Journal of obstetrics and gynaecology Canada最新文献_第10页

Guidance for Prenatal, Postnatal and Neonatal Immunohematology Testing in Canada: Consensus Recommendations from a Modified Delphi Process 加拿大产前、产后和新生儿免疫血液学检测指南：修改德尔菲过程的共识建议。

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2025-09-01 DOI: 10.1016/j.jogc.2025.103088

Lani Lieberman MD , Catharine M. Walsh MD , Rebecca Barty MSc , Jeannie Callum MD , Matthew T.S. Yan MD , Heather VanderMeulen MD , Nancy Robitaille MD , Karen Fung Kee Fung MD , Eugene Ng MD , Heather Hume MD , Jon Barrett MD , Robyn Berman RM , Melanie Colpitts MD , Erin Dowe RN , Barbra de Vrijer MD , Susan Ellis MD , Poh Nyuk Fam MD , Kirsten Grabowska MD , Batya Grundland MD , JoAnn Harrold MD , Gwen Clarke MD

Objectives

Blood Group, antibody screen, fetal maternal hemorrhage tests and Rh(D) immunoglobulin (RhIG) administration are interventions during pregnancy that aid in the prevention of hemolytic disease of the fetus and newborn (HDFN). The timing, frequency, and nature of testing vary across centres due to limited data to inform standards development. Using Delphi methodology, this study aimed to establish guidance for Canadian practice related to prenatal, postnatal and neonatal immunohematologic testing, and RhIG administration, to reduce risk and improve diagnosis of HDFN.

Methods

A national, multidisciplinary Delphi panel rated their agreement with potential guidance statements related to prenatal, postnatal and neonatal immunohematology testing on a 5-point Likert scale during iterative rounds of voting. After each round, responses were analyzed and statements were re-sent to the panel for further ratings until consensus was achieved, defined as Cronbach’s α >0.95 or a maximum of 3 voting rounds. At the conclusion of the Delphi process, statements rated ≥4/5 were included.

Results

In total, 46 experts voted on 49 proposed statements. Consensus was achieved after 3 survey rounds (Cronbach’s α = 0.94), with a 100% response rate throughout. Overall, 44 statements reached consensus. Statements focused on prenatal immunohematology testing (N = 21 statements), maternal–fetal hemorrhage testing and RhIG administration during pregnancy (N = 15), and testing of neonates for surveillance of hyperbilirubinemia secondary to hemolytic disease of the newborn (N = 8).

Conclusions

This Canadian consensus guidance aims to optimize the surveillance of pregnancies at risk of HDFN and the dosing and timing of RhIG administration. It provides actionable recommendations to harmonize practice and support safe, timely, and cost-effective care.

目的：血型、抗体筛查、胎母出血（FMH）试验和Rh(D)免疫球蛋白（RhIG）给药是孕期干预措施，有助于预防胎儿和新生儿溶血性疾病（hddn）。由于为标准制定提供信息的数据有限，各个中心的测试时间、频率和性质各不相同。本研究采用德尔菲法，旨在为加拿大产前、产后和新生儿免疫血液学检测和RhIG给药建立指导方针，以降低HDFN的风险并提高诊断水平。方法：一个全国性的、多学科的德尔菲小组在反复投票的过程中，以5分李克特量表评估他们与产前、产后和新生儿免疫血液学测试相关的潜在指导声明的一致程度。每轮之后，对反馈进行分析，并将陈述重新发送给小组进行进一步评级，直到达成共识，定义为Cronbach的alpha >.95或最多三轮投票。在德尔菲过程结束时，评分≥4/5的陈述被纳入。结果：46位专家对49项提案进行了投票。3轮调查后达成共识（Cronbach's alpha = 0.94），整个调查的回复率为100%。44项声明达成共识。声明集中在产前免疫血液学测试（N = 21），妊娠期间FMH测试和RhIG给药（N = 15），以及新生儿继发于HDN的高胆红素血症监测测试（N = 8）。结论：这份加拿大共识指南旨在优化对有HDFN风险的妊娠的监测以及RhIG给药的剂量和时间。它提供了可行的建议，以协调实践并支持安全、及时和具有成本效益的护理。

