International Journal of Gynecology & Obstetrics最新文献

{"title":"Response: MicroRNA-210 level as a biomarker for pre-eclampsia severity: A systematic review and meta-analysis.","authors":"Dávid Márai, Isabel Pinto Amorim das Virgens, Ádám Vincze, Mahmoud Obeidat, Péter Hegyi, Mikolt Bakony, Zsófia Réka Erdélyi, Zsolt Melczer, Sándor Valent","doi":"10.1002/ijgo.71352","DOIUrl":"10.1002/ijgo.71352","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"1069-1071"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968799","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":"Global and US standards for intrapartum surveillance of the pregnant and the fetal patient.","authors":"Amos Grünebaum, Joachim Dudenhausen, Frank A Chervenak","doi":"10.1002/ijgo.71084","DOIUrl":"10.1002/ijgo.71084","url":null,"abstract":"<p><strong>Objective: </strong>Cardiotocography is a dual-signal physiologic modality monitoring the pregnant and fetal patient. The objective of the present study was to compare global guidelines with the recently updated US Clinical Practice Guideline.</p><p><strong>Methods: </strong>A comparative analysis was conducted across global guidelines and the US guideline, evaluating three domains: uterine physiology, fetal heart rate interpretation, and management models. Definitions, interpretive structures, and triggers for intervention were compared without attempting to reconcile divergent frameworks.</p><p><strong>Results: </strong>Global guidelines (cardiotocography) define uterine activity across multiple physiologic parameters and integrate these with fetal heart rate to assess the maternal-fetal unit as a single physiologic system. In contrast, the US guideline (fetal monitoring) defines tachysystole but does not explicitly define additional uterine physiologic parameters, and intervention is recommended when tachysystole is associated with fetal heart rate abnormalities rather than as an independent physiologic trigger. Global frameworks interpret fetal heart rate patterns within uterine context, whereas the US guideline emphasizes pattern recognition with limited formal integration of uterine physiology. These differences result in a preventive model in global guidelines and a comparatively reactive model in the US guideline.</p><p><strong>Conclusion: </strong>Intrapartum surveillance functions most effectively when uterine activity and fetal heart rate are interpreted as components of a maternal-fetal physiologic system. The US guideline provides detailed fetal definitions but leaves most uterine physiologic elements unspecified. Reintegration of explicit uterine physiologic definitions may improve physiologic coherence and support earlier intervention.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"840-845"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030523","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":"Regulatory role of the soluble TLR4 form in HMGB1-driven inflammation in PCOS: Integration of biochemical and molecular docking evidence.","authors":"Ahmed Kareem Atheeb, Saba Zuhair Hussein","doi":"10.1002/ijgo.71121","DOIUrl":"10.1002/ijgo.71121","url":null,"abstract":"<p><strong>Objective: </strong>Given the recognized role of chronic low-grade inflammation in polycystic ovary syndrome (PCOS), the aim of the present study was to investigate the role of the serum high-mobility group box 1 (HMGB1)-Toll-like receptor 4 (TLR4)-interferon beta (IFN-β) signaling axis and its association with immune-metabolic dysfunctions in women with PCOS.</p><p><strong>Methods: </strong>This was a case-control study involving 90 Iraqi women aged 18-45 years, including 50 newly diagnosed PCOS patients and 40 healthy controls. Serum levels of HMGB1, soluble Toll-like receptor 4 (sTLR4), and INF-β were measured using enzyme-linked immunosorbent assay (ELISA). An automated analyzer was employed to assess the hormonal profile. Molecular docking simulations were performed using MOE software to evaluate the interaction of HMGB1 with both membrane-bond TLR4 and its soluble form.</p><p><strong>Results: </strong>The PCOS group exhibited significant alterations in hormonal profiles compared to healthy controls. Serum levels of HMGB1, sTLR4, and INF-β were significantly elevated, consistent with a state of low-grade inflammation. Molecular docking analysis demonstrated favorable binding of HMGB1 to both TLR4 and sTLR4, with a slightly stronger affinity for sTLR4 (-7.20 kcal/mol; RMSD 2.13 Å) than TLR4 (-6.23 kcal/mol; RMSD 1.73 Å).</p><p><strong>Conclusion: </strong>The HMGB1-TLR4-INF-β signaling axis appears to contribute to low-grade inflammation in PCOS. The soluble form of TLR4 may act as a regulatory modulator that attenuates inflammatory signaling. The integration of biochemical and computational data findings provides novel insights into immune-metabolic dysregulation in PCOS and highlights potential therapeutic targets for modulating inflammation.