International Journal of Gynecology & Obstetrics最新文献

{"title":"Response to Letter to the Editor Re: Does induction or augmentation of labor increase the risk of postpartum hemorrhage in pregnant women with anemia? A multicenter prospective cohort study in India.","authors":"Manisha Nair, Charles Opondo, Saswati Sanyal Choudhury","doi":"10.1002/ijgo.70099","DOIUrl":"https://doi.org/10.1002/ijgo.70099","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763913","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":"Assessing the link between birth interval and pelvic organ prolapse severity in reproductive-age women in rural Turkey: A cross-sectional study on quality of life.","authors":"Ipek Betul Ozcivit Erkan, Atilim Gulcicek","doi":"10.1002/ijgo.70106","DOIUrl":"https://doi.org/10.1002/ijgo.70106","url":null,"abstract":"<p><strong>Objective: </strong>Pelvic organ prolapse (POP) impacts women's quality of life globally. We aimed to assess the association between the number of births, minimum birth intervals, and POP grade, and their relationship with quality of life in reproductive-aged women in rural Turkey.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in rural Turkey from June to September 2024, involving women attending a rural state hospital's gynecology clinic. Participants were divided into group 1 (n = 96, POP stage 0-1) and group 2 (n = 96, POP stage 2-3-4), using Pelvic Organ Prolapse Quantification (POP-Q) system staging. Genital hiatus and perineal body measurements were recorded, and the Prolapse Quality of Life (P-QOL) questionnaire was administered. As outcome measures, we assessed the number of births, minimum birth intervals, genital hiatus, perineal body measurements, and sociodemographic factors, for their associations with POP-Q stage and quality of life.</p><p><strong>Results: </strong>Participants' mean age was 38.0 ± 7.4 years. Women in group 2 had more vaginal deliveries (4.4 ± 1.5 vs. 4.0 ± 1.5; P = 0.042), shorter minimum birth intervals (18.5 ± 7.9 vs. 25 ± 29.5 months; P = 0.004), higher birth weight of the heaviest child (3667.5 ± 540.6 vs. 3468.1 ± 523.3 g; P = 0.008), and larger genital hiatus (4.3 ± 0.9 vs. 3.5 ± 1.0 cm; P < 0.001). Group 2 had significantly higher P-QOL scores, indicating poorer quality of life. Receiver operating characteristic (ROC) curve analysis identified predictive thresholds for severe prolapse: six or more vaginal deliveries, genital hiatus diameter ≥5.25 cm, and heaviest child's birth weight ≥4250 g.</p><p><strong>Conclusion: </strong>Increased number of vaginal births, higher birth weight of the heaviest baby, and shorter intervals between births are significantly associated with more severe POP stages.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752547","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":"Effectiveness of vaginal pessaries versus soft capsules for delivery of progesterone during luteal phase support in frozen embryo transfer cycles: An observational study.","authors":"Alberto Armijo Sánchez, Cristina Fernández-Conde de Paz, Esther Santamaría-López, Jordi Boned López, María Pilar Tirado Carrillo, María Dolores Gómez Manzorro, Elena Mantrana Bermejo","doi":"10.1002/ijgo.70116","DOIUrl":"https://doi.org/10.1002/ijgo.70116","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752551","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":"Successful treatment for aortic dissection in pregnancy: Two case reports.","authors":"Yi Lu, Bisha Su, Yining Cao, Wenchao Sun, Jian Huang, Tingting Wang","doi":"10.1002/ijgo.70098","DOIUrl":"https://doi.org/10.1002/ijgo.70098","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752554","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 effect of antenatal vaginal dilators on perineal trauma: A systematic review and meta-analysis.","authors":"Samantha G Zambuto, Adrienne K Scott, Angela Hardi, Michelle L Oyen, Siobhan Sutcliffe, Jerry L Lowder","doi":"10.1002/ijgo.70096","DOIUrl":"https://doi.org/10.1002/ijgo.70096","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Vaginal dilators use inflatable balloons that can be gently increased in size to dilate the vagina at a controlled rate before or during delivery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary objective of this study was to assess if antenatal use of vaginal dilator devices reduces the incidence of the following outcomes: episiotomy, perineal lacerations, anal sphincter injury, and levator ani avulsion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search strategy: &lt;/strong&gt;We identified studies using Embase, Ovid-Medline All, Scopus, Web of Science, and ClinicalTrials.gov from inception to August 28, 2024. We searched for concepts of vaginal dilators or birth training devices, episiotomy, and injuries to the vagina, perineum, pelvic floor musculature, or obstetric anal sphincter.