Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"Even low levels of anticardiolipin antibodies are associated with pregnancy-related complications: A monocentric cohort study","authors":"Veronika Viktoria Matraszek, Ladislav Krofta, Ilona Hromadnikova","doi":"10.1111/aogs.15096","DOIUrl":"10.1111/aogs.15096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Moderate and high levels of anticardiolipin antibodies (aCL), especially in the setting of the antiphospholipid syndrome, are associated with adverse obstetric outcomes. However, the clinical relevance of low aCL levels (<40 MPL/GPL units) is still a matter of debate. The aim of the study was to evaluate obstetric outcomes in pregnancies with low immunoglobulin M (IgM) and/or immunoglobulin G (IgG) aCL positivity. The association between low aCL positivity and maternal baseline characteristics was also studied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>The retrospective monocentric cohort study of prospectively collected data involved a total 3047 singleton pregnancies that underwent the first-trimester screening involving an aCL test and delivered on site. Obstetric outcomes were compared between the low-titer aCL group (IgM ≥7 MPL units and <40 MPL units and/or IgG ≥10 GPL units and <40 GPL units) and the aCL negative group (IgM <7 MPL units and IgG <10 GPL units, reference group). In addition, obstetric outcomes were evaluated with regard to the antibody isotype: IgM-positive group (IgM <40 MPL units, IgG negative) and IgG-positive group (IgG <40 GPL units, IgM negative or <40 MPL units).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, the occurrence of pregnancy-related complications was significantly higher (27.91% vs. 19.32%, <i>p</i> = 0.034) in the low-titer aCL group. Concerning the antibody isotype, a higher rate of pregnancy-related complications was observed in the IgG-positive group (54.55% vs. 19.32%, <i>p</i> = 0.001), but not in the IgM-positive group (22.43% vs. 19.32%, <i>p</i> = 0.454). The stillbirth rate did not reach statistical significance. Low-titer aCL pregnancies were more frequently of advanced maternal age (<i>p</i> < 0.001), suffered from autoimmune diseases (<i>p</i> < 0.001), chronic hypertension (<i>p</i> = 0.040), and hereditary thrombophilia (<i>p</i> = 0.040). In addition, they had more often a positive history of stillbirth (<i>p</i> < 0.001), underwent conception via assisted reproductive technologies (<i>p</i> < 0.001), were administered low-dose aspirin (<i>p</i> < 0.001), low-molecular-weight heparin (<i>p</i> = 0.018) and immunomodulatory drugs (<i>p</i> < 0.001), and delivered earlier (<i>p</i> = 0.018).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Even low aCL levels are associated with a higher incidence of pregnancy-related complications, but only in the case of IgG antibody isotype presence.","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 5","pages":"897-905"},"PeriodicalIF":3.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15096","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of instrument choice on fear of childbirth after assisted vaginal delivery: A secondary analysis of the Bergen birth study","authors":"Sindre Grindheim, Svein Rasmussen, Johanne Kolvik Iversen, Jørg Kessler, Elham Baghestan","doi":"10.1111/aogs.15097","DOIUrl":"10.1111/aogs.15097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Assisted vaginal delivery has been associated with a negative childbirth experience and the development of secondary fear of childbirth, although it is less consistent than emergency Cesarean delivery. Whether the choice of instrument influences this, and the woman's preference for delivery mode in a potential subsequent pregnancy, is unknown. Our objective was to assess the association between the choice of instrument during assisted vaginal delivery, secondary fear of childbirth, and preference for an elective Cesarean delivery in a potential subsequent pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Study design: Secondary analysis of Bergen birth study, a prospective observational study assessing maternal and neonatal outcomes after assisted vaginal delivery in primiparas at term, inclusion period: June 2021–April 2023. Wijma Delivery Expectancy/Experience Questionnaire version B was completed within a week after delivery. This validated instrument has 33 questions, a total score range from 0 to 165, and a score of ≥85 was used as a cutoff to define fear of childbirth. Preferred mode of delivery in a potential subsequent pregnancy, pain, and overall birth experience was also measured. Main outcome measures: Secondary fear of childbirth and request for Cesarean delivery in the next pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>132 women after forceps, 160 after vacuum, and 139 after spontaneous delivery answered the