The Journal Of Obstetrics And Gynaecology Research[JOURNAL]
Sun
200 papers
The Impact of DRG Review Teams on Obstetric Disease Management and Cost Control: A Variance Analysis Approach.
Liang X, Zhang R, Liao C … +1 more , Zhou Y
J Obstet Gynaecol Res · 2026 Jun · PMID 42310873 · Full text
AIM: The global transition toward Diagnosis-Related Groups (DRG) payment systems has fundamentally reshaped hospital reimbursement landscapes, yet obstetric departments present distinctive implementation challenges owing...
AIM: The global transition toward Diagnosis-Related Groups (DRG) payment systems has fundamentally reshaped hospital reimbursement landscapes, yet obstetric departments present distinctive implementation challenges owing to the dual-patient paradigm and inherent clinical heterogeneity of maternal-fetal medicine. This study investigates whether strategically constituted DRG review teams can optimize both cost containment and care quality in obstetric settings through variance analysis methodology. METHODS: We conducted a retrospective cohort analysis at Shenzhen Baoan Women's and Children's Hospital spanning June 2022 to June 2025, encompassing 120 obstetric cases stratified across major DRG categories. The analytical framework integrated Time Consumption Index (TCI), Cost Consumption Index (CCI), and Boston Matrix positioning analysis. Primary outcomes included cost variance patterns, length of stay trajectories, and composite quality indicators with statistical adjustment for patient complexity. RESULTS: Multidisciplinary DRG review team implementation yielded statistically significant improvements: TCI decreased from 1.15 ± 0.23 to 0.89 ± 0.18 (p < 0.001), representing 22.61% efficiency gains; CCI improved from 1.08 ± 0.21 to 0.91 ± 0.16 (p < 0.001), indicating 15.74% cost reduction. Average length of stay decreased from 6.21 ± 2.34 to 4.73 ± 1.87 days (p < 0.001), with mean cost savings of ¥1333.33 per case. Pharmaceutical expenses demonstrated the strongest correlation with total cost variance (ρ = 0.82, p < 0.001). Critically, quality indicators remained stable throughout implementation, with 30-day readmission rates maintained at 2.50% ± 1.20%. CONCLUSIONS: Structured multidisciplinary DRG review teams demonstrate substantial effectiveness in optimizing obstetric resource utilization while preserving care quality. Variance analysis provides a robust framework for identifying pharmaceutical cost management as the primary leverage point for system-wide optimization, informing targeted intervention strategies for DRG implementation within specialized obstetric contexts.
Endometrial Stromal Sarcoma With Tumor Thrombus: A Rare Manifestation.
Saini M, Manchanda S, Malhotra N … +1 more , Singhal S
J Obstet Gynaecol Res · 2026 Jun · PMID 42309559 · Publisher ↗
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Maternal Hemodynamic Management Using the FloTrac Monitor During Ex Utero Intrapartum Treatment for a Giant Fetal Cervical Mass: A Case Report.
Fujita T, Hyuga S, Adachi M … +2 more , Onishi Y, Okutomi T
J Obstet Gynaecol Res · 2026 Jun · PMID 42304552 · Publisher ↗
Ex utero intrapartum treatment requires profound uterine relaxation while preserving uteroplacental perfusion. Because uterine relaxants and high concentrations of volatile anesthetics may cause hypotension and increase...
Ex utero intrapartum treatment requires profound uterine relaxation while preserving uteroplacental perfusion. Because uterine relaxants and high concentrations of volatile anesthetics may cause hypotension and increase blood loss, tight maternal hemodynamic control is essential. A healthy 36-year-old woman underwent ex utero intrapartum treatment at 32 weeks' gestation for a rapidly enlarging fetal cervical mass. We trended cardiac index and stroke volume variation using an arterial waveform analysis system and applied a predefined algorithm for fluid loading and phenylephrine titration. Maternal systolic blood pressure was maintained within 15% of the preinduction baseline during profound uterine relaxation with high-dose sevoflurane and intravenous nitroglycerin. The fetal airway was secured by tracheal intubation over 13 min with placental support. Maternal blood loss was 2850 mL, and the postoperative course was uneventful. Trend monitoring may help structure real-time fluid and vasopressor decisions during this procedure.
Immunomodulatory Role of Natural Progesterone in Pregnancy: A Review.
Mehta P, Deshpande H, Deshpande A … +6 more , Quadros R, Dharmadhikari S, Khandhedia C, Puppalwar G, Mane A, Mehta S
J Obstet Gynaecol Res · 2026 Jun · PMID 42303279 · Full text
AIM: Pregnancy complications such as miscarriage, preterm birth (PTB), and luteal phase defects (LPD) are significant reproductive health issues globally, with both physical and psychological implications. This review ai...
