AJOG global reports最新文献

{"title":"Three decades after the International Conference on Population and Development: where are we with youth engagement in sexual and reproductive health and rights in Africa?","authors":"Abraham Fessehaye Sium MD","doi":"10.1016/j.xagr.2026.100609","DOIUrl":"10.1016/j.xagr.2026.100609","url":null,"abstract":"<div><div>The world has recently celebrated the 1994 International Conference on Population and Development in Cario, which transformed global thinking on population and development issues by prioritizing the inclusion of reproductive rights, empowering women and girls, and addressing inequalities in nations’ development agenda. A joint statement at the United Nations General Assembly meeting marking the 30th anniversary of this crucial conference called that the march toward a peaceful, equitable, just, and sustainable future continues by ensuring no one is left behind. To date, youth engagement in sexual and reproductive health in developing countries remains low despite the call for nations to meet the educational and service needs of adolescents and youth to enable them to deal in a positive and responsible way with their sexuality and health (one of the bold layouts of the landmark International Conference on Population and Development). Current evidence on youth engagement in sexual and reproductive health shows that there are some effective interventions implemented in African countries that seem creative and encouraging. However, in terms of research, the interventions are fragmented and poorly documented. There are too few studies that looked into the implementation of effective and pragmatic approaches on this topic. Africa should improve its investments in youth sexual and reproductive health interventions with their full participation.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100609"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does gestational age influence the predictive accuracy of the cerebroplacental ratio for intrapartum fetal compromise?","authors":"José Morales-Roselló MD, PhD ,&nbsp;Asma Khalil MD ,&nbsp;Silvia Buongiorno MD ,&nbsp;Maia Brik MD ,&nbsp;Manel Mendoza MD ,&nbsp;Carolina Di Fabrizio MD ,&nbsp;Elisa Scarinci MD ,&nbsp;Silvia Salvi MD","doi":"10.1016/j.xagr.2025.100585","DOIUrl":"10.1016/j.xagr.2025.100585","url":null,"abstract":"<div><h3>Background</h3><div>The accuracy of the cerebroplacental ratio (CPR) in predicting cesarean section for intrapartum fetal compromise (CS-IFC) prior to the onset of labor remains controversial.</div></div><div><h3>Objectives</h3><div>To determine whether advancing gestational age (GA) in the final weeks of pregnancy enhances the predictive performance of CPR and other sonographic parameters for CS-IFC before labor.</div></div><div><h3>Study design</h3><div>This multicentre retrospective study analysed 590 singleton pregnancies across four tertiary centres in Spain, Italy, and the UK. All participants underwent Doppler ultrasound assessment between 35+0 and 41+0 weeks of gestation and delivered within 24 hours of examination. CS-IFC was defined by abnormal intrapartum fetal heart rate patterns or fetal scalp pH &lt;7.20 necessitating emergency caesarean delivery. The predictive performance of CPR, middle cerebral artery (MCA) pulsatility index (PI), and umbilical artery (UA) PI—expressed as multiples of the median (MoM)—was evaluated using ROC curve analysis and logistic regression, alone and in combination with estimated fetal weight centile (EFWc), fetal sex, and type of labour onset (TLO), stratified by gestational age.</div></div><div><h3>Results</h3><div>The highest overall predictive performance between 35 and 40 weeks of gestation was observed with the use of CPR MoM and MCA PI MoM (AUC 0.71, 95% confidence interval [95% CI], 0.64–0.79, <em>P</em>&lt;.00001, AIC 343.6; AUC 0.70, 95% CI, 0.63–0.77, <em>P</em>&lt;.00001, AIC 346.5, respectively). Predictive accuracy further improved with the inclusion of estimated fetal weight centile (EFWc) (AUC 0.73, CI 0.66–0.80, <em>P</em>&lt;.00001, AIC 339.3; AUC 0.74, CI 0.68–0.80, <em>P</em>&lt;.00001, AIC 336.4), and was enhanced even more when additional clinical variables, such as fetal sex and type of labor onset were incorporated (AUC 0.77, CI 0.71–0.83, <em>P</em>&lt;.00001, AIC 327; AUC 0.78, CI 0.72–0.84, <em>P</em>&lt;.00001, AIC 323.9).