Archives Of Gynecology And Obstetrics[JOURNAL]
Sun
200 papers
Beyond the middle cerebral artery: anterior and posterior cerebral artery doppler provide complementary prognostic ınformation in late-onset fetal growth restriction.
Özler MR, Sağlam E, Yılmaz ES … +3 more , Codal B, Dikici Aktaş T, Kından A
Arch Gynecol Obstet · 2026 Jun · PMID 42228130 · Publisher ↗
PURPOSE: To evaluate the association of anterior cerebral artery (ACA) and posterior cerebral artery (PCA) Doppler parameters with adverse perinatal outcomes in pregnancies complicated by late-onset fetal growth restrict...
PURPOSE: To evaluate the association of anterior cerebral artery (ACA) and posterior cerebral artery (PCA) Doppler parameters with adverse perinatal outcomes in pregnancies complicated by late-onset fetal growth restriction (FGR), and assess their potential complementary prognostic role alongside conventional middle cerebral artery (MCA) Doppler assessment. METHODS: This prospective observational study included 130 pregnancies diagnosed with late-onset FGR between 32 and 37 weeks of gestation at a tertiary perinatology center. Doppler evaluation included umbilical artery (UA), uterine artery, MCA, ACA, and PCA. The cerebroplacental ratio (CPR) was calculated as MCA PI/UA PI. The primary outcome was composite adverse perinatal outcome defined as perinatal death, 5-min Apgar score <7, umbilical artery pH < 7.20, neonatal intensive care unit (NICU) admission, or need for mechanical ventilation. Predictive performance of Doppler parameters was assessed using receiver operating characteristic (ROC) analysis and multivariable logistic regression. RESULTS: Composite adverse perinatal outcomes occurred in 45 pregnancies (34.6%). Pregnancies with adverse outcomes had significantly higher UA PI and lower cerebral Doppler indices, including MCA PI (p = 0.004), ACA PI (p = 0.021), PCA PI (p = 0.036), and CPR (p = 0.002). CPR showed the highest discriminative performance (AUC = 0.85; 95%CI: 0.77-0.92), followed by MCA PI (AUC = 0.80), ACA PI (AUC = 0.74), and PCA PI (AUC = 0.70). In multivariable analysis, MCA PI, ACA PI, PCA PI, and estimated fetal weight percentile were independent predictors of adverse perinatal outcome. CONCLUSION: In late-onset FGR, Doppler abnormalities in the anterior and posterior cerebral arteries were associated with adverse perinatal outcomes. Assessment of ACA and PCA Doppler parameters may provide complementary prognostic information regarding fetal cerebral hemodynamic adaptation alongside conventional MCA and CPR evaluation.
Impact of repeated cryopreservation on embryo development and chromosomal ploidy.
Qin X, Fan L, Tang Y … +3 more , Li W, Li Z, Yang Y
Arch Gynecol Obstet · 2026 Jun · PMID 42228014 · Publisher ↗
PURPOSE: The potential adverse effects of repeated freezing and thawing processes on embryos remain controversial. This study aimed to investigate the impact of repeated embryo cryopreservation by comparing preimplantati...
PURPOSE: The potential adverse effects of repeated freezing and thawing processes on embryos remain controversial. This study aimed to investigate the impact of repeated embryo cryopreservation by comparing preimplantation genetic testing for aneuploidy (PGT-A) outcomes and clinical results of single vitrification and double-vitrification embryos. METHODS: This study analyzed the data of 2,335 embryos from 309 patients who underwent PGT-A. Embryos were divided into two groups based on the total number of vitrification procedures: (1) the CV - group (single vitrification, n = 1281), where fresh embryos were directly cultured to the blastocyst stage and vitrified once after trophectoderm biopsy, and (2) the CV + group (double vitrification, n = 1054), where cleavage-stage embryos underwent an initial vitrification, were subsequently warmed and cultured to the blastocyst stage for biopsy, and then vitrified again.Please check and confirm that the authors and their respective affiliations have been correctly identified and amend if necessary.We confirm that the author list and their respective affiliations have been carefully verified and are correct. We have made minor editorial amendments to the English wording of the institutional names to ensure accuracy and consistency with official nomenclature. RESULTS: The CV + group exhibited significantly lower blastocyst formation rate (39.6% vs. 46.6%, adjusted difference: - 6.7%, P = 0.004), high-quality blastocyst formation rate (11.2% vs. 16.7%, adjusted difference: - 5.3%, P = 0.001), and euploid rate per cleavage-stage embryo (7.8% vs. 10.6%, adjusted difference: - 2.6%, P = 0.043) than the CV - group. In contrast, the euploid rate per biopsied blastocyst was not significantly different between groups (19.0% vs. 21.9%, P = 0.175). Complementary embryo-level mixed-effects logistic regression likewise showed no statistically significant association between double vitrification and embryo euploidy outcomes (adjusted OR 0.72, 95% CI 0.49-1.07; P = 0.101). Age-stratified analyses suggested that these detrimental laboratory effects appeared numerically greater in women aged ≥ 38 years, although formal interaction testing did not support statistically significant effect modification by age. No statistically significant differences were observed in live birth or neonatal outcomes following euploid blastocyst transfer; however, these exploratory comparisons were based on limited transfer numbers and, therefore, should be interpreted cautiously. CONCLUSIONS: Repeated vitrification-warming exposure was associated with reduced embryo developmental efficiency and a numerically lower euploid embryo yield per cleavage-stage embryo. No statistically significant differences were observed in reproductive outcomes after euploid blastocyst transfer; however, these analyses were exploratory and substantially underpowered to exclude clinically meaningful differences. Larger adequately powered studies are required to further clarify the reproductive implications of repeated cryopreservation.