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomized and non-randomized studies that reported outcomes of interest in participants who used any vaginal dilator device during pregnancy/delivery compared to those who did not. Inclusion criteria were: (1) original clinical research, (2) use of any vaginal dilator device during pregnancy compared to a non-dilator control group and (3) provision of data on at least one of the four outcomes. Exclusion criteria were: (1) publications in languages other than English and French, (2) not peer-reviewed original research and (3) studies that combined dilator use with a second intervention. For meta-analyses, studies were included in each subgroup if they included relevant data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two independent readers screened studies for inclusion/exclusion criteria and independently performed data extraction. Primary outcomes included episiotomies, perineal lacerations, anal sphincter injury, and levator ani avulsion. These outcomes were analyzed separately and combined. The Cochrane Q Test and Higgin's I&lt;sup&gt;2&lt;/sup&gt; were used to assess study heterogeneity. Random effects models were used to obtain pooled risk ratios and 95% confidence intervals. Subanalyses were also performed limited to higher-quality studies (i.e., randomized controlled trials with or without birth attendant and outcome assessor blinding) and for each device separately.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;Of 64 screened studies, six were included in the meta-analyses. Antenatal vaginal dilator device reduced incidence of episiotomy compared to no treatment in all studies combined (n = 1262; pooled risk ratio = 0.82 [95% CI: 0.69, 0.98]), but not higher-quality studies (n = 862; pooled risk ratio = 0.90 [95% CI: 0.73, 1.11]). No associations were observed for perineal lacerations, obstetric anal sphincter injury, and levator ani injury in all studies combined or in higher-quality studies. No association was also observed when all outcomes were combined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Results from our systematic review and meta-analysis do not support a protective effect of antenatal vaginal dilator device u","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752594","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 Tubo-ovarian abscess study (TOAST): A single-center retrospective review of predictors of failed medical management.","authors":"Anna Marshall, Jordon Wimsett, Charlotte Handforth, Louise Unsworth, Jessica Wilson, Anna-Marie Van Der Merwe, Charlotte Oyston","doi":"10.1002/ijgo.70100","DOIUrl":"https://doi.org/10.1002/ijgo.70100","url":null,"abstract":"<p><strong>Objective: </strong>Tubo-ovarian abscesses (TOAs) cause significant morbidity. Surgical intervention is required if broad-spectrum intravenous antibiotics are unsuccessful. This study aimed to describe admission characteristics that predict failed medical management and to evaluate a previously developed risk score for predicting the need for surgical intervention in cases of TOA.</p><p><strong>Design: </strong>Single centre, retrospective cohort study.</p><p><strong>Setting and patients: </strong>Patients admitted to a tertiary-level public teaching hospital with a radiologically or surgically proven TOA between January 1, 2012 and December 31, 2018.</p><p><strong>Measures: </strong>Demographic and clinical details were obtained from electronic clinical records. Medical treatment was considered \"failed\" when surgical intervention was required beyond 24 h of antibiotics. Multivariable analyses using logistic regression was used to determine predictors of failed medical management. Risk scores were calculated as per Fouks et al. and a receiver operating characteristic curve was constructed to assess correlation with outcomes.