Xiang G, Liu X, Zhang Y
… +5 more, Liu T, Wen Q, He Q, Ma X, Wen Y
J Obstet Gynaecol Res
· 2026 Jun · PMID 42261070
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Congenital sodium diarrhea (CSD) is a rare inherited enteropathy. We report a case of non-syndromic CSD (non-sCSD) diagnosed prenatally. Serial ultrasounds from 22 weeks and 5 days to 28 weeks and 6 days revealed progres...Congenital sodium diarrhea (CSD) is a rare inherited enteropathy. We report a case of non-syndromic CSD (non-sCSD) diagnosed prenatally. Serial ultrasounds from 22 weeks and 5 days to 28 weeks and 6 days revealed progressive rectal dilation (0.80-1.86 cm), rectal hyperperistalsis, evolving small bowel dilation with a "honeycomb" pattern and polyhydramnios. Projectile meconium expulsion at 28 weeks and 6 days confirmed intrauterine diarrhea. Whole-exome sequencing (WES) on amniotic fluid identified compound heterozygous pathogenic variants in the SLC9A3 gene, confirming the diagnosis. To our knowledge, this is the first antenatally diagnosed and genetically confirmed case of SLC9A3-related non-sCSD. This case demonstrates that the integration of serial prenatal ultrasonography, specifically tracking progressive rectal dilation and hyperperistalsis, with WES may enable the early antenatal diagnosis of SLC9A3-related non-sCSD. This approach provides critical information for prognosis, perinatal management, and family genetic counseling.
Mitoma T, Sakata S, Suemori A
… +3 more, Ooba H, Hayata K, Maki J
J Obstet Gynaecol Res
· 2026 Jun · PMID 42244252
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AIM: To assess the utility of intraoperative transvaginal ultrasonography (TVUS) in evaluating the duration of blood flow in cervical hypervascularity as a real time diagnostic marker for placenta accreta spectrum (PAS)...AIM: To assess the utility of intraoperative transvaginal ultrasonography (TVUS) in evaluating the duration of blood flow in cervical hypervascularity as a real time diagnostic marker for placenta accreta spectrum (PAS) in placenta previa. METHODS: This single-center historical cohort study included patients with placenta previa with intraoperative TVUS. The primary outcome was blood flow persistence time, defined as the interval from fetal delivery to disappearance of low-velocity (≤ 2.0 cm/s) color Doppler signals in cervical hypervascularity. Two obstetricians independently reviewed surgical video recordings. Receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance of flow persistence time for predicting PAS. The AUC was calculated to assess discrimination. Optimal cutoffs were based on sensitivity and specificity. Independent predictors of PAS were identified by multivariate regression. RESULTS: PAS was diagnosed in 20 cases (38.5%). Flow persistence time was significantly longer in PAS cases (20.20 ± 14.31 min) than in non-PAS cases (5.69 ± 2.46 min). A cut-off of 7 min achieved 100% sensitivity and 72% specificity (AUC = 0.94), reliably excluding PAS when flow ceased within this period. A threshold of ≥ 14 min yielded 100% positive predictive value for PAS and 96% specificity for predicting hysterectomy. Flow duration remained an independent predictor in multivariable analysis (AUC = 0.95). CONCLUSIONS: Intraoperative assessment of cervical hypervascularity blood flow duration using TVUS may serve as a supportive indicator when PAS is suspected. A flow duration of < 7 min may help rule out PAS, while ≥ 14 min may suggest its presence and guide safer intraoperative management.
