Journal Of Obstetrics And Gynaecology[JOURNAL]
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200 papers
Artificial intelligence for sexual, reproductive and maternal health in Latin America and the Caribbean: a scoping review.
Saban M, Zavala MD, Rubinstein A … +2 more , Esteban S, Cejas C
J Obstet Gynaecol · 2026 Dec · PMID 42402197 · Publisher ↗
BACKGROUND: Artificial intelligence (AI) holds considerable promise for strengthening sexual, reproductive and maternal health (SRMH) by enhancing diagnosis, optimising service delivery and expanding access to informatio...
BACKGROUND: Artificial intelligence (AI) holds considerable promise for strengthening sexual, reproductive and maternal health (SRMH) by enhancing diagnosis, optimising service delivery and expanding access to information. In Latin America and the Caribbean (LAC), however, the scope, focus and maturity of AI applications in SRMH remain poorly described. OBJECTIVE: To identify, map and analyse existing applications of AI in SRMH priority services in LAC, characterising thematic areas, target populations, and types of AI tools, whilst highlighting gaps and future research needs. METHODS: We conducted a scoping review guided by the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Searches were performed in PubMed, SciELO, Cochrane and LILACS up to August 2023, complemented by targeted Google searches and snowballing. We included records reporting AI applications in SRMH services in LAC and extracted data on setting, population, SRMH domain, AI techniques and implementation stage. RESULTS: A total of 1,518 records were identified, of which 143 met the inclusion criteria. Most were published between 2020 and 2023 and originated from Mexico, Colombia, Peru, Brazil and Argentina. Over half were peer-reviewed articles, with additional theses and web-based reports. Applications concentrated on prenatal, childbirth and postnatal care (36%) and reproductive organ cancers (31%), with far fewer initiatives addressing sexual health, contraception, gender-based violence, sexual satisfaction or counselling. Machine learning methods predominated (52%), followed by deep learning (41%). Almost half of initiatives (48%) were exploratory projects, 17% implemented tools without outcome data and 35% reported performance in real-world contexts. CONCLUSIONS: AI applications in SRMH in LAC are expanding but remain thematically narrow, population-selective and predominantly exploratory, highlighting the need for more diverse, rigorously evaluated and equity-oriented tools.
Post-myomectomy age-specific ongoing pregnancy rates in women ≥37 years old: a retrospective non-comparative study.
Visser RH, Don EE, Hehenkamp WWJK … +3 more , Huirne JAF, Timmermans A, De Leeuw RA
J Obstet Gynaecol · 2026 Dec · PMID 42397273 · Publisher ↗
BACKGROUND: Data on reproductive outcomes after myomectomy in women of advanced reproductive age are limited. This study aimed to assess post-myomectomy age-specific ongoing pregnancy rates and associated impact factors...
BACKGROUND: Data on reproductive outcomes after myomectomy in women of advanced reproductive age are limited. This study aimed to assess post-myomectomy age-specific ongoing pregnancy rates and associated impact factors for women aged 37 years and older. METHODS: This observational retrospective cohort study was conducted at a tertiary fibroid-expertise centre in Amsterdam, the Netherlands. Women aged 37 years or older with an active wish to conceive who underwent myomectomy between 2004 and 2022 were included. Data were retrieved from patient records and a questionnaire. The primary outcome was age-specific ongoing pregnancy rates. A multivariable logistic regression analysis was performed to identify predictive factors. RESULTS: A total of 100 patients were included in the analysis. Follow up was a median of 24 months. The ongoing pregnancy rate was 36%, with an age-related trend showing rates of 46.4% in women under 40 years of age compared to 22.7% in women 40 years and older. The overall pregnancy rate was 44% resulting in 49 pregnancies of which 63.3% were live births, 28.6% miscarriages, 8.1% currently ongoing pregnancies and no intrauterine foetal deaths. The number of fibroids and age (<40 and ≥40 years) are both variables that significantly decrease the odds of achieving an ongoing pregnancy. CONCLUSION: Ongoing pregnancy rates after myomectomy in this cohort of advanced age was relatively high, with an age-related decline in fertility. Women of advanced reproductive age can still achieve pregnancy after myomectomy, but these changes decrease after 40 as known from previous literature.
