AJOG global reports最新文献

{"title":"Navigating diversions in the obstetric operating room: focusing amidst distractions","authors":"Kaitlyn Voity ,&nbsp;Christina O’Leary ,&nbsp;Nicole P. Jenkins DO ,&nbsp;Claire Wolford ,&nbsp;Jonathan D. Baum MD ,&nbsp;Antonia F. Oladipo MD, MSCI","doi":"10.1016/j.xagr.2025.100587","DOIUrl":"10.1016/j.xagr.2025.100587","url":null,"abstract":"<div><h3>Background</h3><div>Distractions in the operating room (OR) are known to disrupt surgical workflow and compromise patient safety. However, little is known about the nature and impact of intraoperative distractions during cesarean deliveries, which involve dual-patient care and complex team dynamics. This study aims to characterize the frequency, type, and severity of distractions in the obstetric OR and examine associations with surgical duration and complications.</div></div><div><h3>Objective</h3><div>To systematically characterize the frequency, types, and severity of intraoperative distractions during scheduled cesarean deliveries, and to evaluate their association with surgical duration and maternal or neonatal complications. The study hypothesizes that higher distraction scores are associated with longer procedure times and increased clinical complications.</div></div><div><h3>Study Design</h3><div>We conducted a prospective observational study of 97 scheduled cesarean deliveries at ≥37 weeks’ gestation from March 2023 to December 2024. Distractions were recorded in real time using a published distraction categorization tool and grading system by severity (mild, moderate, severe). A weighted distraction score was calculated per case. Clinical data included procedure duration, staff count, and presence of maternal or neonatal complications.</div></div><div><h3>Results</h3><div>Across 97 cases, 8113 distractions were documented (mean: 81 per case). Door movement and teaching conversations were the most common types of distraction type. While mild distractions were most frequent, moderate distractions contributed the largest portion of the total distraction burden (44.5%). Severe distractions occurred in all cases. No significant correlation was found between surgery length and distraction score. Cases with NICU admissions (n=11) had higher average total distraction scores (98.8) and more severe distractions (mean: 3.56).</div></div><div><h3>Conclusions</h3><div>Distractions in the obstetric OR are frequent and varied, with moderate distractions representing a key contributor to cognitive load. Higher distraction scores may be associated with neonatal complications, underscoring the need for distraction-reduction strategies to optimize safety in cesarean deliveries. Although distractions were not associated with prolonging surgical length, healthcare providers should be cognizant of the amount and type of distractions that can occur that may impact patient outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100587"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of 48 months of elagolix with add-back therapy for endometriosis-associated pain","authors":"Jin Hee Kim MD ,&nbsp;Charles E. Miller MD ,&nbsp;James A. Simon MD ,&nbsp;James W. Thomas MS ,&nbsp;Anna Chan PharmD ,&nbsp;Michael C. Snabes MD, PhD","doi":"10.1016/j.xagr.2025.100584","DOIUrl":"10.1016/j.xagr.2025.100584","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Elagolix (ELA) 200 mg twice daily is an oral treatment approved for moderate-to-severe endometriosis-associated pain. However, the clinical use of ELA is limited by potential hypoestrogenic effects, including the loss of bone mineral density (BMD). The addition of hormonal add-back (AB) therapy (1-mg estradiol/0.5-mg norethindrone acetate once daily) may attenuate BMD loss.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To provide long-term safety results from a 48-month phase 3 trial assessing ELA+AB therapy in premenopausal women with moderate-to-severe endometriosis-associated pain.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;This multicenter, phase 3 trial was conducted between July 7, 2017, and December 6, 2023, and included a 12-month double-blind treatment period, a 36-month open-label extension period, and a 12-month post-treatment follow-up (PTFU) period. At the beginning of the double-blind period, premenopausal women (aged 18−49 years) with moderate-to-severe endometriosis-associated pain were randomized 4:1:2 to ELA+AB therapy, ELA monotherapy for 6 months followed by ELA+AB therapy for the remaining 6 months, or placebo. After the double-blind treatment period, all patients were treated with open-label ELA+AB therapy (referred to as the ELA+AB/ELA+AB, ELA/ELA+AB, and placebo/ELA+AB groups) for the remainder of the 36-month open-label treatment period. Safety was assessed throughout the open-label treatment period. BMD was measured by dual-energy X-ray absorptiometry in the lumbar spine, total hip, and femoral neck during the screening period and every 6 months throughout the study. BMD was analyzed using an analysis