International Journal of Gynecology & Obstetrics最新文献

{"title":"The rising tide: Trends in induction of labor at term over a 5-year period at a single centre.","authors":"Sarah M Nicholson, Susan Hatt, Etaoin M Kent, Michael P Geary, Patrick Dicker, Zara E Molphy, Karen Flood, Fergal D Malone","doi":"10.1002/ijgo.16054","DOIUrl":"https://doi.org/10.1002/ijgo.16054","url":null,"abstract":"<p><strong>Objective: </strong>Induction of labor (IOL) is a controversial topic in contemporary obstetric practice, with some suggesting that the increase in elective induction (eIOL) as a potential contributor to increasing cesarean delivery (CD) rates. The objectives of this single-center study were to examine the rates of IOL, trends in indications for IOL, and the contribution of IOL to the overall CD rate at one of Europe's largest obstetric hospitals.</p><p><strong>Methods: </strong>This retrospective observational cohort study evaluated the outcomes of patients who were delivered following IOL from 2018 to 2022 inclusive at the largest obstetric hospital in Ireland.</p><p><strong>Results: </strong>A total of 36 938 women (16 155 nulliparous and 20 783 multiparous) were delivered during the 5-year study period, of whom 8072 nulliparous and 6343 multiparous women underwent IOL. There was a significant increase in rates of induction, increasing from 42% to 57% (P <0.001) in nulliparous women, and from 27% to 33% (P < 0.001) in multiparous women. The highest contributions to the hospital CD rate were from those being induced for 'fetal' (5%), spontaneous rupture of membranes ('SROM') (4%), and 'maternal' (4%) reasons, with the lowest CD rates in the eIOL category (<1%) in both groups.</p><p><strong>Conclusion: </strong>Our data confirm that the rate of IOL is increasing. The contribution of maternal and fetal reasons for IOL to the overall CD rate may reflect increasing numbers of higher-risk pregnancies. Despite current controversy regarding the role of eIOL, our data do not confirm a significant contribution to either the overall IOL or CD rates in this center.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709967","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":"Menstrual suppression to decrease intrauterine device expulsion in adolescents with inherited bleeding disorders.","authors":"Peter H Cygan, Kelly M Kons, Megan H Fiorillo, Tonya S Wright","doi":"10.1002/ijgo.16063","DOIUrl":"https://doi.org/10.1002/ijgo.16063","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709960","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":"HPV E6/E7 mRNA screening alone can be used as a screening method for cervical cancer in premenopausal women in China: A retrospective study.","authors":"Ying Liu, Shirong Yang, Yingying Ma, Yingying Gong, Beibei Du, Yunfei Wang, Linqing Yang","doi":"10.1002/ijgo.16043","DOIUrl":"https://doi.org/10.1002/ijgo.16043","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the value of a HPV E6/E7 mRNA assay (Aptima® HPV [AHPV]) for primary cervical cancer screening combined with menopausal status.</p><p><strong>Methods: </strong>A total of 16 917 women underwent AHPV testing and had complete histopathological results at the Affiliated Hospital of Jining Medical University China between January 1, 2017 and March 31, 2022. We evaluated the performance of different screening strategies and combined strategies, as well as evaluations of different menopausal states.</p><p><strong>Results: </strong>When identifying LSIL+ (includes low- and high-grade squamous intraepithelial lesions and invasive cervical cancer [ICC]), the sensitivity (91.2%) and negative predictive value (NPV; 96.6%) were significantly higher for AHPV than for liquid-based cytology assay (LBC; 33.2% and 84.7% for sensitivity and NPV, respectively). Furthermore, the co-testing strategy (cytology combined with AHPV), when compared with AHPV, achieved a slightly higher sensitivity (93.6% vs. 91.2%, respectively, P < 0.001), a similar specificity (61.3% vs. 62.7%, respectively, P = 0.014), a similar positive predictive value (PPV; 37.5% vs. 37.8%, respectively, P = 0.709) and a similar NPV (97.5% vs. 96.6%, respectively, P = 0.001). Moreover, AHPV (when compared with menopausal women) achieved a higher sensitivity (93.5% vs. 77.7%, respectively, P < 0.001), a higher NPV (97.3% vs. 93.9%, respectively, P < 0.001), a similar PPV (37.8% vs. 37.0%, respectively, P = 0.618) and a slightly lower specificity (60.7% vs. 72.1%, respectively, P < 0.001) in premenopausal women. These results were similar when identifying HSIL+ (includes high-grade squamous intraepithelial lesion and ICC).