</div><div>Across all models, predictive accuracy improved with advancing GA (<em>P</em>&lt;.00001), peaking at 39 to 40 weeks. This trend was evident for cerebral Doppler indices (CPR MoM and MCA PI MoM), but not for UA PI or EFWc. The improvement in performance remained significant even when only fetuses appropriate for gestational age were analyzed.</div></div><div><h3>Conclusion</h3><div>The predictive ability of cerebral Doppler for CS-IFC, in both high- and low-risk pregnancies, increases with advancing gestational age during the last weeks of gestation.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100585"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of CMV, HSV-2, and HPV infections with spontaneous abortion","authors":"Masoud Doosti Pirani PhD ,&nbsp;Mehrdad Ravanshad PhD ,&nbsp;Mohammad Shayestehpour PhD ,&nbsp;Seyed Alireza Mousavi MD ,&nbsp;Somayeh Jahanabadi MD","doi":"10.1016/j.xagr.2026.100604","DOIUrl":"10.1016/j.xagr.2026.100604","url":null,"abstract":"<div><h3>Background</h3><div>Spontaneous abortion (SA) is a common pregnancy complication, and viral infections have been proposed as potential risk factors. This study investigated the prevalence of cytomegalovirus (CMV), herpes simplex virus type 2 (HSV-2), and human papillomaviruses (HPVs) in women with SA compared to healthy pregnancies.</div></div><div><h3>Method</h3><div>A case–control study was conducted including 50 women with SA and 50 pregnant women without complications. Maternal blood, umbilical cord blood, placental tissue, and cervical swabs were analyzed for viral DNA using polymerase chain reaction with virus-specific primers. β-actin served as an internal control. Demographic and clinical data were also compared.</div></div><div><h3>Results</h3><div>The mean age did not differ significantly between groups (30.02±4.73 vs 29.42±4.54 years, <em>P</em>=.52). Compared with controls, women with SA had significantly higher symptoms of infection during pregnancy (42% vs 16%, <em>P</em>&lt;.01). There was no significant difference in frequency of detected CMV DNA between SA and control groups (4% vs 0%, <em>P</em>=.49). Similarly, frequency of HSV-2 (6% vs 0%, <em>P</em>=.24), and HPV (14% vs 4%, <em>P</em>=.16) did not differ significantly between SA and control groups, respectively. Among HPV subtypes, HPV-16 and HPV-53 were found exclusively in SA cases with no significant difference.</div></div><div><h3>Conclusion</h3><div>Despite slightly higher detection rates of CMV, HSV-2, and HPV in women with SA, no statistically significant association was found between these viral infections and spontaneous abortion. Larger studies are required to further clarify their role in pregnancy outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100604"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating diversions in the obstetric operating room: focusing amidst distractions","authors":"Kaitlyn Voity ,&nbsp;Christina O’Leary ,&nbsp;Nicole P. Jenkins DO ,&nbsp;Claire Wolford ,&nbsp;Jonathan D. Baum MD ,&nbsp;Antonia F. Oladipo MD, MSCI","doi":"10.1016/j.xagr.2025.100587","DOIUrl":"10.1016/j.xagr.2025.100587","url":null,"abstract":"<div><h3>Background</h3><div>Distractions in the operating room (OR) are known to disrupt surgical workflow and compromise patient safety. However, little is known about the nature and impact of intraoperative distractions during cesarean deliveries, which involve dual-patient care and complex team dynamics. This study aims to characterize the frequency, type, and severity of distractions in the obstetric OR and examine associations with surgical duration and complications.</div></div><div><h3>Objective</h3><div>To systematically characterize the frequency, types, and severity of intraoperative distractions during scheduled cesarean deliveries, and to evaluate their association with surgical duration and maternal or neonatal complications. The study hypothesizes that higher distraction scores are associated with longer procedure times and increased clinical complications.