Journal of Obstetrics and Gynaecology Canada : JOGC

The objective is to determine if the timing of midurethral sling (MUS) placement has an impact on the recurrence rate of stress urinary incontinence (SUI). We conducted a retrospective cohort study of patients that underwent robot sacrocolpopexy (RSC) with MUS placement at a large community hospital. Our data demonstrated that there was no significant difference in SUI recurrence when the MUS was placed before or after the RSC (15% vs. 11%, P = 0.41, respectively). We concluded that physician preference may dictate surgical approach to sequence of retropubic MUS placement at the time of RSC...

OBJECTIVE: It is unclear if use of cesarean delivery in people with inflammatory bowel disease (IBD) is guideline-concordant. We compared the odds of cesarean delivery among primiparous individuals with IBD versus without, overall and by disease characteristics, as well as time to subsequent delivery. METHODS: Retrospective matched population-based cohort study between 1 April 1994 and 31 March 2020. Primiparous individuals aged 15-55 years with IBD were matched to those without on age, year, hospital, and number of newborns delivered...

OBJECTIVE: Given the increased risk of fetal acidosis in singleton neonates born to pregnant people with an elevated body mass index (BMI), our objective was to evaluate the association between pre-pregnancy/first trimester BMI and fetal acidosis among term twin pregnancies. METHODS: Retrospective study of pregnant people with twin gestation and their term infants admitted to our centre between 2014 and 2019. Using a generalized estimating equation, the association between maternal BMI and fetal acidosis was determined using odds ratios (OR) with 95% confidence intervals (CI)...

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No abstract text is available yet for this article.

No abstract text is available yet for this article.

Our objective was to determine if placental lake presence or size are associated with adverse pregnancy outcomes. This was a retrospective cohort of patients who had fetal anatomy ultrasounds at 18-22 weeks and delivered between 2018 and 2022. Placental lakes were classified as small (>2.0-3.9 cm) or large (>4 cm). Multiple gestations, placenta previas, and placenta accretas were excluded. Outcomes included low birthweight, cesarean delivery, primary cesarean for non-reassuring fetal heart tracing, fetal growth restriction, preterm birth, and severe preeclampsia...

The COVID-19 pandemic impacted the provision of obstetrical care. This mixed-methods study explores pregnant women's experiences during the COVID-19 pandemic using an explanatory sequential design. The experiences and opinions of obstetrical patients were elicited using an online questionnaire and semi-structured interview as a follow-up. There were 162 completed questionnaires, and 17 interviews. Qualitative analysis themes included worries about the intrapartum experience, impact on partners, and lack of postpartum support for breastfeeding and mental health...

OBJECTIVE: This study assessed the effectiveness of a virtual mindfulness-based stress reduction (MBSR) program to improve quality of life and pain in people with endometriosis. METHODS: This was a multiple methods, before and after study design. Fifteen patients with a clinical or surgical diagnosis of endometriosis were recruited from a Canadian outpatient gynaecology clinic. Participants completed the Endometriosis Health Profile (EHP), a validated survey tool, and a pain medication use questionnaire before and after a virtual 8 week MBSR program run by an experienced social worker...

OBJECTIVE: Venous thromboembolism (VTE) occurs in 0.4-0.7% of benign hysterectomies. Pelvic vascular compression secondary to fibroids may elevate VTE risk. We aimed to evaluate the incidence and timing of VTE among individuals undergoing hysterectomy for fibroids and other benign indications. METHODS: Retrospective cohort study of patients who underwent a hysterectomy for fibroid and non-fibroid indications from January 2015 to December 2021. Main outcome measure was VTE consisting of pulmonary embolism or deep venous thrombosis diagnosed during 3 periods: i) preoperative (1 year before surgery until day before surgery), ii) early postoperative (surgery date through 6 weeks after surgery), and iii) late postoperative (6 weeks to 1 year after surgery)...

