AJOG global reports最新文献

{"title":"“I'm supposed to be a helper”: Spiritual distress of abortion providers after the Dobbs decision","authors":"Leah M Bode BS,&nbsp;Komal A Kumar MD,&nbsp;Josie C McQuillan BS,&nbsp;Nicole P Scott MD,&nbsp;Caitlin Bernard MD, MSCI","doi":"10.1016/j.xagr.2025.100469","DOIUrl":"10.1016/j.xagr.2025.100469","url":null,"abstract":"<div><h3>Background</h3><div>The <em>Dobbs v. Jackson Women's Health Organization</em> decision has undoubtably affected the practice of abortion providers nationally. We hypothesized that <em>Dobbs</em> has also impacted the ways in which providers experience meaning and purpose through their work, which are elements of spirituality.</div></div><div><h3>Objective</h3><div>We sought to describe the spectrum of spirituality of abortion providers and understand whether and how the <em>Dobbs</em> decision caused spiritual distress.</div></div><div><h3>Study Design</h3><div>For this qualitative study, we conducted video interviews with 26 abortion providers from 17 states between November 2022 and February 2023. States were classified according to the Guttmacher Institute classifications from most restrictive to very protective as of December 2022. Interviews included questions such as, <em>“Can you describe your own sense of spirituality or spiritual identity?”</em> and <em>“How does your spiritual belief inform your response to the</em> Dobbs <em>decision?”</em></div></div><div><h3>Results</h3><div>Participants’ states of practice were well-distributed across the abortion restrictive-protective spectrum. The majority of participants were spiritual, while less than half identified as part of an organized religion. Many participants felt a spiritual <em>call</em> or <em>obligation</em> to provide abortion care and 46% described abortion as a <em>spiritual act</em> for provider and/or patient. Most participants experienced spiritual distress (74%), including those practicing in states across the restrictive-protective spectrum. Of note, 92% of participants described their spirituality as helpful in coping with the effects of the fall of <em>Roe v. Wade</em>. Sources of strength included advocacy, agency, legislative work, and community; over half specifically cited the abortion provider community.</div></div><div><h3>Conclusions</h3><div>The <em>Dobbs</em> decision—and subsequent state-level abortion restrictions—impacts abortion providers by causing spiritual distress. While many abortion-restrictive laws are influenced by religious or spiritual beliefs, it is important to recognize that abortion providers are also spiritual individuals.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100469"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620876","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":"Effect of different combinations of serum antimüllerian hormone levels and body mass index on pregnancy outcomes in women with polycystic ovary syndrome","authors":"Yue Niu MD ,&nbsp;Xinwei Han MD ,&nbsp;Huiying Xiao MD ,&nbsp;Ruolan Miao MD ,&nbsp;Gege Ouyang MD ,&nbsp;Qian Wang MD, PhD ,&nbsp;Daimin Wei MD, PhD","doi":"10.1016/j.xagr.2025.100461","DOIUrl":"10.1016/j.xagr.2025.100461","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Both antimüllerian hormone and body mass index are associated with the pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to explore the effect of different combinations of antimüllerian hormone and body mass index on pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization.</div></div><div><h3>STUDY DESIGN</h3><div>This was a post hoc secondary analysis of a multicenter randomized trial. A total of 625 women from 1 center with antimüllerian hormone levels measured before in vitro fertilization treatment were classified into 6 groups: group A (normal weight and low antimüllerian hormone group), group B (normal weight and intermediate antimüllerian hormone group), group C (normal weight and high antimüllerian hormone group), group D (overweight/obese and low antimüllerian hormone group), group E (overweight/obese and intermediate antimüllerian hormone group), and group F (overweight/obese and high antimüllerian hormone group).