Archives of Gynecology and Obstetrics最新文献

{"title":"Benefits of minimal ethanol volume and retention without removal in transvaginal ethanol sclerotherapy for endometriomas","authors":"Hwa Sook Moon,&nbsp;Bo Sun Joo,&nbsp;Jaseong Koo,&nbsp;Kyung Il Nam,&nbsp;Joshua Bonwoo Koo,&nbsp;Sang Gap Kim","doi":"10.1007/s00404-026-08428-w","DOIUrl":"10.1007/s00404-026-08428-w","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aims to introduce an effective protocol for transvaginal ethanol sclerotherapy, focussing on the aspiration of viscous cystic content and the amount of ethanol instilled in the cystic cavity according to cyst size.</p><h3>Methods</h3><p>We retrospectively reviewed the medical records of 90 women who underwent transvaginal ethanol sclerotherapy from 2015 to 2022 at Good Moonhwa Hospital, Busan, Republic of Korea. The volume of ethanol used for sclerotherapy was determined based on the initial volume of aspirated cystic content, with a target limit of 30 cc, and the injected alcohol was retained within the cystic cavity. All patients were followed up on postoperative days 1 and 2, at 2 weeks, 4 weeks, 3 months, 6 months, 12 months, and every 6 months thereafter to assess the ovary, AMH level, complications, recurrence, and pregnancy outcome.</p><h3>Results</h3><p>The cyst size was 5.07 ± 1.56 cm. AMH levels increased in 22 cases (27.4%) and decreased in 68 cases (75.6%). Among the 68 cases that decreased, 38 cases (55.9%) showed a mild decrease of less than 30%. The change rates in AMH levels did not significantly correlate with cyst size, aspirated cyst volume, alcohol instillation volume, operation time, recurrence rate, or pregnancy outcome. The volume of alcohol instilled significantly correlated with operation time. Of the 44 patients (78.9%) who wished to conceive, 17 (38.6%) became pregnant (12 spontaneously and 5 via IVF-ET). Recurrence occurred in 6 cases (6.67%).</p><h3>Conclusion</h3><p>This study demonstrates that our protocol for ethanol sclerotherapy not only significantly reduces the recurrence rate but also preserves ovarian reserve, as reflected by the minimal impact on AMH.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08428-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760542","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":"Transvaginal ultrasonographic characteristics of different types of residual pregnancy tissue in patients with incomplete medication abortion","authors":"Zhiyue Li,&nbsp;Mingcui Chen,&nbsp;Dan Lu,&nbsp;Qin Lu","doi":"10.1007/s00404-026-08420-4","DOIUrl":"10.1007/s00404-026-08420-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;This retrospective study aimed to investigate the transvaginal ultrasound (TVUS) characteristics of different pathological types of retained products of conception (RPOC)—chorionic-decidual versus non-chorionic-decidual—following incomplete medication abortion, to provide an imaging basis for individualized clinical management.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;A total of 300 patients with incomplete medication abortion treated at Kunshan Traditional Chinese Medicine Hospital between January 2023 and June 2025 were enrolled. Based on histopathological examination, patients were categorized into a chorionic-decidual group (&lt;i&gt;n&lt;/i&gt; = 214) and a non-chorionic-decidual group (&lt;i&gt;n&lt;/i&gt; = 86). All patients underwent TVUS examination, which assessed uterine volume, residual tissue morphology (mass-like vs. patchy), echogenicity pattern (hyperechoic, hypoechoic, mixed), local blood flow distribution (graded by the Alder classification), and hemodynamic parameters (pulsatility index, PI; resistance index, RI). Receiver operating characteristic (ROC) analysis was performed to determine optimal cut-off values for PI and RI. Multivariable logistic regression was used to identify independent predictors of chorionic-decidual RPOC.