American Journal of Obstetrics & Gynecology
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© 2024 Published by Elsevier Inc. All rights reserved.
American Journal of Obstetrics & Gynecology
0002-9378
2024-03-29-07:00
© 2024 Published by Elsevier Inc. All rights reserved.
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Giant Nabothian Cysts Mimicking Genitourinary Fistula
https://www.ajog.org/article/S0002-9378(24)00474-5/fulltext?rss=yes
Giant Nabothian Cysts Mimicking Genitourinary Fistula
Daniel Lieberman, Catherine Seaman, Anna Romanova, Emile Gleeson, Lisa Dabney
10.1016/j.ajog.2024.03.038
American Journal of Obstetrics & Gynecology (2024)
2024-03-29
American Journal of Obstetrics & Gynecology
2024-03-29
Images in Gynecology
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Cervical atresia and an obliterated upper vagina presenting as primary amenorrhea
https://www.ajog.org/article/S0002-9378(24)00473-3/fulltext?rss=yes
Cervical atresia and an obliterated upper vagina presenting as primary amenorrhea
Rebecca J. MEISER, Toni S. HORTON, Aakriti R. CARRUBBA, Sherif A. EL-NASHAR, Anita H. CHEN
10.1016/j.ajog.2024.03.037
American Journal of Obstetrics & Gynecology (2024)
2024-03-28
American Journal of Obstetrics & Gynecology
2024-03-28
Images in Gynecology
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The association between postpartum depressive symptoms and contraception
https://www.ajog.org/article/S0002-9378(24)00472-1/fulltext?rss=yes
Postpartum depression affects 10-20% of birthing people and is associated with changes in healthcare utilization. Little is known about the association between postpartum depressive symptoms and choice to use contraception, however both un- or under-treated depression and short interpregnancy intervals pose significant perinatal health risks.
The association between postpartum depressive symptoms and contraception
Chloe N. MATOVINA, Allie SAKOWICZ, Emma C. ALLEN, Mayán I. ALVARADO-GOLDBERG, Danielle MILLAN, Emily S. MILLER
10.1016/j.ajog.2024.03.036
American Journal of Obstetrics & Gynecology (2024)
2024-03-26
American Journal of Obstetrics & Gynecology
2024-03-26
Original Research: Gynecology
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Cost-effectiveness analysis of expectant versus active management for treatment of persistent pregnancies of unknown location
https://www.ajog.org/article/S0002-9378(24)00471-X/fulltext?rss=yes
Persistent pregnancies of unknown location (PUL) are defined by abnormally trending serum human chorionic gonadotropin with nondiagnostic ultrasound. There is no consensus on optimal management.
Cost-effectiveness analysis of expectant versus active management for treatment of persistent pregnancies of unknown location
Jessica R. WALTER, Kurt T. BARNHART, Nathanael C. KOELPER, Nanette F. SANTORO, Heping ZHANG, Tracey R. THOMAS, Hao HUANG, Heidi S. HARVIE, NICHD Reproductive Medicine Network
10.1016/j.ajog.2024.03.035
American Journal of Obstetrics & Gynecology (2024)
2024-03-26
American Journal of Obstetrics & Gynecology
2024-03-26
Original Research: Gynecology
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Enduring Safety Concerns for Out-Of-Hospital Births in the United States
https://www.ajog.org/article/S0002-9378(24)00453-8/fulltext?rss=yes
Enduring Safety Concerns for Out-Of-Hospital Births in the United States
Amos Grünebaum, Frank A. Chervenak
10.1016/j.ajog.2024.03.024
American Journal of Obstetrics & Gynecology (2024)
2024-03-25
American Journal of Obstetrics & Gynecology
2024-03-25
Research Letter
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Defining Success After Surgical Treatment of Stress Urinary Incontinence
https://www.ajog.org/article/S0002-9378(24)00470-8/fulltext?rss=yes
A consensus standardized definition of success after stress urinary incontinence surgical treatment is lacking, which precludes comparisons between studies and affects patient counseling.
Defining Success After Surgical Treatment of Stress Urinary Incontinence
Rubin Raju, Annetta M. Madsen, Brian J. Linder, John A. Occhino, John B. Gebhart, Michaela E. McGree, Amy L. Weaver, Emanuel C. Trabuco
10.1016/j.ajog.2024.03.034
American Journal of Obstetrics & Gynecology (2024)
2024-03-23
American Journal of Obstetrics & Gynecology
2024-03-23
Original Research: Gynecology
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Embryo long-term storage does not affect ART outcome: analysis of 58001 vitrified blastocysts over an 11-year period.
https://www.ajog.org/article/S0002-9378(24)00469-1/fulltext?rss=yes
Recently the potential detrimental effect that the duration of storage time may have on vitrified samples has raised some concern, especially when some studies found an association between cryo-storage length and decreased clinical results.
Embryo long-term storage does not affect ART outcome: analysis of 58001 vitrified blastocysts over an 11-year period.
Ana COBO, Aila COELLO, María J. DE LOS SANTOS, Jose REMOHI, Jose BELLVER
10.1016/j.ajog.2024.03.033
American Journal of Obstetrics & Gynecology (2024)
2024-03-23
American Journal of Obstetrics & Gynecology
2024-03-23
Original Research: Gynecology
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Contribution of Fetal Blood Sampling to Determining the Prognosis of Congenital Cytomegalovirus Infections: A Case-Cohort Study in Switzerland.
https://www.ajog.org/article/S0002-9378(24)00468-X/fulltext?rss=yes
Cytomegalovirus is responsible for the most common congenital infection, affecting 0.5-1% of live births in Europe. Congenital CMV infection can be diagnosed during pregnancy by viral DNA amplification in the amniotic fluid, but the prognosis of fetuses without severe brain abnormalities remains difficult to establish based on prenatal imaging alone.
Contribution of Fetal Blood Sampling to Determining the Prognosis of Congenital Cytomegalovirus Infections: A Case-Cohort Study in Switzerland.
Léo POMAR, Agathe CONTIER, Milos STOJANOV, Cécile GUENOT, Joanna SICHITIU, Anita C. TRUTTMANN, Yvan VIAL, David BAUD
10.1016/j.ajog.2024.03.032
American Journal of Obstetrics & Gynecology (2024)
2024-03-23
American Journal of Obstetrics & Gynecology
2024-03-23
Original Research: Obstetrics
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Prediction of metabolic syndrome following a first pregnancy
https://www.ajog.org/article/S0002-9378(24)00460-5/fulltext?rss=yes
The prevalence of metabolic syndrome is rapidly increasing in the United States. We hypothesized that prediction models using data obtained during pregnancy can accurately predict the future development of metabolic syndrome.
Prediction of metabolic syndrome following a first pregnancy
Tetsuya KAWAKITA, Philip GREENLAND, Victoria L. PEMBERTON, William A. GROBMAN, Robert M. SILVER, C Noel Bairey MERZ, Rebecca B. MCNEIL, David M. HAAS, Uma M. REDDY, Hyagriv SIMHAN, George R. SAADE
10.1016/j.ajog.2024.03.031
American Journal of Obstetrics & Gynecology (2024)
2024-03-23
American Journal of Obstetrics & Gynecology
2024-03-23
Original Research: Obstetrics
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Discrete glucose profiles identified using continuous glucose monitoring data and their association with adverse pregnancy outcomes
https://www.ajog.org/article/S0002-9378(24)00455-1/fulltext?rss=yes
Continuous glucose monitoring (CGM) has facilitated the evaluation of dynamic changes in glucose throughout the day and their effect on fetal growth abnormalities in pregnancy. However, studies of multiple CGM metrics combined and their association with other adverse pregnancy outcomes are limited.
Discrete glucose profiles identified using continuous glucose monitoring data and their association with adverse pregnancy outcomes
Ashley N. BATTARBEE, Sara M. SAUER, Ayodeji SANUSI, Isabel FULCHER
10.1016/j.ajog.2024.03.026
American Journal of Obstetrics & Gynecology (2024)
2024-03-23
American Journal of Obstetrics & Gynecology
2024-03-23
Original Research: Obstetrics
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The Association between discordant umbilical arterial resistance in growth-restricted fetuses and adverse outcomes
https://www.ajog.org/article/S0002-9378(24)00454-X/fulltext?rss=yes
Assessing the umbilical artery pulsatility index (UA PI) via Doppler measurements plays a critical role in evaluating fetal growth impairment. This study aims to investigate perinatal outcomes associated with discordant PIs of umbilical arteries (UAs) in growth-restricted fetuses.
The Association between discordant umbilical arterial resistance in growth-restricted fetuses and adverse outcomes
Misgav Rottenstreich, Swati Agrawal, Homero Flores Mendoza, Sarah D. McDonald, Bryon DeFrance, Jon FR. Barrett, Eran Ashwal
10.1016/j.ajog.2024.03.025
American Journal of Obstetrics & Gynecology (2024)
2024-03-23
American Journal of Obstetrics & Gynecology
2024-03-23
Original Research: Obstetrics
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Duration of biophysical profile in periviable and very preterm low-risk pregnancies
https://www.ajog.org/article/S0002-9378(24)00449-6/fulltext?rss=yes
In recent years, perinatal viability has shifted from 24 to 22 weeks of gestation at many institutions after improvements in survival in neonates delivered at the limit of viability. Monitoring these fetuses is essential since antenatal interventions with resuscitation efforts are available for patients at risk of delivery at the limit of viability. However, fetal monitoring as biophysical profile has not been extensively studied in very preterm pregnancies, particularly in the periviable period (20 weeks 0 days – 23 weeks 6 days).
Duration of biophysical profile in periviable and very preterm low-risk pregnancies
Luis M. Gomez, Laura Willingham, Jenny Wang, Sebastian Nasrallah, Michael B. Vandillen, Giancarlo Mari
10.1016/j.ajog.2024.03.020
American Journal of Obstetrics & Gynecology (2024)
2024-03-23
American Journal of Obstetrics & Gynecology
2024-03-23
Original Research: Obstetrics
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Cefazolin as the Mainstay for Antibiotic Prophylaxis in Penicillin Allergic Patients in Obstetrics and Gynecology
https://www.ajog.org/article/S0002-9378(24)00448-4/fulltext?rss=yes
Cefazolin is the most common antibiotic used for prophylaxis in obstetrics and gynecology. Among those with a penicillin allergy, alternative antibiotics are often chosen for prophylaxis given fears of cross-reactivity between penicillin and cefazolin. Alternative antibiotics in this setting are associated with adverse sequalae including surgical site infection, induction of bacterial resistance, higher costs to the healthcare system, and possible Clostridium difficile infection. Given the difference in R1 side chains between the penicillin and cefazolin, cefazolin use is safe and should be recommended for penicillin allergic patients including those who experience IgE-mediated reactions such as anaphylaxis.
Cefazolin as the Mainstay for Antibiotic Prophylaxis in Penicillin Allergic Patients in Obstetrics and Gynecology
Karley J. Dutra, Gweneth B. Lazenby, Oluwatosin Goje, David E. SOPER
10.1016/j.ajog.2024.03.019
American Journal of Obstetrics & Gynecology (2024)
2024-03-23
American Journal of Obstetrics & Gynecology
2024-03-23
Clinical Opinion
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Cardiovascular protection by normotensive placental extracellular vesicles
https://www.ajog.org/article/S0002-9378(24)00459-9/fulltext?rss=yes
Cardiovascular protection by normotensive placental extracellular vesicles
Sandy Lau, Yourong Feng, Larry Chamley, Carolyn Barrett
10.1016/j.ajog.2024.03.030
American Journal of Obstetrics & Gynecology (2024)
2024-03-22
American Journal of Obstetrics & Gynecology
2024-03-22
Letter to the Editors
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Long-term cardiovascular protection by normotensive placental extracellular vesicles.
https://www.ajog.org/article/S0002-9378(24)00458-7/fulltext?rss=yes
Long-term cardiovascular protection by normotensive placental extracellular vesicles.
L. Carbillon
10.1016/j.ajog.2024.03.029
American Journal of Obstetrics & Gynecology (2024)
2024-03-22
American Journal of Obstetrics & Gynecology
2024-03-22
Letter to the Editors
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Magnesium sulfate prophylaxis for late-postpartum severe hypertension
https://www.ajog.org/article/S0002-9378(24)00457-5/fulltext?rss=yes
Magnesium sulfate prophylaxis for late-postpartum severe hypertension
Kristen Cagino, Malavika Prabhu, Baha Sibai
10.1016/j.ajog.2024.03.028
American Journal of Obstetrics & Gynecology (2024)
2024-03-22
American Journal of Obstetrics & Gynecology
2024-03-22
Letter to the Editors
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Duration of magnesium sulfate for late postpartum hypertension: Is 24 hours always necessary?
https://www.ajog.org/article/S0002-9378(24)00456-3/fulltext?rss=yes
Duration of magnesium sulfate for late postpartum hypertension: Is 24 hours always necessary?
Richard L. Fischer
10.1016/j.ajog.2024.03.027
American Journal of Obstetrics & Gynecology (2024)
2024-03-22
American Journal of Obstetrics & Gynecology
2024-03-22
Letter to the Editors
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The Effect of Subsequent Pregnancy and Childbirth on Stress Urinary Incontinence Recurrence Following Mid-Urethral Sling procedure: a response
https://www.ajog.org/article/S0002-9378(24)00452-6/fulltext?rss=yes
The Effect of Subsequent Pregnancy and Childbirth on Stress Urinary Incontinence Recurrence Following Mid-Urethral Sling procedure: a response
Chen Nahshon, Yoram Abramov, Ariel Zilberlicht
10.1016/j.ajog.2024.03.023
American Journal of Obstetrics & Gynecology (2024)
2024-03-22
American Journal of Obstetrics & Gynecology
2024-03-22
Letter to the Editors
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The Effect of Subsequent Pregnancy and Childbirth on Stress Urinary Incontinence Recurrence Following Mid-Urethral Sling procedure: A comment
https://www.ajog.org/article/S0002-9378(24)00451-4/fulltext?rss=yes
The Effect of Subsequent Pregnancy and Childbirth on Stress Urinary Incontinence Recurrence Following Mid-Urethral Sling procedure: A comment
Aisling A. Clancy, Jocelyn Stairs
10.1016/j.ajog.2024.03.022
American Journal of Obstetrics & Gynecology (2024)
2024-03-22
American Journal of Obstetrics & Gynecology
2024-03-22
Letter to the Editors
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The value of maternal echocardiography after delivery in patients with severe preeclampsia
https://www.ajog.org/article/S0002-9378(24)00450-2/fulltext?rss=yes
The value of maternal echocardiography after delivery in patients with severe preeclampsia
Agata Kantorowska, Anthony Marco Corbo, Meredith B. Akerman, George Gubernikoff, Wendy L. Kinzler, Anthony M. Vintzileos, Patricia Rekawek
10.1016/j.ajog.2024.03.021
American Journal of Obstetrics & Gynecology (2024)
2024-03-22
American Journal of Obstetrics & Gynecology
2024-03-22
Research Letter
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Preoperative free access to water compared to fasting for planned cesarean under spinal anesthesia: A randomized controlled trial
https://www.ajog.org/article/S0002-9378(24)00447-2/fulltext?rss=yes
Contemporary guidance for preoperative feeding allows solids up to six hours and clear fluid up to two hours before anesthesia. Clinical trial evidence to support this approach for cesarean section is lacking. Many medical practitioners continue to follow conservative policies of no intake from midnight to the time of surgery, especially in pregnant women.
Preoperative free access to water compared to fasting for planned cesarean under spinal anesthesia: A randomized controlled trial
Yee Ling Ng, Sabeetha Segaran, Carolyn Chue Wai Yim, Boon Kiong Lim, Mukhri Hamdan, Farah Gan, Peng Chiong Tan
10.1016/j.ajog.2024.03.018
American Journal of Obstetrics & Gynecology (2024)
2024-03-21
American Journal of Obstetrics & Gynecology
2024-03-21
Original Research: Obstetrics
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Reproductive and Obstetric Outcomes After Treatment of Retained Products of Conception: Hysteroscopic Removal Versus Ultrasound-Guided Electric Vacuum Aspiration, a prospective follow-up study
https://www.ajog.org/article/S0002-9378(24)00446-0/fulltext?rss=yes
Traditionally, curettage is the most widely performed surgical intervention used to remove retained products of conception. However, hysteroscopic removal is increasingly performed as an alternative due to the potentially lower risk of intrauterine adhesions and higher rates of complete removal. Until recently, studies comparing curettage with hysteroscopic removal regarding reproductive and obstetric outcomes were limited, and data conflicting.
Reproductive and Obstetric Outcomes After Treatment of Retained Products of Conception: Hysteroscopic Removal Versus Ultrasound-Guided Electric Vacuum Aspiration, a prospective follow-up study
Liselot P. Wagenaar, Wouter L.J. van Vugt, Aleida G. Huppelschoten, Celine M. Radder, Louisette W. Peters, Steven Weyers, Steffi van Wessel, Benedictus C. Schoot, Tjalina W.O. Hamerlynck, Huib A. van Vliet
10.1016/j.ajog.2024.03.017
American Journal of Obstetrics & Gynecology (2024)
2024-03-21
American Journal of Obstetrics & Gynecology
2024-03-21
Original Research: Gynecology
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Transcatheter arterial embolization outperforms surgery in reducing blood transfusions for postpartum vulvovaginal hematoma
https://www.ajog.org/article/S0002-9378(24)00445-9/fulltext?rss=yes
Postpartum vulvovaginal hematoma is a complication of vaginal delivery that may progress to life-threatening conditions. However, the management of hematomas, including conservative therapy, surgery, and arterial embolization, is yet to be standardized.
Transcatheter arterial embolization outperforms surgery in reducing blood transfusions for postpartum vulvovaginal hematoma
Tsukasa TAKAHASHI, Hasumi TOMITA, Hirotaka HAMADA, Mari TADAKAWA, Noriyuki IWAMA, Masatoshi SAITO
10.1016/j.ajog.2024.03.016
American Journal of Obstetrics & Gynecology (2024)
2024-03-20
American Journal of Obstetrics & Gynecology
2024-03-20
Original Research: Obstetrics
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Fetal fraction in noninvasive prenatal testing and adverse pregnancy outcomes
https://www.ajog.org/article/S0002-9378(24)00443-5/fulltext?rss=yes
Fetal fraction in noninvasive prenatal testing and adverse pregnancy outcomes
Lawrence M. PRENSKY
10.1016/j.ajog.2024.03.015
American Journal of Obstetrics & Gynecology (2024)
2024-03-18
American Journal of Obstetrics & Gynecology
2024-03-18
Letter to the Editors
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Fetal fraction in noninvasive prenatal testing and adverse pregnancy outcomes: a response
https://www.ajog.org/article/S0002-9378(24)00444-7/fulltext?rss=yes
Fetal fraction in noninvasive prenatal testing and adverse pregnancy outcomes: a response
Ellis C. Becking, Erik A. Sistermans, Mireille N. Bekker
10.1016/j.ajog.2024.03.014
American Journal of Obstetrics & Gynecology (2024)
2024-03-15
American Journal of Obstetrics & Gynecology
2024-03-15
Letter to the Editors
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Vasa Previa in Singleton Pregnancies: Diagnosis and Clinical Management Based on an International Expert Consensus
https://www.ajog.org/article/S0002-9378(24)00442-3/fulltext?rss=yes
There are limited data to guide the diagnosis and management of vasa previa. Currently, what is known is largely based on case reports or series and cohort studies.
Vasa Previa in Singleton Pregnancies: Diagnosis and Clinical Management Based on an International Expert Consensus
Yinka OYELESE, Ali JAVINANI, Brittany GUDANOWSKI, Eyal KRISPIN, Andrei REBARBER, Ranjit AKOLEKAR, Val CATANZARITE, Rohan D’SOUZA, Richard BRONSTEEN, Anthony ODIBO, Matthias A. SCHEIER, Junichi HASEGAWA, Eric JAUNIAUX, Christoph LEES, Deepa SRINIVASAN, Elizabeth DALY-JONES, Gregory DUNCOMBE, Yaacov MELCER, Ron MAYMON, Robert SILVER, Federico PREFUMO, Daisuke TACHIBANA, Wolfgang HENRICH, Robert CINCOTTA, Scott A. SHAINKER, Angela C. RANZINI, Ashley S. ROMAN, Ramen CHMAIT, Edgar A. HERNANDEZ-ANDRADE, Daniel L. ROLNIK, Waldo SEPULVEDA, Alireza A. SHAMSHIRSAZ
10.1016/j.ajog.2024.03.013
American Journal of Obstetrics & Gynecology (2024)
2024-03-15
American Journal of Obstetrics & Gynecology
2024-03-15
Original Research: Obstetrics
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Posttraumatic Stress Disorder 2 Months After Cesarean Delivery: a Multicenter Prospective Study
https://www.ajog.org/article/S0002-9378(24)00440-X/fulltext?rss=yes
The prevalence and risk factors of posttraumatic stress disorder (PTSD) after cesarean delivery, outside high-risk contexts, remain unclear
Posttraumatic Stress Disorder 2 Months After Cesarean Delivery: a Multicenter Prospective Study
Alizée FROELIGER, Catherine DENEUX-THARAUX, Lola LOUSSERT, Hugo MADAR, Loïc SENTILHES, Tranexamic Acid for Preventing Postpartum Hemorrhage after Cesarean Delivery (TRAAP2) trial study group
10.1016/j.ajog.2024.03.011
American Journal of Obstetrics & Gynecology (2024)
2024-03-15
American Journal of Obstetrics & Gynecology
2024-03-15
Original Research: Obstetrics
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Angiogenic and vasoactive proteins in the maternal-fetal interface in healthy pregnancies and preeclampsia
https://www.ajog.org/article/S0002-9378(24)00441-1/fulltext?rss=yes
Preeclampsia is characterized by maternal endothelial activation and placental dysfunction. Imbalance in maternal angiogenic and vasoactive factors has been linked to the pathophysiology. The contribution of the placenta as a source to these factors remains unclear. Furthermore, little is known about fetal angiogenic and vasoactive proteins and the relation between maternal and fetal levels.
Angiogenic and vasoactive proteins in the maternal-fetal interface in healthy pregnancies and preeclampsia
Ane Cecilie Westerberg, Maren-Helene Langeland Degnes, Ina Jungersen Andresen, Marie Cecilie Paasche Roland, Trond Melbye Michelsen
10.1016/j.ajog.2024.03.012
American Journal of Obstetrics & Gynecology (2024)
2024-03-14
American Journal of Obstetrics & Gynecology
2024-03-14
Original Research: Obstetrics
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Systemic Lupus Erythematosus is Associated With an Increased Frequency of Spontaneous Preterm Births: Systematic Review and Meta-analysis
https://www.ajog.org/article/S0002-9378(24)00439-3/fulltext?rss=yes
Preterm birth (PTB) is one of the most frequent complications of pregnancies in women with systemic lupus erythematosus (SLE). The high indicated PTB proportion due to hypertensive disorders of pregnancy and/or fetal growth restriction is well known, and preventive measures as well as screening for early detection are performed. The risk of spontaneous PTB is less well recognized. The purpose of this study is to determine the proportions of spontaneous and indicated PTB in pregnancies of women with SLE
Systemic Lupus Erythematosus is Associated With an Increased Frequency of Spontaneous Preterm Births: Systematic Review and Meta-analysis
Carolien N.H. ABHEIDEN, Birgit S. BLOMJOUS, Ciska SLAAGER, Anadeijda J.E. M.C. LANDMAN, Johannes C.F. KET, Jane E. SALMON, Jill P. BUYON, Martijn W. HEYMANS, Johanna I.P. DE VRIES, Irene E.M. BULTINK, Marjon A. DE BOER
10.1016/j.ajog.2024.03.010
American Journal of Obstetrics & Gynecology (2024)
2024-03-14
American Journal of Obstetrics & Gynecology
2024-03-14
Systematic Review
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The simultaneous occurrence of gestational diabetes and hypertensive disorders of pregnancy affects fetal growth and neonatal morbidity
https://www.ajog.org/article/S0002-9378(24)00438-1/fulltext?rss=yes
Gestational diabetes (GDM) is associated with an increased risk of hypertensive disorders of pregnancy (HDP), but there are limited data on fetal growth and neonatal outcomes when both conditions are present.
The simultaneous occurrence of gestational diabetes and hypertensive disorders of pregnancy affects fetal growth and neonatal morbidity
Chioma Onuoha, Carolin C.M. Schulte, Tanayott Thaweethai, Sarah Hsu, Deepti Pant, Kaitlyn E. James, Sarbattama Sen, Anjali Kaimal, Camille E. Powe
10.1016/j.ajog.2024.03.009
American Journal of Obstetrics & Gynecology (2024)
2024-03-14
American Journal of Obstetrics & Gynecology
2024-03-14
Original Research: Obstetrics
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Maternal mortality in the United States: are the high and rising rates due to changes in obstetrical factors, maternal medical conditions, or maternal mortality surveillance?
https://www.ajog.org/article/S0002-9378(24)00005-X/fulltext?rss=yes
National Vital Statistics System reports show that maternal mortality rates in the United States have nearly doubled, from 17.4 in 2018 to 32.9 per 100,000 live births in 2021. However, these high and rising rates could reflect issues unrelated to obstetrical factors, such as changes in maternal medical conditions or maternal mortality surveillance (eg, due to introduction of the pregnancy checkbox).
Maternal mortality in the United States: are the high and rising rates due to changes in obstetrical factors, maternal medical conditions, or maternal mortality surveillance?
K.S. Joseph, Sarka Lisonkova, Amélie Boutin, Giulia M. Muraca, Neda Razaz, Sid John, Yasser Sabr, Wee-Shian Chan, Azar Mehrabadi, Justin S. Brandt, Enrique F. Schisterman, Cande V. Ananth
10.1016/j.ajog.2023.12.038
American Journal of Obstetrics & Gynecology (2024)
2024-03-12
American Journal of Obstetrics & Gynecology
2024-03-12
Original Research
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A new technique to preserve the uterus in placenta accreta spectrum: a reply
https://www.ajog.org/article/S0002-9378(24)00437-X/fulltext?rss=yes
A new technique to preserve the uterus in placenta accreta spectrum: a reply
Sergey Barinov, Gian Carlo Di Renzo
10.1016/j.ajog.2024.03.008
American Journal of Obstetrics & Gynecology (2024)
2024-03-08
American Journal of Obstetrics & Gynecology
2024-03-08
Letter to the Editors
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A new technique to preserve the uterus in placenta accreta spectrum
https://www.ajog.org/article/S0002-9378(24)00436-8/fulltext?rss=yes
Barinov and Renzo1 introduced a technique for preserving the uterus in patients with placenta accreta spectrum disorders (PAS). Although this technique proved to be effective and provided a good treatment for PAS, we would like to add a few comments.
A new technique to preserve the uterus in placenta accreta spectrum
Baihui Zhao, Jiamin Chen, Qiong Luo
10.1016/j.ajog.2024.03.007
American Journal of Obstetrics & Gynecology (2024)
2024-03-08
American Journal of Obstetrics & Gynecology
2024-03-08
Letter to the Editors
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Lichen Planus Follicularis Tumidus of the Vulva
https://www.ajog.org/article/S0002-9378(24)00433-2/fulltext?rss=yes
Lichen Planus Follicularis Tumidus of the Vulva
Denali E. TERMIN, Kathryn C. WELCH, Hope K. HAEFNER, Lynette J. MARGESSON, Maxwell D. WANG, Natalie A. SAUNDERS, Ebony C. PARKER-FEATHERSTONE
10.1016/j.ajog.2024.03.004
American Journal of Obstetrics & Gynecology (2024)
2024-03-08
American Journal of Obstetrics & Gynecology
2024-03-08
Images in Gynecology
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Pregnancies complicated by bulimia nervosa are at increased risk of chorioamnionitis, anemia, and preterm birth
https://www.ajog.org/article/S0002-9378(24)00435-6/fulltext?rss=yes
Previous investigations into the risk of adverse pregnancy outcome among people with bulimia nervosa have been largely limited to outcomes such as preterm birth and poor fetal growth.1,2 In this study, we aimed to investigate the risk for a wide array of adverse pregnancy outcomes among people with bulimia nervosa using an adjustment analysis to account for maternal confounding factors.
Pregnancies complicated by bulimia nervosa are at increased risk of chorioamnionitis, anemia, and preterm birth
Rebecca J. Baer, Gretchen Bandoli, Laura L. Jelliffe-Pawlowski, Kyung E. Rhee, Christina D. Chambers
10.1016/j.ajog.2024.03.006
American Journal of Obstetrics & Gynecology (2024)
2024-03-07
American Journal of Obstetrics & Gynecology
2024-03-07
Research Letter
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Plasma proteins and persistent post-surgical pelvic pain among adolescents and young adults with endometriosis
https://www.ajog.org/article/S0002-9378(24)00434-4/fulltext?rss=yes
Non-invasive biomarkers that predict surgical treatment response would inform personalized treatments and provide insight into potential biological pathways underlying endometriosis-associated pain and symptom progression. Thus, we evaluated plasma proteins in relation to persistence of pelvic pain following laparoscopic surgery in predominantly adolescents and young adults with endometriosis using a multiplex aptamer-based proteomics biomarker discovery platform.
Plasma proteins and persistent post-surgical pelvic pain among adolescents and young adults with endometriosis
Naoko Sasamoto, Long Ngo, Allison F. Vitonis, Simon T. Dillon, Pooja Prasad, Marc R. Laufer, Sawsan As-Sanie, Andrew Schrepf, Stacey A. Missmer, Towia A. Libermann, Kathryn L. Terry
10.1016/j.ajog.2024.03.005
American Journal of Obstetrics & Gynecology (2024)
2024-03-07
American Journal of Obstetrics & Gynecology
2024-03-07
Original Research: Gynecology
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Racial and ethnic differences in early-death among gynecologic malignancy
https://www.ajog.org/article/S0002-9378(24)00432-0/fulltext?rss=yes
Racial and ethnic differences in early-death following cancer diagnosis have not been well studied in gynecologic malignancy.
Racial and ethnic differences in early-death among gynecologic malignancy
Matthew W. Lee, Andrew Vallejo, Katelyn B. Furey, Sabrina M. Woll, Maximilian Klar, Lynda D. Roman, Jason D. Wright, Koji Matsuo
10.1016/j.ajog.2024.03.003
American Journal of Obstetrics & Gynecology (2024)
2024-03-06
American Journal of Obstetrics & Gynecology
2024-03-06
Original Research: Gynecology
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Birth Weights at Term Have Increased Globally: Insights from a Systematic Review of 183 Million Births
https://www.ajog.org/article/S0002-9378(24)00431-9/fulltext?rss=yes
To assess global trends in mean birth weights at term, as reported in peer-reviewed literature.
Birth Weights at Term Have Increased Globally: Insights from a Systematic Review of 183 Million Births
Giulia BONANNI, Chiara AIROLDI, Vincenzo BERGHELLA
10.1016/j.ajog.2024.03.002
American Journal of Obstetrics & Gynecology (2024)
2024-03-06
American Journal of Obstetrics & Gynecology
2024-03-06
Systematic Review
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Metformin in pregnancy and childhood neurodevelopmental outcomes: a systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(24)00430-7/fulltext?rss=yes
To examine the impact of maternal metformin use in pregnancy on offspring neurodevelopmental outcomes.
Metformin in pregnancy and childhood neurodevelopmental outcomes: a systematic review and meta-analysis
Hannah G. GORDON, Jessica A. ATKINSON, Stephen TONG, Parinaz MEHDIPOUR, Catherine CLUVER, Susan P. WALKER, Anthea C. LINDQUIST, Roxanne M. HASTIE
10.1016/j.ajog.2024.02.316
American Journal of Obstetrics & Gynecology (2024)
2024-03-06
American Journal of Obstetrics & Gynecology
2024-03-06
Systematic Review
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A Randomized Trial of Double Verses Single-Dose Etonogestrel Implant to Overcome the Interaction with Efavirenz-Based Antiretroviral Therapy
https://www.ajog.org/article/S0002-9378(24)00424-1/fulltext?rss=yes
Concomitant use of efavirenz-based antiretroviral therapy and a standard-dose etonogestrel contraceptive implant resulted in 82% lower etonogestrel exposure compared to women not receiving antiretroviral therapy. The clinical impact of this reduced exposure is supported by retrospective cohort evaluations which demonstrated higher rates of unintended pregnancies when contraceptive implants were combined with efavirenz. We hypothesized that placement of two etonogestrel implants in those taking efavirenz-based antiretroviral therapy could increase etonogestrel exposure and improve measures of contraceptive efficacy.
A Randomized Trial of Double Verses Single-Dose Etonogestrel Implant to Overcome the Interaction with Efavirenz-Based Antiretroviral Therapy
Catherine A. CHAPPELL, Mohammed LAMORDE, Shadia NAKALEMA, Isabella KYOHAIRWE, Pauline BYAKIKA-KIBWIKA, Leslie A. MEYN, Michelle M. PHAM, Kimberly K. SCARSI
10.1016/j.ajog.2024.03.001
American Journal of Obstetrics & Gynecology (2024)
2024-03-06
American Journal of Obstetrics & Gynecology
2024-03-06
Original Research: Gynecology
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Sexual orientation disparities in adverse pregnancy outcomes
https://www.ajog.org/article/S0002-9378(24)00429-0/fulltext?rss=yes
Sexual orientation disparities in adverse pregnancy outcomes
Payal CHAKRABORTY, Ellis SCHROEDER, Colleen A. REYNOLDS, Sarah MCKETTA, Juno OBEDIN-MALIVER, S. Bryn AUSTIN, Bethany EVERETT, Sebastien HANEUSE, Brittany M. CHARLTON
10.1016/j.ajog.2024.02.315
American Journal of Obstetrics & Gynecology (2024)
2024-03-05
American Journal of Obstetrics & Gynecology
2024-03-05
Research Letter
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Maternal heart rate decelerations in cardiotocography as a warning sign of uterine rupture
https://www.ajog.org/article/S0002-9378(24)00428-9/fulltext?rss=yes
We thank Dall’Asta et al1 for their thorough letter to the editors in response to our original research article.1,2 We greatly appreciate the continued interest and dialogue regarding the safety of maternal-fetal surveillance.
Maternal heart rate decelerations in cardiotocography as a warning sign of uterine rupture
Mikko Tarvonen, Vedran Stefanovic, Sture Andersson
10.1016/j.ajog.2024.02.314
American Journal of Obstetrics & Gynecology (2024)
2024-03-05
American Journal of Obstetrics & Gynecology
2024-03-05
Letter to the Editors
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Added value of intrapartum recording of the maternal heart rate as an adjunct to fetal monitoring using external ultrasound transducer: not only about artifacts.
https://www.ajog.org/article/S0002-9378(24)00427-7/fulltext?rss=yes
Added value of intrapartum recording of the maternal heart rate as an adjunct to fetal monitoring using external ultrasound transducer: not only about artifacts.
Andrea Dall’Asta, Lavinia Volpi, Giovanni Morganelli, Tullio Ghi
10.1016/j.ajog.2024.02.313
American Journal of Obstetrics & Gynecology (2024)
2024-03-05
American Journal of Obstetrics & Gynecology
2024-03-05
Letter to the Editors
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Hysterotomy closure at cesarean, beyond the number of layers; a response
https://www.ajog.org/article/S0002-9378(24)00426-5/fulltext?rss=yes
Hysterotomy closure at cesarean, beyond the number of layers; a response
Carry Verberkt, Sanne I. Stegwee, Judith AF. Huirne
10.1016/j.ajog.2024.02.312
American Journal of Obstetrics & Gynecology (2024)
2024-03-05
American Journal of Obstetrics & Gynecology
2024-03-05
Letter to the Editors
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Hysterotomy closure at cesarean: beyond the number of layers
https://www.ajog.org/article/S0002-9378(24)00425-3/fulltext?rss=yes
We read with great interest the results of the randomized trial (2Close study) by Verberkt et al1 comparing 1- and 2-layer uterine closure at cesarean. Although we can appreciate the importance of this trial, we cannot agree with the authors’ conclusion suggesting that surgeons can choose their preferred technique because the type of closure has little impact on future pregnancy outcomes. We believe that the only conclusion that can be drawn is that a 2-layer closure including the endometrium is not associated with improved outcomes.
Hysterotomy closure at cesarean: beyond the number of layers
Sarah Maheux-Lacroix, Emmanuel Bujold
10.1016/j.ajog.2024.02.311
American Journal of Obstetrics & Gynecology (2024)
2024-03-05
American Journal of Obstetrics & Gynecology
2024-03-05
Letter to the Editors
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Urinary incontinence increases risk of postpartum depression: systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(24)00419-8/fulltext?rss=yes
Postpartum depression is one of the most common complications after childbearing. Urinary incontinence is a frequent symptom during pregnancy and the postnatal period, often being the first time that women experience it. This systematic review and meta-analysis aimed to synthesize the evidence on the association between urinary incontinence and postpartum depression and to assess whether this association becomes weaker at 6 months after childbirth.
Urinary incontinence increases risk of postpartum depression: systematic review and meta-analysis
Cristina Gallego-Gómez, Eva Rodríguez-Gutiérrez, Ana Torres-Costoso, Vicente Martínez-Vizcaíno, Sandra Martínez-Bustelo, Claudia Andrea Quezada-Bascuñán, Asunción Ferri-Morales
10.1016/j.ajog.2024.02.307
American Journal of Obstetrics & Gynecology (2024)
2024-03-02
American Journal of Obstetrics & Gynecology
2024-03-02
Systematic Review
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Association of previous stillbirth with subsequent perinatal outcomes: a systematic review and meta-analysis of cohort studies
https://www.ajog.org/article/S0002-9378(24)00418-6/fulltext?rss=yes
We conducted a systematic review and meta-analysis to examine the relationship between stillbirth and various perinatal outcomes in subsequent pregnancy.
Association of previous stillbirth with subsequent perinatal outcomes: a systematic review and meta-analysis of cohort studies
Xiyuan Deng, Bei Pan, Honghao Lai, Qingmei Sun, Xiaojuan Lin, Jinwei Yang, Xin Han, Tingting Ge, Qiuyuan Li, Long Ge, Xiaowei Liu, Ning Ma, Xiaoman Wang, Dan Li, Yongxiu Yang, Kehu Yang
10.1016/j.ajog.2024.02.304
American Journal of Obstetrics & Gynecology (2024)
2024-03-02
American Journal of Obstetrics & Gynecology
2024-03-02
Systematic Review
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Prospective first-trimester transvaginal 3-dimensional power Doppler and hysterectomy association in placenta accreta spectrum
https://www.ajog.org/article/S0002-9378(24)00423-X/fulltext?rss=yes
With rising cesarean delivery rates, there has been a concomitant increase in placenta accreta spectrum (PAS), now occurring in up to 1 in 272 pregnant people.1 Prenatal diagnosis is vital for optimized multidisciplinary care.2 Early identification facilitates timely referral to level III and IV centers.3 Abnormal retroplacental vessels and intraplacental lacunae along the bladder-serosal interface are often observed in PAS and require hysterectomy. We found that color Doppler mapping in the first trimester correlated with the outcome of hysterectomy in patients at risk for PAS.
Prospective first-trimester transvaginal 3-dimensional power Doppler and hysterectomy association in placenta accreta spectrum
Christina L. Herrera, Quyen N. Do, Yin Xi, Catherine Y. Spong, Diane M. Twickler
10.1016/j.ajog.2024.02.310
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Research Letter
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Educational Guidelines on Sexual Orientation, Gender Identity and Expression and Sex Characteristics (SOGIESC) Biases in Medical Education
https://www.ajog.org/article/S0002-9378(24)00422-8/fulltext?rss=yes
A commitment to diversity, equity, inclusion, and belonging in medical education requires addressing both explicit and implicit biases based on sexual orientation, gender identity and expression and sex characteristics (SOGIESC) and the intersectionality with other identities. Heterosexism and heteronormative attitudes contribute to health and health care disparities for lesbian, gay, bisexual, transgender and queer/questioning, intersex, asexual (LGBTQIA) individuals. Student, trainee, and faculty competencies in medical education curricula regarding the care of LGBTQIA patients and those who are gender nonconforming or born with differences of sex development allow for better understanding and belonging within the clinical learning environment of LGBTQIA learners and educators.
Educational Guidelines on Sexual Orientation, Gender Identity and Expression and Sex Characteristics (SOGIESC) Biases in Medical Education
Camille A. CLARE, Mark B. WOODLAND, Samantha BUERY-JOYNER, Sara WHETSTONE, Dotun OGUNYEMI, Shireen Madani SIMS, Michael MOXLEY, Laura E. BAECHER-LIND, B. Star HAMPTON, Archana PRADHAN, Nadine T. KATZ
10.1016/j.ajog.2024.02.309
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Expert Review
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Delivery at an inadequate level of maternal care is associated with severe maternal morbidity
https://www.ajog.org/article/S0002-9378(24)00421-6/fulltext?rss=yes
Implementing levels of maternal care is one strategy proposed to reduce maternal morbidity and mortality. The levels of maternal care framework outline individual medical and obstetric comorbidities, along with hospital resources required for individuals with these different comorbidities to deliver safely. The overall goal is to match individuals to hospitals, so all birthing people get appropriate resources and personnel during delivery to reduce maternal morbidity.
Delivery at an inadequate level of maternal care is associated with severe maternal morbidity
Godwin K. OSEI-POKU, Julia C. PRENTICE, Sarah Rae EASTER, Hafsatou DIOP
10.1016/j.ajog.2024.02.308
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Original Research: Obstetrics
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Longitudinal study of cognitive decline among women with and without urinary incontinence
https://www.ajog.org/article/S0002-9378(24)00417-4/fulltext?rss=yes
Cross-sectional and short-term cohort studies have demonstrated an association between urinary incontinence and dementia as well as lower performance on cognitive testing. The Health and Retirement Study, a longitudinal study of community-dwelling older adults, offers an opportunity to assess the temporal association between these conditions, as this study included an assessment of incontinence symptoms as well as biennial assessments of cognitive function.
Longitudinal study of cognitive decline among women with and without urinary incontinence
Rachel A. High, Miriam Alvarez, Brachel Champion, Jennifer Anger, Victoria L. Handa
10.1016/j.ajog.2024.02.305
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Original Research: Gynecology
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Periodic Mobile Application (eMOM) With Self-Tracking of Glucose and Lifestyle Improves Treatment of Diet-Controlled Gestational Diabetes Without Human Guidance: A Randomized Controlled Trial
https://www.ajog.org/article/S0002-9378(24)00416-2/fulltext?rss=yes
Digitalization with minimal human resources could support self-management in women with gestational diabetes (GDM) and improve maternal and neonatal outcomes.
Periodic Mobile Application (eMOM) With Self-Tracking of Glucose and Lifestyle Improves Treatment of Diet-Controlled Gestational Diabetes Without Human Guidance: A Randomized Controlled Trial
Mikko KYTÖ, Shinji HOTTA, Sari NIINISTÖ, Pekka MARTTINEN, Tuuli E. KORHONEN, Lisa T. MARKUSSEN, Giulio JACUCCI, Harri SIEVÄNEN, Henri VÄHÄ-YPYÄ, Ilkka KORHONEN, Suvi VIRTANEN, Seppo HEINONEN, Saila B. KOIVUSALO
10.1016/j.ajog.2024.02.303
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Original Research: Obstetrics
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A modified diffusion-weighted MRI-based model from the radiologist’s perspective: improved performance in determining the surgical resectability for advanced high-grade serous ovarian cancer
https://www.ajog.org/article/S0002-9378(24)00415-0/fulltext?rss=yes
Complete resection of all visible lesions during primary debulking surgery is associated with the most favorable prognosis in patients with advanced high-grade serous ovarian cancer. An accurate preoperative assessment of resectability is pivotal for tailored management.
A modified diffusion-weighted MRI-based model from the radiologist’s perspective: improved performance in determining the surgical resectability for advanced high-grade serous ovarian cancer
Jing LU, Qinhao GUO, Ya ZHANG, Shuhui ZHAO, Ruimin LI, Yi FU, Zheng FENG, Yong WU, Rong LI, Xiaojie LI, Jinwei QIANG, Xiaohua WU, Yajia GU, Haiming LI
10.1016/j.ajog.2024.02.302
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Original Research: Gynecology
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A sonographic endometrial thickness <7mm in women undergoing in-vitro fertilization increases the risk of placenta accreta spectrum
https://www.ajog.org/article/S0002-9378(24)00414-9/fulltext?rss=yes
The prevalence of placenta accreta spectrum (PAS), a potentially life-threatening condition, has exhibited a significant global rise in recent decades. Effective screening methods and early identification strategies for PAS could enable early treatment and improved outcomes. Endometrial thickness (EMT) plays a crucial role in successful embryo implantation and favorable pregnancy outcomes. Extensive research has been conducted on the impact of EMT on assisted reproductive technology cycles, specifically in terms of pregnancy rates, live birth rates, and pregnancy loss rates.
A sonographic endometrial thickness <7mm in women undergoing in-vitro fertilization increases the risk of placenta accreta spectrum
Siying Lai, Lizi Zhang, Yang Luo, Zhongjia Gu, Zhenping Yan, Yuliang Zhang, Yingyu Liang, Minshan Huang, Jingying Liang, Shifeng Gu, Jingsi Chen, Lei Li, Dunjin Chen, Lili Du
10.1016/j.ajog.2024.02.301
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Original Research: Obstetrics
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The latency interval in preterm prelabor rupture of membranes correlates with the sFlt-1/PlGF ratio
https://www.ajog.org/article/S0002-9378(24)00413-7/fulltext?rss=yes
The latency interval in preterm prelabor rupture of membranes correlates with the sFlt-1/PlGF ratio
Ivana Musilova, Ladislava Pavlikova, Magdalena Holeckova, Jan Kremlacek, Bo Jacobsson, Marian Kacerovsky
10.1016/j.ajog.2024.02.300
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Research Letter
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The Role of cfDNA Biomarkers and Patient Data in the Early Prediction of Preeclampsia: Artificial Intelligence Model
https://www.ajog.org/article/S0002-9378(24)00380-6/fulltext?rss=yes
Accurate individualized assessment of preeclampsia risk enables the identification of patients most likely to benefit from initiation of low-dose aspirin at 12-16 weeks’ gestation when there is evidence for its effectiveness, as well as guiding appropriate pregnancy care pathways and surveillance. The primary objective of this study was to evaluate the performance of artificial neural network models for the prediction of preterm preeclampsia (<37 weeks’ gestation) using patient characteristics available at the first antenatal visit and data from prenatal cell-free DNA (cfDNA) screening.
The Role of cfDNA Biomarkers and Patient Data in the Early Prediction of Preeclampsia: Artificial Intelligence Model
Asma Khalil, Giovanni Bellesia, Mary E. Norton, Bo Jacobsson, Sina Haeri, Melissa Egbert, Fergal D. Malone, Ronald J. Wapner, Ashley Roman, Revital Faro, Rajeevi Madankumar, Noel Strong, Robert M. Silver, Nidhi Vohra, Jon Hyett, Cora Macpherson, Brittany Prigmore, Ebad Ahmed, Zach Demko, J. Bryce Ortiz, Vivienne Souter, Pe’er Dar
10.1016/j.ajog.2024.02.299
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Original Research: Obstetrics
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Is it time to end the use of base deficit for fetal well-being assessment?
https://www.ajog.org/article/S0002-9378(24)00379-X/fulltext?rss=yes
Authors have expressed reservations regarding the use of base deficit on umbilical artery blood samples to assess fetal well-being during the course of labor and predict neonatal neurological morbidity. Despite its integration into clinical practice for over fifty years, obstetricians and maternal fetal medicine specialists may not realize that this marker has significant limitations in accurately assess identifying neonatal metabolic acidosis as a proxy of fetal well-being. In brief, there are two large family of base deficit: whole blood and extracellular fluid.
Is it time to end the use of base deficit for fetal well-being assessment?
Thierry Daboval, Paul Ouellet, Claude Racinet
10.1016/j.ajog.2024.01.031
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Clinical Opinion
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Posterior reversible encephalopathy syndrome following eclampsia: Assessment of clinical and pregnancy characteristics
https://www.ajog.org/article/S0002-9378(24)00378-8/fulltext?rss=yes
Posterior reversible encephalopathy syndrome following eclampsia: Assessment of clinical and pregnancy characteristics
Erin Yu, Jessica M. Green, Laurel S. Aberle, Rachel S. Mandelbaum, Doerthe Brueggmann, Joseph G. Ouzounian, Koji Matsuo
10.1016/j.ajog.2024.02.298
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Research Letter
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Attention-Deficit / Hyperactivity Disorder in pregnancy and the postpartum period
https://www.ajog.org/article/S0002-9378(24)00376-4/fulltext?rss=yes
Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder that frequently persists into adulthood, with 3% of adult women having a diagnosis of ADHD. Many women are diagnosed and treated during their reproductive years, resulting in management implications across pregnancy and postpartum. We know from clinical practice that ADHD symptoms frequently become challenging to manage during the perinatal period, requiring additional support and attention. There is often uncertainty among healthcare providers regarding the management of ADHD in the perinatal period, particularly the safety of pharmacotherapy for the developing fetus.
Attention-Deficit / Hyperactivity Disorder in pregnancy and the postpartum period
Olivia SCOTEN, Katarina TABI, Vanessa PAQUETTE, Prescilla CARRION, Deirdre RYAN, Nevena V. RADONJIC, Elizabeth A. WHITHAM, Catriona HIPPMAN
10.1016/j.ajog.2024.02.297
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Expert Review
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Reducing maternal mortality in low- and middle-income countries: the Nepalese approach of helicopter retrieval
https://www.ajog.org/article/S0002-9378(24)00067-X/fulltext?rss=yes
Ninety-four percent of global maternal deaths occur in low- and middle-income countries (LMICs). The UN has a goal of reducing maternal deaths to <70 per 100,000 live births by 2030, but progress is minimal. Maternal deaths in LMICs are associated with 3 delays in the care of women with obstetrical emergencies: 1) in the family of the woman realizing that her life is at risk, 2) in the transport of the woman to a hospital, and 3) in providing care after arrival at the hospital. These 3 delays function like links in a chain, and failure of any link leads to maternal death.
