BMC Women's Health最新文献

{"title":"Impact of inflammatory bowel disease on perioperative complications in patients undergoing hysterectomy.","authors":"Haihua Liu, Lihui Chen, Nanfeng Huang, Zifeng Wang, Hao Xie, Ming Chen","doi":"10.1186/s12905-026-04670-1","DOIUrl":"10.1186/s12905-026-04670-1","url":null,"abstract":"<p><strong>Objective: </strong>The global prevalence of inflammatory bowel disease (IBD) is escalating rapidly, with its associated systemic inflammation and immune dysregulation potentially compromising surgical outcomes. Nevertheless, IBD's influence on perioperative complications following hysterectomy remains unreported. This investigation sought to examine the relationship between IBD and perioperative complications in hysterectomy patients utilizing the National Inpatient Sample database while analyzing associated risk factors.</p><p><strong>Methods: </strong>Data for patients who underwent hysterectomy between 2016 and 2022 were obtained from the National Inpatient Sample (NIS) database using International Classification of Diseases, Tenth Revision, Clinical Modification codes. Patients younger than 18 years were excluded. Patients were stratified according to the presence or absence of IBD, and demographic characteristics, hospital characteristics, comorbidities, and perioperative outcomes were compared between groups. Statistical analyses included Pearson's χ² test, Wilcoxon rank-sum test, and multivariable logistic regression.</p><p><strong>Results: </strong>Among 187,401 hysterectomy patients, 853 (0.46%) had comorbid IBD. The prevalence of IBD increased from 0.40% in 2016 to 0.51% in 2022. After multivariable adjustment, IBD was associated with higher odds of sepsis (OR = 3.060; 95% CI = 2.095-4.470), shock (OR = 3.031; 95% CI = 1.605-3.722), acute kidney injury (AKI) (OR = 1.643; 95% CI = 1.235-2.184), urinary tract infection (UTI) (OR = 1.882; 95% CI = 1.332-2.659), and in-hospital mortality (OR = 3.827; 95% CI = 1.855-7.893).</p><p><strong>Conclusions: </strong>IBD prevalence among hysterectomy patients increased over time. IBD was associated with higher odds of selected perioperative outcomes, including sepsis, shock, AKI, UTI, and in-hospital mortality. These associations should be interpreted cautiously given the retrospective administrative database design.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219703","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":"Health systems interventions for prevention of maternal peripartum infection in low and middle-income countries: a systematic review.","authors":"Roseline Abwao, Job Mapesa, Wanja Tenambergen, David Odada, Nasra Gathoni, Felix Riunga","doi":"10.1186/s12905-026-04710-w","DOIUrl":"10.1186/s12905-026-04710-w","url":null,"abstract":"<p><strong>Background: </strong>Globally, there is growing recognition that a functional health system is key to improving maternal health and reducing maternal mortality. Maternal peripartum infection remains a major cause of maternal morbidity and mortality, particularly in low- and middle-income countries. This infection is a multifaceted problem with many players. Adopting a health systems approach could help avert this preventable infection by addressing the gaps across all the components of care.</p><p><strong>Objective: </strong>The aim of this systematic review was to identify and evaluate interventions to prevent maternal peripartum infection in LMICs.</p><p><strong>Methods: </strong>A systematic search was conducted in Cochrane Library, CINAHL, MEDLINE (via PubMed) and Scopus, World Health Organization (WHO), and the National Institute for Health and Care Excellence (NICE) websites to identify primary articles reporting on interventions for preventing maternal peripartum infection using the PRISMA model. The article search was conducted for a period of 3 months (01/08/2022 to 30/10/2022). Search terms were \"Peripartum\", \"Infection\", \"Genital tract\", and their MESH terms. The inclusion criteria were primary interventional studies that reported interventions for the prevention of maternal peripartum infection, studies from LMICs, and those written in the English language. Cochrane Risk of Bias tools were used to appraise the quality of the studies.</p><p><strong>Results: </strong>Out of 1662 articles, 24 studies met the inclusion criteria comprising of 55,982 participants. The interventions were grouped into five domains: antibiotic prophylaxis 10(42%) of studies), self-care training 6 (25%), skin preparation 5 (21%), Traditional Birth Attendant training 2(2%) and use of Clean Delivery Kit 1(1%)0.11 studies reported a significantly lower risk of infection. Four studies reported a significantly improved knowledge and practice of women regarding maternal peripartum infection. While six studies reported no change in the risk of infection with the intervention.