Archives of Gynecology and Obstetrics最新文献

{"title":"Offspring long-term infectious morbidity following pregnancies with cervical cerclage","authors":"Amir Snir,&nbsp;Polina Schwarzman,&nbsp;Tamar Wainstock,&nbsp;Eyal Sheiner","doi":"10.1007/s00404-026-08431-1","DOIUrl":"10.1007/s00404-026-08431-1","url":null,"abstract":"<div><h3>Introduction</h3><p>Cervical cerclage is an acceptable procedure in women with cervical insufficiency and is known to be effective in the prevention of preterm delivery. However, limited data exist regarding long-term health outcomes among offspring exposed to cerclage during pregnancy. Since the presence of a foreign body during pregnancy may change the vaginal microbiome, we aimed to study whether a cervical cerclage is associated with long-term infectious morbidity of the offspring.</p><h3>Study design</h3><p>A retrospective population-based cohort study was performed at a tertiary medical center, including all singleton deliveries between the years 1991–2021. Long-term infectious morbidity was compared among offspring after pregnancies with and without cervical cerclage. The diagnoses of infectious morbidities were defined based on ICD-9 codes as recorded in community clinics and hospitalization files. A Kaplan–Meier survival curve was utilized to evaluate the cumulative incidence. A Cox proportional hazards model was used to control for confounders.</p><h3>Results</h3><p>Out of 356,356 offspring included in the analysis, 0.4% (<i>n</i> = 1416) were following pregnancies with cervical cerclage. Unadjusted analyses demonstrated no significant difference in total infectious morbidity between the groups (OR 1.0, 95% CI 0.9–1.1; <i>p</i> = 0.369, Table 1). Kaplan–Meier analysis showed no difference in cumulative incidence (log-rank test <i>P</i>-value = 0.19, Fig. 1). In the primary analysis, cerclage was not associated with long-term infectious morbidity. However, in a secondary model, after adjustment for confounders including gestational age, obesity and diabetes, cerclage exposure was associated with a modest reduction in the risk of long-term infectious morbidity (adjusted HR 0.9, 95% CI 0.87–0.99, <i>p</i> = 0.036).</p><h3>Conclusion</h3><p>In this large population-based cohort, cervical cerclage was not associated with increased long-term infectious morbidity in offspring. A modest association with reduced infectious morbidity was observed after adjustment for confounding factors. These findings should be interpreted cautiously given the observational design and potential residual confounding.</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/PMC13121360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760560","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":"Possible role of hyperimmunoglobulin in reducing the risk of maternal–fetal transmission of cytomegalovirus in the valacyclovir era: a case series","authors":"Anna Barbiero,&nbsp;Daniele Lilleri,&nbsp;Piera d’Angelo,&nbsp;Federica Zavaglio,&nbsp;Matilde Tavanti,&nbsp;Sara Biagioni,&nbsp;Alessandra Ipponi,&nbsp;Michele Cecchi,&nbsp;Beatrice Borchi,&nbsp;Michele Salvatore Trotta,&nbsp;Lucia Pasquini,&nbsp;Alessandro Bartoloni,&nbsp;Lorenzo Zammarchi","doi":"10.1007/s00404-026-08432-0","DOIUrl":"10.1007/s00404-026-08432-0","url":null,"abstract":"<div><h3>Introduction</h3><p>Valacyclovir is the only treatment option during pregnancy which has been demonstrated to be effective within a randomized clinical trial for prevention of transplacental cytomegalovirus (CMV) transmission. However, the use of high dose intravenous hyperimmunoglobulin (HIG) could reduce the rate of vertical transmission according to some observational studies.</p><h3>Cases presentation</h3><p>We report three peculiar cases in which high dose HIG was administered in substitution to or in addition to valacyclovir to reduce the risk of transplacental transmission of CMV. Two were immunocompromised pregnant women—one with recurrent CMV reactivations due to solid organ transplant-related immunosuppression and one with primary CMV infection and lack of IgG production due to anti-CD20 treatment for multiple sclerosis—in which HIG was co-administered with valacyclovir. The third case involved an immunocompetent pregnant woman to whom HIG was administered in substitution to valacyclovir due to severe gastrointestinal side effects related to the latter medication. In all cases, the treatment was well tolerated and the newborns tested negative for CMV at birth.</p><h3>Conclusion</h3><p>Together, these cases give an interesting perspective on the possible role of HIG in selected immunocompromised pregnant women with primary and non-primary CMV infection in addition to valacyclovir, and in immunocompetent pregnant women unable to tolerate valacyclovir or in whom the drug is contraindicated.