Journal of gynecology obstetrics and human reproduction最新文献

{"title":"Obstetrics and gynecology residents’ preparedness to perform essential obstetric procedures autonomously: A national survey among French residents and teachers","authors":"Laura Puroski ,&nbsp;Salma Touleimat ,&nbsp;Patrice Crochet ,&nbsp;Olivia Guerin ,&nbsp;Jean-michel Coq ,&nbsp;Eric Verspyck ,&nbsp;Sophia Braund","doi":"10.1016/j.jogoh.2025.103038","DOIUrl":"10.1016/j.jogoh.2025.103038","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the self-evaluation of French residents and the opinion of academic teachers regarding the autonomy granted during residents’ training and the level of preparation achieved at the end of the residency to perform essential obstetric procedures.</div></div><div><h3>Methods</h3><div>A national survey of French obstetrics and gynecology residents and their academic teachers was conducted using an online questionnaire distributed in 2023, which gathered the self-evaluation by residents and opinion of academic teachers on the level of autonomy for essential obstetric procedures and perceptions of preparedness upon graduation. The survey also examined perceptions on the impact of factors that improve autonomy.</div></div><div><h3>Results</h3><div>510 of the 1197 (43%) residents and 49 of the 137 academic teachers (36%) completed the questionnaire. Both residents and academic teachers were confident that residents would be prepared at the end of residency to perform most essential obstetric procedures, including vacuum and forceps or spatula assisted vaginal delivery. However, regarding advanced obstetric surgery in case of severe postpartum hemorrhage (PPH), only 36% of 6th-year residents reported feeling capable of performing a uterine artery ligation in case of an emergency, and 11% in performing a hemostatic hysterectomy. Main factors that were perceived as important for improving autonomy were the number of cases and the quality of coaching.</div></div><div><h3>Conclusion</h3><div>French residents reported a gradual increase in autonomy throughout their residency for the majority of essential obstetric procedures, with the exception of surgical management of severe PPH. Teachers shared a similar opinion. Simulation and the quality of supervision appear to be promising pathways for enhancing their autonomy.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103038"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091887","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":"Long hours, limited rest: a national snapshot of ObGyn resident work conditions in France and paths to reform","authors":"Charline Bertholdt ,&nbsp;Nadia Magroune ,&nbsp;Anne-Laure Fijean ,&nbsp;Mikaël Agopiantz ,&nbsp;Kévin Guillez ,&nbsp;Matthieu Dap ,&nbsp;Olivier Morel","doi":"10.1016/j.jogoh.2025.103033","DOIUrl":"10.1016/j.jogoh.2025.103033","url":null,"abstract":"<div><h3>Objectives</h3><div>The main aim was to describe the weekly working time of French ObGyn residents. As secondary objectives, we aimed to evaluate the respect of training time and day off for safety and finally, to describe proposed adjustments to respect maximal weekly working time.</div></div><div><h3>Methods</h3><div>This national descriptive survey was addressed among ObGyn residents in 2024. The primary outcome was the average weekly working time declared by all residents. For the secondary outcomes, we assessed the mean number of weekday and weekend on-call, the rate of applicability of day off after on-call, the rate of presence of training days and the description of modalities proposed regarding additional day off to respect working time.</div></div><div><h3>Results</h3><div>413 responses were obtained with 92.8 % of universities represented. The mean weekly working time was 63 h with a daily time range of 10.5 h. In total, 98.1 % of residents worked &gt;48 h by week. In 25 % of cases, residents assumed professional activity after on-call. 57.1 % of French universities offered adjustments to reduce weekly working time consisting of an additional day off for on-call during Friday, Saturday or Sunday.</div></div><div><h3>Conclusion</h3><div>The weekly working time is insufficiently controlled in French ObGyn residents but there are very promising suggestions for improvement.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103033"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064962","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":"Factors affecting the MicroRNA expression pattern in the chorioamniotic membrane: From the perspective of preterm labor","authors":"Yu Yang ,&nbsp;Shuhua Yi ,&nbsp;Yaxin Zhang,&nbsp;Jun He,&nbsp;Tingting Chen,&nbsp;Hongyu Li","doi":"10.1016/j.jogoh.2025.103009","DOIUrl":"10.1016/j.jogoh.2025.103009","url":null,"abstract":"<div><div>Preterm labor is a major contributor to neonatal mortality and morbidity worldwide. Despite extensive research, the molecular mechanisms driving preterm labor are not fully understood. Epigenetic modifications may play a role in the underlying mechanisms leading to adverse pregnancy outcomes, particularly preterm labor. Emerging evidence highlights the role of microRNAs (miRNAs), small non-coding RNAs that regulate gene expression post-transcriptionally, in the pathogenesis of preterm labor. This review focuses on the chorioamniotic membrane, a critical structure for fetal protection and development, and its involvement in miRNA-mediated pathways that contribute to preterm labor. The chorioamniotic membrane, composed of the amnion and chorion, plays a vital role in maintaining pregnancy through extracellular matrix (ECM) remodeling, immune regulation, and inflammatory responses. Dysregulation of miRNAs in this membrane, influenced by environmental stressors (e.g., oxidative stress, pollutants), maternal factors (e.g., age, obesity, diabetes), and fetal factors (e.g., sex, genetic disorders), disrupts these processes, leading to membrane weakening and preterm labor. Inflammation, particularly through Toll-like receptor (TLR) signaling and cytokine production, is a key driver of miRNA dysregulation in conditions like chorioamnionitis and preterm premature rupture of membranes (PPROM). This review summarizes the dysregulated expression of miRNAs in chorioamniotic membranes which are likely to play a role in premature birth.