Archives of Gynecology and Obstetrics最新文献

{"title":"Correlation between 22q11.2 deletion syndrome phenotype and deletion location: a meta-analysis.","authors":"Jianing Li, Rui Wang, Ling Liu, Jun Zhao, Yue Zhao, Fangfang Liu, Mengyao Zhu, Chunyu Feng, Yueshu Zhao","doi":"10.1007/s00404-025-08041-3","DOIUrl":"https://doi.org/10.1007/s00404-025-08041-3","url":null,"abstract":"<p><strong>Background: </strong>The clinical manifestations of 22q11.2 deletion syndrome (22q11.2 DS) are highly heterogeneous, and the underlying causes of phenotypic variation remain unclear. This study conducted a systematic meta-analysis to evaluate the impact of the deletion position within the 22q11.2 region on phenotypic variability.</p><p><strong>Methods: </strong>PubMed, Web of Science, Scopus, Embase, and Cochrane Library databases were searched through 25 September 2024. Literature was screened, and data were extracted based on predefined inclusion and exclusion criteria.</p><p><strong>Results: </strong>A total of 17 articles comprising 4107 subjects were included in this study. Among these, 1296 patients presented with congenital heart malformations, while 220 exhibited psychiatric and behavioral abnormalities. 1. Congenital heart malformations: in the central deletion region, congenital heart malformations were significantly associated with the LCR22B-D deletion [OR (BD/CD): 2.74, 95% CI 1.27-5.92, P = 0.01]. 2. Psychiatric and behavioral abnormalities: psychiatric and behavioral abnormalities were significantly associated with smaller typical deletions. Comparisons between the central deletion region and the classic deletion region confirmed a significant association between mental and behavioral abnormalities and LCR22A-B [OR (AB/BD): 6.26, 95% CI 1.16-33.93, P = 0.03].</p><p><strong>Conclusions: </strong>Congenital heart malformations are strongly associated with the central deletion region, specifically LCR22B-D. In contrast, psychiatric and behavioral abnormalities are more strongly linked to the LCR22A-B region, suggesting that smaller deletions significantly elevate the risk of mental and behavioral abnormalities.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering the influence of pregnancy on rheumatoid arthritis and psoriatic arthritis: insights from musculoskeletal ultrasound dynamics.","authors":"Caroline I Ziegler, Florian Recker, Charlotte Behning, Pia Mielczarek, Brigitte Strizek, Simon M Petzinna, Valentin S Schäfer","doi":"10.1007/s00404-025-08107-2","DOIUrl":"https://doi.org/10.1007/s00404-025-08107-2","url":null,"abstract":"<p><strong>Objective: </strong>This prospective observational, hypothesis-generating study aims to investigate the impact of pregnancy on disease activity in rheumatoid arthritis (RA) and psoriatic arthritis (PsA) using musculoskeletal ultrasound (MSUS) and to explore the potential of MSUS to enhance disease monitoring during pregnancy.</p><p><strong>Methods: </strong>The study enrolled female participants divided into four groups: pregnant women with RA or PsA, non-pregnant women with RA or PsA, healthy pregnant women, and healthy non-pregnant women. Disease activity was assessed using the Rheumatoid Arthritis Impact of Disease (RAID) score and the Psoriatic Arthritis Impact of Disease (PsAID) score, as well as self-reported questionnaires on health perception. MSUS was performed using the Butterfly iQ portable ultrasound scanner, with synovial hypertrophy and joint effusion assessed via the Advanced Sonography of Large Joints in Rheumatology (aSOLAR) score.</p><p><strong>Results: </strong>A total of 105 participants were included: 15 pregnant women with RA or PsA, 30 non-pregnant women with RA or PsA, 30 healthy pregnant women, and 30 healthy non-pregnant women. In pregnant women with RA, conventional disease activity scores and the aSOLAR score showed lower values over the course of pregnancy. In contrast, non-pregnant RA patients generally presented with higher scores in both conventional assessments and the aSOLAR score. Among pregnant PsA patients, conventional scores appeared lower over time, while the aSOLAR score showed comparatively higher values in later pregnancy. Self-reported health perception was more favorable in pregnant RA and PsA patients than in their non-pregnant counterparts. The CRP levels tended to be lower in later pregnancy phases among both RA and PsA patients.