Pub Date : 2025-09-01DOI: 10.1016/j.jogc.2025.103062
Avantika Gupta MS OBGY, Minal Dhanvij MS OBGY, Neha Gangane MD OBGY, Medha Davile MD OBGY, Vasudha Vani Lanka MS OBGY
{"title":"Corrigendum to ‘Triploidy in first trimester growth delay’ [Journal of Obstetrics and Gynaecology Canada 47;4 (2025) 102793]","authors":"Avantika Gupta MS OBGY, Minal Dhanvij MS OBGY, Neha Gangane MD OBGY, Medha Davile MD OBGY, Vasudha Vani Lanka MS OBGY","doi":"10.1016/j.jogc.2025.103062","DOIUrl":"10.1016/j.jogc.2025.103062","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103062"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885008","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 : 2025-09-01DOI: 10.1016/j.jogc.2025.103082
Diane Francoeur MD , Jocelynn L. Cook PhD, MBA , R. Douglas Wilson MD , Frank Potestio MD , Jessie L. Burns PhD
{"title":"The New SOGC Clinical Practice Guidance Development Framework: Enhancing Collaboration and Engagement","authors":"Diane Francoeur MD , Jocelynn L. Cook PhD, MBA , R. Douglas Wilson MD , Frank Potestio MD , Jessie L. Burns PhD","doi":"10.1016/j.jogc.2025.103082","DOIUrl":"10.1016/j.jogc.2025.103082","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103082"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985952","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 : 2025-09-01DOI: 10.1016/j.jogc.2025.103068
Brian Mahoney MD , Brendon Gurd PhD
Despite advances in perioperative care, poor surgical outcomes remain common, particularly, among patients with low physiological reserve associated with age, frailty, poor fitness, or malnutrition. Multimodal prehabilitation (Prehab)—a proactive, patient-centred strategy combining preoperative exercise, nutrition, and mental health support—aims to improve physiological reserve before surgery. This narrative review outlines the theoretical foundation for Prehab, highlights evidence supporting its safety and effectiveness, and explores its applicability to obstetric and gynecologic surgical care. Although high-quality data in these populations remain limited, emerging studies, especially in gynecologic oncology, suggest potential benefits including reduced complication rates, improved recovery, and enhanced quality of life. Barriers to widespread adoption include problem blindness, lack of ownership, and limited resources. Scalable implementation strategies are discussed, ranging from in-office recommendations to centralized digital platforms. As ongoing trials further clarify its efficacy, we argue that Prehab can be embraced now as a feasible and patient-empowering approach to surgical preparation. Enhancing physiological reserve before surgery is a vital, underused lever for improving outcomes.
{"title":"Prehabilitation: Optimizing Patient Health Before Surgery to Enhance Recovery and Outcomes","authors":"Brian Mahoney MD , Brendon Gurd PhD","doi":"10.1016/j.jogc.2025.103068","DOIUrl":"10.1016/j.jogc.2025.103068","url":null,"abstract":"<div><div>Despite advances in perioperative care, poor surgical outcomes remain common, particularly, among patients with low physiological reserve associated with age, frailty, poor fitness, or malnutrition. Multimodal prehabilitation (Prehab)—a proactive, patient-centred strategy combining preoperative exercise, nutrition, and mental health support—aims to improve physiological reserve before surgery. This narrative review outlines the theoretical foundation for Prehab, highlights evidence supporting its safety and effectiveness, and explores its applicability to obstetric and gynecologic surgical care. Although high-quality data in these populations remain limited, emerging studies, especially in gynecologic oncology, suggest potential benefits including reduced complication rates, improved recovery, and enhanced quality of life. Barriers to widespread adoption include problem blindness, lack of ownership, and limited resources. Scalable implementation strategies are discussed, ranging from in-office recommendations to centralized digital platforms. As ongoing trials further clarify its efficacy, we argue that Prehab can be embraced now as a feasible and patient-empowering approach to surgical preparation. Enhancing physiological reserve before surgery is a vital, underused lever for improving outcomes.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103068"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860052","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 : 2025-09-01DOI: 10.1016/j.jogc.2025.103085
Scott A. Farrell MD , Kenneth Gillespie MD , Stephane Foulem MD , Stephanie Lagacé RN
Objectives
When a medical device is available over the counter, the ability of a consumer to correctly self-select to use the device, independent of guidance from a health care professional, is essential and important.
