AJOG global reports最新文献

{"title":"Up-front dissection of the uterovesical space or “bladder-first approach” reduces hemorrhage and bladder injury during hysterectomy for placenta accreta spectrum: reconfirmed in 78 more cases in a prospective single-center study","authors":"Pradip Kumar Saha MD, MAMS , Rashmi Bagga MD, DNB , Rimpi Singla MD , Aashima Arora MD , Vanita Jain MD , Vanita Suri MD , Kajal Jain MD , Parveen Kumar MD, DM , Nalini Gupta MD , Ashish Jain MD , Tulika Singh MD , Ravimohan S. Mavuduru MS, MCh","doi":"10.1016/j.xagr.2024.100425","DOIUrl":"10.1016/j.xagr.2024.100425","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Cesarean hysterectomy for placenta accreta spectrum disorder may be associated with severe hemorrhage because of placental invasion of the myometrium and the uterovesical space or parametrium. It leads to serious complications, such as massive hemorrhage requiring massive transfusion, coagulopathy, bladder and ureteric injuries, need for intensive care unit admission and prolonged hospital stay. To reduce the complications of cesarean hysterectomy for placenta accreta spectrum disorder, ongoing efforts are being made to develop different surgical approaches. In previous 12 cases upfront dissection of uterovesical space (bladder-first approach) before delivery of the neonate was observed to reduce hemorrhage arising from extensive neovascularization in this area and bladder injury.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to assess the efficacy of the bladder-first approach in a large sample to reduce the complications of cesarean hysterectomy for placenta accreta spectrum disorder.</div></div><div><h3>STUDY DESIGN</h3><div>This study presented data of 78 women (2017–2022) who underwent cesarean hysterectomy for placenta accreta spectrum disorder using the “bladder-first approach” from a tertiary care institute in Chandigarh, India. In this surgical approach, dissection of the uterovesical fold from the lower uterine segment to the cervix was performed before making the uterine incision for delivery. During this dissection, vascular areas were isolated and coagulated with bipolar electrosurgery or ligated with silk suture and then divided.</div></div><div><h3>RESULTS</h3><div>The 78 women with placenta accreta spectrum disorder underwent cesarean hysterectomy under general anesthesia. The mean gestational age was 35.0±2.5 weeks (range, 25.4–38.0), the mean blood loss was 1.56±1.06 L (range, 0.40–5.00 L), and the mean number of blood transfusions was 2.08±2.10 units (range, 0.00–9.00). Bladder injury occurred in 3 of 78 women (3.8%), and intensive care unit admission (for ≤24 hours) was needed by 3 of 78 women (3.8%). Histology was available in 73 of 78 women (19 with placenta percreta, 23 with placenta increta, and 31 with placenta accreta). There were 3 of 78 antenatal stillbirths. Of note, 75 women had live-born neonates, including 2 pairs of twins. The Apgar score of ≤7 at 5 minutes was seen in 6 of 77 neonates, and 20 of 77 neonates required neonatal intensive care unit care. There was 1 neonatal death on day 3 of life because of extreme prematurity and sepsis. In addition, 74 women went home with neonates, including 2 pairs of twins.</div></div><div><h3>CONCLUSION</h3><div>Our data support that up-front dissection of the uterovesical space or “bladder-first approach” reduces hemorrhage and bladder injury during cesarean hysterectomy in placenta accreta spectrum disorder, with no adverse effect on neonatal outcome. Achieving peripheral vascular control of the neovascularized uterovesical area before ","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100425"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of eight or more antenatal care contacts and determinants among healthcare providers in Ethiopia: systematic review and meta-analysis","authors":"Agerie Mengistie Zeleke MSc ,&nbsp;Yosef Aragaw Gonete MSc ,&nbsp;Worku Chekol Tassew MSc ,&nbsp;Yeshiwas Ayale Ferede MPH","doi":"10.1016/j.xagr.2024.100418","DOIUrl":"10.1016/j.xagr.2024.100418","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Eight or more antenatal care contact sessions are recommended as part of antenatal care to prevent pregnancy-related complications. However, studies across Ethiopia have shown discrepancies and inconsistent results.</div></div><div><h3>OBJECTIVE</h3><div>The goal of this study was to determine the pooled compliance to ≥8 antenatal care contact sessions and associated factors among Ethiopian healthcare providers.