Best Practice & Research Clinical Obstetrics & Gynaecology最新文献

{"title":"Borderline ovarian tumours: A comprehensive review of published evidence","authors":"Kyriaki-Barbara Papalois ,&nbsp;Michail Sideris ,&nbsp;Samuel George Oxley ,&nbsp;Arjun Jeyarajah ,&nbsp;Alexandra Lawrence ,&nbsp;Elly Brockbank ,&nbsp;Saurabh Phadnis ,&nbsp;James Dilley ,&nbsp;Ranjit Manchanda","doi":"10.1016/j.bpobgyn.2025.102688","DOIUrl":"10.1016/j.bpobgyn.2025.102688","url":null,"abstract":"<div><div>Borderline Ovarian Tumours (BOTs) comprise 15–20 % of all epithelial ovarian tumours. BOTs are characterised by increased mitotic activity but lack infiltrative destructive growth and stromal invasion. Several dilemmas and controversies have been discussed in the literature regarding BOT management including surgical approach (radical versus fertility-sparing surgery), surgical route (open versus laparoscopic surgery) and impact on disease recurrence, follow-up protocols/modalities (imaging, serum biomarkers), role of completion surgery, lymph node dissection during staging, adjuvant chemotherapy, as well as use of Hormone-Replacement Therapy (HRT) post-surgery. We performed a structured narrative review on Medline and Cochrane Library Databases to identify studies pertaining to the management of BOTs. Identifying areas of agreement and outstanding uncertainty are integral to optimise robust treatment regimens for BOT management and improve the Quality of Life (QoL) and clinical outcomes for patients. We discuss a framework of recommendations to counsel, manage and follow-up women diagnosed with BOT.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"104 ","pages":"Article 102688"},"PeriodicalIF":4.1,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of prenatal ultrasound and MRI in predicting survival in severe isolated congenital diaphragmatic Hernia: A systematic review and meta-analysis","authors":"Hiba Mustafa ,&nbsp;Francesco D'Antonio ,&nbsp;Alena Tofte ,&nbsp;Faezeh Aghajani ,&nbsp;Meera A. Thiel ,&nbsp;Anna Flood ,&nbsp;Giorgio Pagani ,&nbsp;Asma Khalil","doi":"10.1016/j.bpobgyn.2025.102687","DOIUrl":"10.1016/j.bpobgyn.2025.102687","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To investigate the predictive accuracy of the ultrasound-measured observed/expected (O/E) lung-to-head ratio (LHR) versus MRI-measured O/E total fetal lung volume (TFLV) in predicting postnatal survival in fetuses with an isolated congenital diaphragmatic hernia (CDH) undergoing expectant management.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A systematic review was conducted including studies reporting on the prognostic value of ultrasound-measured O/E LHR and MRI-measured O/E TFLV in predicting survival to hospital discharge in fetuses diagnosed with isolated CDH. Pregnancies undergoing fetal therapy were excluded. The overall accuracy was assessed by computing summary estimates of sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR–), and diagnostic odds ratio (DOR), using the hierarchical summary receiver operating characteristics (HSROC) model. Synthetic analysis included studies in which the number of true-positive, false-positive, false-negative, and true-negative cases was available or deducible. We planned a subgroup analysis based on index test cut-offs and the side of CDH (left or right). Heterogeneity was assessed using Cochran's Q statistic.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;This systematic review included 33 studies comprising 1702 fetuses with isolated CDH published between 2000 and 2024. The meta-analysis included 18 studies encompassing 960 fetuses with ultrasound-measured O/E LHR and 742 fetuses with MRI-measured O/E TFLV. In the ultrasound studies, the pooled survival was 62 % compared to 68 % in the MRI studies. Both O/E LHR and O/E TFLV were significantly associated with survival (pooled O/E LHR 0.07, 95 % CI 0.04, 0.13; pooled O/E TFLV 0.09, 95 % CI 0.05, 0.17). In all severe CDH cases, both US and MRI appeared comparable. The O/E LHR had a pooled sensitivity of 72.2 % (95 % CI 64.9–78.4), specificity of 83.9 % (95 % CI 71.2–91.6), DOR of 13.5 (95 % CI 7.2–25.3), LR+ of 4.48 (95 % CI 2.5–8.0), and LR-of 0.33 (95 % CI 0.3–0.4). The O/E TFLV had a pooled sensitivity of 84 % (95 % CI 74.7 90.3), specificity of 62.5 % (95 % CI 45.5–76.8), DOR of 8.72 (95 % CI 3.4–22.4), +LR of 2.24 (95 % CI 1.4–3.5), and -LR of 0.26 (95 % CI 0.1–0.5). In the subgroup analysis of left-sided CDH, although the pooled sensitivity and DOR appeared higher using MRI, the 95 % CI overlapped: O/E LHR had a sensitivity of 73.6 (95 % CI 61.5–82.9), specificity 82.0 (95 % CI 63.8–92.2), DOR 12.7 (95 % CI 5.9–27.1), + LR 4.09 (95 % CI 2.0–8.2), and -LR 0.32 (95 % CI 0.2–0.5), while the O/E TFLV had sensitivity of 91.2 (95 % CI 79.7–96.5), specificity of 78.1 (95 % CI 65.3–87.1), DOR 37.1 (95 % CI 12.3–111.6), +LR 4.17 (95 % CI 2.5–6.9), and -LR 0.11 (95 % CI 0.04–0.3). While five studies investigated right-sided CDH in the ultrasound group, there was only one study in the MRI group. Seven studies included head-to-head comparison between prenatal ultrasound and MRI, of which the diagnostic accuracy appeared c","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"104 ","pages":"Article 102687"},"PeriodicalIF":4.1,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrauterine transfusion: Best practices, techniques, and evolving trends","authors":"Roland Devlieger ,&nbsp;Simen Vergote ,&nbsp;Emma Van den Eede ,&nbsp;Kobe Haenen ,&nbsp;Liesbeth Lewi","doi":"10.1016/j.bpobgyn.2025.102686","DOIUrl":"10.1016/j.bpobgyn.2025.102686","url":null,"abstract":"<div><div>Intrauterine transfusion (IUT) remains the cornerstone of treatment for severe fetal anemia, particularly due to red blood cell alloimmunization, and is increasingly utilized in select non-immune conditions such as complicated monochorionic twins and parvovirus B19 infection. This narrative review provides a comprehensive overview of current best practices and recent developments in IUT therapy, including indications, diagnostic strategies, procedural techniques, outcomes, and emerging trends. Evidence-based guidelines, multicenter cohort studies, and expert consensus statements were reviewed, with particular attention to diagnosis and management of fetal anemia, procedural safety, timing, transfusion strategy, and center-level practices. The introduction of ultrasound-guided intravascular transfusion via the intrahepatic vein or placental cord insertion has markedly reduced procedure-related risks, resulting in survival rates exceeding 85 % in most settings and favorable long-term outcomes. Despite these advances, challenges persist for early gestational interventions and recurrent transfusions. Overall, IUT is a highly effective intervention for fetal anemia when performed in specialized centers with multidisciplinary expertise.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"104 ","pages":"Article 102686"},"PeriodicalIF":4.1,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145584180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-utero repair of open neural tube defects, lesion closure techniques and the choice of patch","authors":"Charles B. Stevenson ,&nbsp;Stephen Fletcher ,&nbsp;Thomas Larrew ,&nbsp;Jason K. Chu","doi":"10.1016/j.bpobgyn.2025.102677","DOIUrl":"10.1016/j.bpobgyn.2025.102677","url":null,"abstract":"<div><div>In 2011, the landmark Management of Myelomeningocele Study (MOMS) demonstrated unequivocal benefits for children undergoing prenatal closure of myelomeningocele. In addition to reducing the need for CSF diversion following delivery, the procedure was also shown to improve independent ambulation at school age and beyond, typically yielding a functional neurological level at least 2 better than the anatomic level in these patients. While prenatal myelomeningocele (MMC) closure can be more technically challenging and demanding than postnatal closure, the same basic surgical principles are typically employed during fetal intervention to obtain a multi-layered, water-tight closure with recapitulation of the normal anatomic relationships. Here we describe commonly utilized operative techniques for intrauterine MMC closure, with illustration of both open and endoscopic variations to perform the procedure. As maternal-fetal centers across the globe continue to gain experience with intrauterine MMC closure, it is incumbent that we constantly strive to improve both the efficacy and safety of the procedure, mitigating the potential complications of prenatal closure such that the benefits for the child far outweigh the associated risks for both mother and baby.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"103 ","pages":"Article 102677"},"PeriodicalIF":4.1,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serial amnioinfusions as a regenerative therapy for pulmonary hypoplasia in fetuses with intrauterine renal failure: rationale, techniques, and ethical considerations","authors":"Tanvi Rana ,&nbsp;Jena L. Miller ,&nbsp;Mounira Habli","doi":"10.1016/j.bpobgyn.2025.102676","DOIUrl":"10.1016/j.bpobgyn.2025.102676","url":null,"abstract":"<div><div>This article is a comprehensive review of amniotic fluid, its crucial role in fetal development, particularly lung development, and the implications of its deficiency, oligohydramnios. It describes the various causes of fetal renal failure that lead to oligohydramnios, focusing on congenital anomalies of the urinary tract. The text then introduces amnioinfusion, an experimental therapy that involves infusing fluid into the amniotic sac to compensate for the lack of fetal urine production. It details the rationale for this intervention, outlines the different technical approaches employed, and discusses the potential complications and ethical considerations surrounding this experimental therapy. Lastly, the paper summarizes the rationale and design of the RAFT trial, a clinical study that explored the effectiveness and safety of amnioinfusion in the management of early pregnancy renal anhydramnios (EPRA).