Archives of Gynecology and Obstetrics最新文献

{"title":"Isolated hydrometrocolpos and cloacal malformation: can we prenatally distinguish them?—A case report and literature review","authors":"Meylign Long,&nbsp;Kaiyu Fu,&nbsp;Jie Ruan","doi":"10.1007/s00404-025-08004-8","DOIUrl":"10.1007/s00404-025-08004-8","url":null,"abstract":"<div><h3>Background</h3><p>Hydrometrocolpos (HMC) is a rare prenatal ultrasound abnormality, presenting in two distinct types: urinary-type and secretory-type. The urinary variation is intricately linked to cloacal malformation (CM), thereby posing a heightened risk of perinatal adverse events. Additionally, children affected by this type often face long-term challenges that impact their quality of life. Therefore, predicting the presence of CM in HMC fetuses is of great clinical significance.</p><h3>Case presentation</h3><p>We present a case involving hydrometrocolpos accompanied by oligohydramnios. Prenatally, the condition was strongly indicative of CM based on imaging manifestations and intrauterine procedures, a suspicion that was later confirmed through postnatal autopsy.</p><h3>Conclusion</h3><p>Due to the extremely low incidence of HMC, current literature primarily consists of case reports, and there are no studies that comprehensively analyze the prognosis of the disease. This research fills this gap by statistically analyzing the present case as well as 164 prenatal HMC cases reported in the previous literature. Gestational age (GA) at initial detection, the presence of fetal ascites, urinary tract dilatation, anorectal imaging abnormalities, and Müllerian anomalies are meaningful predictors of CM in HMC fetuses. Intrauterine procedures can be used to preserve organ function in complete lower urinary tract obstruction and oligohydramnios secondary to HMC. In addition, biochemical analysis of HMC fluid can differentiate between urinary-type HMC and secretory-type HMC. This study provides valuable insights into the prognostic factors and management strategies for HMC, which could guide clinical decision-making in prenatal care.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 5","pages":"1467 - 1474"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08004-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762939","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":"Intergroup statement: opportunistic salpingectomy—molecular pathology, clinical outcomes and implications for practice (German Ovarian Cancer Commission, the North-Eastern German Society of Gynecologic Oncology (NOGGO), AGO Austria and AGO Swiss)","authors":"Martin Pölcher,&nbsp;Pauline Wimberger,&nbsp;Ivo Meinhold-Heerlein,&nbsp;Ingo Runnebaum,&nbsp;Susanne Schüler-Toprak,&nbsp;Sven Mahner,&nbsp;Christoph Grimm,&nbsp;Viola Heinzelmann-Schwarz,&nbsp;Annette Hasenburg,&nbsp;Jalid Sehouli","doi":"10.1007/s00404-025-07974-z","DOIUrl":"10.1007/s00404-025-07974-z","url":null,"abstract":"<div><p>Opportunistic salpingectomy is defined as the removal of both fallopian tubes as part of a surgical procedure planned for other reasons. The goal is primary prevention of ovarian cancer. The procedure is offered to patients who are not known to be at increased risk of developing ovarian cancer. This is in contrast to high-risk patients with a germline mutation, particularly BRCA1/2, for whom risk-reducing salpingo-oophorectomy is generally recommended. Premalignant cells and early occult cancers have been detected in RRSO specimens in the fimbrial funnel region, but not on the ovarian surface. The presence of mitoses, nuclear atypia, and staining in response to p53 mutation in these serous intraepithelial carcinomas (STIC) indicates the initial genetic changes in the fallopian tube mucosa that subsequently lead to the development of advanced peritoneal carcinomas. The identification of STICs has challenged the traditional view of the pathogenesis of the largest subset of epithelial ovarian cancers, namely the high-grade serous cancers of the ovary, fallopian tubes, and peritoneum. In a position statement published in 2015, the German Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) Kommission Ovar recommended that patients be informed of the latest findings on the development and potential benefits of bilateral salpingectomy at the time of hysterectomy. This may reduce the risk of developing ovarian cancer later in life. However, the scientific evidence has not been deemed sufficient to justify a general recommendation. In the same year, the Austrian AGO published a statement recommending the broad use of opportunistic salpingectomy without reservation. This review examines the current status of molecular pathology studies, recent evidence on the clinical implications of STIC, new data on the use of opportunistic salpingectomy, and published patient outcomes since then. The question of whether the potential benefit of opportunistic salpingectomy, outweighs the potential harms associated with surgical morbidity, which have not been conclusively excluded, should be revisited in light of these recent data.