Pub Date : 2024-10-06DOI: 10.1016/j.ejogrb.2024.10.007
Maria Sobol , Christos Aravidis , Hugo Hessel , Anna Lindqvist , Izabella Baranowska Körberg
Objective
We report data of non-invasive prenatal testing (NIPT) at Uppsala University Hospital between 2017–2022. Furthermore, we illustrate the potential capacity of massive parallel sequencing-based NIPT beyond identification of common trisomies.
Methods
Maternal blood samples were analyzed using the Verifi NIPT or VeriSeq NIPT assays. Diagnostic testing, performed on amniotic fluid samples, included QF-PCR, microarray (SNP-array) and metaphase FISH.
Results
Among 4532 NIPT tests performed between 2017–2022, 125 samples (2.76%) showed increased risk for trisomies 13, 18, 21 and sex chromosome aneuploidy. For three patients with normal NIPT result further microarray indicated other types of chromosomal rearrangement which were not analyzed by NIPT. For another patient (case 1) the Verifi NIPT indicated trisomy 13. Fetal fraction (FF) was estimated to be 10%. Confirmatory microarray detected a segmental duplication on chromosome 13, as well as a terminal duplication and a terminal deletion on chromosome 10. A complex karyotype was observed in the fetus with metaphase FISH. In the second case the VeriSeq NIPT indicated trisomy 13. FF was estimated to be 11%. Confirmatory microarray detected a mosaicism of trisomy 13 in 30 % of cells.
Conclusion
This study illustrates detection of peculiar abnormalities of chromosome 13 and supports potential to screen copy number variations with genome-wide NIPT.
{"title":"Massive parallel sequencing-based non-invasive prenatal test (NIPT) identifies aberrations on chromosome 13","authors":"Maria Sobol , Christos Aravidis , Hugo Hessel , Anna Lindqvist , Izabella Baranowska Körberg","doi":"10.1016/j.ejogrb.2024.10.007","DOIUrl":"10.1016/j.ejogrb.2024.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>We report data of non-invasive prenatal testing (NIPT) at Uppsala University Hospital between 2017–2022. Furthermore, we illustrate the potential capacity of massive parallel sequencing-based NIPT beyond identification of common trisomies.</div></div><div><h3>Methods</h3><div>Maternal blood samples were analyzed using the Verifi NIPT or VeriSeq NIPT assays. Diagnostic testing, performed on amniotic fluid samples, included QF-PCR, microarray (SNP-array) and metaphase FISH.</div></div><div><h3>Results</h3><div>Among 4532 NIPT tests performed between 2017–2022, 125 samples (2.76%) showed increased risk for trisomies 13, 18, 21 and sex chromosome aneuploidy. For three patients with normal NIPT result further microarray indicated other types of chromosomal rearrangement which were not analyzed by NIPT. For another patient (case 1) the Verifi NIPT indicated trisomy 13. Fetal fraction (FF) was estimated to be 10%. Confirmatory microarray detected a segmental duplication on chromosome 13, as well as a terminal duplication and a terminal deletion on chromosome 10. A complex karyotype was observed in the fetus with metaphase FISH. In the second case the VeriSeq NIPT indicated trisomy 13. FF was estimated to be 11%. Confirmatory microarray detected a mosaicism of trisomy 13 in 30 % of cells.</div></div><div><h3>Conclusion</h3><div>This study illustrates detection of peculiar abnormalities of chromosome 13 and supports potential to screen copy number variations with genome-wide NIPT.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 370-374"},"PeriodicalIF":2.1,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.ejogrb.2024.10.004
Hinpetch Daungsupawong, Viroj Wiwanitkit
{"title":"AI in obstetrics: Evaluating residents' capabilities and interaction strategies with ChatGPT: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1016/j.ejogrb.2024.10.004","DOIUrl":"https://doi.org/10.1016/j.ejogrb.2024.10.004","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544522","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}
Pub Date : 2024-10-05DOI: 10.1016/j.ejogrb.2024.09.041
Basilio Pecorino , Giuseppe Scibilia , Martina Ferrara , Pierfrancesco Veroux , Liliana Mereu , Alessandro Serretti , Paolo Scollo
Mayer–Rokitanski–Kuster–Hauser (MRKH) syndrome consists of a congenital aplasia of the uterus and the upper part of the vagina. It is the most frequent congenital cause of absolute uterine factor infertility, determining psychological disorders due to infertility and reduced quality of sexual activity. Being the necessity of baseline and prolonged assessments, clinicians need evaluation parameters for the monitoring of patients to plan a suitable management strategy and for efficient support before and after interventions, such as neovagina and uterus transplantation.
