Obstetrics and gynecology bulletin — October 25, 2026

Coverage: October 13–25, 2026, following the latest regular issue dated October 12. Six publications with dates and findings checked against their sources.

Obstetrics and maternal-fetal medicine

1. Benzodiazepines and malformations: a large cohort without a consistent overall increase

[Publication: observational cohort] [United States] — October 13, 2026. Annals of Internal Medicine.

Using data from Medicaid (2000–2018) and MarketScan (2003–2020), the study analyzed more than 4.2 million pregnancies resulting in live births, of which more than 79,000 had at least one first-trimester benzodiazepine dispensing. Compared with pregnancies without dispensing, the pooled adjusted relative risk of any major congenital malformation was 0.99 (95% CI, 0.96–1.03); adjusted absolute risks were 4.0% versus 4.1% in Medicaid and 4.9% versus 4.8% in MarketScan.

Why it matters: this informs counseling, but dispensing does not establish ingestion and an observational study does not establish causality; the authors note that data are lacking on rare malformations, longer exposures, and other pregnancy outcomes, so it does not justify treatment changes without individual assessment.

Sources

• [Article] Fung K, Sujan AC, Bateman BT, et al. "Benzodiazepine Use Early in Pregnancy and Risk for Congenital Malformations". Ann Intern Med. 2026. DOI: 10.7326/ANNALS-25-05148. https://doi.org/10.7326/ANNALS-25-05148 PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/42863122/

Gynecologic oncology

2. Language barriers and violence: opportunities to restore cervical screening access

[Publication: retrospective cohort] [France] — October 20, 2026. JAMA Network Open.

At a single tertiary maternity unit, the cohort included 18,253 pregnancies among women aged 25 years or older who delivered between 2019 and 2025 (15,640 distinct women, per the methods); 43.9% of pregnancies were not up to date with cervical screening, defined as a sample (cytology or human papillomavirus test) within the three years before the first antenatal visit. Compared with the low-vulnerability profile, the migrant or language-barrier profile had an adjusted odds ratio for screening inadequacy of 3.40 (95% CI, 3.16–3.66); the physical, sexual, and psychological violence profiles were also associated with more inadequate screening.

Why it matters: the findings support assessing access barriers at prenatal visits, but this was one center and the three-year definition did not distinguish cytology from virus testing; it does not establish a new screening interval for the Dominican Republic.

Sources

• [Article] Haury J, Chanier JB, Renevier B, et al. "Multiple Dimensions of Social Vulnerability and Cervical Cancer Screening Uptake". JAMA Netw Open. 2026;9(10):e2639570. DOI: 10.1001/jamanetworkopen.2026.39570. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855496

Reproduction and endocrinology

3. An additional form did not meaningfully improve mifepristone knowledge

[Randomized clinical trial] [United States] — October 19, 2026. JAMA Internal Medicine.

A total of 599 patients at five facilities were randomized and 593 were analyzed. After routine counseling, randomization determined whether knowledge was assessed before or after receiving and signing the patient agreement form. Adjusted scores were 10.26 and 10.44 out of 12, a difference of 0.18 (95% CI, −0.04 to 0.39), which was not significant.

Why it matters: the outcome was immediate knowledge, not clinical safety or access, and the study does not authorize bypassing local legal requirements. Conflict-of-interest disclosures: Biggs disclosed personal fees from the Center for Reproductive Rights and the American Civil Liberties Union for expert-witness work in litigation challenging abortion restrictions, outside the submitted work. Grossman disclosed personal fees from Planned Parenthood Federation of America for expert-witness work in such litigation. These disclosures do not themselves establish bias or invalidate the findings.

Sources

• [Article] Biggs MA, Ehrenreich K, Kaller S, et al. "Mifepristone Patient Agreement Form and Medication Abortion Knowledge: A Randomized Clinical Trial". JAMA Intern Med. 2026. DOI: 10.1001/jamainternmed.2026.5197. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2855587

4. Galectins in endometriosis and adenomyosis: early research without a validated clinical test

[Publication: exploratory study] [Poland] — October 13, 2026. Frontiers in Endocrinology.

One center compared inflammatory markers in 33 patients (9 with deep endometriosis, 7 with adenomyosis, and 17 with both) against 14 controls who did not undergo laparoscopy. Galectins and other mediators were measured in serum and, in patients only, in peritoneal fluid; several markers were below the quantification limit. In the group with both conditions, galectin-1 was less often detectable in serum than in controls (0/17 versus 8/14) and galectin-9 more often (15/17 versus 4/14).

Why it matters: the study generates hypotheses, but the small size, the lack of a sample size calculation, and the absence of peritoneal fluid from controls prevent presenting this as an available diagnostic test or a new treatment; practice does not change.

Sources

• [Article] Wendlocha D, Smycz-Kubańska M, Kościelniak-Ziemniak M, et al. "Modulation of immune and inflammatory responses involving selected galectins and selected immune-inflammatory mediators in women with deep endometriosis coexisting with adenomyosis – preliminary study". Front Endocrinol (Lausanne). 2026;17:1920315. DOI: 10.3389/fendo.2026.1920315. Open access (CC BY 4.0). https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2026.1920315/full

Minimally invasive surgery and pelvic floor

5. Targeted pelvic floor training outperformed Pilates for stress urinary incontinence

[Randomized clinical trial, blinded assessor] [Brazil] — October 15, 2026. International Urogynecology Journal.

