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

{"title":"Effects on Gynecologic Symptoms and Infertility in the Treatment of Endometrial Osseous Metaplasia: A Systematic Review of Case Reports and Small Series.","authors":"Salwa Farooqi, Praniya Elangainesan, Vrati M Mehra, Ally Murji","doi":"10.1016/j.jogc.2026.103240","DOIUrl":"https://doi.org/10.1016/j.jogc.2026.103240","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review the literature on endometrial osseous metaplasia, its clinical presentation, diagnostic approaches, and the efficacy of uterine-preserving treatments in restoring fertility and alleviating symptoms. This review was registered on PROSPERO (CRD42023387361).</p><p><strong>Data sources: </strong>A comprehensive search of PubMed, OVID and EMBASE was conducted from inception to February 2025.</p><p><strong>Study selection: </strong>Included studies reported on the diagnosis of endometrial osseous metaplasia, uterine-preserving treatments, and fertility or gynecology outcomes. The search yielded 1836 studies, narrowed to 153 articles, of which 37 were included (26 case reports, 8 case series, 2 retrospective and 1 prospective study).</p><p><strong>Data extraction/synthesis: </strong>Across 37 studies, 128 patients were identified. The mean age was 34.4 years, with 64.1% having a history of abortion or miscarriage. Among 83 patients with infertility, 10.8% had primary and 57.8% had secondary infertility. All underwent hysteroscopic resection; 18.0% also had dilatation and curettage, and one received endometrial ablation. Of 60 patients pursuing fertility after treatment, 78.3% conceived: 59.6% spontaneously, 10.6% through assisted reproductive technology, and 4.2% with ovulation induction. The mean time to conception was 6.7 months (range 1-36). Symptom resolution occurred in 83.3% of patients, including improvements in abnormal bleeding, dysmenorrhea, and pelvic pain. Risk of bias varied (scores 2-7), with retrospective cohort studies demonstrating higher methodological quality.</p><p><strong>Conclusion: </strong>Hysteroscopic resection appears to be a promising fertility-sparing treatment for endometrial osseous metaplasia based on case reports and small case series. However, robust data on efficacy and long-term outcomes are lacking. Given its association with prior pregnancy loss and endometrial trauma, greater clinical awareness and early management may improve reproductive outcomes. Further prospective studies are needed to clarify long-term fertility and recurrence post-treatment.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103240"},"PeriodicalIF":0.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146134004","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":"Beyond AJCC Staging: A Socioeconomic-Clinical Nomogram for Predicting 10-Year Survival in Epithelial Ovarian Cancer.","authors":"Jing Zhao, Shangdan Xie, Qilin Cheng, Wei Jin, Haiyan Zhu","doi":"10.1016/j.jogc.2025.103170","DOIUrl":"https://doi.org/10.1016/j.jogc.2025.103170","url":null,"abstract":"<p><strong>Objective: </strong>Despite therapeutic advances improving 5-year survival in epithelial ovarian cancer (EOC), it remains unclear whether these treatments effectively promote long-term survival (currently exceeding 10 years). This study aimed to analyze 10-year survival trends and develop a nomogram to predict long-term survival.</p><p><strong>Methods: </strong>Using the SEER database, we collected data from 30 924 EOC patients diagnosed between 2004 and 2015. Age-adjusted overall survival (OS) and cancer-specific survival (CSS) rates were calculated, and survival trends were analyzed using Joinpoint software. A nomogram was constructed based on clinicopathological and socioeconomic variables, then validated using the C-index, calibration curves, and decision curve analysis (DCA).</p><p><strong>Results: </strong>While 5-year OS and CSS improved significantly, 10-year survival showed minimal improvement (OS: +0.59%/year; CSS: unchanged). Race, household income, stage, tumour size and chemotherapy were identified as independent predictors of OS, while age, marital status, grade, stage, lymph node positivity and chemotherapy were independent predictors of CSS. A nomogram was constructed and validated based on the above independent predictors. Compared with the traditional AJCC staging system, this novel nomogram showed superior prognostic discrimination with a C-index of 0.712 for OS and 0.738 for CSS.</p><p><strong>Conclusion: </strong>The influence of factors such as family income, age, and marital status on the prognosis of ovarian cancer highlights the necessity of comprehensive and sustained management approaches. Additionally, for the first time, we present a multifactorial nomogram for predicting long-term survival in EOC with an accuracy superior to traditional staging methods, offering clinicians a more personalized approach to patient assessment. Résumé OBJECTIF: Malgré les avancées thérapeutiques qui améliorent le taux de survie à 5 ans des personnes atteintes d'un cancer épithélial de l'ovaire (CEO), on ne sait toujours pas avec certitude si ces traitements favorisent efficacement la survie à long terme (établie actuellement à plus de 10 ans). Cette étude avait pour objectif d'analyser les tendances du taux de survie à 10 ans et de concevoir un nomogramme pour prédire le taux de survie à long terme. MéTHODES: Nous avons recueilli des données de la base de données SEER sur 30 924 patientes ayant reçu un diagnostic de CEO dans la période entre 2004 et 2015. Le taux de survie globale (SG) ajusté selon l'âge et le taux de survie spécifique au cancer (SSC) ont été calculés et les tendances de survie ont été analysées au moyen du logiciel Joinpoint. Un nomogramme a été conçu selon des variables socioéconomiques et clinicopathologiques. Il a ensuite été validé au moyen de l'indice de concordance (indice C), des courbes de calibration et de l'analyse de la courbe de décision. RéSULTATS: Bien que les taux de SG et de SSC à 5 ans aient ","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103170"},"PeriodicalIF":0.