International Journal of Gynecology & Obstetrics最新文献

{"title":"A silent pandemic of violence against providers in obstetrics and gynecology: A mixed-methods study based on a global survey.","authors":"Margit Endler, Atziri Ramirez-Negrin, Rubina Sohail","doi":"10.1002/ijgo.15985","DOIUrl":"https://doi.org/10.1002/ijgo.15985","url":null,"abstract":"<p><strong>Objectives: </strong>To quantify and qualify the experience of workplace violence (WPV) in a global sample of providers in obstetrics and gynecology (OBGYN).</p><p><strong>Methods: </strong>We performed a mixed-methods analysis on data from a global survey. Survey content was designed around categorical and open-ended questions in relation to WPV; the occurrence and character, the physical and psychological consequences, training and support structures, and perceived triggers of the experience of WPV. Quantitative data were analyzed using descriptive statistics and text data using mixed deductive-inductive content analysis. These data were integrated using convergent joint display.</p><p><strong>Results: </strong>Between October 2023 and January 2024, survey responses were collected from 77 individual countries. Among the final sample, 764/1016 (75.2%) had experienced WPV, 699/1016 (68.8%) verbal, and 123/1016 (12.1%) physical violence. The violence affected physical health, psychological health, or job satisfaction for 106/764 (13.9%), 36/7642 (47.4%), and 222/764 (29.1%) of individuals respectively; 216/764 (28.3%) received support. Main WPV triggers were staff shortages, lack of security personnel, and long waiting times, identified by 38.8%, 37.5%, and 37.3% of respondents respectively. Qualitative data indicated that violence caused severe and long-lasting suffering. Catalysts for WPV were often reported as complex interplays between unmet or unrealistic expectations and insufficient resources. Lack of support for WPV was explained as violence being \"part of the job\" and a culture of assumed resilience among providers.</p><p><strong>Conclusion: </strong>WPV against OBGYN providers seems to be ubiquitous, arises from a complex interplay of factors, and causes significant injury while receiving insufficient mitigation and support.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics in the provision of obstetric and gynecologic health care for non-binary and transgender individuals.","authors":"Aris Antsaklis, Lourdes B Capito, Suchitra N Pandit","doi":"10.1002/ijgo.15925","DOIUrl":"https://doi.org/10.1002/ijgo.15925","url":null,"abstract":"<p><p>Transgender and non-binary individuals often face bias and a lack of awareness, knowledge, and sensitivity from healthcare professionals. This article aims to raise awareness of the concepts of medical ethics among OBGYNs, so they will be better able to approach complex ethical situations in a clear and structured way when providing obstetric and gynecologic health care for transgender and gender-diverse patients.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term maternal outcomes 5 years after cesarean section in Sierra Leone: A prospective cohort study.","authors":"Erika Logstein, Richard Torp, Thomas Ashley, Michael M Kamara, Alimamy P Koroma, Abu Bakarr Dumbuya, Musa S Suma, Abdul Rahman Moijue, Josien Westendorp, Monica L Kujabi, Marcus J Rijken, Arne Wibe, Lars Hagander, Andrew J M Leather, Håkon A Bolkan, Alex J van Duinen","doi":"10.1002/ijgo.15996","DOIUrl":"https://doi.org/10.1002/ijgo.15996","url":null,"abstract":"<p><p>Cesarean section (CS) is a life-saving procedure when performed for the right indication but carries substantial risks, specifically during subsequent pregnancies. The aim of this study was to evaluate obstetric outcomes for women 5 years after a CS performed by medical doctors and associate clinicians. This was a prospective multi-center observational study of women who had a CS at any of nine hospitals in Sierra Leone. Women and their offspring were followed up with three home visits for 5 years after surgery. Outcomes of interest included long-term complications, mode and place of delivery, and maternal and pediatric outcomes of subsequent pregnancies. Of the 1274 women included in the study, 140 (11.0%) were lost to follow-up. Within 5 years after the index CS, 27.0% of the women became pregnant and 2.5% had a second pregnancy. Women with perinatal death at the index CS had 5.25 higher odds of becoming pregnant within 1 year. Of the 259 women who delivered, 31 (12.0%) had a planned CS and 228 (88.0%) attempted a trial of labor after CS, resulting in either a successful vaginal birth (n = 138; 60.5%) or an emergency CS (n = 90; 39.5%). Peripartum and long-term complications did not significantly differ between those that were operated on by medical doctors and associate clinicians. Within 5 years after CS, one in four women became pregnant again and more than half had a vaginal delivery. Significant differences in place and mode of birth between wealth quintiles illustrate inequities.