Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC最新文献

{"title":"Para-Tubal Cysts and Their Associations with Adnexal Torsion and Obesity.","authors":"A From, M Hirva, G Shapira Zaltsberg, N Barrowman, A Tsampalieros, N Fleming, T Dumont","doi":"10.1016/j.jogc.2025.103145","DOIUrl":"https://doi.org/10.1016/j.jogc.2025.103145","url":null,"abstract":"<p><strong>Background: </strong>Para-tubal cysts, often misdiagnosed as ovarian cysts, may be androgen-sensitive and are of growing clinical concern in relation to obesity and adnexal torsion in adolescents. However, their associations remain underexplored.</p><p><strong>Objective: </strong>To investigate the association between para-tubal cysts, adnexal torsion, and obesity in female adolescents.</p><p><strong>Methods: </strong>Retrospective cohort study of female patients aged 2-18 who underwent surgery for suspected benign adnexal lesions at a tertiary-level pediatric hospital between 2018 and 2024. Data on demographics, body-mass index (BMI), cyst characteristics, surgical outcomes, and androgen profile were collected. Obesity was defined as a BMI or weight >95th percentile, using weight alone when BMI was unavailable.</p><p><strong>Results: </strong>There were 124 patients included, median age 15 years, of whom 43 (34.7%) had para-tubal cysts. Thirty-seven patients (30%) had obesity. Obesity was significantly associated with para-tubal cysts (P = 0.002), with a relative risk of 2.2 (95% CI 1.4, 3.5). In patients with a para-tubal cyst, a positive correlation was found between para-tubal cyst volume and BMI z-score (rho = 0.46, P = 0.007). Para-tubal cysts were also associated with adnexal torsion (P < 0.001), with a relative risk of 2.4 (95% CI 1.6, 3.6) compared to ovarian cysts, and this association remained significant even when restricting ovarian cysts to those of dermoid subtype, which are traditionally considered to be the primary cause of adnexal torsion in the pediatric literature.</p><p><strong>Conclusion: </strong>Para-tubal cysts are more common in adolescents with obesity and are strongly associated with adnexal torsion. This highlights the need for heightened awareness and careful evaluation of para-tubal cysts in patients with obesity to prevent complications like adnexal torsion.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103145"},"PeriodicalIF":0.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Consensus No. 463: Diagnosis and Management of Cesarean Scar Niche.","authors":"Lacey Brennan, Emmanuel Bujold, Sarah Maheux-Lacroix, Ari P Sanders, Mohamed A Bedaiwy, Ally Murji","doi":"10.1016/j.jogc.2025.103143","DOIUrl":"https://doi.org/10.1016/j.jogc.2025.103143","url":null,"abstract":"<p><strong>Objective: </strong>This consensus statement aims to guide clinicians in the diagnosis, management and prevention of cesarean scar niche.</p><p><strong>Target population: </strong>Patients undergoing cesarean delivery or patients with cesarean scar disorder.</p><p><strong>Options: </strong>Options for management include expectant, medical and surgical management. These will depend on symptoms, residual myometrial thickness, and future fertility plans.</p><p><strong>Outcomes: </strong>Outcomes include resolution of symptoms, repair of defect and subsequent successful pregnancy.</p><p><strong>Benefits, harms, and costs: </strong>This guideline aims to benefit patients undergoing cesarean delivery or those suffering from cesarean scar disorder and to offer healthcare providers an evidence-based approach to the prevention, diagnosis and management of cesarean scar defects.</p><p><strong>Evidence: </strong>Published clinical trials, randomized controlled trials, observational studies, population studies, and systematic review articles indexed in PubMed and the Cochrane database were identified between January 1^st, 2005 and April 30^th, 2025 using the search terms \"cesarean scar niche\", \"cesarean scar defect\", and \"isthmocele\". Results were restricted to studies written in English.</p><p><strong>Validation methods: </strong>The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See Appendix A.</p><p><strong>Intended audience: </strong>All health care providers who perform cesarean delivery or who care for patients who have previously undergone a cesarean delivery and may be experiencing symptoms of cesarean scar disorder, including obstetrician gynaecologists, family physicians, registered nurses, nurse practitioners and radiologists.