European journal of obstetrics, gynecology, and reproductive biology最新文献_第4页

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。

{"title":"Assessment of AI-generated responses to common pregnancy questions: A blinded expert evaluation","authors":"Arif Onur Atay , Feride Atay , Oguzcan Corlu","doi":"10.1016/j.ejogrb.2026.114960","DOIUrl":"10.1016/j.ejogrb.2026.114960","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 χ<sup>2</sup>(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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114960"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973295","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

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。

{"title":"Pregnancy outcomes after laparotomic or laparoscopic myomectomy: A multicenter retrospective cohort study","authors":"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","doi":"10.1016/j.ejogrb.2026.114964","DOIUrl":"10.1016/j.ejogrb.2026.114964","url":null,"abstract":"<div><h3>Objective</h3><div>Expend knowledge about pregnancy rate, live birth rate and outcomes after laparotomic or laparoscopic myomectomy.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114964"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003177","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

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。

{"title":"Neurocognitive function, psychosocial characteristics, and occupational performance across menstrual phases in young adults with and without primary dysmenorrhea","authors":"Aysenur Karakus , Semanur Inanc , Gokcen Akyurek","doi":"10.1016/j.ejogrb.2026.114965","DOIUrl":"10.1016/j.ejogrb.2026.114965","url":null,"abstract":"<div><h3>Objective</h3><div>To examine phase-related variations in cognitive, emotional, and occupational functioning among women with and without primary dysmenorrhea (PD).</div></div><div><h3>Study design</h3><div>A repeated-measures case-control study was conducted at a university-based research laboratory and hospital outpatient unit.</div></div><div><h3>Participants</h3><div>Seventy-nine women with PD and fifty-nine asymptomatic women aged 17-25 years participated.</div></div><div><h3>Main outcome measures</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114965"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973290","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

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。

{"title":"Expectant management of tubal ectopic pregnancy: Updated decision tree analysis for the prediction of successful outcomes","authors":"Natasha Graham , Sanem Atakan , Jemma Johns , Jackie A. Ross","doi":"10.1016/j.ejogrb.2026.114966","DOIUrl":"10.1016/j.ejogrb.2026.114966","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Study design</h3><div>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).</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114966"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973385","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

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。

{"title":"Study of the ovarian function and gyneco-obstetrical profile of patients with an HNF1B abnormality","authors":"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","doi":"10.1016/j.ejogrb.2026.114961","DOIUrl":"10.1016/j.ejogrb.2026.114961","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Study design</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114961"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022741","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

Advanced surgical techniques in minimally invasive surgery: multidisciplinary approach for silent obstructive uropathy in deep endometriosis 微创手术中的先进手术技术：多学科方法治疗深部子宫内膜异位症无症状梗阻性尿路病变。

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.2026.114963

Lucía Chaul , Ramiro Cabrera Carranco , Ulises Armando Menocal Tavernier , William Kondo , Ana Gabriela Sierra Brozon , Sofia Hernandez Vega

引用次数: 0

A quantitative study of general practitioners’ experience and confidence with subdermal contraceptive implant devices 全科医生的经验和信心与皮下避孕植入装置的定量研究。

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.2026.114967

Lylas Aljohmani , Linda Kelly , Louise Fitzgerald , Roisin Dolan

Background

Long-acting reversible contraceptives (LARCs), including subdermal contraceptive implants (SCIs), are widely used and highly effective. General practitioners (GPs) provide most implant services, but little is known about their confidence, awareness of updated guidelines, and approaches to complications in the Irish setting.

Aim

To assess GPs’ experience, confidence, awareness of guidelines, and management of complications related to SCIs.

Methods

We conducted a prospective quantitative survey of 100 randomly selected GPs in Ireland. A validated 12-item questionnaire was distributed via Qualtrics, with 74 complete responses analysed in SPSS v29.0. Frequency data and chi-square tests with Cramer’s V were used to assess associations between experience, confidence, and guideline awareness.