AIM: Pregnancy complications such as miscarriage, preterm birth (PTB), and luteal phase defects (LPD) are significant reproductive health issues globally, with both physical and psychological implications. This review aims to examine the role of natural progesterone in pregnancy-related disorders, specifically threatened and recurrent miscarriage, PTB, and LPD. Additionally, it examines how natural progesterone's immune-modulating actions, including both direct and indirect involvement, contribute to maintaining pregnancy. METHODS: This narrative review was conducted using PubMed, Google Scholar, and reference screening to identify English-language studies examining the role of natural progesterone in miscarriage, PTB, and LPD. Emphasis was placed on progesterone's immunomodulatory actions, including cytokine regulation and the activity of the progesterone-induced blocking factor (PIBF), and their relevance to pregnancy maintenance. RESULTS: Natural progesterone demonstrates clinical benefit in managing threatened miscarriage, recurrent pregnancy loss, preterm labor, and LPD. Evidence shows that it is well-tolerated with manageable side effects, reducing miscarriage rates, preventing PTB, and improving LPD outcomes through its effects on the maternal-fetal interface. This review also highlights progesterone's dual immunomodulatory action, direct cytokine regulation, and indirect influence via PIBF, which together contribute to improved pregnancy maintenance and outcomes. CONCLUSION: Natural progesterone supports pregnancy by preventing miscarriages, preterm labor, and LPD through its direct and indirect immunomodulatory mechanisms. Clinically, it is well-tolerated with no serious or unexpected adverse events. However, gaps remain in fully understanding its effectiveness, emphasizing the need for further research.
Implementation and Feasibility of a Real-Life Virtual Reality System in Obstetrical Education for Medical Students: A Questionnaire-Based Study.
Nagata H, Komatsu H, Miyoshi M … +8 more , Matsumoto M, Hikino K, Iida Y, Sawada M, Harada T, Ueki M, Sato S, Taniguchi F
J Obstet Gynaecol Res · 2026 Jun · PMID 42298914 · Publisher ↗
OBJECTIVE: Clinical observation of childbirth is essential in obstetric education; however, opportunities for medical students are increasingly limited due to declining birth rates and the unpredictable timing of deliver...
OBJECTIVE: Clinical observation of childbirth is essential in obstetric education; however, opportunities for medical students are increasingly limited due to declining birth rates and the unpredictable timing of delivery. Restrictions during the COVID-19 pandemic further reduced in-person learning, highlighting the need for alternative educational approaches. Virtual reality (VR) offers immersive learning opportunities. We developed a 360° real-life VR simulation of vaginal delivery and evaluated its educational utility and student satisfaction. METHODS: VR content was created using omnidirectional and high-definition cameras installed in the delivery and ultrasound rooms at Tottori University Hospital. Students viewed the content using a projection-based VR system (Cave Automatic Virtual Environment; CAVE) and head-mounted displays (HMD). Between February 2023 and April 2025, 220 medical students participating in a clinical clerkship observed childbirth and ultrasonography through VR and completed post-session questionnaires. Valid response numbers varied by questionnaire item because some items were added during the study period. RESULTS: Overall student satisfaction with the VR experience was high across content configurations. Scene-specific satisfaction varied, with relatively lower ratings for ultrasonography. After the VR session, the proportion of students expressing a willingness to observe actual childbirth was 94.2%. Students frequently cited the realism of the VR experience and suggested improvements to explanatory content and audiovisual quality. CONCLUSIONS: To our knowledge, this is one of the few studies to examine the implementation of 360° "real-life" VR childbirth education for medical students. Real-life VR may support learner engagement and perceived educational value in obstetric training.
Efficacy of Prophylactic Tranexamic Acid Use After Vaginal Delivery According to Postpartum Hemorrhage Risk: Randomized, Double-Blind, Placebo-Controlled Trial.
Tosun O, Yenigul NN, Bilgin EY … +1 more , Dincgez B
J Obstet Gynaecol Res · 2026 Jun · PMID 42298769 · Publisher ↗
OBJECTIVE: Postpartum hemorrhage (PPH) remains a major cause of maternal morbidity despite standard active management of the third stage of labor. Evidence regarding the prophylactic use of tranexamic acid (TA) after vag...