</p><p><strong>Tweetable abstract: </strong>Cesarean scar niche is a common consequence of cesarean delivery. Symptomatic patients suffering from cesarean scar disorder can be treated expectantly or with medical or surgical options. Asymptomatic patients do not require treatment.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103143"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus clinique n° 463 : Diagnostic et prise en charge de la niche cicatricielle césarienne.","authors":"Lacey Brennan, Emmanuel Bujold, Sarah Maheux-Lacroix, Ari P Sanders, Mohamed A Bedaiwy, Ally Murji","doi":"10.1016/j.jogc.2025.103144","DOIUrl":"https://doi.org/10.1016/j.jogc.2025.103144","url":null,"abstract":"<p><strong>Objectif: </strong>Cette déclaration consensuelle vise à guider les cliniciens dans le diagnostic, la prise en charge et la prévention de la niche cicatricielle césarienne.</p><p><strong>Population cible: </strong>Les patientes subissant un accouchement par césarienne ou les patientes présentant un trouble de la cicatrice de césarienne.</p><p><strong>Options: </strong>Les options de prise en charge comprennent la prise en charge expectative, médicale et chirurgicale. Celles-ci dépendront des symptômes, de l'épaisseur résiduelle du myomètre et des projets de fertilité futurs. RéSULTATS: Les résultats comprennent la résolution des symptômes, la réparation du défaut et la réussite de la grossesse ultérieure. AVANTAGES, INCONVéNIENTS ET COûTS: Cette directive vise à bénéficier aux patientes subissant une césarienne ou souffrant d'un trouble lié à la cicatrice de césarienne et à offrir aux professionnels de santé une approche fondée sur des preuves pour la prévention, le diagnostic et la prise en charge des défauts de la cicatrice de césarienne.</p><p><strong>Preuves: </strong>Les essais cliniques publiés, les essais contrôlés randomisés, les études observationnelles, les études de population et les articles de revue systématique indexés dans PubMed et la base de données Cochrane ont été identifiés entre le 1er janvier 2005 et le 30 avril 2025 à l'aide des termes de recherche « cesarean scar niche », « cesarean scar defect » et « isthmocele ». Les résultats ont été limités aux études rédigées en anglais. MéTHODES DE VALIDATION : MéTHODES DE VALIDATION: Les auteurs ont évalué la qualité des donnees probantes et la force des recommandations en utilisant l'approche GRADE (Grading of Recommendations Assessment, Development and Evaluation). Voir l'annexe A en ligne (tableaux A1 pour les définitions et A2 pour les interprétations des recommandations fortes et conditionnelles [faibles]). PUBLIC VISé: Tous les professionnels de santé qui pratiquent des césariennes ou qui s'occupent de patientes ayant déjà subi une césarienne et pouvant présenter des symptômes de troubles liés à la cicatrice de césarienne, y compris les gynécologues-obstétriciens, les médecins de famille, les infirmières diplômées, les infirmières praticiennes et les radiologues. RéSUMé TWEETABLE: La niche cicatricielle de césarienne est une conséquence courante de l'accouchement par césarienne. Les patientes symptomatiques souffrant d'un trouble de la cicatrice de césarienne peuvent être traitées de manière expectative ou par des options médicales ou chirurgicales. Les patientes asymptomatiques ne nécessitent pas de traitement. MOTS-CLéS: Niche cicatricielle de césarienne, défaut cicatriciel de césarienne, isthmocèle, trouble cicatriciel de césarienne.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103144"},"PeriodicalIF":0.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal Associations between Pre-Pregnancy Obesity Traits and Hypertensive Disorders of Pregnancy: A Two-Sample Mendelian Randomization Analyses.","authors":"Mengjin Hu, Jinggang Xia, Chunlin Yin","doi":"10.1016/j.jogc.2025.103070","DOIUrl":"https://doi.org/10.1016/j.jogc.2025.103070","url":null,"abstract":"<p><strong>Background: </strong>While observational studies have established associations between pre-pregnancy obesity and hypertensive disorders of pregnancy, the causal nature of this relationship requires elucidation.</p><p><strong>Objective: </strong>To investigate potential causal effects of pre-pregnancy obesity traits on hypertensive disorders of pregnancy-gestational hypertension, pre-eclampsia, and eclampsia-using genetic epidemiology approaches.