Obstetrics and Gynecology Science最新文献

{"title":"A substantial proportion of patients with recurrent implantation failure treated with partner lymphocyte immunotherapy achieved live birth within 3 years after immunization.","authors":"Holger Budde, Susanne Papert, Sandra Jordan, Jakob Valk, Beatrix Pollok-Kopp, Monika Goldmann, Andreas Leha, Eva Vokuhl, Tobias J Legler","doi":"10.5468/ogs.26059","DOIUrl":"10.5468/ogs.26059","url":null,"abstract":"<p><strong>Objective: </strong>In the 1980s, the immunotolerance-inducing effect of leukocytes in blood products was observed and our department started using partner lymphocyte immunotherapy (LIT) for patients experiencing recurrent miscarriage. We also used LIT for couples with unexplained infertility who had undergone at least three unsuccessful embryo transfers. The aim of this study was to analyze the live birth rate after LIT in our patient cohort with recurrent implantation failure.</p><p><strong>Methods: </strong>From 2017 to 2022, we conducted a prospective, noninterventional, observational study of patients who received a questionnaire two to 3 years after LIT. We also performed T- and B-cell crossmatches, human leukocyte antigen (HLA) typing, and complement-dependent cytotoxicity assays.</p><p><strong>Results: </strong>We sent questionnaires to 475 couples with unexplained infertility and received 268 responses. A total of 157 live births (58.6%) within 3 years of LIT were reported. We identified a higher proportion of HLA-crossmatch-positive cases in the live birth group (71.8%) than in the group without live births (59.5%). The median age was 34 years in the live birth group and 36 years in the group without live births. We observed no significant influence of additional therapies including immunoglobulins, corticosteroids, anticoagulants, granulocyte colony-stimulating factor, or lipid infusions.</p><p><strong>Conclusion: </strong>In our patient cohort, we observed an substantial proportion of patients giving live birth within 3 years after LIT. An individual treatment decision is required for each patient, as the efficacy of LIT in patients with unexplained infertility needs to be proven in a controlled, randomized study in the future.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"274-284"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to editor: a randomized clinical trial with unresolved data integrity concerns.","authors":"Ahmed M Maged","doi":"10.5468/ogs.26211","DOIUrl":"10.5468/ogs.26211","url":null,"abstract":"","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":"69 4","pages":"300-302"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized clinical trial with unresolved data integrity concerns.","authors":"Nicholas J L Brown, Gideon Meyerowitz-Katz, Ben W Mol","doi":"10.5468/ogs.25244","DOIUrl":"10.5468/ogs.25244","url":null,"abstract":"","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"298-299"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum stroke-disseminated intravascular coagulation associated with amniotic fluid embolism.","authors":"So Young Lee","doi":"10.5468/ogs.25275","DOIUrl":"10.5468/ogs.25275","url":null,"abstract":"<p><p>Postpartum stroke associated with amniotic fluid embolism (AFE) and disseminated intravascular coagulation (DIC) is an extremely rare life-threatening complication. Here, we report the clinical course and functional recovery of a postpartum woman who experienced ischemic stroke due to DIC following an AFE. Intensive and comprehensive rehabilitation therapies including physical, cognitive, and language interventions yielded significant improvements in motor function, balance, communication, and daily living activities. This case highlights the importance of structured rehabilitation to maximize recovery after severe postpartum neurological injury.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"294-297"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid surgical approach for advanced ovarian cancer: hybrid approach for robotic and minimal open abdominal cytoreduction technique.","authors":"Jaekyung Bae, Uisuk Kim, Ji Hyun Kim, Myong Cheol Lim","doi":"10.5468/ogs.26044","DOIUrl":"10.5468/ogs.26044","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility of a hybrid surgical approach combining robotic-assisted pelvic and laparotomic upper abdominal cytoreduction for advanced ovarian cancer.