Congenital adrenal hyperplasia (CAH) can result in masculinized genitalia due to excessive androgen production. This genital virilization often presents as clitoral hypertrophy, ranging from a significantly enlarged clitoris to a phallic-like clitoris in female patients.
Case presentation
A Syrian refugee girl presented at age 24 with complaints of abnormal genitalia. Gynecologic examination revealed clitoromegaly, absence of labia minora, and a single common orifice of the urethra and vagina, the size of a pinhead. Nerve-sparing clitoroplasty, total urogenital sinus mobilization, vaginoplasty, and creation of labia minora with perineoplasty were performed.
Conclusions
There are limited case reports on CAH, clitoroplasty, and urogenital sinus mobilization in adults. This case highlights the feasibility of one-stage feminizing genitoplasty in adulthood and provides unique educational value through detailed step-by-step surgical video documentation.
{"title":"Clitoroplasty and urogenital sinus mobilization in females with congenital adrenal hyperplasia: A case report with focused literature discussion","authors":"Faruk Abike, Fatma Basak Tanoglu, Bashar Yacoub Abdelhafiz Sammour","doi":"10.1016/j.jogoh.2026.103134","DOIUrl":"10.1016/j.jogoh.2026.103134","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital adrenal hyperplasia (CAH) can result in masculinized genitalia due to excessive androgen production. This genital virilization often presents as clitoral hypertrophy, ranging from a significantly enlarged clitoris to a phallic-like clitoris in female patients.</div></div><div><h3>Case presentation</h3><div>A Syrian refugee girl presented at age 24 with complaints of abnormal genitalia. Gynecologic examination revealed clitoromegaly, absence of labia minora, and a single common orifice of the urethra and vagina, the size of a pinhead. Nerve-sparing clitoroplasty, total urogenital sinus mobilization, vaginoplasty, and creation of labia minora with perineoplasty were performed.</div></div><div><h3>Conclusions</h3><div>There are limited case reports on CAH, clitoroplasty, and urogenital sinus mobilization in adults. This case highlights the feasibility of one-stage feminizing genitoplasty in adulthood and provides unique educational value through detailed step-by-step surgical video documentation.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 5","pages":"Article 103134"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-05-01Epub Date: 2026-02-05DOI: 10.1016/j.jogoh.2026.103131
Antonella Iannaccone , Paul Buderath , Martin W. Britten , Alberto Spina , Katharina Krempel , Zeynep Atas Elfrink , Angela Köninger , Rainer Kimmig , Roland Csorba
Cesarean scar pregnancy (CSP) is a variant of uterine ectopic pregnancy defined by full or partial implantation of the gestational sac in the scar of a previous cesarean section. The most usual recommendation is termination of pregnancy in the first trimester.
In this article, we present a case of live birth after detecting CSP in early pregnancy and robotic scar reinforcement surgery, effectively relocating the pregnancy into the cavum. At 25+3 gestational weeks, an emergency caesarean section was performed. A girl weighing 800 g was delivered with APGAR 7/7/9. The percrete area of the placenta was excised and the uterus could be preserved.
Prolongation of CSP and consecutive live birth is feasible and can be achieved. Using robotic surgical approach for both the scar reinforcement surgery as well as the surveillance of the pregnancy including caesarean section with management of placenta percreta require high expertise and specialized centres.
