Journal of obstetrics and gynaecology Canada最新文献

{"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}

{"title":"Trainee Involvement at Vaginal Hysterectomy: A Canadian Multicentre Retrospective Review","authors":"Justin W.J. Lim MD ,&nbsp;Ally Murji MD, MPH ,&nbsp;Lindsay Shirreff MD, MSc(HQ)","doi":"10.1016/j.jogc.2025.103051","DOIUrl":"10.1016/j.jogc.2025.103051","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to describe postgraduate obstetrics and gynaecology trainee involvement at vaginal hysterectomy (VH) compared with laparoscopic hysterectomy (LH) and laparoscopic-assisted vaginal hysterectomies, and to explore the impact of trainee involvement on VH surgical outcomes.</div></div><div><h3>Methods</h3><div>This was a multicentre retrospective cohort study of minimally invasive surgical (MIS) hysterectomies conducted from 2016 to 2022. Patient, surgery, and surgeon characteristics were compared between types of MIS hysterectomy, and factors associated with VH were identified through multivariable logistic regression analysis. Trainee presence at each type of MIS hysterectomy was documented. Analysis of VH surgical outcomes was performed with primary exposure as first-assistant training level (staff, fellow, resident).</div></div><div><h3>Results</h3><div>We included 5246 hysterectomies, with 1491 VHs, 3352 LHs, and 403 laparoscopic-assisted vaginal hysterectomies. Most hysterectomies involved at least 1 trainee (78.0%), less commonly at VH than at LH (76.8% vs. 79.5%, <em>P</em> &lt; 0.05). When comparing VH with LH, more fellow involvement (48.3% vs. 35.1%, <em>P</em> &lt; 0.001) and less resident involvement (60% vs. 66.8%, <em>P</em> &lt; 0.001) was observed. Among hysterectomies that residents were present at, 30.2% of VH cases were performed with residents alone, as opposed to 42.4% of LH cases (<em>P</em> &lt; 0.001). After adjusting for confounding factors, VHs with residents as the first assistant, compared with staff, had longer operative time (151 vs. 102 minutes, <em>P</em> &lt; 0.001), higher estimated blood loss (200 vs. 100 cc, <em>P</em> &lt; 0.001), and a higher rate of postoperative complications or readmission within 30 days of surgery (28.9% vs. 15.4%, <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Residents are less frequently involved at VH compared with LH. VH surgical outcomes were found to worsen when trainees were the first assistant as opposed to staff.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103051"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700860","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":"Superimposed Lipemia During Labor","authors":"Sandrine Dionne MD ,&nbsp;Kevin S. Kim MD, PhD ,&nbsp;Emilie Belley-Côté MD, PhD","doi":"10.1016/j.jogc.2025.103047","DOIUrl":"10.1016/j.jogc.2025.103047","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103047"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700859","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":"Introital Vaginal Adhesion Following Caesarean Section: A Complication of Genitourinary Syndrome of Lactation","authors":"Jenna Anne Rossi MD ,&nbsp;Kyra Bonasia MD, PhD ,&nbsp;Aisling Clancy MD, MSc, MPH","doi":"10.1016/j.jogc.2025.103049","DOIUrl":"10.1016/j.jogc.2025.103049","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103049"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700858","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":"Ultrasound-Guided Removal of an Intrauterine Contraceptive Device with Displaced Strings During Early Pregnancy","authors":"Venu Jain MD, PhD ,&nbsp;Kentia Naud MD ,&nbsp;Anita Singh DMS ,&nbsp;Lisa Brausen DMS ,&nbsp;Cindy Kao MD","doi":"10.1016/j.jogc.2025.103046","DOIUrl":"10.1016/j.jogc.2025.103046","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103046"},"PeriodicalIF":2.