Bjog-An International Journal of Obstetrics and Gynaecology最新文献

{"title":"Preserving Essential Skills: The Future of Vaginal Hysterectomy Training in Urogynaecology","authors":"Reut Rotem,&nbsp;Michael O. Carey,&nbsp;Claire M. McCarthy,&nbsp;Barry A. O'Reilly,&nbsp;Yair Daykan,&nbsp;Orfhlaith E. O'Sullivan","doi":"10.1111/1471-0528.17974","DOIUrl":"10.1111/1471-0528.17974","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the training and self-assessed proficiency of surgeons in the surgical management of pelvic organ prolapse (POP). We focused on the factors that influence decision-making, the surgical techniques employed, the training received, and the management of complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A cross-sectional survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>An electronic questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>European Urogynaecological Association (EUGA) and International Urogynecological Association (IUGA) members.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 33 questions evaluating surgeon preference regarding vaginal surgeries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Demographics, surgical selection, proficiency and technique, and training methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 471 respondents, of which 273 (58%) dedicated more than 50% of their week to urogynaecology. 250 (53%) had completed a fellowship, with 215 (86%) of those fellowships being in urogynaecology and pelvic floor reconstruction. A preference for hysterectomy in cases of uterine descent was noted by 297 (63%) respondents, influenced mainly by patient preference, age, and prolapse anatomical score. A total of 443 (94%) were proficient in vaginal hysterectomy, with two-thirds performing 30 or fewer procedures annually; 212 (45%) reporting a decrease in the number of procedures over the last decade. Additionally, 373 (79%) respondents believed that 10–30 cases were needed to achieve and maintain proficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vaginal hysterectomy remains a key component in uterine prolapse repair. However, with the rise of uterine-sparing prolapse repairs, the decision-making process may be influenced by multiple factors, including surgical training. Emphasis should be placed on training and maintaining proficiency in both traditional and novel techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 2","pages":"205-211"},"PeriodicalIF":4.7,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence of Severe Maternal Morbidity and Transfusion During Delivery Hospitalisations: A Retrospective Cohort Study","authors":"Anne-Sophie van Wingerden,&nbsp;Yongmei Huang,&nbsp;Whitney Booker,&nbsp;Kaitlyn G. Nwaba,&nbsp;Mary E. D'Alton,&nbsp;Alexander Friedman","doi":"10.1111/1471-0528.17969","DOIUrl":"10.1111/1471-0528.17969","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine risks for non-transfusion severe maternal morbidity and transfusion during a second delivery hospitalisation based on clinical risk factors and obstetric complications from an index, first delivery hospitalisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Delivery hospitalisations in the 2010–2017 New York State Inpatient Database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with a first index delivery hospitalisation followed by a second delivery hospitalisation during the study period were included. Clinical risk factors and obstetric complications were obtained from the first index delivery hospitalisation. Adjusted logistic regression models for non-transfusion severe maternal morbidity during the second delivery were performed with adjusted (aORs) odds ratios as measures of effect. These analyses were then repeated for the outcome of transfusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 624 500 paired delivery hospitalisations to 312 250 women, severe maternal morbidity occurred among 0.85% of second deliveries (<i>n</i> = 2672). When adjusted analysis was performed, several clinical factors were associated with severe maternal morbidity in a subsequent pregnancy, including severe maternal morbidity during the index pregnancy (aOR 8.4, 95% CI 7.0, 9.9), transfusion (aOR 2.0, 95% CI 1.6, 2.4) and pregestational diabetes (aOR 2.2, 95% 1.6, 2.9). When analyses were repeated for transfusion, several factors were associated with increased risk, including severe maternal morbidity (aOR 1.5, 95% CI 1.2, 1.8), index transfusion (aOR 6.3, 95% CI 5.6, 7.0), chronic heart disease (aOR 1.6, 95% 1.4, 1.9) and pregestational diabetes (aOR 1.7, 95% 1.3, 2.2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Many obstetric complications and chronic conditions identified during an index delivery hospitalisation are associated with severe morbidity during a second, subsequent delivery. Index severe maternal morbidity is associated with the highest odds. These findings may be of use in patient counselling and risk stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 5","pages":"565-574"},"PeriodicalIF":4.