Gynecologic and Obstetric Investigation最新文献

{"title":"Diagnosis-Day Prothrombin Time and Transaminase as Exploratory Risk-Stratification Indicators for Severe Neonatal Outcomes in Acute Fatty Liver of Pregnancy.","authors":"Dong Xu, Peiyue Jiang, Hong Chen, Lihua Shao, Baihui Zhao","doi":"10.1159/goi/aczag013","DOIUrl":"https://doi.org/10.1159/goi/aczag013","url":null,"abstract":"<p><strong>Objectives: </strong>Acute fatty liver of pregnancy (AFLP) is a life-threatening condition associated with high neonatal morbidity. This study aimed to develop a minimal, clinically feasible prediction model using diagnosis-day laboratory indicators to stratify the risk of severe adverse neonatal outcomes (SANO).</p><p><strong>Methods: </strong>In this single-center retrospective cohort (2004-2021), 18 pregnancies with AFLP confirmed by Swansea criteria were analyzed. Firth penalized logistic regression assessed associations between the first laboratory values on the diagnosis day and SANO (intrauterine death/severe asphyxia). A two-variable model combining prothrombin time (PT) and peak transaminase was developed. Model performance was evaluated via area under the receiver operating characteristic curve (AUC) and leave-one-out cross-validation (LOOCV).</p><p><strong>Results: </strong>The incidence of AFLP was 0.71 per 10,000 pregnancies. SANO occurred in 4 cases (17.39%). Diagnosis-day coagulopathy, especially prolonged PT, was the strongest predictor. The PT+transaminase model showed excellent discriminatory performance (AUC=0.982) and robustness upon internal validation (LOOCV AUC=0.964), with a negative predictive value of 1.000 for ruling out SANO.</p><p><strong>Conclusions: </strong>Coagulation dysfunction at diagnosis is a key indicator for neonatal risk in AFLP. The proposed PT-based model offers a practical bedside tool for early obstetric risk stratification, aiding in urgent clinical decision-making for delivery planning and neonatal resuscitation preparedness.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden, cross-country inequalities, and projection of obesity-related uterine cancer.","authors":"Guanchen Ma, Shuhao Yang, Xingyu Liu","doi":"10.1159/goi/aczag015","DOIUrl":"https://doi.org/10.1159/goi/aczag015","url":null,"abstract":"<p><strong>Background: </strong>Obesity influences nearly 30% of the world population, and is closely related to uterine cancer. This study aims to explore the burden obesity-related uterine cancer and cross-country inequalities across sociodemographic development levels with Global Burden of Diseases 2021 (GBD 2021).</p><p><strong>Materials and methods: </strong>The study analyzed trends of deaths, disability-adjusted life years (DALY), years of life lost (YLL) of obesity-related uterine cancer utilizing age-standardized rates and their average annual percentage changes (AAPCs). Decomposition, cross-country inequality, and predictive analysis were also performed.</p><p><strong>Results: </strong>The global burden of obesity-related uterine cancer increased by 138.49% in deaths, 136.19% in DALY, and 129.61% in YLL from 1990 to 2021. Globally, population growth had the greatest impact on increased DALY between 1990 and 2021, accounting for 46.49%, followed by 40.07% of aging and 13.44% of epidemiologic changes. The slope index of inequality indicated that the gap in DALYs between countries with the highest and lowest sociodemographic index (SDI) increased from 30.05 (95%CI 25.27 to 34.65) in 1990 to 48.49 (95%CI 38.58 to 58.91) in 2021. The concentration index remained stable from 0.49 (95%CI 0.41 to 0.56) in 1990 to 0.41 (95%CI 0.34 to 0.48) in 2021 (p = 0.175). The total DALY is expected to more than double, reaching 1,837,036 in 2050 with age-standardized DALY rate is expected to increase slightly by 2050.</p><p><strong>Conclusion: </strong>The burden of obesity-related uterine cancer is rising rapidly, disproportionately affecting higher-SDI countries, with widening absolute but largely stable relative socioeconomic inequalities. Projections from 2020 to 2050 indicate a steady increase in both cases and age-standardized rates. Weight control is crucial for mitigating the burden of obesity-related uterine cancer.