Acta Obstetricia et Gynecologica Scandinavica最新文献

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Feasibility and acceptability of a brief online acceptance and commitment therapy intervention to reduce fear of childbirth: A novel application of a third-wave cognitive behavioral therapy focused on psychological flexibility and acceptance. 一个简短的在线接受和承诺治疗干预减少分娩恐惧的可行性和可接受性:第三波认知行为治疗的新应用,专注于心理灵活性和接受性。
IF 3.1 2区 医学
Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-07-30 DOI: 10.1111/aogs.70023
Abbey A Ashton, Jane Wilson, Pauline Slade
{"title":"Feasibility and acceptability of a brief online acceptance and commitment therapy intervention to reduce fear of childbirth: A novel application of a third-wave cognitive behavioral therapy focused on psychological flexibility and acceptance.","authors":"Abbey A Ashton, Jane Wilson, Pauline Slade","doi":"10.1111/aogs.70023","DOIUrl":"https://doi.org/10.1111/aogs.70023","url":null,"abstract":"<p><strong>Introduction: </strong>Fear of childbirth (FOC) is a significant issue for many women. However, findings from studies of psychological interventions to reduce FOC are equivocal. Resource constraints highlight the need for brief interventions. Previous research demonstrated that a face-to-face single session acceptance and commitment therapy (ACT) intervention showed promise. The National Health Service (NHS) Long Term Plan for England highlights a wish to increase digitalization. There is a need to test online adaptations of interventions. This study aimed to assess the feasibility and acceptability, and preliminary indications of effectiveness of an online ACT group intervention for individuals who experience FOC in their first pregnancy.</p><p><strong>Material and methods: </strong>Participants were recruited via an NHS maternity service to attend an online two-session, small group, ACT intervention. Information on recruitment, retention, and qualitative and quantitative feedback on the sessions was gathered. Primary outcome measures (FOC and anxiety) and secondary measures (psychological flexibility and coping style) to identify potential mechanisms of change were completed pre-intervention and 2 weeks following the second session.</p><p><strong>Results: </strong>Seven two-session groups ran with 25 individuals participating in both sessions, indicating good feasibility. All participants were retained and provided follow-up data. Feedback information suggested that the intervention was highly acceptable. Statistical and clinical reductions in FOC and anxiety were found. Statistically significant changes in psychological flexibility and coping style offer preliminary hypotheses regarding potential mechanisms of change.</p><p><strong>Conclusions: </strong>A two-session online ACT group intervention tailored for FOC appears feasible and acceptable and shows promise in terms of impact. A pilot randomized controlled trial is warranted.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Burnout, wellbeing and defensive medical practice in obstetricians and gynecologists in the UK before and after the COVID pandemic: A repeated cross-sectional survey study. COVID大流行前后英国妇产科医生的职业倦怠、健康和防御性医疗实践:一项重复的横断面调查研究。
IF 3.1 2区 医学
Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-07-29 DOI: 10.1111/aogs.70006
Nina Parker, Nora Falconieri, Harsha Shah, Christoph Lees, Dirk Timmerman, Ben Van Calster, Tom Bourne
{"title":"Burnout, wellbeing and defensive medical practice in obstetricians and gynecologists in the UK before and after the COVID pandemic: A repeated cross-sectional survey study.","authors":"Nina Parker, Nora Falconieri, Harsha Shah, Christoph Lees, Dirk Timmerman, Ben Van Calster, Tom Bourne","doi":"10.1111/aogs.70006","DOIUrl":"https://doi.org/10.1111/aogs.70006","url":null,"abstract":"<p><strong>Introduction: </strong>There is evidence that burnout rates in doctors are high following the COVID pandemic, but with considerable variation across geographical location and specialty. In 2018, we performed a UK-wide survey of obstetrics and gynecology (O&G) doctors, providing baseline data on burnout, wellbeing, and defensive medical practice (DMP) directly before the pandemic. This study aims to determine the prevalence of burnout, poor wellbeing, and DMP in obstetricians and gynecologists after the pandemic, to compare these to pre-pandemic levels, and to explore the relationship between burnout, poor wellbeing, and DMP.</p><p><strong>Material and methods: </strong>This was a repeated national cross-sectional survey study. Practicing obstetrics and gynecology doctors registered with the Royal College of Obstetricians and Gynaecologists (RCOG) were eligible to participate. In 2022, an email containing a survey link was sent to 7388 UK doctors registered with the RCOG. The same method and measures were used as in our previous 2018 study. Burnout prevalence was assessed using the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI). Wellbeing and DMP were assessed using self-report questionnaires.