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

{"title":"Anatomical distribution of ovarian and deep endometriosis using a multimodal diagnostic approach applying the updated international definition: A prospective observational study","authors":"Shay M. Freger ,&nbsp;Melissa Marien ,&nbsp;Ido Mick ,&nbsp;Mathew Leonardi","doi":"10.1016/j.ejogrb.2026.114947","DOIUrl":"10.1016/j.ejogrb.2026.114947","url":null,"abstract":"<div><h3>Objective</h3><div>To (1) determine how application of the updated international definition of deep endometriosis (DE) alters apparent disease prevalence across pelvic sites, and (2) characterize the distribution of endometriosis phenotypes, including ovarian (OE), DE, and superficial (SE) disease, using a standardized multimodal approach integrating transvaginal ultrasound (TVS), surgical, and histopathologic findings.</div></div><div><h3>Study design</h3><div>Prospective observational study conducted at a tertiary endometriosis center between November 2021 and January 2023.</div></div><div><h3>Methods</h3><div>Consecutive patients undergoing laparoscopy for chronic pelvic pain or infertility underwent systematic TVS and intraoperative assessment performed by a single fellowship-trained operator. Lesions were classified as DE if confirmed by at least two of three modalities. Prevalence estimates under the updated definition were compared descriptively with those using the previous &gt; 5 mm criterion.</div></div><div><h3>Results</h3><div>Among 131 participants, OE were present in 45.4 % (59/130; excluding one participant with prior bilateral oophorectomy) and DE in 64.1 % (84/131). Among individuals with DE, the uterosacral ligaments were the most frequently involved site (52.7 %), followed by bowel (18.3 %), pararectal spaces (16.8 %), posterior vaginal fornix (12.2 %), and parametrium (6.1 %). Under the updated definition, DE prevalence increased from 22.9 % to 52.7 % at the uterosacral ligaments and from 10.7 % to 16.8 % at the pararectal spaces compared with the prior &gt; 5 mm threshold. Isolated SE was found in 32.8 % (43/131) of participants, while OE and DE coexisted in over 90 % of cases with endometrioma.</div></div><div><h3>Conclusions</h3><div>The application of the updated DE definition substantially increases the reported prevalence across key posterior pelvic sites by reclassifying lesions previously categorized as superficial. Comprehensive multimodal assessment further delineates the distribution and overlaps of endometriosis phenotypes, providing a reproducible framework for future multicenter and outcome-based validation.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114947"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973398","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":"Development of predictive models for endometrial outcomes in patients with intrauterine adhesions post-hysteroscopic adhesiolysis: evaluating endometrial vascularization through narrow-band imaging hysteroscopy and Doppler ultrasound","authors":"Jiezhuang Huang ,&nbsp;Yanlan Huang ,&nbsp;Shengcai Chen ,&nbsp;Qing Ye ,&nbsp;Shuang Liang ,&nbsp;Caini Wei ,&nbsp;Zhifu Zhi","doi":"10.1016/j.ejogrb.2026.114951","DOIUrl":"10.1016/j.ejogrb.2026.114951","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the potential of narrow-band imaging (NBI) hysteroscopy and 2-Dimensional (2-D) ultrasound in predicting re-adhesion for patients with intrauterine adhesions (IUAs) following transcervical resection of adhesions (TCRA).</div></div><div><h3>Design</h3><div>Retrospective study.</div></div><div><h3>Patients</h3><div>We included 56 patients diagnosed with IUAs who underwent TCRA with NBI hysteroscopy at the First Affiliated Hospital of Guangxi medical university from June 2020 to February 2023.</div></div><div><h3>Interventions</h3><div>Participants were divided into two groups based on their endometrial recovery during a three-month follow-up after TCRA: a recovery group (n = 42) and a poor recovery group (n = 14). Both univariable and multivariable logistic regression analyses were conducted to identify independent factors impacting postoperative outcomes. Subsequently, nomogram prediction models were constructed and internally validated using the identified independent factors in conjunction with the classifications established by the European Society of Gynecological Endoscopy (ESGE) and the American Fertility Society (AFS).