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

{"title":"Emergency Verbal Consent for Intrapartum Research: A Grounded Theory Study","authors":"Carol Bedwell,&nbsp;Wendy Taylor,&nbsp;Caroline Cunningham,&nbsp;Andrew D. Weeks,&nbsp;Dame Tina Lavender","doi":"10.1111/1471-0528.17997","DOIUrl":"10.1111/1471-0528.17997","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To understand the experiences of women, birth partners and health professionals of verbal followed by retrospective written consent in a prospective cohort study of a device to manage postpartum haemorrhage (PPH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Grounded Theory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Tertiary facility in North-West England, UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Sample</h3>\u0000 \u0000 <p>We used purposive and theoretical sampling to recruit 51 participants; 12 women, 12 birth partners, 16 obstetricians and 11 midwives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted, using a topic guide for focus, until data saturation was achieved. Data were analysed using framework analysis technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most women wanted sufficient information to make a decision at the time of the event, rather than in advance, and preferred not to be overwhelmed with detail. A key factor in making the decision to participate was a positive and trusting relationship with the attending obstetrician. Obtaining consent for research in emergencies was viewed by obstetricians as requiring a different approach and more challenging than consent for standard procedures in an emergency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is one of the first studies to explore verbal followed by retrospective written consent processes with women, clinicians and observers. This was acceptable to all, however information needs to be appropriate, and those discussing consent require adequate training (199/200).</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 4","pages":"446-453"},"PeriodicalIF":4.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17997","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142596800","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":"Outcome Reporting in Studies Investigating Treatment for Caesarean Scar Ectopic Pregnancy: A Systematic Review","authors":"Simrit Nijjar,&nbsp;Simarjit Sandhar,&nbsp;Ilan E. Timor-Tritsch,&nbsp;Andrea Kaelin Agten,&nbsp;Jin Li,&nbsp;Krystle Y. Chong,&nbsp;Munira Oza,&nbsp;Rosanna Acklom,&nbsp;Francesco D'Antonio,&nbsp;Lan N. Vuong,&nbsp;Ben Mol,&nbsp;Cecilia Bottomley,&nbsp;Davor Jurkovic,&nbsp;the International Collaboration COSCAR","doi":"10.1111/1471-0528.17989","DOIUrl":"10.1111/1471-0528.17989","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Caesarean scar ectopic pregnancy (CSEP) is associated with significant maternal and foetal morbidity. However, the optimal treatment remains unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to review outcomes reported in studies on CSEP treatment and outcome reporting quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>We reviewed 1270 articles identified through searching PubMed, MEDLINE and Google Scholar from 2014 to 2024 using the search terms ‘caesarean scar ectopic pregnancy and caesarean scar pregnancy’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>We included all study types evaluating any form of CSEP treatment, with a sample size of ≥ 50, where diagnosis was described, and the article was in English.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Two authors independently reviewed studies and assessed outcome reporting and methodological quality. The relationship between outcome reporting quality and publication year and journal type was assessed with univariate and bivariate models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>A total of 108 studies, including 17 941 women, were included. 83% of all studies originated from China. Studies reported on 326 outcomes; blood loss (86%), need for additional intervention (77%) and time for serum hCG to normalise post treatment (69%) were the most common outcomes. A primary outcome was clearly defined in 11 (10%) studies. The median quality of outcome reporting was 3 (IQR 3–4). No relationship was demonstrated between outcome reporting quality and publication year (<i>p</i> = 0.116) or journal type (<i>p</i> = 0.503).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This review demonstrates that there is a wide variation in outcomes reported in studies on CSEP treatment. Development and implementation of a core outcome set by international stakeholders which includes patients is urgently needed to enable high-quality research that is both useful and relevant to patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 3","pages":"278-287"},"PeriodicalIF":4.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592024","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":"Postpartum Haemorrhage Care in Ghana and Uganda: Grounds for Hope and Concern","authors":"Emily Maclean","doi":"10.1111/1471-0528.17998","DOIUrl":"10.1111/1471-0528.17998","url":null,"abstract":"<p><b>Linked article:</b> This is a mini commentary on Tancred et al., pp. 433–443 in this issue. To view this article visit https://doi.org/10.1111/1471-0528.17953.