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

{"title":"Umbilical cord diameter and cross-sectional area in association with gestational age among women with uncomplicated pregnancies in north-central Nigeria: a cross-sectional study","authors":"Musa A. Muslimah ,&nbsp;Halimat J. Akande ,&nbsp;Hadijat O. Raji ,&nbsp;Bola B. Olafimihan ,&nbsp;Latifat T. Aremu ,&nbsp;James I. Owolabi ,&nbsp;Sadiya M. Gwadabe ,&nbsp;Idris O. Quadri","doi":"10.1016/j.ejogrb.2026.114976","DOIUrl":"10.1016/j.ejogrb.2026.114976","url":null,"abstract":"<div><h3>Aim and objectives</h3><div>To assess gestational age using the umbilical cord diameter (UCD) and cross-sectional area (CSA).</div></div><div><h3>Methodology</h3><div>This was a cross-sectional study among 300 women with no adverse medical history and uncomplicated pregnancies between the 14th and 40th completed weeks of pregnancy. The commonly used foetal parameters for gestational age (GA) estimation: Biparietal Diameter, Head and Abdominal Circumference and Femur Length were measured using standard protocols.</div><div>UCD and CSA were measured in a plane adjacent to cord insertion into the foetal abdomen within 1 cm. UCD was measured in long axis from outer-to-outer border of the umbilical cord using the electronic calipers. The cross-sectional area was obtained in transverse axis using the ellipse measurement and area was calculated automatically by the ultrasound machine in-built software. Measurements were taken twice for each parameter, and the average value was recorded for each participant to reduce intra-observer error.</div></div><div><h3>Result</h3><div>The mean UCD and CSA were 16.12 ± 4.28 mm and 2.08 ± 0.87 cm² respectively. UCD and CSA were observed to increase steadily with GA up to the 33rd week of gestation, decline and then remain stable from the 38th and 39th week gestation respectively until the end of pregnancy. Significant correlations (p = 0.001) between umbilical cord diameter and cross-sectional area with estimated foetal weight (EFW), GA and other foetal parameters for GA estimation was observed.</div><div>A regression analysis model between UCD, CSA and GA showed 95% confidence interval (CI). GA by LMP (weeks) = 1.528 (UCD) + 2.646, 7.544 (CSA) + 11.540. GA by US (weeks) = 1.542 (UCD) + 2.653, 7.618 (CSA) + 11.619.</div></div><div><h3>Conclusion</h3><div>UCD and CSA measurement is a reliable method for prediction of GA and has a strong linear relationship with commonly used foetal parameters.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114976"},"PeriodicalIF":1.9,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with ovarian loss and surgical intervention for perinatal ovarian cysts","authors":"Julia M. Whelchel ,&nbsp;Sofia Perez Otero ,&nbsp;Ashley S. Roman ,&nbsp;Sara G. Brubaker ,&nbsp;Antonia F. Oladipo ,&nbsp;Jason C. Fisher ,&nbsp;Sandra S. Tomita","doi":"10.1016/j.ejogrb.2026.114979","DOIUrl":"10.1016/j.ejogrb.2026.114979","url":null,"abstract":"<div><h3>Background</h3><div>Perinatal ovarian cysts may spontaneously resolve or cause ovarian torsion. Cyst size and appearance often guide surgical decision making. The natural history of these cysts and impact of perinatal interventions on ovarian outcomes remain unclear. We investigated the association of various clinical parameters with operative intervention and ovarian loss.</div></div><div><h3>Methods</h3><div>Infants with ovarian cysts meeting our definition of perinatal (diagnosed between 15 weeks gestational age and 1 year) from November 2006–January 2022 were identified. Cysts were characterized by size, morphology, laterality, and evolution. Outcome measures included resolution, ovarian loss, and operative intervention. Mann–Whitney U and Fisher exact tests were used. Optimal maximal size cutoffs were obtained using ROC curves.