Archives Of Gynecology And Obstetrics[JOURNAL]
Sun
200 papers
Predictive value of uterine electromyography coupled with transvaginal ultrasound cervical assessment in women at risk of preterm delivery.
Zhang L, Mao Y, Shen Y … +6 more , Guo H, Xu S, Shen L, Chen L, Lu L, Yu L
Arch Gynecol Obstet · 2026 Mar · PMID 41770223 · Full text
BACKGROUND: Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, with about 15 million preterm births occurring each year. Accurate prediction of preterm birth is essential for the implement...
BACKGROUND: Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, with about 15 million preterm births occurring each year. Accurate prediction of preterm birth is essential for the implementation of effective interventions. AIM: This study evaluates the combined predictive value of uterine electromyography (EMG) and transvaginal ultrasound (TVUS) cervical parameters for preterm birth in high-risk singleton pregnancies, assessing its superiority over individual methods. METHODS: A retrospective, propensity score-matched cohort study was conducted to collect data of pregnant women at high risk of preterm birth who gave birth in our hospital (Jan 2024-Apr 2025). After 1:1 matching, 180 participants were assigned to spontaneous preterm birth (sPTB, < 37 weeks, n = 90) or term birth (≥ 37 weeks, n = 90) groups. At 20-24 weeks, all underwent TVUS [cervical length (CL) and elastic strain rate (ESR)] and EMG [peak frequency (PK) and propagation velocity (PV)]. The primary aim was to compare the AUC of a combined model (CL + ESR + EMG-PV) versus CL alone. Secondary outcomes included group differences and each model's sensitivity, specificity, and NPV. Logistic regression was used for multivariable analysis, and the DeLong test compared AUCs. RESULTS: After PSM, the baseline data of the two groups were balanced (P > 0.05). The sPTB group had shorter CL and higher ESR, EMG-PK, and EMG-PV (all P < 0.001). Multivariate logistic regression identified CL (OR = 0.85), ESR (OR = 1.32), and EMG-PV (OR = 1.45) as independent predictors. The combined model (CL + ESR + EMG-PV) yielded a significantly higher AUC (0.93, 95%CI 0.89-0.97) than CL alone (0.85, 95%CI 0.79-0.91; DeLong test, P = 0.002). The combined model also demonstrated superior sensitivity (88.9%), specificity (91.1%), and NPV (94.4%) compared with individual models. CONCLUSIONS: Integrating TVUS cervical assessment with EMG monitoring significantly enhances preterm birth prediction in high-risk singletons, offering improved risk stratification despite limitations from its single-center retrospective design requiring future validation.
Unlocking ovarian rejuvenation with platelet-rich plasma: systematic review and proposed clinical framework for Controlled use in poor prognosis patients undergoing in vitro fertilisation.
Alageel AA
Arch Gynecol Obstet · 2026 Feb · PMID 41760981 · Full text
BACKGROUND: Platelet-rich plasma (PRP) is used as an adjunctive treatment in various medical fields, including orthopaedics, plastic surgery, dermatology, and wound healing. However, PRP application in reproductive medic...
BACKGROUND: Platelet-rich plasma (PRP) is used as an adjunctive treatment in various medical fields, including orthopaedics, plastic surgery, dermatology, and wound healing. However, PRP application in reproductive medicine, particularly for fertility restoration, remains controversial, specifically for women with diminished ovarian reserve (DOR), premature ovarian insufficiency (POI), and pre-menopause. This systematic review aimed to comprehensively evaluate the existing literature on autologous PRP use for ovarian rejuvenation, with a focus on refining and standardising PRP protocols and identifying appropriate candidate populations. METHODS: A comprehensive literature search was conducted on the autologous PRP use using Cochrane, Embase, PubMed, MEDLINE, NCBI, and Google Scholar databases. Studies on PRP application in reproductive medicine were identified and classified into two categories: DOR and POI. The PRP preparation protocol was assessed, and the results were compared. This narrative systematic review, carried out in compliance with PRISMA 2020 guidelines, combined results, although meta-analysis was not feasible due to significant variation in study design, PRP preparation, and outcome measures. RESULTS: Several studies reported restoration of menstruation following intraovarian PRP administration in women with POI. In women with DOR, studies reported changes in ovarian reserve markers, including increases in serum anti-Müllerian hormone (AMH) levels and reductions in follicle-stimulating hormone (FSH) levels; however, these changes were not consistently associated with higher antral follicle counts or oocyte yield. Instead, sseveral studies reported higher proportions of mature oocytes and pregnancy and live birth outcomes, particularly following repeated PRP treatment cycles in women with long-standing ovarian dysfunction. CONCLUSIONS: Intraovarian PRP may have a potential role in activating dormant follicles in a selected subset of women with poor ovarian response. However, the current evidence remains limited and heterogeneous, supporting its use only within structured clinical or research protocols until higher-quality, standardised studies are available.
Characterization of exceptional responders with long-term PARP inhibitor therapy in recurrent ovarian cancer: an analysis of 23 patients from Charité.
