Pub Date : 2026-02-20Epub Date: 2026-01-05DOI: 10.1016/j.ejogrb.2026.114941
Bixiu Du , Yaru Yang , Lang He , Ying Tang
Infertility constitutes a major global health concern, affecting approximately 17.5% of couples of reproductive age. Although advances in assisted reproductive technologies (ART) have expanded treatment options, success rates remain highly variable due to host-specific and biological determinants. This review synthesizes current evidence on the reproductive impact of the human microbiota and its translational relevance to ART outcomes. Vaginal microbial communities dominated by Lactobacillus, particularly L. crispatus, are associated with improved conception and implantation, whereas genital or intestinal dysbiosis correlates with infertility and suboptimal treatment responses. The microbiota modulates reproductive competence through intertwined immune, endocrine–metabolic, and mucosal barrier pathways that regulate inflammation, hormonal balance, and epithelial integrity. Emerging findings indicate that gut microbial alterations linked to polycystic ovary syndrome (PCOS) and endometriosis are accompanied by insulin resistance and chronic inflammation, impairing ovulation, endometrial receptivity, and embryo viability. Interventions such as probiotics and synbiotics yield heterogeneous efficacy; individualized antimicrobial strategies, metabolic modulation, and lifestyle optimization may offer complementary benefit, while microbiota reconstruction remains experimental. Methodological limitations, including contamination in low biomass samples, variations in sequencing workflows, and population heterogeneity, still hinder data comparability and mechanistic interpretation. Future research should prioritize adequately powered randomized controlled trials using standardized microbiome metrics and live birth as a primary endpoint. Integrating microbiome profiling into ART workflows may refine patient stratification and inform precision adjuvant therapies. However, clinical implementation requires stronger causal evidence, validated biomarkers, and harmonized methodological frameworks to translate microbiome discoveries into reproducible reproductive gains.
{"title":"Microbiota and infertility: a translational review of mechanisms and clinical applications in assisted reproduction","authors":"Bixiu Du , Yaru Yang , Lang He , Ying Tang","doi":"10.1016/j.ejogrb.2026.114941","DOIUrl":"10.1016/j.ejogrb.2026.114941","url":null,"abstract":"<div><div>Infertility constitutes a major global health concern, affecting approximately 17.5% of couples of reproductive age. Although advances in assisted reproductive technologies (ART) have expanded treatment options, success rates remain highly variable due to host-specific and biological determinants. This review synthesizes current evidence on the reproductive impact of the human microbiota and its translational relevance to ART outcomes. Vaginal microbial communities dominated by <em>Lactobacillus</em>, particularly <em>L. crispatus</em>, are associated with improved conception and implantation, whereas genital or intestinal dysbiosis correlates with infertility and suboptimal treatment responses. The microbiota modulates reproductive competence through intertwined immune, endocrine–metabolic, and mucosal barrier pathways that regulate inflammation, hormonal balance, and epithelial integrity. Emerging findings indicate that gut microbial alterations linked to polycystic ovary syndrome (PCOS) and endometriosis are accompanied by insulin resistance and chronic inflammation, impairing ovulation, endometrial receptivity, and embryo viability. Interventions such as probiotics and synbiotics yield heterogeneous efficacy; individualized antimicrobial strategies, metabolic modulation, and lifestyle optimization may offer complementary benefit, while microbiota reconstruction remains experimental. Methodological limitations, including contamination in low biomass samples, variations in sequencing workflows, and population heterogeneity, still hinder data comparability and mechanistic interpretation. Future research should prioritize adequately powered randomized controlled trials using standardized microbiome metrics and live birth as a primary endpoint. Integrating microbiome profiling into ART workflows may refine patient stratification and inform precision adjuvant therapies. However, clinical implementation requires stronger causal evidence, validated biomarkers, and harmonized methodological frameworks to translate microbiome discoveries into reproducible reproductive gains.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114941"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922006","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}
