Journal Of Obstetrics And Gynaecology[JOURNAL]
Sun
200 papers
Uterocervical angle as a predictor for spontaneous singleton preterm birth: a prospective observational study.
Kassayanan P, Kongsomnuan S, Suntipap M
J Obstet Gynaecol · 2025 Dec · PMID 41222940 · Publisher ↗
BACKGROUND: The use of cervical length (CL) to predict spontaneous preterm birth (sPTB) is limited in performance due to the low prevalence of a short cervix in the Thai population. Therefore, this study aims to evaluate...
BACKGROUND: The use of cervical length (CL) to predict spontaneous preterm birth (sPTB) is limited in performance due to the low prevalence of a short cervix in the Thai population. Therefore, this study aims to evaluate the diagnostic performance of the uterocervical angle (UCA) in comparison with CL, and the integration of these parameters alongside cervical wedging to predict sPTB. METHODS: This prospective cohort study was designed to assess the diagnostic performance of UCA, CL, and cervical wedging for sPTB in singleton pregnancies, between gestational ages of 16 and 24 weeks, using transvaginal ultrasonography. The primary outcome was the diagnostic performance of the UCA, along with the integration of UCA with other parameters in women who delivered before 37 and 34 weeks. RESULTS: A total of 261 participants were included in the analysis. The optimal cut-off value for predicting sPTB before 37 weeks was 85 degrees for UCA, with a sensitivity of 44.8%, specificity of 46.6%, and a diagnostic odds ratio (DOR) of 0.71. For predicting sPTB before 34 weeks, the optimal cut-off for UCA was found to be 95 degrees, with a sensitivity of 71.4%, specificity of 59.8%, and a DOR of 3.73. The integration of UCA with CL or cervical wedging did not yield superior results compared to CL alone. The area under the receiver operating characteristic curve showed that UCA over 85 degrees was not as effective as CL under 33 mm for predicting sPTB before 37 weeks (0.54 vs. 0.51, respectively). However, CL under 30 mm was better than UCA over 95 degrees at predicting sPTB before 34 weeks (0.71 vs. 0.66, respectively). CONCLUSION: A wider UCA is associated with an increased risk of sPTB. However, while UCA alone does not have as high diagnostic performance as CL or cervical wedging alone in predicting sPTB.
Pathway to Endometriosis Diagnosis in South Australia: A Qualitative Study.
Shea G, Bowman R, Shipman J … +2 more , O'Hara R, Barry CM
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41217095 · Publisher ↗
BACKGROUND: Endometriosis is a significant and prevalent health issue. Delayed diagnosis is common and the associated delay to treatment is associated with high socioeconomic and personal costs including chronic pain, in...
BACKGROUND: Endometriosis is a significant and prevalent health issue. Delayed diagnosis is common and the associated delay to treatment is associated with high socioeconomic and personal costs including chronic pain, infertility and reduced quality of life. There is a lack of studies documenting endometriosis pathways in Australia. AIMS: To explore lived experiences of individuals with endometriosis in South Australia and identify perceived barriers to timely diagnosis. MATERIALS AND METHODS: Semi-structured interviews were conducted with 50 participants aged over 18 years living in South Australia with a surgical diagnosis of endometriosis and data was analysed using reflexive thematic analysis. RESULTS: Participants reported significant delays between the onset of symptoms and their diagnosis. Barriers were identified at personal and systemic levels. Personal barriers include societal and self-normalisation of symptoms and stigma associated with discussing menstrual health. Systemic hurdles include symptom dismissal and insufficient endometriosis education within healthcare and community settings. These barriers significantly hinder equitable and empathetic healthcare access. Diagnosis delivery is a key point in the endometriosis care pathway and must be conducted thoroughly and empathetically by health professionals with a patient-centred focus. CONCLUSIONS: This study highlights the need to improve care pathways for the timely recognition and management of persistent pelvic pain. In patients presenting with chronic pelvic pain, endometriosis should be considered as part of the differential diagnosis. Results call for multi-faceted improvements in technology, advocacy, and education for students and health practitioners to improve timely diagnosis and patient-centred outcomes. We suggest re-orientating the healthcare system to centre the individual as the expert in their own journey, fostering a more patient-centred approach.
Correction.