Glajzer J, Sehouli J, Woopen H … +3 more , Braicu EI, Baum J, Grabowski JP
Arch Gynecol Obstet · 2026 Feb · PMID 41746394 · Full text
OBJECTIVE: This analysis aimed to characterize exceptional responder with long-term PARP inhibitor therapy (ExR-LT) in platinum-sensitive recurrent ovarian cancer. METHODS: This analysis included ExR-LT. ExR-LTs are defi...
OBJECTIVE: This analysis aimed to characterize exceptional responder with long-term PARP inhibitor therapy (ExR-LT) in platinum-sensitive recurrent ovarian cancer. METHODS: This analysis included ExR-LT. ExR-LTs are defined as patients that received a continuous maintenance therapy for recurrent ovarian cancer with olaparib or niraparib for at least 5 years and showed an exceptional response. Exceptional response was defined as progression-free survival (PFS) of at least 5 years. This analysis has a retrospective and descriptive character. RESULTS: 23 patients were included. The median duration of PARPi therapy was 7.1 years (range 5.3; 10.5). The longest treatment duration was reached in the BRCA1 mutation (BRCA1m) cohort with a mean duration of 8 years (range 5.3; 10.5 years). The majority of patients (16 patients, 69.7%) reported adverse events (AE) during PARPi therapy. 12 patients (52.2%) had mild AE (CTCAE 1 or 2), 4 patients (17.4%) reported more severe AE (CTCAE 3). 14 patients needed a dose reduction due to treatment-related AE (60.1%). The most common indications for dose reduction were anemia (17.4%), headache and limb pain (17.4%), and fatigue (13%). Four patients (17.4%) required an interruption of PARPi therapy. Ten patients received a dose reduction within the first 6 months and two patients after one and 1.3 years of PARPi therapy. No dose adjustments were necessary between 1.5 and 4 years. After 4 years, 3 patients (13%) received a late dose reduction. 8.6% had another cancer diagnosed before, 4.3% simultaneously, and 13% after the ovarian cancer diagnosis. CONCLUSION: ExR-LTs present with heterogenic clinical and genetic characteristics. Clinical management is complex because of a high rate of AE and need of dose reductions at various points in time. Close monitoring for AE, recurrences and secondary malignancies must be carried out throughout the entire time of treatment.
D-Dimer levels during pregnancy and postpartum: non-applicability of regularly used cut-offs for diagnosis of suspected pulmonary embolism.
Ranieri E, Korte W, Brandi G … +3 more , Kalimeris S, Ochsenbein N, Haslinger C
Arch Gynecol Obstet · 2026 Feb · PMID 41733712 · Full text
PURPOSE: To assess D-dimer levels during pregnancy and postpartum period and evaluate the appropriateness of commonly used cut-offs for ruling out pulmonary embolism (PE) in this population. METHODS: Secondary analysis o...
PURPOSE: To assess D-dimer levels during pregnancy and postpartum period and evaluate the appropriateness of commonly used cut-offs for ruling out pulmonary embolism (PE) in this population. METHODS: Secondary analysis of the prospective PPH 1300 study conducted at the University Hospital Zurich, including 1309 women between 25 + 0 and 42 + 3 weeks of gestation without acute thromboembolic events. D-Dimer levels were measured at admission for delivery and 24-48 h postpartum, stratified into four gestational age groups. RESULTS: Median D-dimer values were 1.56 mg/L (IQR 1.20-2.12) antepartum and 1.78 mg/L (IQR 1.25-2.84) postpartum. Antepartum, 99.3% of women had levels ≥ 0.5 mg/L and 88.8% ≥ 1.0 mg/L; postpartum, 98.8% and 88.1% exceeded these cut-offs, respectively. Antepartum values showed an increasing trend with gestational age, whereas postpartum values remained uniformly elevated. No clinically relevant thromboembolic events occurred during the index hospitalization. CONCLUSIONS: Nearly all pregnant and postpartum women exceed conventional D-dimer thresholds also in the absence of thromboembolism. Standard cut-offs of 0.5 and 1.0 mg/L are therefore unsuitable in obstetric practice, limiting the applicability of general diagnostic algorithms, such as YEARS and Geneva, unless specifically adapted. Trimester- and postpartum-adjusted thresholds or alternative biomarkers are needed to reduce unnecessary imaging and improve clinical management.
A biopsychosocial perspective on endometriosis: the importance of psychological inflexibility.
Åkerblom S, Peppler Jönsson I, Ringqvist Å … +2 more , Nordengren J, Zhao X
Arch Gynecol Obstet · 2026 Feb · PMID 41733684 · Full text
INTRODUCTION: Treatment strategies for endometriosis have traditionally been biomedical. There is a need for a more multidimensional understanding of endometriosis and more targeted and individualized treatment intervent...
INTRODUCTION: Treatment strategies for endometriosis have traditionally been biomedical. There is a need for a more multidimensional understanding of endometriosis and more targeted and individualized treatment interventions, including psychological approaches. METHODS: The aims of this study were twofold: (1) to identify key biopsychosocial characteristics in individuals attending a tertiary clinic for endometriosis and (2) to inform the development of future, targeted, and efficacious interventions by examining the importance of psychological processes central to two scientific models, pain catastrophizing and fear of movement from the fear-avoidance model, and psychological inflexibility from the psychological flexibility model. RESULTS: Psychosocial variables, more specifically perceived control and powerlessness, social support, and depression, were of particular importance to the symptom structure in this patient population. In contrast, biological factors appeared to have low relevance within this network. When aiming to inform the development of future, promising psychological interventions for endometriosis, psychological inflexibility emerged as the most important psychological process variable in the symptom network. CONCLUSIONS: A multidimensional approach based on the biopsychosocial model appears valuable for understanding endometriosis. Treatment interventions grounded in the psychological flexibility model may hold promise for this patient population, a possibility that warrants further investigation in future studies.
