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What your patients are reading: Week of December 16, 2024

December 20, 2024

Unexpected cancer diagnosis from prenatal test

A pregnant clinician in California was diagnosed with cancer after a noninvasive prenatal test (NIPT) detected abnormal DNA. The test, typically used to screen for fetal genetic conditions, identified unusual genetic markers, prompting further investigation. She faced challenges obtaining a full-body MRI from her hospital, so she enrolled in a study at NIH to secure the necessary imaging. Subsequent tests confirmed the presence of stage II Hodgkin lymphoma. This case highlights the potential of NIPT to detect rare maternal cancers and the need for a protocol to obtain additional imaging in cases like these.1

Experts warn of health risks from holding urine

Holding in urine occasionally is generally harmless, but habitual retention can lead to significant health issues. The bladder's capacity is about 400-600 milliliters, and when it is half full, nerve receptors signal the brain to urinate. Ignoring these signals can cause UTIs, which, if untreated, can escalate to kidney infections. Certain populations are at higher risk from delaying urination, including older adults, who may have a reduced capacity to urinate normally due to enlarged prostates and tightening urethras. Individuals with neurogenic bladder, kidney disorders, or those who are pregnant are also at greater risk. These groups may not be able to fight infections as effectively, necessitating more diligence in responding to the urge to urinate.2

Unexpected pain severity in medication abortions revealed by new study

Many women undergoing medication abortions experience more pain than anticipated, according to a study published in BMJ Sexual & Reproductive Health that surveyed around 1,600 women in the U.K. who had undergone medication abortions. Over 90% of respondents rated their pain at least a 4 out of 10, with about 40% describing their pain as severe (8-10 on the pain scale). Many women reported that the pain was significantly more intense than the period-like cramps they were led to expect. This discrepancy underscores the need for improved pain management counseling and setting realistic expectations for patients. “What’s important here is the acknowledgement that everyone’s experience of pain during a medical abortion will be different,” the study’s lead author, Hannah McCulloch, an evaluation researcher at the British Pregnancy Advisory Service, said. “It’s important to be realistic about what women experience during medical abortion in order to provide meaningful patient-centered care.”3

Sources:

1. Howard, J. (2024, December 16). CNN. Routine prenatal test revealed her ‘hidden cancer.’ A study suggests what doctors should watch for. https://www.cnn.com/2024/12/16/health/pregnant-woman-prenatal-testing-cancer/index.html

2. Rogers, K. (2024, December 15). CNN. Holding your pee can have dangerous health risks, experts say. https://www.cnn.com/2024/12/15/health/health-risks-of-holding-your-pee-wellness/index.html.

3. Sullivan, K. (2024, December 17). NBC News. Medication abortions may be more painful than women expect, study finds. https://www.nbcnews.com/health/health-news/medication-abortions-may-painful-women-expect-study-finds-rcna184554