American journal of obstetrics and gynecology最新文献

{"title":"Management of late-onset fetal growth restriction by an antenatal risk stratification protocol.","authors":"Si-Yun Li, Dong-Zhi Li","doi":"10.1016/j.ajog.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.007","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281972","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":"Early gestational diabetes: criticism is based on false premises.","authors":"Apolonia García-Patterson, Montserrat Balsells, Ivan Solà, Rosa Corcoy","doi":"10.1016/j.ajog.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.010","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281970","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":"Early gestational diabetes: methodological gaps in the current evidence synthesis.","authors":"Jiwu Huo, Jianzhong Guan","doi":"10.1016/j.ajog.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.009","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281971","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":"Preterm prelabour rupture of membranes: the use of amniocentesis to detect intra-amniotic infection reduces maternal and neonatal duration of antibiotic exposure.","authors":"Teresa Cobo, Victoria Aldecoa, Silvia Ferrero, Judit Balcells, Ana Lucia Contreras, Andrea Valenzuela, María Pastor, David Boada, Ana Herranz, Montserrat Izquierdo-Renau, Clara Murillo, Ana Del Río, Marta Hernández-Meneses, Berta Fidalgo, Montserrat Rodriguez-Reyes, Francesc Figueras, Eduard Gratacós, Montse Palacio","doi":"10.1016/j.ajog.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.011","url":null,"abstract":"<p><strong>Background: </strong>The current management of patients with preterm prelabor rupture of membranes below 32+0 weeks recommend administering antibiotics although its benefit on the short or long-term neonatal outcome is poor.</p><p><strong>Objective: </strong>To evaluate whether the use of amniocentesis to detect intra-amniotic infection reduces maternal and neonatal duration of antibiotic exposure.</p><p><strong>Methods: </strong>This was a retrospective observational cohort study (2014-2023) including patients diagnosed with preterm prelabor rupture of membranes below 32+0 weeks with an amniocentesis at admission to assess the presence of intra-amniotic infection. We compared two groups according to antenatal management regarding antibiotic treatment. Thus, from 2014-2019, patients were treated at least 5 days with a broad-spectrum antibiotic treatment including intravenous ampicillin and gentamicin, and a single dose of oral azithromycin, regardless of ruling out intra-amniotic infection (standard management group). Beyond 2019, gentamicin was substituted for intravenous ceftriaxone and azithromycin for oral clarithromycin. Antibiotic duration was optimized based on amniotic fluid analysis (amniocentesis-based management): if amniotic fluid glucose concentrations were greater than or equal to 14 mg/dL and Gram staining did not show the presence of bacteria, antibiotic treatment was discontinued at 48 hours. Otherwise, antibiotics were prolonged at least until microbiological amniotic fluid results. Regardless of the management group, if intra-amniotic infection was diagnosed, the type of antibiotic was individualized according to the bacteria isolated and treatment was prolonged for 7-10 days if the delivery did not occur before. There were no other differences in maternal management between the two periods.</p><p><strong>Results: </strong>One hundred seventy-two patients diagnosed with preterm prelabor rupture of membranes below 32+0 weeks were included (122 in the standard management group and 50 in the amniocentesis-based management group). The prevalence of intra-amniotic infection was 29% in both periods, with most (61%) being due to Ureaplasma spp. There were no differences in maternal characteristics between the two groups. As expected, in the amniocentesis-based management group there was shorter maternal exposure to antibiotics (median (25th centile; 75th centile) of 2 (2;3) days (amniocentesis-based management) vs. 5 days (4;5) (standard management), p <0.0001)). In line with the reduction of the duration of antibiotics, we observed that maternal hospital stay was significantly shorter (5 (4; 9) days vs. 11 (5; 21) days, p=0.001), and outpatient management was more frequent (68% vs. 47%, p=0.011). No differences were observed in the in maternal morbidity. Similar results were found when neonatal outcomes were evaluated. Thus, in the amniocentesis-based management group, neonates received less antibiotic treatment at admissi","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281973","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":"The frequency of placental lesions and adverse pregnancy outcomes: a linked cohort study.","authors":"M C Marijnen, C J M Oudejans, A A Freedman, L M Ernst, W Ganzevoort, M H Schoots, L E van der Meeren, S J Gordijn","doi":"10.1016/j.ajog.