Journal of obstetrics and gynaecology Canada最新文献

{"title":"What Are the Current HPV Types Contributing to Cervical High-Grade Squamous Intraepithelial Lesions, Adenocarcinoma In Situ, and Early Cervical Cancer?","authors":"Lina Salman MD, MSc ,&nbsp;Lilian T. Gien MD, MSc ,&nbsp;Danielle Vicus MD, MSc ,&nbsp;Michael Shier MD ,&nbsp;Rachel Kupets MD ,&nbsp;Suzanne Gibbons BSc ,&nbsp;Samar Ashfaq BSc ,&nbsp;Alberto Severini MD ,&nbsp;Allan Covens MD","doi":"10.1016/j.jogc.2025.102783","DOIUrl":"10.1016/j.jogc.2025.102783","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the prevalence of human papillomavirus (HPV) types by genotyping high-grade squamous intraepithelial lesion (HSIL), adenocarcinoma in situ (AIS), and early-stage invasive cervical cancer (ICC) in patients who have been exposed or are naïve to the HPV vaccine.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study. All patients over the age of 18 years who presented to the colposcopy clinic with HSIL, AIS, or ICC who were expected to undergo a cervical biopsy, loop electrosurgical excisional procedure, or cone biopsy were eligible and approached for informed consent. HPV typing was performed to identify the causative HPV types.</div></div><div><h3>Results</h3><div>Between November 2016 and May 2023, 113 patients (34 vaccinated with at least 1 dose, and 79 non-vaccinated) consented to this study. The median ages at coitarche and study entry were 18 (range 14–37) and 34 (range 24–66) years, respectively. Only 3 patients were vaccinated prior to coitarche.</div><div>Histology was as follows: HSIL = 97, AIS = 9, HSIL and AIS = 2, squamous cell carcinoma = 4, and 1 patient with adenocarcinoma. The causative HPV type was 16 or 18 in 59% of the vaccinated group and in 66% of the non-vaccinated group. Most vaccinated patients (74%) reported receiving 2–3 doses of HPV vaccine.</div></div><div><h3>Conclusions</h3><div>In our cohort, the distribution of causative HPV 16 and 18 in patients presenting with HSIL/AIS/ICC was similar between vaccine-naïve and vaccinated patients. This data suggests cervical screening guidelines should not differentiate between “vaccinated” and “non-vaccinated” women without further details of their vaccination.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 3","pages":"Article 102783"},"PeriodicalIF":2.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143083094","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":"Hypoxic respiratory failure in metastatic low grade serous ovarian cancer – a rare newly diagnosed patent foramen ovale","authors":"Samantha Taylor MD ,&nbsp;Shuk On Annie Leung MD ,&nbsp;Gabriel Levin MD","doi":"10.1016/j.jogc.2025.102782","DOIUrl":"10.1016/j.jogc.2025.102782","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 3","pages":"Article 102782"},"PeriodicalIF":2.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076765","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":"sFlt-1, Coagulation Function, and Platelets as Predictors of Preeclampsia","authors":"Jiani Yuan MM,&nbsp;Duanqing Wu BM,&nbsp;Jun Ye MM,&nbsp;Rujun Chen MM,&nbsp;Xiaoqin Wang MM,&nbsp;Liwen Zhang BM","doi":"10.1016/j.jogc.2025.102772","DOIUrl":"10.1016/j.jogc.2025.102772","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the predictive value of soluble FMS-like tyrosine kinase-1 (sFlt-1), coagulation function, and platelet (PLT) parameters for preeclampsia (PE).</div></div><div><h3>Methods</h3><div>A prospective study was conducted on women registered and delivered at Shanghai Fifth People's Hospital from October 2020 to December 2021. All eligible pregnant women were recruited at the time of initial registration in the first trimester. We then obtained serum samples uniformly at 24⁰–28⁰ weeks and stored these samples in a freezer at −80°C and labelled them to create a biobank. Later, when PE was diagnosed, we followed the markers to find their blood samples and complete the tests. Participants were divided into healthy pregnant (HP) and PE groups. Participants were divided into HP and PE groups. Approximately 5 mL of venous blood was collected from each participant at 24⁰–28⁰ weeks gestation. Serum sFlt-1 was measured by enzyme-linked immunosorbent assay. Additionally, D-dimer, activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), antithrombin III (ATIII), fibrinogen, PLT, PLT distribution width (PDW), and mean PLT volume (MPV) were recorded. SPSS 27.0 software was used to analyze the correlation of these parameters with PE. Receiver operating characteristic curve analysis determined the optimal cutoff value for each parameter.