Rafaela de Moraes-Souza, Matías Mayor Arenal, Ana M Carballido Vázquez
{"title":"Type B pigmentary demarcation lines in pregnancy.","authors":"Rafaela de Moraes-Souza, Matías Mayor Arenal, Ana M Carballido Vázquez","doi":"10.1002/ijgo.15909","DOIUrl":"https://doi.org/10.1002/ijgo.15909","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectiveTo analyze and improve the accuracy of preoperative assessment and intraoperative frozen‐section analysis (FSA) for malignant ovarian germ cell tumors (MOGCTs), especially in the context of fertility preservation.MethodsA retrospective review of 48 women aged under 40 years, diagnosed with MOGCTs, and treated at Chonnam National University Hospital between July and December 2022 was conducted. The results of preoperative magnetic resonance imaging (MRI), measurement of serum tumor markers (α‐fetoprotein [AFP], β‐human chorionic gonadotropin, lactate dehydrogenase [LDH], cancer antigen [CA] 125, CA 19–9, CA 72–4, carcinoembryonic antigen), and intraoperative FSA were compared with the final pathology diagnosis.ResultsMRI demonstrated a sensitivity of 95.5%, whereas FSA showed a sensitivity of 72.9% for all MOGCTs. Sensitivities varied according to the subtype, but were consistently higher in MRI (100% for dysgerminoma, 88.9% for immature teratoma, 100% for endodermal sinus tumor, 100% for others). However, there were differences in FSA according to subtype (100% for dysgerminoma, 50.0% for immature teratoma, 100% for endodermal sinus tumor, 25.0% for others). Serum tumor markers also provided diagnostic insights, particularly LDH for dysgerminoma (82.4%) and AFP for immature teratoma (75.0%) and endodermal sinus tumor (100%).ConclusionPreoperative MRI and serum tumor marker measurement may be effective in guiding fertility‐sparing surgical decisions. MRI could outperform FSA in terms of accuracy, especially for immature teratoma.
{"title":"Enhancing the accuracy of preoperative and intraoperative evaluation of malignant ovarian germ cell tumors with a focus on fertility preservation in young women","authors":"U Chul Ju, Woo Dae Kang, Seok Mo Kim","doi":"10.1002/ijgo.15916","DOIUrl":"https://doi.org/10.1002/ijgo.15916","url":null,"abstract":"ObjectiveTo analyze and improve the accuracy of preoperative assessment and intraoperative frozen‐section analysis (FSA) for malignant ovarian germ cell tumors (MOGCTs), especially in the context of fertility preservation.MethodsA retrospective review of 48 women aged under 40 years, diagnosed with MOGCTs, and treated at Chonnam National University Hospital between July and December 2022 was conducted. The results of preoperative magnetic resonance imaging (MRI), measurement of serum tumor markers (α‐fetoprotein [AFP], β‐human chorionic gonadotropin, lactate dehydrogenase [LDH], cancer antigen [CA] 125, CA 19–9, CA 72–4, carcinoembryonic antigen), and intraoperative FSA were compared with the final pathology diagnosis.ResultsMRI demonstrated a sensitivity of 95.5%, whereas FSA showed a sensitivity of 72.9% for all MOGCTs. Sensitivities varied according to the subtype, but were consistently higher in MRI (100% for dysgerminoma, 88.9% for immature teratoma, 100% for endodermal sinus tumor, 100% for others). However, there were differences in FSA according to subtype (100% for dysgerminoma, 50.0% for immature teratoma, 100% for endodermal sinus tumor, 25.0% for others). Serum tumor markers also provided diagnostic insights, particularly LDH for dysgerminoma (82.4%) and AFP for immature teratoma (75.0%) and endodermal sinus tumor (100%).ConclusionPreoperative MRI and serum tumor marker measurement may be effective in guiding fertility‐sparing surgical decisions. MRI could outperform FSA in terms of accuracy, especially for immature teratoma.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adhesions arising from gynecologic surgeries and cesarean sections pose substantial clinical, social, and economic challenges, leading to issues like pelvic pain, infertility, bowel obstruction, and recurring surgeries. Preventing adhesions is a pressing unmet need, hindered by difficulties in assessing postoperative adhesions and understanding barriers. To bridge adhesion prevention gaps, statements on clinical practices were synthesized to present Asia‐Pacific expert perspectives on gynecologic surgery and cesarean section adhesion prevention. An expert panel of eight physicians from various healthcare settings in the Asia‐Pacific region was convened and a comprehensive literature search on topics related to adhesion prevention in gynecologic surgeries and cesarean sections was performed. Information from full‐text publications was used to develop draft consensus statements, with