European journal of obstetrics, gynecology, and reproductive biology最新文献

{"title":"Early-onset preeclampsia: gestational age threshold of potential benefits","authors":"Frank I. Jackson ,&nbsp;Nathan A. Keller ,&nbsp;Sarah Abelman ,&nbsp;Luis A. Bracero ,&nbsp;Matthew J. Blitz","doi":"10.1016/j.ejogrb.2026.114980","DOIUrl":"10.1016/j.ejogrb.2026.114980","url":null,"abstract":"<div><h3>Background</h3><div>Delivery timing in pregnancies complicated by early-onset preeclampsia with severe features (sPEC) is individualized, aiming to prolong gestation for fetal benefit while minimizing maternal risk.</div></div><div><h3>Objective</h3><div>To determine whether expectant management (EM), compared to expedited delivery (ED), improves neonatal outcomes in pregnancies complicated by sPEC.</div></div><div><h3>Study design</h3><div>This retrospective cohort study evaluated pregnancies complicated by sPEC within a large New York health system from 2019 to 2023. Pregnancies requiring immediate delivery (&lt;24 h after diagnosis or without betamethasone administration) were excluded. Patients were classified as ED if delivery occurred within 24–72 h after diagnosis, and EM if delivery occurred after 72 h. The primary outcome was severe neonatal morbidity (SNM), a composite of diagnoses and procedures indicative of life-threatening complications. Secondary outcomes included neonatal death, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), sepsis, and NICU discharge metrics. Outcomes were analyzed by gestational age at diagnosis: &lt;28 weeks and 28–33 weeks.</div></div><div><h3>Results</h3><div>Of 225 pregnancies included, 36 (16.0%) were diagnosed with sPEC &lt; 28 weeks and 189 (84.0%) between 28–33 weeks. Rates of SNM were similar between ED and EM at both gestational age groups (&lt;28 weeks: 92.3% vs. 91.3%; 28–33 weeks: 82.6% vs. 78.3%). Neonatal death was more common in the &lt; 28-week ED group (38.5% vs. 4.3%). Among pregnancies diagnosed at 28–33 weeks, NICU length of stay was shorter in the EM group (21.1 vs. 28.4 days, p = 0.03), while postmenstrual age at discharge was similar (35.4 vs. 35.3 weeks, p = 0.82).</div></div><div><h3>Conclusions</h3><div>For sPEC diagnosed between 28–33 weeks, EM did not significantly reduce SNM but was associated with shorter NICU stays. Among pregnancies diagnosed before 28 weeks, neonatal mortality was higher in the ED group, supporting EM when maternal condition permits.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114980"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inside Back Cover - Editors with images","authors":"","doi":"10.1016/S0301-2115(26)00090-4","DOIUrl":"10.1016/S0301-2115(26)00090-4","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 115024"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147399700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cardiometabolic index and prevalence of ovarian cancer among US adults: A cross-sectional NHANES study","authors":"Xinyan Gao ,&nbsp;Xiaoxiang Jiang ,&nbsp;Junming Chen ,&nbsp;Bin Du ,&nbsp;Xiaojiao Weng ,&nbsp;Jinhuo Lai ,&nbsp;Riping Wu","doi":"10.1016/j.ejogrb.2026.114954","DOIUrl":"10.1016/j.ejogrb.2026.114954","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the possible link between ovarian cancer and cardiometabolic index (CMI).</div></div><div><h3>Methods</h3><div>A cross-sectional investigation was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Sensitivity analysis, smooth curve fitting, and weighted multivariate logistic regression were employed to explore the relationship between CMI and ovarian cancer. The effectiveness of CMI in detecting ovarian cancer was also assessed using eXtreme Gradient Boosting and receiver operating characteristic analysis. Furthermore, subgroup analysis and interaction tests were employed to examine the stability of the connection across different populations.