J Obstet Gynaecol · 2025 Dec · PMID 41194703 · Publisher ↗
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Trends in the Use and Indications for Intracytoplasmic Sperm Injection Between 2005 and 2017: A State-Wide Descriptive Cohort Analysis.
Kink A, Mehdipour P, Hiscock RJ … +11 more , Vollenhoven BJ, Stern CJ, Walker SP, Green MP, Osianlis T, Agresta F, Wilkinson D, Tong S, Hastie R, Kennedy AL, Lindquist AC
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41191966 · Full text
BACKGROUND: Intracytoplasmic sperm injection (ICSI) was first developed to overcome male factor infertility. ICSI has increased in uptake globally, including in cases where its use is non-essential for fertilisation. AIM...
BACKGROUND: Intracytoplasmic sperm injection (ICSI) was first developed to overcome male factor infertility. ICSI has increased in uptake globally, including in cases where its use is non-essential for fertilisation. AIMS: To identify temporal trends in the use of, and indications for ICSI in an Australian context. MATERIALS AND METHODS: A statewide descriptive cohort study examining the trends in ICSI uptake and reported indication/s for ICSI use. The cohort included women undergoing IVF between 2005 and 2017 at IVF clinics across Victoria, Australia that resulted in a birth after 20 weeks' gestation. RESULTS: The dataset comprised 32 102 assisted reproduction cycles: 22 873 (71.3%) ICSI and 9229 (28.7%) conventional IVF. In 2005, ICSI accounted for 60.6% (1182/1952) of cycles, increasing to 79.5% (2344/2947) by 2017 (p < 0.001). Testicular sperm retrieval as an indication for ICSI remained consistent over time (p = 0.15). Male factor infertility as an indication decreased over time (p = 0.007). Vitrified oocyte thaw (p = 0.016) and 'unexplained subfertility' (p = 0.30) cycles did not surpass 1.7% (39/2293) and 0.4% (9/2048), respectively of total cycles in any year. Donor sperm (p = 0.001), pre-implantation genetic testing (p = 0.004), female factors associated with poor IVF outcome (p = 0.005) and advanced maternal age (p = 0.005) all increased as indications for ICSI over time. 'Unspecified' indication accounted for the majority of ICSI cycles after 2008 (p = 0.015). CONCLUSIONS: During our study period, the total use of ICSI increased by 18.9%. Notably, most of these cycles were not medically indicated.
The effect of opioid-free anaesthesia on pain and prognosis in gynaecological laparoscopic surgery: a systematic review and meta-analysis.
Xu P, Hu Z, Chen J
J Obstet Gynaecol · 2025 Dec · PMID 41190639 · Publisher ↗
BACKGROUND: To evaluate the effect of opioid-free anaesthesia on postoperative pain and prognosis in gynaecological laparoscopic surgery. METHODS: A systematic search of four English and four Chinese databases was conduc...
BACKGROUND: To evaluate the effect of opioid-free anaesthesia on postoperative pain and prognosis in gynaecological laparoscopic surgery. METHODS: A systematic search of four English and four Chinese databases was conducted up to 31 January 2024. Ten randomised controlled trials involving 861 patients were included. RESULTS: Opioid-free anaesthesia substantially reduced the incidence of postoperative nausea and vomiting (odds ratio = 0.25), lowered pain scores measured by numeric rating scale (mean difference = -1.43) and Visual Analog Scale (mean differenc = -1.50), improved Quality of Recovery-40 scores (mean differenc = 15.39) and shortened the hospital stay (length of hospital stay) (mean differenc = -1.72). Sensitivity analysis confirmed the robustness of most outcomes. CONCLUSION: Opioid-free anaesthesia improves postoperative pain control and recovery in patients who undergo gynaecological laparoscopic surgery. It effectively reduces postoperative nausea and vomiting and enhances recovery quality, suggesting that opioid-free anaesthesia may be a promising alternative to opioid-based anaesthesia.
Rac3 promotes proliferation and invasion of endometrial cancer through the AKT/mTOR signalling pathway.
Lin R, Zhou L, Hu X
J Obstet Gynaecol · 2025 Dec · PMID 41123453 · Publisher ↗
BACKGROUND: Rac3 is associated with the malignancy of various tumours, including endometrial cancer (EC). Silencing Rac3 has been shown to effectively enhance the sensitivity of EC cells to chemotherapeutic drugs. Noneth...
