American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Letter to editor regarding “systematic review on music interventions during pregnancy in favor of the well-being of mothers and eventually their offspring”","authors":"Qingyong Zheng MD, Yongjia Zhou MD, Jianguo Xu MD, Jinhui Tian MD","doi":"10.1016/j.ajogmf.2024.101587","DOIUrl":"10.1016/j.ajogmf.2024.101587","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 3","pages":"Article 101587"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932835","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":"Aspirin dosage for preeclampsia prophylaxis: an argument for 81-mg dosing","authors":"Kimen S. Balhotra MD,&nbsp;Baha M. Sibai MD","doi":"10.1016/j.ajogmf.2024.101568","DOIUrl":"10.1016/j.ajogmf.2024.101568","url":null,"abstract":"<div><div>Research conducted over the past few decades has shown that low-dose aspirin can effectively reduce the risk of developing preeclampsia. Consequently, numerous prominent organizations have adopted the recommendation to use low-dose aspirin during pregnancy to prevent preeclampsia. However, the optimal dosage of low-dose aspirin (81mg versus 162mg) remains a subject of debate. Currently, there is insufficient high-quality data to justify the use of a higher dosage of low-dose aspirin. In this review, we review the existing evidence that supports the continued use of 81mg of aspirin over a higher dose and emphasize the need for high-quality research to alter current recommendations.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 1","pages":"Article 101568"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717308","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":"Aspirin dosage for preeclampsia prophylaxis: an argument for 162-mg dosing","authors":"Maura E. Jones Pullins MD,&nbsp;Kim A. Boggess MD","doi":"10.1016/j.ajogmf.2025.101620","DOIUrl":"10.1016/j.ajogmf.2025.101620","url":null,"abstract":"<div><div>The optimal aspirin dose for preeclampsia prevention remains controversial, with international guidelines lacking consensus on the most effective regimen. Aspirin is a proven intervention for reducing the risk of preeclampsia, particularly when initiated early in pregnancy. Its benefits stem from the selective inhibition of cyclooxygenase-1 (COX-1), reducing thromboxane A2 synthesis while preserving prostacyclin production, thereby restoring the vascular balance essential for placental health. A dose-response relationship has been established, with doses ≥100 mg showing significantly greater efficacy than lower doses. Furthermore, aspirin's pharmacological effects remain highly specific to COX-1 at the 162 mg dose, minimizing concerns about broader prostaglandin inhibition.</div><div>Emerging evidence suggests that certain patient factors, such as altered pharmacokinetics during pregnancy or obesity, may reduce aspirin's effectiveness at lower doses (e.g., 81 mg). In these studies, aspirin resistance was successfully overcome with a 162 mg dose. While concerns regarding safety at this dose have been raised, contemporary randomized controlled trials utilizing a 150 mg dose have shown no increase in adverse effects compared to placebo. As such, current evidence increasingly supports 162 mg as the optimal dose for preeclampsia prevention, offering greater effectiveness than the commonly used 81 mg dose, without significant evidence of increased risk.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 1","pages":"Article 101620"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399980","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":"Racial and ethnic differences in self-reported substance use and screening during prenatal care","authors":"Erica Holland MD,&nbsp;Naima T. Joseph MD, MPH,&nbsp;Christopher P. Salas-Wright PhD, MSW,&nbsp;Michele R. Hacker ScD, MSPH,&nbsp;Summer Sherburne Hawkins PhD, MS","doi":"10.1016/j.ajogmf.2025.101660","DOIUrl":"10.1016/j.ajogmf.2025.101660","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 5","pages":"Article 101660"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543700","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":"Inpatient pharmacological thromboprophylaxis in the antepartum period: an argument for risk-based thromboprophylaxis","authors":"Jerome J. Federspiel MD, PhD","doi":"10.1016/j.ajogmf.2024.101567","DOIUrl":"10.1016/j.ajogmf.2024.101567","url":null,"abstract":"<div><div>Venous thromboembolism (VTE) is a significant cause of maternal morbidity and mortality in the United States. People hospitalized during pregnancy for reasons other than routine birth (ie, during antepartum admissions) are at increased risk of VTE compared with nonhospitalized obstetric patients, but there is no consensus regarding which patients should receive thromboprophylaxis during antepartum hospitalizations as the absolute event rates are low and anticoagulation can complicate antepartum management. We argue that an approach informed by individualized patient risk assessment is likely to produce the greatest net benefit for patients. Such an approach would avoid the pitfalls of universal pharmacologic prophylaxis (potential to interfere with unplanned delivery or receipt of neuraxial anesthesia) among patients for whom the absolute risk of VTE is low. In contrast, approaches that withhold pharmacologic prophylaxis from all antepartum patients likely place some at significant risk of VTE. We outline the arguments against universal pharmacologic thromboprophylaxis and against universal avoidance of pharmacologic thromboprophylaxis and discuss a risk-based approach proposed at our institution. Finally, we outline a research agenda for identification of optimal antepartum anticoagulation strategies.