The Journal Of Obstetrics And Gynaecology Research[JOURNAL]
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200 papers
Associations Between Late-Night Shift Work and Perinatal Outcomes: A Nationwide Cross-Sectional Study Using JACSIS and JASTIS Data.
Tanaka Y, Kasuga Y, Hosokawa Y … +7 more , Tamai J, Fukuma Y, Otani T, Fukutake M, Ikenoue S, Tabuchi T, Tanaka M
J Obstet Gynaecol Res · 2026 Feb · PMID 41689242 · Full text
AIM: This study investigated associations between late-night shift work and perinatal outcomes. METHODS: Participants were pregnant women with recorded perinatal outcomes (late-night shift group, 626 cases; non-late-nigh...
AIM: This study investigated associations between late-night shift work and perinatal outcomes. METHODS: Participants were pregnant women with recorded perinatal outcomes (late-night shift group, 626 cases; non-late-night shift group, 6633 cases) identified from two Japanese Internet surveys. We analyzed the association between late-night shift work and adverse perinatal outcomes. Furthermore, we examined factors associated with the use of Maternal Health Management and Guidance Cards. RESULTS: The late-night shift group had significantly higher rates of threatened miscarriage, premature rupture of membranes (PROM), use of the Maternal Health Management and Guidance Card, health problems requiring hospitalization, fetal health problems, and infectious diseases compared with the non-late-night shift group. However, other perinatal outcomes, including preterm birth, gestational age at delivery, mode of delivery, and birth weight, did not differ significantly between groups. Among late-night shift-working mothers, those who used the Maternal Health Management and Guidance Card had a higher incidence of hyperemesis gravidarum, threatened miscarriage, and preterm labor than those who did not. CONCLUSIONS: Late-night shift work during pregnancy may be associated with an increased risk of perinatal complications. The Maternal Health Management and Guidance Card may provide support for pregnant women engaged in late-night shift work.
Changes in Epithelial Ovarian Cancer Recurrence and Survival According to Treatment Paradigm Shifts.
Kim J, Suh DH, Kim K … +2 more , No JH, Kim YB
J Obstet Gynaecol Res · 2026 Feb · PMID 41681056 · Full text
AIM: To evaluate oncologic outcomes in patients with epithelial ovarian cancer (EOC) amid evolving surgical and systemic therapy paradigms. METHODS: This retrospective cohort study included patients diagnosed with EOC fr...
AIM: To evaluate oncologic outcomes in patients with epithelial ovarian cancer (EOC) amid evolving surgical and systemic therapy paradigms. METHODS: This retrospective cohort study included patients diagnosed with EOC from June 2003 to December 2020 at a single tertiary center, grouped by diagnosis period. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier and Cox regression analyses. RESULTS: A total of 763 patients were classified as 2003-2008 (Group 1, n = 101), 2009-2013 (Group 2, n = 207), and 2014-2020 (Group 3, n = 455), reflecting changes in cytoreductive surgery and targeted therapies (bevacizumab and PARP inhibitors). Early-stage diagnoses increased over time without statistical significance (Stage I-II: Group 1, 37.6% vs. Group 3, 46.6%; p = 0.200). Group 2 showed greater use of interval debulking surgery (IDS), higher complete cytoreduction rates, and more first-line chemotherapy cycles (all p < 0.001). Group 3 represented the introduction of targeted therapies (p < 0.001 for both). IDS with residual (< 1 cm) was associated with poorer outcomes than complete/optimal primary debulking surgery (PDS) (hazard ratio 2.94, 95% confidence interval 1.5-5.8). Despite unchanged PFS, the 5-year OS improved from 64.0% to 82.5% among patients with advanced-stage disease (p = 0.024). CONCLUSIONS: Over two decades, with the advent of targeted therapies, complete cytoreduction (especially in PDS) has increased. Although the use of IDS also increased, residual disease (< 1 cm) after IDS was associated with poorer outcomes. While PFS remained unchanged, 5-year OS significantly improved among patients with advanced-stage disease diagnosed in the most recent period.
Residual Oil-Based Contrast Medium Mimicking a Metallic Foreign Body After Cesarean Section: Diagnostic Value of AI-Assisted 3D CT Analysis and Prenatal MRI.
Fukuda M, Kagami K, Yasoshima I … +3 more , Iizuka T, Igarashi S, Abiko K
J Obstet Gynaecol Res · 2026 Feb · PMID 41679265 · Full text
A 36-year-old woman underwent an elective cesarean section at 37 weeks of gestation. A postoperative abdominal X-ray unexpectedly revealed a 20 mm hyperattenuating pelvic lesion. Computed tomography (CT) demonstrated a d...
