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LONG-TERM EFFICACY OF CO2 FRACTIONAL LASER IN THE TREATMENT OF GENITOURINARY SYNDROME OF MENOPAUSE. 二氧化碳点阵激光治疗更年期泌尿生殖系统综合征的长期疗效。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-27 DOI: 10.1016/j.jogoh.2025.102933
Dr Amelia Favier, Dr Marion Donnart, Dr Eva Oueld Es Cheikh, Adeline Morisot, Pr Catherine Uzan, Pr Geoffroy Canlorbe

The aim of this study was to evaluate the long-term efficacy and adverse effects of fractionated CO2 laser in the treatment of GSM (Genitourinary Syndrome of menopause). This was a retrospective, monocentric, study conducted between January 2017 and July 2023. Forty-six patients receiving 3 sessions of fractional CO2 laser at 4-6 weeks apart were included. The primary endpoint was the satisfaction of the patient (unsatisfied, neutral or satisfied) 24 months after the treatment. Secondary endpoints were improvement of their GSM, with the use of a sexual health and quality of life scores (FSFI and SF-12), changes in the use of local treatments and adverse events. A sub-group analysis evaluated patients with a history of breast cancer and patient ongoing antihormone therapy. Twenty-four months after treatment, 41% (n=19) patients were satisfied, 21% (n=10) patients were neutral, and 38% (n=17) patients were unsatisfied. There was a significant reduction in hypoesthesia during intercourse (p=0.007), vaginal discharge (p=0.009) and vaginal dryness (p=0.0003). There was no significant improvement in SF-12, FSFI scores or reduction in the use of local treatments. No serious short- or long-term adverse events were reported. Among patients with a history of breast cancer (n=26), there was a significant reduction in hypoesthesia during intercourse (p=0016), vaginal discharge (p=0.041) and vaginal dryness (p=0.0004). The CO2 fractional laser showed an improvement in GSM 24 months after treatment. In the population of patients followed for breast cancer, results were also promising over the long term of treatment.

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引用次数: 0
Assessment of colour-code protocol and neonatal outcomes for emergency caesarean sections 评估紧急剖腹产手术的颜色编码方案和新生儿预后。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-27 DOI: 10.1016/j.jogoh.2025.102932
Marie-Alice Yanni , Oriane Vetier , Linda Lassel , Hélène Isly , Isabelle Enderlé , Maela Le Lous

Context

The use of colour codes for emergency caesareans has significantly improved team communication and protocol compliance over time. However, the impact on neonatal prognosis remains to be demonstrated.

Objectives

Our main objective was to evaluate changes in neonatal morbidity and mortality over time for orange-code (decision-delivery interval ≤ 30 mins) and red-code caesareans (decision-delivery interval ≤ 15 mins), since the introduction of the colour-code protocol. The secondary objectives were to describe maternal complications and types of anaesthesia.

Methods

This retrospective single-centre observational study was carried out in the maternity ward of the Rennes University Hospital and included all patients for whom an emergency caesarean was performed with an orange or red code between 1st January 2015 and 31st December 2021. A composite endpoint of neonatal morbidity and mortality was defined as the primary outcome. A sample of 1301 patients and 1346 newborns was analysed.

Results

Compliance with the colour-code protocol increased significantly during the study period to reach in 2021 97.8 % usage of appropriate colour codes according to the indication (p < 0.0001) and 92.1 % concordance between the colour code and the decision-delivery interval (p < 0.0001). In contrast, changes in neonatal outcomes were minimal and not statistically significant (p = 0.5873). However, the risk of maternal complications did not increase and there was no difference in the rate of general anaesthesia (p = 0.2002).

