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

{"title":"Addition of nitrous oxide and oxygen to carbon dioxide pneumoperitoneum during laparoscopic surgery for pain reduction: A double-blinded randomized controlled trial","authors":"Jasper Verguts,&nbsp;Eline Soors,&nbsp;Ina Callebaut,&nbsp;Stefan Evers,&nbsp;Jeroen Vandenbrande,&nbsp;Angelique Ceulemans,&nbsp;Wouter Smeets,&nbsp;Layth Al Tmimi,&nbsp;Björn Stessel","doi":"10.1111/1471-0528.17939","DOIUrl":"10.1111/1471-0528.17939","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine if peritoneal conditioning with an altered insufflation gas mixture is associated with reduced postoperative pain intensity compared to the standard insufflation gas (i.e., 100% CO₂).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A prospective, single-centre, randomized, double-blind, superiority trial was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>This study was conducted between 4 April 2019 and 10 February 2022 at the Jessa Hospital, Hasselt, Belgium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>Patients scheduled for elective gynaecologic laparoscopic surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-four patients scheduled for elective gynaecologic laparoscopic surgery were randomised to receive either the standard insufflation gas with 100 CO₂ (<i>n</i> = 37; control group) or the altered gas mixture of 86% CO₂, 10% N₂O and 4% O₂ (<i>n</i> = 37; experimental group).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Postoperative pain was assessed at 4, 8 and 24 hours after surgery and on postoperative day (POD) 7 by an 11-point Numeric Rating Scale, with 0 indicating no pain and 10 indicating worst imaginable pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences were found between the control and experimental groups regarding postoperative pain at 4, 8 and 24 h after surgery, as well as on POD7. In addition, the median (25% and 75%) total amount of IV piritramide consumption during the first 24 h after surgery was not significantly different between groups (control group: 18.0 [10.0, 27.0] mg vs. experimental group: 17.0 [10.0, 34.0] mg, <i>p</i> = 0.62).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The alternative insufflation gas mixture comprising 86% CO₂, 10% N₂O and 4% O₂ used for the pneumoperitoneum during gynaecologic laparoscopic surgery does not appear to reduce postoperative pain compared to the standard insufflation gas of 100% CO₂.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 1","pages":"27-34"},"PeriodicalIF":4.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of treatment for early gestational diabetes mellitus on neonatal respiratory distress: A secondary analysis of the TOBOGM study.","authors":"David Simmons, Jincy Immanuel, William M Hague, Suzette Coat, Helena Teede, Christopher J Nolan, Michael J Peek, Jeff R Flack, Mark McLean, Vincent W Wong, Emily J Hibbert, Alexandra Kautzky-Willer, Jürgen Harreiter, Helena Backman, Emily Gianatti, Arianne Sweeting, Viswanathan Mohan, N Wah Cheung","doi":"10.1111/1471-0528.17938","DOIUrl":"https://doi.org/10.1111/1471-0528.17938","url":null,"abstract":"<p><strong>Objective: </strong>To identify factors associated with neonatal respiratory distress (NRD) in early Gestational diabetes mellitus (eGDM).</p><p><strong>Design: </strong>Nested case-control analysis of the TOBOGM trial.</p><p><strong>Setting: </strong>Seventeen hospitals: Australia, Sweden, Austria and India.</p><p><strong>Population: </strong>Pregnant women, <20 weeks' gestation, singleton, GDM risk factors.</p><p><strong>Methods: </strong>Women with GDM risk factors completed an oral glucose tolerance test (OGTT) before 20 weeks: those with eGDM (WHO-2013 criteria) were randomised to immediate or deferred GDM treatment. Logistic regression compared pregnancies with/without NRD, and in pregnancies with NRD, those with/without high-dependency nursery admission for ≤24 h with those admitted for >24 h. Comparisons were adjusted for age, pre-pregnancy body mass index, ethnicity, smoking, primigravity, education and site. Adjusted odds ratios (95% CI) are reported.</p><p><strong>Main outcome measures: </strong>NRD definition: ≥4 h of respiratory support (supplemental oxygen or supported ventilation) postpartum. Respiratory distress syndrome (RDS): Supported ventilation and ≥24 h nursery stay.</p><p><strong>Results: </strong>Ninety-nine (12.5%) of 793 infants had NRD; incidence halved (0.50, 0.31-0.79) if GDM treatment was started early. NRD was associated with Caesarean section (2.31, 1.42-3.76), large for gestational age (LGA) (1.83, 1.09-3.08) and shorter gestation (0.95, 0.93-0.97 per day longer). Among NRD infants, >24 h nursery-stay was associated with higher OGTT 1-h glucose (1.38, 1.08-1.76 per mmol/L). Fifteen (2.0%) infants had RDS.