{"title":"Letter to the editor regarding “Comparative effectiveness of low-molecular-weight heparin (LMW-Heparin) on live birth for recurrent spontaneous abortion: systematic review and network meta-analysis”","authors":"Paul Claman MD","doi":"10.1016/j.ajogmf.2025.101719","DOIUrl":"10.1016/j.ajogmf.2025.101719","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 8","pages":"Article 101719"},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250055","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 twin‐to‐twin transfusion syndrome: update and current challenges","authors":"Hanane Bouchghoul MD, PhD , Hugo Madar MD, PhD , Aurélien Mattuizzi MD , Frédéric Coatleven MD , Marie Vincienne MD , Perrine Prier MD , Alizée Froeliger MD , Loïc Sentilhes MD, PhD","doi":"10.1016/j.ajogmf.2025.101714","DOIUrl":"10.1016/j.ajogmf.2025.101714","url":null,"abstract":"<div><div>Since a 2004 randomized trial established fetoscopy as the gold standard for the treatment for twin-to-twin transfusion syndrome (TTTS), advancements in surgical technique and expert training have considerably improved survival rates to 89% for at least one fetus and 65% for both fetuses. However, many challenges remain. This review provides an update on the current principles, issues, and debates. The Solomon technique has helped improve neonatal outcomes by reducing the risks of postoperative twin anemia-polycythemia sequence and TTTS recurrence. Nevertheless, fetoscopic laser photocoagulation is associated with significant obstetrical risks, including preterm premature rupture of membranes, preterm delivery, and even placental abruption. Additionally, fetal growth restriction, observed in 30% to 50% of cases, may adversely affect double survival rates following fetoscopy, particularly when abnormal Doppler indices are present. Gestational age (GA) at the time of fetoscopy is a critical prognostic factor, as earlier GA is associated with lower survival rates. This consideration raises questions about the optimal timing of the procedure after TTTS diagnosis. Emerging evidence supports expectant management with close ultrasound monitoring for asymptomatic patients with stage I TTTS. In stage III and IV TTTS, laser photocoagulation should not be delayed, whereas stage II TTTS diagnosed at very early GAs might benefit from expectant management until 16 to 17 weeks of gestation. Further advancements, such as flexible video fetoscopy and computer-assisted fetal laser surgery, represent the next frontier in addressing these challenges.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 8","pages":"Article 101714"},"PeriodicalIF":3.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250058","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}
Raneen Abu Shqara MD , Lior Lowenstein MD , Maya Frank Wolf MD
{"title":"Letter in reply to: 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 , Lior Lowenstein MD , Maya Frank Wolf MD","doi":"10.1016/j.ajogmf.2025.101718","DOIUrl":"10.1016/j.ajogmf.2025.101718","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 9","pages":"Article 101718"},"PeriodicalIF":3.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250051","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":"Antenatal dexamethasone vs betamethasone on glycemic control in mild gestational diabetes: a randomized clinical trial","authors":"Fathimath Shamaa Shareef MObGyn, Jesrine Hong MObGyn, Rahmah Saaid MObGyn, Mukhri Hamdan MObGyn, PhD, Siti Zawiah Omar MObGyn, Peng Chiong Tan PhD","doi":"10.1016/j.ajogmf.2025.101715","DOIUrl":"10.1016/j.ajogmf.2025.101715","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Preterm birth and gestational diabetes mellitus are common complications of pregnancy. A widely known side effect of antenatal corticosteroids on fetal maturity in preterm births is maternal hyperglycemia. The choice of antenatal corticosteroid regimens between dexamethasone and betamethasone highly depends on local availability and cost, as current but inconclusive evidence shows similar neonatal outcomes for both regimes.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to compare four 6.0-mg doses of antenatal dexamethasone administered 12 hours apart vs two 11.4-mg doses of antenatal betamethasone administered 24 hours apart in medical nutrition therapy–controlled gestational diabetes mellitus cases on maternal glycemic response for up to 3 consecutive days after administration.</div></div><div><h3>STUDY DESIGN</h3><div>This was a randomized controlled clinical trial conducted between February 2021 and August 2023 at a tertiary university hospital in Malaysia. Pregnant participants with diet-controlled gestational diabetes mellitus and prescribed antenatal corticosteroid were randomized to either four 6.0-mg doses of dexamethasone administered 12 hours apart or two 11.4-mg doses of betamethasone administered 24 hours apart. Self-monitoring of capillary blood glucose level (6 points per 24 hours: 2 hours before and after a meal for the 3 main meals) was started after the first dose of allocated antenatal corticosteroid. Hyperglycemia was defined as a fasting or premeal glucose level of ≥5.3 mmol/L (≤95 mg/dL) or a 2-hour postmeal glucose level of ≥6.7 mmol/L (120 mg/dL). The primary outcomes were number of hyperglycemic episodes within the first and second 24 hours after antenatal corticosteroid administration. Analyses were performed using the <em>t</em> test, Mann-Whitney <em>U</em> test, and chi-square test, as appropriate.