of covariance model with treatment as the main effect and baseline values as covariates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 380 patients who entered the open-label period, 140 (36.8%) completed the treatment period, and 240 (63.2%) discontinued, primarily due to withdrawn consent and adverse events (AEs). In total, 159 (74.0%) patients in the ELA+AB/ELA+AB group, 41 (69.5%) patients in the ELA/ELA+AB group, and 80 (75.5%) patients in the placebo/ELA+AB group reported at least 1 treatment-emergent adverse event (TEAE) during the open-label period. TEAEs were generally mild or moderate and nonserious. The most commonly reported TEAEs were COVID-19, bone density decreases, and sinusitis. No serious AEs were reported in &gt;1 patient in any study group. BMD remained generally stable, with a least squares mean percent decrease from baseline to week 48 &lt;2% in all groups and at all anatomical sites. Similarly, the least squares mean decrease from baseline in BMD was &lt;2% in the ELA+AB/ELA+AB group at all anatomical sites and all time points throughout the study period. For patients in the ELA+AB/ELA+AB group with ≥48 months of treatment and reduced BMD at the final on-treatment visit, the majority (lumbar spine, 13 [59.1%]; total hip, 8 [53.3%]; femoral neck, 12 [57.1%]) partially or fully recove","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100584"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference interval for 24-hour urinary protein excretion in uncomplicated women with twin pregnancies","authors":"Yuguo Deng MD ,&nbsp;Lanyun Liu BS ,&nbsp;Danxiu Lu BS ,&nbsp;Qiulu Wu MD ,&nbsp;Ying Li PhD ,&nbsp;Jinying Yang PhD","doi":"10.1016/j.xagr.2025.100583","DOIUrl":"10.1016/j.xagr.2025.100583","url":null,"abstract":"<div><h3>Background</h3><div>The study of 24-hour urinary total protein (24-h UTP) excretion is an essential parameter for the assessment of renal function and early detection of pregnancy complications. However, data on reference interval for 24-h UTP in women with twin pregnancies are scarce.</div></div><div><h3>Objective</h3><div>We aimed to establish the reference interval for 24-h UTP excretion in women with twin pregnancies and compare it with that in women with singletons.</div></div><div><h3>Study Design</h3><div>A total of 12,633 participants with singletons or twin pregnancies were recruited. They were instructed to collect standard 24-hour urinary samples. Information was extracted from the electronic medical record. The nonparametric percentile method was used to determine reference interval for 24-h UTP excretion during different trimesters in women (excluding, among others, those with preexisting renal disease, gestational or chronic hypertension, pre-eclampsia, and pregestational diabetes mellitus).</div></div><div><h3>Results</h3><div>In twin pregnancies, the 24-h UTP levels expressed as medians and percentiles (5th, 95th) for each trimester were as follows: 74.2 (32.7, 195.5) mg, 104.5 (41.9, 213.1) mg, and 152.6 (46.1, 415.7) mg in the first, second, and third trimesters, respectively. A significant increase in 24-h UTP excretion was observed throughout pregnancy (all <em>P</em>&lt;.001). Furthermore, the median (25th, 75th) of 24-h UTP values in the singleton group and twin groups were 70.2 (48.5, 98.3) vs 74.2 (47.3, 108.2) mg, 84.8 (58.5, 118.2) vs 104.5 (78.4, 135.6) mg, and 108.0 (73.4, 149.3) vs 152.6 (90.8, 192.8) mg in the first, second, and third trimesters, respectively. (Part of the data on singleton pregnancy has previously been published). The 24-h UTP excretion in the twin group was significantly higher than those in the singleton group in the second and third trimesters (both <em>P</em>&lt;.001).</div></div><div><h3>Conclusion</h3><div>Physiological proteinuria levels were approximately doubled in late pregnancy in women with twin pregnancies compared to early pregnancy, and the upper limit of normal 24-h UTP excretion is 415.7 mg in late pregnancy. Moreover, the threshold for elevated proteinuria in twin pregnancies could be higher than in singletons from the second trimester onwards. Understanding these changes is essential for precise twin management and patient counseling.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100583"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual dysfunction in women with endometriosis in a low-middle-income country","authors":"Edna Chacha MMED ,&nbsp;Charles Muteshi MMED ,&nbsp;Felix Oindi MMED ,&nbsp;Elsie Wandera MBA","doi":"10.1016/j.xagr.2025.100600","DOIUrl":"10.1016/j.xagr.2025.100600","url":null,"abstract":"<div><h3>Background</h3><div>Endometriosis affects up to 10% of reproductive-age women and significantly impairs quality of life including sexual function, intimate relationships, fertility, and psychological wellbeing. While its impact has been extensively studied in Western populations, there is limited Sub-Saharan African data exploring how the disease affects female sexual health and distress. This study aimed to assess sexual function and sexual distress among women with endometriosis at a tertiary hospital in Kenya.