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

{"title":"Examining the association of hysterectomy with and without oophorectomy on cardiovascular disease and all-cause, cardiovascular or cancer mortality: A systematic review and meta-analysis","authors":"Yuge Chen, Fengjuan Li, Lei Liang, Huiling Hua, Shizheng Liu, Zihe Yu, Qiuyu Chen, Shufeng Huang, Pei Qin","doi":"10.1111/1471-0528.17843","DOIUrl":"10.1111/1471-0528.17843","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The associations between hysterectomy and cardiovascular disease (CVD) and mortality remains unlcear and a meta-analysis with cohort studies is lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to conduct a systematic review and meta-analysis of cohort studies to investigate the relationship between hysterectomy and CVD, coronary heart disease (CHD), stroke, heart failure, and all-cause, cardiovascular and cancer mortality. We further explored the effect of oophorectomy on the association between hysterectomy and these health outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search strategy</h3>\u0000 \u0000 <p>PubMed, EMBASE and Web of Science were searched up to 24 July 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection criteria</h3>\u0000 \u0000 <p>Cohort studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data collection and analysis</h3>\u0000 \u0000 <p>Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were pooled using a random-effects model. We used <i>I</i><sup>2</sup> to assess the heterogeneity between studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main results</h3>\u0000 \u0000 <p>Forty-three studies were included in the meta-analysis. Hysterectomy was significantly associated with an increased risk of CVD (pooled HR 1.11, 95% CI 1.09–1.13; <i>n</i> = 6; <i>I</i><sup>2</sup> = 0) and stroke (HR 1.09, 95% CI 1.04–1.14; <i>n</i> = 7; <i>I</i><sup>2</sup> = 52%), but with a decreased risk of cancer mortality (HR 0.93, 95% CI 0.86–1.00; <i>n</i> = 4; <i>I</i><sup>2</sup> = 81%). No significant association was observed between hysterectomy and CHD (<i>n</i> = 10; <i>I</i><sup>2</sup> = 83%), all-cause mortality (<i>n</i> = 8; <i>I</i><sup>2</sup> = 81%) or cardiovascular mortality (<i>n</i> = 7; <i>I</i><sup>2</sup> = 89%). Hysterectomy with and without oophorectomy was significantly associated with CVD and stroke risk, but showed a larger effect size for hysterectomy with oophorectomy. A significantly increased risk of CHD was observed in the subgroup of hysterectomy with oophorectomy, but not for the subgroup of hysterectomy alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Hysterectomy may increase the risk of CVD, CHD and stroke, but not all-cause, cardiovascular or cancer mortality. Hysterectomy with oophorectomy may have a higher risk of CVD, ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923900","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":"Self-reported respiratory and gastrointestinal outcomes in children with isolated congenital diaphragmatic hernia: A prospective multicentre study","authors":"Mary Patrice Eastwood, Lennart Van der Veeken, Luc Joyeux, Laura Salazar, Juan Otano, Rashmi d'Souza, Martin Sidler, Francesca Maria Russo, Jordi Prat, Paolo de Coppi, Eduard Gratacós, Jan Deprest","doi":"10.1111/1471-0528.17836","DOIUrl":"10.1111/1471-0528.17836","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate medium-term self-reported respiratory and gastrointestinal (GI) outcomes in children with congenital diaphragmatic hernia (CDH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Self-reported respiratory and GI outcomes correlated with prenatal severity indicators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Prospective study at three fetal medicine units.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Families of children prenatally diagnosed with isolated, left-sided CDH surviving for >1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Families received validated questionnaires for GI outcomes (Infant Gastroesophageal Reflux Questionnaire Revised, I-GERQ-R, for infants aged <2 years, or Paediatric Gastro-oesophageal Symptom and Quality of Life Questionnaire, PGSQ, for children aged aged 2-8 years or >9 years) and respiratory outcomes (preschool respiratory outcome questionnaire, for children aged ≤5 years, or the International Study of Asthma and Allergies in Childhood asthma questionnaire, for children aged 6–8 years or ≥9 years). Prenatal data collected from the medical records included lung size (percentage observed/expected lung-to-head ratio, O/E LHR %), liver position, fetal endoluminal tracheal occlusion (FETO) gestational age (GA) at delivery, and perinatal data included