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;The proportion of patients with increased uterine volume was significantly higher in the chorionic-decidual group than in the non-chorionic-decidual group (33.18% vs. 8.14%, &lt;i&gt;P&lt;/i&gt; = 0.003). Residual tissue in the chorionic-decidual group predominantly presented as mass-like (80.84%), whereas in the non-chorionic-decidual group, it was mainly patchy (87.21%), with a significant intergroup difference (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). Echogenicity in the chorionic-decidual group was primarily hypoechoic (28.97%) or mixed (55.61%), while the non-chorionic-decidual group showed predominantly hyperechoic signals (74.42%) (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). Residual tissue in the chorionic-decidual group demonstrated significantly richer blood flow (Alder grades II–III: 89.72% vs. 10.47%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and lower hemodynamic indices (PI: 0.87 ± 0.14 vs. 1.49 ± 0.20; RI: 0.62 ± 0.08 vs. 0.75 ± 0.12; both &lt;i&gt;P&lt;/i&gt; &lt; 0.001) compared to the non-chorionic-decidual group. Multivariable logistic regression identified mass-like morphology (OR = 12.34, 95% CI: 5.21–29.23, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), mixed/hypoechoic echogenicity (OR = 8.76, 95%CI: 3.98–19.28, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), and Alder grade II–III blood flow (OR = 15.67, 95%CI: 6.54–37.56, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) as independent predictors of chorionic-decidual RPOC. ROC analysis suggested that PI and RI had good discriminatory ability within this cohort, with exploratory cut-offs of ≤ 1.12 for PI (sensitivity 87.4%, specificity 83.7%) and ≤ 0.68 for RI (sensitivity 84.6%, specificity 81.4%). These cut-off values are derived from the current dataset and require external validation.&lt;/p&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Within the selected cohort of patients requiring surgical evacuation, ch","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08420-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760591","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":"Intravaginal progesterone as a fertility-sparing treatment for symptomatic adenomyosis: preliminary results from a monocentric study","authors":"Carlo De Cicco Nardone,&nbsp;Maria Cristina Sangiovanni,&nbsp;Gian Mario Sangiovanni,&nbsp;Francesco Plotti,&nbsp;Roberto Montera,&nbsp;Daniela Luvero,&nbsp;Roberto Angioli,&nbsp;Corrado Terranova","doi":"10.1007/s00404-026-08361-y","DOIUrl":"10.1007/s00404-026-08361-y","url":null,"abstract":"<div><h3>Purpose</h3><p>Adenomyosis is a chronic uterine disorder characterised by ectopic endometrial tissue within the myometrium, frequently associated with dysmenorrhea, abnormal uterine bleeding (AUB), chronic pelvic pain (CPP), and dyspareunia. No standardised guidelines are currently available for its management, and therapeutic options remain limited for women seeking fertility preservation. This study aimed to evaluate the efficacy of intravaginal progesterone in alleviating adenomyosis-related symptoms in patients seeking fertility preservation.</p><h3>Methods</h3><p>In this prospective monocentric observational study, 85 patients aged 22–50 years with ultrasound-confirmed symptomatic adenomyosis were enrolled between April 2020 and April 2024. Inclusion criteria were age 18–55 years, BMI 18–35, and a Visual Analogue Scale (VAS) score ≥ 7 for dysmenorrhea, AUB, CPP, or dyspareunia. All patients received 200 mg/day of intravaginal progesterone for 10 days per cycle. Symptom severity was assessed using VAS scores at baseline and at 6 months. Data were analysed using non-parametric statistical tests.</p><h3>Results</h3><p>Sixty-five patients completed the 6-month follow-up. Four patients conceived during treatment and were excluded from the final analysis. Statistically significant improvements were observed for all assessed symptoms (all p &lt; 0.05). Median VAS scores decreased for dysmenorrhea (9 to 6, p &lt; 0.001), AUB (8 to 6, p &lt; 0.001), chronic pelvic pain (5.5 to 3.5, p &lt; 0.001), and dyspareunia (2 to 0, p = 0.020). The overall treatment satisfaction was high, with a mean Likert score of 7.5 out of 10.</p><h3>Conclusion</h3><p>Intravaginal progesterone appears to be an effective fertility-sparing treatment for symptomatic adenomyosis, providing significant relief across all primary symptoms, with high patient satisfaction. Larger controlled studies are warranted to confirm these preliminary findings and further define its role in clinical practice.