Archives of Gynecology and Obstetrics最新文献

{"title":"Optimizing infertility treatment for ovarian endometrioma: is surgical intervention preferable before or after in-vitro fertilization programs?","authors":"Ivan Sini,&nbsp;Aries Joe,&nbsp;Nining Handayani,&nbsp;Tri Aprilliana Wulandari,&nbsp;Ayu Mulia Sundari,&nbsp;Batara Sirait,&nbsp;Arie Adrianus Polim,&nbsp;Irham Suheimi,&nbsp;Arief Boediono,&nbsp;Andrew Kan","doi":"10.1007/s00404-025-07954-3","DOIUrl":"10.1007/s00404-025-07954-3","url":null,"abstract":"<div><h3>Purpose</h3><p>Endometriosis is one of the common endometrial pathologies that occurs in reproductive-age women and could lead to infertility. This study set out to observe which clinical management of endometriosis with endometrioma is prominent in improving IVF outcomes.</p><h3>Materials and methods</h3><p>This was a retrospective cross-sectional controlled study at Bunda General Hospital and Morula IVF Jakarta Clinic, Indonesia from Jan 2018 to Dec 2022. A total of 279 patients diagnosed with endometriosis were recorded. Of that, 86 couples with endometrioma underwent an in vitro fertilization program (IVF). Forty-eight women performed IVF prior to the removal of endometrioma through surgery (IVF-OPS) while the remaining underwent surgery for endometrioma removal followed by an IVF program (OPS-IVF). Each group was compared to the control group which was administered to an IVF program without the removal of endometriosis. The primary outcome was the clinical pregnancy rate. Mann–Whitney or Kruskal–Wallis and Chi square were used for statistical analysis. A <i>p</i> value of &lt; 0.05 was considered statistically significant.</p><h3>Results</h3><p>A comparable clinical pregnancy rate was observed across the three groups (<i>p</i> = 0.068). Nonetheless, the IVF-OPS approach led to an improved number of top-quality blastocysts compared to both the control and OPS-IVF groups (<i>p</i> &lt; 0.05). Eventually, IVF-OPS was shown to be a prominent approach for endometriosis with endometrioma management in comparison to OPS-IVF in terms of clinical pregnancy rate as well as embryology laboratory outcomes (<i>p</i> &lt; 0.05).</p><h3>Conclusion</h3><p>Our result suggested that intervention of endometriosis with removal surgery was superior when performed after the IVF program.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"781 - 787"},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07954-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565885","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":"Hysteroscopic niche resection can effectively reduce the niche volume, increase residual myometrial thickness, and improve postmenstrual spotting symptoms.","authors":"Yang Wang, Wei Xia, Taotao Sun, Lirong Yan, Chuqing He, Judith A F Huirne, Jian Zhang","doi":"10.1007/s00404-025-07980-1","DOIUrl":"https://doi.org/10.1007/s00404-025-07980-1","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the anatomical changes of the uterine niche in women before and after hysteroscopic niche resection (HNR) and to investigate the correlation between these changes and the improvement in postoperative spotting symptoms by thin-slice MRI.</p><p><strong>Methods: </strong>This prospective observational study enrolled women with symptomatic uterine niches between June 2019 and February 2024. All participants underwent thin-slice magnetic resonance imaging (MRI) before and after HNR. We assessed the effective rate of postoperative spotting at the 6-month follow-up (effective treatment was defined as a reduction of at least 50% in spotting days relative to baseline during the 6-month follow-up period) and the pre- and post-HNR anatomical indicators.</p><p><strong>Results: </strong>A total of 108 women were included in the study. Six months after HNR, 70.4% (76/108) of women experienced at least a 50% reduction in spotting days from baseline. Residual myometrial thickness (RMT) significantly increased by 1.9 ± 2.2 mm (p < 0.01). The volume of niche significantly decreased, with a median reduction rate of 38.5% (IQR 8.5-88.2%) (p < 0.01). Based on the ROC curve, a cut-off value of 50 mm² for volume was identified as an optimal threshold for subclassifying large niches and small niches, according to treatment efficacy. The reduction in niche volume was more pronounced in the small niche group compared to the large niche group, with median reduction rates of 51.9% (IQR 13.5-100.0%) and 12.4% (IQR -15.4-43.9%), respectively (p < 0.01). There is an interesting finding that most cases in the anatomical failure group (those with an enlarged niche) had a preoperative volume of ≥ 50 mm² (19.2%, p < 0.01). Furthermore, the effective treatment group exhibited a more significant increase in RMT and a greater reduction in niche volume after HNR compared to the ineffective group. Multivariate logistic regression analysis indicated that small niches [OR 16.85 (3.36-84.47), p < 0.01] and greater reductions in niche volume [OR 1.14 (1.07-1.21), p < 0.01] were associated with effective treatment.