American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Factors associated with the uptake of prenatal repair for fetal myelomeningocele","authors":"Daniel R. Liesman MD, Steven T. Papastefan MD, Manmeet Singh MS, Amir M. Alhajjat MD, Aimen F. Shaaban MD, Ashish Premkumar MD, PhD","doi":"10.1016/j.ajogmf.2026.101902","DOIUrl":"10.1016/j.ajogmf.2026.101902","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101902"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067362","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 “A simple data-driven dietary pattern associated with lower risk for adverse pregnancy outcomes”","authors":"Zhicheng Du PhD","doi":"10.1016/j.ajogmf.2026.101899","DOIUrl":"10.1016/j.ajogmf.2026.101899","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101899"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709637","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":"Time in range achieved with continuous glucose monitoring in pregnant patients with type 2 diabetes and barriers to achieving high time in range","authors":"Annkay Alexander MD, Amber Sanders, Claire McIlwraith MD, Brian Brocato MD, Ashley Battarbee MD, MSCR","doi":"10.1016/j.ajogmf.2025.101856","DOIUrl":"10.1016/j.ajogmf.2025.101856","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101856"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709644","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":"Azithromycin to improve latency in examination-indicated cerclage: a multicenter randomized controlled trial","authors":"Jenani S. Jayakumaran MD , Kavisha Khanuja MD , Stephanie A. Fischer MD, MPH , Emily S. Miller MD, MPH , Emily B. Rosenfeld DO , Justin S. Brandt MD , Megan Piacquadio MD , Adeeb Kalifeh MD , Rupsa C. Boelig MD","doi":"10.1016/j.ajogmf.2025.101818","DOIUrl":"10.1016/j.ajogmf.2025.101818","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Physical examination–indicated cerclage is an intervention offered to prolong pregnancy in the setting of painless cervical dilation before 24 weeks of gestation. Of note, 1 randomized clinical trial showed an increased incidence of pregnancy prolongation by at least 28 days among participants who received perioperative indomethacin and cefazolin in the setting of a physical examination–indicated cerclage compared with those who did not receive those perioperative medications. Prospective studies have suggested that prophylactic azithromycin may increase latency in the setting of cervical shortening. However, this has not been studied in a controlled manner in patients undergoing physical examination–indicated cerclage.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to determine whether the addition of perioperative azithromycin to cefazolin and indomethacin for physical examination–indicated cerclage increases the latency to delivery compared with perioperative cefazolin and indomethacin alone.</div></div><div><h3>STUDY DESIGN</h3><div>This was an open-label multicenter randomized controlled trial of individuals with singleton gestations who were undergoing a physical examination–indicated cerclage between December 2021 and September 2023 at 4 sites across the United States. This study was approved by the institutional review board and was registered on ClinicalTrials.gov (registration number: NCT05132829). Participants were randomized 1:1 via a computer-generated randomization sequence stratified by site to standard of care (cefazolin 1–2 g intravenously and indomethacin 50 mg preoperatively followed by 2 additional doses at 8 and 16 hours postoperatively, control arm) or standard of care plus azithromycin (azithromycin 1000 mg intravenously in addition to cefazolin and indomethacin described in the control group, azithromycin arm). The primary outcome was gestational latency (days) from cerclage placement to delivery. The secondary outcomes included preterm birth, gestational age at delivery, chorioamnionitis, and neonatal morbidity and mortality.</div></div><div><h3>RESULTS</h3><div>A total of 82 pregnant individuals were assessed for eligibility, and 54 participants were randomized, 27 to the control arm and 27 to the azithromycin arm. In the primary intention-to-treat analysis, the median gestational latency from cerclage placement to delivery did not differ between the intervention and control groups (92 days [interquartile range, 45–118] vs 85 [interquartile range, 20–123] days, respectively; <em>P</em>=.93). Furthermore, there was no statistically significant difference found in any of the secondary obstetrical or neonatal outcomes.