Archives of Gynecology and Obstetrics最新文献

{"title":"Do menstrual symptoms affect motor imagery skills in young women?","authors":"Özgü İnal Özün, Merve Öztürk, Esra Üzelpasacı","doi":"10.1007/s00404-025-07936-5","DOIUrl":"https://doi.org/10.1007/s00404-025-07936-5","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the relationship between menstrual symptoms and motor imagery skills in young women.</p><p><strong>Methods: </strong>A total of 117 women between the ages of 18-40 were included in the study. Visual Analog Scale (VAS) for the menstrual pain intensity, the Menstrual Symptom Questionnaire (MSQ) for the menstrual-related symptoms, and the Kinesthetic and Visual Imagery Questionnaire-20 (KVIQ-20) for the motor imagery were used. All measurements were conducted on the first or second day of the menstruation, depending on when the subject declared subjectively experiencing most symptoms.</p><p><strong>Results: </strong>The relationship between menstruation symptoms and visual imagery (VI) and kinesthetic imagery (KI) skills was examined. A weak negative correlation was found between MSQ_negative effects/somatic complaints and KVIQ-20_KI (p = .040, r = -.199). The relationship between menstrual pain intensity and KVIQ-20 items was examined. The strongest relationship was found between VAS and KVIQ-20_knee_VI and KVIQ-20_hip_VI (p = 003, r = -.288; p = 005, r = -.270; p = 004, respectively). A weak negative correlation was also found between VAS and KVIQ-20_VI_total and KVIQ-20_KI_total (p = 0.004, r = -.275; p = 0.19, r = -.227, respectively).</p><p><strong>Discussion: </strong>This is the first study to examine menstrual symptoms in women in detail and reveal their relationship with motor imagery skills. Menstrual symptoms, especially negative effects/somatic complaints seen during menstruation, negatively affect kinesthetic imagery ability. In addition; chronic menstrual pain has a negative effect on both kinesthetic and visual imagery abilities. Considering the impairments in motor imagery skills due to negative effects/somatic complaints during menstruation and chronic menstrual pain, adding motor imagery training to treatment programs aimed at improving women's health may have positive effects.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073785","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":"Neobladder saving caesarean section in a pregnant woman with congenital bladder exstrophy","authors":"Chiara Granieri,&nbsp;Silvia D’Ippolito,&nbsp;Aniello Foresta,&nbsp;Benedetta Gui,&nbsp;Nazario Foschi,&nbsp;Giovanni Esposito,&nbsp;Giovanni Scambia","doi":"10.1007/s00404-025-07937-4","DOIUrl":"10.1007/s00404-025-07937-4","url":null,"abstract":"<div><h3>Purpose</h3><p>To propose an obstetric management model for patients with congenital bladder exstrophy (BE) and multiple previous surgeries, recognizing the unique anatomical variations of each patient and emphasizing the importance of personalized treatment approaches.</p><h3>Methods</h3><p>We present the obstetric management and delivery of a 32-year-old pregnant woman with congenital BE, focusing on antenatal anatomical assessment, accurate delivery planning and key surgical steps during an elective caesarean section. Additionally, we conduct a comprehensive review of the current literature to enhance understanding of the reproductive implications associated with this exceptionally rare condition.</p><h3>Results</h3><p>Following urological magnetic resonance imaging and intraoperative ultrasound, a successful neobladder-saving caesarean section was performed at 37 weeks, resulting in the delivery of a healthy infant with no maternal complications.</p><h3>Conclusion</h3><p>Obstetric management in women with congenital BE presents unique challenges due to its significant impact on urinary and reproductive functions. Careful delivery planning and antenatal anatomical assessment are crucial for optimizing both maternal and fetal outcomes. A personalized, multidisciplinary approach can help minimize potential complications.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"1221 - 1225"},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07937-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073790","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":"Frequency of CMV testing during pregnancy-a retrospective study","authors":"A. Hadjiiona,&nbsp;I. Michaelides,&nbsp;P. Kummer,&nbsp;M. Kappelmeyer,&nbsp;A. Koeninger,&nbsp;E. Reuschel","doi":"10.1007/s00404-025-07962-3","DOIUrl":"10.1007/s00404-025-07962-3","url":null,"abstract":"<div><h3>Purpose</h3><p>The cytomegalovirus (CMV) belongs to the family of human Herpesviridae and is distributed worldwide. It is the most common cause of viral congenital infections and can have serious consequences for the health of the fetus in the event of a vertical transmission. This study, taking place for the first time in Upper Palatinate, Bavaria, aims to evaluate the frequency of CMV testing among pregnant women in our region in Germany, which for some individuals can be an expensive individual health service.