International Journal of Gynecology & Obstetrics最新文献

{"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}

{"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}