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

{"title":"Effect of Gonadotropin-Releasing Hormone Agonist Pre-Treatment on Outcomes of Fresh and Frozen Embryo Transfers in Women With Adenomyosis: A Retrospective Cohort Study With Literature Review","authors":"Xin Li,&nbsp;Yixin Li,&nbsp;Hexiang Peng,&nbsp;Mengying Wang,&nbsp;Yuqi Liu,&nbsp;Tao Wu,&nbsp;Qing Xue","doi":"10.1111/1471-0528.18026","DOIUrl":"10.1111/1471-0528.18026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the effect of gonadotropin-releasing hormone agonist (GnRHa) pre-treatment on the clinical outcomes of fresh and frozen embryo transfers (ETs and FETs, respectively) in infertile patients with adenomyosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study with literature review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Peking University First Hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>We analysed 413 cycles of 369 women with adenomyosis who underwent ETs or FETs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed logistic regression analysis and meta-analysis to assess the association of GnRHa pre-treatment with the clinical outcomes of ETs and FETs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The live birth rate (LBR) was compared between patients with and without GnRHa pre-treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The LBR was higher in the GnRHa pre-treatment group than in the non-GnRHa pre-treatment group in ETs (41.27% vs. 24.32%, <i>p</i> = 0.034) and FETs (40.36% vs. 20.75%, <i>p</i> = 0.008). The odds of achieving a live birth of women with GnRHa pre-treatment were 2.65 times higher than that of those without (95% CI: 1.19–5.92, <i>p</i> = 0.017) after adjusting for confounders in ETs. Similarly, the adjusted odds ratio (OR) was 2.43 (95% CI: 1.10–5.40, <i>p</i> = 0.029) in FETs. For the meta-analysis, eight studies met the inclusion criteria; however, only six reported the adjusted ORs. Combination of these six adjusted ORs with our results revealed that the GnRHa pre-treatment group had higher LBRs than the non-GnRHa pre-treatment group (ET: OR 1.71, 95% CI: 1.30–2.26, FET: OR 2.61, 95% CI: 1.52–4.49).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In women with adenomyosis, GnRHa pre-treatment may be beneficial for LBRs following both ETs and FETs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S2","pages":"62-74"},"PeriodicalIF":4.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142832775","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":"The Use of Novel Therapies in the Management of Haemolytic Disease of the Fetus and Newborn (HDFN)","authors":"V. Cordell,&nbsp;A. Soe,&nbsp;T. Latham,&nbsp;V. L. Bills,&nbsp;the Royal College of Obstetricians and Gynaecologists","doi":"10.1111/1471-0528.18008","DOIUrl":"10.1111/1471-0528.18008","url":null,"abstract":"<p>Haemolytic disease of the fetus and newborn (HDFN) is a rare condition that causes a baby to develop anaemia while growing inside the woman; or after birth. Left untreated, this may lead to stillbirth or neonatal death.</p><p>HDFN is caused when the pregnant woman's antibodies cross the placenta, enter the baby's circulation, and attach to proteins called antigens (inherited from the father) on the baby's haemoglobin containing red blood cells, and cause them to break apart, causing fetal anaemia.</p><p>Women routinely have their blood tested at the start of pregnancy to assess their ABO blood group and Rh antigens. There are five main Rhesus antigens: D, C, c, E, e; with anti-D being responsible for most cases of HDFN. If a woman is found to be Rh D negative; a ‘non-invasive’ blood test is performed to assess if the fetal blood group is the same as the woman's. If a woman is found to be Rh D negative, and the baby is found to be D positive, the baby is at risk. This is because the baby has inherited the D antigen from the father; so-called Rhesus incompatibility. Other red blood cell antibodies such as anti-Kell or anti-Duffy can also cause fetal anaemia. Women at highest risk of developing HDFN are those who have had at least one previous birth or a sensitising event (such as abdominal trauma) in a current or previous pregnancy, causing the woman and baby's blood to mix.</p><p>Current treatment for haemolytic disease of the fetus involves giving fetal blood transfusions, with a small risk of early labour or pregnancy loss. If anaemia develops later in pregnancy, early delivery of the baby may be recommended; which could lead to complications of prematurity. In cases of mild HDFN, the baby may only require light therapy for neonatal jaundice. However, if the anaemia occurs earlier in pregnancy and is severe, the baby may need blood transfusions while still in the womb - and after birth may require an exchange transfusion, to remove the woman's antibodies from their circulation and to treat the anaemia.