{"title":"Successful live birth following robotic-assisted management of a cesarean scar pregnancy: a promising pathway","authors":"Antonella Iannaccone , Paul Buderath , Martin W. Britten , Alberto Spina , Katharina Krempel , Zeynep Atas Elfrink , Angela Köninger , Rainer Kimmig , Roland Csorba","doi":"10.1016/j.jogoh.2026.103131","DOIUrl":"10.1016/j.jogoh.2026.103131","url":null,"abstract":"<div><div>Cesarean scar pregnancy (CSP) is a variant of uterine ectopic pregnancy defined by full or partial implantation of the gestational sac in the scar of a previous cesarean section. The most usual recommendation is termination of pregnancy in the first trimester.</div><div>In this article, we present a case of live birth after detecting CSP in early pregnancy and robotic scar reinforcement surgery, effectively relocating the pregnancy into the cavum. At 25+3 gestational weeks, an emergency caesarean section was performed. A girl weighing 800 g was delivered with APGAR 7/7/9. The percrete area of the placenta was excised and the uterus could be preserved.</div><div>Prolongation of CSP and consecutive live birth is feasible and can be achieved. Using robotic surgical approach for both the scar reinforcement surgery as well as the surveillance of the pregnancy including caesarean section with management of placenta percreta require high expertise and specialized centres.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 5","pages":"Article 103131"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-22DOI: 10.1016/j.jogoh.2026.103125
Jeremy Boujenah, Bruno Carbonne
{"title":"Doppler ultrasound at 41 weeks: Pragmatic evidence, clinical relevance, and response to methodological considerations","authors":"Jeremy Boujenah, Bruno Carbonne","doi":"10.1016/j.jogoh.2026.103125","DOIUrl":"10.1016/j.jogoh.2026.103125","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103125"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-22DOI: 10.1016/j.jogoh.2026.103124
Margaux Sizaire , Lucie Galvan , Violaine Peyronnet , Emilia Holmström , Charles Egloff , Victoire Pauphilet , Oliver Picone , Laurent Mandelbrot , Imane Ben M’Barek
Context
Foetal Alcohol Syndrome (FAS) is the most severe form of Foetal Alcohol Spectrum Disorders (FASD), caused by prenatal alcohol exposure, a major preventable cause of congenital disability. FASD lack specific prenatal ultrasound signs, making early diagnosis difficult.
Objective
To describe prenatal ultrasound findings in pregnancies with reported alcohol use and compare maternal and neonatal characteristics according to the presence of anomalies.
Methods
We conducted a retrospective multicentre study in three hospitals from September 2013 to April 2025. All women reporting alcohol use during pregnancy were included. Exposure was classified by quantity (moderate: ≤3 drinks/day or <40 cl/day; excessive: >3 drinks/day or >40 cl/day) and frequency (occasional, often, chronic), based on maternal self-report. Ultrasound scans from all trimesters were reviewed for growth and morphological anomalies. Comparative analyses were performed between women with and without anomalies.
Results
Among 94 pregnancies, 30 (32%) showed ultrasound anomalies. Women with anomalies were older (33.9 vs. 31.7 years, p <0.01), with no differences in BMI, parity, or co-exposures. Occasional alcohol use appeared not associated with anomalies, whereas increasing maternal age (aOR = 1.22; 95% CI [1.09-1.40]) was an independent risk factor. Most anomalies were detected in the second trimester, mainly foetal growth restriction (FGR) and microcephaly. Neonatal abnormalities occurred in 70% of the anomaly group versus 10.9% without anomalies (p < 0.01). Seven neonates (11%) had undiagnosed FGR or microcephaly at birth.
Conclusion
Ultrasound anomalies were found in one-third of alcohol-exposed pregnancies, underscoring the risks of chronic alcohol use.
