The Journal Of Obstetrics And Gynaecology Research[JOURNAL]
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200 papers
Survey to Document the Adverse Reactions After Human Papillomavirus Vaccination Among Japanese Female Youth at a University.
Higuchi C, Ogawa C, Iwasaki Y … +2 more , Hagiya H, Masuyama H
J Obstet Gynaecol Res · 2026 May · PMID 42144280 · Full text
AIM: Concerns about possible adverse events remain a critical barrier in implementing human papillomavirus (HPV) vaccination among Japanese youth. This study aimed to understand the time course of adverse events experien...
AIM: Concerns about possible adverse events remain a critical barrier in implementing human papillomavirus (HPV) vaccination among Japanese youth. This study aimed to understand the time course of adverse events experienced by HPV vaccine recipients. METHODS: An online questionnaire survey was given to students, faculty, and staff aged 18-26 years, at Okayama University Hospital, who received the HPV vaccine. The survey gathered information on the number of HPV vaccine doses received, prevaccination health conditions, adverse reactions within 2 h and between 2 h and 7 days postvaccination, menstrual irregularities after vaccination, reasons for getting vaccinated, feelings before and after vaccination, and factors providing reassurance during vaccination. Prevalence of symptoms was expressed as numbers and percentages, and analyses were performed using Chi-squared or Fisher's exact tests. RESULTS: Responses were obtained from 299 participants, yielding a 75% response rate. Approximately 60% participants reported local pain, 30% swelling, and 4% fever. Most symptoms resolved on the vaccination day itself or the following day, although some persisted for 3-7 days. Over 80% participants rated their pain between 0 and 3 on numerical rating scale of 0-10. While 60% experienced anxiety before vaccination, 90% reported no anxiety afterward. CONCLUSIONS: Our study presents one of the first comprehensive accounts of post-HPV vaccination adverse events and their time course, and underpins the importance of disseminating detailed information about vaccine-associated adverse reactions to encourage greater vaccine uptake.
Changes in Epithelial Ovarian Cancer Treatment and Advent of Maintenance Therapy From Real-World Data.
Miyamoto E, Mogi K, Yoshihara M … +8 more , Iyoshi S, Uno K, Fujimoto H, Kunishima A, Yoshikawa M, Kitami K, Yoshikawa N, Kajiyama H
J Obstet Gynaecol Res · 2026 May · PMID 42134975 · Publisher ↗
PURPOSE: Ovarian cancer is the most lethal gynecological malignancy, and chemotherapy strategies have evolved substantially over recent decades. This study aimed to evaluate whether survival outcomes of epithelial ovaria...
PURPOSE: Ovarian cancer is the most lethal gynecological malignancy, and chemotherapy strategies have evolved substantially over recent decades. This study aimed to evaluate whether survival outcomes of epithelial ovarian cancer (EOC) have improved over time and to explore trends in younger patients of reproductive age. BASIC PROCEDURES: We retrospectively analyzed real-world data from the Tokai Ovarian Tumor Study Group. A total of 2824 patients with EOC who were diagnosed between 1986 and 2019 were included. Patients were categorized into three groups according to treatment initiation: Group 1 (1986-1995), Group 2 (1996-2013), and Group 3 (2014 onward). Overall survival (OS) was assessed using the log-rank test, and stratified analyses were performed by stage and histological subtype. Subgroup analysis was conducted for patients aged ≤ 45 years. MAIN FINDINGS: Five-year OS differed significantly among the three groups (p < 0.01), demonstrating improved survival over time. Stratified analyses revealed significant benefits in advanced-stage disease and in chemotherapy-sensitive histologies such as serous and endometrioid carcinoma. Clear cell carcinoma showed modest improvement, whereas mucinous carcinoma showed no significant change. Among patients aged ≤ 45 years, five-year OS showed a trend toward improvement but did not reach statistical significance (p = 0.16). PRINCIPAL CONCLUSIONS: Survival outcomes for ovarian cancer have improved in recent decades, particularly in advanced-stage disease and chemotherapy-sensitive subtypes. Advances in systemic therapy, including the introduction of maintenance strategies, likely contributed to this improvement. Continued data accumulation is essential to clarify treatment efficacy in younger patients and to inform fertility-preserving approaches.
Gastric-Type Adenocarcinoma of the Uterine Cervix From 2013 to 2023: Clinical Characteristics and Outcomes.
Zhao J, Li Z, Qiu H … +1 more , Wang J
J Obstet Gynaecol Res · 2026 May · PMID 42134974 · Publisher ↗
AIM: To summarize our experience with gastric-type adenocarcinoma of the uterine cervix (GAS) at multiple cancer centres. METHODS: This retrospective study included patients diagnosed with GAS (from 1 June 2013 to 1 July...
