This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/policies-and-standards/article-withdrawal).
This article has been retracted at the request of the Editor-in-Chief and the journal's Ethics Committee.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 the methodology and in the data reported in the article: study design, population characteristics, delays.
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.
{"title":"Retraction notice to “Prophylactic Use of Tranexamic Acid for Decreasing the Blood Loss in Elective Cesarean Section: A Placebo-Controlled Randomized Clinical Trial” [J Gynecol Obstet Hum Reprod (2020) 101973]","authors":"Zahra Naeiji , Negar Delshadiyan , Sorayya Saleh , Atefeh Moridi , Nayereh Rahmati , Marzieh Fathi","doi":"10.1016/j.jogoh.2025.102985","DOIUrl":"10.1016/j.jogoh.2025.102985","url":null,"abstract":"<div><div>This article has been retracted: please see Elsevier Policy on Article Withdrawal (<span><span>https://www.elsevier.com/about/policies-and-standards/article-withdrawal</span><svg><path></path></svg></span>).</div><div>This article has been retracted at the request of the Editor-in-Chief and the journal's Ethics Committee.</div><div>After post-publication investigation, issues related to the following were identified in the article:</div><div>Significant inconsistencies in the methodology and in the data reported in the article: study design, population characteristics, delays.</div><div>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.</div><div>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.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 7","pages":"Article 102985"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261601","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}
Adenomyosis and endometriosis are gynecological conditions with overlapping symptoms but distinct pathologies. Both affect the women’s reproductive system, but their interrelation and shared clinical pathways are underexplored. This study investigates the co-occurrence and potential shared pathophysiology of these conditions.
Methods
Utilizing a retrospective cohort design, this study analyzed the medical records of female patients diagnosed with adenomyosis at Changsha Hospital for Maternal & Child Health Care from January 2015 to December 2020. We divided these medical records into two groups: those diagnosed with both adenomyosis and endometriosis and those with adenomyosis alone. Data on demographics, symptoms, and diagnostics were extracted. Statistical analyses, including t-tests, chi-square tests, and multivariable logistic regression, identified significant differences and predictors.
Results
Patients with both adenomyosis and endometriosis were older (mean age 48.88±17.57 years) compared to those with adenomyosis only (mean age 39.16±11.92 years; P = 0.001). Early menarche (<13 years) was more common in the concurrent group (62.6 % vs. 34.4 %; P < 0.001). Menorrhagia and dysmenorrhea were significantly more prevalent in patients with both conditions (72.1 % vs. 26.3 % and 67.3 % vs. 28.1 %, respectively; P < 0.001). Dyspareunia and spontaneous abortion rates were also higher in the concurrent group (59.2 % vs. 46.3 %, P = 0.023 and 69.2 % vs. 52.3 %, P = 0.007, respectively). Multivariable analysis identified older age and early menarche as significant predictors of concurrent endometriosis.
Conclusion
Adenomyosis patients with concurrent endometriosis experience more severe symptoms and different demographic profiles, with older age and early menarche as key predictors. Early screening and tailored management for this subgroup are crucial to improve clinical outcomes.
