American journal of obstetrics and gynecology最新文献

{"title":"A New Perinatal Quality Measure in Nulliparous Term Singleton Vertex (NTSV) Births: Integrating Cesarean Rate, Maternal, and Neonatal Outcomes into a Single Maternal-Newborn Dyadic Metric.","authors":"Frank I Jackson, Anthony M Vintzileos, Sarah H Abelman, Fernando Suarez, Adrianne Combs, Victor Klein, Adi Davidoff, Burton L Rochelson, Matthew J Blitz","doi":"10.1016/j.ajog.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.016","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, hospital perinatal quality and rankings have been based on cesarean rates among nulliparous, term, singleton, vertex (NTSV) patients, and recently added unexpected term newborn complication rates as a separate outcome category. The drawbacks of this methodology are two-fold: first, maternal complications are not considered and second, the maternal-newborn outcomes, which may not be aligned with each other, are reported separately.</p><p><strong>Objectives: </strong>The objectives were to: 1) evaluate the relationships between cesarean, maternal and neonatal complication rates in NTSV patients; 2) develop unified measures incorporating cesarean, maternal, and neonatal complications, utilizing desirability of outcome ranking (DOOR) methodology, to evaluate individual hospital performances; and 3) compare hospital rankings using the most desirable dyadic outcome \"vaginal delivery with no maternal and no neonatal complications\" to cesarean rate-based rankings for the overall population, as well as for low- and high-risk patients.</p><p><strong>Study design: </strong>This retrospective cross-sectional study included all NTSV deliveries at seven hospitals of the Northwell Health system from January 2019 to December 2024. Maternal complications included \"severe obstetric complications\" as per the Joint Commission criteria. Neonatal complications included the conditions described by the Joint Commission as \"unexpected complications in term newborns\". First, statistical analyses were performed to evaluate correlations among cesarean, maternal and neonatal complication rates in the seven hospitals. Second, we employed dyadic maternal-newborn outcomes using a Desirability of Outcome Ranking (DOOR) integrating cesarean, maternal, and neonatal complication rates for each hospital. Third, we used the most desirable outcome, \"vaginal delivery with no maternal and no neonatal complications\" to derive a new seven-hospital ranking which was then compared to the cesarean rate-based ranking. The same comparisons of rankings were also performed after stratification of the data to low and high-risk patients based on the obstetric comorbidity index score on admission (0-3 and ≥4, respectively).</p><p><strong>Results: </strong>A total of 55,841 NTSV deliveries during the years 2019-2024 were analyzed. There was a significant negative correlation between cesarean and neonatal complication rates (r = -0.79, p=0.04), and no correlations between cesarean versus maternal complication rates (r=-0.08, p=0.86) or maternal complication versus neonatal complication rates (r=-0.33, p=0.47) indicating the need for a combined metric. Based on the DOOR methodology, four groups of dyadic outcomes were formed: a) vaginal delivery with no maternal and no neonatal complications; b) cesarean with no maternal and no neonatal complications; c) vaginal delivery with maternal and/or neonatal complications; and d) cesarean with maternal and/or neo","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172339","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":"Small for Gestational Age sub-groups have differential morbidity, growth and neurodevelopment at age 2: the INTERBIO-21st Newborn Study.","authors":"Aris T Papageorghiou,María C Restrepo-Méndez,Rose McGready,Fernando C Barros,Francois Nosten,Shama Munim,Roseline Ochieng,Rachel Craik,Hellen C Barsosio,James A Berkley,Maria Carvalho,Michelle Fernandes,Leila Cheikh Ismail,Ann Lambert,Shane A Norris,Eric O Ohuma,Alan Stein FRCPsych,Chrystelle O O Tshivuila-Matala,Adele Winsey,Zulfiqar A Bhutta,Stephen H Kennedy,Jose Villar","doi":"10.1016/j.ajog.2025.05.017","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.017","url":null,"abstract":"BACKGROUNDSmall for Gestational Age (SGA) is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birth weight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterise distinct SGA sub-groups and assess their neonatal and early childhood health trajectories.OBJECTIVESTo refine the classification of SGA by identifying sub-groups based on maternal, fetal, and environmental factors and evaluating their associations with neonatal morbidity, growth, and neurodevelopment at age 2.STUDY DESIGNProspective Cohort Study. In six countries worldwide, between 2012 and 2018, the INTERBIO-21st Study enrolled SGA and non-SGA newborns defined by the <10th centile of international standards with moderate (≥3rd to <10th centile) and severe (<3rd centile) SGA sub-groups; we assessed their growth, health, nutrition, motor development, and neurodevelopment up to age 2. We used 2-step cluster analysis to identify SGA sub-groups, and a probabilistic approach to choose the optimal sub-group model based on a statistical measure of fit. We performed logistic regression analysis (OR; 95% CI) to assess health and development outcomes among