Retraction Statement: Knowledge, attitude, and practice of obstetricians towards vaginal birth after caesarean in Egypt.
J Obstet Gynaecol · 2026 Dec · PMID 42391455 · Publisher ↗
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Determining the Feasibility of a No-Ultrasound Screening Tool for Early Medical Abortion in Australia.
Melville C, Goldstone P
Aust N Z J Obstet Gynaecol · 2026 Aug · PMID 42385148 · Full text
BACKGROUND: In Australia, ultrasonography to confirm gestational age (GA) and pregnancy location is a routine component of early medical abortion (EMA) care. Internationally, protocols have been developed using a history...
BACKGROUND: In Australia, ultrasonography to confirm gestational age (GA) and pregnancy location is a routine component of early medical abortion (EMA) care. Internationally, protocols have been developed using a history-based screening tool to identify women not requiring ultrasound. This approach, now supported by Australian guidelines, aims to reduce unnecessary barriers to abortion care. AIMS: To assess the validity and accuracy of an eligibility assessment tool for no-ultrasound EMA care. Self-reported estimation of GA and risk factors for ectopic pregnancy were compared to ultrasound findings. MATERIALS AND METHODS: This was a multicentre prospective observational study. Patients aged 14 years and over attending for EMA completed a questionnaire, including estimation of GA using last menstrual period (LMP) or date of conception (DOC), if known, and identification of risk factors for ectopic pregnancy. All patients subsequently underwent routine abortion care, including ultrasound assessment, and outcomes were determined. RESULTS: Of 705 patients who completed the questionnaire between 4 January 2022 and 30 August 2023, 469 were certain of their LMP or DOC (66.5%). When the screening tool was applied, 214 (30.4%) patients remained eligible for no-ultrasound care, and all these were found to have an intrauterine pregnancy. One patient had a GA over 63 days by ultrasound. CONCLUSIONS: A history-based screening tool determined 30% of patients eligible for no-ultrasound EMA care. No eligible patients had an ectopic pregnancy and only one had an ultrasound confirmed GA above 63 days. Models of EMA care not requiring routine ultrasound may improve abortion access, especially for those in rural and remote areas where ultrasound availability can be challenging.
'All In': Equitable Health Outcomes Require Culturally Safe Care for Everybody.
Filoche S, Parker G, Hyde E … +5 more , Ormandy J, Graham K, Kelsey F, Ireland-Blake N, Kerekere E
Aust N Z J Obstet Gynaecol · 2026 Aug · PMID 42381245 · Full text
In May 2026, the Legislation (Definitions of Woman and Man) Amendment Bill was introduced into the New Zealand Parliament; seeking to legally define 'woman' in law as 'an adult human biological female', and 'man' as 'an...
In May 2026, the Legislation (Definitions of Woman and Man) Amendment Bill was introduced into the New Zealand Parliament; seeking to legally define 'woman' in law as 'an adult human biological female', and 'man' as 'an adult human biological male'. It would affect how trans, non-binary, takatāpui, and intersex people are viewed in the eyes of the law, weakening anti-discrimination protections and restricting rights and access to healthcare. RANZCOG's commitment to cultural safety is an important asset to guide health professionals as we grapple with how to respond to the Bill. Equitable health outcomes for everyone depend on it.
Benzylpenicillin Concentrations in Intrapartum Group B Streptococcus Prevention Guidelines; A Systematic Review of the Evidence.
Deegan B, Gourlay A, Eriksson L … +3 more , Roberts J, Amoako A, Eley V
Aust N Z J Obstet Gynaecol · 2026 Aug · PMID 42381244 · Publisher ↗
INTRODUCTION: Intrapartum antibiotics are often used to reduce neonatal risk of early-onset Group B Streptococcus (GBS) disease. Protocols aim to achieve a fetal serum and amniotic fluid concentration above the minimum i...