</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/PMC13121191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760649","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 risk-based model for unplanned cesarean delivery following induction of labor in term hypertensive nulliparas","authors":"Avihu Krieger,&nbsp;Michal Axelrod,&nbsp;Baha Sibai,&nbsp;Shalom Mazaki-Tovi,&nbsp;Michal Fishel Bartal","doi":"10.1007/s00404-026-08445-9","DOIUrl":"10.1007/s00404-026-08445-9","url":null,"abstract":"<div><h3>Purpose</h3><p>To develop a practical risk-stratification framework for unplanned cesarean delivery (CD) among term nulliparous individuals with hypertensive disorders of pregnancy (HDP) undergoing induction of labor (IOL).</p><h3>Methods</h3><p>This was a retrospective cohort study at a single tertiary care center (January 2010-March 2025) of nulliparous individuals with singleton gestations diagnosed with HDP undergoing IOL at ≥ 37 + 0 weeks. We excluded multiple gestations, major fetal anomalies, planned CD, or intrauterine fetal death. We included demographic and pregnancy characteristics available prior to induction and evaluated association with unplanned CD. Stepwise backward logistic regression was used to build a model for identifying independent predictors of unplanned CD. Sensitivity, specificity, and likelihood ratios (LR) were calculated.</p><h3>Results</h3><p>Among 1,326 eligible individuals, 347 (26.2%) underwent unplanned CD. Independent predictors of CD were age &gt; 35 years (adjusted odds ratio [aOR] 1.97, 95% CI 1.45–2.66), body mass index ≥ 30 kg/m² (aOR 2.07, 95% CI 1.58–2.70), HDP with severe features (aOR 1.71, 95% CI 1.17–2.49), thrombocytopenia (aOR 2.66, 95% CI 1.17–6.06), and need for cervical ripening (aOR 1.63, 95% CI 1.23–2.16). Cesarean risk increased stepwise with accumulation of risk factors: 28.4% with ≥ 1 factor, 36.7% with ≥ 2, 44.7% with ≥ 3, and 64.7% with ≥ 4. The presence of ≥ 4 factors yielded a positive LR of 5.17 (95% CI 1.92–13.99).</p><h3>Conclusion</h3><p>In term nulliparous individuals with HDP undergoing induction, approximately one in four require CD. A simple model based on five routinely available pre-induction factors enables individualized counseling and shared decision-making at the bedside.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08445-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738767","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 adverse prognostic impact of reduced chemotherapy dose intensity appears attenuated in early breast cancer patients with treatment-relevant neutropenia: a retrospective cohort study","authors":"K. Eissler,&nbsp;T. Engler,&nbsp;D. Dannehl,&nbsp;B. Schönfisch,&nbsp;J. Englisch,&nbsp;A. D. Hartkopf,&nbsp;S. Y. Brucker,&nbsp;E. M. Grischke,&nbsp;L. L. Volmer,&nbsp;Alexander Englisch","doi":"10.1007/s00404-026-08426-y","DOIUrl":"10.1007/s00404-026-08426-y","url":null,"abstract":"<div><h3>Purpose</h3><p>Maintaining a relative dose intensity (RDI) ≥ 85% during chemotherapy is established as a critical threshold for optimal outcomes in early breast cancer. This study investigates whether the prognostic impact of reduced RDI differs based on the presence of chemotherapy-induced neutropenia requiring treatment modifications (rCIN).</p><h3>Methods</h3><p>We analyzed 730 patients with early breast cancer receiving anthracycline/cyclophosphamide and taxane-based chemotherapy at the University Hospital Tübingen between 2014 and 2021. rCIN was defined as any dose reduction &gt; 15%, delay ≥ 5 days, or discontinuation attributed to neutropenia per Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Patients were stratified into four groups based on RDI (≥ 85% vs. &lt; 85%) and rCIN status. Differences in overall survival (OS) and disease-free survival (DFS) were assessed by Kaplan–Meier analysis, and predictors of DFS were evaluated by Cox regression.</p><h3>Results</h3><p>rCIN occurred in 21.8% of patients, with 59.7% of rCIN patients receiving RDI &lt; 85% versus 16.1% of non-rCIN patients (p &lt; 0.001). Despite lower RDI, rCIN patients maintained similar pathological complete response rates after neoadjuvant therapy. In Kaplan–Meier analysis, patients with RDI &lt; 85% without rCIN had significantly worse DFS and OS than the reference group with RDI ≥ 85% without rCIN (DFS p = 0.003; OS p = 0.002), while patients with RDI &lt; 85% with rCIN showed comparable survival to high-RDI groups (all pairwise p &gt; 0.170). Direct comparison between the two reduced-RDI groups was not statistically significant for either DFS or OS (DFS p = 0.055; OS p = 0.159). Cox regression confirmed RDI &lt; 85% as a negative prognostic factor (HR 2.53; 95% CI 1.38–4.65; p = 0.003). The rCIN × RDI &lt; 85% interaction term was not statistically significant (HR 0.44; 95% CI 0.12–1.60; p = 0.212).