Reducing maternal mortality in low- and middle-income countries: the Nepalese approach of helicopter retrieval
Binod Bindu Sharma, Craig Pennell, Biraj Sharma, Roger Smith
10.1016/j.ajog.2024.01.026
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Special Report
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April 2023 (vol. 228, no. 4, page 453.e6)
https://www.ajog.org/article/S0002-9378(23)00307-1/fulltext?rss=yes
Danaher BG, Seeley JR, Silver RK, et al. Trial of a patient-directed eHealth program to ameliorate perinatal depression: the MomMoodBooster2 practical effectiveness study. Am J Obstet Gynecol 2023;228:453.e1-10.
April 2023 (vol. 228, no. 4, page 453.e6)
10.1016/j.ajog.2023.04.048
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Correction
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June 2022 (vol. 226, no. 6, page 775)
https://www.ajog.org/article/S0002-9378(23)00250-8/fulltext?rss=yes
Fang NZ, Advaney SP, Castaño PM, et al. Female permanent contraception trends and updates. Am J Obstet Gynecol 2022;226:773-80.
June 2022 (vol. 226, no. 6, page 775)
10.1016/j.ajog.2023.04.019
American Journal of Obstetrics & Gynecology (2024)
2024-03-01
American Journal of Obstetrics & Gynecology
2024-03-01
Correction
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Synthetic versus non-synthetic slings for female stress and mixed urinary incontinence: A systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(24)00420-4/fulltext?rss=yes
To systematically review objective and subjective success, and surgical outcomes of sub-urethral sling surgery for female patients with stress or mixed urinary incontinence (SUI, MUI) using synthetic vs. non-synthetic material with corresponding surgical approach (retropubic, RP or transobturator, TO).
Synthetic versus non-synthetic slings for female stress and mixed urinary incontinence: A systematic review and meta-analysis
Maryse LAROUCHE, Mei Mu Zi ZHENG, Emily C. YANG, Rea Konci, Eric BELZILE, Prubjot Kaur GILL, Roxana GEOFFRION
10.1016/j.ajog.2024.02.306
American Journal of Obstetrics & Gynecology (2024)
2024-02-29
American Journal of Obstetrics & Gynecology
2024-02-29
Original Research: Gynecology
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Oxygen saturation during a cesarean identified patients at risk for postpartum hemorrhage
https://www.ajog.org/article/S0002-9378(24)00375-2/fulltext?rss=yes
Early recognition of postpartum hemorrhage (PPH) and the decision to transfuse is challenging.1 Laboratory hemoglobin (Hgb) measurement is the gold standard for the assessment of anemia. Although a preferred method for hemodynamically stable patients, this remains time-consuming, invasive, and intermittent in nature. More often, acute clinical changes in the blood volume are assessed by changes in vital signs and the quantification of blood loss (QBL), which has shown to be less accurate in cesarean deliveries with substantial blood loss.
Oxygen saturation during a cesarean identified patients at risk for postpartum hemorrhage
Megan Ebner, Sean M. Lee, Emma K. Sterling, Alexandra Nesson, Sophia A. Cordes, Mina Felfeli, Jim Slota, Jeffrey S. Berger, Homa K. Ahmadzia
10.1016/j.ajog.2024.02.295
American Journal of Obstetrics & Gynecology (2024)
2024-02-27
American Journal of Obstetrics & Gynecology
2024-02-27
Research Letter
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Impact of the COVID-19 pandemic on fellowship research
https://www.ajog.org/article/S0002-9378(24)00374-0/fulltext?rss=yes
The start of 2020 brought on a new pandemic in the form of COVID-19 (SARS-CoV-2) during which our nation witnessed a large disruption in the balance of scheduled activities within surgical fellowship training programs.1,2 Unprecedented challenges and disturbances in physician training as a consequence of the pandemic have been documented across the world by multiple studies in various specialties.3,4 Obstetrics-gynecology program requirements and certification standards include a minimum of 12 months of protected research within the 4 subspecialties.
Impact of the COVID-19 pandemic on fellowship research
Pooja Shivraj, Rajat Chadha, Heath Kincaid, Anthony Sparks, Amanda Novak, George D. Wendel
10.1016/j.ajog.2024.02.294
American Journal of Obstetrics & Gynecology (2024)
2024-02-27
American Journal of Obstetrics & Gynecology
2024-02-27
Research Letter
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Chronic Vulvar Aphthous Ulcer in Crohn’s Disease
https://www.ajog.org/article/S0002-9378(24)00373-9/fulltext?rss=yes
Chronic Vulvar Aphthous Ulcer in Crohn’s Disease
Shivani Jain, Jennifer Foster, Melissa M. Mauksar
10.1016/j.ajog.2024.02.293
American Journal of Obstetrics & Gynecology (2024)
2024-02-27
American Journal of Obstetrics & Gynecology
2024-02-27
Images in Gynecology
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Piperacillin-tazobactam compared with ampicillin-gentamicin for intraamniotic infection: a noninferior and propensity-matched analysis
https://www.ajog.org/article/S0002-9378(24)00371-5/fulltext?rss=yes
Intrapartum antibiotic therapy is the mainstay of treatment for intraamniotic infection (IAI) and reduces maternal and neonatal morbidity.1–5 There are few direct comparisons of intrapartum antibiotic regimens for treating IAI.2–4 The American College of Obstetricians and Gynecologists recommends ampicillin-gentamicin for the management of IAI and suggests alternative regimens, including piperacillin-tazobactam. During a national shortage of gentamicin in 2021, piperacillin-tazobactam was selected as the preferred IAI regimen at our institution because of expanded anaerobic coverage and lower institutional cost ($12.30 vs $29.64).
Piperacillin-tazobactam compared with ampicillin-gentamicin for intraamniotic infection: a noninferior and propensity-matched analysis
Kathryn Anderson, Matthew Scarpaci, Erica Hardy, Catherine Li, Adam K. Lewkowitz, Dwight J. Rouse, Brock E. Polnaszek
10.1016/j.ajog.2024.02.290
American Journal of Obstetrics & Gynecology (2024)
2024-02-27
American Journal of Obstetrics & Gynecology
2024-02-27
Research Letter
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Placental differences between severe fetal growth restriction and hypertensive disorders of pregnancy requiring early preterm delivery: Morphometric analysis of the villous tree supported by artificial intelligence
https://www.ajog.org/article/S0002-9378(24)00370-3/fulltext?rss=yes
The “great obstetrical syndromes” of fetal growth restriction and hypertensive disorders of pregnancy can occur individually or be interrelated. Placental pathologic findings often overlap between these conditions, regardless of whether one or both diagnoses are present. Quantification of placental villous structures in each of these settings may identify distinct differences in developmental pathways.
Placental differences between severe fetal growth restriction and hypertensive disorders of pregnancy requiring early preterm delivery: Morphometric analysis of the villous tree supported by artificial intelligence
Anna Jacobs, Saif I. Al-Juboori, Evgenia Dobrinskikh, Matthew A. Bolt, Mary D. Sammel, Virginia Lijewski, Miriam D. Post, James M. Small, Emily J. Su
10.1016/j.ajog.2024.02.291
American Journal of Obstetrics & Gynecology (2024)
2024-02-27
American Journal of Obstetrics & Gynecology
2024-02-27
Original Research: Obstetrics
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TEMPORARY REMOVAL: New labor curves of dilation and station to improve the accuracy of predicting labor progress
https://www.ajog.org/article/S0002-9378(24)00369-7/fulltext?rss=yes
TEMPORARY REMOVAL: New labor curves of dilation and station to improve the accuracy of predicting labor progress
Emily F. Hamilton, Tilekbek Zhoroev, Philip A. Warrick, Adi L. Tarca, Thomas J. Garite, Aaron B. Caughey, Jason Melillo, Mona Prasad, Duncan Neilson, Peter Singson, Kimberlee Mckay, Roberto Romero
10.1016/j.ajog.2024.02.289
American Journal of Obstetrics & Gynecology (2024)
2024-02-27
American Journal of Obstetrics & Gynecology
2024-02-27
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Society for Maternal-Fetal Medicine Statement: RhD immune globulin after spontaneous or induced abortion at less than 12 weeks of gestation
https://www.ajog.org/article/S0002-9378(24)00368-5/fulltext?rss=yes
Guidelines for the management of first-trimester spontaneous and induced abortion vary in terms of rhesus factor D (RhD) testing and RhD immune globulin (RhIg) administration. These existing guidelines are based on limited data that do not convincingly demonstrate the safety of withholding RhIg for first-trimester abortions or pregnancy losses. Given the adverse fetal and neonatal outcomes associated with RhD alloimmunization, prevention of maternal sensitization is essential in RhD–negative patients who may experience subsequent pregnancies.
Society for Maternal-Fetal Medicine Statement: RhD immune globulin after spontaneous or induced abortion at less than 12 weeks of gestation
Society for Maternal-Fetal Medicine, Malavika Prabhu, Judette M. Louis, Jeffrey A. Kuller, SMFM Publications Committee
10.1016/j.ajog.2024.02.288
American Journal of Obstetrics & Gynecology (2024)
2024-02-26
American Journal of Obstetrics & Gynecology
2024-02-26
SMFM Statement
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Revisiting the evolution of the Hippocratic Oath in obstetrics and gynecology
https://www.ajog.org/article/S0002-9378(24)00068-1/fulltext?rss=yes
Hippocrates, an influential figure in ancient Greek medicine, is best known for his lasting contribution, the Hippocratic Oath, which includes a significant message about obstetrics and gynecology. Given the Oath’s status as a widely regarded ethical code for medical practice, it requires critical evaluation. The message of the Oath, as it related to obstetrics and gynecology, is expressed in ancient Greek by the phrase “οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω” which translates directly to “I will not give to any woman a harming pessary.” The words fetus and abortion were not present in the original Greek text of the Oath.
Revisiting the evolution of the Hippocratic Oath in obstetrics and gynecology
Anthony M. Vintzileos, Ioannis H. Mylonas
10.1016/j.ajog.2024.01.027
American Journal of Obstetrics & Gynecology (2024)
2024-02-26
American Journal of Obstetrics & Gynecology
2024-02-26
Editorial
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The association between neighborhood deprivation and engagement in mental health care after implementation of the perinatal collaborative care model
https://www.ajog.org/article/S0002-9378(24)00366-1/fulltext?rss=yes
The association between neighborhood deprivation and engagement in mental health care after implementation of the perinatal collaborative care model
Brock E. Polnaszek, Kevin M. Mwenda, Latasha D. Nelson, Dorothy K. Sit, Adam K. Lewkowitz, Emily S. Miller
10.1016/j.ajog.2024.02.286
American Journal of Obstetrics & Gynecology (2024)
2024-02-24
American Journal of Obstetrics & Gynecology
2024-02-24
Research Letter
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Evaluating the overall efficacy of digital health interventions
https://www.ajog.org/article/S0002-9378(24)00364-8/fulltext?rss=yes
We welcome the article by Lewkowitz et al1 who compared the impact of digital health interventions (DHI) with treatment as usual (TAU) for postpartum depression (PPD) and anxiety (PPA). We were pleased to see the study’s clear distinction between and awareness of PPD and PPA. This expanded behavioral health scope may further assist clinicians with individualizing care and optimizing treatments that address the spectrum of mental health disorders in the postpartum period. We would like to propose 3 concepts that may further explain differences that lead to higher lost-to-follow-up (LTFU) rates with DHIs than with TAU.
Evaluating the overall efficacy of digital health interventions
Fatima Humayun, Keisha R. Callins
10.1016/j.ajog.2024.02.285
American Journal of Obstetrics & Gynecology (2024)
2024-02-24
American Journal of Obstetrics & Gynecology
2024-02-24
Letter to the Editors
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Perinatal digital mental health interventions: further analysis of risk factors for high loss-to-follow-up rates
https://www.ajog.org/article/S0002-9378(24)00367-3/fulltext?rss=yes
We thank Ms Humayun and Dr Callins for their favorable response to our meta-analyses that examined the effect of digital health interventions (DHI) on symptoms of postpartum depression (PPD) and anxiety (PPA).1,2 We agree with their assessment that, overall, the risk of not completing the final study assessment was higher among those randomized to DHIs than among those randomized to treatment as usual (TAU) and that multiple factors likely affected the loss-to-follow-up (LTFU) rates in these studies.
Perinatal digital mental health interventions: further analysis of risk factors for high loss-to-follow-up rates
Adam K. Lewkowitz, Nina K. Ayala, Emily S. Miller
10.1016/j.ajog.2024.02.287
American Journal of Obstetrics & Gynecology (2024)
2024-02-23
American Journal of Obstetrics & Gynecology
2024-02-23
Letter to the Editors
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Can placental extracellular vesicles provide long-term protection against cardiovascular disease: a reply
https://www.ajog.org/article/S0002-9378(24)00365-X/fulltext?rss=yes
We thank Tang and Dr Li for their interest in our study and their letter.1 The authors have raised concerns regarding the association between parity and cardiovascular disease (CVD) risk. Although Tang and Li referenced a published relative risk of 1.14 for CVD among parous compared with nulliparous women, this value was not stratified based on the number of pregnancies. It has been acknowledged that a J-shaped relationship exists between parity and the risk for CVD after adjustment for age, traditional CVD risk factors, and socioeconomic variables.
Can placental extracellular vesicles provide long-term protection against cardiovascular disease: a reply
Yourong Feng, Sandy Lau, Carolyn Barrett, Lawrence W. Chamley
10.1016/j.ajog.2024.02.284
American Journal of Obstetrics & Gynecology (2024)
2024-02-23
American Journal of Obstetrics & Gynecology
2024-02-23
Letter to the Editors
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The use of bubble charts in analyzing second stage cesarean delivery rates
https://www.ajog.org/article/S0002-9378(24)00363-6/fulltext?rss=yes
The incidence of second stage cesarean delivery has been rising globally because of the failure or the anticipated difficulty of performing instrumental delivery. Yet, the best way to interpret the figure and its optimal rate remain to be determined. This is because it is strongly influenced by the practice of other 2 modes of birth, namely cesarean delivery performed before reaching the second stage and assisted vaginal birth during the second stage. In this regard, a bubble chart that can display 3-dimensional data through its x-axis, y-axis, and the size of each plot (presented as a bubble) may be a suitable method to evaluate the relationship between the rates of these 3 modes of births.
The use of bubble charts in analyzing second stage cesarean delivery rates
Man Wai Catherine Hung, Lin Tai Linus Lee, Christopher Pak Hey Chiu, Man Kee Teresa Ma, Yuen Yee Yannie Chan, Lee Ting Kwong, Eunice Joanna Wong, Theodora Hei Tung Lai, Oi Ka Chan, Po Lam So, Wai Lam Lau, Tak Yeung Leung, HKCOG Research Group
10.1016/j.ajog.2024.02.283
American Journal of Obstetrics & Gynecology (2024)
2024-02-23
American Journal of Obstetrics & Gynecology
2024-02-23
Original Research
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Dysregulated inflammatory response to urogynecologic meshes in women with diabetes and its implications
https://www.ajog.org/article/S0002-9378(24)00362-4/fulltext?rss=yes
Diabetes is an independent risk factor for mesh complications in women undergoing mesh-augmented surgical repairs of stress urinary incontinence and/or pelvic organ prolapse. The underlying mechanism remains unclear.
Dysregulated inflammatory response to urogynecologic meshes in women with diabetes and its implications
Rui Liang, Eric R. Shaker, Muyun Zhao, Gabrielle King, Pamela A. Moalli
10.1016/j.ajog.2024.02.282
American Journal of Obstetrics & Gynecology (2024)
2024-02-23
American Journal of Obstetrics & Gynecology
2024-02-23
Original Research
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Can placental extracellular vesicles provide long-term protection against cardiovascular disease?
https://www.ajog.org/article/S0002-9378(24)00361-2/fulltext?rss=yes
Placental extracellular vesicles (EVs) are tiny, balloon-like structures that are secreted by placental cells and contain proteins, enzymes, DNA, and other molecules capable of transmitting chemical messages between cells. During pregnancy, the concentration of EVs in maternal circulation is dramatically increased, supporting the hypothesis that placental EVs are involved in implantation, immune activation, angiogenesis, glucose metabolism and uptake, and the onset of labor.
Can placental extracellular vesicles provide long-term protection against cardiovascular disease?
Hai-Shen Tang, Dong-Zhi Li
10.1016/j.ajog.2024.02.281
American Journal of Obstetrics & Gynecology (2024)
2024-02-23
American Journal of Obstetrics & Gynecology
2024-02-23
Letter to the Editors
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Clinical utility of angiogenic biomarkers
https://www.ajog.org/article/S0002-9378(24)00093-0/fulltext?rss=yes
We thank Dr Lola Loussert1 and team for their comments on our recently published article titled “The additive role of angiogenic markers for women with confirmed preeclampsia.”2
Clinical utility of angiogenic biomarkers
Easha Patel, Sunitha Suresh, Sarosh Rana
10.1016/j.ajog.2024.02.022
American Journal of Obstetrics & Gynecology (2024)
2024-02-18
American Journal of Obstetrics & Gynecology
2024-02-18
Letter to the Editors
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Optimal antenatal corticosteroids timing in women with nonsevere preeclampsia
https://www.ajog.org/article/S0002-9378(24)00092-9/fulltext?rss=yes
We read with great interest the original article of Suresh et al1 about the additive role of angiogenic markers for women with confirmed preeclampsia. The authors provide a very clear and comprehensive overview of the performance of the maternal soluble fms-like tyrosine kinase 1 to placental growth factor (sFlt-1/PlGF) ratio. Notably, the sFlt-1/PlGF ratio may help to monitor disease progression in women with preeclampsia and to predict the interval between preeclampsia diagnosis and delivery. This biomarker could then guide management strategies for women with preeclampsia.
Optimal antenatal corticosteroids timing in women with nonsevere preeclampsia
Lola Loussert, Ninon Dupuis, Paul Guerby
10.1016/j.ajog.2024.02.021
American Journal of Obstetrics & Gynecology (2024)
2024-02-18
American Journal of Obstetrics & Gynecology
2024-02-18
Letter to the Editors
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Corrigendum to ‘The incidence of anal incontinence following obstetric anal sphincter injury graded using the Sultan classification: A network meta-analysis’ [American Journal of Obstetrics and Gynecology 228/6 (2023) 675-688]
https://www.ajog.org/article/S0002-9378(24)00070-X/fulltext?rss=yes
The authors regret, that corrections following publication of the manuscript have been made as the mean incidence reported by included studies of anal incontinence with fourth degree tears is 32.4%, not 28.6%. In addition, we have now included the overall incidence of anal incontinence (18.1% (3a=15.6%, 3b=18.3%, 3c=20.6%, 4th=28.4%)) in the 2647 women included in the review.
Corrigendum to ‘The incidence of anal incontinence following obstetric anal sphincter injury graded using the Sultan classification: A network meta-analysis’ [American Journal of Obstetrics and Gynecology 228/6 (2023) 675-688]
Nicola Adanna Okeahialam, Annika Taithongchai, Ranee Thakar, Abdul H. Sultan
10.1016/j.ajog.2024.02.001
American Journal of Obstetrics & Gynecology (2024)
2024-02-18
American Journal of Obstetrics & Gynecology
2024-02-18
Correction
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Fertility protection: a novel approach using pretreatment with mesenchymal stem cell exosomes to prevent chemotherapy–induced ovarian damage in a mouse model
https://www.ajog.org/article/S0002-9378(24)00094-2/fulltext?rss=yes
Primary ovarian insufficiency refers to the loss of ovarian function before the age of 40 years and leads to amenorrhea and infertility. Primary ovarian insufficiency has diverse causes, but a common cause is exposure to gonadotoxic chemotherapy used in cancer treatment. Because of the risk for developing primary ovarian insufficiency, patients who want to preserve their fertility may consider various procedures for fertility preservation. However, current fertility preservation options are highly invasive, carry substantial risks, and have uncertain success rates.
Fertility protection: a novel approach using pretreatment with mesenchymal stem cell exosomes to prevent chemotherapy–induced ovarian damage in a mouse model
Hang-soo Park, Jin Seok, Esra Cetin, Mohammad Mousaei Ghasroldasht, Farzana Liakath Ali, Hanaa Mohammed, Hiba Alkelani, Ayman Al-Hendy
10.1016/j.ajog.2024.02.023
American Journal of Obstetrics & Gynecology (2024)
2024-02-17
American Journal of Obstetrics & Gynecology
2024-02-17
Original Research
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Risk of immune-related diseases in childhood after intrapartum antibiotic exposure
https://www.ajog.org/article/S0002-9378(24)00086-3/fulltext?rss=yes
Intrapartum antibiotic prophylaxis is effective in preventing early-onset group B streptococcal disease in newborn infants, but it influences gut microbiota development. Gut microbiota composition is, in turn, associated with immune-related diseases in childhood.
Risk of immune-related diseases in childhood after intrapartum antibiotic exposure
Sofia Ainonen, Eveliina Ronkainen, Mikael Hakkola, Tytti Pokka, Minna Honkila, Marika Paalanne, Eero Kajantie, Niko Paalanne, Terhi S. Ruuska
10.1016/j.ajog.2024.02.020
American Journal of Obstetrics & Gynecology (2024)
2024-02-16
American Journal of Obstetrics & Gynecology
2024-02-16
Original Research
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Reply: The pelvic floor is a function of the body continuum
https://www.ajog.org/article/S0002-9378(24)00091-7/fulltext?rss=yes
Reply: The pelvic floor is a function of the body continuum
John O. DELANCEY, Sara MASTROVITO, James A. ASHTON-MILLER
10.1016/j.ajog.2024.02.019
American Journal of Obstetrics & Gynecology (2024)
2024-02-15
American Journal of Obstetrics & Gynecology
2024-02-15
Letter to the Editors
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The pelvic floor is the function of the body unit
https://www.ajog.org/article/S0002-9378(24)00090-5/fulltext?rss=yes
I have read with interest the article by Delancey et al,1 and I congratulate them on their publication. The article discusses a possible point of convergence (“to describe a unified pelvic floor conceptual model”) on the understanding of the structure and function of the pelvic floor.1
The pelvic floor is the function of the body unit
Bruno Bordoni
10.1016/j.ajog.2024.02.018
American Journal of Obstetrics & Gynecology (2024)
2024-02-15
American Journal of Obstetrics & Gynecology
2024-02-15
Letter to the Editors
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Postpartum readmission risk: a comparison between stillbirths and live births
https://www.ajog.org/article/S0002-9378(24)00089-9/fulltext?rss=yes
Stillbirth occurs more commonly among pregnant people with comorbid conditions and obstetrical complications. Stillbirth also independently increases maternal morbidity and imparts a psychosocial hazard when compared with live birth. These distinct needs and burden may increase the risk for postpartum readmission after stillbirth.
Postpartum readmission risk: a comparison between stillbirths and live births
Lena C. Sweeney, Uma M. Reddy, Katherine Campbell, Xiao Xu
10.1016/j.ajog.2024.02.017
American Journal of Obstetrics & Gynecology (2024)
2024-02-15
American Journal of Obstetrics & Gynecology
2024-02-15
Original Research
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Meclizine improves endometrial repair and reduces simulated menstrual bleeding in mice with induced adenomyosis
https://www.ajog.org/article/S0002-9378(24)00088-7/fulltext?rss=yes
Adenomyosis is one of the structural causes of abnormal uterine bleeding, which often presents as heavy menstrual bleeding. Mostly because of the poor understanding of its pathophysiology, medical management of adenomyosis-induced heavy menstrual bleeding is still a challenge. We have previously reported that glycolysis is crucial to endometrial repair following menstruation and that suppressed glycolysis can cause heavy menstrual bleeding.
Meclizine improves endometrial repair and reduces simulated menstrual bleeding in mice with induced adenomyosis
Chenyu Mao, Xishi Liu, Sun-Wei Guo
10.1016/j.ajog.2024.02.016
American Journal of Obstetrics & Gynecology (2024)
2024-02-15
American Journal of Obstetrics & Gynecology
2024-02-15
Original Research
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Mode of delivery and subsequent self-perceived sexual life satisfaction: a population-based cohort study
https://www.ajog.org/article/S0002-9378(24)00087-5/fulltext?rss=yes
The potential association between mode of obstetrical delivery and subsequent sexual outcomes of the birthing parent remains uncertain and has not been well investigated from the perspective of positive sexual life satisfaction.
Mode of delivery and subsequent self-perceived sexual life satisfaction: a population-based cohort study
Alma Larsdotter Zweygberg, Florence Z. Martin, Boel Brynedal, Elisabeth Storck Lindholm, Kyriaki Kosidou, Viktor H. Ahlqvist, Cecilia Magnusson
10.1016/j.ajog.2024.02.015
American Journal of Obstetrics & Gynecology (2024)
2024-02-15
American Journal of Obstetrics & Gynecology
2024-02-15
Original Research
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Frequency of same-day contraceptive initiation, recent unprotected intercourse, and pregnancy risk: a prospective cohort study of multiple contraceptive methods
https://www.ajog.org/article/S0002-9378(24)00083-8/fulltext?rss=yes
Same-day start removes barriers to contraceptive initiation and may reduce the risk of unintended pregnancy. It may be appropriate for all contraceptive methods, but we lack data comparing methods.
Frequency of same-day contraceptive initiation, recent unprotected intercourse, and pregnancy risk: a prospective cohort study of multiple contraceptive methods
Erica Torres, Gentry Carter, Alexandra Gero, Rebecca G. Simmons, Jessica N. Sanders, David K. Turok
10.1016/j.ajog.2024.02.014
American Journal of Obstetrics & Gynecology (2024)
2024-02-15
American Journal of Obstetrics & Gynecology
2024-02-15
Original Research
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Prenatal diagnosis of right lung agenesis combined with left pulmonary artery sling
https://www.ajog.org/article/S0002-9378(24)00079-6/fulltext?rss=yes
A 24-year-old primigravida was admitted to our hospital at 29 weeks of gestation with a suspected abnormal fetal heart position. A long-axis scan, together with transverse scans, at both the abdominal and thoracic levels demonstrated that the fetal heart was located on the right side of the thorax, the right lung was absent, and the mediastinum was displaced to the right (Figure 1). A thorough transverse scan was then performed to show the anatomy moving from a 4-chamber view (4CV) into a 3-vessel tracheal (3VT) view using echocardiography.
Prenatal diagnosis of right lung agenesis combined with left pulmonary artery sling
Pan Wang, Yu Wang, Ying Zhang
10.1016/j.ajog.2024.02.009
American Journal of Obstetrics & Gynecology (2024)
2024-02-15
American Journal of Obstetrics & Gynecology
2024-02-15
Images in Obstetrics
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Maternal vaccination against COVID-19 and neonatal outcomes during Omicron: INTERCOVID-2022 study
https://www.ajog.org/article/S0002-9378(24)00078-4/fulltext?rss=yes
In early 2023, when Omicron was the variant of concern, we showed that vaccinating pregnant women decreased the risk for severe COVID-19–related complications and maternal morbidity and mortality.
Maternal vaccination against COVID-19 and neonatal outcomes during Omicron: INTERCOVID-2022 study
Fernando C. Barros, Robert B. Gunier, Albertina Rego, Loïc Sentilhes, Stephen Rauch, Serena Gandino, Jagjit S. Teji, Jim G. Thornton, Alisa B. Kachikis, Ricardo Nieto, Rachel Craik, Paolo I. Cavoretto, Adele Winsey, Paola Roggero, Gabriel B. Rodriguez, Valeria Savasi, Erkan Kalafat, Francesca Giuliani, Marta Fabre, Anne Caroline Benski, Irma Alejandra Coronado-Zarco, Stefania Livio, Adela Ostrovska, Nerea Maiz, Fabiola R. Castedo Camacho, Ashley Peterson, Philippe Deruelle, Carolina Giudice, Roberto A. Casale, Laurent J. Salomon, Constanza P. Soto Conti, Federico Prefumo, Ehab Zakaria Mohamed Elbayoumy, Marynéa Vale, Valeria Hernández, Katherine Chandler, Milagros Risso, Emily Marler, Daniela M. Cáceres, Guadalupe Albornoz Crespo, Ernawati Ernawati, Michal Lipschuetz, Shabina Ariff, Ken Takahashi, Carmen Vecchiarelli, Teresa Hubka, Satoru Ikenoue, Gabriela Tavchioska, Babagana Bako, Adejumoke I. Ayede, Brenda Eskenazi, Zulfiqar A. Bhutta, Stephen H. Kennedy, Aris T. Papageorghiou, Jose Villar, INTERCOVID-2022 International Consortium
10.1016/j.ajog.2024.02.008
American Journal of Obstetrics & Gynecology (2024)
2024-02-15
American Journal of Obstetrics & Gynecology
2024-02-15
Original Research
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Fertility-sparing surgery vs standard surgery for early-stage cervical cancer: difference in 5-year life expectancy by tumor size
https://www.ajog.org/article/S0002-9378(24)00084-X/fulltext?rss=yes
Cervical cancer incidence among premenopausal women is rising, and fertility-sparing surgery serves as an important option for this young population. There is a lack of evidence on what tumor size cutoff should be used to define candidacy for fertility-sparing surgery.
Fertility-sparing surgery vs standard surgery for early-stage cervical cancer: difference in 5-year life expectancy by tumor size
Kirsten A. Jorgensen, Nuria Agusti, Chi-Fang Wu, Alexa Kanbergs, Rene Pareja, Pedro T. Ramirez, Jose Alejandro Rauh-Hain, Alexander Melamed
10.1016/j.ajog.2024.02.012
American Journal of Obstetrics & Gynecology (2024)
2024-02-14
American Journal of Obstetrics & Gynecology
2024-02-14
Original Research
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Psychiatric disorders and mortality due to external causes following diagnosis of endometriosis at a young age: a longitudinal register-based cohort study in Finland
https://www.ajog.org/article/S0002-9378(24)00082-6/fulltext?rss=yes
Endometriosis diagnosed in adults is associated with increased risk of various psychiatric disorders. However, little is known concerning psychiatric comorbidity and mortality due to external causes associated with endometriosis diagnosed at a young age.
Psychiatric disorders and mortality due to external causes following diagnosis of endometriosis at a young age: a longitudinal register-based cohort study in Finland
Elina Rasp, Liisu Saavalainen, Anna But, Mika Gissler, Päivi Härkki, Oskari Heikinheimo, Kristiina Rönö
10.1016/j.ajog.2024.02.011
American Journal of Obstetrics & Gynecology (2024)
2024-02-14
American Journal of Obstetrics & Gynecology
2024-02-14
Original Research
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Interest in over-the-counter progestin-only pills among transgender, nonbinary, and gender-expansive individuals in the United States
https://www.ajog.org/article/S0002-9378(24)00076-0/fulltext?rss=yes
In July 2023, the US Food and Drug Administration approved the first nonprescription oral contraceptive, a progestin-only pill, in the United States. Transgender, nonbinary, and gender-expansive people assigned female or intersex at birth face substantial contraceptive access barriers and may benefit from over-the-counter oral contraceptive access. However, no previous research has explored their perspectives on this topic.
Interest in over-the-counter progestin-only pills among transgender, nonbinary, and gender-expansive individuals in the United States
Kate Grindlay, Juno Obedin-Maliver, Sachiko Ragosta, Jen Hastings, Mitchell R. Lunn, Annesa Flentje, Matthew R. Capriotti, Zubin Dastur, Micah E. Lubensky, Heidi Moseson
10.1016/j.ajog.2024.02.006
American Journal of Obstetrics & Gynecology (2024)
2024-02-14
American Journal of Obstetrics & Gynecology
2024-02-14
Original Research
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Optimal misoprostol dosing among patients with a body mass index greater than 30: a randomized controlled trial
https://www.ajog.org/article/S0002-9378(24)00074-7/fulltext?rss=yes
Patients with obesity experience an increased duration of labor with an increased risk for perinatal morbidity. When compared with parturients without obesity, they also experience fewer uterine contractions after administration of misoprostol. It is unclear if the same dose of misoprostol should be used for induction of labor in patients with obesity compared to non-obese patients. Therefore, we sought to investigate if a higher dose of misoprostol for patients with obesity is more effective.
Optimal misoprostol dosing among patients with a body mass index greater than 30: a randomized controlled trial
Alexander M. Saucedo, Miriam Alvarez, George A. Macones, Alison G. Cahill, Lorie M. Harper
10.1016/j.ajog.2024.02.004
American Journal of Obstetrics & Gynecology (2024)
2024-02-14
American Journal of Obstetrics & Gynecology
2024-02-14
Original Research
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Early vs delayed amniotomy following transcervical Foley balloon in the induction of labor: a randomized clinical trial
https://www.ajog.org/article/S0002-9378(24)00069-3/fulltext?rss=yes
The optimal timing of amniotomy during labor induction is a topic of ongoing debate due to the potential risks associated with both amniotomy and prolonged labor. As such, individuals in the field of obstetrics and gynecology must carefully evaluate the associated benefits and drawbacks of this procedure. While amniotomy can expedite the labor process, it may also lead to complications such as umbilical cord prolapse, fetal distress, and infection. Therefore, a careful and thorough examination of the risks and benefits of amniotomy during labor induction is essential in making an informed decision regarding the optimal timing of this procedure.
Early vs delayed amniotomy following transcervical Foley balloon in the induction of labor: a randomized clinical trial
Marissa Berry, Kelly Lamiman, Megan N. Slan, Xue Zhang, Daphne D. Arena Goncharov, Yihharn P. Hwang, Jennifer A. Rogers, Luis D. Pacheco, George R. Saade, Antonio F. Saad
10.1016/j.ajog.2024.01.028
American Journal of Obstetrics & Gynecology (2024)
2024-02-14
American Journal of Obstetrics & Gynecology
2024-02-14
Original Research
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Fetal death and neighborhood socioeconomic disadvantage
https://www.ajog.org/article/S0002-9378(23)02166-X/fulltext?rss=yes
Fetal death affects 1 in 175 pregnancies annually in the United States, representing 21,105 fetal deaths in 2021.1,2 Recent studies emphasize individual social determinants of health (SDOH) as risk factors for fetal death, including Medicaid health insurance, inadequate prenatal care, and living in poverty.3,4 Neighborhood-level SDOH, such as the area deprivation index (ADI), are associated with adverse pregnancy outcomes;5 however, whether an association exists with fetal death remains to be clarified.
Fetal death and neighborhood socioeconomic disadvantage
Sema Hajmurad, William A. Grobman, David M. Haas, Lynn M. Yee, Jiqiang Wu, Becky McNeil, Jun Wu, Brian Mercer, Hyagriv Simhan, Uma M. Reddy, Robert M. Silver, Samuel Parry, George Saade, Courtney D. Lynch, Kartik K. Venkatesh
10.1016/j.ajog.2023.12.016
American Journal of Obstetrics & Gynecology (2024)
2024-02-14
American Journal of Obstetrics & Gynecology
2024-02-14
Research Letter
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Greater risk of type 2 diabetes progression in multifetal gestations with gestational diabetes: the impact of obesity
https://www.ajog.org/article/S0002-9378(23)02060-4/fulltext?rss=yes
The relationship between gestational diabetes mellitus and adverse outcomes in multifetal pregnancies is complex and controversial. Moreover, limited research has focused on the risk of gestational diabetes mellitus progression to type 2 diabetes mellitus specifically in multifetal pregnancies, resulting in conflicting results from existing studies.
Greater risk of type 2 diabetes progression in multifetal gestations with gestational diabetes: the impact of obesity
Amir Naeh, Esther Maor-Sagie, Mordechai Hallak, Yoel Toledano, Rinat Gabbay-Benziv
10.1016/j.ajog.2023.11.1246
American Journal of Obstetrics & Gynecology (2024)
2024-02-14
American Journal of Obstetrics & Gynecology
2024-02-14
Original Research
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Characteristics associated with blood transfusion among women undergoing laparoscopic myomectomy: a National Surgical Quality Improvement Program study
https://www.ajog.org/article/S0002-9378(24)00081-4/fulltext?rss=yes
Uterine fibroids are the most common benign tumors that affect females. A laparoscopic myomectomy is the standard surgical treatment for most women who wish to retain their uterus. The most common complication of a myomectomy is excessive bleeding. However, risk factors for hemorrhage during a laparoscopic myomectomy are not well studied and no risk stratification tool specific for identifying the need for a blood transfusion during a laparoscopic myomectomy currently exists in the literature.
Characteristics associated with blood transfusion among women undergoing laparoscopic myomectomy: a National Surgical Quality Improvement Program study
Kacey M. Hamilton, Connie Liao, Gabriel Levin, Moshe Barnajian, Yosef Nasseri, Catherine Bresee, Mireille D. Truong, Kelly N. Wright, Matthew T. Siedhoff, Raanan Meyer
10.1016/j.ajog.2024.02.010
American Journal of Obstetrics & Gynecology (2024)
2024-02-13
American Journal of Obstetrics & Gynecology
2024-02-13
Original Research
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Prenatal diagnosis of severe hydrocephalus caused by fetal intracranial pineal gland tumors
https://www.ajog.org/article/S0002-9378(24)00080-2/fulltext?rss=yes
Pineoblastoma (PB) is a rare and highly malignant intracranial neoplasm.1 Thus far, only a limited number of reports of PBs in adults and pediatric patients have been documented, most of which were case studies. PBs have not been reported in fetuses. These undifferentiated embryonal neoplasmas are classified as primitive neuroectodermal tumors. Like other primitive neuroectodermal tumors, PB is highly aggressive and have poor prognoses because of its tendency to invade adjacent structures and disseminate in cerebrospinal fluid.
Prenatal diagnosis of severe hydrocephalus caused by fetal intracranial pineal gland tumors
Bin lv, Ai Zheng, Ling Han
10.1016/j.ajog.2024.01.030
American Journal of Obstetrics & Gynecology (2024)
2024-02-13
American Journal of Obstetrics & Gynecology
2024-02-13
Images in Obstetrics
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Excess morbidity and mortality associated with underuse of estrogen replacement therapy in premenopausal women who undergo surgical menopause
https://www.ajog.org/article/S0002-9378(24)00077-2/fulltext?rss=yes
Contrary to clinical guidelines, there has been a decrease over time in estrogen therapy use in premenopausal women undergoing bilateral oophorectomy for benign indications.
Excess morbidity and mortality associated with underuse of estrogen replacement therapy in premenopausal women who undergo surgical menopause
Jennifer S. Ferris, Yukio Suzuki, Matthew T. Prest, Ling Chen, Elena B. Elkin, Chin Hur, Dawn L. Hershman, Jason D. Wright
10.1016/j.ajog.2024.02.007
American Journal of Obstetrics & Gynecology (2024)
2024-02-13
American Journal of Obstetrics & Gynecology
2024-02-13
Original Research
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Postpartum pharmacologic thromboprophylaxis and complications in a US cohort
https://www.ajog.org/article/S0002-9378(23)00815-3/fulltext?rss=yes
Venous thromboembolism accounts for approximately 9% of pregnancy-related deaths in the United States. National guidelines recommend postpartum risk stratification and pharmacologic prophylaxis in at-risk individuals. Knowledge on modern rates of postpartum pharmacologic thromboprophylaxis and its associated risks is limited.
Postpartum pharmacologic thromboprophylaxis and complications in a US cohort
Ann M. Bruno, Grecio J. Sandoval, Brenna L. Hughes, William A. Grobman, George R. Saade, Tracy A. Manuck, Monica Longo, Torri D. Metz, Hyagriv N. Simhan, Dwight J. Rouse, Hector Mendez-Figueroa, Cynthia Gyamfi-Bannerman, Jennifer L. Bailit, Maged M. Costantine, Harish M. Sehdev, Alan T.N. Tita, National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, Bethesda, MD
10.1016/j.ajog.2023.11.013
American Journal of Obstetrics & Gynecology (2024)
2024-02-11
American Journal of Obstetrics & Gynecology
2024-02-11
Original Research
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Survival without severe neonatal morbidity after antenatal betamethasone dose reduction: a post hoc analysis of a randomized non-inferiority trial
https://www.ajog.org/article/S0002-9378(24)00071-1/fulltext?rss=yes
Antenatal betamethasone is recommended before preterm delivery to accelerate fetal lung maturation. However, its optimal dose remains unknown. A 50% dose reduction was proposed to decrease the potential dose-related long-term neurodevelopmental side effects, including psychological development, sleep, and emotional disorders. Because noninferiority of the half dose in terms of the need for exogenous surfactant was not shown in the primary analysis, its impact on survival without major neonatal morbidity needs to be investigated.
Survival without severe neonatal morbidity after antenatal betamethasone dose reduction: a post hoc analysis of a randomized non-inferiority trial
Olivier Baud, Loic Sentilhes, Moreno Ursino, Muriel Doret-Dion, Corinne Alberti, Camille Aupiais, Thomas Schmitz, BETADOSE trial study group and the GROG (Groupe de Recherche en Obstétrique et Gynécologie)
10.1016/j.ajog.2024.02.002
American Journal of Obstetrics & Gynecology (2024)
2024-02-08
American Journal of Obstetrics & Gynecology
2024-02-08
Original Research
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Human papillomavirus genotypes and risk of persistence and progression in women undergoing active surveillance for cervical intraepithelial neoplasia grade 2
https://www.ajog.org/article/S0002-9378(24)00072-3/fulltext?rss=yes
In recent years, active surveillance has been introduced as an alternative to excisional treatment in younger women with cervical intraepithelial neoplasia grade 2 because regression rates are high and excisional treatment is associated with increased risk of preterm birth. However, early identification of women at increased risk of persistence/progression is important to ensure timely treatment. Evidence is limited on biomarkers that may be used to identify women at increased risk of persistence/progression.
Human papillomavirus genotypes and risk of persistence and progression in women undergoing active surveillance for cervical intraepithelial neoplasia grade 2
Rikke Kamp Damgaard, David Jenkins, Mark H. Stoler, Maurits de Koning, Miekel van de Sandt, Kathrine Dyhr Lycke, Johnny Kahlert, Patti E. Gravitt, Wim G.V. Quint, Torben Steiniche, Lone Kjeld Petersen, Anne Hammer
10.1016/j.ajog.2024.01.029
American Journal of Obstetrics & Gynecology (2024)
2024-02-06
American Journal of Obstetrics & Gynecology
2024-02-06
Original Research
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Effectiveness of care bundles for prevention and treatment of postpartum hemorrhage: a systematic review
https://www.ajog.org/article/S0002-9378(24)00042-5/fulltext?rss=yes
Care bundles are a promising approach to reducing postpartum hemorrhage–related morbidity and mortality. We assessed the effectiveness and safety of care bundles for postpartum hemorrhage prevention and/or treatment.
Effectiveness of care bundles for prevention and treatment of postpartum hemorrhage: a systematic review
Joshua P. Vogel, Phi-Yen Nguyen, Jen Ramson, Manarangi S. De Silva, Minh D. Pham, Saima Sultana, Steve McDonald, Kwame Adu-Bonsaffoh, Annie R.A. McDougall
10.1016/j.ajog.2024.01.012
American Journal of Obstetrics & Gynecology (2024)
2024-02-06
American Journal of Obstetrics & Gynecology
2024-02-06
Systematic Review
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Endometriosis and mental health: a population-based cohort study
https://www.ajog.org/article/S0002-9378(24)00064-4/fulltext?rss=yes
Endometriosis is a chronic gynecologic disorder that leads to considerable pain and a reduced quality of life. Although its physiological manifestations have been explored, its impact on mental health is less well defined. Existing studies of endometriosis and mental health were conducted within diverse healthcare landscapes with varying access to care and with a primary focus on surgically diagnosed endometriosis. A single-payer healthcare system offers a unique environment to investigate this association with fewer barriers to access care while considering the mode of endometriosis diagnosis.
Endometriosis and mental health: a population-based cohort study
Peter S. Thiel, Olga Bougie, Jessica Pudwell, Jonas Shellenberger, Maria P. Velez, Ally Murji
10.1016/j.ajog.2024.01.023
American Journal of Obstetrics & Gynecology (2024)
2024-01-31
American Journal of Obstetrics & Gynecology
2024-01-31
Original Research
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Transplacental transmission of the COVID-19 vaccine messenger RNA: evidence from placental, maternal, and cord blood analyses postvaccination
https://www.ajog.org/article/S0002-9378(24)00063-2/fulltext?rss=yes
SARS-CoV-2 infection presents substantial challenges to global health, necessitating effective interventions such as COVID-19 vaccination. The initial clinical trials for the COVID-19 messenger RNA (mRNA) vaccines excluded pregnant women, leading to a knowledge gap concerning the potential biodistribution of the vaccine’s mRNA to the placenta and/or the fetus after maternal vaccination.
Transplacental transmission of the COVID-19 vaccine messenger RNA: evidence from placental, maternal, and cord blood analyses postvaccination
Xinhua Lin, Bishoy Botros, Monica Hanna, Ellen Gurzenda, Claudia Manzano De Mejia, Martin Chavez, Nazeeh Hanna
10.1016/j.ajog.2024.01.022
American Journal of Obstetrics & Gynecology (2024)
2024-01-31
American Journal of Obstetrics & Gynecology
2024-01-31
Research Letter
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Older maternal age at first vaginal delivery is associated with increased genital hiatus size at 1 year postpartum
https://www.ajog.org/article/S0002-9378(24)00062-0/fulltext?rss=yes
Older maternal age at the time of first vaginal delivery (VD) increases the risk for pelvic organ prolapse (POP) and surgery for POP.1,2 We currently lack a mechanistic understanding of this association. Genital hiatus (GH) enlargement seems to precede POP development.3,4 A possible explanation for the increased POP risk with older maternal age is that aging impairs recovery of the pelvic floor muscles (PFM) and the connective tissues that help to maintain normal GH closure. Therefore, we sought to determine the differences in GH from late pregnancy through 1 year postpartum by maternal age at first VD.
Older maternal age at first vaginal delivery is associated with increased genital hiatus size at 1 year postpartum
Carolyn W. Swenson, Whitney K. Hendrickson, Amanda A. Allshouse, Ingrid E. Nygaard
10.1016/j.ajog.2024.01.021
American Journal of Obstetrics & Gynecology (2024)
2024-01-31
American Journal of Obstetrics & Gynecology
2024-01-31
Research Letter
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Novel metrics to measure gender bias in operating room scheduling priority
https://www.ajog.org/article/S0002-9378(24)00066-8/fulltext?rss=yes
Women in surgical specialties face disproportionate barriers to career advancement compared with their male counterparts.1,2 Previous studies show that female surgeons experience less professional success, are more dissatisfied, have higher levels of burnout, and receive less research funding and overall compensation compared with their male colleagues.1,3,4 Despite these challenges, there is evidence showing that female surgeons may have more favorable mortality outcomes than male surgeons.5 Priority in operating room (OR) scheduling may represent an important contribution to deleterious professional outcomes for female surgeons, as scheduling dynamics affect myriad aspects of surgeon efficiency, compensation, burnout, and well-being.
Novel metrics to measure gender bias in operating room scheduling priority
Kelly Wright, Kacey Hamilton, Joseph Friedman
10.1016/j.ajog.2024.01.025
American Journal of Obstetrics & Gynecology (2024)
2024-01-30
American Journal of Obstetrics & Gynecology
2024-01-30
Research Letter
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Liver endometrioma: a rare extrapelvic site of endometriosis causing catamenial right shoulder pain
https://www.ajog.org/article/S0002-9378(24)00065-6/fulltext?rss=yes
A 31-year-old woman presented with pelvic swelling, dysmenorrhea, dysuria, irregular vaginal bleeding, and catamenial right shoulder pain and was found to have large, complex, bilateral pelvic masses on ultrasound. Magnetic resonance imaging demonstrated severe endometriosis including bilateral ovarian endometriomas, bladder nodules, a vaginal nodule, and multiple liver lesions (Figure 1, axial view, Dixon method, arrow showing endometrioma in the liver). She started an oral contraceptive pill (OCP) and had significant improvement of her symptoms.
Liver endometrioma: a rare extrapelvic site of endometriosis causing catamenial right shoulder pain
Jennifer McCall, Aurelia Busca, Sebastien Gilbert, Erin Williams, Genevieve Horwood, Sukhbir S. Singh
10.1016/j.ajog.2024.01.024
American Journal of Obstetrics & Gynecology (2024)
2024-01-30
American Journal of Obstetrics & Gynecology
2024-01-30
Images in Gynecology
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Risk factors for and outcomes of ring expulsions with a 1-year contraceptive vaginal system
https://www.ajog.org/article/S0002-9378(24)00061-9/fulltext?rss=yes
The US Food and Drug Administration–approved segesterone acetate and ethinyl estradiol ring-shaped contraceptive vaginal system, known as Annovera (Sever Pharma Solutions/QPharma, Malmö, Sweden), was inserted and removed under a woman’s control for a 21 day in and 7 day out regimen for up to 13 cycles of use.
Risk factors for and outcomes of ring expulsions with a 1-year contraceptive vaginal system
Marlena G. Plagianos, Shaalini Ramanadhan, Ruth B. Merkatz, Vivian Brache, Barbara A. Friedland, Lisa B. Haddad
10.1016/j.ajog.2024.01.020
American Journal of Obstetrics & Gynecology (2024)
2024-01-29
American Journal of Obstetrics & Gynecology
2024-01-29
Original Research
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Ultrasound and magnetic resonance imaging–based investigation of the role of perfusion and oxygen availability in menstrual pain
https://www.ajog.org/article/S0002-9378(24)00059-0/fulltext?rss=yes
The mechanisms responsible for menstrual pain are poorly understood. However, dynamic, noninvasive pelvic imaging of menstrual pain sufferers could aid in identifying therapeutic targets and testing novel treatments.
Ultrasound and magnetic resonance imaging–based investigation of the role of perfusion and oxygen availability in menstrual pain
Richard H. Cockrum, Frank F. Tu, Ola Kierzkowska, Nondas Leloudas, Prasad V. Pottumarthi, Kevin M. Hellman
10.1016/j.ajog.2024.01.018
American Journal of Obstetrics & Gynecology (2024)
2024-01-29
American Journal of Obstetrics & Gynecology
2024-01-29
Original Research
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Placenta accreta spectrum disorder at single-cell resolution: a loss of boundary limits in the decidua and endothelium
https://www.ajog.org/article/S0002-9378(23)00729-9/fulltext?rss=yes
Placenta accreta spectrum disorders are associated with severe maternal morbidity and mortality. Placenta accreta spectrum disorders involve excessive adherence of the placenta preventing separation at birth. Traditionally, this condition has been attributed to excessive trophoblast invasion; however, an alternative view is a fundamental defect in decidual biology.