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引用次数: 0

Preeclampsia Screening Taking Into Account Ethnicity and Socioeconomic Status—A Comparison of the Competing Risks Model and Risk Factor Scoring 考虑种族和社会经济地位的子痫前期筛查-竞争风险模型和风险因素评分的比较。

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2025-09-01 DOI: 10.1016/j.jogc.2025.103087

Anastasija Arechvo PhD , Argyro Syngelaki PhD , Ranjit Akolekar PhD , Peter von Dadelszen DPhil , Kypros H. Nicolaides MD , Laura A. Magee MD

Objectives

This study aimed to compare preeclampsia (PE) risk screening by risk factors and the multivariable competing risks model.

Methods

This prospective cohort study enrolled singleton pregnancies, without major anomalies, and delivering at ≥24 weeks. PE risk was compared between the Fetal Medicine Foundation (FMF) model and clinical risk factors by National Institute for Health and Care Excellence (NICE) guidance, U.K. and “NICE-modified” by adding Black ethnicity and social deprivation (index of multiple deprivation deciles 1–4) as moderate risk factors. To compare screening strategies, we matched the FMF screen-positive rate (SPR) to NICE.

Results

At 11–13 weeks, preterm PE risk was assessed in 44 813 pregnancies; 368 (0.8%) developed preterm PE. At SPR = 7.4%, FMF (vs. NICE) almost tripled preterm PE detection rate (DR) but by more (by 19.8%) among Black women. The FMF model at SPR = 7.4% had DR = 67.7% for preterm PE, similar to NICE-modified screening (67.4%, which had SPR = 40.1%). At 35–36 weeks, subsequent PE risk was assessed in 29 035 pregnancies; 654 (2.3%) developed PE. At SPR = 10.9%, FMF (vs. NICE) more than doubled subsequent PE DR, regardless of index of multiple deprivation or Black ethnicity. FMF at SPR = 10.9% had DR for subsequent PE at least as high (70.5%) as NICE-modified screening (61.5%), which had SPR = 37.4%.

Conclusions

The FMF model detects PE risk similar to risk factor–based screening, with addition of Black ethnicity and social deprivation as moderate risk factors but at substantially lower SPR at 11–13 weeks when aspirin is offered to prevent preterm PE and at 35–36 weeks when timed birth at term may prevent term PE.

目的：比较用危险因素和多变量竞争风险模型筛查子痫前期风险。方法：本前瞻性队列研究纳入单胎妊娠，无重大异常，分娩≥24周。通过英国国家健康与护理卓越研究所（NICE）的指导，比较胎儿医学基金会（FMF）模型和临床危险因素之间的PE风险，并通过将黑人和社会剥夺（多重剥夺指数[IMD]十分位数1-4）作为中等危险因素，进行“NICE修正”。为了比较筛查策略，我们将FMF筛查阳性率（SPR）与NICE相匹配。结果：在11-13周时，对44813例妊娠进行了早产风险评估；368例（0.8%）发生早产儿PE。在SPR = 7.4%时，FMF（相对于NICE）几乎是早产PE DR的三倍，但在黑人女性中更多（19.8%）。SPR = 7.4%的FMF模型对早产儿PE的DR = 67.7%，与nice改良筛选（67.4%,SPR = 40.1%）相似。在35-36周时，对29035例妊娠进行PE风险评估；654例（2.3%）发生PE。在SPR = 10.9%时，无论IMD或黑人种族，FMF（与NICE相比）在PE DR后增加了一倍以上。SPR = 10.9%的FMF对随后PE的DR至少与nice改良筛选（61.5%）一样高（70.5%），SPR = 37.4%。结论：FMF模型检测PE风险类似于基于风险因素的筛查，增加了黑人种族和社会剥夺作为中等风险因素，但SPR明显较低，在11-13周时提供阿司匹林以预防早产PE，以及在35-36周时足月分娩可能预防足月PE。

