The Journal Of Obstetrics And Gynaecology Research[JOURNAL]
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200 papers
Number of Authors in Japanese Obstetrics and Gynecology Case Reports: A Preliminary Observation.
Matsubara S
J Obstet Gynaecol Res · 2026 Mar · PMID 41748476 · Publisher ↗
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Elevated Risk of Endometrial Cancer and Precursor Lesions in Patients With Myotonic Dystrophy: A Retrospective Study at a Single Institution in Japan.
Hano R, Ando H, Fujioka M … +7 more , Nakajima M, Shinagawa M, Takeuchi H, Shinagawa M, Kobara H, Yoshinaga T, Miyamoto T
J Obstet Gynaecol Res · 2026 Mar · PMID 41744896 · Full text
AIM: Myotonic dystrophy (MD) has been associated with an increased risk of endometrial cancer (EC) in Western countries; however, data from Japan are limited. This study aimed to evaluate the incidence and clinical chara...
AIM: Myotonic dystrophy (MD) has been associated with an increased risk of endometrial cancer (EC) in Western countries; however, data from Japan are limited. This study aimed to evaluate the incidence and clinical characteristics of EC and its precursor lesion, atypical endometrial hyperplasia (AEH), in Japanese patients with MD. METHODS: We retrospectively reviewed medical records of female patients with MD (MD group, n = 36) and those with other types of muscular dystrophy (control group, n = 84) treated at a single institution between 2008 and 2023. RESULTS: EC/AEH was identified in 5 of 36 patients in the MD group (13.9%), including 3 cases of EC and 2 of AEH, whereas 1 case of EC (1.2%) was observed among 84 control patients, indicating a significantly higher incidence in the MD group (p = 0.014). The median age at diagnosis of EC/AEH in the MD group was 45 years, which was significantly younger than that of non-MD EC/AEH cases treated during the same period (median 59 years). All surgically treated EC cases were early-stage endometrioid carcinoma and achieved favorable oncological outcomes, although perioperative respiratory complications were observed. CONCLUSIONS: Japanese MD patients have a significantly higher risk of developing EC/AEH at a younger age compared with non-MD patients. These findings highlight the importance of regular gynecological surveillance in women with MD.
Uterine Tumor Resembling Ovarian Sex Cord Tumor (UTROSCT) With a GREB1-NCOA2 Fusion: A Case Report and Diagnostic Considerations.
Liang Y, Li X, Yang Y … +2 more , Luo W, Huang J
J Obstet Gynaecol Res · 2026 Mar · PMID 41740988 · Publisher ↗
Uterine Tumor Resembling Ovarian Sex Cord Tumor (UTROSCT) is a rare mesenchymal neoplasm with uncertain malignant potential. We report a 37-year-old woman with menorrhagia, initially suspected as a leiomyoma on MRI. Hyst...
Uterine Tumor Resembling Ovarian Sex Cord Tumor (UTROSCT) is a rare mesenchymal neoplasm with uncertain malignant potential. We report a 37-year-old woman with menorrhagia, initially suspected as a leiomyoma on MRI. Hysteroscopic resection revealed an infiltrative tumor with cords, glands, and spindle cells showing mild-to-moderate atypia. Immunohistochemistry was positive for ER, PR, WT-1, Calretinin, and FOXL2. RNA-based NGS identified the GREB1-NCOA2 fusion. Despite treatment, the patient died from metastases within 24 months. This case highlights UTROSCT's aggressive potential in young patients and underscores the diagnostic utility of molecular testing (e.g., GREB1 rearrangements) to distinguish it from mimics like LG-ESS. The fatal outcome suggests GREB1-NCOA2 may correlate with high-risk behavior, warranting close follow-up.
Comparison of the Effectiveness and Safety of Single-Port Laparoscopic Surgery and Multi-Port Laparoscopic Surgery in the Treatment of Ectopic Pregnancy in Vietnam.
Huynh NX, Nguyen TB, Le KPP … +6 more , Nguyen HT, Truong HQ, Pham HTT, Huynh PN, Nguyen DT, Lam NT
J Obstet Gynaecol Res · 2026 Feb · PMID 41725402 · Publisher ↗
AIM: Single-port laparoscopic surgery has been increasingly used in the management of ectopic pregnancy, but direct comparisons with the conventional four-port method remain limited. This study aimed to assess the effect...
