Pub Date : 2024-08-01DOI: 10.1016/j.jogc.2024.102607
JOGC Editorial Office
{"title":"Corrigendum to 2024 Abstracts: 80th Annual Clinical and Scientific Conference [Journal of Obstetrics and Gynaecology Canada (2024) Article Number 102469]","authors":"JOGC Editorial Office","doi":"10.1016/j.jogc.2024.102607","DOIUrl":"10.1016/j.jogc.2024.102607","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 8","pages":"Article 102607"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004304/pdfft?md5=9b7a6c9a3454626082c342eed1578494&pid=1-s2.0-S1701216324004304-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.jogc.2024.102630
Graeme N. Smith MD, PhD, FRCSC, FCAHS
{"title":"L’avenir du Journal d’obstétrique et gynécologie du Canada : un mot du nouveau rédacteur en chef","authors":"Graeme N. Smith MD, PhD, FRCSC, FCAHS","doi":"10.1016/j.jogc.2024.102630","DOIUrl":"10.1016/j.jogc.2024.102630","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 8","pages":"Article 102630"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048084","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 : 2024-08-01DOI: 10.1016/j.jogc.2024.102629
Graeme N. Smith MD, PhD, FRCSC, FCAHS
{"title":"The Future of the Journal of Obstetrics and Gynaecology Canada: A Word From its New Editor","authors":"Graeme N. Smith MD, PhD, FRCSC, FCAHS","doi":"10.1016/j.jogc.2024.102629","DOIUrl":"10.1016/j.jogc.2024.102629","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 8","pages":"Article 102629"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048083","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 : 2024-08-01DOI: 10.1016/j.jogc.2024.102618
Sebastian R. Hobson MD, PhD, Elissa R. Cohen MD, MA, Shital Gandhi MD, MPH, Venu Jain MD, PhD, Kirsten M. Niles MD, PhD, Marie-Ève Roy-Lacroix MD, Bi Lan Wo MD
<div><h3>Objective</h3><p>To summarize the current evidence and to make recommendations for the diagnosis and management of intrahepatic cholestasis of pregnancy.</p></div><div><h3>Target Population</h3><p>Pregnant people with intrahepatic cholestasis of pregnancy.</p></div><div><h3>Options</h3><p>Diagnosing the condition using fasting or non-fasting bile acids, classifying disease severity, determining what treatment to offer, establishing how to monitor for antenatal fetal wellbeing, identifying when to perform elective birth.</p></div><div><h3>Benefits, Harms, and Costs</h3><p>Individuals with intrahepatic cholestasis of pregnancy are at increased risk of adverse perinatal outcomes including preterm birth, neonatal respiratory distress and admission to a neonatal intensive care unit, with an increased risk of stillbirth when bile acid levels are ≥100 μmol/L. There is inequity in bile acid testing availability and timely access to results, along with uncertainly of how to treat, monitor. and ultimately deliver these pregnancies. Optimization of diagnostic and management protocols can improve maternal and fetal postnatal outcomes.</p></div><div><h3>Evidence</h3><p>Medline, PubMed, Embase, and the Cochrane Library were searched from inception to March 2023, using medical subject headings (MeSH) and keywords related to pregnancy, intrahepatic cholestasis of pregnancy, bile acids, pruritis, ursodeoxycholic acid, and stillbirth. This document presents an abstraction of the evidence rather than a methodological review.</p></div><div><h3>Validation Methods</h3><p>The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See <span><span>Appendix A</span></span> (<span><span>Tables A1</span></span> for definitions and <span><span>A2</span></span> for interpretations).</p></div><div><h3>Intended Audience</h3><p>Obstetric care providers, including obstetricians, family physicians, nurses, midwives, maternal–fetal medicine specialists, and radiologists.</p></div><div><h3>Social Media Abstract</h3><p>Intrahepatic cholestasis of pregnancy requires adequate diagnosis with non-fasting bile acid levels which guide optimal management and delivery timing.</p></div><div><h3>SUMMARY STATEMENTS</h3><p></p><ul><li><span>1.</span><span><p>Intrahepatic cholestasis of pregnancy is a common pregnancy condition manifesting in the late-second or third trimesters (<em>moderate</em>).</p></span></li><li><span>2.</span><span><p>The etiology of intrahepatic cholestasis is complex, involving a combination of hormonal factors, genetic susceptibility, and environmental influences (<em>low</em>).</p></span></li><li><span>3.</span><span><p>Intrahepatic cholestasis remains a diagnosis of exclusion and is based on the presence of maternal pruritis, predominantly of the palms and soles, along with elevated non-fasting bile acids (>19 μmol/L) (<em>moderate</em>).</p></span><
