Obstetrics and gynecology最新文献

{"title":"Clinician Perspectives on Navigating Conversations Around Racial Disparities in Obstetrics.","authors":"Eileen Wang-Koehler,Oluwadamilola Oshewa,Sindhu K Srinivas,Abike T James,Rebecca F Hamm","doi":"10.1097/aog.0000000000006085","DOIUrl":"https://doi.org/10.1097/aog.0000000000006085","url":null,"abstract":"OBJECTIVEDiscussions around racial disparities in obstetrics occur in varied silos including the media, communities, and medical institutions. Yet, whether and how these discussions occur in the context of the patient-clinician relationship is unknown. We sought to explore clinician perspectives on conversations with patients regarding racial disparities in maternal health using a qualitative approach.METHODSWe enrolled perinatal clinicians (N=14) across two hospitals within one academic health system from August 2023 to March 2024, purposively sampled by self-identified race or ethnicity and role until thematic saturation was achieved. Semistructured interviews using the Health Equity Implementation Framework evaluated prior experience with and optimization of disparities counseling, focusing on patient-clinician race concordance, comfort levels, barriers, ideal circumstances, and recommended content for conversations about racial disparities in maternal health. Interviews were coded with a content analysis approach by two coders with high interrater reliability (κ>0.8).RESULTSClinicians universally recognized the effect of race, specifically racism, on U.S. maternal outcomes. Conversations about racial disparities most frequently arose 1) when Black patients voiced fears of dying or concerns about bias in their care or 2) in the context of recommending aspirin for preeclampsia risk reduction. Black clinicians felt more comfortable with these discussions, attributed to lived experience and practice. Although most clinicians agreed that conversations with patients about racial disparities are important, they identified barriers such as fear of patient reactions (particularly with discordant race), time constraints, and unclear actionable response.CONCLUSIONOur findings, along with ongoing work on the patient perspective, highlight the need for respectful, informed conversations centering patient experiences. As awareness of racial disparities grows, perinatal clinicians must develop capabilities for discussing race constructively, practicing relationship-centered care, and promoting psychologic safety for Black patients.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"22 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy in Patients With Cystic Fibrosis.","authors":"Beth L Pineles,Raksha Jain,Traci M Kazmerski,Jennifer L Taylor-Cousar,Christina Chambers,Kimberly L Foil,Andrea H Roe,Sylvia E Szentpetery","doi":"10.1097/aog.0000000000006084","DOIUrl":"https://doi.org/10.1097/aog.0000000000006084","url":null,"abstract":"Cystic fibrosis (CF) is an autosomal recessive, monogenic disorder that affects individuals of all races and ethnicities. It was historically viewed as a pediatric disease, but with comprehensive care and therapeutic advances, adults with CF now outnumber children living with CF in the United States, and the median predicted life expectancy is approximately 61 years. Since 2010, a new drug class called CF transmembrane conductance regulator (CFTR) modulators has emerged and led to improved health outcomes for most people with CF in the United States. These new medications have likely contributed to a doubling of pregnancies among women with CF in recent years. In the setting of increased fertility, people with CF should consider contraception when pregnancy is not desired. For people with CF who are seeking pregnancy, preconception consultation with expertise in maternal-fetal medicine and genetics and a dedicated CF team is important because of the increased morbidity among pregnant people with CF. Breastfeeding is possible and encouraged when taking CFTR modulators, although the pediatrician should monitor the infant for possible side effects given established transfer through breast milk. Single-gene noninvasive prenatal testing is emerging and offers a new strategy to screen for fetal CF, which is increasingly important with emerging evidence that transplacental transfer of CFTR modulators may delay, prevent, or reverse multiple CF manifestations for the fetus with CF. Research is ongoing to study pregnancy and parenthood in the modern era in people with CF.