American journal of obstetrics and gynecology最新文献

{"title":"Information for readers","authors":"","doi":"10.1016/S0002-9378(25)00559-9","DOIUrl":"10.1016/S0002-9378(25)00559-9","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"233 4","pages":"Page A8"},"PeriodicalIF":8.4,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098625","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":"Clarifying sibling analysis in studies of hyperemesis gravidarum (Reply to Letter-to-the-Editor).","authors":"Mads Langager Larsen,Martha Veber Fogh","doi":"10.1016/j.ajog.2025.09.027","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.09.027","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"31 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093546","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":"Relationship between hyperemesis gravidarum and poor school performance unresolved (Letter-to-the-Editor).","authors":"Marlena S Fejzo","doi":"10.1016/j.ajog.2025.09.028","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.09.028","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"22 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093549","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":"Reconsidering the Role of Episiotomy During Instrumental Delivery in Nulliparous Women (Letter-to-the-Editor).","authors":"Yajing Liu,Bingqing Jia,Yunxiang Feng","doi":"10.1016/j.ajog.2025.09.025","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.09.025","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"39 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089875","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":"Neuraxial morphine key factor influencing optimal timing of urinary catheter removal after cesarean delivery (Reply to Letter-to-the-Editor).","authors":"Pervez Sultan,Guillermina Ferrea,Gregg Nelson","doi":"10.1016/j.ajog.2025.09.024","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.09.024","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"22 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145089865","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":"Longitudinal Fetal Heart Rate Analysis Identifies Neonates with Metabolic Acidemia Requiring Therapeutic Hypothermia.","authors":"Lauren M Silva,Dillon Joiner,Jaber Qezelbash-Chamak,Minhee Kim,Cynthia Garvan,Marie Berg,Michael Weiss,Karen Hicklin,John C Smulian","doi":"10.1016/j.ajog.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.09.019","url":null,"abstract":"BACKGROUNDDespite widespread use of intrapartum fetal monitoring, rates of fetal brain injury remain unchanged. Neonatal encephalopathy due to hypoxia-ischemia is a leading cause of neonatal morbidity and mortality, often occurring in the absence of acute intrapartum events. Current fetal heart rate interpretation guidelines rely on static, cross-sectional assessments and offer limited guidance for managing \"indeterminate\" patterns. Machine learning provides an objective, longitudinal analysis of the entire intrapartum fetal heart rate tracing and may enhance the identification of fetuses at risk for neurological injury.OBJECTIVETo evaluate whether a longitudinal machine learning-based analysis of abnormal fetal heart rate patterns-and their duration-throughout labor can identify neonates requiring therapeutic hypothermia among those born with acidemia.STUDY DESIGNWe conducted a retrospective case-control study of neonates born with metabolic acidemia (umbilical or neonatal arterial pH ≤7.15 or base deficit ≥10 mmol/L) who met clinical, biochemical, and neurologic criteria for therapeutic hypothermia (study group). These were compared to a control group of neonates who met clinical and biochemical criteria, but did not meet neurologic criteria for therapeutic hypothermia. Neonates with acute sentinel events were excluded. Maternal and neonatal characteristics were abstracted from electronic medical records. Fetal heart rate tracings for the entire labor course were extracted from the perinatal monitoring system for machine learning analysis. The optimal reading window size was determined by incrementally increasing fetal heart rate tracing reading window sizes by 5-minute intervals until optimal model performance was achieved. After the machine learning-based model was trained for anomaly detection, a two-step process using Isolation Forest followed by Random Forest Classifier was applied to label each window as \"normal\" or \"abnormal.\" The primary outcome was the proportion of fetal heart rate windows labeled as \"abnormal\" during the entire intrapartum course for each fetus. T-tests, Wilcoxon rank-sum tests, chi-square tests, or Fisher's exact tests were used as appropriate.RESULTSThere were 44 mother-infant pairs included, with 22 in each group. There were no significant differences between the study and control groups in umbilical cord pH or base deficit levels. Maternal and neonatal characteristics, duration of tracing analyzed, intrapartum events, and delivery outcomes were similar between groups. The study group had significantly lower APGAR scores, higher Sarnat scores, increased seizure incidence, elevated initial AST and ALT levels, and longer lengths of stay (all p < .03). The proportion of \"abnormal\" 90-minute intrapartum windows was significantly higher in the study group (73.3% ± 15.2%) compared to the control group (4.9% ± 3.3%; p < .001).CONCLUSIONSThe higher proportion of \"abnormal\" 90-minute windows in cases requiring therapeutic ","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"105 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083635","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":"Long-term lymphedema and quality of life following lymph node staging in early cervical cancer: 3 years follow-up in the prospective multicenter SENTIREC CERVIX study.","authors":"Eva B Ostenfeld,Sarah M Bjørnholt,Sara E Sponholtz,Ligita P Frøding,Katrine Fuglsang,Algirdas Markauskas,Erik Parner,Pernille T Jensen","doi":"10.1016/j.ajog.