International Journal of Gynecology & Obstetrics最新文献

{"title":"Association between consumption of ultra-processed foods and glycemic self-monitoring in women with gestational diabetes mellitus and their newborns: A cohort study.","authors":"Amanda Gabriela Araújo da Silva, Maria Eliones de Oliveira Araújo, Amanda Maria Lira de Lucena, Iasmim Leite Fontes, Isabelle Lorena Barbosa De Lima, Pollyana Carvalho de Souza, Cristina Maria de Araujo Medeiros Santos, Juliana Fernandes Dos Santos Dametto, Karla Danielly da Silva Ribeiro","doi":"10.1002/ijgo.16047","DOIUrl":"https://doi.org/10.1002/ijgo.16047","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between the consumption of ultra-processed foods (UPFs) and outcomes of self-monitoring of blood glucose in pregnant woman with gestational diabetes mellitus (GDM) and the occurrence of hypoglycemia in their newborns.</p><p><strong>Methods: </strong>Prospective cohort study of pregnant woman with GDM who were followed up from the second trimester of pregnancy in high-risk prenatal care until the immediate postpartum period. Dietary intake was assessed using 24-h recalls and analyzed according to the Nova Classification. The glycemic profile was assessed by self-monitoring of fasting and postprandial capillary glycemia (pregnant) and by capillary glycemia in the first 48 h of life (neonate). Multilevel binary logistic regression models were used to assess the relationship between increasing UPF intake, considering the highest tertile of UPF consumption, and women's glycemic control and the occurrence of neonatal hypoglycemia.</p><p><strong>Results: </strong>UPFs provided 15% of calories consumed; 33.3% (n = 30) and 52.3% (n = 45) of the women had hyperglycemia in the second and third trimesters of pregnancy, respectively. After adjustment it was observed that UPF consumption had no significant association with maternal glycemic control but it showed a positive association with the occurrence of neonatal hypoglycemia (odds ratio [OR] 1.144, 95% confidence interval [CI] 1.037-1.262, p = 0.007).</p><p><strong>Conclusion: </strong>These data reinforce the need to address food processing during high-risk prenatal care in order to help reduce the negative impacts of UPF consumption on the mother-infant dyad.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785350","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":"Unusual synchronous and metachronous association of hematologic neoplasms with gynecologic neoplasms: A case series and literature review.","authors":"Ipek Betul Ozcivit Erkan, Oguzhan Kuru, Cansu Turker Saricoban, Marwa Wardak, Kubra Hamzaoglu Canbolat, Ahmet Emre Eskazan","doi":"10.1002/ijgo.16075","DOIUrl":"https://doi.org/10.1002/ijgo.16075","url":null,"abstract":"<p><p>The aim of the present study was to evaluate the occurrence of synchronous or metachronous hematologic and gynecologic malignancies. The medical database of the pathology department at a tertiary center was searched from 2016 to 2024 for cases involving both hematologic and gynecologic tumors. A literature search using Google Scholar and PubMed was also conducted between May and June 2024. Articles reporting surgical pathology data were included, while radiologic studies and those lacking pathology data were excluded. Cases involving one gynecologic cancer and one hematologic malignancy were analyzed. Three cases from our center and 25 cases from 15 English-language articles were identified. The mean age of the cases at diagnosis was 61.4 ± 9.4 years. A total of 19 patients (68%) were diagnosed with synchronous cancers, while the rest had metachronous diagnoses. Endometrial cancer was seen in 20 cases (71.4%): 14 synchronous and five metachronous endometrioid adenocarcinomas, and one unspecified metachronous endometrial cancer. This was followed by five cases of ovarian cancer (17.9%): three synchronous serous ovarian carcinomas, one metachronous serous ovarian carcinoma, and one synchronous ovarian adenocarcinoma. Additionally, there were two cases of cervical cancer (7.1%): one synchronous adenosquamous carcinoma and one metachronous invasive squamous carcinoma, and one case of carcinosarcoma (3.6%). Involvement of more than one site is possible for hematolymphoid cancer, commonly affecting the pelvic or para-aortic lymph nodes in 16 patients (57.1%), with other sites including the cervix (4 cases, 14.3%), ovary (4 cases, 14.3%), uterus (2 cases, 7.1%), iliac/inguinal lymph nodes (2 cases, 7.1%), fallopian tube (1 case, 3.6%), vagina (1 case, 3.6%), liver (1 case, 3.6%), abdomen (1 case, 3.6%), and appendix (1 case, 3.6%). Two cases were unspecified. Non-Hodgkin lymphoma (NHL), primarily of B cell lineage, was the most common hematologic malignancy (25 cases, 89.3%, with 22 cases being B cell lineage). In contrast, Hodgkin lymphoma was observed in two cases (7.1%), and acute leukemia in one case (3.6%). Among 21 patients with available follow-up data, eight died during the follow-up period. The co-occurrence of NHL, Hodgkin lymphoma, and acute leukemia with gynecologic cancers is rare. However, during surgery for gynecologic cancers, the potential of synchronous lymphoma should be considered, particularly in cases with unusual retroperitoneal lymphadenopathy.