Archives of Gynecology and Obstetrics最新文献

{"title":"Influence of breast cancer on life satisfaction in the elderly patient","authors":"M. Burgmann,&nbsp;K. Hermelink,&nbsp;A. Lotz,&nbsp;V. Schlager,&nbsp;T. Kolben,&nbsp;Ch. Seifert,&nbsp;S. Schrodi,&nbsp;F. Ganster,&nbsp;Alexander Koenig,&nbsp;S. Beyer,&nbsp;S. Mahner,&nbsp;N. Harbeck,&nbsp;R. Wuerstlein","doi":"10.1007/s00404-025-07956-1","DOIUrl":"10.1007/s00404-025-07956-1","url":null,"abstract":"<div><h3>Purpose</h3><p>Due to increasing life expectancy and demographic trends in recent years, the specific needs of elderly patients have gained more and more attendance. The aim of this study is to determine the impact of adjuvant chemotherapy on health-related life satisfaction of elderly breast cancer patients while considering the conditions of comorbidities and global health status.</p><h3>Methods</h3><p>All breast cancer patients over 60 years who had been treated at the Breast Center of the University Hospital of Munich, Germany between 2010 and 2013 were eligible for participation. Life satisfaction was assessed on the basis of validated questionnaires, with a self-developed questionnaire we assessed issues of the patients general health status and for the geriatric assessment.</p><h3>Results</h3><p>Our research included data of 276 patients. Compared to a normal German population, our cohort reported significantly higher life satisfaction regardless of treatment with chemotherapy. Regardless of the type of therapy, the following factors are associated with a lower life health-related satisfaction: <i>low educational level, obesity</i>, <i>high Charlson Comorbidity Index (CI)</i> and <i>low Barthel Index (BI)</i> as well as <i>polymedication</i>. <i>Obesity</i> and the presence of <i>comorbidities</i> were significantly associated with reduced health-related life satisfaction.</p><h3>Conclusion</h3><p>This cross-sectional, retrospective analysis indicates, that chemotherapy does not impact the patients´ life satisfaction. <i>BI</i> and <i>CCI</i> as well as <i>obesity</i>, <i>polymedication</i> and <i>level of education</i> are significantly associated with a lower satisfaction. These data should be taken into account in the decision-making process to improve the medical care and support of elderly breast cancer patients.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"1163 - 1171"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07956-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405257","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":"Exposure to gonadotropin-releasing hormone agonist in early pregnancy leads to adverse pregnancy outcomes: a retrospective analysis","authors":"Mimi Xiong,&nbsp;Jinyu Lu,&nbsp;Nan Dong,&nbsp;Ruochun Wu,&nbsp;Dingyun Zhang,&nbsp;Bife Li,&nbsp;Wenjun Wang","doi":"10.1007/s00404-024-07914-3","DOIUrl":"10.1007/s00404-024-07914-3","url":null,"abstract":"<div><h3>Background</h3><p>GnRH-a is commonly used in the luteal phase for pituitary down-regulation during in-vitro fertilization (IVF). There is an ineluctable risk of spontaneous pregnancy for infertile couples who lack the use of contraception during the luteal phase down-regulation before IVF treatment. However, it is unclear whether exposure to GnRH-a affects clinical pregnancy outcomes.</p><h3>Methods</h3><p>A single-center retrospective cohort study based on propensity score matching was used to analyze the clinical data of a total of 6602 infertile women who were about to undergo assisted reproduction with IVF or intracytoplasmic microsperm injection with spermatozoa (ICSI) and with confirmed clinical pregnancies outcomes in the Reproductive Center of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China, from January 2011 to December 2022. Participants were divided into the NP group (Natural pregnancy with the use of GnRH-a) and the CT group (Conceived through IVF/ICSI-ET). Baseline characteristics and pregnancy outcomes of the groups were compared by correlation analysis, analysis of variance, and generalized estimating equations. The correlation between pregnancy outcomes and GnRH-a exposure was analyzed based on logistic regression modeling. The primary outcome of the study is the ectopic pregnancy rate. The secondary outcomes included spontaneous abortion rate, clinical pregnancy rate, live birth rate and adverse neonatal outcomes rate.