Journal of obstetrics and gynaecology Canada最新文献

{"title":"Association of Second and Early Third Trimester Cervical Length With Prolonged Pregnancy in Asymptomatic Women at Risk of Preterm Birth","authors":"Joan Crane MD, MSc, FRCSC ,&nbsp;Donnette O’Brien RN","doi":"10.1016/j.jogc.2025.103075","DOIUrl":"10.1016/j.jogc.2025.103075","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine if transvaginal ultrasound cervical length (CL) in the second (T2) (16⁰–23⁶ weeks) or early third trimester (T3) (24⁰–29⁶ weeks) in individuals at increased risk of preterm birth (PTB) is associated with prolonged pregnancy (≥41⁰ weeks), and if there is a specific CL cut-off that is predictive.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included individuals with singleton gestations; and a history of spontaneous PTB, excisional treatment of the cervix or uterine anomaly, undergoing transvaginal ultrasound CL 16⁰–29⁶ weeks. Results were divided by CL quartile in T2 and T3 separately.</div></div><div><h3>Results</h3><div>Overall, 914 individuals were included, 514 having CL assessment in T2 and 857 in T3. In T2, those with CL in quartiles 2, 3, and 4 were more likely to have a prolonged pregnancy compared with quartile 1 (adjusted OR [aOR] 2.47, <em>P</em> = 0.049; aOR 3.15, <em>P</em> = 0.009; aOR 2.73, <em>P</em> = 0.028, respectively). However, the T2 receiver operator characteristic (ROC) area under the curve (AUC) (0.572) did not reach statistical significance (<em>P</em> = 0.057). In T3, those with CL in quartiles 3 and 4 were more likely to have a prolonged pregnancy compared with quartile 1 (aOR 2.42, <em>P</em> = 0.021; and aOR 3.10, <em>P</em> = 0.002, respectively). The T3 ROC curve reached statistical significance (<em>P</em> = 0.002, AUC = 0.622) but did not meet the criteria for a good screening test based on the AUC value. Subgroup analysis of those with a previous spontaneous PTB found the T2 ROC curve to be promising (AUC = 0.700, <em>P</em> = 0.013).</div></div><div><h3>Conclusions</h3><div>In individuals at risk of PTB, longer CL in T3 may be a better predictor of prolonged pregnancy than T2 but does not appear to be a good screening test in either gestational period. Further research is suggested in those with a history of PTB.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 10","pages":"Article 103075"},"PeriodicalIF":2.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862767","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":"Directive n° 461 : La prise en charge des fibromes utérins","authors":"Innie Chen MD, MPH, FRCSC,&nbsp;Sari Kives MD, FRCSC,&nbsp;Elizabeth Randle MD, FRCSC,&nbsp;Darrien Rattray MD, FRCSC,&nbsp;Ari Sanders MD, MSc, FRCSC,&nbsp;George Vilos MD, FRCSC","doi":"10.1016/j.jogc.2025.102971","DOIUrl":"10.1016/j.jogc.2025.102971","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectif&lt;/h3&gt;&lt;div&gt;Fournir aux cliniciens une compréhension de la signification clinique des fibromes pour les personnes ayant un utérus et fournir des conseils fondés sur des données probantes sur les options de traitement actuellement disponibles.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Population cible&lt;/h3&gt;&lt;div&gt;Ce guide de pratique clinique vise à améliorer la vie des personnes symptomatiques de leurs fibromes utérins via des saignements menstruels ou des symptômes de pression. Les considérations relatives à la fertilité ne sont pas abordées en détail, car elles sont décrites dans la directive clinique de la SOGC sur la prise en charge des fibromes utérins chez les femmes souffrant d'une infertilité autrement inattendue.&lt;span&gt;&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Options&lt;/h3&gt;&lt;div&gt;Cette ligne directrice passe en revue les options médicales et chirurgicales disponibles pour le traitement des symptômes liés aux fibromes. D'autres options procédurales, telles que l'embolisation de l'artère utérine et les options de traitement à base d'énergie, sont également examinées.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résultats&lt;/h3&gt;&lt;div&gt;Ce guide de pratique clinique est destiné à faciliter le processus de prise de décision entre les patientes et les prestataires de soins de santé concernant l'évaluation et la prise en charge des fibromes utérins symptomatiques.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Avantages, inconvénients et coûts&lt;/h3&gt;&lt;div&gt;La majorité des patientes présentant des fibromes sont asymptomatiques et ne nécessitent aucune intervention. Pour les patientes présentant des saignements utérins anormaux, une anémie ferriprive, des douleurs pelviennes ou des symptômes de pression, le traitement choisi doit prendre en compte les caractéristiques du fibrome et être orienté vers les symptômes de la patiente et ses objectifs de fertilité. Le coût de la thérapie des personnes atteintes de fibromes pour le système de santé doit être interprété dans le contexte du fardeau économique, de la perte de productivité et des impacts négatifs sur la qualité de vie qui peuvent être associés à une maladie non traitée.