</div></div><div><h3>Study Design</h3><div>We conducted a prospective observational study of 97 scheduled cesarean deliveries at ≥37 weeks’ gestation from March 2023 to December 2024. Distractions were recorded in real time using a published distraction categorization tool and grading system by severity (mild, moderate, severe). A weighted distraction score was calculated per case. Clinical data included procedure duration, staff count, and presence of maternal or neonatal complications.</div></div><div><h3>Results</h3><div>Across 97 cases, 8113 distractions were documented (mean: 81 per case). Door movement and teaching conversations were the most common types of distraction type. While mild distractions were most frequent, moderate distractions contributed the largest portion of the total distraction burden (44.5%). Severe distractions occurred in all cases. No significant correlation was found between surgery length and distraction score. Cases with NICU admissions (n=11) had higher average total distraction scores (98.8) and more severe distractions (mean: 3.56).</div></div><div><h3>Conclusions</h3><div>Distractions in the obstetric OR are frequent and varied, with moderate distractions representing a key contributor to cognitive load. Higher distraction scores may be associated with neonatal complications, underscoring the need for distraction-reduction strategies to optimize safety in cesarean deliveries. Although distractions were not associated with prolonging surgical length, healthcare providers should be cognizant of the amount and type of distractions that can occur that may impact patient outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100587"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of 48 months of elagolix with add-back therapy for endometriosis-associated pain","authors":"Jin Hee Kim MD ,&nbsp;Charles E. Miller MD ,&nbsp;James A. Simon MD ,&nbsp;James W. Thomas MS ,&nbsp;Anna Chan PharmD ,&nbsp;Michael C. Snabes MD, PhD","doi":"10.1016/j.xagr.2025.100584","DOIUrl":"10.1016/j.xagr.2025.100584","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Elagolix (ELA) 200 mg twice daily is an oral treatment approved for moderate-to-severe endometriosis-associated pain. However, the clinical use of ELA is limited by potential hypoestrogenic effects, including the loss of bone mineral density (BMD). The addition of hormonal add-back (AB) therapy (1-mg estradiol/0.5-mg norethindrone acetate once daily) may attenuate BMD loss.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To provide long-term safety results from a 48-month phase 3 trial assessing ELA+AB therapy in premenopausal women with moderate-to-severe endometriosis-associated pain.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;This multicenter, phase 3 trial was conducted between July 7, 2017, and December 6, 2023, and included a 12-month double-blind treatment period, a 36-month open-label extension period, and a 12-month post-treatment follow-up (PTFU) period. At the beginning of the double-blind period, premenopausal women (aged 18−49 years) with moderate-to-severe endometriosis-associated pain were randomized 4:1:2 to ELA+AB therapy, ELA monotherapy for 6 months followed by ELA+AB therapy for the remaining 6 months, or placebo. After the double-blind treatment period, all patients were treated with open-label ELA+AB therapy (referred to as the ELA+AB/ELA+AB, ELA/ELA+AB, and placebo/ELA+AB groups) for the remainder of the 36-month open-label treatment period. Safety was assessed throughout the open-label treatment period. BMD was measured by dual-energy X-ray absorptiometry in the lumbar spine, total hip, and femoral neck during the screening period and every 6 months throughout the study. BMD was analyzed using an analysis of covariance model with treatment as the main effect and baseline values as covariates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 380 patients who entered the open-label period, 140 (36.8%) completed the treatment period, and 240 (63.2%) discontinued, primarily due to withdrawn consent and adverse events (AEs). In total, 159 (74.0%) patients in the ELA+AB/ELA+AB group, 41 (69.5%) patients in the ELA/ELA+AB group, and 80 (75.5%) patients in the placebo/ELA+AB group reported at least 1 treatment-emergent adverse event (TEAE) during the open-label period. TEAEs were