International Journal of Gynecology & Obstetrics最新文献

{"title":"Membranous dysmenorrhea (a case report).","authors":"Nadiia Medvedieva, Mykhailo Medvediev, Andrea Tinelli","doi":"10.1002/ijgo.16128","DOIUrl":"https://doi.org/10.1002/ijgo.16128","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881877","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":"Neonatal outcomes between trial of labor and cesarean delivery for extreme preterm infants.","authors":"Itamar Gilboa, Daniel Gabbai, Yariv Yogev, Emmanuel Attali, Noa Zaltz, Jacky Herzlich, Liran Hiersch, Michael Lavie","doi":"10.1002/ijgo.16113","DOIUrl":"https://doi.org/10.1002/ijgo.16113","url":null,"abstract":"<p><strong>Objective: </strong>To compare adverse neonatal outcomes between trial of vaginal delivery and upfront cesarean delivery for singleton infants born at 24 to 28 weeks of gestation.</p><p><strong>Methods: </strong>This is a retrospective cohort study that was conducted at a university-affiliated tertiary medical center between 2011 and 2022, involving singleton pregnancies delivered between 24^0/7 and 27^6/7 weeks of gestation. Participants were divided into two groups based on their intended mode of delivery: a trial of labor (TOL) group and an upfront cesarean delivery (CD) group. The primary outcome was defined as neonatal death. The secondary outcome was defined as any of the following: intraventricular hemorrhage, necrotizing enterocolitis, bronchopulmonary dysplasia, neonatal sepsis, periventricular leukomalacia, disseminated intravascular coagulation, umbilical cord arterial PH <7.1, or use of postpartum mechanical ventilation. Analyses were performed using an intention-to-treat approach.</p><p><strong>Results: </strong>Overall, 199 patients were enrolled, with 64 in the TOL group and 135 in the upfront CD group. Neonatal deaths occurred in 48 cases (24.2%) across the entire cohort, with no significant difference between the TOL (18.8%) and upfront CD (26.7%) groups (P = 0.223). Rates of other composite adverse outcome were comparable between the groups (26.6% vs. 31.9%, P = 0.448), respectively. A sub-analysis comparing patients with pre-existing contraindications for vaginal delivery, without maternal or fetal indications for delivery, to those in the TOL group who experienced spontaneous onset of labor showed no differences in primary or secondary outcomes between the groups.</p><p><strong>Conclusion: </strong>We found no difference in adverse neonatal outcomes between TOL and upfront CD for singletons born at 24-28 weeks gestation.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876812","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":"Study of the association of niacin and vitamin B6 intake with endometriosis: Evidence from NHANES 2003-2006.","authors":"Jiangxin Sheng, Limei Chen, Han Yan, Jichan Nie","doi":"10.1002/ijgo.16096","DOIUrl":"https://doi.org/10.1002/ijgo.16096","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to investigate the association between dietary intake of niacin and vitamin B6 and the prevalence of endometriosis using data from the National Health and Nutrition Examination Survey (NHANES) 2003-2006.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a cross-sectional analysis using data from women aged 25-45 years in the 2003-2006 NHANES. Niacin and vitamin B6 intake were assessed using 24-h dietary recalls, and endometriosis status was determined by self-report. Covariates included age, race, body mass index, poverty income ratio, smoking status, and alcohol consumption. Weighted logistic regression models were used to evaluate the association between vitamin intake and endometriosis, with stratified analyses performed for different age groups. Data visualization included scatter plots with locally estimated scatterplot smoothing (LOESS) curves to illustrate the relationship between nutrient intake and the probability of endometriosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1467 participants were included, of whom 7.17% (105 individuals) reported having endometriosis. There were significant differences in dietary intake of niacin and vitamin B6 between participants with and without endometriosis. In the unadjusted model, vitamin B6 intake was significantly negatively associated with endometriosis (odds ratio [OR], 0.79 [95% confidence interval (CI), 0.62-0.99], P = 0.033), and niacin intake showed a marginally significant negative association (OR, 0.98 [95% CI, 0.96-1.00], P = 