Pub Date : 2025-12-23DOI: 10.1016/j.jogoh.2025.103098
Hengying Chen , Zhehao Wu , Ze Bo , Mingshan Liu
{"title":"Comment on “Evaluating the applicability of ESGO quality indicators in the surgical management of endometrial cancer: Insights from a Francogyn cohort”","authors":"Hengying Chen , Zhehao Wu , Ze Bo , Mingshan Liu","doi":"10.1016/j.jogoh.2025.103098","DOIUrl":"10.1016/j.jogoh.2025.103098","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103098"},"PeriodicalIF":1.6,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834026","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}
Placenta accreta spectrum (PAS) disorders are increasingly encountered due to the rise in cesarean deliveries and uterine surgeries. In patients with no future fertility desire, planned cesarean hysterectomy may be the most appropriate approach. We report the case of a 37-year-old woman with anterior placenta previa and suspected PAS, managed through a scheduled cesarean hysterectomy following multidisciplinary assessment. Key surgical steps are demonstrated through five didactic video sequences. The procedure was completed without complications, and histology confirmed placenta increta. The patient recovered uneventfully and was discharged on postoperative day seven. This video-enhanced technical note illustrates a structured surgical strategy and highlights important pre-, intra-, and postoperative considerations in PAS cases.
{"title":"Structured approach to one-step cesarean hysterectomy for placenta accreta spectrum: A video-based technical note","authors":"Pierre Carvelli , Mona Massoud , Océane Lablanche , Fabienne Allias , Edouard Ruaux , Pascal Rousset , François Golfier , Pierre-Adrien Bolze","doi":"10.1016/j.jogoh.2025.103096","DOIUrl":"10.1016/j.jogoh.2025.103096","url":null,"abstract":"<div><div>Placenta accreta spectrum (PAS) disorders are increasingly encountered due to the rise in cesarean deliveries and uterine surgeries. In patients with no future fertility desire, planned cesarean hysterectomy may be the most appropriate approach. We report the case of a 37-year-old woman with anterior placenta previa and suspected PAS, managed through a scheduled cesarean hysterectomy following multidisciplinary assessment. Key surgical steps are demonstrated through five didactic video sequences. The procedure was completed without complications, and histology confirmed placenta increta. The patient recovered uneventfully and was discharged on postoperative day seven. This video-enhanced technical note illustrates a structured surgical strategy and highlights important pre-, intra-, and postoperative considerations in PAS cases.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103096"},"PeriodicalIF":1.6,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827899","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 : 2025-12-22DOI: 10.1016/j.jogoh.2025.103097
Yan An , Yamin Zhao , Hongli Wu , Shuhui Zhao , Hongjie Li
Background
Severe postpartum hemorrhage (sPPH) remains a leading cause of preventable maternal morbidity. We evaluated whether a combined early postpartum model incorporating Shock Index (SI), lactate, and fibrinogen improves 24 h sPPH prediction compared with any single marker.
Methods
In this single-center cohort study (January 2019–December 2024), we included deliveries at ≥24 weeks’ gestation in which the first postpartum heart rate and systolic blood pressure (to calculate SI), lactate, and Clauss fibrinogen were all measured within 2 h after placental delivery. The primary outcome was sPPH within 24 h, defined as quantified blood loss ≥1000 mL or bleeding accompanied by hypovolemia. We developed a ridge-penalized logistic regression model using SI, lactate, and fibrinogen and performed internal validation with 1000 bootstrap resamples. We reported discrimination (AUC), calibration (slope and intercept), and Brier score. Single-marker AUCs were compared with the combined model using paired DeLong tests with false discovery rate (FDR) control. Decision-curve analysis evaluated clinical utility at 1%, 2%, and 5% risk thresholds.
Results
Among 12,242 deliveries, 172 sPPH events occurred (1.4%). The median time from placental delivery to sampling was 54 min (IQR 40–78). The combined model achieved an AUC of 0.82 (95% CI 0.77–0.87), with good calibration (slope 0.95; intercept −0.01) and a Brier score of 0.0066. Single-marker AUCs were 0.69 for SI, 0.73 for lactate, and 0.77 for fibrinogen; all were significantly lower than the combined model (FDR-adjusted q ≤ 0.01). At 1%, 2%, and 5% thresholds, sensitivity/specificity were 90.1%/60.0%, 76.2%/82.0%, and 55.2%/93.0%, with net benefit 0.0023, 0.0017, and 0.0002, respectively.
