International Journal of Gynecology & Obstetrics最新文献

{"title":"FIGO statement on respectful care: Addressing disrespectful maternity care.","authors":"Jezid Miranda, Hasmik Bareghamyan, Michelle N S Therrien, Andre Lalonde, Margit Steinholt, Francesca Palestra, Debra Pascali-Bonaro, Mindaugas Kliucinskas, María A Basavilvazo Rodríguez, Garang Ajak, Eliana Amaral, Pius Okong, Birgitta Essèn, Bo Jacobsson, Suellen Miller","doi":"10.1002/ijgo.70513","DOIUrl":"https://doi.org/10.1002/ijgo.70513","url":null,"abstract":"<p><p>The International Federation of Gynecology and Obstetrics (FIGO) Committee on Health Systems Strengthening and Respectful Care recognizes the detrimental effects of disrespectful and abusive practices within maternity care on maternal and neonatal health outcomes. In response, the committee advocates for the implementation of strategic, evidence-based interventions aimed at safeguarding women from substandard and disrespectful treatment during pregnancy, childbirth, and the postpartum period. This statement presents FIGO's recommendations for adopting respectful maternity care into health systems. The proposed policy interventions and clinical strategies are designed to foster compassionate, person-centered, and culturally competent care, thereby contributing to improved maternal and perinatal outcomes globally.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191099","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":"Paracetamol (acetaminophen) use during pregnancy and autism risk: Evidence does not support causal association.","authors":"Frank Louwen, Eileen Deuster, Fionnuala M McAuliffe, Bo Jacobsson, Michael Geary, Steven Fleischman, Anne-Beatrice Kihara","doi":"10.1002/ijgo.70577","DOIUrl":"https://doi.org/10.1002/ijgo.70577","url":null,"abstract":"<p><p>Recent political statements linking paracetamol (acetaminophen) use during pregnancy to autism spectrum disorders have created concern among patients and healthcare providers worldwide. This editorial critically examines the scientific evidence, highlighting that the largest and most methodologically rigorous population-based studies employing sibling control analyses demonstrate no causal association between prenatal paracetamol exposure and neurodevelopmental disorders. While some observational studies have suggested potential weak associations, these findings likely reflect confounding by indication and familial genetic factors rather than actual causal relationships. The most robust evidence comes from a Swedish population-based study of 2.48 million children, which found no increased risk when controlling for familial confounding. Major international medical organizations including ACOG, RCOG, and FIGO, and regulatory agencies including the European Medicines Agency continue to recommend paracetamol as the safest analgesic option during pregnancy when clinically indicated. The established risks of untreated pain and fever during pregnancy significantly outweigh theoretical concerns based on methodologically limited studies. Healthcare providers should continue evidence-based counseling while avoiding unnecessary anxiety about this essential medication in obstetric practice.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199302","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":"Cervical cancer screening: Is self-sampling the answer?","authors":"Anshuja Singla, Sumita Mehta, Anshul Grover, Ashwani Kumar Mishra","doi":"10.1002/ijgo.70562","DOIUrl":"https://doi.org/10.1002/ijgo.70562","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance of self and clinician collected samples for high-risk human papilloma virus (hr HPV) DNA detection and to assess the acceptance and attitude of women towards self-collection.</p><p><strong>Methods: </strong>This was a prospective single blind study done in 396 women (30-65 years) attending the gynecology outpatient department (OPD). Cervical swabs were collected in duplicate (self and clinician) in transport medium and stored at 4°C until further processing. A cervical smear was also collected at the same time. High risk HPV DNA was tested using real-time polymerase chain reaction (PCR). The samples positive for HPV DNA in any of the samples either self or clinician underwent a colposcpy guided biopsy.</p><p><strong>Results: </strong>A total of 396 women underwent screening. A total of 8% women complained of post coital bleeding. Cervical smear was inadequate in 15% and atypical squamous cells of undetermined significance (ASCUS) and above was reported in 3.7% samples. Overall agreement between self and clinician sampled HPV (C-HPV) was 91.4% with Kappa unadjusted being 43.4% (95% CI: 35.8-51.1). Overall agreement between C-HPV and cervical smear was 79.5% with Kappa unadjusted of 19.2% (95% CI: 12.8-25.5). Overall agreement between self and cervical smear was 80.0% with Kappa unadjusted value of 21.7% (95% CI: 14.7 to 28.7). A total of 23 women underwent biopsy of which 19 were diagnosed with cervical intraepithelial neoplasia-1 (CIN-1) and above with a positive predictivity rate of 100% with either screening result being positive.</p><p><strong>Conclusion: </strong>HPV DNA self-sampling can be a major breakthrough in breaking the shackles of underutilization of cervical cancer screening and thus decrease the morbidity and mortality of cervical cancer.