</div></div><div><h3>Results</h3><div>Serum sFlt-1, APTT, TT, ATIII, PLT, MPV, and PDW levels were significantly different between the PE and HP groups (<em>P</em> &lt; 0.05). Among single-factor indicators for predicting PE, sFlt-1 exhibited the highest value. With an optimal cutoff value of 4.409 ng/mL, sFlt-1 demonstrated a sensitivity and specificity of 85.4% and 87.5%, respectively. The combination of sFlt-1, APTT, TT, PDW, and MPV yielded the highest predictive value, with an area under the receiver operating characteristic curve of 0.946, sensitivity of 86.8%, and specificity of 87.5%.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that a combination of sFlt-1, APTT, TT, PDW, and MPV is a valuable tool for predicting PE.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 3","pages":"Article 102772"},"PeriodicalIF":2.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070651","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":"Clinical Care Pathways for Second and Third Trimester Termination of Pregnancy for Medical Reasons in Canada","authors":"Elise Lavoie-Lebel MD, MSc ,&nbsp;Madeleine Ennis PhD ,&nbsp;Regina Renner MD, MPH ,&nbsp;Sarah Munro PhD ,&nbsp;Robin Leung RN ,&nbsp;Jennifer Chisholm PhD ,&nbsp;Brigid Dineley MD, MHSc ,&nbsp;Liv Knutzen MD ,&nbsp;Julie Robertson MD ,&nbsp;Jessica Liauw MD, MHSc","doi":"10.1016/j.jogc.2025.102770","DOIUrl":"10.1016/j.jogc.2025.102770","url":null,"abstract":"<div><h3>Objectives</h3><div>Termination of pregnancy in the second/third trimester for fetal or maternal complications (i.e., for medical reasons) is an essential health service. We aimed to describe the systems-level pathways for this care in Canada.</div></div><div><h3>Methods</h3><div>We conducted one-on-one semi-structured interviews with maternal–fetal medicine (MFM), medical genetics, and nursing/social work clinicians at the 10 academic MFM sites in Canada. We conducted qualitative content analysis to identify categories describing the clinical care pathway. We triangulated data from participants within sites and then compared data across sites to describe similarities and differences in care. We used NVivo14 software for coding.</div></div><div><h3>Results</h3><div>We recruited 28 participants representing all sites: 10 MFM specialists, 9 medical geneticists/genetic counsellors, and 9 nurses/social workers. We identified 4 main categories describing the clinical care pathway: (1) initial visit and clinic structure, (2) offering termination, (3) provision of procedural and medication termination, and (4) post-termination care. Across sites, although clinic structure and post-termination care were similar, there were differences in offering the option of termination (e.g., variable indications qualifying for approval) and variations in details regarding the provision of procedural and medical termination (e.g., upper gestational age limits for procedural vs. medical approaches).</div></div><div><h3>Conclusions</h3><div>Clinical care pathways for second/third trimester termination for medical reasons are variable across Canadian academic MFM centres, especially regarding circumstances under which termination is offered and details regarding the provision of procedural and medical termination. These differences provide opportunities to inform efforts to optimize equitable and comprehensive services in Canada.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 3","pages":"Article 102770"},"PeriodicalIF":2.