sub-groups using the non-SGA as reference group, adjusting for key confounders.RESULTSWe enrolled 5153 non-SGA and 1549 SGA newborns: moderate (≥3rd to <10th centile) SGA=947 and severe (<3rd centile) SGA=602). We identified nine SGA sub-groups: 'no main condition detected' (29.0%); 'previous low birth weight (LBW)/preterm birth (PTB)' (14.6%); 'severe maternal disease' (12.0%); 'maternal short stature (11.6%); 'hypertensive disorders' (9.6%); 'extrauterine infection' (6.8%); 'previous miscarriage(s)' (6.5%); 'smoking' (5.2%), and 'maternal under-nutrition' (4.7%). Severe SGA newborns in the 'severe maternal disease' (OR: 3.2; 95% CI, 1.8-6.0), 'previous LBW/PTB' (OR: 2.8; 95% CI, 1.6-4.8), and 'smoking' (OR: 5.4; 95% CI, 1.3-21.8) sub-groups had increased risk of neonatal and long-term morbidity, and low anthropometric measures at age 2 as compared to the non-SGA group. Moderate SGA newborns in the \"hypertensive disorders\" sub-group had increased risk of neonatal morbidity (OR: 2.6; 95% CI, 1.5-4.6), and higher odds of scoring <10th centile of normative values in language (OR: 3.5; 95%CI, 1.0-12.0) and positive behavior (OR: 2.2; 95%CI, 1.1-4.5). The 'severe maternal disease' sub-group had also higher risk of deficit (<10th centile of normative values) in language (OR: 5.7; 95%CI, 1.3-24.8), positive behavior (OR: 3.4; 95%CI, 1.5-7.6).CONCLUSIONSSGA comprises heterogeneous sub-groups with distinct patterns of neonatal morbidity, postnatal growth, and neurodevelopmental outcomes up to age 2.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"133 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136752","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 Adherence during Pregnancy by Race and Ethnicity.","authors":"Elyse DiCesare,Krista F Huybrechts,Brian T Bateman,Joyce Lii,Loreen Straub","doi":"10.1016/j.ajog.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.015","url":null,"abstract":"BACKGROUNDRecent evidence from the Chronic Hypertension and Pregnancy (CHAP) trial demonstrates that treatment of even mild chronic hypertension during pregnancy reduces the risk of severe adverse maternal, fetal, and neonatal outcomes. Black patients are disproportionately affected by hypertension-related morbidity during pregnancy. Outside of pregnancy, substantial racial and ethnic differences in antihypertensive medication adherence have been reported. Insight into antihypertensive treatment adherence patterns during pregnancy may highlight approaches to decrease racial disparities in hypertension-related adverse pregnancy outcomes.OBJECTIVETo evaluate differences in antihypertensive treatment adherence during pregnancy by race and ethnicity.STUDY DESIGNCohort study of a nationwide sample of publicly insured pregnant individuals nested in the Medicaid Analytic eXtract/Transformed Medicaid Statistical Information System Analytic Files, 2000-2018. Participants were pregnant individuals who initiated recommended antihypertensives (i.e., methyldopa, labetalol, or nifedipine) in the first half of pregnancy, with initiation defined as no antihypertensive medication dispensing during the 3 months before pregnancy. Differences in treatment adherence during pregnancy - defined as &gt;80% of days covered in the second half of pregnancy - by race/ethnicity were evaluated. Potential confounders considered included socio-demographic characteristics, comorbidities and concomitant medication use. Risk ratios and their 95% CI were estimated using log-binomial regression; risk differences were estimated using binomial regression. Sensitivity analyses were conducted to assess the robustness of the findings.RESULTSThe 16,554 hypertensive treatment initiators had a mean age of 29.4 years (standard deviation: 5.9); 7,376 (44.6%) were Black, 2,827 (17.1%) were Hispanic or Latino, 5,194 (31.4%) were White, and 1,157 (7.0%) had other/unknown race and ethnicity. The proportion of initiators with treatment adherence during the second half of pregnancy was considerably lower for individuals classified as Black (16.8%) compared to other race and ethnicity groups (range: 27.2-28.2%). After adjustment for patient characteristics, adherence to treatment was lower among Black individuals as compared to White individuals (risk ratio = 0.59 [95% CI: 0.54, 0.63]; risk difference = -9.91 [-11.71, -8.10] per 100 individuals). Treatment adherence was also lower for individuals categorized as Hispanic or Latino and other/unknown race and ethnicity compared to White individuals, but differences were less pronounced. Findings were consistent across sensitivity analyses, which included restricting the cohort to those with a recorded diagnosis of hypertension, restricting to term births, re-defining adherence as &gt;80% days covered for any antihypertensive medication (i.e., allowing switches to antihypertensives other than methyldopa, labetalol, or nifedipine), and redefining adherence bas","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"93 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136764","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":"Discordance in maximum velocities in the middle cerebral arteries of monochorionic twins: beyond twin-anemia-polycythemia sequence.","authors":"R Bartin,C Colmant,A Claudet,J Stirnemann,Y Ville","doi":"10.1016/j.ajog.