American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Uterine synechiae in pregnancy and the risk of adverse outcomes: a systematic review and meta-analysis.","authors":"Tomi Kanninen, Nicole Feigenblum, Kenzo Lacuarta, Abdulla Al-Khan, Manuel Alvarez, Jesus Alvarez-Perez","doi":"10.1016/j.ajogmf.2026.102151","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.102151","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the association between uterine synechiae identified on ultrasound and adverse pregnancy outcomes through a systematic review and meta-analysis of observational studies.</p><p><strong>Data sources: </strong>A systematic search of PubMed, Cochrane Library, CINAHL and ScienceDirect was performed from database inception to July 2025 in accordance with MOOSE guidelines.</p><p><strong>Study eligibility criteria: </strong>Cohort and case-control studies reporting pregnancy outcomes among women with versus without uterine synechiae were eligible.</p><p><strong>Study appraisal and synthesis methods: </strong>Two reviewers independently screened studies, extracted data and assessed quality using the Newcastle-Ottawa Scale. Random-effects models were used to calculate pooled odds ratios and mean differences for maternal and neonatal outcomes.</p><p><strong>Results: </strong>Four studies met inclusion criteria, comprising 628 pregnancies with uterine synechiae and 65,959 controls. Uterine synechiae were associated with an increased risk of preterm birth <37 weeks (odds ratio 1.80; 95% CI 1.35-2.39), preterm premature rupture of membranes (odds ratio 3.58; 95% CI 1.13-11.36), placental abruption (odds ratio 3.34; 95% CI 1.57-7.13) and placenta previa (odds ratio 3.19; 95% CI 1.07-9.57). Mean birth weight was significantly lower among affected pregnancies (mean difference -154.29 g; 95% CI -259.20 to -49.38). No significant differences were observed for preterm birth <34 weeks, overall cesarean delivery, fetal growth restriction, stillbirth or NICU admission. A subgroup analysis demonstrated higher odds of cesarean delivery for fetal malpresentation in pregnancies with synechiae (odds ratio 1.97; 95% CI 1.23-3.13).</p><p><strong>Conclusions: </strong>Uterine synechiae identified on ultrasound are associated with increased risks of preterm birth, PPROM, placental abruption, placenta previa and fetal malpresentation, as well as lower birth weight. These findings indicate that synechiae are not incidental findings and support their association with adverse outcomes in pregnancy.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"102151"},"PeriodicalIF":3.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170102","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":"Cochrane Update: News and Reviews from the Cochrane Maternal-Newborn-Child Health Thematic Group.","authors":"Gabriela Reis Cunha, Shahd Abdalla, David M Haas","doi":"10.1016/j.ajogmf.2026.102152","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.102152","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"102152"},"PeriodicalIF":3.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171831","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":"Maternal Fatty Acids Are Associated with Spontaneous Labor Duration.","authors":"Eileen Deuster, Maresa Kern, Dörthe Brüggmann, Jakob Thomas Buslowicz, Nina-Naomi Kreis, Frank Louwen, Anna Elisabeth Hentrich","doi":"10.1016/j.ajogmf.2026.102147","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.102147","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"102147"},"PeriodicalIF":3.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149556","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":"Changing practice: establishing a preterm birth risk threshold to guide antenatal corticosteroid administration.","authors":"Moti Gulersen, Adam Lin, Cande V Ananth, Ashley N Battarbee, Robert M Silver, Lynn M Yee, Vincenzo Berghella, David M Haas","doi":"10.1016/j.ajogmf.2026.102149","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.102149","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"102149"},"PeriodicalIF":3.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149353","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":"Sex in pregnancy!","authors":"Vincenzo Berghella, Shannon Davids","doi":"10.1016/j.ajogmf.2026.102117","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.102117","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"102117"},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138643","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":"Fetal Cardiac Structure and Function in Diabetic Pregnancies Within Recommended Glycemic Targets: A Systematic Review and Meta-Analysis.","authors":"Xinyi Hou, Nan Zhang, Wenxin Yang, Ying Zhang, Yu Wang","doi":"10.1016/j.ajogmf.2026.102145","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.102145","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate fetal echocardiographic parameters in diabetic pregnancies meeting guideline-recommended HbA1c targets (< 6.5%) and explore variations across glycemic strata.