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BJOG: An International Journal of Obstetrics and Gynaecology

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https://www.readbyqxmd.com/read/28646578/the-impact-of-a-novel-transendometrial-approach-for-caesarean-myomectomy-on-obstetric-outcomes-of-subsequent-pregnancy-a-longitudinal-panel-study
#1
S Y Huang, S W Shaw, S Y Su, W F Li, H H Peng, P J Cheng
OBJECTIVE: To evaluate the obstetric and surgical outcomes of a novel transendometrial approach for myomectomy during caesarean section in subsequent pregnancies. DESIGN: Longitudinal panel study. SETTING: Chang Gung Memorial Hospital, Taiwan, with approximately 5000 births per annum. POPULATION: Pregnant women complicated with uterine myoma. METHOD: Sixty-three pregnant women who received transendometrial myomectomy during the first caesarean delivery reported a subsequent live pregnancy and planned an elective repeat caesarean delivery...
June 24, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28646576/accuracy-of-visual-cervical-screening-verification-bias-revisited
#2
Nicolas Wentzensen, Tamara Litwin
Cytology-based cervical cancer screening has led to substantial reductions in cancer incidence and mortality. Today, most cervical cancers arise in low-resource countries without screening. Since implementation of cytology is not feasible in most developing countries, visual screening and HPV testing are evaluated as alternative strategies. This article is protected by copyright. All rights reserved.
June 24, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28636771/is-transvaginal-contained-tissue-extraction-for-everyone
#3
Charles Miller
Professor Ghezzi, et al. should be congratulated for their excellent manuscript "Transvaginal Contained Tissue Extraction After Laparoscopic Myomectomy: A Cohort Study". This is a well-conceived, well-written retrospective cohort study describing operative and peri-operative outcomes for patients who have undergone transvaginal morcellation via a posterior colpotomy. Given the continued controversy regarding electronic power morcellation leading to restriction of use in certain areas, this study is not only impactful, in that it describes an alternative technique with data accumulated over a decade of experience, but it describes a technique of contained morcellation that is neither based on the controversial power morcellation, nor the mini-laparotomy (https://www...
June 21, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28631308/association-between-inadequate-antenatal-care-utilisation-and-severe-perinatal-and-maternal-morbidity-an-analysis-in-the-precare-cohort
#4
M Linard, B Blondel, C Estellat, C Deneux-Tharaux, D Luton, J F Oury, T Schmitz, L Mandelbrot, E Azria
OBJECTIVE: Because the effectiveness of antenatal care in reducing pregnancy complications is still discussed despite widespread recommendations of its use, we sought to assess the association between utilisation of recommended antenatal care and severe maternal (SMM) and perinatal morbidity (SPM). DESIGN: Prospective cohort study. SETTING: Four maternity units around Paris in 2010-2012. SAMPLE: 9117 women with singleton pregnancies...
June 20, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28626980/comparison-of-management-regimens-following-ultrasound-diagnosis-of-nontubal-ectopic-pregnancies-a-retrospective-cohort-study
#5
J Ramkrishna, G R Kan, K L Reidy, W C Ang, R Palma-Dias
OBJECTIVE: To review management options for nontubal ectopic pregnancies. DESIGN: Retrospective cohort study. SETTING: Tertiary hospital in Melbourne, Australia. POPULATION: A total of 100 nontubal pregnancies: 1 abdominal, 32 caesarean scar, 14 cervical, 41 cornual-interstitial, 12 ovarian. METHODS: Cases were classified according to ectopic site. Management categories were medical, surgical, combination or expectant...
June 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28626982/vaginal-seeding-or-vaginal-microbial-transfer-from-the-mother-to-the-cesarean-born-neonate-a-commentary-regarding-clinical-management
#6
Thor Haahr, Julie Glavind, Paul Axelsson, Margit Bistrup Fischer, Johanna Bjurström, Gudbjörg Andrésdóttir, Dorte Teilmann-Jørgensen, Ulla Bonde, Nina Olsén Sørensen, Margrethe Møller, Jens Fuglsang, Per G Ovesen, Jesper P Petersen, Jakob Stokholm, Tine D Clausen
Recent evidence suggests cesarean delivery (CD) to be a risk factor for inflammatory and metabolic diseases such as asthma, allergies and other chronic immune disorders in the child. One hypothetical pathogenesis of these associations has been proposed to be a disruption of the neonatal colonization (NC) after CD. To further support this hypothesis, it has been observed that the effect of CD on NC was different according to type of CD, i.e. planned or emergency, and that the risk of asthma in children born by CD was mitigated by rupture of membranes, though still increased compared to children delivered vaginally...
June 18, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28618175/the-ominous-association-between-severe-endometriosis-in-vitro-fertilisation-and-placenta-praevia-raising-awareness-limiting-risks-informing-women
#7
Paolo Vercellini, Maria Pina Frattaruolo, Giussy Barbara, Laura Buggio, Edgardo Somigliana
Endometriosis is associated with several adverse pregnancy outcomes.(1) The most severe maternal complications are spontaneous haemoperitoneum in the second half of pregnancy and placenta praevia.(1) Spontaneous haemoperitoneum, mostly associated with endometriosis infiltrating the broad and uterosacral ligaments and the Douglas pouch, is a potentially fatal but rare event. Placenta praevia is more common,(1-3) and it is important to define its incidence, the association with different lesion types, the impact of additional risk factors, the potential obstetrical consequences, and the information that women should receive...