birthweight, location, patch repair and respiratory support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures</h3>\u0000 \u0000 <p>The GI and respiratory scores were correlated with O/E LHR using linear and logistic regression models. Univariate analysis was used to evaluate associations with perinatal variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We obtained 142 responses from 342 families (representing a response rate of 45%). The baseline characteristics of participants and non-participants were comparable. No correlations between perinatal variables and respiratory or GI scores were identified. Children aged ≤5 years with lower O/E LHR values reported higher respiratory scores (<i>P</i> = 0.0175); this finding was not reported in older children. Overall, the children who underwent FETO (<i>n</i> = 51) had GI (<i>P</i> = 0.290) and respiratory (<i>P</i> = 0.052) scores that were comparable with those of children who were expectantly managed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923903","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":"Investigation and Care of a Small-for-Gestational-Age Fetus and a Growth Restricted Fetus (Green-top Guideline No. 31)","authors":"R. Katie Morris,&nbsp;Edward Johnstone,&nbsp;Christoph Lees,&nbsp;Victoria Morton,&nbsp;Gordon Smith,&nbsp;the Royal College of Obstetricians and Gynaecologists","doi":"10.1111/1471-0528.17814","DOIUrl":"10.1111/1471-0528.17814","url":null,"abstract":"<p>The purpose of this guideline is to provide advice, based on the best evidence available, to guide clinicians regarding the investigation and care of the small-for-gestational-age (SGA) fetus and growth restricted fetus. The guideline reviews the risk factors for these conditions and provides recommendations regarding surveillance, diagnosis, and management, including recommendations for fetal monitoring and birth. Large for gestational age (LGA) is outside the scope of this guidance.</p><p>This guideline is for healthcare professionals who care for women, non-binary and trans people with a SGA fetus or with fetal growth restriction (FGR). Within this document we use the terms woman and women's health. However, it is important to acknowledge that it is not only women for whom it is necessary to access women's health and reproductive services in order to maintain their gynaecological health and reproductive wellbeing. Gynaecological and obstetric services and delivery of care must therefore be appropriate, inclusive and sensitive to the needs of those individuals whose gender identity does not align with the sex they were assigned at birth.</p><p>\u0000 \u0000 </p><p>Fetal size is measured at a single time point in pregnancy and assessed via individual biometric measurements (e.g. head circumference [HC], abdominal circumference [AC], and femur length [FL]) or measurements combined as estimated fetal weight (EFW) using different formulas. Fetal growth is a dynamic process occurring throughout the pregnancy requiring multiple assessments and a minimum of at least two assessments of fetal size. Additional information that can be considered includes maternal history and symptoms, amniotic fluid assessment and Doppler velocimetry. Any measurement obtained (biometry or EFW) can only be interpreted when plotted on a growth chart to determine both the centile of the measurement but also any change in growth trajectory. Growth charts are discussed further in section 7.2.1.</p><p>An appropriate for gestational age (AGA) fetus is one whose size is within a normal range for its gestational age. This is typically defined as between the 10th and 90th centiles. A fetus is considered SGA when individual biometric measurements or a combination of measurements used to estimate fetal weight fall below set parameters and requires accurate assessment of gestational age. Commonly, the definition of SGA refers to a fetus with a predicted weight or an AC measurement less than the 10th centile. SGA at birth is commonly diagnosed based on a birthweight below the 10th centile and often birthweight charts are adjusted for the sex of the baby.</p><p>FGR implies a pathological restriction of the genetic growth potential.<span>^{1, 2}</span> Some, but not all, growth restricted fetuses/infants are SGA. The likelihood of FGR is higher in fetuses that are smaller.