{"title":"Prenatal alcohol exposure and sonographic abnormalities: Insights from a retrospective cohort","authors":"Margaux Sizaire , Lucie Galvan , Violaine Peyronnet , Emilia Holmström , Charles Egloff , Victoire Pauphilet , Oliver Picone , Laurent Mandelbrot , Imane Ben M’Barek","doi":"10.1016/j.jogoh.2026.103124","DOIUrl":"10.1016/j.jogoh.2026.103124","url":null,"abstract":"<div><h3>Context</h3><div>Foetal Alcohol Syndrome (FAS) is the most severe form of Foetal Alcohol Spectrum Disorders (FASD), caused by prenatal alcohol exposure, a major preventable cause of congenital disability. FASD lack specific prenatal ultrasound signs, making early diagnosis difficult.</div></div><div><h3>Objective</h3><div>To describe prenatal ultrasound findings in pregnancies with reported alcohol use and compare maternal and neonatal characteristics according to the presence of anomalies.</div></div><div><h3>Methods</h3><div>We conducted a retrospective multicentre study in three hospitals from September 2013 to April 2025. All women reporting alcohol use during pregnancy were included. Exposure was classified by quantity (moderate: ≤3 drinks/day or <40 cl/day; excessive: >3 drinks/day or >40 cl/day) and frequency (occasional, often, chronic), based on maternal self-report. Ultrasound scans from all trimesters were reviewed for growth and morphological anomalies. Comparative analyses were performed between women with and without anomalies.</div></div><div><h3>Results</h3><div>Among 94 pregnancies, 30 (32%) showed ultrasound anomalies. Women with anomalies were older (33.9 vs. 31.7 years, p <0.01), with no differences in BMI, parity, or co-exposures. Occasional alcohol use appeared not associated with anomalies, whereas increasing maternal age (aOR = 1.22; 95% CI [1.09-1.40]) was an independent risk factor. Most anomalies were detected in the second trimester, mainly foetal growth restriction (FGR) and microcephaly. Neonatal abnormalities occurred in 70% of the anomaly group versus 10.9% without anomalies (p < 0.01). Seven neonates (11%) had undiagnosed FGR or microcephaly at birth.</div></div><div><h3>Conclusion</h3><div>Ultrasound anomalies were found in one-third of alcohol-exposed pregnancies, underscoring the risks of chronic alcohol use.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103124"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-02-05DOI: 10.1016/j.jogoh.2026.103132
Vincent Marcoux , Marie De Antonio , Amélie Delabaere , Marie Accoceberry , Céline Houlle , Pamela Bouchet , Fanny Petillon , Marion Rouzaire , Denis Gallot
Background
Prolonged pregnancy is associated with an increased risk of maternal, fetal and neonatal complications. Careful monitoring and systematic induction at 42 weeks of gestation are recommended in France.
Objectives
Our primary objective was to identify determinants for spontaneous labor during expectant management for prolonged pregnancy. Our secondary objective was to assess the efficacy of membrane sweeping in bringing on labor.
Study design
This observational, retrospective, monocentric study included all patients with a singleton pregnancy who had reached the term of 41 weeks of gestation to within one day. They underwent an expectant period up to 41 weeks and 6 days with fetal heart monitoring and ultrasound every two days. The cohort was divided into two groups according to the presence or absence of membrane sweeping. In the group that did not undergo membrane sweeping (Natural History cohort), we compared patients who entered spontaneous labor with those who required induction of labour.
Results
A total of 366 patients were included. For the 293 patients without membrane sweeping, spontaneous labor occurred in 51.1 % of cases. A higher Bishop score (p = 0.02) and a lower BMI (p = 0.08) were associated with spontaneous labor. Parity had no influence (p = 0.74). Effectiveness of membrane sweeping to promote spontaneous labor was highlighted after adjustment on parity, BMI and Bishop score (71.6 % vs 51.5 %, p = 0.021, SMD=0.422).
Conclusion
In prolonged pregnancy, the probability of going into spontaneous labor was only 50.9 %. Low BMI and high Bishop score were associated with spontaneous onset of labor in case of expectant management. Membrane sweeping was associated with spontaneous labor in our post-term population after adjustment on parity, BMI and Bishop score.
