International Journal of Gynecology & Obstetrics最新文献

{"title":"Ultrasound-guided intercostal block for the management of intercostal neuralgia in pregnant women: Case series and review of the literature.","authors":"Laura Tascón Padrón, Norah L A Emrich, Carolin Schröder, Florian Recker, Brigitte Strizek, Jorge Jiménez Cruz","doi":"10.1002/ijgo.70049","DOIUrl":"https://doi.org/10.1002/ijgo.70049","url":null,"abstract":"<p><p>Intercostal neuralgia (ICN) in pregnancy is a rare condition which, to date, has not been well studied. Due to the lack of evidence, there is not a consensus about effective therapeutic strategies for this condition. The present study investigated the feasibility of ultrasound-guided intercostal block (UG-ICB) using ropivacaine for these patients. A total of 17 cases treated at the University Hospital Bonn from May 2017 to September 2024 were reviewed. Patients presenting with severe unilateral chest or flank pain were diagnosed with ICN. UG-ICB was applied, and all patients reported immediate pain relief, with only two women requiring a second infiltration due to pain recurrence. No serious adverse events were recorded. The application technique can be consulted in the video related to this publication. The present study highlights that UG-ICB is feasible, safe and appears to be effective for managing ICN during pregnancy. This procedure provides significant pain relief while minimizing risks to the fetus. Reviewing the literature this study group was unable to find qualitative evidence assessing ICN and rib pain in pregnancy, although this condition is thought to be related to pregnancy. Further research is recommended to improve treatment strategies for ICN during pregnancy and bridge the gap between clinical knowledge and evidence surrounding this condition.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556836","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":"Outbreak of parvovirus-B19 infection in pregnant women: Is it time to rethink a preconception or first trimester screening?","authors":"Carolina Saffioti, Monica Melchio, Emilio Cristina, Caterina Costagliola, Federico Prefumo, Dario Paladini, Carolina Scala, Eddi Di Marco, Patrizia Caligiuri, Elio Castagnola, Erica Ricci","doi":"10.1002/ijgo.70057","DOIUrl":"https://doi.org/10.1002/ijgo.70057","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556835","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":"Fertility after cancer.","authors":"Jaideep Malhotra, Diksha Goswami, Neharika Malhotra, Shally Gupta, Keshav Malhotra, Priya Bhave Chittawar, Nikhil C Purandare","doi":"10.1002/ijgo.16185","DOIUrl":"https://doi.org/10.1002/ijgo.16185","url":null,"abstract":"<p><p>Both chemotherapy and radiotherapy can cause infertility in a patient undergoing cancer therapy. As both the ovaries and uterus are involved in female patients, the effects are profound. Where cryopreservation is not used or is unavailable, reproductive options include spontaneous conception if fertility returns, donor gametes, adoption, and surrogacy. Semen, oocyte, embryo, and ovarian tissue cryopreservation all offer an opportunity for a pregnancy after cancer cure if natural fertility is not possible. The risks of fertility preservation are significant for women due to the risks of surgical procedures, ovarian hyperstimulation syndrome, and delay of cancer therapy. Pregnancies that establish in women after cancer cure have specific risks including premature labor, cesarean section, congenital anomalies, and the risk of transmitting disease associated with genetic history. Where ovarian reimplantation is considered, the risk of reimplantation of malignant cells must be considered particularly in hematological and breast disease.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556831","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":"Accuracy of sonographic fetal biometry in estimating intertwin size discordance at birth.","authors":"Arietta Vayenas, Sophia Rahimi, Nir Melamed","doi":"10.1002/ijgo.70036","DOIUrl":"https://doi.org/10.1002/ijgo.70036","url":null,"abstract":"<p><strong>Objective: </strong>To determine the accuracy of estimated fetal weight (EFW) and abdominal circumference (AC) discordance in diagnosing large birthweight (BW) discordance and selective fetal growth restriction (sFGR).</p><p><strong>Methods: </strong>Retrospective cohort study of patients with twin pregnancies followed at a tertiary center (N = 1065). We determined the accuracy of intertwin fetal size discordance (based on either EFW or fetal AC) at the last ultrasound exam before birth in estimating birthweight discordance and in diagnosing sFGR at birth.