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

{"title":"Correlation between ultrasonographic findings and histopathological and molecular characteristics in endometrial cancer: A multicenter study","authors":"Irene Colombi ,&nbsp;Giuseppe Vizzielli ,&nbsp;Eugenia Costantini ,&nbsp;Silvia Pisaneschi ,&nbsp;Federica Perelli ,&nbsp;Anna Biasoli ,&nbsp;Stefano Restaino ,&nbsp;Francesca Ciccarone ,&nbsp;Gabriele Centini ,&nbsp;Francesco Giuseppe Martire ,&nbsp;Martina Pacifici ,&nbsp;Alberto Mattei ,&nbsp;Errico Zupi ,&nbsp;Lucia Lazzeri","doi":"10.1016/j.ejogrb.2025.114900","DOIUrl":"10.1016/j.ejogrb.2025.114900","url":null,"abstract":"<div><h3>Background</h3><div>Accurate preoperative assessment of endometrial cancer is crucial for tailoring surgical and therapeutic management. Identifying correlations between ultrasonographic features and tumor histopathological and molecular profiles may help improve the accuracy of presurgical staging.</div></div><div><h3>Objectives</h3><div>This multicenter retrospective study aimed to evaluate the association between ultrasonographic features, histopathological characteristics and molecular profiles in endometrial cancer to improve preoperative assessment and risk stratification.</div></div><div><h3>Study design</h3><div>A total of 156 women from three Italian centers underwent standardized transvaginal or transrectal ultrasound following IETA criteria prior to hysterectomy. Ultrasonographic parameters, including endometrial thickness, echogenicity, junctional zone integrity, and vascularity assessed by Doppler, were analyzed. Postoperative histopathology and molecular classification (p53, MMR, POLE, NSMP) were performed. Statistical analyses evaluated correlations among ultrasound features, pathology, and molecular data.</div></div><div><h3>Results</h3><div>Endometrioid histotype was detected in 88.46 % of cases, mostly low-grade and early-stage. Cases in the early stage (i.e. lesions confined to the uterine corpus) accounted for 77.27 % of all cases. Ultrasound staging was consistent with the final staging in 65.5 % of cases, with errors primarily involving the overestimation of p53-abnormal tumors and the underestimation of MMRd tumors. Increased endometrial thickness was associated with a higher stage and grade (median 20 mm for stage III, p = 0.007). An irregular junctional zone was associated with high-grade tumors (p = 0.016). Complex and multifocal vascular patterns were significantly linked to advanced stages, high grade, and molecular aggressiveness, such as p53 mutations and MMR deficiency. Tumors with scattered vessels showed a higher risk of extensive lymphovascular space invasion.</div></div><div><h3>Conclusions</h3><div>Ultrasound features, particularly vascularity, junctional zone irregularity, and endometrial thickness, are significantly associated with tumor stage, grade, and molecular profiles. Incorporating detailed ultrasonographic assessment into preoperative evaluation can help identify high-risk endometrial cancers and guide personalized management strategies.</div><div>Larger prospective studies are needed to validate these findings.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114900"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789358","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":"Laparoscopic surgical resolution of symptomatic biliary pathology during pregnancy: An early therapeutic approach at any gestational age","authors":"Nicolás Fernandez-Barra ,&nbsp;Camila A Fernández ,&nbsp;Enzo A Muñoz ,&nbsp;Bernardo I Cepeda ,&nbsp;Pedro Gutierrez-Contreras ,&nbsp;Pablo A Silva-Labarca ,&nbsp;Jose Galaz ,&nbsp;Paula A Vargas ,&nbsp;Carolina P Martinovic ,&nbsp;Juan F Prieto ,&nbsp;Daniela P Luna ,&nbsp;Erwin Buckel ,&nbsp;Constanza A Godoy ,&nbsp;Tamara A Álvarez ,&nbsp;Rolando Rebolledo ,&nbsp;Alejandro I Brañes ,&nbsp;José E Ruiz ,&nbsp;Julio E Benítez ,&nbsp;María B García ,&nbsp;Rose M Mege ,&nbsp;Juan P Kusanovic","doi":"10.1016/j.ejogrb.2025.114909","DOIUrl":"10.1016/j.ejogrb.2025.114909","url":null,"abstract":"<div><h3>Background</h3><div>Physiologic changes occurring during pregnancy lead to a higher risk for developing biliary diseases. It is estimated that for every 10,000 pregnant individuals, between 1 and 6 will require a cholecystectomy prior to delivery, most of them being done by a laparoscopic approach. Chile has one of the highest prevalence of gallbladder disease worldwide; however, the characterization of laparoscopic cholecystectomy during pregnancy in Hispanic populations has been poorly investigated.