{"title":"Prediction of Fetal Growth Restriction Using Serum PlGF Combined with PAPP-A in Early Pregnancy.","authors":"Huifang Huang, Sumei Wang","doi":"10.2147/IJWH.S524412","DOIUrl":"10.2147/IJWH.S524412","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the predictive capacity of placenta growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) levels in the serum of pregnant women during early pregnancy (11-13<sup>+6</sup> weeks) for fetal growth restriction (FGR).</p><p><strong>Patients and methods: </strong>A retrospective cohort study was conducted involving 1602 pregnant women who gave birth at The Second Nanning People's Hospital between March 2018 and September 2019. Serum concentrations of PlGF and PAPP-A were measured during early pregnancy for all participants. Based on pregnancy outcomes, participants were categorized into the FGR group (n = 94) and the normal control group (n = 1508). Clinical characteristics, serum PAPP-A, and PlGF levels during early pregnancy (11-13<sup>+6</sup> weeks) were compared between the two groups using <i>t</i>-tests and one-way analysis of variance. Receiver operating characteristic (ROC) curves were generated to assess the predictive value of each biomarker.</p><p><strong>Results: </strong>The overall incidence of FGR in the study cohort was 5.86%. Pregnant women in the FGR group exhibited significantly lower serum levels of PlGF and PAPP-A compared to the control group (both <i>p</i><0.05). Correlation analysis revealed that PAPP-A levels were inversely associated with maternal age, pre-pregnancy body mass index (BMI), platelet count, and fibrinogen (all <i>p</i><0.05). ROC analysis demonstrated that the area under the curve (AUC) for predicting FGR was 0.734 (95% CI: 0.677-0.790) for PlGF and 0.729 (95% CI: 0.676-0.781) for PAPP-A, which indicates a certain individual predictive value. When combined, the predictive efficiency slightly improved (AUC=0.742).</p><p><strong>Conclusion: </strong>Serum levels of PlGF and PAPP-A in early pregnancy can effectively predict FGR, with slightly improved predictive accuracy when used together, presenting a new method for early FGR screening.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2845-2851"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029724","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":"Investigation of the Endometrial Microbiome in Recurrent Pregnancy Loss Individuals: Microbial Imbalance and Network Fragility.","authors":"Bolun Zhang, Shaochong Lin, Sidong Wang, Weiyu Chen, Yushu Chen, Dandan Cao, Qingzhi Liu, Yuanqing Yao","doi":"10.2147/IJWH.S534065","DOIUrl":"10.2147/IJWH.S534065","url":null,"abstract":"<p><strong>Purpose: </strong>Emerging evidence suggests that an abnormal endometrial microbiota may be a potential factor contributing to recurrent pregnancy loss (RPL). This study aimed to characterize the endometrial microbiota in patients with RPL and to explore its association with miscarriage.</p><p><strong>Patients and methods: </strong>Based on specific inclusion and exclusion criteria, EndoMetrial Microbiome Assay (EMMA) data from women attending clinics were collected and categorized into RPL and control groups according to their miscarriage history. Species diversity analysis, differential microbiota analysis, and machine learning methods were employed to identify key microbial genera associated with RPL. Microbial network analysis was then performed to further characterize the endometrial microbiome in patients with RPL.</p><p><strong>Results: </strong>No significant differences in α-diversity were observed between the RPL and control groups across multiple indices (all P > 0.05); however, β-diversity differed significantly (Euclidean distance, P = 0.039). Regarding species composition, the control group showed a significantly higher abundance of <i>Lactobacillus</i>, whereas the RPL group had increased levels of pathogenic bacteria, including <i>Gardnerella, Staphylococcus</i>, and <i>Streptococcus</i>. Machine learning identified three key genera associated with RPL: <i>Streptococcus, Chryseobacterium</i>, and <i>Fusobacterium</i>. Microbial network analysis further revealed the fragility of the endometrial microbial community in patients with RPL.</p><p><strong>Conclusion: </strong>These findings offer novel insights into the mechanisms of endometrial microenvironmental changes in patients with RPL and highlight potential microbial biomarkers and therapeutic targets for future clinical applications.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2853-2868"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023298","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}
Xin Xin, Lu Guan, Jiaxi Li, Jinfu Zhang, Haicui Wu
{"title":"The Impact of Age at First Sexual Intercourse on Female Reproductive Disorders: A Mendelian Randomized Study.","authors":"Xin Xin, Lu Guan, Jiaxi Li, Jinfu Zhang, Haicui Wu","doi":"10.2147/IJWH.S534178","DOIUrl":"10.2147/IJWH.S534178","url":null,"abstract":"<p><strong>Background: </strong>Female reproductive disorders (FRDs) are common diseases among women of childbearing age, affecting their reproductive health. Age at first sexual intercourse (AFS) is potentially linked to FRDs, and this study aims to investigate these associations and underlying mechanisms, to offer new insights and guidance for sex education in adolescent women and reproductive health management.</p><p><strong>Methods: </strong>Mendelian randomization (MR) analysis was performed using summary data from genome-wide association studies (GWASs). The AFS summary data were sourced from 397,338 European participants, and the outcome data were obtained from the FinnGen consortium. Additionally, multivariate MR (MVMR) and mediation analyses were also adopted to explore more detailed association. The MR results were rigorously validated, with the inverse variance weighted (IVW) method employed as the primary approach to assess causal relationships.</p><p><strong>Results: </strong>There is a significant causal relationship between AFS and ovarian dysfunction (OD), polycystic ovarian syndrome (PCOS), and spontaneous abortion (0.45 [0.25-0.81], p=0.008; 0.35 [0.17-0.74], p=0.006; 0.76 [0.63-0.92], p=0.006). Among them, the genetic association between AFS and spontaneous abortion remained significant even after adjusting for more confounding variables (0.73 [0.55-0.95], p=0.020; 0.76 [0.61-0.95], p=0.015), and Body mass index (BMI) may be an important mediating factor in the association between AFS and PCOS (38.41%, p=7.17e-6) or OD (35.64%, p= 1.51e-6).</p><p><strong>Conclusion: </strong>Our research suggested that early AFS is closely associated with a higher risk of reproductive disorders, and timely interventions targeting BMI may partially alleviate the adverse effects of early sexual activity on reproductive health. The analysis based on genetic data emphasizes the importance of early sex education for adolescents, while weight management can to some extent avoid the occurrence of reproductive disorders during childbearing age, which also provide scientific basis for understanding the pathogenesis of FRDs and formulating appropriate reproductive health education strategies.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2833-2844"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015347","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":"Correlation Between Fertility Stress, Psychological Capital, and Conjugal Communication Patterns in Hospitalized Patients with Ovarian Hyperstimulation Syndrome During in vitro Fertilization-Embryo Transfer Cycles.","authors":"Weili Wu, Na Zhou, Ying He","doi":"10.2147/IJWH.S537423","DOIUrl":"10.2147/IJWH.S537423","url":null,"abstract":"<p><strong>Background: </strong>Ovarian hyperstimulation syndrome (OHSS) is a distressing complication of in vitro fertilization-embryo transfer (IVF-ET) that can amplify emotional and psychological burden. Fertility-related stress is influenced by individual psychological resources and the quality of marital communication. However, limited research has examined these associations in patients hospitalized with OHSS.</p><p><strong>Objective: </strong>To examine the relationship between fertility stress, conjugal communication patterns, and psychological capital in hospitalized patients with OHSS following IVF-ET.</p><p><strong>Methods: </strong>This cross-sectional study included 185 women admitted to the fertility ward of a tertiary hospital in China between June 2022 and December 2023. Participants completed the Fertility Problem Inventory (FPI), the Psychological Capital Questionnaire (PCQ), and the Chinese version of the Christensen Marital Communication Model Questionnaire. Descriptive statistics, Pearson correlation, and multiple linear regression analyses were conducted using SPSS version 26.0. Outcomes included the level of fertility stress and its associations with conjugal communication, psychological capital, and relevant demographic and clinical predictors.</p><p><strong>Results: </strong>Participants reported elevated fertility stress (mean ± SD: 155.08 ± 30.58), suboptimal conjugal communication (60.15 ± 24.06), and moderate psychological capital (120.05 ± 18.92). Fertility stress was positively correlated with total avoidance communication (r = 0.373, <i>p</i> < 0.01) and negatively correlated with psychological capital (r = -0.322, <i>p</i> < 0.01). Regression analysis revealed that embryo transfer cycles (β = 9.284, <i>p</i> = 0.007), second pregnancy attempts (β = 11.398, <i>p</i> = 0.049), total avoidance communication (β = 2.080, <i>p</i> < 0.001), and psychological capital (β = -0.337, <i>p</i> = 0.002) were significant predictors of fertility stress.</p><p><strong>Conclusion: </strong>Maladaptive conjugal communication and diminished psychological capital are significantly associated with heightened fertility stress in OHSS patients undergoing IVF-ET. Integrating psychosocial support to enhance marital communication and psychological resilience may help alleviate stress and improve patient outcomes.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2819-2832"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015321","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":"Health Implications of Microplastic Exposure in Pregnancy and Early Childhood: A Systematic Review.","authors":"Sandhya Jinesh, Prerana Aditi","doi":"10.2147/IJWH.S497366","DOIUrl":"10.2147/IJWH.S497366","url":null,"abstract":"<p><p>Microplastics (MPs), defined as plastic particles smaller than 5 mm, have emerged as a significant environmental pollutant, raising concerns about their potential health risks. Emerging evidence shows that MPs can reach human tissues, including the placenta, causing oxidative stress, inflammation, and endocrine disruption These issues are particularly concerning for vulnerable populations like pregnant women and infants, where exposure could negatively impact fetal development and health outcomes. This systematic review, adhering to PRISMA guidelines, aimed to identify and evaluate studies on the impact of microplastic exposure on pregnancy outcomes and early childhood development. A comprehensive search of databases, including Scopus, Web of Science, Medline, and others, along with grey literature and citation searches, was conducted. The review focused on peer-reviewed articles published within the last decade involving human subjects such as newborns, infants, and pregnant women. The systematic search initially identified 328 studies, of which 200 were screened after removing 128 duplicates. From these, 64 full-text articles were assessed for eligibility, and ultimately, 13 studies were included in the final review. Among these, six studies had a low risk of bias, five a moderate risk, and two a high risk of bias. The sample sizes across the studies ranged from 2 to 43 participants, and the most frequently analysed biological material was the placenta (10 out of 13 studies). Microplastics such as polyethylene (PE) and polypropylene (PP) were most detected, appearing in 11 and 10 studies, respectively. Significant associations were observed between microplastic exposure and adverse health outcomes, including reduced birth weight, shortened gestational age, and altered microbiota composition. Methodological variability and potential biases were identified as limitations. Given the increasing global prevalence of microplastic pollution, understanding its health impacts on vulnerable populations such as pregnant women and infants is critical, providing the first comprehensive synthesis of evidence in this area.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2805-2818"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015310","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":"Uterine Reaction to Oxytocin and Maternal-Neonatal Outcomes in Inducing Labor: A Retrospective Cohort Study.","authors":"Huahua Liu, Zhanhong Fan, Fan Wu, Mingbo Wang, Ziyi Yang, Feng Zhang","doi":"10.2147/IJWH.S532773","DOIUrl":"10.2147/IJWH.S532773","url":null,"abstract":"<p><strong>Background: </strong>Previous studies did not investigate the effect of gradually increasing the concentration of low-dose oxytocin on mother and newborn outcomes. The purpose of this study was to look at the relationship between oxytocin responsiveness and outcomes for both mothers and newborns during labor induction.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at Nantong Maternal and Child Health Hospital, and participants were divided into the early reaction to oxytocin group and the later reaction to oxytocin group based on oxytocin response. Primary outcomes included Apgar score at 1 and 5 minutes, umbilical cord artery pH, neonatal intensive care unit admission, and postpartum hemorrhage. Secondary outcomes assessed the duration of labor. Multiple regression models were used to compare maternal and infant outcomes between the two groups.</p><p><strong>Results: </strong>A total of 1803 participants were finally included in the statistical analysis, with 1083 in the early reaction to oxytocin group and 720 in the later reaction to oxytocin group. After adjusting for potential confounding factors, the risk of a lower 1-minute Apgar score (OR: 1.924, 95% CI: 1.012-3.655), an increased rate of neonatal intensive care unit admission (OR: 2.064, 95% CI: 1.150-3.703), and a higher incidence of postpartum hemorrhage were observed in the later reaction to oxytocin group (OR: 2.342, 95% CI: 1.631-3.361). Additionally, in this group, the first and second phases of labor were seen to be more drawn out (P<0.001, P<0.001).</p><p><strong>Conclusion: </strong>Later reaction to oxytocin was consistently associated with lower 1-minute Apgar scores, an increased number of admissions to neonatal intensive care units, a labor's first and second phases lasting a long time, and an increased occurrence of postpartum hemorrhage. These findings underscore the importance of identifying women who exhibit a delayed response to oxytocin in clinical practice.</p><p><strong>Trial registration: </strong>The project was retrospectively registered with the Chinese Clinical Trial Registry (TRN: ChiCTR2100047137; 08/06/2021).</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2793-2803"},"PeriodicalIF":2.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000563","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}
Hui Jin, Yapei Wang, Hongbin Li, Yinqin Cheng, Yumin Ma
{"title":"Causal Associations Between Oral Microbiota and Gestational Diabetes Mellitus: A Two-Sample Mendelian Randomization Study.","authors":"Hui Jin, Yapei Wang, Hongbin Li, Yinqin Cheng, Yumin Ma","doi":"10.2147/IJWH.S531088","DOIUrl":"10.2147/IJWH.S531088","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes. The oral microbiota, influenced by genetic factors, may play a role in GDM development, but the causal association remains unclear.</p><p><strong>Methods: </strong>We employed a two-sample Mendelian randomization (MR) approach using Genome-Wide Association Study (GWAS) data on GDM from FINN cohort data (ID: finngen_R10_GEST_DIABETES) and GWAS data on the Oral microbiota from the Danish ADDITION-PRO cohort. We screened SNPs significantly associated with Oral microbiota abundance as instrumental variables (IVs) and assessed their association with GDM risk. The study primarily used an inverse variance weighting (IVW) approach and further applied MR-Egger regression, weighted median, and weighted mode methods for robustness testing. Sensitivity analyses were conducted to evaluate the impact of heterogeneity and pleiotropy, including MR-Egger, MR-PRESSO, Cochran's Q, and leave-one-out methods.</p><p><strong>Results: </strong>We identified 267 IVs associated with Oral microbiota abundance. IVW analysis revealed a positive causal association between Genus <i>Schaalia</i> and GDM risk (OR = 1.03, 95% CI: 1.01-1.06, P = 0.02) and a negative association between Genus <i>Haemophilus</i> and GDM risk (OR = 0.96, 95% CI: 0.93-1.00, P = 0.034). Sensitivity analyses confirmed the robustness of these two results, showing no evidence of heterogeneity or pleiotropy.</p><p><strong>Conclusion: </strong>Our study provides evidence for a causal association between Genus <i>Schaalia</i> and <i>Haemophilus</i> and GDM risk. This highlights the potential role of the Oral microbiota in GDM pathogenesis and suggests potential targets for GDM prevention and treatment.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2777-2791"},"PeriodicalIF":2.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000495","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":"Telehealth Approach in Breast Cancer Care: A Systematic Review of Models and Outcomes.","authors":"Yanny Trisyani, Aan Nuraeni, Anastasia Anna, Ayu Prawesti Priambodo, Firman Sugiharto","doi":"10.2147/IJWH.S549643","DOIUrl":"10.2147/IJWH.S549643","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer remains the most prevalent malignancy among women worldwide and represents a significant global health burden. Advances in treatment have increased survivorship, but many patients continue to experience persistent physical and psychosocial challenges. Telehealth has emerged as a promising approach to delivering continuous, patient-centered care, particularly during the treatment and survivorship phases. Despite its growing application, there is a lack of synthesized evidence regarding the diverse models, content, and clinical benefits of telehealth interventions in breast cancer care.</p><p><strong>Purpose: </strong>This systematic review aimed to identify the effectiveness of telehealth on clinical outcomes in breast cancer patients.</p><p><strong>Methods: </strong>This review followed the PRISMA guidelines and was registered in PROSPERO. A comprehensive literature search was conducted using relevant keywords across PubMed, Scopus, EBSCOhost, Taylor & Francis, and Google Scholar. Eligible studies were RCTs involving telehealth interventions and targeting adult breast cancer patients. Multiple reviewers independently conducted study selection, data extraction, and quality appraisal using the Joanna Briggs Institute critical appraisal tools. Thematic analysis was used to synthesize extracted data.</p><p><strong>Results: </strong>24 RCTs from 10 countries met the inclusion criteria, with sample sizes ranging from 42 to 454 participants. The studies featured various telehealth models, including psychoeducational, cognitive-behavioral, chronic disease, transtheoritical, behavioural theory, lifestyle management, and nurse-led symptom monitoring model. Delivery methods included telephone calls, web-internet-based platforms, and smartphone applications. Typical intervention contents included education, psychological support, symptom tracking, self-management, empowerment, and exercise guidance. Telehealth interventions have demonstrated positive outcomes, including improvements in quality of life, mood, adherence, self-management skills, self esteem, sleep quality, coping strategy, and also reductions in depression, anxiety,and fatigue.</p><p><strong>Conclusion: </strong>This review highlights the significant role of telehealth as a complementary and integrative component of breast cancer care. It can support patients throughout treatment and survivorship, while improving accessibility and promoting patient-centered outcomes.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2759-2775"},"PeriodicalIF":2.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015383","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}
Huizhu Wang, Xin Jin, Mengmeng Wang, Hezhou Li, Juan Wu, Ling Liu, Zhengfeng Zhu, Mu Qiao, Yingying Wang, Lili Li
{"title":"Prenatal Ultrasound Diagnosis and Prognosis Analysis of Fetal Congenital Cataract.","authors":"Huizhu Wang, Xin Jin, Mengmeng Wang, Hezhou Li, Juan Wu, Ling Liu, Zhengfeng Zhu, Mu Qiao, Yingying Wang, Lili Li","doi":"10.2147/IJWH.S511730","DOIUrl":"10.2147/IJWH.S511730","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the prenatal ultrasound signs of fetal congenital cataract, study the potential etiologies, and evaluate the perinatal outcomes and the prognosis.</p><p><strong>Patients and methods: </strong>The study included 29 cases of fetal congenital cataract identified using prenatal ultrasound screening from January 2018 to September 2023 in our hospital. Ultrasound signs, the potential etiologies, the perinatal outcomes, and prognosis were analyzed.</p><p><strong>Results: </strong>Among the 29 cases, 18 (62.1%) showed complete hyperechogenicity of the lens (type I), 6 (20.7%) showed dot or cluster hyperechogenicity within the lens (type II), and 5 (17.2%) showed the \"double-ring\" sign (type III). Moreover 18 (62.1%) involved isolated cataract and 11 (37.9%) involved cataract associated with extraocular abnormalities, with central nervous system and cardiac abnormalities being the most common. In terms of potential etiology, five cases (17.2%) had a family history, and genetic testing was performed in eight cases, with five of them showing abnormalities. Cases 2 and 16 involved two fetuses of the same pregnant woman, both of which had a hemizygous mutation of the <i>OCRL</i> gene (c.1514G > A). Moreover Case 3 involved Trisomy 13, and Case 17 had heterozygous mutations of the <i>RAB3GAP1</i> gene (c.718C > T and c.1879dupA). Furthermore, Case 21 had a heterozygous mutation of the <i>NHS</i> gene (c.375C > A). Among the 29 cases, pregnancy was terminated in 21 (72.4%) and was continued in 4 (13.8%).</p><p><strong>Conclusion: </strong>Congenital cataract, defined as lens opacity, presents as complete hyperechogenicity of the lens, a double-ring sign, or dot and cluster hyperechogenicity within the lens on prenatal ultrasound. Prenatal ultrasound can help assess the eyes and other systems during prenatal or postnatal examinations and can provide additional information for prenatal counseling and early postnatal treatment of congenital cataract.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2729-2740"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000575","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":"Fatal Umbilical Cord Hemorrhage Triggering Neonatal Demise: Clinicopathological Insights from the Case Analysis.","authors":"Tianshui Yu, Baoqing Pei, Dong Zhao","doi":"10.2147/IJWH.S542329","DOIUrl":"10.2147/IJWH.S542329","url":null,"abstract":"<p><strong>Background: </strong>Umbilical cord hemorrhage (UCH) is a rare but catastrophic obstetric emergency associated with nearly 50% fetal mortality, and its precise pathogenic mechanisms remain elusive in clinical practice. The pathophysiological cascade involves hemorrhagic expansion from ruptured umbilical vessels predominantly the umbilical vein which generates compressive forces on adjacent umbilical arteries within the constrained Wharton's jelly. This acute vascular compromise precipitates the sudden cessation of fetoplacental circulation, culminating in irreversible hypoxic-ischemic injury. Although the pathogenesis of UCH is multifactorial, the structural vulnerabilities of the umbilical vessels particularly elastic fiber deficiencies in the umbilical vein remain understudied. This case report describes a clinical outcome characterized by multifocal hemorrhagic lesions along the umbilical cord resulting from congenital elastic fiber deficiency in the umbilical vein during the late gestational stages, culminating in neonatal death despite emergent intervention.</p><p><strong>Case report: </strong>A 31-year-old primigravida at 40<sup>+4</sup> weeks gestation presented with abdominal pain and vaginal bleeding. Ultrasonography revealed cephalic presentation with the umbilical cord encircling the neck and torso once each. Following abrupt fetal bradycardia (80 bpm), fetal membrane was artificially ruptured, resulting in the release of 10 mL of yellowish-green amniotic fluid, which was classified as thick and contaminated to degree III. An emergency cesarean section was performed, delivering a male neonate (3,670 g). The Apgar scores were 10/2/0 at 1/5/10 min. Despite T-piece ventilation and chest compressions, resuscitation failed, resulting in neonatal death. Histopathological and macroscopic autopsy analyses revealed umbilical cord hemorrhage accompanied by umbilical vascular anomalies, specifically demonstrating a significant deficiency or complete absence of elastic fibers within the umbilical vein wall.</p><p><strong>Conclusion: </strong>Umbilical vein dysplasia, characterized by elastic fiber deficiency, is an underrecognized yet critical contributor to perinatal hemorrhage-related mortality, particularly in cases of mechanical cord compression. We propose systematic elastin-specific histochemical evaluation as an essential component of postmortem protocols for unexplained intrauterine fetal demise. This evidence underscores the need to develop antenatal surveillance strategies targeting high-risk cord structural cord anomalies, specifically incorporating elastin-specific screening.</p>","PeriodicalId":14356,"journal":{"name":"International Journal of Women's Health","volume":"17 ","pages":"2741-2745"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992240","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}