0.019). In the models adjusted for age and race, the negative association between vitamin B6 and endometriosis remained significant (OR, 0.80 [95% CI, 0.63-1.01], P = 0.044), and the association for niacin remained marginally significant (OR, 0.98 [95% CI, 0.96-1.00], P = 0.023). In the fully adjusted model, the negative association for vitamin B6 remained significant (OR, 0.79 [95% CI, 0.63-0.99], P = 0.033), and the association for niacin remained marginally significant (OR, 0.98 [95% CI, 0.96-1.00], P = 0.021). Age-stratified analysis showed that niacin intake was not significantly associated with endometriosis in women aged 35 years and younger (OR, 0.98 [95% CI, 0.95-1.02], P = 0.3), whereas vitamin B6 intake was significantly negatively associated with endometriosis in women older than 35 years (OR, 0.75 [95% CI, 0.56-0.99], P = 0.048). Scatter plots with LOESS curves indicated a negative trend between higher intakes of niacin and vitamin B6 and the probability of endometriosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The findings suggest that dietary vitamin B6 intake is negatively associated with the prevalence of endometriosis, particularly among women older than 35 years, highlighting the potential role of dietary adjustments in managing endometriosis. Niacin intake also showed a protective effect, although this was less pronounced than vitamin B6. These results provide a basis for further research into the relationsh","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876754","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":"Legal challenges in expanding the provider base for abortion in Asia.","authors":"Dipika Jain","doi":"10.1002/ijgo.16119","DOIUrl":"https://doi.org/10.1002/ijgo.16119","url":null,"abstract":"<p><p>In Asia as elsewhere, strict regulations on who is authorized to provide abortion services and to prescribe or dispense medical abortion adversely impact access, especially for marginalized persons and residents in remote areas. The WHO's 2022 Abortion Care Guideline provides an important framework for states to formulate and implement policies to serve sexual and reproductive rights of access to abortion services. The Guideline calls for decriminalization of abortion services to increase authorization to provide abortion services and to promote self-managed medical abortion. This review examines the legal and policy frameworks of Bangladesh, India, Indonesia, Malaysia, and Nepal against the WHO Guideline. Legal and policy reforms successfully introduced in Bangladesh and Nepal to grow the provider base allow healthcare systems to expand safe abortion. This review outlines further challenges where the WHO Guideline on decriminalization and availability of medical abortion is disregarded and advocates a reproductive justice approach promoting egalitarian access to services even among the most marginalized.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876803","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":"Native tissue repair of the female pelvic floor: A four-level surgical concept.","authors":"Michal Otcenasek, Katarzyna Borycka, Hynek Herman","doi":"10.1002/ijgo.16109","DOIUrl":"https://doi.org/10.1002/ijgo.16109","url":null,"abstract":"<p><p>This review describes our experience with native tissue repair of the visceral pelvic fascia, the perineum, and anal sphincters in women. We propose that complex repair of the pelvic floor should consider vaginal support in all three anatomical Delancey's levels, together with more caudal structures-the external and internal anal sphincters. Original illustrations were created to facilitate the understanding of the complex anatomy of common multi-level defects. As the integrity of connective tissue adds to various aspects of the delicate function of the female pelvic floor, it is complete and as perfect as possible repair is a common goal of both gynecologists and colorectal specialists.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876808","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":"CustOmized versus standard fundal-height measuREments for the detection of small-for-gestational age fetuses in low-risk women (CORE study): A randomized controlled trial.","authors":"Farhat Ul Ain Ahmed, Sharoon Hanook, Fatima Ismail, Fatima Shah, Maaz Arsalan, Maria F Lopez Garcia-Tinajero, Judit Martinez-Egea, Francesc Figueras","doi":"10.1002/ijgo.16107","DOIUrl":"https://doi.org/10.1002/ijgo.16107","url":null,"abstract":"<p><strong>Objective: </strong>To compare the proportion of small-for-gestational age (SGA) infants detected by routine care versus a growth assessment protocol using customized fundal-height charts in low-risk pregnancies of a developing country.