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

{"title":"Role of preoperative serum CA-125 and fibrinogen levels in predicting lymph node metastasis, myometrial invasion, and lymphovascular space invasion in patients with endometrial cancer","authors":"Neçirvan Çağdaş Çaltek , Mahmut Yassa , Gözde Şahin , Yahya Özgün Öner , İlteriş Yaman , Can Berk Karabudak , İlkbal Temel Yüksel","doi":"10.1016/j.ejogrb.2026.114985","DOIUrl":"10.1016/j.ejogrb.2026.114985","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether preoperative serum levels of cancer antigen 125 (CA-125) and fibrinogen could provide clinical guidance for surgical planning and treatment management in patients with endometrial cancer.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted, including 582 patients who underwent surgery for endometrial cancer between October 2020 and December 2024 at a tertiary centre. Preoperative CA-125 and fibrinogen levels, clinical variables, and postoperative pathological findings were collected from electronic medical records. The primary outcome was lymph node metastasis (LNM). The secondary outcomes were myometrial invasion (MI) ≥ 50% and the presence of lymphovascular space invasion (LVSI). Independent predictors of LNM, MI ≥ 50% and LVSI were evaluated using multivariable logistic regression based on TRIPOD-aligned preoperative and postoperative modelling frameworks. Model performance was assessed through area under the receiver operating characteristic curve (ROC–AUC), calibration metrics, and decision curve analysis. Optimal biomarker thresholds were determined using ROC analysis and the Youden index. Sensitivity analyses examined the diagnostic performance of the Mayo low-risk criteria and the additional value of incorporating CA-125 ≥ 29.1 U/ml.</div></div><div><h3>Results</h3><div>MI ≥ 50%, LVSI and LNM were identified in 37.3%, 33.2% and 13.2% of patients, respectively. An elevated CA-125 level was significantly associated with MI ≥ 50%, LVSI and LNM (all <em>P</em> < 0.001), while the fibrinogen level only differed between LNM groups (<em>P</em> = 0.009). In univariable analyses, multiple clinicopathological factors – including age, body mass index (BMI), tumour grade, histological subtype, cervical stromal involvement, lower uterine segment involvement, tumour size, MI ≥ 50%, LVSI, CA-125 and fibrinogen – were associated with LNM. In the preoperative model (Model 1), CA-125 [odds ratio (OR) 1.02; <em>P</em> < 0.001], older age (OR 1.05; <em>P</em> = 0.001) and lower BMI (OR 0.92; <em>P</em> = 0.001) were independent predictors of LNM, yielding an AUC of 0.805. In the postoperative model (Model 2), LVSI was the strongest predictor (OR 20.46; <em>P</em> < 0.001), and the model demonstrated improved predictive performance (AUC 0.889). CA-125 remained independently associated with LNM in both models. CA-125 alone achieved an AUC of 0.740 with an optimal cut-off of 29.1 U/ml. For the secondary outcomes, age, tumour size, grade and LVSI independently predicted MI ≥ 50% (AUC 0.862), whereas BMI, histological subtype, cervical stromal involvement, MI ≥ 50% and tumour size independently predicted LVSI (AUC 0.886). Fibrinogen did not have independent predictive value for MI or LVSI. In a sensitivity analysis, the addition of CA-125 ≥ 29.1 U/ml to the Mayo low-risk criteria improved the detection of LNM in cases initially classified as low risk.</div></div><div><h3>Conclusion</h3>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"320 ","pages":"Article 114985"},"PeriodicalIF":1.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146178644","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":"Prognostic factors for persistent urinary incontinence after sling surgery in patients with urethral funneling","authors":"Enrique González-Díaz,&nbsp;Leticia Padilla Mozo,&nbsp;Ester Fraile López,&nbsp;Camino Fernández Fernández","doi":"10.1016/j.ejogrb.2026.115000","DOIUrl":"10.1016/j.ejogrb.2026.115000","url":null,"abstract":"<div><h3>Objective</h3><div>To identify preoperative prognostic factors associated with persistent urinary incontinence (UI) following mid-urethral sling (MUS) surgery in women with sonographically confirmed urethral funneling.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Tertiary referral center with a specialized urogynecology unit.</div></div><div><h3>Patients</h3><div>Forty-seven women diagnosed with stress UI or stress-predominant mixed UI and urethral funneling on preoperative pelvic floor ultrasound (PFUS), undergoing MUS surgery.</div></div><div><h3>Interventions</h3><div>MUS surgery performed retropubic (TVT) or transobturator (TOT) approach.