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

英文中文

Prediction models for intrapartum fetal hypoxia: A systematic review

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-02-25 DOI: 10.1016/j.ejogrb.2025.02.052

Holly J. Giles-Clark , Sasha M. Skinner , May M. Linn , Daniel L. Rolnik , Ben W. Mol

Background

Intrapartum fetal hypoxia (IFH) occurs infrequently and many cases occur unexpectedly, highlighting the importance of identifying at-risk fetuses to prevent hypoxic injury during birth.

Objectives

This systematic review aims to evaluate existing prediction models for IFH and ascertain the predictor variables that were incorporated into most models.

Search strategy

We searched MEDLINE and EMBASE databases from inception to December 2023 for synonyms of fetal distress, operative birth and neonatal asphyxia, with a filter for prediction models.

Selection criteria

Prediction models for IFH were included. IFH was defined as evidence of hypoxia or operative intervention for suspected fetal distress.

Data collection and analysis

Two authors independently extracted information on study design, outcome definition and validation. We evaluated study quality using the PROBAST tool. The number of models in which each predictor variable significantly contributed to the risk of IFH was quantified.

Main results

From 874 articles, 23 publications reported on 41 eligible prediction models. 32 models reported on model development only, while seven models across three studies included both development and internal validation. Of these, two models were also externally validated and refit to the validation data, but investigated fetuses with antenatally-suspected growth restriction, limiting generalisability. Frequently reported predictor variables included parity (13 studies), cerebroplacental ratio (10 studies) and oxytocin use (6 studies).

Conclusions

No prediction models for IFH applicable to the general population are currently ready for clinical application. External validation of existing models or development of new, reliable models applicable to all pregnant women is needed.

{"title":"Prediction models for intrapartum fetal hypoxia: A systematic review","authors":"Holly J. Giles-Clark , Sasha M. Skinner , May M. Linn , Daniel L. Rolnik , Ben W. Mol","doi":"10.1016/j.ejogrb.2025.02.052","DOIUrl":"10.1016/j.ejogrb.2025.02.052","url":null,"abstract":"<div><h3>Background</h3><div>Intrapartum fetal hypoxia (IFH) occurs infrequently and many cases occur unexpectedly, highlighting the importance of identifying at-risk fetuses to prevent hypoxic injury during birth.</div></div><div><h3>Objectives</h3><div>This systematic review aims to evaluate existing prediction models for IFH and ascertain the predictor variables that were incorporated into most models.</div></div><div><h3>Search strategy</h3><div>We searched MEDLINE and EMBASE databases from inception to December 2023 for synonyms of fetal distress, operative birth and neonatal asphyxia, with a filter for prediction models.</div></div><div><h3>Selection criteria</h3><div>Prediction models for IFH were included. IFH was defined as evidence of hypoxia or operative intervention for suspected fetal distress.</div></div><div><h3>Data collection and analysis</h3><div>Two authors independently extracted information on study design, outcome definition and validation. We evaluated study quality using the PROBAST tool. The number of models in which each predictor variable significantly contributed to the risk of IFH was quantified.</div></div><div><h3>Main results</h3><div>From 874 articles, 23 publications reported on 41 eligible prediction models. 32 models reported on model development only, while seven models across three studies included both development and internal validation. Of these, two models were also externally validated and refit to the validation data, but investigated fetuses with antenatally-suspected growth restriction, limiting generalisability. Frequently reported predictor variables included parity (13 studies), cerebroplacental ratio (10 studies) and oxytocin use (6 studies).</div></div><div><h3>Conclusions</h3><div>No prediction models for IFH applicable to the general population are currently ready for clinical application. External validation of existing models or development of new, reliable models applicable to all pregnant women is needed.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 99-111"},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519867","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}

引用次数: 0

Trends in patient characteristics, surgical techniques, and associated complications over time in pelvic organ prolapse repair

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-02-25 DOI: 10.1016/j.ejogrb.2025.02.054

Hilla Rosenberg , Noa Leybovitz-Haleluya , Alla Saban , Adi Y. Weintraub , Reut Rotem

Objective

To investigate trends in pelvic organ prolapse (POP) surgical repair procedures and patient characteristics over the past decade, focusing on peri-operative and post-operative complications.