</p><h3>Results</h3><p>Our study demonstrates statistically significant differences in spontaneous abortion rate (29.5% vs. 13.6%, <i>P</i> &lt; 0.05), ectopic pregnancy rate (14.3% vs. 3.1%, <i>P</i> &lt; 0.05), live birth rate ((56.2% vs. 83.3%, <i>P</i> &lt; 0.05)) between NP group and CT group. Logistic analysis showed that exposure to GnRH-a was a risk factor for adverse pregnancy outcomes and was associated with spontaneous abortion(odds ratio[ OR], 95% confidence interval [95% CI] {2.66,1.61–4.40}, <i>P</i> &lt; 0.05) and ectopic pregnancy(odds ratio [OR], 95%confidence interval [95% CI] {5.21,2.39–11.32}, <i>P</i> &lt; 0.05).</p><h3>Conclusion</h3><p>Exposure to GnRH-a during the luteal phase of down-regulation can adversely affect pregnancy outcomes. Therefore, we recommend contraception during the IVF/ICSI down-regulation. A higher dose of progesterone during early pregnancy is needed for infertile women who conceive spontaneously after exposure to GnRH-a.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"801 - 809"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07914-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405237","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 effect of progesterone level on day of trigger on embryo ploidy in egg donor’s cycles","authors":"Priscilla Lopes Caldeira,&nbsp;Aline Rodrigues Lorenzon,&nbsp;Peter Chedraui,&nbsp;Ana Paula Aquino,&nbsp;Bruna Barros,&nbsp;Eduardo Alves Leme da Motta,&nbsp;Thais Sanches Domingues,&nbsp;Pedro Augusto Araujo Monteleone,&nbsp;Edmund Chada Baracat,&nbsp;José Maria Soares Junior","doi":"10.1007/s00404-025-07942-7","DOIUrl":"10.1007/s00404-025-07942-7","url":null,"abstract":"<div><h3>Purpose</h3><p>Elevated progesterone (P4) has emerged as a cofounder for embryo quality and recently been investigated in blastocyst aneuploidy rates. In this context, we explored the prevalence of aneuploidy in blastocysts generated from donated eggs according to P4 levels on trigger’s day.</p><h3>Methods</h3><p>This retrospective cohort study analyzed data from intracytoplasmic sperm injection (ICSI) cycles using frozen donated oocytes that underwent embryo biopsy (PGT-A) at blastocyst stage. Patients were divided into two groups according to serum P4 on trigger day: &lt; 1.5 ng/mL (group A) and ≥ 1.5 ng/mL (group B). Only euploid embryos were transferred to recipients. Primary outcome was embryo euploidy and aneuploidy rate. Secondary outcomes were number of blastocysts, number of top-quality embryos, number of euploid/aneuploid embryos and clinical pregnancy rate.</p><h3>Results</h3><p>259 ICSI PGT-A cycles with frozen donated oocytes were analyzed. Group A included 75 cycles (57 donors; 69 recipients) and group B 184 cycles (115 donors; 163 recipients). The number of blastocysts (3.60 ± 1.52 vs 3.68 ± 1.52, <i>P</i> = 0.667), top-quality embryos (2.27 ± 1.59 vs 2.28 ± 1.43, <i>P</i> = 0.802), euploid embryos (1.92 ± 1.25 vs 1.92 ± 1.13, <i>P</i> = 0.954) and aneuploid embryos (1.23 ± 1.01 vs 1.14 ± 0.94, <i>P</i> = 0.593) were not significantly different between groups A and B, respectively. Euploid embryo rate (A: 0.31 ± 0.20 vs B: 0.30 ± 0.18, <i>P</i> = 0.626), aneuploidy embryo rate (A: 0.21 ± 0.19 vs B: 0.18 ± 0.15, <i>P</i> = 0.436) and clinical pregnancy rate (A: 73% vs B: 82%, <i>P</i> = 0.476) were comparable between the two groups.</p><h3>Conclusions</h3><p>Elevated P4 values on trigger day did not affect embryo ploidy or embryo quality parameters in donated eggs cycles.