</p><p><strong>Conclusion: </strong>A range of interventions targeting maternal peripartum infection prevention in LMICs were identified in this review. They were all targeting a single intervention without integrating other system components. The review highlights the need for integrated health systems interventions and further research to generate stronger evidence and inform effective implementation.</p><p><strong>Study registration: </strong>PROSPERO CRD42022342550.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227361","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":"Beyond the floodwaters: women's multidimensional vulnerability to flood disasters - a scoping review.","authors":"Farah Khalida Abdul Rahman, Nor Aliya Ayub, Rozita Hod, Rosnah Sutan, Idayu Badilla Idris, Nurfashareena Muhamad","doi":"10.1186/s12905-026-04683-w","DOIUrl":"10.1186/s12905-026-04683-w","url":null,"abstract":"<p><strong>Background: </strong>Flood disasters, intensified by climate change, are increasing in frequency and severity globally, disproportionately affecting vulnerable populations, particularly women. Women's vulnerability during flood disasters extends beyond biological or physical differences and is shaped by broader social, economic, cultural, and institutional conditions. However, synthesised evidence on women's vulnerabilities in flood contexts remains limited.</p><p><strong>Methods: </strong>A scoping review was conducted using the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search of PubMed, Web of Science (WoS), and Scopus databases identified 19 studies published between 2020 and 2024 that met the predefined inclusion criteria. Studies were eligible if they examined women's vulnerabilities in the context of flood disasters and were original peer-reviewed articles. Data were extracted and analysed thematically to identify patterns and relationships among factors contributing to women's vulnerabilities.</p><p><strong>Results: </strong>Five interacting vulnerability domains were identified: physical (including sexual and reproductive health), social, psychological, economic, and environmental. Evidence across studies indicated that these domains are influenced by broader structural conditions such as gender norms, governance exclusion, and socioeconomic inequality, which may interact across exposure, sensitivity, and adaptive capacity to shape compounded gendered flood impacts. In addition, findings highlighted cross-domain patterns of adaptive capacity, where women employed context-specific strategies to respond to constrained conditions. Based on this synthesis, a conceptual framework was developed to illustrate how structural conditions relate to vulnerability processes, adaptive responses, and disaster outcomes.</p><p><strong>Conclusion: </strong>Women's vulnerability to flood disasters reflects a complex interplay of multidimensional risks shaped by gendered roles, socioeconomic disadvantage, limited resource access, and gaps in disaster planning and response. While caregiving responsibilities and health risks increase direct exposure, structural constraints may limit coping and recovery capacity. At the same time, adaptive capacity is actively expressed but often constrained and underrecognised within formal disaster systems. The proposed framework positions gender as a cross-cutting determinant and offers a conceptual lens for identifying policy entry points for gender-responsive disaster risk reduction.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547956","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":"Outcomes of first 60 vaginal myomectomies by one gyn surgeon with 20 years of extensive vaginal surgical expertise.","authors":"Eda Adeviye Şahin, Turan Şahin, Savaş Özgür Ağlamış, Arzu Bilge Tekin, Hanifi Şahin","doi":"10.1186/s12905-026-04715-5","DOIUrl":"10.1186/s12905-026-04715-5","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective single-center study based on prospectively collected data aimed to evaluate changes in operative performance during the initial experience with vaginal myomectomy.</p><p><strong>Methods: </strong>Sixty consecutive patients who underwent VM between January 2021 and December 2023 were included. Demographic features, FIGO-classified myoma characteristics, operative variables, and postoperative outcomes were recorded prospectively. To assess the LC, patients were divided chronologically into four groups of 15 cases. The primary objective was to evaluate changes in operative performance across consecutive cases. Operative time, estimated blood loss, hematocrit decrease, and hospitalization duration were used as measurable indicators of surgical progression, while the occurrence of major complications was assessed as a safety outcome. Groups were compared in terms of preoperative characteristics, intraoperative parameters, and postoperative outcomes.