</div></div><div><h3>Objective</h3><div>To describe maternal and perinatal outcomes among pregnant individuals undergoing laparoscopic cholecystectomy for symptomatic gallbladder disease at a tertiary care center in Chile, across different gestational ages.</div></div><div><h3>Study Design</h3><div>A retrospective cohort study was conducted including all pregnant patients who underwent laparoscopic cholecystectomy between January 2002 and August 2023 in the High-Risk Pregnancy unit at the Sótero del Río hospital in Santiago, Chile. Information related to surgery, early postoperative evolution and perinatal outcomes were analyzed.</div></div><div><h3>Results</h3><div>A total of 158 pregnant patients who underwent laparoscopic surgery were included. The median gestational age at the time of surgery was 20 + 6 weeks (range 5–37 weeks). Most surgeries (61 %) were performed during the midtrimester, while 18 % were at the third trimester. The median admission-to-surgery interval was three days (range: 0–13), and the median hospitalization time was five days (range: 1–22). The mean gestational age at delivery was 38 weeks, and the rate of preterm birth &lt; 37 weeks was 13.5 %. There were three cases of surgical complications (1.9 %) and five pregnancy losses (3.6 %). There were no cases that required admission to an intermediate/intensive care unit after surgery.</div></div><div><h3>Conclusion</h3><div>In this single-center case series, laparoscopic cholecystectomy for symptomatic gallbladder disease during pregnancy was associated with acceptable maternal and perinatal outcomes across a wide range of gestational ages. Laparoscopic cholecystectomy appears feasible at different trimesters of pregnancy. Further studies are needed to determine if this alternative is better than conservative management.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114909"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of concern \"Bacterial vaginosis and infertility: cause or association?\" [Eur. J. Obstet. Gynecol. Reprod. Biol. 167/1 (2013) 59-63].","authors":"Rasheed M Salah, Abdelmonem M Allam, Amin M Magdy, Abeer Sh Mohamed","doi":"10.1016/j.ejogrb.2025.114934","DOIUrl":"https://doi.org/10.1016/j.ejogrb.2025.114934","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"114934"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164755","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":"Cervical Stiffness Index as predictor of preterm birth in women with threatened preterm labor","authors":"Dario Colacurci ,&nbsp;Gabriele Saccone ,&nbsp;Alessandra Ammendola ,&nbsp;Giorgia Buonomo ,&nbsp;Chiara Murolo ,&nbsp;Mariavittoria Locci","doi":"10.1016/j.ejogrb.2025.114910","DOIUrl":"10.1016/j.ejogrb.2025.114910","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the uterine cervix stiffness in patients presenting with threatened preterm labor (PTL) measured with an aspiration-based device (expressed as Cervical Stiffness Index − CSI) and to correlate CSI with pregnancy outcomes.</div></div><div><h3>Study design</h3><div>Single-center, prospective, observational pilot study of patients with singleton pregnancies presenting with threatened PTL between 24^0/7 and 33^6/7 weeks. Patients underwent a physical examination, ultrasound examination, transvaginal ultrasound cervical length (CL) measurement and cervical stiffness assessment using the Pregnolia System, an aspiration-based device measuring the vacuum required to displace the tissue into the device tip by a fixed distance, a proxy for stiffness (CSI, mbar). Higher CSI indicates stiffer tissue.</div></div><div><h3>Results</h3><div>Between April 2022 and August 2024, 100 patients with signs and symptoms of PTL were recruited. Thirty-five had a PTB, of which 7 delivered &lt; 34 weeks, 5 within 14 days and 11 within 28 days from measurement. CSI and CL were significantly different between patients delivering at term and patients with a PTB. The Area under the Curve of CSI and CL for prediction of delivery ≤ 14 days from measurement were 0.979 (95 % CI, 0.952–1.000) and 0.744 (0.369–1.000), respectively; for delivery ≤ 28 days from measurement, 0.802 (0.612–0.993), and 0.764 (0.579–0.948), respectively; for PTB &lt; 34 weeks, 0.873 (0.729–1.000) and 0.836 (0.563–1.000), respectively; and for PTB &lt; 37 weeks 0.845 (0.763–0.926) and 0.779 (0.680–0.877), respectively.