</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"103 ","pages":"Article 102676"},"PeriodicalIF":4.1,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal therapy with mTOR inhibitors in cardiac rhabdomyoma and lymphatic malformations","authors":"Nikan Zargarzadeh ,&nbsp;Pegah Rashidian ,&nbsp;Tishi Shah ,&nbsp;Greg Ryan ,&nbsp;Yalda Afshar","doi":"10.1016/j.bpobgyn.2025.102673","DOIUrl":"10.1016/j.bpobgyn.2025.102673","url":null,"abstract":"<div><div>Fetal therapy has advanced with novel pharmacological approaches to address congenital tumors and malformations, including cardiac rhabdomyomas and lymphatic malformations (LMs). Cardiac rhabdomyomas, often associated with tuberous sclerosis complex (TSC), can lead to significant morbidity due to arrhythmias, left or right ventricular outflow tract obstruction and heart failure, particularly in neonates. LMs, resulting from abnormal development of the lymphatic system, can cause considerable morbidity, including airway obstruction, disfigurement, recurrent infections, bleeding into cysts, and impaired function of affected organs, depending on location. Recent therapies involving mammalian target rapamycin (mTOR) inhibitors, such as everolimus and sirolimus, offer promising interventions for these conditions. As mTOR inhibitors target dysregulated cell growth and angiogenesis, they can effectively reduce the size of both cardiac rhabdomyomas and LMs <em>in-utero</em>. Clinical studies in the pediatric population have shown that mTOR inhibitors promote regression of cardiac rhabdomyomas, leading to improved cardiac function, and similarly reduce the size of lymphatic malformations, thereby decreasing the need for surgical or interventional procedures. Sirolimus has also shown efficacy in treating complex LMs and is increasingly being used as a first line agent alone as well as in conjunction with other treatment modalities like surgery and sclerotherapy. Despite potential side effects, including gastrointestinal discomfort and an increased risk of infection, the risk–benefit ratio should be carefully evaluated on an individual patient basis. This review examines current evidence supporting the use of mTOR inhibitors in fetal therapy, highlighting their ability to mitigate postnatal complications and improve long-term outcomes. Further research is needed to optimize dosing protocols and assess the long-term safety of these therapies in the fetal population.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"103 ","pages":"Article 102673"},"PeriodicalIF":4.1,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of valacyclovir on secondary prevention of congenital cytomegalovirus infection","authors":"Christos Chatzakis ,&nbsp;Nicolas Bourgon ,&nbsp;Jacques Fourgeaud ,&nbsp;Marianne Leruez-Ville ,&nbsp;Yves Ville","doi":"10.1016/j.bpobgyn.2025.102679","DOIUrl":"10.1016/j.bpobgyn.2025.102679","url":null,"abstract":"<div><div>It has been established recently that oral valacyclovir 8g/day reduces significantly the vertical CMV transmission rate in pregnancies with primary Cytomegalovirus (CMV) infection acquired periconceptionally or during the first trimester. Aim of the present study is to expand the result of the previous studies by including any recent cohort study on the topic. MEDLINE, Scopus, Cochrane Central Register of Controlled Trials (Central), the US Registry of clinical trials (<span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span>) and grey literature sources were searched. Randomized controlled trials and cohort studies administering oral valacyclovir 8g/day in pregnancies with primary CMV infection acquired periconceptionally or during the first trimester were included. Cochrane's Risk of Bias 2 and Robins I tools were used for the risk of bias assessment. The result of amniocentesis was the primary outcome of interest. Two-stages individual patient data meta-analysis was performed and a subgroup analysis was carried out, assessing separately the periconceptional period and the first trimester infections. Four studies were included in the analysis (n = 860 participants). Valacyclovir reduced the vertical transmission rate, adjusted odds ratio (a0R) = 0.39 (95 % CI 0.25–0.59). This reduction was apparent both for periconceptional period aOR = 0.30 (95 % CI 0.13–0.68) and first trimester aOR = 0.47 (95 % CI 0.28–0.78) infections. Valacyclovir also reduced the rate of neonatal infection, a0R = 0.45 (95 % CI 0.25–0.83), both in periconceptional period aOR = 0.42 (95 % CI 0.20–0.90)] and in first trimester aOR = 0.54 (95 % CI 0.29–0.99) infections. Oral valacyclovir (8 g/day) reduces the vertical transmission rates of CMV following primary maternal infection acquired periconceptionally or in the first trimester.