International Journal of Gynecology & Obstetrics最新文献

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Volume-based complete automation for ultrasound fetal biometry: A pilot approach to assess feasibility, reliability, and perspectives. 基于体积的超声波胎儿生物测量完全自动化:评估可行性,可靠性和前景的试点方法。
IF 2.6 3区 医学
International Journal of Gynecology & Obstetrics Pub Date : 2025-03-18 DOI: 10.1002/ijgo.70041
Gaëlle Ambroise Grandjean, Matthieu Dap, Cybele Ciofolo-Veit, Laurence Rouet, Yohan Damas, Claire Banasiak, Laurence Bourguignon, Adeline Collin, Olivier Morel, Gabriela Hossu
{"title":"Volume-based complete automation for ultrasound fetal biometry: A pilot approach to assess feasibility, reliability, and perspectives.","authors":"Gaëlle Ambroise Grandjean, Matthieu Dap, Cybele Ciofolo-Veit, Laurence Rouet, Yohan Damas, Claire Banasiak, Laurence Bourguignon, Adeline Collin, Olivier Morel, Gabriela Hossu","doi":"10.1002/ijgo.70041","DOIUrl":"https://doi.org/10.1002/ijgo.70041","url":null,"abstract":"<p><strong>Background: </strong>Detection algorithms targeting anatomic landmarks in three-dimensional (3D) ultrasound (US) volume (three-dimensional US) appear to be a relevant and easy-to-implement option to address junior and occasional operators' difficulties in probe positioning for two-dimensional (2D) fetal biometry.</p><p><strong>Objectives: </strong>This study assesses the feasibility of complete automation for fetal biometry and the resulting agreement with standard 2D (US) measurements. The secondary objectives were to assess the impact of software-driven measurement on image quality scoring, reproducibility, and agreement with human-driven measurements issued from the same volumes.</p><p><strong>Methods: </strong>Datasets were collected from a consecutive sample of women attending standard US follow-up (singleton, 16-30 weeks of gestation). Each dataset contained 2D measurements for reference (head and abdomen circumference and femoral length) and 3D US volume acquisitions of the fetal head, abdomen, and thigh. Both algorithm-based and operator-based detection of the targeted plans and calipers positioning were applied to the 3D volumes to produce software-driven and human-driven measurements. The resulting 3D measurements were assessed for completion rates, image quality, and reproducibility.</p><p><strong>Results: </strong>On 175 datasets collected, completion rates in achieving software-driven 3D measurements ranged between 94% (abdomen) and 100% (head). A modest weakening in quality (of uncertain clinical significance) was notable for the head and abdomen measurements. Compared to the 2D measurements, the software-driven tended to slightly overestimate the estimated fetal weight (EFW; e.g., 95% confidence interval ranging from 445 to 635 g for a 525 g-sized fetus at 22 weeks of gestation). The random error tended to be inflated for fetuses >700 g. Intra- and inter-operator reproducibility were appropriate (intraclass correlation coefficient intervals ranged from 0.8 to 0.99).</p><p><strong>Conclusion: </strong>Complete automation of US biometry appears feasible and presents appropriate reproducibility and image quality scoring, but third-trimester biometry needs improvement. Before clinical implementation, it is time to assess the impact of point-of-care use on large populations.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gynecology residents' preparedness to perform standard gynecological procedures autonomously: A national survey among French residents and faculty. 妇科住院医师自主执行标准妇科手术的准备情况:一项针对法国住院医师和教师的全国性调查。
IF 2.6 3区 医学
International Journal of Gynecology & Obstetrics Pub Date : 2025-03-17 DOI: 10.1002/ijgo.70068
Laura Puroski, Sophia Braund, Olivia Guerin, Eric Verspyck, Patrice Crochet, Salma Touleimat
{"title":"Gynecology residents' preparedness to perform standard gynecological procedures autonomously: A national survey among French residents and faculty.","authors":"Laura Puroski, Sophia Braund, Olivia Guerin, Eric Verspyck, Patrice Crochet, Salma Touleimat","doi":"10.1002/ijgo.70068","DOIUrl":"https://doi.org/10.1002/ijgo.70068","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the perceptions of French residents and academic teachers regarding residents' autonomy during training and their preparedness to perform standard gynecological procedures.</p><p><strong>Methods: </strong>A national survey of French obstetrics and gynecology residents and their academic teachers was conducted using an online questionnaire distributed in 2023, which gathered opinions on the level of autonomy granted in the operating room for performing standard gynecological procedures and perceptions of preparedness upon graduation. The survey also examined perceptions on the impact of factors that improve surgical autonomy.