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

{"title":"A new uterine endometrium preservation hysteroscopic myomectomy: Introduction of improved procedures and a retrospective analysis of 94 cases","authors":"Wataru Isono ,&nbsp;Masanori Maruyama","doi":"10.1016/j.eurox.2024.100354","DOIUrl":"10.1016/j.eurox.2024.100354","url":null,"abstract":"<div><h3>Objective</h3><div>To reduce the damage of uterine endometrium caused during hysteroscopic myomectomy (HM) for reproductive aged patients, a new uterine endometrium preservation hysteroscopic myomectomy (UEP-HM) has been developed. In this study, we introduced this technique with comparing to the conventional hysteroscopic myomectomy (C-HM).</div></div><div><h3>Study Design</h3><div>The data from 94 patients aged 42 or younger who underwent HM (38 cases with UEP-HM and 56 cases with C-HM) for treating single Type 1 or Type 2 submucosal leiomyoma (SL) were analysed retrospectively for comparing the characteristics of both patient and target SL. In this process, we defined the operation time 60 min or over as the longtime operation (LTO) and the SM sized 3 cm or over as the large submucosal leiomyoma (LSL) for detecting the influential factors, including this procedure, on the difficulty of HM. For assisting the prediction of operation time (OT), we investigated the relationship between the OT and the cube of average diameter (AD) of target SL referring with some past reports.</div></div><div><h3>Results</h3><div>Although when comparing UEP and control groups, parity, AD, the number of patients with Type 2 SL, OT, and the number of infertile patients showed significant difference, in the multivariate analysis only LSL showed the significant influence on the possibility of LTO. Next, we compared OT/Cube of AD, which calculated by dividing OT by the cube of AD for evaluating OT from the target SL size and confirmed that there was no difference in those 2 groups (3.7 ± 3.0 (95 %CI: 0.9 - 13.3, n = 38) vs. 3.9 ± 3.2 (95 %CI: 0.4 - 17.3, n = 56), p = 0.79).</div></div><div><h3>Conclusions</h3><div>The new UEP-HM can become an alternative method of C-HM without procedure-specific difficulty. In the future, to investigate the prognosis of this procedure, more patients and further analyses should be accumulated.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"24 ","pages":"Article 100354"},"PeriodicalIF":1.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preterm birth recurrence after spontaneous preterm birth between 16-28 weeks: A national cohort study","authors":"Annabelle L. Van Gils ,&nbsp;Anita C. Ravelli ,&nbsp;Esmé I. Kamphuis ,&nbsp;Brenda M. Kazemier ,&nbsp;Eva Pajkrt ,&nbsp;Martijn A. Oudijk ,&nbsp;Marjon A. De Boer","doi":"10.1016/j.eurox.2024.100356","DOIUrl":"10.1016/j.eurox.2024.100356","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the risk of recurrent preterm birth following spontaneous extreme preterm birth between 16⁺⁰ - 27⁺⁶ weeks.</div></div><div><h3>Methods</h3><div>A nationwide retrospective cohort study was conducted with data from the Perinatal Registry of the Netherlands. We included nulliparous women with a singleton pregnancy that ended in spontaneous preterm birth between 16⁺⁰ and 27⁺⁶ weeks of gestation without congenital anomalies or antenatal death between 2010–2014 and had a subsequent pregnancy in the 5 years following (2010–2019). The primary outcome of this study was recurrent preterm birth &lt; 37 weeks.</div></div><div><h3>Results</h3><div>In total, 1011 women with linked pregnancies were included. The risk of preterm birth &lt; 37 weeks with prior spontaneous birth between 16⁺⁰-19⁺⁶, 20⁺⁰-23⁺⁶, and 24⁺⁰-27⁺⁶ weeks was respectively 19.0 %, 29.5 % and 27.6 %. The risk of subsequent preterm birth &lt; 24 weeks was 5.8 %, 7.2 % and 4.3 %. A short interpregnancy interval of 0–3 months was associated with increased odds for recurrent preterm birth &lt; 32 weeks (OR 2.3 95 % CI 1.4–3.7) and preterm birth &lt; 37 weeks (OR 1.8 95 % CI 1.2–2.6).</div></div><div><h3>Conclusion</h3><div>Patients with previous spontaneous preterm birth from 16 weeks GA onwards are at high risk for recurrent preterm birth and should be regarded as such in the consideration of preventive measures to prevent recurrent adverse pregnancy outcomes.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"24 ","pages":"Article 100356"},"PeriodicalIF":1.