Pub Date : 2026-01-20DOI: 10.1016/j.jogoh.2026.103123
Maria João Carvalho, Fernanda Santos, Vanessa Vieira, Bárbara Laranjeiro, Carlota Anjinho-Carvalhos, Ana Aparício, Mariana Robalo-Cordeiro, Margarida Figueiredo-Dias
Introduction: Endometriosis is characterized by the ectopic implantation of endometrial tissue affecting reproductive-aged women. Available therapies have still unmet needs namely due to recurrence rates and systemic side effects. Emerging evidence suggests endometrial stem cells (EnSCs) contribution in disease pathogenesis, including mesenchymal stem cells (E-MSCs), epithelial progenitor cells (EPCs), and side population cells (ESPs). These stem/progenitor cells are involved in proliferation, migration, and angiogenesis, contributing to endometriosis genesis and persistence. Targeting EnSCs and their regulatory pathways present a promising therapeutic strategy to improve unmet needs in endometriosis.
Materials and methods: This scoping review was based on a systematic literature search conducted in PubMed, EMBASE, and Web of Science considering studies published after 2000. Inclusion criteria focused on original research articles exploring the role and targeting of EnSCs in endometriosis, following PRISMA-ScR guidelines. Data were synthesized through narrative and descriptive methods.
Results: The review structures key pathways and therapeutic agents targeting EnSCs in endometriosis. Notch1, PI3K/Akt, Wnt/β-catenin, and JAK/STAT signalling are pathways that regulate proliferation, migration and survival of EnSCs in endometriosis. Agents such as metformin, lovastatin, sorafenib, quinagolide, and γ-secretase inhibitors demonstrated potential to modulate stemness, leading to a decrease in inflammation, migration and apoptosis. Anti-angiogenic agents showed efficacy in reducing lesion size in vivo, targeting E-MSCs. Exosomes emerge as a cell-free approach, derived from menstrual stem cells (MenSCs) or ginger-based nanoparticles and exhibited properties essential for endometriosis treatment, directed to ectopic stem cells.
Conclusions: EnSCs sustain aberrant cellular behaviours in endometriosis. Targeting EnSCs and their related pathways may be an innovative, individualized, and disease-modifying strategy. Pharmacological modulation, gene therapy and exosome are strategies for stem cell inhibition in endometriosis, being a promising avenue for future research leading to application in clinical practice.
简介：子宫内膜异位症的特征是影响育龄妇女的子宫内膜组织异位着床。由于复发率和全身副作用，现有的治疗方法仍未满足需求。新出现的证据表明，子宫内膜干细胞（EnSCs）在疾病发病机制中起着重要作用，包括间充质干细胞（E-MSCs）、上皮祖细胞（EPCs）和侧群细胞（esp）。这些干细胞/祖细胞参与增殖、迁移和血管生成，有助于子宫内膜异位症的发生和持续。靶向EnSCs及其调控途径为改善子宫内膜异位症的未满足需求提供了一种有希望的治疗策略。材料和方法：本综述基于在PubMed、EMBASE和Web of Science上进行的系统文献检索，考虑了2000年以后发表的研究。纳入标准主要是根据PRISMA-ScR指南，探讨EnSCs在子宫内膜异位症中的作用和靶向性的原创研究文章。通过叙述和描述的方法综合数据。结果：综述了子宫内膜异位症中以EnSCs为靶点的关键通路和治疗药物。Notch1、PI3K/Akt、Wnt/β-catenin和JAK/STAT信号通路在子宫内膜异位症中调控EnSCs的增殖、迁移和存活。二甲双胍、洛伐他汀、索拉非尼、喹那格内酯和γ-分泌酶抑制剂等药物显示出调节干性的潜力，导致炎症、迁移和细胞凋亡的减少。抗血管生成药物在体内以E-MSCs为靶点，可有效减少病变大小。外泌体作为一种无细胞的方法出现，来源于月经干细胞（MenSCs）或基于姜的纳米颗粒，并表现出针对异位干细胞治疗子宫内膜异位症所必需的特性。结论：EnSCs在子宫内膜异位症中维持异常的细胞行为。靶向EnSCs及其相关通路可能是一种创新的、个性化的、疾病修饰的策略。药物调控、基因治疗和外泌体是子宫内膜异位症干细胞抑制的策略，是未来研究和临床应用的一个有前景的途径。