INTRODUCTION: Intrapartum antibiotics are often used to reduce neonatal risk of early-onset Group B Streptococcus (GBS) disease. Protocols aim to achieve a fetal serum and amniotic fluid concentration above the minimum inhibitory concentration (MIC) of GBS at the time of birth. AIMS: We aimed to summarise the evidence for currently recommended doses of benzylpenicillin by comparing intrapartum fetal serum and amniotic fluid concentrations of benzylpenicillin with the associated MIC of GBS at the time of birth. METHODS: We systematically reviewed PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, and Embase databases. We sought studies in which umbilical cord blood and/or amniotic fluid were examined for Benzylpenicillin concentrations after intrapartum intravenous administration. RESULTS: Seven studies were included, using a variety of doses, applying different assay techniques, and reporting a wide range of concentrations reported in the umbilical cord serum and amniotic fluid. Concentrations were often significantly higher than the target MIC of 0.125 mcg/mL. Significant methodological limitations included reporting of total concentrations of antibiotic only and substantial protocol violations. DISCUSSION: There is a lack of high-quality evidence to support the current dosing of intrapartum antibiotics, with regards to whether appropriate MICs are achieved in the fetus. Studies applying rigorous methodology and accounting for drug protein binding are required to determine the dosing regimens required to achieve these concentrations in the umbilical cord serum and amniotic fluid.
Beyond an incidental finding: Reframing persistent left superior vena cava as a marker of comprehensive foetal cardiovascular assessment.
Bravo-Valenzuela NJ, Araujo Júnior E
J Obstet Gynaecol · 2026 Dec · PMID 42370462 · Publisher ↗
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Including support people in gestational diabetes mellitus education: Understanding providers' perspectives.
Mitchell EA, Roberson PNE, Oyedeji O … +5 more , Oakes E, Tasman J, Purvis R, Wolfe L, Maples JM
J Obstet Gynaecol · 2026 Dec · PMID 42363680 · Publisher ↗
Gestational Diabetes Mellitus (GDM) is a common pregnancy complication associated with adverse health outcomes. Health risks are reduced when GDM is well-controlled. Education and social support are key to optimal manage...
Gestational Diabetes Mellitus (GDM) is a common pregnancy complication associated with adverse health outcomes. Health risks are reduced when GDM is well-controlled. Education and social support are key to optimal management; yet support people are rarely included in education. Semi-structured interviews were conducted with 10 healthcare providers (i.e., physicians, dieticians) to understand their perspectives on a) the role of support people in self-management, and b) including support people in education. Thematic analysis was used to identify common themes across interviews. Three themes emerged: (1) knowledge, (2) engagement, and (3) impact. Understanding what causes GDM is essential, and educating support people can improve engagement in implementing lifestyle changes and supporting patients in management. Social support can also reduce patient burden and stress. While relationship strain is possible, patients and support people who approach management together may find that it strengthens their relationship. Implications for designing education for patients and support people are discussed.
Sociodemographic factors shaping knowledge-attitude-behaviour pathways in postpartum fall prevention.
Yang L, Xu L
J Obstet Gynaecol · 2026 Dec · PMID 42334966 · Publisher ↗
BACKGROUND: Postpartum falls threaten maternal and infant safety, yet evidence on postpartum women's fall-prevention knowledge, attitude, and behaviour (KAB) and their sociodemographic correlates remains limited. This st...
