Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"Monochorionic twin pregnancies conceived through assisted reproduction: Maternal and perinatal clinical outcomes.","authors":"Daniela Casati, Mariano M Lanna, Arianna Laoreti, Stefano Faiola, Roberta Morelli, Martina Santapaola, Gianluca Lista, Valeria Savasi","doi":"10.1111/aogs.70186","DOIUrl":"10.1111/aogs.70186","url":null,"abstract":"<p><strong>Introduction: </strong>Monochorionic (MC) twin pregnancies are at high risk of maternal, fetal, and neonatal complications. Assisted reproductive technology (ART) increases the incidence of MC twinning, but its impact on pregnancy outcomes in this subgroup remains unclear. This study aimed to investigate whether conception via ART is associated with adverse maternal and perinatal outcomes in MC twin pregnancies and to highlight key areas for future research.</p><p><strong>Material and methods: </strong>A retrospective observational study was conducted on MC twin and multifetal pregnancies referred to a tertiary fetal medicine center from 2020 to 2023. A total of 100 ART-conceived MC pregnancies (77 homologous ART and 23 egg donation) were compared to 343 spontaneously conceived MC pregnancies. Maternal, fetal, and neonatal outcomes were analyzed. Adjusted odds ratios (aOR) were estimated using logistic regression, and generalized estimating equations were applied to account for within-twin pair correlation.</p><p><strong>Results: </strong>Results are presented for the entire population and for MC diamniotic (MCDA) pregnancies only. Women with ART-conceived MC pregnancies were older and more often nulliparous compared to those with spontaneous conception (p < 0.01), yet exhibited similar rates of preterm delivery and cesarean section. ART was associated with higher risk of maternal complications (p < 0.01), particularly hypertensive disorders (p = 0.02). Fetal demise and postnatal morbidity occurred more frequently in ART pregnancies, although neither association remained statistically significant after adjustment for within-twin pair correlation or in MCDA-only analyses. ART-conceived twins had lower rates of twin-to-twin transfusion syndrome but poorer survival after laser treatment (p < 0.01). Overall survival did not differ across groups.</p><p><strong>Conclusions: </strong>ART-conceived MC pregnancies show an increased burden of maternal complications. Fetal and neonatal outcomes did not differ significantly from those of spontaneously conceived pregnancies after adjustments, despite higher point estimates for adverse outcomes. In the context of the global rise in ART use, these findings underscore the need for further clinical and basic-science research to better characterize the magnitude and mechanisms of ART-associated risks in MC pregnancies.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"868-877"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497326","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":"Accuracy of human papillomavirus testing in detecting persistent or recurrent disease at follow-up after conization.","authors":"Ghina Alaref, Lone Kjeld Petersen","doi":"10.1111/aogs.70168","DOIUrl":"10.1111/aogs.70168","url":null,"abstract":"<p><strong>Introduction: </strong>Currently, the Test of Cure after conization consists of two elements, namely human papillomavirus (HPV) testing and cytology. Given the high sensitivity of HPV testing and its modest resource requirements, we will explore its potential as a stand-alone test for identifying persistent/recurrent cervical intraepithelial neoplasia (CIN) during follow-up after conization, including women at increased risk, such as those with involved resection margins.</p><p><strong>Material and methods: </strong>This retrospective study examined 473 women who underwent conization in Funen, Denmark, between January 1, 2020, and December 31, 2024. During the post-conization follow-up period, data were manually extracted from patients' medical records and PatoBank.</p><p><strong>Results: </strong>At the follow-up, cervical intraepithelial neoplasia grade 1 or worse (CIN1+) persistent/recurrence was experienced by 55 women (11.6%) (median age of 42 years (range 22-87 years)). Among those with involved margins, 30.3% (40/132) experienced persistent/recurrent CIN1+ compared to 3.6% (7/193) with free margins; and 66.4% (314/473) tested negative for high-risk HPV after conization, and only four of them developed persistent/recurrent CIN1+. HPV testing alone predicted the risk of CIN1+ persistence/recurrence with 93% sensitivity and 98.7% negative predictive value (NPV). Combining negative HPV test results with free resection margins yielded a sensitivity and NPV of 100%. Co-testing combined with free margins also provided a sensitivity and NPV of 100%.