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

{"title":"Emotional freedom techniques-based counseling with breathing exercises in in vitro fertilization: effects on psychological distress and well-being","authors":"Merve Coşkun ,&nbsp;Ergül Aslan","doi":"10.1016/j.ejogrb.2025.114891","DOIUrl":"10.1016/j.ejogrb.2025.114891","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether psychosocial care during in vitro fertilization (IVF) treatment affects the emotional capacity and well-being of women undergoing fertility treatment.</div></div><div><h3>Methods</h3><div>This randomized controlled, single-blind study was conducted between February 2020 and March 2021. A total of 112 women undergoing IVF were recruited based on predefined inclusion and exclusion criteria. After a 24.1 % loss to follow-up (n = 27), data from 85 participants (42 in the experimental group, 43 in the control group) were analyzed. The control group received routine care, while the intervention group attended a structured seven-session counseling program that included coping strategies such as Emotional Freedom Technique (EFT) and breathing exercises. Psychological outcomes were measured at three time points using Screening Tool on Distress in Fertility Treatment (SCREENIVF), Fertility Quality of Life Tool (FertiQol), COMPI Fertility Problem Stress Scales (COMPI-FPSS), and Subjective Units of Distress (SUD) scale. Group comparisons were analyzed with appropriate statistical methods.</div></div><div><h3>Results</h3><div>Baseline characteristics did not differ between groups (p &gt; 0.05). The experimental group had a higher positive hCG rate on day + 13 of IVF (42.9 % vs. 18.6 %, p = 0.015). Post-intervention, they showed greater reductions in anxiety (Cohen’s d = –0.72, 95 % CI [–1.15 to –0.28], p = 0.001) and helplessness (Cohen’s d = 1.26, 95 % CI [0.79–1.72], p &lt; 0.001), and increased acceptance (p &lt; 0.001), while depression decreased non-significantly (p = 0.167). Personal and social stress decreased (Cohen’s d = –0.99, 95 % CI [–1.43 to –0.54], p &lt; 0.001; social domain p = 0.003), but marital stress did not (p = 0.619). FertiQOL total and Treatment Environment scores improved (Cohen’s d = –1.89, 95 % CI [–2.39 to –1.39], p &lt; 0.001; Cohen’s d = –1.71, 95 % CI [–2.20 to –1.22], p &lt; 0.001), whereas Treatment Tolerance did not differ (p = 0.001). SUD scores decreased after sessions 2, 4, and 5 (r = –0.62 to –0.63, 95 % CI [–0.77 to –0.46], p &lt; 0.001). Effect sizes indicate medium to large clinical relevance. Participants at risk per SCREENIVF showed marked stress reduction and improved quality of life, with referrals to mental health services as needed.</div></div><div><h3>Conclusion</h3><div>Psychosocial care during IVF treatment appears to reduces psychological distress and enhances treatment-related well-being in women undergoing fertility procedures. These findings support the incorporation of psychosocial interventions into standard fertility care.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114891"},"PeriodicalIF":1.9,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788925","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":"Training and assessment of competencies in hysteroscopy – A systematic review","authors":"Karen Høgh Abrahamsen ,&nbsp;Martine Siw Nielsen ,&nbsp;Nicolaj Bruun Brandt ,&nbsp;Anders Bo Nielsen ,&nbsp;Lars Konge ,&nbsp;Margit Dueholm ,&nbsp;Pernille Ravn","doi":"10.1016/j.ejogrb.2025.114890","DOIUrl":"10.1016/j.ejogrb.2025.114890","url":null,"abstract":"<div><h3>Objective</h3><div>Hysteroscopy is a core gynecological competence, acquired by training. Simulation training offers safe competence acquisition, but requires resource-efficient, clinically transferable approaches. Current hysteroscopic training curricula lack standardized assessment and validated pass-fail criteria. This review synthesizes evidence to inform optimized training and robust competency assessment.</div></div><div><h3>Methods</h3><div>Five databases were systematically searched on June 2nd 2025. Studies assessing hysteroscopy training and skills assessment were included without restrictions on population, study design, or publication year. Data extraction was performed using Covidence. Outcomes were evaluated with Kirkpatrick’s levels and quality assessment was evaluated with the Medical Education Research Study Quality Instrument (MERSQI).</div></div><div><h3>Results</h3><div>A total of 39 studies, 36 prospective cohort studies (92 %) and 3 RCTs (8 %), met the inclusion criteria. Studies used animal (13 %), inanimate (33 %), virtual reality (39 %), and combinations of models (15 %). Training approaches varied, with numbers-based training being most common (74 %). Outcomes were primarily evaluated with pre-post testing (41 %) and self-assessment (28 %). All studies reported improved performance, especially in novices, with either pre- and posttests or questionnaires. Study quality varied, with a mean MERSQI of 11.3 (range 5–16, of possible 5–18). Only one RCT showed clinical transferability.