European Journal of Obstetrics and Gynecology and Reproductive Biology: X最新文献

{"title":"Effect of Enhanced Recovery after Surgery (ERAS) protocol on maternal outcomes following emergency caesarean delivery: A randomized controlled trial","authors":"Rajlaxmi Mundhra ,&nbsp;Dipesh Kumar Gupta ,&nbsp;Anupama Bahadur ,&nbsp;Ajit Kumar ,&nbsp;Rakesh Kumar","doi":"10.1016/j.eurox.2024.100295","DOIUrl":"10.1016/j.eurox.2024.100295","url":null,"abstract":"<div><h3>Background</h3><p>With ever increasing rates of emergency caesarean deliveries (CD),incorporating the ERAS protocol might provide a perfect window of opportunity to increase maternal comfort during the postsurgical period, but also improve outcomes and facilitate optimal return of physiological function.</p></div><div><h3>Objective</h3><p>To determine whether an ERAS pathway at emergency caesarean birth would permit a reduction in postoperative length of stay and improve postoperative patient satisfaction.</p></div><div><h3>Material &amp; methods</h3><p>Patients undergoing emergent caesarean delivery at ≥ 34 weeks of gestation were randomized to ERAS or conventional care. The primary outcome was to compare postoperative length of hospital stay. Secondary outcome variables included first oral intake, passage of flatus/defecation, first ambulation, first urination after catheter removal and postoperative pain scores in both groups.</p></div><div><h3>Results</h3><p>We randomized 142 women (71 each in ERAS versus Conventional arm) undergoing emergency cesarean delivery. Incorporation of ERAS protocol resulted in shorter length of hospital stay (73.92 ± 8.96 in conventional arm vs 53.87 ± 15.02 in ERAS arm; p value &lt;.0001). Significant difference was seen in visual analogue scoring during initial ambulation and rest on day 0 and day 1 between ERAS and conventional arms with mean scores being lower in ERAS arm compared to Conventional arm (p value &lt;.05). In terms of quality of life, ERAS arm had better quality of life compared to conventional arm</p></div><div><h3>Conclusion</h3><p>Incorporation of ERAS protocol in emergency caesarean definitely improves patient outcome in terms of early resumption of activities with better quality of life.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"22 ","pages":"Article 100295"},"PeriodicalIF":0.0,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000152/pdfft?md5=21154d4551496141fd68d76d065b5457&pid=1-s2.0-S2590161324000152-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140085495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of exercise attitudes of women of reproductive age in pregnancy","authors":"Feyza Aktaş Reyhan","doi":"10.1016/j.eurox.2024.100294","DOIUrl":"https://doi.org/10.1016/j.eurox.2024.100294","url":null,"abstract":"<div><h3>Objective</h3><p>This study was conducted to evaluate the exercise attitudes of women of reproductive age during pregnancy.</p></div><div><h3>Method</h3><p>The descriptive study was conducted with 326 women who applied to the gynecology outpatient clinics of a state hospital between September and November 2023. Data were collected with the \"Personal Information Form\" and \"Exercise Attitudes in Pregnant Women Scale\". Statistical analyses were analyzed at p &lt; .05 significance level with the independent samples t test method.</p></div><div><h3>Results</h3><p>Most of the participants (85.6%) stated that they did not know the benefits of exercise during pregnancy and did not exercise during pregnancy (89.6%). The mean exercise attitude scale score of the participants was 135.42 ± 25.90. A significant difference was found between the participants' education level, exercising outside pregnancy, attending a pregnancy school, knowing the benefits of exercise during pregnancy and exercising during pregnancy and all sub-dimension scores (p &lt; .05).</p></div><div><h3>Conclusion</h3><p>In the study, it was observed that the participants had positive attitudes towards exercise during pregnancy, although their knowledge and behaviors were insufficient. Women's attitudes towards exercise should be determined by health professionals and women's positive attitudes, knowledge and behaviors should be improved by organizing trainings and exercise programs starting from pre-pregnancy.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"21 ","pages":"Article 100294"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000140/pdfft?md5=9e0efb059905fb7a4617c7d6c0581afa&pid=1-s2.0-S2590161324000140-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140062241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Maternal and fetal outcomes in mothers with non-congenital mitral valve stenosis and healthy control","authors":"Sima sobhani shari ,&nbsp;Tubi Kazemi ,&nbsp;Ali Bidokhti ,&nbsp;Seyed Mohammad Riahi","doi":"10.1016/j.eurox.2024.100290","DOIUrl":"https://doi.org/10.1016/j.eurox.2024.100290","url":null,"abstract":"<div><h3>Background</h3><p>Physiological changes during pregnancy cause complications in mothers with mitral stenosis and their infants. This study was designed to assess maternal and fetal pregnancy outcomes in women with rheumatic mitral valve stenosis and compare them with the control group.