Pub Date : 2025-08-01DOI: 10.1016/j.xagr.2025.100555
Vincent Landré MD , Hans-Christoph Pape MD , Ksenija Slankamenac MD, PhD , Nicole Ochsenbein-Kölble MD , Nina Kimmich MD
<div><h3>Background</h3><div>Uterine artery pseudoaneurysm (UAP) is a rare but potentially life-threatening condition that can result in severe hemorrhage. Due to its nonspecific clinical presentation, it is often misdiagnosed, leading to delays in appropriate intervention. UAP commonly arises following uterine trauma, including cesarean section, vaginal delivery, and other gynecological procedures or pathologies, such as endometriosis. While selective arterial embolization is the preferred treatment, noninterventional management may be a viable alternative in selected cases.</div></div><div><h3>Case Report</h3><div>We present a case of a 33-year-old woman in her first pregnancy diagnosed with UAP at 27 gestational weeks (GW). She complained about intermittent left lower abdominal pain without vaginal bleeding. Initial imaging with Doppler ultrasonography and noncontrast magnetic resonance imaging (MRI) identified a left paracervical mass consistent with a UAP. Further imaging with contrast-enhanced MRI confirmed the diagnosis and revealed thrombosis of the lesion. Given the absence of perfusion and clinical stability, a noninterventional approach was pursued. The patient remained hemodynamically stable and was discharged after 6 days of hospitalization. At 38+4 GW, she underwent a scheduled cesarean section, and both maternal and neonatal outcomes were favorable. Follow-up at 12 months postdiagnosis showed no recurrence or complications.</div></div><div><h3>Methods</h3><div>A systematic review was conducted, analyzing peer-reviewed studies from 1955 to 2024 in PubMed and EMBASE databases. Inclusion criteria focused on human studies reporting UAP, with data extracted on risk factors, diagnostic modalities, treatment strategies, and clinical outcomes. Statistical analyses included the Student’s <em>t</em> test for continuous variables and the Pearson chi-square test for categorical variables.</div></div><div><h3>Results</h3><div>Out of 790 initially identified articles, 131 met inclusion criteria, comprising 144 patients with uterine artery UAP. Among these, 20 patients were pregnant, and 124 were nonpregnant. Comorbidities were more common in pregnant patients (55% vs 34.7%). Prior uterine manipulation occurred in 50% of pregnant and 90.3% of nonpregnant cases, with laparotomy and cesarean sections being most frequent. Vaginal bleeding was the most common symptom in nonpregnant patients (81.5%), while pain dominated in pregnant cases (85%). Imaging primarily involved ultrasound and angiography, combined with computed tomography (CT) in nonpregnant women (70% vs 35%) and MRI in pregnancy (70% vs 11.3%). Embolization was the main treatment (90% in pregnancy, 99% in nonpregnant), with few complications and no reported deaths. Statistical analysis showed a significant association in nonpregnant patients between vaginal bleeding and the need for transfusion (<em>P</em><.05), as well as between bleeding and smaller UAP size (24.5 vs 32.3 mm, <em>P</
动脉假性动脉瘤（UAP）是一种罕见但可能危及生命的疾病，可导致严重出血。由于其非特异性临床表现，它经常被误诊，导致适当干预的延误。UAP通常发生在子宫外伤后，包括剖宫产、阴道分娩和其他妇科手术或病理，如子宫内膜异位症。虽然选择性动脉栓塞是首选的治疗方法，但在某些情况下，非介入治疗可能是一种可行的选择。病例报告：我们报告一例33岁女性首次妊娠，27孕周时诊断为UAP。她主诉间歇性左下腹疼痛，无阴道出血。最初的多普勒超声和非对比磁共振成像（MRI）发现了一个符合UAP的左侧宫颈旁肿块。进一步的MRI造影证实了诊断，并发现病变处有血栓形成。考虑到缺乏灌注和临床稳定性，采用非介入性方法。患者血流动力学保持稳定，住院6天后出院。在38+4 GW时，她接受了预定的剖宫产，产妇和新生儿的结局都是有利的。随访12个月，无复发及并发症。方法对1955 ~ 2024年PubMed和EMBASE数据库中同行评议的研究进行系统回顾分析。纳入标准侧重于报告UAP的人类研究，并提取有关风险因素、诊断方式、治疗策略和临床结果的数据。统计分析包括对连续变量的学生t检验和对分类变量的皮尔逊卡方检验。结果在最初确定的790篇文章中，131篇符合纳入标准，包括144例子宫动脉UAP患者。其中怀孕20例，未怀孕124例。合并症在孕妇中更为常见（55% vs 34.7%）。50%的孕妇和90.3%的非孕妇有过子宫操作史，其中剖腹手术和剖宫产手术最为常见。阴道出血是非妊娠患者最常见的症状（81.5%），而疼痛以妊娠患者为主（85%）。成像主要包括超声和血管造影，在非孕妇中结合计算机断层扫描（CT）（70%对35%）和在孕妇中结合MRI（70%对11.3%）。栓塞是主要的治疗方法（90%为妊娠，99%为非妊娠），并发症很少，无死亡报告。统计分析显示，在非妊娠患者中，阴道出血与输血需要之间存在显著关联（P< 0.05），出血与较小的UAP尺寸之间存在显著关联（24.5 vs 32.3 mm, P< 0.05）。结论uap是一种罕见且有潜在危害性的疾病。阴道出血是非妊娠患者最常见的表现，而疼痛在妊娠患者中更为常见。较小的uap在未怀孕的患者中更容易出血，这表明破裂风险并不完全取决于尺寸。诊断可以通过超声、血管造影和CT进行，或者在怀孕时，特别是通过MRI进行。栓塞术非常有效，仍然是标准的治疗方法。对于血流动力学稳定的自发性血栓形成或未灌注的uap患者，尽管其有效性的证据仍然有限，但应谨慎考虑非介入治疗。个性化的、多学科的管理仍然是关键。进一步的数据收集将有助于完善治疗策略。
{"title":"Management of uterine artery pseudoaneurysm: a case report of noninterventional treatment with systematic review","authors":"Vincent Landré MD , Hans-Christoph Pape MD , Ksenija Slankamenac MD, PhD , Nicole Ochsenbein-Kölble MD , Nina Kimmich MD","doi":"10.1016/j.xagr.2025.100555","DOIUrl":"10.1016/j.xagr.2025.100555","url":null,"abstract":"<div><h3>Background</h3><div>Uterine artery pseudoaneurysm (UAP) is a rare but potentially life-threatening condition that can result in severe hemorrhage. Due to its nonspecific clinical presentation, it is often misdiagnosed, leading to delays in appropriate intervention. UAP commonly arises following uterine trauma, including cesarean section, vaginal delivery, and other gynecological procedures or pathologies, such as endometriosis. While selective arterial embolization is the preferred treatment, noninterventional management may be a viable alternative in selected cases.