The Journal Of Obstetrics And Gynaecology Research[JOURNAL]
Sun
200 papers
Elevated Body Mass Index Associated With Uterine Fibroids: A Retrospective Cohort Study With Bioinformatic Validation.
Lin J, Zhou L, Zhao M
J Obstet Gynaecol Res · 2026 Jul · PMID 42397288 · Publisher ↗
AIM: Uterine fibroids are the most common benign pelvic tumors in women. Meanwhile, the prevalence of obesity has been increasing annually and affects various health conditions. However, the relationship between obesity...
AIM: Uterine fibroids are the most common benign pelvic tumors in women. Meanwhile, the prevalence of obesity has been increasing annually and affects various health conditions. However, the relationship between obesity and the development of uterine fibroids remains inconsistent and warrants further investigation. METHODS: Clinical data from 1170 women undergoing routine health examinations at the Second Affiliated Hospital of Wenzhou Medical University were retrospectively analyzed. We compared the incidence of uterine fibroids across different body mass index categories and evaluated differences in serum lipid profiles between patients with uterine fibroids and control subjects. These findings were externally validated using data from the National Health and Nutrition Examination Survey. To explore potential molecular mechanisms, gene expression datasets related to uterine fibroids and obesity were obtained from the Gene Expression Omnibus database. Differentially expressed genes were identified and subjected to functional enrichment analysis. Subsequently, a protein-protein interaction network was constructed to identify hub genes using Cytoscape. RESULTS: The incidence of uterine fibroids was significantly higher in both overweight and obese groups compared to the normal weight group. Significant differences in Low-Density Lipoprotein Cholesterol levels were also found between the fibroid and non-fibroid groups. To elucidate the underlying mechanisms, we identified 85 common differentially expressed genes, which were primarily enriched in extracellular matrix-related pathways. Subsequent protein-protein interaction network analysis pinpointed three hub genes: TGFBI, ITGA4, and VCAN. CONCLUSIONS: Our results suggest that weight management may be associated with a reduced risk of uterine fibroids. While these findings are preliminary, they may have some relevance to clinical practice pending confirmation in future studies.
Factors Affecting Quality of Life of Thai Cervical Cancer Patients.
Katanyoo K, Thavorncharoensap M, Kittisiam T
J Obstet Gynaecol Res · 2026 Jul · PMID 42394269 · Publisher ↗
BACKGROUND: This study aimed to assess the quality of life (QoL) among Thai patients with cervical cancer and identify the factors influencing utility scores using the European Organization for the Research and Treatment...
BACKGROUND: This study aimed to assess the quality of life (QoL) among Thai patients with cervical cancer and identify the factors influencing utility scores using the European Organization for the Research and Treatment of Cancer: Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), EORTC: Cervical Cancer Module 24 (EORTC QLQ-CX24), and EQ-5D-5L instruments. METHODS: This cross-sectional study was conducted at Vajira Hospital, Thailand, and included 205 patients with cervical cancer. Demographics data, cancer stage, treatment status, and caregiving support, were collected. The participants completed the QoL questionnaires. Multivariate Tobit regression analysis was used to analyze the predictors of EQ-5D-5L utility scores. RESULTS: The mean global QoL score (EORTC QLQ-C30) and mean utility score (EQ-5D-5L) were 73.62 ± 21.57 and 0.90 ± 0.18, respectively. Fatigue was the most frequently reported symptom, whereas sexual dysfunction (EORTC QLQ-CX24) and emotional distress were common challenges. Patients who had completed treatment without disease reported the highest utility score (mean: 0.96), whereas Stages III-IVA patients under palliative care had the lowest utility score (mean: 0.66). Multivariable analysis revealed that Stage III/IVa, palliative treatment, and having at least one caregiver were independently associated with significantly lower utility scores. CONCLUSIONS: Cervical cancer significantly affects the QoL, with advanced stage and treatment status being major contributors to reduced utility. Additionally, the patient symptom burden is dominated by prominent fatigue and a distinct sexual health profile, characterized by a marked discordance between profoundly low sexual activity and persistent sexual worry.
Association Between Serum Vitamin D Levels and Insulin Resistance in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis.
Guo Q, Du R, Guo C … +1 more , Ma S
J Obstet Gynaecol Res · 2026 Jul · PMID 42387943 · Publisher ↗
BACKGROUND: Vitamin D deficiency has been proposed as a potential contributor to insulin resistance (IR) in polycystic ovary syndrome (PCOS); however, the evidence remains inconclusive. This meta-analysis evaluated the a...
