Journal of obstetrics and gynaecology Canada最新文献

{"title":"Cerebral-Placental-Uterine Ratio in the Early Third Trimester as a Predictor of Small-for-Gestational-Age Birthweight: A Prospective Cohort Study","authors":"Chutinun Leelarujijaroen MD,&nbsp;Chusana Petpichetchian MD,&nbsp;Thitima Suntharasaj MD,&nbsp;Natthicha Chainarong MD,&nbsp;Wattanan Watthanasathitnukun MD","doi":"10.1016/j.jogc.2025.102952","DOIUrl":"10.1016/j.jogc.2025.102952","url":null,"abstract":"<div><h3>Objectives</h3><div>The diagnosis of late-onset fetal growth restriction is challenging, with a low detection rate using ultrasonographic estimation of fetal weight and subtle Doppler changes in commonly assessed fetal vessels. The cerebral-placental-uterine ratio (CPUR) has been reported to better predict small-for-gestational-age (SGA) birthweight. However, its use in the early third trimester has never been evaluated. This study aimed to evaluate the role of the CPUR in the early third trimester for predicting SGA at birth.</div></div><div><h3>Methods</h3><div>This prospective cohort study included 228 women at 28⁰–31⁶ weeks gestation with appropriate-for-gestational-age (AGA) fetuses between May and December 2023 in a tertiary-level hospital. The umbilical, middle cerebral, and uterine artery pulsatility indexes (PIs) were measured to calculate the cerebroplacental ratio and CPUR (CPR-PI/UtA-PI). Parameters were compared between women with AGA and SGA newborns. After determining the CPUR cutoff point, predictors of SGA birthweight were identified using logistic regression analysis.</div></div><div><h3>Results</h3><div>Fifty-one women (22.4%) delivered SGA infants. The optimal CPUR cutoff point for predicting SGA birthweight was 2.1 (sensitivity 88.7%, specificity 31.4%). The SGA group had significantly lower estimated fetal weight, estimated fetal weight percentile, abdominal circumference (AC), AC percentile, and cerebroplacental ratio, than the AGA group. A low CPUR was significantly more common in the SGA than in the AGA group (31.4% vs. 11.3%, <em>P =</em> 0.001). After multivariate analysis, a low CPUR (&lt;2.1) was significantly associated with SGA at birth (odds ratio 4.39; 95% CI 1.88–10.44, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Early third-trimester CPUR was an independent predictor of SGA at birth.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 8","pages":"Article 102952"},"PeriodicalIF":2.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251844","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":"Local and Systemic Methotrexate Administration Along With Hysteroscopic Treatment of Cesarean Scar Pregnancy","authors":"Magdalena Piróg MD, PhD ,&nbsp;Jagoda Sarad MD ,&nbsp;Dominik Skoczylas MD ,&nbsp;Olga Kacalska-Janssen MD, PhD ,&nbsp;Robert Jach MD, PhD","doi":"10.1016/j.jogc.2025.102925","DOIUrl":"10.1016/j.jogc.2025.102925","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate treatment outcomes of local and systemic methotrexate (MTX) treatment followed by hysteroscopic removal of the residual gestational mass in women with cesarean scar pregnancy (CSP).</div></div><div><h3>Methods</h3><div>We studied 43 women with CSP between December 2021 and May 2024. We measured treatment outcomes, including changes in β-human chorionic gonadotropin (β-hCG) levels after MTX administration, along with duration to achieve undetectable β-hCG levels and treatment-related complications.</div></div><div><h3>Results</h3><div>We have enrolled women at a median age of 35.2 ± 4.1 years and a BMI of 25.4 ± 5.3 kg/m². The median gestational age at diagnosis was 8.0 (7.2–9.0) weeks, with a mean gestational sac size of 20.5 ± 4.3 mm and positive fetal cardiac activity in 61.8% (n = 21) women. After a mean time of 49.7 ± 4.8 days, a hysteroscopy was performed. Overall, 41 women (95.3%) were successfully treated and achieved an undetectable β-hCG level, and 2 women had an urgent hysterectomy related to the hemorrhage.</div></div><div><h3>Conclusions</h3><div>In types II and III of CSP, implementing a combination of local and systemic MTX administration followed by hysteroscopic removal of residual gestational mass is a safe, well-tolerated, and fertility-preserving treatment method.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 7","pages":"Article 102925"},"PeriodicalIF":2.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236713","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. 460: Diagnosis and Management of Intrauterine Early Pregnancy Loss","authors":"Helen Pymar MD, MPH,&nbsp;Ashley Waddington MD, MPA,&nbsp;Sarah Prager MD, MAS,&nbsp;Jade Shorter MD, MSHP,&nbsp;Jackie Thomas MD, MSc","doi":"10.1016/j.jogc.2025.102914","DOIUrl":"10.1016/j.jogc.2025.102914","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To provide an evidence-based approach to guide the diagnosis and management of intrauterine early pregnancy loss.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Target Population&lt;/h3&gt;&lt;div&gt;This population includes patients experiencing pregnancy loss/miscarriage and incomplete pregnancy loss in the context of a normally sited intrauterine pregnancy. It does &lt;em&gt;not&lt;/em&gt; include patients with a pregnancy of unknown location, ectopic pregnancy or recurrent pregnancy loss (2 or more pregnancy losses).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Benefits, Harms, and Costs&lt;/h3&gt;&lt;div&gt;Incorrect diagnosis of a pregnancy loss increases the risk of harming a live, normally sited pregnancy. Prolonged waiting for confirmation of a diagnosis can increase anxiety and delay treatment. Patient-centred care discussions can help patients understand their pregnancy loss risk and make decisions about their management and follow-up, including time off for bereavement and mental health support.