</p><h3>Methods</h3><p>Retrospectively, 1000 pregnant patients aged 17–45 years who were treated in the University Clinic St. Hedwig, Regensburg, Germany, were included in the study. It was investigated whether a CMV test was carried out during pregnancy and which results were obtained.</p><h3>Results</h3><p>597 patients (59.7%) had not received a CMV test during pregnancy. Among the 403 (40.3%) patients who had undergone CMV testing, seropositivity was detected in 143 (35.5%). 257 patients (63.8%) were seronegative, while 3 (0.74%) had a primary infection.</p><h3>Conclusion</h3><p>Although CMV is the most common pathogen of viral congenital infections and can severely impair the health of affected newborns, CMV diagnostics during pregnancy is still not an integral part of the maternity guidelines in Germany, but rather an individual healthcare service, meaning that the patients undergoing the test must bear the full cost. An antiviral treatment with valacyclovir has shown good preventive and therapeutic success, but unfortunately, there is currently no vaccination available to prevent vertical transmission, which is why early diagnosis and hygiene measures are the most important means of preventing seroconversion of the mother and possible infection of the fetus.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 5","pages":"1297 - 1304"},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07962-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term effects of bipolar electrocoagulation and suture hemostasis on the ovarian reserve following endometriotic cystectomy: a meta-analysis.","authors":"Jia Wang, Ying Xiang Wang, Hao Tian Wu, Xiao Mao Li","doi":"10.1007/s00404-024-07926-z","DOIUrl":"https://doi.org/10.1007/s00404-024-07926-z","url":null,"abstract":"<p><strong>Objective: </strong>The long-term impact of electrocoagulation and suture hemostasis on ovarian reserve (OR) after endometriotic cystectomy remains uncertain. This meta-analysis aimed to compare the short-term and long-term effects of coagulation and suture hemostasis on ovarian reserve based on the postoperative levels of the anti-Müllerian hormone (AMH).</p><p><strong>Methods: </strong>PubMed, MEDLINE, EMBASE, Cochrane, and other databases were searched for eligible studies published up to May 2023.The quality assessment of the RCTs was performed as indicated by the Cochrane Collaboration tool in the Cochrane Handbook. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the non-RCTs. The random-effects or fixed-effects model was used to quantify the weighted mean difference (WMD) at the 95% confidence interval (CI) in the treatment effect across the different studies.</p><p><strong>Results: </strong>Six randomized controlled trials and two prospective studies were included in this meta-analysis. The meta-analysis showed that there was a statistically significant difference in the AMH levels between the electrocoagulation and the suture group at 1 month (WMD: -0.52, 95%CI (-1.02, -0.01), P = 0.04), 3 months (WMD: -0.72, 95%CI (-1.13, -0.31), P = 0.0005), 6 months (WMD: -0.80, 95%CI (-1.22, -0.38), P = 0.0002) and 12 months (WMD: -0.81, 95%CI (-1.24, -0.37), P = 0.0003), postoperatively. The mean difference of AMH in electrocoagulation group at 1, 3, 6 and 12 months after surgery was -1.75; -1.37; -1.10; -0.92 respectively; meanwhile, in the suture group were -2.50; -2.46; -2.33; -2.24, respectively.</p><p><strong>Conclusion: </strong>Compared with electrocoagulation, suture hemostasis has less impact on OR. Although the OR of two groups gradually recovered, electrocoagulation still caused more damage to AMH than suture at 12 months after surgery. Suturing could be a better choice after stripping ovarian endometriomas.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073788","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":"Radiotherapy improves stress urinary incontinence but impairs pelvic floor function in endometrial cancer patients: a prospective cohort study","authors":"Selçuk Erkılınç,&nbsp;Ilker Çakır,&nbsp;Volkan Karataşlı,&nbsp;Behzat Can,&nbsp;Can Ata,&nbsp;Aytuğ Avşar,&nbsp;Ulaş Solmaz,&nbsp;Muzaffer Sancı,&nbsp;Tevfik Berk Bildacı","doi":"10.1007/s00404-025-07964-1","DOIUrl":"10.1007/s00404-025-07964-1","url":null,"abstract":"<div><h3>Purpose</h3><p>Investigating the impact of radiotherapy on urinary incontinence and pelvic floor dysfunction in endometrial cancer patients.