Therapeutic advances in reproductive health最新文献

{"title":"Ovarian tissue cryopreservation: a narrative review on cryopreservation and transplantation techniques, and the clinical outcomes.","authors":"Zahra Karimizadeh, Zohreh Saltanatpour, Azadeh Tarafdari, Mahroo Rezaeinejad, Amir Ali Hamidieh","doi":"10.1177/26334941251340517","DOIUrl":"10.1177/26334941251340517","url":null,"abstract":"<p><p>Fertility preservation (FP) includes all the methods to preserve germ cells, reproductive tissues, or embryos for the future reproduction of patients at risk of infertility. Cryopreservation is an essential step of FP, storing the specimens in subzero temperatures to suppress cellular metabolism and restore cryopreserved specimens for future use. Although oocyte cryopreservation (OC) and embryo cryopreservation (EC) are two accepted methods of FP in women, ovarian tissue cryopreservation (OTC) is a novel method that is favorable in patients who are not appropriate candidates for OC and EC, and those who suffer from irritating menopause symptoms caused by estradiol deficiency. OTC has shown promising results in restoring fertility and the endocrine function of ovaries. Slow freezing and vitrification are two well-established methods for cryopreservation of biological specimens. Despite recent developments in the vitrification of ovarian tissue and comparable results to slow freezing, we lack a standard protocol for ovarian tissue vitrification, and slow freezing is still the preferred method in most centers. Under an acceptable medical condition and desirability, transplantation of cryopreserved tissue is performed either in orthotopic sites (orthotopic transplantation, OT) such as the original site of the ovaries and uterus, or heterotopic sites (heterotopic transplantation, HT) like abdominal wall, forearm, and peritoneal lining. Although both sites of transplantation are associated with endocrine function recovery, OT better restores fertility. This review will focus on OTC and its types, ovarian tissue transplantation, and efficacy in clinical practice.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"19 ","pages":"26334941251340517"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217782","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":"Application of the Robson classification in assessing cesarean section rates: an audit of a tertiary care hospital's gynecology department in Karachi, Pakistan.","authors":"Syed Muhammad Aqeel Abidi, Syeda Namayah Fatima Hussain, Shahida Abbas, Syeda Tayyaba Fatima Abidi, Sonia Haresh","doi":"10.1177/26334941251339710","DOIUrl":"10.1177/26334941251339710","url":null,"abstract":"<p><strong>Background: </strong>The rising rate of cesarean sections (CSs) has become a global concern due to its implications for maternal and neonatal health. The World Health Organization recommends that CS rates should not exceed 10-15% at the population level. However, many countries report rates well above this threshold.</p><p><strong>Objectives: </strong>To evaluate CS rates using the Robson Ten Group Classification System (TGCS) and identify the major contributing groups to develop targeted strategies for reducing unnecessary cesarean deliveries.</p><p><strong>Design: </strong>A retrospective clinical audit based on standardized classification and descriptive analysis.</p><p><strong>Methods: </strong>This retrospective audit was conducted using hospital delivery records from January 1st to December 31st, 2022, at the Department of Obstetrics and Gynecology, Holy Family Hospital, Karachi, Pakistan. All CSs were categorized into 10 groups using the Robson classification system. Descriptive statistics were used to determine group size, CS rate within each group, relative contribution to the overall CS rate, and absolute group contribution.</p><p><strong>Results: </strong>A total of 1464 deliveries occurred during the study period, including 507 CSs. Of these, 48.8% were elective and 51.2% were emergency CS. The major contributors to the CS rate were group 5 (51.9%), group 2 (18.5%), and group 10 (14.4%). The leading indications for cesarean delivery were previous CS (32.3%), non-progress of labor (21.15%), and cephalopelvic disproportion (16.92%).</p><p><strong>Conclusion: </strong>Targeted strategies such as promoting vaginal birth after cesarean, implementing standardized labor monitoring protocols, and strengthening antenatal counseling can help reduce unnecessary CS while maintaining maternal and neonatal safety.