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08361-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760643","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":"Comparing oxytocin alternatives for postpartum hemorrhage prevention in vaginal and caesarean births: a systematic review and meta-analysis","authors":"Seeta Devi,&nbsp;Maneesha Rajendrakumar Suryavanshi,&nbsp;Ramesh Chandrababu","doi":"10.1007/s00404-026-08368-5","DOIUrl":"10.1007/s00404-026-08368-5","url":null,"abstract":"<div><h3>Background</h3><p>In this systematic review and meta-analysis, we aimed to explore the availability of alternatives to oxytocin for preventing postpartum haemorrhage (PPH) during vaginal births (VB) and caesarean births (CB).</p><h3>Methods</h3><p>We followed the Cochrane guidelines for the review, and reported the results using the PRISMA guidelines. Using a thorough search strategy, we retrieved original articles from SCOPUS, PubMed, Web of Science, and the Cochrane Library from January 2015 to February 2025. We analyzed the RCTs to compare Tranexamic Acid (TXA), carbetocin, and misoprostol with oxytocin for preventing PPH in both vaginal and caesarean births. The review's protocol has been officially registered with PROSPERO under the identifier CRD420251002602.</p><h3>Results</h3><p>A meta-analysis of 20 trials showed no statistically significant difference in reducing blood loss during vaginal births (SMD = − 0.21; 95% CI − 0.62 to 0.19; I² = 96%). However, contrasting results were observed in cesarean births (SMD = − 0.82; 95% CI − 1.49 to − 0.16; p = 0.02). Correspondingly, no statistically significant difference was found in the occurrence of PPH in vaginal births (OR = 0.80; 95% CI 0.53 to 1.21; I² = 98%), while significant variances were detected in cesarean births (OR = 0.58; 95% CI 0.43 to 0.80; I² = 21%). Hemoglobin variation was notably lower in both vaginal and cesarean births (SMD = − 0.32; 95% CI − 0.49 to − 0.16; I² = 93%) and (SMD = − 0.90; 95% CI − 1.52 to − 0.27; I² = 96%), respectively.</p><h3>Conclusion</h3><p>Considering the substantial heterogeneity and mostly non-significant pooled results, the current findings should be viewed as indicative rather than conclusive. Further rigorous, well-designed randomized controlled trials are necessary to better define their effectiveness, optimize dosing, and identify patient groups most likely to benefit.</p><h3>Graphical abstract</h3>\u0000<div><figure><div><div><picture><source><img></source></picture><span>The alternative text for this image may have been generated using AI.</span></div></div></figure></div></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08368-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760483","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":"Walking through trimesters: a quantitative assessment of step counts before and during pregnancy and their impact on pregnancy outcomes","authors":"Michal Ovadia,&nbsp;Noga Nattiv,&nbsp;Rivka Podorovsky Banker,&nbsp;Yair Daykan,&nbsp;Ron Schonman,&nbsp;Tal Biron Shental,&nbsp;Michal Kovo,&nbsp;Yael Yagur,&nbsp;Omer Weitzner","doi":"10.1007/s00404-026-08407-1","DOIUrl":"10.1007/s00404-026-08407-1","url":null,"abstract":"<div><h3>Objective</h3><p>To examine walking behavior during pregnancy and its association with obstetric and neonatal outcomes.</p><h3>Methods</h3><p>This retrospective cohort study included pregnant patients who delivered between 2020 and 2024 at a tertiary medical center. Daily step counts were recorded via the Health Auto Expert mobile application from three months before conception until admission to the labor ward. Pregnancy and delivery data were obtained from medical records. The primary outcome was a composite of delivery complications by step-count category: Above-Average and Below-Average, based on the cohort mean. Secondary outcomes included postpartum complications, mode of delivery, and neonatal outcomes.</p><h3>Results</h3><p>The mean daily step count during pregnancy was 2539, declining progressively with gestation. Of 176 patients, 71 (40%) were Above-Average and 105 (60%) Below-Average. The Above-Average group had higher pre-pregnancy activity (4541.7 vs 2330.3 steps/day, <i>p</i> &lt; 0.001) and higher maternal age. No significant differences were found in composite delivery or postpartum complications. Vacuum extraction was more frequent in the Above-Average group (15.5% vs 3.8%, <i>p</i> = 0.014), though not significant after adjustment. Median neonatal birth-weight percentile was 54.5, lower in the Above-Average group (44.0 [25.0–71.0] vs 60.0 [38.0–78.0], <i>p</i> = 0.024), without significance in multivariable analysis.