each statement assigned the highest available evidence level based on a systematic literature review and graded using the Oxford Center for Evidence‐based Medicine criteria. A modified Delphi process, involving two rounds of online voting and discussions with an extended group of 109 experts, was employed to reach a consensus on six topics related to adhesion barriers. A set of 15 consensus statements were synthesized. Key topics include adhesion incidence in Asia, cesarean section complications, barrier application status, adhesion formation and prevention, absorbable barriers' effectiveness, recommendations, and future considerations. The statements provide guidance for healthcare professionals, especially in the Asia‐Pacific region, to tackle the challenges posed by postoperative adhesions and improve patient outcomes. Further research is needed to enhance understanding and prevention of adhesions in this region.
{"title":"Adhesion barriers in gynecologic surgeries and cesarean section: An Asia‐Pacific expert panel consensus recommendation","authors":"Shinji Tanigaki, Achla Batra, Te‐Fu Chan, Julian Hean‐Leng Kang, Siu‐Keung Lam, Timothy Yong‐Kuei Lim, Raghavendra Mayya, Abdul Ghani Nur Azurah, Graeme Walker","doi":"10.1002/ijgo.15903","DOIUrl":"https://doi.org/10.1002/ijgo.15903","url":null,"abstract":"Adhesions arising from gynecologic surgeries and cesarean sections pose substantial clinical, social, and economic challenges, leading to issues like pelvic pain, infertility, bowel obstruction, and recurring surgeries. Preventing adhesions is a pressing unmet need, hindered by difficulties in assessing postoperative adhesions and understanding barriers. To bridge adhesion prevention gaps, statements on clinical practices were synthesized to present Asia‐Pacific expert perspectives on gynecologic surgery and cesarean section adhesion prevention. An expert panel of eight physicians from various healthcare settings in the Asia‐Pacific region was convened and a comprehensive literature search on topics related to adhesion prevention in gynecologic surgeries and cesarean sections was performed. Information from full‐text publications was used to develop draft consensus statements, with each statement assigned the highest available evidence level based on a systematic literature review and graded using the Oxford Center for Evidence‐based Medicine criteria. A modified Delphi process, involving two rounds of online voting and discussions with an extended group of 109 experts, was employed to reach a consensus on six topics related to adhesion barriers. A set of 15 consensus statements were synthesized. Key topics include adhesion incidence in Asia, cesarean section complications, barrier application status, adhesion formation and prevention, absorbable barriers' effectiveness, recommendations, and future considerations. The statements provide guidance for healthcare professionals, especially in the Asia‐Pacific region, to tackle the challenges posed by postoperative adhesions and improve patient outcomes. Further research is needed to enhance understanding and prevention of adhesions in this region.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectiveTo explore the assisted reproductive outcomes of patients with atypical endometrial hyperplasia (AEH) and early‐stage endometrial cancer (EEC) who achieved complete remission after conservative treatment and to provide reference for clinical selection of appropriate conservative treatment.MethodThis retrospective cohort study included seven patients with EEC and 62 patients with AEH who underwent in vitro fertilization or intracytoplasmic sperm injection at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University between August 2015 and October 2023. The authors divided the participants into two groups based on the type of fertility‐sparing treatment received: the oral medication group and the levonorgestrel‐releasing intrauterine system (LNG‐IUS) group. The primary outcome was the cumulative clinical pregnancy rate. Secondary outcomes included clinical pregnancy rate per transfer cycle, embryo utilization rate, and high‐quality embryo rate.ResultsThe LNG‐IUS group had a significantly higher rate of usable embryos compared with the oral medication group (80.8% vs 91.1%, P = 0.005) and also had a thinner endometrial thickness on the day of embryo transfer. The cumulative clinical pregnancy rate was higher in the LNG‐IUS group compared with the medication group (46.7% vs 78.9%, P = 0.037), and the difference was statistically significant.ConclusionFor patients with AEH and EEC with fertility needs, the conservative treatment method of LNG‐IUS can achieve better assisted reproductive outcomes.