</p><p><strong>Results: </strong>There were 425 patients and 522 admissions with TOA. In the first 24 h, 14% (72/522) of admissions were treated with a surgical intervention in addition to intravenous (IV) antibiotics, while 86% (450/522) were treated with IV antibiotics alone. In those treated with IV antibiotics alone, medical treatment was successful in 65% (293/450) of cases, with 35% (159/450) requiring additional surgical or radiological intervention prior to discharge. Variables independently associated with failed medical treatment were fever at admission (adjusted odds ratio [aOR] 1.72, 95% confidence interval [CI] 1.11-2.67), larger mean diameter of TOA (2% higher odds for every 1-mm increase in abscess size) and higher C-reactive protein value (1% higher odds for every unit increase) at admission. The area under the curve (95% CI) for Fouks et al. scoring system was 0.63 (0.58-0.68), indicating poor discriminatory ability.</p><p><strong>Conclusions: </strong>A third of TOAs managed medically required surgical intervention. Fever, higher inflammatory markers, and larger mass were predictive of requiring surgery. However, a scoring system using these variables had poor discriminatory ability to predict treatment failure. Prospective studies are needed to determine whether earlier recourse to surgery can improve outcomes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752596","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":"Lived experience of hypertensive disorders of pregnancy: Identifying barriers and improving care-A systematic review and meta-analysis.","authors":"Sara R Wetzler, Tabitha Wishlade, Frances Cates, Isla Kuhn, Catherine E Aiken","doi":"10.1002/ijgo.70089","DOIUrl":"https://doi.org/10.1002/ijgo.70089","url":null,"abstract":"<p><strong>Background: </strong>Affecting ~10%-15% of pregnancies worldwide, hypertensive disorders of pregnancy can cause maternal and neonatal morbidity and mortality.</p><p><strong>Objective: </strong>To understand the patient experience of being treated for hypertensive disorders of pregnancy.</p><p><strong>Search strategy: </strong>Between database inception and June 2024, Medline via Ovid, Embase via Ovid, CINAHL via Ebsco, PsycINFO via Ebsco, Scopus, Web of Science Core Collection, and ASSIA via ProQuest were searched.</p><p><strong>Selection criteria: </strong>Studies were included if they contained qualitative data about the lived experience of hypertensive disorders of pregnancy. Critical Appraisal Skills Program checklist for qualitative research was used to perform a quality assessment.</p><p><strong>Data collection and analysis: </strong>NVivo was used to label and organize a framework of themes and subthemes.</p><p><strong>Main results: </strong>The meta-synthesis included 18 studies. Central themes emerged related to structural and individual barriers to accessing care, understanding of condition and care offered, interactions with providers and the experience of receiving treatment. The subtheme of baseline knowledge/understanding and being informed was mentioned most frequently and consistently across studies (frequency effect size 94.4% and intensity effect size 29.1%). Many women reported the need for greater awareness and education regarding blood pressure in pregnancy and the need to seek prenatal care early.</p><p><strong>Conclusions: </strong>We identified areas where woman-centered care for hypertensive disorders of pregnancy could be improved, using reports from across different global contexts. Based on this data from the patient experience, interventions that focus on health education and patient empowerment would improve the quality of the experience of receiving care during pregnancies complicated by hypertensive disorders.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742837","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":"Return to theater following gynecologic surgeries: An institutional audit and review of the literature.","authors":"Oluwaseun Sowemimo, Kofi Yamoah, Babawale Ojo","doi":"10.1002/ijgo.70097","DOIUrl":"https://doi.org/10.1002/ijgo.70097","url":null,"abstract":"<p><strong>Objective: </strong>Return to theater (RTT) for reoperation following a primary surgery has significant implications for patients and the healthcare system. RTT following gynecologic surgeries is a critical clinical incident trigger for reporting and investigation of root cause analyses. Many of the causes of unexpected return to theater after surgery are avoidable and therefore provide essential learning opportunities to prevent future recurrence and to improve patient experience especially in those at risk of specific complications.</p><p><strong>Methods: </strong>The present study was a mixed method retrospective review of all unexpected reoperations following gynecologic surgeries over a 7-year period at Mid Yorkshire Teaching Hospitals NHS Trust and a review of the literature.