Journal of gynecology obstetrics and human reproduction最新文献

{"title":"Fertility preservation in women with endometriosis: A retrospective non-Inferiority study comparing Dienogest in the PPOS protocol to antagonist and agonist protocols","authors":"Maureen Calero ,&nbsp;Julien Robert ,&nbsp;Noémie Ranisavljevic ,&nbsp;Emmanuelle Petit ,&nbsp;Marie Montagut ,&nbsp;Florence Lesourd ,&nbsp;Nicolas Chevalier ,&nbsp;Stéphanie Huberlant","doi":"10.1016/j.jogoh.2025.102950","DOIUrl":"10.1016/j.jogoh.2025.102950","url":null,"abstract":"<div><h3>Background</h3><div>Endometriosis is a common pathology that can lead to a decrease in fertility and is therefore a medical indication for preserving fertility. Traditionally, gonadotropin-releasing hormone (GnRH) antagonist and agonist protocols are used to stimulate the ovaries. However, the recent introduction of the progestin-primed ovarian stimulation (PPOS) protocol, using progestins to prevent LH surges, offers a new alternative. Dienogest, a progestin commonly used to treat endometriosis, could be incorporated into the PPOS protocol for patients with endometriosis, allowing them to maintain their background therapy during ovarian stimulation. The aim of this study was to assess the non-inferiority of using Dienogest in the PPOS protocol compared to antagonist and agonist protocols in terms of the number of mature oocytes retrieved from patients with endometriosis undergoing fertility preservation (FP).</div></div><div><h3>Methods</h3><div>This retrospective, multicenter, non-inferiority study was conducted in patients with endometriosis, comparing the PPOS protocol with Dienogest, the antagonist protocol, and the agonist protocol. The primary endpoint was the number of mature oocytes retrieved. The secondary endpoint included ovarian response parameters, treatment complications, and tolerance assessed by validated questionnaires.</div></div><div><h3>Results</h3><div>The study included 201 cycles performed in 130 patients. Non-inferiority of the PPOS-Dienogest protocol was demonstrated in pairwise comparisons against antagonist protocol (<em>p</em> = 0.0062) and agonist protocol (<em>p</em> = 0.0360) in the number of mature oocytes retrieved. Using Dienogest in the PPOS protocol was not associated with a smaller number of mature oocytes retrieved than with the GnRH antagonist or agonist conventional protocols. Additionally, no significant differences were found in ovarian response parameters, treatment tolerance, or complications between protocols.</div></div><div><h3>Conclusion</h3><div>The PPOS protocol with Dienogest appears to be a promising alternative for FP compared to traditional protocols for patients with endometriosis, without adversely affecting the number of mature oocytes retrieved. Larger prospective studies are required to confirm these results.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 6","pages":"Article 102950"},"PeriodicalIF":1.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying risk factors for postoperative complications following staging surgery for endometrial cancer","authors":"Shai Ram ,&nbsp;Michael Lavie ,&nbsp;Anna Assouline ,&nbsp;Itamar Gilboa ,&nbsp;Lihie Maltz Yacobi ,&nbsp;Gal Ariel ,&nbsp;Nadav Michaan ,&nbsp;Dan Grisaru ,&nbsp;Ido Laskov","doi":"10.1016/j.jogoh.2025.102949","DOIUrl":"10.1016/j.jogoh.2025.102949","url":null,"abstract":"<div><h3>Introduction</h3><div>Endometrial cancer is the most prevalent gynecologic malignancy, with increasing incidence primarily due to aging, obesity, and diabetes. Surgical staging, a gold standard treatment involving total hysterectomy with bilateral salpingo-oophorectomy and sentinel lymph node biopsy, presents various postoperative complications influencing patient outcomes and healthcare costs. This study aims to identify risk factors associated with short term postoperative complications following staging surgery for endometrial cancer.</div></div><div><h3>Methods</h3><div>A retrospective cohort study conducted at a single university-affiliated medical center from January 2016 to December 2022. Data were extracted from electronic medical records, including patient demographics and comorbidities, surgical data including intraoperative complications, tumor histology and surgical outcomes. A composite adverse post operative outcome was defined, including need for post-operative blood transfusion, antibiotic treatment, Intensive care unit (ICU) admission, prolonged hospitalization, and 30-day readmission rates.