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysing the gene expression profiles of the orphan nuclear receptors NR4A1, NR4A2 and NR4A3 in premalignant lesions of the cervix and cervicitis","authors":"Rosa P. Cruz-Nieves ,&nbsp;Gladys E. Ramírez-Rosales ,&nbsp;Javier González-Ramírez ,&nbsp;Fausto Sánchez-Muñoz ,&nbsp;Armando Ruiz-Hernández","doi":"10.1016/j.eurox.2024.100355","DOIUrl":"10.1016/j.eurox.2024.100355","url":null,"abstract":"<div><h3>Objective</h3><div>The main objective of the present study was to evaluate the expression of nuclear orphan receptors in the development of Uterine Cervical Cancer (UCC). The principal cause of dysplastic changes in cervical epithelium is the presence of the human papilloma virus leading to the development of cervical intraepithelial neoplasia I (CIN I), high-grade lesions (CIN II and CIN III) and, finally, invasive cancer. Despite the existence of various treatments and vaccines, there is still a high mortality rate. There is evidence of the participation of a group of nuclear receptors called orphans in the development of various diseases, including cancer.</div></div><div><h3>Study design</h3><div>The expression levels of the orphan receptors NR4A1, NR4A2, and NR4A3 were measured using real-time polymerase chain reaction (RT-PCR) in samples obtained through colposcopy from forty-five patients who attended the Medical Oncology Specialties Unit (UNEME) in Mexicali, B.C.</div></div><div><h3>Results</h3><div>Forty-five cervical biopsy results were obtained, indicating cervicitis, CIN I, or CIN III, none of them CIN II. Our results showed that orphan receptors expressed in a specific manner depending on the degree of premalignant lesions. NR4A1 overexpressed in cervicitis (p &lt; 0.05). NR4A3 was significantly expressed in CIN I (p &lt; 0.05) and NR4A2 was expressed in both cervicitis and CIN III (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Our data suggest, for the first time, that nuclear receptors might be involved in the various stages that precede the development of invasive UCC.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"24 ","pages":"Article 100355"},"PeriodicalIF":1.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the evidence? Updates in the use of antenatal corticosteroids for patients at risk of preterm birth","authors":"Moti Gulersen ,&nbsp;Cynthia Gyamfi-Bannerman","doi":"10.1016/j.eurox.2024.100352","DOIUrl":"10.1016/j.eurox.2024.100352","url":null,"abstract":"<div><div>Antenatal corticosteroids have long been considered one of the most important antenatal therapies available for pregnant patients at risk of preterm birth based on the associated reduction of neonatal morbidity and mortality following their administration. However, despite decades of research since their incorporation into routine clinical practice, a number of key questions related to antenatal corticosteroid use remain. These include evaluating the impact of antenatal corticosteroids at gestational ages outside of the previously recommended window of 24 0/7–33 6/7 weeks of gestation, determining factors associated with optimal steroid timing in order to reduce unnecessary exposure, alterations in its dosing regimen, and their long-term impact. The purpose of this document is to review the latest evidence on antenatal corticosteroids and recent developments in emerging topics related to their use.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"24 ","pages":"Article 100352"},"PeriodicalIF":1.5,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of threatened miscarriage in Malta","authors":"Lara Sammut ,&nbsp;Paul Bezzina ,&nbsp;Vivien Gibbs ,&nbsp;Yves Muscat Baron ,&nbsp;Jean Calleja Agius","doi":"10.1016/j.eurox.2024.100353","DOIUrl":"10.1016/j.eurox.2024.100353","url":null,"abstract":"<div><div>A retrospective cohort study was conducted in Malta to assess the prevalence of threatened miscarriage. The study focuses on cases managed at a local state hospital over a 12-month period. Currently, data on pregnancies prior to 22 weeks’ gestation are not publicly available, which hampers understanding of the frequency and impact of threatened miscarriage. This research provides the basis for a potential prospective study which analysis the epidemiology and outcomes of threatened miscarriage and advocates for early intervention and appropriate patient counselling. The study included females who visited the Accident and Emergency Department in a local state hospital in 2019 with first trimester vaginal bleeding. It excluded patients with incomplete medical records. Data from various hospital departments were collected, anonymised and analysed to track outcomes such as miscarriage, ongoing pregnancy, ectopic or molar pregnancy. The research aimed to create a comprehensive local registry of pregnancy outcomes following