Research of the literature was performed in PubMed and SCOPUS by searching for the terms “Mayer-Rokitanski-Kuster-Hauser” AND “psychological disorders”; from the 60 articles obtained, only 35 articles regarding neovagina creation and uterus transplantation were considered for the present manuscript.
Based on the literature, management of MRKH syndrome by neovagina creation, either surgically or not, can restore a satisfactory sexual life and to reduce stress, signs of mental disorder and depression and improve sexual activity and quality of life.
A psychological assessment of candidates to UT and of their partners is necessary. Recipients had low levels of anxiety compared to the normal population at baseline but a transiently lowered physical quality of life 1 year after surgery; elevated anxiety scores are associated with childlessness in the long-term evaluation.
Further research is necessary to develop suitable evaluation protocols and adequate supportive services, to improve the outcomes of patients who undergo neovagina creation and uterus transplantation.
{"title":"Psychological impact of neovagina creation and uterus transplantation in the patients affected from Mayer–Rokitanski–Kuster–Hauser syndrome: A narrative review","authors":"Basilio Pecorino , Giuseppe Scibilia , Martina Ferrara , Pierfrancesco Veroux , Liliana Mereu , Alessandro Serretti , Paolo Scollo","doi":"10.1016/j.ejogrb.2024.09.041","DOIUrl":"10.1016/j.ejogrb.2024.09.041","url":null,"abstract":"<div><div>Mayer–Rokitanski–Kuster–Hauser (MRKH) syndrome consists of a congenital aplasia of the uterus and the upper part of the vagina. It is the most frequent congenital cause of absolute uterine factor infertility, determining psychological disorders due to infertility and reduced quality of sexual activity. Being the necessity of baseline and prolonged assessments, clinicians need evaluation parameters for the monitoring of patients to plan a suitable management strategy and for efficient support before and after interventions, such as neovagina and uterus transplantation.</div><div>Research of the literature was performed in PubMed and SCOPUS by searching for the terms “Mayer-Rokitanski-Kuster-Hauser” AND “psychological disorders”; from the 60 articles obtained, only 35 articles regarding neovagina creation and uterus transplantation were considered for the present manuscript.</div><div>Based on the literature, management of MRKH syndrome by neovagina creation, either surgically or not, can restore a satisfactory sexual life and to reduce stress, signs of mental disorder and depression and improve sexual activity and quality of life.</div><div>A psychological assessment of candidates to UT and of their partners is necessary. Recipients had low levels of anxiety compared to the normal population at baseline but a transiently lowered physical quality of life 1 year after surgery; elevated anxiety scores are associated with childlessness in the long-term evaluation.</div><div>Further research is necessary to develop suitable evaluation protocols and adequate supportive services, to improve the outcomes of patients who undergo neovagina creation and uterus transplantation.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 356-361"},"PeriodicalIF":2.1,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399786","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}
Pub Date : 2024-10-04DOI: 10.1016/j.ejogrb.2024.10.003
M. Rauh , M. Voigt , M. Kappelmeyer , B. Schmidt , A. Köninger
<div><h3>Objective</h3><div>To determine the association between sonographically measured abdominal wall thickness (AWT) and birth weight of fetuses of pregnant women with diabetes.</div></div><div><h3>Methods</h3><div>This retrospective study included 185 pregnant women who presented to a level I perinatal centre between January 2021 and December 2022. All mothers had diabetes, and were divided into the following subgroups: diet-controlled gestational diabetes mellitus; insulin-dependent gestational diabetes mellitus; type 1 diabetes mellitus; and type 2 diabetes mellitus. At the time of admission, gestational age varied between 29 + 2 and 41 + 2 weeks (+days) of gestation. Weight estimation was performed routinely using the Hadlock I formula. Fetal AWT was determined retrospectively at the same axial level as used for the measurement of abdominal circumference. Only women with a sonographic fetal weight estimation within 5 days before delivery were included.