Archives of Gynecology and Obstetrics最新文献

{"title":"Empowering prevention: uterine cancer awareness and advocacy in the digital age and world of social media","authors":"Esra Bilir,&nbsp;Wasim Ahmed,&nbsp;Xezal Derin,&nbsp;Joanna Kacperczyk-Bartnik,&nbsp;Christina Fotopoulou,&nbsp;Sara Nasser","doi":"10.1007/s00404-026-08438-8","DOIUrl":"10.1007/s00404-026-08438-8","url":null,"abstract":"<div><h3>Purpose</h3><p>We aim to evaluate the reach, engagement, and evolution of the inaugural Uterine Cancer Awareness Month (UCAM) social media campaign (2023–2024) on Twitter/X, focusing on user participation, content trends, and key influencers.</p><h3>Methods</h3><p>We conducted a social network analysis of Twitter/X posts using the hashtags #endometrialcancer, #uterinecancer, and #wombcancer over three years (2022–2024). Data were collected and analysed using NodeXL Pro, utilizing the Clauset–Newman–Moore and Harel–Koren Fast Multiscale algorithms for cluster and layout visualization.</p><h3>Results</h3><p>In 2022, 343 users generated 557 interactions, emphasizing health disparities and symptom awareness. The engagement peaked in 2023 with 302 users and 731 interactions, driven by strategic hashtag use and awareness efforts. A decline was noted in 2024 with 237 users and 484 interactions. Word pair analysis showed evolving themes, from general symptom awareness in 2022 to targeted messaging around advanced cases and recurrence in 2024.</p><h3>Conclusion</h3><p>The UCAM-social media campaign showed promising initial growth but experienced a decline in engagement by 2024, highlighting the need for sustained and diversified strategies. Our study, which assessed the campaign’s impact over a period exceeding one year, a rarity in the current literature, highlights critical insights for future initiatives.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148026036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embryological and clinical predictors of implantation and live birth in 3000 single euploid embryo transfer cycles: a retrospective cohort study","authors":"Gulcin Ozkara,&nbsp;Hakan Kadir Yelke,&nbsp;Caroline Pirkevi Cetinkaya,&nbsp;Yesim Kumtepe Colakoglu,&nbsp;Semra Kahraman","doi":"10.1007/s00404-026-08468-2","DOIUrl":"10.1007/s00404-026-08468-2","url":null,"abstract":"<div><h3>Purpose</h3><p>Although single euploid embryo transfer (SEET) improves implantation and live birth (LB) rates, unsuccessful outcomes may still occur despite the transfer of morphologically high-quality euploid embryos. This study aimed to identify post-thaw embryological and clinical factors associated with implantation and LB outcomes.</p><h3>Methods</h3><p>This retrospective cohort study included 3000 frozen–thawed SEET cycles performed at a single center. Post-thaw embryological parameters evaluated were inner cell mass (ICM) and trophectoderm (TE) grades, expansion grade, presence of necrotic areas (NA) and excluded/extruded blastomeres (EB), embryo biopsy/freezing/transfer day (Day 5 vs. Day 6), cryo-survival rate (≥90% vs. &lt;90%), and re-expansion status. Clinical variables included maternal age, body mass index (BMI), and number of previous IVF cycles. Outcomes were analyzed with adjustment for endometrial preparation using modified natural cycle (mNC) or hormone replacement cycle (HRC) protocols. Multivariate logistic regression analysis was performed to identify independent predictors of implantation and LB.</p><h3>Results</h3><p>Higher cryo-survival (≥90%), Day 5 embryo biopsy/freezing/transfer, and post-thaw re-expansion were associated with increased pregnancy rates (<i>p</i>&lt;0.05). Higher embryo quality, particularly A-grade ICM, was independently associated with increased LB rates (<i>p</i>&lt;0.05). The presence of NA and EB in thawed euploid blastocysts was significantly associated with reduced cryo-survival and lower LB outcomes (<i>p</i>&lt;0.05). Maternal age &lt;35 years was associated with a higher likelihood of LB compared with age ≥43 years (OR: 0.291, 95% CI 0.149–0.569, <i>p</i>&lt;0.001). LB rates were significantly higher in mNC-prepared cycles compared with HRC (85.2% vs. 71.8%, <i>p</i>&lt;0.001). Lower BMI and fewer previous IVF cycles were also associated with improved LB outcomes.</p><h3>Conclusion</h3><p>Post-thaw embryological competence and maternal characteristics significantly influence implantation and live birth outcomes, even in euploid embryo transfers. Comprehensive evaluation of thawed embryo morphology combined with individualized endometrial preparation may optimize clinical outcomes following SEET.