AJOG global reports最新文献

{"title":"Chronic pelvic pain secondary to venous congestion of longitudinal vaginal septum: a case report","authors":"Megan A. Stevenson MD ,&nbsp;Koah R. Vierkoetter MD ,&nbsp;Jennifer W.H. Wong MD","doi":"10.1016/j.xagr.2025.100480","DOIUrl":"10.1016/j.xagr.2025.100480","url":null,"abstract":"<div><div>We describe the first written description of chronic pelvic pain secondary to venous congestion isolated to a longitudinal vaginal septum. A 29-year-old nulliparous female with chronic pelvic pain was diagnosed with a complete longitudinal vaginal septum and complete septate uterus. The patient desired surgical management, and the vaginal septum was excised without complications. Vascular congestion of the septal tissue was noted on pathology, and postoperatively, the patient's pelvic pain improved significantly. Typically, patients with a longitudinal vaginal septum present with pain isolated to vaginal penetration. For atypical presentations like chronic pelvic pain, surgical resection is reasonable to consider with shared patient decision-making.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100480"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571676","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":"Quantifying maternal vaccination opportunities across gestational age windows: a real-world multi-country, longitudinal study","authors":"Rachel Ford MPH ,&nbsp;Oluwatosin Nkereuwem MPH ,&nbsp;Ugochukwu Madubueze MPH ,&nbsp;Urudinachi Agbo FWACP ,&nbsp;Suraj Bhattarai MSc ,&nbsp;Rabin Thami MBBS ,&nbsp;Dan Kajungu PhD ,&nbsp;Victoria Nambasa MSc ,&nbsp;Agnes Msoka PhD ,&nbsp;Mir Mobarak Hossain MPH ,&nbsp;Edward P.K. Parker PhD ,&nbsp;Beate Kampmann PhD","doi":"10.1016/j.xagr.2025.100579","DOIUrl":"10.1016/j.xagr.2025.100579","url":null,"abstract":"<div><h3>Background</h3><div>Maternal vaccination is a recognized strategy for reducing maternal and neonatal morbidity and mortality, including in low- and middle-income countries (LMICs). As new vaccines such as those for respiratory syncytial virus (RSV) and group B streptococcus (GBS) will be administered according to gestational age (GA), understanding real-world patterns of contact of pregnant women with antenatal care services (ANC) across pregnancy is essential to inform the most effective delivery strategies.</div></div><div><h3>Methods</h3><div>We conducted a retrospective longitudinal, multisite analysis using anonymized data extracted from maternal health registers at ANC and delivery clinics in 6 LMICs: Bangladesh, The Gambia, Nepal, Nigeria, Tanzania, and Uganda. Eligible clinics contributed data from ANC and delivery services and access to routine data from January 2019 to December 2022. Retrospective, individual-level ANC attendance data from a total of 123,867 individuals were included in the study. These included the total number of ANC attendances per woman and GA at first and last ANC contact. The GA determination practices of each clinic were also recorded.</div></div><div><h3>Results</h3><div>Across all sites, women had a median of 4 ANC contacts per pregnancy (IQR 2–5). An estimated 79·2% of women had at least one ANC contact during the 24–36-week GA window, falling to 66·6% in a 28−36 week GA window, and 46·5% at 32−36 weeks. When stratified by ANC contact frequency, the proportion with at least one contact in 24−36 weeks increased to 94·1% among women with ≥4 ANC contacts, indicating significantly greater vaccine delivery potential among those with more frequent ANC contacts.</div></div><div><h3>Conclusion</h3><div>In these LMIC settings, the 24–36-week GA window presents opportunity for delivering maternal vaccination at high coverage. These findings underscore the need to align maternal vaccine delivery strategies with real-world ANC patterns to ensure equitable and timely vaccine access in LMICs.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100579"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571677","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":"Mobile telephone provider to provider helpline: A pilot study in Cameroon","authors":"Comfort Enah PhD ,&nbsp;Victoria Jauk MPH ,&nbsp;Mary Glory Ngong ,&nbsp;Christyenne Lily Bond MPH ,&nbsp;Lionel Neba Ambe MD ,&nbsp;Rahel Mbah Kyeng MPH ,&nbsp;Roland Mbole MSc ,&nbsp;Waldemar A. Carlo MD ,&nbsp;Gregory Halle-Ekane MD ,&nbsp;Pius Muffih Tih PhD, MPH ,&nbsp;Jeff Szychowski PhD ,&nbsp;Henna Budhwani PhD, MPH ,&nbsp;Alan Thevenet N. Tita MD, PhD","doi":"10.1016/j.xagr.2025.100581","DOIUrl":"10.1016/j.xagr.2025.100581","url":null,"abstract":"<div><h3>Background</h3><div>Despite the availability of effective strategies, countries in Sub-Saharan Africa continue to be disproportionately affected by maternal and perinatal morbidity and mortality. Mobile health interventions are recognized for their potential usefulness in addressing gaps to quality maternal and neonatal care in low-income countries, including those for health care providers.