The Journal Of Obstetrics And Gynaecology Research[JOURNAL]
Sun
200 papers
The Effects of Pilates-Based Tele-Exercise on Physical and Mental Health in Primary Dysmenorrhea.
Dereli M, Atici E, Azim D
J Obstet Gynaecol Res · 2026 May · PMID 42091251 · Publisher ↗
PURPOSE: This study aimed to evaluate the effects of Pilates-based tele-exercise (PBTE) on physical and mental health in women diagnosed with primary dysmenorrhea. METHODS: The study included 22 volunteers diagnosed with...
PURPOSE: This study aimed to evaluate the effects of Pilates-based tele-exercise (PBTE) on physical and mental health in women diagnosed with primary dysmenorrhea. METHODS: The study included 22 volunteers diagnosed with primary dysmenorrhea, who were randomly assigned to two groups. The intervention group (PBTE, n = 11) participated in Pilates-based tele-exercises for 6 weeks, twice a week, with 50-min sessions. The control group (CG, n = 11) received no intervention. Menstrual-related symptoms were evaluated using the Menstrual Symptom Questionnaire (MSQ), the Menstrual Attitude Questionnaire (MAQ), and the Functional and Emotional Dysmenorrhea Scale (FEDS). RESULTS: The total MSQ score and all subdimensions in the PBTE group decreased significantly following the intervention (p < 0.05). The MAQ subdimensions, including "menstruation as a bothersome phenomenon" and "menstruation as a natural phenomenon," along with the total MAQ score, showed significant intra-group improvements in the PBTE group (p < 0.05). The FEDS total score also significantly decreased in the PBTE group (p < 0.05). CONCLUSION: The findings demonstrate that Pilates-based tele-exercises significantly enhance the overall health and well-being of women with primary dysmenorrhea. This is achieved through improved menstrual symptoms and positive changes in attitudes toward menstruation. These results suggest that PBTE could be an effective non-pharmacological approach to managing primary dysmenorrhea.
Association Between Birth-to-Birth Interval and Postpartum Depressive Symptoms: A Retrospective Cohort Study.
Yamada T, Terada S, Murakoshi T
J Obstet Gynaecol Res · 2026 May · PMID 42083274 · Publisher ↗
AIM: To examine the association between the birth-to-birth interval (BIB) and maternal depressive symptoms at 1 month postpartum, while adjusting for prior postpartum depressive symptoms and other confounders measured du...
AIM: To examine the association between the birth-to-birth interval (BIB) and maternal depressive symptoms at 1 month postpartum, while adjusting for prior postpartum depressive symptoms and other confounders measured during the previous pregnancy. METHODS: We conducted a retrospective cohort study of multiparous women (parity = 2) who delivered their first and second children at a tertiary perinatal center in Japan. The study was restricted to women whose second delivery occurred in 2018-2024 with available outcome data (n = 1144). BIB was defined as the interval in months between the first and second births and was categorized as short (< 24 months), reference (24-59 months), or long (≥ 60 months). The primary outcome was postpartum depressive symptoms, defined as the Edinburgh Postnatal Depression Scale (EPDS) score ≥ 9 at 1 month postpartum. Multivariable logistic regression with multiple imputation (m = 50) was used to estimate adjusted coefficients, adjusting for confounders measured during the previous pregnancy (maternal age, prior-pregnancy EPDS score at 1 month postpartum, use of assisted reproductive technology, body mass index, smoking status, and employment status). RESULTS: Overall, 26.0% (n = 298) and 2.7% (n = 31) of participants had short and long BIBs, respectively. Compared with the reference group, long BIB was associated with higher odds of postpartum depressive symptoms (adjusted OR 5.56; 95% CI, 1.66-18.62), whereas short BIB was not (adjusted OR 1.36; 95% CI, 0.76 to 2.42). CONCLUSIONS: A long but not a short BIB was independently associated with postpartum depressive symptoms at 1 month. Women with a long BIB may benefit from prioritization for early psychosocial support.
Cervical Cancer Screening Utilization Among Female Health Workers in Ethiopia: A Systematic Review and Meta-Analysis.
Usso AA, Mohammed H, Ahmed M
J Obstet Gynaecol Res · 2026 May · PMID 42083273 · Publisher ↗
BACKGROUND: Despite the high incidence of cervical cancer, the screening coverage is low in developing countries, including Ethiopia. This study aimed to assess the pooled prevalence of cervical cancer screening and its...
