Pub Date : 2026-01-14DOI: 10.1016/j.jogc.2025.103200
Jenny Crick MSc
{"title":"Gendered Language in the Journal of Obstetrics and Gynaecology Canada","authors":"Jenny Crick MSc","doi":"10.1016/j.jogc.2025.103200","DOIUrl":"10.1016/j.jogc.2025.103200","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103200"},"PeriodicalIF":2.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this cross-sectional study was to examine trends in gendered language use in abstracts pertaining to obstetrics and gynaecology and use of language specific to the transgender population. Of 4.8 million MEDLINE records, 955 626 abstracts met inclusion criteria and were classified using a natural language processing analysis. A total of 59% contained gendered language, 0.03% transgender, and 40.6% gender-neutral. The proportion of obstetrics and gynecology abstracts containing gender-neutral and transgender language has rapidly increased. This shift may represent a response to journal policies on language, and the growing recognition of the applicability of “women’s” health to a broader population than cis-gendered women.
{"title":"Beyond “Women’s” Health: A Natural Language Processing Analysis of Trends in Gender-Neutral Language Use","authors":"Yann Guérin , Finlay Maguire PhD , Aisling Clancy MD, MPH , Jocelyn Stairs MD, MPH","doi":"10.1016/j.jogc.2025.103199","DOIUrl":"10.1016/j.jogc.2025.103199","url":null,"abstract":"<div><div>The aim of this cross-sectional study was to examine trends in gendered language use in abstracts pertaining to obstetrics and gynaecology and use of language specific to the transgender population. Of 4.8 million MEDLINE records, 955 626 abstracts met inclusion criteria and were classified using a natural language processing analysis. A total of 59% contained gendered language, 0.03% transgender, and 40.6% gender-neutral. The proportion of obstetrics and gynecology abstracts containing gender-neutral and transgender language has rapidly increased. This shift may represent a response to journal policies on language, and the growing recognition of the applicability of “women’s” health to a broader population than cis-gendered women.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103199"},"PeriodicalIF":2.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jogc.2025.103167
Tarek Motan MD, Heather Cockwell MD, Jason Elliott MD, Roland Antaki MD, Justin White MD
<div><h3>Objective</h3><div>The object of this guideline is to provide clinicians with the most up to date evidence available for the evaluation and management of patients with recurrent pregnancy loss.</div></div><div><h3>Target Population</h3><div>Patients with Recurrent Pregnancy Loss (defined as two or more pregnancy losses.)</div></div><div><h3>Options</h3><div>Strategies for managing RPL includes lifestyle changes (reducing caffeine, smoking, alcohol), addressing obesity, screening for thyroid dysfunction, diabetes, antiphospholipid syndrome, and treating uterine anomalies like septate uterus or adhesions. Chronic endometritis may benefit from antibiotics. Genetic testing of gestational tissue and parental karyotyping can identify chromosomal issues. Treating acquired thrombophilias may be beneficial. Progesterone therapy may be helpful, especially if started in the luteal phase. Access to early pregnancy assessment clinics, emotional support, close monitoring, and trauma-informed care are essential, with empirical treatments used cautiously due to limited evidence.</div></div><div><h3>Outcomes</h3><div>Pregnancy loss rate, Live birth rate</div></div><div><h3>Benefits, Harms, and Costs</h3><div>Improved live birth rates and providing etiological answers to affected patients. Patients will sacrifice time and experience the discomfort of investigations with a high probability of negative results. The financial costs of investigations are covered by medical plans, but some of the therapies are uninsured and expensive. Investigations should be done according to evidence-based recommendations and accessible to all women.</div></div><div><h3>Evidence</h3><div>English-language articles were searched from January 1, 2008 to June 30, 2025 in PubMed, Cochrane Library, CINAHL, MEDLINE, Embase and Scopus using the broad search terms habitual abortion, abortion, recurrent abortion, recurrent miscarriage, recurrent early pregnancy loss, recurrent pregnancy loss, idiopathic pregnancy loss, idiopathic recurrent miscarriage.</div></div><div><h3>Validation Methods</h3><div>The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online <span><span>Appendix A</span></span> (<span><span>Tables A1</span></span> for definitions and <span><span>A2</span></span> for interpretations of strong and conditional [weak] recommendations).</div></div><div><h3>Intended Audience</h3><div>All healthcare professionals who care for patients with Recurrent Pregnancy Loss.</div></div><div><h3>Abstract for social media</h3><div>Recurrent Pregnancy Loss (RPL) is defined as two or more pregnancy losses, including non-consecutive and biochemical. Causes range from chromosomal and anatomical to endocrine, immune, infectious, and lifestyle factors—though most remain unexplained. Evaluation and personalized care are essential. While evidence for treatments varies, trauma-i