</p><h3>Conclusions</h3><p>In this retrospective cohort, reduced RDI was associated with poorer outcomes, particularly in patients without rCIN. By contrast, patients with RDI &lt; 85% and rCIN showed no significant differences in Kaplan–Meier survival, and similar pathological complete response rates were observed despite lower RDI in the neoadjuvant subgroup. These findings are hypothesis-generating and require confirmation in larger prospective studies.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08426-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738213","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":"Pregnancy outcomes after ultrasound- and physical examination-indicated cervical cerclage: a retrospective cohort study","authors":"Chen Manor-Bar,&nbsp;Ettie Piura,&nbsp;Zvi Klein,&nbsp;David Rubinshtein,&nbsp;Tal Biron-Shental,&nbsp;Hanoch Schreiber,&nbsp;Michal Kovo,&nbsp;Yair Daykan,&nbsp;Nissim Arbib","doi":"10.1007/s00404-026-08437-9","DOIUrl":"10.1007/s00404-026-08437-9","url":null,"abstract":"<div><h3>Objective</h3><p>To compare pregnancy outcomes after emergency cervical cerclage according to indication: ultrasound-indicated versus physical examination-indicated cerclage.</p><h3>Methods</h3><p>This retrospective cohort study included singleton pregnancies that underwent emergency cerclage using the McDonald technique at 18–23.6 weeks of gestation at a single tertiary center between 2017 and 2023. Cases were classified according to indication: ultrasound-indicated cerclage (cervical length ≤ 25 mm with a closed cervix) or physical examination-indicated cerclage (painless cervical dilation ≥ 1 cm with visible membranes). The primary outcome was early preterm birth, defined as delivery before 34 weeks of gestation. Secondary outcomes included pregnancy prolongation following cerclage and other obstetric outcomes.</p><h3>Results</h3><p>Among 52 emergency cerclage cases, 39 patients underwent ultrasound-indicated cerclage and 13 underwent physical examination-indicated cerclage. Maternal characteristics and gestational age at the time of the procedure were similar between groups. Previous hysteroscopy was more common in the physical examination-indicated cerclage group (<i>p</i> = 0.035). Overall, 84.6% of patients (44/52) delivered after 34 weeks of gestation, with no significant difference in gestational age at delivery between groups (<i>p</i> = 0.886). Pregnancy prolongation did not differ significantly between groups (15.5 ± 4.2 vs. 13.3 ± 6.2 weeks; <i>p</i> = 0.168). In multivariable analysis, cerclage indication was not independently associated with early preterm birth, whereas pre-cerclage cervical length remained an independent predictor (aOR 0.73, <i>p</i> = 0.02).</p><h3>Conclusion</h3><p>Emergency cervical cerclage was associated with substantial pregnancy prolongation. No statistically significant differences were observed between indications, and pre-cerclage cervical length was the only independent predictor of early preterm birth. These findings support, but do not confirm, a potential pathophysiologic continuum of cervical insufficiency.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08437-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738155","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":"Management of incidental STIC lesions with and without BRCA mutations: a survey of current clinical practice in Austria, Germany, and Switzerland","authors":"Natalia Anna Kaufmann,&nbsp;Peter Oppelt,&nbsp;Christoph Grimm,&nbsp;Julia Lastinger,&nbsp;Teresa Eichinger,&nbsp;Philip Trautner,&nbsp;Anja Hartl,&nbsp;Stefan Raidl,&nbsp;Dariga Ramazanova,&nbsp;Caroline Ines Preuss","doi":"10.1007/s00404-026-08442-y","DOIUrl":"10.1007/s00404-026-08442-y","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study was to assess current clinical practices, management, and follow-up care for women with an isolated serous tubal intraepithelial carcinoma (STIC) diagnosis in German-speaking countries.</p><h3>Methods</h3><p>An online survey targeting all German-speaking gynecological centers was developed. The survey included single- and multiple-choice questions on hospital data, such as the number of cases per year and certification, as well as detailed questions on two scenarios: a <i>BRCA1</i>-positive patient undergoing prophylactic bilateral salpingo-oophorectomy and a patient with an incidental STIC finding after hysterectomy and bilateral salpingectomy.