Conclusions
A simple early postpartum model combining SI, lactate, and fibrinogen provided better discrimination than any single marker, with good calibration and positive clinical utility at low-risk thresholds. Multicenter external validation and prospective impact evaluation are warranted before clinical implementation.
背景：严重产后出血（sPPH）仍然是可预防的产妇发病率的主要原因。我们评估了与任何单一指标相比，结合休克指数（SI）、乳酸和纤维蛋白原的产后早期联合模型是否能改善24小时sPPH预测。方法：在这项单中心队列研究（2019年1月- 2024年12月）中，我们纳入了妊娠≥24周的分娩，其中首次产后心率和收缩压（用于计算SI）、乳酸和克劳斯纤维蛋白原均在胎盘分娩后2小时内测量。主要终点为24小时内sPPH，定义为定量失血量≥1,000 mL或出血伴低血容量。我们使用SI、乳酸盐和纤维蛋白原开发了一个脊惩罚逻辑回归模型，并使用1,000个bootstrap样本进行了内部验证。我们报道了辨别（AUC）、校准（斜率和截距）和Brier评分。将单标记auc与组合模型进行比较，使用配对DeLong检验并控制错误发现率（FDR）。决策曲线分析在1%、2%和5%的风险阈值下评估临床效用。结果：在12242例分娩中，发生172例sPPH事件（1.4%）。从胎盘娩出到取样的中位时间为54分钟（IQR 40-78）。联合模型的AUC为0.82 (95% CI 0.77-0.87)，具有良好的校准（斜率0.95，截距-0.01），Brier评分为0.0066。SI的单标记auc为0.69，乳酸为0.73，纤维蛋白原为0.77；均显著低于联合模型（经fdr校正q≤0.01）。在1%、2%和5%阈值下，敏感性/特异性分别为90.1%/60.0%、76.2%/82.0%和55.2%/93.0%，净获益分别为0.0023、0.0017和0.0002。结论：一个简单的产后早期模型结合SI，乳酸和纤维蛋白原比任何单一的指标提供更好的鉴别，具有良好的校准和积极的临床应用在低风险阈值。在临床实施之前，需要进行多中心外部验证和前瞻性影响评估。
{"title":"Predictive value of early postpartum shock index combined with lactate and fibrinogen for severe postpartum hemorrhage","authors":"Yan An , Yamin Zhao , Hongli Wu , Shuhui Zhao , Hongjie Li","doi":"10.1016/j.jogoh.2025.103097","DOIUrl":"10.1016/j.jogoh.2025.103097","url":null,"abstract":"<div><h3>Background</h3><div>Severe postpartum hemorrhage (sPPH) remains a leading cause of preventable maternal morbidity. We evaluated whether a combined early postpartum model incorporating Shock Index (SI), lactate, and fibrinogen improves 24 h sPPH prediction compared with any single marker.</div></div><div><h3>Methods</h3><div>In this single-center cohort study (January 2019–December 2024), we included deliveries at ≥24 weeks’ gestation in which the first postpartum heart rate and systolic blood pressure (to calculate SI), lactate, and Clauss fibrinogen were all measured within 2 h after placental delivery. The primary outcome was sPPH within 24 h, defined as quantified blood loss ≥1000 mL or bleeding accompanied by hypovolemia. We developed a ridge-penalized logistic regression model using SI, lactate, and fibrinogen and performed internal validation with 1000 bootstrap resamples. We reported discrimination (AUC), calibration (slope and intercept), and Brier score. Single-marker AUCs were compared with the combined model using paired DeLong tests with false discovery rate (FDR) control. Decision-curve analysis evaluated clinical utility at 1%, 2%, and 5% risk thresholds.</div></div><div><h3>Results</h3><div>Among 12,242 deliveries, 172 sPPH events occurred (1.4%). The median time from placental delivery to sampling was 54 min (IQR 40–78). The combined model achieved an AUC of 0.82 (95% CI 0.77–0.87), with good calibration (slope 0.95; intercept −0.01) and a Brier score of 0.0066. Single-marker AUCs were 0.69 for SI, 0.73 for lactate, and 0.77 for fibrinogen; all were significantly lower than the combined model (FDR-adjusted <em>q</em> ≤ 0.01). At 1%, 2%, and 5% thresholds, sensitivity/specificity were 90.1%/60.0%, 76.2%/82.0%, and 55.2%/93.0%, with net benefit 0.0023, 0.0017, and 0.0002, respectively.