European Journal of Obstetrics and Gynecology and Reproductive Biology: X最新文献

{"title":"Withdrawal notice to “Could blastocysts derived from abnormal fertilized zygotes be used? A systematic review and meta-analysis” [Eur J Obstet Gynecol Reprod Biol X 26C (2025) 100381]","authors":"Yiqing Wu , Jinglei Xue , Mixue Tu , Yifeng Liu , Dan Zhang","doi":"10.1016/j.eurox.2025.100396","DOIUrl":"10.1016/j.eurox.2025.100396","url":null,"abstract":"","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100396"},"PeriodicalIF":1.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169918","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":"Blood pressure in the second and third trimesters of pregnancy and adverse pregnancy outcomes in singleton pregnancies: A bidirectional cohort study","authors":"Liangkun Ma, Yini Li , Xuanjin Yang , Ye Li, Suhan Zhang, Mingyue Hu, Yin Sun","doi":"10.1016/j.eurox.2025.100400","DOIUrl":"10.1016/j.eurox.2025.100400","url":null,"abstract":"<div><h3>Background</h3><div>Although blood pressure in singleton pregnancies is related to multiple adverse pregnancy outcomes, the blood pressure threshold has been controversial.</div></div><div><h3>Objective</h3><div>To explore the blood pressure reference threshold of singleton pregnant women in the second and third trimesters.</div></div><div><h3>Study design</h3><div>A bidirectional single-centre cohort study was undertaken. Clinical data were collected for women with singleton pregnancies who underwent regular antenatal examinations and delivered at Peking Union Medical College Hospital between July 2020 and June 2023. Blood pressure was recorded at 20–24 and 28–32 weeks of gestation, and hypertension and pre-eclampsia were used as the primary outcomes. The percentiles of blood pressure were calculated, and the 95th percentile was used as the upper limit for the second and third trimesters of pregnancy. Poisson regression was used to calculated adjusted relative risk (aRR) and 95 % confidence intervals (CI) were used to analyse the relationship between elevated blood pressure and adverse pregnancy outcomes, and to further explore the impact of changes in blood pressure in the second and third trimesters on pregnancy outcomes. <em>p</em>-values < 0.05 were considered to indicate significance.</div></div><div><h3>Results</h3><div>In total, 7854 pregnant women with singleton pregnancies were included in this study. For pregnant women who did not experience adverse outcomes related to blood pressure, the 95th percentiles of systolic and diastolic blood pressure in the second trimester were 131 mmHg and 80 mmHg, respectively. Corresponding data for the third trimester were 130 mmHg and 80 mmHg, respectively. Therefore, 130/80 mmHg was taken as the upper limit of blood pressure. After excluding confounding factors, regardless of trimester, the risks of gestational hypertension, pre-eclampsia, preterm birth, low birth weight and neonatal intensive care unit (NICU) admission were found to be significantly higher in pregnant women with elevated blood pressure (<em>p</em> < 0.05). Pregnant women with sustained elevated blood pressure (i.e. in both the second and third trimesters) had aRR values for gestational hypertension, pre-eclampsia, premature birth, low birth weight and NICU admission that were 19.08 (95 % CI 13.04–28.03; <em>p</em> < 0.001), 11.43 (95 % CI 6.94–18.64; <em>p</em> < 0.001), 2.53 (95 % CI 1.83–3.42; <em>p</em> < 0.001), 2.98 (95 % CI 2.05–4.21; <em>p</em> < 0.001) and 1.79 (95 % CI 1.29–1.79; <em>p</em> < 0.001) times higher than those of normotensive pregnant women, respectively.</div></div><div><h3>Conclusion</h3><div>The blood pressure threshold of singleton pregnant women in the second and third trimesters is 130/80 mmHg. Sustained elevated blood pressure is harmful to the health of mothers and infants. Management and monitoring should be strengthened for pregnant women with elevated blood pressure.