Methods

This retrospective cohort study analyzed POP surgeries and short-term complications among women over 18 at a tertiary medical center from 2014 to 2022. Exclusion criteria included pelvic radiation, malignancy, significant comorbidities, incomplete records, or loss to follow-up. Complications were assessed using the Clavien–Dindo Classification, focusing on infection rate, antibiotic use, blood transfusions, readmission within 30 days, and Intensive care unit admission. Univariate analysis and logistic regression were performed.

Results

The study included 490 women, with 239 in 2014 and 251 in 2022. A decrease in invasive procedures, such as vaginal hysterectomy (25.1 % vs. 15.1 %, p < 0.01) and transabdominal hysterectomy (42.7 % vs 23.1 %, p < 0.01), alongside an increase in native tissue repairs like sacrospinous ligament fixation (SSLF) (2.1 % vs. 27.5 %, p < 0.01), anterior colporrhaphy (14.6 % vs. 24.7 %, p < 0.01), and posterior colporrhaphy (0.0 % vs. 2.4 %, p = 0.02), was noted. Additionally, the use of vaginal mesh decreased (4.2 % vs. 1.2 %, p = 0.04). Short-term complications significantly declined, including infection rate (10.9 % vs. 4.4 %, p < 0.01), post-operative antibiotics (10.9 % vs. 4.0 %, p < 0.01) and need for blood transfusion (16.7 % vs. 7.6 %, p < 0.01). SSLF was an independent protective factor against short-term complications (OR = 0.191, CI 0.044–0.826, p = 0.027), adjusted for year and patient age.

Conclusion

Our analysis suggests a shift toward less invasive POP surgeries, potentially contributing to improved short-term outcomes. The increase in native tissue repairs and reduction in hysterectomies may be associated with fewer short-term complications.

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引用次数: 0

Impact of artificial intelligence in paper writing on academia: Considering “Author Who?” 人工智能论文写作对学术界的影响：考虑 "作者是谁？

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-02-25 DOI: 10.1016/j.ejogrb.2025.02.046

Shigeki Matsubara , Daisuke Matsubara

引用次数: 0

Dysphoric Milk Ejection Reflex: Prevalence, persistence, and implications

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-02-24 DOI: 10.1016/j.ejogrb.2025.02.051

Romy Cappenberg , Jesus Garcia Garcia , Ioannis Liolios , Christine Happle , Anna Zychlinsky Scharff

Background

Dysphoric Milk Ejection Reflex (D-MER), characterized by an abrupt wave of negative emotions during milk-letdown, affects a relevant proportion of lactating parents and may significantly impact feeding choices, but remains poorly understood.

Methods

We conducted a cross-sectional study using an online survey of lactating parents of children 18 months and younger who were nursed for any period of time.

Results

The prevalence of D-MER in our cohort was 14.2 % (n = 209/1469). Among the 209 women who reported having experienced D-MER, the most frequently selected descriptions were: tense, hypersensitive, frustrated, irritable, overwhelmed, sad, lonely.

In the D-MER group, 85.9 % (n = 158/184) used a pump to express breastmilk. Of these 57.0 % (n = 90/158) experienced milder or absent D-MER symptoms while pumping as compared to nursing. Only 5.7 %, (n = 9/158) reported more severe symptoms while pumping, and 12.0 % (n = 19/158) experienced symptoms only when pumping.

40.2 % (n = 72/179), of respondents with D-MER reported that their symptoms remained stable between birth and weaning. In 29.6 % (n = 53/179), symptoms became milder and in 9.5 % (n = 17/179) they disappeared. Importantly, 16.9 % (n = 30/177) of D-MER respondents stopped breastfeeding because of D-MER symptoms, and a further 19.2 % (n = 34/177) had considered doing so.

The most frequently reported factor worsening D-MER symptoms was stress, which was selected by 62.1 % (n = 113/182), closely followed by lack of sleep (60.4 %, n = 110/182). Loneliness and conflict with a significant other were also frequently cited (49.5 %, n = 90/182 and 48.9 %, n = 89/182, respectively). The factors most likely to ease D-MER symptoms were “support from partner” and “sleep” (34.6 %, n = 63/182 and 29.7 %, n = 54/182, respectively).

