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

{"title":"High-grade uterine cancer with ambiguous features – a clinicopathological study","authors":"Roy Kessous ,&nbsp;Ofer Wiesel ,&nbsp;Jacob Dreiher ,&nbsp;Mihai Meirovitz ,&nbsp;Sharon Davidesko ,&nbsp;Yarden Kezerle ,&nbsp;Benzion Samueli ,&nbsp;Ruthy Shaco-Levy","doi":"10.1016/j.ejogrb.2026.114952","DOIUrl":"10.1016/j.ejogrb.2026.114952","url":null,"abstract":"<div><h3>Objective</h3><div>Endometrial endometrioid carcinoma FIGO grade 3 (EC3) and endometrial serous carcinoma (SEC), sometimes present diagnostic challenges due to overlapping and ambiguous features. The prognostic significance of assigning histological subtype remains debatable due to conflicting clinical outcome data. This study examined definite and ambiguous EC3 and SEC cases to compare clinicopathologic characteristics and prognosis.</div></div><div><h3>Methods</h3><div>This is a retrospective study of 129 patients diagnosed with EC3 and SEC at a single tertiary center between 2006–2022. Pathological slides were revised and classified as definite or ambiguous for EC3 and SEC. Survival, progression-free survival, and associations between tumor histologic type and clinicopathologic characteristics were analyzed.</div></div><div><h3>Results</h3><div>Definite SEC displayed higher mortality compared to definite EC3 (68.2 % vs. 41.4 %, p = 0.023) as well as a non-significant trend towards lower 5-year survival (p = 0.096). Ambiguous SEC also showed higher mortality compared to ambiguous EC3 (68.8 % vs. 37.5 %, p = 0.020) and a non-significant trend towards lower 5-year survival (p = 0.098). Several parameters suggest that ambiguous cases are intermediate between the definite EC3 (lower) and definite SEC (higher) groups. Rates of lymph node metastases (EC3 6.9 %; ambiguous 16.4 % and SEC 29.5 %; p = 0.013), broad ligament involvement (EC3 0 %; ambiguous 1.8 % and SEC 11.4 %; p = 0.016), and omental involvement (EC3 3.4 %; ambiguous 10.9 % and SEC 29.5 %; p = 0.002). A similar trend was observed for ovarian involvement, but it did not reach statistical significance (EC3 6.9 %; ambiguous 12.7 % and SEC 22.7 %; p = 0.055).</div></div><div><h3>Conclusion</h3><div>Ambiguous cases may represent an intermediate group that displays clinicopathologic features which are more aggressive than in EC3, yet more favorable than in SEC. These results hold implications for managing patients with high-grade endometrial carcinomas, as identifying an intermediate group may inform treatment strategies and prognostic evaluations.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114952"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stem cell therapy in thin endometrium and Asherman’s syndrome: a systematic review and meta-analysis","authors":"Leila Adamyan ,&nbsp;Laura Pivazyan ,&nbsp;Maria Yurkanova ,&nbsp;Veronika Tarlakyan ,&nbsp;Elizaveta Platonova ,&nbsp;Agnessa Osipova ,&nbsp;Karina Mailova ,&nbsp;Assia Stepanian","doi":"10.1016/j.ejogrb.2026.114949","DOIUrl":"10.1016/j.ejogrb.2026.114949","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of mesenchymal stem cell (MSC)-based therapies in improving endometrial thickness and reproductive outcomes in women with refractory thin endometrium or Asherman’s syndrome.</div></div><div><h3>Methods</h3><div>Following PRISMA 2020 guidelines, a systematic search of PubMed, Cochrane Library, Embase, Scopus, <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, and Google Scholar through June 2025 was performed. Eighteen clinical studies involving 323 patients were included. MSCs derived from umbilical cord, bone marrow, adipose tissue, endometrium, or menstrual blood were administered via intrauterine infusion, transmyometrial injection, or scaffold-assisted delivery. The primary outcome was change in endometrial thickness; secondary outcomes included clinical pregnancy rate, live birth rate, and miscarriage rate.</div></div><div><h3>Results</h3><div>Meta-analysis demonstrated a significant increase in endometrial thickness following MSC therapy compared to baseline or control (mean difference = 2.35 mm; 95 % CI, 1.97–2.74; p &lt; 0.00001). Subgroup analysis showed the largest gains in endometrial- and adipose-derived MSC groups. Randomized controlled trials confirmed higher clinical pregnancy (OR = 2.72; p = 0.002) and live birth rates (OR = 2.27; p = 0.01), with a reduced miscarriage rate (OR = 0.24; p = 0.004). No serious adverse events were reported.</div></div><div><h3>Conclusion</h3><div>While MSC therapy appears to be safe, its efficacy must be confirmed by large-scale randomized trials before it can be presented to the public or recommended as an effective approach for endometrial regeneration.