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

{"title":"Retraction notice to “Ovarian parameters and ovarian blood flow of women living in the area of environmental crisis” [Eur. J. Obstet. Gynecol. Reprod. Biol. 200 (2016) 68-71]","authors":"Aru Balmagambetova , Ibrahim A. Abdelazim , Erbol Bekmukhambetov , Gulmira Zhurabekova , Amr H. Yehia , Mohannad AbuFaza","doi":"10.1016/j.ejogrb.2024.11.026","DOIUrl":"10.1016/j.ejogrb.2024.11.026","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"305 ","pages":"Page 209"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871697","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 bilateral transient occlusion of uterine and utero-ovarian arteries on surgical blood loss during laparoscopic myomectomy: A systematic review and meta-analysis of randomized controlled trials","authors":"Saeed Baradwan ,&nbsp;Bandr Hafedh ,&nbsp;Samah Himayda ,&nbsp;Bayan Albouq ,&nbsp;Ehab Badghish ,&nbsp;Neveen Awadh ,&nbsp;Afnan Baradwan ,&nbsp;Mohammed Mamdouh Saleh ,&nbsp;Aziza Hussein Nassef ,&nbsp;Elghamry E. Elghamry ,&nbsp;Mahmoud Moustafa Alshareef ,&nbsp;Alhassan M. Hassan ,&nbsp;Ahmed Mohamed Abdelhakim ,&nbsp;Eman M. Mojahed","doi":"10.1016/j.ejogrb.2024.12.033","DOIUrl":"10.1016/j.ejogrb.2024.12.033","url":null,"abstract":"<div><h3>Background</h3><div>The primary perioperative concern during laparoscopic myomectomy is the risk of significant intraoperative blood loss, which can lead to hypovolemia, necessitate blood transfusion, and result in postoperative anemia. To address this issue, we conducted a systematic review and <em>meta</em>-analysis to assess the impact of temporarily clamping the uterine and utero-ovarian arteries on operative blood loss during laparoscopic myomectomy.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search across various databases to identify eligible clinical trials from inception to May 2024, focusing on randomized controlled trials (RCTs). In the intervention group, temporary bilateral clamping of the uterine and utero-ovarian arteries was performed during laparoscopic myomectomy, while the control group underwent laparoscopic myomectomy without arterial clamping. A <em>meta</em>-analysis was carried out on the gathered data using Revman software. The primary outcomes examined were blood loss and change in hemoglobin, with secondary outcomes including operation time and length of hospital stay.</div></div><div><h3>Results</h3><div>Three RCTs, involving a total of 275 patients, met our inclusion criteria. The intervention group showed significantly lower operative blood loss and a smaller reduction in hemoglobin compared to the control group. There was no notable difference in operation time between the two groups. Moreover, patients in the experimental group experienced a significantly shorter hospitalization duration than those in the control group.</div></div><div><h3>Conclusions</h3><div>The temporary bilateral occlusion of the uterine and utero-ovarian arteries is an effective method for reducing surgical blood loss, hemoglobin decline, and hospital stay duration during laparoscopic myomectomy. However, additional studies are needed to validate these findings.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"305 ","pages":"Pages 241-247"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893144","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":"Dienogest treatment of symptomatic adenomyosis: An in-depth meta-analysis","authors":"Shunhe Lin ,&nbsp;Yishan Chen ,&nbsp;Jingsong Yi ,&nbsp;Xi Xie ,&nbsp;Xishi Liu ,&nbsp;Sun-Wei Guo","doi":"10.1016/j.ejogrb.2024.12.048","DOIUrl":"10.1016/j.ejogrb.2024.12.048","url":null,"abstract":"<div><h3>Background</h3><div>Adenomyosis is a common gynecological disease and a major contributor to dysmenorrhea that substantially reduces the quality of life of the affected. Dienogest has emerged as a promising drug for treating adenomyosis. A few systematic reviews and meta-analyses on this topic have been published recently. However, these meta-analyses were typically based on 2–7 studies, even though numerical data could have been extracted and more studies have been published. Moreover, it is unclear whether there is any characteristic of the patients that is associated with more pronounced improvement after treatment, or which patient subgroup, if any, would benefit most from the dienogest treatment.