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785533","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 predictive model for endometrial cancer recurrence based on molecular markers and clinicopathologic parameters: A double-center retrospective study.","authors":"Yuanyang Yao, Xiaoxiao Luo, Peng Jiang, Heying Liu, Yanzhou Wang, Li Deng, Zhiqing Liang","doi":"10.1002/ijgo.16062","DOIUrl":"https://doi.org/10.1002/ijgo.16062","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to establish a predictive model for endometrial cancer (EC) recurrence based on commonly used molecular markers and clinicopathologic parameters.</p><p><strong>Methods: </strong>This was a double-center retrospective study. The data of patients were retrospectively collected from two tertiary hospitals in Chongqing, China. The patients were divided into training and validation cohorts according to the ratio of 7:3. In the training cohort, the factors related to the recurrence were screened through uni- and multivariate Cox regression analysis, and a nomogram was constructed based on this. Internal and external validation of the model was performed in two cohorts, respectively. In the training cohort, the optimal risk threshold of the model was determined by using the receiver operating characteristic (ROC) curve and the maximum value of the Youden index.</p><p><strong>Results: </strong>A total of 1348 patients were included, including 944 in the training cohort and 404 in the validation cohort. Multivariate analysis suggested that ER expression, P53 expression and other clinicopathologic parameters, were significantly related to recurrence. On this basis, a nomogram was constructed to predict 1-, 3-, and 5-year recurrence-free survival (RFS) rate. The model had good predictive accuracy in both cohorts through the validation. The ROC curve and Youden index suggested that the optimal risk threshold of 3-year RFS rate predicted by the model was 0.83, and there was a significant survival difference between the high- and low-risk groups.</p><p><strong>Conclusion: </strong>Compared to traditional prediction models, the model proposed in this study that combined molecular indicators and clinicopathologic parameters can better predict the prognosis of EC patients.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785331","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 accuracy of DNA methylation detection in endometrial cancer screening: A systematic review and meta-analysis.","authors":"Ran Ran, Ming Wang, Jin Wei Miao","doi":"10.1002/ijgo.16058","DOIUrl":"https://doi.org/10.1002/ijgo.16058","url":null,"abstract":"<p><strong>Objective: </strong>DNA methylation is the hallmark of early endometrial cancer and can be detected through non-invasive methods. The present study systematically reviewed the efficacy of DNA methylation detection for endometrial cancer screening through exfoliative cytology.</p><p><strong>Methods: </strong>A systematic literature review was performed through the following databases from inception to October 7, 2024: PubMed, Embase, and the Cochrane Library. Studies on DNA methylation detection for endometrial cancer screening through exfoliative cytology were included. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relevant variables included cytologic sample type, methylated genes, and marker performance (i.e., AUC value, sensitivity, specificity, and the corresponding 95% confidence interval [CI]), as well as the bias risk assessment according to the Cochrane Collaboration tool (Cochrane Intervention Systematic Review Guide 5.1.0).</p><p><strong>Results: </strong>A total of 31 genes were selected from 20 studies as methylation markers for endometrial cancer detection in cytologic specimens. A total of 19 methylation markers for endometrial cancer detection with an area under the curve value from 0.80 to 0.97 were selected from 10 studies.</p><p><strong>Conclusion: </strong>Cytology-based DNA methylation markers are feasible and accurate non-invasive methods for the early detection of endometrial cancer screening in high-risk populations.