AJOG global reports最新文献

{"title":"Uncontrolled hypertension in siblings: an unsuspected diagnosis","authors":"Sayyad Aleem MD, DrNB,&nbsp;Sanjay Kumar MD, DrNB,&nbsp;Arun Guddeti MD, DM,&nbsp;KVS Hari Kumar MD, DrNB","doi":"10.1016/j.xagr.2026.100615","DOIUrl":"10.1016/j.xagr.2026.100615","url":null,"abstract":"<div><div>Hypertension in the young is defined as the occurrence of elevated blood pressure in patients aged &lt;40 years. It is unusual for hypertension to be present before the second decade of life and more so in a pair of siblings. This study aimed to report a case of a sibling pair (18- and 16-year-olds), reared as females, who presented with primary amenorrhea and resistant hypertension. The initial presentation was hypertension. The siblings were treated with escalating doses of antihypertensive agents, including calcium channel blockers, beta-blockers, and diuretics, with suboptimal control. Primary amenorrhea led to an endocrine referral, and detailed evaluation revealed obesity, acne, atypical external genitalia, and palpable gonads. The hormonal panel showed low cortisol, elevated adrenocorticotropic hormones, and progesterone, along with hypokalemia, raising the possibility of a rare congenital adrenal hyperplasia due to 17-alpha-hydroxylase deficiency. The siblings had a 46 XY karyotype, and CYP17A1 gene sequencing revealed a homozygous deletion of c.157_159TTC of the phenylalanine codon (thymine-thymine-cytosine) at amino acid position 54 (p.Phe54del) in exon 1, confirming our diagnosis. The siblings were treated with glucocorticoids and spironolactone, which remarkably improved the blood pressure, coupled with the gradual withdrawal of all antihypertensive agents. Psychological evaluation established a preference for the female gender. The siblings underwent bilateral gonadectomy with vaginoplasty, along with estrogen replacement therapy. Hypertension in the young suggests a secondary etiology, including renovascular and endocrine conditions. Our report highlights the CYP17A1 gene mutation, a rare form of monogenic hypertension presenting in phenotypical females with a male genotype.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100615"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396416","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":"Care strategies for pregnant people and women living with hepatitis C in North America","authors":"Sofia R. Bartlett PhD ,&nbsp;Jasmin E. Charles MPAS ,&nbsp;Tatyana Kushner MD, MSCE","doi":"10.1016/j.xagr.2025.100580","DOIUrl":"10.1016/j.xagr.2025.100580","url":null,"abstract":"<div><div>Hepatitis C is a global health concern, with over 50 million people infected. Marginalized populations, particularly people who inject drugs, may not receive treatment despite an increased infection rate; similarly, there are gender disparities in the hepatitis C cascade of care, leaving some women undertreated. This is especially problematic, as hepatitis C rates are increasing substantially among individuals of childbearing age and pregnant people. While hepatitis C epidemiology and baseline characteristics are well understood, models of care focused on pregnant people that provide solutions to these barriers in attaining care are needed to increase health equity and achieve hepatitis C elimination. The adoption of highly effective, direct-acting antivirals for hepatitis C treatment has helped tremendously, but direct-acting antivirals must be accessible, and their availability must be combined with enhanced screening efforts. We review newly developed models of care for pregnant people who have hepatitis C and provide several case studies (with patient examples) of methods that have improved the care cascade and patient outcomes in our practices. Some models, such as mother-infant collocated care, allow postpartum and infant hepatitis C care to occur simultaneously, minimizing the number of visits and maximizing access to patient care. Other models, such as mobile point-of-care services and peer navigation, help marginalized populations attain access to care regardless of insurance status and transportation accessibility and provide peer support to help overcome treatment barriers, such as stigma and poverty. Additional innovative hepatitis C care models for pregnant people and women include modeling-based response-guided treatment, interdisciplinary collocated care models, and an integrated medical home model. Ultimately, there is no “one size fits all” hepatitis C model of care, as needs differ according to region, population demographics, and individual circumstances. As our review shows, many of the models apply multidisciplinary approaches to provide a range of care options. Reviewing the available models of care will help identify how practitioners can increase patient engagement with care and improve treatment uptake and completion rates among pregnant people and women and thus can contribute to hepatitis C elimination.