</p><p><strong>Conclusions: </strong>Identifying and treating eGDM reduces NRD risk. NRD is more likely with Caesarean section, LGA and shorter gestation. Further studies are needed to understand the mechanisms behind this eGDM complication and any long-term effects.</p>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001260","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":"Outpatient Hysteroscopy","authors":"Prathiba M. De Silva,&nbsp;Paul P. Smith,&nbsp;Natalie A. M. Cooper,&nbsp;T. Justin Clark,&nbsp;the Royal College of Obstetricians and Gynaecologists","doi":"10.1111/1471-0528.17907","DOIUrl":"10.1111/1471-0528.17907","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;div&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;p&gt;\u0000 \u0000 &lt;/p&gt;&lt;ul&gt;\u0000 \u0000 \u0000 &lt;li&gt;All gynaecology departments should provide a dedicated outpatient hysteroscopy service to aid care of women and people with abnormal uterine bleeding, reproductive problems, and insertion/retrieval of intrauterine devices. [Grade A]&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Written information should be provided to the woman prior to their appointment. This should include details about the procedure, the benefits and risks, advice regarding pre-operative analgesia, as well as alternative options for care and contact details for the hysteroscopy unit. [Good Practice Point]&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Women should be made aware of other settings and modes of anaesthesia for hysteroscopy (e.g. under general or regional anaesthesia or intravenous sedation). [GPP]&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;The woman should be advised that if they find the procedure too painful or distressing at any point, they must alert the clinical team who will stop the procedure immediately. The clinical team should alert the hysteroscopist if the woman appears to be in too much pain or is experiencing a vasovagal episode and therefore unable to voice the concerns so that the procedure can be stopped. [GPP]&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Women should be advised to take standard doses of oral non-steroidal anti-inflammatory agents (NSAIDs) one hour before their scheduled appointment.&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Vaginoscopy should be the standard technique for outpatient hysteroscopy unless the use of a vaginal speculum is required (e.g. for administering local cervical anaesthesia or dilating the cervix). [Grade A]&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;When performing operative hysteroscopy, the smallest diameter hysteroscope should be used, with consideration given to the use of hysteroscopes with expandable outer working channels because they are associated with less pain. [Grade B]&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Mechanical hysteroscopic tissue removal systems should be preferred over miniature bipolar electrodes to remove endometrial polyps. [Grade A]&lt;/li&gt;\u0000 \u0000 \u0000 &lt;li&gt;Local anaesthesia should not be routinely administered prior to outpatient hysteroscopy where a vaginoscopic approach is used. It should be considered where use of a vaginal speculum is planned e.g. for cervical dila","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"131 13","pages":"e86-e110"},"PeriodicalIF":4.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17907","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005740","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":"The placenta and umbilical cord in prenatal care: Unseen, overlooked and misunderstood","authors":"Eric Jauniaux,&nbsp;Christoph Lees,&nbsp;Amar Bhide,&nbsp;Elizabeth Daly-Jones,&nbsp;Deepa Srinivasan,&nbsp;Yinka Oyelese","doi":"10.1111/1471-0528.17936","DOIUrl":"10.1111/1471-0528.17936","url":null,"abstract":"&lt;p&gt;The prenatal diagnosis of placental anomalies was one of the first use of ultrasound imaging in obstetrics from the end of the 1960s.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Conditions such as placenta praevia and hydatidiform mole had been known for centuries to be associated with a high maternal morbidity and mortality, when undiagnosed before labour for placenta praevia or when presenting with severe anaemia and eclampsia for a hydatidiform mole. Previous attempts at imaging the placenta in utero included soft tissue radiography with radioactive isotopes injected into the maternal circulation or the amniotic cavity and pelvic angiography using radio-opaque dyes injected into the femoral artery.