Journal of gynecology obstetrics and human reproduction最新文献

英文中文

Gestational weight management in women with class III obesity : associations with obstetric and perinatal outcomes III级肥胖妇女的妊娠体重管理：与产科和围产期结局的关系

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-12-05 DOI: 10.1016/j.jogoh.2025.103082

Hédia Karkar , Sam Personne , Mohamed Dakin , Olivier Graesslin , Delphine Rousseau , Soukayna Badaoui , René Gabriel , Benjamin Birene

Background

Class III obesity is associated with increased maternal and neonatal complications. Gestational weight gain (GWG) is a modifiable factor that may influence these outcomes, but evidence in women with severe obesity remains limited.

Purpose

To evaluate the impact of GWG adherence to the Institute of Medicine (IOM) and Journal of the American Medical Association (JAMA) recommendations on obstetric and neonatal outcomes in women with class III obesity, and to explore the role of nutritional follow-up.

Methods

Retrospective, single-center cohort study including women with class III obesity who delivered a singleton at the University Hospital of Reims, France. Women were classified according to whether they exceeded GWG recommendations from IOM (≤9 kg) and JAMA (<6 kg), and by receipt of nutritional counseling. The primary outcome was mode of delivery. Secondary outcomes included maternal, obstetric, and neonatal morbidity.

Main findings

Among 300 women, exceeding GWG recommendations was not significantly associated with mode of delivery (IOM p=0.23; JAMA p=0.27). Non-excessive GWG was associated with shorter labor (IOM: 260 vs. 401.5 min, p<0.001), reduced postpartum hemorrhage (IOM: ORa 0.44; 95% CI: 0.20–0.98; p=0.044), lower birthweight, and decreased risk of LGA neonates (IOM: ORa 0.31; 95% CI: 0.11–0.85; p=0.024). Nutritional follow-up was limited, with few women receiving structured guidance.

Conclusions

In women with class III obesity, non-excessive GWG according to recommendations does not appear to affect the mode of delivery. It seems to be associated with shorter labor and a lower risk of macrosomia.

背景：III级肥胖与孕产妇和新生儿并发症增加有关。妊娠期体重增加（GWG）是一个可改变的因素，可能影响这些结果，但在严重肥胖妇女中的证据仍然有限。目的：评估GWG遵守医学研究所（IOM）和美国医学会杂志（JAMA）建议对III级肥胖妇女产科和新生儿结局的影响，并探讨营养随访的作用。方法：回顾性、单中心队列研究，纳入在法国兰斯大学医院分娩一胎的III级肥胖妇女。根据是否超过了IOM（≤9 kg）和JAMA的GWG推荐值对女性进行分类(主要发现：在300名女性中，超过GWG推荐值与分娩方式无显著相关性（IOM p=0.23; JAMA p=0.27）。非过量GWG与产程缩短相关（IOM: 260 vs. 401.5 min, p）结论：在III级肥胖妇女中，根据建议，非过量GWG似乎不会影响分娩方式。它似乎与较短的产程和较低的巨大儿风险有关。

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引用次数: 0

Retraction notice to “A pilot study of a novel technique for hysteroscopic sterilization using the distal ends of a copper-T intrauterine device (Ostialoc)” [J Gynecol Obstet Hum Reprod 49 (2019) 101666] 关于“使用铜- t宫内节育器（Ostialoc）远端进行宫腔镜绝育新技术的试点研究”的撤回通知[J]妇产医学杂志，再生49 (2019)101666]

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-12-05 DOI: 10.1016/j.jogoh.2025.103076

Ayman Shehata Dawood , Ahmed M. Abbas , Adel Elgergawy

引用次数: 0

Calculation of specific risk of trisomy 13: probably still a utopia 计算13三体的具体风险：可能仍然是一个乌托邦。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-12-04 DOI: 10.1016/j.jogoh.2025.103081

Corinne Sault , Sophie Dreux , Estelle Roland , Gilles Renom

Background

In France, legislation regarding pregnancy monitoring considers screening solely for Down syndrom or trisomy 21 (T21). However, health authorities are exploring the possibility of calculating the risks of trisomy 13 (T13) and trisomy 18 (T18), Patau and Edwards syndromes respectively, for patients with indicative serum marker profiles (MSM), to make wider use of the potential of non-invasive prenatal testing (NIPT). Currently, only LifeCycle (revvity®), a software distributed worlwide, offers a specific risk calculation for T13, but its performance has never been assessed.

