Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"How does fetal inflammatory response syndrome change fetal response to hypoxia? An experimental study in a fetal sheep model","authors":"Geoffroy Chevalier,&nbsp;Charles Garabedian,&nbsp;Valeria De Stephano,&nbsp;Anne Wojtanowski,&nbsp;Yasmine Ould Hamoud,&nbsp;Louis Galan,&nbsp;Dyuti Sharma,&nbsp;Kevin Le Duc,&nbsp;Julien De Jonckheere,&nbsp;Laurent Storme,&nbsp;Guillemette Marot,&nbsp;Louise Ghesquière","doi":"10.1111/aogs.14948","DOIUrl":"10.1111/aogs.14948","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Fetal inflammatory response syndrome associated with acidosis during labor is a high-risk situation for the fetus. This study evaluated hemodynamic, gasometric, and heart rate variability changes during acute fetal inflammatory response syndrome associated with hypoxia, compared with isolated hypoxia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Acute fetal inflammatory response syndrome was obtained via an intravenously injection of lipopolysaccharide derived from <i>Escherichia coli</i>. Hypoxia was induced by repeated umbilical cord occlusions during three phases: mild, moderate, and severe umbilical cord occlusions. Two groups were created with chronically instrumented near-term fetal sheep: one group with isolated hypoxia, the other with hypoxia and fetal inflammatory response syndrome. Hemodynamic, gas parameters, and fetal heart rate variability were compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The hypoxia and fetal inflammatory response syndrome group had a higher mortality rate (<i>n</i> = 4/9) compared with the hypoxia group (<i>n</i> = 0/9). Gasometric state was altered earlier in case of lipopolysaccharide injection (pH = 7.22 (7.12–7.24) vs 7.28 (7.23–7.34) <i>p</i> = 0.01; lactate = 10.3 mmol/L (9.4–11.0) vs 6.0 mmol/L (4.1–8.2) <i>p</i> &lt; 0.001 after mild occlusions). After mild occlusions, the hypoxia and fetal inflammatory response syndrome group had higher values on seven heart rate variability parameters compared with the hypoxia group. After moderate occlusions, two parameters remained significantly higher.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>During fetal inflammatory response syndrome, fetal adaptation to hypoxia is impaired. In case of fetal infection, acidosis during labor is likely to become severe more rapidly, requiring closer fetal monitoring during labor.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"103 11","pages":"2281-2288"},"PeriodicalIF":3.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological and emotional profiles of Australian uterine transplant potential recipients: A comparison with international trials.","authors":"Brigitte Gerstl, Eva Kehag, Hayley Mallinder, Tamika Baker, Kaushalya Arulpragasam, Catherine David, Meredith Stone, Elizabeth Fitzsimmons, Kate Hetherington, Rebecca Deans","doi":"10.1111/aogs.14974","DOIUrl":"https://doi.org/10.1111/aogs.14974","url":null,"abstract":"<p><strong>Introduction: </strong>Uterus transplant (UTx) has emerged as a groundbreaking solution for individuals with uterine factor infertility (UFI). This study is the first in Australia to explore the psychosocial functioning of potential recipients assessed for the nation's initial UTx clinical trial and to compare their psychological profiles with those from international UTx trials.</p><p><strong>Material and methods: </strong>This is a mixed methods prospective study incorporating standardized psychological measures and semi-structured interviews. Conducted at a tertiary hospital in Sydney, Australia, the study involved 10 female Australian UTx potential recipients with UFI undergoing assessment for UTx surgery. Participants underwent comprehensive psychological evaluation using validated measures and in-depth semi-structured interviews. Quantitative measurement tools included the Hospital Anxiety and Depression Scale, Short Form-36 Health Survey, Fertility Quality of Life, and the Stanford Integrated Psychosocial Assessment for Transplantation. Thematic analysis was conducted on qualitative data from semi-structured interviews.</p><p><strong>Results: </strong>The Australian UTx potential recipients reported significantly higher Short Form-36 (SF-36) scores compared to the Australian general population in general health (p < 0.04), bodily pain (p < 0.02), social functioning (p < 0.02), and emotional well-being (p < 0.01). Compared with international UTx cohorts, the Australian UTx group showed comparable SF-36 outcomes, with minor variations observed for general health and physical function domains. Hospital Anxiety and Depression Scale scores revealed lower anxiety, but slightly higher depression levels compared to international UTx trial cohorts. Fertility quality-of-life scores were significantly higher in the Australian UTx group compared to women experiencing primary infertility across four domains (p < 0.001). Thematic analysis of interviews highlighted the complex emotional impact of infertility, strong family and social support, and the perception of UTx as a transformative opportunity to achieve wholeness and motherhood.