European journal of obstetrics, gynecology, and reproductive biology最新文献_第3页

Which body region’s fat accumulation increase the risk of stress urinary incontinence? 哪个身体部位的脂肪堆积会增加压力性尿失禁的风险？

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-19 DOI: 10.1016/j.ejogrb.2026.114957

Ana Jéssica dos Santos Sousa , Stela Márcia Mattiello , Ana Paula Rodrigues Rocha , Alessander Danna-Dos-Santos , Patricia Driusso

The objective of this cross-sectional study was to examine the association between fat mass distribution and stress urinary incontinence (SUI) symptoms, as well as the impact of SUI on daily activities. We assessed sociodemographic characteristics, urinary symptoms, and fat mass (total, android, gynoid, and visceral adipose tissue [VAT]). Descriptive statistics, independent t tests, and univariable and multivariable regression analyses were conducted. Women with SUI exhibited significantly higher total, android, gynoid, and VAT fat mass than women without urinary incontinence (p < 0.05). Increases in total, android, gynoid, and VAT fat mass were associated with higher odds of SUI by 0.4%, 4.4%, 2.6%, and 31.4%, respectively. VAT fat mass was particularly influential, increasing the likelihood of SUI by 51% (odds ratio [OR] 1.51; 95% CI). Greater VAT accumulation was also associated with a 16.0% increase in discomfort related to urinary symptoms and a 9.3% increase in the impact on daily activities among women with SUI. In summary, higher adiposity in the android, gynoid, and especially VAT regions are associated with an increased likelihood of SUI and with greater symptom-related discomfort and functional impact.

本横断面研究的目的是探讨脂肪质量分布与压力性尿失禁（SUI）症状之间的关系，以及SUI对日常活动的影响。我们评估了社会人口学特征、泌尿系统症状和脂肪量（总脂肪、安卓脂肪、雌核脂肪和内脏脂肪组织[VAT]）。进行描述性统计、独立t检验、单变量和多变量回归分析。SUI患者的总脂肪量、android脂肪量、gynoid脂肪量和VAT脂肪量明显高于无尿失禁的女性（p < 0.05）。总脂肪量、安卓脂肪量、雌核脂肪量和增值脂肪量的增加分别与SUI的高发生率相关，分别为0.4%、4.4%、2.6%和31.4%。增值脂肪量的影响特别大，使SUI的可能性增加51%（优势比[OR] 1.51; 95% CI）。在患有SUI的女性中，较大的VAT积累还与与泌尿系统症状相关的不适增加16.0%和对日常活动的影响增加9.3%相关。综上所述，android, gyoid，特别是VAT区域的高脂肪与SUI的可能性增加以及更大的症状相关的不适和功能影响相关。

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引用次数: 0

Single-incision slings in stress urinary incontinence: impact of intrinsic sphincter deficiency on surgical success 单切口吊带治疗压力性尿失禁：内在括约肌缺陷对手术成功的影响

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-18 DOI: 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.

目的评价市场上销售的单切口悬吊（SIS）包在女性内生性括约肌缺陷（ISD）患者中的应用效果，并确定手术失败的预测因素。方法在某三级转诊医院进行回顾性队列研究，纳入685例尿动力应激性尿失禁（USI）患者，其中56例为术前尿动力应激性尿失禁。主要结果是USI的客观治愈，定义为在填充膀胱术中腹部压力增加时没有明显的不自主尿漏。主观治愈是对UDI-6问题3的负面反应。次要结果是确定手术失败的预测因素。结果总体而言，术后1年的主要终点客观治愈率为89.5%(613/685)，主观治愈率为87.0%（596/685）。SIS类型的成功率相似：Ophira™，89.8% (114/127)；Solyx™，89% (299/336)；I-Stop-Mini™，90.1%（200/222）。多因素logistic回归模型确定年龄（OR 1.88 1.17-3.01）、绝经后状态（OR 1.42 1.07-2.05）、角度<； 30°（OR 2.96 1.50-4.87）、MUCP （OR 2.35 1.55-3.93）、磁带百分比（OR 1.60 1.19-3.11）是与ISD女性术后SIS失败相关的独立因素。结论sis治疗SUI治愈率高，但治疗ISD的成功率较低。仔细选择患者和考虑手术预测因素可以优化结果。确定的失败预测因素包括年龄较大、绝经后状态、低MUCP、胶带百分位数和膀胱颈角30°。此外，建议术前常规评估膀胱颈部活动能力作为治疗女性ISD的实用工具。

