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

{"title":"Evaluating the Effectiveness of Assisted Oocyte Activation in ICSI: Pairwise Meta-Analyses and Systematic Evidence Evaluation","authors":"Mohamed Fawzy,&nbsp;Mohamad AlaaEldein Elsuity,&nbsp;Yasmin Magdi,&nbsp;Mosab Mahmod Rashwan,&nbsp;Mostafa Ali Gad,&nbsp;Nehal Adel,&nbsp;Mai Emad,&nbsp;Dina Ibrahem,&nbsp;Sara El-Gezeiry,&nbsp;Ahmed Etman,&nbsp;Niveen Shaker Ahmed,&nbsp;Tamer Abdelhamed,&nbsp;Ahmed El-Damen,&nbsp;Ali Mahran,&nbsp;Gamal I. Serour,&nbsp;Mohamed Y. Soliman","doi":"10.1111/1471-0528.18085","DOIUrl":"10.1111/1471-0528.18085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Artificial oocyte activation (AOA) is used to improve fertilisation rates in intracytoplasmic sperm injection (ICSI) cycles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the effectiveness of AOA on fertilisation, embryo development, and clinical outcomes, including live birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>We searched PubMed, Cochrane, and Scopus from January 1990 to March 2024 using terms related to ‘artificial oocyte activation’ and ‘ICSI.’</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Study designs included randomised trials (RCTs), quasi-experimental, cohort, and case–control studies that evaluated AOA's effects on ICSI outcomes, provided quantitative data and were published in English.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Reviewers independently performed data extraction using a standardised form. Study quality was appraised using Joanna Briggs Institute (JBI) Checklists. Meta-analyses employed a random-effects model, and evidence was classified using a comprehensive numerical framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>We included 45 studies covering 56 787 mature oocytes, 7463 women for clinical pregnancies, and 7063 women for live births. AOA showed potential in increasing fertilisation rates in patients with a history of low or absent fertilisation but did not enhance embryo development or clinical outcomes. This effect diminished when excluding low-quality studies or focusing solely on RCTs. In other patient groups, AOA showed limited or nonsignificant benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Applying comprehensive evidence assessment, AOA showed potential in improving fertilisation rates in patients with fertilisation problems but no benefits for embryo development or live birth rates. This underscores the critical importance of rigorous evidence credibility in informing clinical practice in assisted conception.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"724-741"},"PeriodicalIF":4.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068882","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 Influencing Pregnant Women's Participation in Randomised Clinical Trials in India: A Qualitative Study","authors":"Mridula Shankar,&nbsp;Umesh Charantimath,&nbsp;Ashwini Dandappanavar,&nbsp;Alya Hazfiarini,&nbsp;Yeshita V. Pujar,&nbsp;Manjunath S. Somannavar,&nbsp;Sara Rushwan,&nbsp;Joshua P. Vogel,&nbsp;A. Metin Gülmezoglu,&nbsp;Shivaprasad S. Goudar,&nbsp;Meghan A. Bohren","doi":"10.1111/1471-0528.18074","DOIUrl":"10.1111/1471-0528.18074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore factors affecting participation of pregnant women in randomised clinical trials in Belagavi, Karnataka, India.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative study using semi-structured in-depth interviews and focus group discussions as data collection methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Primary, secondary and tertiary health facilities and their community catchment areas in Belagavi district.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Sample</h3>\u0000 \u0000 <p>Thirty-three in-depth interviews with health workers and previous participants of a pregnancy-focused trial, and 12 focus group discussions with currently pregnant women who had not previously participated in a clinical trial, family and community members, and accredited social health activists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Inductive thematic analysis with a team-based approach to interpretation in the study context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pregnant women were often unable to distinguish between maternal health programmes and trial interventions. Among previous trial participants, expectations of higher quality care were a key motivation for trial participation. Household gendered power relations and trust in the health workforce influenced decisional dynamics regarding participation. Health workers vouched for trial safety, once they assessed the intervention as acceptable. Trial Implementation by the health workforce required understanding and navigating pregnancy-related beliefs and practices in communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anticipated health benefits, improved healthcare access, and trust in health workers are facilitators of trial participation. Engaging primary decision-makers is essential due to household gender dynamics. Trials must integrate strategies that clarify the distinct goals of research versus clinical care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"772-781"},"PeriodicalIF":4.