BACKGROUND: Despite the high incidence of cervical cancer, the screening coverage is low in developing countries, including Ethiopia. This study aimed to assess the pooled prevalence of cervical cancer screening and its determinants among female health workers in Ethiopia. METHODS: All published literatures were searched using extensive international databases such as PubMed, Web of Science, Science Direct, Google Scholar, HINARI, Scopus, and Cochrane Library. The pooled prevalence of cervical cancer screening and the effect size of its determinants were illustrated using forest plots, and a DerSimonian-Laird random effect model with 95% Confidence Interval (CI). RESULTS: The pooled prevalence of cervical cancer screening among female health workers in Ethiopia was 17.4% (95% CI: 13.4, 21.3). Being trained in cervical cancer screening (AOR = 1.75, 95% CI: 1.05, 2.44), good knowledge about cervical cancer screening (AOR = 1.31, 95% CI: 1.02, 1.61), having multiple sexual partners (AOR = 2.06, 95% CI: 1.11, 301), and having a history of sexually transmitted infection (STI) (AOR = 2.96, 95% CI: 1.44, 4.47) were the main pooled predictors of cervical cancer screening utilization among female health workers in Ethiopia. CONCLUSIONS: Only one in every six female health workers was screened for cervical cancer in Ethiopia. Training in cervical cancer screening, knowledge of cervical cancer screening, multiple sexual partners, and STIs were the main determinants of cervical cancer screening utilization. Improving the health professionals' knowledge on cervical cancer screening through providing training on cervical cancer screening would be needed to increase the level of cervical cancer screening.
Placenta Accreta Spectrum: A Call for Renewed Caution.
Matsubara S
J Obstet Gynaecol Res · 2026 May · PMID 42083271 · Publisher ↗
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The Risk Factors for Placental Abruption in Preeclamptic Pregnancies: A Retrospective Case-Control Study.
Li K, Lin Q, Xu A … +4 more , Zou J, Zhou L, Hua Y, Huang Q
J Obstet Gynaecol Res · 2026 May · PMID 42083268 · Full text
AIM: Preeclampsia poses a high-risk factor for placental abruption. The precise understanding of the accompanying symptoms and disease phenotype of preeclampsia, in order to promptly identify the occurrence of placental...
AIM: Preeclampsia poses a high-risk factor for placental abruption. The precise understanding of the accompanying symptoms and disease phenotype of preeclampsia, in order to promptly identify the occurrence of placental abruption in preeclamptic women, remains unclear. METHODS: The obstetric data of preeclamptic women were retrospectively analyzed between January 2016 and June 2023 in our hospital. Based on the presence or absence of placental abruption, they were categorized into two groups: placental abruption group and non-placental abruption group. Logistic regression analysis was employed to identify risk factors for placental abruption in preeclamptic women. RESULTS: A total of 709 preeclamptic women were enrolled, of whom 39 cases experienced placental abruption. Compared to the non-placental abruption group, the placental abruption group exhibited a younger age, lower BMI at delivery, and higher incidence of HELLP syndrome (p < 0.05). The risk factors for placental abruption in preeclamptic women included systolic blood pressure/10 (aOR 1.293, 95% CI 1.031-1.613), blurred vision (aOR 3.847, 95% CI 1.175-12.600), positive urine protein (aOR 3.081, 95% CI 1.157-8.208), platelet count/10 (aOR 0.923, 95% CI 0.860-0.991), and maternal age (aOR 0.899, 95% CI 0.836-0.966). The placental abruption group had shorter gestational age at delivery and higher rates of cesarean section delivery, fetal growth restriction, and neonatal asphyxia (p < 0.05). CONCLUSIONS: The occurrence of placental abruption in preeclampsia significantly impacts neonatal well-being. Close monitoring of blood pressure, particularly systolic blood pressure, urine protein, platelet counts, and visual acuity is crucial for preeclamptic women to early identify the occurrence of placental abruption.
Impact of Self-Management on Fitting Success and Continuation of Ring Pessary Therapy for Pelvic Organ Prolapse.
Bun M, Miyoshi A, Kawano M … +2 more , Endo M, Kodama M
J Obstet Gynaecol Res · 2026 May · PMID 42057610 · Publisher ↗
AIM: Ring pessary therapy is a widely used conservative treatment for pelvic organ prolapse (POP). In Japan, pessary self-management (SM) is recognized as a management option that may reduce adverse events; however, its...
AIM: Ring pessary therapy is a widely used conservative treatment for pelvic organ prolapse (POP). In Japan, pessary self-management (SM) is recognized as a management option that may reduce adverse events; however, its adoption in routine clinical practice remains limited, and clinical data are scarce. This study aimed to identify factors associated with successful fitting and continuation of ring pessary therapy, focusing on the role of SM. METHODS: We retrospectively reviewed the medical records of 90 patients with POP who initiated ring pessary therapy at our institution between 2010 and 2020. Patient characteristics, anatomical parameters, pessary management methods (SM or clinic management [CM]), and reasons for discontinuation were analyzed. Kaplan-Meier analysis, multivariate logistic regression, and Cox proportional hazards models were used to evaluate factors associated with fitting success and continuation. RESULTS: Among the 90 patients, 66 (73.3%) selected SM and 24 (26.7%) CM. Successful fitting was achieved in 62 patients (93.9%) in the SM group and in 8 patients (33.3%) in the CM group. SM was independently associated with successful fitting and longer continuation. Among patients with successful fitting, continuation rates were significantly higher in the SM group than in the CM group (p < 0.0001). The median pessary size among successfully fitted patients was 62 mm. In exploratory analyses, patients who discontinued therapy due to pain or discomfort tended to have shorter total vaginal length (TVL) and lower TVL/height ratios. CONCLUSIONS: Ring pessary therapy is a useful conservative treatment option for Japanese women with POP. SM may facilitate successful fitting and prolonged continuation when appropriate patient instruction and follow-up are provided.
