Pub Date : 2025-09-30DOI: 10.1016/j.jogoh.2025.103044
Lijun Shui , Xiaozhu Chen , Xianchao Dou , Liangyi Ni , Chao Chen , Xinyi Zhu , Qi Jin , Shun Bai , Limin Wu , Meihong Hu
Objective
Homocysteine (Hcy) has been reported to be associated with female reproduction. However, the correlation between hyperhomocysteinemia (HHcy) and pregnancy outcomes among infertile women remains unclear. This observational study aims to evaluate the effect of HHcy on pregnancy outcomes in infertile patients undergoing ART treatment.
Methods
Data were collected from 385 patients (50 in the HHcy group and 335 in the non-HHcy group) who underwent In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) at the First Affiliated Hospital of University of Science and Technology of China. Clinical outcomes between the two groups were analyzed.
Results
The number of oocytes retrieved, MII oocytes, oocyte maturation rate and normal fertilization rate did not differ significantly between the two groups. However, the HHcy group exhibited significantly lower rates of biochemical pregnancy (48 % vs. 74.9 %), clinical pregnancy (38 % vs. 63.9 %) and live births (34 % vs. 52.8 %) in the HHcy group compared to non-HHcy group. Logistic regression analyses indicated that HHcy was negatively associated with biochemical pregnancy rate (OR= 0.28, 95 % CI: 0.14–0.54, P < 0.001), clinical pregnancy rate (OR = 0.32, 95 % CI: 0.16–0.61, P < 0.001) and live birth rate (OR = 0.45, 95 % CI: 0.23–0.86, P = 0.02).
Conclusion
HHcy exhibited a negative correlation with live birth among patients underwent IVF/ICSI. Clinicians should consider focusing more attention on patients with HHcy to enhance ART outcomes.
目的：同型半胱氨酸（Hcy）已被报道与女性生殖有关。然而，高同型半胱氨酸血症（HHcy）与不孕妇女妊娠结局之间的相关性尚不清楚。本观察性研究旨在评估HHcy对接受ART治疗的不孕症患者妊娠结局的影响。方法：收集在中国科学技术大学第一附属医院接受体外受精/胞浆内单精子注射（IVF/ICSI）治疗的385例患者（HHcy组50例，非HHcy组335例）的资料。分析两组患者的临床结果。结果：两组获卵数、MII卵母细胞数、卵母细胞成熟率及正常受精率均无显著差异。然而，与非HHcy组相比，HHcy组的生化妊娠率（48% vs. 74.9%）、临床妊娠率（38% vs. 63.9%）和活产率（34% vs. 52.8%）明显低于HHcy组。Logistic回归分析显示，HHcy与生化妊娠率（OR= 0.28, 95% CI: 0.14-0.54, P < 0.001）、临床妊娠率（OR = 0.32,95% CI: 0.16-0.61, P < 0.001）、活产率（OR = 0.45,95% CI: 0.23-0.86, P = 0.02）呈负相关。结论：HHcy与IVF/ICSI患者的活产率呈负相关。临床医生应考虑将更多的注意力放在HHcy患者身上，以提高抗逆转录病毒治疗的效果。
{"title":"Association of hyperhomocysteinemia with IVF live birth rate: A retrospective cohort study","authors":"Lijun Shui , Xiaozhu Chen , Xianchao Dou , Liangyi Ni , Chao Chen , Xinyi Zhu , Qi Jin , Shun Bai , Limin Wu , Meihong Hu","doi":"10.1016/j.jogoh.2025.103044","DOIUrl":"10.1016/j.jogoh.2025.103044","url":null,"abstract":"<div><h3>Objective</h3><div>Homocysteine (Hcy) has been reported to be associated with female reproduction. However, the correlation between hyperhomocysteinemia (HHcy) and pregnancy outcomes among infertile women remains unclear. This observational study aims to evaluate the effect of HHcy on pregnancy outcomes in infertile patients undergoing ART treatment.</div></div><div><h3>Methods</h3><div>Data were collected from 385 patients (50 in the HHcy group and 335 in the non-HHcy group) who underwent In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) at the First Affiliated Hospital of University of Science and Technology of China. Clinical outcomes between the two groups were analyzed.