Journal of gynecology obstetrics and human reproduction最新文献

{"title":"Developing an online calculator to estimate the overall survival benefit from adjuvant radiotherapy in patients with early-stage type II endometrial carcinoma","authors":"Xi Chen ,&nbsp;Junhong Du ,&nbsp;Yuemei Cheng ,&nbsp;Tingyu Lang ,&nbsp;Xiaowei Liu ,&nbsp;Hongli Li ,&nbsp;Yongxiu Yang ,&nbsp;Xiaolei Liang","doi":"10.1016/j.jogoh.2025.103101","DOIUrl":"10.1016/j.jogoh.2025.103101","url":null,"abstract":"<div><h3>Objective</h3><div>The impact of adjuvant radiotherapy (aRT) on overall survival (OS) in early-stage type II endometrial carcinoma (EC) remains uncertain. This study aimed to develop nomograms and a web-based calculator to identify these patients who may benefit from aRT.</div></div><div><h3>Methods</h3><div>Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and divided into the developing and validation cohorts. LASSO Cox regression identified prognostic factors, and nomograms were constructed to predict 1-, 3-, and 5-year OS with/without aRT. The expected OS benefit from aRT was reflected in the difference between the two predicted OS nomograms. Validation involved ROC analysis, calibration curves, and decision curve analysis. A web calculator was created for estimating aRT's net OS benefit.</div></div><div><h3>Results</h3><div>Among the 6084 patients, aRT did not improve OS across all patients but showed benefits in specific subgroups, such as those with clear cell carcinoma and carcinosarcoma. Nomograms were constructed for patients with/without aRT to predict 1-, 3-, and 5-year OS, and they can accurately forecast OS. Additionally, the web-based calculator was developed to estimate the net OS benefit of aRT.</div></div><div><h3>Conclusions</h3><div>The nomograms provide accurate OS estimates for early-stage type II EC patients with/without aRT, thereby supporting individualized treatment decisions. The web calculator offers a quantitative tool for optimizing aRT use based on clinicopathological characteristics.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103101"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843796","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":"A case report of an extremely rare retrorectal ectopic pregnancy: Diagnostic and therapeutic challenges","authors":"Wei Luo ,&nbsp;Xiaoyan Huang ,&nbsp;Xiaoyan Qin ,&nbsp;Hui Zhang ,&nbsp;Yu-Lan Mu","doi":"10.1016/j.jogoh.2026.103110","DOIUrl":"10.1016/j.jogoh.2026.103110","url":null,"abstract":"<div><div>Retrorectal ectopic pregnancy is an extremely rare form of ectopic pregnancy. Early detection and treatment can prevent the risk of massive bleeding. The pathogenesis is unclear. Currently, only one case of retrorectal ectopic pregnancy treated with MTX has been reported. We report the second case of retrorectal ectopic pregnancy treated with laparoscopic surgery under real-time intraoperative ultrasound guidance, achieving complete resection with minimal trauma and rapid recovery. This approach offers new insights into the diagnosis and treatment of this condition.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103110"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989619","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":"Radiation necrosis mimicking tumor recurrence after chemoradiation for vaginal squamous cell carcinoma","authors":"Delia Di Noia ,&nbsp;Mauro Francesco Pio Maiorano ,&nbsp;Alessandra Sanasi ,&nbsp;Erica Zollino ,&nbsp;Sabino Savio Eliotropio ,&nbsp;Angela Calabrese ,&nbsp;Vera Loizzi ,&nbsp;Gennaro Cormio ,&nbsp;Anila Kardhashi ,&nbsp;Salvatore Lopez","doi":"10.1016/j.jogoh.2026.103129","DOIUrl":"10.1016/j.jogoh.2026.103129","url":null,"abstract":"<div><div>Radiation necrosis is a rare but serious complication of pelvic chemoradiotherapy that may closely mimic tumor recurrence on both imaging and clinical examination. We describe the case of a 43-year-old woman with FIGO stage II vaginal squamous cell carcinoma and synchronous CIN3 who developed profuse vaginal discharge and necrotic cervical lesions five months after completing chemoradiation and brachytherapy. MRI revealed a necrotic cervical mass with suspicious features, while biopsies initially yielded inconclusive results. A multidisciplinary approach was adopted: the patient received empirical antibiotics, underwent necrotic tissue debridement, and repeat biopsies. Final histology showed no viable malignancy, confirming radiation necrosis. The patient was managed conservatively with symptomatic improvement. This case highlights the diagnostic challenge of distinguishing necrosis from recurrence, where early imaging, cytology, and even initial biopsies may be misleading. Thorough evaluation and repeated sampling are essential to avoid overtreatment. We provide a literature-informed comparison of distinguishing features to guide clinical decision-making.