Acta Obstetricia et Gynecologica Scandinavica最新文献

{"title":"All-cause mortality after self-reported vs. hospital-reported gynecological surgery: The HUNT study.","authors":"Tina Ellinor Rosland, Nora Johansen, Astrid Helene Liavaag, Bjørn Olav Åsvold, Are Hugo Pripp, Trond Melbye Michelsen","doi":"10.1111/aogs.70354","DOIUrl":"10.1111/aogs.70354","url":null,"abstract":"<p><strong>Introduction: </strong>The impact of hysterectomy and bilateral oophorectomy on future mortality risk is still debated. Self-reported exposure may be a major source of bias in many studies. We aimed to determine mortality following hospital-reported hysterectomy and bilateral oophorectomy and compare to results based on self-reported surgeries.</p><p><strong>Material and methods: </strong>We included 37 140 women from the second (1995-1997) and third (2006-2008) HUNT surveys. HUNT (the Trøndelag Health Study) is a population-based Norwegian cohort study, and we linked to the Norwegian Cause of Death Registry, the Cancer Registry of Norway, and hospital surgical codes. The participants were followed from inclusion in HUNT until December 2020. Women were classified as unexposed, exposed to hysterectomy alone, exposed to bilateral oophorectomy alone, or exposed to both surgeries. Hospital-reported exposure was determined using surgical procedure codes, whereas self-reported exposure was obtained from the HUNT questionnaires. To be classified as exposed based on self-report, a woman had to indicate that she had undergone the surgery and provide her age at the time of the procedure. We compared the hazard of death in unexposed vs. exposed groups using Cox regression analysis, adjusting for relevant covariates.</p><p><strong>Results: </strong>Compared with unexposed women, hospital-reported hysterectomy was associated with a reduced hazard of death (HR 0.72 [95% CI 0.62-0.84]), while self-reported hysterectomy showed no association (HR 1.06 [95% CI 0.97-1.16]). For bilateral oophorectomy, hospital-reported cases showed an HR of 0.83 (95% CI 0.64-1.07), while self-reported cases indicated an HR of 1.14 (95% CI 0.97-1.33). Women who had both hysterectomy and bilateral oophorectomy demonstrated no significant association with mortality, regardless of whether the surgeries were hospital-reported (HR 1.13 [95% CI 0.96-1.34]) or self-reported (0.93 [95% CI 0.82-1.06]). Early hospital-reported bilateral oophorectomy was associated with an increased hazard of death, particularly when performed before the age of 50.</p><p><strong>Conclusions: </strong>Results differed between hospital-reported and self-reported exposure. This could explain the heterogeneity observed in previous studies on mortality risk after hysterectomy and oophorectomy. In this study, hospital-reported hysterectomy and bilateral oophorectomy were not associated with increased mortality, whereas early bilateral oophorectomy was.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975289","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":"Abortion—A brief description of the evolution of methods","authors":"Laura Slade,&nbsp;Andrea Deussen,&nbsp;Jodie Dodd","doi":"10.1111/aogs.70282","DOIUrl":"10.1111/aogs.70282","url":null,"abstract":"<p>Throughout history, women across the world have undergone abortion. This is despite a variety of religious and legal oppositions that remain present in many countries today. Procedures for abortion have evolved considerably and now include safe and effective methods, and access has improved in many settings. There are however many individuals across the world living in environments with restricted access to safe methods because of legal, logistical and social barriers. We discuss a brief history of methods used to terminate pregnancy in the first and second trimesters of pregnancy.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"105 10","pages":"1898-1903"},"PeriodicalIF":3.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148617904","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":"Nausea and vomiting of pregnancy in relation to fear of childbirth: Evidence from a Finnish cohort","authors":"Anna Murto,&nbsp;Linda Laitinen,&nbsp;Eeva Terävä-Utti,&nbsp;Miina Nurmi,&nbsp;Mari Koivisto,&nbsp;Päivi Polo-Kantola","doi":"10.1111/aogs.70307","DOIUrl":"10.1111/aogs.70307","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Nausea and vomiting of pregnancy (NVP) is a common disorder affecting most pregnant women. Previous studies have suggested associations between NVP and psychological pregnancy complications, whereas only a limited number of studies have explored a