目的 探讨经保守治疗后病情完全缓解的非典型子宫内膜增生症（AEH）和早期子宫内膜癌（EEC）患者的辅助生殖效果，为临床选择合适的保守治疗方法提供参考。方法这项回顾性队列研究纳入了2015年8月至2023年10月期间在郑州大学第三附属医院生殖中心接受体外受精或卵胞浆内单精子注射的7例EEC患者和62例AEH患者。作者根据接受的保胎治疗类型将参与者分为两组：口服药物组和左炔诺孕酮释放宫内系统（LNG-IUS）组。主要结果是累积临床妊娠率。结果与口服药物组相比，LNG-IUS 组的可用胚胎率明显更高（80.8% vs 91.1%，P = 0.005），胚胎移植当天的子宫内膜厚度也更薄。LNG-IUS 组的累积临床妊娠率高于药物组（46.7% vs 78.9%，P = 0.037），差异有统计学意义。
{"title":"Analysis of assisted reproductive outcomes in patients with atypical endometrial hyperplasia and early‐stage endometrial cancer after fertility‐sparing treatment","authors":"Jiaheng Li, Mengnuo Li, Yijiang Li, Xianling Zhao, Yichun Guan, Xiaoqiong Yuan, Shanshan Du, Caihua Zhang, Wenxia Liu, Bingnan Ren","doi":"10.1002/ijgo.15898","DOIUrl":"https://doi.org/10.1002/ijgo.15898","url":null,"abstract":"ObjectiveTo explore the assisted reproductive outcomes of patients with atypical endometrial hyperplasia (AEH) and early‐stage endometrial cancer (EEC) who achieved complete remission after conservative treatment and to provide reference for clinical selection of appropriate conservative treatment.MethodThis retrospective cohort study included seven patients with EEC and 62 patients with AEH who underwent in vitro fertilization or intracytoplasmic sperm injection at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University between August 2015 and October 2023. The authors divided the participants into two groups based on the type of fertility‐sparing treatment received: the oral medication group and the levonorgestrel‐releasing intrauterine system (LNG‐IUS) group. The primary outcome was the cumulative clinical pregnancy rate. Secondary outcomes included clinical pregnancy rate per transfer cycle, embryo utilization rate, and high‐quality embryo rate.ResultsThe LNG‐IUS group had a significantly higher rate of usable embryos compared with the oral medication group (80.8% vs 91.1%, <jats:italic>P</jats:italic> = 0.005) and also had a thinner endometrial thickness on the day of embryo transfer. The cumulative clinical pregnancy rate was higher in the LNG‐IUS group compared with the medication group (46.7% vs 78.9%, <jats:italic>P</jats:italic> = 0.037), and the difference was statistically significant.ConclusionFor patients with AEH and EEC with fertility needs, the conservative treatment method of LNG‐IUS can achieve better assisted reproductive outcomes.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the present study we reviewed the existing literature regarding management approaches for ASC‐US and highlight their pros and cons. The ASC‐US entity emerged from Bethesda classification 2001. We conducted this review using search words ASC‐US triage, ASC‐US management in young women, triage tests for ASC‐US, and ASC‐US outcome from the English literature. We included different cervical cancer policies (American, European and for WHO) and research articles published on ASC‐US in young women from the year 2001. We searched in Google Scholar, PubMed, MEDLINE (NCBI) library, Embase (Elsevier), Wiley online library as well as Cochrane library. We defined young women as aged 30 years and below. We identified 52 articles which focused on management approaches of ASC‐US, seven articles focused on young women aged <30 years. Five of these articles combined ASC‐US with low‐grade squamous intraepithelial lesions (ASC‐US/LSIL) while only two addressed ASC‐US as a standalone entity. The limited number of articles restricts the evidence base supporting the adoption of triage strategies. There is yet, no consensus in the literature regarding the management of ASC‐US, more so in young women below the age of 30 years. Researchers, however, agree on a few aspects, which include the necessity for applying a conservative strategy for managing ASC‐US in young women, avoiding direct referral for colposcopy at the initial detection of ASC‐US, and avoiding the use of human papillomavirus (HPV) testing on young women (unless living with HIV). Newer techniques such as HPV E6/E7 messenger RNA (mRNA), and dual staining p16/ki‐67, may serve as better triage to identify cases of HPV persistence and integration which may subsequently lead to preinvasive or invasive lesions.
