Fernanda Villar Fonseca, Gabriela Gracia Malinoski, Giorgia Flexa Zambon, Glória Maria Nassar, Helena Maria Prado Domingues, Heloisa Lipski Landarim, Leonardo Grazziolli
{"title":"Clinical presentation differences of lichen sclerosus in pre- and post-menopausal women.","authors":"Fernanda Villar Fonseca, Gabriela Gracia Malinoski, Giorgia Flexa Zambon, Glória Maria Nassar, Helena Maria Prado Domingues, Heloisa Lipski Landarim, Leonardo Grazziolli","doi":"10.61622/rbgo/2026rbgo15","DOIUrl":"10.61622/rbgo/2026rbgo15","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical differences in the presentation of vulvar lichen sclerosus in pre- and postmenopausal women, aiming to provide insights to improve disease management and promote the health and well-being of affected patients.</p><p><strong>Methods: </strong>This was a retrospective analytical study involving 287 women diagnosed with vulvar lichen sclerosus, conducted between January 2009 and December 2023 at Erasto Gaertner Hospital, in Curitiba, Brazil. Clinical, epidemiological, and therapeutic management aspects were assessed and compared between pre- and postmenopausal patients.</p><p><strong>Results: </strong>Most cases (87%) occurred in women over 50 years of age, showing a strong association with menopause. Systemic arterial hypertension and type II diabetes mellitus were the most frequent comorbidities. Complaints of vulvar atrophy and anatomical deformities predominated among women over 50 years. Pruritus was the most common symptom in both groups, while dyspareunia was more prevalent among younger women. High-potency topical corticosteroid therapy was effective in more than half of the patients in both groups. Additionally, contrary to previous literature, 2% testosterone cream showed significant clinical improvement in the younger group. Progression to in situ neoplasia was observed in 11 cases, and progression to invasive neoplasia occurred in 6 cases.</p><p><strong>Conclusion: </strong>Differences in clinical presentation according to hormonal status reinforce the importance of individualized management strategies. Further studies with larger samples are necessary to optimize treatment approaches and improve quality of life for women affected by this chronic, mutilating, and often neglected dermatosis.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Álvaro Luiz Lage Alves, Lucas Barbosa da Silva, Roxana Knobel
{"title":"Cardiopulmonary arrest and cardiopulmonary resuscitation in pregnancy Number 3 - 2026.","authors":"Álvaro Luiz Lage Alves, Lucas Barbosa da Silva, Roxana Knobel","doi":"10.61622/rbgo/2026FPS3","DOIUrl":"10.61622/rbgo/2026FPS3","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Knowledge and practices of postmenopausal women regarding vitamin D and osteoporosis.","authors":"Yasmin Bastos-Silva, Luiza Borges Aguiar, Luiz Francisco Baccaro, Adriana Orcesi Pedro, Lúcia Costa-Paiva","doi":"10.61622/rbgo/2026rbgo8","DOIUrl":"10.61622/rbgo/2026rbgo8","url":null,"abstract":"<p><strong>Objective: </strong>Vitamin D has a direct influence on musculoskeletal health, and vitamin D deficiency is related to lower bone density and greater bone resorption and to a higher incidence of fractures. To assess knowledge, attitudes and practices regarding vitamin D and osteoporosis in postmenopausal women.</p><p><strong>Methods: </strong>This was a cross-sectional study carried out with 260 postmenopausal women who underwent routine consultations at the menopause outpatient clinic of Campinas State University-São Paulo. Women aged 50 years or older with amenorrhea for at least 12 months were included. From an interview, sociodemographic information and health data were collected, and knowledge about vitamin D, habits related to vitamin D, and knowledge about osteoporosis were evaluated using the Facts on Osteoporosis Quiz (FOOQ) questionnaire.</p><p><strong>Results: </strong>A total of 67.31% of women answered less than half of the questions about knowledge of vitamin D, 58.85% performed their day-to-day activities mostly outdoors, and 53.85% said they did not expose themselves sufficiently to the sun in their daily lives. The average knowledge score on the FOOQ was 15.83 (± 3.75). The variables education level, number of correct FOOQ answers and total self-care score were associated with the highest score for knowledge of vitamin D.</p><p><strong>Conclusion: </strong>Knowledge about vitamin D and osteoporosis in this group of postmenopausal women was limited. High levels of education, knowledge about osteoporosis and self-care were factors associated with knowledge about vitamin D.