</p><p><strong>Methods: </strong>We retrospectively reviewed 20 patients with International Federation of Gynecology and Obstetrics stage III-IV ovarian cancer at the National Cancer Center, Korea, who underwent this hybrid approach between July 2023 and September 2024. Robotic surgery was performed for pelvic procedures, whereas upper abdominal cytoreduction was performed through a small laparotomy. Surgical outcomes included residual tumor status, operation time, estimated blood loss, complications, and postoperative recovery.</p><p><strong>Results: </strong>The median age was 53 years, with 75% of patients diagnosed with high-grade serous carcinoma. The median operation time was 342.5 minutes (range, 200.0-505.0) and the median blood loss was 300 mL (range, 5.0-1,500.0). No gross residual disease was achieved in 95% of patients. Intraoperative complications occurred in two patients (10.0%). The median hospital stay was 8 days (range, 6.0-14.0). Foley catheter removal and the first bowel gas passage occurred at a median of 3.5 and 3.0 postoperative days, respectively. Postoperative complications within 30 days included ileus (10.0%), pleural effusion (10.0%), bowel perforation (5.0%), thromboembolism (5.0%), and wound complications (5.0%). Adjuvant chemotherapy began at a median of 17 days postoperatively (range, 10.0-36.0) and 15% of patients were readmitted for ileus, wound complications, or bowel perforation.</p><p><strong>Conclusion: </strong>This hybrid approach demonstrates feasibility with acceptable morbidity in a selected cohort; however, the absence of a comparator group precludes conclusions regarding superiority over conventional approaches. Further prospective studies are required to validate these findings and evaluate long-term oncologic outcomes.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"254-263"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between circulating metabolites and endometriosis: a bidirectional two-sample Mendelian randomization study.","authors":"Lele Pan, Yuying Chen, Yuzhen Cao, Xiaohui Huang, Ying Ma","doi":"10.5468/ogs.25180","DOIUrl":"10.5468/ogs.25180","url":null,"abstract":"<p><strong>Objective: </strong>Endometriosis (EM) is a chronic gynecological condition of unclear etiology, with evidence suggesting a link between metabolite levels and EM risk. A two-sample Mendelian randomization (MR) approach was used to explore the association between 233 metabolites and EM.</p><p><strong>Methods: </strong>Using publicly available genetic data, we conducted a bidirectional two-sample MR analysis to assess the associations between metabolites and EM. Sensitivity analyses were performed to test robustness and pleiotropy, with Bonferroni correction applied for significance.</p><p><strong>Results: </strong>MR analysis suggested that genetically elevated diacylglycerol levels were significantly associated with increased EM risk (odds ratio [OR], 1.225; P=1.16×10-7), corresponding to a 22.5% increase in risk per standard deviation increase in genetically predicted diacylglycerol levels, and remained significant after Bonferroni correction. Nominally significant associations were observed for several other metabolites; lower ratios of 3-hydroxybutyrate and saturated fatty acids to total fatty acids and of total cholesterol to total lipids in very low-density lipoproteins were associated with a higher EM risk (OR, 0.863; P=0.015; OR, 0.865; P=0.030; OR, 0.855; P=1.51×10-4). Reverse MR analysis showed that increased levels of conjugated linoleic acid (CLA) and tyrosine and the CLA to total fatty acid ratio exhibited nominal associations with EM (OR, 1.026; P=0.043; OR, 1.036; P=3.33×10-4; OR, 1.026; P=0.045). No significant heterogeneity or pleiotropy was observed.</p><p><strong>Conclusion: </strong>This study provides evidence of an association between specific metabolites, especially diacylglycerol, and EM risk, enhancing our understanding of the metabolic profile associated with EM.