</div></div><div><h3>Objectives</h3><div>To measure feasibility and acceptability of an adapted 24/7 mobile phone-based medical information service via telephone (mMIST) provider-to-provider intervention in one district of Cameroon.</div></div><div><h3>Study Design</h3><div>We implemented a multimethods pilot study of mMIST in Ndop Health District in the Northwest region of Cameroon from March 2022 to February 2023. We projected on average one call every 2 days as an acceptable demand level, and at least 70% of providers rated the mMIST intervention as satisfactory for acceptability. We evaluated the feasibility of collecting administrative data on maternal and neonatal morbidity and mortality for the assessment of mMIST on clinical outcomes.</div></div><div><h3>Results</h3><div>Thirty front line and on-call expert maternal healthcare workers who staffed the mMIST answering line and 76 peripheral maternity providers in the Ndop Health District were trained to use the system. A total of 3991 births were reported during the mMIST pilot year. Monthly calls ranged from 2 in the first month to a high of 28 calls by the 6th month, with an average call volume of 14 per month. Forty-six out of 48 providers (96%; 95% confidence interval [78,95]) were satisfied with mMIST. Providers reported that intermittent electricity and internet connectivity issues were the main barriers to usage. We found that it was feasible to obtain administrative data on relevant neonatal and maternal outcomes in the district but inconsistencies in local reporting prevented reliable comparisons.</div></div><div><h3>Conclusion</h3><div>Overall, the mMIST intervention was feasible to implement and was acceptable to maternal healthcare providers who staffed or used the intervention. Adaptation to local context, engagement of, and buy-in from multiple stakeholders in our formative work contributed to feasibility and promising findings to inform larger scale evaluation of the intervention.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100581"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519613","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":"Bone mineral density with elagolix plus add-back therapy in women with heavy menstrual bleeding and uterine fibroids: open-label and post-treatment results of a 60-month phase 3 trial","authors":"Vicki L. Schnell MD ,&nbsp;Liesl K. Bredeson MD ,&nbsp;Eric Brown MD ,&nbsp;Anna Chan PharmD ,&nbsp;James Thomas MS ,&nbsp;James Simon MD ,&nbsp;Michael C. Snabes MD, PhD","doi":"10.1016/j.xagr.2025.100578","DOIUrl":"10.1016/j.xagr.2025.100578","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The gonadotropin-releasing hormone antagonist elagolix (ELA) plus hormonal add-back (+AB) therapy reduces menstrual blood loss in women with heavy menstrual bleeding (HMB) associated and uterine fibroids. Prescribed ELA+AB therapy is limited to 24 months due to concerns about the hypoestrogenic effects of potential decreased bone mineral density (BMD).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To evaluate 48-month safety and BMD effects of ELA+AB therapy in premenopausal women with HMB associated with uterine fibroids.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;This phase 3b, multicenter study (NCT03271489) was conducted September 13, 2017–June 28, 2024. Three study periods included a 12-month randomized, double-blind treatment period (months 1–12), a 36-month open-label extension (OLE) period (months 13–48), and a 12-month post-treatment follow-up period (months 49–60). Premenopausal women aged 18–50 years with HMB associated with uterine fibroids were randomized 2:1 to receive ELA+AB therapy (ELA 300 mg twice daily plus estradiol 1.0 mg/norethindrone acetate 0.5 mg once daily) or placebo during double-blind treatment. All patients entering the OLE received ELA+AB therapy for 36 months, including those switching from placebo (placebo/ELA+AB group) and those remaining on ELA+AB therapy (ELA+AB/ELA+AB group). BMD was assessed every 6 months at the lumbar spine, total hip, and femoral neck using dual-energy X-ray absorptiometry. Data were analyzed using an analysis of covariance model with treatment as the main effect and baseline values as covariates. Safety assessments included incidence of treatment-emergent adverse events (TEAEs).