Obstetrics and Gynecology Science最新文献

{"title":"vNOTES retroperitoneal uterosacropexy using the semitendinosus tendon.","authors":"Klapdor Rüdiger, Bryan Sarah, Dittmann Julian, Lewitz Dorothea, Hornemann Amadeus","doi":"10.5468/ogs.25204","DOIUrl":"10.5468/ogs.25204","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this report is to demonstrate the feasibility of combining the harvested semitendinosus tendon technique (HoTT) technique, originally described laparoscopically, with a retroperitoneal vaginal natural orifice transluminal endoscopic surgery (vNOTES) approach for central compartment prolapse repair.</p><p><strong>Methods: </strong>A 55-year-old woman with stage III uterine prolapse underwent native tissue sacropexy using an autologous semitendinosus tendon via the retroperitoneal vNOTES approach. Via a pararectal entry, the longitudinal ligament was identified, and the uterus was fixed to the longitudinal ligament of the sacrum using the semitendinosus tendon. The procedure combined native tissue repair with minimally invasive access through the vaginal route.</p><p><strong>Results: </strong>The result was an anatomically successful prolapse correction without any intraoperative or postoperative complications. The patient recovered well and was discharged after 48 hours.</p><p><strong>Conclusion: </strong>In conclusion, this is the first case to combine vNOTES with the HoTT technique, enabling a minimally invasive, mesh-free, and anatomically precise prolapse repair. vNOTES offers precise dissection and sacral fixation using a vaginal approach. This should lead to fast recovery and reduced postoperative pain. A retroperitoneal approach allows faster operation times and prevents intraperitoneal adhesions. This technique is promising for patients desiring a mesh-free approach. This innovative approach may serve as a promising alternative to conventional techniques in selected patients.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"155-157"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221295","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 between hysterectomy and dementia risk in Korean women aged 40-59: a nationwide retrospective cohort study.","authors":"Sang-Hee Yoon, Jin-Sung Yuk","doi":"10.5468/ogs.25364","DOIUrl":"10.5468/ogs.25364","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether hysterectomy for benign diseases is associated with the risk of dementia in middle-aged women.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using data from the Korean National Health Insurance Service database (2002-2020). Women aged 40-59 years who underwent hysterectomy for benign indications (n=16,818) were propensity score-matched (1:1) to controls who had not received hysterectomy. Subjects were followed up until the diagnosis of dementia, death, or the end of the study period (2020). Dementia (all types), Alzheimer's disease (AD), and vascular dementia (VaD) were identified by International Classification of Diseases, 10th revision codes. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia associated with hysterectomy.</p><p><strong>Results: </strong>Median follow-up was 11.4 years. Dementia occurred in 302 (1.8%) women who did not undergo hysterectomy and 257 (1.5%) women who underwent hysterectomy (P=0.061). Cox analysis revealed that hysterectomy was not significantly associated with all-cause dementia (HR, 0.865; 95% CI, 0.724-1.033), with a non-significant trend towards reduced risk. Subgroup analysis also failed to identify any significant association; AD (HR, 0.696; 95% CI, 0.463-1.048) and VaD (HR, 0.625; 95% CI, 0.284-1.377) were not significantly associated with an increased hazard.</p><p><strong>Conclusion: </strong>In this large Korean cohort, hysterectomy for benign diseases in women aged 40-59 years was not associated with a significant change in the subsequent risk of dementia. Collectively, our results indicate that hysterectomy was not associated with an increased incidence of dementia, including in analyses stratified by adnexal surgery.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"144-154"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285511","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 intelligence in preterm birth prediction: a narrative review of current approaches and clinical applicability.","authors":"YooKyung Lee","doi":"10.5468/ogs.26043","DOIUrl":"10.5468/ogs.26043","url":null,"abstract":"<p><p>Preterm birth remains the leading cause of neonatal morbidity and mortality worldwide, affecting approximately 13.4 million births annually. Despite advances in our understanding of risk factors, current clinical prediction methods have demonstrated limited accuracy in individual risk stratification. This narrative review examines the current landscape of artificial intelligence (AI) applications for preterm birth prediction and evaluates the methodological quality and clinical applicability across