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BJOG: An International Journal of Obstetrics and Gynaecology

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https://www.readbyqxmd.com/read/28432737/outcome-reporting-across-randomised-controlled-trials-evaluating-therapeutic-interventions-for-pre-eclampsia-a-systematic-review
#1
REVIEW
James M N Duffy, Martin Hirsch, Anusuya Kawsar, Chris Gale, Louise Pealing, Maria N Plana, Marian Showell, Paula R Williamson, Khalid S Khan, Sue Ziebland, Richard J McManus
BACKGROUND: Standardising outcome collection and reporting in pre-eclampsia trials requires an appraisal of current outcome reporting. OBJECTIVES: To map maternal and offspring outcome reporting across randomised trials evaluating therapeutic interventions for pre-eclampsia. SEARCH STRATEGY: Randomised trials were identified by searching bibliographical databases from inception to January 2016. SELECTION CRITERIA: Randomised controlled trials...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28432736/severe-primary-autoimmune-thrombocytopenia-itp-in-pregnancy-a-national-cohort-study
#2
A Care, S Pavord, M Knight, Z Alfirevic
OBJECTIVE: To quantify UK incidence of severe ITP in pregnancy, determine current treatment strategies and establish maternal and neonatal morbidity and mortality associated with severe ITP in pregnancy. DESIGN: A prospective national cohort study SETTING: United Kingdom POPULATION: Women with severe ITP; defined as platelets <50 x 10(9) /l in pregnancy or antenatal treatment of isolated low platelets. METHODS: Data collected via United Kingdom Obstetric Surveillance System (UKOSS) between 1(st) June 2013-31(st) January 2015 from all UK Consultant led obstetric units...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28432722/efforts-to-redefine-endometriosis-prevalence-in-low-risk-patients
#3
Linnea R Goodman, Jason M Franasiak
Endometriosis has significant implications on patient health and well-being, particularly when it comes to pelvic pain and infertility. However, the true epidemiologic state of the disease has remained elusive. Many of the foundational studies characterize surgically confirmed endometriosis in highly selected patient populations. It has been hypothesized that the prevalence of endometriosis is approximately 10% (Vigano et al, Best Practices and Research in Clinical OB/GYN, 2004, 18(2):177-200) of reproductive aged women and may reach rates of 30-50% in symptomatic women...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28432718/long-acting-reversible-contraception-conflicting-perspectives-of-advocates-and-potential-users
#4
S Rowlands, R Ingham
Worldwide, use of long-acting reversible contraception (LARC) has easily overtaken oral contraceptive use, now with double the prevalence.(1) Rates of LARC (defined as subdermal implants, intrauterine contraceptives and injectables) use are twice as high in the developing world as in the developed world.(1) There are many reasons for this increasing use of LARC, some to do with potential users and some to do with advocates of LARC. This article is protected by copyright. All rights reserved.
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28432715/complications-of-pregnancy-and-labor-in-women-with-klippel-trenaunay-syndrome-a-nationwide-cross-sectional-study
#5
S E R Horbach, M M Lokhorst, C E U Oduber, S Middeldorp, J A M van der Post, C M A M van der Horst
OBJECTIVE: To evaluate complications of pregnancy, including thromboembolism, in women with extensive vascular malformations associated with Klippel-Trenaunay Syndrome (KTS). DESIGN: Nationwide cross-sectional study. SETTING: Two tertiary expert centers and the Dutch Klippel-Trenaunay patient organization. SAMPLE: Adult women with KTS. METHODS: Patients with KTS were invited to participate in a comprehensive online survey about their obstetric history...
April 22, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28429869/importance-of-prenatal-care-in-reducing-stillbirth
#6
Robert L Goldenberg, Elizabeth M McClure
The concept of screening for complications prior to delivery originated more than 100 years ago. Initially, prenatal care focused on detecting preeclampsia to reduce maternal mortality with visits weighted toward the third trimester. This, together with increasing hospitalization and early delivery for women with preeclampsia, markedly reduced maternal mortality and reduced stillbirths as well. This article is protected by copyright. All rights reserved.