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"32 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonography-Based Measurements of Endometrial Thickness in Patients With p53 Abnormal Endometrial Carcinomas.","authors":"Matthew K Wagar,Rachel P Mojdehbakhsh,Eric Reetz,Dandi Huang,Mary J Kao,Ahmed N Al-Niaimi,Natalia Gontarczyk Uczkowski,Amy L Godecker,Lisa M Barroilhet,Stephanie M McGregor","doi":"10.1097/aog.0000000000006074","DOIUrl":"https://doi.org/10.1097/aog.0000000000006074","url":null,"abstract":"OBJECTIVETo evaluate prediagnostic endometrial thickness measured by transvaginal ultrasonography (TVUS) in a cohort of patients with endometrial cancer stratified by p53 status to assess accuracy of endometrial thickness as a screening tool in this patient population.METHODSWe conducted a retrospective cohort study of patients diagnosed with endometrial cancer who underwent prediagnostic TVUS between 2004 and 2017. Using a tissue microarray, we categorized cases as p53 abnormal (p53abn) or p53 wild type (p53wt) according to the presence or absence of p53 aberrant immunohistochemistry staining. Cases were stratified according to established screening thresholds of 4-mm or less endometrial thickness used to evaluate postmenopausal bleeding. Clinical data were manually abstracted. All patients included underwent surgical staging, including hysterectomy. Student t, χ2, and Fisher exact tests were performed to assess for variables associated with p53abn endometrial carcinoma. Multivariate logistic regression was performed to assess variables associated with cases of endometrial cancer, with false-negative TVUS screening results defined as an endometrial thickness of 4 mm or less.RESULTSOf the 133 patients identified, 60 (45.1%) were classified as p53abn and 73 (54.9%) as p53wt. The median age of the cohort was 66 years (interquartile range 58-74 years), and median body mass index (BMI) was 31.3 (interquartile range 26.8-37.3). Median endometrial thickness was 16 mm (interquartile range 9-22 mm), and 48 patients (36.1%) had submucosal or intramural leiomyomas identified on TVUS. Patients diagnosed with p53abn endometrial cancers were more likely to have thinner endometrial measurements compared with p53wt cases (10 mm [interquartile range 5-18.5 mm] vs 18 mm [interquartile range 13-23 mm], P<.001). At a threshold of 4 mm or less, patients with p53abn endometrial cancer were more likely to screen negative compared with patients with p53wt endometrial cancer (25% vs 4.1%, P<.001). In multivariate analysis, a threshold of 4 mm or less for endometrial thickness, lower BMI (odds ratio [OR] 0.906, 95% CI, 0.833-0.986, P=.023), and p53 status (OR 9.415, 95% CI, 2.441-36.309, P=.001) remained significant predictors of false-negative screening results.CONCLUSIONEndometrial thickness assessed by TVUS does not appear to be a reliable screening method in patients diagnosed with p53abn endometrial cancers. The use of endometrial thickness as a screening test for endometrial cancer may miss a significant portion of p53abn cases because of false-negative results. In the presence of postmenopausal bleeding, endometrial tissue sampling should be strongly considered.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"8 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Year Outcomes of Second-Stage Pushing Timing on Postpartum Pelvic Floor Morbidity.","authors":"Collin M McKenzie,Candice L Woolfolk,W Thomas Gregory,Amanda B White,Methodius G Tuuli,Alan T N Tita,Sindhu K Srinivas,Aaron B Caughey,Lily A Arya,Jerry L Lowder,George A Macones,Alison G Cahill,Holly E Richter","doi":"10.1097/aog.0000000000006082","DOIUrl":"https://doi.org/10.1097/aog.0000000000006082","url":null,"abstract":"OBJECTIVETo compare the long-term pelvic floor subjective and objective outcomes of immediate and delayed pushing in the second stage of labor.METHODSThis was a multicenter randomized controlled trial that included nulliparous patients at 37 weeks of gestation or more in labor with neuraxial analgesia. Participants were randomized in the second stage of labor to immediate pushing or pushing after a 60-minute delay. Pelvic floor assessments were performed 1-5 days, 4-8 weeks, and 2-3 years postpartum. Pelvic organ prolapse quantification (POP-Q) measurements and validated questionnaire score (PFDI-20 [Pelvic