</div></div><div><h3>Results</h3><div>For the whole cohort, a moderate positive correlation was found between fetal AWT and estimated fetal weight (<em>r</em> = 0.411, <em>p</em> < 0.001), a moderate correlation was found between fetal AWT and birth weight (<em>r</em> = 0.493, <em>p</em> < 0.001), a weak correlation was found between fetal AWT and body length (<em>r</em> = 0.365, <em>p</em> < 0.001), and a weak correlation was found between fetal AWT and body length percentile (<em>r</em> = 0.276, <em>p</em> < 0.001). No strong differences in parameters were found between the diabetes subgroups. Receiver operating characteristic (ROC) curve analysis was performed to identify newborns with birth weight > 4000 g (macrosomia) and birth weight > 90th percentile according to Voigt in the group with gestational age > 37 weeks. ROC curve analysis was performed to identify newborns with birth weight > 90th percentile in the whole cohort. AWT and sonographically estimated fetal weight were included in the calculation. The combination of AWT and estimated fetal weight only led to a marginal improvement compared with estimated fetal weight alone for predicting newborns with birth weight > 4000 g in the group with gestational age > 37 weeks [area under the curve (AUC) 0.857 vs 0.871], and for predicting newborns with birth weight > 90th percentile in the group with gestational age > 37 weeks (AUC 0.840 vs 0.846) and in the whole cohort (AUC 0.816 vs 0.826).</div></div><div><h3>Conclusion</h3><div>A sonographically measured AWT of 7.1 mm in fetuses of diabetic mothers is predictive of birth weight > 90th percentile with sensitivity of 61 %, specificity of 85 %, and AUC of 0.748. ROC curve analysis showed that estimated fetal weight determined by ultrasound (using Hadlock formula I) seems to be slightly superior for the identification of macrosomic fetuses with birth weight > 90th percentile. A threshold value for estimated fetal weight of 3774 g had sensitivity o
{"title":"Correlation of sonographically measured fetal abdominal wall thickness with birth weight in diabetes","authors":"M. Rauh , M. Voigt , M. Kappelmeyer , B. Schmidt , A. Köninger","doi":"10.1016/j.ejogrb.2024.10.003","DOIUrl":"10.1016/j.ejogrb.2024.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the association between sonographically measured abdominal wall thickness (AWT) and birth weight of fetuses of pregnant women with diabetes.</div></div><div><h3>Methods</h3><div>This retrospective study included 185 pregnant women who presented to a level I perinatal centre between January 2021 and December 2022. All mothers had diabetes, and were divided into the following subgroups: diet-controlled gestational diabetes mellitus; insulin-dependent gestational diabetes mellitus; type 1 diabetes mellitus; and type 2 diabetes mellitus. At the time of admission, gestational age varied between 29 + 2 and 41 + 2 weeks (+days) of gestation. Weight estimation was performed routinely using the Hadlock I formula. Fetal AWT was determined retrospectively at the same axial level as used for the measurement of abdominal circumference. Only women with a sonographic fetal weight estimation within 5 days before delivery were included.</div></div><div><h3>Results</h3><div>For the whole cohort, a moderate positive correlation was found between fetal AWT and estimated fetal weight (<em>r</em> = 0.411, <em>p</em> < 0.001), a moderate correlation was found between fetal AWT and birth weight (<em>r</em> = 0.493, <em>p</em> < 0.001), a weak correlation was found between fetal AWT and body length (<em>r</em> = 0.365, <em>p</em> < 0.001), and a weak correlation was found between fetal AWT and body length percentile (<em>r</em> = 0.276, <em>p</em> < 0.001). No strong differences in parameters were found between the diabetes subgroups. Receiver operating characteristic (ROC) curve analysis was performed to identify newborns with birth weight > 4000 g (macrosomia) and birth weight > 90th percentile according to Voigt in the group with gestational age > 37 weeks. ROC curve analysis was performed to identify newborns with birth weight > 90th percentile in the whole cohort. AWT and sonographically estimated fetal weight were included in the calculation. The combination of AWT and estimated fetal weight only led to a marginal improvement compared with estimated fetal weight alone for predicting newborns with birth weight > 4000 g in the group with gestational age > 37 weeks [area under the curve (AUC) 0.857 vs 0.871], and for predicting newborns with birth weight > 90th percentile in the group with gestational age > 37 weeks (AUC 0.840 vs 0.846) and in the whole cohort (AUC 0.816 vs 0.826).</div></div><div><h3>Conclusion</h3><div>A sonographically measured AWT of 7.1 mm in fetuses of diabetic mothers is predictive of birth weight > 90th percentile with sensitivity of 61 %, specificity of 85 %, and AUC of 0.748. ROC curve analysis showed that estimated fetal weight determined by ultrasound (using Hadlock formula I) seems to be slightly superior for the identification of macrosomic fetuses with birth weight > 90th percentile. A threshold value for estimated fetal weight of 3774 g had sensitivity o","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 9-14"},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-04DOI: 10.1016/j.ejogrb.2024.09.043
