Libera Troìa, Alessandro Libretti, Federica Savasta, Daniela Surico, Valentino Remorgida
{"title":"The predictive role of uterocervical angle in labor outcomes: a narrative review.","authors":"Libera Troìa, Alessandro Libretti, Federica Savasta, Daniela Surico, Valentino Remorgida","doi":"10.23736/S2724-606X.24.05572-6","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05572-6","url":null,"abstract":"<p><strong>Introduction: </strong>Uterocervical angle (UCA) is the angle between the anterior or posterior uterine wall and the cervical canal, and it has become an unique ultrasonographic marker in the recent years. The predictive role of the UCA in spontaneous preterm births (sPTB) has been examined by numerous authors, however few data are available on UCA as predictor of labor outcome at term of pregnancy. Therefore, the purpose of this review is to evaluate the effectiveness of transvaginal ultrasound measurement of UCA at term, and its clinical implications in obstetrics' practice.</p><p><strong>Evidence acquisition: </strong>A literature search was conducted including all studies regarding the predictive role of ultrasonographic evaluation of the UCA on labor outcomes from 1990 to 2023.</p><p><strong>Evidence synthesis: </strong>A narrative synthesis was subsequently performed dividing studies that considered posterior and anterior UCA. Five studies were included for the anterior UCA, and ten for the posterior UCA. UCA was then evaluated as predictor of prolonged latent phase and predictor of the onset and mode of delivery.</p><p><strong>Conclusions: </strong>It is likely that the combination of multiple cervical parameters, rather than UCA assessment alone, together with clinical information, can achieve higher levels of accuracy in predicting delivery outcomes. Future prospective studies are needed to define with greater certainty the role of UCA as a useful screening tool before laboring, but, until then, the use of UCA as a screening test to predict labor outcome should remain investigational.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522401","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}
Giuseppe Loverro, Edoardo DI Naro, Matteo Loverro, Antonio D'Amato, Maria T Loverro, Amerigo Vitagliano, Luca M Schounauer, Gianluca R Damiani
{"title":"Intraovarian injection of autologous platelet-rich-plasma: myth or reality?","authors":"Giuseppe Loverro, Edoardo DI Naro, Matteo Loverro, Antonio D'Amato, Maria T Loverro, Amerigo Vitagliano, Luca M Schounauer, Gianluca R Damiani","doi":"10.23736/S2724-606X.24.05480-0","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05480-0","url":null,"abstract":"<p><strong>Introduction: </strong>The diminished ovarian reserve (DOR) relates to a condition in which the ovary experiences a decline in its typical reproductive capacity. Despite notable advancements in understanding the pathophysiology of reduced ovarian reserve in recent years, significant unresolved challenges remain, particularly concerning the optimal therapeutic approaches for this complex condition. The main aim of this study was to investigate the potential of platelet-rich plasma (PRP) in enhancing ovarian follicle numbers by assessing changes in ovarian reserve markers.</p><p><strong>Evidence acquisition: </strong>A comprehensive literature search was conducted on the following databases: PubMed/MEDLINE, SCOPUS, The Cochrane Library, Science Direct and Web of Science. All the relevant studies published till October 2023 were screened. After removing duplicates, and full-text evaluation, 9 articles were eventually included in the present review.</p><p><strong>Evidence synthesis: </strong>The pregnancy rate (PR) among patients with poor ovarian reserve (POR) ranged from 13% to 40%, indicating the potential effectiveness of PRP as a rejuvenating treatment. The live birth rate (LBR) ranged from 13% to 20%, comparable to or not lower than the LBR of a matched healthy population aged between 38 and 42 years. Furthermore, the data presented thus far support the notion that PRP may lead to an average clinical PR of 10% in women affected by premature ovarian insufficiency (POI) and perimenopause.</p><p><strong>Conclusions: </strong>PRP can not be regarded as a gamete replacement therapy, but rather as an 'additional' therapeutic tool in the management of women with DOR or POR, as well as in peri-menopausal women. Additional qualitative studies are required to validate the existing evidence, as the literature currently lacks randomized controlled trials (RCTs) in this regard.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469861","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}
