{"title":"Risk Factors for Readmission Following Minimally Invasive Hysterectomy for Benign Indications in the United States—Outpatient and Inpatient Setting","authors":"Raanan Meyer, Susie Lau, Shannon Salvador, Yosef Nasseri, Moshe Barnajian, Gabriel Levin","doi":"10.1111/1471-0528.70123","DOIUrl":"https://doi.org/10.1111/1471-0528.70123","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"182 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145801130","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":"Effect of Targeted Aspirin After First‐Trimester Preeclampsia Screening on Preterm Birth: Interpreting a Neutral Signal","authors":"Ruijuan Chen, Jingni Zhao, Binglin Li","doi":"10.1111/1471-0528.70117","DOIUrl":"https://doi.org/10.1111/1471-0528.70117","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759791","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}
Tesfaye Tufa,Stephanie Andrea Küng,Delayehu Bekele,Niguse Tadele,Mahari Yihdego,Kidist Lemma,Alice F Cartwright
OBJECTIVETo assess the quality of medication abortion (MA) services provided in pharmacies and drugstores ('pharmaceutical outlets') in Ethiopia.DESIGNA two-stage cross-sectional study.SETTINGPharmaceutical outlets in Addis Ababa, Ethiopia.SAMPLEPhase 1: 1696 pharmaceutical outlets listed in the Ethiopian Federal Ministry of Health Master Facility Registry, plus 187 additional outlets identified in the field. Phase 2: Selected 600 pharmaceutical outlets.METHODSAfter assessing stock availability in phase 1, during phase 2, mystery clients (MCs) visited pharmaceutical outlets to evaluate service quality using an adapted version of the Abortion Care Quality (ACQ) Tool. Descriptive statistics were used to characterise the quality of services provided by the outlets.MAIN OUTCOME MEASURESThe quality of abortion services provided by pharmaceutical outlets.RESULTSAbortion medications were sold without prescriptions in 23.5% of MC visits. Among these sales, client respect (95.7%) and confidentiality (84.4%) were high. Additionally, 67.1% of staff gave correct instructions on dosage, timing, and administration of the medications. However, less than half of the MCs received adequate information on possible complications (36.4%). Almost all medications purchased were unexpired, packaged in aluminum, and of a known brand (96.5%); however, none were characterised as affordable.CONCLUSIONSPharmaceutical outlets demonstrated moderate quality for MA services, yet there were notable gaps in counselling for physical side effects and complications, and affordability challenges. With appropriate policy adjustments and training interventions, there is potential to integrate pharmaceutical outlets into the abortion care service delivery infrastructure, ensuring equitable access to safe and effective abortion services in Ethiopia.
{"title":"Quality of Medication Abortion Services From Pharmacies and Drugstores in Ethiopia: A Two-Stage Study.","authors":"Tesfaye Tufa,Stephanie Andrea Küng,Delayehu Bekele,Niguse Tadele,Mahari Yihdego,Kidist Lemma,Alice F Cartwright","doi":"10.1111/1471-0528.70110","DOIUrl":"https://doi.org/10.1111/1471-0528.70110","url":null,"abstract":"OBJECTIVETo assess the quality of medication abortion (MA) services provided in pharmacies and drugstores ('pharmaceutical outlets') in Ethiopia.DESIGNA two-stage cross-sectional study.SETTINGPharmaceutical outlets in Addis Ababa, Ethiopia.SAMPLEPhase 1: 1696 pharmaceutical outlets listed in the Ethiopian Federal Ministry of Health Master Facility Registry, plus 187 additional outlets identified in the field. Phase 2: Selected 600 pharmaceutical outlets.METHODSAfter assessing stock availability in phase 1, during phase 2, mystery clients (MCs) visited pharmaceutical outlets to evaluate service quality using an adapted version of the Abortion Care Quality (ACQ) Tool. Descriptive statistics were used to characterise the quality of services provided by the outlets.MAIN OUTCOME MEASURESThe quality of abortion services provided by pharmaceutical outlets.RESULTSAbortion medications were sold without prescriptions