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

{"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}

{"title":"Impact of the coronavirus disease-2019 (COVID-19) pandemic on reproductive outcomes in patients with recurrent pregnancy loss.","authors":"Savitha Balachandran, Bahi Fayek, Sabina Dobrer, Sarka Lisonkova, Paul J Yong, K S Joseph, Mohamed A Bedaiwy","doi":"10.1016/j.jogc.2026.103457","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103457","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the impact of the COVID-19 pandemic on reproductive outcomes in patients with recurrent pregnancy loss (RPL) and the influence of material and social deprivation on these outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included RPL patients seen at a specialized clinic between March 1, 2018, and February 28, 2022. Patients were categorized into two groups based on care period: pre-pandemic (March 1, 2018-February 29, 2020) and pandemic (March 1, 2020-February 28, 2022). Cumulative probabilities of birth were estimated using the cumulative incidence function within a competing risk framework, treating pregnancy loss as a competing event. Fine and Gray regression models calculated sub-distribution hazard ratio (sHR) of birth.</p><p><strong>Results: </strong>544 patients were included in the study, with 255 in the pre-pandemic group and 289 in the pandemic group. Individuals in the pandemic group were less likely to achieve pregnancy than those in the pre-pandemic group (relative risk = 0.50, 95% confidence interval [CI] 0.39 - 0.66). Among those who conceived, the cumulative probability of live birth was 0.77 in both groups. Relative to individuals residing in high-social deprivation neighborhoods, those living in moderately deprived areas had higher sub-distribution hazards of live birth (adjusted sHR = 1.97, 95% CI 1.25 - 3.10; P = 0.003).</p><p><strong>Conclusion: </strong>Within specialized RPL care and a universal maternity care system, pregnancy rates were lower during the first two years of the COVID-19 pandemic. However, among those who conceived, the probability of achieving a live birth remained similar between the pre-pandemic and pandemic periods.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103457"},"PeriodicalIF":0.0,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440317","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":"Moving Beyond Unexplained Recurrent Pregnancy Loss: Are We Still Missing the Genetic Diagnosis in SOGC Guidelines?","authors":"Elias M Dahdouh, Camille Sylvestre, Jacques Balayla, Fady I Sharara, William H Kutteh","doi":"10.1016/j.jogc.2026.103419","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103419","url":null,"abstract":"<p><p>The recently published SOGC guideline on recurrent pregnancy loss (RPL) provides a rigorous, evidence-based framework for investigation and management. However, emerging evidence suggests that contemporary genetic technologies are under-integrated. Advances in chromosome microarray analysis (CMA) and next-generation sequencing (NGS) demonstrate that fetal aneuploidy accounts for a substantial proportion of RPL, even after two losses. Systematic genetic testing of products of conception could significantly reduce the proportion of \"unexplained\" RPL, refine prognosis, and guide individualized management. Conditional use of preimplantation genetic testing (PGT), including PGT-A for aneuploidy and PGT-SR for structural rearrangements, in selected patients may further improve patient-centred outcomes.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103419"},"PeriodicalIF":0.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240854","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":"The burden of postpartum hypertension complications on urgent care utilization; a retrospective single centre study.","authors":"Kim Jovanov, Jocelyn Stairs, Allyson Cruickshank, Christopher M Nash","doi":"10.1016/j.jogc.2026.103263","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103263","url":null,"abstract":"<p><strong>Objective: </strong>Hypertensive disorders of pregnancy can cause significant maternal morbidity including during the postpartum period. The aim of this study was to determine the burden of postpartum hypertension complications on urgent care utilization. Secondary outcomes were to assess common presentations of postpartum hypertension, uptake of SOGC guideline recommendations for postpartum hypertension management, and whether the reason for presentation was associated with early discontinuation of antihypertensive medications following delivery.</p><p><strong>Methods: </strong>A single centre cohort study of patients returning to an urgent care setting with postpartum hypertension concerns over two-time periods (July-December 2021 and July-December 2023) was undertaken. Data were abstracted via chart review. Demographic and presentation characteristics of participants were characterized using descriptive statistics. Proportions were compared using a Chi square test and continuous variables were compared using the student's t-test or Wilcoxon rank-sum test.</p><p><strong>Results: </strong>During the study period, 132 of 1535 (9%) postpartum patient presentations in an urgent care setting were for hypertension-related concerns, with stable rates over the two-time periods. 99 (75%) clinical presentations were for symptomatic hypertension, with median presentation occurring on postpartum day 5 (IQR 4-7). 32 (24%) were diagnosed with new postpartum preeclampsia and 91 (69%) were diagnosed with worsening of their antenatally diagnosed hypertensive disorder of pregnancy. Rates of readmission decreased over the two study periods from 24% to 8% (P = 0.01). Reinitiation of medications stopped prior to discharge after delivery occurred in 18 (14%).</p><p><strong>Conclusion: </strong>Hypertension contributes to a significant burden of postpartum urgent care presentations. Enhanced discharge planning and development of a postpartum follow-up program may reduce this burden on urgent care settings.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103263"},"PeriodicalIF":0.0,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147461437","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":"Maternal and Neonatal Outcomes of Placenta Accreta Spectrum Disorders Following Implementation of a Multidisciplinary Management Team.","authors":"Claire M Douglas, Shirmin B Kader, Sarah N Smith","doi":"10.1016/j.jogc.2026.103245","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103245","url":null,"abstract":"<p><strong>Objective: </strong>To compare maternal and neonatal outcomes before and after the implementation of a multidisciplinary management team for placenta accreta spectrum (PAS) disorders.</p><p><strong>Methods: </strong>This retrospective cohort study reviewed pregnancies complicated by PAS disorders that culminated in delivery at the Regina General Hospital between January 2019 and December 2024. Patients were categorized by delivery date before or after the implementation of a multidisciplinary management team for PAS disorders. The primary outcome was the total units of transfused packed red blood cells (PRBCs). Secondary intraoperative and postoperative maternal and neonatal outcomes were also compared.</p><p><strong>Results: </strong>Thirty-seven cases of PAS disorders were included (15 pre-implementation and 22 post-implementation). The post-implementation group received fewer units of transfused PRBCs (2 vs. 4, P = 0.175), had higher hemoglobin at discharge (89.14 g/dl vs. 87.93 g/dl, P = 0.839), fewer ICU admissions (2 vs. 4, P = 0.198), fewer postoperative infections (14% vs. 20%, P = 0.670) and a shorter hospital stay after surgery (median of 3 vs. 4 days, P = 0.094), but these differences did not reach statistical significance. General anesthesia was used more frequently post-implementation (59% vs. 27%, P = 0.061). After implementation, neonates had lower Apgar scores at 1 minute (4.68 vs. 6.40, P = 0.061), 5 minutes (6.73 vs. 8.27, P = 0.025) and 10 minutes (6.33 vs. 8.50, p = 0.045) but the neonatal cord arterial pH was similar (7.30 vs. 7.28, P = 0.413).</p><p><strong>Conclusion: </strong>Our findings generally support the use of a multidisciplinary team for managing PAS disorders.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103245"},"PeriodicalIF":0.0,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204622","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}