Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"Mediator bias and methodological limitations in the evaluation of physiological CTG interpretation.","authors":"Boujenah Jérémy","doi":"10.1111/aogs.70317","DOIUrl":"10.1111/aogs.70317","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"2116-2117"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434537","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":"Genotype-directed therapy for non-small cell lung cancer diagnosed during pregnancy: A pooled analysis of seven cases from the Cancer and Pregnancy Registry with maternal and neonatal outcomes and review of the literature.","authors":"Reed Firestone, John Gaughan, Elyce Cardonick","doi":"10.1111/aogs.70303","DOIUrl":"10.1111/aogs.70303","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnant patients with cancer are routinely excluded from the clinical trials, limiting the evidence to guide the management of advanced malignancies during pregnancy. Data regarding maternal and neonatal outcomes associated with genotype-directed therapy for non-small cell lung cancer (NSCLC) during pregnancy remain limited.</p><p><strong>Material and methods: </strong>We conducted a retrospective multicenter, pooled analysis of pregnant patients diagnosed with NSCLC between 2002 and 2024 who were enrolled in the Cancer and Pregnancy Registry (ClinicalTrials.gov identifier: NCT02749474). Consecutive cases diagnosed during pregnancy were included. Clinical presentation, tumor histology and stage, biomarker and molecular profiling, oncologic treatment administered during pregnancy, obstetric management, maternal outcomes, and neonatal outcomes including pediatric developmental follow-up were systematically reviewed and analyzed.</p><p><strong>Results: </strong>Seven pregnant patients were diagnosed with NSCLC at a median gestational age of 22.4 weeks (range, 10.4-28.8 weeks). Five patients presented with stage IV disease, one with stage III disease, and one with stage II disease. Biomarker testing identified actionable alterations in all 6 patients who underwent testing, including epidermal growth factor receptor (EGFR) mutations or amplification (n = 4), anaplastic lymphoma kinase (ALK) rearrangement (n = 1), and ROS1 rearrangement (n = 1). Biomarker-directed therapy, including osimertinib or alectinib, was administered during the second or third trimester in 3 patients. All pregnancies resulted in live births, including one dichorionic diamniotic twin gestation, yielding eight infants. Median gestational age at delivery was 34.9 weeks. Five infants were small for gestational age, and two required early intervention for prematurity-related developmental delays. No congenital anomalies or placental metastases were observed. Four patients remained alive and clinically stable at least 2.3 years after diagnosis, while all mothers survived to or beyond their child's first birthday.</p><p><strong>Conclusions: </strong>In this limited retrospective study, biomarker-directed therapy during pregnancy was associated with maternal disease control and continuation of pregnancy into later gestation in selected patients. No major fetal toxicity signal was identified; however, these findings should not be interpreted as establishing the safety of targeted therapy during pregnancy. Early biomarker testing and individualized multidisciplinary management may help inform treatment decision-making for carefully selected patients with NSCLC diagnosed during pregnancy.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"2089-2096"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410037","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":"Prediction of coarctation of the aorta in fetuses with transposition of great arteries: Inverted ventricular discrepancy as a predictor of arch repair in TGA.","authors":"Cosimo Marco Campanale, Patrizio Moras, Serena Ventrella, Marco Masci, Luciano Pasquini, Alessandra Toscano","doi":"10.1111/aogs.70321","DOIUrl":"https://doi.org/10.1111/aogs.70321","url":null,"abstract":"<p><strong>Introduction: </strong>Transposition of great arteries (TGA) with coarctation of the aorta (CoA) is a rare association but increases surgical complexity and worsens outcomes. Despite improvements in prenatal diagnosis, CoA remains difficult to diagnose before birth. Fetal ventricular discrepancy is a predictor of CoA in normal cardiac anatomy, and the smaller the mitral valve/ tricuspid valve (MV/TV) annulus diameters ratio, the higher the probability of CoA after birth. The aim of this study was to describe the features of MV/TV ratio in fetuses with TGA and CoA and to explore its predictive value for CoA and aortic arch repair at birth.