BACKGROUND: Vitamin D deficiency has been proposed as a potential contributor to insulin resistance (IR) in polycystic ovary syndrome (PCOS); however, the evidence remains inconclusive. This meta-analysis evaluated the association between serum 25-hydroxyvitamin D [25(OH)D] and IR in PCOS. METHODS: We systematically searched PubMed, Embase, Web of Science, and Cochrane Library up to December 2025 for observational studies reporting correlations of 25(OH)D with IR indices (HOMA-IR/fasting insulin) in women with PCOS. Pooled correlation coefficients (r) with 95% confidence intervals (CI) were calculated using random-effects models. RESULTS: Fourteen studies involving 1856 women with PCOS were included. A significant inverse correlation was found between serum 25(OH)D and IR (pooled r = -0.32, 95% CI: -0.40 to -0.23; p < 0.001; I = 58%). Subgroup analyses revealed stronger associations in overweight/obese women (r = -0.35) and in Asian populations (r = -0.36). Women with vitamin D deficiency (< 20 ng/mL) showed a stronger correlation (r = -0.38). Sensitivity analysis confirmed robustness, and no significant publication bias was detected. CONCLUSION: Lower serum vitamin D is significantly associated with greater insulin resistance in PCOS, especially in overweight/obese and Asian subgroups. These findings highlight the potential value of assessing vitamin D status in the metabolic evaluation of PCOS.
Trends in Initial Cardiac Function, Treatment, and Outcomes in Peripartum Cardiomyopathy.
Kohno Y, Kawano H, Matsuo T … +7 more , Oku K, Suga S, Muroya T, Takeno M, Hasegawa Y, Maemura K, Miura K
J Obstet Gynaecol Res · 2026 Jul · PMID 42386569 · Publisher ↗
BACKGROUND: Peripartum cardiomyopathy (PPCM) is a rare disease that causes heart failure during pregnancy or in the early postpartum period, and there were no reports on the trend of clinical condition and treatment in J...
BACKGROUND: Peripartum cardiomyopathy (PPCM) is a rare disease that causes heart failure during pregnancy or in the early postpartum period, and there were no reports on the trend of clinical condition and treatment in Japan. This explanatory retrospective study aimed to investigate the changes in clinical conditions and treatment in patients with PPCM. METHODS: Twenty-three patients (aged 22-43 years; mean age, 32 years) with PPCM from four hospitals in Nagasaki Prefecture were included. We compared the heart failure status and treatments of PPCM between the 10 years from January 2002 to December 2011 (first era) (N = 10) and the 11 years from January 2012 to December 2022 (second era) (N = 13). RESULTS: Left ventricular ejection fraction (LVEF) on admission was higher (first era 20% (interquartile range (IQR) 17-34) vs. second era 34% (IQR 25-37), p = 0.0213), and less patients treated with inotropes in patients in second era than those in first era (first era 6/10 (60%) vs. second era 2/13 (15%), p = 0.0393). Hospitalization period was shorter in second era than those in first era (first era 38 days (IQR 22-45) vs. second era 19 days (IQR 16-22), p = 0.0159). CONCLUSION: In recent years, patients with PPCM have been admitted before progression of LV dysfunction, and that may be related to a decrease in use of inotropes and hospitalization period in Japan.
Vaginal Microbiome and Preterm Birth in Pregnant Women From India.
Singh A, Chhabria K, Vashist N … +11 more , Singh S, Suneja G, Khater S, Rao A, Arigela C, Kamani A, Das G, Husein A, Urehekar AD, Kumar S, Modi D
J Obstet Gynaecol Res · 2026 Jul · PMID 42385362 · Publisher ↗
OBJECTIVE: Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality worldwide, with India alone contributing nearly 27% of the global PTB burden. Although alterations in the vaginal microbiome have been...