June 15, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28613432/medical-therapy-for-preventing-recurrent-endometriosis-after-conservative-surgery-a-cost-effectiveness-analysis
#8
Bin Wu, Zhiyou Yang, Ruoyan Gai Tobe, Yu Wang
OBJECTIVE: To assess the cost-effectiveness of different strategies, including the gonadotropin-releasing hormone agonist (GnRH-a) and oral contraceptive therapy, for the prevention of endometriosis recurrence after conservative surgery. DESIGN: Cost-effectiveness analysis from a health care perspective. SETTING: Chinese setting represented as a health resource limited setting. POPULATION: patients who undergo laparoscopic or laparotomic conservative surgery for endometriosis...
June 14, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28603938/should-we-implement-universal-screening-with-late-pregnancy-ultrasound-to-prevent-stillbirth
#9
Gordon C S Smith
The first description of ultrasound to estimate fetal weight was published in 1975.(1) More than 40 years later, we still do not know whether universal use of this method prevents perinatal deaths. Multiple lines of evidence suggest that it should work: (i) stillbirth is strongly associated with fetal growth restriction (FGR),(2) (ii) current methods using targeted ultrasound have low detection rates for FGR,(3) (iii) there is strong evidence that induction of labour at term reduces perinatal mortality. This article is protected by copyright...
June 12, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28603909/accuracy-of-combinations-of-visual-inspection-using-acetic-acid-or-lugol-iodine-to-detect-cervical-precancer-a-meta-analysis
#10
Rosa Catarino, Sonja Schäfer, Pierre Vassilakos, Patrick Petignat, Marc Arbyn
BACKGROUND: Visual inspection of the cervix with acetic acid (VIA) or lugol's Iodine (VILI) have been evaluated for cervical cancer screening in developing countries. OBJECTIVES: To assess the diagnostic accuracy and clinical utility of visual methods to detect CIN2+ using: 1) VIA alone, 2) VILI alone, 3) Cotesting, and 4) VILI as triage test of a positive VIA result. SEARCH STRATEGY: PubMed, EMBASE and the Cochrane Library up to May 2016 were searched...
June 12, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28602031/audit-and-feedback-using-the-robson-classification-to-reduce-caesarean-section-rates-a-systematic-review
#11
Adeline Adwoa Boatin, Fiona Cullinane, Maria Regina Torloni, Ana Pilar Betrán
BACKGROUND: In most regions worldwide caesarean section (CS) rates are increasing. In these settings, new strategies are needed to reduce CS rates. OBJECTIVES: To identify, critically appraise and synthesize studies using the Robson classification as a system to categorise and analyse data in clinical audit cycles to reduce CS rates. SEARCH STRATEGY: Medline, Embase, CINAHL and LILACS were searched from 2001-2016. SELECTION CRITERIA: Studies reporting use of the Robson classification to categorise and analyse data in clinical audit cycles to reduce CS rates...
June 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28600893/pregnancy-marfan-syndrome-and-type-b-aortic-dissection
#12
Mark R Johnson, Jolien W Roos Hesselink
Sayama et al describe the outcome of 17 pregnancies in 15 women with a clinical or genetic diagnosis of Marfan syndrome (MS) as per the revised Ghent criteria (Dietz et al, J Med Genet. 2010;47;476-85). Five patients (5 pregnancies) had undergone aortic root replacement prior to pregnancy and 10 (12 pregnancies) had not. A type B aortic dissection AD(B) occurred in 3 of the 5 with prior aortic root replacement (ARR) and 1 of the 10, without. This case series reminds us of critically important points in the management of pregnant women with MS who have undergone ARR...
June 10, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28557289/how-do-late-terminations-of-pregnancy-affect-comparisons-of-stillbirth-rates-in-europe-analyses-of-aggregated-routine-data-from-the-euro-peristat-project
#13
B Blondel, M Cuttini, A D Hindori-Mohangoo, M Gissler, M Loghi, C Prunet, A Heino, L Smith, K van der Pal-de Bruin, A Macfarlane, J Zeitlin
OBJECTIVE: to describe how terminations of pregnancy at gestational ages at or above the limit for stillbirth registration are recorded in routine statistics and to assess their impact on comparability of stillbirth rates in Europe. DESIGN: analysis of aggregated data from the Euro-Peristat project. SETTING: 29 European countries. POPULATION: births and late terminations in 2010. METHODS: assessment of terminations as a proportion of stillbirths and derivation of stillbirth rates including and excluding terminations...