{"title":"Clinical and demographic differences in adenomyosis patients with and without concurrent endometriosis: A retrospective cohort study","authors":"Yuying Song, Haichun Guo, Shanshan Wu, Xiangmei Hu, Sihe Chen, Guangshen Liu, Rui Huang","doi":"10.1016/j.jogoh.2025.102987","DOIUrl":"10.1016/j.jogoh.2025.102987","url":null,"abstract":"<div><h3>Aim</h3><div>Adenomyosis and endometriosis are gynecological conditions with overlapping symptoms but distinct pathologies. Both affect the women’s reproductive system, but their interrelation and shared clinical pathways are underexplored. This study investigates the co-occurrence and potential shared pathophysiology of these conditions.</div></div><div><h3>Methods</h3><div>Utilizing a retrospective cohort design, this study analyzed the medical records of female patients diagnosed with adenomyosis at Changsha Hospital for Maternal & Child Health Care from January 2015 to December 2020. We divided these medical records into two groups: those diagnosed with both adenomyosis and endometriosis and those with adenomyosis alone. Data on demographics, symptoms, and diagnostics were extracted. Statistical analyses, including <em>t</em>-tests, chi-square tests, and multivariable logistic regression, identified significant differences and predictors.</div></div><div><h3>Results</h3><div>Patients with both adenomyosis and endometriosis were older (mean age 48.88±17.57 years) compared to those with adenomyosis only (mean age 39.16±11.92 years; <em>P</em> = 0.001). Early menarche (<13 years) was more common in the concurrent group (62.6 % vs. 34.4 %; <em>P</em> < 0.001). Menorrhagia and dysmenorrhea were significantly more prevalent in patients with both conditions (72.1 % vs. 26.3 % and 67.3 % vs. 28.1 %, respectively; <em>P</em> < 0.001). Dyspareunia and spontaneous abortion rates were also higher in the concurrent group (59.2 % vs. 46.3 %, <em>P</em> = 0.023 and 69.2 % vs. 52.3 %, <em>P</em> = 0.007, respectively). Multivariable analysis identified older age and early menarche as significant predictors of concurrent endometriosis.</div></div><div><h3>Conclusion</h3><div>Adenomyosis patients with concurrent endometriosis experience more severe symptoms and different demographic profiles, with older age and early menarche as key predictors. Early screening and tailored management for this subgroup are crucial to improve clinical outcomes.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 8","pages":"Article 102987"},"PeriodicalIF":1.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293793","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}
To assess the cardiovascular and gynaecological health status of women in France, based on data collected through the Women’s Heart Bus screening and prevention campaign.
Methods
A mobile screening campaign was carried out in 20 cities across France between September 2021 and November 2022. The initiative aimed to establish the cohort of the National Women’s Health Observatory (ONSF) and included 4300 women. A structured assessment booklet was used to collect information on cardiovascular, metabolic, and gynaecological-obstetric risk factors, as well as on medical follow-up by general practitioners and cardiologists. Gynaecological screening practices were also analysed in relation to age and national screening guidelines.
Results
Among the women included, 90.2 % had at least two cardiovascular or metabolic risk factors, and 48.9 % had two or more gynaecological-obstetric risk factors. More than 70 % had never received cardiovascular follow-up, and fewer than half were up to date with gynaecological screening.
Conclusion
The findings underscore the urgent need to improve cardiovascular and gynaecological health in women in France. The Women’s Heart Bus enabled many women to be reintegrated into appropriate care pathways.
{"title":"The “Women’s Heart Bus”: the first french initiative for the prevention of cardiovascular and gynaecological risk in women, prospective multicentre analysis of 4,300 participants","authors":"Manon Jouffroy , Patrick Devos , Thierry Drilhon , Claire Mounier-Vehier","doi":"10.1016/j.jogoh.2025.102983","DOIUrl":"10.1016/j.jogoh.2025.102983","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the cardiovascular and gynaecological health status of women in France, based on data collected through the Women’s Heart Bus screening and prevention campaign.</div></div><div><h3>Methods</h3><div>A mobile screening campaign was carried out in 20 cities across France between September 2021 and November 2022. The initiative aimed to establish the cohort of the National Women’s Health Observatory (ONSF) and included 4300 women. A structured assessment booklet was used to collect information on cardiovascular, metabolic, and gynaecological-obstetric risk factors, as well as on medical follow-up by general practitioners and cardiologists. Gynaecological screening practices were also analysed in relation to age and national screening guidelines.</div></div><div><h3>Results</h3><div>Among the women included, 90.2 % had at least two cardiovascular or metabolic risk factors, and 48.9 % had two or more gynaecological-obstetric risk factors. More than 70 % had never received cardiovascular follow-up, and fewer than half were up to date with gynaecological screening.</div></div><div><h3>Conclusion</h3><div>The findings underscore the urgent need to improve cardiovascular and gynaecological health in women in France. The Women’s Heart Bus enabled many women to be reintegrated into appropriate care pathways.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 7","pages":"Article 102983"},"PeriodicalIF":1.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248248","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 : 2025-05-30DOI: 10.1016/j.jogoh.2025.102982
Xiaotong Liu , Xuyin Zhang , Keqin Hua , Meng Xie
Introduction and Hypothesis
The relationship between female genital tract congenital anomalies and endometriosis is less clear. This study aimed to analyze the prevalence and high-risk factors of endometriosis in patients diagnosed with female genital tract congenital anomalies with functioning endometrium.