{"title":"Guideline No. 464: Recurrent Pregnancy Loss","authors":"Tarek Motan MD, Heather Cockwell MD, Jason Elliott MD, Roland Antaki MD, Justin White MD","doi":"10.1016/j.jogc.2025.103167","DOIUrl":"10.1016/j.jogc.2025.103167","url":null,"abstract":"<div><h3>Objective</h3><div>The object of this guideline is to provide clinicians with the most up to date evidence available for the evaluation and management of patients with recurrent pregnancy loss.</div></div><div><h3>Target Population</h3><div>Patients with Recurrent Pregnancy Loss (defined as two or more pregnancy losses.)</div></div><div><h3>Options</h3><div>Strategies for managing RPL includes lifestyle changes (reducing caffeine, smoking, alcohol), addressing obesity, screening for thyroid dysfunction, diabetes, antiphospholipid syndrome, and treating uterine anomalies like septate uterus or adhesions. Chronic endometritis may benefit from antibiotics. Genetic testing of gestational tissue and parental karyotyping can identify chromosomal issues. Treating acquired thrombophilias may be beneficial. Progesterone therapy may be helpful, especially if started in the luteal phase. Access to early pregnancy assessment clinics, emotional support, close monitoring, and trauma-informed care are essential, with empirical treatments used cautiously due to limited evidence.</div></div><div><h3>Outcomes</h3><div>Pregnancy loss rate, Live birth rate</div></div><div><h3>Benefits, Harms, and Costs</h3><div>Improved live birth rates and providing etiological answers to affected patients. Patients will sacrifice time and experience the discomfort of investigations with a high probability of negative results. The financial costs of investigations are covered by medical plans, but some of the therapies are uninsured and expensive. Investigations should be done according to evidence-based recommendations and accessible to all women.</div></div><div><h3>Evidence</h3><div>English-language articles were searched from January 1, 2008 to June 30, 2025 in PubMed, Cochrane Library, CINAHL, MEDLINE, Embase and Scopus using the broad search terms habitual abortion, abortion, recurrent abortion, recurrent miscarriage, recurrent early pregnancy loss, recurrent pregnancy loss, idiopathic pregnancy loss, idiopathic recurrent miscarriage.</div></div><div><h3>Validation Methods</h3><div>The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online <span><span>Appendix A</span></span> (<span><span>Tables A1</span></span> for definitions and <span><span>A2</span></span> for interpretations of strong and conditional [weak] recommendations).</div></div><div><h3>Intended Audience</h3><div>All healthcare professionals who care for patients with Recurrent Pregnancy Loss.</div></div><div><h3>Abstract for social media</h3><div>Recurrent Pregnancy Loss (RPL) is defined as two or more pregnancy losses, including non-consecutive and biochemical. Causes range from chromosomal and anatomical to endocrine, immune, infectious, and lifestyle factors—though most remain unexplained. Evaluation and personalized care are essential. While evidence for treatments varies, trauma-i","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103167"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jogc.2025.103192
Delaine Pereira BSc , Anick Bérard PhD , Justine Pleau MA , Lisiane F. Leal ScD , Louise M. Winn PhD
In May of 2025, a Canadian Mother–Child Initiative on Drug Safety in Pregnancy symposium was held during the Canadian National Perinatal Research Meeting in Montréal, Québec. This symposium included a presentation covering the mechanistic evidence on the biological plausibility of acetaminophen use during pregnancy affecting neurodevelopment. Three mechanistic pathways including oxidative stress, changes in placental and brain transporter expression, and alterations in epigenetic regulation were presented. Given that much of the mechanistic evidence comes from animal and in vitro studies, limitations with these models and their relevance to human pregnancy were also considered. Current evidence for both human and mechanistic studies remain too limited and inconsistent to infer a causal effect at typical clinical exposures. Therefore, the Society of Obstetricians and Gynaecologists of Canada's recommendation that “the use of acetaminophen as a first-line therapeutic option for fever and pain in pregnancy when medically indicated at recommended doses for the shortest duration required” is supported.
