Journal of Obstetrics and Gynaecology最新文献

{"title":"Expression of Concern: Can a single serum CA125 assay predict the outcome of threatened abortion?","authors":"","doi":"10.1080/01443615.2026.2732303","DOIUrl":"https://doi.org/10.1080/01443615.2026.2732303","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2732303"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945160","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":"Combined electrical muscle stimulation and proprioceptive training for pelvic floor dysfunction: a retrospective cohort study.","authors":"Juan Li, Huihua Chen, Chen Gao, Lei Yang, Surui Lin","doi":"10.1080/01443615.2025.2602881","DOIUrl":"https://doi.org/10.1080/01443615.2025.2602881","url":null,"abstract":"<p><strong>Background: </strong>Pelvic floor dysfunction (PFD) commonly affects postpartum women, yet surgical interventions carry invasiveness and recurrence risks. This retrospective study aims to investigate the effects of pelvic floor electrical muscle stimulation (EMS) combined with proprioceptive training (PT) on pelvic floor function and structural integrity in women with PFD.</p><p><strong>Methods: </strong>A total of 320 women with PFD treated at Ningde Municipal Hospital from October 2022 to December 2024 were stratified into control group, EMS group, PT group and combined group, with 80 patients in each group. All patients received routine pelvic floor functional training; the EMS group additionally received pelvic floor EMS, the PT group received PT and the combined group received pelvic floor EMS following PT. Pelvic floor resting/tonic contraction electromyography (EMG) value, muscle fibre strength, pelvic floor distress inventory-short form 20 (PFDI-20) scores, and pelvic floor ultrasound parameters were assessed before and after treatment.</p><p><strong>Results: </strong>Post-treatment, all groups showed significant improvements in resting/tonic contraction EMG value, muscle fibre strength, PFDI-20 scores and pelvic floor ultrasound parameters (levator ani muscle (LAM) thickness, bladder neck descent, etc.) compared to baseline (<i>p</i> < 0.001). The combined group achieved superior outcomes across all measures (<i>p</i> < 0.0001), with higher EMG value, greater structural restoration (e.g. increased LAM thickness, reduced hiatus area). No baseline differences were observed among groups (<i>p</i> > 0.05), confirming treatment-specific efficacy of the combined approach.</p><p><strong>Conclusions: </strong>Pelvic floor EMS combined with PT effectively promotes recovery of pelvic floor function and structural integrity in women with PFD. This combined therapy warrants clinical application and dissemination.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2602881"},"PeriodicalIF":1.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827835","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":"Statement of Retraction: Umbilical cord diameter in the prediction of foetal growth restriction: a cross sectional study.","authors":"","doi":"10.1080/01443615.2026.2620502","DOIUrl":"https://doi.org/10.1080/01443615.2026.2620502","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2620502"},"PeriodicalIF":1.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146052587","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":"Artificial intelligence for sexual, reproductive and maternal health in Latin America and the Caribbean: a scoping review.","authors":"Martin Saban, Melina Denise Zavala, Adolfo Rubinstein, Santiago Esteban, Cintia Cejas","doi":"10.1080/01443615.2026.2691044","DOIUrl":"https://doi.org/10.1080/01443615.2026.2691044","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) holds considerable promise for strengthening sexual, reproductive and maternal health (SRMH) by enhancing diagnosis, optimising service delivery and expanding access to information. In Latin America and the Caribbean (LAC), however, the scope, focus and maturity of AI applications in SRMH remain poorly described.</p><p><strong>Objective: </strong>To identify, map and analyse existing applications of AI in SRMH priority services in LAC, characterising thematic areas, target populations, and types of AI tools, whilst highlighting gaps and future research needs.</p><p><strong>Methods: </strong>We conducted a scoping review guided by the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Searches were performed in PubMed, SciELO, Cochrane and LILACS up to August 2023, complemented by targeted Google searches and snowballing. We included records reporting AI applications in SRMH services in LAC and extracted data on setting, population, SRMH domain, AI techniques and implementation stage.</p><p><strong>Results: </strong>A total of 1,518 records were identified, of which 143 met the inclusion criteria. Most were published between 2020 and 2023 and originated from Mexico, Colombia, Peru, Brazil and Argentina. Over half were peer-reviewed articles, with additional theses and web-based reports. Applications concentrated on prenatal, childbirth and postnatal care (36%) and reproductive organ cancers (31%), with far fewer initiatives addressing sexual health, contraception, gender-based violence, sexual satisfaction or counselling. Machine learning methods predominated (52%), followed by deep learning (41%). Almost half of initiatives (48%) were exploratory projects, 17% implemented tools without outcome data and 35% reported performance in real-world contexts.