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引用次数: 0

The Society of Obstetricians and Gynecologists of Canada Annual Clinical and Scientific Conference Highlights Editorial 加拿大妇产科医师协会（SOGC）年度临床和科学会议（ACSC）重点编辑。

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2025-09-01 DOI: 10.1016/j.jogc.2025.103066

Graeme Smith MD, PhD

引用次数: 0

Respiratory Syncytial Virus Immunization Review for Prenatal Care Providers 产前保健提供者呼吸道合胞病毒免疫审查。

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2025-09-01 DOI: 10.1016/j.jogc.2025.103064

Jeffrey Man Hay Wong MD , Pascal M. Lavoie MD, PhD

引用次数: 0

Systemic Inequities in Women’s Health for Providers and Patients: The Impact on Access to Care 妇女健康对提供者和患者的系统性不平等：对获得护理的影响。

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2025-09-01 DOI: 10.1016/j.jogc.2025.103080

Nicholas A. Leyland MD, MHCM, Marfy Abousifein BHSc

引用次数: 0

Serum Biglycan and Decorin as Biomarkers for Preterm Birth: A Prospective Cohort Study 血清Biglycan和Decorin作为早产的生物标志物：一项前瞻性队列研究。

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2025-08-26 DOI: 10.1016/j.jogc.2025.103086

Sundas Akram Mphil, Kaleem Maqsood PhD, Javeria Malik PhD, Nabila Roohi PhD

Objectives

Preterm birth (PTB) affects 10% of pregnancies worldwide, causing significant neonatal morbidity and mortality. Biglycan and decorin, essential proteoglycans in fetal membranes, are linked to spontaneous PTB pathophysiology. This study investigates their potential as biomarkers for spontaneous PTB.

Methods

This study included 500 pregnant women from various hospitals. Blood samples were collected, and participants were followed up until delivery. Pregnant women were categorized into groups based on gestational age at birth: moderate PTB, very PTB (vPTB), and term birth (control group). Serum levels of biglycan and decorin were measured using enzyme-linked immunosorbent assay kits. Statistical analysis included analysis of variance, logistic regression, and receiver operating characteristic curve evaluation using SPSS.

Results

Serum levels of biglycan were higher in the vPTB group in the second (82.49 ± 2.86 pg/mL, P = 0.0012) and third trimesters (81.17 ± 2.01 pg/mL, P = 0.0097). In both trimesters, decorin levels were lower in the vPTB group (second: 36.32 ± 0.90 ng/mL, P = 0.0013; third: 34.25 ± 1.86 ng/mL, P = 0.0023). Receiver operating characteristic curve analysis showed fair discriminatory power for decorin in the third trimester (area under the curve = 0.70, P = 0.0021). Multinomial logistic regression further confirmed that both biomarkers (biglycan: OR 1.034, P = 0.001; decorin: OR 0.914, P = 0.001) were significant predictors of PTB.

Conclusions

Reduced amount of decorin and increased concentration of biglycan during pregnancy were associated with enhanced risk of spontaneous PTB. These results support the potential of early gestation serum glycoprotein complex as a predictive model for spontaneous PTB.

导读：早产（PTB）影响全球10%的妊娠，造成显著的新生儿发病率和死亡率。Biglycan和decorin是胎膜中必需的蛋白聚糖，与自发性肺结核的病理生理有关。本研究探讨了它们作为自发性肺结核生物标志物的潜力。方法：本研究包括500名来自不同医院的孕妇。研究人员采集了参与者的血液样本，并对他们进行了随访，直到分娩。孕妇根据出生时的胎龄分为三组：中度早产（mPTB）、重度早产（vPTB）和足月分娩（对照组）。采用酶联免疫吸附试验（ELISA）检测血清多糖和decorin水平。统计分析采用方差分析、logistic回归及SPSS进行ROC曲线评价。结果：vPTB组在妊娠中期（82.49±2.86 pg/mL, P = 0.0012）和妊娠晚期（81.17±2.01 pg/mL, P = 0.0097）血清biglycan水平均较高。vPTB组的Decorin水平在两个妊娠期均较低（第二组：36.32±0.90 ng/mL, P = 0.0013；第三组：34.25±1.86 ng/mL, P = 0.0023）。ROC曲线分析显示，妊娠晚期decorin的区分力较好（AUC = 0.70, P = 0.0021）。多项logistic回归进一步证实了这两种生物标志物（biglycan: OR;1.034, P = 0.001）和decorin: OR； 0.914, P = 0.001)是早产的显著预测因子。结论：妊娠期decorin量的减少和biglycan浓度的升高与自发性早产的风险增加有关。这些结果支持早期妊娠血清糖蛋白复合物作为自发性早产的预测模型的潜力。