The human placenta development and anatomy.
Quaye D, Appiah PO, Obiri D … +2 more , Ahenkorah J, Adu-Bonsaffoh K
Arch Gynecol Obstet · 2026 May · PMID 42204027 · Publisher ↗
The human placenta is a specialized fetomaternal organ whose architecture evolves throughout pregnancy. Its development begins with implantation, followed by the differentiation of trophoblast lineages that establish the...
The human placenta is a specialized fetomaternal organ whose architecture evolves throughout pregnancy. Its development begins with implantation, followed by the differentiation of trophoblast lineages that establish the early villous structures and mediate subsequent exchange between the maternal and fetal circulations. By the end of the second trimester, coordinated remodeling of villous stroma, vasculature, and syncytium transforms the placenta into a highly specialized interface capable of meeting the growing demands of pregnancy. Despite extensive research in this area, most developmental accounts emphasize early morphogenesis, leaving the structural transitions of mid- and late gestation underexplored These later phases are critical for understanding how architectural specialization supports placental function and how deviations in these processes underpin pregnancy complications. This review synthesizes current understanding of placental morphogenesis and histomorphology across gestation. It integrates classical placental histology findings with recent advances in three-dimensional imaging, lineage tracing, and vascular modeling. By combining developmental and structural perspectives, this review offers an updated understanding of how the architecture of the placenta evolves to sustain pregnancy.
Cervical ripening with mechanical method vs oral misoprostol in pregnancies with elevated BMI: a cohort study.
Castoldi M, Fuchs F, Deruelle P … +3 more , Scotti GM, Candiani M, Cavoretto PI
Arch Gynecol Obstet · 2026 May · PMID 42201390 · Publisher ↗
OBJECTIVE: To compare labour duration and the effectiveness of cervical ripening by transcervical balloon versus oral misoprostol in women with elevated body mass index (BMI ≥ 25 kg/m). METHODS: A retrospective single-ce...
OBJECTIVE: To compare labour duration and the effectiveness of cervical ripening by transcervical balloon versus oral misoprostol in women with elevated body mass index (BMI ≥ 25 kg/m). METHODS: A retrospective single-centre cohort (2022-2024) at Montpellier University Hospital including singleton term pregnancies (37-42 weeks) with cephalic presentation, BMI > 25 and Bishop score < 6. Mechanical balloon versus oral misoprostol (25 µg/2 h or 50 µg/4 h) were compared by survival analysis assessing induction-to-delivery interval and by logistic regression assessing vaginal delivery rates, all adjusting for key covariates. EXCLUSION CRITERIA: maternal age < 18 years, scarred uterus, low-lying placenta. RESULTS: Among 7336 births, 2225 (30.3%) underwent labour induction, of which 247 met inclusion criteria. Vaginal delivery occurred in 180/247 (72.9%), of which 21/180(11.7%) were operative vaginal, caesareans were 67/247(27.1%), with no statistically significant difference observed; the study was not powered to assess equivalence of caesarean rates. Balloons achieved shorter induction-to-delivery (Mean 25.5 h; 95%CI 23.8-27.2 h vs. 35.3 h; 95%CI 33.0-37.6 h; p < 0.001), and induction-to-active-phase intervals vs. misoprostol (Mean 21.1 h; SD 12.8 h vs. 30.3 h; SD 17.7 h; p < 0.001), without difference in first active-stage and second-stage duration or among misoprostol regimens. Cox regression identified predictors of longer induction-to-delivery: nulliparity (HR:0.31; 95%CI 0.22-0.42), misoprostol (HR:0.46; 95%CI 0.33-0.66) vs intrauterine balloons, LGA (HR:0.63; 95%CI 0.43-0.92), higher BMI (HR:0.97; 95%CI 0.97-1.00), and excessive weight gain (HR:0.98; 95%CI 0.95-1.00). Treatment-by-parity and treatment-by-Bishop score interactions were not significant. A Fine and Gray competing-risks model showed that mechanical ripening vs. misoprostol provided shorter time intervals from induction to delivery (p = 0.033) and to active phase (p = 0.003). After one cycle of ripening, oxytocin infusion was associated with a higher rate of vaginal birth compared with repeated ripening (sHR 2.28, 95%CI 1.49-3.49). PPH or adverse neonatal outcomes were not different. CONCLUSIONS: In a high-BMI population mechanical cervical ripening vs. oral misoprostol show similar effectiveness, with the first associated with a shorter duration of labour induction.
Cumulative pregnancy and cumulative live birth rates and perinatal and obstetric outcomes in POSEIDON patients: insights from 19,371 IVF/ICSI cycles.
Wu D, Luo W, Li H … +7 more , Yang Y, Yao H, Fang Y, Ba H, Wang Y, Jin L, Hu S
Arch Gynecol Obstet · 2026 May · PMID 42201378 · Publisher ↗
PURPOSE: The objective of this study was to investigate the cumulative pregnancy, cumulative live birth, and perinatal and obstetric outcomes of individuals in the POSEIDON group, with the aim of enhancing the management...