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103129"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113322","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":"Efficacy and safety of early feticide for medical termination of pregnancy in women with a scarred uterus: A bicentric retrospective cohort study","authors":"Apolline Parjadis ,&nbsp;Éric Verspyck ,&nbsp;Élise Machevin ,&nbsp;Anne-Sophie Lafitte ,&nbsp;Louise Maurey ,&nbsp;Marine Carriou ,&nbsp;Sophia Braund","doi":"10.1016/j.jogoh.2026.103113","DOIUrl":"10.1016/j.jogoh.2026.103113","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of early feticide for medical termination of pregnancy in women with a scarred uterus.</div></div><div><h3>Methods</h3><div>This was a bicentric retrospective cohort study involving women with a scarred uterus who underwent medical termination of pregnancy between 16 and 32 weeks of gestation from 2009 to 2023 at the University Hospitals of Rouen and Caen, France. Women were divided into two groups: the early feticide group (i.e. feticide performed before onset of labor), and the control group (i.e. feticide performed at onset of labor or not performed at all). The primary outcome was the rate of vaginal delivery within 12 h of onset of labor.</div></div><div><h3>Results</h3><div>96 women were enrolled, 22 in the early feticide group and 74 in the control group. The rate of vaginal delivery within 12 h (86.4 % vs. 75.7 %, <em>P</em> = 0.22) and the median onset of labor-to-delivery interval (5.12 vs. 7.37 h, <em>P</em> = 0.11) were comparable between the two groups. Use of misoprostol was significantly less frequent in the early feticide group than in the control group (72.7 % vs. 96 %, <em>P</em> = 0.004). Overall maternal morbidity was comparable between the two groups, with one case of uterine rupture reported in each group. In utero maceration rendered fetal autopsy and neuropathological analysis infeasible in the early feticide group.</div></div><div><h3>Conclusion</h3><div>Early feticide was not associated with a statistically significant reduction in the proportion of deliveries occurring within 12 h of labor onset; however, it was associated with reduced use of misoprostol and increased frequency of spontaneous onset of labor, without increased maternal complications.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103113"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989644","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":"PROVAXHPV-3 - School nurse empowerment in HPV vaccination in middle school: Study protocol for a randomized controlled trial evaluating the optimal/most effective strategy comparing the best vaccination strategy in French 7th graders","authors":"Kiara Souletie ,&nbsp;Kevin Diallo ,&nbsp;Emmanuel Chirpaz ,&nbsp;Patricia Villain ,&nbsp;Jessica Sambourg ,&nbsp;Phuong Lien Tran ,&nbsp;Antoine Bertolotti","doi":"10.1016/j.jogoh.2025.103100","DOIUrl":"10.1016/j.jogoh.2025.103100","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103100"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948857","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":"Predictive value of early postpartum shock index combined with lactate and fibrinogen for severe postpartum hemorrhage","authors":"Yan An ,&nbsp;Yamin Zhao ,&nbsp;Hongli Wu ,&nbsp;Shuhui Zhao ,&nbsp;Hongjie Li","doi":"10.1016/j.jogoh.2025.103097","DOIUrl":"10.1016/j.jogoh.2025.103097","url":null,"abstract":"<div><h3>Background</h3><div>Severe postpartum hemorrhage (sPPH) remains a leading cause of preventable maternal morbidity. We evaluated whether a combined early postpartum model incorporating Shock Index (SI), lactate, and fibrinogen improves 24 h sPPH prediction compared with any single marker.</div></div><div><h3>Methods</h3><div>In this single-center cohort study (January 2019–December 2024), we included deliveries at ≥24 weeks’ gestation in which the first postpartum heart rate and systolic blood pressure (to calculate SI), lactate, and Clauss fibrinogen were all measured within 2 h after placental delivery. The primary outcome was sPPH within 24 h, defined as quantified blood loss ≥1000 mL or bleeding accompanied by hypovolemia. We developed a ridge-penalized logistic regression model using SI, lactate, and fibrinogen and performed internal validation with 1000 bootstrap resamples. We reported discrimination (AUC), calibration (slope and intercept), and Brier score. Single-marker AUCs were compared with the combined model using paired DeLong tests with false discovery rate (FDR) control. Decision-curve analysis evaluated clinical utility at 1%, 2%, and 5% risk thresholds.