Paul J. Yong , Zeba Khan , Kate Wahl , Thomas P. Bouchard , Patricia K. Doyle-Baker , Jerilynn C. Prior
{"title":"Connaissances, équité et priorités de recherche en santé menstruelle","authors":"Paul J. Yong , Zeba Khan , Kate Wahl , Thomas P. Bouchard , Patricia K. Doyle-Baker , Jerilynn C. Prior","doi":"10.1016/j.jogc.2024.102746","DOIUrl":"10.1016/j.jogc.2024.102746","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 12","pages":"Article 102746"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866897","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}
Dobrochna Globerman M.D., Alison Carter Ramirez M.D., Maryse Larouche M.D., M. Sc. (santé publique), Dante Pascali M.D., Sinead Dufour pht, Ph. D., Maria Giroux M.D.
{"title":"Directive clinique no 457 : Lésions obstétricales du sphincter anal (LOSA) – Partie I : prévention, détection et prise en charge immédiate","authors":"Dobrochna Globerman M.D., Alison Carter Ramirez M.D., Maryse Larouche M.D., M. Sc. (santé publique), Dante Pascali M.D., Sinead Dufour pht, Ph. D., Maria Giroux M.D.","doi":"10.1016/j.jogc.2024.102720","DOIUrl":"10.1016/j.jogc.2024.102720","url":null,"abstract":"<div><h3>Objectif</h3><div>La présente directive vise à promouvoir la détection et les stratégies de prévention des lésions obstétricales du sphincter anal. Elle fournit aussi des conseils sur la réparation primaire des lésions obstétricales du sphincter anal et leur prise en charge post-partum immédiate afin de limiter les séquelles indésirables.</div></div><div><h3>Population cible</h3><div>Toutes les patientes ayant subi une lésion obstétricale du sphincter anal à l’accouchement vaginal.</div></div><div><h3>Résultats</h3><div>Certaines stratégies préventives sont associées à une diminution de l’incidence des lésions obstétricales du sphincter anal (p. ex., flexion et contrôle de la tête fœtale, utilisation avisée de l’épisiotomie médio-latérale). Les stratégies de prise en charge, telles que le diagnostic et la réparation appropriés des lésions obstétricales du sphincter anal, l’antibioprophylaxie ainsi que la prise en charge du transit intestinal et de la fonction vésicale post-partum, peuvent réduire les séquelles à court et à long terme.</div></div><div><h3>Bénéfices, risques et coûts</h3><div>La mise en application des recommandations de cette directive peut améliorer la détection, la prévention et la prise en charge adéquate des lésions anales obstétricales, ce qui aura pour effet de limiter le fardeau associé à ces lésions. L’adoption de la classification recommandée des lésions obstétricales du sphincter anal améliorera les efforts de recherche nationaux et internationaux.</div></div><div><h3>Données probantes</h3><div>La littérature publiée dans la période du 1<sup>er</sup> septembre 2014 au 30 novembre 2023 a été colligée par des recherches dans les bases de données PubMed, Ovid, Medline, Embase, Scopus et Cochrane Library au moyen de termes MeSH (<em>delivery</em>, <em>obstetrics</em>, <em>obstetric surgical procedures</em>, <em>obstetric labor complications</em>, <em>anal canal</em>, <em>episiotomy</em>) et mots clés pertinents (<em>OASIS</em>, <em>obstetrical anal sphincter injury</em>, <em>anal injury</em>, <em>anal sphincter</em>, <em>vaginal delivery</em>, <em>suture</em>, <em>fecal incontinence</em>, <em>anal incontinence</em>, <em>overlap repair</em>, <em>end-to-end repair</em>, <em>bladder protocol</em>, <em>analgesia</em>). Seuls les résultats de revues systématiques, de méta-analyses, d’essais cliniques randomisés, d’essais cliniques comparatifs, d’études observationnelles et de lignes directrices de pratique clinique ont été retenus. Les recherches se sont limitées aux publications en anglais ou en français. Les données probantes ont été étayées par des références à la directive n<sup>o</sup> 330 de la Société des obstétriciens et gynécologues du Canada, publiée en 2015.</div></div><div><h3>Méthodes de validation</h3><div>Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Vo","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 12","pages":"Article 102720"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711627","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. 