in 23.5% of MC visits. Among these sales, client respect (95.7%) and confidentiality (84.4%) were high. Additionally, 67.1% of staff gave correct instructions on dosage, timing, and administration of the medications. However, less than half of the MCs received adequate information on possible complications (36.4%). Almost all medications purchased were unexpired, packaged in aluminum, and of a known brand (96.5%); however, none were characterised as affordable.CONCLUSIONSPharmaceutical outlets demonstrated moderate quality for MA services, yet there were notable gaps in counselling for physical side effects and complications, and affordability challenges. With appropriate policy adjustments and training interventions, there is potential to integrate pharmaceutical outlets into the abortion care service delivery infrastructure, ensuring equitable access to safe and effective abortion services in Ethiopia.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"175 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752680","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}
Dawn Parris, Yang Xue, Thurga Navaseelan, Carmen Salvadores Fernandez, Maryam Javidan, Rohit Gupta, Nikolaos Salaris, Jeremy Chen, Manish K. Tiwari, Dimitrios Siassakos
Objective Evaluate whether a sensorised surgical glove can serve as an effective training tool in management of impacted fetal head; and improvements needed. Examine location and amount of force applied through operators' hands during simulated disimpaction. Design Feasibility study. Setting National course of rotational vaginal birth and complex caesarean birth. Population Obstetricians of varying seniority. Methods Fetal head disimpaction using a model while wearing a sensorised glove. Maximum and time‐averaged force data were captured by 12 sensors, including the location of force. Thematic analysis of free‐text answers to questionnaires. Main Outcome Measures Sensorised glove's training effectiveness, force location and amount; and themes derived from free‐text answers. Results 13 obstetricians of varying seniority participated. One was considered an expert, and their performance was used as a reference point. Fingertip sensors: highest maximum force values, consistently across participants. Palmar sensors: relatively high peak forces, greater variability. Dorsal sensors: lower forces overall, high variability. Force during fetal disimpaction was applied in brief, targeted bursts (maximum) rather than continuously (time‐averaged). Desirable improvements identified included: making the glove wireless, avoiding the need to triple glove and a standardised model. Conclusions A sensorised glove has been developed, and participants found potential for use in training and management of impacted fetal head. There was consistent use of fingertips to deliver force, perhaps due to their precision and control. Variability in dorsal and palmar regions uncovered differences in hand positioning and technique.
{"title":"Characterising Forces Applied During the Simulated Management of Impacted Fetal Head: Pre‐Clinical Methods Study","authors":"Dawn Parris, Yang Xue, Thurga Navaseelan, Carmen Salvadores Fernandez, Maryam Javidan, Rohit Gupta, Nikolaos Salaris, Jeremy Chen, Manish K. Tiwari, Dimitrios Siassakos","doi":"10.1111/1471-0528.70107","DOIUrl":"https://doi.org/10.1111/1471-0528.70107","url":null,"abstract":"Objective Evaluate whether a sensorised surgical glove can serve as an effective training tool in management of impacted fetal head; and improvements needed. Examine location and amount of force applied through operators' hands during simulated disimpaction. Design Feasibility study. Setting National course of rotational vaginal birth and complex caesarean birth. Population Obstetricians of varying seniority. Methods Fetal head disimpaction using a model while wearing a sensorised glove. Maximum and time‐averaged force data were captured by 12 sensors, including the location of force. Thematic analysis of free‐text answers to questionnaires. Main Outcome Measures Sensorised glove's training effectiveness, force