{"title":"Dysphoric Milk Ejection Reflex: Prevalence, persistence, and implications","authors":"Romy Cappenberg , Jesus Garcia Garcia , Ioannis Liolios , Christine Happle , Anna Zychlinsky Scharff","doi":"10.1016/j.ejogrb.2025.02.051","DOIUrl":"10.1016/j.ejogrb.2025.02.051","url":null,"abstract":"<div><h3>Background</h3><div>Dysphoric Milk Ejection Reflex (D-MER), characterized by an abrupt wave of negative emotions during milk-letdown, affects a relevant proportion of lactating parents and may significantly impact feeding choices, but remains poorly understood.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study using an online survey of lactating parents of children 18 months and younger who were nursed for any period of time.</div></div><div><h3>Results</h3><div>The prevalence of D-MER in our cohort was 14.2 % (n = 209/1469). Among the 209 women who reported having experienced D-MER, the most frequently selected descriptions were: tense, hypersensitive, frustrated, irritable, overwhelmed, sad, lonely.</div><div>In the D-MER group, 85.9 % (n = 158/184) used a pump to express breastmilk. Of these 57.0 % (n = 90/158) experienced milder or absent D-MER symptoms while pumping as compared to nursing. Only 5.7 %, (n = 9/158) reported more severe symptoms while pumping, and 12.0 % (n = 19/158) experienced symptoms only when pumping.</div><div>40.2 % (n = 72/179), of respondents with D-MER reported that their symptoms remained stable between birth and weaning. In 29.6 % (n = 53/179), symptoms became milder and in 9.5 % (n = 17/179) they disappeared. Importantly, 16.9 % (n = 30/177) of D-MER respondents stopped breastfeeding because of D-MER symptoms, and a further 19.2 % (n = 34/177) had considered doing so.</div><div>The most frequently reported factor worsening D-MER symptoms was stress, which was selected by 62.1 % (n = 113/182), closely followed by lack of sleep (60.4 %, n = 110/182). Loneliness and conflict with a significant other were also frequently cited (49.5 %, n = 90/182 and 48.9 %, n = 89/182, respectively). The factors most likely to ease D-MER symptoms were “support from partner” and “sleep” (34.6 %, n = 63/182 and 29.7 %, n = 54/182, respectively).</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 127-131"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143553029","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}

引用次数: 0

Unravelling the mystique of recurrence: A comparative analysis of surgical approaches for early-stage endometrial cancer

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-02-24 DOI: 10.1016/j.ejogrb.2025.02.047

Priya Bhati , Monal Garg , Divya Panyam Vuppu , Anjali S. Nair , V.S. Sheejamol

Aim

This study aims to compare long-term survival differences and recurrence patterns between robotic and open surgery for early-stage endometrial cancer (EC).

Methods

This study was conducted retrospectively from 1st January 2015 to 30th June 2021 on all patients with stage I or stage II EC (FIGO 2023 Staging), irrespective of histology. The primary objective was to compare 3-year Recurrence-Free Survival (RFS) rates between robotic and laparotomy surgical approaches in patients with early-stage endometrial cancer.

Results

In a study of 297 patients, 81.5 % underwent robotic surgeries and 18.5 % underwent open surgeries. Median age was 47.5 years. After a median follow-up period of 36 months, RFS rates of 92.5 % and 86.1 % in robotic and laparotomy groups, respectively (p = 0.6). Most recurrences were found at distant sites (77 %). No significant differences in recurrence sites between surgical groups (p > 0.05), but vaginal vault and para-aortic lymph node recurrences were exclusive to the robotic group. Median time to recurrence was significantly shorter in open group than robotic group (p = 0.01). Patients with focal LVSI (lymphovascular space invasion) had significantly higher recurrence rates compared to THOSE without LVSI (p = 0.04).

Conclusion

No significant difference in RFS rates between two surgical approaches. However, robot-assisted surgery leads to a longer median time before recurrence. Most recurrences are distant, and focal LVSI is significantly associated with these recurrences. It’s important to consider focal LVSI in histopathology reports, and patients with early-stage endometrial cancer should be monitored for potential recurrences.