This study was undertaken to evaluate the self-selection process for the Uresta Bladder Support.
Methods
A total of 49 women were enrolled in this study. The results of a self-selection interview were validated by using a gynaecologic examination as the gold standard.Results: The urinary continence diagnoses broke down as follows: continent 16 (33%), pure stress incontinence 18 (37%), mixed urinary incontinence 13 (27%), and pure urge incontinence 2 (4%). A total of 36 (73%) indicated that they would acquire the bladder support and use it, whereas 13 (27%) indicated that they would not choose to use the device based on their understanding of the device and their personal medical history. A total of 43 (88%) made a correct self-selection decision and 6 (12%) made an incorrect decision. Root cause analysis found that the residual risks associated with use of the Uresta Bladder Support in the over-the-counter context were acceptable and outweighed by the impact of the device on user’s quality of life.
Conclusions
Using the information provided on the external packaging of the Uresta Bladder Support, most users will make a correct self-selection decision regarding the use of the product to manage their incontinence symptoms.
{"title":"A Self-Selection Validation Study of the Uresta Bladder Support","authors":"Scott A. Farrell MD , Kenneth Gillespie MD , Stephane Foulem MD , Stephanie Lagacé RN","doi":"10.1016/j.jogc.2025.103085","DOIUrl":"10.1016/j.jogc.2025.103085","url":null,"abstract":"<div><h3>Objectives</h3><div>When a medical device is available over the counter, the ability of a consumer to correctly self-select to use the device, independent of guidance from a health care professional, is essential and important.</div><div>This study was undertaken to evaluate the self-selection process for the Uresta Bladder Support.</div></div><div><h3>Methods</h3><div>A total of 49 women were enrolled in this study. The results of a self-selection interview were validated by using a gynaecologic examination as the gold standard.<em><strong>Result</strong></em><strong><em>s</em>:</strong> The urinary continence diagnoses broke down as follows: continent 16 (33%), pure stress incontinence 18 (37%), mixed urinary incontinence 13 (27%), and pure urge incontinence 2 (4%). A total of 36 (73%) indicated that they would acquire the bladder support and use it, whereas 13 (27%) indicated that they would not choose to use the device based on their understanding of the device and their personal medical history. A total of 43 (88%) made a correct self-selection decision and 6 (12%) made an incorrect decision. Root cause analysis found that the residual risks associated with use of the Uresta Bladder Support in the over-the-counter context were acceptable and outweighed by the impact of the device on user’s quality of life.</div></div><div><h3>Conclusions</h3><div>Using the information provided on the external packaging of the Uresta Bladder Support, most users will make a correct self-selection decision regarding the use of the product to manage their incontinence symptoms.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 11","pages":"Article 103085"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995042","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}
Blood Group, antibody screen, fetal maternal hemorrhage tests and Rh(D) immunoglobulin (RhIG) administration are interventions during pregnancy that aid in the prevention of hemolytic disease of the fetus and newborn (HDFN). The timing, frequency, and nature of testing vary across centres due to limited data to inform standards development. Using Delphi methodology, this study aimed to establish guidance for Canadian practice related to prenatal, postnatal and neonatal immunohematologic testing, and RhIG administration, to reduce risk and improve diagnosis of HDFN.
Methods
A national, multidisciplinary Delphi panel rated their agreement with potential guidance statements related to prenatal, postnatal and neonatal immunohematology testing on a 5-point Likert scale during iterative rounds of voting. After each round, responses were analyzed and statements were re-sent to the panel for further ratings until consensus was achieved, defined as Cronbach’s α >0.95 or a maximum of 3 voting rounds. At the conclusion of the Delphi process, statements rated ≥4/5 were included.
Results
In total, 46 experts voted on 49 proposed statements. Consensus was achieved after 3 survey rounds (Cronbach’s α = 0.94), with a 100% response rate throughout. Overall, 44 statements reached consensus. Statements focused on prenatal immunohematology testing (N = 21 statements), maternal–fetal hemorrhage testing and RhIG administration during pregnancy (N = 15), and testing of neonates for surveillance of hyperbilirubinemia secondary to hemolytic disease of the newborn (N = 8).
Conclusions
This Canadian consensus guidance aims to optimize the surveillance of pregnancies at risk of HDFN and the dosing and timing of RhIG administration. It provides actionable recommendations to harmonize practice and support safe, timely, and cost-effective care.
