Márai D, Virgens IPAD, Vincze Á
… +6 more, Obeidat M, Hegyi P, Bakony M, Erdélyi ZR, Melczer Z, Valent S
Int J Gynaecol Obstet
· 2026 Jun · PMID 42333998
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BACKGROUND: Pre-eclampsia is a serious pregnancy-related syndrome lacking accurate prognostic markers. MicroRNA-210, overexpressed in the circulation of women with pre-eclampsia, has recently emerged as a promising bioma...BACKGROUND: Pre-eclampsia is a serious pregnancy-related syndrome lacking accurate prognostic markers. MicroRNA-210, overexpressed in the circulation of women with pre-eclampsia, has recently emerged as a promising biomarker. OBJECTIVES: We conducted a systematic review and meta-analysis to evaluate the relationship between miR-210 levels and pre-eclampsia at different degrees of severity. SEARCH STRATEGY: The study was prospectively registered on PROSPERO (CRD42024604698) and included a comprehensive systematic search of five databases conducted on November 21, 2024. SELECTION CRITERIA, DATA COLLECTION AND ANALYSIS: The included studies involved pregnant women with mild or severe pre-eclampsia compared to normotensive controls, meeting guideline-based diagnostic criteria and reporting circulating microRNA-210. Precalculated effect sizes were pooled to obtain a weighted mean and 95% confidence interval (CI) for microRNA-210-fold increase. Subgroup analysis assessed pre-eclampsia severity, using an inverse variance method in random-effects meta-analysis models. MAIN RESULTS: Our search identified 776 records, of which seven were deemed eligible for analysis. The fold change values, reflecting the increase in microRNA-210 levels between the control and pre-eclamptic populations, were 3.33 (CI: 0.69-5.98; I = 93%, CI: 88-96%) in the mild pre-eclampsia group and 7.23 (CI: 2.27-12.18; I = 98%, CI: 98-99%) in the severe pre-eclampsia group, indicating a significant effect (P = 0.01) in the subgroup difference tests. The mean ratio of microRNA-210-fold change between the two severity groups was 2.05 (CI: 1.41-2.69; I = 85%, P < 0.01), favoring the severe population. CONCLUSION: Elevated microRNA-210 levels are strongly associated with pre-eclampsia severity at the time of diagnosis, with a consistent, significant stepwise increase from mild to severe disease. Whether miR-210 holds predictive value earlier in pregnancy remains to be established in prospective studies with first-trimester sampling.
Pardo A, Barbash-Hazan S, Shmueli A
… +7 more, Eisner M, Sigal S, Wiznitzer A, Walfisch A, Sela T, Wolff L, Hadar E
Int J Gynaecol Obstet
· 2026 Jun · PMID 42333975
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OBJECTIVE: To evaluate the feasibility and accuracy of remote, clinician-guided biophysical profile (BPP) assessment using a handheld ultrasound device operated by lay users. METHODS: This prospective, non-randomized, qu...OBJECTIVE: To evaluate the feasibility and accuracy of remote, clinician-guided biophysical profile (BPP) assessment using a handheld ultrasound device operated by lay users. METHODS: This prospective, non-randomized, quasi-blinded study compared clinician-guided ultrasound-based BPP scans performed remotely by lay users using the Pulsenmore ES device with concomitant standard in-clinic ultrasound examinations performed by healthcare professionals, with both assessments conducted consecutively and immediately one after the other. Agreement between modalities was assessed for individual BPP components and overall BPP scores. RESULTS: A total of 30 pregnant women were enrolled at a mean gestational age of 33.0 ± 2.6 weeks. The mean maternal age was 31.4 ± 4.5 years, and mean body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) was 27.4 ± 5.2. Overall agreement between remote and in-clinic BPP scores was 90%. Agreement was 100% for cardiac activity, fetal movements, fetal presentation, placental location, and subjective amniotic fluid volume assessment. Agreement for fetal tone and breathing movements was 96.7 and 93.3%, respectively. Sensitivity and specificity of remote BPP assessment for detecting abnormal overall BPP findings, using the standard in-clinical ultrasound examination as the reference standard, were 92.6 and 66.7%. The mean difference in total BPP score was 0.07 ± 0.64 points. Mean fetal heart rate and maximal vertical pocket measurements were comparable between modalities. Remote examinations required more time than in-clinic scans (8.0 ± 3.9 vs. 4.6 ± 3.3 min) but remained within recommended limits. CONCLUSION: Clinician-guided remote BPP assessment using a handheld ultrasound device operated by lay users demonstrates high agreement with standard in-clinic ultrasound under supervised conditions and may represent a reliable alternative for prenatal surveillance in selected populations.