AIM: Single-port laparoscopic surgery has been increasingly used in the management of ectopic pregnancy, but direct comparisons with the conventional four-port method remain limited. This study aimed to assess the effectiveness and safety of single-port laparoscopic surgery compared to the four-port approach at Hung Vuong Hospital. METHODS: A total of 100 patients were enrolled and allocated to either the single-port or four-port group, with 50 cases in each. Operative time, estimated blood loss, postoperative pain (using the Visual Analog Scale), cosmetic satisfaction, complications, and gastrointestinal recovery were recorded and compared. RESULTS: The average operative time was similar between the two groups (58 ± 18.15 min for single-port vs. 57.42 ± 29.72 min for four-port, p > 0.05), as was the estimated blood loss (84 ± 78.87 mL vs. 84.3 ± 57.78 mL, p > 0.05). Patients in the single-port group reported significantly less pain within the first 12 h (VAS 2.14 ± 0.50 vs. 3.46 ± 0.79, p < 0.001) and expressed higher satisfaction with cosmetic results (p < 0.001). No major complications, such as organ injury or conversion to open surgery, occurred in either group during the study period. However, the time to first bowel movement was longer in the single-port group (1.86 ± 0.83 days vs. 1.10 ± 0.30 days, p < 0.001). CONCLUSIONS: Both single-port and four-port laparoscopic surgeries showed favorable short-term perioperative outcomes in this cohort and were feasible approaches for the management of ectopic pregnancy. The single-port method provided advantages of reduced postoperative pain and improved cosmetic outcomes but was associated with a slightly slower recovery of bowel function.
Abdominal Pregnancy in the Right Uterosacral Ligament: A Novel Case Report.
Zhang Y, Fan Y, Wang H … +1 more , Xiong Y
J Obstet Gynaecol Res · 2026 Feb · PMID 41725295 · Publisher ↗
Abdominal pregnancy is a rare type of ectopic pregnancy, accounting for about 1% of ectopic pregnancies. Early diagnosis of abdominal pregnancy is challenging and may lead to serious complications. This article reports a...
Abdominal pregnancy is a rare type of ectopic pregnancy, accounting for about 1% of ectopic pregnancies. Early diagnosis of abdominal pregnancy is challenging and may lead to serious complications. This article reports a case of a patient who was 58 days postmenopausal and presented with acute lower abdominal pain. The patient's preoperative ultrasound suggested ectopic pregnancy. Laparoscopy and therapeutic surgery were performed. During the surgical procedure, the gestational sac was identified in the right uterosacral ligament, and the gestational tissue was successfully removed with minimal bleeding. Histopathological examination confirmed it to be chorionic tissue. The serum human chorionic gonadotropin level decreased significantly in the postoperative period, and she was discharged from the hospital on the fourth postoperative day. Abdominal pregnancies are rare and early diagnosis is crucial to prevent serious complications. Laparoscopic surgery is an efficacious treatment for early abdominal pregnancy.
Short-Term Outcomes of Expectant Management With Antibiotics for Preterm Subclinical Intra-Amniotic Infection.
Nomiyama M, Tsumura K, Shimomura T … +7 more , Oshima Y, Ono T, Kozuma Y, Yamasaki F, Nakura Y, Yanagihara I, Yokoyama M
J Obstet Gynaecol Res · 2026 Feb · PMID 41725271 · Publisher ↗
AIM: This study assessed the efficacy of expectant management with antibiotics in patients with intra-amniotic infections diagnosed and treated at our institution. Antimicrobial and corticosteroid treatments were initiat...
AIM: This study assessed the efficacy of expectant management with antibiotics in patients with intra-amniotic infections diagnosed and treated at our institution. Antimicrobial and corticosteroid treatments were initiated for patients with intra-amniotic inflammation and a high infection risk, and the diagnosis was confirmed 2 days later by culture results, including Ureaplasma spp. and Mycoplasma hominis, which guided further treatment. METHODS: This retrospective cohort study included singleton pregnant women diagnosed with intra-amniotic infection between 20 + 0 and 33 + 6 weeks of gestation between 2014 and 2021. Intra-amniotic inflammation was defined as an interleukin-6 concentration of ≥ 3.0 ng/mL in amniotic fluid, and intra-amniotic infection was confirmed by positive amniotic fluid cultures combined with inflammation. First-line antimicrobial therapy consisted of sulbactam/ampicillin and azithromycin. Primary outcome was the proportion of patients in which pregnancy was prolonged beyond 48 h without exacerbation of intra-amniotic inflammation. Secondary outcome was prolonged pregnancy beyond 168 h. RESULTS: Of 56 diagnosed patients, 45 were analyzed. Pregnancy was prolonged beyond 48 h without exacerbation in 71.9% of the women in a Ureaplasma spp./Mycoplasma hominis-only group compared with 23.0% in the other bacterial group (p = 0.006). Pregnancy was significantly prolonged beyond 168 h in the Ureaplasma spp./Mycoplasma hominis-only group compared with that in the other bacterial group (28.1% vs. 0%, p = 0.04). CONCLUSIONS: Expectant management with antibiotics is feasible in the short term for subclinical intra-amniotic infections caused solely by Ureaplasma spp./Mycoplasma hominis. However, for cases caused by the other bacteria, further studies are needed to determine appropriate management strategies.