</p></div><div><h3>Materials and methods</h3><p>This study is a case-control study on 153 pregnant women, including 51 with mitral stenosis (MS) and 102 without MS as the control group, between 2007–2022. For each studied patient, two control participants were selected and matched in residence, age, and year of pregnancy. SPSS version 22 was used for data analysis.</p></div><div><h3>Results</h3><p>The mean age was 31.7 ± 4.6 years in cases and 31.6 ± 4.7 in the healthy controls. Demographic variables were not significantly different between the case and control groups. The rate of stillbirth (5.9% vs. 0.0%), %), NICU admission (13.7% vs. 2.0%), and IUGR (5.9% vs. 0.0%) were higher in the fetal case group compared with the control group. On the other hand, maternal outcomes, including pulmonary edema (13.7% vs. 0.0%), ICU admission (23.5% vs. 0.0%), limb edema (15.7% vs. 0.0%), dyspnea (37.3% vs. 0.0%), pulmonary hypertension (9.8% vs. 0.0%), palpitations (21.1% vs. 0.0%) and hospital admission during pregnancy (37.2% vs. 4.9%) were statistically more common in the case groups.</p></div><div><h3>Conclusions</h3><p>Pregnancy is associated with significant fetomaternal morbidities in women with mitral valve heart disease. So they need a multidisciplinary approach in preconception and antenatal care.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"22 ","pages":"Article 100290"},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000103/pdfft?md5=e8a1d714855518d564aa20ba2ad760d6&pid=1-s2.0-S2590161324000103-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140160884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of pentoxifylline and different types of exercise training on coagulation factors in a rat endometriosis model","authors":"Zahra Salehpoor ,&nbsp;Mohamad Rezapourmoghadam ,&nbsp;Nader Tanideh ,&nbsp;Maryam Koushkie Jahromi","doi":"10.1016/j.eurox.2024.100292","DOIUrl":"https://doi.org/10.1016/j.eurox.2024.100292","url":null,"abstract":"<div><h3>Objectives</h3><p>This study evaluated the effects of high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), and pentoxifylline (PTX) on coagulation factors, including the amount and percentage of lymphocytes, PLC, PLR, aPTT, PT, PT.I.N. R in a model of rats with endometriosis.</p></div><div><h3>Methods</h3><p>Endometriosis was surgically induced in female Sprague<img>Dawley rats. The rats with confirmed endometrial implants were divided into control, MICT, pentoxifylline (D), HIIT+D, and MICT+D, HIIT groups. D and exercise interventions were performed for eight weeks. Then, the macroscopic size of endometriosis lesions was measured, and inflammatory factors (count and percentage of lymphocytes) and coagulation factors, including PLC, PLR, aPTT, PT, PT.I.N. R, and PLR in blood samples were evaluated.</p></div><div><h3>Results</h3><p>D significantly decreased the volume of lesions and significantly increased PT and PT.I.N. R in blood. HIIT decreased the volume of lesions and significantly increased PT. MICT did not cause significant effects on the target variables. MICT+D decreased the volume of lesions. HIIT+D significantly decreased the volume of lesions and PLC and increased aPTT as well as the count and percentage of lymphocytes, PT, and PT.I.N. R, and decreased PLR.</p></div><div><h3>Conclusions</h3><p>All interventions(except for MICT) especially HIIT+D and D by priority, induced a significant effect on reducing some indices of inflammation and coagulation.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"21 ","pages":"Article 100292"},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000127/pdfft?md5=2bfe9b72a17cadafb6e53c1690c09d5f&pid=1-s2.0-S2590161324000127-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139936596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between estrogen receptor and programmed death ligand-1 in type I endometrial cancer","authors":"Setyo Teguh Waluyo ,&nbsp;Brahmana Askandar Tjokroprawiro ,&nbsp;Anny Setijo Rahaju","doi":"10.1016/j.eurox.2024.100293","DOIUrl":"10.1016/j.eurox.2024.100293","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the effect of estrogen receptor (ER) on programmed death-ligand 1 (PD-L1) expression in type I endometrial cancer (EC).