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.014","url":null,"abstract":"BACKGROUNDIn monochorionic pregnancies, elevated middle cerebral artery (MCA) peak systolic velocity (PSV) in one twin is a key marker of fetal anemia, notably in TAPS, but may also occur spontaneously in sIUGR, owing to brain-sparing mechanisms or in the context of TTTS particularly following laser therapy. Distinguishing between these etiologies remains challenging, complicating clinical management and counseling. In addition, current MCA-PSV charts are primarily derived from singleton pregnancies, with limited data on monochorionic twins, especially before 18 weeks of gestation.OBJECTIVESThe aim of this study was twofold: first, to establish a dedicated MCA-PSV chart for monochorionic twins, and second, to propose a new hemodynamic index (MCA-PSV/UA-PI ratio) for differentiating MCA-PSV changes due to hemodynamic adaptation from fetal anemia.STUDY DESIGNAll consecutive monochorionic twin pregnancies referred to our tertiary reference center between January 2019 and December 2023, either for standard follow-up or for a specific complication, were included. This study was conducted in two phases : first, the development of gestational age-specific charts for MCA-PSV and the MCA-PSV/UA-PI ratio using data from uncomplicated pregnancies ; second, the evaluation of the hemodynamic index in pathological conditions associated with elevated MCA-PSV values (sIUGR, spontaneous TAPS, and post-laser follow-up). A Z-score of 2.32 (corresponding to the 99th percentile) was used as the threshold for pathological values.RESULTSOverall, 810 monochorionic twin pregnancies were included. 389 patients with uncomplicated pregnancies were used to generate gestational age-specific charts for both MCA-PSV and MCA-PSV/UA-PI ratio. With a total of 4,021 observations of MCA-PSV, including 640 observations between 14 and 18 weeks of gestation, the estimated mean MCA-PSV before 18 weeks significantly differed from both singleton and twin charts. Differences between observed and smoothed mean MCA-PSV were small (0.49 cm/s, SD ± 0.34). We investigated pathological conditions associated with elevated MCA velocity. Among 67 severe sIUGR cases, 40% presented elevated MCA velocity. Their MCA-PSV/UA-PI ratio was significantly different from spontaneous TAPS (mean MCA-PSV/UA-PI ratio Z-score of 0.60 vs 4.16 for sIUGR and TAPS, respectively, p<0.001): The ratio Z-score was within the normal range for 93% of sIUGR cases and for none of the spontaneous TAPS. Post-laser follow-up showed MCA-PSV elevation in 15/281 TTTS cases (5%), with 9/15 diagnosed as post-laser TAPS. No clear correlation was found between Doppler indices and post-laser TAPS.CONCLUSIONThis study provides a new gestational age-specific MCA-PSV chart and introduces a novel hemodynamic index (MCA-PSV/UA-PI ratio) that may help differentiate spontaneous anemia from hemodynamic changes and thus, refine both diagnosis and prognosis of complicated monochorionic pregnancies, especially in early gestational ages.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"22 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130747","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 Art of Cold Knife Conization: A Demonstration of Technique in Live Patients and a Low-Fidelity Simulation Model.","authors":"Katie L Hammond,Zachary A Kopelman,Stuart S Winkler,Marissa C Buchek,Caela R Miller,Emily A Penick,Erica R Hope","doi":"10.1016/j.ajog.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.013","url":null,"abstract":"Cervical excision via cold knife conization is recommended in circumstances such as adenocarcinoma-in-situ or predominantly endocervical high-grade dysplasia. A successful cold knife conization involves visualization, targeting of the pathology, obtaining an unfragmented specimen, and consideration of post-excision endocervical curettage. This video demonstrates cold knife conization techniques to facilitate pathologic analysis and a low-fidelity simulation model for learners. The video depicts two cold knife conizations in nulliparous patients with 1) high-grade lesion on endocervical curettage, and 2) high-grade dysplasia on ectocervical biopsy. Additionally, we demonstrate a low-fidelity simulation model that can be utilized to familiarize physicians with the conization procedure and essential hemostatic techniques. While the authors acknowledge limitations of the model to include lack of bleeding, corresponding patient cases demonstrate essential hemostatic techniques. Utilizing standard surgical instruments, cold knife conization was performed for both patients allowing for excision of an appropriately sized intact specimen. Differences in technical approach when excising the ectocervix vs. the endocervix were detailed. Endocervical curettage was performed following specimen removal, and the tissue bed was made hemostatic. Both conizations were performed without complication and negative margins were achieved. In the simulation model, easily obtainable supplies, including small cups, balloons, cling wrap, cotton balls, and hot dogs were utilized to create an imitation cervix. This can allow for demonstration and practice with suture placement, excision of an intact specimen, and hemostatic techniques. Utilizing proper technique for adequate cold knife conization specimens facilitates pathologic analysis of dysplasia, cancer, and margin status. Negative margins have a significant impact on recurrence and need for future cervical procedures, which may affect future obstetric outcomes. Low-fidelity simulation models can provide accessible avenues for technical familiarization and training in this procedure.