Journal of obstetrics and gynaecology Canada最新文献

{"title":"Guideline No. 451: Asymptomatic Endometrial Thickening in Postmenopausal Women","authors":"Wendy Wolfman MD, Olga Bougie MD, Innie Chen MD, Yale Tang MD, Susan Goldstein MD, Jeanne Bouteaud MD","doi":"10.1016/j.jogc.2024.102591","DOIUrl":"10.1016/j.jogc.2024.102591","url":null,"abstract":"<div><h3>Objective</h3><p>To formulate strategies for clinical assessments for endometrial thickening on ultrasound in a postmenopausal woman without bleeding.</p></div><div><h3>Target population</h3><p>Postmenopausal women of any age.</p></div><div><h3>Outcomes</h3><p>To reduce unnecessary invasive interventions and investigations in women with asymptomatic endometrial thickening while selectively investigating women at risk for endometrial cancer.</p></div><div><h3>Benefits, harms, and costs</h3><p>It is anticipated that the adoption of these recommendations would save postmenopausal women unnecessary anxiety, pain, and risk of procedural complications. It is also expected to decrease the cost to the health care system by eliminating unnecessary interventions.</p></div><div><h3>Evidence</h3><p>English language articles from Medline, Cochrane, and PubMed databases for relevant peer-reviewed articles dating from 1995 to 2022 (e.g., asymptomatic endometrial thickness, endometrial cancer, postmenopausal bleeding, transvaginal ultrasound, endometrial biopsy, cervical stenosis, hormone therapies and the endometrium, tamoxifen, tibolone, aromatase inhibitors). Results were restricted to systematic reviews and meta-analyses, randomized controlled trials/controlled clinical trials, and observational studies.</p></div><div><h3>Validation Methods</h3><p>The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See <span>Appendix A</span> (<span>Tables A1</span> for definitions and <span>A2</span> for interpretations of strong and conditional [weak] recommendations).</p></div><div><h3>Intended Audience</h3><p>Physicians, including gynaecologists, obstetricians, family physicians, radiologists, pathologists, and internists; nurse practitioners and nurses; medical trainees, including medical students, residents, and fellows; and other providers of health care of the postmenopausal population.</p></div><div><h3>Social Media Abstract</h3><p>Postmenopausal women often have a thickening of the lining of the uterus found during ultrasound. Without bleeding, an endometrium <11 mm is rarely a serious problem but should be evaluated by a health care provider.</p></div><div><h3>SUMMARY STATEMENTS</h3><p></p><ul><li><span>1.</span><span><p>Asymptomatic endometrial thickening >5 mm is found in 3%–15% of postmenopausal women depending on the population studied (<em>moderate</em>).</p></span></li><li><span>2.</span><span><p>Ninety percent of postmenopausal women with endometrial cancer present with bleeding (<em>high</em>).</p></span></li><li><span>3.</span><span><p>In postmenopausal women without bleeding and an endometrium <11 mm, the incidence of endometrial cancer is approximately 1% (<em>high</em>).</p></span></li><li><span>4.</span><span><p>Endometrial biopsy is an accurate procedure if an adequate tissue sample is obtained in a patient with global","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 7","pages":"Article 102591"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432166","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":"What Is the Future of Radical Hysterectomy? Commentary on the Indication for Minimally Invasive Surgery for Cervical Cancer ≤2 cm","authors":"Kenro Chikazawa MD, PhD , Ken Imai MD , Tomoyuki Kuwata MD, PhD , Ryo Konno MD, PhD","doi":"10.1016/j.jogc.2023.102242","DOIUrl":"https://doi.org/10.1016/j.jogc.2023.102242","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 7","pages":"Article 102242"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141606335","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":"SOGC Guideline Retirement Notice No. 8","authors":"","doi":"10.1016/j.jogc.2024.102597","DOIUrl":"https://doi.org/10.1016/j.jogc.2024.102597","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 7","pages":"Article 102597"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004201/pdfft?md5=8885d58e0ed636ed4cb1b1842c6a85ce&pid=1-s2.0-S1701216324004201-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141606369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cesarean Scar Ectopic Pregnancy Requiring Hysterectomy","authors":"Cassandra Della Rocca BSc , Basile Tessier-Cloutier MD , Andrew Zakhari MD, FRCSC","doi":"10.1016/j.jogc.2024.102605","DOIUrl":"10.1016/j.jogc.2024.102605","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 8","pages":"Article 102605"},"PeriodicalIF":2.0,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476836","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":"The Success of Mifepristone and Misoprostol in the Management of Early Pregnancy Loss at a Community Hospital: A Prospective Study","authors":"","doi":"10.1016/j.jogc.2024.102604","DOIUrl":"10.1016/j.jogc.2024.102604","url":null,"abstract":"<div><h3>Objectives</h3><p>This prospective single-arm study was conducted to understand the expulsion rate of the gestational sac in the management of early pregnancy loss (EPL).