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Added value of serum proteins to clinical and ultrasound information in predicting the risk of malignancy in ovarian tumors medRxiv. Obstet. Gynecol. Pub Date : 2024-03-15 An Coosemans, Jolien Ceusters, Chiara Landolfo, Thaïs Baert, Wouter Froyman, Ruben Heremans, Gitte Thirion, Sandra Claes, Julie Oosterlynck, Roxanne Wouters, Ann Vankerckhoven, Francesca Moro, Floriana Mascilini, Adam Neumann, Anne-Sophie Van Rompuy, Dominique Schols, Jaak Billen, Toon Van Gorp, Ignace Vergote, Tom Bourne, Caroline Van Holsbeke, Valentina Chiappa, Giovanni Scambia, Antonia Testa, Daniela
Background: The ADNEX model (Assessment of Different NEoplasias in the adnexa) is the best performing model to predict the risk of malignancy (binary) and type of malignancy (multiclass) in ovarian tumors. The immune system plays a role in the onset and progression of ovarian cancer. Preliminary research has suggested that immune-related biomarkers can help in the discrimination of ovarian tumors.
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Menopausal symptom burden as a predictor of mid- to late-life cognitive function and mild behavioral impairment symptoms: A CAN-PROTECT study. medRxiv. Obstet. Gynecol. Pub Date : 2024-03-15 Zahinoor Ismail, Jasper F.E. Crockford, Dylan X Guan, Gillian Einstein, Clive Ballard, Bryon Creese, Anne Corbett, Ellie Pickering, Adam Bloomfield, Pamela Roach, Eric E Smith
Background Recent evidence suggests the experience of menopausal symptoms (i.e., perimenopausal symptoms) may be associated with cognitive and behavioural changes. We investigated these two relationships in a sample of post-menopausal females. Design Cross-sectional observational study. Setting Participant data was collected from the Canadian Platform for Research Online to Investigate Health, Quality
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ARVs is for HIV and cream is for HPV or precancer: Womens Perceptions and Perceived Acceptability of Self-Administered Topical Therapies for Cervical Precancer Treatment: A Qualitative Study from Kenya medRxiv. Obstet. Gynecol. Pub Date : 2024-03-13 Chemtai Mungo, Aparna Ghosh Kachoria, Everlyn Adoyo, Graham Zulu, Supreet Kaur Goraya, Jackton Omoto, Cirilus Osongo, Renée M Ferrari
Background: Women in low- and middle-income countries (LMICs) bear a disproportionate burden of global incidence and deaths from cervical cancer, despite being a preventable disease. Prevention efforts in LMICs are hindered in part by lack of access to cervical precancer treatment, due to weak health infrastructure and a lack of adequate human resources to deliver current provider-administered precancer
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Uterine fibroids and risk of hypertensive disorders of pregnancy; results from a racially diverse high-risk cohort medRxiv. Obstet. Gynecol. Pub Date : 2024-03-07 Katherine Cameron, Mostafa Borahay, Xiumei Hong, Valerie Baker, Arthur Vaught, Xiaobin Wang
Study Question: What is the impact of the presence of uterine fibroids on the risk of developing hypertensive disorders of pregnancy (HDP) in a predominantly urban, low-income, Black, and Hispanic population of women with ultrasound or clinically diagnosed uterine fibroids with rich phenotypic data to carefully control for potential confounders? Summary answers: The odds of HDP were 39% higher in women
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EVALUATION OF THE RELATIOSHIP BETWEEN ADVANCED MATERNAL AGE AND PREGNANCY OUTCOME: A SCOPING REVIEW medRxiv. Obstet. Gynecol. Pub Date : 2024-03-07 Innocent Okafor Eze, Oliver Ezechi, Ahmadu Shehu Mohammed, Uchenna Ifeanyi Nwagha
Background Childbirth at advanced maternal age (AMA) is increasing among women, and some studies have shown adverse outcomes. There is a need to map evidence on the subject to harness findings and identify research gaps for further studies. This scoping review aims to examine pertinent studies on AMA and its impact on pregnancy outcomes. Methods The Preferred Reporting Item for Systematic Review and
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Uterine Fibroids and Hypertensive Disorders in Pregnancy: A Systematic Review and Meta-Analysis medRxiv. Obstet. Gynecol. Pub Date : 2024-03-07 Susan Nasab, Ethan Gough, Elisabeth Nylander, Mostafa Borahay, James Segars, Valerie Baker, Xiaobin Wang, Katherine Cameron
Objective: To examine the association between uterine fibroids and the development of hypertensive disorders in pregnancy. Data sources: Cochrane, Embase, PubMed, MEDLINE, Scopus, and Web of Science databases were searched from inception through April 2023. Study Selection and Synthesis: Cohort, case-control, or case series studies including uterine fibroid status and hypertensive disorders of pregnancy