A Cross-Sectional Study on Healthcare Workers' Knowledge and Attitudes Regarding Menstrual Cup Use in Turkey.
Taşkıran D
J Obstet Gynaecol Res · 2026 Feb · PMID 41725038 · Publisher ↗
OBJECTIVE: Misconceptions surrounding menstrual bleeding and its management persist among the general population, often rooted in cultural norms and upbringing. However, such misconceptions can also be observed among hea...
OBJECTIVE: Misconceptions surrounding menstrual bleeding and its management persist among the general population, often rooted in cultural norms and upbringing. However, such misconceptions can also be observed among healthcare professionals, who are expected to serve as advocates for public health. This study aimed to assess the knowledge and awareness of healthcare professionals in Turkey regarding menstrual cup use and associated topics. PATIENTS AND METHODS: This cross-sectional study was conducted between July 25 and August 10, 2025, using a self-administered online questionnaire via Google Forms. The target population included female healthcare workers employed in various healthcare institutions across Turkey who voluntarily agreed to participate. A total of 309 participants were included through a simple random sampling method based on their institutions of employment. The data were collected using structured questionnaires completed by the participants. RESULTS: Only 6.8% of participants reported ever using a menstrual cup. During menstruation, 97.7% of respondents reported using sanitary pads, whereas 5.2% reported using menstrual cups. Among menstrual cup users, 34.9% expressed satisfaction with the product, while 51.2% were uncertain. Additionally, 62.2% reported no problems during use, 55% stated they felt comfortable, and 60% believed menstrual cups to be environmentally friendly. Overall awareness of menstrual cups among healthcare professionals was low. Most users were physicians and had learned about menstrual cups primarily through social media and peers. Those who used menstrual cups reported lower expenditures on menstrual hygiene products. CONCLUSION: There is a clear need to improve awareness and knowledge about menstrual cup use among healthcare professionals. Enhancing educational efforts and providing accurate information may empower healthcare workers to offer better guidance and promote sustainable menstrual hygiene practices.
A Decade-Long Diagnostic Challenge: A Case of Nonclassical 21-Hydroxylase Deficiency Mistaken for Polycystic Ovary Syndrome.
Kondo E, Makimura M, Hayashi K … +3 more , Kawakami K, Usui T, Yoshizato T
J Obstet Gynaecol Res · 2026 Feb · PMID 41724575 · Publisher ↗
We report a rare case of nonclassical 21-hydroxylase deficiency (NC21-OHD) diagnosed in adulthood after being misdiagnosed as polycystic ovary syndrome (PCOS) for 9 years. A 27-year-old Japanese woman presented with long...
We report a rare case of nonclassical 21-hydroxylase deficiency (NC21-OHD) diagnosed in adulthood after being misdiagnosed as polycystic ovary syndrome (PCOS) for 9 years. A 27-year-old Japanese woman presented with longstanding amenorrhea, hirsutism, and polycystic ovarian morphology on ultrasonography but did not exhibit withdrawal bleeding after standard estrogen/progestin (E/P) therapy. Hormonal evaluation revealed a low luteinizing hormone (LH) level, elevated testosterone (T), and a significantly increased 17α-hydroxyprogesterone level, which further increased following adrenocorticotropic hormone stimulation. Genetic analysis identified compound heterozygous mutations in the CYP21A2 gene (c.92C>T; c.293-13C>G), confirming the diagnosis of NC21-OHD. This case underscores the importance of considering NC21-OHD in adolescents and young adults with atypical PCOS features, such as severe hirsutism, abnormal hormonal profiles (low LH with markedly elevated T levels), and resistance to standard E/P therapy.
Female Underweight/Undernutrition Syndrome (FUS): An Emerging Health Concept in Premenopausal Women - Secondary Publication (English Translation of the Japanese Statement).
Tamura Y, Ogawa W, Ishii K … +11 more , Ishigaki Y, Nagai N, Hirota Y, Morino K, Inokuchi M, Suzuki T, Tanaka S, Terauchi M, Nose-Ogura S, Working Group on Female Underweight/Undernutrition Syndrome, Japan Society for the Study of Obesity
J Obstet Gynaecol Res · 2026 Feb · PMID 41721462 · Full text
In Japan, approximately 20% of women in their twenties are underweight (BMI < 18.5 kg/m), representing one of the highest prevalences among developed nations. Underweight and undernutrition are associated with decreased...
