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

{"title":"Machine learning applications in placenta accreta spectrum disorders","authors":"Mahsa Danaei ,&nbsp;Maryam Yeganegi ,&nbsp;Sepideh Azizi ,&nbsp;Fatemeh Jayervand ,&nbsp;Seyedeh Elham Shams ,&nbsp;Mohammad Hossein Sharifi ,&nbsp;Reza Bahrami ,&nbsp;Ali Masoudi ,&nbsp;Amirhossein Shahbazi ,&nbsp;Amirmasoud Shiri ,&nbsp;Heewa Rashnavadi ,&nbsp;Kazem Aghili ,&nbsp;Hossein Neamatzadeh","doi":"10.1016/j.eurox.2024.100362","DOIUrl":"10.1016/j.eurox.2024.100362","url":null,"abstract":"<div><div>This review examines the emerging applications of machine learning (ML) and radiomics in the diagnosis and prediction of placenta accreta spectrum (PAS) disorders, addressing a significant challenge in obstetric care. It highlights recent advancements in ML algorithms and radiomic techniques that utilize medical imaging modalities like magnetic resonance imaging (MRI) and ultrasound for effective classification and risk stratification of PAS. The review discusses the efficacy of various deep learning models, such as nnU-Net and DenseNet-PAS, which have demonstrated superior performance over traditional diagnostic methods through high AUC scores. Furthermore, it underscores the importance of integrating quantitative imaging features with clinical data to enhance diagnostic accuracy and optimize surgical planning. The potential of ML to predict surgical morbidity by analyzing demographic and obstetric factors is also explored. Emphasizing the need for standardized methodologies to ensure consistent feature extraction and model performance, this review advocates for the integration of radiomics and ML into clinical workflows, aiming to improve patient outcomes and foster a multidisciplinary approach in high-risk pregnancies. Future research should focus on larger datasets and validation of biomarkers to refine predictive models in obstetric care.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100362"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025143","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":"Management of menopausal hot flushes. Recommendations from the Spanish Menopause Society","authors":"M. Fasero ,&nbsp;M. Sanchez ,&nbsp;L. Baquedano ,&nbsp;I. Gippini ,&nbsp;D. Fuentes ,&nbsp;C. Navarro ,&nbsp;E. Beltrán ,&nbsp;M. Lilue ,&nbsp;I. Porcel ,&nbsp;C. Pingarrón ,&nbsp;M. Herrero ,&nbsp;P. Romero ,&nbsp;T. Ortega ,&nbsp;E. Carretero ,&nbsp;S. Palacios ,&nbsp;N. Mendoza ,&nbsp;P.J. Coronado","doi":"10.1016/j.eurox.2025.100366","DOIUrl":"10.1016/j.eurox.2025.100366","url":null,"abstract":"<div><div>This project aims to develop recommendations for treating vasomotor symptoms (VMS) based on the Cervantes short-form scale score (menopausal domain) using the best available evidence. A total of 166 studies were selected: 108 randomized controlled trials, 23 systematic reviews, 3 reviews, 3 meta-analyses, 11 case-control studies, 9 observational studies, and 12 transversal studies. To achieve this objective, a series of PICO (Patient, Intervention, Comparison, and Outcome) questions have been established for the treatment of VMS. We evaluate the quality of the scientific evidence and, with the findings, create a decision framework to treat hot flashes based on the Cervantes short-form scale score.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100366"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174125","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":"A national survey on Thai medical students’ attitudes towards abortion and their confidence in providing abortion services following the amendment to abortion law","authors":"Hathaipat Leetrakool ,&nbsp;Thanathorn Wonglerttham ,&nbsp;Sornchaya Sonthyanonth ,&nbsp;Jen Sothornwit","doi":"10.1016/j.eurox.2024.100364","DOIUrl":"10.1016/j.eurox.2024.100364","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate medical students' attitudes towards abortion and their confidence in providing abortion services in the future.</div></div><div><h3>Material and methods</h3><div>A national cross-sectional online survey was conducted among fifth and sixth-year medical students from 10 Thai universities. A self-administered questionnaire assessed their knowledge, attitudes, and confidence regarding abortion services. Of 340 questionnaires sent, 234 responses were received. We used descriptive statistics and multivariable analysis to explore agreement with abortion and confidence.</div></div><div><h3>Results</h3><div>The mean attitude score towards abortion was 72.68 ± 7.46 out of 85, with 75.6 % of students indicated a favorable attitude toward abortion. The most widely accepted reasons for abortion were serious congenital anomalies in the fetus (99.6 %) and pregnancy resulting from sexual crimes (98.7 %). However, only 42.8 % of the students were willing to provide abortion services, and 33.8 % felt confident in doing so. Additionally, 77.8 % believed that participating in abortion procedures during medical school would increase their confidence in providing these services. No factors were found to be significantly associated with agreement on abortion.</div></div><div><h3>Conclusion</h3><div>Although most medical students had a positive attitude towards abortion, only a minority expressed willingness and confidence in providing abortion care. These findings underscore the importance of incorporating hands-on experience in abortion procedures in medical school curricula.