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

{"title":"Another link in the chain- Diet, digestive health, and pelvic floor integrity: A cross-cultural study","authors":"Reut Rotem ,&nbsp;Michal Ovadia ,&nbsp;Barry A. O’Reilly ,&nbsp;Orfhlaith E. O’Sullivan ,&nbsp;Yael Yagur ,&nbsp;Ron Schonman ,&nbsp;Nissim Arbib ,&nbsp;Zvi Klein ,&nbsp;Yair Daykan","doi":"10.1016/j.ejogrb.2025.03.019","DOIUrl":"10.1016/j.ejogrb.2025.03.019","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the association between impaired bowel function (IBF), diet and their collective impact on the incidence of different pelvic organ prolapse (POP) compartments.</div></div><div><h3>Study design</h3><div>This cross-sectional, international, multi-center study was conducted among patients undergoing pelvic floor repair in Ireland and Israel. Adherence to the Mediterranean diet and the presence of IBF were assessed using validated questionnaires (The Mediterranean Diet Adherence Questionnaire and the Patient Assessment of Constipation Symptoms, respectively). General demographic information, clinical details, and intraoperative data were extracted from the electronic medical records in each hospital. A univariate analysis was followed by a multivariate one, and correlations were assessed using Spearman’s rho coefficient.</div></div><div><h3>Results</h3><div>Among the 204 patients enrolled, 105 (51.5 %) were categorized into the IBF group, and 99 (48.5 %) into the NBF group. There was no difference in age, parity, body mass index and obesity rate between groups. Patients in the IBF group were more often nullipara (1 % Vs. 8.1 %, p = 0.01) and exhibited significantly lower rates of adherence to the Mediterranean diet than the NBF group (22.0 % vs. 70.5 %, p = 0.01). Cystocele, cul-de-sac (enterocele), and genital hiatus prolapse were more prevalent in the IBF group. The distribution of surgical repair procedures was similar between the two groups. Multivariate logistic regression analysis revealed a significant association between surgical repair involving the anterior wall and low adherence to the Mediterranean diet.</div></div><div><h3>Conclusion</h3><div>This study suggests that IBF and constipation shows specific patterns of vaginal wall prolapse as cystocele and enterocele, underscoring the importance of dietary habits in the prevention and management of pelvic floor disorders.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 222-227"},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609184","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":"Comparison of single-site and three-port hysterectomy for benign uterine diseases: A randomised trial (LESS-H)","authors":"Ok-Ju Kang,&nbsp;Joo-Hyun Nam,&nbsp;Jeong-Yeol Park","doi":"10.1016/j.ejogrb.2025.03.005","DOIUrl":"10.1016/j.ejogrb.2025.03.005","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility and safety of laparoendoscopic single-site (LESS) vaginal hysterectomy compared to conventional three-port laparoscopic-assisted vaginal hysterectomy (LAVH) for benign and pre-invasive uterine disease.</div></div><div><h3>Methods</h3><div>We conducted a prospective randomized controlled trial that included patients who were scheduled to undergo hysterectomy using laparoscopic surgery for the benign and pre-invasive uterine diseases. The primary endpoint was to compare the ratio of patients discharged within 2 days after surgery between LESS LAVH and three-port LAVH groups.</div></div><div><h3>Results</h3><div>A total of 428 patients were randomised to the LESS group (n = 216) and the conventional group (n = 212). The two groups did not show significant differences in the proportion of patients discharged within two days after surgery (LESS vs. three-port, 93 % vs. 90 %, <em>P</em> = 0.277). There were also no significant differences in operating time, hemoglobin change, average length of postoperative hospital stay and perioperative complications. While the visual analogue score (VAS) pain score during hospital stay was similar between the two groups, the pain score at the first outpatient visit (2 weeks after surgery) was significantly lower in the LESS group (LESS vs. three-port, 3.29 vs. 3.93, <em>P</em> = 0.012).</div></div><div><h3>Conclusions</h3><div>Although LESS LAVH was not superior to conventional multiport surgery, it is a feasible, safe procedure for managing benign and pre-invasive uterine diseases.