Obstetrics & Gynecology

HIPEC at interval cytoreduction improves survival in newly diagnosed ovarian cancer, but not in recurrence

Across seven RCTs including 1,300 women, adding HIPEC to cytoreductive surgery improved PFS and OS in newly diagnosed ovarian cancer at interval debulking. At interval CRS after neoadjuvant chemotherapy, HIPEC reduced risk of progression (HR 0.65) and death (HR 0.68) versus surgery alone. No significant PFS or OS advantage was seen for HIPEC in the recurrent ovarian cancer setting, including RMST analyses. The greatest benefit appeared with 90‑minute HIPEC protocols, without a statistically significant increase in grade ≥3 adverse events. 1

Cadonilimab plus chemotherapy provides consistent survival benefit in advanced cervical cancer subgroups

In the COMPASSION-16 phase 3 trial, adding cadonilimab to standard chemotherapy improved PFS and OS in persistent, recurrent, or metastatic cervical cancer. Subgroup analyses showed PFS benefit favored cadonilimab across bevacizumab use, prior chemoradiation, PD-L1 CPS, baseline metastases, platinum use, and age. Overall survival gains with cadonilimab were similarly consistent across these predefined clinical and biomarker subgroups. These data support broad first-line use of cadonilimab plus chemotherapy, with or without bevacizumab, in advanced cervical cancer. 2

UA Doppler progression in early severe FGR occurs over days, with low fetal death when intervention is offered

This single-center cohort studied 241 singleton pregnancies with severe early-onset FGR that all progressed to absent or reversed UA end-diastolic flow. Late UA Doppler abnormalities first appeared around 27.5 weeks, with mean gestational age at birth 28.6 weeks despite surveillance. Mean progression times were 7 days from elevated UA-PI to intermittent absent flow, and about 6 days between subsequent stages until reversed flow. Fetal death occurred in 4.6% of pregnancies, mostly previable or after parental decision to decline intervention for poor prognosis. 3

One-step 75 g OGTT increases GDM diagnoses without improving short-term outcomes

In this RCT of 1,439 women, one-step 75 g OGTT identified more GDM than a two-step 50 g screen plus 100 g OGTT. Despite higher diagnostic yield, maternal and neonatal outcomes were similar between strategies, including hypertensive disorders, macrosomia, preterm birth, and NICU admission. Rates of polyhydramnios and insulin-requiring GDM were comparable between screening approaches. Two-hour OGTT glucose values showed the strongest prediction for polyhydramnios and insulin requirement, outperforming other time points and the 50 g screen. 4