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引用次数: 0

Association between cardiometabolic index and prevalence of ovarian cancer among US adults: A cross-sectional NHANES study 美国成年人心脏代谢指数与卵巢癌患病率之间的关系：一项横断面NHANES研究

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-17 DOI: 10.1016/j.ejogrb.2026.114954

Xinyan Gao , Xiaoxiang Jiang , Junming Chen , Bin Du , Xiaojiao Weng , Jinhuo Lai , Riping Wu

Objective

To investigate the possible link between ovarian cancer and cardiometabolic index (CMI).

Methods

A cross-sectional investigation was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Sensitivity analysis, smooth curve fitting, and weighted multivariate logistic regression were employed to explore the relationship between CMI and ovarian cancer. The effectiveness of CMI in detecting ovarian cancer was also assessed using eXtreme Gradient Boosting and receiver operating characteristic analysis. Furthermore, subgroup analysis and interaction tests were employed to examine the stability of the connection across different populations.

Results

In this study involving 8814 individuals aged ≥ 20 years, CMI was found to be positively correlated with ovarian cancer. Each unit increase in CMI was associated with 10 % increased odds of ovarian cancer in the fully adjusted model {odds ratio [OR] 1.10 [95 % confidence interval (CI) 1.02–1.17]}. The prevalence of ovarian cancer was higher in individuals in the highest CMI tertile [OR 3.68 (95 % CI 1.10–12.35)] compared with those in the lowest CMI tertile. There was a non-linear dose–response association (p for non-linearity = 0.004) between the odds of ovarian cancer and CMI. The results of subgroup analysis and interaction tests show that, apart from race, the relationship between CMI and ovarian cancer was consistent across subgroups.

Conclusions

Increased prevalence of ovarian cancer is associated with elevated CMI levels. Improving cholesterol levels and management of dyslipidaemia may help reduce the odds of ovarian cancer.

目的探讨卵巢癌与心脏代谢指数（CMI）的关系。方法采用1999-2018年国家健康与营养检查调查（NHANES）的数据进行横断面调查。采用敏感性分析、平滑曲线拟合、加权多因素logistic回归等方法探讨CMI与卵巢癌的关系。使用极端梯度增强和受者工作特征分析评估CMI检测卵巢癌的有效性。此外，采用亚群分析和相互作用检验来检验不同种群间连接的稳定性。结果本研究共纳入8814例年龄≥20岁的个体，发现CMI与卵巢癌呈正相关。在完全调整的模型中，CMI每增加一个单位，卵巢癌的风险就增加10%[比值比[OR] 1.10[95%可信区间（CI） 1.02-1.17]}。与CMI最低胎率的个体相比，CMI最高胎率的个体卵巢癌患病率更高[OR 3.68 (95% CI 1.10-12.35)]。卵巢癌和CMI的发生率之间存在非线性的剂量-反应关系（非线性p = 0.004）。亚组分析和相互作用试验的结果表明，除种族外，CMI与卵巢癌之间的关系在各亚组中是一致的。结论卵巢癌患病率增高与CMI水平升高有关。改善胆固醇水平和控制血脂异常可能有助于降低患卵巢癌的几率。

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引用次数: 0

Knowledge, awareness and practices regarding human papillomavirus vaccine amongst secondary school girls and mothers in North India 印度北部中学女生和母亲对人乳头瘤病毒疫苗的知识、认识和做法。

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-15 DOI: 10.1016/j.ejogrb.2026.114945

A. Anand , Y.M. Mala , S. Tyagi , P. Sharma

Background

Lack of awareness about cervical cancer, its aetiology and preventive measures are barriers to disease control.

Objectives

To study the knowledge, attitudes and practices of adolescent girls and their mothers regarding cervical cancer, human papillomavirus (HPV) vaccine, and preventive strategies.

Design

A quasi-experimental study amongst girls aged 15–18 years and their mothers. In total, 110 girls and 100 mothers, who gave their consent, were given a pre-intervention questionnaire to assess baseline knowledge and attitudes towards cervical cancer, HPV vaccine, and preventive strategies. Printed educational material was provided. A post-intervention survey was undertaken after a minimum gap of 2 weeks.

