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

{"title":"The Effect of Animated Educational Video to Reduce Anxiety Levels Before Outpatient Medical Abortion: A Randomised Controlled Trial","authors":"Nuttamon Dejchaiyasak,&nbsp;Waranyu Lertrat,&nbsp;Komkrit Aimjirakul,&nbsp;Orawee Chinthakanan,&nbsp;Orawin Vallibhakara","doi":"10.1111/1471-0528.18321","DOIUrl":"10.1111/1471-0528.18321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the efficacy of an animated educational video combined with traditional counselling to reduce anxiety levels among pregnant women seeking outpatient medical abortion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Randomised controlled trial with two parallel groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Single centre in Bangkok, Thailand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population or Sample</h3>\u0000 \u0000 <p>60 pregnant women seeking outpatient medical abortion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants received either an animated educational video combined with traditional counselling (<i>n</i> = 30) or traditional counselling alone (<i>n</i> = 30).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Postintervention anxiety levels were assessed by the Spielberger State–Trait Anxiety Inventory (STAI), and satisfaction levels were measured by a 5-point Likert-type scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no significant differences in demographic characteristics between groups. The postintervention STAI scores were significantly lower in the video group compared to the non-video group (32.70 ± 4.96 vs. 41.47 ± 8.57, <i>p</i> &lt; 0.01). The odds of moderate to severe anxiety were significantly lower in the video group (OR 10.29, 95% CI 2.56–41.37). Patient satisfaction levels were similarly high in both groups (4.92 ± 0.27 vs. 4.85 ± 0.36, <i>p</i> = 0.42).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Incorporating an animated educational video into traditional counselling effectively reduced anxiety in pregnant women seeking outpatient medical abortion while maintaining high levels of satisfaction with the medical service provided.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1753-1761"},"PeriodicalIF":4.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769799","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":"When Is Postpartum Haemorrhage Treatment Initiated? A Nested Observational Study Within the E-MOTIVE Trial","authors":"Kristie-Marie Mammoliti,&nbsp;Fernando Althabe,&nbsp;Christina Easter,&nbsp;Adam Devall,&nbsp;James Martin,&nbsp;Adeosun Love Funmi,&nbsp;Rahmatu Yusuf,&nbsp;Fatima Abubakar,&nbsp;Lolade Christiana Arigbede,&nbsp;JimKelly Mugambi,&nbsp;Polycarp Oyoo,&nbsp;Masumbuko Sambusa,&nbsp;Akwinata Banda,&nbsp;Fawzia Samuels,&nbsp;Sara Willemse,&nbsp;Sibongile Doris Khambule,&nbsp;Hilal Mukhtar Shu'aib,&nbsp;Aminu Ado Wakili,&nbsp;Jenipher Okore,&nbsp;Ard Mwampashi,&nbsp;Mandisa Singata-Madliki,&nbsp;Edna Arends,&nbsp;Elani Muller,&nbsp;Hadiza Galadanci,&nbsp;Zahida Qureshi,&nbsp;Fadhlun Alwy Al-Beity,&nbsp;G. Justus Hofmeyr,&nbsp;Sue Fawcus,&nbsp;Neil Moran,&nbsp;George Gwako,&nbsp;Alfred Osoti,&nbsp;Ioannis Gallos,&nbsp;Arri Coomarasamy","doi":"10.1111/1471-0528.18293","DOIUrl":"10.1111/1471-0528.18293","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the frequency and timing of postpartum haemorrhage (PPH) treatment initiation between hospitals implementing the MOTIVE treatment bundle (which consisted of uterine Massage, Oxytocic drugs, Tranexamic acid, IntraVenous fluids and Examination) and those following usual care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Nested prospective observational study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Hospitals in Nigeria, Kenya, Tanzania and South Africa participating in the E-MOTIVE trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population or Sample</h3>\u0000 \u0000 <p>Healthcare workers treating PPH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between June and December 2022, we observed healthcare workers for 1–2 weeks in 39 E-MOTIVE and 39 usual care hospitals across Nigeria, Kenya, Tanzania, and South Africa managing vaginal birth and treating PPH. We descriptively compared the frequency and timing from PPH detection to treatment initiation of individual treatments and the MOTIVE bundle, between E-MOTIVE care and usual care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2578 observations in E-MOTIVE care hospitals, 295 (11%) PPHs were treated, and among 2834 observations in usual care hospitals, 219 (8%) PPHs were treated. In E-MOTIVE care hospitals, 97% (286/295) of women with PPH received the MOTIVE bundle, compared to 36% (79/219) in usual care. Median initiation times for the first component were similar (0 vs. 1 min), but E-MOTIVE care hospitals achieved faster initiation of all components (13 min, IQR 6–18) compared to usual care (18 min, IQR 10–25). In total, 79% (233/295) of women in E-MOTIVE care had all components initiated within 20 min, compared to 22% (48/219) in usual care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Timely and comprehensive management of PPH using the MOTIVE bundle, particularly initiating all components within 15–20 min, was commonly observed in the E-MOTIVE care hospitals. Scaling up E-MOTIVE care should emphasise timely bundle initiation to strengthen PPH treatment and improve maternal health outcomes in low-and-middle-income countries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 11","pages":"1664-1672"},"PeriodicalIF":4.