{"title":"Targeting endometrial stem cell in endometriosis treatment, a scoping review.","authors":"Maria João Carvalho, Fernanda Santos, Vanessa Vieira, Bárbara Laranjeiro, Carlota Anjinho-Carvalhos, Ana Aparício, Mariana Robalo-Cordeiro, Margarida Figueiredo-Dias","doi":"10.1016/j.jogoh.2026.103123","DOIUrl":"https://doi.org/10.1016/j.jogoh.2026.103123","url":null,"abstract":"<p><strong>Introduction: </strong>Endometriosis is characterized by the ectopic implantation of endometrial tissue affecting reproductive-aged women. Available therapies have still unmet needs namely due to recurrence rates and systemic side effects. Emerging evidence suggests endometrial stem cells (EnSCs) contribution in disease pathogenesis, including mesenchymal stem cells (E-MSCs), epithelial progenitor cells (EPCs), and side population cells (ESPs). These stem/progenitor cells are involved in proliferation, migration, and angiogenesis, contributing to endometriosis genesis and persistence. Targeting EnSCs and their regulatory pathways present a promising therapeutic strategy to improve unmet needs in endometriosis.</p><p><strong>Materials and methods: </strong>This scoping review was based on a systematic literature search conducted in PubMed, EMBASE, and Web of Science considering studies published after 2000. Inclusion criteria focused on original research articles exploring the role and targeting of EnSCs in endometriosis, following PRISMA-ScR guidelines. Data were synthesized through narrative and descriptive methods.</p><p><strong>Results: </strong>The review structures key pathways and therapeutic agents targeting EnSCs in endometriosis. Notch1, PI3K/Akt, Wnt/β-catenin, and JAK/STAT signalling are pathways that regulate proliferation, migration and survival of EnSCs in endometriosis. Agents such as metformin, lovastatin, sorafenib, quinagolide, and γ-secretase inhibitors demonstrated potential to modulate stemness, leading to a decrease in inflammation, migration and apoptosis. Anti-angiogenic agents showed efficacy in reducing lesion size in vivo, targeting E-MSCs. Exosomes emerge as a cell-free approach, derived from menstrual stem cells (MenSCs) or ginger-based nanoparticles and exhibited properties essential for endometriosis treatment, directed to ectopic stem cells.</p><p><strong>Conclusions: </strong>EnSCs sustain aberrant cellular behaviours in endometriosis. Targeting EnSCs and their related pathways may be an innovative, individualized, and disease-modifying strategy. Pharmacological modulation, gene therapy and exosome are strategies for stem cell inhibition in endometriosis, being a promising avenue for future research leading to application in clinical practice.</p>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":" ","pages":"103123"},"PeriodicalIF":1.6,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029903","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}
Sacrocolpopexy remains the gold-standard surgical technique for the management of apical prolapse, whether performed with or without concomitant hysterectomy. However, the use of synthetic mesh has become increasingly debated owing to concerns regarding postoperative complications. Robotic-assisted unilateral pectineal suspension (UPS) has emerged as an innovative, safe, and effective alternative for apical prolapse repair. This minimally invasive, mesh-free procedure achieves uterine suspension by anchoring the anterior cervical surface to Cooper’s iliopectineal ligament. Indications include women of reproductive age seeking a uterus-preserving approach, obese patients, and those unwilling to undergo procedures involving synthetic prostheses; it may also represent a suitable option in selected cases of recurrence following laparoscopic sacrocolpopexy or vaginal repair. We describe the standardized steps of this surgical procedure, along with the specific advantages of the robotic approach, illustrated by a detailed video demonstration to support implementation among surgeons.
