American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Corrigendum to ‘Oral progesterone for the prevention of recurrent preterm birth: systematic review and metaanalysis.’ American Journal of Obstetrics & Gynecology MFM/ Volume 1, Issue 1, March 2019, Pages 50-62","authors":"Rupsa C. Boelig MD , Luigi Della Corte MD , Sherif Ashoush MD , David McKenna MD , Gabriele Saccone MD , Shalini Rajaram MD , Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2025.101752","DOIUrl":"10.1016/j.ajogmf.2025.101752","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 10","pages":"Article 101752"},"PeriodicalIF":3.1,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889410","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":"Cesarean delivery: virtual special issue","authors":"Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2025.101745","DOIUrl":"10.1016/j.ajogmf.2025.101745","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 9","pages":"Article 101745"},"PeriodicalIF":3.1,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144878709","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":"A randomized trial of clustered vs spaced simulation in forceps-assisted vaginal deliveries","authors":"Andrew T. Greene DO , Matthew James Zuber MD , Joshua Nitsche MD, PhD , Mark Newman MD , Brian Brost MD","doi":"10.1016/j.ajogmf.2025.101755","DOIUrl":"10.1016/j.ajogmf.2025.101755","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 10","pages":"Article 101755"},"PeriodicalIF":3.1,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972478","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 corticosteroids for fetal congenital pulmonary airway malformation: a systematic review","authors":"Benedetta Bina MD , Federica Bellussi MD, PhD , Shelly Soni MD , Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2025.101763","DOIUrl":"10.1016/j.ajogmf.2025.101763","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 11","pages":"Article 101763"},"PeriodicalIF":3.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883927","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":"Cerclage for short cervix ≤20 mm before 24 weeks in singleton gestations without prior spontaneous preterm birth decreases preterm birth: a meta-analysis of randomized controlled trials using individual patient-level data","authors":"Vincenzo Berghella MD ,&nbsp;Siani Harding ,&nbsp;Kypros Nicolaides MD ,&nbsp;Orion A. Rust MD ,&nbsp;Katsufumi Otzuki MD ,&nbsp;Sietske Althuisius MD ,&nbsp;Gabriele Saccone MD ,&nbsp;Rupsa C. Boelig MD","doi":"10.1016/j.ajogmf.2025.101756","DOIUrl":"10.1016/j.ajogmf.2025.101756","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy of cervical cerclage in preventing preterm birth (PTB) in asymptomatic singleton pregnancies without prior spontaneous PTB and with a mid-trimester short transvaginal ultrasound cervical length (TVU CL).</div></div><div><h3>Data Sources</h3><div>MEDLINE, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials were searched for the following terms: \"cerclage,\" \"cervical cerclage,\" \"salvage,\" \"rescue,\" \"emergency,\" \"ultrasound-indicated,\" \"short cervix,\" \"cervical length,\" \"ultrasound,\" and \"randomized trial,\" from inception of each database until November 2024. No language restrictions were applied.</div></div><div><h3>Study eligibility criteria</h3><div>We included all randomized controlled trials (RCTs) of asymptomatic singleton pregnancies without prior spontaneous PTB screened with TVU CL, found to have a midtrimester short CL ≤25.9 mm, and then randomized to management with either cerclage or no cerclage. We contacted corresponding authors of all the included trials to request access to the data and perform a meta-analysis of individual patient data.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>Individual patient data from the original RCTs were merged into a master database specifically constructed for the review. The primary outcome was PTB &lt;37 weeks. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95% confidence interval (CI). To obtain the pooled risk ratio estimate the random effects model of DerSimonian and Laird were used</div></div><div><h3>Results</h3><div>Six trials, including 507 asymptomatic singleton gestations without prior spontaneous PTB and with short mid-trimester TVU CL ≤25.9 mm, were included in the meta-analysis. The overall risk of bias of the included trials was judged as low. The primary outcome, PTB &lt;37 weeks, occurred in 89/266 (33.5%) vs 96/241 (39.8%) in the cerclage vs no cerclage group, respectively (RR 0.88, 95% CI 0.59–1.31). Planned subgroup analyses revealed that in patients with CL ≤20.9 mm before 24 weeks, cerclage was associated with a significant decrease in PTB &lt;37 weeks (56/181 (30.9%) vs 66/159 (41.5%); RR 0.75, 95% CI 0.56–0.99) and a significantly longer latency from randomization to delivery (<em>P</em>=.049).</div></div><div><h3>Conclusions</h3><div>In individuals with singleton gestations, without prior spontaneous PTB and with a short TVU CL in the second trimester, cerclage is associated with a significant decrease in PTB &lt;37 weeks and a significant longer latency at TVU CL ≤20.9 mm before 24 weeks, but not an overall effect on TVU CL ≤25 mm.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 10","pages":"Article 101756"},"PeriodicalIF":3.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883925","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":"Routine vaginal examination scheduled at 8 vs 4 hours in multiparous women in early spontaneous labor: a randomized controlled trial","authors":"Izzati Radzali MBBS,&nbsp;Narayanan Vallikkannu MObGyn,&nbsp;Mukhri Hamdan MObGyn, PhD,&nbsp;Thai Ying Wong MRCOG,&nbsp;Farah Gan MObGyn,&nbsp;Peng Chiong Tan FRCOG, PhD","doi":"10.1016/j.ajogmf.2025.101762","DOIUrl":"10.1016/j.ajogmf.2025.101762","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;Vaginal examination can cause pain and embarrassment, but it is recommended to be performed at least every 4 hours to monitor progress in labor. Trial data are sparse on its ideal frequency. Haste to diagnose labor dystocia, especially in low-risk multiparous women, and to resort to oxytocin augmentation and operative delivery may be counterproductive.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;This study aimed to evaluate scheduling the first follow-up vaginal examination at 8 vs 4 hours after diagnosis of early spontaneous labor (cervical dilatation of 3–5 cm) in multiparas.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;A randomized controlled trial was conducted from October 2023 to October 2024 in a university hospital. Multiparas at term were recruited at diagnosis of early spontaneous labor. Participants were randomized to vaginal examination scheduled at 8 or 4 hours. Interim vaginal examination was permitted as clinically indicated. The 2 primary outcomes were the time to birth (noninferiority hypothesis) and maternal satisfaction assessed using a 0-to-10 numerical rating scale (superiority hypothesis). Data were analyzed using the &lt;em&gt;t&lt;/em&gt; test, Mann–Whitney U test, chi-square test (or Fisher exact test), as appropriate.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;A total of 254 women were randomized (127 to each arm). Participants’ characteristics across trial arms were similar. The interval from diagnosis of early labor to birth was mean±standard deviation 4.1±3.0 hours in the 8-hour arm vs 4.5±2.8 hours in the 4-hour arm (mean difference, −0.5; 95% confidence interval, −1.2 to 0.3 hours; &lt;em&gt;P&lt;/em&gt;=.218), which was noninferior within the prespecified 2-hour margin. The score of maternal satisfaction with the allocated vaginal examination experience was significantly lower in the 8-hour arm (median [interquartile range], 8 [7–9] vs 9 [8–9]; &lt;em&gt;P&lt;/em&gt;&lt;.001) (11-point 0-to-10 numerical rating scale). The number of vaginal examinations from labor diagnosis to second stage was median (interquartile range) 1 (1–2) vs 1 (1–2) (&lt;em&gt;P&lt;/em&gt;=.006; mean±standard deviation, 1.4±0.6 vs 1.6±0.8; mean difference, −0.2; 95% confidence interval, −0.1 to −0.4; &lt;em&gt;P&lt;/em&gt;=.007), the oxytocin augmentation rates were 22.0% (28/127) vs 34.6% (44/127) (relative risk, 0.64; 95% confidence interval, 0.42–0.95; &lt;em&gt;P&lt;/em&gt;=.026), the epidural analgesia rates were 7.1% (9/127) vs 15.0% (19/127) (relative risk, 0.47; 95% confidence