Therapeutic Potential of Mesenchymal Stem Cells Transplantation in Nonalcoholic Fatty Liver Disease of Polycystic Ovary Syndrome: A Cross-Talk Between Ovary and Liver.
Abdi A, Ranjbaran M, Seifi B
J Obstet Gynaecol Res · 2026 May · PMID 42057606 · Publisher ↗
AIM: About 51% of women who have patients with polycystic ovary syndrome (PCOS) are impacted by nonalcoholic fatty liver disease (NAFLD). Research in the underlying diseased mechanisms of this link could offer valuable i...
AIM: About 51% of women who have patients with polycystic ovary syndrome (PCOS) are impacted by nonalcoholic fatty liver disease (NAFLD). Research in the underlying diseased mechanisms of this link could offer valuable insights for preventing and treating this complication. METHODS: Three experimental groups were formed by randomly dividing 24 female Wistar rats: Vehicle, PCOS, and PCOS + MSCs. In the PCOS group, letrozole (1 mg/kg, daily) was administered in 0.5% CMC for 21 days. Meanwhile, the PCOS + MSCs group was treated with 1 × 10 MSCs/rat intraperitoneally (IP) on the 22nd day. Ovarian mitochondrial dynamic gene expression, liver and ovarian oxidative stress, liver and ovarian inflammation, liver and ovarian histology, serum testosterone and estradiol levels, glucose homeostatic indexes, liver function enzymes, insulin and glucose concentrations, and lipid profile were evaluated. RESULTS: PCOS groups revealed a notable disturbance of ovarian changes in histology and mitochondrial dynamics, lower liver and SOD of ovary, HDL, estradiol and ovarian MFN2. Furthermore, notable increases were observed in glucose and insulin level, HOMA-IR, and androgen levels, ovarian DRP1 gene expression, liver and ovarian levels of inflammatory factors, MDA, ALT, LDL, TC, TG, AST, and CRP levels in comparison with the Vehicle group. In the PCOS + MSCs group, transplantation of MSCs could lead to improvements in the parameters mentioned above. CONCLUSION: The prescription of MSCs improved ovarian and liver injury in PCOS through its anti-inflammatory and antioxidant characteristics in addition to modulation of mitochondria function in the ovary. This study showed that notice to the liver beside ovarian organs in PCOS is principal.
Hysteroscopy Is A Promising Diagnostic and Therapeutic Approach for Vaginal Foreign Bodies in Preadolescent Girls.
Wang X, Liu T, Jiang X … +3 more , Yang L, Wan D, Qiao B
J Obstet Gynaecol Res · 2026 May · PMID 42057605 · Publisher ↗
BACKGROUND: Vaginal foreign bodies (VFBs) are rare yet clinically significant in preadolescent gynecology. Prompt identification and removal are crucial to avert complications such as infection, mucosal injury or ulcerat...
BACKGROUND: Vaginal foreign bodies (VFBs) are rare yet clinically significant in preadolescent gynecology. Prompt identification and removal are crucial to avert complications such as infection, mucosal injury or ulceration, and potential long-term reproductive consequences. Although hysteroscopic vaginoscopy is widely regarded as the reference standard and allows simultaneous extraction, ultrasound is more commonly used because it is noninvasive, inexpensive, and readily accessible. In China, however, hysteroscopy for VFBs is underutilized due to cultural and socioeconomic considerations and concerns related to anesthesia. METHODS: We conducted a retrospective review of 73 girls with suspected or hysteroscopically confirmed VFBs managed at Chengdu Women's and Children's Central Hospital or Yunyang County People's Hospital between January 2011 and February 2025. Extracted variables included age, presenting symptoms and duration, foreign-body type, pathology results, and length of stay. Diagnostic performance of transabdominal and transperineal ultrasound was evaluated with hysteroscopy as the comparator. RESULTS: Vaginal discharge and bleeding were the leading clinical presentations (34/73, 46.6%; 27/73, 37.0%, respectively). Commonly retrieved objects included textile fibers (20/73, 27.4%) and plastic tubes or fragments (5/73, 6.8%). Transabdominal ultrasound showed sensitivity, specificity, and overall accuracy of 0.556, 0.412, and 0.521, respectively. Transperineal ultrasound yielded higher sensitivity (0.704) and accuracy (0.606) but remained limited in specificity (0.294). CONCLUSION: Ultrasound demonstrated suboptimal diagnostic performance for VFBs in preadolescent girls. Given its greater diagnostic yield and therapeutic utility, hysteroscopy should be considered earlier as a preferred diagnostic and treatment option, especially in cases with negative ultrasound findings of foreign body but persistent clinical symptoms.
Emotional Reaction at Pregnancy Recognition and Risk of Postpartum Depressive Symptoms.