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 5","pages":"1451 - 1459"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07974-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762938","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":"Clinical features and management of thoracic endometriosis: a 20-year monocentric retrospective study","authors":"Dhouha Dridi,&nbsp;Federica Liliana Ottolini,&nbsp;Deborah Ambruoso,&nbsp;Veronica Bandini,&nbsp;Francesca Chiaffarino,&nbsp;Giulia Emily Cetera,&nbsp;Giussy Barbara","doi":"10.1007/s00404-025-08006-6","DOIUrl":"10.1007/s00404-025-08006-6","url":null,"abstract":"<div><h3>Purpose</h3><p>Although thoracic endometriosis (TE) represents the most common manifestation of extra-pelvic endometriosis, it is a rare condition and currently there is no established clinical guideline for the management of this condition. The study's primary objective was to assess patient satisfaction with the treatment provided. A secondary objective was to investigate the efficacy of different treatment modalities in terms of symptom and lesion recurrence.</p><h3>Methods</h3><p>A retrospective review of the clinical records of all women with TE who had been referred to our institution, a tertiary referral center, was conducted between January 2000 and September 2021. A frequency analysis was performed for all the variables examined in the study. The Kaplan–Meier method was adopted to analyse the time from thoracic surgery to PNX recurrence. Lastly, an intention-to-treat analysis was performed.</p><h3>Results</h3><p>Regarding clinical presentation, 50% of women (30/60; 95% CI 36.8–63.2) experienced at least one episode of pneumothorax (PNX). A total of 61.7% of the women in the study underwent surgical intervention, while 36.6% received pharmacological treatment. The cumulative recurrence rate of the first PNX following surgery was 0.26 (0.13–0.41) and 0.82 (0.44–0.95) at six months and 240 months, respectively. At the follow-up assessment, regardless of the administered treatment modality, over half of the women included in the study reported being satisfied with their treatment (PGIC). Additionally, most of them described their overall condition as having improved since the onset of the treatment (PGIS).</p><h3>Conclusion</h3><p>Both surgical and pharmacological treatments are valuable options for TE. Rather than being considered mutually exclusive, these approaches should be viewed as complementary.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 6","pages":"1733 - 1742"},"PeriodicalIF":2.1,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08006-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742076","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":"Approach to abnormal uterine bleeding in presence of endometrial polyps with new hysteroscopic devices.","authors":"Francesco G Martire, Giorgia Schettini, Eugenia Costantini, Claudia d'Abate, Giuseppe Sorrenti, Gabriele Centini, Errico Zupi, Lucia Lazzeri","doi":"10.1007/s00404-025-08005-7","DOIUrl":"https://doi.org/10.1007/s00404-025-08005-7","url":null,"abstract":"<p><strong>Purpose: </strong>To compare different endoscopic techniques, such as hysteroscopy with morcellator and traditional resectoscopy, and different surgical settings, such as operating room setting and outpatient setting, for patients with abnormal uterine bleeding (AUB) and suspected endometrial polyps.</p><p><strong>Metho: </strong>In this prospective study, 180 women diagnosed with endometrial polyps on ultrasound were enrolled. Patients were divided into three groups: 1) resectoscopy under anesthesia in an operating room setting; 2) morcellation with anesthesia in an operating room setting; and 3) outpatient morcellation without anesthesia. The main outcomes included procedure completion rates, operative time, patient satisfaction, and pain intensity using the Visual Analog Scale (VAS). Additionally, histological analysis was conducted for all cases.