Journal of Obstetrics and Gynaecology最新文献

{"title":"Enhancing postpartum haemorrhage training by integrating case-problem based learning with simulation: a quasi-experimental study [Letter].","authors":"Sari Luthfiyah, Triwiyanto Triwiyanto, Mohammed Ismath","doi":"10.1080/01443615.2025.2472782","DOIUrl":"https://doi.org/10.1080/01443615.2025.2472782","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2472782"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585981","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 gonadotropin-releasing hormone antagonist (GnRH-ant) cessation on trigger day in a GnRH-ant protocol: a meta-analysis.","authors":"Xueying Li, Yafang Cao, Jinli Lin, Rui Cai, Linhao Zhang, Yao Liu","doi":"10.1080/01443615.2024.2444496","DOIUrl":"https://doi.org/10.1080/01443615.2024.2444496","url":null,"abstract":"<p><strong>Background: </strong>The gonadotropin-releasing hormone antagonist (GnRH-ant) protocol is associated with few oocytes retrieved, few mature oocytes and poor endometrial receptivity. Omission of GnRH-ants on trigger day seems unlikely to induce preovulation and may improve outcomes in the GnRH-ant protocol. This study aimed to systematically evaluate the effects of GnRH-ant cessation on trigger day on in vitro fertilisation outcomes following the GnRH-ant protocol.</p><p><strong>Methods: </strong>We searched PubMed, Ovid/MEDLINE, Wanfang, VIP, CNKI and ClinicalTrials.gov databases. The last search was conducted on 10 December 2023 in English or Chinese, without time limitations on the collection of studies from the databases. The references in these articles were manually searched. Randomised controlled trials (RCTs) and cohort studies aimed at assessing the effects of GnRH-ant cessation on trigger day using the GnRH-ant protocol were included. The eligible studies included at least one of the main outcomes: number of oocytes retrieved, proportion of mature oocytes, implantation rate or clinical pregnancy rate.</p><p><strong>Results: </strong>Three studies with 1449 cycles were included. Cessation of GnRH-ant on trigger day improved the proportion of mature oocytes (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.09-1.45, <i>I</i>² = 0%) but did not affect the number of oocytes retrieved (mean difference [MD] = 0.50, 95% CI = -0.07 to 1.07, <i>I</i>² = 47%), implantation rate (OR = 0.95, 95% CI = 0.69-1.30, <i>I</i>² = 0%), clinical pregnancy rate (OR = 1.06, 95% CI = 0.71-1.58, <i>I</i>² = 0%), endometrial thickness (MD = -0.09, 95% CI = -0.27 to 0.10, <i>I</i>² = 0%) or cycle cancellation rate (OR = 0.64, 95% CI = 0.15-2.74, I² = 0%).</p><p><strong>Conclusions: </strong>Cessation of GnRH-ant on trigger day of the GnRH-ant protocol is suggested because it could improve the proportion of mature oocytes. However, further RCTs are required.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2444496"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895586","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":"Immunohistochemical and bioinformatics analysis of the placental BCL-2 and Beclin-1 expressions in preeclampsia and HELLP syndrome.","authors":"Süleyman Cemil Oğlak, Fırat Aşır, Emine Zeynep Yılmaz, Ayşegül Aşır, Gökhan Bolluk, Tuğcan Korak, Hayat Ayaz, Elif Ağaçayak","doi":"10.1080/01443615.2025.2478577","DOIUrl":"10.1080/01443615.2025.2478577","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to examine the alterations in apoptosis and autophagy in placental tissues from normal pregnancies compared to those affected by preeclampsia (PE) and HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. We analysed the expression of autophagy-associated proteins, Beclin-1 and BCL-2, in human placental tissues and assessed their variations in placentas from pregnancies complicated by PE and HELLP syndrome by immunohistochemical (IHC) and in silico analyses.</p><p><strong>Methods: </strong>An experimental case-control study was performed, involving 40 pregnant women complicated with preeclampsia, 25 pregnant women with HELLP syndrome, and 40 healthy pregnant women. The placental sections were stained with BCL-2 and Beclin-1 immunostains and subjected to IHC examination. The results of the IHC staining were assessed using semi-quantitative analysis. In silico analyses were performed using STRING and Cytoscape software to construct protein interaction networks for BCL-2 and Beclin-1 in PE and HELLP syndrome, followed by Gene Ontology analysis of common interactors to identify significant biological pathways.