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054291","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":"Impact of Laser-Assisted Hatching on Cognitive and Metabolic Development of Singletons Conceived Through Frozen–Thawed Embryo Transfer: A Matched Cohort Study","authors":"Xin-Yi Liu,&nbsp;Chun-Xi Zhang,&nbsp;Jian-Peng Chen,&nbsp;Qi Liang,&nbsp;Yi-Qing Wu,&nbsp;Jing-Lei Xue,&nbsp;Ling-Hui Li,&nbsp;Qi-Qi Xu,&nbsp;Fang-Hong Zhang,&nbsp;Ying-Zhi Yang,&nbsp;Yue-Mei Wang,&nbsp;Yi-Feng Liu,&nbsp;Dan Zhang","doi":"10.1111/1471-0528.18047","DOIUrl":"10.1111/1471-0528.18047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to examine the impact of laser-assisted hatching (LAH) on the physical, metabolic, cognitive and behavioural profiles of singletons conceived through frozen–thawed embryo transfer (FET) at the preschool age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A matched cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The reproductive centre of Women's Hospital, Zhejiang University School of Medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Singletons born to couples with infertility who underwent FET cycles with or without LAH treatment from 2016 to 2019 and were followed up till age 4–6 years in 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cognitive and behavioural development was evaluated at the preschool age using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) and the Adaptive Behavior Assessment System, Second Edition (ABAS-II). Statistical analysis was performed using moderated multiple linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The full-scale intelligence quotient (FSIQ) and general adaptive composite (GAI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 120 pairs of mother and child were included in the analysis. No significant differences in age, sex, height, weight, body mass index, blood pressure, thyroid function and metabolic indicators were observed between the two groups. After adjusting for demographics and socioeconomic status, LAH singletons showed FSIQ and GAI scores similar to those of non-LAH singletons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>At 4–6 years of age, the cognitive, metabolic and physical developmental outcomes of preschool children born after LAH treatment were comparable with those of the non-LAH group, indicating that LAH may be considered a safe assisted reproductive technology method. However, further longer and regular follow-ups are needed to validate the findings of this study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 S2","pages":"18-25"},"PeriodicalIF":4.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143020976","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":"Impact of the COVID-19 Pandemic on Cervical Cancer Screening: An International Comparative Study by INTRePID","authors":"Maria Carla Lapadula,&nbsp;Dorsa Mohammadrezaei,&nbsp;Angela Ortigoza,&nbsp;Amanda Freitas,&nbsp;Javier Silva-Valencia,&nbsp;the INTRePID Consortium","doi":"10.1111/1471-0528.18077","DOIUrl":"10.1111/1471-0528.18077","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 5","pages":"676-677"},"PeriodicalIF":4.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992117","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":"Managing Pregnancies of Unknown Location With the M4 Prediction Model or the NICE Algorithm: A Randomised Controlled Trial With Cross-Sectional Diagnostic Accuracy Data","authors":"Johan Fistouris,&nbsp;Helen Garbergs,&nbsp;Katja Bergman,&nbsp;Christina Bergh,&nbsp;Annika Strandell","doi":"10.1111/1471-0528.18079","DOIUrl":"10.1111/1471-0528.18079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the diagnostic performance and clinical utility of the M4 prediction model and the NICE algorithm managing women with pregnancy of unknown location (PUL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>The study has a superiority design regarding specificity for non-ectopic pregnancy for M4, given that the primary outcome of sensitivity for ectopic pregnancy (EP) is non-inferior in comparison with the NICE algorithm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Emergency gynaecology units in Sweden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>595 women with PUL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were randomised (1:1) to M4 or the NICE algorithm after two serum human chorionic (hCG) levels and were categorised as high or low risk of having an EP. The diagnostic performance was evaluated on cross-sectional data and utility by parallel groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The proportion of EP categorised as high risk (sensitivity) and non-ectopic pregnancies categorised as low risk (specificity). Clinical outcomes were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sensitivity for EP was 79% (115 of 146) for M4 versus 85% (124 of 146) for the NICE algorithm, <i>p</i> = 0.1496 and the specificity for non-ectopic pregnancies was 67% (300 of 449) for M4 and 74% (334 of 449) for the NICE algorithm, <i>p</i> = 0.0003. Clinical outcomes were similar between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The sensitivity for EP by M4 was non-inferior to NICE, but specificity was better for the NICE algorithm. No between group differences were observed for clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>NCT 03461835, https://www.clinicaltrials.gov\u0000 </p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"742-751"},"PeriodicalIF":4.