questionnaires. Overall prevalence of secondary fear of childbirth was 12.2% after spontaneous and 14.4% after both forceps and vacuum deliveries. Compared with spontaneous delivery, the adjusted odds ratio of developing fear of childbirth was aOR 1.63 (95% CI 0.45–5.17, <i>p</i> = 0.4) after vacuum and aOR 1.71 (95% CI 0.43–6.14, <i>p</i> = 0.4) after forceps delivery. Secondary fear of childbirth (aOR: 11.3 (95% CI 5.30–24.6), <i>p</i> < 0.001) and maternal age ≥35 (aOR: 3.66 (95% CI: 1.49–8.81), <i>p</i> = 0.004) were associated with a preference for cesarean delivery in a potential subsequent pregnancy. Severe pain was reported just as often in the spontaneous delivery cohort (33.8%) as in the vacuum (25.6%) and forceps (24.2%) cohorts. Less than 5% in each cohort indicated that they were very unsatisfied with their birth experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The choice of instrument during assisted vaginal delivery was not associated with secondary fear of childbirth or preference for cesarean delivery in a potential subsequent ","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 5","pages":"886-896"},"PeriodicalIF":3.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional associations between endometriosis and Sjögren's syndrome in the era of multi-omics","authors":"Li-Tzu Wang, Naoko Sasamoto, Jon Ivar Einarsson, Marc R. Laufer, Kevin Sheng-Kai Ma","doi":"10.1111/aogs.15089","DOIUrl":"10.1111/aogs.15089","url":null,"abstract":"<p>We appreciate Zervou and Goulielmos' interest in our research on the bidirectional associations between endometriosis and Sjögren's syndrome (SS). We fully agree that certain genetic factors are critically shared among patients afflicted with both conditions, as these factors could play a pivotal role in identifying potential therapeutic targets for treating both diseases.<span><sup>1</sup></span> Understanding these shared genetic influences is essential, given that they may help guide interventions that could significantly improve the quality of life for those affected by endometriosis and SS.</p><p>Our population-based cohort study, coupled with our transcriptomics analysis, fortifies this perspective by demonstrating that “dendritic cell maturation” and the “hepatic fibrosis signaling pathway” were significantly enriched in both endometriosis and SS.<span><sup>2</sup></span> These findings suggest that similar underlying mechanisms may drive the pathophysiology of these disorders. Zervou and Goulielmos' observations regarding the upregulation of key proteins such as B-cell activating factor (<i>BAFF</i>), <i>HLA-DQA1</i>, and <i>HLA-DRA</i> in both diseases further underline the importance of adaptive immunity and inflammatory pathways,<span><sup>1</sup></span> which we believe are fundamental components that intersect across these conditions.</p><p>Moreover, Zervou and Goulielmos' observations highlighted that interleukin (IL)-1 receptor antagonist (<i>IL1-Ra</i>) and cytotoxic T-lymphocyte-associated protein 4 (<i>CTLA-4</i>) were upregulated in both diseases.<span><sup>1</sup></span> This upregulation indicates the complexity of the biological interactions at play, illustrating how interconnected immune responses may contribute to the development of both diseases. We agree that more efforts are always warranted to investigate the effects of other contributing factors on both disease entities. For instance, environmental factors, such as air pollutants, may as well exacerbate primary SS by upregulating inflammatory pathways through the involvement of the IL-6 pathway and NF-kB signaling.<span><sup>3</sup></span></p><p>Collectively, these findings are clinically relevant not only in elucidating the associations between endometriosis and SS but also in providing a solid framework for studying the established links between endometriosis and the long-term risk of other illnesses, including malignancies such as endometrial cancer and uterine sarcoma.<span><sup>4</sup></span> For example, pathways involving <i>CTLA-4</i> and <i>IL1-Ra</i> have also been implicated in the pathogenesis of endometrial malignancies.<span><sup>3, 4</sup></span> By investigating the shared genetic factors between endometriosis and SS, we may identify novel biomarkers that could predict the onset of these comorbidities in high-risk populations, as well as other long-term conditions.</p><p>Additionally, since our transcriptomic analyses were derived from bulk RNA samp","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 6","pages":"1220-1221"},"PeriodicalIF":3.