Pub Date : 2026-02-03DOI: 10.1016/j.ajog.2026.01.034
Richard SPACEK, Ivana MUSILOVA, Nikola KUZNICIUSOVA, Karolina JANOCHOVA, Ondrej SOUCEK, Tereza SVADLAKOVA, Marek LUBUSKY, Bo JACOBSSON, Marian KACEROVSKY
{"title":"Amniotic fluid interleukin-6 threshold for intra-amniotic inflammation in preterm PROM using the Atellica automated chemiluminescent immunoassay","authors":"Richard SPACEK, Ivana MUSILOVA, Nikola KUZNICIUSOVA, Karolina JANOCHOVA, Ondrej SOUCEK, Tereza SVADLAKOVA, Marek LUBUSKY, Bo JACOBSSON, Marian KACEROVSKY","doi":"10.1016/j.ajog.2026.01.034","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.01.034","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"294 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-03DOI: 10.1016/j.ajog.2026.01.031
Helena C. Bartels, Anjana Ravi Chandran, W. Tony, Ella Huszti, Anat Pardo, Kate Staatsen, Rory C. Windrim, Sebastian R. Hobson, John C. Kingdom
{"title":"Chronic Histiocytic intervillositis of the Placenta: Clinical Outcomes and Relationships with Circulating Placental Growth Factor and Uterine Artery Doppler Waveforms","authors":"Helena C. Bartels, Anjana Ravi Chandran, W. Tony, Ella Huszti, Anat Pardo, Kate Staatsen, Rory C. Windrim, Sebastian R. Hobson, John C. Kingdom","doi":"10.1016/j.ajog.2026.01.031","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.01.031","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"8 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Serotonin–Norepinephrine Reuptake Inhibitors versus Selective Serotonin Reuptake Inhibitors and the Risk of Hypertensive Disorders of Pregnancy","authors":"Anick Bérard, Yves Mufike Lumu, Odile Sheehy, Gabra Nohmie, Narimene Ait Belkacem","doi":"10.1016/j.ajog.2026.01.032","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.01.032","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"15 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-02DOI: 10.1016/j.ajog.2026.01.033
Rodney McLaren, Sarah Crimmins, Vincenzo Berghella, Janet Stein, Kavisha Khanuja
{"title":"A Proposed Classification of Diabetes Mellitus in Pregnancy","authors":"Rodney McLaren, Sarah Crimmins, Vincenzo Berghella, Janet Stein, Kavisha Khanuja","doi":"10.1016/j.ajog.2026.01.033","DOIUrl":"https://doi.org/10.1016/j.ajog.2026.01.033","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"117 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Background</h3><div>Pulmonary embolism presents with nonspecific clinical features, leading to excessive use of computed tomography pulmonary angiography. Although the YEARS rule—incorporating assessment of symptomatic deep vein thrombosis, hemoptysis, and whether pulmonary embolism was the most likely diagnosis—has been shown to help to reduce computed tomography pulmonary angiography exposure during pregnancy, its safety and effectiveness in the postpartum period remain to be elucidated.</div></div><div><h3>Objective</h3><div>To evaluate the safety and effectiveness of a postpartum-adapted YEARS algorithm incorporating elevated D-dimer thresholds, respiratory rate, and venous thromboembolism score for managing postpartum women with suspected pulmonary embolism.</div></div><div><h3>Study design</h3><div>A retrospective cohort was conducted among postpartum mothers with suspected pulmonary embolism from 2022 to 2023 at 2 hospitals in Xinjiang, China. Patients were assessed using the postpartum-adapted YEARS algorithm. This incorporated clinical signs of deep vein thrombosis, hemoptysis, whether pulmonary embolism was the most likely diagnosis, respiratory rate, D-dimer level, and venous thromboembolism score. Pulmonary embolism was ruled out and computed tomography pulmonary angiography was not indicated under any of the following conditions: (1) at least one YEARS criterion was present but neither a high respiratory rate (≥22 bpm) nor a D-dimer ≥5 mg/L was observed; (2) no YEARS criteria were present and the venous thromboembolism score was ≥3, without a high respiratory rate or elevated D-dimer; or (3) no YEARS criteria were present and the venous thromboembolism score was <3 regardless of additional items. Patients not meeting these criteria were indicated for computed tomography pulmonary angiography. The primary outcome was the incidence of pulmonary embolism among patients indicated and not indicated for computed tomography pulmonary angiography. The secondary outcome was the proportion of patients requiring computed tomography pulmonary angiography.