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.004","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245747","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":"Intricacies of studying Doula Care.","authors":"Lara S Lemon, Beth Quinn, Hyagriv N Simhan","doi":"10.1016/j.ajog.2025.05.046","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.046","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245742","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":"Addressing Methodological Gaps in Doula Care Research: Recommendations for Enhancing Rigor and Equity in Maternal Health Studies.","authors":"Jisen Zhao, Dong Guo","doi":"10.1016/j.ajog.2025.05.047","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.047","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245739","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":"Role of FcγR3A polymorphism in the treatment of gestational trophoblastic tumors.","authors":"Mengting Zhang, Yong Ni, Lizhong Duan","doi":"10.1016/j.ajog.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.002","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245746","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":"Role of FcγR3A polymorphism in the treatment of gestational trophoblastic tumors.","authors":"Mengting Zhang, Yong Ni, Lizhong Duan","doi":"10.1016/j.ajog.2025.05.044","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.044","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245745","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":"Optimal follow-up strategy using high-risk HPV testing and cytology after conservative treatment for cervical adenocarcinoma in situ.","authors":"M Schaafsma, T N Schuurman, I S van Maurik, R L M Bekkers, P L M Zusterzeel, M C G Bleeker, A G Siebers, C H Mom, J Berkhof, N E van Trommel","doi":"10.1016/j.ajog.2025.05.040","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.040","url":null,"abstract":"<p><strong>Objective: </strong>After treatment for cervical adenocarcinoma in situ (AIS) patients remain at risk for recurrent AIS, high-grade cervical intraepithelial neoplasia, and cervical carcinoma (combined AIS/CIN3+). This study aimed to determine the optimal follow-up strategy for high-risk HPV and cytology testing in conservatively treated patients with AIS.</p><p><strong>Study design: </strong>Patients were selected from a nationwide, retrospective cohort, in which pathology reports from the Dutch Nationwide Pathology databank (Palga) and survival data from the Central Bureau of Genealogy were collected of patients conservatively treated for AIS between 1990 and 2021. The main outcomes were the 5-year cumulative incidence of AIS/CIN3+ stratified by single and consecutive HPV test and/or cytology results at 6, 12, 18 and 24 months.</p><p><strong>Results: </strong>3,411 patients were eligible for analysis. High-risk HPV and/or cytology results in the first 5 years of follow-up were available in 3,312 of 3,411 patients (97.1%), including 5,207 high-risk HPV results of 1,928 patients and 13,369 cytology results of 3,306 patients. Up to 5 years after a single high-risk HPV test at 6months after treatment, AIS/CIN3+ incidence was lower in high-risk HPV negative patients (2.3%, 95%CI: 0.8-3.7) in comparison to high-risk HPV positive patients (20.1%, 95%CI: 14.2-25.5). Patients with normal cytology 6 months after treatment for AIS had a lower incidence of AIS/CIN3+ (3%, 95%CI: 2.2-3.8) in comparison to patients with low-grade (5.9%, 95%CI: 3.4-8.4) or high-grade cytology (52.1%, 95%CI: 42.7-59.9). The 5-year cumulative incidence of AIS/CIN3+ in patients testing negative for high-risk HPV consecutively at 6 and 12, 6 and 18, and 6 and 24 months was 0.6% (95% CI: 0-1.8), 1.1 (95%CI: 0-3.4), and 0% (95% CI not applicable), respectively. Similarly, for patients with consecutive normal co-tests (high-risk HPV negative with normal or low-grade cytology) at 6 and 12, 6 and 18, and 6 and 24 months the 5-year cumulative incidence of AIS/CIN3+ was 0.6% (95% CI: 0-1.8), 1.2 (95%CI: 0-3.5), and 0% (95% CI not applicable), respectively.</p><p><strong>Conclusion: </strong>After two consecutive negative high-risk HPV or normal co-tests within 2 years after conservative AIS treatment, the risk of AIS/CIN3+ is low and it seems acceptable to refer patients back to the national cervical cancer screening program, if applicable.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245743","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}