Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"Health-related quality of life in adult-type ovarian granulosa cell tumor survivors","authors":"Ulla-Maija Haltia,&nbsp;Saku Torvinen,&nbsp;Saara Bryk,&nbsp;Harri Sintonen,&nbsp;Johanna Tapper","doi":"10.1111/aogs.15144","DOIUrl":"10.1111/aogs.15144","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Adult-type granulosa cell tumor (AGCT) is a rare, slow-growing ovarian neoplasm with a tendency for late relapses. Surgery is the cornerstone of the treatment, and chemotherapy and hormonal treatment are administered in advanced and recurrent disease. The objective of our study was to assess health-related quality of life (HRQoL) in AGCT survivors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>15D and European Organization for Research and Treatment of Cancer (EORTC-QLQ-C30) questionnaires were collected from our prospective AGCT patient cohort, consisting of 171 AGCT survivors. The age-standardized general female population was used as a reference for 15D comparison. Clinical and sociodemographic variables and EORTC-QLQ-C30 symptom and function scales were used as independent variables in regression analysis explaining the variance in the 15D score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-six women (50.3%), with a mean age of 68 years, returned the questionnaires. The HRQoL of AGCT survivors was similar to the general female population. The mean 15D score in our patient group was 0.891 (reference population score 0.899, <i>p</i> = 0.454). The scores were slightly lower on the 15D dimensions of excretion and sexual activity, whereas mental function scores were higher compared with the reference population. A history of tumor recurrence, an increasing number of other chronic illnesses, and financial difficulties each diminished HRQoL in our patient cohort. Regressing the EORTC variables on 15D produced a high explanatory power and accurate predictions of 15D scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HRQoL of AGCT survivors was equal to that of the controls. Mapping EORTC-QLQ-C30 to 15D validly predicted 15D scores in AGCT survivors, confirming the usefulness of generic 15D for estimating quality-adjusted life years in cancer patient trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 7","pages":"1382-1389"},"PeriodicalIF":3.5,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952226","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 recurrence risk of gestational diabetes according to the number of abnormal values in the oral glucose tolerance test","authors":"Jenni Pukkila,&nbsp;Marja Vääräsmäki,&nbsp;Sanna Eteläinen,&nbsp;Sanna Mustaniemi,&nbsp;Hilkka Nikkinen,&nbsp;Mika Gissler,&nbsp;Tuija Männistö,&nbsp;Hannele Laivuori,&nbsp;Eero Kajantie,&nbsp;Elina Keikkala,&nbsp;the FinnGeDi Study Group","doi":"10.1111/aogs.15148","DOIUrl":"10.1111/aogs.15148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Oral glucose tolerance test (OGTT) results may be used to estimate the risk of recurrent gestational diabetes mellitus (GDM) in a subsequent pregnancy in the different study settings. This study assesses the association between the number of abnormal glucose values in the OGTT in the first pregnancy and GDM recurrence in a subsequent pregnancy in a Nordic cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>This register-based cohort study included 1677 women who had their first singleton delivery in 2009, underwent a 75 g 2-h OGTT during the pregnancy, and gave birth at least once more within 10 years according to the Finnish Medical Birth Register. The cut-off values were as follows: ≥5.3 mmol/L at fasting, ≥10.0 mmol/L at 1 h, and ≥8.6 mmol/L at 2 h. The odds ratio (OR) for GDM recurrence in the second pregnancy was analyzed via multivariable logistic regression adjusted for other potential factors associated with recurrence risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the first pregnancy, GDM was diagnosed in 331 (24.5%) women based on one (<i>n</i> = 250) or two or three (<i>n</i> = 81) abnormal glucose values in the OGTT. The total recurrence rate for GDM in the subsequent pregnancy was 56.2%. The rate differed significantly between women with one (51.6%) and women with two or three (70.4%) abnormal values in first-pregnancy OGTT. Compared with those with normal OGTT results, the adjusted OR (aOR) for GDM in the subsequent pregnancy in women with one abnormal glucose value was 6.00 (95% CI, 4.34–8.30), while it was 13.37 (7.52–23.76) in women with two or three abnormal values. The odds for GDM recurrence among those with two or three abnormal glucose values was double compared to those with only one abnormal value (aOR 2.03, 1.12–3.68).