Nakajima K, Nagamatsu T, Tanaka H
… +6 more, Matsunaga S, Makino S, Itoh H, Kudo Y, Itakura A, Perinatal committee of the Japanese Society of Obstetrics and Gynecology
J Obstet Gynaecol Res
· 2026 Jun · PMID 42244119
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OBJECTIVE: To evaluate utilization patterns, safety, and delivery outcomes associated with the recently introduced dinoprostone vaginal insert in Japan using multicenter real-world data. METHODS: This two-stage nationwid...OBJECTIVE: To evaluate utilization patterns, safety, and delivery outcomes associated with the recently introduced dinoprostone vaginal insert in Japan using multicenter real-world data. METHODS: This two-stage nationwide survey targeted training institutions certified by the Japan Society of Obstetrics and Gynecology. An online questionnaire was sent to 690 institutions to identify facilities eligible for secondary data collection. Participating institutions submitted clinical information for up to 25 consecutive cases in which labor was induced with the insert between January and December 2021. Patient characteristics, insert use, delivery outcomes, and adverse events were summarized. In nulliparas, two subgroup comparisons were conducted: (1) those achieving cervical ripening with the insert alone (P) versus those requiring subsequent mechanical ripening (P to M), and (2) those receiving mechanical ripening before the insert (M to P) versus those receiving the insert first (P to M). RESULTS: Of 973 registered cases from 69 institutions, 947 were eligible for analysis. Nulliparous women accounted for 74.8%. The cesarean section rate was 30.7% overall (36.3% in nulliparas; 14.2% in multiparas). Median time from insert initiation to delivery was 31.6 h. Uterine tachysystole occurred in 18.1% and fetal heart rate abnormalities in 15.8%, but timely management prevented serious outcomes. In subgroup analyses, nulliparas ripened with the insert alone demonstrated shorter induction-to-delivery intervals, lower cesarean and oxytocin-use rates, but more tachysystole. Among cases requiring both methods, the order of ripening techniques did not affect vaginal delivery success. CONCLUSION: This first multicenter real-world evaluation demonstrates that the insert is effective and generally safe for cervical ripening and labor induction in Japan.
Tsakır B, Alkan Bülbül G, Ayan Avcı E
… +2 more, Sayal HB, Yavuz A
J Obstet Gynaecol Res
· 2026 Jun · PMID 42237718
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AIM: Although preoperative systemic inflammatory markers have been linked to cerclage outcomes, the prognostic value of postoperative measurements and their dynamic changes remains unclear. We aimed to evaluate postopera...AIM: Although preoperative systemic inflammatory markers have been linked to cerclage outcomes, the prognostic value of postoperative measurements and their dynamic changes remains unclear. We aimed to evaluate postoperative inflammatory markers and their dynamic changes as predictors of outcomes in women with prolapsed membranes undergoing emergency cerclage. METHODS: This single-center retrospective cohort study included 34 singleton pregnancies with prolapsed membranes treated with emergency McDonald cerclage. Neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) were measured preoperatively and 48-72 h postoperatively; Δ values were calculated. The primary outcome was cerclage failure (delivery < 28 weeks). RESULTS: Postoperative inflammatory markers were significantly higher in the failure group, while preoperative and Δ values showed only non-significant trends. Postoperative NLR demonstrated good predictive performance (AUC = 0.825; cutoff ≥ 5.78; sensitivity 80.0%, specificity 84.2%) and correlated negatively with pregnancy prolongation (ρ = -0.561, p < 0.001), birth weight, and gestational age at delivery. CONCLUSION: Postoperative NLR is a promising and accessible predictor of cerclage failure that may enhance risk stratification and support individualized management in women with prolapsed membranes. Larger prospective studies are needed for validation.
J Obstet Gynaecol Res
· 2026 Jun · PMID 42233456
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BACKGROUND: We aimed to evaluate whether hesperidin has a therapeutic role in a uterine scar model created by performing a full-thickness incision on the rat uterus. MATERIALS: Twenty-eight female Wistar albino rats were...BACKGROUND: We aimed to evaluate whether hesperidin has a therapeutic role in a uterine scar model created by performing a full-thickness incision on the rat uterus. MATERIALS: Twenty-eight female Wistar albino rats were divided into four groups. A uterine scar model was created in the scar groups, and hesperidin was administered to the hesperidin groups for 30 days. Four rats from each group were sacrificed, left horns were used for histopathological evaluation (H&E, Masson, TGF-Beta, alpha-SMA), and the right horns were used for biochemical assessment (MDA, SOD, GSH). The remaining rats were mated and subjected to a fertility test. RESULTS: In the histopathological evaluation, similar findings were observed in the control and hesperidin groups. Compared with the scar group, the treatment group showed reduced inflammation, decreased collagen deposition, and increased angiogenesis (p < 0.05). Collagen accumulation detected by Masson staining was highest in the scar group, and the highest alpha-SMA immunostaining score was also observed in the scar group. In the biochemical analysis, the treatment group exhibited lower MDA levels and higher SOD and GSH levels compared with the scar group. In the fertility test, the lowest pregnancy rate was found in the scar group, while the other groups showed similar averages. CONCLUSIONS: Our study demonstrated that hesperidin may prevent uterine scar formation and contribute to the management of postoperative complications. The hesperidin reflected antifibrotic effects and the prevention of collagen accumulation. Additionally, this study is the first in the literature to investigate the in vivo effects of hesperidin on uterine scar formation.
