Journal of obstetrics and gynaecology Canada最新文献

{"title":"Directive clinique no 453 : Ablation de l’endomètre dans la prise en charge des saignements utérins anormaux","authors":"Nicholas Leyland M.D., MHCM, Philippe Laberge M.D., Devon Evans M.D., M. Sc. (santé publique), Émilie Gorak-Savard M.D., David Rittenberg M.D.","doi":"10.1016/j.jogc.2024.102642","DOIUrl":"10.1016/j.jogc.2024.102642","url":null,"abstract":"<div><h3>Objectif</h3><p>Fournir une mise à jour de la directive actuelle fondée sur des données probantes relativement aux techniques et technologies utilisées pour l’ablation de l’endomètre, une technique minimalement invasive pour la prise en charge des saignements utérins anormaux d’origine bénigne.</p></div><div><h3>Population cible</h3><p>Femmes en âge de procréer présentant des saignements utérins anormaux et une pathologie bénigne avec ou sans anomalies structurelles.</p></div><div><h3>Bénéfices, risques et coûts</h3><p>La mise en œuvre des recommandations de la directive améliorera la prestation de l’ablation de l’endomètre en tant que traitement efficace des saignements utérins anormaux. Le respect de ces recommandations permet de réaliser l’intervention chirurgicale de façon sécuritaire et de maximiser le succès du traitement pour les patientes.</p></div><div><h3>Données probantes</h3><p>La directive a été mise à jour à partir de la littérature publiée, telle que relevée par des recherches dans les bases de données Medline et Cochrane Library pour la période de janvier 2014 à avril 2023 en utilisant des termes et mots clés pertinents prédéterminés (<em>endometrial ablation, hysteroscopy, menorrhagia, heavy menstrual bleeding, abnormal uterine bleeding, hysterectomy</em>). Seuls les résultats de revues systématiques, d’essais cliniques randomisés ou comparatifs et d’études observationnelles en anglais ont été retenus.</p><p>La littérature grise (non publiée) a été récupérée auprès de l’Association des obstétriciens et gynécologues du Québec (AOGQ) en 2023.</p></div><div><h3>Méthodes de validation</h3><p>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). Voir l’<span><span>annexe A</span></span> (<span><span>tableau A1</span></span> pour les définitions et tableau <span><span>A2</span></span> pour l’interprétation des recommandations fortes et faibles).</p></div><div><h3>Professionnels concernés</h3><p>Obstétriciens, gynécologues et prestataires de soins primaires.</p></div><div><h3>Résumé des médias sociaux</h3><p>Cette directive est une version mise à jour de la directive de 2015 de la SOGC sur l’ablation de l’endomètre. Les auteurs abordent les considérations particulières, fournissent une mise à jour des données probantes et formulent de nouvelles recommandations concernant le déficit liquidien.</p></div><div><h3>DÉCLARATIONS SOMMAIRES</h3><p></p><ul><li><span>1.</span><span><p>L’ablation de l’endomètre est une intervention chirurgicale minimalement invasive sécuritaire et efficace qui est devenue une solution de rechange bien établie au traitement médical et à l’hystérectomie pour les saignements utérins anormaux dans certains cas (<em>élevée</em>).</p></span></li><li><span>2.</span><span><p>Il est possible de préparer médicalement l’endomètre pour l’amincir afin d’en faciliter l’abla","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102642"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017839","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. 453: Endometrial Ablation in the Management of Abnormal Uterine Bleeding","authors":"Nicholas Leyland MD, MHCM, Philippe Laberge MD, Devon Evans MD, MPH, Emilie Gorak Savard MD, David Rittenberg MD","doi":"10.1016/j.jogc.2024.102641","DOIUrl":"10.1016/j.jogc.2024.102641","url":null,"abstract":"<div><h3>Objective</h3><p>To provide an update of the current evidence-based guideline on the techniques and technologies used in endometrial ablation, a minimally invasive technique for the management of abnormal uterine bleeding of benign origin.</p></div><div><h3>Target Population</h3><p>Women of reproductive age with abnormal uterine bleeding and benign pathology with or without structural abnormalities.</p></div><div><h3>Benefits, Harms, and Costs</h3><p>Implementation of the guideline recommendations will improve the provision of endometrial ablation as an effective treatment for abnormal uterine bleeding. Following these recommendations would allow the surgical procedure to be performed safely and maximize success for patients.</p></div><div><h3>Evidence</h3><p>The guideline was updated with published literature retrieved through searches of Medline and the Cochrane Library from January 2014 to April 2023, using appropriate controlled vocabulary and keywords (endometrial ablation, hysteroscopy, menorrhagia, heavy menstrual bleeding, abnormal uterine bleeding, hysterectomy). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies written in English.</p><p>Grey (unpublished) literature was retrieved from the Association of Obstetricians and Gynecologists of Quebec (AOGQ) in 2023.</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><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 [weak] recommendations).</p></div><div><h3>Intended Audience</h3><p>Obstetricians, gynaecologists, and primary care providers.</p></div><div><h3>Social Media Abstract</h3><p>This is an updated version of the 2015 SOGC Endometrial Ablation guideline. The authors discuss special considerations, update evidence, and make new fluid deficit recommendations.</p></div><div><h3>SUMMARY STATEMENTS</h3><p></p><ul><li><span>1.</span><span><p>Endometrial ablation is a safe and effective minimally invasive surgical procedure that has become a well-established alternative to medical treatment or hysterectomy for abnormal uterine bleeding in select cases (<em>high).</em></p></span></li><li><span>2.</span><span><p>Medical preparation to thin the endometrium can be used to facilitate resectoscopic endometrial ablation and can be considered for some non-resectoscopic techniques. For resectoscopic endometrial ablation, preoperative endometrial thinning results in higher short-term rates of amenorrhea, decreased distension media fluid absorption, and shorter operative time when compared with no treatment (<em>high</em>).</p></span></li><li><span>3.</span><span><p>Non-resectoscopic techniques are technically easier to perform than resectos","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102641"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017840","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 ‘Amniocentesis and Therapeutic Amnioreduction Prior to “Rescue Cerclage” (AARC Protocol): A Prospective Observational Study’ [Journal of Obstetrics and Gynaecology Canada (JOGC). Volume 46, Issue 5, May 2024, 102484]","authors":"Avina De Simone","doi":"10.1016/j.jogc.2024.102617","DOIUrl":"10.1016/j.jogc.2024.102617","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102617"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004407/pdfft?md5=7199b081adbd4264e99e34aa6bcfaf06&pid=1-s2.0-S1701216324004407-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228923","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":"Masthead Pages","authors":"","doi":"10.1016/S1701-2163(24)00471-7","DOIUrl":"10.1016/S1701-2163(24)00471-7","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102648"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004717/pdfft?md5=8b33213e443f788c2ceea092c82e67ff&pid=1-s2.0-S1701216324004717-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227932","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":"Imagerie time-lapse et intelligence artificielle : Ce n’est que la fin du début!","authors":"Peter Kovacs MD , Emilie Sandfeld BS , Nigel Pereira MD , Rebecca Flyckt MD , Steven R. Lindheim MD, MMM","doi":"10.1016/j.jogc.2024.102639","DOIUrl":"10.1016/j.jogc.2024.102639","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102639"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227935","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 Letter to the Editor: Exploring Barriers and Facilitators to COVID-19 Vaccination in People Planning Pregnancy, Trying to Conceive, Pregnant, and Postpartum","authors":"Giuliana Guarna MD, Natasha Bauer-Maison MD, Mahnoor Malik BHSc, Rohan D’Souza MD, PhD, Sapna Sharma MD","doi":"10.1016/j.jogc.2024.102621","DOIUrl":"10.1016/j.jogc.2024.102621","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102621"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228652","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":"Time-Lapse Imaging and Artificial Intelligence: It is Just the End of the Beginning!","authors":"Peter Kovacs MD , Emilie Sandfeld BS , Nigel Pereira MD , Rebecca Flyckt MD , Steven R. Lindheim MD, MMM","doi":"10.1016/j.jogc.2024.102609","DOIUrl":"10.1016/j.jogc.2024.102609","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102609"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227934","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: Exploring Barriers and Facilitators to COVID-19 Vaccination in People Planning Pregnancy, Trying to Conceive, Pregnant and Postpartum","authors":"Hinpetch Daungsupawong PhD , Viroj Wiwanitkit MD","doi":"10.1016/j.jogc.2024.102620","DOIUrl":"10.1016/j.jogc.2024.102620","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102620"},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227936","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":"Pre-delivery BMI and the Accuracy of Fetal Weight Estimation in Very Preterm Infants","authors":"Inshirah Sgayer MD ,&nbsp;Saaed Awwad MD ,&nbsp;Ala Aiob MD ,&nbsp;Susana Mustafa Mikhail MD ,&nbsp;Lior Lowenstein MD ,&nbsp;Marwan Odeh MD","doi":"10.1016/j.jogc.2024.102643","DOIUrl":"10.1016/j.jogc.2024.102643","url":null,"abstract":"<div><h3>Objectives</h3><p>To examine the relation between maternal pre-delivery BMI and the accuracy of sonographic estimated fetal weight (EFW) in very preterm infants (&lt;32 weeks gestation).