{"title":"Unravelling the mystique of recurrence: A comparative analysis of surgical approaches for early-stage endometrial cancer","authors":"Priya Bhati , Monal Garg , Divya Panyam Vuppu , Anjali S. Nair , V.S. Sheejamol","doi":"10.1016/j.ejogrb.2025.02.047","DOIUrl":"10.1016/j.ejogrb.2025.02.047","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to compare long-term survival differences and recurrence patterns between robotic and open surgery for early-stage endometrial cancer (EC).</div></div><div><h3>Methods</h3><div>This study was conducted retrospectively from 1st January 2015 to 30th June 2021 on all patients with stage I or stage II EC (FIGO 2023 Staging), irrespective of histology. The primary objective was to compare 3-year Recurrence-Free Survival (RFS) rates between robotic and laparotomy surgical approaches in patients with early-stage endometrial cancer.</div></div><div><h3>Results</h3><div>In a study of 297 patients, 81.5 % underwent robotic surgeries and 18.5 % underwent open surgeries. Median age was 47.5 years. After a median follow-up period of 36 months, RFS rates of 92.5 % and 86.1 % in robotic and laparotomy groups, respectively (p = 0.6). Most recurrences were found at distant sites (77 %). No significant differences in recurrence sites between surgical groups (p > 0.05), but vaginal vault and <em>para</em>-aortic lymph node recurrences were exclusive to the robotic group. Median time to recurrence was significantly shorter in open group than robotic group (p = 0.01). Patients with focal LVSI (lymphovascular space invasion) had significantly higher recurrence rates compared to THOSE without LVSI (p = 0.04).</div></div><div><h3>Conclusion</h3><div>No significant difference in RFS rates between two surgical approaches. However, robot-assisted surgery leads to a longer median time before recurrence. Most recurrences are distant, and focal LVSI is significantly associated with these recurrences. It’s important to consider focal LVSI in histopathology reports, and patients with early-stage endometrial cancer should be monitored for potential recurrences.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 70-77"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510681","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}

引用次数: 0

Prospective external validation and exploration of the “2021 AAGL endometriosis classification”

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-02-24 DOI: 10.1016/j.ejogrb.2025.02.048

Yu Zhang , Yunting Zhou , Mengjie Zhang , Rui Chen , Liming Wang

Study objective

According to a four-level scale of endometriosis surgical complexity, the 2021 American Association of Gynecologic Laparoscopists (AAGL) endometriosis classification system was externally and prospectively validated. And we explored the relationship between it, and clinical symptoms, CA125 and CA199 levels.

Design

Prospective, AAGL, validation, CA125.

Setting

The Affiliated Hospital of Qingdao University.

Patient

Finally, a total of 164 patients were analysed.

Intervention

Intraoperative imaging (e.g. surgical video/picture) was analysed. For patients with positive pain symptoms, pain was rated from 0 to 10 using the visual analogue scale (VAS) scores. Preoperative serum CA125 and CA199 levels were measured.

Measurements and main results

Weighted kappa coefficient analysis served to evaluate the consistencies across the AAGL staging system and ASRM system with the surgical complexity scale. The Mann–Whitney U test was employed to analyse the relationship with the AAGL staging system and CA125 and CA199 levels of patients.

The weighted kappa score for the overall performance of the AAGL staging system and ASRM to predict AAGL level was 0.665 and 0.287, respectively. Our study showed the CA125 levels of patients having the AAGL stages Ⅲ/ Ⅳ disease exceed the stages Ⅰ / Ⅱ disease(p＜0.05). The CA199 levels of these two groups had no significant difference (p＞0.05). And compared with the patients having AAGL stages Ⅰ / Ⅱ disease, the dysmenorrhea, cyclic low back pain and deep dyspareunia of the patients having AAGL stages Ⅲ / Ⅳ disease had significant differences(p < 0.05).

Conclusion

The 2021 AAGL endometriosis system assisted surgeons accurately evaluating the surgical complexity of endometriosis. Still, the CA125 levels and some clinical symptoms could reflect the surgical complexity of endometriosis.