Results

Ninety-one girls and 82 mothers with a diverse demographic profile completed the study. Pre-intervention findings revealed notable baseline awareness of cervical cancer, albeit with limited understanding of associated symptoms and preventive measures, including HPV vaccination. Post-intervention, knowledge regarding the symptoms of cervical cancer increased significantly among girls (p = 0.000), and awareness of early detection of cervical cancer increased significantly among mothers (p = 0.002). Knowledge about Pap smear tests increased among girls (p = 0.000). An increase in vaccination was seen in girls at the end of the study, but the difference was not significant (pre-intervention 23.1 %, post-intervention 31.9 %; p = 0.045).

Conclusion

Significant improvements were observed in adolescent girls and mothers regarding awareness of symptoms and early detection of cervical cancer.

背景：缺乏对宫颈癌的认识，其病因和预防措施是疾病控制的障碍。目的：了解青春期少女及其母亲对宫颈癌、人乳头瘤病毒（HPV）疫苗及预防策略的认识、态度和行为。设计：在15-18岁的女孩和她们的母亲中进行的一项准实验研究。总共有110名女孩和100名同意的母亲收到了干预前问卷，以评估对宫颈癌、人乳头瘤病毒疫苗和预防策略的基线知识和态度。提供了印刷的教育材料。最少间隔2周后进行干预后调查。结果：91名女孩和82名母亲完成了这项研究，她们的人口结构各不相同。干预前调查结果显示，尽管对相关症状和预防措施（包括HPV疫苗接种）的了解有限，但对宫颈癌的基线认识显著。干预后，女孩对宫颈癌症状的了解显著增加（p = 0.000），母亲对宫颈癌早期检测的认识显著增加（p = 0.002）。女孩对子宫颈抹片检查的了解有所增加（p = 0.000）。在研究结束时，女孩的疫苗接种率有所增加，但差异不显著（干预前23.1%，干预后31.9%;p = 0.045）。结论：在对宫颈癌症状的认识和早期发现方面，青春期女孩和母亲有了显著的改善。

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引用次数: 0

Classification of patients with adenomyosis based on clusters of coexisting diseases: An illustration of clinical diversity 基于共存疾病群的子宫腺肌症患者分类：临床多样性的例证

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-14 DOI: 10.1016/j.ejogrb.2026.114962

Xin Wang , YuDan Fu , RuoXi Zhao , Yong Liu, RuiHua Zhao

Objective

Adenomyosis (AM) is a complex disease with poorly understood pathogenesis and considerable clinical phenotypic heterogeneity. Cluster analysis of coexisting diseases may help identify distinct clinical subtypes of AM and explore the potential association between AM and its coexisting diseases.

Methods

In this study, data were extracted from a cross-sectional questionnaire. AM patients were clustered by Ward’s method according to the coexisting diseases. Cluster of patients with similar coexisting diseases pattern was captured and characterized. Subsequently, the clinical characteristics of these clusters were compared.

Results

Data from 2080 AM patients were collected. Sixteen types of coexisting diseases were included in the cluster analysis, resulting in six distinct clusters: cluster 1 (leiomyoma of the uterus); cluster 2 (endometrial lesions); cluster 3 (benign breast and thyroid masses); cluster 4 (pelvic inflammatory disease); cluster 5 (benign ovarian cyst); cluster 6 (low burden of comorbidity).

Conclusion

Identifying patient clusters with similar coexisting diseases pattern can improve our understanding of the multidimensional nature of AM, reveal the complex inter-disease relationship, aid in early screening for specific diseases in particular subgroups, support the identification of risk factors for AM prevention, and guide the development of tailored management strategies for different subgroups.