</div></div><div><h3>Conclusions</h3><div>In patients presenting with threatened PTL, a softer cervix as measured by CSI was associated with an increased risk of preterm birth. These findings suggest that CSI has potential as a predictor of PTB in symptomatic patients, but require confirmation in larger, independent cohorts.</div></div><div><h3>Clinical trial registration</h3><div>NCT05355649.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114910"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838108","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":"Does BMI affect treatment outcomes following intradetrusor onabotulinumtoxinA (Botox) injection in patients with Overactive Bladder (OAB)?","authors":"Miriam O’Kane ,&nbsp;Adith Thomas ,&nbsp;Erin Fitzsimons-West ,&nbsp;Lily Bracken ,&nbsp;Ana DaSilva ,&nbsp;Hayser Medina Lucena ,&nbsp;Ivilina Pandeva ,&nbsp;Smita Rajshekhar ,&nbsp;Ashish Pradhan","doi":"10.1016/j.ejogrb.2025.114907","DOIUrl":"10.1016/j.ejogrb.2025.114907","url":null,"abstract":"<div><div>Overactive bladder (OAB) is a common condition among women, often impairing quality of life and frequently associated with obesity. Intradetrusor onabotulinumtoxinA (BoNT/A) is an established treatment for refractory OAB; however, the influence of body mass index (BMI) on treatment outcomes remains unclear. This retrospective cohort study examined whether obesity impacts subjective and objective treatment responses in women undergoing BoNT/A injections for refractory OAB. Data were collected from the British Society of Urogynaecology (BSUG) database for patients treated between 2013 and 2023 at a tertiary Urogynaecology Centre in the United Kingdom. Of 522 initial cases, 285 women met inclusion criteria. Patient-reported satisfaction at 6 months post-injection and changes in International Consultation on Incontinence Questionnaire – Overactive Bladder (ICIQ-OAB) scores were evaluated. Women were stratified into BMI &lt;30 and BMI ≥30 groups. Satisfaction rates were high and nearly identical between groups (76.8 % vs. 77.0 %, p = 0.973). Likewise, mean change in ICIQ-OAB scores showed minimal and statistically insignificant differences between BMI categories (p = 0.71). Logistic and linear regression analyses, adjusting for age and BoNT/A dose, confirmed that BMI was not a significant predictor of either patient satisfaction or symptom score improvement. Neither age nor BoNT/A dose significantly influenced outcomes. These findings suggest that BMI does not affect the efficacy of BoNT/A treatment for OAB, supporting its use irrespective of weight status. Clinically, BoNT/A remains a valuable therapeutic option for women with refractory OAB, while weight loss should continue to be encouraged for its broader health benefits, including improvements in urinary continence.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114907"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838109","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 total laparoscopic excision of deep endometriosis (DE) on bladder and bowel dysfunction: a prospective longitudinal study","authors":"James S. Morris ,&nbsp;Smita Rajshekhar ,&nbsp;Giulia Gremmo ,&nbsp;Katie Keane ,&nbsp;Saikat Banerjee","doi":"10.1016/j.ejogrb.2025.114924","DOIUrl":"10.1016/j.ejogrb.2025.114924","url":null,"abstract":"<div><div>Deep endometriosis (DE) is established to cause chronic pelvic pain (CPP), lower urinary tract symptoms (LUTS) and altered bowel function. Although the aim of surgical excision is often to relieve CPP, evidence suggests it could also affect LUTS and bowel symptoms, especially where DE affects the bowel or urinary tract. We assessed the prevalence and improvements in CPP, LUTS and bowel symptoms in 130 patients preoperatively and 6 months following total excision of endometriosis using the British Society for Gynaecological Endoscopy (BSGE) Pelvic Pain Questionnaire. Pain symptoms and LUTS are graded 0–10 whilst bowel function is scored 0–4, each using Likert scales. Patients with urinary tract DE reported median bladder pain and bladder voiding dysfunction of 7/10 (95 % CI: 3–8) and 7/10 (95 % CI: 0–9), respectively. Improvements at follow-up did not reach statistical significance at the Šidák-adjusted significance threshold, although 80.0 % and 60.0 % of patients reported clinically important improvements to these respective symptoms. There were also no cases of <em>de novo</em> LUTS following excision of urinary tract DE. Patients with bowel DE reported CPP and menstrual dyschezia of 7/10 (95 % CI: 6–8) and 8/10 (95 % CI: 4–8), respectively. Although a significant proportion of patients with bowel DE reported clinically important improvements in bowel symptoms, the difference in symptomatic severity failed to reach statistical significance. Whilst excision of DE can produce clinically important improvements in LUTS and bowel symptoms in a large proportion of patients, there is also a considerable risk of occasioning <em>de novo</em> bowel symptoms.