</div></div><div><h3>Measurements and main results</h3><div>Preoperative evaluation included clinical assessment, voiding diary, validated symptom questionnaires (ICIQ-UI-SF), and PFUS. Surgical success was defined as complete resolution of incontinence 24 months postoperatively. Persistent UI was observed in 27.7% of patients. On univariate analysis, higher ICIQ-UI-SF scores (p = 0.0023), longer urethral length (p = 0.011), and TOT use (p = 0.0065) were significantly associated with persistent UI. ROC curves identified ICIQ-UI-SF ≥ 18 (AUC = 0.731) and urethral length ≥ 35 mm (AUC = 0.654) as optimal cutoffs. In multivariate analysis, both ICIQ-UI-SF ≥ 18 (OR = 6.2, 95% CI: 1.2–31, p = 0.028) and TOT (OR = 6.8, 95% CI: 1.6–28.5, p = 0.009) remained independent predictors. The model showed good discrimination (AUC = 0.84).</div></div><div><h3>Conclusion</h3><div>Among women with urethral funneling, greater symptom severity and the use of TOT are independently associated with persistent UI after MUS. The retropubic approach (TVT) may yield better outcomes in this high-risk population. Incorporating these predictors into preoperative decision-making may enhance surgical planning and patient counseling.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"320 ","pages":"Article 115000"},"PeriodicalIF":1.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147281","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":"When to stop? A single center experience on vacuum-assisted deliveries","authors":"Elad Preuss ,&nbsp;Atara De Porto ,&nbsp;Vadim Sheiman ,&nbsp;Moran Bitton ,&nbsp;Josef Tovbin ,&nbsp;Hagit Itzhak Kedem ,&nbsp;Eran Barzilay","doi":"10.1016/j.ejogrb.2026.114983","DOIUrl":"10.1016/j.ejogrb.2026.114983","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between vacuum-assisted vaginal delivery (VAVD) duration and procedural failure and neonatal morbidity, including major neonatal birth trauma, and to assess independent predictors of failed VAVD.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of singleton, vertex pregnancies undergoing a trial of VAVD at a single center. VAVD duration was defined as time from first traction to delivery (successful VAVD) or to the decision to abandon the attempt (failed VAVD). Neonatal morbidity included Apgar scores and arterial pH, and major birth trauma outcomes were extracted from neonatal records. Multivariable logistic regression was performed to identify independent predictors of failed VAVD.</div></div><div><h3>Results</h3><div>Among 2,355 VAVD attempts, 39 (1.7%) failed and all were delivered by cesarean. Failed VAVD had substantially higher cup detachment rates (61.5% vs 9%, p &lt; 0.001) and longer duration (median 12 vs 4 min, p &lt; 0.001). Neonatal outcomes were worse in failed VAVD, including higher rates of low 1-minute Apgar, low 5-minute Apgar, low arterial pH, and composite neonatal morbidity. Major birth trauma extraction identified higher subgaleal hematoma rates in failed VAVD, while intracranial bleeding was not documented. In time-dependent analyses, success declined from 98.3% at commencement to 61.5% at 20 min, whereas composite neonatal morbidity increased from 12.2% to 57.7%. In multivariable analysis, cup detachment, induction of labor, lower head station, and longer duration independently predicted failure.</div></div><div><h3>Conclusion</h3><div>Prolonged VAVD is associated with lower success and higher neonatal morbidity. Duration should inform dynamic reassessment alongside event-based stopping criteria, particularly cup detachments.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"320 ","pages":"Article 114983"},"PeriodicalIF":1.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147285","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":"Integrating quality of life instruments into clinical care for benign gynecological conditions to enhance patient-centered care","authors":"Brooke Neumann ,&nbsp;Morgan Bou Zerdan ,&nbsp;Thammatat Vorawandthanachai ,&nbsp;Elizabeth Schlant ,&nbsp;Ibelle Madera ,&nbsp;Bhuchitra Singh","doi":"10.1016/j.ejogrb.2026.114998","DOIUrl":"10.1016/j.ejogrb.2026.114998","url":null,"abstract":"<div><div>The quality-of-life (QoL) impacts of benign gynecological conditions, such as polycystic ovarian syndrome (PCOS), endometriosis, and uterine fibroids on patients’ lives are underestimated. Upon analysis of the 36-Item Short Form Health Survey questionnaire (SF-36), which assesses physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health, benign gynecological conditions reveal comparable or worse QoL scores compared to QoL scores in other chronic conditions such as diabetes mellitus, breast cancer, and heart disease. The current medical care models focus majorly on physical symptoms and can sometimes fail to capture the full impact of these diseases on patients’ livelihood and well-being. The objective of this perspective paper was to analyze the utility of QoL-related PROMs in obtaining a holistic understanding of the impact of benign gynecological conditions on patients’ lives. QoL-related patient-reported outcome measures (PROMs) can be integrated into clinical practice with the goal of delivering comprehensive, patient-centered care for these diseases. The inclusion of QoL-related PROMs can help characterize a patient’s physical baseline, track improvement or worsening of symptoms throughout the diagnostic and therapeutic course (pre and post intervention. The inclusion of PROMs in patient care settings can facilitate efficient communication between patients and providers for a clinical interaction that is more holistic and patient centered.