AJOG global reports最新文献

{"title":"Hyperpyrexia with hemodynamic instability after sublingual misoprostol: case report and literature review","authors":"Paola A. Castellanos MD ,&nbsp;Juan C. Ureña MD ,&nbsp;Angie J. Acero MD ,&nbsp;Víctor S. Rangel MD","doi":"10.1016/j.xagr.2026.100647","DOIUrl":"10.1016/j.xagr.2026.100647","url":null,"abstract":"<div><div>Misoprostol is widely used in obstetric practice for the prevention and treatment of postpartum hemorrhage due to its uterotonic efficacy, oral administration, and stability at room temperature. Although generally considered safe, rare but severe adverse reactions have been reported. We present the case of a 27-year-old woman who developed hyperpyrexia (41°C), hemodynamic instability, hypoxemia, and generalized seizures shortly after receiving 1000 µg of sublingual misoprostol for postpartum uterine atony. Life-threatening differential diagnoses, including sepsis, pulmonary thromboembolism, eclampsia, and amniotic fluid embolism, were excluded. The patient required intensive supportive care, with complete clinical recovery and no sequelae. A review of the literature shows that similar cases are uncommon but share features such as sublingual administration, high doses, and a self-limited course with supportive management. This report highlights the importance of recognizing misoprostol-induced hyperpyrexia to guide appropriate management and avoid unnecessary interventions.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100647"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147850288","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":"Reducing pain and anxiety with virtual reality in (outpatient) gynecological procedures: a systematic review with meta-analysis","authors":"Annelotte van Haaps MD ,&nbsp;Merel Oskam MD ,&nbsp;Kim Dreyer MD, PhD ,&nbsp;Kimmy Rosielle MD, PhD ,&nbsp;Ralph de Vries MSc ,&nbsp;Ben Willem Mol MD, PhD ,&nbsp;Madelon van Wely MD, PhD ,&nbsp;Jan Willem Kallewaard MD, PhD ,&nbsp;Anneke Schreurs MD, PhD ,&nbsp;Velja Mijatovic MD, PhD","doi":"10.1016/j.xagr.2026.100640","DOIUrl":"10.1016/j.xagr.2026.100640","url":null,"abstract":"<div><h3>Background</h3><div>Virtual Reality (VR) is increasingly used in medicine for pain and anxiety management. It has been frequently studied in the field of Gynecology and Obstetrics and found effective during labour. However, its application during (outpatient) gynecological procedures as pain and anxiety management remains underexplored.</div></div><div><h3>Objective</h3><div>This systematic review with meta-analysis aimed to study the effect of VR on pain, anxiety and patient experiences when provided during (outpatient) gynecological procedures.</div></div><div><h3>Study design</h3><div>A systematic review was performed, by systematically searching PubMed, Embase, APA PsycInfo and Web of Science (Core Collection) from inception to March 20th 2024. Articles on the effect of VR on pain (VAS or NRS) and anxiety (all measurement tools) during (outpatient) gynecological procedures were included. Study designs had to be randomized controlled trials (RCTs) or cohort studies. Data were collected independently by two reviewers. A meta-analysis was performed to calculate mean differences (MD) with 95% Confidence Intervals (95%CI), Sensitivity analyses and a subgroup analysis were performed.</div></div><div><h3>Results</h3><div>Thirteen RCTs, published between 2015 and 2024, reporting on VR during (outpatient) gynecological procedures for benign conditions were included. Virtual Reality significantly improved overall pain scores (MD -0.95 (95%CI -1.44 to -0.47); n=12, I²=77%; scale 0−10), preprocedural anxiety (MD -3.33 (95%CI -5.84 to -0.82); n=5, I²=5%; scale 0−100) and postprocedural anxiety (MD-15.83 (95%CI -29.39 to -2.17); n=6, I²=93%; scale0−100).</div></div><div><h3>Conclusion</h3><div>The meta-analysis suggests that VR could positively influence overall pain and procedural anxiety. Not all studies reported on all outcome measures which might have introduced reporting bias and lead to an overestimation of the effect of VR. Future studies should further study the correlation between pain and anxiety and the effect of VR on this. However, VR provides an alternative to pain medication, without the risks associated with pharmaceuticals, making it an attractive option.