</p><p><strong>Results: </strong>The response rate for the post-pandemic survey was 19% (1400/7388) and 55% (3102/5661) for the pre-pandemic survey. A total of 1114 out of 1400 (80%) met the inclusion criteria and completed the MBI. Burnout criteria were met in 72%, compared with 36% before the pandemic (adjusted odds ratio [AOR] 4.7, 95% confidence interval [CI] 4.0 to 5.5). Highest levels were seen in trainees (80%). Thirty-nine percent of doctors reported DMP compared with 13% pre-pandemic. Worse doctor wellbeing was reported across all items; 62% of doctors reported anxiety, 31% depression, and 9% suicidal thoughts compared with 33%, 14%, and 3% pre-pandemic. Burnout was associated with DMP and poor wellbeing, including suicidal thoughts, depression, and anxiety.</p><p><strong>Conclusions: </strong>This national study suggests high levels of burnout in obstetricians and gynecologists compared with pre-pandemic levels, particularly in trainees. There was a probable decline in wellbeing compared with pre-pandemic levels. Poor wellbeing and DMP were associated with burnout. Burnout interventions to improve doctor wellbeing, quality of care, and patient safety are urgently needed.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Kristeller misunderstood?
IF 3.1 2区 医学
Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-07-28 DOI: 10.1111/aogs.70030
Matthias David
{"title":"Kristeller misunderstood?","authors":"Matthias David","doi":"10.1111/aogs.70030","DOIUrl":"https://doi.org/10.1111/aogs.70030","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Survey of practices in the European Federation for Colposcopy: HPV vaccination after treatment for cervical precancerous lesions. 欧洲阴道镜检查联合会的实践调查:宫颈癌前病变治疗后接种HPV疫苗。
IF 3.1 2区 医学
Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-07-27 DOI: 10.1111/aogs.70027
Annu Heinonen, Ilkka Kalliala, Anne Hammer, Maggie Cruickshank, Xavier Carcopino, Björn Strander, Pekka Nieminen
{"title":"Survey of practices in the European Federation for Colposcopy: HPV vaccination after treatment for cervical precancerous lesions.","authors":"Annu Heinonen, Ilkka Kalliala, Anne Hammer, Maggie Cruickshank, Xavier Carcopino, Björn Strander, Pekka Nieminen","doi":"10.1111/aogs.70027","DOIUrl":"https://doi.org/10.1111/aogs.70027","url":null,"abstract":"<p><strong>Introduction: </strong>Patients treated for cervical precancerous lesions have a long-term increased risk for cervical cancer compared with the general population. As human papillomavirus (HPV) vaccination is effective in preventing cervical cancer and its precursors when given prior to sexual debut, adjuvant HPV vaccination in relation to the treatment of precursor lesions has been of great interest. Existing supporting data are of low quality, and recent meta-analyses called for high-quality randomized controlled trials. The European Federation for Colposcopy (EFC) observed a heterogeneity in clinical practices of adjuvant vaccination, and this survey aimed to assess potential differences in vaccination practices across Europe.</p><p><strong>Material and methods: </strong>A survey was sent out to 100 representatives of the 32 member countries of the EFC. The survey was in English and contained questions on current general HPV vaccination programs, whether guidelines on vaccination after treatment exist, and questions on respondents' own practices of recommending vaccination after treatment. The survey was constructed using the Google Forms web platform and sent by email to representatives of each National Colposcopy Society.</p><p><strong>Results: </strong>In total, 44 answers from 32 different European countries were received. Overall, 12 countries (12/32, 37.5%) reported having a national guideline on HPV vaccination at the time of treatment for precursor lesions, and in nine of these countries, adjuvant HPV vaccination is recommended. A third, 31.8%, of respondents (14/44) found the available evidence sufficient to recommend vaccination at the time of treatment, and 54.5% (24/44) found the evidence to be nearly sufficient. Only 13.6% (6/44) of the respondents found the current evidence insufficient to be able to recommend vaccination. Altogether, 29.5% (13/44) of respondents would recommend vaccination, even if future randomized controlled trials would not show benefits.</p><p><strong>Conclusions: </strong>The varying practices regarding adjuvant HPV vaccination across European countries are concerning and call for ethical evidence-based practices across Europe and reliance on high-quality evidence to assess whether vaccination at the time of treatment is effective.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endometriosis-The scapegoat for pelvic pain? 子宫内膜异位症——骨盆疼痛的替罪羊?
