsfeed/glp-1s-appear-safe-for-treating-diabetes-in-pregnancy-but-large-evidence-gaps-remain
Note: ACOG published in September its Clinical Practice Guideline No. 12, "Obstetric Cerclage" (Obstetrics & Gynecology, DOI 10.1097/AOG.0000000000006379). We could not open the text or confirm the exact publication date, so it is not summarized as an item; it should be read directly: https://www.acog.org/clinical/clinical-guidance/clinical-practice-guideline/articles/2026/09/obstetric-cerclage . No verifiable items this month on postpartum hemorrhage, preeclampsia, induction, cesarean delivery or maternal vaccination.
Gynecologic oncology
2. Relacorilant plus nab-paclitaxel: positive CHMP opinion in platinum-resistant ovarian cancer
[Regulatory EMA] [European Union]
On September 18, 2026 the EMA's CHMP recommended authorizing Lifyorli (relacorilant) with nab-paclitaxel for adults with platinum-resistant high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer after one to three prior lines. The basis is ROSELLA (phase 3, open label, n = 381): median progression-free survival 6.5 versus 5.5 months (HR 0.70; 95% CI 0.54-0.91; P = .0076) and median overall survival 16.0 versus 11.9 months (HR 0.65; 95% CI 0.51-0.83; P = .0004). The European Commission decision is expected in the fourth quarter of 2026.
Why it matters: Four months of overall survival in a population with few options is meaningful, but the data are not new, the trial was open label and sponsored by the manufacturer (Corcept), and the progression gain is one month. It is an opinion, not yet an authorization, and the drug is not registered in the Dominican Republic.
https://www.ema.europa.eu/en/news/meeting-highlights-committee-medicinal-products-human-use-chmp-14-17-september-2026
https://www.cancernetwork.com/view/relacorilant-combo-receives-positive-chmp-opinion-in-ovarian-cancer
3. Senaparib: positive CHMP opinion as first-line maintenance in advanced ovarian cancer
[Regulatory EMA] [European Union / China]
At the same meeting (opinion published September 18, 2026), the CHMP recommended Sepalna (senaparib), a PARP inhibitor developed by IMPACT Therapeutics (China), as maintenance treatment of advanced high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer. In the phase 3 FLAMES trial (senaparib n = 271, placebo n = 133), median progression-free survival was not reached with senaparib versus 13.6 months with placebo (HR 0.43; 95% CI 0.32-0.58; P < .0001), by blinded independent central review at a prespecified interim analysis. Grade 3 or higher adverse events occurred in 66.3% versus 20.3%.
Why it matters: It would be one more PARP inhibitor in a space already held by olaparib and niraparib, with no head-to-head comparison. The analysis is interim, without overall survival, manufacturer sponsored and based on data already published in 2024; the sources consulted do not state where patients were recruited, which should be checked before extrapolating. It does not change local practice.
https://www.ema.europa.eu/en/news/meeting-highlights-committee-medicinal-products-human-use-chmp-14-17-september-2026
https://www.onclive.com/view/eu-approval-reccomended-by-chmp-for-senaparib-in-advanced-ovarian-cancer
4. Japan approves pembrolizumab for platinum-resistant recurrent ovarian cancer
[Regulatory PMDA] [Japan]
MSD announced on September 16, 2026 the Japanese approval of pembrolizumab for platinum-resistant recurrent ovarian cancer. It rests on KEYNOTE-B96, an international randomized double-blind phase 3 trial of 643 patients (37 Japanese): pembrolizumab plus paclitaxel, with or without bevacizumab, versus placebo plus paclitaxel. In the overall population, median progression-free survival was 8.3 versus 6.4 months (HR 0.70; 95% CI 0.58-0.84; P < .0001) and median overall survival 17.7 versus 14.0 months (HR 0.82; 95% CI 0.69-0.97; P = .0115).