Pub Date : 2026-02-20Epub Date: 2025-12-25DOI: 10.1016/j.ejogrb.2025.114921
Sara Ebadi , Viktoria El Radaf , Tahir Mahmood , Charles Savona-Ventura , Mehreen Zaigham
<div><h3>Introduction</h3><div>Since the last two decades, there has been a dramatic rise in caesarean sections (CS) throughout the world. This increase has been seen even in Europe, where rates vary significantly from 17% in Northern Europe to 56% in the South. Although, CS can be a lifesaving intervention when medically necessary, non-essential CS are associated with short- and long-term complications for both the mother and newborn. To curb this rising trend, it is important to understand underlying causes behind regional disparities, including differences between public and private hospitals.</div></div><div><h3>Objective</h3><div>To investigate variations in CS rates between public and private hospitals across European regions and at a country level using the Robson Ten Group Classification.</div></div><div><h3>Methods</h3><div>A systemic review of studies published between 1st January 2000 and 12th March 2025 was conducted using MEDLINE/PubMed, CINAHL, EMBASE, Global Index Medicus, Web of Science and Cochrane library, analysing CS rates in 25 European countries. All studies reporting births in Europe, Robson group, written in English or Swedish were included. The developed protocol was prospectively registered in PROSPERO (Registration number 513579). Meta-analysis using absolute numbers and percentages was conducted to compare the birth rates at country and regional levels. To assess the risk of bias, two reviewers independently evaluated the quality of the studies included using a modified Newcastle–Ottawa Scale adapted for cohort studies.</div></div><div><h3>Results</h3><div>Of 1385 articles, 46 were eligible for inclusion in the final analysis. A total of 12 505<!--> <!-->939 births were analysed, with 8 543<!--> <!-->803 (68.3%) occurring in public hospitals and 3 962<!--> <!-->136 (31.7%) in private hospitals. Overall, Southern Europe illustrated the highest CS rate (54.9% of all births) as compared to Northern Europe (16.9%). There was a lack of reporting from private hospitals, with data only for Southern Europe, where CS rates were significantly higher in private (73.1%) as compared to public (40.9%) hospitals. The largest differences were seen for low-risk women Robson Group 1, 2, 3 and 4 (private vs public: 67.8 vs 28%, 67.6 vs 39.7, 26.9 vs 9.1% and 38 vs 18% respectively).</div></div><div><h3>Conclusion</h3><div>High CS rates were observed across Europe, with Southern Europe reporting the highest levels. Rates were consistently higher in private compared to public hospitals. In both settings, Group 5 (women with a previous CS) was the largest contributor to the overall CS rate. However, low-risk women in private hospitals (Groups 1 and 2) had twice the CS rates compared with public hospitals. These findings highlight that the excess CS burden in private hospitals is largely driven by unnecessary procedures in low-risk groups. There is an urgent need for interventions that promote evidence-based care and reduce unnecessary CS es
在过去的二十年里，全世界剖腹产的数量急剧上升。这种增长甚至出现在欧洲，其比率从北欧的17%到南欧的56%不等。虽然，在医学上必要时，CS可以是一种挽救生命的干预措施，但非必要的CS与母亲和新生儿的短期和长期并发症有关。为了遏制这一上升趋势，重要的是要了解地区差异背后的根本原因，包括公立医院和私立医院之间的差异。目的利用罗布森十组分类法调查欧洲地区和国家一级公立和私立医院CS率的差异。方法采用MEDLINE/PubMed、CINAHL、EMBASE、Global Index Medicus、Web of Science和Cochrane library对2000年1月1日至2025年3月12日发表的研究进行系统评价，分析欧洲25个国家的CS发生率。所有报告欧洲出生的研究，罗布森组，用英语或瑞典语撰写。开发的方案在PROSPERO中前瞻性注册（注册号513579）。采用绝对数字和百分比进行荟萃分析，比较国家和地区水平的出生率。为了评估偏倚风险，两位评论者独立评估了研究的质量，包括使用适用于队列研究的改良纽卡斯尔-渥太华量表。结果1385篇文献中，46篇符合纳入最终分析。共分析了12 505 939例分娩，其中8 543 803例（68.3%）发生在公立医院，3 962 136例（31.7%）发生在私立医院。总体而言，南欧的非传染性疾病发生率最高（占所有新生儿的54.9%），而北欧为16.9%。缺乏来自私立医院的报告，只有南欧的数据，那里私立医院的CS率（73.1%）明显高于公立医院（40.9%）。罗布森组1、2、3和4组的低风险女性差异最大（私人与公共：分别为67.8比28%、67.6比39.7、26.9比9.1%和38%比18%）。结论：整个欧洲都观察到高CS发生率，南欧报告的发生率最高。私立医院的比率一直高于公立医院。在这两种情况下，第5组（以前有过CS的女性）对总体CS率的贡献最大。然而，私立医院低风险妇女（1组和2组）的CS率是公立医院的两倍。这些发现强调，私立医院的CS负担过重主要是由低风险人群的不必要手术造成的。迫切需要采取干预措施，促进循证护理，减少不必要的CS，特别是在低风险妇女中。