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.09.020","url":null,"abstract":"BACKGROUNDPelvic lymphadenectomy (PL) is the gold standard in nodal staging in cervical cancer but increases risk of leg lymphedema (LL). Sentinel lymph node (SLN) mapping is a less invasive technique enabling accurate detection of nodal metastases, although evidence confirming its oncological safety has yet to be established. Knowledge on chronic LL and quality of life (QOL) following PL or SLN mapping is essential for qualifying treatment and survivorship strategies in women with cervical cancer but current evidence is limited OBJECTIVES: To evaluate long-term LL after SLN mapping alone and SLN mapping + PL in women with cervical cancer. Further, to examine risk factors for LL and the condition-specific QOL among patients with LL at 12 months follow-up.STUDY DESIGNThis national prospective cohort study included patients with early-stage cervical cancer who underwent radical surgery including SLN mapping (2017-2021). In case of tumors >20 mm, back-up PL was performed. Patients completed validated patient-reported outcome questionnaires before surgery and 3, 12, 24, and 36 months postoperatively. LL was assessed by the European Organization of Research and Treatment of Cancer (EORTC) cervix cancer module (QLQ-CX24), supplemented by eight single items from the EORTC item library addressing lymphedema of the legs, genitals, and groins. QOL was reported according to the Lymphedema Quality of Life (LYMQOL) tool, the EORTC QLQ-C30 and the QLQ-CX24 modules. Mean difference scores from baseline to each follow-up were estimated with 95% confidence intervals (CIs), defining a change of 8 points or more as clinically significant. Linear regression models were used to examine predictors of LL 12 months postoperatively. We evaluated QOL within LYMQOL domains in patients with lymphedema and analyzed domain trends using multiple linear regression. We compared QOL in patients with and without LL using guidelines for interpretation of clinically important differences.RESULTSAmong 109 women who underwent SLN mapping alone, LL mean score differences from baseline to 3, 12, and 36 months were 6 (95% CI: 2-10), 10 (95% CI: 5-15), and 15 (95% CI: 7-22), respectively. At similar time points, 77 women reported substantial LL after SLN mapping + PL, with mean score differences of 18 (95% CI: 11-25), 29 (95% CI: 21-37), and 21 (95% CI: 11-32). Three-month LL scores were positively associated with LL scores at 12-months regardless of the extent of lymph node removal. BMI predicted LL after SLN mapping alone, whereas chemoradiotherapy was associated with lymphedema following back-up PL. Reporting lymphedema at 12-month follow-up was associated with impairment in several QOL aspects including fatigue, pain, physical, cognitive, social and sexual functioning.CONCLUSIONPatients with cervical cancer reported long-term LL, most pronounced after SLN mapping + PL, and to a lesser extent after SLN mapping alone. Three months LL score predicted persistent lymphedema which was signi","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"73 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077857","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":"Impact of exercise training during pregnancy on maternal biomarkers: A systematic review.","authors":"Redondo-Delgado Paula,Santos-Lozano Alejandro,Maroto-Izquierdo Sergio","doi":"10.1016/j.ajog.2025.09.021","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.09.021","url":null,"abstract":"OBJECTIVEThe aim of this systematic review was to identify and analyze biomarkers that are influenced by physical exercise during pregnancy and that contribute to maternal-fetal health and development.DATA SOURCESA comprehensive systematic search of PubMed, Web of Science, and EBSCO Host databases was conducted without time restriction in accordance with PRISMA guidelines (PROSPERO ID: CRD420251017740).STUDY ELIGIBILITY CRITERIAEligible studies were randomized controlled trials examining the effects of exercise interventions during pregnancy on biomarkers measured in maternal serum, umbilical cord blood, breast milk, and placental tissue.STUDY APPRAISAL AND SYNTHESIS METHODSEleven randomized controlled trials meeting inclusion criteria were analyzed. The effects of different exercise modalities, durations, and intensities on a wide range of biomarkers were evaluated.RESULTSExercise interventions performed for 12 weeks or longer with 2-3 weekly sessions at moderate-to-vigorous intensity, demonstrated significant effects on several biomarkers. These included a reduction in pro-inflammatory markers (TNF-α, IL-6), an increase in anti-inflammatory cytokines (IL-10), improved lipid profiles (lower LDL, triglycerides), improved glucose regulation, and favorable changes in hormonal markers such as leptin and BDNF. Additionally, exercise was associated with positive changes in umbilical cord blood cytokines, immunologic composition of breast milk, and placental mineral content.CONCLUSIONSStructured exercise programs during pregnancy, particularly resistance training and aerobic exercise performed in the same session, show promising effects on modulating inflammatory, metabolic, and immunologic biomarkers that may contribute to improved maternal-fetal health outcomes. However, current evidence is limited by methodological heterogeneity and lack of data from early pregnancy.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"15 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059194","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":"Solutions to Pregnancy Safety Information (Reply to Letter-to-the-Editor).","authors":"Abigail Melake,Leyla Sahin,Lynne Yao","doi":"10.1016/j.ajog.2025.09.016","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.09.016","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"29 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059195","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":"Female stress urinary incontinence: erbium-doped yttrium aluminum garnet laser [Er:YAG laser] (Letter-to-the-Editor).","authors":"Barry O'Reilly,Christian Phillips,Volker Viereck","doi":"10.1016/j.ajog.2025.09.014","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.09.014","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"72 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059227","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}