</div></div><div><h3>Results</h3><div>The number of oocytes retrieved, MII oocytes, oocyte maturation rate and normal fertilization rate did not differ significantly between the two groups. However, the HHcy group exhibited significantly lower rates of biochemical pregnancy (48 % vs. 74.9 %), clinical pregnancy (38 % vs. 63.9 %) and live births (34 % vs. 52.8 %) in the HHcy group compared to non-HHcy group. Logistic regression analyses indicated that HHcy was negatively associated with biochemical pregnancy rate (OR= 0.28, 95 % CI: 0.14–0.54, <em>P</em> < 0.001), clinical pregnancy rate (OR = 0.32, 95 % CI: 0.16–0.61, <em>P</em> < 0.001) and live birth rate (OR = 0.45, 95 % CI: 0.23–0.86, <em>P</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>HHcy exhibited a negative correlation with live birth among patients underwent IVF/ICSI. Clinicians should consider focusing more attention on patients with HHcy to enhance ART outcomes.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103044"},"PeriodicalIF":1.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212829","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 : 2025-09-26DOI: 10.1016/j.jogoh.2025.103041
Zainah Abdulbari Mohammed Alhebshi , Marwah Nasir Ahmad , Husna Irfan Thalib , Ayah Nabil Al Jehani , Amal Mahmoud , Retaj Jameel Tallab , Rasil Fayez A. Alahmadi , Alanood Abdullah Banafea , Saeed Baradwan
Background
Vaginal natural orifice transluminal endoscopic surgery (vNOTES) and laparoendoscopic single-site surgery (LESS) are minimally invasive approaches for ovarian cystectomy, yet their comparative safety, efficacy, and patient-centered outcomes remain insufficiently evaluated, necessitating this systematic review and meta-analysis.
Materials and Methods
In December 2024, we conducted a systematic search using PubMed, Ovid Medline, and Ovid Cochrane. The Methodological Index for Non-Randomized Studies (MINORS) and the Revised Cochrane Risk of Bias (RoB 2) tools have been used for the risk of bias assessment.
Results
From an initial 588 records, four studies (576 patients: 197 vNOTES, 379 LESS) were included. Meta-analysis revealed that vNOTES significantly reduced operative time (pooled mean difference (MD) -13.62 min, P = 0.02) and hospital stay (MD -0.44 days, P = 0.03) compared to LESS, with sensitivity analyses strengthening these findings (e.g., MD -18.23 min and -0.63 days post-exclusion). Postoperative pain scores (by visual analogue score (VAS)) were markedly lower for vNOTES (MD -1.09, P < 0.00001), and time to flatus recovery was shorter (MD -3.72 h, P < 0.00001). No significant differences were observed in intraoperative blood loss (MD -6.99 mL, P = 0.27), conversion rates (odds ratio (OR) 1.15, P = 0.91), or overall adverse events (OR 0.70, P = 0.41), though heterogeneity persisted in retrospective subgroup analyses (I² = 72–96 % for operative time, and pain scores).
Conclusion
These findings position vNOTES as a favorable option for ovarian cystectomy, offering improved efficacy with safety comparable to LESS; however, further RCTs are needed to strengthen these conclusions.
