Risk screening for pre-eclampsia relies on accurate gestational age assessment, but routine access to ultrasound-based gestational dating remains challenging in many low- and middle-income countries. As part of the formative work for the ‘Preventing pre-eclampsia: Evaluating AspiRin Low-dose regimens following risk Screening’ (PEARLS) platform, we aim to validate and implement an artificial intelligence (AI)-based algorithm for estimation of gestational age, using blind sweeps done with a handheld ultrasound device. This study protocol outlines the accuracy cohort for AI-based gestational age estimation in participating facilities in Ghana, Kenya and South Africa.

This multicountry prospective cohort study will recruit 969 pregnant women at 13 health facilities across Kenya, Ghana and South Africa. The eligible population is pregnant women presenting for antenatal visits from 11⁺⁰ to 13⁺⁶ weeks’ gestation. Eligible women will have a gestational age assessment by a trained sonographer using fetal biometry (reference standard), followed by gestational age estimation conducted by a trained midwife using the AI-based Intelligent Ultrasound ScanNav FetalCheck system (experimental). Both conventional and AI-based gestational age scans will be conducted with the General Electric VScan Air platform. Women will return for a second visit between 14⁺⁰ and 27⁺⁶ weeks’ gestation (week of visit is randomly selected) for an assessment with both conventional and AI-based ultrasound. The primary objective is to determine the accuracy and precision of gestational age estimation using an AI ultrasound system in first and second trimesters, as compared with gestational age estimation using crown-rump length measurement by conventional ultrasound in first trimester (11⁺⁰ to 13⁺⁶ weeks’).

This study has received or sought ethics approval from the following entities: Australia: University of Melbourne, Office of Research Ethics and Integrity (Reference Number: 2024–28489-49438-3) and the Alfred Hospital Ethics Committee (Reference: Project 727/23); Ghana: Ghana Health Service Ethics Review Committee (GHS-ERC Number 002/01/24); Kenya: Kenyatta National Hospital, University of Nairobi ERC (Ref: KNH-ERC/01/MISC/20); South Africa: University of Cape Town, Faculty of Health Science, Human Research Ethics Committee (HREC Ref: 138/2024). Key findings will be disseminated to research teams to inform future scale-up of AI-based pregnancy dating and pre-eclampsia risk screening. Findings from this pilot work will be published in peer-reviewed open-access journals, conferences and meetings to maximise reach of our findings.

To develop and internally validate a clinical prediction model estimating the probability of emergency caesarean delivery among low-risk pregnancies using routinely available intrapartum variables. The model is intended to support clinicians in recommending transfer decisions in rural obstetric settings without onsite caesarean capacity.

Retrospective cohort study with multivariable logistic regression and internal validation using bootstrap resampling.

Province-wide birth registry in Ontario, Canada.

Singleton, hospital births from low-risk pregnancies between 1 April 2012 and 31 March 2020, captured in the Better Outcomes Registry and Network Ontario. Exclusions included previous caesarean, major comorbidities and other high-risk conditions.

Emergency caesarean delivery during labour.

Among 611 644 low-risk pregnancies, 66 482 (10.9%) resulted in emergency caesarean delivery. Key predictors included abnormal fetal health surveillance, nulliparity, gestational hypertension, polyhydramnios area under the receiver operating characteristic curve (AUC) and oxytocin augmentation. The optimism-corrected AUC was 0.86, indicating strong discrimination. Calibration was generally good, though the model underestimated caesarean risk in patients first admitted to level I hospitals.

This study presents a proof-of-concept prototype with strong discrimination, though calibration of the full model was suboptimal in level I hospitals, the intended setting for application. While not clinically deployable in its current form, the model lays the groundwork for a translational pathway that will require local recalibration, external validation and contextual adaptation before implementation. Threshold-based clinical utility (eg, positive/negative predictive value or net benefit) was not assessed and will be evaluated during external validation and local recalibration.

During pregnancy, physiological and psychological factors influence eating behaviour and food preferences. Food cravings are common in pregnancy and contribute to excessive gestational weight gain (GWG). Excessive GWG is present across all body mass index (BMI) categories and is associated with adverse outcomes. Outside of pregnancy, highly palatable food cues activate brain regions involved in reward and attention, which may influence eating behaviour and behavioural responses. However, brain and behavioural responses to food cues across pregnancy, and their association with psychological and metabolic factors, remain poorly understood. This study aims to investigate spatiotemporal brain responses to visual food cues across individuals with different BMI categories and their associations with behavioural, psychological and metabolic outcomes during pregnancy.

