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

{"title":"Single-port robotic versus conventional laparoscopic vNOTES hysterectomy: a propensity score-matched comparison of surgical outcomes and literature review","authors":"Kiyoshi Kanno,&nbsp;Ryo Taniguchi,&nbsp;Naofumi Higuchi,&nbsp;Tomoka Kashiwabara,&nbsp;Yuto Onishi,&nbsp;Taisuke Iwata,&nbsp;Yudai Sawai,&nbsp;Sayaka Masuda,&nbsp;Hiroshi Onji,&nbsp;Yoshifumi Ochi,&nbsp;Yoshiko Kurose,&nbsp;Mari Sawada,&nbsp;Shiori Yanai,&nbsp;Tsutomu Hoshiba,&nbsp;Masaaki Andou","doi":"10.1016/j.ejogrb.2025.114757","DOIUrl":"10.1016/j.ejogrb.2025.114757","url":null,"abstract":"<div><h3>Purpose</h3><div>Robotic-assisted (RA) surgery has gained traction for transvaginal natural orifice transluminal endoscopic surgery (vNOTES) and has been applied across a range of gynecologic procedures. The da Vinci SP (SP) system, a recently developed single-port robotic platform, was designed to advance minimally invasive surgery, enabling precise surgery in deep, narrow spaces, such as the vagina. However, perioperative outcomes of RA-vNOTES hysterectomy using SP vaginal-assisted NOTES hysterectomy (SP-VANH) have not been compared with those of conventional laparoscopic (CL)-VANH.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted involving 184 patients who underwent VANH between January 2023 and December 2024. After propensity score matching (PSM), 130 patients (1:1 ratio) were included in the analysis. Perioperative outcomes were compared between the SP-VANH and CL-VANH. Potential confounding bias related to patient characteristics was minimized through the PSM analysis.</div></div><div><h3>Results</h3><div>The mean operative time, estimated blood loss, hemoglobin drop, length of postoperative hospital stay, perioperative complications, and visual analog score (VAS) for postoperative pain at 24 h were 75.4 vs. 83.8 min (p = 0.05), 94.5 vs. 82.2 mL (p = 0.60), −1.2 vs. −1.3 g/dL (p = 0.60), 4.0 vs. 4.0 days (p = 0.72), 4.6 vs. 0 % (p = 0.24), and 16.1 vs. 17.5 mm (p = 0.68) for the SP-VANH and CL-VANH groups, respectively, with no significant differences. All cases in both groups were completed without requiring blood transfusions or conversion to laparotomy or transabdominal laparoscopy.</div></div><div><h3>Conclusion</h3><div>SP-VANH offers a safe and feasible alternative to CL-VANH for the surgical management of benign gynecologic conditions.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114757"},"PeriodicalIF":1.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257514","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":"Sonographic characteristics associated with early pregnancy loss in pregnancies conceived via in vitro fertilization","authors":"Nguyen Thao Thi Nguyen ,&nbsp;Lester Watch ,&nbsp;Carmen Rauh Garrido ,&nbsp;Alexandra Bickett ,&nbsp;Shakthi Unnithan ,&nbsp;Tracy Truong ,&nbsp;Alaattin Erkanli ,&nbsp;Shelby Neal","doi":"10.1016/j.ejogrb.2025.114759","DOIUrl":"10.1016/j.ejogrb.2025.114759","url":null,"abstract":"<div><h3>Research Question</h3><div>Can gestational age–based sonographic criteria with near 100% positive predictive value (PPV) for early pregnancy loss (EPL) be established in pregnancies conceived via in vitro fertilization (IVF)?</div></div><div><h3>Design</h3><div>A retrospective cohort study was conducted at a single academic IVF clinic, including all patients with a positive pregnancy test following embryo transfer between 2014 and 2021. Logistic regression assessed associations between gestational age and presence of sonographic markers (gestational sac, embryo, cardiac activity) with EPL. Youden’s Index identified optimal gestational age cut-points for each marker.</div></div><div><h3>Results</h3><div>The study included 913 patients (mean age 35.5 ± 4.8 years; mean BMI 27.6 ± 6.5 kg/m²). Most underwent frozen single embryo transfer at the blastocyst stage; 15.1 % had preimplantation genetic testing for aneuploidy (PGT-A). Outcomes included 727 live births (79.6 %), 176 EPLs (19.3 %), 3 stillbirths, and 7 terminations. Absence of a gestational sac or embryo by 44 days, or cardiac activity by 46 days, yielded PPVs for EPL of 100 %, 100 %, and 97 %, respectively. Logistic regression confirmed increased odds of EPL with absent markers at the specified gestational age cut-points: absence of a gestational sac at 44 days (OR 5.52, 95 % CI [3.40–8.94]), absence of an embryo at 44 days (OR 5.88, CI [3.64–9.49]), and absence of cardiac activity at 46 days (OR 2.86, CI [1.99–4.12]).