Methods
In this study that included 675 patients who were diagnosed with female genital tract anomalies with functioning endometrium and underwent surgery between January 2013 and December 2023. Data on clinical characteristics were obtained and analyzed. Quantitative and categorical variables were compared using Student’s t-test and chi-squared test, respectively.
Results
The incidence of endometriosis in patients with obstructive anomalies (52.1 %) was significantly higher than non-obstructive anomalies (15.5 %). Ovarian endometrial cysts had the highest incidence among all types of endometriosis (61 %). The incidence of endometriosis and revised American Fertility Society (rAFS) scores were significantly higher in obstructive uterine anomalies or obstructive cervical anomalies than in the obstructive vaginal anomalies group (45.57±25.56, 49.35±33.82, and 31.24±27.82, P= 0.014). Age, cyclic abdominal pain, hematometra before surgery, and type of obstructive anomalies had significant effects on endometriosis in patients with obstructive genital tract anomalies. Multivariant linear regression analysis showed that rAFS scores were associated with cyclic abdominal pain (b = 0.200, P < 0.05).
Conclusions
The incidence and severity of endometriosis were higher in obstructive uterine anomalies or obstructive cervical anomalies. Age, cyclic abdominal pain, hematometra before surgery, and type of obstructive anomalies were the main risk factors for endometriosis in patients with obstructive genital tract anomalies. Cyclic abdominal pain was positively correlated with the severity of endometriosis.
{"title":"Endometriosis in patients with female genital tract congenital anomalies: A retrospective cohort study","authors":"Xiaotong Liu , Xuyin Zhang , Keqin Hua , Meng Xie","doi":"10.1016/j.jogoh.2025.102982","DOIUrl":"10.1016/j.jogoh.2025.102982","url":null,"abstract":"<div><h3>Introduction and Hypothesis</h3><div>The relationship between female genital tract congenital anomalies and endometriosis is less clear. This study aimed to analyze the prevalence and high-risk factors of endometriosis in patients diagnosed with female genital tract congenital anomalies with functioning endometrium.</div></div><div><h3>Methods</h3><div>In this study that included 675 patients who were diagnosed with female genital tract anomalies with functioning endometrium and underwent surgery between January 2013 and December 2023. Data on clinical characteristics were obtained and analyzed. Quantitative and categorical variables were compared using Student’s <em>t</em>-test and chi-squared test, respectively.</div></div><div><h3>Results</h3><div>The incidence of endometriosis in patients with obstructive anomalies (52.1 %) was significantly higher than non-obstructive anomalies (15.5 %). Ovarian endometrial cysts had the highest incidence among all types of endometriosis (61 %). The incidence of endometriosis and revised American Fertility Society (rAFS) scores were significantly higher in obstructive uterine anomalies or obstructive cervical anomalies than in the obstructive vaginal anomalies group (45.57±25.56, 49.35±33.82, and 31.24±27.82, <em>P</em> <em>=</em> 0.014). Age, cyclic abdominal pain, hematometra before surgery, and type of obstructive anomalies had significant effects on endometriosis in patients with obstructive genital tract anomalies. Multivariant linear regression analysis showed that rAFS scores were associated with cyclic abdominal pain (<em>b</em> = 0.200, <em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>The incidence and severity of endometriosis were higher in obstructive uterine anomalies or obstructive cervical anomalies. Age, cyclic abdominal pain, hematometra before surgery, and type of obstructive anomalies were the main risk factors for endometriosis in patients with obstructive genital tract anomalies. Cyclic abdominal pain was positively correlated with the severity of endometriosis.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 7","pages":"Article 102982"},"PeriodicalIF":1.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191885","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 : 2025-05-26DOI: 10.1016/j.jogoh.2025.102980
Ivana Paljk Likar , Kristina Drusany Starič , Marina Jakimovska
Lipschütz ulcers, also known as “ulcus vulvae acutum” are a rare genital ulcerations. They typically present following flu-like or mononucleosis-like symptoms, leading to the sudden appearance of genital ulcers. Although uncommon, the condition is usually self-limiting, resolving within two to four weeks. Treatment focuses on supportive care and pain management. We report a case series that occurred at our emergency gynecology department. This includes three young sexually inactive patients, two of whom presented with recurrent Lipschütz ulcers — a very rare occurrence. Additionaly in one of our cases the acute vulvar ulcers emerged in pregnancy. Lipschütz ulcers are uncommon, but taking an accurate medical history can be beneficial. Increasing awareness of Lipschütz ulcers is essential to ensure proper management and prevent overtreatment or interventions that may cause unnecessary distress for the patient. The occurence in pregnancy has not been described yet.