</div></div><div><h3>Conclusions</h3><div>A simple early postpartum model combining SI, lactate, and fibrinogen provided better discrimination than any single marker, with good calibration and positive clinical utility at low-risk thresholds. Multicenter external validation and prospective impact evaluation are warranted before clinical implementation.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103097"},"PeriodicalIF":1.6,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827812","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 : 2025-12-19DOI: 10.1016/j.jogoh.2025.103095
Anne Murarasu , Grégoire Martin de Frémont , Gaelle Guettrot-Imbert , Nathalie Morel , Emmanuelle Pannier , Adriana Costin-Mihai , Nathalie Costedoat Chalumeau , Véronique Le Guern
Antiphospholipid syndrome (APS) is characterised by thrombotic, obstetric and/or systemic manifestations associated with antiphospholipid antibodies (aPL). The definition of APS manifestations has been imprecise, resulting in heterogeneous study populations and in limited and inconsistent data, particularly for obstetric APS. In 2023, the American College of Rheumatology and the European League Against Rheumatism introduced new classification criteria that prioritize specificity over sensitivity.
Obstetric APS manifestations are mainly the consequence of preeclampsia and placental insufficiency, often early and severe, leading to fetal growth restriction, fetal death, induced prematurity or maternal morbidity. Accordingly, in the new classification criteria, isolated fetal death without preeclampsia and/or placental insufficiency has little significance. The biological definition remains unchanged, requiring persistent aPL. Isolated anticardiolipin or anti-β2-glycoprotein-I antibodies of the IgM isotype or anticardiolipin or anti-β2-glycoprotein-I antibodies of the IgG isotype <40 GPL are no longer sufficient for the classification of APS due to their weak association with clinical manifestations. Lupus anticoagulant is the strongest risk factor for thromboses and adverse obstetric outcomes.
Despite adequate treatment, pregnancies in these patients still carry a significant risk of preeclampsia, placental insufficiency, thrombosis and haemorrhagic events, those events being frequently associated and occurring mainly in the peripartum period, and in women with lupus anticoagulant. In the future, inclusion of individuals using these new classification criteria should ensure more homogeneity in APS trials, especially for obstetric APS. Importantly, these criteria were not designed for diagnosis, thus, in clinical practice, the risks and benefits of modifying the treatment of patients falling out of the 2023 criteria should be weighed by the clinicians (e.g. using aPL profile) and carefully explained to the patient.