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"319 ","pages":"Article 114949"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utility of interleukin-6 compared to conventional sepsis biomarkers in pregnancy – A real-world cohort study","authors":"Seán Olann Whelan ,&nbsp;Gráinne Kelleher ,&nbsp;Sharon Campbell ,&nbsp;Maeve Eogan ,&nbsp;Frank Moriarty ,&nbsp;Mohamed Elsammak ,&nbsp;Richard John Drew","doi":"10.1016/j.ejogrb.2026.114936","DOIUrl":"10.1016/j.ejogrb.2026.114936","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the diagnostic performance of interleukin-6 (IL-6) versus in-use inflammatory markers (C-reactive protein [CRP], procalcitonin [PCT], neutrophil–lymphocyte ratio [NLR]) in maternal sepsis.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study in a single Dublin maternity hospital. All maternity patients (conception to 6-weeks post-partum) in whom IL-6 was measured to investigate suspected sepsis in an 11-month period were included. Cases were categorized twice into physiological (normal, systemic inflammatory response syndrome, sepsis, septic shock) and etiological (bacterial, viral or no infection) categories. Biomarker performance was assessed by area under the receiver operating characteristic curves (AUC) and measures of diagnostic accuracy at optimal cut-offs. Serial sampling evaluated biomarker kinetics.</div></div><div><h3>Results</h3><div>Seventy-two patients were included, 31.9 % had sepsis/septic shock, and 70.9 % had bacterial infection. Significant differences between categories were seen for both physiological and etiological axes for IL-6, for physiological categories alone for NLR, and for neither for PCT and CRP. IL-6 had an AUC of 0.78 for the primary physiological endpoint, significantly higher than CRP and PCT (p = 0.02), but not NLR (AUC 0.72, p = 0.47). The IL-6 AUC for the primary etiological endpoint was 0.94, higher than all other biomarkers (p &lt; 0.001). IL-6 was highly sensitive (91.4 %) but poorly specific (55.1 %) for the physiological endpoint, while both were high in the diagnosis of bacterial infection (88.2 % and 90.5 %). On serial sampling, IL-6 fell rapidly between first and second sampling, while others initially rose further.</div></div><div><h3>Conclusion</h3><div>IL-6 exhibited significantly higher sensitivity compared to conventional sepsis biomarkers in detecting both bacterial infection and maternal sepsis.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114936"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint hypermobility syndrome for the urogynaecologist – A narrative review","authors":"Islam Abaza,&nbsp;Miriam Tadros,&nbsp;Bernadette Lemmon,&nbsp;Alka Bhide,&nbsp;Ruwan Fernando,&nbsp;Vik Khullar","doi":"10.1016/j.ejogrb.2026.114943","DOIUrl":"10.1016/j.ejogrb.2026.114943","url":null,"abstract":"<div><h3>Purpose of this review</h3><div>Joint Hypermobility Syndrome (JHS), also referred to as hypermobile Ehlers–Danlos Syndrome (hEDS), is increasingly recognised as a significant contributor to gynaecological, pelvic floor and lower urinary tract symptoms. This review aims to highlight the current evidence on the relationship between JHS and key urogynaecological conditions, with particular attention to recent developments in epidemiology, clinical presentation, and management.</div></div><div><h3>Recent findings</h3><div>Emerging research demonstrates a strong association between JHS and pelvic organ prolapse (POP), with meta-analytic data showing more than a twofold increased risk. Large cohort studies highlight substantial symptom burden, including high rates of stress and urgency incontinence, bladder pain, pelvic floor dysfunction and sexual difficulties. Recent work also reveals distinct challenges in perioperative care, such as dysautonomia-related anaesthetic risks, tissue fragility, impaired wound healing and higher rates of surgical complications in some series. Studies document higher prevalence of urinary incontinence, bladder diverticula, recurrent urinary infections and voiding dysfunction linked to increased bladder capacity and elevated residual volumes.</div></div><div><h3>Summary</h3><div>Women with JHS experience a wide and often severe spectrum of urogynaecological symptoms that significantly affect quality of life. Although management generally mirrors standard care pathways, the unique connective-tissue and systemic features of JHS necessitate tailored assessment and multidisciplinary involvement. Further high-quality research is required to develop specific management algorithms and clarify the role of conservative versus surgical treatments in this complex clinical population.