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

{"title":"Imaging and quantification of placental terminal villi microvasculature and nuclear characteristics in preeclampsia","authors":"Juul Bierens ,&nbsp;Carmen Severens-Rijvers ,&nbsp;Sven Hildebrand ,&nbsp;Marc van Zandvoort ,&nbsp;Salwan Al-Nasiry ,&nbsp;Dimitrios Kapsokalyvas","doi":"10.1016/j.ejogrb.2025.03.015","DOIUrl":"10.1016/j.ejogrb.2025.03.015","url":null,"abstract":"<div><div>Globally, at least 10 % of maternal deaths, caused by obstetric complications during pregnancy, are linked to preeclampsia or eclampsia. Preeclampsia-induced placental hypoxia leads to vascular injury and syncytial knot formation in terminal villi. Early delivery of preeclampsia placentas complicates comparisons with normotensive term placentas, while the placenta’s non-planar structure limits the effectiveness of 2D histology for vascular analysis. This study used multiphoton microscopy to quantify 3D morphological differences in terminal villi between late-onset preeclampsia and control pregnancies. 7 late-onset preeclampsia (Gestational age: 37.3 weeks) and 10 control (Gestational age: 38.3 weeks) placentas were stained for nuclei and vasculature, optically cleared using ethyl-cinnamate, imaged with multiphoton microscopy, and analysed semi-automatically. Image quantification revealed a 42 % decrease in vascular fraction and a 97 % increase in syncytial knot density in late-onset preeclampsia samples, both statistically significant. No differences were observed in surface area-to-volume ratios, individual syncytial knot volume, or microvascular characteristics, including branchpoint density, vessel length, branching angle, straightness, and diameter. By analysing placentas at comparable gestational ages, we demonstrated that late-onset preeclampsia is characterized by decreased vascular content and increased syncytial knot density, while individual syncytial knot size and microvascular architecture remain unchanged. These findings enhance our understanding of late-onset preeclampsia pathophysiology and could provide a basis to distinguish late-onset preeclampsia from other phenotypes, such as early-onset preeclampsia, highlighting potential differences in disease mechanisms.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 181-189"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592341","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":"Inside Back Cover - Editors with images","authors":"","doi":"10.1016/S0301-2115(25)00143-5","DOIUrl":"10.1016/S0301-2115(25)00143-5","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"307 ","pages":"Page IBC"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143570516","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":"Risk of cervical stenosis after cervical excision in postmenopausal patients","authors":"Eva Hauge ,&nbsp;Line Winther Gustafson ,&nbsp;Mette Tranberg ,&nbsp;Pinar Bor","doi":"10.1016/j.ejogrb.2025.03.017","DOIUrl":"10.1016/j.ejogrb.2025.03.017","url":null,"abstract":"<div><h3>Objective</h3><div>Cervical excision may cause cervical stenosis, leading to suboptimal follow-up of dysplasia and delayed diagnosis of cervical and endometrial pathology. This study aimed to quantify the risk of stenosis development after electrosurgical cervical excision in postmenopausal patients.</div></div><div><h3>Methods</h3><div>Retrospective cohort study based on data collection from electronic medical records and the Danish National Pathology Data Bank. Patients aged ≥45 years who underwent electrosurgical cervical excision in the Gynecological Department, at Randers Regional Hospital from1^st of January 2012 to 31st December 2019 were included. Primary outcome was risk of cervical stenosis following cervical excision.</div></div><div><h3>Results</h3><div>Of the 567 cervical excisions conducted within the study period, 300 patients (52.9 %) met the inclusion criteria. Among these, 79 postmenopausal patients (26.3 %) developed cervical stenosis after cervical excision. Patients with stenosis were significantly older (median 64 years) compared to those without stenosis (median 61 years) (p = 0.004). Patients aged &gt;60 years at the time of cervical excision exhibited an increased risk of cervical stenosis (relative risk 1.51 (95 % confidence interval 1.08–2.18)) compared to those ≤60 years.</div></div><div><h3>Conclusion</h3><div>More than one in four postmenopausal patients experienced the development of cervical stenosis following cervical excision. Patients should be adequately informed of the possible risk of cervical stenosis development prior to undergoing diagnostic or therapeutic cervical excision procedure.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 208-213"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609182","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 the quality and reliability of YouTube videos on obstetric perineal tears","authors":"F. Tellier ,&nbsp;E. Vignozzi ,&nbsp;R. Ramanah ,&nbsp;N. Mottet ,&nbsp;M. Lallemant","doi":"10.1016/j.ejogrb.2025.03.008","DOIUrl":"10.1016/j.ejogrb.2025.03.008","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to assess the quality and reliability of YouTube videos on obstetric perineal tears.