</p><h3>Method</h3><p>A comparative study was conducted between endometrial cancer patients who underwent radiotherapy and those who did not receive adjuvant therapy. Patients were assessed during their first follow-up visit at third month post-radiotherapy or post-surgery. Demographic data and physical examinations were conducted, along with the administration of validated questionnaires. Turkish validated Incontinence Severity Index (ISI), Incontinence Impact Questionairre-7 (IIQ-7) and 20 ıtem Pelvic Floor Dysfunction Index (PFDI-20) were applied to the all patients.</p><h3>Results</h3><p>The study comprised 37 patients in the non-radiotherapy group and 41 patients in the radiotherapy group. Comparable demographics were observed between the two groups. Vaginal length was notably longer in the non-radiotherapy group, and the Q-tip test angle was significantly greater in this group. A higher incidence of stress urinary incontinence and higher scores on the Incontinence Severity Index were noted in the non-radiotherapy group. Conversely, the radiotherapy group exhibited significantly higher scores on the Pelvic Floor Dysfunction Index components and total score. Urogenital Distress Inventory scores were similar between the groups.</p><h3>Conclusion</h3><p>Radiotherapy showed mixed effects on pelvic floor function in endometrial cancer patients. While it potentially improved stress urinary incontinence, it was associated with unfavorable outcomes in overall pelvic floor dysfunction.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"1133 - 1139"},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07964-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063414","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":"Postoperative abdominopelvic adhesion and umbilical wound validation after single-port laparoscopy or two-port laparoscopy for gynecological surgery: a comparison with conventional laparoscopy.","authors":"Sang Wook Yi","doi":"10.1007/s00404-025-07951-6","DOIUrl":"https://doi.org/10.1007/s00404-025-07951-6","url":null,"abstract":"<p><strong>Purpose: </strong>The emergence of minimally invasive surgery has led to the development of laparoscopic surgery to reduce the number of ports. Although the incision for the umbilical port is sufficiently large, thus reducing the number of ports used during laparoscopic surgery, postoperative complications involving incisions at port sites have been reported. Thus, we analyzed postoperative intraperitoneal outcomes after laparoscopy by reviewing operation records and photographs of consecutive surgeries.</p><p><strong>Methods: </strong>A total of 134 patients were enrolled in the clinical study to analyze their intraperitoneal outcomes. The patients were divided into groups, which were compared and analyzed on the basis of the number of ports used intraoperatively. The clinical characteristics of the patients were obtained from their medical records, and their operation records, including those of their consecutive operations, were analyzed.</p><p><strong>Results: </strong>Patients who underwent single-port laparoscopy were included in Group 1, patients who underwent two-port laparoscopy were included in Group 2, and patients who underwent three-port laparoscopy or four-port laparoscopy were included in Group 3. Correlation analysis of the number of ports used during surgery revealed that the white blood cell count before and after surgery and the intraperitoneal umbilical adhesion score were negatively correlated. The incidence of intraperitoneal umbilical adhesions increased as the number of ports used during laparoscopy decreased.</p><p><strong>Conclusions: </strong>Because the incidence of postoperative intraperitoneal umbilical adhesion increases as the size of the umbilical wound increases, such as after single-port laparoscopy, surgical umbilical wounds should be cautiously repaired after single-port laparoscopic surgery.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063412","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 impact of updated imaging software on the performance of machine learning models for breast cancer diagnosis: a multi-center, retrospective study.","authors":"Lie Cai, Michael Golatta, Chris Sidey-Gibbons, Richard G Barr, André Pfob","doi":"10.1007/s00404-024-07901-8","DOIUrl":"https://doi.org/10.1007/s00404-024-07901-8","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial Intelligence models based on medical (imaging) data are increasingly developed. However, the imaging software on which the original data is generated is frequently updated. The impact of updated imaging software on the performance of AI models is unclear. We aimed to develop machine learning models using shear wave elastography (SWE) data to identify malignant breast lesions and to test the models' generalizability by validating them on external data generated by both the original updated software versions.