</div></div><div><h3>STUDY DESIGN</h3><div>Studies were systematically searched from March 1, 2024, to April 2, 2024, using Embase, Web of Science, PubMed/MEDLINE, Science Direct, African Journal Online, and the Wiley Online Library. The data were subsequently transferred to Stata software, version 11, for further data analysis. Pooled effect sizes were calculated based on the prevalence of ≥8 antenatal care contact sessions, and the odds ratios and 95% confidence intervals to indicate statistical significance were determined for the associated factors. To evaluate statistical heterogeneity, the Cochrane Q test and I² statistic were used.</div></div><div><h3>RESULTS</h3><div>In this systematic review and meta-analysis, a total of 492,000 articles were retrieved from various databases and registers. Finally, 16 studies with 7781 participants were included. The overall compliance to the guidelines that recommend ≥8 antenatal care contact sessions was 18.35% (95% confidence interval, 10.98–25.73). Healthcare providers who worked at hospital health facilities (adjusted odds ratio, 5.09; 95% confidence interval, 2.26–11.47) had knowledge of the importance of ≥8 antenatal care contact sessions for pregnant women (adjusted odds ratio 2.04; 95% confidence interval, 1.10–3.78). Those who were able to clearly differentiate between the guidelines recommending 8 antenatal care contact sessions and those recommending 4 antenatal care visits (adjusted odds ratio, 3.95; 95% confidence interval, 2.10–7.33) were more likely to record ≥8 antenatal care contact sessions, which was significantly associated with the outcome variable.</div></div><div><h3>CONCLUSION</h3><div>In this study, more than 80% of antenatal care healthcare providers did not comply with the modern and World Health Organization–recommended antenatal care contact guidelines for a variety of reasons. It is very important to address factors that prevent healthcare providers from complying with the recommended ≥8 antenatal care contact sessions. To improve compliance to the World Health Organization guidelines of ≥8 antenatal care contact sessions, training on these guidelines is recommended.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100418"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New surgical technique for managing placenta accreta spectrum and pilot study of the “CMNT PAS” study","authors":"Hassine Saber Abouda MD ,&nbsp;Haithem Aloui MD ,&nbsp;Eya Azouz MD ,&nbsp;Sofiene Ben Marzouk MD ,&nbsp;Hatem Frikha MD ,&nbsp;Rami Hammami MD ,&nbsp;Sana Minjli MD ,&nbsp;Rachid Hentati MD ,&nbsp;Mehdi Khila MD ,&nbsp;Badis Mohamed Chanoufi MD ,&nbsp;Abir Karoui MD ,&nbsp;Maghrebi Hayen MD","doi":"10.1016/j.xagr.2024.100430","DOIUrl":"10.1016/j.xagr.2024.100430","url":null,"abstract":"<div><h3>Introduction</h3><div>The gold standard for treating the placenta accreta spectrum (PAS) is a cesarean hysterectomy, which harms fertility. Another conservative surgical approach allows the uterus to be preserved: one-step conservative surgery. We will compare these two approaches through the “CMNT PAS” study. Before this main study, we conducted a pilot study to determine the required sample size.</div></div><div><h3>Study Design</h3><div>This pilot study, conducted over 31 months, included patients who underwent surgery for suspected PAS based on imaging findings. Participants were divided into the conservative surgery group (CSG: 6 patients) and the Caesarean Hysterectomy Group (control group [CG]: 6 patients). For the CSG, our team adapted the approach described in previous research by Palacios-Jaraquemada.</div></div><div><h3>Results</h3><div>The primary objective of our study is to ascertain the appropriate sample size for our main investigation on the conservative surgical management of PAS. Concerning the primary outcome, the estimated amount of blood loss was lower in CSG compared to CG, although this difference was not statistically significant (1298.04±556 mL vs 891.051±348 mL, <em>P</em>=.159). The mean decrease in hemoglobin (Δ Hb) was 2.8±1.3251 g/dL in the CG group compared to 1.933±1.0614 g/dL in the CSG group (<em>P</em>=.240). The mean number of transfused red blood cell units was 3±3.2249 in the CG group and 1.5±1.64317 in the CSG group (<em>P</em>=.334).</div></div><div><h3>Conclusion</h3><div>The estimated blood loss between the two groups is not statistically significant. The required sample size is 22 patients.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100430"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ghana abortion care—a model for others: analysis of the 2017 Ghana Maternal Health Survey","authors":"Dhanalakshmi Thiyagarajan MD, MPH ,&nbsp;Kwaku Asah-Opoku MBChB, MPH ,&nbsp;Sarah Compton PhD, MPH","doi":"10.1016/j.xagr.2024.100419","DOIUrl":"10.1016/j.xagr.2024.100419","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>About 5% to 13% of maternal mortality is directly related to unsafe abortion care. Despite the cultural stigmatization of abortions, Ghana has progressive abortion laws, healthcare guidelines, and clinical outcomes.