IF 3.5 2区 医学
Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-07-27 DOI: 10.1111/aogs.70014
Gernot Hudelist, Ezgi Darici Kurt, Davor Jurkovic, Tina Tellum
{"title":"Endometriosis-The scapegoat for pelvic pain?","authors":"Gernot Hudelist, Ezgi Darici Kurt, Davor Jurkovic, Tina Tellum","doi":"10.1111/aogs.70014","DOIUrl":"https://doi.org/10.1111/aogs.70014","url":null,"abstract":"<p><p>Cyclic and noncyclic chronic pelvic pain (CPP) represent a major problem for both affected patients and healthcare providers due to its effects on physical and mental health. In times of social media and digitalization, awareness of endometriosis as a leading cause of CPP is increasing. However, a close look at the current literature does not support endometriosis as the predominant and most common cause of pelvic pain syndromes and associated morbidities. Consequently, other or additional factors may be overlooked, complex pain mechanisms simplified, and symptoms misunderstood, resulting in less optimal treatment concepts. This commentary underlines the necessity to evaluate patients with CPP and suspected endometriosis in a multifactorial and holistic context to provide a better framework of patient care.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Linear association between endometrial thickness and live birth in single blastocyst transfers: A dual-center retrospective cohort study. 单囊胚移植子宫内膜厚度与活产之间的线性关联:一项双中心回顾性队列研究。
IF 3.5 2区 医学
Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-07-26 DOI: 10.1111/aogs.70024
Lidan Liu, Qiuying Gan, Qianyi Huang, Bin Zeng, Mujun Li, Huimei Wu
{"title":"Linear association between endometrial thickness and live birth in single blastocyst transfers: A dual-center retrospective cohort study.","authors":"Lidan Liu, Qiuying Gan, Qianyi Huang, Bin Zeng, Mujun Li, Huimei Wu","doi":"10.1111/aogs.70024","DOIUrl":"https://doi.org/10.1111/aogs.70024","url":null,"abstract":"<p><strong>Introduction: </strong>Our objective was to investigate the linear relationship between endometrial thickness (EMT) and live birth rates (LBR) in single vitrified-warmed blastocyst transfer (SVBT) cycles, and evaluate EMT's independent effect on LBR.</p><p><strong>Material and methods: </strong>A retrospective cohort study analyzed 3375 SVBT cycles conducted at two reproductive centers between June 2016 and December 2022. EMT was stratified into tertiles (<7 mm, 7-8.8 mm, 8.8-10.0 mm, >10.0 mm). Generalized linear models and restricted cubic splines were used to assess the EMT-LBR relationship, adjusting for potential confounders, including maternal age, body mass index, gravidity, parity, and blastocyst quality. Subgroup analyses examined interactions with demographic and clinical variables.</p><p><strong>Results: </strong>Significant positive associations were observed between EMT and LBR across all subgroups. For each 1 mm increase in EMT, the likelihood of live birth increased by 7% (OR = 1.07, 95% CI: 1.03-1.11, p = 0.001). The highest improvements in LBR were seen in women with EMT between 8.8 and 10 mm (OR = 2.37), with a plateau effect observed beyond 10 mm. Subgroup analyses confirmed the consistency of this association across clinical subgroups, with no significant interactions with variables such as maternal age, gravidity, and hormonal profiles. The restricted cubic spline analysis further supported a robust linear positive correlation, remaining stable even after adjusting for potential confounders. These findings emphasize the significant role of EMT in predicting live birth outcomes in assisted reproductive technology.</p><p><strong>Conclusions: </strong>The study confirms a significant linear association between EMT and live birth in SVBT cycles. Higher EMT is consistently linked to improved LBRs, with the most benefit observed around 10 mm. These findings highlight EMT as a key predictor in assisted reproductive technology and emphasize the need for further research to optimize endometrial preparation strategies.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pattern of unreported negative birth experiences in the maternity ward. 产科病房中未报告的负面分娩经历的模式。
IF 3.5 2区 医学
Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-07-25 DOI: 10.1111/aogs.70008
Mette Kring Clausen, Søren Bie Bogh, Søren Fryd Birkeland, Lars Morsø