BACKGROUND: Postpartum falls threaten maternal and infant safety, yet evidence on postpartum women's fall-prevention knowledge, attitude, and behaviour (KAB) and their sociodemographic correlates remains limited. This study examined postpartum fall-prevention KAB and associations among KAB dimensions and in-hospital fall occurrence. METHODS: In this cross-sectional study, 1,220 postpartum women from a tertiary hospital in Chengdu, China, completed a general questionnaire and a self-developed Postpartum Fall Prevention KAB Scale (Cronbach's α = 0.926). Multivariable linear regression examined associations of maternal education, companion education, and residence with KAB scores. Structural equation modelling examined associations among knowledge, attitude, behaviour, and in-hospital fall occurrence. RESULTS: Higher maternal education was associated with higher knowledge (B = 0.22, 95% CI 0.06 to 0.38; = 0.009), attitude (B = 0.23, 95% CI 0.02 to 0.43; = 0.030), and behaviour scores (B = 0.57, 95% CI 0.02 to 1.11; = 0.044). Residence was associated with attitude score (B = 0.77, 95% CI 0.13 to 1.41; = 0.020), but not with knowledge or behaviour. Companion education was associated with behaviour score (B = -0.67, 95% CI -1.15 to -0.20; = 0.005), but not with knowledge or attitude. In the structural model, knowledge was associated with attitude (estimate = 0.289, 95% CI 0.206 to 0.379; p < 0.001) and behaviour (estimate = 0.663, 95% CI 0.455 to 0.908; < 0.001), and attitude was associated with behaviour (estimate = 0.471, 95% CI 0.304 to 0.634; < 0.001). behaviour was not associated with in-hospital fall occurrence (estimate = 0.001, 95% CI -0.001 to 0.002; = 0.506). CONCLUSIONS: Maternal education, residence, and companion education were associated with postpartum fall-prevention KAB scores. The findings support associations broadly consistent with the KAB framework, but causality cannot be inferred. Tailored fall-prevention education should be evaluated in longitudinal, multi-centre studies.
A 3.6:1 myo-inositol to D-chiro-inositol ratio and antioxidant-based food supplement before IVF improves fertility in women with PCOS: a pilot observational retrospective cohort study.
Belchín Fernández P, Calvente V, Gómez Roso MJ … +4 more , González Expósito E, Silván Bueno A, Aparicio Fluge M, Ordoñez Pérez D
J Obstet Gynaecol · 2026 Dec · PMID 42334964 · Publisher ↗
BACKGROUND: PCOS is frequently associated with metabolic disturbances, including a high prevalence of insulin resistance and compensatory hyperinsulinemia, which can impair reproductive outcomes. Previous evidence indica...
BACKGROUND: PCOS is frequently associated with metabolic disturbances, including a high prevalence of insulin resistance and compensatory hyperinsulinemia, which can impair reproductive outcomes. Previous evidence indicates that combining myo-inositol and D-chiro-inositol in a specific 3.6:1 ratio may support ovarian physiology and reproductive performance in women with PCOS. This study aimed to evaluate whether taking a 3.6:1 MYO:DCI inositol-based supplement enriched with antioxidants for at least 1 month prior to controlled ovarian stimulation could improve IVF-ICSI outcomes. METHODS: A retrospective observational cohort study was conducted, including 92 women diagnosed with PCOS according to the Rotterdam criteria. Patients were allocated to 2 groups: those who used the MYO:DCI 3.6:1 antioxidant-containing supplement (Group 1) and those who followed conventional supplementation (Group 2). Outcomes assessed included ovarian response, fertilization rates, blastocyst development and pregnancy results. RESULTS: The number of retrieved oocytes (21.5 in Group 1 vs. 20.7 in Group 2; = 0.56) and the metaphase II oocyte rate (72.06% in Group 1 vs. 71.23% in Group 2; = 0.68) were comparable between both groups. Notably, Group 1 achieved higher fertilization rates (77.66% vs. 71.61%; = 0.0314) and a lower proportion of cycles without at least one good-quality blastocyst to transfer (4.35% vs. 17.39%; = 0.0450). In addition, both clinical and ongoing pregnancy rates were significantly improved in the supplemented group (54.39% vs. 42.65%; = 0.0203; 45.61% vs. 36.76%; = 0.0033). CONCLUSION: This observational pilot study suggests that a pre-treatment with 3.6:1 MYO:DCI ratio and antioxidant-based supplement taken for at least 1 month prior to ovarian stimulation may improve oocyte quality and increase pregnancy rates. These findings, while promising, require confirmation in larger prospective trials.
Retrospective Cohort Study of Foetal Growth Restricted Births After 40 Weeks at an Australian Tertiary Maternity Hospital Between 2018 and 2021.
Perera CN, Goh A
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42320936 · Full text
BACKGROUND: Foetal growth restriction (FGR) increases risks of neonatal morbidity and mortality. Identifying and preventing FGR is key to improving neonatal outcomes. FGR risk assessment tools are designed to recognise w...