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472625","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":"Intrauterine Contraception Device Satisfaction and Continuation in an Urban Youth Clinic in British Columbia, Canada: A Longitudinal Survey Study.","authors":"Melissa Dangerfield, Bronte Johnston, Elizabeth Nethery, Holly Torry, Pamela Sagert, Madeleine Ennis, Mika Ohtsuka, Sarah Munro, Laura Schummers","doi":"10.1016/j.jogc.2025.103033","DOIUrl":"10.1016/j.jogc.2025.103033","url":null,"abstract":"<p><strong>Objectives: </strong>Intrauterine devices (IUDs) are highly effective forms of contraception but may be underutilized by Canadian youth. Youth experiences with IUDs remain poorly understood. This study examined 6-month IUD continuation and satisfaction among youth (aged 12-24 years) attending a youth contraception clinic in Vancouver, British Columbia.</p><p><strong>Methods: </strong>Participants completed surveys at baseline (patient characteristics) and at 2-6 weeks, 3 months, and 6 months post-placement, measuring IUD continuation, satisfaction, side-effects, and menstrual symptoms. We examined baseline characteristics, IUD discontinuation, planned continuation beyond 6 months, and IUD type (levonorgestrel-releasing 'hormonal' or copper). We examined trajectories of reported satisfaction, side effects, and menstrual symptoms over 6 months post-placement.</p><p><strong>Results: </strong>Among 140 participants, 86% (n = 120) chose a hormonal IUD. Five percent of participants removed their IUDs, and 5% had an expulsion. Most (86%) IUDs were in place at 6 months. Nearly all (99%) participants with an IUD in place at 6 months planned to continue use. IUD satisfaction was >90% at each follow-up for both IUD types. Cramping and spotting were the most frequently reported side effects; 49% of all respondents reported cramping at 2-6 weeks post-placement, with this frequency decreasing by 6 months for hormonal users. Copper IUD users experienced more bothersome heavy periods than hormonal users. Most (>70%) hormonal IUD users reported reduced menstrual pain, reduced duration, and reduced flow at 6 months post-placement.</p><p><strong>Conclusions: </strong>This study found low rates of IUD discontinuation, high satisfaction, and reduced menstrual side effects among youth over 6 months after IUD placement. This could inform youth-specific counselling for contraceptive method selection and IUD continuation decision-making soon after placement.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103033"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621683","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":"An Extremely Rare Uterine Rhabdomyosarcoma.","authors":"Andrea A Mosher, Peter Yousef, Shangguo Tang, Mathew Leonardi","doi":"10.1016/j.jogc.2025.103048","DOIUrl":"10.1016/j.jogc.2025.103048","url":null,"abstract":"","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103048"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700856","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":"In Frozen Embryo Transfer, Is High-Dose Aspirin Better?","authors":"Hassan Hamze, Wadad Alameh, Robert Hemmings, Karen Kteily, Camille Sylvestre, Jacques Kadoch, Wael Jamal","doi":"10.1016/j.jogc.2025.103040","DOIUrl":"10.1016/j.jogc.2025.103040","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate whether high-dose aspirin during frozen embryo transfer (FET) improves pregnancy outcomes.</p><p><strong>Methods: </strong>This is a retrospective study of 1207 FET cycles performed in 2022, excluding patients older than 40 years, with recurrent implantation failure, or with recurrent pregnancy loss. Pregnancy outcomes, miscarriage rates, number of clinic visits, and obstetrical outcomes were compared between 2 groups: a group with 81 mg aspirin (January-June 2022) and the other group with 162 mg aspirin (June-December 2022). Aspirin was started on day 1 of the cycle and continued until delivery. Patients were divided into 2 endometrial preparation groups. The modified natural cycle group received ultrasound monitoring, trigger shot at 15 mm follicle size and 7 mm endometrial thickness. The artificial cycle group received estrogen supplementation until endometrial thickness reached ≥7 mm, followed by progesterone.</p><p><strong>Results: </strong>Pregnancy outcomes were similar in both endometrial preparation protocols. The subgroup analysis revealed a trend of lower clinical pregnancy rates and lower live birth rates in the 162 mg aspirin group for both preparation protocols. The only significant complication was hematoma formation, which was higher in the 162 mg group. Multiple regression analysis showed that a higher aspirin dosage and endometrial preparation method significantly increased miscarriage rates.