</p><p><strong>Results: </strong>The mean age and BMI of the patients were 38.1 years and 28.2 kg/m², respectively. Myoma number, diameter, and FIGO-based localization were similar across all groups (p > 0.05). No major intraoperative or postoperative complications occurred. Hematocrit drop and estimated blood loss were significantly higher in the first 15 cases compared to subsequent groups (p = 0.033 and p = 0.005). Operative time significantly decreased after the first 30 cases (p = 0.001), while length of hospital stay significantly shortened after the first 15 cases (p = 0.001). Transfusion rates did not differ between groups (p = 0.923).</p><p><strong>Conclusion: </strong>The findings suggest that improvements in bleeding parameters and hospitalization duration became apparent after approximately 15 procedures, whereas operative efficiency improved and appeared to stabilize after approximately 30-34 procedures. These observations should be interpreted within the context of the initial experience of an experienced vaginal surgeon rather than as universally applicable thresholds.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547941","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":"A predictive model for recurrence after hysteroscopic endometrial polypectomy: a combined analysis of clinical and ultrasound parameters.","authors":"Juanhui Shen, Liqin Liu","doi":"10.1186/s12905-026-04679-6","DOIUrl":"10.1186/s12905-026-04679-6","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a predictive model using clinical characteristics and ultrasound parameters to assess the 12-month recurrence risk following hysteroscopic endometrial polypectomy, and to explore the potential association between inflammation-related variables and recurrence.</p><p><strong>Methods: </strong>This single-center retrospective study enrolled 170 patients who underwent hysteroscopic endometrial polypectomy between March 2023 and December 2024 and completed 12 months of follow-up. Patients were divided into a recurrence group (n = 43) and a non-recurrence group (n = 127). Clinical characteristics, ultrasound parameters, and inflammation-related indicators were collected. Multivariate logistic regression was employed to identify independent risk factors for recurrence. Receiver operating characteristic curve analysis was conducted to assess the predictive performance of individual markers and the integrated model. Risk stratification was performed using the Youden index.</p><p><strong>Results: </strong>Multivariate analysis revealed that a history of polycystic ovary syndrome, increased endometrial thickness, and a higher number of polyps were independent predictors of postoperative recurrence (all P < 0.05). The combined predictive model demonstrated good performance, with an area under the curve of 0.8216. Following risk stratification, the high-risk group exhibited a substantially higher recurrence rate than the low-risk group (46.8% vs. 7.5%).</p><p><strong>Conclusion: </strong>The predictive model, integrating clinical and ultrasound-related factors, performed well in assessing recurrence risk after hysteroscopic endometrial polypectomy. It may serve as a useful tool for postoperative risk stratification and individualized follow-up management.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535293","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":"Fluid deficit-related complications in hysteroscopic surgery using normal saline as distension medium: a retrospective analysis of four surgical modalities and risk factors.","authors":"Ting Guo, Tianyuan Zhu, Rui Zhang, Luyang Zhang, Qihui Zheng, Haitao Jia, Zhiping Wang","doi":"10.1186/s12905-026-04701-x","DOIUrl":"10.1186/s12905-026-04701-x","url":null,"abstract":"<p><strong>Objective: </strong>To compare fluid deficit volumes across four hysteroscopic procedures using normal saline as distension medium, identify risk factors for excessive fluid deficit, and evaluate the impact of intrauterine pressure settings on fluid-related complications.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Department of Day Care, Gansu Provincial Maternity and Child-care Hospital (Gansu Provincial Central Hospital), a tertiary referral center.</p><p><strong>Participants: </strong>A total of 422 patients underwent hysteroscopic surgery for intrauterine lesions between January 2022 and January 2025, including 62 transcervical resection of adhesions (TCRA), 170 hysteroscopic endometrial resection (HER), 80 transcervical resection of septum (TCRS), and 110 transcervical resection of myoma (TCRM) procedures.