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"320 ","pages":"Article 114998"},"PeriodicalIF":1.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187289","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":"Letrozole-stimulated vs artificial hormone-replacement cycles for frozen-thawed embryo transfer in polycystic ovary syndrome: An updated systematic review and meta-analysis of randomized controlled trials","authors":"Carolina Alves Felippe ,&nbsp;Sinrraim dos Santos Chaves ,&nbsp;Deivyd Vieira Silva Cavalcante ,&nbsp;Giovana de Souza Gaio ,&nbsp;Rebeca Ferreira de Souza ,&nbsp;Helen Michaela de Oliveira","doi":"10.1016/j.ejogrb.2026.114999","DOIUrl":"10.1016/j.ejogrb.2026.114999","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"320 ","pages":"Article 114999"},"PeriodicalIF":1.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187477","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":"Placenta accreta spectrum: clinical and radiological follow-up after conservative management and maternal complications","authors":"S. Zullino ,&nbsp;E. Romani ,&nbsp;S. Ottanelli ,&nbsp;M. Vangelisti ,&nbsp;E. Gallucci ,&nbsp;F. Fanelli ,&nbsp;M. Micaglio ,&nbsp;F. Petraglia ,&nbsp;F. Mecacci","doi":"10.1016/j.ejogrb.2026.115002","DOIUrl":"10.1016/j.ejogrb.2026.115002","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of placenta accreta spectrum (PAS) has increased due to higher cesarean section rates and evolving risk factors, such as advanced maternal age. Conservative techniques offer alternatives to cesarean hysterectomy, aiming to reduce adverse outcomes and preserve fertility. However, data on maternal short- and long-term complications, particularly when placental residue is left in utero, remain limited, and follow-up protocols are unclear.</div></div><div><h3>Objectives</h3><div>This study evaluates the safety and effectiveness of a conservative strategy. For patients with placental residue, it assesses resolution through clinical and radiological follow-up and related maternal outcomes.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted at Careggi University Hospital, Florence, from 2019 to 2024. Of 45 PAS patients, 41 (91%) underwent conservative management. Among them, 23/41 had placental residue and underwent follow-up, while 18/41 had complete placental removal.</div></div><div><h3>Results</h3><div>The conservative management success rate was 92.6%. In 20/23 cases (86.9%) with placental residue, complete resorption occurred without major complications. Only 3/41 (7.3%) cases required delayed hysterectomy.</div></div><div><h3>Conclusions</h3><div>Conservative management is a feasible option for most PAS cases, but an experienced multidisciplinary team and careful patient selection are essential for optimal outcomes. When an adherent placental residue is left in utero, accurate clinical and radiological follow-up should be performed until complete resolution, which occurs in most cases.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"320 ","pages":"Article 115002"},"PeriodicalIF":1.9,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187476","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":"Impact of smoking or second-hand smoke exposure on metabolic and hormonal levels in women with polycystic ovary syndrome: A systematic review and meta-analysis","authors":"Ruyu Yan ,&nbsp;Dengxin He ,&nbsp;Wenru Xu ,&nbsp;Fen Yang ,&nbsp;Xinhong Zhu ,&nbsp;Lin Li","doi":"10.1016/j.ejogrb.2026.114973","DOIUrl":"10.1016/j.ejogrb.2026.114973","url":null,"abstract":"<div><h3>Background</h3><div>Evidence on the effects of smoking or second-hand smoke (SHS) exposure on metabolic and hormonal parameters in women with Polycystic Ovary Syndrome (PCOS) remains inconsistent. We systematically reviewed and meta-analyzed these associations.</div></div><div><h3>Methods</h3><div>Six databases (CNKI, PubMed, Web of Science, Cochrane Library, Ovid, EMBASE) were searched from inception to 24 April 2025 for observational studies reporting smoking/SHS exposure and ≥1 metabolic or hormonal outcome in PCOS patients. Study quality was assessed using the Newcastle-Ottawa and AHRQ scales. Random-effects models in Stata pooled SMD with 95% CI. Subgroup analyses evaluated SHS-only exposure; sensitivity analyses assessed robustness; publication bias was examined by funnel plots, Egger’s regression, and Begg’s test. Evidence certainty was graded using GRADE.