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Genital hiatus area and pelvic floor dysfunction symptoms in transgender women after gender-affirming surgery.","authors":"Marina Hazin, Andrea Lemos, Rogerson Andrade, Letícia Gantzel, Leila Barbosa, Caroline Wanderley Souto Ferreira","doi":"10.61622/rbgo/2026rbgo21","DOIUrl":"10.61622/rbgo/2026rbgo21","url":null,"abstract":"<p><strong>Objective: </strong>To describe genital hiatus area, pelvic floor muscle (PFM) function, pelvic floor dysfunction symptoms and sexual function characteristics of transgender women submitted to gender-affirming surgery.</p><p><strong>Methods: </strong>Six participants were included in this case series conducted in a referral hospital which treats transgender individuals in Brazil. An individual assessment was performed with sociodemographic variables, clinical symptoms, PFM function, neovaginal depth and genital distances. Two and three-dimensional translabial ultrasound were used to measure hiatal dimensions. The results were shown with absolute and relative frequencies, mean and standard deviation.</p><p><strong>Results: </strong>The genital hiatus area had an average of 11.09 (SD 3.49) cm² at rest and 14.36 (SD 3.00) cm² during the Valsalva maneuver. The mean distances of clitoris-vagina, genital hiatus and perineal body were 9.30 (SD 1.57) cm, 6.60 (SD 1.43) cm and 4.00 (SD 1.90) cm, respectively. The mean vaginal depth was 9.50 (SD 3.51) cm. Most volunteers had satisfactory PFM strength and tone. Transgender women reported an increase in daytime urinary frequency (100%), nocturia (83.3%), sensation of incomplete evacuation (66.7%), straining during defecation (50%), flatal incontinence (16.6%), dyspareunia (50%) and anodyspareunia (16.6%). There were no reports of urinary or fecal incontinence, vaginal bulging, perineal pain or dysuria.</p><p><strong>Conclusion: </strong>This is the first study reporting genital hiatus area by translabial ultrasound in transgender women. Adequate levator hiatal area and neovaginal depth were found, preserved PFM tone and strength, preserved urinary and fecal continence, increased daytime urinary frequency, nocturia, sensation of incomplete evacuation, dyspareunia during vaginal sex and moderate vaginal sexual satisfaction.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association of maternal IL-2, IL-4, and IL-13 with intrauterine growth restriction and umbilical artery doppler: a case-control study.","authors":"Bahareh Mousavi Afshar, Roghayeh Dargahi, Shervin Tabrizian, Maryam Jafarzadeh, Sajad Sarkhani, Nasrin Sarkhani","doi":"10.61622/rbgo/2026rbgo22","DOIUrl":"10.61622/rbgo/2026rbgo22","url":null,"abstract":"<p><strong>Objective: </strong>Maternal pro-inflammatory responses have been implicated in pregnancy complications. This study examined the association of maternal serum IL-2, IL-4, and IL-13 levels with intrauterine growth restriction (IUGR) and umbilical artery Doppler indices.</p><p><strong>Methods: </strong>This case-control study was conducted at Alavi Teaching and Referral Hospital, Ardabil, Iran, from August 2024 to June 2025. Sixty singleton pregnant women (30 with IUGR and 30 with normal pregnancies) between 28-36 weeks of gestation were included. Umbilical artery resistive (RI) and pulsatility (PI) indices were assessed by a single sonographer, and serum cytokine levels were measured using ELISA. Statistical analyses (t-test, chi-square, Pearson's correlation, logistic regression) were performed with SPSS v25. The study was approved by the Ethics Committee of Ardabil University of Medical Sciences (no. 1403.049).</p><p><strong>Results: </strong>Compared with controls, the IUGR group had higher IL-2 and lower IL-4 and IL-13 levels, as well as increased PI and RI (all P<0.05). Elevated IL-2 (OR=1.027; 95%CI: 1.011-1.044; P=0.001) and reduced IL-4 (OR=0.963; 95%CI: 0.929-0.999; P=0.042) and IL-13 (OR=0.978; 95%CI: 0.962-0.995; P=0.009) were independently associated with IUGR. IL-2 correlated positively, while IL-4 and IL-13 correlated negatively, with both Doppler indices (all P<0.05).</p><p><strong>Conclusions: </strong>Pregnant women with IUGR exhibited a pro-inflammatory Th1-biased cytokine profile, characterized by increased IL-2 and decreased IL-4 and IL-13, which correlated with elevated umbilical vascular resistance. These findings suggest an immunologic contribution to placental dysfunction. However, given the observational design and small sample size, causal inferences cannot be made, and confirmation in larger multicenter studies is warranted.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kellen Crizel da Rocha, Everton Bruno Castanha, Maria Eduarda Minervino Elias, Celene Maria Longo da Silva
{"title":"Human papillomavirus-based vs. cytology for cervical cancer screening: a systematic review with meta-analysis.","authors":"Kellen Crizel da Rocha, Everton Bruno Castanha, Maria Eduarda Minervino Elias, Celene Maria Longo da Silva","doi":"10.61622/rbgo/2026rbgo130","DOIUrl":"10.61622/rbgo/2026rbgo130","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance of HPV-based testing compared to cytology in primary cervical cancer screening.</p><p><strong>Study selection: </strong>This meta-analysis included randomized trials comparing HPV-based screening with cytology in women aged 20-69 with at least one year of follow-up. Studies with overlapping populations, combining screening methods, lacking outcomes of interest, or study protocols were excluded. CENTRAL, PubMed/MEDLINE, and Embase were searched on April 12, 2025. The main outcome is the detection rate of cervical neoplasia grade 2 or worse (CIN2+).</p><p><strong>Data collection: </strong>Analyses followed Cochrane and PRISMA guidelines.</p><p><strong>Data synthesis: </strong>A total of 1,707 articles were identified. After removing duplicate records and excluding studies according to the pre-established criteria, 24 were selected for full-text review. Finally, eight were included in the statistical analysis, totaling 414,846 patients in a per-protocol assessment. The detection rate of CIN2+ by HPV-based tests was 61% higher compared to conventional or liquid-based cytology [RR 1.61; 95% CI 1.30, 1.98; p < 0.00001]. While our findings demonstrate the superior sensitivity of HPV testing, there are concerns about potential overdiagnosis and overtreatment. The absence of defined management protocols for HPV-positive patients contributes to this challenge. Therefore, risk-stratification strategies, such as HPV DNA genotyping, are essential to optimize clinical care and reduce these risks.</p><p><strong>Conclusion: </strong>HPV-based screening has a greater capacity to identify cervical neoplasia than cytology.PROSPERO registry: ID CRD420251027259.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sibele Maria Schuantes-Paim, Dani Ejzenberg, Beatriz Souza Braga Mergulhão, Gabriela Mininel de Medeiros, Anne Caroline Neves Geraldo, Vinícius Temóteo Ferrari, Bartira de Aguiar Roza, Janine Schirmer
{"title":"Risks of uterus transplantation: a scoping review.","authors":"Sibele Maria Schuantes-Paim, Dani Ejzenberg, Beatriz Souza Braga Mergulhão, Gabriela Mininel de Medeiros, Anne Caroline Neves Geraldo, Vinícius Temóteo Ferrari, Bartira de Aguiar Roza, Janine Schirmer","doi":"10.61622/rbgo/2026rbgo14","DOIUrl":"10.61622/rbgo/2026rbgo14","url":null,"abstract":"<p><strong>Objective: </strong>To map risks related to uterus transplantation.</p><p><strong>Methods: </strong>Scoping review based on the Joanna Briggs Institute method. Were included studies published in scientific journals that described complications, adverse events, and risks in women who were uterine transplant recipients, living uterine donors, and newborns, infants and children born from transplanted uteri. A modified version of Failure Modes and Effects Analysis was used for data collection, and the data were quantitatively analyzed through the development of risk categories and risks rates calculation.</p><p><strong>Results: </strong>In total 44 studies from 13 countries were included. Mapped 115 patients, 62 recipients, 34 donors, and 19 newborns, infants, and children born from transplanted uteri, 324 complications and adverse events across 25 risk categories. An online system (UTx Observatory) was developed. Among recipients, 77.5% received uteri from living donors, and 22.5% from deceased donors with most prevalent immunological, vascular, infectious, and prematurity risks. Recipients of deceased donor uteri had a higher adjusted risk rate. Among living donors, most prevalent risks were neurological, infectious, and urological risks. Laparotomy (76.5%) was associated with a higher adjusted risk rate than robotic-assisted surgery (23.5%) for uterus donation. Mainly risks mapped from newborns, infants, and children were respiratory, development-related, and malformations.</p><p><strong>Conclusion: </strong>The study and the UTx Observatory provide a foundation for developing targeted risk-mitigation strategies, shaping future studies and interventions, and informing health teams, authorities, and patients involved in uterus transplantation.Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/524UT.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mariane Nunes de Nadai, Carolina Sales de Oliveira, Cristina Falbo Guazzelli, Milena Brito, Zsuzsanna Ilona Katalin de Jármy Di Bella, Ilza Maria Urbano Monteiro
{"title":"LNG-IUD and breast cancer: Number 2 - 2026.","authors":"Mariane Nunes de Nadai, Carolina Sales de Oliveira, Cristina Falbo Guazzelli, Milena Brito, Zsuzsanna Ilona Katalin de Jármy Di Bella, Ilza Maria Urbano Monteiro","doi":"10.61622/rbgo/2026FPS2","DOIUrl":"10.61622/rbgo/2026FPS2","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Magda Spinello Consul da Silva, Gustavo Yano Callado, Edward Araujo Júnior, Julio Elito
{"title":"Psychological support and postpartum depression in twin gestations: a prospective analysis using the Edinburgh Scale.","authors":"Magda Spinello Consul da Silva, Gustavo Yano Callado, Edward Araujo Júnior, Julio Elito","doi":"10.61622/rbgo/202602","DOIUrl":"10.61622/rbgo/202602","url":null,"abstract":"<p><strong>Objective: </strong>To assess the risk of postpartum depression (PPD) in women with twin pregnancies using the Edinburgh Postnatal Depression Scale (EPDS), and to explore associations between maternal and neonatal complications and depressive symptoms during the postpartum period.</p><p><strong>Methods: </strong>This prospective, mixed-methods study was conducted at the Multiple Pregnancy Outpatient Clinic. Fourteen women with twin pregnancies received psychodynamic psychological prenatal care throughout the pregnancy-puerperal cycle. Postpartum depressive symptoms were screened using the EPDS, with scores ≥13 indicating probable PPD. Associations between EPDS scores and obstetric or perinatal variables were analyzed using Pearson correlation and contingency tables.</p><p><strong>Results: </strong>A high prevalence of depressive symptoms was observed among participants, with 28.6% screening positive for probable PPD and an additional 21.4% at mild risk. Higher EPDS scores were associated with intrapartum hemorrhage, low APGAR scores (1st and 5th <7), cesarean delivery, and neonatal intensive care unit (NICU) admission. Breastfeeding was associated with lower depressive symptom scores. Despite the presence of depressive symptoms in part of the sample, improvements in emotional domains such as anxiety and sadness were noted, suggesting a potential benefit of continuous psychodynamic support.</p><p><strong>Conclusion: </strong>Women with twin pregnancies are at increased risk of postpartum depression, particularly when compounded by obstetric and neonatal complications. Routine mental health screening and structured psychological support-such as psychodynamic prenatal care-should be considered integral components of care for women with multiple gestations. Further studies with larger samples and comparison groups are needed to refine preventive strategies.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Larissa Maroni, Pedro Clarindo Silva, Rafael Kunst, Ricardo Francalacci Savaris
{"title":"Diagnosing ectopic pregnancy using the bayes theorem and neural network: a validation of a retrospective cohort study.","authors":"Larissa Maroni, Pedro Clarindo Silva, Rafael Kunst, Ricardo Francalacci Savaris","doi":"10.61622/rbgo/2026rbgo12","DOIUrl":"10.61622/rbgo/2026rbgo12","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the accuracy of neural networks and Naïve Bayes models in diagnosing ectopic pregnancy, using clinical data, hCG levels, and transvaginal ultrasound findings from a real dataset.</p><p><strong>Methods: </strong>This was a retrospective cohort study based on a public dataset of 2,495 first-trimester pregnant women with confirmed pregnancy under 13 weeks, documented transvaginal ultrasound reports, and follow-up on pregnancy outcome. The cohort presented a natural imbalance (8.5% ectopic, 91.5% intrauterine pregnancies), reflecting real-world clinical prevalence. Data on risk factors, clinical symptoms, ultrasound findings, and serial hCG levels were included. The dataset was preprocessed and split into training (80%) and testing (20%) sets using stratified sampling based on pregnancy outcome to preserve the proportion of ectopic cases in both sets. The main outcome measures were accuracy, sensitivity, specificity, and F1 score.</p><p><strong>Results: </strong>The neural network model achieved an accuracy of 99.4%, sensitivity of 94.6%, specificity of 97.2%, and an F1 score of 95.9%. The Naïve Bayes model showed an accuracy of 96.5%, sensitivity of 98.1%, specificity of 71.2%, and an F1 score of 82.5%. Both models were validated without evidence of overfitting.</p><p><strong>Conclusion: </strong>The neural network model demonstrated statistically significant superior accuracy and reliability in diagnosing ectopic pregnancy compared to the Naïve Bayes model (McNemar's test, p < 0.001), suggesting the potential of machine learning models, particularly deep learning, to enhance early diagnosis and clinical decision-making.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}