</p><p><strong>Methods: </strong>We developed and validated different machine learning models (GLM, MARS, XGBoost, SVM) using multicenter, international SWE data (NCT02638935) using tenfold cross-validation. Findings were compared to the histopathologic evaluation of the biopsy specimen or 2-year follow-up. The outcome measure was the area under the curve (AUROC).</p><p><strong>Results: </strong>We included 1288 cases in the development set using the original imaging software and 385 cases in the validation set using both, original and updated software. In the external validation set, the GLM and XGBoost models showed better performance with the updated software data compared to the original software data (AUROC 0.941 vs. 0.902, p < 0.001 and 0.934 vs. 0.872, p < 0.001). The MARS model showed worse performance with the updated software data (0.847 vs. 0.894, p = 0.045). SVM was not calibrated.</p><p><strong>Conclusion: </strong>In this multicenter study using SWE data, some machine learning models demonstrated great potential to bridge the gap between original software and updated software, whereas others exhibited weak generalizability.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062872","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 effect of pregnancy vitamin D supplementation on maternal blood pressure: real-world data analysis within the MAVIDOS randomised placebo-controlled trial","authors":"Natasha L. Citeroni-Clark,&nbsp;Stefania D’Angelo,&nbsp;Sarah R. Crozier,&nbsp;Alexandra Kermack,&nbsp;Keith M. Godfrey,&nbsp;Cyrus Cooper,&nbsp;Nicholas C. Harvey,&nbsp;Rebecca J. Moon","doi":"10.1007/s00404-025-07958-z","DOIUrl":"10.1007/s00404-025-07958-z","url":null,"abstract":"<div><h3>Purpose</h3><p>Observational studies have suggested negative associations between maternal 25-hydroxyvitamin D (25(OH)D) status and risk of hypertensive disorders of pregnancy [pregnancy-induced hypertension (PIH) and preeclampsia (PET)]. Data from intervention studies are limited. We hypothesised that vitamin D supplementation would lower maternal blood pressure (BP) during pregnancy and reduce the incidence of hypertensive disorders of pregnancy.</p><h3>Methods</h3><p>The Maternal Vitamin D Osteoporosis Study (MAVIDOS) was a randomised placebo-controlled trial. Pregnant women with a baseline 25(OH)D of 25–100 nmol/l were randomized to either 1000 IU/day cholecalciferol or placebo from 14 to 17 weeks’ gestation until delivery. BP recordings documented during routine clinical pregnancy care were obtained from clinical records and grouped into gestational windows based on the schedule for routine antenatal care in the United Kingdom (23⁺⁰–24⁺⁶, 27⁺⁰–28⁺⁶, 33⁺⁰–35⁺⁶, 37⁺⁰–38⁺⁶, 39⁺⁰–40⁺⁶ and ≥ 41⁺⁰ weeks^+days). Systolic and diastolic BP measurements in these gestational windows were compared between randomisation groups. Diagnoses of PIH or PET (in accordance with national guidelines) and the use of antihypertensive agents were also noted and compared between groups.</p><h3>Results</h3><p>Data for 734 women (366 cholecalciferol, 368 placebo) were included. Maternal mean systolic and diastolic BP did not differ between the randomization groups at any of the gestations studied. The incidences of PIH (placebo 1.6%, cholecalciferol 3.6%, <i>p</i> = 0.10) and PET (placebo 3.3%, cholecalciferol 3.8%, <i>p</i> = 0.68) were similar between the two groups.</p><h3>Conclusions</h3><p>Gestational vitamin D supplementation with 1000 IU/day from 14 to 17 weeks gestation did not lower maternal BP or reduce the incidences of PIH or PET in this trial.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"941 - 949"},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07958-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063416","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":"Impact of epidural analgesia on outcomes of vaginal birth after cesarean delivery.","authors":"Tamar Eshkoli, Merav Jacobs, Alla Saban, Yael Baumfeld, Renana Ben Shushan-Amor, Zehava Yohay, Adi Y Weintraub","doi":"10.1007/s00404-025-07959-y","DOIUrl":"https://doi.org/10.1007/s00404-025-07959-y","url":null,"abstract":"<p><strong>Primary objective: </strong>To assess the association between Epidural Analgesia (EA) during Vaginal Birth After Cesarean (VBAC) and delivery mode (spontaneous or instrumental vaginal delivery). Secondary objectives include maternal and neonatal outcomes.