BACKGROUND: Rac3 is associated with the malignancy of various tumours, including endometrial cancer (EC). Silencing Rac3 has been shown to effectively enhance the sensitivity of EC cells to chemotherapeutic drugs. Nonetheless, the underlying mechanism is still unclear. METHODS: Firstly, the association between Rac3 and EC was verified through the TCGA database. Subsequently, Ishikawa cell lines with Rac3 knockdown were constructed. The effects of Rac3 knockdown on the growth, migration and invasion of Ishikawa cells were assessed through clone formation experiments, CCK-8 experiments, flow cytometry, and Transwell experiments. Finally, qRT-PCR and WB experiments were conducted to initially explore the potential mechanism of action of Rac3 in the development of EC. RESULTS: Compared with normal tissues, the expression of Rac3 in EC tissues was significantly elevated, and this expression further increased with the aggravation of tumour. In Ishikawa cells with Rac3 knockdown, cell viability was significantly reduced, the apoptosis rate increased, and the invasion and migration abilities of the cells were inhibited. Correlation analysis of EC samples revealed a positive correlation between Rac3 and AKT2, AKT3 and mTOR. Additionally, WB and qRT-PCR also suggested that the mechanism of action of Rac3 in the development of EC may be related to the upregulation of AKT2, AKT3 and mTOR. CONCLUSIONS: Knockdown of Rac3 may inhibit the occurrence and development of EC, which is related to its inhibition of AKT2, AKT3 and mTOR. This discovery provides a theoretical basis for clinical screening of biomarkers for EC and the development of potential therapeutic targets.
Associations of parabens and age at natural menopause in women in the USA: National Health and Nutrition Examination Survey.
Wang L, Luo X, Ren M … +2 more , Sun D, Wang Y
J Obstet Gynaecol · 2025 Dec · PMID 41117421 · Publisher ↗
BACKGROUND: Menopause is linked to declining ovarian function and adverse health outcomes such as cardiovascular disease and osteoporosis. Early menopause exacerbates these risks, underscoring the need to identify modifi...
BACKGROUND: Menopause is linked to declining ovarian function and adverse health outcomes such as cardiovascular disease and osteoporosis. Early menopause exacerbates these risks, underscoring the need to identify modifiable risk factors. Prior studies associate parabens with altered ovarian reserve markers and ovarian ageing in animal models, yet their relationship with natural menopause onset remains unexplored. METHODS: This cross-sectional study included 2668 female participants aged 18 years and older from the NHANES 2005-2016, excluding those with missing paraben measurements, hysterectomy/ovariectomy or critical variable data. Exposure was assessed via creatinine-corrected urinary concentrations of four parabens [butyl paraben (BuP), ethyl paraben (EtP), methyl paraben (MeP), propyl paraben (PrP)], each categorised by tertiles. The primary outcome was natural menopause onset, defined by self-report (no menstrual periods for ≥12 months due to menopause) per NHANES protocol. Weighted Cox regression models were used to examine associations between each paraben and natural menopause onset. Subgroup analyses were conducted by smoking status, alcohol use and oral contraceptive use. RESULTS: Natural menopause occurred in 1043 women in the total population. Compared with women with the lowest tertile of EtP, women in the second tertile of EtP (HR = 1.26, 95% CI: 1.01-1.57) and the highest tertile of EtP (HR = 1.28, 95% CI: 1.01-1.64) was associated with an increased risk of earlier onset of natural menopause. However, all BuP, MeP and PrP levels were not statistically associated with the onset of natural menopause. The results of subgroup analysis indicated that EtP, MeP and PrP were all associated with the earlier onset of natural menopause in women who did not used oral contraceptives. CONCLUSION: Our findings suggested an association between higher EtP levels and an earlier onset of natural menopause in general U.S. women. The findings of our study necessitate further prospective epidemiologic research to validate.
Retrospective analysis of metabolism-related genes in endometrial carcinoma: links to prognosis and immunity.
Lin Q, Lu R, Chen Y … +3 more , Yu X, Xiao Y, Ye X
J Obstet Gynaecol · 2025 Dec · PMID 41100048 · Publisher ↗
BACKGROUND: Endometrial carcinoma is a clinically complex gynaecologic malignancy exhibiting significant molecular heterogeneity. This heterogeneity manifests as marked variability in clinical outcomes and heterogeneous...