OBJECTIVE: Postpartum hemorrhage (PPH) remains a major cause of maternal morbidity despite standard active management of the third stage of labor. Evidence regarding the prophylactic use of tranexamic acid (TA) after vaginal delivery, particularly according to PPH risk stratification, is limited. This study aimed to evaluate the efficacy of prophylactic intravenous tranexamic acid administered after vaginal delivery in reducing postpartum blood loss. The primary outcome was measured blood loss during the third and fourth stages of labor. Secondary outcomes included the incidence of uterine atony, need for blood transfusion, requirement for additional uterotonics, and treatment-related adverse effects, assessed separately in low- and high-risk PPH groups. MATERIALS AND METHODS: This double-blind, prospective, randomized controlled trial included 480 singleton pregnant women aged 18-45 years who delivered at ≥ 34 weeks of gestation. Participants were first stratified according to postpartum hemorrhage (PPH) risk as low-risk (n = 240) or high-risk (n = 240). Within each risk group, women were randomly assigned in a 1:1 ratio to receive either intravenous tranexamic acid (1 g) or placebo after vaginal delivery (120 participants per treatment arm in each risk group). RESULTS: In low-risk patients, both the collected blood volume and estimated blood loss were significantly lower in the tranexamic acid (TA) group compared with placebo. In high-risk patients, TA administration was associated with significantly reduced collected blood volume and estimated blood loss, as well as a lower incidence of uterine atony. In addition, the need for blood transfusion and additional uterotonic use was lower in patients receiving TA, particularly in the high-risk group. No clinically significant differences were observed in laboratory safety parameters, including D-dimer levels. CONCLUSION: Prophylactic tranexamic acid administration after vaginal delivery significantly reduced postpartum blood loss compared with placebo. While TA was effective in reducing blood loss in both low- and high-risk patients, a significant reduction in uterine atony was observed only in the high-risk group. No major adverse effects related to TA were identified, suggesting that TA was well tolerated in the study population. Major maternal morbidity outcomes were not assessed in this study.
Rapid Enlargement of Vulvar Glomus Tumor After Needle Aspiration and Tumor Base Ligation.
Nagao Y, Tamauchi S, Yokoi A … +3 more , Yoshikawa N, Niimi K, Kajiyama H
J Obstet Gynaecol Res · 2026 Jun · PMID 42298747 · Full text
Vulvar glomus tumors are rare and typically benign, slow-growing tumors. Rapid enlargement is uncommon and may suggest malignancy or other atypical conditions. A 58-year-old postmenopausal woman noticed a small vulvar no...
Vulvar glomus tumors are rare and typically benign, slow-growing tumors. Rapid enlargement is uncommon and may suggest malignancy or other atypical conditions. A 58-year-old postmenopausal woman noticed a small vulvar nodule. After needle aspiration at another hospital, significant bleeding occurred, requiring tumor base ligation. Although hemostasis was achieved, the mass subsequently continued to enlarge rapidly, prompting referral to our hospital. The lesion continued to enlarge gradually, so surgical excision was therefore performed. Histopathological findings confirmed a glomus tumor with atypical features, including a marked edematous stroma. The rapid enlargement was not attributed to malignancy, a hematoma, or an infection, but was considered to represent apparent growth associated with increased edema secondary to vascular congestion within the tumor. The present case highlights that the rapid enlargement of glomus tumor-related lesions does not necessarily indicate malignancy.
Paramedics' Experiences in Managing Obstetric Emergencies: A Qualitative Study Based on Reason's Swiss Cheese Model.
Muslu A, Yurt E
J Obstet Gynaecol Res · 2026 Jun · PMID 42298286 · Publisher ↗
OBJECTIVES: This study explores paramedics' experiences in managing childbirth-related emergencies and examines challenges through Reason's Swiss Cheese Model, which frames obstetric errors as the result of multiple syst...
OBJECTIVES: This study explores paramedics' experiences in managing childbirth-related emergencies and examines challenges through Reason's Swiss Cheese Model, which frames obstetric errors as the result of multiple system-level vulnerabilities. METHODS: A qualitative phenomenological design was employed to gain an in-depth understanding of paramedics' knowledge, experiences, and perceived barriers in obstetric emergencies. Purposive sampling recruited 18 paramedics who had encountered obstetric cases in prehospital settings. Semi-structured, in-depth interviews were conducted between March and July 2025, focusing on clinical experiences, decision-making, and system-related influences. Interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic approach to capture explicit and latent meanings. RESULTS: Three main themes emerged: experiences and interventions, challenges in emergency management, and patient transport issues. Participants identified multiple "latent conditions," such as insufficient obstetric training, limited simulation practice, equipment shortages, and unclear protocols, increasing error risk. Cultural differences affected communication and privacy, while transportation barriers and safety concerns posed additional risks for mothers and newborns. CONCLUSION: System-level weaknesses, rather than individual shortcomings, significantly hinder paramedics' effectiveness in obstetric emergencies. Strengthening safety layers through simulation-based training, standardized equipment, and reliable supply access is critical to improving the quality and safety of prehospital obstetric care.
Can Healthy Diet Buffer the Impact of Adverse Social Determinants on HPV Infection? Evidence From NHANES 2005-2016.
Lin X, Jin W, Huang J … +4 more , Geng H, Tang W, Liang Q, Hu X
J Obstet Gynaecol Res · 2026 Jun · PMID 42289939 · Publisher ↗
OBJECTIVES: Persistent high-risk HPV infection can trigger malignant tumors. The associations of social determinants of health (SDoH) and Healthy Eating Index-2020 (HEI-2020) with HPV remain unclear. HPV prevalence varie...
