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

{"title":"Application and validation of AI-driven methods to explore patient experiences of pre-cervical cancer","authors":"Michael Y. Luo ,&nbsp;Christopher Y.K. Williams","doi":"10.1016/j.ejogrb.2026.114953","DOIUrl":"10.1016/j.ejogrb.2026.114953","url":null,"abstract":"<div><h3>Objective</h3><div>We sought to apply novel natural language processing (NLP) tools to explore patient experiences of pre-cervical cancer on social media and validate the performance of these tools.</div></div><div><h3>Methods</h3><div>All posts and comments were extracted from the forum r/PreCervicalCancer on social media platform <em>Reddit</em>. Using BERTopic, posts were clustered into topics according to their semantic similarity, which were manually reviewed. Topic headings were derived using a large language model (LLM) and compared to manually curated headings. Clustering outliers were reassigned by BERTopic, an LLM and by manual methods in parallel and compared. Post and comment sentiment were quantitatively analysed using VADER. Post upvote scores and comments counts were analysed to measure community engagement.</div></div><div><h3>Results</h3><div>4592 posts were extracted from r/PreCervicalCancer. Posts clustered into 10 different topics using BERTopic with 88.0% accuracy. 80.0% of topic headings generated by GPT-4o mini were deemed appropriate. Reassignment of clustering outliers by BERTopic and GPT-4o mini was limited, 52.8% and 41.1% accuracy, respectively. Key clinical findings reflect several common concerns among patients, particularly regarding specific lasting physical and psychological impact of procedures like LEEP, result anxiety, and challenges in healthcare navigation. Comments had less negative sentiment than posts (Cohen’s d = 0.46), suggesting support.</div></div><div><h3>Conclusions</h3><div>In this cross-sectional study, we validated NLP tools to analyse content, sentiment and reactions to 4592 posts on pre-cervical cancer. Our findings suggest that, with minimal human oversight, automated methods can accurately conduct large-scale analyses of similar clinical content, unlocking new insights of patient experiences using non-traditional data sources.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114953"},"PeriodicalIF":1.9,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973386","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":"Emergency contraception pills among female students: Use, knowledge, perceptions, and expectations","authors":"Alison Catilaz ,&nbsp;Anne-Laure Clairet ,&nbsp;Marilia Girault ,&nbsp;Stéphanie Paris ,&nbsp;Virginie Nerich","doi":"10.1016/j.ejogrb.2026.114946","DOIUrl":"10.1016/j.ejogrb.2026.114946","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the rate of emergency contraception pills (ECP) use among female students, and to examine their characteristics, knowledge, perceptions and expectations regarding ECPs, with particular attention to the experiences and feedback of those who had previously used it.</div></div><div><h3>Study design</h3><div>A cross-sectional, voluntary online survey was conducted among female women students at the Marie and Louis Pasteur University during the 2022–2023 academic year. The questionnaire mainly assessed demographics, contraceptive use, knowledge and perceptions of ECP, and experiences with ECP use. Descriptive and comparative analyses were performed.</div></div><div><h3>Results</h3><div>Among 2,157 female students who completed the survey, i.e., response rate of 15.1 %, 39.1 % reported having previously used ECP at least once, with use increasing significantly with age groups (&lt; 20, 20–29, &gt;29 years). Female students who had used ECP showed higher knowledge and more positive perceptions about ECP, were more likely to use condoms, and primarily consulted pharmacists and the Internet for information. Most ECPs were obtained from community pharmacies, with nearly three-quarters of pharmacists providing information, but only 4 % of dispensations occurred in a confidential space. The main reasons for ECP use were condom breakage, forgetting regular contraception, or not using any regular contraceptive method. Practical and theoretical knowledge about ECP was higher among users.</div></div><div><h3>Conclusion</h3><div>Most female students were aware of emergency contraception and its indications, with a moderate rate of use. These results highlight the need to improve access to reliable information and to explore the role of healthcare professionals and educational strategies in promoting appropriate ECP use.