Placenta accreta spectrum disorder at single-cell resolution: a loss of boundary limits in the decidua and endothelium
Yalda Afshar, Ophelia Yin, Anhyo Jeong, Guadalupe Martinez, Jina Kim, Feiyang Ma, Christine Jang, Sarah Tabatabaei, Sungyong You, Hsian-Rong Tseng, Yazhen Zhu, Deborah Krakow
10.1016/j.ajog.2023.10.001
American Journal of Obstetrics & Gynecology (2024)
2024-01-29
American Journal of Obstetrics & Gynecology
2024-01-29
Original Research
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“PrEPping” women’s healthcare providers: motivational interviewing to support ending the HIV epidemic
https://www.ajog.org/article/S0002-9378(24)00060-7/fulltext?rss=yes
In 2018, cisgender women accounted for nearly 20% of new HIV infections, with women of color disproportionately affected. HIV pre-exposure prophylaxis uptake, adherence, and persistence are paramount to ending the HIV epidemic, but current strategies to promote it have not improved uptake among women. Alternatively, pre-exposure prophylaxis marketing and implementation have traditionally targeted men who have sex with men and transwomen. Women feel most comfortable turning to their primary care and reproductive health providers for HIV and pre-exposure prophylaxis counseling, but prescribing is the lowest among these providers.
“PrEPping” women’s healthcare providers: motivational interviewing to support ending the HIV epidemic
Theresa L. Rager, Golfo Tzilos Wernette, Jenell S. Coleman, Nicole Schechter, Okeoma Mmeje
10.1016/j.ajog.2024.01.019
American Journal of Obstetrics & Gynecology (2024)
2024-01-27
American Journal of Obstetrics & Gynecology
2024-01-27
Clinical Opinion
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A multidimensional appraisal of early menstrual pain experience
https://www.ajog.org/article/S0002-9378(24)00058-9/fulltext?rss=yes
Symptomatic dysmenorrhea is a global problem, affecting more than 40% of menstruating persons. Cross-sectional studies have implicated psychosocial, biological, and sensory factors in dysmenorrhea but the mechanisms are not fully understood. Only a few prospective longitudinal studies have evaluated such factors in relation to the emergence and course of dysmenorrhea at menarche.
A multidimensional appraisal of early menstrual pain experience
Frank F. Tu, Kevin M. Hellman, Sarah E. Darnell, Kaela A. Harber, Amy M. Bohnert, Lavisha Singh, Lynn S. Walker
10.1016/j.ajog.2024.01.017
American Journal of Obstetrics & Gynecology (2024)
2024-01-27
American Journal of Obstetrics & Gynecology
2024-01-27
Original Research
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A 52-mg levonorgestrel-releasing intrauterine system vs bipolar radiofrequency nonresectoscopic endometrial ablation in women with heavy menstrual bleeding: long-term follow-up of a multicenter randomized controlled trial
https://www.ajog.org/article/S0002-9378(24)00045-0/fulltext?rss=yes
The symptom of heavy menstrual bleeding has a substantial impact on professional, physical, and social functioning. In 2021, results from a randomized controlled trial comparing a 52-mg levonorgestrel-releasing intrauterine system and radiofrequency nonresectoscopic endometrial ablation as treatments for women with heavy menstrual bleeding were published. Both treatment strategies were equally effective in treating heavy menstrual bleeding during 2-year follow-up. However, long-term results are also relevant for both patients and healthcare providers.
A 52-mg levonorgestrel-releasing intrauterine system vs bipolar radiofrequency nonresectoscopic endometrial ablation in women with heavy menstrual bleeding: long-term follow-up of a multicenter randomized controlled trial
Daniëlle P.C. Huijs, Arianne J.M. Derickx, Pleun Beelen, Jaklien C. Leemans, Sander M.J. van Kuijk, Marlies Y. Bongers, Peggy M.A.J. Geomini
10.1016/j.ajog.2024.01.016
American Journal of Obstetrics & Gynecology (2024)
2024-01-25
American Journal of Obstetrics & Gynecology
2024-01-25
Original Research
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Uterine artery embolization vs myomectomy for the management of women with uterine leiomyomas: a systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(24)00044-9/fulltext?rss=yes
This study aimed to investigate whether uterine artery embolization offers a better quality of life than myomectomy in premenopausal women diagnosed with leiomyomas of the uterus.
Uterine artery embolization vs myomectomy for the management of women with uterine leiomyomas: a systematic review and meta-analysis
Alexander A. Tzanis, Stavros A. Antoniou, Ioannis D. Gkegkes, Christos Iavazzo
10.1016/j.ajog.2024.01.014
American Journal of Obstetrics & Gynecology (2024)
2024-01-25
American Journal of Obstetrics & Gynecology
2024-01-25
Systematic Review
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Risk of postpartum readmission after hypertensive disorder of pregnancy and variation by discharge antihypertensive medication prescription
https://www.ajog.org/article/S0002-9378(24)00046-2/fulltext?rss=yes
Patients with hypertensive disorders of pregnancy have a high rate of postpartum readmission.
Risk of postpartum readmission after hypertensive disorder of pregnancy and variation by discharge antihypertensive medication prescription
Susanna D. Mitro, Monique Hedderson, Fei Xu, Heather Forquer, Jennifer M. Baker, Michael W. Kuzniewicz, Mara Greenberg
10.1016/j.ajog.2024.01.015
American Journal of Obstetrics & Gynecology (2024)
2024-01-24
American Journal of Obstetrics & Gynecology
2024-01-24
Original Research
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Hypertensive disorders of pregnancy and the risk of maternal dementia: a systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(24)00043-7/fulltext?rss=yes
Hypertensive disorders of pregnancy, including preeclampsia, are associated with an increased risk for maternal cardiovascular disease, stroke, and chronic kidney disease. However, their association with subsequent maternal dementia or cognitive impairment is less well understood. This study aimed to review and synthesize the published literature on hypertensive disorders of pregnancy and the subsequent risk for maternal dementia or cognitive impairment.
Hypertensive disorders of pregnancy and the risk of maternal dementia: a systematic review and meta-analysis
Cian Carey, Emily Mulcahy, Fergus P. McCarthy, Emma Jennings, Karolina Kublickiene, Ali Khashan, Peter Barrett
10.1016/j.ajog.2024.01.013
American Journal of Obstetrics & Gynecology (2024)
2024-01-24
American Journal of Obstetrics & Gynecology
2024-01-24
Systematic Review
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Intrapartum cardiotocography with simultaneous maternal heart rate registration improves neonatal outcome
https://www.ajog.org/article/S0002-9378(24)00033-4/fulltext?rss=yes
Intrapartum cardiotocographic monitoring of fetal heart rate by abdominal external ultrasound transducer without simultaneous maternal heart rate recording has been associated with increased risk of early neonatal death and other asphyxia-related neonatal outcomes. It is unclear, however, whether this increase in risk is independently associated with fetal surveillance method or is attributable to other factors.
Intrapartum cardiotocography with simultaneous maternal heart rate registration improves neonatal outcome
Mikko Tarvonen, Janne Markkanen, Ville Tuppurainen, Riina Jernman, Vedran Stefanovic, Sture Andersson
10.1016/j.ajog.2024.01.011
American Journal of Obstetrics & Gynecology (2024)
2024-01-22
American Journal of Obstetrics & Gynecology
2024-01-22
Original Research
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Implementation of a smartphone survey and mainstreaming for genetic cancer risk assessment in a diverse, urban, Medicaid-predominant gynecology clinic: a step toward health equity
https://www.ajog.org/article/S0002-9378(24)00023-1/fulltext?rss=yes
Recognition of hereditary cancer syndromes is an evidence-based national health priority.1 Fewer than 5% of individuals with hereditary cancer syndromes are identified, partly because of inadequate screening and genetic testing.2 Racial and ethnic minorities and individuals with public insurance are less likely to receive screening or genetic testing for hereditary cancers despite having the same risk for pathogenic variants as the general population.3–5 In this pilot study, we measured the proportion of patients who screened positive during a genetic cancer risk assessment (GCRA) via a smartphone-based survey and uptake of mainstream genetic testing in a racially and ethnically diverse Medicaid-predominant urban gynecologic practice.
Implementation of a smartphone survey and mainstreaming for genetic cancer risk assessment in a diverse, urban, Medicaid-predominant gynecology clinic: a step toward health equity
Emily M. Webster, Muhammad Danyal Ahsan, Auja McDougale, Ravi N. Sharaf, Melissa K. Frey
10.1016/j.ajog.2024.01.009
American Journal of Obstetrics & Gynecology (2024)
2024-01-18
American Journal of Obstetrics & Gynecology
2024-01-18
Research Letter
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First trimester risk of preeclampsia and rate of spontaneous birth in patients without preeclampsia
https://www.ajog.org/article/S0002-9378(24)00022-X/fulltext?rss=yes
First-trimester screening for preeclampsia using a combination of maternal risk factors and mean arterial pressure, uterine artery pulsatility index, and placental growth factor, as proposed by the Fetal Medicine Foundation, provides effective prediction of preterm preeclampsia. Placental dysfunction is a potential precursor of spontaneous birth.
First trimester risk of preeclampsia and rate of spontaneous birth in patients without preeclampsia
Paolo I. Cavoretto, Antonio Farina, Noemi Salmeri, Argyro Syngelaki, Min Yi Tan, Kypros H. Nicolaides
10.1016/j.ajog.2024.01.008
American Journal of Obstetrics & Gynecology (2024)
2024-01-18
American Journal of Obstetrics & Gynecology
2024-01-18
Original Research
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Absence of adverse maternal and neonatal outcomes in patients with 1 or 2 abnormal values during early glucose tolerance testing
https://www.ajog.org/article/S0002-9378(24)00021-8/fulltext?rss=yes
The American College of Obstetricians and Gynecologists (ACOG) recommends universal screening for gestational diabetes mellitus (GDM) at ≥24 weeks of gestation or earlier for patients who are overweight or obese with additional risk factors.1 Although 1 abnormal value during a routine 3-hour oral glucose tolerance test (OGTT) is associated with an increased risk for cesarean delivery (CD), neonatal intensive care unit (NICU) admission, and large for gestational age (LGA) neonate,2 the effect of 1 abnormal value during an early OGTT is unknown.
Absence of adverse maternal and neonatal outcomes in patients with 1 or 2 abnormal values during early glucose tolerance testing
Bertie Geng, Lisbet S. Lundsberg, Jennifer Culhane, Audrey Merriam
10.1016/j.ajog.2024.01.007
American Journal of Obstetrics & Gynecology (2024)
2024-01-17
American Journal of Obstetrics & Gynecology
2024-01-17
Research Letter
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Continuous glucose monitoring in pregnancies with type 1 diabetes: small increases in time-in-range improve maternal and perinatal outcomes
https://www.ajog.org/article/S0002-9378(24)00024-3/fulltext?rss=yes
Continuous glucose monitors provide detailed information regarding glycemic control in pregnant patients with type 1 diabetes. Little data have been published examining the association between continuous glucose monitor parameters and perinatal outcomes among gravidas with type 1 diabetes using continuous glucose monitors.
Continuous glucose monitoring in pregnancies with type 1 diabetes: small increases in time-in-range improve maternal and perinatal outcomes
Nasim C. Sobhani, Sophie Goemans, Antoinette Nguyen, Melissa E. Chambers, Michael Richley, Lauryn C. Gabby, Nancy Field, Christina S. Han, Gladys A. Ramos
10.1016/j.ajog.2024.01.010
American Journal of Obstetrics & Gynecology (2024)
2024-01-16
American Journal of Obstetrics & Gynecology
2024-01-16
Original Research
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Abnormal uterine bleeding diagnoses and care following COVID-19 vaccination
https://www.ajog.org/article/S0002-9378(24)00014-0/fulltext?rss=yes
There is evidence suggesting that COVID-19 vaccination may be associated with small, transitory effects on uterine bleeding, possibly including menstrual timing, flow, and duration, in some individuals. However, changes in health care seeking, diagnosis, and workup for abnormal uterine bleeding in the COVID-19 vaccine era are less clear.
Abnormal uterine bleeding diagnoses and care following COVID-19 vaccination
Neon Brooks, Stephanie A. Irving, Tia L. Kauffman, Kimberly K. Vesco, Matthew Slaughter, Ning Smith, Naomi K. Tepper, Christine K. Olson, Eric S. Weintraub, Allison L. Naleway, Vaccine Safety Datalink Menstrual Irregularities Working Group
10.1016/j.ajog.2024.01.006
American Journal of Obstetrics & Gynecology (2024)
2024-01-12
American Journal of Obstetrics & Gynecology
2024-01-12
Original Research
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Reproductive healthcare in adolescents with autism and other developmental disabilities
https://www.ajog.org/article/S0002-9378(24)00013-9/fulltext?rss=yes
Adults with developmental disabilities often have less access to reproductive health services than adults without these disabilities. However, little is known about how adolescents with developmental disabilities, including autism, access reproductive healthcare.
Reproductive healthcare in adolescents with autism and other developmental disabilities
Jennifer L. Ames, Meredith C. Anderson, Emily Cronbach, Catherine Lee, Morénike Giwa Onaiwu, Amy M. Vallerie, Lisa A. Croen
10.1016/j.ajog.2024.01.005
American Journal of Obstetrics & Gynecology (2024)
2024-01-11
American Journal of Obstetrics & Gynecology
2024-01-11
Original Research
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Gestational diabetes in twin pregnancies—a pathology requiring treatment or a benign physiological adaptation?
https://www.ajog.org/article/S0002-9378(24)00012-7/fulltext?rss=yes
There is level-1 evidence that screening for and treating gestational diabetes in singleton pregnancies reduce maternal and neonatal morbidity. However, similar data for gestational diabetes in twin pregnancies are currently lacking. Consequently, the current approach for the diagnosis and management of gestational diabetes in twin pregnancies is based on the same diagnostic criteria and glycemic targets used in singleton pregnancies. However, twin pregnancies have unique physiological characteristics, and many of the typical gestational diabetes-related complications are less relevant for twin pregnancies.
Gestational diabetes in twin pregnancies—a pathology requiring treatment or a benign physiological adaptation?
Nir Melamed, Tomer Avnon, Jon Barrett, Nathan Fox, Andrei Rebarber, Baiju R. Shah, Ilana Halperin, Ravi Retnakaran, Howard Berger, John Kingdom, Liran Hiersch
10.1016/j.ajog.2024.01.004
American Journal of Obstetrics & Gynecology (2024)
2024-01-11
American Journal of Obstetrics & Gynecology
2024-01-11
Clinical Opinion
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Umbilical–portal–systemic venous shunt and intrauterine growth restriction: an inquiry from a prospective study
https://www.ajog.org/article/S0002-9378(24)00011-5/fulltext?rss=yes
The investigation of the fetal umbilical–portal venous system is based on the premise that congenital anomalies of this system may be related to adverse perinatal outcomes. Several small retrospective studies have reported an association between umbilical–portal–systemic venous shunts and intrauterine growth restriction. However, the prevalence of portosystemic shunts in the fetal growth restricted population is yet to be determined.
Umbilical–portal–systemic venous shunt and intrauterine growth restriction: an inquiry from a prospective study
Shelly Czeiger, Tal Weissbach, Keren Zloto, Ariella Wiener, Omer Nir, Abeer Massarwa, Boaz Weisz, Michal Fishel Bartal, Rakefet Yoeli Ulman, Yossi Bart, Reuven Achiron, Zvi Kivilevitch, Shali Mazaki-Tovi, Eran Kassif
10.1016/j.ajog.2024.01.003
American Journal of Obstetrics & Gynecology (2024)
2024-01-11
American Journal of Obstetrics & Gynecology
2024-01-11
Original Research
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Intra-amniotic infection and/or inflammation is associated with fetal cardiac concentric hypertrophy and diastolic dysfunction in preterm labor and preterm prelabor rupture of membranes
https://www.ajog.org/article/S0002-9378(23)00747-0/fulltext?rss=yes
Preterm delivery is associated with cardiovascular remodeling and dysfunction in children and adults. However, it is unknown whether these effects are caused by the neonatal consequences of preterm birth or if these are already present in utero.
Intra-amniotic infection and/or inflammation is associated with fetal cardiac concentric hypertrophy and diastolic dysfunction in preterm labor and preterm prelabor rupture of membranes
Clara Murillo, Claudia Rueda, Marta Larroya, David Boada, Laia Grau, Júlia Ponce, Ana Herranz, Olga Gómez, Silvia Ferrero, Vicente Andreu-Fernández, Eduard Gratacós, Fàtima Crispi, Montse Palacio, Teresa Cobo
10.1016/j.ajog.2023.10.017
American Journal of Obstetrics & Gynecology (2024)
2024-01-09
American Journal of Obstetrics & Gynecology
2024-01-09
Original Research
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Source of variation in cost of obstetrical care for low-risk nulliparas at term
https://www.ajog.org/article/S0002-9378(24)00010-3/fulltext?rss=yes
In the United States, childbirth is the most common reason for hospitalization and accounts for the single largest share of hospital-based expenditures. However, cost, charge, and reimbursement for obstetric services vary dramatically by setting.1 Our previous work showed that induction (vs expectant management) was not associated with significant cost escalation.2 The objective of this study was to understand what other factors account for cost variation in obstetric care among pregnant individuals at term.
Source of variation in cost of obstetrical care for low-risk nulliparas at term
Brett D. Einerson, Amanda A. Allshouse, Grecio Sandoval, Richard E. Nelson, M. Sean Esplin, Michael Varner, William A. Grobman, Torri D. Metz, National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units Network
10.1016/j.ajog.2023.12.041
American Journal of Obstetrics & Gynecology (2024)
2024-01-06
American Journal of Obstetrics & Gynecology
2024-01-06
Research Letter
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Serial cytoreductive surgery and survival outcomes in recurrent adult-type ovarian granulosa cell tumors
https://www.ajog.org/article/S0002-9378(24)00009-7/fulltext?rss=yes
Few studies have evaluated the role of cytoreductive surgery in patients with recurrent adult granulosa cell tumors of the ovary. Despite a multitude of treatment modalities in the recurrent setting, the optimal management strategy is not known. Cytoreductive surgery offers an attractive option for disease confined to the abdomen/pelvis. However, few studies have evaluated the role of surgery compared with systemic therapy alone following the first recurrence and subsequent disease progressions.
Serial cytoreductive surgery and survival outcomes in recurrent adult-type ovarian granulosa cell tumors
Jeffrey A. How, Alejandra Flores Legarreta, Katelyn F. Handley, Bryan Fellman, Katherine I. Foster, Deanna Glassman, Veena K. Vuttaradhi, Allison L. Brodsky, Barrett Lawson, Michael Frumovitz, Shannon N. Westin, Lois M. Ramondetta, David M. Gershenson, Anil K. Sood, R. Tyler Hillman
10.1016/j.ajog.2024.01.002
American Journal of Obstetrics & Gynecology (2024)
2024-01-06
American Journal of Obstetrics & Gynecology
2024-01-06
Original Research
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Genetic contribution of reproductive traits to risk of uterine leiomyomata: a large-scale, genome-wide, cross-trait analysis
https://www.ajog.org/article/S0002-9378(24)00008-5/fulltext?rss=yes
Although phenotypic associations between female reproductive characteristics and uterine leiomyomata have long been observed in epidemiologic investigations, the shared genetic architecture underlying these complex phenotypes remains unclear.
Genetic contribution of reproductive traits to risk of uterine leiomyomata: a large-scale, genome-wide, cross-trait analysis
Changfeng Xiao, Xueyao Wu, C. Scott Gallagher, Danielle Rasooly, Xia Jiang, Cynthia Casson Morton
10.1016/j.ajog.2023.12.040
American Journal of Obstetrics & Gynecology (2024)
2024-01-05
American Journal of Obstetrics & Gynecology
2024-01-05
Original Research
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Effects and safety of hyaluronic acid gel on intrauterine adhesion and fertility after intrauterine surgery: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials
https://www.ajog.org/article/S0002-9378(24)00007-3/fulltext?rss=yes
This study aimed to determine the efficacy and safety of hyaluronic acid gel for the prevention of intrauterine adhesions and improved fertility after intrauterine surgery.
Effects and safety of hyaluronic acid gel on intrauterine adhesion and fertility after intrauterine surgery: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials
Yan Luo, Yuanyuan Sun, Bixia Huang, Jingjing Chen, Bin Xu, Hui Li
10.1016/j.ajog.2023.12.039
American Journal of Obstetrics & Gynecology (2024)
2024-01-05
American Journal of Obstetrics & Gynecology
2024-01-05
Systematic Review
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Pelvic floor muscle training as treatment for female sexual dysfunction: a systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(24)00006-1/fulltext?rss=yes
This study aimed to investigate the efficacy of pelvic floor muscle training in treating female sexual dysfunction.
Pelvic floor muscle training as treatment for female sexual dysfunction: a systematic review and meta-analysis
Cristine Homsi Jorge, Kari Bø, Camila Chiazuto Catai, Luiz Gustavo Oliveira Brito, Patricia Driusso, Merete Kolberg Tennfjord
10.1016/j.ajog.2024.01.001
American Journal of Obstetrics & Gynecology (2024)
2024-01-05
American Journal of Obstetrics & Gynecology
2024-01-05
Systematic Review
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Modeling delay of age at natural menopause with planned tissue cryopreservation and autologous transplantation
https://www.ajog.org/article/S0002-9378(24)00003-6/fulltext?rss=yes
Ovarian tissue cryopreservation has been proven to preserve fertility against gonadotoxic treatments. It has not been clear how this procedure would perform if planned for slowing ovarian aging.
Modeling delay of age at natural menopause with planned tissue cryopreservation and autologous transplantation
Joshua Johnson, Sean D. Lawley, John W. Emerson, Kutluk H. Oktay
10.1016/j.ajog.2023.12.037
American Journal of Obstetrics & Gynecology (2024)
2024-01-04
American Journal of Obstetrics & Gynecology
2024-01-04
Original Research
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Incidence of breakthrough bleeding in transgender and gender-diverse individuals on long-term testosterone
https://www.ajog.org/article/S0002-9378(24)00002-4/fulltext?rss=yes
Little is known about the maintenance of amenorrhea among transgender and gender-diverse individuals with uteri who are using long-term testosterone gender-affirming hormone therapy. Emerging data describe breakthrough bleeding among adolescents on long-term testosterone therapy and among adults who are seeking a gender-affirming hysterectomy. More studies are needed to better understand breakthrough bleeding patterns among transgender and gender-diverse individuals with uteri who are using testosterone, including the frequency, timing, and etiology of bleeding and how these patterns may differ between adults and younger populations.
Incidence of breakthrough bleeding in transgender and gender-diverse individuals on long-term testosterone
Frances W. Grimstad, Elizabeth R. Boskey, Rachael S. Clark, Cecile A. Ferrando
10.1016/j.ajog.2023.12.036
American Journal of Obstetrics & Gynecology (2024)
2024-01-03
American Journal of Obstetrics & Gynecology
2024-01-03
Original Research
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Effect of COVID-19 pandemic on same-day discharge for elective benign hysterectomy
https://www.ajog.org/article/S0002-9378(24)00001-2/fulltext?rss=yes
Increasing the use of minimally invasive hysterectomy (MIH) approaches has enabled greater use of same-day discharge (SDD).1 This study aimed to determine whether the COVID-19 pandemic was associated with an increased likelihood of SDD among patients undergoing elective MIH for benign indications and discharged within postoperative day 1. The secondary aim was to determine whether the pandemic was associated with postoperative readmission rates after SDD.
Effect of COVID-19 pandemic on same-day discharge for elective benign hysterectomy
Caroline Fryar, Steven Mouro, James L. Whiteside, Dmitry Tumin
10.1016/j.ajog.2023.12.035
American Journal of Obstetrics & Gynecology (2024)
2024-01-03
American Journal of Obstetrics & Gynecology
2024-01-03
Research Letter
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Risk of progression of cervical intraepithelial neoplasia grade 2 in human papillomavirus–vaccinated and unvaccinated women: a population-based cohort study
https://www.ajog.org/article/S0002-9378(23)02035-5/fulltext?rss=yes
Many countries have implemented active surveillance (ie, leaving the lesion untreated) as an option among younger women with cervical intraepithelial neoplasia grade 2 because regression rates are high and excisional treatment increases the risk for preterm birth in subsequent pregnancies. However, early identification of women at increased risk for progression to cervical intraepithelial neoplasia grade 3 or worse is important to ensure timely treatment. Because women who have received a human papillomavirus vaccine have a lower risk for cervical cancer, they may have a lower risk for progression of untreated cervical intraepithelial neoplasia grade 2 to cervical intraepithelial neoplasia grade 3 or worse.
Risk of progression of cervical intraepithelial neoplasia grade 2 in human papillomavirus–vaccinated and unvaccinated women: a population-based cohort study
Louise Krog, Kathrine D. Lycke, Johnny Kahlert, Tina H. Randrup, Pernille T. Jensen, Anne F. Rositch, Anne Hammer
10.1016/j.ajog.2023.11.1235
American Journal of Obstetrics & Gynecology (2023)
2023-12-30
American Journal of Obstetrics & Gynecology
2023-12-30
Original Research
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Normotensive placental extracellular vesicles provide long-term protection against hypertension and cardiovascular disease
https://www.ajog.org/article/S0002-9378(23)02189-0/fulltext?rss=yes
Women with normotensive pregnancy are at a reduced risk of developing cardiovascular disease postpartum compared with those who experience hypertensive conditions during pregnancy. However, the underlying mechanisms remain poorly understood. During normotensive pregnancy, vast numbers of placental extracellular vesicles are released into the maternal circulation, which protect endothelial cells from activation and alter maternal vascular tone. We hypothesized that placental extracellular vesicles play a mechanistic role in lowering the risk of cardiovascular disease following normotensive pregnancy.
Normotensive placental extracellular vesicles provide long-term protection against hypertension and cardiovascular disease
Yourong Feng, Sandy Lau, Qi Chen, Charlotte Oyston, Katie Groom, Carolyn J. Barrett, Lawrence W. Chamley
10.1016/j.ajog.2023.12.030
American Journal of Obstetrics & Gynecology (2023)
2023-12-27
American Journal of Obstetrics & Gynecology
2023-12-27
Original Research
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Establishing the validity of a diagnostic questionnaire for childbirth-related posttraumatic stress disorder: a reply
https://www.ajog.org/article/S0002-9378(23)02182-8/fulltext?rss=yes
We thank Drs May and Callins for their interest in our work and we hope that this work will increase awareness about and the recognition of traumatic experiences during childbirth and the associated maternal mental health toll. We strongly support that the PTSD Checklist for the Diagnostic and Statistical Manual for Mental Disorder, 5 fifth edition (DSM-5) may empower providers and advance patient-centered care because no recommended guidelines exist for screening for childbirth-related posttraumatic stress disorder (CB-PTSD).
Establishing the validity of a diagnostic questionnaire for childbirth-related posttraumatic stress disorder: a reply
Sharon Dekel, Scott P. Orr
10.1016/j.ajog.2023.12.026
American Journal of Obstetrics & Gynecology (2023)
2023-12-27
American Journal of Obstetrics & Gynecology
2023-12-27
Letter to the Editors
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Single-layer vs double-layer uterine closure during cesarean delivery: 3-year follow-up of a randomized controlled trial (2Close study)
https://www.ajog.org/article/S0002-9378(23)02191-9/fulltext?rss=yes
The rising rate of cesarean deliveries has led to an increased incidence of long long-term complications, including niche formation in the uterine scar. Niche development is associated with various gynecologic complaints and complications in subsequent pregnancies, such as uterine rupture and placenta accreta spectrum disorders. Although uterine closure technique is considered a potential risk factor for niche development, consensus on the optimal technique remains elusive.
Single-layer vs double-layer uterine closure during cesarean delivery: 3-year follow-up of a randomized controlled trial (2Close study)
Carry Verberkt, Sanne I. Stegwee, Lucet F. Van der Voet, W. Marchien Van Baal, Kitty Kapiteijn, Peggy M.A.J. Geomini, Rik Van Eekelen, Christianne J.M. de Groot, Robert A. de Leeuw, Judith A.F. Huirne, 2Close study group
10.1016/j.ajog.2023.12.032
American Journal of Obstetrics & Gynecology (2023)
2023-12-26
American Journal of Obstetrics & Gynecology
2023-12-26
Original Research
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Comparing population–based fetal growth standards in a US cohort
https://www.ajog.org/article/S0002-9378(23)02193-2/fulltext?rss=yes
No fetal growth standard is currently endorsed for universal use in the United States. Newer standards improve upon the methodologic limitations of older studies; however, before adopting into practice, it is important to know how recent standards perform at identifying fetal undergrowth or overgrowth and at predicting subsequent neonatal morbidity or mortality in US populations.
Comparing population–based fetal growth standards in a US cohort
Jessica L. Gleason, Uma M. Reddy, Zhen Chen, William A. Grobman, Ronald J. Wapner, Jon G. Steller, Hyagriv Simhan, Christina M. Scifres, Nathan Blue, Samuel Parry, Katherine L. Grantz
10.1016/j.ajog.2023.12.034
American Journal of Obstetrics & Gynecology (2023)
2023-12-25
American Journal of Obstetrics & Gynecology
2023-12-25
Original Research
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TEMPORARY REMOVAL: Tranexamic Acid to reduce post-partum blood loss after a vaginal delivery: a double-blinded randomized controlled trial
https://www.ajog.org/article/S0002-9378(23)02192-0/fulltext?rss=yes
TEMPORARY REMOVAL: Tranexamic Acid to reduce post-partum blood loss after a vaginal delivery: a double-blinded randomized controlled trial
Pratibha Arya, Garima Yadav, Pratibha Singh, Navdeep Kaur Ghuman, Charu Sharma, Meenakshi Gothwal, Priyanka Kathuria
10.1016/j.ajog.2023.12.033
American Journal of Obstetrics & Gynecology (2023)
2023-12-25
American Journal of Obstetrics & Gynecology
2023-12-25
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Aspirin for evidence-based preeclampsia prevention trial: effects of aspirin on maternal serum pregnancy-associated plasma protein A and placental growth factor trajectories in pregnancy
https://www.ajog.org/article/S0002-9378(23)02190-7/fulltext?rss=yes
The exact mechanism by which aspirin prevents preeclampsia remains unclear. Its effects on serum placental biomarkers throughout pregnancy are also unknown.
Aspirin for evidence-based preeclampsia prevention trial: effects of aspirin on maternal serum pregnancy-associated plasma protein A and placental growth factor trajectories in pregnancy
Daniel L. Rolnik, Argyro Syngelaki, Neil O’Gorman, David Wright, Kypros H. Nicolaides, Liona C. Poon
10.1016/j.ajog.2023.12.031
American Journal of Obstetrics & Gynecology (2023)
2023-12-25
American Journal of Obstetrics & Gynecology
2023-12-25
Original Research
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Fetal size vs growth: comparative analysis of 3 models of growth velocity based on third trimester estimated fetal weights for identifying stillbirth risk
https://www.ajog.org/article/S0002-9378(23)02188-9/fulltext?rss=yes
Fetal growth velocity is being recognized as an important parameter by which to monitor fetal wellbeing, in addition to assessment of fetal size. However, there are different models and standards in use by which velocity is being assessed.
Fetal size vs growth: comparative analysis of 3 models of growth velocity based on third trimester estimated fetal weights for identifying stillbirth risk
Oliver Hugh, Joyce Cowan, Emily Butler, Jason Gardosi
10.1016/j.ajog.2023.12.029
American Journal of Obstetrics & Gynecology (2023)
2023-12-25
American Journal of Obstetrics & Gynecology
2023-12-25
Original Research
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Aspirin pharmacokinetics and pharmacodynamics through gestation
https://www.ajog.org/article/S0002-9378(23)02183-X/fulltext?rss=yes
Low dose aspirin is recommended for prevention of preeclampsia, however there is not consensus on the appropriate dose. Pregnancy specific changes have the potential to impact the pharmacology of aspirin in pregnancy, however there are very limited studies on aspirin pharmacokinetics in pregnancy and none linking pharmacokinetics (PK, drug dose and drug level) to pharmacodynamics (PD, drug dose and physiologic response) in pregnancy. As a result, we do not have a good understanding of the pharmacologic response to aspirin in pregnancy, which has important implications for clinical efficacy.
Aspirin pharmacokinetics and pharmacodynamics through gestation
Rupsa C. Boelig, Gagan Kaushal, Ankit Rochani, Steven E. McKenzie, Walter K. Kraft
10.1016/j.ajog.2023.12.028
American Journal of Obstetrics & Gynecology (2023)
2023-12-23
American Journal of Obstetrics & Gynecology
2023-12-23
Original Research
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Letter to the editor regarding “establishing the validity of a diagnostic questionnaire for childbirth-related post-traumatic stress disorder”
https://www.ajog.org/article/S0002-9378(23)02181-6/fulltext?rss=yes
We welcome the article by Arora et al,1 which discusses traumatic childbirth experiences and posttraumatic stress disorder (PTSD) screening. We would like to offer 4 items for contemplation regarding the screening questionnaire for childbirth-related PTSD (CB-PTSD).
Letter to the editor regarding “establishing the validity of a diagnostic questionnaire for childbirth-related post-traumatic stress disorder”
Alicia M.D. May, Keisha R. Callins
10.1016/j.ajog.2023.12.027
American Journal of Obstetrics & Gynecology (2023)
2023-12-23
American Journal of Obstetrics & Gynecology
2023-12-23
Letter to the Editors
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Reply: when the clinical point gets lost in the decimal point
https://www.ajog.org/article/S0002-9378(23)02180-4/fulltext?rss=yes
We appreciate Liqi Li’s attention to the proportions in our study. Li calculated proportions that differed from ours, and raised concern of potential errors elsewhere in the results. However, the differences were due to rounding. Our default software settings were set to output proportions to the second decimal position. Further rounding to the first position led to some proportions that were rounded up rather than down. These rounding inexactitudes are not errors and have no reflection on the analytic strategy, interpretation of results, or importance of the findings.
Reply: when the clinical point gets lost in the decimal point
Nathalie Auger, Émilie Brousseau, William D. Fraser
10.1016/j.ajog.2023.12.025
American Journal of Obstetrics & Gynecology (2023)
2023-12-21
American Journal of Obstetrics & Gynecology
2023-12-21
Letter to the Editors
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Comment on: second trimester abortion and risk of live birth
https://www.ajog.org/article/S0002-9378(23)02179-8/fulltext?rss=yes
I read with interest the article by Auger et al1 entitled “Second trimester abortion and risk of live birth.” The objective of this study was to assess the incidence of live births following second trimester pregnancy termination and ascertain the associated risk factors. The findings of this investigation indicate that second trimester abortion poses a potential risk to live birth, particularly during the gestational period of 20 to 24 weeks, although the administration of feticidal injection may mitigate this outcome.
Comment on: second trimester abortion and risk of live birth
Liqi Li
10.1016/j.ajog.2023.12.024
American Journal of Obstetrics & Gynecology (2023)
2023-12-21
American Journal of Obstetrics & Gynecology
2023-12-21
Letter to the Editors
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Society for Maternal-Fetal Medicine Consult Series #69: Hepatitis B in pregnancy: updated guidelines
https://www.ajog.org/article/S0002-9378(23)02173-7/fulltext?rss=yes
More than 290 million people worldwide, and almost 2 million people in the United States, are infected with hepatitis B virus, which can lead to chronic hepatitis B, a vaccine-preventable communicable disease. The prevalence of chronic hepatitis B infection in pregnancy is estimated to be 0.7% to 0.9% in the United States, with >25,000 infants born annually at risk for chronic infection due to perinatal transmission. Given the burden of disease associated with chronic hepatitis B infection, recent national guidance has expanded both the indications for screening for hepatitis B infection and immunity and the indications for vaccination.
Society for Maternal-Fetal Medicine Consult Series #69: Hepatitis B in pregnancy: updated guidelines
Society for Maternal-Fetal Medicine (SMFM), Martina L. Badell, Malavika Prabhu, Jodie Dionne, Alan T.N. Tita, Neil S. Silverman, SMFM Publications Committee
10.1016/j.ajog.2023.12.023
American Journal of Obstetrics & Gynecology (2023)
2023-12-21
American Journal of Obstetrics & Gynecology
2023-12-21
SMFM Consult Series
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The association of post–embryo transfer SARS-CoV-2 infection with early pregnancy outcomes in in vitro fertilization: a prospective cohort study
https://www.ajog.org/article/S0002-9378(23)02171-3/fulltext?rss=yes
The influence of SARS-CoV-2 infection after embryo transfer on early pregnancy outcomes in in vitro fertilization or intracytoplasmic sperm injection–embryo transfer treatment remains inadequately understood. This knowledge gap endures despite an abundance of studies investigating the repercussions of preceding SARS-CoV-2 infection on early pregnancy outcomes in spontaneous pregnancies.
The association of post–embryo transfer SARS-CoV-2 infection with early pregnancy outcomes in in vitro fertilization: a prospective cohort study
Xue-Fei Li, Yong-Jia Zhang, Ying-Ling Yao, Ming-Xing Chen, Li-Li Wang, Meng-Di Wang, Xin-Yue Hu, Xiao-Jun Tang, Zhao-Hui Zhong, Li-Juan Fu, Xin Luo, Xing-Yu Lv, Li-Hong Geng, Qi Wan, Yu-Bin Ding
10.1016/j.ajog.2023.12.022
American Journal of Obstetrics & Gynecology (2023)
2023-12-20
American Journal of Obstetrics & Gynecology
2023-12-20
Original Research
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The obstetrical emergency department: need, rationale, and guide to implementation
https://www.ajog.org/article/S0002-9378(23)02170-1/fulltext?rss=yes
The past 2 decades have seen dramatic growth in the number of obstetrics and gynecology hospitalists, and many hospitals have created obstetrical-specific emergency departments. The goals of an obstetrics emergency department are to provide safe and efficient care to the pregnant dyad and postpartum patient, while generating revenue for emergency services provided. In an obstetrics emergency department, all patients must be evaluated in person by a licensed practitioner, whereas historically they may have been evaluated in person by nursing staff or a trainee.
The obstetrical emergency department: need, rationale, and guide to implementation
Sarah L. Bradley, Vasiliki Tatsis, Kristen Wolfe, Trina Pagano, Andrea Tucker, Andrea Bartlett, Tyler Katz
10.1016/j.ajog.2023.12.021
American Journal of Obstetrics & Gynecology (2023)
2023-12-19
American Journal of Obstetrics & Gynecology
2023-12-19
Clinical Opinion
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Throwing the spotlight on group B streptococcal early onset sepsis prevention: the importance of appropriate second-line antimicrobials
https://www.ajog.org/article/S0002-9378(23)02168-3/fulltext?rss=yes
We thank Dr Iwai and colleagues for their interest in our recently published article,1 and appreciate the opportunity to respond to their letter. We hope that this study will spotlight the role of second-line antibiotics in group B streptococcal (GBS) early onset sepsis (EOS) prevention. We chose to include all neonates born to GBS-positive mothers who were colonized with GBS from any specimen during pregnancy as a target population because, as the authors pointed out, GBS early onset sepsis is a relatively rare occurrence at 0.5 in 1000 live births.
Throwing the spotlight on group B streptococcal early onset sepsis prevention: the importance of appropriate second-line antimicrobials
Jia Ming Low, Jan Hau Lee, Henry P. Foote, Christoph P. Hornik, Reese H. Clark, Rachel G. Greenberg
10.1016/j.ajog.2023.12.019
American Journal of Obstetrics & Gynecology (2023)
2023-12-19
American Journal of Obstetrics & Gynecology
2023-12-19
Letter to the Editors
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Toward the prevention of group B streptococcal early onset sepsis: the importance of defining target populations and second-line antimicrobials in line with current guideline recommendations
https://www.ajog.org/article/S0002-9378(23)02167-1/fulltext?rss=yes
We read with interest the recently published article by Low et al.1 To the authors’ excellence, this study tackled the clinically relevant issue among all healthcare professionals involved in neonatal care, that is, group B streptococcal (GBS) early-onset
Toward the prevention of group B streptococcal early onset sepsis: the importance of defining target populations and second-line antimicrobials in line with current guideline recommendations
Chikako Iwai, Ryuji Sasaki, Takashi Yoshioka
10.1016/j.ajog.2023.12.017
American Journal of Obstetrics & Gynecology (2023)
2023-12-19
American Journal of Obstetrics & Gynecology
2023-12-19
Letter to the Editors
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Perinatal outcomes of pregnancies complicated by prenatally resolved fetal growth restriction
https://www.ajog.org/article/S0002-9378(23)02165-8/fulltext?rss=yes
Fetal growth restriction (FGR) is associated with an increased risk of adverse maternal and perinatal outcomes.1–3 In our experience, prenatal sonographic resolution of FGR commonly occurs. Considering that maternal and perinatal outcomes in these pregnancies have not been widely studied, we compared the outcomes of these pregnancies to those without FGR and those with persistent FGR.4
Perinatal outcomes of pregnancies complicated by prenatally resolved fetal growth restriction
Luke N. Roberts, Haley Perkins, Wendy Y. Craig, Joseph R. Wax
10.1016/j.ajog.2023.12.015
American Journal of Obstetrics & Gynecology (2023)
2023-12-19
American Journal of Obstetrics & Gynecology
2023-12-19
Research Letter
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Prescription medication use during pregnancy in the United States from 2011 to 2020: trends and safety evidence
https://www.ajog.org/article/S0002-9378(23)02172-5/fulltext?rss=yes
Medication use during pregnancy has increased in the United States despite the lack of safety data for many medications.
Prescription medication use during pregnancy in the United States from 2011 to 2020: trends and safety evidence
Omar Mansour, Rienna G. Russo, Loreen Straub, Brian T. Bateman, Kathryn J. Gray, Krista F. Huybrechts, Sonia Hernández-Díaz
10.1016/j.ajog.2023.12.020
American Journal of Obstetrics & Gynecology (2023)
2023-12-18
American Journal of Obstetrics & Gynecology
2023-12-18
Original Research
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Genetic polymorphisms associated with urinary tract infection in children and adults: a systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(23)02169-5/fulltext?rss=yes
The lifetime risk of urinary tract infection is known from first-degree relative studies to be highly heritable. Associations have also been observed across the life course from pediatric urinary tract infection to recurrent urinary tract infection in adulthood, suggesting lifelong susceptibility factors. Candidate gene studies and genome-wide association studies have tested for genetic associations of urinary tract infection; however, no contemporary systematic synthesis of studies is available.
Genetic polymorphisms associated with urinary tract infection in children and adults: a systematic review and meta-analysis
Jiakun Yu, Glaucia Miranda Varella Pereira, Kristina Allen-Brady, Romana Cuffolo, Aditi Siddharth, Marianne Koch, John W.F. Chua, Felice Sorrentino, Oskar Dytko, Kaa-Yung Ng, Philippe Violette, Vik Khullar, Zhan Tao Wang, Rufus Cartwright
10.1016/j.ajog.2023.12.018
American Journal of Obstetrics & Gynecology (2023)
2023-12-18
American Journal of Obstetrics & Gynecology
2023-12-18
Systematic Review
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Preventing posttraumatic stress disorder following childbirth: a systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(23)02137-3/fulltext?rss=yes
Women can develop posttraumatic stress disorder in response to experienced or perceived traumatic, often medically complicated, childbirth; the prevalence of these events remains high in the United States. Currently, no recommended treatment exists in routine care to prevent or mitigate maternal childbirth-related posttraumatic stress disorder. We conducted a systematic review and meta-analysis of clinical trials that evaluated any therapy to prevent or treat childbirth-related posttraumatic stress disorder.
Preventing posttraumatic stress disorder following childbirth: a systematic review and meta-analysis
Sharon Dekel, Joanna E. Papadakis, Beatrice Quagliarini, Christina T. Pham, Kevin Pacheco-Barrios, Francine Hughes, Kathleen M. Jagodnik, Rasvitha Nandru
10.1016/j.ajog.2023.12.013
American Journal of Obstetrics & Gynecology (2023)
2023-12-17
American Journal of Obstetrics & Gynecology
2023-12-17
Systematic Review
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Physical job demands in pregnancy and associated musculoskeletal health and employment outcomes: a systematic review
https://www.ajog.org/article/S0002-9378(23)02138-5/fulltext?rss=yes
A decline in musculoskeletal health during pregnancy is an underappreciated adverse outcome of pregnancy that can have immediate and long-term health consequences. High physical job demands are known risk factors for nontraumatic musculoskeletal disorders in the general working population. Evidence from meta-analyses suggest that occupational lifting and prolonged standing during pregnancy may increase risk of adverse pregnancy outcomes. This systematic review examined associations between occupational lifting or postural load in pregnancy and associated musculoskeletal disorders and related sequalae.
Physical job demands in pregnancy and associated musculoskeletal health and employment outcomes: a systematic review
Leslie A. MacDonald, Candice Y. Johnson, Ming-Lun Lu, Albeliz Santiago-Colón, Gaelen P. Adam, Hannah J. Kimmel, Peter G. Napolitano, Ian J. Saldanha
10.1016/j.ajog.2023.12.014
American Journal of Obstetrics & Gynecology (2023)
2023-12-16
American Journal of Obstetrics & Gynecology
2023-12-16
Systematic Review
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Twenty-four-hour urinary protein excretion in uncomplicated singleton pregnancy
https://www.ajog.org/article/S0002-9378(23)02129-4/fulltext?rss=yes
Twenty-four-hour urinary total protein excretion is an essential parameter used for evaluation of renal function and early detection of gestational complications. However, data on reference ranges of 24-hour urinary total protein excretion in normal pregnancy are scarce.
Twenty-four-hour urinary protein excretion in uncomplicated singleton pregnancy
Yuguo Deng, Qiulu Wu, Xiaoyu Tan, Wei Ye, Guilian Liao, Jinying Yang
10.1016/j.ajog.2023.12.009
American Journal of Obstetrics & Gynecology (2023)
2023-12-13
American Journal of Obstetrics & Gynecology
2023-12-13
Original Research
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Abortion reporting following changes in state legislation
https://www.ajog.org/article/S0002-9378(23)02132-4/fulltext?rss=yes
Texas has a longstanding requirement for abortion complication reporting by physicians following pregnancy termination. Before state legislation was passed in 2021 (Texas 87th Legislative Session), our institution submitted reporting for medically indicated pregnancy terminations as permitted by state law. Abortion is now banned in Texas with exception for maternal “life-threatening physical condition.”1 Abortion reporting responsibilities were also changed; effective December 2021, legislation expanded the definition of reportable “abortion complications” from 12 to 28 entities1 (Supplemental Table 1).
Abortion reporting following changes in state legislation
Anjali Nambiar, Jessica E. Pruszynski, Lisa Thiele, Patricia Santiago-Munoz, David B. Nelson, Catherine Y. Spong, Courtney C. Baker
10.1016/j.ajog.2023.12.011
American Journal of Obstetrics & Gynecology (2023)
2023-12-12
American Journal of Obstetrics & Gynecology
2023-12-12
Research Letter
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Social vulnerability index and stillbirth: a secondary analysis of the Stillbirth Collaborative Research Network
https://www.ajog.org/article/S0002-9378(23)02131-2/fulltext?rss=yes
Stillbirth remains one of the most common adverse pregnancy outcomes in the United States.1 Various socially constructed indexes have been created and used to study the relationship between social determinants of health and adverse pregnancy outcomes.2–4 However, these indexes remain understudied in assessing stillbirth risk in the United States.3–5 We aimed to determine if there is an association between the Centers for Disease Control and Prevention’s (CDC’s) social vulnerability index (SVI) and stillbirth in the United States.
Social vulnerability index and stillbirth: a secondary analysis of the Stillbirth Collaborative Research Network
Megan M. Smith, Tess E.K. Cersonsky, Nina K. Ayala, Uma Reddy, George R. Saade, Donald J. Dudley, Robert M. Silver, Halit Pinar, Robert L. Goldenberg, Adam K. Lewkowitz, Brock E. Polnaszek
10.1016/j.ajog.2023.12.010
American Journal of Obstetrics & Gynecology (2023)
2023-12-12
American Journal of Obstetrics & Gynecology
2023-12-12
Research Letter
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Prenatal diagnosis of chromosomal abnormalities using optical genome mapping vs chromosomal microarray
https://www.ajog.org/article/S0002-9378(23)02130-0/fulltext?rss=yes
Optical genome mapping (OGM) is the next-generation cytogenomic technology (Supplementary Material). Emerging studies and commentaries demonstrate that OGM is able to detect the majority of structural variations in a single assay with high concordance with standard-of-care methods.1–3 However, the application and evaluation of OGM in prenatal diagnosis remains limited.4,5 Furthermore, no prospective study evaluating its application in prenatal setting has been reported. This study aimed to evaluate the feasibility, efficacy, and incremental yield of OGM compared with chromosomal microarray analysis (CMA) and karyotyping for routine prenatal diagnosis.
Prenatal diagnosis of chromosomal abnormalities using optical genome mapping vs chromosomal microarray
Ping Hu, Yiyun Xu, Qinxin Zhang, Ran Zhou, Xiuqing Ji, Yan Wang, Zhengfeng Xu
10.1016/j.ajog.2023.12.012
American Journal of Obstetrics & Gynecology (2023)
2023-12-12
American Journal of Obstetrics & Gynecology
2023-12-12
Research Letter
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Fetal fraction of cell-free DNA in noninvasive prenatal testing and adverse pregnancy outcomes: a nationwide retrospective cohort study of 56,110 pregnant women
https://www.ajog.org/article/S0002-9378(23)02128-2/fulltext?rss=yes
Noninvasive prenatal testing by cell-free DNA analysis is offered to pregnant women worldwide to screen for fetal aneuploidies. In noninvasive prenatal testing, the fetal fraction of cell-free DNA in the maternal circulation is measured as a quality control parameter. Given that fetal cell-free DNA originates from the placenta, the fetal fraction might also reflect placental health and maternal pregnancy adaptation.