Gertrud Helling-Giese , Claudia Demarta-Gatsi , Joachim Richter
Introduction
Female genital schistosomiasis (FGS) is the manifestation of schistosomiasis in the lower and the upper reproductive organs. In endemic areas FGS is frequent with a tremendous impact on reproductive health. Anecdotal observations indicate that FGS also occurs in travellers who became infected when exposing themselves in natural water bodies in endemic areas.
The objective of this study is to summarize existing knowledge on FGS in travellers with a focus on FGS-associated morbidity, diagnosis, and treatment.
Material and methods
The PubMed database was searched for reports on FGS in travellers from 1980 to 2023. Case reports of FGS in travellers were identified and reviewed.
Results
Thirty-eight case reports were identified. The most common manifestation of FGS were lesions at the vulva (n = 16), the cervix (n = 11), the ovaries and Fallopian tubes (n = 6), the vagina (n = 3) and the endometrium (n = 2). With a few exceptions the diagnosis was spurious. 15 patients with vulval schistosomiasis were treated with the anti-helminthic drug praziquantel (i.e. 40 mg/kg) in 1–3 doses. In all but one patient the lesions disappeared three to six months after treatment.
Conclusions
This study shows that FGS in travellers exhibits the same disease manifestations as in FGS patients living in endemic areas. However, correct diagnosis was established after months to years delaying treatment and cure. This precludes the inclusion of FGS in diagnostic guidelines for female travellers returning from endemic areas for schistosomiasis.
{"title":"Female genital schistosomiasis (FGS) in returned travellers – A review of reported cases","authors":"Gertrud Helling-Giese , Claudia Demarta-Gatsi , Joachim Richter","doi":"10.1016/j.ejogrb.2024.09.043","DOIUrl":"10.1016/j.ejogrb.2024.09.043","url":null,"abstract":"<div><h3>Introduction</h3><div>Female genital schistosomiasis (FGS) is the manifestation of schistosomiasis in the lower and the upper reproductive organs. In endemic areas FGS is frequent with a tremendous impact on reproductive health. Anecdotal observations indicate that FGS also occurs in travellers who became infected when exposing themselves in natural water bodies in endemic areas.</div><div>The objective of this study is to summarize existing knowledge on FGS in travellers with a focus on FGS-associated morbidity, diagnosis, and treatment.</div></div><div><h3>Material and methods</h3><div>The PubMed database was searched for reports on FGS in travellers from 1980 to 2023. Case reports of FGS in travellers were identified and reviewed.</div></div><div><h3>Results</h3><div>Thirty-eight case reports were identified. The most common manifestation of FGS were lesions at the vulva (n = 16), the cervix (n = 11), the ovaries and Fallopian tubes (n = 6), the vagina (n = 3) and the endometrium (n = 2). With a few exceptions the diagnosis was spurious. 15 patients with vulval schistosomiasis were treated with the anti-helminthic drug praziquantel (i.e. 40 mg/kg) in 1–3 doses. In all but one patient the lesions disappeared three to six months after treatment.</div></div><div><h3>Conclusions</h3><div>This study shows that FGS in travellers exhibits the same disease manifestations as in FGS patients living in endemic areas. However, correct diagnosis was established after months to years delaying treatment and cure. This precludes the inclusion of FGS in diagnostic guidelines for female travellers returning from endemic areas for schistosomiasis.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 28-34"},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423004","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}
The study aimed to evaluate the incidence of concurrent endometrial cancer (EC) and lymph node positivity in patients with Atypical Endometrial Hyperplasia (AEH) who underwent surgical staging with sentinel lymph node evaluation. It also sought to identify the risk factors associated with detecting concurrent endometrial cancer in patients with a preoperative diagnosis of AEH.