</div></div><div><h3>CONCLUSION</h3><div>A single perioperative dose of azithromycin in addition to standard of care cefazolin and indomethacin does not improve the latency to delivery or other perinatal outcomes compared with standard of care alone in patients with single","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101818"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369032","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 risk stratification algorithm for placenta accreta spectrum","authors":"Alesha White MD , Jessica E. Pruszynski PhD , Quyen N. Do PhD , Diane M. Twickler MD , Catherine Y. Spong MD , Christina L. Herrera MD","doi":"10.1016/j.ajogmf.2026.101891","DOIUrl":"10.1016/j.ajogmf.2026.101891","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Antenatal diagnosis of placenta accreta spectrum is imperfect, with cases undiagnosed before delivery, resulting in suboptimal outcomes. Currently, there is no agreed-upon standardized protocol for risk stratification of placenta accreta spectrum. Most patients are identified in the second or third trimester of pregnancy, although findings on first-trimester ultrasound may be associated with the development of placenta accreta spectrum. To date, there is no recommended risk stratification algorithm that applies first-trimester findings in a systematic manner with outcome data.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to develop a risk stratification algorithm for placenta accreta spectrum in the first trimester of pregnancy in symptomatic patients.</div></div><div><h3>STUDY DESIGN</h3><div>A retrospective observational study of first-trimester sonograms between January 2021 and February 2024 compared the performance of low implantation with previous cesarean delivery to a newly developed risk stratification algorithm. Low implantation was diagnosed when the distance of the inferior border of trophoblastic change or the border of the gestational sac was ≤5 cm from the external os on ultrasound imaging. Pregnancies were analyzed based on gestational sac location (<10 weeks of gestation) or decidual basalis (≥10 weeks of gestation) and the smallest myometrial thickness to assess placenta accreta spectrum risk. Test parameters of low implantation and the new risk stratification algorithm were calculated. Interreader variability of the smallest myometrial thickness measurement using the kappa statistic and the McNemar test was performed.</div></div><div><h3>RESULTS</h3><div>Of 6213 patients with first-trimester sonography and known delivery outcome, 1252 had a previous cesarean delivery. Moreover, 257 of 1252 patients (20.5%) had low implantation. Of the 12 patients with confirmed placenta accreta spectrum, 10 had low implantation. The sensitivity, specificity, and positive predictive value of low implantation for placenta accreta spectrum were 83.3%, 80.0%, and 3.8%, respectively. Of the 257 patients, 245 had adequate images to test the new algorithm. Of the 245 patients, 10 (4.1%) screened positive. Placenta accreta spectrum was confirmed in 9 of 10 patients with positive screens, with sensitivity, specificity, and positive predictive value for placenta accreta spectrum of 90.0%, 99.6%, and 90.0%, respectively. Weighted kappa statistic of 0.65 (95% confidence interval, 0.46–0.83) and a McNemar test <em>P</em> value of .24 indicated substantial agreement.</div></div><div><h3>CONCLUSION</h3><div>Our first-trimester risk stratification algorithm was more sensitive and specific for placenta accreta spectrum with higher positive predictive value when compared to low implantation with previous cesarean delivery alone. In addition, interreader agreement was high. Future prospective studies to validate this ris","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101891"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020110","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 “Prenatal sonographic predictors of maternal mirror syndrome in hydropic fetuses”","authors":"Ricardo Tudisco MD, Pauline Latapie MD, Alexandra Benachi MD, PhD, Alexandre J. Vivanti MD, PhD","doi":"10.1016/j.ajogmf.2026.101908","DOIUrl":"10.1016/j.ajogmf.2026.101908","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101908"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709638","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":"Erratum to When the first hour counts: critical transfusion and transient uncontrolled bleeding in placenta accreta spectrum hysterectomy American Journal of Obstetrics & Gynecology MFM Volume 8, Issue 1, January 2026, 101834","authors":"Shubhangi Singh MBBS, Lindsay Tremper MD, Christopher DeBarge MD, David E. Arnolds MD, Thomas T. Klumpner MD, Michael Taylor MD, AnneMarie