This study aimed to determine whether transvaginal sonographic measurement of cervical length before labor induction can predict successful induction. This retrospective study recruited 138 pregnant women who underwent labor induction at 37–41 weeks of gestation. Cervical length was measured using transvaginal ultrasonography before labor induction. Labor was induced according to the hospital protocol. Age, gestational age (GA), parity, body mass index (BMI), Bishop score, hemoglobin level, maternal disease, and epidural anesthesia were also recorded. Labor induction outcomes, including cesarean section for failed induction, time of induction, and the three labor stages, were assessed. From December 2018 to December 2021, 138 women were recruited for our study, including 120 and 18 women with successful and failed labor induction, respectively. Shorter cervical length (≤3.415 cm, OR = 6.22, 95% CI = 1.75–22.15) and multiparity (OR = 17.69, 95% CI = 2.94–106.51) were associated with successful induction. Higher BMI was associated with failed induction (OR = 0.87, 95% CI = 0.75–0.99). Age, GA, Bishop score, and fetal birth weight were not associated with successful labor induction. The ROC curve showed a cervical length cutoff value of 3.415 cm, revealing 76.8% of the area under the curve. In conclusion, a shorter cervical length (≤3.415 cm) was associated with a higher chance of successful labor induction (76.8%). This parameter might be used to predict the chance of successful labor induction. This information could help better inform clinician discussions with pregnant women concerning the chance of successful labor induction and consequent decision-making. Nevertheless, further large-scale clinical trials are warranted.

This retrospective cohort study aimed to evaluate the factors related to endometrial cancer (EC) prognosis and survival in eastern Taiwan. The study involved 48 patients diagnosed with EC who underwent hysterectomy-based surgery at Hualien Tzu Chi hospital between January 2011 and June 2021. The patients’ medical history and laboratory examination results were reviewed. Progression-free survival and overall survival were determined. Categorical variables were analyzed using the chi-square test, and continuous variables were analyzed using the independent t-test. The receiver operating characteristic curve was used to predict diagnostic value. Factors associated with cancer mortality were identified via Cox regression analysis (p < 0.05). Patients were divided into the death (n = 7) and survival (n = 41) groups. The median age of the patients was 56 years (range: 31–71 years). The median observation period was 33.29 months. Diabetes mellitus (DM) and monocyte/lymphocyte ratio (MLR) > 0.23886 were significantly associated with cancer mortality (p = 0.024 and p = 0.028, respectively). MLR-low and MLR-high groups exhibited 5-year overall survival rates of 96% and 60%, respectively, and 5-year progression-free survival rates of 96% and 41%, respectively. DM and MLR of >0.2386 were suggested to be associated with cancer death, poor overall survival, and progression-free survival.

Background and Objectives: Epidural analgesia is widely used for intrapartum pain relief; nonetheless, its associations with labor progression and neonatal outcomes remain incompletely characterized in diverse obstetric populations. This retrospective cohort study aimed to investigate the association between labor epidural analgesia and obstetric outcomes, with a focus on the duration of the second stage of labor and the vacuum extraction delivery (VED) rate. Materials and Methods: Maternal and neonatal outcomes were compared between 173 women without epidural analgesia and 386 women with epidural analgesia at a single tertiary center. Independent predictors of VED, duration of the second stage of labor, and 1-min Apgar score ≤ 6 were identified by conducting multivariate logistic and linear regression analyses. Results: After adjustment for maternal age, body mass index, gestational age, parity, labor induction, and comorbidities, epidural analgesia was identified as the strongest independent predictor across all three outcomes. Notably, epidural analgesia was associated with nearly 6.7-fold higher odds of VED (adjusted odds ratio [aOR]: 6.74, 95% confidence interval [CI]: 3.55–12.82), approximately 49 additional min for second-stage labor (β = 48.63, 95% CI: 32.74–64.52), and approximately 5-fold higher odds of low 1-min Apgar score (aOR: 5.14, 95% CI: 1.11–23.87). Higher parity and labor induction were independently associated with a shorter duration of the second stage of labor and with lower odds of instrumental delivery. These associations remained robust after propensity score matching for parity and other baseline covariates, as well as in parity-stratified subgroup analysis (all p < 0.05). Conclusions: These findings highlight the multifaceted obstetric impact of epidural analgesia and underscore the importance of individualized intrapartum monitoring and informed patient counseling.

Many factors can affect delivery mode decisions. Therefore, this study aimed to explore the effects of maternal age, physician’s sex, region, income, and hospital type on cesarean section (C/S) delivery rates between 2008 and 2018 in Taiwan. In this population-based cross-sectional study, data were extracted from the Taiwan National Health Insurance Research Database (2 million individuals). The logistic regression method was used to analyze the aforementioned risk factors, and data are expressed as odds ratios (ORs) and 95% confidence intervals. In total, 9826 and 9714 deliveries in 2008 and 2018, respectively, were included in the analysis. The C/S ratio increased from 16.5% (n = 1607) in 2008 to 19.7% (n = 1916) in 2018. A higher C/S risk for women aged >34 years (ORs: 2.835 and 2.225 in 2008 and 2018, respectively) than for those aged ≤34 years was noted in both years. Female physicians had a lower risk of performing C/S than male physicians in 2008 (OR: .762, 95% confidence interval: .625–.928), but this was not apparent in 2018. Higher income levels (>new Taiwan dollar 45,081) and central Taiwan were associated with a lower C/S risk in both years. Private, not-for-profit hospitals had a lower C/S risk in 2008, which was not apparent in 2018. In conclusion, this study revealed a significant increase in C/S rates over the past decade, which was influenced by multiple factors. Maternal age, physician’s sex, income status, location, and type of hospital may influence C/S rates. Analyzing these relationships can inform the development of strategies aimed at reducing future C/S rates, and targeted interventions may reduce the C/S rates.

Background and Objectives: Carbetocin is increasingly used for postpartum hemorrhage (PPH) prophylaxis, but its selection in routine practice may bias comparisons with oxytocin. This observational study examined the association between the agent received and blood loss after vaginal delivery. Materials and Methods: This retrospective cohort included 559 women delivering vaginally in 2022–2023 who received carbetocin 100 μg intravenously (n = 474) or oxytocin 10 IU by infusion (n = 85). Gravimetric blood loss was analyzed using linear (primary), robust and median (co-primary) regression, and propensity score methods. Results: Carbetocin recipients more often underwent induction (63.3% vs. 43.5%), vacuum extraction (26.8% vs. 15.3%), and epidural analgesia (76.2% vs. 29.4%). Blood loss was higher with carbetocin before adjustment (223.7 vs. 180.0 mL, p = 0.003) but not after adjustment (β 12.72 mL, 95% CI −50.19 to 75.64, p = 0.691; robust p = 0.479; median p = 0.354). Propensity score results conflicted: inverse probability weighting showed higher blood loss with carbetocin (47.84 mL, p = 0.002), whereas matching and trimmed weighting did not. PPH occurred in 2.7% vs. 0% (p = 0.234). Conclusions: Carbetocin was preferentially used in higher-risk labors, indicating confounding by indication. Adjusted blood loss did not differ significantly, although a modest increase could not be excluded. The study was severely underpowered for PPH.