</div></div><div><h3>Trial registration</h3><div><span><span>Clinicaltrial.gov</span><svg><path></path></svg></span> identifier number: NCT01679548, <span><span>https://clinicaltrials.gov/study/NCT01679548</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 251-256"},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619646","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":"Workforce wellbeing in European Healthcare: Challenges and strategic actions based on a questionnaire-based study by the European Board and College of Obstetrics and Gynaecology.","authors":"Sofia Tsiapakidou, Sambit Mukhopadhyay, Frank Louwen, Tahir Mahmood, Jure Klanjscek, Stergios K Doumouchtsis","doi":"10.1016/j.ejogrb.2025.03.029","DOIUrl":"https://doi.org/10.1016/j.ejogrb.2025.03.029","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633874","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":"Seizure prediction in pregnant women with epilepsy: An umbrella review of clinical practice guidelines and systematic reviews","authors":"Fatima Junaid ,&nbsp;Bethan Davies ,&nbsp;Saba Tariq ,&nbsp;Javier Zamora ,&nbsp;Ngawai Moss ,&nbsp;Mairead Black ,&nbsp;Amie Wilson ,&nbsp;Judith Dyson ,&nbsp;Annalise Weckesser ,&nbsp;John Craig ,&nbsp;Rebecca Bromley ,&nbsp;Shakila Thangaratinam ,&nbsp;John Allotey","doi":"10.1016/j.ejogrb.2025.03.022","DOIUrl":"10.1016/j.ejogrb.2025.03.022","url":null,"abstract":"<div><h3>Objective</h3><div>To identify risk factors for seizure in pregnant women, and in the general population with epilepsy.</div></div><div><h3>Study design</h3><div>Umbrella review of clinical practice guidelines and systematic reviews on risk factors or prediction models for seizure occurrence in pregnant women with epilepsy, adults with epilepsy, or all individuals with epilepsy. Guidelines or systematic reviews exclusively for children were excluded. We searched MEDLINE, Emcare, Embase, CINAHL, TRIP PRO, Epistemonikos, World Health Organisation, Guideline International Network, DANS, and grey literature (2000-2023) without language restrictions. Risk factors or predictors listed in the final guidelines or systematic reviews were collated and thematically analysed.</div></div><div><h3>Results</h3><div>From 3406 citations, we included 13 articles (ten guidelines, three systematic reviews) reporting 26 risk factors in pregnant women and the general adult population with epilepsy: eight factors in guidelines for pregnant women only; five in both pregnant women and general adult populations (four in both guidelines and systematic reviews, one in guidelines only); and 13 factors in the general adult population (four in both guidelines and systematic reviews, eight in guidelines, and one in a systematic review). Risk factors were categorised into five broad themes: seizure type; seizure control; anti-seizure medication; neurological; and epilepsy and medical history. Three risk factors for seizure ocurrence were cited in more than two guidelines or systematic reviews: seizure freedom (reduced risk), immediate initiation of anti-seizure medication after first seizure (reduced risk), and abnormal electroencephalogram (increased risk). Three risk factors were linked to a more than two-fold chance of seizures in pregnant women with epilepsy: tonic-clonic seizures in the last three months (RR 7.20, 95% CI 6.63-11.93), a history of non-tonic-clonic seizures (RR 2.11, 95% CI 1.88—2.62), and seizures in the pre-pregnancy year compared to no seizures (RR 3.51, 95% CI 3.13-3.94).</div></div><div><h3>Conclusion</h3><div>Multiple risk factors have been recommended for use in practice across different guidelines and reviews to identify those at increased risk of seizures in the adult population with epilepsy, and specifically in pregnant women with epilepsy. Further research is needed on the implementation of tools for predicting seizures to improve maternal and neonatal outcomes.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 241-250"},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619645","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":"Posterior mesh fixation versus non-fixation in sacrocolpopexy: A randomized clinical trial","authors":"Jasmine Di Biasi ,&nbsp;Stefania Ruggieri ,&nbsp;Chiara Taccaliti ,&nbsp;Michela Ciocca ,&nbsp;Christian Di Florio ,&nbsp;Guglielmo Stabile ,&nbsp;Paola Catana ,&nbsp;Matteo Bruno ,&nbsp;Maurizio Guido","doi":"10.1016/j.ejogrb.2025.03.025","DOIUrl":"10.1016/j.ejogrb.2025.03.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Urogenital prolapse affects up to 50% of women, and its treatment is essential for improving quality of life. Laparoscopic sacrocolpopexy is considered the gold standard, but there is no consensus on the optimal surgical approach. This study tests the hypothesis that the absence of posterior mesh fixation is non-inferior to its fixation.