Journal of obstetrics and gynaecology Canada最新文献

{"title":"Implementation of Placental Growth Factor in a Tertiary Western Canadian Centre: Association with Ultrasound Findings and Perinatal Outcomes","authors":"Ernesto A. Figueiro-Filho MD, PhD,&nbsp;Genevieve Dietrich HBSc, MEng,&nbsp;Adrielle P. Souza Lira BSN, RN,&nbsp;Eman Ramadan MD,&nbsp;Adewumi Adanlawo MD,&nbsp;John Matelski MSc,&nbsp;Joshua D. Buse PhD","doi":"10.1016/j.jogc.2025.103120","DOIUrl":"10.1016/j.jogc.2025.103120","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the association between placental growth factor (PlGF) levels, ultrasound findings, and perinatal outcomes in a high-risk pregnant population at a tertiary referral centre in Western Canada, and to assess the predictive performance of the PlGF test.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 389 high-risk pregnant individuals who underwent PlGF testing between 12⁰ and 36⁰ weeks gestation. Participants were stratified by PlGF level: normal (≥10th centile), inconclusive (5th–9th centile), and low (≤5th centile). Clinical, biochemical, ultrasound, and perinatal outcomes were compared across groups. Odds ratios, sensitivity, specificity, and predictive values were calculated.</div></div><div><h3>Results</h3><div>Low PlGF levels were observed in 33.9% of pregnancies, with testing performed at a median gestational age of 27⁶ weeks. Low PlGF levels were significantly associated with higher maternal BMI, elevated blood pressure, and increased creatinine, uric acid, and proteinuria levels. Ultrasound findings in the low PlGF group revealed higher rates of fetal growth restriction, abnormal Doppler studies, and abnormal placental morphology. These pregnancies had increased incidence of preterm birth &lt;34⁰ weeks (52/132; 39.3%), preeclampsia (69/132; 52.3%), neonatal intensive care unit admission (54/132; 40.9%), and small-for-gestational-age neonates (15/132; 11.4%). Most negative predictive values exceeded 90%.</div></div><div><h3>Conclusions</h3><div>Low maternal PlGF levels are strongly associated with ultrasound and biochemical indicators of placental dysfunction and adverse perinatal outcomes. PlGF testing may serve as an effective risk stratification tool in high-risk pregnancies, particularly in rural and underserved populations.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103120"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056538","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":"Guideline No. 464: Recurrent Pregnancy Loss","authors":"Tarek Motan MD,&nbsp;Heather Cockwell MD,&nbsp;Jason Elliott MD,&nbsp;Roland Antaki MD,&nbsp;Justin White MD","doi":"10.1016/j.jogc.2025.103167","DOIUrl":"10.1016/j.jogc.2025.103167","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Target Population&lt;/h3&gt;&lt;div&gt;Patients with Recurrent Pregnancy Loss (defined as two or more pregnancy losses.)&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Options&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;Pregnancy loss rate, Live birth rate&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Benefits, Harms, and Costs&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Validation Methods&lt;/h3&gt;&lt;div&gt;The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online &lt;span&gt;&lt;span&gt;Appendix A&lt;/span&gt;&lt;/span&gt; (&lt;span&gt;&lt;span&gt;Tables A1&lt;/span&gt;&lt;/span&gt; for definitions and &lt;span&gt;&lt;span&gt;A2&lt;/span&gt;&lt;/span&gt; for interpretations of strong and conditional [weak] recommendations).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Intended Audience&lt;/h3&gt;&lt;div&gt;All healthcare professionals who care for patients with Recurrent Pregnancy Loss.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Abstract for social media&lt;/h3&gt;&lt;div&gt;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}

{"title":"Evaluation of an Obstetric Medicine Curriculum for Obstetrics and Gynecology Trainees: A Quality Improvement Study","authors":"Kelsey MacEachern BMSc, MD ,&nbsp;Katherine Steckham MD ,&nbsp;Michelle Morais BSc, MD, DRCPSC ,&nbsp;Serena Gundy MD ,&nbsp;Amanda Huynh MD, MSc QIPS","doi":"10.1016/j.jogc.2025.103116","DOIUrl":"10.1016/j.jogc.2025.103116","url":null,"abstract":"<div><h3>Objectives</h3><div>Medical disorders in pregnancy are increasing. This highlights the need for obstetrics trainees to develop a strong foundation in managing medical conditions in pregnancy.</div></div><div><h3>Methods</h3><div>To address this, the internal medicine curriculum at our institution was redesigned for first year obstetrics residents to include an obstetric medicine (OBM) rotation.