</div></div><div><h3>Results</h3><div>Among 495 patients, 34.3 % experienced at least one postoperative complication. Significant factors associated with complications included age over 65, ASA score &gt;2, pathologic grade 3 tumours, and non-minimally invasive surgical approaches. Prolonged operative time (&gt;75th percentile) and intraoperative complications also correlated with increased risk. Conversely, higher preoperative haemoglobin levels were protective against complications.</div></div><div><h3>Conclusion</h3><div>The findings emphasize the importance of recognizing risk factors such as advanced age, elevated ASA scores, and specific tumor characteristics to enhance preoperative assessments and surgical planning. By tailoring surgical approaches and optimizing patient preparation, healthcare providers may improve postoperative outcomes and reduce complications for patients undergoing staging surgery for endometrial cancer.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 6","pages":"Article 102949"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentation of the ENDO-SFOG CAMPUS app: An easy therapeutic decision support app in endometrial cancer created by the French Society of Young Gynecological Oncologists (SFOG Campus)","authors":"Virginie Collin-Bund ,&nbsp;Floriane Jochum ,&nbsp;François Margueritte ,&nbsp;Thomas Gaillard ,&nbsp;Morgane Perrin ,&nbsp;Yohan Kerbage ,&nbsp;Renaud Sabatier ,&nbsp;Anne Thoury ,&nbsp;Sarah Betrian ,&nbsp;Guillaume Babin ,&nbsp;Basile Pache ,&nbsp;Phuong Lien Tran ,&nbsp;Noémie Body ,&nbsp;Julie Delvallee ,&nbsp;Houssein El Hajj ,&nbsp;Frederic Guyon ,&nbsp;Emilie Raimond ,&nbsp;Chérif Akladios ,&nbsp;Enora Laas ,&nbsp;Elise Deluche","doi":"10.1016/j.jogoh.2025.102951","DOIUrl":"10.1016/j.jogoh.2025.102951","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates a new decision support tool—a computer/mobile application designed to align with the latest ESGO guidelines, French practices, and molecular biology data—to aid in decision-making for endometrial cancer management.</div></div><div><h3>Methods</h3><div>An observational, multicenter, retrospective study was conducted. It compared management decisions from multidisciplinary tumor boards (MTBs) with those suggested by the application for patients with histologically confirmed endometrial cancer, irrespective of their FIGO stage. Each center included the last 20 cases discussed in multidisciplinary tumor boards between May to December 2022.</div></div><div><h3>Results</h3><div>Thirteen centers participated: eight university hospitals (61.5 %), four cancer centers (30.8 %), and one private center (7.7 %). A total of 259 patients were included, with a mean age of 69 years (range 30−96 years). Most patients had endometrioid tumors (77.2 %), low-grade (62.6 %), FIGO stage IA (41.3 %), no lymphovascular invasion (77.9 %), and a non-specific molecular profile (50.6 %). The application's recommendations matched the MTB decisions 76.6 % of the time. Discrepancies arose mainly from the non-administration of brachytherapy (22.8 %), rare presentations or pathological discordance (22.8 %), and patients' deteriorated conditions precluding standard treatments (19.3 %).</div></div><div><h3>Conclusion</h3><div>The SFOG campus application demonstrates a high concordance with multidisciplinary tumor board decisions, indicating its potential as an efficient, and valuable tool for managing endometrial cancer.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 6","pages":"Article 102951"},"PeriodicalIF":1.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of morbid obesity on surgical and oncological outcomes in patients with endometrial cancer undergoing robotic assisted laparoscopic hysterectomy and pelvic lymph node staging","authors":"DAIX-MOREUX Mathilde ,&nbsp;COHEN Adrien ,&nbsp;DARLET Gael ,&nbsp;MEZZADRI Matthieu ,&nbsp;MARCHAND Eva ,&nbsp;BENIFLA Jean-Louis ,&nbsp;HUCHON Cyrille ,&nbsp;MIMOUN Camille","doi":"10.1016/j.jogoh.2025.102947","DOIUrl":"10.1016/j.jogoh.2025.102947","url":null,"abstract":"<div><h3>Introduction</h3><div>Minimally invasive surgery is the preferred surgical approach in endometrial cancer. Robotic assisted laparoscopy could provide benefits in the obese population.</div></div><div><h3>Objective</h3><div>To compare surgical and oncological outcomes between patients with a BMI &lt; 35 kg/m² (Group 1) and those with a BMI ≥ 35 kg/m² (Group 2) who underwent robotic assisted laparoscopic total non-conservative hysterectomy with pelvic lymph node staging for endometrial cancer.</div></div><div><h3>Material and methods</h3><div>This retrospective monocentric study was conducted at Saint-Louis University Hospital in Paris. The two groups were compared using a univariate analysis.