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100640"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147991289","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":"Treatment of Candida glabrata intraamniotic infection with an antifungal agent in preterm prelabor rupture of the membranes","authors":"Puntabut Warintaksa MD ,&nbsp;Metha Trikasemmart MD ,&nbsp;Pisut Pongchaikul MD, PhD ,&nbsp;Pornpun Vivithanaporn PhD ,&nbsp;Rapeewan Settacomkul ,&nbsp;Suwatcharaporn Hadradchai ,&nbsp;Arunee Singhsnaeh MD ,&nbsp;Anchalee Limrangsikul MD ,&nbsp;Pharuhud Pongmee MD ,&nbsp;Maolee Bhuwapathanapun MD ,&nbsp;Piya Chaemsaithong MD, PhD","doi":"10.1016/j.xagr.2026.100650","DOIUrl":"10.1016/j.xagr.2026.100650","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Intraamniotic infection, a major cause of preterm prelabor rupture of membranes (PPROM), is a risk factor for neonatal morbidity and mortality as well as long-term handicap.</div></div><div><h3>OBJECTIVE</h3><div>We presented a patient with PPROM at 25⁺² weeks of gestation with <em>Candida glabrata</em> intraamniotic infection, for which amniotic fluid culture and 18S rRNA sequencing consistently demonstrated <em>Candida glabrata</em>.</div></div><div><h3>STUDY DESIGN</h3><div>After extensive counseling, expectant management with intravenous liposomal amphotericin B was performed. A repeat amniocentesis (2nd amniocentesis) was performed after 14 days of antifungal treatment (at 27⁺⁵ weeks of gestation). The results of the 2nd amniotic fluid fungal culture and 18S rRNA sequencing continued to demonstrate a <em>Candida glabrata</em> infection. However, a treatment response was observed, as evidenced by a decrease in the number of Candida colonies in the fungal culture, as determined by visual inspection, and by a normalized interleukin-6 (IL-6) concentration, a proxy for intraamniotic inflammation. Therefore, we plan to continue amphotericin B for 1 more week and reassess the amniotic fluid. The third amniocentesis was performed at 29 weeks of gestation (a total of 21 days of liposomal amphotericin B treatment), and the results of fungal culture and 18S rRNA analysis still showed <em>Candida glabrata</em> intraamniotic infection.</div></div><div><h3>Results</h3><div>Subsequently, the patient developed a spontaneous onset of preterm labor at 29⁺³ weeks of gestation. Placental histologic examination revealed acute chorioamnionitis, stage 1, grade 1, without funisitis. The neonate had no fetal inflammatory response syndrome and no <em>Candida glabata</em> septicemia.</div></div><div><h3>Conclusion</h3><div>We hereby report the successful treatment of intraamniotic <em>Candida glabrata</em> infection, aiming to prevent fetal inflammatory response syndrome, in a patient with PPROM at 25⁺² weeks of gestation.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100650"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147991290","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":"Gestational diabetes mellitus (GDM) in the first-reported pregnancy modifies association between interpregnancy-weight-change and GDM risk in the subsequent pregnancy","authors":"Til B. Basnet MSC, MPH, PHD ,&nbsp;Christina R. Dantam MPH ,&nbsp;Charles T. Dupont MS ,&nbsp;Eric S. Torstenson MS ,&nbsp;Guanchao Wang MS ,&nbsp;Elizabeth A. Jasper PHD ,&nbsp;Alison Eastman PHD ,&nbsp;Alexandra C. Sundermann MD, PHD ,&nbsp;Etoi A. Garrison MD, PHD ,&nbsp;Sarah S. Osmundson MD, MPH ,&nbsp;Digna R. Velez Edwards PHD, MS ,&nbsp;Zhiguo Zhao MS ,&nbsp;Ayush Giri MS, PHD","doi":"10.1016/j.xagr.2026.100648","DOIUrl":"10.1016/j.xagr.2026.100648","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Weight change between pregnancies affects gestational diabetes mellitus (GDM) risk in subsequent pregnancies. However, it is unclear whether this impact differs based on the individual’s GDM status in a prior pregnancy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To evaluate whether prior GDM status modifies the association between interpregnancy-weight-change and GDM risk in a subsequent pregnancy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Using Vanderbilt Health's de-identified electronic health record, we identified 4574 individuals with at least 2 recorded pregnancies, with information available on GDM status and body mass index (BMI) at GDM screening. We computed interpregnancy-weight-change as the change in BMI at GDM screening between 2 consecutive-reported pregnancies. Using multivariable linear probability and binomial regression models, we evaluated the association between interpregnancy-weight-change and GDM risk in the second pregnancy, overall, and stratified by GDM status in the first pregnancy. We tested for effect measure modification by calculating the interaction contrast (IC) across the risk differences (RDs). We