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

{"title":"Stress-induced developmental plasticity and spontaneous preterm birth: A justice-oriented eco-evo-devo review","authors":"Gabriella Mayne ,&nbsp;Luwam Ghidei ,&nbsp;Ayisha Buckley ,&nbsp;Wei Perng ,&nbsp;K. Joseph Hurt ,&nbsp;David P. Tracer","doi":"10.1016/j.eurox.2025.100409","DOIUrl":"10.1016/j.eurox.2025.100409","url":null,"abstract":"<div><div>Spontaneous preterm birth (&lt;37 weeks’ gestation) is a leading cause of neonatal morbidity and mortality, with little global progress in prevention. Spontaneous preterm birth disproportionately affects communities marginalized by racism and socio-economic disadvantage. Maternal stress is a well-established risk factor for spontaneous preterm birth and is more prevalent in marginalized communities. Yet, maternal stress remains underutilized as a target for clinical intervention. In this review, we draw from ecological, evolutionary, and developmental (eco-evo-devo) biology, Black feminist theory, and reproductive justice to center the margins of those communities most burdened by both maternal stress and preterm birth. In doing so, we re-frame the importance of maternal stress mitigation in spontaneous preterm prevention. Through the lens of stress-induced developmental plasticity, environmental stressors may shorten gestation through evolutionarily conserved maternal-fetal-placental signaling pathways. Two features of this process are particularly relevant to clinical care: first, stress may impact gestational length in a dose-dependent manner; second, its effects may be reversible. Reducing maternal stress may be a highly feasible clinical opportunity to tangibly reduce spontaneous preterm birth and increase birth equity.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"27 ","pages":"Article 100409"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261910","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 effectiveness of an integrated continuous team midwifery care model on the quality of antenatal care in Iran’s health system: A randomized controlled trial","authors":"Farzaneh Nasiri ,&nbsp;Azam bagheri ,&nbsp;Maryam Dastoorpour ,&nbsp;Shahla Khosravi ,&nbsp;Zahra Abbaspoor","doi":"10.1016/j.eurox.2025.100420","DOIUrl":"10.1016/j.eurox.2025.100420","url":null,"abstract":"<div><h3>Background and aims</h3><div>In maternity care, high quality prenatal care is essential for both women and babies. Continuity and coordination of midwifery care are very crucial in improving the quality of care. The present study investigated the effectiveness of an integrated continuous team midwifery care model (ICTMC) on the quality of antenatal care in Iran’s health system.</div></div><div><h3>Methods</h3><div>This randomized controlled trial included 200 low-risk nulliparous women selected from governmental health centers in Kashan, Iran during 2023–2024. The women were randomized into two groups, with block sizes of four and six, maintaining a 1:1 allocation ratio. A dedicated team of midwives offered continuous care throughout the gestation, labor and parturition periods plus postnatal care (6 weeks after birth) for the women in the intervention group. The control group, on the other hand, received standard care from various midwives during the same periods. A demographic questionnaire, and the Quality of Prenatal Care Questionnaire were used for data collection. Data were analyzed using descriptive and inferential statistics in STATA-17</div></div><div><h3>Results</h3><div>The ICTMC group exhibited a significantly higher mean of quality of prenatal care scores compared to the control group (158.83 ± 17.13 vs.133.51 ± 24.48, p &lt; 0.001), and this superiority was observed in all dimensions of this scale.</div></div><div><h3>Conclusion</h3><div>The present study offers evidence for the benefits of ICTMC, A collaborative approach among inform policymakers, healthcare providers, and researchers is recommended to facilitate the implementation of ICTMC within the Iranian healthcare system.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"27 ","pages":"Article 100420"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826633","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":"Fetal MRI study of brain differences in early-onset fetal growth restriction versus healthy controls at 30 weeks of gestation","authors":"Lotte Meijerink ,&nbsp;Inge van Ooijen ,&nbsp;Fieke Terstappen ,&nbsp;Thomas Alderliesten ,&nbsp;Rutger A.J. Nievelstein ,&nbsp;Femke Lammertink ,&nbsp;Manon Benders ,&nbsp;Mireille Bekker","doi":"10.1016/j.eurox.2025.100417","DOIUrl":"10.1016/j.eurox.2025.100417","url":null,"abstract":"<div><h3>Objective</h3><div>To identify volumetric and diffusion-related brain differences expressed as apparent diffusion coefficient (ADC) values between early-onset brain-sparing fetal growth restriction (FGR) and healthy controls using magnetic resonance imaging (MRI) at 30 weeks of gestation.</div></div><div><h3>Method</h3><div>This prospective, observational, monocenter cohort study included singleton pregnancies with early-onset brain-sparing FGR at the University Medical Center Utrecht. FGR fetuses were compared to healthy controls from the Utrecht YOUth Cohort. Fetal MRI of the brain was performed including T2-weighted and diffusion weighted imaging (DWI) sequences. We measured 2D biometrics, 3D volumetrics using BOUNTI, and ADC values in multiple brain and placental regions. Values were corrected to 30 weeks of gestation.