BACKGROUND: Endometrial carcinoma is a clinically complex gynaecologic malignancy exhibiting significant molecular heterogeneity. This heterogeneity manifests as marked variability in clinical outcomes and heterogeneous therapeutic responses to emerging treatment modalities, particularly to immune checkpoint inhibitors. Metabolic reprogramming has been implicated in tumour progression and immune evasion in endometrial carcinoma. However, the prognostic implications of metabolism-related genes and their interaction with the tumour immune microenvironment remain insufficiently characterised. METHODS: RNA-seq and clinical data of endometrial carcinoma were downloaded from The Cancer Genome Atlas (TCGA) database, along with a metabolism-related gene set (MRGs) curated from the Msigdb database. Differential expression analysis was conducted to identify differentially expressed metabolism-related genes (DE-MRGs), which were subsequently analysed to evaluate their expression patterns and prognostic significance in uterine corpus endometrial carcinoma. Functional enrichment was performed via GO and KEGG analysis. The CIBEROSRT computational algorithm was employed to quantify immune infiltration characteristics and their correlation with MRGs. Furthermore, an external GEO dataset (GSE17025) was employed to validate hub gene expression. RESULTS: A total of 49 differentially expressed MRGs were identified in endometrial carcinoma. Functional analyses showed enrichment in retinol and tyrosine metabolism pathways. Two hub genes, LIPG and DDC, were significantly associated with overall survival ( = 0.01 and = 0.0015, respectively). Multivariate analysis confirmed DDC as an independent prognostic factor ( < 0.001). Immune profiling revealed higher infiltration of regulatory T cells ( = 0.005) and M0 macrophages ( = 2.6 × 10) in tumours. LIPG and DDC exhibited significant correlations with various immune cell populations. CONCLUSION: Our study analysed the expression and prognostic relevance of MRGs of endometrial carcinoma. We validated the prognostic value of MRGs and their potential to offer novel insights into prognostication and personalised treatment strategies for endometrial carcinoma.
Demographics of epithelioid trophoblastic tumour and placental site trophoblastic tumour: a 21 year UK population study.
Savage P, Froeling F, Lythgoe M … +11 more , Fisher R, Maher G, Winter M, Eremeishvili K, Sarwar N, Aguiar X, Singh K, Hancock B, Coleman R, Tidy J, Seckl MJ
J Obstet Gynaecol · 2025 Dec · PMID 41099823 · Publisher ↗
BACKGROUND: Epithelioid and placental site trophoblastic tumours are rare gestational malignancies which have little detailed information on their population incidence or risk related to maternal age. METHODS: We perform...
BACKGROUND: Epithelioid and placental site trophoblastic tumours are rare gestational malignancies which have little detailed information on their population incidence or risk related to maternal age. METHODS: We performed a retrospective UK national population-based study examining all of the cases registered between 2000 and 2020 using the databases at the UK's two gestational trophoblastic treatment centres at Charing Cross Hospital in London and Weston Park Hospital in Sheffield. The data obtained was compared with the contemporary UK birth and pregnancy statistics. RESULTS: Over the 21-year study period, there were 132 cases of ETT or PSST. PSTT comprised 57% of the cases, 30% were ETT and 13% had mixed pathology. The combined incidence of ETT and PSTT was 1:118,736 relative to live births and 1:150,872 compared to total viable conceptions. For women aged under 20 the incidence relative to live births was 1:412,488, increasing to 1:188,292 for women 30-34 years, and 1:1,426 for women aged 45 and above. The median interval from the antecedent pregnancy to the time of diagnosis was 15 months (0-288) for the PSTT patients compared to 24 months (0-336) for patients with a diagnosis of ETT. CONCLUSIONS: ETT and PSTT are both rare diagnoses with little detailed information on their demographics. The data in this study indicates a wide range in the interval from the antecedent pregnancy to diagnosis and confirms a close relationship between increasing incidence and rising maternal age.
Obstetric violence prevalence and risk factors: an umbrella review.
Gabiati Niedo VR, Lahoz Molina LG, Cano-Ibáñez N … +3 more , Waltrich N, Khan KS, Amezcua-Prieto C
J Obstet Gynaecol · 2025 Dec · PMID 41084943 · Publisher ↗
BACKGROUND: Obstetric violence (OV) is a gender-based human rights violation during pregnancy, labour, and postpartum. Despite increasing recognition, the global prevalence and risk factors associated with OV remain poor...