Why it matters: It adds an immunotherapy option with an overall survival benefit in this setting, but the gain is modest (3.7 months), the trial is manufacturer sponsored, and the report does not say whether the Japanese label is restricted by PD-L1 expression. Cost limits its use in the Dominican setting. (source in Japanese)
https://www.carenet.com/news/general/carenet/63624
5. Rezatapopt in TP53 Y220C-mutated ovarian cancer: 46% response rate in phase 2
[Industry] [United States]
PMV Pharmaceuticals reported on August 31, 2026 (covered September 1) interim data from the ovarian cohort of PYNNACLE, a single-arm phase 2 study in platinum-resistant or refractory ovarian cancer harboring a TP53 Y220C mutation. Among 76 evaluable patients, the investigator-assessed objective response rate was 46% (35/76: 4 confirmed complete responses, 29 confirmed partial responses and 2 unconfirmed partial responses), with a median duration of response of 10.0 months. The company plans to file for FDA accelerated approval in the first quarter of 2027.
Why it matters: An interesting signal for a target that was untreatable until now, but this is a manufacturer press release, not peer reviewed, with no comparator, investigator-assessed response (the study's primary endpoint is independent review) and two unconfirmed responses. The mutation is uncommon and requires tumor sequencing; it changes nothing in practice today.
https://www.cancernetwork.com/view/rezatapopt-yields-responses-supports-nda-plan-in-ovarian-cancer
Reproduction and endocrinology
6. FDA: supply difficulties with estradiol transdermal patches
[Regulatory FDA] [United States]
On September 3, 2026 the FDA posted an update on the availability of estradiol transdermal patches, as patients are having difficulty obtaining them because of increased demand. The agency says it is working with all six manufacturers to increase supply, that supply has nearly doubled over the last year, and that patches remain available although certain products or brands may vary by pharmacy or location.
Why it matters: This is not clinical data but a market signal: demand for menopausal hormone therapy is growing fast in the United States. If the shortage reaches importers in the region, other estradiol formulations should be kept in mind.
7. Hormone therapy and mood symptoms in the menopause transition
[Publication] [United States]
A single-center retrospective study (NYU Langone, New York), published online September 9, 2026 in Menopause, analyzed 260 women who completed the Menopause Rating Scale before and after starting systemic hormone therapy (96.5% on transdermal estradiol). The proportion with severe mood symptoms fell from 62.3% to 24.6% after a mean follow-up of 4.5 months, with a similar response across psychiatric history, age, menopause stage and antidepressant use.
Why it matters: It generates a hypothesis and does not change indications: there is no control group, so it cannot separate a drug effect from placebo or regression to the mean, which the authors acknowledge. Hormone therapy is not indicated as a treatment for depression; at most, the finding supports assessing mood when treating vasomotor symptoms.
No verifiable items this month on in vitro fertilization, endometriosis, fibroids or contraception.
Minimally invasive surgery and pelvic floor
8. Laparoscopic sacrocolpopexy: absorbable versus nonabsorbable sutures, 10-year results
[Clinical trial] [Germany]
The International Urogynecology Journal published on September 10, 2026 the 10-year follow-up of a two-center randomized trial (Tübingen and Berlin) in stage II-III vaginal vault prolapse, comparing absorbable with nonabsorbable sutures for vaginal mesh fixation in nerve-preserving laparoscopic sacrocolpopexy. Of 195 women enrolled, 104 had 10-year data (median 10.2 years): 102 were at apical POP-Q stage 0 and 2 at stage I, with no difference between groups. With nonabsorbable sutures there were 3 vaginal suture penetrations, 1 asymptomatic mesh erosion and 1 small vesicovaginal fistula; with absorbable sutures, 2 mesh erosions requiring excision.
Why it matters: It supports using absorbable sutures for vaginal fixation without sacrificing apical durability, which is immediately applicable in any center performing sacrocolpopexy. Serious limitations: only 53% of the cohort reached 10 years, the authors acknowledge the analysis is underpowered, and the abstract offers no formal noninferiority test.
https://link.springer.com/article/10.1007/s00192-026-06850-x
No verifiable items this month on hysterectomy, vNOTES, incontinence or hysteroscopy.