</p><p><strong>Results: </strong>Both BCL-2 expression was significantly decreased (<i>p</i> < 0.001 and <i>p</i> < 0.0001, respectively) and Beclin-1 staining was significantly increased (<i>p</i> < 0.0001 and <i>p</i> < 0.0001, respectively) in the PE group and HELLP group compared to the control group. The changes in BCL-2 and Beclin-1 expression between PE and the HELLP group were also statistically significant. BCL2 expression was notably lower (<i>p</i> < 0.0001), and Beclin-1 staining was significantly higher (<i>p</i> < 0.05) in the HELLP group compared to the PE group. In PE, BCL-2 interactors were enriched in apoptosis, cytokine production, and cell proliferation pathways, while Beclin-1 interactors were linked to autophagy and phosphatidylinositol-mediated signalling. In HELLP, BCL-2 interactors were involved in inflammatory response regulation, whereas Beclin-1 interactors were associated with vascular endothelial growth factor (VEGF) signalling and immune regulation.</p><p><strong>Conclusions: </strong>The differential expression patterns of BCL-2 and Beclin-1 between the PE and HELLP groups suggest that these proteins play distinct roles in the pathophysiology of these conditions.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2478577"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649350","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":"Comparison of sterile normal saline and 1% povidone-iodine for vaginal preparation in vesicovaginal fistula: a randomised trial.","authors":"Xinyan Che, Mingjian Ruan, Yang Yang, Zhijun Xi, Yanbo Huang, Wei Wang, Lijun Zhong, Kaiyue Chen, Yuke Chen, Shiliang Wu","doi":"10.1080/01443615.2024.2439356","DOIUrl":"10.1080/01443615.2024.2439356","url":null,"abstract":"<p><strong>Background: </strong>Vaginal preparation before transvaginal gynecological surgeries improves the success rate. However, there is no consensus on which agent is superior for transvaginal repair of vesicovaginal fistula (VVF). We aimed to compare irritation symptoms and antimicrobial function between sterile normal saline (SS) and 1% povidone-iodine (PI) for vaginal preparation in surgical repair of VVF.</p><p><strong>Methods: </strong>This randomised, controlled trial was conducted on patients with VVF underwent transvaginal repair. Preoperative vaginal irrigation was randomly performed with either SS or 1% PI. The patients' self-reported symptoms questionnaires, including numerical rating scale (NRS) of pain, Indevus urgency severity scale (IUSS), and vaginal symptoms, tissue edoema degree and pathogenic microbiology were recorded.</p><p><strong>Results: </strong>The study included 30 patients in the SS group and 31 patients in the PI group. After twice irrigations before surgery, compared with the PI group, the SS group had a similar count of bacterial species but a higher bacterial load (<i>p</i> = .079 and <i>p</i> = .033). The NRS of pain and IUSS in the SS group were lower than those in the PI group (<i>p</i> < .001). The SS group had less severe vaginal symptoms (<i>p</i> < .001) and tissue edoema (<i>p</i> < .001) than the PI group. The successful repair rates were 86.7% in the SS group and 83.9% in the PI group (<i>p</i> = .758). Patients with more severe urinary and vaginal symptoms had lower successful repair rates (92.3% vs. 72.7%, <i>p</i> = .047).</p><p><strong>Conclusions: </strong>SS is an effective vaginal preparation liquid for transvaginal repair of VVF with less irritation symptoms and acceptable antimicrobial function.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2439356"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433248","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":"Comparison of vaginal moisturisers with ultra-low-dose oestriol and lactobacillus vaginal tablets in women with POP who used a pessary: a randomised controlled trial.","authors":"Orawee Chinthakanan, Sirirat Sarit-Apirak, Komkrit Aimjiraku, Rujira Wattanayingcharoenchai, Jittima Manonai, Apisith Saraluck","doi":"10.1080/01443615.2025.2512772","DOIUrl":"10.1080/01443615.2025.2512772","url":null,"abstract":"<p><strong>Background: </strong>This study aim to compare the proportion of pessary users reporting satisfaction with ultra-low dose oestriol and Lactobacillus vaginal tablets and vaginal moisturiser.</p><p><strong>Methods: </strong>A randomised-controlled trial enrolled patients who were able to take care, insert, and remove a pessary themselves and did not use any local oestrogen or vaginal moisturiser for 3 months at a tertiary centre. Participants were randomised to receive either vaginal moisturisers or ultra-low-dose oestriol and Lactobacillus vaginal tablets for 2 months. A single-blinded evaluator assessed outcomes. The oestriol group received one vaginal tablet daily for 6 days followed by two tablets weekly for 8 weeks. The moisturiser group received one application every 3 days for 8 weeks. The primary outcome was the proportion of patients reporting high satisfaction, defined as 'very much improved' or 'much improved', using the Thai version of the Patient Global Impression of Improvement (PGI-I) scale. Secondary outcomes were subjective and objective outcomes of vaginal health. Sixty patients were randomised, of whom one did not complete treatment.