A 36-year-old woman underwent an elective cesarean section at 37 weeks of gestation. A postoperative abdominal X-ray unexpectedly revealed a 20 mm hyperattenuating pelvic lesion. Computed tomography (CT) demonstrated a dense structure exceeding 3000 Hounsfield units with metallic-like artifacts, suggesting a retained metallic object. Intraoperative video review and instrument count confirmed no missing items. Three-dimensional CT reconstruction and open-source artificial intelligence (AI)-based shape analysis found no similarity to metallic instruments. Review of the patient's history revealed prior hysterosalpingography with oil-based iodinated contrast medium. Retrospective assessment of prenatal magnetic resonance imaging (MRI) showed a cystic lesion with high signal intensity on T- and T-weighted images, with signal suppression on fat-suppressed T-weighted imaging, consistent with fatty components. The lesion was diagnosed as a pseudocyst due to residual contrast medium. This case demonstrates that oil-based contrast can mimic metallic density, and that AI-assisted three-dimensional CT and MRI review can prevent unnecessary reoperation.
Fetal Growth Outcomes in Early Gestational Diabetes Mellitus Managed Immediately After Diagnosis.
Nakanishi S, Miyakoshi K, Yokoyama M … +6 more , Kasuga Y, Iwama N, Yamashita H, Aoki S, Yasuhi I, Sugiyama T
J Obstet Gynaecol Res · 2026 Feb · PMID 41673949 · Full text
AIM: To evaluate fetal growth outcomes in gestational diabetes diagnosed before 20 weeks' gestation (E-GDM) following immediate intervention and to identify factors associated with abnormal fetal growth. METHODS: We retr...
AIM: To evaluate fetal growth outcomes in gestational diabetes diagnosed before 20 weeks' gestation (E-GDM) following immediate intervention and to identify factors associated with abnormal fetal growth. METHODS: We retrospectively analyzed singleton term pregnancies with E-GDM between 2016 and 2021 at two university hospitals in Japan: Keio University Hospital (KUH) and Yokohama City University Medical Center (YCUMC). Dietary management was initiated immediately after diagnosis in both hospitals. At KUH, all E-GDM women underwent self-monitoring of blood glucose (SMBG). At YCUMC, the indication for SMBG was determined based on pre-pregnancy weight, the number of abnormal values on the oral glucose tolerance test, and other glycemic biomarkers, including HbA1c and glycated albumin. Fetal growth outcomes, assessed as the proportions of large-for-gestational-age (LGA) and small-for-gestational-age (SGA), were evaluated in E-GDM receiving early management. RESULTS: Among 509 pregnancies (190 at KUH and 319 at YCUMC), LGA and SGA were observed in 63 (12%) and 46 (9%), respectively. The proportion of LGA was not significantly associated with pre-pregnancy BMI (underweight, 9.6%; normal, 11%; overweight/obese, 16%: p = 0.20). In contrast, there was a significant difference in the proportion of SGA among the three groups (underweight, 19%; normal, 8.2%; overweight/obese, 7.2%: p = 0.024). Multivariate analysis demonstrated that pre-pregnancy underweight was significantly associated with SGA in comparison with pre-pregnancy normal weight. CONCLUSIONS: Fetal growth outcomes in E-GDM receiving early intervention were comparable to that of uncomplicated Japanese pregnancies. Since pre-pregnancy underweight remained a risk factor of SGA, clinicians should pay attention to the development of SGA in lean women with E-GDM.
Impact of Enoxaparin on Hemoglobin and Platelet Parameters in Post-Cesarean Venous Thromboembolism Prophylaxis: A Retrospective Cohort Study.
Dagdeviren E, Tercan C, Yeniocak AS … +4 more , Sari N, Buyuk S, Ataseven E, Arabaci O
J Obstet Gynaecol Res · 2026 Feb · PMID 41668530 · Publisher ↗
AIM: To evaluate the effects of a 10-day postpartum enoxaparin regimen on hemoglobin (HB) levels and platelet indices in women receiving post-cesarean venous thromboembolism (VTE) prophylaxis. METHODS: This retrospective...