</p><p><strong>Conclusion: </strong>The present study suggests that initial screening with HPV E6/E7 mRNA testing rather than combined screening is a suitable candidate for cervical cancer screening in China (especially for premenopausal women) based on economic reasons.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709729","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":"Post-abortal/postpartum uterine vascular malformations: Are they overdiagnosed?","authors":"Tanvi Katoch, Vanita Jain, Rashmi Bagga, Vanita Suri, Harish Bhujade","doi":"10.1002/ijgo.16049","DOIUrl":"https://doi.org/10.1002/ijgo.16049","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692915","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":"Vascular dysfunction in women with recurrent pregnancy loss: Possible association with antiphospholipid antibodies.","authors":"Titi Yang, Emi Okada, Maho Todoroki, Siyu Liu, Rukmali Athurupana, Kumie Kataoka, Chiaki Kashino, Takashi Mitsui, Toru Hasegawa, Yasuhiko Kamada, Hisashi Masuyama, Mikiya Nakatsuka","doi":"10.1002/ijgo.16051","DOIUrl":"https://doi.org/10.1002/ijgo.16051","url":null,"abstract":"<p><strong>Objective: </strong>Antiphospholipid antibodies (aPL) are recognized to have a pivotal role in recurrent pregnancy loss (RPL) and cardiovascular disease. Therefore, we assessed the vascular function of women with RPL and examined the association with each type of aPL.</p><p><strong>Methods: </strong>In this retrospective study, 569 women with RPL and 55 healthy women who had never experienced pregnancy loss were recruited. We performed blood tests for aPL and acceleration plethysmography (APG) to evaluate peripheral vascular function.</p><p><strong>Results: </strong>The differential pulse wave index (DPI), indicating vascular elasticity, was significantly lower in women with RPL (115.6 ± 4.1) compared to the control group (117.0 ± 2.3). DPI in RPL women with anti-β₂ glycoprotein I (aβ₂GPI) IgG was significantly lower than those without. Remained blood volume (RBV), indicating post-vasoconstriction blood content, was significantly higher in RPL women with aβ₂GI IgG than in those without. Regression analysis showed aβ₂GPI IgG and body mass index (BMI) linked negatively with DPI.</p><p><strong>Conclusion: </strong>Women with RPL have subclinical vascular dysfunction even at reproductive age. It is possible that aβ₂GPI IgG is associated with vascular dysfunction in RPL women.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692918","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":"Analysis of risk factors for very early preterm and early preterm birth in twins following in vitro fertilization and intracytoplasmic sperm injection-assisted pregnancy: A retrospective study.","authors":"Huaying Yu, Songying Zhang, Bin Chen, Minling Wei, Aike Xu, Feng Zhou","doi":"10.1002/ijgo.16022","DOIUrl":"https://doi.org/10.1002/ijgo.16022","url":null,"abstract":"<p><p>To investigate the risk factors influencing very early preterm and early preterm births in twin pregnancies after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). This retrospective study analyzed 2042 twin pregnancies that underwent embryo transfer via IVF/ICSI at the Reproductive Center of Sir Run Run Shaw Hospital between January 2019 and December 2022. Spontaneous very early, early preterm, and provider-initiated preterm births were examined separately. Based on gestational age, participants were categorized into three groups: very early preterm birth (<28 weeks), early preterm birth (≥28 to <34 weeks), and ongoing pregnancy (≥34 weeks). Univariate analysis was conducted to assess general conditions, among the three groups. Multiple logistic regression analysis was performed to identify independent risk factors for very early and early spontaneous preterm birth in twin pregnancies. A total of 2042 twin pregnancies were included