{"title":"Guideline No. 452: Diagnosis and Management of Intrahepatic Cholestasis of Pregnancy","authors":"Sebastian R. Hobson MD, PhD, Elissa R. Cohen MD, MA, Shital Gandhi MD, MPH, Venu Jain MD, PhD, Kirsten M. Niles MD, PhD, Marie-Ève Roy-Lacroix MD, Bi Lan Wo MD","doi":"10.1016/j.jogc.2024.102618","DOIUrl":"10.1016/j.jogc.2024.102618","url":null,"abstract":"<div><h3>Objective</h3><p>To summarize the current evidence and to make recommendations for the diagnosis and management of intrahepatic cholestasis of pregnancy.</p></div><div><h3>Target Population</h3><p>Pregnant people with intrahepatic cholestasis of pregnancy.</p></div><div><h3>Options</h3><p>Diagnosing the condition using fasting or non-fasting bile acids, classifying disease severity, determining what treatment to offer, establishing how to monitor for antenatal fetal wellbeing, identifying when to perform elective birth.</p></div><div><h3>Benefits, Harms, and Costs</h3><p>Individuals with intrahepatic cholestasis of pregnancy are at increased risk of adverse perinatal outcomes including preterm birth, neonatal respiratory distress and admission to a neonatal intensive care unit, with an increased risk of stillbirth when bile acid levels are ≥100 μmol/L. There is inequity in bile acid testing availability and timely access to results, along with uncertainly of how to treat, monitor. and ultimately deliver these pregnancies. Optimization of diagnostic and management protocols can improve maternal and fetal postnatal outcomes.</p></div><div><h3>Evidence</h3><p>Medline, PubMed, Embase, and the Cochrane Library were searched from inception to March 2023, using medical subject headings (MeSH) and keywords related to pregnancy, intrahepatic cholestasis of pregnancy, bile acids, pruritis, ursodeoxycholic acid, and stillbirth. This document presents an abstraction of the evidence rather than a methodological review.</p></div><div><h3>Validation Methods</h3><p>The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See <span><span>Appendix A</span></span> (<span><span>Tables A1</span></span> for definitions and <span><span>A2</span></span> for interpretations).</p></div><div><h3>Intended Audience</h3><p>Obstetric care providers, including obstetricians, family physicians, nurses, midwives, maternal–fetal medicine specialists, and radiologists.</p></div><div><h3>Social Media Abstract</h3><p>Intrahepatic cholestasis of pregnancy requires adequate diagnosis with non-fasting bile acid levels which guide optimal management and delivery timing.</p></div><div><h3>SUMMARY STATEMENTS</h3><p></p><ul><li><span>1.</span><span><p>Intrahepatic cholestasis of pregnancy is a common pregnancy condition manifesting in the late-second or third trimesters (<em>moderate</em>).</p></span></li><li><span>2.</span><span><p>The etiology of intrahepatic cholestasis is complex, involving a combination of hormonal factors, genetic susceptibility, and environmental influences (<em>low</em>).</p></span></li><li><span>3.</span><span><p>Intrahepatic cholestasis remains a diagnosis of exclusion and is based on the presence of maternal pruritis, predominantly of the palms and soles, along with elevated non-fasting bile acids (>19 μmol/L) (<em>moderate</em>).</p></span><","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 8","pages":"Article 102618"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875129","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 : 2024-08-01DOI: 10.1016/j.jogc.2024.102615
Amélie Boutin PhD , Arlin Cherian MPH , Jessica Liauw MD, MHSc , Susie Dzakpasu PhD , Heather Scott MD , Michiel Van den Hof MD , Jocelynn Cook PhD , Jennifer Blake MD , K.S. Joseph MD, PhD , Canadian Perinatal Surveillance System (Public Health Agency of Canada)
{"title":"Corrigendum to Database Autopsy: An Efficient and Effective Confidential Enquiry into Maternal Deaths in Canada Journal of Obstetrics and Gynaecology Canada (JOGC). Volume 43, Issue 1 (2021) 58–66","authors":"Amélie Boutin PhD , Arlin Cherian MPH , Jessica Liauw MD, MHSc , Susie Dzakpasu PhD , Heather Scott MD , Michiel Van den Hof MD , Jocelynn Cook PhD , Jennifer Blake MD , K.S. Joseph MD, PhD , Canadian Perinatal Surveillance System (Public Health Agency of Canada)","doi":"10.1016/j.jogc.2024.102615","DOIUrl":"10.1016/j.jogc.2024.102615","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 8","pages":"Article 102615"},"PeriodicalIF":2.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004389/pdfft?md5=acd7be936704e4b61ed9d29d16b72920&pid=1-s2.0-S1701216324004389-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1016/j.jogc.2024.102616
Jacques B.E. Versailles MD, MSc, Luis Bahamondes MD, PhD, Ana Claudia Marcelino MD, MC, Paula da Cunha Pereira RN, MC, Cassia R.T. Juliato MD, PhD
Objectives
The objective was to describe the ease and difficulty of removing intrauterine devices (IUDs).
