Obstetrics and gynecology最新文献

{"title":"In Reply.","authors":"Yuan Li, Yang Xiang","doi":"10.1097/AOG.0000000000005895","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005895","url":null,"abstract":"","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"e145 5","pages":"e146-146"},"PeriodicalIF":5.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034528","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":"Oncologic Outcomes of Laparoscopic Radical Hysterectomy Incorporating Modified Tumor-Free Techniques.","authors":"Ilaria Cuccu, Giorgio Bogani","doi":"10.1097/AOG.0000000000005893","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005893","url":null,"abstract":"","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"145 5","pages":"e145"},"PeriodicalIF":5.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991453","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":"Uterine Rupture Trends in Patients Pursuing Trial of Labor After Cesarean in the United States from 2010 to 2022.","authors":"Lillian H Goodman, Amanda A Allshouse, Torri D Metz, Ann M Bruno","doi":"10.1097/AOG.0000000000005882","DOIUrl":"10.1097/AOG.0000000000005882","url":null,"abstract":"<p><p>National rates of trial of labor after cesarean (TOLAC) have increased, but the risk of uterine rupture remains. Clinical practice- and patient-level changes also have occurred in the past decade, and an evaluation of contemporary uterine rupture rates is needed. Using natality files available in the National Vital Statistics System from 2010 to 2022, we conducted a repeated cross-sectional analysis to evaluate U.S. trends in uterine rupture and perinatal outcomes among individuals undertaking TOLAC. Temporal trends were characterized using joinpoint regression, with average annual percent change (AAPC) and 95% CI reported. There were 2,888 uterine ruptures (0.28%) among 1,016,073 included deliveries. The rate of uterine rupture increased over time, from 0.20% in 2010 to 0.37% in 2022 (AAPC 6.2, 95% CI, 4.3-8.7). Although rates of uterine rupture increased over time, it remains a rare event with a low absolute risk.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":"511-513"},"PeriodicalIF":5.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625575","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":"Efficacy of Fractionated Carbon Dioxide Laser for the Treatment of Genitourinary Syndrome of Menopause: A Systematic Review and Meta-analysis.","authors":"Raquel Vizán-Chaguaceda, Raquel Leirós-Rodríguez, Pablo Hernandez-Lucas","doi":"10.1097/AOG.0000000000005885","DOIUrl":"10.1097/AOG.0000000000005885","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the short-term effectiveness of fractional CO 2 laser for the treatment of genitourinary syndrome of menopause.</p><p><strong>Data sources: </strong>Systematic review was performed of PubMed, Scopus, Web of Science, Cinhal, MEDLINE, and ClinicalTrials.gov .</p><p><strong>Methods of study selection: </strong>The included studies had to meet the following criteria: 1) The sample consisted exclusively of women diagnosed with genitourinary syndrome of menopause; 2) at least one group in the sample underwent treatment with fractional CO 2 laser; 3) the control group received simulated fractional CO 2 laser therapy, topical hormonal treatment, or a topical gel lubricant; 4) the studies evaluated outcomes related to sexual function, urinary symptoms, or the quality of the vaginal epithelium; and 5) the study design was a randomized controlled trial. The exclusion criterion specified that participants should not have a history of any type of cancer or prior treatment with a different type of laser.</p><p><strong>Tabulation, integration, and results: </strong>Two reviewers independently screened articles for eligibility and extracted data. Difference in mean differences and their 95% CIs were calculated as the between-group difference in means divided by the pooled SD. The I2 statistic was used to determine the degree of heterogeneity. The 11 articles included in the review had a group receiving fractional CO 2 laser therapy and a control group receiving simulated fractional CO 2 laser, topical hormonal treatment, or topical gel lubricant. The meta-analyses indicated that fractional CO 2 laser is effective for improving sexual function through increased sexual desire, arousal, lubrication, orgasms, and sexual satisfaction; reducing pain during sexual activity (standardized mean difference 0.51, P =.021); and improving urinary function by reducing the frequency and magnitude of urinary leakage and frequency of urination (standardized mean difference 0.51, P <.001).