</div></div><div><h3>Results</h3><div>52 patients were included, 39 patients in Group 1 and 13 patients in Group 2. Operative room occupancy time and operative time were significantly longer in Group 2 than in Group 1 (255.1 min ± 57.0 vs 210.5 min ± 38.3, <em>p</em> = 0.02 and 166.8 min ± 39.7 vs 139.6 min ± 35.3, <em>p</em> = 0.04 respectively). No significant difference was found in length of hospital stay between the 2 groups even if it appears that patients in Group 2 had slightly longer hospitalization than patients in Group 1 (2 days vs 1 day). Only one complication (laparotomy conversion for digestive injury) was observed in Group 2. No significant difference was found in recurrence between the 2 groups.</div></div><div><h3>Discussion</h3><div>Severe morbid obesity does not affect surgical morbidity or oncological outcomes in women with endometrial cancer who underwent robotic-assisted laparoscopic hysterectomy, bilateral adnexectomy, and pelvic lymph node staging. Optimizing operating room occupancy management must be improved in this patient population.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 5","pages":"Article 102947"},"PeriodicalIF":1.7,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical induced abortion between 14 and 16 weeks of gestation: Complications","authors":"Chloé Hauffray,&nbsp;Elodie Billard,&nbsp;Solène Vigoureux","doi":"10.1016/j.jogoh.2025.102948","DOIUrl":"10.1016/j.jogoh.2025.102948","url":null,"abstract":"<div><h3>Objectives</h3><div>The law of March 2, 2022 authorizes the extension of the time limit for induced abortion from 14 to 16 Weeks of Gestation (WG). Its adoption was discussed at length during the parliamentary debates prior to its promulgation. The aim of this study is to examine the profile of patients undergoing induced abortion between 14 and 16 WG, their management, and the rate of complications.</div></div><div><h3>Study design</h3><div>The study was quantitative, observational, retrospective and multicentric. Patients who underwent induced abortion between 14 and 16 WG in the 8 orthogenic centers concerned by this practice in Pays de la Loire over the period from March 2, 2022 to March 2, 2023 were included.</div></div><div><h3>Results</h3><div>A total of 123 patients were included 119 patients were analysed. Most women were aged between 20 and 29. A notion of violence was noted in 41 % of patients. The different operative complications concerned &lt;1 % of patients, except for the rate of blood loss over 500 mL (7.6 %), need for transfusion (2.5 %) and expulsion of the foetus before the operative procedure (5.9 %).</div></div><div><h3>Conclusion</h3><div>Patient characteristics appeared similar to those of patients undergoing induced abortion before 14 WG, except for the history of violence, which appeared higher. Complication rates were comparable to those for induced abortions performed before 14 WG, except for bleeding over 500 mL, transfusions, and preoperative expulsions. Protocols dedicated to the realization of induced abortions between 14 and 16 WG could be proposed to improve their management.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 6","pages":"Article 102948"},"PeriodicalIF":1.7,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetrical outcomes of women with previous preterm cesarean delivery","authors":"Jade Lebrunet,&nbsp;Carla Héléna Sousa,&nbsp;Marie Alice Yanni,&nbsp;Dr Maela Le Lous,&nbsp;Dr Isabelle Enderle","doi":"10.1016/j.jogoh.2025.102946","DOIUrl":"10.1016/j.jogoh.2025.102946","url":null,"abstract":"<div><div>Purpose: Cesarean deliveries currently account for 21.1 % of all births worldwide. Advances in antenatal care and neonatal resuscitation have led to earlier births, and 69.8 % of deliveries between 27 and 31 weeks' gestation (WG) are now by cesarean. However, outcomes in patients with a history of preterm cesarean remain poorly studied, resulting in inconsistent management during subsequent pregnancies. The objective of this study was to evaluate obstetric outcomes in patients with a scarred uterus resulting from a cesarean delivery prior to 32 WG.</div><div>Materials and Methods: This was an observational, retrospective, single-center study conducted between January 1, 2011 and December 31, 2021 at the University Hospital of Rennes, France. We included patients ≤18 years with a history of cesarean delivery before 32 GW with low transverse incision, and pregnant with a single child with cephalic presentation. The primary outcome was mode of delivery. Secondary outcomes were severe maternal and neonatal morbidities.</div><div>Results: The study included 168 patients of whom 18 had elective repeat cesarean delivery (ERCD) and 150 had trial of labor after cesarean (TOLAC) (92 had spontaneous labor and 58 had induction of labor). 114 delivered vaginally (67.9 %). The rate of maternal and fetal complications was fairly low, and we observed only one case of uterine rupture.</div><div>Conclusion: With a rate of vaginal delivery of approximately 6 8 % among patients who had TOLAC and a low rate of maternal and fetal complications, our findings suggest that a history of preterm cesarean delivery should not be a barrier to a TOLAC.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 6","pages":"Article 102946"},"PeriodicalIF":1.7,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742949","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}