</p><p><strong>Conclusion: </strong>This pioneering study demonstrates the potential impact of pregnancy on the disease activity of RA and PsA. It emphasizes the exploratory potential of MSUS as an imaging biomarker in the assessment of these conditions during pregnancy. The observed discrepancies between conventional, self-reported diagnostic tools and ultrasound findings support the hypothesis that objective imaging modalities may improve disease monitoring. Our findings warrant further validation in larger, confirmatory studies.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The treatment of cervical intraepithelial neoplasia grade 2 (HSIL): between active surveillance and surgery-a 10-year monocentric data analysis.","authors":"Ulrike Ehlers, Lars Hoischen, Jan Lennart Stalp, Jens Hachenberg, Dhanya Ramachandran, Bianca Brüning, Matthias Jentschke, Peter Hillemanns, Agnieszka Denecke","doi":"10.1007/s00404-025-08097-1","DOIUrl":"https://doi.org/10.1007/s00404-025-08097-1","url":null,"abstract":"<p><strong>Purpose: </strong>In recent years, active surveillance has been introduced as an alternative to excisional treatment in younger women with cervical intraepithelial neoplasia grade 2 (CIN 2) because spontaneous regression rate is high and excisional treatment is associated with an increased risk of preterm birth. However, the potential effect of this conservative approach on the risk of developing cervical cancer has not been evaluated very well.</p><p><strong>Methods: </strong>The present study offers a real-life analysis of treatment pathways for patients diagnosed with CIN 2.</p><p><strong>Results: </strong>Following CIN 2 diagnosis, 84 cases out of 187 (44.9%) were managed conservatively for at least 7 months and 103 cases (55.1%) were admitted for an excisional procedure LEEP (loop electrosurgical excision procedure). Out of 84 patients observed with a CIN 2 diagnosis, 64 showed persistence of CIN 2 lesion (76.2%), 14 showed spontaneous remission under active surveillance (16.7%), 4 progressed to CIN 3 (4.8%) and 2 to carcinoma (one case of vaginal carcinoma and one case of cervical adenocarcinoma (Supplementary Fig. 1) (2.4%). We observed the regression of CIN 2 in 16.7% of patients on active surveillance and this was statistically significant during the observation period (95% CI 5.72-10.85, p < 0.001) (Supplementary Fig. 3).</p><p><strong>Conclusion: </strong>The choice of treatment was strongly associated with HPV typing in our study. Patients with HPV 16 infection underwent surgery more often than patients without HPV 16 infection. The difference in our study was statistically significant (p < 0.001). We observed regression of CIN 2 in 16.7% of patients on active surveillance and this was statistically significant to the observation period (95% CI 5.72-10.85, p < 0.001).</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term survival in a patient with brain metastases and leptomeningeal disease of breast cancer: a case report of a patient receiving trastuzumab-deruxtecan.","authors":"Patricia von Kroge, Volkmar Müller, Barbara Schmalfeldt, Kerstin Riecke, Leonor Matos, Johann Kornowski, Elena Laakmann","doi":"10.1007/s00404-025-08096-2","DOIUrl":"https://doi.org/10.1007/s00404-025-08096-2","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of central nervous system (CNS) metastases in breast cancer (BC) patients is increasing, and the prognosis for those with CNS involvement, especially when accompanied by leptomeningeal disease, remains poor. We present a case of long-term survival in a patient with CNS metastases from HER2-positive BC and discuss the treatment considerations in this context.