This is a prospective observational cohort study conducted at the Lausanne University Hospital, Switzerland. 94 pregnant individuals (47 healthy normal weight and 47 with overweight/obesity) will be assessed at 12–16 and 31–36 weeks of gestational age from November 2024 to September 2026. Data collected for the primary outcomes include electroencephalography-based brain responses to validated visual food cues varying in fat and carbohydrate content, behavioural responses to the same cues using a gamified smartphone Go/NoGo task. Secondary validated outcomes include heart rate variability (Actiheart), body composition (InBody S10), glycated haemoglobin (Afinion), cardiorespiratory fitness (The Chester step test), snack intake, eating behaviour (Intuitive Eating Scale-2, Three-Factor Eating Questionnaire-Revised), food cravings (Food Craving Questionnaire-state), mood and depressive symptoms (Edinburgh Postnatal Depression Scale). Statistical analyses include group comparisons, longitudinal analyses and regression models adjusted for potential sociodemographic/medical confounders.

All participants will provide written informed consent. The Human Research Ethics Committee of the Canton de Vaud approved the study protocol (CER-VD 2023-01462). Findings will be disseminated through peer-reviewed publications, (inter)national conferences and shared with healthcare professionals and stakeholders to inform strategies for improving maternal health.

Maternity Waiting Homes (MWHs) are a key strategy for improving maternal health by bringing expectant women closer to health facilities and skilled birth attendants. Despite their potential benefits, a woman’s stay is shaped by various factors, including emotional, social and logistical aspects.

This study aimed to explore the lived experiences of pregnant women using maternity waiting homes in the Ari zone public health facilities, Ethiopia.

A qualitative phenomenological study, grounded in a descriptive (Husserlian) phenomenological orientation and analysed using Colaizzi’s seven-step framework.

Public health facilities providing MWH services in the Ari zone, southern Ethiopia, ranging from a zonal hospital to primary health centres.

15 pregnant women, who had stayed in an MWH for at least 1 week during their current pregnancy, selected using purposive sampling until data saturation was reached.

We conducted in-depth interviews from 15 June 2025 to 15 July 2025 to match the Study Area and Period section. The data were transcribed, translated and thematically analysed with Open Code software V.4.02 to identify key themes and subthemes. The rigour of the study was ensured by applying Guba’s trustworthiness criteria, with a focus on credibility, transferability, dependability and confirmability.

Based on the findings, the experiences of women in maternity waiting homes centred on four main themes. Emotionally, women faced both isolation and anxiety from being away from home but also felt comfort and relief from being near medical care. Socially, they found support from other women and were influenced by the attitudes of health staff while also carrying the burden of family and cultural concerns. Practical challenges included significant financial burdens, lack of food and inadequate facilities. Despite these difficulties, women ultimately valued the homes for the increased confidence and improved access to skilled care they provided for a safer birth.

A woman’s experience in an MWH is shaped by a mix of emotional, social, infrastructural and cultural factors. To improve the use of MWHs and maternal health outcomes, it is crucial to enhance the quality of these facilities, offer psychosocial support and involve communities. Future intervention studies should test whether targeted psychosocial and food-security support measurably improve women’s experiences and MWH uptake.

To investigate the impact of women’s coping with premenstrual symptoms on dyadic adjustment and perceived social support.

The study was conducted with a descriptive and cross-sectional design between October 2023 and February 2024.

The following instruments were administered online: the personal information form, the premenstrual symptom screening tool, the Dyadic Adjustment Scale (DAS), the Multidimensional Scale of Perceived Social Support (MSPSS) and the premenstrual coping measure.

The study was conducted with 395 women in Turkey.

Overall, 58.5% of the women experienced mild premenstrual syndrome, including 9.6% with moderate/severe premenstrual syndrome (PMS) and 31.9% with probable premenstrual dysphoric disorder (PMDD). Among all participants, the mean scores for DAS and MSPSS were 113.05±20.52 and 63.51±15.13, respectively. Dyadic adjustment was significantly lower in women with probable PMDD compared with other groups (F=5.171, p=0.006). Dyadic satisfaction showed a positive correlation with ‘avoiding harm’ and ‘self-care’ subscales, but a negative correlation with ‘adjusting energy’. Furthermore, perceived social support increased as scores for ‘avoiding harm’ (r=0.15, p=0.002), ‘self-care’ (r=0.18, p<0.001) and ‘communicating’ (r=0.30, p<0.001) subdimensions increased.

Health professionals should consider routine screening for premenstrual syndrome and involving spouses or romantic partners in educational interventions to improve awareness of premenstrual symptoms and coping strategies.