</div></div><div><h3>Results</h3><div>Sixty-two female patients with perinatal ovarian cysts were identified. Spontaneous resolution occurred in 35, prenatally and postnatally, with follow-up length averaging 186 days. Of 18 undergoing cystectomies, 9 revealed non-viable ovaries. Overall ovarian loss rate was 29%. Loss occurred more frequently with large, complex, and right-sided cysts (P &lt; 0.05) but some complex cysts also resolved spontaneously. Operative intervention occurred more frequently with larger cysts (P=&lt;0.001) and was associated with ovarian salvage when performed earlier (P = 0.008) on larger cysts (P = 0.02). Maximal cyst diameter &gt; 4.05 cm predicted ovarian loss with 78% sensitivity, 64% specificity (AUC = 0.67,95%CI = 0.54–0.81, P = 0.04). Maximal cyst diameter &gt; 4.55 cm predicted surgery with 83% sensitivity, 82% specificity (AUC = 0.86,95%CI = 0.77–0.96, P &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>29% of perinatal ovarian cysts resulted in ovarian loss. 56% resolved spontaneously (prenatal and postnatal resolution) including some complex cysts. Cysts that were postnatally complex and maximally &gt; 4 cm had higher rates of ovarian loss and operative intervention. Earlier postnatal operative intervention was associated with ovarian preservation. Standardized imaging (such as the IOTA terminology) and management protocols are needed to better understand behavior and improve treatment of these cysts.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114979"},"PeriodicalIF":1.9,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI in the incarceration of the gravid uterus: From diagnosis to individualized management","authors":"Qianshi Zheng,&nbsp;Yu Zou","doi":"10.1016/j.ejogrb.2026.114975","DOIUrl":"10.1016/j.ejogrb.2026.114975","url":null,"abstract":"<div><h3>Background</h3><div>Incarceration of the gravid uterus (IGU) is a rare but serious obstetric condition that demands precise diagnosis for optimal management.</div></div><div><h3>Objectives</h3><div>To evaluate the value of MRI in the diagnosis and individualized management of IGU.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed six patients with IGU admitted to the institution from November 2022 and September 2025. Clinical data like gravidity and parity, gestational weeks of diagnosis and delivery, clinical management and pregnancy outcomes. Imaging findings from MRI and ultrasound were compared, including assessment of cervical elongation, placental position, and complications. The correlation between MRI-measured parameters and pregnancy outcomes was explored.</div></div><div><h3>Results</h3><div>MRI clearly demonstrated typical signs of IGU, including uterine retroversion and anterior cervical displacement. No significant difference was found between MRI and ultrasound in measuring cervical elongation (9.6 ± 4.5 cm vs 7.6 ± 4.2 cm, p = 0.393). MRI additionally enabled assessment of cervical thinning (0.4 ± 0.1 cm) and identified one case of placenta previa missed by ultrasound. Based on MRI findings, four cases underwent successful manual reduction or knee-chest positioning. A preliminary correlation was observed between anterior lower uterine segment thickness and fetal birth weight (r = 1.000, p = 0.020), though this requires validation in larger studies.</div></div><div><h3>Conclusions</h3><div>MRI provides accurate diagnosis and objective assessment of IGU and its complications, serving as a crucial adjunct to ultrasound. Incorporating MRI into the standardized clinical management pathway offers essential evidence for developing individualized treatment strategies.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114975"},"PeriodicalIF":1.9,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of smoking or second-hand smoke exposure on metabolic and hormonal levels in women with polycystic ovary syndrome: A systematic review and meta-analysis","authors":"Ruyu Yan ,&nbsp;Dengxin He ,&nbsp;Wenru Xu ,&nbsp;Fen Yang ,&nbsp;Xinhong Zhu ,&nbsp;Lin Li","doi":"10.1016/j.ejogrb.2026.114973","DOIUrl":"10.1016/j.ejogrb.2026.114973","url":null,"abstract":"<div><h3>Background</h3><div>Evidence on the effects of smoking or second-hand smoke (SHS) exposure on metabolic and hormonal parameters in women with Polycystic Ovary Syndrome (PCOS) remains inconsistent. We systematically reviewed and meta-analyzed these associations.