Journal of gynecology obstetrics and human reproduction最新文献

{"title":"Maternal glycaemic responses to antenatal glucocorticoids: a scoping review","authors":"Annabel S Jones ,&nbsp;I-Lynn Lee ,&nbsp;Devaang Kevat ,&nbsp;Joanne M Said ,&nbsp;Klea Atallah ,&nbsp;Tilda Fletcher ,&nbsp;Christopher J Yates","doi":"10.1016/j.jogoh.2025.103029","DOIUrl":"10.1016/j.jogoh.2025.103029","url":null,"abstract":"<div><h3>Background</h3><div>Antenatal glucocorticoids are associated with significant transient hyperglycaemia in women with diabetes, however, the glycaemic effects of antenatal glucocorticoids for women without diabetes and their neonates are unknown.</div></div><div><h3>Objectives</h3><div>To investigate the maternal glycaemic effects of antenatal glucocorticoids administered for fetal lung maturation in women without diabetes, as well as the association between maternal glycaemia and neonatal hypoglycaemia.</div></div><div><h3>Study design</h3><div>A systematic search was performed in May 2025 using the Ovid Medline and Embase data bases to identify relevant studies reporting glycaemic outcomes for women without diabetes receiving antenatal glucocorticoids. The key outcome of interest was maternal glycaemic patterns; secondary outcomes included the prevalence of neonatal hypoglycaemia as well as factors that may predict maternal hyperglycaemia.</div></div><div><h3>Results</h3><div>There were 14 studies that met the inclusion criteria, comprising 12 cohort studies and 2 randomised controlled trials. All studies unanimously reported maternal hyperglycaemia following the administration of either betamethasone or dexamethasone in women without diabetes, with a prevalence of 54-95 %. While three studies utilised insulin to manage maternal hyperglycaemia, dosages varied significantly, and the impact of treatment on maternal and neonatal outcomes remains unclear.</div></div><div><h3>Conclusions</h3><div>Maternal hyperglycaemia is highly prevalent following antenatal glucocorticoids in women without diabetes; however, it is currently unclear whether this is associated with adverse outcomes including neonatal hypoglycaemia. There is currently insufficient data to support monitoring or management of hyperglycaemia in patients without diabetes receiving antenatal glucocorticoids, however, given the extent and duration of hyperglycaemia documented, large multi-centre trials are required to inform clinical practice.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103029"},"PeriodicalIF":1.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040340","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":"Impact of serum progesterone level on the day of embryo transfer on live birth rate after single frozen-thawed blastocyst transfer in hormone replacement therapy cycles","authors":"Audrey Pérennec ,&nbsp;Thomas Goronflot ,&nbsp;Florence Leperlier ,&nbsp;Thomas Fréour ,&nbsp;Maxime Chaillot","doi":"10.1016/j.jogoh.2025.103024","DOIUrl":"10.1016/j.jogoh.2025.103024","url":null,"abstract":"<div><h3>Purpose</h3><div>As the number of frozen-thawed embryo tryansfer cycles with Hormonal Replacement Therapy increases, the issue of the optimal progesterone level to ensure maximal success rates becomes critical. In this study, we aimed to determine the respective relevance of the 3 recently reported progesterone thresholds using an original statistical method.</div></div><div><h3>Methods</h3><div>This single-center retrospective study was conducted in a University-based Hospital in France in all consecutive single frozen thawed blastocyst transfers (SFBT) performed with HRT protocol in 2021. Progesterone levels were measured on the morning of the transfer. Patients were divided into deciles based on their progesterone levels on the day of SFBT, and outcomes were calculated for each decile. Multivariate logistic regression models were constructed to measure the association of these thresholds with clinical pregnancy rate and live birth rate (LBR), adjusting for demographic and clinical factors.</div></div><div><h3>Results</h3><div>A total of 256 cycles were included in the analysis. Clinical pregnancy rate was 30.1%, and live birth rate (LBR) was 29.3%. An inverted U curve was observed for the Positive Predictive Value of a LB, as it increases up to a peak around 11 ng/ml (optimal interval 10.5-12 ng/ml), before decreasing for high serum progesterone levels (&gt;13 ng/ml).