OBJECTIVES: Persistent high-risk HPV infection can trigger malignant tumors. The associations of social determinants of health (SDoH) and Healthy Eating Index-2020 (HEI-2020) with HPV remain unclear. HPV prevalence varies across socioeconomic levels, and while SDoH is hard to change in the short term, diet is modifiable. Given these differences, it remains to be clarified whether a high-quality diet is associated with lower HPV risk. METHODS: Using NHANES data (2005-2016), weighted logistic regression analyzed separate/combined links of SDoH and HEI-2020 with HPV infection, and subgroup effects were estimated. RESULTS: The study included 6172 eligible participants, among whom 2650 developed HPV infection, with a positive rate of 42.9%. Weighted logistic regression analysis identified a positive association between high-burden SDoH and HPV infection (OR = 1.294, 95% CI: 1.060-1.580) and a negative association between HEI-2020 and HPV infection (OR = 0.761, 95% CI: 0.603-0.961). As for the combined effect of SDoH and HEI-2020 on HPV infection, high-burden SDoH and poor dietary quality were significantly positively associated with HPV infection (OR = 1.511, 95% CI: 1.170-1.952). HEI modulated the effect of SDoH. Subgroup analysis indicated that the association between the combined effect of SDoH and HEI-2020 and HPV infection was stable across all subgroups. CONCLUSION: For vulnerable populations at high risk, it is essential to adopt a comprehensive public health strategy. This strategy must be based on three core measures: HPV vaccination, cervical cancer screening, and improved access to healthcare services. Within this comprehensive support framework, systematically incorporating evidence-based nutritional guidance can promote overall health and help reduce health inequities.
Shortened Telomere Length in Peripheral Blood Leukocytes From Patients With Polycystic Ovary Syndrome and Insulin Resistance.
Ji Y, Yu L, Dong Y … +4 more , Huo Y, Qi Z, Liu Y, Wang F
J Obstet Gynaecol Res · 2026 Jun · PMID 42289365 · Publisher ↗
BACKGROUND: Polycystic ovary syndrome (PCOS) is a common, heterogeneous female endocrine disorder. Although its etiology and pathogenesis are complex, PCOS has been shown to be associated with altered leukocyte telomere...
BACKGROUND: Polycystic ovary syndrome (PCOS) is a common, heterogeneous female endocrine disorder. Although its etiology and pathogenesis are complex, PCOS has been shown to be associated with altered leukocyte telomere length (LTL). The relationship between insulin resistance (IR)-a common manifestation and possible pathogenic factor in PCOS-and LTL remains unclear. MATERIALS AND METHODS: One hundred patients with PCOS and 44 controls were recruited. Anthropometric, clinical, biochemical parameters, and blood samples were collected. Patients with PCOS were divided by Homeostasis Model Assessment (HOMA-IR) index into IR and non-IR (NIR). Genomic DNA was extracted from peripheral blood samples, and the relative LTL was determined using real-time qPCR. RESULTS: The relative LTL was shorter in the PCOS group than that in the control group (p = 0.026), and LTL was significantly shorter in the IR group than that in the control group (p = 0.004). LTL was also shorter in the IR group than in the NIR group (p = 0.032), whereas there was no significant change in LTL in the NIR group compared with controls. Statistically significant differences persisted even after adjusting for age. Individuals with relatively longer LTL have a lower risk of disease compared to those with shorter LTL. In addition, we found that in the PCOS group, relative LTL was correlated with FINS and HOMA-IR, while in the PCOS-IR group, relative LTL was correlated with E2. CONCLUSIONS: The relative LTL in peripheral blood leukocytes was shorter in patients with PCOS than in healthy subjects, and telomere shortening was more pronounced in those with IR.
Role of Reproductive Tract Infections in Spontaneous Abortion: A Review.
Liu T, Xiao D, Jiang T … +3 more , Qu X, Kang Y, Zhou Y
J Obstet Gynaecol Res · 2026 Jun · PMID 42289362 · Publisher ↗
AIM: This review aims to summarize the association between reproductive tract infections and spontaneous abortion, clarify the underlying molecular mechanisms, and provide a scientific basis for clinical screening and ta...
AIM: This review aims to summarize the association between reproductive tract infections and spontaneous abortion, clarify the underlying molecular mechanisms, and provide a scientific basis for clinical screening and targeted interventions. METHODS: The electronic database PubMed was searched for studies published before April 2026. Keywords included "spontaneous abortion," "Recurrent Spontaneous Abortion," "early spontaneous abortion," "Early Pregnancy Loss," "late spontaneous abortion," "late abortion," "miscarriage," "reproductive tract infections," "bacterial vaginosis," "Chlamydia trachomatis," "Ureaplasma urealyticum," "Ureaplasma parvum," "Human Papillomavirus," "Herpes Simplex Virus," "Cytomegalovirus," "Vulvovaginal Candidiasis," "Trichomonas vaginitis," and "vaginal dysbiosis." Relevant references from retrieved manuscripts and review articles were also searched manually to ensure comprehensive coverage of eligible studies. RESULTS: Reproductive tract infections are key factors for spontaneous abortion, with bacterial vaginosis, Chlamydia trachomatis, Ureaplasma urealyticum, and Ureaplasma parvum showing significant associations. Vaginal dysbiosis interacts with reproductive tract infections, potentially promoting spontaneous abortion through inflammatory responses, disrupted maternal-fetal immune tolerance, and direct placental damage. The association between viruses (e.g., Human Papillomavirus, Herpesvirus infections), Mycoplasma hominis, and Trichomonas vaginalis with spontaneous abortion remains controversial. CONCLUSION: During pregnancy, maintaining vaginal microbiota balance, routine screening for infections of the reproductive tract, and timely execution of targeted interventions are critical for spontaneous abortion. Future research should focus on large-scale prospective studies to clarify the precise mechanisms of pathogen transmission and to optimize intervention strategies.
