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Limitations and perspectives of the novel salivary test for endometriosis: an open web-based survey study of German gynecologic healthcare providers. 新型子宫内膜异位症唾液检验的局限性和前景:一项针对德国妇科医疗服务提供者的开放式网络调查研究。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-26 DOI: 10.1007/s00404-024-07601-3
Meletios P Nigdelis, Merle Doerk, Stefanie Burghaus, Martin Sillem, Bashar Haj Hamoud, Erich-Franz Solomayer, Gregor Leonhard Olmes

Introduction: The description of a salivary miRNA signature for endometriosis has led to the development of a non-invasive diagnostic test. Current healthcare provider practices regarding the test remain uncaptured. The application of this test in practice was examined in a web-based survey, with the aim to provide their opinions on it.

Methods: We conducted an open web-based survey study between November 2023 and January 2024. Members of the German society of gynecologic endoscopy (Arbeitsgemeinschaft gynäkologische Endoskopie, AGE), society of endometriosis (Arbeitsgemeinschaft Endometriose, AGEM), and the endometriosis research foundation (Stiftung Endometriose Forschung, SEF) were contacted per e-mail twice. Participants' data were anonymized. Differences in responses based on self-reported expertise in the field (basic knowledge, specialized knowledge, expert) were assessed using the χ2-test or Fisher's exact test. Statistical significance was set as p < 0.05.

Results: In total 141 of 190 respondents completely responded to the survey (> 75% of the questions of the survey). Twenty-one physicians reported having experience with the test, while most participants had at least specialized knowledge on the field (112/141). In terms of specific questions, more than 90% found the costs high; almost 85% did not believe that the test replaces standard diagnostic tools (histology, clinical examination, and sonography). Eighty-six providers supported the use of the test in adolescents. Gynecologists with basic knowledge had a more positive attitude compared with more experienced ones in terms of usefulness (Fisher's exact test, p < 0.001). Significant differences were demonstrated between expertise groups regarding (not only) applicability in adolescents (Fisher's exact test, p = 0.004), and using the test for screening purposes (χ2-test, p = 0.002).

Discussion: Despite the promising benefits of a salivary test for endometriosis, German healthcare providers would not change current practices. Nevertheless, less experienced colleagues were more positive towards the test.

导言:对子宫内膜异位症唾液 miRNA 特征的描述促使了无创诊断测试的发展。目前,医疗服务提供者对该检测方法的实践仍未掌握。我们通过一项网络调查研究了该测试在实践中的应用情况,目的是了解他们对该测试的看法:我们在 2023 年 11 月至 2024 年 1 月期间进行了一项开放式网络调查研究。我们通过电子邮件两次联系了德国妇科内镜学会(Arbeitsgemeinschaft gynäkologische Endoskopie, AGE)、子宫内膜异位症学会(Arbeitsgemeinschaft Endometriose, AGEM)和子宫内膜异位症研究基金会(Stiftung Endometriose Forschung, SEF)的成员。参与者的数据均已匿名。使用χ2检验或费雪精确检验评估了根据自我报告的该领域专业知识(基础知识、专业知识、专家)所作回答的差异。统计显著性设定为 p 结果:在 190 名受访者中,共有 141 人完整回答了调查问题(> 75% 的问题)。有 21 名医生表示有过测试经验,而大多数参与者至少具备该领域的专业知识(112/141)。就具体问题而言,90% 以上的人认为成本高;近 85% 的人不认为该检验能取代标准诊断工具(组织学、临床检查和超声波检查)。86%的医疗服务提供者支持在青少年中使用该检查。与经验丰富的妇科医生相比,有基础知识的妇科医生对唾液检验的实用性持更积极的态度(费雪精确检验,P 2 检验,P = 0.002):讨论:尽管子宫内膜异位症唾液检测具有良好的前景,但德国医疗服务提供者不会改变目前的做法。尽管如此,经验较少的同事对唾液检测的态度更为积极。
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引用次数: 0
Association between pelvic inflammatory disease and risk of ovarian, uterine, cervical, and vaginal cancers—a meta-analysis 盆腔炎与卵巢癌、子宫癌、宫颈癌和阴道癌风险之间的关系--荟萃分析。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-26 DOI: 10.1007/s00404-024-07748-z
Azharuddin Sajid Syed Khaja, Mohd Saleem, Mubashir Zafar, Soha Moursi, Ghorashy Eltayeb Yousif Mohammed, Syed Monowar Alam Shahid, Sahar Hammam, Safia Moussa, Mohammed Salem Alharbi, Ahmed Nawi Alshammari

Background and aim

The present meta-analysis aims to investigate a potential link between pelvic inflammatory disease (PID) and an increased risk of genitourinary cancers (ovarian, cervical, uterus, and vagina cancers). While previous research has hinted at a possible link, this meta-analysis seeks to delve deeper into the available evidence. Understanding this association is crucial for preventive strategies and improving clinical management practices.

Methodology

A comprehensive literature search was conducted across various databases, covering studies published between 2016 and 2024. We included 13 observational studies meeting stringent criteria, followed by meticulous data extraction and quality assessment. Meta-analytical techniques were then employed to calculate pooled odds ratios (ORs), adjusted hazard ratios (HRs), and 95% confidence intervals (CIs), with heterogeneity assessed using the I2 statistic.

Results

Our analysis revealed significant findings, underscoring the association between PID and increased risks of genitourinary cancers. Specifically, individuals with a history of PID demonstrated notably higher odds of developing ovarian cancer (OR = 1.477, 95% CI 1.033–2.207), uterine cancer (OR = 1.263, 95% CI 0.827–2.143), cervical cancer (OR = 1.000, 95% CI 0.900–1.100), and vaginal cancer (OR = 2.500, 95% CI 1.400–4.000) compared to those without such a history. The overall heterogeneity across studies was high (I2 = 82.92%), suggesting varying trends across different populations and study designs.