</div></div><div><h3>Conclusion</h3><div>Simulation-based training enhances hysteroscopic competencies. Despite methodological variability, evidence supports structured curricula combining theory, hands-on training, and pass-fail-based progression. A combination of virtual reality with tactile feedback seems optimal. Overall evidence failed to establish optimized training and robust competency assessment. Future research should include high-quality studies, patient-level outcomes, and updated validity frameworks to decide how to optimize training effectively.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114890"},"PeriodicalIF":1.9,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767344","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":"Ferric carboxymaltose for third-trimester refractory anemia and perinatal outcomes: Retrospective cohort analysis","authors":"Şebnem Karagün ,&nbsp;Hamza Yıldız ,&nbsp;Yusuf Dal ,&nbsp;Sefanur Gamze Karaca ,&nbsp;Hatice Banu Atay ,&nbsp;Mürşide Çevikoğlu Kıllı ,&nbsp;Ayhan Coşkun","doi":"10.1016/j.ejogrb.2025.114887","DOIUrl":"10.1016/j.ejogrb.2025.114887","url":null,"abstract":"<div><h3>Background</h3><div>Iron deficiency anemia (IDA) in the third trimester is associated with adverse perinatal outcomes, but data on intravenous ferric carboxymaltose (FCM) effects beyond hematologic response remain limited.</div></div><div><h3>Methods</h3><div>This retrospective cohort study, conducted at Mersin University Hospital (January 2019 – March 2024), included 311 pregnant women diagnosed with IDA in the third trimester who were clinically recommended FCM therapy due to inadequate response to oral ferrous sulfate. Among these, 206 accepted FCM treatment (in addition to continued oral iron) while 105 declined and received oral iron alone. Women were compared as two groups: those who received oral iron alone versus those who received oral iron plus a single-dose FCM in the third trimester,. At four timepoints (baseline, post-FCM, delivery, and postpartum), hemoglobin (Hgb), hematocrit, MCV, and MCHC levels were evaluated. The primary outcome was maternal perinatal hemoglobin response, while the secondary outcome was the investigation of its correlation with key neonatal outcomes following FCM administration. Repeated measures ANOVA, two-way ANOVA, and correlation analyses were used.</div></div><div><h3>Results</h3><div>The FCM group showed significantly higher Hgb levels at baseline, delivery, and postpartum (all p &lt; 0.05). Birth weight (3164 ± 564 g vs. 2952 ± 691 g, p = 0.007), umblical cord blood pH (7.34 ± 0.04 vs. 7.28 ± 0.03, p &lt; 0.001), and Apgar scores were also improved in the FCM group. Neonatal intensive care unit (NICU) admission was significantly reduced (20.9 % vs. 31.4 %, p = 0.041), as was the incidence of fetal growth restriction (16.5 % vs. 38.1 %, p &lt; 0.001). In the FCM group, changes in Hgb from post-FCM to postpartum were positively correlated with 1-minute Apgar scores (r = 0.177, p = 0.011). Neonates requiring NICU admission showed an attenuated rise in Hgb across the same interval (p = 0.041), and women with adverse composite outcomes had greater Hgb fluctuation, particularly from delivery to postpartum (p = 0.020).</div></div><div><h3>Conclusion</h3><div>Third-trimester FCM therapy leads to superior hematologic correction and improved neonatal outcomes compared to oral iron alone. Hemoglobin recovery patterns after FCM may be predictive of neonatal adaptation and adverse outcomes, highlighting the broader perinatal significance of timely parenteral iron therapy in late pregnancy.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"317 ","pages":"Article 114887"},"PeriodicalIF":1.9,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733940","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":"Efficacy and safety of relugolix therapy for symptomatic uterine fibroids: a systematic review and meta-analysis","authors":"FNU Kalpina ,&nbsp;Dinesh Kumar ,&nbsp;Javeria Taj ,&nbsp;Manal Kaleem ,&nbsp;Tabia Shujaat ,&nbsp;Maimoona Qayyum ,&nbsp;Laiba Jabeen ,&nbsp;Ahmed Raza ,&nbsp;Muhammad Shaheer Bin Faheem","doi":"10.1016/j.ejogrb.2025.114889","DOIUrl":"10.1016/j.ejogrb.2025.114889","url":null,"abstract":"<div><h3>Introduction</h3><div>Uterine fibroids are the most common benign tumors in premenopausal women and often necessitate fertility-sparing treatments. Relugolix, an oral GnRh antagonist has emerged as a promising non-surgical option. This systematic review and meta-analysis evaluate the efficacy and safety of relugolix for symptomatic uterine fibroids.