</p><p><strong>Conclusions: </strong>Using HPV testing as a stand-alone test after conization demonstrates an NPV nearly equal to that of the Test of Cure. Adding free margins to HPV testing further enhanced sensitivity and NPV for detecting CIN1+ persistence or relapse during follow-up. Our results indicate that HPV testing alone can be used as post-conization follow-up for women with negative margins.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"960-968"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375744","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":"Clinical characteristics of adolescents and young adults requesting labiaplasty - A Finnish cross-sectional study.","authors":"Aino Kilpeläinen, Kristiina Rönö, Elina Holopainen","doi":"10.1111/aogs.70192","DOIUrl":"10.1111/aogs.70192","url":null,"abstract":"<p><strong>Introduction: </strong>Women request labiaplasty due to both physical symptoms and aesthetic concerns. Adolescent labiaplasty may carry higher complication risks than in adults; however, data are scarce. The primary aim of this study was to describe characteristics and comorbidities of adolescents and young adults requesting labiaplasty. The secondary aim was to examine labial dimensions in relation to reported physical and nonphysical symptoms.</p><p><strong>Material and methods: </strong>This cross-sectional study was conducted at the Pediatric and Adolescent Gynecology Outpatient Clinic at Helsinki University Hospital, Finland. The study population includes all young women <25 years of age seeking labiaplasty between January 1, 2021, and December 31, 2023. The participants were followed up to August 30, 2024. Data on several subjective physical and psychological symptoms, as well as objective measurements of labia, were collected from patient records. The proportion of young women referred to a plastic surgeon's assessment was recorded.</p><p><strong>Results: </strong>Altogether 65 young women were included. The median age was 20.2 years (range 11.9-25.4), and 22 (33.8%) of the patients were minors. The median body mass index of the participants was 19.7 kg/m² (range 14.9-34.6 kg/m²), and 18 (27.7%) of the patients were underweight. Twenty-six (40.0%) had at least one psychiatric or neuropsychiatric diagnostic code registered. Fourteen (21.5%) had a current psychotropic medication, and 14 (21.5%) had either a current or previous self-reported eating disorder or disordered eating behavior. Labia minora widths were ≤5 cm in 36 (55.4%) of the patients. There were no significant differences in physical symptoms between those with labia minora ≤5 cm and >5 cm. Of self-reported nonphysical symptoms, anxiety was reported more often among those with labia width >5 cm (p < 0.005). In all, 37 (56.9%) were further referred to a plastic surgeon's assessment.</p><p><strong>Conclusions: </strong>Psychiatric morbidity was common among young women seeking labiaplasty, underlining the importance of exploring mental health issues among these patients. Most women lacked obvious labial hypertrophy. Reported physical symptoms did not correlate with labia size. We suggest that all young women requesting labiaplasty should be met by a specialist team for appropriate patient counseling and evaluation.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"819-826"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388750","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":"1 g/h magnesium sulfate maintenance for eclampsia prevention is enough.","authors":"Alessandro Petrecca, Benedetta Bina, Tullio Ghi, Vincenzo Berghella","doi":"10.1111/aogs.70205","DOIUrl":"10.1111/aogs.70205","url":null,"abstract":"<p><p>We conducted two systematic reviews including only randomized controlled trials (RCTs) comparing magnesium sulfate vs placebo/no treatment, as well as 2 g/h vs 1 g/h magnesium sulfate maintenance regimens for prevention of eclampsia. Medline, Cochrane Library, EMBASE, PubMed Central, Scopus, ClinicalTrial.gov were electronically searched from their inception to February 2025. In the five RCTs comparing magnesium sulfate vs placebo/no treatment, a 2-g maintenance dose was used in two RCTs including 176 pregnancies, while a 1 g maintenance dose was used in three RCTs including 5447 pregnancies. Eclampsia incidence was 0.57% with the 2 g/h regimen and 0.76% with the 1 g/h regimen (OR 1.33, 95% CI: 0.18-9.60), while maternal side effects were significantly higher in the 2 g/h regimen (67% vs 22%, OR 7.05, 95% CI: 4.22-11.78). In the five RCTs (n = 283) comparing 2 g/h vs 1 g/h maintenance regimens, no case of eclampsia was reported with either regimen, and maternal side effects were significantly higher in the 2 g/h group (71% vs 42%, OR 1.69, 95% CI: 1.06-2.71). In conclusion, magnesium sulfate maintenance regimen of 1 g/h seems as effective as the 2 g/h regimen for the prevention of eclampsia, with decreased incidence of maternal side effects.