{"title":"Acetaminophen Use During Pregnancy and Neurodevelopmental Risk: Biological Plausibility1","authors":"Delaine Pereira BSc , Anick Bérard PhD , Justine Pleau MA , Lisiane F. Leal ScD , Louise M. Winn PhD","doi":"10.1016/j.jogc.2025.103192","DOIUrl":"10.1016/j.jogc.2025.103192","url":null,"abstract":"<div><div>In May of 2025, a Canadian Mother–Child Initiative on Drug Safety in Pregnancy symposium was held during the Canadian National Perinatal Research Meeting in Montréal, Québec. This symposium included a presentation covering the mechanistic evidence on the biological plausibility of acetaminophen use during pregnancy affecting neurodevelopment. Three mechanistic pathways including oxidative stress, changes in placental and brain transporter expression, and alterations in epigenetic regulation were presented. Given that much of the mechanistic evidence comes from animal and in vitro studies, limitations with these models and their relevance to human pregnancy were also considered. Current evidence for both human and mechanistic studies remain too limited and inconsistent to infer a causal effect at typical clinical exposures. Therefore, the Society of Obstetricians and Gynaecologists of Canada's recommendation that “the use of acetaminophen as a first-line therapeutic option for fever and pain in pregnancy when medically indicated at recommended doses for the shortest duration required” is supported.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 1","pages":"Article 103192"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jogc.2025.103168
Tarek Motan MD, Heather Cockwell MD, Jason Elliott MD, Roland Antaki MD, Justin White MD
<div><h3>Objectif</h3><div>L'objectif de cette ligne directrice est de fournir aux professionnels de santé les données probantes les plus récentes disponibles pour l'évaluation et la prise en charge des patientes souffrant de fausses couches à répétition.</div></div><div><h3>Population cible</h3><div>Les patientes présentant des fausses couches à répétition, définies comme deux fausses couches ou plus.</div></div><div><h3>Options</h3><div>Les stratégies de prise en charge des FCR comprennent des changements de mode de vie (réduction de la consommation de caféine, de tabac et d'alcool), la lutte contre l'obésité, le dépistage des dysfonctionnements thyroïdiens, du diabète et du syndrome des antiphospholipides, ainsi que le traitement des anomalies utérines telles que l'utérus cloisonné(septé) ou les adhérences (synéchies) intrautérines. Les antibiotiques peuvent être bénéfiques en cas d'endométrite chronique. L’analyse génétique des produits de conceptions et le caryotypage parental permettent d'identifier les problèmes chromosomiques. Le traitement des thrombophilies acquises peut être bénéfique. Un traitement à la progestérone peut être utile, en particulier s'il est commencé pendant la phase lutéale. L'accès à des cliniques d'évaluation précoce de la grossesse, un soutien émotionnel, une surveillance étroite et des soins tenant compte des traumatismes sont essentiels, les traitements empiriques étant utilisés avec prudence en raison du manque de preuves.</div></div><div><h3>Résultats</h3><div>taux de fausses couches, taux de naissances vivantes</div></div><div><h3>Avantages, inconvénients et coûts</h3><div>amélioration des taux de naissances vivantes et apport de réponses étiologiques par les professionnels de santé aux patientes concernées. Les patientes devront sacrifier du temps et subir l'inconfort des examens, avec une forte probabilité de résultats négatifs. Les coûts financiers des examens sont couverts par les régimes d'assurance maladie, mais certains traitements ne sont pas pris en charge et sont coûteux. Les examens fondés doivent être effectués conformément aux recommandations fondées sur des données probantes et être accessibles à toutes les femmes.</div></div><div><h3>Preuves</h3><div>des articles en anglais ont été recherchés entre le 1er janvier 2008 et le 30 juin 2025 dans PubMed, Cochrane Library, CINAHL, MEDLINE, Embase et Scopus à l'aide des termes de recherche généraux : abortion, abortion, recurrent abortion, recurrent miscarriage, recurrent early pregnancy loss, recurrent pregnancy loss, idiopathic pregnancy loss, idiopathic recurrent miscarriage.</div></div><div><h3>Méthodes de validation</h3><div>Les auteurs ont évalué la qualité des preuves et la force des recommandations à l'aide de l'approche GRADE (Grading of Recommendations Assessment, Development and Evaluation). Voir l'annexe A en ligne (<span><span>tableaux A1</span></span> pour les définitions et <span><span>A2</span></span> pour les interprétations des recomma