</div></div><div><h3>Objectives</h3><div>To evaluate the efficacy of dienogest in alleviating dysmenorrhea associated with adenomyosis and identifying study/patient characteristics that contribute to a better therapeutic response.</div></div><div><h3>Design</h3><div>An in-depth <em>meta</em>-analysis incorporating more recent published studies.</div></div><div><h3>Methods</h3><div>An in-depth meta-analysis of 14 studies published up to March 2024, involving 637 patients was conducted, using the visual analog scale (VAS) scores on dysmenorrhea severity as the primary outcome measure. Subgroup analyses and multivariable regression were performed to explore potential factors influencing the treatment effect.</div></div><div><h3>Results</h3><div>Dienogest significantly improved dysmenorrhea, with a mean reduction in VAS scores of 6 on a 10-point scale. Subgroup analyses indicated that dienogest was effective across varying severities of dysmenorrhea and different treatment durations. Notably, patients with higher baseline VAS scores and longer treatment durations experienced greater reductions in VAS scores.</div></div><div><h3>Conclusion</h3><div>Dienogest substantially alleviates dysmenorrhea in women with adenomyosis, particularly among those with severe baseline dysmenorrhea and extended treatment periods. However, variability in patient responses and the potential for adverse effects underscores the importance of individualized treatment strategies. Further large-scale, long-term comparative studies and randomized clinical trials are warranted to optimize treatment outcomes and better understand patient-specific factors.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"305 ","pages":"Pages 365-374"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926530","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":"Inside Back Cover - Editors with images","authors":"","doi":"10.1016/S0301-2115(25)00032-6","DOIUrl":"10.1016/S0301-2115(25)00032-6","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"305 ","pages":"Page IBC"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143128007","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 uterine unfolding sign: A sonographic marker in cesarean scar pregnancy beyond the first trimester","authors":"Z. El-Tani ,&nbsp;P. Mathevet ,&nbsp;D. Baud ,&nbsp;L. Alamo ,&nbsp;J. Sichitiu","doi":"10.1016/j.ejogrb.2024.11.047","DOIUrl":"10.1016/j.ejogrb.2024.11.047","url":null,"abstract":"<div><div>Cesarean scar pregnancy refers to the complete or partial implantation of a gestational sac within an existent cesarean scar. Expectant management of caesarean scar pregnancy can lead to uterine rupture, a rare but life-threatening complication. We report here a sonographic marker which could predict short-term risk of uterine rupture in the context of expectant management of CSP after 15 weeks.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"305 ","pages":"Pages 427-430"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822008","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":"Prevalence and characteristics of mistreatment during childbirth in two Israeli hospitals","authors":"Keshet Korem ,&nbsp;Inbal Shlomi Polachek ,&nbsp;Sara Cohen Shabot ,&nbsp;Reuven Kedar ,&nbsp;Mordechai Bardicef ,&nbsp;Shlomi Sagi ,&nbsp;Lena Sagi-Dain","doi":"10.1016/j.ejogrb.2024.12.019","DOIUrl":"10.1016/j.ejogrb.2024.12.019","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the prevalence and characteristics of mistreatment during childbirth in Israeli medical centers, addressing gaps in quantitative data within developed countries.</div></div><div><h3>Study design</h3><div>A new questionnaire, incorporating demographic, obstetric, and mistreatment-related questions, was developed and distributed to postpartum women in two Israeli hospitals. Mistreatment categories included physical, sexual, and verbal abuse, failure to meet professional standards, poor rapport between women and providers, and health system conditions. Statistical analysis examined associations with clinical and demographic variables.