</div></div><div><h3>Conclusions</h3><div>In IVF pregnancies, known gestational age may allow for earlier diagnosis of EPL, as compared to traditional criteria, which are based upon sonographic markers alone. Larger studies are needed to validate these proposed criteria and compare them to traditional criteria for diagnosis of EPL.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114759"},"PeriodicalIF":1.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269578","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":"Ending preventable maternal deaths in Europe – Position statement of the European Board and College of Obstetrics and Gynaecology (EBCOG)","authors":"Mehreen Zaigham ,&nbsp;Frank Louwen ,&nbsp;Sambit Mukhopadhyay ,&nbsp;Tahir Mahmood","doi":"10.1016/j.ejogrb.2025.114750","DOIUrl":"10.1016/j.ejogrb.2025.114750","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114750"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250471","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":"Obstructive sleep apnea in pregnancy: Nationwide assessment of obstetric characteristics and maternal morbidity at delivery","authors":"Jennifer A. Yao ,&nbsp;Fay F. Pon ,&nbsp;Genevieve R. Mazza ,&nbsp;Zaira N. Chavez Jimenez ,&nbsp;Shinya Matsuzaki ,&nbsp;Rachel S. Mandelbaum ,&nbsp;Joseph G. Ouzounian ,&nbsp;Koji Matsuo","doi":"10.1016/j.ejogrb.2025.114753","DOIUrl":"10.1016/j.ejogrb.2025.114753","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Obstructive sleep apnea (OSA) is associated with cardiovascular, metabolic, and psychiatric conditions in the general population. Less is known about the significance of OSA during pregnancy. The objective of this study was to assess the obstetric characteristics and maternal morbidity associated with OSA during pregnancy at a national scale.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This cross-sectional study queried the Healthcare Cost and Utilization Project’s National Inpatient Sample in the United States of America. The study population was 18,056,390 hospital deliveries from 2016 to 2020. OSA was identified using the International Classification of Disease Tenth Revision Clinical Modification code G47.33 (&lt;em&gt;n&lt;/em&gt; = 22,360). Severe maternal morbidity per the Centers for Disease Control and Prevention definitions was assessed in an &lt;em&gt;N&lt;/em&gt;-to-1 propensity score-matched cohort based on pre-pregnant characteristics followed by adjustment for pregnancy confounders in a binary logistic regression model. Patterns of clinical demographics related to OSA were assessed with a classification-tree model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The coded prevalence of pregnant patients with OSA was 12.4 per 10,000, which increased from 8.5 to 16.6 over a 5-year period (&lt;em&gt;P-trend&lt;/em&gt; &lt; 0.001). Patients with OSA were more likely to have a diagnosis of obesity (69.7 % vs 11.4 %, adjusted-odds ratio [aOR] 9.97, 95 % confidence interval [CI] 9.67–10.28), asthma (28.0 % vs 5.2 %, aOR 3.19, 95%CI 3.09–3.29), pre-gestational hypertension (24.8 % vs 2.8 %, aOR 2.77, 95%CI 2.68–2.87), and polycystic ovary syndrome (5.6 % vs 0.7 %, aOR 2.58, 95%CI 2.42–2.74). In the classification-tree model, the coded prevalence rate of OSA increased to 571.4 per 10,000 among pregnant patients with obesity, asthma, and pre-gestational hypertension. In the matched cohort, pregnancy with OSA was associated with gestational hypertension (11.4 % vs 8.7 %, aOR 1.47, 95%CI 1.38–1.57), pre-eclampsia (28.2 % vs 14.7 %, aOR 1.92, 95%CI 1.82–2.02), gestational diabetes (20.1 % vs 13.9 %, aOR 1.45, 95%CI 1.38–1.53), placenta accreta spectrum (0.6 % vs 0.2 %, aOR 1.94, 95%CI 1.35–2.79), extreme preterm delivery (26–33 weeks, 9.3 % vs 4.9 %, aOR 1.53, 95%CI 1.41–1.67), and