Association Between Cell-Free Fetal DNA and Placenta Accreta Spectrum: A Retrospective Cohort Study.
Zhang T, Li P, Liu D … +1 more , Wang S
J Obstet Gynaecol Res · 2026 Jun · PMID 42289361 · Publisher ↗
BACKGROUND: Prenatal diagnosis of placenta accreta spectrum (PAS) enables referral to specialized centers, reducing maternal and neonatal complications. However, imaging methods are not always reliable, and early studies...
BACKGROUND: Prenatal diagnosis of placenta accreta spectrum (PAS) enables referral to specialized centers, reducing maternal and neonatal complications. However, imaging methods are not always reliable, and early studies suggest maternal serum cell-free fetal DNA (cffDNA) may be elevated in PAS. OBJECTIVE: To evaluate the association between cffDNA levels derived from NIPT and PAS, and to assess its discriminative performance. METHODS: This retrospective study included 81 PAS patients who underwent noninvasive prenatal testing (NIPT) at Beijing Hospital between January 2019 and December 2023, along with 810 matched controls (1:10 ratio; total n = 891). Clinical data and cffDNA levels were collected with informed consent. PAS was diagnosed clinically and confirmed histopathologically when hysterectomy was performed. Multivariable logistic regression and restricted cubic spline (RCS) analyses were used to evaluate the association between cffDNA and PAS, with inverse probability of treatment weighting (IPTW) applied to adjust for covariate imbalance. Model discrimination was assessed using receiver operating characteristic (ROC) curves, and the incremental value of cffDNA was evaluated by comparing AUC, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). RESULTS: Elevated cffDNA levels were associated with PAS (OR = 1.98, 95% CI: 1.03-3.81). Prior cesarean delivery (OR = 2.06) and gestational diabetes (OR = 1.74) were independent risk factors. RCS analysis showed a nonlinear, J-shaped association (p = 0.0101; inflection at 0.12). cffDNA alone showed limited discrimination (AUC = 0.573). The full model improved AUC to 0.630, but removing cffDNA resulted in only a small decrease (AUC = 0.604), with no significant incremental value based on NRI and IDI. CONCLUSION: CffDNA is nonlinearly associated with PAS but has limited discriminative ability as a standalone biomarker. It may serve as an adjunct in combination with other clinical or imaging factors.
Knockdown of TSP-4 Promotes Proliferation, Migration, Glucose Uptake, and Inhibits Inflammatory Damage in Trophoblast Cell Lines Exposed to High Glucose.
Chen L, Meng D
J Obstet Gynaecol Res · 2026 Jun · PMID 42289358 · Publisher ↗
BACKGROUND: Gestational diabetes mellitus (GDM) is a common pregnancy-related condition that poses risks to both the mother and the fetus. Although dysregulated thrombospondin-4 (TSP-4) has been observed in women with GD...
BACKGROUND: Gestational diabetes mellitus (GDM) is a common pregnancy-related condition that poses risks to both the mother and the fetus. Although dysregulated thrombospondin-4 (TSP-4) has been observed in women with GDM, the precise role of TSP-4 in the pathogenesis of GDM remains unclear. This study investigates the role of TSP-4 in regulating trophoblast function under high glucose (HG) conditions. METHODS: HTR-8/SVneo cells were exposed to HG to establish an in vitro GDM model. TSP-4 expression was silenced via lentiviral transfection. The effects of TSP-4 knockdown on cell proliferation, migration, invasion, inflammation, and the PI3K/Akt/mTOR signaling pathway were assessed using Western blotting, Cell Counting Kit-8 assay, glucose uptake assay, enzyme-linked immunosorbent assay (ELISA), and Transwell assay. RESULTS: HG exposure significantly upregulated TSP-4 expression in HTR-8/SVneo cells. TSP-4 knockdown under HG conditions enhanced cell migration, invasion, proliferation, and glucose uptake. Furthermore, TSP-4 knockdown inhibited the inflammatory response in HG-treated HTR-8/SVneo cells in the HG group. Notably, TSP-4 knockdown also modulated the activation of the PI3K/Akt/mTOR signaling pathway. CONCLUSION: TSP-4 knockdown promotes proliferation, migration, glucose uptake, reduces inflammation, and regulates the expression of the PI3K/Akt/mTOR signaling pathway in trophoblast cell lines under HG conditions, suggesting a potential role for TSP-4 in the pathophysiology of GDM.