{"title":"Caesarean section rates in public vs private hospitals in Europe: a systematic review and meta-analysis using the Robson ten group classification system","authors":"Sara Ebadi , Viktoria El Radaf , Tahir Mahmood , Charles Savona-Ventura , Mehreen Zaigham","doi":"10.1016/j.ejogrb.2025.114921","DOIUrl":"10.1016/j.ejogrb.2025.114921","url":null,"abstract":"<div><h3>Introduction</h3><div>Since the last two decades, there has been a dramatic rise in caesarean sections (CS) throughout the world. This increase has been seen even in Europe, where rates vary significantly from 17% in Northern Europe to 56% in the South. Although, CS can be a lifesaving intervention when medically necessary, non-essential CS are associated with short- and long-term complications for both the mother and newborn. To curb this rising trend, it is important to understand underlying causes behind regional disparities, including differences between public and private hospitals.</div></div><div><h3>Objective</h3><div>To investigate variations in CS rates between public and private hospitals across European regions and at a country level using the Robson Ten Group Classification.</div></div><div><h3>Methods</h3><div>A systemic review of studies published between 1st January 2000 and 12th March 2025 was conducted using MEDLINE/PubMed, CINAHL, EMBASE, Global Index Medicus, Web of Science and Cochrane library, analysing CS rates in 25 European countries. All studies reporting births in Europe, Robson group, written in English or Swedish were included. The developed protocol was prospectively registered in PROSPERO (Registration number 513579). Meta-analysis using absolute numbers and percentages was conducted to compare the birth rates at country and regional levels. To assess the risk of bias, two reviewers independently evaluated the quality of the studies included using a modified Newcastle–Ottawa Scale adapted for cohort studies.</div></div><div><h3>Results</h3><div>Of 1385 articles, 46 were eligible for inclusion in the final analysis. A total of 12 505<!--> <!-->939 births were analysed, with 8 543<!--> <!-->803 (68.3%) occurring in public hospitals and 3 962<!--> <!-->136 (31.7%) in private hospitals. Overall, Southern Europe illustrated the highest CS rate (54.9% of all births) as compared to Northern Europe (16.9%). There was a lack of reporting from private hospitals, with data only for Southern Europe, where CS rates were significantly higher in private (73.1%) as compared to public (40.9%) hospitals. The largest differences were seen for low-risk women Robson Group 1, 2, 3 and 4 (private vs public: 67.8 vs 28%, 67.6 vs 39.7, 26.9 vs 9.1% and 38 vs 18% respectively).</div></div><div><h3>Conclusion</h3><div>High CS rates were observed across Europe, with Southern Europe reporting the highest levels. Rates were consistently higher in private compared to public hospitals. In both settings, Group 5 (women with a previous CS) was the largest contributor to the overall CS rate. However, low-risk women in private hospitals (Groups 1 and 2) had twice the CS rates compared with public hospitals. These findings highlight that the excess CS burden in private hospitals is largely driven by unnecessary procedures in low-risk groups. There is an urgent need for interventions that promote evidence-based care and reduce unnecessary CS es","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114921"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921949","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}
Pub Date : 2026-02-20Epub Date: 2026-01-02DOI: 10.1016/j.ejogrb.2025.114933
Kerem Doga Seckin, Pinar Kadirogullari
{"title":"Expression of concern: \"Is dienogest a convenient treatment option for cesarean scar endometriosis or should it be treated surgically?\". [Eur. J. Obstet. Gynecol. Reprod. Biol. 282 (2023) 110-115].","authors":"Kerem Doga Seckin, Pinar Kadirogullari","doi":"10.1016/j.ejogrb.2025.114933","DOIUrl":"https://doi.org/10.1016/j.ejogrb.2025.114933","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"114933"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164714","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}
Pub Date : 2026-02-20Epub Date: 2026-02-09DOI: 10.1016/S0301-2115(26)00062-X
{"title":"Inside Back Cover - Editors with images","authors":"","doi":"10.1016/S0301-2115(26)00062-X","DOIUrl":"10.1016/S0301-2115(26)00062-X","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114996"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170084","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}
Pub Date : 2026-02-20Epub Date: 2025-12-18DOI: 10.1016/j.ejogrb.2025.114899
Andrea Woolner , Laura Linehan , Keelin O’Donoghue , Rosinder Kaur , Alexander E.P. Heazell
Background
Second trimester pregnancy loss (STPL) is under-researched. There are no published national or international guidelines. Yet evidence suggests this may be a high risk group. We hypothesised that the management of STPL varied across the UK and Ireland and we asked healthcare professionals’ views on current care and future priorities for STPL.