</p><p><strong>Results: </strong>The response rate was 43% (510/1197) for residents and 31% (42/137) for academic teachers. The opinions of residents and academic teachers regarding residents' surgical preparedness by graduation were similar, except for vaginal hysterectomy (30% vs. 57%, P < 0.001). Residents were thought prepared to perform hysteroscopy and adnexal surgery by laparoscopy by >90% of respondents. Regarding hysterectomy, opinions varied depending on the approach: the only approach for which more than two-thirds of residents (67%) were thought to be prepared by gradation was laparoscopy. Regarding factors promoting surgical autonomy, 99% of residents and 97% of teachers considered case volume and coaching quality essential. Only 37% of residents and 55% of teachers deemed the introduction of summative assessment relevant.</p><p><strong>Conclusion: </strong>French residents and academic teachers reported adequate preparedness for hysteroscopy and adnexal surgery. There were concerns regarding preparedness for more complex surgeries, particularly laparotomic and vaginal hysterectomy. These findings underscore the need for revisions in training methods and residency objectives.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leveraging a criteria-based audit approach to identify challenges and develop strategies to improve management of postpartum hemorrhage: A case study from the Dominican Republic. 利用基于标准的审计方法来识别挑战并制定改善产后出血管理的战略:来自多米尼加共和国的案例研究。
IF 2.6 3区 医学
International Journal of Gynecology & Obstetrics Pub Date : 2025-03-17 DOI: 10.1002/ijgo.70038
Paxton Voigt, Beralis Ramos, Sasha Hernandez, Roberlina Hernandez, Manuel Jimenez, Cayetano Collado, Taraneh Shirazian
{"title":"Leveraging a criteria-based audit approach to identify challenges and develop strategies to improve management of postpartum hemorrhage: A case study from the Dominican Republic.","authors":"Paxton Voigt, Beralis Ramos, Sasha Hernandez, Roberlina Hernandez, Manuel Jimenez, Cayetano Collado, Taraneh Shirazian","doi":"10.1002/ijgo.70038","DOIUrl":"https://doi.org/10.1002/ijgo.70038","url":null,"abstract":"<p><strong>Objective: </strong>Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide. This case study aims to assess current PPH at our study site hospital, identify strategies to enhance management based on audit findings, and pilot test the feasibility and acceptability of these strategies.</p><p><strong>Methods: </strong>A criteria-based audit (CBA) was conducted at La Maternidad Renee Klang Viuda Guzman Hospital in Santiago, Dominican Republic from November 2021 to September 2022. The audit assessed current practice through surveys of 59 healthcare workers and a retrospective review of 10 PPH cases, using eight evidence-based criteria. Audit findings informed the development of a PPH toolkit, protocol, and simulation-based training program (SBT). The toolkit's impact was evaluated through surveys, and SBT effectiveness was assess through post-training feedback from participants.</p><p><strong>Results: </strong>The baseline audit revealed 25% compliance with evidence-based criteria. Key gaps included maternal risk assessment, provider training, and protocol use. Targeted strategies, including a PPH toolkit, protocol and SBT, were implemented. Of the 13 toolkit users, 92% felt it improved timely management. Post-SBT surveys showed that participants rated the training highly, with significant improvements in communication, teamwork, and self-reported competence in PPH management.</p><p><strong>Conclusion: </strong>CBAs are effective in identifying care barriers in middle-income settings. The PPH toolkit and SBT were well received and improved both technical and non-technical skills, offering a scalable model for improving PPH management in low-resource settings.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Response: Weight-based versus fixed-dose oxytocin infusion for preventing uterine atony during cesarean section in laboring patients: A randomized trial. 反应:体重与固定剂量催产素输注预防剖宫产术中子宫张力:一项随机试验。
IF 2.6 3区 医学
International Journal of Gynecology & Obstetrics Pub Date : 2025-03-17 DOI: 10.1002/ijgo.70084
Asha Tyagi, Poonam Bodh