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, Cochrane CENTRAL, Scopus, and <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> through March 2025. Six studies (n = 511) were included in accordance with the PRISMA guidelines. Data were analysed using random-effects models in R (v4.5.0). Risk of Bias was assessed using ROB 2 tool. Continuous outcomes were reported as mean differences (MDs), dichotomous outcomes as odds ratios (ORs) or proportions, and heterogeneity using I² statistics, with sensitivity analyses for I² ≥ 50 %.</div></div><div><h3>Results</h3><div>Pooled analysis revealed a myoma volume reduction (MVR) of −30.18 %, with similar findings when compared to placebo (−28.50 %; p-value = 0.0070). Uterine volume decreased by −27.22 %. When compared with placebo, uterine volume significantly reduced by −30.31 (p-value = 0.0028). Amenorrhea was achieved by 63 % of patients, with relugolix-treated patients showing 31-fold higher odds versus controls (31.07 %; p-value &lt; 0.0001). Haemoglobin levels improved in 46.3 % patients, while relugolix-treated patients achieved significant pain relief compared to controls (OR 9.02; p = value &lt; 0.0001). Subgroup analyses showed that relugolix monotherapy produced greater reductions in myoma and uterine volumes than combination therapy, although both regimens were effective.</div><div>Treatment as generally well-tolerated, with hot flushes being the most common adverse event. A small proportion reported persistent menorrhagia without indicating treatment failure. Other adverse events, such as headache, were also reported, though discontinuation rates were comparable to controls.</div></div><div><h3>Conclusion</h3><div>Relugolix significantly reduces fibroid burden and symptoms with favourable safety profile. It offers a well-tolerated, fertility-preserving alternative to surgery. Further large-scale RCTs are needed to confirm these findings and optimize treatment protocols.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114889"},"PeriodicalIF":1.9,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735920","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":"Tubal patency testing in women with polycystic ovary syndrome − is it worth before ovarian induction: Cost-effectiveness analysis","authors":"Magdalena Piróg ,&nbsp;Bartosz Chrostowski ,&nbsp;Robert Jach","doi":"10.1016/j.ejogrb.2025.114888","DOIUrl":"10.1016/j.ejogrb.2025.114888","url":null,"abstract":"<div><h3>Background</h3><div>Polycystic ovarian syndrome (PCOS) is related to infertility due to anovulatory cycles. However, it is unknown whether women with PCOS are at higher risk of tubal factor of infertility.</div></div><div><h3>Objectives</h3><div>This study sought to investigate the diagnostic accuracy of hysterosalpingo-foam sonography (HyFoSy) in women with polycystic ovarian syndrome (PCOS) before initiation of ovarian induction (OI)?</div></div><div><h3>Study design:</h3><div>We studied 432 infertile women in two groups: 1) with PCOS (n = 216) and 2) without PCOS (n = 216) which served as the controls. Data analysis included basic clinical parameters, duration of infertility, history of previous abdominal surgeries, pelvic inflammatory disease (PID), ectopic pregnancy (EP) and smoking status. The primary outcome of this study was the evaluation of the tubal patency testing outcomes in women with PCOS and compare it to women without ovulatory disorders. Secondary outcome was a cost-effectiveness analysis focused on direct medical costs related to chosen therapeutic models: 1) primary 3 cycles of OI and 2) HyFoSy followed by 3 cycles of OI if at least one tube was patent.</div></div><div><h3>Results</h3><div>Women with PCOS had higher number of previous abdominal surgeries (+23.1 %) compared to the controls, with no differences in previously diagnosed either PID or EP and smoking. Bilateral tubal blockage was observed in 5 % of women with PCOS which was comparable to women without ovulatory disorders (4.2 %, p &gt; 0.05). Regarding risk factors for blockage, among PCOS women at least one risk factor such as previous abdominal surgery, history of PID, EP or smoking were observed in 81.8 % (n = 9) participants with bilateral blocked tubes, 63.2 % (n = 12) in unilateral blocked group and 23.1 % (n = 43) participants with both patent tubes. The mean total costs per women were lower in Model 1 compared to Model 2 ($61 vs. $364, respectively). Implementation of HyFoSy in women with PCOS without risk factors of tubal blockage is not worth the extra cost and prolong the time to pregnancy.</div></div><div><h3>Conclusion</h3><div>A treatment model starting with OI before HyFoSY is cost-effective compared to the model with HyFoSY performed before OI. Tubal factor is present in 5% of woman with PCOS which is comparable to infertile women without ovulatory disorders.