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785526","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":"Interventions for recurrent embryo implantation failure: An umbrella review.","authors":"Abdulla Almohammadi, Fadi Choucair, Khalid S Khan, Aurora Bueno-Cavanillas, Naomi Cano-Ibáñez","doi":"10.1002/ijgo.16066","DOIUrl":"https://doi.org/10.1002/ijgo.16066","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Recurrent implantation failure (RIF) has a multifactorial etiology. An umbrella review was undertaken to evaluate the multiple proposed interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To summarize and assess the strength of evidence of interventions for RIF from published systematic reviews (SR) of randomized clinical trials (RCTs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search strategy: &lt;/strong&gt;After prospective registration (PROSPERO CRD42023414255), a systematic search was conducted in the Cochrane Library, Scopus and Medline from inception until March 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;SRs of RCTs, with or without meta-analyses (MA), were included if they reported clinical pregnancy rates (CPR) or live birth rates (LBR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;The methodological quality of the included SRs was appraised independently in duplicate using the AMSTAR 2 tool. For each intervention, the MAs of RCTs with statistically significant improvements were counted as a percentage of the total assessing the strength of evidence using the GRADE system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;A total of 47 SRs were included: 32 reviews covered immunomodulatory interventions, 10 (68 RCTs) covered uterine and endometrial interventions, one covered antibiotics, and four (69 RCTs) addressed mixed approaches, including laboratory interventions. AMSTAR 2 appraised 41 (88%) SRs as critically low or low, and 6 (12%) as moderate or high in quality. The SRs often had a level of overlap of RCTs (median 33.3%), inconsistent definitions of RIF, and varied comparisons for the interventions. Considering the significant meta-analytic evidence of high-moderate GRADE strength: Granulocyte colony-stimulating factor (G-CSF) showed improvement in CPR in 9/13 (69.2%) MAs and LBR in 1/7 (14%); intralipid infusion showed improvement in CPR in 4/6 (57.14%) MAs and LBR in 3/4 (75%); peripheral blood mononuclear cells (PBMC) showed improvement in CPR in 4/8 (50%) MAs and LBR 3/5 (60%); platelet-rich plasma (PRP) intervention showed improvement in CPR in 6/10 (60%) MAs and LBR in 1/5 (20%); human chorionic gonadotropins showed improvement in CPR in 3/3 (100%) MAs; growth hormone showed improvement in CPR in 1/1 (100%) MA; low molecular weight heparin showed improvement in CPR in 1/1 (100%) MAs and LBR in 1/2 (50%); hysteroscopy showed improvement in CPR in 1/2 (50%) MAs; and, intentional endometrial injury showed improvement in CPR in 3/4 (75%) MAs and LBR in 2/3 (66.66%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Evidence syntheses of RCTs evaluating interventions for RIF suggest a consistent direction, with high to moderate strength, indicating that immunomodulatory treatments, including G-CSF, PBMC, PRP, intralipid infusion, and intentional endometrial injury are likely to be effective. However, this conclusion should be interpreted with caution due to the generally low methodological quality of the included studies and the clinical heteroge","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785521","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":"Cesarean section with operation on placental support as an adapted EXIT procedure for fetal thyroid goiter: A case report and literature review.","authors":"Sanpon Diawtipsukon, Woraluk Moradokkasem, Nareenun Chansriniyom, Pracha Nuntnarumit","doi":"10.1002/ijgo.16060","DOIUrl":"https://doi.org/10.1002/ijgo.16060","url":null,"abstract":"<p><p>The ex-utero intrapartum treatment (EXIT) procedure is a specialized delivery strategy that extends utero-placental-fetal circulation to convert a potential neonatal emergency condition into a condition that is compatible with postnatal life. Cesarean section with operation on placental support is an EXIT technique that requires a relatively short duration of placental support and few skilled medical personnel and specialized instruments; it can successfully treat selected fetal indications. In the present study, we report a case of fetal thyroid goiter as an example of a fetal anomaly requiring the procedure. We then review all cases published in the medical literature that were similar to our procedure (15 cases including our new case). Twelve (80%) cases of fetal anomalies and three prophylactic cases of extremely low birth weight were delivered using a procedure adapted from the standard EXIT procedure. All 12 cases of fetal anomalies were treated by airway intervention. In 12 of the 15 cases (80%), direct laryngoscopy and endotracheal intubation were attempted; intubation was successful in seven of these 12 cases (58%). There was only one case of postpartum hemorrhage caused by uterine incisional bleeding, with a consequence of delayed hysterotomy closure. In summary, cesarean section with operation on placental support is a promising alternative delivery technique for neonates with airway obstructive lesions, especially in resource-limited settings.