Endometriosis affects approximately one in seven women in Australia and is associated with substantial physical, psychological and social impacts. Informational support is critical for enabling informed decision-making and fostering women’s agency in care. While healthcare providers play a central role in delivering such information, existing research has predominantly focused on General Practitioners, despite the pivotal role of gynaecologists in endometriosis management.

This study aimed to explore Australian women’s experiences of endometriosis informational support from gynaecologists.

A descriptive qualitative study was conducted using semi-structured online interviews.

16 women over 18 years old living in Australia with suspected or confirmed endometriosis.

Three main themes were generated: Finding a gynaecologist who felt right: navigating a complex care pathway; Variance in informational support before diagnostic surgery and the uncertainty of recovery time; and Understanding what comes next: informational support and its gaps after diagnosis. The women emphasised the importance of finding not just any gynaecologist, but one with specific expertise in endometriosis. Factors such as geographical location, health insurance and referral pathways shaped this process. Once laparoscopic surgery was scheduled, informational support became particularly important in preparing women for the procedure, with surgical techniques and recovery expectations identified as key areas of informational need. Following diagnosis, the women highlighted the importance of clear communication regarding the nature of endometriosis, available treatment options and fertility considerations.

Informational support was found to be essential across all stages of the diagnostic and post-diagnostic journey. However, the women identified ongoing gaps, suggesting that the provision of information by gynaecologists could be further strengthened to better meet women’s needs.

Female genital mutilation (FGM)/cutting remains highly prevalent in Somalia and is associated with a range of long-term gynaecological and urological complications. However, data on lower urinary tract symptoms (LUTS) and their severity across different FGM types are limited. The aim of this study was to examine the association between FGM type and LUTS among symptomatic care-seeking women with FGM and to evaluate whether symptom severity differed according to FGM type.

This cross-sectional study included 122 symptomatic women with a history of FGM who presented with LUTS between January and April 2024.

Sociodemographic characteristics, FGM type, clinical symptoms, and vaginal and urine culture results were recorded. LUTS severity and associated bother were assessed using the International Consultation on Incontinence Questionnaire–Female Lower Urinary Tract Symptoms Long Form (ICIQ-FLUTS-LF). Comparisons were made between women with FGM types I–II and those with type III.

The mean age of participants was 31.7±7.6 years. Women with FGM type III had a significantly higher prevalence of positive urine culture growth, history of urinary tract infection (UTI) and prior antibiotic use, and abdominal pain compared with those with types I–II (p<0.05). Median scores for all LUTS domains and corresponding bother scores were significantly higher in women with FGM type III compared with types I–II (all p<0.001), and similar findings were confirmed in regression analyses.

Among symptomatic care-seeking women with FGM, type III was associated with greater LUTS burden, higher reported history of UTI and greater symptom-related distress compared with types I and II.

There has been considerable attention placed on ‘failures’ of maternity care in high-income countries, with little focus on the drivers of ‘high-quality’ care delivered at the organisational level. We conducted a realist review with this central focus and report on the first phase, initial programme theories (IPTs) generated from the literature, where a future phase will ‘test’ the IPTs.

A realist review methodology was employed, an interpretative, theory-driven approach designed to explore ‘what works, for whom, in what circumstances’ using context, mechanism and outcome (CMO) propositions.

The search strategy used a purposive database (MEDLINE) and hand searches, including peer-reviewed journals, grey literature and policy reports, to identify literature rich and relevant to the research question.

As per realist review approaches, we included any English-language literature from peer-reviewed journals, grey literature, policy reports, service guidance and public or professional commentary, from high-income countries, that provided explanatory insights to the operationalisation of ‘high-quality’ maternity care at the organisational level. Using an a priori definition, high-quality maternity care was defined based on four outcome criteria: higher service user and staff well-being, lower prevalence of complications/adverse outcomes and optimal use of resources.

Data extraction configured evidence using the ‘If, Then, Leading to’ CMO heuristic. The IPTs were iteratively developed from the synthesised data and refined through consultation with a diverse 26-member core stakeholder group.

The iterative search process included 17 index papers, which were a mix of systematic reviews, primary research studies, commissioned reports, evaluations and commentaries. These papers generated 292 initial CMO hypotheses, which were refined into 11 IPTs focusing on organisational-level mechanisms. The IPTs reflect a ‘both-and’ philosophy, balancing clinical excellence (safety) and values-based relational care (personalisation and staff environment). Key themes include visible and supportive leadership, responsiveness to workload assessments, ensuring operational fitness (system and workplace environment support) and broadening the definition of safety beyond physical safety to include psychological, emotional and cultural safety. The IPT related to ‘A culture of equitable care’ was identified as critical in underpinning all maternity service provision.