{"title":"Prospective external validation and exploration of the “2021 AAGL endometriosis classification”","authors":"Yu Zhang , Yunting Zhou , Mengjie Zhang , Rui Chen , Liming Wang","doi":"10.1016/j.ejogrb.2025.02.048","DOIUrl":"10.1016/j.ejogrb.2025.02.048","url":null,"abstract":"<div><h3>Study objective</h3><div>According to a four-level scale of endometriosis surgical complexity, the 2021 American Association of Gynecologic Laparoscopists <strong>(</strong>AAGL) endometriosis classification system was externally and prospectively validated. And we explored the relationship between it, and clinical symptoms, CA125 and CA199 levels.</div></div><div><h3>Design</h3><div>Prospective, AAGL, validation, CA125.</div></div><div><h3>Setting</h3><div>The Affiliated Hospital of Qingdao University.</div></div><div><h3>Patient</h3><div>Finally, a total of 164 patients were analysed.</div></div><div><h3>Intervention</h3><div>Intraoperative imaging (e.g. surgical video/picture) was analysed. For patients with positive pain symptoms, pain was rated from 0 to 10 using the visual analogue scale (VAS) scores. Preoperative serum CA125 andCA199 levelswere measured.</div></div><div><h3>Measurements and main results</h3><div>Weighted kappa coefficient analysis served to evaluate the consistencies across the AAGL staging system and ASRM system with the surgical complexity scale. The Mann–Whitney <em>U</em> test was employed to analyse the relationship with the AAGL staging system and CA125 and CA199 levels of patients.</div><div>The weighted kappa score for the overall performance of the AAGL staging system and ASRM to predict AAGL level was 0.665 and 0.287, respectively. Our study showed the CA125 levels of patients having the AAGL stages Ⅲ/ Ⅳ disease exceed the stages Ⅰ / Ⅱ disease(p＜0.05). The CA199 levels of these two groups had no significant difference (p＞0.05). And compared with the patients having AAGL stages Ⅰ / Ⅱ disease, the dysmenorrhea, cyclic low back pain and deep dyspareunia of the patients having AAGL stages Ⅲ / Ⅳ disease had significant differences(p < 0.05).</div></div><div><h3>Conclusion</h3><div>The 2021 AAGL endometriosis system assisted surgeons accurately evaluating the surgical complexity of endometriosis. Still, the CA125 levels and some clinical symptoms could reflect the surgical complexity of endometriosis.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 90-95"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510590","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}

引用次数: 0

Comparative analysis of European guideline-based clinicopathological risk groups and the International Federation of Gynecology and Obstetrics staging system for endometrial cancer

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-02-24 DOI: 10.1016/j.ejogrb.2025.02.049

Mikko J. Loukovaara , Annukka M. Pasanen , Heini J. Lassus , Anna L. Luomaranta , Piret Hellberg , Johanna Vartiainen , Johanna E. Tapper , Ralf C. Bützow

Objective

To investigate the correlation between endometrial cancer risk groups, as defined by the 2021 European guidelines, and the 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system. Further, we aimed to evaluate the additional prognostic capability of the staging system within individual risk groups.

Study design

This retrospective cohort study included patients who underwent primary treatment for endometrial cancer at a single tertiary center. Each case was classified into a molecular-integrated risk group according to the 2021 joint guidelines from the European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP). Staging was performed using the FIGO 2023 criteria with molecular classification.

Results

Data from 1044 patients were analyzed. Median follow-up was 70 months. Stage IA2, stage IB, and stage IVB were the most prevalent stages among the ESGO–ESTRO–ESP low-risk, intermediate risk, and advanced-metastatic groups, accounting for 80 %, 75 %, and 54 % of the cases, respectively. The stage distribution was more heterogeneous in the high-intermediate risk and high-risk groups, with stage IIA comprising 36 % and stage IICm_p53abn comprising 35 % of cases in these groups. The FIGO staging system further stratified survival outcomes especially in the high-intermediate and high-risk groups. Stage IIC included a substantial number of cases from the intermediate risk (n = 23), high-intermediate risk (n = 48), and high-risk (n = 27) groups. Risk groups were associated with survival within this stage.

Conclusions

ESGO–ESTRO–ESP high-intermediate risk and high-risk endometrial cancers exhibited the greatest variability in terms of stage distribution and survival outcomes. Stage IIC, the most heterogeneous stage concerning risk groups, showed an association between risk groups and survival.