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785355","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":"Maternal oxygenation and fetal-neonatal mortality among patients with COVID-19 requiring advanced respiratory support in ICU: A multicenter prospective cohort study.","authors":"Daniela N Vasquez, Roberto Giannoni, Adriana Salvatierra, Karina Cisneros, Diego Lafosse, María F Escobar, Martín Montenegro, Paula Juárez, Lucía Visani, Verónica Mandich, Erika Barrozo, Mariana Kirschbaum, Andrea V Das Neves, María F Valenti, María C Canseco, Ignacio Romero, Pedro Macharé, Ana K Marquez, Eva Rodriguez, Cristina Palacio, Laura Rapela, José M Amillategui Scenna, Rosshanna Nuñez, Sebastián Torres, Miguel A González, Lorena Franconieri, Daniela Nasner, Patricia Okurzaty, Gustavo A Plotnikow, Alfredo D Intile","doi":"10.1002/ijgo.16046","DOIUrl":"https://doi.org/10.1002/ijgo.16046","url":null,"abstract":"<p><strong>Objective: </strong>To explore the association of maternal characteristics, oxygenation, and mechanical ventilatory parameters with fetal and neonatal outcomes.</p><p><strong>Methods: </strong>The present study was a multicenter, binational (Argentina/Colombia), prospective, cohort study, conducted in 21 intensive care units (ICUs) and including pregnant or postpartum patients with COVID-19 pneumonia requiring advanced respiratory support and their fetuses/neonates. Advanced respiratory support was defined as high-flow nasal cannula (HFNC), non-invasive ventilation (NIV) or invasive mechanical ventilation (IMV).</p><p><strong>Results: </strong>A total of 91 patients were admitted to 21 ICUs: 63 (69%) antepartum and 28 (31%) postpartum. Among those admitted antepartum (63), delivery was induced in 43 (68.3%), being the reasons mostly maternal (28/43; 65.1%). Of 71 births, 64 (90%) were preterm. A total of 14 fetal/neonatal losses (14/91;15.4%) occurred. The main differences between patients whose fetuses/neonates survived versus those who did not survive were in APACHE II (12 [7-15] vs. 16.5 [14-20]; P = 0.003), SOFA₂₄ (4 [3-5] vs. 6.5 [5-8]; P = 0.001), gestational age at delivery (32.9 ± 3 vs. 27.6 ± 6.2; P = 0.014), acute respiratory distress syndrome (54 [70.1%] vs. 14 [100%]; P = 0.011), septic shock (26 [33.8%] vs. 9 [64.3%]; P = 0.031), IMV (55 [71.4%] vs. 14 [100%]; P = 0.019) and plateau pressure before delivery (23 [21-26] vs. 28 [27-30]; P = 0.019). The incidence of fetal/neonatal mortality among 47 pregnant patients requiring IMV with SpO₂ < 95% versus SpO₂ >95% before intubation was 12/35 (34.28%) versus 1/12 (8.33%), respectively; P = 0.163. The incidence of fetal/neonatal mortality among those with SpO₂ <95% versus SpO₂ >95% before delivery was 5/18 (27.77%) versus 8/29 (25.58%), respectively; P = 0.999.</p><p><strong>Conclusion: </strong>The vast majority of births were preterm. Among patients admitted antepartum, most deliveries were induced for maternal reasons. Fetal/neonatal losses were associated with gestational age at delivery, maternal severity of illness on admission and certain ventilatory parameters but not with maternal oxygenation, as is commonly the focus in these patients.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785523","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":"Capacity building in obstetric ultrasound: Impact of simulation based clinical teaching on resident training at a health facility in India.","authors":"Latika Chawla, Rajan Kumar, Shalini Rajaram, Shalinee Rao, Kanak Dubey, Anupama Bahadur, Amrita Gaurav, Kavita Khoiwal, Rajlaxmi Mundra, Om Kumari, Poonam Gill, Jaya Chaturvedi","doi":"10.1002/ijgo.16076","DOIUrl":"https://doi.org/10.1002/ijgo.16076","url":null,"abstract":"<p><strong>Objective: </strong>Current postgraduate curriculum in India lacks practical training in ultrasound for residents in obstetrics and gynecology. The objective of this study was to develop and assess impact of a capacity building program utilizing clinical teaching and simulation to enhance knowledge and skills of residents at a healthcare facility in India.