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Development and Evaluation of Deep Learning Models for Cardiotocography Interpretation medRxiv. Obstet. Gynecol. Pub Date : 2024-03-06 Nicole Chiou, Nichole Young-Lin, Christopher Kelly, Tiya Tiyasirichokchai, Abdoulaye Diack, Sanmi Koyejo, Katherine Heller, Mercy Nyamewaa Asiedu
The inherent variability in the visual interpretation of cardiotocograms (CTGs) by obstetric clinical experts, both intra- and inter-observer, presents a substantial challenge in obstetric care. In response, we investigate automated CTG interpretation as a potential solution to enhance the early detection of fetal hypoxia during labor, which has the potential to reduce unnecessary operative interventions
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Perceived acceptability of self-administered topical therapy for cervical precancer treatment among women undergoing cervical cancer screening in Kenya medRxiv. Obstet. Gynecol. Pub Date : 2024-03-06 Chemtai Mungo, Grace Ellis, Mercy Rop, Yating Zou, Jackton Omoto, Lisa Rahangdale
Purpose: Innovative strategies are urgently needed to meet the World Health Organizations 2030 target of treating 90% of women with precancerous cervical lesions, especially in countries most affected by cervical cancer. We assessed the acceptability of self-administered intravaginal therapies for treating cervical precancer in women undergoing cervical cancer screening and precancer treatment in Kenya
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Fetal Growth Associated with Maternal Rheumatoid Arthritis and Juvenile Idiopathic Arthritis. medRxiv. Obstet. Gynecol. Pub Date : 2024-03-04 Eugenia Y Chock, Zeyan Liew, Lars Henning Pedersen, Mette Oestergaard Thunbo
Background: Prior studies indicated that women with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA) are at twice higher risk of developing adverse pregnancy outcomes, this include preterm births and infants with low birth weight. A wide knowledge gap exists in our current understanding of how RA and JIA affect fetal growth during pregnancy. Objective: We aimed to evaluate fetal growth
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WITHDRAWN: Impact of spatial clustering of cytotoxic and tumor infiltrating lymphocytes on overall survival in women with high grade serous ovarian cancer medRxiv. Obstet. Gynecol. Pub Date : 2024-02-28 Alex C Soupir, Mary K Townsend, Cassandra A Hathaway, Jonathan Nguyen, Carlos Moran-Segura, Daryoush Saeed-Vafa, Oscar E Ospina, Lauren C Peres, Jose R Conejo-Garcia, Kathryn L Terry, Shelley S Tworoger, Brooke L Fridley
The authors have withdrawn their manuscript owing to incorrect handling of multiple measures in the survival analysis. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.
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Exploring the Capabilities of ChatGPT in Women's Health medRxiv. Obstet. Gynecol. Pub Date : 2024-02-28 Magdalena Elisabeth Bachmann, Ioana Duta, Emily Mazey, William Cooke, Manu Vatish, Gabriel Davis Jones
Introduction: Artificial Intelligence (AI) is redefining healthcare, with Large Language Models (LLMs) like ChatGPT offering novel and powerful capabilities in processing and generating human-like information. These advancements offer potential improvements in Women's Health, particularly Obstetrics and Gynaecology (O&G), where diagnostic and treatment gaps have long existed. Despite its generalist
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Identifying high-risk pre-term pregnancies using the fetal heart rate and machine learning medRxiv. Obstet. Gynecol. Pub Date : 2024-02-27 Gabriel Davis Jones, William Cooke, Manu Vatish
Introduction: Fetal heart rate (FHR) monitoring is one of the commonest and most affordable tests performed during pregnancy worldwide. It is critical for evaluating the health status of the baby, providing real-time insights into the physiology of the fetus. While the relationship between patterns in these signals and adverse pregnancy outcomes is well-established, human identification of these complex
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Postpartum hormonal contraceptive use in Denmark during 1997-2021 medRxiv. Obstet. Gynecol. Pub Date : 2024-02-23 Soren Vinther Larsen, Anders Pretzmann Mikkelsen, Kathrine Bang Madsen, Xiaoqin Liu, Trine Munk-Olsen, Vibe Gedso Frokjaer, Oejvind Lidegaard
Introduction: Hormonal contraception is used by over a quarter of a billion worldwide. In Denmark, 84% have used it before their first pregnancy. After pregnancy, mothers are routinely advised to consider contraception to avoid short interpregnancy intervals due to perinatal and maternal health risks. Yet, mothers are not recommended to start combined hormonal contraception within six weeks postpartum
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Comparison of the ScreenFire and Xpert HPV assays for the detection of human papillomavirus and cervical precancer among women living with HIV in Malawi medRxiv. Obstet. Gynecol. Pub Date : 2024-02-23 Chemtai Mungo, Anagha Guliam, Lameck Chinula, Federica Inturrisi, Lizzie Msowoya, Tawonga Mkochi, Sinyia Jawadu, Silvia de Sanjose, Mark Schiffman, Jennifer H Tang, Jennifer S Smith
