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

英文中文

Expression of concern “Bacterial vaginosis and infertility: cause or association?” [Eur. J. Obstet. Gynecol. Reprod. Biol. 167/1 (2013) 59–63] 关注表达“细菌性阴道病与不孕症：原因还是关联？”(欧元。j .。。Gynecol。天线转换开关。生物学报，167/1 (2013)59-63]

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-01

Rasheed M. Salah , Abdelmonem M. Allam , Amin M. Magdy , Abeer Sh. Mohamed

引用次数: 0

Expression of concern “Maternal and neonatal copeptin levels at caesarean section and vaginal delivery”. [Eur. J. Obstet. Gynecol. Reprod. Biol. 165/2 (2012) 215–218] 关注表达“剖腹产和阴道分娩时产妇和新生儿copeptin水平”。(欧元。j .。。Gynecol。天线转换开关。生物学报，165/2 (2012)215-218]

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-01

Ashraf A. Foda , Ibrahim A. Abdel Aal

引用次数: 0

Expression of concern: “Is dienogest a convenient treatment option for cesarean scar endometriosis or should it be treated surgically?”. [Eur. J. Obstet. Gynecol. Reprod. Biol. 282 (2023) 110–115] 关注表达：“对于剖宫产瘢痕子宫内膜异位症，dienogest是一种方便的治疗选择，还是应该进行手术治疗？”(欧元。j .。。Gynecol。天线转换开关。生物学报。282 (2023)110-115]

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-01

Kerem Doga Seckin , Pinar Kadirogullari

引用次数: 0

Expression of concern “A randomized comparison of a single-incision needleless (Contasure-needleless®) mini-sling versus a mid-urethral sling (Contasure-KIM®): 60-month follow-up results”. [Eur. J. Obstet. Gynecol. Reprod. Biol. 307C (2025) 7–12] “单切口无针（contasure - needeless®）迷你吊带与中尿道吊带（Contasure-KIM®）的随机比较：60个月的随访结果”。(欧元。j .。。Gynecol。天线转换开关。生物学报。307C (2025) 7-12]

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2026-01-01

Ozan Dogan , Pinar Kadirogullari , Erhan Huseyin Comert , Alper Basbug , Murat Yassa

引用次数: 0

Value of triglyceride-glucose index in diagnosis of gestational diabetes mellitus: a systematic review and meta-analysis 甘油三酯-葡萄糖指数在妊娠期糖尿病诊断中的价值：系统回顾和荟萃分析

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-12-31 DOI: 10.1016/j.ejogrb.2025.114931

Binze Chen , Teng Ma , Ying Liu , Mengting Wang , Tingting Yin , Yanxia Han

Purpose

To assess the accuracy of triglyceride-glucose index (TyG) in the diagnosis of gestational diabetes mellitus (GDM).

Methods

Embase, Cochrane Library, PubMed, and Web of Science were searched up to April 18, 2025 for English-language clinical studies using TyG for GDM prediction. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was utilized for quality assessment, and the final results were presented by RevMan5.3. The overall accuracy of TyG in GDM diagnosis was identified using Stata15.0 and Meta-DiSc1.4. We also performed subgroup analyses by the sample size, prevalence, cutoff, and trimester of pregnancy.

Results

Sixteen studies with 480,402 participants were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of TyG in GDM diagnosis were 0.63 (95 % CI 0.56–0.70), 0.64 (95 % CI 0.60–0.68), 1.80 (95 % CI 1.60–1.90), 0.57 (95 % CI 0.49–0.67), and 3.00 (95 % CI 2.00–4.00), respectively. The area under the summary receiver operating characteristic (SROC) curve of TyG was 0.68 (95 % CI 0.64–0.72). Subgroup analyses revealed that small sample sizes, high prevalence, cutoff < 8.5, and the second trimester corresponded to the high accuracy of TyG in GDM diagnosis.