</div></div><div><h3>Results</h3><div>In this study involving 8814 individuals aged ≥ 20 years, CMI was found to be positively correlated with ovarian cancer. Each unit increase in CMI was associated with 10 % increased odds of ovarian cancer in the fully adjusted model {odds ratio [OR] 1.10 [95 % confidence interval (CI) 1.02–1.17]}. The prevalence of ovarian cancer was higher in individuals in the highest CMI tertile [OR 3.68 (95 % CI 1.10–12.35)] compared with those in the lowest CMI tertile. There was a non-linear dose–response association (<em>p</em> for non-linearity = 0.004) between the odds of ovarian cancer and CMI. The results of subgroup analysis and interaction tests show that, apart from race, the relationship between CMI and ovarian cancer was consistent across subgroups.</div></div><div><h3>Conclusions</h3><div>Increased prevalence of ovarian cancer is associated with elevated CMI levels. Improving cholesterol levels and management of dyslipidaemia may help reduce the odds of ovarian cancer.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114954"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel and accessible proband-free approach for noninvasive prenatal diagnosis of single-gene disorders","authors":"Chao Chen ,&nbsp;Yaping Zhu ,&nbsp;Lu Jiang ,&nbsp;Chong Tang ,&nbsp;Zhiyu Peng ,&nbsp;Jin Huang ,&nbsp;Yun Yang","doi":"10.1016/j.ejogrb.2026.114988","DOIUrl":"10.1016/j.ejogrb.2026.114988","url":null,"abstract":"<div><h3>Objective</h3><div>Current haplotype-based noninvasive prenatal diagnosis (NIPD) for recessive single-gene disorders (SGD) is limited by its dependence on proband-derived parental haplotyping or complex haplotyping procedures. To overcome this limitation, this study aims to develop a novel direct parental haplotyping approach, enabling proband-independent NIPD for recessive SGD (NIPD-SGD).</div></div><div><h3>Methods</h3><div>Seven couples at genetic risk of having a fetus with recessive SGD were recruited. Parental haplotypes were constructed using targeted single-tube long fragment read (stLFR) sequencing with a customized 490.6 kb probe. Relative haplotype dosage (RHDO) analysis was performed on maternal plasma samples with the same panel to determine fetal haplotypes. Invasive prenatal diagnosis served as the gold standard for confirming NIPD results.</div></div><div><h3>Results</h3><div>Targeted stLFR sequencing directly phased fourteen parental haplotypes in the target region. Among seven singleton pregnancies, NIPD correctly genotyped all seven fetuses, achieving 100% concordance with the gold standard (7/7). Notably, this method successfully identified four families with large copy number variations, highlighting its effectiveness in detecting complex genetic alterations.</div></div><div><h3>Conclusions</h3><div>Targeted stLFR sequencing is an effective method for direct haplotyping in NIPD-SGD, enabling proband-independent analysis. This approach allows for efficient haplotyping in a single tube, eliminating the need for expensive microfluidic devices. This significant advancement offers a promising solution for expanding the clinical utility of NIPD-SGD.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114988"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with ovarian loss and surgical intervention for perinatal ovarian cysts","authors":"Julia M. Whelchel ,&nbsp;Sofia Perez Otero ,&nbsp;Ashley S. Roman ,&nbsp;Sara G. Brubaker ,&nbsp;Antonia F. Oladipo ,&nbsp;Jason C. Fisher ,&nbsp;Sandra S. Tomita","doi":"10.1016/j.ejogrb.2026.114979","DOIUrl":"10.1016/j.ejogrb.2026.114979","url":null,"abstract":"<div><h3>Background</h3><div>Perinatal ovarian cysts may spontaneously resolve or cause ovarian torsion. Cyst size and appearance often guide surgical decision making. The natural history of these cysts and impact of perinatal interventions on ovarian outcomes remain unclear. We investigated the association of various clinical parameters with operative intervention and ovarian loss.</div></div><div><h3>Methods</h3><div>Infants with ovarian cysts meeting our definition of perinatal (diagnosed between 15 weeks gestational age and 1 year) from November 2006–January 2022 were identified. Cysts were characterized by size, morphology, laterality, and evolution. Outcome measures included resolution, ovarian loss, and operative intervention. Mann–Whitney U and Fisher exact tests were used. Optimal maximal size cutoffs were obtained using ROC curves.