European journal of obstetrics, gynecology, and reproductive biology最新文献

{"title":"Exploring the impact of integrating telehealth in obstetric care: A scoping review","authors":"Mara Tormen ,&nbsp;Barbara Toniolo ,&nbsp;Lucia Pecci ,&nbsp;Giulia Soraci ,&nbsp;Cristina Taliento ,&nbsp;Pantaleo Greco ,&nbsp;Stefano Salvioli","doi":"10.1016/j.ejogrb.2024.09.031","DOIUrl":"10.1016/j.ejogrb.2024.09.031","url":null,"abstract":"<div><h3>Background</h3><div>The use of telemedicine has spread to all areas of medicine, including obstetrics, over the last few decades.</div></div><div><h3>Objective</h3><div>To identify and map the diversity and applicability of telemedicine in the obstetric literature, in the antenatal, intrapartum or postnatal period. To assess patient satisfaction and possible areas for future development.</div></div><div><h3>Methods</h3><div>This scoping review was conducted following the Joanna Briggs Institute (JBI) methodological guidelines for scoping reviews and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and its extension for scoping reviews (PRISMA-ScR). We searched the databases PubMed (Medline), CINAHL, CENTRAL (Cochrane Library), EMBASE Ovid and Scopus. We also searched Google Scholar, <span><span>clinicaltrial.gov</span><svg><path></path></svg></span>, the WHO International Clinical Trials Registry Platform (ICTRP-WHO) and the reference lists of the included studies. We included any primary study design that focused on a population of women in the antenatal, intrapartum or postnatal period. Studies selection and data extraction were performed blindly and independently by two authors. We summarised the results narratively and used graphs and tables to present key concepts thematically.</div></div><div><h3>Results</h3><div>We included 66 studies. We categorised the studies according to population, type of intervention, outcomes and user satisfaction. Most of the studies involved pathological (36%) and physiological (30%) pregnancy management, the type of intervention was mainly divided into televisits or video calls with professionals (43%) and the use of specific apps or devices (40%). The maternal outcomes studied were mainly quantitative, i.e., improvement in blood chemistry tests or vital parameters (65%) and treatment adherence (frequency of follow-up visits or keeping appointments, 27%). Patient satisfaction was positive in the majority of cases.</div></div><div><h3>Conclusions</h3><div>There is still little international agreement on the concept and possible applications of telemedicine in obstetrics, although it is increasingly being used in clinical practice. Studies have shown positive results in terms of improved care, particularly in terms of treatment adherence and as an alternative strategy in the management of pregnancy, postpartum and abortion care. Both patients and health professionals were satisfied with it, especially when offered as a complement or alternative to the traditional method of face-to-face visits. Future developments seem to be the time and cost-saving potential of telemedicine and its application to couples’ infertility.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 242-248"},"PeriodicalIF":2.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between fetal subcutaneous fat thickness and insulin resistance through cord blood analysis immediately after delivery","authors":"Sul Lee ,&nbsp;Hyun-Jin Kim ,&nbsp;Hyun-Joo Lee ,&nbsp;Eun-Hee Yu ,&nbsp;Hyung-Joon Yoon ,&nbsp;Seung-Chul Kim","doi":"10.1016/j.ejogrb.2024.09.024","DOIUrl":"10.1016/j.ejogrb.2024.09.024","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to determine whether fetal subcutaneous tissue (SCT) thickness, measured using ultrasound immediately before and after delivery, can reflect changes in glucose metabolism immediately after delivery. We also evaluated the impact of insulin resistance changes during pregnancy by comparing pregnant women with well-controlled gestational diabetes mellitus (GDM) and those with normal glucose metabolism.</div></div><div><h3>Study design</h3><div>The study participants were 117 pregnant women, including 97 controls and 20 patients with GDM who visited our obstetric clinic between February and December 2022. The participants were scheduled for cesarean delivery at a gestational age of ≥37 weeks. SCT thickness before delivery was measured using ultrasound and within 48 h after delivery using Holtain calipers. The glucose and insulin concentrations were quantified from cord blood collected immediately after delivery. Based on these results, a Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was performed to assess insulin resistance. Independent <em>t</em>-test or Wilcoxon rank-sum test for continuous variables and Fisher’s exact test for categorical variables were used to compare the various parameters. Correlations among the variables in each group were assessed by calculating the correlation coefficient (Pearson’s correlation).