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100580"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841207","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":"Cervical cancer screening in women with disabilities in Ghana: bridging the gap in access and equity","authors":"Yvonne Nartey PhD ,&nbsp;Judith Osae-Larbi PhD ,&nbsp;Joseph Daniels MD","doi":"10.1016/j.xagr.2025.100597","DOIUrl":"10.1016/j.xagr.2025.100597","url":null,"abstract":"<div><div>The burden of cervical cancer continues to grow in many limited-resource regions of the world. It is the third most common cancer in Ghana, and the second most common malignancy among women, with most cases detected at a late stage, leading to poor clinical outcomes. Cervical cancer is preventable through vaccination against human papillomavirus (HPV) infection and screening for precancerous lesions. However, preventive interventions in Ghana face several challenges, including limited infrastructure, financial constraints and human resource shortages. The uptake of HPV vaccination and cervical cancer screening remains low, with certain population groups, particularly women with disabilities being disproportionately affected by cervical cancer. Women with disabilities in Ghana encounter multiple systemic barriers to accessing cervical cancer screening services, including inaccessible healthcare facilities, the absence of disability-sensitive medical equipment and suboptimal communication with healthcare providers. These challenges contribute to markedly low screening uptake among this population, potentially leading to delayed diagnoses and poor clinical outcomes. The article highlights the critical need for focused research to inform the development of inclusive and equitable cervical cancer prevention and control strategies tailored to the needs of women with disabilities in Ghana.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100597"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978169","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":"Evaluation of diagnostic and therapeutic hysteroscopy outcomes at a tertiary hospital in Rwanda","authors":"Vincent Dusingizimana MD, MMed ,&nbsp;Martin Nyundo MD, PhD ,&nbsp;Augustin Limgba MD, MMed ,&nbsp;Jacques Landenne MD, MMed ,&nbsp;Victor Mivumbi Ndicunguye MD, MMed ,&nbsp;Emmanuel Edwar Siddig PhD ,&nbsp;Uwimana Muhuza Marie Parfaite MD, MMed","doi":"10.1016/j.xagr.2025.100599","DOIUrl":"10.1016/j.xagr.2025.100599","url":null,"abstract":"<div><h3>Background</h3><div>Hysteroscopy is a minimally invasive technique for diagnosing and managing intrauterine pathologies, critical in addressing reproductive health issues. In Rwanda, limited data exist regarding the practice and outcomes of hysteroscopic procedures. Therefore, the objective of this study is to evaluate the practice, diagnostic and therapeutic outcomes, and patient-reported results of hysteroscopy performed at the University Teaching Hospital of Kigali (CHUK) from March 2022 to February 2025.</div></div><div><h3>Methods</h3><div>This retrospective and prospective study included 62 women who underwent hysteroscopy at CHUK. Data collected encompassed demographic details, indications, procedural characteristics, outcomes, and follow-up outcomes. Descriptive statistics and bivariate analyses assessed clinical findings, complication rates, efficacy of treatments, and factors associated with symptom improvement.</div></div><div><h3>Results</h3><div>A total of 62 women underwent hysteroscopic procedures within the study period. The mean age was 42 years (±6.4 years), with 74% aged between 30 and 50 years. Most participants were premenopausal (74%) and had attained at least secondary education (50%). The predominant indications for hysteroscopy were abnormal uterine bleeding (59.68%) and infertility (25.8%). Diagnostic hysteroscopy accounted for 52.2% of cases, while therapeutic procedures comprised 46.8%. The most common hysteroscopic findings included endometrial polyps (33.9%), intrauterine adhesions (16.1%), and fibroids (16.1%), with 25.8% showing a normal cavity. The majority of procedures (77.4%) lasted less than an hour, and the complication rate was 4.8%. Most patients (72.6%) had their intrauterine pathology successfully treated during the procedure.</div></div><div><h3>Conclusions</h3><div>Hysteroscopy in Rwanda demonstrates favorable diagnostic yield and therapeutic outcomes, with minimal complications. The increasing adoption of office-based procedures and targeted management of intrauterine lesions can enhance patient care. These findings support the expansion of hysteroscopic services and capacity building in the region.