</p><p><strong>Interventions: </strong>All procedures were performed using normal saline as distension medium. Intrauterine pressure was set at either 80 mmHg or 100 mmHg at the surgeon's discretion.</p><p><strong>Results: </strong>The primary outcome was distension fluid deficit volume. TCRM had the highest median absorption (700.0 mL, IQR 580-800) compared with TCRA (156.8 mL), HER (312.4 mL), and TCRS (278.5 mL) (P < 0.001). Fluid overload events (pulmonary edema or ICU admission) occurred exclusively in the TCRM group (5/110, 4.5%, P = 0.005). Exploratory ROC analysis suggested a candidate threshold of 750 mL for predicting fluid-related adverse events (AUC 0.741, 95% CI 0.641-0.842). However, given the limited number of fluid-related adverse events, a clinically relevant threshold of 1000 mL was used for the primary risk factor analysis. Multivariable logistic regression identified FIGO type 2 myoma (OR 3.60, 95% CI 1.01-12.81), operating time ≥ 60 min (OR 6.42, 95% CI 1.64-25.12), and distension pressure 100 mmHg (OR 4.64, 95% CI 1.32-16.32) were associated with excessive absorption in this exploratory analysis. However, the non-randomized assignment of pressure limits causal interpretation, and these findings require prospective validation.</p><p><strong>Conclusion: </strong>Transcervical resection of myoma (TCRM) is associated with the highest risk of fluid deficit among hysteroscopic procedures performed with normal saline. FIGO type 2 myoma, prolonged operative time, and higher distension pressure (100 mmHg) are independent predictors of excessive fluid deficit. These findings support the use of lower intrauterine pressure (80 mmHg) as a safe and cautious initial approach during TCRM. The candidate threshold for excessive fluid deficit identified in this study requires prospective validation.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547943","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":"Severe anemia and red cell product ordering burden among women hospitalized with benign uterine disorders: a retrospective cohort study using MIMIC-IV.","authors":"Haojie Zhang, Yan Cheng, Fangtao Zhu, Jia Shi, Weihua Huang, Haibin Yu","doi":"10.1186/s12905-026-04716-4","DOIUrl":"10.1186/s12905-026-04716-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Benign uterine disorders, including uterine leiomyomas and uterine endometriosis/adenomyosis-related conditions, are common causes of gynecologic morbidity and represent an important women's health issue. Although these conditions are generally non-malignant, a subset of hospitalizations may involve substantial anemia-related clinical burden. Evidence describing severe inpatient anemia, red cell product ordering, intensive care unit (ICU) use, and short-term hospital outcomes in this population remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective cohort study using hospital data from the Medical Information Mart for Intensive Care IV (MIMIC-IV). Adult female hospitalizations with diagnostic codes related to benign uterine disorders were identified. Hospitalizations with missing hemoglobin data, pregnancy- or obstetric-related diagnoses, and gynecologic malignancy-related diagnoses were excluded. The unit of analysis was hospitalization. Severe anemia was defined as a minimum inpatient hemoglobin level &lt; 8 g/dL during hospitalization. The main outcome was red cell product ordering identified from Blood Bank provider order entry records, which was interpreted as a transfusion-related resource use indicator rather than confirmed red cell administration. Additional hospital burden outcomes included hospital length of stay, ICU admission during hospitalization, in-hospital mortality, and gynecologic procedure-related outcomes. Multivariable logistic regression was used to evaluate the association of severe anemia with red cell product ordering and ICU admission. Models were adjusted for age, race/ethnicity, insurance status, marital status, admission type, and disease group. Sensitivity analyses used hemoglobin &lt; 10 g/dL as an alternative anemia threshold.