&lt;/p&gt;&lt;p&gt;Ultrasound imaging rapidly proved more practical and safer than radiology techniques as it did not expose both mother and fetus to radiation. Rapid improvements in ultrasound resolution over the following decade made it possible to diagnose major fetal anomalies such as spina bifida,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; and a decade later, with the development of colour Doppler imaging, it became possible to accurately identification of small fetal vessels such as vasa praevia.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Placenta praevia was originally defined using transabdominal sonography (TAS) as a placenta developing within the lower uterine segment and graded according to the relationship between the lowest placental edge and the internal cervical os.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; The use of high-resolution transvaginal ultrasound (TVS) has revolutionised the diagnosis and follow-up of placenta praevia by allowing accurate measurements of the distance between the presenting placental edge or vasa praevia and the internal os.&lt;span&gt;&lt;sup&gt;6, 7&lt;/sup&gt;&lt;/span&gt; TVS has proven safe in patients suspected of having a placenta praevia on transabdominal ultrasound&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; and the majority of pregnant patients in the UK who have TVS reported finding the experience acceptable.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Overall, ultrasound imaging has changed the management and outcome of patients presenting with fetal congenital defects, abnormal fetal growth, multiple pregnancies and maternal obstetric disorders such as pre-eclampsia and gestational diabetes, and has led to the development of the subspeciality in materno-fetal medicine (MFM). Similarly, sonographers have become specialised in obstetric scanning. However, during this process, detailed ultrasound examination of the placenta and the umbilical cord has been left behind and is only superficially included in obstetric ultrasound training programmes.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; Furthermore, hyper-specialisation in fetal medicine scanning has limited the exposure of both MFM and sonographer trainees to the use of TVS, which is mainly used in gynaecology and in the evaluation of patients with early pregnancy complications in specialised gynaecology clinics and early pregnancy units. In the present commentary, we address these issues a","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 1","pages":"12-14"},"PeriodicalIF":4.7,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17936","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983816","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":"Intrapartum and postpartum antibiotic use in seven low- and middle-income countries: Findings from the A-PLUS trial","authors":"Sarah Saleem,&nbsp;Haleema Yasmin,&nbsp;Janet L. Moore,&nbsp;Anum Rahim,&nbsp;Iram Shakeel,&nbsp;Adrien Lokangaka,&nbsp;Antoinette Tshefu,&nbsp;Melissa Bauserman,&nbsp;Musaku Mwenechanya,&nbsp;Elwyn Chomba,&nbsp;Shivaprasad S. Goudar,&nbsp;Avinash Kavi,&nbsp;Richard J. Derman,&nbsp;Nancy F. Krebs,&nbsp;Lester Figueroa,&nbsp;Manolo Mazariegos,&nbsp;Paul Nyongesa,&nbsp;Sherri Bucher,&nbsp;Fabian Esamai,&nbsp;Archana Patel,&nbsp;Manjushree Waikar,&nbsp;Poonam Shivkumar,&nbsp;Patricia L. Hibberd,&nbsp;William A. Petri,&nbsp;Sk Masum Billah,&nbsp;Rashidul Haque,&nbsp;Waldemar A. Carlo,&nbsp;Alan Tita,&nbsp;Marion Koso-Thomas,&nbsp;Jennifer Hemingway-Foday,&nbsp;Elizabeth M. McClure,&nbsp;Robert L. Goldenberg","doi":"10.1111/1471-0528.17930","DOIUrl":"10.1111/1471-0528.17930","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 describe the intrapartum and postpartum use of non-study antibiotics in low- and middle-income countries (LMICs) during the double-blinded NICHD Global Network Azithromycin in Labor (A-PLUS) trial.&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;The antibiotic use sub-study was a planned prospective, observational sub-study of the A-PLUS trial.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Settings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study was carried out in hospitals or health centres affiliated with eight sites of the Global Network for Women's and Children's Health Research (Global Network) in seven countries: Bangladesh, Pakistan, India (two sites), Kenya, Zambia, The Democratic Republic of the Congo (DRC) and Guatemala.&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;Totally, 29 278 pregnant women enrolled in the A-PLUS trial.