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"771-777"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632126","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":"Outcomes from blind versus ultrasound-guided uterine evacuation: A retrospective cohort analysis.","authors":"Sarah Dowthwaite, Ann Quinton, Samantha Thomas, Timothy E Schlub, Jillian Clarke","doi":"10.1111/aogs.70179","DOIUrl":"10.1111/aogs.70179","url":null,"abstract":"<p><strong>Introduction: </strong>Women may need a surgical uterine evacuation for miscarriage, surgical termination, or retained products of conception. Previous research has indicated possible complications of uterine dilatation and curettage and potential benefits of an ultrasound-guided procedure. This study aimed to compare the rate of complications for uterine evacuation when performed blind or with ultrasound guidance, including whether the presence of patient risk factors determined the use of ultrasound guidance.</p><p><strong>Material and methods: </strong>This retrospective cohort study included 733 cases in an Australian hospital between January 2019 and December 2023. Medical records, imaging, and surgical reports were searched for patient demographics, risk factors, and the presence of surgical complications. Primary outcomes were complications of uterine perforation, false passage, incomplete curettage, heavy blood loss, or laparoscopy. Secondary outcomes were patient demographics and potential presurgical complication factors. The study created two cohorts: patients receiving evacuation performed blind or with ultrasound guidance.</p><p><strong>Results: </strong>The uterine evacuation was performed blind for 421/733 (57%) women and ultrasound-guided for 312/733 (43%) women. The ultrasound-guided group included higher gestational ages 8 [7-11] weeks vs blind 8 [7-9] weeks, more patients with risk factors (OR 1.7, CI: 1.3 to 2.3), more patients for surgical termination (OR 15.3, CI: 5.4 to 43.3), or postpartum RPOC removal (OR 2.3, CI: 1.3 to 3.9). The ultrasound group had lower overall blood loss (20 mLs vs 30 mL) and clinically significantly lower volumes of continuing retained products of conception, 0.66 cm³ [0.53-1.23] vs 8.35 cm³ [1.49-18.94]. There was no difference in complications between groups after adjusting for gestational age (OR 1.0, CI: 0.5 to 2.0).</p><p><strong>Conclusions: </strong>There were low complication rates for blind and ultrasound-guided uterine evacuations. However, ultrasound guidance was utilized for higher-risk cases and significantly reduced the volume of retained tissue in complicated cases. The use of ultrasound guidance by doctors and sonographers for uterine evacuation is a compelling choice where available.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"827-835"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147368847","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":"Association between history of fertility problems and pregnancy and birth complications: A longitudinal population-based cohort study.","authors":"Cathryn A Tully, Danielle Schoenaker, Leanne Pacella-Ince, Allison M Hodge, Jessica A Grieger","doi":"10.1111/aogs.70178","DOIUrl":"10.1111/aogs.70178","url":null,"abstract":"<p><strong>Introduction: </strong>Infertility is a common reproductive health issue, associated with increased risks of pregnancy complications. However, shared underlying risk factors such as age, BMI, PCOS, endometriosis, and lifestyle may partly explain these associations. In a population-based cohort of women, this study aimed to determine whether a history of fertility problems is independently associated with adverse pregnancy and birth outcomes, including gestational diabetes, hypertensive disorders of pregnancy, low birthweight, and preterm birth.</p><p><strong>Material and methods: </strong>This was a secondary analysis of data from the 1973 to 1978 cohort of the Australian Longitudinal Study on Women's Health, that included surveys from 2003 to 2018 (n = 9854). We examined associations between self-reported fertility problems and four adverse outcomes: gestational diabetes, hypertensive disorders of pregnancy, low birthweight, and preterm birth. Generalized estimating equations with an exchangeable correlation structure were used, with sequential adjustment for socio-demographic, health, and lifestyle-related characteristics.</p><p><strong>Results: </strong>Among 5653 women who reported a live birth, 897 (15.9%) reported a history of fertility problems, of whom 71.6% had sought help. After adjusting for socio-demographic factors alone, there was a statistically significant increased risk of adverse pregnancy outcomes for women with a history of fertility problems compared to those without. However, after further adjustment for health characteristics and pregnancy-related variables, the associations were no longer statistically significant: gestational diabetes [Relative risk (RR): 0.98; 95% confidence interval (CI) (0.78 to 1.22)], hypertensive disorders of pregnancy [RR: 1.08; 95% CI (0.82 to 1.43)], preterm birth [RR: 1.01; 95% CI (0.81 to 1.26)], or low birthweight [RR: 1.04; 95% CI (0.80 to 1.34)].