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for re-hospitalization following cesarean delivery at term.","authors":"Roy Bitan, Yotam Lior, Hila Shalev Ram, Roza Berkovitz-Shperling, Anat Lavie, Yariv Yogev, Shai Ram","doi":"10.1002/ijgo.15997","DOIUrl":"https://doi.org/10.1002/ijgo.15997","url":null,"abstract":"<p><strong>Objective: </strong>To identify the key risk factors contributing to re-hospitalization after term cesarean delivery (CD).</p><p><strong>Methods: </strong>This retrospective cohort study included women who underwent CD at term at a university-affiliated tertiary medical center (January 2021 to March 2023). The primary outcome was risk factors for re-hospitalization within 30 days post-discharge. Data on selected maternal demographic, pregnancy-related and delivery variables were extracted from electronic medical records. A multivariable logistic regression analysis was conducted to identify independent risk factors for re-hospitalization. Logistic regression analysis was used to determine the odds ratios (ORs) and 95% confidence intervals (CIs) for various independent risk factors.</p><p><strong>Results: </strong>A total of 2878 women were included in the study, of whom 76 required re-hospitalization (2.6%). The rates of high-risk pregnancies were more prevalent among those who were re-hospitalized (41 [62.1%] vs. 1148 [49.1%], P = 0.043). Furthermore, the rates of emergency CDs (42 [56%] vs. 1040 [37.8%], P = 0.001), prolonged surgery duration (17 [22.4%] vs. 292 [10.4%], P = 0.001) and hospitalization duration (14 (18.4%) vs. 273 (9.7%), P = 0.015) were significantly higher in the re-hospitalized group. Emergency CD (OR 1.90, 95% CI 1.06-3.42, P = 0.030) and prolonged surgery duration (OR 2.44, 95% CI 1.25-4.77, P = 0.016) remained significant risk factors of re-hospitalization in the multivariate analysis.</p><p><strong>Conclusions: </strong>The need for emergency CD and prolonged surgery duration were found as independent risk factors for re-hospitalization after CD at term.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactions between pregnant women's nutrition habits, psychological well-beings, sleep quality and biochemical parameters.","authors":"Halis Doğukan Özkan, Hilal Doğan Güney","doi":"10.1002/ijgo.15992","DOIUrl":"https://doi.org/10.1002/ijgo.15992","url":null,"abstract":"<p><strong>Objective: </strong>Hormonal changes during pregnancy may cause various changes in biological, physiologic and psychosocial areas. The main objective of this study was to analyze the relationship between dietary habits, psychological well-being, sleep quality and biochemical parameters of pregnant women.</p><p><strong>Methods: </strong>The study was conducted on a total of 93 patients who applied to Ankara Koru Sincan Hospital Gynecology and Obstetrics Outpatient Clinic for routine pregnancy control between November-December 2023, were between the ages of 18-45, had a live singleton fetus, had no diagnosed psychiatric disease or chronic disease, and agreed to participate in the study. Anthropometric measurements and biochemical findings of the individuals were recorded with a questionnaire including the psychological well-being scale (PWBS) and Pittsburgh sleep quality index (PSQI).</p><p><strong>Results: </strong>According to the study, PSQI scores during the second and third trimesters are significantly higher than the first trimester. It was observed that while individuals have bad sleep quality during the second and third trimesters, they have good sleep quality during the first trimester (χ² = 14.736; P < 0.001). In the biochemical results, the thyroid-stimulating hormone (TSH) value in the second trimester was higher (P > 0.05). Weight gain during pregnancy, age and trimester have a negative effect on sleep quality.</p><p><strong>Conclusion: </strong>When the effects of lifestyles and eating habits of pregnant women on the process are considered, there is a relationship between smoking/alcohol consumption, less physical activity, poor eating habits, sleep quality and depressive symptoms. Factors such as age, educational background, trimester period and other basic sociodemographic variables are also involved.