</div></div><div><h3>Results</h3><div>Before implementation, only 19% of residents felt at least moderately comfortable with OBM topics outlined by the Canadian Consensus for a Curriculum in Obstetric Medicine. This increased to 66% after the introduction of the redesigned curriculum. Using quality improvement methodology, we aimed to increase this to 80% via iterative plan-do-study-act cycles. Post-intervention, 81% of trainees reported feeling at least moderately comfortable in 14 of 17 Canadian Consensus for a Curriculum in Obstetric Medicine topics.</div></div><div><h3>Conclusions</h3><div>This quality improvement–driven curriculum enhancement was well-received and further highlights the value of early OBM integration in obstetrics training.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103116"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056534","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":"Trans Peoples’ Interest in Reproduction and Fertility Preservation: A Cross-Sectional, Descriptive Study Into Barriers to Reproductive Care","authors":"Lara Des Roches MD, MSc, BScN,&nbsp;Bianca Ziegler MD, MSc, BHSc,&nbsp;Stacy Deniz MD","doi":"10.1016/j.jogc.2025.103125","DOIUrl":"10.1016/j.jogc.2025.103125","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to ascertain trans peoples’ interest in reproductive choices. Our secondary objective was to understand barriers to meeting their reproductive goals.</div></div><div><h3>Methods</h3><div>We conducted a descriptive cross-sectional study using a one-time anonymous survey. Analysis was conducted using descriptive statistics and a thematic analysis using inductive coding.</div></div><div><h3>Results</h3><div>Analysis of trans participants’ responses revealed 82% (N = 169) of participants are interested in pursuing reproductive options (biologically related children, donor gametes, gestational carriers, or fertility preservation). Sixty-eight percent (N = 172) of participants are taking gender-affirming hormone therapy or plan to start. Forty-nine percent (N = 124) have had or plan to have gender-affirming surgery that affects fertility. Trans folks experience many barriers when accessing fertility care; cost and trans-specific barriers were the most common and insurmountable barriers.</div></div><div><h3>Conclusions</h3><div>Our study highlights that trans folks are interested in reproductive options. However, many trans people experience significant barriers to meeting their reproductive goals and this significantly impacts their quality of life. With most of our survey population identifying as trans at an age during the window of peak fertility, we highlight the importance of early assessment and treatment to achieve fertility goals.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103125"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103088","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":"Evaluation of a Novel Resource Stewardship Curriculum for Residents in Obstetrics and Gynaecology","authors":"Claire Ann Jones MD ,&nbsp;Catherine Friedman MD, HBSc, BScN ,&nbsp;Leslie Po MD, MSc ,&nbsp;Karen Born MSc, PhD ,&nbsp;Heather Shapiro MD ,&nbsp;Geetha Mukerji MD, MSc","doi":"10.1016/j.jogc.2025.103148","DOIUrl":"10.1016/j.jogc.2025.103148","url":null,"abstract":"<div><div>Obstetrics and Gynaecology residents were randomized into 1 of 2 novel resource stewardship curriculum workshops. Surveys elicited skill, comfort, and clinical behaviours around resource stewardship. Communication skills on resource use were evaluated in an Objective Structured Clinical Exam. The curriculum was favourably rated (4.2 of 5) and clinical behaviours around select resource use issues improved. Skill and comfort were not significantly changed, but there was a trend toward improved Objective Structured Clinical Exam scores in residents attending the communication workshop. Favourable ratings and improved behaviour support inclusion of resource stewardship curricula in Obstetrics and Gynaecology residency programs.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103148"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369370","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":"The Effectiveness of Letrozole Adjunct in the Combined Pharmacological and Surgical Treatment of Cesarean Scar Pregnancy: A Prospective Cohort Study","authors":"Iwona Gawron PhD, MD ,&nbsp;Milosz Pietrus PhD, MD ,&nbsp;Andrzej Zmaczynski MD ,&nbsp;Robert Jach PhD, MD","doi":"10.1016/j.jogc.2025.103166","DOIUrl":"10.1016/j.jogc.2025.103166","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the treatment outcomes of cesarean scar pregnancy (CSP) using a combined pharmacological and surgical approach with and without adjunct letrozole.