{"title":"Review of triage strategies for atypical squamous cells of undetermined significance among young women","authors":"Jeremie Cubaka Ntamushigo, Hannah Motshedisi Sebitloane","doi":"10.1002/ijgo.15915","DOIUrl":"https://doi.org/10.1002/ijgo.15915","url":null,"abstract":"In the present study we reviewed the existing literature regarding management approaches for ASC‐US and highlight their pros and cons. The ASC‐US entity emerged from Bethesda classification 2001. We conducted this review using search words ASC‐US triage, ASC‐US management in young women, triage tests for ASC‐US, and ASC‐US outcome from the English literature. We included different cervical cancer policies (American, European and for WHO) and research articles published on ASC‐US in young women from the year 2001. We searched in Google Scholar, PubMed, MEDLINE (NCBI) library, Embase (Elsevier), <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://onlinelibrary.wiley.com/doi/10.1002/dc.23821\">Wiley online library</jats:ext-link> as well as Cochrane library. We defined young women as aged 30 years and below. We identified 52 articles which focused on management approaches of ASC‐US, seven articles focused on young women aged <30 years. Five of these articles combined ASC‐US with low‐grade squamous intraepithelial lesions (ASC‐US/LSIL) while only two addressed ASC‐US as a standalone entity. The limited number of articles restricts the evidence base supporting the adoption of triage strategies. There is yet, no consensus in the literature regarding the management of ASC‐US, more so in young women below the age of 30 years. Researchers, however, agree on a few aspects, which include the necessity for applying a conservative strategy for managing ASC‐US in young women, avoiding direct referral for colposcopy at the initial detection of ASC‐US, and avoiding the use of human papillomavirus (HPV) testing on young women (unless living with HIV). Newer techniques such as HPV E6/E7 messenger RNA (mRNA), and dual staining p16/ki‐67, may serve as better triage to identify cases of HPV persistence and integration which may subsequently lead to preinvasive or invasive lesions.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectiveTo evaluate the optimal timing for fetal weight estimation during the third trimester.MethodsThis retrospective cohort study involved fetal weight estimations from both early (28+0–36+6 weeks) and late (37+0 weeks and beyond) third trimester. These estimations were converted to predicted birth weights using the gestation‐adjusted projection formula. Birth weight predictions were compared with actual birth weights, to identify the most effective timing for weight prediction.ResultsThe study included 3549 cases, revealing mean percentage errors (MPE) of −3.69% for early sonographic assessments, −2.5% for late sonographic assessments, and −1.9% for late clinical assessments. A significant difference was found between early and late sonographic estimations (P < 0.001), whereas late sonographic and clinical assessments did not differ significantly (P = 0.771). Weight predictions for fetuses below the 10th and above the 90th centiles were less accurate than for those within the 10th–90th centiles (P < 0.001). In women with obesity, late clinical estimations were less precise (MPE of −5.85) compared with non‐obese women (MPE of −1.66, P < 0.001). For women with diabetes, early sonographic estimations were more accurate (MPE of −1.31) compared with non‐diabetic patients (MPE of −3.94, P < 0.001) though this difference did not persist later in pregnancy.ConclusionSonographic and clinical weight predictions in the late third trimester were more accurate than earlier third‐trimester sonographic assessments, hence continuous follow up and assessments closer to term are important. In women with diabetes, no adjustments in weight prediction methods are necessary. Accurately predicting birth weights for abnormally small or large fetuses remains challenging, indicating the need for improved screening and diagnostic strategies.