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700862","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":"Ehawawisit: Sociodemographic and Clinical Characteristics and Perinatal Outcomes of Métis Pregnancies in Alberta, Canada","authors":"Maria B. Ospina PhD ,&nbsp;Omolara B. Sanni PhD ,&nbsp;Jesus Serrano-Lomelin PhD ,&nbsp;Ashton James MSc ,&nbsp;Kelsey Bradburn BA ,&nbsp;Reagan Bartel MPH ,&nbsp;Manoj Kumar MD, MSc ,&nbsp;Radha Chari MD ,&nbsp;Rhonda J. Rosychuk PhD ,&nbsp;Susan Crawford MSc ,&nbsp;Alvaro Osornio-Vargas MD, PhD ,&nbsp;Jeffrey A. Bakal PhD ,&nbsp;Britt Voaklander MD, MSc ,&nbsp;Kristin Black MD ,&nbsp;Amy Colquhoun PhD","doi":"10.1016/j.jogc.2025.103044","DOIUrl":"10.1016/j.jogc.2025.103044","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate sociodemographic and clinical characteristics and perinatal outcomes of Métis pregnancies in Alberta, Canada.</div></div><div><h3>Methods</h3><div>This was a retrospective population-based cohort study of all singleton pregnancies resulting in live births (≥22⁰ weeks gestation) in Alberta (2006–2016). Métis births were identified through linkage of the Otipemisiwak Métis Government of the Métis Nation within Alberta Identification Registry with Alberta’s population and perinatal registries, and compared with non-Métis pregnancies. Age-standardized prevalence and adjusted odds ratios (aOR) with 95% CIs were calculated.</div></div><div><h3>Results</h3><div>The study included 7910 Métis and 471 522 non-Métis pregnancies. Métis pregnancies had higher rates of self-reported smoking (aOR 5.83; 95% CI 4.99–6.80), substance use during pregnancy (aOR 1.92; 95% CI 1.65–2.23), and pre-existing chronic hypertension (aOR 1.57; 95% CI 1.11–2.25). Métis deliveries had more obstetric hemorrhage complications (aOR 1.11; 95% CI 1.01–1.23), higher odds of spontaneous vaginal delivery (aOR 1.25; 95% CI 1.11–1.40), and lower odds of vacuum- or forceps-assisted delivery (aOR 0.69; 95% CI 0.63–0.75). Métis newborns had higher birth weights (3.42 kg vs. 3.35 kg), were more often large for gestational age (aOR 1.50; 95% CI 1.35–1.66), and less often small for gestational age (aOR 0.70; 95% CI 0.62–0.79). Rates of preterm births, neonatal intensive care unit admissions, and neonatal deaths were similar to those of non-Métis newborns.</div></div><div><h3>Conclusions</h3><div>Métis pregnancies had low overall perinatal complication rates but distinct differences in maternal and perinatal outcomes relative to non-Métis pregnancies. Métis-specific, culturally sensitive care may support improved perinatal outcomes for Métis families.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103044"},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661692","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":"Severe Maternal Morbidity and Maternal Mortality Associated with Pregnancies Among Women With Solid Organ Transplants","authors":"Yasser Sabr MD, MHSc, MMEd ,&nbsp;Sarka Lisonkova MD, PhD ,&nbsp;Chantal Mayer MD ,&nbsp;K.S. Joseph MD, PhD","doi":"10.1016/j.jogc.2025.103043","DOIUrl":"10.1016/j.jogc.2025.103043","url":null,"abstract":"<div><h3>Objectives</h3><div>Solid organ transplants (SOT), including kidney, liver, heart, lung, and pancreas transplants, have become more common in the last few decades. However, few population-based studies have attempted to comprehensively quantify severe maternal morbidity (SMM) and maternal mortality associated with pregnancies among recipients of SOTs. This study aimed to determine the proportion of women with SOTs among all delivering women, and to quantify the rates of SMM and maternal mortality associated with SOT.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of all hospital deliveries at ≥20⁰ weeks gestation in Canada (excluding Québec) from April 2003 to March 2018. SMM was defined using a standard list of SMM conditions. Logistic regression provided adjusted ORs (AORs) for associations between SOT and SMM/maternal mortality, adjusting for age, parity, plurality, and other confounders.