Conclusion

The colour-code protocol did not show significant changes in neonatal outcomes but remains a relevant reference tool to coordinate the labour ward teams.
{"title":"Assessment of colour-code protocol and neonatal outcomes for emergency caesarean sections","authors":"Marie-Alice Yanni ,&nbsp;Oriane Vetier ,&nbsp;Linda Lassel ,&nbsp;Hélène Isly ,&nbsp;Isabelle Enderlé ,&nbsp;Maela Le Lous","doi":"10.1016/j.jogoh.2025.102932","DOIUrl":"10.1016/j.jogoh.2025.102932","url":null,"abstract":"<div><h3>Context</h3><div>The use of colour codes for emergency caesareans has significantly improved team communication and protocol compliance over time. However, the impact on neonatal prognosis remains to be demonstrated.</div></div><div><h3>Objectives</h3><div>Our main objective was to evaluate changes in neonatal morbidity and mortality over time for orange-code (decision-delivery interval ≤ 30 mins) and red-code caesareans (decision-delivery interval ≤ 15 mins), since the introduction of the colour-code protocol. The secondary objectives were to describe maternal complications and types of anaesthesia.</div></div><div><h3>Methods</h3><div>This retrospective single-centre observational study was carried out in the maternity ward of the Rennes University Hospital and included all patients for whom an emergency caesarean was performed with an orange or red code between 1st January 2015 and 31st December 2021. A composite endpoint of neonatal morbidity and mortality was defined as the primary outcome. A sample of 1301 patients and 1346 newborns was analysed.</div></div><div><h3>Results</h3><div>Compliance with the colour-code protocol increased significantly during the study period to reach in 2021 97.8 % usage of appropriate colour codes according to the indication (<em>p</em> &lt; 0.0001) and 92.1 % concordance between the colour code and the decision-delivery interval (<em>p</em> &lt; 0.0001). In contrast, changes in neonatal outcomes were minimal and not statistically significant (<em>p</em> = 0.5873). However, the risk of maternal complications did not increase and there was no difference in the rate of general anaesthesia (<em>p</em> = 0.2002).</div></div><div><h3>Conclusion</h3><div>The colour-code protocol did not show significant changes in neonatal outcomes but remains a relevant reference tool to coordinate the labour ward teams.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 5","pages":"Article 102932"},"PeriodicalIF":1.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537182","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}
引用次数: 0
Controversies in chronic histiocytic intervillositis
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-25 DOI: 10.1016/j.jogoh.2025.102931
Virginie Collin-Bund , Vincent Poindron , Pauline Le Van Quyen , Éric Boudier , Chris Minella , Bruno Langer , Chérif Akladios , Anne-Sophie Weingertner
Understanding the“paradox” of pregnancy remains a challenging field of investigation especially when immunological dysregulation is suspected in pathological pregnancies. Chronic histiocytic intervillositis (CHI) is an example of a rare placental inflammatory disease that can occur during any trimester of pregnancy. The pathogenesis of CHI involves an abnormal immune response characterized by an inflammatory infiltrate of maternal CD68+ mononuclear immune cells in the intervillous space. CHI may be associated with villous and intervillous fibrinoid deposits. The precise immunological mechanism is not yet fully understood; it probably relies on an allo-immune of graft rejection rather than an auto-immune mechanism, although it has been described in several autoimmune diseases. CHI has also been described in COVID19 infected pregnant women. The recurrence rate is high and complications are severe: CHI is strongly associated with fetal growth restriction, miscarriage and stillbirth. The management of these patients remains an issue lacking of -standardized guidelines. The aim of this narrative review is to focus on the knowledge, pathogenesis, diagnosis and treatment of CHI over the last 5 years.
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引用次数: 0
The impact of the new histological classification of breast cancer with the introduction of HER 2 low status 新的乳腺癌组织学分类引入 Her 2 低分化状态的影响。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-19 DOI: 10.1016/j.jogoh.2025.102928
Myriam Doucet , Marion De Berti , Flavie Arbion , Caroline Goupille , Gilles Body , Lobna Ouldamer

Background

Traditionally, breast cancer HER2 status was categorized simply as positive or negative, with a preference for the negative designation due to its more favorable implications. However, recent advancements in classification have introduced a HER2 low status (score 1+ and 2+ without amplification), which is now recognized in a significant proportion of breast cancer cases. This newly identified HER2 low status is currently under investigation for its potential as a positive prognostic marker, particularly in the context of antibody-drug conjugate therapies. This study offers an overview of the novel HER2 classification as applied to our center's patients, providing insights into prognostic factors and outcomes.

Methods

The study analyzed breast cancer patients managed at the university teaching hospital of Tours between 2000 and 2013. Tumors were reclassified according to the new histological classification including the Her2-low status.

Results

Our patient cohort was distributed into three distinct groups: HER2-low (37 %), HER2-negative (57 %) and HER2-positive (11 %). Notably, HER2-positive patients were on average younger (56.5 years) than those in the other groups, who averaged 60 and 61 years, respectively (p = 0.003). No significant disparities emerged concerning BMI, recurrence patterns (locoregional or distant), or time to recurrence across these groups. However, differences were observed in terms of tumor phenotype, with luminal A tumors being more prevalent in the HER2 low and negative groups, while the luminal B subtype was predominant in the HER2 positive group. Furthermore, HER2-positive patients exhibited a higher prevalence of negative hormone receptors (43 %), contrasting with 8 % in the HER2-low group and 15 % in the HER2-negative group.