</div></div><div><h3>RESULTS</h3><div>After adjustment via multivariate logistic regression, the overweight/obese and high antimüllerian hormone group (group F) had a higher risk of clinical pregnancy miscarriage (adjusted odds ratio, 3.30; 95% confidence interval, 1.35–8.07) than the normal weight and intermediate antimüllerian hormone group (group B). Both the normal weight and high antimüllerian hormone group (group C; adjusted odds ratio, 3.74; 95% confidence interval, 1.06–13.24) and the overweight/obese and high antimüllerian hormone group (group F; adjusted odds ratio, 3.61; 95% confidence interval, 1.05–12.38) had higher risks of ovarian hyperstimulation syndrome than the normal weight and intermediate antimüllerian hormone group (group B).</div></div><div><h3>CONCLUSION</h3><div>In women with polycystic ovary syndrome, high serum antimüllerian hormone levels were associated with an increased risk of clinical pregnancy miscarriage in women who were overweight/obese but not in those with normal weight.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100461"},"PeriodicalIF":0.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611034","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":"Association of Robson Ten Group Classification System with neonatal/postneonatal mortality: an analysis for the effect of the mass migration","authors":"Damla Çarkçı Yıldız MD,&nbsp;Elif Gül Yapar Eyi MD","doi":"10.1016/j.xagr.2025.100464","DOIUrl":"10.1016/j.xagr.2025.100464","url":null,"abstract":"<div><h3>Background</h3><div>Türkiye is the largest host country for refugees and asylum seekers and provides comprehensive maternal care, including antenatal, intrapartum, and postpartum services. However, there is a notable gap in comparative data regarding neonatal and postneonatal mortality for cesarean sections among Turkish citizens and refugees/asylum seekers.</div></div><div><h3>Objective</h3><div>The study aims to: (1) Compare neonatal and postneonatal mortality rates across Robson groups among Turkish citizens and refugees/asylum seekers. (2) Identify risk factors related to neonatal and postneonatal deaths, considering Robson Classification, clinical obstetric parameters, and demographics. (3) Investigate the primary causes of neonatal/postneonatal deaths in a hospital with a cesarean section rate of 48.43%.</div></div><div><h3>Study Design</h3><div>A retrospective cross-sectional study based on hospital electronic data was conducted, analyzing 25,631 cesarean section births. The participants included 89% Turkish citizens and 11% refugees/asylum seekers. Student's t-test, χ² -test, Mann-Whitney U test, Kruskal-Wallis analysis, and logistic regression were applied to identify risk factors and make comparisons.</div></div><div><h3>Results</h3><div>Neonatal Deaths: Out of 26,474 live births, 513 newborns died. Mortality rates were 21.94 per 1000 live births for refugees/asylum seekers and 19.05 per 1000 live births for Turkish citizens. Robson Group Distribution: The distribution of cesarean births across Robson groups was varied, with the highest mortality rates observed in groups R8, R9, R10, R6, and R7 (<em>p</em>=.001). Risk Factors: Logistic regression analysis identified Robson groups, fetal presentation, gestational age, Apgar scores, and newborn weight/height as significant risk factors for neonatal /postneonatal mortality. However, no significant associations were found with demographic factors, including maternal age, parity, and nationality. Main Causes of Deaths: The leading causes were prematurity (452 cases), congenital abnormalities (160 cases), infections (78 cases), asphyxia (17 cases), and meconium aspiration syndrome (9 cases).</div></div><div><h3>Conclusion</h3><div>The integration of the Robson Classification with neonatal and postneonatal mortality data offers a structured method to assess cesarean section outcomes, emphasizing the significant variation in mortality rates across different Robson groups. Notably, the highest risks were linked to multiple pregnancies, abnormal fetal presentations, and preterm births.