International Journal of Gynecology & Obstetrics最新文献

{"title":"Extending the pregnancy from pre-viable to viable, the place of emergency cerclage.","authors":"Sampath Gnanarathne, Chandima Rathnayake","doi":"10.1002/ijgo.70530","DOIUrl":"https://doi.org/10.1002/ijgo.70530","url":null,"abstract":"<p><p>Emergency cervical cerclage is a critical intervention performed during the second trimester of pregnancy. Unlike elective cerclage performed prophylactically in early pregnancy, emergency cerclage is placed reactively in the presence of advanced cervical changes, often with exposed membranes, aiming to prolong pregnancy beyond viability. This case series retrospectively analyzed the outcomes of five patients who underwent emergency cervical cerclage for advanced cervical dilatation between January 1, 2025, and June 31, 2025. The mean pregnancy extension was 64 days, ranging from 5 to 143 days. Outcomes depended on factors such as the timing of the intervention, the type of suture material used, and the patient's clinical presentation. Two patients required a repeat cerclage. Of the five patients who underwent emergency cervical cerclage, four resulted in live births, while one case was complicated by a second-trimester pregnancy loss despite the intervention. This case series highlights the importance of timely diagnosis, appropriate patient selection, and meticulous surgical technique in optimizing outcomes following emergency cerclage. Despite the limited sample size, early intervention is a key factor in improving gestational prolongation and neonatal survival.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033205","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":"Postpartum hemorrhage: Findings of a global survey by the World Association of Trainees in Obstetrics and Gynecology (WATOG).","authors":"Akaninyene E Ubom, Zahra Muslim, Jolly Beyeza-Kashesya, Dietmar Schlembach, Zechariah J Malel, Ferdousi Begum, Inês Nunes, Alison Wright","doi":"10.1002/ijgo.70512","DOIUrl":"https://doi.org/10.1002/ijgo.70512","url":null,"abstract":"<p><p>Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality globally. This global survey was conducted to identify any disparities in the causes, prevalence, treatment, and mortality burden of PPH, with the aim of proposing relevant recommendations to bridge these disparities and ultimately reduce the global maternal mortality and morbidity burden of PPH. A cross-sectional survey of maternity care providers worldwide was conducted by the World Association of Trainees in Obstetrics and Gynecology (WATOG) in collaboration with International Federation of Gynecology and Obstetrics (FIGO) Childbirth and PPH Committee. The study instrument was a 15-item structured electronic questionnaire, designed using Google Forms®. The questionnaire included multiple choice and short answer questions on the baseline characteristics of respondents, causes, prevalence, treatment modalities, and mortality from PPH. The questionnaire was electronically distributed via WATOG and FIGO social media channels to study participants. In total, 339 responses were received from 64 countries in six regions, including Africa, Asia, Europe, North America, South America, and Oceania. The majority (n = 182, 53.7%) of respondents reported seeing an average of at least 10 cases of PPH in their hospitals each month. More respondents in low- and middle-income countries (LMICs) in Africa and Asia reported seeing more than 10 PPH cases monthly, compared to those in high-income countries in Europe and America (57.1% vs. 49.2%, P < 0.001). Most (n = 318, 93.8%) respondents volunteered that their hospitals recorded less than five PPH-related maternal mortalities monthly. All (n = 8, 2.4%) respondents who reported more than five PPH-related maternal mortalities were based in LMICs in Africa. Only 133 (39.2%) respondents reported availability of the non-pneumatic anti-shock garment (NASG) in their hospitals. Of those who reported non-availability of the NASG, 60% were in LMICs. The most common treatment for intractable PPH were uterine compression sutures (n = 177, 52.2%) and hysterectomy (n = 128, 37.8%). Less than 1 in 10 (n = 30, 8.8%) reported availability of vascular ligation and embolization procedures. PPH remains a significant obstetric complication globally, with a higher morbidity and mortality burden in LMICs. There is an urgent need for concerted global efforts to reduce maternal morbidity and mortality from PPH, especially in LMICs.