</div></div><div><h3>Methods</h3><div>All women received 100 mg of methotrexate intravenously and 50 mg intra-amniotically. The intervention group also received 5 mg of letrozole orally for 10 days. After decreased CSP viability, hysteroscopic evacuation of trophoblastic remnants was performed. Biochemical indicators of efficacy and complications of pharmacotherapy, time interval to surgery, intraoperative blood loss, complications, and subsequent obstetric outcomes were compared across both study arms.</div></div><div><h3>Results</h3><div>Among 28 women, 16 received letrozole, whereas 12 received only methotrexate. There were no significant differences in serum β-human chorionic gonadotropin (β-hCG), hemoglobin, renal and liver parameters on days 0, 4, and 7 or in intraoperative blood loss, decrease in postoperative hemoglobin, red blood cell concentrate units transfused, uterine tamponade, complications, or obstetric outcomes. The day 0 β-hCG concentration correlated positively with postoperative hemoglobin reduction (<em>P</em> = 0.007), blood loss (<em>P</em> &lt; 0.001), red blood cell concentrate units transfused (<em>P</em> = 0.012), and risk of uterine perforation or hemorrhage (<em>P</em> = 0.043). Cases with a positive fetal heartbeat experienced significantly greater blood loss (<em>P</em> = 0.019) and a higher number of red blood cell concentrate units transfused (<em>P</em> = 0.033).</div></div><div><h3>Conclusions</h3><div>The incorporation of letrozole in the studied regimen did not impact the final end points. The significant factors influencing intraoperative blood loss and complications were the initial concentration of β-hCG and the presence of a fetal heartbeat. Combined treatment of CSP with methotrexate, followed by hysteroscopy, is a safe method that ensures effective treatment while preserving the uterus.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103166"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427290","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":"Evaluation of Cesarean Delivery Rates across Ontario from 2012 to 2019 Using the Modified Robson Classification System: A Population-Based Study","authors":"Sandra I. Dunn RN, BNSc, MEd, MScN, PhD ,&nbsp;Yanfang Guo MSc, MB, PhD ,&nbsp;Sheryll Dimanlig-Cruz MSc ,&nbsp;Malia S.Q. Murphy PhD ,&nbsp;Sara Carolina Scremin Souza MSc ,&nbsp;Ruth Rennicks White RN, BScN ,&nbsp;Deshayne B. Fell MSc, PhD ,&nbsp;Shi Wu Wen PhD ,&nbsp;Jun Zhang PhD ,&nbsp;Mark C. Walker MD, MSc, MSCHM ,&nbsp;Darine El-Chaâr MD, MSc","doi":"10.1016/j.jogc.2025.103131","DOIUrl":"10.1016/j.jogc.2025.103131","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to describe the trends in cesarean delivery (CD) rates in Ontario using the modified Robson classification system, and identify the most common indications for CD.</div></div><div><h3>Methods</h3><div>We conducted a population-based retrospective cross-sectional study using data from the Better Outcomes Registry &amp; Network, a comprehensive maternal-child registry in Ontario. The analysis included all pregnant persons who delivered a live- or stillborn infant weighing ≥500 g at ≥20⁰ weeks gestation between April 1, 2012 and March 31, 2019.</div></div><div><h3>Results</h3><div>A total of 952 567 pregnant persons gave birth in Ontario, Canada, during the study period. Our findings demonstrated a slight increase in the overall CD rate over 7 fiscal years from 2012–2013 to 2018–2019. Robson group 5 (term, singleton, cephalic pregnancy with previous CD), groups 1 and 2 (nulliparous, term, singleton, cephalic pregnancy and no labour, induced labour, or spontaneous labour), and group 6 (nulliparous pregnancy with breech presentation) made the largest contributions to the overall CD rate over the study period. The top 5 primary indications for CD across all years included previous CD, atypical or abnormal fetal surveillance, malposition/malpresentation, non-progressive first stage of labour, and non-progressive second stage of labour.</div></div><div><h3>Conclusions</h3><div>The results enhance our understanding of the key drivers of CD rates. These findings will help to inform practice improvement, support policy change, and identify areas where future research is needed.