Journal of gynecology obstetrics and human reproduction最新文献

{"title":"Ultrasound-indicated versus systematic intrauterine manual examination in the management of postpartum hemorrhage: a before-and-after study","authors":"Anne-Sophie Boucherie ,&nbsp;Agnès Villart ,&nbsp;Paul Berveiller ,&nbsp;Patrick Rozenberg ,&nbsp;Anne Rousseau ,&nbsp;Thibaud Quibel","doi":"10.1016/j.jogoh.2025.103080","DOIUrl":"10.1016/j.jogoh.2025.103080","url":null,"abstract":"<div><h3>Background</h3><div>The use of intrauterine manual examination in the management of postpartum hemorrhage (PPH) varies widely across countries. French guidelines recommend systematic intrauterine manual examination, while American guidelines support ultrasound use. This study aimed to evaluate whether ultrasound-indicated intrauterine manual examination was associated with higher rates of severe PPH compared with systematic intrauterine manual examination.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, single-center, before-and-after study including all women with vaginal delivery complicated by PPH. In the before period (January 1, 2020, to December 31, 2020), intrauterine manual examination was systematically recommended when PPH was diagnosed, whereas in the after period (January 1, 2022, to December 31, 2022) intrauterine manual examination was performed only when bedside ultrasound suggested retained placental tissue, defined as the presence of an echogenic mass within the uterus on a sagittal ultrasound. The primary outcome was the rate of severe PPH, defined as total quantified blood loss exceeding 1000 ml. Secondary outcomes included the need for blood transfusion, total quantified blood loss volume, and the need for additional uterotonics.</div></div><div><h3>Results</h3><div>The implementation of ultrasound-indicated intrauterine manual examination significantly decreased the rate of intrauterine manual examination (64.2% vs. 29.1%, P &lt;.01) without increasing the incidence of severe PPH (14.9% vs. 13.8%, P=.81). Total blood loss, transfusion rates, and the need for additional uterotonic were comparable between the two periods.</div></div><div><h3>Conclusion</h3><div>Ultrasound-indicated intrauterine manual examination reduced the rate of intrauterine manual examination without increasing the rate of severe PPH.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103080"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661542","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 “Dual trigger using recombinant HCG and gonadotropin-releasing hormone agonist improve oocyte maturity and embryo grading for normal responders in GnRH antagonist cycles: Randomized controlled trial” [J Gynecol Obstet Hum Reprod 49 (2019) 101728]","authors":"Shymaa S. Ali,&nbsp;Elwany Elsenosy,&nbsp;Gamal H. Sayed,&nbsp;Tarek A. Farghaly,&nbsp;Ahmed A. Youssef,&nbsp;Esraa Badran,&nbsp;Ahmed M. Abbas,&nbsp;Ahmed A. Abdelaleem","doi":"10.1016/j.jogoh.2025.103077","DOIUrl":"10.1016/j.jogoh.2025.103077","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103077"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614511","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":"Premature rupture of the membranes in twin pregnancies: Maternal and fetal outcomes","authors":"Anna Nunzia Della Gatta ,&nbsp;Jacopo Lenzi ,&nbsp;Diletta Ricci ,&nbsp;Chiara Montedoro ,&nbsp;Luca Savelli ,&nbsp;Gianluigi Pilu","doi":"10.1016/j.jogoh.2025.103074","DOIUrl":"10.1016/j.jogoh.2025.103074","url":null,"abstract":"<div><h3>Aim</h3><div>To analyse outcomes of twin pregnancies complicated by membranes rupture between 24 and 37 weeks of gestation.</div></div><div><h3>Methods</h3><div>Retrospective matched cohort study on twin pregnancies with premature membranes rupture, through review of clinical records at the Policlinico S. Orsola di Bologna, a tertiary hospital, between 2010 and 2020.</div></div><div><h3>Results</h3><div>171 twin pregnancies were admitted, over 10 years, with a diagnosis of premature rupture of membranes PPROM (fluid pooling on speculum and/or Insulin Growth Factor Binding Protein1 positive on vaginal secretions and oligohydramnios at ultrasound). The maternal and fetal outcomes of these pregnancies were compared to those of uneventful 178 twin pregnancies. There was no difference on risk factors. The mean gestational age at PROM was 33.9 weeks. PPROM newborns showed a lower birth weight (2072 ± 515 g vs. 2384 ± 454, <em>p</em> &lt; 0.001), a higher rate of admission to neonatal intensive care unit (45.6 % vs 22.2 %, <em>p</em> &lt; 0.001), and a higher rate of adverse outcomes, even if it did not achieve statistical significance (crude OR: 3.05, 95 % CI: 2.04–4.56; adjusted OR: 1.45, 95 % CI: 0.87–2.41). No cases of sepsis were found.</div></div><div><h3>Conclusion</h3><div>In our cohort of twin pregnancies no significative risk factors for premature rupture of membranes were found. Although PROM is known to increase infectious morbidity, not all patients will develop these complications. PROM in twin pregnancies does not appear to be an independent risk factor for adverse maternal or neonatal outcomes when the effect of prematurity is accounted for. Strategies to prolong pregnancy, when feasible, may mitigate adverse neonatal outcomes associated with PPROM in twin pregnancies.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103074"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549471","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":"Nine-step standard operating procedure for uterine preservation in placenta accreta spectrum: 7-year experience in a Chinese tertiary hospital","authors":"Zhixia Wei ,&nbsp;Li Feng ,&nbsp;Xiaomin Yang ,&nbsp;Hailan Yang","doi":"10.1016/j.jogoh.2025.103032","DOIUrl":"10.1016/j.jogoh.2025.103032","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate risk factors for adverse outcomes in the placenta accreta spectrum (PAS) and assess the efficacy of a nine-step uterus-sparing cesarean section protocol compared with traditional approaches.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 137 women with PAS who underwent cesarean delivery between 2016 and 2022. Participants were stratified into nine-step surgery (<em>n</em> = 26) and conventional surgery (<em>n</em> = 111) groups. The allocation of patients in each group was based on surgeon experience and surgical team’s intraoperative judgment. The protocol integrates placental mapping, transient uterine ischemia, delayed vascular control, and multilayer reconstruction. Machine learning (SMOTE-enhanced Random Forest) was used to identify the predictors of hemorrhage and hysterectomy.</div></div><div><h3>Results</h3><div>The nine-step surgery group reduced the hysterectomy rate to 1.9 % vs. 9.0 % in the control group (<em>P</em> &lt; 0.001), with fewer severe complications (hemorrhagic shock: 3.8 % vs. 12.6 %; DIC: 1.9 % vs. 8.1 %). Multivariate logistic regression analysis confirmed that nine-step surgery was independently related to a lower probability of hysterectomy (<em>P</em> = 0.050) (odds ratio: 0.107, 95 %CI: 0.011, 0.998). Gravidity (Gini=3.809) and pathological placental adhesion (PPA) were key hemorrhage predictors. The hysterectomy prediction model achieved exceptional discrimination (AUC=0.993), driven by intraoperative blood loss (Gini=16.068) and PPA severity. Experienced teams preserved 83.3 % of the uterus, compared to 63.0 % in the less-experienced group (<em>P</em> = 0.008).</div></div><div><h3>Conclusion</h3><div>The nine-step uterine preservation protocol significantly reduced the hysterectomy rate in the PAS through dynamic risk stratification and staged hemostasis. Integrated machine learning models enhance precision management, enabling fertility preservation while minimizing the risk of severe complications.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103032"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064930","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":"Experience in medical treatment of ectopic pregnancy, cesarean scar with three comparative methods: Methotrexate intra-gestational-sac injection, ultrasound-guided KCL injection, and hysteroscopy-assisted resection","authors":"Nazli Navali ,&nbsp;Saeedeh Mardi ,&nbsp;Solmaz Fallahi","doi":"10.1016/j.jogoh.2025.103056","DOIUrl":"10.1016/j.jogoh.2025.103056","url":null,"abstract":"<div><h3>Introduction</h3><div>Cesarean scar pregnancy (CSP) presents significant risks to the mother, and there is no consensus on the optimal treatment for this condition. This study was conducted to compare the effectiveness of three interventions: methotrexate (MTX) intra-gestational sac injection, potassium chloride (KCL) intra-gestational sac injection under ultrasound guidance, and hysteroscopic resection.</div></div><div><h3>Methods</h3><div>Women with CSP were enrolled and randomly assigned to three groups: (1) MTX injection with curettage, (2) KCl injection with curettage, and (3) hysteroscopic resection performed one day after intramuscular MTX administration. Discharge was scheduled for the following day, provided there were no complications. Weekly follow-up assessments included measuring serum β-human chorionic gonadotropin (β-hCG) levels.</div></div><div><h3>Results</h3><div>No statistically significant differences were observed in serum β-hCG levels among the groups before treatment or after intervention (p-value=0.396 and p-value=0.095, respectively). The length of hospitalization did not differ significantly between the groups (<em>p</em> = 0.903). Similarly, the time to β-hCG normalization showed no significant variation (p = 0.426). All three treatment strategies effectively achieved complete resolution, with a marked decline in serum β-hCG levels across all participants.</div></div><div><h3>Conclusion</h3><div>The comparative analysis indicates equivalent efficacy among the three interventions in terms of gestational sac resolution and β-hCG clearance time. No cases of uterine perforation, hemorrhage, hysterectomy, or extended hospitalization were reported following any of the treatments.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103056"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312959","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":"Multiple papillomas: Risk of atypical lesions, carcinomas in situ and invasive carcinomas","authors":"A. Wahnich ,&nbsp;N. Sritharan ,&nbsp;C. Gu ,&nbsp;A. Benbara ,&nbsp;C. Touboul ,&nbsp;H. Lorphelin ,&nbsp;H. Azaïs ,&nbsp;V. Levy ,&nbsp;G. Canlorbe ,&nbsp;M. Fermaut","doi":"10.1016/j.jogoh.2025.103063","DOIUrl":"10.1016/j.jogoh.2025.103063","url":null,"abstract":"<div><h3>Context</h3><div>Papillomas of the breast are benign tumors associated with underestimation of high-risk lesions. The heterogeneity of the definitions used and the low level of evidence in current studies prevent recommending guidelines for clinical management of multiple papillomas (MP). The primary objective is to estimate the risk of atypical lesions (AL), carcinomas in situ (CIS) and/or invasive carcinomas (IC) associated with MP. Secondary objectives aim to evaluate the risk factors for AL, CIS and/or IC, and to assess the risk of recurrence of MP.