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted involving 108 women aged 18 to 49 with confirmed endometriosis from January to June 2022. The study used validated self-administered questionnaires: Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R). Descriptive and inferential statistics were applied using SPSS v25.</div></div><div><h3>Findings</h3><div>Female sexual dysfunction (FSFI≤26.55) was observed in 76.9% of participants, with the most affected domains being arousal, orgasm, and pain. Sexual distress (FSDS-R≥11.5) was identified in 65.7%. Sociodemographic factors such as marital status, parity, residence, and prior live birth were significantly associated with dysfunction (<em>P</em> &lt; 0.05).</div></div><div><h3>Interpretation</h3><div>Sexual dysfunction and distress are common among Kenyan women with endometriosis, underscoring the need for holistic care strategies that integrate medical and psychosocial support.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100600"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed presentation of a snake bite with multiple life threatening complications in third trimester pregnancy successfully managed in resource limited setting: case report","authors":"Leul Endalamaw Demilew MD ,&nbsp;Misganaw Abere Worku MD ,&nbsp;Girmachew Tesfaye Agegnehu MD ,&nbsp;Asnakew Amisalu Mebratu MD ,&nbsp;Gashaw Awoke Haile MD ,&nbsp;Bezawit Alemu Mengist MD ,&nbsp;Wondwosen Mengist Dereje MD","doi":"10.1016/j.xagr.2026.100603","DOIUrl":"10.1016/j.xagr.2026.100603","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Snakebite envenoming is a potentially life-threatening condition and a common public health problem, particularly in developing countries. Envenomation during pregnancy is rare but carries serious consequences for both the mother and the fetus. Antivenom is the primary treatment; however, its unavailability, along with limited healthcare facilities in developing countries, contributes to significant mortality. In the reported case, we present a 35-year-old woman in her third trimester who developed multiple complications from a snakebite and was managed at our institution.</div></div><div><h3>Case presentation</h3><div>A 35-year-old gravida VI, para V woman was referred from a primary hospital due to the unavailability of an obstetrician, blood products, appropriate diagnostic facilities, and essential medications. She initially presented to the primary hospital with complaints of vaginal bleeding and decreased fetal movement lasting 24 hours. Additionally, the patient reported lightheadedness, easy fatigability, and blurred vision but denied headaches or any abnormal body movements.</div></div><div><h3>Conclusion</h3><div>Although snakebite is a common public health problem, it is often neglected. As with other neglected tropical diseases, estimating the global morbidity, disability, and mortality caused by snakebite envenoming is challenging. The disease is prevalent among individuals in impoverished agricultural and herding communities in low- and middle-income countries, where access to healthcare is limited and health-seeking behavior may be poor, making this health issue potentially fatal. Snakebite envenomation during pregnancy has severe consequences for both the mother and the fetus. Increasing community awareness, ensuring early admission, close follow-up, and appropriate management through a multidisciplinary approach can improve outcomes for both mother and fetus.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100603"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of an external cephalic version simulation-based educational program","authors":"Dhanalakshmi Thiyagarajan MD, MPH ,&nbsp;Megan Gauger MD ,&nbsp;Raj Patel MEng ,&nbsp;Thelma Quarshie MO ,&nbsp;Enaam A. Adanu MBChB ,&nbsp;Julia Kramer PhD, MPH ,&nbsp;Kathleen H. Sienko PhD ,&nbsp;Cheryl A. Moyer PhD, MPH ,&nbsp;Molly Stout MD, MS ,&nbsp;Deborah M. Rooney PhD ,&nbsp;Samuel A. Oppong MBChB, MPH ,&nbsp;Alim Swarray-Deen MBChB, MS ,&nbsp;Emma Lawrence MD, MS","doi":"10.1016/j.xagr.2025.100577","DOIUrl":"10.1016/j.xagr.2025.100577","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Fetal malpresentation contributes significantly to cesarean deliveries. External cephalic version (ECV) reduces this risk but requires skilled performance. In low-resource settings, limited training opportunities hinder its use, highlighting the need for effective simulation-based education.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to develop and evaluate an external cephalic version simulation-based educational program.