Journal of obstetrics and gynaecology Canada最新文献

{"title":"Diagnostic Laparoscopy: Unveiling Primary Fallopian Tube Carcinoma","authors":"Satish Choudhury, Ayushi Sethi, Avantika Gupta","doi":"10.1016/j.jogc.2024.102660","DOIUrl":"10.1016/j.jogc.2024.102660","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274265","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":"Enhanced Recovery After Surgery (ERAS) Practices in Minimally Invasive Gynaecologic Surgery: A National Survey","authors":"Azra Shivji MD, MSc ,&nbsp;Elizabeth Miazga MD, LLM ,&nbsp;Carmen McCaffrey MD, MSc ,&nbsp;Sari Kives MD, MSc ,&nbsp;Alysha Nensi MD, MSc","doi":"10.1016/j.jogc.2024.102657","DOIUrl":"10.1016/j.jogc.2024.102657","url":null,"abstract":"<div><h3>Objectives</h3><div>Enhanced recovery after surgery (ERAS) pathways are evidence-based practices that minimize perioperative physiologic stress, reducing postoperative complications and recovery time. This study assessed the Canadian application of, and adherence to, ERAS recommendations during minimally invasive gynaecologic surgery, and identified barriers to ERAS uptake.</div></div><div><h3>Methods</h3><div>A self-administered cross-sectional survey was distributed to obstetrics and gynaecology residents, fellows, and attendings through 3 national listservs from February 2021 to January 2022. The survey assessed 14 perioperative components per the American Association of Gynecologic Laparoscopists ERAS consensus guidelines. Two study groups were defined—participants with versus without an established ERAS program—and comparison analyses as well as inferential statistical tests were performed.</div></div><div><h3>Results</h3><div>Overall, 158 responses were analyzed. A total of 41.9% of respondents work in a centre with an ERAS program. Adherence to ERAS recommendations was high with engaging patients in the operative processes, changing equipment after a contaminated procedure, discontinuing urinary catheters, and initiating early postoperative mobilization. ERAS programming enhanced adherence to preoperative carbohydrate loading, intraoperative fluid management, normothermia, and bowel-regimen adjuncts (<em>P &lt;</em> 0.05). Despite ERAS programming, adherence to some recommendations—preoperative fasting, and comorbidity optimization—remained low. Most respondents felt that ERAS is safe (98%) and improves outcomes (82%).</div></div><div><h3>Conclusions</h3><div>While the implementation of formal ERAS pathways differs between provinces and hospitals, practitioners across Canada engage in various ERAS components. ERAS program sites had higher adherence to some perioperative recommendations; however, some high-level evidence recommendations still have national adherence gaps. Targeted research around low-adherence components would help identify and address barriers to optimizing surgical care.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289643","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":"Improving Influenza Vaccine Uptake During Pregnancy Through Vaccination at Point of Care: A Before-and-After Study","authors":"Sofiya Manji MPH ,&nbsp;Laura Idarraga Reyes MD ,&nbsp;Sheila McDonald PhD ,&nbsp;Megan Mungunzul Amarbayan MPP ,&nbsp;Deshayne B. Fell PhD ,&nbsp;Amy Metcalfe PhD ,&nbsp;Eliana Castillo MD","doi":"10.1016/j.jogc.2024.102656","DOIUrl":"10.1016/j.jogc.2024.102656","url":null,"abstract":"<div><h3>Objectives</h3><div>Vaccine administration where pregnant individuals receive prenatal care may increase vaccine coverage. Availability of influenza vaccine at prenatal care visits is not standard in Canada. Since the 2016–2017 influenza season, pregnant individuals can receive the influenza vaccine at the point of care (POC) in an urban clinic in Calgary, Alberta. The objective of this study was to descriptively examine vaccination rates across multiple influenza seasons for a POC vaccination in pregnancy (VIP) intervention and describe associations between influenza vaccine coverage and comorbidities and area-level socioeconomic status.</div></div><div><h3>Methods</h3><div>A before-and-after study design was used to examine vaccine coverage across 6 consecutive influenza seasons: 2 before (2014–2015 and 2015–2016) and 4 after POC-VIP implementation (2016–2017 to 2019–2020). We identified the birth cohort and measured influenza vaccine uptake using clinical and administrative databases. Influenza vaccination rates were computed and compared using the Fisher exact test with statistical significance at a <em>P</em> value of 0.05.</div></div><div><h3>Results</h3><div>A total of 4443 pregnancies were identified during the study period. The influenza vaccination rate increased in the intervention years at 40.1 per 1000 patient-weeks (<em>P</em> &lt; 0.001), compared to the pre-intervention influenza seasons at 11.7 per 1000 patient-weeks. Vaccine coverage did not statistically differ between pregnancies with or without comorbidities across most seasons. Vaccine coverage decreased as material deprivation increased in pre-intervention years.</div></div><div><h3>Conclusions</h3><div>The vaccination rate was higher in the intervention years compared to the pre-intervention period. In this study, we applied a systematic methodology to examine vaccine coverage in pregnancy and presented a descriptive examination of a POC-VIP intervention.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289646","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}