Study design
A retrospective study was conducted at Amrita Institute of Medical Sciences, involving 54 cases of AEH diagnosed on pre-operative biopsy specimens and undergoing staging surgery between January 1, 2015, and December 31, 2020. The study analysed demographic parameters, clinical presentations, pathological features, and clinical outcomes. Categorical variables were expressed in numbers and percentages, normal distribution data were presented as mean, and non-normal distribution data were presented as median and range.
Results
Fifty-four patients diagnosed with AEH underwent surgical staging. The median age was 54 years. Final HistoPathology Report (HPR) showed 48.14 % with AEH and 51.85 % with concurrent EC. Among those with concurrent EC, 96.4 % had type I EC, and one patient was upgraded to type 2 EC. Among them, 17.8 % patients belonged to high-intermediate and high-risk categories. Patients with AEH and concurrent EC were more likely to be diabetic (OR: 3.56, p = 0.04), have a BMI ≥25 kg/m2 (OR: 1.47, p = 0.04), exhibit a thickened endometrial lining of ≥9 mm (OR: 3.13, p = 0.05) on ultrasound, and undergo preoperative biopsy at a non-oncology centre (OR: 8.33, p = 0.001) whereas experiencing heavy menstrual bleeding had a substantially lower likelihood (OR: 0.29, p = 0.01) of developing concurrent EC.
Conclusion
The study revealed that more than half of patients undergoing staging surgery for AEH were found to be at risk of having concurrent EC in their final HPR. The research also pointed out that surgical staging can help identify both low-risk and high-risk ECs, which may require additional treatment. Higher BMI, diabetes mellitus, and an endometrial thickness of ≥9 mm were identified as significant risk factors for concurrent EC. Additionally, heavy menstrual bleeding was associated with a decreased risk of concurrent EC.
{"title":"Should we prioritise proper surgical staging for patients with Atypical endometrial hyperplasia (AEH)? Experience from a single-institution tertiary care oncology centre","authors":"Pranidha Shree CA , Monal Garg , Priya Bhati , V.S. Sheejamol","doi":"10.1016/j.ejogrb.2024.09.044","DOIUrl":"10.1016/j.ejogrb.2024.09.044","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to evaluate the incidence of concurrent endometrial cancer (EC) and lymph node positivity in patients with Atypical Endometrial Hyperplasia (AEH) who underwent surgical staging with sentinel lymph node evaluation. It also sought to identify the risk factors associated with detecting concurrent endometrial cancer in patients with a preoperative diagnosis of AEH.</div></div><div><h3>Study design</h3><div>A retrospective study was conducted at Amrita Institute of Medical Sciences, involving 54 cases of AEH diagnosed on pre-operative biopsy specimens and undergoing staging surgery between January 1, 2015, and December 31, 2020. The study analysed demographic parameters, clinical presentations, pathological features, and clinical outcomes. Categorical variables were expressed in numbers and percentages, normal distribution data were presented as mean, and non-normal distribution data were presented as median and range.