BACKGROUND: Obstetric violence (OV) is a gender-based human rights violation during pregnancy, labour, and postpartum. Despite increasing recognition, the global prevalence and risk factors associated with OV remain poorly understood. We aim to estimate the prevalence of OV worldwide, examine regional disparities, and identify the associated risk factors through an umbrella review. METHODS: After prospective registration (PROSPERO CRD42025631985), a comprehensive search was conducted in PubMed, Scopus, Web of Science, and Scielo for reviews published between January 2015 and March 2025. Two reviewers independently selected studies, extracted data, and assessed methodological quality using the AMSTAR 2 tool. Overlap of studies among the included reviews was quantified using the corrected covered area (CCA). The risk factor data were summarised as odds ratio (OR) with 95% confidence interval (CI). RESULTS: Fourteen reviews, with a total of 1,116,159 participants, were included; of which 10 (71.4%) were of critically low or low quality and only one review was high quality. The CCA was very low at 1.136%. OV prevalence varied from 23.2% to 59%, depending on region and definitional criteria. Forms of OV included physical (3.1-78.4%), verbal or psychological (2.6-66%), and social (1.9-94%) mistreatment. Statistically significant risk factors included low socioeconomic status (maximum OR = 3.68; 95% CI = 1.4-9.7), obstetric complications (maximum OR = 6.41; 95% CI: 1.36-30.14), limited education (OR = 5.92; 95% CI 1.38-23.81), public healthcare births (maximum OR = 4.34; IC 95%: 1.58-11.97), instrumental delivery (OR = 2.35; 95% CI: 1.72-3.22), and inadequate provider training (OR = 1.47; 95% CI: 1.05-2.04). CONCLUSIONS: OV is a prevalent global issue. Vulnerable populations, i.e. those with lower socioeconomic status and limited education, were more often affected. The low methodological quality of the existing literature is a key weakness. There is a need for standardised definitions and improved research validity for the development of evidence-based interventions.
Shatavari ( Willd) root extract for postpartum lactation: A randomised, double-blind, placebo-controlled study.
Ajgaonkar A, Debnath T, Bhatnagar S … +2 more , Debnath K, Langade J
J Obstet Gynaecol · 2025 Dec · PMID 41055223 · Publisher ↗
BACKGROUND: Inadequate milk production during the immediate postpartum period is a common problem. Shatavari (), a revered herb in Ayurveda, is traditionally used as a galactagogue. The objective of this study is to asse...
BACKGROUND: Inadequate milk production during the immediate postpartum period is a common problem. Shatavari (), a revered herb in Ayurveda, is traditionally used as a galactagogue. The objective of this study is to assess the safety and effectiveness of Shatavari root extract (SHT) on lactation in post-partum women. METHODS: This prospective, randomised, double-blind, placebo-controlled study enrolled post-partum women (≥37 weeks' gestation, aged 20-40 years) with uncomplicated vaginal or caesarean deliveries who intended to breastfeed. Participants received either Shatavari root extract (SHT; 300 mg) or placebo (PL) capsules twice daily for 72 h postpartum. The primary outcomes included time to evident breast fullness after the last feeding and the total milk volume expressed at 72 h. The secondary outcomes were maternal and investigator-rated satisfaction (e.g. noticeable breast fullness, maternal/infant wellbeing), assessed by a five-point Likert scale. Safety was assessed through adverse event reports. RESULTS: From the 120 enrolled participants, seven participants (3 SHT, 4 PL) did not complete the study, yielding a per-protocol dataset of 113 women (57 SHT and 56 PL). The baseline characteristics were comparable across groups. The time to evident breast fullness after the last feeding was significantly shorter in the SHT group ( = 0.002), and milk volume at 72 h was significantly higher ( < 0.001). Maternal satisfaction with lactation was higher in the SHT group (52.63% vs. 25.00%, = 0.008). SHT participants also reported greater satisfaction with infant well-being. Investigators rated maternal and infant well-being higher for SHT than placebo (80.70% vs. 64.29%). No adverse events occurred, and treatment compliance was high. CONCLUSION: Shatavari root extract improved the milk volume and maternal satisfaction about lactation, indicating its potential as a safe, effective galactagogue.