</p><p><strong>Results: </strong>Among the 180 patients, all procedures were completed in Groups 1 and 2, while Group 3 had a 96.7% completion rate. Procedure duration was the shortest in Group 3 (average 6.5 min), significantly less than in Group 1 (p value < 0.05; CI 95%). Pain was manageable in all groups, with VAS scores < 4 for most patients in the outpatient setting. Histology confirmed benign polyps in most cases, and malignant or premalignant conditions were around 3% of procedure.</p><p><strong>Conclusion: </strong>Outpatient \"see-and-treat\" hysteroscopy with morcellator, performed without anesthesia, proved feasible, safe, and cost-effective, with minimal discomfort and comparable diagnostic accuracy to traditional methods. This technique offers a practical approach for the management of AUB, enabling efficient treatment while reducing costs and resource usage, and may be considered as a preferred option in appropriate patients.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742075","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":"PROM at term: when might be the best time to induce labour? A retrospective analysis.","authors":"Teresa Starrach, Lucia Ehmann, Hannah Volkmann, Andreas Flemmer, Anna Hester, Eileen Tremmel, Susanne Beyer, Linda Hertlein, Christoph Hübener, Roman Hornung, Thomas Kolben, Sven Mahner, Johanna Büchel","doi":"10.1007/s00404-025-07981-0","DOIUrl":"https://doi.org/10.1007/s00404-025-07981-0","url":null,"abstract":"<p><strong>Purpose: </strong>PROM after 37 weeks of gestation occurs in approximately 10% of pregnancies. When spontaneous onset of labour does not follow, induction is recommended to decrease the risk of infection for both mother and child. However, there is no clear consensus on whether induction before 24 h after PROM results in fewer complications compared to induction after > 24 h.</p><p><strong>Material and methods: </strong>This retrospective observational study analysed the outcomes of 3174 women with PROM admitted to the delivery room of LMU Women's Hospital between 10/2015 and 09/2020. We evaluated whether timing of labour induction was associated with maternal or newborn postpartum infection rates.</p><p><strong>Results: </strong>Comparing women with spontaneous onset of labour to those who underwent induction, no significant differences were found in maternal CRP or leukocyte levels, fever, endometritis, or Group B streptococcus colonization. However, intrapartum antibiotic therapy was significantly higher in the induction group. When the induction group was subdivided based on the interval from PROM to induction, no significant differences were observed in maternal infection parameters, need for antibiotics, postpartum length of hospital stay, or endometritis. For newborn infections, a significant difference in CRP levels was found, with higher levels in the groups with \"induction < 12 h\" and \"> 24 h\".</p><p><strong>Conclusion: </strong>The presented data suggests that waiting for spontaneous contractions within the first 24 h after PROM was not associated with the risk of infection if no initial signs for infection are present. However, beyond 24 h, the risk of infection increased. These findings support current recommendations regarding the timing of induction after PROM.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741889","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":"Effect of ethnic origin and newborn gender on mother-infant bonding.","authors":"Hagar Brami, Eyal Sheiner, Tamar Wainstock, Talya Lanxner Battat, Inbal Reuveni, Tom Leibson, Gali Pariente","doi":"10.1007/s00404-025-08003-9","DOIUrl":"https://doi.org/10.1007/s00404-025-08003-9","url":null,"abstract":"<p><strong>Background: </strong>Fetal gender has been shown to influence pregnancy and perinatal outcomes. Adequate mother-infant bonding may have a positive effect on maternal and child's mental health further reducing the risk for maternal depressive symptoms and child's psychopathology.</p><p><strong>Objective: </strong>We aimed to assess the association between newborn gender and mother-infant bonding in the Arab Bedouin women in comparison to the Jewish population residing in the same area.