Methods

We retrospectively studied 88 cases of T13 from a cohort of over 800,000 patients who underwent first-trimester MSM testing. In each case, in addition to the T21 risk, we calculated the specific risks of T18 and T13 using the LifeCycle software, both with and without the measurement of nuchal translucency for these two aneuploidies.

Results

None of the patients with a foetus affected by T13 showed an increased risk for this aneuploidy without simultaneously presenting a high risk for T21 or T18.

Conclusion

The specific risk calculation for T13 using LifeCycle does not improve the screening for this aneuploidy.

背景：在法国，关于妊娠监测的立法只考虑唐氏综合征或21三体（T21）的筛查。然而，卫生当局正在探索计算13三体（T13）和18三体（T18），分别为具有指示性血清标记谱（MSM）的患者的Patau综合征和Edwards综合征的风险的可能性，以更广泛地利用无创产前检测（NIPT）的潜力。目前，只有LifeCycle （revvity®）这一全球分布的软件提供了T13的具体风险计算，但其性能从未被评估过。方法：我们回顾性研究了88例T13病例，这些病例来自于80多万名接受了孕早期MSM检测的患者。在每种情况下，除了T21风险外，我们还使用LifeCycle软件计算了T18和T13的特定风险，无论是否测量这两个非整倍体的颈透明性。结果：受T13影响的胎儿在不同时出现T21或T18的高风险的情况下，没有一例显示出这种非整倍体的风险增加。结论：使用LifeCycle进行T13特异性风险计算并不能提高T13非整倍体的筛查效果。

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引用次数: 0

Ultrasound-indicated versus systematic intrauterine manual examination in the management of postpartum hemorrhage: a before-and-after study 超声指示与系统宫内手工检查在产后出血处理中的对照研究。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-30 DOI: 10.1016/j.jogoh.2025.103080

Anne-Sophie Boucherie , Agnès Villart , Paul Berveiller , Patrick Rozenberg , Anne Rousseau , Thibaud Quibel

Background

The use of intrauterine manual examination in the management of postpartum hemorrhage (PPH) varies widely across countries. French guidelines recommend systematic intrauterine manual examination, while American guidelines support ultrasound use. This study aimed to evaluate whether ultrasound-indicated intrauterine manual examination was associated with higher rates of severe PPH compared with systematic intrauterine manual examination.

Methods

We conducted a retrospective, single-center, before-and-after study including all women with vaginal delivery complicated by PPH. In the before period (January 1, 2020, to December 31, 2020), intrauterine manual examination was systematically recommended when PPH was diagnosed, whereas in the after period (January 1, 2022, to December 31, 2022) intrauterine manual examination was performed only when bedside ultrasound suggested retained placental tissue, defined as the presence of an echogenic mass within the uterus on a sagittal ultrasound. The primary outcome was the rate of severe PPH, defined as total quantified blood loss exceeding 1000 ml. Secondary outcomes included the need for blood transfusion, total quantified blood loss volume, and the need for additional uterotonics.

Results

The implementation of ultrasound-indicated intrauterine manual examination significantly decreased the rate of intrauterine manual examination (64.2% vs. 29.1%, P <.01) without increasing the incidence of severe PPH (14.9% vs. 13.8%, P=.81). Total blood loss, transfusion rates, and the need for additional uterotonic were comparable between the two periods.

Conclusion

Ultrasound-indicated intrauterine manual examination reduced the rate of intrauterine manual examination without increasing the rate of severe PPH.

背景：宫内手工检查在产后出血（PPH）治疗中的应用在各国差异很大。法国指南建议系统的宫内手工检查，而美国指南支持使用超声检查。本研究旨在评估超声指示的宫内手工检查与系统宫内手工检查相比，是否与更高的重度PPH发生率相关。方法：我们对所有阴道分娩合并PPH的妇女进行了回顾性的单中心前后研究。在“前”期（2020年1月1日至2020年12月31日），诊断PPH时系统推荐宫内手工检查，而在“后”期（2022年1月1日至2022年12月31日），只有床边超声提示胎盘组织残留时才进行宫内手工检查，定义为子宫矢状面超声显示子宫内存在回声团块。主要终点是严重PPH的发生率，定义为总定量失血量超过1000 ml。次要终点包括输血、总定量失血量和是否需要额外的子宫强张。结果：实施超声指征宫内手工检查可显著降低宫内手工检查率（64.2% vs. 29.1%）， P结论：超声指征宫内手工检查可降低宫内手工检查率，但未增加重度PPH发生的风险。