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"212-221"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The neutrophil-to-lymphocyte ratio: a marker for microbial invasion of the amniotic cavity in preterm prelabor rupture of membranes.","authors":"Da Eun Jeong, Min Jung Lee, Eun Ji Oh, Young Mi Jung, Hyeon Ji Kim, Jee Yoon Park, Kyung Joon Oh","doi":"10.5468/ogs.26018","DOIUrl":"10.5468/ogs.26018","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the relationship between maternal blood neutrophil-to-lymphocyte ratio (NLR), serum C-reactive protein (CRP) levels, and microbial invasion of the amniotic cavity (MIAC) in the context of preterm prelabor rupture of membranes (pPROM).</p><p><strong>Methods: </strong>This retrospective cohort study included 154 women with pPROM between 20+0 and 33+6 weeks of gestation who underwent transabdominal amniocentesis. MIAC was defined as a positive amniotic fluid culture. Maternal blood samples were collected within 24 hours after amniocentesis. CRP levels and leukocyte differential counts were quantified.</p><p><strong>Results: </strong>MIAC was diagnosed in 36.4% of patients with pPROM. Patients with MIAC had higher median NLR and CRP levels than those without MIAC (NLR, 6.8 vs. 5.0; CRP, 0.58 mg/dL vs. 0.26 mg/dL; both P=0.007). NLR and CRP exhibited comparable areas under the curve of 0.67 (95% confidence interval [CI], 0.58-0.75) vs. 0.63 (95% CI, 0.54-0.72); P=0.59. Receiver operating characteristic curve analysis was performed to establish diagnostic cutoff values for NLR and CRP (6.2 for NLR and 0.7 mg/dL for CRP). The prevalence of MIAC was highest in patients with both elevated NLR and CRP levels (54.3%) and lowest in those with low values of both parameters (18.8%). Intermediate prevalence rates were observed in patients with discordant NLR and CRP values.</p><p><strong>Conclusion: </strong>NLR exhibited a positive association with MIAC in patients with pPROM, with diagnostic performance similar to CRP. Nonetheless, the presence of MIAC in 18.8% of patients with low levels of both parameters highlights the limitations of these measures in ruling out MIAC.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"183-190"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold coagulation revisited: a strategy for high-grade cervical intraepithelial neoplasia in reproductive-age women.","authors":"Ki Eun Seon, Sujung Kim, Yong Jae Lee, Jung-Yun Lee, Sang Wun Kim, Sunghoon Kim, Young Tae Kim, Eun Ji Nam","doi":"10.5468/ogs.25375","DOIUrl":"10.5468/ogs.25375","url":null,"abstract":"<p><strong>Objective: </strong>Cold coagulation, although less commonly used today, offers a less invasive alternative to excisional procedures for high-grade cervical intraepithelial neoplasia (CIN). This study evaluated post-treatment cytologic and virologic negativity rates among reproductive-age women with high-grade CIN.</p><p><strong>Methods: </strong>This retrospective study analyzed the medical records of 151 reproductive-age women diagnosed with CIN2 or 3 who were treated with cold coagulation at a single tertiary referral hospital between January 2010 and April 2022. Efficacy was assessed using follow-up liquid-based cytology and human papillomavirus (HPV) tests performed 3 months to 3 years after treatment. Statistical analyses included odds ratios and a univariate Cox proportional hazards model to evaluate treatment outcomes and failure rates.</p><p><strong>Results: </strong>At 6 months, cytologic negativity was achieved in 66.7% of patients and virologic negativity in 50.0%; these rates increased to 81.3% and 70.0%, respectively, by 3 years. Treatment failure occurred in 26.5% of patients. However, no significant differences in negative test rates were observed between CIN2 and CIN3 or between HPV16/18 and other high-risk HPV types. Persistent disease occurred in 25.8% of patients, whereas recurrence was observed in 2.6%. Minimal complications were reported and no cases of progression to cervical cancer were identified.</p><p><strong>Conclusion: </strong>Cold coagulation demonstrated moderate post-treatment cytologic and virologic negativity rates with minimal immediate complications in this retrospective cohort. However, given the substantial rate of persistent disease and the nonstandard role of ablative treatment in settings where excision is available, these findings should be interpreted with caution.