Conclusion

TyG demonstrates moderate diagnostic accuracy for GDM, with an area under the SROC curve of 0.68. Considering the limitations of the available studies, more prospective studies are still required to clarify the diagnostic value of TyG in actual clinical practice and offer a stronger basis for clinical decision-making.

目的探讨甘油三酯-葡萄糖指数（TyG）在妊娠期糖尿病（GDM）诊断中的准确性。方法检索sembase、Cochrane Library、PubMed和Web of Science，检索截至2025年4月18日使用TyG预测GDM的英文临床研究。采用诊断准确性研究质量评估-2 （QUADAS-2）工具进行质量评估，最终结果由RevMan5.3给出。使用Stata15.0和Meta-DiSc1.4确定TyG在GDM诊断中的总体准确性。我们还根据样本量、患病率、截止时间和妊娠三个月进行了亚组分析。结果共纳入16项研究，480402名受试者。TyG在GDM诊断中的敏感性、特异性、阳性似然比、阴性似然比、诊断优势比分别为0.63 （95% CI 0.56 ~ 0.70）、0.64 （95% CI 0.60 ~ 0.68）、1.80 （95% CI 1.60 ~ 1.90）、0.57 （95% CI 0.49 ~ 0.67）、3.00 （95% CI 2.00 ~ 4.00）。TyG的综合受试者工作特征（SROC）曲线下面积为0.68 （95% CI 0.64 ~ 0.72）。亚组分析显示，样本量小、患病率高、临界值<； 8.5、妊娠中期与TyG在GDM诊断中的准确性较高相对应。结论tyg对GDM的诊断准确率中等，SROC曲线下面积为0.68。考虑到现有研究的局限性，仍需要更多的前瞻性研究来明确TyG在实际临床中的诊断价值，为临床决策提供更有力的依据。

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引用次数: 0

Development and preliminary evaluation of a machine learning model for predicting low birth weight using placental IVIM-MRI and maternal clinical characteristics 利用胎盘IVIM-MRI和产妇临床特征预测低出生体重的机器学习模型的开发和初步评估

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-12-31 DOI: 10.1016/j.ejogrb.2025.114930

Wei Bian, Wenting Zhang, Hui Liu, Linping Wang, Fang Wei, Yuan Yao

Objective

To identify key placental intravoxel incoherent motion (IVIM) MRI parameters and maternal factors associated with low birth weight (LBW), and develop a prenatal predictive model for LBW risk assessment.

Methods

This retrospective study analyzed 113 term neonates (January 2023–December 2024), categorized as LBW or normal birth weight. Twenty-one antenatal metrics, including maternal characteristics and region-specific placental IVIM MRI parameters (perfusion fraction [f], true diffusion coefficient [D], pseudo-diffusion coefficient [D*]), were evaluated. Feature importance was ranked using Shapley Additive Explanations (SHAP) analysis in a Random Forest algorithm. Key predictors were used to build a multivariable logistic regression nomogram. Discrimination (ROC-AUC), calibration, and clinical utility (DCA) were assessed. Internal validation employed bootstrap resampling (1000 iterations).

Results

SHAP identified f values from maximal placental section (f_MPS), central zone (f_CPZ), and fetal side (f_FS) as top predictors. The nomogram showed good discrimination (AUC = 0.86, 95 % CI: 0.74–0.98). Bootstrap validation yielded an AUC of 0.82 (95 % CI: 0.61–0.98), with high sensitivity and specificity. The calibration curve showed good model fit. DCA demonstrated considerable clinical benefit.

Conclusion

Placental IVIM MRI f values from distinct placental regions are significant LBW predictors. The model provides accurate prenatal risk assessment, guiding early interventions to optimize perinatal outcomes.