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 1","pages":"Article 101567"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717313","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":"Management of cervical cerclage after preterm premature rupture of membranes: an argument for removal","authors":"Fabrizio Zullo MD,&nbsp;Daniele Di Mascio MD","doi":"10.1016/j.ajogmf.2024.101570","DOIUrl":"10.1016/j.ajogmf.2024.101570","url":null,"abstract":"<div><div>Cervical cerclage is a widely used intervention to prevent preterm birth in high-risk pregnancies. However, cerclage is associate with risks, including preterm premature rupture of membranes and subsequent complications, such as chorioamnionitis. Our review evaluates the evidence for immediate removal (ie, removal at the time of diagnosis) vs retention of cervical cerclage (ie, removal when clinically indicated) after preterm premature rupture of membranes, focusing on optimizing neonatal outcomes and minimizing maternal and fetal complications. A meta-analysis on the topic that included 169 patients in the “removal” group and 208 in the “retention” group showed that the rates of pregnancy prolongation &gt;48 hours and &gt;7 days were significantly lower in the group who underwent immediate removal of cerclage than in the group who had delayed removal of cerclage (pregnancy prolongation &gt;48 hours: 47% vs 85%, respectively; odds ratio, 0.15; pregnancy prolongation &gt;7 days: 33% vs 57%, respectively; odds ratio, 0.30). In addition, pregnancy latency was significantly lower, despite the absolute mean difference being only 2.84 days. However, the rates of chorioamnionitis and Apgar score &lt;7 at 5 minutes were significantly lower in the immediate removal group than in the retention group (chorioamnionitis: 29% vs 41%, respectively; odds ratio, 0.57; Apgar score &lt;7 at 5 minutes: 16% vs 43%, respectively; odds ratio, 0.22). A proposed balanced approach involves retaining the cerclage for approximately 24 hours after premature rupture of membranes (PROM) to permit steroid administration (initial dose followed by a second dose after 24 hours) before removal. This strategy aims to maximize steroid benefits while minimizing the risks of prolonged cerclage retention, potentially achieving a correct timing that optimizes neonatal outcomes without significantly increasing complications This management approach could be beneficial in situations where immediate removal may preclude full steroid benefits. Our recommendations support a protocol balancing appropriate timing for steroid administration with the risks of extended cerclage retention, namely, chorioamnionitis, unless further randomized controlled trials will show the proper evidence-based management in this clinical scenario.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 1","pages":"Article 101570"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717315","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":"Preterm premature rupture of membranes in the late preterm period: an argument against expectant management","authors":"Ghamar Bitar MD,&nbsp;Baha M. Sibai MD","doi":"10.1016/j.ajogmf.2025.101619","DOIUrl":"10.1016/j.ajogmf.2025.101619","url":null,"abstract":"<div><div>Preterm premature rupture of membranes is defined as the leakage of amniotic fluid through the cervical os before 37 weeks of gestation and before the onset of labor and complicates nearly 3% of deliveries and 30% of indicated late preterm deliveries. The current management of preterm premature rupture of membranes, which occurs between 34 and 36 weeks of gestation, has pivoted from recommending delivery to recommending either delivery or expectant management because of a large trial that evaluated these management strategies. The potential neonatal benefits of expectant management, reducing complications of prematurity, must be weighed with the maternal risks (and, therefore, attached neonatal risks) of prolonging the gestation under close surveillance. Proceeding towards delivery is recommended for preterm premature rupture of membranes occurring at or later than 34 weeks gestation, given the higher risk of maternal complications, specifically hemorrhage and infection, with expectant management. Furthermore, limited evidence exists to prove the increased risks of adverse neonatal outcomes, including sepsis or composite neonatal morbidity, with immediate delivery compared with expectant management.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 1","pages":"Article 101619"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477149","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 “The preeclampsia and hypertension target treatment study: a multicenter prospective study to evaluate the effectiveness of the antihypertensive therapy based on maternal hemodynamic findings”","authors":"Marium Jawaid MBBS,&nbsp;Laiba Tanveer MBBS,&nbsp;Muhammad Maaz MBBS","doi":"10.1016/j.ajogmf.2025.101600","DOIUrl":"10.1016/j.ajogmf.2025.101600","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 3","pages":"Article 101600"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980231","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 role of pravastatin in preventing preeclampsia in high-risk pregnant women: a meta-analysis with trial sequential analysis: a response","authors":"Henrique Provinciatto MD,&nbsp;Maria Esther Barbalho MD","doi":"10.1016/j.ajogmf.2024.101586","DOIUrl":"10.1016/j.ajogmf.2024.101586","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 3","pages":"Article 101586"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967214","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":"Vaginal progesterone for prevention of preterm birth in women with a history of preterm birth regardless of cervical length: an argument against use","authors":"Anthony Melendez Torres MD,&nbsp;Sarahn Wheeler MD, MHS","doi":"10.1016/j.ajogmf.2024.101571","DOIUrl":"10.1016/j.ajogmf.2024.101571","url":null,"abstract":"<div><div>Preterm birth, defined as birth before 37 weeks of gestation, has a significant public health effect as the most frequent cause of neonatal-related death and the second most frequent cause of infant-related death at the age of &lt;5 years. Given the unclear and likely multifactorial etiologic nature of preterm birth, interventions to address this condition remain elusive. Progesterone supplementation was once considered a promising strategy for reducing preterm birth among patients with a history of previous preterm birth. However, more recent data suggesting limited efficacy led the United States Food and Drug Administration to revoke approval of 17-alpha hydroxyprogesterone caproate. Vaginal progesterone supplementation remains controversial. Recently published meta-analyses evaluating large, preregistered randomized controlled trials with low risk of bias and selective outcome reporting have found that recurrent preterm birth rates are not significantly reduced by vaginal progesterone supplementation in patients with a singleton pregnancy and previous history of spontaneous preterm birth. Furthermore, studies reporting any benefit from vaginal progesterone in this patient population are noted to have smaller sample sizes, higher risk of bias and selective outcome reporting, and low external validity. Therefore, our study argues against the universal use of vaginal progesterone supplementation for the prevention of recurrent preterm birth.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 1","pages":"Article 101571"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740568","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}