American journal of obstetrics and gynecology最新文献

{"title":"Prediction of vaginal birth after induction of labor with maternal circulating RNA transcripts","authors":"Wenjing DING PhD, Stephen Siu Chung CHIM PhD, Karen Ka Wing WONG MSc, Elaine Yee Ling KO BSc, Claire Yik Lok CHUNG PhD, Joyce Ka Yu TSE PhD, Ting Fung CHAN PhD, Chi Chiu WANG PhD, Tak Yeung LEUNG MD","doi":"10.1016/j.ajog.2025.06.023","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.023","url":null,"abstract":"Induction of labor is commonly performed in pregnancies for clinical benefits, but 25%-30% of inductions eventually fail and require cesarean delivery. So far, there is no biomarker for the prediction of successful vaginal birth after induction of labor, and clinical prediction remains unsatisfactory.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"13 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144305019","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":"Optimizing use of a uterine manipulator for laparoscopic hysterectomy: a cadaveric study of distances to the pelvic ureter","authors":"Evelyn T. Pan MD, Briana M. Belmonte MD, Clifford Y. Wai MD, Sunil Balgobin","doi":"10.1016/j.ajog.2025.06.022","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.022","url":null,"abstract":"Uterine manipulator use may mitigate the risk of ureteral injury during laparoscopic hysterectomy by distancing the ureters, particularly for critical steps such as uterine artery ligation and colpotomy. However, evidence to reliably support this spatial effect is lacking, and more data is needed to inform optimal manipulator position and technique.","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"14 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144305022","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":"Risk of endometrial cancer after insufficient endometrial biopsy: a retrospective cohort study.","authors":"Chanella Vang, Kristine Juul Hare, Anna Arday, Reza Rafiolsadat Serizawa, Jeppe Bennekou Schroll","doi":"10.1016/j.ajog.2025.06.015","DOIUrl":"10.1016/j.ajog.2025.06.015","url":null,"abstract":"<p><strong>Background: </strong>Endometrial biopsies are used to diagnose abnormalities in the endometrium, but the biopsies are sometimes insufficient.</p><p><strong>Objective: </strong>To evaluate the risk of detecting endometrial cancer in individuals with an insufficient endometrial index biopsy compared to individuals with a normal index biopsy.</p><p><strong>Study design: </strong>In this retrospective cohort study, we used the Danish Pathology Register to identify individuals with endometrial biopsies between 2013 and 2017. We categorized initial and follow-up samples as normal, insufficient, hyperplastic, or cancer by using Systematized Nomenclature of Medicine codes. We had 4 years of follow-up until December 31, 2021, and we compared categories with Kaplan-Meier analysis, a log-rank test, and Cox regression.</p><p><strong>Results: </strong>A total of 80,761 Danish individuals were included. Of these, 13,964 (17.3%) had an insufficient endometrial index biopsy, meaning the index sample contained too little tissue for a definitive diagnosis. From this group, 6130 (43.9%) individuals had a follow-up endometrial biopsy performed. Unadjusted for age (hazard ratio, 3.7; 95% confidence interval, 3.56-3.84), the incidence of endometrial cancer (n=368; 2.6%) was higher in individuals with an insufficient index biopsy compared to those with a normal index biopsy (n=423; 0.7%). However, when we adjusted for age, the hazard for endometrial cancer was only slightly higher after an insufficient biopsy compared to a normal biopsy (hazard ratio, 1.16; 95% confidence interval, 1.02-1.31).</p><p><strong>Conclusion: </strong>We found an increased risk of detecting endometrial cancer in individuals with an insufficient index biopsy compared to individuals with a normal index biopsy. After adjusting for age, the risk was only slightly increased.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293200","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":"A low maternal sFlt-1 before 11 weeks is associated with a greater risk of early preeclampsia.","authors":"Emmanuel Bujold,Charlotte K Ekelund,Berit Woetmann Pedersen,Line Rode","doi":"10.1016/j.ajog.2025.06.019","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.019","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"6 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295714","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":"Response to \"Analysis of cerebral palsy subtypes by intrapartum cardiotocography and postnatal neuroimaging\".","authors":"Shoichi Magawa,Masahiro Nakao,Yukiko Nanba,Mitsutoshi Iwashita,Tomoaki Ikeda","doi":"10.1016/j.ajog.2025.06.021","DOIUrl":"https://doi.org/10.1016/j.ajog.2025.06.021","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"22 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295717","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":"Association between heavy menstrual bleeding and depression among women in South Asia: a cross-sectional study.","authors":"Isabel Charles, Madeleine Patrick, Thea Mink, Tanvir Ahmed, Y Malini Reddy, Marisa R Young, Rachel Waford, Bethany A Caruso, Sheela S Sinharoy","doi":"10.1016/j.ajog.2025.06.018","DOIUrl":"10.1016/j.ajog.2025.06.018","url":null,"abstract":"<p><strong>Objective: </strong>Heavy menstrual bleeding-clinically defined as excessive menstrual blood loss that interferes with physical, emotional, social, or material quality of life -adversely affects health and functional outcomes among individuals who menstruate. However, the full extent of the relationships between heavy menstrual bleeding and health outcomes remains unknown, especially in low- and middle-income countries. To begin to fill this evidence gap, we investigated associations between heavy menstrual bleeding and depression symptomology among women in South Asia.