</div></div><div><h3>Methods</h3><div>This is an observational descriptive multicenter study. Patients with at least 2 synchronous papillomas on surgical specimen(s) between 2010 and 2022 were included. AL, CIS, and IC diagnosed before surgery were excluded.</div></div><div><h3>Results</h3><div>One hundred twenty-eight patients were diagnosed with MP, mainly discovered on single lumpectomy specimens (57 %) and unilateral (80.5 %). Multiple nature of papillomas was a postoperative diagnosis in 47.7 % of cases. Twenty-six patients (20.3 %) had at least one AL. Three patients (2.3 %) were diagnosed with IC. The multivariate logistic model demonstrates that microcalcifications have a significant association with AL, CIS, and/or IC (OR 3.78; 95 %CI [1.24 – 11.47]; <em>p</em> = 0.02). During a median follow-up time of 23 months, 26 patients (21.7 %) underwent surgery or macrobiopsy for recurrence, including 6 (5.0 %) for CIS or IC.</div></div><div><h3>Conclusion</h3><div>Because of the risk of underestimation at preoperative histology and their frequent association with AL, CIS and/or IC, MP require surgical excision. Due to frequent recurrences, clinical and radiological post-treatment follow-up should be recommended annually.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103063"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470949","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 “Prediction of pelvic adhesions at repeat cesarean delivery through assessment of striae gravidarum score: A cross-sectional study” [J Gynecol Obstet Hum Reprod 49 (2019) 101619]","authors":"Ahmed M. Abbas,&nbsp;Mohammed Khalaf,&nbsp;Fatma Abdel-Reheem,&nbsp;Ihab El-Nashar","doi":"10.1016/j.jogoh.2025.103075","DOIUrl":"10.1016/j.jogoh.2025.103075","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103075"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145614509","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\" Evaluation of the M6P model in predicting ectopic pregnancy among pregnancies of unknown location: A prospective monocentric study in Tunisia\"","authors":"Zheng Han ,&nbsp;Jintian Han ,&nbsp;Hongcheng Zhu","doi":"10.1016/j.jogoh.2025.103064","DOIUrl":"10.1016/j.jogoh.2025.103064","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103064"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452069","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":"Case report: Obstetrical maneuver in a case of persistent mentum posterior face presentation","authors":"Sabrina MONTANT ,&nbsp;Fanny MOREIRA ,&nbsp;Clémentine LANGIN ,&nbsp;Pierrick ANDRIEU ,&nbsp;Marion ROUZAIRE ,&nbsp;Denis GALLOT","doi":"10.1016/j.jogoh.2025.103060","DOIUrl":"10.1016/j.jogoh.2025.103060","url":null,"abstract":"<div><div>Face presentation during labor is uncommon. While mentum anterior presentation is mechanically compatible with vaginal delivery, persistent mentum posterior presentation typically necessitates cesarean section. We report a case of a fetus in mentum posterior face presentation managed expectantly due to excellent labor progression. At full cervical dilation, an ultrasound-guided digital maneuver successfully converted the presentation to occipito-iliac anterior, enabling vaginal delivery of a healthy 3350 g infant without instrumental assistance. This obstetric technique offers a potential alternative to cesarean section in selected cases of mentum posterior face presentation, and argues for individualized management by an experienced obstetrician and ultrasound guidance.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103060"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517229","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":"Multiple sclerosis, fertility, pregnancy, and assisted reproductive technology: Current knowledge","authors":"Virginie Trabaud ,&nbsp;Appoline Zimmerman ,&nbsp;Audrey Gnisci ,&nbsp;Bertrand Audoin ,&nbsp;Blandine Courbiere","doi":"10.1016/j.jogoh.2025.103061","DOIUrl":"10.1016/j.jogoh.2025.103061","url":null,"abstract":"<div><div>Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that predominantly affects young women of childbearing age. While pregnancy was once discouraged for women with MS, recent studies have overturned many of the old assumptions about its risks. Current data indicate that MS has no adverse effect on fertility or pregnancy outcomes, and that pregnancy often leads to a decrease in disease activity in the third trimester. However, the reproductive life of these women will require careful and specialized management, particularly concerning the use of disease-modifying therapies (DMTs). We conducted a narrative review to summarize the latest knowledge on MS in relation to fertility, pregnancy, assisted reproductive technology (ART), and postpartum management. We focused on various topics, including fertility, the influence of pregnancy on disease progression and reciprocally, the management of MS women undergoing ART, as well as the specific aspects of postpartum care for these women. Understanding these aspects is crucial for neurologists, gynecologists, and reproductive specialists to provide appropriate and multidisciplinary care to women with MS who want to plan a pregnancy.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103061"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467372","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}