American journal of obstetrics and gynecology最新文献

{"title":"Participant flow and prespecification concerns in the cervical occlusion double-level stitch application randomized trial (letter to the editor).","authors":"Moon-Il Park","doi":"10.1016/j.ajog.2026.09.027","DOIUrl":"10.1016/j.ajog.2026.09.027","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007749","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 selecting a cervical length cut-off after 24 weeks for the prediction of spontaneous preterm birth (reply to letter to the editor).","authors":"Ka Wang Cheung, Tiffany Sin-Tung Au, Mimi Tin Yan Seto","doi":"10.1016/j.ajog.2026.09.029","DOIUrl":"10.1016/j.ajog.2026.09.029","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007708","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":"Participant Flow and Prespecification Concerns in the COSA Randomized Trial (Reply to Letter-to-the-Editor).","authors":"Katarzyna Kosińska-Kaczyńska, Robert Brawura-Biskupski-Samaha, Dorota Sys","doi":"10.1016/j.ajog.2026.09.031","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.09.031","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007766","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 length measurement after 24+0 weeks: which estimate should guide clinical practice (letter to the editor)?","authors":"Emilie Pi Fogtmann Sejer, Steffen Ernesto Kristensen, Martin Grønnebæk Tolsgaard","doi":"10.1016/j.ajog.2026.09.028","DOIUrl":"10.1016/j.ajog.2026.09.028","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007672","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":"Technical distinctions and evidence gaps in vacuum-induced postpartum hemorrhage control (reply to letter to the editor).","authors":"Elisabetta Ranieri, Christian Haslinger","doi":"10.1016/j.ajog.2026.09.025","DOIUrl":"10.1016/j.ajog.2026.09.025","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007684","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":"Interpreting mood symptoms and contraceptive discontinuation in observational research (reply to letter to the editor).","authors":"Bryce Wallis, Lauren A Gimbel, Jessica Sanders","doi":"10.1016/j.ajog.2026.09.012","DOIUrl":"10.1016/j.ajog.2026.09.012","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007753","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":"Reverse causation, detection, and adiposity in the association between early life adversity and polycystic ovary syndrome (letter to the editor).","authors":"Yating Xie, Jingyuan Li, Ting Ye","doi":"10.1016/j.ajog.2026.09.026","DOIUrl":"10.1016/j.ajog.2026.09.026","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149007681","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":"Standalone salpingectomy for primary ovarian cancer prevention: a cost-effectiveness analysis.","authors":"Sonja Lazovic, Ling Chen, Kevin J Rouse, Katherine Fischkoff, Sarah Paraghamian, Larissa A Meyer, Jennifer S Ferris, Rafael Gonzalez, Katina Robison, Dawn L Hershman, Xiao Xu, Jason D Wright","doi":"10.1016/j.ajog.2026.09.017","DOIUrl":"10.1016/j.ajog.2026.09.017","url":null,"abstract":"<p><strong>Background: </strong>Opportunistic salpingectomy, salpingectomy performed at the time of other pelvic or abdominal surgery, is a cost-effective primary prevention strategy against ovarian cancer; however, the cost-effectiveness of standalone salpingectomy, performed independent of any other indicated surgery, is unknown.</p><p><strong>Objective: </strong>We evaluated whether standalone salpingectomy is cost-effective in preventing ovarian cancer.</p><p><strong>Study design: </strong>A state-transition Markov model was developed to simulate health and economic outcomes in patients ages 35, 40, 45, 50, and 60. Standalone salpingectomy was compared with no salpingectomy in simulated cohorts of individuals at population average risk and higher relative risks for ovarian cancer. Cost-effectiveness was assessed using incremental cost-effectiveness ratios and from a societal perspective to identify the relative risk at which standalone salpingectomy becomes a cost effective primary prevention strategy for ovarian cancer.</p><p><strong>Results: </strong>For general population risk, standalone salpingectomy was not cost-effective in any age cohort, with incremental cost-effectiveness ratios ranging from $239,736/quality-adjusted life-years (age 50) to $288,870/quality-adjusted life-years (age 35) against a $150,000/quality-adjusted life-years willingness-to-pay threshold. Incremental costs were approximately $6100-$6225 per person with gains of 0.02 to 0.03 quality-adjusted life-years. At a moderately increased risk (relative risk 1.5), incremental cost-effectiveness ratios fell to $142,516-$172,112/quality-adjusted life-years, making salpingectomy cost-effective at ages 45 and 50. At a relative risk of 2.0, it was cost-effective at all ages (incremental cost-effectiveness ratios $97,336-$118,544/quality-adjusted life-years). Relative risks for ovarian cancer at which standalone salpingectomy becomes cost-effective in each age group ranges from ≥1.44 to ≥1.67.