Conclusion

This meta-analysis provides updated evidence supporting a significant association between PID and an increased risk of cervical, ovarian, and uterine cancers. Early detection and management of PID are crucial in potentially mitigating the risk of these cancers.

背景和目的:本荟萃分析旨在研究盆腔炎(PID)与泌尿生殖系统癌症(卵巢癌、宫颈癌、子宫癌和阴道癌)风险增加之间的潜在联系。虽然以往的研究已经暗示了两者之间可能存在的联系,但这项荟萃分析试图深入研究现有的证据。了解这种关联对于制定预防策略和改进临床管理实践至关重要:我们在各种数据库中进行了全面的文献检索,涵盖了 2016 年至 2024 年间发表的研究。我们纳入了 13 项符合严格标准的观察性研究,随后进行了细致的数据提取和质量评估。然后采用元分析技术计算汇总的几率比(ORs)、调整后的危险比(HRs)和95%置信区间(CIs),并使用I2统计量评估异质性:我们的分析结果表明,PID与泌尿生殖系统癌症风险增加之间存在重要关联。具体而言,与无PID病史者相比,有PID病史者患卵巢癌(OR = 1.477,95% CI 1.033-2.207)、子宫癌(OR = 1.263,95% CI 0.827-2.143)、宫颈癌(OR = 1.000,95% CI 0.900-1.100)和阴道癌(OR = 2.500,95% CI 1.400-4.000)的几率明显更高。各研究之间的总体异质性很高(I2 = 82.92%),表明不同人群和研究设计的趋势各不相同:这项荟萃分析提供了最新证据,证明PID与宫颈癌、卵巢癌和子宫癌风险增加之间存在显著关联。及早发现和治疗 PID 对降低罹患这些癌症的风险至关重要。
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引用次数: 0
First-degree family history of cancers in patients with stage I endometrial carcinoma. Prevalence and prognostic impact I 期子宫内膜癌患者的一级癌症家族史。发病率和对预后的影响。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-26 DOI: 10.1007/s00404-024-07728-3
Abdelrahman Yousif, Zuber D. Mulla, Julia Pudar, Muneer Elshaikh, Remonda Khalil-Moawad, Mohamed A. Elshaikh

Background

We aimed to study the impact of first-degree family history on patients with endometrial cancer.

Methods

We conducted a retrospective chart review from January 1990 to June 2016, comparing stage I endometrial cancer patients with and without a sporadic family history of cancers. We collected the patients’ demographic information, tumor characteristics, and treatment plans. During the follow-up period, patient information on tumor recurrence and survival was collected. The chi-square test was used to assess the associations between categorical variables. The Cox proportional hazards regression model was used to estimate multivariate-adjusted hazard ratios (95% confidence interval (CI)).

Results

Among the 1737 patients with stage I endometrial cancer, 709 had a positive first-degree family history of cancers and 1028 had negative family history (FH) of cancers. Patients with positive FH were more likely to be older, have stage IB disease, and receive adjuvant radiotherapy; however, the difference was not statistically significant. At 5 years follow up, patients with a positive family history had longer time to recurrence (TTR) than their negative FH counterparts. Maternal family history of cancer was the most common, followed by a sister’s history of cancer, paternal history, brother’s history, and offspring history of cancer. Breast, endometrial, and colon cancers are the most common cancers among first-degree relatives.

Conclusion

Endometrial cancer patients with sporadic first-degree FH of cancers share similar demographics and tumor characteristics compared to their counterpart with slightly increased likelihood to be older, with stage IB disease and have a longer TTR compared to their negative counterpart.

背景:我们旨在研究一级家族史对子宫内膜癌患者的影响:我们旨在研究一级家族史对子宫内膜癌患者的影响:我们对 1990 年 1 月至 2016 年 6 月期间的病历进行了回顾性分析,比较了有和无散发性癌症家族史的 I 期子宫内膜癌患者。我们收集了患者的人口统计学信息、肿瘤特征和治疗方案。在随访期间,我们还收集了患者的肿瘤复发和生存信息。我们使用卡方检验来评估分类变量之间的关联。采用考克斯比例危险回归模型估算多变量调整后的危险比(95%置信区间(CI)):结果:在1737名I期子宫内膜癌患者中,709人有阳性一级癌症家族史,1028人有阴性癌症家族史(FH)。有阳性家族史的患者更有可能年龄较大、患有IB期疾病并接受辅助放疗,但差异无统计学意义。在5年的随访中,阳性家族史患者的复发时间(TTR)长于阴性家族史患者。母系癌症家族史最常见,其次是姐妹癌症史、父系癌症史、兄弟癌症史和后代癌症史。乳腺癌、子宫内膜癌和结肠癌是一级亲属中最常见的癌症:子宫内膜癌患者的人口统计学特征和肿瘤特征与他们的同类患者相似,但与阴性同类患者相比,年龄稍大、IB 期疾病和 TTR 较长的可能性略有增加。
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引用次数: 0
Utility of routine mid-trimester fetal ultrasound scan in detecting filar cysts and follow-up outcomes 常规中期胎儿超声扫描在检测丝状囊肿中的作用及随访结果。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-26 DOI: 10.1007/s00404-024-07750-5
Jingping Wu

Purpose

To assess the value of routine mid-trimester fetal ultrasound scans in detecting FCs, as well as the related ultrasound and clinical follow-up outcomes.

Methods

A retrospective analysis was conducted on 1064 fetuses who underwent standardized ultrasound screening during the mid-trimester. During the examination, high-frequency ultrasound was used to examine the fetal spine. Different frequency ultrasound probes were used to compare and analyze the detection rates of FCs. We conducted follow-up ultrasound observations on all FCs and conducted long-term follow-up observations in terms of the motor function of the children after birth.

