International Journal of Gynecology & Obstetrics最新文献

{"title":"Peritraumatic dissociation during childbirth in Nigeria: A preliminary study.","authors":"Babatunde Akinwunmi, Ayodeji S Adeyanju, Isha H Arora, Beatrice Quagliarini, Onyekachi Agwu, Adesina Oladokun, Sharon Dekel","doi":"10.1002/ijgo.70214","DOIUrl":"https://doi.org/10.1002/ijgo.70214","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101888","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 impact of the fetal exposome as a predictor of cancer risk in childhood and adulthood. Aberrant epigenetic events occurring during gestation: May they trigger fetal programming of cancer risk later in life?","authors":"Gavino Faa, Pina Ziranu, Andrea Pretta, Riccardo Cau, Ferdinando Coghe, Flaviana Cau, Matteo Fraschini, Massimo Castagnola, Luca Saba, Mario Scartozzi","doi":"10.1002/ijgo.70224","DOIUrl":"https://doi.org/10.1002/ijgo.70224","url":null,"abstract":"<p><p>The rising incidence of cancer, particularly among children and young adults, has led to renewed interest in the early-life origins of the disease. The fetal programming hypothesis, originally proposed by Barker, posits that environmental disruptions during intrauterine development can induce long-lasting molecular and structural changes that increase susceptibility to diseases, including cancer, later in life. This narrative review examines how prenatal exposures, such as maternal malnutrition, alcohol use, exposure to toxins, obesity, and hormonal imbalances, may epigenetically reprogram the developing fetus, influencing cancer risk throughout the lifespan. We summarize mechanistic evidence from both epidemiologic studies and preclinical models, highlighting the roles of altered DNA methylation, growth factor signaling, and inflammation. While we emphasize fetal life as a critical window for cancer prevention, we also acknowledge alternative explanations for the rising cancer rates among younger populations, including improved diagnostics and lifestyle factors. Gaining an understanding of these early-life determinants of cancer may lead to new opportunities for targeted prevention strategies that begin before birth.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101889","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":"Challenges and management debates of uterocutanous fistula.","authors":"Amany A Makroum, Mohamed E Taman","doi":"10.1002/ijgo.70227","DOIUrl":"https://doi.org/10.1002/ijgo.70227","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093584","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 cerebral blood flow patterns assessed by transcranial doppler in patients with severe pre-eclampsia and eclampsia.","authors":"Roberto Giannoni, Ezequiel Martinez, Ivana S Gonzalez, Carlos R Garnica, Franco F Giannoni, Maria Peral de Bruno, Fabio D Masevicius","doi":"10.1002/ijgo.70210","DOIUrl":"https://doi.org/10.1002/ijgo.70210","url":null,"abstract":"<p><strong>Objective: </strong>To investigate cerebral perfusion variables derived from transcranial Doppler (TCD) in patients with severe hypertensive disorders of pregnancy and determine their association with the development of eclampsia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in an intensive care unit in Argentina. The study included 31 patients with severe pre-eclampsia (sPE), 35 with eclampsia (E), and 20 healthy pregnancies (HP). Doppler indices from the middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), and basilar artery (BA) were compared among the groups.</p><p><strong>Results: </strong>Compared to HP, patients with sPE and E exhibited higher values of cerebral flow index (CFI) (48 [42-57] and 51 [41-68] vs 34 [28-44], P = 0.001), higher cerebral perfusion pressure (CPP) (69 mmHg [56-77] and 68 mmHg [54-92] vs 49 mmHg [42-73], P = 0.044), and increased cerebral blood flow velocities (CBFV) with lower resistance in most examined territories. Patients with E demonstrated significantly higher CBFV values in MCA, PCA, and BA compared to those with sPE, along with a significant decrease in resistance index (RI) of the BA (P < 0.05). In multivariate analysis, the RI of the BA was the only Doppler variable independently associated with E.</p><p><strong>Conclusion: </strong>Increased cerebral flow velocities and lower resistance are characteristic findings in patients with sPE and E. While these changes are evident across all cerebral vascular territories, significant alterations in the Doppler indices of the basilar artery may provide insights into the mechanisms underlying the development of eclampsia.