International Journal of Gynecology & Obstetrics最新文献

{"title":"Risks of misuse and overuse of Kegel exercises in postpartum and postmenopausal urinary incontinence.","authors":"Mostafa Maged Ali, Antonio Simone Laganà, Samina Dornan","doi":"10.1002/ijgo.70569","DOIUrl":"https://doi.org/10.1002/ijgo.70569","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between epidural analgesia and perineal injury in primiparous women: A propensity score-matched cohort study.","authors":"Omri Dominsky, Emmanuel Attali, Uri Amikam, Ronen Gold, Chaim Greenberger, Yariv Yogev, Yoav Baruch","doi":"10.1002/ijgo.70578","DOIUrl":"https://doi.org/10.1002/ijgo.70578","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association between epidural analgesia and perineal injury, including obstetric anal sphincter injury (OASI), in primiparous women.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of primiparous women with singleton, term, vertex, and vaginal deliveries between 2012 and 2024 at a tertiary medical center. Primary outcomes were (1) any perineal injury, and (2) OASI. Propensity score matching (1:1) was used to adjust for maternal and obstetric confounders. Perineal outcomes were compared in matched and unmatched cohorts using standardized mean difference (SMD). An SMD <0.1 was considered negligible, 0.1-0.2 small, and >0.2 clinically significant. Multivariable logistic regression was used to evaluate associations between epidural use and outcomes.</p><p><strong>Results: </strong>Overall, 45 132 women were included, of whom 36 799 (81.5%) received epidural analgesia. After matching (n = 5974 per group), baseline characteristics were balanced apart from fetal head station at full dilation, which was higher in the no-epidural group (0.90 ± 0.9 vs. 0.66 ± 0.8; SMD = 0.239). Perineal injury occurred more often with epidural with a marginal difference (82.2% vs. 78.2%, SMD = 0.10). In a multivariable logistic regression analysis, epidural was associated with more perineal injury only in the absence of episiotomy (adjusted odds ratio [aOR] 1.321; 95% confidence interval [CI]: 1.225-1.425; P < 0.001), but not when episiotomy was performed. Conversely, epidural use was associated with lower OASI risk regardless of whether episiotomy was performed (aOR 0.492; 95% CI: 0.285-0.849; P = 0.011) or not (aOR 0.592; 95% CI: 0.424-0.825; P = 0.002).</p><p><strong>Conclusion: </strong>In primiparous term vaginal deliveries, epidural analgesia modestly increased low-grade perineal tears but reduced OASI risk, supporting its safety regarding severe perineal trauma.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluorescein colposcopy-A more specific diagnostic method for detection of high-grade cervical precancer lesions than acetic acid.","authors":"Sudabeh Moein, Francisco Arnoldo López Romo, Lawrence B Fischel, Nidhi Singh, Joseline Sanchez, José Tirán Saucedo","doi":"10.1002/ijgo.70481","DOIUrl":"https://doi.org/10.1002/ijgo.70481","url":null,"abstract":"<p><strong>Objective: </strong>To compare the sensitivity and specificity of topical fluorescein sodium (FNa) to acetic acid (AA) for the detection of high-grade cervical lesions in colposcopy.</p><p><strong>Materials and methods: </strong>This prospective, cross-sectional study was conducted between January and November 2017 at Christus Muguerza Hospital Conchita in Monterrey, Mexico. 78 women between 18 and 65 years age with a documented abnormal cervical smear test were included. Colposcopy by independent application of 5% AA and 0.06% topical FNa was performed and biopsy obtained for each woman.</p><p><strong>Results: </strong>68 (87%) women tested positive with FNa, while 10 (13%) tested negative. Biopsy demonstrated high grade cervical lesions in 31 of the FNa positive but none of the FNa negative women. FNa staining demonstrated 100% sensitivity, 21% specificity, 46% positive predictive value (PPV), and 100% negative predictive value (NPV) to detect high-grade lesions. In comparison, acetic acid staining demonstrated 100% sensitivity, 9% specificity, 42% PPV, and 100% NPV.</p><p><strong>Conclusion: </strong>FNa had a 133% higher diagnostic specificity than AA (21% vs. 9%) for high-grade lesions at a comparable cost and convenience. Visual inspection with FNa has the potential to replace visual inspection with AA in low-resource settings, thus enabling true \"diagnose and treat\".