</div></div><div><h3>Case Report</h3><div>We present a case of a 33-year-old woman in her first pregnancy diagnosed with UAP at 27 gestational weeks (GW). She complained about intermittent left lower abdominal pain without vaginal bleeding. Initial imaging with Doppler ultrasonography and noncontrast magnetic resonance imaging (MRI) identified a left paracervical mass consistent with a UAP. Further imaging with contrast-enhanced MRI confirmed the diagnosis and revealed thrombosis of the lesion. Given the absence of perfusion and clinical stability, a noninterventional approach was pursued. The patient remained hemodynamically stable and was discharged after 6 days of hospitalization. At 38+4 GW, she underwent a scheduled cesarean section, and both maternal and neonatal outcomes were favorable. Follow-up at 12 months postdiagnosis showed no recurrence or complications.</div></div><div><h3>Methods</h3><div>A systematic review was conducted, analyzing peer-reviewed studies from 1955 to 2024 in PubMed and EMBASE databases. Inclusion criteria focused on human studies reporting UAP, with data extracted on risk factors, diagnostic modalities, treatment strategies, and clinical outcomes. Statistical analyses included the Student’s <em>t</em> test for continuous variables and the Pearson chi-square test for categorical variables.</div></div><div><h3>Results</h3><div>Out of 790 initially identified articles, 131 met inclusion criteria, comprising 144 patients with uterine artery UAP. Among these, 20 patients were pregnant, and 124 were nonpregnant. Comorbidities were more common in pregnant patients (55% vs 34.7%). Prior uterine manipulation occurred in 50% of pregnant and 90.3% of nonpregnant cases, with laparotomy and cesarean sections being most frequent. Vaginal bleeding was the most common symptom in nonpregnant patients (81.5%), while pain dominated in pregnant cases (85%). Imaging primarily involved ultrasound and angiography, combined with computed tomography (CT) in nonpregnant women (70% vs 35%) and MRI in pregnancy (70% vs 11.3%). Embolization was the main treatment (90% in pregnancy, 99% in nonpregnant), with few complications and no reported deaths. Statistical analysis showed a significant association in nonpregnant patients between vaginal bleeding and the need for transfusion (<em>P</em><.05), as well as between bleeding and smaller UAP size (24.5 vs 32.3 mm, <em>P</","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100555"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The rudimentary uterine horn is a Müllerian anomaly, which is characterized by a partial failure in development and fusion. Pregnancy rarely occurs in this horn, and if it does, it usually ruptures in the first or second trimester of pregnancy. It can be missed during antenatal ultrasound scanning and carries a high risk of maternal and fetal mortality. A 26-year-old gravida 2 para 1 Ethiopian woman presented with a gestational age of 29 3/7 weeks and sudden onset abdominal pain of 9 hours of duration. At presentation, the patient was in hemorrhagic shock with abdominal tenderness and signs of fluid collection, and the fetal heart rate was 124 bpm. The patient’s hemoglobin level was 9.4 g/dL. The patient underwent an emergency laparotomy for a ruptured rudimentary horn with active bleeding. Excision of the rudimentary horn was performed, and the mother was discharged with improvement. Although pregnancies in a rudimentary horn rarely progress to the third trimester of pregnancy, this condition should be suspected in patients with hemodynamic instability and abdominal pain. Excision of the rudimentary horn can prevent maternal mortality.
{"title":"Ruptured rudimentary horn pregnancy in third trimester: a case report","authors":"Ayalkibet Alemayehu Debele MD , Wondu Belayineh MD , Eyerusalem Fissehatsion Dejene MD , Fekade Yerakly Lucas MD , Zekarias Dejene Adugna MD , Teketel Tadese Geremew MD","doi":"10.1016/j.xagr.2025.100549","DOIUrl":"10.1016/j.xagr.2025.100549","url":null,"abstract":"<div><div>The rudimentary uterine horn is a Müllerian anomaly, which is characterized by a partial failure in development and fusion. Pregnancy rarely occurs in this horn, and if it does, it usually ruptures in the first or second trimester of pregnancy. It can be missed during antenatal ultrasound scanning and carries a high risk of maternal and fetal mortality. A 26-year-old gravida 2 para 1 Ethiopian woman presented with a gestational age of 29 3/7 weeks and sudden onset abdominal pain of 9 hours of duration. At presentation, the patient was in hemorrhagic shock with abdominal tenderness and signs of fluid collection, and the fetal heart rate was 124 bpm. The patient’s hemoglobin level was 9.4 g/dL. The patient underwent an emergency laparotomy for a ruptured rudimentary horn with active bleeding. Excision of the rudimentary horn was performed, and the mother was discharged with improvement. Although pregnancies in a rudimentary horn rarely progress to the third trimester of pregnancy, this condition should be suspected in patients with hemodynamic instability and abdominal pain. Excision of the rudimentary horn can prevent maternal mortality.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100549"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.xagr.2025.100557
Rima Kaddoura PhD , Reine Zankar MD , Hani Tamim PhD , Martine El Bejjani PhD , Ziyad R. Mahfoud PhD , Pascale Salameh PhD , Lama Charafeddine MD, FAAP
Background
Preterm birth remains a leading cause of neonatal mortality globally and is worsened in crisis-affected countries like Lebanon. This study explored how social determinants of health relate to preterm birth and maternal postpartum outcomes, including quality of life (QoL), perceived stress, and social support.