Results

Among 1064 fetuses detected by ultrasound, a total of 910 fetuses were completely evaluated using high-frequency and low-frequency ultrasound, and 24 FCs were found. In all 24 cases of FCs, 7 cases were detected using low-frequency ultrasound, while high-frequency ultrasound detected all cases. There was a significant difference in the detection rates between the two groups (χ2 = 26.323, P = 0.000). Of all the 24 FCs, 21 cysts disappeared spontaneously (87.5%); one fetus was induced for abortion due to a concurrent cleft lip; after multiple ultrasound examinations, it was found that the cyst persisted in one fetus; one case was not followed up by ultrasound. There was no statistically significant difference in the start of sitting and crawling time between the control group and the FCs group.

Conclusion

Routine mid-trimester fetal ultrasound scan detect FCs, particularly when high-frequency ultrasound probes were routinely applied. Most FCs detected by prenatal ultrasound spontaneously disappear and have no impact on the motor function of the fetus after birth (with the conus medullaris located at or above the L3 level). The shortest time interval from the detection to the disappearance of the cyst was 11 days.

目的:评估常规孕中期胎儿超声扫描在检测 FCs 方面的价值,以及相关的超声和临床随访结果:方法:对1064名在妊娠中期接受标准化超声筛查的胎儿进行了回顾性分析。在检查过程中,使用高频超声检查胎儿脊柱。我们使用不同频率的超声探头来比较和分析 FC 的检出率。我们对所有 FC 胎儿进行了超声随访观察,并对婴儿出生后的运动功能进行了长期随访观察:结果:在超声检测出的 1064 个胎儿中,共有 910 个胎儿接受了高频和低频超声的完整评估,发现了 24 个 FC 胎儿。在所有 24 例 FC 中,低频超声检测出 7 例,而高频超声则检测出所有病例。两组的检出率有明显差异(χ2 = 26.323,P = 0.000)。在所有 24 个 FC 中,21 个囊肿自然消失(87.5%);1 个胎儿因并发唇裂而引产;多次超声检查后发现 1 个胎儿的囊肿仍然存在;1 个病例未进行超声随访。对照组与 FCs 组在开始坐立和爬行的时间上没有统计学差异:结论:常规孕中期胎儿超声扫描可检测出FCs,尤其是在常规应用高频超声探头的情况下。大多数产前超声检测到的 FCs 会自动消失,对胎儿出生后的运动功能没有影响(髓袢位于 L3 水平或以上)。从检测到囊肿消失的最短时间间隔为 11 天。
{"title":"Utility of routine mid-trimester fetal ultrasound scan in detecting filar cysts and follow-up outcomes","authors":"Jingping Wu","doi":"10.1007/s00404-024-07750-5","DOIUrl":"10.1007/s00404-024-07750-5","url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the value of routine mid-trimester fetal ultrasound scans in detecting FCs, as well as the related ultrasound and clinical follow-up outcomes.</p><h3>Methods</h3><p>A retrospective analysis was conducted on 1064 fetuses who underwent standardized ultrasound screening during the mid-trimester. During the examination, high-frequency ultrasound was used to examine the fetal spine. Different frequency ultrasound probes were used to compare and analyze the detection rates of FCs. We conducted follow-up ultrasound observations on all FCs and conducted long-term follow-up observations in terms of the motor function of the children after birth.</p><h3>Results</h3><p>Among 1064 fetuses detected by ultrasound, a total of 910 fetuses were completely evaluated using high-frequency and low-frequency ultrasound, and 24 FCs were found. In all 24 cases of FCs, 7 cases were detected using low-frequency ultrasound, while high-frequency ultrasound detected all cases. There was a significant difference in the detection rates between the two groups (χ<sup>2</sup> = 26.323, <i>P</i> = 0.000). Of all the 24 FCs, 21 cysts disappeared spontaneously (87.5%); one fetus was induced for abortion due to a concurrent cleft lip; after multiple ultrasound examinations, it was found that the cyst persisted in one fetus; one case was not followed up by ultrasound. There was no statistically significant difference in the start of sitting and crawling time between the control group and the FCs group.</p><h3>Conclusion</h3><p>Routine mid-trimester fetal ultrasound scan detect FCs, particularly when high-frequency ultrasound probes were routinely applied. Most FCs detected by prenatal ultrasound spontaneously disappear and have no impact on the motor function of the fetus after birth (with the conus medullaris located at or above the L3 level). The shortest time interval from the detection to the disappearance of the cyst was 11 days.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-operative outcomes associated with anterior mesh location after laparoscopic sacrocolpopexy 腹腔镜骶尾部结肠切除术后与网片前部位置相关的术后效果。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-25 DOI: 10.1007/s00404-024-07719-4
Nassir Habib, Matteo Giorgi, Tania Tahtouh, Amel Hamdi, Gabriele Centini, Alberto Cannoni, Georges Bader

Objective

To investigate the relationship between the anatomical position of the anterior arm of the mesh, measured by ultrasound through the bladder neck–mesh distance technique and the surgical outcomes after laparoscopic sacrocolpopexy (SCP) for apical prolapse.

Study design

It was a retrospective analysis of prospectively collected data in a tertiary care hospital. Between January 2019 and September 2019, 63 women who underwent laparoscopic SCP due to apical prolapse were included. Bladder neck–mesh distance was measured immediately after surgery. The pelvic floor was evaluated using the Pelvic Organ Prolapse Quantification (POP-Q) System before, 1 month, and 2.7 years (mid-term) after the surgery. Post-operative stress urinary incontinence (SUI) and Patient Global Impression of Improvement (PGI-I) scores were also assessed. The correlation between bladder neck–mesh distance and the post-operative outcomes was investigated using the Spearman rank correlation coefficient.

