Archives of Gynecology and Obstetrics最新文献

{"title":"Twin delivery: does induction of labor make a difference?","authors":"L Rüegg, L Vonzun, J Wawrla-Zepf, F Krähenmann, N Ochsenbein-Kölble","doi":"10.1007/s00404-025-07939-2","DOIUrl":"https://doi.org/10.1007/s00404-025-07939-2","url":null,"abstract":"<p><strong>Purpose: </strong>Induction of labor as well as delivery in twin pregnancies bears specific risks. The goal of this study was to analyze the delivery mode in twin pregnancies and influence of induction on the cesarean delivery (CD) rate and perinatal outcome and to identify risk factors for CD and an intertwin interval ≥ 15 min.</p><p><strong>Methods: </strong>This single-center retrospective cohort study analyzed the outcome of 267 twin pregnancies. Inclusion criteria for vaginal delivery in twins are gestational age (GA) > 34 weeks, leading twin in cephalic presentation, estimated weight difference ≤ 500 g and no previous uterine surgery. Women were divided into three groups: 1 = vaginal delivery, 2 = CD for both twins, 3 = emergency CD for second twin. Outcomes were mode of delivery, and influence of induction on the CD rate.</p><p><strong>Results: </strong>We had 156 women (58%) in group 1, 97 (36%) in 2 and 14 (5%) in 3. Induction of labor was performed in 147 cases and led to a higher CD rate (23% vs. 47%, p < 0.001). Induction of labor and nulliparity were associated with a higher risk for CD for both twins. Risk factors for an intertwin interval of ≥ 15 min were maternal age and weight of the second twin. An intertwin interval of ≥ 15 min was associated with a lower umbilical artery pH in the second twin.</p><p><strong>Conclusion: </strong>The rate of CD doubled if induction of labor was necessary. These results emphasize on careful patient counseling that includes information about the risks of deliveries in twin pregnancies.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622974","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":"Investigation of the female genital tract microbiome and its association with hydrosalpinx in women undergoing salpingectomy","authors":"Yael Yagel,&nbsp;Yair Motro,&nbsp;Stefan Green,&nbsp;Hadar Klapper-Goldstein,&nbsp;Ella Pardo,&nbsp;Jacob Moran-Gilad,&nbsp;Adi Y. Weintraub","doi":"10.1007/s00404-025-07944-5","DOIUrl":"10.1007/s00404-025-07944-5","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the microbiome of the vagina and fallopian tubes (FT) and its relation with hydrosalpinx.</p><h3>Methods</h3><p>Case–control study was conducted in women who underwent salpingectomy for hydrosalpinx (case) or other indications (controls). Samples were obtained during surgery and subjected to 16S rRNA amplicon sequencing, and analyses of alpha diversity and beta diversity measures were compared between sites and groups. Differential abundance of bacteria associated with vaginal dysbiosis was compared between cases and controls.</p><h3>Results</h3><p>Nine women with hydrosalpinx and 23 women without hydrosalpinx were included in the study. The mean age of studied women was 41 (range: 29–54) and most (89%) were premenopausal. After in silico decontamination, only 30% of control FT samples and 10% of case FT samples had evidence of bacterial presence. The vaginal microbiome of control patients showed greater abundance of lactobacilli, whereas the vaginal microbiome of case patients contained relatively more bacterial vaginosis-associated bacteria, such as <i>Prevotella</i> and <i>Atopobium</i>. A significant difference was found in alpha and beta diversity between vaginal and FT microbiomes in control patients as FT samples were more diverse. We found that women with hydrosalpinx had a more “dysbiotic” vaginal microbiome and in women without hydrosalpinx, microbial composition within the vagina and FT differed, possibly representing two distinct ecological environments.</p><h3>Conclusion</h3><p>Women undergoing salpingectomy for various reasons harbored bacteria within their FT, while women with hydrosalpinx generally did not. This suggests that even though infection may be an underlying cause of hydrosalpinx, bacteria may not be present by the time patients require surgery.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 6","pages":"1649 - 1656"},"PeriodicalIF":2.