Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"Pebbled mosaic-like heterogeneous echogenicity in ovarian immature teratomas and correlation of ultrasound patterns with pathological grades.","authors":"Tianyu Zhang, Jie Yang, Xiaohua Shi, Zhenzhen Liu, Dan Wang, Yang Zhou, Na Su, Jiaxin Yang","doi":"10.1111/aogs.70360","DOIUrl":"10.1111/aogs.70360","url":null,"abstract":"<p><strong>Introduction: </strong>Ovarian immature teratomas (ITs) are rare malignant ovarian tumors predominantly affecting young women and adolescents. Distinguishing these lesions preoperatively is clinically challenging. This study aimed to describe the clinical and sonographic features of ITs and evaluate the correlation between sonographic manifestations and pathological grades.</p><p><strong>Material and methods: </strong>This retrospective study reviewed the medical records of patients with pure ovarian ITs treated at Peking Union Medical College Hospital between 2017 and 2025. Two experienced gynecologic sonologists independently reassessed the original ultrasound images, recorded the sonographic features and O-RADS category of each mass, and classified the tumors into four predefined sonographic patterns based on imaging pattern recognition. Associations between sonographic features and pathological grade were assessed using Fisher's exact test or Spearman's rank correlation analysis.</p><p><strong>Results: </strong>Thirty patients with histologically confirmed pure ovarian ITs were included, with a median age of 25.2 years (range 7.0-39.0 years). Serum AFP elevation was observed in 56.7% of patients. Pathological grades were distributed as grade 1 (36.7%), grade 2 (36.7%), and grade 3 (26.7%). FIGO stage was predominantly stage IA (46.7%) and IC (50.0%). The median maximum tumor diameter was 16.7 cm (range 5.1-28.2 cm). Grayscale ultrasonography demonstrated solid components in all tumors, with 9 (30.0%) being purely solid and 21 (70.0%) being cystic-solid. Tumor rupture was identified during surgery in 77.8% of patients presenting with solid morphology on ultrasonography. All tumors demonstrated the \"pebbled mosaic sign\" within solid components, manifested as heterogeneous echogenicity on a hypoechoic grayscale background, with scattered hyperechoic foci, localized fatty-like homogeneous hyperechoic areas, and anechoic vesicles. Moderate vascularity was observed in 76.7% of tumors. Minimal and abundant vascularity were seen in 20.0% and 3.3% of tumors, respectively. Solid morphology was associated with higher pathological grade.</p><p><strong>Conclusions: </strong>The \"pebbled mosaic sign\" describes the characteristic heterogeneous sonographic appearance of the solid component of ovarian ITs. Solid tumors classified as pattern 1 may be associated with a higher pathological grade.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149035939","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":"Diagnostic performance and feasibility of classifying placental umbilical cord insertion during routine prenatal ultrasound.","authors":"Ine Hildershavn Moen, Synnøve Lian Johnsen, Jørg Kessler, Alexander Vietheer, Svein Rasmussen, Cathrine Ebbing","doi":"10.1111/aogs.70359","DOIUrl":"10.1111/aogs.70359","url":null,"abstract":"<p><strong>Introduction: </strong>Abnormal cord insertion (velamentous or marginal) is associated with adverse perinatal outcomes, and guidelines recommend prenatal diagnosis when feasible. However, the diagnostic performance and feasibility of classification of the placental cord insertion in an ultrasound screening setting remain uncertain. The aim of the study was to evaluate the feasibility and diagnostic performance of prenatal classification of placental cord insertion site.</p><p><strong>Material and methods: </strong>This prospective observational study was conducted at a Norwegian tertiary center from May 2017 to August 2023. Pregnant women with singleton pregnancies attending the routine ultrasound scans were invited to participate and enrolled after written informed consent. During the scan, the distance between the umbilical cord insertion and the placental edge (the \"test variable\") was measured. At birth, cord insertion was categorized as normal, abnormal (velamentous (≤0 mm) or marginal (1-24 mm) from the placental edge), or unclassifiable. Diagnostic performance of the measured distance by ultrasound to predict insertion type at birth was evaluated using area under the receiver operating characteristic curve (AUC), with adjustment for covariates in Bayesian logistic regression, including sonographer experience. Sensitivity, specificity, and positive and negative predictive values, including optimal thresholds (Youden and Closest top-left criteria), were estimated.