</p><p><strong>Conclusions: </strong>UTx represents a novel treatment option for women with UFI. This is the first qualitative study in Australia, it demonstrates the connection between women with UFI and their motivations for parenthood. These findings highlight the importance of tailored psychological assessments and establish a foundation for future research exploring the psychological characteristics of patient candidacy for UTxs.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discontinuation of cervical cancer screening for HPV-vaccinated women?","authors":"Jesper Bonde,&nbsp;Anne Hammer","doi":"10.1111/aogs.14978","DOIUrl":"10.1111/aogs.14978","url":null,"abstract":"&lt;p&gt;The HPV vaccine has been successful in reducing the incidence of cervical cancer and its precursors.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Without a doubt or discussion. Thus, in 2018, the World Health Organization declared that cervical cancer could be eliminated within the next century (defined as an incidence rate below 4/100 000) if 90% of women receive the HPV vaccine, 70% undergo high-performance screening at least twice, and 90% of women with cervical precancer receive adequate treatment.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Recently, a Danish study published in the &lt;i&gt;International Journal of Cancer&lt;/i&gt; reported that cervical cancer incidence is down to 3 per 100 000 among women aged 20–29, suggesting the elimination of cervical cancer in this group of women.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; As a result of these findings, health economist, Professor Jakob Kjellberg, was quoted in Danish Broadcasting Corporation (DR) saying that screening of HPV-vaccinated women is “overkill and a waste of money” and that discontinuation of screening in this group of women could save hundreds of millions (of Danish Crowns).&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; The news piece was as short as it was unnuanced. Not a single healthcare professional working within the field was consulted for comments.&lt;/p&gt;&lt;p&gt;It is well known that a 3-year cytology screening for HPV-vaccinated women below 30 years as in Denmark and other Nordic countries has decreasing diagnostic value.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; In that context Professor Kjellberg has a point: A different approach is definitively needed, but discontinuation? Here are some reasons why discontinuation is jumping to conclusions.&lt;/p&gt;&lt;p&gt;In Denmark and Sweden, females have been immunized with the bi- or quadrivalent vaccine, protecting against HPV16 and HPV 18 until 2019. From 2019, the nonavalent vaccine has been in use. In Norway and Finland, the bivalent vaccine is still used in the HPV vaccination program, while the nonavalent vaccine is available via prescription. Although responsible for 70% of the cervical cancer cases,&lt;span&gt;&lt;sup&gt;7, 8&lt;/sup&gt;&lt;/span&gt; the bivalent and quadrivalent HPV vaccines do not protect against the remaining 10 genotypes classified as oncogenic and constituting 30% of cervical cancers. This is important! The proportion of cervical cancers attributed to non-HPV16/18 genotypes increases with age and constitute about half of all cervical cancers in older women.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; To cease screening among women immunized with the bivalent or quadrivalent HPV vaccine would be a disservice to those women. Also, age at the time of vaccination matters. Studies have shown optimal impact if the vaccine is given to HPV-naïve persons, in effect, prior to sexual debut which in practical terms is before age 15/16 years. In contrast, there is limited impact of quadrivalent HPV vaccination on cancer rates in those aged 20 or above at the time of HPV vaccination.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Thus, if screening recommendations are to be revise","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"103 11","pages":"2122-2123"},"PeriodicalIF":3.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142306916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trustworthiness criteria for meta-analyses of randomized controlled studies: OBGYN Journal guidelines","authors":"The OBGYN Editors' Integrity Group (OGEIG),&nbsp;Vincenzo Berghella","doi":"10.1111/aogs.14942","DOIUrl":"10.1111/aogs.14942","url":null,"abstract":"&lt;p&gt;Meta-analysis is a quantitative statistical technique used to combine and analyze data from the results of multiple previous independent studies on a particular topic, to derive overall conclusions or effect estimates. In general (but not exclusively), meta-analyses are based on RCTs. The results are often used to develop standard practice or clinical guidelines. However, RCTs may be inaccurate or fabricated, leading to journal withdrawal or retraction. This article aims to expand upon the list of RCT quality criteria for authors of meta-analyses of RCTs, so that low-quality and fabricated studies are excluded from meta-analyses.