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

{"title":"Efficacy of Maintenance Therapy With Adjuvant Chemotherapy of Three Steps in Patients Newly Diagnosed With Advanced Ovarian Cancer: A Phase II Randomised Clinical Trial","authors":"Zhong Zheng,&nbsp;Huayin Wang,&nbsp;Huijuan Yang,&nbsp;Jie Tang,&nbsp;Xi Cheng,&nbsp;Meiqin Zhang,&nbsp;Yulan Ren,&nbsp;Xiaojun Chen,&nbsp;Xinzhu Ju,&nbsp;Liya Xu,&nbsp;Xiaohua Wu","doi":"10.1111/1471-0528.18178","DOIUrl":"10.1111/1471-0528.18178","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of adjuvant chemotherapy of three steps (ACTS) in patients newly diagnosed with advanced ovarian cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Randomised clinical trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The study was conducted at a single centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Newly diagnosed patients with advanced ovarian cancer who showed a complete response to standard chemotherapy (paclitaxel plus carboplatin) were included in this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this open-label phase II trial, patients were randomised 1:1 to receive either ACTS therapy or no maintenance treatment. The ACTS group received step-2 chemotherapy with cyclophosphamide and etoposide (six cycles) and step-3 chemotherapy with cyclophosphamide and carboplatin (six cycles). Key endpoints were overall survival (OS), progression-free survival (PFS) and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The main outcome measures were OS, PFS and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 130 enrolled patients, 65 were assigned to the ACTS group and 65 to the control group. The median OS in the ACTS group was 61.2 months, and patients in the ACTS group had a significantly longer PFS than those in the control group (22.2 vs. 9.73 months). The most common grade ≥ 3 adverse events were thrombocytopenia and neutropenia. No treatment-related deaths occurred during the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Maintenance ACTS Regimen Improved PFS but Not OS and Showed a Tolerable Safety Profile in Patients Newly Diagnosed With Advanced Ovarian cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.org NCT02562365</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S4","pages":"52-61"},"PeriodicalIF":4.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880335","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":"Postpartum Cardiovascular Health in African Women Following Pre-Eclampsia: A Prospective Cohort Study","authors":"Annettee Nakimuli,&nbsp;Emmy Okello,&nbsp;Annette Kesiiga,&nbsp;Moses Adroma,&nbsp;Jackline Akello,&nbsp;Sheila Nabweyambo,&nbsp;Musa Sekikubo,&nbsp;Imelda Namagembe,&nbsp;Robert Kayesubula,&nbsp;Ronald Galiwango,&nbsp;Brittany Jasper,&nbsp;Ashley Moffett,&nbsp;Catherine E. Aiken,&nbsp;Ian B. Wilkinson,&nbsp;Carmel M. McEniery","doi":"10.1111/1471-0528.18192","DOIUrl":"10.1111/1471-0528.18192","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 investigate the prevalence of hypertension and cardiovascular dysfunction 1 year postpartum in Black African women who experienced pre-eclampsia in a low-resource setting in Uganda.&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;Prospective cohort study.&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;Tertiary referral hospital in urban Uganda.&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;Pregnant women who developed pre-eclampsia between 2019 and 2021, matched to normotensive controls with maternal and gestational age.&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;Sociodemographic, clinical and laboratory data were collected at recruitment and 1 year postpartum. Baseline characteristics and incidence rate ratios were calculated to assess risk factors for developing hypertension. Multivariable conditional Poisson regression adjusted for matched study design was used to analyse outcomes.&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;The primary outcome was hypertension (≥ 140/≥ 90 mmHg) at 1 year postpartum. Secondary outcomes included aortic pulse wave velocity, left ventricular mass index, and left ventricular ejection fraction at 1 year postpartum.&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;At one-year postpartum, hypertension prevalence was higher among women with pre-eclampsia than controls (36.4% (96/264) versus 4.5% (12/264); aIRR 1.26, 95% CI 1.16–1.36, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Postpartum median aortic pulse wave velocity was increased in women with pre-eclampsia (6.45 ± 0.76 m/s vs. 5.67 ± 0.22 m/s, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Left ventricular mass indexed to body surface area was increased in women with pre-eclampsia (71.7 ± 19.6 g vs. 76.5 ± 23.2 g, &lt;i&gt;p&lt;/i&gt; &lt; 0.01). Left ventricular ejection fraction was not influenced by pre-eclampsia (&lt;i&gt;p&lt;/i&gt; = 0.35).