interval, 0.22–1.00; &lt;em&gt;P&lt;/em&gt;=.045), and the rates of recommendation of the allocated intervention to a friend were 83.5% (106/127) vs 100% (127/127) (&lt;em&gt;P&lt;/em&gt;&lt;.001) in the 8- and 4-hour arms, respectively. In the 8-hour arm, the first vaginal examination was more likely to be indicated by a bearing-down sensation or nonreassuring fetal heart rate tracing, and less likely to be performed as scheduled at 8 hours. The rates of cesarean delivery, maternal fever, perineal injury, and postpartum hemorrhage were not","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 11","pages":"Article 101762"},"PeriodicalIF":3.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972495","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, fetal, and neonatal serious adverse events associated with low-dose aspirin during the first trimester of pregnancy: A secondary analysis of the Aspirin Supplmentation for Pregnancy Indicated Risk Reduction In Nulliparas (ASPIRIN) trial","authors":"Maria J. Rodriguez-Sibaja MD ,&nbsp;Natalia Galvez-Rubalcava MD ,&nbsp;Gonzalo Hagerman-Sucar MD ,&nbsp;Paulina Alcocer-Gonzalez Camarena MD ,&nbsp;Juan R. Gomez-Woodworth MD ,&nbsp;Mara I. Villalpando-Juarez MD ,&nbsp;Sandra Acevedo-Gallegos MDPhD ,&nbsp;Berenice Velazquez-Torres MD, MMSc ,&nbsp;Jose A. Ramirez-Calvo MD, MMSc ,&nbsp;D. Yazmin Copado-Mendoza MD ,&nbsp;Mario I. Lumbreras-Marquez MD, MMSc","doi":"10.1016/j.ajogmf.2025.101768","DOIUrl":"10.1016/j.ajogmf.2025.101768","url":null,"abstract":"<div><h3>Background</h3><div>Low-dose aspirin (LDA) has been shown to reduce the risk of preterm preeclampsia, particularly when initiated early in pregnancy. However, the safety of starting LDA before 11 0/7 weeks of gestation remains unclear.</div></div><div><h3>Objective</h3><div>To assess whether initiating LDA before 11 0/7 weeks of gestation is associated with increased maternal, fetal, or neonatal serious adverse events compared to later initiation.</div></div><div><h3>Study Design</h3><div>This secondary analysis of the ASPIRIN (Aspirin Supplmentation for Pregnancy Indicated Risk Reduction In Nulliparas) trial included 11,879 nulliparous women with singleton pregnancies randomized to receive LDA (81 mg/d) or placebo between 6 0/7–13 6/7 weeks of gestation. Severe adverse events (ie, maternal death, antepartum hemorrhage, postpartum hemorrhage, anemia, preeclampsia or eclampsia, preterm labor, hypertension admission, fever or infection, fetal loss, neonatal death up to 28 days, miscarriage, abortion, or medical termination of pregnancy, and congenital anomalies) were analyzed based on gestational age at LDA initiation (&lt;11 0/7 vs ≥11 0/7 weeks). Furthermore, congenital anomalies were assessed for therapy initiated during the embryonic (ie, &lt;9 0/7 weeks) or fetal period. Interaction tests were performed via logistic regression models on the ASPIRIN trial safety population (ie, participants who received at least one dose of LDA or placebo) and on the subset of participants who had an adherence to the exposure of ≥90%.</div></div><div><h3>Results</h3><div>Among the 11,879 eligible participants for this secondary analysis, 62% (n=7324) initiated the allocated exposure before 11 0/7 weeks vs 38% (n=4555) that initiated LDA or placebo at a later gestational age. Furthermore, in this population, 84.4% (n=10,030) had an adherence to the intervention of 90% or more. Moreover, the proportion of adherence of ≥90% to LDA or placebo was similar between strata (84.6% [n=6195] for &lt;11 0/7 vs 84.2% [n=3835] ≥11 0/7 weeks, <em>P</em>=.570). No significant differences were observed in the maternal, fetal, or neonatal adverse events described above based on the timing of LDA initiation (<em>P</em>&gt;.05 for all interactions). Likewise, congenital anomalies did not significantly differ between embryonic and fetal exposure periods (interaction <em>P</em>-value = .095). Results remained consistent in participants who had an adherence to the exposure of ≥90%.</div></div><div><h3>Conclusions</h3><div>LDA (81 mg/d) initiated before 11 0/7 weeks of gestation may not increase the risk of maternal, fetal, or neonatal serious adverse events or congenital anomalies. These findings provide reassuring evidence of the safety of LDA exposure during early pregnancy.