</p><p><strong>Conclusions: </strong>In this large cohort of women in Australian, initial associations between fertility problems and adverse pregnancy outcomes were attenuated after adjustment for key health and lifestyle factors. The absence of associations in fully adjusted models suggests that previously reported risks may reflect shared underlying maternal characteristics rather than infertility itself and highlights the importance of cautious interpretation of statistical significance in large observational studies.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"859-867"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147288884","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 freebirth debate: Respecting autonomy while reflecting on our own practices.","authors":"Jóhanna Gunnarsdóttir, Hulda Hjartardóttir","doi":"10.1111/aogs.70239","DOIUrl":"10.1111/aogs.70239","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"105 5","pages":"768-770"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758887","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":"Laparoscopically guided transversus abdominis plane block versus local wound infiltration analgesia in laparoscopic surgery for peritoneal endometriosis: A prospective randomized controlled double-blinded LTAP-trial.","authors":"Anna M Terho, Terhi Puhto, Johanna Laru, Outi Uimari, Pasi Ohtonen, Tero Rautio, Sari Koivurova","doi":"10.1111/aogs.70220","DOIUrl":"https://doi.org/10.1111/aogs.70220","url":null,"abstract":"<p><strong>Introduction: </strong>Endometriosis patients often suffer from more severe pain in association with surgical procedures. The aim of this study was to investigate whether laparoscopically guided transversus abdominis plane block (LTAP) offers an opioid-sparing effect compared to local wound infiltration (LWI) analgesia in laparoscopic surgery performed for suspected peritoneal endometriosis.</p><p><strong>Material and methods: </strong>In this single-center prospective, randomized, controlled, double-blinded clinical study, 46 patients were randomized to receive either levobupivacaine inserted in the four quadrants of the abdomen at LTAP points and saline at trocar sites (n = 23) or saline at the LTAP points and levobupivacaine at trocar sites (n = 23). The study size was based on a power calculation. The primary outcome, opioid consumption 24 h postoperatively, was measured using patient-controlled analgesia pumps. Secondary outcomes included postoperative pain scores and other enhanced recovery after surgery (ERAS) measures, as well as patient outcome questionnaires at six months after surgery. Statistical analyses were performed on an intention-to-treat basis. The study was prospectively registered in Clinicaltrials.gov, ID: NCT04735770, Jan 19, 2021; https://clinicaltrials.gov/study/NCT04735770?term=LTAP&rank=2.</p><p><strong>Results: </strong>There was no significant difference in the mean opioid consumption (iv morphine equivalents) between the study groups: 31.8 ± 25.5 mg in the LTAP group and 27.5 ± 19.3 mg in the LWI group (mean difference 4.3 mg, 95% CI -9.2 to 17.7, p = 0.52). No significant differences were found in the postoperative pains scores, mean operation times, mean total blood loss, or mobilization between the study groups. 17 (73.9%) patients in each group received histological diagnosis of peritoneal endometriosis of the samples obtained during surgery. Times to discharge were 24.4 ± 4.3 (LTAP) and 28.1 ± 14.8 h (LWI), p = 0.25. No complications related to LTAP or LWI were reported.</p><p><strong>Conclusions: </strong>In this study performed on women suffering from long-term abdominal pain preoperatively, no significant differences were found between LTAP and LWI as regards to postoperative opioid consumption, postoperative pain, ERAS factors, or safety.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809151","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":"Probiotic supplementation during pregnancy for vaginal microbiota improvement and pathogen clearance: A systematic review and meta-analysis.","authors":"Zimo Liu, Roujie Huang, Tianshu Sun, Lan Zhu","doi":"10.1111/aogs.70234","DOIUrl":"https://doi.org/10.1111/aogs.70234","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnancy is associated with susceptibility to vaginal dysbiosis, including Group B Streptococcus (GBS), bacterial vaginosis (BV), and vulvovaginal candidiasis (VVC). Probiotic supplementation has emerged as a potential strategy to restore vaginal microecology, yet its effectiveness during pregnancy remains uncertain.