generally mild or moderate and nonserious. The most commonly reported TEAEs were COVID-19, bone density decreases, and sinusitis. No serious AEs were reported in &gt;1 patient in any study group. BMD remained generally stable, with a least squares mean percent decrease from baseline to week 48 &lt;2% in all groups and at all anatomical sites. Similarly, the least squares mean decrease from baseline in BMD was &lt;2% in the ELA+AB/ELA+AB group at all anatomical sites and all time points throughout the study period. For patients in the ELA+AB/ELA+AB group with ≥48 months of treatment and reduced BMD at the final on-treatment visit, the majority (lumbar spine, 13 [59.1%]; total hip, 8 [53.3%]; femoral neck, 12 [57.1%]) partially or fully recove","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100584"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference interval for 24-hour urinary protein excretion in uncomplicated women with twin pregnancies","authors":"Yuguo Deng MD ,&nbsp;Lanyun Liu BS ,&nbsp;Danxiu Lu BS ,&nbsp;Qiulu Wu MD ,&nbsp;Ying Li PhD ,&nbsp;Jinying Yang PhD","doi":"10.1016/j.xagr.2025.100583","DOIUrl":"10.1016/j.xagr.2025.100583","url":null,"abstract":"<div><h3>Background</h3><div>The study of 24-hour urinary total protein (24-h UTP) excretion is an essential parameter for the assessment of renal function and early detection of pregnancy complications. However, data on reference interval for 24-h UTP in women with twin pregnancies are scarce.</div></div><div><h3>Objective</h3><div>We aimed to establish the reference interval for 24-h UTP excretion in women with twin pregnancies and compare it with that in women with singletons.</div></div><div><h3>Study Design</h3><div>A total of 12,633 participants with singletons or twin pregnancies were recruited. They were instructed to collect standard 24-hour urinary samples. Information was extracted from the electronic medical record. The nonparametric percentile method was used to determine reference interval for 24-h UTP excretion during different trimesters in women (excluding, among others, those with preexisting renal disease, gestational or chronic hypertension, pre-eclampsia, and pregestational diabetes mellitus).</div></div><div><h3>Results</h3><div>In twin pregnancies, the 24-h UTP levels expressed as medians and percentiles (5th, 95th) for each trimester were as follows: 74.2 (32.7, 195.5) mg, 104.5 (41.9, 213.1) mg, and 152.6 (46.1, 415.7) mg in the first, second, and third trimesters, respectively. A significant increase in 24-h UTP excretion was observed throughout pregnancy (all <em>P</em>&lt;.001). Furthermore, the median (25th, 75th) of 24-h UTP values in the singleton group and twin groups were 70.2 (48.5, 98.3) vs 74.2 (47.3, 108.2) mg, 84.8 (58.5, 118.2) vs 104.5 (78.4, 135.6) mg, and 108.0 (73.4, 149.3) vs 152.6 (90.8, 192.8) mg in the first, second, and third trimesters, respectively. (Part of the data on singleton pregnancy has previously been published). The 24-h UTP excretion in the twin group was significantly higher than those in the singleton group in the second and third trimesters (both <em>P</em>&lt;.001).</div></div><div><h3>Conclusion</h3><div>Physiological proteinuria levels were approximately doubled in late pregnancy in women with twin pregnancies compared to early pregnancy, and the upper limit of normal 24-h UTP excretion is 415.7 mg in late pregnancy. Moreover, the threshold for elevated proteinuria in twin pregnancies could be higher than in singletons from the second trimester onwards. Understanding these changes is essential for precise twin management and patient counseling.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100583"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed presentation of a snake bite with multiple life threatening complications in third trimester pregnancy successfully managed in resource limited setting: case report","authors":"Leul Endalamaw Demilew MD ,&nbsp;Misganaw Abere Worku MD ,&nbsp;Girmachew Tesfaye Agegnehu MD ,&nbsp;Asnakew Amisalu Mebratu MD ,&nbsp;Gashaw Awoke Haile MD ,&nbsp;Bezawit Alemu Mengist MD ,&nbsp;Wondwosen Mengist Dereje MD","doi":"10.1016/j.xagr.2026.100603","DOIUrl":"10.1016/j.xagr.2026.100603","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Snakebite envenoming is a potentially life-threatening condition and a common public health problem, particularly in developing countries. Envenomation during pregnancy is rare but carries serious consequences for both the mother and the fetus. Antivenom is the primary treatment; however, its unavailability, along with limited healthcare facilities in developing countries, contributes to significant mortality. In the reported case, we present a 35-year-old woman in her third trimester who developed multiple complications from a snakebite and was managed at our institution.