</p><p><strong>Material and methods: </strong>This is a retrospective study at a tertiary center. We selected all cases of TGA from January 2011 to December 2024 excluding complex and/or associated anomalies. We reviewed all fetal echocardiograms available and, at the first diagnostic exam, we measured MV, TV, aortic valve (AV) and pulmonary valve (PV) annulus diameters, and MV/TV and AV/PV ratios were calculated. Transverse aortic arch, isthmus, descending aorta, and ductus arteriosus diameters were measured. We reviewed post-natal diagnosis and surgical reports. Follow-up was extended until the first year of age in terms of aortic re-coarctation, late diagnosis of CoA and reoperations.</p><p><strong>Results: </strong>We identified 188 TGA, among which 19 (10%) had CoA. TGA/VSD were 34 (18%) and TGA/IVS 154 (82%). Among the 136 prenatally diagnosed, 11 had CoA (8%). MV/TV ratio was higher in TGA/CoA group than in isolated TGA group (p < 0.001) and AV/PV ratio was smaller in TGA/CoA compared to isolated TGA (p < 0.001). ROC analysis was performed for the MV/TV ratio discriminating fetuses with TGA/CoA. A cut off value of 1 yielded a sensitivity of 100% and a specificity of 91.5% (AUC 0.99, p < 0.001).</p><p><strong>Conclusions: </strong>We confirmed that the RV is smaller in TGA/CoA than in TGA alone; thus, the ventricular discrepancy is in favor of the LV. MV/TV ratio is a good predictor of CoA in fetuses with TGA, and a cutoff of 1 can be used to discriminate neonates at need for arch repair after birth.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13629825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102744","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":"Women's experiences, responses, and coping strategies when testing positive for human papillomavirus in cervical cancer screening: A qualitative study.","authors":"Joan Hansen, Beth J Maclin, Birgitte Folmann, Jane Ege Møller, Ane Kersti Skaarup Knudsen, Vibeke Raaby, Anne Hammer","doi":"10.1111/aogs.70311","DOIUrl":"10.1111/aogs.70311","url":null,"abstract":"<p><strong>Introduction: </strong>Many countries, including Denmark, are adopting human papillomavirus-based cervical screening due to its higher sensitivity compared to cytology. However, the sexually transmitted nature of HPV may evoke psychosexual distress. We aimed to explore: (1) women's psychosexual experiences, and (2) factors that shape their experiences and coping strategies in relation to routine cervical cancer screening.</p><p><strong>Material and methods: </strong>We conducted a qualitative study at the Department of Obstetrics and Gynecology, Gødstrup Hospital, Denmark from September 2024 to February 2025. We included women aged 30-60 referred to colposcopy due to a high-risk HPV-positive screening. Women were excluded if they had a previous history of excisional treatment. We conducted in-depth semi-structured interviews. All interviews were audiotaped and transcribed verbatim, after which a thematic analysis was performed using a phenomenological approach.</p><p><strong>Results: </strong>We included 21 women with a median age of 42.5 years (range: 32-55 years). Receiving a high-risk HPV result by mail left women without immediate support or information, causing feelings of anxiety about cancer risk, confusion about their health and next steps in treatment. The general practitioner (GP) was perceived as a source of reassurance, but was not always easily accessible. Recognizing the impact of HPV as a sexually transmitted virus triggered feelings of guilt, shame, and embarrassment, as well as sensations of uncleanliness and bodily disconnection. The diagnosis also strained relationships and disrupted sexual intimacy. Although the follow-up gynecological consultation with colposcopy was reassuring, it was experienced as complex due to emotional burdens such as stigma and shame. A sense of needing to simply \"comply\" also hindered open discussion about the sexual nature of HPV and the expression of personal concerns.</p><p><strong>Conclusions: </strong>Based on a practice theoretical framework, this study shows that women's experiences following a high-risk HPV diagnosis in the context of cervical screening are not merely individual responses to medical information, but should be understood within a broader psychological, social, and cultural context that shapes how women process and cope with the diagnosis. These findings underscore the need for a holistic approach to patient care that fosters supportive and informative practices for women affected by HPV, coupled with a broader societal effort to reduce stigma and increase public awareness.