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papaverine administration during labor induction in nulliparous patients: a retrospective cohort study.","authors":"Raneen Abu Shqara, Nadir Ganem, Ala Aiob, Neta Hoffman, Lior Lowenstein, Maya Frank Wolf","doi":"10.1159/goi/aczag017","DOIUrl":"https://doi.org/10.1159/goi/aczag017","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the association between papaverine administration during labor induction and maternal and neonatal outcomes among nulliparous patients, with particular emphasis on cesarean delivery, labor duration, and timing of administration relative to rupture of membranes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Retrospective cohort study. Participants/Materials: The study included 1,889 nulliparous patients with singleton pregnancies who underwent medically indicated labor induction with intravenous oxytocin between January 2020 and December 2024. Patients were categorized according to papaverine exposure: no papaverine (n=1,185), one 80-mg intramuscular dose (n=618), or two 80-mg intramuscular doses (n=86).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;A tertiary university-affiliated medical center in northern Israel.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Maternal, intrapartum, postpartum, and neonatal data were extracted from electronic medical records. The primary outcome was mode of delivery. Secondary outcomes included cesarean delivery due to non-progressive labor, delivery within 24 hours, postpartum hemorrhage, puerperal endometritis, 5-minute Apgar score &lt;7, umbilical cord pH &lt;7.2 and &lt;7.1, and neonatal intensive care unit admission. Pairwise comparisons were performed between each papaverine group and the no-papaverine group using the independent-samples t test, Mann-Whitney U test, Pearson's chi-square test, or Fisher's exact test, as appropriate. A multivariable logistic regression model was used to evaluate factors associated with cesarean delivery. Mode of delivery was also evaluated according to the timing of papaverine administration relative to rupture of membranes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with no papaverine, one-dose papaverine administration was associated with a lower cesarean delivery rate (24.4% vs. 33.9%; RR 0.72, 95% CI 0.61-0.85; P&lt;0.001), whereas the cesarean delivery rate did not differ significantly between the two-dose and no-papaverine groups (30.2% vs. 33.9%; P=0.484). Cesarean delivery due to non-progressive labor was less frequent with one dose compared with no papaverine (11.5% vs. 17.1%; RR 0.67, 95% CI 0.52-0.86; P=0.002), whereas no significant difference was observed between the two-dose and no-papaverine groups (20.9% vs. 17.1%; P=0.369). Delivery within 24 hours was more frequent with one dose than with no papaverine (65.0% vs. 53.9%; RR 1.21, 95% CI 1.12-1.30; P&lt;0.001) and less frequent with two doses than with no papaverine (37.2% vs. 53.9%; RR 0.69, 95% CI 0.52-0.91; P=0.003). Vaginal delivery rates were highest when papaverine was administered before rupture of membranes (77.0%), followed by administration after rupture of membranes (73.0%) and no papaverine exposure (66.1%; P&lt;0.001). In multivariable analysis, papaverine administration was independently associated with lower odds of cesarean delivery (adjusted OR 0.64, 95% CI 0.50-0.81; P&lt;0.001). Maternal postpartum complications ","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the rate of preterm birth change when cervical length isgreater than 25 mm?","authors":"Edgar Hernandez-Andrede, Donatella Gerulewicz, Zulema Alcantar Paniagua, Eleazar E Soto Torres, Sean C Blackwell","doi":"10.1159/goi/aczag016","DOIUrl":"https://doi.org/10.1159/goi/aczag016","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate if the prevalence of preterm birth (PTB) diminishes as the cervix becomes longer than 25 mm.</p><p><strong>Design: </strong>Retrospective cohort Participants/Materials, Setting, Methods: Transvaginal cervical length (CL) was measured in 3,376 singleton pregnancies without fetal anomalies between 17 and 24 weeks of gestation. Patients were classified as low-risk (LR, n=2,863; 84.8%) or high-risk (HR, n=513; 15.2%) based on previous history of PTB. CL measurements were stratified into the following groups: ≤15 mm, 15.1-25.0 mm, and thereafter in 5 mm increments up to 55 mm. Spontaneous PTB was defined as delivery <37 weeks and ≤34 weeks, not attributed to maternal or fetal indications (e.g., preeclampsia, fetal growth restriction). Prevalence of PTB was analyzed across CL categories and between risk groups.