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Primiparous women with one abnormal glucose value in the first OGTT have remarkable odds of GDM recurrence, with the odds doubling when there are two or three abnormal values during the first pregnancy. These findings can be used when planning effective counseling, prevention, and screening strategies for GDM in the subsequent pregnancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 8","pages":"1452-1462"},"PeriodicalIF":3.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958210","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":"Performance of radiomics analysis in ultrasound imaging for differentiating benign from malignant adnexal masses: A systematic review and meta-analysis","authors":"Francesca Moro,&nbsp;Marianna Ciancia,&nbsp;Maria Sciuto,&nbsp;Giulia Baldassari,&nbsp;Huong Elena Tran,&nbsp;Antonella Carcagnì,&nbsp;Anna Fagotti,&nbsp;Antonia Carla Testa","doi":"10.1111/aogs.15146","DOIUrl":"10.1111/aogs.15146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We present the state of the art of ultrasound-based machine learning (ML) radiomics models in the context of ovarian masses and analyze their accuracy in differentiating between benign and malignant adnexal masses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Web of Science, PubMed, and Scopus databases were searched. All studies were imported into RAYYAN QCRI software. All studies that developed and internally or externally validated ML models using only radiomics features extracted from ultrasound images were included. The overall quality of the included studies was assessed using the QUADAS-AI tool. Summary sensitivity and specificity analyses with corresponding 95% confidence intervals (CIs) were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>12 studies developed ML models including only radiomics features extracted from ultrasound images, and six of them were included in the meta-analysis. The overall sensitivity and specificity for differentiating benign from malignant adnexal masses were 0.80 (95% CI 0.74–0.87) and 0.86 (95% CI 0.80–0.90), respectively, in the validation set. All studies demonstrated a high risk of bias in <i>subject selection</i> (e.g., lack of details on image sources or scanner models; absence of image preprocessing), and the majority also showed a high risk in the <i>index test</i> (e.g., models were not validated on external datasets) domain. In contrast, the risk of bias was generally low for the <i>reference standard</i> (i.e., most studies used a reference that accurately identified the target condition) and the testing <i>workflow</i> (i.e., the time interval between the index test and reference standard was appropriate) domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The good performance of ultrasound-based radiomics models in the validation set supports that radiomics is worth exploring to improve the diagnosis of adnexal masses. So far, the studies have a high risk of bias due to the small sample size, single-setting design, and no external validation included.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 8","pages":"1433-1442"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957944","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":"Dienogest vs. combined oral contraceptive: A systematic review and meta-analysis of efficacy and side effects to inform evidence-based guidelines","authors":"Ilaria Piacenti,&nbsp;Veronica Tius,&nbsp;Maria Federica Viscardi,&nbsp;Anna Biasioli,&nbsp;Martina Arcieri,&nbsp;Stefano Restaino,&nbsp;Ludovico Muzii,&nbsp;Giuseppe Vizzielli,&nbsp;Maria Grazia Porpora","doi":"10.1111/aogs.15145","DOIUrl":"10.1111/aogs.15145","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;Dienogest is a synthetic fourth-generation progestin that has been approved for the medical treatment of endometriosis, and its efficacy on pain symptoms and quality of life is well established even in the long term. Nowadays, only a few controlled trials evaluating the safety of dienogest compared with other hormonal therapies have been published. This systematic review and meta-analysis aims to compare efficacy and tolerability data between dienogest and combined oral contraceptives (COC) in patients taking hormonal therapy for endometriosis treatment in order to inform evidence-based guidelines.&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;PubMed (Medline), Web of Science, and Google Scholar were systematically searched from the inception of each database until October 2024. Selection criteria included any articles comparing efficacy outcomes and at least one tolerability data between dienogest and COC in patients diagnosed with endometriosis. Studies comparing COC containing Dienogest or another type of hormonal treatment were excluded. A random-effects meta-analysis was conducted if adequate data were available from at least three studies, reporting pooled mean differences and odds ratios between groups using Review Manager V.7.9.0. PROSPERO registration number: CRD42024598455.