Effect of alpha-lipoic acid and myoinositol on endometrial inflammation in women with unexplained recurrent pregnancy loss.
Tersigni C, Street ME, Castellani R … +6 more , Di Nicuolo F, Onori M, Catellani C, Barbaro G, Ticconi C, Di Simone N
Arch Gynecol Obstet · 2026 Feb · PMID 41739228 · Full text
PURPOSE: The aim of this study was to investigate the effect of oral administration of a combination of alpha- lipoic acid (ALA) and myo-inositol (Myo) on serum and endometrial inflammation of women with unexplained recu...
PURPOSE: The aim of this study was to investigate the effect of oral administration of a combination of alpha- lipoic acid (ALA) and myo-inositol (Myo) on serum and endometrial inflammation of women with unexplained recurrent pregnancy loss (uRPL). METHODS: Serum and endometrial levels of Nacht leucine-rich-repeat protein-3 (NLRP-3) and High Mobility Group Box 1 (HMGB-1) were analyzed by ELISA in women with unexplained Recurrent Pregnancy Loss (uRPL) (n = 31) and in control women who had had at least one uncomplicated pregnancy at term (n = 10) before and after daily oral administration of a commercial combination of ALA and Myo. RESULTS: uRPL women had higher serum levels (p < 0.01) and endometrial content (p < 0.0001) of HMGB-1 than controls while no difference was observed regarding NALP3. Oral administration of ALA and Myo for three months significantly decreased pre-treatment serum levels of NLRP-3 (p < 0.0001) and HMGB-1 (p < 0.0001), as well as endometrial content of NLRP-3 (p < 0.001) and HMGB-1 (p < 0.0001) in uRPL women, similar to those found in controls. CONCLUSION: Women with uRPL have increased systemic and endometrial inflammation than controls. Oral administration of ALA and Myo could modulate serum and endometrial levels of NLRP-3 and HMGB-1 in uRPL women.
Additional risk stratification in women with a history of spontaneous preterm birth and a midtrimester cervical length > 25 millimeters.
van Limburg Stirum EVJ, Breuking SH, van Dijk CE … +6 more , van 't Hooft J, Kazemier BM, de Ruigh AA, Oudijk MA, Pajkrt E, de Boer MA
Arch Gynecol Obstet · 2026 Feb · PMID 41729326 · Full text
PURPOSE: To determine whether there is an association between cervical length > 25 millimeters (mm) and a decrease in cervical length before 24 weeks of gestation with an increased risk of recurrent spontaneous preterm b...
PURPOSE: To determine whether there is an association between cervical length > 25 millimeters (mm) and a decrease in cervical length before 24 weeks of gestation with an increased risk of recurrent spontaneous preterm birth (sPTB)." METHODS: This retrospective cohort study includes women with a singleton pregnancy, a previous sPTB before 34 weeks of gestation, serial cervical length measurements and a shortest midpregnancy cervical length of > 25 mm. Participants received care according to local protocols for the prevention of preterm birth in two academic hospitals in the Netherlands between February 2005 and September 2021. Exclusion criteria were fetal structural anomalies, signs of threatened preterm birth or treatment with a cerclage or pessary. Cervical length measurements were grouped in three timepoints in pregnancy that were chosen a priori: 14 + 0 to 18 + 6 weeks (CL1); 19 + 0 to 20 + 6 weeks (CL2); and 21 + 0 to 23 + 6 weeks (CL3). Outcome measures included percentage of sPTB (< 37, < 34 and < 28 weeks of gestation) with 95% confidence intervals (95% CI) and Odds Ratio's (OR). Association between decrease in cervical length and sPTB were calculated using logistic regression. RESULTS: In total, 469 pregnancies were included. Overall, sPTB recurred in 21.1% (95% CI 17.4-24.8%), 9.0% (95% CI 6.4-11.6%) and 1.9% (95% CI 0.7-3.2%) before 37, 34 and 28 weeks of gestation, respectively. Women with a cervical length of > 25-30 mm in CL3 were at higher risk to deliver before 37 weeks, compared to women with a cervical length > 30 mm (44.7% versus 18.5%, OR 3.6, 95% CI 1.91-6.66). The decrease in cervical length between timepoint CL1, CL2 and CL3 had no association with a recurrent sPTB. CONCLUSIONS: Women with a history of sPTB before 34 weeks of GA and a cervical length of > 25-30 mm before the 24 weeks of gestation have an almost four times higher risk for a recurrent sPTB, compared to those with a longer cervical length. No association was found between decrease in cervical length and the risk of sPTB. Future studies should assess whether women with a history of sPTB and a cervical length of > 25-30 mm benefit from cerclage and cutoff values could be revised accordingly.
