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

{"title":"Impact of Human papillomavirus 9-valent vaccine on viral clearance after surgical treatment: A single-center retrospective observational study","authors":"Mario Palumbo ,&nbsp;Giada Lavitola ,&nbsp;Claudia Di Filippo ,&nbsp;Virginia Foreste ,&nbsp;Maddalena Granata ,&nbsp;Oriana Imperatore ,&nbsp;Mario Ascione ,&nbsp;Luigi Della Corte ,&nbsp;Giuseppe Bifulco","doi":"10.1016/j.ejogrb.2025.113994","DOIUrl":"10.1016/j.ejogrb.2025.113994","url":null,"abstract":"<div><h3>Introduction</h3><div>The effectiveness of post-treatment HPV vaccination with the Human papillomavirus 9-valent <strong>(</strong>9vHPV) vaccine in women treated with loop electrosurgical excision procedure (LEEP) for high-grade cervical intraepithelial neoplasia (CIN2-3) or laser ablation (LA) for low-grade lesions (CIN1) remains a topic of ongoing research.</div><div><em>Study design:</em> This single-center retrospective observational study included 326 women aged 25 to 65 years who underwent surgical treatment between 2020 and 2024. Participants were divided into two groups: vaccinated (V) and non-vaccinated (NV). A further stratification was then reported by age &lt; 40 years (n = 174) and ≥ 40 years (n = 152).</div><div>The primary outcomes were HPV test results and colposcopy findings 6–15 months post-treatment, evaluating the potential adjuvant effect of HPV vaccination.</div></div><div><h3>Results</h3><div>The vaccinated group (V-group) comprised 68 % (222/326) of participants, while 32 % (104/326) were unvaccinated (NV-group). Among women treated for CIN1, a positive HPV test was detected in 38 % of unvaccinated women compared to 18 % in vaccinated women (p = 0.0169). Among those treated for CIN2-3, 18 % of unvaccinated women had a positive HPV test, compared to 8 % in the vaccinated group (p = 0.0353). Vaccination, also in women with an age ≥ 40-year-old had a statistically significant effect in reducing the proportion of women with a positive HPV test (p = 0.0100).</div></div><div><h3>Conclusion</h3><div>Human papillomavirus 9-valent vaccine was associated with a significant reduction in the proportion of women with a positive HPV test. These findings support its potential role in tertiary prevention of HPV-related cervical disease, particularly in reducing HPV persistence after surgical treatment.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113994"},"PeriodicalIF":2.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855679","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 Contributions of delivery mode and intrapartum antibiotic exposure to body mass index among children through 5 years of age","authors":"Corinna Koebnick ,&nbsp;Sagori Mukhopadhyay ,&nbsp;Darios Getahun ,&nbsp;Sara Y. Tartof ,&nbsp;Anny H. Xiang ,&nbsp;Karen M Puopolo ,&nbsp;Margo A. Sidell","doi":"10.1016/j.ejogrb.2025.113984","DOIUrl":"10.1016/j.ejogrb.2025.113984","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate independent effects of group B Streptococcus (GBS) intrapartum antibiotic prophylaxis (IAP) and cesarean delivery (CD) on body mass index (BMI) during early childhood.</div></div><div><h3>Study design</h3><div>Retrospective cohort study of infants (n = 157,820) born 2007–2015 in an integrated healthcare system. Exposures were delivery mode (CD or vaginal delivery [VD]) and GBS IAP exposure. CD was further divided into elective CD (without labor or rupture of membrane [ROM]) or unscheduled CD (following labor and/or ROM). BMI over 5 years was compared using non-linear multivariate models with B-splines, adjusted for demographics, maternal medical and obstetrical factors, and childhood antibiotic exposure.