{"title":"Guidance for Prenatal, Postnatal and Neonatal Immunohematology Testing in Canada: Consensus Recommendations from a Modified Delphi Process","authors":"Lani Lieberman MD , Catharine M. Walsh MD , Rebecca Barty MSc , Jeannie Callum MD , Matthew T.S. Yan MD , Heather VanderMeulen MD , Nancy Robitaille MD , Karen Fung Kee Fung MD , Eugene Ng MD , Heather Hume MD , Jon Barrett MD , Robyn Berman RM , Melanie Colpitts MD , Erin Dowe RN , Barbra de Vrijer MD , Susan Ellis MD , Poh Nyuk Fam MD , Kirsten Grabowska MD , Batya Grundland MD , JoAnn Harrold MD , Gwen Clarke MD","doi":"10.1016/j.jogc.2025.103088","DOIUrl":"10.1016/j.jogc.2025.103088","url":null,"abstract":"<div><h3>Objectives</h3><div>Blood Group, antibody screen, fetal maternal hemorrhage tests and Rh(D) immunoglobulin (RhIG) administration are interventions during pregnancy that aid in the prevention of hemolytic disease of the fetus and newborn (HDFN). The timing, frequency, and nature of testing vary across centres due to limited data to inform standards development. Using Delphi methodology, this study aimed to establish guidance for Canadian practice related to prenatal, postnatal and neonatal immunohematologic testing, and RhIG administration, to reduce risk and improve diagnosis of HDFN.</div></div><div><h3>Methods</h3><div>A national, multidisciplinary Delphi panel rated their agreement with potential guidance statements related to prenatal, postnatal and neonatal immunohematology testing on a 5-point Likert scale during iterative rounds of voting. After each round, responses were analyzed and statements were re-sent to the panel for further ratings until consensus was achieved, defined as Cronbach’s α >0.95 or a maximum of 3 voting rounds. At the conclusion of the Delphi process, statements rated ≥4/5 were included.</div></div><div><h3>Results</h3><div>In total, 46 experts voted on 49 proposed statements. Consensus was achieved after 3 survey rounds (Cronbach’s α = 0.94), with a 100% response rate throughout. Overall, 44 statements reached consensus. Statements focused on prenatal immunohematology testing (N = 21 statements), maternal–fetal hemorrhage testing and RhIG administration during pregnancy (N = 15), and testing of neonates for surveillance of hyperbilirubinemia secondary to hemolytic disease of the newborn (N = 8).</div></div><div><h3>Conclusions</h3><div>This Canadian consensus guidance aims to optimize the surveillance of pregnancies at risk of HDFN and the dosing and timing of RhIG administration. It provides actionable recommendations to harmonize practice and support safe, timely, and cost-effective care.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103088"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985823","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 : 2025-09-01DOI: 10.1016/j.jogc.2025.103087
Anastasija Arechvo PhD , Argyro Syngelaki PhD , Ranjit Akolekar PhD , Peter von Dadelszen DPhil , Kypros H. Nicolaides MD , Laura A. Magee MD
Objectives
This study aimed to compare preeclampsia (PE) risk screening by risk factors and the multivariable competing risks model.
Methods
This prospective cohort study enrolled singleton pregnancies, without major anomalies, and delivering at ≥24 weeks. PE risk was compared between the Fetal Medicine Foundation (FMF) model and clinical risk factors by National Institute for Health and Care Excellence (NICE) guidance, U.K. and “NICE-modified” by adding Black ethnicity and social deprivation (index of multiple deprivation deciles 1–4) as moderate risk factors. To compare screening strategies, we matched the FMF screen-positive rate (SPR) to NICE.
Results
At 11–13 weeks, preterm PE risk was assessed in 44 813 pregnancies; 368 (0.8%) developed preterm PE. At SPR = 7.4%, FMF (vs. NICE) almost tripled preterm PE detection rate (DR) but by more (by 19.8%) among Black women. The FMF model at SPR = 7.4% had DR = 67.7% for preterm PE, similar to NICE-modified screening (67.4%, which had SPR = 40.1%). At 35–36 weeks, subsequent PE risk was assessed in 29 035 pregnancies; 654 (2.3%) developed PE. At SPR = 10.9%, FMF (vs. NICE) more than doubled subsequent PE DR, regardless of index of multiple deprivation or Black ethnicity. FMF at SPR = 10.9% had DR for subsequent PE at least as high (70.5%) as NICE-modified screening (61.5%), which had SPR = 37.4%.
