Archives of Gynecology and Obstetrics最新文献

{"title":"Editorial Expression of Concern: Bee-honey and yogurt: a novel mixture for treating patients with vulvovaginal candidiasis during pregnancy","authors":"Allam M. Abdelmonem, Salah M. Rasheed, Abeer Sh Mohamed","doi":"10.1007/s00404-026-08532-x","DOIUrl":"10.1007/s00404-026-08532-x","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08532-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443717","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":"Editorial Expression of Concern: Office microlaparoscopic ovarian drilling (OMLOD) versus conventional laparoscopic ovarian drilling (LOD) for women with polycystic ovary syndrome","authors":"Imaduldin M. Salah","doi":"10.1007/s00404-026-08533-w","DOIUrl":"10.1007/s00404-026-08533-w","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08533-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443666","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":"Retraction Note: Evaluation of ovarian function and metabolic factors in women affected by polycystic ovary syndrome after treatment with d-Chiro-Inositol","authors":"Antonio Simone Laganà, Luisa Barbaro, Alfonsa Pizzo","doi":"10.1007/s00404-026-08535-8","DOIUrl":"10.1007/s00404-026-08535-8","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08535-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443804","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":"Financial distress among women with advanced or metastatic breast cancer in Germany: secondary analysis of prospective ePROCOM data of a two-center cohort","authors":"Joachim Graf,&nbsp;Harald Abele,&nbsp;Markus Wallwiener,&nbsp;Eva J. Kantelhardt,&nbsp;Sara Y. Brucker,&nbsp;Elisabeth Simoes","doi":"10.1007/s00404-026-08523-y","DOIUrl":"10.1007/s00404-026-08523-y","url":null,"abstract":"<div><h3>Key message</h3><p>In this study, half of all female patients with advanced and metastatic breast cancer reported experiencing financial difficulties. This highlights the need for gynecology and oncology specialists to also address patients’ socio-medical needs. Electronic patient-reported outcomes (ePRO) must be used to identify such areas of concern.</p><h3>Abstract</h3><h3>Purpose</h3><p>The aim was to investigate whether and to what extent female patients with advanced or metastatic breast cancer who are undergoing chemotherapy report financial difficulties due to their physical condition and/or the effects of medical treatment in relation to the German reference cohort.</p><h3>Methods</h3><p>A secondary data analysis was performed using data collected prospectively as part of the ePROCOM study. A total of <i>n</i> = 168 female patients who had answered questions regarding financial implications of the EORTC QLQ-C30 questionnaire were included in the analysis. Unpaired t tests (Welch) and Chi-square tests as well as multiple regressions were conducted. A bilateral <i>p</i> value of &lt; 0.05 was considered statistically significant in all analyses (alpha = 0.05).</p><h3>Results</h3><p>The prevalence of financial distress was 50.0% (95%-CI 42.4%; 57.6%), defined as a response of at least 2 (“a little”) on a 4-point Likert scale. Between the reference cohort scored 4.8 and the breast cancer cohort scored 28.8, there was a significant difference of 24 ± 5.19 score points (<i>p</i> &lt; 0.001; 95%-CI 18.81, 29.19) in financial burden. Overall, the regression model explained 27.7% of the total variance in financial burden through HRQoL, age, and civil status (<i>R</i>² = 0.277).</p><h3>Conclusion</h3><p>Women with advanced or metastatic breast cancer reported substantially higher financial burden than the female German reference population. Lower HRQoL, younger age, and living alone were associated with greater financial impact. These findings support routine assessment of financial distress in those patients and suggest that ePRO-based screening may help identify patients in need of early social-medical support.