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

{"title":"Predictive factors for spontaneous conception in women with moderate and severe endometriosis following operative laparoscopy: A cohort study","authors":"Nivedita Gupta ,&nbsp;Treasa Joseph ,&nbsp;Reka Karuppusami ,&nbsp;Aleyamma T. Kunjummen ,&nbsp;Mohan S. Kamath","doi":"10.1016/j.ejogrb.2025.03.052","DOIUrl":"10.1016/j.ejogrb.2025.03.052","url":null,"abstract":"<div><h3>Study objective</h3><div>To externally validate the Endometriosis Fertility Index (EFI) and to assess cumulative spontaneous pregnancy rates in women with moderate to severe endometriosis following fertility-enhancing minimally invasive surgery.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Tertiary-care center for infertility treatment.</div></div><div><h3>Participants</h3><div>Women diagnosed with r-ASRM Stage III or IV endometriosis following fertility-sparing surgery between June 2013 and July 2023, and who desired for fertility.</div></div><div><h3>Intervention</h3><div>Minimally invasive laparoscopy.</div></div><div><h3>Measurements and main results</h3><div>The follow-up rate was 76.3 %, with a median duration of 15 months [Range (1–130 months)]. The mean age of women was 28.5 ± 3.8 years. Women with low EFI scores (0–3) had lower cumulative spontaneous pregnancy rates (11.4 % at six months, 17 % at three years) compared to those with higher EFI scores (7–8), who had significantly higher rates (35 % at six months, 84.5 % after three years) (P &lt; 0.001). A similar trend was observed for overall pregnancy rates. Factors negatively correlated with spontaneous pregnancy included lower least function scores (P &lt; 0.001), increasing maternal age (P = 0.003), rASRM scores of 16–40 vs. ≥ 71 (P &lt; 0.001), lower antral follicle count (P = 0.02), and increasing paternal age (P &lt; 0.001). Cystectomy (P = 0.001) was positively associated with spontaneous pregnancy post-surgery. Among the 518 women identified with moderate and severe endometriosis, 395 were followed up, out of which 370 attempted spontaneous conception for at least six months, resulting in a pregnancy rate of 37.3 % (138/370).</div></div><div><h3>Conclusion</h3><div>The current study demonstrated that EFI scores correlate with pregnancy rates, validating the scoring system in a South Asian population. Additionally, clinical factors such as low antral follicle count, and advanced paternal age may be considered to make informed clinical decisions post-surgery for women with advanced endometriosis who wish to conceive.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 192-199"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739755","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":"The impact of serum homocysteine levels in women and men on pregnancy outcomes in fresh IVF/ICSI cycles: A retrospective cohort study","authors":"Xuxin Zhan ,&nbsp;Mingwei Zhan ,&nbsp;Qiang Lou ,&nbsp;Lina Liu ,&nbsp;Jianguo Xue ,&nbsp;Xuejun Shang","doi":"10.1016/j.ejogrb.2025.03.038","DOIUrl":"10.1016/j.ejogrb.2025.03.038","url":null,"abstract":"<div><h3>Background</h3><div>High serum homocysteine (Hcy) levels are associated with reduced fertility and adverse pregnancy outcomes. Previous studies have produced inconsistent results regarding the influence of Hcy levels on in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) outcomes. Moreover, most existing studies have predominantly focused on Hcy levels in women, with limited attention given to serum Hcy levels in men.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted at the Reproductive Center of Xi’an People’s Hospital (Xi’an Fourth Hospital) from October 2021 to October 2023, involving a total of 481 patients who underwent fresh embryo transfer. Male and female patients were grouped according to quartiles of serum Hcy concentration. Of these, 290 patients achieved pregnancy, while 191 did not. Follow-up data showed that 250 patients maintained their pregnancies to 12 weeks, while 40 experienced early miscarriage. Pregnancy outcomes were analyzed for all patients and for clinically pregnant women who were followed up to 12 weeks, with a focus on factors associated with early miscarriage.