Conclusions
The FMF model detects PE risk similar to risk factor–based screening, with addition of Black ethnicity and social deprivation as moderate risk factors but at substantially lower SPR at 11–13 weeks when aspirin is offered to prevent preterm PE and at 35–36 weeks when timed birth at term may prevent term PE.
{"title":"Preeclampsia Screening Taking Into Account Ethnicity and Socioeconomic Status—A Comparison of the Competing Risks Model and Risk Factor Scoring","authors":"Anastasija Arechvo PhD , Argyro Syngelaki PhD , Ranjit Akolekar PhD , Peter von Dadelszen DPhil , Kypros H. Nicolaides MD , Laura A. Magee MD","doi":"10.1016/j.jogc.2025.103087","DOIUrl":"10.1016/j.jogc.2025.103087","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to compare preeclampsia (PE) risk screening by risk factors and the multivariable competing risks model.</div></div><div><h3>Methods</h3><div>This prospective cohort study enrolled singleton pregnancies, without major anomalies, and delivering at ≥24 weeks. PE risk was compared between the Fetal Medicine Foundation (FMF) model and clinical risk factors by National Institute for Health and Care Excellence (NICE) guidance, U.K. and “NICE-modified” by adding Black ethnicity and social deprivation (index of multiple deprivation deciles 1–4) as moderate risk factors. To compare screening strategies, we matched the FMF screen-positive rate (SPR) to NICE.</div></div><div><h3>Results</h3><div>At 11–13 weeks, preterm PE risk was assessed in 44 813 pregnancies; 368 (0.8%) developed preterm PE. At SPR = 7.4%, FMF (vs. NICE) almost tripled preterm PE detection rate (DR) but by more (by 19.8%) among Black women. The FMF model at SPR = 7.4% had DR = 67.7% for preterm PE, similar to NICE-modified screening (67.4%, which had SPR = 40.1%). At 35–36 weeks, subsequent PE risk was assessed in 29 035 pregnancies; 654 (2.3%) developed PE. At SPR = 10.9%, FMF (vs. NICE) more than doubled subsequent PE DR, regardless of index of multiple deprivation or Black ethnicity. FMF at SPR = 10.9% had DR for subsequent PE at least as high (70.5%) as NICE-modified screening (61.5%), which had SPR = 37.4%.</div></div><div><h3>Conclusions</h3><div>The FMF model detects PE risk similar to risk factor–based screening, with addition of Black ethnicity and social deprivation as moderate risk factors but at substantially lower SPR at 11–13 weeks when aspirin is offered to prevent preterm PE and at 35–36 weeks when timed birth at term may prevent term PE.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 11","pages":"Article 103087"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995039","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 : 2025-09-01DOI: 10.1016/j.jogc.2025.103066
Graeme Smith MD, PhD
{"title":"The Society of Obstetricians and Gynecologists of Canada Annual Clinical and Scientific Conference Highlights Editorial","authors":"Graeme Smith MD, PhD","doi":"10.1016/j.jogc.2025.103066","DOIUrl":"10.1016/j.jogc.2025.103066","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103066"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850311","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 : 2025-09-01DOI: 10.1016/j.jogc.2025.103064
Jeffrey Man Hay Wong MD , Pascal M. Lavoie MD, PhD
{"title":"Respiratory Syncytial Virus Immunization Review for Prenatal Care Providers","authors":"Jeffrey Man Hay Wong MD , Pascal M. Lavoie MD, PhD","doi":"10.1016/j.jogc.2025.103064","DOIUrl":"10.1016/j.jogc.2025.103064","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103064"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144802392","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 : 2025-09-01DOI: 10.1016/j.jogc.2025.103080
Nicholas A. Leyland MD, MHCM, Marfy Abousifein BHSc
{"title":"Systemic Inequities in Women’s Health for Providers and Patients: The Impact on Access to Care","authors":"Nicholas A. Leyland MD, MHCM, Marfy Abousifein BHSc","doi":"10.1016/j.jogc.2025.103080","DOIUrl":"10.1016/j.jogc.2025.103080","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"47 9","pages":"Article 103080"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985938","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}
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