Journal of Obstetrics and Gynaecology Research最新文献

{"title":"How successful are Alvarado and air scores in excluding gynecopathologies?","authors":"Goksever Akpinar,&nbsp;Batuhan Eyduran,&nbsp;Alaattin Karabulut,&nbsp;Baris Eker","doi":"10.1111/jog.70050","DOIUrl":"10.1111/jog.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Alvarado and acute inflammatory response (AIR) scoring systems are the most common clinical diagnostic scoring systems for the diagnosis of acute appendicitis. We investigated how successful these scorings are in terms of excluding urgent gynecological pathologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent emergency surgery by the general surgery team due to acute abdomen clinic in our hospital between 2018 and 2023 and were detected to have gynecological pathology during the operation were included in the study. General medical characteristics of the patients, preoperative laboratory values, findings in preoperative imaging, Alvarado and AIR scores, final diagnoses, and surgical procedures performed were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 78 patients were included in the study, 39 patients forming the case group and 39 patients forming the control group. No significant difference was found between the control and case groups in terms of the age of the patients, presence of additional diseases, and WBC value (<i>p</i>: 0.877, <i>p</i>: 0.092, <i>p</i>: 0.500). While the rate of normal findings on ultrasonography (USG) in the case group was significantly lower than in the control group (<i>p</i>: 0.001), the rate of normal findings on computed tomography (CT) was significantly higher than in the control group (<i>p</i>: 0.000). CRP value and length of stay in the case group were significantly higher than in the control group (<i>p</i>: 0.050, <i>p</i>: 0.000). There was no statistically significant relationship between Alvarado or AIR score of 9 or above and whether urgent gynecological pathology was detected (<i>p</i>: 0.073, <i>p</i>: 0.723).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It was observed that Alvarado and AIR scores failed to exclude urgent gynecological pathologies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891631","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":"Nitabuch's and Rohr's fibrinoid layers: Revisiting the interface of the placenta and uterus","authors":"Mishu Mangla,&nbsp;Seetu Palo,&nbsp;Rohini Motwani","doi":"10.1111/jog.70052","DOIUrl":"10.1111/jog.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Nitabuch's and Rohr's fibrinoid layers represent critical but often underrecognized structures at the maternal–fetal interface. This review revisits their historical origins, microscopic features, functional significance, and clinical implications in placental pathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive narrative review was conducted using relevant literature sourced from databases including PubMed, Google Scholar, and historical archives. Articles discussing the anatomy, histology, pathological implications, and forensic relevance of Nitabuch's and Rohr's layers were critically reviewed along with their correlations with pregnancy complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nitabuch's layer, historically described as a band of fibrinoid between the basal decidua and cytotrophoblasts, plays a key role in limiting trophoblastic invasion and facilitating placental detachment during delivery. Rohr's fibrinoid, situated beneath the cytotrophoblast layer within the basal plate, is linked with anchoring villi and maternal blood flow regulation. Both layers are formed through complex interactions involving extravillous trophoblasts, maternal decidual cells, and molecular mediators such as matrix metalloproteinases, human leukocyte antigen-G, and transforming growth factor-beta. Aberrations in their development are implicated in conditions like preeclampsia and placenta accreta spectrum, where the absence of Nitabuch's layer correlates with morbid placental adherence. Their recognition can aid in distinguishing normal placental maturation from pathological states and holds potential value in forensic evaluations of retained placenta and unexplained postpartum hemorrhage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A better understanding of the structure and significance of Nitabuch's and Rohr's layers at the maternal–fetal interface can enhance the interpretation of placental pathology, inform clinical management of obstetric complications, and assist in medico-legal investigations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888254","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":"A case of BRAF mutation-positive recurrent ovarian high-grade serous carcinoma with remarkable response to combined dabrafenib and trametinib therapy","authors":"Tatsuhito Furui,&nbsp;Satoru Katsuki,&nbsp;Yurika Yamada,&nbsp;Jotaro Moroi,&nbsp;Kota Umemura,&nbsp;Mayumi Okada","doi":"10.1111/jog.70047","DOIUrl":"10.1111/jog.70047","url":null,"abstract":"<p>Comprehensive genomic profiling (CGP) testing is increasingly used to identify new treatment options for solid tumors lacking standard therapies. While dabrafenib and trametinib combination therapy has shown efficacy in <i>BRAF</i> mutation-positive solid tumors, reports in gynecologic cancers are limited. We report a case of a patient with <i>BRAF</i> mutation-positive recurrent ovarian high-grade serous carcinoma who showed a remarkable response to dabrafenib and trametinib. The patient initially received monotherapy but experienced disease progression. CGP testing revealed a <i>BRAF</i> mutation, leading to the initiation of combination therapy. Tumor markers significantly decreased, and the recurrent pelvic lesion shrank markedly, resulting in a complete response. The patient remains recurrence-free after 9 months of treatment. This case underscores the importance of CGP testing in identifying targeted therapies for solid tumors without standard treatment options.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888256","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":"Reducing medical costs by adopting external cephalic version in a single perinatal center in Japan","authors":"Nami Tamura,&nbsp;Jun Takeda,&nbsp;Yoshifumi Suga,&nbsp;Asako Kumagai,&nbsp;Nana Matsuzawa,&nbsp;Yuka Yamamoto,&nbsp;Atsuo Itakura","doi":"10.1111/jog.70031","DOIUrl":"10.1111/jog.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The rising rate of cesarean is a global public health concern. In Japan, the rate rose to 29.3% in 2023. Non-cephalic fetuses are typically delivered via cesarean; however, the external cephalic version (ECV) has the potential to reduce perinatal complications and healthcare costs. This study aimed to evaluate the medical cost savings and effectiveness of ECV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study was conducted at a single perinatal center in 2023. ECV was performed under combined spinal-epidural anesthesia (CSEA). The primary endpoint was cost savings from ECV from a societal perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, 1332 deliveries occurred, of which 61 cases involved patients with non-cephalic fetuses. Among these, 79% agreed to undergo the ECV trial, with a 93% success rate. The cost savings per successful ECV resulting in normal vaginal delivery versus one elective cesarean were 226 695 yen. Compared to assuming all patients had undergone cesarean, the total delivery cost savings for ECV were 6 947 452 yen/1000 deliveries. ECV adoption reduced the cesarean rate from 26.7% to 23.9%, without significant adverse perinatal outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ECV performed under CSEA demonstrated a reduction in the medical costs covered by health insurance along with a high success rate and a reduction in the cesarean rate. By increasing insurance reimbursements for ECV, facilities that introduce ECV may increase, which may reduce cesarean rates without increasing the burden of social costs in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881323","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":"Prevalence of low genital tract complaints in postmenopausal women assessed with the Vulvovaginal Symptoms Questionnaire: Systematic review and meta-analysis","authors":"Faustino R. Pérez-López,&nbsp;Ana M. Fernández-Alonso,&nbsp;Juan R. Ulloque-Badaracco,&nbsp;Vicente A. Benites-Zapata","doi":"10.1111/jog.70034","DOIUrl":"10.1111/jog.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We evaluated the prevalence of low genital tract symptoms in postmenopausal women using the Vulvovaginal Symptoms Questionnaire (VSQ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic review and meta-analysis of studies reporting results obtained using the VSQ. The study was registered at PROSPERO-University of York (CRD 2024570513). Electronic database searches were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies evaluating postmenopausal women using the VSQ as reported by the authors. The pooled proportions of vulvovaginal symptoms were calculated as the prevalence of symptoms with their 95% confidence interval (CI), using random effects and inverse variance methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We meta-analyzed seven cross-sectional studies with a low to moderate risk of bias, including 1455 postmenopausal women based on the VSQ. Prevalences of vulvovaginal symptoms were dryness at 46.75% (95% CI, 28.61%–65.34%); burning at 26.08% (95% CI, 13.98%–40.36%); discharge at 19.96% (95% CI, 11.04%–30.69%); hurting at 21.26% (95% CI, 10.53%–34.47%); irritation at 31.76% (95% CI, 21.34%–43.18%); itching at 33.30% (95% CI, 22.35%–45.23%); and odor at 23.14% (95% CI, 11.27%–37.67%). The sensitivity analyses showed that the prevalence trends were maintained. The prevalence of women without vulvovaginal symptoms was 29.81% (95% CI, 17.42%–43.91%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The VSQ provides detailed prevalences of vulvovaginal symptoms, ranging from vulvovaginal discharge in 19.96% to dryness in 46.75% of postmenopausal women. The VSQ allows for measuring subjective vulvovaginal symptoms in postmenopausal women and determining their prevalence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869161","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":"Correction to “Changes in preterm and extremely preterm birth rates in Japan after the introduction of obstetrical practice guidelines in 2008”","authors":"","doi":"10.1111/jog.70046","DOIUrl":"10.1111/jog.70046","url":null,"abstract":"<p>Shimano S, Yamada T, Cho K, Sengoku K, Mariya T, Saito T. Changes in preterm and extremely preterm birth rates in Japan after the introduction of obstetrical practice guidelines in 2008. J Obstet Gynaecol Res. 2023;49(9):2283–94.