Yamada T, Suzuki R, Kaneko M … +2 more , Oota T, Murakoshi T
J Obstet Gynaecol Res · 2026 May · PMID 42055564 · Publisher ↗
AIM: To examine whether women's emotional reaction when they first recognize their pregnancy is associated with postpartum depressive symptoms and whether risk increases across positive, ambivalent, and negative feelings...
AIM: To examine whether women's emotional reaction when they first recognize their pregnancy is associated with postpartum depressive symptoms and whether risk increases across positive, ambivalent, and negative feelings. METHODS: We conducted a retrospective cohort study at a tertiary perinatal center in Japan. At the first prenatal visit, women answered the free-text question, "How did you feel when you found out you were pregnant?" Responses were coded as positive, ambivalent, or negative; unclear descriptions were excluded. All women who delivered at ≥ 22 weeks' gestation between 2018 and 2024 were eligible. Postpartum depressive symptoms at 1 month were assessed using the Edinburgh Postnatal Depression Scale. Multivariable logistic regression with multiple imputation for missing EPDS and covariates estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs), adjusting for age, parity, single status, employment, prior mental illness, infertility treatment, plurality, and prior miscarriage. Complete-case analyses were performed as sensitivity analyses. RESULTS: Of the 8932 women, 6835 (76.5%) reported positive, 1729 (19.4%) ambivalent, and 368 (4.1%) negative feelings. The PPD prevalence was 3.5%, 6.2%, and 9.0%, respectively. Compared with positive feelings, aORs were 1.69 (95% CI, 1.30-2.19) for ambivalent and 2.56 (95% CI, 1.73-3.79) for negative feelings (P for trend < 0.001). Estimates were similar in complete-case analyses. CONCLUSIONS: Free-text emotional reactions at pregnancy recognition, categorized as positive, ambivalent, or negative, were strongly and progressively associated with postpartum depressive symptoms. Simple assessment of women's feelings when they discover pregnancy may help identify those at increased risk early in the perinatal course.
The Association of Energy Distribution Between Dinner and Breakfast With Depressive Symptoms in Early Pregnancy.
Jiang Y, Luo J, Zheng L … +4 more , Dai K, Yu L, Zhang H, Wang S
J Obstet Gynaecol Res · 2026 May · PMID 42051063 · Publisher ↗
AIM: To examine the association between the distribution of energy and macronutrients between dinner and breakfast and depressive symptoms in early pregnancy. METHODS: This study used baseline data from a maternity cohor...
AIM: To examine the association between the distribution of energy and macronutrients between dinner and breakfast and depressive symptoms in early pregnancy. METHODS: This study used baseline data from a maternity cohort conducted in Wuhan, China. Dietary intake was assessed via a 24-h recall, and depressive symptoms were defined as EPDS ≥ 10. The differences in energy and macronutrient intake between dinner and breakfast (Δ = dinner-breakfast) were categorized into tertiles. Logistic regression models were developed to assess the associations between Δ and depressive symptoms. Isocaloric substitution models were used to evaluate the effect of shifting energy or macronutrients from dinner to breakfast. RESULTS: Two hundred two individuals (41.74%) met the criteria for depressive symptoms. The highest tertile was associated with a significantly increased risk of depressive symptoms compared with the lowest tertile after multivariable adjustment (ΔEnergy: OR = 1.97, 95% CI: 1.21-3.19; ΔCarbohydrate: OR = 1.89, 95% CI: 1.17-3.06; ΔFat: OR = 1.65, 95% CI: 1.03-2.64). Isocalorically replacing 5% of total energy at dinner with breakfast was associated with a 7% (OR = 0.93, 95% CI: 0.86-0.99) lower risk of depressive symptoms, while macronutrient substitution between meals showed no significant effect. CONCLUSIONS: Higher energy and macronutrient intake at dinner relative to breakfast was associated with a higher risk of depressive symptoms, highlighting the potential importance of daily energy distribution for mental health in early pregnancy.
Efficacy and Safety of Pamiparib Monotherapy in Recurrent Ovarian Cancer After Prior PARPi Exposure: A Prospective, Open-Label, Single-Arm, Phase II Study.
Cheng F, Sun L, Shao F … +3 more , Yang L, Jiang G, Zhu J
J Obstet Gynaecol Res · 2026 May · PMID 42051038 · Publisher ↗
AIM: To evaluate the efficacy and safety of pamiparib monotherapy in recurrent ovarian cancer (rOC) after prior PARPi exposure. METHODS: This was a prospective clinical trial. Fifteen patients were enrolled between Augus...