reported predicted risks for GDM, RD, and Differences in RD in the subsequent pregnancy between patients with and without GDM in their first-recorded pregnancy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;On average, patients gained weight (BMI increased by 0.9 kg/m&lt;sup&gt;2&lt;/sup&gt;) between pregnancies and were more likely to have GDM in their second-recorded pregnancy (6.0% vs 4.4%). Individuals with GDM in their first pregnancy were more likely to have GDM in the second pregnancy compared to individuals without GDM in the first pregnancy (30.2% vs 5.0%). The excess risk of GDM for individuals who gained 5 BMI kg/m&lt;sup&gt;2&lt;/sup&gt; (∼29 pounds [lbs] in patients with BMI of 27.1 kg/m&lt;sup&gt;2&lt;/sup&gt; and height of 5 feet 4 inches) was substantially higher in those with GDM in their first pregnancy (RD=28.0%; 95% CI=19.1%, 36.9%) compared to those without GDM in their first pregnancy (RD=5.6%; 95% CI=3.8%, 7.4%). The IC was 22.4% (95% CI=13.4%, 31.5%; &lt;em&gt;P&lt;/em&gt;&lt;.001) across the RDs,. Similarly, the impact of weight loss (2 BMI units ∼ 12 lbs) on GDM risk reduction in the subsequent pregnancy was greater in individuals with prior GDM in their first pregnancy (RD=−3.9%; 95% CI=−0.7%, −7.2%), than among individuals without prior GDM in their first pregnancy (RD=−1.0%; 95% CI=−0.1%, −1.9%), with some evidence for effect measure modification (IC=−2.9%; 95% CI=−6.3%, 0.5%; &lt;em&gt;P&lt;/em&gt;=.091). However, the predicted risk of subsequent GDM in women with prior history of GDM remains high (17.9% risk with 12 lbs weight loss and 15.4% with 29 lbs weight loss) despite substantial risk reduction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Interpregnancy BMI increase is associated with an elevated risk of GDM in subsequent pregnancies for all individuals but is substantially pronounced in individuals with a history of GDM. Individ","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100648"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944786","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 unique triple association: intravascular leiomyomatosis, benign metastasizing leiomyoma, and early-stage endometrial carcinoma","authors":"Taha Berk Çimen MD,&nbsp;Murat Cengiz MD,&nbsp;Onur Can Zaim MD,&nbsp;Bilal Esat Temiz MD,&nbsp;Murat Gültekin MD,&nbsp;Utku Akgor MD","doi":"10.1016/j.xagr.2026.100639","DOIUrl":"10.1016/j.xagr.2026.100639","url":null,"abstract":"<div><div>Intravascular leiomyomatosis (IVL) and benign metastasizing leiomyoma (BML) are uncommon variants of uterine smooth muscle tumors that can demonstrate extrauterine spread despite their benign histological appearance. Both lesions are known to be estrogen-dependent, yet their coexistence with gynecologic malignancies—particularly endometrial carcinoma—is exceedingly rare. We present a 51-year-old postmenopausal woman who was admitted with progressive abdominal distension and ecchymotic skin changes over the abdominal wall. Radiologic evaluation revealed a large retroperitoneal mass with multiple solid pelvic lesions. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and resection of a para-aortic mass. Histopathological examination identified 3 concurrent entities: intravascular leiomyomatosis confined to the uterus, benign metastasizing leiomyoma involving para-aortic lymph nodes, and an incidental FIGO stage IA1 endometrioid adenocarcinoma confined to an endometrial polyp. Immunohistochemistry confirmed smooth muscle differentiation (Desmin, h-caldesmon), retained FH expression, low proliferative index (Ki-67 ≈ 2%–3%), and wild-type p53 pattern. Postoperative recovery was uneventful, and adjuvant hormonal suppression with letrozole was initiated. The patient remains disease-free during 6 months of follow-up. This case represents an exceptionally rare triple coexistence of IVL, BML, and early-stage endometrial carcinoma. Recognition of such unique associations broadens the understanding of estrogen-dependent uterine neoplasms and emphasizes the need for thorough histopathological and immunohistochemical evaluation. A multidisciplinary approach with long-term hormonal surveillance is recommended to detect recurrence or additional hormone-responsive lesions.