&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;We collected data on 29 278 pregnant women admitted to a facility for delivery related to non-study antibiotic use overall and during three time periods: (1) in the facility prior to delivery, (2) after delivery until facility discharge and (3) after discharge to 42 days post-partum.&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;Non-study antibiotic use overall and for treatment or prophylaxis by the site during the three time periods.&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;Of the 29 278 women in the study, 5020 (17.1%; 95% CI 16.7%–17.6%) received non-study antibiotics in the facility prior to delivery, 11 956 (40.8%; 95% CI 40.3%–41.4%) received non-study antibiotics in the facility after delivery, and 13 390 (47.6%; 95% CI 47.0%–48.2%) women received non-study antibiotics after delivery and after facility discharge. Antibiotics were prescribed more often among women in the Asian and Guatemalan sites than in the African sites. In the three time-periods, among those receiving antibiotics, prophylaxis was the indication in 82.3%, 97.7% and 90.7% of the cases, respectively. The type of antibiotics used varied substantially by time-period and site, but generally, penicillin-type drugs, cephalosporin-type drugs and metronidazole were used more frequently than other types.&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;Across the eight sites of the Global Network, in the facility before delivery, and in the post-partum p","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 1","pages":"72-80"},"PeriodicalIF":4.7,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977123","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":"ChatGPT in a gynaecologic oncology multidisciplinary team tumour board: A feasibility study","authors":"Gabriel Levin,&nbsp;Walter Gotlieb,&nbsp;Pedro Ramirez,&nbsp;Raanan Meyer,&nbsp;Yoav Brezinov","doi":"10.1111/1471-0528.17929","DOIUrl":"10.1111/1471-0528.17929","url":null,"abstract":"&lt;p&gt;The practical medical use of artificial intelligence is rapidly progressing. Specifically, the application of ChatGPT was explored in medical education and even medical clinical data evaluation.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Tumour board is an integral and pivotal part of patient treatment and management in gynaecologic oncology.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; It entails the processing of various pathological and clinical parameters, coupled with the familiarity with treatment guidelines in accordance with the various parameters. The participation of ChatGPT in breast cancer tumour board was previously studied, with contrasting results.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; We aim to study the feasibility of ChatGPT (Versions 3.5 and 4) as a support tool for endometrial cancer (EC) and ovarian cancer (OC) according to the NCCN and ESGO guidelines.&lt;/p&gt;&lt;p&gt;Ten EC cases and ten OC cases were fabricated based on experience of authors pertaining to the most complex scenarios discussed in real practice. For EC the following data was formulated: age, histology, stage, grade, lymphovascular space invasion, tumour size and molecular classification—MMR, p53 and POLE mutation status. For OC, the following data was formulated: age, histology and stage.&lt;/p&gt;&lt;p&gt;We created a new account for ChatGPT 3.5 and purchased and created an account for ChatGPT 4. We used generic prompts for all the cases. The ChatGPT 3.5 and ChatGPT 4 prompt are described (Appendix S1).&lt;/p&gt;&lt;p&gt;For each tumour board case, we accessed the NCCN and ESGO guidelines separately and recorded their recommendation. All ChatGPT recommendations were judged as correct or incorrect by two independent reviewers (G.L. and Y.B.). Data analysis is described in detail in the Appendix S1.&lt;/p&gt;&lt;p&gt;We used SPSS 29 for the statistical analysis. As no patient information was used—no ethical board review was needed for this study.&lt;/p&gt;&lt;p&gt;There were ten cases of EC cancer, stages IA-IIIC with four different histology, and ten cases of OC stages IA-IC3 with five different histology. ChatGPT 3.5 was unable to give a concrete recommendation, and ChatGPT 4 gave a recommendation to all cases. No disagreements between reviewers were noted for all 40 evaluations.