AIM: To evaluate the efficacy and safety of pamiparib monotherapy in recurrent ovarian cancer (rOC) after prior PARPi exposure. METHODS: This was a prospective clinical trial. Fifteen patients were enrolled between August 2022 and December 2023. Oral pamiparib 60 mg twice daily was administered until conditions specified in the protocol. Primary endpoint was clinical benefit rate ≥ 4 months (CBR4m; percentage of patients who sustained complete response, partial response [PR], and stable disease for at least 4 months). Secondary endpoints included progression-free survival (PFS), overall response rate (ORR), overall survival (OS), and safety. RESULTS: Median number of previous treatment line was 3 (range, 2-6). CBR4m was 26.7% and the study was halted in the first stage according to the pre-set statistical criteria. Two patients achieved PR for an ORR of 13.3%. With a median follow-up of 16.1 months, median PFS and OS were respectively 2.8 (95% confidence interval [CI], 1.6-NR) and 15.6 (95% CI, 8.4-NR) months. Subgroup analyses showed CBR4m of 37.5% (3/8) in BRCAmut and 14.3% (1/7) in BRCAwt cohorts. CA-125 response according to GCIG criteria was observed in 26.7% of patients. There were no treatment-related serious adverse events or deaths. CONCLUSIONS: Pamiparib monotherapy preliminarily showed limited efficacy and acceptable safety profiles in heavily pretreated rOC after prior PARPi exposure. The results suggested that single-agent pamiparib retreatment may not be an effective treatment for this patient population; further investigation of combining PARPi with agents with different mechanisms may be warranted.
Long-Term Psychosocial Outcomes in Japanese Mayer-Rokitansky-Küster-Hauser Syndrome: A Single-Center Study.
Okunomiya A, Tsuyuki K, Ohsuga T … +6 more , Ohara T, Yanai A, Mizuno R, Yamanoi K, Egawa M, Mandai M
J Obstet Gynaecol Res · 2026 May · PMID 42049375 · Full text
AIM: Vaginal creation enables sexual intercourse in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. However, long-term psychosocial outcomes, particularly in Japanese patients, remain underreported. This st...
AIM: Vaginal creation enables sexual intercourse in patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. However, long-term psychosocial outcomes, particularly in Japanese patients, remain underreported. This study aimed to explore the long-term psychosocial outcomes associated with different choices of vaginal creation in patients with MRKH syndrome. METHODS: This retrospective study included 24 patients with MRKH syndrome who were managed at Kyoto University Hospital between 1987 and 2024. Medical records were reviewed to evaluate choices regarding vaginal creation, sexual activity, marital status, partner disclosure, reproductive concerns, and psychological well-being. RESULTS: Of the 24 patients, 22 had explicitly planned to undergo vaginal creation using surgical methods or nonsurgical Frank dilation, and 19 actually initiated the procedure, although two discontinued it. Among the 17 patients with a formed neovagina, 11 reported sexual intercourse. Seven patients were married, five of whom married partners they met after vaginal creation. One patient delivered via gestational surrogacy. Four patients, including one who declined vaginal creation, developed delayed psychological distress related to femininity and perceived infertility. CONCLUSION: Gynecological outpatient care often serves as the primary source of long-term psychosocial support for patients with MRKH syndrome. Continuous empathetic follow-up beyond the period of vaginal creation may be essential to address evolving emotional and social challenges.
The Association Between the Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) Score and Lymph Node Metastasis in Early and Locally Advanced Cervical Cancer.
Köksal OK, Baydemir ŞK, Öncü HN … +5 more , Bakan FE, Öztürk N, Ege G, Hanedan C, Korkmaz V
J Obstet Gynaecol Res · 2026 May · PMID 42049285 · Publisher ↗
OBJECTIVE: To investigate the association between hemoglobin-albumin-lymphocyte-platelet (HALP) score and lymph node metastasis (LNM) in patients with early and locally advanced cervical cancer. METHODS: This retrospecti...
OBJECTIVE: To investigate the association between hemoglobin-albumin-lymphocyte-platelet (HALP) score and lymph node metastasis (LNM) in patients with early and locally advanced cervical cancer. METHODS: This retrospective observational cohort study included patients with FIGO 2018 stage IA-IIIC cervical cancer treated at a tertiary gynecologic oncology center between November 2022 and January 2025. Lymph node status was determined by pathological and/or radiological evaluation. HALP score was calculated using pretreatment hemoglobin, albumin, lymphocyte, and platelet values. Receiver operating characteristic (ROC) analysis was performed to determine the optimal HALP cutoff value to predict LNM. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with LNM, adjusting for established clinicopathological variables. RESULTS: A total of 136 patients were included. Patients with LNM had significantly lower HALP scores than those without LNM (median 29.8 vs. 42.8, p = 0.001). ROC analysis demonstrated a moderate discriminative ability of HALP for predicting LNM (AUC 0.697, 95% CI 0.610-0.785), with an optimal cutoff value of 22.4. Sensitivity analysis in surgically staged patients (n = 83) yielded consistent results (AUC 0.692; p = 0.006). In univariate analysis, HALP ≤ 22.4, tumor size > 2 cm, lymphovascular space invasion (LVSI), and parametrial involvement were significantly associated with LNM. In multivariate analysis, HALP ≤ 22.4 and LVSI remained independent predictors of LNM. CONCLUSION: The HALP score is a simple, inexpensive, and readily available immunonutrition index that may serve as an adjunctive biomarker for pretreatment risk stratification of LNM in patients with early and locally advanced cervical cancer. Prospective multicenter studies are warranted to confirm these findings.
A Predictive Model for Intrapartum Cesarean Delivery in Multiparous Women After Active Labor Onset.