</p><p><strong>Results: </strong>The majority of enrolled participants were postmenopausal women with a mean age of 65.54 years, mean BMI of 25.13 kg/m², and advanced-stage POP. The average duration of pessary use was 12-15 months. Patient satisfaction was not significantly different between the oestriol and moisturiser groups at 4 or 8 weeks (93.10% vs. 96.67%, P = 0.61 and 89.66% vs. 93.33%, P = 0.67, respectively). There were no serious adverse events.</p><p><strong>Conclusions: </strong>Vaginal moisturisers and ultra-low-dose oestriol and Lactobacillus acidophilus vaginal tablets provided high satisfaction in pessary users. Both preparations were comparable in both subjective and objective outcomes.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2512772"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216195","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":"Therapeutic strategies to prolong gestation in preterm preeclampsia.","authors":"Henrique Provinciatto, Edward Araujo Júnior, Roberta Granese","doi":"10.1080/01443615.2024.2442815","DOIUrl":"https://doi.org/10.1080/01443615.2024.2442815","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2442815"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894904","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":"Patients with a transabdominal cerclage due to recurrent mid-trimester losses are not at higher risk of foetal growth restriction: a retrospective study.","authors":"David R Hall, Lana Koster, Mari van de Vyver","doi":"10.1080/01443615.2025.2452839","DOIUrl":"10.1080/01443615.2025.2452839","url":null,"abstract":"<p><p>Foetal growth restriction (FGR) is associated with neonatal morbidity, suboptimal neurodevelopmental outcomes and chronic diseases. Successful pregnancies of women with recurrent mid-trimester pregnancy losses may still be at risk of FGR and small for gestational age (SGA) outcomes. This study aimed to investigate whether patients with recurrent mid-trimester pregnancy losses who undergo transabdominal cerclage (TAC) are at an increased risk of FGR. Due to a paucity of information in this regard, and to inform accurate counselling, we performed a secondary analysis of a unique set of patients with a TAC procedure. Foetal growth restriction (<3rd centile) was present in 8% of cases, with more female than male babies falling in this category (9.2 vs. 7.4%). When combined, FGR plus SGA were present in 19.4% of cases. This rate is not higher than the expected population rate of around 20% in low- and middle-income countries.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2452839"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007064","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":"Surgical outcomes after gender-affirming hysterectomies: a consecutive case series of 72 patients.","authors":"Susanna Alder, Kiriaki Papaikonomou, Leonora Tebani, Ilmatar Rooda, Cecilia Dhejne, Pauliina Damdimopoulou, Sebastian Gidlöf","doi":"10.1080/01443615.2025.2463419","DOIUrl":"10.1080/01443615.2025.2463419","url":null,"abstract":"<p><strong>Background: </strong>Hysterectomy is a significant component of gender-affirming treatment for transgender individuals. The choice of surgical technique and associated complications have been studied, but very few studies have used a standardised classification system to grade surgical complications. This study aimed to describe our hospital's experience on gender-affirming hysterectomies with regards to patient demographics, surgical techniques, and postoperative complications using a validated classification system.</p><p><strong>Methods: </strong>The study is a prospective follow-up case-series study of 72 consecutive patients undergoing gender-affirming hysterectomy at Karolinska University Hospital between 2016 and 2023. Patient demographics (age and mean body mass index), tobacco and alcohol habits, medical history and comorbidities, route of hysterectomy, complications and 30-days postoperative outcomes were reported. Surgical complications were graded according to the Clavien-Dindo classification system.</p><p><strong>Results: </strong>The study population, with an average age of 27.6 years, presented diverse medical conditions, with psychiatric diagnoses being the most prevalent. The most common procedure was total laparoscopic hysterectomy, with low intraoperative blood loss. Surgical complications were rare, and primarily required minimal interventions. The 30-day Clavien-Dindo postoperative complication rate of grade II or higher was 19%, although only 4% experienced complications necessitating re-surgery (grade III or higher). Postoperative follow-up emerged as a critical aspect, with 22% of patients seeking non-elective medical attention within the first month, often due to vaginal bleeding or abdominal pain.