International Journal of Women's Health最新文献

{"title":"Multidimensional Informational Needs and Associated Factors Among Indonesian Women with Breast Cancer: A Cross-Sectional Study.","authors":"Yanny Trisyani, Aan Nuraeni, Anastasia Anna, Ayu Prawesti Priambodo, Firman Sugiharto, Mochamad Budi Santoso","doi":"10.2147/IJWH.S625422","DOIUrl":"10.2147/IJWH.S625422","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer remains a major global health burden, with patients in low- and middle-income countries facing substantial gaps in access to adequate health information. In Indonesia, sociocultural barriers and healthcare system constraints further exacerbate unmet informational needs, potentially affecting treatment adherence and quality of life.</p><p><strong>Purpose: </strong>This study aimed to examine the multidimensional informational needs and identify associated demographic and clinical factors among Indonesian women with breast cancer.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 105 breast cancer patients recruited from a referral hospital using consecutive sampling. Data were collected using the Multidimensional Informational Needs Questionnaire for Breast Cancer Patients (MINQ-BC), covering six domains. Rasch model analysis was applied to ensure measurement robustness, and inferential analyses (Chi-square tests with Cramér's V as the measure of association) were performed to identify associated factors.</p><p><strong>Results: </strong>Overall, 77.1% of participants reported high informational needs. The highest needs were observed in follow-up and long-term care (81.9%), whereas lifestyle and self-care needs were predominantly low (81.9%). Educational background was significantly associated with multiple dimensions of information needs, including self-health knowledge, psychosocial and emotional needs, and educational media preferences (<i>p</i><0.05). In contrast, age at diagnosis was associated with educational media preferences (<i>p</i><0.05). Regarding clinical factors, frequency and therapy received, BMI and cancer history were significantly associated with total information needs (<i>p</i><0.05). In addition, several variables were associated with specific dimensions: duration of illness and cancer history with symptom management needs; disease stage with psychosocial and emotional needs; and BMI with self-health knowledge.</p><p><strong>Conclusion: </strong>Informational needs among Indonesian breast cancer patients are substantial, multidimensional, and shaped by both socioeconomic and clinical factors. The prominence of long-term care needs highlights a critical gap in survivorship education. These findings suggest the need for patient-centered educational strategies that are responsive to patients' clinical characteristics, educational background, and survivorship concerns.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"625422"},"PeriodicalIF":2.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Transition in Health Risks and Disease Burden Among Women of Childbearing Age in East Asia and the Pacific, 1990-2023.","authors":"Huayu Huang, Ziyuan Xu, Yong Zhang, Jianbo Wei","doi":"10.2147/IJWH.S624240","DOIUrl":"10.2147/IJWH.S624240","url":null,"abstract":"<p><strong>Background: </strong>Women of childbearing age (WCBA) in East Asia and Pacific (EAP) have experienced rapid epidemiological change, yet research focus and policy priorities often remain concentrated on maternal survival. We aimed to characterize three-decade comprehensive transitions in causes and risk factors, and quantify cross-country gaps.</p><p><strong>Methods: </strong>We analyzed modelled GBD 2023 estimates for women aged 15-49 in the EAP region from 1990 to 2023, quantifying the disease burden by disability-adjusted life years (DALYs). Long-term trends were summarized using estimated annual percentage changes (EAPC), and investigated changes before and after the COVID-19 pandemic. Frontier analysis quantifies the disparities in preventable disease burden across countries.</p><p><strong>Results: </strong>From 1990 to 2023, the age-standardized DALY rate among WCBA in EAP declined from 35,218 to 27,534 per 100,000, yet non-communicable diseases expanded their share from 62.3% to 75.7%. By 2023, gynecological disorders, depression, and headache disorders constituted the leading causes of burden. Among risk factors, high body-mass index risk increased significantly since 1990, and became the top risk factor (ASDR = 583.5 per 100,000) in 2023. During the acute pandemic phase, DALYs rose in 33 of 35 EAP regions. Frontier analysis revealed a 2.8-fold disparity in avoidable burden across countries at comparable development levels, with distance-to-frontier in ASDR ranging from 0.35 (Nauru) to 0.98 (China) in 2023.</p><p><strong>Conclusion: </strong>The WCBA disease burden in EAP has transitioned from maternal and infectious conditions toward chronic, metabolic, and disability-related disorders, with significant persistent intra-regional disparities. Health systems should pivot from isolated reproductive care toward integrated life-course surveillance, embedding NCD and mental health services within routine women's health platforms to address this evolving burden.