April 21, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28422398/do-mhealth-interventions-prevent-excessive-gestational-weight-gain
#7
S J Herring
Mobile technologies are nearly ubiquitous worldwide (Pew Research Center, Technology Device Ownership: 2015). These digital platforms hold considerable promise for delivering weight control interventions due to their broach reach, immediate scalability, and low implementation costs (Bennett G et al. Annu Rev Public Health 2009;30:273-92). There is evidence for their efficacy in promoting weight loss among non-pregnant adults with obesity (Flores Mateo G et al. J Med Internet Res 2015;17(11):e253), yet few studies have examined the feasibility and efficacy of mobile technologies for preventing excessive weight gain in pregnant women at highest risk...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28422387/should-we-be-putting-our-scalpel-down-is-hifu-the-answer-to-fertility-sparing-fibroid-treatment
#8
Nicola Tempest, Dharani Hapangama
Despite HIFU being a fertility sparing, outpatient procedure reported to be safe and effective in treating patients with fibroids for 15 years (Wang et al. Zhonghua Chao Sheng Ying Xiang Xue Za Zhi 2002; 11:161-63); approved by the FDA in America in 2004; and seen to have similar cost-effectiveness as all other uterine preserving treatments; it is currently only available in two private treatment centers and on a case by case basis on the NHS in the UK and not consistently covered by any major US insurance company...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28421665/evaluation-of-hifu-ablation-for-uterine-fibroids-an-ideal-prospective-exploration-study
#9
Jinyun Chen, Youping Li, Zhibiao Wang, Peter McCulloch, Liang Hu, Wenzhi Chen, Guanjian Liu, Jing Li, Jinghe Lang
OBJECTIVE: To evaluate the clinical outcomes of High intensity focused ultrasound (HIFU) and surgery in treating uterine fibroids, and prepare for a definitive randomised trial. DESIGN: Prospective multicentre patient choice cohort study (IDEAL Exploratory study) of HIFU, myomectomy or hysterectomy for treating symptomatic uterine fibroids. SETTING: 20 Chinese hospitals. POPULATION OR SAMPLE: 2411 Chinese women with symptomatic fibroids...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28421657/core-outcome-sets-in-women-s-and-newborn-health-a-systematic-review
#10
James M N Duffy, Rachel Rolph, Chris Gale, Martin Hirsch, Khalid S Khan, Sue Ziebland, Richard J McManus
BACKGROUND: Variation in outcome collection and reporting is a serious hindrance to progress in our specialty, over eighty journals have come together to support the development, dissemination, and implementation of core outcome sets. OBJECTIVE: This study systematically reviewed and characterised registered, progressing, or completed core outcome sets relevant to women's and newborn health. SEARCH STRATEGY: Systematic search using the Core Outcome Measures in Effectiveness Trial initiative and the Core Outcomes in Women's and Newborn Health initiative databases...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28421655/reduction-of-preterm-birth-rates-starts-at-preconception
#11
M A Oudijk
Obesity, in the absence of other chronic disease, is associated with preterm birth (PTB) according to the article by Kim et al. Perhaps their most interesting finding is that obesity is positively associated in nulliparous women with extremely PTB rates (birth at < 28 weeks of gestation), both spontaneous and indicated. This extreme PTB group specifically contributes to neonatal morbidity and mortality. This article is protected by copyright. All rights reserved.
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28421651/self-management-of-first-trimester-medical-termination-of-pregnancy-a-qualitative-study-of-women-s-experiences
#12
Carrie Purcell, Sharon Cameron, Julia Lawton, Anna Glasier, Jeni Harden
OBJECTIVE: To explore the experiences of women in Scotland who return home to complete medical termination of pregnancy (TOP) ≤63 days of gestation, after being administered with mifepristone and misoprostol at an NHS TOP clinic. DESIGN: Qualitative interview study. SETTING: One National Health Service health board (administrative) area in Scotland. POPULATION OR SAMPLE: Women in Scotland who had undergone medical TOP ≤63 days, and self-managed passing the pregnancy at home; recruited from three clinics in on NHS health board area between January and July 2014...
April 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28418597/mid-trimester-residual-cervical-length-and-the-risk-of-preterm-birth-in-pregnancies-after-abdominal-radical-trachelectomy-a-retrospective-analysis
#13
Yoshifumi Kasuga, Kei Miyakoshi, Hiroshi Nishio, Yohei Akiba, Toshimitsu Otani, Marie Fukutake, Satoru Ikenoue, Daigo Ochiai, Tadashi Matsumoto, Kyoko Tanaka, Kazuhiro Minegishi, Naoaki Kuji, Rachel Roberts, Daisuke Aoki, Mamoru Tanaka
OBJECTIVE: To investigate the association between the mid-trimester residual cervical length (CL) and the risk of preterm birth in pregnancies after abdominal radical trachelectomy (RT). DESIGN: Retrospective cohort study. SETTING: University Hospital. POPULATION: A total of 33 deliveries after 22 weeks' gestation in 30 women who underwent abdominal RT including prophylactic cervical cerclage and perinatal care between January 2002 and May 2016...