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Pregnancy Chronic Conditions: Mental Health is a Burgeoning Problem","authors":"Abi Merriel","doi":"10.1111/1471-0528.17959","DOIUrl":"10.1111/1471-0528.17959","url":null,"abstract":"<p><b>Linked article:</b> This is a mini commentary on Lundborg et al., pp. 44–52 in this issue. To view this article visit https://doi.org/10.1111/1471-0528.17885.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 1","pages":"53-54"},"PeriodicalIF":4.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of Intrauterine Adhesions: The Way to Go","authors":"Angelo B. Hooker","doi":"10.1111/1471-0528.17968","DOIUrl":"10.1111/1471-0528.17968","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 2","pages":"165-166"},"PeriodicalIF":4.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PAX1/SOX1 DNA Methylation Versus Cytology and HPV16/18 Genotyping for the Triage of High-Risk HPV-Positive Women in Cervical Cancer Screening: Retrospective Analysis of Archival Samples","authors":"Karen K. L. Chan,&nbsp;Stephanie S. Liu,&nbsp;Lesley S. K. Lau,&nbsp;Siew Fei Ngu,&nbsp;Mandy M. Y. Chu,&nbsp;K. Y. Tse,&nbsp;Annie N. Y. Cheung,&nbsp;Hextan Y. S. Ngan","doi":"10.1111/1471-0528.17965","DOIUrl":"10.1111/1471-0528.17965","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the performance of cytology, HPV16/18 genotyping and PAX1/SOX1 methylation for the triage of high-risk HPV-positive cervical samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective analyses of archival samples collected from a large-scale prospective randomised controlled trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting/Sample</h3>\u0000 \u0000 <p>HPV-positive women recruited from the general cervical screening population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>403 HPV-positive samples including 113 normal, 173 low-grade cervical intraepithelial neoplasia (LG-CIN), 114 HG-CIN and three cervical cancers. All samples were assessed by liquid-based cytology, HPV genotyping and PAX1/SOX1 methylation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>AUC (area under the curve), sensitivity and specificity for cytology, HPV16/18 genotyping and PAX1/SOX1 methylation for high-grade (HG) premalignant cervical lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PAX1 was more sensitive than cytology and HPV16/18 genotyping in detecting a HG lesion (CIN2+). The sensitivity for PAX1, SOX1, cytology and HPV16/18 were 73.5% (95% CI: 65.5–81.5), 41.9% (95% CI: 32.9–50.8), 48.7% (95% CI: 39.7–57.8) and 36.8% (95% CI: 28.0–45.5), respectively, and their respective specificities were 70.3% (95% CI: 65.0–75.6), 83.6% (95% CI: 79.3–87.9), 77.6% (95% CI: 72.8–82.5) and 67.1% (95% CI: 61.7–72.6), respectively. Overall, PAX1 gave the best AUC at 0.72. Adding SOX1 to PAX1 did not improve the AUC (0.68). Three hundred and twenty-two women who did not have a HG lesion at baseline were followed up for two rounds of screening. Fewer women developed a HG lesion with a normal baseline PAX1 compared to women with a normal baseline cytology or negative HPV16/18 (8.4% vs. 14.5% and 17.5%, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PAX1 triage for referral to colposcopy in HPV-positive women may be superior to cytology and HPV16/18 genotyping.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 2","pages":"197-204"},"PeriodicalIF":4.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17965","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142325817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy Outcomes in Women With Vascular EDS Provide High Mortality Rates","authors":"Matthew Cauldwell","doi":"10.1111/1471-0528.17961","DOIUrl":"10.1111/1471-0528.17961","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 2","pages":"220-221"},"PeriodicalIF":4.