Minerva obstetrics and gynecology最新文献

{"title":"Antepartum pelvic floor muscle training (PFMT) plus perineal massage vs. postpartum PFMT alone: analysis of pelvic floor disorders, Quality of Life and sexual function.","authors":"Federica Di Pasquale, Alessia Contadini, Melania Loggia, Federica Sala, Debora Grilli, Lorenzo Campanella, Fabio Manganelli, Pier L Palazzetti, Herbert C Valensise, Michele C Schiavi","doi":"10.23736/S2724-606X.24.05466-6","DOIUrl":"10.23736/S2724-606X.24.05466-6","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to analyze how antepartum pelvic floor muscle training (PFMT) plus perineal massage associated with postpartum PFMT have a significant impact on pelvic floor health during pregnancy and after delivery.</p><p><strong>Methods: </strong>One thousand two hundred thirty-three women were enrolled from January 2019 to December 2021. They were divided into two groups: 786 women underwent postpartum PFMT only, 447 women experienced both prepartum perineal massage and PFMT and postpartum PFMT. The primary endpoint was to evaluate prepartum perineal massage and PFMT's impact on delivery. The second endpoint was the evaluation of Quality of Life and sexual function at 3- and 12-months follow-up after delivery.</p><p><strong>Results: </strong>Women who underwent prepartum PFMT experienced significantly lower percentage of episiotomy, high-grade obstetric tear or instrumental delivery and higher percentage of intact perineum. Furthermore, prepartum PFMT appeared to improve sexual function at 3 months follow-up, and it was associated with an earlier first sexual intercourse after childbirth. The incidence of stress urinary incontinence was significantly higher in women who experienced PFMT only in postpartum, both at 3- and 12-months follow-up, while the other examined clinical parameters did not show a significant difference.</p><p><strong>Conclusions: </strong>Prepartum PFMT has a role in preventing obstetric traumas and on improving Sexual Function and Quality of Live in the immediate postpartum. Moreover, prepartum PFMT in association with postpartum PFMT reduces the incidence of stress urinary incontinence in a higher percentage than postpartum PFMT only.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"148-156"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349874","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":"Multidisciplinary management of agenesis of corpus callosum: a narrative review.","authors":"Carmen Aquino, Mariagrazia Marisei, Mario Tortora, Fabio Tortora, Emanuele Capasso, Daniela Surico, Francesco Briganti, Claudia Casella, Maurizio Guida","doi":"10.23736/S2724-606X.24.05641-0","DOIUrl":"10.23736/S2724-606X.24.05641-0","url":null,"abstract":"<p><p>The corpus callosum (CC) is the most significant of the three cerebral commissures that join the human left and right hemispheres. Numerous vascular, chemical, genetic, and metabolic disturbances can impede the growth of the CC. Complete agenesis of the CC is the most prevalent abnormality. As a result of improvements in our knowledge and advancements in ultrasonography technology, an increasing number of congenital CC abnormalities have been identified. Prenatal magnetic resonance imaging is crucial to identify related central nervous system abnormalities. Counseling about the postnatal result is still difficult. This study sought to characterize the long-term consequences for children with isolated anomalies of CC detected during pregnancy, trying to provide the correct multidisciplinary approach to the pregnant woman also in terms of medical legal and ethical issues.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"247-258"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005374","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":"Racial and ethnic disparities in non-invasive prenatal testing adherence: a retrospective cohort study.","authors":"Marco La Verde, Maria Maddalena Marrapodi, Carlo Capristo, Anna Conte, Rossella Molitierno, Maddalena Morlando, Mario Fordellone, Pasquale De Franciscis, Maria Rosaria Campitiello, Marco Torella","doi":"10.23736/S2724-606X.24.05530-1","DOIUrl":"10.23736/S2724-606X.24.05530-1","url":null,"abstract":"<p><strong>Background: </strong>Fetal aneuploidies, including trisomies 21, 13, and 18, represent a significant issue in prenatal care. The advent of non-invasive prenatal testing (NIPT) through the detection of cell-free DNA (cf-DNA) in maternal blood has modified screening for chromosomal abnormalities. This study evaluates NIPT adherence among pregnant of different ethnicities, addressing potential disparities in prenatal care.