</p><p><strong>Methods: </strong>We performed a comprehensive two-sample Mendelian randomization (MR) analysis leveraging summary statistics from large-scale genome-wide association studies (GWAS). Eleven adiposity-related exposure traits were evaluated: body mass index (BMI), overweight status, obesity (subclassified into grades 1-3), childhood obesity, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), liver fat percentage, visceral adipose tissue volume, and abdominal subcutaneous adipose tissue volume. Primary causal estimates were derived via inverse-variance weighted (IVW) regression, supplemented by sensitivity analyses using MR-Egger and weighted median methods.</p><p><strong>Results: </strong>Genetic predisposition to elevated BMI, overweight, obesity, obesity class 1, obesity class 2, childhood obesity, WHR, and abdominal subcutaneous adipose tissue volume were linked to increased risks of gestational hypertension and pre-eclampsia. Obesity class 3 also increased the risk of gestational hypertension. Additionally, obesity class 3 and childhood obesity increased the risk of eclampsia. Consistent results were observed using alternative MR methods in sensitivity analyses.</p><p><strong>Conclusions: </strong>This genetic evidence substantiates causal effects of multidimensional pre-pregnancy adiposity on hypertensive pregnancy complications. Our findings highlight the importance of life-course weight management strategies beginning in childhood and extending through reproductive planning to mitigate risks of pregnancy-related vascular disorders.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103070"},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Consensus Statements for the Prevention of Maternal Rhesus (RhD) Alloimmunization and Management of Alloimmunized Pregnancies: A Modified Delphi Process.","authors":"Nancy Robitaille, Lani Lieberman, Gwen Clarke, Jon Barrett, Barbra De Vrijer, Heather A Hume, Edwin Massey, Nan Okun, Catherine Taillefer, David Somerset, Evangelia Vlachodimitropoulou, Karen Fung-Kee-Fung","doi":"10.1016/j.jogc.2025.103113","DOIUrl":"https://doi.org/10.1016/j.jogc.2025.103113","url":null,"abstract":"<p><strong>Objective: </strong>National stakeholders developed guidance statements regarding controversial aspects of perinatal testing and management of pregnancies at risk of or affected by alloimmunization. The objective was to create national, standardized recommendations to guide testing practices, reduce unnecessary testing, optimize resources and improve patient care.</p><p><strong>Methods: </strong>46 multidisciplinary Canadian experts participated in an iterative Delphi process to reach consensus on 47 practices regarding all aspects of screening and management of pregnant persons at risk of alloimmunization. The panel rated their agreement on a 5-point Likert scale. After each round, panelists revoted on the statements until consensus was achieved, defined as Cronbach's alpha >0.95 or a maximum of three voting rounds. Fifteen of the forty-seven statements pertaining to High-Risk obstetrical scenarios are presented.</p><p><strong>Results: </strong>46 experts completed all rounds of voting. Consensus was achieved after 3 survey rounds (Cronbach's alpha = 0.94) for all statements. The 15 statements reaching consensus addressed general issues pertinent to the evaluation of the high-risk patient including antibody testing of clinically significant antibodies (e.g. Kell), antibody titration frequency, paternal phenotyping, fetal genotyping, multidisciplinary care,) and administration of RhIG following clinical situations: ectopic and molar pregnancy and following invasive fetal testing and therapeutics.</p><p><strong>Conclusions: </strong>The consensus document provides guidance regarding best practices in prevention and management of alloimmunization to RhD and clinically significant antibodies to optimize RhIG usage and support clinical units. To effect practice change, knowledge translation of this consensus will require a broad educational program involving clinical offices, hospital emergency rooms and birthing units.