</p></div><div><h3>Methods</h3><p>This retrospective study included singleton infants born between January 2010 and March 2023, at gestational ages 23⁰ to 31⁶ weeks, at a tertiary university-affiliated hospital. Absolute weight, percentage error, absolute percentage error, and overestimation and underestimation of EFW were compared between women with pre-delivery normal weight (BMI 18.5–24.99 kg/m²), overweight (BMI 25.0–29.99 kg/m²), and obesity (BMI &gt;35.0 kg/m²). Multivariate linear regression analyses adjusted for potential confounders were performed to assess relations of maternal pre-conception and of pre-delivery BMI, with EFW accuracy.</p></div><div><h3>Results</h3><p>Included were 286 pregnancies. The absolute difference, percentage error, absolute percentage error, error within the 10% range, and underestimation or overestimation of EFW were similar between the groups. The multivariate linear regression analyses did not show significant associations of pre-conceptional BMI or of pre-delivery BMI with the percentage error. However, for small for gestational age compared to appropriate for gestational age fetuses, the percentage error was greater (8.9% vs. –0.6%, β = 0.35, <em>P &lt;</em> 0.001) and the absolute percentage error was greater (11.0% vs. 6.7%, <em>P &lt;</em> 0.001). Small for gestational age fetuses were at risk of fetal weight overestimation (percentage error exceeding 15%); OR 7.20 (95% CI 2.91–17.80).</p></div><div><h3>Conclusions</h3><p>Maternal pre-delivery BMI was not found to be related to EFW accuracy in very preterm infants. Nevertheless, EFW should be interpreted carefully, as it may underdiagnose poor fetal growth in this population.</p></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 10","pages":"Article 102643"},"PeriodicalIF":2.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108489","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":"Comparison of Clinical Outcomes in the Slow-Developing Blastocysts With or Without Preimplantation Genetic Testing-Aneuploidy on Day 6 in the Frozen–Thawed Cycle","authors":"Hee Jun Lee MD, PhD ,&nbsp;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","doi":"10.1016/j.jogc.2024.102644","DOIUrl":"10.1016/j.jogc.2024.102644","url":null,"abstract":"<div><h3>Objectives</h3><p>This study investigated the potential of the slow-developing blastocysts using preimplantation genetic testing-aneuploidy (PGT-A) in patients undergoing frozen–thawed embryo transfer, stratified by age.</p></div><div><h3>Methods</h3><p>A retrospective analysis was performed including a total of 743 cycles, the first frozen embryo transfer (FET) cycle with single embryo transfer, who underwent treatment between January 2020 and July 2023 in a single fertility centre, Gangnam CHA Fertility Center. A total of 743 cycles, in which we performed intracellular sperm injection and freeze-all strategy, from 743 patients were included. The patient group was divided into 4 groups as follows: group 1 (G1), 208 FET on day 5; group 2 (G2), 177 FET with PGT-A on day 5; group 3 (G3), 220 FET on day 6; group 4 (G4), 138 FET with PGT-A on day 6. We also divided into 2 groups—under 35 years of age and over 35 years of age—and performed the analysis separately for each group.</p></div><div><h3>Results</h3><p>In the under 35 years of age group, there were no significant differences in clinical pregnancy and miscarriage rates in G1 and G2 (67.2% vs. 63.8%, not statistically significantly different). Also, G4 had a higher clinical pregnancy rate than G3, but it was not significant (51.8% vs. 54.7%, not statistically significantly different). In the 35 years or older group, G2 had higher pregnancy rates than G1 and lower miscarriage rates (clinical pregnancy rate: 43.3% vs. 67.7%, <em>P</em> = 0.001, miscarriage rate: 22.5% vs. 3.4%, <em>P</em> = 0.001). In addition, G4 had a higher pregnancy rate than G3 and a lower miscarriage rate (clinical pregnancy rate: 31.8% vs. 46.9%, <em>P</em> = 0.003, miscarriage rate: 22.9% vs. 2.2%, <em>P</em> = 0.023).</p></div><div><h3>Conclusions</h3><p>In the under-35-year-old group, PGT-A on day 5 and day 6 showed a high pregnancy rate and a low miscarriage rate. Therefore, using PGT-A seems advantageous for patients of an advanced maternal age.</p></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 10","pages":"Article 102644"},"PeriodicalIF":2.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046834","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}