American journal of obstetrics and gynecology最新文献

{"title":"Rethinking “Obstetric violence”: a misnomer indeed","authors":"Frank A. Chervenak MD, Amos Grünebaum MD","doi":"10.1016/j.ajog.2024.07.013","DOIUrl":"10.1016/j.ajog.2024.07.013","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"232 2","pages":"Page e52"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619021","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":"Restricted physical activity and maternal rest improve fetal growth","authors":"Greggory R. DeVore MD, Bardo Polanco PhD, RDMS, Wesley Lee MD, Jeffrey Brian Fowlkes PhD, Emma E. Peek BS, Manesha Putra MD, John C. Hobbins MD","doi":"10.1016/j.ajog.2024.08.003","DOIUrl":"10.1016/j.ajog.2024.08.003","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"232 2","pages":"Page e63"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905570","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":"Prevalence of and risk factors for endometrial polyps among asymptomatic postmenopausal women with uterovaginal prolapse","authors":"Gabriela M. Weigel MD ,&nbsp;George N. Baison MD ,&nbsp;Linda Mihalov MD ,&nbsp;Tariro Mupombwa MD","doi":"10.1016/j.ajog.2024.08.001","DOIUrl":"10.1016/j.ajog.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of endometrial polyps among asymptomatic, postmenopausal women is not well defined. There is no clear clinical consensus on how to manage endometrial polyps in this population and whether these polyps truly are a cause for clinical concern.</div></div><div><h3>Objective</h3><div>This study aimed to estimate the prevalence of endometrial polyps among asymptomatic (without bleeding), postmenopausal women and to evaluate risk factors associated with their presence.</div></div><div><h3>Study Design</h3><div>This cross-sectional study assessed the prevalence of endometrial polyps among asymptomatic, postmenopausal women who underwent a hysterectomy for uterovaginal prolapse. Patients were excluded if they underwent a hysterectomy for other indications, including postmenopausal bleeding. Following chart review, eligible patients who received care at a single site in Washington state from 2009 to 2018 were included. The primary outcome was the presence of endometrial polyps on pathology. Risk factors associated with polyp prevalence were subsequently assessed using univariate analysis and multivariate regression.</div></div><div><h3>Results</h3><div>Of the 317 eligible women identified, endometrial polyps were identified in 106 women (33.4%). The average polyp size and endometrial thickness was 13±10 mm and 1.4±1.5 mm, respectively. Most cases (78%) had solitary polyps. Premalignant and malignant lesions were found in 2 cases (1.89%); 1 had endometrial carcinoma and 1 had endometrial intraepithelial neoplasia. Baseline clinical and demographic characteristics were similar between patients with and those without endometrial polyps, including the presence of fibroids, endometriosis, and adenomyosis. A multivariate logistic regression showed that the presence of polyps was independently associated with a high body mass index (odds ratio, 1.06; 95% confidence interval, 1.01–1.12; <em>P</em>=.02) and use of menopausal hormone therapy (odds ratio, 1.67; 95% confidence interval, 1.02–2.72; <em>P</em>=.04).</div></div><div><h3>Conclusion</h3><div>Asymptomatic postmenopausal women who underwent hysterectomy for uterovaginal prolapse exhibited a high prevalence of endometrial polyps. Those who used menopausal hormone therapy and who had a high body mass index were at a higher risk for developing endometrial polyps. Although the risk for malignancy seems to be low, more investigation is warranted to truly quantify the lifetime risk. For now, expectant management may be a reasonable approach for incidentally found, asymptomatic polyps.</div></div>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"232 2","pages":"Pages 196.e1-196.e6"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911340","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":"Defining mode of delivery as ‘instrumental vaginal delivery’: are results generalizable to both forceps and vacuum?","authors":"Giulia M. Muraca PhD, MPH","doi":"10.1016/j.ajog.2024.08.021","DOIUrl":"10.1016/j.ajog.2024.08.021","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"232 2","pages":"Page e53"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016087","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":"First trimester anomaly scan in the national screening program","authors":"Avir Sarkar,&nbsp;Aabir Humam,&nbsp;Huda Faisal,&nbsp;Iffat Maab","doi":"10.1016/j.ajog.2024.08.038","DOIUrl":"10.1016/j.ajog.2024.08.038","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"232 2","pages":"Page e81"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103526","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":"Reduced number of regulatory T cells in maternal circulation precede idiopathic spontaneous preterm labor in a subset of patients","authors":"Michal Koucky MD, PhD ,&nbsp;Zdenek Lastuvka MD, PhD ,&nbsp;Helena Koprivova Mgr ,&nbsp;Tereza Cindrova-Davies MD, PhD ,&nbsp;Jiri Hrdy RNDr, PhD ,&nbsp;Karin Cerna MD ,&nbsp;Pavel Calda MD, CSc","doi":"10.1016/j.ajog.2024.11.001","DOIUrl":"10.1016/j.ajog.