目的探讨胎盘体素内不相干运动（IVIM） MRI关键参数及与低出生体重（LBW）相关的母体因素，建立低出生体重风险评估的产前预测模型。方法回顾性分析2013年1月~ 2024年12月113例足月新生儿，均为低体重或正常出生体重。评估21项产前指标，包括产妇特征和区域特异性胎盘IVIM MRI参数（灌注分数[f]、真扩散系数[D]、伪扩散系数[D*]）。使用随机森林算法中的Shapley加性解释（SHAP）分析对特征重要性进行排序。使用关键预测因子构建多变量logistic回归nomogram。评估辨别（ROC-AUC）、校准和临床效用（DCA）。内部验证采用自举重采样（1000次迭代）。结果shap确定最大胎盘切片（f_MPS）、中心区（f_CPZ）和胎儿侧（f_FS）的f值为预测因子。模态图具有良好的鉴别性（AUC = 0.86, 95% CI: 0.74 ~ 0.98）。Bootstrap验证的AUC为0.82 (95% CI: 0.61-0.98)，具有较高的灵敏度和特异性。标定曲线模型拟合良好。DCA显示出相当大的临床益处。结论不同胎盘区域的胎盘IVIM MRI f值是预测LBW的重要指标。该模型提供准确的产前风险评估，指导早期干预以优化围产期结局。

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引用次数: 0

Inside Back Cover - Editors with images 内封底-编辑与图像

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-12-30 DOI: 10.1016/S0301-2115(25)01194-7

引用次数: 0

Factors influencing the size of the urogenital hiatal area assessed by ultrasound 超声评估影响泌尿生殖裂孔面积大小的因素

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-12-30 DOI: 10.1016/j.ejogrb.2025.114922

Jordi Cassadó, Eva Huguet, Anna Carmona, Marta Hinarejos, Mercè Tarragó, Antoni Pessarrodona, Oriol Porta

Background

The urogenital hiatus, as assessed by MRI, has been associated with risk factors for pelvic organ prolapse and its severity. However, there is limited evidence regarding the feasibility of assessing the urogenital hiatus using ultrasound.

Objective

To identify the factors associated with urogenital hiatal enlargement, after confirming the interobserver reproducibility of ultrasound measurements obtained using the OmniView software.

Study Design

This retrospective observational pilot study analyzed a cohort of women who attended the pelvic floor unit of our hospital for any pelvic floor disorder between December 24 and May 25. Epidemiological, clinical, and ultrasound variables were assessed. Transperineal ultrasound was performed using OmniView software to measure the area of the urogenital hiatus during the Valsalva maneuver. The levator hiatal area was measured in the rendered volume during Valsalva, and levator avulsion was evaluated using a multislice system during contraction. Interobserver reproducibility was assessed. Multivariate linear regression was used to identify variables independently associated with the size of the urogenital hiatus.

Results

Overall, 120 women were evaluated. Interobserver correlation assessed by OmniView was strong for the urogenital hiatal area (rs = 0.82). In univariate analysis, levator hiatal area, prolapse stage, parity and levator avulsion were associated with the urogenital hiatal area. However, in multivariate analysis, only levator hiatal area and prolapse stage remained independently associated with the urogenital hiatal area.

Conclusions

Ultrasound assessment of the urogenital hiatal area using OmniView software is reproducible. Both the levator hiatal area and prolapse stage are independently associated with urogenital hiatus size.

背景：经MRI评估，泌尿生殖道裂孔与盆腔器官脱垂及其严重程度的危险因素有关。然而，关于使用超声评估泌尿生殖裂孔的可行性的证据有限。目的利用OmniView软件确认超声测量结果的可重复性，确定与泌尿生殖裂孔扩大相关的因素。研究设计：本回顾性观察性初步研究分析了12月24日至5月25日期间在我院盆底科就诊的盆底疾病患者。评估流行病学、临床和超声变量。使用OmniView软件进行会阴超声测量Valsalva操作时泌尿生殖裂孔的面积。在Valsalva期间，在呈现的体积中测量提提肌裂孔面积，在收缩期间使用多层系统评估提提肌撕脱。评估了观察者间的再现性。多元线性回归用于识别与泌尿生殖裂孔大小独立相关的变量。结果共对120名妇女进行了评估。OmniView评估的观察者间相关性在泌尿生殖裂孔区域很强（rs = 0.82）。在单因素分析中，提肛裂孔面积、脱垂期、胎次和提肛撕脱与泌尿生殖裂孔面积有关。然而，在多变量分析中，只有提肛裂孔面积和脱垂阶段与泌尿生殖裂孔面积独立相关。结论应用OmniView软件对泌尿生殖裂孔区进行超声检查具有较好的重复性。提肛孔面积和脱垂阶段都与泌尿生殖孔大小独立相关。