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"977-986"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217436","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":"Value of echocardiography in the integrated management of fetuses with critical pulmonary stenosis or pulmonary atresia with intact ventricular septum.","authors":"Yuanhong Fu, Chengcheng Pang, Junjun Shen, Liuqing Yang, Wei Pan","doi":"10.1002/ijgo.71105","DOIUrl":"10.1002/ijgo.71105","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to analyze the echocardiographic characteristics, intrauterine progression, postnatal outcomes, and follow-up results of fetuses diagnosed with critical pulmonary stenosis with an intact ventricular septum (CPS/IVS) and pulmonary atresia with an intact ventricular septum (PA/IVS) using echocardiography.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on fetuses with isolated PA/IVS and CPS/IVS, collecting both morphological and hemodynamic echocardiographic data and following them postoperatively.</p><p><strong>Results: </strong>A total of 48 cases were included in the study. On the initial ultrasound, eight cases were diagnosed with PA/IVS and 40 cases with CPS/IVS. The right ventricle/left ventricle long axis (RV/LV) ratio, right ventricle long axis (RV-L) z-score, and pulmonary artery/aorta (PA/AO) ratio for PA/IVS were significantly lower than those for CPS/IVS (RV/LV P < 0.001; RV-L P = 0.002; PA/AO P = 0.003). Severe tricuspid regurgitation (TR) was predominant in both PA/IVS and CPS/IVS, with six and 28 cases, respectively. A significant increase in RV-L, tricuspid valve (TV) annulus, and pulmonary valve (PV) was observed with gestational age and fetal growth. In an exploratory analysis, earlier gestational age at first ultrasound was associated with neonatal intervention (hypothesis-generating due to small sample size). Post-surgical follow-up showed improvements in RV/LV ratio, tricuspid valve/mitral valve (TV/MV) ratio, and PV z-score (P < 0.05), suggesting favorable short-term echocardiographic postoperative outcomes.</p><p><strong>Conclusion: </strong>In this cohort in which all infants achieved biventricular circulation, PA/IVS fetuses showed more compromised RV and PV annular development than CPS/IVS. Serial echocardiography demonstrated measurable growth of RV/TV/PV with gestation, while postnatal and post-intervention follow-up showed improved RV/LV ratio and PV z-scores. These findings support the descriptive value of echocardiography for longitudinal assessment and perioperative follow-up within an integrated management pathway.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"902-910"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149530","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":"Is digital documentation always best?","authors":"Tanvi Rai, Helen Millward, Kate Siddall, Nathan S Riddell, Amy Elsmore, Amrit Dhadda, Seren Willson, Rachel Collis, William Parry-Smith, Peter Collins, Lisa Hinton, Sarah Bell","doi":"10.1002/ijgo.71079","DOIUrl":"10.1002/ijgo.71079","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"1043-1044"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959888","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":"Forensic photography in a sexual assault treatment unit: Insights from an Irish pilot evaluation.","authors":"Catherine Marsh, Christine Pucillo, Deirdra Richardson, Dan Kane, Nicola Maher, Maeve Eogan","doi":"10.1002/ijgo.71075","DOIUrl":"10.1002/ijgo.71075","url":null,"abstract":"<p><strong>Objective: </strong>Accurate and timely injury documentation is essential to post-sexual assault care. Irish Sexual Assault Treatment Units (SATUs) have generally relied on police photographers to photo-document these injuries, leading to potential delays and additional patient distress. International models show that on-site forensic photography by trained forensic examiners improves efficiency and evidentiary quality. The aim of the present study was to evaluate the feasibility, acceptability and service impact of introducing forensic photography by forensic examiners within an Irish SATU.</p><p><strong>Methods: </strong>An 11-month quality improvement pilot was undertaken at the Dublin SATU. A human-centered design approach incorporated staff surveys, forensic examiner reflections, observations and consultation with collaborating agencies. Eligible cases included patient's ≥14 years with visible (non-genital) injuries, examined by SATU forensic examiners who had completed additional training in forensic photography as part of the pilot and who provided informed consent for inclusion in research.