The 11 IPTs offer crucial insights into the context and mechanisms that may produce desired outcomes in high-quality maternity care. Learning from high-quality services (safety II) provides a novel approach compared with focusing only on failings. These globally relevant IPTs can be applied to high-income contexts as a foundation for designing future improvement programmes.

CRD420251104996.

Symptoms associated with vulvovaginal atrophy affect up to 73% of patients with breast cancer, whether menopausal or non-menopausal, because certain breast cancer treatments are responsible for oestrogen deprivation on the genital tract. These symptoms are currently underdiagnosed and undertreated but can significantly impair the quality of life and can be a cause of premature discontinuation of adjuvant hormone therapy. Treatment of vulvovaginal atrophy in patients managed for breast cancer should be the first-line treatment with non-hormonal local moisturising therapy. However, this treatment is often insufficient. Systemic menopause hormone treatment is not indicated and local oestrogen treatment is not a first-line treatment in this neoplastic context. Therapeutic alternatives, such as vaginal radiofrequency (RF) treatment, could be considered. Vaginal RF increases collagen synthesis by stimulating fibroblasts. However, the vaginal RF has not been sufficiently evaluated in the literature. We hypothesised that vaginal RF can improve a patient’s experience of vaginal dryness after breast cancer treatment when first-line local moisturising treatment is insufficient.

The RF-Vaginale trial will be a multicentre randomised phase III trial in two parallel groups until the 6-month assessment comparing a reference treatment with local moisturising (hyaluronic acid-based treatment, three times a week) versus the experimental treatment combining reference treatment+vaginal RF treatment. The vaginal RF treatment will consist of three sessions spaced 4–6 weeks apart (MATMATECH, GynWave 360). The primary outcome will be vaginal dryness, assessed at 6 months using a patient-rated 0–10 numerical scale. The secondary outcomes will be dyspareunia and Vaginal Health Index Score (VHIS). Dyspareunia will be assessed by the patient using a patient-rated 0–10 numerical scale, in patients reporting a sexual life with a male partner engaged in vaginal intercourse. The VHIS will be assessed by a physician blinded to the treatment group. All outcomes will also be evaluated at 3 and 12 months.

This trial will be proposed to a population receiving an adjuvant treatment for breast cancer with an aromatase inhibitor ±luteinising hormone-releasing hormone (LHRH) agonist.

The primary analysis will focus on the evaluation of the mean difference in vaginal dryness score at 6 months between arms, adjusted for baseline value, patient age (

The study protocol has been approved by the ethics committee (CPP Sud Est I, 12 November 2024), complied with the Declaration of Helsinki and French laws and regulations, and followed the International Conference on Harmonisation E6 Guideline for Good Clinical Practice (reference number EMA/CHMP/ICH/135/1995). The trial results, even if inconclusive, will be presented at international oncology congresses and published in peer-reviewed journals.

NCT06900374.

Early obstetric ultrasound improves gestational age estimation, detection of fetal anomalies and management of pregnancy complications. The WHO recommends at least one ultrasound examination before 24 weeks of gestation. However, uptake of early obstetric ultrasound in many low-resource settings remains poorly documented, including in post-conflict Northern Uganda. This study assessed the prevalence and factors associated with uptake of obstetric ultrasound before 24 weeks of gestation among pregnant women attending antenatal care at a tertiary hospital in Northern Uganda.

A facility-based cross-sectional study was conducted among 428 pregnant women attending antenatal care at Gulu Regional Referral Hospital between December 2024 and May 2025. Participants were selected using systematic sampling. Data were collected using a pretested interviewer-administered questionnaire. The facility does not routinely offer a dedicated second-trimester (20–24 weeks) anatomy scan; ultrasound is largely opportunistic and clinician or patient initiated. Multivariable Poisson regression with robust SEs was used to estimate adjusted prevalence ratios (aPR) and 95% CIs.

The prevalence of at least one obstetric ultrasound scan before 24 weeks of gestation was 64.0%. Independent predictors of early ultrasound uptake included access to transportation (aPR=1.96, 95% CI 1.19 to 3.25), history of congenital anomaly (aPR=1.27, 95% CI 1.09 to 1.48), not being in a union (ie, unmarried and not cohabiting with a partner) (aPR=1.29, 95% CI 1.07 to 1.56) and being satisfied with the results of an ultrasound scan in a previous pregnancy (aPR=1.38, 95% CI 1.06 to 1.57).

Uptake of early obstetric ultrasound in Northern Uganda remains suboptimal even in tertiary health facilities. Structural access barriers, obstetric history and previous service experience influence utilisation. Strategies aimed at improving transport access, strengthening provider counselling and improving service quality may enhance early ultrasound uptake.