Objective
to explore the impact of the social environment in polycrises context on preterm birth, the association between preterm birth and maternal postpartum QoL, perceived stress, and social support.
Study Design
A prospective cohort study was conducted in three Lebanese hospitals from September 2021 to December 2023. A total of 116 mother-infant pairs (78 full-term, 38 preterm) were recruited. Data on social determinants, perceived stress (PSS-10), social support (MSPSS), and QoL (WHOQOL-BREF) were collected at delivery and 4 to 6 months postpartum. Analyses included t tests, chi-square tests, and linear mixed models.
Results
Mothers of preterm infants had significantly higher stress (PSS-10: 19.53 vs 15.29, P=.011) and lower QoL scores across physical (39.16 vs 57.4, P<.001), psychological (54.08 vs 66.91, P<.001), and social (58.53 vs 69.56, P=.007) domains at delivery. At 4 to 6 months postpartum, all mothers reported declines in social support (71.8 vs 67.3, P=.003), social QoL (69.4 vs 61.4, P=.005), and environmental QoL (70 vs 64.5, P=.012).
Conclusion
This study highlights the impact of social support, stress, and QoL on preterm birth outcomes in a crisis-affected region. Mothers of preterm infants experienced higher stress and lower QoL at birth, suggesting the need for targeted interventions to support maternal mental health. Addressing these social determinants is needed for improving pregnancy outcomes, particularly in vulnerable populations facing multiple social and economic challenges.
早产仍然是全球新生儿死亡的主要原因，在黎巴嫩等受危机影响的国家，早产情况更加严重。本研究探讨了健康的社会决定因素如何与早产和产妇产后结局相关，包括生活质量（QoL）、感知压力和社会支持。目的探讨多元危机背景下社会环境对早产的影响，以及早产与产妇产后生活质量、感知压力和社会支持的关系。研究设计于2021年9月至2023年12月在黎巴嫩三家医院进行了一项前瞻性队列研究。总共招募了116对母婴（78对足月，38对早产儿）。在分娩和产后4 ~ 6个月收集社会决定因素、感知压力（PSS-10）、社会支持（MSPSS）和生活质量（WHOQOL-BREF）数据。分析包括t检验、卡方检验和线性混合模型。结果早产母亲在分娩时的生理（39.16 vs . 57.4， P= 0.01）、心理（54.08 vs . 66.91， P= 0.01）和社交（58.53 vs . 69.56， P= 0.07）方面的生活质量得分显著高于对照组（PSS-10: 19.53 vs . 15.29， P= 0.011）。在产后4至6个月，所有母亲都报告了社会支持（71.8比67.3，P= 0.003），社会生活质量（69.4比61.4，P= 0.005）和环境生活质量（70比64.5，P= 0.012）的下降。结论本研究强调了社会支持、压力和生活质量对危机影响地区早产儿结局的影响。早产婴儿的母亲在出生时面临更高的压力和更低的生活质量，这表明需要有针对性的干预措施来支持母亲的心理健康。改善妊娠结局需要解决这些社会决定因素，特别是在面临多重社会和经济挑战的弱势群体中。
{"title":"Stress and quality of life postpreterm birth during polycrises: prospective cohort study","authors":"Rima Kaddoura PhD , Reine Zankar MD , Hani Tamim PhD , Martine El Bejjani PhD , Ziyad R. Mahfoud PhD , Pascale Salameh PhD , Lama Charafeddine MD, FAAP","doi":"10.1016/j.xagr.2025.100557","DOIUrl":"10.1016/j.xagr.2025.100557","url":null,"abstract":"<div><h3>Background</h3><div>Preterm birth remains a leading cause of neonatal mortality globally and is worsened in crisis-affected countries like Lebanon. This study explored how social determinants of health relate to preterm birth and maternal postpartum outcomes, including quality of life (QoL), perceived stress, and social support.</div></div><div><h3>Objective</h3><div>to explore the impact of the social environment in polycrises context on preterm birth, the association between preterm birth and maternal postpartum QoL, perceived stress, and social support.</div></div><div><h3>Study Design</h3><div>A prospective cohort study was conducted in three Lebanese hospitals from September 2021 to December 2023. A total of 116 mother-infant pairs (78 full-term, 38 preterm) were recruited. Data on social determinants, perceived stress (PSS-10), social support (MSPSS), and QoL (WHOQOL-BREF) were collected at delivery and 4 to 6 months postpartum. Analyses included <em>t</em> tests, chi-square tests, and linear mixed models.</div></div><div><h3>Results</h3><div>Mothers of preterm infants had significantly higher stress (PSS-10: 19.53 vs 15.29, <em>P</em>=.011) and lower QoL scores across physical (39.16 vs 57.4, <em>P</em><.001), psychological (54.08 vs 66.91, <em>P</em><.001), and social (58.53 vs 69.56, <em>P</em>=.007) domains at delivery. At 4 to 6 months postpartum, all mothers reported declines in social support (71.8 vs 67.3, <em>P</em>=.003), social QoL (69.4 vs 61.4, <em>P</em>=.005), and environmental QoL (70 vs 64.5, <em>P</em>=.012).</div></div><div><h3>Conclusion</h3><div>This study highlights the impact of social support, stress, and QoL on preterm birth outcomes in a crisis-affected region. Mothers of preterm infants experienced higher stress and lower QoL at birth, suggesting the need for targeted interventions to support maternal mental health. Addressing these social determinants is needed for improving pregnancy outcomes, particularly in vulnerable populations facing multiple social and economic challenges.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100557"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.xagr.2025.100553
Shadae K. Beale MD , Natalie Cohen MD , Beatrice Secheli MD , Donald McIntire PhD , Kimberly A. Kho MD, MPH
BACKGROUND
Within public online forums, patients often seek reassurance and guidance from the community regarding postoperative symptoms and expectations, and when to seek medical assistance. Others are using artificial intelligence in the form of online search engines or chatbots such as ChatGPT or Perplexity. Artificial intelligence chatbot assistants have been growing in popularity; however, clinicians may be hesitant to use them because of concerns about accuracy. The online networking service for medical professionals, Doximity, has expanded its resources to include a Health Insurance Portability and Accountability Act–compliant artificial intelligence writing assistant, Doximity GPT, designed to reduce the administrative burden on clinicians. Health professionals learn using a “medical model,” which greatly differs from the “health belief model” that laypeople learn through. This mismatch in learning perspectives likely contributes to a communication mismatch even during digital clinician–patient encounters, especially in patients with limited health literacy during the perioperative period when complications may arise.