</div></div><div><h3>Results</h3><div>Of 422 analyzed questionnaires, most prevalent categories associated with mistreatment during childbirth were failure to meet professional standards (51.9%) and poor rapport between women and providers (33.2%). Cesarean section, complications during childbirth, and planned birth mode were significantly associated with mistreatment. Painful vaginal examinations, inadequate pain relief, and lack of explanations were common concerns. Factors like educational preparation, previous vaginal delivery, and doula support were linked to specific mistreatment subcategories.</div></div><div><h3>Conclusions</h3><div>This study revealed a considerable prevalence of mistreatment during childbirth in Israeli medical centers, emphasizing the urgent need for reform in maternity care. Addressing specific issues, such as improving communication, consent procedures, and pain management during childbirth, is crucial for enhancing the overall birthing experience. The findings contribute valuable insights to promote respectful maternity care practices in Israel.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"305 ","pages":"Pages 285-291"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893139","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":"Delivery mode and risk of intraventricular hemorrhage: A retrospective single-center study on 1760 preterm infants of less than 32 weeks","authors":"Elisa Cimadamore ,&nbsp;Alessio Correani ,&nbsp;Rita D’Ascenzo ,&nbsp;Maria Paola Bellagamba ,&nbsp;Ilaria Burattini ,&nbsp;Giovanna Irene Battistoni ,&nbsp;Andrea Ciavattini ,&nbsp;Virgilio Carnielli","doi":"10.1016/j.ejogrb.2024.12.017","DOIUrl":"10.1016/j.ejogrb.2024.12.017","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between delivery mode and intraventricular hemorrhage (IVH) in infants with a gestational age (GA) &lt; 32 weeks.</div></div><div><h3>Study Design</h3><div>We retrospectively reviewed data of 1760 infants with a GA between 24^+0/7 and 31^+6/7 weeks/days born between 01.01.2004 and 31.12.2022. We excluded outborn, congenital malformations, infants born by complicated delivery and without antenatal corticosteroid administration. Exposure was the delivery mode: cesarean section (CS) versus vaginal delivery (VD). IVH within the first week of life was the primary outcome. Multiple regression analyses were used to evaluate the association between delivery mode and IVH. CS infants were also match-paired for GA and small for gestational age (SGA) with VD infants.</div></div><div><h3>Results</h3><div>The incidence of IVH was lower in 1046 CS than in 144 VD study infants (IVH I-IV: 14 vs 29 %, p &lt; 0.001; IVH I-II: 10 vs 22 %, p &lt; 0.001; IVH III-IV: 3 vs 8 %, p = 0.008). CS was associated with a lower risk of IVH grades I-IV (aOR: 0.52, p = 0.012) after the adjustment for GA, year of birth, sex, singleton pregnancy, SGA, hypertensive disorders of pregnancy, pH ≤ 7.00 and/or standard base excess (SBE) ≤ -12 mmol/L at cord blood gas analysis, early-onset sepsis, hemodynamically significant patent ductus arteriosus, thrombocytopenia, need of blood transfusion, mechanical ventilation and inotropes/vasoactive amines.</div></div><div><h3>Conclusions</h3><div>CS was associated with lower risk of IVH than VD in infants with a GA between 24^+0/7 and 31^+6/7 weeks/days, born by uncomplicated delivery and who have received antenatal corticosteroids.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"305 ","pages":"Pages 147-152"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863716","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":"Prevalence of depression and anxiety in women with chronic pelvic Pain: A systematic review and Meta-Analysis","authors":"João Nogueira Neto ,&nbsp;Antonio Igor da Costa Brito ,&nbsp;Mayara Bottentuit Nogueira ,&nbsp;Lyrian Lorena Freire Lira ,&nbsp;Lyvia Maria Rodrigues de Sousa Gomes ,&nbsp;Plínio da Cunha Leal ,&nbsp;Ed Carlos Rey Moura","doi":"10.1016/j.ejogrb.2024.12.042","DOIUrl":"10.1016/j.ejogrb.2024.12.042","url":null,"abstract":"<div><div><strong>Purpose</strong>: This study aimed to present the prevalence of depression and anxiety in women with