</div></div><div><h3>OBJECTIVE</h3><div>Our study's primary aim was to characterize abortion outcomes in Ghana. Our secondary aims included investigating factors that led to abortion complications and the treatment of these complications.</div></div><div><h3>STUDY DESIGN</h3><div>We used data from the 2017 Ghana Maternal Health Survey. We examined questions that focused on the reasons for abortion, methods used for abortion, healthcare setting for abortion, and health issues after abortion. We performed descriptive and inferential statistics, including cross tabulation with chi-square analysis and logistic regression models.</div></div><div><h3>RESULTS</h3><div>Between 2012 and 2017, 1,425 women reported and completed the abortion-related questions. For those who obtained an abortion for health reasons, 69% had a surgical-based as opposed to herbal or medication-based abortion (<em>P</em>&lt;.001), 94% had a medical facility–based as opposed to non-medical facility–based abortion (<em>P</em>&lt;.001), and 21% had health problems related to the abortion within 1 month (<em>P</em>=.035). Women's reasons for undergoing an abortion did not affect the treatment rates after complications. There was no difference in the occurrence of an abortion-related complication or receipt of treatment for this complication within 1 month after the abortion among those who underwent medical facility–based and those who underwent nonmedical facility based abortion. Those with tertiary-level education or those who knew abortions were legal were more likely to have a surgical and medical facility–based abortion.</div></div><div><h3>CONCLUSION</h3><div>Although Ghana has room to improve the safety and accessibility of abortion services, our analysis suggests abortions in Ghana, regardless of reason given for seeking the service or method of abortion, seem to be safe. Translating Ghana's approach to abortion could minimize unsafe abortions globally.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100419"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of failure to progress within 2 weeks of delivery: results of a multivariable analysis approach","authors":"José Morales-Roselló ,&nbsp;Blanca Novillo-Del Álamo ,&nbsp;Alicia Martínez-Varea","doi":"10.1016/j.xagr.2024.100415","DOIUrl":"10.1016/j.xagr.2024.100415","url":null,"abstract":"<div><h3>Objective</h3><div>The incidence of cesarean section (CS) for failure to progress (FP) has progressively increased; thus, knowing the factors that increase this incidence has become of crucial importance. This study aimed to find the true determinants of CS for FP within 2 weeks of delivery, proposing strategies to reduce its incidence.</div></div><div><h3>Material and Methods</h3><div>A group of 957 term and late preterm (≥34 weeks) singleton pregnancies with a complete gestational follow-up and an ultrasound examination within 2 weeks of delivery were included in a retrospective observational study. Epidemiological, sonographic, and perinatal data were recorded, and multivariable logistic regression analyses were applied to create models to predict the importance of different variables in the explanation of FP.</div></div><div><h3>Results</h3><div>Induction of labor was by far the most important modifiable factor, followed by smoking and maternal weight, while parity was the most important nonmodifiable factor, followed by maternal age and estimated fetal weight. The difference in days from the actual due date exerted no influence.</div></div><div><h3>Conclusions</h3><div>To reduce the incidence of CS for FP, inductions of labor should be performed only under evidence-based medicine indications and kept to a minimum. In addition, maternal overweight reduction and maternal smoking cessation should be promoted before the initiation of gestation.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"4 4","pages":"Article 100415"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142555039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of multidisciplinary convalescence recommendations after childbirth: a modified Delphi study","authors":"Zayël Z. Frijmersum MD ,&nbsp;Eva Van der Meij MD, PhD ,&nbsp;Esther V.A. Bouwsma MD, PhD ,&nbsp;Corine J.M. Verhoeven PhD ,&nbsp;Johannes R. Anema MD, PhD ,&nbsp;Judith A.F. Huirne MD, PhD ,&nbsp;Petra C.A.M. Bakker MD, PhD","doi":"10.1016/j.xagr.2024.100411","DOIUrl":"10.1016/j.xagr.2024.100411","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Evidence suggests that postpartum recovery takes longer than 6 weeks. However, evidence-based recommendations regarding postpartum recovery are lacking. Current research mainly focuses on shortening hospital stay after childbirth, neglecting outpatient recovery.