Int J Gynaecol Obstet
· 2026 Jun · PMID 42333959
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Postpartum hemorrhage (PPH) remains a major cause of both maternal mortality and morbidity worldwide. PPH is a nightmare for obstetricians. Uterine artery embolization (UAE) has a high success rate in controlling bleedin...Postpartum hemorrhage (PPH) remains a major cause of both maternal mortality and morbidity worldwide. PPH is a nightmare for obstetricians. Uterine artery embolization (UAE) has a high success rate in controlling bleeding from secondary PPH, with a success rate of 85%. UAE is particularly useful for PPH caused by uterine atony, retained placental fragments, or abnormal blood vessel formation (AVM). We report a case of a recurrent secondary PPH which was successfully treated with uterine arterial embolization. A 36-year-old female, Para-3, with a history of two previous cesarean sections, presented with massive per vaginal bleeding 40 days after cesarean section due to twin pregnancy. On the 17th post-operative day of cesarean section, she developed severe secondary PPH and underwent D & C for retained product of conception. After the procedure, bleeding continued on and off but the last episode was catastrophic. After initial resuscitation and hemodynamic stabilization and medical management, her bleeding was reduced but still persisted. She received 11 units of blood transfusion throughout the postpartum period .Her ultrasound was done which suspected C-section site-acquired arteriovenous malformation. Considering her age and desire to preserve fertility, the patient underwent bilateral uterine arteriovenous embolization by coils. Her per vaginal bleeding dramatically reduced after the procedure. UAE is often considered when conservative management fails to control bleeding or surgical interventions are not preferred. UAE is a fertility-sparing option, allowing women to potentially have future pregnancies. Compared to surgical interventions like hysterectomy, UAE is less invasive, resulting in short hospital stay and faster recovery times. In essence, UAE is an available tool in the multidisciplinary approach to managing secondary PPH in a tertiary care center.
Int J Gynaecol Obstet
· 2026 Jun · PMID 42329138
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OBJECTIVES: This study examines global and regional trends in maternal mortality (1990-2023) and explores shifts in cause-specific and age-specific patterns using the latest Global Burden of Disease (GBD) 2023 data. METH...OBJECTIVES: This study examines global and regional trends in maternal mortality (1990-2023) and explores shifts in cause-specific and age-specific patterns using the latest Global Burden of Disease (GBD) 2023 data. METHODS: We analyzed maternal deaths and age-standardized mortality rates (ASMR) globally and across Sociodemographic Index (SDI) and GBD regions. Temporal trends were assessed using estimated annual percentage changes (EAPC). Cause-specific and age-specific mortality patterns were examined. RESULTS: Globally, maternal deaths declined by 43.27% from 422 924 in 1990 to 239 929 in 2023, with ASMR falling from 7.46 to 3.00 per 100 000 population. All age-specific rates declined but with uneven pace. The age distribution shifted toward older women, particularly in high SDI regions where the modal age shifted from 20-24 to 30-34 years. The proportion of hemorrhage decreased, while hypertensive disorders and ectopic pregnancy increased, despite stable or falling absolute rates. ASMR rose in high-income North America and Southern Sub-Saharan Africa but fell sharply in East and South Asia. Low SDI regions retained a younger age distribution and high absolute burden despite substantial rate reductions. CONCLUSION: Despite global progress, maternal mortality shows uneven epidemiological transition and widening inequities across age, cause, and region. Future strategies must be tailored to local contexts with strengthening emergency obstetric care and early pregnancy diagnostic capacity in low-resource settings, while integrating multidisciplinary management of complex and indirect causes in higher SDI regions, with a sustained focus on age-specific and equity-oriented interventions.