Methods
We conducted a prospective study at the University of Campinas (UNICAMP), Faculty of Medical Sciences, UNICAMP. We included women who requested IUD removal. We excluded women with partial IUD expulsion in which the IUD was protruded at the external os. We identified difficult IUD removal when the removal was challenging, including the inability to visualize IUD strings extending from the cervical os.
Results
A total of 869 women participated. Women were aged 29.4 ± 8.0 years (mean ± SD; range 14–51) and the duration of IUD use at the time of removal was 4.3 ± 4.2 years. We found that 702 (80.8%) women had visible strings at the external os and the removals were performed at the first attempt without difficulty in 692 (79.6%) participants. The pain was more intense (>4) in cases of difficult removals. After multivariate logistic analysis, difficult removals were associated with users of IUD ≥3 years (3 times higher risk); for each previous cesarean delivery, the risk increased by 1.5 times.
Conclusions
Our study showed that IUD removal is an easy and safe procedure, with only a small proportion of women reporting significant pain with IUD removal.
{"title":"Prospective Evaluation of Ease and Difficulties of 869 Cases of Intrauterine Devices Removals","authors":"Jacques B.E. Versailles MD, MSc, Luis Bahamondes MD, PhD, Ana Claudia Marcelino MD, MC, Paula da Cunha Pereira RN, MC, Cassia R.T. Juliato MD, PhD","doi":"10.1016/j.jogc.2024.102616","DOIUrl":"10.1016/j.jogc.2024.102616","url":null,"abstract":"<div><h3>Objectives</h3><p>The objective was to describe the ease and difficulty of removing intrauterine devices (IUDs).</p></div><div><h3>Methods</h3><p>We conducted a prospective study at the University of Campinas (UNICAMP), Faculty of Medical Sciences, UNICAMP. We included women who requested IUD removal. We excluded women with partial IUD expulsion in which the IUD was protruded at the external os. We identified difficult IUD removal when the removal was challenging, including the inability to visualize IUD strings extending from the cervical os.</p></div><div><h3>Results</h3><p>A total of 869 women participated. Women were aged 29.4 ± 8.0 years (mean ± SD; range 14–51) and the duration of IUD use at the time of removal was 4.3 ± 4.2 years. We found that 702 (80.8%) women had visible strings at the external os and the removals were performed at the first attempt without difficulty in 692 (79.6%) participants. The pain was more intense (>4) in cases of difficult removals. After multivariate logistic analysis, difficult removals were associated with users of IUD ≥3 years (3 times higher risk); for each previous cesarean delivery, the risk increased by 1.5 times.</p></div><div><h3>Conclusions</h3><p>Our study showed that IUD removal is an easy and safe procedure, with only a small proportion of women reporting significant pain with IUD removal.</p></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 10","pages":"Article 102616"},"PeriodicalIF":2.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788442","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 database autopsy method was developed to determine probable causes of maternal deaths in the Canadian Institute for Health Information’s hospital discharge abstract database; however, the method has yet to be validated. Using immediate cause of death information from Québec’s hospitalization database as the gold standard, this study assessed the validity and reliability of the database autopsy method for pregnancy-associated deaths. The method had high sensitivity and specificity for identifying the most common causes of these deaths, as well as high interobserver agreement. We conclude that the database autopsy method is valid and reliable overall.