The Effect of Aerobic Combined With Resistance Exercise Intervention on Patients With Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis.
Yang F, Kang H, Wang Y … +1 more , Hu H
J Obstet Gynaecol Res · 2026 Jun · PMID 42289355 · Publisher ↗
OBJECTIVE: To evaluate the intervention effects of aerobic combined with resistance exercise in patients with gestational diabetes mellitus (GDM). METHODS: RCTs on aerobic combined with resistance exercise in GDM patient...
OBJECTIVE: To evaluate the intervention effects of aerobic combined with resistance exercise in patients with gestational diabetes mellitus (GDM). METHODS: RCTs on aerobic combined with resistance exercise in GDM patients were searched in PubMed, Embase, Web of Science, Cochrane Library, CINAHL, CBM, CNKI, Wanfang, and VIP databases from inception to March 2025. Eligible studies enrolled GDM patients, with interventions combining aerobic and resistance exercise versus routine care or routine care plus aerobic exercise. Two reviewers independently screened studies, assessed bias risk using the Cochrane tool, and extracted data. Effect sizes were calculated as SMD (continuous outcomes) or RR (dichotomous outcomes) with 95% CIs. Heterogeneity was evaluated using I and Cochran's Q, with random-effects models applied when I > 50%. Analyses were performed in Stata 18.0. RESULTS: A total of 24 studies involving 3416 GDM patients were included. Meta-analysis revealed that compared to the control group (receiving routine GDM management or aerobic exercise alone), the intervention group (aerobic combined with resistance exercise) demonstrated significant improvements in blood glucose levels, lipid profiles, maternal outcomes, and neonatal outcomes (p < 0.05), with statistically significant differences. CONCLUSION: The available evidence suggests that combined aerobic and resistance exercise is associated with enhanced glycemic control and improved lipid metabolism in patients with gestational diabetes mellitus, and the incidence of certain adverse maternal and neonatal outcomes may be reduced. However, given the substantial heterogeneity observed among the included studies, the interpretation of pooled estimates warrants caution. Further validation through additional high-quality randomized controlled trials is required to confirm these findings.
Factors Correlating With Quality of Life Among Palestinian Pregnant Women With Gestational Diabetes Attending Antenatal Care Clinics.
Khaleel R, Malak MZ, Shehadeh A … +3 more , Zaben K, Salameh B, Shawawreh R
J Obstet Gynaecol Res · 2026 Jun · PMID 42270452 · Publisher ↗
BACKGROUND: Gestational diabetes mellitus (GDM) can lead to health complications for the mother and the baby. There is a lack of studies examining this issue in Palestine. Thus, this study aimed to assess the factors cor...
BACKGROUND: Gestational diabetes mellitus (GDM) can lead to health complications for the mother and the baby. There is a lack of studies examining this issue in Palestine. Thus, this study aimed to assess the factors correlating with QOL among Palestinian pregnant women with GDM in antenatal care clinics in the West Bank. METHODS: A cross-sectional study and a convenience sample were adopted to include 141 participants attending governmental antenatal care clinics in the West Bank. Data were collected using a questionnaire that included demographic variables, medical history, and clinical variables, and the Diabetes Quality of Life Index (QLI) from July to December 2022. RESULTS: The participants' overall QOL was 18.0 out of 30 (SD = 4.2), reflecting a moderate level. The family domain of QOL was the highest (M = 23.5, SD ±4.9), and the health and functioning domain was the lowest (M = 14.5, SD = 5.1). QOL was negatively correlated with age (r = -0.180, p < 0.05), number of children (r = -0.285, p < 0.01), and FBS (r = -0.320, p < 0.01). Additionally, there was a positive correlation between QOL and level of education (p.b.r = 0.261, p < 0.01), being employed (p.b.r = -0.246, p < 0.01), exercised (p.b.r = -0.188, p < 0.05), having a previous history of GDM (p.b.r = 0.202, p < 0.05), number of pregnancies (p.b.r = -0.302, p < 0.01), and BMI (p.b.r = -0.167, p < 0.05). CONCLUSION: The results could assist policymakers and healthcare providers in designing guidelines and strategies to implement lifestyle interventions for GDM management to enhance the QOL of pregnant women with GDM.
Postoperative Reduction in Postvoid Residual Urine Volume May Be Associated With Bladder Capacity Decrease Rather Than an Increase in Tidal Voided Urine Volume in Patients With Pelvic Organ Prolapse.