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114946"},"PeriodicalIF":1.9,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973397","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":"Fetal 15q duplication syndrome detected by noninvasive prenatal testing: three case reports","authors":"Yong-Shan Chen ,&nbsp;De-Gang Wang ,&nbsp;Jun-Hui Wan ,&nbsp;Jie-Fu He ,&nbsp;Tao Quan ,&nbsp;Shu-Bin Li ,&nbsp;Shun-Ting Huang ,&nbsp;Dong-Zhi Li","doi":"10.1016/j.ejogrb.2026.114956","DOIUrl":"10.1016/j.ejogrb.2026.114956","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114956"},"PeriodicalIF":1.9,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973294","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":"Development of predictive models for endometrial outcomes in patients with intrauterine adhesions post-hysteroscopic adhesiolysis: evaluating endometrial vascularization through narrow-band imaging hysteroscopy and Doppler ultrasound","authors":"Jiezhuang Huang ,&nbsp;Yanlan Huang ,&nbsp;Shengcai Chen ,&nbsp;Qing Ye ,&nbsp;Shuang Liang ,&nbsp;Caini Wei ,&nbsp;Zhifu Zhi","doi":"10.1016/j.ejogrb.2026.114951","DOIUrl":"10.1016/j.ejogrb.2026.114951","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the potential of narrow-band imaging (NBI) hysteroscopy and 2-Dimensional (2-D) ultrasound in predicting re-adhesion for patients with intrauterine adhesions (IUAs) following transcervical resection of adhesions (TCRA).</div></div><div><h3>Design</h3><div>Retrospective study.</div></div><div><h3>Patients</h3><div>We included 56 patients diagnosed with IUAs who underwent TCRA with NBI hysteroscopy at the First Affiliated Hospital of Guangxi medical university from June 2020 to February 2023.</div></div><div><h3>Interventions</h3><div>Participants were divided into two groups based on their endometrial recovery during a three-month follow-up after TCRA: a recovery group (n = 42) and a poor recovery group (n = 14). Both univariable and multivariable logistic regression analyses were conducted to identify independent factors impacting postoperative outcomes. Subsequently, nomogram prediction models were constructed and internally validated using the identified independent factors in conjunction with the classifications established by the European Society of Gynecological Endoscopy (ESGE) and the American Fertility Society (AFS).</div></div><div><h3>Main outcome measures</h3><div>Endometrial restoration within the 3-month follow-up after TCRA.</div></div><div><h3>Results</h3><div>A higher endometrial microvascular index assessed by NBI hysteroscopy and enhanced endometrial blood flow in zone 3, as measured by 2-D Doppler ultrasound, were identified as independent protective factors for postoperative endometrial recovery. The identified factors, when combined with ESGE or AFS classifications, were utilized to build nomogram prediction models, referred to as the NUE and NUA models, respectively. The NUE model (AUC = 0.935, 95% CI: 0.865–1.000) and the NUA model (AUC = 0.939, 95% CI: 0.876–1.000) demonstrated superior discrimination compared to the ESGE (AUC = 0.651, 95% CI: 0.490–0.813) and AFS classifications (AUC = 0.736, 95% CI: 0.578–0.893) alone. The calibration curve indicated that the NUA model exhibited greater consistency between predicted and actual outcomes than the NUE model.</div></div><div><h3>Conclusion</h3><div>Endometrial vascularity is a critical factor for postoperative endometrial recovery in IUAs patients following TCRA. NBI hysteroscopy and Doppler ultrasound provide significant advantages in evaluating endometrial blood vessels, thereby facilitating accurate predictions of endometrial outcomes.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114951"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973399","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":"Multidimensional factors increase menstrual distress in patients with endometriosis.","authors":"Silvia Vannuccini, Francesco La Torre, Ernesto Gallucci, Anna Rosa Speciale, Eleonora Rossi, Emanuele Cassioli, Valdo Ricca, Giovanni Castellini, Felice Petraglia","doi":"10.1016/j.ejogrb.2026.114950","DOIUrl":"https://doi.org/10.1016/j.ejogrb.2026.114950","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a chronic endocrine and inflammatory disease commonly presenting with dysmenorrhea, pelvic pain, and/or infertility. Despite the importance of menstrual symptoms, the impact of menstruation on stress is still poorly assessed. This study aims to objectively measure menstrual distress and identify its determinants in patients with endometriosis.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted over one year, including 75 patients newly diagnosed with endometriosis and an age-matched control group (n = 75) of healthy women. All participants completed the Menstrual Distress Questionnaire (MEDI-Q), which explores 25 items and provides a total score along with subscales: Menstrual Symptoms (MS), Menstrual Symptoms Distress (MSD), and Menstrual Specificity Index (MESI). Scores were compared between cases and controls. A sub-analysis among endometriosis patients identified the key contributors to distress.