AIM: To summarize our experience with gastric-type adenocarcinoma of the uterine cervix (GAS) at multiple cancer centres. METHODS: This retrospective study included patients diagnosed with GAS (from 1 June 2013 to 1 July 2023) from three collaborating institutions. Kaplan-Meier survival analysis was used to determine progression-free survival (PFS) and overall survival (OS). RESULTS: Among the 116 patients with GAS, 71 had negative human papillomavirus (HPV) genotyping results: ThinPrep cytologic test negative for intraepithelial lesion or malignancy in 45; atypical squamous cells of undetermined significance in 8; atypical squamous cells, which cannot exclude a high-grade squamous intraepithelial lesion, in 2; low-grade squamous intraepithelial lesion in 2; high-grade squamous intraepithelial lesion in 5; atypical glandular cell in 19; and adenocarcinoma in 3 patients. Most patients with GAS had advanced stage disease, with only 32.8% having stage I disease. The International Federation of Gynecology and Obstetrics stages were IB, II, III, and IV in 38, 11, 40, and 18 patients, respectively. The median PFS times for stage I and II-IV diseases were 74.9 and 61.3 months, respectively. The median OS times for patients with stage I and II-IV GAS were 109.7 and 87.6 months, respectively. The median PFS times were 74.9, 75.7, 60.3, and 12.8 months for stages I, II, III, and IV, respectively. CONCLUSIONS: GAS is an aggressive form of cervical cancer with poor OS when diagnosed at stage II or higher.
Hysteroscopic Pattern Characterization in Adenomyosis Diagnosed by MUSA 2022 Criteria: A Prospective Observational Study.
Guzelbag B, Bahat PY
J Obstet Gynaecol Res · 2026 May · PMID 42134905 · Publisher ↗
OBJECTIVE: Despite growing recognition of adenomyosis as a significant gynecological condition, standardized hysteroscopic diagnostic criteria remain lacking. This study aimed to systematically characterize endometrial h...
OBJECTIVE: Despite growing recognition of adenomyosis as a significant gynecological condition, standardized hysteroscopic diagnostic criteria remain lacking. This study aimed to systematically characterize endometrial hysteroscopic findings in ultrasonographically confirmed adenomyosis using a clinically relevant classification framework and determine their frequency and morphological patterns in symptomatic women. STUDY DESIGN: Prospective study of 40 women (18-55 years) with MUSA-confirmed adenomyosis who underwent standardized office hysteroscopy at a tertiary center (August 2022-May 2023). All procedures were video-recorded using high-definition equipment for systematic postprocedural analysis. Endometrial findings were systematically categorized into four clinically relevant domains: structural changes, vascular abnormalities, hemorrhagic manifestations, and endometriotic-like features. RESULTS: Hemorrhagic manifestations were present in all 40 patients in our cohort, with hemorrhagic spots identified in 97.5% of cases. Vascular abnormalities occurred in 97.5% of patients: hypervascularization (35.0%), marked hypervascularization (37.5%), focal hyperemia (65.0%), and diffuse hyperemia (25.0%). Structural abnormalities were identified in 92.5% of cases: irregular endometrium (37.5%), trabeculations with small surface openings (25.0%), and enlarged tubal orifices (30.0%). Endometriotic-like features were present in 67.5% of patients: strawberry pattern appearance (25.0%) and white spot lesions (42.5%). Chocolate-brown hemorrhagic lesions occurred in 17.5% of cases. Multiple morphological categories were present concurrently in 87.5% of patients. CONCLUSION: Patients with ultrasonographically confirmed adenomyosis demonstrate characteristic hysteroscopic patterns with predominantly multiple concurrent morphological abnormalities. This systematic characterization provides a standardized framework for hysteroscopic assessment and establishes the foundation for potential integration with existing imaging-based diagnostic approaches.
Congenital Pulmonary Airway Malformation Volume Ratio in Fetuses With Congenital Cystic Lung Diseases to Predict Surgery Within 7 Days of Birth.
Yanagisawa F, Kamihara Y, Shimokaze T … +6 more , Kasai M, Mochizuki K, Aoki S, Miyagi E, Nagase H, Ishikawa H
J Obstet Gynaecol Res · 2026 May · PMID 42134901 · Full text
AIM: To identify congenital pulmonary airway malformation (CPAM) volume ratio (CVR) values that can predict the need for early neonatal surgery. METHODS: We retrospectively reviewed 70 infants diagnosed with congenital c...