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of placental to fetal ratio with pregnancy duration","authors":"Carl P. S. Kulseng,&nbsp;Silje Sommerfelt,&nbsp;Kari Flo,&nbsp;Kjell-Inge Gjesdal,&nbsp;Helene F. Peterson,&nbsp;Vigdis Hillestad,&nbsp;Karianne Sagberg,&nbsp;Anne Eskild","doi":"10.1111/aogs.15082","DOIUrl":"10.1111/aogs.15082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Our objective was to study the association of placental size, fetal size, and placental size relative to fetal size (placental to fetal ratio) at gestational week 27 with time to spontaneous delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>We included 100 pregnancies in a follow-up study from gestational week 27 until spontaneous delivery. Placental and fetal volume (in cm³) were measured at gestational week 27 by magnetic resonance imaging (MRI), and the association of placental to fetal ratio (placental volume/fetal volume) with delivery after spontaneous onset of labor was estimated as hazard ratios (HR) by applying Cox regression models. Pregnancies with deliveries after planned cesarean section or induction of labor provided follow-up time until these events. An HR lower than 1.0 indicates decreased risk of spontaneous delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean placental volume was 532 cm³ (SD 136 cm³) at gestational week 27, and fetal volume was 961 cm³ (SD 112 cm³). This yielded a mean placental to fetal ratio of 0.55 (SD 0.12). The HR of spontaneous delivery decreased with increasing placental to fetal ratio (HR 0.013 (95% CI: 0.001–0.121), Wald statistic 14.704 (<i>p</i> &lt; 0.001)), indicating a longer duration of pregnancy with a higher placental to fetal ratio at gestational week 27. The HR of spontaneous delivery also decreased with increasing placental size, but the association was less prominent than the HR associated with placental to fetal ratio (HR 0.997 [95% CI: 0.995–0.999], Wald statistic 7.638 [<i>p</i> = 0.006]). We estimated no association with fetal size (HR 1.001 [95% CI 0.999–1.003], Wald statistic 1.728 [<i>p</i> = 0.189]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that the placental to fetal ratio at gestational week 27 may be an indicator of the remaining duration of pregnancy until the onset of spontaneous labor.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 5","pages":"913-921"},"PeriodicalIF":3.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperthermic intraperitoneal chemotherapy after upfront cytoreductive surgery for stage III epithelial ovarian cancer: Follow-up of long-term survival","authors":"Ziying Lei,&nbsp;Yue Wang,&nbsp;Runya Fang,&nbsp;Ke Wang,&nbsp;Jun Tian,&nbsp;Yangxiao Chen,&nbsp;Yingsi Wang,&nbsp;Jiali Luo,&nbsp;Jinfu He,&nbsp;Binghui Ding,&nbsp;Xianzi Yang,&nbsp;Li Wang,&nbsp;Shuzhong Cui,&nbsp;Hongsheng Tang,&nbsp;the Chinese Peritoneal Oncology Study group (Gynecologic Oncology Study group)","doi":"10.1111/aogs.15094","DOIUrl":"10.1111/aogs.15094","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The survival benefit of hyperthermic intraperitoneal chemotherapy (HIPEC) has been well defined at the time of interval cytoreductive surgery, but the role of HIPEC remains uncertain for patients with newly diagnosed advanced ovarian cancer in the upfront setting. The present study aimed to report the updated long-term survival outcomes after 5 years of follow-up from our previous multicenter retrospective cohort study to compare primary cytoreductive surgery (PCS) plus HIPEC with PCS alone among women with stage III epithelial ovarian cancer.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Material and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study was conducted at five high-volume gynecological medical centers in China from January 2010 to May 2017. Eligible patients with complete data were treated with either PCS combined with HIPEC or PCS alone. The 5-year overall survival (OS) rate was updated to compare PCS plus HIPEC with PCS alone. The inverse probability of treatment weighting (IPTW) method based on a propensity score model for each patient was used to control the confounding factors and evaluate the effect of HIPEC.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Data from 789 patients, a total of 584 eligible stage III epithelial ovarian cancer patients were ultimately included in the analysis (PCS-plus-HIPEC group, &lt;i&gt;n&lt;/i&gt; = 425; PCS-alone group, &lt;i&gt;n&lt;/i&gt; = 159). After IPTW adjustment, the median OS was 44.5 (95% CI, 40.1–49.1) months in the PCS-plus-HIPEC group and 32.4 (95% CI, 28.8–40.3) months in the PCS-alone group (weighted hazard ratio, 0.74; 95% CI, 0.59–0.93; &lt;i&gt;p&lt;/i&gt; = 0.006). At 5 years, the OS rates were 37.9% (95% CI, 33.0%–42.8%) in the PCS-plus-HIPEC group and 26.4% (95% CI, 18.9%–34.6%) in the PCS-alone group (&lt;i&gt;p&lt;/i&gt; = 0.007). After stratification into optimal and suboptimal cytoreduction subgroups, patients in the PCS-plus-HIPEC group maintained a greater association with improved OS than those in the PCS-alone group. Among the women who underwent optimal cytoreduction in the