OBJECTIVE: Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality worldwide, with India alone contributing nearly 27% of the global PTB burden. Although alterations in the vaginal microbiome have been implicated in PTB, its association in the Indian context is underexplored. This study aimed to investigate the association of the vaginal microbiome and PTB in Indian women at the time of delivery. STUDY DESIGN: The vaginal swabs were collected at the time of delivery from 72 women (31 term, 41 preterm) admitted to a tertiary care hospital in Western India. Microbial DNA was extracted, and the V3-V4 region of the 16S rRNA gene was sequenced. Community composition, alpha and beta diversity, and differential taxonomic abundance were assessed using bioinformatics pipelines. RESULTS: There were no significant differences in alpha or beta diversity between term and preterm groups. Principal coordinate and unsupervised clustering analyses showed no group-wise segregation. The relative abundance of individual Lactobacillus species, including L. iners and L. helveticus, did not differ significantly between the two groups. However, a modest difference in the relative abundance of Streptococcus was observed between the two groups after adjustment. CONCLUSION: This study found no major microbial shifts in the vaginal microbiome associated with preterm birth in this cross-sectional cohort of Indian women, suggesting that vaginal dysbiosis at the time of delivery may not be a principal driver of PTB in this population. These findings underscore the need for larger, longitudinal, and ethnically diverse studies using standardized methodologies better to understand the microbiome's role in PTB risk.
Maternal Severity and Diagnostic Validity of the Revised Japanese Criteria for Obstetric Disseminated Intravascular Coagulation: A Retrospective Observational Study.
Takahashi Y, Obata S, Nakanishi S … +3 more , Shindo R, Aoki S, Miyagi E
J Obstet Gynaecol Res · 2026 Jul · PMID 42381181 · Full text
AIM: In Japan, the diagnostic criteria for obstetric disseminated intravascular coagulation (DIC) were revised in 2024. This study aimed to evaluate the clinical utility of the revised obstetric DIC criteria, defined as...
AIM: In Japan, the diagnostic criteria for obstetric disseminated intravascular coagulation (DIC) were revised in 2024. This study aimed to evaluate the clinical utility of the revised obstetric DIC criteria, defined as the ability to identify patients at higher risk of severe maternal outcomes at presentation. METHODS: This single-center retrospective cohort study included women who delivered at ≥ 22 weeks of gestation and were transferred for primary postpartum hemorrhage (PPH) between April 2016 and March 2025. Women were compared according to obstetric DIC status and the presence of severe maternal outcomes to evaluate the ability of the revised criteria to identify patients with severe outcomes at presentation. RESULTS: Among women transferred for primary PPH, 18% were diagnosed with obstetric DIC. Severe maternal outcomes occurred more frequently in the obstetric DIC group than in the non-obstetric DIC group (55% vs. 24%; p = 0.002; relative risk, 2.27; 95% CI, 1.47-3.51). Fibrinogen levels were significantly lower in the severe group (163 mg/dL vs. 241 mg/dL, p < 0.001), whereas fibrin/fibrinogen degradation product (FDP) (85.6 μg/mL vs. 32.4 μg/mL, p = 0.61) and D-dimer (11.2 μg/mL vs. 9.5 μg/mL, p = 0.083) levels showed no significant differences. CONCLUSIONS: Although the revised obstetric DIC criteria better reflect the underlying pathophysiology by incorporating hyperfibrinolysis, severe maternal outcomes were still observed in women without obstetric DIC, likely reflecting dilutional coagulopathy. These findings suggest that fibrinogen may serve as an indicator of maternal severity, complementing markers of enhanced fibrinolysis.
Role of Fetal Laryngoscopy in Prenatal Counseling for Fetuses With Congenital High Airway Obstruction Syndrome: A Case Report and Review of the Literature.
Hasegawa A, Schenone CV, Fadiloglu E … +4 more , Didier R, Krispin E, Rahbar R, Shamshirsaz AA
J Obstet Gynaecol Res · 2026 Jul · PMID 42373134 · Publisher ↗
Congenital high airway obstruction syndrome (CHAOS) is a rare, life-threatening condition involving complete or near-complete airway obstruction. Fetal laryngoscopy enables direct airway endoluminal visualization of the...
Congenital high airway obstruction syndrome (CHAOS) is a rare, life-threatening condition involving complete or near-complete airway obstruction. Fetal laryngoscopy enables direct airway endoluminal visualization of the airway, thereby complementing prenatal imaging to enhance diagnosis and counseling. In this case, CHAOS was diagnosed at 17 weeks of gestation following ultrasound and fetal magnetic resonance imaging, which revealed tracheal dilation and echogenic lungs. Diagnostic fetal laryngoscopy performed at 24 weeks demonstrated a blind-ended trachea that was not amenable to fetal decompression. Despite counseling regarding the limited feasibility of airway establishment, emergent delivery with an ex utero intrapartum treatment (EXIT) procedure was performed at 30 weeks. Airway establishment was unsuccessful, and the neonate died shortly after birth. Significant maternal hemorrhage occurred after delivery, requiring transfusion. This case underscores the complexity of prenatal counseling and family-centered decision-making. Fetal laryngoscopy may be considered an adjunct to improve diagnostic evaluation and counseling, potentially aiding prenatal decision-making in selected cases of CHAOS.