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Preuves à l'appui&lt;/h3&gt;&lt;div&gt;Cette directive clinique est une mise à jour de la directive clinique n° 318 de la SOGC sur la prise en charge des léiomyomes utérins.&lt;span&gt;&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt; À l'aide de titres MeSH et de mots clés pertinents, la littérature publiée a été recherchée par le biais de recherches dans PubMed et Cochrane Systematic Reviews, la date de la dernière recherche étant comprise entre février 2013 et janvier 2025. La littérature grise a été identifiée en consultant les sites web des agences d'évaluation des technologies de la santé et des agences liées aux technologies de la santé, les collections de lignes directrices pour la pratique clinique et les sociétés nationales et internationales de spécialité médicale.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Méthodes de validation&lt;/h3&gt;&lt;div&gt;Un panel national de patientes partenaires a été réuni pour fournir des comme","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 8","pages":"Article 102971"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500206","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. 461: The Management of Uterine Fibroids","authors":"Innie Chen MD, MPH, FRCSC,&nbsp;Sari Kives MD, FRCSC,&nbsp;Elizabeth Randle MD, FRCSC,&nbsp;Darrien Rattray MD, FRCSC,&nbsp;Ari Sanders MD, MSc, FRCSC,&nbsp;George Vilos MD, FRCSC","doi":"10.1016/j.jogc.2025.102970","DOIUrl":"10.1016/j.jogc.2025.102970","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To provide clinicians with an understanding of the clinical significance of fibroids for individuals with uteruses and provide evidence-based guidance on currently available treatment options.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Target Population&lt;/h3&gt;&lt;div&gt;This clinical practice guidelines seeks to improve the lives of individuals with uterine fibroids and fibroid-associated menstrual bleeding or pressure symptoms. Fertility considerations are not discussed in detail, as they are described in the SOGC’s Clinical Practice Guideline on The Management of Uterine Fibroids in Women with Otherwise Unexpected Infertility guideline.&lt;span&gt;&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Options&lt;/h3&gt;&lt;div&gt;This guideline reviews the available medical and surgical management options available for treatment of fibroid-related symptoms. Alternate procedural options, such as uterine artery embolization and energy-based treatment options are also reviewed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;This clinical practice guideline is intended to facilitate the decision-making process between patients and healthcare providers regarding the assessment and management of symptomatic uterine fibroids.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Benefits, Harms, and Costs&lt;/h3&gt;&lt;div&gt;A majority of fibroid patients are asymptomatic and require no intervention. For patients with abnormal uterine bleeding, iron deficiency anemia, or pelvic pain or pressure symptoms, selected treatment should take into consideration fibroid characteristics and be directed towards patient symptoms and fertility goals. The cost of therapy to the healthcare system for individuals with fibroids must be interpreted in the context of the economic burden, lost productivity, and adverse impacts on quality of life that can be associated with untreated disease.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence&lt;/h3&gt;&lt;div&gt;This clinical practice guideline is an update of the SOGC’s Clinical Practice Guideline No. 318 on The Management of Uterine Leiomyomas.&lt;span&gt;&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt; Using relevant MeSH headings and keywords, published literature was retrieved through searches of PubMed and Cochrane Systematic Reviews the date of last search in February 2013 to January 2025. Grey literature was identified through searching the websites of health technology assessment and health technology–related agencies, clinical practice guideline collections, and national and international medical specialty societies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Validation Methods&lt;/h3&gt;&lt;div&gt;A national panel of patient partners were gathered to provide feedback and perspective on the recommendations and summary statements for this guideline. Patient partners were purposefully selected to ensure representation of Canadian geographic region, racial representation, and fibroid-related symptom and treatment received.