PCS-plus-HIPEC group and PCS-alone group, the median OS was 49.9 (95% CI, 45.2–58.4) months and 37.8 (95% CI, 30.5–53.0) months (&lt;i&gt;p&lt;/i&gt; = 0.042) while the 5-year OS rate was 43.7% (95% CI, 37.7%–49.6%) and 33.2% (95% CI, 23.3%–43.5%), respectively (&lt;i&gt;p&lt;/i&gt; = 0.040). Meanwhile, for those treated with suboptimal cytoreduction subgroup in the PCS-plus-HIPEC and PCS-alone groups, the median OS was 28.4 (95% CI, 22.2–39.9) months and 20.6 (95% CI, 10.6–32.4) months (&lt;i&gt;p&lt;/i&gt; = 0.099) while the 5-year OS rate was 22.4% (95% CI, 15.1%–30.5%) and 12.2% (95% CI, 4.4%–24.2%), respectively (&lt;i&gt;p&lt;/i&gt; = 0.060). The median follow-up period was 87.2 (95% ","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 5","pages":"988-997"},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonographic diagnosis of fetal eye anomalies and their association with syndromal diseases: A retrospective multicenter analysis of 264 cases","authors":"Jorge Jiménez Cruz,&nbsp;Paul Böckenhoff,&nbsp;Laura Tascón Padrón,&nbsp;Norah Emrich,&nbsp;Philipp Kosian,&nbsp;Brigitte Strizek,&nbsp;Cristoph Berg,&nbsp;Eva Weber,&nbsp;Ulrich Gembruch,&nbsp;Annegret Geipel","doi":"10.1111/aogs.15085","DOIUrl":"10.1111/aogs.15085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aims to systematically describe eye malformations and correlate these with extraocular findings. Based on these findings, we propose a protocol for ultrasound evaluation of the fetal eye.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>In this multicentric retrospective cohort study, 264 fetuses with ocular malformations from two tertiary referral centers for prenatal medicine were analyzed. Anophthalmia, microphthalmia, exophthalmos, hyper- or hypotelorism, cataract, aphakia, cyclopia, and retinal detachment were assessed, and their association with extraocular findings and genetic changes was investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The majority of the cases (99.2%) were non-isolated and presented further extraocular findings. Most commonly, the brain and central nervous system (65.9%), the limbs and the heart (46.6% each) and the cranial anatomy (41.2%) were affected. Significant associations were found between exophthalmos and anomalies of the fetal skeletal system (OR = 4.8, 95% CI 1.6–14) and cranial malformations (OR = 3.3, 95% CI 1.5–7.4). Hypotelorism showed an increased risk of cardiac anomalies (OR = 1.8, 95% CI 1.1–3.5) and brain malformations (OR = 2.16, 95% CI 1.2–4.1), with holoprosencephaly being the most common one. Fetuses with microphthalmia were more likely to have anomalies in the renal system (OR = 2.3, 95% CI 1.2–4.3). In 51.4% of the cases, a genetic aberration could be found, among them most frequently trisomy 13.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is a significant association between specific fetal eye anomalies and certain extraocular anomalies, as well as genetic changes. Systematic evaluation of the eye using the proposed protocol is simple to learn and highly reproducible and could help to concentrate diagnosis on a certain group of malformations. Data from this study could help to develop targeted diagnostic molecular tools.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 5","pages":"850-859"},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential prenatal diagnosis of fetal skeletal dysplasia: A cohort study","authors":"Mengting Jiang,&nbsp;Bin Zhang,&nbsp;Jing Wang,&nbsp;Wei Qiao,&nbsp;Xiuzhen Mao,&nbsp;Bin Yu","doi":"10.1111/aogs.15095","DOIUrl":"10.1111/aogs.15095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Genetic factors are considered to be the main factors leading to fetal skeletal dysplasia (SD), and chromosomal microarray analysis (CMA) has been used clinically for the detection of SD fetuses. At present, whole exome sequencing (WES) has been applied in SD fetuses, but there is still a lack of data accumulation. The aim of this study is to perform sequential prenatal diagnosis for fetuses with SD indicated by ultrasound and to explore the clinical value of CMA followed by WES.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>From January 2019 to May 2024, 147 fetuses with SD were detected by prenatal ultrasound screening. After the collection of amniotic fluid or abortive tissue, CMA was performed first, then WES was performed in the cases with a negative CMA result.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>147 cases accepted the prenatal CMA test, and 23 cases were reported to have chromosomal abnormalities, including 9 cases of chromosomal aneuploidies, 11 cases of pathogenic copy number variants, and 3 cases of likely pathogenic copy number variants. The detection rate of chromosomal abnormalities by the prenatal CMA test was 15.6% (23/147). 