International Journal of Gynecology & Obstetrics最新文献

{"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}

{"title":"Letter to the editor: MicroRNA-210 level as a biomarker for pre-eclampsia severity: A systematic review and meta-analysis.","authors":"Siyuan Zhu","doi":"10.1002/ijgo.71351","DOIUrl":"10.1002/ijgo.71351","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"1067-1068"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968746","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":"Minimally invasive surgical approach to OHVIRA syndrome with vaginal fistula and pyocolpos: A fertility-preserving case report.","authors":"José Manuel Zamarripa Leyva, Silvia Andrea Alvarado Jalomo, Natalia Hermosillo Arredondo, Venance Basil Kway","doi":"10.1002/ijgo.71080","DOIUrl":"10.1002/ijgo.71080","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"1048-1049"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004910","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":"Impact of anti-Müllerian hormone and antral follicle count discordance on elective fertility preservation outcomes.","authors":"Hodaya Salhoov, Maayan Yogev, Roni Azulay, Eitan Shinan, Yaakov Bentov, Miri Godin, Efrat Esh-Broder, Ranit Hizkiyahu, Chana Adler Lazarovits, Anat Hershko Klement","doi":"10.1002/ijgo.71115","DOIUrl":"10.1002/ijgo.71115","url":null,"abstract":"<p><strong>Objective: </strong>Anti-Müllerian hormone (AMH) and antral follicle count (AFC) are usually correlated, yet discordance might complicate counseling in elective fertility preservation (EFP). This study evaluated whether discordant ovarian reserve markers affect oocyte yield in healthy women undergoing EFP.</p><p><strong>Methods: </strong>This retrospective cohort study included 230 healthy women aged 30-41 years undergoing their first EFP cycle at a university-affiliated tertiary fertility unit. Participants were categorized based on AMH (<1.1 or ≥1.1 ng/mL) and AFC (<7 or ≥7) thresholds. Analyses focused on concordant versus discordant AMH-AFC groups. The primary outcomes were the number of oocytes retrieved and vitrified. Multivariable linear regression assessed independent predictors of oocyte yield.</p><p><strong>Results: </strong>The overall discordance rate was 30.43%. Women in Group 1 - Normal AFC (≥7) with low AMH (<1.1 ng/mL) (n = 67) had significantly fewer retrieved (mean 6.7 ± 4.5) and vitrified oocytes (mean 4.9 ± 3.4) than those in Group 4 - Normal AFC (≥7) with normal AMH (≥1.1 ng/mL) (n = 149; 14.6 ± 8.1 and 10.6 ± 6.8, respectively; P < 0.001), which represented the two largest study groups. AMH was the strongest independent predictor of oocyte yield. Discordance independently contributed additional explanatory value for the number of retrieved oocytes, with discordant patients predicted to achieve fewer oocytes than concordant-normal counterparts. The concordance status did not significantly affect the number of vitrified oocytes.</p><p><strong>Conclusion: </strong>AMH-AFC discordance (specifically low AMH in the presence of normal AFC) is an independent predictor of reduced oocyte yield in EFP but not of the number of vitrified oocytes. Joint interpretation of both markers might facilitate more accurate patient counseling and expectation management.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"1004-1011"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148225318","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":"Carbon footprint of single-use surgical drapes in an Irish gynecology service.","authors":"Isabel Waters, Ola Løkken Nordrum, Cathy Burke","doi":"10.1002/ijgo.71114","DOIUrl":"10.1002/ijgo.71114","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"1053-1054"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198847","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":"Association between the duration of the third stage of labor and postpartum hemorrhage.","authors":"Kittipat Tuitemwong, Saipin Pongsatha, Threebhorn Kamlungkuea, Natnipa Parapob, Theera Tongsong","doi":"10.1002/ijgo.71120","DOIUrl":"10.1002/ijgo.71120","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association between the duration of the third stage of labor and postpartum hemorrhage (PPH), and to identify an appropriate time threshold for performing manual removal of the placenta (MROP).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted in women who underwent vaginal delivery with an uncomplicated third stage of labor. Data were retrieved from a digital obstetric database, including consecutive records of singleton pregnancies delivered vaginally at ≥24 weeks of gestation. Cases with excessive bleeding or emergency placental removal before completion of the third stage were excluded.