Journal of Obstetrics and Gynaecology Research最新文献

{"title":"Impact of Dietary Habits, Physical Activity, and Stress on Polyendocrine Metabolic Ovarian Syndrome: A Cross-Sectional Study From Pakistan","authors":"Muhammad Aamir,&nbsp;Tayyaba Pervaiz,&nbsp;Adeel Aslam,&nbsp;Asma Ghulam Mustafa,&nbsp;Saimon Shahzad","doi":"10.1111/jog.70521","DOIUrl":"https://doi.org/10.1111/jog.70521","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Polyendocrine metabolic ovarian syndrome (PMOS) is a common endocrine disorder affecting women of reproductive age. It is associated with various lifestyle and psychological factors. The research aims to evaluate the impact of dietary patterns, physical activity, and stress levels on the severity of PMOS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The current study used a cross-sectional study design, and data were collected from 384 PMOS patients attending selected healthcare facilities in Lahore. Participants were recruited through a non-probability convenience sampling. Data were collected using a self-structured questionnaire. The Kruskal-Wallis <i>H</i> test was used to assess the differences in dietary patterns, physical activity, and stress levels across PMOS severity groups. Statistical significance was considered at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In present research, weight (<i>p</i> &lt; 0.001) and family history (<i>p</i> = 0.001) were significantly associated with PMOS severity among all the sociodemographic characteristics. On evaluating the PMOS patients on DASS 21, highest proportion of responses was observed in category 1, ranging from 37.2% to 52.6%, with the item “I felt I wasn't worth much as a person” showing the highest percentage (52.6%). Our findings also demonstrate the moderated level of psychological load on participants. Overall, dietary pattern (<i>p</i> &lt; 0.017). Physical activity (<i>p</i> &lt; 0.001) and stress levels (<i>p</i> &lt; 0.012) were found to be significantly associated with severity of PMOS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings emphasize the importance of adopting healthy dietary habits, engaging in regular physical activity, maintaining an optimal body weight, and implementing effective stress-reduction strategies may help alleviate symptoms, enhance quality of life, improve psychological well-being, and reduce the long-term complications associated with PMOS in women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149205584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Predictors of Surgical Intervention and Ovarian Torsion in Adolescents With Ovarian Cystic Lesions","authors":"Tülin Öztaş,&nbsp;Ayşegül Aşır","doi":"10.1111/jog.70504","DOIUrl":"10.1111/jog.70504","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify clinical and ultrasonographic (US) factors associated with surgical intervention and ovarian torsion in adolescents with ovarian cystic lesions and to evaluate an exploratory clinical risk stratification framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 112 adolescents with ovarian cystic lesions &gt; 30 mm managed at a tertiary pediatric surgery center between January 2023 and January 2026. Clinical presentation, US characteristics, management, and outcomes were evaluated. Height and weight measurements were retrospectively retrieved when available, and body mass index (BMI) was calculated and analyzed as a continuous variable. Multivariable logistic regression was used to identify factors independently associated with surgical intervention and ovarian torsion. Receiver operating characteristic (ROC) analysis was used to determine the optimal lesion diameter threshold for surgical intervention. A exploratory three-level clinical risk stratification framework was subsequently developed using the ROC-derived 60-mm lesion diameter threshold and the presence of abdominal/pelvic pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 112 patients, 26 (23.2%) underwent surgical intervention, whereas 86 (76.8%) were managed conservatively. Surgical indications included ovarian torsion, complex adnexal masses, and persistent or enlarging cysts. Maximum lesion diameter was the strongest independent predictor of both surgical intervention and ovarian torsion. BMI was available for 95 patients (84.8%) and was not independently associated with surgical intervention or significantly different according to ovarian torsion status. The 60-mm threshold provided the best discrimination for surgical intervention. Surgical intervention occurred in 5/75 (6.7%), 2/8 (25.0%), and 19/29 (65.5%) patients in the low-, intermediate-, and high-risk groups, respectively (Fisher–Freeman–Halton exact test, <i>p</i> &lt; 0.001). Ovarian torsion occurred in 2/75 (2.7%), 0/8 (0%), and 11/29 (37.9%) patients, respectively (Fisher–Freeman–Halton exact test, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Maximum lesion diameter was the strongest independent predictor of surgical intervention and ovarian torsion. BMI was not significantly associated with either outcome in the available anthropometric data. The new exploratory risk stratification framework showed distinct clinical patterns across risk categories but requires prospective external validation before clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hysterectomy and Shull Suspension Using the V-NOTES Technique Versus Traditional Vaginal Surgery: A Prospective Analysis of Short-Term Efficacy and Safety","authors":"Michele Carlo Schiavi,&nbsp;Lorenzo Campanella,&nbsp;Pietro Cignini,&nbsp;Gianluca Sasso,&nbsp;Eleonora Lara Repace,&nbsp;Giulia Ferranti,&nbsp;Alessia Baia,&nbsp;Elisa Rossi,&nbsp;Francesca Melis,&nbsp;Livia Arcangeletti,&nbsp;Natalia Golovanova,&nbsp;Marzio Angelo Zullo,&nbsp;Andrea Morciano,&nbsp;Pierluigi Palazzetti,&nbsp;Herbert Carmelo Carlo Valensise,&nbsp;Fabio Manganelli,&nbsp;Azzurra Ligato,&nbsp;Francesco Antonio Bisogni,&nbsp;Valentino Bergamini,&nbsp;Giovanni Grossi","doi":"10.1111/jog.70527","DOIUrl":"10.1111/jog.70527","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study is to describe a modified method for applying Shull's technique using the V-NOTES approach and to compare it with the traditional vaginal technique in terms of efficacy, safety, operative duration, recurrence, and patient-reported outcomes at median follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 40 women with Stage ≥ III uterine prolapse (POP-Q) undergoing conventional vaginal hysterectomy with Shull suspension (vaginal native tissue repair [VNTR] Group A) or V-NOTES hysterectomy with endoscopic Shull suspension (vaginal natural orifice transluminal endoscopic surgery [V-NOTES] Group B) between December 2024 and December 2025. The median follow-up was 6 months. Informed consent was obtained. Outcomes included perioperative parameters, complications, hospital stay, recurrence, and quality-of-life and sexual function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median follow-up was 6 months (5–9); 22 patients underwent VNTR (Group A) and 18 V-NOTES (Group B) during hysterectomy and prolapse repair. Both procedures achieved anatomical improvement, with no difference in recurrence (Group A 1 case [4.5%] vs. Group B 0 cases [0%], <i>p</i> = 0.12). Operative time was comparable (Group A 112 ± 25 min vs. Group B 102 ± 22 min, <i>p</i> = 0.06), while hospital stay was shorter with V-NOTES (Group A 2 days (2–3) vs. Group B 1 day (1–2), <i>p</i> = 0.03). Complications were low (Group A 13.6% vs. Group B 0%, <i>p</i> = 0.05), with two ureteral events only in Group A (4.5% each; <i>p</i> = 0.21 and <i>p</i> = 0.22). Sexual function improved (FSFI Group A 29.63 ± 1.97 vs. Group B 29.23 ± 2.01, <i>p</i> = 0.001), with greater satisfaction in V-NOTES (PGI-I “Very much better”: 68.2% vs. 88.8%; <i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>V-NOTES Shull suspension is a safe and effective alternative with advantages in recovery and patient-reported outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Plasma Afamin Levels in Pregnancies Complicated by Fetal Growth Restriction and Their Association With Doppler Markers of Placental Dysfunction","authors":"Emrah Göçer,&nbsp;Kadriye Yakut Yücel,&nbsp;Cemal Ünlü,&nbsp;Harika Göçer,&nbsp;Şevki Çelen","doi":"10.1111/jog.70524","DOIUrl":"10.1111/jog.70524","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare maternal plasma afamin between pregnancies with fetal growth restriction (FGR) defined by fetal biometry and healthy controls, to test whether the cross-sectional association between afamin and gestational age differs in FGR, and to examine associations with Doppler indices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective study, 84 women assessed at 28–40 weeks (40 FGR, 44 controls) underwent same-day maternal blood sampling and umbilical-, middle-cerebral-, and uterine-artery Doppler. FGR was defined by an estimated fetal weight or abdominal circumference below the 5th percentile. Plasma afamin was measured by enzyme-linked immunosorbent assay. Analyses included a group-by-gestational-age interaction model, multivariable logistic regression, adjusted partial correlations, and receiver operating characteristic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Afamin was higher in FGR than controls (109.6 ± 5.8 vs. 98.2 ± 9.4 mg/L; <i>p</i> &lt; 0.0001), persisting after adjustment (adjusted difference 11.2 mg/L). In controls, afamin was strongly associated with gestational age (<i>r</i> = 0.95), whereas in FGR it was not (<i>r</i> = −0.03); the group-by-gestational-age interaction was significant (<i>p</i> &lt; 0.0001). Afamin was associated with FGR after adjustment (odds ratio 4.99 per 5 mg/L), an effect concentrated before 34 weeks. Pooled afamin–Doppler (Spearman) correlations did not remain significant after adjustment for group. Afamin did not correlate with body mass index. The area under the curve was 0.837.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In biometrically defined FGR, plasma afamin was elevated and, unlike in controls, was not associated with gestational age. Afamin was associated with FGR after covariate adjustment, but its strength varied with gestational age; these cross-sectional, exploratory findings require validation before clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Hysterectomy: A Five-Year Single-Center Experience With Uterine-Sparing Surgery for Clinically Diagnosed Placenta Accreta Spectrum","authors":"Emine Ergin Dogu,&nbsp;Esra Ayanoglu,&nbsp;Cevdet Dogu,&nbsp;Arzu Bilge Tekin,&nbsp;Niyazi Tug","doi":"10.1111/jog.70523","DOIUrl":"https://doi.org/10.1111/jog.70523","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe surgical management and maternal outcomes in placenta accreta spectrum, emphasizing initial uterine-sparing management, secondary intervention, and final uterine preservation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort included 21 patients managed at a tertiary center between June 2018 and August 2023. Clinical severity was classified exclusively from documented intraoperative findings using the International Federation of Gynecology and Obstetrics clinical classification; histopathological findings were evaluated separately. Management strategies, transfusion requirements, maternal morbidity, secondary interventions, and final uterine status were summarized descriptively. Patients with placental retention in situ were reviewed individually.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Initial management comprised segmental resection in seven patients, placental-bed hemostatic suturing in six, placental retention in situ in five, and cesarean hysterectomy in three. Uterine-sparing management was undertaken in 18 patients (85.7%). Red blood cell transfusion was administered to 18 patients (85.7%); seven (33.3%) received at least four units, and five (23.8%) required intensive care. Seven patients underwent a secondary intervention. All five patients with placental retention in situ underwent a secondary procedure on postoperative Days 5–68, including three planned relaparotomies; none subsequently underwent hysterectomy. Final uterine preservation was documented in 18 patients (85.7%), and no maternal deaths occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Uterine-sparing management was followed by final uterine preservation in most patients but was accompanied by substantial transfusion requirements and frequent secondary interventions. Placental retention in situ was followed by further procedures in all five patients. Initial avoidance of hysterectomy and final uterine preservation should be reported separately.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BUN/Albumin Ratio in Preeclampsia: A Comparative Study of Seven Biomarker Ratios","authors":"Neslihan Bademler,&nbsp;Sena Sayan,&nbsp;Hale Özer Çaltek,&nbsp;Emine Yılmaz Güler,&nbsp;Veli Mihmanlı","doi":"10.1111/jog.70518","DOIUrl":"10.1111/jog.70518","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate whether the admission blood urea nitrogen to albumin ratio (BAR) predicts adverse maternal and perinatal outcomes in preeclampsia, and to compare its performance against six other laboratory-derived ratios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Records of 252 preeclamptic pregnancies were reviewed and dichotomised at a BAR cut-off of 3.0: low (&lt; 3.0, <i>n</i> = 135) and high (≥ 3.0, <i>n</i> = 117). Composite adverse maternal outcomes included severe complication, intensive-care admission, or transfusion; composite adverse perinatal outcomes included growth restriction, stillbirth, neonatal death, neonatal-unit admission, or 5-min Apgar below 7. BAR was benchmarked against six other ratios: uric acid/albumin ratio (UAR), lactate dehydrogenase/albumin ratio (LAR), C-reactive protein/albumin ratio (CAR), fibrinogen/CRP ratio, fibrinogen/albumin ratio (FAR), and aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio (De Ritis) by ROC analysis. Independent predictors were sought through multivariable logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients in the high-BAR stratum showed substantially higher rates of composite adverse obstetric outcome (78.6% vs. 54.1%; <i>p</i> &lt; 0.001), composite adverse maternal outcome (28.2% vs. 6.7%; <i>p</i> &lt; 0.001), maternal intensive-care admission (16.2% vs. 3.7%; <i>p</i> = 0.001), and transfusion (12.0% vs. 2.2%; <i>p</i> = 0.002). BAR yielded the most balanced discrimination across endpoints, with AUCs of 0.68 (95% CI: 0.61–0.75) for the obstetric composite, 0.74 (95% CI: 0.65–0.83) for the maternal composite, and 0.66 (95% CI: 0.59–0.73) for the perinatal composite (all <i>p</i> &lt; 0.01); fibrinogen/albumin and AST/ALT ratios were not predictive. BAR did not differ significantly from UAR or LAR by DeLong test (all <i>p</i> &gt; 0.05) and retained independent association with adverse perinatal outcome after adjustment (adjusted OR 1.32; 95% CI: 1.03–1.70; <i>p</i> = 0.03). Sensitivity analyses showed that UAR retained independent significance for all three composite endpoints, positioning BAR and UAR as complementary bedside markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An elevated admission BAR identifies preeclamptic women at higher risk of severe maternal and perinatal events, with performance comparable to that of UAR. Both BAR and UAR may serve as simple complementary bedside adjuncts to existing risk stratification tools in preeclampsia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aggressive Clinical Course of Uterine Tumor Resembling Ovarian Sex Cord Tumor (UTROSCT) Harboring GREB1::SS18 Fusion Gene: A Case Report","authors":"Haruki Kasama,&nbsp;Ayumi Ito,&nbsp;Daichi Maeda,&nbsp;Aki Kido,&nbsp;Takashi Iizuka,&nbsp;Kaoru Abiko","doi":"10.1111/jog.70522","DOIUrl":"10.1111/jog.70522","url":null,"abstract":"<p>We report a fatal case of malignant uterine tumor resembling ovarian sex cord tumor (UTROSCT) harboring the <i>GREB1::SS18</i> fusion gene. A 64-year-old woman presented with a uterine tumor extending into the inferior vena cava, along with multiple hepatic and bone metastases. Although imaging suggested low-grade endometrial stromal sarcoma, histopathology revealed sex cord-like structures. <i>GREB1::SS18</i> fusion was identified by RNA sequencing and independently confirmed by RT-PCR and Sanger sequencing. Despite multimodal therapy, the patient died 26 months postoperatively. While most UTROSCTs follow a benign course, rare malignant cases exist. Literature review suggests <i>GREB1</i>-rearranged UTROSCTs are more aggressive, occurring in older patients with larger tumors compared to <i>ESR1</i>-rearranged tumors. This is the first report of a fatal outcome associated with the <i>GREB1::SS18</i> fusion. This case underscores the importance of molecular diagnosis for predicting malignant potential in UTROSCT, especially when atypical aggressive features are present.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jog.70522","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137100","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":"Distance From Residence to Hospital and Mortality Among Patients Diagnosed With and Receiving Surgical Treatment for Late-Stage Epithelial Ovarian Cancer in the United States","authors":"Neill Bates,&nbsp;Arley Rodriguez,&nbsp;Dmitry Tumin,&nbsp;James L. Whiteside","doi":"10.1111/jog.70517","DOIUrl":"10.1111/jog.70517","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In patients diagnosed with advanced stage ovarian cancer, the distance from their residence to the treating facility has often been interpreted in a linear context, where patients who live greater distances experience higher mortality. Due to recent conflicting evidence and greater area-level deprivation in neighborhoods surrounding cancer facilities, we hypothesized a nonlinear relationship between distance to the treating hospital and overall mortality in women with advanced stage ovarian cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the National Cancer Database and included women ≥ 18 years with Stage III or IV ovarian cancer who underwent surgical treatment of the primary site from 2010 to 2021. The primary outcome was overall mortality with distance (km) from the patient's residence to the treating facility serving as the primary exposure. Chi-squared and Kruskal–Wallis tests were used to compare study variables by quartiles of distance. A survival analysis was performed using Kaplan–Meier curves with log-rank tests and Cox proportional hazard regression with restricted cubic spline (RCS) specification to assess the nonlinear association. Predicted one-, three-, and five-year survival were plotted by distance according to the final model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our final analytic sample had 39 948 patients with unadjusted one-, three-, and five-year mortality rates at 9%, 16%, and 21% respectively, with no statistical difference in overall mortality between distance quartiles (<i>p</i> = 0.282). On multivariable regression, with RCS transformations in the model, mortality did not significantly differ by distance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The nonlinear interpretation of distance did not yield any significant difference in overall mortality, and 1-, 3-, and 5-year mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Stage Risk Redistribution After Clinicopathologic Restaging From FIGO 2009 to FIGO 2023 in Endometrial Cancer","authors":"Yue Gao,&nbsp;Qi Chen,&nbsp;Huali Wang,&nbsp;Rubing Yang,&nbsp;Miao Li,&nbsp;Yating Zhang","doi":"10.1111/jog.70529","DOIUrl":"10.1111/jog.70529","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To examine how clinicopathologic reassignment under FIGO 2023 alters risk grouping and five-year survival patterns among patients staged as early disease by FIGO 2009 when molecular classifiers are unavailable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The cohort comprised 351 patients treated with primary surgery from June 2010 through May 2019. All cases contributed to the restaging analysis; one case with contradictory survival coding was omitted from time-to-event analyses, leaving 350 evaluable patients. Five-year survival was described with Kaplan–Meier estimates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Stage migration occurred in 81 of 351 patients (23.1%): 75 (21.4%) were upstaged and 6 (1.7%) were downstaged; 222 (63.2%) underwent substage refinement. In the 295-patient early-stage cohort, FIGO 2009 showed no stage I-to-II survival gradient (96.7% vs. 100.0%; <i>p</i> = 0.440), whereas reassignment under FIGO 2023 separated stage I from stage II (99.0% vs. 91.9%; <i>p</i> = 0.001). Among 277 FIGO 2009 stage I patients, 74 were upstaged; 8 of 9 deaths occurred in the upstaged group (five-year overall survival, 89.0% vs. 99.5%; <i>p</i> &lt; 0.001). Among the 75 upstaged stage I cases, 66 (88.0%) followed FIGO 2023 IC/IIC pathways defined by aggressive histology, whereas all 9 patients reassigned to IIB had substantial LVSI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinicopathologic FIGO 2023 restaging redistributed adverse outcomes from former stage I into stage II and showed greater five-year overall survival separation. The findings apply to the clinicopathologic framework and do not constitute validation of molecularly integrated staging.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruptured Tubal Ectopic Pregnancy 7 Years After Subtotal Hysterectomy: A Rare Case Report","authors":"Funda Demirel","doi":"10.1111/jog.70515","DOIUrl":"10.1111/jog.70515","url":null,"abstract":"<div>\u0000 \u0000 <p>Pregnancy after subtotal hysterectomy is an exceptionally rare but potentially life-threatening condition that may delay diagnosis because pregnancy is often considered impossible. We report a 41-year-old (gravida 6, parity 6) woman who presented with sudden severe lower abdominal pain 7 years after emergency subtotal abdominal hysterectomy performed for postpartum hemorrhage secondary to uterine atony. Serum β-human chorionic gonadotropin was 2591 mIU/mL, and transvaginal ultrasonography demonstrated a ruptured right tubal ectopic pregnancy with an embryo corresponding to 6 weeks and 6 days of gestation. Exploratory laparotomy revealed approximately 300 mL hemoperitoneum and extensive pelvic adhesions. Right salpingo-oophorectomy together with excision of the cervical stump and remaining adnexa was performed. Histopathological examination confirmed tubal ectopic pregnancy. This case emphasizes that ectopic pregnancy should remain in the differential diagnosis of reproductive-aged women with preserved ovaries after subtotal hysterectomy, and that prompt β-hCG testing and transvaginal ultrasonography are essential for timely diagnosis and treatment.</p>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 10","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}