OBJECTIVE
This study aimed to evaluate the ability of artificial intelligence chatbot assistants (Doximity GPT, Perplexity, and ChatGPT) to generate quality, accurate, and empathetic responses to postoperative patient queries that are also understandable and actionable.
STUDY DESIGN
Responses to 10 postoperative queries sourced from HysterSisters, a public forum for “woman-to-woman hysterectomy support,” were generated using 3 artificial intelligence chatbot assistants (Doximity GPT, Perplexity, and ChatGPT) and a minimally invasive gynecologic surgery fellowship–trained surgeon. Ten physician evaluators compared the blinded responses for quality, accuracy, and empathy. A separate pair of physician evaluators scored the responses for understandability and actionability using the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P). The final scores were the average of both reviewers’ scores. Analysis of variance was used for pairwise comparison of the evaluator scores between sources. Lastly, the Kruskal–Wallis test was used to analyze Flesch–Kincaid scoring for readability. The Pearson chi-square test was used to demonstrate the difference in reading level among the responses for each source.
RESULTS
Compared with a physician, Doximity GPT and ChatGPT were rated as more empathetic than a minimally invasive gynecologic surgeon, but quality and accuracy were similar across these sources. There was a significant difference between Perplexity and the other response sources, favoring the latter, for quality and accuracy (P<.001). Perplexity and the minimally invasive gynecologic surgeon ranked similarly for empathy. Reading ease was greater for the minimally invasive gynecologic surgeon re
{"title":"Comparing physician and artificial intelligence chatbot responses to posthysterectomy questions posted to a public social media forum","authors":"Shadae K. Beale MD , Natalie Cohen MD , Beatrice Secheli MD , Donald McIntire PhD , Kimberly A. Kho MD, MPH","doi":"10.1016/j.xagr.2025.100553","DOIUrl":"10.1016/j.xagr.2025.100553","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Within public online forums, patients often seek reassurance and guidance from the community regarding postoperative symptoms and expectations, and when to seek medical assistance. Others are using artificial intelligence in the form of online search engines or chatbots such as ChatGPT or Perplexity. Artificial intelligence chatbot assistants have been growing in popularity; however, clinicians may be hesitant to use them because of concerns about accuracy. The online networking service for medical professionals, Doximity, has expanded its resources to include a Health Insurance Portability and Accountability Act–compliant artificial intelligence writing assistant, Doximity GPT, designed to reduce the administrative burden on clinicians. Health professionals learn using a “medical model,” which greatly differs from the “health belief model” that laypeople learn through. This mismatch in learning perspectives likely contributes to a communication mismatch even during digital clinician–patient encounters, especially in patients with limited health literacy during the perioperative period when complications may arise.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to evaluate the ability of artificial intelligence chatbot assistants (Doximity GPT, Perplexity, and ChatGPT) to generate quality, accurate, and empathetic responses to postoperative patient queries that are also understandable and actionable.</div></div><div><h3>STUDY DESIGN</h3><div>Responses to 10 postoperative queries sourced from HysterSisters, a public forum for “woman-to-woman hysterectomy support,” were generated using 3 artificial intelligence chatbot assistants (Doximity GPT, Perplexity, and ChatGPT) and a minimally invasive gynecologic surgery fellowship–trained surgeon. Ten physician evaluators compared the blinded responses for quality, accuracy, and empathy. A separate pair of physician evaluators scored the responses for understandability and actionability using the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P). The final scores were the average of both reviewers’ scores. Analysis of variance was used for pairwise comparison of the evaluator scores between sources. Lastly, the Kruskal–Wallis test was used to analyze Flesch–Kincaid scoring for readability. The Pearson chi-square test was used to demonstrate the difference in reading level among the responses for each source.</div></div><div><h3>RESULTS</h3><div>Compared with a physician, Doximity GPT and ChatGPT were rated as more empathetic than a minimally invasive gynecologic surgeon, but quality and accuracy were similar across these sources. There was a significant difference between Perplexity and the other response sources, favoring the latter, for quality and accuracy (<em>P</em><.001). Perplexity and the minimally invasive gynecologic surgeon ranked similarly for empathy. Reading ease was greater for the minimally invasive gynecologic surgeon re","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100553"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uterine prolapse that develops before onset of pregnancy will usually resolve spontaneously by the end of the second trimester of pregnancy without further complications, whereas prolapse that develops during pregnancy is usually first noted in the third trimester of pregnancy. A 28-year-old woman, gravida 3 para 2 (both vaginal delivery), presented with a history of mass protrusion per vagina of 6 hours duration at a gestational age of 34 6/7 weeks of gestation. On physical examination, a complete prolapse of the cervix through the vagina was noted, with part of the lower uterine segment in the vaginal canal. Pelvic ultrasound confirmed the prolapse, with report of part of the lower uterine segment in the vaginal canal. With an assessment of acute uterine prolapse, the patient was placed in a moderately Trendelenburg position, and the prolapse was reduced manually. The cervix was repositioned into the vagina and packed with sterile gauze soaked in saline. Acute presentation of uterine prolapse in the third trimester of pregnancy for the first time is a very rare occurrence. If encountered, a conservative approach that aims at replacing the prolapse back to its position, allowing the cervical edema to subside, should be performed.