In Japan, approximately 20% of women in their twenties are underweight (BMI < 18.5 kg/m), representing one of the highest prevalences among developed nations. Underweight and undernutrition are associated with decreased bone mass, menstrual abnormalities, impaired glucose tolerance, sarcopenia-like changes, and systemic symptoms including depression and fatigue, significantly impacting health from young adulthood through the life course. This situation is influenced by complex factors including the societal internalization of thinness ideals, social media and mass media influences, the off-label use of GLP-1 receptor agonists, and socioeconomic factors such as poverty. However, while current healthcare and screening systems have advanced in addressing obesity, systematic approaches to underweight remain inadequately developed. Based on discussions by an expert working group established by the Japan Society for the Study of Obesity in collaboration with multiple related academic societies, this paper proposes a novel disease concept: Female Underweight/Undernutrition Syndrome (FUS). FUS encompasses the diverse physical and psychological health disorders arising from underweight or undernutrition, aiming to establish clear diagnostic criteria and frameworks for early detection and preventive intervention. Comprehensive measures are required, including stigma prevention, collaboration with educational and industrial sectors, integration into health screening systems, and addressing underlying social determinants. Through the proposal of FUS, we anticipate progress toward comprehensive interventions addressing the societal challenges surrounding women's health and body image.
Nationwide Faculty Development Seminars in Obstetrics and Gynecology in Japan: An Observational Study of Practical Initiatives and Educational Outcomes.
Suemitsu T, Nagayasu Y, Shinagawa M … +7 more , Komatsu H, Maki J, Hirose Y, Eto E, Isobe M, Masuyama H, Watari H
J Obstet Gynaecol Res · 2026 Feb · PMID 41717673 · Publisher ↗
AIM: To evaluate the educational outcomes of a nationwide faculty development initiative tailored to obstetrician-gynecologists in Japan, addressing the gap in systematic faculty development implementation and assessment...
AIM: To evaluate the educational outcomes of a nationwide faculty development initiative tailored to obstetrician-gynecologists in Japan, addressing the gap in systematic faculty development implementation and assessment within the specialty. METHODS: This observational study evaluated three online faculty development seminars conducted by the Japan Society of Obstetrics and Gynecology between December 2023 and August 2024. Using Kirkpatrick's four-level model, we assessed participant satisfaction (Level 1), self-assessed knowledge gain (Level 2), and behavioral implementation in clinical practice (Level 3). Data were collected using post-seminar and longitudinal follow-up questionnaires. RESULTS: Level 1 (Reaction): Among the 195 participants, 85.1% completed the post-seminar surveys, with satisfaction rates ranging from 87.9% to 93.0%. Level 2 (Learning): Self-assessed knowledge scores significantly improved across all three seminars (e.g., Seminar 1: from 4.0 to 7.0 on a 9-point scale, p < 0.05). Level 3 (Behavior): Among participants who attended multiple sessions, 74.1% reported implementing learned skills, such as feedback techniques and leadership strategies, with the majority noting positive educational outcomes. CONCLUSIONS: Nationwide faculty development programs tailored to obstetrics and gynecology can enhance educational competence and promote behavioral change. Our findings highlight the feasibility and effectiveness of specialty-specific faculty development and indicate the need for long-term objective assessments to ensure a sustainable impact. These findings have significant implications for the field of obstetrics and gynecology, suggesting that targeted faculty development initiatives can play a crucial role in improving the quality of medical education and addressing workforce shortages.
Depth of Invasion of 13 mm or Greater Accurately Predicted the Risk of Having a Node Positivity in Lymphadenectomy for Squamous Vulvar Cancer.
Albuquerque RC, Sousa SS, Tozatti GV … +3 more , Boneto B, Torres JC, Vale DB
J Obstet Gynaecol Res · 2026 Feb · PMID 41716116 · Full text
AIM: To analyze factors related to lymph node involvement in patients with squamous vulvar cancer undergoing lymphadenectomy and wide local excision at the University Hospital in Campinas, Brazil. METHODS: A retrospectiv...