</p><p><strong>Case presentation: </strong>A 54-year-old woman with HER2-positive BC developed CNS metastases, including a highly suspicious finding for leptomeningeal disease, 2 years after initial treatment. At the time of her primary BC diagnosis, she received neoadjuvant chemotherapy, followed by breast surgery, adjuvant radiation, and anti-HER2 targeted therapy. Two years later, she developed parenchymal BM, and brain MRI revealed a leptomeningeal involvement, accompanied by neurological symptoms, including an epileptic episode. She underwent surgical resection and stereotactic radiotherapy for the parenchymal BM, followed by reinduction of trastuzumab as systemic treatment. As the disease progressed and neurological symptoms worsened, the patient received T-DM1. After further cerebral progression in 2021, therapy was switched to Trastuzumab-deruxtecan (T-DXd). Since May 2022, she has received 30 cycles of T-DXd (with a reduced dosage of 4.4 mg/kg since August 2023) without evidence of disease progression.</p><p><strong>Conclusion: </strong>Long-term survival is achievable in patients with CNS metastases from BC, even in the presence of leptomeningeal disease, especially with the use of targeted therapies like T-DXd.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hystrosalpingo-foam sonography with ExEm and lidocaine-based foam gel for detecting tubal occlusion: a diagnostic test accuracy systematic review and meta-analysis.","authors":"Mohamed K A Genedy, Reem Shalata, Marwa El-Difrawy, Abdelrahman A Almetwally, Rahma Sameh Shaheen","doi":"10.1007/s00404-025-08105-4","DOIUrl":"https://doi.org/10.1007/s00404-025-08105-4","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of adnexal masses with ultrasonographic parameters and magnetic resonance imaging.","authors":"Cem Erdoğan, Ümmihan Topal, Engin Çelik, İsmail Özdemir","doi":"10.1007/s00404-025-07945-4","DOIUrl":"https://doi.org/10.1007/s00404-025-07945-4","url":null,"abstract":"<p><strong>Purpose: </strong>Adnexal masses (AMs) are commonly seen gynecological problems. Most of the AMs of women in reproductive period are physiologic. A rare but lethal cause of AMs is ovarian cancer. It is important to distinguish benign and malignant AMs. In this study, two scoring systems named \"Evaluation of Different Neoplasms in Adnexa (ADNEX)\" model and \"Ovarian-Adnexal Reporting Data System MR (O-RADS MR)\" were examined in terms of diagnostic performance in distinguishing benign or malignant AMs.</p><p><strong>Methods: </strong>Patients undergone surgery due to AMs were involved in this retrospective study. ADNEX risk model scores and MRI results of patients were re-evaluated for calculating O-RADS MRI scores.</p><p><strong>Results: </strong>284 patients enrolled in this study. ADNEX risk model had a 93.8% (95% CI: 90.9-96.7%) of area under the ROC curve (AUC) for malignancy risk (p < 0.001). O-RADS risk model had a 95.7% (95% CI: 92.8-98.6) of AUC (p < 0.001). When cut-off value was set as 42%, sensitivity and specificity of ADNEX risk model were 87% and 88.6, respectively. Sensitivity and specificity of O-RADS MRI risk scoring system were 93.8% and 93.2 when cut-off value was set as ≥ 4, respectively. AUC values of ADNEX risk model and O-RADS MRI scores were not significantly different in terms of differentiating between benign and malignant cases (p = 0.218).</p><p><strong>Conclusion: </strong>ADNEX risk model and O-RADS MRI score are successful in terms of identifying benign and malign cases for evaluation of AMs. There was no significant difference in the ability of these two methods to distinguish benign and malignant cases.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary hemophagocytic lymphohistiocytosis associated with adjuvant pembrolizumab therapy in a young patient with triple-negative breast cancer: a case report with literature review.","authors":"G L Olmes, M P Nigdelis, B Haj Hamoud, E-F Solomayer, M Bewarder, J T Bittenbring, N Kranzhöfer, L Thurner, Y-J Kim, A Seibold, M Doerk","doi":"10.1007/s00404-025-08078-4","DOIUrl":"https://doi.org/10.1007/s00404-025-08078-4","url":null,"abstract":"<p><strong>Purpose: </strong>Secondary hemophagocytic lymphohistiocytosis (HLH) associated with pembrolizumab is a rare immune-related adverse event (irAE). It features a potential life-threatening status including fever and a hyperinflammatory reaction caused by natural killer cells, CD8 + cytotoxic T cells, and antigen-presenting cells leading to multiorgan failure. Secondary HLH is described for immune checkpoint inhibitor (ICI) therapy. Most descriptions refer to patients with melanoma or lung cancer. We report about a 32 year-old patient with secondary HLH associated with adjuvant pembrolizumab therapy according to the Keynote-522 protocol. It was successfully treated with prednisolone.