Long-term results of apical prolapse correction by unilateral pectineal suspension: A clinical trial.
Brucker CVM, Bolovis DI, Schreibmayer M … +1 more , Hitzl W
Arch Gynecol Obstet · 2026 Feb · PMID 41729323 · Full text
INTRODUCTION: Unilateral pectineal suspension (UPS) is a novel method for mesh-free apical prolapse correction. Short-term follow-up results 6 months after isolated UPS have been very encouraging, resulting in excellent...
INTRODUCTION: Unilateral pectineal suspension (UPS) is a novel method for mesh-free apical prolapse correction. Short-term follow-up results 6 months after isolated UPS have been very encouraging, resulting in excellent apex stability and high patient satisfaction in a cohort of 47 patients with mostly advanced prolapse. METHODS: In order to assess the long-term outcome after isolated UPS, all 47 patients from the original patient cohort treated with isolated UPS were invited for a scheduled follow-up examination after a minimum follow-up period of two years to determine whether the result of the primary surgery remained stable. We analyzed the outcome with regard to apex stability, residual defects, and procedure-related morbidity. RESULTS: UPS as a stand-alone procedure showed high stability at the apex. Throughout the two-year follow-up period, only two patients (4.3%) required secondary surgery for apical recurrence. Increasing age correlated significantly with apical recurrence. Six patients became symptomatic in the anterior and/or the posterior compartment while the apex remained stable (13.0%). With increasing age, the probability of secondary surgery also appeared to rise, however, this was not statistically significant. There was no method-related morbidity. CONCLUSION: UPS is a valuable concept for mesh-free apical prolapse correction. Two-year follow-up after isolated UPS shows stable results at the apex. A combined approach may be valuable to reduce the potential necessity of secondary surgery in the anterior / posterior compartment.
Association between maternal anti-Ro and anti-La antibody levels and congenital heart block: a 20-year cohort study.
Pannain GD, Andrade JQ, Lopes MAB … +4 more , Camargo FM, Krebs VLJ, de Carvalho WB, Francisco RPV
Arch Gynecol Obstet · 2026 Feb · PMID 41721052 · Full text
OBJECTIVE: To evaluate the association between maternal anti-Ro and anti-La antibody levels and the occurrence of congenital heart block (CHB) in fetuses and newborns. METHODS: This retrospective cohort study included 18...
OBJECTIVE: To evaluate the association between maternal anti-Ro and anti-La antibody levels and the occurrence of congenital heart block (CHB) in fetuses and newborns. METHODS: This retrospective cohort study included 182 pregnant women with positive anti-Ro and/or anti-La antibodies who received prenatal care at our tertiary center between 2002 and 2022. Maternal clinical, laboratory, and obstetric variables were analyzed. RESULTS: Thirteen fetuses (7.1%) were diagnosed with CHB. Mothers of affected fetuses had significantly higher anti-Ro (median 240 vs. 42; p < 0.001) and anti-La (median 150 vs. 10; p < 0.001) levels. Anti-La positivity was more frequent in the CHB group (76.9% vs. 42.6%; p = 0.017). Lower complement C4 levels (p = 0.008) and disease duration of less than 1 year since diagnosis (p = 0.008) were also associated with CHB. Preconception hydroxychloroquine and prednisone use were less frequent in affected pregnancies (p = 0.044 and p = 0.039, respectively). CONCLUSION: Higher maternal anti-Ro and anti-La antibody levels were significantly associated with fetal CHB. Preconception hydroxychloroquine may provide a protective effect. Early diagnosis and specialized care are essential for optimizing neonatal outcomes.
Awareness of sustainability among gynecologists in Germany: results of a semirepresentative nationwide survey.
Schiestl LJ, Lukac S, Hagedorn C … +5 more , Ebner F, Bäumer K, Schüler-Toprak S, Schmalfeldt B, Hasenburg A
Arch Gynecol Obstet · 2026 Feb · PMID 41720957 · Full text
OBJECTIVE: To assess the level of awareness, attitudes, and implementation of sustainability practices among gynecologists in Germany, and to identify barriers to sustainable behavior within the field. BACKGROUND: Climat...
OBJECTIVE: To assess the level of awareness, attitudes, and implementation of sustainability practices among gynecologists in Germany, and to identify barriers to sustainable behavior within the field. BACKGROUND: Climate change increasingly affects gynecological and obstetric care. The world health organization (WHO) and the International federation of gynecology and obstetrics (FIGO) have emphasized the need for stronger climate action in healthcare. In response, the German society for gynecology and obstetrics (DGGG) established a working group on sustainability. However, empirical data on sustainability awareness among gynecologists worldwide are lacking. Understanding current attitudes is essential for developing targeted strategies to enhance sustainability in clinical and academic settings. METHODS: A cross-sectional, nationwide online survey was conducted from February to June 2024 in Germany using a self-developed questionnaire. The survey assessed sustainability awareness, perceived relevance of climate change, and implementation of environmentally sustainable measures in both clinical and private practice contexts. Descriptive and comparative statistical analyses were performed. RESULTS: Most respondents reported a high level of awareness regarding climate change, with female participants rating their individual contribution more strongly. Sustainable measures such as waste separation and the reduction of single-use packaging were more frequently implemented in private practices than in hospitals. A large proportion of participants reported using environmentally friendly transportation and avoiding short-haul flights. Virtual participation in conferences was common, and many respondents expressed willingness to pay higher fees for sustainable conference formats. The main barriers to implementation were time constraints, financial limitations, and a lack of sustainable alternatives. CONCLUSION: Sustainability awareness among gynecologists in Germany is increasing, particularly in personal and outpatient practice contexts. Greater dissemination of information and stronger professional networks are needed to promote sustainable practices and strengthen the contribution of gynecology and obstetrics to climate protection in healthcare.