Igasaki M, Furusawa A, Kunishi M
… +7 more, Misaka S, Kamiya N, Kawamura A, Kado N, Mochizuki A, Takahashi N, Takekuma M
J Obstet Gynaecol Res
· 2026 Jun · PMID 42225860
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AIM: This study aimed to evaluate the efficacy of local treatment in patients with sporadic recurrent endometrial cancer. METHODS: We retrospectively reviewed patients who received treatment for first recurrence of endom...AIM: This study aimed to evaluate the efficacy of local treatment in patients with sporadic recurrent endometrial cancer. METHODS: We retrospectively reviewed patients who received treatment for first recurrence of endometrial cancer at our institution between 2012 and 2024. Sporadic recurrence was defined as the presence of up to three metastatic lesions within any single organ, with no more than five total lesions, excluding vaginal cuff recurrence. Patient characteristics, recurrence patterns, and clinical outcomes, including progression-free survival (PFS) and overall survival (OS), were compared between patients receiving local and systemic treatment. RESULTS: A total of 67 patients met the eligibility criteria, of whom 37 received local treatment and 30 received systemic treatment. The baseline characteristics did not differ significantly between the two groups. All 11 patients with recurrent lesions involving the two anatomical regions were treated systemically. In the analysis restricted to single-region recurrences, 37 and 19 patients were included in the local and systemic treatment groups, respectively. In the single-region cohort, local treatment was associated with significantly improved progression-free survival (PFS) in Kaplan-Meier analysis (3-year PFS: 53.7% vs. 15.8%, p = 0.007) and univariate analysis (HR 0.40, p = 0.011), although this was not significant in multivariable analysis (HR 0.50, p = 0.063). No significant difference in overall survival was observed. Patients with shorter treatment-free intervals trended to have poorer outcomes. CONCLUSIONS: Local treatment may provide a clinical benefit in selected patients with sporadic recurrent endometrial cancer confined to a single region, excluding those with vaginal cuff recurrence. However, this benefit may be influenced by patient selection. Further prospective studies are warranted.
Aytekin AM, Ulusoy HE, Efe MA
… +2 more, Yasa C, Buyukoren A
J Obstet Gynaecol Res
· 2026 Jun · PMID 42225434
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OBJECTIVE: To evaluate the impact of bilateral salpingectomy added to hysterectomy performed via different surgical routes on ovarian reserve, ovarian stromal blood flow, and sexual function in premenopausal women. METHO...OBJECTIVE: To evaluate the impact of bilateral salpingectomy added to hysterectomy performed via different surgical routes on ovarian reserve, ovarian stromal blood flow, and sexual function in premenopausal women. METHODS: This prospective longitudinal cohort study included premenopausal women undergoing hysterectomy with bilateral salpingectomy for benign gynecologic indications. Patients were categorized according to surgical approach as laparoscopic hysterectomy (L/S) or abdominal hysterectomy (L/T). Ovarian reserve was assessed using serum anti-Müllerian hormone (AMH) levels preoperatively and at postoperative months 1 and 3. Ovarian stromal blood flow was evaluated bilaterally using color Doppler ultrasonography. Sexual function was assessed using the Female Sexual Function Index (FSFI) preoperatively and at postoperative month 3. RESULTS: A total of 46 patients were included (26 L/S, 20 L/T). In the L/S group, AMH levels showed no significant change at postoperative months 1 or 3. In the L/T group, a significant decline in AMH was observed at postoperative month 1 (p = 0.043), which was not sustained at month 3. No significant between-group differences were observed in AMH changes. Transient alterations in ovarian Doppler indices were observed, with no persistent differences. FSFI scores improved significantly in both groups, with no differences between surgical approaches. CONCLUSION: Opportunistic salpingectomy during hysterectomy does not adversely affect ovarian reserve, ovarian stromal blood flow, or sexual function, regardless of surgical route, supporting its safety in premenopausal women.