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"2104-2113"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590127","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 predictive value of early-pregnancy mean platelet volume for preeclampsia: A meta-analysis.","authors":"Zsófia R Erdélyi, Balázs Mészáros, Zoltán Herold, Tamas Marton, Beata Hargitai, Nándor Ács, Zoltán Kukor, Sándor Valent","doi":"10.1111/aogs.70338","DOIUrl":"https://doi.org/10.1111/aogs.70338","url":null,"abstract":"<p><strong>Introduction: </strong>Preeclampsia is a hypertensive disorder of pregnancy that affects 3-7% of pregnancies globally and is a leading cause of maternal mortality worldwide. Early prediction is crucial for improving maternal and fetal outcomes, but it remains a significant challenge. During pregnancy, hormonal and immunological changes create a hypercoagulable, pro-inflammatory state that leads to endothelial injury, increased platelet consumption, and the release of larger, newly produced and activated platelets, resulting in elevated mean platelet volume (MPV).</p><p><strong>Material and methods: </strong>This meta-analysis aimed to quantify the association between MPV measured in early pregnancy and the subsequent development of preeclampsia, differentiating between its subtypes. A systematic search was conducted in five databases, namely: PubMed, Cochrane Library, Scopus, Embase, and Web of Science up to July 2025. The study was registered in PROSPERO (CRD420251091010). Eligible studies included data on MPV measurements in pregnant women before 20 weeks of gestation who were later diagnosed with or without preeclampsia. Following data extraction, random effects (network) meta-analysis models were performed to calculate the pooled mean difference (MD) and ratio of means (ROM) in MPV between women who developed preeclampsia and normotensive controls. Subgroup analyses were performed for early-onset vs. late-onset and severe vs. mild preeclampsia.</p><p><strong>Results: </strong>Twenty studies involving 3050 preeclamptic patients and 12 522 normotensive controls were included. Women who later developed preeclampsia-irrespective of their preeclampsia subgroups-had higher MPV values in early pregnancy (before 20 weeks of gestation) compared to controls, with a pooled MD and ROM of +0.5681 fL [95% confidence interval (CI): +0.2144 to +0.9217; p = 0.0016] and 105.83% (95% CI: 102.11-109.69%; p = 0.0019), respectively. Subgroup analyses indicated a stronger association in more severe forms of the disease, with a greater MD observed in early-onset preeclampsia (MD = +0.6943 fL, 95% CI: -0.2361 to +1.6246, p = 0.1436; ROM: 107.44%; p = 0.1684) and severe preeclampsia (MD = +0.4201 fL, 95% CI: +0.1210 to +0.7192, p = 0.0059; ROM: 104.26%; p = 0.0064) compared to their controls.</p><p><strong>Conclusion: </strong>Elevated MPV in early pregnancy is associated with an increased risk of developing preeclampsia, particularly its severe and early-onset forms.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102718","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":"Active surveillance of cervical intraepithelial neoplasia and adverse pregnancy outcomes: A register-based cohort study.","authors":"Kirstine Kold Katholm, Lotte Krog Eriksen, Kathrine Dyhr Lycke, Ninna Lund Larsen, Iben Sundtoft, Tina Hovgaard Randrup, Anne Hammer","doi":"10.1111/aogs.70304","DOIUrl":"10.1111/aogs.70304","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have suggested that human papillomavirus (HPV) and HPV-related disease may be associated with increased risk of adverse pregnancy outcomes, e.g., hypertensive disorders of pregnancy, small for gestational age (SGA), and gestational diabetes mellitus (GDM). As active surveillance for cervical intraepithelial neoplasia grade 2 (CIN2) leaves the lesion and underlying infection untreated, we aimed to investigate whether the risk of adverse pregnancy outcomes differs between women who undergo active surveillance for CIN2 compared to women having an immediate large loop excision of the transformation zone (LLETZ).</p><p><strong>Material and methods: </strong>We conducted a nationwide register-based cohort study in Denmark. Individual-level data was collected from Danish healthcare registers. We included women aged 18-40 with a first-time diagnosis of CIN2 between January 1, 1998, and December 31, 2018, and a subsequent singleton birth. We estimated the risk of hypertensive disorder of pregnancy, SGA, and/or GDM in a subsequent pregnancy. We calculated crude and adjusted relative risks (aRR) adjusting for potential confounders using modified Poisson regression.