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RETRACTION: Association of biochemical markers with the severity of pre-eclampsia.","authors":"","doi":"10.1002/ijgo.15984","DOIUrl":"https://doi.org/10.1002/ijgo.15984","url":null,"abstract":"<p><strong>Retraction: </strong>A. M. Maged, G. Aid, N. Bassiouny, D. S. Eldin, S. Dahab, and N K. Ghamry, \"Association of Biochemical Markers With the Severity of Pre-Eclampsia,\" International Journal of Gynecology & Obstetrics 136, no. 2 (2017): 138-144, https://doi.org/10.1002/ijgo.12029. The above article, published online on 16 November 2016 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Michael Geary; the International Federation of Gynecology and Obstetrics; and John Wiley & Sons Ltd. The retraction has been agreed upon following an investigation into concerns raised by a third party regarding improbable values of free categorical variables in Table 1; the statistical significance in Table 1, 2, 3 and 5, where the P-values could not be reproduced using the information presented in the article; and inconsistent information on the number of stillbirth and stillborn neonates in Table 5. The authors were informed about the concerns, but they did not wish to cooperate with the investigation and were not able to provide the raw data as the study was conducted more than 5 years ago and the original data was no longer retained according to institutional policies. The authors' institute was also contacted, but they remained unresponsive. In the absence of a satisfactory explanation or supporting raw data, the editors have determined that the data for this study cannot be considered reliable and decided to retract the article.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of smoking on the efficacy of a single-dose methotrexate treatment for ectopic pregnancy.","authors":"Adi Dayan-Schwartz, Suzan Abd Elgani, Tamam Abdul-Ghani, Ariel Zilberlicht, Liron Kogan, Ari Reiss, Alon Tal","doi":"10.1002/ijgo.15993","DOIUrl":"https://doi.org/10.1002/ijgo.15993","url":null,"abstract":"<p><p>Ectopic pregnancy (EP), which complicates 2% of all pregnancies, can be treated with either methotrexate (MTX) or surgery. While most cases can be managed with a single dose of MTX, the success rate has declined in recent years. One theoretical explanation for this decline might be related to smoking, as studies of patients with rheumatoid arthritis who smoke have demonstrated an inadequate response to MTX treatment. This study aims to identify risk factors for single-dose MTX treatment failure, with a focus on smoking status. We conducted a retrospective cohort study of patients diagnosed with EP and treated with single-dose MTX at a single institution between January 2001 and May 2021. The primary outcome was the incidence of failed MTX treatment, defined as the need for additional surgical intervention. Logistic regression was used to adjust the results and calculate the odds ratio (OR). The final analysis included 299 patients. Overall, 209 (69.9%) patients were treated successfully with a single dose of MTX, while 79 patients (26.4%) required further surgical intervention. A day 1 β-hCG level >1500 mIU/mL and smoking were independently associated with MTX treatment failure, with an OR of 2.69 (95% confidence interval [CI] 1.41-5.13) and 2.58 (95% CI 1.16-5.75), respectively. Smoking and an initial β-hCG level above 1500 mIU/mL might reduce the success rate of single-dose MTX treatment for EP. Future studies should prospectively investigate alternative treatment protocols for patients with risk factors for medical treatment failure.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three consecutive pregnancies in a woman with spastic cerebral palsy being treated with intrathecal baclofen therapy.","authors":"Kim D D Barker, M Imran Murtuza, Ellen V Sloan","doi":"10.1002/ijgo.15988","DOIUrl":"https://doi.org/10.1002/ijgo.15988","url":null,"abstract":"<p><p>Baclofen is a commonly used medication for spasticity in patients with an injury to the central nervous system. For some, intrathecal delivery of baclofen provides better treatment with fewer systemic side effects. Baclofen is a category C medication during pregnancy based on animal studies. This narrative review presents the three consecutive pregnancies of a woman with spastic quadriparesis due to cerebral palsy that was being treated with an intrathecal baclofen (ITB) pump. Her spasticity care occurred at a large academic institution. Her prenatal and perinatal care occurred at the adjacent county hospital. There is limited literature on the safety of the use of an ITB pump for the treatment of spasticity in pregnant women, and this patient presentation aims to describe the course for the mother and her infants as she received treatment for her spasticity with an ITB pump.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The transfer of double cleavage embryos developed from two four-cell embryos may not represent an optimal treatment strategy in cycles with a greater number of four-cell embryos on Day 2.","authors":"Jun Zhang, Shuang Liu, Yunzhu Lan, Shaowei Chen, Ying Wan, Fang Wang","doi":"10.1002/ijgo.15977","DOIUrl":"https://doi.org/10.1002/ijgo.15977","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the impact of the number of Day 2 four-cell (D2-4C) embryos on double embryo transfer and blastocyst culture therapy in the first in vitro fertilization (IVF) cycle.