</p><p><strong>Data sources: </strong>Seven databases were searched from inception through November 2025.</p><p><strong>Study eligibility criteria: </strong>Observational studies comparing fetal echocardiograms between diabetic pregnancies (mean maternal HbA1c < 6.5%) and healthy controls.</p><p><strong>Study appraisal and synthesis methods: </strong>Quality was assessed using Newcastle-Ottawa Scale and JBI checklists; evidence certainty was graded using GRADE. Random-effects models pooled mean differences (MD) and standardized mean differences (SMD).</p><p><strong>Results: </strong>Twenty studies (2,690 participants; 70% East Asian) were included. In the third trimester, fetuses of diabetic mothers with HbA1c < 6.5% exhibited subtle cardiac alterations: increased interventricular septal thickness (MD, 0.67 mm [95% CI, 0.31 to 1.03 mm], P < .001; 95% PI, -0.58 to 1.92 mm), decreased mitral valve E/A ratio (MD, -0.07 [95% CI, -0.12 to -0.02], P = .01; 95% PI, -0.25 to 0.11), and elevated left ventricular myocardial performance index (MD, 0.08 [95% CI, 0.05 to 0.12], P < .001; 95% PI, -0.04 to 0.20). In exploratory subgroup analyses, differences were attenuated in cohorts reporting mean HbA1c ≤ 5.5%. Univariate meta-regression identified maternal age as an exploratory moderator for mitral valve E/A ratio (P = .0016).</p><p><strong>Conclusions: </strong>Diabetic pregnancies meeting target HbA1c (< 6.5%) exhibit subtle fetal cardiac differences, which attenuate at ≤ 5.5%. However, very low-certainty evidence, wide prediction intervals crossing null, and residual confounding limit generalizability to higher-BMI or diverse populations, warranting rigorously adjusted prospective cohorts.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"102145"},"PeriodicalIF":3.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128493","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":"Animation-assisted counseling before fetoscopic laser surgery for twin-to-twin transfusion syndrome: a randomized controlled trial.","authors":"Piyatida Thongkloung, Nisarat Phithakwatchara, Katika Nawapun, Tuangsit Wataganara, Suparat Jaingam, Kanokwaroon Watananirun, Tanchanok Auwattanamongkol, Sommai Viboonchart","doi":"10.1016/j.ajogmf.2026.102146","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.102146","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients considering fetoscopic laser surgery for twin-to-twin transfusion syndrome must understand complex placental anatomy, treatment alternatives, and maternal and fetal risks, usually deciding on the day of counseling during an acutely stressful pregnancy. To our knowledge, how best to deliver this information has not been evaluated in a randomized trial.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluated whether animation-assisted counseling increased immediate factual knowledge compared with standard counseling and estimated its effects on specialist counseling time, total patient education time, anxiety, and prespecified intervention-related harms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;In this single-center, parallel-group randomized trial at a university fetal therapy center, 44 pregnant patients for whom fetoscopic laser surgery was recommended were assigned 1:1 to a 5-minute 16-second tablet animation followed by individualized specialist discussion or to standard specialist verbal counseling with static images. The prespecified primary outcome was a perfect score on a 10-item knowledge questionnaire completed immediately after counseling. Secondary outcomes included the continuous knowledge score, specialist counseling time, and anxiety. Analyses followed the intention-to-treat principle. Post hoc analyses addressed total patient education time, baseline knowledge, poorly performing questionnaire items, and counselor.