</div></div><div><h3>Results</h3><div>At age 5 years, unscheduled CD without GBS IAP (Δ BMI 0.11 kg/m², 95 % CI 0.06 to 0.16, p &lt; 0.0001) and unscheduled CD with GBS IAP (Δ BMI 0.24 kg/m², 95 % CI 0.11 to 0.36 kg/m², p = 0.0002) were positively associated with higher BMI compared to their VD counterparts, respectively. No BMI difference was observed between children born by elective versus unscheduled CD. GBS IAP exposure was positively associated with increased BMI compared to non-exposed births in both VD (Δ BMI 0.07 kg/m², 95 % CI 0.02 to 0.13 kg/m², p = 0.0125) and CD (Δ BMI 0.22 kg/m², 95 % CI 0.09 to 0.35 kg/m², p = 0.0009).</div></div><div><h3>Conclusions</h3><div>Based on our findings, the widespread administration of GBS IAP and birth by cesarean delivery independently contribute to a significant upshift in body weight early in life that compares to or is higher than the annual increase in BMI in U.S. children on a population level.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"311 ","pages":"Article 113984"},"PeriodicalIF":2.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892334","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":"Diagnostic workup of patients with benign or inconclusive reports on office endometrial biopsy after first episode of postmenopausal blood loss","authors":"F.Ciska Slaager ,&nbsp;Johanna A. van der Zande ,&nbsp;Lucy A. van Werkhoven ,&nbsp;Laura D.P.R. van Maldegem ,&nbsp;Maria C. Breijer ,&nbsp;Manja Z. Dorman ,&nbsp;Peggy M.L.H. Vencken ,&nbsp;Judith de Waard ,&nbsp;Ward Hofhuis ,&nbsp;Gatske M. Nieuwenhuyzen-De Boer ,&nbsp;Heleen J. van Beekhuizen ,&nbsp;Klaas Hoogduin ,&nbsp;A. Lex C.F. Makkus ,&nbsp;Nicole van Es ,&nbsp;Patricia C. Ewing-Graham ,&nbsp;Helena C. van Doorn","doi":"10.1016/j.ejogrb.2025.113991","DOIUrl":"10.1016/j.ejogrb.2025.113991","url":null,"abstract":"<div><h3>Background</h3><div>Postmenopausal bleeding carries a risk of endometrial cancer, and office endometrial sampling (OES) is often the first diagnostic approach. Whether further diagnostic procedures such as hysteroscopy or saline infusion sonography (SIS) are required to rule out polyps and malignancies is uncertain. The objective of this study is to evaluate whether clinicians perform further diagnostic tests when OES is benign or inconclusive. Secondary outcomes include the patient characteristics associated with the likelihood of performing further diagnostic tests and the incidence of endometrial intraepithelial neoplasia and endometrial malignancy.</div></div><div><h3>Methods</h3><div>We performed a multicenter, prospective cohort study, evaluating patients with a first episode of postmenopausal bleeding, with an endometrial thickness of &gt;4 mm on 2D vaginal sonography and a benign or inconclusive result of an OES. Patients who underwent further diagnostic or therapeutic procedures (hysteroscopy or SIS) were compared to patients who did not. Univariate and multivariate analyses were performed to identify predictive factors for additional diagnostic procedures and the diagnosis of endometrial malignancy.</div></div><div><h3>Results</h3><div>Of the 350 eligible patients, 197 (56 %) underwent further diagnostic procedures. These patients had a thicker endometrium (median 8.6 mm vs. 6.0 mm; p &lt; 0.001), more frequent suspicion of intracavitary abnormalities (34.0 % vs. 14.4 %; p &lt; 0.001), and more frequent insufficient aspiration samples (20.8 % vs. 11.8 %; p = 0.025) compared to patients who received expectant management. Multivariate regression analysis confirmed these findings. The underlying risk of malignancy was 2.7 % with benign samples and 6.8 % with insufficient samples. Overall, malignancy incidence was higher in those who underwent further diagnostic workup (p = 0.04).</div></div><div><h3>Conclusion</h3><div>In this prospective study, just over half of patients underwent further diagnostic procedures. Endometrial thickness, suspicion of intracavitary abnormality or an insufficient endometrial sample were predictive for further diagnostic workup. The incidence of malignancy was higher in patients who underwent diagnostic workup, which argues for a risk-based strategy in clinical decision-making.