{"title":"Evaluation of sonographic and clinical measures in early versus late third trimester for birth weight prediction","authors":"Shira Regev‐Sadeh, Wisam Assaf, Adi Zehavi, Nadav Cohen, Ofer Lavie, Ariel Zilberlicht","doi":"10.1002/ijgo.15911","DOIUrl":"https://doi.org/10.1002/ijgo.15911","url":null,"abstract":"ObjectiveTo evaluate the optimal timing for fetal weight estimation during the third trimester.MethodsThis retrospective cohort study involved fetal weight estimations from both early (28<jats:sup>+0</jats:sup>–36<jats:sup>+6</jats:sup> weeks) and late (37<jats:sup>+0</jats:sup> weeks and beyond) third trimester. These estimations were converted to predicted birth weights using the gestation‐adjusted projection formula. Birth weight predictions were compared with actual birth weights, to identify the most effective timing for weight prediction.ResultsThe study included 3549 cases, revealing mean percentage errors (MPE) of −3.69% for early sonographic assessments, −2.5% for late sonographic assessments, and −1.9% for late clinical assessments. A significant difference was found between early and late sonographic estimations (<jats:italic>P</jats:italic> < 0.001), whereas late sonographic and clinical assessments did not differ significantly (<jats:italic>P</jats:italic> = 0.771). Weight predictions for fetuses below the 10th and above the 90th centiles were less accurate than for those within the 10th–90th centiles (<jats:italic>P <</jats:italic> 0.001). In women with obesity, late clinical estimations were less precise (MPE of −5.85) compared with non‐obese women (MPE of −1.66, <jats:italic>P</jats:italic> < 0.001). For women with diabetes, early sonographic estimations were more accurate (MPE of −1.31) compared with non‐diabetic patients (MPE of −3.94, <jats:italic>P</jats:italic> < 0.001) though this difference did not persist later in pregnancy.ConclusionSonographic and clinical weight predictions in the late third trimester were more accurate than earlier third‐trimester sonographic assessments, hence continuous follow up and assessments closer to term are important. In women with diabetes, no adjustments in weight prediction methods are necessary. Accurately predicting birth weights for abnormally small or large fetuses remains challenging, indicating the need for improved screening and diagnostic strategies.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectiveIn Japan, amidst insufficient legal provisions and governmental support, in 2010, the first rape crisis center, the Sexual Assault Crisis Healing Intervention Center Osaka (SACHICO) was established. We compared SACHICO visitor data from 2010 to 2021 with National Police Agency statistics to clarify the current situation of sexual assault victims in Japan and considered future issues for Japan to address.MethodsThis study was a cross‐sectional study that analyzed the data described below. All visitations to SACHICO between April 2010 and December 2021 were considered targets for data totaling. Data on crime statistics were gathered from the official governmental statistics portal site.ResultsA total of 12 036 visitations occurred, of which 3189 were first‐time consultations; 3100 initial medical examinations were conducted, and no medical examination was conducted in the remaining 89 cases (2.7%). The number of initial medical examinations increased 3.7 times from 2010 to 2021. Victims under the age of 19 comprised 60% of the total number of initial medical examinations (1863/3100). The reporting rate for all 3100 initial medical examinations was only 31.3% (969/3100) of the cases. The proportion of forcible sexual intercourse versus forcible indecency were the converse of those observed among acknowledged cases nationwide and in Osaka Prefecture. For several years, the number of initial medical consultations at SACHICO has exceeded that of acknowledged cases in Osaka Prefecture.ConclusionSupport for victims of sexual assault in Japan is still insufficient. It is necessary to strengthen the system of rape crisis centers system to realize an unbroken chain of support for victims.