&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 four randomized control trials and one observational study were included, showing moderate risk at bias assessment. Meta-analysis did not show any statistical difference in improving pelvic pain after treatment [CI 95% (−1.45–1.17); &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 86%; &lt;i&gt;p&lt;/i&gt; = 0.84]. In contrast, dyspareunia after treatment was significantly lower in the COC group [CI 95% (0.64–1.33); &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%; &lt;i&gt;p&lt;/i&gt; &lt; 0.00001]. No statistical difference was found in terms of vaginal bleeding [OR = 0.88; CI 95% (0.39–1.96); &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 41%; &lt;i&gt;p&lt;/i&gt; = 0.75], nausea and vomiting [OR = 0.51; CI 95% (0.16–1.63); &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 67%; &lt;i&gt;p&lt;/i&gt; = 0.26], headache [OR = 0.91; CI 95% (0.38–2.21); &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 59%; &lt;i&gt;p&lt;/i&gt; = 0.84], hot flushes [OR = 1.16; CI 95% (0.54–2.48); &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%; &lt;i&gt;p&lt;/i&gt; = 0.71], and hair loss [OR = 1.69; CI 95% (0.52–5.53); &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 46%; &lt;i&gt;p&lt;/i&gt; = 0.39]. Treatment discontinuation rate was similar between groups.&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;Dienogest is comparable to COC in terms of efficacy and tolerability. The therapeutic choice should be based on the patient's ","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 8","pages":"1424-1432"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964535","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":"Long-term gastrointestinal function outcomes of women undergoing nerve-vessel sparing segmental or full-thickness discoid resection for deep colorectal endometriosis","authors":"Daria Pashkunova,&nbsp;Ezgi Darici Kurt,&nbsp;Theresa Hudelist,&nbsp;Anna Rath,&nbsp;Attila Bokor,&nbsp;Gernot Hudelist","doi":"10.1111/aogs.15142","DOIUrl":"10.1111/aogs.15142","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;Patients undergoing colorectal surgery for symptomatic deep endometriosis may experience postoperative impairment of gastrointestinal function. However, there is limited information on long-term follow-up of this surgical sequela. We aimed to analyze 5-year postsurgical outcomes of gastrointestinal function in these patients, reflected by lower anterior resection syndrome (LARS) scores and gastrointestinal quality of life index (GIQLI).&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 prospective study included patients who either underwent nerve-vessel-sparing segmental resection (NVSSR) or full-thickness discoid resection (FTDR) for symptomatic colorectal deep endometriosis from April 2017 to May 2022 at two tertiary referral centers. As published previously, gastrointestinal function was evaluated by LARS and GIQLI scores pre- and postsurgically (postoperative visit 1) and was now re-evaluated (postoperative visit 2) to gain information on long-term outcomes.&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;Out of 121 patients, 92 were eligible for the final analysis at postoperative visit 2. The mean follow-up interval was 58.5 ± 17.9 months in the NVSSR group and 61.6 ± 10.7 months in the FTDR group. As published previously, presurgical LARS-like symptoms were observed in 42/92 (45.7%) of patients, including 37/76 (48.7%) in the NVSSR group and 5/16 (31.3%) in the FTDR group. Compared to preoperative LARS scores, patients in the NVSSR group showed a significant reduction of LARS scores at long-term postoperative visit 2 (&lt;i&gt;p&lt;/i&gt; = &lt;0.001), with LARS scores remaining stable over postoperative visit 1 and visit 2 (&lt;i&gt;p&lt;/i&gt; = 0.09) at 5 years postoperatively. In women following FTDR, presurgical and long-term postoperative visit 2 LARS scores remained statistically unchanged (&lt;i&gt;p&lt;/i&gt; &lt; 0.73), with worsening of LARS scores between postoperative visit 1 and visit 2 (&lt;i&gt;p&lt;/i&gt; = 0.02). In contrast, significant improvement of GIQLI was observed between the preoperative visit and postoperative visit 2 at 5 years follow-up in both NVSSR and FTDR groups (&lt;i&gt;p&lt;/i&gt; ≤ 0.001 and &lt;i&gt;p&lt;/i&gt; = 0.001, respectively).