Journal of gynecology obstetrics and human reproduction最新文献

英文中文

From policy to practice in cervical cancer prevention in Reunion Island 留尼汪岛宫颈癌预防从政策到实践。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-06 DOI: 10.1016/j.jogoh.2025.103067

Pauline Ferreira , Meoin Hagege , Phuong Lien Tran

引用次数: 0

Multiple papillomas: Risk of atypical lesions, carcinomas in situ and invasive carcinomas 多发性乳头状瘤：不典型病变、原位癌和浸润性癌的风险。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-05 DOI: 10.1016/j.jogoh.2025.103063

A. Wahnich , N. Sritharan , C. Gu , A. Benbara , C. Touboul , H. Lorphelin , H. Azaïs , V. Levy , G. Canlorbe , M. Fermaut

Context

Papillomas of the breast are benign tumors associated with underestimation of high-risk lesions. The heterogeneity of the definitions used and the low level of evidence in current studies prevent recommending guidelines for clinical management of multiple papillomas (MP). The primary objective is to estimate the risk of atypical lesions (AL), carcinomas in situ (CIS) and/or invasive carcinomas (IC) associated with MP. Secondary objectives aim to evaluate the risk factors for AL, CIS and/or IC, and to assess the risk of recurrence of MP.

Methods

This is an observational descriptive multicenter study. Patients with at least 2 synchronous papillomas on surgical specimen(s) between 2010 and 2022 were included. AL, CIS, and IC diagnosed before surgery were excluded.

Results

One hundred twenty-eight patients were diagnosed with MP, mainly discovered on single lumpectomy specimens (57 %) and unilateral (80.5 %). Multiple nature of papillomas was a postoperative diagnosis in 47.7 % of cases. Twenty-six patients (20.3 %) had at least one AL. Three patients (2.3 %) were diagnosed with IC. The multivariate logistic model demonstrates that microcalcifications have a significant association with AL, CIS, and/or IC (OR 3.78; 95 %CI [1.24 – 11.47]; p = 0.02). During a median follow-up time of 23 months, 26 patients (21.7 %) underwent surgery or macrobiopsy for recurrence, including 6 (5.0 %) for CIS or IC.

Conclusion

Because of the risk of underestimation at preoperative histology and their frequent association with AL, CIS and/or IC, MP require surgical excision. Due to frequent recurrences, clinical and radiological post-treatment follow-up should be recommended annually.

背景：乳腺乳头状瘤是一种与低估高危病变相关的良性肿瘤。在目前的研究中，使用的定义的异质性和低水平的证据阻碍了对多发性乳头状瘤（MP）的临床管理推荐指南。主要目的是评估与MP相关的非典型病变（AL）、原位癌（CIS）和/或浸润性癌（IC）的风险。次要目的是评估AL， CIS和/或IC的危险因素，并评估MP复发的风险。方法：这是一项观察性描述性多中心研究。在2010年至2022年期间，手术标本上至少有2例同步乳头状瘤的患者被纳入研究。排除术前诊断的AL、CIS和IC。结果：确诊MP患者128例，主要发现于单侧（57%）和单侧（80.5%）。术后诊断多发性乳头瘤占47.7%。26例患者（20.3%）至少有一种AL， 3例患者（2.3%）被诊断为IC。多因素logistic模型显示，微钙化与AL、CIS和/或IC有显著相关性（or 3.78; 95%CI [1.24 - 11.47]; p = 0.02）。在23个月的中位随访期间，26例（21.7%）患者因复发接受了手术或大活检，其中6例（5.0%）因CIS或IC复发。结论：由于术前组织学低估的风险以及它们与AL、CIS和/或IC的频繁关联，MP需要手术切除。由于经常复发，建议每年进行临床和放射治疗后随访。

