American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Risk factors of uterine rupture in individuals attempting trial of labor after cesarean in the setting of stillbirth","authors":"Alyssa Savelli Binsted MD, MS, Elizabeth Miller MD, George Saade MD, Tetsuya Kawakita MD, MS","doi":"10.1016/j.ajogmf.2025.101675","DOIUrl":"10.1016/j.ajogmf.2025.101675","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 6","pages":"Article 101675"},"PeriodicalIF":3.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732113","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":"Glucose time in range trajectories during pregnancy and association with adverse perinatal outcomes: a joint latent-class trajectory modeling approach","authors":"Sara M. Sauer PhD ,&nbsp;Isabel Fulcher PhD ,&nbsp;Ayodeji Sanusi MD ,&nbsp;Ashley N. Battarbee MD","doi":"10.1016/j.ajogmf.2025.101669","DOIUrl":"10.1016/j.ajogmf.2025.101669","url":null,"abstract":"<div><h3>Background</h3><div>While time in range (TIR) summarized over pregnancy is associated with adverse outcomes among individuals with preexisting type 1 or 2 diabetes, the impact of TIR trajectories with advancing gestation is unknown.</div></div><div><h3>Objective</h3><div>To identify glucose TIR trajectories across pregnancy and evaluate their association with perinatal outcomes among patients with preexisting diabetes.</div></div><div><h3>Study Design</h3><div>Retrospective, single-center cohort study of pregnant patients with type 1 or 2 diabetes who used continuous glucose monitoring (CGM) and delivered in 2019 to 2023. Weekly TIR (65-140 mg/dL) was computed starting at 10 weeks’ gestation, and joint latent-class trajectory modeling identified discrete TIR trajectory groups. Patients were classified into groups, and multivariable logistic regression estimated the associations between groups and perinatal outcomes.</div></div><div><h3>Results</h3><div>Of 179 pregnant patients, 91 had type 1 and 88 had type 2 diabetes. We identified four TIR trajectory groups using data from over 5.1 million CGM measurements: (1) good control, stable (<em>n</em>=48), (2) moderate control, initial improvement, and late decline (<em>n</em>=22), (3) moderate control, late improvement (<em>n</em>=63), and (4) poor control, initial worsening and late improvement (<em>n</em>=46). All perinatal outcomes differed by TIR trajectory. Groups 2, 3, and 4 with suboptimal control in early pregnancy were associated with higher odds of preterm birth, indicated preterm birth, and NICU admission, compared to group 1. Groups 3 and 4, which had the lowest TIR during second and early third trimesters, were associated with higher odds of large-for-gestational-age (LGA). Only group 4 was associated with higher odds of preeclampsia and neonatal hypoglycemia.</div></div><div><h3>Conclusion</h3><div>Achieving glycemic control in the second and early third trimesters during fetal and placental growth and development is important to reduce the risk of adverse pregnancy outcomes, particularly LGA. Third-trimester TIR decline may impact risk of preterm birth and NICU admission.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 6","pages":"Article 101669"},"PeriodicalIF":3.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651199","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 impact of an informative video on anxiety levels in women undergoing term induction of labor: a randomized controlled trial","authors":"Matan Friedman MD,&nbsp;Liat Mor MD,&nbsp;Irit Segman MD,&nbsp;Yossi Mizrachi MD,&nbsp;Noa Ben Shushan MD,&nbsp;Hagit Eisenberg MD,&nbsp;Tamar Shieldkrot MD,&nbsp;Eran Weiner MD,&nbsp;Giulia Barda MD","doi":"10.1016/j.ajogmf.2025.101667","DOIUrl":"10.1016/j.ajogmf.2025.101667","url":null,"abstract":"<div><h3>Background</h3><div>Induction of labor (IOL) is frequently performed worldwide. While IOL is often medically necessary to improve maternal and neonatal outcomes, the process can be associated with considerable anxiety, particularly for nulliparous women.</div></div><div><h3>Objective</h3><div>To evaluate the impact of an informative educational video on anxiety levels among women undergoing term IOL.</div></div><div><h3>Methods</h3><div>This randomized controlled trial included 167 women who underwent term IOL at a single medical center between April 2024 and August 2024. Participants in the “video group” (<em>n</em>=81) watched an 8-minute animated video detailing IOL methods and risks in addition to standard counseling. Participants in the control group (<em>n</em>=86) only received standard counseling. Anxiety levels were measured using the State-Trait Anxiety Inventory (STAI) before and after the procedure. The primary outcome was the change in STAI scores. Secondary outcomes including patient satisfaction, as reported on a scale of one to five.</div></div><div><h3>Results</h3><div>Baseline STAI scores before receiving any counseling regarding IOL were similar between the study groups. Postprocedure, women allocated to the video group demonstrated lower anxiety levels compared to women in the control group (38.9±11.0 vs 44.1±11.3, <em>P</em>=.002). Moreover, the decrease in STAI scores was greater in the video group (4.4±7.9 vs 0.6±10.0, <em>P</em>=.007). Multivariate analysis confirmed that the video intervention was independently associated with reduced anxiety (<em>β</em> –7.8, 95% CI –15.1 to –0.5). Finally, Patient satisfaction was also higher in the video group (4.4±0.6 vs 4.1±0.9, <em>P</em>=.018).