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08468-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided bone fulcrum lever rotation for fetal head malposition","authors":"Su-hua Wei,&nbsp;Meng-qin Wang,&nbsp;Cun-hui Yuan,&nbsp;Jing Fang,&nbsp;Xiao-hong Shi","doi":"10.1007/s00404-026-08422-2","DOIUrl":"10.1007/s00404-026-08422-2","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the efficacy and safety of applying the ultrasound-guided bone fulcrum lever rotation method during manual rotation of the fetal head in cases of labor dystocia due to fetal head malposition.</p><h3>Methods</h3><p>This retrospective study analyzed 109 parturients with persistent occiput posterior (POP) or occiput transverse (OT) positions in the second stage of labor, who delivered at a tertiary hospital in Jiangsu Province, China, between January 2024 and September 2025. Participants were divided into an experimental group (ultrasound-guided bone fulcrum lever rotation, <i>n</i> = 54) and a control group (conventional manual rotation, <i>n</i> = 55). Comparisons were made regarding the fetal head rotation success rate, the mode of delivery, and the neonatal outcomes.</p><h3>Results</h3><p>The success rate of fetal head rotation was significantly higher in the experimental group compared to the control group (88.89% vs. 67.27%, <i>P</i> = 0.006). The rotation procedure time was shorter in the experimental group (<i>P</i> = 0.019), and the rate of spontaneous vaginal delivery was significantly higher (94.44% vs. 76.36%, <i>P</i> = 0.008). There were no significant differences in neonatal outcome indicators between the two groups.</p><h3>Conclusion</h3><p>In this study, intrapartum ultrasound localization was combined with manual rotation manipulation for the management of cephalic dystocia. The results indicated that this combined intervention yielded better clinical efficacy than conventional manual rotation alone, and thus it holds high clinical application value.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal growth-guided management of gestational diabetes: A retrospective cohort study on insulin requirements and perinatal outcomes","authors":"Serena Xodo,&nbsp;Andrea Da Porto,&nbsp;Maria De Martino,&nbsp;Annalaura Del Pin,&nbsp;Asia Flaiban,&nbsp;Silvia Galasso,&nbsp;Sara Piccini,&nbsp;Lorenza Driul","doi":"10.1007/s00404-026-08467-3","DOIUrl":"10.1007/s00404-026-08467-3","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate whether a fetal growth-guided management strategy can reduce treatment intensity without compromising maternal and neonatal outcomes in women with gestational diabetes mellitus (GDM).</p><h3>Methods</h3><p>This retrospective cohort study with propensity score matching was conducted at a single tertiary referral center and included 343 women with GDM diagnosed after a second-trimester OGTT, of whom 244 were included in the matched analysis. Participants were managed either with a fetal growth-guided approach, in which glycemic targets and insulin therapy were tailored according to fetal abdominal circumference (AC), or with standard glycemia-based care. In the growth-guided group, stricter targets were applied when AC exceeded the 70th percentile. Outcomes were analyzed in the overall cohort and after matching. Primary outcomes were insulin use and glycemic control. Secondary outcomes included maternal weight gain, obstetric outcomes, and neonatal outcomes such as birthweight, Apgar score, cord blood pH, and size for gestational age.</p><h3>Results</h3><p>In the overall cohort, fetal growth-guided management was associated with lower birthweight (3470 g vs 3544 g; p = 0.036), reduced basal insulin use (58% vs 83%; p &lt; 0.001), lower total insulin dose at delivery (9 vs 18 IU; p &lt; 0.001), and slightly improved glycemic control. After propensity score matching, basal insulin use (65% vs 80%; p = 0.029) remained lower, while glycemic control, obstetric outcomes, and neonatal outcomes were comparable. The sensitivity analysis restricted to insulin-treated patients ahowed no significant differences between the differently managed groups of patients.</p><h3>Conclusions</h3><p>A fetal growth-guided approach to GDM management reduces insulin requirements without worsening maternal or neonatal outcomes.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08467-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometriosis and adverse pregnancy outcomes in primiparous women: a retrospective cohort study","authors":"Julia Téoule Dr. med.,&nbsp;Leonie Zikarsky,&nbsp;Karin Bundschu,&nbsp;Sophia Andres,&nbsp;Katharina Hancke","doi":"10.1007/s00404-026-08465-5","DOIUrl":"10.1007/s00404-026-08465-5","url":null,"abstract":"<div><h3>Objective</h3><p>To assess whether pre-existing endometriosis is associated with specific adverse pregnancy and delivery outcomes in primiparous women.</p><h3>Design</h3><p>Retrospective cohort study.</p><p>Setting.</p><p>Tertiary care university hospital.