American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Guidelines on cerclage placement: a comparative systematic review.","authors":"Aya Mudrik, Romi Levy, Alessandro Petrecca, Moti Gulersen, Suneet P Chauhan, Offer Erez, Misgav Rottenstreich","doi":"10.1016/j.ajogmf.2025.101727","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101727","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to systematically identify, summarize, and compare professional medical-society guidelines on cervical and abdominal cerclage.</p><p><strong>Data sources: </strong>A systematic literature search was conducted in PubMed and Scopus on May 15, 2024 following PRISMA guidelines. The search included English-language clinical practice guidelines published between 2011 and 2024 addressing cervical cerclage.</p><p><strong>Study appraisal and synthesis methods: </strong>Guidelines were independently screened and selected by two reviewers. Quality was assessed using the AGREE II instrument. Data were extracted into a standardized form and synthesized narratively, focusing on comparing recommendations regarding indications, contraindications, timing, technique, and perioperative management of cerclage placement.</p><p><strong>Results: </strong>Twenty guidelines from ten professional societies were included. Consensus existed on several key indications, including history-indicated cerclage for ≥3 second-trimester losses, ultrasound-indicated cerclage for cervical lengths under 10 mm, and abdominal cerclage in cases of prior transvaginal cerclage failure or insufficient cervical tissue. However, disagreements remain. For instance, ACOG (American College of Obstetricians and Gynecologists) recommends considering cerclage after one loss, whereas most guidelines require three. There is also variation regarding the timing of physical examination cerclage beyond 24 weeks, with NICE (National Institute for Health and Care Excellence) extending the window to 28 weeks. Additionally, recommendations diverge on cerclage for prolapsed membranes, with some guidelines advising against the procedure due to a high risk of failure, while others support considering it.</p><p><strong>Conclusions: </strong>Guidelines agree on history-indicated cerclage for ≥3 second-trimester losses, ultrasound-indicated cerclage for cervical lengths under 10 mm, and abdominal cerclage in cases of prior transvaginal cerclage failure or insufficient cervical tissue. While agreement exists on key indications and contraindications, notable divergences remain in certain recommendations. This review emphasizes the need for congruent recommendations to enhance consistency.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101727"},"PeriodicalIF":3.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337128","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":"Subcutaneous tissue closure and postoperative wound complications in cesarean delivery: A systematic review and meta-analysis.","authors":"Giulia Bonanni, Vivian Nguyen, Marta Francescutti, Alireza A Shamshirsaz, Vincenzo Berghella","doi":"10.1016/j.ajogmf.2025.101724","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101724","url":null,"abstract":"<p><strong>Objective: </strong>The benefit of subcutaneous tissue closure during cesarean delivery (CD) has been well established in pregnant individuals with a subcutaneous tissue thickness greater than 2 cm. However, its routine application in all pregnant individuals remains a contentious topic. This meta-analysis aimed to evaluate and quantify the effect of subcutaneous tissue closure compared to non-closure on postoperative wound complications in all patients undergoing CD.</p><p><strong>Data sources: </strong>We searched PubMed, EMBASE, Web of Science, Medline, Scopus, Cochrane Central Register of Clinical Trials, and ClinicalTrials.gov from their inception to October 2024 for randomized controlled trials (RCTs).</p><p><strong>Study eligibility criteria: </strong>Eligible studies included RCTs comparing subcutaneous tissue closure versus non-closure in patients undergoing CD. Studies were excluded if they focused solely on selected subpopulations, such as pregnant individuals with subcutaneous fat >2 cm or those classified as obese. Primary outcomes were seroma formation, hematoma, surgical site infection (SSI), and wound dehiscence. Secondary outcomes included postoperative pain and cosmetic results.</p><p><strong>Study appraisal and synthesis methods: </strong>Random-effects models were used to calculate relative risks (RR) for each outcome. Heterogeneity across studies was assessed using the I² statistic.</p><p><strong>Results: </strong>Eight trials comprising 1,854 participants (918 closure, 936 non-closure) met inclusion criteria. There were no significant differences between groups for SSI (RR 0.95, 95% CI: [0.69-1.31]), dehiscence (RR 0.64, 95% CI: [0.21-1.98]), seroma (RR 0.87, 95% CI: [0.05-14.81]), hematoma (RR 0.54, 95% CI: [0.02-15.90]), or composite wound outcomes (RR 1.05, 95% CI: [0.80-1.38]). Study heterogeneity was low (I² < 45%).</p><p><strong>Conclusions: </strong>Subcutaneous tissue closure during CD does not significantly reduce the risk of wound complications when applied universally. These findings do not support its routine implementation for all patients with subcutaneous thickness less than 2 cm. Further research should focus on refining patient selection criteria and evaluating other potential benefits, including long-term cosmetic outcomes.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101724"},"PeriodicalIF":3.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337129","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":"Letter to Editor: Systematic review on music interventions during pregnancy in favor of the well-being of mothers and eventually their offspring.","authors":"Can Ata, Benil Nesli Ata","doi":"10.1016/j.ajogmf.2025.101726","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101726","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101726"},"PeriodicalIF":3.