457: Obstetrical Anal Sphincter Injuries (OASIS) Part I: Prevention, Recognition, and Immediate Management","authors":"Dobrochna Globerman MD, Alison Carter Ramirez MD, Maryse Larouche MD, MPH, Dante Pascali MD, Sinead Dufour PT, PhD, Maria Giroux MD","doi":"10.1016/j.jogc.2024.102719","DOIUrl":"10.1016/j.jogc.2024.102719","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this guideline is to promote recognition and preventive strategies for obstetrical anal sphincter injuries. Furthermore, it provides guidance on primary repair and immediate postpartum management for obstetrical anal sphincter tears in order to minimize further negative sequelae.</div></div><div><h3>Target Population</h3><div>All patients having a vaginal delivery and those who have sustained an obstetrical anal sphincter injury.</div></div><div><h3>Outcomes</h3><div>Certain preventive strategies have been associated with lower rates of obstetrical anal sphincter injuries (e.g., fetal head flexion and control, appropriate use of mediolateral episiotomy). Management strategies, including appropriate diagnosis and repair of obstetrical anal sphincter injuries, antibiotic prophylaxis, and bowel and bladder function management can decrease associated short- and long-term complications.</div></div><div><h3>Benefits, Harms, and Costs</h3><div>Implementation of the recommendations in this guideline may increase detection, prevention, and appropriate management of obstetrical anal injuries, thus limiting the future burden associated with these injuries. Implementation of the recommended classification of obstetrical anal sphincter injuries will improve national and international research efforts.</div></div><div><h3>Evidence</h3><div>Published literature was retrieved through searches of PubMed, Ovid, Medline, Embase, Scopus, and the Cochrane Library from September 1, 2014, through November 30, 2023, using appropriate MeSH terms (delivery, obstetrics, obstetric surgical procedures, obstetric labor complications, anal canal, episiotomy) and keywords (OASIS, obstetrical anal sphincter injury, anal injury, anal sphincter, vaginal delivery, suture, fecal incontinence, anal incontinence, overlap repair, end-to-end repair, bladder protocol, analgesia). Results were restricted to systematic reviews, meta-analyses, randomized controlled trials/controlled clinical trials, observational studies, and clinical practice guidelines. Results were limited to English- or French-language materials. Evidence was supplemented with references from the 2015 Society of Obstetricians and Gynaecologists of Canada guideline no. 330.</div></div><div><h3>Validation Methods</h3><div>The authors rated the quality of evidence and strength of recommendations using the <span><span>Grading of Recommendations Assessment, Development and Evaluation</span><svg><path></path></svg></span> (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 recommendations).</div></div><div><h3>Intended Audience</h3><div>Obstetrical care providers.</div></div><div><h3>Tweetable Abstract</h3><div>Updated Canadian guideline on recognition, prevention and management of obstetrical anal sphincter injuries (OASIS).</div></div><di","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 12","pages":"Article 102719"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711750","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}
Paul J. Yong , Zeba Khan , Kate Wahl , Thomas P. Bouchard , Patricia K. Doyle-Baker , Jerilynn C. Prior
{"title":"Menstrual Health Literacy, Equity and Research Priorities","authors":"Paul J. Yong , Zeba Khan , Kate Wahl , Thomas P. Bouchard , Patricia K. Doyle-Baker , Jerilynn C. Prior","doi":"10.1016/j.jogc.2024.102711","DOIUrl":"10.1016/j.jogc.2024.102711","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 12","pages":"Article 102711"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866959","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}
Michiel C. Van den Hof M.D., Venu Jain M.D., Ph. D., Ori Nevo M.D.