{"title":"Pattern of unreported negative birth experiences in the maternity ward.","authors":"Mette Kring Clausen, Søren Bie Bogh, Søren Fryd Birkeland, Lars Morsø","doi":"10.1111/aogs.70008","DOIUrl":"https://doi.org/10.1111/aogs.70008","url":null,"abstract":"<p><strong>Introduction: </strong>Denmark is one of the safest places for childbirth, yet some women report dissatisfaction with their maternity care. However, some negative birth experiences may remain unreported due to thresholds for complaining. The study aimed to identify patterns of unreported negative birth experiences and to quantify the extent of these dark figures.</p><p><strong>Material and methods: </strong>A survey was distributed to 3081 women who gave birth at a Danish hospital in 2022, resulting in 1022 responses (response rate = 33.2%). The women reported their birth experiences in categories based on the Healthcare Complaints Analysis Tool (HCAT), specifying problems, harm caused, and whether they had filed a complaint or intended to. Dark figure ratios regarding problems and harm levels were calculated by comparing unreported negative experiences to formally filed complaints based on the survey responses, covering each problem type and harm level.</p><p><strong>Results: </strong>Of the 1022 respondents, 336 (32.9%) women reported negative birth experiences, yet only 26 women had filed complaints. The remaining 310 unreported cases comprised 787 problems across HCAT categories. The most frequent problems were about communication and quality. The highest dark figure ratios were found within the management domain comprising institutional processes (13.0) and environment (9.9). The dark figure ratios showed an inverse relationship with harm severity, being highest for minimal (19.5) and minor (21.2) harm levels and decreasing for moderate (5.5), major (4.8) and catastrophic (0.3) harm levels.</p><p><strong>Conclusions: </strong>This study demonstrates a substantial underestimation of negative birth experiences when relying solely on formal complaints, with dark figure ratios ranging from 4.8 to 13, depending on the issue. The inverse relationship between harm severity and dark figure ratios suggests a threshold for filing a complaint, as the likelihood of reporting increases with greater harm. These findings provide novel insights into unreported maternity care experiences, highlighting the need to integrate patient experiences into healthcare improvements.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between intimate partner violence and birth outcomes among pregnant women in the STOP-VIO-PREG cohort: A cohort study utilizing Patient-Reported Outcome and Danish registers data. STOP-VIO-PREG队列中孕妇亲密伴侣暴力与分娩结局之间的关系:一项利用患者报告结果和丹麦登记数据的队列研究。
IF 3.5 2区 医学
Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-07-25 DOI: 10.1111/aogs.15175
Lea B S Ankerstjerne, Ditte Linde, Berit Schei, Chunsen Wu, Kristina Martha Renault, Hanne Kristine Hegaard, Janet Fanslow, Vibeke Rasch
{"title":"Association between intimate partner violence and birth outcomes among pregnant women in the STOP-VIO-PREG cohort: A cohort study utilizing Patient-Reported Outcome and Danish registers data.","authors":"Lea B S Ankerstjerne, Ditte Linde, Berit Schei, Chunsen Wu, Kristina Martha Renault, Hanne Kristine Hegaard, Janet Fanslow, Vibeke Rasch","doi":"10.1111/aogs.15175","DOIUrl":"https://doi.org/10.1111/aogs.15175","url":null,"abstract":"<p><strong>Introduction: </strong>Adverse birth outcomes, such as preterm birth, low birthweight, and small for gestational age, are critical indicators of neonatal health. While the impact of biomedical risk factors is well established, the role of psychosocial stressors, including intimate partner violence, remains less understood. This study investigates the association between intimate partner violence among pregnant women and adverse birth outcomes in a Danish context.</p><p><strong>Material and methods: </strong>Based on routinely collected Patient-Reported Outcomes, we conducted a cohort study, including 28 697 pregnant individuals. Enrolled in the period from November 2019 to September 2022, the women were followed until childbirth, leading to 22 799 mothers-offspring pairs with valid data. Data on IPV exposure were collected through the Abuse Assessment Screen, detecting physical, psychological, and sexual violence and fear of partner. Birth outcomes were obtained from the Danish registries, including the Danish medical birth registry. Generalized linear models (GLMs) were used to calculate risk ratios (RRs) and 95% confidence intervals (CIs), adjusting for confounders, such as maternal age, socioeconomic position, smoking status, and psychiatric disorders.