</p><p><strong>Results: </strong>Of 370 attending patients, 258 (69.7%) underwent a forensic examination. Among these, 69 (26.7%) were examined by pilot-trained staff and 23 (33.3%) consented to photography, representing 8.9% of the total cohort. Photography added a mean of 9 min to examination time. Examiner confidence improved substantially over the period of the pilot, and a secure chain-of-custody was established. Patient feedback indicated reduced anxiety when photography occurred within the SATU setting. A total of 103 patients with injuries in the non-pilot group received no photo-documentation due to unavailability of trained staff at the time of examination.</p><p><strong>Conclusion: </strong>The introduction of forensic photography within the Dublin SATU proved feasible, acceptable and legally robust. This pilot supports the integration of forensic photography as a trauma-informed component of sexual assault care and provides a foundation for national and international service development.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"789-794"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981778","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":"Understanding barriers to cervical cancer screening in Botswana: Insights from a cross-sectional study.","authors":"Jodie C Russell, Salma Amin, Racquel E Kohler, Helen Kelly, Chelsea Morroni, Mosepele Mosepele, Elysia Larson, Lorato Mochoba, Maduke Kula, Joseph Makhema, Matthys H Botha, Roger Shapiro, Doreen Ramogola-Masire, Rebecca Luckett","doi":"10.1002/ijgo.71089","DOIUrl":"10.1002/ijgo.71089","url":null,"abstract":"<p><strong>Objective: </strong>Cervical cancer is the leading cause of cancer deaths among women in Botswana, yet uptake of cervical screening remains suboptimal. Understanding knowledge and barriers to screening is essential to inform strategies to achieve cervical cancer elimination.</p><p><strong>Methods: </strong>We conducted high-risk human papillomavirus (hrHPV) testing and an accompanying cross-sectional survey at health clinics and in the community in South East District, Botswana (February 2022-July 2023). Eligible participants were women aged ≥25 years with an intact cervix and no prior diagnosis of cervical cancer. Interviewer-administered structured questionnaires assessed demographics, prior screening attendance, knowledge of cervical cancer, and perceived barriers to screening. Open-ended responses were thematically categorized. Logistic regression was used to examine factors associated with knowledge and screening barriers.</p><p><strong>Results: </strong>Of 3000 women screened, 2994 (99.8%) had known HIV status and were included. Median age was 43 years (interquartile range [IQR] 36-51), and 1500 (50.1%) were women with HIV (WWH). Overall, 67.2% (2005/2994) reported prior cervical cancer screening, with substantially higher uptake among WWH than women without HIV (80.0% vs 54.5%, P < 0.001). Knowledge of cervical cancer etiology was limited, with only 27.1% (788/2905) correctly identifying hrHPV as the cause. Younger age, HIV-positive status, higher education, formal employment, and prior screening attendance were independently associated with better knowledge. Among women who had never been screened, the most commonly reported barriers were lack of prioritization (38.3%; 376/981), fear (17.0%; 167/981), lack of awareness (17.0%; 167/981) and service provision issues (12.0%).</p><p><strong>Conclusion: </strong>Despite relatively high screening uptake, important gaps in knowledge and persistent individual- and system-level barriers remain. Strengthening cervical screening delivery through HPV self-collection alongside targeted education, would address current barriers to cervical screening in Botswana.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"817-826"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148030540","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":"Response: The role of the angle of progression in predicting spontaneous vaginal delivery in women with singleton pregnancies.","authors":"Jule Eriç Horasanlı, N Demirbaş, Ü S Mıngır, B Güzelkara Ergene, N Akkaş","doi":"10.1002/ijgo.71355","DOIUrl":"10.1002/ijgo.71355","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"1065-1066"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955815","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":"Fetal autonomic responses inferred from heart rate variability during recurrent decelerations without acidosis-An observational study.","authors":"Shoichi Magawa, Masafumi Nii, Yuya Tamaishi, Asumi Okumura, Sho Takakura, Shintaro Maki, Kuniaki Toriyabe, Erina Takayama, Eiji Kondo, Tomoaki Ikeda","doi":"10.1002/ijgo.71066","DOIUrl":"10.1002/ijgo.71066","url":null,"abstract":"<p><strong>Objective: </strong>Recurrent fetal heart rate (FHR) decelerations without acidosis are frequently observed during labor; however, the underlying autonomic mechanisms remain incompletely understood. This study explored fetal autonomic responses to recurrent decelerations using FHR and FHR variability (FHRV) parameters.