</p><p><strong>Results: </strong>EFW discordance was more accurate than AC discordance in estimating BW discordance as reflected by a smaller systematic error (-0.97% vs. -6.43%, respectively, P < 0.001) and mean absolute percentage error (5.70% vs. 7.35%, respectively, P < 0.001), and a larger proportion of cases with discordance within 5%, 10%, or 15% of BW discordance (53.1% vs. 45.4%, 84.3% vs. 72.4%, and 95.1% vs. 87.0%, respectively). Still, both EFW discordance and AC discordance had low diagnostic accuracy for large BW discordance and sFGR. For example, EFW discordance >20% had a sensitivity of 49.1% and a positive predictive value of 57.0% for BW discordance >20%, and the antenatal diagnosis of sFGR had a sensitivity of 45.8%-54.4% and a positive predictive value of 50.9%-55.2% for the postnatal diagnosis of sFGR.</p><p><strong>Conclusion: </strong>While EFW discordance was more accurate than AC discordance in estimating BW discordance, both measures had low diagnostic accuracy for large BW discordance and sFGR. Care providers should consider the limited diagnostic accuracy when making management decisions on the timing and mode of delivery.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542009","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":"An early prediction model for gestational diabetes mellitus created using machine learning algorithms.","authors":"Zhifen Yang, Xiaoyue Shi, Shengpu Wang, Lijia Du, Xiaoying Zhang, Kun Zhang, Yongqiang Zhang, Jinlong Ma, Rui Zheng","doi":"10.1002/ijgo.70055","DOIUrl":"https://doi.org/10.1002/ijgo.70055","url":null,"abstract":"<p><strong>Objective: </strong>To investigate high-risk factors for gestational diabetes mellitus (GDM) in early pregnancy through an analysis of demographic and clinical data, and to develops a machine-learning-based prediction model to enhance early diagnosis and intervention.</p><p><strong>Methods: </strong>A retrospective study was performed involving 942 pregnant women. A stacking ensemble (machine learning [ML]) was applied to demographic and clinical variables, creating a predictive model for GDM. Model performance was evaluated through receiver-operating characteristics (ROC) analysis, and the area under the curve (AUC) was calculated. Risk stratification was performed using quartile-based probability thresholds, and predictive accuracy was validated using an independent dataset.</p><p><strong>Results: </strong>Significant predictors for GDM included age, pre-pregnancy body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters), history of GDM, family history of diabetes, history of fetal macrosomia, education level, history of hypertension, and gravidity. These factors, which can be collected non-invasively at the first prenatal visit, formed the basis of a robust predictive model (AUC = 0.89). The model demonstrated a strong ability to exclude GDM, at a threshold of 28.53%.</p><p><strong>Conclusions: </strong>The machine-learning-based prediction model effectively identifies populations at high risk for GDM before invasive testing and oral glucose tolerance test, facilitating early clinical intervention and resource optimization.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542010","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 risk scoring model for predicting adverse maternal outcomes in pregnancy with pre-eclampsia.","authors":"Manaphat Suksai, Alan Geater, Pawinee Amornchat, Chitkasaem Suwanrath","doi":"10.1002/ijgo.70044","DOIUrl":"https://doi.org/10.1002/ijgo.70044","url":null,"abstract":"<p><strong>Objective: </strong>Pre-eclampsia can lead to mortality and morbidity. The aim of this study was to establish a multivariate model to predict the adverse maternal events associated with pre-eclampsia in the Thai population and to provide the composite measure of adverse perinatal events.</p><p><strong>Methods: </strong>A retrospective study was conducted at the Songklanagarind Hospital between January 2011 and December 2020. Multivariable logistic regression analysis was used to identify clinical risk factors for adverse maternal outcomes in pregnancies complicated with pre-eclampsia and to establish a predictive model. A nomogram was generated to determine the probability of adverse event in pre-eclampsia patient.