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114924"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881264","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":"Role of mediolateral or lateral episiotomy in preventing obstetric anal sphincter injury (OASI) in nulliparous women undergoing vacuum-assisted delivery: A systematic review and meta-analysis","authors":"Giovanni Morganelli ,&nbsp;Gabriella Maria Celora ,&nbsp;Maria Chiara Bassi ,&nbsp;Andrea Dall’Asta ,&nbsp;Maurizio Di Serio ,&nbsp;Vito Andrea Capozzi ,&nbsp;Tullio Ghi ,&nbsp;Stefania Fieni","doi":"10.1016/j.ejogrb.2026.114939","DOIUrl":"10.1016/j.ejogrb.2026.114939","url":null,"abstract":"<div><h3>Background</h3><div>The potential preventive effect of mediolateral and lateral episiotomy on the risk of anal sphincter injury related to vacuum delivery in nullipara has been reported by different well-designed studies in the last years.</div></div><div><h3>Objectives</h3><div>The aim of this systematic review and <em>meta</em>-analysis is to summarize the available evidence on the protective effect of mediolateral or lateral episiotomy towards the occurrence of obstetric anal sphincter injury (OASI) in nulliparous women who were submitted to vacuum-assisted delivery.</div><div><em>Search strategy:</em> PubMed, Embase, CINAHL, Cochrane Library and Scopus databases were retrospectively searched without any temporal restriction up to March 1st 2025.</div><div><em>Selection criteria:</em> Randomized controlled trials, retrospective, prospective case-control or cohort studies investigating the incidence of perineal tears involving anal sphincter muscles and/or rectal mucosa after vacuum-assisted birth with and without mediolateral/lateral episiotomy in nulliparous women were included.</div><div><em>Data collection and analysis:</em> Risk of bias assessment was conducted for each included study by applying ROB2 score for RCTs and ROBINS-I score for non-randomized studies. Data were extracted and analyzed with Review Manager 5.4.1, results were reported by means of pooled Odd-ratios (ORs) and presented as Forest plots.</div><div><em>Main results:</em> 31 studies (3 RCTs and 28 non-randomized studies) were included. Cumulative sample size consisted in 608,359 nulliparous women who were submitted to vacuum-assisted delivery. Mediolateral/lateral episiotomy was found to halve the incidence of OASI (OR 0.56 [95 % CI 0.42–0.73]) with high between-study heterogeneity reported (I² = 99 %). At sensitivity analysis, a significant reduction in OASI incidence in case of mediolateral/lateral episiotomy was confirmed (OR 0.58 [95 %CI 0.44–0.78]); this analysis was conducted on low/moderate risk of bias studies (1RCT e 5 non-randomized studies, 15,799 patients) and associated with low heterogeneity (I² = 42 %).</div></div><div><h3>Conclusions</h3><div>This updated meta-analysis on the role of mediolateral/lateral episiotomy in nulliparous women submitted to vacuum assisted delivery confirms its protective role from OASI.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114939"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922007","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":"Expectant management of tubal ectopic pregnancy: Updated decision tree analysis for the prediction of successful outcomes","authors":"Natasha Graham ,&nbsp;Sanem Atakan ,&nbsp;Jemma Johns ,&nbsp;Jackie A. Ross","doi":"10.1016/j.ejogrb.2026.114966","DOIUrl":"10.1016/j.ejogrb.2026.114966","url":null,"abstract":"<div><h3>Objectives</h3><div>To re-analyse and update a decision tree developed 20 years ago to counsel women regarding the likelihood of successful expectant management of tubal ectopic pregnancies. The original model was developed using the data from 179 cases.