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Accumulating evidence suggests that spontaneous preterm labor is a syndrome caused by multiple pathological processes. The breakdown of maternal-fetal tolerance has been proposed as a key mechanism of idiopathic spontaneous preterm labor, often viewed as a chronic inflammatory process resulting from the maternal immune system's impaired tolerance of the fetus from early pregnancy. Regulatory T cells are crucial for maintaining maternal-fetal tolerance. Even a partial reduction in their levels can disrupt this tolerance, leading to adverse pregnancy outcomes such as preterm labor. Given the complexity of the T lymphocyte-mediated immune response, identifying candidate signaling pathways involved in maternal-fetal tolerance is challenging. However, current literature highlights the importance of the functional and developmental markers FoxP3, CD45RA, Helios, and CD39 due to their immunosuppressive abilities essential for maintaining pregnancy.</div></div><div><h3>Objective</h3><div>This study aimed to determine whether changes in numbers of selected regulatory T cell subpopulations in the first trimester are associated with subsequent spontaneous preterm labor.</div></div><div><h3>Study Design</h3><div>This prospective study enrolled 43 women with early singleton pregnancies, excluding those with autoimmune diseases, diabetes mellitus (type 1, type 2), primary hypertension, or who had been treated with vaginal progesterone prior to sample collection. We analyzed regulatory T cell subpopulations in maternal circulation using the DURAClone IM T cell kit, focusing on the following subsets: CD4+CD25+FoxP3+, CD4+CD25+FoxP3+CD45RA, CD4+CD25+FoxP3+Helios+, and CD4+CD25+FoxP3+CD39−.</div></div><div><h3>Results</h3><div>Among the participants, 7 experienced spontaneous preterm labor between the 23rd and 33rd weeks of gestation, while 36 delivered at term. The preterm group showed a significant reduction in numbers of all analyzed regulatory T cell subpopulations: CD4+CD25+FoxP3+ (median 0.0410×10ˆ9/L vs median 0.0550×10ˆ9/L, <em>P</em>=.0217), CD4+CD25+FoxP3+CD45RA− (median 0.0310×10ˆ9/L vs median 0.0420×10ˆ9/L, <em>P</em>=.0216), CD4+CD25+FoxP3+Helios+ (median 0.0270×10ˆ9/L vs median 0.0370×10ˆ9/L, <em>P</em>=.0260), CD4+CD25+FoxP3+CD39− (median 0.0300×10ˆ9/L vs median 0.0420×10ˆ9/L, <em>P</em>=.0427).</div></div><div><h3>Conclusion</h3><div>Early first trimester alterations in specific regulatory T cell subpopulations, including diminished levels of CD4+CD25+FoxP3+, CD4+CD25+FoxP3+CD45RA−, CD4+CD25+FoxP3+Helios+, and CD4+CD25+FoxP3+CD39−, are associated with idiopathic spontaneous preterm labor. These findings suggest that early changes in these lymphocyte subpopulations may be linked to spontaneous preterm birth. This highlights the need for further research to understand the mechanisms underlying regulatory T-cell dynamics and their impact on pregnancy outcomes.</div></div>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"232 2","pages":"Pages 222.e1-222.e11"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of COVID-19 pandemic on postpartum depression and contraception","authors":"Chloe N. Matovina MD, MA,&nbsp;Allie Sakowicz MD, MS,&nbsp;Emma C. Allen MD, MEd,&nbsp;Mayán I. Alvarado-Goldberg,&nbsp;Danielle Millan BA,&nbsp;Emily S. Miller MD, MPH","doi":"10.1016/j.ajog.2024.08.020","DOIUrl":"10.1016/j.ajog.2024.08.020","url":null,"abstract":"","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"232 2","pages":"Page e48"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003388","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":"Accuracy of antenatal ultrasound in predicting large-for-gestational-age babies: population-based cohort study","authors":"Lauren J. Ewington PhD ,&nbsp;Oliver Hugh MSc ,&nbsp;Emily Butler BSc (Hons) ,&nbsp;Siobhan Quenby MD, FRCOG ,&nbsp;Jason Gardosi MD, FRCOG","doi":"10.1016/j.ajog.2024.04.052","DOIUrl":"10.1016/j.ajog.2024.04.052","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Pregnancies with large-for-gestational-age fetuses are at increased risk of adverse maternal and neonatal outcomes. There is uncertainty about how to manage birth in such pregnancies. Current guidelines recommend a discussion with women of the pros and cons of options, including expectant management, induction of labor, and cesarean delivery. For women to make an informed decision about birth, antenatal detection of large for gestational age is essential.