Journal of obstetrics and gynaecology Canada最新文献

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Guideline No. 454: Identification and Treatment of Perinatal Mood and Anxiety Disorders 第 454 号指南：围产期情绪和焦虑障碍的识别与治疗。

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2024-10-01 DOI: 10.1016/j.jogc.2024.102696

Alison Shea MD, PhD, Naana Afua Jumah MD, Milena Forte MD, Christina Cantin RN, PhD Student, Hamideh Bayrampour MSc, PhD, Kim Butler MD, Diane Francoeur MD, Courtney Green PhD, Jocelynn Cook PhD

<div><h3>Objective</h3><div>To help perinatal health care providers identify and assist pregnant and postpartum patients with perinatal mental illness, specifically perinatal mood and anxiety disorders. Areas of focus include risk factors and identification, screening, treatment, and referral.</div></div><div><h3>Target Population</h3><div>All individuals who are pregnant or in the first year postpartum.</div></div><div><h3>Outcomes</h3><div>Open dialogue and evidence-informed care for perinatal mood and anxiety disorders, including competency for identification, screening, treatment, and referral, which will lead to improvements in patient care.</div></div><div><h3>Benefits, Harms, and Costs</h3><div>Pregnant and postpartum individuals with untreated perinatal mental illness, including mood and anxiety disorders, may suffer devastating effects and their family may experience short- and long-term adverse outcomes.</div></div><div><h3>Evidence</h3><div>A literature search was conducted using Medline (Ovid), PubMed, Embase and the Cochrane library from inception to June 2024. Additional articles were identified from article bibliographies and grey literature published by reputable societies and organizations (see online <span><span>Appendix A</span></span>).</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 B</span></span> (<span><span>Tables B1</span></span> for definitions and <span><span>B2</span></span> for interpretations of strong and weak recommendations).</div></div><div><h3>Intended Audience</h3><div>All heath care providers who provide preconception counselling and/or care during pregnancy and the postpartum period. The term “perinatal” will be used throughout this guideline to refer to these health care providers.</div></div><div><h3>Social Media Abstract</h3><div>New SOGC Guideline! Identify, support, and treat perinatal mood and anxiety disorders. Focused on risk factors, screening, treatment and referrals during pregnancy and the postpartum period. Let's open dialogue and provide evidence-informed care for improved patient outcomes.</div></div><div><h3>SUMMARY STATEMENTS</h3><div><ul><li><span>1.</span><span><div>Perinatal mood and anxiety disorders are common (<em>high</em>); postpartum depression and anxiety are the most common maternal complications of pregnancy (<em>high</em>).</div></span></li><li><span>2.</span><span><div>The psychological aspects of the transition to parenthood are important factors that affect perinatal mental health (<em>moderate</em>).</div></span></li><li><span>3.</span><span><div>Suicide in the perinatal period is emerging as one of the most common causes of maternal mortality in Canada (<em>moderate</em>).</div></span></li><li><span>4.</span><span><div>Symptoms of anxiety or depression during pregnancy are high

目的帮助围产期医疗服务提供者识别并帮助患有围产期精神疾病（尤其是围产期情绪和焦虑障碍）的孕妇和产后患者。重点领域包括风险因素和识别、筛查、治疗和转介：目标人群：所有怀孕或产后第一年的人：结果：针对围产期情绪和焦虑障碍的公开对话和循证护理，包括识别、筛查、治疗和转诊能力，从而改善患者护理：未经治疗的围产期精神疾病（包括情绪和焦虑障碍）孕妇和产后患者可能会遭受毁灭性的影响，其家人也可能会经历短期和长期的不良后果：我们使用 Medline (Ovid)、PubMed、Embase 和 Cochrane 图书馆进行了从开始到 2024 年 6 月的文献检索。此外，还从知名学会和组织出版的文章书目和灰色文献中找到了其他文章（见附录 A）：作者采用建议评估、发展和评价分级法（GRADE）对证据质量和建议力度进行了评级。参见在线附录 B（表 B1 中的定义和表 B2 中的强推荐和弱推荐的解释）：所有提供孕前咨询和/或孕期及产后护理的医疗服务提供者。在本指南中，"围产期 "一词将用于指代这些医疗服务提供者。社交媒体摘要：SOGC 新指南！识别、支持和治疗围产期情绪和焦虑障碍。重点关注孕期和产后的风险因素、筛查、治疗和转诊。让我们展开对话，提供循证护理，以改善患者的治疗效果。

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引用次数: 0

Corrigendum to Co-Creating an Online Platform to Advance Access to Abortion: Findings From the CART-ACCESS Project 共同创建在线平台以促进堕胎：CART-ACCESS 项目的研究结果