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The final cohort included 1,860 non-obstetric, non-malignant hospitalizations with available hemoglobin data. Severe anemia was present in 425 hospitalizations (22.8%). Compared with hospitalizations without severe anemia, those with severe anemia had a higher proportion of red cell product orders (63.29% vs. 5.09%), longer hospital length of stay [3.436 (1.911-6.389) vs. 2.310 (1.335-3.816) days], and more frequent ICU admission during hospitalization (15.06% vs. 6.13%). In-hospital mortality was uncommon overall and was analyzed only exploratorily. After multivariable adjustment, severe anemia was associated with red cell product ordering [adjusted odds ratio (OR) 33.61, 95% confidence interval (CI) 24.23-47.29] and ICU admission during hospitalization (adjusted OR 2.69, 95% CI 1.84-3.91). In the fibroid-only subgroup, the corresponding adjusted ORs were 35.55 (95% CI 24.96-50.64) for red cell product ordering and 2.68 (95% CI 1.83-3.92) for ICU admission. Sensitivity analyses using hemoglobin &lt; 10 g/dL showed directionally consistent findings. Additional sensitivity analyses using earlier hemoglobin definitio","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535360","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":"Beyond visual inspection: can a multimodal machine learning model improve the preoperative differentiation of endometrial polyps from non-polypoid endometrial lesions?","authors":"Danli Ma, Zhiying Ye, Chuhan Wang, Huizhen Lin, Huimin Yu, Yingsha Yao","doi":"10.1186/s12905-026-04696-5","DOIUrl":"10.1186/s12905-026-04696-5","url":null,"abstract":"<p><strong>Objective: </strong>To develop a multimodal machine learning model that integrates clinical data and ultrasound features to improve the non‑invasive preoperative differentiation between endometrial polyps (EMPs) and non‑polypoid endometrial lesions (including polypoid hyperplasia and normal endometrial tissue).</p><p><strong>Methods: </strong>This single‑center retrospective cohort study included 913 patients with a preoperative diagnosis of endometrial polyp confirmed by postoperative pathology. Based on pathological findings, patients were categorized into a typical polyp group (n = 601) and a non‑polyp group (n = 312, consisting mainly of polypoid hyperplasia). Clinical baseline characteristics, transvaginal ultrasound (TVUS) features, and hysteroscopic observations were collected. Independent predictors were identified through multivariate analysis. Multiple prediction models-including logistic regression, decision tree, random forest, and gradient boosting decision tree (GBDT)-were constructed and evaluated using a 70:30 split into training and test sets.</p><p><strong>Results: </strong>No significant differences were observed between the two groups in baseline characteristics. Typical EMPs more frequently presented as focal masses on ultrasound (82.4% vs. 75.3%) and exhibited detectable intralesional blood flow (51.6% vs. 38.8%). Multivariate analysis identified endometrial thickness on ultrasound, the presence of ultrasound‑detected blood flow, and hysteroscopic visualization of vegetations as independent predictors. Among the tested models, the GBDT demonstrated the best discriminative performance, with an area under the receiver operating characteristic curve (AUC) of 0.727, outperforming the traditional logistic regression model (AUC = 0.599).</p><p><strong>Conclusion: </strong>Multimodal machine learning models, particularly GBDT, offer a potentially useful auxiliary tool for distinguishing EMPs from polypoid hyperplasia. However, their current diagnostic performance remains insufficient to support standalone clinical decision‑making. These findings highlight the limitations of existing non‑invasive methods and reinforce the necessity of histopathological confirmation. Future efforts should focus on incorporating more objective quantitative radiomic features to advance preoperative risk stratification.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535284","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":"Predicting women's intention to use contraceptives in East Africa: a machine learning analysis of predictors.","authors":"Andualem Addisu Birlie, Tamir Wondim Desta, Biruktawit Lelisa Eticha, Adisu Meles Kabtyimer, Altaseb Beyene Kassaw, Halid Worku Jemil, Tesfaye Deribe Bedada","doi":"10.1186/s12905-026-04705-7","DOIUrl":"10.1186/s12905-026-04705-7","url":null,"abstract":"<p><strong>Introduction: </strong>Intention to use contraceptives reflects an individual's or couple's plan to adopt contraceptive methods, supporting women's reproductive autonomy. It is associated with reduced unintended pregnancies, unsafe abortions, and high fertility rates, thereby improving maternal and infant health outcomes. Machine learning approaches can strengthen prediction accuracy and support evidence-based reproductive health planning. This study aimed to predict women's intention to use contraceptives in East Africa using machine-learning methods.