</p><p><strong>Results: </strong>Of the 22 799 mothers, 5.3% screened positive for intimate partner violence, and 1.9% reported intimate partner violence within the last year. Intimate partner violence was positively associated with preterm birth and low birthweight, with an increased risk of preterm birth (adjusted RR: 1.24, 95% CI 1.06, 1.45) and increased risk for low birthweight (adjusted RR: 1.35, 95% CI 1.04, 1.75) but showed no significant association with small for gestational age (adjusted RR: 0.93, 95% CI 0.78, 1.11).</p><p><strong>Conclusions: </strong>Our analysis demonstrates a significantly heightened risk of preterm birth and low birthweight among pregnant women who screened positive for intimate partner violence. These results underscore the need for targeted intimate partner violence screening and intervention strategies during prenatal care to reduce the burden of adverse birth outcomes.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term outcomes of fertility-sparing treatment in endometrial carcinoma and endometrial intraepithelial neoplasia: Recurrence risk factors over a 9-year follow-up. 保留生育能力治疗子宫内膜癌和子宫内膜上皮内瘤变的长期结果:9年随访的复发危险因素
IF 3.5 2区 医学
Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-07-23 DOI: 10.1111/aogs.70028
Ya-Ting Hsu, Heng-Cheng Hsu, Chia-Yi Lee, Wan-Ting Hung, Chi-Hau Chen
{"title":"Long-term outcomes of fertility-sparing treatment in endometrial carcinoma and endometrial intraepithelial neoplasia: Recurrence risk factors over a 9-year follow-up.","authors":"Ya-Ting Hsu, Heng-Cheng Hsu, Chia-Yi Lee, Wan-Ting Hung, Chi-Hau Chen","doi":"10.1111/aogs.70028","DOIUrl":"https://doi.org/10.1111/aogs.70028","url":null,"abstract":"<p><strong>Introduction: </strong>Fertility-sparing treatments using oral progestins have demonstrated promising oncologic outcomes for endometrial intraepithelial neoplasia and early-stage endometrial cancer. However, the high recurrence rate remains a major concern, and the literature on long-term follow-up outcomes is limited. This study aimed to identify recurrence risk factors by analyzing clinicopathological and molecular profiles in a cohort with a median follow-up of 9 years.</p><p><strong>Material and methods: </strong>This retrospective study included patients under 45 years of age who were diagnosed with endometrial intraepithelial neoplasia or endometrial cancer and received fertility-sparing treatments at our center between 2010 and 2021. Patients who achieved complete responses were categorized according to recurrence status. Demographic, clinical, and molecular data were compared between groups. The primary endpoint was to identify risk factors for recurrence; secondary endpoints assessed obstetric and oncologic outcomes in patients with relapse.</p><p><strong>Results: </strong>Out of 40 patients, 8 underwent hysterectomy within 1.5 years, while 32 responded to treatment and continued follow-up. The recurrence and non-recurrence groups contained 20 and 12 patients, respectively, with a median follow-up of 107.5 months (range, 35-175 months). Multivariate analysis showed that a family history of cancer (HR = 2.597, p = 0.039) and treatment with megestrol acetate as the initial therapy (HR = 3.130, p = 0.021) were independent risk factors for shorter time to recurrence. Although mismatch repair deficiency was positively correlated with recurrence, the association did not reach statistical significance (p = 0.057). Four out of 24 patients were upstaged after hysterectomy, and all were in the recurrence group. Nine patients (22.5%) achieved pregnancy, with three successfully conceiving after achieving complete response following retreatment.</p><p><strong>Conclusions: </strong>In patients with long-term follow-up after fertility-sparing treatment, a family history of cancer and initial treatment with megestrol acetate were significantly associated with recurrence.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-time telementoring in gynecology ultrasound: Impact on patient pathway and postgraduate training. 妇科超声实时远程监护:对患者路径和研究生培养的影响。
IF 3.5 2区 医学
Acta Obstetricia et Gynecologica Scandinavica Pub Date : 2025-07-23 DOI: 10.1111/aogs.70029
Sughashini Murugesu, Jennifer Barcroft, Alex Novak, Bara'a Elhag, Srdjan Saso, Tom Bourne
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