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103113"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged exposure to childhood adversity and birth outcomes in a bi-generational longitudinal cohort study.","authors":"Mary-Gray Southern, Cara Girardi, Dmitry Tumin, James L Whiteside","doi":"10.1016/j.jogc.2025.103123","DOIUrl":"https://doi.org/10.1016/j.jogc.2025.103123","url":null,"abstract":"<p><strong>Objective: </strong>A higher number of exposures to different adverse childhood experiences (ACEs) has been associated with worse birth outcomes; however, the duration of ACE exposure could also negatively impact pregnancy outcomes. We sought to use a bi-generational longitudinal cohort survey to test if duration of exposure to specific types of childhood adversity exhibited a graded association with adverse birth outcomes.</p><p><strong>Methods: </strong>The Bureau of Labor Statistics' National Longitudinal Surveys of Youth 1979 cohort was used to create bi-generational cohorts capturing the number and duration of ACE events reported by the oldest cohort, experienced by the middle cohort and linking these with birth outcomes (low birth weight, preterm birth, route of delivery and infant length of stay) documented in the youngest cohort. ACEs examined were maternal incarceration, divorce/separation, maternal binge drinking and poverty.</p><p><strong>Results: </strong>Demographic, birth outcome, and ACE exposures were determined from 1693 cases. Neither the count of ACEs nor the duration of exposure to ACEs were statistically significant predictors of examined birth outcomes, except for greater ACE numbers and prolonged infant length of stay (LOS).</p><p><strong>Conclusion: </strong>No association was identified between worsened birth outcomes and cumulative number or duration of ACE exposures, contradicting prior studies. This discrepancy may be explained by the mediating role of stressors encountered in adulthood, interactions between ACE exposure and adult-onset conditions, missing data on paternal ACE exposure, or differences in recall and reporting bias when collecting interview data from participants versus directly from the grandparent generation.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103123"},"PeriodicalIF":0.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interobserver reproducibility of two endometriosis scoring systems: a multicenter observational prospective study.","authors":"Gabriella Caron-Racine, Anne-Marie Bergeron, Madeleine Lemyre, Kristina Arendas, Jessica Lefebvre, Sarah Maheux-Lacroix","doi":"10.1016/j.jogc.2025.103130","DOIUrl":"https://doi.org/10.1016/j.jogc.2025.103130","url":null,"abstract":"<p><strong>Objective: </strong>To assess the interobserver reproducibility of the Revised American Society for Reproductive Medicine score (r-ASRM) and the Endometriosis Fertility Index (EFI) in women undergoing a conservative laparoscopy to treat endometriosis.</p><p><strong>Methods: </strong>The r-ASRM stage and score and EFI were independently determined by two assessors participating in the surgery. Assessors were either a minimally invasive (MIS) specialist or fellow, a fertility specialist, or an obstetrics and gynecology resident. They both completed the score sheets separately, blindly to the other assessor. A consensus was then obtained, after discussion between the two assessors. Interobserver reproducibility was evaluated using Cohen's Kappa and intraclass correlation coefficient (ICC) for categories and continuous scores, respectively.</p><p><strong>Results: </strong>In this multicenter cross-sectional cohort study, 100 women undergoing a laparoscopy for endometriosis were recruited between April 2020 and May 2023. Most participants had stage 3 (22%) or 4 (43%) endometriosis. The interobserver agreement was strong for the r-ASRM stage, and almost perfect for EFI categories (0-3, 4, 5, 6, 7-8, 9-10) and Least function score categories (1-3, 4-6, and 7-8). The agreement for the r-ASRM score and EFI score is excellent. Interobserver agreement remained strong regardless of the level of expertise, the use of preoperative suppression or history of a prior pelvic surgery.</p><p><strong>Conclusion: </strong>r-ASRM and EFI classifications are highly reproductible between assessors, making them excellent tools for communication between health professionals. However both are limited by their capacity to explain variations in pain symptoms, which remains a challenge to be addressed in future work.