</div></div><div><h3>Results</h3><div>Among 12,242 deliveries, 172 sPPH events occurred (1.4%). The median time from placental delivery to sampling was 54 min (IQR 40–78). The combined model achieved an AUC of 0.82 (95% CI 0.77–0.87), with good calibration (slope 0.95; intercept −0.01) and a Brier score of 0.0066. Single-marker AUCs were 0.69 for SI, 0.73 for lactate, and 0.77 for fibrinogen; all were significantly lower than the combined model (FDR-adjusted <em>q</em> ≤ 0.01). At 1%, 2%, and 5% thresholds, sensitivity/specificity were 90.1%/60.0%, 76.2%/82.0%, and 55.2%/93.0%, with net benefit 0.0023, 0.0017, and 0.0002, respectively.</div></div><div><h3>Conclusions</h3><div>A simple early postpartum model combining SI, lactate, and fibrinogen provided better discrimination than any single marker, with good calibration and positive clinical utility at low-risk thresholds. Multicenter external validation and prospective impact evaluation are warranted before clinical implementation.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103097"},"PeriodicalIF":1.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827812","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":"Comment on “Evaluating the applicability of ESGO quality indicators in the surgical management of endometrial cancer: Insights from a Francogyn cohort”","authors":"Hengying Chen ,&nbsp;Zhehao Wu ,&nbsp;Ze Bo ,&nbsp;Mingshan Liu","doi":"10.1016/j.jogoh.2025.103098","DOIUrl":"10.1016/j.jogoh.2025.103098","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103098"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834026","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":"Contribution of simulation in gynecological ultrasound in resident’s training","authors":"Hélène Creton de Limerville ,&nbsp;Leila Bouazzi ,&nbsp;Coralie Barbe ,&nbsp;Isabelle Célerier ,&nbsp;Amélie Fouchet ,&nbsp;Marie Boiteux-Chabrier ,&nbsp;René Gabriel ,&nbsp;Olivier Graesslin ,&nbsp;Emilie Raimond","doi":"10.1016/j.jogoh.2025.103083","DOIUrl":"10.1016/j.jogoh.2025.103083","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate the contribution of simulation-based gynecologic ultrasound training in resident’s training</div></div><div><h3>Materials and methods</h3><div>This is a descriptive monocentric study carried out among residents from the Champagne-Ardenne region (France) who benefited from the gynecological ultrasound simulation program. At the end of a 6-month study, the results of 43 residents were analyzed.</div></div><div><h3>Results</h3><div>The analysis of the progression curves shows a positive and significant time effect of the repetition of the exercises on the resident' performance. They improved their ability to handle an ultrasound probe, their knowledge of female pelvic anatomy and gynecological diagnosis. The simulation allowed general medical residents and residents with no previous experience with ultrasound to achieve a level of performance similar to other residents. The residents considered each of the sessions to be very formative and felt that the training had improved their theoretical and practical knowledge. They believe they will be more comfortable in the gynecologic emergency room as a result of this training.</div></div><div><h3>Conclusion</h3><div>The training by simulation allowed an improvement of the knowledge and skills of the residents to the gynecological ultrasound. The generalization of this type of education would provide residents with a minimum and standardized initial training in gynecological ultrasound in a safe environment during their early studies.