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 11","pages":"Article 101768"},"PeriodicalIF":3.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972537","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":"Pregnancy Characteristics and Outcomes in Monochorionic Diamniotic Twin Pregnancies Complicated by Proximal Placental Cord Insertions From a Single Center","authors":"Shelly Soni MD ,&nbsp;Juliana S. Gebb MD ,&nbsp;Christina Paidas Teefey MD ,&nbsp;Beverly G. Coleman MD ,&nbsp;Julie S. Moldenhauer MD ,&nbsp;Nahla Khalek MD","doi":"10.1016/j.ajogmf.2025.101761","DOIUrl":"10.1016/j.ajogmf.2025.101761","url":null,"abstract":"<div><h3>Background</h3><div>Proximal placental cord insertion (pPCI), defined as a ≤4 cm distance between umbilical cord insertions, is a distinct anomaly observed in monochorionic diamniotic (MCDA) twin pregnancies, characterized by the umbilical cords of both fetuses inserting in close proximity within the placental tissue. There is limited available data on the pregnancy characteristics and outcomes in monochorionic diamniotic twins with proximal placental cord insertions (pPCI).</div></div><div><h3>Objectives</h3><div>To investigate pregnancy characteristics in monochorionic diamniotic (MCDA) twins complicated by pPCI and compare outcomes with nonproximal PCI (nPCI) cases.</div></div><div><h3>Methods</h3><div>Single center retrospective cohort study of MCDA pregnancies evaluated from 2010 to 2023. pPCI was defined as a ≤4 cm distance between cord insertions on standardized prenatal ultrasound. Maternal characteristics, prenatal diagnoses, interventions, and perinatal outcomes were compared between pPCI and nPCI groups. The primary outcome was perinatal loss, defined as no live births or survival of only 1 fetus to hospital discharge. Multivariable logistic regression was performed to identify predictors of adverse outcomes.</div></div><div><h3>Results</h3><div>A total of 59 pregnancies with pPCI and 1319 pregnancies with nPCI were identified. The pPCI group had higher rates of selective fetal growth restriction (sFGR; 42.4% vs 26.3%, <em>p</em>=0.), type III sFGR (20.3% vs 8.8%, <em>p</em>=.009), and abnormal umbilical artery (UA) Dopplers without definitive diagnosis (11.9% vs 0.2%, <em>p</em>&lt;.0001). Twin to twin transfusion syndrome (TTTS) was less common in the pPCI group (23.7% vs 48.2%, <em>p</em>=.0003). Intervention was performed less frequently in pPCI (45.8% vs 58.5%, <em>p</em>=.05), with higher use of radiofrequency ablation (RFA) (37.3% vs 17.1%, <em>p</em>=.0004) and lower use of laser photocoagulation (3.4% vs 38.3%, <em>p</em>&lt;.0001). Overall perinatal loss did not differ significantly (25.9% vs 21.2%, <em>p</em>=.25), but in the intervention subgroup, the pPCI group had significantly higher rates of “no survivors to hospital discharge” (25.9% vs 11.8%, <em>p</em>=.04). pPCI, sFGR, and gestational age at delivery were independently associated with no survivors to hospital discharge.</div></div><div><h3>Conclusion</h3><div>Proximal cord insertion is an uncommon but clinically relevant finding in MCDA twin pregnancies, associated with a distinct prenatal phenotype. While overall perinatal loss was similar, pPCI was independently associated with adverse outcomes following intervention. Early recognition of pPCI may inform risk stratification, surveillance, and counseling in monochorionic pregnancies. Abnormal UA Dopplers in the absence of other monochorionic pathology should prompt consideration of pPCI.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 10","pages":"Article 101761"},"PeriodicalIF":3.