BACKGROUND: Foetal growth restriction (FGR) increases risks of neonatal morbidity and mortality. Identifying and preventing FGR is key to improving neonatal outcomes. FGR risk assessment tools are designed to recognise women at high risk of FGR. AIMS: This study aims to compare the theoretical effectiveness of four different FGR risk factor assessment pathways in identifying women at risk for FGR: New South Wales (NSW) Foetal Safety Risk Assessment, Safer Baby Bundle FGR pathway, NHS Saving Babies' Lives risk assessment tool and RCOG Screening for Small Gestational Age foetus pathway. These pathways recommend management plans for women identified to be at risk for FGR. MATERIALS AND METHODS: This retrospective study at Westmead Hospital compared singleton births between 2018 and 2021 that were ≥ 40 weeks' gestation with birthweight < 3rd percentile, against the four FGR pathways. Prior to 2022, NSW had no recommended algorithm to identify patients at risk for FGR. RESULTS: 116 women and 116 growth-restricted babies were included for analysis. The NSW Foetal Safety Risk Assessment would have identified 32 (27.6%) women to be at risk for FGR, the Safer Baby Bundle 39 (33.6%), the NHS tool 44 (37.9%) and the RCOG pathway 36 (30%). 32 (23%) babies required neonatal intensive care or special care nursery admission with no neonatal deaths or stillbirths. CONCLUSION: Foetal risk assessment tools increase identification of women at risk of FGR, although none are perfect. Ongoing improvements to risk assessment algorithms will help identify larger cohorts of patients at risk of FGR and reduce poor neonatal outcomes.
Models of Antenatal Care for Rural Indigenous Women: A Systematic Review.
Anderson A, Ranasinghe T, Ostini R
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42310988 · Publisher ↗
AIM: This review sought to ascertain which features of antenatal models promote better outcomes among Indigenous pregnant women living in rural areas. METHODS: Four databases were searched, and then peer-reviewed researc...
AIM: This review sought to ascertain which features of antenatal models promote better outcomes among Indigenous pregnant women living in rural areas. METHODS: Four databases were searched, and then peer-reviewed research comparing models of antenatal care were critically appraised and themes identified. RESULTS: Twenty-nine articles met inclusion criteria and were of acceptable methodological quality for data extraction and analysis. Three main themes around service structure, accessibility and environment emerged, which were broken down into 17 subthemes. Most studies emphasised the importance of involving Indigenous elders and family, as well as Indigenous and female staff, to build community-based and controlled antenatal care, resulting in more holistic and culturally safe practices. A focus on communication, relationship-building and development of trust improved levels of preventative healthcare, risk screening, past negative experiences addressed and health education. In addition to conventional clinical care, home visiting, outreach programmes and quality-improvement approaches (CQI) proved vital for accessibility, engagement and overall model success. CONCLUSION: Successful models of antenatal care for Indigenous women living rurally are those created, managed and run by the community, and should have a focus on culturally safe communication, relationship-building, preventative healthcare and education. PRACTICE IMPLICATIONS: These findings can inform the development of evidence-based, culturally safe antenatal models of healthcare at clinical and policy level, in partnership with and for rural Indigenous women; as well as guide funding and work personnel allocation.
Dispensing of Antiemetics During Pregnancy in Aotearoa New Zealand, 2005-2020.
Donald S, Sharples K, Barson D … +6 more , Maclennan K, Te Karu L, Phone D, van Asten H, Stitely M, Parkin L
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42310984 · Full text
BACKGROUND: Antiemetic use during pregnancy is rising in high-income countries. Increasing use of antiemetics has also been documented in Aotearoa New Zealand (NZ); however, the specific antiemetics dispensed have not be...