</div></div><div><h3>Results</h3><div>Sixty-two female patients with perinatal ovarian cysts were identified. Spontaneous resolution occurred in 35, prenatally and postnatally, with follow-up length averaging 186 days. Of 18 undergoing cystectomies, 9 revealed non-viable ovaries. Overall ovarian loss rate was 29%. Loss occurred more frequently with large, complex, and right-sided cysts (P &lt; 0.05) but some complex cysts also resolved spontaneously. Operative intervention occurred more frequently with larger cysts (P=&lt;0.001) and was associated with ovarian salvage when performed earlier (P = 0.008) on larger cysts (P = 0.02). Maximal cyst diameter &gt; 4.05 cm predicted ovarian loss with 78% sensitivity, 64% specificity (AUC = 0.67,95%CI = 0.54–0.81, P = 0.04). Maximal cyst diameter &gt; 4.55 cm predicted surgery with 83% sensitivity, 82% specificity (AUC = 0.86,95%CI = 0.77–0.96, P &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>29% of perinatal ovarian cysts resulted in ovarian loss. 56% resolved spontaneously (prenatal and postnatal resolution) including some complex cysts. Cysts that were postnatally complex and maximally &gt; 4 cm had higher rates of ovarian loss and operative intervention. Earlier postnatal operative intervention was associated with ovarian preservation. Standardized imaging (such as the IOTA terminology) and management protocols are needed to better understand behavior and improve treatment of these cysts.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114979"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expectant management as a primary approach for asymptomatic endometrial polyps: An ambispective cohort study","authors":"Ana R. Silva ,&nbsp;Mariana Santos ,&nbsp;Alexandra Coelho ,&nbsp;Raquel Condeço ,&nbsp;Filipa Alpendre ,&nbsp;Paula Ambrósio ,&nbsp;Patrícia Pinto ,&nbsp;Maria José Bernardo ,&nbsp;Dusan Djokovic","doi":"10.1016/j.ejogrb.2026.114986","DOIUrl":"10.1016/j.ejogrb.2026.114986","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the natural history and safety of expectant management for sonographically benign endometrial polyps (EPs) in asymptomatic premenopausal and postmenopausal women, focusing on spontaneous regression, growth, abnormal uterine bleeding (AUB) onset, and malignancy risk.</div></div><div><h3>Study design</h3><div>Ambispective cohort study including 298 asymptomatic women (62 premenopausal, 236 postmenopausal) with sonographically benign EPs evaluated between January 2017 and January 2023. Ultrasound data were prospectively collected during routine care according to IETA standards (scheduled follow-up at 3 and 9 months, then annually), while case inclusion was ascertained retrospectively. Outcomes included complete spontaneous regression, lesion growth, AUB onset, hysteroscopic excision, and histopathology when available. Time-to-event analyses and parsimonious Cox proportional hazards models were applied.</div></div><div><h3>Results</h3><div>Median follow-up was 11 months (IQR 6–24). Complete spontaneous regression occurred in 24/298 women (8.05%; 95% CI 5.2%–11.9%), more frequently in premenopausal than postmenopausal women (14.5% <em>vs</em>. 6.4%; log-rank p = 0.058). AUB developed in 26/298 women (8.7%; 95% CI 5.7%–12.6%). Hysteroscopic excision was performed in 90/298 cases (30.2%; 95% CI 25.1%–35.7%), with histology available for 96 lesions (32.2%). One carcinoma was identified (1/96; 1.04%; overall 1/298 = 0.34%). Larger baseline mean diameter (per 5 mm; adjusted HR 1.22, 95% CI 1.06–1.41) and higher vascularity (score ≥ 3 <em>vs</em>. ≤ 2; HR 1.85, 95% CI 1.10–3.11) independently predicted earlier excision.</div></div><div><h3>Conclusions</h3><div>Expectant management of asymptomatic sonographically benign EPs appears safe with low observed malignancy among excised lesions. Structured ultrasound surveillance may reduce unnecessary surgery while enabling timely intervention.