</p><p><strong>Methods: </strong>This was a retrospective, single-center study conducted at a tertiary care university hospital in Italy between March 31, 2021, and September 30, 2022. Participants were categorized by ethnicity (Asian/Pacific islander, Black, Latina, White, Middle Eastern). Maternal demographic characteristics and prenatal test data were recorded. Comparative analyses were executed utilizing a One-Way Analysis of Variance (ANOVA) Test, augmented by Tukey's honestly significant difference test for post-hoc evaluation. Statistical significance was denoted by a P value (P)<0.05. A multivariate analysis through a multinomial regression model was conducted for the results to detect potential bias.</p><p><strong>Results: </strong>Six hundred seventeen pregnancies were included: 418 White, 105 Asian/Pacific islander, 46 Black, 40 Latina, and 8 Middle Eastern. Maternal age showed no significant variation. Black ethnicity had higher prepregnancy Body Mass Index (BMI; mean: 27.5 kg/m²±SD: 5.92, P=0.02), while Asian and White pregnancies had higher nulliparity rates (63.8% and 70.8%). Black ethnicity had no NIPT uptake (0.00%). Asian/Pacific islander and Latina pregnant had lower NIPT utilization (9.5% and 7.5%, P<0.001). White ethnicity had a higher NIPT rate (27.5%). In the NIPT group, 8.9% of White and 12.5% of Middle Eastern pregnancies chose cf-DNA without a prior first-trimester ultrasound test. Considering the first-trimester screening, 30.4% of Black pregnancies had nuchal translucency, while 17.4% combined it with beta-human chorionic gonadotrophin (β-hCG) and associated plasma protein-A (PAPP-A; P<0.001). White pregnancies had high adherence: 74.6% had nuchal translucency and 53.8% had a first-trimester combined test. Overall, 69.6% of Black pregnancies skipped both tests versus 16.5% in the White group (P<0.001).</p><p><strong>Conclusions: </strong>Significant disparities in prenatal care and NIPT adherence were observed among pregnant women of diverse ethnic backgrounds. Lower cf-DNA adhesion and limited adherence to first-trimester screening were observed among any ethnicities. These findings highlight the critical need for targeted interventions and policies to reduce barriers and facilitate access to prenatal care for all women.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"173-179"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492596","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":"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":"157-165"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","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":"Recipients' age, fresh embryo and blastocyst-stage embryo transfer as favorable factors in a transnational oocyte donation program.","authors":"Angelo A Marino, Aldo Volpes, Francesca Sammartano, Martina Modica, Piero Scaglione, Salvatore Gullo, Luis Quintero, Adolfo Allegra","doi":"10.23736/S2724-606X.24.05538-6","DOIUrl":"10.23736/S2724-606X.24.05538-6","url":null,"abstract":"<p><strong>Background: </strong>In Italy, egg donation is being allowed again following the ruling by the Constitutional Court N. 162/2014. Nevertheless, the number of voluntary donors is insignificant, probably because no reimbursement is provided. Therefore, the great majority of egg donation cycles are performed by using imported cryopreserved oocytes from foreign countries. However, recent evidence has questioned the overall efficacy of this strategy in comparison with the shipment of frozen sperm and vitrified embryos.</p><p><strong>Methods: </strong>Retrospective cohort study, conducted at ANDROS Day Surgery Clinic Palermo, Italy in the period 2016-2022, with the objective of evaluating the efficiency of each batch of vitrified oocytes, in terms of completed cycles. The cryopreserved donated oocytes came from a single Spanish clinic (Next Fertility, Valencia, Spain). The primary outcome was the cumulative live birth rate (CLBR). The secondary outcomes were the cumulative ongoing pregnancy rate (COPR), the cumulative clinical pregnancy rate (CCPR) and the miscarriage rate.</p><p><strong>Results: </strong>The CLBR totaled 35.1%, the COPR 36.8%, the CCPR 49.2% and the miscarriage rate 24.7%. In the multivariate analysis, the probability of success was significantly higher in younger recipients, in fresh embryo transfer and in blastocyst-stage embryo transfer.