Conclusion

Our study highlights differences in age and hormonal receptor status among HER2 status groups. The introduction of HER2-low classification opens the door to new treatment strategies, especially with antibody-drug combinations that use HER2 receptors to deliver drugs. Although significant differences in survival rates were not found, ongoing research is crucial to understand how this new classification affects patient parameters. Additionally, it is essential to consider individual factors like age and hormone receptor status when deciding on the best treatment approach.
{"title":"The impact of the new histological classification of breast cancer with the introduction of HER 2 low status","authors":"Myriam Doucet ,&nbsp;Marion De Berti ,&nbsp;Flavie Arbion ,&nbsp;Caroline Goupille ,&nbsp;Gilles Body ,&nbsp;Lobna Ouldamer","doi":"10.1016/j.jogoh.2025.102928","DOIUrl":"10.1016/j.jogoh.2025.102928","url":null,"abstract":"<div><h3>Background</h3><div>Traditionally, breast cancer HER2 status was categorized simply as positive or negative, with a preference for the negative designation due to its more favorable implications. However, recent advancements in classification have introduced a HER2 low status (score 1+ and 2+ without amplification), which is now recognized in a significant proportion of breast cancer cases. This newly identified HER2 low status is currently under investigation for its potential as a positive prognostic marker, particularly in the context of antibody-drug conjugate therapies. This study offers an overview of the novel HER2 classification as applied to our center's patients, providing insights into prognostic factors and outcomes.</div></div><div><h3>Methods</h3><div>The study analyzed breast cancer patients managed at the university teaching hospital of Tours between 2000 and 2013. Tumors were reclassified according to the new histological classification including the Her2-low status.</div></div><div><h3>Results</h3><div>Our patient cohort was distributed into three distinct groups: HER2-low (37 %), HER2-negative (57 %) and HER2-positive (11 %). Notably, HER2-positive patients were on average younger (56.5 years) than those in the other groups, who averaged 60 and 61 years, respectively (<em>p</em> = 0.003). No significant disparities emerged concerning BMI, recurrence patterns (locoregional or distant), or time to recurrence across these groups. However, differences were observed in terms of tumor phenotype, with luminal A tumors being more prevalent in the HER2 low and negative groups, while the luminal B subtype was predominant in the HER2 positive group. Furthermore, HER2-positive patients exhibited a higher prevalence of negative hormone receptors (43 %), contrasting with 8 % in the HER2-low group and 15 % in the HER2-negative group.</div></div><div><h3>Conclusion</h3><div>Our study highlights differences in age and hormonal receptor status among HER2 status groups. The introduction of HER2-low classification opens the door to new treatment strategies, especially with antibody-drug combinations that use HER2 receptors to deliver drugs. Although significant differences in survival rates were not found, ongoing research is crucial to understand how this new classification affects patient parameters. Additionally, it is essential to consider individual factors like age and hormone receptor status when deciding on the best treatment approach.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 4","pages":"Article 102928"},"PeriodicalIF":1.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472551","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}
引用次数: 0
Retraction notice to “Outcome of Laparoscopic Adhesiolysis in Infertile Patients with Pelvic Adhesions Following Cesarean Delivery: A Randomized Clinical Trial” [J Gynecol Obstet Hum Reprod 50 (2021) first page - 101969]
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-18 DOI: 10.1016/j.jogoh.2025.102926
Adel E. Elgergawy, Ahmed E. Elhalwagy, Hesham A Salem, Ayman S. Dawood
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/locate/withdrawalpolicy).
This article has been retracted at the request of the Editors-in-Chief and the journal's Ethics Committee.
After post-publication investigation, issues related to the following were identified in the article:
  • Significant inconsistencies in methodology
To facilitate a thorough examination and ensure the accuracy of the information reported in the article, the authors were asked for the de-identified research data used in the article.
In the absence of an answer from the authors, a decision to retract the article was made in accordance with the journal's commitment to upholding the highest standards of scientific integrity and accuracy in published research.
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引用次数: 0
Improved neonatal outcome following induction of labour using 25 µg versus 50 µg oral Misoprostol: A retrospective, comparative cohort study
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-13 DOI: 10.1016/j.jogoh.2025.102927
Sharon M. Wesselius , Christianne J.M. de Groot , Roel de Heus , Marjon.A. de Boer

Objective

to compare maternal and neonatal outcomes using 25 µg 2-hourly and 50 µg 4-hourly oral Misoprostol for induction of labour (IOL)

Design

observational study

Setting

Tertiary care center, Amsterdam UMC, location VUmc, The Netherlands

Population

Women with a vital singleton pregnancy between 37+0 and 42+0-weeks of pregnancy with an indication for IOL with oral Misoprostol.