Fetal fraction of cell-free DNA in noninvasive prenatal testing and adverse pregnancy outcomes: a nationwide retrospective cohort study of 56,110 pregnant women
Ellis C. Becking, Peter G. Scheffer, Jens Henrichs, Caroline J. Bax, Neeltje M.T.H. Crombag, Marjan M. Weiss, Merryn V.E. Macville, Diane Van Opstal, Elles M.J. Boon, Erik A. Sistermans, Lidewij Henneman, Ewoud Schuit, Mireille N. Bekker
10.1016/j.ajog.2023.12.008
American Journal of Obstetrics & Gynecology (2023)
2023-12-12
American Journal of Obstetrics & Gynecology
2023-12-12
Original Research
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Research on intrauterine manipulators for endometrial cancer: attention to study-level characteristics
https://www.ajog.org/article/S0002-9378(23)02122-1/fulltext?rss=yes
We would like to commend Carlo Zorzato et al1 for their exhaustive review of intrauterine manipulator (IUM) use during minimally invasive hysterectomies for endometrial cancer. We read with interest their ultimate conclusion that IUM use was not associated with oncologic outcomes, but wish to draw attention to the lower boundary of the 95% confidence interval for recurrence-free survival of 0.99 to 2.33. In their discussion, the authors acknowledge that the hazard ratio (HR) of 1.52 “suggests a possible association between the IUM use and a higher risk of recurrence” and that “definitive conclusions are impossible” given the heterogeneity of the studies.
Research on intrauterine manipulators for endometrial cancer: attention to study-level characteristics
X. Mona Guo, Lauren M. Lim, Shinya Matsuzaki, Koji Matsuo
10.1016/j.ajog.2023.12.004
American Journal of Obstetrics & Gynecology (2023)
2023-12-08
American Journal of Obstetrics & Gynecology
2023-12-08
Letter to the Editors
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Risk of thrombosis and bleeding in gynecologic noncancer surgery: systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(23)02117-8/fulltext?rss=yes
This study aimed to provide procedure-specific estimates of the risk for symptomatic venous thromboembolism and major bleeding in noncancer gynecologic surgeries.
Risk of thrombosis and bleeding in gynecologic noncancer surgery: systematic review and meta-analysis
Lauri I. Lavikainen, Gordon H. Guyatt, Ilkka E.J. Kalliala, Rufus Cartwright, Anna L. Luomaranta, Robin W.M. Vernooij, Riikka M. Tähtinen, Borna Tadayon Najafabadi, Tino Singh, ROTBIGGS Investigators, Negar Pourjamal, Sanna M. Oksjoki, Nadina Khamani, Päivi K. Karjalainen, Kirsi M. Joronen, Matthew L. Izett-Kay, Jari Haukka, Alex L.E. Halme, Fang Zhou Ge, Päivi J. Galambosi, P.J. Devereaux, Jovita L. Cárdenas, Rachel J. Couban, Karoliina M. Aro, Riikka L. Aaltonen, Kari A.O. Tikkinen
10.1016/j.ajog.2023.11.1255
American Journal of Obstetrics & Gynecology (2023)
2023-12-08
American Journal of Obstetrics & Gynecology
2023-12-08
Systematic Review
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Reply to Time to rethink maneuvers to resolve shoulder dystocia?
https://www.ajog.org/article/S0002-9378(23)02125-7/fulltext?rss=yes
We thank Dr Meenan for her comments. First, Meenan and Gaskin1 previously advocated to perform posterior arm delivery in all-4 position. We agree that in some situations, it may be easier to perform posterior arm delivery in all-4 position. Yet, because the success rate of posterior arm delivery is already high (86.1%) in supine position,2 it is very reasonable to first try it in supine position. Furthermore, positioning the mother in all-4 position needs cooperation from the mother and takes some time.
Reply to Time to rethink maneuvers to resolve shoulder dystocia?
Tak Yeung Leung, So Ling Lau
10.1016/j.ajog.2023.12.007
American Journal of Obstetrics & Gynecology (2023)
2023-12-07
American Journal of Obstetrics & Gynecology
2023-12-07
Letter to the Editors
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Time to rethink maneuvers to resolve shoulder dystocia?
https://www.ajog.org/article/S0002-9378(23)02124-5/fulltext?rss=yes
We appreciated the rational approach of the expert review entitled, “A Critical evaluation of the external and internal maneuvers for resolution of shoulder dystocia,”1 but we would like to add a few comments. We are impressed that delivery of the posterior arm has a consistently higher success rate (86.1%) than other maneuvers and agree that consideration should be given to earlier use of this maneuver. At the same time, we are wondering why the all-4’s position (Gaskin Maneuver), which makes delivery of the posterior arm so much easier and more successful (86.9% vs 25% success in the lithotomy position)2 is still near the bottom of the list.
Time to rethink maneuvers to resolve shoulder dystocia?
Anna L. Meenan, Ina May Gaskin
10.1016/j.ajog.2023.12.006
American Journal of Obstetrics & Gynecology (2023)
2023-12-07
American Journal of Obstetrics & Gynecology
2023-12-07
Letter to the Editors
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An institutional intervention on toxicology testing reduces inequities during the birthing hospitalization
https://www.ajog.org/article/S0002-9378(23)02120-8/fulltext?rss=yes
This study evaluated the effectiveness of the Mount Sinai Health System’s maternal toxicology policy revision in conjunction with the implementation of the Basic Obstetric Assessment Screen (BOAS), a 6-question screening questionnaire. Together, these components form the BOAS Initiative. This intervention was designed to mitigate the sociodemographic inequities in perinatal substance use and substance use disorder (SUD) assessments. Despite similar rates of substance use across different races,1 historically, minorities have faced biased toxicology testing and, subsequently, disproportionately higher rates of reporting to child welfare service agencies.
An institutional intervention on toxicology testing reduces inequities during the birthing hospitalization
Leah L. Habersham, Angela T. Bianco, Christopher J. Kudrich, Candice L. Woolfolk, Toni A. Stern, Joanne L. Stone, Yasmin L. Hurd
10.1016/j.ajog.2023.11.1254
American Journal of Obstetrics & Gynecology (2023)
2023-12-07
American Journal of Obstetrics & Gynecology
2023-12-07
Research Letter
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Reply to Research on intrauterine manipulators for endometrial cancer: attention to study-level characteristics
https://www.ajog.org/article/S0002-9378(23)02123-3/fulltext?rss=yes
We would like to thank Guo et al for their Letter to the Editors regarding our recently published systematic review and meta-analysis on intrauterine manipulator (IUM) use during minimally invasive hysterectomies for endometrial cancer.1
Reply to Research on intrauterine manipulators for endometrial cancer: attention to study-level characteristics
Simone Garzon, Pier Carlo Zorzato, Stefano Uccella
10.1016/j.ajog.2023.12.005
American Journal of Obstetrics & Gynecology (2023)
2023-12-06
American Journal of Obstetrics & Gynecology
2023-12-06
Letter to the Editors
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Laparoscopic prepregnancy transabdominal cerclage: operative and pregnancy outcomes for a novel technique of suture placement using port closure device
https://www.ajog.org/article/S0002-9378(23)02119-1/fulltext?rss=yes
Transabdominal cerclage is an effective surgical intervention for preterm birth prevention. Placement of cervical sutures using a port closure device for prepregnancy laparoscopic abdominal cerclage has been used at our unit in recent years. We report the operative and pregnancy outcomes for prepregnancy laparoscopic abdominal cerclage using the port closure device and compare it with the outcomes of the traditional approach.For prepregnancy laparoscopic transabdominal cerclage (n=52), the port closure device approach was associated with less blood loss during surgery (0.95±4.4 mL vs 5.4±15.7 mL; P=.007) and a shorter hospital length of stay (0.0; 0.0–0.0 days vs 1.0; 0.0–1.0 days; P<.001).
Laparoscopic prepregnancy transabdominal cerclage: operative and pregnancy outcomes for a novel technique of suture placement using port closure device
Gillian A. Corbett, Catherine Windrim, Shane Higgins, Fionnuala M. McAuliffe, Michael Wilkinson, Donal O’Brien, Siobhan Corcoran
10.1016/j.ajog.2023.12.002
American Journal of Obstetrics & Gynecology (2023)
2023-12-06
American Journal of Obstetrics & Gynecology
2023-12-06
Surgeon's Corner
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Effect of nonsteroidal anti-inflammatory drugs on pelvic floor muscle regeneration in a preclinical birth injury rat model
https://www.ajog.org/article/S0002-9378(23)02118-X/fulltext?rss=yes
Pelvic floor muscle injury is a common consequence of vaginal childbirth. Nonsteroidal anti-inflammatory drugs are widely used postpartum analgesics. Multiple studies have reported negative effects of these drugs on limb muscle regeneration, but their impact on pelvic floor muscle recovery following birth injury has not been explored.
Effect of nonsteroidal anti-inflammatory drugs on pelvic floor muscle regeneration in a preclinical birth injury rat model
Alyssa J. Kobayashi, Francesca Boscolo Sesillo, Emmy Do, Marianna Alperin
10.1016/j.ajog.2023.12.001
American Journal of Obstetrics & Gynecology (2023)
2023-12-06
American Journal of Obstetrics & Gynecology
2023-12-06
Original Research
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A perplexing giant fetal cardiac mass: ultrasound features and management
https://www.ajog.org/article/S0002-9378(23)02121-X/fulltext?rss=yes
A 26-year-old G2P1001 at 33 weeks’ gestation was referred for consultation for a suspected fetal lung mass. The patient had routine antenatal care with a low-risk, cell-free DNA screen. Her history included a previous full-term, uncomplicated vaginal delivery and no relevant medical, surgical, or family history. She had a normal anatomical survey. An interval third-trimester ultrasound scan at 32 weeks’ gestation demonstrated a hyperechoic, solid, right thoracic mass measuring 3.4 cm and she was referred for further evaluation and management.
A perplexing giant fetal cardiac mass: ultrasound features and management
Nicole Krenitsky, Rebecca Epstein, Noelle Breslin, Chia-Ling Nhan-Chang, Julie Glickstein, Lynn L. Simpson, Maria Andrikopoulou
10.1016/j.ajog.2023.12.003
American Journal of Obstetrics & Gynecology (2023)
2023-12-05
American Journal of Obstetrics & Gynecology
2023-12-05
Images in Obstetrics
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Maternal major depression during early pregnancy is associated with impaired child executive functioning at 4.5 years of age
https://www.ajog.org/article/S0002-9378(23)02115-4/fulltext?rss=yes
Maternal depression is a serious condition that affects up to 1 in 7 pregnancies. Despite evidence linking maternal depression to pregnancy complications and adverse fetal outcomes, there remain large gaps in its identification and treatment. More work is needed to define the specific timing and severity of depression that most urgently requires intervention, where feasible, to protect maternal health and the developing fetus.
Maternal major depression during early pregnancy is associated with impaired child executive functioning at 4.5 years of age
Robert D. Levitan, Leslie Atkinson, Julia A. Knight, Rayjean J. Hung, Mark Wade, Jennifer M. Jenkins, Kashtin Bertoni, Jody Wong, Kellie E. Murphy, Stephen J. Lye, Stephen G. Matthews
10.1016/j.ajog.2023.11.1252
American Journal of Obstetrics & Gynecology (2023)
2023-11-30
American Journal of Obstetrics & Gynecology
2023-11-30
Original Research
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Risk of placenta accreta spectrum following myomectomy: a nationwide cohort study
https://www.ajog.org/article/S0002-9378(23)02065-3/fulltext?rss=yes
Whether myomectomy increases the risk of placenta accreta spectrum in the following pregnancies remains controversial.
Risk of placenta accreta spectrum following myomectomy: a nationwide cohort study
Ming-Wei Lin, Heng-Cheng Hsu, Elise Chia Hui Tan, Jin-Chung Shih, Chien-Nan Lee, Jehn-Hsiahn Yang, Yi-Yun Tai, Pao-Ling Torng, Shee-Uan Chen, Hung-Yuan Li, Shin-Yu Lin
10.1016/j.ajog.2023.11.1251
American Journal of Obstetrics & Gynecology (2023)
2023-11-28
American Journal of Obstetrics & Gynecology
2023-11-28
Original Research
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Reply to Third stage of labor: evidence-based practice related to interventions that prevent postpartum hemorrhage
https://www.ajog.org/article/S0002-9378(23)02064-1/fulltext?rss=yes
We thank Drs Zanardo and Straface for their interest in our paper entitled “Third stage of labor: evidence-based practice for prevention of adverse maternal and neonatal outcomes.” Our goal was to review the interventions that prevent postpartum hemorrhage and promote maternal and neonatal health during the third stage of labor. We chose to include widely used interventions, particularly those with higher levels of evidence, such as those evaluated in randomized trials or meta-analyses. Fetal delivery via the 1-step or 2-step approach was not evaluated in our review.
Reply to Third stage of labor: evidence-based practice related to interventions that prevent postpartum hemorrhage
Alyssa R. Hersh, Jorge E. Tolosa
10.1016/j.ajog.2023.11.1250
American Journal of Obstetrics & Gynecology (2023)
2023-11-28
American Journal of Obstetrics & Gynecology
2023-11-28
Letter to the Editors
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Third stage of labor: evidence-based practice related to interventions that prevent postpartum hemorrhage
https://www.ajog.org/article/S0002-9378(23)02063-X/fulltext?rss=yes
We recently enjoyed the excellent expert review by Hersh et al1 entitled “Third stage of labor: evidence-based practice for prevention of adverse maternal and neonatal outcomes,” published in the August 2023 issue of the American Journal of Obstetrics & Gynecology.
Third stage of labor: evidence-based practice related to interventions that prevent postpartum hemorrhage
Vincenzo Zanardo, Gianluca Straface
10.1016/j.ajog.2023.11.1249
American Journal of Obstetrics & Gynecology (2023)
2023-11-28
American Journal of Obstetrics & Gynecology
2023-11-28
Letter to the Editors
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A unified pelvic floor conceptual model for studying morphological changes with prolapse, age, and parity
https://www.ajog.org/article/S0002-9378(23)02061-6/fulltext?rss=yes
Several 2-dimensional and 3-dimensional measurements have been used to assess changes in pelvic floor structures and shape. These include assessment of urogenital and levator hiatus dimensions, levator injury grade, levator bowl volume, and levator plate shape. We argue that each assessment reflects underlying changes in an individual aspect of the overall changes in muscle and fascial structures. Vaginal delivery, aging, and interindividual variations in anatomy combine to affect pelvic floor structures and their connections in different ways.
A unified pelvic floor conceptual model for studying morphological changes with prolapse, age, and parity
John O. DeLancey, Sara Mastrovito, Mariana Masteling, Whitney Horner, James A. Ashton-Miller, Luyun Chen
10.1016/j.ajog.2023.11.1247
American Journal of Obstetrics & Gynecology (2023)
2023-11-28
American Journal of Obstetrics & Gynecology
2023-11-28
Expert Review
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The Arabin cervical pessary for the prevention of preterm birth in twin-to-twin transfusion syndrome treated by fetoscopic laser coagulation: a multicenter randomized controlled trial
https://www.ajog.org/article/S0002-9378(23)02059-8/fulltext?rss=yes
Miscarriage and preterm birth are leading causes of loss and disability in monochorionic twins after laser treatment of twin-twin transfusion syndrome.
The Arabin cervical pessary for the prevention of preterm birth in twin-to-twin transfusion syndrome treated by fetoscopic laser coagulation: a multicenter randomized controlled trial
Carlota Rodo, Nerea Maiz, Silvia Arevalo, Liesbeth Lewi, Isabel Couck, Bettina Hollwitz, Ioannis Kyvernitakis, Elena Carreras, Kurt Hecher
10.1016/j.ajog.2023.11.1245
American Journal of Obstetrics & Gynecology (2023)
2023-11-28
American Journal of Obstetrics & Gynecology
2023-11-28
Original Research
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Neonatal outcomes associated with in utero cannabis exposure: a population-based retrospective cohort study
https://www.ajog.org/article/S0002-9378(23)02034-3/fulltext?rss=yes
The full spectrum of associations between in utero cannabis exposure and adverse neonatal outcomes is still unclear.
Neonatal outcomes associated with in utero cannabis exposure: a population-based retrospective cohort study
Lyndsay A. Avalos, Sara R. Adams, Stacey E. Alexeeff, Nina R. Oberman, Monique B. Does, Deborah Ansley, Nancy Goler, Alisa A. Padon, Lynn D. Silver, Kelly C. Young-Wolff
10.1016/j.ajog.2023.11.1232
American Journal of Obstetrics & Gynecology (2023)
2023-11-26
American Journal of Obstetrics & Gynecology
2023-11-26
Original Research
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The accuracy of ultrasound scan in diagnosing retained products of conception: a systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(23)02057-4/fulltext?rss=yes
This study aimed to analyze and summarize the evidence on the accuracy of different ultrasound methods in the diagnosis of retained products of conception.
The accuracy of ultrasound scan in diagnosing retained products of conception: a systematic review and meta-analysis
Srividya Sundararajan, Subhadeep Roy, Lukasz T. Polanski
10.1016/j.ajog.2023.11.1243
American Journal of Obstetrics & Gynecology (2023)
2023-11-24
American Journal of Obstetrics & Gynecology
2023-11-24
Systematic Review
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Adverse live-born pregnancy outcomes among pregnant people with anorexia nervosa
https://www.ajog.org/article/S0002-9378(23)02056-2/fulltext?rss=yes
Previous findings related to the association of adverse pregnancy outcomes with anorexia nervosa are mixed.
Adverse live-born pregnancy outcomes among pregnant people with anorexia nervosa
Rebecca J. Baer, Gretchen Bandoli, Laura L. Jelliffe-Pawlowski, Kyung E. Rhee, Christina D. Chambers
10.1016/j.ajog.2023.11.1242
American Journal of Obstetrics & Gynecology (2023)
2023-11-24
American Journal of Obstetrics & Gynecology
2023-11-24
Original Research
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Placental, maternal, fetal, and technical origins of false-positive cell-free DNA screening results
https://www.ajog.org/article/S0002-9378(23)02055-0/fulltext?rss=yes
The introduction of noninvasive prenatal testing has resulted in substantial reductions to previously accepted false-positive rates of prenatal screening. Despite this, the possibility of false-positive results remains a challenging consideration in clinical practice, particularly considering the increasing uptake of genome-wide noninvasive prenatal testing, and the subsequent increased proportion of high-risk results attributable to various biological events besides fetal aneuploidy. Confined placental mosaicism, whereby chromosome anomalies exclusively affect the placenta, is perhaps the most widely accepted cause of false-positive noninvasive prenatal testing.
Placental, maternal, fetal, and technical origins of false-positive cell-free DNA screening results
Yvette Raymond, Shavi Fernando, Melody Menezes, Ben W. Mol, Andrew McLennan, Fabricio da Silva Costa, Tristan Hardy, Daniel L. Rolnik
10.1016/j.ajog.2023.11.1240
American Journal of Obstetrics & Gynecology (2023)
2023-11-24
American Journal of Obstetrics & Gynecology
2023-11-24
Expert Review
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Serious complications and recurrences after retropubic vs transobturator midurethral sling procedures for 2682 patients in the VIGI-MESH register
https://www.ajog.org/article/S0002-9378(23)02054-9/fulltext?rss=yes
Midurethral slings are the gold standard for treating stress urinary incontinence, but their complications may raise concerns. Complications may differ by the approach used to place them.
Serious complications and recurrences after retropubic vs transobturator midurethral sling procedures for 2682 patients in the VIGI-MESH register
Camille Armengaud, Arnaud Fauconnier, Hocine Drioueche, Sandrine Campagne Loiseau, Renaud De Tayrac, Christian Saussine, Laure Panel, Michel Cosson, Xavier Deffieux, Jean Philippe Lucot, Anne Cécile Pizzoferrato, Philippe Ferry, Adrien Vidart, Thibault Thubert, Grégoire Capon, Philippe Debodinance, Tristan Gauthier, Antoine Koebele, Delphine Salet-Lizee, Jean-François Hermieu, Xavier Game, Rajeev Ramanah, Gery Lamblin, Emilie Lecornet, Caroline Carlier-Guérin, Emmanuel Chartier-Kastler, Xavier Fritel
10.1016/j.ajog.2023.11.1241
American Journal of Obstetrics & Gynecology (2023)
2023-11-24
American Journal of Obstetrics & Gynecology
2023-11-24
Original Research
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Potential for ChatGPT in obstetrics and gynecology: a response
https://www.ajog.org/article/S0002-9378(23)02053-7/fulltext?rss=yes
Thank you for publishing the insightful letter on the remarkable potential of ChatGPT in the realm of obstetrics and gynecology.1 The authors eloquently highlight the achievements and potential of natural language processing models such as ChatGPT in revolutionizing various educational domains, including medical education.2 We appreciate the emphasis on the critical appraisal of the tool, considering the rapid advancements in the field.
Potential for ChatGPT in obstetrics and gynecology: a response
Amos Grünebaum, Susan Pollet, Frank Chervenak
10.1016/j.ajog.2023.11.1239
American Journal of Obstetrics & Gynecology (2023)
2023-11-24
American Journal of Obstetrics & Gynecology
2023-11-24
Letter to the Editors
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Potential for ChatGPT in obstetrics and gynecology: a comment
https://www.ajog.org/article/S0002-9378(23)02052-5/fulltext?rss=yes
We follow the topic on “The exciting potential for ChatGPT in obstetrics and gynecology.”1 In recent years, advanced deep-learning models have enabled major breakthroughs in natural language processing (NLP). These models have proven to be more effective at performing tasks such as text and speech processing, demonstrating their potential. One significant example is the November 2022 launch of ChatGPT, an online chatbot created by OpenAI. ChatGPT, which is based on a Generative Pretrained Transformer, has been useful in imparting introductory knowledge on a variety of subjects, including obstetrics and gynecology.
Potential for ChatGPT in obstetrics and gynecology: a comment
Somsri Wiwanitmkit, Viroj Wiwanitkit
10.1016/j.ajog.2023.11.1238
American Journal of Obstetrics & Gynecology (2023)
2023-11-23
American Journal of Obstetrics & Gynecology
2023-11-23
Letter to the Editors
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Fatty intrusion in the uterus: a rare case of uterine lipoleiomyoma causing urinary retention
https://www.ajog.org/article/S0002-9378(23)02043-4/fulltext?rss=yes
We present a 53-year-old perimenopausal nulliparous patient who experienced abnormal uterine bleeding with irregular menses and difficulty emptying her bladder because of a large mass compressing her bladder and urethra. A pelvic ultrasound reported an 8.8-cm hyperechoic lesion with minimal vascularity arising from the central uterus and endometrium, suggesting an endometrial neoplasm (Figure 1, A and B). Further evaluation with tissue sampling and contrast-enhanced magnetic resonance imaging (MRI) of the pelvis was recommended.
Fatty intrusion in the uterus: a rare case of uterine lipoleiomyoma causing urinary retention
Teresa Tam, Carlos M. Fernandez, Elliot M. Levine, Lucero Diaz
10.1016/j.ajog.2023.11.1237
American Journal of Obstetrics & Gynecology (2023)
2023-11-19
American Journal of Obstetrics & Gynecology
2023-11-19
Images in Gynecology
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Accessory cavitated uterine mass in a multiparous patient with progressive dysmenorrhea
https://www.ajog.org/article/S0002-9378(23)02042-2/fulltext?rss=yes
A 35-year-old woman presented with progressive dysmenorrhea and dyspareunia. Her menstrual cycles were regular with normal flow. The patient’s medical history included 2 vaginal deliveries and a dilation and curettage (D&C) for a retained placenta after the second birth. During her pregnancies, ultrasound scans found no uterine abnormality. Before the birth of her second child, the patient had never complained of dysmenorrhea. During the past 2 years, the dysmenorrhea worsened and was refractory to medical treatment (ie, nonsteroidal anti-inflammatory drugs and oral contraceptive pills).
Accessory cavitated uterine mass in a multiparous patient with progressive dysmenorrhea
Dan Boitor-Borza, Cristina Rotar, Daniel Muresan
10.1016/j.ajog.2023.11.1236
American Journal of Obstetrics & Gynecology (2023)
2023-11-19
American Journal of Obstetrics & Gynecology
2023-11-19
Images in Gynecology
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Establishing the validity of a diagnostic questionnaire for childbirth-related posttraumatic stress disorder
https://www.ajog.org/article/S0002-9378(23)02031-8/fulltext?rss=yes
Labor and delivery can entail complications and severe maternal morbidities that threaten a woman’s life or cause her to believe that her life is in danger. Women with these experiences are at risk for developing posttraumatic stress disorder. Postpartum posttraumatic stress disorder, or childbirth-related posttraumatic stress disorder, can become an enduring and debilitating condition. At present, validated tools for a rapid and efficient screen for childbirth-related posttraumatic stress disorder are lacking.
Establishing the validity of a diagnostic questionnaire for childbirth-related posttraumatic stress disorder
Isha Hemant Arora, Georgia G. Woscoboinik, Salma Mokhtar, Beatrice Quagliarini, Alon Bartal, Kathleen M. Jagodnik, Robert L. Barry, Andrea G. Edlow, Scott P. Orr, Sharon Dekel
10.1016/j.ajog.2023.11.1229
American Journal of Obstetrics & Gynecology (2023)
2023-11-17
American Journal of Obstetrics & Gynecology
2023-11-17
Original Research
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Maternal high body mass index, but not gestational diabetes, is associated with poorer educational attainment in mid-childhood
https://www.ajog.org/article/S0002-9378(23)02029-X/fulltext?rss=yes
Previous studies suggest that gestational diabetes mellitus is associated with poorer cognitive outcomes in children. However, confounding factors, especially maternal body mass index, have been poorly accounted for.
Maternal high body mass index, but not gestational diabetes, is associated with poorer educational attainment in mid-childhood
Laurentya Olga, Ulla Sovio, Hilary Wong, Gordon C.S. Smith, Catherine E.M. Aiken
10.1016/j.ajog.2023.11.1227
American Journal of Obstetrics & Gynecology (2023)
2023-11-17
American Journal of Obstetrics & Gynecology
2023-11-17
Original Research
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Progesterone use and delivery outcomes for women with a previous spontaneous preterm delivery before and after the Progestins Role in Optimizing Neonatal Gestation trial
https://www.ajog.org/article/S0002-9378(23)02037-9/fulltext?rss=yes
After publication of the Progestins Role in Optimizing Neonatal Gestation (PROLONG) trial1 in October of 2019, which found that 17-hydroxyprogesterone caproate (17-OHP) use was not associated with a reduction in recurrent preterm birth (PTB) in contrast with previous findings2, the use of 17-OHP likely declined, but it is unknown to what extent and how clinicians changed their overall practice with regards to PTB prevention strategies. We sought to examine the use of interventions for PTB prevention (17-OHP, vaginal progesterone, cerclage, and pessary) among women with a previous spontaneous PTB before and after publication of the PROLONG trial and if there was any change in gestational age at delivery.
Progesterone use and delivery outcomes for women with a previous spontaneous preterm delivery before and after the Progestins Role in Optimizing Neonatal Gestation trial
Mackenzie N. Naert, Keizra Mecklai, Thomas F. McElrath, Mark A. Clapp, Sarah Little
10.1016/j.ajog.2023.11.1234
American Journal of Obstetrics & Gynecology (2023)
2023-11-16
American Journal of Obstetrics & Gynecology
2023-11-16
Research Letter
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A case of dichorionic twin reversed arterial perfusion sequence with prenatal diagnosis of vascular anastomosis in the first trimester
https://www.ajog.org/article/S0002-9378(23)02033-1/fulltext?rss=yes
A 33-year-old woman, gravida 2 para 1 with no history of assisted reproductive technology, visited our department at 9 weeks 2 days of gestation. Two gestational sacs, each containing 1 fetus with a heartbeat, were found. Simultaneously, lambda sign and a chorionic membrane between the 2 amnions were confirmed with ultrasonography (Figure 1). A diagnosis of dichorionic (DC) twin pregnancy was made, but the crown-rump lengths (CRLs) differed at 23 mm and 14 mm, respectively.
A case of dichorionic twin reversed arterial perfusion sequence with prenatal diagnosis of vascular anastomosis in the first trimester
Showa Aoki, Ryuichi Iwata, Junko Tomita, Hiromi Yokota, Tokuei Takahara
10.1016/j.ajog.2023.11.1231
American Journal of Obstetrics & Gynecology (2023)
2023-11-16
American Journal of Obstetrics & Gynecology
2023-11-16
Images in Obstetrics
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A prediction tool for mode of delivery in twin pregnancies—a secondary analysis of the Twin Birth Study
https://www.ajog.org/article/S0002-9378(23)02032-X/fulltext?rss=yes
One of the controversies regarding the management of twin gestations relates to the mode of delivery. Currently, counseling regarding the mode of delivery and the chance of successful vaginal twin delivery is based on the average risk for intrapartum cesarean delivery in the general population of twin pregnancies. Decision support tools that provide an individualized risk for intrapartum cesarean delivery based on the unique characteristics of each patient can improve counseling and decision-making regarding the choice of mode of delivery in twin pregnancies.
A prediction tool for mode of delivery in twin pregnancies—a secondary analysis of the Twin Birth Study
Amir Aviram, Jon Barrett, Elad Mei-Dan, Eugene W. Yoon, Nir Melamed
10.1016/j.ajog.2023.11.1230
American Journal of Obstetrics & Gynecology (2023)
2023-11-16
American Journal of Obstetrics & Gynecology
2023-11-16
Original Research
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The racial disparity of severe maternal morbidity across weeks of gestation: a cross-sectional analysis of the 2019 National Inpatient Sample
https://www.ajog.org/article/S0002-9378(23)02030-6/fulltext?rss=yes
Severe maternal morbidity is increasing in the United States. Black women experience the highest rates of severe maternal morbidity and also of preterm births, which are associated with severe maternal morbidity. The racial disparity of severe maternal morbidity across weeks of gestation has not been well-studied.
The racial disparity of severe maternal morbidity across weeks of gestation: a cross-sectional analysis of the 2019 National Inpatient Sample
Emily D.S. Hales, Amy K. Ferketich, Mark A. Klebanoff
10.1016/j.ajog.2023.11.1228
American Journal of Obstetrics & Gynecology (2023)
2023-11-16
American Journal of Obstetrics & Gynecology
2023-11-16
Original Research
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sFlt-1/PlGF ratio is associated with delivery within 7 days in women with spontaneous preterm labor
https://www.ajog.org/article/S0002-9378(23)02036-7/fulltext?rss=yes
Spontaneous preterm labor with intact membranes (PTL) accounts for approximately one-third of all preterm deliveries, although only a minority of women with PTL deliver before 37 weeks of gestation.1 Various clinical strategies, including several single and multiple marker models, have been suggested to precisely identify the subset of women with PTL who are at risk of imminent preterm delivery and thus require corticosteroid treatment to induce fetal lung maturity and improve neonatal outcomes.
sFlt-1/PlGF ratio is associated with delivery within 7 days in women with spontaneous preterm labor
Ivana Musilova, Jan Kremlacek, Ladislava Pavlikova, Magdalena Holeckova, Martina Volnerova, Bo Jacobsson, Marian Kacerovsky
10.1016/j.ajog.2023.11.1233
American Journal of Obstetrics & Gynecology (2023)
2023-11-15
American Journal of Obstetrics & Gynecology
2023-11-15
Research Letter
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The histologic fetal inflammatory response and neonatal outcomes: systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(23)02025-2/fulltext?rss=yes
This study aimed to investigate the prognostic role of concomitant histological fetal inflammatory response with chorioamnionitis on neonatal outcomes through a systematic review and meta-analysis of existing literature.
The histologic fetal inflammatory response and neonatal outcomes: systematic review and meta-analysis
Kinga Kovács, Őzike Zsuzsanna Kovács, Dorina Bajzát, Marcell Imrei, Rita Nagy, Dávid Németh, Tamás Kói, Miklós Szabó, Attila Fintha, Péter Hegyi, Miklós Garami, Ákos Gasparics
10.1016/j.ajog.2023.11.1223
American Journal of Obstetrics & Gynecology (2023)
2023-11-12
American Journal of Obstetrics & Gynecology
2023-11-12
Systematic Review
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Prenatal detection of 22q11.2 deletion syndrome and congenital heart disease
https://www.ajog.org/article/S0002-9378(23)02028-8/fulltext?rss=yes
In the letter by Jing et al, the authors raise the notion that perhaps the benefit of prenatal detection of 22q11.2 deletion syndrome (22qDS) was confounded by the prenatal diagnosis of congenital heart disease (CHD). As illustrated in our paper,1 critical CHD, defined as needing cardiac intervention at ≤30 days of age, was the driver of major morbidity and mortality in live-born infants with 22qDS (n=522). In light of this significant—and not unexpected—finding, the subsequent multivariable models adjusted for the presence of critical CHD.
Prenatal detection of 22q11.2 deletion syndrome and congenital heart disease
Lindsay R. Freud, Ronald Wapner, Donna M. McDonald-McGinn
10.1016/j.ajog.2023.11.1226
American Journal of Obstetrics & Gynecology (2023)
2023-11-11
American Journal of Obstetrics & Gynecology
2023-11-11
Letter to the Editors
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Placental SARS-CoV-2 viral replication is associated with placental coagulopathy and neonatal complications
https://www.ajog.org/article/S0002-9378(23)02024-0/fulltext?rss=yes
The impact of SARS-CoV-2 infection during pregnancy on the placenta and the newborn is not well defined. Thrombotic episodes in utero or newborns born to mothers with COVID-19 have been reported. SERPINE1 gene and its encoding protein, plasminogen activator inhibitor-1 (PAI-1), play a key role in the pathogenesis of hypercoagulability and are linked to increased thrombotic events1 and recurrent implantation failure and preeclampsia.2 Although it was reported that the detection of SARS-CoV-2 RNA occurred in up to 47% of the placentas of COVID-19–positive gravidae, adverse pregnancy outcomes are uncommon3 with only 2% to 3% incidence of vertical transmission.
Placental SARS-CoV-2 viral replication is associated with placental coagulopathy and neonatal complications
Caterina Tiozzo, Claudia Manzano, Xinhua Lin, Selina Bowler, Ellen Gurzenda, Bishoy Botros, Kristen Thomas, Martin Chavez, Iman Hanna, Nazeeh Hanna
10.1016/j.ajog.2023.11.1222
American Journal of Obstetrics & Gynecology (2023)
2023-11-10
American Journal of Obstetrics & Gynecology
2023-11-10
Research Letter
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Improved outcomes in patients with prenatally detected 22q11.2 deletion syndrome
https://www.ajog.org/article/S0002-9378(23)02027-6/fulltext?rss=yes
The 22q11.2 deletion syndrome (22q11.2DS) is the most common microdeletion syndrome in humans. Approximately 60% to 80% of patients have a congenital heart disease (CHD), particularly including a subset of conotruncal defects.1 To date, although 22q11.2DS does not represent an independent risk factor for mortality after cardiac surgery, the short-term surgical outcome may vary for subgroups of patients with specific cardiac phenotypes and for different centers that provide the surgeries.
Improved outcomes in patients with prenatally detected 22q11.2 deletion syndrome
Xiang-Yi Jing, Dong-Zhi Li
10.1016/j.ajog.2023.11.1225
American Journal of Obstetrics & Gynecology (2023)
2023-11-09
American Journal of Obstetrics & Gynecology
2023-11-09
Letter to the Editors
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Second-trimester abortion and risk of live birth
https://www.ajog.org/article/S0002-9378(23)00806-2/fulltext?rss=yes
Second-trimester abortion may result in a live birth, but the extent to which this outcome occurs is unknown.
Second-trimester abortion and risk of live birth
Nathalie Auger, Émilie Brousseau, Aimina Ayoub, William D. Fraser
10.1016/j.ajog.2023.11.004
American Journal of Obstetrics & Gynecology (2023)
2023-11-06
American Journal of Obstetrics & Gynecology
2023-11-06
Original Research
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Society for Maternal-Fetal Medicine Special Statement: Utilizing telemedicine to address disparities in maternal-fetal medicine: a call to policy action
https://www.ajog.org/article/S0002-9378(23)00803-7/fulltext?rss=yes
The combination of deserts in maternal-fetal medicine coverage across the United States and the COVID-19 pandemic accelerated the implementation of telemedicine programs for maternal-fetal medicine care delivery. Although telemedicine-based care has the potential to facilitate timely access to maternal-fetal medicine services, which can improve maternal and neonatal outcomes, telemedicine is a relatively novel healthcare modality that needs to be implemented strategically. As with any medical service, telemedicine care requires rigorous evaluation to assess outcomes and ensure quality.
Society for Maternal-Fetal Medicine Special Statement: Utilizing telemedicine to address disparities in maternal-fetal medicine: a call to policy action
Society for Maternal-Fetal Medicine (SMFM), Adina R. Kern-Goldberger, Tani Malhotra, Chloe A. Zera, SMFM Health Policy and Advocacy Committee
10.1016/j.ajog.2023.11.001
American Journal of Obstetrics & Gynecology (2023)
2023-11-03
American Journal of Obstetrics & Gynecology
2023-11-03
SMFM Special Statement
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Maternal body mass index, birthweight, and placental glucose metabolism: evidence for a role of placental hexokinase
https://www.ajog.org/article/S0002-9378(23)00798-6/fulltext?rss=yes
The principal fetal energy source is glucose provided by the placental transfer of maternal glucose. However, the placenta’s glucose consumption exhibits considerable variation. Hexokinase is the first and one of the rate-limiting enzymes of glycolysis that phosphorylates glucose to glucose-6-phosphate. The role of placental hexokinase activity in human placental glucose metabolism is unknown.
Maternal body mass index, birthweight, and placental glucose metabolism: evidence for a role of placental hexokinase
Muhammad Umar Sajjad, Tore Henriksen, Marie Cecilie P. Roland, Guttorm Haugen, Trond M. Michelsen
10.1016/j.ajog.2023.10.043
American Journal of Obstetrics & Gynecology (2023)
2023-11-02
American Journal of Obstetrics & Gynecology
2023-11-02
Original Research
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Delivery outcomes in the subsequent pregnancy following the conservative management of placenta accreta spectrum disorder: a systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(23)00802-5/fulltext?rss=yes
Cesarean hysterectomy is generally presumed to decrease maternal morbidity and mortality secondary to placenta accreta spectrum disorder. Recently, uterine-sparing techniques have been introduced in conservative management of placenta accreta spectrum disorder to preserve fertility and potentially reduce surgical complications. However, despite patients often expressing the intention for future conception, few data are available regarding the subsequent pregnancy outcomes after conservative management of placenta accreta spectrum disorder.
Delivery outcomes in the subsequent pregnancy following the conservative management of placenta accreta spectrum disorder: a systematic review and meta-analysis
Ali Javinani, Shohra Qaderi, Kamran Hessami, Scott A. Shainker, Amir A. Shamshirsaz, Karin A. Fox, Hiba J. Mustafa, Akila Subramaniam, Meena Khandelwal, Adam T. Sandlin, Christina M. Duzyj, Deirdre J. Lyell, Lisa C. Zuckerwise, J.M. Newton, John C. Kingdom, Rachel K. Harrison, Vineet K. Shrivastava, Andrea L. Greiner, Ryan Loftin, Mehmet R. Genc, Lamia K. Atasi, Sonya S. Abdel-Razeq, Kelly A. Bennett, Daniela A. Carusi, Brett D. Einerson, Jennifer B. Gilner, Alissa R. Carver, Robert M. Silver, Alireza A. Shamshirsaz
10.1016/j.ajog.2023.10.047
American Journal of Obstetrics & Gynecology (2023)
2023-10-31
American Journal of Obstetrics & Gynecology
2023-10-31
Systematic Review
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Addressing challenges related to the professional practice of abortion post-Roe
https://www.ajog.org/article/S0002-9378(23)00756-1/fulltext?rss=yes
The landmark Roe vs Wade Supreme Court decision in 1973 established a constitutional right to abortion. In June 2022, the Dobbs vs Jackson Women’s Health Organization Supreme Court decision brought an end to the established professional practice of abortion throughout the United States. Rights-based reductionism and zealotry threaten the professional practice of abortion. Rights-based reductionism is generally the view that moral or ethical issues can be reduced exclusively to matters of rights.
Addressing challenges related to the professional practice of abortion post-Roe
Frank A. Chervenak, Jonathan D. Moreno, Renee McLeod-Sordjan, Eran Bornstein, Adi Katz, Susan L. Pollet, Adriann Combs, Monique De Four Jones, Dawnette Lewis, Gloria Bachmann, Mollie Rebecca Gordon, Ashley Warman, Amos Grünebaum
10.1016/j.ajog.2023.10.026
American Journal of Obstetrics & Gynecology (2023)
2023-10-31
American Journal of Obstetrics & Gynecology
2023-10-31
Clinical Opinion
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Decrease in peripheral natural killer cell level during early pregnancy predicts live birth among women with unexplained recurrent pregnancy loss: a prospective cohort study
https://www.ajog.org/article/S0002-9378(23)00797-4/fulltext?rss=yes
Previous studies have suggested that trophoblast cells inhibit the proliferation of peripheral natural killer cells and that the level of peripheral natural killer cells decrease in the middle and late pregnancy stage among healthy women. The change in peripheral natural killer cell level during early pregnancy and the relationship between the change in peripheral natural killer cell level and pregnancy outcomes among women with unexplained recurrent pregnancy loss have not been sufficiently explored.
Decrease in peripheral natural killer cell level during early pregnancy predicts live birth among women with unexplained recurrent pregnancy loss: a prospective cohort study
Miaoxian Ou, Lu Luo, Yuxin Yang, Niwei Yan, Xi Yan, Xue Zhong, Ying Cheong, Tinchiu Li, Juan Ouyang, Qiong Wang
10.1016/j.ajog.2023.10.042
American Journal of Obstetrics & Gynecology (2023)
2023-10-30
American Journal of Obstetrics & Gynecology
2023-10-30
Original Research
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A reusable, low-cost model to improve resident confidence in performance of postpartum tubal ligation
https://www.ajog.org/article/S0002-9378(23)00796-2/fulltext?rss=yes
The rates of postpartum abdominal sterilization have steadily decreased from approximately 770 per 10,000 deliveries over the period of 2001 to 20081 to 621 per 10,000 deliveries during 2016 to 2018.2 Postpartum sterilization is a core objective for residency training as outlined by the 13th edition of the Council on Resident Education in Obstetrics and Gynecology Educational Objectives. Many women requesting this procedure are unable to undergo tubal ligation because of institutional barriers and variations in practice.
A reusable, low-cost model to improve resident confidence in performance of postpartum tubal ligation
Carolyn Zahler-Miller, Kelli Braun
10.1016/j.ajog.2023.10.041
American Journal of Obstetrics & Gynecology (2023)
2023-10-27
American Journal of Obstetrics & Gynecology
2023-10-27
Surgeon's Corner
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Incidence of group B streptococcus early-onset sepsis in term neonates with second-line prophylaxis maternal intrapartum antibiotics: a multicenter retrospective study
https://www.ajog.org/article/S0002-9378(23)00771-8/fulltext?rss=yes
The difference in the incidence of early-onset sepsis caused by group B streptococcus among term neonates whose mothers received first-line vs second-line intrapartum prophylaxis is poorly described.
Incidence of group B streptococcus early-onset sepsis in term neonates with second-line prophylaxis maternal intrapartum antibiotics: a multicenter retrospective study
Jia Ming Low, Jan Hau Lee, Henry P. Foote, Christoph P. Hornik, Reese H. Clark, Rachel G. Greenberg
10.1016/j.ajog.2023.10.035
American Journal of Obstetrics & Gynecology (2023)
2023-10-24
American Journal of Obstetrics & Gynecology
2023-10-24
Original Research
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Development of a prediction model of postpartum hospital use using an equity-focused approach
https://www.ajog.org/article/S0002-9378(23)00769-X/fulltext?rss=yes
Racial inequities in maternal morbidity and mortality persist into the postpartum period, leading to a higher rate of postpartum hospital use among Black and Hispanic people. Delivery hospitalizations provide an opportunity to screen and identify people at high risk to prevent adverse postpartum outcomes. Current models do not adequately incorporate social and structural determinants of health, and some include race, which may result in biased risk stratification.
Development of a prediction model of postpartum hospital use using an equity-focused approach
Teresa Janevic, Lewis E. Tomalin, Kimberly B. Glazer, Natalie Boychuk, Adina Kern-Goldberger, Micki Burdick, Frances Howell, Mayte Suarez-Farinas, Natalia Egorova, Jennifer Zeitlin, Paul Hebert, Elizabeth A. Howell
10.1016/j.ajog.2023.10.033
American Journal of Obstetrics & Gynecology (2023)
2023-10-23
American Journal of Obstetrics & Gynecology
2023-10-23
Original Research
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First-trimester cesarean scar pregnancy: a comparative analysis of treatment options from the international registry
https://www.ajog.org/article/S0002-9378(23)00758-5/fulltext?rss=yes
A cesarean scar pregnancy is an iatrogenic consequence of a previous cesarean delivery. The gestational sac implants into a niche created by the incision of the previous cesarean delivery, and this carries a substantial risk for major maternal complications. The aim of this study was to report, analyze, and compare the effectiveness and safety of different treatments options for cesarean scar pregnancies managed in the first trimester through a registry.
First-trimester cesarean scar pregnancy: a comparative analysis of treatment options from the international registry
Andrea Kaelin Agten, Davor Jurkovic, Ilan Timor-Tritsch, Nia Jones, Susanne Johnson, Ana Monteagudo, Judith Huirne, Jonah Fleisher, Ron Maymon, Tania Herrera, Federico Prefumo, Stephen Contag, Marcos Cordoba, Gwendolin Manegold-Brauer, CSP Collaborative Network
10.1016/j.ajog.2023.10.028
American Journal of Obstetrics & Gynecology (2023)
2023-10-19
American Journal of Obstetrics & Gynecology
2023-10-19
Original Research
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The relationship between cesarean delivery and fecundability: a population-based cohort study
https://www.ajog.org/article/S0002-9378(23)00759-7/fulltext?rss=yes
Previous studies have found that women who undergo cesarean delivery have fewer pregnancies. Cesarean delivery is also more common among women with lower fecundability. The potential role of cesarean delivery in reduced fecundability is not known.
The relationship between cesarean delivery and fecundability: a population-based cohort study
Yeneabeba Tilahun Sima, Maria Christine Magnus, Liv Grimstvedt Kvalvik, Nils-Halvdan Morken, Kari Klungsøyr, Rolv Skjærven, Linn Marie Sørbye
10.1016/j.ajog.2023.10.029
American Journal of Obstetrics & Gynecology (2023)
2023-10-18
American Journal of Obstetrics & Gynecology
2023-10-18
Original Research
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Randomized controlled trials: not always the “gold standard” for evidence in obstetrics and gynecology
https://www.ajog.org/article/S0002-9378(23)00745-7/fulltext?rss=yes
Randomized controlled trials are considered the “gold standard” for therapeutic interventions, and it is not uncommon for sweeping changes in medical practice to follow positive results from such trials. However, randomized controlled trials are not without their limitations. Physicians frequently view randomized controlled trials as infallible, whereas they tend to dismiss evidence derived from sources other than randomized controlled trials as less credible or reliable. In several situations in obstetrics and gynecology, there are no randomized controlled trials to help guide the clinician.
Randomized controlled trials: not always the “gold standard” for evidence in obstetrics and gynecology
Yinka Oyelese
10.1016/j.ajog.2023.10.015
American Journal of Obstetrics & Gynecology (2023)
2023-10-12
American Journal of Obstetrics & Gynecology
2023-10-12
Clinical Opinion
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Reducing macrosomia-related birth complications in primigravid women: ultrasound- and magnetic resonance imaging–based models
https://www.ajog.org/article/S0002-9378(23)00740-8/fulltext?rss=yes
Many complications increase with macrosomia, which is defined as birthweight of ≥4000 g. The ability to estimate when the fetus would exceed 4000 g could help to guide decisions surrounding the optimal timing of delivery. To the best of our knowledge, there is no available tool to perform this estimation independent of the currently available growth charts.
Reducing macrosomia-related birth complications in primigravid women: ultrasound- and magnetic resonance imaging–based models
Dominique A. Badr, Mieke M. Cannie, Caroline Kadji, Xin Kang, Andrew Carlin, Jacques C. Jani
10.1016/j.ajog.2023.10.011
American Journal of Obstetrics & Gynecology (2023)
2023-10-10
American Journal of Obstetrics & Gynecology
2023-10-10
Original Research
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Tocolysis after preterm prelabor rupture of membranes and 5-year outcomes: a population-based cohort study
https://www.ajog.org/article/S0002-9378(23)00739-1/fulltext?rss=yes
The administration of tocolytics after preterm prelabor rupture of membranes remains a controversial practice. In theory, reducing uterine contractility should delay delivery and allow for optimal antenatal management, thereby reducing the risks for prematurity and adverse consequences over the life course. However, tocolysis may be associated with neonatal death or long-term adverse neurodevelopmental outcomes, mainly related to prolonged fetal exposure to intrauterine infection or inflammation.
Tocolysis after preterm prelabor rupture of membranes and 5-year outcomes: a population-based cohort study
Elsa Lorthe, Laetitia Marchand-Martin, Mathilde Letouzey, Adrien M. Aubert, Véronique Pierrat, Valérie Benhammou, Pierre Delorme, Stéphane Marret, Pierre-Yves Ancel, François Goffinet, Laurence Foix L’Hélias, Gilles Kayem, EPIPAGE-2 Obstetric Writing Group
10.1016/j.ajog.2023.10.010
American Journal of Obstetrics & Gynecology (2023)
2023-10-10
American Journal of Obstetrics & Gynecology
2023-10-10
Original Research
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The efficiency of cabergoline vs pyridoxine for lactation inhibition—a randomized controlled trial
https://www.ajog.org/article/S0002-9378(23)00738-X/fulltext?rss=yes
Some mothers may seek lactation inhibition on personal, social, or medical grounds. The common drug used for lactation inhibition is cabergoline. Several adverse effects and contraindications are known for this drug. Its use is contraindicated for patients with hypertensive disorders and fibrotic, cardiac, or hepatic diseases. In addition, pyridoxine (vitamin B6) has been used for this indication, with no significant adverse effect, following studies that demonstrated its efficacy.
The efficiency of cabergoline vs pyridoxine for lactation inhibition—a randomized controlled trial
Adi Dayan-Schwartz, Enav Yefet, Manal Massalha, Sally Hosari-Mhameed, Chen Remer-Gross, Eliran Pasand, Zohar Nachum
10.1016/j.ajog.2023.10.009
American Journal of Obstetrics & Gynecology (2023)
2023-10-10
American Journal of Obstetrics & Gynecology
2023-10-10
Original Research
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Adverse pregnancy outcomes and long-term risk of chronic kidney disease in women: national cohort and co-sibling study
https://www.ajog.org/article/S0002-9378(23)00737-8/fulltext?rss=yes
Women with adverse pregnancy outcomes may have higher subsequent risk of chronic kidney disease, but the long-term independent risks and potential causality are unclear.