González-Granados C, Rejas-Gutiérrez J, Ramírez-Mena M
… +10 more, Calvo-Torres J, Del Pino M, Bradbury M, Procas B, Rubio-Arroyo M, Gippini I, Oliva R, Fasero M, Coronado PJ, HPV‐Know Study Group
Int J Gynaecol Obstet
· 2026 Jun · PMID 42329127
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OBJECTIVE: Knowledge about HPV, and whether it differs depending on virus infection status, remains unclear among women in Spain. Thus, the aim of this study was to investigate the level of knowledge, and related outcome...OBJECTIVE: Knowledge about HPV, and whether it differs depending on virus infection status, remains unclear among women in Spain. Thus, the aim of this study was to investigate the level of knowledge, and related outcomes, on HPV in adult women in Spain. METHODS: A cross-sectional, non-interventional multicenter study was carried out in year 2022. Participants, consecutively recruited from 18 centers across the country, completed a validated questionnaire; the HPV-Know-Q, which examines the knowledge on HPV. RESULTS: A total of 1387 women were enrolled, including 1016 HPV-infected and 371 uninfected. The mean knowledge score was 78.6 points (standard deviation [SD] = 23.2). After adjusting by covariates, HPV-infected women mean score (95% confidence interval [CI]) on the HPV knowledge questionnaire was significantly higher compared to those without the infection; 84.8 (83.9-85.6) versus 80.5 (78.6-82.3), P < 0.001, although the effect size was small: Cohen's d of 0.37 (0.22-0.52). Significant differences between the two groups were found across all areas related to HPV infection. Vaccination rates were higher among the infected women; 58.7% versus 27.0%, P < 0.001. CONCLUSION: Knowledge about HPV among women in Spain was high, with HPV-infected women showing significantly greater knowledge compared to non-infected, although effect size was small. Higher educational background and premenopause status were explanatory variables, with limited power, but significantly associated with higher HPV knowledge, while being immunosuppressed would reduce it.
Int J Gynaecol Obstet
· 2026 Jun · PMID 42322124
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BACKGROUND: HPV infection is a major contributor to cervical and other anogenital cancers, with people living with HIV (PLWH) at particularly high risk due to persistent infection. Although prophylactic HPV vaccines are...BACKGROUND: HPV infection is a major contributor to cervical and other anogenital cancers, with people living with HIV (PLWH) at particularly high risk due to persistent infection. Although prophylactic HPV vaccines are widely used and generally safe, their efficacy and safety in PLWH remain uncertain. OBJECTIVE: To evaluate the efficacy and safety of HPV vaccination in PLWH through an overview and network meta-analysis (NMA). SEARCH STRATEGY: An electronic search was conducted in several databases up to August 12, 2025, without date or language restrictions, using keywords related to HPV vaccines, efficacy, and safety. SELECTION CRITERIA: We included systematic reviews of randomized controlled trials (RCTs) involving PLWH with HIV who received bivalent (bHPV), quadrivalent (qHPV), or nonavalent (9vHPV) HPV vaccines. DATA COLLECTION AND ANALYSIS: Study selection (Rayyan software) and data extraction were conducted by two independent researchers, and discrepancies were resolved by a third author. Quantitative synthesis was performed using R software. Risk of bias was assessed using AMSTAR 2. The certainty of the evidence was assessed using the Confidence in Network Meta-Analysis (CINeMA). MAIN RESULTS: NMA identified that the qHPV vaccine showed significant immunological efficacy, with a significant increase in seroconversion for anti-HPV 6 (odds ratio [OR]: 17.72; 95% confidence interval [CI]: 2.55, 123.19) and anti-HPV 18 (OR: 22.81; 95% CI: 2.31, 225.32) antibodies, compared to the control group. No significant differences were observed for types 11 and 16. Regarding safety, qHPV demonstrated the best profile regarding pain outcomes at all doses analyzed, with a P score greater than 0.98. CONCLUSIONS: The qHPV vaccine presented the best safety profile regarding pain, including at all doses. Regarding immunological efficacy, significant differences were only found between patients vaccinated with qHPV for anti-HPV 6 and 18. No trials directly evaluated the 9vHPV in PLWH, limiting the applicability of these findings to current vaccination programs.