Background: The World Health Organization (WHO) recommends human papillomavirus (HPV) testing for primary cervical cancer screening, including among women living with HIV (WLWH). Low-and-middle-income countries (LMICs) account for 85% of the cervical cancer burden globally, yet have limited access to HPV-based screening, largely due to cost. This study aims to compare the performance of a rapid, isothermal
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SARS-CoV-2 infection and Pregnancy outcome: A cross-sectional study from Eastern U.P. Population, India medRxiv. Obstet. Gynecol. Pub Date : 2024-02-17 Sangeeta Rai, Ashish Ashish, Shivani Mishra, Bhupendra Kumar, Kusum Kusum, Royana Singh
Pregnant women with coronavirus infection are at a higher risk for severe diseases. In the present study, we evaluated and compared clinical characteristics and outcomes in pregnancy of normal females and females with SARS-CoV-2 infection. Our study was a cross-sectional study. The pregnant females were examined, their blood samples were taken for Covid Panel (D-Dimer, Ferritin, IL-6, CRP, PCT (Procalcitonin));
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Bioinformatical enrichment analysis of genes involved in the pathway of endometriosis disease medRxiv. Obstet. Gynecol. Pub Date : 2024-02-16 Kusum Kusum, Ashish Ashish, Ravi Bhushan, Radha Chaube, Sangeeta Rai, Royana Singh
Endometriosis is a gynecological disease characterized by the presence of uterine (eutopic) endometrial glands and tissues outside the intra-uterine locations, in ectopic regions such as the pelvic peritoneum, fallopian tubes, or ovaries. Approximately 5-10% of reproductive and 20-50% of infertile women are affected by endometriosis. The pathogenesis of endometriosis involves various factors, including
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The benefits and harms of oral iron supplementation in non-anaemic pregnant women: A systematic review and meta-analysis. medRxiv. Obstet. Gynecol. Pub Date : 2024-02-13 Archie Watt, Holden Eaton, Kate Eastwick-Jones, Elizabeth T Thomas, Annette Pluddemann
Objective: Iron deficiency during pregnancy poses a significant risk to both maternal and foetal health. Despite increased iron requirements during pregnancy, current UK NICE guidelines do not give clear advice on antenatal iron supplementation for non-anaemic women. We aimed to assess whether the benefits of routine antenatal supplementation outweigh potential harms for non-anaemic women. Methods:
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A Performance Evaluation of Computerised Antepartum Fetal Heart Rate Monitoring: The Dawes-Redman Algorithm at Term medRxiv. Obstet. Gynecol. Pub Date : 2024-02-13 Gabriel Davis Jones, Beth Albert, William Cooke, Manu Vatish
Objectives: This study aims to rigorously evaluate the Dawes-Redman computerised cardiotocography algorithm's effectiveness in assessing antepartum fetal wellbeing. It focuses on analysing the algorithm's performance using extensive clinical data, examining accuracy, sensitivity, specificity, and predictive values in various scenarios. The objectives include assessing the algorithm's reliability in
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Preeclampsia prediction with maternal and paternal polygenic risk scores: the TMM BirThree Cohort Study medRxiv. Obstet. Gynecol. Pub Date : 2024-02-09 Hisashi Ohseto, Mami Ishikuro, Taku Obara, Akira Narita, Ippei Takahashi, Genki Shinoda, Aoi Noda, Keiko Murakami, Masatsugu Orui, Noriyuki Iwama, Masahiro Kikuya, Hirohito Metoki, Junichi Sugawara, Gen Tamiya, Shinichi Kuriyama
Background: Genomic information from pregnant women and their husbands may provide effective biomarkers for preeclampsia. This study investigated how parental polygenic risk scores (PRSs) for blood pressure (BP) and preeclampsia are associated with preeclampsia onset and evaluated predictive performances of PRSs with clinical predictive variables. Methods: In the Tohoku Medical Megabank Project Birth
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Men’s perceptions and perceived acceptability of their female partner’s use of self-administered intravaginal therapies for treatment of cervical precancer in Kenya medRxiv. Obstet. Gynecol. Pub Date : 2024-02-07 Chemtai Mungo, Konyin Adewumi, Grace Ellis, Mercy Rop, Everlyn Adoyo, Yating Zou, Lisa Rahangdale
Background Cervical cancer continues to be a major health issue in low- and middle-income countries (LMICs). Despite increasing access to screening, access to precancer treatment remains a significant challenge in LMICs, highlighting a need for innovative, accessible, and resource-appropriate treatment approaches, including self-administered therapies.