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to develop multidisciplinary recommendations on convalescence after vaginal and cesarean delivery using a modified Delphi method to improve recovery after childbirth.</div></div><div><h3>STUDY DESIGN</h3><div>Multidisciplinary experts employed in different medical organizations involved in care and guidance of patients during postpartum recovery participated in the study. The panel included 16 experts (5 gynecologists, 2 senior residents, 4 midwives, 2 maternity nurses, 2 general practitioners, and 1 pelvic floor physical therapist) and representatives from medical organizations. Detailed recommendations on convalescence after uncomplicated vaginal delivery and uncomplicated cesarean delivery were developed. In addition, a list with 35 potential affecting factors that could delay recovery was presented to identify circumstances in which the convalescence recommendation should be adapted. Recommendations were based on a literature review and a modified Delphi procedure among 16 experts. Multidisciplinary consensus of at least 67% was achieved on convalescence recommendations for 27 relevant functional activities after childbirth.</div></div><div><h3>RESULTS</h3><div>Multidisciplinary consensus on convalescence recommendations was reached for 26 of 27 functional activities for uncomplicated vaginal and cesarean delivery after 6 Delphi rounds and 2 group discussions. In total, 7 out of 32 affecting factors were deemed as independent factors that may delay recovery and therefore change the convalescence recommendations. The recommendations were deemed feasible by representatives from the same medical organizations as the panel.</div></div><div><h3>CONCLUSION</h3><div>Multidisciplinary consensus on recommendations regarding convalescence after uncomplicated vaginal delivery and uncomplicated cesarean delivery was achieved.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"4 4","pages":"Article 100411"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine fibroids with heavy menstrual bleeding stratified by race in a commercial and Medicaid database","authors":"Sanjay K. Agarwal MD, FACOG ,&nbsp;Michael Stokes MPH ,&nbsp;Rong Chen MA ,&nbsp;Cassandra Lickert MD","doi":"10.1016/j.xagr.2024.100412","DOIUrl":"10.1016/j.xagr.2024.100412","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Historically, the clinical characteristics and treatment pathways for patients with uterine fibroids and heavy menstrual bleeding have differed between White and Black women.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To provide a contemporary comparison of patient characteristics and treatment patterns among White and Black women with uterine fibroids and heavy menstrual bleeding in the United States.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;This retrospective cohort study included administrative claims data from 46,139 White and 17,297 Black women with uterine fibroids and heavy menstrual bleeding from the Optum Clinformatics database (January 2011–December 2020) and 7353 White and 16,776 Black women from the IBM MarketScan Multi-State Medicaid Insurance database (January 2010–December 2019). Patients were indexed at their initial uterine fibroid diagnosis claim and were required to have a claim for heavy menstrual bleeding and ≥12 months of continuous enrollment pre- and postindex. Patients were followed until the earliest of death, disenrollment, hysterectomy date, or end of study database. Outcomes were stratified by race and included patient demographics, clinical characteristics, pharmacologic treatment patterns, and surgeries/procedures. Pearson's Chi-square test for categorical variables and Student's t-test for continuous data were used to evaluate differences in baseline characteristics. Descriptive statistics were used to characterize treatment pathways for hormonal contraceptive use in women with ≥24 months of follow-up. Kaplan–Meier survival analysis was used to estimate time until hysterectomy, with log-rank testing to assess between-group differences.