AIM: To analyze factors related to lymph node involvement in patients with squamous vulvar cancer undergoing lymphadenectomy and wide local excision at the University Hospital in Campinas, Brazil. METHODS: A retrospective study involving 56 women treated between 2010 and 2022. The primary outcome was inguinal lymph node involvement (positive or negative). Clinical, operative, and pathologic variables were analyzed by appropriate tests. Kaplan-Meier curves were used to determine overall survival rate (OS). A receiver operating characteristic (ROC) curve was created to determine the optimal value of the depth of invasion for predicting node positivity. RESULTS: Of the 56 women who underwent surgery, node involvement was positive in 18 (32.1%). Where node was positive, the tumors were over 5 cm in 22.2% (versus 2.7%, p = 0.035), had an depth of invasion equal to or deeper than 13 mm (13 mm+) in 62.5% (versus 14.3%, p < 0.001), lymphovascular invasion in 33.3% (versus 11.8%, p = 0.024), presented disease progression in 44.4% (versus 11.8%, p = 0.019), and death in 77.8% (versus 31.6%, p = 0.001). The 5-year OS was 57.1% in the node-negative and 8.6% in the node-positive group, with most events occurring within the first 24 months. Depth of invasion 13 mm + increased the risk of node-positivity 11 times (11.37;1.85-69.82), showing a predictive negative value of 83.3%, and accuracy of 78.4%. CONCLUSION: The 13.0 mm cutoff for depth of invasion was independently associated with the risk of having a positive node, with an accuracy of 78.4%. The 5-year OS was 8.6% in the node-positive group, with most events within the first 24 months.
Endoplasmic Reticulum Stress-Induced Membrane Exposure of Calreticulin Serves as a Guide for Phagocytic Removal of Stressed-But-Viable Cytotrophoblasts.
Ikezaki M, Nishioka K, Nishitsuji K … +6 more , Fujino M, Mori N, Uchimura K, Ino K, Iwahashi N, Ihara Y
J Obstet Gynaecol Res · 2026 Feb · PMID 41714878 · Publisher ↗
AIM: Calreticulin (CRT), a protein in the endoplasmic reticulum (ER), plays critical roles in protein quality control and homeostasis of cytosolic and ER calcium levels. We previously reported that ER stress, a risk fact...
AIM: Calreticulin (CRT), a protein in the endoplasmic reticulum (ER), plays critical roles in protein quality control and homeostasis of cytosolic and ER calcium levels. We previously reported that ER stress, a risk factor for poor placentation and preeclampsia, induced extracellular release of CRT in a cytotrophoblast (CTB) BeWo cell model; extracellular CRT impaired CTB syncytialization. Several stresses, including ER stress, reportedly exposed CRT on membranes, but the roles of membrane-exposed CRT in CTBs have remained unclear. METHODS: We investigated whether ER stress-induced membrane exposure of CRT in CTBs and whether membrane-exposed CRT acted as a guide for phagocytic removal of stressed CTBs. RESULTS: Immunohistochemical analysis of preeclamptic placentas demonstrated increased expression of immunoglobulin heavy chain-binding protein, which indicated enhanced ER stress in preeclamptic placentas. The ER stress inducers thapsigargin and tunicamycin-induced membrane exposure of CRT in BeWo cells and primary human CTBs. Phorbol ester-differentiated THP-1 cells phagocytosed ER-stressed and CRT-exposing CTBs, which were blocked by an anti-CRT antibody. CONCLUSIONS: Our results thus propose a pathway for removal of damaged CTBs and thus for maintaining pregnancy. Because ER stress is a risk factor for poor placentation, investigation of physiological and pathological roles of CRT exposure-mediated phagocytic removal deserves future study.
Associations Between Rumination, Pain Resilience, Physical Activity, and Menstrual Symptoms in Young Women.
Dereli M, Ozer Kaya D
J Obstet Gynaecol Res · 2026 Feb · PMID 41708346 · Publisher ↗
AIMS: Menstrual symptoms are prevalent in young women and can adversely affect daily life. Psychosocial factors may influence symptom perception and management, but their roles remain unclear. This study aimed to investi...
AIMS: Menstrual symptoms are prevalent in young women and can adversely affect daily life. Psychosocial factors may influence symptom perception and management, but their roles remain unclear. This study aimed to investigate the relationship between rumination, pain resilience, and physical activity and menstruation symptoms in young women. METHODS: One hundred thirty females (21.31 ± 1.87 years) who menstruated regularly and did not use analgesics or oral contraceptives were included. Participants completed the Menstruation Symptom Scale (MSS), Ruminative Response Scale (RRS), Pain Resilience Scale (PRS), and International Physical Activity Scale (IPAQ) on the 1st and 5th days of their period. Data were analyzed using Spearman correlation and Kruskal-Wallis tests. RESULTS: Among participants, 69.9% were single, and 46.9% were sedentary. Mean menarche age and menstrual period were 13.19 ± 1.35 years and 5.89 ± 1.36 days, respectively. MSS total and subscale scores had small to moderate correlations with RRS total, RRS-brooding, RRS-reflection, and IPAQ-vigorous activity (rho = -0.175 to 0.374). MSS total (rho = -0.201) and MSS-coping methods (rho = -0.213) had a small correlation with PRS-cognitive/affective positivity. MSS-menstrual pain symptoms correlated with IPAQ-moderate activity (rho = -0.182), and MSS-coping methods correlated with PRS total (rho = -0.198) and IPAQ total (rho = -0.215). MSS total score was similar in inactive, minimally active, and active groups (p = 0.089). CONCLUSION: Rumination is correlated with increased menstrual symptoms, indicating an association between ruminative thinking during menstruation and somatic complaints in young women.