BACKGROUND: Antiemetic use during pregnancy is rising in high-income countries. Increasing use of antiemetics has also been documented in Aotearoa New Zealand (NZ); however, the specific antiemetics dispensed have not been reported. AIM: To describe patterns of antiemetic dispensing during pregnancy in NZ, 2005-2020. MATERIALS AND METHODS: Community-based antiemetic dispensings were linked with 1.37 million pregnancies in the New Zealand Pregnancy Cohort. The proportions of pregnancies in which there was at least one dispensing of any and of specific antiemetics were calculated for each trimester and calendar year. Maternal characteristics and the sequence in which unique antiemetic regimens were introduced were described for pregnancies with first trimester exposure. RESULTS: First trimester antiemetic exposure increased from 4.1% to 19.7% of pregnancies between 2005 and 2019. Although metoclopramide was the most commonly dispensed antiemetic during Trimester 1 in all years (increasing from 3.1% to 12.4%), there was a substantial increase in ondansetron dispensing (0.1% to 9.1%). Ondansetron users were more likely than metoclopramide users to be European/Other and have a hospital admission for hyperemesis gravidarum. Metoclopramide and ondansetron monotherapy were first-line regimens in 70.0% and 1.9% of pregnancies with Trimester 1 exposure between 2005 and 2010 versus 46.5% and 26.5% between 2016 and 2020. CONCLUSIONS: Ondansetron dispensing increased substantially over time. Further exploration of the context of ondansetron prescribing in NZ is warranted, as is further research into potential adverse outcomes.
Elevated non-esterified fatty acids in obese women with late-onset preeclampsia: a cross-sectional study.
Nugrahani AD, Pribadi A, Aziz MA … +5 more , Johari Santoso DP, Wicaksono BS, Nugraha AA, Herlambang H, A A Syamsunarno MR
J Obstet Gynaecol · 2026 Dec · PMID 42308373 · Publisher ↗
BACKGROUND: Pre-eclampsia is a pregnancy-specific multisystem disorder and a major cause of maternal and neonatal morbidity and mortality. Late-onset preeclampsia, occurring at or after 34 weeks of gestation, is estimate...
BACKGROUND: Pre-eclampsia is a pregnancy-specific multisystem disorder and a major cause of maternal and neonatal morbidity and mortality. Late-onset preeclampsia, occurring at or after 34 weeks of gestation, is estimated to account for approximately 70-80% of cases and is more strongly associated with maternal metabolic factors, although placental involvement is not absent and is generally less pronounced. Maternal obesity and altered lipid metabolism may be associated with this phenotype; however, the relationship between non-esterified fatty acids (NEFA) and obesity in late-onset preeclampsia remains unclear. METHODS: This cross-sectional study assessed differences and correlations in circulating NEFA levels between obese and normal-weight women with late-onset preeclampsia. Seventy-three women with singleton pregnancies were consecutively recruited, including 44 obese and 29 normal-weight participants classified using WHO Asia-Pacific BMI criteria. Clinical and biochemical data were obtained from medical records and maternal serum NEFA levels were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analyses were performed using appropriate parametric or non-parametric tests, and correlations were assessed using Pearson or Spearman analysis. RESULTS: A total of 73 women with late-onset preeclampsia were included (44 obese and 29 normal weight). Serum NEFA levels were significantly higher in obese women compared with normal-weight women ( = .008). BMI showed a weak but statistically significant positive correlation with NEFA levels ( = .23, 95% CI 0.007-0.442; = .04), indicating a limited association between obesity and circulating NEFA levels within this study. CONCLUSIONS: In women with late-onset preeclampsia, circulating NEFA levels were higher in the obese group and were weakly associated with BMI. These findings suggest an association between obesity and circulating NEFA levels within this clinical phenotype. However, due to the cross-sectional design and absence of normotensive control groups, causality and disease specificity cannot be determined. Further studies are needed to clarify the role of NEFA in preeclampsia.
The Effectiveness of Non-Steroidal Anti-Inflammatory Drugs for Pain Relief During Outpatient Intrauterine Device Insertion: A Systematic Review and Meta-Analysis.
Bolic MS, Ainsworth J, Heal C … +1 more , Drever N
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42304639 · Full text
BACKGROUND: Fear of procedural pain is a significant barrier to intrauterine device (IUD) uptake. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in IUD insertion for their analgesic and anti-inflammator...