location and amount; and themes derived from free‐text answers. Results 13 obstetricians of varying seniority participated. One was considered an expert, and their performance was used as a reference point. Fingertip sensors: highest maximum force values, consistently across participants. Palmar sensors: relatively high peak forces, greater variability. Dorsal sensors: lower forces overall, high variability. Force during fetal disimpaction was applied in brief, targeted bursts (maximum) rather than continuously (time‐averaged). Desirable improvements identified included: making the glove wireless, avoiding the need to triple glove and a standardised model. Conclusions A sensorised glove has been developed, and participants found potential for use in training and management of impacted fetal head. There was consistent use of fingertips to deliver force, perhaps due to their precision and control. Variability in dorsal and palmar regions uncovered differences in hand positioning and technique.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145704232","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}
OBJECTIVETo explore novel biomarkers for clinical prognosis in patients with ovarian ageing, especially in premature ovarian insufficiency (POI).DESIGNProspective Cohort Study.SETTINGReproductive Hospital Affiliated with Shandong University, China.POPULATIONSixty POI patients and 60 control women recruited from 2018 to 2019.METHODSMachine learning algorithms were used to screen features of ovarian ageing from public ovarian transcriptome data. The candidate serum biomarker, endoplasmic reticulum aminopeptidase-2 (ERAP2), was compared between 60 POI patients and 60 control women. A prospective follow-up of 4 years was conducted on POI patients, and prediction models were established for intermittent recovery of ovarian function and clinical pregnancy based on serum ERAP2 levels.MAIN OUTCOME MEASURESIntermittent recovery of ovarian function and clinical pregnancy.RESULTSMachine learning models identified ERAP2 as a novel biomarker associated with ovarian ageing. POI patients exhibited significantly elevated serum ERAP2 levels compared to controls (5.78 ± 2.29 ng/mL vs. 4.81 ± 2.20 ng/mL, p = 0.018). With a prospective follow-up of these POI patients, ERAP2 was found to be a new biomarker for predicting intermittent recovery of ovarian function (AUROC = 0.763, 95% CI 0.734-0.792) and clinical pregnancy (AUROC = 0.768, 95% CI 0.749-0.787). Integrating ERAP2 into existing indices significantly improved their prediction accuracy both in predicting intermittent recovery of ovarian function (IDI = 0.166, p = 0.008) and in clinical pregnancy (NRI = 0.442, p = 0.034; IDI = 0.208, p = 0.018).CONCLUSIONSSerum ERAP2 can serve as a biomarker for intermittent recovery of ovarian function and clinical pregnancy in patients with POI. Combining ERAP2 with other clinical indicators may facilitate personalised intervention strategies for patients with POI in clinic.
目的探讨卵巢老化特别是卵巢功能不全（POI）患者临床预后的新生物标志物。前瞻性队列研究。单位山东大学附属生殖医院。人群：2018 - 2019年招募60名POI患者和60名对照女性。方法利用机器学习算法从公开的卵巢转录组数据中筛选卵巢衰老特征。我们比较了60名POI患者和60名对照女性的候选血清生物标志物内质网氨基肽酶-2 （ERAP2）。对POI患者进行为期4年的前瞻性随访，建立基于血清ERAP2水平的卵巢功能间歇恢复及临床妊娠预测模型。主要观察指标：卵巢功能间歇恢复及临床妊娠。结果机器学习模型鉴定出ERAP2是一种与卵巢衰老相关的新型生物标志物。与对照组相比，POI患者血清ERAP2水平显著升高（5.78±2.29 ng/mL vs. 4.81±2.20 ng/mL, p = 0.018）。通过对这些POI患者的前瞻性随访，发现ERAP2是预测卵巢功能间歇性恢复（AUROC = 0.763, 95% CI 0.734-0.792）和临床妊娠（AUROC = 0.768, 95% CI 0.749-0.787）的新生物标志物。将ERAP2纳入现有指标，无论是预测卵巢功能间歇恢复（IDI = 0.166, p = 0.008）还是临床妊娠（NRI = 0.442, p = 0.034; IDI = 0.208, p = 0.018），均显著提高了其预测准确性。结论血清ERAP2可作为POI患者卵巢功能间歇恢复和临床妊娠的生物标志物。将ERAP2与其他临床指标相结合，有助于临床对POI患者采取个性化的干预策略。