</p><p><strong>Methods: </strong>An open label randomized controlled trial was conducted at the Fatima Memorial Hospital (NUR International University, Pakistan). Low-risk pregnant women were randomly allocated to routine care (Mcdonald's rule for fundal height measurements followed by referral for scan with discrepancy of 3 cm from gestational age and a contingency third trimester scan) or the growth assessment protocol (GAP) developed by the Perinatal Institute (UK), which consists of the use of gestation-related optimal weight (GROW) customized charts, alongside management protocols for suspected SGA fetuses, audit tools and training. The primary prespecified outcome was the detection of SGA (defined as a birthweight <10th centile).</p><p><strong>Results: </strong>Of the 2535 eligible women, 1884 (74%) were randomized (942 to standard care and 942 to GAP). After loss-to-follow-up, 1755 women were analyzed (874 in the standard measurement group and 881 in the GAP group). The detection rate of SGA infants was higher in the GAP group (83.2% [95% CI: 74.4%-89.9%] vs. 29% [95% CI: 20.4%-38.9%], P < 0.001), at the cost of an increased false positive rate (10.4% [95% CI: 8.3%-12.7%] vs. 1.4% [95% CI: 0.7%-2.5%], P < 0.001). The diagnostic odds ratio (positive likelihood ratio/negative likelihood ratio) was 42.6 (95% CI: 24.1-75.4) in the GAP group and 28.3 (95% CI:13.6-59.1) in the standard care group.</p><p><strong>Conclusion: </strong>In low-risk pregnant women of a developing country, a growth assessment protocol based on customized fundal-height charts is superior to standard measurements for the antenatal detection of SGA in newborns.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876468","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":"Diagnostic challenges and management of complete interstitial ectopic pregnancy: A case report in a rural setting.","authors":"Qingyu Guo, Rashad N Ali","doi":"10.1002/ijgo.16088","DOIUrl":"https://doi.org/10.1002/ijgo.16088","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871796","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":"Measurement of thiol/disulfide homeostasis and ischemic modified albumin levels in patients with uterine leiomyomas.","authors":"Bengü Nur Bariş Akcan, Büşra Karagöz Yikilmaz, Uğurcan Zorlu, Özcan Erel, Salim Neşelioğlu, Esra Özyurt, Özlem Moraloğlu Tekin, Burak Elmas","doi":"10.1002/ijgo.16098","DOIUrl":"https://doi.org/10.1002/ijgo.16098","url":null,"abstract":"<p><strong>Objective: </strong>The aim is to contrast the serum levels of thiol-disulfide homeostasis and ischemic modified albumin between patients with leiomyoma and healthy individuals and to assess the impact of oxidative stress on the etiopathogenesis of leiomyoma.</p><p><strong>Methods: </strong>In this prospective case-control study, a total of 154 participants were included, consisting of 77 cases diagnosed with leiomyoma and 77 healthy individuals without leiomyoma. The demographic characteristics and ultrasonographic findings of the participants were recorded, and parameters such as albumin, ischemia-modified albumin, and thiol-disulfide homeostasis were evaluated. The results obtained from the analyses were compared between the two groups.</p><p><strong>Results: </strong>No significant differences were observed in the demographic characteristics between the groups. A significant difference was observed between the leiomyoma and control groups regarding serum albumin parameters, serum ischemic modified albumin, and serum dynamic thiol-disulfide parameters (P < 0.001). No significant difference was found in the ratios of disulfide/total thiol, disulfide/native thiol, native thiol/total thiol (P > 0.05).</p><p><strong>Conclusion: </strong>There was a notable contrast in the levels of albumin, ischemic modified albumin, albumin/ischemic modified albumin ratio, total thiol, native thiol, and disulfide between individuals with uterine leiomyomas and healthy individuals in the control group. Oxidative stress is believed to play a causative role in the etiopathogenesis of uterine leiomyomas.