&lt;/div&gt;&lt;div&gt;The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluatio","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 8","pages":"Article 102970"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500207","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 Association of Acute Histological Chorioamnionitis and Other Placental Lesions with Subsequent Pregnancy Outcomes after Spontaneous Preterm Birth (JOGC 25-00154)","authors":"Ludmila Porto MD, MSc ,&nbsp;John Snelgrove MD, MSc ,&nbsp;Nir Melamed MD, MSc ,&nbsp;John Kingdom MD ,&nbsp;Jon Barrett MD ,&nbsp;Stefania Ronzoni MD, PhD","doi":"10.1016/j.jogc.2025.102943","DOIUrl":"10.1016/j.jogc.2025.102943","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 8","pages":"Article 102943"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826462","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":"Letter to the Editor: Association of Acute Histological Chorioamnionitis and Other Placental Lesions with Subsequent Pregnancy Outcomes after Spontaneous Preterm Birth","authors":"Mohammad Aitzaz Hassan MBBS ,&nbsp;Ashfaq Ahmad MBBS ,&nbsp;Javed Iqbal RN ,&nbsp;Abdur Rehman MBBS","doi":"10.1016/j.jogc.2025.102942","DOIUrl":"10.1016/j.jogc.2025.102942","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 8","pages":"Article 102942"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826461","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":"Technical Update No. 462: Abnormal maternal serum markers and adverse pregnancy outcomes","authors":"Amir Aviram MD,&nbsp;Elad Mei-Dan MD,&nbsp;Gabrielle Cassir MD,&nbsp;Ernesto Figueiro-Filho MD, PhD,&nbsp;Jessica Liauw MHSc, MD,&nbsp;Venu Jain MD, PhD,&nbsp;Emmanuel Bujold MD, MSc,&nbsp;Nir Melamed MD, MSc","doi":"10.1016/j.jogc.2025.103060","DOIUrl":"10.1016/j.jogc.2025.103060","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To review the current data on the association between abnormal first- or second-trimester aneuploidy screening serum markers and adverse pregnancy outcomes, as well as provide health care professionals with recommendations for managing patients with such abnormal serum marker results.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Target Population&lt;/h3&gt;&lt;div&gt;Health care providers involved in antenatal care for pregnant individuals, including general practitioners, obstetricians, midwives, and maternal-fetal medicine specialists.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Benefits, Harms, and Costs&lt;/h3&gt;&lt;div&gt;Implementation of the recommendations in this technical update should increase clinician competency in managing abnormal maternal serum markers results with respect to preventive interventions and antenatal surveillance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;∗Evidence&lt;/h3&gt;&lt;div&gt;Published literature in English was retrieved through searches of PubMed or MEDLINE, CINAHL, and The Cochrane Library through to May 2024 using appropriate controlled vocabulary via MeSH terms (fetal growth retardation, small for gestational age, preeclampsia, preterm birth) and keywords (fetal growth restriction, growth retardation, IUGR, FGR, low birth weight, small for gestational age, Doppler, placenta, preeclampsia, hypertensive disorders of pregnancy, hCG, human chorionic gonadotropin, PAPP-A, pregnancy-associated plasma protein-A, inhibin-A, unconjugated estriol, PlGF, placental growth factor, AFP, alpha-fetoprotein, prenatal screening). Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. Grey literature was identified by searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Validation Methods&lt;/h3&gt;&lt;div&gt;The authors rated the quality of evidence and strength of recommendations using the &lt;span&gt;&lt;span&gt;Grading of Recommendations Assessment, Development and Evaluation&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt; (GRADE) approach. See online &lt;span&gt;&lt;span&gt;Appendix A&lt;/span&gt;&lt;/span&gt; (&lt;span&gt;&lt;span&gt;Tables A1&lt;/span&gt;&lt;/span&gt; for definitions and &lt;span&gt;&lt;span&gt;A2&lt;/span&gt;&lt;/span&gt; for interpretations).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Intended Audience&lt;/h3&gt;&lt;div&gt;Obstetricians, family physicians, nurses, midwives, maternal-fetal medicine specialists, and other health care providers who provide perinatal care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Tweetable Abstract&lt;/h3&gt;&lt;div&gt;Technical update for the interpretation and management of abnormal serum markers&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Summary Statements&lt;/h3&gt;&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;1.