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Overall, 277 patients entered the OLE period, with 103 completing treatment. In the ELA+AB/ELA+AB group, the mean percent decrease in BMD from baseline was &lt;2% in the lumbar spine, total hip, and femoral neck at all scheduled visits through 48 months of treatment. Categorical analysis of percent BMD recovery showed that the majority of patients in the ELA+AB/ELA+AB group who had decreased BMD at month 48 achieved partial or full BMD recovery 12 months after treatment at each anatomic site. In the OLE, TEAEs were reported in 59 (70.2%) patients in the placebo/ELA+AB group and 124 (64.2%) patients in the ELA+AB/ELA+AB group. Most TEAEs were mild or moderate and nonserious, with no severe TEAEs occurring in &gt;1 patient in either treatment group. The most frequent TEAE (excluding COVID-19) was decreased BMD (placebo/ELA+AB, 8 [9.5%] patients; ELA+AB/ELA+AB, 27 [14.0%] patients). BMD-related TEAEs (including osteopenia and bone fractures) in the OLE occurred in 12 (14.3%) patients in the placebo/ELA+AB group and 31 (16.1%) patients in the ELA+AB/ELA+AB group. Decreased BMD was the most common TEAE leading to treatment discontinuation (placebo/ELA+AB, 7 [8.3%] patients; ELA+AB/ELA+AB, 24 [12.4%] patients).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;BMD was st","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100578"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519615","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":"Transradial uterine artery embolization for the treatment of symptomatic fibroids: A ten year experience","authors":"Carlos Jiménez-Rámila MD, PhD ,&nbsp;Ana Redondo-Villatoro MD ,&nbsp;Rafael J. Ruiz-Salmerón MD, PhD ,&nbsp;Sergio Rodríguez de Leiras-Otero MD ,&nbsp;Antonio Jiménez-Caraballo MD, PhD","doi":"10.1016/j.xagr.2025.100582","DOIUrl":"10.1016/j.xagr.2025.100582","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;Uterine fibroids are the most common tumors in women. They are generally asymptomatic but can cause bleeding problems and/or compression of neighboring structures and infertility. Embolization is an effective treatment for fibroids. However, transradial access is underused for various reasons.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;This study aimed to demonstrate that transradial access is safe and effective for treating symptomatic uterine fibroids to avoid the need for conventional surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;A single-center retrospective observational study of medical records between 2012 and 2022, in which 189 procedures were planned in patients with symptomatic uterine fibroids with fulfilled gestational desire, was conducted. The feasibility and safety of the technique, the need for subsequent surgery because of the lack of effectiveness of the treatment in women who could complete it from the date of the procedure until 24 months later, changes in uterine volume and in the largest fibroid, and changes in hemoglobin levels, follicle-stimulating hormone, luteinizing hormone, and estradiol were analyzed before and 6 months after the procedure. Changes in the quality of life questionnaire (Uterine Fibroid Symptom and Health-Related Quality of Life questionnaire) were analyzed before embolization and at 2 and 6 months after embolization.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Of note, 184 of 189 procedures (97.35%) were performed with total or partial angiographic success. Surgical intervention was not necessary 24 months after the procedure in 85.4% of patients (158/180 patients with complete angiographic success) with a very low rate of complications, all of them mild (13/185 [7%]). Between the first visit and the visit at 6 months after the intervention, both the uterine volume decreased (n=176; previous volume, 458.11 mL; volume after 6 months, 311.87 mL; −146.24 mL [95% confidence interval, −115.41 to −177.06]; &lt;em&gt;P&lt;/em&gt;&lt;.001) and the largest fibroid (previous volume 132.31 mL; volume after 6 months, 78.33 mL; −53.98 mL [95% confidence interval, −42.79 to −65.17]; &lt;em&gt;P&lt;/em&gt;&lt;.001) and the scores in the quality of life questionnaires and the hemoglobin level improved (previous level, 11.4 g/dL; level after 6 months, 12.85 g/dL; −9.94 [95% confidence interval, −1.74 to −1.16]; &lt;em&gt;P&lt;/em&gt;&lt;.001). Follicle-stimulating hormone (previous level, 18.61; level after 6 months, 30.68; −4.18 [95% confidence interval, −6.35 to −17.77]; &lt;em&gt;P&lt;/em&gt;&lt;.001) and luteinizing hormone (previous level, 13.52; level after 6 months, 20.91; −3.60 [95% confidence interval, −3.31 to −11.45]; &lt;em&gt;P&lt;/em&gt;&lt;.001) levels were elevated, but estradiol levels (previous level, 97.98; level after 6 months, 99.01; 0.11 [95% confidence interval, −32.40 to 28.84]) levels were not affected.