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07944-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622962","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: statement of the german ovarian cancer commission, the North-Eastern German Society of gynecological Oncology (NOGGO), AGO Austria and AGO Swiss regarding the use of homologous repair deficiency (HRD) assays in advanced ovarian cancer","authors":"Lukas Chinczewski,&nbsp;Philipp Harter,&nbsp;Lukas Heukamp,&nbsp;Doris Mayr,&nbsp;Christoph Grimm,&nbsp;Viola Heinzelmann-Schwarz,&nbsp;Pauline Wimberger,&nbsp;Sven Mahner,&nbsp;Ioana Elena Braicu,&nbsp;Wolfgang Schmitt,&nbsp;Carsten Denkert,&nbsp;Jalid Sehouli","doi":"10.1007/s00404-025-07991-y","DOIUrl":"10.1007/s00404-025-07991-y","url":null,"abstract":"<div><h3>Introduction</h3><p>Homologous recombination deficiency (HRD) is a key biomarker in the management of high-grade serous ovarian cancer (HGSOC), guiding treatment decisions, particularly regarding the use of poly(ADP-ribose) polymerase inhibitors (PARPi). As multiple HRD assays are available, each with distinct methodologies and cutoff values, the interpretation and clinical application of HRD testing remain complex. This intergroup statement, endorsed by the German Ovarian Cancer Commission, NOGGO, AGO Austria, and AGO Swiss, aims to provide guidance on the indications, appropriate use, and limitations of HRD testing in ovarian cancer.</p><h3>Materials and methods</h3><p>The statement is based on an interdisciplinary review of available literature, clinical trial data, and expert consensus. The recommendations focus on the current landscape of HRD assays, their clinical applicability, and practical considerations regarding the optimal timing and indications for testing.</p><h3>Results and discussion</h3><p>Various HRD assays, including established commercial tests and emerging academic-clinical approaches, are reviewed in this statement. The document outlines key eligibility criteria for HRD testing in ovarian cancer, emphasizing its relevance in specific histological subtypes and clinical scenarios. Additionally, exclusion criteria are defined, highlighting cases where HRD testing may not be appropriate due to insufficient clinical validation or lack of therapeutic implications. Finally, the statement discusses the pathological minimum requirements for tissue samples used in HRD testing, ensuring adequate sample quality and tumor content for reliable results.</p><h3>Conclusion</h3><p>HRD testing is a valuable tool for personalizing ovarian cancer treatment, particularly in identifying patients who may benefit from PARPi therapy. However, assay selection, timing, and result interpretation require careful consideration. This statement provides a structured approach to optimize HRD testing, aiming to improve clinical decision-making and patient outcomes.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 5","pages":"1445 - 1450"},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07991-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603702","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: Accuracy of endometrial sampling compared to conventional dilatation and curettage in women with abnormal uterine bleeding","authors":"Ibrahim A. Abdelazim,&nbsp;Khaled M. Abdelrazak,&nbsp;Assem A. M. Elbiaa,&nbsp;Mohamed Al-Kadi,&nbsp;Amr H. Yehia","doi":"10.1007/s00404-025-07998-5","DOIUrl":"10.1007/s00404-025-07998-5","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"1231 - 1231"},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07998-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613220","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":"Hemodynamic considerations for prenatal treatment of severe Ebstein anomaly with circular shunt based on two cases and review of the literature.","authors":"Adeline Walter, Ruben Plöger, Florian Recker, Boulos Asfour, Nathalie Mini, Annegret Geipel, Ulrich Gembruch, Brigitte Strizek","doi":"10.1007/s00404-025-07990-z","DOIUrl":"https://doi.org/10.1007/s00404-025-07990-z","url":null,"abstract":"<p><p>Prenatal severe Ebstein anomaly might be complicated by a circular shunt. In these cases, persistently elevated right atrial and venous pressure (due to severe tricuspid regurgitation) is complicated by a systemic ineffective blood shunt via a DA, resulting in diminished end-organ perfusion and acidosis, due to overall low cardiac output. Affected fetuses are at a significantly higher risk of intrauterine fetal demise. Reduction of ductal flow by prenatal treatment with nonsteroidal anti-inflammatory drugs has recently been described as a potential treatment option. However, published data are limited and management during the antenatal course is not well defined. We provide a literature review to propose a possible algorithm for prenatal assessment and initiation of treatment.