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"19 ","pages":"26334941251339710"},"PeriodicalIF":3.1,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096196","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 between maternal ABO blood group and preeclampsia: a prospective cohort study.","authors":"Zebulon C Okechukwu, George U Eleje, Joseph I Adinma, Gerald O Udigwe, Innocent I Mbachu, Chukwuemeka O Ezeama, Nkiru N Ezeama, Chukwudi A Ogabido, Chukwunwendu F Okeke, Chidinma C Okafor, Stella C Okechukwu, Chinedu L Olisa, Chigozie G Okafor","doi":"10.1177/26334941251338621","DOIUrl":"https://doi.org/10.1177/26334941251338621","url":null,"abstract":"<p><strong>Background: </strong>Preeclampsia is a leading cause of maternal morbidity and mortality. Various predictive methods exist, but none are without flaws. Risk factors vary in different women and at different gestational ages; hence, investigating non-modifiable factors, such as ABO and Rhesus blood groups, may aid prediction and early detection of preeclampsia.</p><p><strong>Objectives: </strong>This study aimed to evaluate the association between maternal ABO blood groups and preeclampsia.</p><p><strong>Design: </strong>This was a prospective cohort study.</p><p><strong>Methods: </strong>This study included singleton, normotensive, Rhesus-positive primigravidae with different ABO blood groups at <20 weeks of gestation. The primary outcome was the incidence of preeclampsia in mothers with Rhesus (D)-positive ABO blood groups (O, A, B and AB), while the secondary outcomes were the overall preeclampsia incidence and the odds ratio for preeclampsia between blood group O and non-O (A, B and AB) participants.</p><p><strong>Results: </strong>A total of 264 participants were enrolled, with 244 followed up until delivery. Eighteen participants developed preeclampsia with an incidence of 7.4% (95% confidence interval: 3.9-10.7). Most participants had blood group O (57.0%), followed by A (29.5%), B (12.7%) and AB (0.8%). The mean gestational age at preeclampsia onset was 37.8 ± 2 weeks. Blood group AB had the highest incidence of preeclampsia (50%), followed by B (16.1%), O (5.8%) and A (5.6%). Among 105 participants with non-O blood groups, 10 developed preeclampsia (<i>p</i> = 0.265). The adjusted odds ratio for the non-O blood group who developed preeclampsia was 1.65.</p><p><strong>Conclusion: </strong>Maternal ABO blood group was not significantly associated with preeclampsia incidence. However, blood group AB exhibited the highest preeclampsia incidence compared with the other blood groups.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"19 ","pages":"26334941251338621"},"PeriodicalIF":3.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054893","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":"A qualitative study of parents and healthcare providers' partnership in improving adolescent sexual and reproductive health services in Rwanda.","authors":"Josephine Uzayisenga, Augustin Nshimiyimana, Madeleine Mukeshimana, Gabriel Muganza, Sylvester Gasurira, Francine Nyirangorore, Aimable Musafili, Laetitia Nyirazinyoye","doi":"10.1177/26334941251337534","DOIUrl":"https://doi.org/10.1177/26334941251337534","url":null,"abstract":"<p><strong>Background: </strong>Adolescents in Africa encounter various sexual and reproductive health (SRH) challenges, such as insufficient information, societal stigma, inadequate services, and cultural obstacles. Enhancing collaboration between parents and healthcare providers can foster trust, improve communication, and provide better support, ultimately leading to improved access, quality, and utilization of SRH services (SRHS) for adolescents.</p><p><strong>Objective: </strong>This paper offers perspectives from parents and healthcare providers on the roles of their partnerships in improving adolescent SRHS.</p><p><strong>Design: </strong>The research employed a qualitative phenomenological study design.</p><p><strong>Methods: </strong>The study included eight focus group discussions with parents whose adolescents attended selected youth centers and four face-to-face in-depth interviews with healthcare providers who worked there.</p><p><strong>Results: </strong>The research revealed two prominent themes regarding the partnership between parents and healthcare professionals in adolescent SRH. The initial theme represents the perspectives of healthcare providers, emphasizing the importance of service awareness, cultural norms, geographic obstacles, and the necessity of parental consent as critical subthemes. The following theme reflects the viewpoints of parents, concentrating on the dialogue surrounding sexual health, the role of healthcare providers in promoting family conversations, and the request for support in providing sexual health information to their adolescents.</p><p><strong>Conclusion: </strong>Collaboration between healthcare providers and parents is essential for improving adolescents' access to SRHS, which can greatly mitigate health-related risks. Nonetheless, this partnership encounters obstacles stemming from insufficient awareness of available services, sociocultural influences, and a lack of parental understanding regarding SRH topics. It is imperative to tackle these challenges through focused educational initiatives and enhanced communication strategies to create a supportive atmosphere that enables both adolescents and their parents to effectively address SRH concerns.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"19 ","pages":"26334941251337534"},"PeriodicalIF":3.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044539","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":"Safety and effectiveness of office hysteroscopic metroplasty with and without uterine stent placement in infertile population: a 10-year retrospective study.","authors":"Mitko Madjunkov, Jak Ozsarfati, Ari Baratz, Karen Glass, Prati Sharma, Clifford Librach","doi":"10.1177/26334941251324951","DOIUrl":"10.1177/26334941251324951","url":null,"abstract":"<p><strong>Background: </strong>Septate uterus is a congenital uterine malformation associated with adverse reproductive and obstetrical outcomes. Hysteroscopic septum resection (HSC) with/without balloon stent placement is a treatment option for reconstituting to a normal uterine cavity; however, procedure safety and efficacy of office-based-ultrasound guided (US) HSC in patients undergoing fertility treatment is not thoroughly studied.</p><p><strong>Objectives: </strong>(1) To assess the safety and efficacy of office-based US-guided HSC septoplasty; (2) compare the safety and effectiveness of adjuvant intrauterine-balloon-Cook stent (IUBS) and (3) to evaluate the reproductive outcomes after each method.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study (<i>n</i> = 90) of patients undergoing HSC at the CReATe Fertility Centre, Toronto, Canada between 2011-2022. The Congenital Uterine Malformation by Experts (CUME-2018) guideline's criteria were used for diagnosis and classification of malformation/septum size as 1-arcuate uterus <10 mm (52% (47/90)), 2-septum 10-19 mm (31% (28/90)), 3-septum 20-40 mm (7% (6/90)), and 4-complete septa (10% (9/90)). The main outcomes were the rate of procedure complications and the efficacy of septum removal. Secondary outcome measures were reproductive outcomes after septoplasty and the safety and effectiveness of adjuvant IUBS placement. <i>T</i>-test and chi-square test, McNemar test, and Cochran-Mantel-Haenszel test were used for stratified statistical analysis.</p><p><strong>Results: </strong>Office-HSC under US guidance was performed in 82 patients (US group) and septoplasty with laparoscopic guidance in 8 patients laparoscopy (LSC) group. IUBS placement had 34% (28/82) of patients in the US group and 12.5% (1/8) in the LSC group. There were no intraoperative or postoperative complications (uterine perforations, excessive bleeding, or infections) in either group. The rate of repeated procedures, implantation, pregnancy, and live birth rates (LBR) were not different when comparing septoplasty with and without IUBS. However, for patients diagnosed with septum class-2, -3, and -4, septoplasty improved their pre-treatment-LBR from 21.6% (8/37) to 77.1% (27/35) post-treatment (<i>p</i> = 0.00005) and decreased pre-treatment miscarriage rate (MR) from 73% (27/37) to post-treatment 29% (7/24) (<i>p</i> = 0.0007) in both groups.</p><p><strong>Conclusion: </strong>Hysteroscopic septum resection with transabdominal US guidance in the office setting is a safe and effective procedure in patients with infertility. Office hysteroscopy should be considered in the management of patients with uterine septum to improve LBR and reduce MR. The value of IUBS needs further evaluation in a larger sample-size study.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"19 ","pages":"26334941251324951"},"PeriodicalIF":3.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694754","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":"Rationalization, facilitators, and impediments of fertility transition in Ethiopia: qualitative exploration of the community readiness, willingness, and ability.","authors":"Tesfay Brhane Gebremariam, Mitike Molla, Wubegzier Mekonnen","doi":"10.1177/26334941251327037","DOIUrl":"10.1177/26334941251327037","url":null,"abstract":"<p><strong>Background: </strong>High fertility and rapid population growth can threaten human development and increase risks to maternal and child health. The diffusion of the benefits of lower fertility requires readiness to plan, and willingness and ability to adopt and use family planning measures.</p><p><strong>Objective: </strong>This assessment aimed to explore the readiness, willingness, and ability (RWA) among selected Ethiopian communities, and identify the facilitators and impediments of fertility transition.</p><p><strong>Design: </strong>This exploratory phenomenological qualitative study collects data from purposefully selected community members and experts in Addis Ababa, Arbaminch, and Jigjiga.</p><p><strong>Method: </strong>The analysis follows deductive coding and a thematic presentation of findings under the RWA domains. Readiness deals with four themes: (1) the rationalization of the value of children, (2) recognition of the burden of high-risk fertility, (3) readiness to define the ideal number of children, and (4) socio-cultural norms about family size. Willingness contains three themes: (1) the psychosocial legitimacy of contraceptives, (2) the religious legitimacy of contraceptives, and (3) women's power to cope with barriers to family planning. The ability domain contains (1) women's knowledge about contraception and (2) access to and utilization of contraceptives.</p><p><strong>Results: </strong>The communities involved in this study recognized the burden of high-risk fertility behaviors (early-age fertility, and frequent and many births), but they prefer large family sizes. Consequently, they exhibit good family planning willingness and practice for birth spacing but not for birth limitation. Recognizing the socio-economic burden of high-risk fertility, accepting and using contraceptives for the health of mothers and children are possible facilitators of fertility transition. Conversely, the desire for high parity, husbands and religious disapproval of contraceptives, side effects of contraceptives, and limited access to method mix are possible impediments.</p><p><strong>Conclusion: </strong>The RWA to space births are adequately diffused and adopted by the community, but birth limitation is not yet recognized. Beyond promoting birth spacing, Ethiopia's fertility transition requires a shift in societal values from large to small family size. Overcoming barriers to contraceptive use also requires tailored efforts to improve the availability of method mix and involve male and religious leaders.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"19 ","pages":"26334941251327037"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694749","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":"Prevalence and determinants of preterm birth among women of reproductive age in Kenya: a multilevel analysis of the 2022 Demographic Health Survey.","authors":"Kobi V Ajayi, Obasanjo Bolarinwa, Toluwani E Adekunle, Oluwatobi Abel Alawode, Nanyangwe Siuluta, Sinegugu Shongwe, Edyta McCallum","doi":"10.1177/26334941251327181","DOIUrl":"10.1177/26334941251327181","url":null,"abstract":"<p><strong>Background: </strong>Globally, over 15 million preterm births (PTB) occur annually, with sub-Saharan Africa bearing a disproportionate burden. In Kenya, studies conducted between 2017 and 2021 at the hospital level show a PTB prevalence ranging from 15.9% to 20.2%. However, current PTB prevalence and associated factors remain underexplored despite their significant public health implications. Understanding the prevalence and factors associated with PTB is critical for effective interventions.</p><p><strong>Objectives: </strong>This study aimed to determine the prevalence of PTB and also to identify individual- and community-level factors influencing PTB among women of reproductive age in Kenya.</p><p><strong>Design: </strong>The study utilised a cross-sectional design, analysing data from the 2022 Kenya Demographic and Health Survey.</p><p><strong>Methods: </strong>A sample of 7291 women aged 15-49 was analysed using weighted multilevel logistic regression in Stata 17.0. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) and a significance threshold of <i>p</i> < 0.05 were used to identify predictors of PTB.</p><p><strong>Results: </strong>The prevalence of PTB was 7.14%. Women aged 25-34 (aOR = 0.67; 95% CI: 0.49-0.94) and 35+ (aOR = 0.86; 95% CI: 0.59-1.24) were less likely to experience PTB compared to younger women (15-24 years). Attending four or more antenatal care visits reduced PTB likelihood (aOR = 0.68; 95% CI: 0.53-0.88). Women in the richest wealth index had higher odds of PTB (aOR = 2.28; 95% CI: 1.39-3.74), while medium community literacy levels increased PTB risk (aOR = 1.56; 95% CI: 1.21-2.03).</p><p><strong>Conclusion: </strong>This study highlights that individual- and community-level factors significantly influence PTB in Kenya. Addressing disparities in socio-demographic and obstetric factors through targeted, multipronged strategies is essential for reducing PTB rates and improving maternal and neonatal outcomes.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"19 ","pages":"26334941251327181"},"PeriodicalIF":3.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694745","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":"HIV status disclosure to male sexual partners and predictors among young women living with HIV in rural Uganda: a cross-sectional study.","authors":"Edward Kumakech, Deo Benyumiza, Marvin Musinguzi, Wilfred Inzama, Ebong Doryn, James Okello, Lydia Kabiri, Vanja Berggren, Jasper Watson Ogwal-Okeng","doi":"10.1177/26334941251317079","DOIUrl":"10.1177/26334941251317079","url":null,"abstract":"<p><strong>Background: </strong>In 2020 in sub-Saharan Africa, 25% of new human immunodeficiency virus (HIV) infections occurred among young women (15-24 years). In Uganda, the HIV prevalence is three times higher among young women at 2.9% compared to 0.8% among their male counterparts. HIV status disclosure is a gateway to preventive services.</p><p><strong>Objectives: </strong>We set out to estimate the prevalence of HIV status disclosure to current male partners, and the predictors among the adolescent girls and young women living with HIV (AGYWLHIV) in a semi-rural northern Uganda.</p><p><strong>Design: </strong>In a cross-sectional study design, a consecutive sample of the AGYWLHIV was recruited from six antiretroviral therapy clinics between November 2022 and April 2023.</p><p><strong>Methods: </strong>Participants were administered an interviewer-guided questionnaire. They were asked whether they have ever disclosed their HIV status to their current male partners. They were also asked about their socio-demographics, sexual and reproductive health profiles, knowledge and perceptions of dual protection, and safer conception methods for AGYWLHIV. Percentages to estimate prevalence, Chi-square tests to assess associations, simple and multivariate modified Poisson regression to identify predictors at <i>p</i> < 0.05 and 95% confidence intervals (CI) were considered.</p><p><strong>Results: </strong>Overall, 423 participants with a median age of 22 (IQR 4) years participated in the study. The prevalence of HIV status disclosure to the current male partners was found at 73.3% (95% CI 69.0-77.5). The predictors for HIV status disclosure were found to include the women's knowledge of their HIV status (APR 1.1 (95% CI 1.0-1.2), <i>p</i> 0.032), knowledge of their male partner's HIV status (APR 0.8 (95% CI 0.7-0.9), <i>p</i> 0.003), and the male partners' disclosure of their HIV status to the women (APR 0.7 (95% CI 0.5-0.9), <i>p</i> <0.016).</p><p><strong>Conclusion: </strong>About three-fourths of the AGYWLHIV in semi-rural northern Uganda disclosed their HIV status to their male partners. The predictors of disclosure included the women's knowledge of their HIV status, knowledge of their male partner's HIV status, and the male partner's reciprocal disclosure of their HIV status. To enhance disclosure rates, post-test, and disclosure counseling for both individuals and couples is recommended as part of the routine HIV testing, treatment, and care programs.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"19 ","pages":"26334941251317079"},"PeriodicalIF":3.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627049","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":"Development of a predictive model for severe peripartum hemorrhage in placenta accreta spectrum cases under neuraxial anesthesia: a multicenter retrospective analysis.","authors":"Yanan Li, Liang Li, Xiao Song, Fanqing Meng, Meiling Zhang, Yarong Li, Ran Chu","doi":"10.1177/26334941251317644","DOIUrl":"10.1177/26334941251317644","url":null,"abstract":"<p><strong>Background: </strong>The placenta accreta spectrum (PAS) represents a significant risk factor for severe postpartum hemorrhage. Recent studies have demonstrated the safety of neuraxial anesthesia (NA) in cesarean delivery (CD) for patients with PAS.</p><p><strong>Objectives: </strong>To evaluate the risk of severe peripartum hemorrhage in patients with PAS who underwent CD under NA.</p><p><strong>Design: </strong>A multicenter retrospective cohort study.</p><p><strong>Methods: </strong>This study analyzed 214 patients diagnosed with PAS. Logistic regression was used to identify factors increasing the risk of severe peripartum hemorrhage. A total of six machine learning (ML) algorithms were employed for model validation.</p><p><strong>Results: </strong>The predictive model includes the following risk factors: age at delivery >33 years (<i>p</i> = 0.004), history of CD >1 (<i>p</i> = 0.020), preoperative HGB ⩽ 100 g/L (<i>p</i> = 0.013), placenta previa classification (<i>p</i> = 0.001), vascular lacunae within the placenta (<i>p</i> = 0.015), and labor duration (<i>p</i> = 0.026). The validation of ML algorithms revealed that the model achieved an accuracy ranging from 0.68 to 0.71, with an area under the receiver operating characteristic curve between 0.75 and 0.79. A nomogram list and web-based calculator were constructed for clinical implementation, and a risk stratification system was established based on model scores.</p><p><strong>Conclusion: </strong>A prenatal risk assessment model was developed to estimate the likelihood of severe peripartum hemorrhage in PAS patients undergoing CD under NA. This model may provide preliminary support for clinicians in tailoring anesthetic management strategies for potentially high-risk cases, but further studies are needed to confirm its clinical utility.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"19 ","pages":"26334941251317644"},"PeriodicalIF":3.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11815799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412058","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":"Prediction nomogram for antepartum hemorrhage in placenta previa women.","authors":"Dazhi Fan, Pengzhen Hu, Jiaming Rao, Dongxin Lin, Jie Yang, Zhengping Liu, Xiaoling Guo","doi":"10.1177/26334941251315127","DOIUrl":"10.1177/26334941251315127","url":null,"abstract":"<p><strong>Background: </strong>Placenta previa with antepartum hemorrhage (APH) is common and closely related to maternal and fetal morbidity and mortality. It is of the utmost importance to prepare for the possibility of APH using perinatal factors prior to delivery.</p><p><strong>Objective: </strong>To develop and validate a nomogram predicting APH in women with placenta previa based on the perinatal factors.</p><p><strong>Design: </strong>This was a retrospective and prospective cohort study of pregnant women with placenta previa.</p><p><strong>Methods: </strong>The model was developed in the retrospective and validated in the prospective cohort study. Multivariate logistic regression was applied to discover independent variables and develop a nomogram to predict the possibility of APH. An Excel form computer interface was constructed to use the model.</p><p><strong>Results: </strong>There are 1601 and 693 participants in the retrospective and prospective cohort study. Maternal age (odds ratio 0.950, 95% confidence interval 0.918-0.984), married (0.533, 0.309-0.920), parity (1.240, 1.024-1.502), threatened abortion (5.059, 3.648-7.014), and complete placenta previa (1.833, 95% CI 1.469-2.289) were independent variables for APH in placenta previa women. The area under the curve and concordance index were 0.828 and 0.676, respectively. The model was a good fit by the Hosmer-Lemeshow test (<i>p</i> = 0.352). The prospective validation proved the reliability of the prediction nomogram. The Excel form computer interface was practical.</p><p><strong>Conclusion: </strong>A nomogram based on perinatal factors was developed and validated to predict APH in women with placenta previa. The reliable tool may thereafter offer important assistance for decision-making processes.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"19 ","pages":"26334941251315127"},"PeriodicalIF":3.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082489","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}