</div></div><div><h3>Conclusion</h3><div>An informative educational video prior to IOL is an effective, low-cost intervention for reducing patient anxiety and improving satisfaction during labor induction.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 6","pages":"Article 101667"},"PeriodicalIF":3.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651227","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":"Reduced odds of severe maternal morbidity associated with the US Affordable Care Act dependent coverage provision","authors":"Jean Guglielminotti MD, PhD ,&nbsp;Jamie R. Daw PhD ,&nbsp;Alexander M. Friedman MD, MPH ,&nbsp;Goleen Samari PhD ,&nbsp;Guohua Li MD, DrPH","doi":"10.1016/j.ajogmf.2025.101668","DOIUrl":"10.1016/j.ajogmf.2025.101668","url":null,"abstract":"<div><h3>Background</h3><div>Continuous perinatal health insurance coverage is a policy intervention that may help reduce severe maternal morbidity (SMM) and racial and ethnic disparities in SMM in the United States. The <em>Affordable Care Act</em> Dependent Coverage Provision (DCP) allowed young adults to remain on their parent's private health insurance plan until their 26^th birthday but its effectiveness in reducing SMM has not been evaluated.</div></div><div><h3>Objective</h3><div>To assess the association of the DCP with SMM during delivery hospitalization.</div></div><div><h3>Study design</h3><div>Difference-in-differences analysis of US delivery hospitalizations from January 2006 to September 2015, stratified according to maternal race and ethnicity. The outcome was SMM exclusive of blood transfusion only, as defined by the Centers for Disease Control and Prevention criteria. The exposure was maternal age categorized into 21 to 25 years (covered by the DCP) and 27 to 31 years (not covered the DCP). The intervention was the DCP categorized into pre- and post-DCP periods (January 2006-September 2010 and October 2010-September 2015, respectively).</div></div><div><h3>Results</h3><div>Of the 4,007,937 delivery hospitalizations in the sample, 22,540 (56.2 per 10,000) recorded SMM. For birthing people aged 21 to 25 years (covered by the DCP), the mean SMM rate was 48.9 per 10,000 during the pre-DCP period and 58.2 per 10,000 during the post-DCP period (crude difference: 9.3 per 10,000). For birthing people aged 27 to 31 years (not covered the DCP), the mean SMM rate was 53.4 per 10,000 during the pre-DCP period and 63.6 per 10,000 during the post-DCP period (crude difference: 10.2 per 10,000). Implementation of DCP was associated with a 1.2% (95% CI: −3.6, 1.3) relative decrease in the mean SMM rate (adjusted odds ratio (aOR): 0.988; 95% CI: 0.964, 1.013). For non-Hispanic White people, the DCP was associated with a 10.7% (95% CI: 7.1, 14.2) relative decrease in the mean SMM rate (aOR: 0.893; 95% CI: 0.858, 0.929). The DCP was associated with an increase in the proportion of privately insured (aOR: 1.225; 95% CI: 1.220, 1.231), a decrease in the proportion of Medicaid beneficiaries (aOR: 0.853; 95% CI: 0.849, 0.856), and a decrease in the proportion of uninsured (aOR: 0.807; 95% CI: 0.798, 0.816).</div></div><div><h3>Conclusions</h3><div>Maternal health benefit of the DCP appears to be limited to non-Hispanic White birthing people.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 6","pages":"Article 101668"},"PeriodicalIF":3.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626409","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 about “The essential role of the nurse in supporting childbirth”","authors":"Tatiana Isabel Vásquez Figueroa MSc,&nbsp;Doris Mariela Morales Córdova MSc,&nbsp;Lilia Jannet Saldarriaga Sandoval PhD","doi":"10.1016/j.ajogmf.2025.101664","DOIUrl":"10.1016/j.ajogmf.2025.101664","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 6","pages":"Article 101664"},"PeriodicalIF":3.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597943","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":"External cephalic version in twin pregnancies with non–vertex-presenting twin","authors":"Zvi Ehrlich MD,&nbsp;Vladimir Plotkin MD,&nbsp;Shirly Shapiro MD,&nbsp;Ari Weiss MD, MPH,&nbsp;Alexander Ioscovich MD,&nbsp;Sorina Grisaru-Granovsky MD, PhD,&nbsp;Misgav Rottenstreich MBA, MD,&nbsp;Hen Y. Sela MD","doi":"10.1016/j.ajogmf.2025.101663","DOIUrl":"10.1016/j.ajogmf.2025.101663","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 5","pages":"Article 101663"},"PeriodicalIF":3.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587592","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":"Breast stimulation vs low dose oxytocin for labor augmentation in women with a previous cesarean delivery, a randomized controlled trial","authors":"Raneen Abu Shqara MD ,&nbsp;Gabriela Goldinfeld MD ,&nbsp;Tikva Assulyn MD ,&nbsp;Inshirah Sgayer MD ,&nbsp;Nadir Ganem MD ,&nbsp;Lior Lowenstein MD ,&nbsp;Maya Frank Wolf MD","doi":"10.1016/j.ajogmf.2025.101658","DOIUrl":"10.1016/j.ajogmf.2025.101658","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Oxytocin and breast stimulation are methods used for labor augmentation in women with a previous cesarean delivery (CD). Compared to spontaneous labor, labor augmentation has been shown to increase the risk of uterine rupture in women with a previous CD. The optimal method of labor augmentation for women with a prior CD has not been established.