{"title":"Multiple papillomas: Risk of atypical lesions, carcinomas in situ and invasive carcinomas","authors":"A. Wahnich , N. Sritharan , C. Gu , A. Benbara , C. Touboul , H. Lorphelin , H. Azaïs , V. Levy , G. Canlorbe , M. Fermaut","doi":"10.1016/j.jogoh.2025.103063","DOIUrl":"10.1016/j.jogoh.2025.103063","url":null,"abstract":"<div><h3>Context</h3><div>Papillomas of the breast are benign tumors associated with underestimation of high-risk lesions. The heterogeneity of the definitions used and the low level of evidence in current studies prevent recommending guidelines for clinical management of multiple papillomas (MP). The primary objective is to estimate the risk of atypical lesions (AL), carcinomas in situ (CIS) and/or invasive carcinomas (IC) associated with MP. Secondary objectives aim to evaluate the risk factors for AL, CIS and/or IC, and to assess the risk of recurrence of MP.</div></div><div><h3>Methods</h3><div>This is an observational descriptive multicenter study. Patients with at least 2 synchronous papillomas on surgical specimen(s) between 2010 and 2022 were included. AL, CIS, and IC diagnosed before surgery were excluded.</div></div><div><h3>Results</h3><div>One hundred twenty-eight patients were diagnosed with MP, mainly discovered on single lumpectomy specimens (57 %) and unilateral (80.5 %). Multiple nature of papillomas was a postoperative diagnosis in 47.7 % of cases. Twenty-six patients (20.3 %) had at least one AL. Three patients (2.3 %) were diagnosed with IC. The multivariate logistic model demonstrates that microcalcifications have a significant association with AL, CIS, and/or IC (OR 3.78; 95 %CI [1.24 – 11.47]; <em>p</em> = 0.02). During a median follow-up time of 23 months, 26 patients (21.7 %) underwent surgery or macrobiopsy for recurrence, including 6 (5.0 %) for CIS or IC.</div></div><div><h3>Conclusion</h3><div>Because of the risk of underestimation at preoperative histology and their frequent association with AL, CIS and/or IC, MP require surgical excision. Due to frequent recurrences, clinical and radiological post-treatment follow-up should be recommended annually.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103063"},"PeriodicalIF":1.6,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145470949","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}

引用次数: 0

Global, regional, and national burden of pregnancy loss from 1990 to 2021: a systematic analysis of incidence and DALYs with projections to 2040 1990年至2021年全球、区域和国家妊娠损失负担：发生率和伤残调整生命年的系统分析，并预测到2040年。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-05 DOI: 10.1016/j.jogoh.2025.103065

Shuangfei Xu, Jing Wang, Jinli Ding

Background

Pregnancy loss is one of the most prevalent pregnancy-related complications in women of reproductive age. The study aimed to investigate the global, regional, and national burden of pregnancy loss in 204 countries and regions worldwide from 1990 to 2021, based on Global Burden of Disease (GBD) 2021.

Methods

Data on the incidence, disability-adjusted life-years (DALYs), age-standardized incidence (ASIR), and age-standardized DALYs rate (ASDR) were extracted and analyzed from GBD 2021, by using joinpoint regression analysis, decomposition analysis, and the health inequality concentration analysis. The Bayesian age-period-cohort (BAPC) model was used to predict the trends up to 2040. The age-period-cohort model was applied to estimate the longitudinal age curves cohort and period relative risks.

Results

There were 38.64 million of pregnancy loss at the global level in 2021, with a decrease of 17.9 % compared to 1990. The DALYs, ASIR and ASDR all showed decreasing trend, mainly driven by epidemiological change (245.19 % and 143.13 % for incidence and DALYs, respectively). The lowest ASIR and ASDR were observed in high SDI regions, while low SDI regions had the highest. Andean Latin America had the highest ASIR (2129.91 per 100,000, 95 % UI: 1702.62, 2655.06), and Central Sub-Saharan Africa had the highest ASDR (179.29 per 100, 000, 95 % UI:125.24, 257.97). BAPC projections indicated continued global decline in both cases and incidence rate though 2040.

Conclusion

Although the global burden of pregnancy loss shows an overall decline from 1990 to 2021, it remains significant, especially in low and low-middle SDI regions, which indicates that the targeted decision-making efforts are needed to raise public awareness of this condition, improve management practices and strategies, and increase support to reduce the risk.

背景：妊娠丢失是育龄妇女最常见的妊娠相关并发症之一。该研究旨在基于全球疾病负担（GBD） 2021，调查1990年至2021年全球204个国家和地区的全球、区域和国家妊娠损失负担。方法：采用关节点回归分析、分解分析和健康不平等集中度分析，提取GBD 2021的发病率、残疾调整生命年（DALYs）、年龄标准化发病率（ASIR）和年龄标准化DALYs率（ASDR）数据并进行分析。使用贝叶斯年龄-时期-队列（BAPC）模型预测到2040年的趋势。采用年龄-时期-队列模型估计纵向年龄曲线队列和时期相对风险。结果：2021年全球发生3863万例妊娠丢失，比1990年下降17.9%。DALYs、ASIR和ASDR均呈下降趋势，主要受流行病学变化驱动（发病率和DALYs分别为245.19%和143.13%）。ASIR和ASDR在高SDI地区最低，而低SDI地区最高。撒哈拉以南非洲东部的ASIR最高（2103.18 / 10万，95% UI: 1600.8, 2704.18），撒哈拉以南非洲中部的ASDR最高（179.29 / 10万，95% UI:125.24, 257.97）。BAPC的预测表明，到2040年，全球病例和发病率都将继续下降。结论：尽管1990年至2021年全球妊娠损失负担总体下降，但仍明显下降，特别是在低、中低SDI地区，这表明需要有针对性的决策努力，提高公众对这一状况的认识，改进管理实践和策略，增加支持以降低风险。