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142992116","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":"Evaluating the Cost-Effectiveness of Antenatal Screening for Major Structural Anomalies During the First Trimester of Pregnancy: A Decision Model","authors":"Helen E. Campbell,&nbsp;Jehan N. Karim,&nbsp;Aris T. Papageorghiou,&nbsp;Edward C. F. Wilson,&nbsp;Oliver Rivero-Arias,&nbsp;the ACCEPTS Study","doi":"10.1111/1471-0528.18053","DOIUrl":"10.1111/1471-0528.18053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the cost-effectiveness of modifying current antenatal screening by adding first trimester structural anomaly screening to standard of care second trimester anomaly screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Health economic decision model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>National Health Service (NHS) in England and Wales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Pregnant women attending for first trimester antenatal screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The decision model estimated pregnancy outcomes (maternal and foetal) and 20-year costs for current screening practice and for a policy adding a protocol screening for eight major structural anomalies to the current first trimester ultrasound scan. Event probabilities, costs, and outcomes for the model were informed by meta-analyses, published literature, and expert opinion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcomes Measures</h3>\u0000 \u0000 <p>Expected numbers of pregnancy outcomes, healthcare costs, and maternal quality-adjusted life years (QALYs). Estimation of the incremental cost-effectiveness ratio (ICER), likelihood of cost-effectiveness, and a value of information (VoI) analysis assessing if further research is needed before making a decision about screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>First trimester anomaly screening increased mean per woman costs by £11 (95% CI £1–£29) and maternal QALYs by 0.002065 (95% CI 0.00056–0.00358). The ICER was £5270 per QALY and the probability of cost-effectiveness at a willingness to pay value for a QALY of £20 000, exceeded 95%. VoI analysis showed further research would be unlikely to represent value for money. The protocol would likely lead to a reduction in infant healthcare costs and QALYs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A protocol to screen for eight major structural anomalies during the first trimester appears to represent value for money for the NHS. The opposing implications for mothers and infants, however, raise complex, challenging, and sensitive issues.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 5","pages":"638-647"},"PeriodicalIF":4.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991563","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":"INTERGROWTH-21st Birthweight Charts Offer Excellent Concordance With UK-WHO Birthweight Charts Used by Neonatologists","authors":"Sophie Alexandra Relph,&nbsp;Julien Josseph Stirnemann,&nbsp;Raffaele Napolitano","doi":"10.1111/1471-0528.18048","DOIUrl":"10.1111/1471-0528.18048","url":null,"abstract":"&lt;p&gt;There is a wide range of charts available for the assessment of estimated foetal weight (EFW) and measured neonatal weight centiles at a given gestational age. Charts vary in methodology, with descriptive and prescriptive, population and customised versions available, many designed with a high risk of bias [&lt;span&gt;1, 2&lt;/span&gt;]. In many countries, including the UK, operators use varied charts for prenatal and neonatal care, leading to disagreement on diagnosis of abnormal growth. In determining which chart to apply in our tertiary centre and potentially nationwide, we aimed to identify a chart package that is applicable to our population, offers charts for assessment of EFW, actual birthweight and fundal height and is concordant with the UK-WHO birthweight charts recommended nationally by the Royal College of Paediatrics and Child Health (RCPCH—rcpch.ac.uk) which are based on British growth reference centiles derived by Cole in 1990 [&lt;span&gt;3&lt;/span&gt;]. Such concordance should facilitate agreement on small or large sizes, including the presence of growth restriction, between obstetricians and neonatologists, improving continuity of care with regard to the risk of perinatal morbidity and mortality. The INTERGROWTH-21st package offers both foetal and neonatal charts and has previously shown good continuity of growth between prenatal and neonatal centiles at late pre-term and term gestations in these populations when EFW in grams was calculated using both their formula including head and abdominal circumference only, or the Hadlock's formula, using three parameters (head, abdominal circumference and femur length) [&lt;span&gt;4, 5&lt;/span&gt;]. INTERGROWTH-21st prenatal chart centiles have also