threatened miscarriage, reflecting the national situation. In 2019, 711 pregnant women in Malta experienced first-trimester vaginal bleeding. Of these, 241 had successful births beyond 22 weeks’ gestation, while 412 experienced miscarriages, with other outcomes including ectopic and molar pregnancies and 58 women had an unknown pregnancy outcome. A significant association was found between maternal age and risk of miscarriage, particularly higher for women aged 35–46 and those under 19. Birthweight data revealed that threatened miscarriage complications likely led to low birthweights in a significant proportion of newborns. This study analysed pregnancy outcomes which were preceded by first trimester vaginal bleeding in pregnant women in Malta. Establishing a local register of pregnancy outcomes following first trimester vaginal bleeding provides clinicians with enhanced insights into the current local context. This resource may improve patient counselling and informed policy decisions and lay the groundwork for future research in the field.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"24 ","pages":"Article 100353"},"PeriodicalIF":1.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal intracranial hemorrhage and infarct: Main sonographic and MRI characteristics: A review article","authors":"Behnaz Moradi ,&nbsp;Reihaneh Mortazavi Ardestani ,&nbsp;Mahboobeh Shirazi ,&nbsp;Laleh Eslamian ,&nbsp;Mohammad Ali Kazemi","doi":"10.1016/j.eurox.2024.100351","DOIUrl":"10.1016/j.eurox.2024.100351","url":null,"abstract":"<div><div>Early detection of fetal intracranial hemorrhage and infarct during pregnancy is crucial for preventing lethal and debilitating complications in neonatal life. Every radiologist must be aware of the imaging features of these conditions to refer patients to specialists. Sonographic and MRI features of fetal intracranial hemorrhage and infarct have been discussed in many previous articles. The aim of this article is to organize and categorize these findings into a practical guideline for improved application in diagnosing these diseases. The use of MRI sequences, such as DWI and multiplanar EPI should be developed for suspected prenatal infarct and intracranial hemorrhage and can serve as additional tools for early detection. In this review article, we first explain possible etiologic factors contributing to the development of fetal IVH and infarct. Then we discuss the different imaging features of these disorders on sonography and MRI separately, as well as their differential diagnosis. Finally, the mortality and morbidity associated with these two concerning fetal abnormalities will be addressed.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"24 ","pages":"Article 100351"},"PeriodicalIF":1.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142651377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pentaerithrityl tetranitrate (PETN) for prevention of fetal growth restriction in pregnancy: A systematic review and meta-analysis","authors":"Ayush Heda ,&nbsp;Akanksha Deshwali ,&nbsp;Sakshi Heda ,&nbsp;Mayank Priyadarshi","doi":"10.1016/j.eurox.2024.100350","DOIUrl":"10.1016/j.eurox.2024.100350","url":null,"abstract":"<div><h3>Background</h3><div>Fetal Growth Restriction (FGR), often due to placental insufficiency, poses significant risks to perinatal outcomes. This review evaluates the efficacy of pentaerythritol tetranitrate (PETN), a nitric oxide donor, in preventing FGR.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis was conducted by searching PubMed, Embase, and CENTRAL up to July 2024. The inclusion criteria focused on randomized controlled trials comparing PETN to placebo in FGR prevention. Key outcomes were incidences of FGR, perinatal mortality, neonatal mortality, and intrauterine fetal demise (IUFD). Other outcomes were classified as maternal, fetal, neonatal and safety outcomes. We used Cochrane RoB 2.0 tool to assess risk of bias, and GRADE criteria for evidence quality.</div></div><div><h3>Results</h3><div>Two eligible studies encompassing 417 pregnant women at risk of FGR were included. PETN did not significantly reduce incidence of FGR (RR 0.83, 95 % CI 0.66–1.04, 2 trials, 417 participants, low certainty) or perinatal mortality (RR 0.64, 95 % CI 0.26–1.58, 2 trials, 417 participants, very low certainty) compared to placebo. None of the studies reported neonatal mortality or IUFD. However, PETN treatment was associated with a reduction in preterm birth (RR 0.74, 95 % CI 0.58–0.93, 2 trials, 417 participants, moderate certainty). Other outcomes were similar between the groups.