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this low-resource setting, black African women with pre-eclampsia had increased cardiovascular risk markers at one year postpartum. Over one-third of women with pre-eclampsia developed hypertension at one year postpartum, emphasising the need for postpartum blood pressure monitoring ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 9","pages":"1319-1328"},"PeriodicalIF":4.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880590","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":"Secondary Cytoreductive Surgery for Ovarian Cancer With Second Platinum-Sensitive Recurrence: A Multicentre Retrospective Cohort Study","authors":"Yuxi Zhao,&nbsp;Zhihao Jiang,&nbsp;Tao Guo,&nbsp;Meiting Cao,&nbsp;Jia Zeng,&nbsp;Rongshou Zheng,&nbsp;Yangchun Sun,&nbsp;Guangwen Yuan,&nbsp;Ning Li,&nbsp;Guihua Shen,&nbsp;Qiubo Lv,&nbsp;Linlin Ma,&nbsp;Yi Zhang,&nbsp;Hongwei Zhao,&nbsp;Jundong Li,&nbsp;Lingying Wu","doi":"10.1111/1471-0528.18184","DOIUrl":"10.1111/1471-0528.18184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare survival outcomes between patients with ovarian cancer with platinum-sensitive recurrence (PSR) who underwent secondary cytoreductive surgery (SCS) at the first recurrence and those who underwent SCS at the second recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Multicentre cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Data were retrospectively collected from five hospitals in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Patients with ovarian cancer who underwent SCS at either the first or second PSR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Overall survival (OS) and time to second progression (PFS2), calculated from the time of recurrence to the next progression following SCS, were compared between the groups. Postsurgical complications were categorised according to the Clavien–Dindo classification system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>OS, PFS2, and postsurgical complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 231 patients included, 175 underwent SCS at the first PSR (Group 1) while 56 underwent SCS at the second PSR (Group 2). Complete resection was achieved in 84.0% of patients in Group 1 and 78.6% in Group 2. Postsurgical complication rates were similar between the groups. The median OS was not reached in Group 1, whereas Group 2 had a median OS of 77.3 months. Patients who underwent SCS at the second PSR had an OS comparable to that of those who underwent SCS at the first PSR. Multivariate analyses revealed that complete resection (hazard ratio [HR] = 0.120, <i>p</i> = 0.002) and optimal resection (HR = 0.228, <i>p</i> = 0.046) were independently associated with improved survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SCS is a safe and effective treatment for patients with platinum-sensitive recurrent ovarian cancer, regardless of whether it is performed at the first or second recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S4","pages":"36-44"},"PeriodicalIF":4.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875983","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":"PARP Inhibitors Rechallenge in Patients With Recurrent Ovarian Cancer: A Multicentre Real-World Study in China","authors":"Jin Li,&nbsp;Lingjun Zhao,&nbsp;Fei Zheng,&nbsp;Hua Zhu,&nbsp;Enchun Li,&nbsp;Wei Zhou,&nbsp;Guorong Yao,&nbsp;Jie Liu,&nbsp;Jianxiao Zheng,&nbsp;Shan Pan,&nbsp;Jinghui Hu,&nbsp;Feng Shao,&nbsp;Xiaohua Wu","doi":"10.1111/1471-0528.18181","DOIUrl":"10.1111/1471-0528.18181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the treatment pattern, outcomes, safety and identify patient populations benefiting from PARP inhibitor (PARPi) rechallenge for recurrent ovarian cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A multicentre, retrospective, real-world study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Twelve hospitals in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Seventy patients with recurrent ovarian cancer underwent PARPi rechallenge between 1 June 2019 and 10 March 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data, including demographic, clinical characteristics and treatment-related information, were retrospectively collected from electronic health records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The primary outcome was progression-free survival (PFS) of PARPi rechallenge (PARPi2) as maintenance therapy. We also conducted exploratory analysis to identify factors influencing PFS and characteristics associated with favourable outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 70 patients, 37.1% had BRCA1/2 mutations. PARPi2 was used as a maintenance therapy in 81.4% of patients, with a median PFS of 8.6 months (95% confidence interval [CI]: 6.0–13.5). PFS did not significantly differ by <i>BRCA</i> status (hazard ratio = 1.25 [95% CI: 0.60–2.60], <i>p</i> = 0.55). Achieving complete response (CR) to the last chemotherapy was a significant predictor for receiving PARPi2 for ≥ 6 months (vs. partial response, odds ratio = 4.25 [95% CI: 1.21–14.9], <i>p</i> = 0.02). Patients receiving combination therapies (33.3%) had longer median PFS than those receiving monotherapy (11.0 [95% CI: 5.2–15.3] vs. 7.7 [95% CI: 5.0–13.5] months). Overall, 2.9% of patients discontinued PARPi2 due to adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PARPi rechallenge as maintenance therapy may be feasible and tolerable. Achieving CR after the last chemotherapy is associated with longer PFS and combined therapies may improve outcomes, indicating potential to overcome PARPi resistance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S4","pages":"45-51"},"PeriodicalIF":4.