</p><p><strong>Results: </strong>Of the 1094 cases of pre-eclampsia identified, 202 (18.46%) developed adverse outcomes. The majority of adverse consequences were cardiorespiratory complications (110 cases, 54.46%), intensive care unit admissions (66 cases, 32.67%), and hematologic disorders (50 cases, 24.75%). Maternal death occurred in four cases (0.37%). Significant risk factors included a history of drug abuse, dyspnea, visual disturbance, systolic blood pressure ≥180 mmHg, hemoglobin <10 g/dL, platelet count <150 000/μL, total bilirubin >0.8 mg/dL, aspartate aminotransferase >35 IU/L, lactate dehydrogenase >500 IU/L, INR >1, creatinine >1 mg/dL, urine protein/creatinine ratio >1 mg/mg, and uric acid >7.5 mg/dL. The regression model for prediction of adverse maternal outcomes in pre-eclampsia achieved a receiver operating characteristic area of 0.86 (95% confidence interval: 0.83-0.89). Pre-eclampsia patients with a total score of ≥3 had an increased risk of developing adverse maternal outcomes (sensitivity: 80%, specificity: 78%).</p><p><strong>Conclusion: </strong>A new simplified scoring model and nomogram based on clinical characteristics and laboratory tests were developed to facilitate risk stratification of adverse maternal outcomes associated with pre-eclampsia in routine clinical practice.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541910","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":"Comparison of transvaginal or transumbilical tissue extraction at laparoscopic gynecologic surgery: A 12-year experience.","authors":"Osman Aşıcıoğlu, Berhan Besimoglu, Sinan Ateş","doi":"10.1002/ijgo.70050","DOIUrl":"https://doi.org/10.1002/ijgo.70050","url":null,"abstract":"<p><strong>Objective: </strong>To present our surgical outcomes by comparing the transumbilical and transvaginal methods for the removal of specimens in laparoscopic surgery of fibroids and adnexal masses during our 12 years of experience.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at our referral center between January 2012 and April 2024. We evaluated surgical outcomes, patients' clinical-demographic characteristics, cosmetic-pain scores and dyspareunia by comparing the two methods that we use routinely.</p><p><strong>Results: </strong>We retrospectively reviewed 285 patients. Visual analog scale (VAS) scores at 24 h were lower in the transvaginal group than in the transumbilical group (0.4 ± 0.6 vs. 0.8 ± 0.8, P < 0.001). The 3-month postoperative cosmetic score (CS) was higher in the transvaginal group than in the transumbilical group (4.5 ± 0.5 vs. 4.1 ± 0.6, P < 0.001). Furthermore, myomectomy and transumbilical were independent risk factors for lower VAS scores 24 h post surgery (myomectomy: odds ratio [OR] 3.42, P = 0.001, transvaginal route: OR 0.41, P = 0.005). Finally, the transumbilical extraction route and extension of the umbilical incision were independent risk factors for lower CS (P = 0.035 and P = 0.028).</p><p><strong>Conclusion: </strong>Removal of the specimen via the transvaginal route in laparoscopic adnexal mass and fibroid surgeries may lead to less pain in the early postoperative period and better cosmetic results without increasing the duration of the operation, the rate of intraoperative complications, and the rate of dyspareunia.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542011","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":"Pregnancy outcomes following different surgical approaches for heterotopic interstitial and angular pregnancy.","authors":"Dan Feng, Tianjiao Liu, Li He, Li Lei","doi":"10.1002/ijgo.70054","DOIUrl":"https://doi.org/10.1002/ijgo.70054","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the perioperative and pregnancy outcomes among different surgical approaches and methods for treating heterotopic pregnancy (HP) and to identify the risk factors for the loss of intrauterine pregnancy (IUP).</p><p><strong>Methods: </strong>We retrospectively reviewed 59 cases of interstitial and angular HP treated surgically between 2014 and 2024 in two women's health centers in southwest China. Surgical methods included multi-port laparoscopy (MPL), transumbilical laparoendoscopic single-site surgery (TU-LESS), and conventional laparotomy (CL), along with cornual wedge resection and linear incision. Clinical outcomes were compared among IUP loss and successful IUP delivery; MPL, TU-LESS, and CL; and cornual wedge resection and linear incision groups. Binary logistic regression analysis was used to assess factors for predicting IUP loss.