Journal of obstetrics and gynaecology Canada最新文献

{"title":"Letter to the Editor: Fertility Care in OBGYN Residency","authors":"Ruth Habte MD , Nicole Thompson BScOT, MClSc, MD , Marguerite Heyns MD","doi":"10.1016/j.jogc.2025.103069","DOIUrl":"10.1016/j.jogc.2025.103069","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 10","pages":"Article 103069"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415870","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}

{"title":"Letter to the Editor: Supporting Non-Urban ObGyn Training","authors":"Giuliana Guarna HBSc, MD, DRCPSC, Andrea Mosher MD, PhD, Sapna Sharma MD, Bryon DeFrance MSc, MD, Jon Barrett MBBch, MD, MRCOG","doi":"10.1016/j.jogc.2025.103084","DOIUrl":"10.1016/j.jogc.2025.103084","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 10","pages":"Article 103084"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415871","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}

{"title":"Acetaminophen Use in Pregnancy and the Purported Link to Neurodevelopmental Disorders","authors":"Graeme N. Smith MD, PhD","doi":"10.1016/j.jogc.2025.103140","DOIUrl":"10.1016/j.jogc.2025.103140","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 10","pages":"Article 103140"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276916","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}

{"title":"First-Line Treatment Use and Survival Outcomes for Patients With Primary Advanced or Recurrent Endometrial Cancer in Alberta, Canada","authors":"Jacob McGee MD, MSC, FRPC ,&nbsp;Dylan E. O’Sullivan PhD ,&nbsp;Sophia Pin MD, MSc, FRCSC ,&nbsp;Winson Y. Cheung MD, MPH, FRPC ,&nbsp;Justin Riemer BSC, MBiotech ,&nbsp;Patrick C. Turnbull PhD ,&nbsp;Diana Martins BScH, MSc","doi":"10.1016/j.jogc.2025.103107","DOIUrl":"10.1016/j.jogc.2025.103107","url":null,"abstract":"<div><h3>Objective</h3><div>To describe first-line treatment patterns and factors impacting survival for patients with primary advanced (stage III–IV) or recurrent (A/R) endometrial cancer (EC) in Canada.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used health administrative data for patients with primary A/R EC (2010–2020) in Alberta, Canada. Characteristics by receipt of first-line systemic therapy were compared. Factors impacting overall survival (OS) after first-line chemotherapy were evaluated using a multivariable Cox proportional hazards model.</div></div><div><h3>Results</h3><div>Of 1185 patients included, 817 (68.9%) received first-line systemic therapy (advanced, n = 679 of 885; recurrent, n = 138 of 300). Patients in this cohort were generally younger, with fewer comorbidities than those who did not receive first-line systemic therapy. Patients with recurrent disease who received previous chemotherapy and who had a longer time to recurrence were more likely to receive first-line systemic therapy. The median OS was 53.5 months (95% CI 37.8–80.1); the OS was shorter with older age (≥75 vs. &lt;65 years, adjusted hazard ratio [aHR] 1.62; 95% CI 1.18–2.23) and high-grade versus low-grade histology (aHR 1.99; 95% CI 1.59–3.67). The OS was longer in patients in stage III who had surgery (aHR 0.35; 95% CI 0.24–0.51).</div></div><div><h3>Conclusion</h3><div>Characteristics such as age and comorbidities impacted first-line systemic therapy use in primary A/R EC. Patients who were older, with high-grade histology, stage IV without surgery, and receiving platinum monotherapy had the shortest OS. Effective treatment options are needed to prolong survival for primary A/R EC.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 10","pages":"Article 103107"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058883","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}

{"title":"Letter to the Editor: Canada’s Perinatal Mental Health Landscape: Policy, Practice, and the Path Forward","authors":"Leo Zhao BHS student ,&nbsp;Sandra Halliday MSc, MLIS ,&nbsp;Michelle Carter RM, BSc, BSN, MSN ,&nbsp;Josephine Etowa RN, RM, PhD ,&nbsp;Canadian Academy of Nursing Fellows Expert Panel on Perinatal Mental Health and Guests,&nbsp;Shahirose Sadrudin Premji RN, BSc, MScN, PhD","doi":"10.1016/j.jogc.2025.103101","DOIUrl":"10.1016/j.jogc.2025.103101","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 10","pages":"Article 103101"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415869","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}