{"title":"New ACR/EULAR 2023 classification criteria for antiphospholipid syndrome, what should a gynaecologist know in 2025","authors":"Anne Murarasu , Grégoire Martin de Frémont , Gaelle Guettrot-Imbert , Nathalie Morel , Emmanuelle Pannier , Adriana Costin-Mihai , Nathalie Costedoat Chalumeau , Véronique Le Guern","doi":"10.1016/j.jogoh.2025.103095","DOIUrl":"10.1016/j.jogoh.2025.103095","url":null,"abstract":"<div><div>Antiphospholipid syndrome (APS) is characterised by thrombotic, obstetric and/or systemic manifestations associated with antiphospholipid antibodies (aPL). The definition of APS manifestations has been imprecise, resulting in heterogeneous study populations and in limited and inconsistent data, particularly for obstetric APS. In 2023, the American College of Rheumatology and the European League Against Rheumatism introduced new classification criteria that prioritize specificity over sensitivity.</div><div>Obstetric APS manifestations are mainly the consequence of preeclampsia and placental insufficiency, often early and severe, leading to fetal growth restriction, fetal death, induced prematurity or maternal morbidity. Accordingly, in the new classification criteria, isolated fetal death without preeclampsia and/or placental insufficiency has little significance. The biological definition remains unchanged, requiring persistent aPL. Isolated anticardiolipin or anti-β2-glycoprotein-I antibodies of the IgM isotype or anticardiolipin or anti-β2-glycoprotein-I antibodies of the IgG isotype <40 GPL are no longer sufficient for the classification of APS due to their weak association with clinical manifestations. Lupus anticoagulant is the strongest risk factor for thromboses and adverse obstetric outcomes.</div><div>Despite adequate treatment, pregnancies in these patients still carry a significant risk of preeclampsia, placental insufficiency, thrombosis and haemorrhagic events, those events being frequently associated and occurring mainly in the peripartum period, and in women with lupus anticoagulant. In the future, inclusion of individuals using these new classification criteria should ensure more homogeneity in APS trials, especially for obstetric APS. Importantly, these criteria were not designed for diagnosis, thus, in clinical practice, the risks and benefits of modifying the treatment of patients falling out of the 2023 criteria should be weighed by the clinicians (e.g. using aPL profile) and carefully explained to the patient.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103095"},"PeriodicalIF":1.6,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804639","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 : 2025-12-15DOI: 10.1016/j.jogoh.2025.103088
Cherif Akladios , Thomas Boisramé , Camille Martel , Djanagane Mounien , Guillaume Henry , Georges Noël , Laure Waeldin , Mathilde Lapointe , Marie Lorho , Marie-Liesse Paty , Eva Fuss , Floriane Jochum , Lise Lecointre
We present the first French case of uterine transposition for fertility preservation in a 25-year-old nulligravida patient with rectovaginal extra-skeletal Ewing sarcoma. After receiving induction chemotherapy, the uterus was transposed to the upper abdomen via laparotomy. During the same procedure, a posterior pelvectomy was performed to achieve wide surgical margins for tumor removal. To mitigate digestive toxicity from subsequent pelvic radiotherapy, a breast expansion prosthesis was placed. The patient experienced regular menstruation postoperatively, indicating preserved uterine function. After completing radiochemotherapy, we successfully repositioned the uterus into the pelvis. Menstruation resumed within months of reimplantation, and a clinical examination revealed a normal-appearing cervix. This case demonstrates the feasibility and potential benefits of uterine transposition for preserving fertility in women with pelvic malignancies who require radiotherapy. Further research is needed to evaluate the long-term outcomes and reproductive potential of this procedure.
{"title":"Uterine transposition for fertility preservation in extra-skeletal ewing sarcoma: the first French case report","authors":"Cherif Akladios , Thomas Boisramé , Camille Martel , Djanagane Mounien , Guillaume Henry , Georges Noël , Laure Waeldin , Mathilde Lapointe , Marie Lorho , Marie-Liesse Paty , Eva Fuss , Floriane Jochum , Lise Lecointre","doi":"10.1016/j.jogoh.2025.103088","DOIUrl":"10.1016/j.jogoh.2025.103088","url":null,"abstract":"<div><div>We present the first French case of uterine transposition for fertility preservation in a 25-year-old nulligravida patient with rectovaginal extra-skeletal Ewing sarcoma. After receiving induction chemotherapy, the uterus was transposed to the upper abdomen via laparotomy. During the same procedure, a posterior pelvectomy was performed to achieve wide surgical margins for tumor removal. To mitigate digestive toxicity from subsequent pelvic radiotherapy, a breast expansion prosthesis was placed. The patient experienced regular menstruation postoperatively, indicating preserved uterine function. After completing radiochemotherapy, we successfully repositioned the uterus into the pelvis. Menstruation resumed within months of reimplantation, and a clinical examination revealed a normal-appearing cervix. This case demonstrates the feasibility and potential benefits of uterine transposition for preserving fertility in women with pelvic malignancies who require radiotherapy. Further research is needed to evaluate the long-term outcomes and reproductive potential of this procedure.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103088"},"PeriodicalIF":1.6,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774895","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}
Endometriosis is a frequent pathology affecting approximately 10% of the general population. Its diagnosis and management have improved in recent years. In France, a national strategy against endometriosis has been gradually developed, particularly through the establishment of regional referral networks to improve access to care. Regarding surgical management, the current trend is to define regional referral centers, although this process is still under development.