BACKGROUND: Fear of procedural pain is a significant barrier to intrauterine device (IUD) uptake. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in IUD insertion for their analgesic and anti-inflammatory properties; however, evidence for their effectiveness remains inconsistent. AIMS: This systematic review and meta-analysis aimed to synthesise current evidence regarding the effectiveness of NSAIDs for pain relief during outpatient IUD insertion. MATERIALS AND METHODS: A search of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL and Scopus was performed from inception to March 3, 2025. The search strategy was developed using the Population, Intervention, Comparator, Outcome (PICO) framework. Two reviewers independently selected studies, extracted data and assessed included studies for bias using the Risk of Bias 2 (RoB 2) tool. Trials comparing pain scores between NSAID and placebo were pooled in a meta-analysis. RESULTS: Twenty-two studies, published between 2006 and 2024, met inclusion criteria. Ibuprofen (n = 6) was most used, followed by diclofenac (n = 4) and naproxen (n = 4). NSAIDs were administered orally (n = 17), intramuscularly (n = 2) and rectally (n = 2), with route not specified in one study. A meta-analysis of fourteen studies comparing NSAID with placebo, with a total sample size of 3358, found a statistically significant reduction in pain scores (mean reduction 0.77, 95% CI -1.29, -0.25). Side effects and adverse events did not differ significantly between groups. CONCLUSIONS: Our review demonstrates an analgesic role for NSAIDs during IUD insertion, with a significant reduction in pain scores when compared to placebo. This evidence, limited by clinical and statistical heterogeneity, is of low certainty.
'Not Just Bad Periods': Survey of Aotearoa New Zealand Endometriosis Patients on Their Perspectives on the Impact of Endometriosis Awareness.
Ellis K, Donoghue JF, Wood R
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42289948 · Full text
Endometriosis is a challenging condition to diagnose, frequently typified by long diagnostic delays. In an online survey study of 657 endometriosis patients from Aotearoa New Zealand, awareness of endometriosis at sympto...
Endometriosis is a challenging condition to diagnose, frequently typified by long diagnostic delays. In an online survey study of 657 endometriosis patients from Aotearoa New Zealand, awareness of endometriosis at symptom onset was low, contributing a two-year increase to diagnostic delay. While respondents most frequently learnt of endometriosis from friends and family (33.8%), they predominantly accessed resources regarding endometriosis online (77.9%). Patients highlighted that resources explaining the full range of endometriosis symptoms were needed for the general public, students, and endometriosis patients to improve surveillance for the condition and allow earlier recognition and diagnosis.
Retraction Statement: Vaginal length and sexual function after vertical versus horizontal closure of the vaginal cuff after abdominal hysterectomy: a randomised clinical trial.
J Obstet Gynaecol · 2026 Dec · PMID 42286996 · Publisher ↗
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Predictors of prolonged decision-to-delivery interval in emergency caesarean section in Northern Uganda: a historical cohort study.
Ochola H, Omoro R, Buga P … +19 more , Ayella Odong E, Ocaya O, Kajabwangu R, Atim N, Akello H, Praiselyn Acayo J, Ekwem D, Namuddu J, Mukurasi D, Lukyamuzi E, Onen H, Lenia M, Gimono M, Webb E, Campbell O, Komata R, Okot J, Ochola E, Ojara S
J Obstet Gynaecol · 2026 Dec · PMID 42275299 · Publisher ↗
BACKGROUND: Delays in decision-to-delivery interval (DDI) during emergency caesarean section (CS) may increase the risk of adverse maternal and neonatal outcomes. Evidence on health-system and provider-related factors in...