&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;Compared to presurgical values, long-term gastrointestinal function reflected by LARS scores remains improved following NVSSR, whereas it remains unchanged following FTDR. However, when GIQLI is applied as patient-reported outcome measurement (PROM), patients show permanent, long-term improvement of gastrointestinal function following either","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 8","pages":"1550-1557"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964693","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":"Prevalence and impact of vasomotor symptoms associated with menopause among Nordic women: Subgroup analysis from an international cross-sectional survey","authors":"Angelica Lindén Hirschberg,&nbsp;Päivi Polo-Kantola,&nbsp;Inger Øverlie,&nbsp;Ellen Løkkegaard,&nbsp;Elinor Cockburn,&nbsp;Carol Rea,&nbsp;Janet S. Kim","doi":"10.1111/aogs.15139","DOIUrl":"10.1111/aogs.15139","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 objectives of this study were to evaluate the prevalence and impact of moderate to severe vasomotor symptoms (VMS) on quality of life, sleep, work, and daily activities. We also assessed treatment patterns for VMS, lifestyle changes to mitigate VMS, and attitudes toward available treatments and menopause.&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;Women from Denmark, Finland, Norway, and Sweden aged 40–65 years completed an online survey as part of a larger multinational study. The primary outcome, prevalence of moderate to severe VMS, was assessed in postmenopausal women. Secondary outcomes, including the impact of VMS on quality of life (Menopause-Specific Quality of Life [MENQoL] questionnaire), sleep (Patient-Reported Outcomes Measurement Information System [PROMIS] Sleep Disturbances-Short Form 8b), and work and daily activities (Work Productivity and Activity Impairment [WPAI] questionnaire) were assessed in perimenopausal and postmenopausal women experiencing ≥1 moderate to severe hot flush per day in the prior month. Additionally, survey questions evaluated treatment patterns, lifestyle changes, and opinions toward VMS treatment and menopause in perimenopausal and postmenopausal women.&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;Among 6383 postmenopausal women (primary analysis population), 739 (11.6%) experienced moderate to severe VMS regardless of whether they were receiving treatment. Among 863 symptomatic perimenopausal and postmenopausal women (secondary analysis population), VMS impaired quality of life and sleep. Work and daily activities were impaired by 24.2% and 30.6%, respectively. Around 35% of women sought advice; however, most women (&gt;60%) reported not taking any treatment for VMS. Among those treating VMS, supplements and nonprescription medications were the most common treatments (19.2%); 12.9% of women reported taking menopausal hormone therapy. As many as 54.3% of women reported taking over-the-counter treatments; 77.8% adopted lifestyle changes to mitigate VMS. One in 4 women (25.6%) expressed concerns about menopausal hormone therapy side effects; 49.5% of women who had used nonmenopausal hormone therapy prescription medication stopped for lack of efficacy. Many women strongly agreed that menopause is a natural part of aging.&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;Over 10% of postmenopausal Nordic women reported suffering from moderate to severe VMS. VMS impaired the quality of life, sleep, work productivity, and daily activities among perimen","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 8","pages":"1575-1586"},"PeriodicalIF":3.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951902","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":"Maternal and fetal outcomes in subsequent pregnancies after peripartum cardiomyopathy: A systematic review and meta-analysis","authors":"Rebecca Man,&nbsp;Jack Le Vance,&nbsp;Hafsa Abdullahi,&nbsp;Clare Davenport,&nbsp;Mengshi Yuan,&nbsp;Laura Ormesher,&nbsp;Sana Usman,&nbsp;James Castleman,&nbsp;Caroline Fox,&nbsp;Lucy Hudsmith,&nbsp;R. Katie Morris,&nbsp;Victoria Hodgetts Morton","doi":"10.1111/aogs.15117","DOIUrl":"10.1111/aogs.15117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We aim to determine the pregnancy and cardiovascular outcomes of subsequent pregnancies following a previous diagnosis of peripartum cardiomyopathy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Medline, Embase, CINAHL, and Web of Science were searched from inception to November 2023. Primary research studies of any design providing data for any of our outcomes of interest with greater than five subsequent pregnancies were eligible for inclusion. Primary outcomes included relapse of cardiac failure in the first subsequent pregnancy and death during any subsequent pregnancy. Secondary outcomes included a range of maternal and fetal outcomes. Proportional meta-analysis, applying a random effects model, was performed using R software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-nine studies involving 779 women were included, performed across 13 countries. The risk of relapse of cardiac failure in the first subsequent pregnancy (20 studies, 376 women) was 32%, 95% confidence interval [CI] 0.23–0.43. In those with recovered (11 studies, 123 pregnancies) and non-recovered (10 studies, 55 pregnancies) cardiac function at subsequent pregnancy outset, the risk of cardiac failure relapse was 24%, 95% CI 0.16–0.35 and 36%, 95% CI 0.24–0.50, respectively. There was a high chance of preterm birth &lt;37 weeks (12 studies, 212 pregnancies) at 22%, 95% CI 0.17–0.29.