{"title":"How to perform unilateral pectineal suspension for apical prolapse by robotic assistance: A technical note with Video","authors":"Gery Lamblin , Graziella Moufawad , Chloé Miguet-Bensouda , Maiti Alefsen-de-Boisredon , Charles-André Philip , Erdogan Nohuz , Laurent de Landsheere","doi":"10.1016/j.jogoh.2026.103122","DOIUrl":"10.1016/j.jogoh.2026.103122","url":null,"abstract":"<div><div>Sacrocolpopexy remains the gold-standard surgical technique for the management of apical prolapse, whether performed with or without concomitant hysterectomy. However, the use of synthetic mesh has become increasingly debated owing to concerns regarding postoperative complications. Robotic-assisted unilateral pectineal suspension (UPS) has emerged as an innovative, safe, and effective alternative for apical prolapse repair. This minimally invasive, mesh-free procedure achieves uterine suspension by anchoring the anterior cervical surface to Cooper’s iliopectineal ligament. Indications include women of reproductive age seeking a uterus-preserving approach, obese patients, and those unwilling to undergo procedures involving synthetic prostheses; it may also represent a suitable option in selected cases of recurrence following laparoscopic sacrocolpopexy or vaginal repair. We describe the standardized steps of this surgical procedure, along with the specific advantages of the robotic approach, illustrated by a detailed video demonstration to support implementation among surgeons.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103122"},"PeriodicalIF":1.6,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010820","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 : 2026-01-18DOI: 10.1016/j.jogoh.2026.103121
FABBRO Laurine , LELOUBE Simon , MONIOD Louise , FABBRO Pascale , CHAULEUR Céline
Introduction
Genitourinary Syndrome of Menopause (GSM) results from reduced estrogen levels, typically postmenopausally or after hormone-dependent cancer. It manifests with vulvovaginal (dryness, itching, burning), sexual (dyspareunia), and urinary (infections, incontinence) symptoms, severely affecting quality of life. For women who cannot use hormonal treatments or are unresponsive to them, CO₂ laser therapy offers a potential alternative.
Objective
This study aimed to assess short- and long-term symptom improvement and sexual quality of life following CO₂ laser treatment for genito-urinary syndrome.
Method
A prospective, monocentric symptom improvement survey was conducted at the Saint-Étienne University Hospital between July 2019 and August 2023 with 138 patients. It was assessed using visual analogue scales (VAS) and the Female Sexual Distress Scale-Revised (FSDS-R) before treatment, one month after each session, and 10–24 months post-treatment.
Results
One month after treatment, significant improvements (p < 0.0001) were noted in all GSM symptoms and sexual quality of life. These improvements remained significant at long-term follow-up (p < 0.001).
Conclusion
Fractional CO₂ laser therapy is an effective, durable treatment for GSM in postmenopausal women or those with hormone-dependent cancer, significantly improving urogenital quality of life.
{"title":"Evaluation of symptom improvement over time after fractional CO2 laser therapy in women with genito-urinary syndrome","authors":"FABBRO Laurine , LELOUBE Simon , MONIOD Louise , FABBRO Pascale , CHAULEUR Céline","doi":"10.1016/j.jogoh.2026.103121","DOIUrl":"10.1016/j.jogoh.2026.103121","url":null,"abstract":"<div><h3>Introduction</h3><div>Genitourinary Syndrome of Menopause (GSM) results from reduced estrogen levels, typically postmenopausally or after hormone-dependent cancer. It manifests with vulvovaginal (dryness, itching, burning), sexual (dyspareunia), and urinary (infections, incontinence) symptoms, severely affecting quality of life. For women who cannot use hormonal treatments or are unresponsive to them, CO₂ laser therapy offers a potential alternative.</div></div><div><h3>Objective</h3><div>This study aimed to assess short- and long-term symptom improvement and sexual quality of life following CO₂ laser treatment for genito-urinary syndrome.</div></div><div><h3>Method</h3><div>A prospective, monocentric symptom improvement survey was conducted at the Saint-Étienne University Hospital between July 2019 and August 2023 with 138 patients. It was assessed using visual analogue scales (VAS) and the Female Sexual Distress Scale-Revised (FSDS-R) before treatment, one month after each session, and 10–24 months post-treatment.</div></div><div><h3>Results</h3><div>One month after treatment, significant improvements (<em>p</em> < 0.0001) were noted in all GSM symptoms and sexual quality of life. These improvements remained significant at long-term follow-up (<em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Fractional CO₂ laser therapy is an effective, durable treatment for GSM in postmenopausal women or those with hormone-dependent cancer, significantly improving urogenital quality of life.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103121"},"PeriodicalIF":1.6,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010894","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 evaluate the efficacy and safety of early feticide for medical termination of pregnancy in women with a scarred uterus.
Methods
This was a bicentric retrospective cohort study involving women with a scarred uterus who underwent medical termination of pregnancy between 16 and 32 weeks of gestation from 2009 to 2023 at the University Hospitals of Rouen and Caen, France. Women were divided into two groups: the early feticide group (i.e. feticide performed before onset of labor), and the control group (i.e. feticide performed at onset of labor or not performed at all). The primary outcome was the rate of vaginal delivery within 12 h of onset of labor.
