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

{"title":"The Use of Intrapartum Ultrasound before Instrumental Delivery in Real Life - Transition from Opt-In to Opt-Out Protocol.","authors":"Wai Lam Chan, Chun Kit Wong, Viola Ying Tze Chan, Wai Lam Lau","doi":"10.1016/j.jogc.2026.103540","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103540","url":null,"abstract":"<p><strong>Background: </strong>Intrapartum ultrasound (IPUS) before instrumental delivery has not improved adverse neonatal outcomes in randomized trials, but only non-emergent indications were included. Whether real-life use of IPUS reduces birth trauma, such as cephalohematoma and subgaleal haemorrhage (SGH), remains unknown.</p><p><strong>Objective: </strong>To assess whether changing from an opt-in to an opt-out IPUS protocol affects IPUS uptake, the incidence of cephalohematoma, SGH and adverse maternal outcomes, and secondary outcomes including the rates of direct second-stage Caesarean delivery, failed, and sequential instrumental delivery.</p><p><strong>Study design: </strong>Retrospective cohort study of women who underwent attempted instrumental delivery in a Hong Kong public hospital. Outcomes were compared between opt-in (2020-2022) and opt-out (2023-2025) periods.</p><p><strong>Results: </strong>Among 822 attempted instrumental deliveries, IPUS uptake increased from 53.3% to 61.8% (P = 0.014). Cephalohematoma (11.1% vs. 12.3%), SGH (2.0% vs. 1.9%) and maternal adverse outcomes did not differ significantly between two periods. A trend towards a decreased rate of direct second-stage Caesarean section was observed (0.25% vs. 0.14%, P = 0.115). The second-stage Caesarean delivery to assisted vaginal birth ratio decreased from 0.056 to 0.031 (P = 0.093), suggesting that instrumental delivery was not discouraged by increasing IPUS use.</p><p><strong>Conclusion: </strong>An opt-out protocol significantly increased IPUS uptake before instrumental delivery without increasing direct second-stage Caesarean section, but did not reduce cephalohematoma, SGH or maternal adverse outcomes. Given the rarity of severe neonatal trauma, demonstrating improved outcomes likely requires much larger sample size with a triage algorithm incorporating IPUS parameters to guide decision making for trial of instrumental delivery versus second-stage Caesarean section.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103540"},"PeriodicalIF":0.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149130117","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":"Real-World Application of the MY-LUNAR Ultrasound Algorithm in Histologically Confirmed Uterine Leiomyosarcoma Cases: A Retrospective Single-Center Analysis.","authors":"Derek A Skolnik, Gabriel Levin, Xing Zeng, Reitan Ribeiro, Jing Feng, Annie Leung, Lucy Gilbert","doi":"10.1016/j.jogc.2026.103532","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103532","url":null,"abstract":"","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103532"},"PeriodicalIF":0.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122470","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":"Navigating Uncertainty in Decision-Making and Challenges to Healthcare Access Following Diagnosis of Fetal Anomaly: Bioethics and Social Factors Impacting Patient Decision-Making.","authors":"Samantha Ables, Naila Ramji","doi":"10.1016/j.jogc.2026.103517","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103517","url":null,"abstract":"<p><p>Pregnant patients weigh many factors when deciding whether to continue a pregnancy with fetal anomaly, including their family context, access to resources, and barriers to healthcare. We explore the social factors and bioethical issues that affect decisions to continue a pregnancy with fetal anomaly, illustrated by our patient's experience of heteropagus twin pregnancy. The patient had to decide whether to undergo delivery and newborn surgery out-of-province, weighed against leaving her special needs child, and limited social supports. We analyze the relevant bioethical concepts: autonomy, justice, relational ethics, and relational autonomy. Physicians who consider these stressors and bioethical issues may better appreciate and support their pregnant patients' decision-making.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103517"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914657","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":"Variation in the Use of Routine Third-Trimester Ultrasound Among Canadian Maternity Care Providers.","authors":"Venu Jain, Jenna B Wowdzia, Laura M Reyes Martinez, Anne-Maude Morency","doi":"10.1016/j.jogc.2026.103519","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103519","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate Canadian clinical practice regarding utilization of routine third-trimester ultrasound in low-risk pregnancies and assess provider expectations regarding components of such scans.</p><p><strong>Methods: </strong>A cross-sectional online survey was distributed to Canadian antenatal providers through the Society of Obstetricians and Gynaecologists of Canada. Information regarding provider characteristics, years in practice and routine use of third-trimester ultrasound in low-risk pregnancies, preferred timing, and expectations regarding performance of biophysical profile (BPP) scoring and fetal Doppler was collected.