in the study, with birth rates of 4.36% (89 of 2042) <28 weeks, 12.14% (248 of 2042) ≥28 to <34 weeks, and 83.50% (1705 of 2042) ≥34 weeks. The primary cause of provider-initiated preterm birth <28 weeks was placental factors, while hypertensive disorders of pregnancy (31.11%) were the predominant cause for preterm births ≥28 to <34 weeks. Multiple logistic regression analysis identified the independent risk factors for births <28 weeks (P < 0.05) as cervical cerclage, history of late miscarriage or premature birth, uterine adhesions, primary infertility of polycystic ovary syndrome (PCOS), monochorionic pregnancies, history of cervical surgery, uterine malformations, body mass index ≥25 kg/m², and uterine longitudinal axis lengths <3.6 cm. Cervical cerclage, main factors of infertility (PCOS), adenomyosis, and uterine longitudinal axis lengths <3.6 cm were identified as independent risk factors for ≥28 to 34 weeks (P < 0.05). It is crucial to consider risk factors during IVF/ICSI treatment because of the high incidence of very early and early preterm twin pregnancies, which can be identified early and properly managed.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692908","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":"Anti-NMDA receptor autoimmune encephalitis associated with ovarian teratoma: A case series and literature review.","authors":"Pham Ba Nha, Nguyen Phuong Tu, Nguyen Viet Ha, Duong Thi Thu Hien, Nguyen Thi Thu Phuong, Nguyen Anh Son, Nguyen Tien Hoang","doi":"10.1002/ijgo.16028","DOIUrl":"https://doi.org/10.1002/ijgo.16028","url":null,"abstract":"<p><p>Autoimmune encephalitis is a group of disorders characterized by symptoms of dysfunction of the limbic and extra-limbic systems that occur in association with antibodies against intracellular antigens, synapses, or proteins located on the surface of nerve cells. Anti-NMDA (N-methyl-D-aspartate) receptor encephalitis was first described in 2007 and has become one of the most commonly recognized autoimmune encephalitides. The disease is predominantly female (81%) and affects young patients (37% <18 years old, 95% <45 years old), with up to 58% of women over 18 years old having ovarian teratoma. Clinical symptoms of anti-NMDA receptor encephalitis include psychiatric disorders (anxiety, agitation, bizarre behavior, hallucinations, delusions, and memory impairment); seizures and epileptic states; and other neurologic symptoms (muscle tone abnormalities, eye movement disorders, and central ventilatory disorders). Diagnosis of this condition can be difficult due to the non-specific nature of the symptoms, often leading to delays in appropriate treatment. Early diagnosis and timely treatment of anti-NMDA receptor encephalitis, especially in young women with ovarian teratoma, has significantly improved the chances of full recovery and improved reproductive health outcomes for patients.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692910","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, management and treatment of acquired uterine arteriovenous malformation: A case series and literature review.","authors":"Lei Yu, Xue Xiao","doi":"10.1002/ijgo.16023","DOIUrl":"https://doi.org/10.1002/ijgo.16023","url":null,"abstract":"<p><p>The rising prevalence of cesarean sections, abortions, and other surgical interventions involving the uterus has led to an increased incidence of acquired uterine arteriovenous malformations (AVMs). These malformations primarily present as vaginal bleeding, which can significantly impair the quality of life for affected individuals and can pose life-threatening risks in severe instances. Currently, there exists considerable variability in the clinical manifestations, treatment indications, and outcomes associated with uterine AVMs, which substantially complicates clinical diagnosis and management. In this report, we present five cases of uterine AVM that developed following abortion and were treated at our institution. The patients underwent various treatment modalities, with all but one achieving a high rate of fertility preservation. We underscore the importance of tailoring AVM treatment to factors such as patient age, volume of vaginal bleeding, urgency of the situation, size of the lesion, and fertility aspirations.