</div></div><div><h3>Results</h3><div>Nine studies were included. Compared with non-exposed participants, smoking or SHS exposure was associated with higher Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) (<em>SMD</em> = 0.16, 95% <em>CI</em> [0.05, 0.27]), Triglyceride (TG) (<em>SMD</em> = 0.25, 95% <em>CI</em> [0.08, 0.42]), Low-Density Lipoprotein Cholesterol (LDL-C) (<em>SMD</em> = 0.16, 95% <em>CI</em> [0.003, 0.33]), Total Testosterone (TT) (<em>SMD</em> = 0.21, 95% <em>CI</em> [0.12, 0.29]) and Free Androgen Index (FAI) (<em>SMD</em> = 0.34, 95% <em>CI</em> [0.14, 0.53]), and lower High-Density Lipoprotein Cholesterol (HDL-C) (<em>SMD</em> = −0.15, 95% <em>CI</em> [-0.25, −0.05]) and Sex Hormone-Binding Globulin (SHBG) (<em>SMD</em> = −0.19, 95% <em>CI</em> [-0.34, −0.04]) (<em>P</em> &lt; 0.05). No significant difference was found in Luteinizing Hormone to Follicle-Stimulating Hormone Ratio (LH/FSH). TG and TT associations persisted in SHS-only groups, whereas HOMA-IR, HDL-C, FAI, and SHBG differences were mainly driven by active smoking. Findings were robust, with no publication bias; GRADE certainty was “very low”.</div></div><div><h3>Conclusion</h3><div>Smoking or SHS exposure was significantly associated with metabolic and hormonal profiles in women with PCOS. Despite observational limitations and absent e-cigarette data, the evidence supports advising PCOS patients to avoid smoking and SHS exposure. Registration: CRD42025633516.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114973"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076483","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":"Expression of concern \"Maternal and neonatal copeptin levels at caesarean section and vaginal delivery\". [Eur. J. Obstet. Gynecol. Reprod. Biol. 165/2 (2012) 215-218].","authors":"Ashraf A Foda, Ibrahim A Abdel Aal","doi":"10.1016/j.ejogrb.2026.114972","DOIUrl":"10.1016/j.ejogrb.2026.114972","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"114972"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776302","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":"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":"Comparative accuracy of mid-thigh soft tissue thickness and the hadlock formula in fetal weight estimation during the third trimester: A prospective cross-sectional study","authors":"Mona Saad Salman ,&nbsp;Ahmed Nagy Shaker ,&nbsp;Mai Mosad Abdelghany Morsy ,&nbsp;Heba Hassan Zeid ,&nbsp;Mohamed Raslan ,&nbsp;Sally Alaa El Dien Ibrahim El Attar ,&nbsp;Ahmed Emad Abd El Tawwab","doi":"10.1016/j.ejogrb.2026.114969","DOIUrl":"10.1016/j.ejogrb.2026.114969","url":null,"abstract":"<div><h3>Background</h3><div>Accurate fetal weight estimation is crucial in prenatal care to prevent complications related to low birth weight or macrosomia. Conventional methods such as the Hadlock formula, based on biometric parameters, may lack accuracy, especially at weight extremes. Mid-thigh soft tissue thickness (MTSTT) has emerged as a promising, reproducible parameter for improved fetal weight estimation. This study aimed to compare the accuracy of mid-thigh soft tissue thickness (MTSTT) and the Hadlock formula in fetal weight estimation during the third trimester of pregnancy.</div></div><div><h3>Methods</h3><div>A prospective cross-sectional study was conducted on 300 term singleton pregnancies at Hospital (2023–2025). Standard fetal biometric parameters were measured using ultrasound, and estimated fetal weight (EFW) was calculated via both Hadlock and MTSTT-based formulas. Actual birth weight was recorded post-delivery. Correlations, error analysis, and ROC curves were used to compare predictive accuracy.</div></div><div><h3>Results</h3><div>EFW using the MTSTT model showed a stronger correlation with Actual birth weight (r = 0.956, r² = 0.914) compared to the Hadlock method (r = 0.778, r² = 0.610). MTSTT-based estimation demonstrated higher accuracy, with 74 % of values within 5 % of Actual birth weight and an AUC of 0.992 for predicting macrosomia. Superior diagnostic performance was consistent across all birth weight categories.</div></div><div><h3>Conclusion</h3><div>MTSTT is a highly accurate and clinically feasible tool for fetal weight estimation. It outperforms the Hadlock formula, especially in extreme weight categories, and offers a reproducible alternative for routine obstetric practice.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114969"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099763","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}