&lt;/span&gt;&lt;span&gt;&lt;div&gt;Abnormal levels of placenta-derived proteins used in the first trimester (low PAPP-A, βhCG, or PlGF) or second trimester (low uE3, or high elevated hCG, AFP, or Inhibin-A) aneuploidy screening (also known ‘markers’) may be associated with placenta-mediated complications such as ","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103060"},"PeriodicalIF":2.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736477","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":"Mise à jour technique no 462 : Marqueurs sériques maternels anormaux et issues défavorables de larossesse","authors":"Amir Aviram MD,&nbsp;Elad Mei-Dan MD,&nbsp;Gabrielle Cassir MD,&nbsp;Ernesto Figueiro-Filho MD, PhD,&nbsp;Jessica Liauw MHSc, MD,&nbsp;Venu Jain MD, PhD,&nbsp;Emmanuel Bujold MD, MSc,&nbsp;Nir Melamed MD, MSc","doi":"10.1016/j.jogc.2025.103061","DOIUrl":"10.1016/j.jogc.2025.103061","url":null,"abstract":"<div><h3>Objectif</h3><div>Examiner les données actuelles sur l'association entre les marqueurs sériques anormaux du dépistage de l'aneuploïdie au premier ou au deuxième trimestre et les issues défavorables de la grossesse, et fournir aux professionnels de la santé des recommandations pour la prise en charge des patientes présentant de tels résultats anormaux des marqueurs sériques.</div></div><div><h3>Population cible</h3><div>Les professionnels de santé impliqués dans les soins prénataux pour les femmes enceintes, y compris les médecins généralistes, les obstétriciens, les sages-femmes et les spécialistes de la médecine fœto-maternelle.</div></div><div><h3>Avantages, inconvénients et coûts</h3><div>La mise en œuvre des recommandations de cette mise à jour technique devrait accroître la compétence des cliniciens dans la gestion des résultats anormaux des marqueurs sériques maternels en ce qui concerne les interventions préventives et la surveillance prénatale.</div></div><div><h3>∗Preuves</h3><div>La littérature publiée en anglais a été recherchée dans PubMed ou MEDLINE, CINAHL et The Cochrane Library jusqu'en mai 2024 en utilisant un vocabulaire contrôlé approprié via des termes MeSH (retard de croissance intra-utérin, petit pour l'âge gestationnel, pré-éclampsie, naissance prématurée) et des mots-clés (restriction de croissance fœtale, retard de croissance, RCIU, RGA, faible poids de naissance, petit pour l'âge gestationnel, Doppler, placenta, pré-éclampsie, troubles hypertensifs de la grossesse, hCG, gonadotrophine chorionique humaine, PAPP-A, protéine plasmatique A associée à la grossesse, inhibine-A, estriol non conjugué, PlGF, facteur de croissance placentaire, AFP, alpha-fœtoprotéine, dépistage prénatal). Les résultats ont été limités aux revues systématiques, aux essais contrôlés randomisés et aux études observationnelles. La littérature grise a été identifiée en consultant les sites web des agences d'évaluation des technologies de la santé et des agences liées aux technologies de la santé, les collections de lignes directrices pour la pratique clinique, les registres d'essais cliniques et les sociétés de spécialité médicale nationales et internationales.</div></div><div><h3>Méthodes de validation</h3><div>Les auteurs ont évalué la qualité des preuves et la force des recommandations en utilisant l'approche GRADE (<span><span>Grading of Recommendations Assessment, Development and Evaluation</span><svg><path></path></svg></span>). Voir l'annexe A en ligne (<span><span>tableaux A1</span></span> pour les définitions et <span><span>A2</span></span> pour les interprétations).</div></div><div><h3>Public cible</h3><div>Obstétriciens, médecins de famille, infirmières, sages-femmes, spécialistes en médecine fœto-maternelle et autres professionnels de la santé en soins périnataux.</div></div><div><h3>Tweetable Abstract</h3><div>Mise à jour technique pour l'interprétation et la prise en charge des marqueurs sériques anormaux</div></div><div><h3>Résu","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103061"},"PeriodicalIF":2.2,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736476","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 Effect of Self-Sampling or Clinician-Based Sampling on Anxiety in Cervical Cancer Screening Among Women: A Randomized Controlled Trial","authors":"Ozge Sen MSc, PhD ,&nbsp;Tulay Yilmaz PhD","doi":"10.1016/j.jogc.2025.103052","DOIUrl":"10.1016/j.jogc.2025.103052","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to determine the effect of self-sampling or clinician-based sampling on anxiety in cervical cancer screening among women.