</p><p><strong>Results: </strong>During a 13-year study period, 13 653 cases were eligible for analysis, comprising 13 509 cases managed expectantly and 54 undergoing MROP. The median duration of the third stage was 5 min, and <1% of cases exceeded 40 min. The duration of the third stage was an independent risk factor for increased blood loss (523 ± 376 vs. 239 ± 161 mL after and before 30 min, respectively; P < 0.001), higher PPH rates, and greater need for blood transfusion. When the third stage exceeded 30 min, MROP resulted in significantly greater median blood loss compared with expectant management (500 vs. 400 mL, P = 0.018) and a higher rate of PPH (62.96% vs. 38.58%, P < 0.001), whereas the duration of the third stage was significantly shortened (38 vs. 50 min, P < 0.001).</p><p><strong>Conclusion: </strong>Blood loss increased with prolonged third-stage duration, with a markedly higher risk of PPH after 30 min. In cases with an uncomplicated third stage, expectant management is preferable within the first 30 min. Beyond this point, either expectant management or MROP may be considered on an individualized basis, with appropriate preparedness for PPH.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"921-929"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156439","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":"A twisted tale of torsion of the uterus in a post-menopausal woman: Computed tomography findings of a rare entity.","authors":"Shruti Chandak, Astha Lalwani, Ashutosh Kumar","doi":"10.1002/ijgo.71106","DOIUrl":"10.1002/ijgo.71106","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"1050-1052"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054345","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":"Maternal and clinical predictors of congenital toxoplasmosis: A prospective cohort study in Brazil.","authors":"Donata D'Ambros, Luiz Henrique Silva Santos, Lara Sales Dos Santos, Manuela Ferreira, Cecília Andrade, Patrícia Guttmann, Ana Cristina Frota, Thalita Abreu, Elizabeth Machado, Cristina B Hofer","doi":"10.1002/ijgo.71131","DOIUrl":"10.1002/ijgo.71131","url":null,"abstract":"<p><strong>Objective: </strong>Congenital toxoplasmosis (CT) remains a major global health concern, with particularly high incidence in Latin America. Despite its relevance, prospective data from Brazilian cohorts are scarce.</p><p><strong>Methods: </strong>We conducted a prospective cohort study at the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG/UFRJ), Rio de Janeiro, including 55 pregnant women with confirmed Toxoplasma gondii infection and their infants (January 2022-April 2025). Maternal sociodemographic, obstetric, behavioral, and clinical data were collected prospectively. Infants were classified as infected or exposed based on serological, molecular, radiologic, and clinical criteria. Regression analysis was used to compare the groups.</p><p><strong>Results: </strong>Among 55 mother-infant pairs followed, 11 (20%) infants were diagnosed with CT. No significant associations were observed with maternal sociodemographic or environmental factors. However, mothers of infected infants had diagnosis later during gestation (24.3 vs. 16.4 weeks; P = 0.02), cohort entry later during gestation (31.2 vs. 24.3 weeks; P = 0.02), and more prenatal visits (7.7 vs. 4.9; P = 0.04 visits) (more prenatal visits likely reflecting increased monitoring after diagnosis). Adenomegaly (P = 0.04) and other systemic symptoms (P = 0.05) were more frequent among mothers of infected infants. Neonatal parameters did not differ significantly, but five infected infants presented neuroimaging abnormalities, five had ophthalmologic lesions, and six tested positive for IgM and/or PCR.</p><p><strong>Conclusion: </strong>Toxoplasmosis diagnosis later during gestation and symptomatic maternal infection were associated with CT. These findings highlight the need for systematic maternal screening, considering maternal clinical manifestations, timely referral, and close clinical monitoring to prevent vertical transmission and adverse neonatal outcomes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"997-1003"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148225305","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":"Determinants of obstructed labor among pregnant women in Mogadishu, Somalia: A case-control study.","authors":"Abdirizak Ali Abdi, Yahye Sheikh Abdulle Hassan, Julius Kwabena Karikari, Abdirasak Sharif Ali, Saadaq Adan Hussein, Nasra Hassan Gargaar, Amina Sheikh Hassan","doi":"10.1002/ijgo.71136","DOIUrl":"10.1002/ijgo.71136","url":null,"abstract":"<p><strong>Objective: </strong>Obstructed labor is a preventable cause of maternal and perinatal mortality, with a disproportionately high burden in low-resource settings. In Somalia, decades of conflict have fragmented the health system, contributing to one of the world's highest maternal mortality ratios. The aim of the present study was to identify the determinants of obstructed labor among women delivering at Banadir Hospital, Mogadishu, Somalia.