Journal of Obstetrics and Gynaecology Research最新文献

{"title":"Impact of health insurance coverage for assisted reproductive technology on multiple embryo transfers and multiple pregnancies in Japan","authors":"Ayumu Ito,&nbsp;Seung Chik Jwa,&nbsp;Akira Kuwahara,&nbsp;Akihiko Ueda,&nbsp;Mai Ohashi,&nbsp;Kiyotaka Kawai,&nbsp;Yoshikazu Kitahara,&nbsp;Toshihiro Habara,&nbsp;Yukiko Katagiri,&nbsp;Akira Iwase","doi":"10.1111/jog.16304","DOIUrl":"https://doi.org/10.1111/jog.16304","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the impact of health insurance coverage for assisted reproductive technology (ART), introduced in Japan in April 2022, on the number of multiple embryo transfers (METs) and multiple pregnancies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed Japanese ART registry data from over 600 registered ART facilities, comparing the rates and numbers of multiple pregnancies in 2022 with those in previous years. Furthermore, age-specific MET rates and proportions of blastocyst transfers in METs were examined separately for fresh and frozen–thawed embryo transfers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2022, 3209 multiple pregnancies were reported, showing an increasing trend and a level equivalent to that in 2007, before single embryo transfer was recommended in the Japan Society for Obstetrics and Gynecology guidelines. For all embryo transfers, the MET rate was significantly lower in 2022 than in 2021, decreasing from 15.4% to 15.0% (<i>p</i> &lt; 0.001), resulting in a similar rate of multiple pregnancies (2.98% vs. 3.05%; <i>p</i> = 0.17). Age-specific MET rates demonstrated a similar increasing trend with age between 2021 and 2022. However, the blastocyst utilization rate in METs was significantly higher in 2022 than in 2021 across almost all age strata in frozen–thawed embryo transfers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In 2022, the MET rate significantly decreased from 2021, whereas the multiple pregnancy rate remained similar. However, the absolute number of multiple pregnancies increased to the level before the single embryo transfer guideline, and the proportion of blastocyst transfers in MET also increased. Continuous monitoring is necessary to capture trends in the number of multiple pregnancies following ART in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914439","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":"Prenatal diagnosis and management of fetal anemia caused by hemoglobin H-Adana: A case report","authors":"Sirinart Sirilert,&nbsp;Kasemsri Srisupundit,&nbsp;Pimlak Charoenkwan,&nbsp;Arunee Phusua,&nbsp;Theera Tongsong","doi":"10.1111/jog.16310","DOIUrl":"https://doi.org/10.1111/jog.16310","url":null,"abstract":"<p>Hemoglobin (Hb) Adana, the alpha-globin gene mutation at codon 59 (GGC → GAC), is very rare globally but occasionally encountered in Southeast Asia. Its combination with alpha0-thalassemia (–^SEA) results in Hb H-Adana, which can lead to severe fetal anemia. This report describes a 22-year-old woman at 33 weeks, presenting with fetal cardiomegaly with early hydropic changes and anemia (middle cerebral artery peak systolic velocity: 1.75 multiple of median [MoM]). Cordocentesis revealed a Hb level of 4.3 g/dL, and intrauterine transfusion (IUT) was performed. However, non-reassuring fetal heart rate developed after IUT and cesarean section was performed. A preterm live male infant was delivered, weighing 1455 g, and was confirmed to be Hb H-Adana. Post-natal life was transfusion-dependent. In conclusion, this case focuses on prenatal features of fetal Hb H-Adana, which caused fetal anemia and hydrops fetalis in the third trimester. In cases of unexplained fetal anemia, Hb H-Adana should be listed in the differential diagnoses, especially in areas of high prevalence.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914437","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":"Successful management with regular factor IX replacement during pregnancy in a hemophilia B carrier: A case report","authors":"Saho Fujino,&nbsp;Kayoko Kaneko,&nbsp;Akitsu Higuchi,&nbsp;Mari Mitsui,&nbsp;Seiji Wada,&nbsp;Akira Ishiguro","doi":"10.1111/jog.16303","DOIUrl":"https://doi.org/10.1111/jog.16303","url":null,"abstract":"<p>Hemophilia B is an X-linked inherited bleeding disorder characterized by decreased coagulation factor IX levels. Female hemophilia carriers can experience bleeding similar to male ones; however, they rarely experience severe bleeding during pregnancy. A 37-year-old hemophilia B carrier experienced severe bleeding after a miscarriage. The bleeding was initially controlled with transfusion and uterine artery embolization. However, after several days, the patient exhibited massive bleeding again, which was controlled with coagulation factor IX replacement. In her subsequent pregnancy, the patient presented with subchorionic hematoma and intermittent noncoagulable vaginal bleeding during the first trimester. Coagulation factor IX replacement was administered regularly to maintain coagulation activity to almost 50%. This then resulted in a successful live birth. In addition to conventional treatment for obstetric bleeding, regular coagulation factor IX replacement based on coagulation activity is beneficial during pregnancy in female hemophilia B carriers with recurrent hemorrhagic episodes.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914438","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":"Delayed villous maturation with and without fetal demise: A case report of three successive pregnancies","authors":"M. C. Marijnen,&nbsp;W. Ganzevoort,&nbsp;S. J. Gordijn,&nbsp;L. E. van der Meeren","doi":"10.1111/jog.16308","DOIUrl":"https://doi.org/10.1111/jog.16308","url":null,"abstract":"<p>This case study examined three subsequent pregnancies with delayed villous maturation (DVM) resulting in infants either large for gestational age (LGA) or appropriate for gestational age. A perinatal pathologist histopathologically reviewed the placentas using the Amsterdam Consensus Criteria. The first pregnancy ended in a term fetal demise of an LGA infant due to severe asphyxia associated with idiopathic DVM. Due to the history of stillbirth and DVM, labor was induced at 36 weeks of gestation in the second and third pregnancies. The second and third pregnancies resulted in liveborn infants with varying weight profiles despite similar placental lesions. All three placentas showed DVM with positive CD15 immunostaining. Additionally, the second and third placentas exhibited villitis of unknown etiology. This case report underscores the importance of structured histologic placental examination following complicated pregnancies by a perinatal pathologist.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jog.16308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914352","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":"Diagnostic accuracy of a specialized pro forma in assessing morbidly adherent placenta in correlation to intra-operative findings","authors":"Fatma F. Ismail,&nbsp;Hassan M. Gaafar,&nbsp;Moutaz M. Elsherbini,&nbsp;Abdalla Mousa","doi":"10.1111/jog.16314","DOIUrl":"https://doi.org/10.1111/jog.16314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the clinical value of ultrasound criteria for the “Morbidly Adherent Placenta” (MAP) and the diagnostic accuracy of a customized “pro forma” in predicting MAP, its extent, and its relationship to intra-operative results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-one pregnant women with a high possibility of placenta accreta were included in the study. Gray scale transabdominal and transvaginal ultrasound with color Doppler were done to confirm the MAP diagnosis and evaluate the signs of placental invasion. The ultrasound findings were compared with the operative details to predict placental invasion (focal or diffuse) and vascularity of the lower uterine segment to assess the clinical significance of the customized “pro forma.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a good accuracy of ultrasound signs to detect the vascularity of the lower uterine segment with a sensitivity of 94.12%, specificity of 25%, positive predictive value (PPV) of 84.21%, negative predictive value (NPV) of 50%, and accuracy of 80.95%; however, it was insignificant (<i>p</i> = 0.352). Additionally, we found a good accuracy of ultrasound signs to detect the degree of placental invasion (focal or diffuse), with a sensitivity of 71.43%, specificity of 100%, PPV of 100%, NPV of 63.64%, and accuracy of 80.95%, which was significant (<i>p</i> = 0.004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This customized “pro forma” has satisfactory accuracy in predicting MAP cases with anterior placenta previa or anterior low-lying placenta.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914351","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":"Risk and survival of third primary cancers in a population-based cohort of patients with a cervical, endometrial, or ovarian cancer","authors":"Elisabete Gonçalves,&nbsp;Filipa Fontes,&nbsp;Jéssica Rocha Rodrigues,&nbsp;Rita Calisto,&nbsp;Maria José Bento,&nbsp;Nuno Lunet,&nbsp;Samantha Morais","doi":"10.1111/jog.16297","DOIUrl":"https://doi.org/10.1111/jog.16297","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Multiple primary cancers are relevant outcomes among survivors of gynecological cancers, contributing to the overall cancer burden and having a potential impact on the management of each primary cancer. This study aimed to estimate the risk and survival of third primary cancers (TPCs) among females with a cervical, endometrial, or ovarian first primary cancer (FPC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with a cervical, endometrial, or ovarian FPC from the Portuguese North Region Cancer Registry, diagnosed between 2000 and 2010 (<i>n</i> = 5846), were followed for a TPC (December 31, 2015) and death from any cause (December 31, 2023). The cumulative incidence of TPCs and mortality was estimated. Patients with a TPC were matched (1:1) to patients without a TPC (FPC + second primary cancer [SPC] only) to