possible association with fear of childbirth (FOC). Shared biological underlying factors have been proposed, but the precise mechanisms remain poorly understood. The objective of our study was to explore the relationship between NVP and FOC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Pregnant women (<i>n</i> = 2411) were recruited from maternity health care clinics in the Turku area, Finland. The severity of NVP was evaluated with the Pregnancy-Unique Quantification of Emesis (PUQE) questionnaire, and the women were categorized into two groups: the no/mild NVP group (PUQE points 3–6, <i>n</i> = 963) and the moderate/severe NVP group (PUQE points 7–15, <i>n</i> = 1366). Data on FOC (International Statistical Classification of Diseases, 10th Revision [ICD-10] code O99.80) and maternal characteristics (age, body mass index, parity, marital status, employment status, and smoking) were drawn from the Finnish Medical Birth Register. The association between NVP and FOC was evaluated using logistic regression adjusted for maternal characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The data of 2329 women were eligible for the analysis. Compared with the women in the no/mild NVP group, those in the moderate/severe NVP group were more likely to suffer from FOC (OR 1.69, 95% CI 1.11–2.58, <i>p</i> = 0.015). The difference between the groups remained after adjustment for maternal background factors (aOR 1.72, 95% CI 1.09–2.71, <i>p</i> = 0.019).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We showed an association between more severe NVP and FOC. The evidence from our study implies that, beyond the physical manifestation, NVP may contribute to psychological distress and influence women's perception of childbirth. These findings highlight the importance of also addressing the psychological aspects of NVP in clinical care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"105 10","pages":"2005-2011"},"PeriodicalIF":3.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148409966","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":"Effects of gestational weight gain and HbA1C on fetal growth and birthweight in women with obesity","authors":"Maja Lecic Bonnichsen,&nbsp;Elisabeth Qvigstad,&nbsp;Lill Trine Nyfløt,&nbsp;Guttorm Haugen,&nbsp;William R. P. Denault,&nbsp;Marie Cecilie Roland","doi":"10.1111/aogs.70298","DOIUrl":"10.1111/aogs.70298","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Fetal growth and birthweight are influenced by various endogenous and exogenous factors during pregnancy. Pregnant women with obesity face higher rates of complications, which can impact fetal growth. This study aims to explore how gestational weight gain and metabolic factors, such as HbA1C and adipokines, are associated with fetal growth in the second and third trimesters and with birthweight in Norwegian women with a pregestational BMI ≥35 kg/m².</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>We conducted a prospective longitudinal cohort study at the Department of Gynecology and Obstetrics at Drammen Hospital from 2016 to 2019. We included 163 pregnant women (nulliparous 47.6%) with pregestational BMI ≥35 kg/m² and singleton pregnancy, excluding type 1 and 2 diabetes. Gestational weight gain (GWG) was calculated as the difference between pregestational weight and the last weight before delivery. Fetal growth was monitored via ultrasonography at five time points, alongside fasting metabolic samples withdrawn around 18 and 36 weeks' gestation. Statistical analyses were conducted using linear regression in Stata Version 17.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean birthweight was within normal ranges (mean <i>z</i>-score 0.117). However, the proportions of LGA (18.4%) and SGA (12.9%) were high. One in three women was diagnosed with GDM, of whom approximately one in three needed medical treatment. In the adjusted multivariate analyses, only HbA1C measured around gestational week 36 and the weekly weight gain remained positively associated with birthweight, biparietal diameter, and mean abdominal diameter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this population of pregnant women with pBMI ≥35 kg/m², weekly GWG calculated from weight measurement around 36 weeks' gestation was positively associated with birthweight (<i>z</i>-score), mean abdominal diameter (MAD), and biparietal diameter (BPD). HbA1C was positively associated with birthweight (<i>z</i>-score). Our results indicate that HbA1C and the modifiable GWG are exposures with the potential to influence fetal growth and birthweight. Nevertheless, current follow-up protocols do not routinely emphasize these factors. Their evaluation therefore warrants further investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"105 10","pages":"1994-2004"},"PeriodicalIF":3.