</div></div><div><h3>Results</h3><div>The results demonstrated that the pregnancy rate with female serum Hcy concentrations ≥ 12.43 µmol/L was significantly lower than in those with Hcy concentrations &lt; 8.07 µmol/L (P = 0.006) and 8.07–9.57 µmol/L (P = 0.008). Female serum Hcy ≥ 12.43 µmol/L was identified as an independent risk factor for early miscarriage (OR = 2.20, 95 % CI 1.24–3.88). No significant correlation was observed between female serum Hcy levels and embryo quality. Additionally, there was no significant association between male serum Hcy levels and clinical pregnancy, pregnancy outcomes, or embryo quality. Among the 250 cases of clinical pregnancy, 97.6 % (244 cases) resulted in successful live births, while 2.4 % (6 cases) did not result in live births. Non-live birth cases were primarily attributed to factors such as premature rupture of membranes, cervical insufficiency, oligohydramnios, fetal abnormalities, and other causes.</div></div><div><h3>Conclusion</h3><div>Elevated serum Hcy concentrations in women adversely affected clinical pregnancy and early miscarriage (≥12.43 µmol/L), while male serum Hcy did not show a significant effect. The inclusion of Hcy levels in both men and women provides a more comprehensive perspective for exploring multidimensional factors influencing fertility outcomes.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 150-157"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704471","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":"Retracted vs non-retracted obstetrical randomized trials: Which quality criteria are most associated with retraction for untrustworthiness?","authors":"Sarah Lawson ,&nbsp;Georgios Doulaveris ,&nbsp;Kathryn Anderson ,&nbsp;Carrie Bennett ,&nbsp;Vincenzo Berghella","doi":"10.1016/j.ejogrb.2025.03.047","DOIUrl":"10.1016/j.ejogrb.2025.03.047","url":null,"abstract":"<div><h3>Background</h3><div>Randomized control trials (RCTs) are an essential pillar of scientific knowledge and medical practice, and their integrity has important implications for reliable systemic reviews and meta-analyses. However, the number of article retractions due to falsified data and scientific misconduct has increased in recent years. In response, the scientific community has pursued the creation of quality criteria that can be utilized to promote trustworthiness.</div></div><div><h3>Methods</h3><div>After a quality criteria checklist was created by a team of experts, retracted and nonretracted studies were evaluated for adherence to assess the checklist’s usefulness and identify potential pitfalls. Retracted studies published in obstetric literature and retracted between 1994–2024 were identified using the online Retraction Watch Database. A previously created database of non-retracted obstetric RCTs published between 2018–2020 was used for the control group.</div></div><div><h3>Results</h3><div>A total of 173 studies were identified, 136 non-retracted and 37 retracted. Overall, 13 of 17 (76.5 %) criteria were statistically different between retracted and non-retracted articles. A cutoff of ≤ 11 total quality criteria granted 94.9 % (95 % CI, 89.7 − 97.9) sensitivity and 78.4 % (95 % CI, 61.8 − 90.2) specificity in distinguishing non-retracted from retracted studies.</div></div><div><h3>Conclusions</h3><div>Retracted studies were significantly less likely to adhere to the 17-quality criteria checklist compared to non-retracted studies, providing useful insight to peer-reviewed scientific journals about what to evaluate for in an RCT manuscript prior to publication. The authors recommend that journal editors play close attention to criteria related to research ethics, data falsification, and risk of bias.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 137-142"},"PeriodicalIF":2.1,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of intramyometrial injection of terlipressin versus carbetocin on hemoglobin and blood loss during open myomectomy operations without using haemostatic tourniquets: Double blinded randomized placebo-controlled trial","authors":"Wael Elbanna ,&nbsp;Mohammed Mahmoud Al Sheikh ,&nbsp;Osama Mahmoud Azmy","doi":"10.1016/j.ejogrb.2025.03.041","DOIUrl":"10.1016/j.ejogrb.2025.03.041","url":null,"abstract":"<div><h3>Background</h3><div>Uterine fibroids are a significant worldwide health problem due to their high prevalence among women during the reproductive period. Conservative surgery such as myomectomy has been of increasing interest. However, intraoperative blood loss represents a challenge to the surgeons. Therefore, the aim of this study was to assess the efficacy of Intramyometrial injection of terlipressin and carbetocin in reducing intraoperative bleeding and preserving the hemoglobin level.