</div></div><div><h3>Study design</h3><div>A retrospective observational analysis spanning a 14-year period was undertaken at the early pregnancy unit of an inner-city teaching hospital. Data were collected for all women who had expectant management when first diagnosed with their tubal ectopic pregnancies. Initial serum human chorionic gonadotropin (hCG) and progesterone levels, gestational age, ectopic morphology and mean diameter of the ectopic were recorded. Data were analysed using decision tree analysis on SPSS (IBM).</div></div><div><h3>Results</h3><div>A total of 798/1968 (40.5%) women with tubal ectopic pregnancies had expectant management and a new decision tree was developed using data from these 798 cases. Expectant management was successful in 512/798. This was 64% of women embarking on expectant management and 26% of all women with tubal ectopic pregnancies. Initial serum hCG level remains the best predictor of success for expectant management. Combined with progesterone level and diameter measurement, the decision tree has been updated.</div></div><div><h3>Conclusion</h3><div>Biochemical and clinical markers can be used to help counsel women about the likelihood of successful expectant management in our early pregnancy unit using decision tree analysis.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114966"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973385","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":"Non-hormonal vaginal gel improves vaginal and sexual health in menopausal women: results from a 6-month prospective study.","authors":"Luigi Della Corte ,&nbsp;Mario Palumbo ,&nbsp;Antonisia Pollio ,&nbsp;Ilenia Nobile ,&nbsp;Lara Cuomo ,&nbsp;Giuseppe Bifulco","doi":"10.1016/j.ejogrb.2025.114902","DOIUrl":"10.1016/j.ejogrb.2025.114902","url":null,"abstract":"<div><h3>Introduction</h3><div>Genitourinary syndrome of menopause (GSM) is a prevalent, progressive condition affecting more than half of postmenopausal women, often compromising vaginal and sexual health. While local estrogen therapy remains the mainstay of treatment, non-hormonal alternatives are increasingly required, particularly for women with contraindications to hormonal therapy.</div></div><div><h3>Study design</h3><div>To evaluate the efficacy and safety of a non-hormonal, Aloe-vera-based vaginal gel enriched with cellulose derivatives and plant extract and sugar complex in improving vaginal health and sexual function in postmenopausal women, as assessed by changes in vaginal pH, Vaginal Health Index (VHI), and Female Sexual Function Index (FSFI) over a six-month period. In this prospective observational study, 52 postmenopausal women were evaluated at baseline, 3 months, and 6 months. Vaginal pH was measured clinically, while the VHI and FSFI were assessed using instruments with established evidence of validity and reliability. Friedman and Wilcoxon tests were applied for within-subject comparisons, and linear mixed-effects models were fitted to evaluate the impact of time, age, and BMI.</div></div><div><h3>Results</h3><div>All parameters significantly improved over time (p &lt; 0.0001). Mean vaginal pH decreased from 5.51 ± 0.39 at baseline to 4.75 ± 0.33 at 6 months, indicating partial restoration of vaginal acidity. VHI increased by + 5.89 ± 2.34 points, and FSFI improved by + 6.80 ± 3.15. At 6 months, 40.4 % of participants achieved FSFI scores ≥ 26.55. Linear mixed models confirmed time as a significant predictor, while age and BMI had no significant effect. No adverse events were reported.</div></div><div><h3>Conclusions</h3><div>Aloe-vera-based non-hormonal vaginal gel therapy significantly improved vaginal health and sexual function in postmenopausal women, independently of age and BMI. The formulation’s moisturizing, soothing, and protective properties likely underlie these benefits, offering a safe and effective non-hormonal option for the management of GSM.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114902"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833471","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":"Assessment of maternal characteristics and outcomes associated with COVID-19-linked HELLP-like syndrome","authors":"Lucy F. Harvey ,&nbsp;Fay F. Pon ,&nbsp;Zaira N. Chavez Jimenez ,&nbsp;Yadira L. Bribiesca Leon ,&nbsp;Carolyn N. Rocha ,&nbsp;Shinya Matsuzaki ,&nbsp;Rachel S. Mandelbaum ,&nbsp;Joseph G. Ouzounian ,&nbsp;Koji Matsuo","doi":"10.1016/j.ejogrb.2026.114959","DOIUrl":"10.1016/j.ejogrb.2026.114959","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114959"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973292","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}