</div></div><div><h3>Results</h3><div>Fifty-four patients diagnosed with AEH underwent surgical staging. The median age was 54 years. Final HistoPathology Report (HPR) showed 48.14 % with AEH and 51.85 % with concurrent EC. Among those with concurrent EC, 96.4 % had type I EC, and one patient was upgraded to type 2 EC. Among them, 17.8 % patients belonged to high-intermediate and high-risk categories. Patients with AEH and concurrent EC were more likely to be diabetic (OR: 3.56, p = 0.04), have a BMI ≥25 kg/m2 (OR: 1.47, p = 0.04), exhibit a thickened endometrial lining of ≥9 mm (OR: 3.13, p = 0.05) on ultrasound, and undergo preoperative biopsy at a non-oncology centre (OR: 8.33, p = 0.001) whereas experiencing heavy menstrual bleeding had a substantially lower likelihood (OR: 0.29, p = 0.01) of developing concurrent EC.</div></div><div><h3>Conclusion</h3><div>The study revealed that more than half of patients undergoing staging surgery for AEH were found to be at risk of having concurrent EC in their final HPR. The research also pointed out that surgical staging can help identify both low-risk and high-risk ECs, which may require additional treatment. Higher BMI, diabetes mellitus, and an endometrial thickness of ≥9 mm were identified as significant risk factors for concurrent EC. Additionally, heavy menstrual bleeding was associated with a decreased risk of concurrent EC.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"303 ","pages":"Pages 1-8"},"PeriodicalIF":2.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406280","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}
Pub Date : 2024-10-03DOI: 10.1016/j.ejogrb.2024.10.002
Anaïs Scohy, Sarah Gillemot, Brecht Dirix, Pierre Bernard, Graciela Andrei, Robert Snoeck, Benoît Kabamba Mukadi
{"title":"Congenital cytomegalovirus infection despite valaciclovir secondary prevention: should we fear antiviral resistance?","authors":"Anaïs Scohy, Sarah Gillemot, Brecht Dirix, Pierre Bernard, Graciela Andrei, Robert Snoeck, Benoît Kabamba Mukadi","doi":"10.1016/j.ejogrb.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.ejogrb.2024.10.002","url":null,"abstract":"","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497488","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}
The first international consensus guideline on physiological interpretation of cardiotocograph (CTG) produced by 44 CTG experts from 14 countries was published in 2018. This guideline ensured a paradigm shift from classifying CTG by arbitrarily grouping certain features of the fetal heart rate into different “categories”, and then, randomly combining them to arrive at an overall classification of CTG traces into “Normal, Suspicious and Pathological” (or Category I, II and III) to a classification which is based on the understanding of fetal pathophysiology. The guideline recommended the recognition of different types of fetal hypoxia, and the determination of features of fetal compensatory responses as well as decompensation to ongoing hypoxic stress on the CTG trace. Since its first publication in 2018, there have been several scientific publications relating physiological interpretation of CTG, especially relating to features indicative of autonomic instability due to hypoxic stress (i.e., the ZigZag pattern), and of fetal inflammation. Moreover, emerging evidence has suggested improvement in maternal and perinatal outcomes in maternity units which had implemented physiological interpretation of CTG. Therefore, the guideline on Physiological Interpretation of CTG has been revised to incorporate new scientific evidence, and the interpretation table has been expanded to include features of chorioamnionitis and relative utero-placental insufficiency of labour (RUPI-L).
