Minerva obstetrics and gynecology最新文献

{"title":"Ovulation induction in anovulatory PCOS women.","authors":"Marialaura Diamanti, Antonio LA Marca","doi":"10.23736/S2724-606X.24.05633-1","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05633-1","url":null,"abstract":"<p><p>Polycystic ovary syndrome (PCOS) is a prevalent endocrine-metabolic disorder characterized by hyperandrogenism, chronic anovulation, and polycystic ovarian morphology, affecting 6-10% of women during their reproductive years. It is a leading cause of female infertility, impacting up to 40% of cases. First described in 1935, PCOS manifests with various clinical features, including hirsutism, amenorrhea, and metabolic disturbances. Additionally, PCOS patients exhibit hormonal imbalances and ovarian dysfunction, contributing to the overall clinical picture. Notably, PCOS is linked to metabolic comorbidities like hepatic steatosis, glucose intolerance, dyslipidemia, type 2 diabetes mellitus (T2DM), and hypertension. This review explores the key aspects of PCOS, providing an overview of ovulation induction strategies, including lifestyle modifications, pharmacological interventions, and emerging approaches. The review synthesizes findings from relevant studies. Effective management of PCOS necessitates early detection and intervention to prevent progression to severe health conditions. Evidence underscores the importance of addressing oxidative stress and low-grade inflammation in treatment plans. A holistic approach, including individualized medication, diet, and lifestyle modifications, is crucial for improving insulin resistance, promoting weight loss, enhancing ovulation rates, and addressing broader metabolic concerns. Key therapeutic strategies include insulin sensitizers like metformin, ovulation induction agents like clomiphene citrate (CC) and aromatase inhibitors (AIs) such as letrozole, and the use of gonadotropins for resistant cases. Combining these treatments with dietary and lifestyle interventions, such as an anti-inflammatory diet, nutritional education, and personalized exercise programs, can enhance treatment outcomes. Through an integrated approach, significant improvements in metabolic health and reproductive function for women with PCOS are possible.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiology and diagnostic criteria of PCOS.","authors":"Anna Capozzi, Michele Vignali, Giovanni Scambia, Stefano Lello","doi":"10.23736/S2724-606X.24.05612-4","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05612-4","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine-metabolic syndrome mainly characterized by ovarian dysfunction, which is only one manifestation of a more complex syndrome with a significant systemic impact.</p><p><strong>Evidence acquisition: </strong>We review scientific literature on the pathophysiology and diagnosis of PCOS evaluating the most relevant data from original articles, reviews and meta-analyses published until June 2024.</p><p><strong>Evidence synthesis: </strong>From a pathophysiological point of view, the concurrence of both metabolic aspects, such as insulin resistance and obesity, and hormonal alterations, such as hyperandrogenemia, might produce the most relevant clinical signs and/symptoms of this syndrome, for instance menstrual irregularities, hair loss, acne and hirsutism. In the latest years, many pieces of evidence highlighted the importance of family history and genetics in the development of the syndrome during adolescence and adult life. According to the available data, hypovitaminosis D could play a detrimental role in the pathogenesis and clinical manifestations of PCOS.</p><p><strong>Conclusions: </strong>PCOS is a challenging endocrine and metabolic dysfunction, due to its different expression among women and to the difficulty in obtaining an accurate diagnosis. The most appropriate approach to women affected by PCOS should involve a multi-step strategy, taking into account the characteristics of each patient, in order to identify the best non-pharmacologic and pharmacologic approach to manage both short- and medium-, and long-term sequelae.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relaxin in pregnancy: a narrative review of a pleiotropic molecule.","authors":"Emma Bertucci, Francesco Ricciardiello, Gloria Guariglia, Francesco Cannistrà, Mariantonietta Oliverio, Filomena G Sileo, Antonio LA Marca","doi":"10.23736/S2724-606X.24.05630-6","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05630-6","url":null,"abstract":"<p><strong>Introduction: </strong>Relaxin is a hormone primarily produced by the corpus luteum during pregnancy, and it plays a critical role in various physiological processes related to pregnancy and childbirth.</p><p><strong>Evidence acquisition: </strong>Studies have suggested a possible link between relaxin levels and preterm birth. Relaxin's effects on the cervix and pelvic ligaments suggest it could influence the mode of delivery. Higher relaxin levels have been hypothesized to facilitate vaginal delivery by promoting cervical ripening and softening of the pelvic ligaments, thereby reducing the need for cesarean sections. The involvement of relaxin in extracellular matrix remodeling suggests it could play a role in placental attachment. Some experimental studies have proposed that aberrant relaxin signaling might contribute to the development of placenta accreta by influencing the invasive properties of trophoblast cells.