Adverse pregnancy outcomes and long-term risk of chronic kidney disease in women: national cohort and co-sibling study
Casey Crump, Jan Sundquist, Kristina Sundquist
10.1016/j.ajog.2023.10.008
American Journal of Obstetrics & Gynecology (2023)
2023-10-10
American Journal of Obstetrics & Gynecology
2023-10-10
Original Research
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Risk of thrombosis and bleeding in gynecologic cancer surgery: systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(23)00735-4/fulltext?rss=yes
This study aimed to provide procedure-specific estimates of the risk of symptomatic venous thromboembolism and major bleeding in the absence of thromboprophylaxis, following gynecologic cancer surgery.
Risk of thrombosis and bleeding in gynecologic cancer surgery: systematic review and meta-analysis
Lauri I. Lavikainen, Gordon H. Guyatt, Anna L. Luomaranta, Rufus Cartwright, Ilkka E.J. Kalliala, Rachel J. Couban, Riikka L. Aaltonen, Karoliina M. Aro, Jovita L. Cárdenas, P.J. Devereaux, Päivi J. Galambosi, Fang Zhou Ge, Alex L.E. Halme, Jari Haukka, Matthew L. Izett-Kay, Kirsi M. Joronen, Päivi K. Karjalainen, Nadina Khamani, Sanna M. Oksjoki, Negar Pourjamal, ROTBIGGS Investigators, Tino Singh, Riikka M. Tähtinen, Robin W.M. Vernooij, Kari A.O. Tikkinen
10.1016/j.ajog.2023.10.006
American Journal of Obstetrics & Gynecology (2023)
2023-10-10
American Journal of Obstetrics & Gynecology
2023-10-10
Systematic Review
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Society of Family Planning Clinical Recommendation: Medication abortion between 14 0/7 and 27 6/7 weeks of gestation
https://www.ajog.org/article/S0002-9378(23)00726-3/fulltext?rss=yes
The objective of this Clinical Recommendation is to review relevant literature and provide evidence-based recommendations for medication abortion between 14 0/7 and 27 6/7 weeks of gestation, with a focus on mifepristone-misoprostol and misoprostol-only regimens. We systematically reviewed PubMed articles published between 2008 and 2022 and reviewed reference lists of included articles to identify additional publications. See Search Strategy for more details. Several randomized trials of medication abortion between 14 0/7 and 27 6/7 weeks of gestation demonstrate that mifepristone 200 mg orally before misoprostol increases effectiveness (complete abortion at 24 or 48 hours) compared to misoprostol only.
Society of Family Planning Clinical Recommendation: Medication abortion between 14 0/7 and 27 6/7 weeks of gestation
Blake Zwerling, Alison Edelman, Anwar Jackson, Anne Burke, Malavika Prabhu
10.1016/j.ajog.2023.09.097
American Journal of Obstetrics & Gynecology (2023)
2023-10-09
American Journal of Obstetrics & Gynecology
2023-10-09
Reviews
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Outcome of partial agenesis of corpus callosum
https://www.ajog.org/article/S0002-9378(23)00736-6/fulltext?rss=yes
The diagnosis of corpus callosum anomalies by prenatal ultrasound has improved over the last decade because of improved imaging techniques, scanning skills, and the routine implementation of transvaginal neurosonography.
Outcome of partial agenesis of corpus callosum
Bart De Keersmaecker, Katrien Jansen, Michael Aertsen, Gunner Naulaers, Luc De Catte
10.1016/j.ajog.2023.10.007
American Journal of Obstetrics & Gynecology (2023)
2023-10-08
American Journal of Obstetrics & Gynecology
2023-10-08
Original Research
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Cerclage prevents ascending intrauterine infection in pregnant mice
https://www.ajog.org/article/S0002-9378(23)00733-0/fulltext?rss=yes
The treatment for cervical insufficiency is cerclage surgery. Although cerclage is a common therapy for prevention of preterm birth, there is no consensus about its mechanism of efficacy. Previous investigators have hypothesized that cerclage prevents preterm birth by improving the cervical barrier to ascending infection. However, this hypothesis is difficult to study in human pregnancy.
Cerclage prevents ascending intrauterine infection in pregnant mice
Yali Zhang, Skye A. Edwards, Michael House
10.1016/j.ajog.2023.10.004
American Journal of Obstetrics & Gynecology (2023)
2023-10-08
American Journal of Obstetrics & Gynecology
2023-10-08
Original Research
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Preeclampsia at term: evidence of disease heterogeneity based on the profile of circulating cytokines and angiogenic factors
https://www.ajog.org/article/S0002-9378(23)00731-7/fulltext?rss=yes
Intravascular inflammation and an antiangiogenic state have been implicated in the pathophysiology of preeclampsia. On the basis of the profiles of their angiogenic/antiangiogenic factors, women with preeclampsia at term may be classified into 2 subgroups with different characteristics and prevalence of adverse outcomes. This study was undertaken to examine whether these 2 subgroups of preeclampsia at term also show differences in their profiles of intravascular inflammation.
Preeclampsia at term: evidence of disease heterogeneity based on the profile of circulating cytokines and angiogenic factors
Tinnakorn Chaiworapongsa, Roberto Romero, Nardhy Gomez-Lopez, Manaphat Suksai, Dahiana M. Gallo, Eunjung Jung, Stanley M. Berry, Awoniyi Awonuga, Adi L. Tarca, David R. Bryant
10.1016/j.ajog.2023.10.002
American Journal of Obstetrics & Gynecology (2023)
2023-10-05
American Journal of Obstetrics & Gynecology
2023-10-05
Original Research
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Effect of maternal hyperoxygenation on neonatal outcomes among women in labour with pathological cardiotocography: an open-label randomized controlled trial
https://www.ajog.org/article/S0002-9378(23)00722-6/fulltext?rss=yes
Hyperoxygenation has shown promise in improving suspicious fetal heart patterns in women in labor. However, the effect of hyperoxygenation on neonatal outcomes in women in labor with pathologic fetal heart rate tracing has not been studied.
Effect of maternal hyperoxygenation on neonatal outcomes among women in labour with pathological cardiotocography: an open-label randomized controlled trial
Sruthy P. Sulaiman, Nivedita Jha, Adhisivam Bethou, Hanumanthappa Nandeeha, Ajay Kumar Jha
10.1016/j.ajog.2023.09.093
American Journal of Obstetrics & Gynecology (2023)
2023-09-29
American Journal of Obstetrics & Gynecology
2023-09-29
Original Research
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Maternal vascular indices at 36 weeks’ gestation in the prediction of preeclampsia
https://www.ajog.org/article/S0002-9378(23)00724-X/fulltext?rss=yes
Epidemiological studies have shown that women with preeclampsia (PE) are at increased long term cardiovascular risk. This risk might be associated with accelerated vascular ageing process but data on vascular abnormalities in women with PE are scarce.
Maternal vascular indices at 36 weeks’ gestation in the prediction of preeclampsia
Tanvi Mansukhani, Alan Wright, Anastasija Arechvo, Bruno Lamanna, Mariana Menezes, Kypros H. Nicolaides, Marietta Charakida
10.1016/j.ajog.2023.09.095
American Journal of Obstetrics & Gynecology (2023)
2023-09-28
American Journal of Obstetrics & Gynecology
2023-09-28
Original Research
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A personalized protocol for prescribing opioids after cesarean delivery: leveraging the electronic medical record to reduce outpatient opioid prescriptions
https://www.ajog.org/article/S0002-9378(23)00721-4/fulltext?rss=yes
Although cesarean delivery is the most common surgery performed in the United States, prescribing practices for analgesia vary. Strategies to manage postpartum pain have mostly focused on the immediate postpartum period when patients are still admitted to the hospital. At discharge, most providers prescribe a fixed number of opioid tablets. Most patients do not use all the opioids that they are prescribed at hospital discharge. This leads to an excess of opioids in the community, which can ultimately lead to misuse and diversion.
A personalized protocol for prescribing opioids after cesarean delivery: leveraging the electronic medical record to reduce outpatient opioid prescriptions
Chinonye S. Imo, Devin A. Macias, Donald D. McIntire, Jennifer McGuire, David B. Nelson, Elaine L. Duryea
10.1016/j.ajog.2023.09.092
American Journal of Obstetrics & Gynecology (2023)
2023-09-28
American Journal of Obstetrics & Gynecology
2023-09-28
Original Research
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Placental histology for targeted risk assessment of recurrent spontaneous preterm birth and response to 17-alpha hydroxyprogesterone caproate supplementation
https://www.ajog.org/article/S0002-9378(23)00625-7/fulltext?rss=yes
Spontaneous preterm birth significantly increases the risk for a recurrent preterm birth. Only a few identifiable clinical risk factors can be referenced in counseling for recurrent preterm birth. Furthermore, treatment using progesterone supplementation has not consistently prevented preterm birth among high-risk patients, but it may be effective in a subset of those patients. Placental pathology from a previous pregnancy may be used to predict which patients will experience a recurrent preterm birth or to identify a subset of patients more likely to respond to treatment with antenatal progesterone.
Placental histology for targeted risk assessment of recurrent spontaneous preterm birth and response to 17-alpha hydroxyprogesterone caproate supplementation
Sunitha Suresh, Alexa Freedman, Marci Adams, Emmet Hirsch, Linda M. Ernst
10.1016/j.ajog.2023.09.018
American Journal of Obstetrics & Gynecology (2023)
2023-09-24
American Journal of Obstetrics & Gynecology
2023-09-24
Original Research
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Accelerated epigenetic clock aging in maternal peripheral blood and preterm birth
https://www.ajog.org/article/S0002-9378(23)00609-9/fulltext?rss=yes
Epigenetic clocks use CpG DNA methylation to estimate biological age. Acceleration is associated with cancer, heart disease, and shorter life span. Few studies evaluate DNA methylation age and pregnancy outcomes. AgeAccelGrim is a novel epigenetic clock that combines 7 DNA methylation components.
Accelerated epigenetic clock aging in maternal peripheral blood and preterm birth
Emily L. Gascoigne, Kyle R. Roell, Lauren A. Eaves, Rebecca C. Fry, Tracy A. Manuck
10.1016/j.ajog.2023.09.003
American Journal of Obstetrics & Gynecology (2023)
2023-09-08
American Journal of Obstetrics & Gynecology
2023-09-08
Original Research
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WITHDRAWN: Reply: The impact of insurance mandates on in vitro fertilization utilization, practices and outcomes: the importance of the statistical analysis
https://www.ajog.org/article/S0002-9378(22)00655-X/fulltext?rss=yes
WITHDRAWN: Reply: The impact of insurance mandates on in vitro fertilization utilization, practices and outcomes: the importance of the statistical analysis
Benjamin J. Peipert, Benjamin S. Harris, Tarun Jain
10.1016/j.ajog.2022.08.020
American Journal of Obstetrics & Gynecology (2022)
2022-08-17
American Journal of Obstetrics & Gynecology
2022-08-17
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Expression of Concern: Re: Shettles LB. Tubal embryo successfully transferred in utero. Am J Obstet Gynecol
https://www.ajog.org/article/S0002-9378(22)00596-8/fulltext?rss=yes
Concern has been raised about this letter to the Editors.1 This letter was written at a time when documentation of a practice or procedure was not stringently required, especially when described in a letter to the Editors. The hospital where the procedure would have taken place was contacted, but the institution was not able to locate records from 1980 that would confirm or deny the claim of Dr Shettles. Given, to the best of the journal’s knowledge, there is no formal article on the topic published by Dr Shettles, and the validity of the claim could not be verified.
Expression of Concern: Re: Shettles LB. Tubal embryo successfully transferred in utero. Am J Obstet Gynecol
10.1016/j.ajog.2022.07.039
American Journal of Obstetrics & Gynecology (2022)
2022-08-09
American Journal of Obstetrics & Gynecology
2022-08-09
Expression of Concern
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WITHDRAWN: Phosphodiesterase-5 inhibitors in Pregnancy: Systematic review and meta-analysis of maternal and perinatal safety and clinical outcomes
https://www.ajog.org/article/S0002-9378(21)00637-2/fulltext?rss=yes
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
WITHDRAWN: Phosphodiesterase-5 inhibitors in Pregnancy: Systematic review and meta-analysis of maternal and perinatal safety and clinical outcomes
Jessica M. TURNER, Francesca RUSSO, Jan DePREST, Ben W. MOL, Sailesh KUMAR
10.1016/j.ajog.2021.06.006
American Journal of Obstetrics & Gynecology (2021)
2021-06-08
American Journal of Obstetrics & Gynecology
2021-06-08
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WITHDRAWN: The next frontier: universal hepatitis C virus screening in pregnant women
https://www.ajog.org/article/S0002-9378(20)30133-2/fulltext?rss=yes
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
WITHDRAWN: The next frontier: universal hepatitis C virus screening in pregnant women
Sammy Saab, Ravina Kullar, Christina Amini, Prabhu Gounder
10.1016/j.ajog.2020.01.058
American Journal of Obstetrics & Gynecology (2020)
2020-02-07
American Journal of Obstetrics & Gynecology
2020-02-07
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WITHDRAWN: The Society for Maternal-Fetal Medicine (SMFM) Fetal Anomalies Consult Series
https://www.ajog.org/article/S0002-9378(19)31024-5/fulltext?rss=yes
WITHDRAWN: The Society for Maternal-Fetal Medicine (SMFM) Fetal Anomalies Consult Series
SMFM Publications Committee
10.1016/j.ajog.2019.08.022
American Journal of Obstetrics & Gynecology (2019)
2019-08-20
American Journal of Obstetrics & Gynecology
2019-08-20
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WITHDRAWN: Paramedian Oro-Facial Cleft
https://www.ajog.org/article/S0002-9378(19)31023-3/fulltext?rss=yes
WITHDRAWN: Paramedian Oro-Facial Cleft
SMFM Publications Committee
10.1016/j.ajog.2019.08.021
American Journal of Obstetrics & Gynecology (2019)
2019-08-20
American Journal of Obstetrics & Gynecology
2019-08-20
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WITHDRAWN: Median Facial Cleft
https://www.ajog.org/article/S0002-9378(19)31022-1/fulltext?rss=yes
WITHDRAWN: Median Facial Cleft
SMFM Publications Committee
10.1016/j.ajog.2019.08.020
American Journal of Obstetrics & Gynecology (2019)
2019-08-20
American Journal of Obstetrics & Gynecology
2019-08-20
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WITHDRAWN: Micrognathia
https://www.ajog.org/article/S0002-9378(19)31021-X/fulltext?rss=yes
WITHDRAWN: Micrognathia
Beryl R. Benacerraf, Bryann S. Bromley, Angie C. Jelin
10.1016/j.ajog.2019.08.019
American Journal of Obstetrics & Gynecology (2019)
2019-08-20
American Journal of Obstetrics & Gynecology
2019-08-20
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WITHDRAWN: Hypotelorism
https://www.ajog.org/article/S0002-9378(19)31020-8/fulltext?rss=yes
The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/<10.1016/j.ajog.2019.08.052>. The duplicate article has therefore been withdrawn.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
WITHDRAWN: Hypotelorism
SMFM Publications Committee
10.1016/j.ajog.2019.08.018
American Journal of Obstetrics & Gynecology (2019)
2019-08-20
American Journal of Obstetrics & Gynecology
2019-08-20
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WITHDRAWN: Hypertelorism
https://www.ajog.org/article/S0002-9378(19)31019-1/fulltext?rss=yes
WITHDRAWN: Hypertelorism
Beryl R. Benacerraf, Bryann S. Bromley, Angie C. Jelin
10.1016/j.ajog.2019.08.017
American Journal of Obstetrics & Gynecology (2019)
2019-08-20
American Journal of Obstetrics & Gynecology
2019-08-20
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WITHDRAWN: Anophthalmia and Microphthalmia
https://www.ajog.org/article/S0002-9378(19)31018-X/fulltext?rss=yes
WITHDRAWN: Anophthalmia and Microphthalmia
Beryl R. Benacerraf, Bryann S. Bromley, Angie C. Jelin
10.1016/j.ajog.2019.08.016
American Journal of Obstetrics & Gynecology (2019)
2019-08-20
American Journal of Obstetrics & Gynecology
2019-08-20
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WITHDRAWN: Absent Nasal Bone
https://www.ajog.org/article/S0002-9378(19)31017-8/fulltext?rss=yes
WITHDRAWN: Absent Nasal Bone
Beryl R. Benacerraf, Bryann S. Bromley, Angie C. Jelin
10.1016/j.ajog.2019.08.015
American Journal of Obstetrics & Gynecology (2019)
2019-08-20
American Journal of Obstetrics & Gynecology
2019-08-20
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WITHDRAWN: Time to move on from early cord clamping in preterm infants
https://www.ajog.org/article/S0002-9378(18)30669-0/fulltext?rss=yes
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
WITHDRAWN: Time to move on from early cord clamping in preterm infants
William Tarnow-Mordi, Jon Dorling, Chris Gale
10.1016/j.ajog.2018.08.016
American Journal of Obstetrics & Gynecology (2018)
2018-08-16
American Journal of Obstetrics & Gynecology
2018-08-16
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WITHDRAWN: Early cord clamping is the experimental intervention not delayed cord clamping
https://www.ajog.org/article/S0002-9378(18)30668-9/fulltext?rss=yes
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
WITHDRAWN: Early cord clamping is the experimental intervention not delayed cord clamping
David J. Hutchon
10.1016/j.ajog.2018.08.015
American Journal of Obstetrics & Gynecology (2018)
2018-08-16
American Journal of Obstetrics & Gynecology
2018-08-16
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WITHDRAWN: A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes
https://www.ajog.org/article/S0002-9378(16)30440-9/fulltext?rss=yes
The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/<10.1016/j.ajog.2016.07.004>. The duplicate article has therefore been withdrawn.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
WITHDRAWN: A dynamic quality assessment tool for laparoscopic hysterectomy to measure surgical outcomes
Sara RC. DRIESSEN, Erik W. VAN ZWET, Pascal HAAZEBROEK, Evelien M. SANDBERG, Mathijs D. BLIKKENDAAL, Andries RH. TWIJNSTRA, Frank Willem JANSEN
10.1016/j.ajog.2016.07.007
American Journal of Obstetrics & Gynecology (2016)
2016-07-09
American Journal of Obstetrics & Gynecology
2016-07-09
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Detection and successful treatment of emergent anti-SSA mediated fetal atrioventricular block
https://www.ajog.org/article/S0002-9378(16)30439-2/fulltext?rss=yes
Fetal complete atrioventricular block occurs between 18 and 26 weeks in 2–4% of anti-SSA-positive pregnancies, but disease burden is considerable: 18% die in utero or before age 2 years, and survivors ultimately require permanent cardiac pacing.1 Reports suggest as the fetal rhythm transitions from normal to complete atrioventricular block, antiinflammatory treatment can improve atrioventricular conduction and even restore sinus rhythm.2,3 Little is known about this transition period of emergent complete atrioventricular block, and to date, surveillance methods have unsuccessfully detected emergent complete atrioventricular block in time for effective in utero treatment.
Detection and successful treatment of emergent anti-SSA mediated fetal atrioventricular block
Bettina F. Cuneo, Steven E. Ambrose, Wayne Tworetzky
10.1016/j.ajog.2016.07.006
American Journal of Obstetrics & Gynecology (2016)
2016-07-09
American Journal of Obstetrics & Gynecology
2016-07-09
Research Letter
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WITHDRAWN: Vaginal fluid IL-6 concentrations as a point-of-care test is of value in women with preterm PROM
https://www.ajog.org/article/S0002-9378(16)30438-0/fulltext?rss=yes
The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.ajog.2016.07.001. The duplicate article has therefore been withdrawn.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
WITHDRAWN: Vaginal fluid IL-6 concentrations as a point-of-care test is of value in women with preterm PROM
Ivana Musilova, Tomas Bestvina, Martina Hudeckova, Igor Michalec, Teresa Cobo, Bo Jacobsson, Marian Kacerovsky
10.1016/j.ajog.2016.07.005
American Journal of Obstetrics & Gynecology (2016)
2016-07-09
American Journal of Obstetrics & Gynecology
2016-07-09
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WITHDRAWN: Discussion: ‘Adherence to hormonal contraception among women veterans,’ by Borrero et al
https://www.ajog.org/article/S0002-9378(13)00709-6/fulltext?rss=yes
The Publisher regrets that this article is an accidental duplication of an article that has already been published, DOI of original article: http://dx.doi.org/10.1016/j.ajog.2013.06.032.The duplicate article has therefore been withdrawn.
WITHDRAWN: Discussion: ‘Adherence to hormonal contraception among women veterans,’ by Borrero et al
George A. Macones, Alison Cahill, Anthony O. Odibo
10.1016/j.ajog.2013.06.047
American Journal of Obstetrics & Gynecology (2013)
2013-07-01
American Journal of Obstetrics & Gynecology
2013-07-01
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WITHDRAWN: Review of the economic and quality-of-life burden of cervical human papillomavirus disease
https://www.ajog.org/article/S0002-9378(06)00817-9/fulltext?rss=yes
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause.The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
WITHDRAWN: Review of the economic and quality-of-life burden of cervical human papillomavirus disease
Rachael L. Fleurence, Julia M. Dixon, Tsveta F. Milanova, Kathleen M. Beusterien
10.1016/j.ajog.2006.06.061
American Journal of Obstetrics & Gynecology (2006)
2006-09-26
American Journal of Obstetrics & Gynecology
2006-09-26
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President's Letter
https://www.ajog.org/article/S0002-9378(24)00404-6/fulltext?rss=yes
President's Letter
10.1016/S0002-9378(24)00404-6
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
A1
A2
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Onabotulinumtoxin a injections for patients with pelvic floor dysfunction
https://www.ajog.org/article/S0002-9378(24)00350-8/fulltext?rss=yes
It is estimated that about 50-90% of patients with chronic pelvic pain have pain that originates from myofascial sources, including the pelvic floor muscles. In patients with pelvic floor dysfunction, we generally recommend that patients start with pelvic floor physical therapy alone or in combination with pelvic trigger point injections with local anesthetic. We offer onabotulinum toxin A to those who require long-term repeat trigger point injections, have barriers to accessing monthly injections, or feel that their symptom relief has plateaued.
Onabotulinumtoxin a injections for patients with pelvic floor dysfunction
G Whitmore, J Tam, M Orlando
10.1016/j.ajog.2024.02.279
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1302
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Fertility sparing approach for hemorrhagic ascites associated with endometriosis
https://www.ajog.org/article/S0002-9378(24)00349-1/fulltext?rss=yes
Endometriosis can present in a variety of ways. This is an example of an unusual presentation of endometriosis but an important presentation.
Fertility sparing approach for hemorrhagic ascites associated with endometriosis
K Schmidt, A Mohr-Sasson, S Shah, A Bhalwal
10.1016/j.ajog.2024.02.278
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1302
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Multidisciplinary surgical management of deep endometriosis with single robot port set-up
https://www.ajog.org/article/S0002-9378(24)00348-X/fulltext?rss=yes
DE endometriosis is a chronic condition that affects up to 10% of reproductive aged women. The presenting symptoms can vary depending on the location, lesion severity, fibrosis and anatomic distortion. Bowel and diaphragmatic endometriosis are estimated to affect 5-12% and 1-1.5%, respectively, of women with DE. Surgical management of these complex cases requires skilled minimally invasive, colorectal and cardiothoracic surgeons. Utilization of the optics and ergonomics provided with the robot can allow for more complete endometriosis excisions and thus improved patient outcomes.
Multidisciplinary surgical management of deep endometriosis with single robot port set-up
J Clay, A Spivak, D Raymond, T Gallant, M Luna Russo
10.1016/j.ajog.2024.02.277
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1302
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Unlocking surgical success: the suprapubic port advantage
https://www.ajog.org/article/S0002-9378(24)00347-8/fulltext?rss=yes
We present unlocking surgical success: the suprapubic port advantage. Suprapubic ports are used by many gynecologic surgeons in laparoscopic surgery. We utilize teaching pearls in port placement and research in ergonomics to make the suprapubic approach accessible to all surgeons. We show how the suprapubic approach can be used to facilitate fundamental surgical techniques such as appropriate tissue tension and adequate exposure and visualization.
Unlocking surgical success: the suprapubic port advantage
P Voigt, L Yu, L Yang
10.1016/j.ajog.2024.02.276
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1301
S1302
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Two layer vaginal cuff closure and uterosacral ligament suspension during robotic assisted total laparoscopic hysterectomy
https://www.ajog.org/article/S0002-9378(24)00345-4/fulltext?rss=yes
Two Layer Vaginal Cuff Closure and Uterosacral Ligament Suspension during Robotic Assisted Total Laparoscopic Hysterectomy.
Two layer vaginal cuff closure and uterosacral ligament suspension during robotic assisted total laparoscopic hysterectomy
J Berry, K Seawright, J Fisher
10.1016/j.ajog.2024.02.274
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1301
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Navigating the pelvis with müllerian anomalies
https://www.ajog.org/article/S0002-9378(24)00344-2/fulltext?rss=yes
The prevalence of congenital uterine anomalies among the general population is estimated to be 5.5%. Some of the symptoms with these anomalies include pelvic pain and abnormal uterine bleeding although many patients can be asymptomatic. Müllerian anomalies have been associated with renal, skeletal, and abdominal wall anomalies with up to 30% of patients having coexisting renal anomalies. Due to abnormalities in pelvic landmarks and the possible presence of other anomalies, surgical management is challenging.
Navigating the pelvis with müllerian anomalies
G Rivera Ortiz, N Mahnert, J Mourad
10.1016/j.ajog.2024.02.273
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1301
-
Ishtmocele with myometrial cysts - hysteroscopic repair
https://www.ajog.org/article/S0002-9378(24)00343-0/fulltext?rss=yes
Surgical video of Hysteroscopic Repair of Isthmocele with Myometrial Cysts.
Ishtmocele with myometrial cysts - hysteroscopic repair
J Tavcar, M Alzamora
10.1016/j.ajog.2024.02.272
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1301
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Rise up: approaches to ensure apical support at time of laparoscopic hysterectomy
https://www.ajog.org/article/S0002-9378(24)00342-9/fulltext?rss=yes
Traditional hysterectomy for whatever indication involves loss of vaginal apical support provided by the cardinal and uterosacral ligaments. While evidence is limited or conflicting as to the role of hysterectomy in the development of pelvic organ prolapse, there are multiple ways to quickly and efficiently restore this support at the time of hysterectomy. Thus, it seems reasonable to restore apical support while more evidence surfaces. At this time, there is no clear evidence that points to one method of apical support as being superior to another.
Rise up: approaches to ensure apical support at time of laparoscopic hysterectomy
E Austin, K Zeng, N Mahnert, J Mourad
10.1016/j.ajog.2024.02.271
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1301
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Hysteroscopic resection of complete uterine septum with intraoperative fluoroscopic guidance
https://www.ajog.org/article/S0002-9378(24)00341-7/fulltext?rss=yes
The prevalence of Mullerian duct anomalies is 1-3% with the most common being complete or partial septate uterus. Pregnancy consequences of anomaly include spontaneous abortion, preterm birth, breech, and abruption. Some physicians have argued for prophylactic hysteroscopic metroplasty in women with septate uterus at the time of diagnosis to prevent miscarriages and pregnancy complications.
Hysteroscopic resection of complete uterine septum with intraoperative fluoroscopic guidance
M Chai, R Jalloul, M Abdallah
10.1016/j.ajog.2024.02.270
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1300
S1301
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Robotic cervical myomectomies: counseling and approaches for surgical success
https://www.ajog.org/article/S0002-9378(24)00340-5/fulltext?rss=yes
Cervical fibroids are rare and associated with severe symptoms and infertility. Limited evidence exists for treatment.
Robotic cervical myomectomies: counseling and approaches for surgical success
E Chen, J Ton
10.1016/j.ajog.2024.02.269
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1300
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Laparoscopic isthmocele resection
https://www.ajog.org/article/S0002-9378(24)00339-9/fulltext?rss=yes
Isthmoceles, or cesarean scar defects, are known complications after cesarean section surgeries. This is usually a thinning of the myometrium at the site of the previous hysterotomy that does not fully heal. This can lead to complications such as secondary infertility, cesarean scar ectopic pregnancies, uterine rupture, etc. When found, resection can be recommended for various reasons, usually fertility. This video goes over laparoscopic technique to resect and repair the isthmocele defect.
Laparoscopic isthmocele resection
N Wallace, M Cesta
10.1016/j.ajog.2024.02.268
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1300
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Repair of a rectovaginal cloacal defect
https://www.ajog.org/article/S0002-9378(24)00338-7/fulltext?rss=yes
Acquired rectovaginal cloacal defects are an uncommon condition encountered by Urogynecologists, Female Urologists, and Colorectal Surgeons. They are thought to occur following third and fourth-degree obstetric anal sphincter lacerations. Patients typically present with fecal or flatal incontinence, pelvic pain, or dyspareunia. On physical examination, providers may notice absence or near loss of the perineal body, abnormalities with the anal sphincter, or distal posterior vaginal wall prolapse.
Repair of a rectovaginal cloacal defect
M Pezzillo, A Luck, M Miller
10.1016/j.ajog.2024.02.267
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1299
S1300
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Contained specimen extraction in MIGS: a decision algorithm
https://www.ajog.org/article/S0002-9378(24)00337-5/fulltext?rss=yes
In 2013, gynecologic tissue extraction came to worldwide media attention due to a case of disseminated leiomyosarcoma. Concern about dissemination of benign and malignant disease led to a decline in minimally invasive techniques despite their recognized advantages. Since then, a variety of contained specimen extraction techniques have been described in appropriately selected patients for whom the risk of occult sarcoma is low. For these patients, part of the preoperative counseling and shared decision making should include a discussion of the anticipated specimen extraction technique.
Contained specimen extraction in MIGS: a decision algorithm
A Ramanathan, M Alzamora, L Cosgriff, E Klein, N Hazen, J Robinson
10.1016/j.ajog.2024.02.266
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1299
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Steps to successful laparoscopic management of cesarean scar ectopic pregnancy
https://www.ajog.org/article/S0002-9378(24)00336-3/fulltext?rss=yes
Cesarean scar ectopic pregnancies (CSEP) occur in about 1 in 1700 pregnancies. The contemporary increase in CSEP matches that of the rise in cesarean births and improved diagnostic capabilities and awareness. CSEP can be life-threatening secondary to massive hemorrhage and is a precursor to placenta accreta spectrum. Therefore, early diagnosis and management is imperative to prevent severe maternal morbidity and mortality. Several treatment options for CSEP have been described, each with varying degree of patient risk, fertility outcomes, and surgeon skill requirements.
Steps to successful laparoscopic management of cesarean scar ectopic pregnancy
K Smith, R Young
10.1016/j.ajog.2024.02.265
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1299
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Introduction to laparoscopy for medical students
https://www.ajog.org/article/S0002-9378(24)00335-1/fulltext?rss=yes
Due to the relative lack of surgical equipment instruction in medical schools nationwide, our team began working on a project to increase medical students' knowledge of and comfortability with laparoscopy. Medical students tend to take active roles in such cases and are historically underprepared due to a lack of knowledge. We hope to increase medical student knowledge of laparoscopy to better prepare them for their clinical rotations.
Introduction to laparoscopy for medical students
L Chrislip, P Downing, A Bondurant
10.1016/j.ajog.2024.02.264
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1298
-
Robotic-assisted repair of a large isthmocele
https://www.ajog.org/article/S0002-9378(24)00334-X/fulltext?rss=yes
Cesarean deliveries Cesarean deliveries have become increasingly common in both developed and developing countries. The exact incidence of isthmocele is unknown, but it’s thought to be up to 61% after primary cesarean and up to 100% after tertiary cesarean. Isthmoceles can cause post-menstrual spotting due to accumulation of blood at the site of the defect, chronic pelvic pain, vaginal discharge, dyspareunia, and secondary infertility. Patients with an isthmocele are at higher risk of cesarean scar pregnancy, placenta accreta spectrum, and uterine scar dehiscence.
Robotic-assisted repair of a large isthmocele
K Ryan, M Mckenna, K Sasaki, C Miller
10.1016/j.ajog.2024.02.263
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1298
-
Posterior vaginal compartment repair: a primer for residents
https://www.ajog.org/article/S0002-9378(24)00333-8/fulltext?rss=yes
In this video, we review the histology and anatomy of the posterior vaginal wall as well as the levels of anatomic support that, when weakened, contribute to posterior vaginal prolapse. We review seven fundamental steps for repair of these defects using a midline plication technique, highlighting common pearls and pitfalls for resident learners.
Posterior vaginal compartment repair: a primer for residents
R Muñoz, C Kunycky, M Willis-Gray, C Chu, N Abu-Alnadi
10.1016/j.ajog.2024.02.262
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1298
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Alternative port placement in a complex surgical abdomen
https://www.ajog.org/article/S0002-9378(24)00332-6/fulltext?rss=yes
Principles of port placement in laparoscopic surgery involve triangulation of the surgical focal point while minimizing restricted motion due to collision of instruments. Some gynecologic surgeons prefer to operate through two ipsilateral ports, while others use their dominant hand in a suprapubic port and non-dominant in a lateral port. Alternative port placement may be necessary in patients with altered anatomy, requiring creative surgical planning. We demonstrate proper prepping and draping with a colostomy in place and display a novel port configuration to maximize triangulation and visibility around the colostomy and adhesive disease.
Alternative port placement in a complex surgical abdomen
K Denny, M Tessmer, S Mansuria
10.1016/j.ajog.2024.02.261
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1298
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Robotic-assisted total laparoscopy hysterectomy for the large uterus: size does not matter
https://www.ajog.org/article/S0002-9378(24)00331-4/fulltext?rss=yes
As surgical techniques continue to push the boundaries of what we know to be possible, large uterine size continues to present a barrier to minimally invasive approaches. A large uterine size presents several challenges, including difficulty with abdominal access, difficult visualization of critical structures, and issues with specimen extraction.
Robotic-assisted total laparoscopy hysterectomy for the large uterus: size does not matter
K Zeng, E Austin, J Mourad
10.1016/j.ajog.2024.02.260
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1297
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Key techniques for difficult bladder dissection during robotic assisted total laparoscopic hysterectomy
https://www.ajog.org/article/S0002-9378(24)00330-2/fulltext?rss=yes
Bladder dissection can be challenging in patients with a history of cesarean section, endometriosis, or prior pelvic surgeries that result adhesive disease of the bladder to the lower uterine segment. It is important for gynecologic surgeons to master techniques to safely accomplish a difficult bladder dissection during minimally invasive hysterectomy to avoid injury or conversion to laparotomy.
Key techniques for difficult bladder dissection during robotic assisted total laparoscopic hysterectomy
M Caplan, M Misal
10.1016/j.ajog.2024.02.259
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1297
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The accuracy of hysterosalpingogram in predicting partial septate uterus
https://www.ajog.org/article/S0002-9378(24)00329-6/fulltext?rss=yes
Imaging studies such as hysterosalpingogram (HSG) are not accurate in detecting patients with partial septate uterus (PSU).
The accuracy of hysterosalpingogram in predicting partial septate uterus
S Joseph, Y Abuzeid, J Hitaj, B Rizk, M Abuzeid
10.1016/j.ajog.2024.02.258
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1297
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Hemi-hysterectomy for rudimentary horn ectopic pregnancy
https://www.ajog.org/article/S0002-9378(24)00328-4/fulltext?rss=yes
Unicornuate uterus is caused by the non-development of one müllerian duct. The condition usually is associated with various degrees of rudimentary horn connected to the unicornuate uterus, when one of the ducts develops only partially. The horn can be communicating or non-communicating, leading to variable clinical presentations. Unicornuate uterus with pregnancy in the noncommunicating rudimentary horn is extremely rare. It can be life-threatening due to risk of uterine rupture, which can occur as early as the first trimester.
Hemi-hysterectomy for rudimentary horn ectopic pregnancy
A Mohr-Sasson, C Leidlein, A Bhalwal
10.1016/j.ajog.2024.02.257
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1296
S1297
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Dry as a desert: a surgical tour of topical hemostatic agents
https://www.ajog.org/article/S0002-9378(24)00327-2/fulltext?rss=yes
Topical hemostatic agents are frequently used in surgery when sutures, clips and electrocautery have failed or are unable to be used due to proximity of vulnerable structures. They are most effective in low pressure, low velocity venous bleeding and should not be used for bleeding prophylaxis. For the purposes of this review, topical hemostatic agents have been categorized into three classes based on the mechanism of action: mechanical, biologically active, and combined.
Dry as a desert: a surgical tour of topical hemostatic agents
B Flynn, J Wong, A Ecker
10.1016/j.ajog.2024.02.256
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1296
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Case report on evacuation of retropubic hematoma after previous transvaginal retropubic sling placement
https://www.ajog.org/article/S0002-9378(24)00326-0/fulltext?rss=yes
Stress urinary incontinence is defined as involuntary leakage of urine on effort or exertion. Retropubic and trans-obturator sling operations are types of minimally invasive surgical treatment for stress urinary incontinence. These procedures are generally safe; however, complications can occur including but not limited to cystostomy or bladder perforation, surgical site infection, postoperative groin pain, urinary tract infections, urinary retention, and hematomas or hemorrhage.
Case report on evacuation of retropubic hematoma after previous transvaginal retropubic sling placement
M Le, G Namazi, H Aubert, S Handler, M Stuparich
10.1016/j.ajog.2024.02.255
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1296
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The 4th arm solution: an easy answer to the robotic hysterectomy without a uterine manipulator
https://www.ajog.org/article/S0002-9378(24)00325-9/fulltext?rss=yes
Every provider has experienced the frustration of not being able to place a manipulator for a hysterectomy. We describe how to use a 4th arm on the robot to overcome these challenges. Research has shown that adding a 4th arm is not associated with increased length of stay, operative/docking time, or intraoperative/postoperative docking times. (Yim GW et al. (2018) Perioperative Outcomes of 3-arm vs 4-arm Robotic Radical Hysterectomy in Patients with Cervical Cancer. Journal of Minimally Invasive Gynecology July-Aug 25(5):823-831).
The 4th arm solution: an easy answer to the robotic hysterectomy without a uterine manipulator
A Barger, L Haworth, M Bennett, J Hudgens, J Woo
10.1016/j.ajog.2024.02.254
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1296
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Introduction to gynecologic surgical instruments
https://www.ajog.org/article/S0002-9378(24)00324-7/fulltext?rss=yes
Ob/Gyn clerkships commonly require medical students’ active assistance during surgical cases. However, it is often the first time many students are introduced to common surgical instruments. There is a paucity of educational resources describing instruments and their use. Furthermore, most available resources describe instruments used in general surgery and often omit instruments commonly used in gynecologic surgery. In this video, we review operative instruments that are commonly used in gynecologic surgery.
Introduction to gynecologic surgical instruments
TB Prinster, L Chrislip, P Downing, A Bounderant
10.1016/j.ajog.2024.02.253
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1295
S1296
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Surgical considerations during laparoscopic hysterectomy in patients with pelvic kidney
https://www.ajog.org/article/S0002-9378(24)00323-5/fulltext?rss=yes
The kidneys are typically located retroperitoneally in the abdomen; however, a pelvic kidney encompasses the anatomical abnormalities that occur when a kidney fails to ascend from the pelvis during embryogenesis. Pelvic kidneys may lead to variations in vascular supply and the ureteral pathway, and therefore, is important to consider in abdominal and pelvic surgery in order to avoid injury.
Surgical considerations during laparoscopic hysterectomy in patients with pelvic kidney
M Yuen, A Farrell, E Parent, E Gagliardi
10.1016/j.ajog.2024.02.252
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1295
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Becoming a “homegrown” surgeon: an applied core skills curriculum and its applicability in the real world
https://www.ajog.org/article/S0002-9378(24)00322-3/fulltext?rss=yes
Given the modern era of work hour restrictions and medicolegal pressures, surgery is increasingly taught outside the OR. Many of the core surgical skills are now being developed utilizing simulators of variable fidelity. Gynecologic laparoscopy is no exception with regards to such needs, however it is fraught with the unique challenge of sharing training time with the development of obstetrical skills required for graduation.
Becoming a “homegrown” surgeon: an applied core skills curriculum and its applicability in the real world
C Manning, T Koi, M Mackenzie, T Kapetanakis
10.1016/j.ajog.2024.02.251
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1295
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Bladder flap dissection in gynecologic surgery: tips and tricks for success
https://www.ajog.org/article/S0002-9378(24)00321-1/fulltext?rss=yes
Laparoscopic gynecologic surgeries are known to have a complication rate of 0.33% for bladder or ureteral injuries. The most common location of injury is on the posterior side of the bladder during vesico-uterine dissection. While injuries are generally noticed at the time of surgery, an unnoticed serosal injury can lead to delayed cystotomy and vesico-vaginal fistula. A safe bladder flap technique is important to prevent complications in both the short and long term.
Bladder flap dissection in gynecologic surgery: tips and tricks for success
C Niino, K Hamilton, R Schneyer, R Meyer, M Siedhoff, K Wright, M Truong
10.1016/j.ajog.2024.02.250
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1294
S1295
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Novel extracorporeal C-incision tissue extraction (ExCITE) model
https://www.ajog.org/article/S0002-9378(24)00320-X/fulltext?rss=yes
The Extracorporal C-Incision Tissue Extraction (ExCITE) technique is a surgical technique used to remove larges sized tissue through a relatively small incision. Residents have varying exposure to the ExCITE method. A new ExCITE simulation was developed and piloted with medical learners to assess its efficacy.
Novel extracorporeal C-incision tissue extraction (ExCITE) model
B Chhor, M Vanbarren, R Lee, S Miles
10.1016/j.ajog.2024.02.249
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1294
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Recurrent ureteral endometriosis
https://www.ajog.org/article/S0002-9378(24)00319-3/fulltext?rss=yes
We present a case of a 31-year-old female with recurrent endometriosis after excision 5 years prior. Imaging was consistent with deep infiltrating endometriosis along the pelvic sidewall and this corresponded with surgical findings of a 1cm deep infiltrating endometriosis lesion extrinsic to the left ureter. It is crucial for the gynecologic surgeon to be familiar with ureteral endometriosis, its preferred treatment algorithm, and how to prevent recurrence.
Recurrent ureteral endometriosis
T Horton, A Carrubba
10.1016/j.ajog.2024.02.248
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1294
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Endometrium sparing technique during hysteroscopic myomectomy
https://www.ajog.org/article/S0002-9378(24)00318-1/fulltext?rss=yes
Intrauterine adhesion formation is a possible complication of hysteroscopic myomectomy, especially in the presence of submucosal myomas on the opposing surfaces. Various approaches have been proposed to reduce postoperative intrauterine adhesions after operative hysteroscopy, such as intrauterine device (IUD), Foley catheter, and Malecot catheter. The described techniques of hysteroscopic myomectomy with morcellation or resection remove the endometrial layer covering the myoma. A technique to spare the endometrial layer may prove beneficial in reducing intrauterine adhesion formation.
Endometrium sparing technique during hysteroscopic myomectomy
S Joseph, M Merida, M Love, A Akinpeloye, M Abuzeid
10.1016/j.ajog.2024.02.247
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1294
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Sustained vaginal stent placement in the surgical management of shortened vaginal length
https://www.ajog.org/article/S0002-9378(24)00317-X/fulltext?rss=yes
Patients with previously normal vaginal length may develop a shortened vaginal length or narrowed vaginal lumen from inflammatory conditions such as lichen planus or graft-versus-host disease or from scar tissue following vaginal surgery. A shortened vaginal length may interfere with a patient’s ability to have vaginal intercourse, prevent evaluation of the cervix and upper vagina, and lead to difficulty with urine or menstrual efflux. When conservative management with vaginal dilator therapy fails, surgical management with intravaginal adhesiolysis is considered.
Sustained vaginal stent placement in the surgical management of shortened vaginal length
S Bhandari Randhawa, MM Mauskar, MM Corton
10.1016/j.ajog.2024.02.246
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1293
S1294
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Short-term outcomes of single port robotic hysterectomy with concomitant sacrocolpopexy
https://www.ajog.org/article/S0002-9378(24)00316-8/fulltext?rss=yes
The Da Vinci single port (SP) robotic platform heralds a new era of minimally invasive surgery (MIS). It differs from traditional and single-site robotic surgery; three instruments and a camera are all operated by a single robotic arm. This platform is approved by the Food and Drug Administration for urologic and otolaryngologic procedures; it is not yet approved for gynecologic surgeries. Current experiences of SP gynecologic procedures are limited to case series performed in other countries. This is the first study to describe SP gynecologic surgeries performed within the United States.
Short-term outcomes of single port robotic hysterectomy with concomitant sacrocolpopexy
S Ashmore, K Kenton, S Collins, J Geynisman-tan, C Lewicky-gaupp, H Nguyen, M Mueller
10.1016/j.ajog.2024.02.245
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1292
S1293
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A value-driven approach to robot-assisted hysterectomy and sacrocolpopexy
https://www.ajog.org/article/S0002-9378(24)00315-6/fulltext?rss=yes
An increasing focus on value within surgical practice encourages surgeons and other members of the multidisciplinary perioperative team to consider cost while implementing surgical initiatives and protocols to enhance patient outcomes. Regarding robotic hysterectomy and sacrocolpopexy in specific, the placement of surgical ports and selection of robotic instrumentation can make a significant impact on the procedure’s cost.
A value-driven approach to robot-assisted hysterectomy and sacrocolpopexy
F Rieker, G Zemtsov, M Bonidie
10.1016/j.ajog.2024.02.244
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1292
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Vaginal colpotomy for traditional and natural orifice transluminal endoscopic surgery (NOTES) vaginal procedures
https://www.ajog.org/article/S0002-9378(24)00314-4/fulltext?rss=yes
Vaginal access is preferred for benign hysterectomy compared to other approaches. Barriers to vaginal hysterectomy include technical difficulty, poor visualization, concern for complications, and lack of surgical skills and training. Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) is a novel technology that can overcome some of these barriers and has broadened the scope of benign vaginal access surgery to multiple gynecologic procedures. However, vNOTES first requires anterior and posterior vaginal colpotomy by traditional surgical techniques.
Vaginal colpotomy for traditional and natural orifice transluminal endoscopic surgery (NOTES) vaginal procedures
L King, E Pan, C Hamid, S Balgobin
10.1016/j.ajog.2024.02.243
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1291
S1292
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Hysterectomy in the setting of vaginal obliteration
https://www.ajog.org/article/S0002-9378(24)00313-2/fulltext?rss=yes
Laparoscopic hysterectomy in the setting of vaginal obliteration can be challenging due to the lack of vaginal access and uterine manipulation. Several case reports have been previously published on pyometra after Le Fort colpocleisis, each resulting in exploratory laparotomy with hysterectomy. One prior case report has been published on a minimally invasive approach to hysterectomy after Le Fort colpocleisis; in this case, they were able to access the vagina through the previously created vaginal channels.
Hysterectomy in the setting of vaginal obliteration
T Horton, S El-Nashar, A Carrubba
10.1016/j.ajog.2024.02.242
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1291
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Robotic-assisted resection of a rudimentary uterine horn
https://www.ajog.org/article/S0002-9378(24)00312-0/fulltext?rss=yes
A unicornute uterus is a type of congenital uterine anomaly that results from malformation of the Mullerian ducts. This can lead to formation of a uterine horn which may become obstructed. This anomaly is associated with chronic pelvic pain and infertility. Management of uterine horn is often limited. However, for patients who suffer from chronic pelvic pain due to a uterine horn or those who wish to optimize fertility, it is important to consider definitive management with resection via a minimally invasive technique.
Robotic-assisted resection of a rudimentary uterine horn
A Farrell, T Koi
10.1016/j.ajog.2024.02.241
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1291
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Symptomatic congenital vascular malformation of the vulva mimicking a lymphangioma
https://www.ajog.org/article/S0002-9378(24)00311-9/fulltext?rss=yes
The goal of our video is to emphasize the importance of preoperative preparation in the surgical intervention of rare symptomatic vulvar vascular malformations with a focus on precise surgical techniques to ensure safety and cosmesis.
Symptomatic congenital vascular malformation of the vulva mimicking a lymphangioma
M Watson, K Schaeffer, S Mama
10.1016/j.ajog.2024.02.240
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1291
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Excision of paraurethral fibroid
https://www.ajog.org/article/S0002-9378(24)00310-7/fulltext?rss=yes
Paraurethral leiomyomas are rare and comprise approximately 5% of all paraurethral masses, which are present in 1 in 1000 women. Given incidence there is a paucity of data regarding surgical approach and management.
Excision of paraurethral fibroid
U Omosigho, M Baker, S Nelamangala, M Coulter, R Adam
10.1016/j.ajog.2024.02.239
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1290
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Vaginal bulge is not always prolapse; could be a cyst
https://www.ajog.org/article/S0002-9378(24)00309-0/fulltext?rss=yes
34yo G0 referred to Urogynecology for a vaginal bulge and occasional dyspareunia. On the exam she had a 4 cm anterior vaginal cystic mass without pelvic organ prolapse. The differential diagnosis for benign vaginal cysts is broad including Müllerian or Gartner’s (mesonephric) ducts, Skene’s, Bartholin gland, epidermal inclusion, or endometriotic cysts, adenosis, or urethral diverticulum. Vaginal cysts may present with or without symptoms. Most are secondary to embryological remnants or trauma. Müllerian ducts form the fallopian tubes, broad ligament, uterus, cervix and upper part of the vagina.
Vaginal bulge is not always prolapse; could be a cyst
A Trikhacheva, K Dengler, T Murdock, D Gruber
10.1016/j.ajog.2024.02.238
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1290
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Laparoscopic utero-ovarian ligament plication and oophoropexy for recurrent adnexal torsion
https://www.ajog.org/article/S0002-9378(24)00308-9/fulltext?rss=yes
Adnexal torsion involves partial or complete twisting of the adnexa which can further compromise vascular flow. It is responsible for 3% of surgical emergencies in women of reproductive age. A major risk factors is prior history of adnexal torsion.