compare survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 29 (0.5% of FPCs and 5.4% of SPCs) TPCs were diagnosed. The most common sites were digestive organs (<i>n</i> = 9) followed by breast and urinary tract cancers (<i>n</i> = 4 each). Among all FPCs, the 10-year cumulative incidence (95% confidence interval [CI]) of a TPC was 0.5% (0.3%–0.7%) and among SPCs, it was 5.8% (3.3%–8.2%). For TPCs, compared to matched patients, the age-adjusted hazard ratio (95% CI) for death was 3.0 (1.39–6.50). The 10-year cumulative mortality of TPCs and matched patients was 75.7% and 42.0%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In Northern Portugal, TPCs occurred mainly in digestive organs, followed by the breast and urinary tract, with a 10-year cumulative incidence of 0.5% among all FPCs. TPCs had a worse long-term survival compared to patients with an SPC only.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889082","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":"Associations between serum and seminal vitamin D levels and sperm parameters","authors":"Goksun Ipek,&nbsp;Sezcan Mumusoglu,&nbsp;Gurkan Bozdag,&nbsp;Serdar Gunalp","doi":"10.1111/jog.16305","DOIUrl":"https://doi.org/10.1111/jog.16305","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To examine the association between serum/seminal plasma vitamin D levels and sperm parameters, the possible effects of serum/seminal vitamin D on sperm motility via seminal intracellular calcium measurement, and the antioxidant effect via malondialdehyde (MDA) measurement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study was conducted on 87 male patients. Serum vitamin D levels of patients were evaluated and grouped based on their serum vitamin D levels: low (&lt;50 nmol/L), normal (50–75 nmol/L), and high (&gt;75 nmol/L). Sperm characteristics were evaluated. Seminal plasma vitamin D, intracellular calcium, and MDA concentrations were measured using Liquid Chromatography Mass Spectrometry (LC–MS/MS), High-performance liquid chromatography (HPLC), and fluorescence plate reader methods, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with normal serum vitamin D levels had higher total progressive motile sperm concentrations (14.0 vs. 8.5 vs. 4 million/mL, <i>p</i> = 0.037) and higher normal sperm morphology (6% vs. 4% vs. 3%, <i>p</i> = 0.020) compared to those with low and high levels. No correlations were found between serum vitamin D levels and seminal vitamin D (<i>r</i> = 0.052, <i>p</i> = 0.468), MDA (<i>r</i> = −0.048, <i>p</i> = 0.791), and intracellular calcium levels (<i>r</i> = 0.064, <i>p</i> = 0.929). Seminal intracellular calcium levels were significantly correlated with total (<i>r</i> = 0.241, <i>p</i> = 0.024) and progressive (<i>r</i> = 0.217, <i>p</i> = 0.043) sperm motility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There were positive correlations between serum vitamin D levels, total progressive motile sperm concentration, and normal sperm morphology. However, serum vitamin D levels were not correlated with seminal vitamin D levels and showed no correlations with potential mechanisms of action, reflected by intracellular calcium and MDA concentrations. Conversely, intracellular calcium levels were positively correlated with both total and progressive sperm motility, suggesting that intracellular calcium plays an essential role in sperm motility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889083","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":"Effects of Exenatide plus Metformin versus Metformin alone on insulin resistance in women with Polycystic Ovary Syndrome: A systematic review and meta-analysis","authors":"Abd-alrahman Al-Qudah,&nbsp;Mohammad Al-Hanaktah,&nbsp;Reham Albadaineh","doi":"10.1111/jog.16296","DOIUrl":"https://doi.org/10.1111/jog.16296","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women, often accompanied by insulin resistance, obesity, and increased metabolic risk. While Metformin (MET) is commonly used to improve insulin sensitivity, its limited effect on postprandial glucose has led to interest in combination therapies. Exenatide (EX), a glucagon-like peptide-1 receptor agonist, may offer complementary benefits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the effectiveness of EX combined with MET (EX + MET) versus MET alone (MET) in improving insulin resistance and metabolic outcomes in overweight and obese women with PCOS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This systematic review and meta-analysis included five randomized controlled trials (<i>n</i> = 339) and followed Preferred Reporting Items for Systematic reviews and Meta-Analysis Extension guidelines. The primary outcome was the change in insulin resistance (Homeostatic Model Assessment of Insulin Resistance [HOMA-IR]). Secondary outcomes included body mass index (BMI), 2-h oral glucose tolerance test (OGTT), lipid profile, and reproductive hormones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pooled analysis revealed that EX + MET significantly reduced HOMA-IR (mean difference [MD]: –0.9; <i>p</i> &lt; 0.001), improved 2-h OGTT values (MD: –1.78; <i>p</i> &lt; 0.001), reduced BMI (MD: –0.4; <i>p</i> = 0.03), with low heterogeneity. Combination therapy also improved triglyceride and total cholesterol levels. However, no significant effects were observed on reproductive hormones or low-density lipoprotein and high-density lipoprotein cholesterol.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While hormonal and some lipid changes were not significant, their inclusion highlights the multifaceted impact of PCOS and the need for longer-term studies. By improving insulin sensitivity and weight-related outcomes, EX + MET may be a valuable clinical option for metabolically high-risk PCOS patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889081","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":"The relationship of marital adjustment with mothers' postpartum comfort and adjustment to the postpartum period in Turkiye: A cross-sectional study","authors":"Rukiye Demir,&nbsp;Pelin Akçar","doi":"10.1111/jog.16293","DOIUrl":"https://doi.org/10.1111/jog.16293","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study is to examine the relationship between marital adjustment and mothers' postpartum comfort and adjustment to the postpartum period in Turkiye.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The cross-sectional study was conducted in a public hospital in Turkey between October 2023 and 2024. The population of the study consisted of women who gave birth in this hospital between the dates of the study, and the sample consisted of 200 women (<i>n</i> = 200). The data were collected through face-to-face interviews using the personal information form, marital adjustment scale, postpartum comfort scale, and postpartum self-assessment scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean total score of the mothers who participated in the study was 41.78 ± 7.96 on the Marital Adjustment Scale [MAS], 174.08 ± 11.80 on the Postpartum Comfort Scale (PCS), and 100.12 ± 3.62 on the Postpartum Self-Assessment Scale. It was determined that the mean total scores of the mothers with high mean total scores on the MAS were higher (186.06 ± 7.53 and 129.28 ± 5.38, respectively) than those with low mean total scores on the MAS (154.16 ± 10.83 and 96.28 ± 3.62, respectively) (<i>p</i> &lt; 0.05). A strong positive correlation was found between the mothers' MAS and PCS and PSAS (<i>r</i> = 0.542, <i>p</i> = 0.000 and <i>r</i> = 0.234, <i>p</i> = 0.021, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the study, it was concluded that marital adjustment increased the postpartum comfort level of mothers and their adaptation to this period.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884022","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":"Outcomes of local vasopressin injection and vaginal evacuation for cesarean scar pregnancy: A retrospective review of 11 cases","authors":"Hiroshi Ishikawa,&nbsp;Yuki Goto,&nbsp;Chigusa Hirooka,&nbsp;Eri Katayama,&nbsp;Nao Baba,&nbsp;Yoshiko Saito,&nbsp;Meika Kaneko,&nbsp;Kaori Koga","doi":"10.1111/jog.16306","DOIUrl":"https://doi.org/10.1111/jog.16306","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Vaginal removal of cesarean scar pregnancy (CSP) carries the risk of massive bleeding and residual gestational tissue. To address these complications, we administered local injections of diluted vasopressin surrounding the gestational tissue before vaginal evacuation. In this study, we investigated the surgical and subsequent reproductive outcomes of patients with CSP treated using this technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 11 patients between January 2014 and December 2023, for whom the above technique was used to manage cases in which gestational tissue did not bulge on the bladder side. We injected 5–10 mL of vasopressin diluted 100 times with saline surrounding the gestational sac under transvaginal ultrasound guidance and performed vaginal evacuation either electronically or manually.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median (range) age, body mass index, and gestational week at surgery were 35 (27–43) years, 26.0 (21.5–33.0) kg/m², and 6 (5–8) weeks of gestation, respectively. The longest diameter of the gestational sac was 9.7 (6.5–19.4) mm, and serum human chorionic gonadotropin level at vaginal evacuation was 6327 (1284–14 446) mIU/mL. Surgeries were completed in 17 (10–18) min with minimal blood loss and no residual tissue. Five of the 10 patients who wished for a subsequent pregnancy conceived successfully, and three patients had term deliveries. One patient with a T-shaped uterine cavity experienced recurrent CSP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Local injection of diluted vasopressin and vaginal evacuation is safe and easy without critical adverse events in patients with CSP, where the gestational tissue is not bulging toward the bladder.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884021","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}