背景：阴道自然孔腔内窥镜手术（vNOTES）和腹腔镜单部位手术（LESS）是卵巢囊肿切除术的微创方法，但它们的相对安全性、有效性和以患者为中心的结果仍未得到充分评估，因此有必要进行本系统综述和荟萃分析。材料和方法：在2024年12月，我们使用PubMed、Ovid Medline和Ovid Cochrane进行了系统检索。使用非随机研究方法学指数（methods Index for non - random Studies，简称：minor）和修订后的Cochrane Risk of Bias （RoB 2）工具进行偏倚风险评估。结果：从最初的588条记录中，纳入了4项研究（576例患者：197例vNOTES， 379例LESS）。荟萃分析显示，与LESS相比，vNOTES显着减少了手术时间（合并平均差(MD) -13.62分钟，P = 0.02）和住院时间（MD -0.44天，P = 0.03），敏感性分析强化了这些发现（例如，MD -18.23分钟和-0.63天）。术后疼痛评分（视觉模拟评分（VAS））明显低于vNOTES (MD -1.09, P < 0.00001)，排气恢复时间较短（MD -3.72小时，P < 0.00001）。术中出血量（MD -6.99 mL, P = 0.27）、转化率（比值比（OR） 1.15, P = 0.91）或总不良事件（OR 0.70, P = 0.41）方面均无显著差异，但在回顾性亚组分析中仍存在异质性（手术时间和疼痛评分I² = 72-96%）。结论：这些研究结果表明vNOTES是卵巢囊肿切除术的有利选择，其疗效和安全性优于LESS；然而，需要进一步的随机对照试验来加强这些结论。
{"title":"Comparing outcomes of ovarian cystectomy by vaginal natural orifice transluminal endoscopic surgery versus laparoendoscopic single-site surgery: A systematic review and meta-analysis","authors":"Zainah Abdulbari Mohammed Alhebshi , Marwah Nasir Ahmad , Husna Irfan Thalib , Ayah Nabil Al Jehani , Amal Mahmoud , Retaj Jameel Tallab , Rasil Fayez A. Alahmadi , Alanood Abdullah Banafea , Saeed Baradwan","doi":"10.1016/j.jogoh.2025.103041","DOIUrl":"10.1016/j.jogoh.2025.103041","url":null,"abstract":"<div><h3>Background</h3><div>Vaginal natural orifice transluminal endoscopic surgery (vNOTES) and laparoendoscopic single-site surgery (LESS) are minimally invasive approaches for ovarian cystectomy, yet their comparative safety, efficacy, and patient-centered outcomes remain insufficiently evaluated, necessitating this systematic review and meta-analysis.</div></div><div><h3>Materials and Methods</h3><div>In December 2024, we conducted a systematic search using PubMed, Ovid Medline, and Ovid Cochrane. The Methodological Index for Non-Randomized Studies (MINORS) and the Revised Cochrane Risk of Bias (RoB 2) tools have been used for the risk of bias assessment.</div></div><div><h3>Results</h3><div>From an initial 588 records, four studies (576 patients: 197 vNOTES, 379 LESS) were included. Meta-analysis revealed that vNOTES significantly reduced operative time (pooled mean difference (MD) -13.62 min, <em>P</em> = 0.02) and hospital stay (MD -0.44 days, <em>P</em> = 0.03) compared to LESS, with sensitivity analyses strengthening these findings (e.g., MD -18.23 min and -0.63 days post-exclusion). Postoperative pain scores (by visual analogue score (VAS)) were markedly lower for vNOTES (MD -1.09, <em>P</em> < 0.00001), and time to flatus recovery was shorter (MD -3.72 h, <em>P</em> < 0.00001). No significant differences were observed in intraoperative blood loss (MD -6.99 mL, <em>P</em> = 0.27), conversion rates (odds ratio (OR) 1.15, <em>P</em> = 0.91), or overall adverse events (OR 0.70, <em>P</em> = 0.41), though heterogeneity persisted in retrospective subgroup analyses (I² = 72–96 % for operative time, and pain scores).</div></div><div><h3>Conclusion</h3><div>These findings position vNOTES as a favorable option for ovarian cystectomy, offering improved efficacy with safety comparable to LESS; however, further RCTs are needed to strengthen these conclusions.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103041"},"PeriodicalIF":1.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on “Efficacy of non-pharmacological therapies in chronic pelvic pain of endometriosis: A systematic review and meta-analysis”","authors":"Dinesh Puri , Nivedita Nikhil Desai , Shubham Kumar","doi":"10.1016/j.jogoh.2025.103040","DOIUrl":"10.1016/j.jogoh.2025.103040","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103040"},"PeriodicalIF":1.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185964","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 : 2025-09-26DOI: 10.1016/j.jogoh.2025.103042
Mathilde Castel , Gaby Moawad , Malik Boukerrou , Phuong Lien Tran
Myomectomy using laparoscopic approach offers patients reduced abdominal scars, better post surgical rehabilitation. However, bleeding control may pose a challenge in spite of techniques already described [1,2]. Our objective is to show a reproducible technique of bleeding control during mini invasive myomectomy.