Int J Gynaecol Obstet
· 2026 Jun · PMID 42322122
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OBJECTIVE: Social determinants of health influence maternal and perinatal outcomes, yet tools to operationalize these risks in clinical care remain scarce. We aimed to study social determinants in Brazilian pregnant wome...OBJECTIVE: Social determinants of health influence maternal and perinatal outcomes, yet tools to operationalize these risks in clinical care remain scarce. We aimed to study social determinants in Brazilian pregnant women and develop a social vulnerability index (SVI) that could correlate with pregnancy and perinatal outcomes. METHODS: The present study was a secondary analysis of 1565 low-risk nulliparous women enrolled in two Brazilian cohort studies. We selected vulnerability indicators from sociodemographic data and tested the performance and risk association of multiple SVI models with any adverse outcome (preterm birth, gestational diabetes mellitus, pre-eclampsia, small or large for gestational age, low 5-min Apgar score, neonatal intubation, neonatal intensive care unit admission, fetal or neonatal death) using chi-square tests, logistic regression, and receiver operating characteristic analysis. RESULTS: Advanced maternal age, non-white ethnicity, and exclusive publicly funded antenatal care were the most consistent vulnerability predictors of adverse outcomes. The final three-variable SVI demonstrated a significant dose-response gradient, with maternal adverse outcomes increasing from 16.4% (no vulnerabilities) to 43.8% (3 vulnerabilities) and perinatal adverse outcomes rising from 22.1% to 35.6%. The model presented a sensitivity of 64.71%, a specificity of 42.56%, a positive predictive value of 47.46% and a negative predictive value of 60.07% for any adverse outcome. CONCLUSION: The three-variable SVI offers a simple, reproducible, and context-adapted screening tool for primary care. Either for individual or population screening, it can be easily combined with clinical risk assessment, targeting those who may benefit from equity-oriented maternal health strategies.
Melamed N, Divakar H, Choolani M
… +17 more, McAuliffe FM, Foo L, Shehata H, Jones G, Senikas V, Van der Beek EM, Palshetkar N, Saccone G, Berghella V, Cuello MA, Konje J, Bhatt B, Cam A, Obimbo M, Papageorghiou A, Hod M, FIGO Committee on Women's Health and Technology
Int J Gynaecol Obstet
· 2026 Jun · PMID 42319236
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Maternal and neonatal mortality and morbidity rates uncover major global health disparities. Despite ongoing efforts, the rates of maternal and neonatal complications remain substantially higher in low- and middle-income...Maternal and neonatal mortality and morbidity rates uncover major global health disparities. Despite ongoing efforts, the rates of maternal and neonatal complications remain substantially higher in low- and middle-income countries (LMICs) compared to high-income countries (HICs). These high rates are the result of several unmet needs in LMICs, including limited access to quality antenatal care, health worker shortages, unreliable infrastructure, sociocultural barriers, low health literacy, environmental and nutritional challenges, and affordability. In addition, while the greatest burden of these complications lies in LMICs, it is crucial to recognize that similar disparities exist in rural and remote areas of large, higher-income countries. FemTech (female technology), which refers to a wide range of digital tools and technologies designed specifically to support women's health, has the potential to address these unmet needs in LMICs. In many LMIC settings, mobile connectivity may represent the most scalable digital infrastructure available to women, often reaching communities long before formal health system expansion. However, the uptake of these in LMICs remains limited by infrastructure, regulatory, affordability, and sociocultural constraints. Introducing these digital solutions to LMICs without careful adaptations to these unique factors is more likely to widen rather than narrow inequities. Many international guidelines advocating the implementation of advanced technologies have not taken into account these unique LMIC-specific challenges. This gap underscores the need to develop strategies for the implementation of FemTech in LMIC settings. FIGO and its partners are well placed to coordinate the development of dedicated global guidance tailored to resource-limited settings. This document is a first step toward this goal.
Int J Gynaecol Obstet
· 2026 Jun · PMID 42319223
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Artificial intelligence (AI) is increasingly being investigated as a decision-support tool in controlled ovarian stimulation (COS) during in vitro fertilization. Machine learning and deep learning algorithms have demonst...Artificial intelligence (AI) is increasingly being investigated as a decision-support tool in controlled ovarian stimulation (COS) during in vitro fertilization. Machine learning and deep learning algorithms have demonstrated promising predictive performance for outcomes including ovarian response, mature oocyte yield, premature luteinizing hormone rise, gonadotropin dose adjustment, and optimization of trigger timing. Convolutional neural networks applied to three-dimensional ultrasound imaging have also enabled automated follicular monitoring and more standardized assessment of follicular development. This narrative review summarizes current AI applications in COS and critically evaluates the methodological quality, validation status, and clinical relevance of available models. Most published studies are retrospective and based on single-center data sets, with limited external validation and scarce prospective randomized evidence. Furthermore, many reported improvements relate primarily to surrogate laboratory outcomes rather than clinically meaningful endpoints such as live birth rates. Although AI-assisted COS demonstrates considerable potential for individualized treatment and workflow optimization, important barriers remain, including model interpretability, generalizability, ethical considerations, data privacy, and regulatory oversight. Future progress will require multicenter collaborations, prospective clinical validation, explainable AI frameworks, and careful integration of AI tools into clinician-guided reproductive care.