{"title":"Response: Weight-based versus fixed-dose oxytocin infusion for preventing uterine atony during cesarean section in laboring patients: A randomized trial.","authors":"Asha Tyagi, Poonam Bodh","doi":"10.1002/ijgo.70084","DOIUrl":"https://doi.org/10.1002/ijgo.70084","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gynecological surgery in patients with kidney failure on chronic kidney replacement therapy: A binational data linkage study of morbidity and mortality outcomes. 慢性肾脏替代疗法对肾衰竭患者的妇科手术:发病率和死亡率结果的两国数据关联研究。
IF 2.6 3区 医学
International Journal of Gynecology & Obstetrics Pub Date : 2025-03-17 DOI: 10.1002/ijgo.70064
Mina Khair, Dharmenaan Palamuthusingam, Carmel M Hawley, Elaine M Pascoe, Usama Shahid, David W Johnson, Magid Fahim
{"title":"Gynecological surgery in patients with kidney failure on chronic kidney replacement therapy: A binational data linkage study of morbidity and mortality outcomes.","authors":"Mina Khair, Dharmenaan Palamuthusingam, Carmel M Hawley, Elaine M Pascoe, Usama Shahid, David W Johnson, Magid Fahim","doi":"10.1002/ijgo.70064","DOIUrl":"https://doi.org/10.1002/ijgo.70064","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates postoperative outcomes of patients with kidney failure on chronic kidney replacement therapy after gynecological surgery.</p><p><strong>Methods: </strong>This binational data-linkage study identified patients with kidney failure via the Australia and New Zealand Dialysis and Transplant Registry who underwent major gynecological surgeries between 2000 and 2015. The primary outcome was postoperative mortality. Secondary outcomes included infective, medical, and wound complications, transfusion requirement, intensive care unit (ICU) admissions, readmissions, length of stay, and dialysis/transplant-specific outcomes. Univariable and multivariable logistic and negative binomial regression models were used.</p><p><strong>Results: </strong>Among the 403 patients included, 30.5% underwent abdominal hysterectomy, 19.1% vaginal hysterectomy and 50.4% ovarian surgery. Thirty-day mortality and morbidity rates were 1.2% (95% confidence interval [CI]: 0.5-3.0) and 30.8% (95% CI: 26.3-35.6), respectively. Compared with abdominal hysterectomy, vaginal hysterectomy was associated with fewer transfusions (adjusted odds ratios [aOR]: 0.40, 95% CI: 0.16-0.98), ICU admissions (aOR: 0.28, 95% CI: 0.09-0.80), and shorter stays (IRR: 0.74, 95% CI: 0.55-0.99). Of all kidney replacement therapies, postoperative mortality was highest in patients on peritoneal dialysis (6.9%, 95% CI: 1.2-24.2, P = 0.026). This cohort also required more transfusions (aOR: 2.84, 95% CI: 1.12-7.21) and had longer stays (IRR: 1.58, 95% CI: 1.07-2.33). Kidney transplant recipients had fewer ICU admissions (aOR: 0.22, 95% CI: 0.09-0.52) and shorter stays (IRR: 0.75, 95% CI: 0.58-0.96). Emergency admissions and older age correlated with poorer outcomes.</p><p><strong>Conclusion: </strong>Patients on chronic kidney replacement therapy undergoing gynecological surgery demonstrated low postoperative mortality but substantial morbidity. Further research is needed to evaluate risk-mitigating strategies.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of twin pregnancies: Remaining challenges and unanswered questions. 双胎妊娠的管理:仍然存在的挑战和未解决的问题。
IF 2.6 3区 医学
International Journal of Gynecology & Obstetrics Pub Date : 2025-03-14 DOI: 10.1002/ijgo.70070
Nir Melamed, Jon Barrett, Amir Aviram, Elad Mei-Dan
{"title":"Management of twin pregnancies: Remaining challenges and unanswered questions.","authors":"Nir Melamed, Jon Barrett, Amir Aviram, Elad Mei-Dan","doi":"10.1002/ijgo.70070","DOIUrl":"https://doi.org/10.1002/ijgo.70070","url":null,"abstract":"<p><p>Several professional societies have published guidelines on twin pregnancies over the past few years. These documents provide recommendations on antenatal surveillance and management of twin pregnancies. At the same time, these guidelines identify several key areas where evidence is limited and additional research is needed. In the present review, we summarize available evidence regarding some of these key areas, including the screening and prevention of preterm birth, the definition and management of fetal growth restriction, the diagnosis and management of gestational diabetes, the optimal maternal gestational weight gain, and the mode and timing of delivery. In addition, we describe several online tools related to these areas that can empower individuals with twin pregnancies and assist care providers in counseling these patients.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictors of surgical outcomes in transcervical resection of myoma. 经宫颈肌瘤切除术预后的预测因素。
IF 2.6 3区 医学