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972498","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":"First-trimester combined screening for preeclampsia in twin pregnancies—results of the first 100 twin pregnancies included in the IPSISS (Implementing Preeclampsia Screening in Switzerland) cohort","authors":"Cécile Monod MD ,&nbsp;Fabienne Trottmann MD ,&nbsp;Luigi Raio MD ,&nbsp;Pauline Challande MD ,&nbsp;Sofia Amylidi-Mohr MD ,&nbsp;Thabea Musik MD ,&nbsp;Cristina Granado MD ,&nbsp;Lysann Hildebrandt MD ,&nbsp;Daniel Surbek MD ,&nbsp;Begoña Martinez de Tejada MD ,&nbsp;Sonia Campelo MD ,&nbsp;Carolin Blume MD ,&nbsp;Martin Hänel MD ,&nbsp;Leonhard Schäffer MD ,&nbsp;Amr Hamza MD ,&nbsp;Anett Hernadi MD ,&nbsp;Joachim Kohl MD ,&nbsp;Markus Hodel MD ,&nbsp;Sara Ardabili MD ,&nbsp;Gwendolin Manegold-Brauer MD ,&nbsp;Beatrice Mosimann MD","doi":"10.1016/j.ajogmf.2025.101760","DOIUrl":"10.1016/j.ajogmf.2025.101760","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;Preeclampsia is more common in twin pregnancies than in singleton pregnancies. First-trimester combined screening, including maternal risk factors, uterine artery pulsatility index, mean arterial pressure, and placental growth factor, is possible in twin pregnancies. However, the performance is reported to be inferior compared with that in singletons.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;This study aimed to assess the performance of preeclampsia screening in the first 100 twin pregnancies included in the Implementing Preeclampsia Screening in Switzerland Study cohort in Switzerland.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;This is a prospective multicenter registry study performed in Switzerland, including all twin and singleton pregnancies included in the registry with complete screening parameters and outcome data, between June 2020 and June 2024. A total of 3263 singleton and 104 twin pregnancies were included in this analysis. Pregnancies considered at risk for preterm preeclampsia were prescribed low-dose aspirin according to local guidelines. All parameters were converted to multiples of medians by the online calculator on the Fetal Medicine Foundation website (The Fetal Medicine Foundation, Calculators, Research Tools [&lt;span&gt;&lt;span&gt;https://fetalmedicine.org/research/peRisk&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;]). Parameters were compared between singleton, monochorionic, and dichorionic twins. Statistical analysis was performed using GraphPad Prism 10.0 for Windows. Continuous variables were analyzed using the Student &lt;em&gt;t&lt;/em&gt; test or Mann–Whitney U-test, whereas proportions were evaluated using the Fisher exact test or chi-squared test and the Kruskal–Wallis test.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;The incidence of preterm preeclampsia in singleton pregnancies with live births was 29 of 3221 (0.9%) as opposed to 5 of 101 (5.0%) in twins. In uneventful pregnancies, median mean arterial pressure (interquartile range) was significantly higher in monochorionic twins compared with singletons, but not in dichorionic twins (88.5 [85.4–98.0] vs 86.3 [81.0–91.5] mm Hg; &lt;em&gt;P&lt;/em&gt;=.005). Median uterine artery pulsatility index (interquartile range) was significantly lower in dichorionic twins compared with singletons and monochorionic twins (1.40 [1.05–1.65] vs 1.50 [1.20–1.9] [&lt;em&gt;P&lt;/em&gt;=.0006] and 1.60 [1.35–1.80] [&lt;em&gt;P&lt;/em&gt;=.022], respectively). Median PlGF (interquartile range) was significantly higher in dichorionic twins than in singletons, but not in monochorionic twins (55.0 [43.5–79.1] vs 41.0 [31.0–53.8] pg/mL; &lt;em&gt;P&lt;/em&gt;&lt;.0001), and median PAPP-A (interquartile range) was significantly higher in both dichorionic and monochorionic twins compared with singletons (9.72 [5.12–14.06] and 6.89 [4.13–11.59] vs 3.25 [1.81–5.15] IU/L [&lt;em&gt;P&lt;/em&gt;&lt;.0001], respectively). In twin pregnancies that later developed preterm preeclampsia, PlGF multiples of the median (interquartile range) were significantly lower ","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 10","pages":"Article 101760"},"PeriodicalIF":3.1,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883926","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":"Duality and the divine: the symbolism and suspicion of twins in ancient Greece and Rome","authors":"Marisa Squillante PhD ,&nbsp;Gabriele Saccone MD, PhD","doi":"10.1016/j.ajogmf.2025.101758","DOIUrl":"10.1016/j.ajogmf.2025.101758","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 10","pages":"Article 101758"},"PeriodicalIF":3.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875607","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}