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSION&lt;/h3&gt;&lt;div&gt;The transradial approach should be adopted as a safe and effective alternative for the tr","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100582"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571678","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":"Patient vs. clinician-collected cervical cytology for screening for CIN: a systematic review and meta-analysis","authors":"Greg Marchand MD, FACS, FICS, FACOG ,&nbsp;Daniela Gonzalez Herrera BS ,&nbsp;Brooke Hamilton BS ,&nbsp;McKenna Robinson BS ,&nbsp;Emily Kline BS ,&nbsp;Sarah Mera BS ,&nbsp;Michelle Koshaba BS ,&nbsp;Greenley Jephson BS ,&nbsp;Nidhi Pulicherla BS ,&nbsp;Ali Azadi MD, FACOG, FPMRS","doi":"10.1016/j.xagr.2025.100575","DOIUrl":"10.1016/j.xagr.2025.100575","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This systematic review and meta-analysis aimed to compare the diagnostic accuracy of self-collected versus clinician-collected cervical cytology for screening for cervical intraepithelial neoplasia (CIN), using cervical biopsy histopathology as the reference standard. The study sought to evaluate self-collection’s potential to enhance cervical cancer screening participation, particularly among under-screened women, by addressing barriers such as discomfort and logistical challenges.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data Sources&lt;/h3&gt;&lt;div&gt;We searched PubMed (MEDLINE), Web of Science, Scopus, and Cochrane databases from their inception to March 1, 2024, to identify relevant studies comparing self-collected and clinician-collected cervical cytology.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Eligibility Criteria&lt;/h3&gt;&lt;div&gt;Eligible studies included adult women (≥18 years) undergoing both self-collected and clinician-collected cervical cytology (conventional Pap smear or liquid-based cytology), with cervical biopsy as the reference standard. Studies were required to report diagnostic outcomes (e.g., sensitivity, specificity) and include a clinician-collected comparator. Non-English studies, those lacking biopsy as the reference standard, or single-arm studies were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Appraisal and Synthesis Methods&lt;/h3&gt;&lt;div&gt;Two independent reviewers screened studies, extracted data, and assessed methodological quality using the QUADAS-2 tool. A diagnostic meta-analysis was conducted with Review Manager 5.4 to calculate pooled sensitivity and specificity with 95% confidence intervals, using both unweighted and weighted methods. Summary receiver operating characteristic (SROC) curves were generated to visualize diagnostic performance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Five studies were included, revealing that self-collected cytology had a pooled sensitivity of 0.698 and specificity of 0.805, while clinician-collected cytology showed a higher sensitivity of 0.765 but lower specificity of 0.613, with variation in sensitivity and specificity observed across different self-collection methods (e.g., brushes, tampons, lavages). QUADAS-2 assessment identified methodological concerns, particularly in patient selection and flow and timing, suggesting risks of bias and limited generalizability to primary screening settings. Methodological limitations in studies, including wide variation in self-collection methods, highlight the need for further research.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Self-collected cervical cytology demonstrates reasonable diagnostic accuracy, offering a promising approach to increase screening uptake among under-screened populations by overcoming barriers to traditional clinician-based methods. However, its lower sensitivity compared to clinician-collected cytology underscores the need for careful implementation, including optimized assay selection and targeted population strategies. Heterogeneity in self-collection me","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100575"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416965","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":"Hypertensive disorders of pregnancy and gestational diabetes mellitus affect fetal growth and perinatal outcomes in women undergoing in vitro fertilization","authors":"Yaxin Su MS ,&nbsp;Yue Niu MD, PhD ,&nbsp;Binbin Zhao MS ,&nbsp;Shizhen Su MS ,&nbsp;Cameron Klein MD, PhD ,&nbsp;Xiaoyang Hou MD, PhD ,&nbsp;Xiao Li MD, PhD ,&nbsp;Hong Lv MD, PhD","doi":"10.1016/j.xagr.2025.100571","DOIUrl":"10.1016/j.xagr.2025.100571","url":null,"abstract":"<div><h3>Background</h3><div>Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are common complications that adversely affect pregnancy outcomes. However, data on their independent and combined impacts on fetal growth and perinatal outcomes in <em>in vitro</em> fertilization (IVF) pregnancies are limited.