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Subsequent pregnancy after peripartum cardiomyopathy presents significant maternal and fetal risks. This study provides quantification of risks to begin to fill the current evidence gap, however is limited by the paucity of existing primary research investigating this population. Robust observational studies of current practice are needed to provide answers in specific populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 6","pages":"1009-1025"},"PeriodicalIF":3.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143951917","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 diagnostic accuracy of different fetal blood sample lactate cutoffs in labor, utilizing the StatStrip Xpress® lactate-meter: A population-based observational study","authors":"Magnus B. Berge,&nbsp;Jørg Kessler,&nbsp;Anne Cathrine Staff,&nbsp;Anne Flem Jacobsen","doi":"10.1111/aogs.15140","DOIUrl":"10.1111/aogs.15140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A recent study recommended 5.2 mmol/L as a cutoff for fetal blood sample (FBS) lactate in labor for the StatStrip Lactate®/Lactate Xpress® lactate meter. In the present study, we validated FBS lactate cutoffs in a larger population-based setting, with different CTG guidelines, testing external validity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>We conducted a prospective population-based study at Oslo University Hospital, Ullevål, Norway, a tertiary referral obstetric department with 7000 annual deliveries. Women with a singleton fetus in cephalic presentation in gestational week ≥36 + 0 were included in the analyses. We used ROC curves to calculate the area under the curve (AUC) and estimate the optimal cutoff for the following adverse neonatal outcomes: Umbilical cord pH ≤7.10, umbilical cord pH ≤7.05, metabolic acidosis (pH &lt;7.0 and Base deficit_{extracellular fluid} &gt; 12 mmol/L), 1-minute Apgar score &lt;4, 5-min Apgar score &lt;7, hypoxic ischemic encephalopathy, and transfer to the neonatal intensive care unit. Analyses were restricted to women with a FBS lactate within 25 min prior to delivery. The study is registered in clinicaltrials.gov (ClinicalTrials.gov Identifier: NCT04779294).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 7816 included women, 1466 (19%) had a FBS lactate measurement within 25 min prior to delivery. The calculated optimal cutoff for FBS lactate varied by outcomes: 5-min Apgar score &lt;7: AUC 0.69 (0.57–0.80), cutoff 4.0 mmol/L; metabolic acidosis: AUC 0.92 (0.78–1.00), cutoff 7.0 mmol/L; hypoxic ischemic encephalopathy: AUC 0.95 (0.86–1.00), cutoff 4.7 mmol/L. Sensitivity increased for some of the outcomes with a decreasing cutoff. Specificity increased for all outcomes with an increasing cutoff.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We consider an FBS lactate cutoff of ≥5.2 mmol/L a good balance between high sensitivity for adverse neonatal outcomes and an acceptable number of needed interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 8","pages":"1496-1504"},"PeriodicalIF":3.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959357","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 migraine, migraine subtype, and adverse pregnancy outcomes: A systematic review and meta-analysis","authors":"Anna Steen Hansen,&nbsp;Cecilie Holm Christiansen,&nbsp;Ane Lilleøre Rom,&nbsp;Nina Olsen Nathan,&nbsp;Marie Stampe Emborg,&nbsp;Line Rode,&nbsp;Hanne Kristine Hegaard","doi":"10.1111/aogs.15115","DOIUrl":"10.1111/aogs.15115","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;Migraine is one of the most prevalent conditions worldwide. This systematic review aimed to evaluate the association between migraine, its subtypes, and adverse pregnancy outcomes.&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;Eligible cohort and retrospective case–control studies were included from PubMed and Embase databases from their inception to May 2024. Adverse pregnancy outcomes of interest were preeclampsia, preterm birth, low birthweight, small for gestational age, and placental abruption. Study quality was assessed using the Newcastle-Ottawa Scale. Meta-analyses of the outcomes with their odds ratios (ORs) and adjusted ORs (aOR), including a 95% confidence interval (CI), were performed using RevMan. Outcomes were pooled using random effects models, with separate analyses for cohort and retrospective case–control studies. The protocol was registered with PROSPERO (no. CRD42023404759).