To determine the incidence and clinical characteristics of surgical complications during pregnancy in women with a history of bariatric surgery.

A nationwide, prospective, population-based cohort study.

High-risk obstetric care in Belgium: 67.6% of maternity units participated, covering 65% of all births in the study period.

Pregnant women with a history of bariatric surgery presenting with a surgical complication (internal hernia, intussusception, volvulus or adhesions; anastomotic ulcer or abscess; gastric band slippage or incisional hernia) between January 2021 and December 2022.

33 women experienced 35 surgical complications. Internal herniation was most common (n=25), predominantly following Roux-en-Y gastric bypass. Mean gestational age at diagnosis was 27+6 weeks. All women underwent surgical exploration within 24 hours; bowel resection was required in two cases. Caesarean section occurred in 48.5%, with 13 preterm births and one neonatal death. One woman required intensive care. No maternal death occurred.

Surgical complications following bariatric surgery in pregnancy are uncommon but carry significant obstetric risks. In this cohort, all reported complications occurred after procedures involving intestinal rerouting, predominantly Roux-en-Y gastric bypass. Prompt surgical management was associated with low maternal morbidity and no mortality, but frequently resulted in preterm birth and emergency caesarean section. These findings highlight the need for a low threshold for surgical evaluation of abdominal pain in pregnant women with previous bariatric surgery and support balanced counselling regarding the potential benefits and risks of different bariatric procedures in women of reproductive age.

Bleeding during and after childbirth (postpartum haemorrhage, PPH) is the leading cause of severe maternal morbidity in the UK. Between 2017 and 2018, a PPH care bundle termed the Obstetric Bleeding Strategy (OBS) was implemented as a quality improvement project across all Welsh maternity units and improvements in maternal outcomes were observed. The OBS PPH care bundle incorporates assessment of bleeding risk, real-time cumulative quantification of blood loss, escalation of multiprofessional care including more senior staff at defined volumes of blood loss and point-of-care testing of coagulation at 1 L blood loss (or earlier if clinical concern) with targeted blood product transfusion in cases of haemostatic impairment. The Obstetric Bleeding Study UK (OBS UK) will evaluate this intervention in a larger number of maternity units across the UK.

OBS UK is a stepped wedge cluster randomised trial designed to test the effectiveness of the OBS intervention compared with usual care on clinical and psychological PPH outcomes after childbirth, evaluate its cost-effectiveness and perform a process evaluation. The study will be capturing data from over 270 000 women and birthing people giving birth in the care of 36 participating maternity units during the 30-month study period. All maternity units will undertake a control period (lasting 3–18 months) during which usual PPH care will be provided, followed by a 9-month implementation period during which the OBS PPH care bundle will be introduced using quality improvement methods and then an OBS UK intervention period (lasting 3–18 months) during which OBS PPH care will be delivered.

The primary outcome is the number of women receiving allogeneic red blood cell transfusion for PPH per 1000 maternities. Secondary outcomes are informed by the core PPH outcome set, psychological and cost-effectiveness measures for women and their partners and a mixed methods process evaluation exploring how the intervention was deployed and possible improvements to inform wider implementation.

OBS UK will establish whether (and how) the OBS UK PPH care bundle improves outcomes and experiences of women and their partners. Published results will provide evidence to inform PPH maternity care across the UK and internationally. Dissemination of the findings will be made available to members of the public and participants.

ISRCTN17679951.

Cryopreservation, particularly vitrification, is a cornerstone of assisted reproductive technology, preventing ice crystal damage to ensure high survival rates. However, existing manual systems, such as Cryotop, depend on the embryologist’s skill, which introduces procedural variability and hinders standardisation. While some semiautomated systems have been developed, issues with laboratory integration and limited throughput have prevented their widespread adoption. To address this, Biorocks (China) has created a novel semiautomated vitrification system. This study consists of a parent multicentre randomised device trial and a prospective observational live-birth extension follow-up study. The parent multicentre randomised controlled trial is designed to determine whether this novel semiautomated vitrification system is non-inferior to the established manual vitrification method in preserving postwarming human blastocyst viability. To further assess clinically relevant reproductive outcomes, a prospective multicentre observational live-birth extension study will evaluate live birth and postpartum safety outcomes among participants who complete the parent trial follow-up.

