Journal of obstetrics and gynaecology Canada最新文献

{"title":"Re: Guideline No. 456: Prenatal Screening for Fetal Chromosomal Anomalies, JOGC No. 456, Nov 2024","authors":"David Somerset BM, MD","doi":"10.1016/j.jogc.2025.102816","DOIUrl":"10.1016/j.jogc.2025.102816","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 5","pages":"Article 102816"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Guideline No. 456: Prenatal Screening for Fetal Chromosomal Anomalies","authors":"Francois Audibert MD, MSc , Karen Wou MD , Nanette Okun MD , Isabelle De Bie MD, PhD , R. Douglas Wilson MD","doi":"10.1016/j.jogc.2025.102815","DOIUrl":"10.1016/j.jogc.2025.102815","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 5","pages":"Article 102815"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guideline No. 345: Primary Dysmenorrhea","authors":"Margaret Burnett MD","doi":"10.1016/j.jogc.2025.102840","DOIUrl":"10.1016/j.jogc.2025.102840","url":null,"abstract":"<div><h3>Objective</h3><div>This guideline reviews the investigation and treatment of primary dysmenorrhea.</div></div><div><h3>Target Population</h3><div>Individuals experiencing menstrual pain for which no underlying cause has been identified.</div></div><div><h3>Benefits, Harms, and Costs</h3><div>Primary dysmenorrhea is common and frequently undertreated, despite effective therapy being widely available at a minimal cost. Treatment of primary dysmenorrhea has the potential to improve quality of life and decrease time away from school or work.</div></div><div><h3>Evidence</h3><div>Published clinical trials, randomized controlled trials, observational studies, population studies, and systematic review articles indexed in PubMed and the Cochrane database were identified using search the terms “dysmenorrhea” and “menstrual pain.” This search builds on the previous review (January 2005 to March 2016), including new literature between March 2016 and December 2024.</div></div><div><h3>Validation Methods</h3><div>The author rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online <span><span>Appendix A</span></span> (<span><span>Tables A1</span></span> for definitions and <span><span>A2</span></span> for interpretations of strong and conditional [weak] recommendations).</div></div><div><h3>Intended Audience</h3><div>Primary care providers, pediatricians, and obstetrician/gynaecologists.</div></div><div><h3>Social Media Abstract</h3><div>Although menstrual pain is commonly experienced by women and adolescents, it is often undertreated or unfairly dismissed. If left untreated, persistent menstrual pain may develop into a chronic pain syndrome. Treatment includes non-steroidal anti-inflammatory drugs and hormonal contraceptives and can be provided without the need for pelvic examinations; treatment should not be delayed pending a definitive diagnosis. Effective treatments are available and do not require a pelvic examination or invasive procedures.</div></div><div><h3>SUMMARY STATEMENTS</h3><div><ul><li><span>1.</span><span><div>Dysmenorrhea is highly prevalent and commonly undertreated (<em>low</em>).</div></span></li><li><span>2.</span><span><div>Risk factors associated with primary dysmenorrhea include age, smoking, alcohol use, diet, level of physical activity, family history, parity and psychosocial factors <em>(high).</em></div></span></li><li><span>3.</span><span><div>Primary dysmenorrhea is crampy, suprapubic pain that begins around menstruation, peaks with maximum blood flow, and lasts 2 to 3 days; common symptoms include nausea, vomiting, diarrhea, headache, dizziness, and fatigue (<em>high</em>).</div></span></li><li><span>4.</span><span><div>MRI is valuable in diagnosing deep endometriosis and adenomyosis but is less effective in detecting superficial endometriosis, which is commonly found during laparoscopy; laparoscopy remains the ","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 5","pages":"Article 102840"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ligne directrice No. 345 : Dysménorrhée primaire","authors":"Margaret Burnett MD","doi":"10.1016/j.jogc.2025.102841","DOIUrl":"10.1016/j.jogc.2025.102841","url":null,"abstract":"<div><h3>Objectif</h3><div>Ce guide passe en revue les investigations et le traitement de la dysménorrhée primaire.</div></div><div><h3>Population cible</h3><div>Personnes souffrant de douleurs menstruelles pour lesquelles aucune cause sous-jacente n'a été identifiée.</div></div><div><h3>Avantages, inconvénients et coûts</h3><div>La dysménorrhée primaire est fréquente et souvent sous traitée, bien qu'une thérapie efficace soit largement disponible à un coût minime. Le traitement de la dysménorrhée primaire peut améliorer la qualité de vie et réduire l'absence scolaire ou professionnel.