</div></div><div><h3>STUDY DESIGN</h3><div>We used Kern’s 6-step framework to develop a program composed of 6 learning objectives with 6 distinct components specifically for low-resource settings. We conducted a 3-round modified Delphi panel to modify the program. We evaluated the program through a cluster randomized study of obstetrics and gynecology house officers, junior residents, senior residents/fellows, and consultants/attendings in January 2025 at Korle Bu Teaching Hospital in Ghana. Self-reported comfort and confidence, knowledge, skill, and program feasibility and acceptability were analyzed using <em>t</em> tests, Fisher exact tests, and Spearman’s rho.</div></div><div><h3>RESULTS</h3><div>The Delphi panel consisted of 14 experts from 5 countries. At least 80% consensus on all external cephalic version program components was reached before implementation. The learning group’s self-reported comfort and confidence (<em>P</em>&lt;.01) and knowledge measured via assessment (<em>P</em>&lt;.01) improved after the program compared with the preprogram period. The learning group’s skill measured via procedural checklist increased compared with the control group (<em>P</em>&lt;.01). Within the learning group, self-reported comfort and confidence (<em>P</em>&lt;.01) and skill in completing key steps on the procedural checklist (<em>P</em>=.02) were higher among those with a higher level of training. The participants were satisfied with the program and found it acceptable, appropriate, and feasible (5-point rating; mean, 4.42; standard deviation, 0.54).</div></div><div><h3>CONCLUSION</h3><div>Our external cephalic version simulation-based program improves comfort and confidence, knowledge, and skill among Ghanaian clinicians. Given that external cephalic version success depends on the skill of the performing clinician, our program may help increase external cephalic version rates and thus decrease the rates of avoidable cesarean delivery and its complications.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100577"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical evaluation of adolescent sexual and reproductive health and rights in Rwanda","authors":"Benjamin David Habikigeni MD,&nbsp;Uwimana Muhuza Marie Parfaite MD,&nbsp;Emmanuel Edwar Siddig PhD, MBBS,&nbsp;Victor Mivumbi Ndicunguye MD","doi":"10.1016/j.xagr.2025.100594","DOIUrl":"10.1016/j.xagr.2025.100594","url":null,"abstract":"<div><div>Adolescent sexual and reproductive health and rights (SRHR) are critical to ensuring the well-being and empowerment of young people, particularly in low-resource settings like Rwanda. Despite progressive policies and commitments aligned with global frameworks such as the Sustainable Development Goals, adolescents in Rwanda face persistent barriers including cultural stigma, gender inequalities, geographic disparities, and infra-structural limitations that hinder access to comprehensive SRHR services. This commentary critically examines Rwanda’s policy landscape, highlights key challenges in implementation, and explores disparities based on gender, location, and disability. It emphasizes the urgent need for multisectoral, community-engaged strategies, improved data systems, and targeted interventions to close critical gaps. Strengthening the operationalization of policies and fostering youth participation are essential to advancing adolescent SRHR and realizing their full rights in Rwanda’s journey toward health and development equity.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100594"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncontrolled hypertension in siblings: an unsuspected diagnosis","authors":"Sayyad Aleem MD, DrNB,&nbsp;Sanjay Kumar MD, DrNB,&nbsp;Arun Guddeti MD, DM,&nbsp;KVS Hari Kumar MD, DrNB","doi":"10.1016/j.xagr.2026.100615","DOIUrl":"10.1016/j.xagr.2026.100615","url":null,"abstract":"<div><div>Hypertension in the young is defined as the occurrence of elevated blood pressure in patients aged &lt;40 years. It is unusual for hypertension to be present before the second decade of life and more so in a pair of siblings. This study aimed to report a case of a sibling pair (18- and 16-year-olds), reared as females, who presented with primary amenorrhea and resistant hypertension. The initial presentation was hypertension. The siblings were treated with escalating doses of antihypertensive agents, including calcium channel blockers, beta-blockers, and diuretics, with suboptimal control. Primary amenorrhea led to an endocrine referral, and detailed evaluation revealed obesity, acne, atypical external genitalia, and palpable gonads. The hormonal panel showed low cortisol, elevated adrenocorticotropic hormones, and progesterone, along with hypokalemia, raising the possibility of a rare congenital adrenal hyperplasia due to 17-alpha-hydroxylase deficiency. The siblings had a 46 XY karyotype, and CYP17A1 gene sequencing revealed a homozygous deletion of c.157_159TTC of the phenylalanine codon (thymine-thymine-cytosine) at amino acid position 54 (p.Phe54del) in exon 1, confirming our diagnosis. The siblings were treated with glucocorticoids and spironolactone, which remarkably improved the blood pressure, coupled with the gradual withdrawal of all antihypertensive agents. Psychological evaluation established a preference for the female gender. The siblings underwent bilateral gonadectomy with vaginoplasty, along with estrogen replacement therapy. Hypertension in the young suggests a secondary etiology, including renovascular and endocrine conditions. Our report highlights the CYP17A1 gene mutation, a rare form of monogenic hypertension presenting in phenotypical females with a male genotype.