58 cases with negative results of CMA underwent WES, and 21 genes with pathogenic/likely pathogenic variants were detected in 21 cases, including <i>FGFR3</i>, <i>COL2A1</i>, <i>COL1A1</i>, <i>COL1A2</i>, <i>RUNX2</i>, <i>LMX1B</i>, <i>GLI3</i>, <i>SHOX</i>, <i>ALPL</i>, and <i>DYNC2H1</i>. The rate of abnormal prenatal WES was 36.2% (21/58). In the subgroup analysis of the SD phenotype, the detection rate of chromosomal abnormalities in isolated SD fetuses was 7.7% (7/91), which was significantly lower than that in SD fetuses combined with other system abnormalities (28.6%, 16/56) (<i>p</i> = 0.001). The detection rate of monogenic abnormalities in short long bones with other skeletal abnormalities was 62.5% (10/16), which was higher than that in short long bones with non-skeletal abnormalities 10.5% (2/19), and the difference was statistically significant (<i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SD is mostly caused by monogenic abnormalities, and prenatal WES has significantly improved the detection rate of SD fetuses. The prenatal WES can be used as an important molecular genetic testing method combined with CMA in the sequential prenatal diagnosis of SD fetuses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 5","pages":"860-874"},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for lymph ascites after surgery for endometrial cancer and impact on lymphedema of the legs. A prospective longitudinal Swedish multicenter study","authors":"Madelene Wedin,&nbsp;Karin Glimskär Stålberg,&nbsp;Ulrika Ottander,&nbsp;Åsa Åkesson,&nbsp;Gabriel Lindahl,&nbsp;Ninnie Borendal Wodlin,&nbsp;Preben Kjølhede","doi":"10.1111/aogs.15077","DOIUrl":"10.1111/aogs.15077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The primary aim was to determine the occurrence of lymph ascites 4–6 weeks after surgery for endometrial cancer. Secondary aims were to assess risk factors for lymph ascites and the association with lymphedema of the legs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This was a post hoc analysis of an observational prospective multicenter study, performed in 14 Swedish hospitals that included 235 women undergoing surgery for early-stage endometrial cancer between June 2014 and January 2018; 116 underwent surgery including pelvic and para-aortic lymphadenectomy and 119 had surgery without lymphadenectomy. Lymph ascites (free intraabdominal fluid or encapsulated pelvic or para-aortic fluid) was assessed by vaginal ultrasound 4–6 weeks postoperatively. Lymphedema was assessed using circumferential measurements of the legs preoperatively and 1 year postoperatively, enabling estimation of leg volume. A BMI-standardized leg volume increase ≥10% was classified as lymphedema. Evaluation of risk factors was performed using multiple logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Lymph ascites 4-6-weeks postoperatively occurred in 28.5% (67/235) of the women. The estimated volume of the lymph ascites in these women was mean 28 mL (standard deviation 48 mL) and median 14 mL (interquartile range 2–36 mL). Lymphadenectomy was a risk factor for lymph ascites (aOR 9.97; 95% CI 4.53–21.97) whereas the use of minimally invasive surgery (aOR 0.50; 95% CI 0.25–0.99) reduced the risk. Twenty-two of 231 women (9.5%) developed lymphedema of the legs 1 year after surgery. The presence of lymph ascites was predictive of lymphedema (aOR 3.90; 95% CI 1.52–9.96).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lymph ascites was common 4–6 weeks after surgery but in a low and clinically insignificant volume. Lymphadenectomy was a strong risk factor for lymph ascites and the use of minimally invasive surgery seemed to reduce the risk. Detection of lymph ascites at early postoperative follow-up may be a means of selecting patients at high risk of developing lymphedema after treatment with endometrial cancer for preventive measures against lymphedema progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 5","pages":"976-987"},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal study of family formation in 892 women and 193 men 8 years after visiting the Fertility Assessment and Counselling (FAC) clinic","authors":"Randi Sylvest,&nbsp;Ida Vittrup,&nbsp;Ditte Vassard,&nbsp;Marte Saupstad,&nbsp;Søren Ziebe,&nbsp;Elisabeth Larsen,&nbsp;Helene Westring Hvidman,&nbsp;Kathrine Birch Petersen,&nbsp;Henriette S. Nielsen,&nbsp;Lone Schmidt,&nbsp;Anja Pinborg","doi":"10.1111/aogs.15071","DOIUrl":"10.1111/aogs.15071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Globally, in high-income countries, couples have been delaying family building. However, postponed childbearing implies a higher risk of declining fertility, not achieving desired family size and ultimately involuntary childlessness. The Fertility Assessment and Counseling (FAC) clinic was established to provide information about individuals' current fertility