Results

A total of n = 74 full responses were collected. Results showed that while a majority (94.6 %) have inserted subdermal contraceptive implants, confidence levels varied, with 37.3 % feeling confident in insertion and removal procedures. Notably, 39.2 % were unaware of updated guidelines from January 2020. Statistical analyses revealed significant associations between general practitioners’ reported experience in subdermal contraceptive implant procedures and confidence in these skills (p < 0.001), as well as awareness of guidelines (p = 0.011). General practitioners with greater experience tended to refer complicated cases to specialist services, contrasting with less experienced peers managing cases independently.

Conclusion

This study underscores the need for enhanced General Practitioners’ training on subdermal contraceptive implant procedures and guideline updates to optimise service delivery. Given the increasing popularity of subdermal contraceptive implants, addressing these gaps is crucial for ensuring safe and effective contraceptive care in primary care settings.

背景：长效可逆避孕药（LARCs），包括皮下避孕植入物（SCIs），应用广泛且效果显著。全科医生（全科医生）提供大多数种植服务，但很少知道他们的信心，更新指南的意识，并在爱尔兰设置并发症的方法。目的：评估全科医生的经验，信心，对指南的认识，以及与SCIs相关的并发症的处理。方法：我们对爱尔兰随机选择的100名全科医生进行了前瞻性定量调查。通过qualics分发了一份经过验证的12项问卷，在SPSS v29.0中分析了74个完整的回答。使用频率数据和Cramer's V卡方检验来评估经验、信心和指南意识之间的关联。结果：共收集到n = 74份完整问卷。结果显示，虽然大多数人（94.6%）植入了皮下避孕植入物，但信心水平各不相同，37.3%的人对植入和取出程序有信心。值得注意的是，39.2%的人不知道2020年1月以来更新的指南。统计分析显示，全科医生报告的皮下避孕植入手术经验与对这些技能的信心之间存在显著关联(p结论：本研究强调需要加强全科医生对皮下避孕植入手术的培训，并更新指南以优化服务提供。鉴于皮下避孕植入物日益普及，解决这些差距对于确保初级保健环境中安全有效的避孕护理至关重要。

{"title":"A quantitative study of general practitioners’ experience and confidence with subdermal contraceptive implant devices","authors":"Lylas Aljohmani , Linda Kelly , Louise Fitzgerald , Roisin Dolan","doi":"10.1016/j.ejogrb.2026.114967","DOIUrl":"10.1016/j.ejogrb.2026.114967","url":null,"abstract":"<div><h3>Background</h3><div>Long-acting reversible contraceptives (LARCs), including subdermal contraceptive implants (SCIs), are widely used and highly effective. General practitioners (GPs) provide most implant services, but little is known about their confidence, awareness of updated guidelines, and approaches to complications in the Irish setting.</div></div><div><h3>Aim</h3><div>To assess GPs’ experience, confidence, awareness of guidelines, and management of complications related to SCIs.</div></div><div><h3>Methods</h3><div>We conducted a prospective quantitative survey of 100 randomly selected GPs in Ireland. A validated 12-item questionnaire was distributed via Qualtrics, with 74 complete responses analysed in SPSS v29.0. Frequency data and chi-square tests with Cramer’s V were used to assess associations between experience, confidence, and guideline awareness.</div></div><div><h3>Results</h3><div>A total of n = 74 full responses were collected. Results showed that while a majority (94.6 %) have inserted subdermal contraceptive implants, confidence levels varied, with 37.3 % feeling confident in insertion and removal procedures. Notably, 39.2 % were unaware of updated guidelines from January 2020. Statistical analyses revealed significant associations between general practitioners’ reported experience in subdermal contraceptive implant procedures and confidence in these skills (p < 0.001), as well as awareness of guidelines (p = 0.011). General practitioners with greater experience tended to refer complicated cases to specialist services, contrasting with less experienced peers managing cases independently.</div></div><div><h3>Conclusion</h3><div>This study underscores the need for enhanced General Practitioners’ training on subdermal contraceptive implant procedures and guideline updates to optimise service delivery. Given the increasing popularity of subdermal contraceptive implants, addressing these gaps is crucial for ensuring safe and effective contraceptive care in primary care settings.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114967"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003123","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