</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of domestic violence in pregnancy and the proffered solutions in a Nigerian teaching hospital.","authors":"Chidinma Ifechi Onwuka, Emeka Ifeanyi Iloghalu, Chidozie Ifechi Onwuka, Peter Chukwudi Udealor, Emmanuel Onyebuchi Ugwu, Godwin Ugonna Odoh, Euzebus Chinonye Ezugwu, Henry Chidi Nnaji, Ifeanyi Emmanuel Menuba, Emmanuel Obiora Izuka, Okechukwu Chidiebere Ifebi, Anthony Victor Nweze","doi":"10.1002/ijgo.70571","DOIUrl":"https://doi.org/10.1002/ijgo.70571","url":null,"abstract":"<p><strong>Objective: </strong>Domestic violence (DV) is a major public health concern with profound emotional, psychological, and medical consequences for women and their families. This study assessed the prevalence, associated factors, and proffered solutions to domestic violence in pregnancy (DVP) among married women in Enugu, southeastern Nigeria.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 447 pregnant married women attending antenatal care at the University of Nigeria Teaching Hospital, Enugu. Data were collected using an interviewer-administered, pretested questionnaire (with supplementary validated tools) and analyzed with IBM SPSS Statistics (version 22.0). Descriptive and inferential statistics were applied, with significance set at P < 0.05.</p><p><strong>Results: </strong>The prevalence of DVP was 27.1%. Husbands or intimate partners were the main perpetrators (66.2%). Emotional/psychological abuse was the most common form of violence (60.3%), while sexual abuse was least reported. On multivariable logistic regression, factors independently associated with DVP included rural residence, maternal age ≥ 30 years, lower maternal educational status, and partners with tertiary education or social habits such as alcohol use, infidelity, and keeping late nights (P < 0.05). Most respondents (40.2%) believed prayer was the solution, while 31.1% felt no solution existed.</p><p><strong>Conclusion: </strong>Domestic violence in pregnancy remains prevalent in Enugu, Nigeria with emotional abuse being most frequent. The reliance on prayer or resignation as \"solutions\" reflects deep-rooted cultural and religious influences. Routine screening during antenatal care, coupled with culturally sensitive counseling, referral pathways, and community-based interventions, is urgently needed to address the burden and prevent associated complications.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early gestational diabetes mellitus versus late gestational diabetes mellitus: Maternal and neonatal outcomes in a retrospective cohort in Asian Indians.","authors":"Haritha Sagili, Priyanka Rajandran, Aby Kuruvilla, Mahadevan Duraiswamy, Anish Keepanasseril, Nishad Plakkal, Sreekumaran Nair, Viswanathan Mohan, Sadishkumar Kamalanathan","doi":"10.1002/ijgo.70568","DOIUrl":"https://doi.org/10.1002/ijgo.70568","url":null,"abstract":"<p><strong>Objective: </strong>The concept of early gestational diabetes mellitus (EGDM) diagnosed in early pregnancy is rapidly evolving, but there is a need for more data. We sought to compare the pregnancy outcomes between EGDM and late gestational diabetes mellitus (LGDM) in South Indians.</p><p><strong>Methods: </strong>This retrospective observational study was carried out in the Department of Obstetrics and Gynecology of a tertiary care institute at Puducherry in South India. The study included a total of 2401 singleton pregnant women aged more than 18 years with gestational diabetes (GDM) diagnosed using International Association of the Diabetes and Pregnancy Study Group criteria. The study participants were divided into EGDM and LGDM groups depending on whether GDM was diagnosed before or at or after 24 weeks of gestation.</p><p><strong>Results: </strong>Early gestational diabetes mellitus was observed in 482 and LGDM in 1919 women. EGDM women had a significantly higher mean maternal age (28.5 vs. 27.5 years, P < 0.001), body mass index ≥25 kg/m² (68.4% vs. 62%, P < 0.001), fewer education years (11.9 vs. 12.2, P = 0.015), and a lower spontaneous conception rate (93.2% vs. 96.7%, P < 0.001). Need for combined insulin and metformin therapy (12% vs. 3.2%, adjusted relative risk (aRR): 2.19, 95% confidence interval [CI]: 1.57-3.05, P < 0.001), metformin alone therapy (35.9% vs. 18.5%, aRR: 1.85, 95% CI: 1.58-2.16, P < 0.001), preterm birth (13.9% vs. 6.5%, aRR: 2.25, 95%CI: 1.69-3.01, P < 0.001), and low birth weight babies (24.5% vs. 17.6%, aRR:1.35, 95%CI: 1.11-1.64, P = 0.002) were significantly higher in women with EGDM relative to LGDM.</p><p><strong>Conclusion: </strong>Women with EGDM have significantly worse metabolic profile, greater need for pharmacotherapy, and worse fetal outcomes compared to LGDM.