</div></div><div><h3>Case presentation</h3><div>A 35-year-old gravida VI, para V woman was referred from a primary hospital due to the unavailability of an obstetrician, blood products, appropriate diagnostic facilities, and essential medications. She initially presented to the primary hospital with complaints of vaginal bleeding and decreased fetal movement lasting 24 hours. Additionally, the patient reported lightheadedness, easy fatigability, and blurred vision but denied headaches or any abnormal body movements.</div></div><div><h3>Conclusion</h3><div>Although snakebite is a common public health problem, it is often neglected. As with other neglected tropical diseases, estimating the global morbidity, disability, and mortality caused by snakebite envenoming is challenging. The disease is prevalent among individuals in impoverished agricultural and herding communities in low- and middle-income countries, where access to healthcare is limited and health-seeking behavior may be poor, making this health issue potentially fatal. Snakebite envenomation during pregnancy has severe consequences for both the mother and the fetus. Increasing community awareness, ensuring early admission, close follow-up, and appropriate management through a multidisciplinary approach can improve outcomes for both mother and fetus.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100603"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of an external cephalic version simulation-based educational program","authors":"Dhanalakshmi Thiyagarajan MD, MPH ,&nbsp;Megan Gauger MD ,&nbsp;Raj Patel MEng ,&nbsp;Thelma Quarshie MO ,&nbsp;Enaam A. Adanu MBChB ,&nbsp;Julia Kramer PhD, MPH ,&nbsp;Kathleen H. Sienko PhD ,&nbsp;Cheryl A. Moyer PhD, MPH ,&nbsp;Molly Stout MD, MS ,&nbsp;Deborah M. Rooney PhD ,&nbsp;Samuel A. Oppong MBChB, MPH ,&nbsp;Alim Swarray-Deen MBChB, MS ,&nbsp;Emma Lawrence MD, MS","doi":"10.1016/j.xagr.2025.100577","DOIUrl":"10.1016/j.xagr.2025.100577","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Fetal malpresentation contributes significantly to cesarean deliveries. External cephalic version (ECV) reduces this risk but requires skilled performance. In low-resource settings, limited training opportunities hinder its use, highlighting the need for effective simulation-based education.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to develop and evaluate an external cephalic version simulation-based educational program.</div></div><div><h3>STUDY DESIGN</h3><div>We used Kern’s 6-step framework to develop a program composed of 6 learning objectives with 6 distinct components specifically for low-resource settings. We conducted a 3-round modified Delphi panel to modify the program. We evaluated the program through a cluster randomized study of obstetrics and gynecology house officers, junior residents, senior residents/fellows, and consultants/attendings in January 2025 at Korle Bu Teaching Hospital in Ghana. Self-reported comfort and confidence, knowledge, skill, and program feasibility and acceptability were analyzed using <em>t</em> tests, Fisher exact tests, and Spearman’s rho.</div></div><div><h3>RESULTS</h3><div>The Delphi panel consisted of 14 experts from 5 countries. At least 80% consensus on all external cephalic version program components was reached before implementation. The learning group’s self-reported comfort and confidence (<em>P</em>&lt;.01) and knowledge measured via assessment (<em>P</em>&lt;.01) improved after the program compared with the preprogram period. The learning group’s skill measured via procedural checklist increased compared with the control group (<em>P</em>&lt;.01). Within the learning group, self-reported comfort and confidence (<em>P</em>&lt;.01) and skill in completing key steps on the procedural checklist (<em>P</em>=.02) were higher among those with a higher level of training. The participants were satisfied with the program and found it acceptable, appropriate, and feasible (5-point rating; mean, 4.42; standard deviation, 0.54).