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033149","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":"Vaginal endometriosis following uterine transplantation in a patient with Mayer-Rokitansky-Küster-Hauser syndrome: A unique case report.","authors":"Jana Moravcova, Roman Chmel, Jana Maluskova, Eva Sticova","doi":"10.1002/ijgo.70531","DOIUrl":"https://doi.org/10.1002/ijgo.70531","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029690","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":"Medical treatment of fibroids: FIGO best practice guidance.","authors":"Ivonne Diaz, Mary Ann Lumsden, Magdalena Zeppernick","doi":"10.1002/ijgo.70497","DOIUrl":"https://doi.org/10.1002/ijgo.70497","url":null,"abstract":"<p><p>Even though uterine fibroids are a widespread condition, the range of approved medical treatment options remains limited. In fact, only a few drugs are officially approved for the therapy of fibroids. In both the USA and the European Medicines Agency region, selected gonadotropin-releasing hormone (GnRH) antagonists have been approved for this indication. GnRH analogs are primarily indicated for the preoperative management of uterine fibroids, largely because of their unfavorable long-term adverse effect profile. The previously approved therapy with ulipristal acetate had to undergo extensive restrictions because of safety concerns. Nevertheless, there are additional medications that may be used in clinical practice. These include combined oral contraceptives, oral progestins, the levonorgestrel-releasing intrauterine system (LNG-IUS), and tranexamic acid. Although not specifically approved for the treatment of fibroids, these agents can reduce the intensity of bleeding in cases of heavy menstrual bleeding and thereby improve symptoms and lead to an improved quality of life for the patients.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029517","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 6-hour versus 12-hour cervical ripening balloon protocols in patients with prior cesarean delivery: A retrospective cohort study.","authors":"Rami Sammour, Shlomi Sagi, Michal Korobochka, Majd Abu Raia, Inna Bleicher","doi":"10.1002/ijgo.70537","DOIUrl":"https://doi.org/10.1002/ijgo.70537","url":null,"abstract":"<p><strong>Objective: </strong>To compare the mode of delivery and other maternal and neonatal outcomes in patients with one prior cesarean delivery undergoing labor induction with a cervical ripening balloon (CRB) for 6 h versus 12 h.</p><p><strong>Methods: </strong>This retrospective study compared two protocols for mechanical cervical ripening: CRB placement for 12 h (12-h group, implemented from 2014 to 2017) versus 6 h (6-h group, implemented from 2020 to 2021). The study included patients with one prior low-segment cesarean delivery. The primary outcome was mode of delivery, including the rate of vaginal birth after cesarean (VBAC). Secondary outcomes included cesarean delivery due to fetal distress or other indications, oxytocin use, umbilical cord pH, and neonatal intensive care unit (NICU) admission.</p><p><strong>Results: </strong>A total of 171 patients were included, with 80 in the 6-h group and 91 in the 12-h group. Patients in the 6-h group were older and more likely to have had a prior vaginal birth, while induction due to oligohydramnios was more common in the 12-h group. Adjusted VBAC rates were similar between the groups (53.7% vs. 51.6%, P = 0.99). Secondary maternal and neonatal outcomes were also comparable between the groups.</p><p><strong>Conclusion: </strong>Removal of the CRB after 6 h, as opposed to 12 h, does not negatively impact VBAC rates or other key maternal and neonatal outcomes in patients with a previous cesarean delivery. These findings suggest that a shorter CRB placement may be a viable option for this population.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029550","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":"Non-invasive prenatal testing: Navigating the ethical, legal, and social frontiers of modern obstetric practice.","authors":"Rachel O'Keeffe, Samantha Doyle","doi":"10.1002/ijgo.70534","DOIUrl":"https://doi.org/10.1002/ijgo.70534","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029540","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":"Levels of placental extracellular vesicles predicts fetal growth restriction and fetal distress in established severe pre-eclampsia.","authors":"Yuanyuan Chen, Yan Wang, Jing Ren, Jianlong Men, Cha Han","doi":"10.1002/ijgo.70521","DOIUrl":"https://doi.org/10.1002/ijgo.70521","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether plasma levels of placental extracellular vesicles (pcEVs), the EV-scavenging factor lactadherin, and prothrombotic markers predict fetal growth restriction (FGR) and/or fetal distress (FD) in established severe pre-eclampsia (sPE).