{"title":"First-time presentation of acute uterine prolapse in third trimester of pregnancy: a case report","authors":"Abraham Fessehaye Sium MD, Amani Nureddin Abdu MD, Hika Hailu Kitila MD, Tadesse Urgie MD","doi":"10.1016/j.xagr.2025.100543","DOIUrl":"10.1016/j.xagr.2025.100543","url":null,"abstract":"<div><div>Uterine prolapse that develops before onset of pregnancy will usually resolve spontaneously by the end of the second trimester of pregnancy without further complications, whereas prolapse that develops during pregnancy is usually first noted in the third trimester of pregnancy. A 28-year-old woman, gravida 3 para 2 (both vaginal delivery), presented with a history of mass protrusion per vagina of 6 hours duration at a gestational age of 34 6/7 weeks of gestation. On physical examination, a complete prolapse of the cervix through the vagina was noted, with part of the lower uterine segment in the vaginal canal. Pelvic ultrasound confirmed the prolapse, with report of part of the lower uterine segment in the vaginal canal. With an assessment of acute uterine prolapse, the patient was placed in a moderately Trendelenburg position, and the prolapse was reduced manually. The cervix was repositioned into the vagina and packed with sterile gauze soaked in saline. Acute presentation of uterine prolapse in the third trimester of pregnancy for the first time is a very rare occurrence. If encountered, a conservative approach that aims at replacing the prolapse back to its position, allowing the cervical edema to subside, should be performed.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100543"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.xagr.2025.100546
Tina Pasciuto PhD , Francesca Moro PhD , Drieda Zace PhD , Lidia Borzì MSc , Katiuscia Patrizi MSc , Roberta Di Battista MSc , Francesca Ciccarone MD , Floriana Mascilini PhD , Elena Teodorico MD , Giulia Zinicola MD , Maria Luisa Di Pietro PhD , Giovanni Scambia PhD , Antonia Carla Testa PhD
Background
The reality of gynecological patients represents a distinct subgroup of the population in which social and psychological distress can coexist alongside the burden of the disease. “Unmet social needs,” including social distress, which encompasses gender and family violence, abuse, unemployment, and food insecurity, are now widely recognized as critical determinants of health. Some studies have examined the social needs experienced by patients with gynecological disorders, but primarily in gynecologic oncology patients.
Objective
This study aims to assess the prevalence of socio-psychological distress, experiences of violence, and food insecurity in patients attending a tertiary outpatient gynecological clinic. Data were collected using a tailored open-ended questionnaire administered by trained volunteers.
Study design
This is a prospective cross-sectional study. An ad-hoc questionnaire, validated through the Delphi methodology, was administered to all women attending the Gynaecological Outpatient Clinic at Fondazione Policlinico A. Gemelli IRCCS in Rome, Italy, from March to November 2023. Their responses were analyzed focusing on self-reported socio-psychological distress, violence experienced and food insecurity. Inferential analysis was provided to evaluate the possible association with socioeconomic distress and clinical characteristics of patients. Multivariable logistic regression models for predicting outcomes were performed including those parameters that were statistically significant at univariable analysis (p value <.05).
Results
A total of 408 women were included in the study. One hundred and fifty-two (37.2%) reported socio-psychological distress, 136 (33.3%) violence, and 60 (14.7%) food insecurity. Independent risk factors for socio-psychological distress included oncological conditions (OR: 3.76, 95% CI: 1.55–9.11), chronic conditions (OR: 2.22, 95% CI: 1.38–3.57), economic difficulties (OR: 3.91, 95% CI: 2.20–6.93), and experiencing violence (OR: 4.65, 95% CI: 2.83–7.65). Independent risk factors for violence were benign gynecological conditions (OR: 1.95, 95% CI: 1.02–3.74), alcohol use (OR: 1.88, 95% CI: 1.16–3.04), economic difficulties (OR: 1.72, 95% CI: 1.02–2.90), and experiencing food insecurity (OR: 1.92, 95% CI: 1.03–3.59). The only independent risk factor for food insecurity was having economic difficulties (OR: 6.01, 95% CI: 3.06–11.81).