AIM: To evaluate the effects of a 10-day postpartum enoxaparin regimen on hemoglobin (HB) levels and platelet indices in women receiving post-cesarean venous thromboembolism (VTE) prophylaxis. METHODS: This retrospective cohort study was conducted at a tertiary care center between December 2022 and June 2025. A total of 141 women who underwent cesarean section and had available hemogram data on postoperative day 10 were included. Patients were categorized into those who received enoxaparin prophylaxis (n = 112) and those who did not (n = 29). HB, hematocrit (HCT), platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR) were evaluated preoperatively, at 6 h postoperatively, and on the 10th postoperative day. The difference between postoperative 10th day and postoperative 6th hour laboratory values was also analyzed among groups receiving no enoxaparin, 40, or 60 mg/day of enoxaparin. RESULTS: No statistically significant differences were observed between the enoxaparin and non-enoxaparin groups in HB or platelet parameters on the 10th postoperative day (p > 0.05). The differences in hematologic indices between the 10th postoperative day and the 6th postoperative hour did not show significant variation among the dosing groups. CONCLUSION: In our study, we did not observe a significant effect of a 10-day enoxaparin regimen used for postoperative VTE prophylaxis in cesarean patients on HB levels or platelet indices. However, given our limited sample size, its hematologic safety should be confirmed through larger prospective studies.
Correction to "Development and Psychometric Properties of the Human Papillomavirus-Know Questionnaire (HPV-Know-Q) to Assess the Knowledge of Women on HPV Infection and Related Outcomes".
J Obstet Gynaecol Res · 2026 Feb · PMID 41668519 · Publisher ↗
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Cervical Cerclage at 17 Gestational Weeks for Delayed-Interval Delivery at 15 and 27 Weeks of Gestation in a Dichorionic Twin Pregnancy: A Case Report.
Suzuki M, Itai T, Shindo R … +8 more , Maruiwa N, Suzuki S, Ono N, Tochio A, Mukaida K, Obata S, Miyagi E, Aoki S
J Obstet Gynaecol Res · 2026 Feb · PMID 41641950 · Publisher ↗
Delayed-interval delivery refers to the delivery of the remaining fetus(es) at least 24 h after the delivery of the first fetus. There have been limited case reports of delayed-interval deliveries in twin pregnancies who...
Delayed-interval delivery refers to the delivery of the remaining fetus(es) at least 24 h after the delivery of the first fetus. There have been limited case reports of delayed-interval deliveries in twin pregnancies whose delivery of the first twin occurred in the early second trimester. We report a delayed-interval delivery of a dichorionic diamniotic pregnancy complicated by multiple fibroids. A 38-year-old primipara woman delivered the first twin at 15 weeks and 3 days of gestation. She did not have uterine contractions or any signs of infection, then McDonald cerclage was performed at 17 weeks and 1 day of gestation. At 27 weeks and 2 days of gestation, the second twin, 922 g, was delivered by caesarean section after premature rupture of membranes. Delayed-interval delivery may be considered in the early second trimester if there is no evidence of uterine contractions or infection, even in patients at risk for preterm birth.
Recurrent Pregnancy Loss and Adverse Outcomes in Chronic Intervillositis of Unknown Etiology: A Systematic Review and Meta-Analysis.
Wu S
J Obstet Gynaecol Res · 2026 Feb · PMID 41639927 · Publisher ↗
AIM: To evaluate the reproductive outcomes associated with chronic intervillositis of unknown etiology (CIUE) and to clarify its clinical relevance in women presenting with recurrent pregnancy loss (RPL). METHODS: A syst...
AIM: To evaluate the reproductive outcomes associated with chronic intervillositis of unknown etiology (CIUE) and to clarify its clinical relevance in women presenting with recurrent pregnancy loss (RPL). METHODS: A systematic review and meta-analysis were conducted across PubMed, Embase, Cochrane Library, and OVID databases through September 2025. Studies reporting histologically confirmed CIUE with documented RPL outcomes were included. Pooled prevalence estimates were calculated using generalized linear mixed models within random-effects frameworks to account for between-study variability. RESULTS: Six studies encompassing up to 263 pregnancies were analyzed. The pooled prevalence of RPL was 37.3%, while live birth, CIUE recurrence, intrauterine growth restriction, and perinatal death were 52.6%, 39.6%, 64.1%, and 13.7%, respectively. Maternal autoimmune disease and fetal chromosomal abnormalities were relatively uncommon. Despite substantial heterogeneity, the overall pattern indicated a consistent burden of adverse pregnancy outcomes in affected women. CONCLUSIONS: CIUE is closely associated with pregnancy loss, fetal growth restriction, and perinatal death and is characterized by a high recurrence rate of approximately 40% in subsequent pregnancies, underscoring its clinical importance in women with unexplained RPL. Early pathological recognition and individualized surveillance may improve pregnancy management and counseling. Further multicenter prospective studies are warranted to define optimal diagnostic and therapeutic strategies.
Associations of Lipid Metabolism Abnormalities and Obesity With Endometriosis-Associated Ovarian Cancer.
Asano F, Momomura M, Shibuya H … +3 more , Matsumoto H, Morisada T, Kobayashi Y
J Obstet Gynaecol Res · 2026 Feb · PMID 41605467 · Publisher ↗
AIM: To investigate the differences in lipid metabolism and obesity between patients with ovarian endometrioid carcinoma (OEC) and ovarian clear cell carcinoma (OCCC), both of which are classified as endometriosis-associ...