Results
96 women were enrolled, 22 in the early feticide group and 74 in the control group. The rate of vaginal delivery within 12 h (86.4 % vs. 75.7 %, P = 0.22) and the median onset of labor-to-delivery interval (5.12 vs. 7.37 h, P = 0.11) were comparable between the two groups. Use of misoprostol was significantly less frequent in the early feticide group than in the control group (72.7 % vs. 96 %, P = 0.004). Overall maternal morbidity was comparable between the two groups, with one case of uterine rupture reported in each group. In utero maceration rendered fetal autopsy and neuropathological analysis infeasible in the early feticide group.
Conclusion
Early feticide was not associated with a statistically significant reduction in the proportion of deliveries occurring within 12 h of labor onset; however, it was associated with reduced use of misoprostol and increased frequency of spontaneous onset of labor, without increased maternal complications.
目的：评价早期人工流产在瘢痕子宫医学终止妊娠中的疗效和安全性。方法：这是一项双中心回顾性队列研究，涉及2009年至2023年在法国鲁昂和卡昂大学医院进行妊娠16至32周药物终止妊娠的瘢痕子宫妇女。妇女被分为两组：早期堕胎组（即在分娩开始前进行堕胎）和对照组（即在分娩开始时进行堕胎或根本不进行堕胎）。主要结果是分娩开始后12小时内阴道分娩的比率。结果：96名妇女入选，早期堕胎组22名，对照组74名。两组12小时内阴道分娩率（86.4% vs. 75.7%, P = 0.22）和分娩间隔中位数（5.12 vs. 7.37 h, P = 0.11）具有可比性。早期堕胎组使用米索前列醇的频率明显低于对照组（72.7% vs. 96%, P = 0.004）。两组之间的总体产妇发病率相当，每组报告1例子宫破裂。宫内浸渍使早期堕胎组无法进行胎儿解剖和神经病理分析。结论：早期堕胎与分娩后12小时内分娩比例的降低没有统计学意义；然而，它与米索前列醇的使用减少和自然分娩频率增加有关，没有增加产妇并发症。
{"title":"Efficacy and safety of early feticide for medical termination of pregnancy in women with a scarred uterus: A bicentric retrospective cohort study","authors":"Apolline Parjadis , Éric Verspyck , Élise Machevin , Anne-Sophie Lafitte , Louise Maurey , Marine Carriou , Sophia Braund","doi":"10.1016/j.jogoh.2026.103113","DOIUrl":"10.1016/j.jogoh.2026.103113","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of early feticide for medical termination of pregnancy in women with a scarred uterus.</div></div><div><h3>Methods</h3><div>This was a bicentric retrospective cohort study involving women with a scarred uterus who underwent medical termination of pregnancy between 16 and 32 weeks of gestation from 2009 to 2023 at the University Hospitals of Rouen and Caen, France. Women were divided into two groups: the early feticide group (i.e. feticide performed before onset of labor), and the control group (i.e. feticide performed at onset of labor or not performed at all). The primary outcome was the rate of vaginal delivery within 12 h of onset of labor.</div></div><div><h3>Results</h3><div>96 women were enrolled, 22 in the early feticide group and 74 in the control group. The rate of vaginal delivery within 12 h (86.4 % vs. 75.7 %, <em>P</em> = 0.22) and the median onset of labor-to-delivery interval (5.12 vs. 7.37 h, <em>P</em> = 0.11) were comparable between the two groups. Use of misoprostol was significantly less frequent in the early feticide group than in the control group (72.7 % vs. 96 %, <em>P</em> = 0.004). Overall maternal morbidity was comparable between the two groups, with one case of uterine rupture reported in each group. In utero maceration rendered fetal autopsy and neuropathological analysis infeasible in the early feticide group.</div></div><div><h3>Conclusion</h3><div>Early feticide was not associated with a statistically significant reduction in the proportion of deliveries occurring within 12 h of labor onset; however, it was associated with reduced use of misoprostol and increased frequency of spontaneous onset of labor, without increased maternal complications.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103113"},"PeriodicalIF":1.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989644","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 : 2026-01-14DOI: 10.1016/j.jogoh.2026.103114
V Balaya, D Desseauve, A Farin, C Daelemans, P F Ceccaldi
Objectives: The primary objective was to assess the internal correlations between TeamSTEPPS behavioral domains as perceived by learners evaluating faculty performance. The secondary objective was to explore the feasibility and reproducibility of a flipped classroom model applied to interprofessional simulation-based obstetrical training.
