Archives of Gynecology and Obstetrics最新文献

{"title":"The correlation between blastocyst morphological parameters and chromosomal euploidy, aneuploidy and other chromosomal abnormalities following pre-implantation genetic testing—a single center retrospective study","authors":"Alyssa Hochberg,&nbsp;Liliane Amoura,&nbsp;Xiao Yun Zhang,&nbsp;Li Zhang,&nbsp;Michael H. Dahan,&nbsp;Asangla Ao","doi":"10.1007/s00404-025-07968-x","DOIUrl":"10.1007/s00404-025-07968-x","url":null,"abstract":"<div><h3>Purpose</h3><p>To examine the association between blastocyst morphology and chromosomal status utilizing pre-implantation genetic testing for aneuploidy (PGT-A).</p><h3>Methods</h3><p>A single-center retrospective cohort study including 169 in-vitro fertilization cycles that underwent PGT-A using Next Generation Sequencing (2017–2022). Blastocysts were morphologically scored based on Gardner and Schoolcraft’s criteria. Chromosomal analysis results included: euploid; aneuploid (single or double); segmental; mosaic; and complex (≥ 3 chromosome abnormalities). We examined associations between morphological parameters and chromosomal statuses of biopsied embryos utilizing multivariate logistic regression.</p><h3>Results</h3><p>Overall, 855 blastocysts underwent PGT-A (PGT-A alone: N = 804; unaffected PGT for monogenic disease (PGT-M) embryos along with PGT-A: N = 51). Of these, 826 were successfully analyzed, with 321 euploid embryos (38.86%). Various morphological parameters (embryo quality, inner cell mass (ICM), trophectoderm (TE), and expansion stage) were more frequent within the double (n = 72, 8.72%), complex (n = 97, 11.74%), mosaic (n = 139, 16.83%), and segmental aneuploidy (n = 28, 3.39%) groups, with similar associations between different morphological parameters and single aneuploidy (n = 169, 20.46%). Utilizing multivariate logistic regression, higher expansion, embryo quality, and TE and ICM grades, were associated with increased odds of euploidy (versus non-euploidy). Higher expansion was a positive predictor of single versus double aneuploidy (aOR 2.94, 95% CI 1.52–5.56, p = 0.001); and higher ICM grade was a positive predictor of single versus complex aneuploidy (aOR 2.86, 95% CI 1.15–7.12, p = 0.024). No morphological parameter was found to be associated with single versus mosaic aneuploidy.</p><h3>Conclusion</h3><p>Various morphological parameters are associated with euploidy and different aneuploidy statuses of pre-implantation blastocysts. These findings may aid in the selection of the assumed best chromosomally structured blastocyst for transfer when PGT-A is not performed.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"827 - 839"},"PeriodicalIF":2.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07968-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057476","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 role of D-dimer changes in predicting delivery time in preterm premature rupture of membranes: a retrospective analysis","authors":"Gizem Aktemur,&nbsp;Betül Tokgöz Çakır,&nbsp;Gülşan Karabay,&nbsp;Can Ozan Ulusoy,&nbsp;Zeynep Seyhanlı,&nbsp;Serap Topkara Sucu,&nbsp;Nazan Vanlı Tonyalı,&nbsp;Can Tekin İskender","doi":"10.1007/s00404-025-07940-9","DOIUrl":"10.1007/s00404-025-07940-9","url":null,"abstract":"<div><h3>Introduction</h3><p>Pregnancy induces a hypercoagulable state, characterized by increased coagulation factors and decreased anticoagulants, alongside ongoing fibrinolysis marked by elevated D-dimer (DD) levels. Reference values for DD in pregnancy often exceed the non-pregnant cutoff due to these changes. Elevated DD levels are common in late pregnancy and may correlate with complications such as gestational diabetes, hypertension, and preterm delivery, particularly in cases of preterm premature rupture of membranes (PPROM). This study investigates the association between DD levels, the duration from PPROM diagnosis to delivery, and neonatal outcomes.</p><h3>Methods</h3><p>This retrospective study was conducted at the Department of Perinatology, Etlik City Hospital, Ankara, Turkey, from October 2022 to May 2023. Eighty patients with PPROM between 24 and 36 weeks of gestation were included. Routine blood tests and coagulation parameters, including DD, were monitored every other day for 2 weeks. Patients were classified into two subgroups based on whether labor occurred within 7 days of PPROM diagnosis. Statistical analyses included the Mann–Whitney <i>U</i> test, Student’s <i>t</i> test, Chi-square test, Friedman test, Durbin–Conover test, generalized estimating equations (GEE), and ROC analysis.