Efficacy of sacral nerve magnetic stimulation in preventing urinary retention after total hysterectomy: a randomised controlled trial.
Chen L, Zhang S, Qin Y
J Obstet Gynaecol · 2025 Dec · PMID 41051260 · Publisher ↗
BACKGROUND: Urinary retention following total hysterectomy is a prevalent postoperative complication that significantly impacts patient recovery and quality of life. Current prevention methods have limitations, prompting...
BACKGROUND: Urinary retention following total hysterectomy is a prevalent postoperative complication that significantly impacts patient recovery and quality of life. Current prevention methods have limitations, prompting exploration of more effective strategies. Sacral nerve magnetic stimulation (SMS), an innovative, non-invasive approach, has shown potential in managing urinary disorders. METHODS: In this single-centre, prospective, randomised controlled trial, 100 patients undergoing surgery for gynaecological malignancies were randomly assigned to receive either standard care (control group) or SMS treatment plus standard care (intervention group). The primary outcome was the incidence of post-operative urinary retention (POUR) (the number of patients with residual urine volume over 100 mL or inability to void divided by the total number of patients in each group, expressed as a percentage), with secondary outcomes including time to spontaneous voiding, re-catheterisation rate and pelvic floor muscle strength. RESULTS: The intervention group had a significantly lower POUR incidence (14% vs. 36%, = .002), shorter time to spontaneous voiding (1.5 days vs. 2.5 days, < .001) and lower re-catheterisation rate (12% vs. 30%, = .012) compared to the control group. Pelvic floor muscle strength also improved in the intervention group ( = .03). No serious adverse events related to SMS were reported. CONCLUSIONS: SMS can significantly reduce the incidence of POUR and shortened the time to spontaneous voiding, while also decreasing the re-catheterisation rate compared to the control group.
Association between serum GDF-15 and hypertension in the third trimester of pregnancy.
Chen C, Li Q, Wang Y
J Obstet Gynaecol · 2025 Dec · PMID 40995730 · Publisher ↗
BACKGROUND: To investigate the expression of serum Growth differentiation factor 15 (GDF-15) and examine its correlation with systolic and diastolic blood pressure in third-trimester pregnant women with hypertensive diso...
BACKGROUND: To investigate the expression of serum Growth differentiation factor 15 (GDF-15) and examine its correlation with systolic and diastolic blood pressure in third-trimester pregnant women with hypertensive disorders of pregnancy (HDP). METHODS: This cross-sectional study included 60 patients with HDP in the third trimester (HDP group) and 50 healthy pregnant women (control group). Clinical characteristics were collected and serum GDF15 levels were measured. RESULTS: Serum GDF-15 levels were significantly elevated in the HDP group compared to controls. Moreover, Serum GDF-15 levels were positively correlated with both systolic blood pressure and diastolic blood pressure in the HDP group. CONCLUSIONS: Serum GDF‑15 levels may be associated with the severity of HDP.
Correction.
J Obstet Gynaecol · 2025 Dec · PMID 40990182 · Publisher ↗
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Bisphenol A and di-(2-ethylhexyl) phthalate: Hidden threats to female fertility.
Incognito GG, Ettore C, Ettore G
J Obstet Gynaecol · 2025 Dec · PMID 40977262 · Publisher ↗
Bisphenol A and di-(2-ethylhexyl) phthalate are among the most widespread endocrine-disrupting chemicals (EDCs), widely present in consumer products and the environment. Preclinical studies have shown that these compound...
Bisphenol A and di-(2-ethylhexyl) phthalate are among the most widespread endocrine-disrupting chemicals (EDCs), widely present in consumer products and the environment. Preclinical studies have shown that these compounds and their metabolites may interfere with key reproductive processes, including folliculogenesis and steroidogenesis. However, translating these findings into clinical relevance remains challenging. Human studies have yielded conflicting results, with some suggesting associations between EDC levels and reduced ovarian reserve or poorer in vitro fertilisation outcomes, while others report no significant correlations. Differences in study design, population characteristics and exposure assessment contribute to this heterogeneity. Despite the current limitations, the topic warrants attention within reproductive medicine, particularly from a preventive perspective. While evidence remains inconclusive, raising awareness and considering lifestyle factors potentially linked to environmental exposures may be a reasonable step in clinical practice. Further studies are needed to clarify their clinical impact and to guide evidence-based reproductive care.
