American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"The Pink Journal Club Toolkit: redefining journal clubs in obstetrics and maternal-fetal medicine","authors":"Mariam K. Ayyash MD, MSCR , Beverly C. Tse MD , Michelle Joy Wang MD","doi":"10.1016/j.ajogmf.2025.101730","DOIUrl":"10.1016/j.ajogmf.2025.101730","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 9","pages":"Article 101730"},"PeriodicalIF":3.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686990","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":"Longitudinal Trends in Physical Activity and Sleep Before, During, and After Pregnancy Using Fitbit and EHR Data from the All of Us Research Program.","authors":"Claire Lo, Jeffrey Annis, Hiral Master, Adnan Cakar, Sarah Osmundson, Douglas Ruderfer, Evan Brittain","doi":"10.1016/j.ajogmf.2025.101744","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101744","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101744"},"PeriodicalIF":3.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676035","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":"Visual Aids for Induction of Labor Education: A Randomized Controlled Trial.","authors":"Halley Staples, Rachel Paul, Fan Zhang, Bridget Huysman, Bree Goodman, Rebecca Rimsza, Brianna Bradley, Lori Atwood, Jeannie C Kelly, Ebony B Carter, Anthony Odibo, Antonina Frolova, Nandini Raghuraman","doi":"10.1016/j.ajogmf.2025.101743","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101743","url":null,"abstract":"<p><strong>Background: </strong>Approximately 20% of patients in the United States undergo an induction of labor (IOL). Patients undergoing induction are more likely to report lower birth satisfaction, especially Black patients. Visual aids have been shown to improve patient satisfaction in medical decision-making, however, there are few studies investigating the use of visual aids for IOL counseling.</p><p><strong>Objective: </strong>To compare standard counseling for induction of labor (IOL) to standard counseling plus a patient-informed visual aid and evaluate differences in patient knowledge of IOL and satisfaction with counseling.</p><p><strong>Study design: </strong>This was a randomized controlled trial of patients with singleton gestations ≥37 weeks admitted for IOL. Patients who were <18 years old, non-English speaking, with prior cesareans, fetal anomalies, intrauterine fetal demise, or whose induction agent had already been determined were excluded. We developed a visual aid handout on induction methods with input from patients that had recently undergone an induction. On admission, patients were randomized to routine counseling or counseling with the visual aid. The primary outcome was patient knowledge, using questions adapted from a published IOL knowledge assessment. Our secondary outcome was satisfaction with IOL counseling, rated on 0-10 scale. Eighty-four patients (42 in each arm) were required to detect a 25% difference in knowledge scores with 85% power. We used an intention-to-treat approach for our analyses; we compared the percentage of correct answers on the IOL knowledge assessment and satisfaction with IOL counseling using Wilcoxon rank sum. We conducted planned stratified analyses by historically marginalized race, level of education, and insurance type.</p><p><strong>Results: </strong>Eighty-four patients were randomized; 39% self-identified as Asian, Black, or Hispanic. The percentage of correct IOL knowledge answers were similar between the visual aid group and the standard counseling group: median 80 (IQR 60-90) versus 70 (60-90), p=0.23. We observed no significant differences between groups after stratifying by historically marginalized race and ethnicity, insurance type, or level of education. Satisfaction with counseling scores were similar between participants receiving the visual aid compared to regular counseling: 9 (8-10) versus 10 (9-10), p=0.08.</p><p><strong>Conclusion: </strong>The introduction of a patient-informed visual aid did not change IOL knowledge or satisfaction with counseling compared to standard counseling. Future directions include modifying the visual aid using patient feedback and evaluating its implementation earlier in antenatal care.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101743"},"PeriodicalIF":3.