{"title":"Directive clinique no 453 : Ablation de l’endomètre dans la prise en charge des saignements utérins anormaux","authors":"Nicholas Leyland M.D., MHCM,&nbsp;Philippe Laberge M.D.,&nbsp;Devon Evans M.D., M. Sc. (santé publique),&nbsp;Émilie Gorak-Savard M.D.,&nbsp;David Rittenberg M.D.","doi":"10.1016/j.jogc.2024.102642","DOIUrl":"10.1016/j.jogc.2024.102642","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectif&lt;/h3&gt;&lt;p&gt;Fournir une mise à jour de la directive actuelle fondée sur des données probantes relativement aux techniques et technologies utilisées pour l’ablation de l’endomètre, une technique minimalement invasive pour la prise en charge des saignements utérins anormaux d’origine bénigne.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Population cible&lt;/h3&gt;&lt;p&gt;Femmes en âge de procréer présentant des saignements utérins anormaux et une pathologie bénigne avec ou sans anomalies structurelles.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Bénéfices, risques et coûts&lt;/h3&gt;&lt;p&gt;La mise en œuvre des recommandations de la directive améliorera la prestation de l’ablation de l’endomètre en tant que traitement efficace des saignements utérins anormaux. Le respect de ces recommandations permet de réaliser l’intervention chirurgicale de façon sécuritaire et de maximiser le succès du traitement pour les patientes.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Données probantes&lt;/h3&gt;&lt;p&gt;La directive a été mise à jour à partir de la littérature publiée, telle que relevée par des recherches dans les bases de données Medline et Cochrane Library pour la période de janvier 2014 à avril 2023 en utilisant des termes et mots clés pertinents prédéterminés (&lt;em&gt;endometrial ablation, hysteroscopy, menorrhagia, heavy menstrual bleeding, abnormal uterine bleeding, hysterectomy&lt;/em&gt;). Seuls les résultats de revues systématiques, d’essais cliniques randomisés ou comparatifs et d’études observationnelles en anglais ont été retenus.&lt;/p&gt;&lt;p&gt;La littérature grise (non publiée) a été récupérée auprès de l’Association des obstétriciens et gynécologues du Québec (AOGQ) en 2023.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Méthodes de validation&lt;/h3&gt;&lt;p&gt;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’&lt;span&gt;&lt;span&gt;annexe A&lt;/span&gt;&lt;/span&gt; (&lt;span&gt;&lt;span&gt;tableau A1&lt;/span&gt;&lt;/span&gt; pour les définitions et tableau &lt;span&gt;&lt;span&gt;A2&lt;/span&gt;&lt;/span&gt; pour l’interprétation des recommandations fortes et faibles).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Professionnels concernés&lt;/h3&gt;&lt;p&gt;Obstétriciens, gynécologues et prestataires de soins primaires.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résumé des médias sociaux&lt;/h3&gt;&lt;p&gt;Cette directive est une version mise à jour de la directive de 2015 de la SOGC sur l’ablation de l’endomètre. Les auteurs abordent les considérations particulières, fournissent une mise à jour des données probantes et formulent de nouvelles recommandations concernant le déficit liquidien.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;DÉCLARATIONS SOMMAIRES&lt;/h3&gt;&lt;p&gt;&lt;/p&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;1.&lt;/span&gt;&lt;span&gt;&lt;p&gt;L’ablation de l’endomètre est une intervention chirurgicale minimalement invasive sécuritaire et efficace qui est devenue une solution de rechange bien établie au traitement médical et à l’hystérectomie pour les saignements utérins anormaux dans certains cas (&lt;em&gt;élevée&lt;/em&gt;).&lt;/p&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;2.&lt;/span&gt;&lt;span&gt;&lt;p&gt;Il est possible de préparer médicalement l’endomètre pour l’amincir afin d’en faciliter l’abla","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017839","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. 453: Endometrial Ablation in the Management of Abnormal Uterine Bleeding","authors":"Nicholas Leyland MD, MHCM,&nbsp;Philippe Laberge MD,&nbsp;Devon Evans MD, MPH,&nbsp;Emilie Gorak Savard MD,&nbsp;David Rittenberg MD","doi":"10.1016/j.jogc.2024.102641","DOIUrl":"10.1016/j.jogc.2024.102641","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;To provide an update of the current evidence-based guideline on the techniques and technologies used in endometrial ablation, a minimally invasive technique for the management of abnormal uterine bleeding of benign origin.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Target Population&lt;/h3&gt;&lt;p&gt;Women of reproductive age with abnormal uterine bleeding and benign pathology with or without structural abnormalities.