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100639"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849907","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":"Endometrial osseous metaplasia presenting as a suspected intrauterine device: diagnostic pitfalls and hysteroscopic management—case report","authors":"Fabio Noriel Rojas Rojas MD ,&nbsp;Víctor S. Rangel MD","doi":"10.1016/j.xagr.2026.100643","DOIUrl":"10.1016/j.xagr.2026.100643","url":null,"abstract":"<div><div>Endometrial osseous metaplasia is a rare cause of abnormal uterine bleeding that can mimic an intrauterine foreign body on imaging, leading to diagnostic uncertainty. We report a 48-year-old woman with long-standing abnormal uterine bleeding, prior term vaginal deliveries, and no history of uterine instrumentation or pregnancy loss. Transvaginal ultrasound suggested an intrauterine device. Diagnostic hysteroscopy revealed a firm, whitish, cylindrical lesion with multiple projections anchored at the isthmus and tightly adherent to the myometrium, precluding complete removal due to perforation risk. Representative biopsies were obtained with minimal bleeding. Histopathology confirmed mature bone consistent with endometrial osseous metaplasia, without malignancy or foreign material. The patient experienced symptomatic improvement post-procedure and had an uncomplicated outpatient follow-up. A brief review of the literature indicates that although most cases are linked to prior obstetric events or uterine instrumentation, osseous metaplasia can occur in their absence and may present as an apparent intrauterine device on ultrasound. This report underscores the importance of considering osseous metaplasia in the differential diagnosis of abnormal uterine bleeding and highlights hysteroscopy as the definitive diagnostic and therapeutic approach to obtain targeted tissue and guide management while avoiding unnecessary interventions.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100643"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147850285","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":"Induction of labor is not associated with decreased rates of breastfeeding in late preterm pregnancies","authors":"Alice Sutton MD ,&nbsp;Daniella Rogerson MD, MS ,&nbsp;Samantha Thomson MD ,&nbsp;Gina Frugoni MD ,&nbsp;Cynthia Gyamfi-Bannerman MD, MS","doi":"10.1016/j.xagr.2026.100637","DOIUrl":"10.1016/j.xagr.2026.100637","url":null,"abstract":"<div><h3>Background</h3><div>Some studies suggest that induction of labor at term is associated with lower rates of breastfeeding than spontaneous labor.</div></div><div><h3>Objective</h3><div>Our objective was to evaluate whether late preterm medically indicated induction of labor is associated with decreased rates of breastfeeding and/or increased rates of breastfeeding complications at the time of discharge from the delivery hospitalization.</div></div><div><h3>Study Design</h3><div>This secondary analysis of a randomized trial of individuals at high risk for late preterm delivery, defined as delivery between 34+0 and 36+6 weeks, included nonanomalous, singleton pregnancies and excluded those with unlabored cesareans or preterm prelabor rupture of membranes. The parent study collected detailed data on breastfeeding and the presence of breastfeeding difficulties, defined as issues in milk production or infant feeding. Subjects with incomplete breastfeeding data were additionally excluded. Participants undergoing late preterm indicted inductions were compared to those who presented with spontaneous preterm labor. The primary outcome, the rate of breastfeeding, was compared between groups. Breastfeeding difficulties were also compared. Baseline demographics were compared using bivariable analyses. We fit logistic regression models to adjust for confounders related to breastfeeding.</div></div><div><h3>Results</h3><div>Two thousand one hundred thirty participants were included. Spontaneous and induction groups were similar in age, tobacco use, gestational diabetes, and insurance type but the induced group had higher body mass index, rates of chronic hypertension and hypertensive disorders of pregnancy (HDP). The rate of breastfeeding did not differ in induced vs spontaneous participants (69.0% vs 68.7%, <em>P</em>=.90). However, breastfeeding difficulties were more common in the induced group in unadjusted analyses (38.8% vs 32.3%, <em>P=</em>.01). After adjusting for confounders, neither breastfeeding rates nor breastfeeding difficulties were different between groups. Of note, government insurance was an independent risk factor for low breastfeeding rates and induction was associated with a decreased rate of cesarean delivery</div></div><div><h3>Conclusion</h3><div>Medically indicated late preterm labor induction was not associated with decreased rates of breastfeeding or increased breastfeeding problems at time of discharge from the delivery hospitalization. Those with government funded insurance may need additional breastfeeding support.