AIM: To investigate the differences in lipid metabolism and obesity between patients with ovarian endometrioid carcinoma (OEC) and ovarian clear cell carcinoma (OCCC), both of which are classified as endometriosis-associated Type I ovarian cancers. METHODS: This retrospective study included 133 patients who underwent surgery for OEC (n = 50) or OCCC (n = 83) between 2010 and 2022. Preoperative serum lipid markers (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) and body mass index (BMI) were compared between the two groups. Associations with menopausal status and disease stage were examined, and independent predictors were evaluated by multivariate logistic regression. RESULTS: Patients with OEC had significantly higher TC (215 vs. 199.5 mg/dL, p = 0.040), LDL-C (139 vs. 120.6 mg/dL, p = 0.026), and BMI (22.1 vs. 20.4 kg/m, p = 0.020) compared with those with OCCC. No significant differences were observed for HDL-C. In premenopausal women, TC and LDL-C were significantly higher in patients with OEC, whereas no intergroup differences were found in postmenopausal women. Among patients with OEC, those with advanced-stage disease had higher TC and LDL-C, whereas no stage-related differences were observed in patients with OCCC. Multivariate analysis identified BMI and LDL-C as independent factors associated with OEC. CONCLUSION: Lipid metabolism abnormalities and obesity were more strongly associated with OEC than with OCCC, suggesting subtype-specific metabolic mechanisms of carcinogenesis and progression. These findings highlight the importance of metabolic factors in OEC, warranting further prospective studies.
Current Status of Fertility-Sparing Treatment for Gynecological Cancers in Japan: A Nationwide Survey.
Shikama A, Nishio H, Okugawa K … +9 more , Kajiyama H, Suzuki N, Fujiwara H, Watari H, Komatsu H, Yamagami W, Satoh T, Kawana K, Kato K
J Obstet Gynaecol Res · 2026 Feb · PMID 41605464 · Publisher ↗
AIM: There is an increasing demand for fertility-sparing treatment (FST) among young women with gynecological cancer. This study aimed to clarify the current status of FST implementation across Japan by focusing on insti...
AIM: There is an increasing demand for fertility-sparing treatment (FST) among young women with gynecological cancer. This study aimed to clarify the current status of FST implementation across Japan by focusing on institutional practice patterns and clinical protocols for cervical, endometrial, and ovarian cancers. METHODS: A nationwide cross-sectional survey was conducted between August and September 2024. An online questionnaire was distributed to 481 gynecologic tumor registry institutions through the Japan Society of Obstetrics and Gynecology mailing list. Data on institutional characteristics, specific FST eligibility criteria, treatment methods, and post-treatment management were collected. RESULTS: Responses were received from 226 institutions (response rate: 47.0%), and all respondent institutions (100%) performed FST for at least one gynecological cancer. Although FST is widely available, significant heterogeneity in clinical protocols was observed across all three cancers. Key variations among respondent institutions included a low implementation rate of radical trachelectomy for cervical cancer (20.8%), a high rate of post-FST hysterectomy for endometrial cancer (63.6%) compared to cervical cancer and ovarian cancer, and exclusion criteria for patients with hereditary cancer syndromes. CONCLUSION: FST is an established practice in Japan; however, there is a lack of consensus regarding its clinical application. These findings provide a critical benchmark for future efforts to standardize care and develop collaborative networks to optimize this essential treatment modality for young patients with gynecological cancer.
Quantitative Evaluation of Coagulability in Obstetric DIC Using TEG6s for New Japanese Diagnostic Criteria of Obstetrical Disseminated Intravascular Coagulation.
Matsunaga S, Nakamura E, Takai Y … +2 more , Itakura A, Perinatal committee of the Japanese Society of Obstetrics and Gynecology
J Obstet Gynaecol Res · 2026 Feb · PMID 41605463 · Full text
Obstetric disseminated intravascular coagulation (DIC) onset is indicated by a bleeding tendency; however, its quantitative evaluation is difficult. Here, we quantitatively evaluated coagulability using the blood viscoel...