</div></div><div><h3>Method</h3><div>We chose six keywords: “tearing birth”, “perineal trauma”, “perineal laceration”, “perineal tear”, “obstetrical anal sphincter injuries (OASIS)” and “vaginal tear”. Each video that met the inclusion criteria were analyzed by two independent raters. Quantitative and qualitative metrics were recorded and scored using the DISCERN instrument.</div></div><div><h3>Results</h3><div>A total of 51 videos were included. The mean overall DISCERN score between the two raters was 44.5 ± 13.6. There was no significant difference between the two raters (43.4 vs 45.6; p = 0.4). The DISCERN sore was statistically higher in videos presented by a physician (p &lt; 0.001) and those that included an explanation of symptoms (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>YouTube videos on obstetric perineal tears have only been rated as fairly reliable. We identified the top four videos using the validated DISCERN instrument.</div><div>Our top four best videos were unpopular because they used medical terms, narrated by physician and the duration was long. Thus, they would be more appropriate to a medical cohort.</div><div>YouTube videos should be improved to better explain obstetric perineal tears to the public.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 228-233"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609183","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":"Longitudinal changes of automated volumetric breast density with postmenopausal hormone therapy","authors":"Ji Yeon Han ,&nbsp;Hoon Kim ,&nbsp;Yun Soo Hong ,&nbsp;Jung Min Chang ,&nbsp;Sung Woo Kim ,&nbsp;Seung-Yup Ku ,&nbsp;Chang Suk Suh ,&nbsp;Seok Hyun Kim","doi":"10.1016/j.ejogrb.2025.03.013","DOIUrl":"10.1016/j.ejogrb.2025.03.013","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate how volumetric percent density (VPD) changes longitudinally with postmenopausal hormone therapy (HT).</div></div><div><h3>Study design</h3><div>Medical records of 297 women who visited the outpatient clinic in a tertiary medical center between 2011 and 2019 were retrospectively reviewed. Study participants were postmenopausal hormone never-users (n = 103), estrogen therapy (ET) users (n = 95), and estrogen plus progestogen (EPT) users (n = 99). All hormone users were naïve to HT before the study. VPD was measured at least twice over 3 years, and was measured before and after HT in all hormone users. Longitudinal VPD changes were analyzed using a linear mixed effects model adjusted for age and body mass index (BMI) at index mammography.</div></div><div><h3>Results</h3><div>The mean age (standard deviation) of study participants at index mammography was 53.0 years (3.3 years). Baseline characteristics, including baseline VPD, were similar across the three groups. After adjustment for age and BMI, the predicted slopes of annual VPD change did not differ among never-users, ET users, and EPT users (−6.8 % (95 % CI −12.1 % to −1.6 %), 0.2 % (95 % CI −4.4 % to 4.8 %), and 0.4 % (95 % CI −5.1 % to 4.3 %), respectively (<em>P</em> = 0.21)). Furthermore, subgroup analyses stratified by estrogen formulation did not demonstrate any difference in the slopes of annual VPD change among never-users, conjugated equine estrogen users, estradiol valerate users, and EPT users (−7.0 %, −1.2 %, 4.9 %, and −0.5 %, respectively; <em>P</em> = 0.27).</div></div><div><h3>Conclusion</h3><div>The predicted annual VPD change did not differ by HT during 3 years of follow-up. Neither ET nor EPT increased VPD.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 195-200"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600781","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":"Commenting on: Sexual function after treatment with non-invasive radiofrequency device for improvement of the genitourinary syndrome of menopause: A multi-arm randomized clinical trial","authors":"Muhammad Zarrar","doi":"10.1016/j.ejogrb.2025.03.011","DOIUrl":"10.1016/j.ejogrb.2025.03.011","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Page 261"},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585196","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":"Six versus twelve hours of intrauterine balloons placement for cervical ripening: A systematic review and meta-analysis","authors":"Shan Xu ,&nbsp;Huihao Zhou ,&nbsp;Yiqin Hu ,&nbsp;Jingui Xu","doi":"10.1016/j.ejogrb.2025.03.007","DOIUrl":"10.1016/j.ejogrb.2025.03.007","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the efficacy of reducing the duration of intrauterine balloons placement from 12 h to 6 h for labor induction, specifically in terms of reducing the time from balloon placement to delivery and the rate of cesarean delivery.</div></div><div><h3>Methods</h3><div>Comprehensive searches were conducted across the Cochrane Library, Web of Science, PubMed, ClinicalTrials.gov, and Embase from their inception until August 2024. Randomized controlled trials (RCTs) incorporated into our <em>meta</em>-analysis involved nulliparous and multiparous women with an unfavorable cervix requiring labor induction, where the intervention was intrauterine balloon placement for 6 h, compared with the placement for 12 h, and the outcomes included the time from balloon placement to delivery, the rate of cesarean delivery, and maternal and neonatal adverse outcomes. The Cochrane risk-of-bias assessment tool was used to appraise the quality of the studies incorporated in our analysis. The <em>meta</em>-analysis was executed using RevMan 5.3 statistical software. Heterogeneity among the selected studies was assessed using the <em>I²</em> statistic. Dichotomous outcomes were expressed as relative risk (RR) with corresponding 95% confidence intervals (CI), while continuous outcomes were represented as the mean difference (MD).