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114888"},"PeriodicalIF":1.9,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735919","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":"Characteristics of ovarian stimulation in adolescents and young adults undergoing fertility preservation","authors":"Tiffany Brun ,&nbsp;Marie Sineux ,&nbsp;Vincent Lavoué ,&nbsp;Ludivine Dion ,&nbsp;Jean Levêque ,&nbsp;Solène Duros","doi":"10.1016/j.ejogrb.2025.114886","DOIUrl":"10.1016/j.ejogrb.2025.114886","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the ovarian response to controlled ovarian hyperstimulation (COH) performed for fertility preservation (FP) in adolescents and young adults (AYA) aged ≤20 years with that of adult women aged 25–35 years.</div></div><div><h3>Materials and Methods</h3><div>This retrospective cohort study included 66 COH cycles in AYA patients (≤20 years) and 107 cycles in adults (25–35 years) treated between January 2014 and March 2022 for oocyte vitrification. Outcomes assessed included the number of mature oocytes vitrified, total oocytes retrieved, total rFSH dose, peak estradiol levels, maturation rate, and duration of stimulation.</div></div><div><h3>Results</h3><div>Groups were comparable regarding BMI, smoking status, AMH, stimulation protocol, and gonadotropin type. Median number of mature oocytes was not statistically different between groups: (9.5 (AYA) vs. 9.0 (A), p = 80.19). The maturation index was significantly lower in AYA (0.80 vs. 0.88, p = 80.02). Peak estradiol was lower in AYA (1267 pg/mL vs. 1582 pg/mL, p = 80.04). Other stimulation parameters were similar.</div></div><div><h3>Conclusion</h3><div>Fertility preservation through COH in adolescents and young adults appears as effective as in adult women in terms of mature oocyte yield. Nevertheless, AYA patients exhibit a lower oocyte maturation rate and lower peak estradiol levels. Larger studies are needed to confirm these findings and better characterise age-related physiological differences in ovarian response.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114886"},"PeriodicalIF":1.9,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780660","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":"HPV awareness and vaccine decision-making: healthcare professionals vs social media in a cross-sectional study from Italy","authors":"Cristina Lumia","doi":"10.1016/j.ejogrb.2025.114885","DOIUrl":"10.1016/j.ejogrb.2025.114885","url":null,"abstract":"<div><h3>Introduction</h3><div>Social media is used increasingly as a source of health information. This study explored how women access information about human papillomavirus (HPV), and whether the use of social media influences vaccine decision-making.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted between October 2018 and March 2019 among 90 women aged 18-45 years attending the University Hospital of Palermo, Sicily (Italy). A 25-item questionnaire assessed sociodemographic characteristics, knowledge about HPV and vaccination, and sources of information. Descriptive statistics and odds ratios (OR) were calculated for behavioural risk factors associated with HPV infection.</div></div><div><h3>Results</h3><div>Overall, 89 % of women reported that they were aware of HPV, and 70 % had heard about HPV vaccination. Only 14 % were vaccinated. Physicians (34 %) and television (20 %) were the main sources of information, while the Internet accounted for 18 %, and social media was rarely used for HPV information (59 % of participants reported no use of social media for HPV information). Most participants (63 %) did not know how to access vaccination services. Risk factors significantly associated with HPV infection included early sexual debut [≤17 years; OR = 3.0, 95 % confidence interval (CI) 1.56-5.7], multiple partners in the past year (OR = 2.3, 95 % CI 1.6-2.5), and low educational level (OR = 2.8-3.1).</div></div><div><h3>Discussion</h3><div>Despite relatively high awareness of HPV, vaccination uptake was low, and social media played only a marginal role in shaping knowledge and decision-making among women. Healthcare professionals remained the main trusted source of information. The gap between awareness and actual vaccination highlights the need for targeted campaigns and easier access to vaccination services.</div></div><div><h3>Conclusion</h3><div>Strategies to increase HPV vaccine uptake should prioritize direct communication from healthcare providers and improve service accessibility, while social media currently appears to have limited influence.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"317 ","pages":"Article 114885"},"PeriodicalIF":1.9,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733942","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":"Prognostic factors for ovarian immature teratoma and significance of alpha-fetoprotein in recurrent cases","authors":"Miaofen Hong ,&nbsp;Kai Yang ,&nbsp;Huijuan Ge ,&nbsp;Jie Tang ,&nbsp;Jin Li ,&nbsp;Shanhui Liang","doi":"10.1016/j.ejogrb.2025.114882","DOIUrl":"10.1016/j.ejogrb.2025.114882","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze clinical characteristics of ovarian immature teratoma patients and to explore prognostic factors of recurrence-free survival.