</p><p><strong>Conclusion: </strong>Standalone salpingectomy is a cost-effective strategy for the primary prevention of ovarian cancer in individuals with a moderately elevated risk of developing ovarian cancer but not in those with average population level risk. Further, standalone salpingectomy was cost effective for women ages 45 to 50 in the majority of simulations. At relative risks between 1.44 and 1.67, standalone salpingectomy was cost effective in each age cohort simulated, implying that there is a role for standalone salpingectomy when considering risk-stratified approaches to mitigating ovarian cancer risk.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001119","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":"Antihypertensive treatment escalation and maternal outcomes during expectant management of early-onset preeclampsia with severe features.","authors":"Yossi Bart, Zakaria Doughan, Laura Diab, Ahmed Salaheldin Zaki Moustafa, Baha M Sibai","doi":"10.1016/j.ajog.2026.09.019","DOIUrl":"10.1016/j.ajog.2026.09.019","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Early-onset preeclampsia with severe features is associated with substantial maternal morbidity. During expectant management, oral antihypertensive medications are frequently escalated and intravenous agents are administered for severe hypertension, yet the clinical significance of escalating antihypertensive treatment has not been well characterized.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the association between antihypertensive treatment escalation during expectant management of early-onset preeclampsia with severe features and adverse maternal outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;This retrospective cohort study included singleton pregnancies managed expectantly for preeclampsia with severe features between 23 weeks 0 days and 33 weeks 5 days at a single level IV referral center from January 2016 through December 2025. The primary exposure was the number of oral antihypertensive medication dose escalations during expectant management. Secondary analyses evaluated dose escalation rate, oral antihypertensive treatment intensity using hypertension daily dose, and intravenous antihypertensive medication pushes for urgent blood pressure control. The primary outcome was a composite maternal adverse outcome including placental abruption, intrauterine fetal death, acute kidney injury, pulmonary edema, myocardial infarction, hemolysis, elevated liver enzymes, and low platelet syndrome, disseminated intravascular coagulation, eclampsia, stroke, or maternal death. Multivariable Poisson and linear regression analyses were performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 396 patients undergoing expectant management, 157 (39.6%) had no oral antihypertensive dose escalations, whereas 100 (25.2%), 84 (21.2%), 33 (8.3%), and 22 (5.6%) had 1, 2, 3, and ≥4 escalations, respectively. The rate of the composite maternal adverse outcome increased across dose escalation categories (P=.01). Each additional dose escalation was associated with an absolute 4.2 percentage point increase in maternal risk (95% confidence interval, 2.0-6.5). Compared with no dose escalations, 3 and ≥4 dose escalations were associated with adjusted relative risks of 4.07 (95% confidence interval, 1.41-11.78) and 5.20 (95% confidence interval, 1.81-14.90), respectively. Daily dose escalation, compared to none, was associated with an adjusted relative risk of 7.92 (95% confidence interval, 2.90-21.63). Similar dose-dependent associations were observed with repeated intravenous antihypertensive medication pushes. Greater hypertension daily dose was associated with increased maternal risk but without a clear dose-response relationship. Neonatal outcomes did not differ across dose escalation categories.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Escalating antihypertensive treatment during expectant management of early-onset preeclampsia with severe features was associated with progressively higher maternal risk. Consistent findings across oral dose escalati","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001152","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":"Increased use of vacuum-induced tamponade for the treatment of postpartum hemorrhage (letter to the editor).","authors":"Tori O'Daniel, Jason D Bell, Kara M Rood","doi":"10.1016/j.ajog.2026.09.022","DOIUrl":"10.1016/j.ajog.2026.09.022","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001135","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}