According to the article, the trial randomized 105 women to three groups of 35: targeted training, Pilates, or Pilates with voluntary pelvic floor contraction. After 12 sessions over six weeks, the incontinence impact questionnaire score fell by 4.4 points with targeted training versus 0.7 in each Pilates group; 88 completed the intervention.

Why it matters: this supports targeted rehabilitation, with short follow-up and losses. The sample size and registration date could not be cross-checked against the official trial record.

Sources

• [Article] Borges FA, Rodrigues EP, Oliveira WS, et al. "Pelvic Floor Muscle Training Outperforms Pilates in Women with Stress Urinary Incontinence: A Randomized Controlled Trial". Int Urogynecol J. 2026. DOI: 10.1007/s00192-026-06900-4. Open access (CC BY 4.0). https://link.springer.com/article/10.1007/s00192-026-06900-4

6. Vaginal laser: no added benefit over sham at twelve months

[Clinical trial: secondary analysis] [Spain] — October 15, 2026. JAMA Network Open.

Among 84 breast cancer survivors with genitourinary symptoms taking aromatase inhibitors, the single-center, double-blind trial compared five monthly sessions of fractional carbon dioxide laser with a sham procedure, with nonhormonal measures in both groups. Sixty-seven participants completed twelve months; among sexually active participants, the difference in FSFI change at 12 months was −0.69 points (95% CI, −3.58 to 2.20; P = .64), with no differences in secondary outcomes.

Why it matters: an exploratory secondary analysis of a single-center trial does not establish absolute equivalence, but it does not support attributing improvement in both groups to laser or routine use in this population.

Sources

• [Article] Anglès-Acedo S, Alonso I, Ribera-Torres L, et al. "Laser Therapy for Sexual Health in Breast Cancer Survivors Receiving Aromatase Inhibitors: A Secondary Analysis of a Randomized Clinical Trial". JAMA Netw Open. 2026;9(10):e2638937. DOI: 10.1001/jamanetworkopen.2026.38937. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855354

Scope and limitations of this edition

Regulatory decisions without official communications, announcements of pending results, and congress figures without primary material were excluded. This edition's oncology coverage focuses on prevention.

Upcoming meetings and dates

The 55th AAGL Global Congress on minimally invasive gynecologic surgery will take place November 13–16, 2026, in Boston, United States. Findings not yet presented are not anticipated.

Sources

• [Meeting] 55th AAGL Global Congress, official announcement in AAGL Newsscope. https://newsscope.aagl.org/volume-40-issue-3/aagl-2026-global-congress-in-boston-a-call-to-shape-the-future-of-womens-surgical-care/

*Obstetrics and Gynecology Bulletin — October 2026*
Greetings, colleagues

🤰 Obstetrics
*First-trimester benzodiazepines*
Adjusted relative risk of major malformations among live births: 0.99; observational evidence, not a guarantee of overall safety.
https://doi.org/10.7326/ANNALS-25-05148

🎗️ Oncology
*Cervical screening access barriers*
43.9% of pregnancies not up to date with cervical screening within three years; one French center, not a new interval guideline.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855496

🧬 Reproduction
*Mifepristone information*
593 participants analyzed: the added form did not meaningfully improve knowledge; clinical safety was not studied.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2855587

🔬 Pelvic floor
*Targeted training versus Pilates*
105 women: score reduction of 4.4 versus 0.7 points; six-week follow-up; sample size not cross-checked against the official trial record.
https://link.springer.com/article/10.1007/s00192-026-06900-4

*Vaginal laser versus sham*
84 women: no added benefit at twelve months; secondary analysis in breast cancer survivors.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855354

Full bulletin and audio: https://boletinesmedicos.com/en/obgyn/2026-10-25.html

Obstetrics and gynecology bulletin — October 25, 2026
6 source-checked publications from Annals of Internal Medicine, JAMA Network Open, JAMA Internal Medicine, Frontiers in Endocrinology, and International Urogynecology Journal.

Three worth your time:
• Pelvic floor: 105 women; targeted training reduced incontinence impact by 4.4 points versus 0.7 with Pilates. Short follow-up; sample size not cross-checked against the official trial record.
• Vaginal laser: 84 participants; no advantage over sham at 12 months. Secondary analysis in breast cancer survivors.
• Cervical screening: 43.9% of pregnancies were not up to date; the migrant or language-barrier profile had an adjusted odds ratio of 3.40. One French center.

Full bulletin, with critical appraisal and primary sources:
https://boletinesmedicos.com/en/obgyn/2026-10-25.html
#ObGyn #Obstetrics #Gynecology #PelvicFloor

Pelvic floor training: −4.4 vs −0.7 points with Pilates (105 women, 6 weeks). Vaginal laser: no benefit over sham at 12 months (84 women). Limited studies.
https://boletinesmedicos.com/en/obgyn/2026-10-25.html