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769699","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":"Effectiveness of Multidisciplinary Treatment Compared to Single Discipline Treatment of Female Chronic Pelvic Pain: A Systematic Review and Meta-Analyses","authors":"Danielle McReynolds,&nbsp;Rebekah Shiraz,&nbsp;Mary-Anne Tangey,&nbsp;Thorlene Egerton,&nbsp;Helena Frawley","doi":"10.1111/1471-0528.18322","DOIUrl":"10.1111/1471-0528.18322","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic pelvic pain (CPP) is persistent pain perceived to originate in the pelvis, lasting ≥ 3 months. Due to its multifactorial presentation, multidisciplinary treatment may provide optimal care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Systematic review with meta-analysis of multidisciplinary (≥ 2 of medical, psychology, physiotherapy, nursing, or dietetics/nutrition disciplines) versus single discipline treatment for females ≥ 13 years with CPP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>Search of six electronic databases, conducted in February 2025.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Randomised or non-randomised controlled trials were included if: participants had CPP ≥ 3 months; they compared multidisciplinary to single discipline treatments; and reported pain, quality of life (QoL), sexual function, anxiety and depression, pelvic floor dysfunction, analgesia use and/or adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Data selection, extraction and risk of bias (Cochrane ROBv2 tool) were completed independently by two reviewers. The GRADE approach was used to evaluate certainty of evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>Eight articles were synthesised. Meta-analysis found lower post-treatment pain scores (MD −2.19; 95% CI −3.17, −1.22) and greater improvements in sexual function (MD 2.47; 95% CI 1.06, 3.88) with multidisciplinary treatments, but no difference between groups for QoL (SMD −0.16; 95% CI −0.52, 0.20). Narrative synthesis was inconclusive for differences in outcomes of anxiety and depression. No between-group differences were found for pelvic floor dysfunction, analgesia use or adverse events. GRADE results showed moderate to very low certainty for all outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Multidisciplinary care may lead to lower pain intensity scores and greater sexual function than single discipline treatments, however future research may change the results and certainty of these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1716-1733"},"PeriodicalIF":4.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747299","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":"SIP 7: Progress in Cervical Cancer Prevention in the UK (2025 Second Edition)","authors":"L. B. Ellis,&nbsp;S. J. Bowden,&nbsp;D. Lyons,&nbsp;M. Kyrgiou,&nbsp;the Royal College of Obstetricians and Gynaecologists","doi":"10.1111/1471-0528.18262","DOIUrl":"10.1111/1471-0528.18262","url":null,"abstract":"<p>Cervical cancer remains a preventable yet significant healthcare problem for women globally. The World Health Organization (WHO) announced a call to eliminate cervical cancer in 2018, with recommendations for screening, vaccination, and treatment of precancerous cervical lesions.</p><p>Screening uptake is on the decline in the UK, particularly for younger women, where the rate has now dropped below 70%. Primary screening is now performed with high-risk human papillomavirus (hrHPV) testing. This test is sensitive, but not specific, meaning it is good at not missing cancers or precancer, but most people who test hrHPV positive will not have cervical cancer or precancer, and therefore testing positive can lead to unnecessary worry. Any samples that test positive for the virus undergo ‘reflex’ cytology (the process by which cells suspended in liquid are stained and examined under the microscope by those trained to perform this assessment). This means only virus-positive samples are tested to select patients for colposcopy (visualisation of the cervix with special lenses, in a specialist gynaecology clinic). Other possibilities for this triage test, which may improve the accuracy of screening, are currently under investigation and include methylation (a chemical change in DNA that can be measured) testing, and testing for specific markers. HPV type 16 is the most common high-risk strain found globally, including in the UK.</p><p>The UK national vaccination programme was started in 2008, and uptake in the UK is currently around 80%. Since 2021, Gardasil9 (offering protection against seven hrHPV types and two HPV types that cause genital warts) has been offered to both boys and girls, at school, aged 12–13. In 2023, new guidance from the Joint Committee on Vaccination and Immunisation (JCVI) recommended a single dose as sufficient. HPV vaccination has almost eliminated cervical cancer in those born in or after 1995.</p><p>Future directions for the screening programme in the UK include self-sampling, adaptations in the post-vaccine era, and increasing the upper age limit of screening. Self-sampling has been shown to be similarly accurate to clinician-taken samples, and may be a good option for those who do not attend for screening, who have been shown to have increased risk of cervical cancer and worse outcomes. One in ten women with cervical cancer in the UK is diagnosed over the age of 75.</p><p>Globally, recommendations for cervical screening exist in 139/202 countries. Of these, 48 currently recommend hrHPV testing. Efforts must be made to encourage uptake of both screening and vaccination in order to continue to reduce rates of cervical cancer in the UK.