Methods

Retrospective cohort study using anonymous data from the Amsterdam UMC from 2016 to 2021. The current procedure (25 µg every 2 h, June 2018-March 2021) was compared to the former procedure (50 µg every 4 h, March 2016-May 2018).

Main Outcome Measures

Primary outcome measure was caesarean section rate. Secondary outcome measures were a composite neonatal outcome (Apgar <7 at 5 mins and/or NICU admission) and uterine hyperstimulation.

Results

A total of 1002 women were included, 621 women using 25 µg and 381 using 50 µg oral Misoprostol. The composite neonatal outcome occurred significantly less in women using 25 µg compared to those using 50 µg (aOR 0.67, 95 % CI 0.46–0.97). There was no significant difference in caesarean section rate between the two protocols (18.4 % vs 21.5 %, respectively, aOR 0.74, 95 % CI 0.52–1.05). A single case of uterine hyperstimulation with fetal heartrate changes occurred after start of oxytocin where 25 µg was used, whereas there was none with 50 µg (0.1 %, P = 0.62).

Conclusions

The caesarean section rate did not alter significantly. The IOL protocol using 25 µg as compared to 50 µg oral Misoprostol was associated with a significant decrease in the composite neonatal outcome. Low-dose oral Misoprostol could be a safe method for outpatient IOL, further research is needed, preferably by RCT's.

Funding

None.
{"title":"Improved neonatal outcome following induction of labour using 25 µg versus 50 µg oral Misoprostol: A retrospective, comparative cohort study","authors":"Sharon M. Wesselius ,&nbsp;Christianne J.M. de Groot ,&nbsp;Roel de Heus ,&nbsp;Marjon.A. de Boer","doi":"10.1016/j.jogoh.2025.102927","DOIUrl":"10.1016/j.jogoh.2025.102927","url":null,"abstract":"<div><h3>Objective</h3><div>to compare maternal and neonatal outcomes using 25 µg 2-hourly and 50 µg 4-hourly oral Misoprostol for induction of labour (IOL)</div></div><div><h3>Design</h3><div>observational study</div></div><div><h3>Setting</h3><div>Tertiary care center, Amsterdam UMC, location VUmc, The Netherlands</div></div><div><h3>Population</h3><div>Women with a vital singleton pregnancy between 37+0 and 42+0-weeks of pregnancy with an indication for IOL with oral Misoprostol.</div></div><div><h3>Methods</h3><div>Retrospective cohort study using anonymous data from the Amsterdam UMC from 2016 to 2021. The current procedure (25 µg every 2 h, June 2018-March 2021) was compared to the former procedure (50 µg every 4 h, March 2016-May 2018).</div></div><div><h3>Main Outcome Measures</h3><div>Primary outcome measure was caesarean section rate. Secondary outcome measures were a composite neonatal outcome (Apgar &lt;7 at 5 mins and/or NICU admission) and uterine hyperstimulation.</div></div><div><h3>Results</h3><div>A total of 1002 women were included, 621 women using 25 µg and 381 using 50 µg oral Misoprostol. The composite neonatal outcome occurred significantly less in women using 25 µg compared to those using 50 µg (aOR 0.67, 95 % CI 0.46–0.97). There was no significant difference in caesarean section rate between the two protocols (18.4 % vs 21.5 %, respectively, aOR 0.74, 95 % CI 0.52–1.05). A single case of uterine hyperstimulation with fetal heartrate changes occurred after start of oxytocin where 25 µg was used, whereas there was none with 50 µg (0.1 %, <em>P</em> = 0.62).</div></div><div><h3>Conclusions</h3><div>The caesarean section rate did not alter significantly. The IOL protocol using 25 µg as compared to 50 µg oral Misoprostol was associated with a significant decrease in the composite neonatal outcome. Low-dose oral Misoprostol could be a safe method for outpatient IOL, further research is needed, preferably by RCT's.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 4","pages":"Article 102927"},"PeriodicalIF":1.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422508","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}
引用次数: 0
Predictive performance of sFlt-1, PlGF and the sFlt-1/PlGF ratio for preeclampsia: A systematic review and meta-analysis
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-11 DOI: 10.1016/j.jogoh.2025.102925
Luhan Zhang , Wenjing Li , Xiaolan Chi , Qi Sun , Yuanyuan Li , Weiwei Xing , Guifeng Ding

Background

It is difficult to evaluate whether monitoring serum sFlt-1, PlGF, or sFlt-1/PlGF in pregnant women who are suspected of having PE can significantly shorten the PE diagnosis time.