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The mean (standard deviation) duration of follow-up was 44.6 (27.9) and 41.0 (24.9) months in the commercial and Medicaid databases, respectively. Mean (standard deviation) age at uterine fibroid diagnosis was lower for Black than White women in both databases (commercial: 42.3 [6.5] vs 44.4 [6.3] years; &lt;em&gt;P&lt;/em&gt;&lt;.0001; Medicaid: 39.6 [7.1] years vs 40.2 [7.2] years; &lt;em&gt;P&lt;/em&gt;&lt;.0001). Anemia was more prevalent in Black vs White women in both databases (commercial: 5.9% [1028/17,297] vs 3.6% [1648/46,139]; &lt;em&gt;P&lt;/em&gt;&lt;.0001; Medicaid: 7.0% [1180/16,776] vs 4.5% [331/7353]; &lt;em&gt;P&lt;/em&gt;&lt;.0001). In the commercial database, approximately one-half of women had claims for ≥1 bulk symptom, with no significant differences between groups. In the Medicaid database, significantly more White than Black women had claims for bulk symptoms (77.0% [5665/7353] vs 68.4% [11,477/16,776]; &lt;em&gt;P&lt;/em&gt;&lt;.0001). Approximately 40% of all patients received hormonal drug therapies as initial treatment, most commonly hormonal contraceptives. However, discontinuation of hormonal contraceptive therapy was nearly universal, with one-half discontinuing within a median treatment duration of ∼5 months. Most women stopped treatment after 1 or","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"4 4","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and neonatal outcomes following antenatal corticosteroids in pregnancies complicated by diabetes: a scoping review","authors":"Klea Atallah BBiomed(Hons) ,&nbsp;Serena Moon MD ,&nbsp;I-Lynn Lee MBBS, BMedSc, FRACP, PhD ,&nbsp;Rosalynn Pszczola MBChB, BMedSci(Hons), FRACP ,&nbsp;Joanne M. Said MBBS, PhD, CMFM","doi":"10.1016/j.xagr.2024.100416","DOIUrl":"10.1016/j.xagr.2024.100416","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the current literature surrounding the administration of antenatal corticosteroids in pregnancies complicated by diabetes and summarize the reported neonatal and maternal outcomes in exposed and unexposed groups.</div></div><div><h3>Data sources</h3><div>A systematic search was performed in November 2023 using Ovid Medline and Embase databases to identify relevant studies.</div></div><div><h3>Study Eligibility Criteria</h3><div>Articles that reported on the maternal or neonatal outcomes in pregnancies complicated by pre-gestational or gestational diabetes after exposure to antenatal corticosteroids were included in this review. Articles were excluded if they did not separately report on the outcomes experienced by women with diabetes.</div></div><div><h3>Methods</h3><div>Maternal and neonatal outcomes of interest included neonatal respiratory distress syndrome, neonatal hypoglycemia, and maternal hyperglycemia. Key words in this search included combinations of the terms related to pre-gestational and gestational diabetes, antenatal corticosteroids, respiratory distress syndrome, hypoglycemia, and hyperglycemia. Title and abstract screening was conducted in duplicate.</div></div><div><h3>Results</h3><div>There were 19 studies that met the inclusion criteria. There were 13 studies that presented results pertaining to neonatal respiratory distress syndrome, 14 studies discussed neonatal hypoglycemia and 5 studies discussed maternal hyperglycemia. Only 2 included studies were randomized controlled trials with the remaining 17 studies being observational. There was heterogeneity in clinical settings, study populations, type of corticosteroid administered and timing of administration across the included studies. This review found that there is no clear evidence of beneficial effect of corticosteroid administration on neonatal respiratory outcomes in pregnancies complicated by diabetes. Additionally, there was discrepancy between studies reporting on neonatal hypoglycemia with 6 studies reporting an increased incidence in this outcome after antenatal corticosteroid exposure whilst 4 studies found no difference between exposed and unexposed groups. This review identified a specific gap in the reporting of maternal hyperglycemia following antenatal corticosteroids. The limited number of studies that did report this outcome unanimously reported an increased incidence of maternal hyperglycemia after corticosteroid exposure. The majority of studies had small sample sizes of pregnancies both complicated by diabetes and exposed to corticosteroids and therefore lacked sufficient power to make robust conclusions about the influence of antenatal corticosteroids in this group.