</p></div><div><h3>Methods</h3><p>We recruited 441 participants; 188 met the eligibility criteria. Participants were 18 years of age and older who experienced a confirmed EPL (&lt;12 weeks gestational age) defined by an intrauterine pregnancy with a non-viable embryonic or anembryonic gestational sac with no fetal heart activity. Participants were given 200 mg of mifepristone pre-treatment orally followed by 2 doses of misoprostol 800 μg vaginally after 24 and 48 hours. Participants were seen in follow-up on day 14 to confirm the absence of a gestational sac, classified as treatment success. For failed treatment (defined by retained gestational sac), we offered expectant management or a third dose of misoprostol and/or dilatation and curettage. We followed all participants for 30 days. We collected data on overtreatment for retained products of conception and hospital admissions for adverse events.</p></div><div><h3>Results</h3><p>Overall, 181 participants followed the protocol and 169 (93.3%) participants had a complete expulsion of the gestational sac by the second visit (day 14). Twelve (6.6%) failed the treatment and 1 had an adverse event of heavy vaginal bleeding requiring dilatation and curettage. Despite the expulsion of the gestational sac, 29 cases (17.1%) at subsequent follow-up were diagnosed as retained products of conception based on ultrasound assessment of thickened endometrium.</p></div><div><h3>Conclusions</h3><p>Pretreatment with mifepristone followed by 2 doses of misoprostol with a 14-day follow-up resulted in a high expulsion rate and is a safe management option for EPL.</p></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102604"},"PeriodicalIF":2.0,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476837","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":"Serum Tumour Necrosis Factor-α (TNF-α) and Lipid Profile in Gestational Diabetes Mellitus","authors":"N. Muthuraman MD ,&nbsp;Premila Abraham MSc, PhD","doi":"10.1016/j.jogc.2024.102592","DOIUrl":"10.1016/j.jogc.2024.102592","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 8","pages":"Article 102592"},"PeriodicalIF":2.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442902","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":"Maternal and Neonatal Outcomes Associated With Route of Progesterone Administration in Pregnancies Following a Single Euploid Frozen Embryo Transfer","authors":"Jaclyn Del Pozzo DO, MS ,&nbsp;Insaf Kouba MD ,&nbsp;Nicholas Dilena DO ,&nbsp;Alexandra Peyser MD ,&nbsp;Julia Katz MD ,&nbsp;Matthew J. Blitz MD, MBA","doi":"10.1016/j.jogc.2024.102587","DOIUrl":"10.1016/j.jogc.2024.102587","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 8","pages":"Article 102587"},"PeriodicalIF":2.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419535","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":"The Blastulation Rate Is Negatively Associated With Euploid Rate","authors":"Ido Feferkorn MD ,&nbsp;Jason Raina MD ,&nbsp;Eva Suarthana MD, PhD ,&nbsp;Mohammad Albar MD ,&nbsp;Asangla Ao PhD ,&nbsp;Xiao Yun Zhang MSc ,&nbsp;Li Zhang PhD ,&nbsp;Einav Kadour-Peero MD ,&nbsp;Ranit Hizkiyahu MD ,&nbsp;Kimberly E. Liu MD ,&nbsp;William M. Buckett MD","doi":"10.1016/j.jogc.2024.102586","DOIUrl":"10.1016/j.jogc.2024.102586","url":null,"abstract":"<div><h3>Objectives</h3><p>To study the association between the blastulation rate, the presence of 1 pronucleus (1PN) zygotes, and the ploidy of the cohort of blastocysts.</p></div><div><h3>Methods</h3><p>A cross-sectional study using the existing databases of 2 university fertility centres in Canada. We included 345 cycles from 235 couples who underwent next-generation sequencing preimplantation genetic testing for the detection of aneuploidy in the study.</p></div><div><h3>Results</h3><p>A total of 1456 blastocysts were biopsied. In multivariate analysis, only female age and the number of 1PN/2PN embryos showed a negative association with euploid ratio. Surprisingly, when the analysis was limited to cycles with no delayed blastulation, the blastulation rate was also negatively associated with the euploid ratio.</p></div><div><h3>Conclusions</h3><p>This study sheds some light on the stages of early embryo development. Further study on the mechanisms governing embryo development and the different cell cycle checkpoints in embryo development is warranted<strong>.</strong></p></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 8","pages":"Article 102586"},"PeriodicalIF":2.