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103131"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115908","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":"SARS-CoV-2 Vaccination and Disorders of Menstruation: A Population-Based Cohort Study","authors":"Maria P. Velez MD, PhD ,&nbsp;Kensie Treacy BSc ,&nbsp;Jonas Shellenberger MSc ,&nbsp;Joel G. Ray MD, MSc","doi":"10.1016/j.jogc.2025.103159","DOIUrl":"10.1016/j.jogc.2025.103159","url":null,"abstract":"<div><div>This population-based study evaluated the association between SARS-CoV-2 vaccination and disorders of menstruation among all women in Ontario aged 18–44 years. Study exposure was receipt of a first dose of any SARS-CoV-2 vaccine from December 2021 to December 2022, handled in a time-varying manner. The outcome was an incident diagnosis of a disorder of menstruation, defined as 2 medical encounters billed as International Classification of Diseases, Ninth Revision diagnosis code 626 up to December 2023. Included were 2 114 589 women, of whom 44.7% were vaccinated against SARS-CoV-2. Disorders of menstruation occurred at a rate of 15.9 per 1000 person-years among vaccinated women, in contrast to a rate of 26.4 per 1000 person-years among unvaccinated women (adjusted rate ratio 0.60; 95% CI 0.59–0.60), supporting a lack of association between SARS-CoV-2 vaccination and an increased risk of disorders of menstruation.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103159"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370582","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":"Ligne directrice n° 464 : Fausses couches à répétition","authors":"Tarek Motan MD,&nbsp;Heather Cockwell MD,&nbsp;Jason Elliott MD,&nbsp;Roland Antaki MD,&nbsp;Justin White MD","doi":"10.1016/j.jogc.2025.103168","DOIUrl":"10.1016/j.jogc.2025.103168","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectif&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Population cible&lt;/h3&gt;&lt;div&gt;Les patientes présentant des fausses couches à répétition, définies comme deux fausses couches ou plus.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Options&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résultats&lt;/h3&gt;&lt;div&gt;taux de fausses couches, taux de naissances vivantes&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Avantages, inconvénients et coûts&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Preuves&lt;/h3&gt;&lt;div&gt;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.&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 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 (&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 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}

{"title":"Assessing the Availability and Components of Perinatal Mental Health Support Programs","authors":"Rebeca C. Urizar BA ,&nbsp;Light Uchechukwu BA ,&nbsp;Kyla F. Wiens BA ,&nbsp;Kaeley M. Simpson MA ,&nbsp;Bhavya Arora BA ,&nbsp;Tia Alsaidi BA ,&nbsp;Patricia Furer PhD ,&nbsp;Gillian M. Alcolado PhD ,&nbsp;Leslie Roos PhD ,&nbsp;Kristin A. Reynolds PhD","doi":"10.1016/j.jogc.2025.103163","DOIUrl":"10.1016/j.jogc.2025.103163","url":null,"abstract":"<div><h3>Objectives</h3><div>Despite the increasing prevalence of anxiety in the perinatal period, limited access to providers and mental health services continues to prevent affected persons from receiving necessary support. Peer support programs may provide timely, accessible support by connecting persons with others who share lived experiences. This study aimed to identify and examine perinatal peer support programs available in Canada, with particular focus on those addressing perinatal anxiety.</div></div><div><h3>Methods</h3><div>We conducted an online environmental scan to identify and examine existing peer support programs available in Canada for persons experiencing perinatal anxiety. Websites were screened according to the inclusion and exclusion criteria, and eligible programs were analyzed for core components such as cost, delivery format, duration, targeted outcomes, and evidence of evaluation.</div></div><div><h3>Results</h3><div>The scan identified 180 websites, of which 8 met the inclusion criteria. Overall, the scan revealed a lack of readily available peer support programs specifically for perinatal anxiety. Program characteristics varied: several were delivered virtually, most were free or offered low-cost options, and few specified durations. Only 1 program reported undergoing scientific evaluation, and none included participant testimonials.</div></div><div><h3>Conclusions</h3><div>Findings highlight the limited availability of perinatal peer support programs in Canada, particularly those targeting perinatal anxiety. Expanding accessible, evidence-based peer support tailored to this population offers a meaningful way to strengthen perinatal mental health services while emphasizing the need for continued program development and broader availability.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 12","pages":"Article 103163"},"PeriodicalIF":2.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576964","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}