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引用次数: 0

Impact of pelvic endometriosis on the chances of pregnancy in the context of oocyte donation 骨盆子宫内膜异位症对卵母细胞捐赠情况下怀孕机会的影响。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-28 DOI: 10.1016/j.jogoh.2025.103079

Julie Jourdaine , Albane Vandecandelaere , Dorian Bosquet , Arthur Foulon , Moncef Ben Khalifa , Rosalie Cabry , Florence Scheffler

Background

Endometriosis is diagnosed in 25% to 40% of infertile patients. This disease can affect ovarian reserve and oocyte quality, as a result Assisted Reproductive Technology is often required. However, the influence of endometriosis on implantation rates remains debated. Here, we assessed its impact on the chances of pregnancy following oocyte donation.

Material and methods

A single-center retrospective study was conducted at the Picardie Center for the Study and Conservation of Oocytes and Sperm (CECOS de Picardie), Amiens CHU. Patients who received a fresh embryo transfer after from donated oocytes between January 2011 and December 2021 were included. Two groups were defined according to the presence or absence of endometriosis. All patients in the endometriosis group had stage III–IV disease, confirmed surgically or radiologically

Results

In total, 175 patients were included, 34 in the endometriosis group and 141 in the control group. Pregnancy rates were comparable between the two groups (29% vs. 37%, p = 0.43) and there were no significant differences in terms of pregnancy outcomes or obstetrical complications (20% vs. 27%, p = 1).

Conclusion

In recipients of donated oocytes, advanced-stage endometriosis does not appear to negatively affect implantation or pregnancy outcomes. These findings support the hypothesis that reduced fertility in endometriosis is primarily related to oocyte quality rather than impaired endometrial receptivity.

背景：25% - 40%的不孕症患者被诊断为子宫内膜异位症。这种疾病会影响卵巢储备和卵母细胞质量，因此通常需要辅助生殖技术。然而，子宫内膜异位症对着床率的影响仍存在争议。在这里，我们评估了其对卵母细胞捐赠后怀孕几率的影响。材料和方法：在Picardie卵母细胞和精子研究和保护中心（CECOS de Picardie）， Amiens CHU进行了一项单中心回顾性研究。在2011年1月至2021年12月期间接受捐赠卵母细胞后接受新鲜胚胎移植的患者被纳入其中。根据有无子宫内膜异位症分为两组。结果：共纳入175例患者，子宫内膜异位症组34例，对照组141例。两组的妊娠率相当（29%对37%，p=0.43），妊娠结局或产科并发症方面无显著差异（20%对27%，p=1）。结论：在接受捐赠卵母细胞的患者中，晚期子宫内膜异位症似乎不会对植入或妊娠结果产生负面影响。这些发现支持了子宫内膜异位症的生育能力降低主要与卵母细胞质量而不是子宫内膜容受性受损有关的假设。

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引用次数: 0

Retraction notice to “Dual trigger using recombinant HCG and gonadotropin-releasing hormone agonist improve oocyte maturity and embryo grading for normal responders in GnRH antagonist cycles: Randomized controlled trial” [J Gynecol Obstet Hum Reprod 49 (2019) 101728] “重组HCG和促性腺激素释放激素激动剂双重触发提高GnRH拮抗剂周期正常应答者的卵母细胞成熟度和胚胎分级：随机对照试验”的撤回通知[J] .妇产科杂志，2019,49 (10):1728]

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-27 DOI: 10.1016/j.jogoh.2025.103077

Shymaa S. Ali, Elwany Elsenosy, Gamal H. Sayed, Tarek A. Farghaly, Ahmed A. Youssef, Esraa Badran, Ahmed M. Abbas, Ahmed A. Abdelaleem

引用次数: 0

Retraction notice to “Prediction of pelvic adhesions at repeat cesarean delivery through assessment of striae gravidarum score: A cross-sectional study” [J Gynecol Obstet Hum Reprod 49 (2019) 101619] “通过评估妊娠纹评分预测重复剖宫产盆腔粘连：一项横断面研究”[J] .妇产科杂志，2019,49（101619）。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-27 DOI: 10.1016/j.jogoh.2025.103075