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093590","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":"Use of the Abbott i-STAT®1 point of care device for hCG quantification in early pregnancy.","authors":"Caroline Joyce, Paula M O'Shea, Rebecca Lynch, Seán J Costelloe, Tommie V McCarthy, John Coulter, Deirdre Hayes-Ryan, Keelin O'Donoghue","doi":"10.1002/ijgo.70217","DOIUrl":"https://doi.org/10.1002/ijgo.70217","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the use of the Abbott i-STAT®1 point-of-care-test (POCT) device for measurement of human chorionic gonadotropin (hCG) to support the management of early pregnancy complications in a remote early pregnancy unit (EPU).</p><p><strong>Methods: </strong>Women attending the EPU who required an hCG blood test were invited to take part in the study. Participants provided an additional blood sample for whole blood hCG measurement using the Abbott i-STAT®1 analyzer. The remaining sample was sent to the hospital laboratory for hCG analysis using the Abbott Architect, the designated comparator method. Statistical analysis was performed using Analyze-IT software.</p><p><strong>Results: </strong>A total of 61 women were recruited, including cases of pregnancy of unknown location, ectopic pregnancy, and molar pregnancy. Fourteen hCG results that were outside the i-STAT®1 assay's quantitative range, although still broadly concordant with laboratory hCG results, were excluded from statistical analysis. Analysis of the remaining 47 paired hCG results demonstrated strong agreement across the concentration range (4-2072 IU/L), with excellent Spearman correlation (r = 0.99, P < 0.001). Passing-Bablok linear regression indicated good agreement (y = 1.18 + 0.96x) and Bland-Altman analysis showed a mean difference of -23.7 IU/L (-3.5%).</p><p><strong>Conclusions: </strong>All hCG results from the i-STAT®1 analyzer were clinically concordant with the central laboratory method, supporting its application in an EPU setting using established clinical decision thresholds. However, further verification through larger-scale studies is necessary before the i-STAT®1 analyzer can be integrated into clinical practice.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093593","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":"Development of evaluation grids for obstetrical techniques in simulation training using the Delphi method.","authors":"Théo Jouen, Pauline Jeanneteau, Véronique Beaudoux, Florence Biquard, Léa Delbos, Philippe Gillard, Sébastien Madzou, Andrew Spiers, Philippe Descamps, Pierre-Emmanuel Bouet, Guillaume Legendre","doi":"10.1002/ijgo.70176","DOIUrl":"https://doi.org/10.1002/ijgo.70176","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Simulation-based training has become a cornerstone in obstetrics education, offering valuable opportunities to practice rare and complex procedures in a controlled environment. The importance of simulation in obstetrics and gynecology is well documented internationally, particularly in improving clinical skills and patient safety.In some countries, certain obstetric procedures, such as vaginal breech delivery or shoulder dystocia management, are infrequently performed, which highlights the challenge of ensuring that practitioners are adequately prepared for these rare events. Research has shown that simulation can bridge this gap by providing a means to gain familiarity with procedures that may not be regularly encountered.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To develop and validate evaluation grids for these key obstetric maneuvers through the Delphi method to ensure a reproducible and reliable assessment tool for use in simulation-based education.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We employed the Delphi method to achieve consensus among a panel of 14 obstetric experts with extensive experience in simulation training. Three successive rounds of evaluation were conducted to assess the relevance of various criteria for the maneuvers in question: breech maneuvers, version and breech extraction, and shoulder dystocia maneuvers. Nine experts responded to the three rounds. A criterion was included in the final gird if it obtained a median score between 7 and 9 with 80% of the responses within this interval. A criterion was excluded if it obtained a median score between 1 and 3 with 80% of the responses in this interval. Criterion that were neither included nor excluded were submitted to the next round. At the end of the third round, the criterion was included if the median was between 7 and 9 over the three successive rounds, even if less than 80% of the responses were in this interval. In all other cases, the criterion was excluded at the end of the third round.