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2024-10-01 DOI: 10.1016/j.jogc.2024.102652

Abdul-Fatawu Abdulai, Cam Duong, Efrat Czerniak, Aashay Mehta

引用次数: 0

Directive clinique N° 454 : Identification et traitement des troubles périnataux de l'humeur et de l'anxiété 临床指南第 454 号：围产期情绪和焦虑障碍的识别与治疗。

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2024-10-01 DOI: 10.1016/j.jogc.2024.102697

Alison Shea MD, PhD, Naana Afua Jumah MD, Milena Forte MD, Christina Cantin RN, PhD étudiant, Hamideh Bayrampour MSc, PhD, Kim Butler MD, Diane Francoeur MD, Courtney Green PhD, Jocelynn Cook PhD

<div><h3>Objectif</h3><div>Soutenir le personnel de santé en périnatalité à identifier et à assister les personnes enceintes et en post-partum vivant avec des troubles de santé mentale périnatale, plus particulièrement des troubles de l'humeur et d'anxiété en contexte périnatal. L'accent est mis sur les facteurs de risque et l'identification, le dépistage, le traitement et le référencement.</div></div><div><h3>Population cible</h3><div>Toutes les personnes enceintes ou dans la première année du post-partum.</div></div><div><h3>Résultats</h3><div>Dialogue ouvert et soins basés sur des données probantes lors de troubles périnataux de l'humeur et de l'anxiété, y compris les compétences en matière d'identification, de dépistage, de traitement et de référencement.</div></div><div><h3>Bénéfices, risques et coûts</h3><div>Les personnes enceintes et celles en post-partum atteinte de troubles de santé mentale périnatale non traitée, y compris de troubles de l'humeur et d'anxiété, peuvent subir, ainsi que leur famille, des effets néfastes ainsi que des conséquences négatives à leur santé, à court et à long terme.</div></div><div><h3>Données probantes</h3><div>Une recherche documentaire a été effectuée sur Medline (Ovid), PubMed, Embase et la bibliothèque Cochrane depuis le début jusqu'à juin 2024. Des articles supplémentaires ont été identifiés à partir de bibliographies d'articles et de la littérature grise publiée par des sociétés et des organisations réputées (voir l'<span><span>annexe A</span></span> en ligne).</div></div><div><h3>Méthodes de validation</h3><div>Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Voir l’<span><span>annexe B</span></span> en ligne (<span><span>tableau B1</span></span> pour les définitions et <span><span>tableau B2</span></span> pour l’interprétation des recommandations fortes et faibles).</div></div><div><h3>Professionnels concernés</h3><div>Tous les prestataires de soins de santé qui fournissent offrent des conseils en périnatalité. Le terme "périnatal" sera utilisé tout au long de cette directive pour désigner ces professionnels de la santé.</div></div><div><h3>Résumé des médias sociaux</h3><div>Nouvelle directive clinique de la SOGC ! Identifier, accompagner et traiter les troubles d'humeur et d'anxiété périnataux. Axée sur les déterminants et les facteurs de risque, le dépistage, le traitement et le référencement tout au long de la trajectoire périnatale. La directive vise un dialogue et des soins personnalisés basés sur des données probantes pour des soins de qualité en contexte de santé mentale périnatale.</div></div><div><h3>DÉCLARATIONS SOMMAIRES</h3><div><ul><li><span>1.</span><span><div>Les troubles périnataux de l'humeur et de l'anxiété sont fréquents (<em>élevée</em>) ; la dépression et l'anxiété post-partum représentent des complications maternelles les plus f

目标：支持围产期医护人员识别和帮助患有围产期精神疾病（尤其是围产期情绪和焦虑症）的孕妇和产后妇女。重点是风险因素和识别、筛查、治疗和转诊。目标人群：所有怀孕或产后第一年的妇女。成果：针对围产期情绪和焦虑障碍的开放式对话和循证护理，包括识别、筛查、治疗和转诊技能。益处、风险和成本：围产期心理健康障碍（包括情绪和焦虑障碍）未得到治疗的孕妇和产后妇女可能会在短期和长期内对自身及其家人造成不良影响和负面健康后果。资料来源：对 Medline (Ovid)、PubMed、Embase 和 Cochrane 图书馆进行了从开始到 2024 年 6 月的检索。此外，还从知名协会和组织出版的文章书目和灰色文献中找到了其他文章（见附录 A）。验证方法：作者采用 GRADE（建议、评估、发展和评价分级）方法框架评估了证据的质量和建议的力度。参见附录 B（表 B1 为定义，表 B2 为强建议和弱建议的解释）。相关专业人员：所有提供围产期建议的医疗服务提供者。在本指南中，"围产期 "一词将用于指代这些医疗保健专业人员。社会媒体摘要：新版 SOGC 临床实践指南！识别、支持和治疗围产期情绪和焦虑障碍。重点关注围产期的决定因素和风险因素、筛查、治疗和转诊。该指南旨在促进围产期心理健康方面的对话和个性化循证护理。