</div></div><div><h3>Main outcome measures</h3><div>Endometrial restoration within the 3-month follow-up after TCRA.</div></div><div><h3>Results</h3><div>A higher endometrial microvascular index assessed by NBI hysteroscopy and enhanced endometrial blood flow in zone 3, as measured by 2-D Doppler ultrasound, were identified as independent protective factors for postoperative endometrial recovery. The identified factors, when combined with ESGE or AFS classifications, were utilized to build nomogram prediction models, referred to as the NUE and NUA models, respectively. The NUE model (AUC = 0.935, 95% CI: 0.865–1.000) and the NUA model (AUC = 0.939, 95% CI: 0.876–1.000) demonstrated superior discrimination compared to the ESGE (AUC = 0.651, 95% CI: 0.490–0.813) and AFS classifications (AUC = 0.736, 95% CI: 0.578–0.893) alone. The calibration curve indicated that the NUA model exhibited greater consistency between predicted and actual outcomes than the NUE model.</div></div><div><h3>Conclusion</h3><div>Endometrial vascularity is a critical factor for postoperative endometrial recovery in IUAs patients following TCRA. NBI hysteroscopy and Doppler ultrasound provide significant advantages in evaluating endometrial blood vessels, thereby facilitating accurate predictions of endometrial outcomes.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114951"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973399","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":"Rehabilitation of pelvic floor muscle for women with urinary incontinence post hysterectomy: A randomized controlled trial","authors":"Marwa S. Abd Elhady ,&nbsp;Niven R. Basyouni ,&nbsp;Salam Bani Hani ,&nbsp;Hala N. El Galada","doi":"10.1016/j.ejogrb.2025.114908","DOIUrl":"10.1016/j.ejogrb.2025.114908","url":null,"abstract":"<div><h3>Objective</h3><div>Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are common conditions among women that can impact all aspects of quality of life. This study aims to compare active training (birth ball) and passive training (biofeedback) on pelvic floor muscle strength and urinary incontinence among post-hysterectomy women.</div></div><div><h3>Methods</h3><div>A Randomized Controlled Trial design was carried out that recruited a purposive sample of 40 women who were allocated randomly into two groups, 20 participants for each group. The intervention group received training in PFM by using biofeedback, while the control group demonstrated active PFM training using a birth ball. Data collected using a basic data structured interview schedule, the Protection, Amount, Frequency, Adjustment, Body Image (PRAFAB) questionnaire, and the Pelvic floor muscles strength test (Manometric Assisted Biofeedback-MBF).</div></div><div><h3>Findings</h3><div>Following 6 weeks and 3 months of interventions, there was a statistically significant difference in the two groups concerning pelvic floor muscle strength. Regarding the degree of urinary incontinence, a statistically significant difference was found between the two study groups after 6 weeks and 3 months following the intervention, with p-values of 0.048 and 0.024, respectively. In favor of the control group, where most participants (75 %) had mild urinary incontinence compared to only 50 % of the intervention group.</div></div><div><h3>Conclusion</h3><div>The study found that pelvic floor exercises improved strength and reduced incontinence, with active birth ball training yielding better outcomes and lower recurrence than passive biofeedback.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114908"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145826987","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":"Robotic indocyanine green-guided sentinel lymph node mapping in early-stage cervical cancer: The fluorescent robotic indocyanine endoscopic node detection series (FRIENDS)","authors":"Rahul Chatterjee ,&nbsp;Marielle Nobbenhuis ,&nbsp;Jenneke Kasius ,&nbsp;Manou Kaur ,&nbsp;Katherine Vroobel ,&nbsp;Ayoma Attygalle ,&nbsp;Thomas Edward James Ind","doi":"10.1016/j.ejogrb.2025.114927","DOIUrl":"10.1016/j.ejogrb.2025.114927","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the implementation of robotic indocyanine green (ICG)–guided sentinel lymph node (SLN) mapping for nodal staging in early-stage cervical cancer and to report mapping outcomes, anatomical distribution of SLNs, and perioperative morbidity.