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004092/pdfft?md5=faf4c3ea25f00fd26aa2c308e39968e9&pid=1-s2.0-S1701216324004092-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Cognitive Decline in Patients Undergoing Major Gynecologic Oncology Surgery: A Pilot Prospective Study","authors":"Mallika Makkar MD, HBSc ,&nbsp;Rebekah Hunter MD ,&nbsp;Anjali Kulkarni MD, MSc ,&nbsp;Julie M.V. Nguyen MD, MSc","doi":"10.1016/j.jogc.2024.102584","DOIUrl":"10.1016/j.jogc.2024.102584","url":null,"abstract":"<div><h3>Objectives</h3><p>Postoperative cognitive decline (POCD) is characterised by deficits in attention, memory, executive function, and information processing that persist beyond the early postoperative period. Its incidence ranges from 10%–25% after noncardiac surgery. Limited literature exists on POCD after gynecologic oncology surgery. Our primary objective was to identify the incidence of POCD among patients 55 years or older undergoing major gynecologic oncology surgery.</p></div><div><h3>Methods</h3><p>This mixed-methods, prospective, observational cohort study followed patients 55 years or older who underwent surgery for gynecologic malignancies between February and July 2022. Semi-structured interviews and the Mini-Mental State Exam (MMSE) were administered before surgery as well as 1 and 3 months after. Assessments were delivered virtually and in-person in the context of the COVID-19 pandemic. POCD was defined as ≥2-point decline from baseline MMSE score.</p></div><div><h3>Results</h3><p>Twenty-four patients participated; 19 completed the 1-month follow-up, and 15 completed the 3-month follow-up. The average age was 64 (range: 56–90). The mean preoperative MMSE score was 16.6 out of 17 (virtual) and 12.9 out of 13 (in-person). Two patients had a 1-point decline in their 1-month MMSE score; both recovered by 3 months. One patient had a 1-point decline in their 3-month MMSE score. Semi-structured interviews revealed common themes of “brain fog” at the 1-month follow-up and mild, persistent attention and word-finding deficits at 3 months postoperatively.</p></div><div><h3>Conclusions</h3><p>This study’s qualitative component captured subtle subjective findings suggestive of potential POCD. Larger studies are required, and a more extensive neuropsychological test battery may be required to elicit subtle findings not clearly reflected by MMSE scores.</p></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 8","pages":"Article 102584"},"PeriodicalIF":2.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004079/pdfft?md5=8f851bda4724f1fcca3eb53a80e94818&pid=1-s2.0-S1701216324004079-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Yoga Therapy in Premenstrual Syndrome: A Systematic Review and Meta-Analysis of Randomised Controlled Trials","authors":"","doi":"10.1016/j.jogc.2024.102579","DOIUrl":"10.1016/j.jogc.2024.102579","url":null,"abstract":"<div><h3>Objective</h3><div>Up to 80% of women of reproductive age are thought to experience premenstrual stress, which is characterised by physical, psychological, and behavioural changes. Yoga activity lowers harmful inflammatory secretions that provide comfort for premenstrual syndrome (PMS) sufferers.</div></div><div><h3>Data Sources</h3><div>The following worldwide databases were searched for this systematic review: Scopus, PubMed, Cochrane Library, PEDro, and Google Scholar from inception to August 2022.</div></div><div><h3>Study Selection</h3><div>A population, intervention, comparison, outcome, and study design framework was used for searching. Population included those with PMS or premenstrual tension syndromes, the intervention included yoga therapy, comparator was with control group, and outcome measures included blood pressure (BP) (systolic BP [SBP], diastolic BP [DBP]) and heart rate (HR).</div></div><div><h3>Data Extraction and Synthesis</h3><div>To evaluate the study, we employed the methodological index for randomised controlled trials. Fixed effects meta-analysis and qualitative synthesis were conducted. A total of 14 studies out of 224 were included. The main outcome measures included in this review were SBP, DBP, HR, and Moos Menstrual Distress Questionnaire. For the meta-analysis, 7 studies were considered. Three studies contributed data of SBP (mean difference [MD] –0.30; 95% CI –2.29 to 1.69, heterogenicity [I²] = 96%, <em>P</em> = 0.00001) and DBP (MD –0.25; 95% CI –0.99 to 0.49, I² = 79%, <em>P</em> = 0.009). HR results from 4 studies were included (MD 0.08; 95% CI –0.83 to 0.99, I² = 89%, <em>P</em> = 0.00001). A total of 3 studies contributed data of Moos Menstrual Distress Questionnaire (MD 1.50; 95% CI 0.91–2.10, I² = 92%, <em>P</em> = 0.00001).</div></div><div><h3>Conclusion</h3><div>Yoga can help people with both medical and psychological conditions including menstrual pain, irregular periods, stress, tension, and anxiety. It has been shown to lessen women's emotional, behavioural, and physical PMS symptoms, which has enhanced their quality of life.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 10","pages":"Article 102579"},"PeriodicalIF":2.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317492","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}