</p><p><strong>Results: </strong>Women with endometriosis showed significantly higher score for MEDI-Q Total (median = 14.00, interquartile range: [5.00---30.50] vs 12.00 [2.00---20.00], p < 0.05) as well for the subscale MSD (2.24 [1.67---2.81] vs 1.71 [1.00---2.30], p < 0.01) compared to controls. Menstrual distress was primarily associated with dyspareunia, dyschezia, dysuria, gastrointestinal symptoms (nausea, diarrhea, constipation, decreased appetite), reduced sexual drive, impaired concentration, and insomnia. A heightened perception of discomfort with bleeding, particularly in the presence of adenomyosis, further increased distress.</p><p><strong>Conclusion: </strong>Menstrual distress is significantly higher in women with endometriosis and involves multidimensional factors beyond pain. These findings support the need for a personalized and comprehensive approach in the clinical management of endometriosis.</p>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"114950"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997850","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":"High-grade uterine cancer with ambiguous features – a clinicopathological study","authors":"Roy Kessous ,&nbsp;Ofer Wiesel ,&nbsp;Jacob Dreiher ,&nbsp;Mihai Meirovitz ,&nbsp;Sharon Davidesko ,&nbsp;Yarden Kezerle ,&nbsp;Benzion Samueli ,&nbsp;Ruthy Shaco-Levy","doi":"10.1016/j.ejogrb.2026.114952","DOIUrl":"10.1016/j.ejogrb.2026.114952","url":null,"abstract":"<div><h3>Objective</h3><div>Endometrial endometrioid carcinoma FIGO grade 3 (EC3) and endometrial serous carcinoma (SEC), sometimes present diagnostic challenges due to overlapping and ambiguous features. The prognostic significance of assigning histological subtype remains debatable due to conflicting clinical outcome data. This study examined definite and ambiguous EC3 and SEC cases to compare clinicopathologic characteristics and prognosis.</div></div><div><h3>Methods</h3><div>This is a retrospective study of 129 patients diagnosed with EC3 and SEC at a single tertiary center between 2006–2022. Pathological slides were revised and classified as definite or ambiguous for EC3 and SEC. Survival, progression-free survival, and associations between tumor histologic type and clinicopathologic characteristics were analyzed.</div></div><div><h3>Results</h3><div>Definite SEC displayed higher mortality compared to definite EC3 (68.2 % vs. 41.4 %, p = 0.023) as well as a non-significant trend towards lower 5-year survival (p = 0.096). Ambiguous SEC also showed higher mortality compared to ambiguous EC3 (68.8 % vs. 37.5 %, p = 0.020) and a non-significant trend towards lower 5-year survival (p = 0.098). Several parameters suggest that ambiguous cases are intermediate between the definite EC3 (lower) and definite SEC (higher) groups. Rates of lymph node metastases (EC3 6.9 %; ambiguous 16.4 % and SEC 29.5 %; p = 0.013), broad ligament involvement (EC3 0 %; ambiguous 1.8 % and SEC 11.4 %; p = 0.016), and omental involvement (EC3 3.4 %; ambiguous 10.9 % and SEC 29.5 %; p = 0.002). A similar trend was observed for ovarian involvement, but it did not reach statistical significance (EC3 6.9 %; ambiguous 12.7 % and SEC 22.7 %; p = 0.055).</div></div><div><h3>Conclusion</h3><div>Ambiguous cases may represent an intermediate group that displays clinicopathologic features which are more aggressive than in EC3, yet more favorable than in SEC. These results hold implications for managing patients with high-grade endometrial carcinomas, as identifying an intermediate group may inform treatment strategies and prognostic evaluations.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114952"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973387","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 utility of interleukin-6 compared to conventional sepsis biomarkers in pregnancy – A real-world cohort study","authors":"Seán Olann Whelan ,&nbsp;Gráinne Kelleher ,&nbsp;Sharon Campbell ,&nbsp;Maeve Eogan ,&nbsp;Frank Moriarty ,&nbsp;Mohamed Elsammak ,&nbsp;Richard John Drew","doi":"10.1016/j.ejogrb.2026.114936","DOIUrl":"10.1016/j.ejogrb.2026.114936","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the diagnostic performance of interleukin-6 (IL-6) versus in-use inflammatory markers (C-reactive protein [CRP], procalcitonin [PCT], neutrophil–lymphocyte ratio [NLR]) in maternal sepsis.