</p><p><strong>Methods: </strong>A retrospective review was performed on 1039 blastocyst culture cycles to compare outcomes between available and unavailable blastocyst cycles, emphasizing the relationship between the number of D2-4C embryos and blastocyst availability. Furthermore, the correlation between four-cell embryo counts and live births was analyzed in 986 transfer cycles.</p><p><strong>Results: </strong>The analysis revealed that the number of D2-4C embryos independently influenced the availability of blastocysts (odds ratio [OR] 1.693, 95% confidence interval [CI] 1.306-2.195, P < 0.001). Receiver operating characteristic (ROC) analysis indicated that D2-4C embryos displayed the highest predictive value for available blastocysts, with an area under the curve (AUC) of 0.861 (95% CI 0.826-0.896). The cut-off point was determined to be 4.5, particularly for individuals younger than 25 years, where the AUC reached 0.927. This suggests that the number of D2-4C embryos has significant predictive value for available blastocysts. The live birth rate (LBR) of fresh embryo transfers significantly increased with the number of D2-4C embryos (P = 0.004). LBRs for zero, one, and two four-cell embryos in double cleavage embryo transfer were 20.24%, 34.97%, and 38.08%, respectively (P = 0.005). In the twin group, the percentages for zero, one, and two four-cell embryos were 1.21%, 9.75%, and 89.02%, respectively (P < 0.001). Single blastocyst transfer achieved an LBR comparable to that of two four-cell embryos (34.8% vs 39.0%, P = 0.415), while the twin rate significantly decreased with single blastocyst transfer (25.17% vs 1.40%, P < 0.001).</p><p><strong>Conclusion: </strong>The number of D2-4C embryos exhibits significant predictive value for available blastocysts, particularly among young women. Furthermore, most twins resulted from the transfer of double cleavage embryos derived from two four-cell embryos. Consequently, when the D2-4C count exceeds four in a cycle, blastocyst culture therapy is preferred over double cleavage-stage embryo transfer.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Content and design of respectful maternity care training packages for health workers in sub-Saharan Africa: Scoping review.","authors":"Judith Yargawa, Marina Daniele, Kelly Pickerill, Marianne Vidler, Angela Koech, Hawanatu Jah, Grace Mwashigadi, Mukaindo Mwaniki, Peter von Dadelszen, Marleen Temmerman, Veronique Filippi, Hannah Blencowe","doi":"10.1002/ijgo.15938","DOIUrl":"https://doi.org/10.1002/ijgo.15938","url":null,"abstract":"<p><strong>Background: </strong>Training health workers might facilitate respectful maternity care (RMC); however, the content and design of RMC training remain unclear.</p><p><strong>Objective: </strong>To explore the content and design of RMC training packages for health workers in sub-Saharan Africa.</p><p><strong>Search strategy: </strong>MEDLINE, EMBASE, CINAHL Complete, Web of Science Core Collections, SCOPUS, and grey literature sources (including websites of RMC-focused key organizations and Ministries of Health) were searched for journal papers, reports, and training guides from January 2006 up to August 2022.</p><p><strong>Selection criteria: </strong>There were no restrictions on study designs, language, or health-worker cadre. Two reviewers independently screened results.</p><p><strong>Data collection and analysis: </strong>Key data, including training content and methods used, were extracted and summarized.</p><p><strong>Main results: </strong>Thirty-two citations from 26 studies/programs were identified (24 journal papers, 5 manuals/guides, 2 reports and 1 PhD thesis), with 27 citations from 22 studies informing the review findings. About half of all conducted studies were from East Africa. The most common topics in RMC trainings were communication, privacy and confidentiality, and human resources. Most trainings were multicomponent and appear to be largely in-service training. Health workers providing direct care to women, compared with non-clinical staff such as receptionists and cleaners, were the only recipients of training in most studies (81.8%). Two broad categories of training methods/tools were identified: workshop-based and action-based. Over 90% of the studies assessed impact of the training, with a majority focused on impacts on maternal health and care; however, half of the latter studies did not appear to have feedback mechanisms in place for implementing change.</p><p><strong>Conclusions: </strong>The content and design of RMC training in sub-Saharan Africa are multifaceted, suggesting the complexity of implementing/promoting RMC. Some progress has been made; however, missed opportunities in training remain with respect to study populations, training topics, cadres, and feedback mechanisms.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}