</div></div><div><h3>Results</h3><div>Among the 4, 157 547 women who delivered during the study period, 342 had an SOT (63% kidney, 25% liver transplant). The composite SMM rate was significantly higher in the SOT group than in the non-SOT group (134.5 vs. 9.97 per 1000 deliveries; unadjusted odds ratio 13.5; 95% CI 10.1–18.0, AOR 10.8; 95% CI 7.60–15.3). Women with SOT had higher rates of specific SMM types, including severe preeclampsia (AOR 8.29; 95% CI 2.99–23.0), eclampsia (AOR 10.8; 95% CI 3.42–34.1), acute renal failure (AOR 93.9; 95% CI 58.3–151.2), acute fatty liver with transfusion (AOR 21.3; 95% CI 2.89–157.8), hepatic failure (AOR 91.4; 95% CI 11.6–722.4), cardiac conditions (AOR 7.52; 95% CI 2.72–20.8), and other SMM. The median hospital stay was 8 versus 3 days for women with and without SOT, respectively; the proportion with prolonged stay (≥7 days) was 22.3% versus 1.78% (rate ratio 12.5; 95% CI 9.84–16.0).</div></div><div><h3>Conclusions</h3><div>Prolonged hospitalization and elevated severe morbidity rates highlight the substantial clinical risk associated with deliveries to women who have had an SOT.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103043"},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661695","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":"Pseudocyst Formation in Residual Ovary Syndrome: A Unique Consequence of Ovarian Preservation","authors":"Arohumam Kan MD,&nbsp;Chanel Ghesquiere MSc,&nbsp;Maria Josefina Odulio MD,&nbsp;Debra Millar MD,&nbsp;Yasmin Derayat MD,&nbsp;Mark S. Carey MD","doi":"10.1016/j.jogc.2025.103042","DOIUrl":"10.1016/j.jogc.2025.103042","url":null,"abstract":"<div><div>Residual ovary syndrome (ROS) is a consequence of ovarian preservation after pelvic surgery. One unique and understudied manifestation of ROS includes patients who present with pseudocyst formation. These patients often have a history of multiple pelvic surgeries. Although the etiology is poorly understood, ovarian pseudocysts presumably develop because of ovulation into an enclosed space secondary to the formation of inflammatory adhesions. Herein, we describe a small cohort of patients with ROS from pseudocyst formation to highlight a rational approach to the diagnosis and management of this rare condition. This report brings attention to this uncommon but important cause of ROS.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103042"},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661694","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":"Understanding Burnout in Canadian Obstetrics and Gynecology Residents: A Longitudinal Cohort Study","authors":"Sahra Nathoo BSc, MSc ,&nbsp;Michelle Morais BSc, MD","doi":"10.1016/j.jogc.2025.103041","DOIUrl":"10.1016/j.jogc.2025.103041","url":null,"abstract":"<div><div>Resident burnout has been increasing in prevalence, with rates as high as 75%. Unfortunately, limited insight exists into the causes and manifestations of burnout in obstetrics and gynecology residents. To date, there are no Canadian longitudinal studies evaluating burnout. The goal of this study was to characterize the evolution of burnout. From January 2021 to January 2023, we used the Maslach Burnout Inventory and an associated survey to assess burnout in obstetrics and gynecology residents at McMaster University. A total of 95 responses were obtained, with self-reported burnout ranging from 33% to 56% versus actualized burnout rates of 49%–69%, with a high sense of depersonalization and emotional exhaustion. Contributing factors included long duty hours and protective factors focused on introspection. Interestingly, career regret remained low between 3% and 11%.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103041"},"PeriodicalIF":2.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661696","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":"Corrigendum to ‘Comparison of Clinical Outcomes in the Slow-Developing Blastocysts With or Without Preimplantation Genetic Testing-Aneuploidy on Day 6 in the Frozen–Thawed Cycle’ [Journal of Obstetrics and Gynaecology Canada 46;10 (2024) 102644]","authors":"Jae Eun Park MD ,&nbsp;Jihye Jeong MS ,&nbsp;Tae Hyung Kim BS ,&nbsp;Sola Yoon MS ,&nbsp;Jisoo Han PhD ,&nbsp;Jin Hee Eum PhD ,&nbsp;Hyelim Sung MD ,&nbsp;Youngsok Choi PhD ,&nbsp;Woo Sik Lee MD, PhD ,&nbsp;Hee Jun Lee MD, PhD","doi":"10.1016/j.jogc.2025.103029","DOIUrl":"10.1016/j.jogc.2025.103029","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 8","pages":"Article 103029"},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614518","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}