&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;This meta-analysis included 19 studies (11 cohort and 8 retrospective case–control) encompassing 1 420 690 deliveries. Significant associations were observed between migraine and increased risk of preeclampsia (cohort: aOR 1.28 [95% CI: 1.11–1.47], &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%), (retrospective case–control: aOR 3.4 [95% CI: 1.81–6.4], &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 83%) and preterm birth (cohort: aOR 1.30 [95% CI: 1.17–1.44], &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 11%). The meta-analyses of adjusted data on low birthweight and small for gestational age were inconsistent with respect to statistical significance (cohort: aOR 1.27 [95% CI: 0.89–1.82], &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 36% and cohort: aOR 1.07 [95% CI: 1.03–1.12], &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%, respectively). In addition, migraine without aura (MO) (cohort: OR 1.62 [95% CI: 1.30–2.01], &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%; retrospective case–control: aOR 4.91 [95% CI: 2.78–8.67], &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%) and migraine with aura (MA) (cohort: OR 2.06 [95% CI: 1–4.27], &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 29%) were significantly associated with the risk of preeclampsia. Similarly, MO (cohort: OR 1.28 [95% CI: 1.11–1.49], &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%) and MA (cohort: OR 1.25 [95% CI: 1.07–1.47], &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%) were associated with preterm birth risk.&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;Pregnant women with migraines have a higher risk of preeclampsia and preterm birth compared with those without migraines. Migraine could be associated with an increased risk of low birth weight and small for gestational age. Sub-analyses indicate an elevated r","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 6","pages":"1026-1040"},"PeriodicalIF":3.5,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960408","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":"Magnetic resonance guided high intensity focused ultrasound (MR-HIFU) effectively reduces fibroid-related symptoms and improves quality of life—A prospective single-centre 12-month follow-up study","authors":"Saara Otonkoski,&nbsp;Antti Viitala,&nbsp;Gaber Komar,&nbsp;Teija Sainio,&nbsp;Anna Yanovskiy,&nbsp;Roberto Blanco Sequieros,&nbsp;Antti Perheentupa,&nbsp;Kirsi Joronen","doi":"10.1111/aogs.15086","DOIUrl":"10.1111/aogs.15086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Uterine fibroids are the most common benign tumors among women, and it is estimated that approximately 70% of women have one or multiple fibroids by the age of menopause. About 30% of these women suffer from symptoms related to the fibroids. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a novel, non-invasive treatment method for symptomatic uterine fibroids.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>In this prospective, single-centre follow-up study, 175 women with symptomatic uterine fibroids were treated with MR-HIFU. The effect of MR-HIFU on fibroid symptoms and quality of life was evaluated using a uterine fibroid-specific quality of life questionnaire (UFS-QoL). The main outcome measure was the symptom severity score and quality of life (QoL) before the MR-HIFU and 3 and 12 months after the treatment. This study was registered at clinicaltrials.gov (NCT03937401).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median symptom severity score decreased from 56 (IQR 44–69) at baseline to 28 (IQR 16–44) at 3 months (<i>p</i> &lt; 0.01) and 25 (IQR 16–38) at 12 months (<i>p</i> &lt; 0.01) after treatment. The QoL score increased from a median of 48 (IQR 33–66) at baseline to 73 (IQR 59–93) at 3 months (<i>p</i> &lt; 0.01) and 78 (IQR 66–90) at 12 months after treatment (<i>p</i> &lt; 0.01). The reintervention rate during the 12-month follow-up was 2%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MR-HIFU significantly reduces the severity of fibroid-related symptoms in selected patients as early as 3 months after MR-HIFU. The effect persists at 12 months. There is also a significant improvement in the quality of life 3 months after treatment, which further increases at 12 months.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"104 6","pages":"1172-1180"},"PeriodicalIF":3.5,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.15086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958078","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}