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114943"},"PeriodicalIF":1.9,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of placenta accreta spectrum on sexual and psychological health: a comparative analysis using FSFI and SF-36","authors":"Dini Hidayat ,&nbsp;Sri Dewi Rahmawati Syarief ,&nbsp;Vyanda Sri Weningtyas ,&nbsp;Faradiba Janiyustika","doi":"10.1016/j.ejogrb.2026.114942","DOIUrl":"10.1016/j.ejogrb.2026.114942","url":null,"abstract":"<div><h3>Background</h3><div>Placenta accreta spectrum (PAS) is a potentially life-threatening obstetric condition characterized by abnormal placental adherence to the myometrium. While hysterectomy remains the standard definitive management, conservative strategies such as wedge resection or delayed hysterectomy have been increasingly adopted to preserve fertility. The comparative impact of these approaches on women’s quality of life (QoL), particularly social and sexual functioning, has not been well investigated.</div></div><div><h3>Method</h3><div>A cross-sectional study included 185 women who underwent caesarean section (CS) for histopathologically confirmed PAS at Dr. Hasan Sadikin General Hospital, Bandung, West Java, from 2022 to 2024. A total of 161 met the inclusion criteria and were analyzed, while 24 were excluded. Sexual function and QoL were assessed using the Female Sexual Function Index (FSFI) and the 36-Item Short Form Health Survey (SF-36), respectively. Non-parametric analysis using the Mann–Whitney <em>U</em> test was applied for scale scores and categorical comparisons were analyzed using Chi-square or Fisher’s exact test, with p &lt; 0.05 considered significant.</div></div><div><h3>Result</h3><div>Median FSFI scores for desire (3.0 [2.5–3.5] vs. 3.0 [2.0–4.0], p = 0.015), arousal (2.5 [2.0–3.5] vs. 3.0 [2.0–4.0], p = 0.048), and pain (2.4 [2.0–2.7] vs. 3.0 [2.0–4.0], p = 0.021) differed significantly between the hysterectomy and conservative groups, although median values for desire were similar. Other FSFI domains and total scores were not significantly different (p &gt; 0.05). In the SF-36, a statistically significant difference was observed only in the social functioning domain, despite comparable median scores between groups.</div></div><div><h3>Conclusion</h3><div>Conservative management in PAS was associated with better preservation of specific aspects of sexual function, particularly pain and arousal.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114942"},"PeriodicalIF":1.9,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidural analgesia in small for gestational age and growth restricted fetuses: Impact on emergency delivery for presumed fetal distress","authors":"Anna Fichera ,&nbsp;Chiara Pedretti ,&nbsp;Nicola Fratelli ,&nbsp;Adriana Valcamonico ,&nbsp;Daniela Recupero ,&nbsp;Andrea Coelli ,&nbsp;Angelica Fiorini ,&nbsp;Antonino D’Ippolito ,&nbsp;Franco E. Odicino","doi":"10.1016/j.ejogrb.2026.114940","DOIUrl":"10.1016/j.ejogrb.2026.114940","url":null,"abstract":"<div><h3>Introduction</h3><div>Epidural analgesia (EDA) is widely used for pain relief during labor. Concerns have been raised about its potential association with an increased risk of emergency delivery for presumed fetal compromise, particularly in fetuses with low birth weight. This study aimed to evaluate whether EDA increases the risk of emergency delivery for suspected fetal distress in small-for-gestational-age and fetal growth restricted fetuses.</div></div><div><h3>Methods</h3><div>Retrospective cohort study conducted on singleton pregnancies with prenatal diagnosis of small-for-gestational-age or fetal growth restricted fetuses, delivering at ≥ 36 + 0 weeks at a tertiary care center between January 2020 and January 2024. The primary exposure was EDA; the primary outcome was emergency cesarean section or vacuum-assisted delivery due to presumed fetal distress, based on cardiotocographic findings. The secondary outcome was the incidence of a composite neonatal outcome defined as the occurrence of at least one of umbilical artery pH &lt; 7.00, base excess &lt; –12 mEq/L, 5-minute Apgar score &lt; 7, or NICU admission. The two groups (EDA vs. non-EDA) were compared using the chi-square test for categorical variables and the Mann–Whitney <em>U</em> test for continuous variables. Multivariate logistic regression was used to control for confounders.