</p><p><strong>Conclusion: </strong>HNR is a promising approach for managing postmenstrual spotting, especially in treating small uterine niches (volume < 50 mm²). After HNR, RMT increases, and niche size decreases slightly.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555725","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":"Efficacy and safety of acupuncture-related therapies in symptomatic endometriosis: a systematic review and network meta-analysis","authors":"Yang Su,&nbsp;Ran Ji,&nbsp;Xiaoyan Zheng,&nbsp;Yan Jia,&nbsp;Hao Zhu,&nbsp;Chaoliang Li,&nbsp;Zheng Yu,&nbsp;Manjia Zhu,&nbsp;Siyi Yu,&nbsp;Xiaoping Tian,&nbsp;Jie Yang","doi":"10.1007/s00404-025-07979-8","DOIUrl":"10.1007/s00404-025-07979-8","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the effectiveness and safety of different acupuncture-related therapies combined with pharmacotherapies for treating symptomatic endometriosis.</p><h3>Methods</h3><p>A pre-defined search strategy was conducted across eight databases (Chinese Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, China Science and Technology Journal Database, PubMed, Embase, Cochrane Library, and Web of Science) from inception to May 1, 2023. The included studies were evaluated for methodological quality using the Cochrane risk of bias assessment tool. The surface under the cumulative ranking (SUCRA) was applied to rank the acupuncture-related therapies for each outcome.</p><h3>Results</h3><p>Twenty-three randomized controlled trials (RCTs) involving one thousand five hundred forty-five patients were included in the network meta-analysis. Ear electroacupuncture (SUCRA = 83.0%), needle warming moxibustion with Modified Neiyi Zhitong Formula (SUCRA = 80.6%), and auricular needle-embedding (SUCRA = 79.6%) demonstrated a statistically significant reduction in comprehensive symptoms compared to the control group. Studies have shown that body electroacupuncture (OR = 4.33, 95% CI 1.20–15.61), acupoint catgut (OR = 4.32, 95% CI 1.08–17.25), and auricular needle-embedding (OR = 7.56, 95% CI 1.89–30.28) are statistically significantly more effective than conventional treatment.</p><h3>Conclusion</h3><p>The results of this analysis suggest that acupuncture-related therapies are effective in managing symptomatic endometriosis. Further high-quality randomized controlled trials are warranted to explore their efficacy and safety in greater depth.</p><h3>Trial registration</h3><p>Our study protocol was registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY); registration number: INPLASY202380077.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"697 - 714"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07979-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522570","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: Is follicular flushing really effective? A clinical study","authors":"Mustafa Kara,&nbsp;Turgut Aydin,&nbsp;Nurettin Turktekin","doi":"10.1007/s00404-025-07987-8","DOIUrl":"10.1007/s00404-025-07987-8","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"929 - 929"},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07987-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522569","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":"An elevated triglyceride-glucose index in the first-trimester predicts adverse pregnancy outcomes: a retrospective cohort study","authors":"Songhong Song,&nbsp;Qi Luo,&nbsp;Xinyang Zhong,&nbsp;Man Huang,&nbsp;Jinxiu Zhu","doi":"10.1007/s00404-025-07973-0","DOIUrl":"10.1007/s00404-025-07973-0","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;The relationship of the first-trimester triglyceride-glucose (TyG) index with GDM (gestational diabetes mellitus) and other adverse pregnancy outcomes has yet to be fully understood. This study aims to investigate the relationship between the first-trimester TyG index and the risk of adverse pregnancy outcomes in pregnant women.