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

{"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, Aris T. Papageorghiou","doi":"10.1111/1471-0528.17967","DOIUrl":"10.1111/1471-0528.17967","url":null,"abstract":"<p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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.</p><p>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, Katariina Laine, 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, Hisako Okada, Amir L. Butt, 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}

{"title":"Assessment of Structural and Process Readiness for Postpartum Haemorrhage Care in Uganda and Ghana: A Mixed Methods Study","authors":"Tara Tancred,&nbsp;Andrew D. Weeks,&nbsp;Vincent Mubangizi,&nbsp;Emmanuel Nene Dei,&nbsp;Sylvia Natukunda,&nbsp;Chloe Cobb,&nbsp;Imelda Bates,&nbsp;Lucy Asamoah-Akuoko,&nbsp;Bernard Natukunda","doi":"10.1111/1471-0528.17953","DOIUrl":"10.1111/1471-0528.17953","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine structural and process readiness for postpartum haemorrhage (PPH) care at referral-level facilities in Ghana and Uganda to identify opportunities for strengthening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Mixed-methods cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Three districts in Ghana and two in Uganda.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population or Sample</h3>\u0000 \u0000 <p>Nine hospitals in Ghana and seven in Uganda; all hospitals had theoretical capacity for caesarean section and blood transfusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We deployed a modular quantitative health facility assessment to explore structural readiness (drugs, equipment, staff) complemented by in-depth interviews with maternity health service providers to understand process readiness (knowledge, attitudes, and practices as related to World Health Organization [WHO] guidance on PPH care).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Availability of essential structural components needed to support key PPH processes of care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In both countries, there was generally good structural readiness for PPH care. However, key common gaps included inadequate staffing (especially specialist physicians), and unavailability of blood for transfusion. Interviews highlighted particularly good process readiness in the provision of uterotonics, recognising and responding to retained placenta, and repairing tears. However, there were clear gaps in the utilisation of tranexamic acid and uterine balloon tamponade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We have identified good structural and process readiness across both Ghanaian and Ugandan health facilities to support PPH responses. However, some key missed opportunities—to align with current WHO guidance on providing bundles of interventions for PPH care—could be strengthened with minimal investment but promising impact.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 4","pages":"433-443"},"PeriodicalIF":4.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247139","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":"Emergency Maternal Hospital Readmissions in the Postnatal Period: A Population-Based Cohort Study","authors":"Ruth V. Pritchett,&nbsp;Gavin Rudge,&nbsp;Beck Taylor,&nbsp;Carole Cummins,&nbsp;Sara Kenyon,&nbsp;Ellie Jones,&nbsp;Sharon Morad,&nbsp;Christine MacArthur,&nbsp;Kate Jolly","doi":"10.1111/1471-0528.17955","DOIUrl":"10.1111/1471-0528.17955","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the change in English emergency postnatal maternal readmissions 2007–2017 (pre-COVID-19) and the association with maternal demographics, obstetric risk factors and postnatal length of stay (LOS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>National cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>All English National Health Service hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>A total of 6 192 140 women who gave birth in English NHS hospitals from April 2007 to March 2017.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Statistical analysis using birth and readmission data from routinely collected National Hospital Episode Statistics (HES) database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Rate of emergency postnatal maternal hospital readmissions related to pregnancy or giving birth within 42 days postpartum, readmission diagnoses and association with maternal demographic factors, obstetric risk factors and postnatal LOS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant increase in the rate of emergency postnatal maternal readmissions from 15 128 (2.5%) in 2008 to 20 734 (3.4%) in 2016 (aOR 1.32, 95% CI 1.28–1.37) was found. Risk factors for readmission included minoritised ethnicity (particularly Black or Black British ethnicity: aOR 1.35, 95% CI 1.31–1.39); age &lt; 20 years (aOR 1.09, 95% CI 1.05–1.12); 40+ years (aOR 1.07, 95% CI 1.03–1.10); primiparity (multiparity: aOR 0.92, 95% CI 0.91–0.93); nonspontaneous vaginal birth modes (emergency caesarean: aOR 1.86, 95% CI 1.82–1.90); longer LOS (4+ vs. 0 days: aOR 1.58, 95% CI 1.53–1.64); and obstetric risk factors including urinary retention (aOR 2.34, 95% CI 2.06–2.53) and postnatal wound breakdown (aOR 2.01, 95% CI 1.83–2.21).