</p><p><strong>Methods: </strong>We performed a literature review in PubMed including the terms \"HLH OR hemophagocytic lymphohistiocytosis AND breast cancer\". We found four other cases meeting the inclusion criteria (abstract available in English, breast cancer patient, HLH related to ICI therapy).</p><p><strong>Results: </strong>Apart from the case report, the review featured main aspects about the diagnosis (HScore, histopathological assessment), onset of HLH, and medical treatment. The review indicated that secondary ICI induced HLH in breast cancer patients may be associated with complete response according to their tumor burden. Most cases are reported with an onset of secondary HLH within the neoadjuvant treatment phase and were treated analogously to the Keynote-522 protocol. Our case showed an onset almost 1 year after the initiation of pembrolizumab therapy.</p><p><strong>Conclusion: </strong>Gyneco-oncologist should be aware of secondary HLH during pembrolizumab therapy and should assess patients with persistent fever using the HScore to diagnose secondary HLH early.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectopic pregnancies: laparoscopic versus vNOTES approach. Surgical and obstetric outcomes.","authors":"Anne-Sophie Vertongen, Andrea Stuart, Kristin Stuhr Olsson, Karin Källén, Jan Baekelandt","doi":"10.1007/s00404-025-08098-0","DOIUrl":"https://doi.org/10.1007/s00404-025-08098-0","url":null,"abstract":"<p><strong>Introduction: </strong>Extrauterine pregnancy (EP), represents a significant challenge in reproductive medicine, manifesting in approximately 2% of all pregnancies, primarily implanting within the fallopian tubes (95%). Surgery remains a cornerstone in the therapeutic options for ectopic pregnancies. The most common surgical approach at the moment is laparoscopy. However a relatively new surgical technique, vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) has evolved which is a vaginal entry to the abdomen in conjunction with endoscopy via the vagina. In this study we compare the surgical and obstetrical outcomes of these two techniques.</p><p><strong>Results: </strong>The operation time using the vNOTES approach was significantly shorter when compared to a laparoscopic approach, mean surgical time was 35 versus 47 min (p < 0.001). Both techniques had a very low complication and postoperative infection rate. Duration of hospital stay was not significantly lower in the vNOTES group but a trend was seen (p = 0.06). No significant differences were observed in the obstetric outcomes.</p><p><strong>Conclusion: </strong>This study shows that the vNOTES approach is a good and safe technique to operate ectopic pregnancies and can provide shorter operating time and duration of hospitalisation. Early data shows promising results on safety for future pregnancies but further research is warranted.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct endometriosis involvement confers divergent oncologic outcomes in ovarian clear cell carcinoma.","authors":"Jie Deng, Jiayuan Li, Lian Xu, Tianjin Yi","doi":"10.1007/s00404-025-08025-3","DOIUrl":"10.1007/s00404-025-08025-3","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinicopathologic characteristics and survival outcomes of ovarian clear cell carcinoma (OCCC) patients with different endometriosis statuses.</p><p><strong>Methods: </strong>This retrospective study included OCCC patients diagnosed between 2012 and 2021, classified into three groups based on the Sampson and Scott criteria: Without (no endometriosis), Arising (OCCC arising from endometriosis), and Coexisting (OCCC coexisting with endometriosis). Clinical and pathological characteristics were compared across groups, and survival outcomes were analyzed using Kaplan-Meier methods. Prognostic factors for progression-free survival (PFS) and overall survival (OS) were identified through univariate and multivariate analyses.