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100599"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183715","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":"The influence of antenatal and pregnancy-related factors on recovery after childbirth: a systematic review","authors":"Zayël Z. Frijmersum MD ,&nbsp;Eva Van der Meij MD, PhD ,&nbsp;Ralph De Vries MSc ,&nbsp;Johannes R. Anema MD, PhD ,&nbsp;Judith A.F. Huirne MD, PhD ,&nbsp;Petra C.A.M. Bakker MD, PhD","doi":"10.1016/j.xagr.2026.100610","DOIUrl":"10.1016/j.xagr.2026.100610","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>This study aimed to identify antenatal and pregnancy-related factors that affect recovery after childbirth, with the purpose of improving maternal health, return to work, and social participation.</div></div><div><h3>DATA SOURCES</h3><div>We searched PubMed, Embase, and Web of Science up to October 2024 using predefined search terms. The review is registered in PROSPERO (#CRD42022361262).</div></div><div><h3>STUDY ELIGIBILITY CRITERIA</h3><div>We included cohort studies, randomized controlled trials, and cross-sectional studies published in English or Dutch that evaluated antenatal and pregnancy-related factors associated with maternal morbidity beyond 6 weeks postpartum among women aged ≥18 years who delivered live-born singletons. A minimum follow-up of 6 weeks postpartum was required.</div></div><div><h3>METHODS</h3><div>Two reviewers independently screened and assessed studies for quality. Data were synthesized narratively, organized by recovery domain.</div></div><div><h3>RESULTS</h3><div>A total of 56 studies were included. Seven categories of influencing factors were identified: mental health in pregnancy (n=18), demographic and socioeconomic background (n=17), medical and psychological history (n=16), lifestyle in pregnancy (n=12), physical health in pregnancy (n=9), prepregnancy social and lifestyle factors (n=8), and psychosocial resources in pregnancy (n=5). Recovery outcomes included persistent pain, mental health problems, functional ability, and urinary incontinence. Although 47 studies focused on physical or mental health, only 9 studies assessed functional ability. No studies explicitly examined social participation. Previous pain, high body mass index, and antenatal mental health problems were consistently associated with poorer recovery outcomes. In contrast, physical activity, social support, and psychological resilience were generally protective factors.</div></div><div><h3>CONCLUSION</h3><div>Postpartum recovery is influenced by multiple antenatal and pregnancy-related factors. A personalized, biopsychosocial approach to care may improve maternal health outcomes and social participation.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100610"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357718","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":"Ruptured uterus: a rare and catastrophic complication of molar pregnancy","authors":"Ayalkibet Alemayehu Debele MD ,&nbsp;Shimelis Fantu Gebresilasie MD ,&nbsp;Solomon Elias Kefeni MD ,&nbsp;Gelagay Zewudie Workineh MD ,&nbsp;Eyerusalem Fissehatsion Dejene MD ,&nbsp;Zekarias Dejene Adugna MD","doi":"10.1016/j.xagr.2025.100591","DOIUrl":"10.1016/j.xagr.2025.100591","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Gestational trophoblastic disease is the term used to describe the heterogeneous group of interrelated lesions that arise from abnormal proliferation of placental trophoblasts. The clinical presentations of the gestational trophoblastic tumor include vaginal bleeding, uterine enlargement greater than expected for gestational age, hyperemesis, and secondary clinical hyperthyroidism. Less common presentations include pregnancy-induced hypertension in the first or second trimester of pregnancy and theca lutea cyst torsion. It is a rare incident to find uterine rupture because of a molar pregnancy. Most uterine ruptures reported so far were all malignant histologic types of the spectrum. This study presents a case of a ruptured uterus as a complication of complete molar pregnancy presenting with shock and severe anemia.</div></div><div><h3>CASE PRESENTATION</h3><div>A 37-year-old gravida 6, para 5 patient with a 5-month amenorrhea presented to the hospital with vaginal bleeding, abdominal pain, and symptoms of anemia. The patient’s hemoglobin level was 2.8 g/dL. Further assessment revealed a honeycomb-appearing endometrial mass and free fluid in the general peritoneum. The patient underwent emergency laparotomy, where a hysterectomy was performed for cornual uterine rupture. The patient was tested for serial serum human chorionic gonadotropin and declared cured after 6 months of observation.