Chronic Pelvic Pain (CPP) and their associated factors. <strong>Methods</strong>: This systematic review and <em>meta</em>-analysis were conducted using the PubMed, Embase, and SciELO platforms, focusing on studies published between 2010 and 2024. <strong>Results</strong>: Eight studies were evaluated and demonstrated a significant prevalence of anxiety and depression in women with CPP, ranging from 22.8% to 79.0% and 14.0% to 56.9%, respectively. The HADS (Hospital Anxiety and Depression Scale) was the most used tool for screening anxiety and depression (37.5%), the PHQ (Patient Health Questionnaire) was used by 25.0%, one study used the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders), and another relied on self-reporting of these disorders. In the <em>meta</em>-analysis, patients with CPP were found to be twice as likely to have anxiety disorders but not depression. The studies varied in their healthcare context, and only two specifically focused on evaluating mental disorders in women with CPP. <strong>Conclusion</strong>: An increased prevalence of anxiety was observed in women with CPP, while the prevalence of depression was elevated but not statistically significant. Significant associations were found with physical and sexual abuse, early emotional trauma, endometriosis, and surgical trauma.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"305 ","pages":"Pages 312-317"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902794","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 effects of e-health care on health outcomes and psychological distress in patients undergoing assisted reproductive technology: A systematic review and meta-analysis of randomized controlled trials","authors":"Yan Wang ,&nbsp;Xiaoyan Zhao ,&nbsp;Yuyang Wang ,&nbsp;Yan Pu","doi":"10.1016/j.ejogrb.2024.12.053","DOIUrl":"10.1016/j.ejogrb.2024.12.053","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Many studies have reported that electronic health (e-health) care helps health professionals manage patients undergoing assisted reproductive technology (ART) and improves their reproductive outcomes and psychological distress. However, little is known about the effectiveness of e-health care on the health outcomes of patients undergoing ART.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;This study aimed to evaluate the effectiveness of e-health care on patient-centered health outcomes, such as live birth rate, pregnancy rate, time to pregnancy, etc. as well as psychological distress (i.e., infertility distress and anxiety) among individuals undergoing ART.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A systematic review with random-effects or fixed-effects meta-analysis was conducted to compare e-health interventions with usual care in patients undergoing ART.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;Electronic database, including Medline, EMBASE, Web of Science, CINHAL, and CENTRAL, were systematically searched from the inception to December 01, 2023. The authors independently reviewed the articles based on inclusion and exclusion criteria, extracted data, and assessed risk of bias used the Cochrane Risk of Bias tool version 2.0. Heterogeneity was evaluated with &lt;em&gt;I&lt;sup&gt;2&lt;/sup&gt;&lt;/em&gt; and Chi-square. We pooled data from each study using fixed-effects meta-analysis if heterogeneity was low. Random-effects meta-analysis was used to pool data with high heterogeneity. Subgroup analysis (i.e., data collection time point) and sensitivity analysis was performed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Result&lt;/h3&gt;&lt;div&gt;Data were synthesized from 21 articles covering a total of 6,749 participants (female:6,227; male:522). Pooled analysis showed that e-health care may not increase live birth rate (&lt;em&gt;RR&lt;/em&gt; 1.44 95 %CI0.78–2.67, &lt;em&gt;P&lt;/em&gt; = 0.25). The clinical pregnancy rate was increased to 1.57 times in the e-health care group compared with the control group (&lt;em&gt;Z&lt;/em&gt; = 2.19, &lt;em&gt;P&lt;/em&gt; = 0.03) and the e-health care group had an increase in time to pregnancy by 17.40 days than that of the control group (&lt;em&gt;Z&lt;/em&gt; = 2.13, &lt;em&gt;P&lt;/em&gt; = 0.03). Lower score of Fertility Problem Inventory-social subscale was found in the e-health care group. Subgroup analysis showed that the risk ratio of clinical pregnancy was 3.07 (95 %CI 1.60–5.89) in &lt; 3 months group, 1.21 (95 %CI 0.93–1.59) in &lt;strong&gt;≥&lt;/strong&gt;3 months group. The fertility-related knowledge level in e-health group was higher than that of the control group (&lt;em&gt;Z&lt;/em&gt; = 2.01, &lt;em&gt;P&lt;/em&gt; = 0.04).