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103130"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of cesarean delivery rates across Ontario from 2012-2019 using the modified Robson classification system: a population-based study.","authors":"Sandra I Dunn, Yanfang Guo, Sheryll Dimanlig-Cruz, Malia S Q Murphy, Sara Carolina Scremin Souza, Ruth Rennicks White, Deshayne B Fell, Shi Wu Wen, Jun Zhang, Mark C Walker, Darine El-Chaâr","doi":"10.1016/j.jogc.2025.103131","DOIUrl":"https://doi.org/10.1016/j.jogc.2025.103131","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to describe the trends in cesarean delivery (CD) rates in Ontario using the modified Robson classification system and identify the most common indications for CD.</p><p><strong>Methods: </strong>We conducted a population-based retrospective cross-sectional study using data from the Better Outcomes Registry & Network (BORN), a comprehensive maternal-child registry in Ontario. The analysis included all pregnant individuals who delivered a live or stillborn infant weighing ≥500 grams at ≥20 weeks' gestation between 1 April 2012 and 31 March 2019.</p><p><strong>Results: </strong>A total of 952 567 pregnant individuals gave birth in Ontario, Canada, during the study period. Our findings demonstrated a slight increase in the overall CD rate over seven fiscal years from 2012-2013 to 2018-2019. Robson Group 5 (term singleton cephalic pregnancy with previous CD), Groups 1 and 2 (nulliparous, term, singleton, cephalic pregnancy and no labour, induced labour, or spontaneous labour), and Group 6 (nulliparous pregnancy with breech presentation) made the largest contributions to the overall CD rate over the study period. The top five primary indications for CD across all years included previous CD, atypical or abnormal fetal surveillance, malposition/malpresentation, non-progressive first stage of labour and non-progressive second stage of labour.</p><p><strong>Conclusion: </strong>The results enhance our understanding of the key drivers of the CD rates. These findings will help to inform practice improvement, support policy change, and identify areas where future research is needed.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103131"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Gaps in the Management of Genitourinary Syndrome of Menopause.","authors":"Alison K Shea, Jennifer Blake, Kaitlyn Treleaven, Leticia Hernandez-Galan","doi":"10.1016/j.jogc.2025.103129","DOIUrl":"https://doi.org/10.1016/j.jogc.2025.103129","url":null,"abstract":"<p><p>Genitourinary syndrome of menopause (GSM) affects most postmenopausal women and gender diverse persons (GDP). Many will notice symptoms prior to the cessation of menstruation, related to declining hormone levels. Our aim was to assess GSM incidence among those referred to a specialized Canadian menopause clinic, and to identify potential gaps in care. Among 529 participants, 74% reported bothersome vaginal dryness, but only 10.9% had been prescribed a local vaginal hormone prior to referral. With long wait times for menopause clinics, our results highlight an important area for education for all providers caring for women and GDP in midlife and menopause.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103129"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrial Carcinoma Molecular Classification and Barriers to Implementation, Possible Solutions, and the Implications for Ongoing Clinical Trials.","authors":"Anjelica Hodgson, Kathy Han, Stephen Welch, Wendy R Parulekar, Jessica N McAlpine, Mary Kinloch","doi":"10.1016/j.jogc.2025.103124","DOIUrl":"10.1016/j.jogc.2025.103124","url":null,"abstract":"<p><p>Molecular classification of endometrial carcinoma provides important prognostic and predictive information and ongoing clinical trials are investigating different treatment paradigms and therapy de-escalation. Despite its benefits, there is variability in the application of molecular classification worldwide, including in Canada. A digital survey was distributed to gynaecologic pathologists in 13 Canadian academic pathology departments, and areas of homogeneity and variability in practice for endometrial carcinoma molecular classification were identified. Perceived barriers to universal application included resource restrictions and ambiguity of management implications. Focused research, knowledge translation, and guideline development will aid in more consistent implementation/application.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103124"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}