AIM: To identify congenital pulmonary airway malformation (CPAM) volume ratio (CVR) values that can predict the need for early neonatal surgery. METHODS: We retrospectively reviewed 70 infants diagnosed with congenital cystic lung diseases (CCLD) over the past 10 years at our center (10 with CPAM, 25 with intra- and extra-lobar bronchopulmonary sequestrations, and 35 with bronchial atresia). Perinatal features, the maximum CVR during pregnancy, and the final CVR before delivery were compared between the early surgery group (surgery within 1 week of birth) and the follow-up group (surgery after 1 week of birth or no surgery). RESULTS: Among all fetuses with CCLD, the median maximum and final CVR values were 1.2 (interquartile range [IQR]: 0.7-1.9) and 0.5 (IQR: 0.2-0.9) with a median gestational age of 26 weeks (IQR: 24-30) and 34 weeks (IQR: 32-37), respectively. Early neonatal surgery was required in nine infants (five with CPAM, one with bronchopulmonary sequestrations, and three with bronchial atresia). Compared to the follow-up groups, patients in the early surgery group had higher maximum CVR, higher final CVR, and a greater incidence of polyhydramnios. The maximum and final CVR thresholds of 1.86 and 0.9, yielded sensitivity of 78% and 78% and specificity of 80% and 85%, respectively. The areas under the curve for the maximum and final CVR values were 0.85 and 0.88, respectively. CONCLUSION: A maximum CVR threshold of 1.86 and a final CVR threshold of 0.9 may be useful indicators for predicting the need for early neonatal surgery.
Diagnostic and Prognostic Value of Platelet Indices in Placenta Accreta Spectrum.
Karabay G, Seyhanli Z, Filiz AA … +7 more , Cakır BT, Aktemur G, Tonyalı NV, Bulan DD, Bülbül K, Dagdeviren G, Cağlar AT
J Obstet Gynaecol Res · 2026 May · PMID 42120176 · Publisher ↗
AIM: Placenta accreta spectrum (PAS) is a major obstetric emergency associated with massive hemorrhage, peripartum hysterectomy, and maternal morbidity. This study aimed to evaluate the diagnostic and prognostic value of...
AIM: Placenta accreta spectrum (PAS) is a major obstetric emergency associated with massive hemorrhage, peripartum hysterectomy, and maternal morbidity. This study aimed to evaluate the diagnostic and prognostic value of platelet indices in PAS patients. METHODS: A retrospective study was conducted at Ankara Etlik City Hospital between August 2022 and August 2024. A total of 200 pregnant women were divided into three groups: PAS (n = 63), placenta previa (n = 67), and controls (n = 70). Maternal demographics, delivery outcomes, neonatal parameters, and laboratory results were analyzed. Platelet indices-platelet count, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet large cell ratio (P-LCR)-were obtained from first trimester and preoperative blood counts. Receiver operating characteristic (ROC) analysis determined predictive cut-off values. Multivariate logistic regression was performed to identify independent predictors of hysterectomy. RESULTS: First-trimester MPV < 10.45 demonstrated the highest discriminatory performance for predicting peripartum hysterectomy (AUC = 0.709, sensitivity 70.9%, specificity 71.4%). Third-trimester MPV, PDW, and P-LCR also showed moderate predictive value. First-trimester PDW > 12.75 predicted postpartum hemorrhage (AUC = 0.678), while PDW > 12.35 was associated with composite adverse neonatal outcomes (AUC = 0.597). In placenta previa patients, first-trimester PCT < 0.26 predicted PAS (AUC = 0.627). In multivariate analysis, only first-trimester MPV remained independently associated with hysterectomy (aOR 0.647, 95% CI 0.428-0.979; p = 0.040). CONCLUSIONS: Platelet indices show statistically significant but moderate associations with adverse outcomes in PAS. First-trimester MPV may serve as an early adjunctive marker in high-risk pregnancies; however, these parameters should not replace imaging modalities and require validation in prospective multicenter studies.
Preliminary Evaluation of Leuprorelin Acetate Microspheres Plus Levonorgestrel-Releasing Intrauterine System in Endometriosis: An Exploratory Study Focusing on BNIP3 and EPAC1 Expression.
Liu J, Li M, Zhang J
J Obstet Gynaecol Res · 2026 May · PMID 42120175 · Publisher ↗
AIM: This exploratory pilot study aimed to assess the preliminary clinical effects of leuprorelin acetate microspheres for injection [gonadotropin-releasing hormone agonist (GnRH-a)] combined with levonorgestrel-releasin...
