American journal of obstetrics and gynecology最新文献

{"title":"Clinical context and future evaluation of the suprapubic descent angle (reply to letter to the editor).","authors":"Shin Hashiramoto, Ryu Matsuoka, Akihiko Sekizawa","doi":"10.1016/j.ajog.2026.08.042","DOIUrl":"10.1016/j.ajog.2026.08.042","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856811","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 call for standardized placental dye injection and postnatal evaluation in monochorionic twins after single fetal demise (reply to letter to the editor).","authors":"Mathies Rondagh, Sylke J Steggerda, Enrico Lopriore","doi":"10.1016/j.ajog.2026.08.029","DOIUrl":"10.1016/j.ajog.2026.08.029","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838824","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":"Fetoscopic visualization of meconium-mediated spinal cord injury in fetal myelomeningocele.","authors":"Ifeoma Maureen Ogamba-Alphonso, Julia Kim, Christina Sarris, Barbara Coons, Erin Lonergan, Martin Chavez, Jose L Peiro","doi":"10.1016/j.ajog.2026.08.033","DOIUrl":"10.1016/j.ajog.2026.08.033","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838790","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":"Age differences in clitoral-vestibular bulb anatomy across the adult lifespan.","authors":"Shaniel T Bowen, Pamela A Moalli, Arijit Dutta, Krystyna Rytel, Francisco J Gomez Rivas-Vazquez, Holly E Richter, Mark E Lockhart, Sara Perelmuter, Deborah C Marshall, Mercedes Balcells, Elazer R Edelman, Steven D Abramowitch","doi":"10.1016/j.ajog.2026.08.030","DOIUrl":"10.1016/j.ajog.2026.08.030","url":null,"abstract":"<p><strong>Background: </strong>There is sparse normative data on clitoral-vestibular bulb anatomy and how it changes with aging, despite growing evidence of the latter playing a notable role in female sexual function and other pelvic symptoms.</p><p><strong>Objective: </strong>To identify age-related differences in clitoral-vestibular bulb anatomy (dimensions, position, and shape) among women across the adult lifespan.</p><p><strong>Study design: </strong>This was a retrospective study of pelvic magnetic resonance images of women (≥18 years) without pelvic floor disorder/dysfunction symptom indications (pelvic organ prolapse, urinary incontinence/pain, fecal incontinence/pain, dyspareunia) and with normal pelvic anatomy (radiographically normal reproductive, genitourinary, or gastrointestinal systems). Participants were categorized into the following age groups: Young Adult (18-34 years), Early Midlife (35-49 years), and Older Adult (≥50 years). Axial images of participants in the supine position at rest were acquired for medical indications. The clitoral-vestibular bulb complex, vagina, and urethra were manually segmented to construct 3-dimensional anatomical models. Computational methods quantified clitoral-vestibular bulb dimensions, position, vaginal-urethral distances, and shape (given by principal component scores obtained from a statistical shape model). Age differences in clitoral-vestibular bulb measures were evaluated using Bonferroni-corrected one-way multivariate and univariate analyses of covariance, with adjustments for body mass index and parity. Age-related correlations were assessed using Spearman's rank correlation.</p><p><strong>Results: </strong>A total of 134 women were analyzed (median [range] age, 39 [19-80] years): 47 young adult, 46 early midlife, and 41 older adult women. All young adult and early midlife women were premenopausal, whereas 27 (71%) of older adult women were postmenopausal. Older adult women had a shorter clitoral body length than early midlife women (24.1 mm vs 27.9 mm; P=.006). Overall, smaller vestibular bulb volume was associated with increasing age (P=.04). Older Adult women had a more caudally positioned (lower in the pelvis) clitoral-vestibular bulb complex than Early Midlife women (-21.0 mm vs -17.6 mm; P<.001) and Young Adult women (-21.0 mm vs -17.9 mm; P<.001). Across the entire cohort, increasing age correlated with a shorter clitoral body length (ρ=-0.21; P=.01), smaller vestibular bulb volume (ρ=-0.20; P=.02), and a more dorsally (ρ=-0.22; P=.01) and caudally (ρ=-0.43; P<.001) positioned clitoral-vestibular bulb complex, whereas clitoral volume remained unchanged (ρ=-0.03; P=.73). The shape analysis revealed that age predominantly affected the vestibular bulbs, which became more medially positioned (closer together) (ρ=-0.28; P=.001) and proportionally smaller relative to the clitoris (ρ=-0.28; P=.001) with advancing age.