{"title":"International expert consensus statement on physiological interpretation of cardiotocograph (CTG): First revision (2024)","authors":"Edwin Chandraharan , Susana Pereira , Tullio Ghi , Anna Gracia Perez-Bonfils , Stefania Fieni , Yan-Ju Jia , Katherine Griffiths , Suganya Sukumaran , Caron Ingram , Katharine Reeves , Mareike Bolten , Katrine Loser , Elena Carreras , Anna Suy , Itziar Garcia-Ruiz , Letizia Galli , Ahmed Zaima","doi":"10.1016/j.ejogrb.2024.09.034","DOIUrl":"10.1016/j.ejogrb.2024.09.034","url":null,"abstract":"<div><div>The first international consensus guideline on physiological interpretation of cardiotocograph (CTG) produced by 44 CTG experts from 14 countries was published in 2018. This guideline ensured a paradigm shift from classifying CTG by arbitrarily grouping certain features of the fetal heart rate into different “categories”, and then, randomly combining them to arrive at an overall classification of CTG traces into “Normal, Suspicious and Pathological” (or Category I, II and III) to a classification which is based on the understanding of fetal pathophysiology. The guideline recommended the recognition of different types of fetal hypoxia, and the determination of features of fetal compensatory responses as well as decompensation to ongoing hypoxic stress on the CTG trace. Since its first publication in 2018, there have been several scientific publications relating physiological interpretation of CTG, especially relating to features indicative of autonomic instability due to hypoxic stress (i.e., the ZigZag pattern), and of fetal inflammation. Moreover, emerging evidence has suggested improvement in maternal and perinatal outcomes in maternity units which had implemented physiological interpretation of CTG. Therefore, the guideline on Physiological Interpretation of CTG has been revised to incorporate new scientific evidence, and the interpretation table has been expanded to include features of chorioamnionitis and relative utero-placental insufficiency of labour (RUPI-L).</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 346-355"},"PeriodicalIF":2.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142389074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.ejogrb.2024.09.019
A.E. McGee, S. Hawco, S. Bhattacharya, S.J.B. Hanley, M.E. Cruickshank
Objectives
In 2021, the World Health Organisation (WHO) updated its guidelines for cervical screening from cytology testing to primary high-risk human papillomavirus (HR-HPV) testing. This change in testing has effectively led to a ‘new disease’ as women are now aware of having a virus that induces changes that can cause cancer, which they would have been unaware of previously. While current management involves a ‘watch and wait’ approach and no active treatment, the anxiety associated with having HR-HPV may prompt some women to seek ‘treatments’ outside the screening programme.
● to identify potential treatment options available for women with persistent HR-HPV and/or low-grade cervical intraepithelial neoplasia (CIN), i.e. ≤CIN 1.
● to determine the clinical effectiveness of these treatments, namely by:
◦ HR-HPV clearance rate, and/or:
◦ CIN regression.
Methods
We searched MEDLINE, PubMed, EMBASE, Web of Science and the Cochrane Library. We included cohort studies and randomised controlled trials (RCTs) only. Records (n = 2135) were screened in Rayyan by two independent reviewers. Quality assessment was conducted using the ROBINS-I tool and the ROB-2 tool.
Results
12 studies (four cohort studies and eight RCTs) were included: six oral medications, two topical medications, one vaccination, and three non-surgical device treatments. Meta-analysis revealed that some therapeutic interventions, including vaginal gels, photodynamic therapy, and some oral medications, may lead to earlier resolution of persistent HR-HPV and regression of low-grade CIN when compared with natural clearance.
Conclusion
This review can better inform discussions with HR-HPV+ women and answer their questions about alternatives to surveillance.