Obstetric disseminated intravascular coagulation (DIC) onset is indicated by a bleeding tendency; however, its quantitative evaluation is difficult. Here, we quantitatively evaluated coagulability using the blood viscoelasticity test, TEG6s, for determining the threshold at which bleeding tendency occurs based on coagulation function test results and bleeding volume. This retrospective, observational study included 33 cases with potential obstetric DIC. For the coagulation blood test, we evaluated fibrinogen, fibrin/fibrinogen degradation products (FDP), platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), hemoglobin, and bleeding amount. We evaluated using TEG6s blood viscoelasticity. Among the measurement items related to viscoelasticity in TEG6s, we used MA (maximum amplitude)-CRT. The causes of bleeding among the 33 cases included: atonic hemorrhage, 13; placenta previa, 11; amniotic fluid embolism, three; hypertension disorder of pregnancy, two; and others, four. Bivariate analysis showed a significant positive correlation between MA-CRT and fibrinogen and FDP. Inverse estimated values calculated using a nonlinear regression model for each test item showed the following results: MA-CRT < 46.6 mm and MA-CRT < 50 mm: fibrinogen, 135.4 mg/dL and 157.7 mg/dL; and FDP, 79.5 μg/mL and 60.8 μg/mL. In summary, fibrinogen and FDP indicated bleeding tendency, with recommended threshold values being 150 mg/dL and 60 μg/mL, respectively.
Impact of Power Morcellation and Histopathological Subtypes on the Development of Peritoneal Leiomyomatosis Following Laparoscopic Myomectomy.
Şimşek E, Durdağ GD, Yağınç DA … +3 more , Aydın Ş, Şimşek SY, Çelik H
J Obstet Gynaecol Res · 2026 Feb · PMID 41605457 · Publisher ↗
AIM: Laparoscopic myomectomy with power morcellation is a common approach for the management of uterine myomas. However, besides myoma recurrence, rare complications such as peritoneal leiomyomatosis may arise postoperat...
AIM: Laparoscopic myomectomy with power morcellation is a common approach for the management of uterine myomas. However, besides myoma recurrence, rare complications such as peritoneal leiomyomatosis may arise postoperatively. The histopathological subtype of fibroids-particularly cellular leiomyoma-may impact the risk of recurrence and dissemination, though current evidence remains limited. The aim of this study is to evaluate the impact of power morcellation on the development of disseminated peritoneal leiomyomatosis and to assess the association between the histopathological subtype of myoma and patient outcomes during follow-up. METHODS: This retrospective cohort study analyzed 997 patients who underwent laparoscopic myomectomy with power morcellation at a single tertiary center between 2012 and 2024. Patients were followed through clinical evaluations and ultrasonography. Peritoneal leiomyomatosis was evaluated in relation to surgical technique (confined vs. unconfined morcellation) and histopathological subtype. RESULTS: Of the 553 patients with available follow-up, myoma recurrence was observed in 130 (23.5%), reoperation in 53 (9.6%), and peritoneal leiomyomatosis in 8 patients (1.4%). All peritoneal leiomyomatosis cases occurred in the unconfined morcellation group. Cellular leiomyoma was identified in 5 of the 8 peritoneal leiomyomatosis cases (62.5%). One peritoneal leiomyomatosis case was diagnosed as leiomyosarcoma after surgery for disseminated leiomyomatosis. Overall myoma recurrence was significantly higher in patients with multiple myomas and in those with cellular leiomyoma. CONCLUSION: Peritoneal leiomyomatosis is a rare complication of laparoscopic myomectomy and increased incidence after unconfined morcellation is a serious concern. Confined (in-bag) morcellation appears to reduce the risk of peritoneal leiomyomatosis and should be the standard of care. Diagnosis of myomas as cellular leiomyoma subtype on histopathology merits high clinical suspicion for possibility of subsequent peritoneal leiomyomatosis in patients with unconfined morcellation. Therefore, close and long-term follow-up of these patients is essential.
Development and Psychometric Properties of the Human Papillomavirus-Know Questionnaire (HPV-Know-Q) to Assess the Knowledge of Women on HPV Infection and Related Outcomes.
González-Granados C, Rejas-Gutiérrez J, Calvo-Torres J … +5 more , Ramírez-Mena M, García-Santos JF, Bellón M, Fasero M, Coronado PJ
J Obstet Gynaecol Res · 2026 Jan · PMID 41603215 · Publisher ↗
AIM: To provide the psychometric properties of a novel patient-reported outcomes measurement (PROM), the HPV-Know-Q questionnaire, to assess the HPV-related knowledge in adult women in Spain. METHODS: After reviewing lit...