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"624240"},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of High Intensity Sweeteners on the Reproductive System: From the Onset of Puberty to Menstrual Health: A Comprehensive Review of Human and Animal Evidence.","authors":"Behrang Rezvani Kakhki, Saboura Sahebi, Saber Sahebi","doi":"10.2147/IJWH.S621813","DOIUrl":"10.2147/IJWH.S621813","url":null,"abstract":"<p><strong>Introduction: </strong>High-Intensity Sweeteners (HISs) are widely consumed as calorie-free sugar substitutes, particularly among girls and women of reproductive age. Despite their regulatory approval, growing evidence suggests potential endocrine-disrupting properties that may negatively impact women's reproductive health.</p><p><strong>Objective: </strong>This narrative review synthesizes human and animal evidence on the Potential Pathological Effects of AS on puberty onset and menstrual health, while elucidating the underlying biological mechanisms.</p><p><strong>Methods: </strong>A structured search of references in PubMed, Scopus, Web of Science, and Embase up to 2025 was conducted, prioritizing studies from 2015 onwards. Inclusion criteria required quantitative measurements of AS exposure and reproductive endpoints in non-pregnant, non-lactating women, or relevant animal models. Seventeen studies (12 animals, 5 humans) were thematically synthesized.</p><p><strong>Results: </strong>Chronic exposure to AS specifically aspartame, sucralose, saccharin, and acesulfame-K-disrupts female reproductive physiology through composition-dependent and developmentally timed mechanisms. These mechanisms include (1) suppression of the hypothalamic-pituitary-gonadal (HPG) axis through downregulation of Kiss1; (2) ovarian mitochondrial dysfunction, oxidative stress, and follicular atresia; and (3) reduced estrogen production by the gut microbiota through disruption of the estrobulum. Importantly, these effects often occur independently of body weight or metabolic changes. Human data have linked maternal and prepubescent AS consumption to premature thelarche, menstrual irregularities, and altered rate of puberty, particularly in carriers of TAS1R2/TAS1R3 polymorphisms. It is noteworthy that not all sweeteners pose the same risk: advantame and glycyrrhizin show neutral or protective profiles.</p><p><strong>Conclusion: </strong>Artificial sweeteners may not be harmless, especially above the acceptable daily intake (ADI), and they could act as bioactive endocrine disruptors. However, given that much of the current evidence derives from animal studies and limited observational human data, further well-designed human studies are needed to confirm these associations and clarify their clinical significance.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"621813"},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148828451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric Properties of the Chinese Version of the Ford Insomnia Response to Stress Test (FIRST-C) Among Pregnant Women in Qinghai Province, China: A Cross-Sectional Validation Study with Measurement Invariance Testing.","authors":"Lianhui Wei, Pengmao Duojie, Xiaoyan Yuan, Mengyun Hu, Xiaan Sun, Chunlan Jiang, Jiao Wang, Xuekun Zhang","doi":"10.2147/IJWH.S617011","DOIUrl":"10.2147/IJWH.S617011","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines the psychometric properties and measurement invariance of the FIRST-C in a sample of pregnant women from Qinghai, with a particular focus on invariance across ethnic groups and between the second and third trimesters in this high-altitude, multi-ethnic region.</p><p><strong>Methods: </strong>An 810-participant cross-sectional study using convenience sampling was conducted at a tertiary hospital in Qinghai from March to August 2025. Participants completed demographic and sleep questionnaires in paper or online format. Internal consistency was evaluated with Cronbach's alpha, construct validity with confirmatory factor analysis (CFA), and criterion-related validity by correlating FIRST-C scores with the Pittsburgh Sleep Quality Index (PSQI). Measurement invariance across ethnic groups and gestational stages was examined through multi-group CFA.</p><p><strong>Results: </strong>The FIRST-C showed strong internal consistency (α = 0.917) and a unidimensional structure with good fit indices (χ²/df = 2.897, TLI=0.983, CFI=0.987, RMSEA=0.048, SRMR=0.018). Criterion-related validity was supported by a weak yet significant positive correlation with the Pittsburgh Sleep Quality Index (PSQI) (<i>r</i> = 0.22, <i>p</i> < 0.001), distinguishing trait-like reactivity from state-like quality. Employing a previously defined cut-off, 50.2% of participants surpassed the high sleep reactivity threshold. Multi-group confirmatory factor analysis (CFA) affirmed measurement invariance across ethnic groups and across the second and third trimesters.