</p><p><strong>Conclusions: </strong>AI applications in SRMH in LAC are expanding but remain thematically narrow, population-selective and predominantly exploratory, highlighting the need for more diverse, rigorously evaluated and equity-oriented tools.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2691044"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391159","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":"Climacteric symptoms among full-time working HRT never-users in different work environments: a cross-sectional study.","authors":"Maija Lipasti, Jaana Jalava-Broman, Lauri Sillanmäki, Juha Mäkinen, Päivi Rautava","doi":"10.1080/01443615.2026.2678186","DOIUrl":"10.1080/01443615.2026.2678186","url":null,"abstract":"<p><strong>Background: </strong>Climacteric symptoms affect a large and growing proportion of women worldwide. Furthermore, women are increasingly participating in the workforce. Many women do not use treatment for their symptoms; however, little is known about how untreated women experience climacteric symptoms. This study examined the occurrence and severity of climacteric symptoms among full-time working women before treatment and compared their experiences across two different work environments.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in a group of Finnish women aged 52-66 years who had never used any treatment for their climacteric symptoms and were employed full-time. The data were obtained from two population-based postal surveys. Statistical techniques were used to analyse the data.</p><p><strong>Results: </strong>The most common symptoms among all participants (<i>n</i> = 338) were hot flushes (80%), sweats (72%), and sleeping problems (72%). The most severe symptoms were hot flushes, sweats, and loss of sexual desire; 12% of participants experienced each of these as severe. Regarding symptom categories, vasomotor symptoms and loss of sexual desire were the most common and the most severe. Participants in either low-strain or high-strain jobs (<i>n</i> = 164) most often experienced five (15%) or 10 (13%) different symptoms out of 12 presented in the study questionnaire. Participants in high-strain jobs (<i>n</i> = 79) experienced a higher number of symptoms (<i>p</i> = 0.019) and more often urinary incontinence (<i>p</i> = 0.008) and depressive symptoms (<i>p</i> = 0.043) than those in low-strain jobs (<i>n</i> = 85). Furthermore, they experienced more severe sweats (<i>p</i> = 0.038).</p><p><strong>Conclusions: </strong>Hot flushes, sweats, sleeping problems, and loss of sexual desire were both common and severe among full-time working untreated women. In addition, symptoms were more troublesome among women in high-strain than low-strain jobs. Therefore, healthcare professionals should pay special attention to the above symptoms and to women in high-strain jobs.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2678186"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042659","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":"Manual rotation and maternal positioning for managing fetal occiput posterior position during labor: a network meta-analysis.","authors":"Mahsa Maghalian, Somayeh Abdolalipour, Nafiseh Ghassab-Abdollahi, Mahin Kamalifard, Mojgan Mirghafourvand","doi":"10.1080/01443615.2026.2704339","DOIUrl":"https://doi.org/10.1080/01443615.2026.2704339","url":null,"abstract":"<p><strong>Background: </strong>The occiput posterior (OP) foetal position is a global obstetric challenge associated with increased maternal and neonatal complications. Manual rotation and specific maternal positioning (hands-and-knees, lateral position) are potential interventions for managing persistent OP position during labour; however, their comparative effectiveness remains uncertain. This systematic review and network meta-analysis aimed to evaluate the efficacy of these interventions versus standard care.</p><p><strong>Methods: </strong>A systematic search of multiple databases was conducted from inception to January 3, 2025 following PRISMA-NMA guidelines. An updated literature search using the same criteria was performed on July 5, 2026 during the final stage of peer review, which yielded no additional studies for inclusion. Randomised controlled trials comparing manual rotation, hands-and-knees position, or lateral position to standard care or each other were included. The primary outcome was spontaneous vaginal delivery. Secondary outcomes included caesarean delivery, severe perineal lacerations, and low Apgar score. Bayesian and frequentist network meta-analysis was performed using MetaInsight software.