Liu Y, Fan J, Man F … +2 more , Hu H, Tang B
J Obstet Gynaecol Res · 2026 May · PMID 42044919 · Full text
OBJECTIVE: Although prediction models for cesarean delivery have been established for nulliparous women, few have been developed for multiparous women, particularly for predicting intrapartum cesarean delivery after the...
OBJECTIVE: Although prediction models for cesarean delivery have been established for nulliparous women, few have been developed for multiparous women, particularly for predicting intrapartum cesarean delivery after the onset of active labor. This study aimed to develop and validate a risk prediction model for intrapartum cesarean delivery in this population and evaluate its clinical utility. METHODS: We conducted a retrospective case-control study at a single tertiary center (Suining Central Hospital, China) from January 2019 to June 2025. The study included 58 multiparous women who required cesarean delivery after active labor onset (cases) and 116 who had successful vaginal deliveries (controls). Candidate predictors included maternal age, prenatal body mass index, gravidity, parity, interdelivery interval, induction of labor, amniotic fluid characteristics, and fetal abdominal circumference. Predictors were identified through univariate analyses (Mann-Whitney U test for continuous variables, chi-square tests for categorical variables) followed by multivariate logistic regression. Model performance was evaluated by assessing discrimination (area under the receiver operating characteristic curve [AUC]), calibration (Hosmer-Lemeshow goodness-of-fit test), and internal validity (bootstrapping with 1000 replicates). A clinical nomogram was developed using R software (version 4.2.3) to facilitate practical application of the prediction model. RESULTS: The final model incorporated five independent predictors: prenatal BMI, induction of labor, interdelivery interval, fetal abdominal circumference, and amniotic fluid characteristics. The model demonstrated good discrimination, with an AUC of 0.82 (95% CI: 0.76-0.89). The Hosmer-Lemeshow test showed good calibration (p = 0.91), and bootstrap validation yielded a calibration slope of 0.92, indicating minimal overfitting. CONCLUSIONS: This novel prediction model, using readily available intrapartum variables, shows promise for identifying multiparous women at high risk of intrapartum cesarean delivery after active labor onset, potentially aiding clinical decision-making. External validation is warranted before clinical implementation.
Uterine and Sigmoid Colon Perforation Following Hysteroscopy-Guided Microwave Endometrial Ablation (MEA) in a Patient With a Bicornuate Uterus and Multiple Myomas: A Case Report.
Dofutsu K, Masuda K, Takemura M … +3 more , Sumikura T, Morishige KI, Takemura M
J Obstet Gynaecol Res · 2026 May · PMID 42044918 · Publisher ↗
In Japan, the microwave endometrial ablation system (MEA, Microsulis PLC, Waterlooville, UK) is the most widely used device for endometrial ablation and is considered a minimally invasive, uterus-preserving treatment for...
In Japan, the microwave endometrial ablation system (MEA, Microsulis PLC, Waterlooville, UK) is the most widely used device for endometrial ablation and is considered a minimally invasive, uterus-preserving treatment for menorrhagia. Although MEA is generally safe, uterine and/or bowel perforation can occur as a rare but serious complication. We report a case of uterine and sigmoid colon perforations following hysteroscopy-guided MEA in a patient with a bicornuate uterus, endometriosis, and multiple uterine myomas. To our knowledge, this is the first reported case of simultaneous uterine and bowel perforation due to thermal injury after MEA in a patient with a bicornuate uterus. Careful preoperative evaluation and appropriate postoperative counseling are crucial, particularly in patients with uterine anomalies or suspected intra-abdominal adhesions.
Evaluation of Urine Nephrin:Creatine Ratio Longitudinally in Pregnancy for the Detection of Preeclampsia and Kidney Damage in Women With Pre-Existing Diabetes.
Zhang K, Alahakoon TI, Shaw A … +3 more , Cheung NW, Lee VW, Padmanabhan S
J Obstet Gynaecol Res · 2026 May · PMID 42036794 · Publisher ↗
AIMS: (i) To evaluate longitudinal changes in urine nephrin to creatinine ratio (NCR) throughout gestation in women with pre-existing diabetes; (ii) To evaluate the association of NCR with diabetic nephropathy and pregna...
AIMS: (i) To evaluate longitudinal changes in urine nephrin to creatinine ratio (NCR) throughout gestation in women with pre-existing diabetes; (ii) To evaluate the association of NCR with diabetic nephropathy and pregnancy outcomes including preeclampsia. METHODS: A prospective cohort study of 158 pregnant women with pre-existing diabetes was conducted. Changes in urinary nephrin, protein, albumin and creatinine were assessed serially during pregnancy at four time points. The association with diabetic nephropathy and pregnancy outcomes was investigated by linear mixed effects models. Spearman's rank correlation was used to assess the correlation of NCR with protein/albumin to creatinine ratio (PCR/ACR). RESULTS: NCR increased from early to late pregnancy (p < 0.05); however, there was no significant difference in NCR between those with and without preeclampsia irrespective of gestational age. Women with diabetic nephropathy had 3.48 times greater [1.38-8.77] NCR at 14 weeks compared to those without (p < 0.01), although this was not sustained in late pregnancy. NCR was positively associated with PCR through pregnancy (p < 0.01) and with ACR at 14 and 30 weeks (p < 0.05); however, the associations were weak. CONCLUSIONS: While all women with diabetes show a gradual increase in NCR during pregnancy, it was not a useful marker in predicting preeclampsia. However, higher NCR was indicative of kidney damage in the first trimester and could potentially be useful for monitoring diabetic nephropathy.