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100464"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643179","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":"Understanding the potential contribution of polygenic risk scores to the prediction of gestational and type 2 diabetes in women from British Pakistani and Bangladeshi groups: a cohort study in Genes and Health","authors":"Julia Zöllner PhD ,&nbsp;Binur Orazumbekova MA ,&nbsp;Sam Hodgson MBBS ,&nbsp;David A. van Heel PhD","doi":"10.1016/j.xagr.2025.100457","DOIUrl":"10.1016/j.xagr.2025.100457","url":null,"abstract":"<div><h3>Background</h3><div>British Pakistani and Bangladeshi (BPB) women have disproportionately high rates of gestational diabetes mellitus (GDM), with prevalence estimates up to three times higher than in the general population. They are also at increased risk of progressing to type 2 diabetes, leading to significant health complications. Despite this, predictive models tailored to this high-risk, yet understudied group are lacking.</div></div><div><h3>Objective</h3><div>To investigate whether combining genetic and traditional clinical data improves risk prediction of GDM and progression to type 2 diabetes among BPB women. We hypothesized that incorporating polygenic risk scores (PRS) would enhance the predictive accuracy of existing models.</div></div><div><h3>Study Design</h3><div>An observational cohort study utilizing the Genes &amp; Health dataset, which includes comprehensive electronic health records. Women who gave birth between 2000 and 2023, both with and without a history of GDM, were included. Controls were defined as women without a GDM diagnosis during this period but who had a birth record. A total of 117 type 2 diabetes or GDM PRS were tested to determine the optimal PRS based on predictive performance metrics. The best-performing PRS was integrated with clinical variables for statistical analyses, including descriptive statistics, chi-square tests, logistic regression, and receiver operating characteristic curve analysis.</div></div><div><h3>Results</h3><div>Of 13,489 women with birth records, 10,931 were included in the analysis, with 29.3% developing GDM. Women with GDM were older (mean age 31.7 years, <em>P</em>&lt;.001) and had a higher BMI (mean 28.4 kg/m², <em>P</em>&lt;.001) compared to controls. The optimal PRS demonstrated a strong association with GDM risk; women in the highest PRS decile had significantly increased odds of developing GDM (OR 5.66, 95% CI [4.59, 7.01], <em>P</em>=3.62×10⁻⁵⁸). Furthermore, the risk of converting from GDM to type 2 diabetes was 30% in the highest PRS decile, compared to 19% among all GDM cases and 11% in the lowest decile. Incorporating genetic risk factors with clinical data improved the C-statistic for predicting type 2 diabetes following GDM from 0.62 to 0.67 (<em>P</em>=4.58×10⁻⁶), indicating better model discrimination.</div></div><div><h3>Conclusion</h3><div>The integration of genetic assessment with traditional clinical factors significantly enhances risk prediction for BPB women at high risk of developing type 2 diabetes after GDM. These findings support the implementation of targeted interventions and personalized monitoring strategies in this high-risk population. Future research should focus on validating these predictive models in external cohorts and exploring their integration into clinical practice to improve health outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100457"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681047","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":"Practice of pharmacological labor pain management and associated factors among healthcare providers in Ethiopia: a systematic review and meta-analysis","authors":"Agerie Mengistie Zeleke MSc ,&nbsp;Yeshiewas Ayale Ferede MPH ,&nbsp;Worku Chekol Tassew MSc ,&nbsp;Yosef Aragaw Gonete MSc","doi":"10.1016/j.xagr.2025.100456","DOIUrl":"10.1016/j.xagr.2025.100456","url":null,"abstract":"<div><h3>Background</h3><div>Achieving positive obstetric health outcomes is a global priority, and the implementation of pharmacological and evidence-based interventions for pain relief during labor is strongly recommended. However, there is a notable scarcity of systematic review evidence concerning the practice of pharmacological labor pain management services. Therefore, this study aimed to evaluate the pooled practices of pharmacological labor pain management and the associated factors among healthcare providers in Ethiopia.