{"title":"Global, regional, and national burden of pregnancy loss from 1990 to 2021: a systematic analysis of incidence and DALYs with projections to 2040","authors":"Shuangfei Xu, Jing Wang, Jinli Ding","doi":"10.1016/j.jogoh.2025.103065","DOIUrl":"10.1016/j.jogoh.2025.103065","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy loss is one of the most prevalent pregnancy-related complications in women of reproductive age. The study aimed to investigate the global, regional, and national burden of pregnancy loss in 204 countries and regions worldwide from 1990 to 2021, based on Global Burden of Disease (GBD) 2021.</div></div><div><h3>Methods</h3><div>Data on the incidence, disability-adjusted life-years (DALYs), age-standardized incidence (ASIR), and age-standardized DALYs rate (ASDR) were extracted and analyzed from GBD 2021, by using joinpoint regression analysis, decomposition analysis, and the health inequality concentration analysis. The Bayesian age-period-cohort (BAPC) model was used to predict the trends up to 2040. The age-period-cohort model was applied to estimate the longitudinal age curves cohort and period relative risks.</div></div><div><h3>Results</h3><div>There were 38.64 million of pregnancy loss at the global level in 2021, with a decrease of 17.9 % compared to 1990. The DALYs, ASIR and ASDR all showed decreasing trend, mainly driven by epidemiological change (245.19 % and 143.13 % for incidence and DALYs, respectively). The lowest ASIR and ASDR were observed in high SDI regions, while low SDI regions had the highest. Andean Latin America had the highest ASIR (2129.91 per 100,000, 95 % UI: 1702.62, 2655.06), and Central Sub-Saharan Africa had the highest ASDR (179.29 per 100, 000, 95 % UI:125.24, 257.97). BAPC projections indicated continued global decline in both cases and incidence rate though 2040.</div></div><div><h3>Conclusion</h3><div>Although the global burden of pregnancy loss shows an overall decline from 1990 to 2021, it remains significant, especially in low and low-middle SDI regions, which indicates that the targeted decision-making efforts are needed to raise public awareness of this condition, improve management practices and strategies, and increase support to reduce the risk.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103065"},"PeriodicalIF":1.6,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458946","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}

引用次数: 0

The shadow of unjustified surgical interventions in gynecology: Time for transparency, accountability and quality care 妇科不合理手术干预的阴影：是时候实现透明度、问责制和优质护理了。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-04 DOI: 10.1016/j.jogoh.2025.103062

Lobna Ouldamer

引用次数: 0

Evaluating the applicability of ESGO quality indicators in the surgical management of endometrial cancer: Insights from a Francogyn cohort 评估ESGO质量指标在子宫内膜癌手术治疗中的适用性：来自Francogyn队列的见解。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-04 DOI: 10.1016/j.jogoh.2025.103066

Jerome Lorenzini , Flavie Arbion , Cyril Touboul , Yohann Dabi , Yohan Kerbage , Helene Costaz , Vincent Lavoué , Pierre-François Dupré , Cyrille Huchon , Alexandre Bricou , Geoffroy Canlorbe , Emilie Raimond , Pauline Chauvet , Raffaele Fauvet , Martin Koskas , Gilles Body , Lobna Ouldamer , FRANCOGYN Research Group

Background

Endometrial cancer (EC) is a significant health concern in France, necessitating high-quality surgical care to improve patient outcomes. The European Society of Gynaecological Oncology (ESGO) established quality indicators (QIs) to standardize and improve management.

Objective

This study evaluates the applicability of ESGO QIs in a real-world setting across 13 centers in France.

Methods

This retrospective multicenter cohort study included 2789 patients surgically treated for EC from 2001 to 2020. Demographic data, surgical techniques, adherence to ESGO QIs and trends over time were analyzed. Key indicators analyzed included multidisciplinary team discussions, pre-operative imaging adequacy, surgical techniques employed, and molecular classifications.