</div></div><div><h3>RESULTS</h3><div>The median hyperglycemic episodes were similar between the dexamethasone group and the betamethasone group: 4.0 (interquartile range, 2.3–5.0) vs 4.0 (interquartile range, 3.5–5.0), respectively, on day 1 (<em>P</em>=.168), 4.0 (interquartile range, 3.0–5.0) vs 5.0 (interquartile range, 4.0–5.0), respectively, on day 2 (<em>P</em>=.002), and 1.0 (interquartile range, 0.0–2.0) vs 2.0 (interquartile range, 1.0–3.0), respectively, on day 3 (<em>P</em><.001). In addition, the median blood glucose levels were significantly lower in the dexamethasone group than in the betamethasone group on days 1, 2, and 3 (day 1: 6.3 [interquartile range, 5.8–7.0] vs 6.7 [interquartile range, 6.3–7.0], respectively; <em>P</em>=.016; day 2: 6.4 [interquartile range, 6.0–6.9] vs 6.7 [interquartile range, 6.3–7.2], respectively; <em>P</em>=.001; day 3: 5.2 [interquartile range, 4.8–5.5] vs 5.7 [interquartile range, 5.4–6.0], respectively; <em>P</em><.001). The mean blood glucose levels were higher in the betamethasone group than in the dexamethasone group on day 1 to","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 8","pages":"Article 101715"},"PeriodicalIF":3.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235442","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}
Teresa C. Logue MD, MPH , Fabrizio Zullo MD , Fiamma van Biema MA , Moeun Son MD, MSCI , Lauren London MD , Sneha Paranandi MD , Anthony C. Sciscione DO , Giuseppe Rizzo MD , Daniele Di Mascio MD , Suneet P. Chauhan MD, Hon DSc
{"title":"Erratum to ‘High- vs low-dose oxytocin regimens for labor augmentation: a systematic review and meta-analysis’. American Journal of Obstetrics & Gynecology MFM/ Volume 7 Issue 2 (February 2025)/ 101604","authors":"Teresa C. Logue MD, MPH , Fabrizio Zullo MD , Fiamma van Biema MA , Moeun Son MD, MSCI , Lauren London MD , Sneha Paranandi MD , Anthony C. Sciscione DO , Giuseppe Rizzo MD , Daniele Di Mascio MD , Suneet P. Chauhan MD, Hon DSc","doi":"10.1016/j.ajogmf.2025.101685","DOIUrl":"10.1016/j.ajogmf.2025.101685","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 7","pages":"Article 101685"},"PeriodicalIF":3.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250049","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}
Gabriella D. Cozzi-Glaser MD , Allison M. Davis MD , Megan Bell MLIS, AHIP , Ashley N. Battarbee MD, MSCR
{"title":"Pregnancy outcomes following diabetic ketoacidosis: a systematic review","authors":"Gabriella D. Cozzi-Glaser MD , Allison M. Davis MD , Megan Bell MLIS, AHIP , Ashley N. Battarbee MD, MSCR","doi":"10.1016/j.ajogmf.2025.101711","DOIUrl":"10.1016/j.ajogmf.2025.101711","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The primary objective of this systematic review was to evaluate pregnancy outcomes following at least 1 episode of diabetic ketoacidosis in patients with gestational or pregestational diabetes mellitus.</div></div><div><h3>DATA SOURCES</h3><div>An electronic search of English-language publications in PubMed, Embase, Web of Science, and Google Scholar covered the period from January 1990 to June 2023.</div></div><div><h3>STUDY ELIGIBILITY CRITERIA</h3><div>The eligibility criteria included randomized clinical trials or observational studies (ie, cohort studies, case–control studies) of patients with diabetic ketoacidosis in pregnancy and evaluation of maternal or neonatal outcomes. Systematic reviews, expert reviews, case reports, case series, animal studies, non–peer-reviewed publications, abstract-only publications, and publications without available full-text articles were excluded.</div></div><div><h3>METHODS</h3><div>Each study was reviewed in detail by 2 coauthors. The quality of each study was appraised using the Cochrane RoB 2 risk-of-bias tool for randomized trials and the JBI Critical Appraisal tools for cohort and case–control analyses.</div></div><div><h3>RESULTS</h3><div>Of the 1313 studies identified through data search, 7 met the final inclusion criteria. Study heterogeneity precluded any meta-analysis. High rates of adverse maternal and neonatal outcomes were found among those with at least 1 episode of diabetic ketoacidosis in pregnancy, with the following incidence rates: 7% to 35% for stillbirth, 49% to 64% for cesarean delivery, 25% to 83% for preterm birth, and 40% to 65% for neonatal intensive care unit admission. The most recent studies note a stillbirth rate of 7% to 31%, with most analyses finding a rate <17%.</div></div><div><h3>CONCLUSION</h3><div>There is a paucity of well-designed studies evaluating pregnancy outcomes associated with diabetic ketoacidosis. Maternal and fetal outcomes following diabetic ketoacidosis remain poor, although stillbirth may be incrementally decreasing over time. As diabetes care and diabetic ketoacidosis management advance, future retrospective and prospective analyses should evaluate the management and outcomes of diabetic ketoacidosis.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 8","pages":"Article 101711"},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188232","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}
Mukhri Hamdan MObGyn, PhD, Thai Ying Wong MBBS, MRCOG, Peng Chiong Tan FRCOG, PhD
{"title":"Reply to: Regarding “Tugging the Foley catheter balloon every three hours in induction of labor after one previous cesarean: a randomized controlled trial”1","authors":"Mukhri Hamdan MObGyn, PhD, Thai Ying Wong MBBS, MRCOG, Peng Chiong Tan FRCOG, PhD","doi":"10.1016/j.ajogmf.2025.101708","DOIUrl":"10.1016/j.ajogmf.2025.101708","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 8","pages":"Article 101708"},"PeriodicalIF":3.8,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188209","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}