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;The data for the retrospective cohort study were derived from the Maternal and Child Health Hospital of Longgang District, Shenzhen, China. To calculate the TyG index, health indicators were measured in the early pregnancy period (&lt;14 gestational weeks), including triglycerides and fasting blood glucose levels in pregnant women. Multivariable regression analysis and subgroup analysis were used to ascertain the independent association between the TyG index and the possibility of adverse pregnancy outcomes. Interaction analysis was performed to assess the potential heterogeneity of associations among subgroups. Nonlinear associations and the predictive value of the TyG index were explored using restricted cubic splines and receiver operating characteristic (ROC) curves. The discrimination and accuracy of the fully adjusted model were evaluated using calibration curves, Brier scores, and decision curve analysis (DCA). Mediation analysis was conducted to assess the impact of GDM (gestational diabetes mellitus) and PE (preeclampsia) as intermediaries on the risk of Preterm delivery.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;The study included a cohort of 11,942 pregnant women, with an average TyG index of 8.36 ± 0.41. Logistic regression analysis showed that after adjusting for covariates, for each 1-unit increase in the TyG index, the risk of GDM increased by 2.21-fold, and this result was significantly different across all quartiles. Compared to the lowest quartile group, the highest TyG index group had the highest risk of PE (OR: 2.89; 95% CI 1.39 ~ 6.50), GH (gestational hypertension) (OR: 1.47; 95% CI 1.07 ~ 2.02), and Preterm delivery (OR: 1.75; 95% CI 1.21 ~ 2.56).The analysis of data stratification and interaction confirmed the validity of our study results. However, the analysis found no statistically significant association between the TyG index and low birth weight and macrosomia. GDM and PE were identified as partial mediating factors between TyG and the risk of preterm delivery, with variance contributions of 7.23% and 20.33%. The TyG index demonstrated the highest area under the curve (AUC) values in the ROC curves for GDM, PE, GH, and preterm delivery, with values of 0.61, 0.67, 0.58, and 0.56, respectively. The combination of the TyG index, maternal age, and pre-pregnancy body mass index predicted outcomes better than the TyG index alone (&lt;i&gt;p&lt;/i&gt; &lt; 0.01).After adjustment for confounders, the model showed good accuracy and net benefit in predicting adverse pregnancy outcomes, as supported by calibration curves, Brier scores, and decision curve analysis.&lt;/p&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"915 - 927"},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07973-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498105","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":"Global prevalence of stillbirth among fetuses from twin pregnancies: a systematic review and meta-analysis.","authors":"Nader Salari, Mahan Beiromvand, Reza Abdollahi, Mahvan Hemmati, Pegah Heidarian, Kimia Hashemian, Shamarina Shohaimi, Masoud Mohammadi","doi":"10.1007/s00404-025-07982-z","DOIUrl":"https://doi.org/10.1007/s00404-025-07982-z","url":null,"abstract":"<p><strong>Background: </strong>Evidence shows that twin pregnancy is associated with increased adverse outcomes, including stillbirth. The present study aimed to investigate the global prevalence of stillbirth among fetuses resulting from twin pregnancies through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>To identify relevant studies, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched databases including PubMed, Web of Science, Google Scholar, Scopus, Embase, and Science Direct using keywords such as \"stillbirth,\" \"twin pregnancy,\" \"fetus,\" and \"prevalence\" without applying any time constraints to the search. The quality of the articles was evaluated using the STROBE checklist. To ensure the reliability of our findings, we employed a random-effects model for analysis, and the heterogeneity of the studies was assessed using the I² index. Data analysis was conducted using Version 2 of Comprehensive Meta-Analysis software.