BJOG: An International Journal of Obstetrics & Gynaecology最新文献

{"title":"Vaginal Misoprostol Compared to Vaginal Dinoprostone for Induction of Labour: A Systematic Review and Meta‐Analysis","authors":"Georgina Andersson, Benjamin Greenfield, Alexandra Hunt, Amr Malawany, Ben Luke Choo, William Dixon, David Lissauer, Andrew D. Weeks, Andrew Sharp, Gemma Clayton, Abi Merriel","doi":"10.1111/1471-0528.70314","DOIUrl":"https://doi.org/10.1111/1471-0528.70314","url":null,"abstract":"Introduction Induction of labour is a common intervention. The prostaglandin dinoprostone is often used, but there is increasing evidence that misoprostol may be more effective without compromising safety. This review compares the efficacy and safety of vaginal misoprostol and vaginal dinoprostone. Methods Electronic databases were searched for randomised controlled trials comparing singleton, term inductions with vaginal dinoprostone or vaginal misoprostol. The primary outcome was vaginal births within 24 h. Secondary outcomes included induction to birth interval, mode of birth, oxytocin augmentation, uterine hyperstimulation, fetal distress and adverse maternal and neonatal outcomes. A sub‐group analysis by misoprostol dosage (25 and ≥ 50 μg) was planned. A random effects meta‐analysis was performed and risk of bias assessed using Cochrane Risk of Bias 2 tool. Results 44 papers reported 7040 participants induced with vaginal misoprostol and 6604 with vaginal dinoprostone. Participants given vaginal misoprostol were 48% (OR 1.48 95% CI 1.20, 1.84) more likely to achieve vaginal birth within 24 h, although heterogeneity was high. The rates of caesarean section, and adverse maternal or neonatal outcomes were comparable. In the vaginal misoprostol group, fewer patients required oxytocin (OR 0.51 95% CI 0.40, 0.65) and time to birth was reduced (−230 min (95% CI −286 to −175, <jats:italic>I</jats:italic> <jats:sup>2</jats:sup> 57.6%)). These findings were consistent in the subgroup analysis, although uterine hyperstimulation with fetal heart rate changes was reduced in the 25‐μg group. Conclusion Vaginal misoprostol is more effective for achieving vaginal birth in 24 h, reducing time to birth and oxytocin use when compared to vaginal dinoprostone. It does not seem to increase caesarean birth and has a similar side‐effect profile. At lower doses (25‐μg), it is likely to be similarly effective with a lower incidence of uterine hyperstimulation. This information can be used to support discussions around choice of induction agent.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148767528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Use of the Nausicaa Compression Suture in a Case of Placenta Accreta Spectrum","authors":"Naoko Suga, Ayumi Yasuda, Takafumi Ujihira, Shintaro Makino","doi":"10.1111/1471-0528.70319","DOIUrl":"https://doi.org/10.1111/1471-0528.70319","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long‐Term Effects of Pelvic Floor Muscle Training Combined With Electrical Stimulation Biofeedback Among Women With Symptomatic Pelvic Organ Prolapse: A Randomised Controlled Trial","authors":"Min Li, Yuhan Lyu, Pingping Li, Yaxin Liang, Tianzi Gai, Qiubo Lyu, Shuai Huang, Lin Liang, Yue Yu, Xinyue Zhang","doi":"10.1111/1471-0528.70313","DOIUrl":"https://doi.org/10.1111/1471-0528.70313","url":null,"abstract":"Objective To determine whether adding electrical stimulation (ES) biofeedback to supervised pelvic floor muscle training (PFMT) provides additional long‐term benefit in prolapse anatomy among women with symptomatic pelvic organ prolapse (POP). Design Randomised controlled trial. Setting A tertiary hospital in Beijing, China. Population Primiparas (20–40 years) with symptomatic pelvic organ prolapse quantitation (POP‐Q) stage II to III at 42–60 days postpartum following a full‐term, vaginal singleton delivery. Methods We randomised 220 participants (1:1) to the intervention group (PFMT+ES+biofeedback) or control group (PFMT‐only) for a 12‐week intervention. The PFMT‐only group received supervised PFMT (15 min/session, three times/week). The PFMT+ES+biofeedback group received two weekly sessions of ES (10 min) with biofeedback‐mediated PFMT (15 min), and one session of supervised PFMT. Main Outcome Measures Primary outcome was POP‐Q stage at 24 months. Secondary outcomes included Pelvic Floor Impact Questionnaire Short Form‐7 (PFIQ‐7) score, pelvic floor muscle (PFM) strength, PFM electromyography values, and economic analysis. Results At 24 months, the proportion of participants with improved POP‐Q stage was not significantly different between PFMT+ES + biofeedback and PFMT‐only groups. PFM strength demonstrated significant improvement in PFMT+ES + biofeedback group. No significant differences were observed in PFIQ‐7 score or PFM electromyography values. Adding ES cost more, but had similar quality‐adjusted life years. No adverse events were reported. Conclusions A single course of ES biofeedback plus supervised PFMT provides limited long‐term benefit in postpartum prolapse. Trial Registration Chinese Clinical Trial Registry: ChiCTR1900021719; <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://www.chictr.org.cn/showproj.html?proj=35452\">https://www.chictr.org.cn/showproj.html?proj=35452</jats:ext-link>","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of Delivery Following Transabdominal Cerclage: A Retrospective Cohort Study","authors":"Laura van der Krogt, Lisa Story, Natalie Suff, Andrew Shennan","doi":"10.1111/1471-0528.70315","DOIUrl":"https://doi.org/10.1111/1471-0528.70315","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concern About the Trends of Letters to Editors","authors":"Shigeki