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044046","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":"Acceptability of Mifepristone and Misoprostol and Patients’ Experience With the Early Pregnancy Assessment Clinic at a Community Hospital in Canada","authors":"Salwa Farooqi MD, MSc ,&nbsp;Elyse Lackie MD ,&nbsp;Alice Pham MD ,&nbsp;Lynne Zolis MD ,&nbsp;Kalpana Sharma MD ,&nbsp;Karthika Devarajan MD ,&nbsp;Kirsten Smith MD ,&nbsp;Alexandra Nevin-Lam MD ,&nbsp;Sabrina Lee MD ,&nbsp;Heather Tempest RN ,&nbsp;Elad Mei-Dan MD ,&nbsp;Modupe Tunde-Byass MBBS","doi":"10.1016/j.jogc.2025.102771","DOIUrl":"10.1016/j.jogc.2025.102771","url":null,"abstract":"<div><h3>Objectives</h3><div>Early pregnancy loss (EPL) is a common complication of pregnancy. Research has demonstrated the efficacy of mifepristone pre-treatment followed by misoprostol for the induction of an EPL. North York General Hospital (NYGH) provides an all-in-one Early Pregnancy Assessment Clinic (EPAC) to streamline the care of women with an EPL.</div></div><div><h3>Methods</h3><div>We conducted a prospective single cohort qualitative survey to understand patients’ satisfaction with mifepristone and misoprostol and their experience with EPAC at NYGH. We recruited 191 patients with a confirmed EPL. They were given mifepristone and misoprostol. We administered the validated modified version of the Short Form-36 Health Survey Revised quality of life scales questionnaire to study the following outcomes: (1) acceptability of mifepristone and misoprostol: cramping, bleeding, duration of treatment, and recommendation to others; (2) effect on social activities; and (3) participants’ overall satisfaction with the EPAC at NYGH.</div></div><div><h3>Results</h3><div>We found that 96% of our participants responded completely to our questionnaire. For cramping, 24% reported definitely acceptable, whereas 8% definitely unacceptable. For bleeding, 26% reported definitely acceptable, whereas 4.8% definitely unacceptable. For duration of treatment, 27% reported definitely acceptable and 2.7% definitely unacceptable. Finally, for recommendation to others, 41% reported definitely acceptable and 2.1% definitely unacceptable. The rating for NYGH’s EPAC was high, with 68% of participants rating it as excellent.</div></div><div><h3>Conclusions</h3><div>We found that the acceptability of the medical management at our EPAC for an EPL is high with the mifepristone and misoprostol protocol. This study encourages this treatment and the establishment of similar centres.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 4","pages":"Article 102771"},"PeriodicalIF":2.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044045","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":"Impassable passages: a case of intrauterine adhesions at the time of first trimester abortion","authors":"Chelsie Warshafsky MD, MS ,&nbsp;Julie Thorne MD, MPH ,&nbsp;Mostafa Atri MBBS ,&nbsp;Heather Millar MD, MIPH","doi":"10.1016/j.jogc.2025.102769","DOIUrl":"10.1016/j.jogc.2025.102769","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 3","pages":"Article 102769"},"PeriodicalIF":2.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143044047","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 Development and Validation of a Patient Questionnaire Tool for the Assessment of Patient-Reported Experiences With Endometriosis Ultrasound","authors":"Jayesh Tigdi MD, MBA ,&nbsp;Mahsa Gholiof MSc ,&nbsp;Allyson Bontempo PhD ,&nbsp;Hanan Alsalem MBBS ,&nbsp;Aikansha Chawla MD ,&nbsp;Shay Freger MPH ,&nbsp;Mathew Leonardi MD, PhD","doi":"10.1016/j.jogc.2024.102760","DOIUrl":"10.1016/j.jogc.2024.102760","url":null,"abstract":"<div><h3>Objectives</h3><div>Endometriosis ultrasound is an accurate, cost-effective, and non-invasive diagnostic tool that can help improve the diagnostic delay that patients with endometriosis experience. As an emerging diagnostic method, the perspectives of patients undergoing endometriosis ultrasound remain unexplored. Therefore, the objective of this study was to develop and validate an assessment tool that evaluates patient-reported experiences with endometriosis ultrasound as a decision-making tool.</div></div><div><h3>Methods</h3><div>This was a 2-part study with the first phase involving a modified Delphi consensus process including a panel of clinicians, sonologists, researchers, and a patient with lived experience of endometriosis. Pre- and post-ultrasound patient questionnaires were subsequently developed. The second phase included validating the questionnaires via a prospective cross-sectional survey study carried out at the Endometriosis Clinic at McMaster University Medical Centre in Hamilton, Canada. Data were analyzed using measures of central tendency, chi-square test, and Fisher exact test as appropriate. Statistical significance was determined by 2-sided <em>P</em> values less than 0.05.