May 30, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28548227/changing-the-risk-threshold-for-surgical-prevention-of-ovarian-cancer
#14
Ranjit Manchanda, Rosa Legood, Antonis C Antoniou, Leigh Pearce, Usha Menon
Ovarian cancer (OC) remains a lethal disease and a major cause of deaths from gynaecological cancer particularly in western countries. Despite advances in treatment, there have been only marginal improvements in survival rates over the last 30years. Additionally, the number of OC cases in the UK is estimated to increase by 27-45%, which translates to a 15% rise in the incidence rate by 2035.(1) A national OC screening programme is unavailable as this has not yet shown a conclusive mortality benefit.(2) Hence, primary prevention continues to be the cornerstone in reducing the burden of OC and improving health outcomes...
May 26, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28544572/inositol-treatment-of-anovulation-in-women-with-polycystic-ovary-syndrome-a-meta-analysis-of-randomised-trials
#15
Jyotsna Pundir, Dimitrios Psaroudakis, Prakash Savnur, Priya Bhide, Luca Sabatini, Helena Teede, Arri Coomarasamy, Shakila Thangaratinam
BACKGROUND: Polycystic ovary syndrome is a common cause of anovulation and infertility, and a risk factor for development of metabolic syndrome and endometrial cancer. OBJECTIVES: Systematic review and meta-analysis of randomised controlled trials that evaluated the effects of inositol as an ovulation-induction agent. SEARCH STRATEGY: We searched MEDLINE, EMBASE, Cochrane and ISI conference proceedings, Register and Meta-register for RCTs and WHO trials' search portal...
May 24, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28544220/gdm-shades-of-gray
#16
Robert M Silver
In this issue of BJOG, Kapur and colleagues call for all European women to undergo screening for gestational diabetes (GDM) as recommended by FIGO (Kapur et al., BJOG 2017 XX). They rightly note the adverse fetal, neonatal, and maternal effects of GDM as well as possible downstream implications for the mother and child. Their recommendations echo those of several leading organizations including FIGO. However, despite these recommendations, some European countries, communities, hospitals and clinicians do not screen all women for GDM...
May 24, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28544260/hysteroscopic-excision-of-symptomatic-myometrial-adenomyosis-feasibility-and-effectiveness
#17
W Xia, D Zhang, Q Zhu, H Zhang, S Yang, J Ma, H Pan, T Tong, J Sun, J Zhang
OBJECTIVE: To explore the feasibility and efficacy of hysteroscopic excision of myometrial adenomyotic lesions. DESIGN: A case-series study. SETTING: A university medical centre. POPULATION: 51 women with myometrial adenomyosis completed the study. METHODS: The patients underwent hysteroscopic excision of myometrial adenomyosis and were followed up for 24 months. The degree of symptoms, uterine volume, and serum CA125 concentrations were recorded...
May 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28516500/healthcare-utilisation-induced-labour-and-caesarean-section-in-the-pregnancy-after-stillbirth-a-prospective-study
#18
Ida Kathrine Gravensteen, Eva-Marie Jacobsen, Per Morten Sandset, Linda Björk Helgadottir, Ingela Rådestad, Leiv Sandvik, Øivind Ekeberg
OBJECTIVE: To investigate healthcare utilisation, induced labour and caesarean section (CS) in the pregnancy after stillbirth and assess anxiety and dread of childbirth as mediators for these outcomes. DESIGN: Population-based pregnancy cohort study. SETTING: The Norwegian Mother and Child Cohort Study. SAMPLE: 901 pregnant women; 174 pregnant after stillbirth, 362 pregnant after live birth and 365 previously nulliparous...
May 18, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28504857/hysteroscopic-resection-of-a-uterine-caesarean-scar-defect-niche-in-women-with-postmenstrual-spotting-a-randomised-controlled-trial
#19
A J M W Vervoort, L F Van der Voet, W J K Hehenkamp, A L Thurkow, P J M van Kesteren, H Quartero, W Kuchenbecker, M Bongers, P Geomini, L H M de Vleeschouwer, M H A van Hooff, H van Vliet, S Veersema, W B Renes, K Oude Rengerink, S E Zwolsman, H A M Brölmann, B W J Mol, J A F Huirne
OBJECTIVE: To compare in women with postmenstrual spotting and a uterine caesarean scar defect the effectiveness of a hysteroscopic niche resection versus no treatment. DESIGN: Multicentre randomised controlled trial. SETTING: 11 hospitals collaborating in a consortium for women's health research in the Netherlands. POPULATION: Women reporting postmenstrual spotting after a caesarean section who had a niche with a residual myometrium of ≥3mm measured during sonohysterography...
May 15, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28502106/misoprostol-for-cervical-priming-prior-to-office-hysteroscopy-works-in-premenopausal-nulliparous-but-not-in-postmenopausal-women
#20
Shagaf Bakour
This randomized controlled trial (RCT) by Tasma et al. reports on pain at hysteroscopy. This is an important subject since hysteroscopy is the single most common procedure in gynaecology. There has been limited or conflicting evidence regarding misoprostol for cervical priming prior to hysteroscopy. Although there have been three meta-analyses and 25 RCTs published to date, the heterogeneity among regimens, doses, and route of administration plus clinical diversity, make analysis of the data difficult. This article is protected by copyright...
May 14, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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