{"title":"Episiotomy as a Strategy to Minimise Obstetrical Anal Sphincter Injuries Risk","authors":"Chelsea Harris MD ,&nbsp;Jocelyn Stairs MD","doi":"10.1016/j.jogc.2025.102931","DOIUrl":"10.1016/j.jogc.2025.102931","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 10","pages":"Article 102931"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145104","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}

{"title":"Comment on “Letter to the Editor: Supporting Non-Urban OBGYN Training”","authors":"Jena Hall MD, MEd, CIP,&nbsp;Erin Brennand MD, MSc","doi":"10.1016/j.jogc.2025.103083","DOIUrl":"10.1016/j.jogc.2025.103083","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 10","pages":"Article 103083"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145415872","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}

{"title":"Consensus clinique n° 463 : Diagnostic et prise en charge de la niche cicatricielle césarienne","authors":"Lacey Brennan MD, MBE,&nbsp;Emmanuel Bujold M.D., M.Sc.,&nbsp;Sarah Maheux-Lacroix MD, PhD,&nbsp;Ari P. Sanders MD, MSc,&nbsp;Mohamed A. Bedaiwy MD, PhD,&nbsp;Ally Murji docteur en médecine, titulaire d'une maîtrise en santé publique","doi":"10.1016/j.jogc.2025.103144","DOIUrl":"10.1016/j.jogc.2025.103144","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectif&lt;/h3&gt;&lt;div&gt;Cette déclaration consensuelle vise à guider les cliniciens dans le diagnostic, la prise en charge et la prévention de la niche cicatricielle césarienne.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Population cible&lt;/h3&gt;&lt;div&gt;Les patientes subissant un accouchement par césarienne ou les patientes présentant un trouble de la cicatrice de césarienne.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Options&lt;/h3&gt;&lt;div&gt;Les options de prise en charge comprennent la prise en charge expectative, médicale et chirurgicale. Celles-ci dépendront des symptômes, de l'épaisseur résiduelle du myomètre et des projets de fertilité futurs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résultats&lt;/h3&gt;&lt;div&gt;Les résultats comprennent la résolution des symptômes, la réparation du défaut et la réussite de la grossesse ultérieure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Avantages, inconvénients et coûts&lt;/h3&gt;&lt;div&gt;Cette directive vise à bénéficier aux patientes subissant une césarienne ou souffrant d'un trouble lié à la cicatrice de césarienne et à offrir aux professionnels de santé une approche fondée sur des preuves pour la prévention, le diagnostic et la prise en charge des défauts de la cicatrice de césarienne.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Preuves&lt;/h3&gt;&lt;div&gt;Les essais cliniques publiés, les essais contrôlés randomisés, les études observationnelles, les études de population et les articles de revue systématique indexés dans PubMed et la base de données Cochrane ont été identifiés entre le 1er janvier 2005 et le 30 avril 2025 à l'aide des termes de recherche « cesarean scar niche », « cesarean scar defect » et « isthmocele ». Les résultats ont été limités aux études rédigées en anglais.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Méthodes de validation&lt;/h3&gt;&lt;div&gt;Les auteurs ont évalué la qualité des donnees probantes et la force des recommandations en utilisant l'approche GRADE (Grading of Recommendations Assessment, Development and Evaluation). Voir l'annexe A en ligne (&lt;span&gt;&lt;span&gt;tableaux A1&lt;/span&gt;&lt;/span&gt; pour les définitions et &lt;span&gt;&lt;span&gt;A2&lt;/span&gt;&lt;/span&gt; pour les interprétations des recommandations fortes et conditionnelles [faibles]).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Public visé&lt;/h3&gt;&lt;div&gt;Tous les professionnels de santé qui pratiquent des césariennes ou qui s'occupent de patientes ayant déjà subi une césarienne et pouvant présenter des symptômes de troubles liés à la cicatrice de césarienne, y compris les gynécologues-obstétriciens, les médecins de famille, les infirmières diplômées, les infirmières praticiennes et les radiologues.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résumé tweetable&lt;/h3&gt;&lt;div&gt;La niche cicatricielle de césarienne est une conséquence courante de l'accouchement par césarienne. Les patientes symptomatiques souffrant d'un trouble de la cicatrice de césarienne peuvent être traitées de manière expectative ou par des options médicales ou chirurgicales. Les patientes asymptomatiques ne nécessitent pas de traitement.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RÉSUMÉ&lt;/h3&gt;&lt;div&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;1)&lt;/span&gt;&lt;span&gt;&lt;div&gt;Les niches cicatricielles de césariennes sont fréquentes chez les patientes ayant accouché par césarienne, la p","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 11","pages":"Article 103144"},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215519","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}