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875871","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":"Dysmenorrhea and Adolescent Mental Health: A School-Based Cross-Sectional Study","authors":"Pietro Gambadauro,&nbsp;Gergö Hadlaczky,&nbsp;Danuta Wasserman,&nbsp;Vladimir Carli","doi":"10.1111/1471-0528.18187","DOIUrl":"10.1111/1471-0528.18187","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;While active monitoring of adolescent menstrual and mental health is advocated, research on their possible bidirectional relationship is limited. This study examines the association between adolescent dysmenorrhea and psychological symptoms.&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;Cross-sectional study.&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;116 schools in Stockholm, Sweden.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Sample&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;1054 postmenarchal school girls (mean age 14.1 ± 0.7) randomly sampled from a population of 10 299 lower-secondary pupils in a school-based project.&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;A self-report health survey assessed psychological symptoms using validated instruments. A multiple-choice item identified dysmenorrhea (menstrual pain affecting everyday life) and severe dysmenorrhea (dysmenorrhea that is hard to cope with).&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;Prevalence of dysmenorrhea and severe dysmenorrhea in girls with and without symptoms of depression (Beck's Depression Inventory-II score ≥ 20), anxiety (Generalised Anxiety Disorder 7-Item Scale score ≥ 10), self-injury (≥ 3 instances on a modified Deliberate Self-harm Inventory), and suicide ideation (recent serious thoughts/plans on the Paykel Suicide Scale).&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;Overall, 55.1% reported dysmenorrhea while 11.7% reported severe dysmenorrhea. Prevalence was 29%–34% higher among girls with psychological symptoms compared to those without. Severe dysmenorrhea was significantly more frequent among girls with any symptom (prevalence ratio [PR] 2.25; 95% CI 1.61, 3.13), depression (PR 2.60; 95% CI 1.86, 3.63), anxiety (PR 2.89; 95% CI 2.09, 4.00), self-injury (PR 1.87; 95% CI 1.29, 2.71), and suicide ideation (PR 1.75; 95% CI 1.18, 2.58) compared to girls without the same manifestations. These findings were consistent after adjustments for age, age of menarche, country of birth, and hormonal contraception.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;These findings emphasise the need for integrated approaches to adolescent menstrual and mental health ca","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 9","pages":"1278-1284"},"PeriodicalIF":4.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872082","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":"Post-Operative Pain After Pelvic Organ Prolapse Surgery (POPPOP): A Double Blind Randomised Multicentre Study to Assess the Effect of Local Anaesthesia During Vaginal Hysterectomy","authors":"Gans Thiagamoorthy,&nbsp;Anu Dua,&nbsp;George Araklitis,&nbsp;Rayan Mohamed-Ahmed,&nbsp;Jassimran Bansal,&nbsp;Faisal Karim,&nbsp;Cathy Davis,&nbsp;Rufus Cartwright,&nbsp;Vik Khullar,&nbsp;Aethele Khunda,&nbsp;Sushma Srikrishna,&nbsp;Dudley Robinson,&nbsp;Linda Cardozo","doi":"10.1111/1471-0528.18162","DOIUrl":"10.1111/1471-0528.18162","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 local anaesthetic with adrenaline (LAA) with normal saline for hydrodissection at vaginal hysterectomy.&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;A double-blind, two parallel group multicentre randomised controlled trial (RCT) was planned.&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;217 women undergoing vaginal hysterectomy were screened in the five participating centres between March 2015 and December 2018.&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;156 patients were recruited.&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 were randomised to Bupivacaine 0.25%/0.5% with adrenaline 1:200000 vesus normal saline. They completed baseline ‘pre-operation’, ‘same day 3–6 h post-op’ and ‘morning after surgery’ short-form McGill pain questionnaire (SFMcGill).&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;Primary endpoint was post-operative pain measured using SFMcGill. Secondary endpoints included estimated blood loss (EBL), ease of dissection, severity of ooze, change in pre- and post-operative haemoglobin, operating time, duration of inpatient stay and incidence of post-operative morbidity.