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100615"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Care strategies for pregnant people and women living with hepatitis C in North America","authors":"Sofia R. Bartlett PhD ,&nbsp;Jasmin E. Charles MPAS ,&nbsp;Tatyana Kushner MD, MSCE","doi":"10.1016/j.xagr.2025.100580","DOIUrl":"10.1016/j.xagr.2025.100580","url":null,"abstract":"<div><div>Hepatitis C is a global health concern, with over 50 million people infected. Marginalized populations, particularly people who inject drugs, may not receive treatment despite an increased infection rate; similarly, there are gender disparities in the hepatitis C cascade of care, leaving some women undertreated. This is especially problematic, as hepatitis C rates are increasing substantially among individuals of childbearing age and pregnant people. While hepatitis C epidemiology and baseline characteristics are well understood, models of care focused on pregnant people that provide solutions to these barriers in attaining care are needed to increase health equity and achieve hepatitis C elimination. The adoption of highly effective, direct-acting antivirals for hepatitis C treatment has helped tremendously, but direct-acting antivirals must be accessible, and their availability must be combined with enhanced screening efforts. We review newly developed models of care for pregnant people who have hepatitis C and provide several case studies (with patient examples) of methods that have improved the care cascade and patient outcomes in our practices. Some models, such as mother-infant collocated care, allow postpartum and infant hepatitis C care to occur simultaneously, minimizing the number of visits and maximizing access to patient care. Other models, such as mobile point-of-care services and peer navigation, help marginalized populations attain access to care regardless of insurance status and transportation accessibility and provide peer support to help overcome treatment barriers, such as stigma and poverty. Additional innovative hepatitis C care models for pregnant people and women include modeling-based response-guided treatment, interdisciplinary collocated care models, and an integrated medical home model. Ultimately, there is no “one size fits all” hepatitis C model of care, as needs differ according to region, population demographics, and individual circumstances. As our review shows, many of the models apply multidisciplinary approaches to provide a range of care options. Reviewing the available models of care will help identify how practitioners can increase patient engagement with care and improve treatment uptake and completion rates among pregnant people and women and thus can contribute to hepatitis C elimination.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100580"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical cancer screening in women with disabilities in Ghana: bridging the gap in access and equity","authors":"Yvonne Nartey PhD ,&nbsp;Judith Osae-Larbi PhD ,&nbsp;Joseph Daniels MD","doi":"10.1016/j.xagr.2025.100597","DOIUrl":"10.1016/j.xagr.2025.100597","url":null,"abstract":"<div><div>The burden of cervical cancer continues to grow in many limited-resource regions of the world. It is the third most common cancer in Ghana, and the second most common malignancy among women, with most cases detected at a late stage, leading to poor clinical outcomes. Cervical cancer is preventable through vaccination against human papillomavirus (HPV) infection and screening for precancerous lesions. However, preventive interventions in Ghana face several challenges, including limited infrastructure, financial constraints and human resource shortages. The uptake of HPV vaccination and cervical cancer screening remains low, with certain population groups, particularly women with disabilities being disproportionately affected by cervical cancer. Women with disabilities in Ghana encounter multiple systemic barriers to accessing cervical cancer screening services, including inaccessible healthcare facilities, the absence of disability-sensitive medical equipment and suboptimal communication with healthcare providers. These challenges contribute to markedly low screening uptake among this population, potentially leading to delayed diagnoses and poor clinical outcomes. The article highlights the critical need for focused research to inform the development of inclusive and equitable cervical cancer prevention and control strategies tailored to the needs of women with disabilities in Ghana.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100597"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}