</p><p><strong>Methods: </strong>We recruited 80 sPE patients, 41 normal pregnancies, and 27 non-pregnant women. SPE patients were further dichotomized into event and non-event groups based on the occurrence of FGR/FD during a follow-up period of 77 days. Plasma levels of pcEVs, lactadherin, von Willebrand factor (VWF), antithrombin (AT), and tissue plasminogen activator-plasminogen activator inhibitor complex (tPAI-C) were analyzed for predicting FGR and FD.</p><p><strong>Results: </strong>Plasma levels of pcEVs, lactadherin, VWF, and tPAI-C were progressively increased from non-pregnant women, women with normal pregnancies, and patients with sPE, whereas levels of AT were decreased. Subgroup analyses further showed that pcEVs, lactadherin, and tPAI-C were 2.7, 1.5, and 1.5 times higher in sPE patients with FGR/FD than those without FGR/FD. In contrast, levels of AT were decreased by 10%. The receiver operating characteristic (ROC) analysis found pcEVs to be 84.4% sensitive and 71.4% specific for predicting FGR/FD. Logistic regression analysis indicated that levels of pcEVs were associated with heavy proteinuria (OR = 4.657) and combined antihypertensive therapy (OR = 6.972) in sPE patients. Patients with pcEVs exceeding 6524/μL had an elevated cumulative risk of FGR/FD (log-rank χ² = 25.964, P = 0.000) and predicted FGR/FD in sPE patients, with a hazard ratio of 6.940.</p><p><strong>Conclusion: </strong>Plasma pcEVs may serve as an independent predictive biomarker for FGR/FD in sPE patients.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023289","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":"Diagnostic accuracy of combination of CA125 for endometriosis: A network meta-analysis.","authors":"Lan Wu, Zeyu Yang, Han Chen, Yunhe Piao","doi":"10.1002/ijgo.70509","DOIUrl":"https://doi.org/10.1002/ijgo.70509","url":null,"abstract":"<p><strong>Background: </strong>Currently, CA125 combined with other biomarkers significantly outperforms CA125 alone in diagnosing endometriosis (EM), but the efficiency of combined diagnosis remains unclear. This network meta-analysis compared the accuracy of CA125 combined with different biomarkers in diagnosing EM.</p><p><strong>Objectives: </strong>The aim of this study was to conduct a network meta-analysis (NMA) to evaluate the diagnostic accuracy of CA125 combined with different biomarkers for EM.</p><p><strong>Methods: </strong>Data were sourced from PubMed, Embase, Cochrane Library, and Web of Science databases. This meta-analysis was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines. Studies that compared the diagnostic accuracy between CA125 plus other biomarkers and CA125 alone (control) in patients with suspected EM were included. The agreement between CA125 alone and in combination with other biomarkers was assessed. NMA was performed, and the surface under the cumulative ranking curve (SUCRA) values were obtained to calculate the probability of which combination would be the most effective diagnostic method. The CINeMA tool was used to assess the quality of the included studies.</p><p><strong>Results: </strong>Direct comparison and inconsistency test and NMA were performed, and SUCRA values were obtained. A total of 10 articles were eligible for inclusion. CA125+CA19+IL-6 showed the highest SUCRA value in terms of sensitivity, positive predictive value and precision, followed by CA125+NLR. The quality of the included evidence was classified as moderate.</p><p><strong>Conclusion: </strong>This meta-analysis shows that CA125+CA199+IL-6 might be more efficient for diagnosing EM compared with other diagnostic methods.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023284","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 multicountry, multicenter report to identify nutritional risks in female populations using the FIGO Nutrition Checklist.","authors":"Alex K L Taylor, Lucy Murphy, Sophie Callanan, Sarah Louise Killeen, Sharleen L O'Reilly, Hema Divakar, Hamid Jan Bin Jan Mohamed, Mark A Hanson, Fionnuala M McAuliffe","doi":"10.1002/ijgo.70525","DOIUrl":"https://doi.org/10.1002/ijgo.70525","url":null,"abstract":"<p><strong>Objective: </strong>To identify potential nutritional risks for women using the FIGO Nutrition Checklist in relation to region, age and pregnancy/intention.