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A perfect score was achieved by 15 of 22 participants (68.2%) after animation-assisted counseling and 7 of 22 (31.8%) after standard counseling (risk difference, 36.4 percentage points; 95% confidence interval, 6.9-58.2; risk ratio, 2.14; 95% confidence interval, 1.09-4.21; P=.016). This estimate was unchanged after excluding the 2 items with negative item-total correlations, and the risk ratio was 1.95 after adjustment for baseline knowledge (small-sample-corrected 95% confidence interval, 0.98-3.89). Mean postcounseling knowledge was 9.50 vs 8.45 (mean difference, 1.05 points; 95% confidence interval, 0.38-1.71; P=.003) and remained higher after baseline adjustment (0.95 points; 95% confidence interval, 0.35-1.56; P=.003). Specialist counseling time was 513 vs 909 seconds (mean difference, -396 seconds; 95% confidence interval, -537 to -255; P&lt;.001), whereas total patient education time including the animation was similar (829 vs 909 seconds; mean difference, -80 seconds; 95% confidence interval, -221 to 61; P=.256). Anxiety findings were inconclusive, and no intervention-related harms occurred.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Animation-assisted counseling improved immediate factual knowledge at the point of the treatment decision and released specialist counseling time without lengthening patient education. It is best used as a standardized adjunct to individualized dialogue. Whether these gains translate into retained understanding and better decis","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"102146"},"PeriodicalIF":3.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115886","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":"Survey of Maternal-Fetal Medicine Fellows Career Priorities.","authors":"Emma James, Nichole Nidey, Sherrill Rose, Andrea Greiner, Hayley Miller","doi":"10.1016/j.ajogmf.2026.102144","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.102144","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"102144"},"PeriodicalIF":3.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115894","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":"Buprenorphine-Based Medication for Opioid Use Disorder Is Associated with Reduced Stimulant Use During Pregnancy.","authors":"Alexander M Harrison, Cynthia Cockerham, Adrianne N Caudill, Victoria L Stanton, Gregory S Hawk, Barbara V Parilla","doi":"10.1016/j.ajogmf.2026.102143","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.102143","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"102143"},"PeriodicalIF":3.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115823","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":"Cost effectiveness of outpatient balloon catheter induction of labor compared with inpatient prostaglandin: Economic analysis alongside the OBLIGE randomised controlled trial.","authors":"Karyn Anderson, Michelle Wise, Lynn Sadler, John M D Thompson, Richard Edlin","doi":"10.1016/j.ajogmf.2026.102142","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2026.102142","url":null,"abstract":"<p><strong>Background: </strong>Induction of labor is a common obstetric intervention. Numerous methods and protocols for achieving cervical ripening exist, including outpatient management using a balloon catheter.</p><p><strong>Objective (s): </strong>This study aims to perform a cost-effectiveness analysis of the OBLIGE trial, a multicentre randomised controlled trial comparing outpatient single balloon catheter for cervical ripening to inpatient vaginal prostaglandin (PG), using cesarean births avoided as the primary outcome measure.</p><p><strong>Study design: </strong>Using a health service payer perspective, this cost-effectiveness analysis considers the direct healthcare costs (2021 NZ Dollars) from randomisation to 42 days post-birth. Clinical outcomes were identified from trial data collection, while healthcare resource use and costs were identified from routinely collected national data.</p><p><strong>Results: </strong>Across bootstraped replicates, the difference in mean costs -$256 (95% CI $-1172 to $639) and caesarean births avoided -5.67% (95% CI -11.09 to 0.07) did not reach statistical significance. These results suggest that balloon catheters may be considered cost-effective where decision makers value a cesarean birth avoided below $4,519. Subgroup analysis demonstrates outpatient balloon catheters are dominated (less effective and more costly) among parous women.</p><p><strong>Conclusion (s): </strong>Immediate costs are unlikely to be critical in decisions about the use of outpatient balloon catheter induction of labor. In future economic analyses, consideration of longer-term costs and clinical outcomes resulting from cesarean birth, and any quality of life impacts of outpatient induction, would be important to clarify the cost-effectiveness of this intervention.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"102142"},"PeriodicalIF":3.6,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115839","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}