{"title":"Prolonged Exposure to Childhood Adversity and Birth Outcomes in a Bi-Generational Longitudinal Cohort Study","authors":"Mary-Gray Southern MD ,&nbsp;Cara Girardi MD ,&nbsp;Dmitry Tumin PhD ,&nbsp;James L. Whiteside MD, MA, MHA","doi":"10.1016/j.jogc.2025.103123","DOIUrl":"10.1016/j.jogc.2025.103123","url":null,"abstract":"<div><h3>Objectives</h3><div>A higher number of exposures to different adverse childhood experiences (ACEs) has been associated with worse birth outcomes; however, the duration of ACE exposure could also negatively impact pregnancy outcomes. We sought to use a bi-generational longitudinal cohort survey to test if duration of exposure to specific types of childhood adversity exhibited a graded association with adverse birth outcomes.</div></div><div><h3>Methods</h3><div>The Bureau of Labor Statistics’ National Longitudinal Surveys of Youth 1979 cohort was used to create bi-generational cohorts capturing the number and duration of ACE events (reported by the oldest cohort and experienced by the middle cohort) and linking these with birth outcomes (low birth weight, preterm birth, route of delivery, and infant length of stay) documented in the youngest cohort. ACEs examined were maternal incarceration, divorce/separation, maternal binge drinking, and poverty.</div></div><div><h3>Results</h3><div>Demographic, birth outcome, and ACE exposures were determined from 1693 cases. Neither the count of ACEs nor the duration of exposure to ACEs was a statistically significant predictor of examined birth outcomes, except for greater ACE numbers and prolonged infant length of stay.</div></div><div><h3>Conclusions</h3><div>No association was identified between worsened birth outcomes and cumulative number or duration of ACE exposures, contradicting prior studies. This discrepancy may be explained by the mediating role of stressors encountered in adulthood, interactions between ACE exposure and adult-onset conditions, missing data on paternal ACE exposure, or differences in recall and reporting bias when collecting interview data from participants versus directly from the grandparent generation.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103123"},"PeriodicalIF":2.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139907","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}

{"title":"Interobserver Reproducibility of Two Endometriosis Scoring Systems: A Multicentre Observational Prospective Study","authors":"Gabriella Caron-Racine MD ,&nbsp;Anne-Marie Bergeron MD ,&nbsp;Madeleine Lemyre MD ,&nbsp;Kristina Arendas MD ,&nbsp;Jessica Lefebvre MD ,&nbsp;Sarah Maheux-Lacroix MD, PhD","doi":"10.1016/j.jogc.2025.103130","DOIUrl":"10.1016/j.jogc.2025.103130","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the interobserver reproducibility of the Revised American Society for Reproductive Medicine score (r-ASRM) and the Endometriosis Fertility Index (EFI) in women undergoing a conservative laparoscopy to treat endometriosis.</div></div><div><h3>Methods</h3><div>The r-ASRM stage and score and EFI were independently determined by 2 assessors participating in the surgery. Assessors were either a minimally invasive specialist or fellow, a fertility specialist, or an obstetrics and gynecology resident. They both completed the score sheets separately, blindly to the other assessor. A consensus was then obtained, after discussion between the 2 assessors. Interobserver reproducibility was evaluated using Cohen’s κ and intraclass correlation coefficient for scores by categories and continuous scores, respectively.</div></div><div><h3>Results</h3><div>In this multicentre cross-sectional cohort study, 100 women undergoing a laparoscopy for endometriosis were recruited between April 2020 and May 2023. Most participants had stage 3 (22%) or 4 (43%) endometriosis. The interobserver agreement was strong for the r-ASRM stage, and almost perfect for EFI categories (0–3, 4, 5, 6, 7–8, 9–10) and Least function score categories (1–3, 4–6, and 7–8). The agreement for the r-ASRM score and EFI score is excellent. Interobserver agreement remained strong, regardless of the level of expertise, the use of preoperative suppression, or history of a pelvic surgery.</div></div><div><h3>Conclusions</h3><div>The r-ASRM and EFI classifications are highly reproductible between assessors, making them excellent tools for communication between health professionals. However both are limited by their capacity to explain variations in pain symptoms, which remains a challenge to be addressed in future work.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 11","pages":"Article 103130"},"PeriodicalIF":2.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115890","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}