Evaluating tumor chemosensitivity: a head-to-head comparison of the prognostic value of KELIM (modeled CA125 elimination rate constant K) and RECIST 1.1 (radiological response valuation criteria in solid tumors) in ovarian cancer.
Michalczyk K, Mokrzycka A, Rudzińska M … +2 more , Misiek M, Chudecka-Głaz A
Arch Gynecol Obstet · 2026 Feb · PMID 41711981 · Full text
PURPOSE: The aim of the study was to analyze KELIM (modeled CA125 ELIMination rate constant K) and RECIST 1.1. (radiological response valuation criteria in solid tumors) as indicators of tumor chemosensitivity and their...
PURPOSE: The aim of the study was to analyze KELIM (modeled CA125 ELIMination rate constant K) and RECIST 1.1. (radiological response valuation criteria in solid tumors) as indicators of tumor chemosensitivity and their role in predicting patient prognosis. METHODS: This retrospective single-center analysis included 165 consecutive patients with advanced newly diagnosed high-grade serous ovarian, fallopian tube, or primary peritoneal cancer who underwent surgical and chemotherapeutical treatment at the Department of Gynecologic Oncology. RESULTS: There were significant differences in OS between the neoadjuvant and adjuvant groups of patients (20.87 vs 32.88 months). There was a significant difference in the response to treatment assessed in imaging studies between the groups, with higher rates of complete and partial responses to treatment among PDS patients (p = 0.002). However, upon a separate analysis of the NACT and PDS subgroups, the multivariate analysis showed no significant influence of KELIM and RECIST 1.1. response on patients' overall survival of patients. CONCLUSION: Our findings showed no significant associations between KELIM, RECIST and overall survival of patients. However, further studies on bigger homogenous population samples are required to confirm our findings.
Age-dependent differences in survival of patients with early breast cancer: analysis of SUCCESS A, B, C trials.
Lukac S, Dayan D, Janni W … +7 more , Rack B, Fink V, Veselinovic K, Pfister K, Fink A, Friedl TWP, Leinert E
Arch Gynecol Obstet · 2026 Feb · PMID 41711956 · Full text
PURPOSE: Elderly breast cancer (BC) patients are commonly at risk of under-treatment, which can negatively affect their prognosis. Therefore, we analyzed age-related survival differences considering clinico-pathological...
PURPOSE: Elderly breast cancer (BC) patients are commonly at risk of under-treatment, which can negatively affect their prognosis. Therefore, we analyzed age-related survival differences considering clinico-pathological parameters among patients with early BC. METHODS: 8190 BC patients from SUCCESS A, B, and C trials who underwent surgery and adjuvant systemic therapy were analyzed. Tumor and nodal stage, grading, biological subtype, types of surgical and systemic therapies, and other clinico-pathological parameters were compared between age groups ≤ 50 years, 51-65 years, > 65 years (chi-square tests). Breast cancer-free interval (BCFI), breast cancer-specific survival (BCSS), overall survival (OS), invasive disease-free survival (iDFS), and distant disease-free survival (DDFS) were analyzed using univariable and adjusted multivariable Cox regression models. Two-way interactions between age and other clinico-pathological parameters were calculated. RESULTS: There were significant differences between the age groups concerning almost all parameters analyzed, especially more advanced tumor stages in the elderly group. Univariable analysis showed significant differences between the age groups for all survival parameters (all p < 0.001). However, after adjustment for other prognostic parameters, an independent significant age effect was found only for iDFS (p = 0.038), while there was no significant independent age effect on BCFI (p = 0.286), BCSS (p = 0.981), OS (p = 0.131) and DDFS (p = 0.316). CONCLUSION: Although elderly BC patients > 65 years had poorer survival, multivariable analysis suggests this difference is mostly attributable to advanced tumor stages rather than age itself. Effective BC screening and research related to the influence of (biological) age on response to cancer therapies could be the next step to improve understanding the relationship between patient age and BC survival.
Impact of maternal HIV infection on pregnancy and labor complication and perinatal health outcomes: a South African retrospective study.
Mlambo Z, Ramdin S, Green-Thompson R … +2 more , Moodley J, Govender N
Arch Gynecol Obstet · 2026 Feb · PMID 41711938 · Full text
BACKGROUND: Maternal HIV infection is associated with increased risks of pregnancy complications and adverse perinatal outcomes, particularly in high-prevalence settings like South Africa. The COVID-19 pandemic disrupted...