{"title":"The dawn of a sexual assault relief center: A 12‐year fact‐finding survey of victims of sexual assault conducted since 2010 by SACHICO, Japan's first rape crisis center","authors":"Yuki Kusumoto, Eiji Kobayashi, Asami Yagi, Emi Ishida, Aya Miyazawa, Kaori Kikuchi, Kana Kudara, Katsuko Shimada, Seiichi Yamamasu, Yutaka Ueda, Tadashi Kimura, Haruko Kato","doi":"10.1002/ijgo.15906","DOIUrl":"https://doi.org/10.1002/ijgo.15906","url":null,"abstract":"ObjectiveIn Japan, amidst insufficient legal provisions and governmental support, in 2010, the first rape crisis center, the Sexual Assault Crisis Healing Intervention Center Osaka (SACHICO) was established. We compared SACHICO visitor data from 2010 to 2021 with National Police Agency statistics to clarify the current situation of sexual assault victims in Japan and considered future issues for Japan to address.MethodsThis study was a cross‐sectional study that analyzed the data described below. All visitations to SACHICO between April 2010 and December 2021 were considered targets for data totaling. Data on crime statistics were gathered from the official governmental statistics portal site.ResultsA total of 12 036 visitations occurred, of which 3189 were first‐time consultations; 3100 initial medical examinations were conducted, and no medical examination was conducted in the remaining 89 cases (2.7%). The number of initial medical examinations increased 3.7 times from 2010 to 2021. Victims under the age of 19 comprised 60% of the total number of initial medical examinations (1863/3100). The reporting rate for all 3100 initial medical examinations was only 31.3% (969/3100) of the cases. The proportion of forcible sexual intercourse versus forcible indecency were the converse of those observed among acknowledged cases nationwide and in Osaka Prefecture. For several years, the number of initial medical consultations at SACHICO has exceeded that of acknowledged cases in Osaka Prefecture.ConclusionSupport for victims of sexual assault in Japan is still insufficient. It is necessary to strengthen the system of rape crisis centers system to realize an unbroken chain of support for victims.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142202897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jean Paul Buhendwa Cikwanine, Jonathan Tunangoya Yoyu, Emile Shalamba Mapatano, Souhil Lebdai, Denis Mukwege, Ludovic Martin
ObjectiveThe purpose of the present study was to assess the benefits of simulation for advancing knowledge and assisting healthcare staff in optimization of procedures when managing severe pre‐eclampsia/eclampsia (sPE/E).MethodsA randomized educational trial was conducted with two groups: Group I received theoretical training, while group II received the same training along with simulation scenarios based on the management of sPE/E. The study involved 199 healthcare providers, including physicians, midwives, skilled birth attendants, and nurses. The study analyzed the percentage of correct answers on both the multiple‐choice questions (MCQ) and the objective structured clinical examinations (OSCE) to evaluate theoretical knowledge and clinical skills objectively.ResultsStatistically significant differences were found immediately after training between groups I and II, whose mean percentages were 65.0% (±11.2) versus 71.0% (±9.8) (P < 0.001). A statistically significant reduction in the percentage of correct answers was found in both groups and demonstrated a discrepancy between immediate post‐training test and post‐training test at 3 months scores of 11.6% (±1.3) in group I versus 7.2% (±0.6) in group II. OSCE1 and OSCE2 scores were significantly higher in group II than in group I (P < 0.001).ConclusionSimulation combined with theoretical training would appear to be an interesting method of training for advancing knowledge and improving skills of healthcare providers in their management of sPE/E. Our goal is for this method to be used to reduce real‐life maternal mortality in the South Kivu region of the Democratic Republic of Congo.