</p><p><strong>Conclusions: </strong>Our \"transnational\" donation program with vitrified oocytes has good success rates. The main focus of our analysis is the negative effect of advancing recipient age on success rates, outlining a possible, important role of age-related uterine factor on implantation mechanisms. This aspect should be emphasized during the counselling with couples much more than is routinely done.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"180-191"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604117","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":"Early gestational diabetes mellitus and the effect of metformin use on perinatal outcomes: a systematic review.","authors":"Gianna Wilkie, Allison Payne, Becky Baltich Nelson, Anna R Whelan","doi":"10.23736/S2724-606X.25.05591-5","DOIUrl":"10.23736/S2724-606X.25.05591-5","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to perform a systematic review to assess whether metformin therapy in patients diagnosed with gestational diabetes mellitus (GDM) in early pregnancy is associated with improved perinatal outcomes. We searched Ovid MEDLINE, Scopus, and Cochrane library (inclusive of ClinicalTrials.gov) from inception through November 29, 2023. We included all randomized trials that assessed metformin use in early GDM.</p><p><strong>Evidence acquisition: </strong>The 3665 results produced from the database searches were imported into Covidence, a systematic review screening tool, and duplicates were removed. The remaining 2731 citations were screened by title and abstract against predetermined inclusion and exclusion criteria by 2 independent reviewers with discrepancies resolved after group discussion. After screening was completed, 46 studies underwent full text review, with 1 study eligible for inclusion.</p><p><strong>Evidence synthesis: </strong>The included study showed no difference in a composite adverse perinatal outcome between those diagnosed with early GDM and treated with metformin (59.3%) vs. placebo (57.1%).</p><p><strong>Conclusions: </strong>There is a paucity of data regarding the management of early GDM and the lack of standardization in its definition for this condition.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"215-218"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674288","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":"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":"237-246"},"PeriodicalIF":1.6,"publicationDate":"2025-06-01","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":"The predictive role of uterocervical angle in labor outcomes: a narrative review.","authors":"Libera Troìa, Alessandro Libretti, Federica Savasta, Daniela Surico, Valentino Remorgida","doi":"10.23736/S2724-606X.24.05572-6","DOIUrl":"10.23736/S2724-606X.24.05572-6","url":null,"abstract":"<p><strong>Introduction: </strong>Uterocervical angle (UCA) is the angle between the anterior or posterior uterine wall and the cervical canal, and it has become an unique ultrasonographic marker in the recent years. The predictive role of the UCA in spontaneous preterm births (sPTB) has been examined by numerous authors, however few data are available on UCA as predictor of labor outcome at term of pregnancy. Therefore, the purpose of this review is to evaluate the effectiveness of transvaginal ultrasound measurement of UCA at term, and its clinical implications in obstetrics' practice.</p><p><strong>Evidence acquisition: </strong>A literature search was conducted including all studies regarding the predictive role of ultrasonographic evaluation of the UCA on labor outcomes from 1990 to 2023.</p><p><strong>Evidence synthesis: </strong>A narrative synthesis was subsequently performed dividing studies that considered posterior and anterior UCA. Five studies were included for the anterior UCA, and ten for the posterior UCA. UCA was then evaluated as predictor of prolonged latent phase and predictor of the onset and mode of delivery.</p><p><strong>Conclusions: </strong>It is likely that the combination of multiple cervical parameters, rather than UCA assessment alone, together with clinical information, can achieve higher levels of accuracy in predicting delivery outcomes. Future prospective studies are needed to define with greater certainty the role of UCA as a useful screening tool before laboring, but, until then, the use of UCA as a screening test to predict labor outcome should remain investigational.