</p><h3>Results</h3><p>This survey was answered by 77 physicians. For a patient with a known <i>BRCA1</i> mutation and STIC, 89.29% of respondents would perform further diagnostics. The most frequent diagnostic steps would be a CA-125 test (83.64%) and a CT abdomen (63.64%). Further surgery would be performed by 77.78% of respondents, including 75.93% without and 5.56% with lymph node staging. 79.25% would prefer laparoscopic surgery. The majority (90.57%) would not recommend adjuvant therapy. In a patient without a known mutation and STIC, 88.46% of respondents would recommend further examinations. 58.82% would carry out genetic panel testing. Another subsequent surgery would be performed by 76.47%, with 66.67% planning to perform surgery without lymph node staging. 53.06% of respondents would follow up patients for five years. Percentages are reported based on the number of valid responses for each item.</p><h3>Conclusion</h3><p>This survey demonstrates differences in the clinical management of isolated STIC across German-speaking countries, highlighting discrepancies between guideline recommendations and real-world practices.</p><h3>This study is registered in the German Clinical Trials Register under </h3><p>DRKS00033112</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08442-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728290","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":"Multidisciplinary team approach in placenta accreta surgery: concerns and clarifications","authors":"Shigeki Matsubara","doi":"10.1007/s00404-026-08434-y","DOIUrl":"10.1007/s00404-026-08434-y","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08434-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728261","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":"Psychosocial impact of maternal mortality on bereaved families and health care providers: what do we know?","authors":"Dana Alhaj,&nbsp;Selma Schmock,&nbsp;Lito-Laura Gerhold,&nbsp;Stephanie Wallwiener,&nbsp;Jarmila Zdanowicz,&nbsp;Claudia Hanson,&nbsp;Joachim Dudenhausen,&nbsp;Josefine Königbauer","doi":"10.1007/s00404-026-08424-0","DOIUrl":"10.1007/s00404-026-08424-0","url":null,"abstract":"<div><h3>Introduction</h3><p>Maternal mortality remains a critical global health issue with profound psychosocial consequences that extend beyond the deceased woman to her family and the healthcare professionals (HCP) involved in her care. While substantial progress has been made in reducing maternal mortality worldwide, its social and psychological sequelae remain insufficiently studied, particularly in high-income countries.</p><h3>Methods</h3><p>This narrative review is based on a structured literature search conducted in PubMed and Google Scholar for studies published between 2000 and 2025. Study selection was guided by predefined inclusion criteria, and relevant articles were identified through keyword searches and snowballing. Data were extracted and analyzed using a narrative thematic approach focusing on psychosocial outcomes in families and HCP.</p><h3>Results</h3><p>The available evidence, predominantly derived from qualitative and mixed-methods studies in low- and middle-income countries—especially sub-Saharan Africa—demonstrates consistent patterns of psychological distress, social disruption, and long-term adverse outcomes among affected families. Children are particularly vulnerable to educational, emotional, and economic disadvantages following maternal death. For HCP, particularly midwives, maternal mortality is associated with significant emotional burden, including guilt, grief, and professional self-doubt, as well as social and occupational consequences.</p><h3>Discussion</h3><p>Despite the global relevance of maternal mortality, there is a marked lack of data from high-income settings. Existing findings suggest that both families and HCP experience substantial and enduring psychosocial impacts, yet structured institutional support systems are often lacking.</p><h3>Conclusion</h3><p>Maternal mortality has far-reaching psychosocial consequences for families and HCP alike. The findings highlight the urgent need for targeted support interventions, structured training, and further research, particularly in high-income countries, to better understand and mitigate these effects.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697165","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":"Long-term clinical outcomes of ischial spine fascia fixation compared with sacrospinous ligament fixation: a prospective cohort study over 10 years","authors":"Yiwei Zhang,&nbsp;Zhibo Zhang,&nbsp;Rusha Yin,&nbsp;Chang Ren,&nbsp;Lan Zhu","doi":"10.1007/s00404-026-08430-2","DOIUrl":"10.1007/s00404-026-08430-2","url":null,"abstract":"<div><h3>Purpose</h3><p>To compare the long-term effects of ischial spine fascia fixation (ISFF) and sacrospinous ligament fixation (SLFF).