AIM: To provide the psychometric properties of a novel patient-reported outcomes measurement (PROM), the HPV-Know-Q questionnaire, to assess the HPV-related knowledge in adult women in Spain. METHODS: After reviewing literature and interviewing women with HPV infection, instrument items and domains were developed. A draft self-administered, multiple-choice questionnaire including relevant questions about HPV infection was pilot tested for comprehension and ease of completion. Psychometric evaluation of the final HPV-Know-Q questionnaire was performed in a cross-sectional, multicenter, validation study conducted in a representative sample of women with HPV infection attending gynecology consultations in Spain. RESULTS: A total of 349 (153 HPV+/196 HPV-) women participated. HPV-Know-Q questionnaire had acceptable metric properties of feasibility, internal consistency and temporal stability (reliability). Construct validity was supported by analyzing item-to-item and item-to-domain correlation and know groups validity, which discriminated the knowledge on HPV of women related to their infection status, abnormal cytology, educational level and prior HPV vaccination. Concurrent validity was demonstrated with a significant correlation with other scales measuring mental and sexual functioning. CONCLUSION: The HPV-Know-Q questionnaire, a novel and innovative PROM, showed acceptable psychometric properties to evaluate the HPV knowledge in women that support its use in daily medical practice and research.
A Novel Nomogram for Predicting Endometrial Malignancy in Postmenopausal Women.
Zhu H, Ai F, Liu P … +4 more , Ma L, He X, Zhou L, Wang S
J Obstet Gynaecol Res · 2026 Jan · PMID 41539692 · Publisher ↗
AIM: To identify clinical risk factors for endometrial malignancy in postmenopausal women and develop a predictive model for early detection and personalized intervention. METHODS: This study analyzed 1146 postmenopausal...
AIM: To identify clinical risk factors for endometrial malignancy in postmenopausal women and develop a predictive model for early detection and personalized intervention. METHODS: This study analyzed 1146 postmenopausal women undergoing diagnostic hysteroscopy. Inclusion required: confirmed menopause (age ≥ 40) with recent endometrial thickness measurement, successful hysteroscopy, histopathological verification, and complete records. Exclusions involved incomplete data, type II carcinoma, hormonally active tumors, or prior hysteroscopy indications. Demographics, clinical features, comorbidities, imaging data, and biomarkers were analyzed. Histology was confirmed via standard pathology. Risk factors were identified through univariate and multivariate logistic regression. The resultant predictive nomogram for endometrial malignancy risk stratification underwent rigorous validation using: (1) receiver operating characteristic curve analysis (discriminative power); (2) calibration plotting (prediction accuracy); and (3) decision curve analysis (clinical net benefit). RESULTS: Among 1146 postmenopausal women undergoing diagnostic hysteroscopy, histopathological analysis identified 69 cases (6.0%) of endometrial carcinoma (EC) and 15 cases (1.3%) of atypical endometrial hyperplasia, with the remaining cases (92.7%) demonstrating benign pathology. Multivariate analysis identified seven independent risk factors for EC: elevated fibrinogen and D-dimer levels, hypertriglyceridemia, decreased high-density lipoprotein, postmenopausal bleeding, ultrasonography blood-flow signals, and increased endometrial thickness. The predictive nomogram incorporating these parameters demonstrated outstanding diagnostic performance, with area under the curve values of 0.955 in the training cohort and 0.960 in the validation cohort, indicating excellent discriminative ability for EC risk stratification. CONCLUSION: We developed and validated a novel 7-indicator prediction model for assessing endometrial malignancy risk in postmenopausal women undergoing hysteroscopy biopsy.
Live Birth Outcomes After Extended or Repeated High-Dose Medroxyprogesterone Acetate Therapy for Fertility-Sparing Management of Endometrial Neoplasia: A Single-Center Retrospective Case Series.
Yamamura A, Okunomiya A, Yanai A … +7 more , Yamanoi K, Taki M, Ohara T, Miyamoto T, Sunada M, Okada Y, Mandai M
J Obstet Gynaecol Res · 2026 Jan · PMID 41534944 · Full text
AIM: To clarify live birth outcomes among women receiving extended or repeated high-dose medroxyprogesterone acetate (MPA) therapy for fertility-sparing management of atypical endometrial hyperplasia or endometrioid carc...
AIM: To clarify live birth outcomes among women receiving extended or repeated high-dose medroxyprogesterone acetate (MPA) therapy for fertility-sparing management of atypical endometrial hyperplasia or endometrioid carcinoma grade 1. METHODS: We conducted a single-center retrospective case series of 53 patients undergoing MPA therapy between 2005 and 2023. Patients were stratified into three groups: (i) complete response (CR) within 6 months (standard group), (ii) CR after extended treatment beyond 6 months (extended group), and (iii) CR after MPA retreatment for first intrauterine recurrence (retreatment group). Primary outcome was the live birth rate (LBR). Secondary outcomes included the effect of initial reproductive intentions, interval from CR to conception, recurrence rates, and recurrence-free interval (RFI). RESULTS: LBRs were 33% (10/30) in the standard group, 8% (1/12) in the extended group, and 17% (2/12) in the retreatment group. Among eight patients undergoing MPA retreatment for a second or subsequent recurrence, none achieved live birth. Patients with an initial desire for prompt conception had significantly higher LBRs than those without (38% vs. 5%, p < 0.01). Median time from CR to conception leading to live birth was 12 months. Patients achieving live birth had significantly longer RFIs than those without (p < 0.01). CONCLUSIONS: Live birth is most likely when CR is achieved within 6 months of MPA therapy; nonetheless, extended or repeated MPA treatment may still result in live birth. These findings suggest the importance of appropriate patient selection and careful monitoring during extended or repeated therapy and attempting conception promptly in fertility-sparing management of endometrial neoplasia.