Co-Occurrence of Osteogenesis Imperfecta Type III and Chronic Abruption-Oligohydramnios Sequence: A Case Report Suggesting a Possible Role of Type I Collagen Fragility.
Okuyama A, Izdebski T, Goto M … +3 more , Seo K, Tominaga M, Ichizuka K
J Obstet Gynaecol Res · 2026 Feb · PMID 41705594 · Full text
Pregnancy complicated by severe osteogenesis imperfecta (OI) is rare, and chronic abruption-oligohydramnios sequence (CAOS) is an uncommon obstetric disorder characterized by persistent bleeding and oligohydramnios witho...
Pregnancy complicated by severe osteogenesis imperfecta (OI) is rare, and chronic abruption-oligohydramnios sequence (CAOS) is an uncommon obstetric disorder characterized by persistent bleeding and oligohydramnios without membrane rupture. To our knowledge, this is the first report describing the coexistence of type III OI and CAOS. A 24-year-old woman with OI developed recurrent bleeding early in pregnancy. Genetic testing revealed a novel COL1A1 splice-site variant (c.1876-2A>C). Ultrasonography showed a circumferential subchorionic hematoma and progressive fluid loss, leading to CAOS diagnosis at 19 weeks. Despite amnioinfusion, the amniotic cavity collapsed, and pregnancy was terminated via cesarean section at 20 weeks. Placental pathology showed hemosiderin and fibrin deposition. In this case, both functional and structural factors possibly associated with type I collagen abnormalities may have contributed to CAOS development. Although causality cannot be proven, persistent bleeding in severe OI may warrant greater caution for progression to CAOS.
Can Podocalyxin Immunoreactivity Facilitate Histopathological Diagnosis of Placenta Accreta Spectrum (PAS) Disorders?
Sayıt B, Atilgan R, Aslan M … +5 more , Kuloğlu T, Özercan IH, Hançer S, Yavuzkır Ş, Tepe B
J Obstet Gynaecol Res · 2026 Feb · PMID 41702842 · Publisher ↗
AIM: Placenta accreta spectrum (PAS) is linked to severe maternal morbidity and mortality, ranging from severe bleeding to death from placental failure at birth. PAS arises when the placenta invades the myometrium abnorm...
AIM: Placenta accreta spectrum (PAS) is linked to severe maternal morbidity and mortality, ranging from severe bleeding to death from placental failure at birth. PAS arises when the placenta invades the myometrium abnormally rather than the decidua basalis. Although uterine scarring is known to play a part in the pathophysiology of PAS, the fact that it can be observed in women who are nulliparous or who have not had uterine surgery raises the possibility that immunohistological changes may also play a role in the development of PAS in addition to anatomical defects. Ki-67 and vascular endothelial growth factor (VEGF) are crucial for placental angiogenesis and trophoblast invasion. The migration and invasion of cancer cells are especially aided by podocalyxin (PCX) overexpression. In this study, we want to examine PCX immunoreactivity in pathology samples from patients with a placenta increta diagnosis. METHODS: We compared the hysterectomy specimens of two groups of patients: those who had a cesarean hysterectomy with a clinical diagnosis of placenta increta, and those who had histopathologically confirmed placenta increta but were not diagnosed with placenta increta. RESULTS: We demonstrated that patients with placenta increta had considerably higher levels of VEGF, Ki-67, and PCX immunoreactivity. CONCLUSIONS: In PAS cases undergoing clinical hysterectomy, the increase in PCX immunoreactivity can be used as an immunohistochemical marker to support the diagnosis of PAS in histopathological confirmation of PAS diagnosis.
Placental Insufficiency and Neonatal Vulnerability: Organ-Specific Mechanisms Shaping Early-Life Health.
Ichinose M, Iriyama T, Hirota Y
J Obstet Gynaecol Res · 2026 Feb · PMID 41702376 · Full text
Placental insufficiency is a central pathological condition underlying fetal growth restriction and is strongly associated with adverse outcomes during the neonatal period. Although epidemiological and clinical studies h...
