Journal of Gynecology Obstetrics and Human Reproduction妇产科与人类生殖杂志
Journal of Gynecology Obstetrics and Human Reproduction,ISSN 0368-2315,中文译名:妇产科与人类生殖杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
Journal of Gynecology Obstetrics and Human Reproduction 最新收录文献
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1. [Neuroprotection for preterm infants with antenatal magnesium sulphate].
PMID:日期:2016-12-01To evaluate in preterm born children the neuroprotective benefits and the risks, at short- and long-term outcome, of the antenatal administration of magnesium sulphate (MgSO) in women at imminent risk of preterm delivery. Computer databases Medline, the Cochrane Library and the recommendations of various international scientific societies. Given the demonstrated benefit of antenatal MgSO intravenous administration on the reduction of cerebral palsy rates and the improvement of motor development in children born preterm, it is recommended for all women whose imminent delivery is expected or programmed before 32 weeks of gestation (WG) (grade A). The analysis of the literature finds no argument for greater benefit of antenatal MgSO administration in sub-groups of gestational age, or depending on the type of pregnancy (single or multiple pregnancy) or with the cause of preterm birth (NP2). Its administration is recommended before 32 WG, if single or multiple pregnancy, whatever the cause of prematurity (grade B). It is recommended 4g loading dose (professional consensus). With a loading dose of 4g intravenous (IV) in 20min, the serum magnesium is lower than with intramuscular suggesting a preference for the IV route (professional consensus). It is proposed to use a maintenance dose of 1g/h until delivery with a maximum recommended duration of 12hours without exceeding a cumulative dose of 50g (professional consensus). These doses are without severe adverse maternal side effects or adverse effects in newborns at short- and medium-term outcome (NP1). It is recommended to administer magnesium sulfate to the women at high risk of imminent preterm birth before 32 WG, whether expected or planned (grade A), with a 4g IV loading dose followed by a maintenance dose of 1g/h for 12hours (professional consensus), the pregnancy is single or multiple, whatever the cause of prematurity (professional consensus).
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2. [Is universal screening for cervical length among singleton pregnancies with no history of preterm birth justified?]
PMID:日期:2016-12-01The ultrasonographic measurement of cervical length with a cutoff of 15mm is currently the best method to identify a group of asymptomatic women in the general population at risk of spontaneous preterm birth, especially among asymptomatic patients with a singleton pregnancy with no history of preterm birth. Cerclage and 17 alpha-hydroxyprogesterone caproate (17OHP-C) are ineffective to reduce the risk of preterm birth among asymptomatic patients with a short cervix in midtrimester. However, vaginal progesterone (200-mg capsules of micronized progesterone or gel containing 90mg progesterone) has been demonstrated effective in 2 large randomized trials to reduce the risk of preterm birth and possibly the composite morbidity and perinatal mortality associated among asymptomatic women with a short cervix in the general population screened by ultrasound of the cervix in midtrimester. Three cost-effectiveness analyses are converging to show that universal screening for cervical length with vaginal progesterone treatment seems to be cost-effective compared with no screening. However, it is too early to definitively conclude that universal screening is justified for several reasons: many women must be screened to prevent a relatively small number of preterm births. Moreover, the epidemiology of preterm delivery is such that the use of progesterone in asymptomatic women with a short cervix screened by ultrasound in midtrimester in the general population will not significantly reduce the prevalence of preterm births; there are no data comparing the effectiveness of universal ultrasound screening followed by vaginal progesterone treatment in case of short cervix versus no universal screening associated to a progesterone treatment in case of incidentally observed short cervix; the universal ultrasound screening may not produce the same results in practice than those observed in published randomized trials, due to population differences, "indication creep", or "stretching of the cutoff" defining the short cervix. Moreover, the implementation of unevaluated or not recommended treatments, such as bed rest, tocolytics, 17OHP-C or cerclage, can potentially cause unintended deleterious consequences and reduce the cost-effectiveness; the cost-effectiveness analyses evaluating universal screening for cervical length present uncertainties on critical variables, notably the short cervix prevalence and the progesterone efficacy. In conclusion, although the implementation of such a screening strategy can be considered by individual practitioners, this screening cannot be universally mandated.
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3. [Lifestyle recommendations for prevention of spontaneous preterm birth in asymptomatic pregnant women].