AIM: This exploratory pilot study aimed to assess the preliminary clinical effects of leuprorelin acetate microspheres for injection [gonadotropin-releasing hormone agonist (GnRH-a)] combined with levonorgestrel-releasing intrauterine system (LNG-IUS) in treating endometriosis (EMs), and to examine associated changes in Bcl-2/adenovirus E1B 19 kDa interacting protein 3 (BNIP3) and exchange protein directly activated by cAMP 1 (EPAC1) messenger RNA (mRNA) expression. METHODS: A total of 120 EMs patients undergoing laparoscopic surgery between June 2020 and December 2023 were enrolled. Participants were allocated to a control group (n = 60, postoperative treatment with GnRH-a) or a combined group (n = 60, postoperative treatment with GnRH-a + LNG-IUS) using a simple alternation method as part of an exploratory allocation strategy. RESULTS: The combined group demonstrated a higher overall response rate and greater improvements in Visual Analog Scale and Kupperman scores compared with the control group (p < 0.05). After 6 months, patients receiving combined therapy exhibited lower follicle-stimulating hormone, estradiol, and progesterone levels and higher luteinizing hormone levels relative to controls (p < 0.05). Additionally, treatment was associated with decreased mRNA expression and increased BNIP3 mRNA expression in the combined group (p < 0.05). CONCLUSIONS: This exploratory pilot study suggests that postoperative GnRH-a combined with may offer enhanced symptom relief and hormonal regulation in patients with EMs, accompanied by preliminary changes in serum BNIP3 and EPAC1 mRNA expression. However, the findings are hypothesis-generating and require confirmation in future randomized controlled trials.
Autonomic Nervous Function in Pregnant and Postpartum Women Measured From Fingertip Volume Pulse Waves.
Shimabukuro M, Kotaki H, Sakuma J … +3 more , Takano M, Nagasaki S, Nakata M
J Obstet Gynaecol Res · 2026 May · PMID 42120174 · Publisher ↗
PURPOSE: To evaluate the autonomic nervous function noninvasively, quickly and simply using fingertip volume pulse waves and examine the characteristics of each pregnancy stage. METHODS: The subjects of the present study...
PURPOSE: To evaluate the autonomic nervous function noninvasively, quickly and simply using fingertip volume pulse waves and examine the characteristics of each pregnancy stage. METHODS: The subjects of the present study are pregnant women aged 20 or older who received pregnancy and delivery care at our hospital between April 2021 and October 2023. We conducted a longitudinal comparison of participants, and measurement data was acquired at least four times between the 10th week of gestation and 1 month postpartum, with intervals of 4-8 weeks. We employed Vital Monitor (Fatigue Science Laboratory Co. Ltd., Japan.) to measure fingertip volume pulse waves and analyzed heart rate variability to evaluate autonomic nervous function of normal pregnant women. RESULTS: We were able to collect and analyze data prospectively and longitudinally for 22 pregnant women. We could evaluate autonomic nerve function by photoplethysmography for 2 min using the Vital Monitor, which is simpler than those reported previously. In this study, LF/HF ratio, which reflects thesympathetic activity, was highest in late pregnancy and decreased after birth (LF/HF: group3 = 2.26, group4 = 0.94), but no significant difference was observed (p = 0.0511) (Figure 3). HF, which reflects the parasympathetic activity, declined from early to late pregnancy and recovered after birth (HF: group1 = 517 ms/Hz, group3 = 303 ms/Hz group4 = 566 ms/Hz; p = 0.006) (Figure 2). CONCLUSION: This study is the first to longitudinally analyze the characteristics of each pregnancy period using fingertip volume pulse waves. Autonomic nervous function was assessed noninvasively and simply from fingertip volume pulse waves of pregnant and postpartum women. This has potential for future applications through further development.
Scientific Perspectives on Evaluating Fetal Physical Development Around Birth: Historical Approaches and Practices in Japan.
Shinozuka N
J Obstet Gynaecol Res · 2026 May · PMID 42120173 · Full text
Fetal growth assessment has been performed using ultrasound measurements and the estimated fetal weight (EFW) derived from them. The Shinozuka formula-a rational equation based on fetal volume and specific gravity-has se...
Fetal growth assessment has been performed using ultrasound measurements and the estimated fetal weight (EFW) derived from them. The Shinozuka formula-a rational equation based on fetal volume and specific gravity-has served as the de facto standard, maintaining high accuracy across a wide range of gestational ages and independent of fetal body proportions. The reference values used to evaluate these measurements were established from a normal control survey population, representing fetuses developing under optimal conditions. As the distribution of these reference values has been confirmed to follow a normal distribution, measurements can be uniformly evaluated in relation to gestational age using standard deviations from the mean. This paper provides an overview of methods for fetal growth assessment, the theoretical basis of reference values, and the historical development and clinical application of fetal biometric evaluation in Japan.
Proposals for Improving Maternal Safety (2024 Edition): Insights From the Analysis of Maternal Deaths in Japan.