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence&lt;/h3&gt;&lt;div&gt;The following search terms were entered into PubMed from January 2021 to December 2024: early pregnancy loss, incomplete, spontaneous abortion, diagnosis, and management. The International Society of Ultrasound in Obstetrics and Gynecology (2021 and 2022), and Association of Early Pregnancy Units presentations and references were also used.&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 Grading of Recommendations Assessment, Development and Evaluation (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;Health care providers who provide care to pregnant patients experiencing intrauterine early pregnancy loss.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Tweetable Abstract&lt;/h3&gt;&lt;div&gt;Early pregnancy loss is a common experience that can be traumatic. Patient-centred care in an Early Pregnancy Assessment Clinic can help patients make informed decisions.&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;Early pregnancy bleeding and loss are common reasons for health care visits (&lt;em&gt;high&lt;/em&gt;).&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;2.&lt;/span&gt;&lt;span&gt;&lt;div&gt;Most early pregnancy loss results from aneuploidy and is not preventable or treatable (&lt;em&gt;high&lt;/em&gt;).&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;3.&lt;/span&gt;&lt;span&gt;&lt;div&gt;Early pregnancy loss has significant psychosocial consequences for patients and their families that can include depression, anxiety and Post-Traumatic Stress Disorder (PTSD) (&lt;em&gt;high&lt;/em&gt;).&lt;/div&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;4.&lt;/span&gt;&lt;span&gt;&lt;div&gt;The establishment of multidisciplinary Early Pregnancy Assessment clinics across the country is recommended; they improve patient experience by expediting evaluation of early pregnancy bleeding and providing physical and emotional care specific to EPL, reducing visits to the emergency department and","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 ","pages":"Article 102914"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015975","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":"Developing a Differentiated Care Pathway for Socially Vulnerable Pregnant Individuals in Vancouver: Feasibility of a Community Health Worker-Supported Prenatal Program","authors":"Estefania Orta 1,&nbsp;Aiyanas Ormond,&nbsp;Abiola Adeniyi,&nbsp;Kiran Nayar,&nbsp;Zoe Hodgson,&nbsp;Astrid Christoffersen-Deb,&nbsp;Lee Saxell","doi":"10.1016/j.jogc.2025.102890","DOIUrl":"10.1016/j.jogc.2025.102890","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102890"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261534","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":"Connection to Perinatal Care for the Management of Maternal Non-communicable Diseases: The CONNECT Project","authors":"Darine El-Chaâr 1,&nbsp;Robin Ducharme,&nbsp;Sara Scremin Souza,&nbsp;Chengchun Yu,&nbsp;Katherine Muldoon,&nbsp;Natalie Dayan,&nbsp;Steven Hawken","doi":"10.1016/j.jogc.2025.102859","DOIUrl":"10.1016/j.jogc.2025.102859","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102859"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261696","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":"DECIDE Communication Approach: Improving Patient-Provider Vaccination Communication in Pregnancy","authors":"Eliana Castillo 1,&nbsp;Medea Myers-Stewart,&nbsp;Monica Surti,&nbsp;Maria Castrellon Pardo,&nbsp;Marcia Bruce,&nbsp;Andrea Patey,&nbsp;Maoliosa Donald","doi":"10.1016/j.jogc.2025.102852","DOIUrl":"10.1016/j.jogc.2025.102852","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102852"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261809","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":"Youth Experiences of Accessing Free and Pharmacist-Prescribed Contraception in British Columbia: Results of a Qualitative Investigation","authors":"Sarah Munro 1,&nbsp;Victoria Paller,&nbsp;I Fan Kuo,&nbsp;Skye Barbic,&nbsp;Wendy V. Norman,&nbsp;Jane Xia,&nbsp;Kaiya Jacob,&nbsp;Laure Schummers","doi":"10.1016/j.jogc.2025.102884","DOIUrl":"10.1016/j.jogc.2025.102884","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102884"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262017","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- and Post-operative Pathology Concordance in Endometrial Intraepithelial Neoplasia","authors":"Jenny Dimakos 1,&nbsp;Dong Bach Nguyen,&nbsp;Jessica Papillon Smith,&nbsp;Fady Willianson Mansour,&nbsp;Srinivasan Krishnamurthy,&nbsp;Andrew Zakhari","doi":"10.1016/j.jogc.2025.102856","DOIUrl":"10.1016/j.jogc.2025.102856","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102856"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262578","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":"Oncologic and Obstetrical Outcomes Following Excisional Procedures for Cervical Dysplasia: A Retrospective Cohort Study","authors":"Kristen McFadyen 1,&nbsp;Alicia Tuccinardi,&nbsp;Andrew McClure,&nbsp;Emily A. Goebel,&nbsp;Basim Abu Rafea,&nbsp;Ji-Hyun Jang","doi":"10.1016/j.jogc.2025.102880","DOIUrl":"10.1016/j.jogc.2025.102880","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102880"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262161","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":"Sexual Mindfulness and Daily Sexual Functioning: A Dyadic Diary Study","authors":"Emily Jarvis 1,&nbsp;Jackie Huberman,&nbsp;Natalie Rosen","doi":"10.1016/j.jogc.2025.102870","DOIUrl":"10.1016/j.jogc.2025.102870","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 6","pages":"Article 102870"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262352","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}