</di","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100400"},"PeriodicalIF":1.5,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169917","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":"Exposure to violence and risk of hypertensive disorders in pregnancy: Systematic review and meta-analysis","authors":"Prakasini Satapathy ,&nbsp;Abhay M. Gaidhane ,&nbsp;Nasir Vadia ,&nbsp;Soumya V. Menon ,&nbsp;Kattela Chennakesavulu ,&nbsp;Rajashree Panigrahi ,&nbsp;Ganesh Bushi ,&nbsp;Mahendra Singh ,&nbsp;Sanjit Sah ,&nbsp;Awakash Turkar ,&nbsp;S. Govinda Rao ,&nbsp;Khang Wen Goh ,&nbsp;Muhammed Shabil ,&nbsp;Edward Mawejje","doi":"10.1016/j.eurox.2025.100398","DOIUrl":"10.1016/j.eurox.2025.100398","url":null,"abstract":"<div><h3>Background</h3><div>Hypertensive disorders during pregnancy (HDP) are a significant global health concern, affecting 5–10 % of pregnancies and contributing to maternal and newborn morbidity and mortality. While various factors, including genetics and physiological changes, influence the development of HDP, emerging evidence suggests a strong association with psychosocial stressors, particularly exposure to violence. This meta-analysis aimed to assess the association between exposure to violence and risk of hypertensive disorders in pregnancy.</div></div><div><h3>Methods</h3><div>A literature review was performed across EMBASE, PubMed, and Web of Science from their inception until October 2024. The review included observational studies that examined exposure to various type of violence and their association with hypertensive disorders in pregnancy. Pooled effect estimates, including odds ratios (ORs) and relative risks (RRs) were computed using a random-effects model.</div></div><div><h3>Results</h3><div>Sixteen studies met the inclusion criteria. Meta-analysis revealed that violence exposure during pregnancy was associated with a significantly increased risk of HDP, with a pooled OR of 1.380 (95 % CI: 1.079–1.765) and a pooled RR of 1.235 (95 % CI: 1.074–1.420). Subgroup analysis indicated that cohort studies demonstrated a stronger association (OR: 1.726, 95 % CI: 1.182–2.519) compared to cross-sectional studies (OR: 1.112, 95 % CI: 1.009–1.226).</div></div><div><h3>Conclusion</h3><div>Experiencing violence during pregnancy is significantly linked to a heightened risk of HDP, indicating the need for regular violence screening and early preventive measures in prenatal care. Public health initiatives focused on reducing violence against women, especially during pregnancy, are crucial for improving maternal health and lowering the incidence of hypertensive complications.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100398"},"PeriodicalIF":1.5,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169916","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 diagnostic potential of elastosonography in cesarean scar pregnancy","authors":"Ömer Tammo ,&nbsp;Esra Söylemez ,&nbsp;Enes Çelik ,&nbsp;Süleyman Yıldız ,&nbsp;Emre Uysal ,&nbsp;Yurdagül Tolu Gökhaner ,&nbsp;Rahime Kada Düken","doi":"10.1016/j.eurox.2025.100399","DOIUrl":"10.1016/j.eurox.2025.100399","url":null,"abstract":"<div><h3>Background</h3><div>Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy where the embryo implants in the scar from a previous cesarean section. CSP is a high-risk condition that can cause serious complications, such as uterine rupture and life-threatening bleeding. This study investigated the accuracy and reliability of elastosonography in diagnosing CSP.</div></div><div><h3>Method</h3><div>A prospective cohort study was conducted at Mardin Training and Research Hospital (Turkey) between October 2023 and January 2024. The study included 61 patients with CSP and a separate control group of 61 patients, all between 6 and 12 weeks of gestation. Both groups were evaluated using elastosonography.</div></div><div><h3>Results</h3><div>Elastosonography parameters, including strain ratio, myometrial shear wave velocity, and scar hardness, were significant in diagnosing CSP. Age, BMI, parity, and number of previous cesarean sections did not significantly correlate with elastosonography findings. Beta-hCG and fetal heart rate were not significant diagnostic factor</div></div><div><h3>Conclusion</h3><div>Elastosonography shows promise as a diagnostic tool for CSP. Further research is needed to confirm its clinical utility.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100399"},"PeriodicalIF":1.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089857","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":"Risk factors of recurrent cervical intraepithelial neoplasm 2/3 after primary excisional conization/LEEP treatments: A follow-up nationwide cohort study","authors":"Hung Shen ,&nbsp;Mei-Hsuan Wu ,&nbsp;Jian-Jhih Lin ,&nbsp;Heng-Cheng Hsu ,&nbsp;Yi-Jou Tai ,&nbsp;Chia-Ying Wu ,&nbsp;Chia-Yi Lee ,&nbsp;Yen-Han Wang ,&nbsp;Ying-Cheng Chiang","doi":"10.1016/j.eurox.2025.100397","DOIUrl":"10.1016/j.eurox.2025.100397","url":null,"abstract":"<div><h3>Objective</h3><div>Follow-up human papillomavirus (HPV) testing 6 months after treatment is suggested for women with cervical intraepithelial neoplasm (CIN) 2/3. However, the Pap smear remains the only feasible tool in areas with limited resources. Our study aimed to evaluate the risk factors of recurrent CIN2/3 after excision treatment by follow-up Pap smear in a nationwide database.