PURPOSE: The objective of this study was to investigate the cumulative pregnancy, cumulative live birth, and perinatal and obstetric outcomes of individuals in the POSEIDON group, with the aim of enhancing the management of individuals receiving assisted reproductive technology (ART) who have characteristics associated with a poor prognosis. METHODS: In this study, 19,371 patients with infertility who underwent their first IVF/ICSI cycle at the Tongji Hospital from January 2016 to December 2021 were enrolled. The population was divided into 4 Poseidon subgroups (PG1-PG4) and a non-Poseidon (non-PG) group based on the POSEIDON criteria. The stratification is based on ovarian reserve and ovarian response to stimulation, with the goal of tailoring individualized stimulation strategies. RESULTS: The cumulative clinical pregnancy rate (CPR) gradually decreased from non-PG patients to PG 1-4 patients, with rates of 84.6%, 72.5%, 54.7%, 51.7%, and 30.7%, respectively. The cumulative live-birth rate (CLBR) was highest in non-PG patients, followed by PG1 patients, PG3 patients, PG2 patients, and PG4 patients, with rates of 81.0%, 67.0%, 45.3%, 45.2%, and 22.9%, respectively (p < 0.001). Additionally, the PG patients did not differ from the non-PG patients in terms of perinatal and birth outcomes, except for a decrease in gestational age and birth weight and an increase in the rate of preterm births, gestational diabetes, and cesarean section. CONCLUSIONS: Maternal age was the primary factor affecting pregnancy outcome. The younger subgroups (PG1, PG3) presented an acceptable CLBR (> 50%) and were not associated with an increased risk of abnormal perinatal outcomes.
Empowering prevention: uterine cancer awareness and advocacy in the digital age and world of social media.
Bilir E, Ahmed W, Derin X … +3 more , Kacperczyk-Bartnik J, Fotopoulou C, Nasser S
Arch Gynecol Obstet · 2026 May · PMID 42189261 · Publisher ↗
PURPOSE: We aim to evaluate the reach, engagement, and evolution of the inaugural Uterine Cancer Awareness Month (UCAM) social media campaign (2023-2024) on Twitter/X, focusing on user participation, content trends, and...
PURPOSE: We aim to evaluate the reach, engagement, and evolution of the inaugural Uterine Cancer Awareness Month (UCAM) social media campaign (2023-2024) on Twitter/X, focusing on user participation, content trends, and key influencers. METHODS: We conducted a social network analysis of Twitter/X posts using the hashtags #endometrialcancer, #uterinecancer, and #wombcancer over three years (2022-2024). Data were collected and analysed using NodeXL Pro, utilizing the Clauset-Newman-Moore and Harel-Koren Fast Multiscale algorithms for cluster and layout visualization. RESULTS: In 2022, 343 users generated 557 interactions, emphasizing health disparities and symptom awareness. The engagement peaked in 2023 with 302 users and 731 interactions, driven by strategic hashtag use and awareness efforts. A decline was noted in 2024 with 237 users and 484 interactions. Word pair analysis showed evolving themes, from general symptom awareness in 2022 to targeted messaging around advanced cases and recurrence in 2024. CONCLUSION: The UCAM-social media campaign showed promising initial growth but experienced a decline in engagement by 2024, highlighting the need for sustained and diversified strategies. Our study, which assessed the campaign's impact over a period exceeding one year, a rarity in the current literature, highlights critical insights for future initiatives.
Fetal growth-guided management of gestational diabetes: A retrospective cohort study on insulin requirements and perinatal outcomes.
Xodo S, Da Porto A, De Martino M … +5 more , Del Pin A, Flaiban A, Galasso S, Piccini S, Driul L
Arch Gynecol Obstet · 2026 May · PMID 42166007 · Publisher ↗
PURPOSE: To evaluate whether a fetal growth-guided management strategy can reduce treatment intensity without compromising maternal and neonatal outcomes in women with gestational diabetes mellitus (GDM). METHODS: This r...
PURPOSE: To evaluate whether a fetal growth-guided management strategy can reduce treatment intensity without compromising maternal and neonatal outcomes in women with gestational diabetes mellitus (GDM). METHODS: This retrospective cohort study with propensity score matching was conducted at a single tertiary referral center and included 343 women with GDM diagnosed after a second-trimester OGTT, of whom 244 were included in the matched analysis. Participants were managed either with a fetal growth-guided approach, in which glycemic targets and insulin therapy were tailored according to fetal abdominal circumference (AC), or with standard glycemia-based care. In the growth-guided group, stricter targets were applied when AC exceeded the 70th percentile. Outcomes were analyzed in the overall cohort and after matching. Primary outcomes were insulin use and glycemic control. Secondary outcomes included maternal weight gain, obstetric outcomes, and neonatal outcomes such as birthweight, Apgar score, cord blood pH, and size for gestational age. RESULTS: In the overall cohort, fetal growth-guided management was associated with lower birthweight (3470 g vs 3544 g; p = 0.036), reduced basal insulin use (58% vs 83%; p < 0.001), lower total insulin dose at delivery (9 vs 18 IU; p < 0.001), and slightly improved glycemic control. After propensity score matching, basal insulin use (65% vs 80%; p = 0.029) remained lower, while glycemic control, obstetric outcomes, and neonatal outcomes were comparable. The sensitivity analysis restricted to insulin-treated patients ahowed no significant differences between the differently managed groups of patients. CONCLUSIONS: A fetal growth-guided approach to GDM management reduces insulin requirements without worsening maternal or neonatal outcomes.
Embryological and clinical predictors of implantation and live birth in 3000 single euploid embryo transfer cycles: a retrospective cohort study.