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引用次数: 0

Extraits de la littérature médicale mondiale : Gynécologie 世界医学文献摘录：妇科

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2024-10-01 DOI: 10.1016/j.jogc.2024.102677

Paul J. Yong MD, PhD

引用次数: 0

Towards Better Perinatal Mental Health Care 改善围产期心理健康护理

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2024-10-01 DOI: 10.1016/j.jogc.2024.102680

Simone N. Vigod MD, MSc , Benicio N. Frey MD, PhD

引用次数: 0

Clinical Consensus No. 455: Fetal Sex Determination and Disclosure. 临床共识第 455 号：胎儿性别鉴定与披露。

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2024-10-01 DOI: 10.1016/j.jogc.2024.102675

Michiel C Van den Hof, Venu Jain, Ori Nevo

Objective: To provide guidance on ultrasound review of the fetal perineum as well as fetal sex determination and disclosure.

Target population: All individuals with ongoing pregnancies.

Options: To include a review of the fetal perineum and determination of fetal sex as a component of the anatomic review during the routine second-trimester obstetric ultrasound and adhere to patient wishes regarding the disclosure of fetal sex.

Outcomes: Prenatal diagnosis of fetal genital and sex anomalies or variants, parental and pregnancy caregiver knowledge of fetal sex, and adherence to parental wishes regarding knowledge of fetal sex.

Benefits, harms, and costs: Benefits include the potential to improve perinatal outcomes through the diagnosis of fetal genital anomalies and respect for women's rightful autonomy over personal health information. Potential harms or costs include a possible error in fetal sex determination, increased time for patients and health care providers in scheduling and performing the imaging, and the minimal risk of patients choosing to abort a pregnancy if the fetus is not the desired sex.

Evidence: Evidence built on the literature from the prior version of this statement through a review of international guidelines, Canadian legal rulings, and a literature search of PubMed and the Cochrane Database. English language research articles, review articles, and systematic reviews between January 1, 2003, and December 31, 2023, were included. Search terms included fetal ultrasonography, sex determination, and genitalia. The references of relevant articles were assessed, and applicable articles were included as well.

Intended audience: All care providers for pregnant individuals in Canada.

Social media abstract: Fetal genitalia should be examined in pregnancy and the sex safely disclosed to the patient if they want this information. CONSENSUS-BASED GOOD PRACTICE STATEMENTS.

目标：为胎儿会阴超声检查以及胎儿性别鉴定和披露提供指导：为胎儿会阴部超声波检查以及胎儿性别鉴定和披露提供指导：目标人群：所有正在妊娠的个体：备选方案：在常规第二产程产科超声检查中，将胎儿会阴部检查和胎儿性别鉴定作为解剖学检查的一部分，并遵从患者关于披露胎儿性别的意愿：结果：产前诊断胎儿生殖器和性别异常或变异、父母和孕期护理人员对胎儿性别的了解、父母对胎儿性别了解意愿的遵从：益处包括通过诊断胎儿生殖器畸形改善围产期预后的可能性，以及尊重妇女对个人健康信息的自主权。潜在的危害或成本包括：胎儿性别鉴定可能出现错误、患者和医疗服务提供者在安排和进行造影检查时需要花费更多时间，以及如果胎儿性别不符合预期，患者选择流产的风险极小：证据：通过对国际指南、加拿大法律裁决的审查，以及对 PubMed 和 Cochrane 数据库的文献检索，以本声明上一版本的文献为基础。2003年1月1日至2023年12月31日期间的英语研究文章、综述文章和系统综述均被纳入其中。检索词包括胎儿超声造影、性别鉴定和生殖器。对相关文章的参考文献进行了评估，并纳入了适用的文章：社交媒体摘要：孕期应检查胎儿生殖器，并在患者需要时向其安全披露性别信息。

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引用次数: 0

Vers de meilleurs soins en santé mentale périnatale 改善围产期心理保健

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2024-10-01 DOI: 10.1016/j.jogc.2024.102681

Simone N. Vigod MD, MSc , Benicio N. Frey MD, PhD

引用次数: 0

Bilateral Sacrospinous Vaginal Vault Fixation With Synthetic Mesh Arms: A Novel Technique 用合成网臂固定双侧骶棘阴道穹隆：一项新技术。

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2024-09-28 DOI: 10.1016/j.jogc.2024.102671

Roxana Geoffrion MDCM, Nicole Koenig BA, CCRP, Lina Roa MD, MPH

Sacrospinous ligament suspension is used for suspension of apical prolapse; however, it has a high rate of recurrence compared with sacrocolpopexy, and a high rate of pain compared with uterosacral suspension. We developed a novel surgical procedure of bilateral sacrospinous vaginal vault fixation with synthetic mesh arms. We previously demonstrated its safety, and in Supplementary video 1, we describe a step-by-step surgical approach that could be replicated. This technique restores support, creating an anatomically correct midline configuration of the vaginal axis with minimal tension. A randomized controlled trial is underway to examine durability of mesh versus suture techniques for sacrospinous ligament suspension.