Kuroda K, Miyoshi H, Hamamoto K … +4 more , Kawamura K, Masunaga A, Kobayashi H, Ito K
J Obstet Gynaecol Res · 2026 Jun · PMID 42270091 · Full text
AIM: More than half of patients with pelvic organ prolapse (POP) complain of lower urinary tract symptoms (LUTS), especially voiding difficulty. Surgical approaches such as laparoscopic sacrocolpopexy (LSC) and transvagi...
AIM: More than half of patients with pelvic organ prolapse (POP) complain of lower urinary tract symptoms (LUTS), especially voiding difficulty. Surgical approaches such as laparoscopic sacrocolpopexy (LSC) and transvaginal mesh surgery (TVM) often result in improved voiding function in POP cases. The present study primarily aimed to evaluate postoperative longitudinal changes in bladder-related parameters after POP repair rather than determine superiority between surgical techniques. METHODS: We retrospectively evaluated 216 patients with POP treated with LSC or TVM at our hospital. LSC was used for 86 patients, and TVM for 130 patients. Preoperative bladder capacity (BC), voided urine volume (VV), and post-void residual urine volume (PVR) were recorded. The International Prostate Symptom Score (IPSS), quality of life (QOL) score, and 60-min pad weight testing were also used to assess QOL change in LUTS. RESULTS: BC significantly decreased 3, 6, and 12 months after LSC, and 6, 12 months after TVM. VV significantly declined 12 months after LSC but almost did not change compared with its preoperative value. PVR, IPSS, and QOL score significantly decreased 3-12 months postoperatively in both groups. Conversely, the rate of complications after surgery did not significantly differ between both groups. Comparison of preoperative condition and 1-year postoperative outcomes showed no significant differences in PVR, 60-min pad test, and IPSS plus QOL score. CONCLUSIONS: Our findings suggest that postoperative reduction in PVR may be associated with decreased BC at strong desire to void rather than increased tidal VV.
Association of Postpartum Depression With Phenotypic Biological Aging and Aging-Related Diseases in Midlife Women.
Zhu J, Meng W, Guo J … +2 more , Zhu T, Sheng N
J Obstet Gynaecol Res · 2026 Jun · PMID 42265949 · Publisher ↗
BACKGROUND: Postpartum depression (PPD) is a common mental health condition affecting women after childbirth and has been linked to long-term health outcomes. However, it remains unclear whether PPD is associated with ac...
BACKGROUND: Postpartum depression (PPD) is a common mental health condition affecting women after childbirth and has been linked to long-term health outcomes. However, it remains unclear whether PPD is associated with accelerated aging and increased burden of aging-related diseases later in life. METHODS: We conducted a cross-sectional analysis among 38 551 parous women from the UK Biobank. Phenotypic biological aging was assessed using two aging clocks, PhenoAge and Klemera-Doubal biological age (KDMAge), derived from clinical biomarkers. Age acceleration was quantified as standardized BAGs after regressing biological age on chronological age. Aging-related disease burden was defined as the presence of at least one of 69 chronic diseases mapped to molecular hallmarks of aging. Multivariable logistic regression models were used to examine associations between PPD and phenotypic BAGs or aging-related disease phenotypes. Subgroup analyses were conducted across demographic, socioeconomic, and lifestyle factors. RESULTS: Women with a history of PPD showed modestly higher phenotypic aging measures than women without PPD. PPD was associated with higher PhenoAge BAGs and KDMAge BAGs, as well as a higher likelihood of having at least one aging-related disease. These associations were largely consistent across socioeconomic strata defined by education, employment, and Townsend Deprivation Index. Subgroup analyses demonstrated similar patterns across demographic and lifestyle factors, with limited evidence of effect modification. CONCLUSION: PPD was associated with modestly accelerated biological aging and a greater burden of aging-related diseases in later life. These findings suggest that postpartum mental health may have long-term implications for systemic aging processes and women's health trajectories.
Impact of Sarcopenia and Pretreatment Skeletal Muscle Loss on Survival in Endometrial Cancer Patients Treated With Immune Checkpoint Inhibitors.
Katayama K, Yoshikawa N, Nonoyama K … +7 more , Hattori S, Yoshida K, Yoshihara M, Tamauchi S, Yokoi A, Niimi K, Kajiyama H
J Obstet Gynaecol Res · 2026 Jun · PMID 42264544 · Full text
AIM: Sarcopenia and cancer-related muscle wasting may affect the efficacy of immune checkpoint inhibitors (ICIs). However, their prognostic significance in endometrial cancer (EC), particularly concerning skeletal muscle...