cesarean delivery (62.3 % vs 50.4 %, aOR 1.42, 95%CI 1.37–1.48). The odds of severe maternal morbidity at delivery was increased in pregnant patients with OSA (6.7 % vs 1.9 %, aOR 2.51, 95%Cl 2.24–2.81), particularly for respiratory morbidity indicators including maternal ventilation (0.8 % vs &lt; 0.1 %, aOR 7.25, 95%CI 4.54–11.56), acute respiratory distress syndrome (2.3 % vs 0.3 %, aOR 4.97, 95%CI 3.88–6.36), and pulmonary edema including acute heart failure (2.0 % vs 0.4 %, aOR 4.06, 95%CI 3.19–5.18). In addition, the odds of peripartum cardiomyopathy increased by nearly seven-fold for the OSA vs non-OSA group (0.6 % vs &lt; 0.1 %, aOR 6.62, 95%CI 3.86–11.36).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclus","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114753"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257578","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":"Biostimulation with polynucleotide cream during adjuvant therapy for breast cancer","authors":"Giada Lavitola ,&nbsp;Virginia Foreste ,&nbsp;Danilo Borrelli ,&nbsp;Claudia Di Filippo ,&nbsp;Francesca Corace ,&nbsp;Giuseppe Bifulco","doi":"10.1016/j.ejogrb.2025.114754","DOIUrl":"10.1016/j.ejogrb.2025.114754","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of a polynucleotide-based vaginal cream for the treatment of genitourinary syndrome of menopause (GSM) in breast cancer patients receiving adjuvant therapy.</div></div><div><h3>Methods</h3><div>A prospective, single-arm longitudinal study was conducted at the University of Naples Federico II. Sixty women with breast cancer and GSM were treated with a polynucleotide-based vaginal cream for 6 months according to a standardized regimen. Clinical and patient-reported outcomes were assessed at baseline, 1 month, and 6 months. Endpoints included the Vaginal Health Index (VHI), Vulvar Assessment Score (VuAS), Vaginal Assessment Score (VAS), Female Sexual Function Index–6 (FSFI-6), International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF), and global patient satisfaction.</div></div><div><h3>Results</h3><div>Of the 60 women enrolled (mean age 50.6 ± 7.0 years), 53 completed the study. At 6 months, the mean VHI increased from 11.9 ± 2.3 to 17.6 ± 2.4, while the VAS and VuAS decreased from 6.3 ± 2.0 to 2.3 ± 1.1 and from 4.7 ± 2.0 to 1.4 ± 1.5, respectively (all p &lt; 0.001). Dyspareunia, vaginal dryness, and vulvar itching were significantly improved. Mild improvements were also observed in sexual function and urinary symptoms. The treatment was well tolerated, with no serious adverse events reported.</div></div><div><h3>Conclusion</h3><div>For breast cancer survivors receiving adjuvant therapy, polynucleotide-based vaginal cream is a well-tolerated, non-hormonal option that effectively manages GSM.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114754"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250404","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":"Paternal exposure to antidiabetic medications during reproductive period and adverse birth outcomes: A meta-analysis and systematic review","authors":"Caroline Saabye Simonsen ,&nbsp;Michael L. Eisenberg ,&nbsp;Rune Lindahl-Jacobsen","doi":"10.1016/j.ejogrb.2025.114747","DOIUrl":"10.1016/j.ejogrb.2025.114747","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes affected approximately 6% of all adults globally in 2021, and the use of antidiabetic medications is expected to increase among men of reproductive age. The impact of paternal exposure to these medications during spermatogenesis on offspring is still unclear.</div></div><div><h3>Objective</h3><div>To review the association between paternal use of antidiabetic medications during spermatogenesis and adverse birth outcomes.</div><div><em>Data sources:</em> On 27 January 2025, a systematic search of Medline, Embase and Cochrane libraries was conducted without restriction on publication year, supplemented by a manual search.</div><div><em>Study selection and synthesis:</em> Population-based studies examining paternal preconception exposure to antidiabetic medications compared with non-exposed fathers were included. Study quality and validity were assessed using the MOOSE guidelines, and synthesis used fixed- and random-effects models. The Oxford Centre for Evidence-Based Medicine and risk-of-bias tools were also used.