Gloria Guariglia, Cristina Salerno, Beatrice Melis, Martina Benuzzi, Daniela Menichini, Enrica Perrone, Fabio Facchinetti, Antonio LA Marca, Isabella Neri, Francesca Monari
{"title":"Is it possible to detect women at higher risk of intrapartum stillbirth? An area-based prospective cohort study.","authors":"Gloria Guariglia, Cristina Salerno, Beatrice Melis, Martina Benuzzi, Daniela Menichini, Enrica Perrone, Fabio Facchinetti, Antonio LA Marca, Isabella Neri, Francesca Monari","doi":"10.23736/S2724-606X.24.05580-5","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05580-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study is to perform an overview of intrapartum stillbirth (SB) at term, assessing risk factors, causes of death and quality of pregnancy care.</p><p><strong>Methods: </strong>This is an area-based, prospective cohort study on pregnant women at ≥37 weeks from 2014 to 2021. We compared intrapartum SB' information to alive birth and to antepartum deaths of the same period. Results of logistic regression are reported as the Odds Ratio (OR) with 95% confidence interval (95% CI) and the P value. A descriptive analysis about the causes of death and quality of pregnancy care is performed.</p><p><strong>Results: </strong>The overall rate of SB at term in Emilia-Romagna was 1.06 ‰ births. Among the 260 cases, 27 (10.4%) occurred during labor, with an intrapartum SB rate of 0.11‰. This SB rate was stable during years. SGA newborn (P=0.005, 95% CI 1.47-9.04, OR 3.63), low level of education (P<0.0001, 95% CI 2.98-16.11, OR 6.93), pre pregnancy BMI ≥ 25 kg/m<sup>2</sup> (P<0.0001, 95% CI 6.61-31.74, OR 14.50) are independent risk factors for intrapartum SB when compared to alive newborns. Compared with antepartum SB, excessive weight gain in pregnancy (RR 2.91, 1.43-3.98, P=0.001) represents a risk factor for intrapartum ones.</p><p><strong>Conclusions: </strong>Preventing intrapartum SB at term in developed country should be based on both the appropriate antenatal management of fetal growth and the avoidance of maternal excessive weight gain. An effort toward pre conceptional intervention of improving maternal shape could be of value.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391753","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}
Emma Bertucci, Maria Longo, Elisa Semprini, Giulia Tarozzi, Antonio La Marca
{"title":"Risk factors of intramural ectopic pregnancy.","authors":"Emma Bertucci, Maria Longo, Elisa Semprini, Giulia Tarozzi, Antonio La Marca","doi":"10.23736/S2724-606X.24.05608-2","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05608-2","url":null,"abstract":"","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391755","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}
Tullio Golia D'Augè, Ilaria Cuccu, Emanuele DE Angelis, Violante DI Donato, Ludovico Muzii, Ottavia D'Oria, Vito Chiantera, Sandro Gerli, Donatella Caserta, Aris R Besharat, Antonio S Laganà, Giorgio Bogani, Alessandro Favilli, Andrea Giannini
{"title":"Laparoscopic prediction of primary cytoreducibility of epithelial ovarian cancer.","authors":"Tullio Golia D'Augè, Ilaria Cuccu, Emanuele DE Angelis, Violante DI Donato, Ludovico Muzii, Ottavia D'Oria, Vito Chiantera, Sandro Gerli, Donatella Caserta, Aris R Besharat, Antonio S Laganà, Giorgio Bogani, Alessandro Favilli, Andrea Giannini","doi":"10.23736/S2724-606X.24.05452-6","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05452-6","url":null,"abstract":"<p><p>Ovarian cancer affects thousands of women every year and represents the female cancer with the highest mortality rate. Effectively, it is a severe disease that requires a multidisciplinary approach for optimal treatment. Surgery currently is the cornerstone of its treatment and numerous methods have been analyzed and developed to predict the possibility of obtaining a residual tumor of 0 (RT=0). This review aimed to analyze the available data in the literature about minimally invasive surgical methods to predict an RT=0 in patients with advanced epithelial ovarian carcinoma undergoing primary debulking surgery. An accurate