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Outcomes and reinterventions following uterine artery embolization for the treatment of uterine leiomyomata medRxiv. Obstet. Gynecol. Pub Date : 2024-02-04 Jonathan G Martin, Alexis Medema
Purpose: Over the past two decades, uterine artery embolization (UAE) has emerged as a minimally invasive treatment for uterine leiomyomata. While prior work has established the safety and efficacy of this procedure, there exist few reports quantifying rates of subsequent retreatment and primary ovarian insufficiency. The purpose of this study is to investigate the frequency of reintervention and primary
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Modelling and Preliminary Clinical Validation of Home-based Menstrual Neuromodulation Therapy medRxiv. Obstet. Gynecol. Pub Date : 2024-02-04 Emile Radyte, Laura Stankeviciute, Ervinas Bernatavicius, Alexander Cook, Yvinna Tamiris Rodrigues, Tatiana Camila Lima de Alves Silva, Maria Thereza Albuquerque Barbosa Cabral Micussi, Rodrigo Pegado
Primary dysmenorrhea (PD), characterised by chronic pelvic pain during menstruation, significantly impairs the quality of life for many women. This paper presents a modelling and clinical validation study of the novel Nettle device for at-home transcranial direct current stimulation (tDCS) for alleviating PD symptoms. Specifically, we aimed to investigate the electric field patterns induced by Nettle
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Impact of continuous labour companion- who is the best: A comprehensive meta-analysis on familiarity, training, temporal association, and geographical location medRxiv. Obstet. Gynecol. Pub Date : 2024-02-03 DMCS Jayasundara, IA Jayawardane, SDS Weliange, TDKM Jayasingha, TMSSB Madugalle
Abstract Background: Continuous labour support is widely acknowledged for potentially enhancing maternal and neonatal outcomes and smoothing the labour process. However, existing literature lacks a comprehensive analysis of the optimal characteristics of labour companions, particularly in comparing the effects of trained versus untrained and familiar versus unfamiliar labour companions across diverse
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Large-scale genome-wide association study to determine the genetic underpinnings of female genital tract polyps medRxiv. Obstet. Gynecol. Pub Date : 2024-01-30 Amruta D.S. Pathare, Natàlia Pujol-Gualdo, Valentina Rukins, Jelisaveta Džigurski, Maire Peters, Estonian Biobank Research Team, Reedik Mägi, Andres Salumets, Merli Saare, Triin Laisk
STUDY QUESTION Can a large-scale genome-wide association study (GWAS) meta-analysis identify the genomic risk loci and associated candidate genes for female genital tract (FGT) polyps, provide insights into the mechanism underlying their development, and inform potential overlap with other traits, including endometrial cancer? SUMMARY ANSWER GWAS meta-analysis of FGT polyps highlighted the potentially
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Development of a spontaneous preterm birth predictive model using a panel of serum protein biomarkers for early pregnant women: A nested case-control study medRxiv. Obstet. Gynecol. Pub Date : 2024-01-29 Shuang Liang, Yuling Chen, Tingting Jia, Ying Chang, Wen Li, Yongjun Piao, Xu Chen
Objective: To develop a model based on first trimester maternal serum LC-MS/MS to predict spontaneous preterm birth (sPTB) < 37weeks. Methods: A cohort of 2,053 women were enrolled in a tertiary maternity hospital in China from July 1, 2018 to January 31, 2019. In total, 110 singleton pregnancies (26 cases of sPTB and 84 controls) at 11-136/7 gestational weeks were used for model development and internal
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Sociodemographic Factors Associated with Antenatal Steroid Exposure among Late Preterm Births medRxiv. Obstet. Gynecol. Pub Date : 2024-01-24 Mark Allen Clapp, Jessica Cohen, Cynthia Gyamfi-Bannerman, Anjali Kaimal, Scott Lorch, Jason Wright, Alexander Melamed
As the risk of preterm birth is known to vary widely, we aimed to determine if antenatal steroid exposure among LPBs varied based on sociodemographic characteristics. We hypothesized that sociodemographic factors may influence a provider's clinical judgment of a patient's likelihood of preterm birth and, therefore, also be associated with antenatal steroid use. This cross-sectional analysis used the
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Health services provided at the time of abortion in the US: a scoping review of the qualitative and quantitative evidence medRxiv. Obstet. Gynecol. Pub Date : 2024-01-23 Katherine Mahoney, Licia Bravo, Arden McAllister, Kacie Bogar, Sean Hennessy, Courtney A Schreiber, Alice Abernathy
Objectives: While it is well documented that abortion access is associated with improved health, pregnancy-related, and socioeconomic outcomes, the association between abortion access and other reproductive health outcomes is less well described. Abortion-providing clinics also offer preventative reproductive health services. We conducted a scoping review to ascertain the extent to which preventive
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Deep Survival Analysis for Interpretable Time-Varying Prediction of Preeclampsia Risk medRxiv. Obstet. Gynecol. Pub Date : 2024-01-20 Braden W Eberhard, Kathryn J Gray, David W Bates, Vesela P Kovacheva
Objective Survival analysis is widely utilized in healthcare to predict the timing of disease onset. Traditional methods of survival analysis are usually based on Cox Proportional Hazards model and assume proportional risk for all subjects. However, this assumption is rarely true for most diseases, as the underlying factors have complex, non-linear, and time-varying relationships. This concern is especially
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UPTAKE OF REPRODUCTIVE, MATERNAL AND NEWBORN HEALTH IN THE CONTEXT OF COVID-19 PANDEMIC IN KENYA medRxiv. Obstet. Gynecol. Pub Date : 2024-01-20 Joyce Jebet, Ruth Muia, Abednego Ongeso, Blasio Omuga, Grace Omoni, Miriam Wagoro
Background The outbreak of COVID 19 in 2019 lead to destabilization of all sectors globally including access to health care. The strain on the health care system as a result of the disease outbreak led to a shift in operations in the health care system. Maternal and neonatal care was affected as women and their families could not freely access health care owing to the restrictions to curb the spread
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Psychological and social risk factors and pregnancy outcome: a prospective cohort study medRxiv. Obstet. Gynecol. Pub Date : 2024-01-15 Elbert-Jaap I. Schipper, Klaas J. Wardenaar, Annemieke C. Bolte, Rei Monden, Titus W.D.P. van Os, Marieke Wichers, Peter de Jonge
Background Research suggests that besides somatic factors, psychological and social factors are associated with pregnancy outcomes. The objective of this study was to determine the independent effects of psychosocial risk factors on maternal blood pressure, gestational age at birth, birthweight and Apgar score.