</div><div><em>Main outcome:</em> Congenital malformations.</div></div><div><h3>Results</h3><div>Of 2859 studies identified, four met the inclusion criteria. Two studies (2,435,462 births analysed) linked metformin to congenital malformations [adjusted odds ratio (aOR) 1.40, 95 % confidence interval (CI) 1.08–1.82; <em>p</em> = 0.012; adjusted hazard ratio 1.4, 95 % CI 1.11–1.76]. The common-effect model for metformin and congenital malformations was non-significant (aOR 1.05, 95 % CI 0.95–1.17) with high heterogeneity (<em>I</em>² = 76.9 %) (<em>p</em> = 0.0017).</div><div>Conclusion and relevance.</div><div>Paternal use of metformin during spermatogenesis was not consistently associated with congenital malformations based on low-certainty evidence. Further studies should investigate polytherapy and poorly controlled diabetes as risk factors for adverse birth outcomes.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114747"},"PeriodicalIF":1.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218185","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":"Evaluation of serum-based inflammatory and haematological markers in patients with endometriosis: A case–control study","authors":"Dilara Sarikaya Kurt ,&nbsp;Arife Akay ,&nbsp;Can Ozan Ulusoy ,&nbsp;Ahmet Kurt ,&nbsp;Gülşan Karabay ,&nbsp;Hüseyin Levent Keskin","doi":"10.1016/j.ejogrb.2025.114751","DOIUrl":"10.1016/j.ejogrb.2025.114751","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the diagnostic value of serum-based inflammatory and haematological markers in women with endometriosis, and determine their relationship with disease severity, including lesion characteristics.</div></div><div><h3>Materials and methods</h3><div>This prospective study included 103 patients with endometriosis (aged 18–45 years) and 103 healthy controls. Serum C-reactive protein (CRP), albumin and complete blood counts were obtained pre-operatively, and inflammatory markers [neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, neutrophil-to-platelet ratio (NPAR), CRP-to-albumin ratio (CAR), systemic inflammation index (SII), systemic inflammatory response index (SIRI) and pro-inflammatory index (PIV)] were calculated. Surgical evaluation (laparoscopy/laparotomy) provided histopathological confirmation of endometriosis. The 1996 revised American Society for Reproductive Medicine (rASRM) classification was used for staging. Statistical analyses used <em>t</em>-tests, Mann–Whitney <em>U</em>-tests, Chi-squared tests, Spearman’s correlation, and linear regression modelling. <em>p</em> &lt; 0.05 was considered to indicate significance.</div></div><div><h3>Results</h3><div>Compared with controls, patients with endometriosis had lower white blood cell (7.28 vs 8.43 × 10³/mm³; <em>p</em> &lt; 0.001), neutrophil (4.17 vs 5.09 × 10³/mm³; <em>p</em> &lt; 0.001) and CRP (2.45 vs 3.34 mg/l; <em>p</em> = 0.008) levels, but higher haemoglobin (12.8 vs 11.9 g/dl; <em>p</em> = 0.001) and haematocrit (40.5 % vs 38.1 %; <em>p</em> &lt; 0.001) levels. NPAR (1.38 vs 1.48; <em>p</em> &lt; 0.001), SII (539 vs 737; <em>p</em> &lt; 0.001), SIRI (1004 vs 1337; <em>p</em> &lt; 0.001), PIV (302 vs 422; <em>p</em> &lt; 0.001), CAR (0.061 vs 0.079; <em>p</em> = 0.008) and NLR (1.89 vs 2.44; <em>p</em> &lt; 0.001) were also significantly lower in patients with endometriosis. Postoperatively, NLR, SIRI, PIV and NPAR increased (<em>p</em> &lt; 0.05). Receiver operating characteristic curve analysis indicated moderate diagnostic performance for neutrophil percentage, NLR, SII, SIRI and PIV. On multi-variate analysis, bilaterality (<em>p</em> &lt; 0.001) and area of endometriomas (<em>p</em> = 0.020) correlated with rASRM score.</div></div><div><h3>Conclusion</h3><div>Serum inflammatory markers reflect systemic immune changes in endometriosis. Although they offer diagnostic insights, lesion bilaterality and size remain stronger predictors of disease severity. Larger, multi-centre studies are needed to refine cut-off values and optimize clinical application of these markers.