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 4","pages":"444-445"},"PeriodicalIF":4.7,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142596801","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":"Studying Prevention of Postpartum Venous Thromboembolism With Low-Molecular-Weight Heparin","authors":"Ishwa Shakir,&nbsp;Maryam Tariq","doi":"10.1111/1471-0528.17995","DOIUrl":"10.1111/1471-0528.17995","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 5","pages":"678-679"},"PeriodicalIF":4.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592025","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":"BJOG Mini Commentary on Systematic Review of Clinical Prediction Models for the Risk of Emergency Caesarean Births","authors":"Hala Eldamanhoury","doi":"10.1111/1471-0528.17992","DOIUrl":"10.1111/1471-0528.17992","url":null,"abstract":"<p><b>Linked article</b>: This is a mini commentary on Hunt et al., pp. 231–240 in this issue. To view this article visit https://doi.org/10.1111/1471-0528.17948.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 3","pages":"241-242"},"PeriodicalIF":4.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584850","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":"Gynaecological surgery","authors":"Patrick Chien","doi":"10.1111/1471-0528.17988","DOIUrl":"10.1111/1471-0528.17988","url":null,"abstract":"&lt;p&gt;I like to highlight the improved knowledge from findings of research reports on gynaecological surgery in this issue of BJOG.&lt;/p&gt;&lt;p&gt;The length of post-operative stay following a hysterectomy has reduced considerably over the last 4 decades following the introduction of the minimally access surgical approach. Many of us may not remember patients used to routinely stay for 5–7 days post-operatively following this procedure when it was performed either via a laparotomy or vaginally. Since then, the use of the laparoscopic approach has reduced this duration to 2 days routinely with a significant reduction in the number of hospital beds required to deliver this service. Dedden and colleagues conducted a randomised controlled trial to compare the physical function of patients at 7 days post-operatively when patients were either discharge home within the same day or the next day follow a total laparoscopic hysterectomy for benign gynaecological indications (pages 1762–1770). The study concluded that this outcome was non-inferior between same and next day discharge from hospital. The study also reported that the post-operative complication rate at 6 weeks post-operatively, re-admission rate and the number of post-operative patient reviews at both hospital and primary care were not statistically significantly different between both study groups. The data also showed that the level of physical function 6 weeks after surgery is still below that measured pre-operatively, suggesting that full recovery from this type of surgery requires a longer time period. Hence, patients undergoing an unremarkable laparoscopic and possibly robotic assisted hysterectomy can be feasibly discharged on the same day after surgery, especially when early mobilisation and other aspects of enhanced surgical recovery are also implemented.&lt;/p&gt;&lt;p&gt;There remains uncertainty with the effectiveness of surgical excision to cure the pelvic pain from endometriosis. Currently there is an ongoing randomised clinical trial comparing pelvic pain following surgical excision versus placebo for patients with superficial peritoneal disease&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;. On pages 1793–1804, Lewin and colleagues analysed data from an international database on the effectiveness of surgical excision alone versus excision plus hysterectomy with or without bilateral oophorectomy for improving pelvic pain and quality of life in women with deep recto-vaginal endometriosis. When compared to women who undergone excision alone, non-cyclical pain, dyspareunia, back pain and quality of life scores at 24 months post-operatively were significantly improved in those women who had the endometriosis excised plus hysterectomy without oophorectomy. Those women who had surgical excision together with hysterectomy and bilateral oophorectomies also had significant improvement in these outcomes compared to those with excision alone. Women who had the removal of both ovaries during a hysterectomy at the time of the surgical ex","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"131 13","pages":"1737-1738"},"PeriodicalIF":4.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17988","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584853","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":"Care of late intrauterine fetal death and stillbirth","authors":"Christy Burden,&nbsp;Abi Merriel,&nbsp;Danya Bakhbakhi,&nbsp;Alexander Heazell,&nbsp;Dimitrios Siassakos,&nbsp;the Royal College of Obstetricians and Gynaecologists","doi":"10.1111/1471-0528.17844","DOIUrl":"10.1111/1471-0528.17844","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;div&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 \u0000 &lt;li&gt;A combination of mifepristone and a prostaglandin preparation should usually be recommended as the first-line intervention for induction of labour (Grade B).