Results

At mid-term follow-up visit, bladder neck–mesh distance was inversely correlated with the correction of apical prolapse and post-operative SUI. No correlation was detected with the anterior compartment prolapse correction. PGI-I scores were high in all patients at mid-term follow-up, irrespective of bladder neck–mesh distance values.

Conclusion

The shorter the bladder neck–mesh distance, the better the outcome for apical compartment repair. Bladder neck–mesh distance had no correlation with the anterior anatomical correction. Shorter bladder neck–mesh distance values were positively correlated to better PGI-I scores and a higher risk of SUI.

目的通过膀胱颈-网片距离技术,用超声波测量网片前臂的解剖位置,研究网片前臂的解剖位置与腹腔镜骶尾部脱垂(SCP)术后手术效果之间的关系:研究设计:这是对一家三级医院前瞻性收集数据的回顾性分析。纳入了2019年1月至2019年9月期间,63名因子宫尖脱垂而接受腹腔镜骶骨外翻术(SCP)的女性。术后立即测量膀胱颈-网眼距离。在术前、术后1个月和术后2.7年(中期),使用盆腔器官脱垂定量(POP-Q)系统对盆底进行评估。此外,还对术后压力性尿失禁(SUI)和患者总体改善印象(PGI-I)评分进行了评估。使用斯皮尔曼等级相关系数研究了膀胱颈-网眼距离与术后结果之间的相关性:结果:在中期随访中,膀胱颈网距离与顶端脱垂矫正和术后 SUI 成反比。与前室脱垂矫治无相关性。无论膀胱颈网距离值如何,中期随访时所有患者的PGI-I评分都很高:结论:膀胱颈-网眼距离越短,顶腔修复的效果越好。结论:膀胱颈网眼距离越短,顶腔修复的效果越好。膀胱颈网眼距离与前部解剖矫正没有相关性。较短的膀胱颈网距离值与较好的 PGI-I 评分和较高的 SUI 风险呈正相关。
{"title":"Post-operative outcomes associated with anterior mesh location after laparoscopic sacrocolpopexy","authors":"Nassir Habib,&nbsp;Matteo Giorgi,&nbsp;Tania Tahtouh,&nbsp;Amel Hamdi,&nbsp;Gabriele Centini,&nbsp;Alberto Cannoni,&nbsp;Georges Bader","doi":"10.1007/s00404-024-07719-4","DOIUrl":"10.1007/s00404-024-07719-4","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the relationship between the anatomical position of the anterior arm of the mesh, measured by ultrasound through the bladder neck–mesh distance technique and the surgical outcomes after laparoscopic sacrocolpopexy (SCP) for apical prolapse.</p><h3>Study design</h3><p>It was a retrospective analysis of prospectively collected data in a tertiary care hospital. Between January 2019 and September 2019, 63 women who underwent laparoscopic SCP due to apical prolapse were included. Bladder neck–mesh distance was measured immediately after surgery. The pelvic floor was evaluated using the Pelvic Organ Prolapse Quantification (POP-Q) System before, 1 month, and 2.7 years (mid-term) after the surgery. Post-operative stress urinary incontinence (SUI) and Patient Global Impression of Improvement (PGI-I) scores were also assessed. The correlation between bladder neck–mesh distance and the post-operative outcomes was investigated using the Spearman rank correlation coefficient.</p><h3>Results</h3><p>At mid-term follow-up visit, bladder neck–mesh distance was inversely correlated with the correction of apical prolapse and post-operative SUI. No correlation was detected with the anterior compartment prolapse correction. PGI-I scores were high in all patients at mid-term follow-up, irrespective of bladder neck–mesh distance values.</p><h3>Conclusion</h3><p>The shorter the bladder neck–mesh distance, the better the outcome for apical compartment repair. Bladder neck–mesh distance had no correlation with the anterior anatomical correction. Shorter bladder neck–mesh distance values were positively correlated to better PGI-I scores and a higher risk of SUI.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cervical length evolution in pregnancy and prediction of preterm delivery 孕期宫颈长度变化与早产预测
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-23 DOI: 10.1007/s00404-024-07745-2
A. P. Souka, V. Maritsa, P. Antsaklis, A. Pilalis, G. Daskalakis

Purpose

To construct reference charts for cervical length (CL) in pregnancy based on longitudinal measurements and to assess the value of measuring cervical length after 24 weeks of gestation.

Methods

CL was measured transvaginally in singleton pregnancies at 5 to 41 weeks. Pregnancies with more than one measurement were used for creating the CL chart, whereas any measurement after 24 weeks was considered for assessing the correlation of CL with preterm delivery.

Results

The dataset consisted of 12,601 pregnancies and 33,899 observations. Gestational age was the main predictor of CL (R2 = 67.3%). Further adjustments in the fixed effects part for maternal characteristics (age, BMI, smoking status, parity, history of miscarriage, and cervical surgery) improved the prediction ability (R2 = 78.4%). CL was predictive of spontaneous preterm delivery before 37 weeks when measured at any gestation between 24 and 35 weeks and it was predictive of spontaneous preterm delivery before 32 weeks when measured between 28 and 31 weeks (AUC = 0.68).

Conclusion

Gestational age is the main predictor of CL followed by maternal characteristics and history. CL assessment between 24 and 35 + 6 weeks can enhance our ability to predict spontaneous preterm delivery.