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100637"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797432","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":"Effectiveness of psychological interventions for reducing depressive symptoms among women experiencing perinatal depression: a systematic review","authors":"Abdissa Boka MSc ,&nbsp;Debela Gela MSc ,&nbsp;Jembere Tesfaye MSc","doi":"10.1016/j.xagr.2026.100654","DOIUrl":"10.1016/j.xagr.2026.100654","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Psychological interventions are well established as effective treatments for perinatal depression, with strong evidence supported by randomized controlled trials carried out in diverse cultural contexts and in settings with limited resources. Approaches such as cognitive behavioral therapy, problem-solving therapy, interpersonal therapy, and community based models that rely on task-sharing have repeatedly shown meaningful reductions in depressive symptoms and notable improvements in maternal functioning and overall well-being. These interventions are especially important in low- and middle- income countries (LMICs) where access to specialist mental health professionals is seriously limited. Evidence demonstrating that appropriately trained non-specialist including community health workers (CHW), Peers, and lay counselors can successfully deliver this intervention within primary health care and community platforms highlighting their practicality and effectiveness. Consequently, task-sharing strategies are therefore considered a promising and sustainable approach for reducing the treatment gap for perinatal depression in resource-constrained contexts.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This systematic review aimed to evaluate the effectiveness of psychological interventions in reducing depressive symptoms among women experiencing perinatal depression in low and middle income countries.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Studies were eligible if they evaluated task-shared or lay-delivered psychological interventions for perinatal depression among pregnant or postpartum women aged 18 years and older in LMICs. Only randomized controlled trials or cluster randomized controlled trials were included. Participants were required to have screened positive for depressive symptoms or to have been diagnosed with major depressive disorder using validated screening or diagnostic instruments. Studies that solely addressed severe mental illness necessitating inpatient psychiatric treatment lacked a comparison group or did not report outcomes related to depression were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods and information sources&lt;/h3&gt;&lt;div&gt;Major electronic databases commonly utilized in health research were thoroughly and systematically searched, with the most recent search conducted in Month/Year. Only studies published in English were considered. The study selection was carried out in staged manner according to predetermined eligibility criteria, with independent review of titles, abstracts, and full-text articles. The methodological quality and risk of bias of included studies were evaluated using standardized appraisal tools and relevant data were collected using a structured and piloted data extraction form. Due to substantial heterogeneity in intervention content, delivery modes, settings, and outcome measures, a narrative synthesis was undertaken rather than a meta-analysis. The level of confidence in the evidence for t","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100654"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148167667","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 retrospective study of the relationship between low-density lipoprotein cholesterol and pregnancy outcomes after assisted reproductive technology treatments in women with diabetes mellitus and infertility","authors":"Chun Yuan MD, PhD ,&nbsp;Yuan Guo Msc ,&nbsp;Jing Wang MD, PhD ,&nbsp;Jinghui Guo PhD ,&nbsp;Jinyong Liu MD, PhD","doi":"10.1016/j.xagr.2026.100634","DOIUrl":"10.1016/j.xagr.2026.100634","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>This study aimed to investigate the role of low-density lipoprotein cholesterol as a key parameter in improving pregnancy outcomes after assisted reproductive technology treatments in women with diabetes mellitus.</div></div><div><h3>OBJECTIVE</h3><div>To investigate the relationship between low-density lipoprotein cholesterol and pregnancy outcomes after assisted reproductive technology treatments in women with diabetes and infertility.</div></div><div><h3>STUDY DESIGN</h3><div>474 female patients diagnosed with diabetes were included in this study. The patients were divided into the high LDL-C group (≥3 mmol/L) and the low LDL-C group (&lt;3 mmol/L). According to the protocol of ovarian stimulation, the clinical characteristics in ART cycles and pregnancy outcomes were compared separately. The data were analyzed after propensity score matching.</div></div><div><h3>RESULTS</h3><div>In the GnRH antagonist protocol group, there were no significant differences in baseline characteristics between the high- and low-LDL-C groups. Nevertheless, ART treatment characteristics and pregnancy outcomes did not differ significantly between the 2 groups (<em>P</em>&gt;.05). However, the rate of early miscarriage in GnRH antagonist protocol-FET cycles had a significantly positive association with LDL-C level (<em>P</em>=.0004).In the long-acting GnRH agonist protocol group, there were no significant differences in baseline characteristics between the high- and low-LDL-C groups; however, total cholesterol, triglycerides, and AST/ALT levels were significantly higher in the high-LDL-C group (<em>P</em>&lt;.05). Although the clinical pregnancy rate of fresh embryo cycles in the high-LDL-C group was considerably higher than that of the low-LDL-C group (<em>P</em>=.001), there was a statistical difference in the early miscarriage rate between the 2 groups. (<em>P</em>&lt;.05).</div></div><div><h3>CONCLUSION</h3><div>This study demonstrates that in infertile women with diabetes mellitus undergoing ART, elevated pretreatment LDL-C is a significant and modifiable marker associated with an increased risk of early miscarriage and a reduced live birth rate. The impact of LDL-C varies by ovarian stimulation protocol. These findings underscore the importance of integrating preconception lipid management into the clinical pathway and adopting a protocol-specific risk assessment to optimize pregnancy outcomes.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100634"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230617","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":"Ultrasound-guided radiofrequency ablation of an intramural fibroid in a woman desiring fertility with coexisting focal adenomyosis: a case report","authors":"Francesco G. Martire MD, PhD,&nbsp;Claudia d’Abate MD,&nbsp;Eugenia Costantini MD,&nbsp;Ilaria Ianes MD,&nbsp;Emilio Pieri MD,&nbsp;Lorenza Minisci MD,&nbsp;Maria De Bonis MD,&nbsp;Lucia Lazzeri MD, PhD,&nbsp;Errico Zupi MD","doi":"10.1016/j.xagr.2026.100645","DOIUrl":"10.1016/j.xagr.2026.100645","url":null,"abstract":"<div><h3>Objective</h3><div>To report the reproductive outcome after ultrasound-guided radiofrequency ablation (RFA) in a woman with an intramural uterine fibroid and coexisting focal adenomyosis who experienced infertility and desired pregnancy.</div></div><div><h3>Design</h3><div>Case report.</div></div><div><h3>Patient</h3><div>A 40-year-old nulligravid woman with heavy menstrual bleeding, dysmenorrhea, and a history of infertility, defined by failure to conceive after more than 12 months of unprotected intercourse. Transvaginal ultrasound demonstrated a FIGO type 3 intramural fibroid distorting the endometrial cavity and associated focal anterior adenomyosis.</div></div><div><h3>Intervention</h3><div>Ultrasound-guided transvaginal RFA of the intramural fibroid.</div></div><div><h3>Main Outcome Measures</h3><div>Changes in fibroid volume and uterine cavity morphology on ultrasound, improvement of clinical symptoms, and reproductive outcome.</div></div><div><h3>Results</h3><div>The procedure was completed without complications. Follow-up ultrasound showed progressive fibroid volume reduction of 76.9% at 6 months, migration of the lesion away from the endometrial cavity, restoration of normal cavity anatomy, and improvement of sonographic features of focal adenomyosis. Menstrual symptoms improved significantly. Spontaneous conception subsequently occurred, resulting in an uncomplicated term vaginal delivery.</div></div><div><h3>Conclusion</h3><div>This case suggests that ultrasound-guided RFA may represent a minimally invasive, uterus-sparing option for selected women with intramural fibroids and coexisting focal adenomyosis associated with infertility.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100645"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849906","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}