Results

All patients were discussed in multidisciplinary meetings. Adequate preoperative imaging was achieved in 80.63 % of cases. Minimally invasive surgery was performed in 66.12 % of early-stage patients, showing a significant year-on-year increase from 12 % in 2001 to 85 % in 2020. Among obese patients, 60.78 % underwent laparoscopic procedures, with a conversion rate to open surgery of 3.57 %. Molecular classification results highlighted 35 % of patients as low risk and 32 % as high risk.

Conclusion

Our findings indicate that adherence to actual ESGO QIs has substantially improved the quality of surgical management for endometrial cancer in France, despite some areas requiring further enhancement. A coordinated political approach is essential to address existing barriers and ensure consistent implementation of these quality standards across all centers, ultimately aiming to elevate patient care and outcomes in the French healthcare system.

背景：子宫内膜癌（EC）在法国是一个重要的健康问题，需要高质量的手术护理来改善患者的预后。欧洲妇科肿瘤学会（ESGO）建立了质量指标（QIs）来规范和改进管理。目的：本研究评估了ESGO QIs在法国13个中心的现实环境中的适用性。方法：这项回顾性多中心队列研究纳入了2001年至2020年接受手术治疗的2789例EC患者。分析了人口统计数据、手术技术、ESGO QIs依从性和随时间的趋势。分析的关键指标包括多学科团队讨论、术前影像充分性、采用的手术技术和分子分类。结果：所有患者均在多学科会议上进行了讨论。80.63%的病例术前有充分的影像学检查。早期患者进行微创手术的比例为66.12%，从2001年的12%增长到2020年的85%。在肥胖患者中，60.78%的患者接受了腹腔镜手术，转换率为3.57%。分子分类结果显示35%的患者为低风险，32%为高风险。结论：我们的研究结果表明，尽管一些领域需要进一步加强，但在法国，坚持实际的ESGO QIs已经大大提高了子宫内膜癌手术治疗的质量。协调一致的政治方法对于解决现有障碍和确保所有中心一致实施这些质量标准至关重要，最终旨在提高法国医疗保健系统的患者护理和结果。

{"title":"Evaluating the applicability of ESGO quality indicators in the surgical management of endometrial cancer: Insights from a Francogyn cohort","authors":"Jerome Lorenzini , Flavie Arbion , Cyril Touboul , Yohann Dabi , Yohan Kerbage , Helene Costaz , Vincent Lavoué , Pierre-François Dupré , Cyrille Huchon , Alexandre Bricou , Geoffroy Canlorbe , Emilie Raimond , Pauline Chauvet , Raffaele Fauvet , Martin Koskas , Gilles Body , Lobna Ouldamer , FRANCOGYN Research Group","doi":"10.1016/j.jogoh.2025.103066","DOIUrl":"10.1016/j.jogoh.2025.103066","url":null,"abstract":"<div><h3>Background</h3><div>Endometrial cancer (EC) is a significant health concern in France, necessitating high-quality surgical care to improve patient outcomes. The European Society of Gynaecological Oncology (ESGO) established quality indicators (QIs) to standardize and improve management.</div></div><div><h3>Objective</h3><div>This study evaluates the applicability of ESGO QIs in a real-world setting across 13 centers in France.</div></div><div><h3>Methods</h3><div>This retrospective multicenter cohort study included 2789 patients surgically treated for EC from 2001 to 2020. Demographic data, surgical techniques, adherence to ESGO QIs and trends over time were analyzed. Key indicators analyzed included multidisciplinary team discussions, pre-operative imaging adequacy, surgical techniques employed, and molecular classifications.</div></div><div><h3>Results</h3><div>All patients were discussed in multidisciplinary meetings. Adequate preoperative imaging was achieved in 80.63 % of cases. Minimally invasive surgery was performed in 66.12 % of early-stage patients, showing a significant year-on-year increase from 12 % in 2001 to 85 % in 2020. Among obese patients, 60.78 % underwent laparoscopic procedures, with a conversion rate to open surgery of 3.57 %. Molecular classification results highlighted 35 % of patients as low risk and 32 % as high risk.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that adherence to actual ESGO QIs has substantially improved the quality of surgical management for endometrial cancer in France, despite some areas requiring further enhancement. A coordinated political approach is essential to address existing barriers and ensure consistent implementation of these quality standards across all centers, ultimately aiming to elevate patient care and outcomes in the French healthcare system.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103066"},"PeriodicalIF":1.6,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458937","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}

引用次数: 0

Comment on" Evaluation of the M6P model in predicting ectopic pregnancy among pregnancies of unknown location: A prospective monocentric study in Tunisia" 评价M6P模型在预测未知位置妊娠中的异位妊娠：突尼斯的一项前瞻性单中心研究。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-11-03 DOI: 10.1016/j.jogoh.2025.103064

Zheng Han , Jintian Han , Hongcheng Zhu

引用次数: 0

Multiple sclerosis, fertility, pregnancy, and assisted reproductive technology: Current knowledge 多发性硬化症，生育能力，怀孕和辅助生殖技术：最新知识

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-10-25 DOI: 10.1016/j.jogoh.2025.103061

Virginie Trabaud , Appoline Zimmerman , Audrey Gnisci , Bertrand Audoin , Blandine Courbiere

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that predominantly affects young women of childbearing age. While pregnancy was once discouraged for women with MS, recent studies have overturned many of the old assumptions about its risks. Current data indicate that MS has no adverse effect on fertility or pregnancy outcomes, and that pregnancy often leads to a decrease in disease activity in the third trimester. However, the reproductive life of these women will require careful and specialized management, particularly concerning the use of disease-modifying therapies (DMTs). We conducted a narrative review to summarize the latest knowledge on MS in relation to fertility, pregnancy, assisted reproductive technology (ART), and postpartum management. We focused on various topics, including fertility, the influence of pregnancy on disease progression and reciprocally, the management of MS women undergoing ART, as well as the specific aspects of postpartum care for these women. Understanding these aspects is crucial for neurologists, gynecologists, and reproductive specialists to provide appropriate and multidisciplinary care to women with MS who want to plan a pregnancy.

多发性硬化症（MS）是一种慢性中枢神经系统炎症性疾病，主要影响育龄年轻女性。虽然曾经不鼓励患有多发性硬化症的女性怀孕，但最近的研究推翻了许多关于其风险的旧假设。目前的数据表明，多发性硬化症对生育能力或妊娠结局没有不良影响，妊娠通常导致妊娠晚期疾病活动减少。然而，这些妇女的生殖生活将需要仔细和专门的管理，特别是在使用疾病缓解疗法方面。我们对MS在生育、妊娠、辅助生殖技术（ART）和产后管理方面的最新知识进行了综述。我们专注于各种主题，包括生育，怀孕对疾病进展的影响，接受抗逆转录病毒治疗的多发性硬化妇女的管理，以及这些妇女的产后护理的具体方面。了解这些方面对于神经科医生、妇科医生和生殖专家为想要计划怀孕的多发性硬化症妇女提供适当的多学科护理至关重要。

{"title":"Multiple sclerosis, fertility, pregnancy, and assisted reproductive technology: Current knowledge","authors":"Virginie Trabaud , Appoline Zimmerman , Audrey Gnisci , Bertrand Audoin , Blandine Courbiere","doi":"10.1016/j.jogoh.2025.103061","DOIUrl":"10.1016/j.jogoh.2025.103061","url":null,"abstract":"<div><div>Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system that predominantly affects young women of childbearing age. While pregnancy was once discouraged for women with MS, recent studies have overturned many of the old assumptions about its risks. Current data indicate that MS has no adverse effect on fertility or pregnancy outcomes, and that pregnancy often leads to a decrease in disease activity in the third trimester. However, the reproductive life of these women will require careful and specialized management, particularly concerning the use of disease-modifying therapies (DMTs). We conducted a narrative review to summarize the latest knowledge on MS in relation to fertility, pregnancy, assisted reproductive technology (ART), and postpartum management. We focused on various topics, including fertility, the influence of pregnancy on disease progression and reciprocally, the management of MS women undergoing ART, as well as the specific aspects of postpartum care for these women. Understanding these aspects is crucial for neurologists, gynecologists, and reproductive specialists to provide appropriate and multidisciplinary care to women with MS who want to plan a pregnancy.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103061"},"PeriodicalIF":1.6,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467372","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}

引用次数: 0

Is sonographic measurement of head–perineum distance useful for predicting a need for instrument change in vacuum-assisted delivery? 超声测量头会阴距离是否有助于预测在真空辅助分娩时是否需要更换仪器？

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-10-25 DOI: 10.1016/j.jogoh.2025.103059

B. Dürr , P. Berveiller , N. Ramdane , H. Behal , L. Ghesquière , L. Benoit , G-E Roth , N. Sananès , C. Garabedian

Background

– Use of ultrasound before operative vaginal delivery (OVD), especially head-perineum distance (HPD) measurement, has shown promising results in the prediction of vacuum-assisted delivery failure. However, the studies were monocentric and there was variation in reported thresholds.

Objectives

To assess HPD measurement as a predictor of the failure of vacuum-assisted delivery, requiring an instrument change.

Study design

Multicenter, retrospective cohort study in three tertiary maternity hospitals in France, from January 2019 to December 2020. Analyses included all vacuum-assisted delivery attempts in singleton pregnancies of ≥ 34 weeks gestation and for which an ultrasound HPD measurement was available. Vacuum deliveries were classified as success or failure (i.e., leading to an instrument change).

Results

- Among 23,974 deliveries, vacuum delivery was performed in 2,432 cases (10.1 %) among which 1,197 (49.2 %) had HPD measurements. Instrument change occurred in 123 (10.3 %). The area under the curve for predicting the failure of a vaginal delivery with vacuum according to HPD measurement was 0.58, smaller in the success group (40.1 ± 12.6 mm vs 43.3 ± 10.9 mm, p <0.001). After multivariable analysis, gestational age and HPD were significantly associated with OVD failure (respectively, OR(95 %CI) 1.26 (1.05-1.51), p=0.015, 1.14 (1.04–1.25), p=0.004); whereas fetal head position did not reach the significance level (p=0.06). However more failure were observed in case of transverse position compared to anterior position (ORa = 2.10 (1.13 to 3.90)).

Conclusion

- In our multicenter and retrospective study, HPD measurement has a low predictive value for the need for instrument change in vacuum-assisted OVD. It will be interesting to test mix models including maternal and sonographic parameters.

背景-阴道分娩（OVD）术前超声，特别是头-会阴距离（HPD）测量，在预测真空辅助分娩失败方面显示出有希望的结果。然而，这些研究是单中心的，报告的阈值存在差异。目的评估HPD测量作为真空辅助分娩失败的预测指标，是否需要更换仪器。研究设计2019年1月至2020年12月在法国三家三级妇产医院进行的多中心回顾性队列研究。分析包括妊娠≥34周且超声HPD测量可用的单胎妊娠的所有真空辅助分娩尝试。真空交付被分类为成功或失败（即，导致仪器更换）。结果：在23,974例分娩中，有2,432例（10.1%）进行了真空分娩，其中1,197例（49.2%）进行了HPD测量。123例（10.3%）发生仪器更换。根据HPD测量预测阴道真空分娩失败的曲线下面积为0.58，成功组较小（40.1±12.6 mm vs 43.3±10.9 mm, p <0.001）。经多变量分析，胎龄和HPD与OVD衰竭显著相关(OR（95% CI）分别为1.26 (1.05-1.51),p=0.015, 1.14 (1.04-1.25), p=0.004)；胎儿头位未达到显著性水平（p=0.06）。然而，与前位相比，横位的失败率更高（ORa = 2.10(1.13至3.90)）。结论：在我们的多中心回顾性研究中，HPD测量对真空辅助OVD中仪器更换需求的预测价值较低。这将是有趣的测试混合模型包括产妇和超声参数。

{"title":"Is sonographic measurement of head–perineum distance useful for predicting a need for instrument change in vacuum-assisted delivery?","authors":"B. Dürr , P. Berveiller , N. Ramdane , H. Behal , L. Ghesquière , L. Benoit , G-E Roth , N. Sananès , C. Garabedian","doi":"10.1016/j.jogoh.2025.103059","DOIUrl":"10.1016/j.jogoh.2025.103059","url":null,"abstract":"<div><h3>Background</h3><div><em>–</em> Use of ultrasound before operative vaginal delivery (OVD), especially head-perineum distance (HPD) measurement, has shown promising results in the prediction of vacuum-assisted delivery failure. However, the studies were monocentric and there was variation in reported thresholds.</div></div><div><h3>Objectives</h3><div>To assess HPD measurement as a predictor of the failure of vacuum-assisted delivery, requiring an instrument change.</div></div><div><h3>Study design</h3><div>Multicenter, retrospective cohort study in three tertiary maternity hospitals in France, from January 2019 to December 2020. Analyses included all vacuum-assisted delivery attempts in singleton pregnancies of ≥ 34 weeks gestation and for which an ultrasound HPD measurement was available. Vacuum deliveries were classified as success or failure (i.e., leading to an instrument change).</div></div><div><h3>Results</h3><div>- Among 23,974 deliveries, vacuum delivery was performed in 2,432 cases (10.1 %) among which 1,197 (49.2 %) had HPD measurements. Instrument change occurred in 123 (10.3 %). The area under the curve for predicting the failure of a vaginal delivery with vacuum according to HPD measurement was 0.58, smaller in the success group (40.1 ± 12.6 mm vs 43.3 ± 10.9 mm, p <0.001). After multivariable analysis, gestational age and HPD were significantly associated with OVD failure (respectively, OR(95 %CI) 1.26 (1.05-1.51), p=0.015, 1.14 (1.04–1.25), p=0.004); whereas fetal head position did not reach the significance level (p=0.06). However more failure were observed in case of transverse position compared to anterior position (ORa = 2.10 (1.13 to 3.90)).</div></div><div><h3>Conclusion</h3><div>- In our multicenter and retrospective study, HPD measurement has a low predictive value for the need for instrument change in vacuum-assisted OVD. It will be interesting to test mix models including maternal and sonographic parameters.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103059"},"PeriodicalIF":1.6,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145418885","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}

引用次数: 0

Case report: Obstetrical maneuver in a case of persistent mentum posterior face presentation 病例报告：产科手法治疗持续性颅脑后面表现1例

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-10-24 DOI: 10.1016/j.jogoh.2025.103060

Sabrina MONTANT , Fanny MOREIRA , Clémentine LANGIN , Pierrick ANDRIEU , Marion ROUZAIRE , Denis GALLOT

Face presentation during labor is uncommon. While mentum anterior presentation is mechanically compatible with vaginal delivery, persistent mentum posterior presentation typically necessitates cesarean section. We report a case of a fetus in mentum posterior face presentation managed expectantly due to excellent labor progression. At full cervical dilation, an ultrasound-guided digital maneuver successfully converted the presentation to occipito-iliac anterior, enabling vaginal delivery of a healthy 3350 g infant without instrumental assistance. This obstetric technique offers a potential alternative to cesarean section in selected cases of mentum posterior face presentation, and argues for individualized management by an experienced obstetrician and ultrasound guidance.

分娩时面部表现不常见。虽然颏部前位与阴道分娩机械相容，但持续的颏部后位通常需要剖宫产。我们报告一例胎儿在颏后面表现管理预期由于良好的产程。在宫颈完全扩张时，超声引导下的指位手法成功地将胎儿位转换为枕髂前位，使3350 g的健康婴儿在没有器械辅助的情况下顺利阴道分娩。这种产科技术提供了一种潜在的替代剖宫产在选定的情况下，颏后面表现，并主张个体化管理由经验丰富的产科医生和超声指导。

引用次数: 0

Effect of SARS-CoV-2 infection on perinatal outcomes by disease severity and trimester of pregnancy: A prospective cohort study SARS-CoV-2感染对围产儿结局的影响：一项前瞻性队列研究。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of gynecology obstetrics and human reproduction

Pub Date : 2025-10-23 DOI: 10.1016/j.jogoh.2025.103058

Paula Garcia-Aguilar , Valeria Rolle , Berta Serrano , Carlota Rodó , Itziar Garcia-Ruiz , Pablo Garcia-Manau , Alba Farras , Lidia Illan , Elena Moreno , Marta Dalmau , Eva Roldan , Eloi Sirvent , Joaquin Temprado , Naia Seminario , Nuria Fernández-Hidalgo , Elena Sulleiro , Joan Balcells , Roser Ferrer-Costa , Nerea Maiz , Elena Carreras , Manel Mendoza

Introduction

To describe the effects of maternal COVID-19 on the incidence of small for gestational age (SGA) newborns and other pregnancy outcomes according to disease severity and trimester of infection.

Material and Methods

This was a prospective cohort study conducted at Vall d'Hebron University Hospital between March 2020 and June 2023 which included 404 consecutive single pregnancies with SARS-CoV-2 infection classified by severity and trimester of infection and a reference group of 404 consecutive single pregnancies with no suspicion of SARS-CoV-2 infection. The primary outcome was the incidence of SGA newborns. Secondary outcomes included other adverse perinatal and neonatal outcomes.

Results

The rate of SGA newborns was higher in the COVID-19 group, with an adjusted relative risk of 1.60 (95 % CI, 1.03–2.48). The risk was particularly elevated in severe cases and when infection occurred during the first trimester. No association was found between COVID-19 and preeclampsia or spontaneous preterm birth. COVID-19 cases showed a higher risk of iatrogenic preterm birth and maternal intensive care unit admission, particularly in severe cases during the third trimester. When analysed by severity and trimester, adverse neonatal outcomes were more frequent in severe cases and in third trimester.