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"765 - 774"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07942-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405268","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":"Body image and mental health in women with polycystic ovary syndrome-a cross-sectional study.","authors":"Konstantin Hofmann, Claire Decrinis, Norman Bitterlich, Katharina Tropschuh, Petra Stute, Annette Bachmann","doi":"10.1007/s00404-024-07913-4","DOIUrl":"https://doi.org/10.1007/s00404-024-07913-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Polycystic Ovary Syndrome (PCOS) is a multifaceted endocrine-metabolic condition affecting around 5-15% of women globally. Despite its prevalence and diverse impact, the psychological aspect of PCOS is often underestimated in clinical settings, leading to significant distress among affected individuals. This study aimed to explore the extent of body image perception disorders, psychological comorbidities, and their influence on the health-related quality of life (HRQOL) in women with PCOS. Additionally, we focused on measuring the impact of factors associated with PCOS, particularly obesity, to gain a more comprehensive understanding of their effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An online survey was distributed anonymously to gynecologists, hospitals, and women's clinics across Austria, Germany, and Switzerland, as well as through social media platforms to connect with women with PCOS. The survey was conducted from November 14, 2023, to February 05, 2024. HRQOL, anxiety/depression levels, body image and self-esteem were assessed employing the Modified-PCOS-Questionnaire (MPCOSQ), Hospital Anxiety and Depression Scale (HADS), Multidimensional Body-Self Relations Questionnaire Appearance Scales (MBSRQ-AS) and Rosenberg Self-Esteem Scale (RSE) respectively. Identification of potential confounding variables relied on their plausibility and association with the estimate. Adjusted odds ratios and their respective 95% confidence intervals were computed through regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;587 participants fully completed the questionnaire. The study participants were on average 32.5 ± 5.9 years old and had a BMI of 31.3 ± 7.8 kg/m&lt;sup&gt;2&lt;/sup&gt;. In this study, 84.5% of all PCOS patients exhibited pathological scores in the MBSRQ-AS Appearance Evaluation, 83.8% in Body Areas Satisfaction, and 67.5% in Overweight Preoccupation. Half of the participants (46.7%) showed significantly poor results in the RSE, indicating low self-esteem. A notable portion of the study participants displayed elevated HADS scores, which supports a higher rate of distress in PCOS patients. (HADS-Anxiety &gt; 8: 75.0% (440); HADS-Depression &gt; 8: 57.6% (338). Examining the HRQOL of PCOS patients revealed that all average scores of the subscales, except for the Acne subscale and MPCOSQ-Total (3.6 ± 1:0), were situated in the lower half, indicating diminished HRQOL. The linear regression revealed that pathological values in the MBSRQ-AS, indicating impaired body image, were associated with low scores in the MPCOSQ subscales and HADS scales, suggesting impaired HRQOL and a higher rate of distress in PCOS patients. Furthermore, the multivariate analysis showed a statistically significant link between adverse body perception and HRQOL, as well as distress among PCOS patients in this study group. [multivariate HADS-Anxiety: MBSRQ-AS Body Areas Satisfaction (B: - 2.10; CI: - 3.88; - 0.33; p = 0.02) HADS-Depression MBSRQ-AS Body Areas Sat","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405180","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":"Assessing the impact of both preimplantation genetic testing for aneuploidy with blastocyst morphologic grade on live birth rates in frozen embryo transfers from fresh and frozen donor oocytes","authors":"Alyson Dennis,&nbsp;Nirali Jain,&nbsp;Emily Auran Clarke,&nbsp;Jennifer K. Blakemore","doi":"10.1007/s00404-024-07876-6","DOIUrl":"10.1007/s00404-024-07876-6","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the live birth rate (LBR) following donor frozen embryo transfer (dFET) of preimplantation genetic testing for aneuploidy (PGT-A) versus untested donor embryos, stratified by blastocyst morphologic grade (MG).</p><h3>Methods</h3><p>This was a retrospective cohort study of 146 patients undergoing dFET of a single euploid blastocyst from fresh or frozen oocytes using PGT-A compared to age-matched controls (1:1 ratio) who did not use PGT-A. Primary outcome was LBR. LBR was compared among cohorts, with further stratification by (<b>1) high/low MG</b> and (<b>2) fresh/frozen oocyte status</b>. Secondary outcomes included perinatal outcomes.