</p><p><strong>Study design: </strong>We carried out a secondary analysis of cross-sectional data from household surveys conducted with 3438 adult women between August 2021 and June 2022 in 5 cities: Meherpur and Saidpur, Bangladesh; and Narsapur, Tiruchirappalli, and Warangal, India. Heavy menstrual bleeding was measured using the clinically validated SAMANTA scale, and depression symptomology was measured using the Center for Epidemiological Studies Short Depression scale. Regression analyses examined associations between heavy menstrual bleeding and depression symptomology among our analytic sample of 2564 women who had experienced a menstrual period in the previous 12 months.</p><p><strong>Results: </strong>The prevalence of heavy menstrual bleeding was 45% across the pooled sample, with city-specific prevalences ranging from 41% to 46%. The median Center for Epidemiological Studies Short Depression scale score was 6 (range: 4-29, out of a possible 30), with 30% of women scoring above the screening threshold for depression. Pooled analyses revealed a significant association between heavy menstrual bleeding and increased Center for Epidemiological Studies Short Depression scale scores (β: 0.07; 95% confidence interval, 0.03, 0.12) and a 15% increased risk of a binary depression outcome (95% confidence interval, 1.03, 1.29) among women with heavy menstrual bleeding. City-level analyses showed variability in the strength and significance of these associations, with some cities demonstrating stronger associations than others.</p><p><strong>Conclusion: </strong>The findings highlight the substantial burden of heavy menstrual bleeding on women's mental health in South Asia. Addressing heavy menstrual bleeding as part of comprehensive women's reproductive healthcare is crucial for improving overall well-being. The study underscores the need for further research to explore the mechanisms linking heavy menstrual bleeding and depression, and to develop effective interventions tailored to the specific needs of women in different contexts. Understanding these relationships can provide healthcare providers and policymakers with evidence to better support women's health and mental well-being.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293174","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":"Analysis of cerebral palsy subtypes by intrapartum cardiotocography and postnatal neuroimaging.","authors":"Avir Sarkar, Bijoya Mukherjee, Priyanka Mondal, Subrat Panda, Suman Sandeep Samal","doi":"10.1016/j.ajog.2025.06.020","DOIUrl":"10.1016/j.ajog.2025.06.020","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293172","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":"Fc gamma receptor IIIa polymorphism as a predictive marker for avelumab efficacy in gestational trophoblastic neoplasia.","authors":"Adrien Msika, Pierre-Adrien Bolze, Alice Koenig","doi":"10.1016/j.ajog.2025.05.043","DOIUrl":"10.1016/j.ajog.2025.05.043","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293197","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 anal sphincter injuries in spontaneous vaginal births in nulliparous pregnant individuals: a 21-year cohort study based on real-world data.","authors":"Katariina Laine, Kathrine Fodstad, Sari Räisänen","doi":"10.1016/j.ajog.2025.06.014","DOIUrl":"10.1016/j.ajog.2025.06.014","url":null,"abstract":"<p><strong>Background: </strong>In 2005, the Norwegian Directorate of Health implemented a national care bundle of education and training on correct perineal protection during childbirth to reduce increasing incidence of obstetric anal sphincter injuries. The intervention involved manual support of the perineum using one hand protecting the perineum, with the other hand controlling the expulsion speed of the baby's head, communicating with the individual in labor to avoid pushing during the last phase of fetal head crowning to reduce the risk of obstetric anal sphincter injuries, and performing a lateral or mediolateral episiotomy with correct technique by indication when necessary.</p><p><strong>Objective: </strong>To determine the secular trends of obstetric anal sphincter injuries incidence in nulliparous individuals with singleton spontaneous vaginal births at≥22 weeks' gestation in Norway during 2002‒2022.</p><p><strong>Study design: </strong>This was a population-based cohort study based on real-world data of 324,930 nulliparous pregnant individuals with singleton spontaneous vaginal births at≥22 weeks gathered from Medical Birth Registry of Norway. The main outcome measure was obstetric anal sphincter injuries incidence during the 21-year time period from 2002 to 2022. Secular trends of obstetric anal sphincter injuries were determined separately for the 7 3-year time periods. Both descriptive statistics and multivariable analyses by logistic regression were performed. Both crude and adjusted odds ratios with 95% confidence interval were determined.</p><p><strong>Results: </strong>We observed that the obstetric anal sphincter injuries incidence reduced significantly from 5.4% during 2002‒2004 to 2.1% during 2020‒2022. After adjustment for the individual's age and country of birth, infant birthweight, use of epidural analgesia, and episiotomy, the obstetric anal sphincter injuries incidence was reduced by 63% (adjusted odds ratio = 0.37, 95% confidence interval = 0.34-0.40) from 2002‒2004 to 2020‒2022. This reduction in obstetric anal sphincter injuries incidence was independent of individual characteristics, episiotomy use, and infant birthweight. The use of epidural analgesia during birth accounted for 7.8% to 15.8% of the observed reduction in obstetric anal sphincter injuries incidence between 2002 and 2016.</p><p><strong>Conclusion: </strong>The substantial decrease in obstetric anal sphincter injuries incidence among nulliparous individuals with singleton spontaneous vaginal births can be attributed to the widespread adoption of manual perineal protection techniques, following comprehensive staff training.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":8.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293199","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":"A pragmatic approach to antenatal risk stratification of late fetal growth restriction.","authors":"Piyanga Athauda, Raffaele Napolitano","doi":"10.1016/j.ajog.2025.06.008","DOIUrl":"10.1016/j.ajog.2025.06.008","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":"144281967","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}