Association Analysis of Imaging-Based Lean Mass Distribution and History of Gestational Diabetes Mellitus in NHANES 2011-2018.
Lu Y, Li S, Liu X … +1 more , Liang S
J Obstet Gynaecol Res · 2026 Jul · PMID 42373107 · Publisher ↗
AIM: This work examines potential links between lean tissue composition and prior occurrences of gestational diabetes mellitus (GDM) within a nationally representative cohort. METHODS: This cross-sectional study included...
AIM: This work examines potential links between lean tissue composition and prior occurrences of gestational diabetes mellitus (GDM) within a nationally representative cohort. METHODS: This cross-sectional study included 1807 participants from the National Health and Nutrition Examination Survey (NHANES) (2011-2018). GDM history was self-reported. Body composition was assessed using dual-energy X-ray absorptiometry (DXA). Weighted multivariable logistic regression, adjusted for covariates, was used to assess the relationships between body composition distribution and GDM history. Nonlinear associations were evaluated using cubic spline functions, with subgroup and sensitivity analyses to assess robustness. RESULTS: The adjusted model revealed that a history of GDM was associated with higher android-to-gynoid lean mass ratio (AGLR), android lean mass index (ALMI), and android-to-gynoid fat ratio (AGFR). Multivariable restricted cubic spline (RCS) analysis showed a significant linear association between AGLR, AGFR, and GDM history (nonlinearity p > 0.05), while ALMI demonstrated a nonlinear relationship (nonlinearity p < 0.05). These associations were significantly influenced by economic status and blood pressure levels (p < 0.05). Sensitivity analysis excluding participants whose last live birth occurred > 10 years ago yielded results consistent with the primary analysis. CONCLUSIONS: Higher AGLR, ALMI, and AGFR are associated with increased odds of a history of GDM, with AGLR showing the strongest correlation. These findings underscore the importance of incorporating GDM history and regional lean mass distribution into risk assessment.
Evaluating microRNA-720 and microRNA-1275 as Noninvasive Specific Test Compared With Maternal Serum Alpha-Fetoprotein and Three-Dimensional Ultrasound to Diagnose Fetal Neural Tube Defects.
Khaled H, Attia AAA, Farag MK … +3 more , Abdelwahab H, Senousy SM, Gaber KR
J Obstet Gynaecol Res · 2026 Jul · PMID 42373079 · Publisher ↗
BACKGROUND: Neural tube defects (NTDs) are common congenital anomalies of the central nervous system and are associated with substantial fetal and neonatal morbidity and mortality. Although maternal serum alpha-fetoprote...
BACKGROUND: Neural tube defects (NTDs) are common congenital anomalies of the central nervous system and are associated with substantial fetal and neonatal morbidity and mortality. Although maternal serum alpha-fetoprotein (MSAFP) and ultrasonography (US) are routinely used for prenatal screening, small or atypical lesions may be missed. Circulating microRNAs have emerged as promising noninvasive biomarkers in prenatal diagnosis. AIM: To calibrate the diagnostic utility of circulating microRNA-720 and microRNA-1275 for prenatal detection of fetal NTDs and to compare their performance with MSAFP and two- and three-dimensional US. METHODS: This case-control study included 48 pregnant women undergoing second-trimester screening (15-22 weeks of gestation), divided into 24 cases with fetal NTDs and 24 controls with normal fetuses. All participants underwent detailed two- and three-dimensional US evaluation and MSAFP measurement. Circulating microRNA-720 and microRNA-1275 expression levels were quantified using real-time quantitative polymerase chain reaction, and diagnostic performance was assessed using receiver operating characteristic curve analysis. RESULTS: MicroRNA-720 was significantly upregulated and microRNA-1275 significantly downregulated in NTD-affected pregnancies compared with controls (p < 0.001). Both microRNAs showed high diagnostic accuracy. Expression levels varied among NTD subtypes, with the highest microRNA-720 levels observed in acrania, followed by encephalocele and spina bifida. MSAFP levels were also significantly higher in cases than in controls (p < 0.001). CONCLUSION: Circulating microRNA-720 and microRNA-1275 are promising noninvasive biomarkers that provide a molecular layer of validation for fetal NTDs. They may complement established tools by providing additional diagnostic confidence, particularly in cases with borderline biochemical profiles.