</p><p>Intravenous immunoglobulin (IVIG) is a potential non-invasive method to prevent or delay the onset of severe anaemia. It is a blood product given intravenously every week to women who have been deemed at very high risk of early onset HDFN. It can be started at the end of the first trimester until birth, or until anaemia develops. This paper will discuss the evidence behind IVIG and other novel therapies during pregnancy, including the risks and the benefits. The developers of the paper include obstetricians, neonatologists and haematologists to provide different opinions on this topic.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 4","pages":"e53-e60"},"PeriodicalIF":4.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841778","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":"Serum Progesterone Level on the Day of Embryo Transfer Is Not a Reliable Predictor for Frozen–Thawed Embryo Transfer Outcomes With Euploid Blastocyst Transfer: A Retrospective Cohort Study","authors":"Wenjun Chen,&nbsp;Yiyao Xu,&nbsp;Xinyan Liu,&nbsp;Jiafu Pan,&nbsp;Bing Cai,&nbsp;Canquan Zhou,&nbsp;Yanwen Xu,&nbsp;Fang Gu","doi":"10.1111/1471-0528.18045","DOIUrl":"10.1111/1471-0528.18045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate whether serum progesterone (P4) levels on embryo transfer (ET) day correlate with the likelihood of live birth in artificial frozen–thawed transfer cycles using intramuscular progesterone.</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>University-affiliated hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Patients undergoing single euploid blastocyst transfer after preimplantation genetic testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Live birth rate (LBR) was calculated in each percentile of serum P4 to detect a threshold associated with an increased probability of LB. The association between serum P4 and pregnancy outcomes was evaluated using multivariable logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>LBR was the primary outcome. Secondary outcomes included clinical pregnancy rate (CPR) and early pregnancy loss (EPL) rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 761 patients were included, and the overall LBR was 55.72%. For LBR, each percentile group of serum P4 did not significantly differ. The distributions of P4 were comparable between the LB and non-LB groups, with an average of 12.62 ± 4.05 and 12.84 ± 4.39 ng/mL, respectively. The multivariate analysis revealed that serum P4 did not affect the LBR, whereas the day of the blastocyst (D5 vs. D6: adjusted odds ratio [aOR] 2.15, 95% confidence interval [CI] 1.52–3.03) and embryo quality (good vs. viable embryo: aOR 1.88, 95% CI 1.37–2.58) were independently associated with LBR. Similarly, serum P4 was not associated with CPR and EPL rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Serum P4 levels on ET day do not predict LBR in artificial cycles with intramuscular progesterone.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S2","pages":"53-61"},"PeriodicalIF":4.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142832785","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":"Effect of Preimplantation Genetic Testing for Aneuploidy on Live Birth Rate in Young Women With Recurrent Implantation Failure: A Secondary Analysis of a Multicentre Randomised Trial","authors":"Hengyu Guan,&nbsp;Yaqiong He,&nbsp;Yao Lu,&nbsp;Jiaan Huang,&nbsp;Yuan Wang,&nbsp;Qinling Zhu,&nbsp;Jia Qi,&nbsp;Wen Lin,&nbsp;Steven R. Lindheim,&nbsp;Zhe Wei,&nbsp;Ying Ding,&nbsp;Yun Sun","doi":"10.1111/1471-0528.18027","DOIUrl":"10.1111/1471-0528.18027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the benefit of preimplantation genetic testing for aneuploidy (PGT-A) in recurrent implantation failure (RIF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Secondary analysis of a multicentre, randomised, double-blind, placebo-controlled clinical trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Eight academic fertility centres in China, 2018–2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Overall, 485 infertile women aged &lt; 38 years were evaluated. They had a history of two or more unsuccessful embryo transfer cycles with at least three good-quality embryos that had been transferred cumulatively and underwent a single blastocyst transfer with or without PGT-A. Those with thin endometrium or recurrent pregnancy loss were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were categorised into PGT-A and non-PGT-A groups. All pregnancies were followed to delivery. Pregnancy and neonatal outcomes were obtained from obstetric and neonatal medical records. Propensity score matching (PSM) and multivariate logistic regression models were applied to adjust for potential confounding factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>LBR per embryo transfer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result(s)</h3>\u0000 \u0000 <p>There was no significant difference in LBR between the PGT-A and non-PGT-A groups both before (39.1% vs. 41.5%, <i>p</i> = 0.760) and after (39.1% vs. 40.6%, <i>p</i> = 0.862) PSM. Unadjusted and adjusted logistic regression models revealed no beneficial effect of PGT-A on LBR per embryo transfer (crude odds ratio: 0.91, 95% confidence interval: 0.49–1.69; adjusted odds ratio: 1.04, 95% confidence interval: 0.53–2.03). The incidence of maternal and neonatal complications was not significantly different between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with RIF aged &lt; 38 years do not benefit from PGT-A. Thus, factors other than genetic abnormalities may contribute to this clinical conundrum.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S2","pages":"92-99"},"PeriodicalIF":4.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142825047","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":"Neglected for Too Long: Perinatal Mental Health Impacts of Stillbirth in Low- and Middle-Income Countries","authors":"Hannah Blencowe,&nbsp;Oona Campbell,&nbsp;Toma Kerac,&nbsp;Renae Stafford,&nbsp;Vandana Tripathi,&nbsp;Veronique Filippi","doi":"10.1111/1471-0528.18051","DOIUrl":"10.1111/1471-0528.18051","url":null,"abstract":"&lt;p&gt;Stillbirths are one of the world's most neglected tragedies. The estimated 1.9 million babies that are stillborn after 28 completed weeks of pregnancy in 2021 underestimates the overall burden of all fetal deaths from 22 weeks onward [&lt;span&gt;1&lt;/span&gt;]. Each death has an important impact on affected women, families and healthcare workers [&lt;span&gt;2&lt;/span&gt;]. Yet, despite this, until very recently, national governments, UN organisations and civil society institutions (including non-governmental organisations and professional associations) worldwide have given little attention to stillbirths. This has resulted in lack of prioritisation of stillbirths in data strengthening efforts, limiting visibility of underlying biomedical causes [&lt;span&gt;3&lt;/span&gt;]. This coupled with the failure to include stillbirths in maternal and child health dialogues exacerbates stigma towards affected women, and frequently leaves bereaved parents to deal with their grief in silence.&lt;/p&gt;&lt;p&gt;Perinatal mental health disorders, occurring during pregnancy and in the first year after childbirth, affect almost one in five women giving birth and have only recently been brought out of the shadows [&lt;span&gt;4&lt;/span&gt;]. Many organisations are now accelerating their focus on the issue and global guidance on the integration of perinatal mental health into routine healthcare provision is now available [&lt;span&gt;5&lt;/span&gt;]. However, despite a strong body of evidence describing increased risks of adverse perinatal mental health outcomes associated with stillbirth in high-income countries [&lt;span&gt;2&lt;/span&gt;], and newer evidence reporting similar effects across a wide range of low- and middle- income countries (LMICs) [&lt;span&gt;6-9&lt;/span&gt;], stillbirths have been to-date largely left out of perinatal mental health guidance.&lt;/p&gt;&lt;p&gt;We conducted a rapid review of evidence on the perinatal mental health consequences of stillbirth as part of the MOMENTUM Safe Surgery in Family Planning and Obstetrics (MOMENTUM Safe Surgery) project's work to improve postnatal services [&lt;span&gt;10, 11&lt;/span&gt;]. Collating available data across 20 studies from 12 low- and middle-income countries, a median of 41% of women reported evidence of depression in the year following a perinatal loss (stillbirth or early neonatal death) [&lt;span&gt;9&lt;/span&gt;]. This is at least double the risk compared to after a live birth, translating to around 1.2 million women annually with depression in the year following a stillbirth or early neonatal death in sub-Saharan Africa and South Asia alone. Increases in anxiety and stress were also observed, presenting a substantial burden on women, families and communities in these regions.&lt;/p&gt;&lt;p&gt;Adverse perinatal mental health consequences following stillbirth can be partly mitigated through timely, person-centred supportive bereavement care. The past decade has seen large advances in understanding the experiences and care needs for affected women, partners and families, including the introduction of national care berea","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 5","pages":"554-556"},"PeriodicalIF":4.