{"title":"Ligne directrice n° 464 : Fausses couches à répétition","authors":"Tarek Motan MD, Heather Cockwell MD, Jason Elliott MD, Roland Antaki MD, Justin White MD","doi":"10.1016/j.jogc.2025.103168","DOIUrl":"10.1016/j.jogc.2025.103168","url":null,"abstract":"<div><h3>Objectif</h3><div>L'objectif de cette ligne directrice est de fournir aux professionnels de santé les données probantes les plus récentes disponibles pour l'évaluation et la prise en charge des patientes souffrant de fausses couches à répétition.</div></div><div><h3>Population cible</h3><div>Les patientes présentant des fausses couches à répétition, définies comme deux fausses couches ou plus.</div></div><div><h3>Options</h3><div>Les stratégies de prise en charge des FCR comprennent des changements de mode de vie (réduction de la consommation de caféine, de tabac et d'alcool), la lutte contre l'obésité, le dépistage des dysfonctionnements thyroïdiens, du diabète et du syndrome des antiphospholipides, ainsi que le traitement des anomalies utérines telles que l'utérus cloisonné(septé) ou les adhérences (synéchies) intrautérines. Les antibiotiques peuvent être bénéfiques en cas d'endométrite chronique. L’analyse génétique des produits de conceptions et le caryotypage parental permettent d'identifier les problèmes chromosomiques. Le traitement des thrombophilies acquises peut être bénéfique. Un traitement à la progestérone peut être utile, en particulier s'il est commencé pendant la phase lutéale. L'accès à des cliniques d'évaluation précoce de la grossesse, un soutien émotionnel, une surveillance étroite et des soins tenant compte des traumatismes sont essentiels, les traitements empiriques étant utilisés avec prudence en raison du manque de preuves.</div></div><div><h3>Résultats</h3><div>taux de fausses couches, taux de naissances vivantes</div></div><div><h3>Avantages, inconvénients et coûts</h3><div>amélioration des taux de naissances vivantes et apport de réponses étiologiques par les professionnels de santé aux patientes concernées. Les patientes devront sacrifier du temps et subir l'inconfort des examens, avec une forte probabilité de résultats négatifs. Les coûts financiers des examens sont couverts par les régimes d'assurance maladie, mais certains traitements ne sont pas pris en charge et sont coûteux. Les examens fondés doivent être effectués conformément aux recommandations fondées sur des données probantes et être accessibles à toutes les femmes.</div></div><div><h3>Preuves</h3><div>des articles en anglais ont été recherchés entre le 1er janvier 2008 et le 30 juin 2025 dans PubMed, Cochrane Library, CINAHL, MEDLINE, Embase et Scopus à l'aide des termes de recherche généraux : abortion, abortion, recurrent abortion, recurrent miscarriage, recurrent early pregnancy loss, recurrent pregnancy loss, idiopathic pregnancy loss, idiopathic recurrent miscarriage.</div></div><div><h3>Méthodes de validation</h3><div>Les auteurs ont évalué la qualité des preuves et la force des recommandations à l'aide de l'approche GRADE (Grading of Recommendations Assessment, Development and Evaluation). Voir l'annexe A en ligne (<span><span>tableaux A1</span></span> pour les définitions et <span><span>A2</span></span> pour les interprétations des recomma","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103168"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-29DOI: 10.1016/j.jogc.2025.103194
James Humber BSc(c) , Kevin Dick BSc, PhD , Robin Ducharme BSc, MSc , Serine Ramlawi BSc, MSc , Faisal Sugati MD , Steven Hawken BSc, MSc, PhD , Mark C. Walker MD, FRCSC, MSc, MHCM
Objective
In recent years, the exponential growth of artificial intelligence (AI) has fuelled extensive research and high expectations for its potential applications. Generative AI has shown promise in streamlining clinical work. This study aimed to evaluate the ability of ChatGPT 3.5, a publicly available generative AI tool, to generate high-quality patient information materials for gestational diabetes mellitus, a common pregnancy complication.
Methods
This was an anonymized, within-subjects survey study comparing how obstetrical health care workers rated the understandability and actionability of 2 patient information sheets: the current standard version used at The Ottawa Hospital and an AI-derived version created using ChatGPT 3.5. Eligible obstetrical health care workers participated in the survey, reviewing the 2 versions of the patient education sheet without labels to identify which sheet was which. An adapted version of the Patient Education Materials Assessment Tool (PEMAT) was used to evaluate and score both versions on their understandability and actionability. We also collected information on the respondents’ opinions on and exposure to the use of AI in health care to help describe their level of AI-familiarity.
Results
A total of 70 complete responses were received and included in the analysis. Survey respondents consisted of nurses (52.9%), resident or fellow physicians (28.6%), and practising physicians (14.3%). Respondents rated the standard and AI-generated materials similarly in understandability. Although the AI-generated version scored slightly lower in actionability, both instruments achieved scores above the 70% threshold, which is generally accepted as evidence that patient education materials are sufficiently understandable and actionable.
Conclusions
These findings suggest that AI can produce patient education materials of similar quality to those currently used at The Ottawa Hospital. The actionability of the AI-generated patient education materials could be improved via prompt generation, thereby improving AI applications in clinical work and patient care.
