AJOG global reports最新文献

{"title":"Determinants of tetanus toxoid immunization among pregnant women in Somaliland: evidence from the 2020 nationwide survey using a zero-inflated negative binomial model","authors":"Hamda Jama Yousuf MD,&nbsp;Mohamed Hussein Egeh MD,&nbsp;Ahmed Abdirahman Farah MD,&nbsp;Ali Ahmed Hussein MD,&nbsp;Abdiasis Aden Omer MD","doi":"10.1016/j.xagr.2026.100641","DOIUrl":"10.1016/j.xagr.2026.100641","url":null,"abstract":"<div><h3>Background</h3><div>Tetanus toxoid (TT) immunization is a critical public health intervention for reducing maternal and neonatal mortality. Despite global recommendations, TT coverage remains low in several low- and middle-income countries, including Somaliland.</div></div><div><h3>Objective</h3><div>This study aims to assess the prevalence and determinants of TT immunization among pregnant women in Somaliland using the 2020 Somaliland Demographic Health Survey.</div></div><div><h3>Methods</h3><div>A cross-sectional analytic study was conducted using the 2020 Somaliland Demographic Health Survey. Data from 2584 women aged 15 to 49 years. STATA 17 was used for analysis. Descriptive statistics were used to examine immunization coverage. The chi-square test was used to identify bivariate associations between TT uptake and explanatory variables. Given the nature of the count outcome and high proportion of zeros, a zero-inflated negative binomial regression model was applied. The result was interpreted using incidence rate ratios with 95% confidence intervals. The model with the lowest Akaike Information Criterion and Bayesian Information Criterion values and the highest log likelihood was selected as the best fit.</div></div><div><h3>Results</h3><div>Only 14.24% of pregnant women received at least two TT doses, while 73.03% received none. Antenatal care (ANC) attendance (IRR=3.93; 95% CI: 3.32–4.66), wealth index, maternal employment (IRR=0.41; 95% CI: 0.23–0.75 for unemployed), institutional delivery, and distance to health facility (IRR=1.17; 95% CI: 1.02–1.34) were significantly associated with TT uptake. Regional disparities and media exposure were associated with a slightly lower rate of TT uptake.</div></div><div><h3>Conclusion</h3><div>TT immunization among pregnant women in Somaliland is alarmingly low and shaped by both socio-demographic and reproductive health factors. Targeted interventions should focus on expanding ANC coverage, reducing geographic and economic barriers, empowering women, enhancing awareness through media, and improving physical access to healthcare facilities. These findings are aligned with Sustainable Development Goal 3 in Somaliland.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100641"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147850289","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":"Recent HIV-1 infection and associated factors among newly diagnosed female sex workers in Ethiopia-2019 to 2022","authors":"Minilik Demissie Amogne PhD ,&nbsp;Tekalign Deressa PhD ,&nbsp;Fethia Kedir MD, MSc ,&nbsp;Feyiso Bati MPH ,&nbsp;Abnet Assefa MPH ,&nbsp;Jaleta Bulti Tura MPH ,&nbsp;Ayalew Aklilu MPH ,&nbsp;Wudinesh Belete Belihu PhD ,&nbsp;Birra Bejiga Bedassa MSc ,&nbsp;Saro Abdella PhD ,&nbsp;Fekadu Yadeta MPH ,&nbsp;Moges Asressie Chanyalew PhD ,&nbsp;Mesay Hailu MD, PhD ,&nbsp;Getachew Tollera MD, MPH ,&nbsp;Sileshi Lulseged MD, MSc ,&nbsp;Zenebe Melaku MD ,&nbsp;Gemechu Tadesse PhD","doi":"10.1016/j.xagr.2026.100653","DOIUrl":"10.1016/j.xagr.2026.100653","url":null,"abstract":"<div><h3>Background</h3><div>Detecting sub-population groups that are most at risk for HIV is critical for designing effective intervention. In this study, we aimed to examine the magnitude and associated factors for recent HIV infection among newly diagnosed HIV-positive female sex workers (FSWs) in Ethiopia.</div></div><div><h3>Methods</h3><div>We analyzed data collected from health facilities involved in the surveillance program from July 2019 to June 2022. HIV case surveillance is an ongoing data collection system from people newly diagnosed with HIV. HIV testing was conducted using the national algorithm, and recency testing done using Asante HIV-1 Rapid Recency Assay. Bivariable and multivariable logistic regression analyses were employed to determine associations between demographic and behavioral factors and recent HIV infection. <em>P</em>&lt;.05 was used to declare statistical significance of multivariable logistic regression analyses.