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":"Principal investigator gender and clinical trial success: analysis of over 3000 obstetrics and gynecology trials","authors":"Jecca R. Steinberg MD, MSc ,&nbsp;Julia D. Ditosto MS ,&nbsp;Brandon E. Turner MD, MSc ,&nbsp;Anna Marie Pacheco Young MD, MPH ,&nbsp;Naixin Zhang MD ,&nbsp;Danielle Strom MD ,&nbsp;Sarah Andebrhan MD ,&nbsp;Madeline F. Perry MD ,&nbsp;Danika Barry MD, MPH ,&nbsp;Kai Holder MD ,&nbsp;Natalie A. Squires MD ,&nbsp;Jill N. Anderson MD ,&nbsp;Michael T. Richardson MD ,&nbsp;Dario R. Roque MD ,&nbsp;Lynn M. Yee MD, MPH","doi":"10.1016/j.xagr.2024.100427","DOIUrl":"10.1016/j.xagr.2024.100427","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;In obstetrics and gynecology (OBGYN) research, gender disparities permeate through leadership, funding, promotion, mentorship, publishing, compensation, and publicity. Few studies have investigated OBGYN clinical trial leadership as it relates to investigator gender. Thus, we undertook an investigation of principal investigator (PI) gender and clinical trial success.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;To characterize United States (US) OBGYN clinical trials by PI gender and analyze the association between PI gender and features of trial success.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;This is a cross-sectional study of all US-based obstetric and gynecologic clinical trials registered on ClinicalTrials.gov (2007–2020). We examined associations between PI gender (ie, led by women, men, or both) and four primary outcomes that capture clinical trial success: early discontinuation (ie, absence of early discontinuation is a feature of success), reporting of complete trials to ClinicalTrials.gov, publication in a peer-reviewed journal, and clinical trial participant diversity (reporting of racial and ethnic diversity data and representation of diverse cohorts). Multivariable analyses controlled for subspecialty, multiple PI status, source of funding, primary purpose, phase, number of arms, enrollment, year of trial registration, blinding, oversight by a Data Safety Monitoring Committee, and number of study sites. Sensitivity analysis accounted for individual PI who led multiple clinical trials. Univariable and multivariable logistic regression analysis models were applied. We conducted multiple imputation for missing covariable data. There were no missing exposure or outcome data in the final cohort.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;We reviewed 12,635 clinical trials focused on OBGYN. Of the 4342 trials with at least one site in the US, PI names were available for 3087 trials (71.1%). The majority of OBGYN trials were women-led (women 1696, 54.9%; men 1272, 41.2%, coled 119, 3.9%). A greater proportion of obstetrics trials (617, 60.0%) were women-led than gynecology trials (1079, 52.4%). Family planning had the greatest proportion of women-led trials (145, 74.7%), whereas reproductive endocrinology and infertility had the lowest (50, 30.9%). A greater proportion of industry-funded trials were led by men (123, 64.7%). In adjusted analysis, women-led trials had lower odds of early discontinuation (men-led reference; women-led adjusted odds ratio [aOR] 0.58, 95% confidence interval [CI] 0.44, 0.77). Women-led trials reported results less frequently (men-led reference; women-led aOR 0.52, CI 0.40–0.62) but no significant difference was seen in publication (men-led reference; women-led aOR 1.02, CI 0.57, 1.81). Women-led trials had greater odds of reporting race and ethnicity participant data (men-led reference; aOR 1.87, CI 1.27–2.47) but there was no difference in cohort diversity by PI gender.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CON","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100427"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025859","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":"Disclosing possible nonmedically indicated cesarean sections in 5 high-volume urban maternity units in Tanzania: a criterion-based clinical audit","authors":"Sarah Hansen BSc. Med ,&nbsp;Monica Lauridsen Kujabi MD, PhD ,&nbsp;Rikke Damkjær Maimburg PhD ,&nbsp;Anna Macha MD ,&nbsp;Luzango Maembe MD ,&nbsp;Idrissa Kabanda MD ,&nbsp;Manyanga Hudson MD ,&nbsp;Rukia Juma Msumi MD ,&nbsp;Mtingele Sangalala MD ,&nbsp;Natasha Housseine MD, PhD ,&nbsp;Brenda Sequeira D'mello MD, PhD ,&nbsp;Kidanto Hussein MD, PhD ,&nbsp;Thomas van den Akker MD, PhD ,&nbsp;Dan Wolf Meyrowitsch PhD ,&nbsp;Nanna Maaløe MD, PhD","doi":"10.1016/j.xagr.2024.100437","DOIUrl":"10.1016/j.xagr.2024.100437","url":null,"abstract":"<div><h3>Background</h3><div>Globally, the cesarean section rate has increased dramatically with many cesarean sections being performed on questionable medical indications. Particularly in urban areas of sub-Saharan Africa, the cesarean section rate is currently increasing rapidly. This potentially undermines the positive momentum of increased facility births and may be a central contributor to a growing \"urban disadvantage\" in maternal and perinatal health, which is seen in some settings.</div></div><div><h3>Objective</h3><div>To assess to what extent cesarean section indications follow evidence-based, locally co-created audit criteria in five urban, high-volume maternity units in Dar es Salaam, Tanzania, and identify reasons contributing to nonmedically indicated cesarean sections.