</p><p><strong>Results: </strong>In total, 2859 examinations were carried out, and 2553 examinations in 1919 pregnancies were between 11 and 18 gestational weeks and included in the analyses. Of these, 634 had two examinations. Cord insertion site was classifiable in all but 14/2859 examinations (0.49%). The AUC for prenatal identification of abnormal cord insertion was 0.76. Using the Youden threshold, sensitivity was 0.64 and specificity 0.76; using the Closest top-left threshold, sensitivity was 0.69 and specificity 0.70. Negative predictive values exceeded 0.90, whereas positive predictive values (PPVs) were lower. Diagnostic performance was higher for velamentous cord insertion specifically (AUC = 0.89) than for abnormal insertion overall. Adjusting for additional covariates (operator experience and maternal characteristics) minimally affected AUC estimates.</p><p><strong>Conclusions: </strong>Assessment of the umbilical cord insertion during routine prenatal ultrasound was feasible and demonstrated high negative but limited PPV, suggesting that cord insertion assessment may be incorporated into routine antenatal imaging to support risk stratification.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13601763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029405","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":"Sexual function in women with a history of sexual assault: A cross-sectional study.","authors":"Sigrid Bergsmyr, Signe Nilssen Stafne, Cecilie Therese Hagemann","doi":"10.1111/aogs.70314","DOIUrl":"10.1111/aogs.70314","url":null,"abstract":"<p><strong>Introduction: </strong>There is inconsistency in the literature regarding how a history of sexual assault influences adult sexual function. Our objective was to investigate the association between a history of sexual assault (as a child, as an adult, or both) vs. no history of sexual assault and various aspects of sexual function, including sexual activity, overall sexual function, and specific subdomains such as desire, arousal, lubrication, orgasm, satisfaction, and pain.</p><p><strong>Material and methods: </strong>For this cross-sectional descriptive study, 397 women (47% response rate) answered an online survey targeting validation of a pelvic pain questionnaire. Sexual function was measured using the Female Sexual Function Index (FSFI). History of sexual assault, demographic, gynecological, and other health-related variables were collected. Comparisons were done by chi square, variance, and multiple logistic regression analyses.</p><p><strong>Results: </strong>Of the 394 participants, 38 (9.6%) reported child sexual assault, 56 (14.2%) adult sexual assault, and 26 (6.6%) both child and adult sexual assault. Sexual activity did not differ between groups. Among the 261 sexually active participants, the total FSFI mean score was 26.4 (standard deviation 5.5). Women reporting adult sexual assault or both child and adult sexual assault had lower total FSFI mean scores than those reporting child sexual assault only or no history of sexual assault (p = 0.005). The same pattern was observed for the arousal (p = 0.008) and orgasm (p = 0.003) subdomains. In contrast, lower pain subdomain scores were reported by women with a history of child sexual assault or both child and adult sexual assault (p = 0.005). After adjustment for potential confounders, only adult sexual assault was associated with low overall sexual function (adjusted odds ratio 2.5, 95% confidence interval 1.2-5.2).</p><p><strong>Conclusions: </strong>Our findings confirm the previously demonstrated association between a history of adult sexual assault and low overall sexual function. However, the different exposures seem to relate differently to the various dimensions of sexual functioning. It is essential that healthcare professionals treating individuals with pelvic pain or diminished sexual function remain vigilant to the potential impact of sexual assault history and are encouraged to address this issue proactively and sensitively in clinical practice.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015222","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":"Incidence and risk factors for postpartum infections: A Norwegian cohort study, 2012-2020.","authors":"Kjerstine Røe, Ingvil Krarup Sørbye, Cecilie Fredvik Torkildsen, Anders Engeland, Hilde Marie Engjom, Roy Miodini Nilsen, Kari Klungsøyr","doi":"10.1111/aogs.70355","DOIUrl":"10.1111/aogs.70355","url":null,"abstract":"<p><strong>Introduction: </strong>Few epidemiological studies have examined postpartum infections in the Nordic countries. This study aimed to assess the incidence and risk factors for postpartum infections in Norway.</p><p><strong>Material and methods: </strong>We conducted a historical cohort study including all deliveries in Norway from 2012 to 2020, using linked nationwide data from the Medical Birth Registry of Norway, the Norwegian Patient Registry, and Statistics Norway. We defined two outcomes: endometritis/puerperal sepsis (O85, International Classification of Diseases 10th version (ICD-10); the code does not differentiate between endometritis and puerperal sepsis, and endometritis predominates) and other postpartum infections (O86, ICD-10). Associations were estimated as relative risks (RR) with 95% confidence intervals (CI) using log-binomial regression.