</div></div><div><h3>Methods</h3><div>Six databases (CNKI, PubMed, Web of Science, Cochrane Library, Ovid, EMBASE) were searched from inception to 24 April 2025 for observational studies reporting smoking/SHS exposure and ≥1 metabolic or hormonal outcome in PCOS patients. Study quality was assessed using the Newcastle-Ottawa and AHRQ scales. Random-effects models in Stata pooled SMD with 95% CI. Subgroup analyses evaluated SHS-only exposure; sensitivity analyses assessed robustness; publication bias was examined by funnel plots, Egger’s regression, and Begg’s test. Evidence certainty was graded using GRADE.</div></div><div><h3>Results</h3><div>Nine studies were included. Compared with non-exposed participants, smoking or SHS exposure was associated with higher Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) (<em>SMD</em> = 0.16, 95% <em>CI</em> [0.05, 0.27]), Triglyceride (TG) (<em>SMD</em> = 0.25, 95% <em>CI</em> [0.08, 0.42]), Low-Density Lipoprotein Cholesterol (LDL-C) (<em>SMD</em> = 0.16, 95% <em>CI</em> [0.003, 0.33]), Total Testosterone (TT) (<em>SMD</em> = 0.21, 95% <em>CI</em> [0.12, 0.29]) and Free Androgen Index (FAI) (<em>SMD</em> = 0.34, 95% <em>CI</em> [0.14, 0.53]), and lower High-Density Lipoprotein Cholesterol (HDL-C) (<em>SMD</em> = −0.15, 95% <em>CI</em> [-0.25, −0.05]) and Sex Hormone-Binding Globulin (SHBG) (<em>SMD</em> = −0.19, 95% <em>CI</em> [-0.34, −0.04]) (<em>P</em> &lt; 0.05). No significant difference was found in Luteinizing Hormone to Follicle-Stimulating Hormone Ratio (LH/FSH). TG and TT associations persisted in SHS-only groups, whereas HOMA-IR, HDL-C, FAI, and SHBG differences were mainly driven by active smoking. Findings were robust, with no publication bias; GRADE certainty was “very low”.</div></div><div><h3>Conclusion</h3><div>Smoking or SHS exposure was significantly associated with metabolic and hormonal profiles in women with PCOS. Despite observational limitations and absent e-cigarette data, the evidence supports advising PCOS patients to avoid smoking and SHS exposure. Registration: CRD42025633516.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114973"},"PeriodicalIF":1.9,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which body region’s fat accumulation increase the risk of stress urinary incontinence?","authors":"Ana Jéssica dos Santos Sousa ,&nbsp;Stela Márcia Mattiello ,&nbsp;Ana Paula Rodrigues Rocha ,&nbsp;Alessander Danna-Dos-Santos ,&nbsp;Patricia Driusso","doi":"10.1016/j.ejogrb.2026.114957","DOIUrl":"10.1016/j.ejogrb.2026.114957","url":null,"abstract":"<div><div>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 &lt; 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.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114957"},"PeriodicalIF":1.9,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-incision slings in stress urinary incontinence: impact of intrinsic sphincter deficiency on surgical success","authors":"Tsia-Shu Lo ,&nbsp;Chean Wen Li ,&nbsp;Irene Balonzo Villaflor ,&nbsp;Ai-Leen Ro ,&nbsp;Chien-Chien Yu ,&nbsp;Tzu Hsiang Hsieh","doi":"10.1016/j.ejogrb.2026.114968","DOIUrl":"10.1016/j.ejogrb.2026.114968","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the outcome of single-incision sling (SIS) kits available on the market in women with intrinsic sphincter deficiency (ISD) and identify predictors of surgical failure.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study in a tertiary referral hospital, involving 685 women with urodynamic stress incontinence (USI), including 56 ISD preoperatively. The primary outcome was objective cure of USI, defined as the absence of demonstrable involuntary urine leakage upon increased abdominal pressure in filling cystometry. Subjective cure was a negative response to the UDI-6 question 3. The secondary outcome was to identify predictors of surgical failure.