</div></div><div><h3>Results</h3><div>SCT thickness measured using ultrasound and calipers demonstrated a strong correlation where pregnant women with GDM exhibited thicker fetal SCT and neonate skinfolds than in those without GDM. Glucose and insulin levels in the cord blood were significantly elevated (p &lt; 0.05) in the gestational diabetic group, along with remarkable differences (p &lt; 0.001) in HOMA-IR. These variables indicated a higher prevalence of glucose intolerance in the neonates of mothers with GDM. In pregnant women with GDM, there was a statistically significant correlation between fetal abdominal SCT thickness and glucose levels (r = 0.64, p &lt; 0.01) and HOMA-IR (r = 0.48, p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Measuring the subcutaneous fat thickness of the fetus shortly before delivery is beneficial for predicting insulin resistance in neonates. This is considered particularly useful for women with effectively managed GDM, where the presence of conditions such as macrosomia may not be pronounced.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 325-331"},"PeriodicalIF":2.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of obstetric anal sphincter injury and mediolateral episiotomy with increasing birth weight and duration of second stage of labour in spontaneous vaginal delivery","authors":"J. van Bavel ,&nbsp;A.C.J. Ravelli ,&nbsp;J.P.W.R. Roovers ,&nbsp;A. Abu-Hanna ,&nbsp;B.W. Mol ,&nbsp;J.W. de Leeuw","doi":"10.1016/j.ejogrb.2024.09.021","DOIUrl":"10.1016/j.ejogrb.2024.09.021","url":null,"abstract":"<div><h3>Objectives</h3><div>Analysis of the association of mediolateral episiotomy (MLE) with obstetric anal sphincter injury (OASI) in women with spontaneous vaginal delivery.</div><div>Design.</div><div>Population-based cohort study with data from the Netherlands Perinatal Registry, describing 541 055 women who delivered a singleton live born infant in cephalic presentation spontaneously at term. Risk indicators for OASI were tested using univariate and multivariate analysis. Additional analysis for the interaction of MLE with other risk indicators was performed.</div></div><div><h3>Results</h3><div>The rate of OASI was 4.2 % in 215 241 nulliparous and 1.4 % in 325 814 multiparous women. In nulliparous and multiparous women MLE was associated with a reduction of OASI (adjusted OR (aOR) 0.3, 95 % CI 0.30–0.34 and aOR 0.32, 95 % CI 0.30–0.34).</div><div>The association of MLE with a reduced rate of OASI was stronger in high birthweight and in prolonged 2nd stage groups.</div><div>In nulliparous women, the number needed to treat (NNT) for the use of MLE to prevent one OASI is 31 in general. With MLE, the OASI rate reduced from 11.5 % to 2.9 with a NNT of 12 in the group with a birth weight ≥ 4000 g and a duration of the second stage of labour of 60–120 min. The NNT is 9 In the group with a birth weight ≥ 4000 g and a duration of the second stage of labour ≥ 120 min (reduction rate of OASI from 14.2 % to 3.5 %).</div></div><div><h3>Conclusions</h3><div>Use of MLE is associated with a reduction of OASI in spontaneous vaginal delivery.</div><div>In nulliparous women, an episiotomy with an anticipated birth weight &gt; 4000 g and a duration of the 2nd stage of more than 60 min should be considered.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 294-300"},"PeriodicalIF":2.1,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing precision in hysteroscopic surgery: The role of intraoperative ultrasound","authors":"Luís Ferreira de Castro ,&nbsp;Inês Santos ,&nbsp;Antonio Simone Laganà ,&nbsp;Bart de Vree ,&nbsp;Bruno J. van Herendael ,&nbsp;Dusan Djokovic","doi":"10.1016/j.ejogrb.2024.09.027","DOIUrl":"10.1016/j.ejogrb.2024.09.027","url":null,"abstract":"<div><div>Hysteroscopy stands as the gold-standard approach for managing intrauterine pathology. However, in complex clinical cases, hysteroscopic evaluation alone may prove insufficient for the safest and successful patient management. Intraoperative ultrasound (IOUS) has emerged as a valuable adjunct to hysteroscopic surgery, offering real-time visualization of endometrial cavity, uterine walls and instruments within the uterine cavity, enabling precise delineation of anatomical structures, and helping to assess the extent of pathology during intricate interventions. This review aims to comprehensively assess the applications, efficacy and utility of IOUS in hysteroscopic surgery.