</div></div><div><h3>CONCLUSION</h3><div>Although rupture of the uterus is rare, a ruptured uterus in a molar pregnancy can be a catastrophic complication, presenting with massive hemoperitoneum and hemorrhagic shock. Hysterectomy, along with vascular filling with crystalloid and transfusion of blood products, can save a patient’s life. Patients can be followed by serial serum human chorionic gonadotropin (HCG) safely for any transformation to gestational trophoblastic neoplasia (GTN).</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100591"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926987","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":"THE INAPRES (Indonesia Preeclampsia Study): impact of eclampsia on maternal and perinatal outcomes among women with preeclampsia: findings from a National Multicenter Cohort","authors":"Muhammad Ilham Aldika Akbar MD, PhD, MME ,&nbsp;Ernawati MD, PhD ,&nbsp;Manggala Pasca Wardhana MD, PhD ,&nbsp;Ruth Widhiati Raharjo Putri MD ,&nbsp;Anak Agung Gede Putra Wiradnyana MD, PhD ,&nbsp;Dhanny Primantara Johari Santoso MD ,&nbsp;Wiku Andonotopo MD, PhD ,&nbsp;Gustaaf Dekker MD, PhD, FDCOG, FRANZCOG ,&nbsp;Rozi Aditya Aryananda ,&nbsp;HKFM Preeclampsia Research Group","doi":"10.1016/j.xagr.2025.100596","DOIUrl":"10.1016/j.xagr.2025.100596","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Hypertension during pregnancy, including preeclampsia (PE) and its severe complication, eclampsia, remains a primary cause of maternal mortality globally. Eclampsia is a critical complication of PE that severely impacts maternal and neonatal health. Evidence regarding outcomes in pregnancies complicated by eclampsia, especially in developing nations, is limited.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study aimed to compare the maternal and perinatal outcomes in patients with preeclampsia, both with and without eclampsia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;This was a national, multicenter, observational, retrospective cohort study conducted in Indonesia. Data were gathered from medical records of patients who delivered at 30 hospitals across five principal islands in Indonesia between January 2022 and December 2023. The study included 1,808 cases with complete data who met the inclusion criteria, consisting of all pregnancies impacted by PE that culminated in delivery at the research sites. The sample was classified into 2 groups: the eclampsia group (n=151) and the non-eclampsia group (n=1657). Primary outcomes examined included maternal outcomes (eg, severe morbidity, maternal mortality), intrapartum management, labor complications, and perinatal outcomes (eg, preterm birth, neonatal morbidity, neonatal death). Statistical analysis utilized SPSS version 29, employing independent t-tests or Mann-Whitney U tests for continuous data, and Chi-square or Fisher's exact tests for categorical variables, with results expressed as numerical percentages, mean ± SD, or median (minimum-maximum).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The overall incidence of PE during the study period was 5.3% (6763 out of 127,604 births). Among PE patients with complete data (n=1808), the incidence of eclampsia was 8.35% (151 cases). Pregnant women with eclampsia were significantly younger, more frequently nulliparous, and had elevated diastolic blood pressure compared to the noneclamptic cohort (&lt;em&gt;p&lt;/em&gt;&lt;.05). Eclampsia was associated with markedly greater maternal morbidity, including HELLP syndrome (27.8% vs 10.7%; RR: 2.85), hypertensive emergencies (35.1% vs 21.4%; RR: 1.80), CVA (2.0% vs 0.1%; RR: 18.01), and ICU admission (34.4% vs 13.2%; RR: 2.86) (&lt;em&gt;p&lt;/em&gt;&lt;.05). The eclampsia cohort also had a higher likelihood of cesarean section delivery (95.4% vs 83.7%) and a markedly elevated incidence of seizures during labor (31.3% vs 0.0%). Perinatal morbidity was also greater in the eclampsia cohort, with increased preterm birth rates (52.3% vs 42.5%; RR: 1.35), lower absolute and percentile birth weight, lower Apgar scores at 1 minute (&lt;7: 76.2% vs 46.3%; RR: 1.80) and 5 minutes (&lt;7: 38.4% vs 21.5%; RR: 1.96), increased NICU admissions (32.2% vs 22.8%; RR: 1.59), and a greater prevalence of respiratory distress syndrome (RDS) (32.2% vs 12.9%; RR: 2.80), necrotizing enterocolitis (NEC) (4.7% vs 0.8%; RR: 7.00), and neon","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100596"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978172","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":"Determinants of maternal transportation mode and travel time for timely emergency obstetric care in selected public hospitals, Addis Ababa, Ethiopia, 2025","authors":"Boyosa Yadessa Banti MPH ,&nbsp;Bacha Mirkena Dhabi MPH ,&nbsp;Damtew Workineh Regasa MPH","doi":"10.1016/j.xagr.2026.100612","DOIUrl":"10.1016/j.xagr.2026.100612","url":null,"abstract":"<div><h3>Background</h3><div>Inadequate transportation infrastructure and ineffective emergency transport services remain critical barriers to timely obstetric care in low- and middle-income countries, particularly in sub-Saharan Africa. In Ethiopia, despite efforts to expand ambulance coverage, many pregnant women still face delays in accessing emergency obstetric services, contributing to preventable maternal morbidity and mortality.