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To investigate the ability of antenatal ultrasound scans to predict large for gestational age at birth.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;In this retrospective cohort study, we analyzed data from a routinely collected database from the West Midlands, United Kingdom. We included pregnancies that had an antenatal ultrasound-estimated fetal weight between 35+0 and 38+0 weeks gestation for any indication and a subgroup where the reason for the scan was that the fetus was suspected to be big. Large for gestational age was defined as &gt;90th customized GROW percentile for estimated fetal weight as well as neonatal weight. In addition, we tested the performance of an uncustomized standard, with Hadlock fetal weight &gt;90th percentile and neonatal weight &gt;4 kg. We calculated diagnostic characteristics for the whole population and groups with different maternal body mass indexes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The study cohort consisted of 26,527 pregnancies, which, on average, had a scan at 36+4 weeks gestation and delivered 20 days later at a median of 39+3 weeks (interquartile range 15). In total, 2241 (8.4%) of neonates were large for gestational age by customized percentiles, of which 1459 (65.1%) had a scan estimated fetal weight &gt;90th percentile, with a false positive rate of 8.6% and a positive predictive value of 41.0%. In the subgroup of 912 (3.4%) pregnancies scanned for a suspected large fetus, 293 (32.1%) babies were large for gestational age at birth, giving a positive predictive value of 50.3%, with a sensitivity of 77.1% and false positive rate of 36.0%. When comparing subgroups from low (&lt;18.5 kg/m&lt;sup&gt;2&lt;/sup&gt;) to high body mass index (&gt;30 kg/m&lt;sup&gt;2&lt;/sup&gt;), sensitivity increased from 55.6% to 67.8%, false positive rate from 5.2% to 11.5%, and positive predictive value from 32.1% to 42.3%. A total of 2585 (9.7%) babies were macrosomic (birthweight &gt;4 kg), and of these, 1058 (40.9%) were large for gestational age (&gt;90th percentile) antenatally by Hadlock’s growth standard, with a false positive rate of 4.9% and a positive predictive value 41.0%. Analysis within subgroups showed better performance by customized than uncustomized standards for low body mass index (&lt;18.5; diagnostic odds ratio, 23.0 vs 6.4) and high body mass index (&gt;30; diagnostic odds ratio, 16.2 vs 8.8).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Late third-trimester ultrasound estimation of fetal weight for any indica","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"232 2","pages":"Pages 210.e1-210.e10"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140896753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate vs delayed postpartum insertion of long-acting reversible contraception methods: meta-analysis of randomized controlled trials","authors":"Henrique Provinciatto MD ,&nbsp;Yasmin Jardim Meirelles Dias MD ,&nbsp;Sabrina Lara Abonizio Magdalena MS ,&nbsp;Marcus Vinicius Barbosa Moreira MS ,&nbsp;Lucas Rezende de Freitas MS ,&nbsp;Caroline Cristine Almeida Balieiro MS ,&nbsp;Cristina Aparecida Falbo Guazzelli PhD ,&nbsp;Edward Araujo Júnior PhD","doi":"10.1016/j.ajog.2024.09.019","DOIUrl":"10.1016/j.ajog.2024.09.019","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to conduct a meta-analysis of randomized trials comparing the immediate vs delayed provision of long-acting reversible contraceptives in postpartum subjects, focusing on short-interval pregnancies, utilization rates, and adverse events.</div></div><div><h3>Data sources</h3><div>Cochrane Central, Embase, PubMed, and ClinicalTrials.gov were systematically searched from inception up to December 19, 2023, without filters or language limitation.</div></div><div><h3>Study eligibility criteria</h3><div>We selected randomized controlled trials assessing the immediate insertion of long-acting reversible contraceptives in women during postpartum period in comparison with the delayed provision.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>We calculated relative risks with 95% confidence intervals to analyze the primary outcome of utilization rates and secondary endpoints, including initiation rates, pregnancy, any breastfeeding, exclusive breastfeeding, and serious adverse events. A random-effects model was employed in the R software. Moreover, we assessed the risk of bias of selected randomized controlled trials using version 2 of the Cochrane Risk of Bias Assessment Tool.