</div></div><div><h3>Methods</h3><div>Fifty-eight cases with ovarian immature teratoma who underwent surgery in Fudan University Shanghai Cancer Center from January 2008 to January 2023, were retrospectively analyzed. The potential risk factors of recurrence were investigated. Subgroup analysis was conducted in stage I patients and in recurrent cases.</div></div><div><h3>Results</h3><div>The median age of diagnosis was 24.5 years (range, 7∼40 years), twenty-eight patients relapsed after a median follow-up of 72.3 months, with a 5-year recurrence-free survival and disease-specific survival rate of 81.0 % and 89.7 %, respectively. Multivariate analysis showed that adjuvant chemotherapy (HR = −1.556, 95 %CI 0.056∼0.793, <em>P</em> = 0.021), stage II-III (HR = 1.549, 95 %CI 1.572∼14.086, <em>P</em> = 0.006) and unknown residual lesions (HR = 1.591 95 %CI 1.602∼15.039<em>P</em> = 0.005) were risk factors of recurrence. Subgroup analysis was conducted in 32 stage I patients, the recurrence-free survival rate between adjuvant chemotherapy and surveillance group were statistically significant (<em>P</em> &lt; 0.05). There was significant difference in AFP level between 15 cases with immature recurrence and 10 cases with mature recurrence(<em>P</em> = 0.015), a cut-off value of 25.67 ng/ml was found to be predictive for immature recurrence of ovarian immature teratoma with an area under the curve of 0.793, sensitivity and specificity were 53.3 % and 100 %, respectively.</div></div><div><h3>Conclusions</h3><div>Adjuvant chemotherapy, stage II-III and unknown residual lesions were the prognostic factors for ovarian immature teratoma. Surveillance is not a substitute for adjuvant chemotherapy in stage I patients of any grade. Serum AFP level exceeding 25.67 ng/ml can be a predictor of immature recurrence.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"317 ","pages":"Article 114882"},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733941","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":"Inside Back Cover - Editors with images","authors":"","doi":"10.1016/S0301-2115(25)01151-0","DOIUrl":"10.1016/S0301-2115(25)01151-0","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"316 ","pages":"Article 114875"},"PeriodicalIF":1.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733535","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 impact of early amniotomy on delivery outcomes in pregnancies with fetal macrosomia","authors":"Or Touval ,&nbsp;Gal Cohen ,&nbsp;Adi Koriat ,&nbsp;Lior Heresco ,&nbsp;Tal Biron-Shental ,&nbsp;Michal Kovo ,&nbsp;Hanoch Schreiber","doi":"10.1016/j.ejogrb.2025.114881","DOIUrl":"10.1016/j.ejogrb.2025.114881","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of early versus late amniotomy on delivery outcomes in pregnancies complicated by fetal macrosomia.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted at a tertiary university-affiliated medical center between 2014 and 2020. The included patients admitted during the latent phase of labor (&lt;6 cm cervical dilatation) who delivered neonates with birthweight ≥ 4,000 g. and underwent amniotomy during labor. Participants were classified into two groups according to cervical dilatation at the time of amniotomy: early amniotomy (≤4 cm) and late amniotomy (&gt;4 cm). Delivery and neonatal outcomes were compared, and multivariable logistic regression was performed to adjust for potential confounders.</div></div><div><h3>Results</h3><div>A total of 789 patients were included (early amniotomy, n = 353; late amniotomy, n = 436). Baseline estimated fetal weights and neonatal birthweights were similar between groups. Compared with the late amniotomy group, the early amniotomy group had higher rates of nulliparity, diabetes, induction of labor (IOL), epidural use, and intrapartum fever.</div><div>In a multivariable analysis of the entire cohort, after adjusting for confounders, early amniotomy was independently associated with an increased risk of intrapartum cesarean delivery. However, sub analyses for induced vs. spontaneous labors revealed that this association was only observed in women undergoing IOL (14 % vs. 4 %, p = 0.009), whereas no significant difference was observed among women presenting in spontaneous labor (8.1 % vs. 5.2 %, p = 0.214).</div></div><div><h3>Conclusions</h3><div>In pregnancies with fetal macrosomia, early amniotomy was associated with an increased risk of intrapartum cesarean delivery among women undergoing induction of labor. The timing of amniotomy in this population should therefore be carefully considered.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"317 ","pages":"Article 114881"},"PeriodicalIF":1.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733939","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}