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引用次数: 0

Pregnancy and perinatal outcomes in women with different phenotypes of adenomyosis: A retrospective cohort study 不同表型子宫腺肌症妇女的妊娠和围产期结局：一项回顾性队列研究

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-12-30 DOI: 10.1016/j.ejogrb.2025.114926

Wan Yang , Xiaoyan Liu , Lin Zeng , Piaoe Zeng , Yan Zhang , Rong Li

Background

To evaluate maternal and perinatal outcomes in women with different adenomyosis phenotypes and to assess the impact of placental attachment site in patients with intrinsic adenomyosis.

Methods

This retrospective cohort study analysed 255 patients with adenomyosis who delivered between January 2014 and December 2019. Patients were classified into diffuse (n = 119), intrinsic (n = 89) and extrinsic (n = 47) phenotypes. Within the intrinsic group, patients were further subdivided into lesion-attached (n = 49) and lesion-unattached (n = 40) subgroups according to placental location relative to the adenomyotic lesion. To identify independent risk factors for key outcomes while adjusting for potential confounders, multivariable logistic regression analysis was employed.

Results

The rates and volume of postpartum haemorrhage (PPH) were significantly higher in the diffuse group compared to the focal phenotypes, with uterine atony identified as a key contributing factor. Among patients with intrinsic adenomyosis, the lesion-attached subgroup exhibited significantly greater blood loss, a lower mean gestational age at delivery (37.4 ± 2.9 vs. 38.8 ± 1.3 weeks, P = 0.006), and a higher preterm birth rate (26.5 % vs. 5.0 %, P = 0.009) compared to the lesion-unattached subgroup. Multivariate analysis confirmed placental attachment site as an independent predictor of preterm delivery, although the estimate was imprecise due to wide confidence intervals. A post hoc power analysis indicated 82 % power to detect the observed difference in preterm birth rates between these subgroups.

Conclusions

Diffuse adenomyosis and lesion-attached intrinsic adenomyosis are associated with an increased risk of postpartum hemorrhage. Furthermore, placental attachment to an adenomyosis lesion significantly elevates the risk of preterm delivery in patients with intrinsic disease. These findings underscore the importance of phenotype-specific and placental-site assessment for antenatal risk stratification.

背景：评估不同子宫腺肌症表型妇女的孕产妇和围产期结局，并评估胎盘附着部位对内在子宫腺肌症患者的影响。方法本回顾性队列研究分析了2014年1月至2019年12月期间分娩的255例子宫腺肌症患者。患者分为弥漫性（n = 119）、内在型（n = 89）和外在型（n = 47）。在固有组中，根据胎盘相对于腺肌病灶的位置，将患者进一步细分为病变附着组（n = 49）和病变未附着组（n = 40）。为了确定关键结果的独立危险因素，同时调整潜在的混杂因素，采用多变量logistic回归分析。结果弥漫性组产后出血（PPH）发生率和产出量明显高于局灶性组，子宫张力不全是关键因素。在患有内源性bb0的患者中，病变附着亚组的出血量明显增加，分娩时平均胎龄较低（37.4±2.9周对38.8±1.3周，P = 0.006），早产率较高（26.5%对5.0%,P = 0.009）。多变量分析证实胎盘附着部位是早产的独立预测因子，尽管由于置信区间较宽，估计并不精确。事后功效分析显示，检测这些亚组之间观察到的早产率差异的功效为82%。结论弥漫性血凝斑和病变附着的内生性血凝斑与产后出血风险增加有关。此外，胎盘附着于子宫腺肌症病变显著增加了先天性疾病患者早产的风险。这些发现强调了表型特异性和胎盘部位评估对产前风险分层的重要性。