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142825048","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 After Metabolic Bariatric Surgery: Risks and Rewards for Mother and Child","authors":"Dries Ceulemans,&nbsp;Ellen Deleus,&nbsp;Katrien Benhalima,&nbsp;Bart van der Schueren,&nbsp;Matthias Lannoo,&nbsp;Roland Devlieger","doi":"10.1111/1471-0528.18032","DOIUrl":"10.1111/1471-0528.18032","url":null,"abstract":"<div>\u0000 \u0000 <p>As the prevalence of obesity increases worldwide, and lifestyle modification or pharmaceutical treatment yields insufficient results for patients with severe obesity, an increasing number of patients opt for metabolic bariatric surgery as an effective and durable treatment of this disease. Seeing as 80% of these patients are women, many of whom are of reproductive age, pregnancies after metabolic bariatric surgery become increasingly common. Metabolic bariatric surgery has many benefits for overall health and pregnancy outcomes, but certain risks are also reported. This leads to the rise of a new population of patients with their own specific needs regarding follow-up. This review discusses the various benefits and risks of these types of surgery for pregnancy. We provide an overview of the current state of the evidence and look into future research goals.</p>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 4","pages":"401-413"},"PeriodicalIF":4.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142810160","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":"A Care Bundle Aiming to Reduce the Risk of Obstetric Anal Sphincter Injury: A Survey of Women's Experiences","authors":"Magdalena Jurczuk,&nbsp;Lizzie Phillips,&nbsp;Posy Bidwell,&nbsp;Dorian Martinez,&nbsp;Louise Silverton,&nbsp;Nick Sevdalis,&nbsp;Jan van der Meulen,&nbsp;Ipek Gurol-Urganci,&nbsp;Ranee Thakar","doi":"10.1111/1471-0528.18029","DOIUrl":"10.1111/1471-0528.18029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To study experiences of women who gave birth in maternity units that have implemented a ‘care bundle’ quality improvement initiative to reduce obstetric anal sphincter injury (OASI) and associated morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Postnatal electronic questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Twenty-nine maternity units across England, Scotland and Wales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Women with live vaginal births.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Descriptive statistics for quantitative results. Analysis of free-text responses informed by framework method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Experience with components of the care bundle: information provision, manual perineal protection (MPP) and post-birth rectal examination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, 1208 women completed the survey: 684 (56.6%) said they received antenatal information about perineal health, 377 (31.2%) recalled MPP, and 664 (55.0%) recalled rectal examination. Of the 684 women who said they received antenatal information, 595 (87.0%) agreed that the information was easy to understand, and 423 (61.8%) agreed that it helped them to make their own choices to reduce their OASI risk. One hundred and fifty-four (22.5%) agreed that the information made them fearful about giving birth vaginally. Of the 377 women who recalled MPP, 203 (53.9%) felt it provided them with support, and another 97 (25.7%) did not mind the sensation. Of the 664 women who recalled rectal examination, 281 (42.3%) did not mind the exam, and another 335 (50.5%) felt it was uncomfortable but understood its importance. Free-text responses aligned with quantitative results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Many women did not recall MPP or rectal examination. The reported experiences for those who recalled these components do not support concerns that the OASI care bundle has negative effects on women's experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 5","pages":"588-595"},"PeriodicalIF":4.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142810161","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":"Point-of-Care Tests for Preeclampsia: Systematic Review and Meta-Analysis of Diagnostic Test Accuracy Studies","authors":"Nouran Elbarbary,&nbsp;Filippa Pritsini,&nbsp;Ayisha Kazi,&nbsp;Chao Wang,&nbsp;Baskaran Thilaganathan,&nbsp;Amarnath Bhide","doi":"10.1111/1471-0528.18040","DOIUrl":"10.1111/1471-0528.18040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Preeclampsia is a common condition associated with significant maternal and foetal complications. The diagnosis of preeclampsia is based on clinical criteria, with recent introduction of angiogenic markers as an aid to clinical triage. Several biomarkers are now available in a point-of-care test format, which provide swift results to support clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine sensitivity and specificity of available point-of-care tests used for preeclampsia prediction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>Systematic searches of databases (PubMed/Medline, Ovid Embase) from inception till May 2024 were done to identify relevant studies. Selection criteria: we included studies reporting on the diagnostic test accuracy of any point-of-care test for short-term prediction of preeclampsia in the second or third trimester.