been shown to adequately fit the distribution of a large French prospective sample of ultrasound-derived foetal measurements [&lt;span&gt;6&lt;/span&gt;]. Here, we describe work to evaluate whether the INTERGROWTH-21st birthweight centiles are concordant with those of the UK-WHO birthweight charts for pre-term and term births [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We used 10th, 50th and 90th centile thresholds published by the INTERGROWTH-21st group for neonatal birthweight charts at each gestational day between 24 and 42 weeks to produce centile charts for male and female babies. UK-WHO birthweight centiles have only been published in chart format, from which it is difficult to derive the exact birthweight for the 10th, 50th and 90th centiles during each gestational day. We therefore produced a simulation data set, including male and female neonates with birthweights of 10-g increments between 400 and 5500 g, for each gestational day between 24 and 42 weeks. We calculated the UK-WHO birthweight centiles using the Stata ‘zanthro’ command (StataCorp LLC, Texas, USA). &lt;i&gt;Zanthro&lt;/i&gt; is a user-written command that calculates z-scores for anthropometric measures according to reference growth charts, with a specific option to apply the Cole UK-WHO charts. We then converted z-scores into birthweight cent","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 5","pages":"674-675"},"PeriodicalIF":4.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142990547","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":"Salpingectomy With Delayed Oophorectomy Versus Salpingo-Oophorectomy in BRCA1/2 Carriers: Three-Year Outcomes of a Prospective Preference Trial","authors":"Majke H. D. Van Bommel,&nbsp;Miranda P. Steenbeek,&nbsp;Joanna Inthout,&nbsp;Tessa Van Garderen,&nbsp;Marline G. Harmsen,&nbsp;Marieke Arts-De Jong,&nbsp;Angela H. E. M. Maas,&nbsp;Judith B. Prins,&nbsp;Johan Bulten,&nbsp;Helena C. Van Doorn,&nbsp;Marian J. E. Mourits,&nbsp;Rachel Tros,&nbsp;Ronald P. Zweemer,&nbsp;Katja N. Gaarenstroom,&nbsp;Brigitte F. M. Slangen,&nbsp;Monique M. A. Brood-Van Zanten,&nbsp;M. Caroline Vos,&nbsp;Jurgen M. J. Piek,&nbsp;Luc R. C. W. van Lonkhuijzen,&nbsp;Mirjam J. A. Apperloo,&nbsp;Sjors F. P. J. Coppus,&nbsp;Nicoline Hoogerbrugge,&nbsp;Rosella P. M. G. Hermens,&nbsp;Joanne A. De Hullu","doi":"10.1111/1471-0528.18075","DOIUrl":"10.1111/1471-0528.18075","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 menopause-related quality of life (QoL) after risk-reducing salpingectomy (RRS) versus risk-reducing salpingo-oophorectomy (RRSO) until 3 years of post-surgery.&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 prospective study (TUBA study) with treatment allocation based on patients' preference. Data were collected pre-surgery and at 3 months, 1 and 3 years of post-surgery.&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;Multicentre prospective preference trial in thirteen hospitals in the Netherlands.&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;\u0000 &lt;i&gt;BRCA1/2&lt;/i&gt; pathogenic variant (PV) carriers aged 25–40 (&lt;i&gt;BRCA1&lt;/i&gt;) or 25–45 (&lt;i&gt;BRCA2&lt;/i&gt;), who were premenopausal, without a future child wish and without current (treatment for) malignancy.&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;Treatment allocation was based on patients' preference: either RRS from the age of 25 years with delayed oophorectomy at the maximum age of 45 (&lt;i&gt;BRCA1&lt;/i&gt;) or 50 (&lt;i&gt;BRCA2&lt;/i&gt;), or RRSO between the ages of 35–40 (&lt;i&gt;BRCA1&lt;/i&gt;) or 40–45 (&lt;i&gt;BRCA2&lt;/i&gt;). After RRSO, hormone replacement therapy (HRT) was recommended, if not contraindicated. Primarily, menopause-related QoL as measured with the Greene Climacteric Scale (GCS) was compared between the RRS and RRSO without HRT group. Secondarily, GSC-scores of the RRS group were compared with the scores of the RRSO with HRT after surgery group. A higher GSC-score reflects more climacteric symptoms.&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;Until April 2023, 410 participants had undergone RRS and 160 RRSO. The &lt;i&gt;BRCA1/BRCA2&lt;/i&gt; proportions were 51.4%/48.6%. The mean age at surgery (SD) was 37.9 (3.5) years. Participants 3 years after RRSO without HRT had a 4.3 (95% CI 2.1–6.5; &lt;i&gt;p&lt;/i&gt; &lt; 0.001) point higher increase in GCS-score from baseline compared to those after RRS, while the difference was 7.9 (95% CI 5.9–9.8) and 8.5 (95% CI 6.5–10.5) points at 3 and 12 months, respectively. Among participants with HRT after surgery, the RRSO group had a 2.4 (95% CI 0.8–3.9; &lt;i&gt;p =&lt;/i&gt; 0.002) point higher increase in GCS-score from baseline compared to the RRS group.&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 multicentre preference trial, me","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"782-794"},"PeriodicalIF":4.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987604","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":"Intrauterine Contraction Monitoring in Chorioamnionitis: A Secondary, Blinded Analysis of a Randomised Controlled Trial Cohort","authors":"Milla Juhantalo,&nbsp;Tuija Hautakangas,&nbsp;Outi Palomäki,&nbsp;Jukka Uotila","doi":"10.1111/1471-0528.18076","DOIUrl":"10.1111/1471-0528.18076","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 study the effects of chorioamnionitis on uterine activity and to investigate associations between external and intrauterine monitoring methods and neonatal outcomes.