{"title":"A Comparison of Patient Information Sheets for Gestational Diabetes Created by Large Language Models and Health Professionals","authors":"James Humber BSc(c) , Kevin Dick BSc, PhD , Robin Ducharme BSc, MSc , Serine Ramlawi BSc, MSc , Faisal Sugati MD , Steven Hawken BSc, MSc, PhD , Mark C. Walker MD, FRCSC, MSc, MHCM","doi":"10.1016/j.jogc.2025.103194","DOIUrl":"10.1016/j.jogc.2025.103194","url":null,"abstract":"<div><h3>Objective</h3><div>In recent years, the exponential growth of artificial intelligence (AI) has fuelled extensive research and high expectations for its potential applications. Generative AI has shown promise in streamlining clinical work. This study aimed to evaluate the ability of ChatGPT 3.5, a publicly available generative AI tool, to generate high-quality patient information materials for gestational diabetes mellitus, a common pregnancy complication.</div></div><div><h3>Methods</h3><div>This was an anonymized, within-subjects survey study comparing how obstetrical health care workers rated the understandability and actionability of 2 patient information sheets: the current standard version used at The Ottawa Hospital and an AI-derived version created using ChatGPT 3.5. Eligible obstetrical health care workers participated in the survey, reviewing the 2 versions of the patient education sheet without labels to identify which sheet was which. An adapted version of the Patient Education Materials Assessment Tool (PEMAT) was used to evaluate and score both versions on their understandability and actionability. We also collected information on the respondents’ opinions on and exposure to the use of AI in health care to help describe their level of AI-familiarity.</div></div><div><h3>Results</h3><div>A total of 70 complete responses were received and included in the analysis. Survey respondents consisted of nurses (52.9%), resident or fellow physicians (28.6%), and practising physicians (14.3%). Respondents rated the standard and AI-generated materials similarly in understandability. Although the AI-generated version scored slightly lower in actionability, both instruments achieved scores above the 70% threshold, which is generally accepted as evidence that patient education materials are sufficiently understandable and actionable.</div></div><div><h3>Conclusions</h3><div>These findings suggest that AI can produce patient education materials of similar quality to those currently used at The Ottawa Hospital. The actionability of the AI-generated patient education materials could be improved via prompt generation, thereby improving AI applications in clinical work and patient care.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 1","pages":"Article 103194"},"PeriodicalIF":2.2,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-29DOI: 10.1016/j.jogc.2025.103195
Francisca Ferreira MD , Marta Henriques Costa MD , Hélio Alves MD , Ana Rute Costa PhD , Joana Costa MD , Antónia Costa PhD
Objectives
To evaluate the effect of incisional negative pressure wound therapy (iNPWT) on surgical outcomes in patients undergoing wide vulvar surgical excision with simultaneous plastic reconstruction.
Methods
We conducted a single-centre retrospective cohort study at a São João Local Health Unit. The study included 21 patients diagnosed with vulvar malignancy who underwent wide vulvar surgical excision with immediate reconstruction with flaps between 2017 and 2024. Patients were divided into 2 groups based on postoperative wound management: the iNPWT group (N = 7), who received incisional negative pressure wound therapy, and the conventional care group (N = 14), submitted to standard wound management.
The study’s primary outcome was the occurrence of postoperative wound complications. Secondary outcomes assessed the occurrence of specific complications, such as wound infection, dehiscence, necrosis and hematoma, and length of hospital stay.
Results
Overall wound complications occurred in 12 cases of conventional care patients (85.7%) but in none of the iNPWT group patients (P < 0.001). Compared to those submitted to incisional negative pressure wound therapy, the conventional care group had significantly higher prevalence of wound dehiscence (0.0% vs. 64.3%, P = 0.007) and infection (0.0% vs. 78.6%, P = 0.001). There was no significant difference (P = 0.521) in the necrosis rate. Median hospital stay was similar between groups (21.00 vs. 25.50 days, P = 0.488).
Conclusions
Fewer postoperative complications were observed in the iNPWT group compared to the conventional care group, particularly wound dehiscence and infection. These findings suggest that iNPWT may be a valuable tool in improving surgical outcomes and reducing postoperative morbidity in patients undergoing wide vulvar surgical excisions.