目的子宫腺肌症（AM）是一种复杂的疾病，发病机制尚不清楚，临床表型异质性较大。对共存疾病的聚类分析有助于识别AM的不同临床亚型，并探索AM与其共存疾病之间的潜在关联。方法本研究采用横断面调查问卷。采用Ward 's法将AM患者按共存疾病进行聚类。捕获具有相似共存疾病模式的患者群并对其进行特征描述。随后，比较这些群集的临床特征。结果共收集了2080例AM患者的数据。16种共存的疾病被纳入聚类分析，得出6个不同的聚类：聚类1（子宫平滑肌瘤）；集群2（子宫内膜病变）；第三组（乳腺和甲状腺良性肿块）；第4组（盆腔炎）；第五组（良性卵巢囊肿）；第6组（共病负担低）。结论识别具有相似疾病共存模式的患者群，可以提高我们对AM的多维性认识，揭示复杂的疾病间关系，有助于对特定亚组特定疾病的早期筛查，支持识别AM预防的危险因素，指导制定针对不同亚组的针对性管理策略。

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引用次数: 0

Assessment of AI-generated responses to common pregnancy questions: A blinded expert evaluation 评估人工智能对常见妊娠问题的回答：盲法专家评估

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-14 DOI: 10.1016/j.ejogrb.2026.114960

Arif Onur Atay , Feride Atay , Oguzcan Corlu

Introduction

We conducted a cross-sectional, blinded expert evaluation of AI-generated answers to 22 frequently asked pregnancy questions to characterize content quality and potential clinical utility.

Methods

Five obstetricians (not involved in rating) compiled the questions; ChatGPT produced responses using a minimal prompt with a fresh session per item. Forty board-certified OB/GYNs rated each answer on 5-point Likert scales for accuracy, comprehensiveness, safety, and understandability; two deliberately incorrect attention-check items were embedded and excluded.

Results

We obtained 879/880 expected rating blocks (<0.1% missing). Domain means clustered tightly (accuracy 3.95 ± 0.20, safety 3.94 ± 0.16, understandability 3.94 ± 0.19, comprehensiveness 3.91 ± 0.17), with no overall domain difference (Friedman χ²(3) = 3.13, p = 0.372). Question-level means ranged 3.71–4.31, highest for routine daily-life topics (air travel, sexual activity, sleep position, exercise) and lowest for context-dependent items (e.g., (non-stress test) NST 3.71; heartburn 3.72; edema 3.79; vaginal bleeding 3.81). Pre-specified subgroups showed a small but significant difference (Kruskal–Wallis p = 0.033): daily life scored higher than follow-up/testing/procedures (adjusted p < 0.05), whereas daily life vs symptoms and symptoms vs follow-up were not significant. In domain × subgroup analyses, only understandability differed (p = 0.020), with daily life > symptoms (adjusted p = 0.043); safety’s global difference did not yield significant pairwise contrasts. Overall inter-rater reliability was moderate, supporting consistent expert evaluation while underscoring increased variability in symptom-based assessments.

Conclusions

Experts rated the AI-generated answers as moderate-to-high overall; however, inter-rater reliability was only moderate and varied markedly by question type (highest for daily life questions and very low for symptom-related questions) indicating heterogeneous clinician judgments and supporting cautious interpretation of these findings.

我们对人工智能生成的22个常见妊娠问题的答案进行了横断面、盲法专家评估，以表征内容质量和潜在的临床应用。方法5名产科医生（未参与评分）编制问题；ChatGPT使用最小的提示和每个项目的新会话来生成响应。40名经委员会认证的妇产科医生对每个答案的准确性、全面性、安全性和可理解性进行5分李克特评分；两个故意错误的注意力检查项目被嵌入和排除。结果我们获得了879/880个预期评级块（缺失0.1%）。域均值聚类紧密（准确性3.95±0.20，安全性3.94±0.16，可理解性3.94±0.19，综合性3.91±0.17），总体无统计学差异（Friedman χ2(3) = 3.13, p = 0.372）。问题水平平均值范围为3.71 - 4.31，最高的是日常生活话题（航空旅行、性活动、睡眠姿势、运动），最低的是情境相关项目(例如，（非压力测试）NST 3.71；胃灼热3.72;水肿3.79;阴道出血3.81)。预先指定的亚组显示出小而显著的差异（Kruskal-Wallis p = 0.033）：日常生活得分高于随访/测试/程序得分（调整p <； 0.05），而日常生活与症状和症状与随访的得分不显著。在域×亚组分析中，只有可理解性不同（p = 0.020），日常生活和gt；症状（调整后p = 0.043）；安全性的整体差异没有产生显著的两两对比。总体评分者之间的信度为中等，支持一致的专家评估，同时强调基于症状的评估增加了可变性。专家对人工智能生成的答案总体评价为中高；然而，评估者间信度仅为中等，且因问题类型而有显著差异（日常生活问题的信度最高，症状相关问题的信度极低），表明临床医生的判断存在差异，支持对这些发现的谨慎解释。