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引用次数: 0

Longitudinal ultrasound-based follow up of non-surgically treated endometriosis using #Enzian classification 纵向超声随访非手术治疗子宫内膜异位症采用#Enzian分类。

IF 1.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology

Pub Date : 2025-12-29 DOI: 10.1016/j.ejogrb.2025.114923

Sara Valeriani , Aikaterini Selntigia , Consuelo Russo , Myriam Adele Traulo , Elvira Nocita , Federica Iacobini , Daniele Farsetti , Giorgia Soreca , Caterina Exacoustos

Objectives

This study aimed to compare clinical and ultrasound outcomes over 24 months in premenopausal women with ultrasound-diagnosed endometriosis/adenomyosis, never treated surgically, and managed with or without hormonal therapy. We specifically assessed ultrasonographically disease progression progression, symptom control, and lesion dynamics using the compartment-based #Enzian classification.

Materials and methods

This single-center retrospective study included patients with endometriosis/adenomyosis who underwent transvaginal ultrasound (TVUS) and clinical assessment at baseline, 12, and 24 months. All lesions were classified according to #Enzian compartments. Patients were divided into Group A, receiving continuous hormonal therapy, and Group B managed without hormonal treatment.

Results

A total of 125 patients were included (Group A: n = 95; Group B: n = 30). In Group A, endometrioma prevalence declined from 87.4 % at baseline to 66.3 % at 24 months (p = 0.001), with O2 lesions decreasing from 45.3 % to 6.3 % and O1 lesions increasing from 42.1 % to 60.0 %, reflecting lesion shrinkage. Group B showed no significant changes in the O compartment (p = 0.7). FA (adenomyosis) lesions remained stable in Group A (p = 0.3) but increased from 53.0 % to 73.0 % in Group B over 24 months (p = 0.01). Compartments A, B, and C of deep endometriosis showed no significant changes in either group. Symptom prevalence decreased significantly in Group A compared with Group B.

Conclusions

#Enzian-based ultrasound provides a standardized approach for non-invasive longitudinal monitoring of endometriosis/adenomyosis. Hormonal therapy mainly improved symptoms, with significant lesion changes limited to O compartment, supporting its use ad a conservative management strategy while reserving surgery for selected cases.

目的：本研究旨在比较超声诊断为子宫内膜异位症/子宫腺肌症的绝经前妇女24个月的临床和超声结果，这些妇女从未接受过手术治疗，并接受或不接受激素治疗。我们使用基于室室的#Enzian分类对疾病进展、症状控制和病变动态进行了超声评估。材料和方法：本单中心回顾性研究纳入了在基线、12和24个月时接受阴道超声检查和临床评估的子宫内膜异位症/子宫腺肌症患者。所有病变按#Enzian区室进行分类。将患者分为持续激素治疗的A组和不进行激素治疗的B组。结果：共纳入125例患者，其中A组95例，B组30例。在A组，子宫内膜瘤的患病率从基线时的87.4%下降到24个月时的66.3% (p = 0.001)， O2病变从45.3%下降到6.3%，O1病变从42.1%上升到60.0%，反映了病变的缩小。B组O室无明显变化（p = 0.7）。24个月内，A组FA（子宫腺肌症）病变保持稳定（p = 0.3），而B组FA（子宫腺肌症）病变从53.0%增加到73.0% （p = 0.01）。两组深部子宫内膜异位症的A、B、C室未见明显变化。结论：基于enzian的超声为子宫内膜异位症/子宫腺肌症的无创纵向监测提供了一种标准化的方法。激素治疗主要改善症状，明显病变改变仅限于O室，支持其使用和保守管理策略，同时保留手术治疗的选择病例。

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