</p><p><strong>Results: </strong>Fifteen randomised trials involving 2,934 participants were analysed. No intervention demonstrated statistically significant benefits for any primary or secondary outcome. For spontaneous vaginal delivery, the lateral position showed the highest point estimate (OR: 1.97, 95% CrI 0.83 to 4.88), though all credible intervals were wide and crossed the null value. The evidence was characterised by substantial imprecision and methodological limitations, resulting in low to very low certainty for all comparisons.</p><p><strong>Conclusion: </strong>Current evidence does not support the routine use of manual rotation or specific maternal positions for managing persistent OP position. The substantial uncertainty and methodological limitations preclude definitive recommendations. Future high-quality trials with larger sample sizes and standardised protocols are essential.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2704339"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548800","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":"Ultrasound-guided aspiration of large cystic uterine fibroids during pregnancy - description of a novel technique.","authors":"Lauren Berg, Pat O'Brien, Vadivu Palaniappan, Davor Jurkovic","doi":"10.1080/01443615.2026.2701318","DOIUrl":"10.1080/01443615.2026.2701318","url":null,"abstract":"<p><p>In this case series, we describe a novel technique for the treatment of large cystic fibroids causing pressure on the diaphragm and dyspnoea during pregnancy. In all three cases, patients developed breathing difficulties prior to 28 weeks' gestation. The aim of treatment was to enable continuation of pregnancy and prevent iatrogenic early preterm birth. We performed transabdominal ultrasound-guided aspiration of fibroids under local anaesthesia in the outpatient setting between 24 and 31 weeks' gestation. The volumes of fluid aspirated were 600 ml, 1700 ml and 2000 ml. The procedures were uncomplicated, and all patients continued their pregnancy until elective caesarean delivery between 34 and 37 weeks' gestation. This series shows that antenatal ultrasound-guided aspiration may be a simple, safe and effective option for the treatment of symptomatic cystic fibroids, allowing pregnancy to continue without patients being exposed to surgical or anaesthetic risks, and preventing the major neonatal sequelae of very preterm birth.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2701318"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148604285","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 gestational ecosystem: decoding mechanistic links between the maternal microbiome, obstetric outcomes, and offspring health: a narrative review.","authors":"Lelin Chen","doi":"10.1080/01443615.2026.2681762","DOIUrl":"https://doi.org/10.1080/01443615.2026.2681762","url":null,"abstract":"<p><p>Pregnancy is now recognised as a dynamic gestational ecosystem where maternal microbial communities influence maternal physiology, obstetric outcomes, and offspring health. This review synthesises recent advances in understanding the maternal microbiome's role in this process.</p><p><p>We examine the spatial and temporal dynamics of the maternal microbiome, highlighting niche-specific remodelling in the gut, vagina, and oral cavity, and critically appraise the controversial evidence for a placental microbiome. We explore cutting-edge mechanistic pathways, including immunomodulation via short-chain fatty acids (SCFAs) and histamine, metabolic cross-talk through bile acids and neurotransmitters, vascular disruption via metabolites like trimethylamine N-oxide (TMAO), and the role of biofilm-associated infection. These pathways link microbial dysbiosis to adverse outcomes such as preterm birth, preeclampsia, and gestational diabetes. Furthermore, we detail how maternal microbes program offspring metabolic, immune, and neurodevelopmental trajectories through vertical transmission and metabolite-mediated epigenetic regulation.</p><p><p>This review shows that the maternal microbiome is a modifiable axis that influences pregnancy outcomes and offspring health through immune, metabolic, and epigenetic pathways. Translation to practice will require stronger causal evidence, contamination-aware low-biomass methods, and carefully designed intervention trials, including next-generation probiotics, postbiotics, and precision lifestyle strategies.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2681762"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794505","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":"Vaginitis testing outcomes by documented symptom status in a student-run free clinic: a retrospective study.","authors":"Gabriel Alexander Lee, Gunnar Meyer, Yuehe Anna Wang, Isabella Gluzman, Hayley Dunlop, Frances Trezza, Nisha Makkar, Bella Donnelly, Nathan Helsabeck, Courtney DuBois Shihabuddin","doi":"10.1080/01443615.2026.2718719","DOIUrl":"https://doi.org/10.1080/01443615.2026.2718719","url":null,"abstract":"<p><strong>Background: </strong>Vaginitis is a common gynaecologic condition in patients assigned female at birth in the United States, most often caused by bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), or trichomoniasis vaginalis (TV). Symptoms such as discharge, irritation, and burning often overlap. Symptom-based diagnosis is frequently inaccurate, with correct identification in only about half of cases. Empiric treatment without confirmatory testing remains common and can drive inappropriate therapy and antimicrobial resistance. Uninsured populations face higher infection burdens and barriers to care, yet data on vaginitis testing outcomes in student-run free clinics (SRFCs) are limited.