</p><p><strong>Conclusion: </strong>Increasing age was weakly correlate","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838778","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":"Methodological considerations regarding probiotics for prevention of recurrent spontaneous preterm delivery (letter to the editor).","authors":"Cagdas Nurettin Emeklioglu","doi":"10.1016/j.ajog.2026.08.031","DOIUrl":"10.1016/j.ajog.2026.08.031","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838853","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 role of placental anastomoses in severe brain injury after fetal demise in monochorionic twins: a multicenter retrospective study (letter to the editor).","authors":"Rishika Das, Shadjay Ap","doi":"10.1016/j.ajog.2026.08.028","DOIUrl":"10.1016/j.ajog.2026.08.028","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823961","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":"Providing context behind reporting elements of a systematic review exploring urogynecological neurostimulation. (reply to letter to the editor).","authors":"Ritesh Rikain Warty","doi":"10.1016/j.ajog.2026.08.035","DOIUrl":"10.1016/j.ajog.2026.08.035","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824045","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":"Universal aspirin dispensation for prevention of preeclampsia in a high-risk population.","authors":"Elaine Duryea, Anne Ambia, Jessica Pruszynski, Joyce Miller, Sharon Hubbard, Carrie Berge, David Nelson, Catherine Spong","doi":"10.1016/j.ajog.2026.08.036","DOIUrl":"10.1016/j.ajog.2026.08.036","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive disorders of pregnancy are a major cause of maternal morbidity and mortality. Aspirin therapy has shown benefit in high-risk populations; however, current characteristic-based screening approaches are cumbersome, and the risks of aspirin exposure are low, making universal prescribing appealing.</p><p><strong>Objective: </strong>To report the effect of universal aspirin dispensation for preeclampsia prevention in a population with a high rate of hypertensive disorders.</p><p><strong>Study design: </strong>This observational cohort study includes all deliveries between April 2020 and July 2025 at Parkland Health, a high-volume obstetric service with community clinics capable of directly dispensing medication during prenatal visits. Patients who initiated prenatal care by 16 weeks gestation received 162 mg aspirin daily beginning August 3, 2022; prior to this date, aspirin was not recommended regardless of risk factors. Deliveries during the washout period (August 3, 2022-February 3, 2023) were excluded. The primary outcome was preeclampsia with severe features, which was a clinical diagnosis characterized by the administration of magnesium sulfate for severe hypertension, lab abnormalities, or eclampsia.</p><p><strong>Results: </strong>Two cohorts of 18,457 patients, before and after aspirin implementation, were compared. Patients in the aspirin epoch had a lower incidence of preeclampsia with severe features (6.9% vs 5.1%, P<.001), adjusted odds ratio of 0.65 (0.60-0.72). In addition, the time to diagnosis of preeclampsia with severe features was longer in the aspirin epoch (P<.001). Patients with chronic hypertension were also less likely to develop preeclampsia with severe features, with an adjusted odds ratio of 0.72 (0.59-0.86) in the aspirin epoch. The rates of abruption, postpartum hemorrhage, and neonatal complications did not increase in the aspirin epoch. Pharmacy data confirmed that at least 14,754 (80.4%) patients with a prenatal visit at ≤16 weeks received aspirin during the later epoch, with a median of 180 tablets dispensed.</p><p><strong>Conclusion: </strong>Universal dispensation of 162 mg aspirin daily at the first prenatal visit in a population with a high rate of hypertensive disorders was associated with a population-level reduction in the development of preeclampsia with severe features in patients with and without chronic hypertension, without an increase in abruption or postpartum hemorrhage. This study demonstrates the possible benefit of a universal approach to aspirin prescribing in high-risk populations, especially if direct dispensation is performed.</p>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838846","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 key reporting elements in a systematic review of intravaginal electrical stimulation for urinary incontinence (letter to the editor).","authors":"Jiyu Zhao, Jing Yan","doi":"10.1016/j.ajog.2026.08.034","DOIUrl":"10.1016/j.ajog.2026.08.034","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838808","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":"Center effects and concomitant interventions in probiotic prevention of recurrent spontaneous preterm delivery (reply to letter to the editor).","authors":"Satoshi Yoneda, Shintaro Iwamoto, Shigeru Saito","doi":"10.1016/j.ajog.2026.08.032","DOIUrl":"10.1016/j.ajog.2026.08.032","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823975","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}