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191687","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":"Pregnant women's use of early obstetric ultrasound during antenatal care in sub-Saharan Africa: A Cross-sectional study.","authors":"Addisu Girma, Merid Tadesse, Tesema Eshete, Birtukan Asmare, Abraham Fessehaye Sium","doi":"10.1002/ijgo.70558","DOIUrl":"https://doi.org/10.1002/ijgo.70558","url":null,"abstract":"<p><strong>Objective: </strong>To determine the rate of utilization of early obstetric ultrasound as part of antenatal care and factors associated with among pregnant women following antenatal care (ANC) in Ambo town.</p><p><strong>Methods: </strong>A prospective cross-sectional study was conducted on 355 pregnant women attending antenatal care from January 1-30, 2024, in Ambo Town public health care institutions in Ethiopia. One public health center and one hospital were selected by simple random method. A systematic sampling technique was used to select study participants who attended the antenatal service during the data collection period. Logistic regression analysis was performed to determine the association between the explanatory and response variables. Adjusted odds ratios (AOR) with 95% and P values less than 0.05 were used to present results significance.</p><p><strong>Results: </strong>The utilization of early obstetric ultrasound among the pregnant women was 63.4% (95% confidence interval [CI]: [56.3%-70.5%]). Urban place of residence (AOR = 6.0, 95% CI: 2.44, 14.70), place of delivery (AOR = 3.8, 95% CI: 1.06, 13.37), history of pre-existing medical disease(s) (AOR = 4.3, 95% CI: 1.36, 8.91), history of abortion (AOR = 4.0, 95% CI: 1.50, 7.10), and good knowledge on the use of early obstetric ultrasound (AOR = 3.0, 95% CI: 1.3, 7.03) were associated with the utilization of early obstetric ultrasound.</p><p><strong>Conclusion: </strong>In this study, the utilization of early obstetric ultrasound (<24 weeks of gestation) utilization during pregnancy was lower than that recommended by the WHO and national guidelines.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185907","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":"Ending female genital mutilation: A global call to action from FIGO.","authors":"Aparna Sridhar, Mikaela Koch, Maryam En-Nosse, Ashraf Nabhan, Juan Diego Villegas-Echeverri","doi":"10.1002/ijgo.70544","DOIUrl":"https://doi.org/10.1002/ijgo.70544","url":null,"abstract":"<p><p>Female Genital Mutilation (FGM) affects over 230 million women and girls in more than 90 countries. Despite global condemnation and recognition of FGM as a violation of fundamental human rights, the practice persists, alongside an alarming rise of medicalization - with over 52 million procedures now performed by healthcare professionals. FGM causes severe short- and long-term consequences, including obstetric complications, chronic pain, infertility, sexual dysfunction, and significant mental health burdens. Ending FGM is a medical responsibility and a moral imperative. FIGO unequivocally condemns all forms of FGM, including medicalization, and calls for unified global action. FIGO urges its member societies and healthcare providers to strengthen capacity-building, enforce ethical guidelines, raise community awareness, provide reconstructive care and mental health care, and advance research in this field.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175548","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 epidemiology and pathogenesis of uterine fibroids.","authors":"Malcolm G Munro, Svetlana N Tchaikovski, Ally Murji","doi":"10.1002/ijgo.70527","DOIUrl":"https://doi.org/10.1002/ijgo.70527","url":null,"abstract":"<p><p>Uterine fibroids, or leiomyomas, are the most common benign tumors of the female reproductive tract, ultimately affecting a majority of women worldwide, primarily during their reproductive years. While their origin appears genetic, manifesting in monoclonal tumors, diverse features and mechanisms contribute to their growth and further development. Understanding the interplay between epidemiological and biological factors is vital for clinicians and essential for investigators, whether basic, translational, clinical, or epidemiological, who aim to shed light on this ubiquitous clinical problem. Leiomyomas are experienced globally, and while there are relatively minor differences in the lifetime prevalence for women, the tumors appear to develop in those of African ancestry earlier than white women. While most leiomyomas are not symptomatic, those that cause symptoms can adversely affect lifestyle, physical function, and fertility and exert substantial socioeconomic pressure on healthcare systems. Because most leiomyomas are asymptomatic, it is also apparent that, in many cases, presenting symptoms may not be caused by the tumors themselves. As a result, it is essential that the clinician understand the pathogenesis of these tumors and how they manifest with symptoms. Despite their prevalence and evolving understanding of genetic, racial, and environmental factors contributing to their growth and development, much remains to be learned about these ubiquitous tumors in a way that can inform strategies for prevention, early detection, and effective therapy. This paper reviews the current understanding of the epidemiology and pathogenesis of uterine fibroids, highlighting key risk factors, genetic and molecular mechanisms, and implications for public health.