</p><p><strong>Methods: </strong>In this retrospective population-based cohort study, all women who underwent a VBAC with and without EA, between the years 1996-2016 at the Soroka University Medical Center (SUMC) were included. Women who delivered by cesarean section (elective and non-elective) and those who gave birth to a newborn with chromosomal abnormalities or major malformations, and multifetal gestations were excluded. Demographical, clinical, and obstetrical characteristics were recorded, and pregnancy complications and adverse perinatal outcomes were compared between the groups. The primary outcome was the type of delivery. Univariate analysis was followed by a multivariate analysis to control for confounders. A p value of < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>During the study period, 17,516 women who have had a previous CS met the inclusion criteria, of which 15% (n = 2652) used EA during labor, while the rest of the cohort 85% (n = 14,864) were non-EA users. Women in the EA group had higher rates of instrumental delivery and postpartum hemorrhage (PPH) as well as higher rates of oxytocin augmentation and a longer second stage of labor. The use of EA was found to be an independent risk factor for instrumental delivery after controlling for maternal age, ethnicity, parity, DM (diabetes mellitus), hypertensive disorders of pregnancy, oxytocin augmentation, prolonged second stage of labor, induction of labor, fertility treatments and oligohydramnios. However, no significant differences were observed regarding neonatal outcomes including perinatal mortality, birth weight, Apgar scores and shoulder dystocia rates.</p><p><strong>Conclusion: </strong>EA for women undergoing a VBAC was associated with higher rates of instrumental delivery and PPH, oxytocin augmentation and a longer second stage of labor compared with women without EA. However, neonatal outcomes did not differ between the groups.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063472","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":"Comparisons among radiologist, MR findings and radiomics-clinical models in predicting placenta accreta spectrum disorders: a multicenter study.","authors":"Changyi Guo, Shunlin Guo, Chao He, Xirong Zhang, Dong Han, Hui Tan, Xiaoqi Huang, Yiming Li","doi":"10.1007/s00404-025-07960-5","DOIUrl":"https://doi.org/10.1007/s00404-025-07960-5","url":null,"abstract":"<p><strong>Objective: </strong>To assess and compare the diagnostic accuracy of radiologist, MR findings, and radiomics-clinical models in the diagnosis of placental implantation disorders.</p><p><strong>Methods: </strong>Retrospective collection of MR images from patients suspected of having placenta accreta spectrum (PAS) was conducted across three institutions: Institution I (n = 505), Institution II (n = 67), and Institution III (n = 58). Data from Institution I were utilized to form a training set, while data from Institutions II and III served as an external test set. Radiologist diagnosis was performed by radiologists of varying levels of experience. The interpretation of MR findings was conducted by two radiologists with 10-15 years of experience in pelvic MR diagnosis, following the guidelines for diagnosis. Radiomics analysis extracted features from sagittal T2-weighted images and combined them with prenatal clinical features to construct predictive models. These models were then evaluated for discrimination and calibration to assess their performance.</p><p><strong>Results: </strong>As measured by the area under the receiver operating characteristic curve (AUC), the diagnostic efficacy was 0.587 (0.542-0.630) for junior radiologists from Institution I, 0.568 (0.441-0.689) from Institution II, and 0.507 (0.373-0.641) from Institution III. The AUC was 0.623 (0.580-0.666) for senior radiologists from Institution I, 0.635 (0.508-0.749) from Institution II, and 0.632 (0.495-0.755) from Institution III. The diagnostic efficacy of MR findings was 0.648 (0.601-0.695) for Institution I, 0.569 (0.429-0.709) for Institution II, and 0.588 (0.442-0.735) for Institution III. The diagnostic efficacy of the radiomics-clinical model was significantly higher, with an AUC of 0.794 (0.754-0.833) for Institution I, 0.783 (0.664-0.903) for Institution II, and 0.816 (0.704-0.927) for Institution III. The diagnostic efficacy of the Fusion model was significantly higher, with an AUC of 0.867 (0.836-0.899) for Institution I, 0.849 (0.753-0.944) for Institution II, and 0.823 (0.708-0.939) for Institution III.</p><p><strong>Conclusion: </strong>The fusion models demonstrated superior diagnostic efficacy compared to radiologists, MR findings, and the radiomics-clinical models. Furthermore, the diagnostic accuracy of PAS was notably higher when utilizing the radiomics-clinical models than when relying solely on radiologist diagnosis or MR findings.</p><p><strong>Advances in knowledge: </strong>Radiomics analysis substantially augments the diagnostic precision in PAS, providing a significant enhancement over conventional radiologist and MRI findings. The diagnostic efficacy of the fusion model is notably superior to that of individual diagnostic modalities.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063470","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}