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676037","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 feasibility and effectiveness of using an adhesion barrier in preventing dysmenorrhea, pain, and niche-related problems after cesarean sections: a multicenter randomized pilot study.","authors":"B L Post, C Verberkt, D van Veen, L van der Voet, M Y Bongers, M A de Boer, E J Wortelboer, J A F Huirne, R A de Leeuw","doi":"10.1016/j.ajogmf.2025.101742","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101742","url":null,"abstract":"<p><strong>Background: </strong>A cesarean scar can lead to various gynecological complaints, including abdominal pain, dysmenorrhea, postmenstrual spotting, and unexplained secondary infertility. The ethiology of the development of a niche is currently not clear. A possible hypothesis is the involvement of vesicouterine adhesions formed after the cesarean section.</p><p><strong>Objective: </strong>This study explores the feasibility of a randomized controlled trial assessing the effectiveness of an adhesion barrier on the uterine wound in women undergoing their first cesarean section on gynecological symptoms and the presence of adhesions evaluated by transvaginal ultrasound.</p><p><strong>Study design: </strong>A multicenter randomized pilot study was performed on women undergoing their first cesarean section. They were randomly allocated to the application of the adhesion barrier 4DryField © PH after uterine closure or no adhesion barrier. They were followed for nine months using transvaginal ultrasound and questionnaires. The primary outcome measure was feasibility (protocol compliance, loss-to-follow-up, data collection). Secondary outcomes were perioperative outcomes, menstrual outcomes, Quality of Life, and sexual function at nine months, as well as ultrasound findings such as vesicouterine adhesion and niche measurements at three months.</p><p><strong>Results: </strong>One hundred seventeen participants (58 intervention, 59 control) were enrolled. Protocol adherence was 94.8% to 100%, and follow-up loss was 3% to 12%. Difficulties in feasibility included ultrasound evaluation, ultrasound storage, and participant recall bias. At nine months, 40% of participants had amenorrhea and/or gave breastfeeding or used hormonal contraceptives. There was no apparent difference in dysmenorrhea, but postmenstrual spotting was less in the intervention group (0% vs 18.4%, p=0.04). Furthermore, there was a trend toward fewer adhesions and niches in the intervention group.</p><p><strong>Conclusions: </strong>The study showed no clear limitations, feasible execution of the procedure, and a low drop-out rate. Spotting was less in the intervention group. Nevertheless, a larger sample size is needed to draw solid conclusions concerning the beneficial effect of reducing niches, adhesions, dysmenorrhea, and chronic pelvic pain. Our findings are encouraging and support the design of a comparatively large randomized controlled trial with a refined methodology to enhance feasibility and accuracy.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101742"},"PeriodicalIF":3.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676036","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":"Early wound dressing (soft gauze/tape dressing) removal after cesarean delivery: a meta-analysis of randomized trials","authors":"Leshae A. Cenac MD ,&nbsp;Serena Guerra MD ,&nbsp;Alicia Huckaby DO ,&nbsp;Gabriele Saccone MD, PhD ,&nbsp;Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2025.101739","DOIUrl":"10.1016/j.ajogmf.2025.101739","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether removing the wound dressing within 24 hours after a cesarean delivery leads to any negative effects on wound healing and to recommend the best time for dressing removal.</div></div><div><h3>Data sources</h3><div>Science Direct, PubMed, Cochrane Library, and Scopus as the electronic databases from their inception until December 2024.</div></div><div><h3>Criteria for study eligibility</h3><div>Randomized controlled trials (RCTs) were incorporated in the databases, irrespective of their publication language, sample size, publication date, use of blinding, or study setting/location.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>A systematic review of RCTs was conducted to compare wound outcomes in cesarean delivery patients with early dressing removal vs standard care. Utilizing an intent-to-treat approach, the analysis evaluated wound complication rates through both objective wound scores and subjective patient-reported complaints. The primary outcome of the study was postoperative wound complications, defined as any of the following: infection, disruption (skin dehiscence or deeper), or seroma/hematoma. The summary measures were reported as odds ratio (OR) or as mean difference with 95% of confidence interval (CI), using the random effects model of DerSimonian and Laird.