</div></div><div><h3>Methods</h3><div>We retrospectively identified women receiving excision treatment for CIN2/3 from 2007 to 2016 in the Taiwan National Cervical Cancer Screening Database. Risk factors of recurrence including age, education status, follow-up frequency, and the results of serial follow-up Pap smears were analyzed.</div></div><div><h3>Results</h3><div>In total, 11595 women were enrolled, 287 having recurrent CIN2 + diseases (cumulative incidence of recurrence of 24.8/1000 people). The incidence of recurrent CIN2 + lesions was highest in the over 60-year-old age group (12.12/1000 person-years). For the first follow-up Pap smear, the highest recurrence rate was in the AGC/HSIL+ group (106.6/1000 people). Multivariate Cox regression analysis revealed that over 60 years of age, AGC/HSIL+ in the first follow-up pap smear, and any abnormal pap smear result within the first year after treatment were risk factors of CIN2/3 recurrence.</div></div><div><h3>Conclusions</h3><div>In patients receiving excision for CIN2/3, the recurrence risk was higher in patients older than 60 years of age, and who had any abnormal follow-up Pap smear results, especially AGC/HSIL+ , in the first year after treatment.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100397"},"PeriodicalIF":1.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098321","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":"Immediate skin-to-skin contact after caesarean section – A simulation study","authors":"Leena Taittonen,&nbsp;Tanja Mäkynen,&nbsp;Tiina-Liisa Erkinheimo","doi":"10.1016/j.eurox.2025.100392","DOIUrl":"10.1016/j.eurox.2025.100392","url":null,"abstract":"<div><h3>Background</h3><div>Performing a caesarean section using a drape with a transparent window between the mother and the surgical area has not been studied previously.</div></div><div><h3>Aim</h3><div>To describe ways of passing a baby to the mother for skin-to-skin contact after caesarean section, and to analyse the time lapse between cutting the umbilical cord and placement of the baby on the mother.</div></div><div><h3>Methods</h3><div>Simulation characters were used as study subjects. Three methods of passing a baby to the mother for skin-to-skin contact after caesarean section were assessed. In the first method, an opaque drape was placed between the mother and the surgical area, so the mother could not see the baby being born. The surgeon passed the baby to the midwife, who placed the baby on the mother for skin-to-skin contact. In the second method, the mother was able to see the baby being born through a transparent drape. The baby was otherwise handled as in the first method. In the third method, a transparent drape with a window was placed between the mother and the surgical area, so the mother could see the baby being born. The baby was passed through the window in the drape and placed on the mother for skin-to-skin contact. The time lapse between cutting the umbilical cut and skin-to-skin contact was analysed for the three methods.</div></div><div><h3>Results</h3><div>For the first and second methods, the time between cutting the umbilical cord and skin-to-skin contact ranged from 11 to 15.5 s. For the third method, the time was 20–29 s. A minor technical difficulty was noted for the third method.</div></div><div><h3>Conclusion</h3><div>Passing a baby to the mother through a transparent drape with a window after caesarean section is not superior in terms of time, but may improve bonding between the mother and baby.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100392"},"PeriodicalIF":1.5,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089858","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":"Splenectomy during cytoreductive surgery in advanced epithelial ovarian cancer can be predicted","authors":"Thien-Kim Do ,&nbsp;Yohann Dabi ,&nbsp;Cyril Touboul ,&nbsp;Jennifer Uzan ,&nbsp;François Margueuritte ,&nbsp;Geoffroy Canlorbe ,&nbsp;Yohan Kerbage ,&nbsp;Vincent Lavoué ,&nbsp;Chérif Akladios ,&nbsp;Lobna Ouldamer ,&nbsp;Hélène Costaz ,&nbsp;Alexandre Bricou ,&nbsp;Henri Azaïs ,&nbsp;Pauline Chauvet ,&nbsp;Xavier Carcopino ,&nbsp;Cyrille Huchon ,&nbsp;Camille Mimoun","doi":"10.1016/j.eurox.2025.100395","DOIUrl":"10.1016/j.eurox.2025.100395","url":null,"abstract":"<div><h3>Introduction</h3><div>Splenectomy may be necessary for complete cytoreductive surgery (CRS) in advanced stage epithelial ovarian cancer (AS-EOC), potentially raising perioperative morbidity and necessitating specific patient management.