Objectives

To estimate the accuracy of sFlt-1, PlGF and sFlt-1/PlGF in preeclampsia prediction.

Search strategy

Databases including PubMed, Web of Science, Medline, CNKI, SinoMed, VIP Journal, and Wanfang Data were searched for eligible studies published until October 7, 2022.

Selection criteria

The research subjects were pregnant women with or without PE. The research types were case-control studies and cohort studies. This was an original study involving the detection of at least one of the following in the blood, serum or plasma: sFlt-1, PlGF, and sFlt-1/PlGF.

Data collection and analysis

StataSE 16.0 was employed, using the Sen, Spe, PLR, and NLR to plot SROC, and subgroup analysis and meta-regression were conducted.

Main results

Meta-analysis showed that the combined Sen of sFlt, PlGF and sFlt-1/PlGF was 0.79 (95 % CI: 0.68–0.87), 0.76 (95 % CI: 0.69–0.82), and 0.83 (95 % CI: 0.77–0.88), respectively; the Spe was 0.86 (95 % CI: 0.77–0.92), 0.83 (95 % CI: 0.78–0.88), and 0.88 (95 % CI: 0.82–0.92), respectively; and the AUC was 0.89, 0.87, and 0.92, respectively. It was found to be attributable to study design, literature quality, sample size, disease subtypes, and cut-off values by using subgroup analysis and meta-regression.

Conclusions

The sFlt-1/PlGF ratio showed better predictive performance for preeclampsia than sFlt-1 or PlGF alone. However, the predictive value of the latter two cannot be ignored.This study highlights the performance of biomarkers in the diagnosis and prediction of PE, but that there is currently a lack of data to assess the value of using these biomarkers in clinical practice, and that the use of these biomarkers has not yet been shown to improve pregnancy outcomes.
{"title":"Predictive performance of sFlt-1, PlGF and the sFlt-1/PlGF ratio for preeclampsia: A systematic review and meta-analysis","authors":"Luhan Zhang ,&nbsp;Wenjing Li ,&nbsp;Xiaolan Chi ,&nbsp;Qi Sun ,&nbsp;Yuanyuan Li ,&nbsp;Weiwei Xing ,&nbsp;Guifeng Ding","doi":"10.1016/j.jogoh.2025.102925","DOIUrl":"10.1016/j.jogoh.2025.102925","url":null,"abstract":"<div><h3>Background</h3><div>It is difficult to evaluate whether monitoring serum sFlt-1, PlGF, or sFlt-1/PlGF in pregnant women who are suspected of having PE can significantly shorten the PE diagnosis time.</div></div><div><h3>Objectives</h3><div>To estimate the accuracy of sFlt-1, PlGF and sFlt-1/PlGF in preeclampsia prediction.</div></div><div><h3>Search strategy</h3><div>Databases including PubMed, Web of Science, Medline, CNKI, SinoMed, VIP Journal, and Wanfang Data were searched for eligible studies published until October 7, 2022.</div></div><div><h3>Selection criteria</h3><div>The research subjects were pregnant women with or without PE. The research types were case-control studies and cohort studies. This was an original study involving the detection of at least one of the following in the blood, serum or plasma: sFlt-1, PlGF, and sFlt-1/PlGF.</div></div><div><h3>Data collection and analysis</h3><div>StataSE 16.0 was employed, using the Sen, Spe, PLR, and NLR to plot SROC, and subgroup analysis and meta-regression were conducted.</div></div><div><h3>Main results</h3><div>Meta-analysis showed that the combined Sen of sFlt, PlGF and sFlt-1/PlGF was 0.79 (95 % CI: 0.68–0.87), 0.76 (95 % CI: 0.69–0.82), and 0.83 (95 % CI: 0.77–0.88), respectively; the Spe was 0.86 (95 % CI: 0.77–0.92), 0.83 (95 % CI: 0.78–0.88), and 0.88 (95 % CI: 0.82–0.92), respectively; and the AUC was 0.89, 0.87, and 0.92, respectively. It was found to be attributable to study design, literature quality, sample size, disease subtypes, and cut-off values by using subgroup analysis and meta-regression.</div></div><div><h3>Conclusions</h3><div>The sFlt-1/PlGF ratio showed better predictive performance for preeclampsia than sFlt-1 or PlGF alone. However, the predictive value of the latter two cannot be ignored.This study highlights the performance of biomarkers in the diagnosis and prediction of PE, but that there is currently a lack of data to assess the value of using these biomarkers in clinical practice, and that the use of these biomarkers has not yet been shown to improve pregnancy outcomes.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 4","pages":"Article 102925"},"PeriodicalIF":1.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414422","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}
引用次数: 0
Reflector-guided localization compared with wire-guided localization for non-palpable breast cancer resection: organizational impacts and costs analysis 反射镜引导定位与线导定位在非可触及乳腺癌切除术中的比较:组织影响和成本分析。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.jogoh.2024.102892
Pauline Cavagna , Tess Martin , Nicolas Martelli , Huyen-Thu Nguyen-Xuan , Henri Azais , Louise Benoit , Enrica Bentivegna , Anne-Sophie Bats , Meriem Koual