Association of Retained Placenta After Spontaneous Separation With Conversion to Hysterectomy in Cases of Cesarean Sections With Suspected Placenta Accreta Spectrum.
Mukouyama F, Omoto A, Anbe M … +6 more , Shinohara Y, Sato M, Nagasawa A, Nakada E, Ishikawa H, Koga K
J Obstet Gynaecol Res · 2026 Jul · PMID 42363659 · Publisher ↗
AIM: To identify clinical parameters for conversion to cesarean hysterectomy (CH) due to uncontrollable hemorrhage in cesarean sections performed for placenta previa with suspected placenta accreta spectrum (PAS). METHOD...
AIM: To identify clinical parameters for conversion to cesarean hysterectomy (CH) due to uncontrollable hemorrhage in cesarean sections performed for placenta previa with suspected placenta accreta spectrum (PAS). METHODS: We retrospectively analyzed 44 cases of cesarean sections for placenta previa with suspected PAS performed between 2008 and 2025. Outcomes were assessed based on the intraoperative status of placental separation, with particular emphasis on cases exhibiting placental separation. Univariable analyses were conducted to identify factors associated with increased blood loss. RESULTS: CH was performed in 21 cases without placental separation according to institutional management protocols. Among the 23 cases with placental separation, 12 required CH due to uncontrollable hemorrhage, whereas uterine preservation was successfully accomplished in 11. Within this subgroup, blood loss was significantly greater in cases requiring CH (p = 0.045), and the presence of partial placental remnants was more frequent (odds ratio, 19.25; 95% confidence interval, 1.76-209.5; p = 0.0094). Additionally, the presence of partial placental remnants was associated with increased blood loss (p = 0.015). CONCLUSIONS: Intraoperative placental remnants after spontaneous placental separation were associated with uncontrollable hemorrhage requiring CH. When partial placental remnants are identified after placental separation, careful attention to hemorrhage management and intraoperative decision-making is required.
Third-Trimester Fetal MRI Enabling Definitive Diagnosis and Palliative Birth Planning in Suspected Anencephaly.
Saito W, Ota K, Sugihara M … +3 more , Matsumoto R, Ota Y, Shimoya K
J Obstet Gynaecol Res · 2026 Jul · PMID 42360007 · Publisher ↗
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A Novel Strategy Using Dental Pulp Stem Cells and Jiarong Tablets to Treat Intrauterine Adhesions in Rats.
Huang YH, Ding X, Liang YT … +4 more , Wang Y, Ma GH, Li Z, Shi C
J Obstet Gynaecol Res · 2026 Jul · PMID 42359984 · Publisher ↗
AIM: To evaluate the efficacy and underlying mechanisms of dental pulp stem cells (DPSCs), alone or with Jiarong Tablets, for the treatment of intrauterine adhesions (IUAs) in rats. METHODS: IUAs were induced in Sprague...
AIM: To evaluate the efficacy and underlying mechanisms of dental pulp stem cells (DPSCs), alone or with Jiarong Tablets, for the treatment of intrauterine adhesions (IUAs) in rats. METHODS: IUAs were induced in Sprague Dawley (SD) rats. The rats were randomly assigned to the following groups (n = 18/group): Sham, IUA, IUA + Estrogen, IUA + low-/medium-/high-dose DPSC (5 × 10, 1 × 10 and 2 × 10 cells), IUA + DPSC + Estrogen (1 × 10 DPSCs + estradiol (E2)), and IUA + DPSC + Jiarong Tablets (1 × 10 DPSCs +40 mg/mL Jiarong Tablet administered by gavage). At 28 days post-establishment, the rats were sacrificed (n = 12/group) and assessed for endometrial morphology, gland count, fibrosis, serum E2 levels, and PKH26-labeled DPSC tracking, and protein and mRNA analyses of connective tissue growth factor (CTGF), estrogen receptor alpha 1 (ESR1), transforming growth factor beta 1 (TGF-β1), and vascular endothelial growth factor (VEGF) were conducted. Fertility was evaluated on gestational Day 14 after mating (n = 6/group). RESULTS: Compared with the rats in the sham group, the rats in the IUA group exhibited uterine occlusion, a reduced number of endometrial glands, increased fibrosis, decreased serum E2 levels (p < 0.01), and more irregularly shaped glands (p < 0.05). Treatment with DPSCs (all doses) and combination therapies significantly improved uterine morphology and reduced fibrosis and E2 levels (p < 0.05). Treatment with low- and medium-dose DPSCs increased gland count (p < 0.05), whereas treatment with DPSCs + Jiarong Tablet reduced the number of irregularly shaped glands (p < 0.01). The fluorescence intensity of DPSCs was dose-dependent in uterine and ovarian tissues (p < 0.05). The occurrence of IUAs significantly increased the expressions of CTGF, TGF-β1, and VEGF, which were reversed following treatment (p < 0.05). ESR1 expression was significantly increased after treatment with DPSC and Jiarong Tablet (p < 0.05). Fertility outcomes improved significantly in all treatment groups. CONCLUSIONS: DPSCs were used to effectively treat IUAs, with 1 × 10 cells being identified as the optimal dose. Combining DPSCs with Jiarong Tablets further enhanced the therapeutic outcomes by modulating the levels of fibrosis-related factors (CTGF, TGF-β1) and angiogenesis factor (VEGF) and estrogen response (ESR1).