{"title":"Comparative analysis of European guideline-based clinicopathological risk groups and the International Federation of Gynecology and Obstetrics staging system for endometrial cancer","authors":"Mikko J. Loukovaara , Annukka M. Pasanen , Heini J. Lassus , Anna L. Luomaranta , Piret Hellberg , Johanna Vartiainen , Johanna E. Tapper , Ralf C. Bützow","doi":"10.1016/j.ejogrb.2025.02.049","DOIUrl":"10.1016/j.ejogrb.2025.02.049","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the correlation between endometrial cancer risk groups, as defined by the 2021 European guidelines, and the 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system. Further, we aimed to evaluate the additional prognostic capability of the staging system within individual risk groups.</div></div><div><h3>Study design</h3><div>This retrospective cohort study included patients who underwent primary treatment for endometrial cancer at a single tertiary center. Each case was classified into a molecular-integrated risk group according to the 2021 joint guidelines from the European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP). Staging was performed using the FIGO 2023 criteria with molecular classification.</div></div><div><h3>Results</h3><div>Data from 1044 patients were analyzed. Median follow-up was 70 months. Stage IA2, stage IB, and stage IVB were the most prevalent stages among the ESGO–ESTRO–ESP low-risk, intermediate risk, and advanced-metastatic groups, accounting for 80 %, 75 %, and 54 % of the cases, respectively. The stage distribution was more heterogeneous in the high-intermediate risk and high-risk groups, with stage IIA comprising 36 % and stage IICm<sub>p53abn</sub> comprising 35 % of cases in these groups. The FIGO staging system further stratified survival outcomes especially in the high-intermediate and high-risk groups. Stage IIC included a substantial number of cases from the intermediate risk (n = 23), high-intermediate risk (n = 48), and high-risk (n = 27) groups. Risk groups were associated with survival within this stage.</div></div><div><h3>Conclusions</h3><div>ESGO–ESTRO–ESP high-intermediate risk and high-risk endometrial cancers exhibited the greatest variability in terms of stage distribution and survival outcomes. Stage IIC, the most heterogeneous stage concerning risk groups, showed an association between risk groups and survival.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 85-89"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510588","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}

引用次数: 0

Primary infertile couples share more HLA alleles than expected by chance

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-02-24 DOI: 10.1016/j.ejogrb.2025.02.053

David Göhring , Maren Goeckenjan , Inés Göhring , Vinzenz Lange , Jürgen Sauter , Denise Kreßner-Kiel , Alexander H. Schmidt , Ilona Croy

Objective

To examine whether the rate of HLA similarity among 609 primarily infertile couples is higher than would be expected by chance.

Design

Clinical Trial.

Subjects

609 primary infertile couples (mean age women: 34.35 years, men: 37.59 years) were recruited before undergoing IVF or ICSI therapy. Couples with former pregnancies, tubal factor, azoospermia or donor therapies were excluded.

Intervention

For each of the partners, exons encoding the corresponding antigen recognition sites of HLA-A, −B, −C, −DRB1, −DQB1, and −DPB1 were sequenced by using next-generation sequencing. HLA similarity between partners was determined based on the probability of homozygous offspring and the observed probability of heterozygous offspring in the sample of primary infertile couples was comparted to the probability for random pairing using bootstrapping.

Main outcome measures

HLA similarity of infertile couples compared to randomly assigned couples.

Results

In each of the loci, infertile pairs shared more alleles than expected by chance. This result was significant for all HLA class 2 loci (−DRB1, −DQB1, −DPB1), as well as for the HLA class I locus −C, while HLA-A and −B showed a nonsignificant trend towards higher similarity.

Conclusion

These data suggest that HLA similarity between couples relates to primary infertility.