</div></div><div><h3>Results</h3><div>A total of 4852 newly diagnosed HIV positive FSWs, with a median age of 29 years [IQR: 11], were included in the analysis. The proportion of recent HIV infection was 16.4%. Multivariable logistic regression revealed that FSWs aged &lt;30 years, those never married or widowed, those tested in community-based settings, and those with a history of previous HIV testing had higher odds of recent infection. On the other hand, individuals who reported having sexual contact with a known HIV positive person (or an index case) had lower odds of having recent HIV infection.</div></div><div><h3>Conclusion</h3><div>The analysis revealed a high proportion of recent HIV infection among FSWs. These findings provide critical evidence to the HIV program, enabling tailored and effective interventions targeting FSWs at highest risk of HIV infection.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100653"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148167669","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":"Obstructed hemivagina and ipsilateral renal anomaly syndrome: a case series of 4 patients with insights into diagnosis and treatment strategies","authors":"Soukaina Mouiman MD,&nbsp;Khadija Errmili MD,&nbsp;Nada Douraidi MD,&nbsp;Amina Etber MD,&nbsp;Najia Zeraidi MD, PhD,&nbsp;Aziz Baidada MD, PhD","doi":"10.1016/j.xagr.2026.100642","DOIUrl":"10.1016/j.xagr.2026.100642","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Obstructed hemivagina and ipsilateral renal anomaly syndrome was first identified by Purslow in 1922 as a result of abnormal embryologic development of the Müllerian (paramesonephric) and Wolffian (mesonephric) ducts. The syndrome typically presents with cyclical lower abdominal pain and abnormal vaginal discharge in postpubertal females. Although the optimal timing and method of surgical treatment remain unclear, resection of the vaginal septum is commonly performed. This article presents 4 previously asymptomatic patients who developed an acute abdomen after menarche and were treated with hysteroscopic resection of the vaginal septum. This study retrospectively reviewed 4 postmenarchal female patients diagnosed with obstructed hemivagina and ipsilateral renal anomaly syndrome and treated surgically at our institution between 2023 and 2025. Cases 1 and 2 were 2 female patients (aged 14 and 15 years, respectively) who presented with acute abdominal pain, dysmenorrhea, and pelvic fullness after menarche. Imaging revealed left renal agenesis and hemorrhagic fluid in the left vagina. The patients underwent hymenotomy and left transverse vaginal septum resection under general anesthesia, draining 400 to 450 mL of coagulated blood. Follow-up imaging revealed a normal uterine morphology. Case 3 was an 11-year-old female patient with severe dysmenorrhea and a tense mass in the vagina who was diagnosed with a didelphic uterus and hematometra. The patient underwent a septum incision under anesthesia, with a significant amount of hemorrhagic material drained. Follow-up showed regular menstruation. Case 4 was a 16-year-old female patient who presented with severe cyclical pelvic pain and was diagnosed with obstructed hemivagina and ipsilateral renal anomaly syndrome (Herlyn-Werner-Wunderlich syndrome) based on imaging findings that revealed a didelphic uterus, an obstructed right hemivagina with hematocolpos, and a right renal agenesis. The patient underwent a successful surgical resection of the vaginal septum, which resulted in the resolution of her symptoms and a favorable postoperative recovery. Of note, 4 female patients aged 11 to 16 years with obstructed hemivagina and ipsilateral renal anomaly syndrome presented with progressive dysmenorrhea, pelvic pain, and vaginal fullness after menarche. Imaging confirmed a didelphys uterus, an obstructed hemivagina, a hematocolpos, and an ipsilateral renal agenesis in all cases. Surgical management via vaginal incision or resection of the vaginal septum successfully drained the accumulated blood and relieved symptoms. Postoperative follow-up showed resolution of hematocolpos, normal uterine morphology, and no major complication or recurrence. All patients reported a significant improvement in symptoms, with regular menstruation restored in the longer-term follow-up. The triad of obstructed hemivagina, uterus didelphys, and ipsilateral renal anomaly constitutes obstructed hemivagina and ipsilateral