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引用次数: 0

Association Between Elevated Maternal BMI, Cervical Length, and Spontaneous Preterm Birth in Persons at Increased Risk of Spontaneous Preterm Birth 在自发性早产风险增加的个体中，母亲BMI升高、宫颈长度和自发性早产之间的关系

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2025-08-26 DOI: 10.1016/j.jogc.2025.103090

Joan Crane MD, MSc , Donnette O’Brien BN

Objectives

To evaluate the association between maternal BMI, short cervical length (CL) ≤2.50 cm, and spontaneous preterm birth (SPTB) in persons with risk factors for SPTB, including those with a history of excisional cervical procedures or uterine anomalies.

Methods

This retrospective cohort study included asymptomatic pregnant persons with singleton gestations and intact membranes, without a history of SPTB but at increased risk of SPTB (including those with a history of excisional cervical procedures or uterine anomalies), who underwent transvaginal ultrasound assessment of CL between 16⁰ and 23⁶ weeks gestation and had pre-pregnancy BMI (or height and weight) reported. The primary exposure was pre-pregnancy BMI, with the primary outcomes of interest being CL and SPTB. Univariate and multivariate logistic regression analyses were performed to assess the associations between BMI and CL and BMI and SPTB <37 weeks gestation, adjusting for possible confounders.

Results

Of the 407 persons included, 198 (48.6%) had a BMI ≥25.0. BMI ≥25.0 and CL ≤2.50 cm were associated with SPTB <37 weeks gestation (adjusted OR 2.65; 95% CI 1.09–6.43, P = 0.031 and adjusted OR 7.30; 95% CI 2.18–24.50, P = 0.001; respectively). BMI ≥25.0 was not associated with CL ≤2.50 cm in the univariate or multivariate regression analyses (P = 0.29 and P = 0.48, respectively).

Conclusions

In persons with a history of an excisional cervical procedure or uterine anomaly, BMI ≥25.0 is associated with SPTB <37 weeks gestation but is not associated with CL ≤2.50 cm in the second trimester.

目的：探讨具有SPTB危险因素（包括宫颈手术切除史或子宫异常史）的产妇BMI、宫颈短长(CL) < 2.50 cm与自发性早产（SPTB）的关系。方法：本回顾性队列研究纳入了无症状的单胎妊娠、胎膜完整、无SPTB病史但SPTB风险增加的孕妇（包括宫颈手术切除史或子宫异常史），在妊娠160至237周期间接受阴道超声检查CL，并有孕前BMI（或身高和体重）报告。主要暴露是孕前BMI，主要关注的结局是CL和SPTB。进行单因素和多因素logistic回归分析，评估BMI与CL、BMI与妊娠< 37周SPTB之间的关系，并对可能的混杂因素进行校正。结果：在纳入的407人中，198人（48.6%）的BMI为25.0。BMI > 25.0和CL < 2.50 cm与SPTB < 37周妊娠相关（aOR分别为2.65,95% CI 1.09 ~ 6.43, P = 0.031； aOR为7.30,95% CI 2.18 ~ 24.50, P = 0.001）。在单因素或多因素回归分析中，BMI bb0 25.0与CL < 2.50 cm无关（P分别= 0.29和P = 0.48）。结论：在宫颈手术切除史或子宫异常的个体中，BMI b> 25.0与妊娠< 37周的SPTB相关，但与妊娠中期CL < 2.50 cm无关。