</div></div><div><h3>Conclusion</h3><div>While PETN does not significantly impact FGR rates or perinatal mortality, it is associated with a reduction in preterm birth, suggesting potential benefits in high-risk pregnancies. Larger trials are necessary to substantiate these findings and clarify the role of PETN in FGR prevention.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"24 ","pages":"Article 100350"},"PeriodicalIF":1.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent pain after laparoscopic surgery for ovarian endometrioma: Clinical features and long-term follow up","authors":"Yushi Wu,&nbsp;Yi Dai,&nbsp;Jinghua Shi,&nbsp;Shiqing Lyu,&nbsp;Zhiyue Gu,&nbsp;Chenyu Zhang,&nbsp;Hailan Yan,&nbsp;Jinhua Leng,&nbsp;Xiaoyan Li","doi":"10.1016/j.eurox.2024.100349","DOIUrl":"10.1016/j.eurox.2024.100349","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to examine the clinical characteristics of patients with ovarian endometriosis (OMA) who were diagnosed with recurrent pain after laparoscopic surgery in an 8- to 12- year postoperative follow-up.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data of 45 OMA patients with recurrent pain, including a minimum 8 years of post-laparoscopic follow-up reports. All laparoscopic cystectomy procedures were performed by the same surgeon at Peking Union Medical College Hospital between January 2009 and April 2013. Clinical data were retrieved to analyze patients' preoperative characteristics, relevant surgical findings, and postoperative outcomes at follow-up.</div></div><div><h3>Results</h3><div>A total of 45 patients with OMA were included, with a mean age of 31.8 ± 4.92 years. The mean recurrence period was 45.78 ± 24.89 months. Before surgery, 60 % (27/45) of patients had severe dysmenorrhea. During surgery, 93.3 % (42/45) of patients were in stage III/IV, 51.1 % (23/45) had coexisting adenomyosis, and 66.7 % (30/45) had deep infiltrating endometriosis (DIE). For the whole study group, mean follow-up time was 121.96 ± 15.55 months. All patients underwent postoperative medical treatment. The mean recurrence period was 45.78 ± 24.89 months. Cyst recurrence was presented in 24.4 % (11/45) of patients, while 75.6 % (34/45) only complained of pain recurrence. At the end of follow-up, spontaneous pregnancy was seen in 24.4 % (11/45) of patients and 6.7 % (3/45) received in vitro fertilization and embryo transfer (IVF-ET).</div></div><div><h3>Conclusions</h3><div>Patients with symptomatic recurrence after surgery had more severe dysmenorrhea, larger proportion of coexisting adenomyosis and DIE, and a higher revised American Fertility Society (rAFS) stage. Recurrence of endometrial cysts was not related to pain recurrence. Long-term postoperative pharmacological therapy is recommended to reduce recurrence.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"24 ","pages":"Article 100349"},"PeriodicalIF":1.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical cerclage vs cervical pessary in women with cervical insufficiency: A multicentric, open-label, randomised, controlled pilot trial [the CEPEIC trial]","authors":"Andrea Gascón ,&nbsp;Nerea Maiz ,&nbsp;Maia Brik ,&nbsp;Manel Mendoza ,&nbsp;Ester del Barco ,&nbsp;Elena Carreras ,&nbsp;Maria Goya","doi":"10.1016/j.eurox.2024.100347","DOIUrl":"10.1016/j.eurox.2024.100347","url":null,"abstract":"<div><h3>Objective</h3><div>Cervical insufficiency accounts for 8 % of preterm births. Pessary and cerclage are considered preventive approaches for preterm birth. These interventions were compared in terms of reducing the prematurity rate in women with previous preterm birth, due to cervical insufficiency or due to having a short cervix in their current pregnancy.</div></div><div><h3>Methods</h3><div>This was a prospective, multicentric, open-label, randomised, pilot, controlled trial. Participants were women with singleton pregnancies who had previous preterm birth caused by cervical insufficiency or previous preterm birth and a short cervix [≤ 25 mm] in their current pregnancy. Women were randomised [1:1] to either cerclage or pessary. The primary outcome was to assess the feasibility of a trial on cervical pessary vs. cerclage to prevent preterm birth before 34 weeks in women with cervical insufficiency. As a secondary outcome, we studied the morbidity rate of the pessary versus the cerclage in women with cervical insufficiency and assessed the financial impact of using both devices in these women. The sample size was calculated based on the estimated population that we could potentially recruit: 60 women, 30 for each group, to ascertain whether the rate of preterm birth &lt; 34 weeks of gestation may be reduced from 34 % to at least 27 % in the pessary group, as in the results obtained with the cerclage.