ren","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100642"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148167670","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":"Tranexamic acid use for the prevention of postpartum hemorrhage in high-income countries: a review of recent literature","authors":"Sangita M. Baxi MPhil, MAS ,&nbsp;Irogue I. Igbinosa MD ,&nbsp;Elliott K. Main MD ,&nbsp;Jessica R. Ansari MD ,&nbsp;Shona Olalere Oluwatola MPhil, MSc ,&nbsp;Rachel K. Landis PhD, MPP","doi":"10.1016/j.xagr.2026.100651","DOIUrl":"10.1016/j.xagr.2026.100651","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Postpartum hemorrhage (PPH) is the leading global cause of maternal morbidity and mortality. Tranexamic acid (TXA), an antifibrinolytic agent that has been shown to reduce hemorrhage-related mortality in trauma, is used off-label for the prevention and treatment of PPH, typically in conjunction with uterotonic agents. If TXA is effective in the prevention and management of PPH, this inexpensive medication could improve PPH care and reduce PPH-related morbidity and mortality. The majority of evidence on TXA use for PPH prevention and treatment comes from studies conducted in low- and middle-income countries (LMICs) and may be of less relevance to the U.S. or other high-income contexts.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To review recent, high-quality evidence on the use of tranexamic acid (TXA) for the prevention and treatment of postpartum hemorrhage (PPH) in high-income countries (HICs).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;We searched databases including PubMed, CINAHL, EMBASE, Web of Science, and SCOPUS for recent evidence on the use of TXA for prevention or treatment of PPH. Searches were limited to English-language records of human subjects published between January 2019 and February 2025. Supplementary searches of the grey literature, including Advanced Google Scholar and ClinicalTrials.gov, were also conducted. We used explicit inclusion and exclusion criteria determined &lt;em&gt;a priori&lt;/em&gt; following the PECOTS framework. Publication types were restricted to completed randomized controlled trials (RCTs) meeting minimum sample size criteria in their reporting. We also included recent large seminal trials that included HICs in their study population even if they were published prior to January 2019.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We identified thirteen recent RCTs conducted in HICs; 3 of these met sample size requirements, and all focused on the use of TXA for PPH prevention. No large RCTs focused exclusively on the use of TXA for PPH treatment in HICs. Studies included a mix of cesarean (2 RCTs) and vaginal (1 RCT) deliveries.&lt;/div&gt;&lt;div&gt;Only 2 new, large trials (both on PPH prevention in cesarean deliveries) were published within the last five years. These 2 studies conflicted on whether TXA prevents PPH: the larger RCT (conducted in the U.S.) showed no reduction in PPH (≥1,000 mL or greater blood loss), and the smaller RCT (TRAAP2 trial, conducted in France) showed that TXA reduced the incidence of PPH overall, and reduced estimated blood loss but not gravimetrically estimated blood loss. However, neither study found TXA effective for preventing clinical outcomes associated with PPH, including the rate of blood transfusions, use of surgical interventions, or ICU admissions. The third RCT (TRAAP trial, conducted in France) was published in 2018 and found that TXA was not effective at preventing PPH, including the rate of blood transfusions and the use of surgical interventions, after vaginal deliver","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 2","pages":"Article 100651"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230616","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":"Intimate hygiene practices during pregnancy with demographic and preterm birth associations: a large cohort study","authors":"Josef Alexander Locher MBChB, MMED ,&nbsp;Amy Wise MBBCh, MMED ,&nbsp;Renate Strehlau MBBCh, PhD","doi":"10.1016/j.xagr.2025.100592","DOIUrl":"10.1016/j.xagr.2025.100592","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Intimate hygiene practices during pregnancy can influence maternal and neonatal health outcomes. Limited data exist on these practices among South African women. This study aimed to characterize intimate hygiene practices among pregnant women in Johannesburg and examine associations with demographic factors and preterm birth.