Obstetrics and Gynecology Science最新文献

{"title":"Interleukin-6 and hormonal biomarker profiles in Moroccan women with endometriosis.","authors":"Chafika Nadifi, Chaimaa Hilali, Modou Mamoune Mbaye, Mohamed Zarqaoui, Noureddine Louanjli, Moncef Benkhalifa, Fatima Azzahra Lahlou","doi":"10.5468/ogs.25347","DOIUrl":"10.5468/ogs.25347","url":null,"abstract":"<p><strong>Objective: </strong>Endometriosis remains an underdiagnosed gynecological condition due to the lack of validated non-invasive biomarkers. This study aimed to evaluate the diagnostic value of plasma interleukin-6 (IL-6), serum cancer antigen 125 (CA125), anti-Müllerian hormone (AMH), and other hormonal parameters in women with endometriosis.</p><p><strong>Methods: </strong>A total of 224 Moroccan women (n=224) were recruited from a gynecology center in Morocco, including 112 patients with laparoscopically confirmed endometriosis and 112 asymptomatic controls. Plasma levels of IL-6 and serum levels of CA125, AMH, and gonadotropins were measured using enzyme-linked immunosorbent assay and electrochemiluminescence immunoassay. The diagnostic performance was assessed using receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>Plasma IL-6 and serum CA125 levels were significantly elevated in the endometriosis group (P<0.001), whereas reproductive hormone levels were significantly lower (P<0.001). Among all biomarkers tested, IL-6 demonstrated the highest diagnostic performance, with an area under the curve of 0.952, a sensitivity of 91.1%, and a specificity of 80.4%.</p><p><strong>Conclusion: </strong>IL-6 may serve as a promising non-invasive biomarker for the detection of endometriosis, with superior diagnostic accuracy compared to currently used markers. Further multicenter validation is warranted to establish clinical cutoffs and confirm its utility in routine practice.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"222-234"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876007","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":"Initiating robotic vaginal natural orifice transluminal endoscopic surgery: a Beginner's guide.","authors":"Aya Mohr-Sasson, Asha Bhalwal, Alvaro Montealegre","doi":"10.5468/ogs.25407","DOIUrl":"10.5468/ogs.25407","url":null,"abstract":"<p><strong>Objective: </strong>Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is associated with reduced postoperative pain and faster recovery compared with conventional laparoscopy. However, its adoption is limited by challenging triangulation, caudal-to-cephalic visualization requiring a learning curve, and restricted instrument length when managing complex pathology. Robotic assistance provides three-dimensional visualization, wristed instrumentation with enhanced dexterity, and surgeon-controlled camera movement, which may help overcome these limitations and expand the role of minimally invasive vaginal surgery. This video aims to demonstrate essential procedural steps and practical tips for surgeons beginning robotic vNOTES hysterectomy.</p><p><strong>Methods: </strong>The first part of the video demonstrates key procedural steps using a simulation model. Following anterior and posterior colpotomy and bilateral detachment of the uterosacral ligaments, an Alexis ring (Applied Medical, Rancho Santa Margarita, CA, USA) is inserted, as in conventional vNOTES. GelPoint (Applied Medical) trocars are arranged in a diamond configuration on the GelSeal cap (Applied Medical) and secured to the ring to establish pneumoperitoneum. The patient is placed in Trendelenburg position, the robot is docked, and the camera trocar is inserted first, followed by two additional trocars with appropriate spacing to avoid arm collision. The second part of the video demonstrates application of the technique in a 43-year-old woman who presented with heavy uterine bleeding secondary to multiple fibroids.</p><p><strong>Results: </strong>The patient successfully underwent robotic vNOTES hysterectomy, bilateral salpingectomy, and right ovarian cystectomy, demonstrating translation of simulation-based principles into clinical practice.</p><p><strong>Conclusion: </strong>Robotic vNOTES is a feasible approach that combines robotic advantages with vaginal access, enabling minimally invasive management of complex gynecologic pathology under direct visualization.