骶棘韧带悬吊术用于悬吊顶端脱垂，但与骶骨整形术相比，其复发率高，与子宫骶骨悬吊术相比，其疼痛率高。我们开发了一种新型手术方法，即使用合成网臂固定双侧骶棘阴道穹隆。在视频 1 中，我们介绍了可复制的逐步手术方法。这种技术可以恢复支撑力，在最小张力的情况下形成解剖学上正确的阴道轴中线结构。目前正在进行一项随机对照试验，以研究网片与缝合技术在骶棘韧带悬吊术中的耐久性。

引用次数: 0

Prevalence and Associated Risk Factors with Unawareness of Folic Acid Benefits Prior to Pregnancy: Results From Canadian Community Health Survey 孕前不了解叶酸益处的发生率和相关风险因素：加拿大社区健康调查的结果。

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2024-09-28 DOI: 10.1016/j.jogc.2024.102670

Vrati M. Mehra BSc, MSc , Ellen M. Greenblatt BSc, MD , Hala Tamim BSc, MSc, PhD , John W. Snelgrove BSc, MD, MSc , Claire A. Jones BSc, MD

Recent national studies on awareness of folic acid (FA) prior to pregnancy among Canadian women are lacking. Using the 2017–2018 Canadian Community Health Survey, we aimed to estimate prevalence and risk factors associated with Canadian women who reported they were unaware of the benefits of FA supplementation before pregnancy. Prevalence of unawareness of FA was 22.1%. Lower education, lack of a health care provider, low household income, and an immigrant background were associated with greater odds of unawareness of the benefits of FA supplementation. Persistent associations with measures of social disadvantage and social determinants of health emphasize the need for new targeted public health campaigns.

近期缺乏有关加拿大妇女孕前叶酸（FA）意识的全国性研究。利用 2017-18 年加拿大社区健康调查，我们旨在估算那些表示不知道孕前补充叶酸益处的加拿大妇女的患病率和相关风险因素。不知道补充足量叶酸的患病率为 22.1%。教育程度较低、没有医疗保健提供者、家庭收入较低和移民背景与不了解补充叶酸益处的几率较高有关。与社会不利条件和健康的社会决定因素的持续关联强调了开展新的有针对性的公共卫生运动的必要性。

引用次数: 0

Exclusive Breastfeeding Rates Upon Hospital Discharge at a Tertiary Centre Prior to and During the COVID-19 Pandemic 在 COVID-19 大流行之前和期间，一家三级医疗中心出院时的纯母乳喂养率。

IF 2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada

Pub Date : 2024-09-27 DOI: 10.1016/j.jogc.2024.102669

Hannah Matthews BSc , Jo Watson PhD, RN(EC), IBCLC , Sue Hermann MN, RN, IBCLC, PNC(C) , Karen Fleming MD

This study aimed to describe exclusive breastfeeding (EBF) rates at discharge at Sunnybrook Health Sciences Centre and explore factors that contributed to changes in breastfeeding rates during the COVID-19 pandemic. Overall, 4762 patient charts were reviewed, 2000 from the pre-pandemic period, and 2762 from the lockdown period. Data was collected on EBF status at discharge, on maternal health history, and on infant characteristics. EBF rates fell from 75.8% to 73.85% from the pre-COVID-19 to COVID-19 period. During the pandemic, EBF was positively associated with BMI <30, spontaneous conception, and infants at risk of low blood sugar. Non-spontaneous conception was associated with lower EBF.

本研究旨在描述桑尼布鲁克健康科学中心（Sunnybrook Health Sciences Centre）患者出院时的纯母乳喂养率（EBF），并探讨导致 COVID-19 大流行期间母乳喂养率变化的因素。共审查了 4762 份患者病历，其中 2000 份来自大流行前，2762 份来自封锁期间。收集的数据包括出院时的母乳喂养情况、产妇健康史和婴儿特征。从 COVID 前到 COVID 期间，EBF 率从 75.8% 降至 73.85%。在大流行期间，EBF 与体重指数小于 30、自然受孕和有低血糖风险的婴儿呈正相关。非自然受孕与 EBF 值较低有关。

引用次数: 0

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