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148710948","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":"Planned cesarean section or attempted vaginal delivery: Which is more environmentally friendly? An observational life cycle assessment study in France.","authors":"Sherazade Jaafar, Sayed Gillani, Sophie Cordier, Charles Garabedian","doi":"10.1111/aogs.70335","DOIUrl":"10.1111/aogs.70335","url":null,"abstract":"<p><strong>Introduction: </strong>While the health sector is known to contribute significantly to environmental degradation, little is known about the specific ecological footprint of childbirth. We thus aimed to compare the environmental impacts of attempted vaginal delivery and planned cesarean section (c-section), and to identify opportunities for improvement.</p><p><strong>Material and methods: </strong>We performed a life cycle assessment to quantify 16 environmental impact indicators from vaginal and c-section deliveries. Data were collected at Lille University Hospital in 2024. Hotspot analyses were undertaken to identify the most impactful stages within each scenario.</p><p><strong>Results: </strong>Attempted vaginal delivery consistently had a lower environmental impact compared with planned c-section, the carbon footprints of which were 23.2 kg carbon dioxide equivalent (CO₂e) versus 42.9 kg CO₂e, respectively. Compared with planned c-section, attempted vaginal delivery reduced greenhouse gas emissions by 46%, water consumption by 26%, fossil resource use by 44%, and mineral and metal resource use by 30%.</p><p><strong>Conclusions: </strong>Attempted vaginal delivery is more environmentally sustainable compared with planned c-section. Perinatal health professionals should incorporate environmental considerations into clinical and public health decision-making, and should engage in other efforts to reduce this sector's contributions to climate change.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918082","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":"Methodological considerations in the implementation of HPV self-sampling for cervical cancer screening.","authors":"Faizan Ahmed, Maryam Bibi, Shahzadi Gulfishan, Ahmed Raza, Muhammad Hassan Imtiaz","doi":"10.1111/aogs.70356","DOIUrl":"10.1111/aogs.70356","url":null,"abstract":"","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13547937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900065","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":"Magnesium sulfate for neuroprotection before preterm birth: Uptake and adherence in clinical practice after National Guideline Implementation.","authors":"Hanne Trap Wolf, Sofie Elise Gellert, Lene Drasbek Huusom, Mads Langager Larsen","doi":"10.1111/aogs.70348","DOIUrl":"10.1111/aogs.70348","url":null,"abstract":"<p><strong>Introduction: </strong>Magnesium sulfate (MgSO₄) administered before very preterm birth reduces the risk of cerebral palsy in surviving infants and is recommended in international guidelines. In April 2020, a national guideline for MgSO₄ for fetal neuroprotection was introduced in Denmark. We evaluated clinical uptake and adherence following guideline implementation.</p><p><strong>Material and methods: </strong>This retrospective medical chart review study included women who delivered at gestational age 24 + 0 to 31 + 6 weeks of gestation at nine different Danish hospitals between April 2020 and December 2023. These departments handled around 50% of all deliveries in Denmark in this period. Data were obtained from electronic medical records. The primary outcome was administration of MgSO₄ for fetal neuroprotection among eligible women. Secondary outcomes included temporal trends in uptake, differences by gestational age and hospital size, and documented reasons for non-administration. Descriptive statistics were used to summarize uptake rates and patient characteristics, and comparisons were performed using appropriate statistical tests.</p><p><strong>Results: </strong>A total of 583 eligible women were included. Overall, 481 women (83%) received MgSO₄ for fetal neuroprotection; of these, 340 women (71%) received MgSO₄ within 24 h of birth. Uptake was highest among women delivering before 28 weeks of gestation, where MgSO₄ was administered in nearly all eligible cases. Among women delivering between 28 + 0 and 31 + 6 weeks, approximately one in five did not receive treatment. Uptake did not increase over the study period, suggesting early adoption followed by stable implementation. Large-volume hospitals demonstrated higher treatment rates compared with smaller hospitals. The most frequent reasons for non-administration were lack of guideline awareness/oversight at later gestational ages and rapid delivery or maternal/fetal instability at earlier gestations.