Conclusion
Socio-psychological distress and experiences of violence were found to be prevalent in over one-third of the population studied. Identified risk factors include the type of gynecological condition, economic hardship, and food insecurity. These findings underscore the urgent need for the development of comprehensive social support systems to assist women with gynecological conditions. While integrated clinical and social
{"title":"Socio-psychological distress, violence, and food insecurity in women undergoing gynecological examinations: insights from a cross-sectional study of an Italian Tertiary Clinic","authors":"Tina Pasciuto PhD , Francesca Moro PhD , Drieda Zace PhD , Lidia Borzì MSc , Katiuscia Patrizi MSc , Roberta Di Battista MSc , Francesca Ciccarone MD , Floriana Mascilini PhD , Elena Teodorico MD , Giulia Zinicola MD , Maria Luisa Di Pietro PhD , Giovanni Scambia PhD , Antonia Carla Testa PhD","doi":"10.1016/j.xagr.2025.100546","DOIUrl":"10.1016/j.xagr.2025.100546","url":null,"abstract":"<div><h3>Background</h3><div>The reality of gynecological patients represents a distinct subgroup of the population in which social and psychological distress can coexist alongside the burden of the disease. “Unmet social needs,” including social distress, which encompasses gender and family violence, abuse, unemployment, and food insecurity, are now widely recognized as critical determinants of health. Some studies have examined the social needs experienced by patients with gynecological disorders, but primarily in gynecologic oncology patients.</div></div><div><h3>Objective</h3><div>This study aims to assess the prevalence of socio-psychological distress, experiences of violence, and food insecurity in patients attending a tertiary outpatient gynecological clinic. Data were collected using a tailored open-ended questionnaire administered by trained volunteers.</div></div><div><h3>Study design</h3><div>This is a prospective cross-sectional study. An ad-hoc questionnaire, validated through the Delphi methodology, was administered to all women attending the Gynaecological Outpatient Clinic at Fondazione Policlinico A. Gemelli IRCCS in Rome, Italy, from March to November 2023. Their responses were analyzed focusing on self-reported socio-psychological distress, violence experienced and food insecurity. Inferential analysis was provided to evaluate the possible association with socioeconomic distress and clinical characteristics of patients. Multivariable logistic regression models for predicting outcomes were performed including those parameters that were statistically significant at univariable analysis (<em>p</em> value <.05).</div></div><div><h3>Results</h3><div>A total of 408 women were included in the study. One hundred and fifty-two (37.2%) reported socio-psychological distress, 136 (33.3%) violence, and 60 (14.7%) food insecurity. Independent risk factors for socio-psychological distress included oncological conditions (OR: 3.76, 95% CI: 1.55–9.11), chronic conditions (OR: 2.22, 95% CI: 1.38–3.57), economic difficulties (OR: 3.91, 95% CI: 2.20–6.93), and experiencing violence (OR: 4.65, 95% CI: 2.83–7.65). Independent risk factors for violence were benign gynecological conditions (OR: 1.95, 95% CI: 1.02–3.74), alcohol use (OR: 1.88, 95% CI: 1.16–3.04), economic difficulties (OR: 1.72, 95% CI: 1.02–2.90), and experiencing food insecurity (OR: 1.92, 95% CI: 1.03–3.59). The only independent risk factor for food insecurity was having economic difficulties (OR: 6.01, 95% CI: 3.06–11.81).</div></div><div><h3>Conclusion</h3><div>Socio-psychological distress and experiences of violence were found to be prevalent in over one-third of the population studied. Identified risk factors include the type of gynecological condition, economic hardship, and food insecurity. These findings underscore the urgent need for the development of comprehensive social support systems to assist women with gynecological conditions. While integrated clinical and social ","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100546"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.xagr.2025.100548
S. Heidarifard PhD , M. Khoshnamrad PhD
Pregnant women with substance use (SUD), are a vulnerable group with special reproductive health needs. The study aimed to assess the supportive needs of pregnant women with substance use. This study adopted a 3-phase qualitative methodology: (1) qualitative content analysis to identify supportive needs, (2) a 3-round Delphi process involving 20 purposively sampled experts (conducted via email over 6 months), and (3) a nominal group technique session with 10 of the original experts to prioritize critical needs. The focus was on pregnant women with substance use disorder. Five categories of needs emerged: socio-cultural support, health/financial support, consultation services, psychological needs, and access to training. Among these, education on sexual health, sexually transmitted diseases, and harm reduction principles during pregnancy scored highest (mean: 3.95). Expert consensus via the nominal group emphasized developing an educational protocol based on the Theory of Planned Behavior to address behavioral changes aligned with maternal needs. The paramount need for pregnant women with SUD is structured education on sexual health and harm reduction in pregnancy. Findings advocate for tailored, theory-based interventions to provide holistic support, potentially improving maternal and fetal outcomes.
{"title":"Assessing supportive needs in pregnant women with substance use, a qualitative study","authors":"S. Heidarifard PhD , M. Khoshnamrad PhD","doi":"10.1016/j.xagr.2025.100548","DOIUrl":"10.1016/j.xagr.2025.100548","url":null,"abstract":"<div><div>Pregnant women with substance use (SUD), are a vulnerable group with special reproductive health needs. The study aimed to assess the supportive needs of pregnant women with substance use. This study adopted a 3-phase qualitative methodology: (1) qualitative content analysis to identify supportive needs, (2) a 3-round Delphi process involving 20 purposively sampled experts (conducted via email over 6 months), and (3) a nominal group technique session with 10 of the original experts to prioritize critical needs. The focus was on pregnant women with substance use disorder. Five categories of needs emerged: socio-cultural support, health/financial support, consultation services, psychological needs, and access to training. Among these, education on sexual health, sexually transmitted diseases, and harm reduction principles during pregnancy scored highest (mean: 3.95). Expert consensus via the nominal group emphasized developing an educational protocol based on the Theory of Planned Behavior to address behavioral changes aligned with maternal needs. The paramount need for pregnant women with SUD is structured education on sexual health and harm reduction in pregnancy. Findings advocate for tailored, theory-based interventions to provide holistic support, potentially improving maternal and fetal outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100548"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.xagr.2025.100556
Moira D. Cruickshank PhD , Clare Robertson MSc , Miriam G. Brazzelli PhD , Aniebiet I. Ekong PhD , Mo Ade PGCE (Secondary Education) , Pauline Mcdonagh Hull PGDip (BJTC) , Paul D. Manson PGDip , Debra E. Bick PhD , Denitza O. Williams PhD (Medicine) , Gillian Taylor Registration Midwife , Lilla A. Ward Legal Practice Course , Mary M. Kilonzo MSc , Tara E. Fairley MBChB , Siladitya Bhattacharya MD , Louise Locock PhD , Magdalena Rzewuska Diaz PhD , Mairead E. Black PhD
Objective
In antenatal care in the UK NHS, the concept of choice of mode of birth (MOB) has been recommended for some years but is still poorly operationalised. Proactive, routine provision of balanced and relevant information to women in antenatal care can be supported by using decision aids but such an aid does not currently exist. The objective of this qualitative systematic review was to identify the factors shaping women’s MOB preference and the barriers and facilitators to supported MOB decision-making.