To the Editor: Tan RCA, Jie Ying KO, Ng QJ, Qi M, Lee JM, Bhutia K. vNOTES hysterectomy for patients with large uteri: Initial experience in the largest Tertiary Centre in Singapore. Eur J Obstet Gynecol Reprod Biol. 2025 Jun;310:113952. https://doi.org/10.1016/j.ejogrb.2025.113952. Epub 2025 Apr 4 致编者：Tan RCA， Jie Ying KO, Ng QJ, Qi M, Lee JM, Bhutia K. vNOTES大子宫患者的子宫切除术：在新加坡最大的三级中心的初步经验。[J] .中华妇产科杂志，2015;31(10):113952。https://doi.org/10.1016/j.ejogrb.2025.113952。Epub 2025 4月4日

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-12 DOI: 10.1016/j.ejogrb.2026.114955

Wai Yoong, Esther Skene, Martin Kawabata, Joachim Ho

引用次数: 0

Delivery plan in cardio-obstetric management of pregnant patients with heart disease: an Italian Delphi study 分娩计划在心脏病孕妇的心脏产科管理：意大利德尔菲研究

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-12 DOI: 10.1016/j.ejogrb.2026.114958

Elena Zaccone , Barbara Zaina , Laura Angeli , Gaia Spaziani , Stefano Carugo , Massimo Micaglio , Giuseppe Sofi , Fabio Parazzini , Federico Mecacci , Irene Cetin

Background

Cardiovascular disease (CVD) is the leading indirect cause of maternal morbidity and mortality in high-income countries. Managing pregnant women with cardiac conditions requires multidisciplinary coordination and individualized planning. Early risk stratification, commonly performed using the modified World Health Organization (mWHO) classification, is essential to guide the management of pregnant women with heart disease. The Delivery Plan (DP) is proposed as a standardized tool to guide peripartum care in this population.

Objective

To evaluate expert consensus on the structure and implementation of a standardized DP for pregnant women with heart disease, using a modified Delphi methodology.

Methods

A two-round Delphi survey was conducted among 30 cardio-obstetric experts from five tertiary Italian centers. The first phase assessed current practices regarding cardiac follow-up and investigations in pregnancy. The second phase evaluated agreement on 21 proposed DP items across different mWHO risk classes and explored the role of non-cardiac risk factors.

Results

In phase one, consensus (≥70% agreement) was achieved for 78.4% of cardiac follow-up practices and 87.9% of diagnostic investigations. In phase two, all 21 DP items were endorsed for general inclusion. Stratification by mWHO risk class showed no consensus for mWHO I, partial agreement for mWHO II, and full consensus for mWHO II/III to IV. Strong agreement (median ≥ 9, IQR ≤ 2) was observed for most items in higher-risk classes. Additionally, obesity, hypertension, and preeclampsia were identified as relevant non-cardiac risk factors warranting structured planning.

Conclusions

The study supports the use of a structured, risk-adapted DP for pregnant women with cardiac disease. High consensus in moderate-to-severe risk groups confirms the DP’s utility in enhancing multidisciplinary coordination and may contribute to improved maternal–fetal outcomes, pending prospective validation.