Objective
The primary objective of this study was to describe the characteristics of posterior deep infiltrating endometriosis (DIE) surgical activity in mainland France. The secondary objective was to describe patient characteristics and conditions of access to surgical care.
Materials and Methods
We performed a descriptive observational study using the French national medico-administrative database ((Program of Medicalization of Information Systems (PMSI) between January 1 and December 31, 2023. We identified all hospital stays involving posterior DIE surgery and recorded the number of procedures performed in each healthcare institution, their geographic location, and patients’ sociodemographic and clinical characteristics.
Results
In 2023, a total of 5364 hospital stays for posterior DIE surgery were recorded. We identified 339 distinct healthcare institutions that performed at least one hospital stay for posterior DIE surgery. The annual mean number of surgeries was 16.6 (±50.8 SD) per healthcare institution, but activity was highly concentrated, with fewer than 20% of healthcare institutions performing 80% of all surgeries nationwide. Mapping revealed that most surgeries were performed in major urban centers, leaving some regions with limited access. The average distance between patients’ residence and treating healthcare institution was 46.5 km (±51.6), corresponding to an average driving time of 34.3 minutes (±31.6). Social deprivation markers (universal health insurance (UHI) (p=0,019) and complementary universal health insurance (UHIc) (p<0.0001)) and higher Charlson comorbidity score were significantly more frequent in patients treated in public or nonprofit private institutions compared to private institutions (p<0.0001).
Conclusion
Posterior DIE surgical activity in France is unevenly distributed both in volume and geography. A collective reorganization is needed to ensure equitable access while maintaining high-quality surgical care.
{"title":"Posterior deep infiltrating endometriosis surgery: current status and mapping of care in France","authors":"Audrey PIVANO , Vanessa PAULY , Nicolas PIRRO , Laurent BOYER , Julie BERBIS , Aubert AGOSTINI","doi":"10.1016/j.jogoh.2025.103086","DOIUrl":"10.1016/j.jogoh.2025.103086","url":null,"abstract":"<div><h3>Background</h3><div>Endometriosis is a frequent pathology affecting approximately 10% of the general population. Its diagnosis and management have improved in recent years. In France, a national strategy against endometriosis has been gradually developed, particularly through the establishment of regional referral networks to improve access to care. Regarding surgical management, the current trend is to define regional referral centers, although this process is still under development.</div></div><div><h3>Objective</h3><div>The primary objective of this study was to describe the characteristics of posterior deep infiltrating endometriosis (DIE) surgical activity in mainland France. The secondary objective was to describe patient characteristics and conditions of access to surgical care.</div></div><div><h3>Materials and Methods</h3><div>We performed a descriptive observational study using the French national medico-administrative database ((Program of Medicalization of Information Systems (PMSI) between January 1 and December 31, 2023. We identified all hospital stays involving posterior DIE surgery and recorded the number of procedures performed in each healthcare institution, their geographic location, and patients’ sociodemographic and clinical characteristics.</div></div><div><h3>Results</h3><div>In 2023, a total of 5364 hospital stays for posterior DIE surgery were recorded. We identified 339 distinct healthcare institutions that performed at least one hospital stay for posterior DIE surgery. The annual mean number of surgeries was 16.6 (±50.8 SD) per healthcare institution, but activity was highly concentrated, with fewer than 20% of healthcare institutions performing 80% of all surgeries nationwide. Mapping revealed that most surgeries were performed in major urban centers, leaving some regions with limited access. The average distance between patients’ residence and treating healthcare institution was 46.5 km (±51.6), corresponding to an average driving time of 34.3 minutes (±31.6). Social deprivation markers (universal health insurance (UHI) (p=0,019) and complementary universal health insurance (UHIc) (p<0.0001)) and higher Charlson comorbidity score were significantly more frequent in patients treated in public or nonprofit private institutions compared to private institutions (p<0.0001).</div></div><div><h3>Conclusion</h3><div>Posterior DIE surgical activity in France is unevenly distributed both in volume and geography. A collective reorganization is needed to ensure equitable access while maintaining high-quality surgical care.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103086"},"PeriodicalIF":1.6,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774914","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 : 2025-12-15DOI: 10.1016/j.jogoh.2025.103087
Karen C. Schliep , May Shaaban , Emmanuel Adediran , Anna Z. Pollack , Kathryn M. Rexrode , Rachael Hemmert , Madeline Paulsen , Jessica Treidl , Hediyeh Baradaran , Jennifer J. Majersik , Michael W. Varner , C. Matthew Peterson , Joseph B. Stanford , Jenna R. Krall , Jessica M. Page , Leslie V. Farland
Background
Endometriosis has been linked to cardiometabolic alterations, but whether these associations vary by disease severity or phenotype is unclear. We examined lipid profiles across endometriosis diagnosis, stage, and typology.