</div></div><div><h3>Study Design</h3><div>This was a retrospective cross-sectional study conducted, from October 1st, 2021 to August 31st, 2022. A criterion-based audit with pre-defined, localized audit criteria was used to examine the clinical case-files of all women who gave birth by cesarean section during 3-month periods at the 5 maternity units. Primary outcomes were the cesarean section rate, indications for cesarean section, and proportion of nonmedically indicated cesarean sections. The PartoMa study is registered in ClinicalTrials.gov (NCT04685668).</div></div><div><h3>Results</h3><div>Overall, the cesarean section rate was 31.5% (2949/9364), of which 2674/2949 (90.7%) cesarean sections had available data for analysis. Main indications were previous cesarean section (1133/2674; 42.4%), prolonged labor (746/2674; 27.9%), and fetal distress (554/2674; 20.7%). Overall, 1061/2674 (39.7%) did not comply with audit criteria at the time cesarean section was decided. Main reasons were one previous cesarean section with no trial of labor (526/1061; 49.6%); reported prolonged labor without actual slow progress (243/1061; 22.9%); and fetal distress with normal fetal heart rate at time of decision (211/1061; 19.9%).</div></div><div><h3>Conclusion</h3><div>Two in 5 cesarean sections were categorized as nonmedically indicated at time of decision. Particularly, fear of poor outcomes and delay in accessing emergency surgery may cause resource-consuming \"defensive decision-making\" for cesarean section. Investments in conducive urban maternity units are crucial to ensure safe vaginal births and to reach a population-based approach that provides best possible timely care for all with the limited resources available.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100437"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082366","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 male involvement in postnatal care service utilization among men whose wives gave birth in the last year","authors":"Fillorenes Ayalew Sisay MSc,&nbsp;Abeba Belay Ayalew MSc ,&nbsp;Besfat Berihun Erega MSc ,&nbsp;Wassie Yazie Ferede MSc ,&nbsp;Assefa Kebie Mitiku MSc ,&nbsp;Eyaya Habtie Dagnaw MSc ,&nbsp;Tegegne Wale Belachew MSc ,&nbsp;Temesgen Dessie Mengistu MSc ,&nbsp;Begizew Yimenu Mekuriaw MSc ,&nbsp;Yonas Zenebe Yiregu MSc ,&nbsp;Tigist Seid Yimer MSc","doi":"10.1016/j.xagr.2025.100459","DOIUrl":"10.1016/j.xagr.2025.100459","url":null,"abstract":"<div><h3>Background</h3><div>Both maternal and neonatal mortality were high in the immediate postnatal period. Men's involvement is essential to improve maternal, neonatal as well as the health of their children in the postpartum period. However, reproductive health has long been seen as a woman's concern, and as such, it continues to be a significant difficulty, particularly in developing countries including Ethiopia. Despite this, Limited studies were done to assess the predictors of male involvement in postnatal care in Ethiopia. Therefore, this study aimed to assess male partner involvement in postnatal care service in the South Gondar zone, North West Ethiopia in 2024.</div></div><div><h3>Objective</h3><div>This study assessed male involvement in Postnatal care services of their partners and its predictors in South Gondar Zone, Ethiopia.</div></div><div><h3>Method</h3><div>A community-based cross-sectional study was conducted from October –November 30/2023. Four hundred seventeen participants were recruited by using the multistage sampling technique. The data were collected through face-to-face interviews using a pretested and semi-structured questionnaire. Multivariable logistic regression analyses were computed to identify factors associated with the outcome variable. Adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance.</div></div><div><h3>Results</h3><div>The overall magnitude of male partner involvement in postnatal care service was 23.7%. Urban residence, College and above education, men whose wives' occupations were students, Good knowledge about PNC, and, joint health care decisions were the main predictors of male involvement in postnatal care service.</div></div><div><h3>Conclusion and Recommendation</h3><div>The magnitude of male involvement in postnatal care was low. The finding highlights the importance of women's empowerment, awareness creation joint decision-making, and increasing men's educational levels are essential to increase the involvement of male partners in postnatal care service.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100459"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636271","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":"Evaluating Nigeria's recently announced free cesarean delivery initiative","authors":"Patrick Tobechi Ashinze MBBS,&nbsp;Jonathan Adeola MBBS,&nbsp;Victor Mayowa Adeleye MBBS","doi":"10.1016/j.xagr.2025.100448","DOIUrl":"10.1016/j.xagr.2025.100448","url":null,"abstract":"","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 1","pages":"Article 100448"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684839","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}