</div></div><div><h3>Conclusions</h3><div>Our study, aligned with recent literature, identified a positive relationship between progesterone levels on the day of SFBT in HRT and the positive predictive value of a live birth, the \"ideal window\" of progesterone on the day of FET being 10.5-12 ng/mL.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103024"},"PeriodicalIF":1.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015569","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":"Activity and access of surgical abortion in metropolitan France","authors":"Aubert Agostini ,&nbsp;Vanessa Pauly ,&nbsp;Veronica Orléans ,&nbsp;Fanny Romain ,&nbsp;Bach Tran ,&nbsp;Dong Keon Yon ,&nbsp;Masoud Rahmati ,&nbsp;Julie Berbis ,&nbsp;Pascal Auquier ,&nbsp;Laurent Boyer","doi":"10.1016/j.jogoh.2025.103023","DOIUrl":"10.1016/j.jogoh.2025.103023","url":null,"abstract":"<div><h3>Objective</h3><div>To report the territorial distribution and characteristics of healthcare centres performing surgical abortion in France, along with the accessibility of these centres.</div></div><div><h3>Material and Methods</h3><div>A nationwide population-based cohort study of all women hospitalized for surgical abortion was conducted from January 1 to December 31, 2022 in metropolitan France. Number, location, activity volume and use of local anaesthesia rate of surgical abortion centres were reported as distribution activity across metropolitan France. Correlation between socioeconomic status neighbourhood and surgical abortion centre was evaluated.</div></div><div><h3>Results</h3><div>There were 52,292 surgical abortion hospital stays among 51,507 women in 497 centres in 2022. Majority of them were performed in public sector (46,979/52,292 (89.8 %)). More than half of surgical abortion centres perform a maximum of 50 IVTP/year (277/497 (55.7 %)). There was an Inequality in the distribution of surgical abortion across centres with 49 (10 %) centres performing 50 % of surgical abortion. Only 10,141(19.4 %) surgical abortion were performed under local anaesthesia and more frequently in centres with high activity.</div><div>Women residing in the most deprived areas had longer average travel distances (mean: 21.82 ± 25.98 Km) and times (mean:19,87±19,2 min) to reach surgical abortion centre.</div></div><div><h3>Conclusion</h3><div>activity of surgical abortion is unequally distributer in metropolitan France. There are significant regional variations and unequal access depending on place of residence. Access to surgical abortion centre is more difficult for populations with low socioeconomic status. It is important that health system managers take into account this inequality, which concerns populations where abortion is more frequent.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103023"},"PeriodicalIF":1.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008244","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":"Retraction notice to “The value of ultrasound guidance during IUD insertion in women with RVF uterus: A randomized controlled trial” [J Gynecol Obstet Hum Reprod 50 (2025) 101875]","authors":"Ahmed M. Maged,&nbsp;Adel M. Nada,&nbsp;Hala Abdelwahab,&nbsp;Emad Salah,&nbsp;Mahmoud Soliman,&nbsp;Eman A. Hussein,&nbsp;Aimy Essam,&nbsp;Hala Nabil","doi":"10.1016/j.jogoh.2025.103016","DOIUrl":"10.1016/j.jogoh.2025.103016","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103016"},"PeriodicalIF":1.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932957","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":"Retraction notice to “Comparison of the four malignancy risk indices in the discrimination of malignant ovarian masses: A cross-sectional study” [J Gynecol Obstet Hum Reprod 50 (2025) 101986]","authors":"Mustafa N. Ali,&nbsp;Dina Habib,&nbsp;Ahmed I. Hassanien,&nbsp;Ahmed M. Abbas","doi":"10.1016/j.jogoh.2025.103021","DOIUrl":"10.1016/j.jogoh.2025.103021","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103021"},"PeriodicalIF":1.