</div><div>Registration: Central study approval was obtained at the Erasmus MC (MEC 2015-740). The study was registered in the Dutch trial register (<span><span>www.onderzoekmetmensen.nl</span><svg><path></path></svg></span>, NL7608).</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113991"},"PeriodicalIF":2.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876537","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":"Capio slim suture capturing device for transvaginal apical pelvic organ prolapse","authors":"Paolo Luffarelli ,&nbsp;Kiara Sejfullai ,&nbsp;Costanza Mazzola ,&nbsp;Claudia Tempesta ,&nbsp;Michele Carlo Schiavi ,&nbsp;Valerio Napolitano ,&nbsp;Marzio Angelo Zullo","doi":"10.1016/j.ejogrb.2025.113993","DOIUrl":"10.1016/j.ejogrb.2025.113993","url":null,"abstract":"<div><h3>Objective</h3><div>Pelvic organ prolapse is an extremely common condition, with approximately 12% of women requiring surgical correction over their lifetime. This is the first study comparing standard technique with Capio device with a prolonged follow-up. The aim of this study was to describe a standardization technique and its efficacy to treat vaginal vault prolapse based on Capio device to sacrospinous ligament (SSL) suspension in comparison to the well-known and described “Capio-free” standard technique (ST).</div></div><div><h3>Materials and methods</h3><div>From January 2016 to January 2022, we retrospectively evaluated 163 women undergoing surgery to treat apical vaginal prolapse with ST and/or Capio technique (CT) at two high-volume centers.</div></div><div><h3>Results</h3><div>ST mean operative time resulted to be longer in comparison to the CT (98 ± 22.6 m vs 86 ± 17.4 m, p &lt; 0.001). Mean intraoperative bleeding, hospital stay, and indwelling catheter resulted to be comparable between the two groups (all p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>The CT used to treat women with vaginal vault prolapse was effective, secure, easy to perform, and associated with low risks of bleeding, perineal pain, vessel injuries and recurrent prolapse. The shorter operative time observed in surgery performed with Capio device, could suggest an implementation of such technique due to the overlapping complications, prolapse recurrence and postoperative quality of life.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113993"},"PeriodicalIF":2.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859390","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":"Menopause, urinary incontinence prevalence and impact on healthy living","authors":"Eda Yakıt Ak,&nbsp;Mehmet Ali Şen","doi":"10.1016/j.ejogrb.2025.113987","DOIUrl":"10.1016/j.ejogrb.2025.113987","url":null,"abstract":"<div><h3>Aim</h3><div>Urinary incontinence (UI) is one of the most common symptoms during menopause, leading to decreased quality of life. This study was conducted to determine the prevalence of UI and the effect of associated factors on healthy lifestyle behaviors in menopausal women.</div></div><div><h3>Methods</h3><div>The study was carried out with a total of 439 women. The data were collected between October 15, 2022, and July 30, 2023. The data were evaluated by correlation between the Descriptive Information Form, Bristol Female Lower Urinary Tract Symptoms (BFLUTS), and Healthy Lifestyle Behaviors Scale II (HLBS II).</div></div><div><h3>Results</h3><div>The overall prevalence of urinary incontinence was 30.8 %; 59.5 % had stress urinary incontinence (SUI). There was no significant relationship between BFLUTS and HLBS II scores (p &gt; 0.05). There was a weak positive correlation between BFLUTS and age (p = 0.000), number of pregnancies (p = 0.040), number of births (p = 0.044), and duration of menopause (years) (p = 0.001) (p &lt; 0.01). There was a weak negative association between HLBS II and pregnancy (p = 0.005) and number of births (p = 0.025) (p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Screening for early diagnosis and appropriate treatment of urinary incontinence should be performed to prevent the frequent occurrence of urinary incontinence in menopausal women and its devastating effects on quality of life.