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08523-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443776","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":"Association between preconception serum homocysteine levels and early pregnancy loss in women with recurrent pregnancy loss","authors":"Xiuli Tian,&nbsp;Xin Yang,&nbsp;Chen Wang,&nbsp;Xiaofeng Li,&nbsp;Fang Wang","doi":"10.1007/s00404-026-08538-5","DOIUrl":"10.1007/s00404-026-08538-5","url":null,"abstract":"<div><h3>Background</h3><p>Elevated homocysteine (HCY) levels have been implicated in early pregnancy loss (EPL) but evidence remains inconclusive. The aim of this study was to investigate the association between preconception serum HCY levels and EPL in women who have experienced recurrent pregnancy loss (RPL).</p><h3>Methods</h3><p>Using data from a prospective dynamic pregnancy loss cohort established by our group, we screened 812 eligible patients with RPL, collected their medical records, and followed them for subsequent pregnancy outcomes. Multivariable logistic regression was used to assess the relationship between preconception serum HCY levels and the risk of subsequent EPL. Generalized additive models were also used to examine nonlinear associations between serum HCY levels and EPL. Subgroup analyses were further performed according to age, body mass index (BMI), and the number of previous pregnancy losses.</p><h3>Results</h3><p>The proportion of subsequent EPL was 22.66% (184/812). Significant differences in the proportion of EPL were observed across HCY quartiles (Q1: 10.45%, Q2: 14.80%, Q3: 21.23%, Q4: 43.84%; <i>P</i> &lt; 0.0001). After adjusting for confounders, elevated preconception serum HCY levels were found to be associated with an increased risk of EPL (adjusted OR = 1.27, 95% CI: 1.14–1.42). Participants in Q3 and Q4 had significantly higher odds of EPL than those in Q1, with adjusted ORs of 5.55 (95% CI: 1.01–30.49) for Q3 and 10.79 (95% CI: 1.87–62.37) for Q4. Additionally, the analyses demonstrated a nonlinear relationship between preconception serum HCY levels and EPL risk. In this cohort, when HCY levels were ≥ 10.71 μmol/L, the risk of EPL increased significantly (adjusted OR = 1.27; 95% CI: 1.03–1.58).</p><h3>Conclusions</h3><p>Elevated preconception serum HCY levels were associated with an increased risk of EPL in women with RPL, and the data-derived threshold of 10.71 μmol/L supports preconception risk stratification in this high-risk population.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08538-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444013","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":"PIK3CA mutations and PI3K isoform expression define prognostic signatures in ovarian clear cell carcinoma","authors":"Xiaonan Zhou,&nbsp;Yifei Liu,&nbsp;Jing Zhang,&nbsp;Min Ren,&nbsp;Gang Ji,&nbsp;Xu Cai,&nbsp;Rui Bi","doi":"10.1007/s00404-026-08525-w","DOIUrl":"10.1007/s00404-026-08525-w","url":null,"abstract":"<div><h3>Purpose</h3><p>Ovarian clear cell carcinoma (OCCC) is frequently characterized by dysregulation of the PI3K/AKT/mTOR (PAM) pathway; however, the expression patterns and clinical significance of class I PI3K catalytic isoforms remain incompletely understood. This study aimed to comprehensively evaluate PI3K catalytic subunit expression, co-expression patterns, and their prognostic relevance in OCCC.</p><h3>Methods</h3><p>A retrospective cohort of 100 patients with OCCC was analyzed. Immunohistochemistry was performed to assess the expression of p110α, p110β, p110δ, p110γ, and pAKT. PIK3CA exon 9 and exon 20 mutations were evaluated in available formalin-fixed paraffin-embedded tissues. Associations between PI3K isoforms, pAKT activation, clinicopathological characteristics, and survival outcomes were investigated.</p><h3>Results</h3><p>The expression positivity rates of the four class I PI3K catalytic subunits in OCCC were 86% for p110γ, 77% for p110α, 58% for p110δ, and 56% for p110β. p110α and p110β were positively associated with pAKT activation, whereas p110δ and p110γ showed no significant association. p110δ expression was significantly correlated with PI3KCA exon9 mutation. Frequent co-expression of multiple PI3K catalytic subunits was observed, with simultaneous expression of all four isoforms representing the predominant pattern and significantly correlating with pAKT positivity. In advanced-stage disease, p110β expression was significantly associated with poorer progression-free survival (PFS), while pAKT positivity correlated with worse overall survival (OS) and PFS.