&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;There were no demographic differences between the groups. LAA was associated with significantly smaller increases in pain scores compared to placebo, both between pre-operative and same-day post-operative (7.105 &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and to the next day post-operative (1.334 &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 \u0000 &lt;p&gt;Use of placebo infiltrate was associated with increased intra-operative bleeding (difference in EBL 110 mL &lt;i&gt;p&lt;/i&gt; &lt; 0.001), increased severity of ooze (VAS difference 5.01 &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and more difficult dissection (VAS difference 2.96 &lt;i&gt;p&lt;/i&gt; &lt; 0.001). There were no differences in pre-operative or post-operative measures of Hb, PCV, or post-operative analgesia (&lt;i&gt;p&lt;/i&gt; &gt; 0.05). There were significantly more complications in the placebo arm (5 vs. 0, &lt;i&gt;p&lt;/i&gt; = 0.02).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This multicentre-RCT demonstrated the value of LAA compared to normal saline as a paracervical infiltrate during vaginal hysterectomy under general anaesthesia: reduced intra-operative blood loss, improved ease of dissection, decreased same and next","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 9","pages":"1212-1219"},"PeriodicalIF":4.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862259","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":"Combination of PARP Inhibitor and Antiangiogenic Therapy Following Disease Progression in Patients With Epithelial Ovarian Cancer Undergoing PARP Inhibitor Maintenance Therapy: A Real-World Study","authors":"Nan Zhang,&nbsp;Hong Zheng,&nbsp;Yunong Gao,&nbsp;Tong Shu,&nbsp;Hongguo Wang,&nbsp;Yan Cai","doi":"10.1111/1471-0528.18179","DOIUrl":"10.1111/1471-0528.18179","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate whether the combination of antiangiogenic therapy and poly-ADP-ribose polymerase inhibitors (PARPi) can enhance the effectiveness of maintenance therapy in patients with progressive ovarian cancer who are progressing after PARPi maintenance therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Single-centre tertiary hospital in Beijing, China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Patients treated with combination therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed the clinicopathological data of patients with epithelial ovarian cancer. Telephone follow-ups were performed for eligible participants to verify disease progression and survival status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Clinical endpoints included objective response rate (ORR), disease control rate (DCR), time-to-symptomatic progression (TTSP), and progression-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 25 patients were analysed. Overall confirmed ORR was 44%, and the DCR was 68%. The median TTSP was 12.0 months (95% CI: 2.05–24.73). In the progression-free interval (PFI) &gt; 12 months group (<i>n</i> = 15), the ORR was 60% (9/15), and the DCR was 73.3%. In the PFI ≤ 12 months group (<i>n</i> = 10), the ORR was 20% (2/10), and the DCR was 60%. The median TTSP was not reached in the PFI &gt; 12 months group and was 4.0 months (95% CI: 2.988–5.012) for the PFI ≤ 12 months group. The 6-month progression-free survival rates were 58% and 40%, respectively. Among the 10 patients who received subsequent chemotherapy, seven achieved partial response (PR), and one had stable disease. The respective ORR and DCR values were 70% and 80%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Combining antiangiogenic therapy with the original PARPi may benefit patients with ascites-free ovarian cancer and a low tumour burden who experience disease progression following PARPi maintenance therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S4","pages":"29-35"},"PeriodicalIF":4.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862175","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":"Maternal Anaemia and Congenital Heart Disease in Offspring: A Case–Control Study Using Linked Electronic Health Records in the United Kingdom","authors":"Manisha Nair,&nbsp;Cynthia W. Drakesmith,&nbsp;Margaret Smith,&nbsp;Clare R. Bankhead,&nbsp;Duncan B. Sparrow","doi":"10.1111/1471-0528.18150","DOIUrl":"10.1111/1471-0528.18150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Assessment of whether maternal anaemia in early pregnancy is associated with offspring congenital heart disease (CHD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Matched case–control study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>January 1998–October 2020, United Kingdom.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Women with a haemoglobin measurement in the first 100 days of pregnancy and a CHD-diagnosed child.