{"title":"Validation of Database Autopsy for Review of Pregnancy-Associated Deaths in Canada","authors":"Susie Dzakpasu PhD , Zhiping Li MSc , Aimina Ayoub MSc , Shu Qin Wei PhD , Nathalie Auger MD MSc","doi":"10.1016/j.jogc.2024.102611","DOIUrl":"10.1016/j.jogc.2024.102611","url":null,"abstract":"<div><p>The database autopsy method was developed to determine probable causes of maternal deaths in the Canadian Institute for Health Information’s hospital discharge abstract database; however, the method has yet to be validated. Using immediate cause of death information from Québec’s hospitalization database as the gold standard, this study assessed the validity and reliability of the database autopsy method for pregnancy-associated deaths. The method had high sensitivity and specificity for identifying the most common causes of these deaths, as well as high interobserver agreement. We conclude that the database autopsy method is valid and reliable overall.</p></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102611"},"PeriodicalIF":2.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004341/pdfft?md5=8873964b5a8d42edba374d8828d7f99d&pid=1-s2.0-S1701216324004341-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-14DOI: 10.1016/j.jogc.2024.102612
Øjvind Lidegaard MD, DMSci , Hjarn V. Zernichow Borberg MEcon , Steen C. Rasmussen MSci, MPH , Anders P. Mikkelsen MD, PhD
Objectives
Little is known about whether induced abortions are associated with the final lifetime number of live births (life births). The objective of this study was to examine the association between the number of life births with the number of abortions a female has had in her lifetime.
Methods
In a national cohort design, we followed all Danish females from ages 15 to 44 years through the period 1977–2017 for induced abortions and live births. For each lifetime number of induced abortions, the average number of life births was assessed, and rates with 95% CI were calculated.
Results
The study included 409 497 females who completed 222 482 induced abortions and 831 742 live births. Of 265 573 (64.9%) females who did not have any induced abortion, the average number of life births was 2.09 (95% CI 2.08–2.10). For females with 1 (23.4%), 2 (7.4%), 3 (2.6%), 4 (1.0%), and ≥5 (0.7%) induced abortions during their reproductive lifespan, the average number of life births was 1.88 (1.87–1.89), 1.99 (1.98–2.00), 2.09 (2.06–2.11), 2.13 (2.09–2.15), and 2.25 (2.21–2.29), respectively. The increase in number of life births in females with 1 to females with 5+ induced abortions was 4.7% for each additional induced abortion.
Conclusion
We found the number of induced abortions during a woman’s reproductive lifespan to be positively correlated to the number of live births. This association is likely explained by a high fecundity in females with multiple pregnancies including induced abortions and suggests that even several induced abortions do not compromise a woman’s general reproductive end points.
{"title":"Lifetime Induced Abortions and Live Births: A 40-Year Historical Cohort Study","authors":"Øjvind Lidegaard MD, DMSci , Hjarn V. Zernichow Borberg MEcon , Steen C. Rasmussen MSci, MPH , Anders P. Mikkelsen MD, PhD","doi":"10.1016/j.jogc.2024.102612","DOIUrl":"10.1016/j.jogc.2024.102612","url":null,"abstract":"<div><h3>Objectives</h3><p>Little is known about whether induced abortions are associated with the final lifetime number of live births (life births). The objective of this study was to examine the association between the number of life births with the number of abortions a female has had in her lifetime.</p></div><div><h3>Methods</h3><p>In a national cohort design, we followed all Danish females from ages 15 to 44 years through the period 1977–2017 for induced abortions and live births. For each lifetime number of induced abortions, the average number of life births was assessed, and rates with 95% CI were calculated.</p></div><div><h3>Results</h3><p>The study included 409 497 females who completed 222 482 induced abortions and 831 742 live births. Of 265 573 (64.9%) females who did not have any induced abortion, the average number of life births was 2.09 (95% CI 2.08–2.10). For females with 1 (23.4%), 2 (7.4%), 3 (2.6%), 4 (1.0%), and ≥5 (0.7%) induced abortions during their reproductive lifespan, the average number of life births was 1.88 (1.87–1.89), 1.99 (1.98–2.00), 2.09 (2.06–2.11), 2.13 (2.09–2.15), and 2.25 (2.21–2.29), respectively. The increase in number of life births in females with 1 to females with 5+ induced abortions was 4.7% for each additional induced abortion.</p></div><div><h3>Conclusion</h3><p>We found the number of induced abortions during a woman’s reproductive lifespan to be positively correlated to the number of live births. This association is likely explained by a high fecundity in females with multiple pregnancies including induced abortions and suggests that even several induced abortions do not compromise a woman’s general reproductive end points.</p></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 9","pages":"Article 102612"},"PeriodicalIF":2.0,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004353/pdfft?md5=9c8635ffc82aa254d653bd4e5c7b9c51&pid=1-s2.0-S1701216324004353-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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