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, for breech maneuvers, five criteria for the preparatory maneuver, 11 criteria for the Lovset maneuver, five criteria for the Bracht maneuver, and eight criteria for the Mauriceau maneuver were included in our evaluation tool. For the version and breech extraction maneuver, four criteria concerning preparation and 13 criteria relative to the stages of the maneuver were included in our evaluation grid. Finally, for the shoulder dystocia maneuvers, five preparatory criteria, four criteria for the McRoberts maneuver, six criteria for the reverse Woods maneuver and nine criteria for the Jacquemier maneuver were included in the evaluation grid.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;We successfully developed a set of evaluation grids for three critical obstetric maneuvers using the Delphi method, with input from experts. In future, these grids can be used to certify obstetrics residents during their curriculum, after being validated ","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093587","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":"Plexiform neurofibroma infiltrating uterine cervix and parametrium, causing hydronephrosis: A case report and review of the literature.","authors":"Yasin Durmuş, Mustafa Koray Kırdağ, Kıvanç Yılmaz, Emre Aydın, Mesut Ozturk, Özlem Sezer","doi":"10.1002/ijgo.70212","DOIUrl":"https://doi.org/10.1002/ijgo.70212","url":null,"abstract":"<p><p>Neurofibromatosis Type 1 is a genetic disorder resulting in RAS pathway activation. As a result, risk of developing both benign and malignant neoplasms is higher, compared with the general population. Plexiform neurofibromas are benign tumors of the peripheral nerve sheath affecting 40%-50% of patients with neurofibromatosis Type 1. Cervical-parametrial plexiform neurofibroma is a very rare neoplasm. Here we present the ninth case in the literature. A 37-year-old woman presented with chronic pelvic pain and a pelvic mass that was 73 × 33 mm in size. Most of the mass was located between the proximal vagina-cervix and the bladder. It was infiltrating the bilateral parametrium and the pararectal tissues. There was hydronephrosis on the right side and her right kidney was atrophic. The tumor would likely also cause obstruction on the left side. We performed a type B radical hysterectomy, right salpingo-oophorectomy, left salpingectomy, cystoscopy, left ureterorenoscopy, and left ureteral double-j catheterization, in addition to resection of the tumor, which was located between the cervix and bladder. She was followed for 11 months without any tumor relapse. The left kidney remained normal in the follow-up period. To our knowledge, this is the first publication reporting the neurofibromatosis Type1 mutation c.7615 + 6 T>C as a pathogenic variant. In this case, we showed that plexiform neurofibromas and neurofibromatosis should be taken into account, when a pelvic mass adjacent to the uterine cervix is diagnosed, particularly if the tumor tends to accompany the peripheral nerve tracts. Surgical treatment of cervical-parametrial plexiform neurofibromas is recommended in certain circumstances and a multidisciplinary approach may help to determine the optimal management.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077929","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":"Contraceptive use and associated factors among female university students in Rwanda: A cross-sectional study.","authors":"Sanstrace Mugabe, Diomede Ntasumbumuyange, Patrick Gatsinzi Bagambe, Urania Magriples, Vidler Marianne, Abraham Fessehaye Sium","doi":"10.1002/ijgo.70220","DOIUrl":"https://doi.org/10.1002/ijgo.70220","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of modern contraceptive use and associated factors among female university students at university of Rwanda.</p><p><strong>Methods: </strong>We conducted a cross-sectional study on the prevalence of modern contraception utilization and associated factors among female university students at the University of Rwanda. Data were collected prospectively using a structured questionnaire. We used STATA version 13 to analyze the data. Chi-squared test, Fisher exact test, and multivariate regression analysis were performed as appropriate. A P value less than 0.05 and odds ratio with 95% confidence interval (CI) were used to present the results significance.</p><p><strong>Results: </strong>Among 385 female students included in the study, 34% (131/385) were using modern contraceptive methods. Being married (AOR 2.6, 95% CI: 1.05-7.10) and having a history of pregnancy (AOR 3.6, 95% CI: 1.53-8.45) were associated with modern contraceptive use. Address, educational level, and age were not associated with contraceptive use.