International Journal of Gynecology & Obstetrics Pub Date : 2025-03-14 DOI: 10.1002/ijgo.70015
Elizabeth Joan E Ocampo, Macario F Reandelar, Peng-Hui Wang
{"title":"Predictors of surgical outcomes in transcervical resection of myoma.","authors":"Elizabeth Joan E Ocampo, Macario F Reandelar, Peng-Hui Wang","doi":"10.1002/ijgo.70015","DOIUrl":"https://doi.org/10.1002/ijgo.70015","url":null,"abstract":"<p><strong>Objective: </strong>To verify identified predictors of surgical outcomes in transcervical resection of myoma (TCRM) in Filipino women.</p><p><strong>Methods: </strong>A retrospective analytical cross-sectional study was done on 474 women who underwent TCRM between 2010 and 2020, in St Luke's Medical Center, Philippines. Ethical exemption was granted by the Institutional Ethics Committee. Identified predictors of prolonged operative time (>60 min)-increased blood loss (>70 mL), fluid overload, uterine perforation, and incomplete resection-in published research studies were analyzed.</p><p><strong>Results: </strong>Univariate analysis revealed that European Society for Gynecological Endoscopy (ESGE) type 2, and myoma size ≥5 cm, myoma number ≥3 were associated with prolonged operative time. ESGE type 2 and myoma size ≥5 cm were associated with increased blood loss and incomplete resection. Myoma size ≥5 cm, an intraoperative fluid deficit of 1000 mL (hypotonic) or 2500 mL (isotonic), and prolonged operative time were correlated with fluid overload. ESGE type 2 is associated with uterine perforation. Only a Lasmar score ≥5 was significantly associated with all the aforementioned unfavorable surgical outcomes. Multivariate analysis showed that a Lasmar score ≥5 (odds ratio [OR] 6143.26; 95% confidence interval [CI] 456-82 680; P < 0.001) and myoma size ≥5 cm (OR 21.56; 95% CI 1.67-277; P = 0.019) were independent predictors of adverse surgical outcomes.</p><p><strong>Conclusion: </strong>This study verified that the Lasmar classification can predict TCRM complexity with cut-off values of 5 for both Lasmar score and myoma size. We recommend that the use of the Lasmar scoring classification preoperatively may be beneficial in TCRM in Filipino women.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
External validation of web-based calculator to predict cesarean delivery after induction of labor. 网络计算器预测引产后剖宫产的外部验证。
IF 2.6 3区 医学
International Journal of Gynecology & Obstetrics Pub Date : 2025-03-12 DOI: 10.1002/ijgo.70069
Malini Sukayogula, Maimoona Ahmed, Parthbhai Donga, Ananta Ghimire
{"title":"External validation of web-based calculator to predict cesarean delivery after induction of labor.","authors":"Malini Sukayogula, Maimoona Ahmed, Parthbhai Donga, Ananta Ghimire","doi":"10.1002/ijgo.70069","DOIUrl":"https://doi.org/10.1002/ijgo.70069","url":null,"abstract":"<p><strong>Objective: </strong>To externally validate a prediction model for the risk of a cesarean section after induction of labor (IOL) using a web-based cesarean risk calculator in a tertiary perinatal center and to compare the performance of three calculators in predicting the cesarean risk after IOL based on their sensitivity and specificity.</p><p><strong>Methods: </strong>This was a prospective observational study of 577 women over a period of 1 year at a tertiary perinatal center in India. Women with singleton-term pregnancies with intact membranes that underwent induction were included. We used three prediction tools; Levine's, Rossi's and Irwinda's calculators for predicting cesarean rates. The variables were entered directly into the calculators at the start of IOL, producing an individualized risk of cesarean delivery. The mode of delivery was the primary outcome variable. Area under the ROC curve (AUC), calibration plots and decision making curve analysis were used for comparison.</p><p><strong>Results: </strong>Out of 577 mothers who underwent IOL, 345 (59.79%) women had a vaginal birth and 232 (40.21%) underwent cesarean section. The Levine calculator reached the maximum discriminative capacity (AUC: 0.785) for our population, followed by Rossi (AUC: 0.7723) and Irwinda (AUC: 0.6608). Levine's calculator slightly overestimated the risk of cesarean section at lower thresholds but underestimated the risk at higher threshold probabilities whereas Rossi's calculator underestimated the risk of cesarean section at all threshold probabilities above 11%.</p><p><strong>Conclusion: </strong>The Levine and Rossi calculators have the greatest potential for use in clinical settings. However, these cannot be used individually for clinical decision making without prospective studies evaluating their clinical impact on pregnant women undergoing IOL.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Laparoscopic repair of uterine rupture after delivery: A comprehensive evaluation of the uterine rupture management, with a proposal surgical method. 腹腔镜修复产后子宫破裂:综合评价子宫破裂处理方法,并提出手术方法。