目的：探讨切口负压创面治疗（iNPWT）对外阴大面积切除同时整形重建患者手术效果的影响。方法：我们在 o jo o地方卫生单位进行了一项单中心回顾性队列研究。该研究包括21名被诊断为外阴恶性肿瘤的患者，他们在2017年至2024年间接受了广泛的外阴手术切除并立即用皮瓣重建。根据术后创面处理将患者分为两组：iNPWT组（N = 7）采用切口负压创面治疗，常规护理组（N = 14）采用标准创面处理。该研究的主要结果是术后伤口并发症的发生。次要结局评估特定并发症的发生，如伤口感染、裂开、坏死和血肿，以及住院时间。结果：常规护理组有12例（85.7%）出现整体伤口并发症，而iNPWT组无一例（P < 0.001）。常规护理组创面裂开发生率（0.0%比64.3%,P = 0.007）和感染发生率（0.0%比78.6%,P = 0.001）明显高于切口负压治疗组。两组坏死率差异无统计学意义（P = 0.521）。两组住院时间中位数相似（21.00 vs 25.50天，P = 0.488）。结论：与常规护理组相比，iNPWT组术后并发症较少，尤其是伤口开裂和感染。这些发现表明，iNPWT可能是一个有价值的工具，在改善手术结果和减少术后发病率的患者接受外阴手术切除。
{"title":"The Role of Incisional Negative Pressure Wound Therapy in Vulvar Surgical Outcomes","authors":"Francisca Ferreira MD , Marta Henriques Costa MD , Hélio Alves MD , Ana Rute Costa PhD , Joana Costa MD , Antónia Costa PhD","doi":"10.1016/j.jogc.2025.103195","DOIUrl":"10.1016/j.jogc.2025.103195","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effect of incisional negative pressure wound therapy (iNPWT) on surgical outcomes in patients undergoing wide vulvar surgical excision with simultaneous plastic reconstruction.</div></div><div><h3>Methods</h3><div>We conducted a single-centre retrospective cohort study at a São João Local Health Unit. The study included 21 patients diagnosed with vulvar malignancy who underwent wide vulvar surgical excision with immediate reconstruction with flaps between 2017 and 2024. Patients were divided into 2 groups based on postoperative wound management: the iNPWT group (N = 7), who received incisional negative pressure wound therapy, and the conventional care group (N = 14), submitted to standard wound management.</div><div>The study’s primary outcome was the occurrence of postoperative wound complications. Secondary outcomes assessed the occurrence of specific complications, such as wound infection, dehiscence, necrosis and hematoma, and length of hospital stay.</div></div><div><h3>Results</h3><div>Overall wound complications occurred in 12 cases of conventional care patients (85.7%) but in none of the iNPWT group patients (<em>P</em> < 0.001). Compared to those submitted to incisional negative pressure wound therapy, the conventional care group had significantly higher prevalence of wound dehiscence (0.0% vs. 64.3%, <em>P</em> = 0.007) and infection (0.0% vs. 78.6%, <em>P</em> = 0.001). There was no significant difference (<em>P</em> = 0.521) in the necrosis rate. Median hospital stay was similar between groups (21.00 vs. 25.50 days, <em>P</em> = 0.488).</div></div><div><h3>Conclusions</h3><div>Fewer postoperative complications were observed in the iNPWT group compared to the conventional care group, particularly wound dehiscence and infection. These findings suggest that iNPWT may be a valuable tool in improving surgical outcomes and reducing postoperative morbidity in patients undergoing wide vulvar surgical excisions.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103195"},"PeriodicalIF":2.2,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-29DOI: 10.1016/j.jogc.2025.103191
In Ok Lee MD , Maryam Ghiasi DDS, MSc , Karen Wong MD, MSc , Mark Walker MD, MSc, MSCHM
Objectives
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have recently gained dramatic popularity and use in treating type 2 diabetes mellitus and obesity. Although reports of accidental periconceptional exposure to these drugs have emerged and are expected to increase, the limited evidence of their impact during pregnancy makes informed decision-making difficult. This scoping review aims to identify and comprehensively report available evidence regarding the periconceptional use of GLP-1 RAs and their effects on pregnancy outcomes.
Methods
The review was conducted following the Joanna Briggs Institute methodology. All levels of evidence and types of reports regarding pregnancy outcomes after periconceptional exposure to GLP-1 RAs of individuals with type 2 diabetes mellitus or obesity were included. Databases including MEDLINE, Embase, Scopus, and open-access clinical trial registries were searched from January 1, 2005, to March 12, 2025. ProQuest Dissertations & Theses Global and medRxiv were also screened during the same period to include the most current reports. Studies were screened in duplicate at the abstract level, then at the full-text level by 2 independent reviewers, with disagreements resolved through consensus. The included articles were charted, and the data were summarized narratively and presented in the Table.
Results
After eliminating duplicates, 881 articles were screened, and 13 articles, 10 case reports and 3 cohort studies, met eligibility criteria for inclusion. Minor pregnancy complications reported in the case reports included emergency cesarean delivery, preeclampsia, macrosomia, shoulder dystocia, and transient neonatal hypoglycemia. However, all studies did not find an increased risk of major congenital malformations. Pregnancy losses and elective termination of pregnancy were not reported in any study.
Conclusions
Accidental periconceptional exposure to GLP-1 RAs may not be associated with an increased risk of adverse pregnancy outcomes, particularly major congenital malformations and pregnancy loss. More high-level evidence will be warranted to confirm these findings and guide clinical decision-making.