</div></div><div><h3>Results</h3><div>Overall, the primary outcome of objective cure for SIS was 89.5 % (613/685), and the subjective cure rate was 87.0 % (596/685) at the 1-year post-operative follow-up. Success rates were similar across the SIS types: Ophira™, 89.8 % (114/127); Solyx™, 89 % (299/336); and I-Stop-Mini™, 90.1 % (200/222). Multivariate logistic regression model identified age (OR 1.88 1.17–3.01), postmenopausal status (OR 1.42 1.07–2.05), angle &lt; 30° (OR 2.96 1.50–4.87), MUCP (OR 2.35 1.55–3.93), tape percentile (OR 1.60 1.19–3.11) as independent factors associated with postoperative failure of SIS in women with ISD.</div></div><div><h3>Conclusion</h3><div>SIS has a high cure rate for SUI but shows lower success in women with ISD. Careful patient selection and consideration of surgical predictors may optimize outcomes. Predictors of failure identified include older age, postmenopausal status, low MUCP, tape percentile, and a bladder neck angle &lt; 30°. Additionally, routine preoperative assessment of bladder neck mobility is suggested as a practical tool for managing women with ISD.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114968"},"PeriodicalIF":1.9,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cardiometabolic index and prevalence of ovarian cancer among US adults: A cross-sectional NHANES study","authors":"Xinyan Gao ,&nbsp;Xiaoxiang Jiang ,&nbsp;Junming Chen ,&nbsp;Bin Du ,&nbsp;Xiaojiao Weng ,&nbsp;Jinhuo Lai ,&nbsp;Riping Wu","doi":"10.1016/j.ejogrb.2026.114954","DOIUrl":"10.1016/j.ejogrb.2026.114954","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the possible link between ovarian cancer and cardiometabolic index (CMI).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>p</em> 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114954"},"PeriodicalIF":1.9,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, awareness and practices regarding human papillomavirus vaccine amongst secondary school girls and mothers in North India","authors":"A. Anand ,&nbsp;Y.M. Mala ,&nbsp;S. Tyagi ,&nbsp;P. Sharma","doi":"10.1016/j.ejogrb.2026.114945","DOIUrl":"10.1016/j.ejogrb.2026.114945","url":null,"abstract":"<div><h3>Background</h3><div>Lack of awareness about cervical cancer, its aetiology and preventive measures are barriers to disease control.</div></div><div><h3>Objectives</h3><div>To study the knowledge, attitudes and practices of adolescent girls and their mothers regarding cervical cancer, human papillomavirus (HPV) vaccine, and preventive strategies.</div></div><div><h3>Design</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>p</em> = 0.000), and awareness of early detection of cervical cancer increased significantly among mothers (<em>p</em> = 0.002). Knowledge about Pap smear tests increased among girls (<em>p</em> = 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 %; <em>p</em> = 0.045).</div></div><div><h3>Conclusion</h3><div>Significant improvements were observed in adolescent girls and mothers regarding awareness of symptoms and early detection of cervical cancer.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114945"},"PeriodicalIF":1.9,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification of patients with adenomyosis based on clusters of coexisting diseases: An illustration of clinical diversity","authors":"Xin Wang ,&nbsp;YuDan Fu ,&nbsp;RuoXi Zhao ,&nbsp;Yong Liu,&nbsp;RuiHua Zhao","doi":"10.1016/j.ejogrb.2026.114962","DOIUrl":"10.1016/j.ejogrb.2026.114962","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114962"},"PeriodicalIF":1.9,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of AI-generated responses to common pregnancy questions: A blinded expert evaluation","authors":"Arif Onur Atay ,&nbsp;Feride Atay ,&nbsp;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 (&lt;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 &lt; 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 &gt; 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}