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were extracted from the United Kingdom Clinical Practice Research Datalink GOLD database of electronic health records. Cases were 2,776 women with a CHD-diagnosed child. These were compared to 13 880 matched controls, women without a CHD-diagnosed child. Anaemia was classified as &lt; 110 g/L haemoglobin following the WHO definition. A conditional logistic regression analysis was conducted, adjusted for potential maternal demographic and health-related confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Offspring CHD diagnosed within 5 years of birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>123 (4.4%) cases and 390 (2.8%) controls had anaemia. After adjusting for potential confounders, the odds of giving birth to a CHD-diagnosed child were 47% higher among anaemic mothers (adjusted OR 1.47, 95% CI 1.18,1.83, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The observed association between maternal anaemia in early pregnancy and increased risk of offspring CHD supports our recent evidence in mice. Approximately two-thirds of anaemia cases globally are due to iron deficiency. A clinical trial of periconceptional iron supplementation might be a minimally invasive and low-cost intervention for the prevention of some CHD if iron deficiency anaemia is proven to be a cause.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 8","pages":"1139-1146"},"PeriodicalIF":4.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862285","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 Forefront of Maintenance Therapy for Newly Diagnosed Advanced Ovarian Cancer in China: A Review of Updated Evidence With PARP Inhibitors","authors":"Lingling Xie,&nbsp;Shaodan Lin,&nbsp;Yunyun Liu,&nbsp;Xiaoting Ling,&nbsp;Zhongqiu Lin","doi":"10.1111/1471-0528.18180","DOIUrl":"10.1111/1471-0528.18180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In the first-line (1L) maintenance treatment of newly diagnosed advanced ovarian cancer (OC), poly (ADP-ribose) polymerase inhibitors (PARPi) have demonstrated significant benefits in progression-free survival (PFS) and an encouraging trend in overall survival (OS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To provide a summary of advances and evidence regarding the use of PARPi in the maintenance treatment of newly diagnosed advanced OC in the Chinese population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>Systematic search of PubMed from January 2016 to June 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Phase III randomized trials and real-world studies conducted in China were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>PARPi 1L maintenance studies conducted in China have shown that PARPi can prolong PFS in OC patients with manageable safety. Chinese patients differ from foreign patients in baseline characteristics and safety data. Given the current situation of 1L maintenance therapy in China, recommendations are made for maintenance strategies based on different biomarker status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PARPi 1L maintenance therapy offers survival benefit to Chinese patients with newly diagnosed advanced OC. OC has become a chronic disease that requires the selection of appropriate maintenance regimens based on multiple factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S4","pages":"5-12"},"PeriodicalIF":4.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857761","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":"Correction to: Predicting Risk of Endometrial Cancer in Asymptomatic Women (PRECISION): Model Development and External Validation","authors":"","doi":"10.1111/1471-0528.18174","DOIUrl":"10.1111/1471-0528.18174","url":null,"abstract":"<p>Citation: Kitson SJ, Crosbie EJ, Evans DG, Lophatananon A, Muir KR, Ashcroft D, Kontopantelis E, Martin GP. Predicting risk of endometrial cancer in asymptomatic women (PRECISION): Model development and external validation. BJOG. 2024 Jun;131(7):996–1005. doi: 10.1111/1471-0528.17729.</p><p>In section 3.1 and supplementary material 1, the equation for the PRECISION model was incorrect. Two minus signs were incorrectly placed outside of the brackets. The authors also wish to make it clear that to calculate a percentage risk, the result of the survivor function should be subtracted from 1 and multiplied by 100. The equation should, therefore, be:</p><p>10 year risk of endometrial cancer = (1-(0.994744^exp.((3.255742*(ln(age)-4.006403)) + (0.068818*(bmi-26.86005)) + (0.009267*(waist circumference-84.10584)) + (−0.00409*((age at menarche)^2–165.4293)) + (−0.00046*((age at last birth)^2–765.6623)) + (0.45412*late menopause) + (0.436605*HRT use) + (−0.3111*OCP use) + (1.038374*tamoxifen) + (0.346162*t2d) + (−0.29201*smoking) + (0.141787*fhx bowel cancer) + (−0.06*HRT use*(bmi-26.86005)))))*100.</p><p>We apologize for this error.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 8","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853103","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}