</div></div><div><h3>Methods</h3><div>Studies systematically searched electronic databases including Scopus, Medline/PubMed, Web of Science, Science Direct, African Journal Online, the Wiley Online Library, and National Digital Library repositories from April 1, 2024, to April 30, 2024. Data extracted from Microsoft Excel were imported into STATA version 11 for further analysis. A modified version of the Newcastle–Ottawa scale employed for cross-sectional studies used for quality assessment. A random-effects model was used to estimates pooled prevalence. Cochran's <em>Q</em> test and <em>I</em>² statistics were used to assess the heterogeneity of the studies. Percentages and odds ratios (OR) with 95% CI were used to pool the effect measure. The symmetry of the funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was done on the study years, and sample sizes.</div></div><div><h3>Results</h3><div>The pooled practice of pharmacological labor pain management services among healthcare providers was found to be 43.83% (95% CI: 37.45–50.20). Caregivers with sufficient knowledge (AOR: 2.36; 95% CI: 1.99–2.81), those who held positive attitudes (AOR: 3.66; 95% CI: 3.13–4.31), caregivers who received training related to obstetric protocols (AOR: 3.42; 95% CI: 2.36–4.97), laboring mothers expressed a preference for such interventions (AOR=2.33; 95% CI: 1.50, 3.63) were associated with practicing pharmacological labor pain management.</div></div><div><h3>Conclusion</h3><div>The overall pooled practice of pharmacological labor pain management among healthcare providers was found to be inadequate. Key factors such as obstetric care-related training, knowledge, attitudes, and the availability of options for labor pain management were strongly associated with this outcome. Therefore, it is crucial to provide training on labor pain management techniques to enhance healthcare providers’ knowledge and attitudes toward these interventions across all levels of the healthcare system. Moreover, recommend that all healthcare providers offer pain relief in a manner that aligns with the preferences of laboring women, ensuring that care is both responsive and respectful.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100456"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714700","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":"Mapping traditional birth attendance in sub-Saharan Africa between 2012 and 2023: analysis of data from demographic and health surveys","authors":"Daniel Gashaneh Belay MSc, MPH ,&nbsp;Gizachew A. Tessema PhD ,&nbsp;Jennifer Dunne PhD ,&nbsp;Kefyalew Addis Alene PhD ,&nbsp;Tefera Taddele MSc ,&nbsp;Theodros Getachew PhD ,&nbsp;Richard Norman PhD","doi":"10.1016/j.xagr.2025.100454","DOIUrl":"10.1016/j.xagr.2025.100454","url":null,"abstract":"<div><h3>Background</h3><div>Traditional birth attendance (TBA) remains common in Sub-Saharan Africa (SSA), impacting maternal and neonatal mortality rates. This study aimed at producing high-resolution geospatial estimates and identifying predictors of TBA-assisted childbirth in SSA.</div></div><div><h3>Methods</h3><div>We used the latest Demographic and Health Survey (DHS) data (2012–2023) from 32 SSA countries. Our sample included 231,189 reproductive-aged women who had given live birth to a child within the past 5 years. A multilevel binary logistic regression model was employed to identify the predictors of TBA-assisted childbirth, accounting for individual, household, and community-level factors. Geospatial analysis identified geographic hotspot areas where TBA is most prevalent.</div></div><div><h3>Result</h3><div>The proportion of TBA-assisted childbirth among reproductive-aged women in SSA was 12.43% (95% CI: 10.02%, 14.84%), ranging from 0.3% (South Africa) to 49.4 % (Chad). Hotspot clusters of TBA-assisted childbirth were found in Chad, Ethiopia, Madagascar, Guinea, and Niger. TBA-assisted childbirth was associated with women with community low women literacy (AOR=2.82; 95% CI; 2.57, 3.09), low household wealth status (AOR=1.42; 95% CI; 1.34, 1.49), and residing in rural areas (AOR=2.95; 95% CI; 2.68, 3.24) or had major problems with distance from the health facilities (AOR=1.22; 95% CI; 1.17, 1.26).</div></div><div><h3>Conclusion</h3><div>Significant geographic variation in TBA-assisted childbirth among women in SSA indicates the need for targeted health interventions to improve access to skill delivery services and empower women through financial and literacy initiatives.