Zhou L, Zhang YJ, Zhang XZ
… +2 more, Liu XY, Li CG
J Obstet Gynaecol Res
· 2026 Jun · PMID 42210618
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OBJECTIVE: To investigate the effects of irisin on the Wnt/β-catenin signaling pathway in the endometrium of obese rats. METHODS: Seventy-two female Sprague Dawley rats of 5 weeks old were randomly divided into the norma...OBJECTIVE: To investigate the effects of irisin on the Wnt/β-catenin signaling pathway in the endometrium of obese rats. METHODS: Seventy-two female Sprague Dawley rats of 5 weeks old were randomly divided into the normal group (n = 24) and obese group (n = 48). The obese group was fed a high-fat diet, while the normal group was fed a conventional diet. After successful modeling, obese rats were randomly divided into the model group (n = 24) and irisin group (n = 24). The irisin group was given an intraperitoneal injection of recombinant irisin every day, while the model group and the normal group were intraperitoneally injected with an equal volume of normal saline. Then, female rats in estrus were mated with male rats. Twelve rats were sacrificed in each group on Day 5 and day 10 of pregnancy. The pregnancy rate, average number of blastocysts, histological and morphological changes were observed; the expression of Leukemia Inhibitory Factor (LIF), integrin αvβ3, Wnt4, and β-catenin in the uterus of rats was detected. RESULTS: Compared with the normal group, levels of pregnancy rate, average number of blastocyst, LIF, integrin αvβ3, Wnt4, and β-catenin in the endometrium of the model group rats were significantly decreased. After irisin intervention, compared with the model group, levels of pregnancy rate, average number of blastocyst, LIF, integrin αvβ3, Wnt4, and β-catenin in the endometrium of the irisin group were significantly increased. CONCLUSION: Irisin may improve endometrial receptivity in obese rats, potentially involving the regulation of the Wnt/β-catenin signaling pathway.
Mutola S, Nonde S, Mwamba M
… +4 more, Ng N, Menda DM, Louis VR, Michael LW
J Obstet Gynaecol Res
· 2026 Jun · PMID 42209438
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BACKGROUND: Obstetric fistula remains an understudied severe maternal health outcome in Zambia. This study examines the socioeconomic, reproductive, and healthcare access factors associated with obstetric fistula among w...BACKGROUND: Obstetric fistula remains an understudied severe maternal health outcome in Zambia. This study examines the socioeconomic, reproductive, and healthcare access factors associated with obstetric fistula among women in Zambia. METHODS: We conducted a cross-sectional analysis of 10 296 women using data from the 2018 Zambia Demographic and Health Survey (ZDHS). The outcome variable was self-reported lifetime experience of continuous leakage of urine or stool from the vagina. Survey-weighted proportions were used to describe the prevalence and distribution of obstetric fistula. Associations were assessed using Firth logistic and survey-weighted regression in both unadjusted and adjusted models, accounting for the rarity of the outcome and the complex sampling design, respectively. RESULTS: The weighted prevalence of obstetric fistula was 0.24%. Among the 32 women who reported a history of obstetric fistula, 77% (n = 24) initiated sexual activity between the ages of 15 and 19. Women who were no longer in union had higher odds of reporting a history of obstetric fistula in both the Firth model (AOR: 4.81; 95% CI: 1.80-12.86) and survey-weighted model (AOR: 3.55; 95% CI: 1.25-10.05). Similarly, women in polygynous unions had higher odds of reporting a history of obstetric fistula (Firth AOR: 4.82; 95% CI: 1.58-14.69, survey-weighted AOR: 5.65; 95% CI: 2.50-12.76). Women in the poor wealth group showed higher odds only in the survey-weighted model (AOR: 9.38; 95% CI: 1.63-54.16). Finally, women with no antenatal care had higher odds of reporting obstetric fistula than those with four or more visits in the Firth model (AOR: 5.62; 95% CI: 1.29-24.42), but this association was not present in the survey-weighted model. CONCLUSION: The findings suggest that marital structure, low socioeconomic status, and the lack of antenatal care are important underlying factors that may be associated with experiencing obstetric fistula in Zambia. Therefore, improving access to antenatal care and addressing women's social and structural vulnerabilities may contribute to reducing the burden of obstetric fistula.