</div></div><div><h3>Materials and Methods</h3><div>We conducted a randomized, single-blinded, monocentric, non-inferiority trial in Italy (NCT04358978). In Group A, the posterior mesh was placed without fixation, while in Group B, it was fixed to the rectovaginal fascia and levator ani muscle. The primary outcome was the correction of prolapse, with secondary outcomes including intraoperative parameters, postoperative characteristics, and urogenital prolapse correction at 1, 6 and 12, months, as well as long-term morbidity.</div></div><div><h3>Results</h3><div>120 women were randomized into two groups with no significant differences. At 12 months, both groups reported no bulge symptoms, and pelvic pain was 3,3 %. Urinary dysfunction decreased in both groups, with a reduction in de novo incontinence (Group A: 1.6 %, Group B: 3.3 %) and persistent incontinence (Group A: 0 %, Group B: 7 %). Persistent constipation at 12 months was 3.3 % in Group A and 13 % in Group B. No cases of obstructed defecation or mesh erosion were observed. Five cases of failure (8.3 %) were reported in both groups, defined as Ba point reaching the hymen.</div></div><div><h3>Conclusions</h3><div>The absence of posterior mesh fixation is non-inferior to fixation in laparoscopic sacrocolpopexy in terms of treatment success and postoperative complications.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"309 ","pages":"Pages 1-6"},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628944","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 relationship between platelet indices and hypertensive disorders of pregnancy","authors":"Myah M. Griffin ,&nbsp;Christina A. Penfield ,&nbsp;Anaïs Hausvater ,&nbsp;Ariel Schaap ,&nbsp;Ashley S. Roman ,&nbsp;Yuhe Xia ,&nbsp;Dana R. Gossett ,&nbsp;Gwendolyn P. Quinn ,&nbsp;Jeffrey S. Berger","doi":"10.1016/j.ejogrb.2025.03.014","DOIUrl":"10.1016/j.ejogrb.2025.03.014","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the relationship between platelet indices (count, size and production/immaturity) and hypertensive disorders of pregnancy.</div></div><div><h3>Study Design</h3><div>This was a secondary analysis of a prospective cohort of pregnant individuals followed from first trimester through delivery at an academic tertiary care institution. Routine platelet indices obtained prospectively during prenatal care and delivery were compared between those who developed a hypertensive disorder of pregnancy and those who did not. We assessed platelet count (by trimester), mean platelet volume, and immature platelet fraction measured as percent (%) and absolute count. Data were analyzed using Fisher’s Exact test, chi-square test, and multivariable logistic regression. P &lt; 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Among 459 participants enrolled, 78 (17.0 %) developed a hypertensive disorder of pregnancy. Pregnant individuals who developed a hypertensive disorder of pregnancy had significantly higher mean platelet volume (11.7 fL [10.8,12.4] vs. 11.1 fL [10.5,12.0], P_adj &lt; 0.01), percent immature platelet fraction (7.3 % [4.9,10.7] vs. 5.9 % [4.2,9.2], P_adj = 0.01) and absolute immature platelet fraction (16.4 × 10⁹ [11.2,20.4] vs. 13.3 × 10⁹ [9.3,17.4], P_adj = 0.01) compared to those without a hypertensive disorder of pregnancy, after adjusting for age, race/ethnicity, obesity, nulliparity, and chronic hypertension. The prevalence and likelihood of a hypertensive disorder of pregnancy increased with increasing mean platelet volume, as well as with both the percent and absolute immature platelet fraction. There was no difference between groups in platelet count in the first trimester, second trimester, or at delivery.</div></div><div><h3>Conclusions</h3><div>An increase in platelet size and immaturity was observed in those with a hypertensive disorder of pregnancy. These data support further investigation of platelets in the mechanisms of the development of hypertensive disorders of pregnancy and the use of platelet indices to better identify high risk groups in pregnancy.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 234-239"},"PeriodicalIF":2.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619648","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":"Should men whose female partners have cervical high grade intraepithelial lesion (HSIL) be screened?","authors":"Olivier Aynaud ,&nbsp;Bernard Huynh ,&nbsp;Christine Bergeron","doi":"10.1016/j.ejogrb.2025.03.001","DOIUrl":"10.1016/j.ejogrb.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>The subject of screening for genital HPV lesions in the male partner of women with cervical high-grade squamous intraepithelial lesions (HSIL) remains a topic of discussion. The present study evaluated the prevalence of penile high-grade squamous intraepithelial lesion (HSIL) clinical lesions in 196 men whose female partners had been diagnosed with cervical low-grade and high-grade intraepithelial lesions (LSIL, HSIL) in Ile-de-France.