</div></div><div><h3>Results</h3><div>The study included 26 FGR fetuses at gestational age (GA) 26.3–32 weeks and 71 controls at GA 30.1–34 weeks. At 30 weeks, total brain volume (TBV) was significantly smaller in FGR (144.2 ± 11.5 vs 166.9 ± 17.5 milliliters, p &lt; 0.001). After dividing all absolute volumes by TBV, only cerebellar volume remained significantly reduced (0.045 [0.00] vs 0.048 [0.01], p = 0.006). ADC values were lower in all brain regions except the cerebellum. Placental ADC values were also significantly lower in FGR.</div></div><div><h3>Conclusion</h3><div>Altered brain development in brain-sparing FGR is already present at 30 weeks of gestation. Lower brain volumes and ADC values may reflect the effects of altered perfusion, chronic hypoxia and microstructural changes in the brains of FGR fetuses. Future studies linking these MRI findings to long-term neurodevelopmental outcomes will aid in more personalized prognoses and might also inform the timing of delivery, ultimately enhancing clinical decision-making.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"27 ","pages":"Article 100417"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589208","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":"Assessing Characteristics of Mother–Infant Dyadic Synchrony Among Vulnerable Mothers Using the Infant CARE-Index","authors":"Camilla Ejlertsen ,&nbsp;Ingeborg Hedegaard Kristensen ,&nbsp;Anne Brødsgaard","doi":"10.1016/j.eurox.2025.100426","DOIUrl":"10.1016/j.eurox.2025.100426","url":null,"abstract":"<div><h3>Objective</h3><div>The postnatal period crucially influences the mother–infant relationship and subsequently the infant’s cognitive, physical, and psychosocial development. Maternal poor mental health may impact early interactions, potentially causing the infant’s developmental needs to go neglected.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, we used the Infant CARE-Index to examine mother–infant interaction patterns among mothers with a history of depression or anxiety. Ten mother–infant dyads recruited from a Danish obstetric department participated in video recordings of mother–infant interactions three months postpartum. The primary outcome was the assessment of mother–infant dyadic synchrony using observational measures of the Infant CARE-Index when infants were three months old.</div></div><div><h3>Results</h3><div>Mother–infant dyadic synchrony was found to lack sensitivity, with maternal behaviour predominantly exhibiting low sensitivity and, occasionally, control, leading to overall unresponsiveness. The infants in the dyads exhibited moderately cooperative behaviour but with tendencies towards compulsive and challenging behaviours.</div></div><div><h3>Conclusion</h3><div>This study offers novel observational insights into early relational dynamics in mother–infant dyads affected by maternal mental health history—an area underexplored in Danish postnatal care. By applying the Infant CARE-Index, the findings highlight specific behavioural patterns that may hinder bonding and development. These results underscore the need for relationship-based, targeted, and flexible interventions to support vulnerable dyads and promote healthier developmental trajectories.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"27 ","pages":"Article 100426"},"PeriodicalIF":1.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004269","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":"Change management - digitalisation of labor room: A mixed-methods study to assess the level of acceptance of 'Arc Partograph' application to go paperless in labor rooms.","authors":"Gaurang Narayan, Alka Patankar, Daya Narayan, Tarun Kumar Suvvari, Anchit Chauhan","doi":"10.1016/j.eurox.2025.100423","DOIUrl":"10.1016/j.eurox.2025.100423","url":null,"abstract":"<p><strong>Introduction: </strong>Delivery-related complications significantly contribute to maternal, fetal, and neonatal mortality, particularly in low-resource settings like India. Effective labor monitoring, exemplified by the WHO-endorsed partograph, is crucial but often underutilized due to various challenges. The transition to digital partographs offers potential benefits but faces obstacles that need to be addressed, especially regarding healthcare workers' acceptance and readiness for such changes.</p><p><strong>Materials and methods: </strong>This explanatory sequential mixed-methods study was conducted at a public tertiary hospital in Nagpur, India, over two months in 2024. After demonstrating the 'arcPartograph' application, a web-based tool for digital labor monitoring, 60 obstetricians participated in a quantitative survey, followed by a focused group discussion (FGD) with a subset of participants. Data were analyzed using both statistical methods and manual content analysis.</p><p><strong>Results: </strong>Among the 75 obstetricians contacted, 60 (80 %) participated, with 91.7 % (n = 55) expressing readiness to transition from paper-based to digital partographs, and 93.3 % (n = 56) willing to use the 'arcPartograph' application. Participants showed strong readiness for digital adoption (mean score 16.2) and positive perceptions (mean score 16.1), though global change acceptance was relatively low (mean score 27.0). No significant associations were found between socio-demographic factors and willingness to adopt digital tools. The FGD revealed diverse perceptions, identifying both facilitators and barriers to digital change management.</p><p><strong>Conclusion: </strong>The study highlights a strong readiness among obstetricians to embrace digital partographs, underscoring the need for targeted strategies to address technical and logistical challenges for successful implementation in low-resource settings.