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100364"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029664","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":"Association of physical activity during pregnancy with labor and delivery in nulliparous patients","authors":"Shuqun Ren ,&nbsp;Qian Zhao ,&nbsp;Liyin Luo ,&nbsp;Xiaohong You ,&nbsp;Aihong Jin","doi":"10.1016/j.eurox.2024.100361","DOIUrl":"10.1016/j.eurox.2024.100361","url":null,"abstract":"<div><h3>Background</h3><div>Physical activity during pregnancy is a positive behavior for improving pregnancy outcomes, yet the relationship between physical activity during pregnancy and labor is still debated.</div></div><div><h3>Objective</h3><div>This study aimed to test our hypothesis that a higher level of physical activity during pregnancy is associated with a shorter labor duration.</div></div><div><h3>Study design</h3><div>This was a prospective cohort study of pregnant women with singleton pregnancies and no contraindications to physical activity during pregnancy. physical activity according to type and intensity were evaluated with the Chinese version of the Pregnancy Physical Activity Questionnaire. This questionnaire categorizes physical activities into different types and intensities and quantifies them. The primary study outcome was labor duration. The secondary outcomes were delivery mode, conversion from vaginal delivery to cesarean section, prolonged second stage of labor, perineal tears, episiotomy, and postpartum hemorrhage within 24 hours. Generalized additive models were used to identify both linear and nonlinear relationships between physical activity during pregnancy and labor. A segmented linear model was employed to calculate the saturation effect. Stratified logistic regression was used for subgroup analysis.</div></div><div><h3>Results</h3><div>In total, 226 women participated in the physical activity survey during pregnancy and gave birth at our hospital. The energy expenditure of physical activity during pregnancy was 145.70 (111.92, 181.69) weekly energy expenditure (MET-h•wk-1). After full adjustment for covariates, a nonlinear relationship was observed between physical activity during pregnancy and the duration of the first stage of labor. Different correlations were observed when the energy expenditure of physical activity during pregnancy was 142.28 MET-h•wk-1. In the two-part regression model, the inflection point of physical activity during pregnancy was at 142.28 MET-h•wk-1. When the energy expenditure of physical activity during pregnancy exceeded 142.28 MET-h•wk-1, each standard deviation increase in physical activity was associated with a decrease of 149.85 minutes in the duration of the first stage of labor (β:-149.85, 95 % CI: −247.54 to −52.17, P = 0.0080).</div></div><div><h3>Conclusions</h3><div>A nonlinear relationship between physical activity during pregnancy and duration of the first stage of labor ha been identified.When physical activity exceeds 142.28 MET-h•wk-1, each additional standard deviation reduces the first stage of labor by 149.85 minutes. Physical activity is not limited to exercise programs; daily activities such as cleaning, shopping, and walking to and from work are effective ways to increase energy expenditure and help individuals achieve the recommended level of physical activity.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100361"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013490","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":"To do or not to do? – Endometrial biopsy in younger women with abnormal uterine bleeding","authors":"Sandra Lynn Jaya-Bodestyne ,&nbsp;Marlene Samantha Goh ,&nbsp;Madeline Chan Hiu Gwan ,&nbsp;Sonali Prashant Chonkar ,&nbsp;Khurshid Merchant ,&nbsp;Manisha Mathur","doi":"10.1016/j.eurox.2025.100368","DOIUrl":"10.1016/j.eurox.2025.100368","url":null,"abstract":"<div><h3>Objective</h3><div>Abnormal uterine bleeding (AUB) can be associated with underlying endometrial pathology. The current existing guidelines discuss the role of endometrial biopsy in women 40 years old and above, however, there are no clear recommendations for younger women. This study aims to identify the factors that increase the risk of endometrial pathology in women below 40 years of age presenting with AUB for consideration of endometrial biopsy.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study reviewing the records of 464 women aged under 40 years old who underwent endometrial biopsy for AUB. The data analysis included demographics, investigations undertaken, ultrasound findings, biopsy results, and treatment. Multivariable analysis was performed using modified Poisson regression models to compare women with endometrial hyperplasia (EH) (with or without atypia) and endometrial cancer (EC), to those with benign pathology, to identify risk factors for endometrial pathology.