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603679","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":"Subdermal implants vs. levonorgestrel intrauterine devices outcomes in reproductive-aged women: a systematic review and meta-analysis","authors":"Juliana Almeida Oliveira,&nbsp;Gabriel Lage Neves,&nbsp;Matheus Eduardo Soares Pinhati,&nbsp;Flávia Ribeiro de Oliveira,&nbsp;Agnaldo Lopes da Silva Filho","doi":"10.1007/s00404-025-07943-6","DOIUrl":"10.1007/s00404-025-07943-6","url":null,"abstract":"<div><h3>Purpose</h3><p>We aimed to conduct a systematic review and meta-analysis comparing the outcomes of subdermal implants and levonorgestrel intrauterine system (LNG-IUS) in reproductive-aged women.</p><h3>Methods</h3><p>In April 2024, we searched Pubmed, Embase and Cochrane trials using the search terms: “etonogestrel”, “levonorgestrel” and “randomized controlled trials”. We identified 2862 results comparing the LNG-IUS to subdermal implants. Randomized controlled trials (RCTs) were selected with no restrictions on language or year of publication.</p><h3>Results</h3><p>We include six RCTs comprising 1503 patients. R Studio was used for statistical analysis. Subdermal implants were associated with a higher risk of dissatisfaction (OR 2.42; 95% CI 1.47–3.98), acne (OR 2.21; 95% CI 1.21–4.04), weight gain (OR 4.63; 95% CI 1.96–10.63), and device removal due to side effects (OR 2.02; 95% CI 1.20–3.41) compared to the LNG-IUS group. Subgroup analysis indicated that irregular bleeding may be influenced by gynecological conditions, and the risk of new ovarian cyst detection was lower in healthy women using subdermal implants. Norplant-2 was associated with an increased risk of irregular bleeding and a decreased risk of amenorrhea or infrequent bleeding. The leave-one-out analysis and heterogeneity were well distributed among studies for all evaluated outcomes.</p><h3>Conclusions</h3><p>Reproductive-aged women in use of subdermal implants experienced a higher rate of acne, weight gain, device removal due to side effects and dissatisfaction compared to those in use of LNG-IUS.</p><h3>Trial registration</h3><p>PROSPERO ID: CRD42024516472.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"1173 - 1180"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07943-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603714","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 efficacy of progestins in managing pain associated with endometriosis, fibroids and pre-menstrual syndrome: a systematic review","authors":"Connor Luke Allen,&nbsp;Saikat Banerjee,&nbsp;Mahantesh Karoshi,&nbsp;Peter Humaidan,&nbsp;Farshad Tahmasebi","doi":"10.1007/s00404-025-07957-0","DOIUrl":"10.1007/s00404-025-07957-0","url":null,"abstract":"<div><h3>Purpose</h3><p>Alongside being contraceptives, progestins have been investigated as potential anti-inflammatory and analgesic therapies for use in painful gynaecological conditions. This review aims to synthesise evidence pertaining to the efficacy of progestins as analgesics for use in endometriosis, fibroids and pre-menstrual syndrome (PMS).</p><h3>Methods</h3><p>We conducted a systematic review of the extant literature investigating the analgesic efficacy of progestins compared to any comparator interventions for individuals with the three specified gynaecological conditions. The search was carried out across the PubMed and CENTRAL databases on 7 April 2024 for randomised control trials (RCTs) published in the peer-reviewed literature from 2000 onwards. Data pertaining to analgesic efficacy, assessed by changes in pain indices/scores before and after treatment, were synthesised narratively. Data pertaining to adverse effect frequency and changes in bone mineral density (BMD) were also synthesised narratively. Risk of bias was assessed using the Cochrane risk of bias 2 tool.