</p><p><strong>Results: </strong>Among 242 patients, 53.7% were in the Without group, 29.3% in the Arising group, and 16.9% in the Coexisting group. The Arising group had the highest prevalence of early FIGO stage disease (91.6%) compared to the Coexisting (75.6%, p = 0.041) and Without (67.7%, p = 0.000) groups. Lymph-node metastasis was significantly lower in the Arising group (2.8%) than in the Coexisting (19.5%, p = 0.010) and Without (10%, p = 0.011) groups. Notably, the Arising group demonstrated unique atypical endometriosis features. In univariate analysis, the presence of endometriosis (either arising from or coexisting with endometriosis) was associated with improved PFS (p = 0.004 and p = 0.009, respectively); however, multivariate analysis confirms only coexisting with endometriosis as an independent factor (HR: 0.11, 95% CI: 0.01-0.84). For OS, the Arising group demonstrated the most significant benefit, with a 5-year OS of 92.4% compared to the Coexisting group (83.9%, p = 0.293) and the Without group (62.6%, p = 0.023). Multivariate analysis identified only FIGO stage (HR: 5.89, 95% CI: 2.06-16.82) as an independent prognostic factor for OS, while endometriosis did not reach statistical significance (HR: 0.62, 95% CI: 0.26-1.53).</p><p><strong>Conclusions: </strong>Classifying OCCC with endometriosis statuses reveals distinct prognostic patterns. Coexisting with endometriosis positively impacts PFS, while the Arising subgroup shows the most significant OS benefit but may be confounded with other factors.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":"273-286"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968413","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":"Analysis of the outcomes and factors influencing vaginal trial labor in primiparas at term.","authors":"Songwen Nian, Huixia Yang, Yumei Wei","doi":"10.1007/s00404-024-07816-4","DOIUrl":"10.1007/s00404-024-07816-4","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the outcomes and factors influencing vaginal trial labor in primiparas with term singleton fetuses.</p><p><strong>Methods: </strong>A retrospective analysis of 9174 first-time mothers who opted for a vaginal trial of labor at Peking University First Hospital from October 2019 to September 2022 was performed. The primary outcomes included the outcome of the trial of labor and influencing factors.</p><p><strong>Results: </strong>Of the total population, the success rate of attempted vaginal delivery was 74.3% (6818/9174). Logistic regression analysis revealed that increasing maternal age (OR = 1.054; 95% CI = 1.239-2.316; p < 0.001), gestational weight gain (OR = 1.033; 95% CI = 1.022-1.045; p < 0.001), neonatal weight (OR = 1.971; 95% CI = 1.724-2.253; p < 0.001), prepregnancy body mass index (BMI) ≥ 24 kg/m² (OR = 1.605; 95% CI = 1.411-1.825; p < 0.001), prenatal BMI ≥ 24 kg/m² (OR = 1.326; 95% CI = 1.137-1.546; p < 0.001), and induced labor (OR = 2.434; 95% CI = 2.187-2.708; p < 0.001) increased the risk of failed vaginal delivery attempts, and labor analgesia reduced the risk of failed vaginal delivery attempts (OR = 0.356; 95% CI = 0.320-0.397; p < 0.001). However, the use of assisted reproductive technology had no significant effect on the outcome of attempted vaginal delivery (p = 0.137). According to the partial regression coefficient, the area under the ROC curve was 0.710 (95% CI = 0.698-0.723), and the model passed the Hosmer-Lemeshow test and had good discrimination and calibration (χ² = 12.833, p = 0.118). The postpartum hemorrhage (PPH) rate and overall neonatal asphyxia rate differed significantly between women who had different outcomes of vaginal trial labor.</p><p><strong>Conclusions: </strong>There are many factors affecting the occurrence of abnormal delivery in primiparas. These independent factors can be used for prenatal evaluation.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":"69-76"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765737","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}