Association Between D-Dimer/Fibrinogen Ratio and Pregnancy Outcomes in Normocoagulable Women Undergoing Frozen-Thawed Embryo Transfer Cycles: A Retrospective Cohort Study.
Wang L, Li H, Zhou W
J Obstet Gynaecol Res · 2026 Jan · PMID 41531252 · Publisher ↗
AIM: To explore the association between D-dimer/fibrinogen ratio (DFR) and outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in normocoagulable women. METHODS: This retrospective cohort study...
AIM: To explore the association between D-dimer/fibrinogen ratio (DFR) and outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in normocoagulable women. METHODS: This retrospective cohort study included 869 women undergoing their first single blastocyst frozen-thawed embryo transfer (FET) cycles at Beijing Chao-Yang Hospital. Data were collected from the medical records of FET cycles performed at the reproductive medicine center between January 2016 and November 2022. Eligible participants were normocoagulable women aged 22-38 years with a body mass index (BMI) < 30 kg/m, those with metabolic or uterine disorders or incomplete records were excluded. The primary outcomes were live birth and miscarriage. Participants were stratified by live birth status to assess the association between DFR and pregnancy outcomes. RESULTS: Participants were categorized into live birth group (n = 357) and non-live birth group (n = 512). Compared to the non-live birth group, the live birth group had lower D-dimer (0.19 vs. 0.23 mg/L, p = 0.010) and DFR (0.07 vs. 0.08, p = 0.003). Logistic regression revealed that elevated DFR increased pregnancy failure risk. Receiver operating characteristic (ROC) analysis indicated that DFR predicted live birth with a cut-off value of 0.085. Stratified by this cut-off value, the DFR > 0.085 group had a higher miscarriage rate (26.40% vs. 15.04%), a lower clinical rate (46.98% vs. 54.51%), and a lower live birth rate (34.38% vs. 46.31%). CONCLUSIONS: A higher pre-pregnancy DFR is associated with adverse pregnancy outcomes in normocoagulable women and may serve as a predictor for IVF/ICSI.
Regional Heterogeneity and Future Challenges in Ovarian Cancer Burden in Asia.
Zhang H, Chen J, Li D
J Obstet Gynaecol Res · 2026 Jan · PMID 41531239 · Publisher ↗
BACKGROUND: Ovarian cancer (OC) is a growing public health challenge in Asia, with rising incidence and regional disparities. Using the Global Burden of Disease (GBD) 2021 dataset, this study assessed temporal trends, sp...
BACKGROUND: Ovarian cancer (OC) is a growing public health challenge in Asia, with rising incidence and regional disparities. Using the Global Burden of Disease (GBD) 2021 dataset, this study assessed temporal trends, spatial patterns, and determinants of OC burden in Asia from 1990 to 2021, with projections to 2036. METHODS: Data were extracted from GBD 2021 for all Asian regions. Three indicators were analyzed: age-standardized incidence rate (ASIR), mortality rate (ASMR), and disability-adjusted life years rate (ASDR). Trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression. Decomposition analysis examined contributions of population aging, growth, and epidemiological shifts. Age-period-cohort (APC) analysis was performed to disentangle the effects of age, period, and cohort on OC incidence. Future burden (2022-2036) was projected with an autoregressive integrated moving average (ARIMA) model. RESULTS: From 1990 to 2021, OC burden increased markedly. Southeast, South, and Central Asia had the greatest rises in ASIR, ASMR, and ASDR, while East Asia and high-income Asia Pacific showed stable or declining trends, likely due to healthcare advances and early detection. Higher sociodemographic index (SDI) correlated with greater incidence and mortality. Decomposition revealed aging as the main driver in East Asia and high-income Asia Pacific, while population growth dominated in South Asia. APC analysis highlighted age as the primary risk factor, with a rising period effect and a declining cohort effect. ARIMA projections (2022-2036) show steady ASIR growth and U-shaped trajectories (initial decline then rise) for ASMR and ASDR. CONCLUSION: The increasing OC burden in Southeast, South, and Central Asia underscores the urgent need for region-specific strategies. Interventions focusing on early diagnosis, equitable healthcare, and addressing demographic and epidemiological drivers are essential to mitigate the projected rise by 2036.