</p><h3>Results</h3><p>The primary search identified 1220 potentially eligible RCTs of which 21 were ultimately included; 19 RCTs related to endometriosis, two related to fibroids and zero related to PMS. Quality assessment identified nine studies to be at a low risk of bias, nine studies with some concerns surrounding bias and three studies to be at a high risk of bias. The included studies represented a total of 2745 participants of whom 1317 were treated with a progestin and 1428 received a comparator intervention. In 18 of the 19 studies concerning endometriosis, progestins produced a statistically significant reduction in pain, further, in five instances progestins were more efficacious in reducing pain than comparator interventions. In both studies on fibroids, progestins produced significant reductions in pain, however, statistically significant differences compared to comparator interventions were not demonstrated. The most frequently cited adverse effect of progestins was spotting/irregular bleeding whilst those receiving comparator interventions most often reported hot flushes; cited in 12 and seven studies respectively. Five studies assessed the impact of progestins and comparators on BMD. Three studies found progestins significantly reduced BMD, however, in these instances reductions were significantly lower than those produced by comparator interventions and in two studies were not statistically significant after 12 months of follow-up.</p><h3>Conclusion</h3><p>Our review demonstrates the potential scope for the use of progestins as analgesics in the management of pain associated with endometriosis. Further research will need to be conducted to identify their efficacy in the management of pain associated with fibroids and PMS.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 6","pages":"1511 - 1533"},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07957-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603715","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":"Evolution of lymphovascular space invasion in early-stage endometrial carcinoma: stratification, quantification, and clinical implications: a systematic review.","authors":"Hai-Yan Sun, Xu Wang, Li-Xian Wang, Qiu-Man Wang, Shan Kang","doi":"10.1007/s00404-025-07997-6","DOIUrl":"https://doi.org/10.1007/s00404-025-07997-6","url":null,"abstract":"<p><strong>Purpose: </strong>Endometrial carcinoma (EC) represents the most prevalent malignancy of the female genital tract in the United States, with lymphovascular space invasion (LVSI) recognized as a critical prognostic factor that significantly influences disease outcomes. This review aims to elucidate the evolving understanding of LVSI in early-stage EC, highlighting its implications for stratification, quantification, and clinical management.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Comprehensive searches of the PubMed, Web of Science, and Embase/MEDLINE databases were performed for studies published from January 1, 1985, to November 16, 2024. Peer-reviewed articles that reported multivariable hazard ratios (HR) for LVSI in endometrial cancer were included, while meta-analyses, reviews, and case reports were excluded from analysis.</p><p><strong>Results: </strong>A total of 6 studies involving 2,345 patients were included. The majority of the population was characterized by endometrioid histotype (85.7%) and classified as FIGO stage I (75.1%). LVSI was documented in 21.5% of cases, with 62.4% of patients receiving adjuvant treatment. The literature on LVSI was categorized into three thematic areas: stratification classifications, quantitative assessments, and guideline development, illustrating the progression from binary systems to more nuanced tiered classifications that enhance prognostic accuracy.</p><p><strong>Conclusion: </strong>Foundational studies established LVSI as a significant risk factor in endometrial cancer, while subsequent research has refined its classification and quantification. However, inconsistencies in LVSI thresholds among current clinical guidelines pose challenges for standardization in practice. Addressing these discrepancies through future research, including multicenter studies and the integration of emerging technologies, is crucial for improving risk stratification and clinical management of endometrial carcinoma.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The combined impact of meconium stained amniotic fluid and small for gestational age on delivery outcomes.","authors":"Gal Cohen, Adi Shilony, Reut Batia Amrami, Tal Biron-Shental, Michal Kovo, Hanoch Schreiber","doi":"10.1007/s00404-025-07995-8","DOIUrl":"https://doi.org/10.1007/s00404-025-07995-8","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the delivery complications in neonates with meconium stained amniotic fluid (MSAF) and small for gestational age (SGA) birthweight.