Data sources
Seven major electronic databases were searched for articles published in English between 2011 and November 2022. Study eligibility criteria Eligible studies were of any design and provided qualitative data from currently or previously pregnant women in high-income countries, about reasons for MOB preference, and/or barriers or facilitators to women making supported MOB choices. Data were extracted into a pre-designed data extraction form. Identified subthemes were grouped and mapped onto two preestablished global themes. Study quality was assessed using the CASP tool for qualitative research. Confidence in the findings was assessed using GRADECERQual.
Results
Women’s preferences for MOB were shaped by perceptions of advantages or disadvantages of each MOB and their own or other women’s previous birth experiences. Barriers to informed MOB decision-making were mainly relating to healthcare professionals’ (HCPs’) negative attitudes, which limited women’s perceived options, and women’s own strong personal beliefs and opinions. Facilitators included having time, support and information on which to make a robust decision.
Conclusions
Barriers to supported decision-making about MOB still exist. HCPs are well placed to guide women through the decision-making process. Informed implementation of decision aids has the potential to address barriers in supported decision-making about MOB in routine NHS antenatal care.
{"title":"What are the influences on women’s preferences and decision-making when planning mode of birth in high-income countries? A qualitative systematic review","authors":"Moira D. Cruickshank PhD , Clare Robertson MSc , Miriam G. Brazzelli PhD , Aniebiet I. Ekong PhD , Mo Ade PGCE (Secondary Education) , Pauline Mcdonagh Hull PGDip (BJTC) , Paul D. Manson PGDip , Debra E. Bick PhD , Denitza O. Williams PhD (Medicine) , Gillian Taylor Registration Midwife , Lilla A. Ward Legal Practice Course , Mary M. Kilonzo MSc , Tara E. Fairley MBChB , Siladitya Bhattacharya MD , Louise Locock PhD , Magdalena Rzewuska Diaz PhD , Mairead E. Black PhD","doi":"10.1016/j.xagr.2025.100556","DOIUrl":"10.1016/j.xagr.2025.100556","url":null,"abstract":"<div><h3>Objective</h3><div>In antenatal care in the UK NHS, the concept of choice of mode of birth (MOB) has been recommended for some years but is still poorly operationalised. Proactive, routine provision of balanced and relevant information to women in antenatal care can be supported by using decision aids but such an aid does not currently exist. The objective of this qualitative systematic review was to identify the factors shaping women’s MOB preference and the barriers and facilitators to supported MOB decision-making.</div></div><div><h3>Data sources</h3><div>Seven major electronic databases were searched for articles published in English between 2011 and November 2022. Study eligibility criteria Eligible studies were of any design and provided qualitative data from currently or previously pregnant women in high-income countries, about reasons for MOB preference, and/or barriers or facilitators to women making supported MOB choices. Data were extracted into a pre-designed data extraction form. Identified subthemes were grouped and mapped onto two preestablished global themes. Study quality was assessed using the CASP tool for qualitative research. Confidence in the findings was assessed using GRADECERQual.</div></div><div><h3>Results</h3><div>Women’s preferences for MOB were shaped by perceptions of advantages or disadvantages of each MOB and their own or other women’s previous birth experiences. Barriers to informed MOB decision-making were mainly relating to healthcare professionals’ (HCPs’) negative attitudes, which limited women’s perceived options, and women’s own strong personal beliefs and opinions. Facilitators included having time, support and information on which to make a robust decision.</div></div><div><h3>Conclusions</h3><div>Barriers to supported decision-making about MOB still exist. HCPs are well placed to guide women through the decision-making process. Informed implementation of decision aids has the potential to address barriers in supported decision-making about MOB in routine NHS antenatal care.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100556"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.xagr.2025.100544
Kelvin H.M. Kwok PhD , Mika Gissler PhD , Mette Ø. Thunbo MD, PhD , Elizabeth C. Hsia MD, MSCE , May Lee Tjoa PhD , Shengxin Liu PhD , Malin Almgren PhD , Vedran Stefanovic MD, PhD , Lars H. Pedersen MD, PhD , Agneta Wikman MD, PhD
<div><h3>Background</h3><div>Red blood cell (RBC) alloimmunization is an immune response where the maternal immune system produces antibodies against fetal RBCs, which can lead to hemolytic disease of the fetus and newborn (HDFN). Despite the significant clinical burden of HDFN, there are few large international cohorts that focus on perinatal care and outcomes of at-risk pregnancies.</div></div><div><h3>Objective</h3><div>To describe the maternal characteristics and outcomes of pregnancies affected by RBC alloimmunization, as well as the characteristics and outcomes of neonates from such pregnancies.</div></div><div><h3>Study Design</h3><div>Utilizing data from nationwide health registers, this population-based cohort study identified all singleton pregnancies in individuals who had ≥1 pregnancy monitored or treated for potential alloimmunization, or ≥1 child with a postnatal diagnosis of HDFN-related conditions, between January 1, 2000, and December 31, 2021, in Sweden and Finland, and between January 1, 1997, and December 31, 2018, in Denmark. Among the identified pregnancies, those with a diagnosis of maternal care for alloimmunization or fetal hydrops, or neonates with a postnatal diagnosis of HDFN-related conditions, were categorized as HDFN pregnancies. The remaining pregnancies—sibling pregnancies that may have been at risk of alloimmunization but did not receive any alloimmunization- or HDFN-related diagnosis—were categorized as non-HDFN pregnancies.