Clinicopathological Status and Prognostic Factors of Recurrent Epithelial Ovarian Cancer in Japan: Retrospective Survey of JSOG Committee on Gynecologic Oncology.
Watanabe Y, Baba T, Soeda S … +13 more , Tokunaga H, Yamagami W, Nomura H, Kobayashi Y, Kawana K, Yoshino K, Yokoyama Y, Nishi H, Kobayashi H, Matsuzawa Y, Oyamada S, Takahashi S, Nagase S
J Obstet Gynaecol Res · 2026 May · PMID 42027044 · Full text
AIM: Despite advancements in maintenance therapies, recurrent epithelial ovarian cancer remains a clinical challenge with varying outcomes. This study aimed to evaluate the clinicopathological status and prognostic facto...
AIM: Despite advancements in maintenance therapies, recurrent epithelial ovarian cancer remains a clinical challenge with varying outcomes. This study aimed to evaluate the clinicopathological status and prognostic factors of patients with recurrent epithelial ovarian cancer. METHODS: We conducted a retrospective survey through the Committee on Gynecologic Oncology of the Japan Society of Gynecology and Obstetrics across 16 institutions. RESULTS: Histological subtypes included high-grade serous (HGS; n = 304), clear-cell (CC; n = 83), endometrioid (EM; n = 35), mucinous (n = 12), and low-grade serous (n = 9) carcinomas. At recurrence, the median age was 61 years, 74.0% of patients had a platinum-free interval (PFI) ≥ 6 months, and 78.8% maintained a performance status (PS) of 0. Genetic testing identified 42 BRCA1/2 mutations and 52 cases of homologous recombination deficiency positivity. Recurrence occurred primarily in the peritoneum, lymph nodes, and liver. For PFI ≥ 6 months, paclitaxel/carboplatin ± bevacizumab was the primary treatment; for PFI < 6 months, pegylated liposomal doxorubicin ± bevacizumab predominated. The overall response rate was 69.9% for PFI ≥ 6 months versus 17.7% for PFI < 6 months. Median overall survival was 27.9 months. Multivariate analysis confirmed histological subtype (CC/EM vs. HGS), PS, CA125 (≥ 100 U/mL), and PFI as significant independent prognostic factors, while first-line molecularly targeted therapy use showed no significant impact. CONCLUSION: PFI, histological subtype, PS, and CA125 levels are important prognostic factors for the use of molecular-targeted agents for recurrent epithelial ovarian cancer. Patients with CC and EM subtypes experience worse outcomes than those with HGS, highlighting the need for subtype-specific management in recurrent ovarian cancer.
Estimation of Perineal Length in First and Second Stage of Labor Among South Indian Women and Its Association With Perineal Tears-A Prospective Observational Study.
Krishnappa R, Ulaganeethi R, Dorairajan G
J Obstet Gynaecol Res · 2026 Apr · PMID 42002311 · Publisher ↗
AIM: To estimate average perineal length during first and second stages of labor and its association with composite perineal tears. METHODS: A prospective observational study was conducted at a tertiary institute in Sout...
AIM: To estimate average perineal length during first and second stages of labor and its association with composite perineal tears. METHODS: A prospective observational study was conducted at a tertiary institute in Southern India. Perineal length was measured using a sterile flexible tape; an episiotomy was made when the perineum appeared stretched and thinned out. Composite tears and obstetric anal sphincter injuries (OASI) were detected clinically. Incidence of tears and their association with perineal length was analyzed using a chi-squared test and log binomial regression was used to estimate adjusted relative risk (aRR). We used receiver operating characteristic curve to find the optimal cut off for predicting the occurrence of composite tears. RESULTS: We recruited 553 women. The mean perineal length was 3.5 ± 0.5 cm and 4.5 ± 0.5 cm in the first and second stages of labor, respectively. The incidence of composite perineal tear and obstetric anal sphincter injuries (OSAIS) were 7.6% and 0.54%, respectively. OASIS was 2.5% in women who underwent instrumental delivery, and a shorter perineum (< 3 cm) involved the anal sphincter (p = 0.01) during instrumental delivery. A perineal length of ≤ 3.2 cm in the first stage was independently associated with composite perineal tears (aRR = 2.5) after adjusting for birth weight, duration of the second-stage labor, and mode of delivery. CONCLUSION: Mean perineal length at the first stage was 3.5 cm and increased by a centimeter during the second stage. Perineal length of ≤ 3.2 cm in the first stage significantly increases the risk of composite perineal tears.