&lt;/p&gt;&lt;p&gt;The editors in the group were invited to participate in monthly or bimonthly calls regarding trustworthiness in OBGYN publishing, with the aim of preventing publication of untrustworthy science in women's health. Using data from the published literature, including our prior work,&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Cochrane guidance,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; the TRACT Checklist,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; the author instructions of the various journals, and other publications related to trustworthiness of meta-analyses of RCTs,&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; criteria for meta-analyses were reviewed, reaching consensus by majority.&lt;/p&gt;&lt;p&gt;By consensus, 21 quality criteria were agreed upon by the editors. The aim is for authors to check and confirm the quality criteria for &lt;i&gt;each&lt;/i&gt; identified RCT when carrying out a meta-analysis of RCTs (Tables 1 and 2). These criteria help to identify trustworthy RCTs, and are assigned to two groups: absolute criteria and “other quality” criteria. “Absolute” trustworthiness criteria are those that, if not met, would suggest noninclusion in the main results of meta-analyses of RCTs (Table 1). “Other quality” criteria are those that, if not met, would suggest lower quality of RCTs (Table 2). In addition, the meta-analysis should be prospectively registered in the PROSPERO database (or a similar international, publicly accessible database, eg INPLASY; Research Registry – Registry of Systematic Review/Meta-Analysis).&lt;/p&gt;&lt;p&gt;The consensus decision was that the abstract and primary analysis of meta-analyses should report only trustworthy, “high-quality” RCTs that meet all of the “absolute” criteria (Table 1). Authors of meta-analyses are encouraged to contact RCT authors for additional information regarding the criteria in Tables 1 and 2 if the details cannot be found in the published manuscript or registered protocol. At a minimum, all coauthors of meta-analyses should confirm at the point of submission that each included article meets the criteria included in Table 1. Individual journals may also ask authors to confirm that each article meets the criteria in Table 2, or may go further and ask authors to complete and submit a checklist for the criteria in Tables 1 and 2 for each article included in the meta-analysis. In general, RCTs that are published as an abstract only seldom report all criteria","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"103 11","pages":"2118-2121"},"PeriodicalIF":3.5,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early surgical outcomes of 550 consecutive patients treated for benign gynecological conditions by transvaginal natural orifice transluminal endoscopic surgery","authors":"Yannick Hurni,&nbsp;Colin Simonson,&nbsp;Marcello Di Serio,&nbsp;Régine Lachat,&nbsp;Pauline Bodenmann,&nbsp;Stéphanie Seidler,&nbsp;Daniela Huber","doi":"10.1111/aogs.14889","DOIUrl":"10.1111/aogs.14889","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Evidence about intra- and postoperative complication rates related to transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for benign gynecological conditions is still limited. We report and analyze data from a large cohort of patients operated in a single institution during 3.5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>To evaluate the safety and feasibility of vNOTES for benign gynecological indications, we performed a single-center observational study reporting and analyzing perioperative outcomes of 550 consecutive patients operated between 2020 and 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 550 included patients, 365 (66.4%) underwent a vNOTES hysterectomy, 167 (30.4%) a procedure limited to the adnexa, and 18 (3.3%) other interventions, including myomectomy, pelvic adhesiolysis, post-hysterectomy pelvic hematoma drainage, pelvic organ prolapse repair, and appendectomy. The mean age was 49.4 ± 12.2 years, and the mean BMI was 26.2 ± 5.8 kg/m². The total complication rate was 6.5% (36 cases), of which 2.7% (15 cases) were intraoperative complications and 4.0% (22 cases) were postoperative complications. Patients presented postoperative complications classified as Clavien–Dindo (CD) grade I in 4 cases (0.7%), grade II in 10 cases (1.8%), and grade III in 8 cases (1.5%). We observed no CD grade IV and V complications. Three patients (0.5%) were rehospitalized for postoperative complications management. The conversion rate was 1.6%, with nine cases of conversion to conventional laparoscopy and none to laparotomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The application of vNOTES appears safe and feasible for most benign gynecological surgeries. Our study focused on surgical complications and