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Incidence of occult cancer in patients diagnosed with adenocarcinoma in situ by cervical punch biopsy or endocervical curettage medRxiv. Obstet. Gynecol. Pub Date : 2024-01-12 Byung-Su Kwon, Dong Hoon Suh, Myong Cheol Lim, Kidong Kim, Chae Hyeong Lee, Hyun Hoon Chung, Yong-Beom Kim
Objectives To investigate the incidence of occult cancer in patients diagnosed with adenocarcinoma in situ through punch biopsy or endocervical curettage.
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Understanding Individualized Risk of Respiratory Morbidity to Guide Shared Decision-Making Around Late Preterm Steroids medRxiv. Obstet. Gynecol. Pub Date : 2024-01-08 Mark A. Clapp, Siguo Li, Jessica L. Cohen, Cynthia Gyamfi-Bannerman, Anjali J. Kaimal, Amy B. Knudsen, Scott A Lorch, Tanayott Thaweethai, Jason D. Wright, Alexander Melamed
Objective To estimate the effect of antenatal steroids on the absolute risk of respiratory morbidity among subgroups of patients based on two clinical factors with known varying baseline risks of morbidity: planned mode of delivery and gestational age at presentation.
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Disruption of maternal IgA by prenatal antibiotics precedes intestinal E. coli colonization and late-onset sepsis in neonates medRxiv. Obstet. Gynecol. Pub Date : 2024-01-05 Katya McDonald, Danielle Browning, Kara G. Greenfield, Kathryn Lin, Josephine Meier, Matthew Butoryak, Alexandria Sasaki, Eva Fandozzi, Tim Hand, Christina Megli, Kathryn A. Knoop
Neonates, particularly prematurely born neonates, are particularly vulnerable to enteric pathogens. Antibiotics are widely administered during pregnancy for off-label use and prevention, but the effect on neonatal physiology has not been well characterized. Maternally derived IgA provided in milk is a predominant protective measure in the intestinal lumen of the nursing offspring. The connection between
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Comparing Adverse Maternal And Neonatal Outcomes in Adolescent versus Adult Mothers in Sub-Saharan Africa medRxiv. Obstet. Gynecol. Pub Date : 2024-01-05 Chibuikem N. Onuzo, Promise E. Sefogah, Nelson K. Damale, Theodore K. Boafor, Alim Swarray-Deen, Kareem Mumuni
Objective Adolescent pregnancy is a major social and public health problem that burdens affected families, the communities and societies globally. It has been associated with a higher prevalence of adverse pregnancy outcomes compared to pregnancy in adults. To compare adverse pregnancy outcomes in adolescents (13-19 years) and those in adults (20 to 35 years) at the Korle-Bu Teaching Hospital in Accra
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Understanding diagnostic delay for endometriosis: a scoping review medRxiv. Obstet. Gynecol. Pub Date : 2024-01-09 Jodie Fryer, Amanda J. Mason-Jones, Amie Woodward
Abstract Introduction Diagnostic delay for endometriosis is a well-established phenomenon. Despite this, little is known about where in the health care system these delays occur or why they occur. Our review is the first attempt to synthesise and analyse this evidence. Methods A systematic scoping review with a pre-specified protocol was used to incorporate the global mixed methods literature on diagnostic
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Customization and acceptability of the WHO Labor care guide to improve labor monitoring among health workers in Uganda. An Iterative Development Study medRxiv. Obstet. Gynecol. Pub Date : 2024-01-09 Godfrey R. Mugyenyi, Josaphat Byamugisha, Wilson Tumuhimbise, Esther C. Atukunda, Fajarldo Tones Yarine
Background: Cognisant of the persistent maternal and perinatal mortality rates, the WHO has called for adoption and evaluation of new adaptable and context-specific health solutions to improve labor monitoring and health outcomes. We aimed at customizing and refining the new WHO labour care guide (LCG) to suite health care provider (HCP) needs in monitoring labour in Southwestern Uganda. Methods: We
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Widely accessible prognostication using medical history for fetal growth restriction and small for gestational age in nationwide insured women medRxiv. Obstet. Gynecol. Pub Date : 2024-01-09 Herdiantri Sufriyana, Fariska Zata Amani, Aufar Zimamuz Zaman Al Hajiri, Yu-Wei Wu, Emily Chia-Yu Su
Objectives: Prevention of fetal growth restriction/small for gestational age is adequate if screening is accurate. Ultrasound and biomarkers can achieve this goal; however, both are often inaccessible. This study aimed to develop, validate, and deploy a prognostic prediction model for screening fetal growth restriction/small for gestational age using only medical history. Methods: From a nationwide
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Probiotic effect of trichloroacetic acid on cervicovaginal microbiota in cervical intraepithelial neoplasia: A pilot study medRxiv. Obstet. Gynecol. Pub Date : 2024-01-09 Takeo Shibata, Ayumu Ohno, Isao Murakami, Masahiro Takakura, Toshiyuki Sasagawa, Tadashi Imanishi, Mikio Mikami
Symbiosis of bacteria and human papillomavirus (HPV) in the cervicovaginal environment influences cervical intraepithelial neoplasia (CIN) progression or regression. In this case series, we enrolled all 10 patients who had resolved CIN after a cervical local treatment using trichloroacetic acid (TCA). Prominent changes in the cervicovaginal microbiota, such as an enrichment of the genus Bifidobacterium