Material and methods
Data came from 476 women in the NICHD ENDO cohort. Endometriosis was confirmed laparoscopically and staged using the rASRM criteria (I−IV). Typology was categorized as superficial endometriosis (SE), ovarian endometrioma (OE), deep infiltrating endometriosis (DE), and OE+DE. We compared endometriosis status, stage (I/II vs III/IV), and typology to no endometriosis using adverse lipid thresholds (total cholesterol ≥200 mg/dL, HDL <50 mg/dL, LDL ≥100 mg/dL, triglycerides ≥175 mg/dL, non-HDL ≥130 mg/dL, VLDL ≥30 mg/dL, ApoA1 <125 mg/dL, and ApoB ≥120 mg/dL). Adjusted prevalence ratios (aPR) and 95 % CIs were estimated via generalized linear models, controlling for age, race/ethnicity, BMI, income, marital status, and serum cotinine.
Results
Endometriosis diagnosis alone was not associated with adverse lipid profiles. In contrast, moderate/severe disease showed higher prevalence of elevated triglycerides (aPR= 2.27; 95 % CI: 1.18,4.35) and VLDL (aPR= 2.41; 95 % CI: 1.50, 3.85). Typology revealed stronger patterns: OE and OE+DE were associated with adverse profiles across multiple markers (aPRs 1.59–4.09), particularly ApoB and triglycerides. Minimal/mild disease and SE were not associated.
Conclusions
The metabolic signal was phenotype-driven rather than diagnosis-driven, with severe stage and OE/OE+DE showing clear associations with adverse lipid profiles. These findings suggest lipid profiles may serve as markers of phenotype severity or shared biological milieu. Replication in larger cohorts is needed.
{"title":"Endometriosis phenotypes and staging in relation to lipid biomarkers: Findings from the ENDO Cohort Study","authors":"Karen C. Schliep , May Shaaban , Emmanuel Adediran , Anna Z. Pollack , Kathryn M. Rexrode , Rachael Hemmert , Madeline Paulsen , Jessica Treidl , Hediyeh Baradaran , Jennifer J. Majersik , Michael W. Varner , C. Matthew Peterson , Joseph B. Stanford , Jenna R. Krall , Jessica M. Page , Leslie V. Farland","doi":"10.1016/j.jogoh.2025.103087","DOIUrl":"10.1016/j.jogoh.2025.103087","url":null,"abstract":"<div><h3>Background</h3><div>Endometriosis has been linked to cardiometabolic alterations, but whether these associations vary by disease severity or phenotype is unclear. We examined lipid profiles across endometriosis diagnosis, stage, and typology.</div></div><div><h3>Material and methods</h3><div>Data came from 476 women in the NICHD ENDO cohort. Endometriosis was confirmed laparoscopically and staged using the rASRM criteria (<em>I</em>−IV). Typology was categorized as superficial endometriosis (SE), ovarian endometrioma (OE), deep infiltrating endometriosis (DE), and OE+DE. We compared endometriosis status, stage (I/II vs III/IV), and typology to no endometriosis using adverse lipid thresholds (total cholesterol ≥200 mg/dL, HDL <50 mg/dL, LDL ≥100 mg/dL, triglycerides ≥175 mg/dL, non-HDL ≥130 mg/dL, VLDL ≥30 mg/dL, ApoA1 <125 mg/dL, and ApoB ≥120 mg/dL). Adjusted prevalence ratios (aPR) and 95 % CIs were estimated via generalized linear models, controlling for age, race/ethnicity, BMI, income, marital status, and serum cotinine.