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Breast cancer is the most common malignancy diagnosed in the female population worldwide and the leading cause of death among perimenopausal women. Screening is essential, since earlier detection in combination with improvements in breast cancer treatment can reduce the associated mortality. The aim of this study was to review and compare the recommendations from published guidelines on breast cancer screening. A total of 14 guidelines on breast cancer screening issued between 2014 and 2022 were identified. A descriptive review of relevant guidelines by the World Health Organization (WHO), the U.S. Preventive Services Task Force (USPSTF), the American Cancer Society (ACS), the National Comprehensive Cancer Network (NCCN), the American College of Obstetricians and Gynecologists (ACOG), the American Society of Breast Surgeons (ASBrS), the American College of Radiology (ACR), the Task Force on Preventive Health Care (CTFPHC), the European Commission Initiative on Breast Cancer (ECIBC), the European Society for Medical Oncology (ESMO), the Royal Australian College of General Practitioners (RACGP) and the Japanese Journal of Clinical Oncology (JJCO) for women both at average and high-risk was carried out. There is a consensus among all the reviewed guidelines that mammography is the gold standard screening modality for average-risk women. For this risk group, most of the guidelines suggest annual or biennial mammographic screening at 40–74 years, while screening should particularly focus at 50–69 years. Most of the guidelines suggest that the age limit to stop screening should be determined based on the women's health status and life expectancy. For women at high-risk, most guidelines recommend the use of annual mammography or magnetic resonance imaging, while the starting age should be earlier than the average-risk group, depending on the risk factor. There is discrepancy among the recommendations regarding the age at onset of screening in the various high-risk categories. The development of consistent international practice protocols for the most appropriate breast cancer screening programs seems of major importance to reduce mortality rates and safely guide everyday clinical practice. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to review and compare the most recently published influential guidelines on postnatal care practices, as the ongoing health care provision of both the mother and her offspring helps to timely identify and effectively manage any arising complications and therefore secure maternal and infant short- and long-term well-being. Methods A comprehensive review of guidelines from the American College of Obstetricians and Gynecologists, the World Health Organization, the National Institute for Health and Care Excellence, and the Public Health Agency of Canada regarding postnatal care was carried out. Results All the reviewed guidelines underline the importance of postnatal health care provision, including home visits and midwifery services and the use of telemedicine for the facilitation of communication with the patient, and agree on the appropriate preparation for discharge and the discharge criteria. There is also agreement on the clinical aspects that should be evaluated at each postnatal visit, although discrepancies exist with regard to the contact schedule. In addition, there is consensus concerning the management of postnatal infections, perineal pain, fecal and urinary incontinence, and physical activity guidance. Clinicians should address mental health issues at each postnatal visit, according to all medical societies, but routine screening for depression is not recommended universally. As for the optimal interpregnancy interval, the American College of Obstetricians and Gynecologists recommends avoiding pregnancy for at least 6 months postpartum, whereas the National Institute for Health and Care Excellence recommends a 12-month interval. Discrepancies were identified with regards to the nutrition guidance, the recommended contraceptive methods, and the postpartum management of pregnancy complications. Of note, the World Health Organization is the only one to provide guidance regarding the prevention of specific infections during the postpartum period. Conclusion Although the puerperium is a critical period for the establishment of motherhood and the transition to primary care, postnatal care remains a relatively underserved aspect of maternity care. Therefore, it is crucial to develop consistent international strategies for the optimal care and support of women during this period to safely guide clinical practice and subsequently reduce maternal and neonatal morbidity. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to review and compare the most recently published major guidelines on the indications, contraindications, techniques and timing of placing and removal of cervical cerclage, which represents one of the limited effective measures currently available for the prevention of preterm labor caused by cervical insufficiency contributing in the reduction of neonatal morbidity and mortality rates, worldwide. Methods A descriptive review of guidelines from the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynaecologists, the Society of Obstetricians and Gynaecologists of Canada and the International Federation of Gynaecology and Obstetrics on cervical cerclage was carried out. Results There is consensus among the reviewed guidelines regarding the recommended techniques, the physical examination-based indications for cervical cerclage, the contraindications as well as the optimal timing of placement and removal. All medical societies also agree that ultrasound-indicated cerclage is justified in women with history of prior spontaneous preterm labor or mid-trimester loss and a short cervical length detected on ultrasound. In addition, following cerclage, serial sonographic measurement of the cervical length, bed rest and routine use of antibiotics, tocolysis and progesterone are unanimously discouraged. In case of established preterm labor, cervical cerclage should be removed, according to the American, the English and the Canadian guidelines. Furthermore, the Royal College of Obstetricians and Gynaecologists and the Society of Obstetricians and Gynaecologists of Canada agree on the prerequisites that should be met before attempting CC. These two guidelines along with the International Federation of Gynaecology and Obstetrics recommend history-indicated cerclage for women with three or more previous preterm deliveries and/or 2nd trimester pregnancy losses, while the American College suggests the use of cerclage in singleton pregnancies with one or more previous 2nd trimester miscarriages related to painless cervical dilation or prior cerclage due to painless cervical dilation in the 2nd trimester. The role of amniocentesis in ruling out intra-amniotic infection before rescue cerclage remains a matter of debate. As for preterm premature rupture of membranes, the Royal College points out that if it occurs between 24 and 34 weeks of gestation and there are no signs of infection or preterm labor, cerclage removal should be delayed for 48 hours in order to allow in utero transfer. Conclusion Cervical cerclage is an obstetric intervention used to prevent miscarriage and preterm labor in women considered as high-risk for these common pregnancy complications. The development of uniform international practice protocols for the insertion of cervical cerclage seems of paramount importance and will hopefully improve the outcomes of such pregnancies. [ABSTRACT FROM AUTHOR]

Importance: Preterm prelabor rupture of membranes (PPROM) represents a significant contributor of maternal and neonatal morbidity complicating a significant proportion of pregnancies worldwide., Objective: The aim of this review was to summarize and compare the most recently published guidelines on the diagnosis and management of this critical pregnancy complication., Evidence Acquisition: A comparative review of 3 recently updated national guidelines from the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynaecologists, and the Society of Obstetricians and Gynaecologists of Canada on PPROM was conducted., Results: There is an overall agreement that the diagnosis of PPROM should be mainly based on sterile speculum examination and patient's history, followed by additional tests in equivocal cases, although the accuracy and contribution of both ultrasound and amniotic proteins tests in the diagnosis remain debatable. Following PPROM confirmation, all guidelines recommend the performance of vaginal and rectal swabs, the evaluation of fetal and maternal status, the administration of antibiotics and corticosteroids, and the immediate induction of labor, if severe complications are identified. Expectant management from viability until late preterm period is universally recommended; nevertheless, there are discrepancies on the optimal timing of delivery. Magnesium sulfate should be administered in case of imminent preterm delivery; however, there is no consensus on the upper gestational age limit. Recommendations on inpatient and outpatient management of PPROM are also inconsistent. Moreover, there is no common guidance on the use of tocolysis or antibiotic regimens. Finally, all medical societies agree that closer surveillance of future pregnancies is required., Conclusions: PPROM remains the most common identifiable risk factor of preterm delivery, despite constant improvement in prenatal provision of care. Thus, the establishment of consistent international practice protocols for the timely and accurate diagnosis and the optimal management of this complication seems of vital importance and will hopefully lead to significant reduction of the associated adverse outcomes.