Placental insufficiency is a central pathological condition underlying fetal growth restriction and is strongly associated with adverse outcomes during the neonatal period. Although epidemiological and clinical studies have consistently linked compromised placental function to neonatal respiratory, neurological, gastrointestinal, and infectious morbidity, the mechanisms through which placental insufficiency translates into organ-specific neonatal vulnerability remain unclear. Increasing evidence from human observations and experimental animal models indicates that placental insufficiency disrupts coordinated fetal development through alterations in perfusion, vascular patterning, cellular differentiation, barrier maturation, and immune responsiveness, rather than through uniform growth failure. This review summarizes current progress in the understanding of organ-specific mechanisms by which placental insufficiency shapes neonatal vulnerability, with a focus on the lung, brain, intestine, and immune system. We further discuss how these developmental perturbations interact with postnatal environmental exposures and highlight future perspectives for identifying at-risk infants and developing targeted strategies to mitigate adverse neonatal outcomes.
Association of Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels With Acute Kidney Injury and Postpartum Renal Functional Recovery in Patients With Preeclampsia.
Gao J, Wu L, Li W … +3 more , Xu M, Liu Y, Liu F
J Obstet Gynaecol Res · 2026 Feb · PMID 41693384 · Publisher ↗
OBJECTIVE: To examine the association between neutrophil gelatinase-associated lipocalin (NGAL) level and acute kidney injury as well as postpartum renal functional recovery. METHODS: A retrospective study was conducted...
OBJECTIVE: To examine the association between neutrophil gelatinase-associated lipocalin (NGAL) level and acute kidney injury as well as postpartum renal functional recovery. METHODS: A retrospective study was conducted on 100 preeclampsia patients who were admitted and delivered in the Department of Obstetrics at our hospital between July 2024 and January 2025. Among them, 26 patients had concurrent acute kidney injury (AKI) while 74 did not. Demographic data and laboratory parameters were collected for all patients. Statistical analyses included Student's t-test, Pearson correlation analysis, and receiver operating characteristic (ROC) curve analysis for comparisons. RESULTS: Compared with the non-AKI group, the AKI group exhibited significantly higher levels of 24-h urinary protein excretion (1.91 ± 0.68 vs. 0.74 ± 0.20 g/24 h, p < 0.001), D-dimer (5.15 ± 0.73 vs. 3.15 ± 1.13 mg/L, p < 0.001), and neutrophil gelatinase-associated lipocalin (NGAL; 461.33 ± 75.74 vs. 370.22 ± 56.51 ng/mL, p < 0.001), but a significantly lower estimated glomerular filtration rate (eGFR; 165.27 ± 19.44 vs. 181.66 ± 25.80 mL/min/1.73m, p = 0.004). NGAL level showed positive correlations with D-dimer (r = 0.402) and 24-h urinary protein excretion (r = 0.367). The area under the curve (AUC) for predicting AKI occurrence superimposed on preeclampsia (PE) was 0.974 for 24-h urinary protein excretion,0.699 for eGFR,0.923 for D-dimer and 0.841 for NGAL, indicating their predictive value. Compared with Day 1, NGAL levels decreased on Days 5 and 7 in the renal function recovery group, while NGAL levels increased on Day 7 in the group without renal function recovery. CONCLUSION: Elevated serum NGAL levels at admission are significantly associated with acute kidney injury in patients with preeclampsia and serve as a valuable predictor for its occurrence, as evidenced by a high AUC.
Efficacy of Postoperative Para-Aortic and Pelvic Lymphadenectomies for Intermediate- to High-Risk Endometrial Cancer.
Okumura A, Yoshida K, Kotaka S … +4 more , Okamoto K, Matsumoto T, Kubo-Kaneda M, Kondo E
J Obstet Gynaecol Res · 2026 Feb · PMID 41693118 · Publisher ↗
PURPOSE: A two-stage surgery for endometrial cancer is associated with a high physical and psychological burden on the patient and possibly increases the risk of subsequent abdominal surgeries. In this study, we aimed to...
