International Journal of Gynecology & Obstetrics最新文献

{"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}

{"title":"Evaluation Of Maternal And Fetal Findings In Patients With Pemphigoid Gestationis.","authors":"Nihan Erdoğan Atalay, Funda Dağıstanlı, Hayal Uzelli Şimşek, Eray Caliskan","doi":"10.1002/ijgo.16086","DOIUrl":"https://doi.org/10.1002/ijgo.16086","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the maternal and fetal outcomes of 12 pregnant women diagnosed with pemphigoid gestationis, in conjunction with a review of the literature.</p><p><strong>Methods: </strong>A retrospective review was conducted on the medical records of 12 patients diagnosed with pemphigoid gestationis who presented  between January 2014 and January 2024.</p><p><strong>Results: </strong>Twelve pregnant patients with pemphigoid gestationis were included in the study. The disease manifested during the first pregnancy in six patients. Mean maternal age was 30 years, mean gestational age at delivery was 33 weeks, and mean birth weight was 2146 g. Neonatal lesions were identified in two neonates. Intrauterine growth restriction, starting at an average of 33 weeks of gestation, was observed in four patients. Oligohydramnios was noted in two patients, hypertension in one patient, placental abruption in one patient, and gestational diabetes mellitus in one patient. During pregnancy, five patients were treated with oral steroids, six patients with intravenous steroids, and nine patients with topical steroids. Neonatal intensive care unit admission occurred in six neonates, and maternal intensive care unit admission was required for one patient.</p><p><strong>Conclusion: </strong>Patients with pemphigoid gestationis are at significant risk for severe maternal morbidity and adverse fetal outcomes in both the antepartum and postpartum periods. Early diagnosis of vesiculobullous lesions and close monitoring as high-risk pregnancies through a multidisciplinary approach are recommended.</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":"142854009","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":"Differences in physiological indicators between twin and singleton pregnancy.","authors":"Siyu Liu, Huifeng Shi, Shiyu He, Lanxin Hu, Yangyu Zhao","doi":"10.1002/ijgo.16097","DOIUrl":"https://doi.org/10.1002/ijgo.16097","url":null,"abstract":"<p><strong>Objective: </strong>It has been widely reported that there are physiological differences between twin and singleton pregnancies, as evidenced by physiological indicators examined during prenatal period. However, not all physiological indicators have been evaluated. Physiological indicators of twin pregnancies still refer to the standards of single pregnancies and lack precise variation intervals. Therefore, our study compared and analyzed the differences in physiological indicators between twin and singleton pregnancies.</p><p><strong>Methods: </strong>Retrospective cohort data of deliveries at Peking University Third Hospital from January 1, 2012, to February 8, 2021, were utilized. Information of pregnant women, including maternal characteristics, 49 physiological indicators examined during four periods (postpartum, first, second, and third trimester), and pregnancy complications, was extracted from medical records. Mann-Whitney test and multiple linear regressions were conducted to evaluate the differences in physiological indicators between twin and singleton pregnancies and to demonstrate their variation trend throughout gestation.</p><p><strong>Results: </strong>A total of 40 746 cases were included (38 320 singleton pregnancy cases and 2426 twin pregnancy cases). In twin pregnancies, 16 indicators related to red blood cells, platelets, coagulation function, protein, creatinine, and blood lipids exhibited distinctions compared to singleton pregnancies throughout gestation. The results remained stable regardless of maternal complications.</p><p><strong>Conclusion: </strong>Twin and singleton pregnancies are in distinct physiological conditions. It is of great necessity to establish specific reference intervals for twin pregnancies. Further study is needed to investigate the impact of physiological indicators on predicting adverse outcomes in twin pregnancies.</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":"142853983","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":"Letter to the Editor: Mifepristone and misoprostol versus misoprostol alone for induction of labor in women with intrauterine fetal death: A meta-analysis and systematic review.","authors":"Shanzay Akhtar, Hammad Amjad, Mobeen Abid, Muhammad Farhan","doi":"10.1002/ijgo.16105","DOIUrl":"https://doi.org/10.1002/ijgo.16105","url":null,"abstract":"","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":"142854012","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}