</div></div><div><h3>Objectives</h3><div>To investigate risks of abnormal fetal growth and perinatal outcomes following conventional IVF treatment across distinct groups categorized by GDM-affected, HDP-affected, HDP/GDM comorbidity (HDP/GDM), and those unaffected by neither disorder (unaffected).</div></div><div><h3>Study design</h3><div>In this retrospective cohort study, we analyzed data from 20,907 women who achieved singleton deliveries during their first IVF cycles. Multivariate logistic regression analysis was performed to evaluate the effects of HDP and GDM on fetal and perinatal outcomes, adjusting for confounding factors.</div></div><div><h3>Results</h3><div>Compared to unaffected IVF pregnancies, those complicated by HDP alone showed significantly increased risks of small for gestational age (SGA) infants (aOR 5.67, 95% CI 4.56–7.04, <em>P&lt;.</em>001), low birthweight (aOR 7.37, 95% CI 6.00–9.06, <em>P&lt;.</em>001), preterm delivery, and cesarean section. Pregnancies affected by GDM alone were associated with increased risks of SGA (aOR 1.34, 95% CI 1.04–1.72, <em>P=.</em>023), low birthweight (aOR 1.55, 95% CI 1.20–1.99, <em>P&lt;.</em>001), large for gestational age (LGA) infants (aOR 1.24, 95% CI 1.11–1.39, <em>P&lt;.</em>001), macrosomia (aOR 1.24, 95% CI 1.06–1.45, <em>P=.</em>005), preterm delivery, and cesarean section. The co-occurrence of HDP and GDM further elevated the risk of SGA (aOR 6.37, 95% CI 3.63–11.18, <em>P&lt;.</em>001), low birthweight (aOR 7.77, 95%CI 4.70–12.84, <em>P&lt;.</em>001), preterm delivery, and cesarean section.</div></div><div><h3>Conclusions</h3><div>IVF pregnancies affected by HDP or GDM exhibit risk profiles for abnormal fetal growth and adverse perinatal outcomes similar to those observed in naturally conceived pregnancies. The combined impact of HDP and GDM significantly exacerbates these risks. Importantly, these adverse outcomes are consistent regardless of whether the embryos transferred were fresh or frozen.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100571"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416964","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":"Care strategies for pregnant people and women living with hepatitis C in North America","authors":"Sofia R. Bartlett PhD ,&nbsp;Jasmin E. Charles MPAS ,&nbsp;Tatyana Kushner MD, MSCE","doi":"10.1016/j.xagr.2025.100580","DOIUrl":"10.1016/j.xagr.2025.100580","url":null,"abstract":"<div><div>Hepatitis C is a global health concern, with over 50 million people infected. Marginalized populations, particularly people who inject drugs, may not receive treatment despite an increased infection rate; similarly, there are gender disparities in the hepatitis C cascade of care, leaving some women undertreated. This is especially problematic, as hepatitis C rates are increasing substantially among individuals of childbearing age and pregnant people. While hepatitis C epidemiology and baseline characteristics are well understood, models of care focused on pregnant people that provide solutions to these barriers in attaining care are needed to increase health equity and achieve hepatitis C elimination. The adoption of highly effective, direct-acting antivirals for hepatitis C treatment has helped tremendously, but direct-acting antivirals must be accessible, and their availability must be combined with enhanced screening efforts. We review newly developed models of care for pregnant people who have hepatitis C and provide several case studies (with patient examples) of methods that have improved the care cascade and patient outcomes in our practices. Some models, such as mother-infant collocated care, allow postpartum and infant hepatitis C care to occur simultaneously, minimizing the number of visits and maximizing access to patient care. Other models, such as mobile point-of-care services and peer navigation, help marginalized populations attain access to care regardless of insurance status and transportation accessibility and provide peer support to help overcome treatment barriers, such as stigma and poverty. Additional innovative hepatitis C care models for pregnant people and women include modeling-based response-guided treatment, interdisciplinary collocated care models, and an integrated medical home model. Ultimately, there is no “one size fits all” hepatitis C model of care, as needs differ according to region, population demographics, and individual circumstances. As our review shows, many of the models apply multidisciplinary approaches to provide a range of care options. Reviewing the available models of care will help identify how practitioners can increase patient engagement with care and improve treatment uptake and completion rates among pregnant people and women and thus can contribute to hepatitis C elimination.