</p><p><strong>Methods: </strong>The medical records of all term, singleton deliveries during 2014-2021 were reviewed. Obstetric characteristics and neonatal outcomes were evaluated among the following groups: SGA neonates with MSAF (SGA-MSAF group), SGA neonates without MSAF (SGA group), appropriate for gestational age (AGA) neonates with MSAF (AGA-MSAF group) and AGA without MSAF (AGA group).</p><p><strong>Results: </strong>A total of 44,911 deliveries were included in the study, with 673 in the SGA-MSAF group, 2,762 in the SGA group, 6,958 in the AGA-MSAF group, and 34,518 in the AGA group. The SGA-MSAF group exhibited higher rates of nulliparity and hypertensive disorders compared to the SGA, AGA-MSAF, and AGA groups (p ≤ 0.001). Oligohydramnios, labor induction, vacuum extractions (VE), and intrapartum cesarean deliveries (CD) were significantly more frequent in the SGA-MSAF group compared to the SGA, AGA-MSAF, and AGA groups (p ≤ 0.003). The SGA-MSAF group had the highest rates of adverse composite neonatal outcomes compared to the SGA, AGA-MSAF, and AGA groups (p < 0.001). Multivariable logistic regression, adjusted for confounders, revealed increased ORs for the adverse neonatal composite outcome, VE, VE due to NRFHR, intrapartum CD, and CD due to NRFHR, in the presence of MSAF or SGA, and mostly when both risk factors were present (p ≤ 0.002).</p><p><strong>Conclusion: </strong>Deliveries complicated with MSAF and SGA were associated with increased obstetric complications compared to each alone. Clinicians should be aware of this and manage labor accordingly.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596188","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":"Comparison of vaginal breech deliveries with and without magnetic resonance imaging in primigravidas: a retrospective cohort analysis and literature review","authors":"G. Cinari,&nbsp;A. Edner,&nbsp;A. Rody,&nbsp;K. Kraft","doi":"10.1007/s00404-024-07915-2","DOIUrl":"10.1007/s00404-024-07915-2","url":null,"abstract":"<div><h3>Purpose</h3><p>Pelvimetry is often recommended in primiparous patients before offering vaginal breech delivery. Later studies show a reduction in perinatal mortality in women undergoing pelvimetry while earlier studies show the opposite. Magnetic resonance imaging (MRI), considered a new technology in 1990, has become the more expensive method for pelvimetry with lower-radiation, believed to prevent unnecessary cesarean sections and “falsely attempted vaginal deliveries”.</p><h3>Methods</h3><p>This retrospective cohort study (November 2019–February 2024) involved 160 primigravidas with breech presentation. The deliveries were attended by a team of experienced obstetricians (defined as attending at least 20 vaginal breech deliveries per year). Our cohort without MRI was compared with four study cohorts with MRI that were also used in a 2022 systematic review assessing delivery outcomes.</p><h3>Results</h3><p>Neonatal outcomes, cesarean section rate and vaginal delivery rate were compared. Umbilical artery pH was significantly lower in two study cohorts (Hoffmann et al. 2016 7.18 vaginal vs. 7.24 caesarean section (<i>p</i> &lt; 0.001), our cohort 7.19 vaginal vs. 7.27 cesarean section (<i>p</i> &lt; 0.001)). The vaginal delivery rate without MRI (our cohort) was 65.6%. In studies with prior MRI as a selection criterion, the rate was between 65.4% and 67.5% (Hoffmann, Van Loon, Klemt). 25.5% of our patients who had to be delivered by cesarean had non-reassuring fetal heart tones in the second stage of labor. Only 4.4% of the patients attempted delivery with epidural anesthesia.</p><h3>Conclusion</h3><p>Pelvimetry has not been shown to predict neonatal outcome and there is still no consensus on the interpretation of MRI measurements. Many authors argue, as confirmed by our results, that the outcomes are not dependent on pelvimetry, but on the competence of the obstetric delivering team.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 5","pages":"1315 - 1320"},"PeriodicalIF":2.1,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07915-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571651","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}