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103009"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812099","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":"What changes in the fetal heart rate are associated with neonatal acidosis during the second stage of labor?","authors":"G. Dhenin ,&nbsp;S. Godin ,&nbsp;N. Ramdane ,&nbsp;H. Behal ,&nbsp;C. Garabedian","doi":"10.1016/j.jogoh.2025.103043","DOIUrl":"10.1016/j.jogoh.2025.103043","url":null,"abstract":"<div><h3>Objective</h3><div>To describe fetal heart rate (FHR) patterns associated with neonatal acidosis during the second stage of labor.</div></div><div><h3>Method</h3><div>This single-center (Lille, France) retrospective cohort study was conducted between September 2022 and January 2023. Fetal heart rate (FHR) during maternal expulsive efforts was interpreted for all low-risk women who delivered vaginally after 37 weeks' gestation. Low risk was defined by the absence of any maternal history, obstetric complications, and a normal fetal heart rate in the hour before the onset of expulsive efforts. A baseline increase was defined as a greater than 20 % increase in baseline FHR. Reduced variability and marked variability were defined as a variability &lt;5 bpm and greater than 25 bpm, respectively. FHRs were also described according to Melchior's classification. Neonatal acidosis was defined as umbilical artery pH &lt;7.15.</div></div><div><h3>Results</h3><div>Among the 275 expulsion FHRs analysed, 7.3 % (20/275) showed increased baseline and 5.5 % (15/275) abnormal variability. Neonatal acidosis occurred in 19.6 % (54/275) of neonates. Increased baseline and bradycardia were significantly associated with neonatal acidosis (14.8 % vs 5.4 %, <em>p</em> = 0.035 and 20.4 % vs 10.0 %, <em>p</em> = 0.035, respectively).</div></div><div><h3>Conclusion</h3><div>Increased baseline fetal heart rate during the second stage of labor was associated with a significant risk of neonatal acidosis. It would be interesting to include it in classifications related to this stage.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103043"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212862","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 “Efficacy of non-pharmacological therapies in chronic pelvic pain of endometriosis: A systematic review and meta-analysis”","authors":"Dinesh Puri ,&nbsp;Nivedita Nikhil Desai ,&nbsp;Shubham Kumar","doi":"10.1016/j.jogoh.2025.103040","DOIUrl":"10.1016/j.jogoh.2025.103040","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103040"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185964","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":"Association of hyperhomocysteinemia with IVF live birth rate: A retrospective cohort study","authors":"Lijun Shui ,&nbsp;Xiaozhu Chen ,&nbsp;Xianchao Dou ,&nbsp;Liangyi Ni ,&nbsp;Chao Chen ,&nbsp;Xinyi Zhu ,&nbsp;Qi Jin ,&nbsp;Shun Bai ,&nbsp;Limin Wu ,&nbsp;Meihong Hu","doi":"10.1016/j.jogoh.2025.103044","DOIUrl":"10.1016/j.jogoh.2025.103044","url":null,"abstract":"<div><h3>Objective</h3><div>Homocysteine (Hcy) has been reported to be associated with female reproduction. However, the correlation between hyperhomocysteinemia (HHcy) and pregnancy outcomes among infertile women remains unclear. This observational study aims to evaluate the effect of HHcy on pregnancy outcomes in infertile patients undergoing ART treatment.</div></div><div><h3>Methods</h3><div>Data were collected from 385 patients (50 in the HHcy group and 335 in the non-HHcy group) who underwent In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) at the First Affiliated Hospital of University of Science and Technology of China. Clinical outcomes between the two groups were analyzed.</div></div><div><h3>Results</h3><div>The number of oocytes retrieved, MII oocytes, oocyte maturation rate and normal fertilization rate did not differ significantly between the two groups. However, the HHcy group exhibited significantly lower rates of biochemical pregnancy (48 % vs. 74.9 %), clinical pregnancy (38 % vs. 63.9 %) and live births (34 % vs. 52.8 %) in the HHcy group compared to non-HHcy group. Logistic regression analyses indicated that HHcy was negatively associated with biochemical pregnancy rate (OR= 0.28, 95 % CI: 0.14–0.54, <em>P</em> &lt; 0.001), clinical pregnancy rate (OR = 0.32, 95 % CI: 0.16–0.61, <em>P</em> &lt; 0.001) and live birth rate (OR = 0.45, 95 % CI: 0.23–0.86, <em>P</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>HHcy exhibited a negative correlation with live birth among patients underwent IVF/ICSI. Clinicians should consider focusing more attention on patients with HHcy to enhance ART outcomes.