</p><p><strong>Conclusion: </strong>The FIRST-C demonstrates satisfactory psychometric properties and measurement invariance across ethnic groups and between the second and third trimesters in this Qinghai pregnancy sample, supporting its use as a research instrument for assessing sleep reactivity in this population.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"617011"},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression and Associated Factors Among Perimenopausal Women: A Cross-Sectional Study in Ho Chi Minh City, Vietnam.","authors":"Dat Q Nguyen, Dung V Do, Du V Tran, Thinh H Cao, Tuan M Vo","doi":"10.2147/IJWH.S631126","DOIUrl":"10.2147/IJWH.S631126","url":null,"abstract":"<p><strong>Objective: </strong>Ho Chi Minh City's aging population sees a rise in perimenopausal women. The hormonal, psychological, and social shifts during this time heighten the risk of depression, yet it is frequently neglected in healthcare. Thus, it is crucial to evaluate the prevalence of depression and its contributing factors in this demographic. The research aims to identify the depression prevalence among women aged 45 to 55 in Ho Chi Minh City and examine the associated factors.</p><p><strong>Methods: </strong>A community-based study took place in Ho Chi Minh City using a multi-stage cluster sampling approach. From March to December 2025, 669 perimenopausal women filled out a self-administered questionnaire. Their depression symptoms were evaluated with the PHQ-9 scale, using a cut-off score of 5 or higher to indicate depression risk.</p><p><strong>Results: </strong>The prevalence of depression in perimenopausal women was 25.1% (95% CI: 21.9-28.6). Factors associated with depression included: domestic violence (POR = 4.72), chronic medical conditions (POR = 1.85), anxiety about family problems (POR = 1.68), hot flashes (POR = 2.04), and painful intercourse (POR = 2.02).</p><p><strong>Conclusion: </strong>The prevalence of depressive disorders among perimenopausal women is greater than that in women of reproductive age and is similar to that found in older women in Ho Chi Minh City. Given their susceptibility to mental health challenges, women aged 45-55 in the city should be regarded as a critical health priority by health administrators, necessitating early screening and intervention initiatives within the community.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"631126"},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rupture of a Nongravid Unicornuate Uterus Following Failed Induction of a Noncommunicating Rudimentary Horn Pregnancy: A Rare Case Report.","authors":"Khalid Abdirahman Ahmed, Chaltu Reggesa, Safa Elmi, Khalid Mohamed Bashiir","doi":"10.2147/IJWH.S627753","DOIUrl":"10.2147/IJWH.S627753","url":null,"abstract":"<p><p>Pregnancy within a non-communicating rudimentary horn is a rare and potentially life-threatening form of ectopic gestation associated with Müllerian duct anomalies. Diagnosis is frequently delayed because ultrasonographic findings may mimic those of a normal intrauterine pregnancy. We report the case of a 24-year-old gravida 2 para 1 woman who presented with a 14-week-and-6-day missed abortion initially interpreted as intrauterine pregnancy. Medical induction with misoprostol failed to achieve cervical dilatation; a mechanical cervical ripening attempt with a transcervical Foley catheter also failed, and oxytocin infusion was subsequently started. Shortly afterward the patient developed severe abdominal pain with hemodynamic compromise. Emergency laparotomy demonstrated a right-sided non-communicating rudimentary horn pregnancy within a unicornuate uterus. The gravid rudimentary horn remained intact, while a full-thickness rupture was identified in the posterolateral wall of the nongravid unicornuate uterine cavity; direct intraoperative inspection confirmed this rupture to be iatrogenic, resulting from a false passage created during Foley catheter insertion and propagated by subsequent oxytocin-induced contractions. Excision of the rudimentary horn, together with the ipsilateral fallopian tube, and repair of the uterine rupture were successfully performed. Persistent failed induction in a presumed second-trimester missed abortion should prompt evaluation for obstructive Müllerian anomalies, including noncommunicating rudimentary horn pregnancy, before further mechanical instrumentation is attempted.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"627753"},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Pregnancy Stress in High-Risk Pregnant Women Before Invasive Prenatal Diagnosis: A Cross-Sectional Study.","authors":"Xu Chen, Yali Zhao, Qingqing Gu, Zhiwei Wang, Shuting Yang, Ting Yin, Dongmei Yan, Leilei Wang","doi":"10.2147/IJWH.S623345","DOIUrl":"10.2147/IJWH.S623345","url":null,"abstract":"<p><strong>Purpose: </strong>Pregnant women often experience pregnancy stress, which negatively impacts maternal and fetal health. Studies on pregnancy stress in high-risk pregnancies are limited. This study aimed to investigate pregnancy stress in high-risk pregnant women before invasive prenatal diagnosis and analyze factors associated with pregnancy stress.