</div></div><div><h3>Methods</h3><div>In cases involving couples where the female partner had been diagnosed with a cervical LSIL or HSIL lesion, the male partner underwent examination using the peniscopy method. The presence of clinical identified HPV lesions was confirmed by biopsy proven histological analysis.</div></div><div><h3>Results</h3><div>The mean age of the 196 couples was 33.4 years for women and 35.6 years for men. Among the 196 women, 125 (64 %) had cervical LSIL and 71 (36 %) had cervical HSIL detected by colposcopy and confirmed by histology. Among 196 men, 65 (33 %) HPV lesions were identified and confirmed by histology. Of these, 44/196 (22 %) were penile LSIL and 21/196 (11 %) were penile HSIL. The risk of penile HSIL increased twofold (Fisher test 1.9) if the female partner had cervical HSIL (11/71, 15.5 %) versus cervical LSIL (10/125, 8 %).</div></div><div><h3>Conclusion</h3><div>A man with a partner who has cervical HSIL is twice as likely to have penile HSIL than if his partner has LSIL cervical. This suggests that peniscopy should be offered to this population. It could avoid the persistence or recurrence of cervical HSIL of their partner.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 257-260"},"PeriodicalIF":2.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619647","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 Quit Together couples-focused pilot randomized trial of tobacco cessation for pregnant smokers","authors":"Cristian I. Meghea ,&nbsp;Marina D. Dascal ,&nbsp;Rana Jaber ,&nbsp;Alexandra Brinzaniuc ,&nbsp;Alexandra Onisor ,&nbsp;Razvan M. Chereches ,&nbsp;Dan Mihu ,&nbsp;Cristian I. Iuhas ,&nbsp;Florin Stamatian ,&nbsp;Daniel Muresan ,&nbsp;Gabriela Caracostea ,&nbsp;Kristie Foley ,&nbsp;Adriana Baban ,&nbsp;Thomas C. Voice ,&nbsp;Ken Resnicow ,&nbsp;David W. Wetter ,&nbsp;Oana M. Blaga","doi":"10.1016/j.ejogrb.2025.03.010","DOIUrl":"10.1016/j.ejogrb.2025.03.010","url":null,"abstract":"<div><h3>Aims</h3><div>This study reports on the feasibility and preliminary efficacy of prenatal and postnatal couples-focused telephone counseling for pregnant tobacco smokers.</div></div><div><h3>Design and setting</h3><div>This pilot randomized controlled trial (RCT) was conducted online in Romania and enrolled a total of 90 pregnant smokers and 77 of their life partners.</div></div><div><h3>Participants</h3><div>90 adult pregnant smokers and 77 of their life partners were randomized either to (1) Motivation and Problem Solving (MAPS) telephone counseling (n = 45 pregnant smokers who received up to 8 pre/postnatal telephone counseling sessions and n = 40 partners who received up to 4 sessions) or (2) usual care (n = 45 pregnant smokers and n = 37 partners).</div></div><div><h3>Measurements</h3><div>The primary outcomes were maternal 7-day self-reported and biochemically verified tobacco point-prevalence abstinence (PPA) and prolonged abstinence (PA) between birth and three months postpartum. Unadjusted group comparisons were used to assess preliminary intervention efficacy.</div></div><div><h3>Findings</h3><div>20 % of women in the intervention group reported PPA, compared to 15.6 % (p = 0.58) in the usual care group. Women (n = 15) who received three or more counseling sessions had higher PPA (40.0 vs 15.6 %, p &lt; 0.05) than women in the usual care group. 8.9 % of the women in the intervention group had biochemically verified abstinence compared to 4.4 % (p = 0.67) in the usual care group, with a significantly higher rate among women who received at least three counseling sessions (26.7 % vs 4.4 %, p = 0.03).</div></div><div><h3>Conclusion</h3><div>A prenatal and postnatal couple-focused telephone counseling intervention for pregnant smokers is feasible and provides preliminary efficacy of cessation and postpartum abstinence when a minimum intervention dosage is delivered.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 162-168"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578859","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":"Maternal hypertensive disorders among Individuals of reproductive age (15–49 Years) in South Asia: A global Burden of Disease study (1990–2021) with future Projections","authors":"Muhammed Shabil ,&nbsp;Abhay M Gaidhane ,&nbsp;Nasir Vadia ,&nbsp;Soumya V Menon ,&nbsp;Kattela Chennakesavulu ,&nbsp;Rajashree Panigrahi ,&nbsp;Ganesh Bushi ,&nbsp;Diptismita Jena ,&nbsp;Harish Kumar ,&nbsp;Anju Rani ,&nbsp;Sanjit Sah ,&nbsp;Mahendra Singh ,&nbsp;Khang Wen Goh ,&nbsp;Lovely Jain","doi":"10.1016/j.ejogrb.2025.03.012","DOIUrl":"10.1016/j.ejogrb.2025.03.012","url":null,"abstract":"<div><h3>Background</h3><div>Maternal hypertensive disorders (HDP) remain a major contributor to maternal and perinatal morbidity and mortality worldwide, particularly in South Asia, where healthcare disparities persist.