{"title":"Association Between Elevated Maternal BMI, Cervical Length, and Spontaneous Preterm Birth in Persons at Increased Risk of Spontaneous Preterm Birth","authors":"Joan Crane MD, MSc , Donnette O’Brien BN","doi":"10.1016/j.jogc.2025.103090","DOIUrl":"10.1016/j.jogc.2025.103090","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the association between maternal BMI, short cervical length (CL) ≤2.50 cm, and spontaneous preterm birth (SPTB) in persons with risk factors for SPTB, including those with a history of excisional cervical procedures or uterine anomalies.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included asymptomatic pregnant persons with singleton gestations and intact membranes, without a history of SPTB but at increased risk of SPTB (including those with a history of excisional cervical procedures or uterine anomalies), who underwent transvaginal ultrasound assessment of CL between 16<sup>0</sup> and 23<sup>6</sup> weeks gestation and had pre-pregnancy BMI (or height and weight) reported. The primary exposure was pre-pregnancy BMI, with the primary outcomes of interest being CL and SPTB. Univariate and multivariate logistic regression analyses were performed to assess the associations between BMI and CL and BMI and SPTB <37 weeks gestation, adjusting for possible confounders.</div></div><div><h3>Results</h3><div>Of the 407 persons included, 198 (48.6%) had a BMI ≥25.0. BMI ≥25.0 and CL ≤2.50 cm were associated with SPTB <37 weeks gestation (adjusted OR 2.65; 95% CI 1.09–6.43, <em>P</em> = 0.031 and adjusted OR 7.30; 95% CI 2.18–24.50, <em>P</em> = 0.001; respectively). BMI ≥25.0 was not associated with CL ≤2.50 cm in the univariate or multivariate regression analyses (<em>P</em> = 0.29 and <em>P</em> = 0.48, respectively).</div></div><div><h3>Conclusions</h3><div>In persons with a history of an excisional cervical procedure or uterine anomaly, BMI ≥25.0 is associated with SPTB <37 weeks gestation but is not associated with CL ≤2.50 cm in the second trimester.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 10","pages":"Article 103090"},"PeriodicalIF":2.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985900","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}

引用次数: 0

Viral Load Testing Practices Among Pregnant People Living With HIV on Admission From Obstetrical Triage 从产科分诊入院的艾滋病毒感染孕妇的病毒载量检测实践。

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2025-08-26 DOI: 10.1016/j.jogc.2025.103089

Jessica Shu Nan Li MD, MPH , Alysha Nensi MD, MSc , Mark H. Yudin MD, MSc

Objectives

Routine viral load (VL) testing is recommended for pregnant people living with HIV (PLWH) to confirm viral suppression antenatally. The exact timing of this varies in practice. To obtain an up-to-date VL immediately prior to delivery, our institution implemented a policy to test VLs for all pregnant PLWH on admission. Our objective was to characterize testing practices since implementation.

Methods

Retrospective chart review of all pregnant PLWH admitted through obstetrical triage at St. Michael’s Hospital in Toronto, Ontario from January 2013 to December 2022. Outcomes of interest included VL completion status, stratified by year and other competing admission tasks.

Results

This study identified 135 admissions. The majority had VLs ordered (61.5%) and drawn (85.9%) on admission. VL ordering improved over the latter half of the study period (44.6% vs. 82.0%, P < 0.001). More VLs were ordered among Group B Streptococcus-negative patients (71.3%) compared to positive (41.4%) (P = 0.031) and among those who received an epidural (74.2% vs. 50.7%, P = 0.020). More VLs were drawn by nurses among patients who delivered during the admission (90.9% vs. 42.9%, P < 0.001) and patients who received an epidural (93.5% vs. 79.5%, P = 0.019).

Conclusions

While the rate of ordering VLs improved over the course of the study, the rate of drawing VLs remained high throughout, indicating that nurses consistently drew the bloodwork irrespective of an actual order. VL testing improved with the introduction of pre-printed orders, and varied by Group B Streptococcus status, epidural usage, and delivery status. These findings offer opportunities to guide future clinical practices on antenatal VL testing.