</div></div><div><h3>Conclusion</h3><div>This review concludes that there are insufficient data regarding the risks and benefits of antenatal corticosteroid administration in pregnancies complicated by diabetes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"4 4","pages":"Article 100416"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of iron deficiency anemia and its associated factors among pregnant women seeking antenatal care in public health facilities of southwestern Ethiopia. A mixed study","authors":"Endale Tamiru Burayu MSc,&nbsp;Bekem Dibaba Degefa MSc","doi":"10.1016/j.xagr.2024.100417","DOIUrl":"10.1016/j.xagr.2024.100417","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Anemia is a major problem in Ethiopia, affecting a large part of the population. Despite the importance of the problem, the causes of anemia, especially iron deficiency anemia, among pregnant women attending antenatal care (ANC) in the study area have been little studied. Therefore, the aim of this study was to investigate iron deficiency anemia and its associated factors in pregnant women seeking antenatal care in public health facilities in Southwest Ethiopia in 2023.</div></div><div><h3>METHODS AND MATERIALS</h3><div>A mixed facility-based cross-sectional study was conducted involving 364 pregnant women from selected health facilities in Ilubabor and Buno Bedele zones. Backward multiple logistic regression was used to analyze the relationship between dependent and independent variables, with statistical significance set at a <em>P</em> value less than .05.</div></div><div><h3>RESULTS</h3><div>In this study, the prevalence of iron deficiency anemia was found to be 21.4%. Several factors have been significantly associated with iron deficiency anemia including; presence of malaria parasite [AOR=15.8, CI=5.1–48.4], presence of Helminthes [AOR=8.1, CI=2.8–23.9], consumption of leafy vegetables less than once a day [AOR=3.4, CI = 1.5–13.3] and not taking iron supplements/consumption [AOR=2.2, CI=1.1–4.4].</div></div><div><h3>CONCLUSION AND RECOMMENDATIONS</h3><div>The overall prevalence of iron deficiency anemia in the study area suggests that, it is a moderate public health problem. In order to improve the nutritional status of women, routine and consistent nutritional advice, the establishment of regular preventive systems and the implementation of feedback mechanisms are recommended.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"4 4","pages":"Article 100417"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mistreatment in healthcare: peripartum experience in a Tunisian maternity","authors":"Haithem Aloui MD,&nbsp;Hatem Frikha MD,&nbsp;Rami Hammami MD,&nbsp;Amal Chermiti MD,&nbsp;Hassine Saber Abouda MD,&nbsp;Mohamed Badis Channoufi PhD,&nbsp;Abir Karoui PhD","doi":"10.1016/j.xagr.2024.100410","DOIUrl":"10.1016/j.xagr.2024.100410","url":null,"abstract":"<div><h3>Background</h3><div>Mistreatment in healthcare is defined by the set of behaviors, acts, and omissions committed by the healthcare providers on patients. Pregnant women can be exposed to this behavior during pregnancy, childbirth, and the postpartum period. It can have several aspects and affects the women's mental health, social and professional life, and also their newborns and families.</div></div><div><h3>Objective</h3><div>This study was made to estimate the frequency of mistreatment during the peripartum period in a Tunisian maternity unit, determine its impact on the parturient and her entourage, and draw up recommendations for the prevention of this public health problem.</div></div><div><h3>Study Design</h3><div>We conducted a cross-sectional survey in Department C of the Tunis Maternity and Neonatology Center from July 2022 to September 30, 2022. Our questionnaire encompassed verbal and physical abuse, patient information, consent, unprofessional conduct, poor communication, and discrimination.</div></div><div><h3>Results</h3><div>This study included 400 patients. The average age was 29.3+–5.65. Single women represented 12.3% of the cases. Seventy-five percent of women reported having been victims of at least one type of violence during childbirth. Verbal abuse was the most frequent type observed. Eighty-two percent of women reported verbal abuse, while 23.25% underwent physical violence. After the delivery, 391 women (97.8%) stated that the delivery was a source of anxiety and that they were not ready to repeat the experience. Six of them were followed up in psychiatry. Mistreatment was expressed by a lack of information and/or respect for consent, unprofessional conduct, or poor communication between the caregiver and the patient.</div></div><div><h3>Conclusion</h3><div>This study emphasizes the significance of including women in decision-making processes regarding their care. Establishing systematic approaches for providing information and obtaining consent is crucial, ensuring a dynamic approach that promotes women's freedom of choice.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"4 4","pages":"Article 100410"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}