status, aiming to prevent infertility and support the realization of desired family sizes. The aim is to explore the reproductive outcomes and health behaviors 8 years after attending fertility assessment and counseling in the FAC clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Cohort study including women and men who attended the FAC clinic in Copenhagen, Denmark, from 2011 to 2017. From June 2011 until July 2017 2635 women and 1073 men attended fertility counseling at the FAC clinic. Eight years later, an electronic questionnaire was distributed to collect information on subsequent pregnancies and deliveries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The follow-up questionnaire had a response rate of 34% (<i>n</i> = 892) for women and 18% for men (<i>n</i> = 193). The mean age for the subgroup of 892 women who responded at 8 years follow-up was 32.6 (±SD 4.4) years at baseline which was equal to the total cohort of 2635 women at baseline (32.7 (±SD 4.7) years). Most of the women (75%) and men (96%) were in a heterosexual relationship at follow-up. A total of 85% of the 892 women had conceived after the baseline FAC visit. Among those having conceived, the mean number of pregnancies was 2.10 per woman (±SD 1.1). In total, 703 (79%) of the 892 women had delivered at least one child. Among women having delivered, the average number of children was 2.0 (±SD 0.6). Among the men, 91% had conceived with their partner. Women and men were smoking less and drinking less alcohol at the follow-up compared to the baseline visit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This follow-up study emphasizes the importance of fertility assessment and counseling for women and couples during reproductive age, a critical period when decisions about family building are made.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 5","pages":"922-936"},"PeriodicalIF":3.5,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The severity of second-degree perineal tears and dyspareunia during one year postpartum: A prospective cohort study","authors":"Jeanette Risløkken,&nbsp;Marthe Dalevoll Macedo,&nbsp;Kari Bø,&nbsp;Marie Ellström Engh,&nbsp;Franziska Siafarikas","doi":"10.1111/aogs.15084","DOIUrl":"10.1111/aogs.15084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Childbirth-related injuries of the pelvic floor may impact women's sexual health with symptoms such as dyspareunia. A better understanding of dyspareunia based on tissue trauma severity in second-degree tears is needed. The primary aim of this study was to assess differences in dyspareunia according to the severity of perineal tears, with a focus on subcategories of second-degree tears at three and twelve months postpartum. The secondary aim was to assess the time to resumption of intercourse after birth according to the severity of second-degree tears.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This single-center observational cohort study was conducted between January 2021 and July 2022. Women meeting the inclusion criteria were included during pregnancy. After birth, all perineal tears were classified according to RCOG recommendation, and second-degree tears were further subcategorized based on the percentage of damage to the perineum (2A, 2B, 2C). Dyspareunia and time to resumption of intercourse were collected through an electronic questionnaire at three and twelve months postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our study included 857 women; of them, 51.6% (<i>n</i> = 442) were primipara and 48.4% (<i>n</i> = 415) were multipara. The percentages of women reporting dyspareunia according to the degree of the tear at three months postpartum were as follows: no tear/first-degree tear 60%, 2A-tear 60%, 2B-tear 52%, 2C-tear 77%, and episiotomy 77%; and at twelve months postpartum: no tear/first-degree tear 52%, 2A-tear 50%, 2B-tear 40%, 2C-tear 69%, and episiotomy 64%. When comparing dyspareunia between the no tear/first-degree tear category and the second-degree subcategories, no statistically significant differences were found. Women in all second-degree subcategories resumed intercourse approximately 4.8 months postpartum, compared to 3.8 months postpartum for those with no tear or first-degree tear (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was no statistically significant association between the severity of second-degree tears and dyspareunia. The proportion of women reporting dyspareunia is noticeable for all perineal tear categories, with the highest rate among women with the most severe second-degree perineal tear. Women in all second-degree subcategories resumed intercourse approximately one month later than those with no tear or first-degree tear.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 5","pages":"968-975"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}