Japan Maternal Death Exploratory Committee
J Obstet Gynaecol Res · 2026 May · PMID 42120172 · Full text
The Proposals for Improving Maternal Safety (2024 Edition) were developed by the Japan Maternal Death Exploratory Committee and the Japan Association of Obstetricians and Gynecologists based on systematic reviews of 640...
The Proposals for Improving Maternal Safety (2024 Edition) were developed by the Japan Maternal Death Exploratory Committee and the Japan Association of Obstetricians and Gynecologists based on systematic reviews of 640 maternal deaths reported nationwide between 2010 and 2024. Obstetric hemorrhage remained the leading cause of maternal death, followed by intracranial hemorrhage, amniotic fluid embolism, suicide, cardiovascular disease, infection, and pulmonary disease. In 2024, maternal deaths increased sharply to 47, largely driven by a resurgence of hemorrhage-related deaths, while suicide has persistently ranked among the top causes in recent years. Detailed analysis revealed preventable system-level failures in diagnosis, timing of intervention, and interdisciplinary collaboration. Based on these findings, five key proposals are presented: (1) Immediate recognition and correction of consumptive coagulopathy in placental abruption with fetal death, emphasizing early fibrinogen measurement and replacement. (2) Prompt re-laparotomy when cesarean suture dehiscence is suspected, as balloon tamponade and arterial embolization are ineffective for structural lesions. (3) Active implementation of the Mississippi protocol for HELLP (hemolysis, elevated liver enzyme levels, and low platelet count) syndrome to prevent fatal cerebral hemorrhage. (4) Prevention of maternal suicide through regional collaboration among obstetrics, psychiatry, and administrative agencies, combined with a population-based mental health approach. (5) Appropriate and proactive intervention for hyperemesis gravidarum, recognizing its association with severe physical complications and maternal mental health deterioration. These proposals highlight urgent priorities for clinical practice, education, and system reform to reduce preventable maternal deaths in Japan.
Impact of Opioid-Free Anesthesia Combined With Enhanced Recovery After Surgery Protocol on Postoperative Recovery Quality in Patients Undergoing Laparoscopic Total Hysterectomy.
Lv Y, Li X, Liu Y … +3 more , Ren S, Shang R, Li G
J Obstet Gynaecol Res · 2026 May · PMID 42120170 · Full text
AIM: Opioid-based anesthesia in laparoscopic hysterectomy is associated with adverse effects (e.g., postoperative nausea and vomiting [PONV], ileus, cognitive impairment) that impede recovery. This study evaluates whethe...
AIM: Opioid-based anesthesia in laparoscopic hysterectomy is associated with adverse effects (e.g., postoperative nausea and vomiting [PONV], ileus, cognitive impairment) that impede recovery. This study evaluates whether opioid-free anesthesia (OFA) combined with an Enhanced Recovery After Surgery (ERAS) protocol improves postoperative recovery quality. METHODS: This retrospective cohort study included 255 patients who underwent laparoscopic total hysterectomy between February 2023 and April 2025. Patients were allocated to TOA (124 patients received traditional opioid-based anesthesia) and OFA + ERAS (131 patients received OFA combined with ERAS) groups. Outcomes included recovery times, hemodynamic stability, pain scores (Visual Analog Scale [VAS]), cognitive function (Mini-Mental State Examination [MMSE]), adverse events, sleep quality, and quality of life (QOR-15, Activities of Daily Living [ADL]). Multivariate analyses were performed to adjust for potential confounders. RESULTS: The OFA + ERAS group demonstrated significantly shorter time to awakening (p < 0.001), extubation (p < 0.001), first flatus (p < 0.001), and hospital stay (p < 0.001). Postoperative pain scores were consistently lower in the OFA + ERAS group at all time points (all p < 0.001), with a 72% reduction in the odds of tramadol use (OR = 0.28, 95% CI: 0.14-0.56, p < 0.001). The incidence of PONV (OR = 0.35, p = 0.002) and postoperative cognitive dysfunction (OR = 0.31, p = 0.008) was significantly reduced. The OFA + ERAS group also showed better hemodynamic stability during surgery and improved MMSE, sleep quality, QOR-15, and ADL scores at 48 h postoperatively (all p < 0.001). CONCLUSION: OFA combined with ERAS enhances postoperative recovery in laparoscopic total hysterectomy by reducing pain, opioid-related complications, and hospital stay while improving cognitive and functional outcomes.
Comparative Efficacy of Hysteroscopic Evacuation Versus Oral Estrogen-Progestogen Therapy (Femoston) for Retained Products of Conception After Abortion: A Prospective Comparative Study.