</p><p>Population or sample.</p><p>Primiparous women with singleton pregnancies.</p><h3>Methods</h3><p>Women with endometriosis were compared with primiparous controls without endometriosis. Primary outcomes were preterm birth and cesarean delivery; placenta previa was examined as a key secondary outcome. Multivariable logistic regression models adjusted for maternal age and mode of conception were used.</p><p>Main outcome measures.</p><p>Preterm birth, cesarean delivery, placenta previa.</p><h3>Results</h3><p>Among 16,033 primiparous women, 118 had a diagnosis of endometriosis prior to pregnancy. After adjustment for maternal age and mode of conception, endometriosis was not independently associated with preterm birth (adjusted odds ratio 0.75; 95% confidence interval 0.44–1.28) or cesarean delivery (adjusted odds ratio, 1.17; 95% confidence interval, 0.81–1.71). In contrast, endometriosis was associated with placenta previa (adjusted odds ratio, 5.90; 95% confidence interval, 2.37–14.71).</p><h3>Conclusion</h3><p>In primiparous women, pre-existing endometriosis was independently associated with placenta previa, but not with preterm birth or cesarean delivery. These findings support abnormal early placentation as a potential mechanism linking endometriosis to adverse obstetric outcomes.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13190462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram integrating a novel uterine isthmus ratio (APTUIR), sonographic signs and clinical symptoms for predicting posterior deep endometriosis","authors":"Shun Yang,&nbsp;Yitong He,&nbsp;Chunchun Jin,&nbsp;Meifang Deng,&nbsp;Yuyu Zhou,&nbsp;Kaiju Luo,&nbsp;Lvhuan Qiu,&nbsp;Yanling Bei,&nbsp;Qiuxiang Chen","doi":"10.1007/s00404-026-08466-4","DOIUrl":"10.1007/s00404-026-08466-4","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to propose a novel, reproducible transvaginal ultrasound (TVUS) measurement—anterior–posterior wall thickness of the uterine isthmus ratio (APTUIR)—and to construct a nomogram model integrating this parameter with other ultrasound assessments and clinical symptoms for predicting the risk of posterior pelvic deep endometriosis (DE).</p><h3>Methods</h3><p>This retrospective study included 362 patients with endometriosis (153 with posterior pelvic DE; 209 without) who underwent TVUS and surgery between 2021 and 2024. APTUIR, uterine white sliding lines (WSL), and clinical symptoms were assessed. LASSO regression was used to identify independent predictors and construct a nomogram. Model performance was evaluated by area under the curve (AUC), calibration curves and decision curve analysis (DCA) with internal validation (500 bootstrap samples).</p><h3>Results</h3><p>Results showed statistically significant differences between groups in dyspareunia, menstrual defecation abnormalities, CA125, uterine anteroposterior diameter, concomitant endometrial polyps (EPs), uterine posterior isthmus echo, uterine anterior WSL, uterine posterior WSL, ovarian kiss sign and APTUIR (<i>p</i> &lt; 0.05). Four key predictors were identified: APTUIR, posterior uterine wall WSL, EPs, and menstrual bowel dysfunction. The nomogram demonstrated excellent predictive performance: AUC 0.933 (95% CI: 0.901–0.957), sensitivity of 85.0%, specificity of 88.0% and accuracy of 86.7%. The calibration curve of the nomogram demonstrated good consistency, whilst the decision curve indicated favourable clinical utility.</p><h3>Conclusion</h3><p>The APTUIR-based nomogram provides a non-invasive, highly accurate tool for identifying high-risk posterior pelvic DE. It facilitates objective risk stratification and timely specialist referral, particularly in non-specialised settings.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08466-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latency following preterm prelabor rupture of membranes before 34 weeks of gestation and its association with perinatal outcomes: a retrospective cohort study","authors":"Pilar López-Martínez,&nbsp;Javier Sánchez-Romero,&nbsp;Rosa Muñoz-Porcel,&nbsp;Zoraya Mokachir-Mohsenin,&nbsp;José Eliseo Blanco-Carnero,&nbsp;Paz Crespo-Bañón,&nbsp;Romina Sol Liandro,&nbsp;Laura Hernández-Hernández,&nbsp;Themistoklis Dagklis,&nbsp;Aníbal Nieto-Díaz,&nbsp;Catalina de Paco-Matallana","doi":"10.1007/s00404-026-08463-7","DOIUrl":"10.1007/s00404-026-08463-7","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the association between latency duration and perinatal outcomes in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation, and to assess the role of gestational age at PPROM and amniotic fluid volume.