{"title":"Maternal and perinatal morbidity of pregnancy denial: Twenty-year case-control study at the Caen University Hospital","authors":"Louise Mutio Desvallées ,&nbsp;Damiano Cerasuolo ,&nbsp;Gwenaëlle Andro ,&nbsp;Michel Dreyfus ,&nbsp;Maxime Eslier","doi":"10.1016/j.jogoh.2025.102943","DOIUrl":"10.1016/j.jogoh.2025.102943","url":null,"abstract":"<div><h3>Background</h3><div>Denial of pregnancy is the fact that a pregnant woman does not become aware of her pregnancy until the second trimester and sometimes only on the day of delivery. The lack of follow-up can then suggest that she and her child are exposed to an increased risk of complications.</div></div><div><h3>Objective</h3><div>The objective was to evaluate the maternal and perinatal morbidities of the denial of pregnancy, compared to women who not deny their pregnancy.</div></div><div><h3>Materials and methods</h3><div>This is a retrospective, observational, case-control type, unicentric study carried out at the University Hospital of Caen from January 1, 2002 to April 30, 2022. The exposure variable was the fact of having denied pregnancy and any woman having had a pregnancy discovered beyond 14 WA and 6 days and giving birth during the study period was included in the group of cases. Twin pregnancies and pregnancy concealed or insufficiently or even not voluntarily supported were excluded.</div></div><div><h3>Results</h3><div>Were included 137 singleton pregnancies in each group discovered. There is a rate of 1 to 4 denials per 1000 deliveries. There is no increase in maternal or obstetrical morbidity except for a large number of out-of-hospital deliveries (30 % of complete denials) and premature deliveries (16 %, <em>p</em> = 0.04). Fetal morbidity appears to be higher with a rate increased of hypotrophic newborns and hospitalizations in neonatology. The woman denying her pregnancy is rather precarious and heterogeneously adheres to psychosocial support.</div></div><div><h3>Conclusion</h3><div>Denial of pregnancy seems more morbid for the child than for its mother, if we do not take into account the psychological impact of this extraordinary pregnancy.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 6","pages":"Article 102943"},"PeriodicalIF":1.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human papillomavirus genotype distribution among high-grade cervical lesions in French women born between 1972 and 1993","authors":"Philomène Lenoir ,&nbsp;Julie Guillet ,&nbsp;Maxime Desmarets ,&nbsp;Alice Baraquin ,&nbsp;Rajeev Ramanah ,&nbsp;Justine Rousse ,&nbsp;Christiane Mougin ,&nbsp;Quentin Lepiller ,&nbsp;Jean-Luc Prétet ,&nbsp;HPV Impact Study Group","doi":"10.1016/j.jogoh.2025.102945","DOIUrl":"10.1016/j.jogoh.2025.102945","url":null,"abstract":"<div><h3>Background</h3><div>Implementation of HPV vaccination programmes may induce significant changes in the distribution of HPV genotypes detected in cervical (pre-)cancers.</div></div><div><h3>Methods</h3><div>In a multicentre study in France, we investigated the distribution of HPV genotypes using a sensitive molecular technique in 611 histological specimens diagnosed with high-grade lesions (CIN2/3) in a large cohort of women born between 1972 and 1993. Women born after 1983 were potentially vaccinated because of their young age.</div></div><div><h3>Results</h3><div>High-risk HPV genotypes were detected in 93.4 % of women and 24.4 % had a multiple infections. HPV16/18 genotypes were more frequently associated with CIN3 than with CIN2 lesions (66 % vs. 57 %, <em>p</em> = 0.045). The prevalence of HPV16 and HV18 genotypes did not change according to the year of birth.</div></div><div><h3>Conclusion</h3><div>Contrary to previous descriptions in countries with a high HPV vaccination coverage, we did not observe difference in the prevalence of HPV16 and HPV18 genotypes in CIN2/3 lesions after the introduction of HPV vaccination in France, in a context of low national vaccination coverage.</div></div><div><h3>ClinicalTrials.gov ID</h3><div>NCT04167501</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 5","pages":"Article 102945"},"PeriodicalIF":1.7,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692251","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}