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100454"},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611033","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":"Predicting complications in hypertensive disorders of pregnancy: external validation of a prognostic model for adverse perinatal outcomes","authors":"Klaartje M. Olde Loohuis MD ,&nbsp;Kim Luijken MSc, PhD ,&nbsp;Hannah Brown Amoakoh MD, PhD ,&nbsp;Kwame Adu-Bonsaffoh MD, PhD ,&nbsp;Diederick E. Grobbee MD, PhD, FESC ,&nbsp;Kerstin Klipstein-Grobusch MSc PhD ,&nbsp;Emmanuel Srofenyoh MD ,&nbsp;Mary Amoakoh-Coleman MD, PhD ,&nbsp;Joyce L. Browne MD, PhD","doi":"10.1016/j.xagr.2025.100455","DOIUrl":"10.1016/j.xagr.2025.100455","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Prediction models can be used as simple evidence-based tools to identify fetuses at risk of perinatal death. Payne et al developed a prognostic model for perinatal death in women with hypertensive disorders of pregnancy, a leading cause of maternal/fetal morbidity and mortality.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to externally validate the predictive performance of this model in pregnant women with hypertensive disorders of pregnancy admitted between 26 and 34 weeks of gestation in Ghana.</div></div><div><h3>STUDY DESIGN</h3><div>The perinatal model was applied in the SPOT (Severe Pre-eclampsia adverse Outcome Triage) study, a cohort of women with hypertensive disorders of pregnancy admitted between 26 and 34 weeks of gestation to referral facilities in Ghana. Predictive performance was assessed by calibration (calibration-in-the-large coefficient and calibration slope) and discrimination (based on the c-statistic).</div></div><div><h3>RESULTS</h3><div>Of the 543 women included in the validation analysis, 87 (16%) experienced perinatal death from delivery until hospital discharge. Predictive performance of the model was poor. The calibration-in-the-large coefficient was 1.12 (95% confidence interval, 0.87–1.36, 0 for good calibration), calibration slope was 0.08 (95% confidence interval, −0.21 to 0.36, 1 for good calibration), and c-statistic was 0.52 (95% confidence interval, 0.44–0.59).</div></div><div><h3>CONCLUSION</h3><div>This perinatal prediction model performed poorly in this cohort in Ghana. Possible reasons include differences in case mix, clinical management strategies, or data collection procedures between development and validation settings; suboptimal modeling strategies at development; or omission of important predictors. Given the burden of perinatal mortality and importance of risk stratification, new prediction model development and validation is recommended.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100455"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611003","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":"How obstetricians experience stillbirth and perinatal loss: a systematic review and meta-synthesis","authors":"Frances Cates ,&nbsp;Sara Wetzler ,&nbsp;Tabitha Wishlade ,&nbsp;Mehali Patel ,&nbsp;Catherine E. Aiken MB/BChir, PhD","doi":"10.1016/j.xagr.2025.100465","DOIUrl":"10.1016/j.xagr.2025.100465","url":null,"abstract":"<div><h3>Objective</h3><div>Globally, ∼2 million babies are stillborn annually, many in low- and middle-income countries. We aim to understand the experience of obstetricians caring for parents who experience stillbirth and perinatal loss across global settings.</div></div><div><h3>Data Sources</h3><div><em>:</em> Medline via Ovid, Embase via Ovid, CINAHL via Ebsco, PsychINFO via Ebsco, Scopus, Web of Science Core Collection, and ASSIA via Proquest were searched, database inception-June 2024.</div></div><div><h3>Study Eligibility Criteria</h3><div>Studies with qualitative components describing experiences of obstetricians providing stillbirth care in any global setting.</div></div><div><h3>Study Appraisal and Synthesis Methods</h3><div>The Critical Appraisal Skills Programme checklist for qualitative research was utilized to conduct quality assessment. NVivo software was employed for inductive coding and thematic analysis.