American journal of obstetrics and gynecology最新文献

{"title":"Prenatal diagnosis and postnatal outcomes of a rare venous anomaly: prominent azygos vein with an uninterrupted inferior vena cava","authors":"Balaganesh Karmegaraj MD, DM , Sowmya Vijayakumar MD","doi":"10.1016/j.ajog.2025.09.048","DOIUrl":"10.1016/j.ajog.2025.09.048","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 3","pages":"Pages 856-859"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limits on vaginal intercourse after mid-urethral sling: a randomized trial","authors":"Catherine A. Matthews MD ,&nbsp;Katherine N. Hines MD ,&nbsp;Hoa Nguyen MD ,&nbsp;Sarah Collins MD ,&nbsp;Erinn Myers MD ,&nbsp;Julia Geynisman-Tan MD ,&nbsp;Gregory Russell MS ,&nbsp;Candace Parker-Autry MD ,&nbsp;Kimberly Kenton MS, MD","doi":"10.1016/j.ajog.2025.10.013","DOIUrl":"10.1016/j.ajog.2025.10.013","url":null,"abstract":"<div><h3>Background</h3><div>Women undergoing synthetic mid-urethral slings for stress urinary incontinence are typically advised to refrain from penetrating intercourse for 4 to 6 weeks postprocedure, yet no prospective studies inform this recommendation.</div></div><div><h3>Objective</h3><div>To compare satisfaction between women restricted from sexual intercourse for 2 weeks (early) vs 6 weeks (standard) after retropubic sling surgery. Secondary aims compared preference for the alternative randomization assignment, sexual function including de novo dyspareunia, urinary incontinence symptoms, and adverse events.</div></div><div><h3>Study Design</h3><div>This is a randomized, multicentered clinical trial of sexually active women undergoing synthetic retropubic sling. At baseline, women completed the Urinary Distress Inventory 6 and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, International Urogynecology Association-Revised questionnaires. At 2 weeks postsurgery, if the vaginal incision was intact, women were randomized to early or standard restrictions for vaginal intercourse. Women returned at 3 months for repeat pelvic examination and questionnaires. The primary outcome, collected at 3 months, was patient satisfaction (very satisfied or satisfied) on a 5-point Likert scale with ability to return to vaginal intercourse. Using a 2-sample proportion test with type 1 error set to 0.05% and 80% power, we needed 59 women per group to detect a difference of 80% vs 54% satisfaction in the early vs standard groups, respectively.</div></div><div><h3>Results</h3><div>Between April 2021 and June 2024, 124 women were randomized with 62 per group across 4 centers in the United States. Mean age was 47 years. The majority were premenopausal (72%) and Caucasian (85%). Satisfaction with return to vaginal penetration was 66% (31/47) and 68% (30/44) with an estimated difference in proportions and 95% confidence interval of 2.5% (−19.3%, 24.3%) in the early vs standard groups, respectively (<em>P</em>&gt;.99). Preference for the alternate randomization group was 13% (6/47) in the early vs 43% (19/44) in the standard group (<em>P</em>=.0019). There were 0 cases of mesh exposure. De novo dyspareunia at 3 months was reported in 6/36 (17%) in the early vs 2/29 (7%) in the standard resumption group (<em>P</em>=.28). There was marked improvement in urinary incontinence and sexual function symptoms at 3 months with no difference between groups.</div></div><div><h3>Conclusion</h3><div>Permission to resume vaginal intercourse after 2 vs 6 weeks following isolated retropubic sling resulted in similarly high satisfaction with no adverse impact on efficacy, mesh exposure, or sexual function. Larger studies are needed to investigate the impact of early return to sexual function on de novo dyspareunia. Women significantly (<em>P</em>=.0019) preferred the option of resuming penetrating intercourse after 2 weeks.</div></div>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 3","pages":"Pages 613-619"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations for contraceptive counseling among women prescribed psychotropic medications","authors":"Tanja Boehnke MSc","doi":"10.1016/j.ajog.2025.10.018","DOIUrl":"10.1016/j.ajog.2025.10.018","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 3","pages":"Page e114"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical education professionals need the necessary support to effectively integrate artificial intelligence into medical education practicesle","authors":"Hongnan Ye MSc","doi":"10.1016/j.ajog.2025.10.024","DOIUrl":"10.1016/j.ajog.2025.10.024","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 3","pages":"Page e99"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of cervical softening and the prediction of preterm birth (STIPP study): a prospective cohort study","authors":"Sofie H. Breuking MD,&nbsp;Martijn A. Oudijk MD, PhD,&nbsp;Benjamin Y. Gravesteijn MD, PhD,&nbsp;Marjon A. de Boer MD, PhD,&nbsp;Eva Pajkrt MD, PhD,&nbsp;Frederik J.R. Hermans