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Low certainty evidence suggests that e-health care increases the clinical pregnancy rate after the intervention. Additionally, e-health care benefits in improving perceived infertility-related stress specific to social and the level of infertility-related knowledge. Future studies are needed to establish core outcome measures for e-health intervention targeting infertile indi","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"305 ","pages":"Pages 394-403"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930864","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":"Logistics for achieving delivery: A secondary analysis of the home induction randomised controlled trial","authors":"Sarah M. Nicholson ,&nbsp;Karen Flood ,&nbsp;Patrick Dicker ,&nbsp;Zara E. Molphy ,&nbsp;Orla T. Smith ,&nbsp;Corina I. Oprescu ,&nbsp;Eimear M. Wall ,&nbsp;Sara N. El Nimr ,&nbsp;Ita M. Shanahan ,&nbsp;Bernard J. Kennedy ,&nbsp;Ronan V. Daly ,&nbsp;Michael P. Geary ,&nbsp;Geraldine Gannon ,&nbsp;Claudia Looi ,&nbsp;Brian J. Cleary ,&nbsp;Elena Fernandez ,&nbsp;Fergal D. Malone","doi":"10.1016/j.ejogrb.2024.11.043","DOIUrl":"10.1016/j.ejogrb.2024.11.043","url":null,"abstract":"<div><h3>Objective</h3><div>This secondary analysis evaluates the logistics of achieving vaginal delivery following outpatient induction. This includes changes in Bishop score before and after cervical ripening, the need for additional ripening agents, time interval from induction to delivery, all of which provide invaluable information when developing an outpatient induction of labour service.</div></div><div><h3>Study design</h3><div>We randomised healthy nulliparous women with no significant medical history, who agreed to elective induction of labour at 39 weeks’ gestation, to one of three forms of initial cervical ripening at home: 12 h of Dilapan-S, 24 h of Dilapan-S, or 24 h of slow-release dinoprostone (Propess). Patients returned to the hospital after 12 or 24 h for either amniotomy or, if the cervix remained unripe, additional doses of Prostin. We present our experience with the development of a regulated protocol for outpatient induction of labour, as well as safety considerations, in order to assist those wishing to adopt such practice. Effectiveness of each induction agent, time to delivery, and length of hospital stay were assessed as part of this secondary analysis.</div></div><div><h3>Results</h3><div>A total of 180/271 (66%) of all nulliparous women were delivered within 48 h of induction commencing, and 254/271 (94%) delivered within 72 h, inclusive of the time period spent at home. Participants in the Propess group were more likely to require early readmission than in the Dilapan-S groups (45% vs 9%). Patients randomised to Dilapan-S 12 h and Dilapan-S 24 h were more likely to require additional Prostin prior to amniotomy being possible (65% vs 34%). Those who did not require additional ripening had very high vaginal delivery rates ranging from 80% to 88%. Induction agent removal time to delivery was similar across all groups. The length of hospital stay ranged from a median of 76 to 88 h from readmission to discharge.</div></div><div><h3>Conclusion</h3><div>Outpatient cervical ripening is an efficient and useful option for dealing with the logistical challenges facing busy Labour Wards, with the majority of nulliparous patients delivering within 48 h, including time spent at home. This resource-friendly option requires less time within the hospital setting for a carefully selected cohort.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"305 ","pages":"Pages 56-61"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794195","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}