Discussion

Pregnancies affected by COVID-19, especially severe cases and first-trimester infections, were associated with a 60 % increased risk of small for gestational age newborns and also raises the risk of iatrogenic preterm delivery, adverse neonatal outcomes, and maternal intensive care unit admission, particularly in severe cases or third-trimester infections.

Conclusion

Healthcare providers should remain vigilant about the risk of adverse pregnancy outcomes in severe cases of COVID19.

前言：根据疾病严重程度和感染的三个月，描述母亲COVID-19对小胎龄新生儿（SGA）发生率和其他妊娠结局的影响。材料和方法：这是一项于2020年3月至2023年6月在瓦尔德希布伦大学医院进行的前瞻性队列研究，其中包括404例连续单胎感染SARS-CoV-2，按感染的严重程度和感染的三个月分类，以及404例未怀疑SARS-CoV-2感染的连续单胎妊娠作为参照组。主要结局是SGA新生儿的发生率。次要结局包括其他不良围产期和新生儿结局。结果：COVID-19组新生儿SGA发生率较高，调整后相对危险度为1.60 （95% CI, 1.03-2.48）。在严重病例中，当感染发生在妊娠头三个月时，风险特别高。未发现COVID-19与子痫前期或自发性早产之间存在关联。COVID-19病例显示医源性早产和孕产妇入住重症监护病房的风险较高，特别是在妊娠晚期的严重病例中。当按严重程度和妊娠期进行分析时，不良新生儿结局在严重病例和妊娠晚期更为常见。讨论：受COVID-19影响的妊娠，特别是严重病例和妊娠早期感染，与小于胎龄新生儿的风险增加60%相关，还增加了医源性早产、新生儿不良结局和孕产妇入住重症监护病房的风险，特别是在严重病例或妊娠晚期感染时。结论：医疗保健提供者应对covid - 19重症病例的不良妊娠结局风险保持警惕。

{"title":"Effect of SARS-CoV-2 infection on perinatal outcomes by disease severity and trimester of pregnancy: A prospective cohort study","authors":"Paula Garcia-Aguilar , Valeria Rolle , Berta Serrano , Carlota Rodó , Itziar Garcia-Ruiz , Pablo Garcia-Manau , Alba Farras , Lidia Illan , Elena Moreno , Marta Dalmau , Eva Roldan , Eloi Sirvent , Joaquin Temprado , Naia Seminario , Nuria Fernández-Hidalgo , Elena Sulleiro , Joan Balcells , Roser Ferrer-Costa , Nerea Maiz , Elena Carreras , Manel Mendoza","doi":"10.1016/j.jogoh.2025.103058","DOIUrl":"10.1016/j.jogoh.2025.103058","url":null,"abstract":"<div><h3>Introduction</h3><div>To describe the effects of maternal COVID-19 on the incidence of small for gestational age (SGA) newborns and other pregnancy outcomes according to disease severity and trimester of infection.</div></div><div><h3>Material and Methods</h3><div>This was a prospective cohort study conducted at Vall d'Hebron University Hospital between March 2020 and June 2023 which included 404 consecutive single pregnancies with SARS-CoV-2 infection classified by severity and trimester of infection and a reference group of 404 consecutive single pregnancies with no suspicion of SARS-CoV-2 infection. The primary outcome was the incidence of SGA newborns. Secondary outcomes included other adverse perinatal and neonatal outcomes.</div></div><div><h3>Results</h3><div>The rate of SGA newborns was higher in the COVID-19 group, with an adjusted relative risk of 1.60 (95 % CI, 1.03–2.48). The risk was particularly elevated in severe cases and when infection occurred during the first trimester. No association was found between COVID-19 and preeclampsia or spontaneous preterm birth. COVID-19 cases showed a higher risk of iatrogenic preterm birth and maternal intensive care unit admission, particularly in severe cases during the third trimester. When analysed by severity and trimester, adverse neonatal outcomes were more frequent in severe cases and in third trimester.</div></div><div><h3>Discussion</h3><div>Pregnancies affected by COVID-19, especially severe cases and first-trimester infections, were associated with a 60 % increased risk of small for gestational age newborns and also raises the risk of iatrogenic preterm delivery, adverse neonatal outcomes, and maternal intensive care unit admission, particularly in severe cases or third-trimester infections.</div></div><div><h3>Conclusion</h3><div>Healthcare providers should remain vigilant about the risk of adverse pregnancy outcomes in severe cases of COVID19.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 1","pages":"Article 103058"},"PeriodicalIF":1.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370285","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Journal of gynecology obstetrics and human reproduction

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