Methods
A prospective cross-sectional survey was conducted as part of the PASTeL-3 project. An electronic online survey was live between 19th November 2024 and 7th March 2025. Professionals working in maternity services in the UK and Ireland were invited to participate the survey via social media and email.
Findings
The definition of STPL varied between hospitals, with lack of consensus on the lower and upper gestational age limits. Care location for assessment and management of STPL differed between hospitals. 43 % of women could self-refer for assessment in the second trimester. Dosages of misoprostol used for STPL varied between hospitals from 50-400 µg, and 63 % of respondents reported uncertainty over the optimal dosage of misoprostol for STPL. Elective surgical management for STPL was rarely offered. Pharmacological management of the third stage of labour after STPL was largely based on oxytocics, with a minority using Misoprostol alone (10 %). Although almost all units reported consultant follow-up, only 45 % of respondents reported routine follow up took place in a dedicated pregnancy loss clinic. Only 52 % of respondents reported that post-mortem examination was routinely offered after STPL. Respondents reported antenatal care after a STPL was provided in a specialist pregnancy loss clinic (31 %) or preterm birth clinic (43 %); 80.1 % reported they felt confident caring for women in a asubsequent pregnancy after STPL. Respondents highlighted concerns with care locations for women with STPL under 16–18 weeks’ gestation and contingency locations where bereavement suites were in use. Highlighted research priorities included: optimising medical management of STPL for women with a scarred uterus, medical methods to reduce the risk of retained placenta after STPL, the impact of STPL on next pregnancies and investigations after STPL.
Interpretation
There is confusion over the definitions, appropriate location for care, optimal therapeutic options and follow up needed following STPL. High quality research for STPL should be prioritised to develop evidence-based clinical guidance to reduce variation in care.
{"title":"Current management and research priorities for second trimester pregnancy loss: a survey of healthcare professionals in the UK and Ireland (PASTeL-3)","authors":"Andrea Woolner , Laura Linehan , Keelin O’Donoghue , Rosinder Kaur , Alexander E.P. Heazell","doi":"10.1016/j.ejogrb.2025.114899","DOIUrl":"10.1016/j.ejogrb.2025.114899","url":null,"abstract":"<div><h3>Background</h3><div>Second trimester pregnancy loss (STPL) is under-researched. There are no published national or international guidelines. Yet evidence suggests this may be a high risk group. We hypothesised that the management of STPL varied across the UK and Ireland and we asked healthcare professionals’ views on current care and future priorities for STPL.</div></div><div><h3>Methods</h3><div>A prospective cross-sectional survey was conducted as part of the PASTeL-3 project. An electronic online survey was live between 19th November 2024 and 7th March 2025. Professionals working in maternity services in the UK and Ireland were invited to participate the survey via social media and email.</div></div><div><h3>Findings</h3><div>The definition of STPL varied between hospitals, with lack of consensus on the lower and upper gestational age limits. Care location for assessment and management of STPL differed between hospitals. 43 % of women could self-refer for assessment in the second trimester. Dosages of misoprostol used for STPL varied between hospitals from 50-400 µg, and 63 % of respondents reported uncertainty over the optimal dosage of misoprostol for STPL. Elective surgical management for STPL was rarely offered. Pharmacological management of the third stage of labour after STPL was largely based on oxytocics, with a minority using Misoprostol alone (10 %). Although almost all units reported consultant follow-up, only 45 % of respondents reported routine follow up took place in a dedicated pregnancy loss clinic. Only 52 % of respondents reported that post-mortem examination was routinely offered after STPL. Respondents reported antenatal care after a STPL was provided in a specialist pregnancy loss clinic (31 %) or preterm birth clinic (43 %); 80.1 % reported they felt confident caring for women in a asubsequent pregnancy after STPL. Respondents highlighted concerns with care locations for women with STPL under 16–18 weeks’ gestation and contingency locations where bereavement suites were in use. Highlighted research priorities included: optimising medical management of STPL for women with a scarred uterus, medical methods to reduce the risk of retained placenta after STPL, the impact of STPL on next pregnancies and investigations after STPL.</div></div><div><h3>Interpretation</h3><div>There is confusion over the definitions, appropriate location for care, optimal therapeutic options and follow up needed following STPL. High quality research for STPL should be prioritised to develop evidence-based clinical guidance to reduce variation in care.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114899"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788926","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}
Pub Date : 2026-02-20Epub Date: 2026-01-02DOI: 10.1016/j.ejogrb.2026.114937
Shuang Ran , Xiaozhou Jia , Jun He , Tuanmei Wang , Donghua Xie , Xianglian Peng , Xingli Li
Objective
To investigate the influence of growth discordance in different trimesters of dichorionic twins on frequent adverse birth outcomes (preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA)).