</div><div>Available evidence indicates that in hysteroscopic myomectomy, IOUS significantly reduces the risk of uterine perforation, particularly in submucosal FIGO 2 myomas, and enhances the likelihood of a single-step procedure. During hysteroscopic metroplasty, ultrasound guidance decreases the chance of incomplete uterine septum resection. In the hysteroscopic management of severe Asherman syndrome, IOUS reduces the risk of uterine perforation or false passage. For cesarean scar pregnancy (CSP), ultrasound is crucial in defining the most appropriate surgical approach and is effective in guiding the hysteroscopic treatment of endogenic CSP.</div><div>The use of IOUS in hysteroscopy proves valuable in complex cases where the risk of uterine perforation or incomplete procedure is increased.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 306-309"},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive, emotional, communicative, and motor development in children born from couple’s gametes cryopreserved oocytes. A 20 years single-center experience","authors":"Massimo Romano ,&nbsp;Federico Cirillo ,&nbsp;Miriam Comparini ,&nbsp;Valentina Immediata ,&nbsp;Andrea Busnelli ,&nbsp;Emanuela Morenghi ,&nbsp;Elena Albani ,&nbsp;Paolo Emanuele Levi-Setti","doi":"10.1016/j.ejogrb.2024.09.029","DOIUrl":"10.1016/j.ejogrb.2024.09.029","url":null,"abstract":"<div><h3>Objective</h3><div>To study if social and emotional, communicative, cognitive, motor development of children born from cryopreserved oocytes are comparable to general population.</div></div><div><h3>Design</h3><div>Survey study.</div></div><div><h3>Exposure</h3><div>This is a single-center population study, focusing on all children born from cycles of in vitro fertilization of cryopreserved oocytes at Humanitas Fertility Center from January 1st,2003, until December 31st, 2021.</div></div><div><h3>Main outcome measures</h3><div>General information about birth history were collected from all parents. Then, screening for developmental delay was performed by administration of a questionnaire, edited according to milestones set for age by the Center for Disease Control and Prevention.</div><div>Primary outcomes included the percentage of children, for each age range, that reached related milestones. In children younger than 6 years of age, milestones were considered to be reached by each age-based population subgroup studied when ≥ 75 % of included children expressed the tested competences.</div></div><div><h3>Results</h3><div>A total of 355 live births fulfilled the inclusion and exclusion criteria and were included in the study. Results showed that each age-based population subgroup, younger than 6 years of age, scored ≥ 75 % in all the milestones included in the questionnaire.</div><div>In preadolescents and adolescents, it was noted a decrease in unstructured in-person socializing. Indeed, milestones that scored the lowest values, based on parents’ judgement, included tasks concerning peer-to-peer interaction (72.31%) and sexuality and sentimental relationships (63.08%).</div></div><div><h3>Conclusions</h3><div>Results indicated that the achievement of emotional, communicative, cognitive, and motor milestones in infants, toddlers, and preschoolers was comparable to the general pediatric population. Similarly, emotional wellbeing and social engagement in school-aged children, preadolescents, and adolescents were in line with their peers.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 232-237"},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confocal Laser Endomicroscopy as a method for assessing endometriosis: A pilot study","authors":"Fernanda Okita ,&nbsp;Marina Paula Andres ,&nbsp;Renata de Almeida Coudry ,&nbsp;Luiza Gama Coelho Riccio ,&nbsp;Edmund Chada Baracat ,&nbsp;Maurício Simões Abrão","doi":"10.1016/j.ejogrb.2024.09.025","DOIUrl":"10.1016/j.ejogrb.2024.09.025","url":null,"abstract":"<div><h3>Objectives</h3><div>To validate probe-based Confocal Laser Endomicroscopy (pCLE) as a method in assessing endometriosis during conventional and robot-assisted laparoscopy.</div></div><div><h3>Study Design</h3><div>Pilot study, including five women in Hospital Moriah, São Paulo, Brazil. During laparoscopic procedures, pCLE was used to assess endometriosis lesions, complemented by subsequent histological evaluations. 