</div></div><div><h3>Results</h3><div>Among 310 eligible deliveries, 135 (43.5 %) received EDA. Emergency delivery for suspected fetal distress occurred in 16.5 % of cases. There were no significant differences in emergency delivery rates between the EDA and non-EDA groups (15.56 % vs 17.14 %; p = 0.759), nor within the small-for-gestational-age (13.4 % vs 13.9 %; p = 0.896) and the growth restricted fetuses (21.5 % vs 22.4 %; p = 0.874) subgroups. No significant difference in the composite adverse neonatal outcome was observed between the EDA and non-EDA groups (8.15 % vs 7.43 %; p = 0.814). Multivariate analysis confirmed no association between EDA and emergency delivery (p = 0.600), whereas nulliparity (p = 0.024) and U/C ratio &gt; 0.8 (p = 0.004) emerged as independent risk factors. Composite neonatal outcomes were similar between groups.</div></div><div><h3>Conclusions</h3><div>In this cohort of well-characterized small-for-gestational-age and fetal growth restricted fetuses, EDA was not associated with an increased risk of emergency delivery for suspected fetal distress. Individualized patient assessment and tailored management of labor analgesia remain crucial to ensure maternal and fetal safety.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114940"},"PeriodicalIF":1.9,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of mediolateral or lateral episiotomy in preventing obstetric anal sphincter injury (OASI) in nulliparous women undergoing vacuum-assisted delivery: A systematic review and meta-analysis","authors":"Giovanni Morganelli ,&nbsp;Gabriella Maria Celora ,&nbsp;Maria Chiara Bassi ,&nbsp;Andrea Dall’Asta ,&nbsp;Maurizio Di Serio ,&nbsp;Vito Andrea Capozzi ,&nbsp;Tullio Ghi ,&nbsp;Stefania Fieni","doi":"10.1016/j.ejogrb.2026.114939","DOIUrl":"10.1016/j.ejogrb.2026.114939","url":null,"abstract":"<div><h3>Background</h3><div>The potential preventive effect of mediolateral and lateral episiotomy on the risk of anal sphincter injury related to vacuum delivery in nullipara has been reported by different well-designed studies in the last years.</div></div><div><h3>Objectives</h3><div>The aim of this systematic review and <em>meta</em>-analysis is to summarize the available evidence on the protective effect of mediolateral or lateral episiotomy towards the occurrence of obstetric anal sphincter injury (OASI) in nulliparous women who were submitted to vacuum-assisted delivery.</div><div><em>Search strategy:</em> PubMed, Embase, CINAHL, Cochrane Library and Scopus databases were retrospectively searched without any temporal restriction up to March 1st 2025.</div><div><em>Selection criteria:</em> Randomized controlled trials, retrospective, prospective case-control or cohort studies investigating the incidence of perineal tears involving anal sphincter muscles and/or rectal mucosa after vacuum-assisted birth with and without mediolateral/lateral episiotomy in nulliparous women were included.</div><div><em>Data collection and analysis:</em> Risk of bias assessment was conducted for each included study by applying ROB2 score for RCTs and ROBINS-I score for non-randomized studies. Data were extracted and analyzed with Review Manager 5.4.1, results were reported by means of pooled Odd-ratios (ORs) and presented as Forest plots.</div><div><em>Main results:</em> 31 studies (3 RCTs and 28 non-randomized studies) were included. Cumulative sample size consisted in 608,359 nulliparous women who were submitted to vacuum-assisted delivery. Mediolateral/lateral episiotomy was found to halve the incidence of OASI (OR 0.56 [95 % CI 0.42–0.73]) with high between-study heterogeneity reported (I² = 99 %). At sensitivity analysis, a significant reduction in OASI incidence in case of mediolateral/lateral episiotomy was confirmed (OR 0.58 [95 %CI 0.44–0.78]); this analysis was conducted on low/moderate risk of bias studies (1RCT e 5 non-randomized studies, 15,799 patients) and associated with low heterogeneity (I² = 42 %).</div></div><div><h3>Conclusions</h3><div>This updated meta-analysis on the role of mediolateral/lateral episiotomy in nulliparous women submitted to vacuum assisted delivery confirms its protective role from OASI.