Gong X, Zhong H, Peng J … +4 more , Liao J, Gong S, Zhou R, Liu X
J Obstet Gynaecol Res · 2026 May · PMID 42093117 · Publisher ↗
AIM: To compare the clinical efficacy and safety of hysteroscopic evacuation and oral estrogen-progestogen therapy (Femoston) in the management of retained products of conception (RPOC) after abortion. METHODS: This pros...
AIM: To compare the clinical efficacy and safety of hysteroscopic evacuation and oral estrogen-progestogen therapy (Femoston) in the management of retained products of conception (RPOC) after abortion. METHODS: This prospective comparative study enrolled 75 women with post-abortion RPOC. Participants were allocated to treatment according to informed preference: 38 received oral Femoston therapy, and 37 underwent hysteroscopic evacuation. Outcomes included duration of vaginal bleeding, time to resumption of menstruation, endometrial thickness after menstrual cleansing, treatment success, and adverse outcomes. RESULTS: Compared with the hysteroscopy group, the Femoston group had shorter vaginal bleeding duration and earlier resumption of menstruation. Endometrial thickness after menstrual cleansing was greater in the Femoston group. The Femoston group also had a lower overall rate of recorded adverse outcomes, including infection and adhesions. Both groups showed clinical improvement in intrauterine residual tissue, while hysteroscopic evacuation achieved a numerically higher immediate clearance rate. However, oral Femoston achieved a comparable overall clinical effect without invasive intervention. CONCLUSION: Both hysteroscopic evacuation and oral Femoston showed clinical benefit in the management of post-abortion RPOC. In selected clinically stable patients, oral Femoston may be a feasible conservative alternative, associated with shorter bleeding duration, earlier resumption of menses, greater endometrial thickness after treatment, and fewer recorded adverse outcomes. These findings should be interpreted cautiously due to the non-randomized design and limited sample size, and further, larger studies with standardized safety and outcome assessment are needed.
Climate Change and Pregnant Women: Context of Education?
Matsubara S
J Obstet Gynaecol Res · 2026 May · PMID 42092749 · Publisher ↗
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A New Diagnostic Strategy for Polycystic Ovary Syndrome Combining Japanese and International Diagnostic Criteria Using Anti-Müllerian Hormone.
Noguchi H, Iwasa T, Iwase A … +7 more , Kanasaki H, Kimura F, Kugu K, Saito K, Baba T, Hara T, Matsuzaki T
J Obstet Gynaecol Res · 2026 May · PMID 42092744 · Full text
AIM: We had defined the anti-Müllerian hormone (AMH) cut-off value level 2 aligned with the Rotterdam/International Evidence-based Guideline (IEBG) for the Assessment and Management of polycystic ovary syndrome (PCOS) 20...
AIM: We had defined the anti-Müllerian hormone (AMH) cut-off value level 2 aligned with the Rotterdam/International Evidence-based Guideline (IEBG) for the Assessment and Management of polycystic ovary syndrome (PCOS) 2023 criteria. In this study, we evaluated the utility of AMH cut-off value level 2 in patients who could not be diagnosed under the Japan Society of Obstetrics and Gynecology (JSOG) 2024 criteria due to the absence of endocrinological abnormalities and estimated the utility of a new diagnostic approach combining the JSOG 2024 and the Rotterdam/IEBG 2023 criteria. METHODS: Through a nationwide survey in Japan, data were collected for 270 patients with irregular menstrual cycles and an antral follicle count of ≥ 10 to assess the new diagnostic approach. RESULTS: Of 270 patients, 213 (78.9%) met the JSOG 2024 criteria due to the presence of endocrinological abnormalities. Of the remaining 57 patients (21.1%) who did not meet the JSOG 2024 criteria, 36 (63.2%) were additionally diagnosed with PCOS under the Rotterdam/IEBG 2023 criteria by applying elevated serum AMH (level 2). Consequently, the diagnostic rate of PCOS increased by 16.9% (obese/overweight: 9.8%, non-obese/overweight: 19.7%), and the overall diagnostic rate reached 92.2%. The diagnostic rate of this new diagnostic approach was significantly higher than that of the JSOG 2024 or the Rotterdam/IEBG 2023 criteria alone. Patients additionally diagnosed by this new diagnostic approach were significantly older and had a higher prevalence of oligomenorrhea and lower prevalence of amenorrhea compared with those diagnosed under the JSOG 2024 criteria. CONCLUSION: Applying elevated serum AMH (level 2) based on the Rotterdam/IEBG 2023 criteria improved the diagnostic rate of PCOS, particularly in non-obese/overweight patients and relatively older women with milder PCOS phenotypes. This new approach is practical, complementary, and can help overcome limitations of the diagnosis of PCOS and thus expand diagnostic opportunities.