</p><h3>Conclusions</h3><p>Walking patterns declined across pregnancy. Step count was not associated with delivery complications or adverse maternal or neonatal outcomes. Walking during pregnancy appears safe and was not associated with adverse maternal or neonatal outcomes in this predominantly sedentary cohort of low-risk pregnancies.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08407-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760641","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":"Role of placental glucose metabolism in steroidogenesis in healthy pregnancies at term","authors":"Muhammad Umar Sajjad,&nbsp;Tore Henriksen,&nbsp;Guttorm Haugen,&nbsp;Trond M. Michelsen","doi":"10.1007/s00404-025-08293-z","DOIUrl":"10.1007/s00404-025-08293-z","url":null,"abstract":"<div><h3>Background</h3><p>The human placenta consumes, on average, one third of the glucose from maternal blood. However, the role of placental glucose consumption in the production of estradiol and progesterone remains unclear. We hypothesized that placental glucose consumption in humans is associated with steroid production via a non-glycolytic pathway.</p><h3>Methods</h3><p>We included 41 healthy pregnancies at term. Blood samples were obtained from the maternal radial artery, uterine vein, and from the umbilical artery and vein during scheduled cesarean delivery. Blood flow in the uterine artery and umbilical vein was measured using Doppler ultrasound. Plasma concentrations of estradiol, progesterone, glucose, insulin, lactate, and ketones were analyzed. We calculated uteroplacental uptake and consumption of maternal glucose and ketones, and the loss of uteroplacental lactate in 6-carbon units as well as the release of steroid hormones into maternal circulation.</p><h3>Results</h3><p>Our data revealed a net placental release of estradiol and progesterone into maternal circulation [24.1 (5.34, 49.8) and 560.3 (61.2, 798.2) nmol/min, respectively]. The release of estradiol was positively associated with uteroplacental glucose uptake (ρ = 0.59, <i>p</i> &lt; 0.001) and consumption (ρ = 0.43, <i>p</i> = 0.005), while progesterone exhibited similar associations (ρ = 0.61, <i>p</i> &lt; 0.001; ρ = 0.43, <i>p</i> = 0.005). Notably, both hormones correlated positively with lactate-adjusted uteroplacental glucose consumption but not with acetate-equivalent uteroplacental ketone consumption.</p><h3>Conclusion</h3><p>Placental release of estradiol and progesterone correlates with uteroplacental consumption of glucose that primarily occurs via non-glycolytic pathways in the third trimester placenta.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08293-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760636","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 cohort study of fetal urinary tract abnormalities and chromosomal copy number variations: a retrospective analysis of 9-year data","authors":"Lin Chen,&nbsp;Wei Yang,&nbsp;Li Liu,&nbsp;Huimin Shen,&nbsp;Chao Wang,&nbsp;Ruijing Wang,&nbsp;Qiao Li,&nbsp;Yu Liu,&nbsp;Zhixin Di,&nbsp;Nan Lv,&nbsp;Xin Huang,&nbsp;Meimei Liu","doi":"10.1007/s00404-026-08421-3","DOIUrl":"10.1007/s00404-026-08421-3","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the association between ultrasonically detected fetal urinary system abnormalities and chromosomal copy number variations (CNVs) in Heilongjiang Province, northeastern China.</p><h3>Methods</h3><p><i>Cohort study</i>: 183 fetuses with ultrasound-detected urinary system anomalies (invasive prenatal diagnosis, 2017.01–2025.09, Second Affiliated Hospital of Harbin Medical University) were enrolled. All underwent CNV analysis: 21 without karyotyping, 12 with abnormal karyotypes, 150 with normal karyotypes. The 150 normal-karyotype cases were split into isolated CAKUT (63, 42%) and non-isolated CAKUT (87, 58%) groups; CNV abnormalities were compared between groups. <i>Meta-analysis</i>: Studies on CNVs in CAKUT fetuses (2017.01–2025.09) were retrieved from PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Data, SinoMed. Pooled effect sizes were calculated via Stata 17.0.</p><h3>Results</h3><p>Among 162 fetuses who underwent conventional karyotyping, chromosomal aneuploidy occurred in 7.41% (12/162). In 150 karyotypically normal cases, pathogenic/likely pathogenic (p/lp) CNVs were detected in 7.33% (11/150): 3.17% (2/63) for isolated CAKUT and 10.34% (9/87) for non-isolated CAKUT (<i>P</i> = 0.120, non-significant).