目的：建议孕妇HIV感染者（PLWH）进行常规病毒载量（VL）检测，以确认产前病毒抑制。具体的时间在实践中是不同的。为了在分娩前立即获得最新的VL，我们机构实施了一项政策，对所有怀孕的PLWH在入院时进行VL测试。我们的目标是描述自实现以来的测试实践。方法：回顾性分析2013年1月至2022年12月在安大略省多伦多市圣迈克尔医院（St. Michael's Hospital）通过产科分诊入院的所有妊娠PLWH。感兴趣的结果包括VL完成状态，按年份和其他竞争入学任务分层。结果：本研究确定了135例入院患者。大多数人在入场时订购了vl(61.5%)，并抽取了vl（85.9%）。VL排序在研究后期有所改善（44.6% vs 82.0%, P < 0.001）。gbs阴性患者（71.3%）比阳性患者（41.4%）（P = 0.031）和接受硬膜外麻醉的患者（74.2%对50.7%,P = 0.020）订购了更多的vl。入院时分娩的患者（90.9% vs 42.9%, P < 0.001）和硬膜外麻醉的患者（93.5% vs 79.5%, P = 0.019），护士绘制的vl更多。结论：虽然在整个研究过程中，静脉滴注率有所提高，但抽取静脉滴注率始终保持在较高水平，这表明护士无论实际订单如何都坚持抽血。VL测试随着预先打印的订单的引入而改进，并且根据GBS状态、硬膜外使用和交付状态而变化。这些发现为指导未来产前VL检测的临床实践提供了机会。

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引用次数: 0

Perspectives and Motivational Factors Surrounding Decision-Making in Women With Cancer Considering Fertility Preservation 考虑保留生育能力的癌症妇女决策的观点和动机因素。

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2025-08-15 DOI: 10.1016/j.jogc.2025.103074

Trish Dinh MD, MSc , Salina Kanji MD , Nicola Farnell CRNP , Ruth Ronn MD , Graciella Pio MD , Xin Xu MD , Swati Dixit PhD , Ellen M. Greenblatt MD

Objectives

To assess perspectives of patients referred for urgent oncofertility consultation influencing whether to proceed or decline fertility preservation (FP).

Methods

An online survey was conducted in newly diagnosed cancer patients from August 2021 to July 2023 after an oncofertility consultation. Post-pubertal people with ovaries, a recent cancer diagnosis, and those who were referred for urgent oncofertility preservation consultation were eligible. Primary outcomes were patients’ experiences and final treatment decisions; secondary outcomes included cycle outcomes.

Results

Overall, 67/126 (53.2%) completed the survey and met our study criteria. Median age was 28 years (IQR 29–36). Most referrals were from medical (47.8%; 32/67) and surgical (35.8%; 24/67) oncologists with a median interval of 3 days (IQR 2–6) from referral to consultation. Breast (64.2%; 43/67) and hematological (11.9%; 8/67) cancers were most common. Overall, 55/67 (82.1%) proceeded with cryopreservation, 38/55 (69.1%) oocyte cryopreservation, 12/55 (21.8%) embryo cryopreservation, and 5/55 (9.1%) both. Of those planning chemotherapy/radiation, 42/56 (75%) chose gonadotropin-releasing hormone agonist. Of those who declined cryopreservation, 3 (25%) chose gonadotropin-releasing hormone agonist treatment as the only form of FP; 9/67 (13.4%) chose no FP treatment. The most common reasons for not cryopreserving included: no time to complete FP before cancer treatment (41.7%; 5/12) and delaying cancer treatment (41.7%; 5/12). The most common motivating factors for pursuing FP were concern for future fertility (72.4%; 42/58) and health care provider advice (48.2%; 28/58).

Conclusions

Most patients who received urgent oncofertility counselling proceeded with treatment. Common reasons for declining were timing of FP and delaying oncological treatment.