</div></div><div><h3>Methods</h3><div>This single-centre cohort study included women with presumed early-stage cervical cancer who underwent robotic ICG-guided SLN mapping between 2015 and 2025. SLN mapping was performed with or without pelvic lymphadenectomy according to a side-specific algorithm. Institutional practice evolved over time from routine SLN mapping with lymphadenectomy to selective SLN-only staging. Outcomes included SLN detection rates, anatomical distribution of SLNs, nodal metastases, and postoperative morbidity.</div></div><div><h3>Results</h3><div>A total of 161 women underwent robotic SLN mapping. SLN detection was achieved in all patients, with bilateral mapping in 145 (90.1 %). Sixteen women (9.9 %) had nodal metastases; all metastatic disease was identified within sentinel lymph nodes. SLNs were most frequently located in the obturator and external iliac regions, with occasional upper pelvic and <em>para</em>-aortic drainage when lymphatic channels extended cranially. Lymphoedema occurred in 18 women (11.2 %) and was observed only in those who underwent pelvic lymphadenectomy.</div></div><div><h3>Conclusions</h3><div>This study describes long-term, real-world implementation of robotic ICG-guided SLN mapping in early-stage cervical cancer. The findings demonstrate consistent SLN detection, characteristic patterns of lymphatic drainage, and a lower observed incidence of lymphoedema when lymphadenectomy is avoided, supporting the role of SLN-guided nodal staging within contemporary, algorithm-based surgical practice.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114927"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145922009","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":"2026-02-20","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":"Pregnancy outcomes after laparotomic or laparoscopic myomectomy: A multicenter retrospective cohort study","authors":"Bernies J. Bos ,&nbsp;Elisabeth R. Knorren Loes ,&nbsp;Cathy van de Graaf ,&nbsp;Marjan van den Berg ,&nbsp;Jeroen R. Dijkstra ,&nbsp;Mirjam J.A. Apperloo ,&nbsp;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":"2026-02-20","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}

{"title":"Diurnal variation in urine protein-to-creatinine ratio among pregnant women with and without hypertensive disorders: A retrospective clinical study","authors":"Cami Lehavi ,&nbsp;Amir Naeh ,&nbsp;Eiman Shalabna ,&nbsp;Rinat Gabbay-Benziv ,&nbsp;Esther Maor-Sagie","doi":"10.1016/j.ejogrb.2025.114893","DOIUrl":"10.1016/j.ejogrb.2025.114893","url":null,"abstract":"<div><h3>Objective</h3><div>Physiological proteinuria occurs in approximately 8 % of normal pregnancies due to increased glomerular filtration and altered tubular reabsorption. Hypertensive disorders complicate 3–8 % of pregnancies and are associated with adverse outcomes. Although 24-hour urine collection is the traditional standard for assessing proteinuria, it is cumbersome and time-consuming. The urine protein-to-creatinine ratio (Upcr) has largely replaced it owing to its convenience and strong correlation with 24-hour values. However, Upcr relies on random sampling and may be influenced by diurnal variation. This study aimed to assess and compare Upcr diurnal variability in normotensive versus hypertensive singleton pregnancies.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted of all Upcr tests performed between January 2021 and March 2024 at a single university-affiliated center. Tests were ordered following a positive urine dipstick during routine screening. Only the first test per pregnancy was included. Upcr values were compared by sampling time—day (07:00–22:59) versus night (23:00–06:59)—and by subsequent development of hypertensive disorders. Differences were analyzed using the Kruskal–Wallis test.</div></div><div><h3>Results</h3><div>Among 13,054 deliveries, 1,317 (10 %) underwent Upcr testing; 35.8 % developed hypertensive disorders. Most samples were collected during the day (1,121 vs. 196 at night). Hypertensive pregnancies exhibited higher Upcr levels regardless of sampling time. In this group, daytime Upcr values were significantly higher than nighttime values (0.75 vs. 0.39, <em>p</em> = 0.02), whereas no diurnal difference was observed in normotensive pregnancies.