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932956","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":"Predictors for the efficacy of methotrexate and mifepristone treatment in ectopic pregnancy","authors":"Chaoying Feng","doi":"10.1016/j.jogoh.2025.103022","DOIUrl":"10.1016/j.jogoh.2025.103022","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the efficacy of methotrexate (MTX) alone versus MTX plus mifepristone for stable ectopic pregnancy, identify predictors of treatment success, and explore outcome-prediction models.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, two‑arm observational cohort of consecutive patients with stable ectopic pregnancy treated in routine care (MTX‑only <em>n</em> = 138; MTX+mifepristone <em>n</em> = 132). Treatment assignment was non‑randomized, reflecting clinician judgment and patient preference. Baseline characteristics and treatment details were recorded, and the primary outcome—resolution of the EP without surgery—was assessed. Predictive factors were analyzed via logistic regression with Hosmer–Lemeshow testing for calibration. We further evaluated advanced machine learning models to classify treatment success.</div></div><div><h3>Results</h3><div>Overall treatment success rates were 73.91% (MTX-only) and 78.79% (MTX plus mifepristone), with no statistically significant difference between groups (<em>p</em> = 0.38). Across the combined cohort, factors strongly predicting success included initial hCG &lt;1500 mIU/mL (adjusted OR 2.70, <em>p</em> = 0.01), absence of fetal cardiac activity (adjusted OR 2.10, <em>p</em> = 0.04), lower gestational age at diagnosis (adjusted OR 0.82 per week, <em>p</em> = 0.02), and <em>a</em> ≥ 15% hCG decline by Day 4 (adjusted OR 2.40, <em>p</em> = 0.02). By location, success rates were similar in tubal and non‑tubal strata. The treatment × location interaction was not significant (<em>p</em> = 0.85), and tubal‑only results were unchanged. The multivariable logistic regression predicting treatment success vs failure showed good discrimination (AUC 0.82) and adequate calibration (Hosmer–Lemeshow <em>p</em> = 0.45). In exploratory benchmarking of algorithms trained to predict success vs failure on the same predictors, gradient boosting yielded the highest apparent discrimination (accuracy 84%; AUC 0.88) in this dataset.</div></div><div><h3>Conclusions</h3><div>MTX plus mifepristone did not significantly outperform MTX alone in resolving stable ectopic pregnancy. Key predictors of successful medical management included lower baseline hCG levels, earlier gestational age, and substantial early hCG declines. Advanced machine learning approaches may improve predictive accuracy, supporting more individualized treatment selection for ectopic pregnancy.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103022"},"PeriodicalIF":1.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956768","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 polycystic ovarian syndrome in South Asian countries and 21 global regions with Sociodemographic index: A systematic analysis of the Global Burden of Disease (1990–2021)","authors":"Prakasini Satapathy ,&nbsp;Nasir Vadia ,&nbsp;Soumya V Menon ,&nbsp;Kattela Chennakesavulu ,&nbsp;Rajashree Panigrahi ,&nbsp;Ganesh Bushi ,&nbsp;Mahendra Singh ,&nbsp;Sanjit Sah ,&nbsp;Awakash Turkar ,&nbsp;S． Govinda Rao ,&nbsp;Muhammed Shabil ,&nbsp;Manya Soni","doi":"10.1016/j.jogoh.2025.103019","DOIUrl":"10.1016/j.jogoh.2025.103019","url":null,"abstract":"<div><h3>Background</h3><div>This analysis examines both the prevalence and the disability-adjusted life years (DALYs) linked to polycystic ovary syndrome (PCOS) across South Asia and worldwide, drawing on data from the Global Burden of Disease (GBD) 1990–2021 study.</div></div><div><h3>Methods</h3><div>Data from GBD 2021 were analyzed using Joinpoint Regression to assess age-standardized prevalence rates (ASPR) and DALYs (ASDR). Sociodemographic index (SDI) was incorporated to evaluate the relationship between socioeconomic factors and PCOS burden. The analysis was conducted across 21 global regions, with Pearson's correlation assessing the association between SDI and PCOS outcomes.</div></div><div><h3>Results</h3><div>The prevalence of PCOS in South Asia increased significantly, with an average annual percentage change (AAPC) of 1.87 % (95 % CI: 1.85–1.88) from 1990 to 2021. India had the highest prevalence in 2021 (269.8 per 100,000), and the highest total percentage change (TPC) in prevalence (86.9 %). DALYs rate in India were similarly high (11.1 per 100,000. A positive correlation (<em>r</em> = 0.57, <em>p</em> &lt; 0.001) between SDI and both prevalence and DALYs was observed.