This is a multicentre, randomised controlled trial that will enrol 176 women between the ages of 20 and 39 who are undergoing in vitro fertilisation-embryo transfer or intracytoplasmic sperm injection. The study will be carried out in China at Nanjing Drum Tower Hospital, The Second Affiliated Hospital of Air Force Medical University, Shenzhen Maternity and Child Healthcare Hospital and Guangdong Provincial Maternity and Child Healthcare Hospital. On Day 5 or Day 6 of embryo culture, high-quality blastocysts will be randomised in a 1:1 ratio to either the novel semiautomated Biorocks vitrification system or the manual gold standard Cryotop method. The blastocyst survival rate after the warming serves as the primary outcome, defined as a warmed blastocyst maintaining at least 75% cellular integrity or re-expanding within 1–2 hours. Participants who complete the 10-week post-transfer follow-up in the parent trial may enter a prospective observational live-birth extension follow-up study after separate informed consent, with live birth status, concomitant medications and adverse events assessed up to 42 days postpartum.

Ethical approvals for this study were obtained from the research ethics committees of Nanjing Drum Tower Hospital (IRB approval #: 2024–529-01, 2024–529-02), The Second Affiliated Hospital of Air Force Medical University (IRB approval #: 202504–12), Shenzhen Maternity and Child Healthcare Hospital (IRB approval #: SZFYGCPLS2025001) and Guangdong Provincial Maternity and Child Healthcare Hospital (IRB approval #: 2025IRB009). This study has been registered in the Chinese Clinical Trial Registry (ChiCTR2400093517). Before any procedures, written informed consent will be obtained from all enrolled participants. Study data will be stored electronically in the electronic data capture system for interim analysis. The findings will be disseminated through presentations at international conferences and publications in peer-reviewed journals.

The live-birth follow-up extension study (ChiCTR2500109209) is planned as a prospective, multicentre observational extension of the parent randomised device trial. At the time of this report, ethics approval for the extension study has been obtained from the Ethics Committee of Nanjing Drum Tower Hospital, the coordinating centre (IRB approval #: 2025–0732-01). Site-specific ethics applications for the remaining participating centres are being prepared or submitted. Each additional centre will be activated for extension follow-up only after local ethics approval has been obtained; before such approval, no extension-specific procedures at that centre, including re-consent, follow-up contact or collection of extension follow-up data beyond the parent trial, will be initiated.

ChiCTR2400093517 (URL: https://www.chictr.org.cn/showproj.html?proj=251859, Date of registration: 06–12-2024, Protocol version: V1.1/20-01-2025, Identifier: BELK-DHF-CRYC-426-A), ChiCTR2500109209 (Live-birth follow-up extension study, URL: https://www.chictr.org.cn/showproj.html?proj=286900, Date of registration: 15–09-2025, Protocol version: V1.0/08-07-2025, Identifier: BELK-DHF-CRYC-426-B).

ChiCTR2400093517 and ChiCTR2500109209.

The increased resources available to improve the population’s sexual and reproductive health do not always reach migrant women equally. This is relevant in a context where 26.6% of births in 2024 were to foreign-born mothers. The objective of this study is to analyse the adherence among the migrant population in the autonomous region of the Basque Country (Spain) to the established protocols for pregnancy, childbirth and postnatal care, as well as their use of health services. In addition, it aims to identify the barriers and facilitators that influence their access to and continuity of care.

This mixed-methods study comprises two phases: (a) a population-based, descriptive, retrospective study using data from the routine monitoring of health programmes for women who gave birth during 2024 in the Basque Country. Variables related to the women’s characteristics, healthcare utilisation, and the course of pregnancy, childbirth and the postnatal period will be analysed. The analysis will include descriptive statistics, bivariate techniques and multivariate modelling; (b) a qualitative study using focus groups. At least five focus groups will be organised to ensure representation by continent and country of origin. These groups will explore experiences and perceived barriers related to the adaptation of sexual and reproductive health self-care practices to the healthcare system among migrant women. The sessions will be audio-recorded, transcribed verbatim, coded and categorised to develop a conceptual framework that will later be analysed with the text.

The study has been approved by the Basque Country Ethics Committee. Informed consent will be obtained from all participants for the collection of primary data, and participants may withdraw from the study at any time without consequence. Authorisation has also been granted by the Basque Health Service Directorate to access recorded data, which will be provided in anonymised form, ensuring that individuals cannot be reidentified. Findings will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals.

Pregestational diabetes is one of the most frequent medical conditions in pregnancy. Nutrition insecurity is a non-medical, health-related social need and affects glycaemic management and pregnancy outcomes for women with both type 1 and type 2 pregestational diabetes. Collaborative healthcare-community partnerships to enhance food access, facilitate culinary medicine, diabetes self-management education and support (DSMES) and address unmet social needs for pregnant women with pregestational diabetes remain to be evaluated.