MD, PhD","doi":"10.1016/j.ajog.2025.10.039","DOIUrl":"10.1016/j.ajog.2025.10.039","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 3","pages":"Pages e90-e92"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145434549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doxycycline vs levofloxacin combined with tinidazole for treating chronic endometritis (letter to the editor)","authors":"Jyotsna Rani MS, DNB,&nbsp;Sushmita Sharma MS,&nbsp;Sunita Dubey MD","doi":"10.1016/j.ajog.2025.10.040","DOIUrl":"10.1016/j.ajog.2025.10.040","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 3","pages":"Page e121"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145434972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tackling the challenge of in utero blood exchange transfusion for fetal anemia at 15 weeks’ gestation","authors":"Wing Ting Tse MRCOG ,&nbsp;Shuk Yi Annie Hui FRCOG ,&nbsp;Lo Wong MRCOG ,&nbsp;Angel Hoi Wan Kwan MRCOG ,&nbsp;So Ling Lau MRCOG ,&nbsp;Natalie Kwun Long Wong MRCOG ,&nbsp;Wing Lam Cheung MRCOG ,&nbsp;Fangzi Liu MRCOG ,&nbsp;Tak Yeung Leung MD","doi":"10.1016/j.ajog.2025.10.046","DOIUrl":"10.1016/j.ajog.2025.10.046","url":null,"abstract":"<div><div>Severe fetal anemia due to parvovirus infection and alpha-thalassemia major can occur during the first trimester of pregnancy. In utero transfusion before 16 weeks of gestation is beneficial but challenging because the umbilical vein is too narrow to be precisely punctured. In addition, the fetal circulating volume is small, and the heart of an affected fetus is compromised. To avoid vascular overload, exchange transfusion may be considered. The technical difficulties make in utero simple transfusions seldom performed before 16 weeks of gestation, and exchange transfusion before 16 weeks of gestation has not been reported. Hence, we reported our technique of successful in utero exchange transfusion in a fetus with alpha-thalassemia major at 15 weeks of gestation. The keys of success were as follows:<ul><li><span>1.</span><span><div>A 20-gauge needle was used as it has a stiffer and larger lumen.</div></span></li><li><span>2.</span><span><div>A high-quality ultrasound machine was used to guide the needle to the placental cord insertion site and magnify the narrow umbilical vein.</div></span></li><li><span>3.</span><span><div>Donor blood was preloaded in 3-mL syringes, which had lower flow resistance than larger syringes.</div></span></li><li><span>4.</span><span><div>To minimize dead space and resistance, the preloaded 3-mL syringe was directly connected to the needle cannula without connecting tubing or a 3-way stopcock.</div></span></li><li><span>5.</span><span><div>After transfusing the first 3 mL of blood, the same 3-mL syringe was used to aspirate 3 mL of blood from the fetal circulation for exchange transfusion, and the next cycle was repeated using another preloaded syringe.</div></span></li></ul></div><div>Fetal blood was not withdrawn for diagnostic investigation before the first transfusion for the following pragmatic reasons:<ul><li><span>1.</span><span><div>If blood was first withdrawn, but the needle was displaced and failed to reenter the umbilical vein, the anemic fetus would have lost blood but received no transfusion.</div></span></li><li><span>2.</span><span><div>Although the posttransfusion fetal blood was mixed with some donor blood, the diagnostic accuracy based on the presence of hemoglobin Bart disease and the homozygous alpha gene deletion should not be affected.</div></span></li><li><span>3.</span><span><div>The pretransfusion fetal hemoglobin level could be retrospectively calculated using the posttransfusion hemoglobin level.</div></span></li></ul></div></div>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 3","pages":"Pages 860-863"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical priming during vaginoscopic hysteroscopy using lower doses of vaginal misoprostol (reply to letter to the editor)","authors":"Dilip Kumar Maurya MD,&nbsp;Raju Govindegowdanadoddi Puttaswamy MS,&nbsp;Anish Keepanasseril MD","doi":"10.1016/j.ajog.2025.09.009","DOIUrl":"10.1016/j.ajog.2025.09.009","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 3","pages":"Page e108"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetric risks from Assisted Reproductive Technology: clarifying the forest to identify the right trees","authors":"David Huang MD,&nbsp;Marcelle I. Cedars MD","doi":"10.1016/j.ajog.2025.10.021","DOIUrl":"10.1016/j.ajog.2025.10.021","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 3","pages":"Page e117"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Male partner treatment and the potential sexual transmission of bacterial vaginosis","authors":"Golsa M. Yazdy MD,&nbsp;Kimberly A. Workowski MD,&nbsp;Khalil G. Ghanem MD, PhD,&nbsp;Susan Tuddenham MD, MPH","doi":"10.1016/j.ajog.2025.12.055","DOIUrl":"10.1016/j.ajog.2025.12.055","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 3","pages":"Page e94"},"PeriodicalIF":8.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}