</div></div><div><h3>Données probantes</h3><div>Les essais cliniques publiés, les essais contrôlés randomisés, les études observationnelles, les études de population et les articles de revue systématique indexés dans PubMed et la base de données Cochrane ont été identifiés à l'aide des termes de recherche \"dysménorrhée\" et \"douleurs menstruelles\". Cette recherche s'appuie sur l'examen précédent (janvier 2005 à mars 2016) et inclut la nouvelle littérature entre mars 2016 et décembre 2024.</div></div><div><h3>Méthodes de validation</h3><div>L'auteur a évalué la qualité des preuves et la force des recommandations en utilisant l'approche GRADE (Grading of Recommendations Assessment, Development and Evaluation). Voir l'annexe A en ligne (<span><span>tableaux A1</span></span> pour les définitions et <span><span>A2</span></span> pour les interprétations des recommandations fortes et conditionnelles [faibles]).</div></div><div><h3>Public cible</h3><div>Médecin généraliste, pédiatres et gynécologues-obstétriciens.</div></div><div><h3>Résumé pour les médias sociaux</h3><div>Bien que les douleurs menstruelles soient couramment ressenties par les femmes et les adolescentes, elles sont souvent sous-traitées ou injustement rejetées. Si elles ne sont pas traitées, les douleurs menstruelles persistantes peuvent se transformer en un syndrome douloureux chronique. Le traitement comprend des anti-inflammatoires non stéroïdiens et des contraceptifs hormonaux et peut être dispensé sans qu'il soit nécessaire de procéder à un examen pelvien ; le traitement ne doit pas être retardé dans l'attente d'un diagnostic définitif. Des traitements efficaces sont disponibles et ne nécessitent pas d'examen pelvien ni de procédures invasives.</div></div><div><h3>ÉTATS RÉCAPITULATIFS</h3><div><ul><li><span>1.</span><span><div>La dysménorrhée est très répandue et souvent insuffisamment traitée (<em>faible</em>).</div></span></li><li><span>2.</span><span><div>Les facteurs de risque associés à la dysménorrhée primaire, notamment l'âge, le tabagisme, la consommation d'alcool, le régime alimentaire, le niveau d'activité physique, les antécédents familiaux, la parité et les facteurs psychosociaux <em>(élevés).</em></div></span></li><li><span>3.</span><span><div>La dysménorrhée primaire se caractérise par des crampes et des douleurs sus-pubiennes qui apparaissent au moment des règles, atteignent leur paroxysm","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 5","pages":"Article 102841"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Continuing Education to Build Provider Capacity in Perinatal Mental Health: Learnings from Evaluation of a Pilot Project ECHO in Québec","authors":"Clara Vincent BA , Laurie Nadeau BSc , Anabel Carmel MD , Irena Stikarovska MD , Martin St-André MD , Tina Montreuil PhD , Anna L. MacKinnon PhD","doi":"10.1016/j.jogc.2025.102913","DOIUrl":"10.1016/j.jogc.2025.102913","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102913"},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal Outcomes Among Patients Using OB Teleflex, A Hybrid Prenatal Telemedicine Program","authors":"Devika Lekshmi MPH ,&nbsp;Sophie Nader MS ,&nbsp;Jennifer Roberts-Barry BSN, RN ,&nbsp;Laura E. Baecher Lind MD, MPH ,&nbsp;Alysa St. Charles MA ,&nbsp;Erika F. Werner MD, MS ,&nbsp;Sebastian Z. Ramos MD","doi":"10.1016/j.jogc.2025.102911","DOIUrl":"10.1016/j.jogc.2025.102911","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess obstetric outcomes among participants of the OB Teleflex program, in which roughly half of prenatal care was virtual, compared to those who were eligible, but elected traditional prenatal care.</div></div><div><h3>Methods</h3><div>This retrospective cohort study of patients who delivered between October 1, 2021, and September 30, 2022, compared OB Teleflex participation to routine prenatal care. Low-risk patients with a singleton, viable, non-anomalous fetus, and without hypertension requiring medication, were eligible for OB Teleflex and included in the study. Inverse-probability weighting was used to obtain unbiased estimates of the program effect on a composite of adverse outcomes that included primary cesarean delivery, neonatal intensive care unit admission, preterm birth, insufficient gestational weight gain, and hypertensive disorders of pregnancy.</div></div><div><h3>Results</h3><div>Out of 674 patients who delivered at our centre during the study period, 347 were eligible for OB Teleflex and met the study criteria. Of the 347 patients eligible for OB Teleflex, 63 (18%) chose to participate in the program. Those who elected OB Teleflex compared to those who did not, differed by race, parity, and history of cesarean deliveries. In both adjusted and unadjusted analyses of the composite of adverse outcomes, there was no difference between OB Teleflex participants and those receiving standard care.