214 optical biopsies were performed. These assessments contributed to the development of a comparative atlas, which was used by surgeons to respond to a questionnaire to identify specific cellular structures related to endometriosis in selected confocal images.</div></div><div><h3>Results</h3><div>The patients had an average age of 35, exhibiting predominant symptoms like dysmenorrhea and dyspareunia. Despite varied familiarity with pCLE, surgeons demonstrated positive acceptance of the method, with 63.1% recommending its use for intraoperative diagnosis. The technique was particularly noted for its ability to provide real-time, detailed images aiding the identification of endometriosis and associated structures like adipocytes and vascularization, with average evaluation scores exceeding 8 of 10.</div></div><div><h3>Conclusions</h3><div>This study underscores pCLE’s potential as a transformative diagnostic tool in minimally invasive gynecological surgery. It highlights the feasibility and initial acceptance among surgeons, emphasizing the need for further improvements in device durability and cost-effectiveness. pCLE promises significant advancements in the diagnosis and management of endometriosis, suggesting a future direction for clinical applications and technological refinement.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 225-231"},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated bioinformatic analysis reveals the gene signatures, epigenetic roles, and regulatory networks in endometriosis","authors":"Clara Riski Amanda ,&nbsp;Fadilah ,&nbsp;Andon Hestiantoro ,&nbsp;Raden Muharam ,&nbsp;Dwi Anita Suryandari ,&nbsp;Togas Tulandi ,&nbsp;Asmarinah","doi":"10.1016/j.ejogrb.2024.09.026","DOIUrl":"10.1016/j.ejogrb.2024.09.026","url":null,"abstract":"<div><h3>Objectives</h3><div>Endometriosis is a common gynecological disease with a significant economic burden. Growing evidence has suggested the role of aberrant gene expression and epigenetic mechanisms in the pathogenesis of endometriosis. This study aims to identify potential key genes, epigenetic features, and regulatory networks in endometriosis using an integrated bioinformatic approach.</div></div><div><h3>Methods</h3><div>Six microarray and RNA-sequencing datasets (GSE23339, GSE7305, GSE25628, GSE51981, GSE120103, GSE87809) were downloaded from the Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) of each dataset were analyzed using the GEO2R tool, and their mRNA, miRNA, and lncRNA components were identified subsequently. The common DEGs between datasets were combined, and the Gene ontology (GO) and pathway enrichment were analyzed using the ShinyGo. The protein–protein interaction (PPI) network of DEGs, miRNA, and lncRNA was constructed using STRING and Cytoscape, and then the top 15 hub genes in the PPI network were identified using CytoHubba.</div></div><div><h3>Results</h3><div>A total of 551 common DEGs were identified from four or more studies, including 292 upregulated and 259 downregulated genes. Besides alterations in protein-coding genes (mRNA), 16 miRNA (5 upregulated and 11 downregulated) were identified from all studies, along with 12 lncRNA (10 upregulated and 2 downregulated) that were common in at least three studies. Enriched DEGs were mainly associated with extracellular matrix (ECM) interaction, P53 signaling pathway, and focal adhesion, which are suggested to play vital roles in the pathogenesis of endometriosis. Through PPI network construction of common DEGs, 178 nodes and 683 edges were obtained, from which 15 hub genes were identified, including CDK1, CCNB1, KIF11, CCNA2, BUB1B, DLGAP5, BUB1, TOP2A, ASPM, CEP55, CENPF, TPX2, CCNB2, KIFC, NCAPG.</div></div><div><h3>Conclusions</h3><div>Our in-depth bioinformatics analysis reveals the critical molecular basis underlying endometriosis. The role of identified hub genes, miRNA, and lncRNA may also have an opportunity to be explored as potential biomarkers for endometriosis diagnosis and prognosis.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 216-224"},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validated predictive risk analyses for neonatal brain injury before birth","authors":"Arne Jensen ,&nbsp;Gerhard Neuhäuser","doi":"10.1016/j.ejogrb.2024.09.016","DOIUrl":"10.1016/j.ejogrb.2024.09.016","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 391-393"},"PeriodicalIF":2.