</div></div><div><h3>Methods</h3><div>We conducted the randomized, double-blind, placebo-controlled trial from February 2022 to April 2024, in the El-Resala and Al-Aseema hospitals under the direction of the National Research Center.</div></div><div><h3>Results</h3><div>A total of 99 eligible female patients out of 119 (13werenotmeetingtheinclusioncriteria) with uterine fibroid were recruited into the study and allocated into three groups (n = 33): terlipressin group (A), carbetocin group (B), and saline group (C). Blood loss was significantly different among groups (P &lt; 0.001), being significantly lower in the Terlipressin group than the carbetocin group (mean = 321 vs 418 ml) and significantly lower in both groups than the saline (mean = 969 ml). The Terlipressin group required significantly less blood transfusion than the saline group (P &lt; 0.05). The operative time and side effects were not statistically different among the three groups (P &lt; 0.05).</div><div>The operative time and side effects were not statistically different among the three groups.</div></div><div><h3>Conclusions</h3><div>Our study provided evidence that terlipressin is effective in reducing blood loss during myomectomy with advantages over carbetocin. Based on our results, we recommend the adoption of terlipressin to improve myomectomy outcomes and enhance patient safety, further studies with a larger sample size is recommended to confirm our findings.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 186-191"},"PeriodicalIF":2.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734838","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":"Predictors of vasovagal symptoms or syncope during outpatient diagnostic hysteroscopy: A prospective observational study","authors":"A. Úbeda ,&nbsp;S. Cabrera ,&nbsp;C. Escales ,&nbsp;B. Funes ,&nbsp;M. Martínez ,&nbsp;A. Puche ,&nbsp;S. Martínez García","doi":"10.1016/j.ejogrb.2025.03.044","DOIUrl":"10.1016/j.ejogrb.2025.03.044","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze factors conditioning the apparition of vasovagal prodromic symptoms or vagal syncope during or immediately after a diagnostic hysteroscopy performed in an outpatient setting.</div></div><div><h3>Study Design</h3><div>Prospective observational study including 1255 patients who received an outpatient diagnostic hysteroscopy in the Hysteroscopy Unit of Quirón Dexeus University Hospital, Barcelona, Spain since April 2019 until December 2021. Data such as fasting, smoking, analgesic or anxiolytic treatment intake, parity and menopausal status were collected. Patients with pathologies or treatments that could modify pain tolerance were excluded.</div></div><div><h3>Results</h3><div>Mean age was 42.7 ± 9.03 years. An 84.3 % of patients were premenopausal, while 15.7 % were smokers and 59 % of them had smoked 30 min before the procedure. Thirty-three point three percent of patients were fasting and 56.5 % had taken analgesic or anxiolytic pre-medication. A total of 79 patients (6.3 %) developed symptoms of vasovagal reaction. Pain was reported as 7.56 ± 1.97 in the Visual Analogic Scale (VAS) in patients with vagal symptoms versus 4.95 ± 2.66 in patients without vagal symptoms (p &lt; 0.001). In the multivariate logistic model only a higher VAS score and a previous history of vasovagal symptoms during medical procedures were associated to a higher probability of developing vagal symptoms after adjusted by covariates [Odds Ratio (OR): 1.67 (95 % confidence interval (CI):1.45;1.93), OR:3.44 (95 % CI: 2.04;5.79) respectively].</div></div><div><h3>Conclusions</h3><div>When performing an outpatient hysteroscopy, patients should be asked about their previous history of vagal symptoms during medical procedures. Painful procedures should be immediately stopped in order to prevent discomfort, avoid the apparition of vagal prodromes or syncope and improve satisfaction with the procedure.