Cross-cutting
9. Costa Rica presents its national roadmap to eliminate cervical cancer, 2026-2030
[Guideline] [Costa Rica]
On September 4, 2026, Costa Rica presented, with PAHO support, its National Roadmap toward the Elimination of Cervical Cancer 2026-2030 and made official a directive to implement it. The country diagnoses an average of 270 new cases a year and records more than one hundred deaths annually. It adopts the 90-70-90 targets for 2030 (HPV vaccination, screening with high-performance tests, and treatment) and the goal of fewer than 4 cases per 100,000 women.
Why it matters: This is a policy announcement, without outcomes yet, and the report gives no baseline coverage or budget. It is useful as a model roadmap with targets and deadlines for Caribbean countries, the Dominican Republic included.
10. Roche Diagnostics and PAHO agree on HPV DNA test supply for Latin America and the Caribbean
[Industry] [Latin America and the Caribbean]
According to an EFE wire story of September 23, 2026, Roche Diagnostics and PAHO signed an agreement to accelerate access to HPV DNA screening tests, to be implemented through PAHO's Regional Revolving Funds. The region has an age-adjusted incidence of 15.1 cases per 100,000 women, almost four times the WHO elimination threshold (4 per 100,000).
Why it matters: It may lower the cost of moving from cytology to HPV testing in countries that purchase through the Revolving Funds, a mechanism open to member states. But the story was produced with support from Roche, gives no prices, volumes or countries, and we found no PAHO release of its own; the concrete terms remain to be seen. (source in Spanish)
Upcoming meetings and dates
- IGCS 2026 (International Gynecologic Cancer Society): October 1-3, Montréal. Under way; results will be covered in the next issue.
- The Menopause Society Annual Meeting: October 20-24, San Diego (in-person registration sold out; virtual option available).
- ASRM 2026 Scientific Congress & Expo: October 24-28, Baltimore.
- AAGL 55th Global Congress on MIGS: announced for mid-November (November 13-16 according to an exhibitor calendar; date and venue not confirmed on the official page).
- ESMO 2026: scheduled for October; we could not confirm dates on the official page. FIGO holds no world congress in 2026 (the next is October 31 to November 5, 2027, Montréal).
Ready-to-paste LinkedIn post
Monthly obstetrics and gynecology bulletin — October 1, 2026 10 verified items from the past month, from The Lancet Obstetrics, Gynaecology & Women's Health, the International Urogynecology Journal, Menopause, the EMA, the FDA and PAHO. A thin month for new trials. Three worth your time: • GLP-1 receptor agonists and pregnancy: meta-analysis of 7 studies and more than 43,000 exposed women, no excess preterm birth or preeclampsia; early loss 31% more common. Observational evidence only. • Relacorilant plus nab-paclitaxel in platinum-resistant ovarian cancer: positive CHMP opinion; overall survival 16.0 versus 11.9 months (HR 0.65). Open-label, manufacturer-sponsored trial. • Laparoscopic sacrocolpopexy at 10 years: 102 of 104 women with intact apical support, no difference between absorbable and nonabsorbable sutures. Only 53% follow-up. Full bulletin, with a critical reading of each study and links to primary sources: https://boletinesmedicos.com/en/ginecologia/2026-10-01.html #ObGyn #Obstetrics #Gynecology #OvarianCancer #Menopause
Ready-to-paste X (Twitter) post
GLP-1 agonists in pregnancy: 7 studies, 43,000+ exposed, no excess preterm birth or preeclampsia; early loss 31% more common. Relacorilant in platinum-resistant ovarian cancer: OS 16.0 vs 11.9 months, CHMP positive. https://boletinesmedicos.com/en/ginecologia/2026-10-01.html
Get every issue by email
Free. One email per issue, with the full text and the audio link. No advertising, no data sharing; unsubscribe with a single message.
Subscribe by email Your email program will open with the message already written; just send it.