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"World postpartum hemorrhage day: Renewing the global call to end deaths from postpartum hemorrhage.","authors":"","doi":"10.1002/ijgo.70550","DOIUrl":"https://doi.org/10.1002/ijgo.70550","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal diagnosis and early intervention of intrauterine atrial flutter: Two case reports and literature review.","authors":"Nan Li, Yin Wang, Hui Chen, Suqing Wu","doi":"10.1002/ijgo.70561","DOIUrl":"https://doi.org/10.1002/ijgo.70561","url":null,"abstract":"<p><p>Perinatal onset of fetal atrial flutter (AFL) often presents with nonspecific symptoms, making it prone to missed diagnosis. Fetal AFL is a severe life-threatening arrhythmia, and early diagnosis and prompt treatment are crucial. Prenatal diagnosis of AFL primarily relies on fetal echocardiography; hence, enhancing the diagnostic accuracy of fetal echocardiography for AFL is crucial. Simultaneously, timely intervention and standardized treatment are equally important for maternal and fetal safety during the perinatal period.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poster Presentations","authors":"","doi":"10.1002/ijgo.70503","DOIUrl":"https://doi.org/10.1002/ijgo.70503","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":"171 S2","pages":"121-653"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1002/ijgo.70503","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145196447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FIGO good practice recommendations on anemia in pregnancy, to reduce the incidence and impact of postpartum hemorrhage (PPH).","authors":"Akaninyene E Ubom, Ferdousi Begum, Diana Ramasauskaite, Albaro J Nieto-Calvache, Monica Oguttu, Inês Nunes, Zechariah J Malel, Jolly Beyeza-Kashesya, Alison Wright","doi":"10.1002/ijgo.70529","DOIUrl":"https://doi.org/10.1002/ijgo.70529","url":null,"abstract":"<p><p>Anemia affects 32 million pregnant women globally, contributing annually to more than 115 000 maternal deaths and 591 000 perinatal deaths worldwide. Low- and middle-income countries (LMICs) bear the highest burden of anemia in pregnancy, with nearly 50% of affected pregnant women. It is now 2025, which is WHO's target year for a 50% reduction in maternal anemia, and the global prevalence of anemia in pregnancy remains more than twice the target of 15%. This calls for a renewed global focus on optimal approaches for reducing the burden and complications of anemia in pregnancy. In this FIGO Childbirth and Postpartum Hemorrhage (PPH) Committee paper, current best evidence on anemia in pregnancy has been reviewed and synthesized, to make recommendations on screening, diagnosis, prevention, and treatment of anemia in pregnancy. We recommend that all pregnant women should be screened for anemia in pregnancy at booking and again at 28 weeks of pregnancy, with a full blood count (FBC), or packed cell volume/hemoglobin concentration in settings where FBC is not available. A hemoglobin concentration cutoff of less than 11 g/dL in all trimesters of pregnancy and during the postpartum period, as well as in all settings and populations, is recommended for the diagnosis of anemia in pregnancy. Routine iron and folic acid supplementation, either alone, or as components of multiple micronutrient supplements, is also recommended during pregnancy. We also made recommendations for malaria and anti-helminthic chemoprophylaxis, hemoglobinopathy screening, iron, folate, and multiple micronutrient supplementation, and blood transfusion in pregnant women with hemoglobinopathies. Finally, the relationship between anemia and postpartum hemorrhage is highlighted.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the impact of micro- and nanoplastics on female reproduction: What we know and gaps in knowledge.","authors":"Sanchayana Raghuvir, Shawn Alex, Deborah Clegg","doi":"10.1002/ijgo.70552","DOIUrl":"https://doi.org/10.1002/ijgo.70552","url":null,"abstract":"<p><p>Micro-and nanoplastics (MNPs) are breakdown products of plastics, and humans are exposed to these particles through air, water, food, and soil. There is a growing concern that human exposure to MNPs negatively impacts health. In this review we will discuss the potential health impact of MNPs on ovarian function and the hypothalamic-pituitary-ovarian (HPO) axis. We will highlight that the deleterious effects of MNPs on female reproductive health have been mostly documented in animal models. Studies have demonstrated that MNPs accumulate in ovarian tissue, disrupt hormonal signaling, and induce oxidative stress, leading to hormonal irregularities, ovarian atrophy, and increased androgen levels. Additionally, there is accumulating evidence that not only are MNPs a concern by themselves, but they are also carriers of endocrine-disrupting chemicals (EDCs) which further exacerbate reproductive dysfunction. While animal models demonstrate reproductive toxicity from MNP exposure, there are gaps in our knowledge on whether these findings can be translated to humans. Human clinical trials to directly determine the impact of MNPs are unethical because the evidence suggests MNP exposure may be detrimental to health. In this review, we highlight gaps in our knowledge and suggest areas which need further research.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}