Fanaki M, Kordali T, Thomakos N
… +3 more, Vlachos DE, Haidopoulos D, Pergialiotis V
Int J Gynaecol Obstet
· 2026 Jun · PMID 42319211
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BACKGROUND: Cancer antigen 125 (CA-125) is widely used for monitoring epithelial ovarian cancer, but the prognostic significance of an early postoperative decline remains uncertain. OBJECTIVE: This systematic review and...BACKGROUND: Cancer antigen 125 (CA-125) is widely used for monitoring epithelial ovarian cancer, but the prognostic significance of an early postoperative decline remains uncertain. OBJECTIVE: This systematic review and meta-analysis evaluated whether postoperative CA-125 decline is associated with improved survival outcomes. SEARCH STRATEGY: A systematic literature search was conducted to identify studies reporting survival outcomes according to postoperative CA-125 change following primary cytoreductive surgery. SELECTION CRITERIA: We included studies investigating the prognostic impact of perioperative or postoperative CA-125 decline and dynamics in surgically treated patients with ovarian cancer, and correlated CA-125 changes with survival outcomes. DATA COLLECTION AND ANALYSIS: A total of 12 studies met eligibility criteria for the systematic review. MAIN RESULTS: The primary outcomes were progression-free survival (PFS) and overall survival (OS). Hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted and pooled using fixed- and random-effects meta-analysis models. Statistical heterogeneity was assessed using the I statistic and chi-square test. Of these, three retrospective cohort studies reported sufficient data for quantitative synthesis and were included in the meta-analysis. Across included studies, postoperative CA-125 decline was consistently associated with improved survival outcomes. Pooled estimates demonstrated a significant association between postoperative CA-125 response and prognosis, with moderate heterogeneity observed between studies (I approximately 60%). CONCLUSIONS: Postoperative CA-125 decline may represent a clinically significant prognostic marker associated with improved survival outcomes in ovarian cancer patients and may contribute to postoperative risk stratification. Nevertheless, the small number of studies available for quantitative synthesis, together with the considerable methodological heterogeneity among cohorts, warrants cautious interpretation of the findings and underscores the need for larger prospective studies using standardized definitions of CA-125 response.
Int J Gynaecol Obstet
· 2026 Jun · PMID 42319204
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OBJECTIVE: To evaluate the association between physician experience and the use of forceps-assisted vaginal delivery, and to assess whether increasing experience is associated with changes in cesarean delivery rates in a...OBJECTIVE: To evaluate the association between physician experience and the use of forceps-assisted vaginal delivery, and to assess whether increasing experience is associated with changes in cesarean delivery rates in a tertiary academic health care network. METHODS: We conducted a retrospective longitudinal cohort study including all physician-attended deliveries within a tertiary academic healthcare network in Santiago, Chile, between 2014 and 2024. The unit of analysis was the physician-year. Physician experience was defined as years since completion of residency and analyzed as a continuous variable. Outcomes included forceps-assisted and cesarean deliveries, modeled using volume-weighted logistic regression at the physician-year level. A sensitivity analysis restricted the data set to physician-years with ≥20 deliveries. RESULTS: The data set included 109 physicians, 641 physician-year observations, and 26 898 deliveries. Cesarean delivery accounted for 46.05%, spontaneous vaginal delivery for 46.18%, and forceps-assisted delivery for 7.75%. Increasing physician experience was associated with higher odds of forceps delivery (odds ratio [OR] per year, 1.013 [95% confidence interval [CI], 1.008-1.018]; p < 0.001). Although a statistically significant association was observed for cesarean delivery (OR per year, 1.007 [95% CI, 1.005-1.010]; p < 0.001), the magnitude was minimal and not clinically meaningful. Findings were consistent in the ≥20-delivery sensitivity analysis. CONCLUSION: Increasing physician experience is associated with greater use of forceps-assisted delivery, while cesarean delivery rates remain largely unchanged. These findings suggest that operative vaginal delivery depends on sustained clinical exposure, and preserving training opportunities may help maintain its role as an alternative to cesarean delivery in appropriately selected patients.