背景：胰高血糖素样肽-1受体激动剂（GLP-1 RAs）最近在治疗2型糖尿病（T2D）和肥胖方面得到了极大的普及和应用。虽然意外暴露于这些药物的报告已经出现，预计会增加，但有限的证据表明其在怀孕期间的影响，使知情决策困难。本综述旨在确定和全面报告有关围孕期使用GLP-1 RAs及其对妊娠结局影响的现有证据。方法：采用乔安娜布里格斯研究所（JBI）的方法。所有水平的证据和类型的报告，关于妊娠期暴露于GLP-1 RAs后妊娠结局的T2D或肥胖个体被纳入。检索了2005年1月1日至2025年3月12日期间的MEDLINE、Embase、Scopus和开放获取临床试验注册数据库。ProQuest dissertation & Theses Global和medRxiv也在同一时期进行了筛选，以包括最新的报告。研究在摘要水平上一式两份进行筛选，然后在全文水平上由两位独立审稿人进行筛选，分歧通过共识解决。将纳入的文章绘制成图表，并对数据进行叙述总结并以表格形式呈现。结果：在消除重复后，筛选了881篇文章，其中13篇文章，10篇病例报告和3篇队列研究符合入选标准。病例报告中报道的轻微妊娠并发症包括紧急剖宫产、先兆子痫、巨大儿、肩难产和新生儿短暂性低血糖。然而，所有的研究都没有发现主要先天性畸形的风险增加。在任何研究中都没有关于流产和选择性终止妊娠的报道。结论：意外孕周暴露于GLP-1 RAs可能与不良妊娠结局的风险增加无关，特别是重大先天性畸形和妊娠流产。需要更多的高水平证据来证实这些发现并指导临床决策。背景：rcv， la popularit des agonistes du rcv -1肽-1型胰高血糖素（GLP-1）和leur的利用，pour trater l' obcv - 3和lediabete de 2型糖尿病患者的糖尿病和糖尿病。如果你不确定，你就不能确定，你就不能确定，你就不能确定，你就不能确定，你就不能确定，你就不能确定，如果你确定，你就不能确定，你就不能确定，你就不能确定。L的用处cet(中央东部东京)反省de la矿物是德新上的菜les数据probantes这类关于L 'utilisation periconceptionnelle des阿冈尼司帝斯杜recepteur GLP-1等他们运用苏尔les个怀孕危险问题et d没有做联合国考虑建筑渲染完整。乔安娜布里格斯研究所（JBI）： La revue a samadress a samadress a samadress au moyen de La samadress dologie du Joanna Briggs Institute。该报告包括两种不同类型的报告和不同程度的质量、不同程度的 - t - est和不同程度的 - t - est、不同程度的 - t - est、不同类型的 - t - est、不同类型的 - t - est、不同类型的 - t - est、不同类型的 - t - est、不同类型的 - t - est和2型糖尿病。研究人员研究了所有的电子烟和其他的电子烟和其他的电子烟和其他的电子烟。研究人员研究了所有的电子烟和其他的电子烟和其他电子烟。全球范围内，所有的澳大利亚的澳大利亚的澳大利亚的澳大利亚的澳大利亚的澳大利亚的澳大利亚的澳大利亚的澳大利亚的澳大利亚的澳大利亚的澳大利亚的澳大利亚的澳大利亚的其他国家的，包括三个国家和地区。所有的samsamas，所有的samsamas，所有的samsamas，所有的samsamas，所有的samsamas，所有的samsamas，所有的samsamas，所有的samsamas，所有的samsamas，所有的samsamas，所有的samsamas。这些条款包括：不包括所有的薪金和薪金，不包括所有的薪金和薪金，不包括薪金和薪金，不包括薪金和薪金。rs - sats: rs - sats消除了2个条目，保留了881个条目。总而言之，13条、10份报告和3份报告符合列入标准。综上所列的复杂情况和复杂情况分别是：1 .与普通情况有关；2 .与普通情况有关；3 .与普通情况有关；3 .与普通情况有关；3 .与普通情况有关；然而，由于不可抗力造成的畸形，因此，有必要将其视为不可抗力。当你提到一个简单的问题时，你就会想到一个简单的问题。结论：“暴露性”与“意外性”、“过度性”与“过度性”、“过度性”与“过度性”、“过度性”与“过度性”、“过度性”与“过度性”，尤其是“过度性”与“过度性”。交换器- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
{"title":"Outcomes of Maternal Periconceptional Exposure to Glucagon-Like Peptide-1 Receptor Agonists: A Scoping Review of Evidence and Reporting Trends","authors":"In Ok Lee MD , Maryam Ghiasi DDS, MSc , Karen Wong MD, MSc , Mark Walker MD, MSc, MSCHM","doi":"10.1016/j.jogc.2025.103191","DOIUrl":"10.1016/j.jogc.2025.103191","url":null,"abstract":"<div><h3>Objectives</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have recently gained dramatic popularity and use in treating type 2 diabetes mellitus and obesity. Although reports of accidental periconceptional exposure to these drugs have emerged and are expected to increase, the limited evidence of their impact during pregnancy makes informed decision-making difficult. This scoping review aims to identify and comprehensively report available evidence regarding the periconceptional use of GLP-1 RAs and their effects on pregnancy outcomes.</div></div><div><h3>Methods</h3><div>The review was conducted following the Joanna Briggs Institute methodology. All levels of evidence and types of reports regarding pregnancy outcomes after periconceptional exposure to GLP-1 RAs of individuals with type 2 diabetes mellitus or obesity were included. Databases including MEDLINE, Embase, Scopus, and open-access clinical trial registries were searched from January 1, 2005, to March 12, 2025. ProQuest Dissertations & Theses Global and medRxiv were also screened during the same period to include the most current reports. Studies were screened in duplicate at the abstract level, then at the full-text level by 2 independent reviewers, with disagreements resolved through consensus. The included articles were charted, and the data were summarized narratively and presented in the Table.</div></div><div><h3>Results</h3><div>After eliminating duplicates, 881 articles were screened, and 13 articles, 10 case reports and 3 cohort studies, met eligibility criteria for inclusion. Minor pregnancy complications reported in the case reports included emergency cesarean delivery, preeclampsia, macrosomia, shoulder dystocia, and transient neonatal hypoglycemia. However, all studies did not find an increased risk of major congenital malformations. Pregnancy losses and elective termination of pregnancy were not reported in any study.</div></div><div><h3>Conclusions</h3><div>Accidental periconceptional exposure to GLP-1 RAs may not be associated with an increased risk of adverse pregnancy outcomes, particularly major congenital malformations and pregnancy loss. More high-level evidence will be warranted to confirm these findings and guide clinical decision-making.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 1","pages":"Article 103191"},"PeriodicalIF":2.2,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-29DOI: 10.1016/j.jogc.2025.103193