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692914","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 potential hazards of high doses of vitamin B6 in treating nausea and vomiting in pregnancy: A systematic review.","authors":"Ling He, Yulin Fan, Yuanmei Hu, Chunhua Tian, Ying Tian, Jidong Zhang, Yanping Ren, Jun Tan","doi":"10.1002/ijgo.16032","DOIUrl":"https://doi.org/10.1002/ijgo.16032","url":null,"abstract":"<p><p>Vitamin B6 is frequently utilized as a therapeutic agent for nausea and vomiting of pregnancy (NVP). Research indicates that excessive intake of vitamin B6 can have implications on neurological function, underscoring the importance of cautious consideration when administering vitamin B6 treatment during early pregnancy. This systematic review investigates the effects of high doses of vitamin B6 on pregnant women experiencing NVP. We searched the PubMed® MEDLINE® database for articles using the following terms: \"pregnancy\" or \"nausea and vomiting during pregnancy\" and \"vitamin B6.\" Women with nausea and vomiting symptoms during pregnancy use more than the tolerable amount of vitamin B6. A total of 136 articles were identified from the PubMed® MEDLINE® database. The etiology and treatment of NVP are briefly outlined, followed by a summary and analysis of 19 relevant literature sources. Among these sources, 12 reports detailed the adverse effects of excessive vitamin B6 intake in women; 164/1226 individuals experienced neurological symptoms such as burning, tingling, paresthesia, ataxia, or perioral numbness. Additionally, out of 245 women, four experienced miscarriages and one had an intrauterine demise. The overconsumption of vitamin B6 has the potential to impact nerve function, particularly during the critical first trimester of embryonic development. It might result in adverse outcomes such as miscarriage, intrauterine fetal demise, and congenital abnormalities.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681686","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":"Optimal timing for induction of labor in normotensive women: A retrospective cohort study.","authors":"Jóhanna Gunnarsdóttir, Emma Marie Swift, Alexander Smárason, Kristjana Einarsdóttir","doi":"10.1002/ijgo.16050","DOIUrl":"https://doi.org/10.1002/ijgo.16050","url":null,"abstract":"<p><strong>Objective: </strong>Labor induction is offered to reduce the risk of stillbirth at late term (41⁺⁰ to 41⁺⁶) but earlier induction in normotensive singleton pregnancies is supported by weak evidence. The aim of the present study was to investigate the optimal timing for induction in normotensive women.</p><p><strong>Methods: </strong>This was a retrospective cohort study including 70 293 singleton term births in Iceland during 1997-2018. Women with serious pre-gestational comorbidity, hypertension, stillbirth or previous cesarean birth were excluded. The risk of adverse maternal and neonatal outcomes for induction at each week from gestational age 37-41 weeks was compared with expectant management, defined as deliveries at a later gestational age. Risk ratios (RRs) and 95% confidence intervals (95% CI) were calculated using log-binomial regression adjusting for sociodemographics, parity, and pregnancy complications.</p><p><strong>Results: </strong>The risk of cesarean was lower with induction at ≥40⁺⁰ than expectant management, especially at late term (RR 0.73, 95% CI: 0.63-0.83). Respiratory distress was diagnosed in 4.4% of infants after induction from 37⁺⁰ to 37⁺⁶ but 1.3% in the expectant management group (RR 3.08, 95% CI: 1.97-4.81). Induction between 37⁺⁰ and 38⁺⁶ compared with expectant management was associated with a reduced risk of shoulder dystocia, but this was non-significant in births of infants with normal birthweight.</p><p><strong>Conclusion: </strong>Labor induction from 40⁺⁰ compared with expectant management was associated with reduced risk of cesarean birth in Icelandic women without an increase in risk of adverse maternal or neonatal outcomes. No additional benefit appeared to be from inducing at earlier gestations in low-risk pregnancies.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681683","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}