</div></div><div><h3>Results</h3><div>Endometriosis diagnosis alone was not associated with adverse lipid profiles. In contrast, moderate/severe disease showed higher prevalence of elevated triglycerides (aPR= 2.27; 95 % CI: 1.18,4.35) and VLDL (aPR= 2.41; 95 % CI: 1.50, 3.85). Typology revealed stronger patterns: OE and OE+DE were associated with adverse profiles across multiple markers (aPRs 1.59–4.09), particularly ApoB and triglycerides. Minimal/mild disease and SE were not associated.</div></div><div><h3>Conclusions</h3><div>The metabolic signal was phenotype-driven rather than diagnosis-driven, with severe stage and OE/OE+DE showing clear associations with adverse lipid profiles. These findings suggest lipid profiles may serve as markers of phenotype severity or shared biological milieu. Replication in larger cohorts is needed.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103087"},"PeriodicalIF":1.6,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774884","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 : 2025-12-13DOI: 10.1016/j.jogoh.2025.103085
Margaux Lebreton , Martin Willemart , Julie Marcadet , Malik Boukerrou , Capucine Benoit de coignac , Phuong Lien Tran
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Pub Date : 2025-12-13DOI: 10.1016/j.jogoh.2025.103084
Diane Brebant , Olivier Picone , Nadja van Ginneken , Christelle Vauloup-Fellous , Nicolas Vignier
Background
Screening of some infectious diseases is consistently recommended during pregnancy in France. Although Human T lymphotropic virus type 1 (HTLV-1) infection is a contraindication for breastfeeding, its screening is not routinely recommended as it is uncommon in a native mainland French population. However, HTLV-1 screening should be recommended among women from endemic countries. This study aims to evaluate HTLV-1 knowledge and screening practices of French healthcare professionals among pregnant women.
Methods
A French national professional practice evaluation study was conducted in 2022. An electronic questionnaire was distributed to midwives, gynecologists, and general practitioners in partnership with medical societies, and hospitals.
Results
A total of 936 participants were included, 75.4% (n=706) of whom were midwives and 21.8% were gynecologists (n=204). Among the participants, 62.1% had outpatient practice and 71.1% had never received previous specific training in obstetric infectious diseases. Only 27.5% of participants reported HTLV-1 as a contraindication to breastfeeding. Of these, a significant proportion had prior specific training in obstetric infectious diseases and practiced in the Paris region or endemic French overseas territories. Knowledge of countries that should lead to HTLV-1 screening was limited and appeared to vary among participants.
Conclusion
This national practice evaluation study highlighted the widespread lack of awareness of the issue of HTLV-1 infection. Further studies are needed to assess HTLV-1 seroprevalence in pregnant women (in France or similar European countries), and to evaluate relevance of targeted screening and psychological impact of a positive diagnosis.