Ahmed M. Abbas, Mohammed Khalaf, Fatma Abdel-Reheem, Ihab El-Nashar

引用次数: 0

Retraction notice to “Bilateral uterine artery ligation plus intravenous tranexamic acid during cesarean delivery for placenta previa: a randomized double-blind controlled trial” [J Gynecol Obstet Hum Reprod 48 (2018) 115–119] “双侧子宫动脉结扎联合静脉注射氨甲环酸治疗前置胎盘剖宫产术的随机双盲对照研究”[J] .妇产科杂志，2018,48(11):115-119。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-27 DOI: 10.1016/j.jogoh.2025.103078

Ahmed M. Abbas , Nahla W. Shady , Hany F. Sallam

引用次数: 0

Premature rupture of the membranes in twin pregnancies: Maternal and fetal outcomes 双胎胎膜早破：母体和胎儿的结局。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-16 DOI: 10.1016/j.jogoh.2025.103074

Anna Nunzia Della Gatta , Jacopo Lenzi , Diletta Ricci , Chiara Montedoro , Luca Savelli , Gianluigi Pilu

Aim

To analyse outcomes of twin pregnancies complicated by membranes rupture between 24 and 37 weeks of gestation.

Methods

Retrospective matched cohort study on twin pregnancies with premature membranes rupture, through review of clinical records at the Policlinico S. Orsola di Bologna, a tertiary hospital, between 2010 and 2020.

Results

171 twin pregnancies were admitted, over 10 years, with a diagnosis of premature rupture of membranes PPROM (fluid pooling on speculum and/or Insulin Growth Factor Binding Protein1 positive on vaginal secretions and oligohydramnios at ultrasound). The maternal and fetal outcomes of these pregnancies were compared to those of uneventful 178 twin pregnancies. There was no difference on risk factors. The mean gestational age at PROM was 33.9 weeks. PPROM newborns showed a lower birth weight (2072 ± 515 g vs. 2384 ± 454, p < 0.001), a higher rate of admission to neonatal intensive care unit (45.6 % vs 22.2 %, p < 0.001), and a higher rate of adverse outcomes, even if it did not achieve statistical significance (crude OR: 3.05, 95 % CI: 2.04–4.56; adjusted OR: 1.45, 95 % CI: 0.87–2.41). No cases of sepsis were found.

Conclusion

In our cohort of twin pregnancies no significative risk factors for premature rupture of membranes were found. Although PROM is known to increase infectious morbidity, not all patients will develop these complications. PROM in twin pregnancies does not appear to be an independent risk factor for adverse maternal or neonatal outcomes when the effect of prematurity is accounted for. Strategies to prolong pregnancy, when feasible, may mitigate adverse neonatal outcomes associated with PPROM in twin pregnancies.

目的：分析24 ~ 37周双胎合并胎膜破裂的结局。方法：回顾性匹配队列研究2010年至2020年在博洛尼亚三级医院polilinico S. Orsola di Bologna的临床记录。结果：171例双胎妊娠入院，10年内诊断为胎膜早破（阴道分泌物和/或阴道分泌物胰岛素生长因子结合蛋白1阳性，超声检查羊水过少）。将这些孕妇和胎儿的结局与178例正常的双胎妊娠进行比较。在危险因素上没有差异。平均胎龄为33.9周。PPROM新生儿的出生体重较低（2072±515 g比2384±454 g， p < 0.001），新生儿重症监护病房入院率较高（45.6%比22.2%,p < 0.001），不良结局发生率较高，即使没有达到统计学意义（粗OR: 3.05, 95% CI: 2.04-4.56；调整OR: 1.45, 95% CI: 0.87-2.41）。未发现脓毒症病例。结论：在我们的双胎妊娠队列中，未发现胎膜早破的显著危险因素。虽然已知PROM会增加感染性发病率，但并非所有患者都会出现这些并发症。当考虑到早产的影响时，双胎妊娠的胎膜早破似乎不是产妇或新生儿不良结局的独立危险因素。延长妊娠期的策略，在可行的情况下，可以减轻双胎妊娠与PPROM相关的不良新生儿结局。

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Comment on “Experience in medical treatment of ectopic pregnancy, cesarean scar with three comparative methods: Methotrexate intra-gestational-sac injection, ultrasound-guided KCL injection, and hysteroscopy-assisted resection” 评析“甲氨蝶呤卵囊内注射、超声引导下KCL注射、宫腔镜辅助切除三种比较方法治疗异位妊娠、剖宫产瘢痕的体会”

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-16 DOI: 10.1016/j.jogoh.2025.103073

Wendi Zhao, Min Li, Yijing Chu

引用次数: 0

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