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 121-125"},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686439","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":"Comparative outcomes of interventional embolization and laparoscopic tubal ligation on frozen-thawed embryo transfer success in women with hydrosalpinx","authors":"Yuefan Qi ,&nbsp;Jie Zhang ,&nbsp;Li Tan","doi":"10.1016/j.ejogrb.2025.03.046","DOIUrl":"10.1016/j.ejogrb.2025.03.046","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the comparative effects of interventional embolization and laparoscopic tubal ligation on the success rates of frozen-thawed embryo transfer (FET) in women with hydrosalpinx, along with an analysis of the specific characteristics associated with each surgical technique.</div></div><div><h3>Methods</h3><div>Individuals experiencing infertility due to bilateral hydrosalpinx-induced tubal obstruction who had prior unsuccessful assisted reproductive technology (ART) attempts at the Reproductive Center of the Second Affiliated Hospital of Zhengzhou University between January 2015 and May 2024 were included in this study. Participants were allocated into four groups: the interventional embolization group (93 cases), where the proximal hydrosalpinx tube was embolized using a micro coil under X-ray guidance; the laparoscopic ligation group (129 cases), which involved laparoscopic proximal tubal ligation with the creation of a distal stoma; the untreated hydrosalpinx group (146 cases); and the control group (186 cases), consisting of women without hydrosalpinx who underwent FET during the same time frame. The study outcomes assessed FET outcomes, length of stay (LOS), effectiveness, and costs associated with the surgical interventions.</div></div><div><h3>Results</h3><div>Both the average length of procedure (LOP) and LOS in the laparoscopic ligation group were significantly longer than those in the interventional embolization group, with a statistically significant difference (<em>F</em> = 13.092, <em>P</em> &lt; 0.001). Furthermore, the average hospitalization cost was notably higher in the laparoscopic ligation group (21,548 ± 5,321) yuan compared to the interventional embolization group (8,569 ± 627) yuan, with a statistically significant difference (<em>F</em> = 23.633, <em>P</em> &lt; 0.001). Both surgical groups showed significantly higher embryo implantation rates (48.97 %, 59.56 % vs. 29.25 %) and clinical pregnancy rates (58.84 %, 55.81 % vs. 40.41 %) compared to the untreated hydrosalpinx group, with a statistically significant difference (<em>x²</em> = 38.437, <em>x²</em> = 10.462, respectively, <em>P</em> &lt; 0.001). However, the difference between the two surgical groups was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Both interventional embolization and laparoscopic ligation surgeries can improve fertility outcomes in women with hydrosalpinx. Interventional embolization emerged as the more minimally invasive, cost-effective, and efficient surgical option.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 143-149"},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697256","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":"Prevalence of term prelabor rupture of membranes and factors associated with a longer interval of rupture: data from the 2021 French national perinatal survey","authors":"Clementine Renaudin ,&nbsp;Caroline Diguisto ,&nbsp;Nathalie Lelong ,&nbsp;Elsa Tavernier ,&nbsp;Camille Le Ray ,&nbsp;the ENP 2021 Study Group","doi":"10.1016/j.ejogrb.2025.03.036","DOIUrl":"10.1016/j.ejogrb.2025.03.036","url":null,"abstract":"<div><h3>Objectives</h3><div>Term prelabor rupture of membranes (term PROM) increases maternal and neonatal morbidity, but its current prevalence is unknown. This study aimed to estimate the prevalence of term PROM and to identify factors associated with a longer interval of rupture of membranes using recent national population-based data.