Journal of Obstetrics and Gynaecology Research最新文献

{"title":"The Effect of the Wireless Fetal Monitoring Used During Birth on the Women's Comfort, Labor Pain, and Birth Satisfaction.","authors":"Demet Çakır, Gülseren Dağlar","doi":"10.1111/jog.70466","DOIUrl":"10.1111/jog.70466","url":null,"abstract":"<p><strong>Background: </strong>Wired electronic fetal monitoring (EFM) restricts maternal mobility during labor and may negatively affect pain coping, comfort, birth satisfaction. Although both wired and wireless systems are available, wired EFM remains the standard method in many countries, including Türkiye. This randomized controlled trial evaluated the effects of wireless EFM on maternal comfort, labor pain, birth satisfaction.</p><p><strong>Materials and methods: </strong>The final sample comprised 88 women, with 44 participants in the experimental group and 44 in the control group. Data were collected using the personal information form, childbirth comfort questionnaire (CCQ), visual analog scale (VAS), and birth satisfaction scale-revised (BSS-R). Women in the experimental group were monitored using wireless EFM, whereas those in the control group received conventional wired EFM. The VAS and CCQ were administered during the active phase of labor (8-10 cm cervical dilatation), and the BSS-R was completed 1 h postpartum.</p><p><strong>Results: </strong>Labor duration was shorter, reactive EFM findings were more frequent in the experimental group. Mean CCQ and BSS-R scores were higher, whereas mean VAS scores were lower in the experimental group. Significant between-group differences were observed for VAS and BSS-R scores, whereas the difference in CCQ scores was not statistically significant.</p><p><strong>Conclusion: </strong>Women monitored with wireless EFM experienced lower perceived labor pain and higher birth satisfaction than those receiving conventional wired EFM. Wireless EFM was also associated with shorter labor duration and a higher rate of reactive EFM findings. These findings suggest that wireless EFM may improve women's childbirth experience while maintaining effective fetal monitoring.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 9","pages":"e70466"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to \"The Effect of Coffee and Warm Water on Gastrointestinal Tract After Cesarean Section: A Randomized Controlled Trial\".","authors":"Meilin Liu, Fan Zhou, Zhanli Liu","doi":"10.1111/jog.70484","DOIUrl":"10.1111/jog.70484","url":null,"abstract":"","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 9","pages":"e70484"},"PeriodicalIF":1.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to: “Oral Misoprostol Versus Vaginal Dinoprostone for Labor Induction: A Systematic Review and Meta-Analysis”","authors":"Hafiz Mohsin Hameed","doi":"10.1111/jog.70479","DOIUrl":"https://doi.org/10.1111/jog.70479","url":null,"abstract":"","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823311","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 Serum Placental Growth Factor and Uterine Artery Pulsatility Index for Early-Onset Preeclampsia Prediction in Chinese Women: A Retrospective Cohort Study","authors":"Haixia Liang,&nbsp;Ying He,&nbsp;Ying Zhang,&nbsp;Yujie Wu,&nbsp;Han Wu,&nbsp;Zehui Zhang,&nbsp;Xuejing Zhao","doi":"10.1111/jog.70446","DOIUrl":"https://doi.org/10.1111/jog.70446","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early-onset preeclampsia (EOPE) accounts for a disproportionate share of severe maternal–fetal complications. First-trimester screening based on traditional risk factors alone lacks sufficient sensitivity. We evaluated whether maternal serum placental growth factor (PlGF) and uterine artery pulsatility index (UtA-PI), alone or in combination, enhance first-trimester prediction of EOPE in a Chinese cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study recruited 680 singleton pregnancies delivered in our centre between January 2022 and January 2025. After excluding pre-existing diseases and other pregnancy complications, 120 EOPE cases delivered &lt; 34 weeks were compared with 480 normotensive controls. Maternal serum PlGF and UtA-PI were measured at 11–13⁺⁶ and 14–24⁺⁶ weeks. Logistic regression and ROC analyses were used to assess predictive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In early pregnancy, women who later developed EOPE exhibited lower PlGF (36.8 ± 15.3 vs. 89.7 ± 23.5 pg/mL, <i>p</i> &lt; 0.001) and higher UtA-PI (1.90 ± 0.60 vs. 1.20 ± 0.30, <i>p</i> &lt; 0.001) than controls. Both markers were independent predictors in multivariable models (PlGF OR 0.95, UtA-PI OR 1.82; both <i>p</i> &lt; 0.001). ROC curves indicated that combined assessment yielded superior discrimination: early-pregnancy AUC 0.94 (95% CI 0.90–0.98) and mid-pregnancy AUC 0.87 (0.82–0.92), both exceeding single-marker performance (<i>p</i> &lt; 0.05). Optimal cut-offs in early pregnancy (PlGF ≤ 62.5 pg/mL and UtA-PI ≥ 1.5) provided 82.5% sensitivity and 88.3% specificity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Combining PlGF and UtA-PI significantly improved first-trimester prediction of EOPE. These findings establish a foundation for population-level implementation of this dual-marker strategy to reduce the burden of early-onset preeclampsia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 9","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148823265","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":"Narrative Nursing and Perioperative Psychological Outcomes in Women Undergoing Cervical Cerclage: The Potential Indirect Role of Fear of Childbirth","authors":"Zeyang Zhang,&nbsp;Sudan Liu,&nbsp;Yufan Yuan,&nbsp;Lanlan He,&nbsp;Lian Zhao,&nbsp;Wenjie Ning","doi":"10.1111/jog.70431","DOIUrl":"10.1111/jog.70431","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Women undergoing cervical cerclage commonly experience fear of childbirth, anxiety, and depressive symptoms, while evidence on the psychological effects of narrative nursing in this population remains limited. This study evaluated the association of narrative nursing with perioperative psychological changes and explored the potential indirect role of fear of childbirth in these associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This quasi-experimental study included 230 women undergoing cervical cerclage between January 2023 and December 2024. Participants were nonrandomly allocated to either a narrative nursing group (<i>n</i> = 115) or a routine nursing group (<i>n</i> = 115) according to the nursing model implemented at the hospital campus where they received care. Fear of childbirth, anxiety, and depression were assessed using the Mandarin Chinese versions of the W-DEQ-A, SAS, and SDS at baseline before surgery (T0), on postoperative day 3 (T1), and before discharge (T2). Longitudinal changes were analyzed using linear mixed-effects models incorporating group, time, and group × time interaction terms. Exploratory single-mediator analyses with 5000 bootstrap resamples were conducted using the T1 W-DEQ-A score as the potential mediator and the T2 SAS or SDS score as the outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant group × time interactions were observed for W-DEQ-A, SAS, and SDS scores (all <i>p</i> ≤ 0.005). Compared with routine nursing, narrative nursing was associated with lower adjusted W-DEQ-A scores at T1 and T2, lower SAS scores at T1 and T2, and a lower SDS score at T2. At T2, the adjusted between-group differences were −5.7 points for the W-DEQ-A, −3.3 points for the SAS, and −2.6 points for the SDS. Exploratory mediation analyses identified significant indirect associations through T1 fear of childbirth for both T2 anxiety (estimated indirect association, −0.54; 95% bootstrap CI, −0.93 to −0.23) and T2 depression (estimated indirect association, −0.45; 95% bootstrap CI, −0.81 to −0.18). The direct associations remained statistically significant in both models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Narrative nursing was associated with greater short-term reductions in fear of childbirth, anxiety, and depression among women undergoing cervical cerclage. Exploratory findings were consistent with a potential partial indirect role of fear of childbirth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808786","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":"The Impact of Contained Versus Uncontained Morcellation Following Laparoscopic Myomectomy on Operation Time, Pain Perception and Bleeding","authors":"Ann-Sophie Jensen,&nbsp;Martin Rudnicki","doi":"10.1111/jog.70471","DOIUrl":"10.1111/jog.70471","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Title</h3>\u0000 \u0000 <p>The impact of contained power versus uncontained manual morcellation following laparoscopic myomectomy on operation time, pain perception, and bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Knowledge of contained power morcellation in relation to operation time, bleeding, and in-hospital-stay is sparse. Our study aimed to investigate how contained power versus uncontained manual morcellation following laparoscopic myomectomy influenced operation time and bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women undergoing laparoscopic myomectomy at Odense University Hospital between September 2019 and September 2024 were included. Inclusion criteria were women ≥ 18 years undergoing a laparoscopic myomectomy. The size of the myomas, number of myomas, and demographics did not affect patient eligibility. Exclusion criteria were robot-assisted or open myomectomy, and malignancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 116 women met inclusion criteria and underwent laparoscopic myomectomy. Of these, 74 (63.8%) underwent contained power morcellation and 42 (36.2%) uncontained manual morcellation. The operation time was 118.0 min (±54.07) in the contained group and 114.5 min (±32.53) in the uncontained manual group (<i>p</i> = 0.704). Perioperative bleeding was significantly lower in the contained power group versus the uncontained manual group (224.5 mL [±358.6] vs. 521.1 mL [±497.2], <i>p</i> = 0.0005). The length of hospitalization did not differ between contained power group and the uncontained manual group (0.57 days [±0.98] vs. 0.69 days [±0.68]; <i>p</i> = 0.473). One woman in the uncontained manual group had an intraabdominal abscess, and two women had intraabdominal bleeding, one in the uncontained manual group and one in the contained power group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study demonstrated that contained power morcellation following myomectomy did not increase the operation time. The contained power morcellation was associated with lower perioperative bleeding; however, this finding should be interpreted cautiously because of the retrospective study design and potential residual confounding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of Preconception Care for Optimizing Fetal Growth in Pregnancies Complicated by Psychiatric Disorders","authors":"Hitoshi Isohata,&nbsp;Sumie Miura,&nbsp;Yu Yamazaki,&nbsp;Dai Goto,&nbsp;Hiroyuki Goto,&nbsp;Yoshihiro Yoshimura,&nbsp;Kyoko Hattori,&nbsp;Takao Shimaoka,&nbsp;Ken Inada,&nbsp;Daigo Ochiai","doi":"10.1111/jog.70470","DOIUrl":"https://doi.org/10.1111/jog.70470","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate the determinants of fetal growth abnormalities such as large for gestational age (LGA) and small for gestational age (SGA) in singleton pregnancies complicated by maternal psychiatric disorders, particularly focusing on the impact of psychotropic medication exposure and maternal background factors on infants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective single-center cohort study was conducted involving 400 singleton pregnancies complicated by maternal psychiatric disorders, with deliveries occurring between 2019 and 2023. Data regarding maternal characteristics, psychiatric diagnoses, psychotropic medication use including polypharmacy and metabolically high-risk psychotropic medications, and obstetric outcomes were extracted from medical records. Infants were classified as LGA or SGA according to gestational age-specific birth weight standards. Multivariable logistic regression analyses were performed to identify independent factors associated with LGA and SGA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 400 pregnancies, 40 infants were classified as LGA and 40 as SGA. Psychotropic medication use, including polypharmacy and metabolically high-risk psychotropic medications, was not independently associated with either LGA or SGA. For LGA, only high prepregnancy BMI was identified as an independent risk factor. For SGA, hypertensive disorders of pregnancy, maternal alcohol consumption, and lower prepregnancy BMI were independently associated with increased risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In pregnancies complicated by psychiatric disorders, fetal growth abnormalities were primarily associated with maternal background factors. No statistically significant association was identified between psychotropic medication use and LGA or SGA fetuses in our study cohort. These findings highlight the potential importance of preconception care focused on optimizing metabolic health and lifestyle factors to improve fetal growth outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148785004","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 Novel Preoperative Cervical Cerclage Staging and the Outcomes Accordingly at a Tertiary Center","authors":"Lütfiye Uygur,&nbsp;Abdullah Tabakçı,&nbsp;Işıl Ayhan,&nbsp;Hazal Sağkol,&nbsp;Ceren Unal,&nbsp;Resul Karakuş,&nbsp;Çetin Kılıccı,&nbsp;Önder Tosun,&nbsp;Mucize Eriç Özdemir","doi":"10.1111/jog.70474","DOIUrl":"https://doi.org/10.1111/jog.70474","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To present a novel preoperative staging for cervical cerclage and the outcomes of the procedure according to this staging. The second aim is to identify the predictors of cerclage failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective monocentric cohort study including 136 singleton pregnancies with cervical insufficiency who had undergone cervical cerclage. Preoperative examination findings, ultrasound results, and demographic data were obtained from hospital records. The patients were assigned to four main stages and seven substages according to their ultrasound and examination findings. Cerclage failure rates were detected, and the pregnancy outcomes and the factors that affect operation outcomes were evaluated in each stage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean gestational age at birth was 34.1 ± 5.7 for the entire cohort. The mean cerclage-to-delivery interval was 15.4 ± 6.7 weeks. Shorter cervical length, sludge, cervical dilatation, prolapsed membranes into the cervical canal or vagina, and need for long-term tocolysis (&gt; 3 days) were associated with cerclage failure. No significant difference in pregnancy outcomes was detected between dilated and non-dilated cervix, as long as the membranes were not prolapsed. Pregnancy outcomes differed significantly between the cases with prolapsed membranes above and below the external os.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This staging system can assist obstetricians in preoperative counseling about individualized success chances for the operation and the risk factors that increase the risk of operation failure. As the stage advances, clinical factors related to infection seem to have more impact on outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784946","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: When Routine Gynecologic Procedures Unmask a Systemic Bleeding Disorder: Refractory Uterine Hemorrhage Leading to the Diagnosis of AL Amyloidosis","authors":"Nur İlayda Genç,&nbsp;Mehmet Gökhan Gönenli,&nbsp;Sogol Sadri,&nbsp;Toygun Çakmak,&nbsp;İbrahim Öner Doğan,&nbsp;Olga Meltem Akay","doi":"10.1111/jog.70469","DOIUrl":"https://doi.org/10.1111/jog.70469","url":null,"abstract":"<div>\u0000 \u0000 <p>Refractory peri-procedural bleeding may be the first manifestation of an occult systemic bleeding disorder. A 46-year-old woman with heavy menstrual bleeding developed severe uterine hemorrhage after endometrial sampling and intrauterine device removal, refractory to conservative treatment and requiring balloon tamponade and uterine artery embolization. Her history revealed spontaneous ecchymoses, hematemesis, and a previous nontraumatic subcapsular liver hematoma. Further evaluation showed nephrotic-range proteinuria, monoclonal IgG-lambda in serum and urine, an abnormal serum free light chain ratio, and gastrointestinal amyloid deposition. Bone marrow examination demonstrated 11% lambda-restricted clonal plasma cells, confirming AL amyloidosis. Factor X activity was mildly reduced to 63% (reference range: 70%–120%). This case highlights that near-normal routine coagulation studies do not exclude clinically significant bleeding risk. Careful bleeding history and recognition of systemic disorders are essential when peri-procedural hemorrhage is disproportionate to the intervention.</p>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784033","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":"Fetal Acidemia Prediction Using a Random Forest Model With Cumulative Fetal Stress Assessment During Labor","authors":"Ayumu Ito,&nbsp;Yoko Nagayasu,&nbsp;Rei Mitsuhashi,&nbsp;Mio Kamiya,&nbsp;Eijiro Hayata,&nbsp;Masahiko Nakata","doi":"10.1111/jog.70467","DOIUrl":"https://doi.org/10.1111/jog.70467","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To improve prediction of fetal acidemia during labor using a random forest model incorporating cumulative fetal stress assessment, focusing on an umbilical cord arterial pH &lt; 7.20 as an early clinically relevant threshold.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective case-enriched model development study was conducted at Toho University Omori Medical Center. Data were collected from full-term vaginal deliveries between January 2017 and June 2021 for cases with umbilical cord arterial pH &lt; 7.20 and between September 2018 and April 2019 for those with pH ≥ 7.20. Fetal acidemia was defined as pH &lt; 7.20 to account for the time gap between fetal heart rate–based prediction and actual pH measurement at birth. A random forest model was developed using fetal heart rate data, including all decelerations within 30 min before delivery. Model performance was evaluated using five-fold cross-validation. Two datasets were created: Dataset 1 included fetal heart rate data alone, whereas Dataset 2 additionally included maternal and perinatal factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Dataset 1 achieved a test accuracy of 91.0% and an area under the receiver operating characteristic curve (AUC) of 0.95. Dataset 2 showed improved test accuracy of 93.0% with a similar AUC. Variable importance analysis identified variability as the strongest predictor, followed by the duration of mild and severe prolonged decelerations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this case-enriched derivation dataset, a random forest model incorporating cumulative CTG-derived fetal stress variables showed high discrimination for umbilical artery pH &lt; 7.20. External validation in independent consecutive populations is required before clinical implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 8","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784419","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}