Laparoscopic utero-ovarian ligament plication and oophoropexy for recurrent adnexal torsion
A Joshi, T Koi, E Gagliardi
10.1016/j.ajog.2024.02.237
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1290
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Approach to the obliterated anterior Cul-De-Sac during a total laparoscopic hysterectomy
https://www.ajog.org/article/S0002-9378(24)00307-7/fulltext?rss=yes
An obliterated anterior cul-de-sac occurs when the vesico-uterine avascular space is absent leading to distortion of normal anatomy. Risk factors include cesarean deliveries, prior pelvic surgeries, infection, and endometriosis. Knowledge of anatomy and good surgical technique is critical to safe completion of a hysterectomy. The laparoscopic approach provides advantages of improved visualization posteriorly, global survey, assistance of the pneumo-peritoneum in plane dissection, and decreased blood loss.
Approach to the obliterated anterior Cul-De-Sac during a total laparoscopic hysterectomy
A Nutaitis, M Billow
10.1016/j.ajog.2024.02.236
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1289
S1290
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Surgical approach and technique for robotic assisted ureteroneocystotomy using barbed suture
https://www.ajog.org/article/S0002-9378(24)00306-5/fulltext?rss=yes
With the invention of barbed suture, it has become popular among minimally invasive surgery to allow for quicker, more economical, and efficient tissue reapproximation. Barbed suture has been widely used in gynecologic surgery and studies have suggested that it is effective and quicker specifically for minimally invasive urological procedures as well. Given its extensive use and comfort in gynecologic surgery, presented is a video of the surgical technique demonstrating use of barbed suture in a robotic assisted ureteroneocystotomy.
Surgical approach and technique for robotic assisted ureteroneocystotomy using barbed suture
K Ellsworth, L Jenusaitis, C Degraffenreid, G Kilic
10.1016/j.ajog.2024.02.235
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1289
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The blunt fascial entry technique - a new abdominal access technique for laparoscopic surgery
https://www.ajog.org/article/S0002-9378(24)00305-3/fulltext?rss=yes
The most common access location for laparoscopic surgery is the umbilicus, due to the fusion of subcutaneous layers, lack of subcutaneous fat and improved cosmetic results. Several techniques have been described for peritoneal cavity access, the most common being the open (Hasson) technique, the closed Veress needle technique, and the visual entry technique. Randomized controlled trials indicate the risk of complications is low and comparable between the different access techniques, ranging from 1.1-5.5 per 1000 cases.
The blunt fascial entry technique - a new abdominal access technique for laparoscopic surgery
R Meyer, K Hamilton, M Siedhoff
10.1016/j.ajog.2024.02.234
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1288
S1289
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Novel technique of laparoscopic rectus fascial sling insertion for urinary stress incontinence
https://www.ajog.org/article/S0002-9378(24)00304-1/fulltext?rss=yes
Stress urinary incontinence (SUI) is a common condition that has a significant impact on quality of life. The integral theory showed that defective mid urethral support and the resultant low urethral pressure are the main mechanism behind SUI. Concerns have been raised about safety of vaginal mid urethral mesh tapes with a move towards native tissue treatments. Rectus fascial sling has high success rate. It is done through a laparotomy, and is associated with high rates of voiding dysfunction. More recently, sling on a string was introduced using a laparotomy, with blind introduction of the strings using a special curved needle.
Novel technique of laparoscopic rectus fascial sling insertion for urinary stress incontinence
A Fayyad
10.1016/j.ajog.2024.02.233
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1288
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Surgical management for endometriosis
https://www.ajog.org/article/S0002-9378(24)00303-X/fulltext?rss=yes
A case of a 42 year old patient with cyclical pelvic pain, pain with intercourse, and dysmenorrhea with worsening characteristics is presented. The patient had already been treated for her pelvic pain based on a diagnosis by ultrasound of fibroids and an ovarian cyst with no improvement of her symptoms. On physical examination she had pain with palpation of the pelvic floor muscles, tenderness along ischial spines bilaterally, and tenderness along the posterior uterus. An MRI of the pelvis demonstrated endometriosis with visible lesions at the site of uterine retroflexion, along the right anterior uterus and a left ovarian endometrioma.
Surgical management for endometriosis
MJ Calero, A Carrubba
10.1016/j.ajog.2024.02.232
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1288
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Teaching video: removal of die (#Enzian P3, A2, B2/0, C3)
https://www.ajog.org/article/S0002-9378(24)00302-8/fulltext?rss=yes
Video, no abstract needed (due to information of Vivian Gies email Aug 17th 2023).
Teaching video: removal of die (#Enzian P3, A2, B2/0, C3)
L Ziurle, O Preyer, U Hager, M Ziurlys, E Janschek
10.1016/j.ajog.2024.02.231
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1288
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To visualize beyond: vaginoscopy
https://www.ajog.org/article/S0002-9378(24)00301-6/fulltext?rss=yes
A vaginoscopy involves using a camera to evaluate the vaginal canal, cervix, and uterine cavity. During this procedure, a small diameter endoscope containing a light source and irrigation fluid is used without requiring a speculum or forceps used in traditional approaches to hysteroscopy. Vaginoscopy is performed to evaluate and treat various conditions including abnormal uterine bleeding, retained products of conception, and endometrial polyps. The benefits of vaginoscopy over traditional approaches to hysteroscopy include less pain and increased comfort, shortened procedure and recovery time, fewer vasovagal events, and improved visualization of structures.
To visualize beyond: vaginoscopy
S Desar, G Namazi, S Nahas, M Stuparich, S Behbehani
10.1016/j.ajog.2024.02.230
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1287
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Not just a simple cyst
https://www.ajog.org/article/S0002-9378(24)00300-4/fulltext?rss=yes
In dynamic work environments, a continuous cycle of monitoring to assess a situation, take appropriate actions and re-evaluate the results, is required. Surgeons' intraoperative decision making is a key element of clinical practice, yet, gets limited attention. Studies demonstrating the process of intraoperative decision making are rare.
Not just a simple cyst
A Mohr-Sasson, S Jhajj, R Jalloul
10.1016/j.ajog.2024.02.229
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1287
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Resection of non-congenital premenopausal vaginal stenosis
https://www.ajog.org/article/S0002-9378(24)00299-0/fulltext?rss=yes
Non-congenital vaginal stenosis is uncommon. Consequences of vaginal stenosis include psychological distress, dyspareunia, and pain and difficulty with pelvic exams. This can affect important cervical cancer screening. Risk factors for stenosis include menopause, pelvic radiation, prior vaginal surgery, and hysterectomy. Management includes vaginal dilators, estrogen, and surgical resection. Case reports have reported on the use of hysteroscopy in resection of a vaginal septum. We present a case of a 40-year-old nulliparous premenopausal woman with persistent non-congenital vaginal stenosis.
Resection of non-congenital premenopausal vaginal stenosis
A Bruscke, D Carr, P Rosenblatt
10.1016/j.ajog.2024.02.228
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1286
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Minimally invasive approach to the excision of endometriosis from the abdominal wall, bladder, and pelvis
https://www.ajog.org/article/S0002-9378(24)00298-9/fulltext?rss=yes
Extrapelvic endometriosis is a clinical entity in which implants of endometrial glandular tissue are found outside of the uterus and pelvis. Lesions are commonly associated with the abdominal wall, and patients may experience significant associated catamenial pain and bleeding at these sites. Safe surgical management often requires multidisciplinary planning with implementation of meticulous intraoperative technique to identify planes of dissection.
Minimally invasive approach to the excision of endometriosis from the abdominal wall, bladder, and pelvis
C French, R Korets, E Gagliardi
10.1016/j.ajog.2024.02.227
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1286
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MRI anatomy of the anal sphincter
https://www.ajog.org/article/S0002-9378(24)00296-5/fulltext?rss=yes
One of the most common and devastating complications of vaginal delivery is the 4th degree perineal laceration or anal sphincter separation. It is troubling for patients- often leading to infection, wound complications, and it can lead to decades of anal incontinence. Accurate and meticulous repair of the anal sphincter complex is imperative for optimal outcomes. With this video we aim to help identify relevant anal sphincter anatomy for the Obstetrician Gynecologist.
MRI anatomy of the anal sphincter
A Sammarco, C Hong, R Genadry, A Stork, D Herman, D Hobson, C Swenson, J Delancey
10.1016/j.ajog.2024.02.225
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1285
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Robotic assisted paraurethral fibroid excision via retzius space dissection
https://www.ajog.org/article/S0002-9378(24)00295-3/fulltext?rss=yes
This video describes the diagnosis and management of a rare case of a paraurethral fibroid. Urethral and paraurethral fibroids have primarily been described in case reports and have a reported incidence of 5% of urethral masses. The primary management is surgical excision.
Robotic assisted paraurethral fibroid excision via retzius space dissection
P Coombs, O Cardenas-Trowers
10.1016/j.ajog.2024.02.224
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1285
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Vaginal assisted laparoscopic sacrocolpopexy (VALS) for gals with advanced pelvic organ prolapse
https://www.ajog.org/article/S0002-9378(24)00294-1/fulltext?rss=yes
Sacrocolpopexy is an abdominal mesh suspension procedure for treatment of pelvic organ prolapse that suspends the vaginal apex to the sacrum. VALS is a modified approach to sacrocolpopexy, where the mesh is attached vaginally to the anterior and posterior vagina prior to abdominal sacral attachment.
Vaginal assisted laparoscopic sacrocolpopexy (VALS) for gals with advanced pelvic organ prolapse
E Welch, K Dengler, J Gisseman, D Gruber
10.1016/j.ajog.2024.02.223
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1284
S1285
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Excision of a vaginal cuff nodule in 9 steps
https://www.ajog.org/article/S0002-9378(24)00293-X/fulltext?rss=yes
Endometriosis affects 6-10% of women and can have a serious impact on women’s quality of life. While rare, endometriosis can occur at incisional sites following obstetric and gynecologic surgeries, such as cesarean section scars, port sites and the vaginal cuff. Endometriosis at the vaginal cuff occurs in 0.02% of cases. These lesions can cause pain, irregular bleeding, and dyspareunia, and the mainstay of treatment is surgical resection. Given that endometriosis at the vaginal cuff is a rare occurrence, many surgeons may not have experience performing the resection of a vaginal cuff nodule.
Excision of a vaginal cuff nodule in 9 steps
V Buckley, B Malone, S Simko, S Handler, S Nahas, M Stuparich
10.1016/j.ajog.2024.02.222
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1284
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Robotic vaginal hernia repair for recurrent vaginal prolapse status-post radical cystectomy with indiana pouch
https://www.ajog.org/article/S0002-9378(24)00292-8/fulltext?rss=yes
Pelvic organ prolapse following a radical cystectomy is challenging to treat. A radical cystectomy in women includes the removal of the bladder, reproductive organs, and a portion of the anterior vaginal wall. This leads to the disruption of fascial planes and weakening of the pelvic floor (2). The literature cites the average presentation of symptomatic prolapse as 1-2 years following a radical cystectomy (1). Recurrence of prolapse after primary repair is common in this population due to compromised pelvic floor support and tissue quality (3).
Robotic vaginal hernia repair for recurrent vaginal prolapse status-post radical cystectomy with indiana pouch
L Carbone, V Webber, R Rothenberger, S Lenger, A Gupta, S Francis
10.1016/j.ajog.2024.02.221
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1283
S1284
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vNOTES hysterectomy of the large fibroid uterus - tips and tricks
https://www.ajog.org/article/S0002-9378(24)00291-6/fulltext?rss=yes
vNOTES hysterectomy represents a unique fusion of vaginal, laparoscopic, and laparo-endoscopic single-site surgery (LESS) techniques, offering an essential tool in the repertoire of gynecologic surgeons. It holds the potential to reverse the decline in vaginal hysterectomies and empowers gynecologic surgeons to continue providing "scarless” surgeries with reduced post-operative complications, improved pain management, and quicker recovery times. vNOTES proves to be a feasible approach for a wide range of gynecological procedures, including adnexal surgery, myomectomy, pelvic floor prolapse suspension procedures, and hysterectomy, including of large fibroid uteri.
vNOTES hysterectomy of the large fibroid uterus - tips and tricks
L Liron, V Lerner
10.1016/j.ajog.2024.02.220
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1283
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Excision of mid-urethral sling mesh using a supraurethral approach
https://www.ajog.org/article/S0002-9378(24)00290-4/fulltext?rss=yes
A 44-year-old female with history of a transobturator tape sling presented at her four week visit with post-operative complications of urinary retention, urinary urgency and frequency, and a urethral stricture on exam. A diagnostic cystoscopy was performed that was unremarkable other than a urethral stricture. Urethral stricture was managed by urethral dilation in the office. Over the next year, symptoms worsened, and new onset vaginal pain occurred. She was seen by a different gynecologist and cystoscopy was repeated.
Excision of mid-urethral sling mesh using a supraurethral approach
A Gee, LL Lua-Mailland, S Vasavada, MF Paraiso
10.1016/j.ajog.2024.02.219
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1282
S1283
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Inguinal hernia resulting in ectopic ovary to the left vulva
https://www.ajog.org/article/S0002-9378(24)00289-8/fulltext?rss=yes
This video reviews the diagnosis, surgical management, and unique mullerian anomaly of a patient with an ectopic ovary to the vulva.
Inguinal hernia resulting in ectopic ovary to the left vulva
A Jackovic, C Polen-De, L Mellert, M Cesta
10.1016/j.ajog.2024.02.218
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1282
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Integration of MRI for detection and surgical planning of advanced endometriosis
https://www.ajog.org/article/S0002-9378(24)00288-6/fulltext?rss=yes
While physical examination, laboratory tests, and imaging have been used in the work-up of endometriosis, diagnostic laparoscopy with histopathology has long been used as the gold standard for endometriosis diagnosis. This method, however, has diagnostic limitations given variability of the appearance of lesions. Surgery also comes with potential patient complications and a high cost to the healthcare system. (Byrne, et al. 2018). A recent systematic review and meta-analysis revealed that ultrasound and MRI may be highly useful alternatives to laparoscopy for diagnosis of deep infiltrating endometriosis (Zhang et al.
Integration of MRI for detection and surgical planning of advanced endometriosis
T Gallant, C King, M Luna Russo, J Clay, J Hansen
10.1016/j.ajog.2024.02.217
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1282
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Peritoneal neovagina with uterine anastamosis: a novel single surgery approach
https://www.ajog.org/article/S0002-9378(24)00287-4/fulltext?rss=yes
While vaginal agenesis is most frequently accompanied by an absent or rudimentary, nonfunctioning uterus, it may also occur in isolation with a fully developed uterine body. In these scenarios, anastomosis of the functional uterus to a neovagina allows for both egress of menstrual blood as well as potential preservation of fertility: case reports exist of spontaneous conception following creation of a neovagina. However, prior attempts at anastomosis have all included delayed surgery with anastomosis to the uterus several months following the creation of the neovagina.
Peritoneal neovagina with uterine anastamosis: a novel single surgery approach
M Baker, A Yunker, S Kassis, M Kaufman, A Khan, B Chaya, K Martin
10.1016/j.ajog.2024.02.216
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1281
S1282
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A novel simulation model for ureteral stent placement
https://www.ajog.org/article/S0002-9378(24)00286-2/fulltext?rss=yes
Cystoscopy and ureteral stenting are important skills for trainees in gynecologic and urologic surgery to acquire during their training. Oncological and benign conditions requiring complex pelvic surgery are associated with an increased risk of urinary tract injuries. Therefore, placement of temporary ureteral stents either prophylactically or when a ureteral injury is suspected may be necessary. Advanced gynecology trainees such as fellows in urogynecology, oncology and minimally invasive gynecologic surgery should be well versed in placing temporary ureteral stent to avoid or diagnose a ureteral injury.
A novel simulation model for ureteral stent placement
N Wood, L Cheng, D Volkin, E Tunitsky
10.1016/j.ajog.2024.02.215
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1281
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Uterine manipulator simulation: a simple universal uterine model to allow placement and simulation of any uterine manipulator
https://www.ajog.org/article/S0002-9378(24)00285-0/fulltext?rss=yes
Uterine manipulator placement and intra-operative uterine manipulation are crucial skills for safe and effective laparoscopic gynecologic surgery but it can be challenging to teach these skills without an accessible, reliable, and high-fidelity model.
Uterine manipulator simulation: a simple universal uterine model to allow placement and simulation of any uterine manipulator
J Perez, C Kwon, G Silverstein, A Mcclurg
10.1016/j.ajog.2024.02.214
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1280
S1281
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Technique for excision of rectovaginal endometriotic nodules
https://www.ajog.org/article/S0002-9378(24)00284-9/fulltext?rss=yes
Rectovaginal endometriosis is a severe form of endometriosis, often presenting with different symptoms including but not limited to pelvic pain, dysmenorrhea, dyspareunia, dyschezia. History, physical exam and imaging techniques are crucial for diagnosis and surgical counseling.
Technique for excision of rectovaginal endometriotic nodules
G Namazi, S Nahas, J Cruz, M Stuparich
10.1016/j.ajog.2024.02.213
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1280
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Endometriosis of the bladder trigone: a fertility- sparing approach
https://www.ajog.org/article/S0002-9378(24)00283-7/fulltext?rss=yes
Endometriosis can affect a variety of organs, including the urinary tract. Involvement of urinary structures occurs in 1-5% of endometriosis cases. Patients with urinary tract endometriosis can present with cyclic urinary frequency, dysuria, hematuria, urgency and pain with bladder distention. This video presents a 35-year-old nulliparous woman with dysmenorrhea, dysuria, urgency and pain with bladder distention. Pelvic MRI demonstrated uterine fibroids and deep infiltrating endometriosis invading the right pelvic sidewall and right bladder base involving the full thickness of the bladder near the right ureterovesical junction, without ureteral obstruction.
Endometriosis of the bladder trigone: a fertility- sparing approach
T Muir, R Young, E Lin, J Gahan, K Kho
10.1016/j.ajog.2024.02.212
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1280
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Surgical management of a vaginally placed mesh eroded into the urethra
https://www.ajog.org/article/S0002-9378(24)00281-3/fulltext?rss=yes
Urinary tract mesh erosions are a rare but known complication of vaginal mesh procedures. Bladder erosions are more common but urethral erosions have been described.
Surgical management of a vaginally placed mesh eroded into the urethra
B Clarke, A Davenport, S Shridhar, R Gutman
10.1016/j.ajog.2024.02.210
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1279
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Hysteroscopic resection of interstitial pregnancy
https://www.ajog.org/article/S0002-9378(24)00280-1/fulltext?rss=yes
Approximately 1% of all ectopic pregnancies are within the uterine interstitial space or cornua. Of those, the mortality rate has been reported as 2-2.5%.1 Traditional treatment of interstitial pregnancy includes medical management with methotrexate, interstitial wedge resection, or cornuostomy.2 The traditional surgical methods mentioned above may lead to increased infertility risk and are relatively invasive. We present a novel surgical approach utilizing only the hysteroscopic resectoscope for management of an interstitial ectopic pregnancy.
Hysteroscopic resection of interstitial pregnancy
A Cronin, A Fielden
10.1016/j.ajog.2024.02.209
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1279
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Ureterolysis for advanced endometriosis: principles and pearls for safe execution
https://www.ajog.org/article/S0002-9378(24)00279-5/fulltext?rss=yes
Ureterolysis is typically required during resection of advanced endometriosis to keep the ureters safely distant during the procedure or to resect endometriosis involving the ureter itself. Proper technique is imperative to minimize the risk of ureteral injury.
Ureterolysis for advanced endometriosis: principles and pearls for safe execution
R Schneyer, K Hamilton, R Meyer, M Truong, K Wright, M Siedhoff
10.1016/j.ajog.2024.02.208
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1278
S1279
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Laparoscopic management of postabortion pyomyoma
https://www.ajog.org/article/S0002-9378(24)00278-3/fulltext?rss=yes
Pyomyoma, or suppurative leiomyoma, is a rare gynecologic complication with high morbidity and mortality without prompt and appropriate treatment. Since 1945, the number of reported cases in the literature is less than 100 case reports and in most reported cases, surgical treatment is recommended with intravenous antibiotics (IV).
Laparoscopic management of postabortion pyomyoma
S Parikh, M Lazenby, E Root, SM Lenger, S Francis
10.1016/j.ajog.2024.02.207
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1277
S1278
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Gender affirming peritoneal vaginoplasty: a modified davydov technique
https://www.ajog.org/article/S0002-9378(24)00277-1/fulltext?rss=yes
Single-stage penile inversion vaginoplasty requires an adequate amount of penoscrotal tissue to line the neovaginal canal and create external vulvar structures sufficiently. Some patients have an insufficient amount of penoscrotal tissue, especially those who have undergone gender-affirming hormone therapy with puberty blockers. Peritoneal vaginoplasty, also known as peritoneal-pull-through vaginoplasty, is a procedural option for transfeminine patients who desire gender-affirming surgery but may have insufficient genital skin.
Gender affirming peritoneal vaginoplasty: a modified davydov technique
S Rahman, R Rolston, M Dewitt-Foy, C Ferrando
10.1016/j.ajog.2024.02.206
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1277
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Exercises and ergonomics for the pregnant surgeon
https://www.ajog.org/article/S0002-9378(24)00276-X/fulltext?rss=yes
Physical pain in pregnancy is common, with almost two thirds of women experiencing low back pain. Literature suggests that healthcare workers in general are high risk for musculoskeletal complications in pregnancy, but there is limited data specifically for pregnant surgeons. Exercise has been shown to have benefit in decreasing severity and preventing common musculoskeletal issues such as low back pain and pelvic pain.
Exercises and ergonomics for the pregnant surgeon
E Olig, H Coulter, M Louie
10.1016/j.ajog.2024.02.205
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1277
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Development of a simulation model for minimally invasive ovarian cystectomy
https://www.ajog.org/article/S0002-9378(24)00275-8/fulltext?rss=yes
Ovarian cystectomy is a common gynecologic procedure that requires application of various surgical techniques to preserve ovarian tissue and avoid cyst rupture. These include techniques related to tissue and instrument handling, tissue dissection, application of hemostasis strategies, suturing, and coordination between surgeon and assistant. We created an ovarian cystectomy model to practice these skills in a simulation setting for OB/GYN residents and fellows.
Development of a simulation model for minimally invasive ovarian cystectomy
C Liao, K Hamilton, R Schneyer, A Mahavni, R Meyer, K Wright, M Siedhoff, M Truong
10.1016/j.ajog.2024.02.204
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1277
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Laparoscopic retropubic urethropexy
https://www.ajog.org/article/S0002-9378(24)00274-6/fulltext?rss=yes
The retropubic urethropexy is well-established surgical repair for treating women with stress, urinary incontinence that fell out of favour after the introduction of the mid-urethral sling in the nineties. Few surgeons now perform it, yet for patients, who prefer to avoid the use of mesh, the laparoscopic retropubic urethropexy offers an effective and minimally invasive surgery.
Laparoscopic retropubic urethropexy
H Vincent, F Mohtashmi, G Cundiff
10.1016/j.ajog.2024.02.203
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1276
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The anatomy of the clitoris on MRI: an educational tutorial
https://www.ajog.org/article/S0002-9378(24)00273-4/fulltext?rss=yes
Historically, anatomists often described female genitals as an inferior version of male anatomy. They published what they believed instead of what they observed, which perpetuated inaccurate and incomplete understanding of female anatomy for many years. Due to ongoing gender-based inequities, female anatomy has been poorly represented in the literature compared to males. This is demonstrated by the fact that a pubmed search reveals 15 times the publications on penile anatomy compared to clitoral anatomy.
The anatomy of the clitoris on MRI: an educational tutorial
A Madsen, J De Lancey, A Gupta, K Propst, A Vaccarello, M Corton, A Sammarco
10.1016/j.ajog.2024.02.202
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1276
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A comparative life cycle cost analysis of uterine manipulators for hysterectomy
https://www.ajog.org/article/S0002-9378(24)00271-0/fulltext?rss=yes
The U.S. health care system contributes approximately 10% to total greenhouse gas emissions nationally and makes up approximately 18.3% of the U.S. gross domestic product. Single-use disposable supplies contribute significantly to these emissions, though they are often preferred because of their lower initial purchase cost compared to reusable options. Uterine manipulators can be manufactured from reusable stainless steel, disposable materials, or both - all of which have distinct carbon footprints and associated costs.
A comparative life cycle cost analysis of uterine manipulators for hysterectomy
A Melnyk, S Glass Clark, N Silva De Souza Lima Cano, M Bilec, A Artsen
10.1016/j.ajog.2024.02.200
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1274
S1275
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The feasibility and benefits of minimally invasive hysterectomy for large uterus
https://www.ajog.org/article/S0002-9378(24)00270-9/fulltext?rss=yes
A uterus with a size of 18 to 20 weeks or more is generally considered a large uterus by most gynecological surgeons. Therefore, laparotomy, rather than minimally invasive surgery, is commonly performed to remove the uterus. However, it is well established that minimally invasive surgery offers numerous benefits to patients compared to laparotomy. Uterine size should not be an excluding factor for minimally invasive surgery.
The feasibility and benefits of minimally invasive hysterectomy for large uterus
L Uzianbaeva, P Wang
10.1016/j.ajog.2024.02.199
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1274
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Sexual harassment, bullying, abuse, and discrimination among obgyn physicians and trainees: a systematic review
https://www.ajog.org/article/S0002-9378(24)00269-2/fulltext?rss=yes
Harassment and discrimination are pervasive across our society. Fields such as medicine, engineering and academic science share characteristics and create conditions that make sexual harassment more likely to occur.
Sexual harassment, bullying, abuse, and discrimination among obgyn physicians and trainees: a systematic review
A Gupta, J Thompson, N Ringel, S Kim-Fine, L Ferguson, S Blank, C Iglesia, E Balk, A Alvarez Secord, J Hines, J Brown, C Grimes
10.1016/j.ajog.2024.02.198
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1273
S1274
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Assessing the presence and impact of care centralization on travel distance for hysterectomies in michigan
https://www.ajog.org/article/S0002-9378(24)00268-0/fulltext?rss=yes
Centralization of care to high-volume centers is associated with increased patient travel burden.
Assessing the presence and impact of care centralization on travel distance for hysterectomies in michigan
J Wang, CX Hong, KR Latack, N Kamdar, B Madden, CA Pizzo, K Ashbaugh, B Cheng, DM Morgan
10.1016/j.ajog.2024.02.197
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1273
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Opioid use and postoperative pain after hysterectomy
https://www.ajog.org/article/S0002-9378(24)00267-9/fulltext?rss=yes
Post-surgical pain is known to a major contributor to the opioid crisis. Among patients treated with opioids post-surgically, the prolonged use of opioids after hysterectomy is considered to be low (0.06%). To reduce the use of opioids post-surgically, one strategy has been to reduce the use of opioids intra-operatively during general anesthesia. However, the effects of reduced intra-operative opioids and postoperative pain outcomes is not well studied. This study sought to examine the association of intra-operative opioid use and postoperative pain and opioid usage, focusing on usage in the PACU.
Opioid use and postoperative pain after hysterectomy
NB Luna Ramirez, NB Barba, E Flores, P Gracia-Filion, N Mahnert
10.1016/j.ajog.2024.02.196
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1271
S1273
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Developmental uterine anomalies in transgender patients receiving gender-affirming hysterectomies
https://www.ajog.org/article/S0002-9378(24)00266-7/fulltext?rss=yes
Most developmental uterine anomalies occur due to Mullerian duct maldevelopment and are often incidentally discovered through pelvic imaging or intraoperatively. The incidence and prevalence of uterine anomalies are well known in the cisgender female general population. A few studies on gender-affirming hysterectomies have reported on the histological endometrial findings of patients using testosterone therapy, with findings of endometrial atrophy ranging from 18 to 50%. 1-3. However, there are no known studies which report developmental uterine anomalies in transgender male or nonbinary (TGNB) patients.
Developmental uterine anomalies in transgender patients receiving gender-affirming hysterectomies
N Nguyen, H Kim, M Sumida, R Galzote
10.1016/j.ajog.2024.02.195
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1271
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Prophylactic ureteral stents in complex pelvic surgery and rates of acute kidney injury
https://www.ajog.org/article/S0002-9378(24)00265-5/fulltext?rss=yes
Prophylactic Ureteral Catheterization (PUC) is among the adjunctive strategies aimed at preventing intraoperative ureteral injury. It has gained some acceptance as a technique to assist in identifying the ureter during surgery. However, there is ongoing debate regarding the acceptance and application of PUC, as there are mixed reports regarding its advantages, complications, and cost-effectiveness. While certain authors claim reduced rates of intraoperative ureteral injury with PUC, aggregated data has failed to conclusively demonstrate its clinical benefits.
Prophylactic ureteral stents in complex pelvic surgery and rates of acute kidney injury
F Sunez, R Jalloul, H Ayoub, J Ma, R Pham, A Agarwal
10.1016/j.ajog.2024.02.194
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1270
S1271
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Does pudendal nerve block improve perioperative pain following onabotulinumtoxina injection for myofascial pelvic pain?
https://www.ajog.org/article/S0002-9378(24)00264-3/fulltext?rss=yes
OnabotulinumtoxinA (BTA) injections are useful for treatment of myofascial pelvic pain. Concurrent pudendal nerve block (PNB) has been suggested to decrease postoperative pain, as BTA does not take immediate effect. The efficacy of PNB for this purpose has not been well elucidated. We aim to determine if PNB improves pain in the perioperative period following pelvic floor BTA injections.
Does pudendal nerve block improve perioperative pain following onabotulinumtoxina injection for myofascial pelvic pain?
P Coombs, G Lewis, A Chen, A Carrubba
10.1016/j.ajog.2024.02.193
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1270
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Correlation of CT derived biomarkers of presacral adiposity with body mass index
https://www.ajog.org/article/S0002-9378(24)00263-1/fulltext?rss=yes
Sacrocolpopexy (SC) is often cited as the gold standard for pelvic organ prolapse surgery. Dissection of the presacral space is inherently difficult as this space contains many vulnerable structures including the common iliac vessels, the presacral vessels, and the hypogastric nerve. Inaccessability of the sacral promontory has been associated with conversion to open sacrocolpopexy. It is not known if BMI or other biometrics are associated with sacral accessibility.
Correlation of CT derived biomarkers of presacral adiposity with body mass index
J Pennycuff, D Jaber, G Toia, P Pickhardt
10.1016/j.ajog.2024.02.192
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1269
S1270
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Ovarian torsion: diagnostic predictors and rates of oophorectomy in a large safety-net hospital
https://www.ajog.org/article/S0002-9378(24)00262-X/fulltext?rss=yes
Diagnosing ovarian torsion is challenging due to its unclear clinical presentation and the variable sensitivity and specificity of diagnostic predictor tests. For example, the use Doppler ultrasound in confirming or ruling out ovarian torsion is highly unreliable. This underscores the critical importance of maintaining a high level of clinical suspicion for timely intervention and the preservation of ovarian function. In the county hospital, many challenges related to medical case complexity, high patient volume and varying availability of immediate testing may further create barriers for accurate and efficient diagnosis and treatment.
Ovarian torsion: diagnostic predictors and rates of oophorectomy in a large safety-net hospital
R Jalloul, J Swan
10.1016/j.ajog.2024.02.191
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1269
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Factors associated to the presence of isthmocele diagnosed by pelvic ultrasound, magnetic resonance imaging or diagnostic hysteroscopy: a cross-sectional study
https://www.ajog.org/article/S0002-9378(24)00260-6/fulltext?rss=yes
Cesarean section is one of the most performed surgery around the world. Not only its rate is on the rise but also associated complications such as isthmocele and the related risk factors for developing isthmocele are unclear.
Factors associated to the presence of isthmocele diagnosed by pelvic ultrasound, magnetic resonance imaging or diagnostic hysteroscopy: a cross-sectional study
JP Leonardo-Pinto, R Bellumoni, CL Benetti-Pinto, LGO Brito, DA Yela
10.1016/j.ajog.2024.02.189
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1268
S1269
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Measuring the intangibles of obstetrics and gynecology residency training: a comparative analysis across specialties
https://www.ajog.org/article/S0002-9378(24)00259-X/fulltext?rss=yes
Obstetrics and gynecology (OB/GYN) residency programs present unique challenges for trainees, such as demanding work schedules, significant financial burdens, and the need to balance professional responsibilities with personal life. These stressors have significant implications for residents’ overall health and well-being during residency. Despite the well-documented challenges of residency, the literature lacks a comprehensive evaluation of the fringe benefits offered to support residents during this period, specifically in obstetrics and gynecology.
Measuring the intangibles of obstetrics and gynecology residency training: a comparative analysis across specialties
H Kyllo, N Larrea, N Nguyen, T Muffly
10.1016/j.ajog.2024.02.188
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1268
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Access to general obstetrics and gynecology care among medicaid beneficiaries and the privately insured: a nationwide mystery caller study in the united states
https://www.ajog.org/article/S0002-9378(24)00258-8/fulltext?rss=yes
Rapid healthcare access is crucial for improved patient outcomes and satisfaction. The COVID-19 pandemic has exacerbated challenges in maintaining short wait times, with a surge in demand for medical care in recent years due to deferred treatments.
Access to general obstetrics and gynecology care among medicaid beneficiaries and the privately insured: a nationwide mystery caller study in the united states
H Kyllo, W Bresnitz, M Bickner, M Matous, N Mulenga, E O'brien, S Whitehead, N Fordwuo, E Wong, K Adkins, T Muffly
10.1016/j.ajog.2024.02.187
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1268
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A comparison of operative outcomes for abdominal myomectomies using cherney incisions vs pfannensteil incisions
https://www.ajog.org/article/S0002-9378(24)00257-6/fulltext?rss=yes
Out our institution, abdominal myomectomies are performed primarily using Pfannenstiel or Cherney incisions. Limited data suggests similar outcomes with midline vertical and Cherney incisions in gynecologic surgery. There are no studies comparing Cherney and Pfannenstiel incisions for abdominal myomectomies. Furthermore, there is limited published data on the use of Cherney incisions for abdominal myomectomies.
A comparison of operative outcomes for abdominal myomectomies using cherney incisions vs pfannensteil incisions
N Atobiloye, V Flatow, S Khalil, L Rosen, C Ascher-Walsh, K Zakashansky
10.1016/j.ajog.2024.02.186
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1267
S1268
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The impact of obstetrics and gynecology journal podcasts on the dissemination of featured articles
https://www.ajog.org/article/S0002-9378(24)00256-4/fulltext?rss=yes
Podcasts have gained popularity as a platform for sharing published research. This shift challenges conventional metrics of an article’s quality and impact. Bibliometrics, the traditional statistical analysis of research publications, struggle to capture the growing influence of non-traditional media outlets. Altmetrics are research metrics that analyze article dissemination across diverse platforms including social media, blogs, policy documents and news outlets. Currently, data are limited regarding the effect of podcasts in Obstetrics and Gynecology on research dissemination and impact of presented articles, as measured by bibliometrics or altmetrics.
The impact of obstetrics and gynecology journal podcasts on the dissemination of featured articles
J Hayden, C Maxey, K Hamilton, R Schneyer, M Siedhoff, M Truong, R Meyer
10.1016/j.ajog.2024.02.185
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1266
S1267
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The economic impact of unused suture at a community hospital
https://www.ajog.org/article/S0002-9378(24)00255-2/fulltext?rss=yes
Climate change is a pressing matter that over the upcoming decades will put the health of billions at risk. The health care sector while simultaneously striving to improve the health of people, is perpetuating climate change with its considerable carbon footprint. Operating rooms and labor-delivery suites in the United States make up as much as 70% of waste produced from hospitals, and while. many studies acknowledged that waste associated with disposable medical supplies is an area of potential improvement, few have quantified its economic impact to the healthcare system.
The economic impact of unused suture at a community hospital
J Pennycuff, A Zinter, S Barman, T Price, T Gill, C Heisler
10.1016/j.ajog.2024.02.184
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1265
S1266
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It is feasible to offer laparoscopically approach hysterectomy with contained morcelation even with huge uteri
https://www.ajog.org/article/S0002-9378(24)00254-0/fulltext?rss=yes
Multiple studies show improved outcomes of laparoscopic hysterectomy compared to laparotomy, including decreased blood loss, shorter hospitalization and faster recovery. These outcomes are preserved even with longer operative time. Huge uteri make minimally invasive surgery technically challenging. Due to the risk of leiomyosarcoma in a presumed benign uterus, we offer patients contained morcellation as part of the minimally invasive approach. Very few publications describe the technical challenges of laparoscopic surgery for very large uteri, particularly if contained morcellation is planned.
It is feasible to offer laparoscopically approach hysterectomy with contained morcelation even with huge uteri
D Pino, A Romo
10.1016/j.ajog.2024.02.183
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1264
S1265
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Novel surgical approach to remote management of recurrent spontaneous bladder rupture
https://www.ajog.org/article/S0002-9378(24)00253-9/fulltext?rss=yes
Spontaneous bladder rupture (SBR) is a rare condition (1:126,000) but with significant risk for morbidity and mortality (10-20%). It is more prevalent in men and is usually diagnosed around the age of 60. Risk factors include bladder outlet obstruction, neurogenic bladder, and various chronic conditions like diabetes and hypertension. Strategies reported in the medical literature include surgical management at the time of the rupture and/or conservative catheterization management. It has a recurrence rate of 2-5%.
Novel surgical approach to remote management of recurrent spontaneous bladder rupture
P Lotze, M Umble
10.1016/j.ajog.2024.02.182
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1264
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Value of uterus: quality of life, symptom severity, and treatment decisions in patients with fibroids
https://www.ajog.org/article/S0002-9378(24)00252-7/fulltext?rss=yes
Fibroids are the most common benign pelvic tumor in women with a cumulative incidence greater than 70% by the age of 50. Understanding patient preferences regarding uterine preservation in the surgical management of fibroids is crucial to shared-decision making and improved counseling. In order to provide patient-centered, culturally competent care, we must understand the value patients place on uterine preservation, and understand the racial and cultural influences that impact valuation of the uterus.
Value of uterus: quality of life, symptom severity, and treatment decisions in patients with fibroids
V Fuentes, M Cantave, C Okuagu, C Mulligan, K Scholl, E Bardawil, K De Souza, S Biest, W Trotter Ross
10.1016/j.ajog.2024.02.181
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1263
S1264
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Two pee or not two pee: a cost analysis of second postoperative void trials
https://www.ajog.org/article/S0002-9378(24)00251-5/fulltext?rss=yes
While postoperative urinary retention affects anywhere from 15-50% of Urogynecologic patients, discharge with a foley catheter is unappealing to many patients, and second attempts at trial of void (TOV) after initial failure are often requested. While a second attempt does improve pass rates and decreases the need for outpatient management of urinary retention, it also extends time in the PACU and delays discharge.
Two pee or not two pee: a cost analysis of second postoperative void trials
M Baker, S Nelamangala, U Omosigho, C Zimmerman, R Adam, D Biller
10.1016/j.ajog.2024.02.180
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1262
S1263
-
The fate of the abstract: presentation and publication characteristics of abstracts presented at the society of gynecologic surgeons annual scientific meetings 2013-2020
https://www.ajog.org/article/S0002-9378(24)00250-3/fulltext?rss=yes
Society annual scientific meetings are a time for new and innovative ideas to be disseminated in an academic community. Research presented at a scientific meeting can lead to change in practice, as it is assumed it will subsequently be published in a peer-reviewed journal. However, limited research exists within the field of gynecology to assess whether or not this is the case.
The fate of the abstract: presentation and publication characteristics of abstracts presented at the society of gynecologic surgeons annual scientific meetings 2013-2020
N Wood, M Kasoff, S Muluk, R Wang, E Tunitsky-Bitton, E Sappenfield
10.1016/j.ajog.2024.02.179
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1261
S1262
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Breakdown of gender representation in leadership of professional gynecologic specialty societies worldwide
https://www.ajog.org/article/S0002-9378(24)00249-7/fulltext?rss=yes
As of the 2021-2022 academic year, 55% of matriculating US medical students were female and female physicians accounted for 86.2% of US obstetrics and gynecology residents. Furthermore, since 2012, women have made up more than half of practicing fellows within the American College of Obstetrics and Gynecology. Despite this rise in gender diversity within medicine and our specialty, several recent studies have demonstrated an unequal gender breakdown in academic and departmental leadership positions.
Breakdown of gender representation in leadership of professional gynecologic specialty societies worldwide
E Farabee, V Aldrich, A Gupta, S Francis, S Lenger
10.1016/j.ajog.2024.02.178
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1261
-
Natural electrospun scaffold fabrication as an alternative to surgical mesh for stress urinary incontinence
https://www.ajog.org/article/S0002-9378(24)00248-5/fulltext?rss=yes
Over 25% of adult women experience pelvic floor disorders, including stress urinary incontinence (SUI). The most common surgical intervention for SUI is implantation of a mid-urethral sling composed of polypropylene (PP) mesh. Although highly effective for most patients, PP mesh carries a risk of erosion and exposure due to its host tissue-mesh incompatibility and friction in 3-7% of patients. Mesh erosion and exposure can cause an increased risk of infection, bleeding, and chronic pain. Autologous fascia, a biocompatible material harvested from the Iliotibial band, can be used as an alternative to PP mesh; however, it requires a second procedure for harvesting, resulting in donor site morbidity and prolonged surgery time.
Natural electrospun scaffold fabrication as an alternative to surgical mesh for stress urinary incontinence
R Thomson, C Basham, J Shaw, K Hixon, D Van Citters
10.1016/j.ajog.2024.02.177
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1260
S1261
-
Vaginal antiseptic preparation at the time of hysterectomy: a systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(24)00246-1/fulltext?rss=yes
Antiseptic vaginal preparation is recommended before all gynecologic surgery, and povidone iodine (PI) is the only FDA-approved vaginal antiseptic. Chlorhexidine gluconate (CHG), however, has shown to be superior to PI as an antiseptic skin preparation for the prevention of surgical site infections (SSIs). The American Academy of Gynecologic Laparoscopy supports the vaginal use of CHG, and a meta-analysis revealed a reduction in SSI with vaginal CHG prep at the time of cesarean delivery. There has been no meta-analysis, however, comparing CHG with PI vaginal prep at the time of hysterectomy.
Vaginal antiseptic preparation at the time of hysterectomy: a systematic review and meta-analysis
S Rozycki, V Nguyen, N Miroballi, E Rutledge, E Balk, D Antosh
10.1016/j.ajog.2024.02.175
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1259
S1260
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Evaluating the basics: development and implementation of a gynecologic surgical simulation curriculum for obstetrics and gynecology residents
https://www.ajog.org/article/S0002-9378(24)00245-X/fulltext?rss=yes
Obstetrics and Gynecology residents are expected to become proficient in obstetrics, ambulatory care, and gynecologic surgeries. Depending on the hospital system in which the resident is training, there can be significant heterogeneity in the skills and proficiency acquired. Previous survey studies suggest a gap in the required skills necessary to graduate from residency and a post-residency graduate’s ability to perform major gynecologic surgeries and operate independently. Furthermore, focused simulations have been shown to enhance surgical education and improve surgical skills.
Evaluating the basics: development and implementation of a gynecologic surgical simulation curriculum for obstetrics and gynecology residents
P Vyas, K Plewniak
10.1016/j.ajog.2024.02.174
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1259
-
How predictive is the cough stress test of mid-urethral sling success?
https://www.ajog.org/article/S0002-9378(24)00244-8/fulltext?rss=yes
Stress urinary incontinence affects between 11 and 44% of women, causing significant impact on women’s quality of life. While it can be managed with a variety of conservative interventions, synthetic mid-urethral sling (MUS) has become the gold standard for surgical treatment of SUI. Studies have shown that risk factors associated with decreased success of MUS for treatment of SUI include mixed urinary incontinence, previous incontinence surgery, BMI ≥35 kg/m2, age≥75, the presence of diabetes mellitus, as well as pre-operative urodynamic study (UDS) parameters indicating detrusor overactivity, voiding difficulties, low urethral pressure, and bladder-neck immobility.
How predictive is the cough stress test of mid-urethral sling success?
L Cheng, N Wood, D O'sullivan, E Tunitsky-Bitton
10.1016/j.ajog.2024.02.173
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1258
S1259
-
LAPRO study: learning and acquisition of laparoscopic procedural skills in the operating room
https://www.ajog.org/article/S0002-9378(24)00243-6/fulltext?rss=yes
Learning surgery is a complex cognitive and physical task that occurs within a multifaceted learning environment. Despite robust theoretical foundations within and beyond the field of medical education, our understanding of how surgical trainees learn to perform surgery in the operating room (OR) environment remains just that, largely theoretical.
LAPRO study: learning and acquisition of laparoscopic procedural skills in the operating room
J Hall, J Young, A Brown, K Nelson
10.1016/j.ajog.2024.02.172
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1258
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Outcomes for combined sacrocolpopexy-rectopexy compared to sacrocolpopexy or rectopexy alone: a nsqip study
https://www.ajog.org/article/S0002-9378(24)00242-4/fulltext?rss=yes
There is a growing body of data that supports performing pelvic organ prolapse procedures and rectal prolapse procedures as combined surgical procedures. Some studies have found similar complication rates between sacrocolpopexy, rectopexy, and combined procedures, while other studies have found higher rates of surgical site infections with concurrent surgeries. With the growing trend of performing concurrent prolapse surgeries, it is crucial to understand the differences in surgical outcomes from alone versus combined procedures so that patients with prolapse receive the safest and most effective treatments.
Outcomes for combined sacrocolpopexy-rectopexy compared to sacrocolpopexy or rectopexy alone: a nsqip study
C Moore, S Rahman, S Lee, Y Cheng, Y Ling, R Pelsang, C Carter-Brooks
10.1016/j.ajog.2024.02.171
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1257
S1258
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Surgical volume: what can patients access?
https://www.ajog.org/article/S0002-9378(24)00241-2/fulltext?rss=yes
Multiple studies and systematic reviews have associated high volume hospitals and high volume surgeons with lower morbidity and mortality rates. In 2013, Doll et al. concluded that lower volume surgeons had higher postoperative morbidity rates after hysterectomy for benign indications compared with high volume surgeons. Despite this well-recognized correlation, publicly available information regarding surgeon and hospital volume is limited.
Surgical volume: what can patients access?
N Patel, J Lee, S Karkal, C Iglesia, A Dieter
10.1016/j.ajog.2024.02.170
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1256
S1257
-
Usage rates and effects of prophylactic antibiotics on post-myomectomy surgical outcomes
https://www.ajog.org/article/S0002-9378(24)00240-0/fulltext?rss=yes
Surgical intervention for uterine myomas can be accomplished via either laparoscopic or abdominal approaches. Uterine fibroids are a common cause of abnormal uterine bleeding and can also be associated with bulk symptoms and infertility. Many patients choose surgical management, in the form of myomectomy, to treat their symptoms. The American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin #195 outlines current guidelines for prophylactic antibiotic use in gynecological surgeries, but does not specifically address myomectomy.
Usage rates and effects of prophylactic antibiotics on post-myomectomy surgical outcomes
H Wulf, A Brawley, C Stetter, A Molina, K Riley
10.1016/j.ajog.2024.02.169
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1256
-
Urinary incontinence screening and outpatient treatment patterns during preventive gynecologic care in an academic resident practice: a pre-post intervention study
https://www.ajog.org/article/S0002-9378(24)00239-4/fulltext?rss=yes
Urinary incontinence (UI) is a common condition, however many patients are hesitant to seek care for UI symptoms. Screening for UI symptoms is recommended during preventive gynecologic care for patients aged 18 and older.
Urinary incontinence screening and outpatient treatment patterns during preventive gynecologic care in an academic resident practice: a pre-post intervention study
N Meckes, S Glass Clark, K Ruppert, C Judkins, GS Napoe
10.1016/j.ajog.2024.02.168
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1255
S1256
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The impact of american urological association antibiotic prophylaxis guidelines at the time of sacral neuromodulation implantation on rates of infection
https://www.ajog.org/article/S0002-9378(24)00238-2/fulltext?rss=yes
One significant complication of sacral neuromodulation (SNM) is a wound infection. Previous studies have shown infection rates for SNM range from 5-10%, with the most cultured bacteria from infected leads being Staphylococcus aureus. Current American Urological Association (AUA) guidelines recommend perioperative prophylaxis using two antibiotics: 1) first/second generation cephalosporin and aminoglycoside, 2) aztreonam and 1st/2nd generation cephalosporin, 3) aminoglycoside and vancomycin, or 4) aztreonam and vancomycin.
The impact of american urological association antibiotic prophylaxis guidelines at the time of sacral neuromodulation implantation on rates of infection
H Bauer, P Johnston, S Rhodes, D Sheyn
10.1016/j.ajog.2024.02.167
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1254
S1255
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Building a conceptual model on surgical preparedness
https://www.ajog.org/article/S0002-9378(24)00237-0/fulltext?rss=yes
Patients with increased surgical preparedness report better outcomes, postoperative satisfaction, and are less likely to report complications. However, minimal data exist on how to increase surgical preparedness.
Building a conceptual model on surgical preparedness
G Halder, K Lewis, C Elhenawy, G Dunivan, B Roberts, O Chang, T Ishag, K Meriwether
10.1016/j.ajog.2024.02.166
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1253
S1254
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Rate of unanticipated malignant or pre-malignant vaginal pathology following pelvic organ prolapse surgery
https://www.ajog.org/article/S0002-9378(24)00236-9/fulltext?rss=yes
Pelvic organ prolapse (POP) is a heterogenous condition defined as descent or bulging of pelvic organs into the vaginal canal. It is estimated to affect 1 in every 10 women, with more than 300,000 surgeries being performed annually in the United States. Given that the incidence of all vaginal cancers (0.18 per 100,000 women) and vaginal intraepithelial neoplasia (VAIN) (0.2-2 per 100,000 women) is rare, there is debate regarding the clinical utility and cost effectiveness of routine pathologic assessment of the vaginal epithelium in patients undergoing POP repair, when the concern for malignant transformation is low.
Rate of unanticipated malignant or pre-malignant vaginal pathology following pelvic organ prolapse surgery
J Lazaro, S Jansen, A Johnson, J Stewart
10.1016/j.ajog.2024.02.165
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1252
S1253
-
A prospective comparison of robotic-assisted burch urethropexy with retropubic midurethral sling for the surgical management of stress urinary incontinence
https://www.ajog.org/article/S0002-9378(24)00235-7/fulltext?rss=yes
Due to increased patient concerns regarding mesh complications, there is increasing interest in non-mesh surgeries for stress urinary incontinence (SUI). Similar subjective outcomes for laparoscopic Burch urethropexy and retropubic MUS (RMUS) have been reported, though specific data regarding robotic-assisted Burch (RA-Burch) is lacking.