</p><p><strong>Results: </strong>A total of 765 responses were obtained, including 309 family physicians, 171 midwives, 272 obstetricians and gynecologists (OBG), and 13 OBG residents. Preference for routine third-trimester ultrasound assessment was reported by 41-63% of OBG, 50-62% of residents, 13-20% of family physicians and 2-15% of midwives. Most common timing was a single scan at 30-32 weeks or two scans at 32 and 36 weeks. Even in absence of fetal growth abnormality or other risk factor, BPP scoring was expected to be included in such scan by 27-67% of family physicians, 36-46% of midwives, 39-60% of OBG, and 25-75% of residents. Fetal Doppler was expected by 12-21% of family physicians, 6-14% of midwives, 5-17% of OBG, and around 25% of residents.</p><p><strong>Conclusion: </strong>Substantial variation exists among Canadian antenatal care providers regarding routine use of third-trimester ultrasound in low-risk pregnancies. Differences are also evident in expectations regarding additional fetal surveillance measures. These findings highlight the need for greater awareness of current evidence and clinical guidelines to promote more standardized and evidence-based use of third trimester ultrasound.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103519"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914753","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":"Menstrual Suppression and Contraception in a Cohort of Gender Diverse Adolescents Assigned Female at Birth.","authors":"Coralie Michaud, Andréanne Jodoin, Janie Kelley, Lyne N Chiniara, Afnan Al-Saleh, Nicholas Chadi","doi":"10.1016/j.jogc.2026.103520","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103520","url":null,"abstract":"<p><strong>Objective: </strong>To describe the different menstrual suppression and contraceptive treatments provided to a cohort of transgender and gender diverse young people assigned female at birth receiving care at a gender diversity clinic.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted in a pediatric gender diversity clinic. Included participants were young people assigned female at birth aged between 11 - 18 years-old, consecutively seen for a first visit between November 1, 2016, and May 31, 2021, and followed until June 1, 2022. Gender identity, medical gender affirming treatments and outcome measures, including menstrual suppression, were obtained from medical records. Menstrual suppression treatment and contraception use in transgender males and non-binary or questioning participants were compared.</p><p><strong>Results: </strong>In total, 112 young people were included in the study (median age at first consultation 15.2 years). The majority identified as transgender binary (n = 91, 81%) while other participants identified as non-binary or questioning (n = 21, 19%). Nearly half (44.6%) of participants received gonadotropin-releasing hormone agonists alone at least once during follow-up, with high rates of menstrual suppression. Hormonal contraceptive monotherapy was prescribed to 40.2% of the cohort, with similar proportion among transgender binary (38.5%) and non-binary or questioning (47.6%) participants.</p><p><strong>Conclusion: </strong>This study provides important data on the menstrual suppression and contraceptive treatments provided to young people assigned female at birth in pediatric gender diversity clinic.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103520"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914608","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":"Real-world uptake of Lynch syndrome testing among patients with mismatch repair-deficient endometrial cancer in Québec.","authors":"Emily Eiley, Gabriel Levin, Lucy Gilbert, Reitan Ribeiro, Annie Leung, Laurence Bernard, Derek Skolnik, Bavi Ganesu, Xing Zeng","doi":"10.1016/j.jogc.2026.103516","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103516","url":null,"abstract":"<p><p>There is lack of data pertaining to Lynch syndrome presenting as endometrial cancer in Quebec. We evaluated real-world follow-up of mismatch repair-deficient (dMMR) endometrial cancers screened through universal immunohistochemistry at a tertiary center in Québec. Among 222 dMMR tumors, MLH1/PMS2 loss predominated. Seventy-four patients with methylation-negative tumors were eligible for Lynch syndrome evaluation; 73 (98.6%) were referred, and 57 completed germline testing. Pathogenic germline variants were identified in 54.4%. These findings demonstrate high downstream testing uptake and a substantial diagnostic yield, underscoring the importance of systematic linkage from tumor screening to genetic assessment to optimize Lynch syndrome detection.