背景：心血管疾病（CVD）是高收入国家孕产妇发病和死亡的主要间接原因。管理患有心脏病的孕妇需要多学科协调和个性化规划。早期风险分层，通常使用修改后的世界卫生组织（mWHO）分类进行，对于指导心脏病孕妇的管理至关重要。分娩计划（DP）提出作为一个标准化的工具，以指导围产期护理在这一人群。目的采用改进的德尔菲法，评价专家对心脏病孕妇标准计划的结构和实施的共识。方法采用两轮德尔菲调查法对意大利5所三级医院的30名产科专家进行调查。第一阶段评估了妊娠期心脏随访和调查的现行做法。第二阶段评估了21个拟议DP项目在不同mWHO风险类别中的一致性，并探讨了非心脏风险因素的作用。结果在第一阶段，78.4%的心脏随访实践和87.9%的诊断调查达成了共识（≥70%的同意）。在第二阶段，所有21个发展规划项目均获核可普遍列入。按mWHO风险等级分层显示，对mWHO I没有共识，对mWHO II部分一致，对mWHO II/III至IV完全一致。在高风险等级中，大多数项目的一致性很强（中位数≥9，IQR≤2）。此外，肥胖、高血压和先兆子痫被确定为相关的非心脏危险因素，需要有组织的计划。结论：该研究支持对患有心脏病的孕妇使用结构化的、风险适应的DP。中度至重度风险人群的高共识证实了DP在加强多学科协调方面的效用，并可能有助于改善母胎结局，有待于前瞻性验证。

{"title":"Delivery plan in cardio-obstetric management of pregnant patients with heart disease: an Italian Delphi study","authors":"Elena Zaccone , Barbara Zaina , Laura Angeli , Gaia Spaziani , Stefano Carugo , Massimo Micaglio , Giuseppe Sofi , Fabio Parazzini , Federico Mecacci , Irene Cetin","doi":"10.1016/j.ejogrb.2026.114958","DOIUrl":"10.1016/j.ejogrb.2026.114958","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) is the leading indirect cause of maternal morbidity and mortality in high-income countries. Managing pregnant women with cardiac conditions requires multidisciplinary coordination and individualized planning. Early risk stratification, commonly performed using the modified World Health Organization (mWHO) classification, is essential to guide the management of pregnant women with heart disease. The Delivery Plan (DP) is proposed as a standardized tool to guide peripartum care in this population.</div></div><div><h3>Objective</h3><div>To evaluate expert consensus on the structure and implementation of a standardized DP for pregnant women with heart disease, using a modified Delphi methodology.</div></div><div><h3>Methods</h3><div>A two-round Delphi survey was conducted among 30 cardio-obstetric experts from five tertiary Italian centers. The first phase assessed current practices regarding cardiac follow-up and investigations in pregnancy. The second phase evaluated agreement on 21 proposed DP items across different mWHO risk classes and explored the role of non-cardiac risk factors.</div></div><div><h3>Results</h3><div>In phase one, consensus (≥70% agreement) was achieved for 78.4% of cardiac follow-up practices and 87.9% of diagnostic investigations. In phase two, all 21 DP items were endorsed for general inclusion. Stratification by mWHO risk class showed no consensus for mWHO I, partial agreement for mWHO II, and full consensus for mWHO II/III to IV. Strong agreement (median ≥ 9, IQR ≤ 2) was observed for most items in higher-risk classes. Additionally, obesity, hypertension, and preeclampsia were identified as relevant non-cardiac risk factors warranting structured planning.</div></div><div><h3>Conclusions</h3><div>The study supports the use of a structured, risk-adapted DP for pregnant women with cardiac disease. High consensus in moderate-to-severe risk groups confirms the DP’s utility in enhancing multidisciplinary coordination and may contribute to improved maternal–fetal outcomes, pending prospective validation.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114958"},"PeriodicalIF":1.9,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973307","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

Assessment of maternal characteristics and outcomes associated with COVID-19-linked HELLP-like syndrome 评估与covid -19相关的help样综合征相关的孕产妇特征和结局

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-12 DOI: 10.1016/j.ejogrb.2026.114959

Lucy F. Harvey , Fay F. Pon , Zaira N. Chavez Jimenez , Yadira L. Bribiesca Leon , Carolyn N. Rocha , Shinya Matsuzaki , Rachel S. Mandelbaum , Joseph G. Ouzounian , Koji Matsuo

引用次数: 0