</p><p><strong>Results: </strong>The overall prevalence of PTB <37 weeks was 21.7% (733/3,376), and of PTB ≤34 weeks was 5.5% (n=188/3,376). In LR patients, the prevalence of PTB <37 weeks was higher at CL ≤25 mm, and did not change when the cervix was >25 mm. In LR patients, the prevalence of PTB ≤34 weeks was higher at 25.1-30.0 mm, as compared to patients with CL >30 mm. Thereafter, the prevalence of PTB ≤34 weeks did not change. In HR pregnancies, the prevalence of PTB <37 weeks did not change at CL >15 mm, and of PTB ≤34 weeks at CL >25 mm.</p><p><strong>Limitations: </strong>Small variations among operators may affect cervical length measurements. Patients with a short cervix were offered vaginal progesterone, which could affect the frequency of PTB.</p><p><strong>Conclusion: </strong>In LR pregnant women, the prevalence of PTB ≤34 weeks was higher at CL 25-30 mm than at CL>30 mm. HR patients had a significantly higher prevalence of PTB at any CL than LR patients.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrial Thickness and Ectopic Pregnancy Risk following in vitro Fertilization Embryo Transfer: A Systematic Review and Meta-Analysis.","authors":"MeiFang Zeng, BaoPing Zhu, Hao Wei","doi":"10.1159/goi/aczag006","DOIUrl":"10.1159/goi/aczag006","url":null,"abstract":"<p><strong>Background: </strong>Endometrial thickness is a significant determinant of pregnancy outcomes following in vitro fertilization embryo transfer (IVF-ET). However, the relationship between endometrial thickness and the risk of ectopic pregnancy after IVF-ET remains debated.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search of the PubMed, Cochrane Library, and Embase databases to identify relevant studies. In fresh embryo transfer cycles, endometrial thickness was measured on the day of hCG triggering; in frozen-thawed embryo transfer cycles, measurement was performed during the endometrial preparation phase prior to embryo transfer. The ectopic pregnancy rate was designated as the primary outcome measure. Pairwise meta-analyses were performed using Review Manager 5.3.</p><p><strong>Results: </strong>A total of ten studies met the inclusion criteria. In the meta-analysis, women with a thin endometrium undergoing IVF-ET had a significantly higher risk of ectopic pregnancy compared with those with a non-thin endometrium (odds ratio [OR] 2.27, 95% confidence interval [CI] 1.78-2.91, I2 = 48%). Subgroup analyses showed consistent findings in both fresh embryo transfer (OR 2.58, 95% CI 1.62-4.10, I2 = 23%) and frozen-thawed embryo transfer cycles (OR 2.16, 95% CI 1.61-2.89, I2 = 60%). When thin endometrium was defined as <7 mm or <8 mm, the risks remained elevated (OR 2.00 and 2.36, respectively).</p><p><strong>Conclusion: </strong>In IVF-ET cycles, a thin endometrium is associated with a significantly increased ectopic pregnancy rate. No optimal thickness range can be identified from the available data due to the lack of individual patient information and the absence of dose-response analyses.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Advanced\" versus Conventional Trigger results in comparable clinical outcomes in In Vitro Fertilization Cycles.","authors":"Peter Kovacs, Chantal Kinsey, Emilie Sandfeld, Phillip Romanski, Nigel Pereira, Szabolcs Matyas, Yao Lu, Gordon W Bates, Steven L Lindheim","doi":"10.1159/goi/aczag003","DOIUrl":"https://doi.org/10.1159/goi/aczag003","url":null,"abstract":"<p><strong>Objectives: </strong>IVF cycle monitoring involves frequent ultrasound and serum hormone measurement until the day of trigger. Alternatively, given known growth trajectory, folliclular maturity can often be anticipated with scheduled trigger (advanced trigger [AT]) obviating the need for frequent monitoring. Thus, we evaluated the impact of AT compared to conventional trigger (CT) on IVF cycle outcomes.</p><p><strong>Design: </strong>Retrospective analysis of IVF cycles progressing to trigger and retrieval between 2020-2023. 