{"title":"Lipschütz ulcers: Case series of an uncommon clinical entity featuring a first reported case in pregnancy","authors":"Ivana Paljk Likar , Kristina Drusany Starič , Marina Jakimovska","doi":"10.1016/j.jogoh.2025.102980","DOIUrl":"10.1016/j.jogoh.2025.102980","url":null,"abstract":"<div><div>Lipschütz ulcers, also known as “ulcus vulvae acutum” are a rare genital ulcerations. They typically present following flu-like or mononucleosis-like symptoms, leading to the sudden appearance of genital ulcers. Although uncommon, the condition is usually self-limiting, resolving within two to four weeks. Treatment focuses on supportive care and pain management. We report a case series that occurred at our emergency gynecology department. This includes three young sexually inactive patients, two of whom presented with recurrent Lipschütz ulcers — a very rare occurrence. Additionaly in one of our cases the acute vulvar ulcers emerged in pregnancy. Lipschütz ulcers are uncommon, but taking an accurate medical history can be beneficial. Increasing awareness of Lipschütz ulcers is essential to ensure proper management and prevent overtreatment or interventions that may cause unnecessary distress for the patient. The occurence in pregnancy has not been described yet.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 7","pages":"Article 102980"},"PeriodicalIF":1.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173867","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 : 2025-05-25DOI: 10.1016/j.jogoh.2025.102981
Estefania Rivera Mudafort , Mymy Nguyen , Batsheva R Rubin , Rose Al Abosy , Rodney Bruno , Joseph A Politch , Julia C. Bond , Lauren A. Wise , Mary Louise Fowler , Wendy Kuohung
Objective
To compare differences in the management and outcomes of ectopic pregnancy (EP) in an urban population before and after the COVID-19 pandemic.
Methods
A retrospective cohort study of 188 patients aged >18 years who presented with an EP to Boston Medical Center (BMC) between March 2019 and March 2021 was performed. Sociodemographic and clinical data were collected from medical records. Patients were stratified into ‘pre-COVID’ and ‘intra-COVID' groups. Differences in patient characteristics, presentation, and management between the groups were evaluated.
Results
There were 95 patients in the pre-COVID group and 93 in the intra-COVID group. Overall, there was little difference in age, socio-demographics, presenting symptoms, management, or outcomes, across groups. However, patients presenting intra-COVID were more likely to have a prior history of STIs (difference in proportion +0.14 (95 % CI 0.02, 0.25), report current alcohol use (+0.14 (95 % CI 0.02, 0.25)), and current recreational drug use (+0.11 (95 % CI 0.01, 0.20)). Time from decision for surgery to start of operation (+49.3 min, (95 % CI -62.5, 161.1)) and estimated blood loss (EBL) (+12.9 mL (95 % CI -13.0, 38.8)) was greater for the intra-COVID group.