</div></div><div><h3>Objective</h3><div>This study aimed to assess determinants of maternal transportation mode and travel time for emergency obstetric care (EmOC) among pregnant women attending selected public hospitals in Addis Ababa, Ethiopia.</div></div><div><h3>Study Design</h3><div>An institutional-based cross-sectional study was conducted from June to July 2025 across three public referral hospitals in Addis Ababa. Data were collected through a pretested structured questionnaire. Of the 319 mothers selected, 311 provided complete responses, yielding a response rate of 97.2%. Analysis was conducted exclusively on these respondents. Descriptive statistics summarized participant characteristics, and logistic regression was employed to identify associations between transportation mode and influencing factors. Statistical significance was set at <em>P</em>&lt;.05.</div></div><div><h3>Results</h3><div>A majority of the participants relied on private car or ride-hailing service (39.2%) during obstetric emergencies, with only 35.7% utilizing ambulances. Despite an average travel time of approximately 51 minutes, 27% experienced a second delay in reaching care. Ambulance use was significantly associated with urban residence, transportation preparedness, prior awareness of emergency transport phone numbers, and knowledge of available services, while 27.7% of participants experienced delivery complications—most commonly prolonged labor (8%), eclampsia (6.8%), and retained placenta (5.1%).</div></div><div><h3>Conclusion</h3><div>This study underscores that transportation barriers—especially reliance on private transport and underutilization of ambulances—remain a major contributor to delays in accessing EmOC in Addis Ababa. Key predictors of ambulance use, such as residence and awareness of emergency services, point to systemic gaps in public education and referral coordination. Strengthening transport systems and community awareness is essential to reducing second delays and improving maternal outcomes in urban Ethiopia.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100612"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379859","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":"The migration of placenta even after 30 gestational weeks is a risk factor for postpartum hemorrhage","authors":"Gaku Yamamoto MD ,&nbsp;Kosuke Hiramatsu MD, PhD ,&nbsp;Yoko Kawanishi MD, PhD ,&nbsp;Mamoru Kakuda MD, PhD ,&nbsp;Koji Nakamura MD, PhD ,&nbsp;Tatsuya Miyake MD, PhD ,&nbsp;Kazuya Mimura MD, PhD ,&nbsp;Toshihiro Kimura MD, PhD ,&nbsp;Masayuki Endo MD, PhD ,&nbsp;Tadashi Kimura MD, PhD ,&nbsp;Michiko Kodama MD, PhD","doi":"10.1016/j.xagr.2025.100593","DOIUrl":"10.1016/j.xagr.2025.100593","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Almost 10% of all pregnant women are diagnosed with placental location abnormalities (PLA), including placenta previa and low-lying placenta; however, most of PLA resolve as pregnancy process. Despite of placental migration, postpartum hemorrhage (PPH) is often experienced in those cases. The association between the timing of placental migration and the risk of PPH has remained unclear.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The aim of this study is to investigate the relationship between the timing of placental migration and the PPH, and to establish a cutoff value to accurately predict the risk of PPH in cases who underwent the placental migration during course of pregnancy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;This was a retrospective cohort study using electronic medical records in Osaka University Hospital (Japan). Patients diagnosed with PLA after 22 gestational weeks using transvaginal ultrasonography were eligible for inclusion. All patients delivered at our hospital between 2009 and 2022. Focusing on the cases in which placental migration (more than 2 cm away from the internal cervical os) were observed, the association between the timing of placental migration and the PPH was investigated only in vaginal delivery using the multivariate analyses with collecting covariates that could affect the PPH. Based on the results, receiver operating characteristic curves were generated to determine the optimal cutoff for the number of weeks of placental migration to predict PPH.