</div></div><div><h3>Results</h3><div>In our study, 71.3 % of women had a benign histology, 22.8 % had EH with and without atypia and 2.2 % of women had a diagnosis of EC. A BMI ≥ 30 (RR 1.76, p = 0.002), nulliparity (RR 1.84, p = 0.001), ultrasound findings of thickened endometrium ≥ 15 mm (RR 1.39, p = 0.048) and cystic spaces in the endometrium (RR 1.83, p &lt; 0.001) were identified as significant risk factors after a multivariate analysis. A combination of at least 3 of these risk factors had a cumulative increased risk of EH/EC (RR 3.80, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Endometrial biopsy in younger women with AUB should be carefully considered on a case-by-case basis and reserved for those with risk factors for a serious endometrial pathology.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100368"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174136","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":"Global, regional, and national prevalence and disability-adjusted life-years for endometriosis in 204 countries and territories, 1990–2019: Findings from a global burden of disease study","authors":"Dong Yi Shen ,&nbsp;Jing Li ,&nbsp;PanWei Hu ,&nbsp;Cong Qi ,&nbsp;Hong Yang","doi":"10.1016/j.eurox.2024.100363","DOIUrl":"10.1016/j.eurox.2024.100363","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to analyze the worldwide, regional burden of endometriosis and its trends from 1990 to 2019, utilizing the latest data from Global Burden of Disease (GBD) 2019. GBD 2019 is a global database tool for comprehensive analysis and an important result of long-term collaboration among governments worldwide.</div></div><div><h3>Methods</h3><div>We utilized the Global Health Data Exchange Query tool to analyze endometriosis in prevalence numbers, age-standardized prevalence rates (ASPR), and disability-adjusted life-years (DALYs) from 1990 to 2019 in 204 countries and regions. Additionally, this study investigated the impacts of period, age, and cohort on the prevalence and DALYs of endometriosis from the global perspective and in the five sociodemographic index (SDI) regions.</div></div><div><h3>Results</h3><div>Among the 21 regions, the most significant reduction in the prevalence of endometriosis between 1990 and 2019 occurred in Central Latin America. In 204 countries, the most pronounced decline was observed in Guatemala. At the SDI level, with the increase of SDI, the ASPR of endometriosis in all regions worldwide showed an overall decreasing trend. The prevalence of endometriosis peaked between the ages of 25 and 29.</div></div><div><h3>Discussion</h3><div>The findings of this study reflect the temporal and spatial tendency of the burden of endometriosis during the study period, and provide a reference for health agencies around the world to formulate policies on endometriosis, so as to reduce the harm of endometriosis to women worldwide.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100363"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029672","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":"Artificial womb technology – A more physiologic solution to treating extreme prematurity","authors":"Felix R. De Bie ,&nbsp;Chase C. Binion ,&nbsp;Ryan M. Antiel","doi":"10.1016/j.eurox.2024.100359","DOIUrl":"10.1016/j.eurox.2024.100359","url":null,"abstract":"<div><div>Treatment of extreme premature infants (EPI) is limited by developmental immaturity primarily of the lung. A paradigm shift towards a more physiologic treatment of EPI as fetal neonates or <em>fetonates</em>, by keeping them in a womb-like environment to allow continued organ maturation, is the rationale for artificial womb technology. In this review, we discuss the artificial placenta and womb technology, it’s rationale, the history of its development, the most recent preclinical models described in the literature and finally pertinent ethical considerations.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100359"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013488","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 single-cell immune profile throughout gestation and its potential value for identifying women at risk for spontaneous preterm birth","authors":"Dorien Feyaerts ,&nbsp;Maïgane Diop ,&nbsp;Jose Galaz ,&nbsp;Jakob F. Einhaus ,&nbsp;Petra C. Arck ,&nbsp;Anke Diemert ,&nbsp;Virginia D. Winn ,&nbsp;Mana Parast ,&nbsp;Cynthia Gyamfi-Bannerman ,&nbsp;Jelmer R. Prins ,&nbsp;Nardhy Gomez-Lopez ,&nbsp;Ina A. Stelzer","doi":"10.1016/j.eurox.2025.100371","DOIUrl":"10.1016/j.eurox.2025.100371","url":null,"abstract":"<div><div>Precisely timed immune adaptations, observed in the maternal circulation, underpin the notion of an immune clock of human pregnancy that supports its successful progression and completion at delivery. This immune clock is divided into three immunological phases, with the first phase starting at the time of conception and implantation, shifting into the second phase that supports homeostasis and tolerance throughout pregnancy, and culminating in the last phase of labor and parturition. Disruptions of this immune clock are reported in pregnancy complications such as spontaneous preterm birth. However, our understanding of the immune clock preceding spontaneous preterm birth remains scattered. In this review, we describe the chronology of maternal immune cell adaptations during healthy pregnancies and highlight its disruption in spontaneous preterm birth. With a focus on single-cell cytometric, proteomic and transcriptomic approaches, we review recent studies of term and spontaneous preterm pregnancies and discuss the need for future prospective studies aimed at tracking pregnancies longitudinally on a multi-omic scale. Such studies will be critical in determining whether spontaneous preterm pregnancies progress at an accelerated pace or follow a preterm-intrinsic pattern when compared to those delivered at term.