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113987"},"PeriodicalIF":2.1,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869388","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":"Clinical results after laparoscopic sacrocolpopexy for genital prolapse − a high success rate: A three-year follow-up study","authors":"Stefan Angelov Bouzalov ,&nbsp;Plamen Ivanov Yanev ,&nbsp;Yasen Trifonov Ivanov ,&nbsp;Galina Ivelinova Staneva ,&nbsp;Slavcho Tomov Tomov ,&nbsp;Tihomir Pankov Totev","doi":"10.1016/j.ejogrb.2025.113985","DOIUrl":"10.1016/j.ejogrb.2025.113985","url":null,"abstract":"<div><h3>Background</h3><div>Laparoscopic sacrocolpopexy is an effective method for the treatment of pelvic organ prolapse which gives very good anatomical and functional results.</div></div><div><h3>Objective</h3><div>To assess the subjective and objective rate of success and complications after laparoscopic sacrocolpopexy.</div></div><div><h3>Study design</h3><div>We followed 356 of the 482 patients with genital prolapse who have underwent laparoscopic sacrocolpopexy performed at the Obstetrics and Gynecology Ward of MBAL “Trakia” EOOD, Stara Zagora, Bulgaria, for a period of 3 years. We performed gynecological examinations and patient history and objective data on a number of indicators related to the perioperative status of patients.</div></div><div><h3>Results</h3><div>In our study, the anatomically successful surgeries were 94.9% (338), with 5.1% (18) recurrence 72.2% (13) of them were cystocele, 22.2% (4) − rectocele and only one (5.6%) – mixed). The subjective success rate – fully satisfied, is 86.47% (308). Moderately satisfied (patients with mesh erosion and newly occurring stress and mixed incontinence) were 8.42% (30), underdeveloped – 5.1% (18). Perioperative complications – hematoma of the abdominal wall around the trocar opening – 2; vaginal wall lesion during surgery for prolapse of the vault after hysterectomy – 4; rectum lesion – 1; postoperative ileus − 1. Mesh erosion in 9 patients (2.53%). De novo stress incontinence 6,46 % (23), de novo detrusor instability − 6.74% (24).</div></div><div><h3>Conclusion</h3><div>Laparoscopic sacrocolpopexy is an operative method that shows good anatomical and functional results for the treatment of genital prolapse in women.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113985"},"PeriodicalIF":2.1,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of stress urinary incontinence procedures on bladder and voiding function: A comparison between Tension-free Vaginal Tape (TVT), autologous fascial sling (AFS) and Burch colposuspension (BC)","authors":"A. Rahman ,&nbsp;R. Bugeja ,&nbsp;K. McCrossan ,&nbsp;S. Jha","doi":"10.1016/j.ejogrb.2025.113988","DOIUrl":"10.1016/j.ejogrb.2025.113988","url":null,"abstract":"<div><h3>Introduction</h3><div>Stress urinary incontinence (SUI) is common, affecting one-third of women [1,2]. The impact of SUI surgery on overactive bladder symptoms (OAB) is poorly understood. This study aims to evaluate the effect of SUI surgeries on bladder and voiding function.</div></div><div><h3>Materials and methods</h3><div>A retrospective study of 100 women who underwent SUI surgery at a UK tertiary centre was conducted. Pre-operative and post-operative bladder function was assessed using validated pelvic floor questionnaires, Electronic Personal Assessment Questionnaire(ePAQ). Five domains were analysed: pain and sensation, voiding, stress incontinence, OAB, and quality of life (QoL). Domain scores were calculated and change in scores analysed using paired T-test. A one-way analysis of variance (ANOVA) was used to compare results.</div></div><div><h3>Results</h3><div>The mean age of women was 51 years.</div><div>Post-operative analysis using paired T-tests showed significant improvement in stress incontinence and quality of life(p &lt; 0.05). OAB symptoms improved significantly following all three procedures(p &lt; 0.05). Voiding dysfunction improved significantly following AFS surgery(p &lt; 0.05), with non-significant improvements noted in the TVT and Burch colposuspension cohorts (p = 0.47, 0.2 respectively).