</p><p><strong>Results: </strong>Among 516 874 deliveries, we identified 5942 cases (1.15%) of endometritis/puerperal sepsis (O85) and 8833 (1.71%) of other postpartum infections (O86). The incidence of endometritis/puerperal sepsis increased over time from 0.93% in 2012 to 1.38% in 2020 (test for trend, p < 0.001). After adjusting for all covariates, delivery-related factors demonstrated the strongest associations with both outcomes, especially emergency cesarean section (aRR_O85 2.8; 95% CI 2.6-3.0/aRR_O86 5.1; 95% CI 4.8-5.5) and postpartum hemorrhage (aRR_O85 3.2; 2.9-3.4/aRR_O86 2.0; 1.9-2.2). Risk factors not directly related to delivery, such as multifetal gestation, obesity, nulliparity and maternal single status, were also associated with both outcomes (aRRs in the range of 1.2-2.5). Chorioamnionitis lies on the same infectious continuum as postpartum endometritis and is treated with intrapartum antibiotics, usually discontinued after delivery unless persisting signs of infection. We found a strong association between chorioamnionitis/intrapartum infection and postpartum infections (aRR_O85 5.7; 5.1-6.4/aRR_O86 3.2; 2.9-3.6). Alongside the strong associations with postpartum infections, we also observed an increasing incidence over time in chorioamnionitis/intrapartum infection (p < 0.001) and postpartum hemorrhage (p < 0.001).</p><p><strong>Conclusions: </strong>Postpartum infections are common, and the incidence of endometritis/puerperal sepsis is increasing. For all postpartum infections, delivery-related factors demonstrate the strongest associations. Postpartum hemorrhage and chorioamnionitis/intrapartum infection may represent key targets for prevention/prevention of progression. Revision of the coding system is necessary to enable differentiation between puerperal sepsis and endometritis for better surveillance.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987776","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":"Dual acellular subnormothermic machine perfusion for enhanced uterus preservation in a swine model.","authors":"Lucile Cabanel, Haïzam Oubari, Bradley W Ellis, Ludivine Dion, Vincent Lavoué, Carla Sousa, Loïc Van Dieren, Olivier Morel, Mark A Randolph, Curtis L Cetrulo, Korkut Uygun, Alexandre G Lellouch, Yanis Berkane, Basak E Uygun","doi":"10.1111/aogs.70346","DOIUrl":"10.1111/aogs.70346","url":null,"abstract":"<p><strong>Introduction: </strong>Machine perfusion has rapidly developed in the last decade and demonstrated improved preservation of conventional and marginal organs by reducing ischemia and hypoxia injuries. The aim of this study was to assess whether subnormothermic machine perfusion improves graft preservation compared with SCS in a porcine uterus model.</p><p><strong>Material and methods: </strong>Swine uteri were procured from circulatory-dead donors and allocated into two groups. In the experimental group, the organs were preserved with 4 h-dual subnormothermic machine perfusion (n = 4) while the control group (n = 4) underwent 4 h-static cold storage. After preservation, all uteri received ex vivo whole blood normothermic reperfusion (NMP) to simulate transplantation. Perfusate samples were analyzed from uterine arteries and veins every 30 min for gas and metabolic analysis, and weight variations were recorded continuously during perfusion. Following simulated transplantation, uterine contraction was assessed after oxytocin injection, and macrovascular perfusion was evaluated using contrast angiography. Several biopsies were procured from different parts of the uterus for histological and immunohistochemistry analysis.</p><p><strong>Results: </strong>In the experimental group, the weight of the uteri and lactate difference between vein and artery decreased during subnormothermic machine perfusion. Weight gain was significantly higher in the control group (p = 0.03), which was consistent with interstitial edema observed on histological sections in this group. Uterine contraction evaluated through semi-quantitative scoring was higher in the experimental group (p = 0.02).</p><p><strong>Conclusions: </strong>In this porcine model, subnormothermic machine perfusion reduces edema and preserves contractility more effectively than static cold storage. We demonstrate its particular interest in recovering organs procured from deceased donors. In addition, subnormothermic machine perfusion may enable other applications, including graft assessment, treatment and tolerance induction.