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;In a cohort of patients with one previous CD, we aimed to compare maternal and neonatal outcomes according to the method of labor augmentation; breast stimulation or intravenous oxytocin.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;This randomized controlled trial (RCT) was conducted at a single, tertiary, university-affiliated hospital. The participants had one previous CD and a cervical dilatation of 2 to 6 cm, had inadequate uterine contractions, defined as less than 3 per 10 minutes, and were candidates for labor augmentation. They were randomized for augmentation by breast stimulation using a breast pump, or by intravenous low-dose oxytocin starting at 0.5 to 2 milliunits/min and increasing incrementally by 1 to 2 milliunits/min every 15 to 40 minutes. An intrauterine pressure catheter was inserted. Both augmentation treatments were continued for a maximum of 12 hours. If active labor did not occur within 12 hours, the intervention was deemed a failure. An intention-to-treat analysis was performed. The co-primary outcomes were the time from augmentation to delivery, and uterine contraction intensity as measured by Montevideo units (MVU). Secondary outcomes included intervention failure, meconium-stained amniotic fluid, vaginal delivery after cesarean section, uterine rupture, infectious outcomes, postpartum hemorrhage, and maternal hospitalization length. The neonatal outcomes included: Apgar score at 5 minutes, umbilical cord pH&lt;7.1, neonatal intensive care unit admission, asphyxia, and perinatal death.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The breast stimulation and the intravenous oxytocin groups included 33 and 34 patients, respectively. The participants’ demographic and obstetric characteristics were similar. The median time from augmentation to delivery was longer in the breast stimulation than the oxytocin group: 10.9 hours (total range 1.5–63.2) vs 5.1 hours (0.8–30), &lt;em&gt;P&lt;/em&gt;&lt;.001. The median (range) contraction intensity as measured by MVU was similar between the groups in the first stage of labor, 125 (70–270) vs 180 (80–280), &lt;em&gt;P&lt;/em&gt;=.110; and in the second stage of labor, 145 (30–280), vs 175 (50–290), &lt;em&gt;P&lt;/em&gt;=.164. The tachysystole rate was lower, with statistical significance, in the breast stimulation than the oxytocin group, 6% vs 27%, &lt;em&gt;P&lt;/em&gt;=.044; while the rates of tachysystole-associated nonreassuring fetal heart rates did not differ significantly, 6% vs 21%, &lt;em&gt;P&lt;/em&gt;=.427. Similar proportions of patients delivered within 24 hours of intervention. Uterine rupture occurred in two patients in the ox","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 5","pages":"Article 101658"},"PeriodicalIF":3.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587579","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”","authors":"Muhammad Ilham Aldika Akbar MD, PhD,&nbsp;Gustaaf Dekker MD, PhD","doi":"10.1016/j.ajogmf.2024.101585","DOIUrl":"10.1016/j.ajogmf.2024.101585","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 3","pages":"Article 101585"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956174","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 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":"Elvira di Pasquo MD,&nbsp;Tullio Ghi MD, PhD","doi":"10.1016/j.ajogmf.2025.101601","DOIUrl":"10.1016/j.ajogmf.2025.101601","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 3","pages":"Article 101601"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013157","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":"Nonsevere hypertensive disorders of pregnancy and oral antihypertensive medications: an argument in favor of use","authors":"Lorena Carolina Martinez-King MD, MAS,&nbsp;Leah M Savitsky MD,&nbsp;Sherill Rose MD,&nbsp;Catherine Albright MD, MS","doi":"10.1016/j.ajogmf.2024.101561","DOIUrl":"10.1016/j.ajogmf.2024.101561","url":null,"abstract":"<div><div>Hypertensive disorders of pregnancy are a common complication of pregnancy and a major contributor to both immediate and long-term morbidity and mortality. Recent data support the treatment of chronic hypertension during pregnancy to a blood pressure goal of &lt;140/90 mmHg. Treatment of severe range blood pressures (<span><math><mo>≥</mo></math></span>160/110 mmHg) in the setting of gestational hypertension is recommended to prevent severe morbidity and mortality; however, there remains clinical equipoise regarding treatment of gestational hypertension with blood pressures <span><math><mo>≥</mo></math></span>140/90 but &lt;160/110. While there is limited data to support the treatment of gestational hypertension, we believe that treatment of gestational hypertension to a blood pressure of &lt;140/90, similar to the recommendations for chronic hypertension, will lead to a reduction in severe maternal and neonatal morbidity and mortality related to hypertensive disorders of pregnancy. In this expert review, we summarize the available data regarding the treatment of gestational hypertension and offer recommendations for the treatment of gestational hypertension based on our clinical experience.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 1","pages":"Article 101561"},"PeriodicalIF":3.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740871","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}