目的:根据纵向测量结果构建孕期宫颈长度(CL)参考图表,并评估妊娠 24 周后测量宫颈长度的价值:经阴道测量单胎妊娠 5 至 41 周时的宫颈长度。测量超过一次的孕妇被用于创建宫颈长度图表,而 24 周后的任何测量值都被用于评估宫颈长度与早产的相关性:数据集包括 12,601 例妊娠和 33,899 个观测值。妊娠年龄是预测CL的主要因素(R2 = 67.3%)。在固定效应部分对产妇特征(年龄、体重指数、吸烟状况、胎次、流产史和宫颈手术)做进一步调整,提高了预测能力(R2 = 78.4%)。如果在 24 至 35 周之间的任何孕期测量,CL 可预测 37 周前的自然早产;如果在 28 至 31 周之间测量,CL 可预测 32 周前的自然早产(AUC = 0.68):胎龄是预测CL的主要因素,其次是母体特征和病史。结论:胎龄是预测CL的主要因素,其次是孕产妇特征和病史。在24周到35+6周之间进行CL评估可提高我们预测自发性早产的能力。
{"title":"Cervical length evolution in pregnancy and prediction of preterm delivery","authors":"A. P. Souka,&nbsp;V. Maritsa,&nbsp;P. Antsaklis,&nbsp;A. Pilalis,&nbsp;G. Daskalakis","doi":"10.1007/s00404-024-07745-2","DOIUrl":"10.1007/s00404-024-07745-2","url":null,"abstract":"<div><h3>Purpose</h3><p>To construct reference charts for cervical length (CL) in pregnancy based on longitudinal measurements and to assess the value of measuring cervical length after 24 weeks of gestation.</p><h3>Methods</h3><p>CL was measured transvaginally in singleton pregnancies at 5 to 41 weeks. Pregnancies with more than one measurement were used for creating the CL chart, whereas any measurement after 24 weeks was considered for assessing the correlation of CL with preterm delivery.</p><h3>Results</h3><p>The dataset consisted of 12,601 pregnancies and 33,899 observations. Gestational age was the main predictor of CL (R<sup>2</sup> = 67.3%). Further adjustments in the fixed effects part for maternal characteristics (age, BMI, smoking status, parity, history of miscarriage, and cervical surgery) improved the prediction ability (R<sup>2</sup> = 78.4%). CL was predictive of spontaneous preterm delivery before 37 weeks when measured at any gestation between 24 and 35 weeks and it was predictive of spontaneous preterm delivery before 32 weeks when measured between 28 and 31 weeks (AUC = 0.68).</p><h3>Conclusion</h3><p>Gestational age is the main predictor of CL followed by maternal characteristics and history. CL assessment between 24 and 35 + 6 weeks can enhance our ability to predict spontaneous preterm delivery.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trial of labor following cesarean among patients with polyhydramnios: a multicenter retrospective study 多胎妊娠患者剖宫产后试产:一项多中心回顾性研究。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-21 DOI: 10.1007/s00404-024-07742-5
Ari Weiss, Tzuria Peled, Reut Rotem, Hen Y. Sela, Sorina Grisaru-Granovsky, Misgav Rottenstreich

Purpose

This study aimed to assess maternal and neonatal outcomes in patients with polyhydramnios attempting trial of labor after cesarean (TOLAC) compared to those undergoing planned repeat cesarean delivery (PRCD).

Methods

A multi-center retrospective cohort study was conducted and included women with term singleton viable pregnancies following a single low-segment transverse cesarean delivery (CD) with a polyhydramnios diagnosis (maximal vertical pocket > 8 cm and/or Amniotic Fluid Index > 24 cm) within 14 days before birth who delivered between the years 2017 and 2021. Maternal and neonatal outcomes were compared between those attempting TOLAC and those opting for PRCD. The primary outcome was composite adverse maternal. Univariate analysis was followed by multivariate analysis to control for potential confounders.

Results

Out of 358 included births with a previous CD, 208 (58.1%) attempted TOLAC, while 150 had PRCD (41.9%). The successful vaginal birth after cesarean (VBAC) rate was 82.2%, and no cases of uterine rupture, hysterectomy, or maternal intensive care unit admission occurred in either group. After controlling for potential confounders, no independent association between TOLAC and composite adverse maternal (adjusted odds ratio [aOR] 0.62, 95% confidence interval [CI] 0.32–1.20, p = 0.16) and neonatal (aOR 0.89, 95% CI 0.51–1.53, p = 0.67) adverse outcomes was demonstrated.

Conclusion

In patients with a term diagnosed polyhydramnios, TOLAC appears to be a reasonable alternative associated with favorable outcomes. Larger prospective studies are needed to refine management strategies and enhance maternal and neonatal outcomes in this context.

目的:本研究旨在评估剖宫产术后试产(TOLAC)与计划再次剖宫产(PRCD)的多胎妊娠患者的产妇和新生儿结局:该研究是一项多中心回顾性队列研究,纳入了2017年至2021年期间分娩的、单次低段横切口剖宫产(CD)并在产前14天内诊断出多羊水(最大垂直袋>8厘米和/或羊水指数>24厘米)的足月单胎存活妊娠妇女。对尝试 TOLAC 和选择 PRCD 的产妇和新生儿结局进行了比较。主要结果是产妇综合不良反应。单变量分析后进行多变量分析,以控制潜在的混杂因素:结果:在358名既往有子宫内膜异位症的新生儿中,208名(58.1%)尝试了TOLAC,150名(41.9%)进行了PRCD。剖宫产后经阴道分娩(VBAC)的成功率为82.2%,两组产妇均未发生子宫破裂、子宫切除或入住重症监护室。在控制了潜在的混杂因素后,TOLAC与产妇(调整赔率[aOR]0.62,95%置信区间[CI]0.32-1.20,P = 0.16)和新生儿(aOR 0.89,95%置信区间[CI]0.51-1.53,P = 0.67)综合不良结局之间没有独立的关联:结论:对于确诊为多羊水症的产妇,TOLAC似乎是一种合理的选择,并能带来良好的结果。在这种情况下,需要进行更大规模的前瞻性研究,以完善管理策略,提高孕产妇和新生儿的预后。
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引用次数: 0
Improved contingent screening strategy increased trisomy 21 detection rate in the second trimester. 改进后的应急筛查策略提高了 21 三体综合征在妊娠后三个月的检出率。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-21 DOI: 10.1007/s00404-024-07743-4
Wei Luo, Bin He, Daiwen Han, Lixing Yuan, Jun Tang, Ling Pang, Kai Zhao, Fene Zou, Ting Hu, Shanling Liu

Purpose: This study aimed to establish suitable threshold values for biochemical indicators in low-risk pregnant women who underwent second trimester screening and design strategies for consecutive prenatal testing to increase trisomy 21 detection.