A prospective comparison of robotic-assisted burch urethropexy with retropubic midurethral sling for the surgical management of stress urinary incontinence
A Melnyk, N Meckes, T Kenkre, M Bonidie, A Artsen
10.1016/j.ajog.2024.02.164
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1251
S1252
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Disparities in the management of recurrent urinary tract infections
https://www.ajog.org/article/S0002-9378(24)00234-5/fulltext?rss=yes
While evidence-based guidelines exist for the management of recurrent urinary tract infections (UTI), there is little data to elucidate whether patients have equal access to these interventions.
Disparities in the management of recurrent urinary tract infections
S Agrawal, U Andy, L Arya, H Harvie
10.1016/j.ajog.2024.02.163
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1250
S1251
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The effect of prior myomectomy on incidence of perioperative complications at time of minimally invasive hysterectomy
https://www.ajog.org/article/S0002-9378(24)00233-3/fulltext?rss=yes
Uterine fibroids are common benign tumors that affect 50-60% of women of reproductive age and are a common cause of abnormal uterine bleeding, infertility, and bulk symptom. Many women desire treatment with expectant, medical, or surgical management. Surgical management includes endometrial ablation, uterine artery embolization, radiofrequency ablation or definitive hysterectomy as non-fertility-sparing options. However, for women who desire fertility-sparing treatment, myomectomy, or surgical removal of fibroids, is the standard of care.
The effect of prior myomectomy on incidence of perioperative complications at time of minimally invasive hysterectomy
L Cheng, N Chawla, D O'sullivan, J Mullins
10.1016/j.ajog.2024.02.162
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1250
-
Implementation of a robotic surgery curriculum in an obstetrics and gynecology residency program
https://www.ajog.org/article/S0002-9378(24)00232-1/fulltext?rss=yes
Robotic surgery is becoming more prevalent. In a recent survey in 2016, 99% of residents nationally reported availability of a robot, and 35% reported no structured robotics training program was available. The American College of Obstetrics and Gynecology and the Society for Gynecologic Surgery recommend completion of a robotic training program, but do not have a standardized curriculum available and defer this to individual institutions. A robotics curriculum was initiated for the obstetrics and gynecology residents at an academic institution in 2021.
Implementation of a robotic surgery curriculum in an obstetrics and gynecology residency program
F Mak, T Baker, E Wu
10.1016/j.ajog.2024.02.161
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1249
S1250
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Factors associated with preoperative delays or cancellations of scheduled non-obstetric surgeries
https://www.ajog.org/article/S0002-9378(24)00231-X/fulltext?rss=yes
Prior research has demonstrated racial and socioeconomic disparities in surgical care. This has primarily focused on delays from cancer diagnoses to surgical treatment, such as surgical management of breast and endometrial cancer among non-Hispanic Black patients, and among patients in lower socioeconomic groups. During the COVID pandemic, these barriers were exacerbated as hospitals needed to pause elective surgeries, and prior studies show that, in other specialties, non-English speaking, uninsured patients living in lower incomes were less likely to be scheduled or have longer wait times following the pandemic.
Factors associated with preoperative delays or cancellations of scheduled non-obstetric surgeries
A Hersey, E Brakewood, L Schlichting, C Foley
10.1016/j.ajog.2024.02.160
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1248
S1249
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Risk factors for postpartum urinary retention: a case-control study
https://www.ajog.org/article/S0002-9378(24)00230-8/fulltext?rss=yes
Postpartum urinary retention (PUR) is rare, with incidence estimates ranging from 1.7% to 17.9%. Though usually a temporary condition, unrecognized urinary retention may result in considerable morbidity, such as bladder distension injury, long-term voiding dysfunction and bladder rupture. Factors associated with PUR include prolonged second stage of labor, assisted vaginal delivery, perineal laceration or episiotomy, use of systemic narcotics, epidural anesthesia, cesarean delivery, higher birth weight and nulliparity.
Risk factors for postpartum urinary retention: a case-control study
K Warner, GA Avery, S Battula, A Esparza, A Pinto, CA Heisler
10.1016/j.ajog.2024.02.159
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1247
S1248
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Evaluating the fibromyalgia screening questionnaire and pain catastrophizing scale on patients undergoing prolapse surgery
https://www.ajog.org/article/S0002-9378(24)00229-1/fulltext?rss=yes
Chronic pain is prevalent in older adults, affects healthcare outcomes1 and is understudied. Since age is also a risk factor for pelvic organ prolapse2, it is likely that chronic pain disorders are prevalent in this population and may impact postoperative experiences. The Fibromyalgia Survey Questionnaire (FSQ) allows for epidemiologic research on chronic pain disorders3 and has been previously used in gynecologic research as a perioperative screening tool4,5. FSQ≥13 is diagnostic for fibromyalgia.
Evaluating the fibromyalgia screening questionnaire and pain catastrophizing scale on patients undergoing prolapse surgery
H Nguyen, K Kenton, E Bretschneider, O Brown, J Geynisman-Tan
10.1016/j.ajog.2024.02.158
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1246
S1247
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Torsion time - does gender matter
https://www.ajog.org/article/S0002-9378(24)00228-X/fulltext?rss=yes
Gonadal torsion is a surgical emergency, and with delays risk loss of function and fertility. A recent study demonstrated time to the operating room was delayed comparing ovarian to testicular torsions. While the location inside the abdominal cavity (ovaries) vs outside (testicles) can account for some of this delay, their data suggested female vs. male staff could increase delays, one of many gender biases for surgeons.
Torsion time - does gender matter
L Roth, W Nilsson, A Newmark, J Shepherd
10.1016/j.ajog.2024.02.157
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1245
S1246
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Preoperative pelvic pain syndromes are a risk factor for failure in patients undergoing radiofrequency endometrial ablation
https://www.ajog.org/article/S0002-9378(24)00227-8/fulltext?rss=yes
Endometrial ablation is a widely used procedure for treatment of heavy menstrual bleeding in premenopausal patients. It is less invasive than hysterectomy, has high patient satisfaction rates (92%), and an excellent safety profile. Published rates of treatment failure range from 23-36%, with increased failure noted in age less than 40, history of cesarean section, abnormal imaging prior to procedure (fibroid, polyp, thickened endometrial stripe), history of tubal ligation, and irregular bleeding profile.
Preoperative pelvic pain syndromes are a risk factor for failure in patients undergoing radiofrequency endometrial ablation
K Rakes, J Sosa-Stanley
10.1016/j.ajog.2024.02.156
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1244
S1245
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The impact of transversus abdominus plane (TAP) blocks for total laparoscopic hysterectomy on postoperative pain and recovery time: a retrospective analysis
https://www.ajog.org/article/S0002-9378(24)00226-6/fulltext?rss=yes
The multimodal approach to pain control as outlined by the Enhanced Recovery after Surgery program (ERAS) includes consideration of transversus abdominis plane (TAP) blocks, a form of opioid-sparing regional analgesia. Recent studies have shown mixed results; one systematic review demonstrated significant improvement in postoperative early and delayed pain control compared with placebo (Bacal et al., 2019), while other meta-analyses showed no clinically significant difference in pain scores or opioid consumption with or without TAP block for laparoscopic hysterectomy (Shin et al., 2020; Lopez-Ruiz et al., 2022).
The impact of transversus abdominus plane (TAP) blocks for total laparoscopic hysterectomy on postoperative pain and recovery time: a retrospective analysis
J Wong, S Lim, D Rasugu, A Broach, A Song, C Sobolewski
10.1016/j.ajog.2024.02.155
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1244
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What is normal? using objective measurements to describe typical vulvar anatomy
https://www.ajog.org/article/S0002-9378(24)00225-4/fulltext?rss=yes
There is a paucity of research describing normal dimensions of external female genitalia, and many women are requesting surgical alteration. Due to the lack of scientific information, physicians and patients alike may draw from anecdotal experience or media to define "normal” female anatomy, thus setting unsubstantiated anatomic expectations.
What is normal? using objective measurements to describe typical vulvar anatomy
J Wheat, H Stautz, A Watson, J Carty, K Dengler, K Shvartsman, C Vaccaro
10.1016/j.ajog.2024.02.154
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1243
S1244
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Provider’s perspectives on customizable pessaries
https://www.ajog.org/article/S0002-9378(24)00224-2/fulltext?rss=yes
Pelvic floor disorders, a prevalent issue among women, are conventionally managed using pessaries, mechanical devices available in various standardized sizes. Despite the availability of over fifteen different shapes, the "one size fits most” approach may not cater to the diverse anatomical variations among women. Recent advancements have seen the development of customizable pessaries, aiming to offer a tailored approach to managing pelvic floor disorders. This study aims to gauge healthcare providers' perspectives on the potential benefits and applicability of these customizable pessaries in clinical practice.
Provider’s perspectives on customizable pessaries
A Brausch, T Muffly
10.1016/j.ajog.2024.02.153
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1242
S1243
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Descriptions of trainee surgical skill in letters of recommendation for urogynecology fellowship
https://www.ajog.org/article/S0002-9378(24)00223-0/fulltext?rss=yes
The surgical aptitude of fellowship applicants is of particular interest in Urogynecology. A better understanding of the frequency and manner in which surgical skills are described in Urogynecology fellowship letters of recommendation (LOR) would assist letter authors and evaluators.
Descriptions of trainee surgical skill in letters of recommendation for urogynecology fellowship
K Kurchena, J Shinnick, S Hampton
10.1016/j.ajog.2024.02.152
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1241
S1242
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Characterization of PCOS twitter: an analysis of users and trends
https://www.ajog.org/article/S0002-9378(24)00222-9/fulltext?rss=yes
Polycystic Ovary Syndrome (PCOS) is a disorder affecting 6-12% of women of reproductive age, with life-long health implications. Despite prevalence, studies show dissatisfaction amongst patients regarding diagnosis, treatment, and accessible information. Social media has become a valuable resource for healthcare conversations for physicians and patients.
Characterization of PCOS twitter: an analysis of users and trends
M Glass, E Chorna, P Xu, F Ricciardi, S Ohrn, C Grimes
10.1016/j.ajog.2024.02.151
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1241
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Assessing perioperative risk for minimally invasive sacrocolpopexy: how accurate is the ACS NSQIP calculator?
https://www.ajog.org/article/S0002-9378(24)00221-7/fulltext?rss=yes
Minimally invasive sacrocolpopexy is increasing in frequency for correction of pelvic organ prolapse, a common condition whose prevalence is expected to increase as the population ages. There is consequently a heightened need to predict and minimize perioperative risk for patients undergoing this procedure. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) surgical risk calculator has been used to predict eighteen distinct 30-day perioperative complications based on preoperative characteristics and type of surgery performed as determined by current procedural terminology (CPT) code.
Assessing perioperative risk for minimally invasive sacrocolpopexy: how accurate is the ACS NSQIP calculator?
K Christensen, M Mckevitt, B Gaigbe-Togbe, M Sarker, A Hardart
10.1016/j.ajog.2024.02.150
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1240
S1241
-
Transurethral buccal mucosal graft for urethroplasty following complex diverticulectomy
https://www.ajog.org/article/S0002-9378(24)00220-5/fulltext?rss=yes
Complex urethral diverticulectomies are challenging and complications include de novo stress urinary incontinence, recurrent diverticula, urethrovaginal fistulas, and rarely strictures. Buccal mucosal grafts are used to treat urethral strictures but have not been described for urethral reconstruction during a diverticulectomy.
Transurethral buccal mucosal graft for urethroplasty following complex diverticulectomy
J Wheat, K Dengler, F Balzano
10.1016/j.ajog.2024.02.149
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1239
S1240
-
Assessing perioperative risk with hysterectomy in very large uteri by surgical route
https://www.ajog.org/article/S0002-9378(24)00219-9/fulltext?rss=yes
Uterine size plays an important role in the surgical route offered to patients undergoing hysterectomy for benign indications. Some studies have proposed a uterine size greater than 15 weeks gestation or uterine weight greater than 500 g as the safe upper limit for offering a minimally invasive approach.
Assessing perioperative risk with hysterectomy in very large uteri by surgical route
S Gupta, P Maghsoudlou, L Perkins King, J Einarsson, M Ajao
10.1016/j.ajog.2024.02.148
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1239
-
ERAS protocols and medication choices: impacts on pain and opioid use post-midurethral sling
https://www.ajog.org/article/S0002-9378(24)00218-7/fulltext?rss=yes
Stress urinary incontinence (SUI) is a prevalent condition that affects up to a third of U.S. adult women, imposing a significant health burden. While Enhanced Recovery After Surgery (ERAS) protocols are traditionally linked with improved pain control and fewer postoperative complications in various major surgical procedures, their influence on postoperative pain and opioid consumption following a midurethral sling procedure remains unclear. This research investigates the impact of preoperative ERAS medications and intraoperative medication choices in this context.
ERAS protocols and medication choices: impacts on pain and opioid use post-midurethral sling
M Taboada, E Hoover, K James, A Silfen, Y Kim, M Weinstein, D Ellis, M Ortega
10.1016/j.ajog.2024.02.147
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1238
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Performance of chatGPT on female pelvic medicine and reconstructive surgery PROLOG exam
https://www.ajog.org/article/S0002-9378(24)00217-5/fulltext?rss=yes
A notable milestone is the performance of Chat-GPT, which has achieved scores at or near the passing threshold on the United States Medical Licensing Exam (USMLE). This development has catalyzed discussions about AI's potential role in medical education and complex decision-making within healthcare environments. The Council on Resident Education in OBGYN (CREOG) administers annual in-service exams to assess the readiness of OBGYN residents for their board examinations at the culmination of their residency training.
Performance of chatGPT on female pelvic medicine and reconstructive surgery PROLOG exam
I Burgard, P Altshuler, T Muffly
10.1016/j.ajog.2024.02.146
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1237
S1238
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Urinary incontinence care-seeking barriers among latina patients, what are we missing?
https://www.ajog.org/article/S0002-9378(24)00216-3/fulltext?rss=yes
Urinary incontinence (UI) is prevalent and burdensome among women, yet most women with symptoms do not seek care. The Latina population is the largest growing ethnic group in the United States with unfortunately high levels of health disparities in UI treatment and complications rates compared with White women. Failure to seek care and resultant health inequities may be due to disproportionately high barriers to UI care-seeking among Latinas and other minoritized ethnic/racial groups.
Urinary incontinence care-seeking barriers among latina patients, what are we missing?
A Pancheshnikov, B Harrington, V Handa, L Yanes, K Voegtline, S Olson, M Le Neveu, J Blomquist, S Jacobs, D Patterson, CCG Chen
10.1016/j.ajog.2024.02.145
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1237
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Surgical outcomes in patients undergoing hysterectomy for gender dysphoria
https://www.ajog.org/article/S0002-9378(24)00215-1/fulltext?rss=yes
Gender-affirming surgeries are performed to help individuals with gender dysphoria align their physical characteristics with their gender identity. Comparative data on the surgical outcomes and complications between different approaches of hysterectomy performed for gender dysphoria is minimally reported.
Surgical outcomes in patients undergoing hysterectomy for gender dysphoria
D Strozza, S Narayanamoorthy, K Hanson, E Habermann, J Occhino
10.1016/j.ajog.2024.02.144
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1235
S1236
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Log in or walk in? evaluating 30-day outcomes following virtual vs. In-Person consultations for UTIs
https://www.ajog.org/article/S0002-9378(24)00213-8/fulltext?rss=yes
Urinary tract infections (UTIs) are the most common bacterial infections in the United States. The rise of virtual visits for UTIs, particularly post the COVID-19 pandemic, marks a significant shift in healthcare delivery. However, despite the surge in patients opting for virtual care for UTIs, there's a noticeable lack of data on outcomes and safety compared to traditional in-person consultations.
Log in or walk in? evaluating 30-day outcomes following virtual vs. In-Person consultations for UTIs
G Yadav, S Yang, S Menefee, J Tan-Kim
10.1016/j.ajog.2024.02.142
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1234
S1235
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Patient experiences with standard behavioral restrictions after total laparoscopic hysterectomy
https://www.ajog.org/article/S0002-9378(24)00212-6/fulltext?rss=yes
Hysterectomy is one of the most commonly performed procedures in the United States. Patients typically receive standard counseling on postoperative behavioral limitations to optimize healing and decrease risk of complications. While pelvic rest may be associated with reduced risk of vaginal cuff dehiscence, other limitations, such as weight bearing exercise and lifting, have limited evidence supporting their efficacy in reducing complications. Additionally, they may significantly interfere with patients’ activities of daily living and risk increasing postoperative morbidity such as deconditioning and venous thromboembolism.
Patient experiences with standard behavioral restrictions after total laparoscopic hysterectomy
RG Silverstein, K Lecroy, N Abu-Alnadi, E Carey, A Mcclurg
10.1016/j.ajog.2024.02.141
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1234
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Virtual appointments: current practices and perspectives of gynecologic surgeons
https://www.ajog.org/article/S0002-9378(24)00211-4/fulltext?rss=yes
Virtual appointments were implemented out of necessity during the COVID-19 pandemic. This included surgical consultations and post-operative appointments for major gynecologic surgeries that historically took place in-person. At present, some gynecologic surgeons have returned to primarily in-person appointments, whereas others have continued to schedule virtual appointments. While several studies have reported the positive effect of virtual appointments on patient satisfaction and clinical efficiency, no prior work has described gynecologic surgeon experience with virtual care.
Virtual appointments: current practices and perspectives of gynecologic surgeons
R Mickelsen, C Triplett, M Wong, M Yamamoto
10.1016/j.ajog.2024.02.140
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1233
S1234
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Analysis of temporal trends and characteristics of gender affirming hysterectomies pre- and post-expansion of health care coverage at a large integrated california health care system
https://www.ajog.org/article/S0002-9378(24)00210-2/fulltext?rss=yes
Due to changes in gender affirming practices and the expansion of healthcare coverage in 2013, access to gender affirming care is steadily increasing. Despite improved access, few studies have investigated temporal trends in gender affirming surgeries (GAS) including hysterectomies.
Analysis of temporal trends and characteristics of gender affirming hysterectomies pre- and post-expansion of health care coverage at a large integrated california health care system
J Radoc, E Zaritsky, Y Zhao, L Tucker, A Huynh, M Weintraub
10.1016/j.ajog.2024.02.139
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1232
S1233
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Cannabidiol therapy prevalence for the treatment of chronic pelvic pain
https://www.ajog.org/article/S0002-9378(24)00209-6/fulltext?rss=yes
Chronic pelvic pain (CPP) affects approximately one out of every seven women. A variety of treatments currently exist, however, many patients self-treat for persistent pains. In recent years, cannabidiol (CBD), a naturally occurring chemical in cannabis leaves, has become a remedy of interest. An estimated 33% of American adults use CBD and many chronic pain patients anecdotally claim relief. CBD efficacy studies in a multitude of chronic pain disorders have shown potential benefit, though with varying quality of data and results.
Cannabidiol therapy prevalence for the treatment of chronic pelvic pain
J De Luca, M Ahrens, J Sosa-Sanley, J Casey
10.1016/j.ajog.2024.02.138
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1231
S1232
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Patient perceptions and attitudes toward surgical mesh across a urogynecology practice
https://www.ajog.org/article/S0002-9378(24)00208-4/fulltext?rss=yes
The controversy and litigation arising from complications of transvaginal mesh (TVM) has resulted in negative media attention, which has likely affected patients' perceptions regarding mesh use. It is therefore important to understand patients’ perspectives and determine the factors that may influence these views.
Patient perceptions and attitudes toward surgical mesh across a urogynecology practice
D Carr, S Ward, T Marczak, W Winkelman, E Elkadry
10.1016/j.ajog.2024.02.137
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1231
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Tamsulosin for prevention of postoperative urinary retention after vaginal pelvic organ prolapse surgery: a retrospective review
https://www.ajog.org/article/S0002-9378(24)00207-2/fulltext?rss=yes
Over 300,000 surgeries are performed annually in the United States for women with pelvic organ prolapse. Postoperative urinary retention is a common but unfortunate outcome, occurring in up to 51% of women undergoing surgery for POP or stress urinary incontinence. The need for postoperative catheterization can be distressing and can negatively impact women’s surgical experience. Of the interventions studied for reducing the risk of postoperative urinary retention, alpha receptor antagonists appear to show promise.
Tamsulosin for prevention of postoperative urinary retention after vaginal pelvic organ prolapse surgery: a retrospective review
J Song, A Alas
10.1016/j.ajog.2024.02.136
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1230
S1231
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Adherence to pelvic floor physical therapy in postpartum patients with complex obstetric injuries
https://www.ajog.org/article/S0002-9378(24)00206-0/fulltext?rss=yes
Pelvic floor physical therapy (PT) is often recommended for patients with pelvic floor symptoms after delivery and especially in patients who have sustained an obstetric anal sphincter injury (OASIS). However, there is a paucity of data on adherence to PT in these patients.
Adherence to pelvic floor physical therapy in postpartum patients with complex obstetric injuries
D Das, C Tilley, O Brown, C Lewicky-Gaupp, K Weeks, J Geynisman-Tan
10.1016/j.ajog.2024.02.135
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1229
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Adverse events and practice considerations for transgender patients undergoing hysterectomy
https://www.ajog.org/article/S0002-9378(24)00205-9/fulltext?rss=yes
Transgender individuals are people whose gender identities do not align with their sex recorded at birth. For transgender men, gender affirming care often involves using testosterone and undergoing hysterectomy to reduce dysphoria associated with menses. (1) Two large studies have found no increased rate of postoperative complication in a transgender cohort compared to cisgender women undergoing hysterectomy. (2, 3) However due to vaginal atrophy from testosterone and gender dysphoria, it has been suggested that transgender patients may seek care for vaginal bleeding (VB) more often than their cisgender counterparts.
Adverse events and practice considerations for transgender patients undergoing hysterectomy
C Pando, L Gerlach, SA Challa, A Pan, J Francis
10.1016/j.ajog.2024.02.134
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1228
S1229
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Is colpocleisis alone enough to treat stress incontinence in patients with prolapse?
https://www.ajog.org/article/S0002-9378(24)00204-7/fulltext?rss=yes
The decision of whether to place a midurethral sling at the time of prolapse repair to reduce a patient's chance of postoperative stress urinary incontinence (SUI) is a hot and growing topic. This decision has been described as the Urogynecologist's ink blot test, and as more data grows regarding outcomes and cost-effectiveness of this procedure we may be forced to re-examine our own practice. For women with confirmed SUI, a midurethral mesh sling is often placed at the time of colpocleisis. However, it is possible that the bulk of inverted vagina/uterus upon completion of the colpocleisis supports the midurethra and prevents incontinence with cough or valsalva, similar to an incontinence pessary.
Is colpocleisis alone enough to treat stress incontinence in patients with prolapse?
A Clark, L Griswold, J Lanzer
10.1016/j.ajog.2024.02.133
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1227
S1228
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Understanding waste management practices in OBGYN and urology clinics
https://www.ajog.org/article/S0002-9378(24)00203-5/fulltext?rss=yes
The U.S. healthcare sector contributes to approximately 8.5% of the country’s carbon emissions, perpetuating the effects of human-induced climate change. In gynecology and urology, waste quantification and potential for sustainable interventions in operating rooms have been studied more frequently than for outpatient procedures.
Understanding waste management practices in OBGYN and urology clinics
S Potarazu, R Jamshidi, C Carter-brooks
10.1016/j.ajog.2024.02.132
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1226
S1227
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Preoperative factors associated with the diagnosis of adenomyosis and coexistent endometriosis at hysterectomy
https://www.ajog.org/article/S0002-9378(24)00202-3/fulltext?rss=yes
Despite recent developments in imaging-based criteria for adenomyosis, early and accurate diagnosis is limited by heterogeneous symptomatology and frequent coexistence of other gynecologic pathologies. Delayed or misdiagnosis may be associated with inappropriate treatments, persistent symptoms, and reductions in quality of life.
Preoperative factors associated with the diagnosis of adenomyosis and coexistent endometriosis at hysterectomy
H Kyllo, C Mangham, G Whitmore, J Tam, K Hampanda, M Orlando
10.1016/j.ajog.2024.02.131
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1226
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Ideal incision and dissection for martius flap: a cadaver-based study on nerve and vascular density
https://www.ajog.org/article/S0002-9378(24)00201-1/fulltext?rss=yes
Martius flap technique includes the cultivation of a well-vascularized labial fat-pad from the labium majus for the interposition between a surgical site and the vaginal wall. The preservation of necessary vascular structures is critical in this setting with minimal transection of nerves to decrease labial numbness or discomfort. Optimal size and location of incision within the labial fat-pad and laterality of incision are not known.
Ideal incision and dissection for martius flap: a cadaver-based study on nerve and vascular density
R Rothenberger, R Feroz, N Hogarth, L Carbone, S Lenger, A Gupta, S Francis, N Herring
10.1016/j.ajog.2024.02.130
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1225
S1226
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Racial and ethnic disparities in rates of minimally invasive hysterectomy across the united states: a systematic review
https://www.ajog.org/article/S0002-9378(24)00200-X/fulltext?rss=yes
Minimally invasive hysterectomy (MIH) is associated with important clinical benefits compared with abdominal hysterectomy, including faster recovery and reduced surgical complications. Despite constituting the standard of care for benign gynecologic conditions, disparities in access to MIH have been demonstrated in multiple studies from varied regions, datasets, populations, and racial groups.
Racial and ethnic disparities in rates of minimally invasive hysterectomy across the united states: a systematic review
K Sandhu, R Wilson, M Yao, L Hackett, M Orlando, R Kho
10.1016/j.ajog.2024.02.129
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1224
S1225
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Obstetrics and gynecology resident education in cosmetic gynecology
https://www.ajog.org/article/S0002-9378(24)00199-6/fulltext?rss=yes
While cosmetic gynecology has gained popularity over the recent years, the training experience in this area for obstetrics and gynecology residents is limited and not standardized.
Obstetrics and gynecology resident education in cosmetic gynecology
S Lee, A Sinha, M Yao, V Reed, N Wood, S Wallace
10.1016/j.ajog.2024.02.128
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1223
S1224
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Histopathologic confirmation of adenomyosis for individuals with clinical features of the disease
https://www.ajog.org/article/S0002-9378(24)00198-4/fulltext?rss=yes
Adenomyosis is defined by ectopic endometrium-like tissue identified within the uterine myometrium. However, there are no consensus guidelines regarding adequate myometrial sampling protocols for histopathologic diagnosis.
Histopathologic confirmation of adenomyosis for individuals with clinical features of the disease
C Mangham, H Kyllo, L Mclemore, G Whitmore, J Tam, K Hampanda, M Orlando
10.1016/j.ajog.2024.02.127
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1223
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Optimal timing for repeat in-office voiding trial after failed post-operative voiding trial
https://www.ajog.org/article/S0002-9378(24)00197-2/fulltext?rss=yes
Post-operative urinary retention requiring discharge with an indwelling catheter is common following urogynecologic surgery. Optimal timing for when to repeat a voiding trial in the office to maximize pass rates remains unclear.
Optimal timing for repeat in-office voiding trial after failed post-operative voiding trial
A Stork, L King, D Jaraki, J Pruszynski, M Florian-Rodriguez
10.1016/j.ajog.2024.02.126
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1222
S1223
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An analysis of body mass index and the risk of postoperative complications following colorectal resection for endometriosis
https://www.ajog.org/article/S0002-9378(24)00196-0/fulltext?rss=yes
It is estimated that approximately 5-25% of women with endometriosis experience deep infiltrating endometriosis with colorectal involvement. Surgical options include bowel shaving, discoid excision, or segmental resection, and the majority of studies on the topic focus on these approaches. Currently, data are limited regarding the effect of BMI on surgical outcomes following colorectal resection for endometriosis.
An analysis of body mass index and the risk of postoperative complications following colorectal resection for endometriosis
C Maxey, R Meyer, M Truong, K Wright, M Axelrod, Y Nasseri, M Barnajian, K Hamilton, R Schneyer, M Siedhoff
10.1016/j.ajog.2024.02.125
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1221
S1222
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Perioperative care pathway for vulvar reconstruction: a case series
https://www.ajog.org/article/S0002-9378(24)00195-9/fulltext?rss=yes
Vulvar reconstructive surgery is performed for a variety of indicated etiologies. Labial, vulvar, and clitoral adhesions may be caused by vulvar dermatologic conditions such as lichen sclerosus and lichen planus in addition to hypoestrogenic state. Other etiologies of abnormal vulvar anatomy include genital and birth trauma, and female genital mutilation. There is currently no recommended perioperative management following vulvar reconstructive surgery, leading to varied postoperative management and patient counseling, which may contribute to the wide range of recurrence (0-55%).
Perioperative care pathway for vulvar reconstruction: a case series
K Stewart, C Heisler, G Seibert
10.1016/j.ajog.2024.02.124
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1220
S1221
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The effect of prophylactic antibiotic administration for endometriosis surgery
https://www.ajog.org/article/S0002-9378(24)00194-7/fulltext?rss=yes
Endometriosis is commonly diagnosed and treated with laparoscopic surgery. Previous studies have found an association between endometriosis and pelvic infections, both prior to and after surgery. The pathogenic mechanisms leading to pelvic infection in patients with endometriosis may be the result of increased inflammatory state, alteration of pelvic microbiome, impaired immune response, and/or anatomy distortion favorable to bacteria proliferation. Currently, the American College of Obstetrics and Gynecology (ACOG) does not recommend antibiotic prophylaxis for laparoscopic procedures that do not include entry into the bowel or the vagina.
The effect of prophylactic antibiotic administration for endometriosis surgery
K Work, R Meyer, R Schneyer, M Truong, K Wright, M Siedhoff
10.1016/j.ajog.2024.02.123
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1219
S1220
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#prolapse: who is leading the conversation? - categorizing the top instagram posts using the #prolapse tag
https://www.ajog.org/article/S0002-9378(24)00193-5/fulltext?rss=yes
Patients are increasingly consuming medical information from social media and 169 million individuals in the United States use Instagram.
#prolapse: who is leading the conversation? - categorizing the top instagram posts using the #prolapse tag
R Patel, W Winkelman
10.1016/j.ajog.2024.02.122
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1219
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Comparison of costs associated with apical suspension procedures
https://www.ajog.org/article/S0002-9378(24)00192-3/fulltext?rss=yes
There are numerous suspension procedures for apical prolapse with different risks and benefits. In the current healthcare climate, evaluating costs of different procedures is critically important.
Comparison of costs associated with apical suspension procedures
A Gee, J Shepherd, S Wallace
10.1016/j.ajog.2024.02.121
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1218
S1219
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Knowledge and perceptions of pelvic floor disorders and the impact of television advertisement on women in a major metropolitan area
https://www.ajog.org/article/S0002-9378(24)00191-1/fulltext?rss=yes
The utilization of synthetic mesh in pelvic reconstructive survey continues to be a controversial subject due to a wide variance in patient perspective. Despite having a multitude of data on synthetic mesh currently in use, data on current patient perspectives is limited to small sample sizes. Specifically, there is a lack of information on whether legal advertisements have an impact on patient decisions to undergo surgery.
Knowledge and perceptions of pelvic floor disorders and the impact of television advertisement on women in a major metropolitan area
B Hallner, Z Selzler, R Denneny, N Thompson, L Peacock
10.1016/j.ajog.2024.02.120
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1217
S1218
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Social media analysis of public perception after retaliation for sexual harassment in medicine
https://www.ajog.org/article/S0002-9378(24)00190-X/fulltext?rss=yes
Sexual harassment is a prevalent issue among obstetrician-gynecologists with rates as high as 70% reported among trainees. Affected individuals are subject to health impacts, disrupted work productivity, and changes in career trajectory. In May 2023, the physical assault of a gynecologic oncology provider by a former trainee’s spouse was filmed and circulated via an anonymous Twitter account. This event stemmed from an alleged act of sexual assault against this former trainee during her training and is currently under investigation.
Social media analysis of public perception after retaliation for sexual harassment in medicine
N Gaddam, C Mccullough, R Richards, C Toal, J Fitzgerald, C Grimes, C Iglesia
10.1016/j.ajog.2024.02.119
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1216
S1217
-
A didactic simulation to increase OB/GYN resident knowledge and comfort level with vaginal pessaries
https://www.ajog.org/article/S0002-9378(24)00189-3/fulltext?rss=yes
Recent studies show that OB/GYN residents feel inadequately prepared for vaginal pessary fitting and management.
A didactic simulation to increase OB/GYN resident knowledge and comfort level with vaginal pessaries
C Peterson, S Sanchez, Z Mulla, P Maldonado, I Montoya
10.1016/j.ajog.2024.02.118
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1216
-
Cesarean scar pregnancy: is surgery the preferred method of treatment?
https://www.ajog.org/article/S0002-9378(24)00188-1/fulltext?rss=yes
As the rate of Cesarean sections continue to elevate, Cesarean section scar pregnancies are becoming more common. This unique ectopic pregnancy can be missed if early diagnosis is not completed, due to persist longer pregnancy that can lead to catastrophic consequences. Early diagnosis allows effective treatment with good outcomes. Treatment is recommended based on the desire for future fertility and the gestational age at diagnosis and include surgical and conservative treatments. Surgical approaches include hysterectomy when future fertility is not desired, and hysteroscopy or excision of the pregnancy with uterine niche repair, depending on the residual myometrial thickness at the area of the uterine scar.
Cesarean scar pregnancy: is surgery the preferred method of treatment?
A Bhalwal, N Das Agarwal, A Mohr-Sasson
10.1016/j.ajog.2024.02.117
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1215
S1216
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Rate of urine culture contamination with different methods of urine specimen collection
https://www.ajog.org/article/S0002-9378(24)00187-X/fulltext?rss=yes
Many urogynecology and urology clinics collect urine specimens as midstream urine (MSU) samples for the evaluation of urinary symptoms. A recent study reported 46% of MSU samples collected in an academic urology practice were mixed flora indicating contamination, and the prevalence was higher in women and with advanced age regardless of additional patient education about specimen collection. It is essential to determine more accurate methods of obtaining urine specimen for urinalysis and cultures to mitigate contamination risk.
Rate of urine culture contamination with different methods of urine specimen collection
S Ashmore, J Shi, T Samsel, M Mueller, J Letko, K Kenton
10.1016/j.ajog.2024.02.116
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1215
-
Validity of the EQ-5D for women with chronic pelvic pain
https://www.ajog.org/article/S0002-9378(24)00186-8/fulltext?rss=yes
Chronic pelvic pain (CPP) is a debilitating condition defined as pain located below the umbilicus for 6 months or greater that is associated with significant disturbance in daily function. It can adversely affect physical and mental health, increase the risk of depression and anxiety, and impose significant economic burdens due to healthcare costs, lost income, and reduced productivity. Health-related quality of life (HRQoL) is evaluated using standardized utility preference scores, ranging from 0 (low HRQoL) to 1 (high HRQoL), that quantify the severity of the condition.
Validity of the EQ-5D for women with chronic pelvic pain
M Bibi, E Drugge, E Kiley, D Thorpe, E Felder, J Keltz
10.1016/j.ajog.2024.02.115
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1214
S1215
-
Complex cervical dysgenesis and concurrent uterine anomalies: a dynamic case presentation and management
https://www.ajog.org/article/S0002-9378(24)00185-6/fulltext?rss=yes
Cervical agenesis and dysgenesis are rare anomalies, occurring between approximately 1 in 80,000 to 100,000 women. Cervical dysgenesis may present with other complicating uterine and vaginal anomalies including transverse vaginal septum or hemi-uterus. Those presenting with combination anomalies are difficult to both diagnose and manage. There remains great variation in treatment including conservative measures and hysterectomy.
Complex cervical dysgenesis and concurrent uterine anomalies: a dynamic case presentation and management
K Gervas, A Croak
10.1016/j.ajog.2024.02.114
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1213
S1214
-
Risk factors and indications for hospital readmission after benign hysterectomy
https://www.ajog.org/article/S0002-9378(24)00184-4/fulltext?rss=yes
Understanding patient-specific risk factors associated with readmission to the hospital after hysterectomy is essential to improving patient outcomes and reducing healthcare costs.
Risk factors and indications for hospital readmission after benign hysterectomy
E Marra, G Chapman, C Rossi, L Griebel
10.1016/j.ajog.2024.02.113
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1212
S1213
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Patient insights into women’s health: mapping the pelvic floor surgery journey
https://www.ajog.org/article/S0002-9378(24)00183-2/fulltext?rss=yes
Pelvic floor disorders (PFDs) are broadly categorized into urinary incontinence (UI), fecal incontinence (FI), and pelvic organ prolapse (POP). It is estimated that the prevalence of PFDs ranges from 12-42% and increases with age. PFDs are stigmatizing and profoundly impactful on intimate and social relationships. Despite the effect on emotional well-being and quality of life, less than half of women with PFDs seek care. Capturing a true prevalence is difficult and limited by patient reporting and barriers to care-seeking including misconceptions about the conditions, lack of awareness around options for management, and personal embarrassment.
Patient insights into women’s health: mapping the pelvic floor surgery journey
S Haikal, L Galuban, B Garza, G Bejarano, K Carberry, J Cardwell, S Wallace, E Teisberg, L Caldwell, M Rieger, A White
10.1016/j.ajog.2024.02.112
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1212
-
Impact factor bias in randomized controlled trials on minimally invasive gynecologic surgery
https://www.ajog.org/article/S0002-9378(24)00182-0/fulltext?rss=yes
Impact factor (IF) bias is a particular kind of publication bias where positive results tend not only to be published more than nonsignificant or negative results but are also more likely to be published in higher impact factor journals, leading to distorted reader’s exposure to the scientific data. Although IF bias has been addressed in several medical disciplines, it hasn’t been studied in the field of minimally invasive gynecologic surgery.
Impact factor bias in randomized controlled trials on minimally invasive gynecologic surgery
SN Friedrich, S Toussia-Cohen, K Hamilton, G Levin, R Meyer
10.1016/j.ajog.2024.02.111
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1211
-
Feasibility and safety of same-day discharge after obliterative surgery for pelvic organ prolapse
https://www.ajog.org/article/S0002-9378(24)00181-9/fulltext?rss=yes
There is increasing momentum for same-day discharge (SDD) after gynecologic surgery, especially in light of the COVID-19 pandemic and the need for optimization of inpatient bed availability. There is limited evidence on the safety of SDD for patients undergoing obliterative surgery for pelvic organ prolapse who tend to be older and frailer.
Feasibility and safety of same-day discharge after obliterative surgery for pelvic organ prolapse
T Walker, J Shen, R Ghandour, J Miranne, E Kim
10.1016/j.ajog.2024.02.110
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1210
-
A new protocol for pessary fitting and refitting as first line treatment for pelvic floor disorders
https://www.ajog.org/article/S0002-9378(24)00180-7/fulltext?rss=yes
Pessaries are vaginal devices that provide nonsurgical treatment for pelvic organ prolapse and stress urinary incontinence. However, despite limited research on frequency of follow-up visits, there is no standardized protocol for pessary fitting and whether how often there is need for refitting after the initial visit.
A new protocol for pessary fitting and refitting as first line treatment for pelvic floor disorders
H Abed
10.1016/j.ajog.2024.02.109
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1209
S1210
-
Tubo-ovarian abscess masquerading as solitary uterine fibroid: a case report of oral flora in the reproductive tract
https://www.ajog.org/article/S0002-9378(24)00179-0/fulltext?rss=yes
Tubo-ovarian abscesses usually present with fever, leukocytosis, pelvic mass, and pelvic pain and the usual pathogens are genitourinary anaerobic bacteria. Porphyromas gingivalis and Parvinmonas micra are colonizers of the mouth and can cause oral abscesses and occasionally systemic infections. However, they are unheard of pathogens of the genital tract.
Tubo-ovarian abscess masquerading as solitary uterine fibroid: a case report of oral flora in the reproductive tract
E Cook, D Allison, B Griffin, L Harvey
10.1016/j.ajog.2024.02.108
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1209
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Introduction of fundamentals of vaginal surgery to west african obstetrics and gynecology trainees
https://www.ajog.org/article/S0002-9378(24)00177-7/fulltext?rss=yes
Vaginal surgery is a cost-effective, minimally-invasive approach to treating various gynecologic conditions. Supporting physicians in low-and-middle income countries (LMICs) to be proficient in vaginal surgery should be a priority as it can be performed with minimal equipment and personnel. Fundamentals of Vaginal Surgery (FVS) is a vaginal simulation system that could be used in LMICs to aid in the assessment, development, and maintenance of vaginal surgical skills (Figure 1).
Introduction of fundamentals of vaginal surgery to west african obstetrics and gynecology trainees
M Bangura, G Ganyaglo, D Kupualor, E Lawrence, D Rooney, P Schmidt
10.1016/j.ajog.2024.02.106
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1208
S1209
-
Implementation, satisfaction, and attitudes towards fundamentals of laparoscopic surgery (FLS) for obstetrics and gynecology (OB/GYN) residencies in the united states
https://www.ajog.org/article/S0002-9378(24)00176-5/fulltext?rss=yes
Fundamentals of Laparoscopic Surgery (FLS) certification became a requirement for board certification by the American Board of Obstetrics & Gynecology in 2020. Subsequently, thousands of OB/GYN trainees have been affected by this change and residencies have been forced to incorporate FLS training into their didactics. To date, little research has been performed describing residency program satisfaction with FLS or its impact on resident surgical performance.
Implementation, satisfaction, and attitudes towards fundamentals of laparoscopic surgery (FLS) for obstetrics and gynecology (OB/GYN) residencies in the united states
A Davenport, B Clarke, N Hazen
10.1016/j.ajog.2024.02.105
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1208
-
Pelvic floor dysfunction in female rock climbers
https://www.ajog.org/article/S0002-9378(24)00175-3/fulltext?rss=yes
A previous study identified that pelvic floor disorders are common amongst female triathletes, and this population should be screened for these disorders. As opposed to endurance sports, rock climbing is a core-intensive and low-impact exercise that has dramatically increased in popularity over the last decade with more female participants. This population has not been evaluated explicitly for pelvic floor disorders and incontinence.
Pelvic floor dysfunction in female rock climbers
P Altshuler, I Burgard, T Muffly, J Poling
10.1016/j.ajog.2024.02.104
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1207
S1208
-
Regional variation in the use of hysterectomy for gynecologic conditions in the united states
https://www.ajog.org/article/S0002-9378(24)00174-1/fulltext?rss=yes
In the United States, hysterectomy utilization varies by region. The variation in use of hysterectomy for specific benign and gynecologic diseases is not known.
Regional variation in the use of hysterectomy for gynecologic conditions in the united states
D Morgan, K Chalmers, V Saini, V Gopinath, J Norsigian, S Uppal, D Thiyagarajan, T Johnson
10.1016/j.ajog.2024.02.103
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1207
-
Better uterine manipulation performance (BUMP) study - comparing medical students performance of uterine manipulation after a simulated model curriculum
https://www.ajog.org/article/S0002-9378(24)00173-X/fulltext?rss=yes
Medical students have limited, if any, experience with minimally invasive gynecologic surgery and therefore are unfamiliar with how to perform uterine manipulation. Oftentimes, students rely on informal instruction given just prior to performing uterine manipulation in the operating room.
Better uterine manipulation performance (BUMP) study - comparing medical students performance of uterine manipulation after a simulated model curriculum
R Patel, K Adam, K Ryan, A Gonzalez Morbey, C Lusby, R Frenn, T Pham
10.1016/j.ajog.2024.02.102
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1206
-
Hemostatic agent use in minimally invasive hysterectomies: complications and cost
https://www.ajog.org/article/S0002-9378(24)00172-8/fulltext?rss=yes
Hemostatic agents (HAs) are commonly used as adjuncts in minimally invasive gynecologic surgery to control or prevent surgical bleeding; use across discplines is increasing(1). Use of HAs in gynecologic surgery may decrease blood loss and operative time(2). HAs vary in their mechanism of action, absorption time, and cost. Data on the risk of postoperative pelvic infection/abscess after HA use at hysterectomy reveals mixed results(3,4). We sought to examine the difference in both postoperative complications and cost with use of microporous polysacharide spheres (AristaTM) and flowable gelatin-thrombin matrix (SurgifloTM) at the time of hysterectomy.
Hemostatic agent use in minimally invasive hysterectomies: complications and cost
H Pope, L Glaser
10.1016/j.ajog.2024.02.101
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1204
S1205
-
Utility of pre-operative laboratory testing for patients undergoing minimally invasive sacrocolpopexy
https://www.ajog.org/article/S0002-9378(24)00171-6/fulltext?rss=yes
There are limited guidelines on routine pre-operative laboratory testing prior to major pelvic reconstructive surgeries such as minimally invasive sacrocolpopexy.
Utility of pre-operative laboratory testing for patients undergoing minimally invasive sacrocolpopexy
E Byrne, R Ghandour, J Shen, JM Miranne, EK Kim
10.1016/j.ajog.2024.02.100
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1203
S1204
-
Presurgical vaginal preparation regimens for antisepsis in gynecologic surgery: a systematic review and meta-analysis
https://www.ajog.org/article/S0002-9378(24)00170-4/fulltext?rss=yes
ACOG does not currently endorse a standard regimen for vaginal preparation prior to gynecologic surgery, but does recommend the use of alcohol-based agents for abdominal preparation. Chlorhexidine gluconate (CHG) is often found as an alcohol-based solution and is thus commonly used for abdominal skin preparation. Contrastingly, povidone-iodine (PI), is often found in aqueous form and the only surgical preparation currently approved by the FDA for pre-operative vaginal antisepsis. Several randomized controlled trials (RCTs) have assessed differences in these preparation regimens regarding antiseptic efficacy, but there remains no definitive evidence to support the superiority of one over the other.
Presurgical vaginal preparation regimens for antisepsis in gynecologic surgery: a systematic review and meta-analysis
E Farabee, M Manning, A Stuart, J Gaskins, A Gupta, S Francis, S Lenger
10.1016/j.ajog.2024.02.099
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1203
-
Evaluation and repair of a complex recurrent urethral diverticulum with calculus formation involving a sub-urethral incontinence sling: a case report
https://www.ajog.org/article/S0002-9378(24)00169-8/fulltext?rss=yes
Many women experience poor quality of life due to problems with their urinary tract including urinary incontinence and urethral diverticula. Urethral diverticula may cause chronic urinary tract infections (UTI’s), difficulty urinating, painful urination, vaginal pressure, or pain with sex. Diverticula may occur in 1-6% of women but are underreported. Some women suffer from both urinary incontinence and urethral diverticulum, which can be challenging to diagnose and treat successfully. A literature search revealed reports describing women with either a calculus within a urethral diverticulum or attached to a mesh sling.
Evaluation and repair of a complex recurrent urethral diverticulum with calculus formation involving a sub-urethral incontinence sling: a case report
M Carlson, K Gervas, A Croak
10.1016/j.ajog.2024.02.098
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1202
S1203
-
Reported maternal satisfaction following an obstetric anal sphincter injury a decade after delivery
https://www.ajog.org/article/S0002-9378(24)00168-6/fulltext?rss=yes
Currently, the long-term psychological consequences of sustaining an obstetric anal sphincter injury (OASI) are unknown. Furthermore, parsing out the unique effect of an OASI on the maternal childbirth experience is challenging because these injuries often occur within the broader physical trauma of a vaginal birth, an operative vaginal delivery (OVD), or an episiotomy.
Reported maternal satisfaction following an obstetric anal sphincter injury a decade after delivery
B Ha, K Voegtline, S Olson, V Handa
10.1016/j.ajog.2024.02.097
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1201
S1202
-
Evaluating the impact of video-based surgical coaching on obstetrics and gynecology residents’ laparoscopic suturing skills
https://www.ajog.org/article/S0002-9378(24)00167-4/fulltext?rss=yes
A 2019 study revealed significant surgical case volume variability between residency programs with approximately half of graduating residents unable to meet minimum case requirements for laparoscopic hysterectomy (Hall, 2019). As such, there is a critical need for innovation in the ways we design Ob/Gyn residency surgical training. Surgical coaching involves the development of a partnership between two surgeons in which one surgeon (coach) guides the other (coachee) in identifying goals, providing feedback, and facilitating action planning.
Evaluating the impact of video-based surgical coaching on obstetrics and gynecology residents’ laparoscopic suturing skills
T Gallant, C King, M Luna Russo, A Carey-Love
10.1016/j.ajog.2024.02.096
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1201
-
Diaphragmatic endometriosis excisions and associated pathology in VATS procedures
https://www.ajog.org/article/S0002-9378(24)00166-2/fulltext?rss=yes
It is estimated that in approximately 12% of endometriosis cases, lesions are found outside of the pelvis. The most common site of extra-pelvic disease is the diaphragm. (Andres et al. 2020). Despite the estimated low incidence of concomitant diaphragmatic and pleural cavity disease, patients with diaphragmatic disease opt to undergo a Video-Assisted Thoracic Surgery (VATS) procedure to further evaluate for thoracic endometriosis. Data are limited showing the proportion of diaphragmatic endometriosis patients who also have pleural cavity involvement.
Diaphragmatic endometriosis excisions and associated pathology in VATS procedures
T Gallant, M Luna-Russo, C King
10.1016/j.ajog.2024.02.095
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1200
-
Lower urinary tract symptoms in transmasculine individuals: prevalence and association with anxiety and depression
https://www.ajog.org/article/S0002-9378(24)00165-0/fulltext?rss=yes
In the United States alone, 1.6 million people identify as transgender and gender diverse. While there is a large spectrum of possible gender identities, there is limited evidence from focus groups that transgender men and transmasculine (TGM/TM) individuals assigned female at birth report a variety of lower urinary tract symptoms (LUTS) which adversely affects patients’ mental health. LUTS research, however, is limited by inequities. While there is considerable research on the impact of LUTS on mental health in cisgender women, little is known about LUTS experienced by TGM/TM individuals.