Educational Implications of a Tiered, Competency-Based "Step Ladder System".
Komatsu H, Ueki M, Yamada N … +5 more , Hikino K, Nagata H, Sawada M, Taniguchi F, Harada T
J Obstet Gynaecol Res · 2026 Jul · PMID 42357989 · Publisher ↗
BACKGROUND: Aligning undergraduate and early postgraduate clinical training remains challenging. We evaluated a tiered competency checklist ("Step Ladder System") implemented in an obstetrics-gynecology (OBGYN) rotation...
BACKGROUND: Aligning undergraduate and early postgraduate clinical training remains challenging. We evaluated a tiered competency checklist ("Step Ladder System") implemented in an obstetrics-gynecology (OBGYN) rotation using a mobile assessment platform. METHODS: We retrospectively analyzed 74 learners (41 final-year medical students, 33 first-year residents) who completed an OBGYN rotation at a Japanese university hospital (April 2022-November 2024). The Step Ladder System includes 93 workplace-based tasks across obstetrics, gynecology, and general practice, organized into three progressive steps (Steps 1-3). Outcomes were stepwise completion rates, gender differences, supervisor ratings, and app-recorded feedback. We also identified "seamless" tasks and "low-achievement" tasks to inform curriculum improvement. RESULTS: Students achieved higher completion than residents in Step 1 (82.4% vs. 73.2%, p < 0.05), similar completion in Step 2 (59.2% vs. 54.4%, ns), and lower completion in Step 3 (17.1% vs. 22.1%, p < 0.05). Female learners showed higher completion in several knowledge-focused Step 2 tasks, while a small number of procedural tasks favored males. Supervisor ratings were predominantly positive (4-5/5), supported by encouraging narrative comments. Ten "seamless" tasks (high completion in both groups with minimal between-group differences) indicated similar achievement patterns across learner groups, whereas "low-achievement" tasks (low completion across learners) clustered in advanced Step 3. CONCLUSIONS: A mobile, stepwise competency checklist provides a structured framework for clinical training and enables real time documentation and feedback. Completion data may serve as a curriculum diagnostic tool by highlighting stable competencies and potential gaps.
Letter to "Laparoscopic Cervical Cerclage Offers Greatest Benefit for Patients With Multiple Conizations or Significantly Shortened Cervix: A Retrospective Study Based on Causal Inference Modeling".
Park YJ, Park MI
J Obstet Gynaecol Res · 2026 Jul · PMID 42349854 · Publisher ↗
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Tissue Factor Pathway Inhibitor-2 (TFPI2) as a Biomarker in Gynecologic Malignancies: A Narrative Review Focusing on Clear Cell Carcinoma.
Kawaguchi R, Miyagi E, Tomoka M … +3 more , Yamada Y, Kobayashi H, Kimura F
J Obstet Gynaecol Res · 2026 Jul · PMID 42349846 · Publisher ↗
Tissue factor pathway inhibitor-2 (TFPI2) is a Kunitz-type serine protease inhibitor and a highly specific biomarker for gynecologic clear cell carcinomas, particularly ovarian clear cell carcinoma (CCC). This review sum...