{"title":"ERAP2 as a Potential Marker for Ovarian Ageing and Spontaneous Ovulation Recovery in Women With Premature Ovarian Insufficiency.","authors":"Tingting Meng,Yunju Jo,Shibo Wei,Hanbing Zhu,Changjing Wang,Shutong Meng,Hyun Joo Lee,Jongkil Joo,Jiangtao Zhang,Daimin Wei,Zi-Jiang Chen,Dongryeol Ryu,Yingying Qin,Xue Jiao","doi":"10.1111/1471-0528.70105","DOIUrl":"https://doi.org/10.1111/1471-0528.70105","url":null,"abstract":"OBJECTIVETo explore novel biomarkers for clinical prognosis in patients with ovarian ageing, especially in premature ovarian insufficiency (POI).DESIGNProspective Cohort Study.SETTINGReproductive Hospital Affiliated with Shandong University, China.POPULATIONSixty POI patients and 60 control women recruited from 2018 to 2019.METHODSMachine learning algorithms were used to screen features of ovarian ageing from public ovarian transcriptome data. The candidate serum biomarker, endoplasmic reticulum aminopeptidase-2 (ERAP2), was compared between 60 POI patients and 60 control women. A prospective follow-up of 4 years was conducted on POI patients, and prediction models were established for intermittent recovery of ovarian function and clinical pregnancy based on serum ERAP2 levels.MAIN OUTCOME MEASURESIntermittent recovery of ovarian function and clinical pregnancy.RESULTSMachine learning models identified ERAP2 as a novel biomarker associated with ovarian ageing. POI patients exhibited significantly elevated serum ERAP2 levels compared to controls (5.78 ± 2.29 ng/mL vs. 4.81 ± 2.20 ng/mL, p = 0.018). With a prospective follow-up of these POI patients, ERAP2 was found to be a new biomarker for predicting intermittent recovery of ovarian function (AUROC = 0.763, 95% CI 0.734-0.792) and clinical pregnancy (AUROC = 0.768, 95% CI 0.749-0.787). Integrating ERAP2 into existing indices significantly improved their prediction accuracy both in predicting intermittent recovery of ovarian function (IDI = 0.166, p = 0.008) and in clinical pregnancy (NRI = 0.442, p = 0.034; IDI = 0.208, p = 0.018).CONCLUSIONSSerum ERAP2 can serve as a biomarker for intermittent recovery of ovarian function and clinical pregnancy in patients with POI. Combining ERAP2 with other clinical indicators may facilitate personalised intervention strategies for patients with POI in clinic.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"365 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145664282","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}
Simi Bansal,Alena U Uus,Agnieszka Glazewska-Hallin,Caitlin Allwin,Hadi Waheed,Vanessa Kyriakopoulou,Anna L David,Dimitrios Siassakos,Manju Chandiramani,Jana Hutter,Lisa Story,Mary A Rutherford
OBJECTIVETo use low-field MRI to produce reconstructions and 3D models of the cervix and to automate measurements for correlation with demographics and birth outcomes.DESIGNProspective cohort study.SETTINGKCL Advanced Imaging Centre, St Thomas's Hospital.POPULATIONLate gestation (36-41w) women attempting their first vaginal birth, recruited to the MiBirth study (n = 97).METHODSReconstructed images were produced from 2D T2-weighted Turbo-Spin-Echo 2D sequences acquired with a 0.55 T Freemax MRI scanner. Segmentations and anatomical landmarks were automated using an in-house 3D deep learning segmentation network, from which cervical 2D measurements and 3D volumes were generated.MAIN OUTCOME MEASURESQuality of reconstructed images and segmentations. Inter-rater variability for cervical biometry. Correlation between cervical measurements, maternal demographics and birth outcomes.RESULTSSuccessful reconstructions were obtained for 92.9%; 84.9% were good quality. Excellent or good quality segmentations were obtained for all successful reconstructions (n = 99). Inter-rater variability between automated and manual biometry was excellent or good for cervical measurements. Total cervical and stroma volumes significantly increased with cervical length (p < 0.01). Os diameters and utero-cervical angle significantly decreased as cervical length increased (p < 0.001). Cervical stroma volume increased with maternal age (p = 0.02). Controlling for maternal age, an increased cervical volume was associated with an increased risk of caesarean section (OR 1.09, p = 0.04).CONCLUSIONSThis is a novel, accurate automated system to assess MRI late gestation cervical biometry and volumetry. We have shown that the late gestation cervical phenotype may influence birth outcomes and provided a new mechanism for increased risk of caesarean with maternal age.