Conclusion
The observed increase in EBL from EPs managed surgically and in “decision-to-incision” time in the intra-COVID group may be explained by cumbersome personal protective equipment protocols and turnaround time for required COVID-19 PCR testing. The higher prevalence of STIs among intra-COVID patients may reflect increased unwanted sexual activity or reduced access to barrier protection among socioeconomically disadvantaged patients.
目的：比较新型冠状病毒肺炎（COVID-19）大流行前后城市人群异位妊娠（EP）处理和结局的差异。方法：对2019年3月至2021年3月期间就诊于波士顿医学中心（BMC）的188例年龄在bb0 ~ 18岁的EP患者进行回顾性队列研究。从医疗记录中收集社会人口学和临床数据。患者被分为“前冠”组和“内冠”组。评估两组患者特征、表现和治疗的差异。结果：冠前组95例，冠内组93例。总体而言，各组在年龄、社会人口统计学、表现症状、管理或结果方面几乎没有差异。然而，出现covid - 19的患者更有可能有既往性传播感染史(比例差异为+0.14 (95% CI 0.02, 0.25)，报告当前饮酒（+0.14 (95% CI 0.02, 0.25)）和当前娱乐性药物使用（+0.11 (95% CI 0.01, 0.20)）。从决定手术到开始手术的时间（+49.3分钟，（95% CI -62.5, 161.1））和估计失血量（EBL） （+12.9 mL (95% CI -13.0, 38.8)）在covid组中更大。结论：观察到的手术处理的EPs的EBL增加和“决定到切口”时间的增加，可能是由于繁琐的个人防护装备方案和所需的COVID-19 PCR检测的周转时间。covid - 19患者中性传播感染的较高患病率可能反映了社会经济弱势患者中不受欢迎的性活动增加或获得屏障保护的机会减少。
{"title":"Ectopic pregnancy management and higher risk sexual behavior during the COVID-19 pandemic at a safety net hospital","authors":"Estefania Rivera Mudafort , Mymy Nguyen , Batsheva R Rubin , Rose Al Abosy , Rodney Bruno , Joseph A Politch , Julia C. Bond , Lauren A. Wise , Mary Louise Fowler , Wendy Kuohung","doi":"10.1016/j.jogoh.2025.102981","DOIUrl":"10.1016/j.jogoh.2025.102981","url":null,"abstract":"<div><h3>Objective</h3><div>To compare differences in the management and outcomes of ectopic pregnancy (EP) in an urban population before and after the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>A retrospective cohort study of 188 patients aged >18 years who presented with an EP to Boston Medical Center (BMC) between March 2019 and March 2021 was performed. Sociodemographic and clinical data were collected from medical records. Patients were stratified into ‘pre-COVID’ and ‘intra-COVID' groups. Differences in patient characteristics, presentation, and management between the groups were evaluated.</div></div><div><h3>Results</h3><div>There were 95 patients in the pre-COVID group and 93 in the intra-COVID group. Overall, there was little difference in age, socio-demographics, presenting symptoms, management, or outcomes, across groups. However, patients presenting intra-COVID were more likely to have a prior history of STIs (difference in proportion +0.14 (95 % CI 0.02, 0.25), report current alcohol use (+0.14 (95 % CI 0.02, 0.25)), and current recreational drug use (+0.11 (95 % CI 0.01, 0.20)). Time from decision for surgery to start of operation (+49.3 min, (95 % CI -62.5, 161.1)) and estimated blood loss (EBL) (+12.9 mL (95 % CI -13.0, 38.8)) was greater for the intra-COVID group.</div></div><div><h3>Conclusion</h3><div>The observed increase in EBL from EPs managed surgically and in “decision-to-incision” time in the intra-COVID group may be explained by cumbersome personal protective equipment protocols and turnaround time for required COVID-19 PCR testing. The higher prevalence of STIs among intra-COVID patients may reflect increased unwanted sexual activity or reduced access to barrier protection among socioeconomically disadvantaged patients.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 7","pages":"Article 102981"},"PeriodicalIF":1.7,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159543","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 : 2025-05-20DOI: 10.1016/j.jogoh.2025.102979
Marcos Javier Cuerva , Miguel Pou , Mariona Cruset , Ana Llamazares , Alicia Ramirez-Castan , Marta Cortes , Francisco Lopez , José Luis Bartha
Context
Thierry's spatulas are obstetric instruments used for assisted vaginal births, known for their propulsion and guidance mechanism that minimizes traction on the fetal head. Over time, multiple models with design variations have been commercialized under the same name. The biomechanical implications of these variations remain unclear. This study aims to compare different models of Thierry's spatulas to evaluate biomechanical differences.