</div></div><div><h3>Results</h3><div>We looked at recruitment cohorts by year in case 2022 data were influenced by COVID-19 infection, which has been associated with an increased risk of pulmonary embolism. In 2023, of a total 205 women, there were 18 cases of pulmonary embolism (21.95%, 18/82) in computed tomography pulmonary angiography–indicated patients, whereas computed tomography pulmonary angiography was avoided in 60.0% (123/205) of all patients. In 2022, among 57 women, 8 pulmonary embolism cases (29.63%, 8/27) were diagnosed in the computed tomography pulmonary angiography–indicated group, and computed tomography pulmonary angiography avoidance was achieved in 52.63% (30/57). No pulmonary embolism cases were detected during follow-up. Across the overall cohort, the adapted algorithm showed a sensitivity of 100% (95% confidence interval: 87%–100%), a specificity of 65% (95%
{"title":"A postpartum-adapted algorithm for safe management of suspected pulmonary embolism: a retrospective cohort study","authors":"Yunzhen Ye PhD , Shaya Mahati PhD , Wusiniayi Aihemaiti MD , Gaigai Lu MBBS , Yongjie Ding MD , BaHaErGuLi ABuLaiTi MD , Xirong Xiao MD","doi":"10.1016/j.ajog.2025.10.035","DOIUrl":"10.1016/j.ajog.2025.10.035","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism presents with nonspecific clinical features, leading to excessive use of computed tomography pulmonary angiography. Although the YEARS rule—incorporating assessment of symptomatic deep vein thrombosis, hemoptysis, and whether pulmonary embolism was the most likely diagnosis—has been shown to help to reduce computed tomography pulmonary angiography exposure during pregnancy, its safety and effectiveness in the postpartum period remain to be elucidated.</div></div><div><h3>Objective</h3><div>To evaluate the safety and effectiveness of a postpartum-adapted YEARS algorithm incorporating elevated D-dimer thresholds, respiratory rate, and venous thromboembolism score for managing postpartum women with suspected pulmonary embolism.</div></div><div><h3>Study design</h3><div>A retrospective cohort was conducted among postpartum mothers with suspected pulmonary embolism from 2022 to 2023 at 2 hospitals in Xinjiang, China. Patients were assessed using the postpartum-adapted YEARS algorithm. This incorporated clinical signs of deep vein thrombosis, hemoptysis, whether pulmonary embolism was the most likely diagnosis, respiratory rate, D-dimer level, and venous thromboembolism score. Pulmonary embolism was ruled out and computed tomography pulmonary angiography was not indicated under any of the following conditions: (1) at least one YEARS criterion was present but neither a high respiratory rate (≥22 bpm) nor a D-dimer ≥5 mg/L was observed; (2) no YEARS criteria were present and the venous thromboembolism score was ≥3, without a high respiratory rate or elevated D-dimer; or (3) no YEARS criteria were present and the venous thromboembolism score was <3 regardless of additional items. Patients not meeting these criteria were indicated for computed tomography pulmonary angiography. The primary outcome was the incidence of pulmonary embolism among patients indicated and not indicated for computed tomography pulmonary angiography. The secondary outcome was the proportion of patients requiring computed tomography pulmonary angiography.</div></div><div><h3>Results</h3><div>We looked at recruitment cohorts by year in case 2022 data were influenced by COVID-19 infection, which has been associated with an increased risk of pulmonary embolism. In 2023, of a total 205 women, there were 18 cases of pulmonary embolism (21.95%, 18/82) in computed tomography pulmonary angiography–indicated patients, whereas computed tomography pulmonary angiography was avoided in 60.0% (123/205) of all patients. In 2022, among 57 women, 8 pulmonary embolism cases (29.63%, 8/27) were diagnosed in the computed tomography pulmonary angiography–indicated group, and computed tomography pulmonary angiography avoidance was achieved in 52.63% (30/57). No pulmonary embolism cases were detected during follow-up. Across the overall cohort, the adapted algorithm showed a sensitivity of 100% (95% confidence interval: 87%–100%), a specificity of 65% (95%","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 2","pages":"Pages 523-533"},"PeriodicalIF":8.