PMID:日期:2016-12-01To establish recommendations for lifestyle of pregnant women and its impact on spontaneous preterm births. We searched Pubmed and Cochrane databases and checked reference lists of retrieved studies. This review of the literature concerns only women who have no symptoms for the ongoing pregnancy. Concerning maternal occupation during pregnancy, there is a mild increase of the risk of preterm birth only for women who work more than 40hours a week or who have hard working conditions according to a fatigue score (LE2). With a weekly working time of 35hours, it is not recommended to prescribe routinely a sick leave to pregnant women in order to prevent preterm birth (grade B). Practicing exercise during pregnancy does not increase the risk of preterm birth before 37 weeks (LE2) and is recommended for women with normal pregnancy (grade A). Sexual intercourses during pregnancy do not increase the risk of prematurity (LE2), even for women with a history of preterm birth (LE3). A dietary pattern including vegetables, fruits and whole grain cereals during pregnancy might be associated with a lower risk of spontaneous preterm birth (LE3), while vitamin D and omega-3 supplementation has no effect on the gestational age of delivery (LE1). A dietary pattern including fruits, vegetables and whole grain cereals is thus recommended (grade C). Smoking is associated with spontaneous preterm birth (NP2). Smoking cessation interventions can result in 6 % smoking withdrawal in late pregnancy and 14 % reduction of preterm birth, while nicotine replacement therapies taken alone, such as nicotine-based patches, has no effect on both outcomes. Smoking cessation is also recommended in pregnant women, whatever the gestational age (grade A). Psychological disorders such as depression, anxiety and maternal stress are significantly associated with preterm birth (LE1). Among asymptomatic patients with a short cervix, bed rest is not associated with a reduction of preterm birth (LE3), and is also not systematically recommended (grade C). For multiple pregnancies without any symptoms, systematic hospitalization with bed rest is not recommended (grade A), especially since bed rest is associated with more thromboembolic events (LE3). Among preventable risk factors of spontaneous prematurity, cessation of smoking has been demonstrated to be effective on the decrease of preterm birth. A dietary pattern including vegetables, fruits and whole grain cereals might be also associated with a reduction of spontaneous prematurity.
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5. [Psychological aspects of abortion].
PMID:日期:2016-12-01To propose recommendations for women's counseling in abortion request and the psychological experience of orthogenic teams. Bibliographic search in the Medline database, PubMed, Cochrane Database Library, EM Premium bases, ENT Unistra and Cairn from 1990 to 2016. During the pre-abortion consultations, it is recommended to respect the choice of the woman on to see or not the ultrasound images (gradeC) and determine with her the time it needs to perform abortion (professional agreement). Women's satisfaction seems greater when they have the possibility to choose the abortion method (grade B). It is therefore important that both methods are available to all gestational ages (professional agreement). There is no relationship between an increase in psychiatric disorders and induced abortion (NP2). Meetings for professionals are useful and should, to the extent possible, be established (professional agreement). Improving psychological support for women involve listening them and respect their choice. This also involves thinking as a team.
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7. [Tocolysis for preterm labor without premature preterm rupture of membranes].
PMID:日期:2016-12-01To propose guidelines for clinical practice for tocolysis in preterm labor without premature preterm rupture of the membranes (PPROM). Bibliographic searches were performed in the Medline and Cochrane databases and gynecologist and obstetricians' international society guidelines. It is important to note that most studies included women in preterm labour with and without PPROM. Compared with placebo, tocolytics are not associated with a reduction in neonatal mortality or morbidity (LE2). Compared with betamimetics, nifedipine is associated with a reduction in necrotizing enterocolitis, intraventricular hemorrhage and respiratory distress syndrome (LE2). There is no difference between nifedipine and atosiban regarding neonatal prognosis, except a modest reduction in NICU transfer with nifedipine (LE2). Betamimetics, atosiban and nifedipine are equivalent to prolong pregnancy for more than 48hours (LE2). Compared with betamimetics, nifedipine reduces delivery before 34 WG and is associated with a longer pregnancy (LE2). Atosiban and nifedipine are equivalent to prolong the pregnancy over 7 days (LE2), but in women with spontaneous preterm labour without PPROM, nifedipine reduces deliveries before 37 WG and pregnancy prolongation is longer, without improving neonatal prognosis (LE2). Maternal severe adverse effects may occur with all tocolytics (LE4). Betamimetics cardiovascular adverse effects are frequents (LE2) and may be serious (maternal death) (LE4). Nifedipine and atosiban reduce maternal adverse effect compared with placebo (LE2). Cardiovascular adverse effects are moderately increased with nifedipine compared with atosiban (LE2), without increasing treatment discontinuation (LE2). Regarding their benefits on pregnancy prolongation and good maternal tolerance, atosiban and nifedipine can be used for tocolysis in spontaneous preterm labour without PPROM (Grade B), for singleton and multiple pregnancies (Professional Consensus). Advantageously, nifedipine is orally taken and is inexpensive (Professional Consensus). Nicardipine should not be used for tocolysis (Professional Consensus) and betamimetics should not be prescribed anymore for tocolysis (Grade C). All tocolytic treatment should be prescribed for up to 48hours (Grade B). In case of initial tocolysis failure, another treatment may be proposed with the other class of tocolytic (Professional Consensus). Different class of tocolytics should not be combined (Grade C). Scientific data are lacking to propose guidelines regarding a rescue tocolysis, after a first previous successful tocolysis with complete antenatal corticosteroid therapy (Professional Consensus). There is no scientific evidence to propose a tocolysis in women with advanced dilatation (GradeC), nor prescribe a tocolysis after 34 WG (Professional Consensus). There is no evidence to define a gestational age lower limit for tocolysis (Professional Consensus). Nifedpine and atosiban can be used for tocolysis (Grade B), including for multiple pregnancies (Professional Consensus). Maintenance tocolysis is useless (Grade C) and potentially harmful (Grade C). Betamimetics should not be used for tocolysis (Professional Consensus).