Fatal Aortic Rupture at Term Pregnancy Caused by Vascular Ehlers-Danlos Syndrome Diagnosed by Postmortem Genetic Testing Using Formalin-Fixed, Paraffin-Embedded Tissue.
Tadakawa M, Yamaguchi T, Tomita H … +6 more , Mochii N, Hamada H, Tsubata M, Kosho T, Aoki Y, Saito M
J Obstet Gynaecol Res · 2026 May · PMID 42092737 · Full text
Vascular Ehlers-Danlos syndrome (vEDS) is a life-threatening connective tissue disorder that often remains undiagnosed before pregnancy and carries a markedly high risk of maternal mortality. We report the case of a 34-y...
Vascular Ehlers-Danlos syndrome (vEDS) is a life-threatening connective tissue disorder that often remains undiagnosed before pregnancy and carries a markedly high risk of maternal mortality. We report the case of a 34-year-old pregnant woman who experienced sudden abdominal pain at 39 weeks of gestation and died shortly after delivery. Autopsy revealed an aortic rupture with histopathological findings suggestive of vEDS. Her family history included her father's sudden vascular death, and her personal history was notable for easy bruising and early-onset varicose veins. Next-generation sequencing-based postmortem genetic testing (PMGT) using formalin-fixed, paraffin-embedded liver tissue confirmed a pathogenic variant in COL3A1. This result facilitated genetic counseling for the family, allowing presymptomatic diagnosis and preventive management, including celiprolol therapy for at-risk relatives. This case underscores the value of PMGT in identifying the underlying cause of unexpected maternal death, particularly when conventional samples are unavailable.
Vitamin D and Body Mass Index/Obesity in Postmenopausal Women: A Cross-Sectional Study With Analysis of the Atherogenic Index of Plasma as a Mediator.
Lu X, Zhou Q, Mao C … +3 more , Zhou W, Deng X, Song X
J Obstet Gynaecol Res · 2026 May · PMID 42091424 · Publisher ↗
OBJECTIVE: To investigate the link between serum 25-hydroxyvitamin D [25(OH)D] and obesity in postmenopausal women, and to evaluate the potential mediating effect of the atherogenic index of plasma (AIP). METHODS: In thi...
OBJECTIVE: To investigate the link between serum 25-hydroxyvitamin D [25(OH)D] and obesity in postmenopausal women, and to evaluate the potential mediating effect of the atherogenic index of plasma (AIP). METHODS: In this cross-sectional analysis, data from 3386 postmenopausal women were extracted from the National Health and Nutrition Examination Survey (2011-2018). Participants were stratified by vitamin D status: deficient (< 50 nmol/L), insufficient (50-75 nmol/L), and sufficient (≥ 75 nmol/L). Adjusted weighted regression models assessed associations with body mass index (BMI) and obesity (BMI ≥ 30 kg/m), while mediation analysis quantified the role of AIP. RESULTS: After comprehensive covariate adjustment, a significant inverse relationship was observed between serum 25(OH)D and BMI (β = -2.36, 95% CI: -3.16, -1.55). Vitamin D deficient women exhibited a mean BMI increase of 1.98 units (95% CI: 0.96, 3.00) and an elevated odds of obesity (OR = 1.81, 95% CI: 1.30, 2.50) relative to the sufficient group. These findings were robust across demographic and clinical subgroups. Mediation analysis indicated AIP accounted for 9.53% of the association with BMI and 9.40% with obesity (both p < 0.001). CONCLUSION: This study demonstrates a significant inverse association between vitamin D status and obesity in postmenopausal women, with lipid metabolism, as reflected by AIP, partially mediating this relationship. Further longitudinal research is required to establish causality.
Examination of the Effect of Emotional Freedom Technique on Quality of Life and Symptoms in Dysmenorrhea.
Çuvadar A, Özcan H
J Obstet Gynaecol Res · 2026 May · PMID 42091422 · Publisher ↗
PURPOSE: The present study aims to evaluate the effectiveness of Emotional Freedom Techniques (EFT) in improving quality of life and alleviating symptoms among women experiencing primary dysmenorrhea. METHOD: The present...