</p><h3>Result(s)</h3><p>Median age in both groups was 44.5 years (<i>p</i> = 0.98). LBR was similar among the two cohorts (PGT-A: 57.5% vs. untested: 50.0%, <i>p</i> = 0.20). There was similar LBR in <b>fresh</b> (PGT-A: 59.2% vs. untested: 50.0%, <i>p</i> = 0.20) and <b>frozen</b> (PGT-A: 47.6% vs. untested: 50.0%, <i>p</i> = 0.85) oocyte subgroups. When stratified by <b>MG</b>, we appreciated similar LBR among <b>high-quality</b> blastocysts (PGT-A-high: 56.5% vs. untested-high: 52.3%, <i>p</i> = 0.49) <b>among the whole cohort</b>, as well as in <b>fresh</b> (fresh-PGT-A-high: 58.3% vs. fresh-untested-high: 52.9%, <i>p</i> = 0.46) and <b>frozen</b> (frozen-PGT-A-high: 44.4% vs. frozen-untested-high: 51.7%, <i>p</i> = 0.59) subgroups. Similarly, we appreciated no difference in LBR among <b>low-quality</b> blastocysts (PGT-A-low: 75.0% vs. untested-low: 31.2%, <i>p</i> = 0.08) <b>among the whole cohort</b>, as well as in the <b>fresh</b> (fresh-PGT-A-low: 80.0% vs. fresh-untested-low: 16.1%, <i>p</i> = 0.08) or <b>frozen</b> (frozen-PGT-A-low: 66.7% vs. frozen-untested-low: 40.0%, <i>p</i> = 0.56) subgroups. Gestational age (37.8 weeks, <i>p</i> = 1.0) and infant birth weight (PGT-A: 3128.0 g vs. untested: 3150.2 g, <i>p</i> = 0.60) were similar.</p><h3>Conclusion(s)</h3><p>Though limited by the small number of MG blastocysts, overall PGT-A did not improve LBR regardless of blastocyst quality from fresh and previously frozen donor oocytes.</p><h3>Capsule</h3><p>Use of PGT-A did not improve live birth rate regardless of blastocyst quality from both fresh and previously frozen donor oocytes.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"819 - 826"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07876-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405230","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":"Progestin-primed ovarian stimulation (PPOS) in preimplantation genetic testing for aneuploidy: a retrospective study and meta-analysis","authors":"Xi Qin,&nbsp;Li Fan,&nbsp;Yuxing Luo,&nbsp;Zhibing Deng,&nbsp;Zhonghong Zeng,&nbsp;Xiaoling Jiang,&nbsp;Yihua Yang","doi":"10.1007/s00404-024-07918-z","DOIUrl":"10.1007/s00404-024-07918-z","url":null,"abstract":"<div><h3>Background</h3><p>Information on the impact of Progestin-primed ovarian stimulation (PPOS) protocol on embryo euploid status and preimplantation genetic testing for aneuploidy (PGT-A) outcomes is limited compared with other ovarian stimulation protocols. We conducted a retrospective cohort study and a meta-analysis to evaluate the application value of the PPOS protocol in PGT-A cycles.</p><h3>Methods</h3><p>In the cohort study, we retrospectively analyzed 962 ovarian stimulation cycles, including 413 cycles of PPOS protocol, 327 cycles of gonadotropin-releasing hormone antagonist (GnRH-ant) protocol, and 222 cycles of GnRH agonist (GnRH-a) protocol. In the meta-analysis, we searched PubMed, Embase, Cochrane Library, Web of Science, Sinomed, CNKI, Wanfang and VIP databases as well as clinical trial registration websites. Pooled or narrative analyses were performed on embryo and pregnancy outcomes according to whether baseline characteristics were balanced.</p><h3>Results</h3><p>In our retrospective study, compared to the GnRH agonist protocol, patients receiving the PPOS and GnRH antagonist protocols were older, and there was a significant decrease in the number of antral follicles, Anti-Mullerian hormone (AMH) levels, stimulation duration, gonadotropin (Gn) dosage, as well as the number of retrieved oocytes and euploid blastocysts. Regression analysis showed that the ovarian stimulation protocol was not associated with the number of euploid blastocysts or the rate of euploid blastocysts per biopsy. There were no significant differences in the rates of biochemical pregnancy, clinical pregnancy, premature birth, live birth, or miscarriage per embryo transfer among the three groups. The meta-analysis included data from seven studies. There were no significant differences in stimulation duration, Gn dosage, number of oocytes retrieved, number of euploid blastocysts, euploid blastocyst rate, clinical pregnancy rate, or live birth rate between PPOS protocol and GnRH antagonist protocol, but the abortion rate of PPOS protocol decreased significantly.