</div></div><div><h3>Results</h3><div>This study included 14,732 singleton pregnancies in Sweden, 5863 in Finland, and 11,964 in Denmark. Among these pregnancies, 7391 (50%) in Sweden, 2885 (49%) in Finland, and 6150 (51%) in Denmark were categorized as HDFN pregnancies. Maternal complications and stillbirth rates were comparable between HDFN and non-HDFN pregnancies. Caesarean deliveries were more frequent in HDFN pregnancies. A total of 14,519 neonates in Sweden, 5827 in Finland, and 11,803 in Denmark were born to all pregnancies identified. Of these, 7289 (50%), 2849 (49%), and 6076 (51%) had HDFN. Among the neonates with HDFN, 27% in Sweden, 38% in Finland, and 12% in Denmark received HDFN-related treatment, including intrauterine transfusion (IUT; data unavailable for Finland), neonatal transfusion, and phototherapy. Compared to non-HDFN neonates, those in the IUT and neonatal transfusion groups had lower gestational age, birth weight and length, and higher rates of neonatal unit admission, and were more frequently diagnosed postnatally with growth disturbances and disorders of the nervous system.</div></div><div><h3>Conclusion</h3><div>This is a comprehensive overview of perinatal characteristics and outcomes of pregnancies at risk of HDFN in Sweden, Finland, and Denmark. Our findings highlight the significant unmet need in perinatal care among neonates with HDFN, particularly those treated with IUT or neonatal transfusion. Further research is warranted to improve the management of seve
{"title":"Clinical characteristics and outcomes of pregnancies at-risk of hemolytic disease of the fetus and newborn in Sweden, Finland, and Denmark: a population-based register study","authors":"Kelvin H.M. Kwok PhD , Mika Gissler PhD , Mette Ø. Thunbo MD, PhD , Elizabeth C. Hsia MD, MSCE , May Lee Tjoa PhD , Shengxin Liu PhD , Malin Almgren PhD , Vedran Stefanovic MD, PhD , Lars H. Pedersen MD, PhD , Agneta Wikman MD, PhD","doi":"10.1016/j.xagr.2025.100544","DOIUrl":"10.1016/j.xagr.2025.100544","url":null,"abstract":"<div><h3>Background</h3><div>Red blood cell (RBC) alloimmunization is an immune response where the maternal immune system produces antibodies against fetal RBCs, which can lead to hemolytic disease of the fetus and newborn (HDFN). Despite the significant clinical burden of HDFN, there are few large international cohorts that focus on perinatal care and outcomes of at-risk pregnancies.</div></div><div><h3>Objective</h3><div>To describe the maternal characteristics and outcomes of pregnancies affected by RBC alloimmunization, as well as the characteristics and outcomes of neonates from such pregnancies.</div></div><div><h3>Study Design</h3><div>Utilizing data from nationwide health registers, this population-based cohort study identified all singleton pregnancies in individuals who had ≥1 pregnancy monitored or treated for potential alloimmunization, or ≥1 child with a postnatal diagnosis of HDFN-related conditions, between January 1, 2000, and December 31, 2021, in Sweden and Finland, and between January 1, 1997, and December 31, 2018, in Denmark. Among the identified pregnancies, those with a diagnosis of maternal care for alloimmunization or fetal hydrops, or neonates with a postnatal diagnosis of HDFN-related conditions, were categorized as HDFN pregnancies. The remaining pregnancies—sibling pregnancies that may have been at risk of alloimmunization but did not receive any alloimmunization- or HDFN-related diagnosis—were categorized as non-HDFN pregnancies.</div></div><div><h3>Results</h3><div>This study included 14,732 singleton pregnancies in Sweden, 5863 in Finland, and 11,964 in Denmark. Among these pregnancies, 7391 (50%) in Sweden, 2885 (49%) in Finland, and 6150 (51%) in Denmark were categorized as HDFN pregnancies. Maternal complications and stillbirth rates were comparable between HDFN and non-HDFN pregnancies. Caesarean deliveries were more frequent in HDFN pregnancies. A total of 14,519 neonates in Sweden, 5827 in Finland, and 11,803 in Denmark were born to all pregnancies identified. Of these, 7289 (50%), 2849 (49%), and 6076 (51%) had HDFN. Among the neonates with HDFN, 27% in Sweden, 38% in Finland, and 12% in Denmark received HDFN-related treatment, including intrauterine transfusion (IUT; data unavailable for Finland), neonatal transfusion, and phototherapy. Compared to non-HDFN neonates, those in the IUT and neonatal transfusion groups had lower gestational age, birth weight and length, and higher rates of neonatal unit admission, and were more frequently diagnosed postnatally with growth disturbances and disorders of the nervous system.</div></div><div><h3>Conclusion</h3><div>This is a comprehensive overview of perinatal characteristics and outcomes of pregnancies at risk of HDFN in Sweden, Finland, and Denmark. Our findings highlight the significant unmet need in perinatal care among neonates with HDFN, particularly those treated with IUT or neonatal transfusion. Further research is warranted to improve the management of seve","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"5 3","pages":"Article 100544"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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