</div></div><div><h3>Conclusion</h3><div>PCOS prevalence and DALYs are rising across South Asia, with India experiencing the highest burden. Public health interventions should focus on improving awareness, diagnosis, and management, especially in lower SDI regions to mitigate the growing health challenge.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103019"},"PeriodicalIF":1.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956749","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":"New challenges in operative vaginal delivery: the Odon device. A systematic review","authors":"Mattia Dominoni ,&nbsp;Gabriele Rasore ,&nbsp;Martina Rita Pano ,&nbsp;Alessia Scimeca ,&nbsp;Barbara Gardella","doi":"10.1016/j.jogoh.2025.103017","DOIUrl":"10.1016/j.jogoh.2025.103017","url":null,"abstract":"<div><div>Operative vaginal delivery is the best option for accelerating labor in the second stage labor; however, this technique requires precise clinical assessment, customized care, skilled and appropriately educated workers, in order to avoid both maternal and fetal complications. The aim of this systematic review is to analyze the innovation, design, and effectiveness of a new instrument for Operative Vaginal Delivery, the Odon device, in order to improve intrapartum obstetric care in clinical practice, to facilitate the instrumental vaginal birth, and increase maternal and neonatal outcomes.</div><div>A literature search was conducted thought electronic databases PubMed, EMBASE, Web Of Science. We considered papers published online from 2000 until January 2025, reporting the use of Odon device for operative vaginal delivery. The research was performed utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Two reviewers independently screened the abstracts of the selected studies and extracted data from full-text articles. The data were subsequently tabulated and evaluated. We selected 14 studies suitable for this systematic review.</div><div>The operative vaginal birth is expedited with the Odon Device, which reported a safe, feasible and effective profile, both for structural characteristics and clinical application. There are no serious maternal and neonatal adverse events related to the use of the device during birth. There are no serious adverse device effects. The operators reported elevated value of satisfaction about the use and application of this new instrument. A favorable evaluation and positive experience were reported also by pregnant women and obstetrics. In conclusion, phase I and II trials show that the Odon device has satisfactory safety, feasibility, and efficacy profile, so it may be considered for potential clinical uses in addition to existing procedures for operative vaginal delivery. Randomized clinical studies are required to clarify the potentials benefits associated with the use of the Odon device on newborns in comparison to other instruments for OVD.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103017"},"PeriodicalIF":1.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932955","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":"Impact of a National Public Health Plan on the time frame for moderate and severe endometriosis diagnosis","authors":"Emilie Gastineau ,&nbsp;Laura Miquel ,&nbsp;Antoine Netter ,&nbsp;Aubert Agostini ,&nbsp;Maeva Jego ,&nbsp;Blandine Courbiere","doi":"10.1016/j.jogoh.2025.103011","DOIUrl":"10.1016/j.jogoh.2025.103011","url":null,"abstract":"<div><h3>Objective</h3><div>to study the time from symptom onset to the diagnosis of moderate and severe endometriosis and to compare this delay before and after the implementation of the French National Endometriosis Public Health Plan.</div></div><div><h3>Design</h3><div>Monocentric retrospective cohort study.</div></div><div><h3>Exposure</h3><div>A comparison of diagnostic delays for moderate and severe endometriosis in women before and after the implementation of a National Public Health Plan in February 2022.