Opipari MD, Shitanshu Uppal MBBS, Aimee Rolston MD, Yuan Yuan MS, Graciela Mentz PhD, Nicholas J. Douville MD, Milo Engoren MD, Shih-Hon Li MD, Carlo Pancaro MD","doi":"10.1016/j.ajogmf.2026.101906","DOIUrl":"10.1016/j.ajogmf.2026.101906","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101906"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193137","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":"Perceived social support and adverse pregnancy outcomes among nulliparous individuals","authors":"Brock E. Polnaszek MD, MPH,&nbsp;Hyagriv N. Simhan MD, MS,&nbsp;Uma M. Reddy MD, MPH,&nbsp;Robert M. Silver MD,&nbsp;David M. Haas MD, MS,&nbsp;Lynn M. Yee MD, MPH,&nbsp;William Grobman MD, MBA","doi":"10.1016/j.ajogmf.2026.101894","DOIUrl":"10.1016/j.ajogmf.2026.101894","url":null,"abstract":"<div><h3>Video Abstract</h3><div><span><span><span><span><video><source></source></video></span><span><span>Download: <span>Download video (4MB)</span></span></span></span><span><span><p>Video Source: Polnaszek. Perceived social support and adverse pregnancy outcomes. Am J Obstet Gynecol MFM 2026.</p></span></span></span></span></div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101894"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709533","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 Du: Differences in experimental setting make validation harder","authors":"Andrew Batuure MS,&nbsp;George I. Austin MS,&nbsp;Tal Korem PhD","doi":"10.1016/j.ajogmf.2026.101900","DOIUrl":"10.1016/j.ajogmf.2026.101900","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101900"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147709645","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":"Development and external validation of a nomogram for predicting spontaneous preterm birth in singleton pregnancies with a short cervix","authors":"Xinyue Han MSc,&nbsp;Qidi Zhang PhD,&nbsp;Yuli Ke MSc,&nbsp;Yuchun Zhu PhD,&nbsp;Huixia Yang PhD,&nbsp;Yumei Wei PhD","doi":"10.1016/j.ajogmf.2025.101859","DOIUrl":"10.1016/j.ajogmf.2025.101859","url":null,"abstract":"<div><h3>Background</h3><div>Spontaneous preterm birth (sPTB) is a major cause of neonatal morbidity and mortality. Women with a short cervix (≤25 mm) are at particularly high risk; prediction based solely on this single measurement is often insufficient. There is an urgent need for more accurate, externally validated tools to stratify risk in this high-risk population.</div></div><div><h3>Objective</h3><div>To develop and externally validate a dynamic, multivariable nomogram for predicting individualized, time-dependent risks of sPTB in singleton pregnancies with a short cervix.</div></div><div><h3>Study Design</h3><div>We conducted a retrospective training cohort (<em>n</em>=591) of singleton pregnancies with a short cervix identified before 24 weeks of gestation from our Xicheng campus (2016–2022) and a prospective external validation cohort (<em>n</em>=215) from our Daxing campus (2024–2025). A multivariable Cox proportional hazards model was used to identify independent predictors. The model’s performance was rigorously evaluated for discrimination (time-dependent area under the curve [AUC]), calibration (calibration plots and Brier scores), and clinical utility (decision curve analysis [DCA]).</div></div><div><h3>Results</h3><div>Three independent predictors were incorporated into the final nomogram: a history of prior preterm birth (hazard ratios [HR]=3.94), cervical length (HR=0.91), and the gestational week at diagnosis (HR=1.18). The nomogram demonstrated good discrimination, with time-dependent AUCs for sPTB before 32, 34, and 37 weeks of 0.774, 0.740, and 0.724 in the training cohort, and 0.757, 0.734, and 0.719 in the external test cohort, respectively. The model was well-calibrated in both cohorts, confirmed by low Brier scores and nonsignificant Hosmer–Lemeshow tests. DCA showed a consistent net benefit across a wide range of risk thresholds. The model’s performance was maintained despite the validation cohort representing a demographically distinct and higher-risk population.</div></div><div><h3>Conclusion</h3><div>This study established and externally validated a simple, clinically practical nomogram for predicting sPTB in singleton pregnancies with a short cervix. This robust, clinically applicable tool can aid in patient counseling and the stratification of high-risk pregnancies to guide personalized management strategies.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"8 4","pages":"Article 101859"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606400","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}