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Background</h3><div>Diagnosis of dysglycemia is traditionally based on classical criteria, such as those outlined by the American Diabetes Association (ADA), which rely on isolated glucose measurements. However, these static assessments may not fully capture an individual’s dynamic glycemic profile. Continuous glucose monitoring (CGM) offers an alternative approach that provides a more comprehensive and accurate reflection of glycemic status over time. Women with a history of gestational diabetes mellitus (GDM) represent a particularly high-risk group. Compared with women who maintained normoglycemia during pregnancy, those with prior GDM have a significantly increased risk of developing dysglycemia. In addition to altered glucose metabolism, they frequently exhibit a cluster of cardiometabolic abnormalities, including obesity, dyslipidemia, hypertension, and early cardiac dysfunction.</div></div><div><h3>Objective</h3><div>To compare continuous glucose monitoring to American Diabetes Association criteria, in the postpartum period in women who had developed gestational diabetes mellitus during their recent pregnancy, for diagnosis of type 2 diabetes mellitus complicated by clinical obesity.</div></div><div><h3>Study Design</h3><div>Between September 2023 and April 2025, we conducted a multiproposal cohort study at King's College Hospital, London, UK. We invited consecutive women with and without gestational diabetes mellitus at 5 months postpartum. Gestational diabetes mellitus patients were also invited for a 1-year follow-up clinic. Blinded continuous glucose monitoring (Dexcom G7; Dexcom, San Diego, CA) was performed for 10 days. The primary outcome was type 2 diabetes mellitus with clinical obesity, defined by first, the American Diabetes Association criteria (hemoglobin A1c ≥6.5%, fasting plasma glucose ≥126 mg/dL, or 2-hour oral glucose tolerance test of ≥200 mg/dL), and second, continuous glucose monitoring average glucose ≥131.5 mg/dL, which is the mean+2 standard deviation of our nongestational diabetes mellitus group. Clinical obesity was defined by the recently published <em>The Lancet Diabetes and Endocrinology Commission</em>, as excess body fat directly affecting the function of organs and tissues.</div></div><div><h3>Results</h3><div>We examined 1118 women, including 276 (24.7%) nongestational diabetes mellitus controls at 5 months postpartum, 539 (48.2%) postgestational diabetes mellitus at 5 months postpartum, and 303 (27.1%) postgestational diabetes mellitus at 1 year postpartum. In the nongestational diabetes mellitus group, the mean+2 standard deviation average glucose was ≥131.5 mg/dL. At 5 months postpartum in the gestational diabetes mellitus group, continuous glucose monitoring classified 8.9% (48/539) women as diabetes mellitus type 2 with clinical obesity and the respective value by the American Diabetes Association criteria was 4.3% (23/539). Women diagnosed by continuous glucose monitoring but not the American
{"title":"Continuous glucose monitoring: criteria for the diagnosis of type 2 diabetes mellitus with clinical obesity after gestational diabetes","authors":"Cristina Gómez Fernández MD , Rea Mitsigiorgi MD , Micaela Fochini MD , Angel Leung MSc , Cristina Fernández Pérez MD, PhD , Kypros H. Nicolaides MD","doi":"10.1016/j.ajog.2025.09.031","DOIUrl":"10.1016/j.ajog.2025.09.031","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosis of dysglycemia is traditionally based on classical criteria, such as those outlined by the American Diabetes Association (ADA), which rely on isolated glucose measurements. However, these static assessments may not fully capture an individual’s dynamic glycemic profile. Continuous glucose monitoring (CGM) offers an alternative approach that provides a more comprehensive and accurate reflection of glycemic status over time. Women with a history of gestational diabetes mellitus (GDM) represent a particularly high-risk group. Compared with women who maintained normoglycemia during pregnancy, those with prior GDM have a significantly increased risk of developing dysglycemia. In addition to altered glucose metabolism, they frequently exhibit a cluster of cardiometabolic abnormalities, including obesity, dyslipidemia, hypertension, and early cardiac dysfunction.