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114986"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146117925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of pelvic floor muscle training combined with promestriene in improving pelvic floor dysfunction in middle-aged and elderly women: a retrospective study","authors":"Jia Shan","doi":"10.1016/j.ejogrb.2026.114987","DOIUrl":"10.1016/j.ejogrb.2026.114987","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate the efficacy of pelvic floor muscle training (PFMT) combined with intravaginal Promestriene, a local steroid hormone precursor that is converted within vaginal tissues into active estrogens and androgens with minimal systemic absorption, in middle-aged and elderly women with pelvic floor dysfunction (PFD) and to explore its effects on muscle strength recovery, tissue improvement, and urinary control enhancement.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This single-center retrospective case analysis included 166 middle-aged and elderly female patients who received pelvic floor rehabilitation between January 2020 and December 2023. Based on previous treatment regimens, patients were divided into an intervention group (PFMT combined with Promestriene, n = 82) and a control group (PFMT alone, n = 84). The intervention period was 6–8 weeks, and all patients underwent follow-up assessments before the intervention, at the end of the intervention, and at 3 months post-intervention. Primary outcome measures included pelvic floor muscle strength (Oxford grading scale, electromyographic maximum voluntary contraction), muscle endurance, urinary control function (International Consultation on Incontinence Questionnaire-Short Form [ICIQ-SF] score, pad test weight), and vaginal tissue health (Vaginal Health Index [VHI] score, with higher values indicating better vaginal tissue health, pH, epithelial thickness, and tissue elasticity). Secondary outcomes included quality of life scores (Pelvic Floor Impact Questionnaire-Short Form 7 [PFIQ-7], Female Sexual Function Index [FSFI], Pittsburgh Sleep Quality Index [PSQI]), pelvic organ support (Pelvic Organ Prolapse Quantification [POP-Q] measurements), and adverse events. Propensity score matching was employed for sensitivity analysis to control for confounding factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The intervention group demonstrated significantly greater improvements in pelvic floor muscle strength, muscle endurance, and electromyographic parameters compared to the control group (all P &lt; 0.01). Regarding urinary control, the ICIQ-SF score decreased by an average of 5.4 points from baseline in the intervention group versus 3.7 points in the control group (P &lt; 0.001), with a correspondingly greater reduction in pad test weight. Vaginal tissue health indicators showed that intravaginal Promestriene significantly improved mucosal color, lubrication, epithelial thickness, and tissue elasticity, with a greater overall improvement in VHI total score compared to the control group (P &lt; 0.001). Quality of life across various domains also showed more pronounced enhancement, particularly in FSFI satisfaction and sleep quality. Improvements in pelvic support structures, such as POP-Q points Aa and Ba, were more marked in the intervention group. The clinical response rate (defined as a ≥ 4-point improvement in ICIQ-SF) was 68.3% in the intervention group, significantly higher t","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114987"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful management of early-diagnosed cervical pregnancy with suction curettage alone: A case series","authors":"Tatsuya Arakaki,&nbsp;Ryu Matsuoka,&nbsp;Yuriko Yagi,&nbsp;Hiroko Takita,&nbsp;Yuka Yamashita,&nbsp;Mayumi Kaneko,&nbsp;Akihiko Sekizawa","doi":"10.1016/j.ejogrb.2026.114978","DOIUrl":"10.1016/j.ejogrb.2026.114978","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114978"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI in the incarceration of the gravid uterus: From diagnosis to individualized management","authors":"Qianshi Zheng,&nbsp;Yu Zou","doi":"10.1016/j.ejogrb.2026.114975","DOIUrl":"10.1016/j.ejogrb.2026.114975","url":null,"abstract":"<div><h3>Background</h3><div>Incarceration of the gravid uterus (IGU) is a rare but serious obstetric condition that demands precise diagnosis for optimal management.