April 18, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28417507/understanding-the-roots-of-health-inequalities-requires-new-methods
#14
Shawn Walker
It is easy to teach health care professionals and students to follow a guideline, tricky to teach them to become aware of unconscious biases and assumptions which may influence how they execute that guideline. Substandard care may be easily recognised in retrospect, but understanding how and why it continues to happen, to some populations more than others, is key to reducing such disparities. Hypertensive disorders of pregnancy affect women of immigrant populations more often and with worse outcomes than native residents of industrialised countries...
April 17, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28397979/the-obstetric-consultant-on-the-labour-ward-beyond-infancy-to-early-adolescence
#15
William F Rayburn
Hospital medicine has emerged over the last two decades into a practice pattern for those with generalist training in internal medicine, family medicine, and pediatrics. Their hospital consultative practices are now generally acceptable in light of a changing health care financial landscape, primary care physicians leaving the hospital workplace, and a push to improve the efficiency and effectiveness of systems-based hospital care. Today, several specialties are more involved in hospital consultant programs such as obstetrics, emergency medicine, surgery, and psychiatry...
April 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28397976/resident-consultant-cover-may-become-part-of-21st-century-maternity-care-but-it-is-not-a-panacea
#16
Matt Prior, Tim Draycott, Christy Burden
Resident consultant cover has long been proposed as a solution to a wide variety of current intrapartum issues: poor clinical outcomes; high intervention rates, particularly increasing rates of caesarean section; middle grade rota gaps, and decreased training opportunities. However, as for many previous well-intentioned, apparently simple and plausible interventions introduced into maternity care, there may be little or no benefit when robustly tested. This article is protected by copyright. All rights reserved...
April 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28391658/otc-medical-abortion-to-be-or-not-to-be
#17
Kamheang Chaturachinda
The article by Kapp et al summarizing further research to move early medical pregnancy termination over the counter (OTC) is timely and appropriate. Universal access over the counter of this 'silver bullet', de facto de-medicalisation of early abortion would save a large number of maternal deaths and spare women from the debility from unsafe abortion worldwide. It would greatly improve women's reproductive health (Rosenfield A. Int J Gynaecol Obstet 1994; 46: 173-179). Easy access to safe abortion would also benefit women in remote and rural area as well as urban ones (Jones RK et al...
April 9, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28391626/urinary-hpv-testing-may-offer-hope-for-cervical-screening-non-attenders
#18
Dominic A Blake, Emma J Crosbie, Sarah Kitson
Despite the success of cervical screening, cancer of the cervix is the fourth most common cancer affecting women worldwide (CRUK 2014). Rates are particularly high in developing nations, which lack the requisite infrastructure for cytology and colposcopy-based screening, and in certain demographic groups, where uptake of screening is poor. Recent research has focussed on developing less invasive and potentially more acceptable means of identifying women at high risk of cervical intraepithelial neoplasia (CIN)...
April 9, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28391609/hpv-testing-in-first-void-urine-provides-sensitivity-for-cin2-detection-comparable-to-a-physician-taken-smear-or-brush-based-self-sample-cross-sectional-data-from-a-triage-population
#19
Annemiek Leeman, Marta Del Pino, Anco Molijn, Agata Rodriguez, Aureli Torné, Maurits de Koning, Jaume Ordi, Folkert van Kemenade, David Jenkins, Wim Quint
OBJECTIVES: To compare sensitivity of high-risk HPV (hrHPV) and genotype detection in self-collected morning (U1) and later (U2) urine samples, brush-based self-samples (SS) and physician-taken smears (PTS) for detecting CIN2+ in a colposcopic referral population. DESIGN: Cross-sectional single centre study. SETTING: A colposcopy clinic in Spain. POPULATION: 113 women referred for colposcopy after an abnormal Pap-smear...
April 9, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28383781/pitfalls-in-the-use-of-register-based-data-for-comparing-adverse-maternal-and-perinatal-outcomes-in-different-birth-settings
#20
A de Jonge, M G A J Wouters, J Klinkert, J Brandenbarg, J J Zwart, J Van Dillen, H E van der Horst, F G Schellevis
Routinely collected registration data are an efficient source for conducting research. In particular, they are useful for studies with rare outcomes, as these require large sample sizes, which are difficult to obtain through targeted data collection. Registration data are often used to compare severe, adverse maternal and perinatal outcomes in different birth settings. However, registration data are primarily recorded for purposes other than research, such as supporting care processes. Subsequently, if these data are used for scientific studies, the analyses are, by definition, 'secondary' and therefore are likely to have more limitations compared to prospectively and purposely collected research data...
April 6, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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