Shimizu F, Arakaki T, Takita H
… +4 more, Yamashita Y, Kaneko M, Matsuoka R, Sekizawa A
J Obstet Gynaecol Res
· 2026 Jun · PMID 42209248
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AIM: To examine the association between third-stage duration and total blood loss in women with retained placenta. Secondary analyses were performed to explore clinical factors associated with postpartum hemorrhage (PPH)...AIM: To examine the association between third-stage duration and total blood loss in women with retained placenta. Secondary analyses were performed to explore clinical factors associated with postpartum hemorrhage (PPH). METHODS: This retrospective cohort study included women with singleton vaginal deliveries at ≥ 22 gestational weeks between 2019 and 2024 complicated by retained placenta. The association between third-stage duration and total blood loss was assessed using Spearman's correlation. Multivariable logistic regression analysis was used to explore factors associated with PPH. Blood loss and third-stage duration were descriptively compared between cases with and without manual removal of the placenta (MROP). RESULTS: Among 4543 vaginal deliveries, 47 (1.0%) cases of retained placenta were identified, of which 27 (57.4%) developed PPH. Total blood loss positively correlated with third-stage duration (Spearman's ρ = 0.488, p < 0.001). In exploratory multivariable analysis, assisted reproductive technology (ART) pregnancy (adjusted odds ratio [aOR], 18.50; 95% confidence interval [CI], 3.28-104.0) and third-stage duration (per 30 min: aOR, 1.86; 95% CI, 1.10-3.16) were associated with PPH, although the estimates were imprecise. MROP was performed in 32 patients (68.1%) at physician discretion. Third-stage duration did not differ between groups, but greater blood loss was observed in cases in which MROP was performed. CONCLUSION: Prolonged third-stage duration was associated with greater blood loss in women with retained placenta and may reflect the overall clinical course rather than an isolated causal factor. ART pregnancy was also associated with PPH.
Takeda T, Isobe M, Nagamatsu T
… +3 more, Nakashma A, Saito M, Yotsumoto F
J Obstet Gynaecol Res
· 2026 May · PMID 42178191
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BACKGROUND: Although female-specific conditions are frequently encountered in general clinical practice, nonspecialist physicians may have limited preparedness to manage these conditions. Therefore, Kampo medicine may be...BACKGROUND: Although female-specific conditions are frequently encountered in general clinical practice, nonspecialist physicians may have limited preparedness to manage these conditions. Therefore, Kampo medicine may be a practical therapeutic option in these settings. AIM: To identify Kampo formulas that are considered essential for general clinicians managing female-specific conditions through a nationwide survey of obstetricians and gynecologists (OB/GYNs) in Japan. METHODS: An anonymous web-based questionnaire was administered among members of the Obstetrics and Gynecology Kampo Research Group between May and September 2025. The respondents selected up to eight Kampo formulas that were considered essential. Recommendation frequencies were analyzed, and the eight most frequently recommended formulas were defined as essential Kampo formulas. Associations with physician characteristics were examined using logistic regression and correspondence analyses. RESULTS: Thirty Kampo formulas were used. The recommendation frequencies showed a nonuniform distribution, with endorsements concentrated among a limited number of formulas. Eight formulas, Kamishoyosan, Keishibukuryogan, Tokishakuyakusan, Goreisan, Yokukansan, Hangekobokuto, Hochuekkito, and Kamikihito, were identified as essential. Recommendation patterns were consistent across physicians' backgrounds, although minor differences were observed according to sex and clinical experience. CONCLUSIONS: A core set of Kampo formulas commonly recommended by OB/GYNs was identified, providing a practical foundation for clinical education and the implementation of Kampo medicine by general clinicians managing female-specific conditions.