Floor Distress Inventory], PFIQ-7 [Pelvic Floor Impact Questionnaire], FISI [Fecal Incontinence Severity Index], and MMHQ [Modified Manchester Health Questionnaire]) assessments were compared within and between the immediate and delayed pushing groups. Pelvic floor questionnaire assessments were performed 1-5 days and 2-3 years postpartum. The POP-Q examinations were performed at 4-8 weeks and 2-3 years postpartum. Changes in questionnaire scores were adjusted for birth weight exceeding 4,000 g and duration of pushing.RESULTSA total of 2,414 participants were randomized between 2014 and 2017. Three hundred fifty-six women (14.7%) completed pelvic floor assessments at 2-3 years, 175 in the immediate pushing group and 181 in the delayed pushing group. Patients with an interval pregnancy were excluded (n=236). There was no significant difference in POP-Q stage at 2-3 years postpartum. Intergroup and intragroup changes in total and subscale scores for the PFIQ, FISI, and MMHQ were not significantly different at 2-3 years postpartum (-12.8±47.2 vs -22.0±58.7, P=.09; -1.2±8.0 vs -0.6±7.7, P=.56; and 3.1±22.5 vs -0.1±20.2, P=.53, respectively). The changes in PFDI-20 score were not significantly different (3.4±29.1 vs 0.4±36.2, P=.40). However, the Colorectal-Anal Distress Inventory subscale score change was significantly different (2.4±16.0 vs -5.7±15.7, P=.01).CONCLUSIONAmong nulliparous patients in the second stage of labor with neuraxial analgesia, immediate compared with delayed pushing did not result in significant differences in POP-Q measures and most pelvic floor symptoms at 2-3 years.CLINICAL TRIAL REGISTRATIONClinicalTrials.gov, NCT02137200.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"76 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy-Related Deaths Due to Infection: Pregnancy Mortality Surveillance System, 2012-2019.","authors":"Fanny Njie,Ashley A Busacker,Carla Syverson,Antoinette T Nguyen,Elizabeth A Clark,Randal Leggett,Crystal Gibson,David A Goodman,Lisa M Hollier","doi":"10.1097/aog.0000000000006076","DOIUrl":"https://doi.org/10.1097/aog.0000000000006076","url":null,"abstract":"Infection has been a leading cause of pregnancy-related death in the Centers for Disease Control and Prevention's Pregnancy Mortality Surveillance System since 1987, when reporting began. For this descriptive study, we used 2012-2019 data from the Pregnancy Mortality Surveillance System. Specific subclassifications of infection deaths were analyzed by sociodemographic characteristics, and pregnancy-related mortality ratios (pregnancy-related deaths per 100,000 live births) were calculated for each infection subclassification. The overall pregnancy-related mortality ratio for infection was 2.23. Sepsis was the most frequent subclassification (46.4%) of pregnancy-related infection deaths, followed by other nonpelvic infections (25.2%). Endocarditis deaths had the largest relative increase in pregnancy-related mortality ratio among pregnancy-related infection deaths between 2012 (0.10) and 2019 (0.56). Reporting subclassifications of pregnancy-related infection deaths could improve the ability to focus interventions for reducing pregnancy-related deaths and assessing progress over time.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"76 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID After Acquisition of the Omicron Variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) During Pregnancy Compared With Outside of Pregnancy.","authors":"Torri D Metz,Harrison T Reeder,Rebecca G Clifton,Valerie Flaherman,Leyna V Aragon,Leah Castro Baucom,Carmen J Beamon,Alexis Braverman,Jeanette Brown,Megan Carmilani,Tingyi Cao,Ann Chang,Maged M Costantine,Jodie A Dionne,Kelly S Gibson,Rachel S Gross,Estefania Guerreros,Mounira Habli,Rachel Hess,Leah Hillier,Sally Hodder,M Camille Hoffman,Matthew K Hoffman,Weixing Huang,Brenna L Hughes,Xiaolin Jia,Minal Kale,Stuart D Katz,Victoria Laleau,Hector Mendez-Figueroa,Grace A McComsey,Igho Ofotokun,Megumi J Okumura,Luis D Pacheco,Anna Palatnik,Kristy T S Palomares,Samuel Parry,Christian M Pettker,Beth A Plunkett,Athena Poppas,Patrick Ramsey,Uma M Reddy,Dwight J Rouse,George R Saade,Grecio J Sandoval,Frank Sciurba,Hyagriv N Simhan,Daniel W Skupski,Amber Sowles,John M Thorp,Alan T N Tita,Samantha Wiegand,Steven J Weiner,Lynn M Yee,Leora I Horwitz,Andrea S Foulkes,Vanessa L