</div></div><div><h3>Main outcome measures</h3><div>Diagnostic delay, defined as the time from symptom onset to a final diagnosis of moderate or severe endometriosis confirmed by imaging or surgery.</div></div><div><h3>Results</h3><div>The median diagnostic delay was 5.0 years (range 1.6–11.2) with no statistically significant difference observed before and after the implementation of the National Endometriosis Public Health Plan: median delay of 5.7 years (range 1.6–11.8) <em>Vs.</em> 4.2 years (range 1.5–11.1) (<em>P</em> = 0.70). The most common presenting symptom was dysmenorrhea (73 %), and 91 women (65 %) experienced primary infertility. Women whose initial symptom was infertility had a significantly shorter diagnostic delay compared to those with pain symptoms: median (IQR) of 1.5 (0.9–3.1) <em>Vs.</em> 6.9 (2.1–12.6) years, <em>P</em> ≤ 0.001. A younger age at symptom onset was associated with a longer diagnostic delay.</div></div><div><h3>Conclusion</h3><div>Despite increased awareness efforts by Public Health institutions, significant diagnostic delays for moderate and severe endometriosis persist, particularly among younger women. The objective of the National Endometriosis Public Health Plan was to raise awareness among healthcare providers to reduce diagnostic delays; however, further longitudinal studies are needed to confirm its long-term impact.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103011"},"PeriodicalIF":1.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862250","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 a second cervical ripening procedure improve vaginal delivery outcomes in primiparous women with an unfavourable Cervix? A before-and-after French study","authors":"Mathilde Frere ,&nbsp;Clemence Klapczynski ,&nbsp;Eric Verspyck ,&nbsp;Sophia Braund","doi":"10.1016/j.jogoh.2025.103008","DOIUrl":"10.1016/j.jogoh.2025.103008","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of a second cervical ripening procedure in primiparous women with an unfavourable persistent cervix.</div></div><div><h3>Methods</h3><div>This retrospective, before-and-after, comparative study was conducted at Rouen University Hospital, France between January 1st, 2018, and August 15th, 2022. Inclusion criteria were women with indications for labour induction with singleton term pregnancies in cephalic presentation and with a Bishop score &lt;6 who required an initial cervical ripening. All women underwent an initial cervical ripening procedure with either a balloon catheter or vaginal dinoprostone. In the before-protocol group, labour induction was mostly pursued with oxytocin regardless of cervical status. In the after-protocol group (post-November 2020), a second cervical ripening procedure was proposed if the Bishop score remained ≤ 4. The primary outcome was caesarean section rate. A sensitivity analysis was also performed in women with a Bishop score &lt;6 after the first ripening.</div></div><div><h3>Results</h3><div>A total of 384 women were included in the study and were then divided in the before- protocol group (n=184) or in the after-protocol group (n=200). The caesarean section rate significantly decreased in the after-protocol group (31 % vs. 40.8 %; p=0.04). Bishop scores before oxytocin administration were significantly higher in the after-protocol group (median: 6 vs. 5; p=0.01). After adjustment, no significant association was found between the use of the new protocol and the caesarean section risk (OR 0.82; 95 % CI [0.58–1.34]). Factors independently associated with caesarean delivery were advanced maternal age, women not born in France, and lower Bishop scores both before and after cervical ripening. In the subgroup of women with persistent unfavourable cervix, the second procedure improved Bishop scores but was not associated with a significant reduction in caesarean section rate.</div></div><div><h3>Conclusion</h3><div>A second cervical ripening procedure for women with persistent low Bishop scores was not significantly associated with reduced caesarean section rates. Further studies are needed to evaluate whether combining cervical ripening methods can enhance vaginal delivery rates.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103008"},"PeriodicalIF":1.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847077","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}