Tissue factor pathway inhibitor-2 (TFPI2) is a Kunitz-type serine protease inhibitor and a highly specific biomarker for gynecologic clear cell carcinomas, particularly ovarian clear cell carcinoma (CCC). This review summarizes current evidence on its roles in gynecologic malignancies, focusing on clear cell histology. A structured PubMed search was performed. English-language original articles and reviews addressing the diagnostic, prognostic, and functional roles of TFPI2 were included. Although TFPI2 is commonly silenced as a tumor suppressor in many cancers, it is consistently overexpressed in Müllerian clear cell carcinomas. Clinically, circulating TFPI2 shows high specificity for ovarian CCC, distinguishing it from other ovarian tumors and benign conditions. Its combination with cancer antigen 125 improves diagnostic sensitivity, including in early-stage disease. TFPI2 is selectively expressed in tumor cells, supporting its role as a histology-specific marker across the ovary, endometrium, and cervix. Functionally, TFPI2 may contribute to CCC biology by suppressing cell adhesion and promoting a floating dissemination phenotype. Elevated circulating TFPI2 is associated with poor outcomes in ovarian and endometrial cancers and may reflect coagulation abnormalities. It is also linked to venous thromboembolism and may improve risk stratification when combined with D-dimer. TFPI2 is a unique biomarker with diagnostic, prognostic, and biological significance, with potential applications in precision diagnostics, monitoring, and thrombosis risk assessment.
Atypical Presentation of Catastrophic Antiphospholipid Syndrome (CAPS) Following Cesarean Delivery in a Patient With Persistent Multiorgan Dysfunction: A Case Report.
Kamiya S, Okano H, Okamoto H
J Obstet Gynaecol Res · 2026 Jul · PMID 42349842 · Publisher ↗
Catastrophic antiphospholipid syndrome (CAPS) is a rare, life-threatening condition with 30% mortality that poses diagnostic challenges during pregnancy due to overlap with preeclampsia and HELLP syndrome. We report a wo...
Catastrophic antiphospholipid syndrome (CAPS) is a rare, life-threatening condition with 30% mortality that poses diagnostic challenges during pregnancy due to overlap with preeclampsia and HELLP syndrome. We report a woman in her 30s who developed probable CAPS following emergency cesarean delivery at 22 weeks for severe preeclampsia. Unlike typical CAPS presentations, our patient lacked characteristic cutaneous manifestations, instead presenting with progressive cardiac, pulmonary, and renal dysfunction persisting despite delivery. Serial chest radiographs showed significant pulmonary edema and worsening bilateral pleural effusions, requiring noninvasive positive pressure ventilation and chest tube placement. The patient improved with supportive care and was discharged from ICU after 7 days. This case emphasizes the importance of considering CAPS in patients with persistent multiorgan dysfunction following delivery, even without typical cutaneous findings. Recognition of atypical presentations may facilitate timely intervention and improve patient outcomes.
Elevated FTX Expression in Polycystic Ovary Syndrome: Correlations With Insulin Resistance, Dyslipidemia, and Diagnostic Potential.
Ling L, Guo R, Hua K
J Obstet Gynaecol Res · 2026 Jun · PMID 42324911 · Publisher ↗
BACKGROUND: This study aims to investigate the expression changes of FTX (long noncoding RNA) in polycystic ovary syndrome (PCOS) and its relationship with insulin resistance and lipid metabolism, thereby providing new d...
BACKGROUND: This study aims to investigate the expression changes of FTX (long noncoding RNA) in polycystic ovary syndrome (PCOS) and its relationship with insulin resistance and lipid metabolism, thereby providing new directions for the diagnosis and treatment of PCOS. METHODS: A total of 69 PCOS patients and 74 healthy controls were recruited. The levels of FTX and lipid-regulating genes (Pparg, Pgc1, and Pgc1-α) were quantitatively analyzed using RT-qPCR. Human granulosa cell tumor line KGN was treated with insulin to study the relationship between FTX and insulin. Additionally, FTX expression was altered in KGN cells through transfection to explore its regulatory mechanism on lipid metabolism. RESULTS: The results indicated that serum FTX levels in PCOS patients were significantly higher than those in healthy controls, and FTX showed potential diagnostic value for PCOS in this cohort. FTX levels were significantly positively correlated with HOMA-IR, TC, TG, and LDL-C, while negatively correlated with HDL-C. FTX also demonstrated preliminary recognition ability for PCOS patients with HOMA-IR ⩾ 2.5. Furthermore, in vitro experiments revealed that insulin treatment significantly increased FTX levels in KGN cells. FTX overexpression inhibited the expression of lipid metabolism-related genes, while silencing FTX promoted their expression. CONCLUSION: FTX is significantly upregulated in patients with PCOS and may serve as a candidate biomarker, although external validation is still required. Additionally, FTX may be involved in PCOS through the regulation of insulin resistance and lipid metabolism.