BACKGROUND: Delays in decision-to-delivery interval (DDI) during emergency caesarean section (CS) may increase the risk of adverse maternal and neonatal outcomes. Evidence on health-system and provider-related factors influencing DDI in low-resource settings remains limited. We examined whether surgeon cadre, operating theatre location, and the presence of intern healthcare professionals were associated with prolonged DDI in a tertiary hospital in Northern Uganda. METHODS: We conducted a historical cohort study at St. Mary's Hospital Lacor, a tertiary hospital in Northern Uganda, involving women who underwent emergency CS (6 September 2022 to 1 June 2024). Logistic regression was used to examine the association between prolonged DDI (≥60 minutes) and surgeon cadre, operating theatre location, and intern presence, adjusting for confounders. Effect modification by emergency CS indication was assessed. RESULTS: Of the 760 participants enrolled (median DDI was 51 minutes [IQR: 36-67]), 36.0% had prolonged DDI. Emergency CS performed by junior doctors had twice the odds of prolonged DDI compared to fully-licensed doctors (adjusted odds ratio [aOR]: 2.07; 95% CI: 1.38-3.10). Theatre location and presence of interns showed no association with prolonged DDI (aOR: 0.89; 95% CI: 0.61-1.28) and (aOR: 0.71; 95% CI: 0.50-1.02), respectively. There was no statistically significant evidence that these associations differed by the CS indication. CONCLUSIONS: Emergency CS performed by junior doctors was associated with increased odds of prolonged DDI compared with procedures performed by fully-licensed doctors. These findings highlight the importance of strengthening supervision, mentorship and emergency obstetric training for junior doctors in resource-limited settings. Operating theatre location and the presence of intern healthcare professionals were not significantly associated with prolonged DDI.
Co-Creating an Interconception Infographic for Women From Priority Populations for Inclusion in the Baby Bundle at a Victorian Hospital: A Feasibility and Acceptability Pilot Study.
Subasinghe AK, Xiao J, Patlori S … +5 more , Parker T, Wijesinghe N, Cussen S, Sheehan P, Boyle JA
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42272097 · Full text
Providing high-quality reproductive health information for pregnant women will promote health literacy, improve postpartum maternal health and optimise preconception health before future pregnancies. We analysed antenata...
Providing high-quality reproductive health information for pregnant women will promote health literacy, improve postpartum maternal health and optimise preconception health before future pregnancies. We analysed antenatal data from 314 women attending a Victorian Hospital for pregnancy services, and co-designed and evaluated a culturally responsive interconception health tool for inclusion in the baby bundle provided to women attending this service. Information around family planning, nutrition and physical activity, lactation, common conditions in pregnancy, mental health and support networks was included in the tool. Women reported that combining an interconception resource with the standard midwifery-led discharge consultation would be optimal.
Delayed childbearing and reproductive ageing: a narrative review.
Yang D, Huang H, He Y
J Obstet Gynaecol · 2026 Dec · PMID 42261812 · Publisher ↗
BACKGROUND: Delayed childbearing is increasingly common worldwide, with more women conceiving at age ≥35 years. This demographic shift intersects with age-related fertility decline, affecting natural conception, assisted...
BACKGROUND: Delayed childbearing is increasingly common worldwide, with more women conceiving at age ≥35 years. This demographic shift intersects with age-related fertility decline, affecting natural conception, assisted reproductive technology (ART) outcomes and perinatal health. METHODS: We conducted a narrative review based on structured searches of PubMed, Embase and Web of Science (2015-2025), supplemented by landmark earlier studies. We included peer-reviewed original research, systematic reviews, meta-analyses and clinical guidelines. Findings were synthesised narratively. RESULTS: Social, economic and cultural factors drive pregnancy postponement, increasing demand for ART. Female reproductive ageing involves declining oocyte quantity and quality, mitochondrial dysfunction, and aneuploidy - reducing fecundability and live birth rates. Advanced maternal age (AMA) elevates risks of gestational diabetes, hypertensive disorders, preterm birth, foetal growth restriction, stillbirth and congenital anomalies. Advanced paternal age independently contributes to miscarriage, preterm birth and offspring neurodevelopmental risks via epigenetic alterations and mutations. Donor oocytes partially offset embryonic decline, but uterine ageing persists, especially after 45 years. Social oocyte freezing offers age-dependent efficacy, with optimal cost-effectiveness when performed in the early 30s. CONCLUSIONS: The health challenges of delayed childbearing may stem from a fundamental mismatch between enabling societal structures and immutable biological timelines. Clinical practice should adopt proactive, age-stratified care that includes preconception education, timely ART, risk-adapted obstetric management and advocacy for supportive social policies.
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