<span>³</span> Growth restricted fetuses may manifest evidence of fetal compromise ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17814","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917411","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":"Stillbirth mortality by Robson ten-group classification system: A cross-sectional registry of 80 663 births from 16 hospital in sub-Saharan Africa","authors":"Claudia Hanson,&nbsp;Kristi Sidney Annerstedt,&nbsp;Maria Del Rosario Alsina,&nbsp;Muzdalifat Abeid,&nbsp;Hussein L. Kidanto,&nbsp;Helle Mölsted Alvesson,&nbsp;Andrea B. Pembe,&nbsp;Peter Waiswa,&nbsp;Jean-Paul Dossou,&nbsp;Effie Chipeta,&nbsp;Manuela Straneo,&nbsp;Lenka Benova,&nbsp;the ALERT team","doi":"10.1111/1471-0528.17833","DOIUrl":"10.1111/1471-0528.17833","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess stillbirth mortality by Robson ten-group classification and the usefulness of this approach for understanding trends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Prospectively collected perinatal e-registry data from 16 hospitals in Benin, Malawi, Tanzania and Uganda.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>All women aged 13–49 years who gave birth to a live or stillborn baby weighting &gt;1000 g between July 2021 and December 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We compared stillbirth risk by Robson ten-group classification, and across countries, and calculated proportional contributions to mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures</h3>\u0000 \u0000 <p>Stillbirth mortality, defined as antepartum and intrapartum stillbirths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 80 663 babies born to 78 085 women; 3107 were stillborn. Stillbirth mortality by country were: 7.3% (Benin), 1.9% (Malawi), 1.6% (Tanzania) and 4.9% (Uganda). The largest contributor to stillbirths was Robson group 10 (preterm birth, 28.2%) followed by Robson group 3 (multipara with cephalic term singleton in spontaneous labour, 25.0%). The risk of dying was highest in births complicated by malpresentations, such as nullipara breech (11.0%), multipara breech (16.7%) and transverse/oblique lie (17.9%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings indicate that group 10 (preterm birth) and group 3 (multipara with cephalic term singleton in spontaneous labour) each contribute to a quarter of stillbirth mortality. High mortality risk was observed in births complicated by malpresentation, such as transverse lie or breech. The high mortality share of group 3 is unexpected, demanding case-by-case investigation. The high mortality rate observed for Robson groups 6–10 hints for a need to intensify actions to improve labour management, and the categorisation may support the regular review of labour progress.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899871","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":"Oral misoprostol alone, compared with oral misoprostol followed by oxytocin, in women induced for hypertension of pregnancy: A multicentre randomised trial","authors":"Shuchita Mundle,&nbsp;Kate Lightly,&nbsp;Jill Durocher,&nbsp;Hillary Bracken,&nbsp;Moushmi Tadas,&nbsp;Seema Parvekar,&nbsp;Poonam Varma Shivkumar,&nbsp;Brian Faragher,&nbsp;Thomas Easterling,&nbsp;Simon Leigh,&nbsp;Mark Turner,&nbsp;Zarko Alfirevic,&nbsp;Beverly Winikoff,&nbsp;Andrew D. Weeks","doi":"10.1111/1471-0528.17839","DOIUrl":"10.1111/1471-0528.17839","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 assess whether, in those requiring continuing uterine stimulation after cervical ripening with oral misoprostol and membrane rupture, augmentation with low-dose oral misoprostol is superior to intravenous oxytocin.&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;Open-label, superiority randomised trial.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Government hospitals in India.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Population&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Women who were induced for hypertensive disease in pregnancy and had undergone cervical ripening with oral misoprostol, but required continuing stimulation after artificial membrane rupture.&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;Participants received misoprostol (25 micrograms, orally, 2-hourly) or titrated oxytocin through an infusion pump. All women had one-to-one care; fetal monitoring was conducted using a mixture of intermittent and continuous electronic fetal monitoring.&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;Caesarean birth.&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 520 women were randomised and the baseline characteristics were comparable between the groups. The caesarean section rate was not reduced with the use of misoprostol (misoprostol, 84/260, 32.3%, vs oxytocin, 71/260, 27.3%; aOR 1.23; 95% CI 0.81–1.85; &lt;i&gt;P&lt;/i&gt; = 0.33). The interval from randomisation to birth was somewhat longer with misoprostol (225 min, 207–244 min, vs 194 min, 179–210 min; aOR 1.137; 95% CI 1.023–1.264; &lt;i&gt;P&lt;/i&gt; = 0.017). There were no cases of hyperstimulation in either arm. The rates of fetal heart rate abnormalities and maternal side effects were similar. Fewer babies in the misoprostol arm were admitted to the special care unit (10 vs 21 in the oxytocin group; aOR 0.463; 95% CI 0.203–1.058; &lt;i&gt;P&lt;/i&gt; = 0.068) and there were no neonatal deaths in the misoprostol group, compared with three neonatal deaths in the oxytocin arm. Women's acceptability ratings were high in both study groups.