</div></div><div><h3>Results</h3><div>We included 24 randomized trials comprising 2507 participants, of whom 1293 (51.6%) were randomized to the immediate insertion. Postpartum women in the immediate group had lower risk of pregnancy (relative risk 0.16; 95% confidence interval 0.04–0.71; <em>P</em>=.02) compared with delayed group, and higher rates of long-acting reversible contraceptives at 6 months of follow-up (relative risk 1.23; 95% confidence interval 1.09–1.37; <em>P</em>&lt;.01).</div></div><div><h3>Conclusion</h3><div>Inserting long-acting reversible contraceptives before hospital discharge was associated with a reduction in the risk of pregnancy, and increased rates of its utilization at 6 months of follow-up. This intervention may be an effective contraception strategy for postpartum women.</div></div>","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"232 2","pages":"Pages 139-149.e16"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275296","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":"Approach to radical hysterectomy for cervical cancer after the Laparoscopic Approach to Cervical Cancer trial and associated complications: a National Surgical Quality Improvement Program study","authors":"Gabriel Levin MD ,&nbsp;Pedro T. Ramirez MD ,&nbsp;Jason D. Wright MD ,&nbsp;Brian M. Slomovitz MD ,&nbsp;Kacey M. Hamilton MD ,&nbsp;Rebecca J. Schneyer MD ,&nbsp;Moshe Barnajian MD ,&nbsp;Yosef Nasseri MD ,&nbsp;Matthew T. Siedhoff MD, MSCR ,&nbsp;Kelly N. Wright MD ,&nbsp;Raanan Meyer MD","doi":"10.1016/j.ajog.2024.08.008","DOIUrl":"10.1016/j.ajog.2024.08.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The Laparoscopic Approach to Cervical Cancer study results revolutionized our understanding of the best surgical management for this disease. After its publication, the guidelines state that the standard and recommended approach for radical hysterectomy is an open abdominal approach. Nevertheless, the effect of the Laparoscopic Approach to Cervical Cancer trial on real-world changes in the surgical approach to radical hysterectomy remains elusive.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aimed to investigate the trends and routes of radical hysterectomy and to evaluate postoperative complication rates before and after the Laparoscopic Approach to Cervical Cancer trial (2018).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;The National Surgical Quality Improvement Program registry was used to examine radical hysterectomy for cervical cancer performed between 2012 and 2022. This study excluded vaginal radical hysterectomies and simple hysterectomies. The primary outcome measures were the trends in the route of surgery (minimally invasive surgery vs laparotomy) and surgical complication rates, stratified by periods before and after the publication of the Laparoscopic Approach to Cervical Cancer trial in 2018 (2012–2017 vs 2019–2022). The secondary outcome measure was major complications associated specifically with the different routes of surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of the 3611 patients included, 2080 (57.6%) underwent laparotomy, and 1531 (42.4%) underwent minimally invasive radical hysterectomy. There was a significant increase in the minimally invasive surgery approach from 2012 to 2017 (45.6% in minimally invasive surgery in 2012 to 75.3% in minimally invasive surgery in 2017; &lt;em&gt;P&lt;/em&gt;&lt;.01) and a significant decrease in minimally invasive surgery from 2018 to 2022 (50.4% in minimally invasive surgery in 2018 to 11.4% in minimally invasive surgery in 2022; &lt;em&gt;P&lt;/em&gt;&lt;.001). The rate of minor complications was lower in the period before the Laparoscopic Approach to Cervical Cancer trial than after the trial (317 [16.9%] vs 288 [21.3%], respectively; &lt;em&gt;P&lt;/em&gt;=.002). The major complication rates were similar before and after the Laparoscopic Approach to Cervical Cancer trial (139 [7.4%] vs 78 [5.8%], respectively; &lt;em&gt;P&lt;/em&gt;=.26). The rates of blood transfusions and superficial surgical site infections were lower in the period before the Laparoscopic Approach to Cervical Cancer trial than in the period after the trial (137 [7.3%] vs 133 [9.8%] [&lt;em&gt;P&lt;/em&gt;=.012] and 20 [1.1%] vs 53 [3.9%] [&lt;em&gt;P&lt;/em&gt;&lt;.001], respectively). In a comparison of minimally invasive surgery vs laparotomy radical hysterectomy during the entire study period, patients in the minimally invasive surgery group had lower rates of minor complications than in those in the laparotomy group (190 [12.4%] vs 472 [22.7%], respectively; &lt;em&gt;P&lt;/em&gt;&lt;.001), and the rates of major complications were similar in both groups (100","PeriodicalId":7574,"journal":{"name":"American journal of obstetrics and gynecology","volume":"232 2","pages":"Pages 208.e1-208.e11"},"PeriodicalIF":8.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995101","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}