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Data were extracted using pre-designed template, and statistical analysis was performed to pool sensitivity and specificity and a hierarchal summary receiver operating characteristic curve model was used. Quality of included studies and risk of bias were assessed following the QUADAS-2 tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>We identified 17 studies that met the inclusion criteria, six of which described the use of glycosylated fibronectin, five with Congo red, two with placental growth factor (PlGF) and one study each investigated nephrin, misfolded protein, CD44/FKBPL ratio and inositol phosphoglycan-P. Meta-analysis was possible only for glycosylated fibronectin with a pooled sensitivity of 0.80 (95% CI: 0.51–0.94) and a specificity of 0.84 (95% CI: 0.71–0.93). Five studies were included in meta-analysis, all of which had a low risk of bias on the QUADAS assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that the point-of-care glycosylated fibronectin testing might be beneficial in clinical triage for preeclampsia in an at-risk population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 4","pages":"414-425"},"PeriodicalIF":4.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142810158","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":"Factors Contributing to Uptake of Stillbirth Evaluations: A Qualitative Analysis","authors":"Naomi O. Riches,&nbsp;Tsegaselassie Workalemahu,&nbsp;Erin P. Johnson,&nbsp;Sarah Lopez,&nbsp;Nathan Blue,&nbsp;Jessica Page,&nbsp;Robert M. Silver,&nbsp;Erin Rothwell","doi":"10.1111/1471-0528.18038","DOIUrl":"10.1111/1471-0528.18038","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;The purpose of this study was to explore individuals' beliefs, values, and experiences surrounding stillbirth evaluation decisions.&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;Qualitative research.&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;University of Utah Health.&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;Parents who experienced a stillbirth in the past 5 years (&lt;i&gt;n&lt;/i&gt; = 19) were interviewed about their experiences and decision to consent to or decline stillbirth evaluations, such as autopsy, placental histopathology, or genetic testing.&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;Qualitative content analysis.&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;Barriers and facilitators to parentsstillbirth postmortem decision-making.&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;Participants communicated several facilitators and barriers that contributed to their stillbirth evaluation decision. Reasons for consenting to evaluations were belief in science, background in medicine, altruism, to inform future pregnancies, thinking about preventing another stillbirth, and how patients viewed the care of their stillborn by the medical team. Reasons for declining evaluations were receiving a diagnosis prior to being offered a postmortem evaluation, intent to avoid causing further harm to the baby, interest to spend more time with their baby, and cost of the evaluation.&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;Stillbirth is one of the most difficult experiences of a parent. Diagnostic and emotional barriers create further challenges to decision-making for stillbirth postmortem evaluations. Parents often rely on inadequate information and personal values and beliefs during this time-sensitive decision process. Decision support for stillbirth evaluations and training for medical providers could benefit parents, may increase stillbirth evaluation uptake, and potentially prevent decisional regret.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Funding&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Research reported in this publication was sup","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 5","pages":"606-613"},"PeriodicalIF":4.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793209","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":"Biopsychosocial Approaches to Treat Female Chronic Pelvic Pain","authors":"Jim G. Thornton,&nbsp;Nick Brown","doi":"10.1111/1471-0528.18035","DOIUrl":"10.1111/1471-0528.18035","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 7","pages":"1010-1011"},"PeriodicalIF":4.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793210","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}