International Journal of Gynecology & Obstetrics最新文献

{"title":"Oral contraceptive use as a risk factor for acute ischemic stroke: A population-based cross-sectional study.","authors":"Alis J Dicpinigaitis, Giana Dawod, Catherine A Morse, Fawaz Al-Mufti","doi":"10.1002/ijgo.70557","DOIUrl":"https://doi.org/10.1002/ijgo.70557","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113183","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":"Syphilis in pregnancy: A practical guide for prenatal care providers.","authors":"Audrey Anne Desjardins, Eliana Amaral, Jezid Miranda, Dharmintra Pasupathy, Maria Luisa Martins, Edward Buga, David Aronoff, Deborah Money, Isabelle Boucoiran","doi":"10.1002/ijgo.70511","DOIUrl":"https://doi.org/10.1002/ijgo.70511","url":null,"abstract":"<p><p>Syphilis during pregnancy remains a persistent global public health challenge. Untreated or inadequately treated syphilis infection during pregnancy contributes significantly to preventable perinatal morbidity and mortality. In the last five years, a resurgence of syphilis among pregnant women in several regions has led to a concerning rise in congenital syphilis cases. Vertical transmission can occur at any point during pregnancy or delivery, with the highest risk observed during primary and secondary stages of infection compared to latent phases. To align with the World Health Organization (WHO) target of reducing the vertical transmission rate below 0.05%, the International Federation of Gynecology and Obstetrics (FIGO) has developed evidence-based guidance for the management of syphilis during pregnancy. The guidance advocates for universal early screening, strengthened health systems to ensure access to free and timely prenatal care, and the integration of effective follow-up strategies. As early diagnosis and treatment are highly effective in reducing transmission, syphilis screening should begin at the first prenatal visit. While regional protocols vary, at a minimum, screening should be repeated at delivery in countries that have not yet met WHO eradication targets. Benzathine penicillin remains the treatment of choice, with proven efficacy and safety. Additionally, screening and treatment of sexual partners are essential to prevent maternal reinfection and community transmission. Strengthening health systems to support these interventions is fundamental to improving maternal and fetal/neonatal health outcomes and advancing towards global elimination of congenital syphilis worldwide.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113167","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":"Cardiovascular risk profile according to World Health Organization medical eligibility criteria for contraceptive use of women using hormonal contraception in Rio de Janeiro state, Brazil.","authors":"Isabela Pereira Fonseca Brusth, Juliana Montani Raimundo, Helene Nara Henriques Blanc","doi":"10.1002/ijgo.70548","DOIUrl":"https://doi.org/10.1002/ijgo.70548","url":null,"abstract":"<p><strong>Objective: </strong>Hormonal contraception, especially combined oral contraceptives, is associated with an increase in cardiovascular risk. Thus, we aimed to analyze the use of hormonal contraceptive methods in the state of Rio de Janeiro (Brazil), with a focus on determining whether contraceptive use follows the cardiovascular profile of women according to the World Health Organization Medical Eligibility Criteria for Contraceptive Use (MEC).</p><p><strong>Methods: </strong>This was a descriptive cross-sectional study based on a self-completed online survey about information concerning socioeconomic status, cardiovascular profile, and hormonal contraceptive use. A total of 501 responses were evaluated.</p><p><strong>Results: </strong>Combined oral contraceptive was the choice of 58.97% of participants. Our data show that 88.27% of participants presented at least one cardiovascular risk factor, with sedentary lifestyle, overweight, and obesity being the most prevalent. Regarding cardiovascular risk factors considered in MEC, 81.60% of participants use the appropriate contraceptive for their health. Most women reported using the contraceptive with a prescription, including 83.33% of participants in categories 3 and 4, which represent contraindications for hormonal contraceptive use according to MEC.</p><p><strong>Conclusion: </strong>Although most women living in Rio de Janeiro use an appropriate hormonal contraceptive, clinical management and cardiovascular risk assessment must be improved to protect women's health and ensure an evidence-based family planning strategy.