</p><p><strong>Materials and methods: </strong>This single-center, cross-sectional study, conducted from September 2023 to May 2024 at a medical institution in Jiangsu Province, China, included 509 high-risk pregnant women. Convenience sampling was used to recruit participants. Self-administered questionnaires were used to collect socio-demographic characteristics, clinical characteristics, pregnancy stress, doctor-patient communication, and family function. Pregnancy stress was assessed using the Pregnancy Stress Rating Scale (PSRS). Multiple linear regression identified factors associated with pregnancy stress.</p><p><strong>Results: </strong>Among the participants, 363 (71.3%) had mild stress, and 53 (10.4%) had moderate to high stress. Among the three dimensions of PSRS, worrying about the health and safety of the mother and child had the highest score. Multiple linear regression analysis showed that factors associated with pregnancy stress in high-risk women included knowledge of prenatal genetic testing (<i>B</i> = 0.108, 95% <i>CI</i>: 0.030-0.186, <i>P</i> < 0.01), reproductive history (<i>B</i> = 0.116, 95% <i>CI</i>: 0.047-0.186, <i>P</i> < 0.01), pregnancy symptoms (<i>B</i> = -0.111, 95% <i>CI</i>: -0.217 - -0.004, <i>P</i> < 0.05), nutritional status (<i>B</i> = 0.079, 95% <i>CI</i>: 0.007-0.151, <i>P</i> < 0.05), perceived poor resistance (<i>B</i> = 0.179, 95% <i>CI</i>: 0.056-0.302, <i>P</i> < 0.01), doctor-patient communication (<i>B</i> = -0.014, 95% <i>CI</i>: -0.028 - -0.001, <i>P</i> < 0.05), and family function (<i>B</i> = -0.045, 95% <i>CI</i>: -0.063 - -0.027, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Doctor-patient communication, family function, and some clinical characteristics was associated with pregnancy stress in high-risk pregnant women. Therefore, future interventions should enhance family support and improve doctor-patient communication.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"623345"},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Postpartum Atypical Hemolytic Uremic Syndrome Caused by a C3 Pathogenic Variant: A Case Report.","authors":"Jiaomei Zhu, Limin Zhang, Huibo Zhao, Huaying Pei, Shaomei Li, Li Tian","doi":"10.2147/IJWH.S618301","DOIUrl":"10.2147/IJWH.S618301","url":null,"abstract":"<p><strong>Background: </strong>Atypical hemolytic uremic syndrome (aHUS) is a life-threatening thrombotic microangiopathy (TMA) driven by uncontrolled activation of the complement alternative pathway. Pregnancy and postpartum period are well-recognized triggers for aHUS. In recent years, the prognosis of aHUS has substantially improved with the use of complement-targeted therapies. However, timely recognition, accurate classification, and prompt treatment initiation remain critical. This report describes a case of postpartum aHUS caused by a C3 gene mutation that achieved complete clinical and laboratory remission following a treatment strategy that included early eculizumab, plasma infusion, and renal replacement therapy. Drawing on the literature, we discuss key diagnostic and therapeutic considerations as well as clinical implications to provide guidance for clinical practice.</p><p><strong>Case presentation: </strong>We present a 35-year-old multiparous woman (gravida 3, para 3) who developed acute kidney injury, microangiopathic hemolytic anemia, and severe thrombocytopenia 2 days after cesarean section. She had a history of similar TMA episode 8 years postpartum. Laboratory investigations showed normal ADAMTS13 activity, negative autoimmune antibodies, reduced serum complement C3 and factor I levels, and elevated sC5b-9. Whole-exome sequencing identified a heterozygous pathogenic mutation in the <i>C3</i> gene: c.1774C>T (p.R592W). Eculizumab was initiated within 24 hours of clinical suspicion, combined with plasma infusion and renal replacement therapy. The patient achieved complete clinical and laboratory remission: renal function, platelet count, hemoglobin, and lactate dehydrogenase returned to normal within 4 weeks. She remained stable during long-term follow-up on maintenance eculizumab. This case is particularly instructive because the patient had a prior TMA episode that was retrospectively suggestive of aHUS following genetic confirmation; however, definitive reclassification could not be established with certainty due to the lack of genetic testing at that time.</p><p><strong>Conclusion: </strong>This case highlights that <i>C3</i> variant-mediated aHUS can be repeatedly triggered by pregnancy. Early recognition, prompt initiation of C5 inhibition, and multidisciplinary care are critical for renal recovery and favorable outcomes. Clinicians should distinguish postpartum aHUS from preeclampsia, HELLP syndrome, and TTP to prevent treatment delay.