PURPOSE: The present study aims to evaluate the effectiveness of Emotional Freedom Techniques (EFT) in improving quality of life and alleviating symptoms among women experiencing primary dysmenorrhea. METHOD: The present study is a randomized and controlled study with a pretest-posttest design. The study sample consists of a total of 65 women calculated by using the G*Power program. Data collection was conducted using a Personal Information Form, Dysmenorrhea Diagnosis Form, Menstruation Symptom Scale, and Quality of Life Scale. The experimental group received two sessions of EFT, each lasting approximately 45-60 min, aimed at reducing negative emotions and promoting positive coping with menstrual pain, while the control group was provided with dysmenorrhea awareness training and informational brochures as part of routine counseling. Statistical analyses were performed using SPSS 26 software. RESULTS: In the EFT group, there was a significant decrease in negative effects/somatic complaints originating from menstrual symptoms and mean total scores, as well as in pain due to dysmenorrhea. Negative effects/somatic complaints from menstruation and general symptoms increased with increasing pain due to dysmenorrhea. There were significant differences in the physical function quality of life parameter in the EFT group. CONCLUSION: It was determined that EFT reduces pain, alleviates symptoms, and enhances quality of life in women with dysmenorrhea symptoms. TRIAL REGISTRATION: Clinicaltrials.gov identifier: NCT06129279.
Affective Temperament Traits as Predictors of Menopausal Symptom Severity in the Late Menopausal Transition and Early Postmenopause.
Hayırlıoğlu N, İlhan C
J Obstet Gynaecol Res · 2026 May · PMID 42091421 · Publisher ↗
AIM: This study examined the role of affective temperament traits as stable psychological vulnerability factors for menopausal symptom severity during the late menopausal transition and early postmenopause. METHODS: A to...
AIM: This study examined the role of affective temperament traits as stable psychological vulnerability factors for menopausal symptom severity during the late menopausal transition and early postmenopause. METHODS: A total of 105 women aged 40-55 years meeting STRAW+10 criteria for stages -1, +1a, or +1b were included. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS), and affective temperaments were evaluated with the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A). Correlation analyses and multivariable linear regression models were used to identify independent predictors of menopausal symptom severity. RESULTS: Mean MRS total score was 18.37 ± 8.65, and 59.0% of participants reported severe symptoms. Anxious temperament showed the strongest correlations with somatic (r = 0.470), psychological (r = 0.574), urogenital (r = 0.300), and total MRS scores (r = 0.570; all p < 0.01). In multivariable analyses, anxious temperament independently predicted somatic, psychological, and total symptom scores, while irritable temperament independently predicted urogenital symptoms. CONCLUSIONS: Anxious and irritable affective temperaments are significant independent predictors of menopausal symptom severity. Assessing temperament profiles may help identify women at increased risk for heightened symptom perception and support individualized counseling during the menopausal transition. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06972290.
Histone Deacetylase 10 Inhibitors Suppress Progression of Endometriosis via Activation of Interferon Regulatory Factor 6 and Dachshund Homolog 1.
Aso S, Kurogi S, Kubo S … +5 more , Hijiya N, Aoyagi Y, Kai K, Kobayashi E, Nasu K
J Obstet Gynaecol Res · 2026 May · PMID 42091420 · Publisher ↗
AIM: To investigate the mechanisms of histone deacetylase (HDAC) 10 inhibitors (HDAC10Is) action in endometriosis and the target molecules of HDAC10Is. METHODS: We assessed the effects of HDAC10Is, tucidinostat and TH34,...
AIM: To investigate the mechanisms of histone deacetylase (HDAC) 10 inhibitors (HDAC10Is) action in endometriosis and the target molecules of HDAC10Is. METHODS: We assessed the effects of HDAC10Is, tucidinostat and TH34, on the proliferation and the cell cycle in human endometriotic cyst stromal cells (ECSCs). Target genes of HDAC10 were identified by RNA sequencing. We assessed the expression of dachshund homolog 1 (DACH1) and interferon regulatory factor 6 (IRF6) mRNA in ECSCs and normal endometrial stromal cells. The functions of DACH1 and IRF6 were confirmed by compulsory expression of these genes in ECSCs using lentivirus. Effects of tucidinostat and TH34 on the promoter acetylation of the DACH1 and IRF6 genes in ECSCs were assessed by chromatin immunoprecipitation assays. RESULTS: Both HDAC10Is had an inhibitory effect on the proliferation of ECSCs and caused them to enter cell cycle arrest at G0/G1. DACH1 and IRF6 were identified as the target genes of HDAC10. HDAC10Is caused acetylated histones to accumulate in the promoters of the genes encoding DACH1 and IRF6 in ECSCs. CONCLUSIONS: These findings indicate that HDAC10 is a factor which contributes to endometriosis pathogenesis by inhibiting DACH1 and IRF6 expression, and that HDAC10Is are therefore promising agents for endometriosis treatment.
Correction to "Evaluation of Urine Nephrin:Creatine Ratio Longitudinally in Pregnancy for the Detection of Preeclampsia and Kidney Damage in Women With Pre-Existing Diabetes".
J Obstet Gynaecol Res · 2026 May · PMID 42091252 · Publisher ↗
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