</p><p><strong>Methods: </strong>A cross-sectional study was performed on women who delivered singletons during bonding questionnaire (PBQ). A second analysis of the four sub-scales of the PBQ questionnaire was conducted. The risk for post-partum depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) questionnaire. Self-reported questionnaires were administered to obtain sociodemographic data and additional information was drawn from women's medical records. Multivariable linear regression models were constructed to control for potential confounders.</p><p><strong>Results: </strong>The final analysis included 218 women, of whom 98 (44.9%) were of Bedouin origin and 120 (55.1%) were of Jewish origin. While total PBQ score was significantly lower among Bedouin women delivering male infants compared to female infants, demonstrating better mother-infant bonding (8.8 ± 3.8 vs. 15.1 ± 9.5, p = 0.010), no difference was found in the total PBQ score between Jewish women delivering male or female infants. Multivariable linear regression models controlling for maternal age, primiparity, and EPDS score demonstrated better mother-infant bonding when delivering a male infant compared to female infant among the Bedouin women (Beta 5.86, 95% CI 1.80-9.90, p = 0.006). Among Jewish women, no independent association was found between infant gender and mother-infant bonding.</p><p><strong>Conclusion: </strong>Better mother-infant bonding was found among Bedouin women delivering male infants compared to females. Modernization is challenging the Bedouins' patriarchal society; therefore, attempts to strengthen mother-infant bonding of the female gender are to be considered.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741878","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":"Precision surgery for endometriosis: preventing chronic pelvic pain in patients with higher pre-operative pain scores and in patients of advanced age","authors":"Davit Bokhua,&nbsp;Angela Kather,&nbsp;Anna Kaufmann,&nbsp;Evangelia Polychronaki,&nbsp;Valentina Auletta,&nbsp;Ingo B. Runnebaum","doi":"10.1007/s00404-025-07996-7","DOIUrl":"10.1007/s00404-025-07996-7","url":null,"abstract":"<div><h3>Objective</h3><p>Symptom relief can be achieved for many patients with endometriosis by tailored individual treatment. However, therapy resistance is observed in some patients. This study surveyed patient-reported long-term outcomes after laparoscopic endometriosis surgery and evaluated potential pre-operative predictors for insufficient symptom control.</p><h3>Methods</h3><p>This retrospective study included patients with complete surgical endometriosis resection treated between 2013–2016 at the Department of Gynaecology and Reproductive Medicine, Jena University Hospital. Our 2020 survey gathered socio-demographic, reproductive, symptom-related, and subjective general condition data from 122 patients. Overall pain intensity was assessed using a numeric rating scale (NRS) from zero (no pain) to 100 (highest imaginable pain). Clinical records provided additional information.</p><h3>Results</h3><p>Median time between surgery and interview was 6 years. Postoperatively, the proportion of patients reporting symptoms was considerably reduced (menstrual pain 32.0% vs. 85.2%, chronic pelvic pain [CPP] 40.2% vs. 67.2%, dyspareunia 34.4% vs. 59.8%, hypermenorrhea 17.2% vs. 49.2%; p &lt; 0.001). The majority of respondents (70%) reported improved subjective general condition. Mean NRS Score significantly decreased from 77.2 to 26.6 (p &lt; 0.001). Among pre-operatively infertile women, 45.2% reported successful pregnancies. However, 20–30% of patients did not respond to therapy in one of the analyzed domains. Multivariate logistic regression identified CPP as a strong predictor for failure in permanent pain reduction (OR 5.544, 95% CI 1.338–22.965, p = 0.018) and risk for reoperation (OR 5.191, 95% CI 1.100-24.501, p = 0.038). Higher pre-operative NRS scores and increasing age were associated with better long-term pain relief.</p><h3>Conclusion</h3><p>Patients with higher pre-operative pain scores and patients of advanced age benefit significantly from precision surgery, experiencing sustained symptom relief and improved subjective general condition. However, younger patients with CPP and moderate pre-operative pain intensity showed a higher risk for therapy resistance and require multimodal treatment strategies.