Material and methods: This study is an ancillary analysis of the PARTUM training program («Prise en charge desAccouchements àRisque eTdesUrgencesMaternelles», Management of High-risk delivery and obstetrical emergencies). Within the flipped classroom framework, learners designed a practical case involving a pregnant woman experiencing a local anesthetics overdose during labor. Two groups of teachers were evaluated by learners according to the modified Teamwork attitude questionnaire, consisting of 16 items rated from 1 ("very below expectations") to 5 ("very above expectations").
Results: The PARTUM 2022 session included seven teachers and eighteen learners. In the pooled analysis, three items among the 16 of the Teamwork attitude questionnaire (TAQ) were found to be below expectations with a mean score lower than 3: check-back using (m= 2.75 ± 0.84), callouts using (m= 2.91 ± 0.81) and appropriate task delegation or assignments (m= 2.95 ± 0.74). No significant differences were found between groups 1 and 2. Leadership was strongly correlated to team structure (r= 0.701, p< 0.001), situation monitoring (r= 0.651, p= 0.001), and team communication (r= 0.576, p= 0.005).
Conclusion: This study showed that a flipped classroom simulation was feasible and reproducible for interprofessional teaching of obstetric emergencies. Leadership appeared as the cornerstone of the teamwork.
{"title":"A feasibility study of flipped classroom and TeamSTEPPS integration for obstetrical emergency simulations: Insights from the PARTUM group study.","authors":"V Balaya, D Desseauve, A Farin, C Daelemans, P F Ceccaldi","doi":"10.1016/j.jogoh.2026.103114","DOIUrl":"https://doi.org/10.1016/j.jogoh.2026.103114","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective was to assess the internal correlations between TeamSTEPPS behavioral domains as perceived by learners evaluating faculty performance. The secondary objective was to explore the feasibility and reproducibility of a flipped classroom model applied to interprofessional simulation-based obstetrical training.</p><p><strong>Material and methods: </strong>This study is an ancillary analysis of the PARTUM training program («Prise en charge desAccouchements àRisque eTdesUrgencesMaternelles», Management of High-risk delivery and obstetrical emergencies). Within the flipped classroom framework, learners designed a practical case involving a pregnant woman experiencing a local anesthetics overdose during labor. Two groups of teachers were evaluated by learners according to the modified Teamwork attitude questionnaire, consisting of 16 items rated from 1 (\"very below expectations\") to 5 (\"very above expectations\").</p><p><strong>Results: </strong>The PARTUM 2022 session included seven teachers and eighteen learners. In the pooled analysis, three items among the 16 of the Teamwork attitude questionnaire (TAQ) were found to be below expectations with a mean score lower than 3: check-back using (m= 2.75 ± 0.84), callouts using (m= 2.91 ± 0.81) and appropriate task delegation or assignments (m= 2.95 ± 0.74). No significant differences were found between groups 1 and 2. Leadership was strongly correlated to team structure (r= 0.701, p< 0.001), situation monitoring (r= 0.651, p= 0.001), and team communication (r= 0.576, p= 0.005).</p><p><strong>Conclusion: </strong>This study showed that a flipped classroom simulation was feasible and reproducible for interprofessional teaching of obstetric emergencies. Leadership appeared as the cornerstone of the teamwork.</p>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":" ","pages":"103114"},"PeriodicalIF":1.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989672","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 : 2026-01-13DOI: 10.1016/j.jogoh.2026.103112
Helyett Ollivier , Valérie Malan , Raphael Bartin , Jean-Michel Dupont , Julien Stirnemann , Yves Ville , Matthieu Dap
Introduction
In most European countries, if the risk of trisomy 21 exceeds 1/50, Women are offered further investigation through an invasive test. Since the development of the non-invasive test based on circulating free DNA from the entire genome (cfDNA), the use of non-invasive tests in this high-risk population is now being debated. Our study aims to investigate a cohort of women at high risk of isolated trisomy 21 with no ultrasound abnormalities at the first trimester ultrasound scan or nuchal translucency greater than the 99th percentile who underwent invasive sampling with chromosomal microarray analysis (CMA).