BACKGROUND: Maternal HIV infection is associated with increased risks of pregnancy complications and adverse perinatal outcomes, particularly in high-prevalence settings like South Africa. The COVID-19 pandemic disrupted healthcare access, potentially exacerbating challenges in antenatal care and HIV management. To our knowledge, limited South African data exist regarding the impact of maternal HIV on birth complications and perinatal birth outcomes especially during the COVID-19 pandemic. AIM: This study thus evaluates the impact of maternal HIV on pregnancy and perinatal outcomes before and during the COVID-19 pandemic using archived chart records from a tertiary hospital in KwaZulu-Natal, South Africa. METHODS: A retrospective analysis of 8456 birth records from March 2019 to December 2020 was conducted, categorized into pre-pandemic and pandemic periods. Data were stratified by maternal HIV status and analyzed for demographics, antenatal care attendance, ART regimens, labor characteristics, and birth outcomes. Statistical tests, including Chi-square and logistic regression, were used to assess associations between HIV status and outcomes. RESULTS: Hospital attendance declined during the COVID-19 period, especially among women living with HIV, whose age ranged between 19 and 35 years, and were multigravida, and multiparous. Antenatal care attendance was suboptimal and worsened during the COVID-19 period. ART coverage remained high with maintained viral suppression. Women living with HIV had shorter "active labor" and higher elective cesarean rates during the COVID-19 period. Preterm birth risk was also higher pre-pandemic among women living with HIV but not significantly different during COVID-19 period. Birth weights were lower in HIV-exposed infants pre-pandemic with a non-significant shift during COVID-19 period. Sepsis incidence increased among women living with HIV during COVID-19 period. No maternal deaths were reported. CONCLUSION: A decline in hospital attendance was noted during the COVID-19 period among women living with HIV, with antenatal care attendance being suboptimal and exacerbated. Maternal HIV remains a critical factor influencing birth outcomes, necessitating sustained focus on tailored care during crises to protect vulnerable populations.
Diameter of the fetal pancreas and abdomen-to-pancreas-ratio: novel ultrasound parameters in fetal growth restriction.
von der Gathen L, Braun J, Möllers M … +6 more , De Santis C, Willy D, Schmidt R, Oberste K, Schmitz R, Oelmeier K
Arch Gynecol Obstet · 2026 Feb · PMID 41699140 · Full text
PURPOSE: The aim of this study was to compare fetal pancreas size at second trimester ultrasound screening of growth-restricted and normal weight fetuses. METHODS: One hundred sixty-six fetuses between 18 + 0 and 21 + 6 ...
PURPOSE: The aim of this study was to compare fetal pancreas size at second trimester ultrasound screening of growth-restricted and normal weight fetuses. METHODS: One hundred sixty-six fetuses between 18 + 0 and 21 + 6 weeks of gestation were included in this retrospective study. 83 fetuses with a birth weight below the 10th centile were included in the study group which was further subdivided into two subgroups depending on the presence (subgroup 1) or absence (subgroup 2) of prenatal signs of fetal growth restriction. The control group consisted of 83 normal fetuses matched for sex and gestational age at examination. The pancreatic diameter (PD) was measured in a standard 2D plane of the fetal abdomen. Statistical analyses comprised descriptive statistics, reliability testing, and multivariable modelling to explore group differences and covariate effects on pancreatic diameter. RESULTS: The diameter of the pancreas was increased in the LBW group compared to the control group [3.7 mm vs. 3.1 mm (p < 0.001)]. The ratio of abdominal circumference (AC) to pancreatic diameter was significantly smaller in the LBW group [41.51 vs. 50.62 (p < 0.001)]. The result was consistent in the subgroup analysis. The difference of the median PD and ratio of AC/PD is greatest in subgroup 1 compared to the control group [PD: 4.2 mm vs. 3.1 mm (p < 0.001) and AC/PD-ratio 35.33 vs. 51.88 (p < 0.001)]. CONCLUSION: The diameter of the fetal pancreas, as measured in this study, is a valuable parameter for the detection of small for gestational age and growth-restricted fetuses. Further studies are needed to further validate our results and their implication for clinical decision-making.
Luteal-phase deficiency and diminished ovarian reserve: a narrative review of interactions and clinical implications.
Zhang C, Gao M
Arch Gynecol Obstet · 2026 Feb · PMID 41697397 · Full text
Diminished ovarian reserve (DOR) and luteal phase defect (LPD) are common endocrine disorders affecting the fertility of women of reproductive age. Traditionally, these conditions have been considered and treated indepen...
Diminished ovarian reserve (DOR) and luteal phase defect (LPD) are common endocrine disorders affecting the fertility of women of reproductive age. Traditionally, these conditions have been considered and treated independently. However, clinical observations frequently reveal that patients with DOR also exhibit features of LPD, suggesting a potential pathophysiological link between them. This review aims to explore the interplay between DOR and LPD from a novel perspective by integrating epidemiological data, current diagnostic and therapeutic practices, and recent insights into molecular mechanisms. Special emphasis is placed on the role of hypothalamic-pituitary-gonadal (HPG) axis dysfunction, oxidative stress-inflammatory microenvironment imbalance, and key signaling pathways, such as PI3K/Akt/mTOR, in mediating their interaction. We propose a central hypothesis: LPD may not merely be a complication of DOR; rather, intrinsic features of LPD-such as insufficient or prematurely withdrawn progesterone secretion-may exert negative feedback on the HPG axis and exacerbate oxidative damage within the ovarian microenvironment, thereby actively contributing to the onset or progression of DOR. Based on this hypothesis, we further suggest that treating LPD-particularly through luteal phase support therapy-may have benefits beyond improving endometrial receptivity. Such interventions could potentially modulate the endocrine milieu at both the systemic and local ovarian levels, thereby playing a role in managing DOR and possibly improving antral follicle count (AFC). These insights open up new directions for future therapeutic strategies targeting DOR.