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Endometriosis risk is associated with shorter anogenital distance by meta-analysis medRxiv. Obstet. Gynecol. Pub Date : 2024-01-07 Bernard J. Crespi
Background Anogenital distance is a well-validated marker of prenatal testosterone, with shorter distances indicating lower levels during early gestation. A suite of studies has linked anogenital distance with risk of endometriosis, but the findings are variable, leading to uncertainty in interpretation. The relationship of anogenital distance with endometriosis is especially important because lower
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Maternal SARS-CoV-2 impacts fetal placental macrophage programs and placenta-derived microglial models of neurodevelopment medRxiv. Obstet. Gynecol. Pub Date : 2023-12-30 Lydia L. Shook, Rebecca A. Batorsky, Rose M. De Guzman, Liam T. McCrea, Sara M. Brigida, Joy E. Horng, Steven D. Sheridan, Olha Kholod, Aidan M. Cook, Jonathan Z. Li, Brittany A. Goods, Roy H. Perlis, Andrea G. Edlow
The SARS-CoV-2 virus activates maternal and placental immune responses, which in the setting of other infections occurring during pregnancy are known to impact fetal brain development. The effects of maternal immune activation on neurodevelopment are mediated at least in part by fetal brain microglia. However, microglia are inaccessible for direct analysis, and there are no validated non-invasive surrogate
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Co-design and refinement of an optimised antenatal education session to better inform women and prepare them for labour and birth medRxiv. Obstet. Gynecol. Pub Date : 2023-12-29 Abi Merriel, Miriam Toolan, Mary Lynch, Gemma Clayton, Andrew Demetri, Lucy Willis, Narendra Mampitiya, Alice Clarke, Katherine Birchenall, Chloe de Souza, Emma Harvey, Tamarind Russell-Webster, Eva Larkai, Mariusz Grzeda, Kate Rawling, Sonia Barnfield, Maggie Smith, Rachel Plachcinski, Christy Burden, Abigail Fraser, Michael Larkin, Anna Davies
Objective To co-design, implement, evaluate acceptability and refine an optimised antenatal education session to improve birth preparedness.
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Transforming Healthcare Education: Harnessing Large Language Models for Frontline Health Worker Capacity Building using Retrieval-Augmented Generation medRxiv. Obstet. Gynecol. Pub Date : 2023-12-17 Yasmina Al Ghadban, Huiqi (Yvonne) Lu, Uday Adavi, Ankita Sharma, Sridevi Gara, Neelanjana Das, Bhaskar Kumar, Renu John, Praveen Devarsetty, Jane E. Hirst
In recent years, large language models (LLMs) have emerged as a transformative force in several domains, including medical education and healthcare. This paper presents a case study on the practical application of using retrieval-augmented generation (RAG) based models for enhancing healthcare education in low- and middle-income countries. The model described in this paper, SMARThealth GPT, stems from
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Factors influencing referral to maternity models of care in Australian general practice medRxiv. Obstet. Gynecol. Pub Date : 2023-12-18 Jaime Thomas, Lesley Kuliukas, Jacqueline Frayne, Zoe Bradfield
Background: In the Australian maternity system, general practitioners play a vital role in advising and directing prospective parents to maternity models of care. Optimising model of care discussions and the decision-making process avoids misaligning women with over or under specialised care, reduces the potential for disruptive care transitions and unnecessary healthcare costs, and is critical in
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Feasibility of adjuvant self-administered intravaginal 5-fluorouracil cream following primary treatment of cervical intraepithelial neoplasia grade 2 or 3 among women living with HIV in Kenya: study protocol for a pilot trial medRxiv. Obstet. Gynecol. Pub Date : 2023-12-14 Chemtai Mungo, Elizabeth Bukusi, Grace E Kirkland, Cirillus Ogollah, Gershon Rota, Jackton Omoto, Lisa Rahangdale
Background Women living with HIV (WLWH), the majority of whom live in low- and middle-income countries (LMICs), are at higher risk of cervical precancer, known as cervical intraepithelial neoplasia (CIN), and are up to six times more likely to get cervical cancer. Current CIN treatment methods, primarily ablation or excision, have high treatment failure rates among WLWH, up to 30% for CIN grade 2 or
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Placental transfer dynamics and durability of maternal COVID-19 vaccine-induced antibodies in infants medRxiv. Obstet. Gynecol. Pub Date : 2023-12-10 Paola A. Lopez, Nadège Nziza, Tina Chen, Lydia L. Shook, Madeleine D. Burns, Stepan Demidkin, Olyvia Jasset, Babatunde Akinwunmi, Lael M. Yonker, Kathryn J. Gray, Michal A. Elovitz, Douglas A. Lauffenburger, Boris D. Julg, Andrea G. Edlow
Completion of a COVID-19 vaccination series during pregnancy effectively reduces COVID-19 hospitalization among infants less than 6 months of age. Elucidating the dynamics of transplacental transfer of maternal vaccine-induced antibodies, and their persistence in infants at 2, 6, 9 and 12 months, has implications for new vaccine development and timing of vaccine administration in pregnancy to optimize