Ozkara G, Yelke HK, Cetinkaya CP … +2 more , Colakoglu YK, Kahraman S
Arch Gynecol Obstet · 2026 May · PMID 42165893 · Publisher ↗
PURPOSE: Although single euploid embryo transfer (SEET) improves implantation and live birth (LB) rates, unsuccessful outcomes may still occur despite the transfer of morphologically high-quality euploid embryos. This st...
PURPOSE: Although single euploid embryo transfer (SEET) improves implantation and live birth (LB) rates, unsuccessful outcomes may still occur despite the transfer of morphologically high-quality euploid embryos. This study aimed to identify post-thaw embryological and clinical factors associated with implantation and LB outcomes. METHODS: This retrospective cohort study included 3000 frozen-thawed SEET cycles performed at a single center. Post-thaw embryological parameters evaluated were inner cell mass (ICM) and trophectoderm (TE) grades, expansion grade, presence of necrotic areas (NA) and excluded/extruded blastomeres (EB), embryo biopsy/freezing/transfer day (Day 5 vs. Day 6), cryo-survival rate (≥90% vs. <90%), and re-expansion status. Clinical variables included maternal age, body mass index (BMI), and number of previous IVF cycles. Outcomes were analyzed with adjustment for endometrial preparation using modified natural cycle (mNC) or hormone replacement cycle (HRC) protocols. Multivariate logistic regression analysis was performed to identify independent predictors of implantation and LB. RESULTS: Higher cryo-survival (≥90%), Day 5 embryo biopsy/freezing/transfer, and post-thaw re-expansion were associated with increased pregnancy rates (p<0.05). Higher embryo quality, particularly A-grade ICM, was independently associated with increased LB rates (p<0.05). The presence of NA and EB in thawed euploid blastocysts was significantly associated with reduced cryo-survival and lower LB outcomes (p<0.05). Maternal age <35 years was associated with a higher likelihood of LB compared with age ≥43 years (OR: 0.291, 95% CI 0.149-0.569, p<0.001). LB rates were significantly higher in mNC-prepared cycles compared with HRC (85.2% vs. 71.8%, p<0.001). Lower BMI and fewer previous IVF cycles were also associated with improved LB outcomes. CONCLUSION: Post-thaw embryological competence and maternal characteristics significantly influence implantation and live birth outcomes, even in euploid embryo transfers. Comprehensive evaluation of thawed embryo morphology combined with individualized endometrial preparation may optimize clinical outcomes following SEET.
Ultrasound-guided bone fulcrum lever rotation for fetal head malposition.
Wei SH, Wang MQ, Yuan CH … +2 more , Fang J, Shi XH
Arch Gynecol Obstet · 2026 May · PMID 42165850 · Full text
OBJECTIVE: To investigate the efficacy and safety of applying the ultrasound-guided bone fulcrum lever rotation method during manual rotation of the fetal head in cases of labor dystocia due to fetal head malposition. ME...
OBJECTIVE: To investigate the efficacy and safety of applying the ultrasound-guided bone fulcrum lever rotation method during manual rotation of the fetal head in cases of labor dystocia due to fetal head malposition. METHODS: This retrospective study analyzed 109 parturients with persistent occiput posterior (POP) or occiput transverse (OT) positions in the second stage of labor, who delivered at a tertiary hospital in Jiangsu Province, China, between January 2024 and September 2025. Participants were divided into an experimental group (ultrasound-guided bone fulcrum lever rotation, n = 54) and a control group (conventional manual rotation, n = 55). Comparisons were made regarding the fetal head rotation success rate, the mode of delivery, and the neonatal outcomes. RESULTS: The success rate of fetal head rotation was significantly higher in the experimental group compared to the control group (88.89% vs. 67.27%, P = 0.006). The rotation procedure time was shorter in the experimental group (P = 0.019), and the rate of spontaneous vaginal delivery was significantly higher (94.44% vs. 76.36%, P = 0.008). There were no significant differences in neonatal outcome indicators between the two groups. CONCLUSION: In this study, intrapartum ultrasound localization was combined with manual rotation manipulation for the management of cephalic dystocia. The results indicated that this combined intervention yielded better clinical efficacy than conventional manual rotation alone, and thus it holds high clinical application value.
Endometriosis and adverse pregnancy outcomes in primiparous women: a retrospective cohort study.
Téoule J, Zikarsky L, Bundschu K … +2 more , Andres S, Hancke K
Arch Gynecol Obstet · 2026 May · PMID 42159780 · Full text
OBJECTIVE: To assess whether pre-existing endometriosis is associated with specific adverse pregnancy and delivery outcomes in primiparous women. DESIGN: Retrospective cohort study. SETTING: Tertiary care university hosp...
OBJECTIVE: To assess whether pre-existing endometriosis is associated with specific adverse pregnancy and delivery outcomes in primiparous women. DESIGN: Retrospective cohort study. SETTING: Tertiary care university hospital. POPULATION OR SAMPLE: Primiparous women with singleton pregnancies. METHODS: Women with endometriosis were compared with primiparous controls without endometriosis. Primary outcomes were preterm birth and cesarean delivery; placenta previa was examined as a key secondary outcome. Multivariable logistic regression models adjusted for maternal age and mode of conception were used. MAIN OUTCOME MEASURES: Preterm birth, cesarean delivery, placenta previa. RESULTS: Among 16,033 primiparous women, 118 had a diagnosis of endometriosis prior to pregnancy. After adjustment for maternal age and mode of conception, endometriosis was not independently associated with preterm birth (adjusted odds ratio 0.75; 95% confidence interval 0.44-1.28) or cesarean delivery (adjusted odds ratio, 1.17; 95% confidence interval, 0.81-1.71). In contrast, endometriosis was associated with placenta previa (adjusted odds ratio, 5.90; 95% confidence interval, 2.37-14.71). CONCLUSION: In primiparous women, pre-existing endometriosis was independently associated with placenta previa, but not with preterm birth or cesarean delivery. These findings support abnormal early placentation as a potential mechanism linking endometriosis to adverse obstetric outcomes.