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175493","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":"Risk of cancers in women with polycystic ovary syndrome: Cohort study based on health insurance database in South Korea.","authors":"Jin-Sung Yuk, Ji Hyun Noh, Gwan Hee Han, Sang Hee Yoon, Myounghwan Kim","doi":"10.1002/ijgo.70560","DOIUrl":"https://doi.org/10.1002/ijgo.70560","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the risk of all cancer types associated with polycystic ovary syndrome (PCOS) in a Korean population-based study.</p><p><strong>Methods: </strong>This retrospective cohort study used national health checkups and insurance data between January 1, 2011, and December 31, 2020. Women aged 20-50 years who attended medical institutions for PCOS or underwent health checkups were included. In total, 774 811 participants were included. The PCOS and non-PCOS groups comprised 127 980 and 563 850 patients, respectively. After 1:1 propensity score matching, each group consisted of 127 712 participants. Hazard ratios were evaluated for all types of cancers associated with PCOS across age groups.</p><p><strong>Results: </strong>Demographic and clinical characteristics of women with and without PCOS were not significantly different. However, in the PCOS group, the total cancer risk increased (hazard ratio: 1.156, 95% confidence interval: 1.058-1.263, P = 0.001), and the risk of uterine and ovarian cancers increased (hazard ratio: 4.963, 95% confidence interval: 3.282-7.504, P < 0.001; hazard ratio: 1.774, 95% confidence interval: 1.142-2.755, P = 0.011, respectively). The risk of thyroid cancer increased in the 20-29 years age group within the PCOS group (hazard ratio: 1.2, 95% confidence interval: 1.009-1.427, P = 0.039).</p><p><strong>Conclusion: </strong>PCOS is associated with an increased risk of uterine and ovarian cancers. An increased risk of thyroid cancer was associated with PCOS in the 20-29 years age group. However, no link was found between PCOS and breast cancer. This should be considered when treating patients with PCOS.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175540","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":"Prevalence and trends of moderate-to-severe depression during antenatal and two-year postpartum periods: A secondary data analysis from NHANES 2007-2018.","authors":"Yan Chen, Yiwen Wang, Peipei Hu, Luming Sun, Yongjun Zhang","doi":"10.1002/ijgo.70551","DOIUrl":"https://doi.org/10.1002/ijgo.70551","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prevalence and trend in depression during antenatal and two-year postpartum periods in the USA.</p><p><strong>Methods: </strong>Using the data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018, 1099 adult pregnant women and women within 24 months postpartum were included. The depression status was defined as having a patient health questionnaire (PHQ-9) score.</p><p><strong>Results: </strong>The estimated prevalence of overall and moderate-to-severe depressive symptoms was 29.7% (95% confidence interval [CI]: 26.1%-33.3%) and 13.7% (95% CI: 11.1%-16.2%), respectively, which did not change apparently from 2007 to 2018. Stratified analyses confirmed a substantial upward trend in the prevalence of moderate-to-severe depressive symptoms among women aged 26-35 years, from 7.5% (95% CI: 1.2%-13.8%) in 2007-2008 to 17.2% (95% CI: 7.7%-26.7%) in 2017-2018 (P for trend = 0.019), with a 5.7% relative increase (95% CI: 1.5%-10.2%) per two-year cycle. In the whole population, the prevalence of moderate-to-severe depressive symptoms was 10.4% (95% CI: 6.6%-14.1%) in pregnancy, 13.9% (95% CI: 9.7-18.0) in the first year postpartum, to 16.8% (95% CI: 11.3%-22.3%) in the second year postpartum, P for trend = 0.047. In maternal women with depressive symptoms, 36.1% (95% CI: 25.0%-47.1%) had moderate-to-severe type in pregnancy, 47.7% (37.2%-58.1%) in the first year postpartum, and 53.1% (95% CI: 43.4%-62.9%) in the second year postpartum, P for trend = 0.038.</p><p><strong>Conclusion: </strong>In general, the prevalence of moderate-to-severe depressive symptoms has remained relatively stable during 2007-2018, but it still tended to be severe in certain subgroups of the population and deserves more concern.