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303107","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":"Stillbirth is associated with postpartum severe maternal morbidity compared to gestational age matched and term livebirths.","authors":"Dante Varotsis, Jordan Beacham, Julie Gomez, Zain Hannan, Rupsa C Boelig, Vincenzo Berghella, Moti Gulersen","doi":"10.1016/j.ajogmf.2025.101725","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101725","url":null,"abstract":"<p><strong>Background: </strong>Rates of severe maternal morbidity in the United States continue to increase. ACOG recommends close postpartum follow up for patients at increased risk for severe maternal morbidity and mortality, such as those suffering from preeclampsia or hypertension. Data exploring the association between stillbirth and severe maternal morbidity are limited.</p><p><strong>Objective: </strong>To evaluate the association between stillbirth and severe maternal morbidity when compared to gestational age matched and term livebirths.</p><p><strong>Study design: </strong>This was a multicenter retrospective cohort study performed at three centers within a hospital system from 2017-2023. SMM was defined with guidance from the indicators outlined by the Centers for Disease Control. Inclusion criteria for the stillbirth group was delivery of a fetus showing no signs of life at 20 weeks gestation or later. Antepartum preeclampsia, multiple pregnancies, maternal age less than 18 years old, duplicate records, and voluntary terminations of pregnancy greater than 20 weeks gestation were excluded. We selected gestational age and term matched livebirths as control groups. Logistic regression was performed to evaluate the odds of composite severe maternal morbidity in stillbirths versus gestational age matched and term matched livebirths, separately, while adjusting for potential confounders. Data were presented as adjusted Odds Ratios (aOR) with 95% confidence intervals (CI) and statistical significance set at P < 0.05.</p><p><strong>Results: </strong>Of the 29,060 deliveries during the study period, there were 129 (0.44%) stillbirths. Stillbirth was associated with significantly higher odds of severe maternal morbidity compared to term (aOR = 4.35, 95% CI 1.75-10.84) and gestational age matched livebirths (aOR = 3.39, 95% CI 1.72-6.66). There was no significant difference in the rate of postpartum hemorrhage compared between stillbirths and gestational age matched livebirths (10.1% vs. 7.3%, p = 0.42), however there were significantly more transfusions needed in the stillbirth group (10.1% vs. 1.6%, p = 0.017). When compared to term livebirths, there were significantly more transfusions (10.1% vs. 1.6%, p <0.001), intensive care admissions (2.3% vs. 0%, p = 0.007). postpartum preeclampsia (2.3% vs. 0%, p = 0.007), and sepsis (2.3% vs. 0%, p = 0.007).</p><p><strong>Conclusion: </strong>Stillbirth is associated with an increased risk of severe maternal morbidity compared to gestational age and term matched livebirths. Increased postpartum surveillance should be implemented into practice, and preventative interventions such as tranexamic acid administration should be further evaluated with prospective studies.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101725"},"PeriodicalIF":3.8,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294999","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":"The state of residency training in treatment of opioid use disorder in obstetrics and gynecology.","authors":"Julia Whitley, Karen George, Jeannie C Kelly, Megan L Lawlor, Erika Banks, Phillip Ma, Jillian Catalanotti","doi":"10.1016/j.ajogmf.2025.101723","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101723","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101723"},"PeriodicalIF":3.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276188","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":"Letter in Reply re: Comparative effectiveness of low molecular weight heparin on live birth for recurrent spontaneous abortion: systematic review and network meta-analysis.","authors":"Wenrui Huang, Xuelian Du","doi":"10.1016/j.ajogmf.2025.101720","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101720","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101720"},"PeriodicalIF":3.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250052","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":"Letter in Reply Re: Quantifying placenta accreta spectrum severity and its associated blood loss: a novel transvaginal ultrasound scoring system.","authors":"Neha Agarwal, Edgar Hernandez-Andrade, Baha M Sibai, Farah H Amro, Jennie O Coselli, Michal F Bartal, Dejian Lai, Eleazar E Soto-Torres, Sami Backley, Anthony Johnson, Jimmy Espinoza, Eric P Bergh, Sen Zhu, Ashley Salazar, Sean C Blackwell, Ramesha Papanna","doi":"10.1016/j.ajogmf.2025.101722","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101722","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101722"},"PeriodicalIF":3.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250053","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":"Letter to the Editor regarding 'Breast Stimulation vs. Low Dose Oxytocin for Labor Augmentation in Women with a Previous Cesarean Delivery, a Randomized Controlled Trial'.","authors":"Songjie Liao, Di Xiao, Yaling Li, Liqiu Kou","doi":"10.1016/j.ajogmf.2025.101717","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101717","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101717"},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250057","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":"Letter to the Editor re: \"Impact of Prenatal Vaccination Counseling on Non-Birthing Partners' Vaccination Rates\".","authors":"Umama Muskan, Iftikhar Khan, Maryam Karim, Jamal Shah, Sozen Rehman","doi":"10.1016/j.ajogmf.2025.101716","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101716","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101716"},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250054","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":"Letter to the editor Re: Comparative effectiveness of low molecular weight heparin (LMW-Heparin) on live birth for recurrent spontaneous abortion: systematic review and network meta analysis.","authors":"Paul Claman","doi":"10.1016/j.ajogmf.2025.101719","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101719","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101719"},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250055","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}