</div></div><div><h3>Study design</h3><div>Women with singleton pregnancies and term deliveries from the 2021 French National Perinatal Survey were selected. The prevalence of term PROM, defined as the rupture of membranes from 37 weeks before spontaneous labor, and its 95 % confidence interval (CI) were estimated. The median interval of rupture, defined as the time between the rupture of membranes and the onset of spontaneous labor, induction or prelabor caesarean (whichever occurred first) was calculated. Sociodemographic and pregnancy factors related to a longer interval of rupture of membranes were analyzed using a survival analysis, adjusting for competitive risks of a spontaneous labor: induction of labor and prelabor cesarean. Adjusted Hazard Ratios (aHR) were calculated using multivariate analysis.</div></div><div><h3>Results</h3><div>Among 10,810 eligible women, 3,052 had a term PROM, yielding a prevalence of 28.2 % (95 %CI 27.4–29.1). The median interval of rupture was 8.3 h (Interquartile 25–75[3.5–21.3]). Within the first 24 h following PROM, 90 % of women with a spontaneous labor were in labor. Factors associated with a longer interval of rupture included maternal age ≥35 (aHR = 0.82 95 %CI 0.72–0.93), primiparity (aHR = 0.73 95 %CI 0.66–0.81), Body-mass Index ≥25 (aHR = 0.87 95 %CI 0.77–0.97) or ≥30 (aHR = 0.73 95 %CI 0.62–0.85), being single (aHR = 0.66 95 %CI 0.48–0.90) and lower education (aHR = 0.82 95 %CI 0.69–0.97).</div></div><div><h3>Conclusions</h3><div>Term PROM affects more than one in four women. Sociodemographic factors and parity are associated with a longer interval of rupture.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 161-167"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704469","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":"Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy for Pseudomyxoma peritonei originating from ovarian teratomas: A single-center case series and literature review","authors":"Guanjun Shi ,&nbsp;Chong Wang ,&nbsp;Yiyan Lu ,&nbsp;Pu Zhang ,&nbsp;Lubiao An ,&nbsp;Haipeng Zhou ,&nbsp;Ruiqing Ma ,&nbsp;Huafeng Shou","doi":"10.1016/j.ejogrb.2025.03.043","DOIUrl":"10.1016/j.ejogrb.2025.03.043","url":null,"abstract":"<div><div>Pseudomyxoma peritonei (PMP) is a complex malignant peritoneal tumor which generally originates from appendiceal mucinous tumors, but can more rarely arise from ovarian mature teratomas. Herein, we evaluated the treatment efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for PMP derived from ovarian mature teratomas. This study retrospectively analysed the clinical data of four patients with a mean age of 50.25 years treated between January 2021 and December 2024. The data included general patient information, surgical details, postoperative pathology, adjuvant therapies, and outcomes. Pathological findings confirmed ovarian mature teratomas in all cases. Peritoneal lesions included one case of acellular mucin, two cases of low-grade PMP, and one case of high-grade PMP with signet-ring cells. All patients underwent CRS with HIPEC treatment with no surgical complications. However, none achieved optimal cytoreduction. During follow-up, the patient with high-grade PMP and signet-ring cells had a postoperative survival time of 12 months, while the remaining patients continue to show good postoperative outcomes. Overall, CRS with HIPEC is a safe and effective treatment strategy for PMP originating from ovarian mature teratomas; even without achieving optimal cytoreduction, this therapy can extend survival and improve quality of life. However, high-grade PMP may require more aggressive treatment.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 107-112"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of pelvic floor dysfunction after total hysterectomy: A preliminary study based on transperineal ultrasound and shear wave elastography","authors":"XiuMei Li ,&nbsp;ZhenZhen Zhang ,&nbsp;Yong Li ,&nbsp;Cheng Zhao ,&nbsp;Ping Li ,&nbsp;GuiJun Zhang ,&nbsp;ZongLi Yang","doi":"10.1016/j.ejogrb.2025.03.040","DOIUrl":"10.1016/j.ejogrb.2025.03.040","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the application of transperineal ultrasound (TPUS) and shear wave elastography (SWE) in the assessment of pelvic floor dysfunction (PFD) after total hysterectomy and to explore associated imaging indicators.