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001174","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":"Menopausal status at the age of 46: Its association with depressive and anxiety symptoms and morbidity in women-A northern Finland birth cohort 1966 study.","authors":"Tiia Saarinen, Susanna M Savukoski, Paula Pesonen, Jouko Miettunen, Maarit Niinimäki","doi":"10.1111/aogs.70358","DOIUrl":"https://doi.org/10.1111/aogs.70358","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of several morbidities increases during the menopausal transition. However, studies of the association between early-onset menopause and psychiatric symptoms and morbidity are scarce. We aimed to investigate how climacteric status at age 46 was associated with depressive and anxiety symptoms.</p><p><strong>Material and methods: </strong>This prospective cohort study included 2632 female participants from the Northern Finland Birth Cohort 1966 who participated in the 46-year follow-up. Among these, 356 participants (13%) were classified as climacteric. Data regarding the participants' backgrounds as well as anxiety and depressive symptoms (measured by the Hopkins Symptom Checklist-25 and the Beck Depression Inventory) were analyzed. Information on psychiatric medication purchases was retrieved from a national registry. The association between climacteric status at age 46 and the presence of psychiatric symptoms or medication purchases was evaluated using binary logistic regression.</p><p><strong>Results: </strong>Climacteric women exhibited a higher prevalence of significant anxiety symptoms compared with preclimacteric women (22.6% vs. 16.0%, p = 0.002) with an odds ratio of 1.53 (95% confidence interval: 1.16-2.02), as measured by the Hopkins Symptom Checklist-25 questionnaire. This association remained statistically significant after adjusting for smoking, alcohol consumption, body mass index, and education (odds ratio 1.44; 95% confidence interval: 1.04-2.00). The climacteric women also reported depression symptoms more frequently than the preclimacteric women (30.1% vs. 24.6%, p = 0.032), and the association persisted after adjustment for covariates (odds ratio 1.39; 95% confidence interval: 1.03-1.85). The Beck Depression Inventory-21 indicated higher rates of depression among climacteric women (17.7% vs. 13.6%, p = 0.046); however, no independent association was observed following adjustment. Purchases of antidepressants (48% vs. 41%, p = 0.012) and benzodiazepine derivatives (18.3% vs. 13.3%, p = 0.012) between the ages 40 and 57 were more frequent among climacteric women aged 40-57, yet no independent association was identified between advanced climacteric status and medication purchases in the multivariate model.</p><p><strong>Conclusions: </strong>Advanced menopausal status at age 46 was linked to a higher risk of anxiety and depressive symptoms. It is crucial to support the mental health and well-being of women during and after menopause, especially for those experiencing early-onset menopause.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982000","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}

{"title":"Early- vs. late-onset gestational diabetes: Differential impact on maternal and neonatal outcomes","authors":"Baolai Li,&nbsp;Wenjun Ji,&nbsp;Rui Zhao,&nbsp;Jinchun Zhang","doi":"10.1111/aogs.70308","DOIUrl":"10.1111/aogs.70308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The timing of gestational diabetes mellitus (GDM) diagnosis may influence maternal and neonatal outcomes, yet the differential impact of early-onset versus late-onset GDM remains incompletely characterized, particularly in Chinese populations. To compare maternal and neonatal outcomes between early-onset GDM (diagnosed before 20 weeks' gestation) and late-onset GDM (diagnosed at 24–28 weeks' gestation).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 1847 singleton pregnancies complicated by GDM at Qingdao Municipal Hospital from January 2020 to December 2023. Participants were classified into early-onset (<i>n</i> = 583) and late-onset (<i>n</i> = 1264) groups. Primary outcomes included composite adverse neonatal outcome, preeclampsia, and cesarean delivery. Multivariate logistic regression was performed to calculate adjusted odds ratios (aOR) after controlling for maternal age, pre-pregnancy BMI, nulliparity, family history of diabetes, and chronic hypertension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Women with early-onset GDM demonstrated significantly higher rates of insulin requirement (45.8% vs. 21.1%, <i>p</i> &lt; 0.001). Early-onset GDM was associated with increased risks of preeclampsia (aOR 1.85, 95% CI 1.38–2.47), cesarean delivery (aOR 1.84, 95% CI 1.53–2.28), and preterm birth (aOR 2.69, 95% CI 2.05–3.47). Neonatal complications were substantially elevated in the early-onset group, including macrosomia (aOR 1.86, 95% CI 1.41–2.37), neonatal hypoglycemia (aOR 2.04, 95% CI 1.57–2.67), respiratory distress (aOR 2.60, 95% CI 1.78–3.71), and NICU admission (aOR 2.16, 95% CI 1.69–2.74). The composite adverse neonatal outcome occurred in 61.2% of early-onset versus 37.7% of late-onset cases (aOR 2.57, 95% CI 2.13–3.15).