Impact of a new image enhancement technology on the biometric measurements in pregnancy.
Elger T, Bettecken K, Prodan N … +3 more , Sonek J, Hoopmann M, Kagan KO
Arch Gynecol Obstet · 2026 Feb · PMID 41697389 · Full text
OBJECTIVE: To examine the impact of a new image enhancement technique on biparietal diameter (BPD), head and abdominal circumference (HC and AC), and femur length (FL) measurements as well as the estimated fetal weight (...
OBJECTIVE: To examine the impact of a new image enhancement technique on biparietal diameter (BPD), head and abdominal circumference (HC and AC), and femur length (FL) measurements as well as the estimated fetal weight (EFW). METHODS: In this retrospective study, the second and third trimester biometry (BPD, HC, AC, and FL) images that were taken with two GE Voluson E22 ultrasound machines between May and July 2025 were collected. Each measurement was retrospectively obtained using the following settings in sequence: the radiant mode turned off and with the radiant mode turned on minimum, medium, and maximum levels. The measurements were made using automated caliper placement technology. The EFW was calculated using the Hadlock formula. Only the cases where each of the measurements were adequately identified by the automated measurement system were used in the study. Comparisons among the measurements taken without the radiant mode and with the three levels of the radiant mode were then made. RESULTS: The study population consisted of 298 women. The median gestational age was 23 weeks. The automated measurement system was able to place the calipers correctly for all required measurements in 253 (84.9%) cases. These cases were then used for further analysis. A comparison of the measurements done without radiant mode and those with the aid of radiant technology showed that BPDs were slightly larger and the FLs were shorter. The HCs and ACs remained unchanged with all three radiant settings. The EFWs also remained unchanged with the minimum radiant setting but were lower with both the medium and maximum radiant setting. The changes were most pronounced with the maximum setting. The average bias was between - 0.11% and 1.51%. The widest range of biases was found for the estimated fetal weight when a maximum radiant mode was used. In this case, 95% of the biases were within - 6.1 and 9.0%. CONCLUSION: The radiant mode can affect the automated fetal biometry, particularly using the maximum mode. Although the average effect is modest, biases may be clinically relevant, especially if other factors increase the extent of the bias.
Correlation of blood lipid levels with the severity of polycystic ovary syndrome and its predictive value for pregnancy outcome.
Mao D, Wei Y, Wang C … +1 more , Tao J
Arch Gynecol Obstet · 2026 Feb · PMID 41691582 · Full text
OBJECTIVE: To analyze the correlation between lipid levels and the severity of polycystic ovary syndrome (PCOS) and its predictive value for pregnancy outcome. METHODS: This retrospective study included 275 PCOS patients...
OBJECTIVE: To analyze the correlation between lipid levels and the severity of polycystic ovary syndrome (PCOS) and its predictive value for pregnancy outcome. METHODS: This retrospective study included 275 PCOS patients treated with ovulation induction therapy and 234 healthy controls (used only for baseline comparisons). Lipid levels were correlated with disease phenotype and sex hormones using Spearman/Pearson coefficients. Binary logistic regression and ROC curves assessed the predictive value of lipid levels for pregnancy failure. RESULTS: There were statistically significant differences between the two groups in glycemic indexes (fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment for insulin resistance (HOMA-IR)) and sex hormone indexes (testosterone (T), luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), anti-Müllerian hormone (AMH)). The levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (Apo B) were significantly elevated in patients with PCOS and were closely correlated with the severity of the disease. In addition, these four lipid parameters were significantly positively correlated with T, LH, FSH, and AMH, and significantly negatively correlated with E2. Elevated levels of T, LH, TG, LDL-C, and Apo B were independent risk factors for pregnancy failure after ovulation induction treatment. TG assisted in predicting pregnancy failure after ovulation induction therapy in PCOS patients with an AUC of 0.861 (sensitivity 75.61%, specificity 85.53%); LDL-C assisted in predicting pregnancy failure after ovulation induction therapy in PCOS patients with an AUC of 0.868 (sensitivity 75.61%, specificity 83.55%); and Apo B assisted in predicting pregnancy failure after ovulation induction therapy in PCOS patients with an AUC of 0.836 (sensitivity 74.80%, specificity 86.84%). CONCLUSION: Lipid levels were significantly correlated with the severity of disease in PCOS patients, and TG, LDL-C, and Apo B levels assisted in predicting the occurrence of pregnancy failure after ovulation induction therapy.
The research on the relationship between mesenchymal stromal cell exosomes and recurrent spontaneous abortion.