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"e185-e193"},"PeriodicalIF":4.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144737409","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":"Patient Decision Aids for Pelvic Floor Surgery and Impact on Decisional Conflict","authors":"Roberta Bugeja,&nbsp;Ruth Athey,&nbsp;Swati Jha","doi":"10.1111/1471-0528.18311","DOIUrl":"10.1111/1471-0528.18311","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To evaluate whether the use of a patient decision aid (PDA) diminishes decision conflict in patients considering surgical treatment for stress urinary incontinence (SUI) or pelvic organ prolapse (POP) and to assess patient satisfaction concerning the PDA's user-friendliness and overall utility.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;One hundred women attending routine urogynaecology clinic appointments were offered the PDA as part of standard care and recruited into the study. After using the PDA, participants completed a decisional conflict scale (DCS) to assess their decision-making experience.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Single-site NHS tertiary-level care hospital outpatient department.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Population and Sample&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study included women considering surgical management for uterine/vault prolapse or SUI. Exclusion criteria comprised individuals under 18 years of age, those unable to communicate in English and patients not eligible for all surgical options presented in the PDAs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Patients presenting to the urogynaecology clinic with symptomatic SUI or POP considering surgical treatment were invited to participate in the study. After using the PDA and at their next clinic visit, participants completed a DCS to assess their decision-making experience.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measure&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The DCS assessed the level of uncertainty and difficulty participants experienced in deciding on surgical treatment after using the PDA. A DCS score of less than 25 was associated with certainty in implementing the decision.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This was a prospective cohort study of 100 participants. The DCS scores for the cohorts showed low decisional conflict, with median scores of 0.8 (IQR 4.7) for the vault PDA, 6.3 (IQR 25) for the uterine PDA and 7.8 (IQR 21.1) for the SUI PDA. A sub-score analysis revealed higher scores for ‘uncertainty’ and ‘effective decision making’ in 21 participants with total DCS scores above 25.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;NICE","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1817-1822"},"PeriodicalIF":4.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715704","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":"Traditional Versus Contemporary Models for Identifying Causes of Maternal Death: A Population-Based Study","authors":"Yasser Sabr,&nbsp;Sarka Lisonkova,&nbsp;Amélie Boutin,&nbsp;Chantal Mayer,&nbsp;K. S. Joseph","doi":"10.1111/1471-0528.18298","DOIUrl":"10.1111/1471-0528.18298","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine differences in cause-of-maternal-death assignment based on underlying versus multiple causes of death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional, population-based study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>United States, 1999–2002 and 2018–2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>1633 maternal deaths in 1999–2002 and 1929 maternal deaths in 2018–2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Causes of death were identified based on the underlying cause of death and also based on multiple causes of death. The frequency of six selected obstetrical causes of death was quantified and ranked.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pre-eclampsia (0.87 per 100 000 live births, 95% confidence interval [CI] 0.74–1.02) was the most common cause of maternal death in 2018–2022, when cause-of-death assignment was based on the underlying cause of death. Amniotic fluid embolism and cardiomyopathy tied for second rank, haemorrhage placed fourth and puerperal sepsis and uterine rupture tied for the fifth rank. Rankings based on multiple causes of death showed a different pattern: haemorrhage (1.13 per 100 000 live births, 95% CI 0.98–1.29) was the most common cause, followed by pre-eclampsia, cardiomyopathy, amniotic fluid embolism, puerperal sepsis and uterine rupture. There was no significant correlation between the cause-of-maternal death rankings based on the underlying and multiple causes of death (correlation coefficient 0.62, 95% CI-0.39, 0.95; <i>p</i> value 0.19) in 2018–2022. Cause-of-death rankings were significantly correlated under the two methods of cause-of-death assignment in 1999–2002 (correlation coefficient 0.83, 95% CI 0.05, 0.98; <i>p</i> value 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Basing cause-of-death assignment and ranking of the causes of maternal death using a multiple causes-of-death approach may better inform clinical and public health priorities for reducing maternal mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 11","pages":"1689-1696"},"PeriodicalIF":4.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715676","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":"Outpatient Versus Inpatient Induction of Labour With Oral Misoprostol: A Multicentre Randomised-Controlled Trial","authors":"Fride E. Austad,&nbsp;Jörg Kessler,&nbsp;Elisabeth Balstad Magnussen,&nbsp;Are Hugo Pripp,&nbsp;Janne Rossen","doi":"10.1111/1471-0528.18296","DOIUrl":"10.1111/1471-0528.18296","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To compare childbirth satisfaction and obstetrical outcomes with outpatient versus inpatient induction of labour (IOL).