&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 analysis of a randomised controlled trial cohort.&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;Two labour wards, in a university tertiary hospital and a central hospital.&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;Parturients with singleton pregnancies, gestational age ≥ 37 weeks and fetus in cephalic position. Clinical chorioamnionitis developed in 8.6% of cases (&lt;i&gt;n&lt;/i&gt; = 130/1504).&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;Analyses of uterine activity (contractions/10 min or intrauterine pressure in Montevideo units) during the 4 h before birth adjusted for maternal characteristics and intrapartum factors.&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;Uterine activity with or without chorioamnionitis and the intervention of external versus intrauterine monitoring in relation to fetal distress (admission to neonatal intensive care with umbilical artery pH ≤ 7.10 or 5-min Apgar score &lt; 7), stratified by chorioamnionitis status.&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;Uterine contraction frequency/10 min decreased in labours with chorioamnionitis during the final hour preceding birth (4.2 [SD 1.1] vs. 3.9 [SD 1.2], adjusted regression coefficient −0.383, 95% CI −0.654 to −0.112, &lt;i&gt;p&lt;/i&gt; = 0.006) compared to non-infected labors. In chorioamnionitis cases, mean frequency/10 min during last 4 h was higher with external versus intrauterine monitoring (4.2 [SD 0.8] vs. 3.8 [SD 0.9], MD 0.39, 95% CI 0.02–0.76, &lt;i&gt;p&lt;/i&gt; = 0.038), and the intrauterine monitoring group had a lower incidence of fetal distress (6.7% vs. 23.1%, OR 0.24, 95% CI 0.07–0.79, &lt;i&gt;p&lt;/i&gt; = 0.013).&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;Chorioamnionitis impairs uterine activity. Intrauterine monitoring may provide more accurate contraction analysis than external tocodynamometry and help reduce fetal compromise during labours complicated by chorioamnionitis.&lt;/p&gt;\u0000 &lt;/sec","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 6","pages":"795-804"},"PeriodicalIF":4.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142987148","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":"Consensus on Symptom Selection for Endometriosis Questionnaires: A Modified e-Delphi Study","authors":"Tong Zhu,&nbsp;Henrik Marschall,&nbsp;Karina E. Hansen,&nbsp;Andrew W. Horne,&nbsp;Lucky Saraswat,&nbsp;Krina T. Zondervan,&nbsp;Stacey A. Missmer,&nbsp;Lone Hummelshoj,&nbsp;Atilla Bokor,&nbsp;Camilla S. Østrup,&nbsp;Anna Melgaard,&nbsp;Dorte Rytter","doi":"10.1111/1471-0528.18066","DOIUrl":"10.1111/1471-0528.18066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To build consensus on most important symptoms and related consequences for use in questionnaires to characterise individuals with suspected and confirmed endometriosis in the general population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A questionnaire of 107 symptoms and related consequences of endometriosis was collaboratively developed by patients, medical doctors and researchers and further assessed in a two-round e-Delphi study. Participants assessed the relevance of the symptoms, and a priori it was decided that 70% was the threshold for inclusion of a symptom.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Participants represented 7 countries, including Australia, Denmark, France, Hungary, the United Kingdom, the United States, and Turkey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Individuals with endometriosis, medical doctors and researchers with expertise in endometriosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A modified e-Delphi study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Consensus-based selection of symptoms for endometriosis questionnaires.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-six participants completed the first Delphi round and 65 completed the second round. Four symptoms met consensus in the first round (menstrual pain, pain during sexual intercourse, cyclic pain during defecation, and infertility), with two additional symptoms reaching consensus in the second round (cyclic pain and increased doctor/health care contacts for abdominal/pelvic pain).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlighted six symptoms relevant for inclusion in endometriosis research questionnaires: menstrual pain, pain during sexual intercourse, cyclic pain during defecation, cyclic pain, infertility, and a high number of doctor/health care visits due to abdominal/pelvic pain. Recognising a broad range of potential symptoms is essential for raising awareness and supporting early detection efforts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 5","pages":"656-662"},"PeriodicalIF":4.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967909","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}