</p><p><strong>Results: </strong>In a review of 10 studies with a sample size of 627,797 people, our meta-analysis revealed a global prevalence of stillbirth among fetuses resulting from twin pregnancies, reported to be 1.4% (95% CI 0.9-2.1). Our study also showed that with increasing sample size and years of study, the global prevalence of stillbirth among fetuses resulting from twin pregnancies decreased (p < 0.05). The highest prevalence of stillbirth, 3.5 (95% CI 2.2-5.4), was reported in the monochorionic type.</p><p><strong>Conclusion: </strong>The occurrence of stillbirth in twin pregnancies is a significant health concern for countries worldwide. Identifying its prevalence and contributing factors can aid health planning and policy development.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466770","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":"Retraction Note: Effect of intramural fibroid on uterine and endometrial vascularity in infertile women scheduled for in‑vitro fertilization","authors":"Ahmed Kamel,&nbsp;Akmal El‑Mazny,&nbsp;Wafaa Ramadan,&nbsp;Suzy Abdelaziz,&nbsp;Sherine Gad‑Allah,&nbsp;Hany Saad,&nbsp;Ahmed M. Hussein,&nbsp;Emad Salah","doi":"10.1007/s00404-025-07985-w","DOIUrl":"10.1007/s00404-025-07985-w","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"931 - 931"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07985-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466773","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":"Tinidazole vs metronidazole for the treatment of bacterial vaginosis: a systematic review and meta-analysis","authors":"Milene Vitória Sampaio Sobral,&nbsp;Victor Gonçalves Soares,&nbsp;João Lucas de Magalhães Leal Moreira,&nbsp;Livia Kneipp Rodrigues,&nbsp;Hilária Saugo Faria,&nbsp;Clara de Andrade Pontual Peres,&nbsp;Lubna Al-Sharif,&nbsp;Maria Julia Gonzaga Pascoalin,&nbsp;Fernando Augusto Barreiros,&nbsp;Marina Ayabe Gomes de Moraes","doi":"10.1007/s00404-024-07899-z","DOIUrl":"10.1007/s00404-024-07899-z","url":null,"abstract":"<div><h3>Introduction</h3><p>Tinidazole shows potential as a first-line treatment for bacterial vaginosis (BV). However, its superiority to metronidazole remains uncertain. Therefore, this meta-analysis compares tinidazole versus metronidazole in patients with BV.</p><h3>Methods</h3><p>We systematically searched PubMed, Embase and Cochrane for studies comparing tinidazole and metronidazole in patients with BV. Statistical analyses were performed using R Studio 4.3.2. Heterogeneity was examined with the Cochran Q test and I² statistics. Risk ratios (RR) with 95% confidence intervals (CI) were pooled across trials. Outcomes of interest were BV cure at the first and the second follow-up appointment, and adverse events such as nausea and bad or metallic taste.</p><h3>Results</h3><p>Five randomized controlled trials and 1 prospective observational study, reporting data on 1,036 patients were included in this meta-analysis. Among them, 511 (49%) received tinidazole and 525 (51%) received metronidazole. Follow-up ranged from 1 to 6 weeks. There was no significant difference between groups for BV cure at the first follow-up appointment (RR 1.03; 95% CI 0.92 to 1.14; I² = 76%), cure at the second follow-up appointment (RR 1.05; 95% CI 0.80–1.38; I² = 88%), nausea (RR 0.89; 95% CI 0.39–2.04; I² = 83%), and bad or metallic taste (RR 0.74; 95% CI 0.12–4.45; I² = 89%).</p><h3>Conclusion</h3><p>In patients with BV, tinidazole and metronidazole exhibit similar efficacy and safety, with equivalent cure rates and incidence of adverse events.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 2","pages":"333 - 340"},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07899-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447863","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 of serum AMH levels with the number of oocytes retrieved in adolescent and young adult women undergoing controlled ovarian stimulation for fertility preservation","authors":"Sung Woo Kim,&nbsp;Hee Jin Son,&nbsp;Ji Yeon Han,&nbsp;Hoon Kim,&nbsp;Seung-Yup Ku","doi":"10.1007/s00404-025-07976-x","DOIUrl":"10.1007/s00404-025-07976-x","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate whether the number of oocytes retrieved after controlled ovarian stimulation (COS) for fertility preservation (FP) can be predicted using serum anti-Müllerian hormone (AMH) levels in adolescent and young adult (AYA) women.