Lewis JM, Wu H, Rojas AC
… +8 more, Boekhorst F, Osório F, Topcu EG, Baba T, Lopez CC, Wang K, Meinhold-Heerlein I, Wasson M
Int J Gynaecol Obstet
· 2026 Jun · PMID 42311201
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Surgery continues to be a mainstay of treatment for patients with symptomatic fibroids. Hysterectomy is an option for those desiring definitive treatment and myomectomy is preferred for those that have not yet completed...Surgery continues to be a mainstay of treatment for patients with symptomatic fibroids. Hysterectomy is an option for those desiring definitive treatment and myomectomy is preferred for those that have not yet completed childbearing or wish to retain their uterus. While open laparotomy remains a viable approach to both hysterectomy and myomectomy, minimally invasive techniques for the surgical management of symptomatic fibroids are preferred options for many due to improved patient outcomes. These include hysteroscopic myomectomy, laparoscopic and robotically assisted myomectomy, and vaginal, laparoscopic, and robotically assisted hysterectomy. Patients have a faster recovery and less postoperative pain compared to a laparotomic approach. More recently, uterine-sparing outpatient modalities such as ultrasound-guided radiofrequency ablation and high-intensity focused ultrasound have emerged as promising alternatives for selected patients. Benefits include clinically significant reduction in fibroid size and menstrual bleeding with small or no abdominal incisions and an expedited convalescence. This article reviews preoperative evaluation and imaging for fibroids, as well as the techniques, approach, indications, patient selection, procedural management, and surgical and fertility outcomes for each surgical and procedural management of uterine fibroids.
Belmont-Rojo L, Hernandez-Cruz R, Lopez-Diaz AJ
… +4 more, Copado-Mendoza DY, Rubalcava-Rubalcava T, Lumbreras-Marquez MI, Pijuan-Domenech MA
Int J Gynaecol Obstet
· 2026 Jun · PMID 42311199
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OBJECTIVE: This study aimed to describe maternal and perinatal outcomes among pregnant women with echocardiographically high probability of pulmonary arterial hypertension (PAH) managed at a quaternary center and to comp...OBJECTIVE: This study aimed to describe maternal and perinatal outcomes among pregnant women with echocardiographically high probability of pulmonary arterial hypertension (PAH) managed at a quaternary center and to compare outcomes between women with and without cardiac complications (CC). METHODS: This retrospective cohort study included pregnant women with echocardiographically estimated high probability of PAH and managed at a referral center between 2015 and 2022. Clinical, obstetric, and neonatal outcomes were obtained from medical records. CC were defined as heart failure, pulmonary edema, arrhythmia, pulmonary embolism, or maternal death during pregnancy or up to 6 weeks postpartum. Outcomes were compared between women with and without CC. Receiver operating characteristic (ROC) curve analysis was performed as an exploratory analysis to assess the discriminatory ability of pulmonary artery systolic pressure (PASP) for CC. RESULTS: Sixty-two pregnancies in 60 women (mean age 24.5 ± 6.5 years) were analyzed. Eight pregnancies (12.9%) were electively terminated, while 54 (87.1%) continued. CC occurred in 11 pregnancies (17.7%), mainly heart failure. Four maternal deaths (6.5%) were recorded. Among ongoing pregnancies, the median gestational age at delivery was 37.1 weeks, and the median birthweight was 2445 g. Fetal growth restriction occurred in 27.7%, and 62.9% of deliveries were by cesarean section. Neonatal mortality was 5.5%. In exploratory analysis, a PASP threshold of 64 mmHg predicted CC with 91% sensitivity and 60% specificity (area under the curve = 0.749). CONCLUSION: Pulmonary arterial hypertension is a high-risk condition in pregnancy, with substantial maternal and perinatal complications. Although maternal mortality was lower than historically reported in similar settings, the incidence of CC remained considerable. PASP might reflect disease severity and shows exploratory discriminatory ability but requires cautious interpretation.