</p><p><strong>Results: </strong>There were 24 RTTs following gynecologic surgeries during the period. The overall RTT rate was three per 1000. Hysterectomies accounted for 14 (58.3%) of the reoperations. Similarly, 11 (45.8%) of the reoperations were as a result of hemorrhagic complications. Other themes identified include port site hernia in three patients (12.5%), ureteric injury in two patients (8.3%), while three patients (12.5%) had no abnormality detected at reoperation.</p><p><strong>Conclusion: </strong>Unexpected reoperation following gynecologic surgery is an uncommon complication at three per 1000 surgeries. Reactionary and secondary hemorrhages are the most common causes and hysterectomy irrespective of the approach remains the leading primary surgery. The causes are largely preventable.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742840","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":"Governance in obstetrics and gynecology associations in sub-Saharan Africa: Challenges and adaptive strategies for enhanced organizational effectiveness.","authors":"Hani W Fawzi","doi":"10.1002/ijgo.70051","DOIUrl":"https://doi.org/10.1002/ijgo.70051","url":null,"abstract":"<p><p>This review examines the governance structures of professional associations within the obstetrics and gynecology sector in Sub-Saharan Africa (SSA), emphasizing the need for adaptive and resilient governance models. Using a mixed-methods approach, this study integrates quantitative and qualitative data to assess the effects of governance on organizational effectiveness. The findings indicate that adaptive governance significantly enhances organizational resilience and performance. The review highlights specific governance challenges unique to the African context, such as resource limitations, cultural diversity, and regulatory variability. Recommendations are made for the implementation of flexible, context-aware governance frameworks that can improve health outcomes by enhancing the operational capacities of professional associations in SSA.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742835","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":"Virtual reality simulation training for childbirth: A cluster randomized crossover study.","authors":"Arundhati Gosavi, Abhiram Kanneganti, Eng Tat Khoo, Kuldip Singh, Liang Shen, Mary Rauff, Chang Liu, Mahesh Choolani","doi":"10.1002/ijgo.70053","DOIUrl":"https://doi.org/10.1002/ijgo.70053","url":null,"abstract":"<p><strong>Objective: </strong>To compare knowledge acquisition and domain-specific feedback between virtual reality (VR) and mannequin-based simulation for teaching medical students normal vaginal delivery (NVD).</p><p><strong>Methods: </strong>We conducted a cluster randomized crossover study comparing a novel in-house-developed NVD VR simulator utilizing an Oculus® Quest 2 HMD with the PROMPT Flex® mannequin. We randomly assigned medical student clinical groups to either VR or mannequin simulation. Participants took an 11-item knowledge quiz before and after their first simulation before crossing over to the alternate simulation. Participants took a six-domain, 14-item feedback questionnaire evaluating both simulations. The primary outcome was percentage improvement in knowledge scores, while the secondary outcome was adjusted mean difference in mean feedback scores between each simulation.</p><p><strong>Results: </strong>Twenty clinical groups comprising 111 medical students participated. There was no difference in either arm for baseline characteristics and pre-simulation knowledge scores. Medical students undergoing VR simulation had significantly higher overall post-simulation mean percentage correct scores (79.0% vs. 54.0%; P < 0.001). The mannequin simulator had significantly higher feedback scores (61.0 vs. 58.3; adjusted mean difference 2.45 [95% confidence interval 0.95-3.95]; P = 0.002) and in five of six domains. A total of 40.5% of respondents preferred the mannequin simulation, 4.5% preferred the VR simulation, and 42.5% preferred a mixture of the two.</p><p><strong>Conclusions: </strong>Our novel VR NVD simulator was superior to traditional mannequin simulation in content delivery. As more respondents preferred a mixed approach over any single method, VR simulation could complement legacy mannequin simulation methods by serving as a primer or a distance-learning tool and help increase skill birth attendant training.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742843","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}