Methods
This was a simulation-based, experimental, prospective, randomized, three-arm study. Six obstetricians with varying levels of experience performed 108 spatula-assisted births using a birthing simulator. Three different spatula models were evaluated. Traction force on the fetal head, perineal pressure, operative time, subjective difficulty, and hand pain were recorded.
Results
Significant differences were observed in the force exerted on the fetal head, with the original model applying the least force (15 (8; 21.5) N, P < 0.001). Obstetricians with more than 15 years of experience applied significantly less traction force compared to those with less than 5 years of experience.
After adjusting for the spatula model and the obstetrician's experience using multiple linear regression, the force applied to the infant was found to be independently associated with both factors.
Conclusion
Thierry's spatulas models exhibit biomechanical differences, with the original design applying the least traction force. Experience influences instrument performance, highlighting the importance of proper training. Clinicians should be aware of model-specific differences when selecting Thierry's spatulas for operative births.
背景：蒂埃里刮刀是用于辅助阴道分娩的产科器械，以其推进和引导机制而闻名，可最大限度地减少对胎儿头部的牵引力。随着时间的推移，设计变化的多个模型已经以相同的名称商业化。这些变异的生物力学意义尚不清楚。本研究旨在比较不同模型的蒂埃里刮刀，以评估生物力学差异。方法：这是一项基于模拟的、实验性的、前瞻性的、随机的三组研究。六位经验不同的产科医生使用分娩模拟器进行了108例刮刀辅助分娩。评估了三种不同的刮刀模型。记录胎头牵引力、会阴压力、手术时间、主观难度、手部疼痛。结果：胎头受力差异有统计学意义，原模型胎头受力最小(15 (8)；21.5) n, p < 0.001)。与经验不足5年的产科医生相比，经验超过15年的产科医生使用的牵引力明显更小。在调整了抹刀模型和产科医生的经验后，使用多元线性回归，发现施加在婴儿身上的力与这两个因素独立相关。结论：Thierry的锅铲模型表现出生物力学差异，原始设计的锅铲施加的牵引力最小。经验影响乐器的性能，突出了适当培训的重要性。临床医生在选择Thierry刮刀进行手术分娩时应注意模型特异性差异。
{"title":"Are all Thierry’s spatulas the same? A simulation study comparing various available models","authors":"Marcos Javier Cuerva , Miguel Pou , Mariona Cruset , Ana Llamazares , Alicia Ramirez-Castan , Marta Cortes , Francisco Lopez , José Luis Bartha","doi":"10.1016/j.jogoh.2025.102979","DOIUrl":"10.1016/j.jogoh.2025.102979","url":null,"abstract":"<div><h3>Context</h3><div>Thierry's spatulas are obstetric instruments used for assisted vaginal births, known for their propulsion and guidance mechanism that minimizes traction on the fetal head. Over time, multiple models with design variations have been commercialized under the same name. The biomechanical implications of these variations remain unclear. This study aims to compare different models of Thierry's spatulas to evaluate biomechanical differences.</div></div><div><h3>Methods</h3><div>This was a simulation-based, experimental, prospective, randomized, three-arm study. Six obstetricians with varying levels of experience performed 108 spatula-assisted births using a birthing simulator. Three different spatula models were evaluated. Traction force on the fetal head, perineal pressure, operative time, subjective difficulty, and hand pain were recorded.</div></div><div><h3>Results</h3><div>Significant differences were observed in the force exerted on the fetal head, with the original model applying the least force (15 (8; 21.5) N, <em>P</em> < 0.001). Obstetricians with more than 15 years of experience applied significantly less traction force compared to those with less than 5 years of experience.</div><div>After adjusting for the spatula model and the obstetrician's experience using multiple linear regression, the force applied to the infant was found to be independently associated with both factors.</div></div><div><h3>Conclusion</h3><div>Thierry's spatulas models exhibit biomechanical differences, with the original design applying the least traction force. Experience influences instrument performance, highlighting the importance of proper training. Clinicians should be aware of model-specific differences when selecting Thierry's spatulas for operative births.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 7","pages":"Article 102979"},"PeriodicalIF":1.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127515","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 : 2025-05-16DOI: 10.1016/j.jogoh.2025.102978
A. Caroff , F. Scheffler , C. Bulle , A. Berdin , C. Bouit , L. Courtois , D. Olivier , P. Decaigny , l. Fillipuzzi , E. Joyeux , N. Mottet , C. Nallet , R. Ramanah
Introduction
Endometriosis, affecting approximately 10 % of women of reproductive age, is a chronic condition that significantly impacts quality of life through a range of debilitating symptoms. Diagnosis, often delayed and relies on symptom assessment, clinical examination, and imaging. Management typically involves analgesics, hormonal treatments, surgery, and assisted reproduction technology (ART) if needed. To enhance patient care, the Bourgogne Franche-Comté endometriosis network established multidisciplinary team meetings (MDTs) using the Covotem® online platform. This study evaluates the effectiveness of this approach.
Materials and methods
This multicentric retrospective study analyzed patient files presented at endometriosis MDTs from November 2022 to February 2024. Data were gathered from the Covotem® platform and patients' medical records.
Results
A total of 269 cases were included, with 180 cases (66,9 %) from Franche-Comté region and 89 (33,1 %) from Bourgogne. Deep endometriosis was present in 52 % of cases, while ovarian endometriosis was observed in 30 %. Infertility was reported in 48 % of cases. The MDTs comprised at least three specialties in 97 % of meetings. Quality-of-life assessments were conducted for 27 % of patients. Pelvic MRI reviews were performed for 66 % of patients, leading to report modifications in 41 % of cases. MDT recommendations included surgical intervention for 26 %, medical management for 36 %, fertility preservation for 6 %, and ART for 19 %. The MDT recommendations were implemented for 92 % of patients, typically within 22 days.
Conclusion
This regional online MDT platform improved endometriosis diagnosis and optimized therapeutic strategies, particularly through enhanced imaging reviews and refined treatment recommendations.
{"title":"Assessing the impact of a regional multidisciplinary team meeting for endometriosis using the CovotemⓇ online platform","authors":"A. Caroff , F. Scheffler , C. Bulle , A. Berdin , C. Bouit , L. Courtois , D. Olivier , P. Decaigny , l. Fillipuzzi , E. Joyeux , N. Mottet , C. Nallet , R. Ramanah","doi":"10.1016/j.jogoh.2025.102978","DOIUrl":"10.1016/j.jogoh.2025.102978","url":null,"abstract":"<div><h3>Introduction</h3><div>Endometriosis, affecting approximately 10 % of women of reproductive age, is a chronic condition that significantly impacts quality of life through a range of debilitating symptoms. Diagnosis, often delayed and relies on symptom assessment, clinical examination, and imaging. Management typically involves analgesics, hormonal treatments, surgery, and assisted reproduction technology (ART) if needed. To enhance patient care, the Bourgogne Franche-Comté endometriosis network established multidisciplinary team meetings (MDTs) using the Covotem® online platform. This study evaluates the effectiveness of this approach.</div></div><div><h3>Materials and methods</h3><div>This multicentric retrospective study analyzed patient files presented at endometriosis MDTs from November 2022 to February 2024. Data were gathered from the Covotem® platform and patients' medical records.</div></div><div><h3>Results</h3><div>A total of 269 cases were included, with 180 cases (66,9 %) from Franche-Comté region and 89 (33,1 %) from Bourgogne. Deep endometriosis was present in 52 % of cases, while ovarian endometriosis was observed in 30 %. Infertility was reported in 48 % of cases. The MDTs comprised at least three specialties in 97 % of meetings. Quality-of-life assessments were conducted for 27 % of patients. Pelvic MRI reviews were performed for 66 % of patients, leading to report modifications in 41 % of cases. MDT recommendations included surgical intervention for 26 %, medical management for 36 %, fertility preservation for 6 %, and ART for 19 %. The MDT recommendations were implemented for 92 % of patients, typically within 22 days.</div></div><div><h3>Conclusion</h3><div>This regional online MDT platform improved endometriosis diagnosis and optimized therapeutic strategies, particularly through enhanced imaging reviews and refined treatment recommendations.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 7","pages":"Article 102978"},"PeriodicalIF":1.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094036","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 : 2025-05-15DOI: 10.1016/j.jogoh.2025.102975