</p><p><strong>Material and methods: </strong>To evaluate whether probiotic supplementation during pregnancy increases the likelihood of clearance of GBS colonization, BV, and VVC. We systematically searched PubMed, Embase, Cochrane CENTRAL, and Web of Science from inception to 16 April 2025. Eligible studies were randomized or non-randomized studies comparing probiotic supplementation with placebo or no treatment in pregnant women, reporting outcomes related to vaginal microbiota, pathogen decolonization, or infection resolution. Two reviewers independently screened studies and extracted data. Randomized controlled trials (RCT) were evaluated using the Cochrane ROB-1 tool, and the single non-RCT was assessed using ROBINS-I. Meta-analyses were performed for co-primary outcomes, with subgroup analyses by timing, comparator type (placebo-controlled vs. no-treatment control), and duration of intervention.</p><p><strong>Results: </strong>Eighteen studies (n = 3705) were included. For the co-primary outcomes, a statistically significant increase in the odds of GBS decolonization was observed (OR 1.38, 95% CI 1.08-1.76; I² = 2%). This association was no longer statistically significant in analyses restricted to RCTs (OR = 1.28, 95% CI 0.93-1.76; I² = 9%) and remained non-significant when further restricted to placebo-controlled RCTs (OR = 1.32, 95% CI 0.94-1.85; I² = 31%). No significant effects were found for BV (OR 0.91) or VVC (OR 0.65). An exploratory pooled analysis across infection types showed no significant overall improvement in infection clearance (OR 1.13, 95% CI 0.94-1.36; I² = 16%). Subgroup analysis indicated greater efficacy in interventions initiated during the third trimester or lasting ≤4 weeks, though interaction tests were not significant.</p><p><strong>Conclusions: </strong>Probiotic supplementation during pregnancy may increase the likelihood of GBS decolonization. However, this association was not statistically significant in sensitivity analyses restricted to randomized and placebo-controlled trials. No consistent benefit was observed for BV or VVC. Standardized probiotic regimens and harmonized diagnostic frameworks are needed.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759513","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":"Women's motivations for and experiences with transabdominal cerclage: A qualitative study.","authors":"Stina Lou, Lea Kirstine Hansen, Lotte Groth Jensen, Niels Uldbjerg, Pernille Tine Jensen, Thea Kallesen, Puk Sandager, Rikke Bek Helmig, Julie Glavind","doi":"10.1111/aogs.70217","DOIUrl":"https://doi.org/10.1111/aogs.70217","url":null,"abstract":"<p><strong>Introduction: </strong>Transabdominal cerclage (TAC) is used to prevent pregnancy loss and preterm birth in women with previous failed transvaginal cerclage or insufficient cervical tissue. TAC requires laparoscopic or open abdominal surgery, cesarean birth, and the potential long-term effect are currently unknown. While the procedural aspects, indications, and pregnancy outcomes associated with TAC are subject to ongoing research, little is known about how women experience the decision to undergo a TAC and the pregnancy that follows.</p><p><strong>Material and methods: </strong>We conducted a qualitative interview study with 12 Danish women who had undergone laparoscopic TAC. Participants were recruited through a national online support group. Interviews lasted 58-90 min. Data were analyzed thematically using Braun and Clarke's approach.</p><p><strong>Results: </strong>Two overarching themes were identified. The first theme, What it takes, describes how the decision to undergo TAC was often considered self-evident and necessary in light of previous pregnancy losses. Thus, the decision-making was shaped by prior trauma and urgent hope, but also grounded in careful assessment of risks, benefits, and prior experiences. The women downplayed the potential drawbacks of TAC (cesarean birth, long-term complications) in favor of the chance to carry a healthy baby to term. The second theme, Feeling safe(-r), describes how the TAC offered reassurance and allowed the woman to be more active during pregnancy compared to previous pregnancy experiences. However, anxiety and emotional vulnerability persisted, rooted in prior losses. Trusting relationships with healthcare providers were described as essential to navigate worry and uncertainty during pregnancy. All women with a TAC pregnancy achieved a live birth.</p><p><strong>Conclusions: </strong>For the women who underwent TAC, the intervention represented hope, and the downsides were perceived to be outweighed by an increased probability of having a healthy baby. The findings highlight the importance of continuity in care and patient-centered counseling that addresses the clinical and emotional dimensions of TAC. Future research should explore long-term physical and psychological outcomes and develop supportive interventions to improve care for this high-risk population.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759570","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}