</p><h3>Conclusions</h3><p>OCCC displays substantial heterogeneity in PI3K catalytic isoform expression and co-expression. p110α and p110β were associated with pAKT activation. In advanced-stage OCCC, high p110β expression was associated with poorer PFS, whereas pAKT activation was associated with both poorer PFS and OS, supporting further investigation of PI3K-targeted therapeutic strategies.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08525-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434955","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":"Does a larger estimated fetus compared with prior birthweight increase the risk of cesarean delivery after a prior vaginal birth?","authors":"Or Touval,&nbsp;Or Eliner,&nbsp;Sivan Farladansky-Gershnabel,&nbsp;Tal Biron-Shental,&nbsp;Dorit Ravid","doi":"10.1007/s00404-026-08529-6","DOIUrl":"10.1007/s00404-026-08529-6","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate whether an increase in estimated fetal weight (EFW) relative to the birthweight of a prior vaginal delivery is associated with intrapartum cesarean delivery (CD) or other adverse obstetric outcomes.</p><h3>Methods</h3><p>This retrospective cohort study included patients with two consecutive term singleton deliveries (2014–2025). All had a vaginal first delivery and underwent a trial of labor in the second pregnancy. Patients were categorized by the difference between EFW and prior birthweight: higher (&gt; 15%) and similar (-15% to 15%). The primary outcome was intrapartum CD. Multivariable logistic regression adjusted for clinically relevant confounders. Subgroup analysis stratified by EFW (&lt; 3500 vs. ≥ 3500 g) evaluated the effect of absolute fetal size.</p><h3>Results</h3><p>The primary analysis included 2849 patients: 2265 in the similar-weight group and 584 in the higher-weight group. The crude intrapartum CD rate was higher in the higher-weight group (5.3% vs 3.0%, <i>p</i> = 0.006). After adjustment, weight difference was not independently associated with CD (adjusted odds ratio [aOR] 1.43; 95% CI 0.91–2.27; <i>p</i> = 0.12). In subgroup analysis, among patients with EFW ≥ 3500 g, a trend toward increased CD risk was observed in the higher-weight group (aOR 1.68, 95% CI 0.94–2.99, <i>p</i> = 0.08).</p><h3>Conclusion</h3><p>An increase in EFW relative to prior birthweight was not independently associated with intrapartum CD among patients with a prior vaginal delivery. Among patients with larger absolute EFW, a non-significant trend toward increased intrapartum CD risk was observed, a finding that warrants future investigation. These findings suggest that interpregnancy weight differences alone should not guide delivery planning in otherwise uncomplicated pregnancies.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08529-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148443974","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":"Retraction Note: Laparoscopic ventral rectopexy plus sacral colpopexy: continuous locked suture for mesh fixation. A randomized clinical trial","authors":"Andrea Morciano,&nbsp;Dario Caliandro,&nbsp;Giuseppe Campagna,&nbsp;Giovanni Panico,&nbsp;Alessia Giaquinto,&nbsp;Giorgio Fachechi,&nbsp;Marzio Angelo Zullo,&nbsp;Andrea Tinelli,&nbsp;Alfredo Ercoli,&nbsp;Giovanni Scambia,&nbsp;Mauro Cervigni,&nbsp;Giuseppe Marzo","doi":"10.1007/s00404-026-08534-9","DOIUrl":"10.1007/s00404-026-08534-9","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-026-08534-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148434996","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":"Methotrexate in relatively contraindicated ectopic pregnancies: who benefits from treatment?","authors":"Gülhan Özüm,&nbsp;Hakan Güraslan,&nbsp;Nurşen Kurtoğlu,&nbsp;Levent Deniz","doi":"10.1007/s00404-026-08501-4","DOIUrl":"10.1007/s00404-026-08501-4","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to evaluate the efficacy of methotrexate (MTX) therapy and identify clinical and laboratory predictors of treatment failure, particularly in relatively contraindicated cases.