{"title":"Benefits of simulation on multidisciplinary management of severe pre‐eclampsia/severe eclampsia in 15 health districts in eastern Democratic Republic of Congo: A randomized educational trial","authors":"Jean Paul Buhendwa Cikwanine, Jonathan Tunangoya Yoyu, Emile Shalamba Mapatano, Souhil Lebdai, Denis Mukwege, Ludovic Martin","doi":"10.1002/ijgo.15893","DOIUrl":"https://doi.org/10.1002/ijgo.15893","url":null,"abstract":"ObjectiveThe purpose of the present study was to assess the benefits of simulation for advancing knowledge and assisting healthcare staff in optimization of procedures when managing severe pre‐eclampsia/eclampsia (sPE/E).MethodsA randomized educational trial was conducted with two groups: Group I received theoretical training, while group II received the same training along with simulation scenarios based on the management of sPE/E. The study involved 199 healthcare providers, including physicians, midwives, skilled birth attendants, and nurses. The study analyzed the percentage of correct answers on both the multiple‐choice questions (MCQ) and the objective structured clinical examinations (OSCE) to evaluate theoretical knowledge and clinical skills objectively.ResultsStatistically significant differences were found immediately after training between groups I and II, whose mean percentages were 65.0% (±11.2) versus 71.0% (±9.8) (<jats:italic>P</jats:italic> < 0.001). A statistically significant reduction in the percentage of correct answers was found in both groups and demonstrated a discrepancy between immediate post‐training test and post‐training test at 3 months scores of 11.6% (±1.3) in group I versus 7.2% (±0.6) in group II. OSCE1 and OSCE2 scores were significantly higher in group II than in group I (<jats:italic>P</jats:italic> < 0.001).ConclusionSimulation combined with theoretical training would appear to be an interesting method of training for advancing knowledge and improving skills of healthcare providers in their management of sPE/E. Our goal is for this method to be used to reduce real‐life maternal mortality in the South Kivu region of the Democratic Republic of Congo.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142202894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ruxue Han, Feifeng Zhang, Xiaolin Jiang, Chaohua Wang, Xin Yang
ObjectiveTo investigate the benefits of menstrual management in women undergoing hematopoietic stem cell transplantation (HSCT), in whom heavy menstrual bleeding (HMB) can be an underestimated bleeding complication.MethodsThis was a retrospective cohort study. Patients who had undergone HSCT in the Gynecological Endocrinology Clinic of Peking University People's Hospital were included over 10 years. The data of hematology and menstruation for all participants were collected. The management methods of the intervention group include gonadotropin‐releasing hormone agonists (GnRHa), combined oral contraceptives (COC), or low‐dose mifepristone. Patients who did not receive management were included in the control group.ResultsThere were 112 patients included in the intervention group and 218 patients included in the control group. In all, 90.0%(297/330) of patients presented with HMB before HSCT. In the control group, 83.5%(182/218) of patients experienced menstruation in the laminar air‐flow room (LAFR), whereas only 22.3%(25/112) did in the intervention group. After leaving the LAFR, the incidence of recurrent uterine bleeding was significantly reduced in the intervention group (17.9%(20/112/) versus 50.9%(111/218), p < 0.001). Patients who did not undergo menstrual management had a higher risk of bleeding than those who did (odds ratio 18.12, p < 0.001).ConclusionMenstrual management significantly reduces the incidence of HMB in HSCT patients and acts as a protective factor to prevent menstrual bleeding in the LAFR.
{"title":"Effects of management of heavy menstrual bleeding of patients undergoing haploidentical hematopoietic stem cell transplantation","authors":"Ruxue Han, Feifeng Zhang, Xiaolin Jiang, Chaohua Wang, Xin Yang","doi":"10.1002/ijgo.15905","DOIUrl":"https://doi.org/10.1002/ijgo.15905","url":null,"abstract":"ObjectiveTo investigate the benefits of menstrual management in women undergoing hematopoietic stem cell transplantation (HSCT), in whom heavy menstrual bleeding (HMB) can be an underestimated bleeding complication.MethodsThis was a retrospective cohort study. Patients who had undergone HSCT in the Gynecological Endocrinology Clinic of Peking University People's Hospital were included over 10 years. The data of hematology and menstruation for all participants were collected. The management methods of the intervention group include gonadotropin‐releasing hormone agonists (GnRHa), combined oral contraceptives (COC), or low‐dose mifepristone. Patients who did not receive management were included in the control group.ResultsThere were 112 patients included in the intervention group and 218 patients included in the control group. In all, 90.0%(297/330) of patients presented with HMB before HSCT. In the control group, 83.5%(182/218) of patients experienced menstruation in the laminar air‐flow room (LAFR), whereas only 22.3%(25/112) did in the intervention group. After leaving the LAFR, the incidence of recurrent uterine bleeding was significantly reduced in the intervention group (17.9%(20/112/) versus 50.9%(111/218), <jats:italic>p</jats:italic> < 0.001). Patients who did not undergo menstrual management had a higher risk of bleeding than those who did (odds ratio 18.12, <jats:italic>p</jats:italic> < 0.001).ConclusionMenstrual management significantly reduces the incidence of HMB in HSCT patients and acts as a protective factor to prevent menstrual bleeding in the LAFR.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142202893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ObjectiveThe aim of this study was to identify survival rates and potential prognostic factors of ovarian squamous cell carcinoma (OSCC), offering valuable insights for clinical decision making.MethodsLeveraging the Surveillance, Epidemiology, and End Results (SEER) database, we selected 11 078 serous carcinoma (SC) patients and 198 OSCC patients based on predetermined criteria diagnosed from 2000 to 2020. We compared the overall survival (OS) and cancer‐specific survival (CSS) before and after propensity score matching (PSM) in two groups. Prognostic differences were also compared between OSCC and SC groups at different stages. Univariate and multivariate Cox regression analyses were performed to investigate the impact of clinical and pathologic variables on the survival of patients with OSCC. Finally, we developed and validated a nomogram predictive model.ResultsOSCC tumors exhibited distinct characteristics, being relatively larger, more frequently unilateral, and better differentiated than SC tumors. After PSM, Kaplan–Meier analysis revealed significantly lower survival rates for OSCC patients in Stages IIB–IV, while Stages IA–IC displayed comparable survival. Independent risk factors for OSCC patients included advanced age, single marital status, higher tumor stage, and increased tumor size. Conversely, higher median household income and chemotherapy emerged as independent protective factors. Our predictive model and nomogram accurately forecasted patient survival rates in both SEER and internal validation datasets.ConclusionOSCC patients face significantly poorer prognosis than their SC counterparts, except in the very early stages. Higher median household income was associated with better OSCC survival.
{"title":"Comparative prognosis analysis of ovarian squamous cell carcinoma versus serous carcinoma: Insights from the SEER database","authors":"Xianglin Nie, Ting Xu, Wenjun Cheng","doi":"10.1002/ijgo.15899","DOIUrl":"https://doi.org/10.1002/ijgo.15899","url":null,"abstract":"ObjectiveThe aim of this study was to identify survival rates and potential prognostic factors of ovarian squamous cell carcinoma (OSCC), offering valuable insights for clinical decision making.MethodsLeveraging the Surveillance, Epidemiology, and End Results (SEER) database, we selected 11 078 serous carcinoma (SC) patients and 198 OSCC patients based on predetermined criteria diagnosed from 2000 to 2020. We compared the overall survival (OS) and cancer‐specific survival (CSS) before and after propensity score matching (PSM) in two groups. Prognostic differences were also compared between OSCC and SC groups at different stages. Univariate and multivariate Cox regression analyses were performed to investigate the impact of clinical and pathologic variables on the survival of patients with OSCC. Finally, we developed and validated a nomogram predictive model.ResultsOSCC tumors exhibited distinct characteristics, being relatively larger, more frequently unilateral, and better differentiated than SC tumors. After PSM, Kaplan–Meier analysis revealed significantly lower survival rates for OSCC patients in Stages IIB–IV, while Stages IA–IC displayed comparable survival. Independent risk factors for OSCC patients included advanced age, single marital status, higher tumor stage, and increased tumor size. Conversely, higher median household income and chemotherapy emerged as independent protective factors. Our predictive model and nomogram accurately forecasted patient survival rates in both SEER and internal validation datasets.ConclusionOSCC patients face significantly poorer prognosis than their SC counterparts, except in the very early stages. Higher median household income was associated with better OSCC survival.","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142202930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：