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114939"},"PeriodicalIF":1.9,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922007","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":"Microbiota and infertility: a translational review of mechanisms and clinical applications in assisted reproduction","authors":"Bixiu Du ,&nbsp;Yaru Yang ,&nbsp;Lang He ,&nbsp;Ying Tang","doi":"10.1016/j.ejogrb.2026.114941","DOIUrl":"10.1016/j.ejogrb.2026.114941","url":null,"abstract":"<div><div>Infertility constitutes a major global health concern, affecting approximately 17.5% of couples of reproductive age. Although advances in assisted reproductive technologies (ART) have expanded treatment options, success rates remain highly variable due to host-specific and biological determinants. This review synthesizes current evidence on the reproductive impact of the human microbiota and its translational relevance to ART outcomes. Vaginal microbial communities dominated by <em>Lactobacillus</em>, particularly <em>L. crispatus</em>, are associated with improved conception and implantation, whereas genital or intestinal dysbiosis correlates with infertility and suboptimal treatment responses. The microbiota modulates reproductive competence through intertwined immune, endocrine–metabolic, and mucosal barrier pathways that regulate inflammation, hormonal balance, and epithelial integrity. Emerging findings indicate that gut microbial alterations linked to polycystic ovary syndrome (PCOS) and endometriosis are accompanied by insulin resistance and chronic inflammation, impairing ovulation, endometrial receptivity, and embryo viability. Interventions such as probiotics and synbiotics yield heterogeneous efficacy; individualized antimicrobial strategies, metabolic modulation, and lifestyle optimization may offer complementary benefit, while microbiota reconstruction remains experimental. Methodological limitations, including contamination in low biomass samples, variations in sequencing workflows, and population heterogeneity, still hinder data comparability and mechanistic interpretation. Future research should prioritize adequately powered randomized controlled trials using standardized microbiome metrics and live birth as a primary endpoint. Integrating microbiome profiling into ART workflows may refine patient stratification and inform precision adjuvant therapies. However, clinical implementation requires stronger causal evidence, validated biomarkers, and harmonized methodological frameworks to translate microbiome discoveries into reproducible reproductive gains.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114941"},"PeriodicalIF":1.9,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922006","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":"Should we modify eligibility criteria for fetal surgery for open spinal dysraphism?","authors":"Jean-Marie Jouannic ,&nbsp;Anaïs Dugas ,&nbsp;Paul Maurice ,&nbsp;Ferdinand Dhombres ,&nbsp;Catherine Garel ,&nbsp;Éléonore Blondiaux ,&nbsp;Timothée de Saint Denis ,&nbsp;Lucie Guilbaud","doi":"10.1016/j.ejogrb.2025.114912","DOIUrl":"10.1016/j.ejogrb.2025.114912","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114912"},"PeriodicalIF":1.9,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921950","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":"Lactobacillus, vitamin C, cranberry and hibiscus versus placebo for prolonging the latency period of premature rupture of membranes: a double-blind randomized clinical trial","authors":"Iris Janeth Portillo Gonzales ,&nbsp;Ramon Armando Lobo Oliva ,&nbsp;Betsaida María Colindres Cruz ,&nbsp;Lessy Yolanda Díaz Galeas ,&nbsp;Ricardo Arturo Gutierrez-Ramirez","doi":"10.1016/j.ejogrb.2026.114938","DOIUrl":"10.1016/j.ejogrb.2026.114938","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of a supplement blend (<strong>lactobacillus, vitamin C, cranberry and hibiscus</strong>) on the latency period after preterm premature rupture of membranes (PPROM).</div></div><div><h3>Study design</h3><div>A single-center, randomized (1:1), double-blind, placebo-controlled trial enrolled 84 patients with PPROM (24–34 weeks). Participants were assigned to daily oral supplements or an identical placebo. The primary outcome was the latency period from membrane rupture to delivery. Analysis was by intention-to-treat.</div></div><div><h3>Result</h3><div>The mean latency period was significantly longer in the intervention group compared to the placebo group (11.7 ± 7.2 days vs. 7.6 ± 4.8 days; mean difference 4.1 days, 95 % CI 1.4–6.8; p = 0.003). The standardized mean difference (Cohen’s d) was 0.67 (95 % CI 0.23–1.10), indicating a moderate-to-large effect size. Exploratory analysis suggested a more pronounced effect when treatment was initiated before 32 weeks and continued for over six days.</div></div><div><h3>Conclusion</h3><div>Supplementation with lactobacillus, vitamin C, cranberry and hibiscus significantly prolonged the latency period in PPROM, which may represent a low-cost adjunct to conservative management.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114938"},"PeriodicalIF":1.9,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917417","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}