</p><p><strong>Methods: </strong>We conducted an IRB-approved retrospective chart review of patients receiving vaginitis testing at a no-cost SRFC affiliated with a Midwestern academic medical centre between October 2019 and November 2023. 104 testing encounters met inclusion criteria for BV, VVC, or TV testing. Demographics, age, and symptom status were extracted from the electronic medical record. Encounters were categorised as having documented vaginitis symptoms or no documented symptoms at the time of testing. All tests used transcription-mediated amplification. Proportional-difference chi-square tests compared results by symptom status, and logistic regression assessed associations between age and positive test results.</p><p><strong>Results: </strong>The sample was predominantly comprised of patients assigned female at birth with a mean age of 31.1 years; 38% identified as Black. No significant differences were observed in positive or negative BV, VVC, or TV test results between encounters with and without documented vaginitis symptoms. Comparisons of positive VVC and TV results were limited by the small number of positive cases. Age was not associated with testing positive for BV, VVC, or TV.</p><p><strong>Conclusions: </strong>Documented symptom status did not consistently correspond with organism-specific test results in this uninsured clinic population. Findings among patients without documented symptoms should be interpreted cautiously because testing was frequently bundled and symptom status was determined retrospectively.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2718719"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794532","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":"Effect of postoperative hormonal therapy on pain following endometriosis surgery: a retrospective cohort study.","authors":"Simon Blum, Louisa Hofbeck, Nadezda Sipulina, Katharina Au, Laura Lotz, Moreno Giacomozzi, Peter A Fasching, Matthias W Beckmann, Stefanie Burghaus","doi":"10.1080/01443615.2026.2649743","DOIUrl":"10.1080/01443615.2026.2649743","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is heterogeneous, and evidence for individualised postoperative management is limited. We assessed whether postoperative hormonal therapy exposure is associated with one-year changes in pain domains after first-time endometriosis surgery and explored factors related to treatment allocation.</p><p><strong>Methods: </strong>Retrospective cohort study (Erlangen, 09/2019-06/2024) of premenopausal women (18-45 years) undergoing first minimally invasive surgery for endometriosis-associated pain with one-year follow-up. Patients were classified into four hormonal therapy (HT) patterns based on baseline and follow-up status: HT none (<i>n</i> = 73), HT initiation (<i>n</i> = 57), HT discontinuation (<i>n</i> = 21), and HT continuation (<i>n</i> = 38). For each pain domain, adjusted analysis of covariance (ANCOVA) models estimated one-year follow-up Numeric Rating Scale (NRS) differences, and therapy-group effects were tested using robust Wald omnibus tests with Holm multiplicity adjustment across domains, and post-hoc contrasts were Holm-adjusted within domains and interpreted only for domains with significant omnibus tests. HT-group membership was analysed using multinomial logistic regression.</p><p><strong>Results: </strong>After multiplicity adjustment across domains, therapy-group differences were observed only for dysmenorrhoea/pelvic pain (<i>p</i> < 0.001). Within this domain, only HT initiation was associated with lower one-year follow-up scores versus HT none (adjusted difference -2.39 NRS points, 95% confidence interval (CI) -3.58 to -1.21; <i>p</i> < 0.001), whereas other contrasts were not significant after within-domain multiplicity correction. No domain-level evidence of between-group differences was found for dyspareunia, dysuria, or dyschezia. Younger age was associated with HT initiation (odds ratio (OR) 0.92, 95% CI 0.86-0.98; <i>p</i> = 0.012) and continuation (OR 0.82, 95% CI 0.74-0.91; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>HT initiation was associated with lower one-year dysmenorrhoea/pelvic pain scores, while other domains showed no consistent differences. Younger patients were more likely to initiate or continue hormonal therapy, suggesting non-random allocation. Given the observational design and potential residual confounding, findings are hypothesis-generating and support symptom-profile-guided postoperative management; prospective studies with standardised regimens and domain-specific outcomes are needed.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"46 1","pages":"2649743"},"PeriodicalIF":2.2,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774349","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}