</p><h3>Methods</h3><p>In a single-center prospective cohort study of 42 patients, 22 patients underwent ISFF and 20 patients underwent SSLF. The follow-up period of more than 10 years included a total of 32 patients. The main outcomes are the subjective failure and retreatment rates.</p><h3>Results</h3><p>Fifteen of twenty patients (75%) in the SSLF group and seventeen of twenty-two patients (77.3%) in the ISFF group completed the last follow-up with a median follow-up time of 133 (120–156) months. The ISFF and SSLF groups achieved estimated subjective failure rate of 40.35% and 31.62%, respectively, at the postoperative period of 10 years. The retreatment rates for both the ISFF and SSLF groups remained consistent at 5 and 10-year intervals after surgery, with corresponding percentages of 16.49% and 11.11%. While the ISFF group exhibited marginally elevated subjective failure rates and re-treatment rates compared to the SSLF group, no statistically significant difference was observed. No patients had pain in the leg or hip over 10-year follow-up. </p><h3>Conclusion</h3><p>ISFF is a safe approach that showed no statistically significant difference in recurrence results and improved quality of life scores compared to SSLF. Due to the relatively small sample size (<i>N</i> = 42), this study is underpowered to definitively claim equivalence or non-inferiority between the two procedures. This long-term study on native tissue transvaginal repair for POP indicates the clinical use of ISFF is safe and long-lasting.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697187","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":"Prenatal genetic diagnostics and postnatal outcomes of fetal auricular dysplasia","authors":"Yuanhang Zhu,&nbsp;Xiao Han,&nbsp;Xuezhe Ouyang,&nbsp;Tiantian Chu,&nbsp;Naiqi Li,&nbsp;Jie Yang,&nbsp;Xin Cheng,&nbsp;Ling Liu","doi":"10.1007/s00404-026-08419-x","DOIUrl":"10.1007/s00404-026-08419-x","url":null,"abstract":"<div><h3>Purpose</h3><p>Auricular dysplasia is a common fetal anomaly. Despite existing studies in postnatal populations, there remains a paucity of prenatal data on genetic etiology and prognostic analysis for this condition. This study aimed to analyze the genetic etiology and associated postnatal outcomes of auricular dysplasia, in order to provide guidance for prenatal genetic counseling.</p><h3>Methods</h3><p>This retrospective cohort study evaluated 105 singleton and 5 twin pregnancies with prenatally diagnosed auricular dysplasia between May 2019 and June 2024. Genetic investigations included chromosomal microarray (CMA), copy number variation sequencing (CNV-seq), and whole-exome sequencing (WES) to elucidate potential genetic etiologies. Longitudinal postnatal follow-up was systematically conducted to assess auricular morphology, auditory function, and associated systemic anomalies, providing comprehensive prognostic insights.</p><h3>Results</h3><p>Fetal auricular dysplasia predominantly manifests as unilateral involvement (with right-sided predominance), while bilateral cases are more frequently associated with concurrent multisystem developmental anomalies. Genetic analyses revealed trisomy 21 and CNVs of uncertain clinical significance, including 4q22.1 microdeletion, 3p12.2 microduplication, etc. In bilateral cases with multisystem anomalies, variants in SLC25A24, EFTUD2, and ABCA12 were identified. Postnatally, no pathogenic/likely pathogenic chromosomal or genetic variants were detected in isolated auricular dysplasia cases. However, in cases with concurrent systemic anomalies, compound heterozygous variants were identified in HSPA9 and ADGRV1. Follow-up data showed that 4 (12.90%) of prenatally diagnosed neonates exhibited no auricular malformations postnatally, and 12 (38.71%) had normal hearing, with auditory impairment mostly confined to the affected ear in unilateral cases.</p><h3>Conclusion</h3><p>Isolated auricular dysplasia is generally not associated with genetic abnormalities. However, bilateral auricular dysplasia with concurrent multisystem developmental anomalies demonstrates a correlation with pathogenic gene variants. Prenatal ultrasound diagnosis of auricular dysplasia carries a potential for misdiagnosis, but isolated cases typically manifest postnatally with auricular malformations and ipsilateral hearing impairment. In contrast, bilateral auricular dysplasia accompanied by multisystem anomalies may serve as a prognostic indicator of adverse fetal outcomes, necessitating comprehensive genetic and systemic evaluations.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13083462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687794","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}