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The concerning rise in emergency maternal readmissions should be addressed from a health inequalities perspective focusing on women from minoritised ethnic groups; those &lt; 20 and ≥ 40 years old; primiparous women; and those with specified obstetric risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 2","pages":"178-188"},"PeriodicalIF":4.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142236962","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":"Differences in Factors Associated With Preterm and Term Stillbirth: A Secondary Cohort Analysis of the DESiGN Trial","authors":"Chivon Winsloe,&nbsp;James Elhindi,&nbsp;Matias C. Vieira,&nbsp;Sophie Relph,&nbsp;Charles G. Arcus,&nbsp;Alessandro Alagna,&nbsp;Annette Briley,&nbsp;Mark Johnson,&nbsp;Louise M. Page,&nbsp;Andrew Shennan,&nbsp;Baskaran Thilaganathan,&nbsp;Neil Marlow,&nbsp;Christoph Lees,&nbsp;Deborah A. Lawlor,&nbsp;Asma Khalil,&nbsp;Jane Sandall,&nbsp;Andrew Copas,&nbsp;Dharmintra Pasupathy,&nbsp;the DESiGN Trial team","doi":"10.1111/1471-0528.17951","DOIUrl":"10.1111/1471-0528.17951","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 identify whether maternal and pregnancy characteristics associated with stillbirth differ between preterm and term stillbirth.&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;Secondary cohort analysis of the DESiGN RCT.&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;Thirteen UK maternity units.&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;Singleton pregnant women and their babies.&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;Multiple logistic regression was used to assess whether the 12 factors explored were associated with stillbirth. Interaction tests assessed for a difference in these associations between the preterm and term periods.&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;Stillbirth stratified by preterm (&lt;37&lt;sup&gt;+0&lt;/sup&gt; weeks') and term (37&lt;sup&gt;+0&lt;/sup&gt;–42&lt;sup&gt;+6&lt;/sup&gt; weeks') births.&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;A total of 195 344 pregnancies were included. Six hundred and sixty-seven were stillborn (3.4 per 1000 births), of which 431 (65%) were preterm. Significant interactions were observed for maternal age, ethnicity, IMD, BMI, parity, smoking, PAPP-A, gestational hypertension, pre-eclampsia and gestational diabetes but not for chronic hypertension and pre-existing diabetes. Stronger associations with term stillbirth were observed in women with obesity compared to BMI 18.5–24.9 kg/m&lt;sup&gt;2&lt;/sup&gt; (BMI 30.0–34.9 kg/m&lt;sup&gt;2&lt;/sup&gt; term adjusted OR 2.1 [95% CI 1.4–3.0] vs. preterm aOR 1.1 [0.8–1.7]; BMI ≥ 35.0 kg/m&lt;sup&gt;2&lt;/sup&gt; term aOR 2.2 [1.4–3.4] vs. preterm aOR 1.5 [1.2–1.8]; &lt;i&gt;p&lt;/i&gt;-interaction &lt; 0.01), nulliparity compared to parity 1 (term aOR 1.7 [1.1–2.7] vs. preterm aOR 1.2 [0.9–1.6]; &lt;i&gt;p&lt;/i&gt;-interaction &lt; 0.01) and Asian ethnicity compared with White (&lt;i&gt;p&lt;/i&gt;-interaction &lt; 0.01). A weaker or lack of association with term, compared to preterm, stillbirth was observed for older maternal age, smoking and pre-eclampsia.&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;Differences in association exist between mothers experiencing preterm and term stillbirth. These differences could contribute to design of timely surveillance and interventions to","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 1","pages":"89-98"},"PeriodicalIF":4.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17951","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245525","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":"Julia Sanders,&nbsp;Christy Barlow,&nbsp;Peter Brocklehurst,&nbsp;Rebecca Cannings-John,&nbsp;Susan Channon,&nbsp;Judith Cutter,&nbsp;Billie Hunter,&nbsp;Mervi Jokinen,&nbsp;Fiona Lugg-Widger,&nbsp;Sarah Milosevic,&nbsp;Christopher Gale,&nbsp;Rebecca Milton,&nbsp;Leah Morantz,&nbsp;Shantini Paranjothy,&nbsp;Rachel Plachcinski,&nbsp;Michael Robling","doi":"10.1111/1471-0528.17960","DOIUrl":"10.1111/1471-0528.17960","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 2","pages":"226-227"},"PeriodicalIF":4.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275609","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":"Advocating for Change: Lifting Mesh Suspension in SUI Surgery Based on Established Literature and Long-Term TVT Study Results","authors":"Reut Rotem,&nbsp;Orfhlaith E. O'Sullivan","doi":"10.1111/1471-0528.17963","DOIUrl":"10.1111/1471-0528.17963","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 4","pages":"539-540"},"PeriodicalIF":4.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142245526","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}