Background

Wire-guided localization (WGL) for non-palpable breast cancer lesions has drawbacks like wire migration, localization difficulties, and logistical challenges. Wireless methods, such as reflector-guided localization (RGL), address these issues and are compatible with breast MRI. This study evaluates the organizational and cost impacts of RGL compared to WGL.

Research Design and methods

Our retrospective study compared the organizational impacts and costs of RGL and WGL at a university hospital. Quantitative and qualitative assessments included operating time and a questionnaire for surgeons and radiologists. Cost analysis covered device costs.

Results

The study involved 60 patients (30 with RGL and 30 with WGL). The RGL group had a significantly longer duration between device insertion and surgery (3.73 ± 5.5 days) compared to the WGL group (same day or day before surgery). The WGL group required more devices whereas cost were higher for RGL. Health professionals reported a major positive impact of RGL on healthcare processes and safety, with minor negative impact on training.

Conclusions

RGL offers flexible scheduling by decoupling radiology and surgery but is limited by high costs. Further data is needed to identify ideal candidates, assess patient satisfaction, and evaluate its long-term benefits in breast cancer care.
背景:线导定位(WGL)治疗不可触及的乳腺癌病变存在钢丝移位、定位困难和后勤挑战等缺点。无线方法,如反射器引导定位(RGL),解决了这些问题,并与乳房MRI兼容。本研究评估了RGL与WGL对组织和成本的影响。研究设计与方法:回顾性比较某大学医院RGL和WGL的组织影响和成本。定量和定性评估包括外科医生和放射科医生的手术时间和问卷调查。成本分析包括设备成本。结果:本研究共纳入60例患者(30例为RGL, 30例为WGL)。RGL组置入器械至手术时间(3.73±5.5天)明显长于WGL组(手术当日或术前)。WGL组所需器械较多,而RGL组费用较高。卫生专业人员报告说,RGL对卫生保健流程和安全产生了重大的积极影响,对培训产生了轻微的负面影响。结论:RGL通过分离放射学和外科提供灵活的日程安排,但受高成本的限制。需要进一步的数据来确定理想的候选药物,评估患者满意度,并评估其在乳腺癌护理中的长期益处。
{"title":"Reflector-guided localization compared with wire-guided localization for non-palpable breast cancer resection: organizational impacts and costs analysis","authors":"Pauline Cavagna ,&nbsp;Tess Martin ,&nbsp;Nicolas Martelli ,&nbsp;Huyen-Thu Nguyen-Xuan ,&nbsp;Henri Azais ,&nbsp;Louise Benoit ,&nbsp;Enrica Bentivegna ,&nbsp;Anne-Sophie Bats ,&nbsp;Meriem Koual","doi":"10.1016/j.jogoh.2024.102892","DOIUrl":"10.1016/j.jogoh.2024.102892","url":null,"abstract":"<div><h3>Background</h3><div>Wire-guided localization (WGL) for non-palpable breast cancer lesions has drawbacks like wire migration, localization difficulties, and logistical challenges. Wireless methods, such as reflector-guided localization (RGL), address these issues and are compatible with breast MRI. This study evaluates the organizational and cost impacts of RGL compared to WGL.</div></div><div><h3>Research Design and methods</h3><div>Our retrospective study compared the organizational impacts and costs of RGL and WGL at a university hospital. Quantitative and qualitative assessments included operating time and a questionnaire for surgeons and radiologists. Cost analysis covered device costs.</div></div><div><h3>Results</h3><div>The study involved 60 patients (30 with RGL and 30 with WGL). The RGL group had a significantly longer duration between device insertion and surgery (3.73 ± 5.5 days) compared to the WGL group (same day or day before surgery). The WGL group required more devices whereas cost were higher for RGL. Health professionals reported a major positive impact of RGL on healthcare processes and safety, with minor negative impact on training.</div></div><div><h3>Conclusions</h3><div>RGL offers flexible scheduling by decoupling radiology and surgery but is limited by high costs. Further data is needed to identify ideal candidates, assess patient satisfaction, and evaluate its long-term benefits in breast cancer care.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 2","pages":"Article 102892"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794835","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}
引用次数: 0
New reference charts for fetal ultrasound corpus callosum length with emphasis on the third trimester 新的胎儿超声波胼胝体长度参考图,重点是妊娠三个月。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.jogoh.2024.102884
S. Friszer , JP. Bernard , T. Bultez , U. Metzger , R. Bessis , C. Lamourdedieu , B. Deloison