Int J Gynaecol Obstet
· 2026 Jun · PMID 42311195
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OBJECTIVE: To examine how different antiphospholipid antibody (aPL) profiles influence placental-mediated adverse pregnancy outcomes (APOs) in women with systemic lupus erythematosus (SLE). METHODS: This retrospective co...OBJECTIVE: To examine how different antiphospholipid antibody (aPL) profiles influence placental-mediated adverse pregnancy outcomes (APOs) in women with systemic lupus erythematosus (SLE). METHODS: This retrospective cohort study included 245 pregnant women with SLE and 490 controls from a single center. Clinical features, immunologic markers and aPL profiles were analyzed. Logistic regression models were used to explore associations between antiphospholipid syndrome (APS), individual aPL subtypes, antibody burden and placental-mediated APOs. RESULTS: Placental-mediated APOs occurred more often in SLE pregnancies than in controls (27.8% vs. 9.8%). After adjustment, APS was not independently associated with APOs. Renal involvement, chronic hypertension and hypocomplementemia remained significant predictors (P < 0.05). Among antibody types, lupus anticoagulant (LAC) showed the strongest association in univariate analysis, but the effect weakened in multivariable analysis. Women with multiple aPL positivity had a higher risk of placental complications, whereas single positivity showed little independent effect. CONCLUSION: In SLE pregnancies, obstetric risk is not explained by APS alone. Antibody burden, especially multiple aPL positivity, together with renal disease, hypertension and complement levels appears more informative for assessing placental-related risk.
Benagiano G, Gemzell-Danielsson K, Habiba M
… +1 more, Shantha-Kumari S
Int J Gynaecol Obstet
· 2026 Jun · PMID 42311183
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The term femicide, widely used in reference to the "killing of a woman because she is a woman," has been questioned on the ground that it implies unequal dignity of men and women victims of gender related death. This pos...The term femicide, widely used in reference to the "killing of a woman because she is a woman," has been questioned on the ground that it implies unequal dignity of men and women victims of gender related death. This position called for an analysis of the terminology used to describe and define the various forms of killing of women and men. We conclude that the use of the term "femicide" retains as a central facet the objective of raising awareness of this crime and combating violence directed at women by men. We also analyzed the current use of the word "androcide" and concluded that its present use is limited to situations where the killing of men is systematic, such as illegal war crimes. In this regard, we address the occurrence of deaths that may be related to gender within or outside relationships. We addressed the under reported issue of intimate partner violence (IPV) and killing of men. The latter has not attracted as much attention and remains a complex problem to understand and study. The issue is further compounded because domestic violence has also been a factor in cases of suicide. Violent behavior directed against men may occur in heterosexual or gay relationships. Estimates of the prevalence of IPV against men in heterosexual relationships, vary from 3.4% to 20.3%. The victim's own behavior is often advanced in mitigation. Although reports on violent behavior among gay and bisexual men have been relatively rare, IPV is at least as prevalent in this group. Indeed, some studies report alarmingly high incidence. In conclusion, there must be a continued focus on gender related death of women, but this should not distract from the occurrences when the victim is a man. There needs to be a drive to improve data collection from all countries with special focus on those in Africa and Asia that do not fully contribute to the global effort. There is also a need to better define the underlying causes and triggers for death, including by suicide, to enable the development of informed prevention strategies.
Int J Gynaecol Obstet
· 2026 Jun · PMID 42311171
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OBJECTIVE: This study estimates the prevalence of various forms of intimate partner violence (IPV) and examines their associations with depressive and post-traumatic stress disorder (PTSD) symptoms among lesbian and bise...OBJECTIVE: This study estimates the prevalence of various forms of intimate partner violence (IPV) and examines their associations with depressive and post-traumatic stress disorder (PTSD) symptoms among lesbian and bisexual women (LBW) in India. METHODS: This cross-sectional online survey included 53 self-identified LBW college women in India. Participants were recruited through social media platforms, instant messaging applications, and student listservs. Interested participants were invited to complete an online survey assessing IPV experiences and symptoms of depression and PTSD. RESULTS: Overall, 58.5% of participants reported experiencing at least one form of IPV. Psychological IPV was most prevalent (49.1%), followed by digital IPV (34%), physical IPV (28.3%), injuries (26.4%), and sexual IPV (26.4%). Approximately 26.4% of participants met the threshold for probable depression and 30% for probable PTSD. Correlational analyses revealed significant associations between various forms of IPV and symptoms of depression and PTSD. Negative binomial regression analyses indicated that experiencing IPV, particularly psychological and digital IPV, was associated with higher levels of depressive and PTSD symptoms. CONCLUSION: This exploratory study observed substantial IPV prevalence among lesbian and bisexual college women in India, highlighting its impact on mental health symptoms. Targeted interventions designed to address both IPV and its associated mental health consequences can potentially enhance help-seeking behavior within this vulnerable population.