&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;\u0000 \u0000 &lt;p&gt;A single 200 milligram dose of mifepristone is appropriate for this indication, followed by: \u0000\u0000 &lt;/p&gt;&lt;ul&gt;\u0000 \u0000 &lt;li&gt;24&lt;sup&gt;+0&lt;/sup&gt;–24&lt;sup&gt;+6&lt;/sup&gt; weeks of gestation – 400 micrograms buccal/sublingual/vaginal/oral of misoprostol every 3 hours;&lt;/li&gt;\u0000 \u0000 &lt;li&gt;25&lt;sup&gt;+0&lt;/sup&gt;–27&lt;sup&gt;+6&lt;/sup&gt; weeks of gestation – 200 micrograms buccal/sublingual/vaginal/oral of misoprostol every 4 hours;&lt;/li&gt;\u0000 \u0000 &lt;li&gt;from 28&lt;sup&gt;+0&lt;/sup&gt; weeks of gestation – 25–50 micrograms vaginal every 4 hours, or 50–100 micrograms oral every 2 hours [Grade C].&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 \u0000 &lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;There is insufficient evidence available to recommend a specific regimen of misoprostol for use at more than 28&lt;sup&gt;+0&lt;/sup&gt; weeks of gestation in women who have had a previous caesarean birth or transmural uterine scar [Grade D].&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Women with more than two lower segment caesarean births or atypical scars should be advised that the safety of induction of labour is unknown [Grade D].&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Staff should be educated in discussing mode of birth with bereaved parents. Vaginal birth is recommended for most women, but caesarean birth will need to be considered for some [Grade D].&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;A detailed informed discussion should be undertaken with parents of both physical and psychological aspects of a vaginal birth versus a caesarean birth [Grade C].&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Parents should be cared for in an environment that provides adequate safety according to individual clinical circumstance, while meeting their needs to grieve and feel supported in doing so (GPP).&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Clinical and laboratory tests should be recommended to assess maternal wellbeing (including coagulopathy) and to determine the cause of fetal death, the chance of recurrence and possible means of avoiding future pregnancy complications [Grade D].&lt;/li&gt;\u0000 \u0000 \u0000 &lt;l","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 1","pages":"e1-e41"},"PeriodicalIF":4.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17844","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523569","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 for the Management of Female Chronic Pelvic Pain: A Systematic Review","authors":"Selina Johnson,&nbsp;Alison Bradshaw,&nbsp;Rebecca Bresnahan,&nbsp;Emma Evans,&nbsp;Katie Herron,&nbsp;Dharani K. Hapangama","doi":"10.1111/1471-0528.17987","DOIUrl":"10.1111/1471-0528.17987","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Objective</h3>\u0000 \u0000 <p>Current guidelines recommend biopsychosocial-informed treatment for chronic pelvic pain (CPP). The objective of this systematic review was to describe the available biopsychosocial approaches for the treatment of CPP, and the outcomes reported, to understand how guideline-recommended treatments can be applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>MEDLINE, CINAHL, PsycINFO, EMBASE, Emcare, AMED and Cochrane trial registries were searched (inception to 17 November 2023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>CPP Studies in women where the principal treatment modality was a biopsychosocial approach were included. Prospero registration: CRD42022374256.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection/Analysis</h3>\u0000 \u0000 <p>Data extraction included study setting, population, study design, intervention characteristics and outcome measures and is described via a narrative synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The review included 14 RCTs (871 patients) and identified four broad intervention categories (Acceptance Commitment Therapy <i>n</i> = 2, Cognitive Behavioural Therapy <i>n</i> = 6, Mindfulness-based approaches <i>n</i> = 2, and Physiotherapy-based interventions <i>n</i> = 4). Pain science education (PSE) and, exposure/engagement with valued activity were recognised as important aspects of treatment regardless of intervention type. The most utilised outcomes were pain reduction and emotional functioning, with all studies reporting improvements in these domains. Heterogeneity in outcomes prevented efficacy comparison. High risk of bias was identified in six studies (1/4 physiotherapy-based approaches, 2/6 CBT, 1/2 ACT and 2/2 mindfulness-based interventions).