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study in a single Dublin maternity hospital. All maternity patients (conception to 6-weeks post-partum) in whom IL-6 was measured to investigate suspected sepsis in an 11-month period were included. Cases were categorized twice into physiological (normal, systemic inflammatory response syndrome, sepsis, septic shock) and etiological (bacterial, viral or no infection) categories. Biomarker performance was assessed by area under the receiver operating characteristic curves (AUC) and measures of diagnostic accuracy at optimal cut-offs. Serial sampling evaluated biomarker kinetics.</div></div><div><h3>Results</h3><div>Seventy-two patients were included, 31.9 % had sepsis/septic shock, and 70.9 % had bacterial infection. Significant differences between categories were seen for both physiological and etiological axes for IL-6, for physiological categories alone for NLR, and for neither for PCT and CRP. IL-6 had an AUC of 0.78 for the primary physiological endpoint, significantly higher than CRP and PCT (p = 0.02), but not NLR (AUC 0.72, p = 0.47). The IL-6 AUC for the primary etiological endpoint was 0.94, higher than all other biomarkers (p &lt; 0.001). IL-6 was highly sensitive (91.4 %) but poorly specific (55.1 %) for the physiological endpoint, while both were high in the diagnosis of bacterial infection (88.2 % and 90.5 %). On serial sampling, IL-6 fell rapidly between first and second sampling, while others initially rose further.</div></div><div><h3>Conclusion</h3><div>IL-6 exhibited significantly higher sensitivity compared to conventional sepsis biomarkers in detecting both bacterial infection and maternal sepsis.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114936"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973396","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":"Joint hypermobility syndrome for the urogynaecologist – A narrative review","authors":"Islam Abaza,&nbsp;Miriam Tadros,&nbsp;Bernadette Lemmon,&nbsp;Alka Bhide,&nbsp;Ruwan Fernando,&nbsp;Vik Khullar","doi":"10.1016/j.ejogrb.2026.114943","DOIUrl":"10.1016/j.ejogrb.2026.114943","url":null,"abstract":"<div><h3>Purpose of this review</h3><div>Joint Hypermobility Syndrome (JHS), also referred to as hypermobile Ehlers–Danlos Syndrome (hEDS), is increasingly recognised as a significant contributor to gynaecological, pelvic floor and lower urinary tract symptoms. This review aims to highlight the current evidence on the relationship between JHS and key urogynaecological conditions, with particular attention to recent developments in epidemiology, clinical presentation, and management.</div></div><div><h3>Recent findings</h3><div>Emerging research demonstrates a strong association between JHS and pelvic organ prolapse (POP), with meta-analytic data showing more than a twofold increased risk. Large cohort studies highlight substantial symptom burden, including high rates of stress and urgency incontinence, bladder pain, pelvic floor dysfunction and sexual difficulties. Recent work also reveals distinct challenges in perioperative care, such as dysautonomia-related anaesthetic risks, tissue fragility, impaired wound healing and higher rates of surgical complications in some series. Studies document higher prevalence of urinary incontinence, bladder diverticula, recurrent urinary infections and voiding dysfunction linked to increased bladder capacity and elevated residual volumes.</div></div><div><h3>Summary</h3><div>Women with JHS experience a wide and often severe spectrum of urogynaecological symptoms that significantly affect quality of life. Although management generally mirrors standard care pathways, the unique connective-tissue and systemic features of JHS necessitate tailored assessment and multidisciplinary involvement. Further high-quality research is required to develop specific management algorithms and clarify the role of conservative versus surgical treatments in this complex clinical population.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114943"},"PeriodicalIF":1.9,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922005","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":"Impact of placenta accreta spectrum on sexual and psychological health: a comparative analysis using FSFI and SF-36","authors":"Dini Hidayat ,&nbsp;Sri Dewi Rahmawati Syarief ,&nbsp;Vyanda Sri Weningtyas ,&nbsp;Faradiba Janiyustika","doi":"10.1016/j.ejogrb.2026.114942","DOIUrl":"10.1016/j.ejogrb.2026.114942","url":null,"abstract":"<div><h3>Background</h3><div>Placenta accreta spectrum (PAS) is a potentially life-threatening obstetric condition characterized by abnormal placental adherence to the myometrium. While hysterectomy remains the standard definitive management, conservative strategies such as wedge resection or delayed hysterectomy have been increasingly adopted to preserve fertility. The comparative impact of these approaches on women’s quality of life (QoL), particularly social and sexual functioning, has not been well investigated.