</div></div><div><h3>Results</h3><div>Pre- and post-ultrasound questionnaires were developed comprising 8 and 10 questions, respectively. Of 46 respondents, there was a similar representation of patients with an abnormal endometriosis ultrasound (58.7% of patients, n = 27) and those with a normal endometriosis ultrasound (41.3 %, n = 19). Moreover, endometriosis ultrasound results helped most participants (84.8%, n = 39) with treatment decision-making.</div></div><div><h3>Conclusions</h3><div>This study validates a survey tool that can be used clinically to assess patient-reported experiences with endometriosis ultrasound. It also demonstrates the highly informative nature of endometriosis ultrasound, with many patients choosing to defer more invasive diagnostic methods (i.e., surgery).</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 3","pages":"Article 102760"},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934409","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":"An Insidious Dyad: Velamentous Cord Insertion and Intraamniotic Hemorrhage","authors":"Ottavio Cassardo MD,&nbsp;Michele Orsi MD","doi":"10.1016/j.jogc.2024.102733","DOIUrl":"10.1016/j.jogc.2024.102733","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 1","pages":"Article 102733"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782269","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":"Digital Health Tools for Miscarriage Support: A Survey of Canadian Women Facing Early Pregnancy Loss","authors":"Breanna Flynn MD ,&nbsp;Megan Gomes MD, MSc ,&nbsp;Genevieve Tam MD, MSc ,&nbsp;Roopan Gill MD, MPH","doi":"10.1016/j.jogc.2024.102722","DOIUrl":"10.1016/j.jogc.2024.102722","url":null,"abstract":"<div><h3>Objectives</h3><div>Early pregnancy loss (EPL) affects 1 in 4 recognised pregnancies, yet often lacks patient-centred supportive care. This study assesses the feasibility and acceptance of a digital health tool to support those affected by EPL. The objectives are to (1) understand the experiences of those who have miscarried, (2) explore their methods of accessing health information, and (3) determine their preferences regarding digital tool content and design.</div></div><div><h3>Methods</h3><div>This mixed-methods study included Canadian persons aged 18–45 years who self-reported to have experienced EPL up to 12⁶ weeks gestation in the preceding 2 years. Recruitment was via social media and hospital posters. Participants completed an online survey and optional follow-up interview between September 2021 and April 2022. Survey responses were analysed using descriptive statistics. Interview findings are presented in a separate paper. Local ethics approval was obtained.</div></div><div><h3>Results</h3><div>Of the 185 survey respondents, 28% revealed that they are somewhat or very dissatisfied with the overall health care they received for their miscarriage. Thirty-nine percent of survey respondents are somewhat or very dissatisfied with how their mental/emotional health was addressed. Notably, 82% supported the development of a digital health tool for EPL care. Ninety-one percent of survey respondents use the internet to access health information.</div></div><div><h3>Conclusions</h3><div>Many participants reported dissatisfaction with their care after EPL but showed strong interest in a user-friendly digital tool that provides general information and mental health support. These findings, along with qualitative interview data, will guide the development and testing of the desired digital health tool, aiming to enhance patient experience and support after miscarriage.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 1","pages":"Article 102722"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756018","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":"Index des directives cliniques de la SOGC – 2024","authors":"","doi":"10.1016/j.jogc.2024.102747","DOIUrl":"10.1016/j.jogc.2024.102747","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 1","pages":"Article 102747"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158839","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}