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091528","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":"Diagnosis and classification of uterine fibroids.","authors":"Rosa Lakabi, Sebastian Harth, Ivo Meinhold-Heerlein, Alisha V Olsthoorn, Malcolm G Munro, Ally Murji","doi":"10.1002/ijgo.70538","DOIUrl":"https://doi.org/10.1002/ijgo.70538","url":null,"abstract":"<p><p>Uterine fibroids, or leiomyomas, are benign uterine tumors with a lifetime prevalence of approximately 75%. While only a minority become symptomatic, their impact on quality of life remains profound owing to heavy menstrual bleeding, bulk symptoms, and reproductive dysfunction. Interestingly, fibroids are not reliably diagnosed on physical examination, nor can their impact be predicted through palpation. Consequently, the diagnosis and phenotypic categorization of uterine fibroids relies primarily on imaging to guide subsequent clinical management. Ultrasound should be the first-line diagnostic modality, and magnetic resonance imaging should be reserved for complex cases and/or surgical planning. Adherence to standardized structured reporting across imaging modalities is critical to improve diagnostic accuracy, differentiate fibroids from conditions such as adenomyosis or malignancies, predict therapeutic responses, and plan surgical interventions. Imaging reports should follow the FIGO classification system for uterine fibroids, to enable a standardized description of their relationship to the endometrium, myometrium, and uterine serosa.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086200","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":"Experiences of psychological interventions for women and men undergoing assisted reproductive technologies: A qualitative systematic review.","authors":"Crystal Min Siu Chua, Zhongwei Huang, Hsiu Kim Lina Lim, Apiradee Nantsupawat, Orn-Anong Wichaikhum, Jovin Jie Ning Lee, Cornelia Yin Ing Chee, Shefaly Shorey","doi":"10.1002/ijgo.70533","DOIUrl":"https://doi.org/10.1002/ijgo.70533","url":null,"abstract":"<p><strong>Objective: </strong>Given the adverse psycho-emotional impacts, psychological interventions can support couples undergoing assisted reproductive technologies (ART). A qualitative systematic review is needed to help us understand the intricacies of the experiences with ART-based psychological interventions. This study consolidates and synthesizes available evidence of experiences of women and men undergoing ART with psychological interventions.</p><p><strong>Methods: </strong>Six electronic databases were searched for studies published in English from the inception date (1961) up to February 2023: Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Embase, PsycINFO, Scopus, and Mednar. Studies that used qualitative research designs or mixed methods on women and men experience with psychological interventions during ART were included. The Critical Appraisal Skills Program tool was used to appraise the quality of the included studies. The review was registered on the International Prospective Register of Systematic Reviews. The data synthesis was guided by Sandelowski and Barroso's guidelines.</p><p><strong>Results: </strong>Ten qualitative studies were included in this systematic review. The identified overarching theme was the impact of psychological interventions from \"being lost\" to \"finding ways,\" which was supported by three themes: (1) better coping and acceptance of infertility, (2) knowing and \"finding ways\" to what was unknown, and (3) preferred way forward for infertility treatment.</p><p><strong>Conclusion: </strong>The study reveal that psychological interventions were favorable for women and men undergoing ART with perceived lower stress levels and anxiety symptoms. Participants from the included studies also expressed better coping skills. Both women and men in the included studies highlighted that future interventions should provide adequate educational information on ART, teach individualized coping skills, and offer psychological support, specifically for those with unsuccessful ART outcomes. Moreover, couple-based interventions should be further explored from varied geographical and cultural backgrounds.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086247","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":"Long-term results of the Musset surgical technique in the treatment of recto-vaginal fistulas.","authors":"Joy Bloomfield, Bassam Haddad, Geoffroy Canlorbe, Cyril Touboul, Edouard Lecarpentier, Yohann Dabi","doi":"10.1002/ijgo.70532","DOIUrl":"https://doi.org/10.1002/ijgo.70532","url":null,"abstract":"<p><strong>Objective: </strong>Recto-vaginal fistulas (RVF) are a rare pathology, mostly affecting developing countries. They are mainly obstetrical (88% of cases) and have an incidence of 0.5%. Musset's surgical technique in the management of RVF has been the subject of few studies and there is little data in the literature concerning the evaluation of its long-term efficiency and its morbidity. The aim of our study was to investigate the long-term results of patients who underwent Musset's surgery for cure of RVF.</p><p><strong>Methods: </strong>We conducted a monocentric cohort study between January 1, 2002, and December 31, 2020 including patients who had undergone a RVF cure by the Musset technique. These patients were recalled in consultation to be examined and completed a questionnaire designed for this study with validated functional and quality-of-life scores. For patients who did not respond to this solicitation, information was retrieved from their postoperative consultations in their medical records. The surgical technique was considered successful if the patient did not present gas or stool incontinence postoperatively.</p><p><strong>Results: </strong>A total of 38 patients had RVF repair surgery by the Musset technique, and the technique was successful in 48.4% of cases, with high complication and reintervention rates (54.8% and 35.7%, respectively). Half of the patients had a recurrence of symptoms (51.6%) with mainly gas incontinence (43.8%). A total of 11 patients had a long-term evaluation (28.9%) with a median follow-up of 5 years (4-15.5 years). Among the patients that were re-evaluated, all had felt that their life had improved postoperatively and were satisfied with the intervention with a median PGI-I score of 1 (1-1.5). According to the surveys, quality-of-life was improved postoperatively with a median Cleveland score decreasing from 2.5 (1.5-3.75) to 0.5 (0-3.75) and there were no limitations due to physical health or emotional problems according to the SF-36 questionnaire. Patients had satisfactory sexual intercourses after the procedure with a median high score of 5.2/6 according to the FSFI questionnaire.</p><p><strong>Conclusion: </strong>The Musset technique provides good functional results and high satisfaction rates and is associated with improved quality-of-life postoperatively. However, it is also associated with a high rate of complications and reinterventions. Treatment of RVF can be long and complicated and should therefore be done in referral centers in order to optimize the results.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074989","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":"Transvaginal hemiperitoneal cervical cerclage for cervical insufficiency: A single-center retrospective study.","authors":"Xin Zhao, Meicheng Wang, Le Cai, Yan Sun, Yansong Liu","doi":"10.1002/ijgo.70520","DOIUrl":"https://doi.org/10.1002/ijgo.70520","url":null,"abstract":"<p><strong>Background: </strong>Cervical insufficiency (CI) is thought to be responsible for 8% of miscarriages and preterm births. Cervical cerclage is the main treatment for CI. There are different approaches to cervical cerclage, and it is particularly important to find a method of cervical cerclage that is simple to perform and results in better pregnancy outcomes.</p><p><strong>Objective: </strong>This study investigates the clinical efficacy of transvaginal hemiperitoneal cervical cerclage in the treatment of CI and its impact on maternal and fetal outcomes.</p><p><strong>Methods: </strong>We performed a descriptive retrospective single-center study, including all patients who had a transvaginal hemiperitoneal cervical cerclage between January 1, 2020, and December 31, 2023. The main outcomes measured were pregnancy outcomes.</p><p><strong>Results: </strong>Twenty transvaginal hemiperitoneal cervical cerclages were performed over the period studied: 35% had a history of cervical conization, 65% had history of one or more mid-trimester miscarriages, and 15% had a history of a failed emergency or prophylactic cerclage. The median gestational age (GA) at cerclage placement was 14.19 ± 2.88 weeks of gestation (WG). There was one case of delivery between 28 and 32 weeks, and there were five cases of delivery between 32 and 37 weeks and 11 cases of delivery over 37 weeks, of which three cases were in pregnancy, at gestational weeks of 16, 18, and 21 weeks, respectively. The mean gestational age of cerclage removal, was 36.42 ± 2.76 (WG).