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early-onset GDM may represent a clinically distinct, higher-risk phenotype with notably elevated maternal and neonatal morbidity compared to late-onset disease. Given the observational design and the potential for residual confounding, these findings should be regarded as hypothesis-generating rather than definitive. They require confirmation in prospective, multicenter studies before risk stratification by diagnostic timing or intensified surveillance can be advocated for routine clinical implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"105 10","pages":"2012-2022"},"PeriodicalIF":3.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454216","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":"Prophylactic ureteral stent placement for the prevention of urinary tract injuries in women with placenta accreta spectrum undergoing peripartum cesarean hysterectomy: A retrospective cohort study","authors":"Hasan Berkan Sayal,&nbsp;And Yavuz,&nbsp;Merve Turk,&nbsp;Busra Tsakir,&nbsp;Erzat Toprak,&nbsp;Zeynep Ozturk Inal","doi":"10.1111/aogs.70305","DOIUrl":"10.1111/aogs.70305","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This retrospective cohort study investigated whether preoperative bilateral ureteral stent placement reduces urinary system injuries in pregnant women with placenta accreta spectrum (PAS) undergoing peripartum cesarean hysterectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>The sociodemographic, clinical characteristics, and laboratory results of 273 women who underwent peripartum cesarean hysterectomy due to suspected PAS during the study period were documented and compared. One hundred and twenty-three of these did not receive preoperative urinary stent placement (Group 1), while 150 had such stents installed (Group 2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Red blood cell counts (4.10 ± 1.78 vs. 3.06 ± 0.96, odds ratio (OR): 0.782, 95% confidence interval (CI): 0.619–0.989; <i>p</i> = 0.027) and fresh frozen plasma replacement values (2.22 ± 0.63 vs. 3.22 ± 1.01, OR: 1.238, CI: 1.009–1.518; <i>p</i> = 0.035), operative times (120.0 [100.0–165.0] mins vs. 110.0 [80.0–120.0] mins , OR: 0.984, CI: 0.972–0.997; <i>p</i> = 0.012), days of hospitalization (6.34 ± 1.98 vs. 4.68 ± 1.45, OR: 0.849, CI: 0.736–0.979; <i>p</i> = 0.017), and urinary tract complications (14 [11.4%] vs. 5 [3.3%], OR: 8.357, CI: 1.784–39.153; <i>p</i> = 0.007) differed significantly between the groups. Additionally, while preoperative hemoglobin, hematocrit, and platelet counts were comparable between the groups (<i>p</i> &gt; 0.05), postoperative hemoglobin (9.61 ± 1.75 vs. 10.08 ± 1.81 gm/dl; <i>p</i> = 0.004) and hematocrit (28.88 ± 1.80 vs. 30.19 ± 2.30; <i>p</i> = 0.003) levels differed between them. In multivariable logistic regression analysis, both the number of previous cesarean sections (OR: 1.687; 95% CI: 1.079–2.636; <i>p</i> = 0.022) and the absence of ureteral stent placement (OR: 3.964; 95% CI: 1.199–13.107; <i>p</i> = 0.024) were independently associated with urinary tract injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This retrospective cohort study suggests that prophylactic temporary ureteral stent placement may be associated with a reduction in urinary tract injury in women with PAS undergoing peripartum cesarean hysterectomy. However, given the non-randomized design, potential selection bias, and limited number of events, these findings should be interpreted with caution. Larger, multicenter prospective studies with appropriate adjustment for confounding variables are needed to confirm these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"105 10","pages":"2023-2029"},"PeriodicalIF":3.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417734","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":"Transumbilical laparoendoscopic single-site surgery versus conventional multi-port laparoscopy for myomectomy: A large single-center retrospective study","authors":"Xu Yang,&nbsp;Hong Liao,&nbsp;Hongyu Jin,&nbsp;Fan Yang,&nbsp;Sijing Chen,&nbsp;Yu Chen,&nbsp;Jianhong Liu,&nbsp;Xiaorong Qi,&nbsp;Kana Wang,&nbsp;Jinke Li,&nbsp;Qiao Wang,&nbsp;Ying Zheng","doi":"10.1111/aogs.70309","DOIUrl":"10.1111/aogs.70309","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;Uterine leiomyomata are the most common neoplasms among women of reproductive age. Laparoscopic myomectomy is desirable for patients who wish to preserve their fertility or retain their uterus. There lacks a large-scale study to compare the surgical safety between transumbilical laparoendoscopic single-site surgery (single-site laparoscopy) and conventional multi-port laparoscopy.&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 registered retrospective observational study (MR-51-23-020457, ChiCTR) included patients with leiomyomata who underwent single-site laparoscopy or multi-port laparoscopy for myomectomy. The patients' characteristics, perioperative outcomes, obstetric outcomes, and satisfaction scores for the incision were recorded and analyzed between the two groups. The primary outcome was the incidence of intraoperative adverse events, including organ injury and bleeding, and the secondary outcomes were Enhanced Recovery After Surgery indicators, including surgery-related pain, flatulence time, postoperative hospital stay, and cosmetic satisfaction of incisions.