{"title":"Consensus clinique No 455 : Déterminer et révéler le sexe fœtal","authors":"Michiel C. Van den Hof M.D., Venu Jain M.D., Ph. D., Ori Nevo M.D.","doi":"10.1016/j.jogc.2024.102676","DOIUrl":"10.1016/j.jogc.2024.102676","url":null,"abstract":"<div><h3>Objectif</h3><div>Donner une orientation sur l’examen échographique du périnée du fœtus ainsi que sur la détermination et la divulgation du sexe fœtal.</div></div><div><h3>Population cible</h3><div>Toutes les personnes ayant une grossesse évolutive.</div></div><div><h3>Options</h3><div>Inclure l’examen du périnée fœtal et la détermination du sexe fœtal comme élément de l’examen anatomique à l’échographie obstétricale de routine du deuxième trimestre et respecter le souhait des patientes en ce qui concerne la divulgation du sexe fœtal.</div></div><div><h3>Résultats</h3><div>Diagnostic prénatal des anomalies ou variantes sexuelles ou génitales du fœtus, connaissance du sexe fœtal par les parents et le personnel obstétrical et respect du souhait des parents concernant la connaissance du sexe fœtal.</div></div><div><h3>Bénéfices, risques et coûts</h3><div>Les bénéfices regroupent la possibilité d’améliorer les issues périnatales grâce au diagnostic des anomalies génitales fœtales et le respect de l’autonomie légitime des femmes en matière de renseignements personnels de santé. Les préjudices et coûts potentiels sont une erreur possible de détermination du sexe fœtal; une augmentation du temps consacré par les patientes et les professionnels de la santé à la planification et à la réalisation de l’examen d’imagerie; et le risque minime que les patientes choisissent d’avorter si le fœtus n’est pas du sexe désiré.</div></div><div><h3>Données probantes</h3><div>Les données probantes reposent sur la littérature de la version précédente de cette déclaration par l’examen de lignes directrices à l’international, la consultation des décisions juridiques canadiennes et une recherche documentaire dans les bases de données PubMed et Cochrane Database. Les articles de recherche, les articles de synthèse et les revues systématiques publiés en anglais entre le 1 janvier 2003 et le 31 décembre 2023 ont été inclus. Les termes de recherche utilisés étaient <em>fetal ultrasonography</em>, <em>sex determination</em> et <em>genitalia</em>. Les bibliographies des articles pertinents ont été évaluées et les articles applicables ont également été inclus.</div></div><div><h3>Professionnels concernés</h3><div>Tous les prestataires de soins aux personnes enceintes au Canada.</div></div><div><h3>Résumé des médias sociaux</h3><div>Les organes génitaux du fœtus doivent être examinés pendant la grossesse et le sexe doit être divulgué en toute sécurité à la patiente si elle souhaite obtenir cette information.</div></div><div><h3>DÉCLARATIONS DE CONSENSUS SUR LES BONNES PRATIQUES</h3><div><ul><li><span>1.</span><span><div>Les professionnels d’imagerie diagnostique et les autres professionnels de la santé doivent respecter les souhaits des parents concernant la divulgation du sexe fœtal.</div></span></li><li><span>2.</span><span><div>Les professionnels d’imagerie diagnostique doivent s’efforcer de déterminer le sexe fœtal au cours d’une échographie obstétricale à partir du de","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 11","pages":"Article 102676"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372103","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}
Phoebe Friesen PhD , Wan-Li Sun BSc , Sarah Towle MSc
{"title":"Consent and Educational Sensitive Exams on Anesthetized Patients: Experiences of Medical Students Across Canada","authors":"Phoebe Friesen PhD , Wan-Li Sun BSc , Sarah Towle MSc","doi":"10.1016/j.jogc.2024.102585","DOIUrl":"10.1016/j.jogc.2024.102585","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigates experiences of medical students across Canada related to consent for educational sensitive (i.e., pelvic, rectal) exams under anesthesia (EUAs).</div></div><div><h3>Methods</h3><div>A bilingual online questionnaire was developed and distributed to medical students across Canada.</div></div><div><h3>Results</h3><div>Of 134 respondents, 63% had performed a pelvic EUA, 35% a rectal EUA, and 11% another sensitive EUA during their training. For those who had performed pelvic EUA, 28% were unsure if consent had taken place, 26% reported no specific consent, 20% reported specific consent, and 25% had mixed experiences of consent. For rectal EUAs, 48% reported no specific consent, 37% were unsure if consent had taken place, 13% reported that there had been specific consent, and 2% reported mixed experiences. Most respondents were uncomfortable (36%) or not sure if they were comfortable (32%) with how the consent process was handled for student pelvic EUAs; 31% were comfortable. In open-ended responses, respondents described experiences related to variability, discomfort, and authority.</div></div><div><h3>Conclusions</h3><div>Non-consensual educational sensitive EUAs continue to take place in medical training across Canada, although practices of consent are highly variable. The majority of respondents reported being uncomfortable or unsure if they were comfortable with how consent for educational sensitive EUAs was practised during their training, and some respondents struggled to express their discomfort given the power dynamics at play.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 11","pages":"Article 102585"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327612","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":"Introducing a Series of Clinical Vignettes on Maternal Mortality and Morbidity in Canada","authors":"Rohan D’Souza MD, PhD, FRCOG , Graeme Smith MD, PhD, FRCSC, FCAHS","doi":"10.1016/j.jogc.2024.102728","DOIUrl":"10.1016/j.jogc.2024.102728","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 11","pages":"Article 102728"},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759513","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}