Where the Line Is Drawn: The Prognostic Role of Surgical Margins in Vulvar SCC.
Güzel D, Terek C, Besler A … +7 more , Serin G, Önal Z, Akman L, Zekioğlu O, Özdemir N, Özsaran A, Yıldırım N
J Obstet Gynaecol Res · 2026 Jan · PMID 41531178 · Publisher ↗
AIM: To evaluate the clinical, pathological, and treatment-related factors influencing recurrence and mortality in patients diagnosed with vulvar squamous cell carcinoma (SCC), with a specific focus on the prognostic sig...
AIM: To evaluate the clinical, pathological, and treatment-related factors influencing recurrence and mortality in patients diagnosed with vulvar squamous cell carcinoma (SCC), with a specific focus on the prognostic significance of surgical margin width. METHODS: This retrospective study included 70 patients with histologically confirmed vulvar SCC treated between 2000 and 2020 at a tertiary academic center. Patients were categorized based on tumor-free surgical margin width (< 2 mm, 2-8 mm, > 8 mm). Demographic, clinical, and histopathological parameters were analyzed using Cox regression and Kaplan-Meier methods to assess their impact on disease-free survival (DFS) and overall survival (OS). RESULTS: The median age at diagnosis was 68 years, and 74.3% of cases were FIGO stage I. Median DFS and OS were 46 and 56 months, respectively. Age and tumor grade emerged as independent predictors of mortality and recurrence. Surgical margins < 2 mm were significantly associated with increased recurrence risk (p = 0.001), while no significant effect on OS was observed. Margins ≥ 2 mm conferred a lower recurrence risk, especially in the 2-8 mm group. Lymphovascular space invasion (LVSI) and depth of invasion were significant in univariate analysis but lost significance after adjustment. CONCLUSION: Surgical margin width, particularly margins < 2 mm, is a strong predictor of local recurrence in vulvar SCC. Age and tumor grade are independent predictors of prognosis. These findings highlight the importance of individualized surgical planning and support the development of risk-adapted treatment strategies. Future prospective studies are warranted to refine optimal margin thresholds and improve outcomes, especially in high-risk populations.
Impact of Prolonged Surgical Waiting Time on 5-Year Progression-Free Survival in Patients With Endometrial Cancer.
Pulsawat A, Noothong S, Sirimusika N
J Obstet Gynaecol Res · 2026 Jan · PMID 41508733 · Full text
AIM: To evaluate the impact of surgical waiting time (SWT) on 5-year progression-free survival (PFS). Secondary objectives were to evaluate 5-year overall survival (OS) and prognostic factors for recurrence and OS in end...
AIM: To evaluate the impact of surgical waiting time (SWT) on 5-year progression-free survival (PFS). Secondary objectives were to evaluate 5-year overall survival (OS) and prognostic factors for recurrence and OS in endometrial cancer (EC), considering Thailand's Key Performance Indicator (KPI) recommending surgery within 4 weeks. METHODS: This retrospective cohort study included 377 patients with histologically confirmed EC who underwent primary surgery at Hatyai Hospital between October 2016 and September 2024. SWT was defined as the time from diagnostic biopsy to definitive surgery and categorized as early (≤ 4 weeks) or delayed (> 4 weeks). Survival outcomes were assessed using Kaplan-Meier curves and log-rank tests. Prognostic factors were analyzed using Cox proportional hazards models. RESULTS: The median SWT was 32 days. Median follow-up was 23 months. Delayed surgery correlated with higher BMI, larger tumors, and increased recurrence (12.7% vs. 4.9%, p = 0.010). Advanced FIGO stage, non-endometrioid histology, grade 3 tumors, LVSI, and delayed SWT were significant recurrence risk factors. Multivariate analysis confirmed advanced stage (HR: 5.15, p < 0.001) and SWT > 4 weeks (HR: 3.22, p = 0.011) as independent predictors. Recurrence risk increased with longer delays (> 6 weeks: HR: 3.22; > 8 weeks: HR: 3.16). Kaplan-Meier curves showed significantly reduced PFS with prolonged SWT, while its effect on 5-year OS was not significant (p = 0.1). CONCLUSIONS: Surgical delays beyond 4 weeks were associated with reduced PFS and increased recurrence, supporting Thailand's KPI and underscores the importance of timely surgery. The short follow-up may limit interpretation of long-term outcomes. Longer follow-up is warranted to confirm these results.
When a Journal Says, "I Am JOGR.".
Matsubara S
J Obstet Gynaecol Res · 2025 Dec · PMID 41493842 · Publisher ↗
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