</p><p><strong>Evidence synthesis: </strong>The current evidence on relaxin's role in preterm birth, mode of delivery, and placenta accreta is not definitive. While there are plausible mechanisms by which relaxin could influence these outcomes, clinical studies have yet to provide strong, consistent evidence. Future research should focus on well-designed, large-scale studies to better understand the relationship between relaxin levels and these critical pregnancy outcomes.</p><p><strong>Conclusions: </strong>The focus of this review is to evaluate relaxin as a potential biomarker and its potential future therapeutic applications during pregnancy and consider the limitations that must be addressed in future studies.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal delivery of the second twin: simulation to improve trainee knowledge and comfort.","authors":"Claudio Celentano, Daniela A Iaccarino, Barbara Matarrelli, Maurizio Rosati, Federico Prefumo","doi":"10.23736/S2724-606X.24.05614-8","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05614-8","url":null,"abstract":"<p><strong>Background: </strong>Vaginal delivery in twins is feasible but challenging. Successful vaginal delivery of a non-vertex second twin depends on knowledge of specific obstetrical maneuvers. Skill acquisition at the patient's bedside is difficult, making simulation training an integral part of obstetrics and gynecology residency programs.</p><p><strong>Methods: </strong>This prospective, randomized, controlled, single-center study involved obstetrics and gynecology residents. Group A attended a frontal lecture followed by practical simulation; Group B received digital home learning. One month later, both groups underwent a simulation test to identify fetal small parts using a birth simulator with a fetus model placed in a simulated amniotic cavity. Training was conducted with an actor facilitator and supervised by six specialists, focusing on obtaining information, using external and internal hands. A 25-question Likert scale questionnaire was administered via Google Forms. Metrics evaluated included time to reach foot/feet, number of attempts, and answers on Kirkpatrick levels 1-4.</p><p><strong>Results: </strong>Twenty-four participants were recruited and randomized into two groups, with five lost to follow-up at the time of the simulation test. Group A required less time for internal podalic version and breech extraction of the second twin (P=0.02) and fewer attempts to reach the foot/feet of the second twin (P=0.01). Supervisor evaluations of \"asking information\" and \"internal hand use\" were better in Group A.</p><p><strong>Conclusions: </strong>Simulation training for the vaginal delivery of a non-vertex second twin is feasible and has a favorable impact on resident performance.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune biomarkers in cases of recurrent pregnancy loss and recurrent implantation failure.","authors":"Marcelo B Cavalcante, Manoel Sarno, Ricardo Barini","doi":"10.23736/S2724-606X.24.05549-0","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05549-0","url":null,"abstract":"<p><p>Reproductive failures, such as recurrent pregnancy loss (RPL) and recurrent implantation failures (RIF) are a major challenge for reproductive medicine. The current management of RPL and RIF cases identifies some causes for unsuccessful pregnancy in up to half of patients. Several studies have suggested that immune disorders are responsible for an important portion of unexplained cases of RPL and RIF. Moreover, the immune abnormalities responsible for reproductive failures can be classified into disorders related to autoimmunity and changes in cellular immunity. Antiphospholipid syndrome (APS), testing for antiphospholipid (aPL) antibodies, antinuclear antibodies, and antithyroid antibodies are identified as biomarkers of autoimmunity that can predict reproductive failure. The cellular immune response in cases of RPL and RIF can be investigated through the study of natural killer (NK) cells (uterine and peripheral blood) and T lymphocytes (T helper [Th]-1, Th-2, regulatory T and Th-17 cells). Several types of laboratory assays have been used to evaluate the endometrial immune microenvironment, such as the endometrial immune profile and decidualization score. However, the effectiveness of the treatment of RPL and RIF with immunomodulatory drugs has not yet been confirmed. Recently, a group of experts from the International Federation of Gynecology and Obstetrics and the European Society of Human Reproduction and Embryology recommended the investigation of some immune factors and treatment with immunosuppressants in women with RPL. In conclusion, it is important to consider immune abnormalities when managing women with RPL and RIF. The use of immunotherapies must be personalized and based on a specific diagnosis to obtain favorable outcomes.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian reserve, metabolic and neuroendocrine profiles of cadets from Air Force Academy: a pilot study.","authors":"Alessandro Conforti, Giulia A Guadalupi, Giuseppe Perruolo, Renata S Auriemma, Raffaella DI Girolamo, Luigi Carbone, Federica Cariati, Maria G Orsi, Antonio Raffone, Ida Strina, Pietro Formisano, Maurizio Guida, Gianfrancesco Capuano, Francesca DI Rella, Salvatore Longobardi, Carlo Alviggi, Antonio Mollo","doi":"10.23736/S2724-606X.24.05542-8","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05542-8","url":null,"abstract":"<p><strong>Background: </strong>Intensive physical activity and rigid dietary regimes can act as modifiers of neuroendocrine axes in women, inducing hormonal disorders and related menstrual irregularities such as functional hypothalamic amenorrhea (FHA). It would be important to evaluate if such disturbances may worsen female fertility. The aim of this study was to evaluate ovarian reserve markers and neuroendocrine axis in young military academy female cadets with years of training and occurrence of FHA.</p><p><strong>Methods: </strong>This is a prospective pilot study involving young female cadets from the Military Academy training program. Ovarian reserve markers and metabolic and neuroendocrine factors in the early follicular phase were measured with blood tests and transvaginal ultrasound.</p><p><strong>Results: </strong>The study group consisted of 11 women belonging to the first year of training and the control group of 33 women belonging to the second to sixth year of training. No differences were found about ovarian reserve markers between the two groups. Moreover, the occurrence of FHA did not modify the ovarian reserve compared to eumenorrhea in both groups. Women from the study group showed significantly higher levels of fasting Insulin (42.18±26.14 uUI/mL versus 11.9±10.2 ng/mL, P value <0.001) and insulin-like growth factor 1 (310.06±67.90 uUI/mL versus 248.67±61.57 uUI/mL, P value = 0.015) compared with control group.</p><p><strong>Conclusions: </strong>Both intense physical training and FHA do not appear to impact the ovarian reserve of young female cadets. Although preliminary, these findings seem reassuring about the reproductive health of these women and their future fertility.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of endometriosis on oocyte quality in women undergoing assisted reproduction.","authors":"Parimala Chinta, Treasa Joseph, Nadia Imam, Nivedita Gupta, Hemapriya Mohan, Mohan S Kamath","doi":"10.23736/S2724-606X.24.05552-0","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05552-0","url":null,"abstract":"<p><p>Endometriosis is a chronic gynecological condition which can lead to infertility in women during reproductive age. Endometriosis influences the assisted reproductive technology (ART) outcomes by its impact on oocyte and embryo quality, oocyte numbers and subsequently the embryo numbers and endometrial receptivity. There has been clinical dilemma as to whether it is predominantly the oocyte, or the endometrium which affects the pregnancy outcomes in women with endometriosis. In this review we provide an overview of the effect of endometriosis on the oocyte molecular mechanism, the overall effect of endometriosis and its various stages as well as the effect of endometrioma on the oocyte quality in autologous study models. We have also provided a review of the donor oocyte models to study the effect of endometriosis on the endometrium. While initial small donor oocyte-based model studies suggested a possible major detrimental impact of oocyte quality on ART outcomes in women with endometriosis, the more recent studies have found minimal or no impact of oocyte quality on treatment outcomes. There is growing evidence to suggest an important contributory role of reduced oocyte yield on ART success in women with endometriosis. There is a need to explore whether oocyte yield and not the oocyte quality or endometrial receptivity, is the main reason for lower success in women with endometriosis following ART.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Membrane sweeping versus transcervical Foley catheter for induction of labor in women with a previous cesarean delivery: a randomized controlled trial.","authors":"Soon L Yong, Joyce C Ting, Xiu S Wong, George H Wong, Marcus Kang","doi":"10.23736/S2724-606X.24.05470-8","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05470-8","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the effectiveness of membrane sweeping and transcervical Foley catheters for the induction of labor after one previous cesarean delivery.</p><p><strong>Methods: </strong>An open-label, prospective, randomized controlled trial was performed at Sibu Hospital, Sarawak, Malaysia between 15^th February 2018 and 30^th August 2018. Pregnant women aged 18 or above at term who had one previous uncomplicated lower segment cesarean section and required induction of labor were randomized to membrane sweeping or transcervical Foley catheter insertion.</p><p><strong>Results: </strong>A total of 60 women were recruited in the study, of whom 30 were randomized to the membrane sweeping group and 30 to the Foley catheter group. The number of women who achieved a Bishop Score ≥8 was significantly higher in the Foley catheter arm than in the membrane sweeping arm (76.7% versus 43.3%; P=0.008). Compared with membrane sweeping, transcervical Foley catheter insertion significantly improved Bishop scores and allowed more women to achieve a favorable cervix that permitted an amniotomy by 48 hours of labor induction (P<0.05). The mode of delivery, intrapartum oxytocin use, maternal complications and neonatal outcomes were similar in both groups. No women had a uterine rupture or uterine hyperstimulation.</p><p><strong>Conclusions: </strong>Although transcervical Foley catheter insertion is superior to membrane sweeping in terms of the efficacy of labor induction, both methods did not show a statistically significant difference in vaginal delivery rates and their overall complication rates were similar.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An update on epigenetic mechanisms in endometriosis.","authors":"Kyle N LE, Ariel Benor, Alan Decherney","doi":"10.23736/S2724-606X.24.05631-8","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05631-8","url":null,"abstract":"<p><p>The etiopathogenesis of endometriosis, a chronic debilitating disease affecting nearly 10% of women, has evaded elucidation until the recent epigenetic discoveries. Although still deemed multifactorial, endometriosis is likely predisposed in women with genetic and epigenetic alterations, which are activated by environmental factors. There are many epigenetic changes that have recently been associated with endometriosis: DNA methylation and phosphorylation, modifications to histones and non-coding RNA, and chromatin remodeling and organization. Gene markers, such as HOXA10, SF-1, and GATA transcription factors, are also debatably correlated to endometriosis. An improved understanding of the etiopathogenesis of endometriosis may propel our field toward our objectives: sooner and more efficient detection as well as targeted therapy. In this comprehensive review, we will identify and discuss the current literature on epigenetic changes seen in endometriosis. A primary computerized search was performed on PubMed and Google scholar of publications from 1990 to 2022. We searched for keyword terms such as \"endometriosis\" and \"endometriosis epigenetics.\" We also looked through the references of prior articles to find other relevant articles to this topic. Articles were categorized by type of epigenetic change found such as DNA hypo- or hyper- methylation, histone hyper- or hypo-acetylation, chromatin remodeling, and non-coding RNA-mediated down-regulation and the research was elaborated in sections based on the type of epigenetic change. There are many articles on TET, DNMTs, EZH2, HDACs, HATs, let-7 family, miRNAs, Hox proteins, GATA family, sirtuins (e.g. SIRT1, SIRT3), ARID1A, SF-1, USF1, USF2, STRA6, ESR1, ESR2, PGR, ALDHIA2, and CTCF; however, the studies analyzed in this review were heterogeneous in comparison populations, analysis methods, tissues types (e.g. endometriomas, ectopic endometriotic tissue, eutopic endometrial tissue). Due to this, it is difficult to synthesize over-arching conclusions based on the current literature; however, there are many epigenetic changes and genes linked to endometriosis as noted in the literature.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Office endometrial sampling: effectiveness and predictive factors of success in Novak versus Endosampler devices.","authors":"M Carolina Carneiro, Patrícia G Ferreira, Susana M Saraiva, Cátia D Rodrigues, Susana Leitão, Cristina M Costa, Maria da Soledade Ferreira","doi":"10.23736/S2724-606X.23.05358-7","DOIUrl":"10.23736/S2724-606X.23.05358-7","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to evaluate the rate of endometrial sampling (ES) failure, predictive factors of success, and reliability as diagnostic methods of Endosampler versus Novak.</p><p><strong>Methods: </strong>A retrospective single-center study was carried out with all patients who underwent ES via Endosampler or Novak in 2020 and 2021. Demographic data, personal background, and histopathologic results were evaluated.</p><p><strong>Results: </strong>Eighty-six patients underwent ES by Novak and 90 by Endosampler. The failure rate of ES was 43.2% with lower values for Endosampler (33.3% vs. 53.5%, P<0.05). Age, biopsy device, menopausal status, indication for biopsy, and amount of sample collected were predictive factors of failure. Analyzing each device, Endosampler was only affected by menopausal status. Only 50% in Novak and 62.5% in the Endosampler group of endometrial neoplasia cases were detected by these methods. Analyzing the performance for endometrial neoplasia (EN), we obtained higher values of sensitivity and accuracy for Endosampler (62.5% vs. 50.0% and 83.3% vs. 72.7%), respectively.</p><p><strong>Conclusions: </strong>In our study, the failure rate obtained was in line with other previous studies. Menopausal status, age, type of biopsy device, indication for biopsy, and amount of sample collected affected ES performance. Analyzing diagnostic performance for EN, we found that these methods have better reliability for positive results than for negative ones, which may indicate the need for further evaluation in cases of high clinical suspicion. In short, we obtain a higher rate of success rate in Endosampler devices and better performance in diagnosing EN, which is the major objective of an ES.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"522-531"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138445435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}