</p>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"27 ","pages":"100423"},"PeriodicalIF":1.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875640","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":"Added value of radiological staging to clinical examination in different histopathological subtypes of uterine cervical cancer: A retrospective study","authors":"Carla Linn Stadler ,&nbsp;Sara N. Strandberg","doi":"10.1016/j.eurox.2025.100376","DOIUrl":"10.1016/j.eurox.2025.100376","url":null,"abstract":"<div><h3>Objective</h3><div>Accurate staging of uterine cervical cancer (UCC) is crucial for treatment guidance and prognostic predictions. This study investigated the added value of conventional diagnostic imaging for different histopathological subtypes of UCC by comparing clinical staging according to International Federation of Gynaecology and Obstetrics staging system (cFIGO) and radiological staging (rFIGO) with histopathological staging (pFIGO) as reference.</div></div><div><h3>Methods</h3><div>26 consecutive patients with UCC from the retrospective part of the PRODIGYN study (ethical approval number 2022-04207-01; NCT05855941) were included in the present study. Data from study participants was collected from radiological and histopathological records 2016–2022 at the University hospital of Umeå. Staging was assessed according to the FIGO 2018 staging system. Statistical analysis included descriptive statistics and Cohen’s weighted kappa coefficient (κ) for calculation of agreement between cFIGO and rFIGO, and between rFIGO and pFIGO.</div></div><div><h3>Results</h3><div>With rFIGO staging, more advanced disease stages were found in 67 % (8/12 patients with known cFIGO). Poor agreement was found between cFIGO and rFIGO (κ =0.057) and between rFIGO and pFIGO (κ= 0169). Among the patients with squamous cell carcinoma (SCC) positive for human papilloma virus (HPV+), 67 % (4/6) were assigned a higher stage by rFIGO compared to cFIGO. For the single patients with HPV-negative SCC and HPV status unknown SCC, both were upstaged by rFIGO. In the case of adenocarcinomas, 67 % (2/3) of the patients were assigned a higher stage with rFIGO.</div></div><div><h3>Conclusions</h3><div>In primary staging of UCC, rFIGO leads to substantial up-staging compared to cFIGO, without obvious differences in subtypes.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100376"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577462","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":"Clinical investigation of fertility after uterine artery embolization combined with dilation and curettage(D&C) or D&C alone for cesarean scar pregnancies","authors":"Jie Gao ,&nbsp;Wenjing Wang ,&nbsp;Zhuoying Zhang,&nbsp;Saiming Cheng,&nbsp;Jiejun Cheng,&nbsp;Le Fu,&nbsp;Feng Gao","doi":"10.1016/j.eurox.2025.100379","DOIUrl":"10.1016/j.eurox.2025.100379","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to compare the reproductive outcomes of patients with cesarean scar pregnancies (CSP) following uterine artery embolization (UAE) and dilation and curettage (D&amp;C) treatments, and to evaluate the impact of UAE on fertility.</div></div><div><h3>Materials</h3><div>and methods: A retrospective case-control study was conducted. Patients diagnosed with CSP between 2019 and 2021 were included in the study. Clinical data and fertility outcomes were collected and reviewed retrospectively. Patients were divided into two groups based on their treatment option: the UAE combined with D&amp;C group and the D&amp;C alone group.</div></div><div><h3>Results</h3><div>A total of 91 CSP patients were enrolled in the study. Of these, 49 were treated with D&amp;C, while 42 received UAE combined with D&amp;C. The average gestational age in the UAE group was significantly longer than that in the D&amp;C group. The average diameter of the gestational mass was significantly larger in the UAE group than in the D&amp;C group (42.2 ± 19.8 mm vs 23.8 ± 15.9 mm). The other clinical features were not significantly different between the two groups. The average menstrual recovery time was 1.0 ± 0.20 months (range: 1–2 months) in the D&amp;C group, and 2.0 ± 2.85 months (range: 1–18 months) in the UAE combined with D&amp;C group, with a significant difference between the two groups. The average menstrual blood volume (MBV) decreased in 79 % of patients in the UAE group, compared to 18 % in the D&amp;C group, with a significant difference between the two groups. There was no significant difference between the two groups in terms of pregnancy rate and birth rate (75 % vs 78 %, 63 % vs 56 %).</div></div><div><h3>Conclusion</h3><div>UAE combined with D&amp;C is an efficient and safe treatment for CSP. Our study showed that decreased MBV and longer menstrual recovery time in UAE combined with D&amp;C group, but there are no statistical difference in fertility outcomes between the two groups, which suggests probably a reversible impact on the reproductive function.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"26 ","pages":"Article 100379"},"PeriodicalIF":1.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686980","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":"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":"2025-06-01","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":"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 ,&nbsp;Jinglei Xue ,&nbsp;Mixue Tu ,&nbsp;Yifeng Liu ,&nbsp;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":"2025-06-01","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":"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":"2025-06-01","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}