demonstrated a profile similar to those reported in previous studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"103 11","pages":"2203-2210"},"PeriodicalIF":3.5,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative cervicovaginal fluid fetal fibronectin: A liquid biopsy for intra-amniotic inflammation","authors":"Puntabut Warintaksa,&nbsp;Roberto Romero,&nbsp;Waranyu Lertrat,&nbsp;Nutnaree Yuenyongdechawat,&nbsp;Paninee Mongkolsuk,&nbsp;Supakorn Chaiyakarn,&nbsp;Rapeewan Settacomkul,&nbsp;Pisut Pongchaikul,&nbsp;Pornpun Vivithanaporn,&nbsp;Piya Chaemsaithong","doi":"10.1111/aogs.14899","DOIUrl":"10.1111/aogs.14899","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Intra-amniotic inflammation is causally linked to spontaneous preterm labor. The gold standard for the diagnosis of intra-amniotic inflammation is the determination of an amniotic fluid profile obtained from transabdominal amniocentesis, which is invasive. Cervicovaginal fluid fetal fibronectin (fFN) is a widely-used predictive biomarker for spontaneous preterm labor. The aims of this study are to determine (1) whether a quantitative cervicovaginal fluid fFN test can be used to identify the presence of intra-amniotic inflammation; and (2) an appropriate cut-off value of a cervicovaginal fluid fFN concentration for the identification of intra-amniotic inflammation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Material and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This prospective cohort study included 78 patients with preterm labor and intact membranes who had a sample collected for quantitative cervicovaginal fluid fFN measurement and underwent transabdominal amniocentesis. Intra-amniotic inflammation was defined as an amniotic fluid interleukin-6 concentration ≥2.6 ng/mL. Clinicians were masked from the results of cervicovaginal fluid fFN and amniotic fluid interleukin-6 concentrations. Logistic regression analysis was used to determine which factors were significant predictors of intra-amniotic inflammation. The diagnostic indices of the cervicovaginal fluid fFN test for the identification of intra-amniotic inflammation were calculated.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;(1) Frequency of intra-amniotic inflammation was 26.9% (21/78); (2) the higher the cervicovaginal fluid fFN concentration, the greater the risk of intra-amniotic inflammation (&lt;i&gt;p&lt;/i&gt; &lt; 0.001); (3) cervicovaginal fluid fFN concentration ≥125 ng/mL had an area under the curve of 0.91 (95% confidence interval: 0.83–0.96) for the identification of intra-amniotic inflammation with 100% sensitivity, 100% negative predictive value, 82.46% specificity and a positive likelihood ratio of 5.7; and (4) cervicovaginal fluid fFN cut-off of 125 ng/mL had a significant higher predictive performance than the traditional cut-off (50 ng/mL) for the identification of intra-amniotic inflammation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Quantitative cervicovaginal fluid fFN with a cut-off of 125 ng/mL had a high sensitivity and a negative predictive value as well as a positive likelihood ratio for the identification of intra-amniotic inflammation. Its high sensitivity and negative predictive value can be used to decrease an index of suspicion of intra-amniotic inflammation. ","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"103 11","pages":"2252-2263"},"PeriodicalIF":3.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.14899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic isthmus flow reversal in fetal coarctation of the aorta and the associated factors","authors":"Guihong Chen,&nbsp;Yongfeng Han,&nbsp;Congxin Sun,&nbsp;Wei Xiang,&nbsp;Wei Zhao,&nbsp;Pei Zhou,&nbsp;Tianxiao Yu,&nbsp;Zhuo Chen,&nbsp;Bulang Gao,&nbsp;Shuping Ge,&nbsp;Jie Mi","doi":"10.1111/aogs.14940","DOIUrl":"10.1111/aogs.14940","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The aim of this study was to investigate the presence of aortic isthmus flow reversal and its associated factors in fetuses with positive and false-positive coarctation of the aorta (CoA) compared with normal controls.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Material and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pregnant women with fetuses suspected of CoA and normal control were enrolled, and these women experienced prenatal ultrasound scan and followed up for 6 months after birth to confirm the presence of CoA. All the ultrasound parameters were analyzed.