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103044"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212829","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 the CAESARE tool in the management of non-reassuring fetal status at risk of acidosis","authors":"Simon Hubert ,&nbsp;Océane Brodbeck ,&nbsp;Fares Ghrairi ,&nbsp;Amjad Kattini ,&nbsp;Jan Chrusciel ,&nbsp;Stéphane Sanchez","doi":"10.1016/j.jogoh.2025.103037","DOIUrl":"10.1016/j.jogoh.2025.103037","url":null,"abstract":"<div><h3>Introduction</h3><div>Developed in 2020, the CAESARE tool is a decision-support tool for interpreting fetal heart rate (FHR). In a preliminary study, the use of CAESARE led to a significant reduction in caesarean section rates.</div></div><div><h3>Methods</h3><div>We assessed the ability of the CAESARE tool to predict acidosis earlier by reducing the time-to-intervention in cases of non-reassuring fetal status (NRFS). We performed a retrospective, single-center case-control analysis evaluating associations between CAESARE scoring and the onset of neonatal acidosis. The primary outcome was presence or absence of fetal acidosis at birth based on CAESARE score. The case population was patients whose fetuses had fetal heart rate abnormalities and an arterial pH &lt; 7.00 at birth. The control population was patients who had fetal heart rate abnormalities without the fetuses having acidosis at birth.</div></div><div><h3>Results</h3><div>CAESARE influenced decisions regarding the continuation of labor. It was associated with increased end of labor in the case group (<em>p</em> &lt; 0.01) and greater expectant management in the control group (<em>p</em> &lt; 0.01). CAESARE sensitivity and specificity were 0.97 and 0.88, respectively.</div></div><div><h3>Conclusion</h3><div>In our study, 32.1% of neonatal acidosis cases could have potentially been avoided if CAESARE had been used. The tool enabled extended expectant management in 42% of cases where end of labor was recommended. These findings support the implementation of a procedure for improved FHR analysis practices.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103037"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086312","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":"Favorable pregnancy outcome in a woman with extensive disseminated peritoneal leiomyomatosis","authors":"E. Hagelauer ,&nbsp;M. Beck ,&nbsp;C. Rousset-Jablonski ,&nbsp;E. Ruaux ,&nbsp;A. Trecourt ,&nbsp;P. Rousset ,&nbsp;W. Gertych","doi":"10.1016/j.jogoh.2025.103045","DOIUrl":"10.1016/j.jogoh.2025.103045","url":null,"abstract":"<div><div>Disseminated peritoneal leiomyomatosis (DPL) is a rare and benign condition characterized by the progression of smooth muscle tumors across the peritoneal cavity. The etiology is not well understood and could include previous surgeries and hormonal stimulation. We report on a 39-year-old woman with extensive DPL at the end of her pregnancy. She was diagnosed in the context of amenorrhea and was initially treated by gonadotropin-releasing hormone (GnRH) agonist. During pregnancy, a significant increase in lesion size was observed. The day before the planned cesarean-section (C-section), she presented with severe hypercalcemia, which was probably from a paraneoplastic origin. The patient underwent a planned C-section at 36 weeks and 5 days of gestation by midline sub-umbilical laparotomy, allowing a safe delivery.</div><div>This case provides insights for healthcare providers facing similar cases, considering that the obstetrical management of patients with DPL has not yet been defined.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103045"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232810","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":"Evaluation of the M6P model in predicting ectopic pregnancy among pregnancies of unknown location: A prospective monocentric study in Tunisia","authors":"Wissal Jaafar ,&nbsp;Ferdaous Mellouli ,&nbsp;Hamdi Dhaouadi ,&nbsp;Yasmine Chiba ,&nbsp;Malak Medemagh ,&nbsp;Mehdi Bouassida ,&nbsp;Nahed Khalifa ,&nbsp;Mechaal Mourali","doi":"10.1016/j.jogoh.2025.103035","DOIUrl":"10.1016/j.jogoh.2025.103035","url":null,"abstract":"<div><h3>Introduction</h3><div>Pregnancy of unknown location (PUL) refers to a positive pregnancy test without definitive ultrasound evidence of intrauterine or ectopic pregnancy. It present a diagnostic challenge in early pregnancy management due to the risk of ectopic pregnancy (EP).</div></div><div><h3>Methods</h3><div>A prospective, observational study was conducted on 179 women presenting with PUL. We assessed the predictive accuracy of the M6P model and analyzed its performance compared to standard clinical, biological, and ultrasound parameters among patients with PUL in a Tunisian population.</div></div><div><h3>Results</h3><div>The M6P model showed promising performance in stratifying EP risk factors significantly associated with high-risk EP included history of ectopic pregnancy, intrauterine device use, history of pelvic inflammatory disease, and smoking.</div></div><div><h3>Conclusion</h3><div>The M6P model is a valuable, objective, and reproducible tool for early risk stratification in PUL, with potential to reduce unnecessary hospitalizations and improve patient care.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103035"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080801","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":"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":"2025-12-01","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}