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引用次数: 0

Pregnancy outcomes after laparotomic or laparoscopic myomectomy: A multicenter retrospective cohort study 剖腹或腹腔镜子宫肌瘤切除术后妊娠结局：一项多中心回顾性队列研究。

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-14 DOI: 10.1016/j.ejogrb.2026.114964

Bernies J. Bos , Elisabeth R. Knorren Loes , Cathy van de Graaf , Marjan van den Berg , Jeroen R. Dijkstra , Mirjam J.A. Apperloo , Jorien M. Woolderink

Objective

Expend knowledge about pregnancy rate, live birth rate and outcomes after laparotomic or laparoscopic myomectomy.

Methods

In four hospitals in the Netherlands patients with a FIGO type 3–7 myoma who underwent laparoscopic or laparotomic myomectomy between January 2007 and April 2022, were retrospectively identified. Indication for the myomectomy was abnormal uterine bleeding, bulk-related symptoms and/or infertility. Baseline characteristics, data of the myomectomy and outcomes including pregnancy rates, live birth rates and complications during pregnancy or delivery, were extracted from electronic patient records. Logistic regression analysis was used to identify factors influencing the live birth rate.

Results

One hundred sixty four patients were included. Sixty one patients had 94 pregnancies after the myomectomy (pregnancy rate: 37 %), resulting in 64 deliveries in 50 patients (30 %). The most common mode of delivery was caesarean section (CS) (n = 40, 62 %). Forty-six patients had a live birth after the myomectomy (live birth rate: 28 %), together they had 60 children. No major complications related to the myomectomy occurred during pregnancy or delivery. Patients who had been pregnant before the myomectomy and patients with infertility as primary symptom, had a higher probability of live birth after myomectomy.

Conclusion

Patients who underwent a laparotomic or laparoscopic myomectomy have a live birth rate of 28%, with a pregnancy rate of 37%. The most common mode of delivery is CS. No major complications were found during delivery. Patients with a pregnancy prior to the myomectomy or with infertility as primary symptom had an increased probability of live birth after myomectomy.

目的：了解剖腹或腹腔镜子宫肌瘤切除术后的妊娠率、活产率及预后。方法：回顾性分析2007年1月至2022年4月期间荷兰四家医院进行腹腔镜或剖腹子宫肌瘤切除术的FIGO 3-7型肌瘤患者。子宫肌瘤切除术的指征是子宫异常出血、肿块相关症状和/或不孕。从电子病历中提取基线特征、子宫肌瘤切除术数据和结果，包括妊娠率、活产率和妊娠或分娩期间的并发症。采用Logistic回归分析确定影响活产率的因素。结果：共纳入164例患者。61例患者子宫肌瘤切除术后妊娠94次（妊娠率：37%），50例患者（30%）分娩64次。最常见的分娩方式是剖宫产（CS）（n = 40, 62%）。子宫肌瘤切除术后46例患者活产（活产率：28%），共生育60个孩子。妊娠或分娩期间未发生与子宫肌瘤切除术相关的主要并发症。子宫肌瘤切除术前已怀孕及以不孕症为主要症状的患者，子宫肌瘤切除术后活产的概率更高。结论：接受剖腹或腹腔镜子宫肌瘤切除术的患者活产率为28%，妊娠率为37%。最常见的交付方式是CS。分娩过程中未见重大并发症。子宫肌瘤切除术前怀孕或以不孕症为主要症状的患者，子宫肌瘤切除术后活产的可能性增加。

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引用次数: 0

Neurocognitive function, psychosocial characteristics, and occupational performance across menstrual phases in young adults with and without primary dysmenorrhea 有或无原发性痛经的青壮年经期的神经认知功能、社会心理特征和职业表现

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-14 DOI: 10.1016/j.ejogrb.2026.114965

Aysenur Karakus , Semanur Inanc , Gokcen Akyurek

Objective

To examine phase-related variations in cognitive, emotional, and occupational functioning among women with and without primary dysmenorrhea (PD).