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using 1515 responses from the online version of the FIGO Nutrition Checklist available on the FIGO website. Participants who responded \"No\" to at least one dietary question were classified as at potential nutritional risk.</p><p><strong>Results: </strong>Most participants (1432/1515, 94.5%) answered \"No\" to at least one of the diet quality questions. Low fish intake was the most common potential nutritional risk (687/1515, 45.3%), followed by limited pulses consumption (577/1515, 38.1%). Over half of the participants aged 17-44 years (653/1265, 51.6%) reported not taking a folic acid supplement. More women of post-reproductive age (>45 years) reported achieving the recommended standards for fruit and vegetables (166/236, 70.3% vs. 786/1265, 60.7%, P = 0.005), pulses (178/236, 75.4% vs. 749/1265, 59.2% vs. P < 0.001) and fish (147/236, 62.3% vs. 671/1265, 53% P = 0.009) compared with peak reproductive age participants. More non-pregnant women (<45 years) reported meeting the recommended standards for wholegrain foods (391/480, 81.5% vs. 598/782, 76.5%, P = 0.037) and meat, poultry or eggs (416/480, 86.7% vs. 623/782, 79.7%, P = 0.002) compared with pregnant/planning pregnancy participants. When the five FIGO regions were compared, Africa and the Eastern Mediterranean were more likely to achieve all nutritional requirements followed by North America. Nearly half of the Asia Oceania region reported at least four potential nutritional risks (191/401, 47.6%), higher than other world regions.</p><p><strong>Conclusion: </strong>Nutritional risk is a global concern. The FIGO Nutrition Checklist helps healthcare professionals identify potential nutritional risks in women's diets and supports national and international implementation of nutrition guidelines.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023257","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":"Developing the FIGO-IPPS \"R U MOVVING SOMe\" classification system for female chronic pelvic pain.","authors":"Georgine Lamvu, Juan D Villegas-Echeverri, Catherine Allaire, Sawsan As-Sanie, Jorge Carrillo, Susan Khalil, Andrew W Horne, Alexander Wang, Malcolm G Munro","doi":"10.1002/ijgo.70522","DOIUrl":"https://doi.org/10.1002/ijgo.70522","url":null,"abstract":"<p><p>The goal was to develop a pragmatic classification system for conditions associated with chronic pelvic pain (CPP), aiming to enhance diagnosis, management, education, and research of CPP. An international, multidisciplinary panel participated in a modified RAND/UCLA Delphi consensus. This panel included healthcare professionals, medical society representatives, experts, individuals with lived experience of pain, advocacy groups, researchers, educators, and journal editors. The Delphi process comprised three rounds: two online surveys and one virtual meeting. Participants scored their agreement with statements using a 9-point Likert scale (1 = strongly disagree, 9 = strongly agree). A priori criteria for consensus were defined as follows: agreement, a mean score ≥7 with <15% scoring ≤3; disagreement, a mean score ≤3 with <15% scoring ≥7. Responses not meeting these criteria were considered indeterminate and advanced for further refinement in subsequent rounds. In round 1, 65 of 77 (84.4%) stakeholders participated; round 2 consisted of responses from 54 (70.1%) stakeholders, and 34 (44.2%) stakeholders engaged in round 3. The Delphi process yielded broad consensus on the definition of CPP and a corresponding classification system with the acronym R U MOVVING SOMe. This novel system comprises 12 categories: Reproductive, Urinary, Musculoskeletal, Other (not otherwise classified), Vulvovaginal, Vascular, Idiopathic (no pain contributor identified), Neurologic, Gastrointestinal, Sensitization/Nociplastic, Overlapping pain conditions, and Mental health. The R U MOVVING SOMe classification system represents a significant step towards a standardized framework for evaluating CPP. The high level of engagement and consensus among a diverse group of international stakeholders underscores its future potential to improve communication, clinical practice, education, and research in this challenging field.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023249","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}