</p><p><strong>Conclusion: </strong>The transvaginal hemiperitoneal cervical cerclage is simple to operate, not limited by gestational age, and less invasive and has a low cost. It is effective in patients with a short cervix and has good pregnancy outcomes.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075119","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 position statement on surrogacy: Ethical considerations.","authors":"Rafal Zadykowicz, Katie Watson, Aris Antsaklis","doi":"10.1002/ijgo.70507","DOIUrl":"https://doi.org/10.1002/ijgo.70507","url":null,"abstract":"<p><p>Surrogacy raises complex social and ethical issues related to autonomy, informed consent, potential exploitation, and the welfare of all parties involved. In this article, FIGO advocates for ethically sound surrogacy practices that prioritize voluntary and informed consent, safeguard the well-being of surrogates, uphold the rights and responsibilities of intended parents, and place the welfare of the child at the center of all decisions. FIGO discourages surrogacy arrangements in which a woman agrees in advance to surrender a child to whom she is genetically related (\"traditional surrogacy\") and supports surrogacy arrangements in which a woman agrees in advance to surrender a child to whom she is not genetically related (\"gestational surrogacy\") provided they align with core ethical principles. FIGO also emphasizes the importance of adhering to international ethical standards, particularly in the context of cross-border surrogacy arrangements.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069683","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":"Transverse parallel compression suture with endotracheal tube tamponade for management of hemorrhage in complete placenta previa: A retrospective study.","authors":"Xi-Shi Lin, Xiao-Xing Zhang, Jie Chen, Ling-Li Ning, Li-Yuan Zhang, Ying Jiang, Wei-Miao Yao, Bai-Hui Zhao, Qiong Luo","doi":"10.1002/ijgo.70535","DOIUrl":"https://doi.org/10.1002/ijgo.70535","url":null,"abstract":"<p><strong>Objective: </strong>Our study developed the Transverse Parallel Compression Suture (TPCS) with endotracheal tube tamponade, hypothesizing that its transverse compression design would enhance hemostasis, particularly in placenta accreta spectrum (PAS) cases.</p><p><strong>Methods: </strong>Between January 1, 2022, and December 31, 2024, 346 women with complete placenta previa were enrolled in this study. To minimize selection bias and control for potential con-founders, we performed propensity score matching (PSM) using a 1:1 nearest-neighbor algorithm with a caliper width of 0.02. The matched cohorts (53 TPCS cases vs. 53 uterine packing controls) demonstrated balanced baseline characteristics. Relevant outcomes, such as operative duration, estimated blood loss, transfusion needs, and hospital stays were collected. Additional data included the uterotonics, postoperative pain levels, re-operation rate, and newborn outcomes.</p><p><strong>Results: </strong>The results showed that the TPCS group had significantly shorter operative time (59.62 ± 27.04 min vs. 73.87 ± 26.28 min, P = 0.007), reduced intraoperative blood loss (792.45 ± 892.46 mL vs. 1220.75 ± 1090.93 mL, P = 0.029). Also, TPCS was associated with shorter hospitalization (6.10 ± 2.06 vs. 7.49 ± 3.29 days, P = 0.003) and markedly lower reoperation rates (3.8% vs. 60.4%, P < 0.001). TPCS was associated with markedly improved pain management, with 96.2% of patients reporting mild pain (Visual Analogue Scale less than 4) versus 18.9% in the packing group (P < 0.001), alongside an 84% relative reduction in analgesic use (11.3% vs. 71.7%, P < 0.001). Besides, Neonatally, TPCS showed lower NICU admissions (34.0% vs. 56.6%, P = 0.031) with comparable Apgar scores and birth weights.</p><p><strong>Conclusion: </strong>After rigorous PSM adjustment, TPCS demonstrated superior perioperative safety and recovery advantages over uterine packing in placenta previa management, supporting its adoption in clinical practice. Its simplicity and low resource demand highlight potential utility in diverse settings.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069606","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":"Response: Inter-twin delivery interval and outcome of the second twin: A retrospective study.","authors":"Ezra Osnat, Barzilay Eran","doi":"10.1002/ijgo.70540","DOIUrl":"https://doi.org/10.1002/ijgo.70540","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069623","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}