Integrated bioinformatic and experimental study links cyclin B1/B2 to poor prognosis and immune infiltration in endometrial cancer.
Yang H, Zhang Z, Liu H … +5 more , Zhong Y, Pan R, Zheng D, Li L, Yu L
J Obstet Gynaecol · 2025 Dec · PMID 40944462 · Publisher ↗
BACKGROUND: Although most cases of endometrial cancer (EC) are diagnosed at an early stage with favourable outcomes, the prognosis for advanced or recurrent disease remains poor, highlighting the need for novel therapeut...
BACKGROUND: Although most cases of endometrial cancer (EC) are diagnosed at an early stage with favourable outcomes, the prognosis for advanced or recurrent disease remains poor, highlighting the need for novel therapeutic targets. This study aimed to examine the correlation between Cyclin B1 (CCNB1) and Cyclin B2 (CCNB2) expression and disease severity in EC through bioinformatics analysis. METHODS: Common differentially expressed genes were identified in two EC cohorts from the Gene Expression Omnibus. A protein-protein interaction (PPI) network was constructed to identify hub genes. Aberrant expression of the hub genes was validated in external datasets. Their prognostic values were evaluated in a cohort from The Cancer Genome Atlas (TCGA). Knockdown of the hub genes was conducted to explore their functions in the malignant behaviour of EC cells . RESULTS: CCNB1 and CCNB2 were identified as the top 2 hub genes in the PPI network. High CCNB1/CCNB2 expression was significantly associated with shorter survival in EC patients. Overexpression of CCNB1/CCNB2 in endometrial tumour tissue was validated in public datasets. In TCGA cohort, high expression of CCNB1/CCNB2 correlated with greater disease severity and predicted poor prognosis. In addition, high expression of CCNB1/CCNB2 was strongly associated with immune cell infiltration, as well as increased expression of immune checkpoint genes and mismatch repair genes. Furthermore, knockdown of CCNB1/CCNB2 significantly suppressed the proliferation, migration, and invasion of HEC-1 and Ishikawa cells . CONCLUSIONS: CCNB1 and CCNB2 may serve as potential prognostic markers and therapeutic targets for the management of EC.
Outcomes of transvaginal natural orifice transluminal endoscopic hysterectomy: a multi-centre retrospective study from Turkey (TR-MIGS).
Gungorduk K, Akpak YK, Erkılınc S … +12 more , Sacinti KG, Korkmaz V, Iscan SC, Kanmaz AG, Khatib G, Kosan B, Hanedan C, Toz E, Gülseren V, Taskın S, Ozerkan K, Taskıran C
J Obstet Gynaecol · 2025 Dec · PMID 40944439 · Publisher ↗
BACKGROUND: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy is gaining increasing popularity among gynaecological surgeons worldwide due to its minimally invasive nature and associated benef...
BACKGROUND: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy is gaining increasing popularity among gynaecological surgeons worldwide due to its minimally invasive nature and associated benefits. However, despite its growing adoption, it remains a relatively novel surgical technique that continues to be evaluated and refined in clinical practice. The primary objective of this study is to share and analyse our initial experiences with the implementation of vNOTES hysterectomy across six specialised gynaecological centres in Turkey. METHODS: This retrospective analysis included all women who underwent vNOTES hysterectomy, with or without salpingo-oophorectomy, for benign or malignant conditions. All procedures adhered to the standardised protocol described by Baekelandt Data on baseline patient characteristics, intraoperative details, and postoperative outcomes were collected and analysed. RESULTS: A total of 685 patients underwent vNOTES procedures. Among them, 64 women (9.3%) had a history of one caesarean delivery, 38 (5.5%) had two prior caesareans, and 11 (1.6%) had three or more. Myoma, with or without accompanying metrorrhagia, was the most common surgical indication (53.0%). The mean operative time was 72.4 ± 40.2 min, and the average haemoglobin decrease was 1.3 ± 1.0 g/dL. The mean uterine weight was 204 ± 145 g. Intraoperative complications occurred in 1.7% of cases ( = 12), while postoperative complications were observed in 1.4% ( = 10). Conversion to conventional laparoscopy occurred in six cases (0.9%), primarily due to an obliterated pouch of Douglas or intraoperative complications. The average hospital stay was 2.3 ± 1.4 days. CONCLUSIONS: These findings support vNOTES as a safe and effective surgical approach, offering a viable alternative to traditional laparoscopic or vaginal techniques in select patient populations.