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"45 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114296","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":"Less is More: Rare Ectopic Variants Beyond the Goal and Scope of SRU Consensus First Trimester Lexicon.","authors":"Lori M Strachowski,Shuchi K Rodgers,Mindy M Horrow","doi":"10.1016/j.ajog.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.011","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"136 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114297","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":"Subsequent risk for preterm birth following second trimester medical termination of pregnancy.","authors":"Annabelle L VAN Gils,Ian Koorn,Josephine G Jonker,Brenda M Kazemier,Martijn A Oudijk,Eva Pajkrt","doi":"10.1016/j.ajog.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.012","url":null,"abstract":"BACKGROUNDMedical termination of pregnancy (using mifepristone and misoprostol) is a commonly performed health intervention. High quality cohort studies are warranted to investigate the association of second-trimester medical termination of pregnancy and subsequent pregnancy outcomes.OBJECTIVEThis study aims to assess the risk of subsequent spontaneous preterm birth following second trimester medical termination of pregnancy.STUDY DESIGNWe performed a cohort study in the Amsterdam University Medical Centre, location AMC. We included all individuals who underwent a second trimester medical termination of pregnancy between 2008-2023 using mifepristone and/or misoprostol and had a known subsequent pregnancy up to 2024. Exclusion criteria were other methods of termination (e.g. cesarean section, hysterectomy, curettage or foley catheter) and indication for mTOP due to intra-uterine fetal demise or previable prelabor rupture of membranes. The primary outcome was spontaneous preterm birth < 37 weeks in the subsequent pregnancy. Secondary outcomes included subsequent miscarriage < 16 weeks, repeated termination, and rates of total, spontaneous and iatrogenic preterm birth < 37, < 32 and < 28 week. Subgroup analyses were performed on the interpregnancy interval, gestational age at medical termination of pregnancy and postpartum surgical interventions using logistic regression estimating odds ratios (OR) and 95% confidence intervals, with adjustment for confounders. Subsequent singleton and multiple pregnancies were assessed separately.RESULTSOut of the 1,438 eligible cases, 1,033 were known to have a subsequent pregnancy of which 986 outcomes were available (singletons n=962, multiples n=24). In subsequent singleton pregnancies exceeding 16 weeks, spontaneous preterm birth < 37 weeks occurred in 39/831 cases (4.7%). In multiples, spontaneous preterm birth < 37 weeks occurred in 4/24 cases (16.7%). In subsequent singletons, rates of spontaneous preterm birth < 37 weeks were higher following an IPI < 3 months compared to 12-24 months (6.8% vs 3.2% aOR 2.2 95% CI 0.69-7.4, p-value 0.2), and higher for a GA >20 weeks at mTOP compared to < 12+0 - 15+6 weeks (5.9% vs 2.6% aOR 2.2 95% CI 0.92 - 5.4, p-value 0.07), though both not statistically significant. However, when gestational age at mTOP was included as a continues variable (in weeks) in a linear regression model, a significant positive association with subsequent spontaneous preterm birth was found (B=0.56, R2=0.31, p=0.04).CONCLUSIONSecond-trimester medical termination of pregnancy can be considered safe with regards to subsequent spontaneous preterm birth risk. As recommended following preterm and term birth, patient counseling should include the importance of allowing time for cervical remodeling to mitigate preterm birth risks, especially for those with a medical termination of pregnancy at higher gestational ages.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"34 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144114295","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":"Balancing speed and precision in genetic testing after pregnancy loss.","authors":"Yong Wu","doi":"10.1016/j.ajog.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.006","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"14 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087512","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":"Expanding Access to Pregnancy Loss Testing Through Rapid and Affordable Genomic Technology.","authors":"Zev Williams,Shan Wei,Eric J Forman","doi":"10.1016/j.ajog.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.007","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"91 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087519","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":"More need to Refine the risk stratification of sFlt-1/PIGF Ratios in Clinical Management for Suspected Preeclampsia.","authors":"Chen Yunshan,Xiang Guochun","doi":"10.1016/j.ajog.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.05.009","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"61 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087513","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}