PURPOSE: A two-stage surgery for endometrial cancer is associated with a high physical and psychological burden on the patient and possibly increases the risk of subsequent abdominal surgeries. In this study, we aimed to characterize the oncological features of endometrial cancer patients with lymph node-positive and lymph node-recurrent disease who underwent two-stage lymphadenectomy after initial hysterectomy without pelvic and para-aortic lymphadenectomy and were at intermediate or high risk for postoperative recurrence. METHODS: This single-center retrospective study evaluated a total of 37 patients with endometrial cancer who underwent postoperative para-aortic lymphadenectomy between April 2020 and March 2023. RESULTS: The median follow-up duration was 42 months. The 3-year survival rate was 90%, and the 3-year recurrence-free survival rate was 80%. Lymph node metastasis occurred in 13.5% of the patients, of whom 2.7% had skip metastases in the para-aortic lymph nodes only. Histologically, most patients (80%) had endometrioid carcinoma grade 1. Overall recurrence was observed in 16.2%. The median recurrence-free survival time was 20.5 months. Poorly differentiated or non-endometrioid histology was found in 66.6% of the patients. All patients with low-grade endometrioid carcinoma with lymph node metastasis or recurrence had p53 mutations. CONCLUSION: No patients with lymph node metastasis relapsed during the follow-up period. Two-stage lymphadenectomy may have contributed to the favorable outcomes. However, it is difficult to perform molecular pathological evaluation in all cases preoperatively. Therefore, it is acceptable to perform a hysterectomy and undergo a two-stage lymphadenectomy in minimally invasive surgery according to risk classification.
Gestational Age-Dependent Effects of Antenatal Magnesium Sulfate on Fetal S100B Levels: An Observational Study Using Cord Serum.
Shimaya T, Fuma K, Tano S … +5 more , Matsuo S, Ushida T, Imai K, Kajiyama H, Kotani T
J Obstet Gynaecol Res · 2026 Feb · PMID 41692700 · Full text
AIM: Magnesium sulfate (MgSO) is widely used for fetal neuroprotection in preterm births before 32 weeks of gestation, yet it remains unclear whether its effect depends on gestational age. S100 calcium-binding protein B...
AIM: Magnesium sulfate (MgSO) is widely used for fetal neuroprotection in preterm births before 32 weeks of gestation, yet it remains unclear whether its effect depends on gestational age. S100 calcium-binding protein B (S100B), a protein secreted by astrocytes, is recognized as a biomarker of neural distress. This study aimed to investigate the relationship between antenatal MgSO administration and umbilical cord serum S100B levels, with a focus on gestational age. METHODS: This retrospective study included women who delivered between 22 and 33 weeks of gestation at a tertiary center. Patients with hypertensive disorders of pregnancy, category 1 cesarean sections, multiple pregnancies, major congenital anomalies, or insufficient MgSO administration were excluded. Cord blood samples were analyzed for S100B levels using ELISA. Multiple linear regression and restricted cubic spline modeling were performed to assess the association between MgSO and S100B levels across different gestational ages. RESULTS: Among 69 eligible patients, MgSO administration was significantly associated with higher cord serum S100B levels who delivered at ≥ 30 weeks of gestation (adjusted estimate 0.39, 95% confidence interval 0.17-0.62), but not in those who delivered at < 30 weeks (-0.12, -0.43 to 0.19) in multiple linear regression adjusted for birth weight and antenatal corticosteroids. This association remained consistent across multiple sensitivity analyses. S100B levels exhibited a gestational age-dependent increase in response to MgSO, peaking at approximately 32 weeks in restricted cubic spline modeling. CONCLUSIONS: Antenatal MgSO administration beyond 30 weeks of gestation at delivery is associated with increased fetal S100B levels, suggesting a potential gestational age-specific response.
Interval Vaginal Delivery of Term Twins From Bilateral Horns of a Uterus Didelphys: Insight Into Labor Initiation and Progression.
Hiratsuka D, Iriyama T, Sayama S … +3 more , Kumasawa K, Harada M, Hirota Y
J Obstet Gynaecol Res · 2026 Feb · PMID 41689253 · Full text
Uterus didelphys, characterized by two separate uterine cavities and cervices, is associated with increased obstetric complications. Twin pregnancy with one fetus in each horn is exceptionally rare, often managed by cesa...
Uterus didelphys, characterized by two separate uterine cavities and cervices, is associated with increased obstetric complications. Twin pregnancy with one fetus in each horn is exceptionally rare, often managed by cesarean or resulting in preterm birth. We report the first known case of term vaginal deliveries from both horns, occurring 6 days apart. A 28-year-old woman with uterus didelphys spontaneously conceived twins, with one fetus in each horn. At 37 + 4 weeks of gestation, labor began spontaneously in the left uterus. The cardiotocogram initially showed asynchronous contractions between the horns during the latent phase, becoming synchronous in the active phase. The first twin was delivered via forceps due to non-reassuring fetal status. The right uterus showed weak contractions but did not progress to labor. Six days later, labor was induced, and the second twin was also delivered via forceps. This case offers rare clinical insight into labor initiation and inter-horn coordination.
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