</p><p><strong>Results: </strong>There were 47 cases of live births of IUP. The operation duration was longer in the IUP-lost group (94.58 ± 32.51 min) versus the IUP-delivered group (67.29 ± 25.37 min, P = 0.001), and the incidence of hemorrhagic shock was significantly higher in the IUP-lost group (25% vs 2.1%, P = 0.024). There was one case of incomplete uterine rupture in the cornual wedge resection group. A history of biochemical pregnancy or missed abortion (Exp B = 32.610, P = 0.042), and fresh embryo transfer (Exp B = 0.126, P = 0.022) predicts IUP loss.</p><p><strong>Conclusion: </strong>CL, MPL, and TU-LESS, as well as cornual wedge resection and linear incision for treating HP, all showed comparable perioperative and IUP outcomes. Linear incision has relatively better surgical outcomes than cornual wedge resection. Factors such like fresh embryo transfer and a previous history of biochemical pregnancy or missed miscarriage predict IUP loss.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541940","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 role of heat shock proteins in placental ischemic disease: A narrative review of the current literature.","authors":"Athina A Samara, Anastasios Lafioniatis, Maria Ioannou, Sofia Tsiapakidou, Angeliki Gerede, Eleftherios Anastasakis, Alexandros Daponte, Sotirios Sotiriou","doi":"10.1002/ijgo.70039","DOIUrl":"https://doi.org/10.1002/ijgo.70039","url":null,"abstract":"<p><p>Pre-eclampsia, placental abruption, and fetal growth restriction (FGR) are collectively referred to as placental ischemic disease (PID). Heat shock proteins (HSPs), originally considered as a response to the heat shock, have a central role in regulating the cellular functions by quality controlling the newly synthesized proteins. The aim of the present review is to investigate the expression of the HSPs in PID and their potential role as biomarkers, based on the available data in the literature. A considerable amount of research has been conducted in order to determine the significance of HSPs in placental pathology and insufficiency, using both immunochemistry and circulating mRNA approaches. HSPs seem to be promising biomarkers that could be used for screening and monitoring the cellular stress of the placenta and its dysfunction. Yet, in order to be able to reach more solid evidence and draw a safer conclusion regarding their utility in clinical practice there is still a long way to go and further well-designed greater scale studies are required.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541941","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":"From tumor suspicion to tuberculoma discovery: A pregnancy case report and literature review.","authors":"Daniela Vinueza, David E Rebellón-Sánchez, Maria Alejandra Recio, Ana Maria Granados, Luis Alberto Escobar, Fernando Rosso","doi":"10.1002/ijgo.70045","DOIUrl":"https://doi.org/10.1002/ijgo.70045","url":null,"abstract":"<p><p>This article presents the case of a 22-year-old woman at 29 weeks of pregnancy, who exhibited recent onset neurologic symptoms including paresthesia of the right side of the face, involuntary myoclonic movements in the ipsilateral hand, 1 week of weakness in the right side of the body, and imaging features that were highly suggestive of a brain tumor diagnosis. A challenging decision making process was conducted by a team of multidisciplinary experts, leading to a consensus on adopting a conservative approach involving the use of steroids and antiepileptic medications, to which the patient responded favorably. When the patient reached 34 weeks of pregnancy, a cesarean section was performed, without complications, with the delivery of a healthy premature newborn. Upon delivery, surgical resection of the brain lesion was performed. Histopathologic analysis of the biopsy did not show signs consistent with neoplasia. Instead, it highlighted areas of necrosis along with the presence of granulomas and giant cells. Notably, despite extensive testing and staining for tuberculous bacilli across multiple samples yielding negative results, definitive confirmation was only secured via a gene X-pert test on the biopsied tissue. This diagnostic process emphasizes the importance of considering infectious diseases in atypical cases, highlighting the complexity of neurologic symptom assessment during pregnancy and the need to explore epidemiologic, systemic, and personal history factors.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542012","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}