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8. [Prediction of preterm delivery in symptomatic women (preterm labor)].
PMID:日期:2016-12-01To evaluate the predictors of spontaneous preterm birth in case of preterm labor. Literature search in Medline and Cochrane databases and recommendations of international societies. Selection of studies in symptomatic women (with preterm labor). Preterm labor is defined as a clinical situation occurring between 22 and 36 weeks + 6 days, in which cervical changes are observed associated with uterine contractions, evolving spontaneously or not to preterm delivery (Professional consensus). Uterine contractions can be detected by the cardiotocometry and by the patient herself. Uterine contractions frequency does not reliably predict spontaneous preterm birth (NP3). Cervical modifications may be appreciated by ultrasonographic measurement of cervical length and vaginal examination (Bishop score). Cervical length is significantly correlated with the risk of spontaneous preterm birth (NP1). The 15 and 25mm thresholds are the most relevant to respectively predict and rule out spontaneous premature birth at 48hours and 7 days (professional consensus). In symptomatic patients, routine ultrasonographic measurement of cervical length at admission is not associated with a significant reduction of spontaneous preterm birth rate (NP3). Clinical evaluation of the cervix (Bishop score) by vaginal examination is an effective parameter for the prediction of preterm birth (NP2). The higher the Bishop score, the higher the risk of preterm birth (NP3). It is not possible to recommend the use of a tool more than another (cervix ultrasound versus vaginal examination) in women experiencing preterm labor (grade B). However, due to the excellent negative predictive value of cervical ultrasound measurement and the lower interobserver variability, we suggest to perform a cervical ultrasonographic measurement before an in utero transfer for preterm labor (professional consensus). Screening for fetal fibronectin in the genital tract of patients with preterm labor has an excellent negative predictive value for predicting the absence of spontaneous preterm birth at 48hours and 7 days (NP2). Nevertheless, its use in symptomatic women is not associated with a reduction of preterm birth rate (NP2) and is therefore not recommended (professional consensus). Predictors of preterm birth in women with preterm labor are effective but do not allow a reduction of the preterm birth rate. The high negative predictive value of these predictors (Bishop score, ultrasound measurement of the cervix, fetal fibronectin detection in the genital tract) is an asset in the choice of an appropriate management in women with preterm labor (in utero transfer or corticosteroids).
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9. [Prevention of preterm birth by uterine cervical cerclage].