{"title":"HTLV-1, a neglected disease among breastfeeding women from endemic areas: a national survey of knowledge and screening practices in France","authors":"Diane Brebant , Olivier Picone , Nadja van Ginneken , Christelle Vauloup-Fellous , Nicolas Vignier","doi":"10.1016/j.jogoh.2025.103084","DOIUrl":"10.1016/j.jogoh.2025.103084","url":null,"abstract":"<div><h3>Background</h3><div>Screening of some infectious diseases is consistently recommended during pregnancy in France. Although Human T lymphotropic virus type 1 (HTLV-1) infection is a contraindication for breastfeeding, its screening is not routinely recommended as it is uncommon in a native mainland French population. However, HTLV-1 screening should be recommended among women from endemic countries. This study aims to evaluate HTLV-1 knowledge and screening practices of French healthcare professionals among pregnant women.</div></div><div><h3>Methods</h3><div>A French national professional practice evaluation study was conducted in 2022. An electronic questionnaire was distributed to midwives, gynecologists, and general practitioners in partnership with medical societies, and hospitals.</div></div><div><h3>Results</h3><div>A total of 936 participants were included, 75.4% (n=706) of whom were midwives and 21.8% were gynecologists (n=204). Among the participants, 62.1% had outpatient practice and 71.1% had never received previous specific training in obstetric infectious diseases. Only 27.5% of participants reported HTLV-1 as a contraindication to breastfeeding. Of these, a significant proportion had prior specific training in obstetric infectious diseases and practiced in the Paris region or endemic French overseas territories. Knowledge of countries that should lead to HTLV-1 screening was limited and appeared to vary among participants.</div></div><div><h3>Conclusion</h3><div>This national practice evaluation study highlighted the widespread lack of awareness of the issue of HTLV-1 infection. Further studies are needed to assess HTLV-1 seroprevalence in pregnant women (in France or similar European countries), and to evaluate relevance of targeted screening and psychological impact of a positive diagnosis.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 3","pages":"Article 103084"},"PeriodicalIF":1.6,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756871","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 : 2025-12-06DOI: 10.1016/j.jogoh.2025.103083
Hélène Creton de Limerville , Leila Bouazzi , Coralie Barbe , Isabelle Célerier , Amélie Fouchet , Marie Boiteux-Chabrier , René Gabriel , Olivier Graesslin , Emilie Raimond
Objective
Evaluate the contribution of simulation-based gynecologic ultrasound training in resident’s training
Materials and methods
This is a descriptive monocentric study carried out among residents from the Champagne-Ardenne region (France) who benefited from the gynecological ultrasound simulation program. At the end of a 6-month study, the results of 43 residents were analyzed.
Results
The analysis of the progression curves shows a positive and significant time effect of the repetition of the exercises on the resident' performance. They improved their ability to handle an ultrasound probe, their knowledge of female pelvic anatomy and gynecological diagnosis. The simulation allowed general medical residents and residents with no previous experience with ultrasound to achieve a level of performance similar to other residents. The residents considered each of the sessions to be very formative and felt that the training had improved their theoretical and practical knowledge. They believe they will be more comfortable in the gynecologic emergency room as a result of this training.
Conclusion
The training by simulation allowed an improvement of the knowledge and skills of the residents to the gynecological ultrasound. The generalization of this type of education would provide residents with a minimum and standardized initial training in gynecological ultrasound in a safe environment during their early studies.
{"title":"Contribution of simulation in gynecological ultrasound in resident’s training","authors":"Hélène Creton de Limerville , Leila Bouazzi , Coralie Barbe , Isabelle Célerier , Amélie Fouchet , Marie Boiteux-Chabrier , René Gabriel , Olivier Graesslin , Emilie Raimond","doi":"10.1016/j.jogoh.2025.103083","DOIUrl":"10.1016/j.jogoh.2025.103083","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate the contribution of simulation-based gynecologic ultrasound training in resident’s training</div></div><div><h3>Materials and methods</h3><div>This is a descriptive monocentric study carried out among residents from the Champagne-Ardenne region (France) who benefited from the gynecological ultrasound simulation program. At the end of a 6-month study, the results of 43 residents were analyzed.</div></div><div><h3>Results</h3><div>The analysis of the progression curves shows a positive and significant time effect of the repetition of the exercises on the resident' performance. They improved their ability to handle an ultrasound probe, their knowledge of female pelvic anatomy and gynecological diagnosis. The simulation allowed general medical residents and residents with no previous experience with ultrasound to achieve a level of performance similar to other residents. The residents considered each of the sessions to be very formative and felt that the training had improved their theoretical and practical knowledge. They believe they will be more comfortable in the gynecologic emergency room as a result of this training.</div></div><div><h3>Conclusion</h3><div>The training by simulation allowed an improvement of the knowledge and skills of the residents to the gynecological ultrasound. The generalization of this type of education would provide residents with a minimum and standardized initial training in gynecological ultrasound in a safe environment during their early studies.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 2","pages":"Article 103083"},"PeriodicalIF":1.6,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708418","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}
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