</p><p>A meta-analysis of 30 studies (9284 pregnant women) demonstrated a weighted pooled incidence of p/lp CNVs of 6% (95% CI 0.05–0.07) in karyotypically normal CAKUT fetuses, with weighted pooled incidences of 5% (95% CI 0.03–0.06) for isolated CAKUT and 8% (95% CI 0.06–0.10) for non-isolated CAKUT.</p><h3>Conclusions</h3><p>This is the first cohort study utilizing nine-year data from Heilongjiang Province, a cold region in northeastern China, to analyze the association between fetal urinary system anomalies and CNVs. In this region, the incidence of p/lp CNVs among CAKUT fetuses with normal karyotypes was 7.33%. Notably, seven pathogenic CNV fragments (deletions at 4p15.31, 5p13.1, 15q11.2, 16p11.2, Xq28, and Xp22.31; duplication at 11q15.5) previously unreported in Northeast China were identified, expanding the genetic spectrum associated with CAKUT in cold regions. The meta-analysis noted that the cumulative crude incidence of p/lp CNV in CAKUT fetuses was 5.71% (498/8,723) across all included studies. Both the cohort study and the meta-analysis showed a numerically higher incidence of p/lp CNVs in non-isolated CAKUT compared with isolated cases (10.34% vs. 3.17%, <i>P</i> = 0.120; 8% vs. 5% weighted pooled incidences from the meta-analysis, respectively), though this difference did not reach statistical significance in the cohort study. Thus, routine CNV screening is recommended for all CAKUT fetuses, particularly non-isolated cases, to comprehensively exclude genetic abnormalities, guiding clinical prenatal diagnosis and genetic counseling.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08421-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760456","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":"Placental mesenchymal dysplasia: diagnostic and management insights from a case report and literature review","authors":"Qiuyan Luo,&nbsp;Yan Qin,&nbsp;Zhimei Zeng,&nbsp;Yukui Huang,&nbsp;Xiaoli Sun,&nbsp;Wenjin Zheng","doi":"10.1007/s00404-026-08416-0","DOIUrl":"10.1007/s00404-026-08416-0","url":null,"abstract":"<div><h3>Background</h3><p>Limited awareness of placental mesenchymal dysplasia (PMD) and the diagnostic challenges in differentiating it from partial hydatidiform moles on imaging often lead to inappropriate management. This study presents a case report and literature review to elucidate the etiology, clinical features, and management of PMD.</p><h3>Case presentation</h3><p>The patient was admitted with a history of amenorrhea lasting over two months and experiencing vaginal bleeding for four days. Ultrasonography at 12 weeks of gestation revealed extensive cystic changes within the placenta, and was subsequently corroborated by magnetic resonance imaging. The differential diagnosis comprised placental structural abnormalities indicative of PMD or a hydatidiform mole. The patient opted to terminate the pregnancy citing concerns regarding an unfavorable prognosis. Placental pathology confirmed PMD. Fetal short tandem repeat analysis revealed a biparental diploid, whereas the placenta demonstrated androgenetic and biparental chimerism. Postoperative serial monitoring indicated a progressive decrease in serum β-hCG level, and no signs of gestational trophoblastic disease or other maternal complications were observed.</p><h3>Conclusion</h3><p>PMD should be considered when prenatal ultrasonography reveals cystic placental lesions, typically manifested as cystic or hypoechoic regions within an enlarged placenta and often accompanied by mildly elevated maternal serum β-hCG levels. The fetal karyotype is typically normal, with a predominance of females. Pathological examination demonstrates a considerably enlarged placenta characterized by vesicular, grape-like structures on its surface. Some mothers may develop complications such as hypertensive disorders of pregnancy, while adverse perinatal outcomes—such as preterm delivery or stillbirth due to fetal distress or malformations—may also occur. However, a considerable proportion of maternal and fetal outcomes remains favorable. Enhanced maternal and fetal monitoring in PMD pregnancies has the potential to enhance perinatal outcomes.