</div></div><div><h3>Objectives</h3><div>To evaluate the value of MRI in the diagnosis and individualized management of IGU.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed six patients with IGU admitted to the institution from November 2022 and September 2025. Clinical data like gravidity and parity, gestational weeks of diagnosis and delivery, clinical management and pregnancy outcomes. Imaging findings from MRI and ultrasound were compared, including assessment of cervical elongation, placental position, and complications. The correlation between MRI-measured parameters and pregnancy outcomes was explored.</div></div><div><h3>Results</h3><div>MRI clearly demonstrated typical signs of IGU, including uterine retroversion and anterior cervical displacement. No significant difference was found between MRI and ultrasound in measuring cervical elongation (9.6 ± 4.5 cm vs 7.6 ± 4.2 cm, p = 0.393). MRI additionally enabled assessment of cervical thinning (0.4 ± 0.1 cm) and identified one case of placenta previa missed by ultrasound. Based on MRI findings, four cases underwent successful manual reduction or knee-chest positioning. A preliminary correlation was observed between anterior lower uterine segment thickness and fetal birth weight (r = 1.000, p = 0.020), though this requires validation in larger studies.</div></div><div><h3>Conclusions</h3><div>MRI provides accurate diagnosis and objective assessment of IGU and its complications, serving as a crucial adjunct to ultrasound. Incorporating MRI into the standardized clinical management pathway offers essential evidence for developing individualized treatment strategies.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114975"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic literature review and meta-analysis of postoperative complications of surgical management of vulvar cancer: what is the impact of frailty factors?","authors":"E. Raimond ,&nbsp;C. Mimoun ,&nbsp;I. Menouer ,&nbsp;O. Graesslin ,&nbsp;A. Fauconnier ,&nbsp;C. Huchon","doi":"10.1016/j.ejogrb.2026.114974","DOIUrl":"10.1016/j.ejogrb.2026.114974","url":null,"abstract":"<div><h3>Introduction</h3><div>Vulvar cancer surgery is associated with high rates of morbidity. Preventing or minimizing these morbidities is an important objective, as they impact on patients’ quality of life, and are highly deleterious in frail, aged patients, who represent the majority of those affected by this disease. This systematic literature review and meta-analysis assesses post-operative complications in vulvar cancer surgery, and attempts to identify the impact of frailty factors.</div></div><div><h3>Method</h3><div>A Pubmed search was conducted to identify studies reporting data on complications of vulvar cancer surgery in frail patients, from January 2000 to April 2022, following the recommendations of the PRISMA, and registered in PROSPERO (CRD 42024503036). The evaluation criteria were: age, frailty, and complications. Statistical heterogeneity of results was assessed by graphical representations of confidence intervals (CI) on forest plot and by a Chi2 heterogeneity test.</div></div><div><h3>Result</h3><div>Frailty related to age &gt; 70 years increases the risk of inguinal disunion (OR = 1.89, 95%CI [1.12–3.20]). Frailty (due to age and obesity) does not increase the risk of lymphocele. Frailty factors, such as obesity, are risk factors for inguinal cellulitis (OR = 1.86, 95%CI [1.12–3.08]), and diabetes is a risk factor for inguinal infection.</div></div><div><h3>Conclusion</h3><div>This literature review and meta-analysis precludes drawing any significant clinical conclusion regarding the impact of frailty, in particular age-related frailty, on the occurrence of complications. This is due to different definitions of complications, a lack of precision in the data provided, the variety of surgical techniques performed, the absence of an age group or a frailty group.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114974"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}