</div><div>The ANOVA test revealed a statistically significant difference in OAB symptoms based on the type of surgery (p = 0.013) in favour of TVT but no significant difference in other domains (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that all three SUI procedures significantly improve stress incontinence and QoL. OAB symptoms improved in all three groups; however, the type of surgery did have a statistically significant impact on symptoms. This can aid clinicians in effective patient counselling. Further research is warranted to analyse this further.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"311 ","pages":"Article 113988"},"PeriodicalIF":2.1,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892335","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 effect of menopausal hormone therapy on thyroid cancer survivors from the National Health Insurance Database in South Korea cohort","authors":"Jin-Sung Yuk ,&nbsp;Jin Li Lee ,&nbsp;Yeonjin Shin ,&nbsp;Gwan Hee Han ,&nbsp;Sang-Hee Yoon ,&nbsp;Myoung Hwan Kim ,&nbsp;Ji Hyun Noh ,&nbsp;Yujin Lee ,&nbsp;Jungbin Kim ,&nbsp;Sam-Youl Yoon ,&nbsp;Hyunjin Cho ,&nbsp;Keunho Yang ,&nbsp;Byung Noe Bae ,&nbsp;Ki Whan Kim ,&nbsp;Geumhee Gwak","doi":"10.1016/j.ejogrb.2025.113983","DOIUrl":"10.1016/j.ejogrb.2025.113983","url":null,"abstract":"<div><h3>Objective</h3><div>There is a lack of research on how menopausal hormone therapy (MHT) affects the prognosis of postmenopausal thyroid cancer (TC) survivors. This study aimed to evaluate the association between MHT and the risk of death in postmenopausal TC survivors.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used the data of women with the diagnostic code for TC from the Korean National Health Insurance Database between 2007 and 2021. The postmenopausal women with TC who received radical treatment such as surgery or/and radioactive iodine therapy were divided into two groups – MHT group and non-MHT group – according to whether or not they received MHT after TC treatment. The risk of death in TC survivors was analysed according to the type and duration of the MHT regimen.</div></div><div><h3>Results</h3><div>Among postmenopausal TC survivors, the risk of death did not differ between the women with MHT duration &gt; 5 years and the non-MHT group, with a hazard ratio (HR) of 0.964 [95 % confidence interval (CI) 0.697–1.334] (<em>p</em> = 0.826). However, MHT duration &lt; 5 years was associated with increased risk of death, with the MHT group having an HR of 1.744 (95 % CI 1.105–2.753) (<em>p</em> = 0.017) compared with the non-MHT group. A trend was observed towards increased risk of death in women with MHT duration ≤ 6 months, with an HR of 1.703 (95 % CI 0.98–2.962) (<em>p</em> = 0.059). The risk of death did not differ between women with MHT duration &gt; 6 months and women in the non-MHT group (HR 1.205, 95 % CI 0.79–1.839) (<em>p</em> = 0.064). In analyses by MHT regimen, no increase in the risk of death was observed for any MHT regimen for any duration.</div></div><div><h3>Conclusion</h3><div>The risk of death in postmenopausal TC survivors who used MHT for &gt; 5 years did not differ from that of their counterparts who did not use MHT. However, postmenopausal TC survivors who used MHT for &lt; 5 years, particularly those who used MHT for &lt; 6 months, had a higher risk of death than their counterparts who did not use MHT.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113983"},"PeriodicalIF":2.1,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of D-dimer monitoring combined with anticoagulation therapy on pregnancy outcomes and complications in recurrent spontaneous abortion: A case-control study","authors":"Xi Ye ,&nbsp;Yongsheng Li ,&nbsp;Chenmin Zheng","doi":"10.1016/j.ejogrb.2025.113982","DOIUrl":"10.1016/j.ejogrb.2025.113982","url":null,"abstract":"<div><h3>Background</h3><div>Recurrent abortion is often linked to coagulation abnormalities. Anticoagulation therapy combined with D-dimer monitoring may improve outcomes. To evaluate the effects of D-dimer monitoring combined with anticoagulation therapy on complications and pregnancy outcomes in recurrent abortion.