PMID:日期:2016-12-01To review the scientific literature on cervical insufficiency and indications of cervical cerclage cervix. The PubMed database, the Cochrane Library and the recommendations from the French and international obstetrical societies between 1972 and June 2016 have been consulted. Cervical insufficiency is a pathophysiological concept and to date no consensual definition is available: the diagnosis is clinical and discussed retrospectively in case of patients with a history of late miscarriages and/or spontaneous preterm delivery, with asymptomatic dilatation of the cervix (professional consensus). The risk of preterm birth is higher in case of surgical cold-knife conisation as compared to loop electrosurgical excision (LE3) and laser vaporization has a negligible impact (LE3). In patients with a history of late pregnancy loss or preterm birth, investigations for the diagnosis of uterine malformation are recommended (grade C). No investigation is recommended for the diagnosis of a cervical insufficiency (professional consensus). A history-indicated cerclage is not recommended in case of only past history of conisation (grade C), uterine malformation (professional consensus), isolated history of preterm delivery (grade B) or twin pregnancies in primary (grade B) or secondary (grade C) prevention of preterm birth. A history-indicated cerclage is recommended for single pregnancy with a history of at least three late miscarriages or preterm deliveries (grade A). In case of history of one or two late miscarriages or preterm deliveries, there are not sufficient arguments to recommend a history-indicated cerclage (professional consensus). Further studies are needed. The ultrasound-indicated cerclage is not recommended in case of short cervical length during the 2nd trimester of single pregnancy without past history of gynecologic or obstetrical event (grade B). In case of past history of a single pregnancy delivery before 34 weeks gestation (WG), ultrasound cervical length screening is recommended between 16 and 22 WG in order to propose a cerclage in case of length<25mm before 24 WG (grade C). Ultrasound-indicated cerclage is not recommended for multiple pregnancy with a short cervix (grade B). Emergency cerclage using the MacDonald technique is recommended during the second trimester of pregnancy in case of major changes of the cervix, with or without protrusion of the fetal membranes, but without premature rupture of membranes or chorioamnionitis (grade C). Tocolysis and antibiotics during cerclage should be considered individually (professional consensus). There is no reason to recommend a period of expectative before considering an emergency cerclage (professional consensus). A maximum gestational age to perform a cerclage cannot be recommended (professional consensus). A cervico-isthmic cerclage can be discussed in case of failure of MacDonald cerclage (professional consensus). Scientific data are insufficient to recommend or not a vaginal bacteriological analysis before performing a cerclage (professional consensus). The use of double cerclage does not improve perinatal outcome (NP3) and is not recommended (grade C). There is insufficient scientific argument to recommend a type of stitch over another (grade C). The available data are not in favor of a superiority of the Shirodkar cerclage in case of history- or ultrasound-indicated cerclage and the MacDonald cerclage is firstly recommended because technically easier and less risky (grade C). Overall, complications of cerclage are rare but potentially serious. The occurrence of complications is no different between the history-indicated and echo-indicated cerclage (LE4). There is no scientific evidence on the benefit of bed rest and adjuvant treatments (antibiotics or indomethacin) during history or ultrasound-indicated cerclage (professional consensus). Available data in the literature about cervical cerclage are generally of low level of evidence.
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10. [Predictive tools of preterm birth in asymptomatic high-risk pregnancy].
PMID:日期:2016-12-01Describe tools designed to predict preterm birth in asymptomatic high-risk pregnancy and determine their predictive value. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. Obstetric history particularly spontaneous preterm birth identifies a population at risk for preterm birth for the current pregnancy (LE3). This risk is related to the number of prior preterm birth and is even higher than the term of the prior event is more premature and that the event concerns the last pregnancy (LE3). The literature data are insufficient to recommend systematic cervical examination at each prenatal visit in asymptomatic high-risk pregnancy (multiple pregnancy, uterine malformations, history of spontaneous preterm birth, excisional cervical procedure or at least two voluntary first trimester abortion) (professional consensus). Regular recording of uterine activity and home visits for asymptomatic high-risk pregnancy did not predict nor reduce the risk of preterm birth (LE2) and are not recommended (grade B). In asymptomatic high-risk pregnancy, ultrasonographic measurement of cervical length estimates the risk of preterm birth (LE2). Shorter is the cervical length higher is the risk of preterm birth (LE3). In asymptomatic patient with prior preterm birth, ultrasonographic measurement of cervical length estimates the risk of preterm birth (LE2). The strategy of ultrasound indicated cerclage are discussed in dedicated chapter. The measurement of cervical length by transvaginal ultrasonography in asymptomatic pregnancy with uterine malformation, a history of cervical treatment, at least two voluntary abortions or having a multiple pregnancy would estimate the risk of preterm birth (LE3). A shortening of more than 10% of the cervical length at 3-week interval is associated with an increased risk of preterm birth (LE3). Systematic detection of fetal fibronectin is not recommended in asymptomatic high-risk population (grade C). The combination of ultrasound measurement of cervical length and fetal fibronectin detection improves modestly the prediction of preterm birth (LE3). However, literature data are insufficient to recommend routine measurement of cervical length by transvaginal ultrasonography during surveillance ultrasounds and/or detection of fetal fibronectin because this policy has never demonstrated its interest in preventing preterm birth and in the reduction of neonatal morbidity and mortality (professional consensus). Several predictive tools are described to define the risk of preterm birth but there is no evidence to date of the effectiveness of systematic screening strategy on the prevention of prematurity in asymptomatic high-risk population, except the ultrasound measurement of the cervical length in the population of patients having had a prior preterm birth.