IF 2.6 3区 医学
International Journal of Gynecology & Obstetrics Pub Date : 2025-03-12 DOI: 10.1002/ijgo.70066
Giovanni Pecorella, Martina Licchelli, Gaetano Panese, Andrea Morciano, Radmila Sparic, Ioannis Kosmas, Filippo De Rosa, Antonio Malvasi, Andrea Tinelli
{"title":"Laparoscopic repair of uterine rupture after delivery: A comprehensive evaluation of the uterine rupture management, with a proposal surgical method.","authors":"Giovanni Pecorella, Martina Licchelli, Gaetano Panese, Andrea Morciano, Radmila Sparic, Ioannis Kosmas, Filippo De Rosa, Antonio Malvasi, Andrea Tinelli","doi":"10.1002/ijgo.70066","DOIUrl":"https://doi.org/10.1002/ijgo.70066","url":null,"abstract":"<p><p>Uterine rupture constitutes a critical obstetric emergency that presents substantial risks to both the maternal and fetal populations. This investigation evaluated the surgical interventions available for uterine rupture, emphasizing laparoscopic repair subsequent to uterine rupture. Laparoscopic repair serves as a fertility-sustaining alternative to conventional laparotomy, demonstrating comparable operative durations of 80 min (interquartile range [IQR] 60-114) for laparoscopic procedures versus 78 min (IQR 58-114) for laparotomy interventions. Nevertheless, laparoscopic approaches confer significant advantages, including a reduced incidence of intensive care unit (ICU) admissions (14.2% vs. 40% for laparotomy), a diminished requirement for blood transfusions (14.2% vs. 60%), and abbreviated hospital stays (median of 3 days vs. 5 days for laparotomy). The investigation explored the contentious discourse surrounding single-layer versus double-layer suturing methodologies, noting that barbed sutures significantly decrease uterine closure times (224 ± 46 vs. 343 ± 75 s for traditional sutures). Single-layer suturing is advocated as sufficient for maintaining uterine integrity in suitably selected cases. The necessity of meticulous postoperative monitoring, particularly concerning the assessment of recurrence in subsequent pregnancies, is emphasized, with recurrence rates varying from 4.8% to 19.4%. Finally, authors also proposed a feasible laparoscopic technique to repair a uterine rupture (the \"CHEESE\" method [closure of hemodynamically stable, early uterine rupture, via endoscopic surgery after spontaneous delivery]), appropriate for hemodynamically stable patients with minor ruptures. This review underscores the progressive role of minimally invasive techniques in the management of uterine rupture and seeks to optimize clinical outcomes for both maternal and neonatal health.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A practical guideline on the fertility-sparing treatment of patients with endometrial carcinoma and atypical endometrial hyperplasia 子宫内膜癌和不典型子宫内膜增生患者保留生育能力治疗的实用指南。
IF 2.6 3区 医学
International Journal of Gynecology & Obstetrics Pub Date : 2025-03-12 DOI: 10.1002/ijgo.70059
Ursula Catena, Kirsten Louise Tryde Macklon, Alexandros Rodolakis, Giovanni Scambia
{"title":"A practical guideline on the fertility-sparing treatment of patients with endometrial carcinoma and atypical endometrial hyperplasia","authors":"Ursula Catena,&nbsp;Kirsten Louise Tryde Macklon,&nbsp;Alexandros Rodolakis,&nbsp;Giovanni Scambia","doi":"10.1002/ijgo.70059","DOIUrl":"10.1002/ijgo.70059","url":null,"abstract":"<p><i>Conception and design</i>: Ursula Catena, Kirsten Louise Tryde Macklon, Alexandros Rodolakis and Giovanni Scambia. <i>Writing and drafting</i>: Ursula Catena. <i>Editing and revising</i>: Kirsten Louise Tryde Macklon, Alexandros Rodolakis and Giovanni Scambia. <i>Final approval and decision-making</i>: Kirsten Louise Tryde Macklon, Alexandros Rodolakis and Giovanni Scambia.</p><p>We, the authors, declare that we have no conflicts of interest related to the research presented in this manuscript. We confirm that there are no financial, personal, or professional relationships that could be perceived to influence the work.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":"169 2","pages":"453-455"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ijgo.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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