Jacoby, ","doi":"10.1097/aog.0000000000006067","DOIUrl":"https://doi.org/10.1097/aog.0000000000006067","url":null,"abstract":"OBJECTIVETo evaluate whether the risk of long COVID among individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy differs from that of individuals who were not pregnant at time of virus acquisition.METHODSWe conducted a multicenter observational cohort study at 79 NIH RECOVER (Researching COVID to Enhance Recovery) sites. Individuals assigned female at birth aged 18-45 years with an index (first) SARS-CoV-2 infection on or after December 1, 2021, were included. The exposure was pregnancy (any gestational age) at the time of index SARS-CoV-2 infection. The primary outcome was long COVID 6 months after index infection, defined as RECOVER-Adult Long COVID Research Index score 11 or higher based on a detailed symptom survey. To account for confounding and differential selection between participants who were pregnant and not pregnant at infection, propensity score-matching methods were used to balance the groups on variables potentially associated with both pregnancy status and long COVID.RESULTSOverall 2,423 participants were included; 580 (23.9%) were pregnant at index SARS-CoV-2 infection. The median age at infection was 33 years (interquartile range 28-38 years), and 2,131 of participants (90.0%) with known vaccination status were vaccinated. After propensity score matching, the adjusted long COVID prevalence estimates 6 months after index infection were 10.2% (95% CI, 6.2-14.3%) among those pregnant at infection and 10.6% (95% CI, 8.8-12.4%) among those not pregnant at infection. Pregnancy was not associated with a difference in adjusted risk of long COVID (adjusted risk ratio 0.96, 95% CI, 0.63-1.48).CONCLUSIONAcquisition of SARS-CoV-2 during pregnancy was not associated with a differential risk of long COVID at 6 months compared with similar-aged individuals who acquired SARS-CoV-2 outside of pregnancy.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"120 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Feasibility Study for Mapping Ovarian Sentinel Lymph Nodes: A Memorial Sloan Kettering Cancer Center Team Ovary Study.","authors":"Olga T Filippova,Dennis S Chi,Alexia Iasonos,Nadeem R Abu-Rustum,Kara C Long,Yukio Sonoda,Oliver Zivanovic,Morgan Tomberlin,Elizabeth Jewell,Emeline Aviki,Jennifer J Mueller,Ginger J Gardner","doi":"10.1097/aog.0000000000006077","DOIUrl":"https://doi.org/10.1097/aog.0000000000006077","url":null,"abstract":"BACKGROUNDTo evaluate four methods of injecting indocyanine green (ICG) around the adnexa and identify the optimal technique for ovarian sentinel lymph node (SLN) mapping.METHODPatients presenting for management of an adnexal mass were prospectively enrolled. Patients with peritoneal carcinomatosis were excluded. Four injection methods were evaluated: 1) intratubal, 2) paraovarian peritoneum, 3) infundibulopelvic (IP) ligament after resection of the adnexal mass, and 4) IP ligament before resection of the adnexal mass. Two mL of ICG was injected, and at least 10 minutes of transit time was allowed. The ipsilateral and contralateral pelvic and para-aortic lymph node beds were evaluated for ICG uptake. Retroperitoneal nodal resection was performed if indicated.EXPERIENCEForty patients were enrolled, 10 in each group. For method 1, 20.0% of SLNs mapped, all to the ipsilateral para-aortic lymph node bed. For method 2, 10.0% mapped, only to the ipsilateral para-aortic lymph node bed. For method 3, 50.0% mapped to the ipsilateral para-aortic lymph node bed (n=3), contralateral para-aortic lymph node bed (n=1), or ipsilateral pelvic lymph node bed (n=1). For method 4, 70.0% mapped to the ipsilateral para-aortic lymph node bed (n=5) or ipsilateral pelvic lymph node bed (n=2). Surgeons reported methods 1 and 2 as cumbersome, and excessive peritoneal staining made SLN identification difficult. No injection-related complications were reported.CONCLUSIONInjection of ICG into the IP ligament before or after adnexal mass resection led to similar rates of SLN mapping and was deemed feasible by surgeons. Only one SLN was identified contralateral to the adnexal mass, and all but three mapped to the para-aortic region. Injection into the IP ligament should be evaluated in patients with likely adnexal malignancy, including SLN resection.