</div></div><div><h3>Conclusions</h3><div>Upcr demonstrates significant diurnal variation in hypertensive pregnancies. These findings support reevaluating current proteinuria thresholds and incorporating time-of-day considerations in Upcr interpretation.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114893"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767364","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 sonographic subpubic area is a predictor of anal incontinence after a first vaginal delivery: A prospective cohort study","authors":"Bram Packet ,&nbsp;Rik Van Severen ,&nbsp;Laura Cattani ,&nbsp;Adela Samesova ,&nbsp;Florian Ramakers ,&nbsp;Helena Williams ,&nbsp;Jute Richter ,&nbsp;Jan Deprest","doi":"10.1016/j.ejogrb.2025.114867","DOIUrl":"10.1016/j.ejogrb.2025.114867","url":null,"abstract":"<div><h3>Objectives</h3><div>To study the association between the subpubic arch angle and area, the latter a novel estimator of maternal pelvic outlet dimensions, and postpartum anal incontinence.</div></div><div><h3>Methods</h3><div>Convenience sample from a prospective observational cohort study conducted in primiparous women who delivered vaginally at term. A transperineal ultrasound (TPUS) volume was acquired before the second stage for <em>offline</em> measurement of the subpubic arch angle, area, and levator ani hiatal area. Six to eight weeks postpartum, anal incontinence was self-reported using the St. Marks Incontinence Score (SMIS), and perineal and pelvic floor muscle structural changes were assessed by TPUS. Intra and inter-observer agreement on subpubic arch angle and area measurements was assessed. Anal incontinence and its potential predictors were studied in multivariable logistic regression. Last, a prediction model for postpartum anal incontinence was fitted based on antenatal predictors (age, BMI, anal incontinence at term). Individual sonographic variables were added to this baseline model to assess whether they influenced discriminatory accuracy by comparing the AUC.</div></div><div><h3>Results</h3><div>Data on 156 participants were available, of whom 73.7 % delivered spontaneously. Postpartum anal respective fecal incontinence was reported by 70.5 % and 7.7 %. The incidence of obstetric anal sphincter injury was 3.8 %. Inter- and intra-rater agreement was better for the subpubic area (ICC 0.95, 95 % CI 0.92–0.97 and ICC 0.97, 95 % CI 0.95–0.98) than the subpubic arch angle. Anal incontinence at term (aOR 3.77, 95 % CI1.46–9.73) and assisted vaginal birth (aOR 4.05, 95 %CI 1.27–12.92) were the strongest predictors of <em>postpartum</em> anal incontinence. Although less strong, the subpubic area was also an independent predictor (aOR 1.44, 95 %1.08–1.93). Addition of the subpubic area to the antenatal model did not improve discriminatory accuracy (AUC baseline model: 0.70, 95 % CI 0.61–0.80).</div></div><div><h3>Conclusion</h3><div>The subpubic area can be reliably measured on TPUS. Herein, it was an independent predictor of postpartum anal incontinence. Nonetheless, the addition of this variable to a model containing <em>antenatal</em> predictors only, did not improve discriminatory accuracy for <em>postpartum</em> anal incontinence, questioning its added value for individualized risk prediction.</div></div><div><h3>Funding</h3><div>Research Council Flanders (grant number 1S49923N).</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"318 ","pages":"Article 114867"},"PeriodicalIF":1.9,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780057","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":"2026-02-20","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":"Neurocognitive function, psychosocial characteristics, and occupational performance across menstrual phases in young adults with and without primary dysmenorrhea","authors":"Aysenur Karakus ,&nbsp;Semanur Inanc ,&nbsp;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&lt;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&lt;0.001), and reduced self-esteem (p&lt;0.001). Cognitive performance significantly declined during the luteal phase (p=0.01-0.004). No significant differences were observed in body awareness (p&gt;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":"2026-02-20","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}