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"618301"},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome-Wide Prenatal cfDNA Screening and the Obstetric Incidentalome: Maternal Cancer, Placental Mosaicism, and Pregnancy Risk.","authors":"Meng Xu, Yuling Liu, Meiling Gao, Yu Zhu","doi":"10.2147/IJWH.S625975","DOIUrl":"10.2147/IJWH.S625975","url":null,"abstract":"<p><p>Prenatal cell-free DNA (cfDNA) screening was introduced as a highly accurate test for common fetal aneuploidies, but genome-wide implementation has exposed a broader and more complex clinical landscape. Maternal plasma cfDNA is a composite biological signal rather than a fetal signal in isolation. It contains predominantly maternal cfDNA, a pregnancy-derived placental fraction that serves as the practical fetal proxy in screening, and, in selected circumstances, cfDNA derived from maternal pathological processes. As a result, abnormal, complex, discordant, or nonreportable cfDNA findings may reflect fetal chromosomal disease, confined placental mosaicism (CPM), rare autosomal trisomy (RAT), maternal copy-number variation or mosaicism, benign maternal lesions, vanishing twin, technical artifact, or occult maternal malignancy. This review uses the concept of the \"obstetric incidentalome\" to integrate these maternal, placental, fetal, and technical findings into a single interpretive model for genome-wide prenatal cfDNA screening. Particular emphasis is placed on unusual cfDNA patterns associated with maternal cancer, rare RATs as potential markers of placental mosaicism and placenta-mediated pregnancy risk, and the diagnostic ambiguity created when placental and fetal genomes differ. We propose that the clinical value of genome-wide cfDNA screening lies less in expanding the catalogue of detectable abnormalities than in resolving the biological origin and clinical relevance of abnormal signals. A coherent clinical pathway should combine fetal diagnostic confirmation, selective maternal evaluation, genetic counseling, and risk-adapted obstetric surveillance while avoiding indiscriminate overdiagnosis. The next phase of evidence should determine whether structured management of the obstetric incidentalome improves maternal and perinatal outcomes beyond diagnostic yield alone.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"625975"},"PeriodicalIF":2.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse Uterine Leiomyomatosis: A Retrospective Study of Clinical Features and Outcomes in Nine Cases with Literature Review.","authors":"Nuo Ye, Ridwan Abdifatah Mohamed, Hailei Gu, Fang Teng, Xuemei Jia","doi":"10.2147/IJWH.S598761","DOIUrl":"10.2147/IJWH.S598761","url":null,"abstract":"<p><strong>Purpose: </strong>Diffuse uterine leiomyomatosis (DUL) is a rare variant of uterine leiomyomas, characterized by ill-defined, cobblestone-like nodules throughout the myometrium, frequently associated with menorrhagia, anemia, and infertility. This study aimed to analyze the clinical features, diagnostic approaches, treatment strategies, and prognostic outcomes of DUL.</p><p><strong>Patients and methods: </strong>We enrolled nine DUL patients diagnosed via imaging or intraoperative confirmation, who were admitted to the Women's Hospital of Nanjing Medical University between January 2020 and April 2024. We retrospectively collected and analyzed their clinical data, including symptoms, diagnostic methods, treatments, and follow-up outcomes.</p><p><strong>Results: </strong>Mean age at onset was 26.67±4.35 years (18-33 years). Eight cases (88.89%) mainly presented with menorrhagia, seven of which were accompanied by anemia (77.78%). Pelvic magnetic resonance imaging (MRI) indicated DUL in eight cases (88.89%). All patients underwent surgery, four (44.44%) received total abdominal/laparoscopic hysterectomy, four (44.44%) underwent transabdominal myomectomy, and one (11.11%) underwent laparoscopic myomectomy. During a mean follow-up of 53.22±19.19 months (25-76 months), and all patients exhibited significant symptom improvement. Of the five patients who received fertility-preserving surgery, one patient (20.00%) developed MRI-documented recurrence of DUL 42 months after surgery, followed by subsequent total hysterectomy; one patient developed irregular menstrual bleeding 45 months postoperatively and was subsequently treated with gonadotropin-releasing hormone agonist (GnRHa). The remaining three patients had small leiomyomas detected by gynecological ultrasound, but no clinical recurrence of symptoms was observed. Among these three patients, one achieved full-term pregnancy; the remaining two patients had no immediate fertility plans.</p><p><strong>Conclusion: </strong>DUL is associated with early onset and anemia, and appears to carry a risk of recurrence following fertility-sparing surgery. Imaging (particularly MRI) is the primary diagnostic method, and DUL should be distinguished from common multiple uterine fibroids. Hysterectomy is the standard treatment for non-fertility cases, while myomectomy or resection of diffuse lesions is recommended for fertility preservation.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"598761"},"PeriodicalIF":2.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}