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103516"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908572","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":"From Mandate to Maintenance: Quantifying the association between menstrual product availability and school attendance.","authors":"Kamilla Bonnesen, Olivia Cooke, Amanda Krygsman, Sarah Hobson, Jessica Poff, Tracy Vaillancourt","doi":"10.1016/j.jogc.2026.103518","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103518","url":null,"abstract":"<p><strong>Objective: </strong>Period poverty affects one-third of menstruating girls in high-income countries and is associated with toxic shock syndrome, psychosocial distress, and educational absenteeism. We conducted the first evaluation of implementation fidelity for a school-based menstrual equity policy and its association with student-reported health and attendance outcomes in a rural Ontario school board.</p><p><strong>Methods: </strong>A cross-sectional analysis of a subsample of the Time 1 2025 Health and Peer Relations Study was conducted. Girls in Grades 5-12 who had reached menarche (N = 863) reported on dispenser stocking frequency and policy benefits (attendance, extracurricular participation, well-being, and financial relief). We used binary logistic regression to estimate adjusted odds ratios (aOR) and calculated the unadjusted absolute risk difference (ARD).</p><p><strong>Results: </strong>Menstruation-related school disruption was common, with 57.1% reporting at least one form of absenteeism. Only 33.1% of students reported that dispensers were reliably stocked; middle school students reported that dispensers were never stocked significantly more often than secondary school students (29.7% vs. 10.5%). Reliable stocking was associated with nearly triple the odds of improved school attendance (aOR = 2.69, 95% CI 1.91-3.78) and overall well-being (aOR = 3.13, 95% CI 2.20-4.45). Reliable access corresponded to a 22.6 percentage-point ARD for school attendance. BIPOC students were significantly more likely to report financial relief than white students (31.3% vs. 19.5%).</p><p><strong>Conclusion: </strong>Legislative mandates for free products do not ensure health equity if implementation, specifically stocking reliability, is inconsistent. Reliable access to menstrual products in schools represents a primary healthcare intervention that significantly reduces the burden of menstruation-related disruption, including school absenteeism.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103518"},"PeriodicalIF":0.0,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908548","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":"Guideline No. 470: Nicotine and Pregnancy.","authors":"Ludmila Porto, Alice Ordean, Caroline Morin, Jocelynn Cook, Barbara Smith, Lisa Graves","doi":"10.1016/j.jogc.2026.103464","DOIUrl":"10.1016/j.jogc.2026.103464","url":null,"abstract":"<p><strong>Objective: </strong>To provide evidence-informed recommendations for the screening, management, and cessation of nicotine use during pregnancy and the postpartum period.</p><p><strong>Target population: </strong>Women who are pregnant or planning a pregnancy who use nicotine-containing products, including combustible tobacco, electronic cigarettes and smokeless tobacco.</p><p><strong>Options: </strong>Screening approaches, behavioural counselling interventions, pharmacologic therapies, harm-reduction strategies, and health system interventions for nicotine cessation.</p><p><strong>Outcomes: </strong>Improved maternal and neonatal outcomes, reduced nicotine exposure during pregnancy, improved cessation rates for nicotine-containing products, and prevention of postpartum relapse.</p><p><strong>Benefits, harms, and costs: </strong>Implementation of these recommendations may improve smoking cessation rates during pregnancy and reduce adverse maternal and neonatal outcomes. Potential harms include increased clinical time requirements and resource utilization for cessation programs.</p><p><strong>Evidence: </strong>Evidence was identified through comprehensive literature reviews addressing key clinical questions related to nicotine exposure, screening, cessation interventions, electronic cigarettes, and postpartum relapse prevention.</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 online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations).</p><p><strong>Intended audience: </strong>This guideline is intended for health care professionals involved in the care of pregnant individuals and those planning pregnancy, including obstetricians, family physicians, midwives, nurses, nurse practitioners, and other health professionals providing prenatal and postpartum care. It may also be relevant to public health practitioners, smoking cessation specialists, and policy makers involved in maternal and child health.</p><p><strong>Social media abstract: </strong>Nicotine use in pregnancy remains a major preventable cause of adverse maternal and neonatal outcomes. This SOGC guideline recommends routine screening, behavioural counselling as first-line therapy, cautious use of NRT or other pharmacotherapy when needed, and continued postpartum support to reduce relapse.</p><p><strong>Summary statements: </strong>RECOMMENDATIONS.