review of the literature has been performed on the available data about the surgical criteria of cytoreducibility during primary debulking surgery. An accurate assessment of the extent of intra- and extra-abdominal pathology is essential to guide the surgeon in the most appropriate therapeutic choice for patients with ovarian cancer and multidisciplinary approaches that combine different methodologies such as radiological methods (magnetic resonance imaging, positron emission tomography and computed tomography), surgical (mini-laparotomy, laparoscopy) and serological (CA-125, HE4) data provide a complete picture in determining the extent of the tumor and an enormous aid in personalizing the therapeutic approach.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391754","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}
Peter Kovacs, David U Nagy, Szabolcs Matyas, Elizabeth Culberson, Chantal Kinsey, Yao Lu, Steven R Lindheim
{"title":"In-vitro fertilization experience with follitropin-delta in poor responders identified by POSEIDON Classification.","authors":"Peter Kovacs, David U Nagy, Szabolcs Matyas, Elizabeth Culberson, Chantal Kinsey, Yao Lu, Steven R Lindheim","doi":"10.23736/S2724-606X.24.05576-3","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05576-3","url":null,"abstract":"<p><strong>Background: </strong>Controlled ovarian stimulation during in-vitro fertilization (IVF) is personalized based on anticipated hyper, normal, poor response. With respect to poor responders, who are often treated using higher gonadotropin dosing and combination of urinary and recombinant gonadotropins (rFSH) with marginal benefit, we report our experience with a newer, more potent rFSH (Follitropin-δ) undergoing IVF.</p><p><strong>Methods: </strong>Retrospective analysis of all IVF cycles in which follitropin-δ was used alone or combined with urinary gonadotropins over a 3-year period. Patients were grouped according to the POSEIDON Classification as expected low responders (POSEIDON 3-4; AMH<1.2; N.=45), unexpected low responders (POSEIDON 1-2; retrieval of ≤9 oocytes; N.=67) and those with a normal response (N.=93). Demographic, stimulation (including target number of retrieved oocytes [8 to14]), embryology and clinical outcome parameters (clinical pregnancy rate [CPR], live birth rate [LBR], cumulative live birth rate [cLBR]) were compared.</p><p><strong>Results: </strong>Those categorized as POSEIDON patients were older, had lower ovarian reserve, were more likely to use a mixed protocol, less likely to reach the target oocytes retrieved (35.7% vs. 51.6%, P<0.001), and had a lower cLBR per patient (29.5% vs. 38.7%, P=0.006) when compared to non-POSEIDON patients. Expected low responders (POSEIDON 3-4) were older and had lower AMH when compared to unexpected low responders (POSEIDON 1-2), but no differences in the target of oocytes retrieved (33.3% vs. 37.3%, P=0.66) and cLBR (28.9% vs. 37.3%, P=0.06) were noted.</p><p><strong>Conclusions: </strong>In expected low responders, follitropin-δ can be used to optimize oocyte collection and clinical outcome though one may need to deviate from the algorithm-suggested dose. Future studies should explore stimulation modifications in unexpected low responders.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391752","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}
Gilad Karavani, Diana Prus, Anna Elia, Natali Schachter-Safrai, Adiel Cohen, Dvora Bauman, Talya Mordechai-Daniel, Tal Imbar
{"title":"Assessment of ovarian cortex follicles in chemotherapy naïve and chemotherapy exposed patients.","authors":"Gilad Karavani, Diana Prus, Anna Elia, Natali Schachter-Safrai, Adiel Cohen, Dvora Bauman, Talya Mordechai-Daniel, Tal Imbar","doi":"10.23736/S2724-606X.24.05547-7","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05547-7","url":null,"abstract":"<p><strong>Background: </strong>Histological evaluation of ovarian tissue harvested as part of the attempt to preserve fertility might clarify the mechanism by which ovarian failure is caused. The purpose of this study was to compare the histologic appearance of ovarian tissue harvested for ovarian tissue cryopreservation (OTC) in chemotherapy naïve and chemotherapy exposed patients regarding the presence of follicles in different stages of development and to explore ovarian tissue histology in patients exposed to low- and high-cytotoxicity risk chemotherapy.