</div></div><div><h3>Objective</h3><div>To compare continuous glucose monitoring to American Diabetes Association criteria, in the postpartum period in women who had developed gestational diabetes mellitus during their recent pregnancy, for diagnosis of type 2 diabetes mellitus complicated by clinical obesity.</div></div><div><h3>Study Design</h3><div>Between September 2023 and April 2025, we conducted a multiproposal cohort study at King's College Hospital, London, UK. We invited consecutive women with and without gestational diabetes mellitus at 5 months postpartum. Gestational diabetes mellitus patients were also invited for a 1-year follow-up clinic. Blinded continuous glucose monitoring (Dexcom G7; Dexcom, San Diego, CA) was performed for 10 days. The primary outcome was type 2 diabetes mellitus with clinical obesity, defined by first, the American Diabetes Association criteria (hemoglobin A1c ≥6.5%, fasting plasma glucose ≥126 mg/dL, or 2-hour oral glucose tolerance test of ≥200 mg/dL), and second, continuous glucose monitoring average glucose ≥131.5 mg/dL, which is the mean+2 standard deviation of our nongestational diabetes mellitus group. Clinical obesity was defined by the recently published <em>The Lancet Diabetes and Endocrinology Commission</em>, as excess body fat directly affecting the function of organs and tissues.</div></div><div><h3>Results</h3><div>We examined 1118 women, including 276 (24.7%) nongestational diabetes mellitus controls at 5 months postpartum, 539 (48.2%) postgestational diabetes mellitus at 5 months postpartum, and 303 (27.1%) postgestational diabetes mellitus at 1 year postpartum. In the nongestational diabetes mellitus group, the mean+2 standard deviation average glucose was ≥131.5 mg/dL. At 5 months postpartum in the gestational diabetes mellitus group, continuous glucose monitoring classified 8.9% (48/539) women as diabetes mellitus type 2 with clinical obesity and the respective value by the American Diabetes Association criteria was 4.3% (23/539). Women diagnosed by continuous glucose monitoring but not the American","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 2","pages":"Pages 534-549"},"PeriodicalIF":8.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ajog.2025.09.005
Kuan-Ju Huang MD, MS
{"title":"Insights into the impact of body mass index on post-treatment CIN3+ risk","authors":"Kuan-Ju Huang MD, MS","doi":"10.1016/j.ajog.2025.09.005","DOIUrl":"10.1016/j.ajog.2025.09.005","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 2","pages":"Page e73"},"PeriodicalIF":8.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ajog.2025.09.004
Megan A. Clarke PhD, Nicolas Wentzensen MD, PhD
{"title":"Clarifying the complex relationship between obesity and posttreatment CIN3+: evidence gaps and clinical research priorities (reply to letter to the editor)","authors":"Megan A. Clarke PhD, Nicolas Wentzensen MD, PhD","doi":"10.1016/j.ajog.2025.09.004","DOIUrl":"10.1016/j.ajog.2025.09.004","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 2","pages":"Page e74"},"PeriodicalIF":8.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ajog.2025.09.047
Hana Okamoto MD , Kuniaki Ota MD, PhD , Toshifumi Takahashi MD, PhD , Yoshiaki Ota MD, PhD , Koichiro Shimoya MD, PhD
{"title":"Persistent isolated hyperlordosis in the fetal and neonatal period: clinical course and outcome","authors":"Hana Okamoto MD , Kuniaki Ota MD, PhD , Toshifumi Takahashi MD, PhD , Yoshiaki Ota MD, PhD , Koichiro Shimoya MD, PhD","doi":"10.1016/j.ajog.2025.09.047","DOIUrl":"10.1016/j.ajog.2025.09.047","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 2","pages":"Pages 579-581"},"PeriodicalIF":8.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1016/j.ajog.2025.10.014
Alexander M. Quaas MD, PhD , Eli Y. Adashi MD, MS
{"title":"The California infertility insurance mandate: another step toward reproductive justice?","authors":"Alexander M. Quaas MD, PhD , Eli Y. Adashi MD, MS","doi":"10.1016/j.ajog.2025.10.014","DOIUrl":"10.1016/j.ajog.2025.10.014","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"234 2","pages":"Pages 287-290"},"PeriodicalIF":8.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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