</p><p><strong>Methods: </strong>This retrospective observational study included healthy women with singleton pregnancies, no pregnancy complications requiring treatment, and an umbilical artery pH >7.2 at delivery. Continuous FHR monitoring using fetal head electrodes was performed for ≥2 h before delivery (June-December 2021). FHRV was assessed using time-domain, frequency-domain, and nonlinear indices.</p><p><strong>Results: </strong>Twenty-four patients were included. Baseline FHR did not differ between groups. In the recurrent deceleration group, root mean square of successive differences and high-frequency power were higher during the final 60 min before delivery. No differences were observed in standard deviation of normal-to-normal intervals or very-low-frequency power. Sample entropy was also higher, suggesting increased complexity of autonomic regulation.</p><p><strong>Conclusion: </strong>Fetuses with recurrent decelerations without acidosis demonstrated patterns consistent with increased vagal modulation, as inferred from FHRV indices. These findings may reflect an adaptive autonomic response; however, given the exploratory nature and small sample size, further studies are warranted.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"749-755"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868263","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":"The value of hysteroscopic microvascular and morphological subclassification in diagnosing endometrial malignant lesions: A single-center retrospective study.","authors":"Xinyu Liao, Yu Liu, Yizhen Cui, Yan Lei","doi":"10.1002/ijgo.71118","DOIUrl":"10.1002/ijgo.71118","url":null,"abstract":"<p><strong>Objective: </strong>This study develops and validates an integrated assessment system based on hysteroscopic features of microvascular morphology, lesion appearance, and extent, aiming to standardize the observational protocol and provide auxiliary judgment for diagnosing endometrial malignant lesions, especially for less experienced practitioners.</p><p><strong>Methods: </strong>Data from 168 patients who underwent hysteroscopy with initial suspicion of endometrial malignant lesions at Hubei Maternal and Child Health Hospital from March 2020 to June 2021 were retrospectively analyzed. Hysteroscopic findings were systematically recorded according to lesion extent (localized/diffuse), microvascular classification (Type I-IV), morphological type (polypoid, nodular, papillary, ulcerative, hyperplastic), and the presence of necrosis or calcification. Biopsies were taken from suspicious areas for pathological examination. Using histopathology as the gold standard, the diagnostic performance of each indicator was evaluated.</p><p><strong>Results: </strong>First, microvascular classification showed a significant correlation with lesion malignancy: Types I-II were most frequent in the hyperplasia without atypia group (68.6%), Type III was most frequent in the atypical hyperplasia group (54.9%), and Type IV was most frequent in the endometrial cancer group (48.4%). Second, among morphological types, the papillary pattern had the highest occurrence in the endometrial cancer group (58.1%) and, together with Type IV vessels, was significantly associated with malignant lesions (P < 0.001). Third, the proportion of postmenopausal patients in the endometrial cancer group was 64.5%, significantly higher than that in the benign group (P < 0.01). Fourth, a diagnostic model combining microvascular classification, lesion extent, and morphological type demonstrated excellent predictive value, with an AUC of 0.950 (95% CI: 0.912-0.989), a sensitivity of 87.1%, and a specificity of 84.7%. Finally, in this study, the under-diagnosis rate was 3.6%, and the over-diagnosis rate was 8.9%.</p><p><strong>Conclusion: </strong>The hysteroscopic microvascular and morphological classification system aids in distinguishing between benign and malignant endometrial lesions. Specifically, a papillary appearance and Type IV vessels are important indicators suggestive of malignancy. Combining multiple indicators improves diagnostic accuracy and can serve as an auxiliary tool for hysteroscopists, particularly for beginners.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"987-996"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217478","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}