</div></div><div><h3>Methods</h3><div>Forty-seven women who underwent total hysterectomy and 70 healthy women were prospectively enrolled in our study. We recorded relevant clinical information, including age, body mass index (BMI), and obstetric history. All participants underwent TPUS and SWE examination at rest, during contraction, and during the maximum Valsalva maneuver. The intra- and inter-observer repeatability of SWE measurements was assessed. And the comparison of the imaging parameters between the two groups was conducted. Further receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of TPUS and SWE in predicting PFD.</div></div><div><h3>Results</h3><div>SWE used in this study to quantify LAM elasticity demonstrated satisfactory repeatability with all <em>ICC</em> values higher than 0.75. The incidence of PFD was significantly higher in the case group compared to the control group (57.45 % vs. 38.57 %, <em>P</em> = 0.045). The sagittal hiatal diameter (SHD) was higher while the thickness of the levator ani muscle (LAM) was lower in the case group compared to the normal group (<em>P</em> &lt; 0.05), and the SHD showed a positive correlation with PFD while LAM showed a negative correlation. The elastic modulus values of <em>E</em>_max and <em>E</em>_mean were significantly increased during contraction in the case group (<em>P</em> = 0.011 and <em>P</em> = 0.029). Further ROC analysis showed that TPUS alone and the combination of TPUS with SWE were both effective in diagnosing PFD than SWE alone (AUC = 0.946, 0.971 and 0.642 respectively).</div></div><div><h3>Conclusion</h3><div>Our research highlights the significance of the visual assessment of PFD using TPUS and SWE. A widened SHD, a thinned LAM and decreased compliance of LAM during contraction may be correlated with increased PFD.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 113-120"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673579","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":"IV iron supplementation, dosage, and timing in pregnancy: A single-institution review on a maternal transfusion reduction bundle","authors":"Alixandria F. Pfeiffer ,&nbsp;Nathalie Chang ,&nbsp;Oxana Zarudskaya ,&nbsp;Cece Cheng ,&nbsp;Michael D. Berkus ,&nbsp;Angela R. Boyd ,&nbsp;John J. Byrne ,&nbsp;Nora M. Doyle","doi":"10.1016/j.ejogrb.2025.03.045","DOIUrl":"10.1016/j.ejogrb.2025.03.045","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about the effects of intravenous iron (IVFe) supplementation on maternal hemoglobin (Hb) by timing of infusion and dosage.</div></div><div><h3>Objective</h3><div>To identify the association of IVFe timing and dose on pre-delivery Hb.</div></div><div><h3>Study Design</h3><div>A retrospective cohort study of pregnant patients with iron deficiency anemia (IDA) who received iron sucrose (Venofer®) at our Level IV maternity care center following the implementation of a quality improvement (QI) transfusion reduction bundle from January 2020 to December 2023. The primary outcome was the association between IVFe timing and pre-delivery Hb. Secondary outcomes included the impact of IVFe dosage and infusion-to-delivery interval on Hb. Statistical analyses included paired t-tests, Mann-Whitney U tests, χ² tests, ANOVA, and post-hoc Tukey multiple comparisons (significance set at p &lt; 0.05).</div></div><div><h3>Results</h3><div>295 patients were included. Mean age, BMI, and ferritin were 26.6 ± 6.3 years, 28.1, and 7.2 ± 7.8 μg/L, respectively. Mean GA for IVFe administration was 34 weeks. Two patients required intrapartum/postpartum red blood cell transfusions. A greater mean Hb difference (2.5 g/dL vs 1.3 g/dL), was observed with IVFe at &lt;34 weeks compared to ≥34 weeks (p &lt; 0.001). Higher IVFe doses were associated with increased pre-delivery Hb levels (p = 0.002) and a longer infusion-to-delivery interval (p = 0.049). The strongest Hb improvement was seen with latency from ≥6–8 weeks with doses &gt;800 mg versus &lt;2 weeks at doses ≤ 800 mg (increase of 2.6 – 3.1 g/dL, p &lt; 0.0001).</div></div><div><h3>Conclusion</h3><div>Substantial benefit is seen when IVFe is given in the early third trimester, especially with ≥6 weeks of latency and doses ≥800 mg.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 42-47"},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644781","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}