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100371"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427645","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 effect of oxytocin, sublingual, and intrauterine misoprostol on blood loss in cesarean delivery: A randomized clinical trial","authors":"Mahdieh Masoumzadeh ,&nbsp;Vahideh Rahmani ,&nbsp;Manizheh Sayyah-Melli ,&nbsp;Anis Sani","doi":"10.1016/j.eurox.2025.100369","DOIUrl":"10.1016/j.eurox.2025.100369","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of different uterotonic agents is yet to be determined.</div></div><div><h3>Methods</h3><div>This was a randomized clinical trial on 240 pregnant mothers with a history of cesarean section in three groups: A: sublingual misoprostol and oxytocin, B: intrauterine misoprostol and oxytocin, and C: a higher dose of oxytocin alone. The intrapartum blood loss and the estimated blood loss within 24 h after surgery were compared between the groups.</div></div><div><h3>Results</h3><div>The baseline characteristics showed no significant differences among the groups. The volume of blood loss during surgery and within 24 h postpartum did not differ significantly among the groups (A: 230.72 ± 97.30, B: 245.60 ± 88.50, C: 229.02 ± 109.78, p = 0.115, and A: 2023.84 ± 480.08, B: 2045.26 ± 598.99, C: 2025.61 ± 538.93, p = 0.819, respectively).</div></div><div><h3>Conclusion</h3><div>Intrauterine misoprostol plus oxytocin, sublingual misoprostol plus oxytocin and a higher dose of oxytocin did not show any significant difference in the amount of blood loss during surgery and within 24 h post-operation.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100369"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143327423","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":"Implementation of antepartum preterm birth interventions: A scoping review","authors":"Etoroabasi Ekpe ,&nbsp;Jason Collier ,&nbsp;Benjamin H. Chi ,&nbsp;Divya Mallampati","doi":"10.1016/j.eurox.2025.100373","DOIUrl":"10.1016/j.eurox.2025.100373","url":null,"abstract":"<div><div>While antenatal recommendations regarding preterm birth are essential to preventing neonatal morbidity and mortality, implementation of these recommendations underscore how health system capacity and systemic factors, such as access and quality, greatly influence their utilization. To date, there is limited synthesis focused on the implementation of antenatal preterm birth interventions. Our objectives were to focus on implementation science studies intended to 1) increase referral mechanisms of pregnant people to higher levels of care where the management of preterm labor or delivery is possible and 2) map the implementation of preterm birth interventions, including the administration of antenatal corticosteroids, magnesium sulfate, and antibiotics. We conducted a scoping review using key terms in online databases to identify implementation science strategies focused on referral mechanisms and preterm birth interventions. Studies were selected based on the strength of existing literature. Quality assessment was conducted with the Mixed Methods Assessment Tool (MMAT). To evaluate study intervention strategies, we used the RE-AIM framework – a comprehensive evaluative framework composed of 5 dimensions: reach, effectiveness, adoption, implementation, and maintenance. Of the 1178 articles that were screened, 18 were evaluated, and 13 included in this review. The studies were conducted in 12 countries, the majority of which were lower to lower-middle income countries. Designs ranged from quantitative non-randomized studies to qualitative and mixed methods. By using the RE-AIM framework, we found that there was heterogeneity among the studies with regards to whether they addressed reach, effectiveness, adoption, implementation, or maintenance. Common interventions for referring pregnant women to higher levels of care included the use of skilled birth attendants, referral systems, financial incentives, quality of emergency obstetric care, and community health workers. Implementation studies on preterm birth interventions with corticosteroids or magnesium sulfate focused on increasing awareness and knowledge of evidence-based practices using care bundles, online or in person training sessions, focus groups, interviews, and surveys. Overall, we identified how implementation studies increased the use of antenatal corticosteroids and magnesium sulfate and also identified how community health workers, skilled birth attendants, and referral systems can reduce complications from preterm birth. With further review of implementation science research, implementation science can be used to further understand and integrate evidence based-knowledge into practice in a consistent and reproducible matter.</div></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"25 ","pages":"Article 100373"},"PeriodicalIF":1.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143452998","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}