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114751"},"PeriodicalIF":1.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218235","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":"Changing trends in caesarean section rate in Ireland’s four largest maternity hospitals 2015–2021: which groups account for the rising caesarean section rate?","authors":"Charles Leahy ,&nbsp;Richard Greene ,&nbsp;Joye McKernan","doi":"10.1016/j.ejogrb.2025.114749","DOIUrl":"10.1016/j.ejogrb.2025.114749","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyse the changing trends in Caesarean Section (CS) rates in Ireland’s four largest maternity hospitals between 2015 and 2021, utilizing the Robson Ten Group Classification System (TGCS).</div></div><div><h3>Methods</h3><div>This retrospective cohort study reviewed 221,098 deliveries from Cork University Maternity Hospital, The National Maternity Hospital, Rotunda Hospital, and The Coombe Hospital, spanning from 2015 to 2021. Data, collected by each individual hospital and submitted to the National Perinatal Audit Centre (NPEC), was combined into a single dataset. Statistical analysis was performed using linear regression to identify trends in CS rates and group contributions according to the TGCS. Pearson’s coefficient was employed to assess statistical significance.</div></div><div><h3>Results</h3><div>The overall CS rate significantly increased from 30.13 % in 2015 to 35.89 % in 2021 (p = 0.001). The primary drivers of this increase, accounting for over 90 % of the rise, were Group 2 and Group 5. Group 5 demonstrated a statistically significant increase in its Caesarean Section rate by 6.52 % (p = 0.001). Additionally, Group 10 (preterm birth) showed a significant increase in its Caesarean Section rate by 8 % (p = 0.046). Changes in Caesarean Section rates within other TGCS groups were not statistically significant.</div></div><div><h3>Conclusion</h3><div>The rising Caesarean Section rate in Ireland’s largest maternity hospitals is predominantly influenced by an increasing proportion of Group 2 and Group 5 overall and a higher Caesarean Section rate in Group 5. Targeted interventions aimed at reducing the overall CS rate should focus on these specific groups, potentially through optimizing induction practices, promoting shared decision-making regarding pre-labour Caesarean Section.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114749"},"PeriodicalIF":1.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218234","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":"Implementation of enhanced recovery after surgery in gynaecologic oncology surgery: where should we start?","authors":"Koray Aslan ,&nbsp;Mükiye Kabakçi ,&nbsp;Tuba Zengin Aksel ,&nbsp;Menşure Kaya ,&nbsp;Funda Atalay","doi":"10.1016/j.ejogrb.2025.114752","DOIUrl":"10.1016/j.ejogrb.2025.114752","url":null,"abstract":"<div><h3>Purpose</h3><div>Compliance with elements of an enhanced recovery after surgery (ERAS) protocol is associated with better outcomes, including decreased length of hospital stay (LHS), but complete implementation is challenging. This study aimed to identify the role of individual ERAS elements on LHS to facilitate the implementation process.</div></div><div><h3>Methods</h3><div>This retrospective single-centre study included 233 women with gynaecological cancers who underwent surgery between 1 February 2021 and 31 July 2023. The first 120 consecutive patients after implementation of the ERAS programme were defined as the ERAS group, and the other patients were in the pre-ERAS group. The groups were compared in terms of LHS. Univariate and multi-variate analyses were used to define independent predictors of decreased LHS (≤5 days).