</p><h3>Conclusions</h3><p>Current findings indicate that the PPOS protocol is comparable to other ovarian stimulation protocols in embryo euploid status or pregnancy outcomes and may be an attractive option in PGT-A cycles, which needs to be validated in more well-designed RCTs and long-term follow-ups.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"1181 - 1193"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07918-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405264","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":"Postpartum hemorrhage: risk factors for severe blood loss, surgical intervention and peripartum hysterectomy.","authors":"Emma Barth, Rüdiger Klapdor, Lars Brodowski, Peter Hillemanns, Constantin von Kaisenberg, Vivien Dütemeyer","doi":"10.1007/s00404-025-07969-w","DOIUrl":"https://doi.org/10.1007/s00404-025-07969-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate risk factors in patients presenting with postpartum hemorrhage (PPH) associated with severe blood loss (BL), surgical intervention or peripartum hysterectomy.</p><p><strong>Methods: </strong>This retrospective cohort study included all patients who gave birth at the Hannover Medical School between January 2013 and August 2022 with PPH, defined as BL ≥ 500 ml after vaginal delivery and ≥ 1000 ml after cesarean section. The threshold for severe PPH was set at BL ≥ 1500 ml. Operative management included manual placental removal and/or aspiration/curettage, need for intrauterine balloon tamponade, uterine packing with a chitosan covered gauze or compression sutures. Hysterectomy as ultima ratio was observed separately.</p><p><strong>Results: </strong>In total 20.9% of 1038 patients with PPH developed severe BL. Several risk factors were identified such as nicotine abuse (aOR 3.45, 95% CI 1.57-7.59, p = 0.002), multiparity (aOR 2.12, 95% CI 1.10-4.10, p = 0.03), uterine malformation (aOR 5.09, 95% CI 1.22-21.16, p = 0.03), c-section (aOR 3.92, 95% CI 2.59-5.92, p < 0.001), placenta praevia (aOR 2.82, 95% CI 1.2-6.63, p = 0.02), abnormal placentation (aOR 9.76, 95% CI 4.22-22.56, p < 0.001) and inversion of the uterus (aOR 16.89, 95% CI 1.62-176.12, p = 0.02). More than one third of the women had a surgical intervention. Independent risk factors for an operative management of PPH were uterus malformation (aOR 5.04, 95% CI 1.22-20.91, p = 0.03), placenta praevia (aOR 2.84, 95% CI 1.23-6.53, p = 0.01), abnormal placentation (aOR 9.78, 95% CI 4.30-22.27, p < 0.001) and c-section (aOR 4.65, 95% CI 3.14-6.89, p < 0.001). Peripartum hysterectomy occurred in 1.9% of the cases and was in addition independently associated wih preeclampsia (aOR 7.50, 95% CI 1.29-43.81, p = 0.03) and amniotic infection syndrome (aOR 12.22, 95% CI 1.92-77.90, p = 0.01).</p><p><strong>Conclusion: </strong>PPH is a common complication in modern obstetrics and one in five patients with pathological bleeding after birth develops severe BL. There are specific risk factors associated with a BL ≥ 1500 ml, surgical intervention and peripartum hysterectomy in PPH that should be assessed by health professionals and taken into account in the management of this postpartum complication.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397908","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":"Latency to delivery and incidence of adverse obstetric and perinatal outcomes in preterm premature rupture of membranes before 32 weeks.","authors":"Viola Seravalli, Chiara Colucci, Chiara Di Cencio, Anna Morucchio, Federica Barsanti, Mariarosaria Di Tommaso","doi":"10.1007/s00404-025-07970-3","DOIUrl":"https://doi.org/10.1007/s00404-025-07970-3","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the average latency to delivery, obstetric outcomes and neonatal survival in pregnancies complicated by preterm premature rupture of membranes (PPROM) before 32 weeks.</p><p><strong>Methods: </strong>A retrospective study was conducted on pregnant women admitted for PPROM before 32 weeks. Patients were categorized into three groups based on gestational age (GA) at PPROM (< 24, 24 to 28, 28 to 32 weeks). Latency to delivery, obstetric outcomes and neonatal survival were analyzed.