Objectives

To provide new prospective 2D ultrasound reference charts of fetal corpus callosum (CC) length on a large sample size with emphasis on the third trimester of pregnancy and to establish other standards of CC growth evaluation (external cranial occipitofrontal dimension (ECOFD) / CC length ratio and head circumference (HC) / CC length ratio) in a large population of healthy fetuses.

Methods

A prospective observational study was conducted in a single expert center for fetal ultrasound between November 1st 2021 and June 30th 2022. CC measurement was performed in all fetuses examined between 17 weeks and 36+6 weeks. Image quality criteria for a strict mid-sagittal plane of the fetal brain and caliper position for CC measurement were defined prior to data collection and only high-quality measurements were included for analysis. Fetuses with inaccurate gestational ages and at high-risk of central nervous system anomalies were excluded.

Results

Among 3591 CC measurements available, 3191 were included in this study. An accurate high-quality measurement was obtained in 92.8 % of cases. We established the third-degree polynomial model expressing the length of the corpus callosum as a function of Corpus callosum length in mm=0.00213x(GA in weeks)3 − 0.2538x(GA in weeks)2 + 10.5897xGA in weeks −108.8556 +/- SD (SD=0.0567xGA In weeks + 0.1054), with an R² adj of 0.94. ECOFD/CC and HC/CC ratios were stable throughout pregnancy at 2.7 ± 0.2 and 7.7 ± 0.6 respectively.

Conclusion

These new reference charts were established using a uniform methodology of the highest quality in order to assess CC growth accurately and help clinicians correctly define a “short” CC. ECOFD/CC and HC/CC ratios may be used as additional markers of normal CC development in borderline cases.
目的:在大量健康胎儿中提供新的前瞻性二维超声胎儿胼胝体(CC)长度参考图,重点关注妊娠三个月,并建立CC生长评估的其他标准(颅枕外侧尺寸(ECOFD)/CC长度比和头围(HC)/CC长度比):2021 年 11 月 1 日至 2022 年 6 月 30 日期间,在一家胎儿超声专家中心开展了一项前瞻性观察研究。所有受检胎儿的CC测量均在17周至36+6周之间进行。在收集数据之前,已确定了严格的胎儿大脑中矢状面图像质量标准和测量CC的卡钳位置,只有高质量的测量结果才会被纳入分析。胎龄不准确的胎儿和中枢神经系统异常的高风险胎儿被排除在外:在 3591 个可用的 CC 测量值中,有 3191 个被纳入本研究。92.8%的病例获得了准确的高质量测量结果。我们建立了三度多项式模型,将胼胝体长度表示为胼胝体长度(毫米)=0.00213x(GA,周数)3 -0.2538x(GA,周数)2 +10.5897xGA in weeks -108.8556 +/- SD (SD SD=0.0567xGA In weeks + 0.1054) 的函数,R² adj 为 0.94。ECOFD/CC和HC/CC比率在整个孕期保持稳定,分别为2.7 ± 0.2和7.7 ± 0.6:这些新的参考图表是采用最高质量的统一方法建立的,目的是准确评估 CC 的生长情况,帮助临床医生正确定义 "短 "CC。ECOFD/CC和HC/CC比率可作为边缘病例中CC正常发育的额外标记。
{"title":"New reference charts for fetal ultrasound corpus callosum length with emphasis on the third trimester","authors":"S. Friszer ,&nbsp;JP. Bernard ,&nbsp;T. Bultez ,&nbsp;U. Metzger ,&nbsp;R. Bessis ,&nbsp;C. Lamourdedieu ,&nbsp;B. Deloison","doi":"10.1016/j.jogoh.2024.102884","DOIUrl":"10.1016/j.jogoh.2024.102884","url":null,"abstract":"<div><h3>Objectives</h3><div>To provide new prospective 2D ultrasound reference charts of fetal corpus callosum (CC) length on a large sample size with emphasis on the third trimester of pregnancy and to establish other standards of CC growth evaluation (external cranial occipitofrontal dimension (ECOFD) / CC length ratio and head circumference (HC) / CC length ratio) in a large population of healthy fetuses.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted in a single expert center for fetal ultrasound between November 1st 2021 and June 30th 2022. CC measurement was performed in all fetuses examined between 17 weeks and 36<sup>+6</sup> weeks. Image quality criteria for a strict mid-sagittal plane of the fetal brain and caliper position for CC measurement were defined prior to data collection and only high-quality measurements were included for analysis. Fetuses with inaccurate gestational ages and at high-risk of central nervous system anomalies were excluded.</div></div><div><h3>Results</h3><div>Among 3591 CC measurements available, 3191 were included in this study. An accurate high-quality measurement was obtained in 92.8 % of cases. We established the third-degree polynomial model expressing the length of the corpus callosum as a function of Corpus callosum length in mm=0.00213x(GA in weeks)<sup>3</sup> − 0.2538x(GA in weeks)<sup>2</sup> + 10.5897xGA in weeks −108.8556 +/- SD (SD=0.0567xGA In weeks + 0.1054), with an R² adj of 0.94. ECOFD/CC and HC/CC ratios were stable throughout pregnancy at 2.7 ± 0.2 and 7.7 ± 0.6 respectively.</div></div><div><h3>Conclusion</h3><div>These new reference charts were established using a uniform methodology of the highest quality in order to assess CC growth accurately and help clinicians correctly define a “short” CC. ECOFD/CC and HC/CC ratios may be used as additional markers of normal CC development in borderline cases.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 2","pages":"Article 102884"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716226","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}
引用次数: 0
The characteristics and parenthood aspirations of single women and lesbian couples seeking motherhood through sperm donation 通过捐精寻求母亲身份的单身女性和女同性恋伴侣的特点和为人父母的愿望。
IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-01 DOI: 10.1016/j.jogoh.2024.102889
Claire Gouya , Romane Mougel , George Riley , Catherine Diligent , Delphine Morettini , Olivier Morel , Mikaël Agopiantz