A nomogram integrating a novel uterine isthmus ratio (APTUIR), sonographic signs and clinical symptoms for predicting posterior deep endometriosis.
Yang S, He Y, Jin C … +6 more , Deng M, Zhou Y, Luo K, Qiu L, Bei Y, Chen Q
Arch Gynecol Obstet · 2026 May · PMID 42151482 · Publisher ↗
OBJECTIVE: This study aims to propose a novel, reproducible transvaginal ultrasound (TVUS) measurement-anterior-posterior wall thickness of the uterine isthmus ratio (APTUIR)-and to construct a nomogram model integrating...
OBJECTIVE: This study aims to propose a novel, reproducible transvaginal ultrasound (TVUS) measurement-anterior-posterior wall thickness of the uterine isthmus ratio (APTUIR)-and to construct a nomogram model integrating this parameter with other ultrasound assessments and clinical symptoms for predicting the risk of posterior pelvic deep endometriosis (DE). METHODS: This retrospective study included 362 patients with endometriosis (153 with posterior pelvic DE; 209 without) who underwent TVUS and surgery between 2021 and 2024. APTUIR, uterine white sliding lines (WSL), and clinical symptoms were assessed. LASSO regression was used to identify independent predictors and construct a nomogram. Model performance was evaluated by area under the curve (AUC), calibration curves and decision curve analysis (DCA) with internal validation (500 bootstrap samples). RESULTS: Results showed statistically significant differences between groups in dyspareunia, menstrual defecation abnormalities, CA125, uterine anteroposterior diameter, concomitant endometrial polyps (EPs), uterine posterior isthmus echo, uterine anterior WSL, uterine posterior WSL, ovarian kiss sign and APTUIR (p < 0.05). Four key predictors were identified: APTUIR, posterior uterine wall WSL, EPs, and menstrual bowel dysfunction. The nomogram demonstrated excellent predictive performance: AUC 0.933 (95% CI: 0.901-0.957), sensitivity of 85.0%, specificity of 88.0% and accuracy of 86.7%. The calibration curve of the nomogram demonstrated good consistency, whilst the decision curve indicated favourable clinical utility. CONCLUSION: The APTUIR-based nomogram provides a non-invasive, highly accurate tool for identifying high-risk posterior pelvic DE. It facilitates objective risk stratification and timely specialist referral, particularly in non-specialised settings.
Latency following preterm prelabor rupture of membranes before 34 weeks of gestation and its association with perinatal outcomes: a retrospective cohort study.
López-Martínez P, Sánchez-Romero J, Muñoz-Porcel R … +8 more , Mokachir-Mohsenin Z, Blanco-Carnero JE, Crespo-Bañón P, Liandro RS, Hernández-Hernández L, Dagklis T, Nieto-Díaz A, de Paco-Matallana C
Arch Gynecol Obstet · 2026 May · PMID 42143156 · Publisher ↗
PURPOSE: To evaluate the association between latency duration and perinatal outcomes in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation, and to assess the role of ges...
PURPOSE: To evaluate the association between latency duration and perinatal outcomes in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation, and to assess the role of gestational age at PPROM and amniotic fluid volume. METHODS: This retrospective cohort study included pregnancies complicated by PPROM before 34 weeks of gestation managed expectantly at a tertiary care center. Latency duration was defined as the interval from membrane rupture to delivery. Composite neonatal and pregnancy adverse outcomes were analyzed using latency-based time-to-event methods. Cox proportional hazards models were used to assess the independent associations of gestational age at PPROM and amniotic fluid pocket with adverse pregnancy and neonatal outcomes. RESULTS: A total of 278 pregnancies were included in the final analysis. Latency duration was strongly associated with gestational age at PPROM, with progressively shorter latency observed at more advanced gestational ages. Larger residual amniotic fluid pockets were independently associated with prolonged latency. In latency-based Cox models, gestational age at PPROM was significantly associated with both pregnancy-adverse and neonatal composite outcomes. In contrast, latency duration itself and residual amniotic fluid volume were not independently associated with adverse neonatal outcomes after accounting for gestational age variables. CONCLUSIONS: In pregnancies complicated by PPROM before 34 weeks of gestation, gestational age at membrane rupture is the principal determinant of latency duration and perinatal outcomes. Latency should be interpreted as a gestational-age-dependent phenomenon rather than an independent predictor of neonatal risk, supporting individualized expectant management that prioritizes gestational age advancement while balancing maternal risk.
Maternal diabetes subtypes and offspring cutaneous health: developmental programming of sebaceous gland function in over 330,000 live births.
Honig E, Amitai N, Weissmann S … +2 more , Horev A, Eshkoli T
Arch Gynecol Obstet · 2026 May · PMID 42138741 · Publisher ↗
OBJECTIVE: Maternal diabetes is a known driver of fetal metabolic programming, yet its impact on offspring cutaneous health remains poorly characterized. We investigated the impact of intrauterine exposure to various mat...