{"title":"Alternatives to surveillance for persistent human papillomavirus after a positive cervical screen: A systematic review and meta-analysis","authors":"A.E. McGee, S. Hawco, S. Bhattacharya, S.J.B. Hanley, M.E. Cruickshank","doi":"10.1016/j.ejogrb.2024.09.019","DOIUrl":"10.1016/j.ejogrb.2024.09.019","url":null,"abstract":"<div><h3>Objectives</h3><div>In 2021, the World Health Organisation (WHO) updated its guidelines for cervical screening from cytology testing to primary high-risk human papillomavirus (HR-HPV) testing. This change in testing has effectively led to a ‘new disease’ as women are now aware of having a virus that induces changes that can cause cancer, which they would have been unaware of previously. While current management involves a ‘watch and wait’ approach and no active treatment, the anxiety associated with having HR-HPV may prompt some women to seek ‘treatments’ outside the screening programme.</div><div>● to identify potential treatment options available for women with persistent HR-HPV and/or low-grade cervical intraepithelial neoplasia (CIN), i.e. ≤CIN 1.</div><div>● to determine the clinical effectiveness of these treatments, namely by:</div><div> <!-->◦ HR-HPV clearance rate, and/or:</div><div> <!-->◦ CIN regression.</div></div><div><h3>Methods</h3><div>We searched MEDLINE, PubMed, EMBASE, Web of Science and the Cochrane Library. We included cohort studies and randomised controlled trials (RCTs) only. Records (n = 2135) were screened in Rayyan by two independent reviewers. Quality assessment was conducted using the ROBINS-I tool and the ROB-2 tool.</div></div><div><h3>Results</h3><div>12 studies (four cohort studies and eight RCTs) were included: six oral medications, two topical medications, one vaccination, and three non-surgical device treatments. Meta-analysis revealed that some therapeutic interventions, including vaginal gels, photodynamic therapy, and some oral medications, may lead to earlier resolution of persistent HR-HPV and regression of low-grade CIN when compared with natural clearance.</div></div><div><h3>Conclusion</h3><div>This review can better inform discussions with HR-HPV+ women and answer their questions about alternatives to surveillance.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 332-338"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.ejogrb.2024.09.042
Marine Lallemant , Alessandro Ferdinando Ruffolo , Yohan Kerbage , Charles Garadebian , Louise Ghesquiere , Chrystèle Rubod , Michel Cosson
Objectives
To review and compare existing guidelines on the intrapartum management and postpartum follow-up of obstetric anal sphincter injuries (OASIS)
Methods
We conducted a systematic review of clinical guidelines related to OASIS management, focusing on intrapartum care and postpartum follow-up. Searches were performed in July 2024 across multiple databases, including PubMed, Embase, and the Cochrane Library. Guidelines published after 2010 in English were included.
Results
Nine national guidelines were included. There was a consensus on OASIS classification and immediate management, particularly regarding suture techniques, materials, and the necessity of adequate analgesia. However, notable variations were identified in the timing of repair, specialist involvement, use of prophylactic antibiotics, and post-operative care protocols. Postpartum follow-up practices also varied, especially regarding the role of physiotherapy and the timing of specialist consultations, reflecting inconsistencies in long-term care recommendations.
Conclusion
Significant variability existed in the guidelines for the management and follow-up of OASIS, particularly in postpartum care. This study underscored the need for standardized, evidence-based guidelines to ensure consistent and optimal care for women affected by OASIS.
{"title":"Clinical practices in the management and follow-up of obstetric anal sphincter injuries: a comprehensive review","authors":"Marine Lallemant , Alessandro Ferdinando Ruffolo , Yohan Kerbage , Charles Garadebian , Louise Ghesquiere , Chrystèle Rubod , Michel Cosson","doi":"10.1016/j.ejogrb.2024.09.042","DOIUrl":"10.1016/j.ejogrb.2024.09.042","url":null,"abstract":"<div><h3>Objectives</h3><div>To review and compare existing guidelines on the intrapartum management and postpartum follow-up of obstetric anal sphincter injuries (OASIS)</div></div><div><h3>Methods</h3><div>We conducted a systematic review of clinical guidelines related to OASIS management, focusing on intrapartum care and postpartum follow-up. Searches were performed in July 2024 across multiple databases, including PubMed, Embase, and the Cochrane Library. Guidelines published after 2010 in English were included.</div></div><div><h3>Results</h3><div>Nine national guidelines were included. There was a consensus on OASIS classification and immediate management, particularly regarding suture techniques, materials, and the necessity of adequate analgesia. However, notable variations were identified in the timing of repair, specialist involvement, use of prophylactic antibiotics, and post-operative care protocols. Postpartum follow-up practices also varied, especially regarding the role of physiotherapy and the timing of specialist consultations, reflecting inconsistencies in long-term care recommendations.</div></div><div><h3>Conclusion</h3><div>Significant variability existed in the guidelines for the management and follow-up of OASIS, particularly in postpartum care. This study underscored the need for standardized, evidence-based guidelines to ensure consistent and optimal care for women affected by OASIS.</div></div>","PeriodicalId":11975,"journal":{"name":"European journal of obstetrics, gynecology, and reproductive biology","volume":"302 ","pages":"Pages 362-369"},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号