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100580"},"PeriodicalIF":0.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841207","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":"Development and evaluation of an external cephalic version simulation-based educational program","authors":"Dhanalakshmi Thiyagarajan MD, MPH ,&nbsp;Megan Gauger MD ,&nbsp;Raj Patel MEng ,&nbsp;Thelma Quarshie MO ,&nbsp;Enaam A. Adanu MBChB ,&nbsp;Julia Kramer PhD, MPH ,&nbsp;Kathleen H. Sienko PhD ,&nbsp;Cheryl A. Moyer PhD, MPH ,&nbsp;Molly Stout MD, MS ,&nbsp;Deborah M. Rooney PhD ,&nbsp;Samuel A. Oppong MBChB, MPH ,&nbsp;Alim Swarray-Deen MBChB, MS ,&nbsp;Emma Lawrence MD, MS","doi":"10.1016/j.xagr.2025.100577","DOIUrl":"10.1016/j.xagr.2025.100577","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Fetal malpresentation contributes significantly to cesarean deliveries. External cephalic version (ECV) reduces this risk but requires skilled performance. In low-resource settings, limited training opportunities hinder its use, highlighting the need for effective simulation-based education.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to develop and evaluate an external cephalic version simulation-based educational program.</div></div><div><h3>STUDY DESIGN</h3><div>We used Kern’s 6-step framework to develop a program composed of 6 learning objectives with 6 distinct components specifically for low-resource settings. We conducted a 3-round modified Delphi panel to modify the program. We evaluated the program through a cluster randomized study of obstetrics and gynecology house officers, junior residents, senior residents/fellows, and consultants/attendings in January 2025 at Korle Bu Teaching Hospital in Ghana. Self-reported comfort and confidence, knowledge, skill, and program feasibility and acceptability were analyzed using <em>t</em> tests, Fisher exact tests, and Spearman’s rho.</div></div><div><h3>RESULTS</h3><div>The Delphi panel consisted of 14 experts from 5 countries. At least 80% consensus on all external cephalic version program components was reached before implementation. The learning group’s self-reported comfort and confidence (<em>P</em>&lt;.01) and knowledge measured via assessment (<em>P</em>&lt;.01) improved after the program compared with the preprogram period. The learning group’s skill measured via procedural checklist increased compared with the control group (<em>P</em>&lt;.01). Within the learning group, self-reported comfort and confidence (<em>P</em>&lt;.01) and skill in completing key steps on the procedural checklist (<em>P</em>=.02) were higher among those with a higher level of training. The participants were satisfied with the program and found it acceptable, appropriate, and feasible (5-point rating; mean, 4.42; standard deviation, 0.54).</div></div><div><h3>CONCLUSION</h3><div>Our external cephalic version simulation-based program improves comfort and confidence, knowledge, and skill among Ghanaian clinicians. Given that external cephalic version success depends on the skill of the performing clinician, our program may help increase external cephalic version rates and thus decrease the rates of avoidable cesarean delivery and its complications.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100577"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841208","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":"Characteristics of parents accessing a new postmortem imaging service to diagnose miscarriage in the United Kingdom","authors":"Holly Ellard MSc,&nbsp;Celine Lewis PhD,&nbsp;Ulrika Kreicbergs PhD,&nbsp;Audrey Lamouroux MD,&nbsp;Owen J. Arthurs PhD,&nbsp;Ian C. Simcock PhD","doi":"10.1016/j.xagr.2025.100573","DOIUrl":"10.1016/j.xagr.2025.100573","url":null,"abstract":"","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 4","pages":"Article 100573"},"PeriodicalIF":0.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363189","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}