</div></div><div><h3>Objective</h3><div>This study aimed to develop a predictive score of splenectomy in CRS of AS-EOC.</div></div><div><h3>Materials and methods</h3><div>Data from histologically confirmed AS-EOC (FIGO IIB-IV) before CRS and diagnosed between 01/01/2000 and 01/06/2017, were extracted from the FRANCOGYN multicentric database (14 French hospitals). After identifying predictive factors of splenectomy, we performed a logistic regression to develop a prediction model and construct a risk score, allowing identification of a high-risk group. Model discrimination was assessed using a Receiver Operating Characteristic (ROC) curve. Decision Curve Analysis (DCA) was then conducted to evaluate the model’s net clinical benefit across a range of threshold probabilities.</div></div><div><h3>Results</h3><div>Among 1288 patients included, 7 % (n = 91) underwent splenectomy. Four independent variables statistically associated with splenectomy were identified: age &lt; 60 years (aDOR = 1.76, 95 % CI [1.13–2.75], p = 0.015), omental cake (aDOR = 2.12, 95 % CI [1.11–4.08], p = 0.024), diaphragmatic carcinosis (aDOR = 2.36, 95 % CI [1.34–4.18], p = 0.001), and digestive involvement at initial CT and/or laparoscopy (aDOR = 3.24, 95 % CI [1.93–5.43], p &lt; 0.001). The ROC-AUC of this prediction model was 0.76. Patients meeting all 4 criteria with a maximum of 10 points defined the high-risk group and had a splenectomy probability of 32 % (95 % CI [22.00–44.31]), with a specificity of 95.8 % (95 % CI [94.5–96.9]) and a positive likelihood ratio of 6.31 (95 % CI [4.08–9.78]). The DCA showed a positive net clinical benefit of the model between 15 % and 40 % threshold probabilities.</div></div><div><h3>Conclusion</h3><div>Using a simple 4 – variable predictive score, patients at high risk of splenectomy during CRS in AS-EOC could be identified to improve patients’ preoperative information and perioperative management.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100395"},"PeriodicalIF":1.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948949","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":"Predictors of delivery at 48 hours or more in pregnant women with preterm prelabor rupture of membrane: A retrospective cohort study","authors":"Chatuporn Duangkum ,&nbsp;Suphawan Pattamathamakul ,&nbsp;Sukanya Chaiyarach ,&nbsp;Piyamas Saksiriwuttho ,&nbsp;Jen Sothornwit ,&nbsp;Pongsatorn Paopongsawan ,&nbsp;Kittisak Sawanyawisuth ,&nbsp;Sathida Chantanaviliai ,&nbsp;Manasicha Pongsamakthai","doi":"10.1016/j.eurox.2025.100393","DOIUrl":"10.1016/j.eurox.2025.100393","url":null,"abstract":"<div><h3>Objective</h3><div>Expectant management is an option for preterm prelabor rupture of the membrane (PPROM) between 34 0/7 and 36 6/7 weeks of gestation. Even though expectant delivery in PPROM is justified, there is limited data on predictors of PPROM delivered <u>&gt;</u> 48 hrs in a real-world setting. Therefore, this study aimed to find clinical predictors for delivery <u>&gt;</u> 48 hrs in women with PPROM as well as clinical outcomes in clinical practice.</div></div><div><h3>Materials and methods</h3><div>This was a retrospective cohort study conducted at two tertiary care hospitals. The inclusion criteria were a singleton pregnancy with PPROM and planned expectant management. Clinical data were retrieved from the hospitals’ databases. Eligible pregnant women were categorized into two groups: PPROM delivered &lt; 48 hrs or PPROM delivered <u>&gt;</u> 48 hrs. The primary outcome was factors predictive of PPROM delivered <u>&gt;</u> 48 hrs.</div></div><div><h3>Results</h3><div>During the study period, 519 pregnant women met the study criteria. Of those, 90 pregnant women (17.34 %) had PPROM delivered <u>&gt;</u> 48 hrs. Factors independently associated with PPROM delivered <u>&gt;</u> 48 hrs were maternal age ≥ 19 years (adjusted odds ratio [aOR] 0.95, 95 % CI [0.91, 0.99]) and oligohydramnios (aOR 2.41, 95 % CI [1.45, 4.00]). Regarding maternal and neonatal outcomes, the PPROM delivered <u>&gt;</u> 48 hrs group had lower neonatal birth weights (2245 g vs. 2490 g; p &lt; 0.001) than the PPROM delivered &lt; 48 hrs group. However, neonatal outcomes, including respiratory distress, sepsis, neonatal intensive care unit admission, early jaundice, hypoglycemia, positive pressure ventilation, and early respiratory support, were not different.