</p><h3>Methods</h3><p>This is a retrospective cohort study in a large university-affiliated fertility center. AYA women aged 11 to 25 years received COS using gonadotropin-releasing hormone (GnRH) antagonist protocols for FP were enrolled. Those with canceled cycles or incomplete data were excluded. The primary outcome is to determine whether the number of oocytes retrieved can be predicted through serum AMH levels using multiple linear regression analysis.</p><h3>Results</h3><p>The mean numbers of oocytes retrieved, mature oocytes retrieved, and oocytes cryopreserved were 10.3 ± 7.6, 6.9 ± 6.2, and 8.5 ± 6.8, respectively. Multiple stepwise linear regression analysis revealed that serum AMH level independently predicts COS outcomes, including the total number of oocytes retrieved (adjusted <i>R</i>² = 0.222, <i>P</i> &lt; 0.001), the number of mature oocytes retrieved (adjusted <i>R</i>² = 0.102, <i>P</i> = 0.013), and the number of oocytes cryopreserved (adjusted <i>R</i>² = 0.153, <i>P</i> = 0.003).</p><h3>Conclusion</h3><p>Serum AMH level was a significant predictor of the number of oocytes retrieved after COS for FP in AYA women, while antral follicle count and age were not significantly related.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"811 - 818"},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07976-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447851","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":"Factors, pregnancy outcomes, and management associated with non-reportable results in prenatal cell-free DNA testing.","authors":"Hailing Yin, Jue Wang, Xin Wu, Mingzhu Miao, Ya Wang, Jiale Shi, Xi Wang, Xiang Ma","doi":"10.1007/s00404-025-07977-w","DOIUrl":"https://doi.org/10.1007/s00404-025-07977-w","url":null,"abstract":"<p><strong>Purpose: </strong>To offer more effective strategies by classification of non-reportable results for physicians to manage those pregnancies.</p><p><strong>Methods: </strong>From July 2022 to May 2024, a total of 14,073 prenatal cell-free DNA (cfDNA) tests were performed by massively parallel sequencing (MPS) in our genetic laboratory and 52 cases received non-reportable results caused by different reasons. Chi-square analysis and logistic regression analysis were used to analyze the risk factors contributing to non-reportable results. The redraw test results and the pregnancy outcomes were collected and analyzed.</p><p><strong>Results: </strong>Overall, 52 (0.37%) of 14,073 pregnant women had non-reportable cfDNA testing results after the first draw. Multivariate logistic regression analysis revealed that pregnancies conceived by in vitro fertilization (IVF) (OR = 2.42, 95% CI 1.08-5.42, P = 0.03) and heparin use (OR = 7.04, 95% CI 2.40-20.62, P < 0.001) were independent factors for non-reportable cfDNA test results. In 52 cases with non-reportable results, 27 (51.92%) cases had borderline Z scores, 15 (28.85%) cases had a low fetal fraction (< 4.0%), 5 (9.62%) cases indicated multiple chromosomal aberrations (MCA, ≥ 4), and 5 (9.62%) cases had data fluctuation in sex chromosomes. All 52 (100%) cases chose to have a redraw test. The overall success rate of redraw test was 65.38%; however, cases with MCA mainly caused by cfDNA from uterine fibroids or maternal malignancies had relatively low success rate of redraw testing. Compared to pregnant women without risk factors, those with caution indications and with low fetal fraction (LFF) had a lower chance to obtain valid redraw testing results (100.00% vs 16.67%, P = 0.002). The abnormal conditions of perinatal women and infants were more frequent in the cases with non-reportable results after redraw tests (2.94% vs 14.71%, P = 0.027; 7.41% vs 14.81%, P = 0.038).</p><p><strong>Conclusion: </strong>Repeated testing was not suitable for all cases with non-reportable results. Invasive prenatal diagnosis should be recommended for cases with MCA, cases with caution indications and with low fetal fraction for the first non-reportable results, cases with consecutive non-reportable cfDNA results. More attention should be paid to the cases with non-reportable cfDNA results, especially to the cases with non-reportable redraw testing results.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447853","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}