</p><p><strong>Methods: </strong>We analyzed Demographic and Health Survey (DHS) data from 11 East African countries (2015-2024) in a community-based cross-sectional design. Country-specific sampling weights, stratification, and clustering were applied to account for the complex survey design. Missing data were imputed using the KNNImputer, and predictors were harmonized across surveys. Data preprocessing included cleaning, transformation, integration, and one-hot encoding, with an 80/20 train-test split. Seven machine learning algorithms were evaluated: adaptive boosting, CatBoost, random forest, light gradient boosting, extreme gradient boosting, logistic regression, and decision tree. Hyperparameters for CatBoost were tuned using Bayesian optimization under stratified 10-fold cross-validation. Model transportability was assessed using leave-one-country-out cross-validation.</p><p><strong>Results: </strong>Among 123,290 reproductive-age women in East Africa, 51.23% reported intention to use contraceptives. Boosted tree algorithms performed best, particularly CatBoost achieving the highest discrimination with an AUC of 80.09% and an accuracy of 73.48%. Leave-one-country-out cross-validation confirmed moderate transportability with an AUC 74%, while calibration analysis showed reliable probability estimates (Brier score 0.179). SHAP feature importance identified employment, education, age, hearing about family planning, pregnancy, breastfeeding, barriers to healthcare access, and fertility preference as the most influential predictors of contraceptive intention.</p><p><strong>Conclusion: </strong>This study provides a transparent, reproducible framework for pooled DHS prediction modeling, offering actionable insights for policymakers and health planners while serving as a methodological foundation for future applied work.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519914","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":"Robotic gynecologic surgery in Saudi Arabia: a descriptive retrospective cohort study of contemporary second-decade perioperative outcomes.","authors":"Khalid Akkour, Eman Alshehri, Hani Alhalal, Ali Bassi, Mujahid Bukhari, Mansour Alshamari, Assem Kalantan, Lolowah Alghuson, Ahmed Sherif Abdel-Hamid Abdel-Wahab, Amal El Shabrawy","doi":"10.1186/s12905-026-04684-9","DOIUrl":"10.1186/s12905-026-04684-9","url":null,"abstract":"<p><strong>Background/aim: </strong>Following early feasibility reports in 2010, this retrospective cohort study evaluates contemporary robotic gynecologic outcomes after ten years of institutional integration. We aim to assess perioperative safety and explore clinical trends associated with adverse events during this phase at a Saudi tertiary center.</p><p><strong>Patients and methods: </strong>A retrospective cohort study of robotic-assisted surgeries performed between January 2018 and December 2020 at King Saud University Medical City, Riyadh. Adult women (N=112) undergoing elective robotic surgery for benign (e.g., symptomatic fibroids, AUB) or malignant conditions were included. We excluded emergency cases, patients scheduled for primary open/laparoscopic approaches, and those with incomplete perioperative records. Data on demographics, surgical metrics (OR time, blood loss), and complications were analyzed using binary logistic regression (p < 0.05) to identify risk factors.</p><p><strong>Results: </strong>Among 112 patients (mean age 56.9 years, mean BMI 36.67 kg/m2), 72.3% had prior abdominal surgeries and 54.5% had multiple comorbidities. The conversion rate to laparotomy was 0%. Indications included abnormal uterine bleeding (28.6%), endometrial cancer (27.7%), and hyperplasia (17%). Median blood loss was 100 mL, and the mean operation duration was 142 minutes. Most patients (75.9%) were discharged within one day. Five complications occurred (4.5%): two gastrointestinal, two bladder injuries, and one hernia/obstruction. Univariate analysis identified potential exploratory associations between perioperative events and prior cesarean sections (p=0.048), blood loss (p=0.016), and operating room (OR) duration (p=0.005). Due to the low event rate (4.5%), a multivariate model could not reliably confirm independent risk factors.</p><p><strong>Conclusion: </strong>This second-decade experience demonstrates a high level of safety and technical feasibility in robotic gynecology. The zero conversion rate and low overall morbidity, even in high-BMI and multi-scarred patients, affirm robotic surgery as a dependable primary modality. The identified risk factors should be interpreted strictly as exploratory trends for perioperative planning rather than definitive predictors.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"26 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535346","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}