Methods
Based on the Hunan Maternal and Child Health Hospital (HMCH) twin pregnancy cohort. Participants with dichorionic twin pregnancies who received prenatal care and delivered at HMCH between January 2019 and December 2024 were divided into four groups: whole-pregnancy concordant group (n = 428), isolated third-trimester discordant group (n = 30), isolated first-trimester discordant group (n = 35), and whole-pregnancy discordant group (n = 12). Grouping was based on whether first- and third-trimester fetal growth measured by ultrasound is concordant and tracking adverse birth outcomes in each group.
Results
Our study included 505 dichorionic twin pregnancies, with a maternal mean age of 30.97 ± 3.70 years. Compared to whole-pregnancy concordant group, isolated first-trimester discordant group did not have a higher risk of any adverse birth outcome (p ≥ 0.05), isolated third-trimester discordant group had a higher risk of SGA (RR = 3.48, 95 % CI: 2.38––5.10), and whole-pregnancy discordant group had a higher risk of both SGA and LBW (RR = 5.07, 95 % CI: 3.43–7.47; RR = 1.51, 95 % CI: 1.25–1.83). The risk of SGA and LBW was linearly correlated with the degree of growth discordance in the third trimester.
Conclusion
In dichorionic twin pregnancies, discordant growth in the first trimester does not increase the risk of adverse birth outcomes. The presence of discordant growth in the third trimester is the critical gestational period contributing to SGA and LBW. Therefore, it is essential to maintain growth concordance in dichorionic twins when entering the third trimester.
{"title":"The influence of discordant growth during pregnancy in dichorionic twins on adverse birth outcomes","authors":"Shuang Ran , Xiaozhou Jia , Jun He , Tuanmei Wang , Donghua Xie , Xianglian Peng , Xingli Li","doi":"10.1016/j.ejogrb.2026.114937","DOIUrl":"10.1016/j.ejogrb.2026.114937","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the influence of growth discordance in different trimesters of dichorionic twins on frequent adverse birth outcomes (preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA)).</div></div><div><h3>Methods</h3><div>Based on the Hunan Maternal and Child Health Hospital (HMCH) twin pregnancy cohort. Participants with dichorionic twin pregnancies who received prenatal care and delivered at HMCH between January 2019 and December 2024 were divided into four groups: whole-pregnancy concordant group (n = 428), isolated third-trimester discordant group (n = 30), isolated first-trimester discordant group (n = 35), and whole-pregnancy discordant group (n = 12). Grouping was based on whether first- and third-trimester fetal growth measured by ultrasound is concordant and tracking adverse birth outcomes in each group.</div></div><div><h3>Results</h3><div>Our study included 505 dichorionic twin pregnancies, with a maternal mean age of 30.97 ± 3.70 years. Compared to whole-pregnancy concordant group, isolated first-trimester discordant group did not have a higher risk of any adverse birth outcome (<em>p</em> ≥ 0.05), isolated third-trimester discordant group had a higher risk of SGA (RR = 3.48, 95 % <em>CI</em>: 2.38––5.10), and whole-pregnancy discordant group had a higher risk of both SGA and LBW (RR = 5.07, 95 % <em>CI</em>: 3.43–7.47; RR = 1.51, 95 % <em>CI</em>: 1.25–1.83). The risk of SGA and LBW was linearly correlated with the degree of growth discordance in the third trimester.</div></div><div><h3>Conclusion</h3><div>In dichorionic twin pregnancies, discordant growth in the first trimester does not increase the risk of adverse birth outcomes. The presence of discordant growth in the third trimester is the critical gestational period contributing to SGA and LBW. Therefore, it is essential to maintain growth concordance in dichorionic twins when entering the third trimester.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114937"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899680","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}
Pub Date : 2026-02-20Epub Date: 2026-01-18DOI: 10.1016/j.ejogrb.2026.114968
Tsia-Shu Lo , Chean Wen Li , Irene Balonzo Villaflor , Ai-Leen Ro , Chien-Chien Yu , Tzu Hsiang Hsieh
Objective
To evaluate the outcome of single-incision sling (SIS) kits available on the market in women with intrinsic sphincter deficiency (ISD) and identify predictors of surgical failure.