In a two-arm randomised controlled trial, we will examine the combined effects of a tripartite NOURISH intervention ((1) produce home delivery, (2) culinary medicine with DSMES and (3) community health worker-led social needs assessment and support) versus the current standard of diabetes and prenatal care. We will recruit and enrol 174 pregnant women (87 NOURISH, 87 standard care) ≤22+6 weeks of gestation with pregestational diabetes, inadequate glycaemic management (haemoglobin A1c≥6.5%) and self-reported risk of food insecurity from a diabetes and prenatal care programme at a tertiary care academic health system located in the USA. We will measure the primary outcome of glycaemic management by delivery (haemoglobin A1c

The Institutional Review Board at The Ohio State University approved this study (IRB: STUDY20260307; date: 23 April 2026). We plan to submit results of the trial for publication in peer-reviewed journals and presentations at international scientific meetings.

NCT07560813.

The low uptake of cervical cancer screening (CCS) in rural areas is mainly related to the lack of awareness regarding cervical cancer. Using educational interventions has been shown to substantially improve knowledge and attitude towards cervical cancer, which are important determinants of undergoing CCS. The aim of this study was to analyse the impact of different educational intervention methods on knowledge, attitudes and willingness to undergo CCS among women in rural Indonesia.

A quasi-experimental study with a non-equivalent control group design.

The study was conducted in North Tobelo, a rural district in North Halmahera Regency.

Sample size was calculated using Power and Sample Size Calculations software (V.3.1.2). 150 women were recruited via convenience sampling from 12 Integrated Health Service Posts, cluster-randomised into three arms: control (n=50), flipchart (n=50) and video (n=50). A per-protocol approach was applied; all participants completed pre-intervention and post-intervention assessments within a single visit with no loss to follow-up. Continuous outcomes were analysed using the Kruskal-Wallis and Wilcoxon tests; categorical outcomes using ² or Fisher’s exact tests with Bonferroni correction. Non-parametric analysis of covariance (Quade’s method) controlled for baseline scores, age at first sexual intercourse and household income, with partial eta-squared reported as the effect size.

All study arms received identical educational content presented in simple Indonesian language and avoiding the use of medical terminology. The educational content included cervical cancer epidemiology, aetiology, risk factors, clinical symptoms, prevention methods, various CCS methods, visual inspection with acetic acid screening procedures, benefits and side effects of getting human papillomavirus vaccination and CCS, as well as a brief explanation regarding cervical cancer treatment. Knowledge, attitude and willingness were assessed using a structured pre-intervention and post-intervention questionnaire comprising both dichotomous items and Likert-scale questions.

Although knowledge improved significantly in all intervention groups (p

In conclusion, the video-based educational intervention demonstrated the greatest improvements in knowledge, attitude, and willngness to undergo CCS compared to other methods.

Serous endometrial intraepithelial carcinoma (SEIC) is a rare, non-invasive lesion of the endometrial epithelium, typically characterised by p53 abnormalities. Although regarded as a precursor lesion, recent classification systems increasingly position SEIC within the broader spectrum of serous carcinomas and current guidelines place non-invasive p53-abnormal serous lesions in an uncertain risk category due to limited outcome data. As a result, SEIC is not consistently addressed as a distinct diagnosis, contributing to variation in clinical management. Complete surgical staging, including pelvic and para-aortic lymph node assessment, is frequently performed, yet supporting evidence remains scarce. This study aims to collect longitudinal data to evaluate surgical management strategies in relation to clinical outcomes, survival and quality of life.

This multicentre prospective observational cohort will enrol patients diagnosed with SEIC or equivalent non-invasive serous lesions who provide informed consent. Data will be collected using electronic case report forms (Castor Electronic Data Capture). Baseline clinical, pathological, molecular and treatment data will be collected, including imaging, histopathology, immunohistochemistry and molecular classification when available. Patient-reported outcomes will be assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Endometrial Cancer Module (EORTC QLQ-EN24) and EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L) questionnaires at baseline, 6 months, 2 years and 5 years after diagnosis. The primary outcome is progression-free survival, secondary outcomes include overall survival, health-related quality of life and adverse events. Analyses will be primarily descriptive. Survival outcomes will be estimated using Kaplan-Meier methods, with Cox proportional hazards modelling used to explore predictors of outcome where feasible.

The study will be conducted in accordance with the Declaration of Helsinki and applicable regulations. Ethical approval was obtained at the Erasmus MC (MEC-2025-0368). Results will be disseminated through peer-reviewed publications and scientific meetings.

NCT06677242.