</p><h3>Methods</h3><p>This retrospective cohort study included pregnancies complicated by PPROM before 34 weeks of gestation managed expectantly at a tertiary care center. Latency duration was defined as the interval from membrane rupture to delivery. Composite neonatal and pregnancy adverse outcomes were analyzed using latency-based time-to-event methods. Cox proportional hazards models were used to assess the independent associations of gestational age at PPROM and amniotic fluid pocket with adverse pregnancy and neonatal outcomes.</p><h3>Results</h3><p>A total of 278 pregnancies were included in the final analysis. Latency duration was strongly associated with gestational age at PPROM, with progressively shorter latency observed at more advanced gestational ages. Larger residual amniotic fluid pockets were independently associated with prolonged latency. In latency-based Cox models, gestational age at PPROM was significantly associated with both pregnancy-adverse and neonatal composite outcomes. In contrast, latency duration itself and residual amniotic fluid volume were not independently associated with adverse neonatal outcomes after accounting for gestational age variables.</p><h3>Conclusions</h3><p>In pregnancies complicated by PPROM before 34 weeks of gestation, gestational age at membrane rupture is the principal determinant of latency duration and perinatal outcomes. Latency should be interpreted as a gestational-age-dependent phenomenon rather than an independent predictor of neonatal risk, supporting individualized expectant management that prioritizes gestational age advancement while balancing maternal risk.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08463-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal diabetes subtypes and offspring cutaneous health: developmental programming of sebaceous gland function in over 330,000 live births","authors":"Eliya Honig,&nbsp;Nir Amitai,&nbsp;Sarah Weissmann,&nbsp;Amir Horev,&nbsp;Tamar Eshkoli","doi":"10.1007/s00404-026-08398-z","DOIUrl":"10.1007/s00404-026-08398-z","url":null,"abstract":"<div><h3>Objective</h3><p>Maternal diabetes is a known driver of fetal metabolic programming, yet its impact on offspring cutaneous health remains poorly characterized. We investigated the impact of intrauterine exposure to various maternal diabetes subtypes on the risk of offspring seborrheic dermatitis (SD), and to explore whether this risk is modulated by maternal glycemic control or treatment modality.</p><h3>Methods</h3><p>This large-scale, population-based cohort study included 331,335 mother–child pairs. Maternal diabetes subtypes—type 1 (T1DM), type 2 (T2DM), and gestational diabetes mellitus (GDM)—were assessed, along with glycemic control (HbA1c) and pharmacological treatment. SD was identified using physician-documented diagnoses and medication records. Multivariable logistic regression models adjusted for maternal and perinatal factors were used to estimate adjusted odds ratios (aORs).</p><h3>Results</h3><p>The incidence of SD was 4.5%. SD was significantly more frequent among offspring of mothers with diabetes (4.9% vs. 4.4%, p &lt; 0.001), primarily driven by GDM. T1DM and T2DM showed similar trends but weren't statistically significant. SD risk did not differ by treatment modality or glycemic control. While overall associations for T1DM and T2DM did not reach significance in the full cohort, age-stratified analysis revealed that maternal diabetes was significantly associated with increased SD risk across all subtypes within the first year of life (T1DM: p = 0.033, T2DM: p = 0.024, GDM: p = 0.019). Multivariable analysis showed maternal diabetes was independently associated with increased SD risk (aOR 1.16, 95% CI 1.08–1.24).</p><h3>Conclusion</h3><p>Maternal diabetes is associated with a significantly increased risk of infantile SD across all diabetes subtypes, suggesting that the intrauterine diabetic environment may influence early-life cutaneous homeostasis through metabolic programming of the pilosebaceous unit.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08398-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and safety of 4DryField® PH as a hemostatic agent in ovarian surgery on fertility: a pilot randomized study","authors":"Laura Tascón Padrón,&nbsp;Carolin Schröder,&nbsp;Lucia A. Otten,&nbsp;Nicole Sänger,&nbsp;Eva-Katharina Egger,&nbsp;Alexander Mustea","doi":"10.1007/s00404-026-08447-7","DOIUrl":"10.1007/s00404-026-08447-7","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the feasibility and safety of the hemostatic powder 4DryField® PH in laparoscopic ovarian cystectomy and its impact on fertility compared to conventional bipolar electrocautery.</p><h3>Methods</h3><p>This is a prospective, randomized, controlled, single-center, single-blind pilot study, included in the german registry for clinical trials (DRKS-ID: DRKS00038742). The study was developed in the.