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A secondary analysis was conducted on data from 18,076 pregnant women enrolled in the Group B Streptococcus Correlates of Protection Cohort Study in Johannesburg, South Africa. Participants completed questionnaires detailing their intimate hygiene practices, including frequency, methods, and products used. Statistical analyses assessed the prevalence of these practices, their association with demographic characteristics (age, race, education, occupation, dwelling type, parity, and HIV status), and preterm birth outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The mean age was 28.4 years (range 18–49). Most participants were Black (93.0%), single (80.4%), unemployed (64.7%), and resided in urban areas (70.7%). They reported a median intimate cleaning frequency of 14 times per week (IQR 8–14). Over half (53.3%) practiced douching, and 48.4% added products to their bathwater.&lt;/div&gt;&lt;div&gt;Race was significantly associated with adding bathwater products (&lt;em&gt;P&lt;/em&gt;&lt;.00001). White women (44.3%) had the highest proportion adding products. Tertiary-educated mothers were more likely to add products (27.0%, &lt;em&gt;P&lt;/em&gt;=.0041). Students had the highest rate of product use (28.7%, &lt;em&gt;P&lt;/em&gt;=.0018). Urban participants were more likely to add products (25.2%) than semi-urban women (23.2%, &lt;em&gt;P&lt;/em&gt;=.025).&lt;/div&gt;&lt;div&gt;Douching was also significantly associated with race (&lt;em&gt;P&lt;/em&gt;&lt;.00001), with the “Other” category (65.1%) reporting the highest rate. Women with no schooling had the highest douching rate (53.2%, &lt;em&gt;P&lt;/em&gt;=.0006). Semi-urban mothers douched the most frequently (53.4%, &lt;em&gt;P&lt;/em&gt;&lt;.00001). Marital status was significantly associated with douching (&lt;em&gt;P&lt;/em&gt;&lt;.00001), with the highest prevalence among single women (45.8%). Occupation was also significantly associated with douching (&lt;em&gt;P&lt;/em&gt;=.016), with students having the highest douching prevalence (28.7%).&lt;/div&gt;&lt;div&gt;A significant association was observed between gestational age and the addition of products to bathwater for deliveries between 34 and &lt;37 weeks compared to term deliveries (&lt;em&gt;P&lt;/em&gt;=.045). Women who did not add products were more likely to deliver at term, while those who added products had a higher likelihood of delivering preterm. For deliveries &lt;34 weeks compared to 34–&lt;37 weeks, women who did not add products were more likely to deliver at 34–&lt;37 weeks (&lt;em&gt;P&lt;/em&gt;=.02).&lt;/div&gt;&lt;div&gt;For deliveries at &lt;34 weeks compared to 34–&lt;37 weeks, women who douched were less likely to deliver at &lt;34 weeks, while those who did not douche had lower proportions of deliveries at ","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100592"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841209","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":"Disparities in planned and successful vaginal delivery after a cesarean delivery by body mass index: a population-based cohort study","authors":"Emily Gray MD ,&nbsp;Mary M. Brown PhD ,&nbsp;Christy G. Woolcott PhD ,&nbsp;John Fahey MMath ,&nbsp;Victoria M. Allen MD, MSc ,&nbsp;Heather M. Scott MD ,&nbsp;Sarka Lisonkova MD, PhD ,&nbsp;Azar Mehrabadi PhD","doi":"10.1016/j.xagr.2025.100595","DOIUrl":"10.1016/j.xagr.2025.100595","url":null,"abstract":"<div><h3>Background</h3><div>Previous literature suggests that pregnant individuals with obesity have fewer planned and successful vaginal births following a previous cesarean delivery. Concern is growing that discrimination based on body mass index (BMI) and comorbidities associated with BMI, rather than BMI itself, are primarily responsible for these findings.</div></div><div><h3>Objective</h3><div>To describe disparities in planning and having a successful vaginal delivery after a previous cesarean delivery by BMI status.</div></div><div><h3>Study Design</h3><div>This population-based cohort study included all singleton pregnancies ≥37 weeks’ gestation from 2003 to 2021 in Nova Scotia, Canada, with one previous cesarean and without contraindications for a trial of labor. Adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) were estimated using Poisson regression, incorporating inverse probability weighting to account for confounding by demographic characteristics and co-morbidities.</div></div><div><h3>Results</h3><div>Among 12 646 deliveries, approximately 31% experienced pre-pregnancy obesity. Of those with obesity, 34% planned a vaginal birth compared to 44% of those without obesity (aRR: 0.82, 95% CI: 0.78, 0.86). Higher BMI classification was associated with a reduced likelihood of planned vaginal delivery: class I: 37%, aRR: 0.88 (95% CI: 0.82, 0.94); class II: 32%, aRR: 0.81 (95% CI: 0.74, 0.89); class III: 26%, aRR 0.65 (95% CI: 0.56, 0.75). Among those planning a vaginal delivery, those with obesity were less likely to have a vaginal birth compared to those without obesity (57% vs 69%; aRR: 0.87, 95% CI: 0.82, 0.92); successful vaginal birth was less likely as BMI increased.</div></div><div><h3>Conclusion</h3><div>Obesity was associated with reduced planned and successful vaginal delivery after a previous cesarean delivery and the association was most pronounced at higher BMI after accounting for demographic characteristics and co-morbidities. While discrimination based on BMI was unmeasured, notable disparities in planning and having a vaginal delivery by BMI suggest that training for health care providers and the availability of appropriate infrastructure may help optimize care for this population.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100595"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978171","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":"Simple conservative surgery for placenta accreta spectrum without parametrial invasion: a novel uterus-sparing approach","authors":"Anh Duy Nguyen PhD ,&nbsp;Ha Thi Thu Nguyen PhD ,&nbsp;Thuy Bien Nguyen MD ,&nbsp;Dat Tuan Do PhD ,&nbsp;Giang Thi Tra Duong MD ,&nbsp;Thanh Hoang Luong MD","doi":"10.1016/j.xagr.2026.100606","DOIUrl":"10.1016/j.xagr.2026.100606","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Placenta accreta spectrum (PAS) is a life-threatening condition often managed by cesarean hysterectomy, resulting in numerous negative impacts on women's health. Most PAS cases do not involve parametrial invasion and may not require aggressive or complex surgical approaches. However, no simplified uterus-sparing technique exists for this subgroup. Therefore, we developed a novel surgical approach, “Simple Conservative surgical Approach for Placenta Accreta Spectrum – SCAPAS,” tailored for PAS without parametrial invasion. SCAPAS included eight main steps.</div></div><div><h3>OBJECTIVES</h3><div>To evaluate the efficacy and safety of SCAPAS in conservative surgical management of women with PAS without parametrial invasion.</div></div><div><h3>STUDY DESIGN</h3><div>This prospective study was conducted from January 2022 to June 2023 at Hanoi Obstetrics and Gynecology Hospital. Sixty-three women with PAS without suspected parametrial invasion, according to the prenatal ultrasound staging system for PAS disorder, underwent elective cesarean delivery using the SCAPAS technique at ≥35 weeks of gestation. Maternal and fetal outcomes were collected. Successful cases were defined as those achieved uterine conservation following SCAPAS without any life-threatening complications.</div></div><div><h3>RESULTS</h3><div>Of the 63 cases, 74.6% were patients under 35, and 66.7% had a history of two or more cesarean sections. The majority of women were diagnosed with PAS2 (69.8%). The success rate of SCAPAS was 85.7%. Success rates for placenta accreta, increta, and percreta were 100%, 82.4%, and 81.8%, respectively. The overall median intraoperative blood loss was 1200 mL (range 400–2500 mL), and the median duration of surgery was 80 minutes (range 35–124 minutes), with a mean interval from skin incision to fetal delivery was 30 minutes. Bladder injury and mild wound infections occurred in 6.3% (4/63) and 4.8% (3/63) cases, respectively. No patient required re-laparotomy. Total 20.6% of newborns had an Apgar score of less than 7 at 1 minute, but all recovered after 5 minutes.</div></div><div><h3>CONCLUSIONS</h3><div>SCAPAS is a simple, safe, and effective surgical approach for conservative management of PAS without suspected parametrial invasion. Further studies are needed to develop a preoperative classification based on location, area, and degree of invasion to improve outcomes in PAS patients.</div></div>","PeriodicalId":72141,"journal":{"name":"AJOG global reports","volume":"6 1","pages":"Article 100606"},"PeriodicalIF":0.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328165","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":"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}