Material and methods
This retrospective cohort included 159 women with isolated high-risk of Trisomy 21 (T21) screening who underwent invasive testing with CMA between 2017 and 2023. We described chromosomal abnormalities and explored associations with first-trimester markers and ultrasound findings.
Results
Chromosomal abnormalities were identified in 24% of cases (38/159), including twenty-seven trisomy 21, two trisomy 18, four true fetal mosaicisms (one trisomy 22, two trisomy 16, and one monosomy X), two cases of confined placental mosaicism (trisomy 22 and trisomy 13), and three copy number variants (two likely benign and one pathogenic). Low PAPP-A levels were significantly associated with chromosomal imbalance (p < 0.001).
Conclusion
In a population of women with a high risk of trisomy 21 but without nuchal translucency greater than the 99th percentile or ultrasound signs at the first trimester, the rate of chromosomal abnormalities is 24%. Although these abnormalities are heterogeneous, the majority are aneuploidy; with only large CNVs of 13.9 Mb having a poor neurodevelopmental prognosis.
{"title":"Chromosomal abnormalities diagnosed at the chromosomal microarray in pregnancies with isolated high risk of trisomy 21","authors":"Helyett Ollivier , Valérie Malan , Raphael Bartin , Jean-Michel Dupont , Julien Stirnemann , Yves Ville , Matthieu Dap","doi":"10.1016/j.jogoh.2026.103112","DOIUrl":"10.1016/j.jogoh.2026.103112","url":null,"abstract":"<div><h3>Introduction</h3><div>In most European countries, if the risk of trisomy 21 exceeds 1/50, Women are offered further investigation through an invasive test. Since the development of the non-invasive test based on circulating free DNA from the entire genome (cfDNA), the use of non-invasive tests in this high-risk population is now being debated. Our study aims to investigate a cohort of women at high risk of isolated trisomy 21 with no ultrasound abnormalities at the first trimester ultrasound scan or nuchal translucency greater than the 99th percentile who underwent invasive sampling with chromosomal microarray analysis (CMA).</div></div><div><h3>Material and methods</h3><div>This retrospective cohort included 159 women with isolated high-risk of Trisomy 21 (T21) screening who underwent invasive testing with CMA between 2017 and 2023. We described chromosomal abnormalities and explored associations with first-trimester markers and ultrasound findings.</div></div><div><h3>Results</h3><div>Chromosomal abnormalities were identified in 24% of cases (38/159), including twenty-seven trisomy 21, two trisomy 18, four true fetal mosaicisms (one trisomy 22, two trisomy 16, and one monosomy X), two cases of confined placental mosaicism (trisomy 22 and trisomy 13), and three copy number variants (two likely benign and one pathogenic). Low PAPP-A levels were significantly associated with chromosomal imbalance (<em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>In a population of women with a high risk of trisomy 21 but without nuchal translucency greater than the 99th percentile or ultrasound signs at the first trimester, the rate of chromosomal abnormalities is 24%. Although these abnormalities are heterogeneous, the majority are aneuploidy; with only large CNVs of 13.9 Mb having a poor neurodevelopmental prognosis.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103112"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989647","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 : 2026-01-13DOI: 10.1016/j.jogoh.2026.103111
Amélie Sarribouette , Antoine Netter , Véronique Lejeune , Alain Proust , Emmanuel Peigné , Philippe Boisselier , Aubert Agostini
Objective
Complications of operative hysteroscopy (OH) are rare and usually minor. However, in rare cases, certain complications such as gas embolism (GE) can be life-threatening. The objective of this study was to analyze the circumstances and outcomes of GE cases occurring during OH.
Materials and Methods
This retrospective descriptive observational study included all cases of GE during OH reported between 2016 and 2023 in the experience feedback (REX) database of Gynerisq, an organization accredited in risk management in Gynecology and Obstetrics by the French National Authority for Health (HAS).
Results
Among 318 reported OH complications, 14 cases of GE were identified (4.4%). The procedures involved fibroid resection in 11 patients (78.6%) and endometrectomy in 3 patients (21.4%). Bipolar energy was used in all cases. Of the 14 GE cases, 5 had serious consequences, including cardiac arrest and intensive care unit (ICU) admission. Eight cases were considered probably avoidable by the reporting practitioners, particularly due to non-compliance with the recommendations of the French National College of Gynecologists and Obstetricians (CNGOF), such as unpurged tubing and failure to monitor intrauterine pressure.