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"119-127"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522401","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":"Clinical factors predicting objective response to bevacizumab-based chemotherapies in advanced and recurrent epithelial ovarian cancer.","authors":"Nijat Khanmammadov, Izzet Dogan, Necla S Okay, Bayarmaa Khishigsuren, Abdulmunir Azizy, Pinar Saip, Khayal Gasimli, Adnan Aydiner","doi":"10.23736/S2724-606X.24.05540-4","DOIUrl":"10.23736/S2724-606X.24.05540-4","url":null,"abstract":"<p><strong>Background: </strong>Bevacizumab-based chemotherapies are commonly administered in the treatment of patients diagnosed with epithelial ovarian cancer (EOC). The primary aim of this study was to assess the factors that predict the objective response to bevacizumab-based therapies in cases of advanced and recurrent EOC.</p><p><strong>Methods: </strong>The retrospective data of 264 patients with EOC from the current study were collected between 2009 and 2022 at our clinic. Survival analyses were conducted utilizing the Kaplan-Meier method and the log-rank test. Binary logistic regression analysis was employed to assess the factors predicting the objective response.</p><p><strong>Results: </strong>A predominant subset of patients (83%) presented with serous adenocarcinoma, exhibiting a high-grade differentiation at 87%. The vast majority (80%) of the cohort experienced disease recurrence. Three-fourths of the cases received bevacizumab in combination with platinum-based doublet chemotherapy. In the multivariate analysis, clinical factors such as a disease recurrence (P=0.031), upfront tumor debulking surgery before bevacizumab (P=0.009), doublet chemotherapy (P=0.003), and the presence of malignant pleural effusion (P=0.024) emerged as significant determinants influencing the Objective Response Rate (ORR) in patients undergoing bevacizumab-based therapy. The ORR was 67.5% (N.=178), comprising 15.2% complete responses (N.=40) and 52.1% partial responses (N.=138). The median Progression-Free Survival (PFS) and Overall Survival (OS) were estimated at 10.2 months (95% CI, 8.60-11.9) and 20.1 months (95% CI, 16.0-24.2), respectively.</p><p><strong>Conclusions: </strong>The responses to bevacizumab-based chemotherapies could be predict by the presence of malignant pleural effusion, disease recurrence, upfront tumor debulking surgery and doublet regimen of chemotherapy.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"112-118"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248304","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":"A vaginal birth is a cost-reduction strategy for women with a low-lying placenta.","authors":"Elisabetta Colciago, Pietro Ferrara, Isadora Vaglio Tessitore, Lorenzo G Mantovani, Patrizia Vergani, Sara Ornaghi","doi":"10.23736/S2724-606X.24.05443-5","DOIUrl":"10.23736/S2724-606X.24.05443-5","url":null,"abstract":"<p><strong>Background: </strong>Alongside health consequences, cesarean delivery (CD) has been associated with increased healthcare resource utilization (HCRU). A CD should be performed in case of placenta previa; in turn, the most appropriate mode of birth in women with a low-lying placenta (LLP) is still controversial. Since no previous data are available on the topic, the aim of this study was to evaluate the HCRU and economic impact on the Italian HC system of vaginal birth (VB) and CD in women with a LLP.</p><p><strong>Methods: </strong>This retrospective study used patient-level real-world data of a cohort of women with a LLP confirmed at 28-30 weeks. A cost-minimization analysis (CMA) was conducted to compare VB and CD. Since Diagnosis-Related-Group payment may not reflect the actual use of hospital resources, a micro-costing analysis (MCA) was performed to more comprehensively evaluate the economic impact of VB and CD.</p><p><strong>Results: </strong>The study included 86 women with a LLP at the third trimester scan, of which 49 (57%) had a VB and 37 (43%) underwent a CD. The CMA showed an economically marginal difference between VB and CD, especially when considering opportunity costs associated with the resources needed to look after women. However, the MCA identified charges for each VB being about half of those for each CD.</p><p><strong>Conclusions: </strong>The use of patient-level real-world data allowed to generate basic information to assess the value of available interventions in case of LLP. A VB should be promoted in women with LLP, avoiding further burden on the HC system's limited resources.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"85-92"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293947","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}