</div></div><div><h3>Results</h3><div>A total of six studies, encompassing a total of 1,160 nulliparous and multiparous women with an unfavorable cervix, were incorporated into the systematic review. In comparison to the 12-hours groups, women in 6-hours group experienced a significantly shorter interval from intrauterine balloon placement to delivery (MD = −3.67, 95 %CI: −4.73, −2.62, <em>P&lt;</em>0.00001), and a reduced rate of cesarean delivery (RR = 0.83, 95 %CI: 0.71, 0.98, <em>P</em> = 0.02). Additionally, no statistically significant differences were noted in maternal and neonatal adverse outcomes between the two groups.</div></div><div><h3>Conclusions</h3><div>These findings substantiate the potential benefits of reducing the duration of intrauterine balloons usage from 12 to 6 h during labor induction.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 153-161"},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562138","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":"Clarifying risk factors and missed opportunities in levator ani muscle avulsion research","authors":"Aly Youssef ,&nbsp;Kobe Haenen","doi":"10.1016/j.ejogrb.2025.02.060","DOIUrl":"10.1016/j.ejogrb.2025.02.060","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Page 262"},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A direct comparison of the diagnostic accuracy of ST segment analysis (STAN) and fetal scalp blood sample lactate: A population-based observational study","authors":"Magnus B. Berge ,&nbsp;Anne Flem Jacobsen ,&nbsp;Branka M. Yli ,&nbsp;Anne Cathrine Staff ,&nbsp;Nina Gunnes ,&nbsp;Ragnhild Sørum Falk ,&nbsp;Linda Bjørk Helgadottir ,&nbsp;Jørg Kessler","doi":"10.1016/j.ejogrb.2025.03.002","DOIUrl":"10.1016/j.ejogrb.2025.03.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Fetal scalp blood sample (FBS) lactate and ST analysis (STAN) are adjuncts to cardiotocography (CTG) in high-risk deliveries, aiming to increase the specificity of the fetal monitoring. These methods have never been compared directly, through simultaneous evaluation in the same deliveries.</div></div><div><h3>Material and methods</h3><div>We conducted a prospective, population-based study on deliveries with singleton, cephalic fetuses in gestational week ≥ 36 + 0 monitored with internal CTG. Cases were defined as deliveries with umbilical cord artery pH ≤ 7.10. For each case, the following three deliveries with umbilical cord artery pH &gt; 7.10 were included as controls. The sensitivity and specificity of FBS lactate and STAN for the predefined adverse neonatal outcomes were compared using McNemar’s test.</div></div><div><h3>Results</h3><div>Of 10,000 women included by passive consent, 178 deliveries were included as cases, and 516 as controls. STAN had a significantly higher sensitivity for the main outcome (pH ≤ 7.10) compared to FBS lactate (49 % vs. 40 %, <em>p =</em> 0.03). Although STAN showed a tendency toward a higher sensitivity for the secondary outcomes, differences were not statistically significant (<em>p</em> = 0.14–0.50). FBS lactate had significantly higher specificity for all outcomes (main outcome 88 % vs. 69 %, <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>STAN demonstrated a higher sensitivity for moderate acidemia compared to FBS lactate, but with lower specificity for all outcomes. These results do not not provide evidence to support the choice of one fetal surveillance system over the other. Further research should focus on how potential advantages of either method could be combined.</div><div>The study is registered in <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier: NCT04779294).</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 147-152"},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562142","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":"Voluntary multifetal pregnancy reduction: who should decide and select, and why?","authors":"Sara Patuzzo Manzati ,&nbsp;Chiara Casprini ,&nbsp;Mariachiara Bosco ,&nbsp;Ricciarda Raffaelli ,&nbsp;Stefano Uccella ,&nbsp;Massimo Franchi ,&nbsp;Simone Garzon","doi":"10.1016/j.ejogrb.2025.03.006","DOIUrl":"10.1016/j.ejogrb.2025.03.006","url":null,"abstract":"<div><div>Over the last four decades, the increase in assisted reproductive medicine has led to a growing incidence of multiple pregnancies. As a result, Multifetal Pregnancy Reduction, which consists of reducing the number of fetuses, usually in the late first trimester, has become a method to avoid complications associated with multiple pregnancies, such as fetal loss and preterm birth. In this paper, we will discuss the ethical dilemmas surrounding this issue by reviewing various possible situations and reexamining the laws regulating elective abortion to develop a bioethical discussion underlining clinical practice.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 143-146"},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143553027","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}