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"103 ","pages":"Article 102679"},"PeriodicalIF":4.1,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologics in red cell and platelet alloimmunizations: State of the science and future perspectives","authors":"Kenneth J. Moise Jr ,&nbsp;Eleonor Tiblad","doi":"10.1016/j.bpobgyn.2025.102682","DOIUrl":"10.1016/j.bpobgyn.2025.102682","url":null,"abstract":"<div><div>Hemolytic disease of the fetus and newborn (HDFN) is routinely treated with the intrauterine transfusion (IUT) of compatible donor red cells once fetal anemia is detected. Intravenous immune globulin (IVIG) is often used in patients with a previous history of early onset disease in a previous pregnancy. Although IUT's are still required in the majority of these pregnancies, IVIG appears to prolong the gestational age until these are necessary. IVIG with or without oral steroids is utilized in most countries to prevent thrombocytopenia and intracranial hemorrhage in cases of fetal/neonatal alloimmune thrombocytopenia (FNAIT). Nipocalimab, a humanized monoclonal antibody that blocks the neonatal Fc receptor, is currently undergoing clinical trials in both HDFN and FNAIT as a potential new form of immunotherapy for these alloimmune disorders of pregnancy.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"103 ","pages":"Article 102682"},"PeriodicalIF":4.1,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early twin-to-twin transfusion syndrome: From early gestational physiology to diagnosis and management","authors":"Ali Javinani ,&nbsp;Asma Khalil ,&nbsp;Eyal Krispin","doi":"10.1016/j.bpobgyn.2025.102675","DOIUrl":"10.1016/j.bpobgyn.2025.102675","url":null,"abstract":"<div><div>Twin-to-Twin Transfusion Syndrome (TTTS) occurs in about 15 % of monochorionic twin pregnancies, less frequently does it occur prior to 18 weeks of gestation. When occurring early, this severe complication presents unique diagnostic and management challenges. In this review we will focus on the pathophysiological mechanisms underlying early TTTS. We will be emphasizing the role of placental vascular anastomoses and hemodynamic imbalances in disease progression. Advances in imaging techniques allow early diagnosis of the disease, impacting on consultation and clinical decision-making. Current treatment strategies, specifically including fetoscopic laser photocoagulation, are reviewed with a focus on optimizing perinatal outcomes. By integrating insights from fetal physiology, diagnostic innovations, and therapeutic advancements, this review aims to refine clinical management approaches to improve survival and morbidity outcomes for monochorionic twin pregnancies complicated by early TTTS.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"103 ","pages":"Article 102675"},"PeriodicalIF":4.1,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From concept to practice: Screening for fetal and neonatal alloimmune thrombocytopenia (FNAIT)","authors":"R. Pothof ,&nbsp;T.W. de Vos ,&nbsp;E. Lopriore ,&nbsp;D. Winkelhorst ,&nbsp;C.E. van der Schoot ,&nbsp;M. de Haas ,&nbsp;E.J.T. Verweij","doi":"10.1016/j.bpobgyn.2025.102683","DOIUrl":"10.1016/j.bpobgyn.2025.102683","url":null,"abstract":"<div><div>Affecting 1 per 1000 to 2000 pregnancies, Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) is the leading cause for (severe) thrombocytopenia in term neonates. Due to an incompatibility between fetal and maternal platelets, maternal alloantibodies are formed against paternally derived human platelet antigens (HPAs). The alloantibodies can cross the placenta into the fetal circulation, where they can destruct the fetal platelets. As a result, severe thrombocytopenia may occur, potentially leading to intracranial hemorrhage (ICH) or severe organ bleeding during pregnancy or shortly after birth. In the absence of a universal prenatal screening program focussed on HPA-1a, FNAIT is often diagnosed too late, typically after the onset of severe fetal or neonatal bleeding complications. A screening program could be very effective in identifying the first pregnancy complicated with FNAIT, allowing timely intervention and prevent severe ICH and its associated long-term permanent sequelae. The aim of this review is to provide a comprehensive overview of the existing evidence regarding a possible future screening program for FNAIT. Additionally, challenges will be explored that need to be addressed for successful implementation of a screening program.</div></div>","PeriodicalId":50732,"journal":{"name":"Best Practice & Research Clinical Obstetrics & Gynaecology","volume":"103 ","pages":"Article 102683"},"PeriodicalIF":4.1,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}