目的利用低场MRI进行宫颈重建和三维模型，并自动测量与人口统计学和出生结局的相关性。前瞻性队列研究。背景：圣托马斯医院高级影像中心。人群：MiBirth研究招募了第一次阴道分娩的晚期（36-41w）妇女（n = 97）。方法利用0.55 T Freemax MRI扫描仪采集的二维t2加权Turbo-Spin-Echo二维序列重建图像。使用内部3D深度学习分割网络自动分割和解剖标志，从中生成颈椎2D测量和3D体积。主要观察指标重建图像和分割的质量。宫颈生物测量的评分间变异性。宫颈测量、产妇人口统计学和出生结局之间的相关性。结果重建成功率92.9%；84.9%质量优良。所有成功的重建均获得了优良或良好的分割（n = 99）。在宫颈测量中，自动和手动生物测量之间的差异是优秀的或良好的。宫颈总体积和间质体积随宫颈长度的增加而显著增加（p < 0.01）。随着宫颈长度的增加，子宫颈直径和子宫颈角明显减小（p < 0.001）。宫颈间质体积随母亲年龄增加而增加（p = 0.02）。在控制产妇年龄的情况下，宫颈容量增加与剖腹产风险增加相关（OR 1.09, p = 0.04）。结论：这是一种新颖、准确的自动化系统，可用于评估MRI孕晚期宫颈生物测量和体积测量。我们已经表明，妊娠晚期宫颈表型可能影响分娩结果，并提供了一个新的机制，增加剖腹产的风险与母亲的年龄。
{"title":"Low-Field Magnetic Resonance Imaging of the Late Gestation Cervix and Birth Outcome Correlation: A Prospective Cohort Study.","authors":"Simi Bansal,Alena U Uus,Agnieszka Glazewska-Hallin,Caitlin Allwin,Hadi Waheed,Vanessa Kyriakopoulou,Anna L David,Dimitrios Siassakos,Manju Chandiramani,Jana Hutter,Lisa Story,Mary A Rutherford","doi":"10.1111/1471-0528.70103","DOIUrl":"https://doi.org/10.1111/1471-0528.70103","url":null,"abstract":"OBJECTIVETo use low-field MRI to produce reconstructions and 3D models of the cervix and to automate measurements for correlation with demographics and birth outcomes.DESIGNProspective cohort study.SETTINGKCL Advanced Imaging Centre, St Thomas's Hospital.POPULATIONLate gestation (36-41w) women attempting their first vaginal birth, recruited to the MiBirth study (n = 97).METHODSReconstructed images were produced from 2D T2-weighted Turbo-Spin-Echo 2D sequences acquired with a 0.55 T Freemax MRI scanner. Segmentations and anatomical landmarks were automated using an in-house 3D deep learning segmentation network, from which cervical 2D measurements and 3D volumes were generated.MAIN OUTCOME MEASURESQuality of reconstructed images and segmentations. Inter-rater variability for cervical biometry. Correlation between cervical measurements, maternal demographics and birth outcomes.RESULTSSuccessful reconstructions were obtained for 92.9%; 84.9% were good quality. Excellent or good quality segmentations were obtained for all successful reconstructions (n = 99). Inter-rater variability between automated and manual biometry was excellent or good for cervical measurements. Total cervical and stroma volumes significantly increased with cervical length (p < 0.01). Os diameters and utero-cervical angle significantly decreased as cervical length increased (p < 0.001). Cervical stroma volume increased with maternal age (p = 0.02). Controlling for maternal age, an increased cervical volume was associated with an increased risk of caesarean section (OR 1.09, p = 0.04).CONCLUSIONSThis is a novel, accurate automated system to assess MRI late gestation cervical biometry and volumetry. We have shown that the late gestation cervical phenotype may influence birth outcomes and provided a new mechanism for increased risk of caesarean with maternal age.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656835","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}
Objectives To assess the effect of an aspirin intervention program on preterm birth (PTB) rates in women identified as high‐risk for preterm preeclampsia in the first‐trimester screening. Design This is a retrospective study evaluating the impact of the intervention program on preterm birth using interrupted time series analysis (ITSA) with an ARIMA model that accounts for seasonality and autocorrelation. Setting St George's University Hospital, data collected on pregnancies between 2016 and 2022. Population Pregnant women followed from the first trimester of pregnancy. Methods An ITSA was conducted on the studied population to assess whether the introduction of an aspirin intervention program, based on first‐trimester screening, influenced preterm birth rates. Main Outcome Measures Primary outcomes included overall PTB rates, while secondary outcomes included iatrogenic preterm birth (iPTB) and spontaneous preterm birth (sPTB). Results Among 31 534 births, there were 1435 PTBs: 734 spontaneous and 701 iatrogenic. ITSA analysis revealed no significant impact of the screening program on PTB rates. There was a nonsignificant decrease in total PTB and iPTB over time, with similar trends observed for early PTB (< 34 weeks). Conclusions First‐trimester screening for preterm preeclampsia identifies women at higher risk for both preterm preeclampsia and PTB. While aspirin prophylaxis and serial assessments improve some perinatal outcomes, they do not significantly reduce spontaneous or iatrogenic PTB rates. Additional interventions will be needed to achieve a substantial reduction in PTB rates in a high‐risk population.