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological impact of Placenta Accreta Spectrum disorders (PAS) and risk of Post-Traumatic Stress Disorder (PTSD): A cross-sectional study","authors":"Gonçalo Freitas ,&nbsp;Ana Lúcia Ramos ,&nbsp;Pedro Viana Pinto ,&nbsp;Ana Paula Machado ,&nbsp;Henrique Salgado ,&nbsp;Miguel Bragança ,&nbsp;Marina Moucho","doi":"10.1016/j.ejogrb.2024.09.023","DOIUrl":"10.1016/j.ejogrb.2024.09.023","url":null,"abstract":"<div><h3>Objective</h3><p>Placenta Accreta Spectrum disorders (PAS) are a group of obstetric complications with an increasing incidence. The high maternal and neonatal morbidity and mortality associated with PAS leads to concerns about the negative psychological impact, and even the risk of developing Post-Traumatic Stress Disorder (PTSD). The aim of this study was to assess the psychological impact of PAS diagnosis and intervention during pregnancy and postpartum and its potential association with PTSD.</p><p>STUDY DESIGN: A cross-sectional study was conducted, including cases of PAS FIGO grade 2 and 3 treated at University Hospital Center São João, between 2010–2023. Only cases with histopathological confirmation after peripartum hysterectomy were included. Data were obtained from electronic medical records (Sclinic® and Obscare®). The impact of Event Scale – Revised (IES-R), a validated questionnaire, was applied, after surgery for PAS, to assess the psychological impact of PAS diagnosis and treatment.</p></div><div><h3>Results</h3><p>Fourteen cases of PAS were identified. The mean maternal age was 36.8 years. Approximately 86 % of cases had antenatal suspicion. The mean gestational age at delivery was 34 weeks. Of the 14 women, only 11 responded to the request to participate in the study (7 interviewed in person and 4 remotely). Four women had IES-R scores indicative of high risk of PTSD (IES-R&gt;33 points), one had an intermediate risk (IES-R between 24–32 points), and 6 fell into the low-risk category. The mean score was 22.4 points. The analysis of IES-R results by clusters showed higher scores in the intrusion category, which relates to intrusive and unwanted thoughts, images and memories.</p></div><div><h3>Conclusion</h3><p>Given the high morbidity and mortality described in women with PAS, the risk of PTSD should be acknowledged, motivating early intervention to prevent the development of severe and potentially chronic symptoms. Supportive measures and psychiatric and/or psychological follow-up should be promptly implemented, ideally by multidisciplinary teams.</p></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 184-189"},"PeriodicalIF":2.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0301211524005189/pdfft?md5=e38d6f94f7af8115f82daacadd63d519&pid=1-s2.0-S0301211524005189-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Nrf2-Keap-1 pathway, Sestrin 2 and oxidative stress markers in serum of patients with placenta Accreata spectrum","authors":"Hafize Gökçe Gökdeniz ,&nbsp;Neslihan Tepe Bayramoglu ,&nbsp;Seyithan Taysi","doi":"10.1016/j.ejogrb.2024.09.022","DOIUrl":"10.1016/j.ejogrb.2024.09.022","url":null,"abstract":"<div><div>Placenta accreta spectrum (PAS) is an important disease group with risks such as maternal bleeding, hysterectomy, and death, which expresses the pathological adhesion of the placenta to the uterine myometrium, including placenta accreta, increta, and percreta, with an increased incidence with an increase in cesarean section rates. In this study, we aimed to investigate the Nuclear factor erythroid 2-related factor 2 (Nrf2)-Kelch-like ECH-related protein 1 (Keap1) pathway in these patients.</div><div>Serum Sestrin 2, Nrf2, Keap1, glycogen synthase kinase 3β (GSK-3β), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activities and malondialdehyde-modified low-density lipoprotein (MDA-LDL) levels were performed by the Enzyme-Linked Immunosorbent Assay (ELISA) method.</div><div>In the findings obtained, Nrf2, Keap1, GSK-3ß, MDA-LDL levels, SOD and GSH-Px activities were statistically significantly different in the patient group compared to the control group. While MDA-LDL values were found to be high in the patient group, Nrf2, Keap1, GSK-3ß levels, SOD and GSH-Px activities were significantly lower, except for Sestrin 2 values. In addition, when grouped according to the degree of invasion, Nrf2 levels were found to be lower and Keap1 levels higher.</div><div>As a result, it was determined that the Nrf2-Keap1 pathway was disrupted in PAS patients, and the oxidant/antioxidant balance was impaired in the oxidant direction. The results show that Nrf2 and Keap1 parameters can be useful in determining the degree of placental invasion.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 211-215"},"PeriodicalIF":2.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}