different data modalities. PubMed, Embase, and Web of Science were searched to develop and validate machine learning models for predicting spontaneous preterm births. AI approaches include electronic health record-based models, deep learning for ultrasound image analysis, cervical texture and radiomics feature extraction, elastography-derived parameters, and multi-omics integration using transformer architectures. Area under the receiver operating characteristic curve values range from 0.61 to 0.89 across modalities. However, the systematic reviews identified significant methodological limitations; 79% of the studies had a high risk of bias according to the prediction model risk-of-bias assessment tool criteria, with a median transparent reporting of multivariable prediction model for individual prognosis or diagnosis (TRIPOD) adherence of only 49%. Common deficiencies include inadequate sample sizes, a lack of external validation, and failure to report calibration metrics. Although AI-based prediction shows promise, substantial improvements in methodological rigor are required before clinical implementation. Priority areas include rigorous external validation, adherence to TRIPOD+AI reporting standards, and prospective evaluation of clinical utility.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"94-102"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349368","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":"Consensus-based guideline of the Korean Society of Gynecologic Oncology for high-risk human papillomavirus testing in cervical cancer screening.","authors":"Ju-Hyun Kim, Seung-Hyuk Shim, Kyung-Jin Min, Jae-Kwan Lee, Chong Woo Yoo, Min-Jung Kwon, Shin-Wha Lee, Jaeman Bae","doi":"10.5468/ogs.26066","DOIUrl":"10.5468/ogs.26066","url":null,"abstract":"<p><p>High-risk human papillomavirus (hrHPV) is an important cause of cervical cancer. hrHPV testing has emerged as an effective screening modality to address the limitations of cytology-based screening. However, in Korea, the absence of standardized clinical guidance has resulted in variability in practice. This consensus-based clinical practice guideline was developed by a multidisciplinary expert committee under the Korean Society of Gynecologic Oncology and includes specialists in gynecologic oncology, pathology, laboratory medicine, and public health. Relevant domestic and international evidence was systematically reviewed and perspectives from diverse clinical settings were incorporated through four public hearings. The final recommendations were established through expert consensus. These guidelines present four key recommendations. First, hrHPV testing may be considered for women aged ≥25 years, with a screening interval of 3 to <5 years. Second, screening assays should differentiate between HPV genotypes 16 and 18 while detecting other high-risk types, and tests with established clinical validity are recommended. Third, hrHPV testing should be performed in appropriately equipped settings, following standardized procedures for specimen handling and reporting, with clear documentation of HPV 16/18 status in positive cases. Fourth, the testing should operate under rigorous internal and external quality control systems to ensure reliability and consistency. These guidelines aim to promote consistent and evidence-based implementation of hrHPV testing for cervical cancer screening in Korea, supporting early detection and prevention.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"85-93"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349291","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 utility assessment framework for machine learning-based fetal health classification in cardiotocography: an observational study.","authors":"YooKyung Lee, So Yun Kim, Hana Park","doi":"10.5468/ogs.25376","DOIUrl":"10.5468/ogs.25376","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical utility and implementation considerations of artificial intelligence (AI)-based fetal health classification systems using the Kaggle Fetal Health Classification dataset, with a focus on obstetric physicians' perspectives.</p><p><strong>Methods: </strong>We analyzed the Kaggle Fetal Health Classification dataset (n=2,126), containing 21 cardiotocography parameters. Five machine-learning algorithms were evaluated: logistic regression, random forest, gradient boosting, support vector machine, and decision tree. Class weighting was applied to address the dataset imbalance. The model performance was assessed using standard classification metrics. An expert opinion-based clinical utility assessment framework was developed to assess interpretability, workflow integration, and safety.