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142321863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professor Christopher Redman MBBChir (Cantab), FRCP, FRCOG (fellowship ad eundem), 30 November 1941 to 13 August 2024","authors":"Manu Vatish,&nbsp;Aris T. Papageorghiou","doi":"10.1111/1471-0528.17967","DOIUrl":"10.1111/1471-0528.17967","url":null,"abstract":"&lt;p&gt;With profound sadness, the community mourns the loss of Professor Christopher (Chris) Redman, who passed away at the age of 82 after a distinguished career as a pioneering obstetric physician and professor. Chris' relentless pursuit of knowledge and his contributions to the health of women and newborns left an indelible mark on the field and on all who had the privilege of working alongside him.&lt;/p&gt;&lt;p&gt;Born in South Africa in 1941, Chris' early years were shaped by his father's work as an astronomer, leading the family to move to the United Kingdom where he attended grammar school in Cambridge. His academic journey led him from Cambridge University to Oxford's Clinical Medical School, igniting a passion for medical research that would define his career. His clinical journey took him to Johns Hopkins University in Baltimore USA, to the University of Sheffield and then back to Oxford where he joined the Regius Department of Medicine.&lt;/p&gt;&lt;p&gt;Chris was a trailblazing innovator in maternal and fetal medicine. His first foray into obstetric research was a clinical trial on the efficacy of methyldopa for moderate hypertension in pregnancy where he showed a reduction in fetal loss, which was not due to a reduction in preeclampsia rates. He demonstrated that the drug had no adverse effects on fetal growth confirming that this drug was safe to use in pregnancy. From here onwards, Chris' career became focussed on preeclampsia and he led groundbreaking research into the role of extracellular vesicles released from the placenta in the pathogenesis of the condition.&lt;/p&gt;&lt;p&gt;His improvements in outcomes for mothers were not being matched by enhanced fetal outcomes and this culminated in the creation, alongside Professor Geoffrey Dawes, of the first computerised system for antepartum fetal heart rate analysis. This system, now used worldwide, has revolutionised clinical practice and decision-making in maternal and fetal medicine and stands as a testament to his foresight and unwavering dedication to patient care.&lt;/p&gt;&lt;p&gt;Chris started his high-risk clinic in 1983. Such was his commitment to his patients that they founded the Silver Star Charity in 1988 to raise funds for the unit and his research work. Even after retirement in 1998, Chris retained a major interest in driving understanding of preeclampsia and improving the Dawes-Redman algorithm, resulting in the publication of over 250 papers in this period alone, the most recent in June 2024.&lt;/p&gt;&lt;p&gt;In parallel with his academic achievements, Chris co-founded Action on Preeclampsia in 1991 (with Isobel Walker, a preeclampsia survivor and patient advocate), a charity that has dramatically improved care and awareness of the disease. He gave countless presentations and published comprehensive patient guides. His commitment to community engagement mirrored his zest for life, demonstrated in his enthusiasm for marathon running, hiking, ballroom dancing, and cycling to work, activities that kept him vibrant and well-conn","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"131 12","pages":"1734-1735"},"PeriodicalIF":4.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17967","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142317208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' reply","authors":"Kathrine Fodstad,&nbsp;Katariina Laine,&nbsp;Sari Räisänen","doi":"10.1111/1471-0528.17958","DOIUrl":"10.1111/1471-0528.17958","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 1","pages":"103-104"},"PeriodicalIF":4.7,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142276797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of IFH: Challenges in UK Training","authors":"Junaid Rafi","doi":"10.1111/1471-0528.17962","DOIUrl":"10.1111/1471-0528.17962","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 4","pages":"543-544"},"PeriodicalIF":4.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Utero Aspirin Exposure and Child Neurocognitive Development: Causation Over Correlation","authors":"Leslie L. Shultz,&nbsp;Hisako Okada,&nbsp;Amir L. Butt,&nbsp;Kaitlyn J. Kulesus","doi":"10.1111/1471-0528.17964","DOIUrl":"10.1111/1471-0528.17964","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 3","pages":"392-393"},"PeriodicalIF":4.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}