J Obstet Gynaecol Res
· 2026 May · PMID 42163016
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AIM: This study examines the associations of human papillomavirus awareness, HPV-related concern, and fear of cancer with women's attitudes toward preventing cervical cancer (CC). METHOD: This cross-sectional, correlatio...AIM: This study examines the associations of human papillomavirus awareness, HPV-related concern, and fear of cancer with women's attitudes toward preventing cervical cancer (CC). METHOD: This cross-sectional, correlational study was conducted with women aged 18-65 years who attended a community health center in a province in northwestern Türkiye. Participants were recruited from women presenting to the Bartın Community Health Center for various health services (e.g., examination, screening, or accompaniment). The study was completed with 640 women who met the inclusion criteria. Data were collected using the "Descriptive Information Form," the "Human Papillomavirus Awareness and Concern Scale (HPV-ACS)," the "Fear of Cancer Scale (FCS)," and the "Attitude Scale for Protection From Cervical Cancer (ASPFCC)." RESULTS: HPV-ACS, FCS, and ASPFCC scores were significantly associated with women's sociodemographic characteristics (p < 0.05). When factors associated with ASPFCC were examined, the independent variables explained 11% of the variance in attitudes toward preventing CC. Women's attitudes toward preventing CC were significantly associated with age (B = 0.440, p < 0.001), HPV-ACS scores (B = 0.294, p < 0.001), and fear of cancer (B = 0.228, p < 0.001). CONCLUSION: In this study, women's HPV awareness and HPV-related concern levels and their attitudes toward preventing CC were high, while fear of cancer was at a moderate level. Higher HPV awareness, HPV-related concern, and fear of cancer were associated with more positive attitudes toward preventing CC.
J Obstet Gynaecol Res
· 2026 May · PMID 42157683
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AIM: Embryo selection in assisted reproduction is pivotal for optimizing pregnancy outcomes. While Day 5 blastocysts are generally preferred due to earlier development, the clinical efficacy of high-quality Day 6 embryos...AIM: Embryo selection in assisted reproduction is pivotal for optimizing pregnancy outcomes. While Day 5 blastocysts are generally preferred due to earlier development, the clinical efficacy of high-quality Day 6 embryos remains debatable, particularly concerning aneuploidy risk and pregnancy loss. This study aims to compare chromosomal euploidy rates and clinical outcomes between Day 5 blastocysts and Day 6 blastocysts after preimplantation genetic testing for aneuploidy (PGT-A). METHODS: This retrospective cohort study included 349 frozen embryo transfer cycles (Day 5: n = 165, Day 6: n = 184). All embryos underwent PGT-A using next-generation sequencing. Clinical outcomes, fetal loss, and ploidy status were assessed. Logistic regression identified predictors of fetal loss and aneuploidy. RESULTS: No significant difference in overall aneuploidy rates was observed between Day 5 and Day 6 embryos (47.9% vs. 48.9%, p = 0.847). However, early fetal loss (< 12 weeks) was higher among Day 6 embryos (26.6% vs. 17.6%, p = 0.043). Regression analysis revealed Day 6 transfer was associated with increased odds of fetal loss (OR = 1.707, p = 0.045), while greater blastocyst expansion and secondary infertility were protective. Higher FSH levels and inner cell mass (ICM) Grade B were significant predictors of aneuploidy. CONCLUSION: Top-quality Day 6 embryos demonstrate similar aneuploidy rates to Day 5 embryos but are associated with higher early pregnancy loss. Morphological grading and hormonal markers remain essential adjuncts in embryo selection post-PGT-A.
Masaoka S, Takeda J, Toride A
… +5 more, Yokoyama M, Koiwa C, Ito M, Negishi T, Itakura A
J Obstet Gynaecol Res
· 2026 May · PMID 42157348
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OBJECTIVES: Non-rotational forceps delivery (NRFD) has a possibility of ophthalmic complications when applied in cases with an oblique sagittal suture. To overcome this and improve the success rate of forceps delivery, w...OBJECTIVES: Non-rotational forceps delivery (NRFD) has a possibility of ophthalmic complications when applied in cases with an oblique sagittal suture. To overcome this and improve the success rate of forceps delivery, we have introduced Kielland rotational forceps delivery (KRFD) since 2016; however, reports about the ophthalmic complications of KRFD are limited. Here, we aimed to investigate the safety and availability of KRFD compared to NRFD. METHODS: We collected forceps delivery from April 2016 to August 2023, excluding cases using both forceps or ending in cesarean section. Cases were classified as NRFD or KRFD. The rate of ophthalmic complications, such as injuries in the cornea, anterior chamber, sclera, conjunctiva, and retina, was set as a primary outcome. RESULTS: We analyzed 1924 NRFD cases and 144 KRFD cases. Complications in the cornea, anterior chamber, or sclera were observed only on the ipsilateral side as the forceps marks on the orbit in NRFD (3.1%). Conjunctival complications were observed only in NRFD but on both sides (ipsilateral 5.1%, contralateral 1.8%). Retinal complications were observed in both NRFD and KRFD but were less frequent in KRFD (NRFD: ipsilateral 9.8%, contralateral 11.2%; KRFD: ipsilateral 0%, contralateral 23.1%). The rate of ophthalmological consultation did not differ significantly between groups. CONCLUSIONS: KRFD reduced all types of ophthalmic complications compared to NRFD, suggesting that the traction force required during forceps delivery might be reduced when fetal malposition was corrected in KRFD. Proper use of Kielland rotational forceps with good practice would be a more valuable option to achieve safer delivery.