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175507","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":"Online decision aids for contraceptive choices in women with chronic conditions: A systematic review.","authors":"Begashaw Melaku Gebresillassie, Nicole Doley, Melissa L Harris","doi":"10.1002/ijgo.70555","DOIUrl":"https://doi.org/10.1002/ijgo.70555","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Women with chronic conditions face increased risks of unintended pregnancy and adverse maternal and perinatal outcomes. Tailored, online contraceptive decision aids might improve informed decision-making and support reproductive health by promoting patient-centered care in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study systematically reviews the characteristics and effectiveness of online decision aids designed to support contraceptive and reproductive health choices in women with chronic conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search strategy: &lt;/strong&gt;We searched Medline, Embase, CINAHL, Maternity and Infant Care Database, and Emcare up until November 30, 2024, using terms related to contraception, decision aids, chronic conditions, and women's health. We also searched thesis repositories and reference lists of relevant reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;Included studies evaluated web-based decision aids with a contraceptive choice component, targeted women of reproductive age (15-50 years) with chronic conditions, and assessed outcomes related to feasibility, user experience, knowledge, communication, or contraceptive uptake and behavior change.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two reviewers independently extracted data on study characteristics, intervention features, and outcomes and assessed methodological quality using the Mixed Methods Appraisal Tool (MMAT). A narrative synthesis was conducted due to heterogeneity in study designs and outcomes. The GRADE approach was not applied to assess the quality of the included studies due to variability in study designs and outcomes. The protocol was registered with PROSPERO (CRD42023473313).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;Ten studies evaluating nine distinct decision aids met the inclusion criteria. Eight focused primarily on contraceptive choices, while two addressed broader reproductive health planning. Most studies were conducted in the USA (n = 8) and employed various designs: randomized controlled trials (n = 4), mixed-methods studies (n = 2), and descriptive studies (n = 3). The decision aids targeted various chronic conditions, including hypertension, diabetes, cancer, rheumatic diseases, cystic fibrosis, and sickle cell disease. The aids incorporated interactive features, personalized recommendations, and multimedia formats, with high user satisfaction and usability ratings reported. Some decision aids demonstrated improvements in contraceptive use, reproductive health knowledge, and communication. However, the effect on long-term contraceptive behaviors was mixed, with three studies showing positive but not statistically significant changes and one study reporting a negative correlation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Online decision aids tailored for women with chronic conditions showed promise in improving user satisfaction, reproductive health knowledge, and patient-provider communication. However, their im","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145175565","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":"National trends of episiotomy in non-instrumental vaginal deliveries (2013-2022): A multi-data source approach.","authors":"Mariana Bandeira, Cristina Costa-Santos, Fernando Lopes, João Bernardes, Ana Reynolds","doi":"10.1002/ijgo.70564","DOIUrl":"https://doi.org/10.1002/ijgo.70564","url":null,"abstract":"<p><strong>Objective: </strong>Episiotomy and obstetric anal sphincter injuries (OASIS) are recognized indicators of intrapartum care quality. The aim of this study was to assess episiotomy trends in non-instrumental vaginal deliveries across all Portuguese public maternities over the last decade. Rates of third- and fourth-degree perineal lacerations were also evaluated.</p><p><strong>Methods: </strong>A retrospective secondary data analysis was conducted using data from an official national health entity, including all non-instrumental vaginal deliveries in the Portuguese National Health Service between January 1, 2013 and December 31, 2022. Information on episiotomy and third- and fourth-degree perineal lacerations was extracted. Descriptive statistics were presented using absolute and relative frequencies. Linear regression was used to assess trends. Additional national databases were consulted to validate findings, and data quality was assessed using the intraclass correlation coefficient (ICC). A significance level of 5% was considered.</p><p><strong>Results: </strong>Of 689 908 registered deliveries, 490 322 (71%) were vaginal, and 361 887 (52%) were non-instrumental vaginal deliveries. Among the latter, the episiotomy rate was 42.5%. A significant decrease was observed in episiotomy rates, from 63% in 2013 to 21% in 2022, (P < 0.001), accompanied by a significant increase in third-degree perineal lacerations (0.15% to 0.31%, P < 0.001), while fourth-degree perineal lacerations remained stable (0.03% to 0.02%, P = 0.001).</p><p><strong>Conclusion: </strong>A restrictive episiotomy policy was increasingly adopted in Portugal over the last decade. Although rare, third-degree perineal lacerations increased during this period. Further research is needed to determine optimal intrapartum care practices regarding episiotomy use. Standardized data coding and improved access to anonymized national datasets are essential for accurate monitoring and cross-country comparability.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148863","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}