</p><p><strong>Methods: </strong>A hospital-based unmatched case-control study was conducted from June to August 2025. A total of 450 participants were enrolled. Data were collected using a structured questionnaire through participant interviews. Multivariable logistic regression analysis was performed to identify independent risk factors associated with obstructed labor. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Cephalopelvic disproportion was the primary cause of obstructed labor (63.3%). Significant independent risk factors included diabetes in pregnancy (aOR = 9.09, 95% CI: 2.73-30.29), being referred from another health facility (aOR = 7.00, 95% CI: 2.98-16.46), labor duration ≥12 h (aOR = 5.11, 95% CI: 2.71-9.63), and attending fewer than four antenatal care (ANC) visits (aOR = 3.71, 95% CI: 1.21-11.40). Other determinants included residing outside Mogadishu (aOR = 2.84, 95% CI: 1.16-6.93), maternal overweight body mass index (BMI) (aOR = 2.56, 95% CI: 1.36-4.82), neonatal birth weight ≥3.5 kg (aOR = 2.41, 95% CI: 1.37-4.24), and a previous history of obstructed labor (aOR = 2.06, 95% CI: 1.20-3.53). Primiparity was also a major risk factor, as multiparity demonstrated a 90% reduction in risk (aOR = 0.10, 95% CI: 0.05-0.23).</p><p><strong>Conclusion: </strong>Obstructed labor in Mogadishu is driven by a convergence of physiological vulnerabilities and systemic health system failures, characterized by the three delays in accessing and receiving care. To reduce the burden of this condition, interventions must focus on strengthening the continuum of care. Key priorities include improving early risk identification and diabetes screening during ANC, streamlining referral pathways from peripheral clinics, and ensuring the consistent use of partographs for intrapartum monitoring to prevent dangerously prolonged labor.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"1020-1029"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239273","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 utility of serum markers in the conservative management of placenta accreta spectrum (PAS) by leaving the placenta in situ in women with high-grade PAS.","authors":"Ammar Al Naimi, Charlotte Wiesmann, Doerthe Brueggmann, Anna Elisabeth Hentrich, Eileen Deuster, Samira Catharina Hoock, Lukas Jennewein, Frank Louwen","doi":"10.1002/ijgo.71113","DOIUrl":"10.1002/ijgo.71113","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between serum markers and successful conservative management of patients with placenta accreta spectrum (PAS).</p><p><strong>Methods: </strong>This was a retrospective case-control study where patients with high-grade PAS between 2011 and 2025 undergoing conservative leaving the placenta in situ were included. The management followed the Frankfurt PAS Procedure where the placenta was left in situ after cesarean section (CS) followed by uterine artery embolization and two-step surgery. Regular laboratory investigations included the assessment of serum markers including beta human chorionic gonadotropin (β-hCG), serum placental growth factor (PlGF), progesterone, and pregnancy-associated plasma protein A (PAPP-A). Mixed effects models with random intercept were utilized to assess the association between the marker levels and uterine preservation over follow-up time.</p><p><strong>Results: </strong>The study included 24 women, seven of which with successful uterine preservation had lower β-hCG, PlGF and progesterone with medians of 1469 (282.2, 5532), 117 (27.2, 258), and 24.5 (4.2, 66) compared to the 17 needing hysterectomy with medians of 9041 (3563, 16 824), 227.2 (129, 368), and 60 (47, 83), respectively, but no difference in PAPP-A levels. The mixed effects models showed a decline for β-hCG, PAPP-A, progesterone over time (P < 0.001), but not for PlGF. The rate of β-hCG drop was higher for patients with preserved uterus especially within the first two weeks of follow-up with a coefficient of 311 mIU/mL per day.</p><p><strong>Conclusion: </strong>β-hCG, PlGF and progesterone levels successively decrease after conservative PAS management, and there is a negative association between successful uterine retention and serum β-hCG levels. The optimal window for performing a two-step surgery might be 2-3 weeks post CS.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":"895-901"},"PeriodicalIF":2.7,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137960","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}