Methods: This study examined singleton pregnant women who underwent double, triple, or quadruple screening in the second trimester over six years. To obtain adequate detection efficiency for low-risk pregnancies, threshold values for serum biochemical indicators were established, and a cost-effectiveness assessment of the improved contingent screening strategy was conducted.

Results: Participants were included in serum double- (n = 88,550), triple- (n = 29,991), and quadruple-screening (n = 15,004) groups. Threshold values were defined as having a free beta subunit of human chorionic gonadotropin (free β-hCG) multiple of the median (MoM) ≥ 2.50, alpha-fetoprotein (AFP) MoM ≤ 0.50, or unconjugated estriol (uE3) MoM ≤ 0.70 for low risk. Low-risk pregnancies, comprising 1.35% (988/73,183), 4.45% (1,171/26,286), and 11.91% (1,559/13,085) of the double-, triple-, and quadruple-screening groups, respectively, underwent further non-invasive prenatal screening. In the double-, triple-, and quadruple-screening groups, we detected 11.76% (2/17), 40.00% (2/5), and 66.67% (2/3) of trisomy 21 cases with false negative results, respectively, with the overall detection rates of 85.00% (85/100), 90.63% (29/32), and 95.24% (20/21), respectively, and decreased ratio of overall costs of 5.26%, 16.63%, and 24.36%, respectively.

Conclusion: Utilizing threshold values of AFP, free β-hCG, and uE3 to trigger further non-invasive prenatal screening may increase trisomy 21 detection in pregnancies deemed low risk in the second trimester while reducing the overall costs of screening strategies.

目的:本研究旨在为接受第二孕期筛查的低风险孕妇建立合适的生化指标阈值,并设计连续产前检测策略以提高 21 三体综合征的检出率:本研究对六年内接受第二孕期双胎、三胎或四胎筛查的单胎孕妇进行了调查。为使低风险妊娠获得足够的检测效率,确定了血清生化指标的阈值,并对改进后的或然筛查策略进行了成本效益评估:结果:参与者分为血清双重筛查组(88,550 人)、三重筛查组(29,991 人)和四重筛查组(15,004 人)。阈值定义为游离β亚单位人绒毛膜促性腺激素(游离β-hCG)中位数的倍数(MoM)≥2.50,甲胎蛋白(AFP)MoM≤0.50,或非结合雌三醇(uE3)MoM≤0.70为低风险。在双筛组、三筛组和四筛组中,分别有 1.35%(988/73183)、4.45%(1171/26286)和 11.91%(1559/13085)的低风险孕妇接受了进一步的无创产前筛查。在双筛组、三筛组和四筛组中,我们分别检出了11.76%(2/17)、40.00%(2/5)和66.67%(2/3)的21三体综合征假阴性病例,总检出率分别为85.00%(85/100)、90.63%(29/32)和95.24%(20/21),总费用下降率分别为5.26%、16.63%和24.36%:结论:利用 AFP、游离 β-hCG 和 uE3 的阈值来触发进一步的无创产前筛查,可提高在第二孕期被视为低风险妊娠的 21 三体综合征的检出率,同时降低筛查策略的总体成本。
{"title":"Improved contingent screening strategy increased trisomy 21 detection rate in the second trimester.","authors":"Wei Luo, Bin He, Daiwen Han, Lixing Yuan, Jun Tang, Ling Pang, Kai Zhao, Fene Zou, Ting Hu, Shanling Liu","doi":"10.1007/s00404-024-07743-4","DOIUrl":"https://doi.org/10.1007/s00404-024-07743-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to establish suitable threshold values for biochemical indicators in low-risk pregnant women who underwent second trimester screening and design strategies for consecutive prenatal testing to increase trisomy 21 detection.</p><p><strong>Methods: </strong>This study examined singleton pregnant women who underwent double, triple, or quadruple screening in the second trimester over six years. To obtain adequate detection efficiency for low-risk pregnancies, threshold values for serum biochemical indicators were established, and a cost-effectiveness assessment of the improved contingent screening strategy was conducted.</p><p><strong>Results: </strong>Participants were included in serum double- (n = 88,550), triple- (n = 29,991), and quadruple-screening (n = 15,004) groups. Threshold values were defined as having a free beta subunit of human chorionic gonadotropin (free β-hCG) multiple of the median (MoM) ≥ 2.50, alpha-fetoprotein (AFP) MoM ≤ 0.50, or unconjugated estriol (uE3) MoM ≤ 0.70 for low risk. Low-risk pregnancies, comprising 1.35% (988/73,183), 4.45% (1,171/26,286), and 11.91% (1,559/13,085) of the double-, triple-, and quadruple-screening groups, respectively, underwent further non-invasive prenatal screening. In the double-, triple-, and quadruple-screening groups, we detected 11.76% (2/17), 40.00% (2/5), and 66.67% (2/3) of trisomy 21 cases with false negative results, respectively, with the overall detection rates of 85.00% (85/100), 90.63% (29/32), and 95.24% (20/21), respectively, and decreased ratio of overall costs of 5.26%, 16.63%, and 24.36%, respectively.</p><p><strong>Conclusion: </strong>Utilizing threshold values of AFP, free β-hCG, and uE3 to trigger further non-invasive prenatal screening may increase trisomy 21 detection in pregnancies deemed low risk in the second trimester while reducing the overall costs of screening strategies.</p>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Severe ovarian hyperstimulation syndrome following sole gonadotropin-releasing hormone (GnRH) agonist trigger: a case series and literature review 单纯促性腺激素释放激素(GnRH)激动剂触发后的严重卵巢过度刺激综合征:病例系列和文献综述。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-20 DOI: 10.1007/s00404-024-07740-7
Roza Berkovitz-Shperling, Nivin Samara, Reut Meir, Omri Dominsky, Foad Azam, Ido Feferkorn