Conclusion
This analysis shows that all reported GEs occurred during procedures using bipolar energy and following fibroid or endometrial resection. However, a causal relationship between bipolar energy and GE cannot be established. Further studies are required to assess the role of bipolar energy and the conditions of its use in the occurrence of GE.
{"title":"Gas embolism during operative hysteroscopy: Analysis of the Gynerisq experience feedback database","authors":"Amélie Sarribouette , Antoine Netter , Véronique Lejeune , Alain Proust , Emmanuel Peigné , Philippe Boisselier , Aubert Agostini","doi":"10.1016/j.jogoh.2026.103111","DOIUrl":"10.1016/j.jogoh.2026.103111","url":null,"abstract":"<div><h3>Objective</h3><div>Complications of operative hysteroscopy (OH) are rare and usually minor. However, in rare cases, certain complications such as gas embolism (GE) can be life-threatening. The objective of this study was to analyze the circumstances and outcomes of GE cases occurring during OH.</div></div><div><h3>Materials and Methods</h3><div>This retrospective descriptive observational study included all cases of GE during OH reported between 2016 and 2023 in the experience feedback (REX) database of Gynerisq, an organization accredited in risk management in Gynecology and Obstetrics by the French National Authority for Health (HAS).</div></div><div><h3>Results</h3><div>Among 318 reported OH complications, 14 cases of GE were identified (4.4%). The procedures involved fibroid resection in 11 patients (78.6%) and endometrectomy in 3 patients (21.4%). Bipolar energy was used in all cases. Of the 14 GE cases, 5 had serious consequences, including cardiac arrest and intensive care unit (ICU) admission. Eight cases were considered probably avoidable by the reporting practitioners, particularly due to non-compliance with the recommendations of the French National College of Gynecologists and Obstetricians (CNGOF), such as unpurged tubing and failure to monitor intrauterine pressure.</div></div><div><h3>Conclusion</h3><div>This analysis shows that all reported GEs occurred during procedures using bipolar energy and following fibroid or endometrial resection. <u>However, a causal relationship between bipolar energy and GE cannot be established.</u> Further studies are required to assess the role of bipolar energy and the conditions of its use in the occurrence of GE.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103111"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988237","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 : 2026-01-13DOI: 10.1016/j.jogoh.2026.103110
Wei Luo , Xiaoyan Huang , Xiaoyan Qin , Hui Zhang , Yu-Lan Mu
Retrorectal ectopic pregnancy is an extremely rare form of ectopic pregnancy. Early detection and treatment can prevent the risk of massive bleeding. The pathogenesis is unclear. Currently, only one case of retrorectal ectopic pregnancy treated with MTX has been reported. We report the second case of retrorectal ectopic pregnancy treated with laparoscopic surgery under real-time intraoperative ultrasound guidance, achieving complete resection with minimal trauma and rapid recovery. This approach offers new insights into the diagnosis and treatment of this condition.
{"title":"A case report of an extremely rare retrorectal ectopic pregnancy: Diagnostic and therapeutic challenges","authors":"Wei Luo , Xiaoyan Huang , Xiaoyan Qin , Hui Zhang , Yu-Lan Mu","doi":"10.1016/j.jogoh.2026.103110","DOIUrl":"10.1016/j.jogoh.2026.103110","url":null,"abstract":"<div><div>Retrorectal ectopic pregnancy is an extremely rare form of ectopic pregnancy. Early detection and treatment can prevent the risk of massive bleeding. The pathogenesis is unclear. Currently, only one case of retrorectal ectopic pregnancy treated with MTX has been reported. We report the second case of retrorectal ectopic pregnancy treated with laparoscopic surgery under real-time intraoperative ultrasound guidance, achieving complete resection with minimal trauma and rapid recovery. This approach offers new insights into the diagnosis and treatment of this condition.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103110"},"PeriodicalIF":1.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989619","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 : 2026-01-12DOI: 10.1016/j.jogoh.2026.103109
Clément Wulveryck, Eva Van Steijvoort, Nicolas Sananès, Romain Demailly, Paulo Rodrigues
Objective: Cell-free DNA (cfDNA) screening test has been reimbursed in France since 2019 as part of the national trisomy 21 (T21) screening program. The expansion of cfDNA sequencing in September 2024 to include additional chromosomal anomalies raises new challenges for information delivery and informed consent. This study aimed to assess pregnant women's understanding of trisomy 21 prenatal screening information, distinct from satisfaction with or access to information, in light of these developments.