</p><p><strong>Methods: </strong>A training program comprising of 14 modules on basic obstetric ultrasounds was created over 3 months. These modules, validated by fetal medicine experts, underwent a pilot study for face validity. A total of 18 newly enrolled junior residents without prior ultrasound experience were recruited. A two-day workshop included interactive module sessions and 6 h and 30 min of hands-on training using an obstetric simulator. Pre- and post-tests consisting of 50 multiple-choice questions (MCQs) assessed knowledge. Follow-up assessments were carried out at 1 and 3 months. Skill assessment at the third month was conducted using an objective structured practical examination (OSPE), alongside image submission by residents.</p><p><strong>Results: </strong>There was significant improvement in marks over time, with a mean pretest score of 24 ± 2.7 out of 50 marks, post-test score of 36.81 ± 2.86 and stable scores (34.6 ± 3.21, 34.4 ± 2.96) during follow-up reviews. OSPE scores at third month averaged at 21.47 ± 2.3 (maximum marks 30); image assessment scores averaged at 83 ± 8.62 (maximum marks 100). Participant feedback indicated a positive response to all program aspects (practicality, content and structured training). Confidence levels in performing clinical ultrasound improved significantly after attending the module (P < 0.0001).</p><p><strong>Conclusion: </strong>Simulation with clinical teaching effectively enhanced knowledge and skills of residents, fostering confidence in performing basic obstetric ultrasounds early on in their residency. Integrating similar capacity building initiatives into residency training programs can improve healthcare delivery by ensuring a well prepared cadre of doctors skilled in obstetric ultrasounds.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768104","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":"Brazil regresses in defending the sexual and reproductive health of its girls and women.","authors":"José Paulo de Siqueira Guida, Fernanda Surita, Sara de Pinho Cunha Paiva, Rosires Pereira Andrade, Silvana Maria Quintana, Aline Veras Morais Brilhante, Cristião Fernando Rosas, Marla Niag Dos Santos Rocha, Marcia Sacramento Cunha Machado","doi":"10.1002/ijgo.16065","DOIUrl":"https://doi.org/10.1002/ijgo.16065","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768121","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":"Yield of endocervical curettage in detecting cervical intraepithelial neoplasia grade 2 or higher during colposcopy: A prospective, cross-sectional study.","authors":"Nida Jareemit, Lalita Theerarojanapong, Natthawadee Laokulrath, Vuthinun Achariyapota, Khemanat Khemworapong, Sompop Kuljarasnont, Pornporm Ittiamornlert, Vitcha Poonyakanok, Perapong Inthasorn","doi":"10.1002/ijgo.16074","DOIUrl":"https://doi.org/10.1002/ijgo.16074","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed the prevalence and factors associated with detecting cervical intraepithelial neoplasia grade 2 or higher (CIN2+) via endocervical curettage (ECC) during colposcopy.</p><p><strong>Methods: </strong>Between December 2020 and September 2023, a prospective, cross-sectional study involving women with abnormal cervical cancer screening results who underwent colposcopy was conducted. ECC was performed via a Kevorkian endocervical curette following colposcopy-directed biopsy. The exclusion criteria were glandular cytology abnormalities, pregnancy, post-hysterectomy status, and cervical cancer.</p><p><strong>Results: </strong>The study included 569 women, with a mean age of 41.6 ± 11.7 years. Among the participants, 78.9% presented with low-grade cytology, whereas 21.1% presented with high-grade cytology. All of the patients underwent ECC, with 0.4% (two patients) yielding inadequate samples. ECC detected CIN2+ lesions in 11.6% of the patients (95% confidence interval [CI], 9-14.3). Univariable analysis revealed that age, menopausal status, history of CIN2+, high-grade cytology, and high-grade colposcopy impression were significant factors for CIN2+ detection by ECC. Multivariable analysis confirmed high-grade cytology as the sole independent factor (adjusted odds ratio [OR], 13.81 [95% CI, 4.60-41.42], P < 0.001). ECC added a diagnostic yield of 2.9% (95% CI, 1.5-4.3) for detecting CIN2+ lesions missed by colposcopy-directed biopsy. Multivariable analysis demonstrated an independent association between human papillomavirus 16 (HPV-16) infection and the additional diagnostic benefit of ECC, with an adjusted odds ratio (OR) of 6.26 (95% CI, 1.49-26.23, P = 0.012).</p><p><strong>Conclusion: </strong>This study highlights the critical role of ECC in detecting CIN2+ lesions, particularly in patients with high-grade cytology or HPV-16 positivity.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768715","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}