Alessandro Ferdinando Ruffolo, Marine Lallemant, Anna Barrieux, Chrystele Rubod, Michel Cosson
Following transvaginal mesh interdiction, native tissue repair (NTR) emerged as the standard surgical approach for anterior pelvic organ prolapse (POP) requiring vaginal intervention, despite high recurrence rates with traditional methods. This study presents a novel NTR technique combining vaginal patch plastron (VPP) with anterior sacrospinous ligament fixation (SSLF-A) to address anterior and apical POP. Incorporating apical suspension during anterior repair reduces recurrence compared to non-apical procedures. The VPP technique involves creating a vaginal strip on the anterior colpocele, suspended bilaterally to the sacrospinous ligament (SSL) and arcus tendineus fasciae pelvis, secured with non-absorbable sutures. It can be paired with SSL hysteropexy or vault suspension for comprehensive support. Early results suggest enhanced anatomical stability and reduced relapse risk by addressing multicompartmental defects through a single vaginal approach. While demonstrating procedural safety and feasibility, further comparative studies are needed to evaluate this approach against existing techniques for advanced anterior-apical prolapse.
{"title":"The autologous vaginal patch plastron associated with the anterior sacrospinous ligament fixation for the treatment of anterior and apical pelvic organ prolapse: Technical note with video demonstration","authors":"Alessandro Ferdinando Ruffolo, Marine Lallemant, Anna Barrieux, Chrystele Rubod, Michel Cosson","doi":"10.1016/j.jogoh.2025.102975","DOIUrl":"10.1016/j.jogoh.2025.102975","url":null,"abstract":"<div><div>Following transvaginal mesh interdiction, native tissue repair (NTR) emerged as the standard surgical approach for anterior pelvic organ prolapse (POP) requiring vaginal intervention, despite high recurrence rates with traditional methods. This study presents a novel NTR technique combining vaginal patch plastron (VPP) with anterior sacrospinous ligament fixation (SSLF-A) to address anterior and apical POP. Incorporating apical suspension during anterior repair reduces recurrence compared to non-apical procedures. The VPP technique involves creating a vaginal strip on the anterior colpocele, suspended bilaterally to the sacrospinous ligament (SSL) and arcus tendineus fasciae pelvis, secured with non-absorbable sutures. It can be paired with SSL hysteropexy or vault suspension for comprehensive support. Early results suggest enhanced anatomical stability and reduced relapse risk by addressing multicompartmental defects through a single vaginal approach. While demonstrating procedural safety and feasibility, further comparative studies are needed to evaluate this approach against existing techniques for advanced anterior-apical prolapse.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 7","pages":"Article 102975"},"PeriodicalIF":1.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094039","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 : 2025-05-14DOI: 10.1016/j.jogoh.2025.102977
Emma Bajeux , Vincent Lavoué
{"title":"Response to the letter regarding “robot-assisted versus conventional laparoscopic hysterectomy in endometrial cancer”","authors":"Emma Bajeux , Vincent Lavoué","doi":"10.1016/j.jogoh.2025.102977","DOIUrl":"10.1016/j.jogoh.2025.102977","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 7","pages":"Article 102977"},"PeriodicalIF":1.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086321","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}
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