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"114 1","pages":""},"PeriodicalIF":7.2,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145209211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Pharmacotherapies for Menopausal Symptoms.","authors":"Caiyun Liao, Lubna Pal","doi":"10.1097/AOG.0000000000006025","DOIUrl":"10.1097/AOG.0000000000006025","url":null,"abstract":"<p><p>Menopausal hormone therapy (HT) is highly effective against vasomotor symptoms (VMS). When HT is contraindicated, ineffective, or unacceptable, alternatives have included antidepressants, antiseizure, and antihypertensive formulations. Novel pharmacologic treatments for VMS have emerged in recent decades, some of which are already approved by the U.S. Food and Drug Administration (FDA) (eg, fezolinetant, a neurokinin 3B antagonist), and others are poised to seek FDA approval (eg, elinzanetant, a dual neurokinin 1B and 3B antagonist, and estetrol, a natural estradiol derivative that is unique to the pregnant state). Oxybutynin was shown to be effective for VMS and could provide additional benefits against overactive bladder, but long-term safety data are needed before wider utilization can be recommended.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":"473-486"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Health-Related Social Needs With Adverse Pregnancy Outcomes Among Black and Latina Individuals.","authors":"Lauren Belak, Kaitlyn James, Marya Rana, Victoria Viscosi, Imuetiyan Eweka, Jaiden Busso, Amy Sarma, Camille Powe, Katherine Economy, Michael C Honigberg","doi":"10.1097/AOG.0000000000005999","DOIUrl":"10.1097/AOG.0000000000005999","url":null,"abstract":"<p><p>Rates of adverse pregnancy outcomes (APOs) are increasing among Black and Latina Americans. Whether health-related social needs (HRSNs) are prospectively associated with APOs among racial and ethnic minoritized groups is unclear. Black and Latina pregnant individuals completed a Centers for Medicare & Medicaid Services-endorsed screening tool encompassing 13 domains of HRSNs. We tested the association of cumulative HRSN scores with APOs, adjusted for age, prior APO history, and parity. Among 320 participants, 119 (37.2%) had at least one APO. Each 1-point increase in a composite HRSN score was associated with 11.0% higher odds of developing an APO. An HRSN score of 7 or higher, compared with 0-4, was associated with 2.34-fold odds of APOs (95% CI, 1.26-4.34, P =.007). Pregnancy may provide an opportunity to identify and address HRSNs that place Black and Latina Americans at risk for APOs.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":"541-543"},"PeriodicalIF":4.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACOG Clinical Practice Guideline No. 10:Intrapartum Fetal Heart Rate Monitoring: Interpretation and Management.","authors":"","doi":"10.1097/aog.0000000000006049","DOIUrl":"https://doi.org/10.1097/aog.0000000000006049","url":null,"abstract":"PURPOSEThe purpose of this document is to provide an evidence-based framework for the evaluation and management of intrapartum fetal heart rate (FHR) patterns.TARGET POPULATIONPregnant individuals in the first or second stage of labor.METHODSThis guideline was developed using an a priori protocol in conjunction with a writing team consisting of three maternal-fetal medicine subspecialists and one specialist in obstetrics and gynecology appointed by the American College of Obstetricians & Gynecologists' (ACOG) Committee on Clinical Practice Guidelines-Obstetrics. ACOG medical librarians completed a comprehensive literature search for primary literature within Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, EMBASE, PubMed, and MEDLINE. Studies that moved forward to the full-text screening stage were assessed by the writing team based on standardized inclusion and exclusion criteria. Included studies underwent quality assessment, and a modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) evidence-to-decision framework was applied to interpret and translate the evidence into recommendation statements.RECOMMENDATIONSThis Clinical Practice Guideline includes an overview of intrapartum FHR monitoring nomenclature and classification systems and provides recommendations for evaluation and management of intrapartum FHR tracings. Recommendations are classified by strength and evidence quality.","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"9 1","pages":"583-599"},"PeriodicalIF":7.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}