</p><h3>Materials and methods</h3><p>This retrospective cohort study included 225 hemodynamically stable patients with ectopic pregnancy treated with MTX between January 2019 and December 2024 at a tertiary university hospital. Relatively contraindicated cases were defined as having one or more of the following: β-hCG ≥ 5000 IU/L, ectopic mass ≥ 4 cm, fetal cardiac activity, or pelvic free fluid ≥ 5 cm. 58 patients met these criteria, while 167 were MTX-indicated. All patients received a single-dose intramuscular MTX protocol (50 mg/m² on day 0), and serum β-hCG levels were measured on days 0, 4, and 7. Treatment success was defined as a decline of β-hCG to &lt; 5 mIU/mL without surgical intervention. Predictive factors for treatment failure were analyzed using logistic regression. Based on the identified independent predictors, a preliminary scoring model was constructed to explore risk stratification.</p><h3>Results</h3><p>The overall MTX success rate was 85.8%. Success was significantly higher in the indicated group (92.8%) than in the relatively contraindicated group (65.5%). In the latter, treatment failure was significantly associated with higher baseline β-hCG levels and the pelvic free fluid ≥ 5 cm in the pouch of douglas. Multivariate analysis identified a significant association between these factors and MTX failure (β-hCG: OR 7.44, p &lt; 0.001; free fluid: OR 4.10, p = 0.022). Other parameters, including fetal cardiac activity, yolk sac presence, adnexal mass size, and patient age, did not show a significant relationship in this model. The median time to surgical intervention in failed cases was 7 days.</p><h3>Conclusion</h3><p>Single-dose MTX remains a safe and effective option for carefully selected patients with relatively contraindicated ectopic pregnancies, achieving a 65.5% success rate. High baseline β-hCG and pelvic free fluid may serve as predictors of treatment failure, but do not preclude medical management when close monitoring is ensured. The proposed scoring system should be considered exploratory and requires external validation before clinical implementation. Further prospective studies are needed to confirm these findings and better define candidates for MTX therapy in high-risk cases.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418230","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":"Risk factors for postpartum hemorrhage after pregnancy termination for fetal malformations: a retrospective study and internally validated prediction model","authors":"Cuihua Zhou,&nbsp;Shujuan Yang,&nbsp;Xiuhua Zhang,&nbsp;Hongbiao Yu,&nbsp;Mei Song,&nbsp;Qian Rao","doi":"10.1007/s00404-026-08509-w","DOIUrl":"10.1007/s00404-026-08509-w","url":null,"abstract":"<div><h3>Purpose</h3><p>This study aims to elucidate the risk factors contributing to postpartum hemorrhage (PPH) in women undergoing pregnancy termination due to fetal malformations and to construct a predictive model.</p><h3>Methods</h3><p>A retrospective study of 268 women after termination for fetal malformations was conducted. Logistic regression identified risk factors for postpartum hemorrhage, and a nomogram was constructed. Model discrimination, calibration, and goodness of fit were evaluated using the AUC, Hosmer–Lemeshow test, and 1,000 bootstrap resampling iterations.</p><h3>Results</h3><p>Gravidity, placental adhesion/retention, history of uterine surgery, pregnancy-induced hypertension, and uterine atony were identified as independent risk factors for PPH in women undergoing termination for fetal malformations (<i>P</i> &lt; 0.05). The predictive model demonstrated an overall accuracy of 89.55% (95% CI 85.31–92.67%), with a sensitivity of 37.14% (95% CI 23.17–53.66%), specificity of 97.42% (95% CI 94.50–98.81%), positive predictive value of 68.42% (95% CI 46.01–84.64%), and negative predictive value of 91.16% (95% CI 86.99–94.09%). The discriminative ability of the model was evaluated using the ROC curve, yielding an AUC of 0.8445 (95% CI 0.7731–0.9158, <i>P</i> &lt; 0.0001).</p><h3>Conclusion</h3><p>Our proposed model may help identify a subset of women at increased risk of PPH after termination for fetal malformations and support clinical preparedness following internal validation. Further validation in independent cohorts is needed before broader clinical application.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"313 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418223","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}