</p><p><strong>Conclusion: </strong>In this study, only one in three female university students were using modern contraception, which is lower than reports from other African countries. This implies there is a high need for advocacy on contraception use among university students in Rwanda.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077883","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":"\"First do no harm\": Fundal pressure during labor-How safe is it?","authors":"O Eliner, M Kovo, M Semo, D Yacobi, S Brodsky, T Biron, G Shechter Maor","doi":"10.1002/ijgo.70218","DOIUrl":"https://doi.org/10.1002/ijgo.70218","url":null,"abstract":"<p><strong>Objective: </strong>Fundal pressure (FP), a controversial obstetric maneuver due to its potential benefits and risks, lacks robust evidence concerning its effects. This study aimed to evaluate the maternal and neonatal outcomes associated with the application of FP during the second stage of labor.</p><p><strong>Methods: </strong>Following our departmental protocol, FP is applied by obstetricians trained under the supervision of the head of the labor ward. Its implementation requires patient consent and documentation. This case-control study encompassed vaginal deliveries (VDs) involving FP (FP group) during the second stage of labor. The control group included subsequent deliveries matched 1:1 for gestational age, parity, and mode of delivery (vacuum extraction [VE] or VD). Maternal and neonatal outcomes were compared between the groups. Composite adverse outcomes included the presence of at least one of the following: grade 3-4 perineal tear, shoulder dystocia, postpartum hemorrhage, postpartum hospitalization exceeding 4 days, or postpartum use of analgesics exceeding five doses.</p><p><strong>Results: </strong>Among 12 048 deliveries during the 3-year study period, 325 (2.7%) involved FP. There were no significant differences in maternal age, body mass index, or gestational age between the FP (n = 325) and control groups (n = 325). However, the FP group exhibited higher rates of labor induction (41.5% vs. 19.3%, P < 0.0001), oxytocin augmentation (52% vs. 23.6%, P < 0.0001), and prolonged duration of the second stage of labor (1.88 ± 1.2 vs. 1.57 ± 1.3 h, P = 0.003). There were no significant differences in the rate of postpartum hemorrhage, composite adverse maternal outcomes, or early neonatal outcomes between the groups.</p><p><strong>Conclusion: </strong>Fundal pressure, when administered by trained obstetricians, was not associated with adverse obstetric, maternal, or neonatal outcomes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077839","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":"Trial of labor following cesarean among patients with oligohydramnios at term: A multicenter retrospective study.","authors":"Ari Weiss, Tzuria Peled, Reut Rotem, Hen Y Sela, Sorina Grisaru-Granovsky, Misgav Rottenstreich","doi":"10.1002/ijgo.70202","DOIUrl":"https://doi.org/10.1002/ijgo.70202","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the maternal and neonatal outcomes of patients with oligohydramnios attempting a trial of labor after cesarean (TOLAC) versus those who underwent planned repeat cesarean delivery (PRCD).</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study of patients with a term singleton pregnancy following a single low-segment transverse cesarean delivery (CD) and a recent diagnosis of oligohydramnios (maximal vertical pocket <2 cm) between 2017 and 2021. Maternal and neonatal outcomes were compared between patients attempting TOLAC and those opting for PRCD. Univariate analysis was conducted, followed by a multivariate analysis.</p><p><strong>Results: </strong>A total of 352 deliveries were included, of which 278 (79%) attempted TOLAC and 74 (21%) attempted PRCD. The successful vaginal delivery rate for patients who attempted TOLAC was 84.5%. The uterine rupture rate was not significantly different between those attempted TOLAC versus PRCD (1.1% vs. 0%, P = 0.371). However, the rate of hypoglycemia (2.2% vs. 8.1%, P = 0.012) and the composite adverse neonatal outcome was higher among patients with PRCD (11.5% vs. 24.3%, P = 0.005). After controlling for potential confounders, we still demonstrated an independent association between reduced rates of composite adverse neonatal outcome and TOLAC (adjusted odds ratio 0.46, 95% CI: 0.23-0.92, P = 0.028).</p><p><strong>Conclusion: </strong>TOLAC for patients with oligohydramnios appears to be a reasonable alternative and is associated with favorable outcomes. Further large and prospective research on this subject may lead to improved management strategies and better maternal and neonatal outcomes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077895","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}