目的：评估紧急不孕咨询患者的观点对是否继续或放弃生育保留（FP）的影响。方法：于2021年8月至2023年7月对新诊断的癌症患者进行在线调查。青春期后卵巢，近期癌症诊断，和那些谁被转诊为紧急保癌咨询符合条件。主要结局是患者的经历和最终的治疗决定；次要结局包括周期结局。结果：总体而言，67/126（53.2%）完成了调查，符合我们的研究标准。中位年龄28岁（IQR 29-36）。大多数转诊来自医疗机构(47.8%；32/67)和外科(35.8%；24/67)，从转诊到会诊的中位间隔为3天（IQR 2-6）。乳腺癌(64.2%;43/67)和血液学(11.9%；癌症是最常见的。55/67（82.1%）进行冷冻保存，38/55（69.1%）进行卵母细胞冷冻保存，12/55（21.8%）进行胚胎冷冻保存，5/55（9.1%）同时进行冷冻保存。在计划化疗/放疗的患者中，42/56（75%）选择GnRH激动剂。在拒绝冷冻保存的患者中，3例（25%）选择GnRHa治疗作为FP的唯一形式。9/67（13.4%）患者选择不使用FP治疗。不冷冻保存的最常见原因包括：在癌症治疗前没有时间完成FP (41.7%)；5/12)和延迟癌症治疗(41.7%；5/12)。追求计划生育最常见的激励因素是对未来生育的担忧(72.4%；42/58)和保健提供者咨询(48.2%；28/58)。结论：大多数接受紧急不孕咨询的患者接受了治疗。下降的常见原因是计划生育的时间和延迟肿瘤治疗。

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引用次数: 0

Placental Growth Factor Diagnostic Testing: An Opportunity to Transform Pregnancy Care for Patients With Suspected Preeclampsia in Canada 胎盘生长因子（PlGF）诊断测试：一个机会，以改变妊娠护理患者的怀疑先兆子痫在加拿大。

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2025-08-14 DOI: 10.1016/j.jogc.2025.103076

Kelsey McLaughlin PhD , Melanie C. Audette MD, PhD , Harrison Banner MD, MSc , Jon Barrett MB, MD , Emmanuel Bujold MD, MSc , Honzer Chen MD , Nicole Cohen MD , Tina Delaney MD , Ernesto A. Figueiro-Filho MD, PhD , Rachel A. Gladstone MD, MSc , Venu Jain MD, PhD , Jessica Liauw MD, MSc , Isabelle Malhamé MD, MSc , Elad Mei-Dan MD , Nir Melamed MD, MSc , Kellie E. Murphy MD, MSc , Christopher M. Nash MD , Christy Pylypjuk MD, MSc , Naila Ramji MD, MSc , Anjana Ravi Chandran MSc , John W. Snelgrove MD, MSc

Preeclampsia is a leading cause of maternal morbidity and adverse perinatal outcomes in Canada. Growing evidence supports the novel blood-based biomarker placental growth factor (PlGF) as a diagnostic test to accelerate the timely diagnosis of preeclampsia, enhancing care for hypertensive pregnant patients. Despite national endorsement, challenges like regional disparities and test standardization hinder PlGF implementation. The Canadian PlGF Strategy & Research Consortium convened with representation from clinicians, researchers, and patient partners to discuss the current state of PlGF testing. We universally agreed there is an urgent need to implement diagnostic PlGF testing to improve maternal and perinatal outcomes in Canada.

在加拿大，先兆子痫是产妇发病和不良围产期结局的主要原因。越来越多的证据支持新的基于血液的生物标志物胎盘生长因子（PlGF）作为一种诊断试验，加速先兆子痫的及时诊断，加强对高血压妊娠患者的护理。尽管国家认可，但地区差异和测试标准化等挑战阻碍了PlGF的实施。加拿大PlGF战略与研究联盟召集了来自临床医生、研究人员和患者合作伙伴的代表，讨论了PlGF检测的现状。我们普遍认为，迫切需要实施诊断性PlGF测试，以改善加拿大的孕产妇和围产期结局。

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引用次数: 0