Matsubara","doi":"10.1111/1471-0528.70312","DOIUrl":"https://doi.org/10.1111/1471-0528.70312","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Antimicrobials and the Evolving Landscape of Urinary Tract Infection Management in Women","authors":"Zainab Al‐Jawahiri, Maya Basu","doi":"10.1111/1471-0528.70316","DOIUrl":"https://doi.org/10.1111/1471-0528.70316","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"279 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Investigation and Care of a Small‐for‐Gestational‐Age Fetus and a Growth Restricted Fetus (Green‐top Guideline No. 31)”","authors":"","doi":"10.1111/1471-0528.70291","DOIUrl":"https://doi.org/10.1111/1471-0528.70291","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148459253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertensive Disorders of Pregnancy and the Long-Term Risk of Maternal Retinal and Ophthalmic Disease: A Systematic Review and Meta-Analysis.","authors":"Peter Barrett,Cian Carey,Sinéad O'Riordan,Angela Ding Wu,Emma Wallace,Matilda Biba,Karolina Kublickiene,Fergus McCarthy,Ali Khashan","doi":"10.1111/1471-0528.70307","DOIUrl":"https://doi.org/10.1111/1471-0528.70307","url":null,"abstract":"BACKGROUNDHypertensive disorders of pregnancy (HDP) are associated with increased long-term risk of maternal cardio-metabolic disease, but links with future retinal diseases remain unclear.OBJECTIVEThe objective of this study is to synthesise the published literature on HDP and subsequent retinal and other ophthalmic disease.SEARCH STRATEGYDatabases including PubMed, Embase, Web of Science, and Cochrane Library were searched to March 2026 following a pre-registered PROSPERO protocol, CRD42024589508.SELECTION CRITERIAThese included: a population of parous women, exposure to HDP at least once, at least one primary outcome (retinal disease) or secondary outcome (other ophthalmic disease). Women with pre-pregnancy retinal/ophthalmic diseases were excluded.DATA COLLECTION AND ANALYSISTwo reviewers independently screened studies, extracted data, and assessed bias using an adapted Newcastle-Ottawa tool. Random-effects meta-analyses were performed.RESULTSOf 5673 studies retrieved, 13 were eligible for inclusion (2 450 072 participants). HDP was associated with increased risk of diabetic retinopathy (aRR 3.54, 95% CI 2.19-5.74), particularly after preeclampsia (aRR 4.24, 95% CI 3.51-5.12). HDP-exposed women were also at higher risk of non-diabetic retinopathy (aRR 3.65, 95% CI 1.18-11.33), retinal detachment (aRR 1.54, 95% CI 1.28-1.86), and retinal vascular occlusion (aRR 2.09, 95% CI 1.55-2.81). HDP-exposed women may also be at risk of hypertensive retinopathy and central serous chorioretinopathy, but aRRs did not reach statistical significance. Across individual studies, HDP-exposed women were reported to be at increased risk of cataract extraction, non-infectious uveitis, and choroidal neovascular age-related macular degeneration.CONCLUSIONWomen who experience HDP may be at future risk of retinal and other ophthalmic diseases, particularly diabetic retinopathy. Further observational research is required to confirm these associations.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Related Risk of Miscarriage Is Low but More Research Will Be Welcome","authors":"Sophie Alexander","doi":"10.1111/1471-0528.70302","DOIUrl":"https://doi.org/10.1111/1471-0528.70302","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148432098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lithium Use in Pregnancy and the Risk of Spontaneous Preterm Birth: An Australian Statewide Retrospective Cohort Study.","authors":"Alexandra Roddy Mitchell,Anthea Lindquist,Richard J Hiscock,Anna Forsythe,Hannah Gordon,Caroline S E Homer,Natasha Pritchard,Jessica Atkinson,Susan P Walker,Stephen Tong,Roxanne Hastie","doi":"10.1111/1471-0528.70301","DOIUrl":"https://doi.org/10.1111/1471-0528.70301","url":null,"abstract":"OBJECTIVETo investigate whether lithium exposure in pregnancy is associated with spontaneous preterm birth, congenital malformations and abnormal fetal growth.DESIGNStatewide retrospective cohort study.SETTINGVictoria, Australia.POPULATION867 454 births (2009-2020), including 234 (0.03%) exposed to lithium during pregnancy.METHODSInverse probability weighted regression adjustment to investigate the association between maternal lithium use and perinatal outcomes.MAIN OUTCOME MEASURESSpontaneous preterm birth (< 37 weeks' gestation), large for gestational age (LGA) (birthweight > 90th percentile), macrosomia (birthweight > 4000 g), major congenital malformations, congenital cardiac malformations.RESULTSLithium use was associated a two-fold increased risk of spontaneous preterm birth compared with unexposed pregnancies (8.1% vs. 2.4%; adjusted relative risk [aRR] 2.18, 95% CI 1.45-3.30). Lithium was associated with an increased risk of an LGA infant (13.7% vs. 6.4%; aRR 1.94, 95% CI 1.36-2.76), and congenital cardiac malformations (3.0% vs. 0.8%; aRR 2.64, 95% CI 1.26-5.53). Lithium was not associated with an altered risk of major congenital malformations overall (aRR 1.51, 95% CI 0.92-2.50). Restricting the cohort to women with bipolar disorder or schizophrenia diagnoses, associations remained between lithium exposure and spontaneous preterm birth (aRR 1.88, 95% CI 1.06-3.32) and birth of an LGA infant (aRR 1.68, 95% CI 1.07-2.65).CONCLUSIONSIn our study, lithium exposure during pregnancy was associated with a two-fold increased risk of spontaneous preterm birth. Lithium use was also associated with an increased risk of cardiac malformations and having an LGA infant. These findings may be useful for shared decision-making around lithium use during pregnancy.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}