Study design: A cross-sectional online survey was conducted in August-September 2024 among women aged ≥18 years who had experienced at least one pregnancy since January 2019. Participants were recruited via Instagram and targeted mailing. The questionnaire assessed participants perceptions of the clarity, completeness, and sufficiency of T21 screening information, and included five open-ended questions to assess objective understanding. A comprehension score (0-10) was calculated using semantic analysis (BERT model) and predefined criteria. Associations between comprehension and sociodemographic factors were examined.
Results: Among 2,146 respondents, 94.5% received information from a healthcare professional. Within this group, 35.6% sought additional sources. Only 43.8% judged the information as very clear, and less than 30% considered it sufficient or complete. The median comprehension score was 2.6 out of10. Misconceptions were common, notably the confusion between screening and diagnosis. Higher comprehension was significantly associated with full-time employment (p = .001), higher education level (p < .001), and multiparity (p = .003).
Conclusion: Although most women received information from a healthcare professional, both their perceived and actual comprehension of trisomy 21 screening, especially regarding cfDNA screening test, remained limited. These findings highlight the need for improved communication tools and tailored support to ensure informed decision-making across diverse populations.
{"title":"Understanding of trisomy 21 prenatal screening among pregnant women in France: a cross-sectional study in light of 2019 guidelines.","authors":"Clément Wulveryck, Eva Van Steijvoort, Nicolas Sananès, Romain Demailly, Paulo Rodrigues","doi":"10.1016/j.jogoh.2026.103109","DOIUrl":"https://doi.org/10.1016/j.jogoh.2026.103109","url":null,"abstract":"<p><strong>Objective: </strong>Cell-free DNA (cfDNA) screening test has been reimbursed in France since 2019 as part of the national trisomy 21 (T21) screening program. The expansion of cfDNA sequencing in September 2024 to include additional chromosomal anomalies raises new challenges for information delivery and informed consent. This study aimed to assess pregnant women's understanding of trisomy 21 prenatal screening information, distinct from satisfaction with or access to information, in light of these developments.</p><p><strong>Study design: </strong>A cross-sectional online survey was conducted in August-September 2024 among women aged ≥18 years who had experienced at least one pregnancy since January 2019. Participants were recruited via Instagram and targeted mailing. The questionnaire assessed participants perceptions of the clarity, completeness, and sufficiency of T21 screening information, and included five open-ended questions to assess objective understanding. A comprehension score (0-10) was calculated using semantic analysis (BERT model) and predefined criteria. Associations between comprehension and sociodemographic factors were examined.</p><p><strong>Results: </strong>Among 2,146 respondents, 94.5% received information from a healthcare professional. Within this group, 35.6% sought additional sources. Only 43.8% judged the information as very clear, and less than 30% considered it sufficient or complete. The median comprehension score was 2.6 out of10. Misconceptions were common, notably the confusion between screening and diagnosis. Higher comprehension was significantly associated with full-time employment (p = .001), higher education level (p < .001), and multiparity (p = .003).</p><p><strong>Conclusion: </strong>Although most women received information from a healthcare professional, both their perceived and actual comprehension of trisomy 21 screening, especially regarding cfDNA screening test, remained limited. These findings highlight the need for improved communication tools and tailored support to ensure informed decision-making across diverse populations.</p>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":" ","pages":"103109"},"PeriodicalIF":1.6,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984935","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":"PROVAXHPV-3 - School nurse empowerment in HPV vaccination in middle school: Study protocol for a randomized controlled trial evaluating the optimal/most effective strategy comparing the best vaccination strategy in French 7th graders","authors":"Kiara Souletie , Kevin Diallo , Emmanuel Chirpaz , Patricia Villain , Jessica Sambourg , Phuong Lien Tran , Antoine Bertolotti","doi":"10.1016/j.jogoh.2025.103100","DOIUrl":"10.1016/j.jogoh.2025.103100","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103100"},"PeriodicalIF":1.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948857","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