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"1111 - 1125"},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07996-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727484","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":"SARS-CoV-2 infection in pregnant women and incidence of thromboembolic disease: an analysis of the Covid-19-Related Obstetric and Neonatal Outcome Study (CRONOS) in Germany","authors":"Ulrich Pecks,&nbsp;Michael K. Bohlmann,&nbsp;Kristin Andresen,&nbsp;Johanna Büchel,&nbsp;Catharina Bartmann,&nbsp;Magdalena Sitter,&nbsp;Anastasia Tihon,&nbsp;Peter Kranke,&nbsp;Achim Wöckel,&nbsp;Regina Hollweck,&nbsp;Iris Dressler-Steinbach,&nbsp;Susanne Gruessner,&nbsp;Teresa M. Gruber,&nbsp;Teresa Eichinger,&nbsp;Jula Manz,&nbsp;Ina M. Ruehl,&nbsp;Angela Lihs,&nbsp;Anna-Lena Biermann,&nbsp;Lea M. Bauerfeind,&nbsp;Kathleen M. Oberste,&nbsp;Babett Ramsauer,&nbsp;Eveline Russe,&nbsp;Susanne Schrey-Petersen,&nbsp;Filiz Markfeld Erol,&nbsp;Cahit Birdir,&nbsp;Lisa Kaup,&nbsp;Gregor Seliger,&nbsp;Christine Morfeld,&nbsp;Martin A. Berghaeuser,&nbsp;Manuela F. Richter,&nbsp;Peter Jakubowski,&nbsp;Birgit Linnemann,&nbsp;Werner Rath","doi":"10.1007/s00404-025-08007-5","DOIUrl":"10.1007/s00404-025-08007-5","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of the present study was to quantify the rate of thromboembolic events (TE) in pregnant women with SARS-CoV-2 infection and to characterize risk factors to provide a basis for individualized recommendation on prophylactic measures.</p><h3>Methods</h3><p>CRONOS is a multicenter, prospective observational study conducted in Germany and Austria during the COVID-19 pandemic. Pregnant women with confirmed SARS-CoV-2 infection were enrolled. Data on demographics, medical history, COVID-19-related aspects, and pregnancy and birth outcomes were collected. TE was particularly queried and used as the primary outcome. A combination of “TE,” “maternal or fetal death,” or “severe postpartum hemorrhage” was defined as a secondary endpoint. Risk analyses were performed using univariate and multivariable logistic regression models.</p><h3>Results</h3><p>Data from 8033 pregnant patients showed 40 TEs (0.5% incidence). TE rates were 10% in ICU patients, 0.2–0.4% in those with moderate-to-mild COVID-19, and &lt; 0.1% in asymptomatic women. Pulmonary embolism occurred in 21 cases, deep vein thrombosis in 12, and 7 had atypical or arterial TE. Risk factors included advanced gestational age, COVID-19 symptoms, hospitalization or ICU admission, premature birth, cesarean section, delivery within 4 weeks of infection, higher weight gain, anemia, and chronic inflammatory bowel disease. COVID-19 vaccination reduced risk. The logistic risk model yielded an AUC of 0.87 (95% CI 0.81–0.94).</p><h3>Conclusion</h3><p>The TE rate in pregnant women is largely determined by the severity of the disease. In asymptomatic or mild cases, other factors outweigh TE risk, while severe COVID-19 requiring ICU admission poses a high TE risk despite prophylaxis.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 6","pages":"1667 - 1682"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08007-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708166","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":"Virtual reality-based pain control in endometriosis: a questionnaire-based pilot study of applications for relaxation and physical activity","authors":"Viktoria Pakebusch,&nbsp;Barbara Schlisio,&nbsp;Birgitt Schönfisch,&nbsp;Sara Y. Brucker,&nbsp;Bernhard Krämer,&nbsp;Jürgen Andress","doi":"10.1007/s00404-025-08000-y","DOIUrl":"10.1007/s00404-025-08000-y","url":null,"abstract":"<div><h3>Purpose</h3><p>Virtual reality (VR) based technology may offer new avenues in the management of chronic endometriosis-related pain. Our prospective, 14-week, open, three-phase, cross-over pilot study investigated whether the use of VR technology equipped with a relaxation-inducing application (VR-R) or an activity-stimulating application (VR-A) could change endometriosis-related chronic pelvic pain levels and impairment of daily life.</p><h3>Methods</h3><p>23 women aged 32.7 (SD 8.2) with endometriosis-related pelvic pain were each assigned to a permutated sequence of three 4-week phases: (A) the VR-R, (B) VR-A, and (C) intervention-free control phases. Phases were separated by two interspersed 1-week washout phases. Main outcome measures included: momentary, average, and maximum pain intensities on a 0–10 numerical rating scale (NRS); the Pain Disability Index (PDI) score; the Pain Catastrophizing Scale (PCS) score; sleep quality (Medical Outcomes Study Sleep Scale (MOS-SS) score); the Depression Anxiety Stress Scales (DASS) score; and the general health-related quality-of-life score (Short Form (12) Health Survey (SF-12)).