</div></div><div><h3>Conclusions</h3><div>Hybrid prenatal telemedicine did not differ from standard prenatal care in the rate of adverse maternal and perinatal outcomes. Programs like OB Teleflex may help to remove barriers from care without worsening birth outcomes. Larger studies are needed to investigate whether hybrid prenatal care can improve outcomes.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102911"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Non-Urban Access to Specialist OBGYN Care in Canada: A Call to Action","authors":"Jena Hall MD, MEd, CIP ,&nbsp;Robert Anderson MD ,&nbsp;Jonathan Cluett MD ,&nbsp;Melinda Davis BMed ,&nbsp;Aaron Johnston MD, CCFP-EM ,&nbsp;Gail Lam MD ,&nbsp;Aaron Low MD ,&nbsp;Jadine Paw MD ,&nbsp;Erin Brennand MD, MSc","doi":"10.1016/j.jogc.2025.102912","DOIUrl":"10.1016/j.jogc.2025.102912","url":null,"abstract":"<div><div>There are significant inequities in access to specialist obstetrical and gynecologic care between urban and non-urban Canada. Without purposeful action, this inequity crisis will worsen.</div><div>The relationship between postgraduate training site and practice location is well-established: non-urban training site is associated with subsequent non-urban practice. Therefore, one avenue to increase the recruitment and retention of Obstetricians and Gynecologists in non-urban locations is to establish university-affiliated non-urban postgraduate training sites.</div><div>We outline the rationale for, and practical considerations of, the establishment of distributed non-urban Obstetricians and Gynecologists training sites across Canada to improve access to specialty female reproductive health care for all populations.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102912"},"PeriodicalIF":2.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Appraisal of: Systematic Review and Meta-Analysis Assessing GnRH Antagonists, Considering Add-Back Therapy, for Endometriosis-Associated Pain","authors":"Sylvie Bowden MD ,&nbsp;Jena Hall MD, MEd","doi":"10.1016/j.jogc.2025.102835","DOIUrl":"10.1016/j.jogc.2025.102835","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102835"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey of Recurrent Pregnancy Loss Management in Canada","authors":"Vanessa Bacal MD, MSc ,&nbsp;Sony Sierra MD, MSc ,&nbsp;Michelle EyunJung Shin MSc ,&nbsp;Ellen M. Greenblatt MD","doi":"10.1016/j.jogc.2025.102844","DOIUrl":"10.1016/j.jogc.2025.102844","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102844"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending the Time Limit of the Second Stage of Labour Versus Delivering on Time Operatively: A Retrospective Cohort Study","authors":"Khadeje Seh MD ,&nbsp;Manal Massalha MD ,&nbsp;Raed Salim MD","doi":"10.1016/j.jogc.2025.102837","DOIUrl":"10.1016/j.jogc.2025.102837","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the effect of extending the second stage on maternal outcomes compared to not exceeding the time at the expense of 100% operative delivery.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted in a university teaching hospital on data between 2018 and 2020. Nulliparous with a singleton, viable, term fetus in a cephalic presentation at the second stage was incorporated. Study cohort was partitioned into 3 groups: group 1, nulliparous who delivered operatively (100%) by cesarean delivery or vacuum extraction within 2 hours (or 3 hours with epidural); group 2, nulliparous who proceeded with a trial of labour past 2 hours (or 3 hours with epidural); group 3, nulliparous who had a spontaneous vaginal delivery within 2 hours (or 3 hours with epidural). The primary outcome was a composite of maternal morbidities that included at least 1 of the followings: postpartum hemorrhage, infection (any), fever ≥38°C, abdominal organs injury, anal sphincter injury, relaparotomy, and maternal intensive care unit admission.</div></div><div><h3>Results</h3><div>Overall, 1007 nulliparous were eligible, 215, 252, and 540 in groups 1, 2, and 3 respectively. Incidence of the primary outcome was 31 (14.4%), 62 (24.6%), and 73 (13.5%) in groups 1, 2, and 3 respectively (<em>P</em> = 0.001). After adjusting for demographic and obstetric variables, the primary outcome rate remained significantly greater in group 2 compared to group 1 (adjusted OR 1.86; 95% CI 1.10–3.15, <em>P</em> = 0.021) and group 3 (adjusted OR 1.62; 95% CI 1.05–2.50<em>, P</em> = 0.029).</div></div><div><h3>Conclusions</h3><div>In nulliparous women, extending the second stage &gt;2 hours (or &gt;3 hours with epidural) was associated with increased maternal morbidity compared to a shortened second stage and 100% operative delivery.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102837"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}