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103464"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671641","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":"Does additional anaerobic coverage improve surgical site infection prophylaxis in elective hysterectomy: A systematic review and meta-analysis.","authors":"Hailey Penny, Keiko Patterson, Claire Connors, Erin Brennand, Jena Hall","doi":"10.1016/j.jogc.2026.103484","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103484","url":null,"abstract":"<p><strong>Background: </strong>Surgical site infections (SSIs) remain one of the most common healthcare-associated infections. The SOGC recommends antimicrobial prophylaxis with a first- or second-generation cephalosporin for elective hysterectomy. In some centers, metronidazole is additionally used to provide both aerobic and anaerobic coverage. However, evidence is lacking to support this. This review assessed whether the addition of an anti-anaerobic antibiotic to a first- or second-generation cephalosporin reduces rates of SSIs following elective hysterectomy for benign indications.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with the PRISMA 2020 checklist and registered with Prospero. Study eligibility criteria included those with (1) participants >18-year-old undergoing elective hysterectomy for benign indications; (2) anti-anaerobic antibiotic combined with a first- or second-generation cephalosporin compared with these cephalosporins alone; (3) rate of SSIs. MEDLINE, OVID, and Web of Science were searched with literature extending into August 2024. Meta-analysis was conducted using R Statistical Software.</p><p><strong>Results: </strong>The search identified 275 studies. Four met eligibility criteria (2 RCTs, 1 prospective cohort study, and 1 retrospective cohort study). Sample sizes ranged from 46-4271 participants. Rate of SSIs among the intervention and control groups ranged from 2.4-17.4% and 4.4-21.7%, respectively. Two studies demonstrated reduced SSIs with the addition of an anti-anaerobic antibiotic; none achieved statistical significance. The meta-analysis summary estimate demonstrated no statistical significance between the intervention and control groups (RR 0.95; 95% CI 0.76-1.20; P = 0.47). Using ROB2 tool for randomized control trials (RCTs) and ROBIN-I tool for observational studies, three of the four studies demonstrated a moderate-to-high risk of bias.</p><p><strong>Conclusions: </strong>Based on the available evidence, the addition of anaerobic coverage has no statistically significant impact on SSI rates following elective hysterectomy. Additional rigorous and adequately powered studies are required.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103484"},"PeriodicalIF":0.0,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631985","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":"Menopause and Endometriosis - Symptoms and Risk of Malignant Transformation: A Systematic Review of the Literature.","authors":"Lara Sacramento Fitas, Pedro Viana Pinto, João Bernardes","doi":"10.1016/j.jogc.2026.103468","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103468","url":null,"abstract":"<p><strong>Objective: </strong>To review the evidence concerning the clinical presentation of endometriosis in postmenopausal women and the associated risk of malignant transformation.</p><p><strong>Data sources: </strong>This systematic review was conducted following the PRISMA 2020 guidelines and prospectively registered with PROSPERO (CRD420251025035). The study research was conducted across three databases: MEDLINE/PubMed, Scopus, and the Cochrane Library. Only studies published in English were considered, and publications prior to 2000 were excluded from the review.</p><p><strong>Study selection: </strong>Two authors independently screened all records. Studies were selected if they included postmenopausal women with endometriosis and reported data on clinical symptoms or malignant transformation of endometriotic lesions. We included 32 articles, comprising case-control studies, cohort studies, case series, and cross-sectional studies, encompassing 30 895 women with histologically confirmed endometriosis.</p><p><strong>Data extraction and synthesis: </strong>Six studies provided information on the clinical manifestations, with 55.7% of women experiencing no symptoms. Among symptomatic women, pelvic or abdominal pain was the most common. Malignant transformation of endometrioma into ovarian cancer was reported in 29 articles, with 821 ovarian cancer cases identified. Ovarian clear cell carcinoma (OCCC) and ovarian endometrioid carcinoma (OEC) were the most common histological subtypes related to endometriosis. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) Critical Appraisal Tools.</p><p><strong>Conclusions: </strong>Most postmenopausal women with endometriosis are asymptomatic; however, a small subset may have ectopic implants that remain biologically active and progress to malignant precursor forms. Postmenopausal endometriosis appears to confer an increased risk of ovarian carcinoma, particularly OCCC and OEC. Therefore, clinicians should consider this diagnosis and ensure an appropriate assessment for malignancy.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103468"},"PeriodicalIF":0.0,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551940","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}