Kitamura K, Colli E, Kikuyama R
… +3 more, Kurihara Y, Azuma R, Kagawa T
J Obstet Gynaecol Res
· 2026 May · PMID 42152782
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AIM: We conducted a 24-cycle study to evaluate long-term safety of 4 mg of drospirenone (DRSP), a progestin-only pill (POP), for contraception in Japanese women. METHODS: A multicenter, single-arm 24-cycle study was cond...AIM: We conducted a 24-cycle study to evaluate long-term safety of 4 mg of drospirenone (DRSP), a progestin-only pill (POP), for contraception in Japanese women. METHODS: A multicenter, single-arm 24-cycle study was conducted in women who participated in the 13 cycle study of DRSP. In each cycle, 4 mg of DRSP tablet was administered orally once daily for 24 consecutive days, followed by a placebo tablet for 4 days. RESULTS: In this 24-cycle study, the total number of DRSP exposure cycles was 3878. Fifty-two subjects (100.0%) experienced treatment-emergent adverse events (TEAEs), and 50 (96.2%) experienced adverse drug reactions. All TEAEs were mild or moderate with no severe events. The most common TEAE was intermenstrual bleeding, which occurred in 49 (94.2%) subjects. Although 50.0% of the subjects had risk factors for venous thromboembolism (VTE), no VTE-related TEAEs were observed. No TEAEs led to discontinuation of the study. During 3878 exposure cycles, pregnancy occurred in one subject. The overall Pearl index [95% CI] was 0.34 [0.01, 1.87], and the cumulative pregnancy rate was 0.4%. CONCLUSIONS: In this study, the safety of DRSP, the first POP in Japan, was evaluated in Japanese women for 24 cycles. The DRSP-only pill provides a new option for contraception for Japanese women, including those at risk of developing VTE.
Wakana K, Akita M, Tsubata F
… +3 more, Kori Y, Odai T, Miyasaka N
J Obstet Gynaecol Res
· 2026 May · PMID 42152606
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Cervical large-cell neuroendocrine carcinoma (LCNEC) is a rare and highly aggressive malignancy with poor prognoses, particularly in advanced or recurrent disease. We describe a case of advanced and recurrent cervical LC...Cervical large-cell neuroendocrine carcinoma (LCNEC) is a rare and highly aggressive malignancy with poor prognoses, particularly in advanced or recurrent disease. We describe a case of advanced and recurrent cervical LCNEC in which long-term disease-free survival was achieved following a systemic-first, sequential multimodal treatment strategy. A 41-year-old woman presented with abnormal vaginal bleeding and was diagnosed with cervical LCNEC with pelvic and para-aortic lymph node metastases. Neoadjuvant irinotecan-cisplatin chemotherapy resulted in marked tumor regression, enabling radical hysterectomy. Postoperative therapy consisted of etoposide-cisplatin chemotherapy, followed by pelvic and para-aortic radiotherapy. Mediastinal lymph node recurrence developed 3 years later and was successfully treated using the same chemotherapy regimen combined with site-directed radiotherapy, resulting in complete remission. The patient remained disease-free 9 years after the final treatment completion. This case suggests that carefully sequenced systemic chemotherapy, surgery, and radiotherapy integration may provide durable disease control in selected patients with advanced or recurrent cervical LCNEC.