</div></div><div><h3>Results</h3><div>Thirteen qualitative studies from both low- and high-resource settings met the inclusion criteria for meta-synthesis. We identified several major themes including the emotional burdens experienced by obstetricians providing stillbirth care, the challenges of patient-provider interactions following adverse outcomes, and a lack of support and resources. Obstetricians across global settings felt devastation, guilt, blame, and a sense of personal responsibility following stillbirth. Obstetricians struggled to navigate the burden of expectation placed on their overall provision of care and tended to question their own professional competence. A subset of obstetricians felt unprepared for the complexity of patient-provider interactions following stillbirth.</div></div><div><h3>Conclusions</h3><div>Obstetricians experienced complex and conflicting emotions, citing high emotional burden from managing stillbirth cases. Obstetricians identified lack of training and support for providing bereavement care across healthcare settings, indicating a gap that should be filled by stillbirth and bereavement care interventions and education in obstetrical training programs across global settings. Infrastructure for bereavement care training and support systems for obstetricians are crucial to improve the quality of stillbirth and perinatal loss care and prevent an exodus of needed providers for women's care worldwide.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 2","pages":"Article 100465"},"PeriodicalIF":0.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580020","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":"Recurrent syncope after hysteroscopy finally diagnosed as cerebral venous sinus thrombosis: a case report","authors":"Yongqing Zhang MD ,&nbsp;Hongxing Ye MD ,&nbsp;Danqing Chen MD, PhD ,&nbsp;Guohui Yan MD ,&nbsp;Zhanfu Li MD ,&nbsp;Qianhui Xie MD ,&nbsp;Guodong Shan MD ,&nbsp;Zhaoxia Liang MD, PhD","doi":"10.1016/j.xagr.2025.100446","DOIUrl":"10.1016/j.xagr.2025.100446","url":null,"abstract":"<div><div>Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular condition that causes obstruction of venous blood flow or cerebrospinal fluid circulation, leading to intracranial hypertension symptoms such as syncope and vomiting. Transurethral Resection of the Prostate (TURP) syndrome, a complication of hysteroscopic surgery, can also present with cerebral edema and symptoms similar to CVST, making differentiation challenging. Cases of unexplained recurrent syncope posthysteroscopy diagnosed as CVST have not been previously reported. We present a case of a 33-year-old woman who underwent hysteroscopy for abnormal uterine bleeding. Five hours postoperation, she experienced syncope, which resolved spontaneously. Ten hours later, she had recurrent syncope, nausea, and vomiting. Head computed tomography suggested cerebral edema, potentially indicating TURP syndrome. However, the brief surgery and minimal fluid imbalance (200 mL) made TURP syndrome unlikely. Further investigation with cranial magnetic resonance venography revealed multiple venous sinus thromboses, explaining the recurrent syncope linked to minimal fluid volume expansion postsurgery. Subsequent screening identified hyperhomocysteinemia as a contributing factor. Treatment with anticoagulants, folic acid, and vitamin B6 led to a favorable outcome. This case involves recurrent syncope after hysteroscopy secondary to CVST. If symptoms such as recurrent syncope, nausea, and vomiting, indicating increased intracranial pressure, arise posthysteroscopy and cannot be attributed to typical TURP syndrome, primary intracranial vascular conditions like CVST should be considered, as even a minor increase in blood volume can exacerbate these intracranial pressure symptoms.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100446"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104011","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 role of tranexamic acid in reducing postpartum hemorrhage in high-risk pregnancies","authors":"Vijay Kumar BPH,&nbsp;Diptismita Jena PhD,&nbsp;Ashok Kumar Balaraman PhD,&nbsp;Rachana Mehta PhD,&nbsp;Sanjit Sah MD","doi":"10.1016/j.xagr.2025.100458","DOIUrl":"10.1016/j.xagr.2025.100458","url":null,"abstract":"","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100458"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576949","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}