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;One hundred and forty-five patients were diagnosed with PLA after 22 gestational weeks and delivered at our hospital between 2009 and 2022. Seventy-six after-placental migration cases with successful vaginal delivery were analyzed. The median gestational age of placental migration was 32 weeks, and the median amount of hemorrhage during delivery was 777 mL. PPH (500–1000 mL) occurred in 34 cases (44.7%), &gt;1000 mL in 26 (34.2%). In the univariate analysis, a positive correlation was observed between the timing of placental migration and the amount of hemorrhage (&lt;em&gt;r&lt;/em&gt;=0.365, &lt;em&gt;P&lt;/em&gt;&lt;.01). Furthermore, multivariate analysis showed that the timing of placental migration is the most strongly influential covariate (standardized partial regression coefficient: 0.31, &lt;em&gt;P&lt;/em&gt;=.0036) for predicting the amount of hemorrhage. In addition, the timing of placental migration was a significant risk for PPH (more than 500 mL) (adjusted unit OR 1.26 [95% CI: 1.07–1.49]). The receiver operating characteristic curve indicated that the moderate cutoff of the timing of placental migration to predict the risk of PPH (more than 500 mL) was 29 gestational weeks. In comparison between the groups in which placental migration was confirmed before 29 gestational weeks (&lt;em&gt;n&lt;/em&gt;=19) and after 30 gestational weeks (&lt;em&gt;n&lt;/em&gt;=57), the incidences of PPH (more than 500 mL) were significantly higher in the group in wh","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100593"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926985","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":"Awareness and associated factors of pregnancy-induced hypertension among pregnant women in Africa: a systematic review and meta-analysis","authors":"Getanew Kegne Nigate MPH ,&nbsp;Yeshiwas Ayale Ferede MPH ,&nbsp;Berhanu Wale Yirdaw MSC ,&nbsp;Worku Chekol Tassew MSC","doi":"10.1016/j.xagr.2025.100601","DOIUrl":"10.1016/j.xagr.2025.100601","url":null,"abstract":"<div><h3>Introduction</h3><div>Pregnancy-Induced hypertension (PIH) remains a major contributor to maternal and fetal illness and death. Enhancing knowledge and implementing preventive measures for PIH among pregnant women is crucial for achieving positive health outcomes. This study explored the level of knowledge and the associated factors among pregnant women in Africa.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted on June, 2025, using international electronic databases including PubMed, Google Scholar, Hinari, Medline, and Open Google to assess the pooled awareness of pregnancy-induced hypertension and its associated factors among pregnant women. Two authors independently screened and extracted relevant data from the eligible studies. The collected data were compiled in Excel and subsequently analyzed using STATA version 11. Heterogeneity among the studies was assessed using the I² statistic, while potential small study effects were evaluated through graphical methods and Egger’s test, with a significance threshold set at 5%. Subgroup and sensitivity analyses were also performed.</div></div><div><h3>Result</h3><div>A total of eight studies met the inclusion criteria and were incorporated into the systematic review and meta-analysis. The meta-analysis revealed significant associations between PIH knowledge and several factors: educational status (AOR = 4.88, 95% CI: 1.73–13.79), history of previous births (OR = 2.04, 95% CI: 1.30–3.19), and employment status (OR = 2.85, 95% CI: 1.26–6.44). However, due to the limited number of studies addressing each specific variable, the evidence was insufficient to establish conclusive links between PIH knowledge and other factors such as primi gravida status, socioeconomic status, maternal age, sources of information, marital status, maternal nutrition, antenatal care attendance, place of residence, and other related variables.</div></div><div><h3>Conclusion</h3><div>Awareness of PIH is typically lower among women with a personal or family history of the condition, first-time mothers (primiparous women), and those with limited educational attainment, compared to their respective counterparts. To address this gap, increased investment in women's health is essential, with healthcare providers giving particular attention to those at higher risk due to limited PIH knowledge. Moreover, targeted interventions should aim to improve educational opportunities for women and raise awareness about the risk factors associated with PIH.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100601"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396570","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}