</p><p>There are two minor numerical errors in Table 2A. Nationwide's PTBR value for fiscal years 2010 should be 5.72% instead of 5.73%, and the value for 2015 should be 5.59% instead of 5.58%.</p><p>We apologize for these errors.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/jog.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861722","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":"Comparison of outcomes between laparoscopic and open radical hysterectomy for early-stage cervical cancer in women with body mass index greater than 24","authors":"Lin Xu,&nbsp;Yang Li,&nbsp;Jia Lu","doi":"10.1111/jog.70041","DOIUrl":"10.1111/jog.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This is a retrospective cohort study to compare outcomes of laparoscopic radical hysterectomy (LRH) and open radical hysterectomy (ORH) in overweight and obese women with early-stage cervical cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 112 patients, with 50 undergoing LRH and 62 undergoing ORH; these were overweight or obese women (BMI ≥24 kg/m²) diagnosed with stage IB–IB2 cervical cancer from 2015 to 2022 Baseline characteristics, including age, smoking status, alcohol consumption, BMI, number of pregnancies, history of abortion, previous abdominal surgeries, menopausal status, radiation therapy, neoadjuvant chemotherapy, clinical tumor stage, tumor grade, or histological subtype, were comparable between the ORH and LRH groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LRH was associated with significantly lower intraoperative blood loss (165 mL vs. 604 mL, <i>p</i> &lt; 0.001) and shorter hospital stays (9 vs. 11.5 days, <i>p</i> &lt; 0.001). No significant differences were observed in overall survival and disease-free survival of 1-year, 3-year, and total between the two groups. Complication rates were similar; though, LRH resulted in significantly fewer incidences of wound fat liquefaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the technical challenges associated with LRH in obese patients, the procedure demonstrated clear benefits in terms of reduced blood loss and quicker postoperative recovery. The oncological safety of LRH was comparable to ORH, supporting its use as a viable and potentially preferable option for surgical management of early-stage cervical cancer in overweight and obese women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833139","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":"Application of feedforward control management combined with holistic operating room nursing in gynecological laparoscopic surgery","authors":"Juan Liu,&nbsp;Chunmei Ji,&nbsp;Hongmei Yang","doi":"10.1111/jog.70021","DOIUrl":"10.1111/jog.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study analyzes the effects of feedforward control management combined with holistic operating room nursing in gynecological laparoscopic surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy patients undergoing gynecological laparoscopic surgery were enrolled and randomized into two groups: the control group (35 patients) and the observation group (35 patients). The control group received conventional operating room nursing, while the observation group received feedforward control management plus holistic operating room management. Postoperative recovery (Postoperative Quality of Recovery Scale [PQRS]) and psychological status (Self-Rating Depression Scale [SDS], Self-Rating Anxiety Scale [SAS]) were compared between groups. Additionally, surgical complications, surgery duration, and postoperative hospital stay were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The PQRS score in the observation group was higher versus the control group (<i>p</i> &lt; 0.05). Both groups showed decreased SAS and SDS scores postoperatively (<i>p</i> &lt; 0.05), with the observation group having lower scores (<i>p</i> &lt; 0.05). The incidence of surgical complications, surgery duration, and postoperative hospital stay were all lower in the observation group (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Feedforward control management combined with holistic operating room nursing enhances postoperative recovery quality, improves psychological conditions, reduces surgical complications, and shortens surgery time and hospital stay.