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Clinical features of cystic neutrophil granulomatous mastitis in 62 cases medRxiv. Obstet. Gynecol. Pub Date : 2023-12-09 Mengjie Wang, Dongxiao Zhang, Na Fu, Min Liu, Hongkai Zhang, Shuo Feng, Yifei Zeng, Wenjie Zhao, Jianchun Cui, Khattak Mazher Mansoor
Background Cystic Neutrophilic Granulomatous Mastitis (CNGM) is a rare inflammatory condition affecting the breast. Despite its rarity, understanding its pathogenesis and clinical features is crucial for accurate diagnosis and effective management. This study delves into the nuanced aspects of CNGM, shedding light on its unique characteristics and potential underlying mechanisms. Methods: In this meticulous
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Expression of mechano-growth factor (MGF) in refractory overactive bladder medRxiv. Obstet. Gynecol. Pub Date : 2023-12-09 E Spiritosanto, B Lemmon, F Mohamedi-Yousufi, HA Munasinghe, A Mahmood, R Bray, R McNeice, FE Mackenzie, NJ Hill, E Cortes
Overactive bladder (OAB) is a urological symptom complex defined by urinary urgency. It can have a devastating impact on an individual’s quality of life and leads to significant financial cost. Insulin-like growth factor 1 (IGF-1) is a protein hormone involved in a broad range of processes including cell proliferation and differentiation. IGF-1 is also regulated through alternative splicing. While
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An Exploration of the Mental Health impact among Menopausal Women: The MARIE Project Protocol (International Arm) medRxiv. Obstet. Gynecol. Pub Date : 2023-11-28 Gayathri Delanerolle, Heitor Cavalini, Julie Taylor, Sharron Hinchliff, Vikram Talaulikar, Zukiswa Zingela, Teck-Hock Toh, Xiu-Sing Wong, Kim-Yen Lee, Jeffrey Soon-Yit Lee, Sanghamitra Pati, Nirmala Rathnayake, Thamudi Sundarappeuma, Tharanga Mudalige, Lanka Dasanayake, Damayanthi Dasanayake, Vindya Pathiraja, Prasanna Herath, Om Kurmi, Ashish Shetty, Muhammed Irfan, Rabia Kareem, Helen Kemp, Subrata
Introduction Menopause is characterised by the ending of the menstrual cycle as part of a natural process. However, menopause can also be caused by other health conditions, such as premature ovarian failure or cancers that may have led to an oophorectomy or a radical hysterectomy. The physiological and psychological mechanisms linked to menopause across all age groups, races and ethnicities are not
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Predictors of High-grade Squamous Intraepithelial Lesion treatment failure medRxiv. Obstet. Gynecol. Pub Date : 2023-11-23 S. Botting-Provost, A. Koushik, H. Trottier, F. Coutlée, MH Mayrand
Objective To estimate the association between several risk factors and high-grade squamous intraepithelial lesions (HSIL) treatment failure in order to identify predictors.
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Clinical validation of novel second-trimester preterm preeclampsia risk predictors combining clinical variables and serum protein biomarkers medRxiv. Obstet. Gynecol. Pub Date : 2023-11-15 Louise C. Laurent, George R. Saade, Glenn R. Markenson, Kent D. Heyborne, Corina N. Schoen, Jason K. Baxter, Sherri A. Longo, Leonardo M. Pereira, Emily J. Su, Matthew K. Hoffman, Garrett K. Lam, Angela C. Fox, Ashoka D. Polpitiya, Md. Badahur Badsha, Tracey C. Fleischer, Thomas J. Garite, J. Jay Boniface, Paul E. Kearney
Objective To develop and validate mid-trimester preterm preeclampsia (PE) risk predictors combining clinical factors and serum protein analytes, and to compare their performance with those of widely used clinical and risk assessment algorithms endorsed by professional societies. Methods This was a secondary analysis of data from two large, multicenter studies in pregnant individuals (PAPR, NCT01371019;
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A 4-year review of amniocentesis at a tertiary hospital in Ethiopia: an experience from a LMIC medRxiv. Obstet. Gynecol. Pub Date : 2023-11-11 Haile Mekuria, Hilkiah Suga, Gadise Bekele
Background: Amniocentesis is a technique for withdrawing amniotic fluid from the uterine cavity using a needle via a trans-abdominal approach. It has multiple diagnostic and therapeutic uses such as prenatal genetic studies and amnioreduction for polyhydramnios. The commonest indications are advanced maternal age and increased risk on maternal serum screening. The objective of this study is to review
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Acupuncture for the treatment of pregnancy-related low back pain: a systematic review and network meta-analysis medRxiv. Obstet. Gynecol. Pub Date : 2023-11-10 Min Lin, Zongyi Xiao, Dongling Tan, Daqiang Zhao, Qi Chen
Background: Despite the effectiveness of acupuncture in the treatment of musculoskeletal pain, many physical therapists are unwilling to use it on pregnant women. A recent systematic review of acupuncture for pregnant women did not include a comparison with sham acupuncture (SAcu). Thus, we aimed to explore the effects of acupuncture, SAcu, and standard care (SC) on pregnancy-related low back pain
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Elevated Pre-Treatment Systemic Immuno-Inflammatory Indices, Triple-Negative Breast Cancer, and p53 Mutation are Associated with Early-Onset Breast Cancer in Southern Nigeria medRxiv. Obstet. Gynecol. Pub Date : 2023-11-10 Jude Ogechukwu Okoye, Dorcas Onyeka Samuel, Kosisochukwu Stephanie Ezidiegwu, Michael Emeka Chiemeka