</p></div><div><h3>Material and Methods</h3><p>This retrospective study included 85 patients with type I EC who underwent surgery at Dr. Soetomo Hospital between 2018 and 2022. A random sampling technique was employed. Immunohistochemistry (IHC) with ER and PD-L1 antibodies was performed on all samples. In this study, ER expression served as the independent variable, while PD-L1 expression was considered the dependent variable. Data analysis was performed using Spearman's rank correlation coefficient test.</p></div><div><h3>Results</h3><p>Out of the 85 patients with type I EC, 58 (68.2%) exhibited positive and 27 (31.8%) exhibited negative ER expression. Meanwhile positive PD-L1 expression was seen in 67 (78.8%) and 18 (21.2%) exhibited negative PD-L1 expression. The study revealed a strong negative correlation between ER and PD-L1 expression in EC (rho value = −0.886, p-value = 0.0001).</p></div><div><h3>Conclusion</h3><p>ER downregulates PD-L1 in type I EC. The findings of this study can be used as reference data and as the basis for further research, especially investigations of the prognostic and immunotherapeutic value of ER and PD-L1 expression in type I EC.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"21 ","pages":"Article 100293"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000139/pdfft?md5=a8e2819dd0df6a08c7f6592abc15b6a8&pid=1-s2.0-S2590161324000139-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139966712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in cervical length during the second trimester among normal weight, overweight and obese women: A systematic review and meta-analysis","authors":"Michail Panagiotopoulos,&nbsp;Vasilios Pergialiotis,&nbsp;Konstantina Trimmi,&nbsp;Antonia Varthaliti,&nbsp;Antonios Koutras,&nbsp;Panagiotis Antsaklis,&nbsp;Georgios Daskalakis","doi":"10.1016/j.eurox.2024.100291","DOIUrl":"10.1016/j.eurox.2024.100291","url":null,"abstract":"<div><h3>Objective</h3><p>Maternal obesity has been previously linked to increased risk of preterm birth; however, the actual pathophysiology behind this observation remains unknown. Cervical length seems to differentiate among overweight, obese and extremely obese patients, compared to normal weight women. However, to date the actual association between body mass index and cervical length remains unknown. In this systematic review, accumulated evidence is presented to help establish clinical implementations and research perspectives.</p></div><div><h3>Methods</h3><p>We searched Medline, Scopus, the Cochrane Central Register of Controlled Trials CENTRAL, Google Scholar, and Clinicaltrials.gov databases from inception till February 2023. Observational studies that reported on women undergone ultrasound assessment of their cervical length during pregnancy were included, when there was data regarding their body mass index. Statistical meta-analysis was performed with RStudio. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS).</p></div><div><h3>Results</h3><p>Overall, 20 studies were included in this systematic review and 12 in the meta-analysis. Compared to women with normal weight, underweight women were not associated with increased risk of CL &lt; 15 mm or &lt; 30 mm and their mean CL was comparable (MD −1.51; 95% CI −3.07, 0.05). Overweight women were found to have greater cervical length compared to women with normal weight (MD 1.87; 95% CI 0.52, 3.23) and had a lower risk of CL &lt; 30 mm (OR 0.65; 95% CI 0.47, 0.90).</p></div><div><h3>Conclusion</h3><p>Further research into whether BMI is associated with cervical length in pregnant women is deemed necessary, with large, well-designed, prospective cohort studies with matched control group.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"21 ","pages":"Article 100291"},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000115/pdfft?md5=920c2ba8a8bd706734302603fd01bb31&pid=1-s2.0-S2590161324000115-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139887382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the interplay between food security and antenatal care utilization among pregnant women in Southern Ethiopia: Insights from an institution-based cross-sectional study","authors":"Gemeda Wakgari Kitil ,&nbsp;Lema Fikadu Wedajo ,&nbsp;Gizu Tola Feyisa ,&nbsp;Bekem Dibaba Degefa ,&nbsp;Shambel Negese Marami ,&nbsp;Agmasie Damtew Walle ,&nbsp;Alex Ayenew Chereka ,&nbsp;Dagne Deresa Dinagde","doi":"10.1016/j.eurox.2024.100288","DOIUrl":"10.1016/j.eurox.2024.100288","url":null,"abstract":"<div><h3>Background</h3><p>Ensuring the satisfaction of pregnant women with antenatal care is crucial for positive pregnancy outcomes and their engagement with emerging technologies and alternative care models. Maintaining high satisfaction during the antenatal period significantly impacts the well-being of both the expectant mother and the unborn child. Despite the recognized importance of antenatal care satisfaction, comprehensive information on satisfaction levels and influencing factors in the specific study area is lacking. Therefore, this study aims to assess antenatal care service satisfaction and associated factors among pregnant women in Arba Minch town, southern Ethiopia.