1351 were included in the analysis. CT was applied in 447 cycles (33.1%) and an AT in 904 cycles (66.9%); specifically, one (-1; 496 (54.9%)), two (-2; 337 (37.3%)), three (-3; 66 (7.3%)), and four (-4; 5 (0.5%)) days prior to the anticipated trigger. Patients/Materials, Setting, Methods: Infertile patients undergoing IVF in either a government owned public clinic or a university based academic fertility center. Those managed by CT were compared to those whose last monitoring was done at least one day prior to the trigger (AT). Data was collected for baseline, emrbyology and clinical outcomes from the medical files. The primary outcome was cumulative live birth rate (cLBR). Secondary outcomes included embryology outcomes and complications. Outcomes were compared using t-test, chi-square test, and ANOVA. Univariate and multiple logistic regression was applied to examine associations of cLBR with AT or CT.</p><p><strong>Results: </strong>No differences in embryology outcomes were observed. With respect to clinical outcomes, in the crude analysis, cCPR (44.7% vs 36.2%, p=0.002) and cLBR (40.7% vs 33.2%, p<0.001) were significantly greater in those undergoing CT vs AT. After controlling for confounding variables including age, diagnosis, 2pn/M2 oocytes, multiple regression analysis suggested that cLBR was comparable regardless of using CT or AT (1.17; 95% CI: 0.8-1.72, p=0.41). Adverse events occurred infrequently with no association to trigger type.</p><p><strong>Limitations: </strong>Retrospective anaylsis with potentially unmeasured confounders. Data on costs were not collected. The inclusion of 2 centers only could limit external validity.</p><p><strong>Conclusion: </strong>This study suggests that an AT does not appear to negatively impact IVF outcomes, suggesting that this may represent an option to improve clinic efficiency while maintinaing IVF success. Our results suggest that AT can be an alternative to CT and should be considerd when patient contact needs to be limited or when clinic visit logistics should interfere with treatment start.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse-Led Supportive Physical and Psychological Therapies versus Orthopedic Specialist-Led Usual Care for Postmenopausal Women with Osteoporosis: A 24-Month Prospective, Non-Randomized Interventional Study with Retrospective Data Analysis (Quasi-Experimental Design).","authors":"Yuefei Li, Yanling Guan, Meilan Zou","doi":"10.1159/goi/aczag010","DOIUrl":"https://doi.org/10.1159/goi/aczag010","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Postmenopausal osteoporosis is a progressive skeletal disorder that poses a substantial public health burden due to increased fracture risks. Specialized orthopedic clinics are often structurally constrained by high surgical volumes, limiting their capacity to provide the continuous cognitive reinforcement necessary to maintain long-term medication compliance. Objectives of the study were to evaluate the 24-month clinical utility, behavioral outcomes, and safety profiles of a nurse-led supportive physical and psychological therapy (NT) model compared with traditional orthopedic specialist-led usual care (OU) in postmenopausal women with newly diagnosed primary osteoporosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This 24-month quasi-experimental, non-randomized prospective interventional study analyzed registry data from January 2020 to July 2022 at a single center in China. Out of 415 screened postmenopausal women, 381 with complete 24-month data were evaluated (NT cohort: n = 190, receiving monthly theory-based counseling; OU cohort: n = 191, receiving standard quarterly visits). Both groups received standard guideline-directed medical therapy. Primary metrics included the Medication Possession Ratio (MPR), Osteoporosis Self-Efficacy Scale (OSES), and Osteoporosis Health Belief Scale (OHBS). Separate multivariable linear and logistic regression models adjusted for baseline covariates, with a Bonferroni-corrected significance threshold set at P &lt; 0.0167.