OBJECTIVE: Maternal diabetes is a known driver of fetal metabolic programming, yet its impact on offspring cutaneous health remains poorly characterized. We investigated the impact of intrauterine exposure to various maternal diabetes subtypes on the risk of offspring seborrheic dermatitis (SD), and to explore whether this risk is modulated by maternal glycemic control or treatment modality. METHODS: This large-scale, population-based cohort study included 331,335 mother-child pairs. Maternal diabetes subtypes-type 1 (T1DM), type 2 (T2DM), and gestational diabetes mellitus (GDM)-were assessed, along with glycemic control (HbA1c) and pharmacological treatment. SD was identified using physician-documented diagnoses and medication records. Multivariable logistic regression models adjusted for maternal and perinatal factors were used to estimate adjusted odds ratios (aORs). RESULTS: The incidence of SD was 4.5%. SD was significantly more frequent among offspring of mothers with diabetes (4.9% vs. 4.4%, p < 0.001), primarily driven by GDM. T1DM and T2DM showed similar trends but weren't statistically significant. SD risk did not differ by treatment modality or glycemic control. While overall associations for T1DM and T2DM did not reach significance in the full cohort, age-stratified analysis revealed that maternal diabetes was significantly associated with increased SD risk across all subtypes within the first year of life (T1DM: p = 0.033, T2DM: p = 0.024, GDM: p = 0.019). Multivariable analysis showed maternal diabetes was independently associated with increased SD risk (aOR 1.16, 95% CI 1.08-1.24). CONCLUSION: Maternal diabetes is associated with a significantly increased risk of infantile SD across all diabetes subtypes, suggesting that the intrauterine diabetic environment may influence early-life cutaneous homeostasis through metabolic programming of the pilosebaceous unit.
Feasibility and safety of 4DryField PH as a hemostatic agent in ovarian surgery on fertility: a pilot randomized study.
Tascón Padrón L, Schröder C, Otten LA … +3 more , Sänger N, Egger EK, Mustea A
Arch Gynecol Obstet · 2026 May · PMID 42138724 · Full text
PURPOSE: To evaluate the feasibility and safety of the hemostatic powder 4DryField® PH in laparoscopic ovarian cystectomy and its impact on fertility compared to conventional bipolar electrocautery. METHODS: This is a pr...
PURPOSE: To evaluate the feasibility and safety of the hemostatic powder 4DryField® PH in laparoscopic ovarian cystectomy and its impact on fertility compared to conventional bipolar electrocautery. METHODS: This is a prospective, randomized, controlled, single-center, single-blind pilot study, included in the german registry for clinical trials (DRKS-ID: DRKS00038742). The study was developed in the. Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Germany. Twenty women (≥ 18 years old) undergoing laparoscopic ovarian cystectomy for benign ovarian lesions with baseline serum anti-Müllerian hormone (AMH) ≥ 2.0 ng/mL were enrolled and randomized equally to two hemostatic methods. Hemostasis was achieved using either bipolar electrocautery (n = 10) or topical 4DryField® PH powder (n = 10). Both groups underwent standardized laparoscopic cystectomy performed by experienced surgeons. Serum AMH, C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), white blood cell counts, hemoglobin and hematocrit were assessed preoperatively, on postoperative day (POD) 1, and POD 14. RESULTS: Baseline AMH levels were comparable between groups (4.54 ± 2.24 ng/mL vs. 4.39 ± 2.08 ng/mL, p = 0.85). By POD 14, the mean percent decline in AMH from baseline was smaller in the 4DryField group than in the electrocautery group (mean difference = 16.77%; 95% CI: -5.39 to 38.93). This difference was not statistically significant (p = 0.36), with an estimated effect size of d= 0.72 (95% CI: -0.19 to 1.62). IL-6 increased transiently on POD 1 in the 4DryField group (9.2 pg/mL [IQR 78.6] vs. 3.85 pg/mL [IQR 2.80]; p = 0.016) but normalized by POD 14, indicating a short, non-pathologic inflammatory response. No significant differences were observed in CRP, PCT, or leukocyte counts. No adverse events, infections, or hemorrhagic complications occurred in either group. CONCLUSION: In this pilot study, the use of 4DryField® PH appears feasible and safe for laparoscopic ovarian cystectomy. While the reduction in AMH levels was numerically smaller in the 4DryField group, the difference was not statistically significant. These results are hypothesis-generating and underscore the need for larger trials to evaluate the potential benefits of non-thermal hemostatic strategies for ovarian reserve preservation. TRIAL REGISTRATION: Clinical trial; DRKS00038742.
Ovarian pregnancy: clinical characteristics, diagnostic challenges, and sonographic features-a multicenter case series with narrative literature overview.
Dayan-Schwartz A, Zilberlicht A, Cohen N … +6 more , Leen F, Abd Elgani S, Kogan L, Reiss A, Beck-Fruchter R, Daniel-Spiegel E
Arch Gynecol Obstet · 2026 May · PMID 42128898 · Publisher ↗
PURPOSE: To describe the demographic, clinical, laboratory, imaging, and surgical features of 15 histologically confirmed ovarian pregnancies (OP) and to contextualize these findings within a narrative literature overvie...