Maternal Complications and Facility-Level Differences in the Management of Placental Abruption in Japan: A Retrospective Analysis Using a Multicenter DPC Database.
Hirano S, Kanda M, Nii M … +3 more , Kondo E, Ikeda T, Inoue T
J Obstet Gynaecol Res · 2026 Jun · PMID 42324850 · Publisher ↗
OBJECTIVE: To evaluate maternal characteristics, management practices, and outcomes of placental abruption according to facility type in Japan, and to assess the effectiveness of the country's centralized perinatal care...
OBJECTIVE: To evaluate maternal characteristics, management practices, and outcomes of placental abruption according to facility type in Japan, and to assess the effectiveness of the country's centralized perinatal care system. METHODS: This retrospective observational study used the Diagnosis Procedure Combination database from acute-care hospitals between May 2014 and April 2024. Cases coded with ICD-10 O45.0 or O45.9 were included, excluding those with multiple gestations or placenta previa. Patients were categorized into Comprehensive Perinatal Medical Centers (CPMCs) and Regional Perinatal Medical Centers/General Hospitals (non-CPMCs). The primary outcomes were severe and serious maternal complications as defined by Ananth et al. Secondary outcomes included mode of delivery, hysterectomy, transfusion use and volume, maternal and fetal mortality, intensive care unit admission, estimated blood loss at delivery, and length of hospital stay. RESULTS: Among 771 eligible cases, 257 (33.3%) were admitted to CPMCs and 514 (66.7%) to non-CPMCs. Referrals (78.2% vs. 68.5%) and ambulance transports (63.0% vs. 37.5%) were significantly more frequent in CPMCs. Severe maternal complications were more common in CPMCs (30.0% vs. 18.3%), particularly coagulopathy and hypovolemic shock, many of which were present at admission. Despite higher baseline severity, rates of serious maternal complications and maternal mortality did not differ. The mean length of hospital stay was shorter in CPMCs (6.0 vs. 6.7 days). CONCLUSION: Severe placental abruption cases appear to be effectively centralized within this multicenter cohort. The advanced maternal emergency capacity of CPMCs may mitigate morbidity despite higher baseline severity, supporting the functional role of perinatal regionalization within this network.
Review System: Single or Double Blinded?
Matsubara S
J Obstet Gynaecol Res · 2026 Jun · PMID 42322028 · Publisher ↗
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Para-Aortic Lymph Node Metastasis Detected by Sentinel Lymph Node Biopsy in Cervical Cancer Initially Presumed to be Stage IA2: A Case Report.
Ouchi H, Chiyoda T, Sakai K … +3 more , Shiraishi Y, Nishio H, Yamagami W
J Obstet Gynaecol Res · 2026 Jun · PMID 42319385 · Full text
Sentinel node navigation surgery (SNNS) minimizes unnecessary lymphadenectomy and its associated complications while enhancing detection of lymph node micrometastases through ultrastaging. A 34-year-old nulligravid woman...
Sentinel node navigation surgery (SNNS) minimizes unnecessary lymphadenectomy and its associated complications while enhancing detection of lymph node micrometastases through ultrastaging. A 34-year-old nulligravid woman with a history of CIN2 was diagnosed with squamous cell carcinoma (4.5 mm width, 4 mm depth) with lymphovascular invasion after conization. Clinical stage was T1a2 (FIGO 2018). Modified-radical trachelectomy with SNNS was planned for fertility preservation. SPECT-CT identified bilateral obturator and left lower para-aortic sentinel nodes. Intraoperative frozen sections revealed a 1.1 mm micrometastasis in the left obturator node and a 2.5 mm macrometastasis in the left para-aortic node. The procedure was converted to modified-radical hysterectomy with bilateral adnexectomy and pelvic lymphadenectomy, followed by concurrent chemoradiotherapy including the para-aortic field. The patient remains disease-free at 10 months. Without SNNS, the para-aortic metastasis would have been undetected, resulting in inadequate radiation coverage. SNNS fundamentally changes therapeutic approaches by enabling accurate disease extent identification and individualized treatment.
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