Statement of Retraction: Early prediction of the failure of methotrexate treatment by Days 1-4 serum β-hCG change and 48-hour pre-treatment increment in β-hCG.
J Obstet Gynaecol · 2025 Dec · PMID 40938087 · Publisher ↗
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Women's knowledge, attitudes and interest in antenatal perineal massage - a cross-sectional survey.
Lee HCP, Lo TK
J Obstet Gynaecol · 2025 Dec · PMID 40926322 · Publisher ↗
BACKGROUND: Antenatal perineal massage (APM) is an established technique for preventing severe perineal trauma, but it is uncommonly practised in Hong Kong. This study aimed to investigate pregnant women's knowledge, att...
BACKGROUND: Antenatal perineal massage (APM) is an established technique for preventing severe perineal trauma, but it is uncommonly practised in Hong Kong. This study aimed to investigate pregnant women's knowledge, attitudes and interest in APM, and to identify factors that influence their interest in the technique. METHODS: A prospective cross-sectional study was conducted over 7 months at Princess Margaret Hospital. Pregnant women aged 18 years or above and under 37 weeks of gestation were invited to participate via a bilingual questionnaire distributed during antenatal clinic visits. Descriptive and regression analyses were used. RESULTS: Out of 385 respondents, only 31.4% were aware of APM with social media (61.2%) as their main source of knowledge. Only 44.8% of the questions were answered correctly, with a median knowledge score of 3.0 out of 7. A majority were unaware of the long-term impacts of severe perineal injury (57.7%) and potential benefits of perineal massage (54.5%), highlighting a deficiency of knowledge. Interest in APM was high (66.2%). Non-Chinese, higher education, planned vaginal delivery and knowledge of the technique's benefit are positive predictors of expressed interest. However, concerns about discomfort (38.5%) and embarrassment (38.5%) were notable barriers to participation. Among those who practised APM, the median Likert score was 4 out of 5, indicating a generally positive perception of its benefits. CONCLUSIONS: This study reveals important areas where knowledge regarding obstetric anal sphincter injuries (OASIS) and APM is lacking among some pregnant women in Hong Kong. There is a need to enhance education and resources regarding these topics in antenatal classes.
Using robotic single-port vNOTES for gynaecological oncology: omentectomy in a patient with an ovarian granulosa cell tumor-a case study.
Zhang C, Li Q, Fang F … +1 more , Guan X
J Obstet Gynaecol · 2025 Dec · PMID 40914934 · Publisher ↗
BACKGROUND: Robotic single-port transvaginal natural orifice transluminal endoscopic surgery (RSP-vNOTES) is an emerging minimally invasive approach that combines the advantages of robotic surgery with scarless transvagi...
BACKGROUND: Robotic single-port transvaginal natural orifice transluminal endoscopic surgery (RSP-vNOTES) is an emerging minimally invasive approach that combines the advantages of robotic surgery with scarless transvaginal access. Its application in gynecologic oncology remains limited, particularly for omentectomy during ovarian cancer staging. METHODS: We present the case of a 45-year-old woman with an ovarian granulosa cell tumor (GCT) who underwent supplemental staging surgery following unilateral oophorectomy. Using a single-port robotic system via the transvaginal route, hysterectomy, right salpingo-oophorectomy, and omentectomy were performed. Key technical steps included enhanced visualization with gauze placement and use of an additional robotic arm for omental traction. RESULTS: The procedure lasted 2 hours and 10 minutes with an estimated blood loss of 50 mL. No intraoperative or postoperative complications occurred. The patient did not require postoperative analgesics and was discharged on postoperative day 3. Final pathology confirmed absence of omental metastasis. CONCLUSION: This case demonstrates the feasibility and safety of RSP-vNOTES for omentectomy in gynecologic oncology. The technique offers potential benefits including reduced abdominal trauma, faster recovery, and superior visualization for complex dissections. While further studies are necessary to validate long-term oncologic outcomes, RSP-vNOTES may represent a promising minimally invasive option for selected patients requiring ovarian cancer staging surgery.
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