Zhao C, Wang J, Liu W
Arch Gynecol Obstet · 2026 Feb · PMID 41691134 · Full text
OBJECTIVE: To clarify the association between mesenchymal stromal cell exosomes (MSC-exosomes) and recurrent spontaneous abortion (RSA) Clarify the biological characteristics of MSC-exosomes and their potential regulator...
OBJECTIVE: To clarify the association between mesenchymal stromal cell exosomes (MSC-exosomes) and recurrent spontaneous abortion (RSA) Clarify the biological characteristics of MSC-exosomes and their potential regulatory functions in pregnancy maintenance. METHODS: By using the literature review method combined with the published relevant experimental research results, the biological characteristics of MSC-exosomes were systematically sorted out and analyzed to explore their potential mechanism of action in the process of pregnancy maintenance. The results show that MSC-exosomes can participate in the key processes of pregnancy maintenance by regulating the immune microenvironment at the maternal-fetal interface, promoting local angiogenesis and maintaining the normal physiological functions of trophoblast cells. The content of MSC-exosomes in the body shows a dynamic changing trend during pregnancy. A large number of studies have confirmed that MSC-exosomes are closely related to the establishment and maintenance of normal pregnancy and the occurrence and development of pathological pregnancy. CONCLUSION: In-depth exploration of the intrinsic association and mechanism of action between MSC-exosomes and RSA can provide a new perspective for the study of the pathogenesis of RSA, and at the same time offer potential biomarkers and therapeutic targets for the clinical diagnosis and targeted therapy of RSA, which has significant theoretical value and clinical significance.
The dual face of human chorionic gonadotropin in the CNS: neuroprotection, signaling, and possible pathological effects.
Hosseini S, Ghanavati P, Esfidani T … +3 more , Reveshti NT, Babaei H, Etezadi A
Arch Gynecol Obstet · 2026 Feb · PMID 41691129 · Full text
BACKGROUND: Human chorionic gonadotropin (hCG) is a glycoprotein hormone critical for reproduction, particularly in pregnancy maintenance and fertility treatments. Beyond reproduction, hCG may influence immune regulation...
BACKGROUND: Human chorionic gonadotropin (hCG) is a glycoprotein hormone critical for reproduction, particularly in pregnancy maintenance and fertility treatments. Beyond reproduction, hCG may influence immune regulation, cancer biology, and neurological processes. OBJECTIVE: This review critically examines the current evidence regarding the potential neurological effects of hCG, synthesizing findings from experimental and clinical studies to assess its proposed roles in neuroinflammation, oxidative stress, and blood-brain barrier modulation. RESULT: Dysregulated hCG levels-arising from pregnancy complications, assisted reproductive technologies (ART), or hCG-secreting tumors-have been associated with markers of neurotoxicity, including neuroinflammation, oxidative stress, and altered blood-brain barrier integrity. Evidence remains largely associative, and causal mechanisms linking hCG to neurobiological vulnerability are not yet established. Proposed pathways include modulation of immune cell activity, neurotransmitter signaling, and endothelial function. CONCLUSION: hCG exhibits a dual nature: essential for reproduction and immune adaptation, yet potentially neurotoxic under dysregulated conditions. This review synthesizes mechanistic hypotheses, highlights knowledge gaps, and underscores the need for rigorous longitudinal and experimental studies to clarify hCG's impact on the nervous system.
Geographic variation in supply, demand, and adequacy of the obstetrics and gynecology physician workforce: forecasts and shortage risks in the United States.
Silvestre J, Lazenby GB
Arch Gynecol Obstet · 2026 Feb · PMID 41691088 · Full text
PURPOSE: This study assessed geographic variations in the supply, demand, and adequacy of the United States (US) obstetrics and gynecology physician (OGP) workforce. METHODS: This was a cross-sectional analysis of OGPs u...
PURPOSE: This study assessed geographic variations in the supply, demand, and adequacy of the United States (US) obstetrics and gynecology physician (OGP) workforce. METHODS: This was a cross-sectional analysis of OGPs using the Health Workforce Simulation Model. Supply and demand were defined as the numbers of full-time equivalent (FTE) OGPs working and needed, respectively. Adequacy was defined as the ratio of supply to demand. Comparisons were made using Chi-squared tests, and linear regression was used to analyze OGP workforce trends. RESULTS: From 2025 to 2037, the demand for OGPs is projected to increase (52,620-54,020 FTEs, 2.7% increase, p < 0.001) while the supply of OGPs is projected to decrease (49,170-44,130 FTEs, 10.3% decrease, p < 0.001). As a result, OGP workforce adequacy is projected to decrease over the study period from 93.4% to 81.7% (P < 0.001). By 2037, the West had the lowest OGP workforce adequacy and the Northeast had the highest adequacy (74.4% vs 98.6%, P < 0.001). Non-metropolitan areas were projected to have lower OGP workforce adequacy than metropolitan areas (51.4% vs 85.1%, p < 0.001). The states with the lowest projected OGP workforce adequacy were Utah (49.3%), Idaho (51.5%), and Arizona (58.3%) in 2037. CONCLUSION: OGP workforce supply is expected to fall short of anticipated demand, with uneven geographic distribution across the US. Addressing this imbalance will require strategic planning to expand the OGP workforce equitably, especially in non-metropolitan areas, the West, and certain identified states like Utah and Idaho.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe