International Journal of Women's Health最新文献

{"title":"Multiparametric Pelvic-Floor Magnetic Resonance Imaging for the Staging of Anterior-Compartment Clinical Pelvic Organ Prolapse: A Prospective Study.","authors":"Shan Xiong, Wenze Wu, Li Xiao, Dijiao Tian, Bing Wan, Furong Lv","doi":"10.2147/IJWH.S597329","DOIUrl":"https://doi.org/10.2147/IJWH.S597329","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the utility of multiparametric pelvic-floor magnetic resonance imaging (MRI) for identifying stage III-IV anterior-compartment clinical pelvic organ prolapse (POP) and guiding clinical management.</p><p><strong>Methods: </strong>In total, 123 women with confirmed anterior-compartment clinical POP were prospectively categorized into non-stage III-IV (n = 60) and stage III-IV (n = 63) groups. All participants underwent combined pelvic-floor <i>static</i>-dynamic MRI and T2 star (T2*) mapping. Levator ani muscle (LAM) injury was assessed. The perpendicular distance from the bladder base to the pubococcygeal line (B-PCL), H-line, M-line, levator hiatus area (LHA), levator plate angle, and iliococcygeal angle were measured at rest and maximum Valsalva. T2* values were measured in LAM. Univariate and logistic regression analyses were used to diagnose stage III-IV prolapse. The optimal model was compared with the conventional MRI-based \"rule of three\".</p><p><strong>Results: </strong>Compared with the non-stage III-IV group, the stage III-IV group was significantly older in age; had higher Pelvic Floor Distress Inventory-20 scores; exhibited larger B-PCL, M-line, and LHA values at maximum Valsalva; and demonstrated lower pubovisceral muscle T2* values. Compared with the \"rule of three\", the optimal multiparametric MRI-based model achieved an area under the curve of 0.802, with significantly higher sensitivity, modestly lower specificity, and superior overall accuracy.</p><p><strong>Conclusion: </strong>The multiparametric pelvic-floor MRI-based diagnostic model demonstrates superior performance in identifying stage III-IV anterior-compartment clinical POP. This model provides an objective imaging-based reference to support accurate POP staging and guide clinical management.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"597329"},"PeriodicalIF":2.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770722","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":"Reducing Iatrogenic Female Genitourinary Fistula: Impact of Short-Term Obstetric Training for Lower Cadre Surgeons in Uganda.","authors":"Musa Kayondo, Onesmus Byamukama, Brenda Ainomugisha, Wilson Birungi, Rogers Kajabwangu, Paul Kato Kalyebara, Christopher M Tarnay, Verena Geissbühler","doi":"10.2147/IJWH.S594992","DOIUrl":"https://doi.org/10.2147/IJWH.S594992","url":null,"abstract":"<p><strong>Background: </strong>In Uganda, almost 50% of genitourinary fistulae are iatrogenic, primarily resulting from inadvertent urinary tract injuries during obstetric and gynecologic surgeries. Cesarean sections (CS), often performed by less experienced providers at lower-level facilities, account for 70% of these cases. In 2022, the Essential Training in Operative Obstetrics (ETOO) program was introduced to improve surgical skills among lower cadre surgeons. This study evaluated the program's impact on iatrogenic fistula incidence at a tertiary teaching hospital in southwestern Uganda.</p><p><strong>Methods: </strong>A retrospective review was conducted on women who underwent fistula repair at a tertiary teaching hospital in southwestern Uganda between January 2020 and December 2024. Data from the pre-training period (2020-2021) were compared with post-training data (2022-2024). Fistulae were classified as iatrogenic if caused by surgical error rather than obstructed labor. Anatomical subtypes included ureteric injuries, vault fistulas, and vesico-[utero]/-cervico-vaginal fistulas. The primary outcome was the annual number and proportion of iatrogenic fistula cases.</p><p><strong>Results: </strong>Among 102 fistula cases post-training, 57 (55.9%) were iatrogenic. Most followed CS (66.7%) and involved ureteric injuries (54.3%). A significant portion (34.8%) originated from private facilities. Following ETOO implementation, annual iatrogenic cases declined from 39 in 2020 to 19 in 2024. A marked drop occurred in late 2022, aligning with program rollout. The trend slope of -5.4 suggests a steady annual decline.</p><p><strong>Conclusion: </strong>The ETOO program is associated with a notable reduction in iatrogenic fistula incidence. Expansion to private and lower-level facilities is recommended to enhance nationwide surgical safety.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"594992"},"PeriodicalIF":2.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771154","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":"Holographic Imaging Combined with VR Simulation in Obstetrics and Gynecology Resident Training: A Review on Skill Development and Patient Privacy Protection.","authors":"Lisha Yi, Zhimin Dong, Jiali Zeng, Jingyi Ou, Eryong Zhao","doi":"10.2147/IJWH.S590972","DOIUrl":"https://doi.org/10.2147/IJWH.S590972","url":null,"abstract":"<p><p>The integration of holographic imaging technology with virtual reality (VR) simulation represents a significant advancement in medical education, particularly in the training of obstetrics and gynecology residents. This review explored the background and importance of these cutting-edge technologies in enhancing clinical skill acquisition while addressing the critical issue of patient privacy protection. Studies have highlighted the foundational principles of holographic and VR technologies, as well as their evolving roles in medical training. Their combined application in obstetrics and gynecology possesses notable advantages, including improved surgical precision, enhanced clinical decision-making, and increased effectiveness in emergency response situations among resident physicians. Moreover, the review examined the potential of these technologies to safeguard patient privacy by creating secure virtual environments that minimize exposure to sensitive clinical data. Ethical considerations and data security challenges in VR platforms were also discussed, along with emerging solutions. Through a systematic review and integration of current literature, this review provides a comprehensive overview of how holographic imaging combined with VR simulation can optimize educational outcomes and privacy standards in resident training programs. The review concluded with recommendations for future technological enhancements and innovative teaching methodologies to further support the training of proficient and ethically responsible practitioners in the field of obstetrics and gynecology.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"590972"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771312","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":"Comparative Effectiveness of Azithromycin versus Erythromycin for Latency Prolongation in Preterm Prelabor Rupture of Membranes < 34 Weeks of Gestation.","authors":"Saifon Chawanpaiboon, Julaporn Pooliam","doi":"10.2147/IJWH.S603582","DOIUrl":"https://doi.org/10.2147/IJWH.S603582","url":null,"abstract":"<p><strong>Objective: </strong>Preterm prelabor rupture of membranes (PPROM) is a major contributor to preterm birth and neonatal morbidity. Although azithromycin is increasingly used as an alternative to erythromycin for latency antibiotic therapy, comparative data remain limited. This study evaluated whether azithromycin is associated with latency duration and maternal-neonatal outcomes comparable to those of erythromycin in pregnancies complicated by PPROM before 34 weeks of gestation.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a tertiary referral hospital by reviewing medical records from January 2011 through December 2024. Pregnant women with PPROM at 24 to <34 weeks of gestation who completed latency antibiotic regimens were included and categorized into azithromycin or erythromycin groups. The primary outcome was latency period (time from membrane rupture to delivery). Secondary outcomes included maternal infectious complications and neonatal morbidity and mortality. Multivariable logistic regression was performed to adjust for baseline differences between groups.</p><p><strong>Results: </strong>A total of 720 participants were included (56 azithromycin; 664 erythromycin). Baseline characteristics were generally comparable, although maternal age, monthly income, and previous PPROM differed between groups. Median latency duration did not differ significantly between azithromycin and erythromycin overall (3.70 vs 3.23 days; <i>P</i> = 0.287) or across gestational-age subgroups. After adjustment for baseline differences, the likelihood of achieving latency ≥3 days was similar between groups. Maternal outcomes were largely comparable, although postpartum endometritis occurred more frequently in the azithromycin group with small event numbers. Neonatal outcomes were generally similar; NICU admission was lower, whereas intraventricular hemorrhage was more frequent in the azithromycin group, both based on small numbers.</p><p><strong>Conclusion: </strong>Azithromycin was associated with latency duration and maternal-neonatal outcomes comparable to those of erythromycin and represents a practical alternative regimen for PPROM management. Prospective studies are warranted to confirm these findings.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"603582"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771324","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 Influencing Successful Aging in Community-Dwelling Older Women: A SOC Model Approach.","authors":"Eun Kyoung Han, Hae Kyoung Son","doi":"10.2147/IJWH.S594173","DOIUrl":"https://doi.org/10.2147/IJWH.S594173","url":null,"abstract":"<p><strong>Purpose: </strong>South Korea entered a super-aged society in December 2024, and the proportion of elderly women, who have a longer life expectancy than men, has also been steadily increasing. Consequently, social interest and community-level interventions for successful aging are required. This study examined the effects of perceived health status, urinary incontinence, sleep quality, social support, and selective optimization with compensation (SOC) strategies on successful aging among community-dwelling older women.</p><p><strong>Methods: </strong>The cross-sectional design was used. A structured questionnaire survey was conducted from July 1 to August 30, 2024, with 154 women aged 65 years and older enrolled at eight senior centers in Seoul and Gyeonggi Province, South Korea. Validated questionnaires were used to assess the perceived health status, urinary incontinence, sleep quality, social support, SOC strategies, and successful aging. Data were analyzed using <i>t</i>-tests, analysis of variance, Pearson's correlation analysis, and hierarchical regression analysis.</p><p><strong>Results: </strong>Successful aging was positively correlated with perceived health status, social support, and SOC strategies, and negatively correlated with urinary incontinence and poor sleep quality. Hierarchical regression analysis revealed that the three-stage regression model was statistically significant (F=25.223, P<0.001). In the third stage, perceived health status (β=0.463, P<0.001), social support (β=0.469, P<0.001), and SOC strategies (β=0.124, P=0.022) were identified as statistically significant variables. The model explained 58.8% of the variance.</p><p><strong>Conclusion: </strong>Perceived health status, social support, and SOC strategies have been identified as factors influencing successful aging. Despite the limitations of the cross-sectional study design based on convenience sampling, the findings of this study provide a foundation for developing interventions aimed at promoting healthy aging among the elderly population.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"594173"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771307","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":"Age-Stratified Modeling of Clinical Heterogeneity in Polycystic Ovary Morphology Using Ultrasound-Based Machine Learning.","authors":"Chenke Kuang, Qiao Wei, Zichao Liu, Yanfen Zhang, Zhuomin Zhong, Nian Hu, Chun Xiao, Liang Bao, Yaocheng Xiao, Meng Du, Zhiyi Chen","doi":"10.2147/IJWH.S592244","DOIUrl":"https://doi.org/10.2147/IJWH.S592244","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to employ machine learning for automated age stratification in patients with polycystic ovary morphology (PCOM) and to clarify the age-specific contributions of key clinical characteristics, thereby improving diagnostic accuracy.</p><p><strong>Patients and methods: </strong>A total of 192 ovaries with corresponding clinical and ultrasound data were analyzed. Automated age stratification was performed using the K-means unsupervised clustering model along with the elbow method. XGBoost, Random Forest (RF), Support Vector Machine (SVM), and Artificial Neural Network (ANN) algorithms were applied to compare full and selected feature sets. Model performance was evaluated using five-fold cross-validation with metrics including accuracy, sensitivity, F1-score, and area under the curve (AUC), validating the stratification robustness and feature selection strategy.</p><p><strong>Results: </strong>Automated age stratification categorized PCOM patients into three distinct age groups. A stable positive correlation was observed between ovarian volume and follicle count across all strata; however, key diagnostic drivers varied significantly by age. Beyond ovarian volume, follicle count, and BMI, the 18-22 years group was primarily influenced by menstrual cycle phase. The 23-29 years group was characterized by the number of pregnancies and the ovarian stromal artery blood flow RI. In the 30-40 years group, the ovarian stromal artery blood flow S/D ratio and the number of live births showed increasing importance.</p><p><strong>Conclusion: </strong>This study highlights the differential role of age-sensitive indicators in ultrasound-based diagnosis of PCOM and provides a framework for more personalized diagnostic assessment.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"592244"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771337","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":"Genitourinary Syndrome of the Menopause in Jordanian Women: A Cross-Sectional Study in a Tertiary Hospital in Jordan.","authors":"Ayman Qatawneh, Lana A AlRaie, Ragda Mihdawi, Ghaidaa Alassaf, Dar'a Meqdady, Yasmine AlHurani, Sereen Ahmad Bani-Said, Dana Alqatawneh, Fida Thekrallah","doi":"10.2147/IJWH.S583748","DOIUrl":"https://doi.org/10.2147/IJWH.S583748","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the prevalence of genitourinary syndrome of the menopause (GSM) signs and symptoms and their severity in postmenopausal Jordanian women attending a tertiary care hospital in Jordan.</p><p><strong>Methodology: </strong>A cross-sectional study was conducted on women with medical records at the University of Jordan Hospital complaining of symptoms related to the GSM. The participants were contacted by phone, briefed about the study, and asked if they would like to enroll. The study included demographic questions and validated assessments of Urinary Distress Inventory-6 (UDI-6) and Vulvar Disease Quality of Life Index (VQLI). Differences in the mean scores were assessed based on data normality and association assessment was performed using Pearson's chi-square test.</p><p><strong>Results: </strong>GSM was reported by 84.9% of 325 postmenopausal women enrolled in the study with an average of 5.1 symptoms per person. Most of the reported urinary symptoms were stress urinary incontinence (54.8%), followed by urge incontinence (48.6%). Furthermore, most reported genital complaints were vulva itching and/or burning sensations (41.2%) and vaginal discharge (40.3%). GSM interfered with the participants' sexual activity in 44% of the population studied. Smoking was associated with higher UDI-6 scores (p =0.045), and with stress urinary incontinence (1.74 versus 2.19; p = 0.004) and painful intercourse (1.66 versus 2.27; p = 0.011). Furthermore, high BMI was associated with higher UDI-6 and VQDL1 scores (p = 0.029 and p = 0.043). Dysuria was higher (p = 0.007) in women with shorter years of postmenopause (5 years or less), whereas difficulty in emptying the bladder and GSM interference with sexual activity scores were higher in women who had been postmenopausal for more than 5 years (p = 0.041, p = 0.053).</p><p><strong>Conclusion: </strong>The present study showed that a high percentage of postmenopausal Jordanian women developed GSM, with several symptoms per person. Furthermore, the severity of GSM interfered with sexual activity. Smoking and obesity were associated with overall GSM symptoms in Jordanian women.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"583748"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771256","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":"Hemoglobin Trajectory During Pregnancy and Postpartum Hemorrhage: A Retrospective Cohort Study.","authors":"Ge Mu, Hong Li, Jiang Du, Yingying Jian, Xin Shen, Yani Su","doi":"10.2147/IJWH.S601942","DOIUrl":"https://doi.org/10.2147/IJWH.S601942","url":null,"abstract":"<p><strong>Background: </strong>Studies on the association between anemia and postpartum hemorrhage (PPH) mostly use the hemoglobin (Hb) levels in a single trimester, thereby failing to capture the dynamic changes of Hb levels during pregnancy. This study aims to assess the trajectories of Hb during pregnancy and evaluate their association with PPH.</p><p><strong>Methods: </strong>The study population consisted of 4296 women who gave birth in a tertiary hospital after 28 weeks of gestation between January 2024 and February 2025. Group-based trajectory modelling was used to identify hemoglobin trajectories. Logistic regression models were applied for evaluating the associations between hemoglobin trajectories and PPH.</p><p><strong>Results: </strong>Three trajectories of maternal Hb were identified. In trajectory 1 (decline-stable, 20.41%), maternal Hb levels were higher than those in trajectory 2 in the first trimester, and rapidly declined across pregnancy with the lowest point at 35 weeks. In trajectory 2 (decline-rise, 73.16%), maternal Hb decreased during the first and second trimesters, and slightly increased during the third trimester. In trajectory 3 (stable-rise, 6.42%), maternal Hb remained stable in early and mid-pregnancy and increased in late pregnancy. Compared with trajectory 2, trajectory 1 was associated with a 2.36-fold higher risk of PPH (95% CI: 1.59-3.47), while trajectory 3 showed no significant association (OR: 0.79, 95% CI: 0.27-1.81), after adjustment. The area under the receiver operating characteristic curve was 0.74 (95% CI: 0.70-0.79). Compared with women with Hb ≥116 g/L at 28-32 weeks, women with Hb <116 g/L had a 1.64-fold higher risk of PPH (95% CI: 1.08-2.52).</p><p><strong>Conclusion: </strong>Women who are not anemic in early pregnancy but experience a rapid decline in Hb during pregnancy, especially those with Hb <116 g/L in the early third trimester, are at high risk for PPH.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"601942"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771331","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 Validation of a Patient-Reported Measure of Pregnancy and Motherhood Experiences in Turkish Women with Physical Disabilities.","authors":"Mehmet Çopuroğlu, Özge B A Y K A N Çopuroğlu, Hanife Abakay, Ayşe Güç","doi":"10.2147/IJWH.S601748","DOIUrl":"https://doi.org/10.2147/IJWH.S601748","url":null,"abstract":"<p><strong>Objective: </strong>Women with physical disabilities experience distinct physical, psychological, and social challenges during pregnancy and motherhood, yet culturally appropriate and psychometrically validated patient-reported outcome measures remain limited. The Pregnancy and Motherhood Evaluation Questionnaire (PMEQ) was developed to address this gap. No validated instrument currently captures these experiences in the Turkish context. This study aimed to translate, culturally adapt, and comprehensively validate the PMEQ for use in the Turkish population.</p><p><strong>Methods: </strong>The PMEQ was translated and culturally adapted in line with internationally accepted cross-cultural adaptation procedures for self-report instruments, including forward-backward translation, expert review, and cognitive debriefing. The study included 160 Turkish women with chronic physical disabilities who had experienced pregnancy and early motherhood. Internal consistency was assessed using Cronbach's alpha and McDonald's omega. Construct validity was examined using exploratory and confirmatory factor analyses, and test-retest reliability was evaluated over a 10-day interval using intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>The Turkish PMEQ demonstrated excellent internal consistency (Cronbach's α = 0.90; ω = 0.92). Exploratory factor analysis identified a four-factor structure explaining 64.1% of the total variance. Confirmatory factor analysis supported this structure, showing good model fit (χ²/df = 2.1, RMSEA = 0.056, CFI = 0.94, TLI = 0.91, SRMR = 0.045). Test-retest reliability was high, with ICCs ranging from 0.79 to 0.86 across subscales and 0.88 for the total score. The factor structure was consistent with the original PMEQ framework.</p><p><strong>Conclusion: </strong>The Turkish version of the PMEQ is a valid and reliable patient-reported outcome measure for assessing pregnancy and motherhood experiences among women with physical disabilities. This study provides the first culturally validated tool for this population in Turkey, addressing a critical gap in disability-inclusive maternal health assessment.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"601748"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771174","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":"Concordance of AI-Assisted and Hybrid AI-Assisted Cervical Imaging Systems with Visual Inspection with Acetic Acid for Cervical Precancer Screening in West Bandung, Indonesia.","authors":"Kemala Isnainiasih Mantilidewi, Rizky Ramadhan Sayyid Zenyda, Muhammad Riza Vikar Akbar Alhayat, Rajendra Maheswara Wisnu Wardhana, Qonita Adzkia, Nadiyah An Nabiylah, Muhammad Gifary Syah Zahran, Hilmi Mukhayadi, Dodi Suardi, Dwi Agustian, Yudi Mulyana Hidayat","doi":"10.2147/IJWH.S585614","DOIUrl":"https://doi.org/10.2147/IJWH.S585614","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer remains a major cause of morbidity and mortality among women, particularly in low- and middle-income countries (LMICs) where screening access is limited. Visual Inspection with Acetic Acid (VIA) is widely used but subject to inter-observer variability. Artificial intelligence (AI)-assisted cervical imaging may improve standardization; however, real-world community evidence is limited.</p><p><strong>Objective: </strong>To evaluate the concordance of AI-assisted and hybrid AI-assisted cervical imaging systems (CIS) relative to VIA findings in a community-based cervical precancer screening program in West Bandung, Indonesia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 71 women to assess concordance and operational performance of two AI-based approaches: an AI-assisted CIS (Cerviray AI^®, AIDOT Inc., Seoul, South Korea) and a hybrid AI-assisted CIS incorporating expert review within a VIA-based workflow.</p><p><strong>Results: </strong>The AI-assisted CIS showed sensitivity of 66.7% (95% CI 20.8-93.9) and specificity of 95.6% (95% CI 87.8-98.5), with PPV 40.0% and NPV 98.5%. The hybrid approach demonstrated similar sensitivity (66.7%; 95% CI 20.8-93.9) and slightly higher specificity (97.1%; 95% CI 89.9-99.2), with PPV 50.0% and NPV 98.5%. VIA positivity was low (4.2%; 8.5% using a composite definition), likely inflating specificity and NPV. All metrics were calculated against VIA rather than histopathology. Agreement with VIA was moderate (κ = 0.472 and κ = 0.550).</p><p><strong>Conclusion: </strong>AI-assisted and hybrid CIS showed moderate agreement with VIA. Interpretation is limited by small sample size, wide confidence intervals for sensitivity, low disease prevalence, and use of VIA as the reference standard. These preliminary findings suggest a potential supportive role for AI-assisted imaging in LMIC screening, warranting validation in larger studies using histopathologic reference standards.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"18 ","pages":"585614"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771283","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}