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864117","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":"Takayasu's arteritis in pregnancy: A case report and literature review.","authors":"Apeksha Bista, Durga Thapa, Prawesh Neupane, Swati Gupta, Shreyashi Aryal, Jyotshna Sharma","doi":"10.1002/ijgo.16089","DOIUrl":"https://doi.org/10.1002/ijgo.16089","url":null,"abstract":"<p><p>Takayasu's arteritis (TA) is a rare, chronic inflammatory disease of unknown cause, primarily affecting young women in their reproductive years. It can result in the narrowing and occlusion of arteries and the formation of aneurysms in arteries, especially those related to the aorta, creating significant risks during pregnancy. Women with TA are more susceptible to cardiovascular complications, including hypertension and heart failure, which can negatively affect both maternal and fetal health. This case report details a 23-year-old pregnant woman diagnosed with TA during the first trimester, presenting with symptoms of fainting and pulselessness in her right upper limb. Doppler imaging of the right upper limb confirmed the diagnosis. Treatment for TA was initiated alongside comprehensive antenatal care. In the third trimester, she also developed gestational hypertension. And at 36 weeks of gestation, due to placenta previa and preterm premature rupture of membranes, an emergency cesarean section was performed. Timely medical intervention resulted in a favorable outcome, with an uneventful postpartum recovery. This case highlights the need for early diagnosis and collaborative care in pregnant women with TA to ensure better outcomes for both mother and child. Understanding the clinical aspects of TA is essential for effective management and improved prognosis.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864087","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":"Efficacy and safety of different progestogens in women with first threatened miscarriage: A network meta-analysis.","authors":"Hongqiong Zhao, Wei He, Chunyu Xia, Zhu Yang","doi":"10.1002/ijgo.15987","DOIUrl":"https://doi.org/10.1002/ijgo.15987","url":null,"abstract":"<p><p>Threatened miscarriage is defined as early vaginal bleeding before 12 weeks of gestational age and can occur in any pregnancy regardless of maternal age, race, comorbidities, lifestyle, or socioeconomic status, and about one-quarter of threatened miscarriages proceed to complete miscarriage. To assess the relative effectiveness and safety of different progestogens in women with first threatened miscarriage, using a network meta-analysis. A systematic search was conducted in PubMed, EMBASE, and Cochrane Library databases from inception to April 2023. Randomized controlled trials (RCTs) assessing the effectiveness or safety of placebo or different progestogens for the treatment of threatened miscarriage were eligible for inclusion, including dydrogesterone (oral), progesterone (oral, vaginal, rectal), and 17-α-hydroxyprogesterone (intramuscular). A Bayesian network meta-analysis with Markov chain Monte-Carlo simulation was performed in this study. A pairwise meta-analysis was carried out by synthesizing studies that compared the same interventions using a fixed-effects model. The primary outcome was the percentage of miscarriage (defined as delivery before 24 weeks of gestation) and preterm birth (defined as birth before 37 weeks of gestation), and the secondary outcomes were live birth rate, congenital abnormalities, neonatal outcomes (low birth weight <2500 g), and adverse events. The risk of bias was assessed by using the Cochrane Risk of Bias Tool. In total, 18 RCTs with six different interventions were included. Oral dydrogesterone can reduce the risk of miscarriage compared with both placebo (odds ratio [OR] 0.5, 95% confidence interval [CI] 0.32-0.76) and vaginal progesterone (OR 0.57, 95% CI 0.36-0.89) in women with first threatened miscarriage. In women with first threatened miscarriage, oral progesterone also reduced the risk of miscarriage compared with placebo (OR 0.61, 95% CI 0.39-0.93). However, from the available evidence, there was no statistically significant difference between progestogens and placebo in preterm birth, congenital abnormality, and live birth rate. Oral dydrogesterone was safe and better at reducing miscarriage than vaginal progesterone and placebo for women with first threatened miscarriage, and better at reducing miscarriage compared with placebo for women with threatened miscarriage.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854006","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}