{"title":"Enhanced recovery after surgery (ERAS) protocol with multimodal analgesia incorporating transverse abdominis plane block after elective caesarean delivery: A randomised controlled trial","authors":"Vidushi Kulshrestha ,&nbsp;Nisha ,&nbsp;Richa Vatsa ,&nbsp;Rajeshwari Subramaniam ,&nbsp;Perumal Vanamail ,&nbsp;Ajisha Aravindan ,&nbsp;Vatsla Dadhwal","doi":"10.1016/j.jogoh.2025.102939","DOIUrl":"10.1016/j.jogoh.2025.102939","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate ERAS protocol with multimodal analgesia incorporating transverse abdominis plane(TAP) block compared to routine postoperative care for pain control in women undergoing elective caesarean delivery.</div></div><div><h3>Methods</h3><div>This randomized study was conducted after ethical approval and CTRI registration (2020/10/028652). Total 140 women scheduled for elective caesarean were randomised into two groups. ERAS protocol was implemented in Group-1(n=70), and routine practice was followed in Group-2(n=70). Multimodal analgesia included TAP block after skin closure and intravenous paracetamol at shifting to recovery, followed by oral drugs as per analgesic clock. Outcomes were Pain Numerical Rating Scale(NRS) at rest and on movement at 6, 12, 24, 48 hours and at readiness for discharge, and need for rescue analgesics.</div></div><div><h3>Results</h3><div>NRS was significantly less in group-1 at all time points at rest and movement. Mean±SD NRS at rest was 30.57±1.52 vs. 64.71±1.52 at 6 hours, 28.14±1.39 vs. 56.57±1.39 at 12 hours in group-1 vs. group-2 respectively; (P=0.001). NRS on mobilisation was 37.71±1.57 vs. 74.00±1.57 and 36.42±1.46 vs. 65.28±1.46 at 6 and 12 hours respectively, (P=0.001). Patients needing rescue analgesia were 30 % vs. 87.1 % within 6 hours(65 % reduction), in 24.3 % vs. 77.1 % between 6–12 hours, 4.3 % vs. 40 % between 12–24 hours in group-1 and 2 respectively; with no requirement after 48 hours in either group. The mean Likert score for satisfaction was 4.4±0.60 and 3.4±0.78 in group-1 and group-2, respectively, p&lt;0.001.</div></div><div><h3>Conclusion</h3><div>ERAS protocol incorporating TAP block was effective in reducing postoperative pain, with 65 % reduction in requirement of rescue analgesia within six hours.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 5","pages":"Article 102939"},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrapartum monitoring of the fetal heart rate using transabdominal electrocardiography: A reliability and accuracy study","authors":"Anne Wojtanowski ,&nbsp;Charles Garabedian ,&nbsp;Pierre Charlier ,&nbsp;Pierre Prot ,&nbsp;Louise Ghesquiere ,&nbsp;Julien De jonckheere","doi":"10.1016/j.jogoh.2025.102942","DOIUrl":"10.1016/j.jogoh.2025.102942","url":null,"abstract":"<div><h3>Introduction</h3><div>In this study, we evaluated the performance of an intrapartum monitoring system (the TOCONAUTE) for fetal heart rate estimation using transabdominal electrocardiography.</div></div><div><h3>Method</h3><div>This prospective study was conducted in Lille University Hospital's maternity ward between August 2022 and November 2023 to assess the performance of the TOCONAUTE compared to a cardiotocograph (CTG). Pregnant women in labor at 36 weeks or more of gestation with a singleton in cephalic presentation were eligible for enrollment in the study. In addition to the cardiotocograph, the participants received an abdominal electrode patch after providing their written informed consent. The positive percent agreement with the cardiotocograph indicated reliability, and the Bland–Altman analysis determined accuracy.</div></div><div><h3>Results</h3><div>Of the 60 patient recruited, 35 patients were included in the recording analysis. The recordings had a mean duration of 519 ± 210 min. The TOCONAUTE's fetal heart rate (FHR) overall positive percent of agreement (PPA) was 84.2 ± 10.4 %. The PPA was greater than 80 % for all labor phases, except for expulsion (44.7 %). The overall mean bias was 1.7 ± 2.4. For the FHR, the mean bias was lower than 2 bpm for all labor phases, except for expulsion (14.13 ± 15.04 bpm).</div></div><div><h3>Conclusion</h3><div>Compared with traditional CTG, this study demonstrated the TOCONAUTE's reliability and accuracy for FHR estimation in all labor phases except expulsion.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 5","pages":"Article 102942"},"PeriodicalIF":1.7,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657513","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}