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"244-248"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692941","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":"Intravaginal magnesium sulfate as an alternative to intravenous dexamethasone for labor acceleration: first direct comparison in a bayesian adaptive trial.","authors":"Kobra Hosseini, Mahin Seifi Alan, Leila Asadpoor Asl, Niloofar Seighali, Haniyeh Rashidi, Bita Badehnosh, Hadith Rastad","doi":"10.5468/ogs.26002","DOIUrl":"10.5468/ogs.26002","url":null,"abstract":"<p><strong>Objective: </strong>Labor acceleration remains a major challenge in obstetric care. Although intravenous (IV) dexamethasone has been shown to be effective for labor acceleration, its systemic adverse effects limit its use. Intravaginal magnesium sulfate (MgSO4) may offer a potential alternative; however, comparative studies are needed. This study compared the safety and efficacy of these interventions for labor acceleration.</p><p><strong>Methods: </strong>This Bayesian adaptive, three-arm randomized controlled trial enrolled 150 women in latent labor and assigned them to receive intravaginal MgSO4 (50%; 10 mL), IV dexamethasone (8 mg), or usual care. The primary outcomes were labor duration and change in Bishop score; secondary outcomes included Apgar scores.</p><p><strong>Results: </strong>Both active treatments significantly improved Bishop scores compared with control at 6 hours (3.06 vs. 3.05 points; P<0.001), with no significant difference between them. However, intravaginal MgSO4 reduced labor duration more effectively. It shortened the latent phase by 3.0 hours (95% credible intervals [CrI], 2.2 to 3.9) compared with dexamethasone (1.8 hours; 95% CrI, 1.2 to 2.4) and the active phase by 1.99 hours (95% CrI, 1.03 to 2.99) compared with 1.09 hours (95% CrI, 0.54 to 1.71), with a posterior probability of superiority exceeding 99.9%. All neonates had Apgar scores ≥8.</p><p><strong>Conclusion: </strong>Intravaginal MgSO4 produced cervical effacement and dilation comparable to IV dexamethasone but achieved a significantly greater reduction in labor duration. Given similar neonatal safety outcomes, these findings suggest that intravaginal MgSO4 may be a preferable first-line agent for labor acceleration.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"172-182"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582517","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":"Maternal morbidity and cumulative infant mortality among women with disabilities: a nationwide population-based study in Korea, 2013-2022.","authors":"Kyung Ju Lee, Seokmin Lee, Inhye Kim, Jinah Park","doi":"10.5468/ogs.25402","DOIUrl":"10.5468/ogs.25402","url":null,"abstract":"<p><strong>Objective: </strong>This nationwide population-based descriptive study examined differences in fertility trends, infant mortality, and maternal morbidity between women with and without disabilities in Korea using linked National Health Insurance Service (NHIS) data from 2013 to 2022.</p><p><strong>Methods: </strong>The study included women of reproductive age (15-49 years) with live births, identified through NHIS eligibility files, claims data, mortality records, and the maternal-neonatal linked database. Disability status was categorized as physical, internal, or mental. Annual birth trends, cumulative mortality among live-born infants at 1 and 5 years, and maternal morbidity during the antepartum, intrapartum, and postpartum periods were compared between women with and without disabilities.</p><p><strong>Results: </strong>Among 2,861,120 mothers, births among women with disabilities declined more steeply than those among women without disabilities, accompanied by a shift in peak fertility from ages 30-34 to 35-39 years. Infants born to women with disabilities experienced consistently higher cumulative mortality throughout follow-up, with disparities widening over time. Across all perinatal periods, women with disabilities had lower overall maternal morbidity than women without disabilities, with morbidity occurring more frequently during pregnancy and delivery than during the post-partum period in both groups.</p><p><strong>Conclusion: </strong>These findings highlight important differences in reproductive patterns and infant health outcomes that warrant comprehensive, disability-informed maternal care spanning the antepartum period through enhanced postpartum recovery services. Further research linking administrative data with clinical and social datasets is needed to characterize the morbidity burden more accurately and identify modifiable gaps in care.