Background: In West Africa, breast cancer (BC) patients have a mortality rate that is three times higher than those in North America and Northwestern Europe. This study aimed to identify high-risk patients by evaluating the pre-treatment systemic inflammatory indices, p53, and BRCA2 expressions in molecular sub-types of BC in West Africa. Methods: This retrospective cohort study included 152 BC tissues
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Refugee and asylum seekers’ engagement with health services during pregnancy: A rapid review medRxiv. Obstet. Gynecol. Pub Date : 2023-11-07 Jennifer Green, Jane Herbert, Leissa Pitts, Nyari Garakasha, Lisa Gaye Smithers
The objective of this work was to summarise and describe antenatal care experiences of people from refugee and asylum seeker backgrounds living in high-income countries with universal healthcare. Academic articles from six databases and grey literature from selected government websites were systematically searched for English-language articles published 2012-2022. Articles describing perinatal care
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Fetal macrosomia and its associated factors among pregnant women delivered at national referral hospital in Uganda, a case-control study. medRxiv. Obstet. Gynecol. Pub Date : 2023-11-06 Peter Wanyera, Eve Nakabembe, Mike Nantamu Kagawa
Background: The delivery of macrosomic newborns (newborns>4000gm) is associated with many complications, yet the number macrosomic newborns is increasing steadily worldwide. Studies suggest the risk factors for fetal macrosomia include weight at first antenatal visit, previous delivery of a large newborn, newly diagnosed diabetes in pregnancy, increasing number of deliveries, a male fetus, and many
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Gestational diabetes as a risk factor for GBS maternal rectovaginal colonization: a systematic review and meta-analysis medRxiv. Obstet. Gynecol. Pub Date : 2023-11-03 Vicki Mercado-Evans, Jacob J. Zulk, Zainab A. Hameed, Kathryn A. Patras
Background Maternal rectovaginal colonization by group B Streptococcus (GBS) increases the risk of perinatal GBS disease that can lead to death or long-term neurological impairment. Factors that increase the risk of rectovaginal GBS carriage are incompletely understood resulting in missed opportunities for detecting GBS in risk-based clinical approaches. There is a lacking consensus on whether gestational
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Identification of fallopian tube microbiota and its association with ovarian cancer: a prospective study of intraoperative swab collections from 187 patients medRxiv. Obstet. Gynecol. Pub Date : 2023-11-01 Bo Yu, Congzhou Liu, Sean Proll, Enna Mannhardt, Shuying Liang, Sujatha Srinivasan, Elizabeth Swisher, David N Fredricks
Investigating the human fallopian tube (FT) microbiota has significant implications for understanding the pathogenesis of ovarian cancer (OC). In this large prospective study, we collected swabs intraoperatively from the FT and other surgical sites as controls to profile the microbiota in the FT and to assess its relationship with OC. 81 OC and 106 non-cancer patients were enrolled and 1001 swabs were
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A multi-ancestry genome-wide association study identifies novel candidate loci in the RARB gene associated with hypertensive disorders of pregnancy medRxiv. Obstet. Gynecol. Pub Date : 2023-11-01 Jasmine A. Mack, Adam Burkholder, Farida S. Akhtari, John S. House, Ulla Sovio, Gordon C.S. Smith, Charles P. Schmitt, David C Fargo, Janet E Hall, Alison A. Motsinger-Reif
Background Genetic factors related to pregnancy-related traits are understudied, especially among ancestrally diverse cohorts. This study assessed maternal contributions to hypertensive disorders of pregnancy (HDP) in multi-ancestry cohorts. Methods We performed a genome-wide association study of HDP using data from the Personalized Environment and Genes Study (PEGS) cohort (USA) with validation in
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Histomorphometric features of placentae from women having malaria and HIV coinfection with preterm births medRxiv. Obstet. Gynecol. Pub Date : 2023-10-31 Yusuf Adam Khalil, Moses Madadi Obimbo, Edwin Oloo Walong, Omondi Ogutu, Jesee Gitaka, Shadrack B Ojwang
Background: Malaria and HIV are associated with preterm births possibly due to partial maternal vascular malperfusion resulting from altered placental angiogenesis. There is a paucity of data describing structural changes associated with malaria and HIV coinfection in the placentae of preterm births thus limiting the understanding of biological mechanisms by which preterm birth occurs. Objectives:
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Corticosteroids for improving patient relevant outcomes in HELLP syndrome: a systematic review and meta-analysis medRxiv. Obstet. Gynecol. Pub Date : 2023-10-30 Asmaa F Kasem, Hamdy B Alqenawy, Marwa A Elgendi, Radwa R Ali, Rania HM Ahmed, Mohammad N Sorour, Khadiga MH Hegab, Rania G El-skaan, Rowyna H El Helw, Mohamed S Elsewefy, Maya M Abdelrazek, Yasser M Elrefaey, Mohamed YG Albahaie, Mohamed H Salama, Ashraf F Nabhan
Objectives: We conducted an update of systematic review to assess the effects of corticosteroids vs placebo or no treatment for improving patient relevant outcomes in hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome. Design: a systematic review and meta-analysis of randomized controlled trials. Data sources: CENTRAL, MEDLINE/PubMed, Web of Science, and Scopus from the date of inception