PURPOSE: To describe the demographic, clinical, laboratory, imaging, and surgical features of 15 histologically confirmed ovarian pregnancies (OP) and to contextualize these findings within a narrative literature overview in order to improve clinical recognition and facilitate earlier diagnosis. METHODS: A retrospective multicenter case series was conducted across two university-affiliated hospitals between 2012 and 2024. Women with histologically confirmed OP were included. Demographic data, risk factors, presenting symptoms, β-hCG dynamics, ultrasound findings, operative details, and postoperative outcomes were collected and analyzed. RESULTS: Fifteen patients were identified. The mean age was 34.6 ± 4.2 years; 46.7% used an intrauterine device, 33.3% had prior cesarean delivery, and 13.3% conceived through assisted reproduction. Abdominal pain was the predominant symptom (86.7%), whereas vaginal bleeding occurred in 26.7%. The mean preoperative β-hCG level was 6,436 ± 5,570 mIU/mL and serial measurements showed inappropriate rises. OP was suspected preoperatively in 53.3% of cases; identification appeared higher in cases with formal ultrasound (85.7%), although this observation is limited by differences in imaging setting and documentation.. Observed sonographic features included a hyperechoic peripheral ring and a Doppler pattern demonstrating a single dominant feeding vessel; A trilaminar endometrial pattern was not observed in evaluable cases. Rupture occurred in 73.3% of patients with a median blood loss of 300 mL (IQR 10-2000 mL). All patients were treated surgically with ovarian preservation, and postoperative day-1 β-hCG declined by 59 ± 12%. CONCLUSION: OP commonly presents with abdominal pain and minimal bleeding and carries a high rupture risk. The described sonographic patterns may represent hypothesis-generating observations that could support clinical suspicion and warranting further study.
Clinical outcomes and practical management implications in rudimentary horn pregnancies: a systematic review and pooled analysis (2010-2025).
Emrich NLA, Padrón LT, Schröder C … +4 more , Mustea A, Strizek B, Gembruch U, Cruz JJ
Arch Gynecol Obstet · 2026 May · PMID 42118334 · Full text
PURPOSE: Rudimentary horn pregnancies are rare and carry significant maternal and fetal risks. This study aims to systematically review published cases of rudimentary horn pregnancies describing data about time of diagno...
PURPOSE: Rudimentary horn pregnancies are rare and carry significant maternal and fetal risks. This study aims to systematically review published cases of rudimentary horn pregnancies describing data about time of diagnosis, time of rupture, and live birth rate (LBR), with exploratory comparisons between communicating (CHP) and non-communicating horn pregnancies (NCHP). METHODS: A PRISMA-guided systematic search of PubMed, MEDLINE, and Cochrane (October 1, 2025) was performed with terms "unicornuate uterus pregnancy" OR "rudimentary horn pregnancy." Case reports, series, and reviews with defined clinical data were included; abstracts and unclear reports were excluded. Three independent reviewers extracted data using a standardized protocol. Descriptive statistics (means, medians, standard deviations, and ranges) and exploratory group comparisons (Fisher's exact test, Mann-Whitney U and Student's t test with p < 0.05 denoting significance) were performed. RESULTS: From 132 articles, 190 cases were included: 27 CHP (14.2%) and 163 NCHP (85.8%). Time of diagnosis was earlier in NCHP (15.9 ± 8.9 weeks) than CHP (22.1 ± 10.0 weeks, p = 0.01). Rupture occurred in 68 cases (35.8%), similarly in CHP (48.1%) and NCHP (33.7%, p = 0.19). Time of rupture was earlier in NCHP (18.7 ± 6.6 weeks) than CHP (23.0 ± 9.2 weeks, p = 0.02). Four cases attempted to continue pregnancy; all resulted in premature rupture. Reported live births were infrequent (11.6%) and more common in published CHP (25.9%) vs. NCHP cases (9.2%; p = 0.02). CONCLUSIONS: This descriptive synthesis indicates uterine horn communication may be associated with later diagnosis/rupture and reported live births were significantly more frequent in published CHP vs. NCHP cases. However, all comparisons are exploratory and must be interpreted with extreme caution, as data limitations preclude causal inference. Exhaustive imaging and diagnosis are essential to characterize horn type. Surgical termination is advised, but if expectant management is chosen, close monitoring and multidisciplinary care, including weekly ultrasounds, are advisable to mitigate complications.
Maternal serum sex hormone-binding globulin and androgen levels in fetuses with intrauterine growth restriction: a prospective case-control study.
Ceylan MK, Öz ÖF, Ersoy BK … +2 more , Yavuz A, Atmaca F
Arch Gynecol Obstet · 2026 May · PMID 42118292 · Publisher ↗
PURPOSE: To compare maternal serum sex hormone-binding globulin (SHBG) and androgen markers in intrauterine growth restriction (IUGR) and gestational-age-matched controls, and to assess their associations with fetal grow...
PURPOSE: To compare maternal serum sex hormone-binding globulin (SHBG) and androgen markers in intrauterine growth restriction (IUGR) and gestational-age-matched controls, and to assess their associations with fetal growth. METHODS: This prospective case-control study included 45 IUGR pregnancies and 50 controls. Blood was collected in the late third trimester, preferentially antepartum; otherwise within 24 h postpartum (IUGR: 36/45 antepartum, 9/45 postpartum; controls: 9/50 antepartum, 41/50 postpartum). Total testosterone, dehydroepiandrosterone sulfate, estradiol, androstenedione, and SHBG were measured by immunoassay. FAI was calculated as (testosterone [nmol/L]/SHBG [nmol/L]) × 100 after conversion of testosterone from ng/mL to nmol/L. Sensitivity analyses compared hormone levels within antepartum and postpartum subgroups. Exploratory multivariable linear regression in the IUGR group assessed whether SHBG and total testosterone were independently associated with birth weight percentile and abdominal circumference percentile after adjustment for maternal age, systolic blood pressure, and sampling time. RESULTS: IUGR mothers were older, delivered earlier, and had higher systolic blood pressure than controls. Birth weight was lower in IUGR (2190 ± 624 g vs 3306 ± 391 g). SHBG was lower in IUGR (257 ± 117 vs 382 ± 106 nmol/L, p < 0.001), whereas FAI was modestly higher (1.27 ± 1.06 vs 0.85 ± 0.71, p = 0.018). In the antepartum-only subgroup, SHBG remained lower in IUGR, whereas FAI did not differ significantly. Unadjusted correlations of SHBG and total testosterone with fetal growth parameters in IUGR were attenuated after adjustment. CONCLUSION: IUGR was associated with lower maternal SHBG. The FAI difference was modest and not robust in the antepartum-only analysis. Hormone-growth associations were exploratory and were not independently significant after adjustment.