</p><h3>Results</h3><p>Gestational age at admission was significantly lower in patients who delivered later than 7 days post-PPROM. Significant differences were observed in ultrasonographic measurements, with larger fetal parameters in the early delivery group. Higher DD levels at the third follow-up correlated with shorter durations to delivery (<i>p</i> = 0.021). Longitudinal analysis showed significant fluctuations in DD levels over time, particularly near delivery. The GEE analysis demonstrated a strong inverse relationship between DD levels and time to delivery (<i>p</i> = 0.004), supported by ROC analysis (AUROC = 0.811).</p><h3>Conclusions</h3><p>Elevated DD levels are associated with shorter durations from PPROM diagnosis to delivery, indicating their potential utility in predicting labor onset. Monitoring DD levels may help in clinical decision-making for managing PPROM, including planning neonatal care and timing of interventions.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 2","pages":"323 - 331"},"PeriodicalIF":2.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07940-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051024","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":"Fasting glucose levels at diagnosis and delivery are associated with postpartum glucose abnormalities in GDM women","authors":"Ying Gu,&nbsp;Yu Chen,&nbsp;Lingli Hu,&nbsp;Sha Chen,&nbsp;Lin Wang,&nbsp;Mengting Chen,&nbsp;Yanfang Gu,&nbsp;Qi Chen","doi":"10.1007/s00404-025-07953-4","DOIUrl":"10.1007/s00404-025-07953-4","url":null,"abstract":"<div><p>Women with a history of gestational diabetes mellitus (GDM) significantly increase the risk of developing type 2 diabetes later in life. Although the increased glucose levels typically return to normal range after delivery for most GDM women, a significant proportion of GDM women develop impaired glucose tolerance or overt diabetes after delivery. Several factors associated with postpartum glucose abnormalities have been identified, yet the link between fasting glucose levels at diagnosis of GDM and postpartum glucose abnormalities remains unclear. In this retrospective study with 866 GDM women, we found that 12.5% presented with abnormal postpartum fasting glucose levels (prediabetes). Among those with postpartum fasting glucose abnormalities (n = 109), 63 (57%) women had abnormal fasting glucose levels at diagnosis, indicating an odds ratio of 1.662 (95% CI: 1.12, 2.479, p &lt; 0.001) for these GDM women developing postpartum fasting glucose abnormalities, compared to those GDM women with normal postpartum fasting glucose levels. Additionally, of GDM women with abnormal postpartum glucose levels (n = 109),70 (64%) presented with abnormal fasting glucose levels one day before delivery. The odds ratio for these GDM women presenting with abnormal postpartum fasting glucose levels was 3.751 (95% CI: 2.462, 5.664, p &lt; 0.001) compared to those GDM women with normal postpartum fasting glucose levels. Furthermore, GDM women with additional insulin treatment or delivered an LGA infant significantly increased the risk of developing postpartum fasting glucose abnormalities. Our findings suggest that abnormal fasting glucose levels at diagnosis or shortly before delivery could be a predictive indicator for postpartum glucose abnormalities in GDM women.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"633 - 638"},"PeriodicalIF":2.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-025-07953-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051342","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":"Comparison of MRI findings for predicting massive hemorrhage during cesarean section in patients with placental malposition: partial placental volume of lower uterine segment is an accurate and objective indicator","authors":"Hiroshi Kuwamura,&nbsp;Takero Terayama,&nbsp;Fumiko Hamabe,&nbsp;Hiromi Edo,&nbsp;Kenta Matsuda,&nbsp;Morikazu Miyamoto,&nbsp;Masashi Takano,&nbsp;Hiroshi Shinmoto","doi":"10.1007/s00404-024-07909-0","DOIUrl":"10.1007/s00404-024-07909-0","url":null,"abstract":"<div><h3>Purpose</h3><p>To comprehensively compare the diagnostic ability and inter-reader agreement of magnetic resonance imaging (MRI) findings for predicting massive hemorrhage after cesarean section in patients with placental malposition, aiming to identify the most reliable and objective indicators.</p><h3>Methods</h3><p>Totally, 148 consecutive patients with placental malposition underwent MRI and cesarean section at our hospital between January 2014 and July 2021. The patients were divided into massive and non-massive hemorrhage groups. MRI findings of placenta accreta, placental position, and placental volume were evaluated by two radiologists, and inter-reader agreement was calculated. Diagnostic ability for predicting massive hemorrhage was evaluated using receiver operating characteristic analysis.</p><h3>Results</h3><p>Intraplacental T2 dark bands (100% vs. 58.2%, <i>p</i> = 0.001), placental bulge (50% vs. 3.7%, <i>p</i> &lt; 0.001), loss of retroplacental T2 hypointense line (100% vs. 67.2%, <i>p</i> = 0.01), myometrial thinning (92.9% vs. 57.5%, <i>p</i> = 0.009), total placenta previa (64.3% vs. 23.9%, <i>p</i> = 0.033), and anterior placenta (35.7% vs. 10.5%<i>, p</i> = 0.02) were significantly observed in massive hemorrhage group. Partial placental volume of lower uterine segment (PV_partial) was larger in massive hemorrhage group (166 [108–214] cm³ vs. 70 [43–112] cm³ <i>p</i> &lt; 0.001), had the second highest intraclass correlation coefficient (0.84), and had the highest area under the curve (0.81) for diagnosing massive hemorrhage.</p><h3>Conclusion</h3><p>This study revealed PV_partial is an accurate and objective indicator for massive hemorrhage, independent of radiologists’ experience. This indicator potentially enables prediction of massive hemorrhage, improving pre-operative planning in high-risk pregnancies.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 5","pages":"1285 - 1295"},"PeriodicalIF":2.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07909-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051341","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":"Maternal cell-free DNA in early pregnancy for preeclampsia screening: a systematic review","authors":"Svitlana Arbuzova,&nbsp;Howard Cuckle","doi":"10.1007/s00404-024-07905-4","DOIUrl":"10.1007/s00404-024-07905-4","url":null,"abstract":"<div><h3>Purpose</h3><p>To quantify the separation between maternal blood cell-free (cf)DNA markers in preeclampsia and unaffected pregnancies and compare with existing markers. This approach has not been used in previous studies.</p><h3>Methods</h3><p>Comprehensive systematic literature search of PubMed to identify studies measuring total cfDNA, fetal cf(f)DNA or the fetal fraction (FF) in pregnant women. Included—studies of asymptomatic pregnancies with subsequent preeclampsia (cases) and unaffected pregnancies (controls) tested in the first or second trimester and before the clinical onset of preeclampsia. Excluded—studies not reporting the median or mean, standard deviation, inter-quartile range or range in cases and controls. Information from 26 eligible studies was entered into a meta-analysis to estimate, for each marker, the Mahalanobis distance, a measure of separation between the overlapping distributions in preeclampsia and unaffected pregnancies. This was compared with estimates for mean arterial pressure (MAP), uterine artery Doppler pulsatility index (UtA-PI), pregnancy associated plasma protein (PAPP)-A and placental growth factor (PlGF).</p><h3>Results</h3><p>The mean Mahalanobis distance for total cfDNA was 0.44 (95% CI 0.12–0.76), which fell between UtA-PI (0.53) and the absolute value of PAPP-A (– 0.36). For cffDNA the distance was 1.03 (0.37–1.69), which is superior to MAP (0.74), UtA-PI, PlGF (– 0.57) and PAPP-A. The distance for FF was – 0.34 (– 0.56 to – 0.12), similar to PAPP-A.</p><h3>Conclusion</h3><p>All three markers have a potential preeclampsia screening role, particularly cffDNA. However, to estimate the screening performance in combination with existing markers further large studies are needed. The current analysis will help in the power calculation for such studies.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 5","pages":"1249 - 1258"},"PeriodicalIF":2.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07905-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051343","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 outcome of early perineal rehabilitation in obstetric anal sphincter injuries: a single-center experience.","authors":"Martina Arcieri, Ginevra Battello, Annalisa Graziano, Matteo Alfarè Lovo, Stefano Restaino, Francesco D'Antonio, Alessandro Lucidi, Michela Segatti, Marina Comuzzi, Elisa Barbui, Chiara Carpenedo, Emanuele Biasutti, Lorenza Driul, Giuseppe Vizzielli","doi":"10.1007/s00404-024-07906-3","DOIUrl":"https://doi.org/10.1007/s00404-024-07906-3","url":null,"abstract":"<p><strong>Purpose: </strong>The objective of this study is to evaluate the impact of pelvic floor physical therapy (PFPT) on symptoms and quality of life in women who experienced third- and fourth-degree perineal tears (Obstetric Anal Sphincter Injuries, OASIS) during childbirth. OASIS can lead to anal incontinence and dyspareunia, having important implications regarding the quality of life and health of women but, unfortunately, there is no standard practice for postpartum care following OASIS.</p><p><strong>Methods: </strong>In this retrospective observational study, patients diagnosed with OASIS between January 2016 and June 2023 were enrolled. Since 2016, all women with OASIS have been routinely referred for physiatric evaluation and pelvic floor rehabilitation. Validated questionnaires (Wexner score and Marinoff scale) were administered to enrolled women to assess anal incontinence and dyspareunia.</p><p><strong>Results: </strong>The study included 148 women, of whom 88 responded to the questionnaires. Participants were divided into two groups: those who underwent PFPT (N = 68) and those who declined it (N = 20). The mean follow-up period was 1447.35 days. The Wexner score was lower in the PFPT group compared to the no-PFPT group (p = 0.050). The Marinoff score did not show a statistically significant difference between the two groups (p = 0.381).</p><p><strong>Conclusion: </strong>PFPT was shown to be effective in reducing AI symptoms in women with OASIS, improving quality of life and maintaining its effects in the long term, but without providing benefits for dyspareunia. Strengths of this study include the use of validated questionnaires, the long follow-up period, and the involvement of a specialized team of physiatrists and physiotherapists.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045452","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":"Impact of a new image enhancement technology on the nuchal translucency thickness.","authors":"Tania Elger, Natalia Prodan, Kristina Bettecken, Jiri Sonek, Karl Oliver Kagan","doi":"10.1007/s00404-024-07924-1","DOIUrl":"https://doi.org/10.1007/s00404-024-07924-1","url":null,"abstract":"<p><strong>Objective: </strong>To examine the impact of a new image enhancement technique on the distribution of NT measurements.</p><p><strong>Methods: </strong>In this retrospective study, nuchal translucency (NT) images that were taken with the GE Voluson E22 ultrasound machine between May and September 2024 were collected. One operator took manual and automated NT measurements in an NT image without radiant enhancement mode followed by automated measurements in NT images with minimum, medium and maximum radiant mode. The automated measurement in the NT images without radiant mode were considered gold standard. The relative bias of the gold standard, the manual measurement and the automated measurements with the radiant enhancement technology were compared using median and 25-75th interquartile range as well as by the Wilcoxon test.</p><p><strong>Results: </strong>The database search yielded 352 NT images from 101 pregnant women. Average maternal age of the study population was 34.0 years and average crown-rump length was 68.3. The median NT thickness was 1.7 mm for both the manual and automated measurements done without the use of radiant mode. The median automated measurement with minimum, medium and maximum radiant mode was 2.00, 2.05 and 2.10 mm, respectively. All automated measurements were significantly higher than the gold standard.</p><p><strong>Discussion: </strong>The use of the radiant mode results in an increase in the NT thickness. This effect should be taken into account when calculating the risk for chromosomal abnormalities.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036257","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 complications and surgery outcomes in skin closure methods following cesarean sections.","authors":"Daniel Gabbai, Chen Jacoby, Itamar Gilboa, Sharon Maslovitz, Yariv Yogev, Emmanuel Attali","doi":"10.1007/s00404-024-07911-6","DOIUrl":"https://doi.org/10.1007/s00404-024-07911-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the impact of absorbable subcutaneous staples for skin closure in cesarean delivery (CD) on maternal morbidity.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a single tertiary university-affiliated medical center between January 2011 and April 2022. In 2020, a new technique involving absorbable subcutaneous staples for skin closure in CD was introduced. We compared surgical outcomes among three groups: non-absorbable staples, absorbable subcutaneous staples, and absorbable subcutaneous sutures. Data were compared between the three groups and demographic, obstetric, and surgical characteristics were analyzed using univariate and multivariate analysis.</p><p><strong>Results: </strong>During the study period, 31,660 CDs were performed in our center. The data of 31,419 CDs were available for analysis. Absorbable subcutaneous staples were associated with a significantly shorter surgery time in comparison to non-absorbable staples and sutures (52 min vs 53 min vs 60 min, p < 0.001). No differences were found in rates of wound infections or any surgical site surgery in the 45 days following CD. In a multivariate analysis: the use of absorbable subcutaneous staples was associated with a significantly lower risk for prolonged hospitalization > 5 days (OR 0.6, p < 0.001) and re-admission within 45 days (OR 0.8, p = 0.04).</p><p><strong>Conclusion: </strong>The use of absorbable subcutaneous staples for skin closure during CD is associated with shorter surgery times and a lower risk of prolonged hospitalization and readmission within 45 days.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036255","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":"Unmet clinical needs in women with polycystic ovary syndrome regarding fertility and obesity: a cross-sectional study from the patient’s perspective","authors":"Annette Bachmann,&nbsp;Susanna Weidlinger,&nbsp;Michael von Wolff,&nbsp;Norman Bitterlich,&nbsp;Thomas Karn,&nbsp;Julia Estermann,&nbsp;Marina Sourouni,&nbsp;Petra Stute","doi":"10.1007/s00404-024-07916-1","DOIUrl":"10.1007/s00404-024-07916-1","url":null,"abstract":"<div><h3>Purpose</h3><p>Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age, often leading to anovulatory infertility. Obesity exacerbates the reproductive, metabolic and psychological features of PCOS, making fertility treatment and patient satisfaction difficult. Despite guidelines from the European Society of Human Reproduction and Embryology (ESHRE) emphasizing lifestyle modifications and specific treatments, there remains a significant gap in adherence to these guidelines by both healthcare providers and patients.</p><h3>Methods</h3><p>A cross-sectional online survey was conducted from 1 January to 14 March 2021 among PCOS patients in Germany, Austria and Switzerland. A non-standardized, non-validated questionnaire covering several aspects of reproductive health was distributed via online channels. Data were analyzed using descriptive statistics, chi-squared tests, Student’s t-tests and Jonckheere-Terpstra tests, with significance set at p &lt; 0.05.</p><h3>Results</h3><p>Out of 2029 participants, 1902 completed the fertility questionnaire. Of these, 73.9% perceived their fertility to be impaired, with this perception being higher in obese women (80.8% vs. 67.4%, p &lt; 0.001). The analysis focused on 564 childless women with a current desire to have children, 67.0% of whom met WHO criteria for infertility. Obese women (BMI ≥ 30 kg/m²) reported lower satisfaction with fertility treatment (40.9 vs. 47.8, p = 0.009) and were less likely to receive fertility treatment (56.7% vs. 75.8%, p &lt; 0.001). Despite recommendations, only 34.1% reported lifestyle changes as part of their treatment. Letrozole, the recommended first-line treatment, was underused (14.6%) and clomiphene citrate was more commonly prescribed (35.4%). Obese women reported fewer current pregnancies (4% vs. 13.9%, p &lt; 0.001) and were more likely to be infertile for more than one year (77.0% vs. 53.0%, p &lt; 0.001). They also expressed a greater desire for possibilities to ask more questions about PCOS and fertility and to undergo more infertility tests. (56.1% vs. 45.3%, p = 0.013; 69.4% vs. 59.8%, p = 0.020).</p><h3>Conclusions</h3><p>Fertility management in PCOS patients, especially in obese patients, shows significant gaps in adherence to recommended guidelines, highlighting the need for improved patient education, professional training and individualized treatment strategies. Improved health care is essential to address reproductive concerns and improve outcomes in this population.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 3","pages":"851 - 859"},"PeriodicalIF":2.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07916-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036261","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 intrapartum deinfibulation on obstetric outcomes and postpartum sexual function in pregnant women with Type 3 Female Genital Mutilation/Cutting","authors":"Yaşam Kemal Akpak,&nbsp;Erhan Aktürk,&nbsp;Serkan Oral,&nbsp;Mehmet Ferdi Kıncı,&nbsp;Ahkam Göksel Kanmaz,&nbsp;Mehmet Bora Bozgeyik,&nbsp;Emrah Töz","doi":"10.1007/s00404-024-07923-2","DOIUrl":"10.1007/s00404-024-07923-2","url":null,"abstract":"<div><h3>Purpose</h3><p>Female Genital Mutilation/Cutting (FGM/C) is a surgical intervention that is still performed in large numbers worldwide and has severe effects in terms of both obstetric and sexual consequences. Due to the increase in immigration, it has become more frequent in many countries. This study aims to compare the labor performance, complications, and postpartum sexual function of Type 3 Female Genital Mutilation/Cutting (FGM/C) pregnant women undergoing deinfibulation with Type 3 FGM/C patients without deinfibulation.</p><h3>Methods</h3><p>This is a prospective study of pregnant women with Type 3 FGM/C and puerperium patients at Nyala Turkish Training and Research Hospital in Sudan over 4 years, from September 2018 to September 2022. Type 3 FGM/C patients who underwent deinfibulation were compared with those who did not, considering age, parity, and obstetric and neonatal outcomes and the Female Sexual Function Index (FSFI) scores at 3 months.</p><h3>Results</h3><p>In our homogeneous Type 3 FGM/C group mainly consisting of primiparous women, it was found that more episiotomy procedures were performed. The second stage of labor was significantly prolonged, and perineal damage was greater in the group without deinfibulation. In addition, postpartum hemorrhage and hospitalization of mother and baby were longer in the group without deinfibulation. In the second part of our study, we compared the FSFI scores between the deinfibulation group and the episiotomy subgroup. The results indicated that the deinfibulation group exhibited higher scores across all FSFI domains.</p><h3>Conclusion</h3><p>Type 3 FGM/C is definitely associated with poor obstetric and sexual outcomes. It is essential to include partners in family discussions and to protect the perineum by performing deinfibulation and episiotomy at appropriate times and in the correct manner during labor.</p><h3>What does this study adds to the clinical work</h3><p>The contribution of the deinfibulation procedure, which is recognized for its obstetric benefits, should also be communicated to families and spouses in terms of its long-term impact on sexual performance. By sharing this information, the devastating effects of Female Genital Mutilation/Cutting (FGM/C) can be mitigated, both obstetrically and sexually.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":"311 4","pages":"933 - 940"},"PeriodicalIF":2.1,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07923-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036259","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}