Christina Antinora MD, BSc , M. Anne Harris BSc(H), MSc, PhD , Claire Mazzia MSc , Anne Berndl MD, MSc
Objectives
Women comprise approximately 20% of all adults living with spinal cord injury (SCI), and incidence of SCI among women continues to increase annually. Despite the profound impact of SCI on women in their reproductive years, there is a paucity of literature on the unique health care needs and concerns in this population. We examined the health care experiences of these patients, spanning the preconception to postpartum period.
Methods
Data was obtained from a large online observational questionnaire examining reproductive health outcomes of people with SCI between 2019 and 2021. Overall, 167 women with pre-pregnancy SCI were surveyed across a total of 257 singleton pregnancies resulting in live birth. Quantitative and qualitative survey questions were statistically analyzed.
Results
Over half of respondents felt they had little to no access to informational resources about SCI in pregnancy, and over 34% requested a pre-pregnancy consultation with a health care provider. The most frequently reported positive experiences in the perinatal period revolved around feeling supported by their health care team and having access to specialized, knowledgeable obstetrical providers. The most frequently cited negative experiences were judgment by the health care team and physical accessibility issues in clinics and labour and delivery units. Postpartum, a minority of respondents indicated feeling stigmatized due to their SCI.
Conclusions
Women with SCI face unique challenges and concerns in interacting with the health care system during pregnancy and pregnancy planning. Understanding what health care providers are doing to foster and hinder a positive experience for these patients is the first step in creating a more supportive environment.
{"title":"Health Care Experiences of Patients With Spinal Cord Injury in the Preconception, Antepartum, and Postpartum Period","authors":"Christina Antinora MD, BSc , M. Anne Harris BSc(H), MSc, PhD , Claire Mazzia MSc , Anne Berndl MD, MSc","doi":"10.1016/j.jogc.2025.103193","DOIUrl":"10.1016/j.jogc.2025.103193","url":null,"abstract":"<div><h3>Objectives</h3><div>Women comprise approximately 20% of all adults living with spinal cord injury (SCI), and incidence of SCI among women continues to increase annually. Despite the profound impact of SCI on women in their reproductive years, there is a paucity of literature on the unique health care needs and concerns in this population. We examined the health care experiences of these patients, spanning the preconception to postpartum period.</div></div><div><h3>Methods</h3><div>Data was obtained from a large online observational questionnaire examining reproductive health outcomes of people with SCI between 2019 and 2021. Overall, 167 women with pre-pregnancy SCI were surveyed across a total of 257 singleton pregnancies resulting in live birth. Quantitative and qualitative survey questions were statistically analyzed.</div></div><div><h3>Results</h3><div>Over half of respondents felt they had little to no access to informational resources about SCI in pregnancy, and over 34% requested a pre-pregnancy consultation with a health care provider. The most frequently reported positive experiences in the perinatal period revolved around feeling supported by their health care team and having access to specialized, knowledgeable obstetrical providers. The most frequently cited negative experiences were judgment by the health care team and physical accessibility issues in clinics and labour and delivery units. Postpartum, a minority of respondents indicated feeling stigmatized due to their SCI.</div></div><div><h3>Conclusions</h3><div>Women with SCI face unique challenges and concerns in interacting with the health care system during pregnancy and pregnancy planning. Understanding what health care providers are doing to foster and hinder a positive experience for these patients is the first step in creating a more supportive environment.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"48 2","pages":"Article 103193"},"PeriodicalIF":2.2,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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