&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;Following cervical preparation with oral misoprostol and membrane rupture, the use of continuing oral misoprostol for augm","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17839","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899836","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":"Trends in severe postpartum haemorrhage among nulliparous women with spontaneous onset of labour: A population-based cohort study","authors":"Camilla Tjønneland Mentzoni,&nbsp;Kari Klungsøyr,&nbsp;Hilde Marie Engjom","doi":"10.1111/1471-0528.17838","DOIUrl":"10.1111/1471-0528.17838","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the incidence of severe postpartum haemorrhage among nulliparous women with a spontaneous onset of labour at term from 2000 to 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Population-based cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>National, using the Medical Birth Registry of Norway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Women (<i>n</i> = 330 244) who gave birth to their first singleton child in a cephalic presentation after a spontaneous onset of labour at term.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-tabulations and regression analysis with generalised linear models were used to assess time trends and adjust for potential confounding factors. We also stratified the analyses by maternal age groups, obstetric interventions, mode of delivery and institution size. Time trends were analysed using periods of 5 or 6 years as a unit, and the period from 2000 to 2004 was used as the reference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures</h3>\u0000 \u0000 <p>Severe postpartum haemorrhage (PPH) was defined as blood loss of &gt;1500 mL within 24 h and/or in combination with blood transfusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Severe PPH occurred in 7601/330 244 (2.30%) women. The incidence increased from 1.24% in 2000–2004 to 3.83% in 2015–2020 (adjusted relative risk, aRR 2.90; 95% CI 2.70–3.12). Changes in maternal characteristics or obstetric interventions did not explain the increase, and we found similar increases across institutions of all sizes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The incidence of severe PPH among nulliparous women increased almost threefold over 21 years. The current high incidence warrants urgent efforts to assess unknown risk factors, the health care provided and health system factors that may contribute to the increase, to inform improvements in care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17838","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899911","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":"Phenotypes of maternal vascular malperfusion placental pathology and adverse pregnancy outcomes: A retrospective cohort study","authors":"Rebecca L. Zur,&nbsp;Kelsey McLaughlin,&nbsp;Laura Aalto,&nbsp;Yidi Jiang,&nbsp;Ella Huszti,&nbsp;W. Tony Parks,&nbsp;John C. Kingdom","doi":"10.1111/1471-0528.17837","DOIUrl":"10.1111/1471-0528.17837","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 which components of maternal vascular malperfusion (MVM) pathology are associated with adverse pregnancy outcomes and to investigate the morphological phenotypes of MVM placental pathology and their relationship with distinct clinical presentations of pre-eclampsia and/or fetal growth restriction (FGR).&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;Retrospective 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 care hospital in Toronto, Canada.&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 individuals with low circulating maternal placental growth factor (PlGF) levels (&lt;100 pg/mL) and placental pathology analysis between March 2017 and December 2019.&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;Association between each pathological finding and the outcomes of interest were calculated using the chi-square test. Cluster analysis and logistic regression was used to identify phenotypic clusters, and their association with adverse pregnancy outcomes. Cluster analysis was performed using the K-modes unsupervised clustering algorithm.