OBJECTIVES: Investigations about cesarean delivery (CD) on maternal request (CDMR) and infant infection risk frequently rely on administrative data with poorly defined indications for CD. We sought to determine the association between CDMR and infant infection using an intent-to-treat approach. METHODS: This was a population-based cohort study of low-risk singleton pregnancies with a term livebirth in Ontario, Canada between April 2012 and March 2018. Subjects with prior CD were excluded...

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OBJECTIF: Fournir une approche contemporaine pour comprendre les impacts de l'endométriose et les méthodes de diagnostic au Canada. POPULATION CIBLE: Les personnes, familles, communautés, prestataires de soins et administrateurs de services de santé qui sont concernés par l'endométriose, qui soignent des patientes atteintes d'endométriose ou qui gèrent la prestation de services relatifs à l'endométriose. OPTIONS: Le diagnostic de l'endométriose se fait par une anamnèse détaillée, un examen physique et des examens d'imagerie effectués par des prestataires expérimentés dans le traitement de l'endométriose...

OBJECTIVE: To provide a contemporary approach to the understanding of the impact and methods for the diagnosis of endometriosis in Canada. TARGET POPULATION: Individuals, families, communities, health care providers, and health care administrators who are affected by, care for patients with, or manage delivery of services for endometriosis. OPTIONS: The diagnosis of endometriosis is facilitated by a detailed history, examination, and imaging tests with providers who are experienced in endometriosis care...

OBJECTIVE: This guideline provides recommendations for the prevention of Rh D alloimmunization (isoimmunization) in pregnancy, including parental testing, routine postpartum and antepartum prophylaxis, and other clinical indications for prophylaxis. Prevention of red cell alloimmunization in pregnancy with atypical antigens (other than the D antigen), for which immunoprophylaxis is not currently available, is not addressed in this guideline. TARGET POPULATION: All Rh D-negative pregnant individuals at risk for Rh D alloimmunization due to potential exposure to a paternally derived fetal Rh D antigen...

OBJECTIF: La présente directive fournit des recommandations pour la prévention de l'allo-immunisation (iso-immunisation) Rhésus D pendant la grossesse. Elle porte notamment sur les analyses de laboratoire parentales, les prophylaxies prénatale et post-partum de routine et les autres indications cliniques de la prophylaxie. La prévention de l'allo-immunisation érythrocytaire pendant la grossesse avec antigènes atypiques (autres que l'antigène D), pour lesquels aucune immunoprophylaxie n'est actuellement offerte n'est pas abordée dans cette directive...

OBJECTIVE: To evaluate the safety and efficacy of first trimester "No Touch" medication abortion programs at two clinics in Toronto, Ontario during their early implementation in response to the COVID-19 pandemic. METHODS: This retrospective study included all patients who underwent virtual consultation for mifepristone-misoprostol medication abortion between April 2020 - August 2022 at two reproductive health clinics. In response to the pandemic, "No Touch" abortion protocols had been developed that align with the Canadian Protocol for the Provision of Medical Abortion via Telemedicine...

OBJECTIVE: To compare surgeon responses regarding their surgical plan before and after receiving a patient-specific 3D-printed model of a patient's multifibroid uterus created from their magnetic resonance imaging (MRI). METHODS: 3D printed models were derived from standard-of-care pelvic MRI of patients scheduled for surgical intervention for multifibroid uterus. Relevant anatomical structures were printed using a combination of transparent and opaque resin types...

No abstract text is available yet for this article.

OBJECTIVES: International infectious disease/obstetrical societies have recently recommended universal hepatitis C virus (HCV) prenatal screening, and these same recommendations are forthcoming in Canada. At present, there is no formal analysis of universal HCV screening or linkage to care of pregnant people in Ontario. The objectives of our study were to determine the seroprevalence of HCV using two different methods to evaluate universal screening, as well as identify opportunities that may improve linkage to care...