</div></div><div><h3>Results</h3><div>Four trials, including 2130 participants, were included in the meta-analysis. Most of them defined early dressing removal as 24 hours after cesarean, and late removal as 48 hours after cesarean. All trials used soft gauze/tape dressing. Pooled data showed that early removal did not increase the incidence of wound complications (17.9% vs 19.4%; OR 0.90, 95% CI 0.72–1.14), and was associated with higher maternal satisfaction.</div></div><div><h3>Conclusion</h3><div>Early dressing removal (≤24 hours) after cesarean delivery appears to be safe and preferable compared to later removal, since it is associated with higher maternal satisfaction.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 9","pages":"Article 101739"},"PeriodicalIF":3.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650800","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":"Keep Your Candle Lit: A Story for Maternal-Fetal Medicine Physicians.","authors":"Michael R Foley","doi":"10.1016/j.ajogmf.2025.101741","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101741","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101741"},"PeriodicalIF":3.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638321","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":"Randomized, controlled trial of the impact of ursodeoxycholic acid on glycemia in gestational diabetes mellitus: the GUARDS trial.","authors":"Catalina de Paco Matallana, Jose E Blanco-Carnero, Ana Company Calabuig, Manuela Fernandez, Monika Lewanczyk, Matilda Burton, Xi Yang, Alice L Mitchell, Anita Lovgren-Sandblom, Hanns-Ulrich Marschall, David Wright, Caroline Ovadia, Kypros Nicolaides, Catherine Williamson","doi":"10.1016/j.ajogmf.2025.101732","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101732","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is a pregnancy complication that can be associated with increased risks of adverse maternal and neonatal outcomes. Optimal glycemic control remains challenging for many patients despite existing management strategies. Ursodeoxycholic acid (UDCA) is commonly used for cholestasis in pregnancy and has shown potential metabolic benefits, including improved insulin sensitivity and reduced inflammation. We hypothesize that UDCA may improve glycemic control in GDM.</p><p><strong>Objective: </strong>to compare treatment with ursodeoxycholic acid (UDCA) versus placebo to improve maternal glycemia in GDM.</p><p><strong>Study design: </strong>single-site, randomized, double-blinded, placebo-controlled trial of UDCA in 113 women with GDM at 24-28 weeks' gestation. The primary outcome was maternal fasting blood glucose concentration at 35⁺⁰-37⁺⁶ weeks' gestation.</p><p><strong>Results: </strong>The primary outcome did not differ significantly between groups when evaluated by intention to treat (treatment effect 0.98 (95% CI 0.92 to 1.05, p=0.61)); there were no differences in maternal or fetal secondary outcomes, including maternal weight change, need for insulin treatment, birthweight centile, proportion of large or small for gestational age infants, neonatal hypoglycemia or admission to the neonatal unit. A pre-specified secondary analysis measured serum concentrations of UDCA using UPLC-MS/MS and showed that participants taking larger numbers of tablets had higher serum concentrations of UDCA. Post hoc analysis revealed no difference in the rate of fasting blood glucose concentrations at or above the recommended target of 90mg/dL according to intention to treat (5/50 (10.0%) versus 8/53 (15.1%), RR 0.66, 95% CI 0.23 to 1.89, p=0.557). However, in patients with serum UDCA ≥0.5µmol/L, consistent with having taken UDCA, fewer patients had fasting glucose above target (2/42 (4.8%) versus 11/57 (19.3%), RR 0.25, 95% CI 0.06 to 1.06, p=0.039).</p><p><strong>Conclusions: </strong>This trial demonstrated no difference in fasting glycemia for women with GDM treated with UDCA compared to placebo. However, those with elevated serum UDCA concentrations were more likely to have fasting blood glucose concentrations below recommended thresholds, suggesting potential benefit of further investigation.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101732"},"PeriodicalIF":3.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620828","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":"Corrigendum to Cervical cerclage for short cervix at 24 to 26 weeks of gestation: systematic review and meta-analysis of randomized controlled trials using individual patient-level data American Journal of Obstetrics & Gynecology MFM Volume 5, Issue 6, June 2023, 100930","authors":"Moti Gulersen MD, MSc ,&nbsp;Erez Lenchner PhD ,&nbsp;Kypros H. Nicolaides MD ,&nbsp;Katsufumi Otsuki MD ,&nbsp;Orion A. Rust MD ,&nbsp;Sietske Althuisius MD ,&nbsp;Eran Bornstein MD ,&nbsp;Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2024.101411","DOIUrl":"10.1016/j.ajogmf.2024.101411","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 8","pages":"Article 101411"},"PeriodicalIF":3.