Methods
This is a retrospective cohort study in a tertiary referral hospital, involving 685 women with urodynamic stress incontinence (USI), including 56 ISD preoperatively. The primary outcome was objective cure of USI, defined as the absence of demonstrable involuntary urine leakage upon increased abdominal pressure in filling cystometry. Subjective cure was a negative response to the UDI-6 question 3. The secondary outcome was to identify predictors of surgical failure.
Results
Overall, the primary outcome of objective cure for SIS was 89.5 % (613/685), and the subjective cure rate was 87.0 % (596/685) at the 1-year post-operative follow-up. Success rates were similar across the SIS types: Ophira™, 89.8 % (114/127); Solyx™, 89 % (299/336); and I-Stop-Mini™, 90.1 % (200/222). Multivariate logistic regression model identified age (OR 1.88 1.17–3.01), postmenopausal status (OR 1.42 1.07–2.05), angle < 30° (OR 2.96 1.50–4.87), MUCP (OR 2.35 1.55–3.93), tape percentile (OR 1.60 1.19–3.11) as independent factors associated with postoperative failure of SIS in women with ISD.
Conclusion
SIS has a high cure rate for SUI but shows lower success in women with ISD. Careful patient selection and consideration of surgical predictors may optimize outcomes. Predictors of failure identified include older age, postmenopausal status, low MUCP, tape percentile, and a bladder neck angle < 30°. Additionally, routine preoperative assessment of bladder neck mobility is suggested as a practical tool for managing women with ISD.
{"title":"Single-incision slings in stress urinary incontinence: impact of intrinsic sphincter deficiency on surgical success","authors":"Tsia-Shu Lo , Chean Wen Li , Irene Balonzo Villaflor , Ai-Leen Ro , Chien-Chien Yu , Tzu Hsiang Hsieh","doi":"10.1016/j.ejogrb.2026.114968","DOIUrl":"10.1016/j.ejogrb.2026.114968","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the outcome of single-incision sling (SIS) kits available on the market in women with intrinsic sphincter deficiency (ISD) and identify predictors of surgical failure.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study in a tertiary referral hospital, involving 685 women with urodynamic stress incontinence (USI), including 56 ISD preoperatively. The primary outcome was objective cure of USI, defined as the absence of demonstrable involuntary urine leakage upon increased abdominal pressure in filling cystometry. Subjective cure was a negative response to the UDI-6 question 3. The secondary outcome was to identify predictors of surgical failure.</div></div><div><h3>Results</h3><div>Overall, the primary outcome of objective cure for SIS was 89.5 % (613/685), and the subjective cure rate was 87.0 % (596/685) at the 1-year post-operative follow-up. Success rates were similar across the SIS types: Ophira™, 89.8 % (114/127); Solyx™, 89 % (299/336); and I-Stop-Mini™, 90.1 % (200/222). Multivariate logistic regression model identified age (OR 1.88 1.17–3.01), postmenopausal status (OR 1.42 1.07–2.05), angle < 30° (OR 2.96 1.50–4.87), MUCP (OR 2.35 1.55–3.93), tape percentile (OR 1.60 1.19–3.11) as independent factors associated with postoperative failure of SIS in women with ISD.</div></div><div><h3>Conclusion</h3><div>SIS has a high cure rate for SUI but shows lower success in women with ISD. Careful patient selection and consideration of surgical predictors may optimize outcomes. Predictors of failure identified include older age, postmenopausal status, low MUCP, tape percentile, and a bladder neck angle < 30°. Additionally, routine preoperative assessment of bladder neck mobility is suggested as a practical tool for managing women with ISD.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114968"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022742","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}
Pub Date : 2026-02-20Epub Date: 2026-01-11DOI: 10.1016/j.ejogrb.2026.114944
Lotus van Duin , Sabrine Kol , Astrid Cantineau , Robert de Leeuw , Velja Mijatovic , Laura van Loendersloot
{"title":"Therapeutic outcomes and patient-reported experiences for endometriosis in the canal of Nuck","authors":"Lotus van Duin , Sabrine Kol , Astrid Cantineau , Robert de Leeuw , Velja Mijatovic , Laura van Loendersloot","doi":"10.1016/j.ejogrb.2026.114944","DOIUrl":"10.1016/j.ejogrb.2026.114944","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114944"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022743","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}
Pub Date : 2026-02-20Epub Date: 2025-12-15DOI: 10.1016/j.ejogrb.2025.114895
D.Bazaran Paredes , N. Sachs-Guedj , V.L. Crofts , M. Yaron
Objective
Abortion remains a sensitive and highly debated topic globally, with significant variations in legal frameworks between countries. Although abortion rates differ considerably between regions, repeat induced abortions (RIA) continue to represent a public health concern in many settings. This study aims to identify and analyse risk factors for RIA and their interconnections.
Study Design: We conducted a systematic review of the literature, examining 34 articles from various regions around the world. Exclusions included studies focused on spontaneous abortion, induced abortion for medical reasons, and systematic reviews, meta-analyses, or non-conclusive studies. The selected articles encompassed data on 373,424 women. This review was registered in PROSPERO (CRD420251003863) and conducted according to PRISMA guidelines.
Results
Across 34 studies including 373,424 women, the most frequently reported risk factors for repeat induced abortion (RIA) were older age, higher parity, lower educational attainment, urban residence, contraceptive failure or misuse, intimate partner violence, adverse childhood experiences, and substance use. Several studies also showed that early initiation of contraception after the first abortion—particularly with long-acting reversible contraceptives (LARCs)—reduced the likelihood of subsequent abortions.
Conclusion
Addressing these risk factors with comprehensive support can significantly improve women’s reproductive health and reduce the occurrence of RIA.
{"title":"Repeat induced abortion: what are the risk factors? A systematic review","authors":"D.Bazaran Paredes , N. Sachs-Guedj , V.L. Crofts , M. Yaron","doi":"10.1016/j.ejogrb.2025.114895","DOIUrl":"10.1016/j.ejogrb.2025.114895","url":null,"abstract":"<div><h3>Objective</h3><div>Abortion remains a sensitive and highly debated topic globally, with significant variations in legal frameworks between countries. Although abortion rates differ considerably between regions, repeat induced abortions (RIA) continue to represent a public health concern in many settings. This study aims to identify and analyse risk factors for RIA and their interconnections.</div><div>Study Design: We conducted a systematic review of the literature, examining 34 articles from various regions around the world. Exclusions included studies focused on spontaneous abortion, induced abortion for medical reasons, and systematic reviews, <em>meta</em>-analyses, or non-conclusive studies. The selected articles encompassed data on 373,424 women. This review was registered in PROSPERO (CRD420251003863) and conducted according to PRISMA guidelines.</div></div><div><h3>Results</h3><div>Across 34 studies including 373,424 women, the most frequently reported risk factors for repeat induced abortion (RIA) were older age, higher parity, lower educational attainment, urban residence, contraceptive failure or misuse, intimate partner violence, adverse childhood experiences, and substance use. Several studies also showed that early initiation of contraception after the first abortion—particularly with long-acting reversible contraceptives (LARCs)—reduced the likelihood of subsequent abortions.</div></div><div><h3>Conclusion</h3><div>Addressing these risk factors with comprehensive support can significantly improve women’s reproductive health and reduce the occurrence of RIA.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114895"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145826975","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}
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