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"191-201"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784019","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 value of platelet rich plasma in women with intrauterine adhesions. A systematic review and meta-analysis.","authors":"Nour A El-Goly, Ahmed M Maged, Sally El-Attar, Nada Kamal, Mohamed N Farid","doi":"10.5468/ogs.26001","DOIUrl":"https://doi.org/10.5468/ogs.26001","url":null,"abstract":"<p><p>To evaluate the benefits of platelet-rich plasma administration after adhesiolysis in women with intrauterine adhesions. A database search using the keywords (autologous platelet-rich plasma) AND (intrauterine adhesions) and their Medical Subject Headings terms revealed 11 studies with 1,130 participants. Endometrial thickness was reported in four studies with 274 participants. The mean difference effect estimate was 0.53 with a 95% confidence interval (CI) of 0.23, 0.82; P<0.001, and I²=0%. The menstrual pattern after the procedure showed that the odds ratio (OR) effect estimates for amenorrhea, hypomenorrhea, and normal menstruation were 6.47 (0.24, 174.08), 0.84 (0.41, 1.73), and 1.21 (0.51, 2.84), respectively, and the P-values were 0.27, 0.63, and 0.66, respectively. The number of women with adhesions after the procedure showed that the OR effect estimates for grade I, II, and III adhesions were 1.74 (0.41, 7.45), 0.76 (0.21, 2.70), and 0.31 (0.11, 0.88), respectively, and the P-values were 0.46, 0.67, and 0.03, respectively. Changes in the American Fertility Society (AFS) score after the operation were reported in three studies with 276 participants. The mean difference effect estimate was 0.87, with a 95% CI of 0.17, 1.56; P=0.01; I²=0%. The clinical pregnancy rate was reported in five studies involving 506 participants. The OR effect estimate was 1.80 with a 95% CI of 1.18, 2.75; a P-value of 0.006, and I² of 0%. Platelet-rich plasma administration after hysteroscopic adhesiolysis improved endometrial thickness (low evidence), recurrence of grade III adhesions (low evidence), AFS score of adhesions (low evidence), and clinical pregnancy rates (moderate evidence).</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783954","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":"Synergistic effects of melatonin and dienogest on pain relief in endometriosis: a randomized controlled trial.","authors":"Mahroo Rezaeinejad, Homa Homam, Parand Gheshlaghi, Leila Jafari, Shahed Shoari, Marjan Ghaemi","doi":"10.5468/ogs.25053","DOIUrl":"https://doi.org/10.5468/ogs.25053","url":null,"abstract":"<p><strong>Objective: </strong>Endometriosis affects 5-10% of reproductive-aged women and is characterized by chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. Standard hormonal therapies, such as dienogest, effectively manage symptoms, but are often associated with side effects and high recurrence rates after discontinuation. This study investigated the efficacy of melatonin as an adjunct to dienogest for reducing endometriosis-associated pain.</p><p><strong>Methods: </strong>Ninety-four women with ultrasonography-confirmed ovarian endometrioma were randomized 1:1 to receive melatonin+dienogest or placebo+dienogest for 6 months. Analyses were performed on both per-protocol (PP; n=52) and intention-to-treat bases (ITT; n=94). The primary outcome was dysmenorrhea measured using the visual analog scale. The secondary outcomes included dyspareunia, pelvic pain, dyschezia, quality of life (World Health Organization quality of life-brief version [WHOQOL-BREF]), and clinical symptoms (Biberoglu&Behrman [B&B] scale).</p><p><strong>Results: </strong>Dysmenorrhea scores decreased significantly more in the melatonin arm (Δ=-1.3 points; P=0.011 PP; Δ=-1.2; P=0.014 ITT). No significant between-group differences were observed in dyspareunia, pelvic pain, or dyschezia. WHOQOL-BREF scores improved by 6.5±9.2 points in the melatonin group and 5.9±8.7 in the placebo group (P=0.71). B&B composite pain scores decreased by 4.1±2.9 (melatonin) and 3.8±3.0 (placebo) (P=0.64). No serious adverse events occurred; however, vertigo was more frequent in the melatonin group (53.8% vs. 7.7%).</p><p><strong>Conclusion: </strong>Adjunctive melatonin therapy with dienogest significantly improved dysmenorrhea compared with dienogest alone. However, the addition of melatonin did not yield significant improvements in other pain domains or quality of life indices. These results support the use of melatonin as a targeted adjunct treatment for menstrual pain during endometriosis.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582610","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":"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":2.5,"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":2.5,"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":2.5,"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":"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":2.5,"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}