Objective

The aim of this study was to report three cases of early severe ovarian hyperstimulation syndrome (OHSS) in patients undergoing a GnRH antagonist protocol triggered with GnRH agonist (GnRH-a), leading to hospitalization and the need for peritoneal drainage. Additionally, a review of the existing literature on this topic is provided.

Design

This is a retrospective case series and a literature review.

Setting

This study was conducted at obstetrics and gynecology department of tertiary academic referral hospitals, Israel.

Participants

This study included three patients presented with severe OHSS symptoms, including abdominal distension, ascites, and hemoconcentration.

Main outcome measures

The main focus of the treatment was to address the symptoms and prevent any further complications. The outcome was the complete recovery of the patients.

Results

The presented cases detail instances of severe OHSS following oocyte retrieval, utilizing GnRH-a for triggering. Case 1 involved a 33-year-old patient with a history of polycystic ovary syndrome (PCOS), Case 2 featured a 22-year-old patient with familial adenomatous polyposis (FAP), and Case 3 included a 41-year-old patient with a history of depressive disorder. All patients receiving supportive care, including infusions and medications, exhibited gradual improvement during hospitalization, with complete resolution observed during the 20-day post-hospitalization check-up.

Conclusions

These three cases highlight the occurrence of severe early OHSS following a GnRH antagonist protocol triggered with GnRH-a in the absence of human chorionic gonadotropin (hCG) administration for trigger or luteal-phase support. Clinicians must be aware that a GnRH-a trigger followed by a freeze-all approach does not guarantee the complete elimination of OHSS in all patients.

研究目的本研究旨在报告三例早期重度卵巢过度刺激综合征(OHSS)病例,患者在接受GnRH拮抗剂方案治疗的同时使用GnRH激动剂(GnRH-a),导致住院治疗并需要腹腔引流。此外,本文还回顾了有关这一主题的现有文献:设计:这是一个回顾性系列病例和文献综述:本研究在以色列三级学术转诊医院的妇产科进行:本研究包括三名出现严重OHSS症状的患者,包括腹胀、腹水和血液浓缩:治疗的主要重点是消除症状和预防进一步的并发症。主要结果指标:治疗的重点是消除症状和预防进一步的并发症,结果是患者完全康复:所提供的病例详细描述了利用 GnRH-a 进行促排卵取卵后出现严重 OHSS 的病例。病例 1 涉及一名 33 岁的多囊卵巢综合征(PCOS)患者,病例 2 涉及一名 22 岁的家族性腺瘤性息肉病(FAP)患者,病例 3 涉及一名 41 岁的抑郁症患者。所有接受输液和药物等支持性治疗的患者在住院期间的病情都逐渐好转,在住院后 20 天的检查中观察到病情完全缓解:这三例病例突出表明,在未使用人绒毛膜促性腺激素(hCG)触发或黄体期支持的情况下,使用GnRH-a触发GnRH拮抗剂方案后会出现严重的早期OHSS。临床医生必须意识到,在使用 GnRH-a 触发后再使用全部冻结方法并不能保证所有患者都能完全消除 OHSS。
{"title":"Severe ovarian hyperstimulation syndrome following sole gonadotropin-releasing hormone (GnRH) agonist trigger: a case series and literature review","authors":"Roza Berkovitz-Shperling,&nbsp;Nivin Samara,&nbsp;Reut Meir,&nbsp;Omri Dominsky,&nbsp;Foad Azam,&nbsp;Ido Feferkorn","doi":"10.1007/s00404-024-07740-7","DOIUrl":"10.1007/s00404-024-07740-7","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study was to report three cases of early severe ovarian hyperstimulation syndrome (OHSS) in patients undergoing a GnRH antagonist protocol triggered with GnRH agonist (GnRH-a), leading to hospitalization and the need for peritoneal drainage. Additionally, a review of the existing literature on this topic is provided.</p><h3>Design</h3><p>This is a retrospective case series and a literature review.</p><h3>Setting</h3><p>This study was conducted at obstetrics and gynecology department of tertiary academic referral hospitals, Israel.</p><h3>Participants</h3><p>This study included three patients presented with severe OHSS symptoms, including abdominal distension, ascites, and hemoconcentration.</p><h3>Main outcome measures</h3><p>The main focus of the treatment was to address the symptoms and prevent any further complications. The outcome was the complete recovery of the patients.</p><h3>Results</h3><p>The presented cases detail instances of severe OHSS following oocyte retrieval, utilizing GnRH-a for triggering. Case 1 involved a 33-year-old patient with a history of polycystic ovary syndrome (PCOS), Case 2 featured a 22-year-old patient with familial adenomatous polyposis (FAP), and Case 3 included a 41-year-old patient with a history of depressive disorder. All patients receiving supportive care, including infusions and medications, exhibited gradual improvement during hospitalization, with complete resolution observed during the 20-day post-hospitalization check-up.</p><h3>Conclusions</h3><p>These three cases highlight the occurrence of severe early OHSS following a GnRH antagonist protocol triggered with GnRH-a in the absence of human chorionic gonadotropin (hCG) administration for trigger or luteal-phase support. Clinicians must be aware that a GnRH-a trigger followed by a freeze-all approach does not guarantee the complete elimination of OHSS in all patients.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00404-024-07740-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sleep duration and sleep loss during pregnancy: a longitudinal FinnBrain birth cohort study 怀孕期间的睡眠时间和睡眠损失:FinnBrain 出生队列纵向研究。
IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-20 DOI: 10.1007/s00404-024-07727-4
Linda Aukia, E. Juulia Paavonen, Linnea Karlsson, Juho Pelto, Laura Perasto, Hasse Karlsson, Päivi Polo-Kantola

Purpose

To investigate sleep duration and sleep loss during antenatal period and assess associative factors, including maternal characteristic and mood symptoms.