</div></div><div><h3>Results</h3><div>The median LHS was 6 [interquartile range (IQR) 1–29] days for the ERAS group and 7 (IQR 3–23) days for the pre-ERAS group (<em>p</em> = 0.006). Avoidance of mechanical bowel preparation (<em>p</em> = 0.007), avoidance of surgical site drainage (<em>p</em> &lt; 0.001), removal of urinary drainage before postoperative day 3 (<em>p</em> = 0.02), regular diet initiation on postoperative day 0 (<em>p</em> = 0.02), and reduction in total opioid dose (<em>p</em> = 0.006) were significantly associated with LHS ≤ 5 days on univariate analysis. On multi-variate analysis, avoidance of surgical site drainage (<em>p</em> = 0.014), removal of urinary drainage before postoperative day 3 (<em>p</em> = 0.037), and reduction in total opioid dose (<em>p</em> = 0.045) remained significant for LHS ≤ 5 days.</div></div><div><h3>Conclusion</h3><div>Avoidance of surgical site drainage, removal of urinary drainage before postoperative day 3, and reduction in total opioid dose were found to be independent predictors of decreased LHS among ERAS items. Special consideration should be given to these items during the adoption of ERAS programmes.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114752"},"PeriodicalIF":1.9,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145218127","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":"Studying medicine – Does it influence the choice of contraceptive method?","authors":"Jan Pietruszka ,&nbsp;Maria Szewczyk ,&nbsp;Maciej Taraszkiewicz-Sirocki ,&nbsp;Maciej Walędziak ,&nbsp;Anna Różańska-Walędziak","doi":"10.1016/j.ejogrb.2025.114748","DOIUrl":"10.1016/j.ejogrb.2025.114748","url":null,"abstract":"<div><h3>Introduction</h3><div>Choosing a contraceptive method is an important aspect of sexual life. However, it can be a difficult decision due to insufficient knowledge about the physiology of the menstrual cycle and different methods of contraception. This raises the question of whether female medical students, who should have greater knowledge in this area, choose different contraceptive methods compared with non-medical students.</div></div><div><h3>Aim</h3><div>To examine contraceptive preferences in female students, and establish whether their field of study affects these preferences.</div></div><div><h3>Materials and methods</h3><div>This study included 414 female students: 189 from non-medical faculties, 122 from medical and dental faculties, and 103 from other medical faculties. The inclusion criteria for the study were: female gender; age ≥18 years; student status; informed consent to participate in the study; and completion of the questionnaire. Failure to meet any of the inclusion criteria resulted in exclusion from the study. Data were obtained through an anonymous survey created on the Google Forms platform, consisting of 16 questions. The questionnaire was distributed to potential female respondents via social media, and was open from 3 October 2023 to 3 December 2023.</div></div><div><h3>Results</h3><div>Barrier methods of contraception were used most commonly [264 respondents (63.78 %)], regardless of field of study, and the least commonly used method of contraception, chosen by only three respondents (0.72 %), was the hormone-free intrauterine device. When divided into three groups according to field of study, as in the survey, no significant correlation was found between field of study and preferred contraceptive method. However, when divided into two fields of study (combining medical and dental faculties with other medical faculties in one group), a significant correlation was found between field of study and the use of combined oral contraceptives containing oestrogens and progestins, which was more popular among medical students compared with non-medical students (33.3 % vs 24.3 %).</div></div><div><h3>Conclusions</h3><div>The influence of field of study on preferred contraceptive method is limited, possibly due to the fact that the majority of students, regardless of their field of study, obtain their knowledge about contraception from the internet – 48.9 % of medical students and 58.2 % of non-medical students. In comparison, 12.4 % of medical students but only 1.1 % of non-medical students reported obtaining their knowledge about contraception from lectures at university.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"315 ","pages":"Article 114748"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250479","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}