Exploring the Involvement of RSPO1 Gene Variations in 46,XX DSD Patients With Mullerian Agenesis and/or Gonadal Dysgenesis-An Indian Study.
T S R, K S S, Daniel S … +6 more , F S, Gilvaz S, K V D, Francis J, Pulikkottil Raphael V, Raveendran SK
J Obstet Gynaecol Res · 2026 Apr · PMID 41992751 · Publisher ↗
INTRODUCTION: There is a dearth of knowledge on the genetic background of Indian 46,XX DSD patients with Mullerian agenesis (MA) and/or gonadal dysgenesis (GD). Being one of the key controlling genes in female sex determ...
INTRODUCTION: There is a dearth of knowledge on the genetic background of Indian 46,XX DSD patients with Mullerian agenesis (MA) and/or gonadal dysgenesis (GD). Being one of the key controlling genes in female sex determination/differentiation, there is a paucity of study regarding the association of RSPO1 variations with MA/GD. Hence in this study, we screened proximal as well as exonic regions of the RSPO1 gene in 25 Indian 46,XX DSD patients with MA and/or GD. METHODOLOGY: Bidirectional PCR-Sanger sequencing was performed with RSPO1 proximal promoter and coding sequence-specific primers. The identified noncoding and coding variations were analyzed using various population and microRNA databases and in silico tools. RESULTS: We observed three promoters (c.-1189C>G;rs10908365, c.-1112G>A;rs59740072, and c.-1038T>C;rs11585920), two 5' UTRs (c.-247C>G;rs187926864 and c.-119G>A;rs530760760), four intronic (c.286+33G>A;rs12039431, c.286+34C>T;rs12046650, c.95-34C>G;rs45577433, and c.94+37G>A), and a missense variant (c.484A>C;p.Lys162Gln) in our study subjects. In pathogenic prediction, the identified variations were found to be normal. CONCLUSION: Although no clearly pathogenic RSPO1 variants were identified, this study contributes important data on RSPO1 sequence variation in 46,XX DSD cases involving MA and GD.
Atractylenolide III Alleviates the Lipid Metabolic Disorders in Ovariectomy-Induced Estrogen-Deficient Mice Through Repairing Intestinal Inflammation and Microenvironment.
Yanyan X, Yanyu Q, Qiao G … +3 more , Jiabo G, Desong K, Heiying J
J Obstet Gynaecol Res · 2026 Apr · PMID 41992528 · Full text
OBJECTIVE: To investigate the mechanism by which Atractylenolide III (ATIII) alleviates ovariectomy-induced, estrogen-deficient lipid metabolism disorders through the repair of intestinal inflammation and the barrier mic...
OBJECTIVE: To investigate the mechanism by which Atractylenolide III (ATIII) alleviates ovariectomy-induced, estrogen-deficient lipid metabolism disorders through the repair of intestinal inflammation and the barrier microenvironment. METHODS: Female C57BL/six mice (8 weeks old) were randomly assigned to three groups: a blank control group (Con, n = 10), a sham surgery group (Sham, n = 10), and an ovariectomized (OVX) group (n = 70). The OVX group was further subdivided into a model group (OVX + HFD), low- and high-dose ATIII groups (ATIII-L, ATIII-H), an estradiol (E2) group, and groups receiving fecal microbiota transplantation (FMT) from the blank control, model, or high-dose ATIII donors. After 60 days on a high-calorie diet, treatments were administered for 28 consecutive days. Serum, liver, and intestinal tissues, and cecal contents were collected from six randomly selected mice per group. Body weight was monitored; hepatic and colonic morphology was assessed by H&E staining; serum lipid profiles were determined using an automated biochemical analyzer; ELISA quantified estradiol and inflammatory cytokine levels; expression of colonic barrier-related proteins was evaluated by Western blot; and gut microbiota composition was analyzed via 16S rRNA sequencing. RESULTS: Under conditions of estrogen deficiency, a high-calorie diet mimicking modern human intake predisposed mice to significant weight gain (p < 0.05) and dyslipidemia, accompanied by a spectrum of pathological alterations including intestinal barrier dysfunction (evidenced by downregulated tight junction proteins), systemic inflammation (reflected by elevated pro-inflammatory cytokines), hepatic steatosis, colonic inflammatory damage, and gut microbiota dysbiosis. ATIII intervention effectively mitigated these abnormalities, as demonstrated by reduced body weight, improved lipid profiles, repaired hepatic and colonic injuries, upregulated intestinal barrier proteins, downregulated inflammatory cytokines, a tendency toward elevated estrogen levels, and enhanced gut microbial diversity. CONCLUSIONS: ATIII ameliorates ovariectomy-induced estrogen-deficient dyslipidemia by repairing intestinal barrier function and modulating intestinal inflammation. Concurrently, it exerts beneficial effects on estrogen levels and gut microbiota composition, in which the gut microbiota plays a mediating role. The experiment demonstrated that the active ingredients of traditional Chinese medicine hold significant value in treating lipid metabolism disorders in perimenopausal women, and there is potential for further in-depth research into the mechanism by which they enhance efficacy through modulating gut microbiota.
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