{"title":"Effect of Targeted Aspirin Administration Based on First Trimester Combined Screening for Preeclampsia on Preterm Birth: An Interrupted Time Series Analysis","authors":"Monica Minopoli, Alicia Martínez‐Varea, Claire Pegorie, Pilar Palmrich, Ana Pinas, Basky Thilaganathan","doi":"10.1111/1471-0528.70100","DOIUrl":"https://doi.org/10.1111/1471-0528.70100","url":null,"abstract":"Objectives To assess the effect of an aspirin intervention program on preterm birth (PTB) rates in women identified as high‐risk for preterm preeclampsia in the first‐trimester screening. Design This is a retrospective study evaluating the impact of the intervention program on preterm birth using interrupted time series analysis (ITSA) with an ARIMA model that accounts for seasonality and autocorrelation. Setting St George's University Hospital, data collected on pregnancies between 2016 and 2022. Population Pregnant women followed from the first trimester of pregnancy. Methods An ITSA was conducted on the studied population to assess whether the introduction of an aspirin intervention program, based on first‐trimester screening, influenced preterm birth rates. Main Outcome Measures Primary outcomes included overall PTB rates, while secondary outcomes included iatrogenic preterm birth (iPTB) and spontaneous preterm birth (sPTB). Results Among 31 534 births, there were 1435 PTBs: 734 spontaneous and 701 iatrogenic. ITSA analysis revealed no significant impact of the screening program on PTB rates. There was a nonsignificant decrease in total PTB and iPTB over time, with similar trends observed for early PTB (< 34 weeks). Conclusions First‐trimester screening for preterm preeclampsia identifies women at higher risk for both preterm preeclampsia and PTB. While aspirin prophylaxis and serial assessments improve some perinatal outcomes, they do not significantly reduce spontaneous or iatrogenic PTB rates. Additional interventions will be needed to achieve a substantial reduction in PTB rates in a high‐risk population.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"189 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145592869","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":"Rising Trends and Inequalities in Pre‐Existing Diabetes in Pregnancy: A Population‐Based Time‐Trend Analysis","authors":"Hasan Jamil, Roham Hadidchi, Stuart Gilmour","doi":"10.1111/1471-0528.70098","DOIUrl":"https://doi.org/10.1111/1471-0528.70098","url":null,"abstract":"","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145594058","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}
Nav La, Schawanya K. Rattanapitoon, Chutharat Thanchonnang, Nathkapach K. Rattanapitoon
Data Availability Statement
The authors have nothing to report.
数据可用性声明作者没有什么可报告的。
{"title":"Metformin and Hyperemesis Gravidarum: Reframing a Metabolic Disorder Through the Lens of Placental Adaptation","authors":"Nav La, Schawanya K. Rattanapitoon, Chutharat Thanchonnang, Nathkapach K. Rattanapitoon","doi":"10.1111/1471-0528.70086","DOIUrl":"https://doi.org/10.1111/1471-0528.70086","url":null,"abstract":"<h2>Data Availability Statement</h2>\u0000<p>The authors have nothing to report.</p>","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145485755","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":"Evaluating Fetal Well‐Being at Labor Onset: Is Intermittent Auscultation Enough?","authors":"Charles Garabedian, Paul Guerby, Paul Berveiller","doi":"10.1111/1471-0528.70085","DOIUrl":"https://doi.org/10.1111/1471-0528.70085","url":null,"abstract":"Click on the article title to read more.","PeriodicalId":8984,"journal":{"name":"BJOG: An International Journal of Obstetrics & Gynaecology","volume":"105 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145485752","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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