</p><p><strong>Conclusion: </strong>Fractional CO 2 laser is associated with statistically significant improvements in the short-term treatment of sexual and urinary symptoms but not vaginal epithelium quality. The clinical significance of these changes is unclear.</p><p><strong>Systematic review registration: </strong>PROSPERO, CRD42023435636.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":"475-485"},"PeriodicalIF":5.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670514","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":"Payer-Based Segregation in Obstetrics and Gynecology Ambulatory Care: Implications for Quality, Safety, and Equity.","authors":"Suzanna Larkin, Erika Harness, Kavita Shah Arora, Neena Qasba, Arina Chesnokova, Erika Banks, Karen George, Kavita Vinekar","doi":"10.1097/AOG.0000000000005883","DOIUrl":"10.1097/AOG.0000000000005883","url":null,"abstract":"<p><p>Separation of patients by insurance status in ambulatory care settings is a long-standing practice in academic medicine. This payer-based segregation of patients between resident and faculty outpatient practices may lead to inequitable quality of care. Informed by replies to a free-response text question for residents and program directors within the 2023 U.S. obstetrics and gynecology in-service examination, we provide commentary on this structural inequity within obstetrics and gynecology. The purpose of this commentary is to discuss the differences in patient population served, gaps in resources in resident clinics, quality of care and moral injury, limited continuity of care, and training and supervision. Further work is needed to guide systemic integration efforts and to explore the effects of program integration on patient health outcomes. We nonetheless urge academic medical centers to consider organizational shifts toward payer-integrated care.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":"469-474"},"PeriodicalIF":5.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625561","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":"Trends Before and After the Removal of Race and Ethnicity from the Vaginal Birth After Cesarean Calculator.","authors":"Annika Hikade, Kelly Nichols, Katherine Ahrens","doi":"10.1097/AOG.0000000000005880","DOIUrl":"10.1097/AOG.0000000000005880","url":null,"abstract":"<p><p>We conducted a population-based retrospective cohort study and performed interrupted time series analyses to examine whether the removal of race and ethnicity from the vaginal birth after cesarean (VBAC) calculator was associated with changes in rates of trial of labor after cesarean (TOLAC) and VBAC in the United States. After the calculator revision, rates of TOLAC and VBAC in the overall eligible population and among the four largest racial and ethnic groups (Hispanic, non-Hispanic Asian, non-Hispanic Black, and non-Hispanic White) (rate ratios ranged from 0.99 to 1.04, and all 95% CIs included the null) were unchanged. Rates of successful VBAC among Hispanic (75.0%), non-Hispanic Asian (71.0%), and non-Hispanic Black (67.0%) people remained lower compared with non-Hispanic White people (77.2%). More work is needed to address the significant racial disparities that persist for TOLAC outcomes.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":"514-518"},"PeriodicalIF":5.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625574","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":"Frequency of Preconception and Prenatal Cannabis Use and Nausea and Vomiting in Pregnancy.","authors":"Kelly C Young-Wolff, Felicia W Chi, Cynthia I Campbell, Stacey E Alexeeff, Deborah Ansley, Alyssa Vanderziel, Gwen T Lapham","doi":"10.1097/AOG.0000000000005884","DOIUrl":"10.1097/AOG.0000000000005884","url":null,"abstract":"<p><p>This cross-sectional study analyzed associations between preconception and prenatal cannabis use and first-trimester nausea and vomiting in pregnancy (NVP) using data from 356,343 pregnancies in a large health care system (2011-2022). Prevalence of preconception and prenatal cannabis use was 11.3% (2.7% daily, 2.4% weekly, 6.3% monthly or less) and 6.5% (0.7% daily, 0.7% weekly, 1.4% monthly or less, 3.7% positive toxicology with no self-reported use), respectively. Based on International Classification of Diseases diagnostic codes, 3.6% of patients were diagnosed with severe NVP and 16.0% with mild NVP. Self-reported preconception daily cannabis use was associated with greater odds of mild (adjusted odds ratio [aOR] 1.68, 95% CI, 1.59-1.77) and severe (aOR 2.61, 95% CI, 2.40-2.84) NVP when compared with individuals without preconception use. Self-reported weekly cannabis use was associated with greater odds of mild (aOR 1.26, 95% CI, 1.19-1.34) and severe (aOR 1.73, 95% CI, 1.57-1.90) NVP compared with no preconception use. Similarly, self-reported prenatal daily cannabis use was associated with greater odds of mild (aOR 1.97, 95% CI, 1.79-2.17) and severe (aOR 3.80, 95% CI, 3.28-4.39) NVP compared with no prenatal use. Self-reported weekly cannabis use was associated with greater odds of mild (aOR 1.85, 95% CI, 1.68-2.03) and severe (aOR 2.87, 95% CI, 2.47-3.34) NVP compared with individuals without prenatal use. This study found that preconception and prenatal cannabis use were associated with increased odds of both mild and severe NVP during the first trimester, with the highest odds observed among individuals using cannabis daily before or during early pregnancy. Findings underscore the need for patient education and medically appropriate therapies for NVP management.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":"519-522"},"PeriodicalIF":5.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625560","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":"In Reply.","authors":"Minhazur R Sarker, Gladys A Ramos, Chelsea A DeBolt","doi":"10.1097/AOG.0000000000005899","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005899","url":null,"abstract":"","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"145 5","pages":"e149"},"PeriodicalIF":5.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031056","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":"Mothers on the Frontline: The Crisis of Maternal Health in Conflict-Torn Sudan.","authors":"Ibrahim Nagmeldin Hassan, Muhsin Nagmeldin Hassan Ibrahim, Mohamed Ibrahim, Nagmeldin Abuassa","doi":"10.1097/AOG.0000000000005906","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005906","url":null,"abstract":"<p><p>The ongoing armed conflict in Sudan, which began in April 2023, has had devastating effects on maternal health services across the country. More than 1.1 million pregnant women are now in urgent need of medical care as health care infrastructure crumbles under the strain of violence. Hospitals and health centers have been destroyed or rendered inaccessible, and shortages of medical supplies and the widespread loss of health care workers have left many women without access to essential maternal services, including antenatal care, safe delivery assistance, and postnatal care. Consequently, countless women are forced to give birth in unsafe conditions without the presence of skilled health care personnel, dramatically increasing the risk of complications such as sepsis, hemorrhage, and obstructed labor. The conflict also has contributed to a surge in preterm births due to heightened stress, insecurity, and malnutrition affecting expectant mothers. In addition to the physical dangers, the psychological toll on pregnant women is profound. The trauma of living in war-torn regions, displacement, and the constant threat of violence have led to rising levels of anxiety, depression, and other mental health disorders. Furthermore, the conflict has exacerbated incidents of sexual and gender-based violence, further endangering the lives of women and compounding their psychological trauma. This article examines the diverse aspects of the maternal health crisis in Sudan, calling for immediate humanitarian aid, including medical, nutritional, and psychosocial support. Long-term solutions also are needed to rebuild maternal health services and address the ongoing physical and psychological suffering of Sudanese women and their children.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"146 1","pages":"e1-e6"},"PeriodicalIF":5.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326457","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":"In Reply.","authors":"Per Damkier, Erika B Gram, Michael Ceulemans, Alice Panchaud, Brian Cleary, Christina Chambers, Corinna Weber-Schöndorfer, Debra Kennedy, Ken Hodson, Kimberly S Grant, Orna Diav-Citrin, Sarah G Običan, Svetlana Shechtman, Sura Alwan","doi":"10.1097/AOG.0000000000005897","DOIUrl":"https://doi.org/10.1097/AOG.0000000000005897","url":null,"abstract":"","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":"145 5","pages":"e147-e148"},"PeriodicalIF":5.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045675","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}