</div></div><div><h3>Methods</h3><div>This study was conducted between October 2022 and December 2023 in a family health centre among women aged 30–65 years who had not undergone cervical cancer screening in the last 5 years, were sexually active, and could read and write Turkish. Participants (N = 110) were randomly divided into 2 groups (1:1): the experimental group (n = 55) and control group (n = 55). Women in the experimental group were trained before the procedure and were allowed to take samples from the vaginal area on their own. The women in control group were sampled from cervical region by the clinician. Both groups were pretested before the procedure using the “descriptive information form” and “state anxiety inventory” to measure anxiety. After the sampling procedure, a post-test was administered to the experimental and control groups using the state anxiety inventory. Statistical Package for Social Sciences for Windows 24.0 was used for the analysis and <em>P</em> &lt; 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Results showed that the descriptive characteristics of the groups were distributed homogeneously. In the pretest, there was no significant difference between groups in terms of anxiety levels (<em>P</em> &gt; 0.05), whereas in the post-test, it was observed that anxiety levels of women in experimental group were significantly lower than those in the control group (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>This study observed that women’s self-sampling during cervical cancer screening reduced their anxiety level.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103052"},"PeriodicalIF":2.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710524","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":"Fetal Heart Rhabdomyomas: Three-dimensional Virtual Reconstruction Model","authors":"Marcela Castro Giffoni MD ,&nbsp;Nathalie Jeanne Bravo-Valenzuela PhD ,&nbsp;Edward Araujo Júnior PhD ,&nbsp;Renato Silveira Ximenes MD ,&nbsp;Heron Werner PhD","doi":"10.1016/j.jogc.2025.103045","DOIUrl":"10.1016/j.jogc.2025.103045","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103045"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700857","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":"Two Prophylactic Antibiotic Protocols Compared for the Treatment of Preterm Pre-labour Rupture of Membranes","authors":"Maya Frank Wolf MD ,&nbsp;Raneen Abu Shqara MD ,&nbsp;Gabriela Goldinfeld MD ,&nbsp;Dan Miron MD ,&nbsp;Lior Lowenstein MD","doi":"10.1016/j.jogc.2025.103050","DOIUrl":"10.1016/j.jogc.2025.103050","url":null,"abstract":"<div><h3>Objectives</h3><div>Antibiotic prophylaxis in preterm pre-labour rupture of membranes (PPROM) is associated with a reduced rate of clinical chorioamnionitis. In recent randomized controlled trials, cefuroxime combined with a macrolide was more effective than traditional ampicillin-based regimens in prolonging latency and reducing gram-negative neonatal infections. Accordingly, our institution revised its PPROM prophylactic antibiotic protocol from ampicillin and roxithromycin to cefuroxime and azithromycin. We compared the infectious morbidity associated with these 2 regimens to assess their clinical effectiveness in routine practice.</div></div><div><h3>Methods</h3><div>This retrospective study included 170 women with PPROM at &lt;37⁰ weeks gestation, managed expectantly and treated with antibiotic prophylactic protocols: 83 received ampicillin and roxithromycin from February 2022 to March 2023, and 87 received cefuroxime and azithromycin from April 2023 to May 2024. We conducted a multivariate regression analysis to predict clinical chorioamnionitis rates, controlled for PPROM week, group B <em>Streptococcus</em> colonization, antibiotic regimen, and latency.</div></div><div><h3>Results</h3><div>Gestational age at PPROM, parity, group B <em>Streptococcus</em> status, and the latency period were comparable between the groups. In the ampicillin and roxithromycin group, compared with the cefuroxime and azithromycin group, intrapartum fever and clinical chorioamnionitis rates were higher (9.6% vs. 1.1%, <em>P</em> = 0.013 and 8.4% vs. 1.1%, <em>P</em> = 0.046, respectively). Compared with the later regimen, the earlier regimen was associated with higher rates of cesarean delivery, maternal postpartum infections, and antibiotic treatment (33.7% vs. 19.5%, <em>P</em> = 0.036; 4.8% vs. 0%, <em>P</em> = 0.038; and 9.6% vs. 2.3%, <em>P</em> = 0.042; respectively). Positive chorioamniotic membrane cultures and ampicillin-resistant <em>Enterobacteriaceae</em> species were more prevalent in the ampicillin and roxithromycin group (67.8% vs. 50.0%, <em>P</em> &lt; 0.001, and 23% vs. 10%, <em>P</em> = 0.027, respectively).</div></div><div><h3>Conclusions</h3><div>Cefuroxime plus azithromycin as prophylaxis for PPROM at &lt;37⁰ weeks showed fewer maternal peripartum infectious outcomes than ampicillin plus roxithromycin; this was supported by bacteriologic findings.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103050"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700861","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}