</p><p><strong>Methods: </strong>A cohort of post-pubertal cancer survivors who underwent OTC between 1997 and 2018 was evaluated. An expert pathologist reviewed the pathology slides taken during OTC. The assessment included counting number of primordial, primary, secondary, and antral follicles. A comparison was made between chemotherapy naïve and chemotherapy exposed women and further between women who previously received low- versus high-risk gonadotoxic regimens.</p><p><strong>Results: </strong>Seventy post-pubertal patients were included in the study. Seventeen (24.3%) received chemotherapy prior to OTC, and 53 (75.7%) were chemotherapy naïve at the time of OTC. A significant difference was found only in the number of secondary follicles, which was increased in chemotherapy naïve patients (2.81±4.26 vs. 0.88±1.18, respectively; P=0.005). Similar results were observed in a subgroup analysis of hematologic malignancies separately. Comparison of patients with previous exposure to chemotherapy revealed similar follicular appearance, except for the number of secondary follicles, which was higher in patients receiving low-risk compared to high-risk chemotherapy (1.40±1.28 vs. 0.14±0.35, respectively; P=0.006).</p><p><strong>Conclusions: </strong>The ovarian follicular pool at OTC appears comparable between chemotherapy naïve individuals and those post-exposure, as well as among patients receiving low versus high-risk gonadotoxic regimens, with the exception of secondary follicles, which are presented in increased numbers in chemotherapy naïve and those exposed to low-risk gonadotoxic chemotherapy.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391750","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":"Intrauterine device use in adolescence: a narrative review.","authors":"Aikaterini Zoi, Anastasia Vatopoulou, Xara Skentou, Orestis Tsonis, Georgia Galaziou, Nikoleta Koutalia, Kalypso Margariti, Eftychia Chatzisavva, Minas Paschopoulos, Fani Gkrozou","doi":"10.23736/S2724-606X.24.05405-8","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05405-8","url":null,"abstract":"<p><p>Contraceptive use in adolescence remains a challenging issue. Adolescents are at high risk of unintended pregnancies and sexual transmitted infections. During the past few decades intrauterine devices are recommended from global health organization, including the American Academy of Pediatrics, American College of Obstetricians and Gynecologists and World Health Organization as a method of contraception for adolescents. Intrauterine devices are part of the long-acting reversible contraceptives (LARCs) and include the copper bearing device (CU-IUD) and the levonorgestrel intrauterine system (LNG-IUS). IUDs are a safe and effective contraceptive method for adolescents with a failure rate less than 1%. Their use is not limited only in contraception. LNG-IUS 52 mg is approved for treating heavy menstrual bleeding and protection from endometrial hyperplasia in women receiving hormone replacement therapy. It can also be an effective tool in the management of dysmenorrhea, while CU-IUD can provide emergency contraception. Nevertheless, IUDs remain underutilized in this group of population. Adolescents' lack of proper education about contraception and sexual behavior creates myths and misconceptions about the possible side effects and the suitability of IUDs in this age group. Furthermore, health care providers remain skeptical and hesitate to suggest IUDs to adolescents. Other barriers including high cost, concern about confidentiality and difficulties in access contribute to its limited use. It is of high importance to eliminate barriers and offer more accessible contraceptive services to adolescents.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391751","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}
Ana M Fernández-Alonso, Isabel M Fernández-Alonso, Ignacio Rodríguez, Faustino R Pérez-López