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567946","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":"ACUPUNT Study: Addressing Concerns on Trial Design and Traditional Chinese Medicine Protocols.","authors":"Montserrat Zamora-Brito, Federico Migliorelli, Montse Palacio","doi":"10.1016/j.ajogmf.2025.101734","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2025.101734","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101734"},"PeriodicalIF":3.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565286","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":"Postpartum diuretic administration and hospital readmission: a systematic review and meta-analysis","authors":"Julia Whitley MD ,&nbsp;Julia Burd MD ,&nbsp;Michelle Doering MLIS ,&nbsp;Amanda Zofkie MD ,&nbsp;Antonina Frolova MD, PHD ,&nbsp;Jeannie Kelly MD, MS ,&nbsp;Nandini Raghuraman MD, MSCI","doi":"10.1016/j.ajogmf.2025.101738","DOIUrl":"10.1016/j.ajogmf.2025.101738","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;We aimed to determine if postpartum administration of loop diuretic therapy among patients at risk of or diagnosed with a hypertensive disorder of pregnancy impacts the rate of hospital readmission compared to typical care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data sources&lt;/h3&gt;&lt;div&gt;This study was a systematic review and meta-analysis of randomized controlled trials (RCTs). A research librarian performed a database search using a combination of standardized terms and keywords related to postpartum hypertension and loop diuretics from database inception until February 2025. This study was registered in PROSPERO (registration number CRD42024546708).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study eligibility criteria&lt;/h3&gt;&lt;div&gt;RCTs that compared outcomes between administration of loop diuretic therapy and routine care among postpartum patients at risk of or diagnosed with a hypertensive disorder of pregnancy were included. Inclusion criteria and diagnosis of hypertensive disorder of pregnancy were defined per each trial’s protocol. Nonrandomized trials, quasi-randomized trials, and animal models were excluded. All titles and abstracts obtained through the search were independently assessed by two reviewers using the screening tool in Covidence, and full-text articles were reviewed. A total of 10 articles met inclusion criteria and were included in the systematic review and meta-analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study appraisal and synthesis methods&lt;/h3&gt;&lt;div&gt;Two independent investigators independently abstracted data using a standardized template created in Covidence. The primary outcome was the rate of hospital readmission. Secondary maternal outcomes included readmission for hypertension, mean postpartum blood pressure, and severe maternal morbidity. The risk of bias in each study was assessed using the guidelines outlined in the Cochrane Handbook for Systematic Reviews of Interventions. Heterogeneity was measured using Higgins &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;. Meta-analysis was performed in Review Manager 5.4.1 to produce summary treatment effects in terms of relative risk (RR) or mean difference with 95% confidence intervals (CIs).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Ten RCTs, including 1401 patients, were included in the meta-analysis. The rate of hospital readmission, reported in 3 studies, did not differ between administration of loop diuretic therapy and routine care (RR=2.00; 95% CI, 0.71–5.67). The rate of readmission for hypertension also did not differ between groups (3 studies, RR=0.69; 95% CI, 0.35–1.36). Additional antihypertensive requirements were lower in patients who received diuretics (6 studies, RR=0.47; 95% CI, 0.26–0.85). There were no differences in any other secondary maternal outcomes, including discharge on antihypertensives (8 studies, RR=1.00; 95% CI, 0.91–1.11), hospital length of stay (6 studies, mean difference=0.15; 95% CI, –0.18 to 0.48), or severe maternal morbidity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;There is insufficient evidence to ","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 9","pages":"Article 101738"},"PeriodicalIF":3.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565329","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}