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08416-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760597","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":"Unfavorably altered fibrin clot properties in women with unexplained infertility: association with pregnancy outcomes","authors":"Magdalena Piróg,&nbsp;Robert Jach,&nbsp;Michał Ząbczyk,&nbsp;Joanna Natorska","doi":"10.1007/s00404-026-08418-y","DOIUrl":"10.1007/s00404-026-08418-y","url":null,"abstract":"<div><h3>Objectives</h3><p>Ovarian stimulation (OS) and pregnancy were shown to be associated with a prothrombotic state. We sought to determine whether a positive pregnancy outcome is related to fibrin clot properties and thrombin generation in women with unexplained infertility (UI) after OS followed by intrauterine insemination (IUI).</p><h3>Methods</h3><p>We studied 70 women with UI, aged 30.7 ± 3.5 years, BMI 24.7 ± kg/m² together with 70 controls who had healthy births matched for age and weight. We measured thrombin generation capacity, plasma fibrin clot permeability (K_s), and fibrinolytic potential (clot lysis time, CLT). In women with UI, after OS followed by IUI, pregnancy outcomes were recorded.</p><h3>Results</h3><p>UI women had prolonged lag time (+ 10.0%) and lower thrombin generation reflected by ETP (−17.8%) and formed clots less permeable (− 20.8%; K_s) and more resistant to lysis (+ 17.5% CLT) compared to controls (all <i>p</i> &lt; 0.05). Women with UI and positive pregnancy outcome (<i>n</i> = 19, 27.1%) showed increased K_S (+ 67.9%) along with shorter CLT (− 15.9%) with no difference in thrombin generation, when compared to non-pregnant women. In women with UI ETP was associated with peak thrombin (<i>r</i> = 0.57, <i>p</i> = 0.02), whereas CLT was negatively correlated both with K_S (<i>r</i> =  − 0.42, <i>p</i> = 0.001) and TSH (<i>r</i> =  − 0.56, <i>p</i> = 0.04).</p><h3>Conclusions</h3><p>Women with UI display unfavorably modified fibrin clot properties, especially those with negative pregnancy outcomes, which suggests the impact of fibrin clot characteristics on treatment results.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760633","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":"The role of large language models in the diagnosis and management of obstetric patients: a pilot feasibility study using simulated obstetric cases","authors":"Iason Psilopatis,&nbsp;Katharina Redling,&nbsp;Valeria Filippi,&nbsp;Sofia Kappos,&nbsp;Julius Emons,&nbsp;Beatrice Mosimann,&nbsp;Tibor A. Zwimpfer","doi":"10.1007/s00404-026-08423-1","DOIUrl":"10.1007/s00404-026-08423-1","url":null,"abstract":"<div><h3>Objective</h3><p>This feasibility study aimed to assess the potential of freely available large language models (LLMs) to support clinical decision-making in obstetrics.</p><h3>Methods</h3><p>Five fictional obstetric patient cases, encompassing a range of clinical presentations (preeclampsia, fetal growth restriction, preterm premature rupture of membranes, vaginal bleeding, and abdominal trauma), were presented to three LLMs: Chat-GPT (OpenAI), Gemini (Google), and DeepSeek. The LLMs were tasked with evaluating the patient information, suggesting potential diagnoses, and outlining appropriate management strategies. The responses were qualitatively assessed, and subsequently, four expert obstetricians evaluated the LLMs’ recommendations using the Global Quality Score (GQS).</p><h3>Results</h3><p>The LLMs demonstrated an ability to process complex obstetric scenarios and generate diagnostic and management considerations that often aligned with established clinical principles. In cases like preeclampsia and preterm premature rupture of membranes, the LLMs accurately identified key issues and proposed relevant management steps. For fetal growth restriction, vaginal bleeding, and abdominal trauma, they outlined appropriate evaluation frameworks and differential diagnoses. The responses varied in their level of detail and directness. DeepSeek received the highest GQS for all five cases in total, whereas Google Gemini was outperformed by the two other LLMs in the cases of vaginal bleeding and abdominal trauma.</p><h3>Conclusion</h3><p>This preliminary feasibility assessment suggests that freely available LLMs can generate plausible-sounding responses to obstetric vignettes. Further rigorous evaluation using quantitative methods, real-world data, and exploration of integration strategies is warranted to fully understand their role in enhancing clinical decision-making and improving patient care in obstetric practice.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760646","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}