</p><p><strong>Results: </strong> 86 women who had PPROM before 32 weeks were identified. The mean GA at PPROM was 26.1 weeks and the median latency to delivery was 16 days (IQR 4, 27). The median latency to delivery was 22 days for previable PPROM, 11 days for PPROM between 24 and 28 weeks, and 16 days for PPROM between 28 and 32 weeks (p = 0.29). All cases of placental abruption (7/86, 8%) and cord prolapse (6/86, 7%) occurred in women with PPROM before 28 weeks. In 44% of PPROM, placental histology demonstrated chorionamnionitis. Neonatal survival at discharge was significantly lower in previable PPROM (< 24 weeks) compared to PPROM at 24-26 weeks (58% vs 92%, p = 0.04), and it reached 100% in cases of PPROM after 28 weeks.</p><p><strong>Conclusion: </strong>In PPROM occurring before 32 weeks the median latency to delivery ranged between 11 and 22 days. Neonatal survival improves with higher GA at PPROM, and it increases by more than 33% when PPROM occurs after 24 weeks of gestation. These data may be valuable for patient counselling.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381490","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":"Retrospective analysis of autologous bone marrow mesenchymal stem cells as adjuvant therapy in recurrent intrauterine adhesions","authors":"Yu Wang,&nbsp;Li-Li Yin,&nbsp;Xiao-Fei Sun,&nbsp;Qing Yang,&nbsp;Yan-Qiu Yu,&nbsp;Yao-Xing Rong,&nbsp;Zhe Chen,&nbsp;Guang-Wei Wang","doi":"10.1007/s00404-025-07952-5","DOIUrl":"10.1007/s00404-025-07952-5","url":null,"abstract":"<div><h3>Objectives</h3><p>We aimed to retrospectively analyze the efficacy and safety of autologous bone marrow mesenchymal stem cells (BM-MSCs) as adjuvant therapy for intrauterine adhesion (IUA) and endometrial repair.</p><h3>Methods</h3><p>Patients enrolled at Shengjing Hospital Affiliated to China Medical University from January 2017 to January 2020 for the treatment of infertility who diagnosed with recurrent IUA as confirmed by hysteroscopy were included. BM-MSC was isolated from the patient’s own bone marrow collected before and preserved. The patients were admitted to the hospital for hysteroscopic transcervical resection of adhesions in the early proliferative phase of the menstrual cycle, given the first intrauterine perfusion of BM-MSCs on the same day of surgery and after surgery for the second and third perfusion on the fifth day of the menstrual cycle.After the third perfusion and improvement in the menstrual cycle, the patients were followed up once a year, for up to two years.</p><h3>Result</h3><p>All patients had menstrual bleeding and significantly increased menstrual flow during three rounds of perfusions with MSC compared to before treatment. However, this effect was reversed and there was no significant difference between the menstrual flow 1 year after treatment vs before treatment. The IUA scores after three rounds of treatment as well as one and two years after treatments were significantly lower compared to before surgery. No IUA recurrence was observed during the 2 year follow-up. Endometrial thickness had significantly increased during treatment. During the 2 year follow-up period, one patient conceived naturally. One patient was successfully implanted after in vitro fertilization and embryo transfer.</p><h3>Conclusion</h3><p>Intrauterine perfusion of autologous BM-MSCs, assisted by adhesiolysis, was effective in preventing postoperative IUA recurrence and partially improved the reproductive prognosis.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"789 - 799"},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07952-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363442","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":"Expression of concern: Modified thermal balloon endometrial ablation in low resource settings: a cost-effective method using Foley’s catheter","authors":"Adel Saad Helal,&nbsp;El-Said Abdel-Hady,&nbsp;Abd El-Mageed Mashaly,&nbsp;Mohamed El Shafaie,&nbsp;Lotfy Sherif","doi":"10.1007/s00404-025-07978-9","DOIUrl":"10.1007/s00404-025-07978-9","url":null,"abstract":"","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 2","pages":"581 - 581"},"PeriodicalIF":2.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07978-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363441","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}