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A total of 134 pregnant women were enrolled, with 43 CoA-positive fetuses and 91 CoA false-positive fetuses, and 334 matched pregnant women were enrolled in the control group. Aortic isthmus flow reversal occurred in 28 (65.1%) fetuses in the CoA-positive group, significantly (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) more than in the false-positive (37 or 40.7%) or control group (64 or 19.2%). Aortic isthmus flow reversal was mostly in the full systole (&lt;i&gt;n&lt;/i&gt; = 17 or 60.7%) or late systole and early-middle diastole (&lt;i&gt;n&lt;/i&gt; = 10 or 35.7%) in the CoA-positive fetuses (&lt;i&gt;n&lt;/i&gt; = 27 or 96.4%), significantly (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) different from that in the false-positive or control group. The aortic isthmus flow reversal peak systolic velocity (PSV), flow volume, and ratio of reversed flow/forward flow were significantly (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) increased in the CoA-positive and false-positive groups than in the control group. The aortic isthmus flow reversal incidence was significantly (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) correlated with the middle cerebral artery (MCA) PSV in the total three groups or in the false-positive group but was significantly (&lt;i&gt;p&lt;/i&gt; &lt; 0001) negatively correlated with the MCA resistance index (RI) in the CoA-positive group. The incidence of the aortic isthmus flow reversal was significantly (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) positively correlated with the umbilical artery (UA) RI in the false-positive group and with the UA RI in the total three groups. Independently associated factors for aortic isthmus flow reversal were isthmic flow volume/CCO (combined cardiac output) in the CoA-positive group.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Reversal of flow in the aortic isthmus is much more common in true-positive cases of CoA as compared to controls, and isthmic flow reversal in the full systolic phase only suggests presence of CoA. The aortic isthmic reversed flow volume accounts for over half of the isthmic forward flow volume in the CoA-positive fetuses t","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"103 11","pages":"2264-2272"},"PeriodicalIF":3.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.14940","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of obstetric violence in high-income countries: A systematic review of mixed studies and meta-analysis of quantitative studies","authors":"Laura Katrina Fraser, Naomi Cano-Ibáñez, Carmen Amezcua-Prieto, Khalid Saeed Khan, Ronald F. Lamont, Jan Stener Jørgensen","doi":"10.1111/aogs.14962","DOIUrl":"https://doi.org/10.1111/aogs.14962","url":null,"abstract":"Obstetric violence, or mistreatment of women in obstetric care, can have severe consequences such as fear of future childbirth, post-traumatic stress disorder, and depression.","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"12 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrapartum ultrasound for cervical dilatation: Inter- and intra-observer agreement","authors":"Arwa Hanidu, Mariya Kovalenko, Sana Usman, Lorenzo Monasta, Giulia Zamagni, Tamara Stampalija, Christoph Lees","doi":"10.1111/aogs.14970","DOIUrl":"https://doi.org/10.1111/aogs.14970","url":null,"abstract":"Digital vaginal examination (DVE) is considered the standard of care for assessing labor progress and cervical dilatation. However, it may be painful and is a subjective method that can increase the risk of chorioamnionitis. Known inter- and intra-observer variability exists in measurements of cervical dilatation obtained digitally. However, little is known about the inter- and intra-observer variability when using intrapartum transperineal ultrasound (TPUS). Our objectives were to investigate the relationship between cervical dilatation as assessed by TPUS and DVE. To assess inter- and intra-observer variability in both single and repeated ultrasound assessments of cervical dilatation during active labor.","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"53 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prepregnancy body mass index and visceral fat exhibit divergent associations with metabolic factors in pregnant women with obesity: A Norwegian cohort study","authors":"Maja Lecic Bonnichsen, Nina Gunnes, Lill Trine Nyfløt, Guttorm Haugen, Marie Cecilie Roland","doi":"10.1111/aogs.14968","DOIUrl":"https://doi.org/10.1111/aogs.14968","url":null,"abstract":"Pregnancy involves changes in maternal metabolism that differ between normal-weight women and women with overweight or obesity, including changes in glucose, insulin, lipids, and adipokines. These changes contribute to altered risk profiles for adverse outcomes for both mother and child during pregnancy, childbirth, and postpartum. We explored associations between visceral fat and prepregnancy body mass index (pBMI), respectively, with glucose and lipid metabolism, as well as with adipokines and C-reactive protein (CRP), measured fasting in early and late pregnancy. We hypothesized that among women with pBMI ≥35 kg/m², visceral fat measured around gestational week 18 (visceral fat18) would show associations with greater number of metabolic variables during pregnancy, than pBMI.","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"117 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142255767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}