</div></div><div><h3>Methods</h3><div>From February 2019 to March 2021, 104 pregnant women with recurrent abortion were divided into a control group (n = 52, placebo) and an observation group (n = 52, D-dimer monitoring + anticoagulation). Uterine artery blood flow (S/D, PI, RI, diastolic notch) and coagulation parameters (PT, TT, APTT, FIB) were assessed before and after treatment. Pregnancy outcomes and complications were recorded.</div></div><div><h3>Results</h3><div>After treatment, the observation group showed significantly improved uterine artery blood flow (lower S/D, PI, RI, diastolic notch; P &lt; 0.05) and coagulation parameters (higher PT, TT, APTT; P &lt; 0.05). Pregnancy loss and complications (preeclampsia, gestational hypertension, etc.) were significantly lower in the observation group (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>D-dimer monitoring combined with anticoagulation therapy improves uterine artery blood flow, balances coagulation, and reduces complications in recurrent abortion, enhancing pregnancy success rates. This approach is clinically valuable and warrants further application.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"311 ","pages":"Article 113982"},"PeriodicalIF":2.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931393","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":"External validation of the IOTA two-step strategy in the preoperative characterization of ovarian masses","authors":"Sabrina Einig ,&nbsp;Terese Puls ,&nbsp;Hubertina Reina ,&nbsp;Andreas Schoetzau ,&nbsp;Céline Montavon ,&nbsp;Annkathrin Butenschön ,&nbsp;Viola Heinzelmann-Schwarz ,&nbsp;Gwendolin Manegold-Brauer","doi":"10.1016/j.ejogrb.2025.113981","DOIUrl":"10.1016/j.ejogrb.2025.113981","url":null,"abstract":"<div><h3>Objectives</h3><div>Preoperative sonographic evaluation of ovarian masses is crucial for improving outcomes. The Risk of Malignancy Index (RMI) has been a standard for malignancy triage, while the International Ovarian Tumor Analysis Group (IOTA) has proposed a two-step strategy to estimate the risk of malignancy and suggest management steps by translating risks to Ovarian Adnexal Reporting Data System (O-RADS) categories. This study compares the accuracy of RMI and the IOTA two-step strategy in predicting malignancy.</div></div><div><h3>Methods</h3><div>We included patients with preoperative ultrasound and pathological reports. RMI and O-RADS scores based on the IOTA two-step strategy were assessed. Performance was evaluated using receiver operating characteristic (ROC) curves and calibration plots.</div></div><div><h3>Results</h3><div>A total of 453 cases were included. Of these, 90 (19.9 %) were malignant, 21 (4.6 %) were borderline tumors (BOT), and 342 (75.5 %) were benign. The area under the ROC curve (AUC) for the IOTA two-step strategy was 0.958 (95 % CI, 0.938–0.978), compared to 0.904 (0.865–0.943) for RMI with a &gt; 200 cut-off. The IOTA two-step strategy had a sensitivity of 96.4 %, specificity of 79.7 %, positive predictive value (PPV) 60.2 %, and negative predictive value (NPV) 98.6 %, while RMI showed sensitivity of 70.4 %, specificity 93.4 %, PPV 79.2 %, and NPV 89.8 %. For predicting BOTs, the IOTA two-step AUC was 0.902, compared to 0.719 for RMI.</div></div><div><h3>Conclusion</h3><div>The IOTA two-step strategy outperforms RMI in the preoperative assessment of adnexal masses, particularly in detecting BOTs. It should be implemented in routine clinical practice.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"310 ","pages":"Article 113981"},"PeriodicalIF":2.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855072","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}