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Baseline demographic and clinical parameters were well-matched between the two cohorts. From baseline to the 24-month endpoint, within-group analyses showed significant improvements in psychological indices for both cohorts (P &lt; 0.001). However, inter-group comparisons at 24 months revealed significantly higher health belief scores in the NT cohort (P &lt; 0.001) and markedly superior personal satisfaction (median 2 vs. 1; P &lt; 0.0001). Continuous median MPR was higher in the NT group (0.76) than the OU group (0.74; P = 0.0006). Crucially, 34.7% of the NT cohort achieved the optimal therapeutic adherence threshold (MPR ≥ 0.80) compared to 20.4% in the OU cohort. Multivariable logistic regression confirmed that allocation to the nurse-led framework was associated with a 3.45-fold increase in the odds of achieving optimal adherence (aOR = 3.45; 95% CI: 1.85-6.42; P = 0.0006). Exploratory safety observations recorded zero deaths in the NT group and six descriptive deaths in the OU group (P = 0.032).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;A structured nurse-led supportive care model is strongly associated with higher rates of optimal medication adherence and more robust improvements in health beliefs among postmenopausal women with osteoporosis compared to standard orthopedic care. While patient self-selection and confounding follow-up frequencies necessitate interpreting these findings as longitudinal clinical associations rather than definitive caus","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of miR-382-5p in polycystic ovary syndrome and its role in regulating granulosa cell function via targeting TOP1.","authors":"Min Zhang, Yanqiu Ding, Yingying Yu","doi":"10.1159/goi/aczag011","DOIUrl":"https://doi.org/10.1159/goi/aczag011","url":null,"abstract":"<p><strong>Objectives: </strong>The function of miR-382-5p in polycystic ovary syndrome (PCOS) remains unclear. This study aimed to investigate the potential regulatory mechanisms of the miR-382-5p/DNA topoisomerase I (TOP1) axis in PCOS.</p><p><strong>Design: </strong>The study included 120 healthy controls and 120 PCOS patients. Serum samples were collected from all participants. Human granulosa-like cell line KGN was cultured in vitro and treated with insulin.</p><p><strong>Methods: </strong>Reverse transcription quantitative PCR (RT-qPCR) was used to detect RNA expression; the Cell Counting Kit-8 (CCK-8) assay was used to assess cell proliferation; flow cytometry was used to detect cell apoptosis; and enzyme-linked immunosorbent assay (ELISA) was used to measure the protein levels of Bcl-2, Bax, and Cyclin D1. The protein content of TOP1 in KGN cells was detected by Western blotting. RNA immunoprecipitation (RIP) and dual-luciferase assays were used to validate the binding relationship.</p><p><strong>Results: </strong>Serum miR-382-5p levels were significantly downregulated in PCOS patients, demonstrating good diagnostic value and showing a negative correlation with key clinical indicators of PCOS. In vitro experiments confirmed that, under insulin-induced conditions, overexpression of miR-382-5p significantly inhibited insulin-induced abnormal proliferation of granulosa cells, downregulated the protein of cyclin D1, and simultaneously promoted apoptosis by upregulating the pro-apoptotic protein Bax and downregulating the anti-apoptotic protein Bcl-2. This mechanism was associated with the direct targeting and inhibition of topoisomerase I (TOP1). In PCOS patients, elevated TOP1 mRNA and protein expression correlated negatively with miR-382-5p levels. Overexpression of TOP1 significantly reversed the antiproliferative and proapoptotic effects of miR-382-5p.</p><p><strong>Limitations: </strong>The verification of the miR 382 5p/TOP1 regulatory mechanism was limited to incomplete in vitro cell experiments and non-standard clinical detection, which cannot fully confirm its exact binding effect, in vivo cascade specificity, and independent pathogenic causality in PCOS patients. Additionally, all PCOS patients presented oligo-/anovulation, whereas healthy controls had regular menstrual cycles; given that circulating miR‑382‑5p levels vary with menstrual cycle phases, the observed downregulation in PCOS serum may partly stem from disrupted cyclic ovulation rather than representing an intrinsic PCOS-specific molecular alteration. Therefore, miR‑382‑5p should be interpreted as a correlative biomarker associated with PCOS phenotypes rather than an independent pathogenic mediator.