Study design

A repeated-measures case-control study was conducted at a university-based research laboratory and hospital outpatient unit.

Participants

Seventy-nine women with PD and fifty-nine asymptomatic women aged 17-25 years participated.

Main outcome measures

Menstrual pain intensity (Visual Analog Scale), menstrual attitudes (Menstrual Attitudes Questionnaire), body awareness (Body Awareness Questionnaire), occupational performance and satisfaction (Canadian Occupational Performance Measure), and self-esteem (Rosenberg Self-Esteem Scale) were assessed across three menstrual phases. Cognitive functions (attention, processing speed, and executive control) were evaluated using the Stroop Test and the Paced Auditory Serial Addition Test. Mann-Whitney U and Friedman tests were used for between- and within-group analyses, and regression models identified predictors of occupational performance and self-esteem.

Results

Women with PD reported higher pain intensity (p<0.001), lower BMI (p=0.022), and a more frequent family history of dysmenorrhea (p = 0.016). They also had more negative and proactive menstrual attitudes (p=0.01-0.04), lower occupational performance and satisfaction (p<0.001), and reduced self-esteem (p<0.001). Cognitive performance significantly declined during the luteal phase (p=0.01-0.004). No significant differences were observed in body awareness (p>0.05).

Conclusion

Women with PD experience cognitive, emotional, and occupational challenges that extend beyond menstrual pain. Integrative, multidisciplinary interventions addressing both physical and psychosocial domains are recommended to improve overall functioning and well-being.

目的探讨原发性痛经（PD）患者和非患者在认知、情感和职业功能方面的阶段性变化。研究设计在一所大学的研究实验室和医院门诊部进行了重复测量的病例对照研究。参与者：79名PD女性和59名无症状女性，年龄17-25岁。主要结果测量：月经疼痛强度（视觉模拟量表）、月经态度（月经态度问卷）、身体意识（身体意识问卷）、职业表现和满意度（加拿大职业表现量表）和自尊（罗森博格自尊量表）在三个月经阶段进行评估。认知功能（注意力、处理速度和执行控制）使用Stroop测试和节奏听觉串行加法测试进行评估。Mann-Whitney U和Friedman检验用于组间和组内分析，回归模型确定了职业表现和自尊的预测因子。结果PD患者的疼痛强度更高（p= 0.001）， BMI更低（p=0.022），痛经家族史更频繁（p= 0.016）。她们也有更多消极和主动的月经态度（p=0.01-0.04），更低的职业绩效和满意度（p < 0.001），更低的自尊（p < 0.001）。认知能力在黄体期显著下降（p=0.01-0.004）。两组身体意识差异无统计学意义（p>0.05）。结论：PD患者经历的认知、情感和职业挑战超出了经期疼痛。建议针对身体和社会心理领域采取综合、多学科干预措施，以改善整体功能和福祉。

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引用次数: 0

Expectant management of tubal ectopic pregnancy: Updated decision tree analysis for the prediction of successful outcomes 输卵管异位妊娠的预期治疗：预测成功结果的最新决策树分析

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-14 DOI: 10.1016/j.ejogrb.2026.114966

Natasha Graham , Sanem Atakan , Jemma Johns , Jackie A. Ross

Objectives

To re-analyse and update a decision tree developed 20 years ago to counsel women regarding the likelihood of successful expectant management of tubal ectopic pregnancies. The original model was developed using the data from 179 cases.

Study design

A retrospective observational analysis spanning a 14-year period was undertaken at the early pregnancy unit of an inner-city teaching hospital. Data were collected for all women who had expectant management when first diagnosed with their tubal ectopic pregnancies. Initial serum human chorionic gonadotropin (hCG) and progesterone levels, gestational age, ectopic morphology and mean diameter of the ectopic were recorded. Data were analysed using decision tree analysis on SPSS (IBM).

Results

A total of 798/1968 (40.5%) women with tubal ectopic pregnancies had expectant management and a new decision tree was developed using data from these 798 cases. Expectant management was successful in 512/798. This was 64% of women embarking on expectant management and 26% of all women with tubal ectopic pregnancies. Initial serum hCG level remains the best predictor of success for expectant management. Combined with progesterone level and diameter measurement, the decision tree has been updated.