Lower urinary tract symptoms in transmasculine individuals: prevalence and association with anxiety and depression
F Kreines, C Cox, H Harvie, L Arya, U Andy
10.1016/j.ajog.2024.02.094
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1199
S1200
-
Postoperative urinary retention and glycopyrrolate use during urogynecologic surgery
https://www.ajog.org/article/S0002-9378(24)00164-9/fulltext?rss=yes
Overall, urinary retention occurs following 2.5-43% of pelvic reconstructive surgeries. Many studies have evaluated surgical factors that increase the risk of postoperative urinary retention (POUR), including BMI, baseline bladder dysfunction, prior incontinence surgery, intraoperative fluids, and opioids. Few studies have assessed anesthetic factors that may contribute to POUR. While glycopyrrolate, an antimuscarinic medication, is most commonly used to counteract bradycardia when reversing a neuromuscular blockade with neostigmine, this medication may have other unanticipated effects.
Postoperative urinary retention and glycopyrrolate use during urogynecologic surgery
A Bruscke, M Hacker, Z Glicksman, W Winkelman
10.1016/j.ajog.2024.02.093
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1199
-
Prevalence of endometriosis and pelvic pain in patients with hereditary connective tissue disorders
https://www.ajog.org/article/S0002-9378(24)00163-7/fulltext?rss=yes
Chronic pelvic pain is one of the most common reasons for referral to a gynecologic provider, accounting for up to 20% of outpatient visits in the specialty. The true prevalence of chronic pelvic pain is difficult to assess, with rates of 4-25% reported in the literature. Endometriosis is similar, but has an accepted prevalence of around 10% for reproductive women. Chronic pain is a hallmark of many hereditary connective tissue disorders (HCTDS) with over 92% of female patients with EDS reporting pain.
Prevalence of endometriosis and pelvic pain in patients with hereditary connective tissue disorders
N Jesse, A Yunker
10.1016/j.ajog.2024.02.092
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1198
S1199
-
Update - ethical issues in gynecologic surgery
https://www.ajog.org/article/S0002-9378(24)00162-5/fulltext?rss=yes
Ethical and legal issues are prominent in the practice of surgical gynecology. Discussion and review of these topics is typically of interest at national meetings yet there is rarely a dedicated session to discuss. Some salient topics for discussion include but are not limited to: disparate billing for gynecologic surgery, disparities (racial and other) in access to advanced gynecologic surgery, volume as a cut off for privileging, exams under anesthesia, sexual misconduct in gynecology, surgical care for trans and intersex patients.
Update - ethical issues in gynecologic surgery
L King
10.1016/j.ajog.2024.02.091
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1198
-
Trends of fistula management during COVID 19 pandemic in a tertiary care hospital
https://www.ajog.org/article/S0002-9378(24)00160-1/fulltext?rss=yes
Fistula is a frequent presentation in the Obstetrics and Gynecology departments of the developing countries. The involuntary leakage of urine or stool per vaginam (vaginal fistula) remains a serious public health issue in the developing regions of Africa and South Asia.
Trends of fistula management during COVID 19 pandemic in a tertiary care hospital
S Luqman, S Rauf, M Zafar, S Mutahir, I Akram
10.1016/j.ajog.2024.02.089
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1197
S1198
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Twin pregnancy with one alive and co-existing complete mole
https://www.ajog.org/article/S0002-9378(24)00159-5/fulltext?rss=yes
Twin pregnancy with one complete mole and other fetus is rare with incidence of 1 in 20,000 – 1 in 100,000. Decision to continue with pregnancy should be patient’s decision after having understanding of all complications. We are reporting the case of twin pregnancy of complete hydatiform mole with fetus resulting in live birth and neonatal survival.
Twin pregnancy with one alive and co-existing complete mole
S Rauf, M Batool, S Sharafat, J Mumtaz, SB Mazhar
10.1016/j.ajog.2024.02.088
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1196
S1197
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MorpheusV radiofrequency microneedling of the vaginal canal for genitourinary syndrome of menopause
https://www.ajog.org/article/S0002-9378(24)00158-3/fulltext?rss=yes
Genitourinary syndrome of menopause (GSM) is a symptom-complex that a large percentage of women develop after menopause. Common symptoms include vaginal dryness, dyspareunia and irritative bladder symptoms. While vaginal estrogen therapy is an effective treatment there are patients who have either an absolute or relative contraindication to estrogen or simply prefer not to take it. Thus, there is a significant need to have a non-hormonal alternative for this common and distressing disorder.
MorpheusV radiofrequency microneedling of the vaginal canal for genitourinary syndrome of menopause
R Rothenberger, M Karram
10.1016/j.ajog.2024.02.087
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1195
S1196
-
Prolapsed fibroid in pregnancy- case repost
https://www.ajog.org/article/S0002-9378(24)00157-1/fulltext?rss=yes
Fibroids are benign smooth muscle tumors of the uterus. Depending upon the size , the incidence of uterine fibroids in pregnancy varies between 1.6 and 10.7%, while cervical fibroids are less than 1%. The morbidity of pregnancy with fibroid is related to their number, location and size. In majority cases, fibroids don’t cause symptoms during pregnancy, however, in 10-30% of the pregnancies, they may lead to complications in pregnancy and even in post natal period, causing a management dilemma.
Prolapsed fibroid in pregnancy- case repost
S Rauf, M Batool, A Ahmed, S Sharafat, S Rasheed
10.1016/j.ajog.2024.02.086
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1195
-
An independent, linear relationship between operative time and post-operative complications in benign minimally invasive hysterectomy
https://www.ajog.org/article/S0002-9378(24)00156-X/fulltext?rss=yes
There is increasing evidence in other surgical disciplines that there is an independent, linear relationship between operative time and post-operative complications. Prior analysis of data examining this relationship for hysterectomies have not separated out types of hysterectomy or tested for linear correlation.
An independent, linear relationship between operative time and post-operative complications in benign minimally invasive hysterectomy
A Lalla, L King, M Ajao, E Kim
10.1016/j.ajog.2024.02.085
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1194
S1195
-
Does active management of or scheduling impact or utilization?
https://www.ajog.org/article/S0002-9378(24)00155-8/fulltext?rss=yes
Elective surgery is essential to maintain the financial solvency of most health systems, contributing as much as 60% of hospital revenue. Scheduling of surgical cases to optimally utilize operating room (OR) resources requires thoughtful planning and communication within the complex healthcare team. Under-estimating surgical time, late cancellations, and prolonged delays between cases undermines the effort to care for as many patients as possible and can dramatically affect the financial balance of the hospital.
Does active management of or scheduling impact or utilization?
K Mamelson, E Weber-Lebrun
10.1016/j.ajog.2024.02.084
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1193
S1194
-
The economic and carbon footprint impact of virtual preoperative visits implementation
https://www.ajog.org/article/S0002-9378(24)00154-6/fulltext?rss=yes
Telemedicine has existed since the 1950s but had relatively low utilization prior the emergence of the COVID-19 pandemic. The need for social distancing facilitated rapid expansion of telemedicine in gynecology. Currently, data are scarce regarding the effect of preoperative virtual visits on outcomes. Moreover, there are no data regarding the sustainability impact of preoperative visit practice changes in gynecology.
The economic and carbon footprint impact of virtual preoperative visits implementation
R Meyer, K Hamilton, R Schneyer, C Niino, M Truong, M Siedhoff, K Wright
10.1016/j.ajog.2024.02.083
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1192
S1193
-
Feasibility and impact of a postoperative pelvic floor physical therapy telehealth appointment: a pilot study
https://www.ajog.org/article/S0002-9378(24)00153-4/fulltext?rss=yes
Laparoscopic surgery is a common intervention for chronic pelvic pain (CPP) as it is currently the only way to definitively diagnosis endometriosis. Pelvic floor physical therapy (PFPT) has recently been introduced as an option for the management of CPP with the aim of relaxing pelvic muscles in order to reduce spasm and associated pain. With an increased focus on multimodal care for CPP, more patients are being referred to PFPT preoperatively. While patients may experience improvement in their pain syndrome prior to surgery, patients may suffer a setback in PFPT progression postoperatively from limitations in movement and postoperative kinesiophobia.
Feasibility and impact of a postoperative pelvic floor physical therapy telehealth appointment: a pilot study
UOPS Medicine, N Donnellan, N Goodman
10.1016/j.ajog.2024.02.082
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1191
S1192
-
The impact of surgeons’ specialty on surgical outcomes following colorectal resection for endometriosis
https://www.ajog.org/article/S0002-9378(24)00152-2/fulltext?rss=yes
It is estimated that 5-25% of women with endometriosis have colorectal involvement. Surgical management options include shaving, discoid excision, and resection. In cases of large bowel infiltration, colorectal resection may be the most suitable technique. However, colorectal resection is also associated with the highest rate of postoperative complications. Currently, data focusing on surgeons’ specialty and surgical outcomes are scant.
The impact of surgeons’ specialty on surgical outcomes following colorectal resection for endometriosis
K Hamilton, R Meyer, R Schneyer, G Levin, M Truong, K Wright, M Siedhoff, M Barnajian, Y Nasseri
10.1016/j.ajog.2024.02.081
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1190
S1191
-
Vaginal cuff complications in total laparoscopic hysterectomy utilizing barbed suture via an endoscopic suturing device versus conventional intracorporeal suturing
https://www.ajog.org/article/S0002-9378(24)00151-0/fulltext?rss=yes
Proficiency with laparoscopic suturing is often the rate-limiting step in performing a total laparoscopic hysterectomy. Conventional intracorporeal suturing is challenging due to difficulties with needle control and tissue handling. Automated suturing devices such as the Endostitch have been developed in an effort to improve ease and efficiency of laparoscopic suturing; however, there are concerns that the Endostitch may lead to a less precise vaginal cuff closure and subsequent complications.
Vaginal cuff complications in total laparoscopic hysterectomy utilizing barbed suture via an endoscopic suturing device versus conventional intracorporeal suturing
N Brzozowski, L Deng, A Laibangyang, M Talari, S Gill, B Nolan, D Doo, L Chuang
10.1016/j.ajog.2024.02.080
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1190
-
Identifying modifiable risk factors for urinary tract infections after benign hysterectomies using ACS-NSQIP
https://www.ajog.org/article/S0002-9378(24)00150-9/fulltext?rss=yes
Hysterectomies are among the most commonly performed surgical procedures, with over 600,000 performed each year. As hysterectomies involve breaching the genital tract and often require use of an indwelling catheter postoperatively, patients who undergo hysterectomies are susceptible to urinary tract infections (UTIs). The evaluation and treatment of a UTI costs the US healthcare system an estimated $2 billion and also impacts quality of life. Further, postoperative UTI is a quality indicator for pelvic surgery.
Identifying modifiable risk factors for urinary tract infections after benign hysterectomies using ACS-NSQIP
A Murthy, L Pandya, W Kobak, K Forero
10.1016/j.ajog.2024.02.079
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1189
-
Perspectives of older women with coexisting urinary incontinence and high fall risk
https://www.ajog.org/article/S0002-9378(24)00149-2/fulltext?rss=yes
Urgency urinary incontinence (UUI) is strongly associated with falling in older adults. Despite these known linkages, little attention has been directed toward understanding the unique experiences of women who live with both coexisting conditions.
Perspectives of older women with coexisting urinary incontinence and high fall risk
G Kilic, S Fisher, G Halder, T Ishag
10.1016/j.ajog.2024.02.078
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1188
S1189
-
Comparing self-reported surgical readiness of Ob/Gyn resident trainees in the united states and canada
https://www.ajog.org/article/S0002-9378(24)00148-0/fulltext?rss=yes
Surgical volume is decreasing for obstetrics and gynecology residents. Given high volume surgeons have better outcomes and fewer complications, solutions to this “volume problem” for trainees are necessary. One option is extending the length of residency. Whereas all U.S. Ob/Gyn residencies are 4-year programs, in Canada they are all 5 years. This difference in training provides an opportunity to compare trainee feelings of surgical preparedness. Though the U.S. and Canadian Ob/Gyn resident populations have been independently surveyed about surgical confidence levels, there has not been a comparative survey of their self-efficacy levels in performing independent gynecologic surgery.
Comparing self-reported surgical readiness of Ob/Gyn resident trainees in the united states and canada
E Lin, C Warshafsky, J Su, I Chen, K Warner, O Fajardo, J Pruszynski, K Kho
10.1016/j.ajog.2024.02.077
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1188
-
Assessment of education and management of endometriosis among colorectal surgery residents
https://www.ajog.org/article/S0002-9378(24)00147-9/fulltext?rss=yes
Nearly 20% of women with endometriosis are diagnosed with deep infiltrating disease and among those, 5-12% have bowel or rectovaginal involvement. Gynecologic and colorectal surgeons highly trained in endometriosis resection are important to maximize adequate resection and minimize complications. Prior data suggests that endometriosis-focused surgical training for colorectal surgeons can be optimized.
Assessment of education and management of endometriosis among colorectal surgery residents
G Rivera Ortiz, AL Gubbels, G Poles, N Mahnert
10.1016/j.ajog.2024.02.076
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1187
S1188
-
Vaginal natural orifice transluminal endoscopic surgery (vNOTES) for gender affirmation
https://www.ajog.org/article/S0002-9378(24)00146-7/fulltext?rss=yes
The process of transitioning from female to male in transgender persons usually includes medical treatment as well as surgical interventions, including removal of the uterus and ovaries. Nulliparity and prolonged exposure of the vaginal mucosa to testosterone, which are common among transgender men, may present challenges to performing a vaginal hysterectomy with salpingo-oophorectomy, which is commonly performed only for multiparous individuals.
Vaginal natural orifice transluminal endoscopic surgery (vNOTES) for gender affirmation
A Mohr-Sasson, M Hui, M Bonilla Moreno, A Montealegre
10.1016/j.ajog.2024.02.075
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1187
-
Gender disparities in the authorship of invited commentaries in the highest impact obstetrics & gynecology journals
https://www.ajog.org/article/S0002-9378(24)00145-5/fulltext?rss=yes
Although women constitute the majority of practicing obstetrician-gynecologists and trainees, they remain under-represented in academic medicine. Fortunately, recent studies have demonstrated more women are cited as first authors of original publications, although gains as senior authors have lagged. Additionally, women are less likely to be invited to contribute editorial commentary, a role that implies expertise and prestige, in medical journals from all fields.
Gender disparities in the authorship of invited commentaries in the highest impact obstetrics & gynecology journals
E Cook, A Zhao, O Fajardo, N Jesse, L Harvey, K Chavez
10.1016/j.ajog.2024.02.074
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1186
S1187
-
Treatment of genitourinary syndrome of menopause: a sualitative study on patient perspectives on vaginal estrogen
https://www.ajog.org/article/S0002-9378(24)00144-3/fulltext?rss=yes
Genitourinary syndrome of menopause (GSM) refers to a constellation of localized symptoms associated with estrogen deficiency that ensues with menopause. Vaginal estrogen therapy is widely accepted in the medical community as a safe and effective treatment option for symptoms of GSM. However, vaginal estrogen therapy may be underutilized due to various factors relating to patient perceptions, access to resources, or healthcare systems outreach.
Treatment of genitourinary syndrome of menopause: a sualitative study on patient perspectives on vaginal estrogen
AM Dascanio, H Zhang, D Malacarne Pape, V Rodriguez, G Yaskhi, D Janvier, ES Chorna, M Glass, L Immers, O Nussbaum, L Zweig, A Akbar, M Kasoff, B Roca, C Lleras, A Steinhart, CL Grimes, SE Andiman
10.1016/j.ajog.2024.02.073
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1186
-
Vitamin D deficiency in black women with uterine fibroids
https://www.ajog.org/article/S0002-9378(24)00143-1/fulltext?rss=yes
Uterine leiomyomas are benign tumors of the uterus that are composed of smooth muscle cells and fibroblasts and are rich in extracellular matrix. Leiomyomas are often associated with pelvic pain or pressure, menorrhagia, dysmenorrhea, dyspareunia, miscarriage and infertility, and are one of the leading indications for hysterectomy. Vitamin D is a hormone with anti-proliferative and anti-fibrotic effects that have been found to inhibit the growth of human uterine leiomyoma cells. In vitro studies have shown that myometrial tissue are sensitive target organs for vitamin D, and that their cell growth is effectively inhibited by physiologic vitamin D concentrations.
Vitamin D deficiency in black women with uterine fibroids
J Williams, K Forlenza, H Swede, D Luciano, A Ulrich
10.1016/j.ajog.2024.02.072
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1185
S1186
-
The impact of virtual preoperative visits on complications of gynecologic surgery
https://www.ajog.org/article/S0002-9378(24)00142-X/fulltext?rss=yes
The COVID-19 pandemic accelerated the use of telemedicine across many specialties, with high satisfaction rates among patients and providers. Our division of minimally invasive gynecologic surgery (MIGS) has since implemented preoperative virtual visits for most patients and has maintained this practice. Currently, limited data exist regarding the impact of telemedicine on outcomes of gynecologic surgery.
The impact of virtual preoperative visits on complications of gynecologic surgery
R Schneyer, R Meyer, K Hamilton, M Truong, K Wright, M Siedhoff
10.1016/j.ajog.2024.02.071
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1184
S1185
-
“pandemic pelvis”: identifying high tone pelvic floor disorder and associated pelvic floor symptoms during the COVID-19 pandemic
https://www.ajog.org/article/S0002-9378(24)00141-8/fulltext?rss=yes
Psychological stress and emotional factors have an established relationship with pelvic floor syndromes. The COVID-19 pandemic considerably disrupted individuals’ lives and emotional well-being. Articles have highlighted a phenomenon of “pandemic pelvis”: an anecdotal increase in patients seeking urogynecologic care for high tone pelvic floor disorder (HTPFD) during the COVID-19 pandemic. However, to our knowledge, this has not been formally evaluated.
“pandemic pelvis”: identifying high tone pelvic floor disorder and associated pelvic floor symptoms during the COVID-19 pandemic
TB Prinster, P Downing, RH Sperling, RM Smith, LC Hickman
10.1016/j.ajog.2024.02.070
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1183
S1184
-
Clinical trial race and ethnic disparities in minimally invasive gynecologic surgery
https://www.ajog.org/article/S0002-9378(24)00140-6/fulltext?rss=yes
Understanding disparities in the field of Minimally Invasive Gynecologic Surgery (MIGS) is crucial to establishing equitable care for patients. Previous studies, primarily in the realm of oncology and obstetrics, have highlighted uneven enrollment of different groups in clinical trials. Representative participation in trials is needed to avoid erroneous conclusions for populations based on generalized results. There is currently a paucity of data regarding race and ethnicity differences in the realm of benign gynecology trials.
Clinical trial race and ethnic disparities in minimally invasive gynecologic surgery
K Moran, R Meyer, A Ohayon, G Levin, K Hamilton, M Truong, K Wright, M Siedhoff
10.1016/j.ajog.2024.02.069
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1182
S1183
-
Pain following vaginal natural orifice transluminal endoscopic surgery (vNOTES) in obese compared to non-obese women
https://www.ajog.org/article/S0002-9378(24)00139-X/fulltext?rss=yes
Overweight and obesity are increasing dramatically worldwide and contribute substantially to the burden of morbidity and mortality. Vaginal natural orifice transluminal endoscopic surgery (vNOTES) seems as the favorable approach for obese women undergoing gynecological benign surgeries, as it avoids the major challenges of abdominal entry of conventional laparoscopy. Due to higher burden of omental fat in obese women, sub-diaphragmatic entrapment of air could potentially lead to higher frequency of post operative pain.
Pain following vaginal natural orifice transluminal endoscopic surgery (vNOTES) in obese compared to non-obese women
A Mohr-Sasson, M Hui, M Bonilla Moreno, A Bhalwal, A Montealegre
10.1016/j.ajog.2024.02.068
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1182
-
Bowel endometriosis excision – approaches and outcomes
https://www.ajog.org/article/S0002-9378(24)00138-8/fulltext?rss=yes
Hand sewing discoid excisions does not require the use of a circular stapler and can be performed by a skilled laparoscopic surgeon. There is limited prior data on outcomes following hand sewn closure of discoid resection for bowel endometriosis.
Bowel endometriosis excision – approaches and outcomes
L Chatroux, P Maghsoudlou, M Ajao, L King, J Einarsson
10.1016/j.ajog.2024.02.067
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1181
S1182
-
Resident’s training in vaginal natural orifice transluminal endoscopic surgery (vNOTES)
https://www.ajog.org/article/S0002-9378(24)00137-6/fulltext?rss=yes
As the vaginal natural orifice transluminal endoscopic surgery (vNOTES) is becoming a common acceptable approach to perform benign gynecological surgeries there is need to incorporate it in resident's curriculum for surgical training.
Resident’s training in vaginal natural orifice transluminal endoscopic surgery (vNOTES)
A Bhalwal, M Hui, O Dziadek, R Jalloul, A Montealegre, A Mohr-Sasson
10.1016/j.ajog.2024.02.066
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1180
S1181
-
Does preoperative uterine artery embolization decrease blood loss during total abdominal hysterectomy for uterine fibroids?
https://www.ajog.org/article/S0002-9378(24)00136-4/fulltext?rss=yes
Uterine fibroids, a common gynecologic condition in reproductive-age women, often present with symptoms of heavy uterine bleeding and abdominal pain. Hysterectomy is the definitive treatment, particularly for large fibroids. Intraoperative bleeding risks are of concern during hysterectomy for large fibroid uterus as bleeding can limit intraoperative visualization and increase morbidity. Uterine artery embolization (UAE) is a minimally invasive procedure that decreases blood flow to the uterus and fibroids by occluding the uterine arteries.
Does preoperative uterine artery embolization decrease blood loss during total abdominal hysterectomy for uterine fibroids?
C Lara, G Lewis
10.1016/j.ajog.2024.02.065
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1180
-
Impact of informal spousal caregiver dyads on recovery after urogynecologic surgery in older adults
https://www.ajog.org/article/S0002-9378(24)00135-2/fulltext?rss=yes
Caregiving is often studied in the context of long-term care for chronic conditions. This leaves gaps in knowledge of the impact of caregiving in short-term settings, like surgical recovery from elective, major surgery, in which an informal caregiver is often preferred. It is known that informal spousal caregiver-patient dyads are more common with older adults, especially in long-term or end-of-life care. However, the dynamics of older adult spousal caregiver-patient dyads in the setting of recovery from elective urogynecologic surgery is not well understood.
Impact of informal spousal caregiver dyads on recovery after urogynecologic surgery in older adults
L Yu, L Vargas, A Pollard, S Zuo, S Orris, J Chang, M Ackenbom
10.1016/j.ajog.2024.02.064
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1180
-
A comparative carbon footprint analysis of uterine manipulators for hysterectomy
https://www.ajog.org/article/S0002-9378(24)00133-9/fulltext?rss=yes
The health care system is a main contributor of greenhouse gas emissions in the United States. Single-use disposable supplies contribute significantly to these emissions and over 95% of their environmental impacts occur during production and manufacturing phases. Uterine manipulators can be manufactured from reusable stainless steel, disposable materials, or both, all of which have distinct carbon footprints.
A comparative carbon footprint analysis of uterine manipulators for hysterectomy
A Melnyk, N Silva De Souza Lima Cano, S Glass Clark, A Artsen
10.1016/j.ajog.2024.02.062
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1178
S1179
-
Validation of ICIQ-LUTS questionnaire in the transmasculine population
https://www.ajog.org/article/S0002-9378(24)00132-7/fulltext?rss=yes
In the United States alone, 1.6 million people identify as transgender and gender diverse. While there is a large spectrum of possible gender identities, there is now limited evidence from focus group studies that transgender men and transmasculine (TGM/TM) individuals assigned female at birth report a variety of lower urinary tract symptoms (LUTS) such as frequency, urgency, nocturia, and incontinence and which result in shame, fear, and embarrassment. LUTS research, however, is limited by inequities.
Validation of ICIQ-LUTS questionnaire in the transmasculine population
F Kreines, C Cox, H Harvie, L Arya, U Andy
10.1016/j.ajog.2024.02.061
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1177
S1178
-
Ultrasound diagnosis of adenomyosis – a blinded validation study of the 2022 MUSA guidelines
https://www.ajog.org/article/S0002-9378(24)00131-5/fulltext?rss=yes
Adenomyosis is a common gynecologic condition characterized by the presence of endometrial glands and stroma within the myometrium and can lead to heavy, painful menses. It is also associated with infertility and poor IVF outcomes. The gold standard for diagnosis is histopathologic examination of the uterus which requires hysterectomy. A growing body of evidence suggests that ultrasound can identify adenomyosis. Consensus guidelines describing standardized terms to describe specific features of adenomyosis were published in 2015 by the Morphological Uterus Sonographic Assessment (MUSA) group.
Ultrasound diagnosis of adenomyosis – a blinded validation study of the 2022 MUSA guidelines
L Chatroux, P Maghsoudlou, M Ajao, L King, Y Groszmann
10.1016/j.ajog.2024.02.060
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1177
-
The impact of perioperative pharmacologic anticoagulation on venous thromboembolism and bleeding complications following surgery for pelvic organ prolapse
https://www.ajog.org/article/S0002-9378(24)00130-3/fulltext?rss=yes
Venous thromboembolism (VTE) is one of the most common preventable causes of morbidity and mortality following surgery. Rates of VTE following major gynecologic surgery range from 15-40% in patients who receive no thromboprophylaxis, either mechanical or pharmacologic. The current recommendations on initiating VTE prophylaxis in gynecologic surgery originate from the American College of Chest Physicians guidelines, which stratify patients into low, moderate, and high risk. Most patients undergoing benign gynecologic surgery fall into the moderate to high-risk categories based on age and duration of procedure, indicating that they should receive either pharmacologic or mechanical VTE prophylaxis.
The impact of perioperative pharmacologic anticoagulation on venous thromboembolism and bleeding complications following surgery for pelvic organ prolapse
H Bauer, M Schlussel, S Rhodes, D Sheyn
10.1016/j.ajog.2024.02.059
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1176
S1177
-
Retrospective cohort of in-office backfill-assisted voiding trial versus at-home catheter discontinuation with autofill voiding trial on the day after urogynecologic surgery
https://www.ajog.org/article/S0002-9378(24)00129-7/fulltext?rss=yes
To decrease patient and provider burden, we performed A Postoperative Cohort Study Assessing Healthcare Utilization and Feasibility of Transurethral Catheter Self-Discontinuation (FLOTUS) to examine at-home VT as a possible alternative to in-office VT following gynecologic surgery. FLOTUS subjects were given instructions on performing at-home catheter self-discontinuation with autofill VT (“at-home VT”) on postoperative day (POD) 1. Passing at-home VT was defined as voiding at least 150 mL over 6 hours.
Retrospective cohort of in-office backfill-assisted voiding trial versus at-home catheter discontinuation with autofill voiding trial on the day after urogynecologic surgery
A Davenport, C Chung, H William, A Dieter
10.1016/j.ajog.2024.02.058
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1175
S1176
-
Tissue retrieval of laparoscopically excised adnexal specimens in gynecologic surgery: posterior culdotomy versus abdominal extraction
https://www.ajog.org/article/S0002-9378(24)00128-5/fulltext?rss=yes
Despite the established benefits of minimally invasive surgery, tissue extraction can remain a challenge to successfully complete a procedure in a minimally invasive fashion or without the need to significantly enlarge an abdominal incision. For this reason, specimen extraction via the posterior culdotomy has gained attention in more recent years. Limited studies have evaluated the technique, but available data suggest it is safe and feasible, with possible reduction in postoperative pain scores.
Tissue retrieval of laparoscopically excised adnexal specimens in gynecologic surgery: posterior culdotomy versus abdominal extraction
T Horton, H Palin, A Carrubba
10.1016/j.ajog.2024.02.057
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1175
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Learning curve of laparoscopic myomectomy in recently-graduated minimally invasive gynecologic surgeons: a cumulative sum analysis
https://www.ajog.org/article/S0002-9378(24)00127-3/fulltext?rss=yes
Laparoscopic myomectomy is a technically challenging surgery. Prior studies have evaluated surgical learning curves to determine when proficiency is obtained for specific procedures. However, the learning curve for laparoscopic myomectomy has not yet been assessed. While MIGS fellowship helps graduates to achieve laparoscopic myomectomy competence, proficiency is likely obtained after independent practice.
Learning curve of laparoscopic myomectomy in recently-graduated minimally invasive gynecologic surgeons: a cumulative sum analysis
A Kosmacki, R Huang, C Mulligan, C Okuagu, E Bardawil, K De Souza, S Biest, W Ross
10.1016/j.ajog.2024.02.056
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1174
S1175
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Leiomyoma characteristics and their effect on lower urinary tract symptoms after surgical treatment of leiomyomas
https://www.ajog.org/article/S0002-9378(24)00126-1/fulltext?rss=yes
Leiomyomas are associated with lower urinary tract symptoms (LUTS). Several studies identify baseline leiomyoma characteristics associated with the prevalence of LUTS, including size and location. While some data demonstrate improvement in urinary symptoms following leiomyoma debulking, few studies define baseline leiomyoma characteristics associated with symptomatic improvement following surgical management.
Leiomyoma characteristics and their effect on lower urinary tract symptoms after surgical treatment of leiomyomas
I Agu, S Mcfarlane, B Cureton, ET Carey, CM Chu
10.1016/j.ajog.2024.02.055
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1172
S1174
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Fibroids larger than 10 cm and pregnancy outcomes: does location matter?
https://www.ajog.org/article/S0002-9378(24)00125-X/fulltext?rss=yes
Fibroids are the most common uterine neoplasm, occurring in at least 20–25% of all reproductive age women. They have been associated with a number of pregnancy complications. The location and size have also been associated with adverse obstetrical outcomes. However, there is scant literature evaluating these outcomes, specifically in cases when the fibroids are larger than 10 cm.
Fibroids larger than 10 cm and pregnancy outcomes: does location matter?
R Jalloul, K Schmidt, C Livingston, D Goodly, B Sibai
10.1016/j.ajog.2024.02.054
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1171
S1172
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Leveraging electronic alerts to enhance the detection of post-operative complications in the emergency department after gynecologic surgery
https://www.ajog.org/article/S0002-9378(24)00124-8/fulltext?rss=yes
Complications are a risk of surgery. Delayed recognition of post-operative complications can exacerbate morbidity. Delays of care in patients presenting to the emergency department (ED) is multifactorial, and strategies to mitigate the risks for post-surgical patients have not been well-described. For patients whose care spans across different units and specialties, electronic warning systems are a known tool to prevent catastrophic outcomes.
Leveraging electronic alerts to enhance the detection of post-operative complications in the emergency department after gynecologic surgery
B Geng, N Pondugula, R Sangal, L Lundsberg, H Zurich, L Fan
10.1016/j.ajog.2024.02.053
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1171
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Battle of the bots: a comparative analysis of generative ai responses from leading chatbots to patient questions about endometriosis
https://www.ajog.org/article/S0002-9378(24)00123-6/fulltext?rss=yes
The use of generative artificial intelligence (AI) has begun to permeate through most industries including medicine, and it is inevitable that patients will begin using these large language model chat bots as a modality for education. Different chatbots can provide different answers to the same question due to variability in training data, the statistical nature of response production and use-specific interactions. As healthcare information technology continues to evolve, it is imperative to evaluate chatbots and the accuracy of the information they provide to patients, and to determine if there is variability between them.
Battle of the bots: a comparative analysis of generative ai responses from leading chatbots to patient questions about endometriosis
N Cohen, K Kho, K Smith
10.1016/j.ajog.2024.02.052
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1170
-
Performance of chat generative pre-trained transformer (ChatGPT) on personal review of learning in obstetrics and gynecology
https://www.ajog.org/article/S0002-9378(24)00122-4/fulltext?rss=yes
Chat generative pre-trained transformer (ChatGPT) is a natural language processing model that uses an unsupervised deep learning algorithm to process prompts and produce a human-like response through prediction of the most likely word in a sequence. There is increasing interest in the application of ChatGPT in medicine, including the development of medical education and patient materials. Therefore, it is important to understand ChatGPT’s medical specialty specific knowledge.
Performance of chat generative pre-trained transformer (ChatGPT) on personal review of learning in obstetrics and gynecology
A Cohen, J Burns, M Gabra, A Gordon, N Deebel, R Terlecki, K Woodburn
10.1016/j.ajog.2024.02.051
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1169
S1170
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Current trends in surgical procedures for stress urinary incontinence
https://www.ajog.org/article/S0002-9378(24)00121-2/fulltext?rss=yes
Colposuspensions and pubovaginal slings were commonplace surgeries for stress urinary incontinence (SUI) until the 1990s when the mid urethral sling (MUS) was introduced. The sling offered an effective, fast, and safe surgical management option and became the gold standard. Urogynecology and Reconstructive Pelvic Surgery (URPS) fellows are required to perform a minimum of 5 retropubic procedures. This has become increasingly difficult to achieve due to the shift in management of SUI in the United States.
Current trends in surgical procedures for stress urinary incontinence
C Seaman, C Sham, D Lieberman, L Dabney, C Ascher-Walsh, A Romanova, A Hardart
10.1016/j.ajog.2024.02.050
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1169
-
Urinary tract injuries during hysterectomy for endometriosis: a NSQIP study
https://www.ajog.org/article/S0002-9378(24)00120-0/fulltext?rss=yes
Urinary tract injuries following hysterectomy are rare, though endometriosis is a known risk factor. Rates of injury in this setting following wide adoption of laparoscopy are of interest.
Urinary tract injuries during hysterectomy for endometriosis: a NSQIP study
B Hickey, K Stewart, A Cope, K Tessier, C Fok, S Hutto
10.1016/j.ajog.2024.02.049
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1168
S1169
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Association between limited english proficiency and OASIS injury
https://www.ajog.org/article/S0002-9378(24)00119-4/fulltext?rss=yes
Between 2009 to 2013, US Census Data identified 25 million individuals with limited English proficiency (LEP). Non-English speakers face decreased access to health care, decreased quality of healthcare, and increased risk of adverse health outcomes. As pregnant women with LEP suffer disparities in obstetric care, outcomes following challenging deliveries, including the occurrence of OASIS injuries may be impacted. There currently is limited evidence on the relationship between LEP and OASIS injuries.
Association between limited english proficiency and OASIS injury
A Nadgauda, T Ganti, X Jiang, J Long
10.1016/j.ajog.2024.02.048
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1167
S1168
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Natural experiment: clinical pathway for hysterectomy care in a statewide surgical collaborative leads to fewer complications and more efficient care
https://www.ajog.org/article/S0002-9378(24)00118-2/fulltext?rss=yes
Reducing complications and improving efficiency is an imperative for quality improvement (QI) in healthcare. To guide healthcare teams in best practices, a statewide surgical quality collaborative developed a clinical pathway of favored practices for hysterectomy.
Natural experiment: clinical pathway for hysterectomy care in a statewide surgical collaborative leads to fewer complications and more efficient care
D Morgan, W Weng, J Boyd, P Raachi, Y Chen, M Moniz
10.1016/j.ajog.2024.02.047
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1167
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Mapping out an anatomic zone of safety of the presacral space for sacrocolpopexy suture placement
https://www.ajog.org/article/S0002-9378(24)00117-0/fulltext?rss=yes
Safe dissection and suture placement during sacrocolpopexy requires knowledge of critical anatomy in and around the presacral space. Understanding the thickness of the anterior longitudinal ligament (ALL) facilitates judicious suture and mesh placement that may promote durability of prolapse repair while decreasing complications. As minimally invasive approaches become the preferred route, the impact of reduced haptic feedback to aid in suture location has been more apparent. Although prior investigations have described the thickness in the craniocaudal orientation, few have studied the lateral relationship.
Mapping out an anatomic zone of safety of the presacral space for sacrocolpopexy suture placement
S Bhandari Randhawa, LA King, ME Florian-rodriguez, JM Shelton, J Williams, JE Pruszynski, CY Wai
10.1016/j.ajog.2024.02.046
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1166
S1167
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A bundle of evidence-based opioid-sparing strategies (BOSS) to eliminate routine opioid prescribing after minimally invasive pelvic reconstructive surgery
https://www.ajog.org/article/S0002-9378(24)00116-9/fulltext?rss=yes
Although many patients do not use prescribed opioids following reconstructive pelvic surgery, it is unclear if it is feasible to eliminate routine opioid prescriptions without a negative impact on patients or providers.
A bundle of evidence-based opioid-sparing strategies (BOSS) to eliminate routine opioid prescribing after minimally invasive pelvic reconstructive surgery
J Selle, D Strozza, M Branda, J Gebhart, E Trabuco, J Occhino, B Linder, S El Nashar, A Madsen
10.1016/j.ajog.2024.02.045
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1165
S1166
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36 month outcomes to a randomized clinical trial of perioperative vaginal estrogen as adjunct to native tissue vaginal apical prolapse repair
https://www.ajog.org/article/S0002-9378(24)00114-5/fulltext?rss=yes
As the muscular and connective tissue components of the vagina are estrogen-responsive, clinicians may recommend vaginal estrogen to “optimize” tissues preoperatively and as a possible means to reduce prolapse recurrence, but long-term effects of perioperative intravaginal estrogen on surgical prolapse management are uncertain.
36 month outcomes to a randomized clinical trial of perioperative vaginal estrogen as adjunct to native tissue vaginal apical prolapse repair
D Rahn, H Richter, V Sung, J Pruszynski
10.1016/j.ajog.2024.02.043
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1163
S1164
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Views and values of the uterus across the united states – a multicenter mixed-methods analysis (VUterus)
https://www.ajog.org/article/S0002-9378(24)00113-3/fulltext?rss=yes
Traditionally, counseling for a hysterectomy procedure is focused on surgical and treatment outcomes. With the growing number of uterine-preserving procedures available for benign gynecologic conditions, there is a need to understand the value that women place on the uterus.
Views and values of the uterus across the united states – a multicenter mixed-methods analysis (VUterus)
O Chang, A Huynh, N Ringel, P Hudson, G Halder, W Winkelman, J Ton, E Davidson, K Meriwether
10.1016/j.ajog.2024.02.042
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1162
S1163
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Excess use of surgical supplies in minimally invasive benign gynecology surgery: an observational study
https://www.ajog.org/article/S0002-9378(24)00112-1/fulltext?rss=yes
Single use materials and equipment are regularly opened by the surgical team during procedures but left unused, potentially resulting in superfluous costs and excess environmental waste.
Excess use of surgical supplies in minimally invasive benign gynecology surgery: an observational study
A Mohr-Sasson, M Aycock, N Higgason, M Hui, A Bhalwal, R Jalloul, O Dziadek, M Leon, A Montealegre
10.1016/j.ajog.2024.02.041
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1162
-
The presacral space re-visited. correlation between presacral depth and body mass index (BMI)
https://www.ajog.org/article/S0002-9378(24)00111-X/fulltext?rss=yes
Sacrocolpopexy has been thought to be the most durable operation for advanced pelvic organ prolapse. The surgical technique involves dissection of the presacral space (PSS) to the anterior longitudinal ligament (ALL) for mesh fixation. Increased depth of the presacral space from adipose deposition can make this dissection more challenging and may increase risk of injury to nearby structures. There is currently a paucity of data regarding what patient factors affect the depth of the presacral space.
The presacral space re-visited. correlation between presacral depth and body mass index (BMI)
K Gulbrand, A Laporte, A Sammarco, M Masteling, J Swensson, J De Lancey, J Hamner
10.1016/j.ajog.2024.02.040
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1161
S1162
-
Surgical recovery among patients with chronic pain undergoing pelvic reconstructive surgery: a prospective cohort study
https://www.ajog.org/article/S0002-9378(24)00110-8/fulltext?rss=yes
A majority of patients undergoing pelvic reconstructive surgery recover well, with overall low pain scores, narcotic requirements postoperatively and early return to physical activity. The majority of the studies evaluating the postoperative recovery specifically exclude patients with chronic pain so information is limited regarding the postoperative recovery and pain management requirements in this patient population.
Surgical recovery among patients with chronic pain undergoing pelvic reconstructive surgery: a prospective cohort study
A Werth, E Tunitsky, V Abalyan, D O'sullivan, E Sappenfield
10.1016/j.ajog.2024.02.039
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1159
S1161
-
Work related pain in gynecologic surgeons - a survey study
https://www.ajog.org/article/S0002-9378(24)00109-1/fulltext?rss=yes
Surgeons are at particularly high risk for work-related pain (WRP). WRP contributes to decreased surgical productivity, disability leave, and early retirement in procedural-focused physicians. Pelvic surgery offers unique ergonomic challenges for the gynecologic surgeon; however, this specific population is understudied.
Work related pain in gynecologic surgeons - a survey study
R Young, A Allen, D Mcintire, E Robinson, O Bougie, K Kho
10.1016/j.ajog.2024.02.038
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1158
S1159
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The impact of social determinants and social support on surgical outcomes among hysterectomy patients during the COVID-19 pandemic
https://www.ajog.org/article/S0002-9378(24)00108-X/fulltext?rss=yes
Gynecologic surgery outcome research during the SARS-CoV-2 (COVID-19) pandemic is lacking. There exists limited investigation regarding the impact of mental health, social support, and socioeconomic status on gynecology patients during the pandemic.
The impact of social determinants and social support on surgical outcomes among hysterectomy patients during the COVID-19 pandemic
A Hare, E Tappy, J Schaffer, K Kossl, B Gaigbe-Togbe, A Kapadia, A Dieter, J Hamner, A Laporte, T Mou, M Mueller, J Doo, A Park, G Chapman, G Northington, M Shockley, C Iglesia, M Heit
10.1016/j.ajog.2024.02.037
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1157
S1158
-
The role of gender bias in patient ratings of minimally invasive gynecologic surgeons
https://www.ajog.org/article/S0002-9378(24)00107-8/fulltext?rss=yes
Gender disparities are known to occur within academic and healthcare systems. Wage gaps and under representation in leadership positions have been reported to be more of a reality for female surgeons than their male colleagues. Moreover, a recent study noted that patients' implicit bias of provider gender may impact how they rate their surgeon. Our study attempts to further investigate and explore the role of gender bias amongst patient ratings in surgeons trained in minimally invasive gynecologic surgery.
The role of gender bias in patient ratings of minimally invasive gynecologic surgeons
P Urbina, L Yang, S Swartz, A Emeka
10.1016/j.ajog.2024.02.036
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1157
-
Workplace microaggressions: results of a survey of the american college of surgeons (ACS) members
https://www.ajog.org/article/S0002-9378(24)00106-6/fulltext?rss=yes
There is growing awareness that workplace microaggressions are a longstanding problem in the health care workforce. Microaggressions are a detriment to the recipient as well as bystanders and can be disruptive to a functional team dynamic, lowering job satisfaction and organizational commitment. They are linked to negative emotional and physical health outcomes and can contribute to burnout and suboptimal delivery of patient care. They also negatively impact recruitment, retention and promotion of qualified personnel, which often results in attrition.
Workplace microaggressions: results of a survey of the american college of surgeons (ACS) members
H Heisler, A Godecker, J Byam, D Verran, M Sinha, P Miller
10.1016/j.ajog.2024.02.035
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1156
S1157
-
Effect of a guided video-based coaching session on resident satisfaction and confidence: a randomized control trial
https://www.ajog.org/article/S0002-9378(24)00105-4/fulltext?rss=yes
There is a recognized need for improved quality and quantity of structured feedback in surgical education. MyTip has been utilized in ObGyn as a feedback and evaluation tool across multiple training programs. However, there is limited data evaluating MyTIP as a feedback tool. Surgical coaching and video review are widely accepted as beneficial to surgical education. Data to support video-based coaching within ObGyn narrowly focuses on suturing and recordings of simulations. There are no current studies examining the impact of video-based review of live surgery on resident satisfaction with feedback or confidence.
Effect of a guided video-based coaching session on resident satisfaction and confidence: a randomized control trial
P Giglioayers, K Zaluski, MM Scarpaci, BS Hampton, CE Foley
10.1016/j.ajog.2024.02.034
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1154
S1156
-
The SAVVy study: SGS/AAGL survey of barriers for vaginal access surgery
https://www.ajog.org/article/S0002-9378(24)00104-2/fulltext?rss=yes
Vaginal hysterectomy is associated with decreased perioperative morbidity and healthcare costs. However, recent trends have shown that fewer gynecologists are using the vaginal approach to perform hysterectomy.
The SAVVy study: SGS/AAGL survey of barriers for vaginal access surgery
G Halder, C Ferrando, R Kho, C Elhenawy, C Grimes, S Balgobin, R Rogers, A Sokol
10.1016/j.ajog.2024.02.033
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1153
S1154
-
Geographic distribution and accessibility of urogynecology subspecialists across the united states
https://www.ajog.org/article/S0002-9378(24)00103-0/fulltext?rss=yes
The geographic distribution of gynecologic healthcare providers may vary between generalists and subspecialists. Patients living in areas remote from urogynecology subspecialists might face challenges when seeking specialized care for pelvic floor disorders. Identifying geographic regions with limited access to urogynecologic subspecialists may aid in efforts to improve access to urogynecologic healthcare.
Geographic distribution and accessibility of urogynecology subspecialists across the united states
C Hong, J Wang, D Morgan
10.1016/j.ajog.2024.02.032
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1152
S1153
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Man vs. machine: identifying chatGPT-generated abstracts in gynecology and urogynecology
https://www.ajog.org/article/S0002-9378(24)00102-9/fulltext?rss=yes
The advent of ChatGPT, a publicly available artificial intelligence (AI) language model, has allowed for sophisticated AI technology on demand. With widespread access to AI writing, the medical community has yet to understand the capabilities and ethical considerations of AI chatbots in the context of scientific research.
Man vs. machine: identifying chatGPT-generated abstracts in gynecology and urogynecology
E Pan, M Florian-Rodriguez
10.1016/j.ajog.2024.02.031
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1151
S1152
-
Association of Catechol-O-Methyltransferase (COMT) val158met genetic polymorphism and outcomes following sacral neuromodulation or onabotulinumtoxina in women with urgency irinary incontinence
https://www.ajog.org/article/S0002-9378(24)00101-7/fulltext?rss=yes
The mechanism of action of neuromodulation (percutaneous tibial nerve stimulation [PTNS] or sacral neuromodulation [SNM]) for the treatment of urgency urinary incontinence and/or fecal incontinence is poorly understood. Previously we showed an association between the catechol-O-methyltransferase (COMT) Val158Met (rs4680) single nucleotide polymorphism (SNP) and PTNS response in women with fecal incontinence. We hypothesized that COMT may also be associated with response to SNM.
Association of Catechol-O-Methyltransferase (COMT) val158met genetic polymorphism and outcomes following sacral neuromodulation or onabotulinumtoxina in women with urgency irinary incontinence
M Florian-Rodriguez, H Richter, M Carnes, H Zyczynski, E Lukacz, A Visco, L Arya, V Sung, D Mazloomdoost, M Gantz
10.1016/j.ajog.2024.02.030
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1150
S1151
-
Sterilization surgery trends in texas after passage of the texas heartbeat act
https://www.ajog.org/article/S0002-9378(24)00100-5/fulltext?rss=yes
On September 1, 2021, abortion became illegal in Texas once embryonic cardiac activity could be detected. Before that, elective abortions were allowed up to 20 weeks post-fertilization. The change in law led women seeking abortions to face logistical, emotional, and financial hardships. In order to primarily avoid unwanted pregnancy, a trend for younger women to seek a definite contraception method has been observed, however, this has not been studied.
Sterilization surgery trends in texas after passage of the texas heartbeat act
A Mohr-Sasson, L Weitzel, S Carlisle, A Bhalwal
10.1016/j.ajog.2024.02.029
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1150
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Patient perspectives in adverse event reporting after apical prolapse surgery
https://www.ajog.org/article/S0002-9378(24)00099-1/fulltext?rss=yes
Many clinical trials use systematic methodology to monitor adverse events (AEs) determining grade (severity), expectedness and relatedness to treatments from the clinician perspective; however, there is a lack of input from the patient perspective.
Patient perspectives in adverse event reporting after apical prolapse surgery
V Sung, S Menefee, H Richter, P Moalli, M Paraiso, U Andy, A Weidner, S Jeney, D Mazloomdoost, R Whitworth, J Gilbert, S Thomas
10.1016/j.ajog.2024.02.028
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1149
S1150
-
Pain without prejudice? examining disparities in endometriosis and pelvic pain management stratified by race in an integrative healthcare system
https://www.ajog.org/article/S0002-9378(24)00098-X/fulltext?rss=yes
An estimatedApproximately 10% of reproductive age women suffer from endometriosis; however, racial variations in prevalence and treatment are unknown. Black women are often undertreated for pain and medical conditions.
Pain without prejudice? examining disparities in endometriosis and pelvic pain management stratified by race in an integrative healthcare system
E Zaritsky, A Childs, E Hen, L Tucker, M Weintraub-Ritterman, C Wicks
10.1016/j.ajog.2024.02.027
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1148
S1149
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Effectiveness & safety of a novel, collapsible pessary for management of pelvic organ prolapse
https://www.ajog.org/article/S0002-9378(24)00097-8/fulltext?rss=yes
Pessaries are an effective treatment for pelvic organ prolapse, yet currently available pessaries can cause discomfort with removal and insertion. An early feasibility trial of an investigational, collapsible pessary (Figures 1A and 1B) previously demonstrated mechanical feasibility during a brief 15-minute office trial. Longer term, patient-centered safety and efficacy data is needed.
Effectiveness & safety of a novel, collapsible pessary for management of pelvic organ prolapse
K Strohbehn, P Wadensweiler, H Richter, C Grimes, C Rardin, P Rosenblatt, M Toglia, G Siddiqui
10.1016/j.ajog.2024.02.026
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1148
-
Retropubic versus single-incision mid-urethral sling for concomitant management of stress urinary incontinence during native tissue vaginal repair: a randomized clinical trial
https://www.ajog.org/article/S0002-9378(24)00096-6/fulltext?rss=yes
Choice of mid urethral sling type may impact efficacy and complications in women undergoing transvaginal native tissue repair of multicompartment pelvic organ prolapse (POP).
Retropubic versus single-incision mid-urethral sling for concomitant management of stress urinary incontinence during native tissue vaginal repair: a randomized clinical trial
C Matthews, C Rardin, A Sokol, C Iglesia, S Collins, C Ferrando, H Winkler, K Kenton, J Geynisman-Tan, R Gutman
10.1016/j.ajog.2024.02.025
American Journal of Obstetrics & Gynecology 230, 4 (2024)
2024-04
American Journal of Obstetrics & Gynecology
2024-04
230
4
S0002-9378(24)X0005-8
S1147