</p><p><strong>Conclusions: </strong>miR-382-5p regulated the imbalance between insulin-mediated proliferation and apoptosis in KGN cells by directly targeting TOP1, thereby contributing to the progression of PCOS.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Market Safety Analysis of Mirvetuximab Soravtansine: A Pharmacovigilance Analysis from a Large, Real-World Database.","authors":"Connor Frey","doi":"10.1159/goi/aczag012","DOIUrl":"https://doi.org/10.1159/goi/aczag012","url":null,"abstract":"<p><strong>Background: </strong>Mirvetuximab soravtansine (MIRV) received FDA approval for FRα-positive, platinum-resistant epithelial ovarian cancer. Its post-marketing safety profile outside the trial setting has not been systematically characterized.</p><p><strong>Methods: </strong>A retrospective disproportionality analysis was conducted using the FDA Adverse Event Reporting System (FAERS). Frequentist metrics and Bayesian metrics were calculated for all MIRV-event pairs.</p><p><strong>Results: </strong>Of 474 drug-event pairs evaluated, 56 (11.8%) met signal criteria. Ocular toxicity dominated, with 22 signals including keratopathy (PRR = 1306.90; n = 35) and corneal epithelial microcysts (PRR = 2318.20; n = 5). Pneumonitis was the most clinically prominent non-ocular signal (PRR = 61.63; n = 57). Peripheral neuropathy had the highest absolute case count (n = 65; PRR = 19.41).</p><p><strong>Conclusions: </strong>Post-marketing FAERS data corroborate the established safety profile, with strong disproportionality signals for ocular toxicity, pneumonitis, and peripheral neuropathy. These findings and underscore the need for prospective confirmation as MIRV exposure accumulates.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Long-Term Effects of Oophoropexy following Recurrent Ovarian Torsion: A Case-Control Study.","authors":"Amir Akdam, Yossi Tzur, Nadav Michaan, Einat Tako, Ishai Levin, Aviad Cohen","doi":"10.1159/goi/aczag008","DOIUrl":"10.1159/goi/aczag008","url":null,"abstract":"<p><strong>Objectives: </strong>The aim was to evaluate the long-term impact of oophoropexy on pelvic pain symptoms and fertility outcomes in women with recurrent ovarian torsion.</p><p><strong>Design: </strong>This was a retrospective case-control study.</p><p><strong>Participants: </strong>Thirty women who underwent oophoropexy for recurrent ovarian torsion were matched in a 1:2 ratio with 60 women who experienced a single episode of ovarian torsion treated with detorsion alone.</p><p><strong>Setting: </strong>The review was conducted a tertiary university-affiliated medical center.</p><p><strong>Methods: </strong>Demographic, clinical, surgical, and follow-up data were obtained from medical records and structured telephone interviews. Long-term outcomes included dysmenorrhea, dyspareunia, and non-menstrual pelvic pain assessed using a numeric rating scale. Reproductive outcomes were also evaluated. Conditional logistic regression was performed to account for the matched case-control design.</p><p><strong>Results: </strong>Median follow-up was 48 months (IQR 16-60). Women who underwent oophoropexy had significantly higher rates of worsening dysmenorrhea (46% vs. 10%), dyspareunia (23.3% vs. 1.7%), and non-menstrual pelvic pain (36.7% vs. 11.7%) compared with controls (all p < 0.01). In adjusted conditional logistic regression accounting for the matched design, oophoropexy remained independently associated with worsening dysmenorrhea (aOR 4.11, 95% confidence interval 1.15-14.66, p = 0.030). Fertility outcomes were comparable between groups.</p><p><strong>Limitations: </strong>The retrospective design and limited sample size may affect the generalizability of the findings, and long-term symptoms were assessed using patient-reported measures.</p><p><strong>Conclusions: </strong>Oophoropexy following recurrent ovarian torsion may be associated with long-term pelvic pain symptoms without compromising fertility. These potential risks should be discussed with patients during preoperative counselling.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1"},"PeriodicalIF":2.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}