</div></div><div><h3>Method</h3><div>A cross-sectional study included 185 women who underwent caesarean section (CS) for histopathologically confirmed PAS at Dr. Hasan Sadikin General Hospital, Bandung, West Java, from 2022 to 2024. A total of 161 met the inclusion criteria and were analyzed, while 24 were excluded. Sexual function and QoL were assessed using the Female Sexual Function Index (FSFI) and the 36-Item Short Form Health Survey (SF-36), respectively. Non-parametric analysis using the Mann–Whitney <em>U</em> test was applied for scale scores and categorical comparisons were analyzed using Chi-square or Fisher’s exact test, with p &lt; 0.05 considered significant.</div></div><div><h3>Result</h3><div>Median FSFI scores for desire (3.0 [2.5–3.5] vs. 3.0 [2.0–4.0], p = 0.015), arousal (2.5 [2.0–3.5] vs. 3.0 [2.0–4.0], p = 0.048), and pain (2.4 [2.0–2.7] vs. 3.0 [2.0–4.0], p = 0.021) differed significantly between the hysterectomy and conservative groups, although median values for desire were similar. Other FSFI domains and total scores were not significantly different (p &gt; 0.05). In the SF-36, a statistically significant difference was observed only in the social functioning domain, despite comparable median scores between groups.</div></div><div><h3>Conclusion</h3><div>Conservative management in PAS was associated with better preservation of specific aspects of sexual function, particularly pain and arousal.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114942"},"PeriodicalIF":1.9,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973308","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":"Epidural analgesia in small for gestational age and growth restricted fetuses: Impact on emergency delivery for presumed fetal distress","authors":"Anna Fichera ,&nbsp;Chiara Pedretti ,&nbsp;Nicola Fratelli ,&nbsp;Adriana Valcamonico ,&nbsp;Daniela Recupero ,&nbsp;Andrea Coelli ,&nbsp;Angelica Fiorini ,&nbsp;Antonino D’Ippolito ,&nbsp;Franco E. Odicino","doi":"10.1016/j.ejogrb.2026.114940","DOIUrl":"10.1016/j.ejogrb.2026.114940","url":null,"abstract":"<div><h3>Introduction</h3><div>Epidural analgesia (EDA) is widely used for pain relief during labor. Concerns have been raised about its potential association with an increased risk of emergency delivery for presumed fetal compromise, particularly in fetuses with low birth weight. This study aimed to evaluate whether EDA increases the risk of emergency delivery for suspected fetal distress in small-for-gestational-age and fetal growth restricted fetuses.</div></div><div><h3>Methods</h3><div>Retrospective cohort study conducted on singleton pregnancies with prenatal diagnosis of small-for-gestational-age or fetal growth restricted fetuses, delivering at ≥ 36 + 0 weeks at a tertiary care center between January 2020 and January 2024. The primary exposure was EDA; the primary outcome was emergency cesarean section or vacuum-assisted delivery due to presumed fetal distress, based on cardiotocographic findings. The secondary outcome was the incidence of a composite neonatal outcome defined as the occurrence of at least one of umbilical artery pH &lt; 7.00, base excess &lt; –12 mEq/L, 5-minute Apgar score &lt; 7, or NICU admission. The two groups (EDA vs. non-EDA) were compared using the chi-square test for categorical variables and the Mann–Whitney <em>U</em> test for continuous variables. Multivariate logistic regression was used to control for confounders.</div></div><div><h3>Results</h3><div>Among 310 eligible deliveries, 135 (43.5 %) received EDA. Emergency delivery for suspected fetal distress occurred in 16.5 % of cases. There were no significant differences in emergency delivery rates between the EDA and non-EDA groups (15.56 % vs 17.14 %; p = 0.759), nor within the small-for-gestational-age (13.4 % vs 13.9 %; p = 0.896) and the growth restricted fetuses (21.5 % vs 22.4 %; p = 0.874) subgroups. No significant difference in the composite adverse neonatal outcome was observed between the EDA and non-EDA groups (8.15 % vs 7.43 %; p = 0.814). Multivariate analysis confirmed no association between EDA and emergency delivery (p = 0.600), whereas nulliparity (p = 0.024) and U/C ratio &gt; 0.8 (p = 0.004) emerged as independent risk factors. Composite neonatal outcomes were similar between groups.</div></div><div><h3>Conclusions</h3><div>In this cohort of well-characterized small-for-gestational-age and fetal growth restricted fetuses, EDA was not associated with an increased risk of emergency delivery for suspected fetal distress. Individualized patient assessment and tailored management of labor analgesia remain crucial to ensure maternal and fetal safety.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114940"},"PeriodicalIF":1.9,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917400","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}