{"title":"Primary infertile couples share more HLA alleles than expected by chance","authors":"David Göhring , Maren Goeckenjan , Inés Göhring , Vinzenz Lange , Jürgen Sauter , Denise Kreßner-Kiel , Alexander H. Schmidt , Ilona Croy","doi":"10.1016/j.ejogrb.2025.02.053","DOIUrl":"10.1016/j.ejogrb.2025.02.053","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether the rate of HLA similarity among 609 primarily infertile couples is higher than would be expected by chance.</div></div><div><h3>Design</h3><div>Clinical Trial.</div></div><div><h3>Subjects</h3><div>609 primary infertile couples (mean age women: 34.35 years, men: 37.59 years) were recruited before undergoing IVF or ICSI therapy. Couples with former pregnancies, tubal factor, azoospermia or donor therapies were excluded.</div></div><div><h3>Intervention</h3><div>For each of the partners, exons encoding the corresponding antigen recognition sites of HLA-A, −B, −C, −DRB1, −DQB1, and −DPB1 were sequenced by using next-generation sequencing. HLA similarity between partners was determined based on the probability of homozygous offspring and the observed probability of heterozygous offspring in the sample of primary infertile couples was comparted to the probability for random pairing using bootstrapping.</div></div><div><h3>Main outcome measures</h3><div>HLA similarity of infertile couples compared to randomly assigned couples.</div></div><div><h3>Results</h3><div>In each of the loci, infertile pairs shared more alleles than expected by chance. This result was significant for all HLA class 2 loci (−DRB1, −DQB1, −DPB1), as well as for the HLA class I locus −C, while HLA-A and −B showed a nonsignificant trend towards higher similarity.</div></div><div><h3>Conclusion</h3><div>These data suggest that HLA similarity between couples relates to primary infertility.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 47-53"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488356","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}

引用次数: 0

Expert opinion by the Italian Society of Gynecology of the Third Age (SIGiTE) and the Italian Society of Menopause (SIM) on hormone therapy with bioidentical hormones

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-02-24 DOI: 10.1016/j.ejogrb.2025.02.045

Stefano Lello , Anna Capozzi , Angelo Cagnacci , Marco Gambacciani , Lino Del Pup , Costantino Di Carlo , Executive Committee of the Italian Society of Gynecology of the Third Age SIGiTE and the Italian Society of Menopause SIM

The publication of the study WHI (Women’s Health Initiative) represented a critical moment for the management of menopause considering the alarming results about breast cancer and cardiovascular risks. Anyway, several further studies progressively clarified over time the effective clinical impact of hormone replacement therapy (HRT) among post-menopausal women if adequately started before the age of sixty and no more than ten years after the last menstrual cycle and properly customized according to the major international recommendations. Robust evidence exists on different approved bioidentical HRT (abHRT) but data about galenic composed bioidentical hormone therapy (cbHRT) remain poor. The purpose of this expert opinion is to elucidate the position on Hormone Therapy with Bioidentical Hormones of the major Italian societies dealing with menopause, that is the Italian Society of Gynecology of the Third Age (SIGiTE) and the Italian Society of Menopause (SIM), in order to aware physicians about the suitability of their use.

{"title":"Expert opinion by the Italian Society of Gynecology of the Third Age (SIGiTE) and the Italian Society of Menopause (SIM) on hormone therapy with bioidentical hormones","authors":"Stefano Lello , Anna Capozzi , Angelo Cagnacci , Marco Gambacciani , Lino Del Pup , Costantino Di Carlo , Executive Committee of the Italian Society of Gynecology of the Third Age SIGiTE and the Italian Society of Menopause SIM","doi":"10.1016/j.ejogrb.2025.02.045","DOIUrl":"10.1016/j.ejogrb.2025.02.045","url":null,"abstract":"<div><div>The publication of the study WHI (Women’s Health Initiative) represented a critical moment for the management of menopause considering the alarming results about breast cancer and cardiovascular risks. Anyway, several further studies progressively clarified over time the effective clinical impact of hormone replacement therapy (HRT) among post-menopausal women if adequately started before the age of sixty and no more than ten years after the last menstrual cycle and properly customized according to the major international recommendations. Robust evidence exists on different approved bioidentical HRT (abHRT) but data about galenic composed bioidentical hormone therapy (cbHRT) remain poor. The purpose of this expert opinion is to elucidate the position on Hormone Therapy with Bioidentical Hormones of the major Italian societies dealing with menopause, that is the Italian Society of Gynecology of the Third Age (SIGiTE) and the Italian Society of Menopause (SIM), in order to aware physicians about the suitability of their use.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"308 ","pages":"Pages 67-69"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488355","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}

引用次数: 0

Response to the Letter by Yong-Shan Chen and Dong-Zhi Li Regarding Our Publication: “Gestational Diabetes Mellitus and Group B Streptococcus Maternal Colonization”

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-02-22 DOI: 10.1016/j.ejogrb.2025.02.044

Mohammed R. Khalil

引用次数: 0

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