American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Selective Fetal Reduction of Uncomplicated Dichorionic Twins on Parental Request Versus Ongoing Twins and Pregnancy Outcomes: A Systematic Review and Meta-analysis.","authors":"Ioannis Mitrogiannis, Christos Chatzakis, Alexandros Sotiriadis, Stylianos Makrydimas, Alexandros Katrachouras, Athina Efthymiou, George Makrydimas","doi":"10.1016/j.ajogmf.2024.101492","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101492","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess the effect of elective fetal reduction in uncomplicated twin pregnancies on maternal-fetal outcomes, compared to ongoing twin pregnancies.</p><p><strong>Data sources: </strong>PubMed, Scopus (until December 2023), and references of retrieved articles.</p><p><strong>Study appraisal and synthesis methods: </strong>Quality assessment of observational studies was conducted using the ROBINS-I tool. The overall quality of evidence was evaluated per GRADE. A quantitative analysis was performed for electively reduced dichorionic twins. Primary outcome was preterm birth. Secondary outcomes were gestational age at delivery, stillbirth and neonatal intensive care unit, gestational diabetes mellitus, pre-eclampsia, and pregnancy loss < 24 weeks of gestation. Summary odds ratio (ORs) with 95% confidence intervals (CIs) were calculated, and random-effects models were used for data synthesis.</p><p><strong>Results: </strong>The initial electronic search yielded 745 studies; 175 studies were further identified from reference citations. Five articles included appropriate data and were finally included in the meta-analysis. All studies were evaluated as \"moderate risk of bias\". Those five studies reported on dichorionic twins. Elective reduction in dichorionic twins reduces the risk for preterm birth <37 weeks (4 studies; n=1577; OR 0.14, 95% CI 0.09-0.22, moderate-quality evidence), <34 weeks (3 studies; n=1335; OR 0.22, 95% CI 0.07-0.69; low-quality evidence), <32 weeks (3 studies; n=1335; OR 0.31, 95% CI, 0.11-0.88; low-quality evidence), gestational diabetes (3 studies; n= 1410; OR 0.57, 95% CI 0.33-0.97, low-quality evidence), pregnancy-associated hypertensive disorders (2 studies; n=581; OR 0.29, 95% CI 0.10-0.83; low-quality evidence), birthweight <10<sup>th</sup> centile (2 studies; n=1163; OR 0.27, 95% CI 0.17-0.43; moderate-quality evidence), birthweight< 5<sup>th</sup> centile (2 studies; n=1163; OR 0.31, 95% CI 0.19-0.50; low-quality evidence) and increases gestational age at delivery {four studies; n= 1362; MD 2.93 weeks, 95% CI 2.08-3.77; moderate-quality evidence}. The risk for stillbirth (2 studies; n= 1311; OR 1.63, 95% CI 0.43-6.21; very low-quality evidence) or pregnancy loss< 24 weeks (3 studies; n=1436; OR 1.20, 95% CI 0.55-2.58; very low-quality evidence) were not statistically significant different.</p><p><strong>Conclusions: </strong>Compared to ongoing dichorionic twin pregnancies, dichorionic pregnancies that undergo elective selective fetal reduction are associated with lower incidences of preterm birth < 37 weeks, <34 weeks, <32 weeks, birthweight <10<sup>th</sup> centile and <5<sup>th</sup> centile, gestational diabetes, hypertensive disorders of pregnancy, and later gestational age at delivery by almost 3 weeks. These associations were often based on very low quality of evidence; so these results should be interpreted with caution and further studies should be conducte","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297368","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":"Beyond race: embracing epistemic justice in addressing antiblack racism as a cardiovascular risk factor in pregnancy.","authors":"Arthurine K Zakama, Erinma P Ukoha, Maura Jones Pullins, Edward Miller, Lisa D Levine, Abike James","doi":"10.1016/j.ajogmf.2024.101485","DOIUrl":"10.1016/j.ajogmf.2024.101485","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297344","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":"Lest we're lost.","authors":"Suneet P Chauhan","doi":"10.1016/j.ajogmf.2024.101487","DOIUrl":"10.1016/j.ajogmf.2024.101487","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297349","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":"Utilizing Perinatal Patient Navigation to Address Self-Identified Social Determinants of Health in Pregnancy.","authors":"Kirat Sandhu, Cara Dolin, Adina R Kern-Goldberger","doi":"10.1016/j.ajogmf.2024.101489","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101489","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297372","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":"Telelactation Use Patterns among a Racially and Ethnically Diverse Sample of U.S. Parents: Secondary Analysis of a Randomized Controlled Trial: Telelactation Use Patterns among a Racially and Ethnically Diverse Sample.","authors":"Kandice A Kapinos, Molly Waymouth, Kristin N Ray, Jill R Demirci, Ateev Mehrotra, Kortney James, Gabriela Alvarado, Khadesia Howell, Maria DeYoreo, Lori