Current UK guidelines recommend measurement of symphyseal fundal height and measurement of maternal blood pressure and urinalysis, with the aim of detecting women at increased risk of fetal growth restriction (FGR) and pre-eclampsia. Between 2008 and 2013, we conducted a prospective cohort study recruiting 4512 nulliparous women at the Rosie Hospital, Cambridge, where we performed serial ultrasonic imaging and serial blood sampling and generated a novel screening test for pre-eclampsia and FGR. The method involved measuring the ratio of two placental biomarkers (soluble fms-like tyrosine kinase receptor-1 and placenta growth factor) at ~36 weeks of gestational age (wkGA) and combining the result with maternal characteristics and ultrasonic imaging. Women who screened positive had a ~50% risk of a composite outcome, consisting of pre-eclampsia±delivery of a baby with a birth weight

Nulliparous women with an apparently normal singleton pregnancy will be recruited at their dating ultrasound scan. Blood will be obtained at this visit, at their anomaly scan (20 wkGA), and at two research appointments (28 wkGA and 36 wkGA) when research ultrasound scans will be performed. Blood for DNA will be obtained from the father of the baby where possible and the placenta will be sampled following birth. At 36 wkGA, women will be consented for participation in the randomised controlled trial (RCT) element of the study and their risk of term pre-eclampsia and FGR will be assessed using the novel approach. Women who screen high-risk will then be randomly allocated to either having the result revealed or masked. Women randomised to having the result revealed will be offered early delivery and/or enhanced monitoring. Where the result is masked, there will be no communication between the research team and the participant, and she will continue to receive routine care at the Rosie Hospital. The primary outcome is a composite of pre-eclampsia, FGR and perinatal morbidity and mortality. The study will also generate data and biological samples to support future research in novel screening methods and disease mechanisms.

The study received ethical approval from the East of England Research Ethics Committee. All women provide written informed consent to participate in the cohort. Women provide a second written informed consent to participate in the RCT. The study results will be disseminated by presentation at international conferences and publication in peer reviewed journals.

ISRCTN1218142.

The relationship between clomiphene citrate (CC) dosing regimens and adverse reproductive outcomes has not been fully elucidated, both with and without use of in vitro fertilisation (IVF). We aimed to study the association between cumulative CC dose and perinatal outcomes among fresh autologous IVF cycles.

Retrospective cohort study.

We included all fresh autologous IVF embryo transfer cycles performed in the US fertility clinics during 2004–2021 using CC for ovulation induction. We used robust Poisson regression models to estimate adjusted risk ratios (aRRs) and 95% CIs for associations between four categories of CC dose (

21 004 fresh autologous embryo transfer cycles using CC.

The primary outcome measures included biochemical pregnancy, clinical pregnancy, spontaneous abortion, stillbirth, live birth, multiple birth and preterm delivery.

Among fresh autologous embryo transfer cycles using CC, 21.3% used

Our findings extend previous findings on the association between CC exposure and adverse perinatal outcomes by demonstrating a dose-dependent relationship.

Induced abortion remains a significant reproductive health issue in Iran, shaped by complex socio-economic, cultural and legal factors. Despite its importance, limited evidence exists on the underlying motivations for seeking abortion in a context of restrictive laws and pronatalist policies.

This study aimed to explore the reasons underlying couples’ decisions to seek induced abortion within the constraints of the current legal framework.

Qualitative interview study, co-designed with couples with a history of induced abortion.

We conducted semi-structured interviews with a purposively selected sample of couples. Data analysis followed a content analysis approach and was iterative, occurring concurrently with data collection until thematic saturation was reached.

Baharloo, Arash and Imam Khomeini hospitals, as well as private gynaecology and midwifery clinics in Tehran, Iran, between January and November 2024.

32 adults participated, including 18 women who had experienced an induced abortion and 14 of their male partners, representing diverse socio-economic backgrounds.

Participants’ decisions about abortion were shaped by multiple, interconnected factors. Economic pressures, including job instability and high costs of childbearing, intersected with relationship concerns, such as lack of partner support and unstable marital life. Social norms influenced choices through expectations of parenting, emphasis on individual autonomy and attitudes toward fertility. Pregnancy-related fears, including past traumatic experiences, health concerns and worries about fetal well-being, further contributed to decision-making. Finally, social uncertainty and anxieties about children’s futures, along with perceived inadequacy of government support, created conditions in which continuing a pregnancy often seemed unfeasible.

Couples’ decisions to seek induced abortion in Iran emerge from complex interactions between economic pressures, relational dynamics, cultural shifts, embodied experiences and structural constraints. Pro-natalist policies that fail to address these underlying factors are unlikely to reduce abortion rates. Findings underscore the need for comprehensive interventions addressing socioeconomic insecurities, relationship support and reproductive health services, while respecting couples’ decision-making autonomy.