</p></div><div><h3>Methods</h3><p>We conducted an institution-based cross-sectional study among 418 pregnant women from December 2022 to January 30, 2023, using a systematic sampling method. Data were collected using the Kobo Toolbox and analyzed with SPSS Version 26. The threshold for statistical significance was set at a p-value of less than 0.05.</p></div><div><h3>Results</h3><p>Out of 418 participants, 54.3% (95% CI=49.4–60.4) expressed satisfaction with antenatal care services. Factors significantly associated with women's satisfaction included: being unable to read and write (AOR=2.37; 95% CI: 1.97–3.80), being aged 25–29 years (AOR=3.20; 95% CI: 1.65–6.22), receiving antenatal care at a hospital (AOR=1.81; 95% CI: 1.05–3.12), having a previous history of antenatal visits (AOR=2.59; 95% CI: 1.26–5.30), a monthly income of 2500–5000 ETB (AOR=1.44; 95% CI: 1.21–3.94), waiting times of less than 30 min (AOR=2.59; 95% CI: 1.52–4.41), maintaining a positive attitude towards antenatal care (AOR=2.50; 95% CI: 1.05–3.65), and having a secure food source (AOR=2.06; 95% CI: 1.13–3.78).</p></div><div><h3>Conclusion</h3><p>Over 54% of participants were satisfied with antenatal care services. To improve satisfaction levels, recommended strategies include enhancing healthcare infrastructure, establishing maternity waiting areas, reducing waiting times, and expanding services to remote areas.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"21 ","pages":"Article 100288"},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000085/pdfft?md5=817e874c247436611cba2f08ff465124&pid=1-s2.0-S2590161324000085-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139833220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female sexuality across the menopausal age group: A cross sectional study","authors":"Rajlaxmi Mundhra,&nbsp;Anupama Bahadur,&nbsp;Kavita Khoiwal,&nbsp;Mukesh Kumar,&nbsp;Shivani Singh Chhetri,&nbsp;Jaya Chaturvedi","doi":"10.1016/j.eurox.2024.100287","DOIUrl":"10.1016/j.eurox.2024.100287","url":null,"abstract":"<div><h3>Background</h3><p>Female sexual dysfunction (FSD) is an important health issue and its relationship with menopausal symptoms needs special attention.</p></div><div><h3>Objective</h3><p>To identify the frequency of FSD in middle aged women and assess its relationship with obesity and menopausal symptoms.</p></div><div><h3>Methods</h3><p>This was a cross sectional study performed at a tertiary care centre in North India over a period of one year from June 2022 to May 2023. Sexually active women aged 40–55 years were included in the study sample. Exclusion criteria included those not willing to participate, having pregnancy, malignancy, mental illness or history of pelvic surgery. Baseline demographic and anthropometric details were noted. Sexual function and menopausal symptoms were assessed using Menopause Rating Scale (MRS) and Female Sexual Function Index Scale (FSFI) questionnaire respectively.</p></div><div><h3>Results</h3><p>Among one hundred and forty three sexually active middle aged women, 43 women had FSD (30.06%). FSD was observed in 9.09%, 22.73% and 45.45% in- 40–45 years, 46–50 years and 51–55 years respectively. No significant difference was seen in desire (p value=0.281), arousal (p value=0.424), lubrication (p value=0.143), orgasm (p value=0.637), satisfaction (p value=0.675), pain (p value=0.833), total score (p value=0.601) between body mass index (kg/m²). A significant strong negative correlation of somatic, urogenital, psychological and total MRS scores with female sexuality domains was observed excepting non-significant mild negative correlation between somatic with pain and psychological with orgasm and pain.</p></div><div><h3>Conclusion</h3><p>Female sexual dysfunction are quite common and has negative correlation with menopausal symptoms. Health care providers need to focus on this issue as part of their routine assessment for better quality of life.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"21 ","pages":"Article 100287"},"PeriodicalIF":0.0,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000073/pdfft?md5=8b479b10669be3d4484ad28dad062a33&pid=1-s2.0-S2590161324000073-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139877420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of neurosonography in CHD-fetuses and controls in a clinical tertiary setting","authors":"Sheila M. Everwijn ,&nbsp;Jiska F. van Bohemen ,&nbsp;Fenna A. Jansen ,&nbsp;Sylke J. Steggerda ,&nbsp;Aalbertine K. Teunissen ,&nbsp;Monique C. Haak","doi":"10.1016/j.eurox.2024.100289","DOIUrl":"https://doi.org/10.1016/j.eurox.2024.100289","url":null,"abstract":"<div><h3>Objective</h3><p>Ultrasonographic examination is the first-tier test to detect abnormal development of central nervous system (CNS). In optimal conditions, neurosonography can detect all important hallmarks of CNS development. It is, however, not known how the performance of this modality is in a routine setting. We aimed to evaluate the feasibility of neurosonography in a time-limited routine setting.