Pregnancy and delivery after myomectomy for large fibroids: utilization of trial of labor and obstetric outcomes in a single-center cohort study.
Mor M, Gil O, Feldman N … +3 more , Naor-Dovev M, Eisenberg N, Smorgick N
Arch Gynecol Obstet · 2026 May · PMID 42118171 · Publisher ↗
PURPOSE: To quantify obstetric outcomes after prior myomectomy in a tertiary center and to explore whether operative and clinical characteristics are associated with uterine rupture. METHODS: Single-center retrospective...
PURPOSE: To quantify obstetric outcomes after prior myomectomy in a tertiary center and to explore whether operative and clinical characteristics are associated with uterine rupture. METHODS: Single-center retrospective cohort of deliveries following laparotomic or laparoscopic myomectomy between August 2015 and January 2023. We extracted demographic, surgical, and obstetric data from electronic records, and analyzed only the first consecutive post-myomectomy pregnancy per patient. RESULTS: Sixty-three women delivered after prior myomectomy. 75.5% underwent laparotomic myomectomy and the remainder laparoscopic. The mean largest myoma diameter was 9.6 ± 3.4 cm; 66.7% were intramural. Uterine cavity entry occurred in 30.4%. Trial of labor after myomectomy was attempted in four patients (6.3%) and was successful in three. Two patients had placenta accreta spectrum (3.2%), and two required transfusions for postpartum hemorrhage. One full-thickness uterine rupture was identified incidentally at a planned elective cesarean at 37.4 weeks (1/63; 1.6%) in an asymptomatic patient not in labor. A short myomectomy-to-pregnancy interval showed an association with rupture: < 3 months (OR 103.0, 95% CI 2.85-3728.2; p = 0.007) and < 6 months (OR 25.9, 95% CI 1.94-716.8; p = 0.037). No other variables reached statistical significance, although the analysis was underpowered to assess additional predictors. CONCLUSION: Uterine rupture after myomectomy was rare (1.6%) in our cohort and was associated with a short myomectomy-to-pregnancy interval. However, as this association is based on a single event, it should be interpreted with caution and considered hypothesis-generating. Despite the low absolute risk, and consistent with literature supporting TOLAM in selected patients, TOLAM was markedly underutilized in our center, highlighting a practice gap that may be addressed through more standardized counseling and delivery planning in tertiary settings.
Clinical practice guideline "preconception care".
Krischer B, Bürki R, Hösli I … +3 more , Renteria S, Streuli I, Surbek D
Arch Gynecol Obstet · 2026 May · PMID 42115436 · Publisher ↗
The Swiss Society of Gynecology and Obstetrics recently issued a Clinical Practice Guideline "Preconception Care". In the German-speaking countries, this constitutes the first guideline of its kind and one of the few for...
The Swiss Society of Gynecology and Obstetrics recently issued a Clinical Practice Guideline "Preconception Care". In the German-speaking countries, this constitutes the first guideline of its kind and one of the few for Europe. The authors present the guideline, adapted for an international audience. Preconception care (PCC) is a dynamic, process-oriented approach aimed at improving maternal and neonatal health outcomes by reducing risks before conception occurs. Central to PCC is comprehensive counseling that enables women and couples to make informed decisions regarding their reproductive health. This involves the early identification of potential medical, lifestyle, or environmental risk factors, alongside the provision of targeted advice and timely interventions. Preconception care should not be regarded as a single consultation but rather as an ongoing component of routine gynecological care that is adapted to individual needs. By focusing on health optimization-such as managing chronic conditions, encouraging healthy nutrition and physical activity, and avoiding substance use-PCC lays the foundation for safer pregnancies and healthier offspring. Equally, the intentional planning of pregnancy is emphasized, given that planned pregnancies are associated with lower maternal and fetal morbidity compared to unplanned ones. Since many beneficial interventions require weeks or months to exert their effects, counseling should ideally begin well before the discontinuation of contraception. This clinical practice guideline of PCC provides a comprehensive and structured framework for anticipatory guidance, enabling risk minimization and improved health trajectories for both mother and child.
Clinical relevance and prognostic role of PDL-1 expression in cervical cancer patients.
Arnò A, Pernazza A, Leopizzi M … +13 more , Benedettucci E, Cerbelli B, Manganaro L, Barchiesi G, Tomao F, Perniola G, Di Donato V, Gentile G, Mancini S, De Felice F, Muzii L, Rocca CD, Palaia I
Arch Gynecol Obstet · 2026 May · PMID 42104993 · Publisher ↗
Abstract loading — click title to view on PubMed.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe