International Journal of Gynecology & Obstetrics最新文献

{"title":"FIGO committee opinion: Environmental drivers of gynecologic and reproductive health.","authors":"Nathaniel DeNicola, Jun Zhang, Annette Hasenburg, Roxana Schwab, Krishnendu Gupta, Ditas Decena, Francisco Edna, David Graham, Edward Morris, Blami Dao","doi":"10.1002/ijgo.70547","DOIUrl":"https://doi.org/10.1002/ijgo.70547","url":null,"abstract":"<p><p>This FIGO committee opinion paper addresses the growing body of evidence linking environmental exposures to common gynecologic and reproductive conditions across the life course. From adolescence through menopause, women are exposed to a wide range of environmental toxicants, including endocrine-disrupting chemicals, air pollutants, heavy metals, pesticides, and industrial compounds, which influence hormonal function, ovarian reserve, and disease risk. This article synthesizes high-quality systematic and authoritative reviews along with high-quality literature on exposures that can increase the risk of infertility, polycystic ovary syndrome, endometriosis, uterine fibroids, hormonally mediated cancers, and menopause. It highlights underlying mechanisms, such as endocrine disruption, oxidative stress, inflammation, and epigenetic modification. Importantly, the article emphasizes disparities in exposure and outcomes, particularly among historically marginalized populations with heightened vulnerability to environmental injustice. Practical guidance is offered to help clinicians incorporate environmental health into routine care, through patient counseling, exposure screening, and advocacy. The article calls for obstetrician/gynecologists to take leadership roles in recognizing environmental risk as a determinant of reproductive health and equity-both within the clinic and through systems-level policy change.</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":"145148825","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":"Extraperitoneal vaginal natural orifice transluminal endoscopic pelvic reconstruction for multi compartment pelvic organ prolapse.","authors":"Jing Peng, Junwei Li, Keqin Hua, Yisong Chen","doi":"10.1002/ijgo.70402","DOIUrl":"https://doi.org/10.1002/ijgo.70402","url":null,"abstract":"<p><p>We describe a novel extraperitoneal vaginal natural orifice transluminal endoscopic surgery (vNOTES) approach for pelvic reconstruction in women with multicompartment pelvic organ prolapse (POP). This retroperitoneal technique enables direct exposure of the presacral area, allowing secure fixation of a Y-shaped mesh to the anterior longitudinal ligament and comprehensive restoration of anterior, middle, and posterior compartment support. From April to December 2024, 118 patients underwent extraperitoneal vNOTES pelvic reconstruction. The mean age was 61.1 ± 6.6 years, the mean body mass index was 24.5 ± 2.6 kg/m², the mean operative time was 103.3 ± 25.7 minutes, and the mean estimated blood loss was 97.7 ± 47.7 ml. During a median follow-up of 6.9 months (range: 4.1-11.2 months), all patients experienced significant improvement in anatomic and functional outcomes, with no recurrence, mesh exposure, or reoperation. Three patients (2.5%) developed retroperitoneal hematomas that resolved with conservative management. These early results suggest that extraperitoneal vNOTES pelvic reconstruction is a feasible and safe technique, with the potential to reduce operative complexity and intra-abdominal risks compared with conventional transperitoneal approaches.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137664","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":"FIGO good practice recommendations: Assisted vaginal birth and the second stage of labor.","authors":"Akaninyene E Ubom, Eytan R Barnea, Nicoletta DiSimone, Martin Mueller, Jolly Beyeza-Kashesya, Ines Nunes, Albaro J Nieto-Calvache, Elif G Topcu, Zechariah J Malel, Bo Jacobsson, Alison Wright","doi":"10.1002/ijgo.70528","DOIUrl":"https://doi.org/10.1002/ijgo.70528","url":null,"abstract":"<p><p>Cesarean birth (CB) rates are increasing globally, with a current prevalence of 21.1% and a projected prevalence of 28.5% by 2030. Conversely, assisted vaginal birth (AVB) rates are declining, with reported rates of less than 10% in low- and middle-income countries (LMICs) and 10%-15% in high-income countries (HICs). In some African countries, AVB rates are as low as <1%. Declining AVB rates are attributable to lack of appropriate skills, equipment, and trained personnel, especially in LMICs, fear of litigation, and misconceptions that CB is safer, paucity of local guidelines and policies encouraging AVB, and increasingly accessible, acceptable, and safer CB techniques, amongst others. Optimizing appropriate care and decision making around CB and mode of birth is now a public health priority, especially given the significantly higher morbidity and mortality associated with CB compared to vaginal birth. Increasing AVB rates can potentially reduce CB rates, therefore improving maternity safety. This paper reviews the current best evidence on AVB and makes recommendations for good practice, including indications and prerequisites for AVB, who to determine who is suitable for AVB, choice of instrument, sequential application of instrument, when to abandon AVB, analgesia, antibiotic prophylaxis and episiotomy for AVB, special situations such as fetal macrosomia, maternal viral infections, previous CB, and risks and benefits of AVB versus second stage CB. An AVB safety checklist is included to reduce the risk of complications. We conclude by recommending that all maternity care providers and skilled birth attendants, including obstetricians, obstetric trainees/residents, interns, and midwives, should be trained and competent to perform AVB, to potentially reduce the current CB epidemic and its associated higher mortality and morbidity.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137686","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 novel paper-based electrochemical DNA biosensor technique for detection of microbial infections within 90 min in urinary samples of symptomatic women: A pilot study.","authors":"Kavita Khoiwal, Balram Ji Omar, Pooja Goswami, Manisha Perka, Minakshi Singh, Ankit Agarwal, Amrita Gaurav, Jaya Chaturvedi","doi":"10.1002/ijgo.70556","DOIUrl":"https://doi.org/10.1002/ijgo.70556","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130748","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":"Gynecologic surgery for benign disease: Preserving reproductive potential.","authors":"Togas Tulandi, Edgar Mocanu, Nikhil Purandare, Scott M Nelson, Eytan R Barnea, Ruth Dolmo Carluccio, Elif Goknur Topcu, Dov Feldberg","doi":"10.1002/ijgo.70546","DOIUrl":"https://doi.org/10.1002/ijgo.70546","url":null,"abstract":"<p><p>Preserving fertility is essential when managing benign gynecologic disorders in reproductive-aged women. Surgical interventions can impact future fertility, therefore requiring an evidence-based, individualized approach. The FIGO Committee on Reproductive Endocrinology and Infertility reviewed current literature to develop recommendations for fertility-sparing surgical management. Effective treatment must balance disease control with fertility preservation. Evidence supports refined surgical techniques and alternative methods that minimize reproductive harm. In pregnancy loss management, medical treatment is preferred; however, if surgery is needed, hysteroscopic evacuation is safer than sharp curettage, reducing the risk of intrauterine adhesions. Similarly for other operative hysteroscopic procedures or abdominal procedures, including myomectomy, the use of an adhesion-reducing substance is recommended. During abdominal myomectomy, only symptomatic or fertility-impairing fibroids should be removed, as excessive resection may reduce pregnancy chances. In endometrioma surgery, preserving ovarian tissue is crucial by minimizing stripping of the pseudocapsule, or using sclerotherapy may help. Oocyte cryopreservation should be discussed when recurrence or reduced ovarian reserve is a concern. Hydrosalpinx often requires salpingectomy to enhance in vitro fertilization outcomes, but surgeons should protect ovarian blood flow by minimizing thermal injury. For adenomyosis, medical management is preferred due to the risks associated with surgical techniques like the triple-flap procedure. In polycystic ovary syndrome, laparoscopic ovarian drilling is discouraged; ovulation induction with letrozole or gonadotropins is safer and effective. In summary, fertility-sparing treatment demands personalized, evidence-based strategies that prioritize reproductive potential while managing disease. As reproductive goals evolve, continued refinement of these approaches remains vital to women's health care.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130757","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":"Gender inequity in postpartum hemorrhage: A public health issue.","authors":"Anne-Beatrice Kihara, Monica Oguttu, Ahmet Metin Gülmezoglu, Albaro Jose Nieto-Calvache, Akaninyene Eseme Ubom, Cherrie Evans, Diana Ramasauskaite, Zechariah J Malel, Dietmar Schlembach, Ines Nunes, Bo Jacobsson, Jolly Beyeza-Kashesya, Ferdousi Begum, Alison Wright","doi":"10.1002/ijgo.70526","DOIUrl":"https://doi.org/10.1002/ijgo.70526","url":null,"abstract":"<p><p>Postpartum hemorrhage (PPH), a leading cause of maternal mortality globally, disproportionately affects women in low- and middle-income countries (LMICs), highlighting the deep-rooted gender related inequities in healthcare access, quality, and outcomes. Despite being largely preventable and treatable, PPH continues to claim the lives of thousands of women annually, because of systemic failures, including inadequate maternal health infrastructure, under-resourced healthcare systems, and sociocultural norms that devalue women's health. Gender inequity is manifested in delayed care-seeking, a lack of decision-making autonomy, limited access to skilled birth attendants, and emergency obstetric care. Moreover, implicit biases and structural discrimination often limit investment in women-centered health interventions. This issue is compounded by socioeconomic disparities, educational gaps, and the underrepresentation of women's health priorities in policy and research agendas. Addressing PPH through a gender-equity lens is imperative to improve maternal health outcomes and achieve global health equity. This paper underscores the urgent need for integrated, gender-sensitive public health strategies to mitigate the burden of PPH and protect the rights and lives of women.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137625","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: FIGO statement: Cosmetic genital surgery.","authors":"Adam Ostrzenski","doi":"10.1002/ijgo.70488","DOIUrl":"https://doi.org/10.1002/ijgo.70488","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130696","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: FIGO statement: Cosmetic genital surgery.","authors":"Pablo González-Isaza, Rafael Sánchez-Borrego, Stefano Salvatore, Alejandro Carbone","doi":"10.1002/ijgo.70543","DOIUrl":"https://doi.org/10.1002/ijgo.70543","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130707","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: Oncologic outcome and recurrence patterns of clinical stage IB and IIA cerviscal cancer: A large retrospective analysis of a tertiary reference center.","authors":"Parsa Torkaman, Ali Hosseini","doi":"10.1002/ijgo.70542","DOIUrl":"https://doi.org/10.1002/ijgo.70542","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124241","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":"FIGO recommendations on objective measurement of blood loss after birth for early detection of postpartum hemorrhage.","authors":"Ferdousi Begum, Albaro J Nieto-Calvache, Dietmar Schlembach, Justus Hofmyer, Jose Palacios-Jaraquemada, Ajey Bhardwaj, Maria A Suarez, Juan M Burgos-Luna, Jolly Beyeza-Kashesya, Akaninyene E Ubom, Alison Wright","doi":"10.1002/ijgo.70523","DOIUrl":"https://doi.org/10.1002/ijgo.70523","url":null,"abstract":"<p><p>Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality worldwide, particularly in resource-constrained and remote settings. The cornerstone of reducing PPH-related morbidity and mortality lies in its early recognition, timely treatment, and adherence to evidence-based protocols, all of which are heavily dependent on an accurate assessment of postpartum blood loss. Visual estimation, unfortunately, is still widely used, highly inaccurate, and often leads to underdiagnosis, resulting in a delayed or sometimes absent response to PPH. Objective quantification of blood loss, although not perfectly precise, provides a far more reliable estimate and is critical to triggering timely and effective interventions. This approach requires coordinated teamwork, leadership, institutional commitment, and a shift in clinical culture from subjective to standardized measurement practices. Scientific evidence strongly supports the integration of objective quantification into routine obstetric care. The use of calibrated drapes, cumulative measurement, and the combination of quantification with early warning systems have all proven to be effective in reducing PPH-related complications and deaths. Practical barriers are faced in implementing objective measurement strategies at the facility and institutional level, including availability, supply costs, environmental concerns, national and institutional advocacy, policy change, leadership, appropriate training, and, more importantly, resistance to change. Low-cost, reusable, and locally made devices can offer promising solutions for scaling up this intervention in resource-limited environments. Sustained success will depend on engagement with health departments of the governments for framing policies, guidelines for implementation, procurement and regular supplies, inter-institutional collaboration, and ongoing and refresher training for in-service healthcare providers. In the longer term, it requires inclusion into the medical curriculum, local leadership, champions, behavioral interventions, recognition and rewards to individuals, and teams who promote long-term adherence to best practice. Ultimately, although technical knowledge on PPH management is now well established, the real challenge lies in its consistent and context-appropriate identification and application. This article discusses the different definitions of PPH. It highlights the importance of objective quantification of blood loss during and after childbirth and the various available methods for blood loss measurement and explores their implementation across different clinical settings.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123973","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}