Introduction

In 2021, France authorized access to assisted reproductive technology (ART) for single women (SWs) and lesbian couples (LCs). We aimed to describe these new populations and compare their characteristics with those of the historical population of heterosexual couples (HCs) using ART with sperm donation.

Material and methods

We conducted a monocentric observational retrospective study at the Nancy Regional University Hospital Fertility Center from October 1, 2021, to June 30, 2023. The demographic and clinical characteristics of all the women/couples willing to engage in parenthood with sperm donation, as well as their parenthood aspirations data, were collected.

Results

We included 638 women/couples; 49.7 % were SWs; 44.5 % were LCs; and only 5.8 % were HCs. The mean age of the whole population was 33.4 ± 5.5 years. The SW population was significantly older by 6 years and came from executive and intellectual professions. A total of 18.3 % of the LCs were interested in the reception of oocytes from the partner (ROPA). HCs (77.8 %) and LCs (73.2 %) were more interested in phenotypic matching than SWs (49.1 %) (p < 0.001). Monocentric support was more common in SW patients (88.9 %) than in LCs patients (79.5 %) and HCs (56.8 %) (p < 0.001).

Discussion

In a large cohort, we focused on and discussed the characteristics and the aspirations of these intended parents. We found that new populations favored ART with sperm donation. The overall characteristics of both heterosexual and lesbian couples were broadly comparable, as were the two LCs members. A French multicenter large-scale prospective study and anthropological studies are necessary to confirm and explain this data.
简介:2021年,法国授权单身女性(SWs)和女同性恋伴侣(LCs)获得辅助生殖技术(ART)。我们的目的是描述这些新的人群,并将他们的特征与使用ART和精子捐赠的异性恋夫妇(hc)的历史人群进行比较。材料和方法:我们于2021年10月1日至2023年6月30日在南希地区大学医院生育中心进行了一项单中心观察性回顾性研究。收集了所有愿意捐精为人父母的妇女/夫妇的人口学和临床特征,以及他们的生育愿望数据。结果:纳入638名女性/夫妇;49.7%为SWs;44.5%为lccs;只有5.8%是hc。人口平均年龄33.4±5.5岁。SW人口明显老了6岁,来自行政和知识分子行业。共有18.3%的LCs对接受伴侣的卵母细胞感兴趣(ROPA)。HCs(77.8%)和LCs(73.2%)比SWs(49.1%)对表型匹配更感兴趣(p讨论:在一个大型队列中,我们关注并讨论了这些意向父母的特征和愿望。我们发现,新的人群更喜欢精子捐赠的抗逆转录病毒治疗。异性恋和女同性恋夫妇的总体特征大致相似,两个LCs成员也是如此。需要法国多中心大规模前瞻性研究和人类学研究来证实和解释这一数据。
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引用次数: 0
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Journal of gynecology obstetrics and human reproduction
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