</div></div><div><h3>Conclusions</h3><div>Clinical predictors for PPROM delivered <u>&gt;</u> 48 hrs in a real-world setting were maternal age and presence of oligohydramnios. Maternal and neonatal outcomes in the PPROM delivered <u>&gt;</u> 48 hrs were almost comparable with the PPROM delivered &lt; 48 hrs. PPROM delivered <u>&gt;</u> 48 hrs may be safe and can be a treatment option for PPROM. However, further studies may be required in terms of generalizability as this study was conducted retrospectively in tertiary care hospitals in Thailand.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100393"},"PeriodicalIF":1.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906363","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":"Escalating caesarean deliveries and the impact on subsequent preterm birth","authors":"Laura van der Krogt,&nbsp;Agnieszka Glazewska-Hallin,&nbsp;Natalie Suff,&nbsp;Lisa Story,&nbsp;Andrew Shennan","doi":"10.1016/j.eurox.2025.100391","DOIUrl":"10.1016/j.eurox.2025.100391","url":null,"abstract":"<div><div>The rate of caesarean section, including those performed in-labour, is on the rise. Worldwide 1 in 5 women are delivering by caesarean section. Emerging evidence has demonstrated an association between in-labour caesarean section and mid-trimester loss (delivery between 14 and 24 weeks gestation) as well as spontaneous preterm birth, (delivery before 37 weeks’ gestation). This problem is more likely to recur in subsequent pregnancies and is difficult to treat with evidence suggesting that transvaginal cerclage may be a less efficacious preventative measure in women with a short cervix and previous in-labour caesarean section. This review explores the scope of the issue including the evidence for in-labour caesarean section as a risk factor for preterm birth and the possible underlying mechanism. It will discuss management strategies, as well as highlighting areas where further research is required.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100391"},"PeriodicalIF":1.5,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891119","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":"Association between different types and characteristics of fetal deceleration during labour and neonatal acidemia at delivery: A case-control study","authors":"Maria Fogelberg ,&nbsp;Charlotte Dahlbäck ,&nbsp;Frida Ekengård ,&nbsp;Gisela Rickle ,&nbsp;Andreas Herbst","doi":"10.1016/j.eurox.2025.100389","DOIUrl":"10.1016/j.eurox.2025.100389","url":null,"abstract":"<div><h3>Objective</h3><div>Classification of fetal heart rate (FHR) decelerations as suspicious or pathological differs between current interpretation templates for intrapartum cardiotocography. Decelerations are the most frequent FHR pattern irregularities during labour. The aim of this study was to assess the association between different types and characteristics of decelerations and acidemia at birth.</div></div><div><h3>Methods</h3><div>This case-control study includes 365 cases with cord pH &lt; 7.10 after 1st stage cesarean delivery or pH &lt; 7.05 after vaginal delivery at &gt; 34 + 0 weeks after induced or spontaneous labour, and 730 controls with pH ≥ 7.15. Cardiotocographic recordings from 60 min before birth were scrutinized and decelerations evaluated in detail. Odds ratios (OR) with 95 % confidence intervals for acidemia at birth were determined.</div></div><div><h3>Results</h3><div>The following types of decelerations were associated with acidemia: Late decelerations; OR 9.0 (6.1–13) if &gt; 5, and OR 19 (9.7–37) if repetitive &gt; 20 min, combined decelerations; OR 4.2 (2.7–6.4) if &gt; 5 and OR 6.4 (3.1–13) if repetitive &gt; 20 min, one prolonged deceleration &gt; 5 min; OR 12 (7.9–19), three prolonged decelerations for 3–5 min; OR 10 (4.3–25), and &gt; 5 variable decelerations &gt; 60 s; OR 2.2 (1.6–2.9). For variable decelerations &gt; 60 s, absent variability within decelerations was the only additional characteristic significantly associated with acidemia; OR 5.8 (2.1–16). A strong association with acidemia was noted for a FHR below the baseline ≥ 50 % of the time &gt; 30 min; OR 14 (10−19).</div></div><div><h3>Conclusion</h3><div>Late and prolonged decelerations are strongly, and combined decelerations moderately associated with acidemia. The risk of acidemia is highly increased if FHR is below baseline ≥ 50 % of the time.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100389"},"PeriodicalIF":1.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886598","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}