&lt;/p&gt;&lt;p&gt;The rate of correct recommendations was 70% (14/20) for NCCN guidelines and 60% (12/20) for ESGO guidelines (&lt;i&gt;p&lt;/i&gt; = 0.512). (Table 1). There were 55% (11/20) of cases with correct recommendations for both guidelines, 20% (4/20) of cases in which a correct recommendation was given only according to one guideline (Figure S1), and 25% (5/20) of cases in which an incorrect recommendation was given. Of those with an incorrect recommendation, 80% (4/5) were EC, stages IA-II, of all histology, and one case of OC, stage IA. Of the four single guidelines correct recommendations, all were EC, with three incorrect recommendations according to ESGO guidelines, including the only two cases with a positive POLE mutation. OC had higher complete correct recommendation as compared to EC ","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 1","pages":"99-101"},"PeriodicalIF":4.7,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17929","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977122","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":"Enhancing HPV vaccination and education to reduce vaginal cancer incidence","authors":"Tomoyuki Kawada","doi":"10.1111/1471-0528.17935","DOIUrl":"10.1111/1471-0528.17935","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 3","pages":"389"},"PeriodicalIF":4.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917984","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":"Obstetric anal sphincter injuries during instrumental vaginal delivery","authors":"Prathamesh Lanjewar,&nbsp;Avir Sarkar","doi":"10.1111/1471-0528.17931","DOIUrl":"10.1111/1471-0528.17931","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 1","pages":"102"},"PeriodicalIF":4.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972283","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":"Evaluating waterbirth risks: A deep dive into the POOL cohort study's research gaps","authors":"Wei-Zhen Tang,&nbsp;Tai-Hang Liu,&nbsp;Xia Lan","doi":"10.1111/1471-0528.17934","DOIUrl":"10.1111/1471-0528.17934","url":null,"abstract":"","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 2","pages":"224-225"},"PeriodicalIF":4.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917985","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":"Magnetic resonance imaging and clinical features of Mayer–Rokitansky–Küster–Hauser syndrome: A 10-year review from a dedicated specialist centre","authors":"Nina Cooper,&nbsp;Maya Al-Memar,&nbsp;Kristofer Linton-Reid,&nbsp;Keith Edmonds,&nbsp;Gillian Rose,&nbsp;Nuala Dixon,&nbsp;Cillian McNamara,&nbsp;Christina Fotopoulou,&nbsp;Katherine Van Ree,&nbsp;Nishat Bharwani","doi":"10.1111/1471-0528.17928","DOIUrl":"10.1111/1471-0528.17928","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To correlate the clinical history with imaging findings of women with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>A UK IOTA and ESGO-certified tertiary referral centre for disorders of reproductive development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Population</h3>\u0000 \u0000 <p>All patients with a diagnosis of MRKH and who had undergone an MRI pelvis between 1 January 2011 and 31 April 2021 were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MRI images were analysed by specialist gynaecological radiologists. Clinical data was extracted from an electronic patient record system. Statistical analysis was computed in R (version 4.1.2), R base stats package and ggstatsplot (v0.5.0).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Clinical history and predefined imaging features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and thirty-four patients were included. Median age at MRI was 18 years (10–64 years). Half (48.2%) of women presenting had a history of pain, most often abdominal (84.6%) or vaginal (9.2%). Remnants were identified in 91.8% of women (<i>n</i> = 123). 4.5% of women had imaging features of endometriosis (<i>n</i> = 6). Women with a functional remnants were significantly more likely to experience pain (<i>p</i> &lt; 0.001). Pain history was not strongly associated with ectopic ovarian position. Common gynaecological pathology such as endometriosis, ovarian cysts and fibroids were also identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We identify that majority of women with MRKH will have uterine remnants with a connecting fibrous band, and an ectopic ovarian position 44.0% of cases. Abdominal pain was significantly associated with functional remnants on MRI. Further work is required to identify how other gynaecological pathology impacts women with MRKH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 1","pages":"64-71"},"PeriodicalIF":4.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.17928","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917986","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}