&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;Preterm delivery &lt;34&lt;sup&gt;+0&lt;/sup&gt; weeks of gestation, early onset pre-eclampsia with delivery &lt;34&lt;sup&gt;+0&lt;/sup&gt; weeks of gestation, birthweight &lt;10th percentile (small for gestational age, SGA) and stillbirth.&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;The diagnostic features of MVM most strongly associated with delivery &lt;34&lt;sup&gt;+0&lt;/sup&gt; weeks of gestation were: infarction, accelerated villous maturation, distal villous hypoplasia and decidual vasculopathy. Two dominant phenotypic clusters of MVM pathology were identified. The largest cluster (&lt;i&gt;n&lt;/i&gt; = 104) was characterised by both reduced placental mass and hypoxic ischaemic injury (infarction and accelerated villous maturation), and was associated with combined pre-eclampsia and SGA. The second dominant cluster (&lt;i&gt;n&lt;/i&gt; = 59) was characterised by infarction and accelerated villous maturation alone, and was associated with pre-eclampsia and average birthweight for gestational age.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17837","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899837","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":"Maternal suicide up to 1 year postpartum: Evidence or emotion-based medicine?","authors":"Alain Braillon","doi":"10.1111/1471-0528.17841","DOIUrl":"https://doi.org/10.1111/1471-0528.17841","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892897","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":"Perceived health status after mid-urethral sling revision in 287 women from the VIGI-MESH registry: A cross-sectional study","authors":"Hugo Camilli,&nbsp;Brigitte Fatton,&nbsp;Elise Gand,&nbsp;Sandrine Campagne-Loiseau,&nbsp;Renaud De Tayrac,&nbsp;Laurent Wagner,&nbsp;Christian Saussine,&nbsp;Jérôme Rigaud,&nbsp;Thibault Thubert,&nbsp;Xavier Deffieux,&nbsp;Michel Cosson,&nbsp;Philippe Ferry,&nbsp;Grégoire Capon,&nbsp;Laure Panel,&nbsp;Emmanuel Chartier-Kastler,&nbsp;Tristan Gauthier,&nbsp;Xavier Game,&nbsp;Cassandra Bouynat,&nbsp;Romane Bichon,&nbsp;Arnaud Fauconnier,&nbsp;Anne-Cécile Pizzoferrato,&nbsp;Xavier Fritel","doi":"10.1111/1471-0528.17835","DOIUrl":"10.1111/1471-0528.17835","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the health status and recovery of women after mid-urethral sling (MUS) revision in response to complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional study using a questionnaire sent to women from a registry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Twenty-two French surgical centres.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>A total of 287 women from the VIGI-MESH registry responded, having undergone MUS revision for complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our sample of women were compared against a representative set of French women taken from the Eurostat database. Multivariate analysis was performed to identify clinical predictors for successful MUS revision. A qualitative analysis was carried out on free-text comments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures</h3>\u0000 \u0000 <p>Health status, defined by the Minimum European Health Module, and recovery, assessed by Patient Global Impression of Improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The response rate was 76% (287/378), with 49% of the women (141/287, 95% CI 43%–55%) reporting good health status, which was 8 points lower than that expected from the comparator French set (57%, 95% CI 55%–58%). Overall, 53% (147/275, 95% CI 47%–59%) of the women reported feeling much better after MUS revision. Just over one-third (35%, 95/275, 95% CI 29%–40%) of respondents reported poor health with little or no improvement. Multivariate analysis showed that being operated on for pain at revision was associated with worse self-perceived health than being operated on for exposure (OR 0.36, 95% CI 0.14–0.95); women with pre-existing comorbidity reported a poorer health status following MUS revision (OR 0.22, 95% CI 0.13–0.38).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results suggest that half of the women recovered good health status after MUS revision, whereas a proportion appeared to be seriously affected by an MUS complication despite the revision.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892898","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":"Improving trustworthiness in research on women's health: Some suggestions from a reviewer's viewpoint.","authors":"Shigeki Matsubara","doi":"10.1111/1471-0528.17842","DOIUrl":"https://doi.org/10.1111/1471-0528.17842","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877853","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}