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103083"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708418","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":"Uterine transposition for fertility preservation in extra-skeletal ewing sarcoma: the first French case report","authors":"Cherif Akladios ,&nbsp;Thomas Boisramé ,&nbsp;Camille Martel ,&nbsp;Djanagane Mounien ,&nbsp;Guillaume Henry ,&nbsp;Georges Noël ,&nbsp;Laure Waeldin ,&nbsp;Mathilde Lapointe ,&nbsp;Marie Lorho ,&nbsp;Marie-Liesse Paty ,&nbsp;Eva Fuss ,&nbsp;Floriane Jochum ,&nbsp;Lise Lecointre","doi":"10.1016/j.jogoh.2025.103088","DOIUrl":"10.1016/j.jogoh.2025.103088","url":null,"abstract":"<div><div>We present the first French case of uterine transposition for fertility preservation in a 25-year-old nulligravida patient with rectovaginal extra-skeletal Ewing sarcoma. After receiving induction chemotherapy, the uterus was transposed to the upper abdomen via laparotomy. During the same procedure, a posterior pelvectomy was performed to achieve wide surgical margins for tumor removal. To mitigate digestive toxicity from subsequent pelvic radiotherapy, a breast expansion prosthesis was placed. The patient experienced regular menstruation postoperatively, indicating preserved uterine function. After completing radiochemotherapy, we successfully repositioned the uterus into the pelvis. Menstruation resumed within months of reimplantation, and a clinical examination revealed a normal-appearing cervix. This case demonstrates the feasibility and potential benefits of uterine transposition for preserving fertility in women with pelvic malignancies who require radiotherapy. Further research is needed to evaluate the long-term outcomes and reproductive potential of this procedure.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103088"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774895","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":"Posterior deep infiltrating endometriosis surgery: current status and mapping of care in France","authors":"Audrey PIVANO ,&nbsp;Vanessa PAULY ,&nbsp;Nicolas PIRRO ,&nbsp;Laurent BOYER ,&nbsp;Julie BERBIS ,&nbsp;Aubert AGOSTINI","doi":"10.1016/j.jogoh.2025.103086","DOIUrl":"10.1016/j.jogoh.2025.103086","url":null,"abstract":"<div><h3>Background</h3><div>Endometriosis is a frequent pathology affecting approximately 10% of the general population. Its diagnosis and management have improved in recent years. In France, a national strategy against endometriosis has been gradually developed, particularly through the establishment of regional referral networks to improve access to care. Regarding surgical management, the current trend is to define regional referral centers, although this process is still under development.</div></div><div><h3>Objective</h3><div>The primary objective of this study was to describe the characteristics of posterior deep infiltrating endometriosis (DIE) surgical activity in mainland France. The secondary objective was to describe patient characteristics and conditions of access to surgical care.</div></div><div><h3>Materials and Methods</h3><div>We performed a descriptive observational study using the French national medico-administrative database ((Program of Medicalization of Information Systems (PMSI) between January 1 and December 31, 2023. We identified all hospital stays involving posterior DIE surgery and recorded the number of procedures performed in each healthcare institution, their geographic location, and patients’ sociodemographic and clinical characteristics.</div></div><div><h3>Results</h3><div>In 2023, a total of 5364 hospital stays for posterior DIE surgery were recorded. We identified 339 distinct healthcare institutions that performed at least one hospital stay for posterior DIE surgery. The annual mean number of surgeries was 16.6 (±50.8 SD) per healthcare institution, but activity was highly concentrated, with fewer than 20% of healthcare institutions performing 80% of all surgeries nationwide. Mapping revealed that most surgeries were performed in major urban centers, leaving some regions with limited access. The average distance between patients’ residence and treating healthcare institution was 46.5 km (±51.6), corresponding to an average driving time of 34.3 minutes (±31.6). Social deprivation markers (universal health insurance (UHI) (p=0,019) and complementary universal health insurance (UHIc) (p&lt;0.0001)) and higher Charlson comorbidity score were significantly more frequent in patients treated in public or nonprofit private institutions compared to private institutions (p&lt;0.0001).</div></div><div><h3>Conclusion</h3><div>Posterior DIE surgical activity in France is unevenly distributed both in volume and geography. A collective reorganization is needed to ensure equitable access while maintaining high-quality surgical care.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103086"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774914","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}