</p><h3>Results</h3><p>Compared to baseline, VR-R use showed statistically significant positive effects for several scores (NRS “average pain”; PDI “total score”; PCS “total score” and the “magnification”, “rumination”, and “helplessness” subscores; MOSS-SS “index I and II”; and the DASS “depression” and “stress” subscores), whereas VR-A yielded significant positive changes only for PDI “total score”; PCS “total score” and the “helplessness” and “magnification” subscores; MOSS-SS “index II”; and DASS “depression” and “stress”. As four scale scores also showed significant improvements for control, a comparison of the effects was performed to offset a potential placebo-like effect by comparing difference from baseline against control. This analysis yielded significantly greater positive effects only for VR-R: PCS “total score” and “helplessness”; MOSS-SS “index I” and “index II”; and the three DASS subscores “depression”, “anxiety”, and “stress”. SF-12 showed no significant changes in either analysis.</p><h3>Conclusions</h3><p>VR-R and VR-A showed positive effects on several pain and quality-of-life scores, which were significant for some scores compared to baseline. For VR-R, some of these improvements were indeed significantly greater than under control conditions, while the effects with VR-A were not. Larger studies are needed to corroborate these findings.</p><h3>Trial registration</h3><p>DRKS00030189.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 6","pages":"1721 - 1731"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-08000-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708174","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":"Effect of nitric oxide donor and plasma volume expansion on pregnancies with early onset fetal growth restriction: a randomized controlled trial","authors":"Maya Mahmoud Abdelrazek,&nbsp;Mai Abdelfattah Ahmed,&nbsp;Mohamed Elmandooh Mohamed Ibrahim","doi":"10.1007/s00404-025-07988-7","DOIUrl":"10.1007/s00404-025-07988-7","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the effect of nitric oxide (NO) donor, in combination with plasma volume expansion, on both fetal and maternal outcomes in pregnancies complicated by early-onset fetal growth restriction (FGR).</p><h3>Methods</h3><p>A total of 40 pregnant women diagnosed with early onset FGR were recruited from Ain Shams University Maternity Hospital between June 2023 to December 2023. The patients were randomly assigned into two groups, 20 in each group. Group A received Nitroderm TTS ^® 5 mg for 12 h daily with plasma volume expansion (PVE) in the form of 2.5 L of water per day. Group B represented the control group. The primary endpoint of the study, assessed after 2 weeks of treatment initiation, focused on fetal growth parameters as the primary outcome. In addition, amniotic fluid volume, umbilical artery Doppler changes, development of fetal complications, maternal vital signs, and any side effects, were recorded. At the time of delivery, the following also documented: timing, mode, and interval to delivery, along with neonatal outcomes.</p><h3>Results</h3><p>Group A exhibit statistically significant enhancement in fetal growth compared to Group B in terms of estimated fetal weight, abdominal circumference, head circumference, biparietal diameter, femur length, amniotic fluid volume, and umbilical artery pulsatility index. Furthermore, Group A demonstrated more favorable outcomes in terms of gestational age at delivery, interval to delivery, birth weight, APGAR score and rates of NICU admission.</p><h3>Conclusion</h3><p>The combination of NO donors and PVE has shown promising results in enhancing fetal growth and extending gestation. This study adds to the existing body of evidence supporting the effectiveness of NO donor therapy when used in conjunction with fluid management for managing FGR. Nonetheless, additional research is essential to validate these results and refine the treatment strategy for optimal outcomes in affected pregnancies.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 5","pages":"1435 - 1444"},"PeriodicalIF":2.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07988-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699446","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}