</div></div><div><h3>CONCLUSION</h3><div>Our external cephalic version simulation-based program improves comfort and confidence, knowledge, and skill among Ghanaian clinicians. Given that external cephalic version success depends on the skill of the performing clinician, our program may help increase external cephalic version rates and thus decrease the rates of avoidable cesarean delivery and its complications.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100577"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical evaluation of adolescent sexual and reproductive health and rights in Rwanda","authors":"Benjamin David Habikigeni MD,&nbsp;Uwimana Muhuza Marie Parfaite MD,&nbsp;Emmanuel Edwar Siddig PhD, MBBS,&nbsp;Victor Mivumbi Ndicunguye MD","doi":"10.1016/j.xagr.2025.100594","DOIUrl":"10.1016/j.xagr.2025.100594","url":null,"abstract":"<div><div>Adolescent sexual and reproductive health and rights (SRHR) are critical to ensuring the well-being and empowerment of young people, particularly in low-resource settings like Rwanda. Despite progressive policies and commitments aligned with global frameworks such as the Sustainable Development Goals, adolescents in Rwanda face persistent barriers including cultural stigma, gender inequalities, geographic disparities, and infra-structural limitations that hinder access to comprehensive SRHR services. This commentary critically examines Rwanda’s policy landscape, highlights key challenges in implementation, and explores disparities based on gender, location, and disability. It emphasizes the urgent need for multisectoral, community-engaged strategies, improved data systems, and targeted interventions to close critical gaps. Strengthening the operationalization of policies and fostering youth participation are essential to advancing adolescent SRHR and realizing their full rights in Rwanda’s journey toward health and development equity.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100594"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual dysfunction in women with endometriosis in a low-middle-income country","authors":"Edna Chacha MMED ,&nbsp;Charles Muteshi MMED ,&nbsp;Felix Oindi MMED ,&nbsp;Elsie Wandera MBA","doi":"10.1016/j.xagr.2025.100600","DOIUrl":"10.1016/j.xagr.2025.100600","url":null,"abstract":"<div><h3>Background</h3><div>Endometriosis affects up to 10% of reproductive-age women and significantly impairs quality of life including sexual function, intimate relationships, fertility, and psychological wellbeing. While its impact has been extensively studied in Western populations, there is limited Sub-Saharan African data exploring how the disease affects female sexual health and distress. This study aimed to assess sexual function and sexual distress among women with endometriosis at a tertiary hospital in Kenya.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted involving 108 women aged 18 to 49 with confirmed endometriosis from January to June 2022. The study used validated self-administered questionnaires: Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R). Descriptive and inferential statistics were applied using SPSS v25.</div></div><div><h3>Findings</h3><div>Female sexual dysfunction (FSFI≤26.55) was observed in 76.9% of participants, with the most affected domains being arousal, orgasm, and pain. Sexual distress (FSDS-R≥11.5) was identified in 65.7%. Sociodemographic factors such as marital status, parity, residence, and prior live birth were significantly associated with dysfunction (<em>P</em> &lt; 0.05).</div></div><div><h3>Interpretation</h3><div>Sexual dysfunction and distress are common among Kenyan women with endometriosis, underscoring the need for holistic care strategies that integrate medical and psychosocial support.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100600"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}