AIM: Sarcopenia and cancer-related muscle wasting may affect the efficacy of immune checkpoint inhibitors (ICIs). However, their prognostic significance in endometrial cancer (EC), particularly concerning skeletal muscle status at ICI initiation and pretreatment muscle change, remains unclear. We evaluated the impact of sarcopenia at ICI initiation and pre-ICI skeletal muscle dynamics on clinical outcomes in EC. METHODS: We retrospectively analyzed 20 EC patients treated with ICIs between May 2019 and December 2024. Skeletal muscle index (SMI) was quantified using abdominal CT at the L3 level within 2 months before ICI initiation. Sarcopenia was defined as SMI < 38.5 cm/m. Pretreatment SMI change (ΔSMI) was calculated using baseline CT before any cancer-directed therapy and CT immediately prior to ICI. Survival outcomes were assessed using Kaplan-Meier and Cox regression analyzes. RESULTS: Ten patients (50%) were sarcopenic at ICI initiation and showed a trend toward poorer progression-free survival (PFS) and overall survival (OS). Pre-treatment muscle loss occurred in two-thirds of patients. Patients with decreased SMI had significantly worse OS (HR 3.64, 95% CI 1.11-11.94). In subgroup analysis, SMI decline was frequent among sarcopenic patients but did not stratify survival. In contrast, among nonsarcopenic patients, greater SMI loss was associated with poorer survival, and each 1-unit decrease in SMI significantly worsened OS (HR 1.64, 95% CI 1.05-2.63). CONCLUSIONS: Sarcopenia at ICI initiation and pretreatment skeletal muscle loss are potential predictors of poor prognosis in EC. Evaluating baseline muscle mass and its trajectory may improve risk stratification and help identify patients at higher risk of ICI resistance.
Cerebral Venous Sinus Thrombosis Occurring During Estetrol/Drospirenone Combined Oral Contraceptive Use in a Woman With Multiple Thrombotic Risk Factors: A Case Report.
Nakahara M, Fuse A, Ito Y … +3 more , Kasahara H, Maruyama Y, Ogishima D
J Obstet Gynaecol Res · 2026 Jun · PMID 42261188 · Publisher ↗
Estetrol/drospirenone (E4/DRSP) is a combined oral contraceptive noted for its minimal hemostatic impact compared to ethinyl estradiol-based preparations. However, real-world thrombotic risk data in patients with signifi...
Estetrol/drospirenone (E4/DRSP) is a combined oral contraceptive noted for its minimal hemostatic impact compared to ethinyl estradiol-based preparations. However, real-world thrombotic risk data in patients with significant comorbidities remain limited. A woman in her early 40s with adenomyosis and menorrhagia was prescribed E4/DRSP. Six weeks later, she developed acute left upper extremity weakness; imaging confirmed superior sagittal sinus thrombosis. She had severe iron deficiency anemia (hemoglobin 6.4 g/dL). Multiple overlapping risk factors-including severe iron deficiency anemia with reactive thrombocytosis, adenomyosis, obesity, hypertension, and age over 40-likely contributed synergistically, and the independent contribution of E4/DRSP cannot be determined. She was treated with anticoagulation and transitioned to relugolix for adenomyosis management. Although E4/DRSP has a favorable coagulation profile, thrombotic risk persists in women with adenomyosis and severe anemia. Pre-prescription assessment including correction of anemia and consideration of estrogen-free alternatives is warranted.
Comparison of Robotic and Laparoscopic Approaches for Para-Aortic Lymphadenectomy in Patients With Endometrial or Ovarian Cancer.
Sasano T, Taniguchi R, Takimoto Y … +6 more , Ueda T, Wakimoto Y, Nakabayashi M, Kawaguchi R, Kitai M, Mabuchi S
J Obstet Gynaecol Res · 2026 Jun · PMID 42261125 · Publisher ↗
AIM: To compare the surgical and oncological outcomes between robotic and laparoscopic para-aortic lymphadenectomy (PALND) in Japanese women with endometrial cancer or ovarian cancer. METHODS: This retrospective study in...
AIM: To compare the surgical and oncological outcomes between robotic and laparoscopic para-aortic lymphadenectomy (PALND) in Japanese women with endometrial cancer or ovarian cancer. METHODS: This retrospective study included patients who underwent minimally invasive surgery, including PALND, between March 2018 and January 2025 at three Japanese institutions. Patients with endometrial cancer or ovarian cancer were divided into robotic and laparoscopic surgery groups. Surgical outcomes and oncological outcomes were compared between the two groups. RESULTS: A total of 60 patients were analyzed (robotic group: n = 33; laparoscopic group: n = 27). The operative time was significantly longer in the robotic group, whereas intraoperative blood loss did not differ significantly between the groups. No significant differences were observed in intraoperative or postoperative complication rates, nor in the length of hospital stay. The total number of retrieved pelvic and para-aortic lymph nodes was comparable between the two groups [70.0 (robotic group) vs. 72.5 (laparoscopic group), p = 0.480]. Furthermore, there were no significant differences in overall survival (p = 0.483) or progression-free survival (p = 0.837) between the groups. CONCLUSIONS: Robotic PALND demonstrated perioperative safety, surgical quality, and oncological outcomes comparable to those of laparoscopic PALND. These findings suggest that robotic-assisted PALND can be performed safely and effectively, with outcomes comparable to those achieved with conventional laparoscopic approaches in Japanese patients with gynecological cancers.
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