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832447","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":"Surveillance of laparoscopic systemic para-aortic lymphadenectomy for patients with intermediate- and high-risk endometrial cancer in Japan","authors":"Michiko Kodama,&nbsp;Yoshito Terai,&nbsp;Makoto Fujii,&nbsp;Masahide Ohmichi,&nbsp;Nao Suzuki,&nbsp;Masaki Mandai,&nbsp;Aikou Okamoto","doi":"10.1111/jog.70001","DOIUrl":"10.1111/jog.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the feasibility and safety of laparoscopic systemic para-aortic lymphadenectomy (PALN) for endometrial cancer in a multicenter setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data from 403 patients who underwent laparoscopic PALN for intermediate- and high-risk endometrial cancer under Japan's advanced medical care procedure between July 2017 and March 2020 were prospectively collected. Clinical background, surgical outcome, perioperative complications, and prognosis were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histological subtype was 219 (54.4%) G1 or G2 endometrioid carcinoma, 64 (15.9%) G3 endometrioid carcinoma, 64 (15.9%) serous carcinoma, 24 (6.0%) carcinosarcoma, 15 (3.7%) clear cell carcinoma, and 17 (4.2%) others. Simple hysterectomy was performed in 180 cases (44.7%) and modified radical hysterectomy (mRH) in 213 cases (52.9%). Median intraoperative blood loss was 110 mL (range: 0–2092), and 7 (1.7%) received blood transfusions. Intraoperative complications occurred in 20 cases (5.0%) including ureteral injuries (1.7%), vascular injuries (1.0%), and bowel injuries (0.5%). High-volume facilities performing more than 15 PALN procedures harvested significantly more para-aortic nodes than facilities performing fewer procedures. Four cases (1.0%) converted to laparotomy. Postoperative complications occurred in 53 cases (13.2%), with approximately related to lymphadenectomy. Multivariate analysis identified intraoperative blood loss, number of pelvic lymph node (PLN) removed, and radical hysterectomy (RH) as risk factors for urological complications. The number of PLNs removed and mRH were associated with lymphadenectomy-related complications. Over a median follow-up of 14 months (1–39), 20 patients (5.0%) experienced recurrence, and 7 (1.7%) died of the disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Laparoscopic PALN for intermediate- and high-risk endometrial cancer could be performed safely.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832884","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":"Progestogen therapy in threatened miscarriage and unexplained recurrent pregnancy loss: Recommendations by the Thai interest group","authors":"Kiattisak Kongwattanakul,&nbsp;Phudit Jatavan,&nbsp;Olarik Musigavong,&nbsp;Savitree Pranpanus,&nbsp;Lingling Salang,&nbsp;Chonthicha Satirapod,&nbsp;Somsin Petyim,&nbsp;Boonchai Uerpairojkit","doi":"10.1111/jog.70038","DOIUrl":"10.1111/jog.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Threatened miscarriage and unexplained recurrent pregnancy loss (RPL) pose significant physical and psychological challenges for women and their families globally. The lack of local guidelines and variations in recommendations by existing guidelines result in inconsistent management of these conditions in Thailand. The Thai interest group aims to provide recommendations to healthcare providers for the use of progesterone supplementation in women experiencing threatened miscarriage and unexplained RPL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Existing guidelines and relevant studies were reviewed to explore the role of oral, vaginal, and injectable progestogens. In the present evidence-based recommendations, the Thai interest group delineated effective diagnostic and therapeutic strategies for managing patients with threatened miscarriages and unexplained RPL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Treatment initiation for unexplained RPL is recommended after experiencing two or more pregnancy losses, regardless of consecutive occurrences. Oral progestogen (dydrogesterone) is recommended for the management of both threatened miscarriage and unexplained RPL. Exceeding 200 mg of micronized vaginal progesterone (MVP) per intake is not advisable for threatened miscarriage or preventing recurrent miscarriage because of luteal phase insufficiency. Treatment with intramuscular injection progestin should be continued at a dosage of 250 mg twice weekly for several weeks. Additionally, patient experiences and safety concerns related to MVP and injectable progestogens are discussed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These inaugural evidence-based Thai recommendations can be applied in regional healthcare settings for improved outcomes in threatened miscarriage and unexplained RPL. Further research is needed to better understand the epidemiology and etiology of these conditions in Thailand.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 8","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/jog.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832885","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}