</p></div><div><h3>Study design</h3><p>We have performed a prospective study in which we have included a group of pregnant women carrying a fetus with an isolated congenital heart defect (CHD), and a control group of fetuses without structural anomalies. We have performed basic neurosonography examination according to the guideline ‘how to perform a basic screening examination of the CNS’, published by the international society of ultrasound in obstetrics and gynecology in both groups. In all these examinations, 9 brain structures were scored in 3 different planes, by researchers that were blinded for group allocation. A sufficient neurosonogram was performed when 7 or more out of 9 CNS structures were clearly visible during the off-line scoring of the examination.</p></div><div><h3>Results</h3><p>A total of 574 neurosonographic examinations were performed in 151 fetuses, 90 in the CHD-group and 61 in the control group. A sufficient neurosonogram could be performed in 79% (234/294) of cases in a clinical setting (CHD cases) and in 90% (253/280) of control pregnancies. Higher maternal BMI (&gt;30), maternal age, fetal cephalic position, fetal gender and placental position did not significantly influence neurosonography scores.</p></div><div><h3>Conclusion</h3><p>In clinical setting, basic fetal neurosonography can be sufficiently performed in the majority of cases. This was not significantly influenced by maternal or fetal factors. The optimal gestational age for neurosonography is between 22 and 34 weeks.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"21 ","pages":"Article 100289"},"PeriodicalIF":0.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000097/pdfft?md5=387429e04a46981d374b4707b26bae12&pid=1-s2.0-S2590161324000097-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139743206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methotrexate as the first-line treatment of unruptured tubular ectopic pregnancies with high initial human chorionic gonadotropin levels: A retrospective cohort","authors":"Fatemeh Keikha ,&nbsp;Shireen Shams Ardekani ,&nbsp;Mohammadamin Parsaei ,&nbsp;Nikan Zargarzadeh ,&nbsp;Alireza Hadizadeh ,&nbsp;Azadeh Tarafdari","doi":"10.1016/j.eurox.2024.100286","DOIUrl":"https://doi.org/10.1016/j.eurox.2024.100286","url":null,"abstract":"<div><h3>Objectives</h3><p>To evaluate the effectiveness of the first-line medical management with Methotrexate (MTX) in the treatment of patients with stable tubal Ectopic Pregnancies (EPs) and varying ranges of Beta-Human Chorionic Gonadotropin (β-HCG) levels.</p></div><div><h3>Materials and methods</h3><p>In this retrospective cohort study, we reviewed the medical records of a total of 184 patients with the diagnosis of tubal EP, who received MTX as their first-line treatment. Patients with a baseline β-HCG&lt; 4800 mIU/mL received single-dose MTX (n = 136) and those with an initial β-HCG≥ 4800 mIU/mL underwent the double-dose MTX regimen (n = 48). The treatment success was determined by evaluating the reported weekly β-HCG levels of the patients.</p></div><div><h3>Results</h3><p>Baseline β-HCG and mass size in the single-dose group were 1895.1 ± 1463.4 mIU/mL and 2.2 ± 1.1 cm, respectively, compared to 17,867.6 ± 31,870.5 mIU/mL and 2.3 ± 1.1 cm in the double-dose group. Treatment duration was 30.6 ± 16.9 days for single dose and 41.0 ± 27.0 days for double dose, with additional MTX in 27.2% and 12.5% in respective groups. Single dose achieved a 92.6% success rate, and double dose, 81.3%, without serious adverse effects. No significant effects were seen for either baseline β-HCG and mass size on the treatment success rates of both groups (p-value&gt;0.05). However, the presence of Fetal Heart Rate (FHR) was associated with poorer responses only in the single-dose group (p-value=0.034).</p></div><div><h3>Conclusions</h3><p>Medical management with MTX shows promise as a first-line treatment for tubal EPs with β-HCG&gt; 2000, suggesting a potential reassessment of existing guidelines in light of this emerging evidence. However, further research seems crucial in this field.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":"21 ","pages":"Article 100286"},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000061/pdfft?md5=431263de8c006c6db5bdefabced89d80&pid=1-s2.0-S2590161324000061-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139714938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}