</div></div><div><h3>Objective</h3><div>This study aims to analyze trends in maternal hypertensive disorders across South Asia from 1990 to 2021, leveraging data from the Global Burden of Disease (GBD) study to evaluate the effectiveness of healthcare interventions and provide actionable recommendations.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis using GBD 2021 data for Bangladesh, Bhutan, India, Nepal, and Pakistan. Health trends such as prevalence, incidence, and maternal mortality ratios (MMR) were analyzed using descriptive statistics and Join point regression. This approach allowed us to identify significant changes and trends over the studied period.</div></div><div><h3>Results</h3><div>The study revealed significant declines in the prevalence and MMR associated with maternal hypertensive disorders across the region. Notable reductions were observed in Bangladesh, Bhutan, India, and Nepal, while Pakistan showed minimal improvement, indicating ongoing healthcare challenges. The analysis underscores substantial regional disparities, particularly in Pakistan, which reported higher prevalence rates and MMR across all age groups.</div></div><div><h3>Conclusions</h3><div>The findings suggest that targeted healthcare interventions can effectively reduce the burden of maternal hypertensive disorders in South Asia. However, persistent disparities in Pakistan highlight the need for region-specific strategies to address gaps in healthcare access and quality. Strengthening healthcare policies and improving intervention coverage could further mitigate the burden of HDP in South Asia.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 214-221"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609962","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":"Effect of epidural labour analgesia on gastric emptying during labour: A prospective controlled study","authors":"Wenhao Bu ,&nbsp;Wei Wu ,&nbsp;Jing Cheng","doi":"10.1016/j.ejogrb.2025.03.003","DOIUrl":"10.1016/j.ejogrb.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Epidural analgesia is frequently used to alleviate labour pain, and dietary management during labour is of crucial importance. Therefore, this study investigates the impact of epidural analgesia for labour on gastric emptying in parturient women.</div></div><div><h3>Methods</h3><div>A total of 70 full-term parturient women were recruited and divided into two groups: the epidural analgesia group (LA, n = 35) and the non-epidural analgesia group (NA, n = 35). Fasting gastric antrum cross-sectional area (CSA0) was assessed using B-mode ultrasonography at T0. Both groups then consumed 300 g of millet porridge (600KJ). Post-meal, CSAs were measured at 60 min (CSA1, T1), 90 min (CSA2, T2), and 120 min (CSA3, T3) using ultrasonography. Pain scores were recorded for both groups at these four time points, and gastric emptying time was noted.</div></div><div><h3>Results</h3><div>The CSA in the NA group were larger than those in the LA group (CAS₁:11.4 ± 0.8 vs 10.2 ± 0.6;CAS₂:9.3 ± 0.6 vs 8.3 ± 0.5,CAS₃:7.4 ± 0.5 vs 6.5 ± 0.4; <em>P</em> = 0.00). The gastric emptying time in the LA group was shorter than that in the NA group (197.5 ± 27.2 vs. 220.9 ± 29.2, P = 0.00).</div></div><div><h3>Conclusions</h3><div>Epidural analgesia facilitates gastric emptying during labour. Therefore, the administration of epidural analgesia during labour does not adversely affect maternal dietary preferences.</div><div>Plain language summary.</div><div>During labour, women often endure severe pain, prompting the widespread use of epidural analgesia for pain relief. However, the dietary considerations for women opting for epidural analgesia during labour have increasingly garnered attention. Numerous studies have now corroborated that moderate food consumption can supply energy to women without posing any detrimental effects. Our research has observed that epidural analgesia can expedite gastric emptying during labour. Previous clinical experience suggested that patients should not eat before or after anesthesia, but this study shows that even if a parturient opts for epidural labor analgesia, she can still continue to consume a certain amount of semi-solid food to provide energy throughout the labor process, without needing to worry about an increased risk of vomiting.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 169-173"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592340","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}