</p><p><strong>Results: </strong>With class weighting applied, gradient boosting achieved the highest accuracy (89.67%), followed by random forest (88.50%) and logistic regression (82.16%). The most important predictive features were abnormal short-term variability (16.23% importance) and the percentage of time with abnormal long-term variability (13.21% importance). An analysis of all 21 features revealed that contraction-related parameters, including uterine_contractions, contributed minimally to the classification performance. The 35.3% false negative rate for pathological cases represents a significant safety concern and requires physician oversight.</p><p><strong>Conclusion: </strong>AI-based fetal health classification systems show potential for future applications when properly validated. However, the significant false negative rate for pathological cases indicates that these systems cannot function independently. External validation using multicenter clinical data and prospective outcome studies is essential before clinical implementation.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"119-127"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310884","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":"Dual-output, web-based risk assessment system for cesarean section due to dystocia: integration of logistic regression and risk scoring models.","authors":"Yun Seok Yang, Kwan Young Oh, Jae Young Kwack, YouJin Kim, Byung Hun Kang, Mi Hye Park, JooYong Park","doi":"10.5468/ogs.25314","DOIUrl":"10.5468/ogs.25314","url":null,"abstract":"<p><strong>Objective: </strong>To develop a web-based risk assessment system to predict cesarean section (CS) due to dystocia at admission in nulliparous term singleton vertex pregnancies, tailored for Korean women.</p><p><strong>Methods: </strong>This case-control study analyzed the data of 126 women with CS due to dystocia and 490 women who had vaginal deliveries. Eight predictors-gestational age, maternal age, maternal height, pre-gestational body mass index, birth weight, fetal sex, cervical dilatation at admission, and maternal-fetal ratio-were identified using multivariate logistic regression. The system integrated both logistic regression and risk-scoring models simultaneously to provide individualized risk probabilities and categorical risk levels.</p><p><strong>Results: </strong>The model demonstrated strong predictive accuracy, with an area under the receiver operating characteristic curve of 0.86. Risk stratification classified the patients into low-, intermediate-, and high-risk groups, corresponding to CS rates of 1.6, 47.6, and 50.8%, respectively (p<0.001).</p><p><strong>Conclusion: </strong>This dual-output, user-friendly, and admission-based web system enhances interpretability and supports personalized counseling and evidence-based decision-making. Specifically designed for Korean women, it enables the early identification of high-risk cases and may help reduce unnecessary operative interventions. Therefore, further multicenter studies are warranted.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"108-118"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907002","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":"Practical technique and clinical management guide for external cephalic version.","authors":"Jun Takeda, Asako Kumagai, Nami Tamura, Rie Seyama, Shun Masaoka, Nana Matsuzawa, Yuka Yamamoto, Yasuhisa Terao","doi":"10.5468/ogs.25397","DOIUrl":"10.5468/ogs.25397","url":null,"abstract":"<p><p>The external cephalic version (ECV) is a manual procedure that rotates the fetus from breech to cephalic presentation through external abdominal manipulation. Major international guidelines recommend offering ECV at term to eligible women to reduce cesarean delivery rates. However, detailed technical guidance and standardized perioperative management remain limited. This review aims to provide a practical and clinically applicable guide based on an established institutional protocol, covering key preparatory measures, including patient selection and informed consent, a reproducible step-by-step technique, and post-procedure management. ECV is generally indicated for singleton breech pregnancies at or beyond 37 weeks of gestation, when vaginal birth is not contraindicated. Informed consent is required as an elective procedure, supported by balanced counseling on risks, benefits, and shared decision-making. Preprocedural management includes ultrasound assessment, fetal monitoring, and the use of ritodrine hydrochloride and neuraxial analgesia to enhance comfort and facilitate uterine relaxation. This technique emphasizes complete disengagement of the fetal buttocks, direction-specific wide-arc rotation of the fetal head while maintaining continuous upward lifting of the fetal buttocks, and secure engagement of the head beneath the pubic symphysis to prevent reversion. This step is followed by ultrasound confirmation that no umbilical cord or fetal extremity is present before the head. Safety was reinforced by performing the procedure in an operating room with immediate access for cesarean delivery and appropriate postprocedure monitoring. By offering a concise, reproducible approach and a supplementary procedural video, this review supports safer and more effective implementation of ECV and may help reduce unnecessary cesarean births.