Conclusion

Biochemical and clinical markers can be used to help counsel women about the likelihood of successful expectant management in our early pregnancy unit using decision tree analysis.

目的重新分析和更新20年前制定的决策树，为输卵管异位妊娠成功的可能性提供建议。最初的模型是利用179个病例的数据开发的。研究设计：在市中心一家教学医院的早孕病房进行了为期14年的回顾性观察分析。收集所有首次诊断为输卵管异位妊娠的妇女的数据。记录初始血清人绒毛膜促性腺激素（hCG）和孕酮水平、胎龄、异位形态和异位平均直径。数据分析采用SPSS （IBM）的决策树分析。结果798/1968例（40.5%）输卵管异位妊娠患者采用了准治疗，并建立了新的决策树。准管理在512/798年是成功的。在所有输卵管异位妊娠的女性中，这一比例为64%，占26%。初始血清hCG水平仍然是预期治疗成功的最佳预测指标。结合孕激素水平和直径测量，更新了决策树。结论采用决策树分析方法，利用生化指标和临床指标，可帮助指导早孕妇女成功进行妊娠管理的可能性。

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引用次数: 0

Study of the ovarian function and gyneco-obstetrical profile of patients with an HNF1B abnormality HNF1B异常患者卵巢功能及妇产科概况的研究

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-14 DOI: 10.1016/j.ejogrb.2026.114961

Audrey Cartault , Camille Paret , Charlotte Garczynski , Sabrina Da Costa , Zeina Chakhtoura , Perrine Ernoult , Dominique Chauveau , Stéphane Decramer , Stanislas Faguer , Magali Viaud , Céline Mercier , Vanessa Rousseau , Claire Thalamas , Nicolas Gatimel , Catherine Pienkowski

Objective

HNF1B variant is a rare autosomal dominant disease that affects the embryonic development of the urogenital system, the mullerian development, the liver, the exocrine and endocrine pancreas functions responsible for MODY 5 diabetes. The objective of this study was to evaluate the ovarian reserve and the gyneco-obstetric profile of patients with an HNF1B anomaly.

Study design

This was a pilot study coordinated by the Reference Centre of Rare Gynecological Pathologies (RGP). It was conducted in 3 hospital sites after agreement of the Reference Centres of Rare Renal Diseases. The primary endpoint was the serum AMH concentration, the secondary endpoint was the gyneco-obstetric characteristics of the patients.

Results

26 of the 54 patients aged 29 ± 13 years agreed to participate. All are carriers of the HNF1 pathogenic variant with a deletion in 50% of cases. 38% of patients had an AMH level <25th percentile adjusted for age. No statistical significant association was observed with genetic, renal abnormality, or Mody diabetes. Their gynecological profile was comparable to general population. 42% had uterine malformation. Obstetric complications of threatened premature delivery, cholestasis of pregnancy were noted.

Conclusions

We have, for the first time, described the ovarian function and gyneco-obstetric profile of patients with an HNF1 variant. We highlighted the value of monitoring their ovarian reserve. Fertility preservation should be discussed on an individual basis. These data need to be confirmed by a larger study and a longitudinal follow up.

目的hnf1b变异体是一种罕见的常染色体显性遗传病，影响胚胎发育的泌尿生殖系统，苗勒管发育，肝脏，外分泌和内分泌胰腺功能负责mody5型糖尿病。本研究的目的是评估卵巢储备和HNF1B异常患者的妇产科概况。研究设计这是一项由罕见妇科病理参考中心（RGP）协调的试点研究。经罕见肾脏疾病参考中心同意后，在3家医院进行了检查。主要终点是血清AMH浓度，次要终点是患者的妇产科特征。结果54例患者（29±13岁）中26例同意参与。所有人都是HNF1致病变异的携带者，50%的病例有缺失。38%的患者有AMH水平<；年龄调整后的第25百分位。未观察到与遗传、肾脏异常或糖尿病有统计学意义的关联。他们的妇科概况与一般人群相当。42%有子宫畸形。产科并发症的先兆早产，胆汁淤积妊娠注意。结论：我们首次描述了HNF1变异患者的卵巢功能和妇产科特征。我们强调了监测卵巢储备的价值。保留生育能力应在个人基础上进行讨论。这些数据需要通过更大规模的研究和纵向随访来证实。

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引用次数: 0