</p><p><strong>Results: </strong>We included 10 537 women with CIN2 and a subsequent singleton birth; 4430 women (42%) underwent active surveillance, and 6107 women (58%) had a LLETZ. We identified 548 (5.2%) cases of hypertensive disorders of pregnancy, 379 cases of SGA (3.6%), and 315 cases of GDM (3.0%). For all three outcomes, the adjusted relative risk was comparable between active surveillance and immediate LLETZ (aRR 1.08 (95% CI 0.91-1.29), aRR 0.94 (95% CI 0.74-1.19), aRR 0.92 (95% CI 0.73-1.16), respectively). Stratified analyses revealed insignificant differences in the risk of hypertensive disorders of pregnancy, SGA, and GDM.</p><p><strong>Conclusions: </strong>No association was found between CIN2 management and risks of hypertensive disorders, SGA, or GDM in later pregnancy. These findings suggest that untreated HPV-related lesions do not increase adverse pregnancy risks and may help reassure women during clinical counseling about future pregnancies after CIN2 treatment.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"2097-2103"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359027","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":"Commentary on central sensitization in chronic pelvic pain.","authors":"Shahzadi Gulfishan, Ahmed Raza, Abdullah Aman","doi":"10.1111/aogs.70292","DOIUrl":"10.1111/aogs.70292","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"2114-2115"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359087","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":"Robust associations between physiological CTG interpretation and improved neonatal outcomes after excluding tocolysis.","authors":"Sophia Andres, Frank Reister, Kay Stankov","doi":"10.1111/aogs.70337","DOIUrl":"10.1111/aogs.70337","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"2118-2119"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148667967","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":"Interpreting comparative effectiveness of vacuum-assisted hemorrhage control and uterine balloon tamponade: The impact of temporal and clinical confounding.","authors":"Archana Mehta, Hemant Gopalrao Deshpande, Kotina Shridevi, Deepika Raina, Hariharan Srinivasan","doi":"10.1111/aogs.70367","DOIUrl":"10.1111/aogs.70367","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079381","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":"Predictive factors for chronic pain related to childbirth: A prospective cohort study.","authors":"Beata Molin, Susanne Georgsson, Anna-Karin Berger, Anna Sand","doi":"10.1111/aogs.70368","DOIUrl":"10.1111/aogs.70368","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic postpartum pain is an understudied maternal health issue, and large prospective studies examining predictive factors are scarce. This study aimed to identify predictive factors for chronic pain 8 months after childbirth.</p><p><strong>Material and methods: </strong>This exploratory analysis was based on data from a prospective multicenter cohort study. Data were collected through two questionnaires and the Obstetrix record system. Swedish-speaking women who gave birth to a live infant completed a baseline questionnaire 24-36 h postpartum (n = 1507), with follow-up at 8 months. Chronic pain was defined as pain with onset in relation to labor and still present at 8 months postpartum. A total of 1171 women (77.7%) completed the eight-month follow-up questionnaire and were included in the analyses. Crude and multivariable logistic regression analyses were performed to identify factors associated with chronic postpartum pain.</p><p><strong>Results: </strong>Eight months after giving birth, 89/1171 (7.6%) of the women reported chronic pain related to labour. In the multivariable logistic regression analysis, menstrual pain before pregnancy (aOR 2.07, 95% CI 1.24-3.47), dyspareunia before pregnancy (aOR 2.08, 95% CI 1.12-3.89), chronic pain before pregnancy (aOR 2.11, 95% CI 1.19-3.74), pain lasting more than 3 months during pregnancy (aOR 2.14, 95% CI 1.24-3.70), and moderate or severe acute postpartum pain (NRS 4-10; aOR 2.16, 95% CI 1.16-4.02) were independently associated with chronic postpartum pain.</p><p><strong>Conclusions: </strong>Pain-related conditions before and during pregnancy, together with moderate or severe acute postpartum pain, were associated with chronic postpartum pain 8 months after childbirth. Several predictive factors can be identified before childbirth, providing an opportunity to identify women at increased risk, while acute postpartum pain underscores the importance of timely pain assessment and management.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079369","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}