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Multicentre, randomised-controlled trial.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Eight hospitals in Norway.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Population&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Women scheduled for IOL, single cephalic presentation, ≥ 37 weeks, no previous uterine scar, and low risk of complications by predefined criteria.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Included women received oral misoprostol (25 μg) for up to 48 h as the primary induction agent. The Childbirth Experience Questionnaire (CEQ) and the Experience with Induction Tool (EXIT) were used to assess childbirth satisfaction.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;CEQ-score.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Secondary Outcome Measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;EXIT questionnaire and obstetrical outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Of 283 women randomised, 152 women were allocated to outpatient and 131 to inpatient settings. Outpatient IOL resulted in a more positive childbirth experience (mean CEQ-score 3.1 [0.44] vs. 3.0 [0.45]), mean difference 0.14, 95% CI (0.02–0.25), &lt;i&gt;p&lt;/i&gt; = 0.02. In the outpatient group, women were admitted to the hospital 21 h shorter before delivery (15 vs. 36 h, mean difference −21, 95% CI −25 to −17, &lt;i&gt;p&lt;/i&gt; &lt; 0.01). Obstetrical outcomes were similar, and there were no cases of hyperstimulation before labour or serious adverse events.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Outpatient IOL using oral misoprostol was associated with high maternal satisfaction, with 89% of women expressing a preference for this method in future pregnancies. Labour outcomes appear comparable to those of inpatient induction, while outpatient management also provides potential cost benefits due to shorter hospital admission. We advocate for this method as a feasible option for appropriately selected women; however, the occurrence of rare adverse events necessitates further investigation through larger studies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Trial Registration&lt;/h3&gt;\u0000 \u0000 ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 11","pages":"1562-1573"},"PeriodicalIF":4.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693311","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":"When More of the Same Is Not Better","authors":"Shannon M. Bates","doi":"10.1111/1471-0528.18313","DOIUrl":"10.1111/1471-0528.18313","url":null,"abstract":"<p><b>Linked article:</b> This is a mini commentary on Magee et al. To view this article visit https://doi.org/10.1111/1471-0528.18229.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1892-1893"},"PeriodicalIF":4.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684169","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":"RETRACTION: Direct Aspiration Versus Follicular Flushing in Poor Responders Undergoing Intracytoplasmic Sperm Injection: A Randomised Controlled Trial","authors":"","doi":"10.1111/1471-0528.18319","DOIUrl":"10.1111/1471-0528.18319","url":null,"abstract":"<div>\u0000 \u0000 <p>\u0000 RETRACTION: <span>B. Haydardedeoglu</span>, <span>F. Gjemalaj</span>, <span>P.C. Aytac</span>, and <span>E.B. Killicdag</span>, “ <span>Direct Aspiration Versus Follicular Flushing in Poor Responders Undergoing Intracytoplasmic Sperm Injection: A Randomised Controlled Trial</span>,” <i>BJOG: An International Journal of Obstetrics &amp; Gynaecology</i> <span>124</span>, no. <span>8</span> (<span>2017</span>): <span>1190</span>–<span>1196</span>, https://doi.org/10.1111/1471-0528.14629.\u0000 </p>\u0000 <p>The above article, published online on 09 March 2017 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Aris Papageorghiou; and John Wiley &amp; Sons Ltd. UK. Concerns were raised by a third party regarding the randomized control trial and the successful implementation of randomization. The third party was unable to recalculate the statistical results presented in Table 1, raising concerns that the statistical reports were also flawed. The authors provided their raw dataset to the journal so it could be evaluated by an independent expert. This expert confirmed that many of the statistical results were not reproducible using the reported methods. They also found several inconsistencies and errors within the article, including the duplication of two participants in the dataset. As a result, the data and conclusions are considered unreliable and the article must be retracted.</p>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 11","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677655","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":"The Causes and Effects of the Global Rise in Caesarean Delivery Rates","authors":"Philip J. Steer","doi":"10.1111/1471-0528.18315","DOIUrl":"10.1111/1471-0528.18315","url":null,"abstract":"<p><b>Linked article:</b> This is a mini commentary on Moster et al., pp. 1781–1788 in this issue. To view this article, visit https://doi.org/10.1111/1471-0528.18301.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 12","pages":"1789-1790"},"PeriodicalIF":4.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677638","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}