Uscher-Pines","doi":"10.1016/j.ajogmf.2024.101483","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101483","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297369","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":"Patient Understanding of Prenatal Exome Sequencing.","authors":"Kate Swanson, Mary E Norton, Sara L Ackerman, Ms Billie R Lianoglou, Nuriye N Sahin-Hodoglugil, Teresa N Sparks","doi":"10.1016/j.ajogmf.2024.101490","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101490","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297363","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":"Exploring whether measuring gender in pregnancy research results in participant loss","authors":"","doi":"10.1016/j.ajogmf.2024.101484","DOIUrl":"10.1016/j.ajogmf.2024.101484","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297347","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":"Reply to \"Contractions of the lower uterine segment during transvaginal ultrasound cervical length: incidence, significance, proper measurement, and management\".","authors":"Vincenzo Berghella, Moti Gulersen","doi":"10.1016/j.ajogmf.2024.101480","DOIUrl":"10.1016/j.ajogmf.2024.101480","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297373","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":"Differences in neonatal sepsis among immunosuppression regimens in pregnancies of transplant recipients: Neonatal sepsis differs among immunosuppression regimens in pregnancies of transplant recipients.","authors":"Neema Pithia, Ophelia Yin, Lisa A Coscia, Serban Constantinescu, Michael J Moritz, Yalda Afshar","doi":"10.1016/j.ajogmf.2024.101482","DOIUrl":"https://doi.org/10.1016/j.ajogmf.2024.101482","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297346","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 dinoprostone vs Foley catheter for induction of labor at term with an unfavorable cervix: an open-label randomized controlled trial","authors":"","doi":"10.1016/j.ajogmf.2024.101436","DOIUrl":"10.1016/j.ajogmf.2024.101436","url":null,"abstract":"<div><h3>Background</h3><p>Induction of labor (IOL) with mechanical methods or pharmacological agents is used in about 20% to 30% of all pregnant women. We specialized in comparing the effectiveness and safety of dinoprostone vs transcervical Foley catheter for IOL in term pregnant women with an unfavorable cervix with adequate samples.</p></div><div><h3>Objective</h3><p>To compare the effectiveness and safety of dinoprostone vs transcervical Foley catheter for IOL in term pregnant women with an unfavorable cervix.</p></div><div><h3>Study Design</h3><p>This is a parallel, open-label randomized controlled trial in two maternal centers in Shanghai, China between October 2019 and July 2022. Women with a singleton pregnancy in cephalic presentation at term and an unfavorable cervix (Bishop score &lt;6) scheduled for IOL were eligible. A total of 1860 women were randomly allocated to cervical ripening with either a dinoprostone vaginal insert (10 mg) or a 60 cc Foley catheter for up to 24 hours. The primary outcomes were vaginal delivery rate and time to vaginal delivery. Secondary outcomes included time to delivery and maternal and neonatal morbidity. Analysis was done from an intention-to-treat perspective. The trial was registered with the China trial registry (CTR2000038435).</p></div><div><h3>Results</h3><p>The vaginal birth rates were 72.8% (677/930) vs 69.9% (650/930) in vaginal dinoprostone and Foley catheter, respectively (aRR 1.04, 95% confidence interval [CI] 0.98-1.10, risk difference: 0.03). Time to vaginal delivery was not significantly different between the two groups (sub-distribution hazard ratio 1.11, 95% CI 0.99-1.24). Vaginal dinoprostone was more likely complicated with hyperstimulation with fetal heart rate changes (5.8% vs 2.8%, aRR 2.09, 95% CI 1.32-3.31) and placenta abruption (0.9% vs 0.1%, aRR: 8.04, 95% CI 1.01-64.15), while Foley catheter was more likely complicated with suspected intrapartum infection (5.1% vs 8.2%, aRR: 0.62, 95% CI 0.44-0.88) and postpartum infection (1.4% vs 3.7%, aRR: 0.38, 95% CI 0.20-0.72). The composite of poor neonatal outcomes was not significantly different between the two groups (4.5% vs 3.8%, aRR 1.21, 95% CI 0.78-1.88), while more neonatal asphyxia occurred in the dinoprostone group (1.2% vs 0.2%, aRR 5.39, 95% CI 1.22-23.92). In a subgroup analysis, vaginal dinoprostone decreased vaginal birth rate slightly in multiparous women (90.6% vs 97.0%, aRR 0.93, 95% CI 0.88-0.99).</p></div><div><h3>Conclusions</h3><p>In term pregnant women with an unfavorable cervix, IOL with vaginal dinoprostone or Foley catheter has similar effectiveness. Foley catheter leads to better safety for neonates, while it may result in a higher risk of maternal infection. Furthermore, Foley catheter should be preferred in multiparous women.</p></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890288","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}