</p><p><strong>Conclusions: </strong>Following the implementation of the national guideline, uptake of MgSO₄ for fetal neuroprotection in Denmark was high but incomplete. Persistent gaps in treatment, particularly among women delivering after 28 weeks of gestation, indicate a need for targeted implementation strategies to improve adherence and ensure equitable neuroprotective care.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148885886","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) therapy of uterine fibroids effectively reduces both bleeding and bulk symptoms-A prospective single-center 12-month follow-up study.","authors":"Saara Otonkoski, Antti Viitala, Gaber Komar, Teija Sainio, Anna Yanovskiy, Ina Lehtonen, Roberto Blanco Sequeiros, Antti Perheentupa, Kirsi Joronen","doi":"10.1111/aogs.70268","DOIUrl":"10.1111/aogs.70268","url":null,"abstract":"<p><strong>Introduction: </strong>Uterine fibroids are common benign neoplasms in women. Magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) is a noninvasive treatment that has been shown to reduce fibroid-related symptoms and improve quality of life (QoL). In this study, we aimed to clarify symptom reduction in patients with isolated bleeding or bulk symptoms.</p><p><strong>Material and methods: </strong>This prospective study with a 12-month follow-up included 163 women with uterine fibroids causing either bleeding or bulk symptoms and deemed suitable for MR-HIFU treatment. Treatments were carried out using an extracorporeal tabletop MR-HIFU system (Sonalleve V2, Profound Medical Inc., Mississauga, Canada). The non-perfused volume ratio (NPV%) was determined after treatment. Symptom severity and QoL were assessed using the Uterine Fibroid Symptom and Quality of Life questionnaire at baseline, 3 months, and 12 months after treatment. The study was registered at ClinicalTrials.gov (NCT02914704).</p><p><strong>Results: </strong>A total of 122 women with bleeding and 41 women with bulk symptoms were included. The overall mean NPV% for all patients was 62%. The median symptom severity score (SSS) at baseline was 56 (IQR 47-69) and 46 (34-63), at 3 months 28 (16-44) and 19 (6-30), and at 12 months 25 (13-31) and 19 (6-41) for the bleeding and bulk groups, respectively. The reduction of SSS was statistically significant between baseline and 3 months (p < 0.001) and between baseline and 12 months (p < 0.001) in both groups. The median of QoL at baseline was 43 (IQR 31-58) and 74 (45-83), at 3 months 70 (53-82) and 89 (74-97), and at 12 months 82 (69-91) and 82 (67-100) for the bleeding and bulk groups, respectively. In the bleeding patients, the increase in QoL was statistically significant between all the time points compared (p < 0.05). In the bulk group, the increase in QoL was statistically significant from baseline to 3 months (p < 0.001) and from baseline to 12 months (p < 0.01).</p><p><strong>Conclusions: </strong>MR-HIFU resulted in significant symptom reduction and improved QoL in patients with both bleeding and bulk-related fibroid symptoms. When successful, MR-HIFU provides effective and rapid symptom relief for both symptom types.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"1840-1847"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248812","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":"Balancing diagnostic accuracy and cost in the follow-up of histological low-grade squamous intraepithelial lesions.","authors":"Riina Aarnio, Vasudha Ahuja, Linda Ryen, Lovisa Bergengren","doi":"10.1111/aogs.70255","DOIUrl":"10.1111/aogs.70255","url":null,"abstract":"<p><strong>Introduction: </strong>Primary cervical screening with testing for human papillomavirus (HPV) brings increased detection of women with low-grade squamous intraepithelial lesion recommended for follow-up with colposcopy. This study evaluates whether co-testing (HPV + cytology) or testing for HPV alone can safely replace colposcopy as follow-up for histologically confirmed low-grade squamous intraepithelial lesions. It estimates these strategies' diagnostic performance in detecting histological high-grade squamous intraepithelial or more severe lesions at follow-up and analyzes their relative cost-effectiveness.</p><p><strong>Material and methods: </strong>This is a retrospective cohort study on follow-up data of women aged 23-70 with histological low-grade squamous intraepithelial lesion, diagnosed during 2017-2018, with an analysis of data from the Swedish National Cervical Screening Registry. Out of the 14 643 women with low-grade squamous intraepithelial lesions, 4213 women with complete data on HPV, cytology, and histology results were analyzed. The primary outcome was to estimate the diagnostic performance of the strategies of co-testing (HPV + cytology) and human papillomavirus-alone in detecting histological high-grade squamous intraepithelial or more severe lesions in the follow-up of histological low-grade squamous intraepithelial lesions. The secondary outcome was to perform a cost-effectiveness analysis of these strategies.</p><p><strong>Results: </strong>Using co-testing as the primary follow-up and reserving colposcopy for women who tested positive for HPV or cytology results yielded a sensitivity of 96% for high-grade squamous intraepithelial or more severe lesions. HPV-alone testing had 88% sensitivity. Adding colposcopy to co-testing would require 1735 (70%) additional examinations to detect 14 (3.9%) more women with high-grade squamous intraepithelial or more severe lesions. No cancer cases were missed by co-testing or HPV-alone. The cost of detecting one extra high-grade squamous intraepithelial or more severe lesion by adding colposcopy to co-testing was 81 959 EUR.</p><p><strong>Conclusions: </strong>Histological low-grade squamous intraepithelial lesion follow-up can be safely managed with co-testing, considerably reducing the number of colposcopies and associated costs.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"1871-1878"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004111","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":"Central sensitization in patients with chronic pelvic pain resistant to hormonal therapy: A cross-sectional study of prevalence and clinical correlates in a tertiary referral cohort.","authors":"Hajar Alawadi, Marie Cid, Jérôme Delotte, Pierre-Alexis Gauci","doi":"10.1111/aogs.70266","DOIUrl":"10.1111/aogs.70266","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pelvic pain (CPP) affects over 25% of women, with endometriosis being a predominant cause. Central sensitization, particularly pelvic and perineal pain central sensitization (PPCS), is increasingly recognized as a key mechanism in CPP, yet its prevalence and clinical implications across the broader CPP population are underexplored.</p><p><strong>Material and methods: </strong>The aim was to determine the prevalence of PPCS among patients with CPP unresponsive to hormonal therapy and to assess its impact on symptomatology, analgesic consumption, and quality of life. This retrospective study included 270 consecutive patients presenting for the first time with CPP resistant to hormonal therapy, with or without endometriosis, at a tertiary referral center in France (2024-2025). PPCS was defined using the Convergences PP criteria (score ≥5), and neuropathic-like features using the DN4 score (≥4). Data collected included pain features, comorbid symptoms, quality of life (EHP-5), history of violence, and prior treatments. Multivariable logistic and linear regression analyses were conducted to assess associations with analgesic use and EHP-5 scores.</p><p><strong>Results: </strong>PPCS was present in 54.4% of patients and associated with more severe, multisystem symptoms, including urinary, gastrointestinal, and sexual dysfunction. Patients with PPCS had significantly higher use of strong analgesics (adjusted OR 2.48, 95% CI: 1.05-5.83, p = 0.038) and markedly impaired quality of life (+5.19 EHP-5 points, p < 0.001). A history of gender-based violence, reported by 25.9% of patients, was independently associated with higher analgesic consumption (aOR 2.56, p = 0.028) and was more prevalent among those with PPCS. Neuropathic-like features were associated with lower quality of life but not with increased analgesic use.</p><p><strong>Conclusions: </strong>These findings support routine screening for central sensitization and trauma history in gynecological practice and advocate for multidisciplinary, trauma-informed, and neuromodulation-focused approaches to CPP management.</p>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":" ","pages":"1833-1839"},"PeriodicalIF":3.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13394637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148040743","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}