</p><p><strong>Conclusions: </strong>Our findings support the safety and feasibility of gender-affirming hysterectomies, particularly when performed laparoscopically, with very few severe complications observed using a validated scoring system. Extensive follow-up care, as well as addressing common postoperative concerns, is essential. Despite a relatively small sample size and lack of a control group, this study provides valuable insights into transgender healthcare from a previously unstudied region. Future research should preferably include larger cohorts, multicentre and registry-based studies.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2463419"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414554","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":"Chronic hepatitis B infection and pre-eclampsia/eclampsia: a Mendelian randomisation study.","authors":"Rui Pu, Zhen Wang, Xiaopeng Shang, Jiexia Lu, Jiling Xu, Yuhang Xing","doi":"10.1080/01443615.2025.2500972","DOIUrl":"https://doi.org/10.1080/01443615.2025.2500972","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the potential causal association between chronic hepatitis B (CHB) infection and the risk of pre-eclampsia/eclampsia using a Mendelian randomisation (MR) design.</p><p><strong>Methods: </strong>We conducted a two-sample MR analysis using genome-wide association study (GWAS) summary statistics from three large-scale datasets. For CHB infection, we used data from 351,885 individuals UK Biobank. For pre‑eclampsia/eclampsia, we analysed two FinnGen datasets with sample sizes of 118,291 and 126,760 individuals, respectively. Genetic variants strongly associated with CHB infection (<i>p</i> < 5 × 10^-8) were selected as instrumental variables. The inverse-variance weighted (IVW) method was employed as the primary analysis. Sensitivity analyses included MR-Egger regression, weighted median, weighted mode and MR-PRESSO. Cochran's <i>Q</i> test and MR-Egger intercept tests were performed to assess heterogeneity and horizontal pleiotropy, respectively.</p><p><strong>Results: </strong>MR analysis revealed significant positive genetic associations between CHB infection and increased risk of pre-eclampsia (OR = 1.154, 95%CI = 1.014-1.313, <i>p</i> = .029) and eclampsia (OR = 1.561, 95%CI = 1.030-2.366, <i>p</i> = .035). Findings were robust across sensitivity analyses for both outcomes.</p><p><strong>Conclusions: </strong>Our study provides genetic evidence that CHB infection increases the risk of both pre-eclampsia and eclampsia. These findings suggest that considering CHB status as a risk factor and implementing targeted HBV screening programmes may be beneficial for pregnant women.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2500972"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078626","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 retrospective study of WeChat app-based health management for patients with gestational diabetes mellitus.","authors":"Biyun Huang, Huimin Zhai","doi":"10.1080/01443615.2024.2435065","DOIUrl":"https://doi.org/10.1080/01443615.2024.2435065","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore and evaluate the effectiveness of WeChat app-based health management in patients with gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>This study retrospectively analysed a cohort of 100 patients with GDM. Since the application we used went live in April 2023, we enrolled patients from April 2022 to June 2022 into the control group (<i>n</i> = 50) and patients from April 2023 to June 2023 into the observation group (<i>n</i> = 50) for contemporaneous comparisons. The control group received routine health management procedures, whereas the observation group received app-based health management. Fasting plasma glucose, 2-hour postprandial blood glucose, and haemoglobin A1c levels were compared between the two groups before and four and eight weeks after app management; the incidence of adverse pregnancy outcomes and weight gain before and after pregnancy was also compared between the two groups.</p><p><strong>Results: </strong>Fasting plasma glucose and 2-hour postprandial blood glucose levels were lower in the observation group than in the control group four and eight weeks after intervention (<i>p</i> < 0.05). In addition, the incidence of adverse pregnancy outcomes and weight gain was lower in the observation group than in the control group (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Implementing WeChat app-based health management can effectively improve blood glucose levels, reduce adverse pregnancy events in patients with GDM, and decrease weight gain during pregnancy.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2435065"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769924","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}