</div></div><div><h3>Results</h3><div>No significant differences in preterm birth &lt; 34 weeks of gestation were observed in our study, although it was underpowered to detect these differences [the relative risk [RR] of PB &lt; 34 weeks of gestation was 0.8 [95 % CI: 0.31–2.09, p = 0.888]. The rates of obstetric and perinatal complications were similar for both devices [15 cases in both groups, 50 % of cases [RR; 0.6–1.68; p = 1]. Cervical pessary had fewer secondary effects than the cerclage [less bleeding at insertion in the pessary group compared with cerclage, 1 case vs 14 cases, p &lt; 0.001; less pain at removal in the pessary group compared with cerclage, 14 vs 22 cases. p = 0.042 and less bleeding, 2 cases vs. 10 cases, p = 0.027].</div></div><div><h3>Conclusions</h3><div>Pessary does not seem less effective than cerclage, although these findings need to be confirmed in a larger randomised controlled trial. Pessary had fewer secondary effects than cerclage both at insertion and removal.</div></div><div><h3>Sinopsis</h3><div>Cervical pessary does not seem to be less effective than cerclage. Cervical pessary had fewer secondary effects than cerclage.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"24 ","pages":"Article 100347"},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association and diagnostic value between Maternal Serum Placental Markers and Placenta Previa","authors":"Panpan Ma ,&nbsp;Tingting Hu ,&nbsp;Yiming Chen","doi":"10.1016/j.eurox.2024.100346","DOIUrl":"10.1016/j.eurox.2024.100346","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate the correlation and diagnostic value of maternal serum placental markers: pregnancy-associated plasma protein-A (PAPP-A), free beta human chorionic gonadotropin (free β-hCG), and alpha fetoprotein (AFP) in relation to placenta previa.</div></div><div><h3>Methods</h3><div>A retrospective case-control study was conducted to gather data on 137 pregnant women who were hospitalized for delivery at Hangzhou Women’s Hospital. These women participated in the late stage of early and mid-term maternal serum prenatal screening between January 2018 and December 2020. Of the 137 women, 45 were diagnosed with placenta previa, while 92 were selected at random as the control group, in a ratio of 1: 2. Independent samples t-test or Mann-Whitney U test were utilized to compare the quantitative data of the two groups, and the Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of maternal serum placental marker levels for placenta previa.</div></div><div><h3>Results</h3><div>The levels of first trimester and second trimester free beta subunit of human chorionic gonadotropin (FT-Free β-hCG; ST-Free β-hCG) in the placenta previa group were higher than those in the normal group [1.38 (0.55–6.03) MoM vs.1.08 (0.32–4.00) MoM, 1.38 (0.39–4.10) MoM vs.1.01 (0.29–4.12) MoM], and the differences between the groups were statistically significant (<em>Z</em> = 2.830, <em>Z</em> = 2.846, both <em>P</em> &lt; 0.05). The AFP level was higher than the normal group [1.13 (0.65–2.15) MoM vs. 0.94 (0.51–2.02) MoM], and the difference was statistically significant (<em>Z</em> = 2.551, <em>P</em> &lt; 0.05). There was no significant difference in PAPP-A between the placenta previa group and the normal group (<em>Z</em> = 1.396, <em>P</em> &gt; 0.05). The ROC curve analysis results showed that the AUCs of FT-Free β-hCG and ST-Free β-hCG for placenta previa were 0.649 (95 % CI: 0.551–0.747, <em>P</em> = 0.005), 0.634 (95 % CI: 0.539–0.730, <em>P</em> = 0.011), and 0.650 (95 % CI: 0.554–0.746, P = 0.004). Using PPV, NPV, FPR, FNR, +LR, and -LR as evaluation indicators for the 5 models, the results showed that FT-Free β-hCG was the best performer in terms of PPV, FPR, and +LR, with values of 0.725, 0.600, and 2.632, respectively. The three-indicator combined detection model (AFP + ST-Free β-hCG + FT-Free β-hCG) had the best performance in terms of NPV and -LR, with values of 0.770 and 0.298, respectively.</div></div><div><h3>Conclusion</h3><div>The elevated maternal serum levels of Free β-hCG and AFP may be associated with placenta previa. The combined detection of maternal serum markers in the early and mid-trimesters has better diagnostic value for predicting placenta previa than individual detection.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"24 ","pages":"Article 100346"},"PeriodicalIF":1.5,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}