</p><p><strong>Conclusion: </strong>High-dose aspirin during FET cycles may negatively impact pregnancy outcomes, increasing miscarriage risk. Lower-dose aspirin (81 mg) may be more beneficial.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"103040"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661693","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":"Prenatal screening for and diagnosis of aneuploidy in twin pregnancies.","authors":"François Audibert,&nbsp;Alain Gagnon","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To provide a Canadian consensus document with recommendations on prenatal screening for and diagnosis of fetal aneuploidy (e.g., Down syndrome and trisomy 18) in twin pregnancies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Options: &lt;/strong&gt;The process of prenatal screening and diagnosis in twin pregnancies is complex. This document reviews the options available to pregnant women and the challenges specific to screening and diagnosis in a twin pregnancy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Clinicians will be better informed about the accuracy of different screening options in twin pregnancies and about techniques of invasive prenatal diagnosis in twins.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Evidence: &lt;/strong&gt;PubMed and Cochrane Database were searched for relevant English and French language articles published between 1985 and 2010, using appropriate controlled vocabulary and key words (aneuploidy, Down syndrome, trisomy, prenatal screening, genetic health risk, genetic health surveillance, prenatal diagnosis, twin gestation). Results were restricted to systematic reviews, randomized controlled trials, and relevant observational studies. Searches were updated on a regular basis and incorporated in the guideline to August 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The previous Society of Obstetricians and Gynaecologists of Canada guidelines regarding prenatal screening were also reviewed in developing this clinical practice guideline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Values: &lt;/strong&gt;The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Benefits, harms, and costs: &lt;/strong&gt;There is a need for specific guidelines for prenatal screening and diagnosis in twins. These guidelines should assist health care providers in the approach to this aspect of prenatal care of women with twin pregnancies. SUMMARY STATEMENTS 1. Fetal nuchal translucency combined with maternal age is an acceptable first trimester screening test for aneuploidies in twin pregnancies. (II-2) 2. First trimester serum screening combined with nuchal translucency may be considered in twin pregnancies. It provides some improvement over the performance of screening by nuchal translucency and maternal age by decreasing the false-positive rate. (II-3) 3. Integrated screening with nuchal translucency plus first and second trimester serum screening is an option in twin pregnancies. Further prospective studies are required in this area, since it has not been validated in prospective studies in twins. (III) 4. Non-directive counselling is essential when invasive testing is offered. (III) 5. When chorionic villus sampling is performed in non-monochorionic multiple pregnancies, a combination of tra","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"754-67"},"PeriodicalIF":1.8,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30000875","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":"SOGC clinical practice guidelines: Canadian contraception consensus.","authors":"Amanda Black,&nbsp;Diane Francoeur,&nbsp;Timothy Rowe,&nbsp;John Collins,&nbsp;Dianne Miller,&nbsp;Thomas Brown,&nbsp;Michèle David,&nbsp;Sheila Dunn,&nbsp;William A Fisher,&nbsp;Nathalie Fleming,&nbsp;Claude A Fortin,&nbsp;Edith Guilbert,&nbsp;Louise Hanvey,&nbsp;André Lalonde,&nbsp;Ruth Miller,&nbsp;Margaret Morris,&nbsp;Teresa O'Grady,&nbsp;Helen Pymar,&nbsp;Thirza Smith,&nbsp;Elke Henneberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To provide guidelines for health-care providers on the use of contraceptive methods to prevent pregnancy and sexually transmitted diseases.</p><p><strong>Outcomes: </strong>Overall efficacy of cited contraceptive methods, assessing reduction in pregnancy rate, risk of infection, safety, ease of use, and side effects; the effect of cited contraceptive methods on sexual health and general well-being; and the cost and availability of cited contraceptive methods in Canada.</p><p><strong>Evidence: </strong>Medline and the Cochrane Database were searched for articles in English on subjects related to contraception, sexuality, and sexual health from January 1988 to March 2003, in order to update the Report of the Consensus Committee on Contraception published in May-July 1998. Relevant Canadian Government publications and position papers from appropriate health and family planning organizations were also reviewed.</p><p><strong>Values: </strong>The quality of the evidence is rated using the criteria described in the Report of the Canadian Task Force on the Periodic Health Examination. Recommendations for practice are ranked according to the method described in this Report.</p>","PeriodicalId":520287,"journal":{"name":"Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC","volume":" ","pages":"219-96"},"PeriodicalIF":1.8,"publicationDate":"2004-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40837547","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}