Methods

A cohort of 3038 women was enrolled. Self-reported sleep duration and sleep loss, the latter being calculated from preferred sleep need and actual sleep duration, were measured in early, mid- and late pregnancy, and at delivery. The associations with age, BMI, parity, education, smoking, napping, and depressive and anxiety symptoms were evaluated.

Results

Sleep duration was longest in early pregnancy and shortest at delivery (7.93 h–7.76 h, p < 0.001). The proportion of short sleepers (< 6 h) increased from 1.4% to 5.9% throughout the studied period (p < 0.001). Mean sleep loss remained stable in early- and mid-pregnancy, lowering in late pregnancy (p < 0.001) and increasing again until delivery (p = 0.003). The number of women with notable sleep loss (> 2 h) was similar during the first three measurement points (9.4%, 8.9% and 9.5%), but increased until delivery (14.1%, p < 0.001). Older, multiparous, and more-depressive women slept less (p < 0.001, p < 0.001, p = 0.017). Women with higher BMI were more likely to sleep < 6 h in late pregnancy (p = 0.012). Multiparous, more-depressive, and higher-BMI women reported more sleep loss (p < 0.001, p < 0.001, p = 0.049).

Conclusion

We confirmed earlier reported decrease in sleep duration at the end of pregnancy. As a novel finding, we showed a notable increase in sleep loss during the last month of pregnancy. Various factors were associated with both short sleep and sleep loss, especially multiparity, napping and depressive symptoms.

目的:调查产前睡眠时间和睡眠损失,并评估相关因素,包括产妇特征和情绪症状:方法:共招募了 3038 名产妇。在孕早期、孕中期、孕晚期和分娩时测量了自我报告的睡眠时间和睡眠损失,后者是根据首选睡眠需求和实际睡眠时间计算得出的。评估了睡眠时间与年龄、体重指数、胎次、教育程度、吸烟、午睡、抑郁和焦虑症状的关系:前三个测量点的睡眠持续时间相似(9.4%、8.9% 和 9.5%),但在分娩前睡眠持续时间有所延长(14.1%,p 结论:我们证实了早先报道的睡眠持续时间缩短的现象:我们证实了之前报道的妊娠末期睡眠时间缩短的情况。作为一项新发现,我们发现在妊娠的最后一个月,睡眠时间减少的情况明显增加。睡眠时间短和睡眠减少与多种因素有关,尤其是多胎妊娠、午睡和抑郁症状。
{"title":"Sleep duration and sleep loss during pregnancy: a longitudinal FinnBrain birth cohort study","authors":"Linda Aukia,&nbsp;E. Juulia Paavonen,&nbsp;Linnea Karlsson,&nbsp;Juho Pelto,&nbsp;Laura Perasto,&nbsp;Hasse Karlsson,&nbsp;Päivi Polo-Kantola","doi":"10.1007/s00404-024-07727-4","DOIUrl":"10.1007/s00404-024-07727-4","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate sleep duration and sleep loss during antenatal period and assess associative factors, including maternal characteristic and mood symptoms.</p><h3>Methods</h3><p>A cohort of 3038 women was enrolled. Self-reported sleep duration and sleep loss, the latter being calculated from preferred sleep need and actual sleep duration, were measured in early, mid- and late pregnancy, and at delivery. The associations with age, BMI, parity, education, smoking, napping, and depressive and anxiety symptoms were evaluated.</p><h3>Results</h3><p>Sleep duration was longest in early pregnancy and shortest at delivery (7.93 h–7.76 h, <i>p</i> &lt; 0.001). The proportion of short sleepers (&lt; 6 h) increased from 1.4% to 5.9% throughout the studied period (<i>p</i> &lt; 0.001). Mean sleep loss remained stable in early- and mid-pregnancy, lowering in late pregnancy (<i>p</i> &lt; 0.001) and increasing again until delivery (<i>p</i> = 0.003). The number of women with notable sleep loss (&gt; 2 h) was similar during the first three measurement points (9.4%, 8.9% and 9.5%), but increased until delivery (14.1%, <i>p</i> &lt; 0.001). Older, multiparous, and more-depressive women slept less (<i>p</i> &lt; 0.001, <i>p</i> &lt; 0.001, <i>p</i> = 0.017). Women with higher BMI were more likely to sleep &lt; 6 h in late pregnancy (<i>p</i> = 0.012). Multiparous, more-depressive, and higher-BMI women reported more sleep loss (<i>p</i> &lt; 0.001, <i>p</i> &lt; 0.001, <i>p</i> = 0.049).</p><h3>Conclusion</h3><p>We confirmed earlier reported decrease in sleep duration at the end of pregnancy. As a novel finding, we showed a notable increase in sleep loss during the last month of pregnancy. Various factors were associated with both short sleep and sleep loss, especially multiparity, napping and depressive symptoms.</p></div>","PeriodicalId":8330,"journal":{"name":"Archives of Gynecology and Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Archives of Gynecology and Obstetrics
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