{"title":"Age and phytoestrogen use, but not resilience, influence urinary incontinence in postmenopausal women.","authors":"Ana M Fernández-Alonso, Isabel M Fernández-Alonso, Ignacio Rodríguez, Faustino R Pérez-López","doi":"10.23736/S2724-606X.24.05440-X","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05440-X","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to determine factors involved in urinary incontinence (UI), and psychological resilience in postmenopausal women.</p><p><strong>Methods: </strong>In this cross-sectional study, 137 postmenopausal women (aged 50-75 years) filled out the 4-item International Consultation on Incontinence Questionnaire short form (ICIQ-SF), the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), the 10-item Connor-Davidson Resilience Scale (CD-RISC), and a questionnaire containing personal data. We designed a directed acyclic graph (DAG) to identify covariates related to urinary incontinence and resilience in postmenopausal women.</p><p><strong>Results: </strong>The mean age of all surveyed women was 58.7±5.1 years, the majority were Caucasian (92.7%). There was an inverse correlation between item-1 ICIQ-SF scores and CD-RISC Scores. Women with severe UI had a higher median total ICIQ-SF score and lower total CD-RISC Scores as compared to those with nil or mild (P<0.05 for both). Odds ratios of sociodemographic and clinical characteristics indicate that phytoestrogen use (OR: 10.80; 95% CI 2.42-48.13) and economic problems (OR: 2.46; 95% CI 1.22-4.93) were associated with UI. However, a multivariable logistic model only identified urinary incontinence significantly associated with phytoestrogen use and age (P<0.05). The effect of other variables was attenuated in the model when controlling for population confounders, and significance was not achieved.</p><p><strong>Conclusions: </strong>Urinary incontinence was significantly associated with economic problems, phytoestrogen use, and depressive symptoms compared to women without urinary complaints. The multivariable logistic model confirmed age and phytoestrogen use as causal factors for urinary incontinence.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391749","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}
Hannah M Kyllo, Wyanet Bresnitz, Mayu Bickner, Morgan A Matous, Nelly M Mulenga, Elizabeth A O'Brien, Sophie M Whitehead, Nana S Fordwuo, Erica M Wong, Katlynn Adkins, Tyler M Muffly
{"title":"Access to general obstetrics and gynecology care among Medicaid beneficiaries and the privately insured: a nationwide mystery caller study in the USA.","authors":"Hannah M Kyllo, Wyanet Bresnitz, Mayu Bickner, Morgan A Matous, Nelly M Mulenga, Elizabeth A O'Brien, Sophie M Whitehead, Nana S Fordwuo, Erica M Wong, Katlynn Adkins, Tyler M Muffly","doi":"10.23736/S2724-606X.24.05497-6","DOIUrl":"10.23736/S2724-606X.24.05497-6","url":null,"abstract":"<p><strong>Background: </strong>The mean wait time for new patient appointments has been growing across specialties, including obstetrics and gynecology, in recent years. This study aimed to assess the impact of insurance type (Medicaid versus commercial insurance) on new patient appointment wait times in general obstetrics and gynecology practices.</p><p><strong>Methods: </strong>A cross-sectional study used covert mystery calls to general obstetrician gynecologists. Physicians were selected from the American College of Obstetricians and Gynecologists directory and stratified by districts to ensure nationwide representation. Wait times for new patient appointments were collected and analyzed.</p><p><strong>Results: </strong>Regardless of insurance type, the mean wait time for all obstetrician gynecologists was 29.9 business days. Medicaid patients experienced a marginally longer wait time of 4.8% (Ratio: 1.048). While no statistically significant difference in wait times based on insurance type was observed (P=0.39), the data revealed other impactful factors. Younger physicians and those in university-based practices had longer wait times. The gender of the physician also influenced wait times, with female physicians having a mean wait time of 34.7 days compared to 22.7 days for male physicians (P=0.03). Additionally, geographical variations were noted, with physicians in American College of Obstetricians and Gynecologists District I (Atlantic Provinces, CT, ME, MA, NH, RI, VT) having the longest mean wait times and those in District III (DE, NJ, PA) the shortest.</p><p><strong>Conclusions: </strong>While the type of insurance did not significantly influence the wait times for general obstetrics and gynecology appointments, physician demographic and geographic factors did.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248303","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}