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Benefits, Harms, and Costs&lt;/h3&gt;&lt;p&gt;Implementation of the guideline recommendations will improve the provision of endometrial ablation as an effective treatment for abnormal uterine bleeding. Following these recommendations would allow the surgical procedure to be performed safely and maximize success for patients.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence&lt;/h3&gt;&lt;p&gt;The guideline was updated with published literature retrieved through searches of Medline and the Cochrane Library from January 2014 to April 2023, using appropriate controlled vocabulary and keywords (endometrial ablation, hysteroscopy, menorrhagia, heavy menstrual bleeding, abnormal uterine bleeding, hysterectomy). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies written in English.&lt;/p&gt;&lt;p&gt;Grey (unpublished) literature was retrieved from the Association of Obstetricians and Gynecologists of Quebec (AOGQ) in 2023.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Validation Methods&lt;/h3&gt;&lt;p&gt;The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See &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;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Intended Audience&lt;/h3&gt;&lt;p&gt;Obstetricians, gynaecologists, and primary care providers.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Social Media Abstract&lt;/h3&gt;&lt;p&gt;This is an updated version of the 2015 SOGC Endometrial Ablation guideline. The authors discuss special considerations, update evidence, and make new fluid deficit recommendations.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;SUMMARY STATEMENTS&lt;/h3&gt;&lt;p&gt;&lt;/p&gt;&lt;ul&gt;&lt;li&gt;&lt;span&gt;1.&lt;/span&gt;&lt;span&gt;&lt;p&gt;Endometrial ablation is a safe and effective minimally invasive surgical procedure that has become a well-established alternative to medical treatment or hysterectomy for abnormal uterine bleeding in select cases (&lt;em&gt;high).&lt;/em&gt;&lt;/p&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;2.&lt;/span&gt;&lt;span&gt;&lt;p&gt;Medical preparation to thin the endometrium can be used to facilitate resectoscopic endometrial ablation and can be considered for some non-resectoscopic techniques. For resectoscopic endometrial ablation, preoperative endometrial thinning results in higher short-term rates of amenorrhea, decreased distension media fluid absorption, and shorter operative time when compared with no treatment (&lt;em&gt;high&lt;/em&gt;).&lt;/p&gt;&lt;/span&gt;&lt;/li&gt;&lt;li&gt;&lt;span&gt;3.&lt;/span&gt;&lt;span&gt;&lt;p&gt;Non-resectoscopic techniques are technically easier to perform than resectos","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017840","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":"Corrigendum to ‘Amniocentesis and Therapeutic Amnioreduction Prior to “Rescue Cerclage” (AARC Protocol): A Prospective Observational Study’ [Journal of Obstetrics and Gynaecology Canada (JOGC). Volume 46, Issue 5, May 2024, 102484]","authors":"Avina De Simone","doi":"10.1016/j.jogc.2024.102617","DOIUrl":"10.1016/j.jogc.2024.102617","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004407/pdfft?md5=7199b081adbd4264e99e34aa6bcfaf06&pid=1-s2.0-S1701216324004407-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228923","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}

{"title":"Masthead Pages","authors":"","doi":"10.1016/S1701-2163(24)00471-7","DOIUrl":"10.1016/S1701-2163(24)00471-7","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1701216324004717/pdfft?md5=8b33213e443f788c2ceea092c82e67ff&pid=1-s2.0-S1701216324004717-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227932","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}

{"title":"Imagerie time-lapse et intelligence artificielle : Ce n’est que la fin du début!","authors":"Peter Kovacs MD ,&nbsp;Emilie Sandfeld BS ,&nbsp;Nigel Pereira MD ,&nbsp;Rebecca Flyckt MD ,&nbsp;Steven R. Lindheim MD, MMM","doi":"10.1016/j.jogc.2024.102639","DOIUrl":"10.1016/j.jogc.2024.102639","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227935","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":"Reply to Letter to the Editor: Exploring Barriers and Facilitators to COVID-19 Vaccination in People Planning Pregnancy, Trying to Conceive, Pregnant, and Postpartum","authors":"Giuliana Guarna MD,&nbsp;Natasha Bauer-Maison MD,&nbsp;Mahnoor Malik BHSc,&nbsp;Rohan D’Souza MD, PhD,&nbsp;Sapna Sharma MD","doi":"10.1016/j.jogc.2024.102621","DOIUrl":"10.1016/j.jogc.2024.102621","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228652","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":"Time-Lapse Imaging and Artificial Intelligence: It is Just the End of the Beginning!","authors":"Peter Kovacs MD ,&nbsp;Emilie Sandfeld BS ,&nbsp;Nigel Pereira MD ,&nbsp;Rebecca Flyckt MD ,&nbsp;Steven R. Lindheim MD, MMM","doi":"10.1016/j.jogc.2024.102609","DOIUrl":"10.1016/j.jogc.2024.102609","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227934","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}