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"103-107"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272325","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":"Promising survival prospects and immunotherapy potential in polymerase epsilon-mutated endometrial cancer: a comprehensive systematic review and meta-analysis unveiling future therapeutic opportunities.","authors":"Cut Adeya Adella, Felix Khosasi, Elbert Elbert","doi":"10.5468/ogs.25179","DOIUrl":"10.5468/ogs.25179","url":null,"abstract":"<p><strong>Objective: </strong>Mutations in the DNA polymerase epsilon (POLE) gene in endometrial cancer define a distinct molecular subgroup with therapeutic relevance. This study evaluates their prognostic significance to refine risk stratification and guide treatment planning, especially within immunotherapy-based approaches.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and was registered in the PROSPERO database (CRD420251064413). Cohort studies from 2018-2025 were retrieved from major databases. Study quality was assessed using the quality in prognostic studies tool. Hazard ratios for overall survival, disease-specific survival, and progression-free survival were synthesized using Review Manager 5.4 (Cochrane Collaboration, London, United Kingdom), and R statistical software 4.4.2 (R Foundation for Statistical Computing, Vienna, Austria) with heterogeneity assessed using the I-squared statistic and publication bias examined through funnel plots, Egger's test, and the Trim-and-Fill method.</p><p><strong>Results: </strong>POLE mutations were identified in 9% of endometrial cancer cases (95% confidence interval, 9-11%; I2=90.6%; P<0.0001). Patients with POLE mutations showed significantly improved progression-free survival (hazard ratio, 0.37; 95% confidence interval, 0.26-0.53; I2=0%) and overall survival (hazard ratio, 0.57; 95% confidence interval, 0.40-0.79; I2=41%). Most cases were early stage (International Federation of Gynecology and Obstetrics I-II, 86%), endometrioid type (84%), with low myometrial invasion (<50%, 56%), limited lymphovascular space invasion (25%), and low lymph node metastasis (29%).</p><p><strong>Conclusion: </strong>POLE mutations in endometrial cancer are associated with a favorable prognosis and show promising potential for immunotherapy. Molecular subtyping that incorporates POLE mutation status should be considered standard practice for risk stratification and treatment planning.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"128-143"},"PeriodicalIF":1.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272330","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":"Active surveillance for CIN 2: methodological issues and clinical implications.","authors":"Pınar Karaçin","doi":"10.5468/ogs.26023","DOIUrl":"https://doi.org/10.5468/ogs.26023","url":null,"abstract":"","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272352","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":"Outcome of pregnancy after adenomyomectomy: a review.","authors":"Ha Lim Shin, Young Mi Jung, Hyeon Ji Kim, Jee Yoon Park","doi":"10.5468/ogs.25157","DOIUrl":"10.5468/ogs.25157","url":null,"abstract":"<p><p>Adenomyosis, a prevalent yet frequently underdiagnosed uterine disorder, poses significant challenges for women of reproductive age, especially those seeking fertility. Although hysterectomy remains the definitive treatment, fertility-sparing interventions such as adenomyomectomy have gained traction despite ongoing debates regarding their efficacy and safety. This review synthesizes the current evidence on reproductive and perinatal outcomes following adenomyomectomy, evaluates its risks and benefits and provides evidence-based clinical recommendations. We reviewed the diagnosis and treatment of adenomyosis, with a particular focus on fertility-sparing surgery, and summarized the pregnancy outcomes and obstetric risks after adenomyomectomy, including recommendations for prenatal care. Adenomyomectomy may improve fertility in carefully selected patients; however, it carries substantial obstetric risks including placenta accreta spectrum, preterm birth, and life-threatening hemorrhage. While it offers a viable alternative to hysterectomy, its use should be restricted to women with severe symptoms or those who have failed assisted reproductive technology cycles and should be managed within a framework of shared decision-making and high-risk obstetric care. Future research should address diagnostic standardization, long-term reproductive outcomes, and strategies to mitigate surgical complications.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"16-26"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557969","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}