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"235-243"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-year post-recurrence survival outcome by leukopenia grade 2+ during systemic chemotherapy in recurrent cervical cancer.","authors":"Pornpawee Wangsatidtongbai, Rakchai Buhachat, Ekasak Thiangphak","doi":"10.5468/ogs.26032","DOIUrl":"10.5468/ogs.26032","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the association between grade ≥2 chemotherapy-induced leukopenia (CIL) and 3-year post-recurrence survival (PRS) in patients with recurrent cervical cancer (CC) undergoing systemic chemotherapy.</p><p><strong>Methods: </strong>We conducted a retrospective comparative cohort study of patients with recurrent CC who received ≥3 cycles of systemic chemotherapy at a tertiary referral center between January 2000 and June 2022. Complete serial blood counts were performed for each cycle. Patients were classified according to the development of grade ≥2 leukopenia (white blood cell count <3,000 cells/μL) within the first three cycles. Three-year PRS was analyzed using Kaplan-Meier estimates and Cox proportional hazards models.</p><p><strong>Results: </strong>Among 164 patients (mean age 52.4±11.0 years), leukopenia G2+ occurred in 29 patients (17.7%). Median 3-year PRS was significantly longer in the leukopenia G2+ group than in the non-leukopenia G2+ group (28.9 vs. 17.5 months). The 3-year PRS rates were 38.8% and 16.9%, respectively (P=0.022). On univariate analysis, longer intervals from complete clinical remission to recurrence, platinum regimens, and grade ≥2 leukopenia were associated with improved survival. Multivariate analysis confirmed that leukopenia conferred a 47% reduction in mortality risk (hazard ratio, 0.53; 95% confidence interval, 0.31-0.91; P=0.021).</p><p><strong>Conclusion: </strong>CIL during early treatment cycles was independently associated with superior survival in patients with recurrent CC. In the absence of infectious complications, leukopenia may reflect adequate pharmacodynamic drug exposure and host treatment response. It should be interpreted as a post-hoc prognostic indicator, supporting its potential role as a pragmatic surrogate marker of chemotherapy efficacy.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"202-211"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for hysterectomy strategic repositioning of the vaginal route through technological evolution and emerging surgical variants.","authors":"Yun Seok Yang, Jinyu Lee, Chul Kwon Lim, Jae Young Kwack, Jun-Hyeok Kang, Seong Hee Kim, Kwan Young Oh","doi":"10.5468/ogs.25285","DOIUrl":"10.5468/ogs.25285","url":null,"abstract":"<p><p>Vaginal hysterectomy remains the least invasive approach for benign gynecologic diseases, but has steadily declined due to limited surgical exposure during residency. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has emerged as an innovative technique that combines endoscopic advantages with those of the vaginal route. This review systematically evaluates the clinical outcomes, emerging technological advancements, and global feasibility of vNOTES hysterectomy with a particular focus on its potential to strategically reposition the vaginal route as the primary minimally invasive option in gynecologic surgery. A comprehensive literature review was performed to assess comparative studies, surgical variants, perioperative outcomes, and learning curves of vNOTES, including advanced forms of total NOTES hysterectomy (TNH), isobaric vNOTES (iNH), and robotic vNOTES (RvNH). vNOTES hysterectomy consistently demonstrates favorable perioperative outcomes, such as reduced operative time, lower blood loss, decreased postoperative pain, and shorter hospital stay, compared with laparoscopic hysterectomy. vNOTES provides particular advantages in complex cases, including large uteri, obesity, nulliparity, and pelvic adhesions. Emerging variants such as TNH, iNH, and RvNH show promising feasibility but require further validation. The relatively short learning curve of vNOTES supports its broad clinical adoption. vNOTES hysterectomy is a transformative advancement that complements existing minimally invasive techniques and offers a strategic opportunity to revive the declining vaginal route. The versatility, evolving technical adaptations, and potential for global scalability of vNOTES make it a key modality in gynecologic surgery. Successful dissemination relies on structured training, standardized guidelines, device development, and long-term safety data.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"159-171"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}