We performed a mini-invasive myomectomy using with robotic surgery, with Da Vinci, X. We describe the case of a 35 year-old women, gesta 0 para 0, who presented with menorrhagia, avec pelvic pain, because of a fibroma FIGO 2–5 of 8 cm. She had a desire of pregnancy. We show tips and tricks to control bleeding: (a) two ways of accessing to uterine artery for its occlusion, using either a vascular clamp or a metallic clip; (b) sub serous infiltration with 20 mL of xylocaine with 1% adrenalin, diluated in 100 mL of NaCl serum using a oocyte punction needle; (c) suture with barbed suture. Blood loss was <200 mL.
腹腔镜子宫肌瘤切除术使患者腹部疤痕减少，术后康复效果更好。然而，尽管已经描述了一些技术[1,2]，但出血控制可能会带来挑战。我们的目的是展示一种在微创子宫肌瘤切除术中可重复的出血控制技术。我们使用机器人手术进行了微创子宫肌瘤切除术，使用达芬奇，x。我们描述了一个35岁的女性，妊娠0 para 0，因FIGO 2-5的8cm纤维瘤而出现月经过多，骨盆疼痛。她渴望怀孕。我们展示了控制出血的技巧和技巧：(a)两种进入子宫动脉闭塞的方法，使用血管夹或金属夹；(b)浆膜下浸润20mL加1%肾上腺素的木卡因，用卵母细胞穿刺针稀释100mL NaCl血清；(c)用倒钩缝合。失血是
{"title":"Tips and tricks: How to control bleeding in mini invasive myomectomy?","authors":"Mathilde Castel , Gaby Moawad , Malik Boukerrou , Phuong Lien Tran","doi":"10.1016/j.jogoh.2025.103042","DOIUrl":"10.1016/j.jogoh.2025.103042","url":null,"abstract":"<div><div>Myomectomy using laparoscopic approach offers patients reduced abdominal scars, better post surgical rehabilitation. However, bleeding control may pose a challenge in spite of techniques already described [<span><span>1</span></span>,<span><span>2</span></span>]. Our objective is to show a reproducible technique of bleeding control during mini invasive myomectomy.</div><div>We performed a mini-invasive myomectomy using with robotic surgery, with Da Vinci, X. We describe the case of a 35 year-old women, gesta 0 para 0, who presented with menorrhagia, avec pelvic pain, because of a fibroma FIGO 2–5 of 8 cm. She had a desire of pregnancy. We show tips and tricks to control bleeding: (a) two ways of accessing to uterine artery for its occlusion, using either a vascular clamp or a metallic clip; (b) sub serous infiltration with 20 mL of xylocaine with 1% adrenalin, diluated in 100 mL of NaCl serum using a oocyte punction needle; (c) suture with barbed suture. Blood loss was <200 mL.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103042"},"PeriodicalIF":1.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185959","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 : 2025-09-22DOI: 10.1016/j.jogoh.2025.103039
M. Goetz-Fu , M. Haller , T. Collins , N. Begusic , F. Jochum , Y. Keeza , J. Uwineza , J. Marescaux , A.S. Weingertner , N. Sananès , A. Hostettler
Objectives
The objective was to develop an artificial intelligence (AI)-based system, using deep neural network (DNN) technology, to automatically detect standard fetal planes during video capture, measure fetal biometry parameters and estimate fetal weight.
Methods
A standard plane recognition DNN was trained to classify ultrasound images into four categories: head circumference (HC), abdominal circumference (AC), femur length (FL) standard planes, or ‘other’. The recognized standard plane images were subsequently processed by three fetal biometry DNNs, automatically measuring HC, AC and FL. Fetal weight was then estimated with the Hadlock 3 formula. The training dataset consisted of 16,626 images. A prospective temporal validation was then conducted using an independent set of 281 ultrasound videos of healthy fetuses. Fetal weight and biometry measurements were compared against an expert sonographer. Two less experienced sonographers were used as controls.
Results
The AI system obtained a significantly lower absolute relative measurement error in fetal weight estimation than the controls (AI vs. medium-level: p = 0.032, AI vs. beginner: p < 1e-8), so in AC measurements (AI vs. medium-level: p = 1.72e-04, AI vs. beginner: p < 1e-06). Average absolute relative measurement errors of AI versus expert were: 0.96 % (S.D. 0.79 %) for HC, 1.56 % (S.D. 1.39 %) for AC, 1.77 % (S.D. 1.46 %) for FL and 3.10 % (S.D. 2.74 %) for fetal weight estimation.
Conclusion
The AI system produced similar biometry measurements and fetal weight estimation to those of the expert sonographer. It is a promising tool to enhance non-expert sonographers’ performance and reproducibility in fetal biometry measurements, and to reduce inter-operator variability.
{"title":"Development and temporal validation of a deep learning model for automatic fetal biometry from ultrasound videos","authors":"M. Goetz-Fu , M. Haller , T. Collins , N. Begusic , F. Jochum , Y. Keeza , J. Uwineza , J. Marescaux , A.S. Weingertner , N. Sananès , A. Hostettler","doi":"10.1016/j.jogoh.2025.103039","DOIUrl":"10.1016/j.jogoh.2025.103039","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective was to develop an artificial intelligence (AI)-based system, using deep neural network (DNN) technology, to automatically detect standard fetal planes during video capture, measure fetal biometry parameters and estimate fetal weight.</div></div><div><h3>Methods</h3><div>A standard plane recognition DNN was trained to classify ultrasound images into four categories: head circumference (HC), abdominal circumference (AC), femur length (FL) standard planes, or ‘other’. The recognized standard plane images were subsequently processed by three fetal biometry DNNs, automatically measuring HC, AC and FL. Fetal weight was then estimated with the Hadlock 3 formula. The training dataset consisted of 16,626 images. A prospective temporal validation was then conducted using an independent set of 281 ultrasound videos of healthy fetuses. Fetal weight and biometry measurements were compared against an expert sonographer. Two less experienced sonographers were used as controls.</div></div><div><h3>Results</h3><div>The AI system obtained a significantly lower absolute relative measurement error in fetal weight estimation than the controls (AI vs. medium-level: <em>p</em> = 0.032, AI vs. beginner: <em>p</em> < 1e-8), so in AC measurements (AI vs. medium-level: <em>p</em> = 1.72e-04, AI vs. beginner: <em>p</em> < 1e-06). Average absolute relative measurement errors of AI versus expert were: 0.96 % (S.D. 0.79 %) for HC, 1.56 % (S.D. 1.39 %) for AC, 1.77 % (S.D. 1.46 %) for FL and 3.10 % (S.D. 2.74 %) for fetal weight estimation.</div></div><div><h3>Conclusion</h3><div>The AI system produced similar biometry measurements and fetal weight estimation to those of the expert sonographer. It is a promising tool to enhance non-expert sonographers’ performance and reproducibility in fetal biometry measurements, and to reduce inter-operator variability.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103039"},"PeriodicalIF":1.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137888","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 : 2025-09-17DOI: 10.1016/j.jogoh.2025.103038
Laura Puroski , Salma Touleimat , Patrice Crochet , Olivia Guerin , Jean-michel Coq , Eric Verspyck , Sophia Braund
Objective
To assess the self-evaluation of French residents and the opinion of academic teachers regarding the autonomy granted during residents’ training and the level of preparation achieved at the end of the residency to perform essential obstetric procedures.
Methods
A national survey of French obstetrics and gynecology residents and their academic teachers was conducted using an online questionnaire distributed in 2023, which gathered the self-evaluation by residents and opinion of academic teachers on the level of autonomy for essential obstetric procedures and perceptions of preparedness upon graduation. The survey also examined perceptions on the impact of factors that improve autonomy.
Results
510 of the 1197 (43%) residents and 49 of the 137 academic teachers (36%) completed the questionnaire. Both residents and academic teachers were confident that residents would be prepared at the end of residency to perform most essential obstetric procedures, including vacuum and forceps or spatula assisted vaginal delivery. However, regarding advanced obstetric surgery in case of severe postpartum hemorrhage (PPH), only 36% of 6th-year residents reported feeling capable of performing a uterine artery ligation in case of an emergency, and 11% in performing a hemostatic hysterectomy. Main factors that were perceived as important for improving autonomy were the number of cases and the quality of coaching.
Conclusion
French residents reported a gradual increase in autonomy throughout their residency for the majority of essential obstetric procedures, with the exception of surgical management of severe PPH. Teachers shared a similar opinion. Simulation and the quality of supervision appear to be promising pathways for enhancing their autonomy.
{"title":"Obstetrics and gynecology residents’ preparedness to perform essential obstetric procedures autonomously: A national survey among French residents and teachers","authors":"Laura Puroski , Salma Touleimat , Patrice Crochet , Olivia Guerin , Jean-michel Coq , Eric Verspyck , Sophia Braund","doi":"10.1016/j.jogoh.2025.103038","DOIUrl":"10.1016/j.jogoh.2025.103038","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the self-evaluation of French residents and the opinion of academic teachers regarding the autonomy granted during residents’ training and the level of preparation achieved at the end of the residency to perform essential obstetric procedures.</div></div><div><h3>Methods</h3><div>A national survey of French obstetrics and gynecology residents and their academic teachers was conducted using an online questionnaire distributed in 2023, which gathered the self-evaluation by residents and opinion of academic teachers on the level of autonomy for essential obstetric procedures and perceptions of preparedness upon graduation. The survey also examined perceptions on the impact of factors that improve autonomy.</div></div><div><h3>Results</h3><div>510 of the 1197 (43%) residents and 49 of the 137 academic teachers (36%) completed the questionnaire. Both residents and academic teachers were confident that residents would be prepared at the end of residency to perform most essential obstetric procedures, including vacuum and forceps or spatula assisted vaginal delivery. However, regarding advanced obstetric surgery in case of severe postpartum hemorrhage (PPH), only 36% of 6th-year residents reported feeling capable of performing a uterine artery ligation in case of an emergency, and 11% in performing a hemostatic hysterectomy. Main factors that were perceived as important for improving autonomy were the number of cases and the quality of coaching.</div></div><div><h3>Conclusion</h3><div>French residents reported a gradual increase in autonomy throughout their residency for the majority of essential obstetric procedures, with the exception of surgical management of severe PPH. Teachers shared a similar opinion. Simulation and the quality of supervision appear to be promising pathways for enhancing their autonomy.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103038"},"PeriodicalIF":1.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091887","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 : 2025-09-17DOI: 10.1016/j.jogoh.2025.103031
Wei-Ran Jin , Shu-Yang He , Xian-Xian Mao , Jing-Yuan Li , Xiang-Cheng Zhang , Quan-Wen Liu
Premature ovarian failure (POF), a common endocrine disorder, pertains to the loss of ovarian function in women under the age of 40 years. It is clinically characterized by estrogen deficiency with increased gonadotropin level and amenorrhea, which can lead to loss of fertility and increase the risk of other diseases, including cardiovascular disorders, osteoporosis, and mood disorders. Currently, the most common treatment is hormone replacement therapy (HRT), it relieves menopausal symptoms but does not improve the function of the ovary. Mesenchymal stem cells (MSCs) share the ability of self-renewal and differentiation, playing an important role in the regeneration of injured tissues. Notably, accumulating evidence indicates that MSCs primarily exert their effects through paracrine interactions with the ovarian cortex, rather than contributing to de novo oocyte generation. This suggests that ovarian exhaustion is not complete in POF, leaving a residual ovarian environment that allows MSCs to act. So far, many reports have demonstrated that transplantation of MSCs can improve ovarian structure and function, promote follicular development, and restore hormone levels by anti-apoptosis, promoting angiogenesis, immunomodulation, and anti-oxidation, suggesting the potential of MSCs as alternative therapeutics for POF. Therefore, this study aims to summarize the latest findings on the mechanism and application of MSCs in POF treatment, providing directions for continued research and clinical therapy.
{"title":"The potential and mechanism of mesenchymal stem cells in the treatment of premature ovarian failure","authors":"Wei-Ran Jin , Shu-Yang He , Xian-Xian Mao , Jing-Yuan Li , Xiang-Cheng Zhang , Quan-Wen Liu","doi":"10.1016/j.jogoh.2025.103031","DOIUrl":"10.1016/j.jogoh.2025.103031","url":null,"abstract":"<div><div>Premature ovarian failure (POF), a common endocrine disorder, pertains to the loss of ovarian function in women under the age of 40 years. It is clinically characterized by estrogen deficiency with increased gonadotropin level and amenorrhea, which can lead to loss of fertility and increase the risk of other diseases, including cardiovascular disorders, osteoporosis, and mood disorders. Currently, the most common treatment is hormone replacement therapy (HRT), it relieves menopausal symptoms but does not improve the function of the ovary. Mesenchymal stem cells (MSCs) share the ability of self-renewal and differentiation, playing an important role in the regeneration of injured tissues. Notably, accumulating evidence indicates that MSCs primarily exert their effects through paracrine interactions with the ovarian cortex, rather than contributing to de novo oocyte generation. This suggests that ovarian exhaustion is not complete in POF, leaving a residual ovarian environment that allows MSCs to act. So far, many reports have demonstrated that transplantation of MSCs can improve ovarian structure and function, promote follicular development, and restore hormone levels by anti-apoptosis, promoting angiogenesis, immunomodulation, and anti-oxidation, suggesting the potential of MSCs as alternative therapeutics for POF. Therefore, this study aims to summarize the latest findings on the mechanism and application of MSCs in POF treatment, providing directions for continued research and clinical therapy.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103031"},"PeriodicalIF":1.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086342","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 : 2025-09-16DOI: 10.1016/j.jogoh.2025.103037
Simon Hubert , Océane Brodbeck , Fares Ghrairi , Amjad Kattini , Jan Chrusciel , Stéphane Sanchez
Introduction
Developed in 2020, the CAESARE tool is a decision-support tool for interpreting fetal heart rate (FHR). In a preliminary study, the use of CAESARE led to a significant reduction in caesarean section rates.
Methods
We assessed the ability of the CAESARE tool to predict acidosis earlier by reducing the time-to-intervention in cases of non-reassuring fetal status (NRFS). We performed a retrospective, single-center case-control analysis evaluating associations between CAESARE scoring and the onset of neonatal acidosis. The primary outcome was presence or absence of fetal acidosis at birth based on CAESARE score. The case population was patients whose fetuses had fetal heart rate abnormalities and an arterial pH < 7.00 at birth. The control population was patients who had fetal heart rate abnormalities without the fetuses having acidosis at birth.
Results
CAESARE influenced decisions regarding the continuation of labor. It was associated with increased end of labor in the case group (p < 0.01) and greater expectant management in the control group (p < 0.01). CAESARE sensitivity and specificity were 0.97 and 0.88, respectively.
Conclusion
In our study, 32.1% of neonatal acidosis cases could have potentially been avoided if CAESARE had been used. The tool enabled extended expectant management in 42% of cases where end of labor was recommended. These findings support the implementation of a procedure for improved FHR analysis practices.
{"title":"Contribution of the CAESARE tool in the management of non-reassuring fetal status at risk of acidosis","authors":"Simon Hubert , Océane Brodbeck , Fares Ghrairi , Amjad Kattini , Jan Chrusciel , Stéphane Sanchez","doi":"10.1016/j.jogoh.2025.103037","DOIUrl":"10.1016/j.jogoh.2025.103037","url":null,"abstract":"<div><h3>Introduction</h3><div>Developed in 2020, the CAESARE tool is a decision-support tool for interpreting fetal heart rate (FHR). In a preliminary study, the use of CAESARE led to a significant reduction in caesarean section rates.</div></div><div><h3>Methods</h3><div>We assessed the ability of the CAESARE tool to predict acidosis earlier by reducing the time-to-intervention in cases of non-reassuring fetal status (NRFS). We performed a retrospective, single-center case-control analysis evaluating associations between CAESARE scoring and the onset of neonatal acidosis. The primary outcome was presence or absence of fetal acidosis at birth based on CAESARE score. The case population was patients whose fetuses had fetal heart rate abnormalities and an arterial pH < 7.00 at birth. The control population was patients who had fetal heart rate abnormalities without the fetuses having acidosis at birth.</div></div><div><h3>Results</h3><div>CAESARE influenced decisions regarding the continuation of labor. It was associated with increased end of labor in the case group (<em>p</em> < 0.01) and greater expectant management in the control group (<em>p</em> < 0.01). CAESARE sensitivity and specificity were 0.97 and 0.88, respectively.</div></div><div><h3>Conclusion</h3><div>In our study, 32.1% of neonatal acidosis cases could have potentially been avoided if CAESARE had been used. The tool enabled extended expectant management in 42% of cases where end of labor was recommended. These findings support the implementation of a procedure for improved FHR analysis practices.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103037"},"PeriodicalIF":1.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086312","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 : 2025-09-15DOI: 10.1016/j.jogoh.2025.103036
Gautier Chene , Ana Gjorgjievska-Delov , Anthony Atallah , Alexandra Ohannessian , Emanuele Cerruto , Erdogan Nohuz
Removing deep subcutaneous contraceptive implants is a challenge. Despite modifications to the inserter and insertion site, the prevalence of deep implants is still estimated at 1/1000. In this technical note, we describe strategies for safely locating and removing deep implants.
{"title":"How to detect and remove deep or nonpalpable contraceptive implants ? A technical note","authors":"Gautier Chene , Ana Gjorgjievska-Delov , Anthony Atallah , Alexandra Ohannessian , Emanuele Cerruto , Erdogan Nohuz","doi":"10.1016/j.jogoh.2025.103036","DOIUrl":"10.1016/j.jogoh.2025.103036","url":null,"abstract":"<div><div>Removing deep subcutaneous contraceptive implants is a challenge. Despite modifications to the inserter and insertion site, the prevalence of deep implants is still estimated at 1/1000. In this technical note, we describe strategies for safely locating and removing deep implants.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103036"},"PeriodicalIF":1.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080842","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}
Pregnancy of unknown location (PUL) refers to a positive pregnancy test without definitive ultrasound evidence of intrauterine or ectopic pregnancy. It present a diagnostic challenge in early pregnancy management due to the risk of ectopic pregnancy (EP).
Methods
A prospective, observational study was conducted on 179 women presenting with PUL. We assessed the predictive accuracy of the M6P model and analyzed its performance compared to standard clinical, biological, and ultrasound parameters among patients with PUL in a Tunisian population.
Results
The M6P model showed promising performance in stratifying EP risk factors significantly associated with high-risk EP included history of ectopic pregnancy, intrauterine device use, history of pelvic inflammatory disease, and smoking.
Conclusion
The M6P model is a valuable, objective, and reproducible tool for early risk stratification in PUL, with potential to reduce unnecessary hospitalizations and improve patient care.
{"title":"Evaluation of the M6P model in predicting ectopic pregnancy among pregnancies of unknown location: A prospective monocentric study in Tunisia","authors":"Wissal Jaafar , Ferdaous Mellouli , Hamdi Dhaouadi , Yasmine Chiba , Malak Medemagh , Mehdi Bouassida , Nahed Khalifa , Mechaal Mourali","doi":"10.1016/j.jogoh.2025.103035","DOIUrl":"10.1016/j.jogoh.2025.103035","url":null,"abstract":"<div><h3>Introduction</h3><div>Pregnancy of unknown location (PUL) refers to a positive pregnancy test without definitive ultrasound evidence of intrauterine or ectopic pregnancy. It present a diagnostic challenge in early pregnancy management due to the risk of ectopic pregnancy (EP).</div></div><div><h3>Methods</h3><div>A prospective, observational study was conducted on 179 women presenting with PUL. We assessed the predictive accuracy of the M6P model and analyzed its performance compared to standard clinical, biological, and ultrasound parameters among patients with PUL in a Tunisian population.</div></div><div><h3>Results</h3><div>The M6P model showed promising performance in stratifying EP risk factors significantly associated with high-risk EP included history of ectopic pregnancy, intrauterine device use, history of pelvic inflammatory disease, and smoking.</div></div><div><h3>Conclusion</h3><div>The M6P model is a valuable, objective, and reproducible tool for early risk stratification in PUL, with potential to reduce unnecessary hospitalizations and improve patient care.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 10","pages":"Article 103035"},"PeriodicalIF":1.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080801","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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