</p><p>Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Germany.</p><p>Twenty women (≥ 18 years old) undergoing laparoscopic ovarian cystectomy for benign ovarian lesions with baseline serum anti-Müllerian hormone (AMH) ≥ 2.0 ng/mL were enrolled and randomized equally to two hemostatic methods. Hemostasis was achieved using either bipolar electrocautery (<i>n</i> = 10) or topical 4DryField® PH powder (<i>n</i> = 10). Both groups underwent standardized laparoscopic cystectomy performed by experienced surgeons. Serum AMH, C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), white blood cell counts, hemoglobin and hematocrit were assessed preoperatively, on postoperative day (POD) 1, and POD 14.</p><h3>Results</h3><p>Baseline AMH levels were comparable between groups (4.54 ± 2.24 ng/mL vs. 4.39 ± 2.08 ng/mL, <i>p</i> = 0.85). By POD 14, the mean percent decline in AMH from baseline was smaller in the 4DryField group than in the electrocautery group (mean difference = 16.77%; 95% CI: -5.39 to 38.93). This difference was not statistically significant (<i>p</i> = 0.36), with an estimated effect size of <i>d</i>= 0.72 (95% CI: -0.19 to 1.62). IL-6 increased transiently on POD 1 in the 4DryField group (9.2 pg/mL [IQR 78.6] vs. 3.85 pg/mL [IQR 2.80]; <i>p</i> = 0.016) but normalized by POD 14, indicating a short, non-pathologic inflammatory response. No significant differences were observed in CRP, PCT, or leukocyte counts. No adverse events, infections, or hemorrhagic complications occurred in either group.</p><h3>Conclusion</h3><p>In this pilot study, the use of 4DryField® PH appears feasible and safe for laparoscopic ovarian cystectomy. While the reduction in AMH levels was numerically smaller in the 4DryField group, the difference was not statistically significant. These results are hypothesis-generating and underscore the need for larger trials to evaluate the potential benefits of non-thermal hemostatic strategies for ovarian reserve preservation.</p><h3>Trial registration</h3><p>Clinical trial; DRKS00038742.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08447-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147938362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian pregnancy: clinical characteristics, diagnostic challenges, and sonographic features—a multicenter case series with narrative literature overview","authors":"Adi Dayan-Schwartz,&nbsp;Ariel Zilberlicht,&nbsp;Nadav Cohen,&nbsp;Fahoum Leen,&nbsp;Suzan Abd Elgani,&nbsp;Liron Kogan,&nbsp;Ari Reiss,&nbsp;Ronit Beck-Fruchter,&nbsp;Etty Daniel-Spiegel","doi":"10.1007/s00404-026-08460-w","DOIUrl":"10.1007/s00404-026-08460-w","url":null,"abstract":"<div><h3>Purpose</h3><p>To describe the demographic, clinical, laboratory, imaging, and surgical features of 15 histologically confirmed ovarian pregnancies (OP) and to contextualize these findings within a narrative literature overview in order to improve clinical recognition and facilitate earlier diagnosis.</p><h3>Methods</h3><p>A retrospective multicenter case series was conducted across two university-affiliated hospitals between 2012 and 2024. Women with histologically confirmed OP were included. Demographic data, risk factors, presenting symptoms, β-hCG dynamics, ultrasound findings, operative details, and postoperative outcomes were collected and analyzed.</p><h3>Results</h3><p>Fifteen patients were identified. The mean age was 34.6 ± 4.2 years; 46.7% used an intrauterine device, 33.3% had prior cesarean delivery, and 13.3% conceived through assisted reproduction. Abdominal pain was the predominant symptom (86.7%), whereas vaginal bleeding occurred in 26.7%. The mean preoperative β-hCG level was 6,436 ± 5,570 mIU/mL and serial measurements showed inappropriate rises. OP was suspected preoperatively in 53.3% of cases; identification appeared higher in cases with formal ultrasound (85.7%), although this observation is limited by differences in imaging setting and documentation.. Observed sonographic features included a hyperechoic peripheral ring and a Doppler pattern demonstrating a single dominant feeding vessel; A trilaminar endometrial pattern was not observed in evaluable cases. Rupture occurred in 73.3% of patients with a median blood loss of 300 mL (IQR 10–2000 mL). All patients were treated surgically with ovarian preservation, and postoperative day-1 β-hCG declined by 59 ± 12%.</p><h3>Conclusion</h3><p>OP commonly presents with abdominal pain and minimal bleeding and carries a high rupture risk. The described sonographic patterns may represent hypothesis-generating observations that could support clinical suspicion and warranting further study.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08460-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}