&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;A total of 1437 single-site laparoscopy and 2514 multi-port laparoscopy patients were included. The incidence of Grade I intraoperative adverse events (organ injury) was 0.70% in single-site laparoscopy and 0.44% in multi-port laparoscopy (&lt;i&gt;p&lt;/i&gt; = 0.624), the Grade II intraoperative adverse events (bleeding requiring blood transfusion) were 6.75% in single-site laparoscopy and 6.24% in multi-port laparoscopy (&lt;i&gt;p&lt;/i&gt; = 0.533). Single-site laparoscopy patients had shorter postoperative hospital stay (2.21 ± 1.18 vs. 2.70 ± 1.37, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and lower surgery-related pain score (2.82 ± 0.58 vs. 2.89 ± 0.63, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Besides, patients from single-site laparoscopy had a higher satisfaction score for incisional healing (4.60 ± 0.62 vs. 4.43 ± 0.66, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) than those from the multi-port laparoscopy group. Additionally, seven single-site laparoscopy patients and nine multi-port laparoscopy patients were diagnosed with uterine sarcoma. During the second surgery, the isolated and minor pelvic implantation found in one patient (0.5 × 0.5 cm) from the single-site laparoscopy group had a smaller size and narrower distribution than that found in the three patients (1.0 × 1.0 cm, 3.0 × 3.0 cm,3.0 × 3.0 cm) from the multi-port laparoscopy group.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;These findings support the notion that single-site laparoscop","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"105 10","pages":"2068-2080"},"PeriodicalIF":3.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434531","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":"Externally validated risk prediction models for gestational diabetes mellitus: A systematic review and meta-analysis","authors":"Beminate Lemma Seifu,&nbsp;Yitayeh Belsti,&nbsp;Nigus Bililign Yimer,&nbsp;Rebecca F. Goldstein,&nbsp;Joanne Enticott,&nbsp;Helena Teede","doi":"10.1111/aogs.70300","DOIUrl":"10.1111/aogs.70300","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Risk prediction models for gestational diabetes mellitus (GDM) offer potential for early identification and targeted prevention. External validation is crucial to assess model performance across diverse populations. Despite the availability of numerous GDM prediction models, limited evidence exists on their external validation frequency, methodological quality, and clinical applicability. This systematic review evaluated externally validated GDM prediction models, focusing on methodological rigor, reporting standards, and clinical relevance to inform future research and implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Databases including Ovid MEDLINE, Embase, Scopus, Emcare, and CINAHL were searched up to May 1, 2025. Studies reporting external validation of GDM risk prediction models were included. Two reviewers independently screened studies. Data were extracted using the CHARMS framework, and risk of bias and applicability were assessed using PROBAST+AI. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420251125758).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six studies validated 33 models, with validation sample sizes ranging from 50 to 75 161. Over half used the IADPSG criteria to define GDM. Discrimination metrics were commonly reported, but calibration, overall performance, and clinical utility were often lacking. Meta-analysis was feasible for only four models: Teede et al., Nanda et al., Naylor et al., and Van Leeuwen et al., each showing fair discrimination. The Teede et al. model was the most widely validated, with 11 external validations across six continents and a pooled AUC of 0.72 (95% CI: 0.67–0.76). Despite fewer validations, the Nanda et al. model achieved the highest pooled discrimination (5 validations; pooled AUC 0.77, 95% CI: 0.74–0.80). The Naylor et al. and van Leeuwen et al. models also underwent meta-analysis, as sufficient external validation studies were available to support comparative performance assessment. Notably, 69.23% of studies had a high risk of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While many models showed acceptable predictive performance, most validations were methodologically weak. Future studies should follow best-practice guidelines and promote scalable validation strategies, such as algorithm sharing, to enhance clinical utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"105 10","pages":"1918-1931"},"PeriodicalIF":3.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374334","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}