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CBT and ACT-based biopsychosocial approaches were found effective in reducing pain and improving psychometric outcomes for CPP. Evaluation indicated PSE, and exposure/engagement in valued activity are important components of biopsychosocial management. Outcome heterogeneity needs to be addressed in future trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 3","pages":"266-277"},"PeriodicalIF":4.7,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512369","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":"First-Trimester Prediction Models Based on Maternal Characteristics for Adverse Pregnancy Outcomes: A Systematic Review and Meta-Analysis","authors":"Jacintha C. A. van Eekhout,&nbsp;Ellis C. Becking,&nbsp;Peter G. Scheffer,&nbsp;Ioannis Koutsoliakos,&nbsp;Caroline J. Bax,&nbsp;Lidewij Henneman,&nbsp;Mireille N. Bekker,&nbsp;Ewoud Schuit","doi":"10.1111/1471-0528.17983","DOIUrl":"10.1111/1471-0528.17983","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early risk stratification can facilitate timely interventions for adverse pregnancy outcomes, including preeclampsia (PE), small-for-gestational-age neonates (SGA), spontaneous preterm birth (sPTB) and gestational diabetes mellitus (GDM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To perform a systematic review and meta-analysis of first-trimester prediction models for adverse pregnancy outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>The PubMed database was searched until 6 June 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>First-trimester prediction models based on maternal characteristics were included. Articles reporting on prediction models that comprised biochemical or ultrasound markers were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Two authors identified articles, extracted data and assessed risk of bias and applicability using PROBAST.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main results</h3>\u0000 \u0000 <p>A total of 77 articles were included, comprising 30 developed models for PE, 15 for SGA, 11 for sPTB and 35 for GDM. Discriminatory performance in terms of median area under the curve (AUC) of these models was 0.75 [IQR 0.69–0.78] for PE models, 0.62 [0.60–0.71] for SGA models of nulliparous women, 0.74 [0.72–0.74] for SGA models of multiparous women, 0.65 [0.61–0.67] for sPTB models of nulliparous women, 0.71 [0.68–0.74] for sPTB models of multiparous women and 0.71 [0.67–0.76] for GDM models. Internal validation was performed in 40/91 (43.9%) of the models. Model calibration was reported in 21/91 (23.1%) models. External validation was performed a total of 96 times in 45/91 (49.5%) of the models. High risk of bias was observed in 94.5% of the developed models and in 58.3% of the external validations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Multiple first-trimester prediction models are available, but almost all suffer from high risk of bias, and internal and external validations were often not performed. Hence, methodological quality improvement and assessment of the clinical utility are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 3","pages":"243-265"},"PeriodicalIF":4.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490046","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-Associated Maternal Mortality Within One Year After Childbirth: Population-Based Cohort Study","authors":"Nadia Arshad,&nbsp;Rolv Skjærven,&nbsp;Kari Klungsøyr,&nbsp;Linn Marie Sørbye,&nbsp;Liv Grimstvedt Kvalvik,&nbsp;Nils-Halvdan Morken","doi":"10.1111/1471-0528.17985","DOIUrl":"10.1111/1471-0528.17985","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 objective of this study is to assess associations between pregnancy complications and pregnancy-associated maternal mortality (PAM) within 1 year after childbirth.&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;Population-based 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;Norway, 1967–2020.&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;1 237 254 mothers with one or more singleton pregnancies registered in the Medical Birth Registry, 1967–2019 and followed in the Cause of Death Registry to 2020.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;b&gt;s&lt;/b&gt;&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for maternal education, age, year of first childbirth and chronic medical conditions.&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;PAM by lifetime history of pregnancy complications: placental abruption, preeclampsia, preterm birth, perinatal death, small for gestational age (&lt; 2.5 percentile), gestational diabetes and gestational hypertension.&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;Crude OR for PAM was 4.24 (95% CI 3.53–5.10), if complications occurred in the last pregnancy, whereas 2.52 (2.08–3.06) if complications occurred in the first pregnancy, compared to mothers without complications in any pregnancy. Adjusted ORs for PAM when complications occurred in the last pregnancy were, for placental abruption 3.75 (1.20–11.72), preeclampsia: 4.42 (3.17–6.15), preterm birth: 4.32 (3.25–5.75), perinatal death: 24.18 (16.66–35.08), small for gestational age: 2.90 (1.85–4.54), gestational diabetes: 1.43 (0.63–3.25) and pregnancy hypertension: 2.05 (1.12–3.74) compared to mothers without complications. The OR for PAM increased slightly by increasing the number of complicated pregnancies but the trend was stronger for increasing number of complications in the last pregnancy (e.g., during 1999–2019: one complication; 4.14 [2.79–6.13], two complications; 11.50 [6.81–19.43]).&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;Complications in the last pregnancy were more strongly associated with PAM than those in the first pregnancy","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 3","pages":"365-374"},"PeriodicalIF":4.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488188","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}