{"title":"Determinents of spontaneous labor for prolonged pregnancy and effectiveness of membrane sweeping: An observational study","authors":"Vincent Marcoux , Marie De Antonio , Amélie Delabaere , Marie Accoceberry , Céline Houlle , Pamela Bouchet , Fanny Petillon , Marion Rouzaire , Denis Gallot","doi":"10.1016/j.jogoh.2026.103132","DOIUrl":"10.1016/j.jogoh.2026.103132","url":null,"abstract":"<div><h3>Background</h3><div>Prolonged pregnancy is associated with an increased risk of maternal, fetal and neonatal complications. Careful monitoring and systematic induction at 42 weeks of gestation are recommended in France.</div></div><div><h3>Objectives</h3><div>Our primary objective was to identify determinants for spontaneous labor during expectant management for prolonged pregnancy. Our secondary objective was to assess the efficacy of membrane sweeping in bringing on labor.</div></div><div><h3>Study design</h3><div>This observational, retrospective, monocentric study included all patients with a singleton pregnancy who had reached the term of 41 weeks of gestation to within one day. They underwent an expectant period up to 41 weeks and 6 days with fetal heart monitoring and ultrasound every two days. The cohort was divided into two groups according to the presence or absence of membrane sweeping. In the group that did not undergo membrane sweeping (Natural History cohort), we compared patients who entered spontaneous labor with those who required induction of labour.</div></div><div><h3>Results</h3><div>A total of 366 patients were included. For the 293 patients without membrane sweeping, spontaneous labor occurred in 51.1 % of cases. A higher Bishop score (<em>p</em> = 0.02) and a lower BMI (<em>p</em> = 0.08) were associated with spontaneous labor. Parity had no influence (<em>p</em> = 0.74). Effectiveness of membrane sweeping to promote spontaneous labor was highlighted after adjustment on parity, BMI and Bishop score (71.6 % vs 51.5 %, <em>p</em> = 0.021, SMD=0.422).</div></div><div><h3>Conclusion</h3><div>In prolonged pregnancy, the probability of going into spontaneous labor was only 50.9 %. Low BMI and high Bishop score were associated with spontaneous onset of labor in case of expectant management. Membrane sweeping was associated with spontaneous labor in our post-term population after adjustment on parity, BMI and Bishop score.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103132"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-13DOI: 10.1016/j.jogoh.2026.103112
Helyett Ollivier , Valérie Malan , Raphael Bartin , Jean-Michel Dupont , Julien Stirnemann , Yves Ville , Matthieu Dap
Introduction
In most European countries, if the risk of trisomy 21 exceeds 1/50, Women are offered further investigation through an invasive test. Since the development of the non-invasive test based on circulating free DNA from the entire genome (cfDNA), the use of non-invasive tests in this high-risk population is now being debated. Our study aims to investigate a cohort of women at high risk of isolated trisomy 21 with no ultrasound abnormalities at the first trimester ultrasound scan or nuchal translucency greater than the 99th percentile who underwent invasive sampling with chromosomal microarray analysis (CMA).
Material and methods
This retrospective cohort included 159 women with isolated high-risk of Trisomy 21 (T21) screening who underwent invasive testing with CMA between 2017 and 2023. We described chromosomal abnormalities and explored associations with first-trimester markers and ultrasound findings.
Results
Chromosomal abnormalities were identified in 24% of cases (38/159), including twenty-seven trisomy 21, two trisomy 18, four true fetal mosaicisms (one trisomy 22, two trisomy 16, and one monosomy X), two cases of confined placental mosaicism (trisomy 22 and trisomy 13), and three copy number variants (two likely benign and one pathogenic). Low PAPP-A levels were significantly associated with chromosomal imbalance (p < 0.001).
Conclusion
In a population of women with a high risk of trisomy 21 but without nuchal translucency greater than the 99th percentile or ultrasound signs at the first trimester, the rate of chromosomal abnormalities is 24%. Although these abnormalities are heterogeneous, the majority are aneuploidy; with only large CNVs of 13.9 Mb having a poor neurodevelopmental prognosis.
{"title":"Chromosomal abnormalities diagnosed at the chromosomal microarray in pregnancies with isolated high risk of trisomy 21","authors":"Helyett Ollivier , Valérie Malan , Raphael Bartin , Jean-Michel Dupont , Julien Stirnemann , Yves Ville , Matthieu Dap","doi":"10.1016/j.jogoh.2026.103112","DOIUrl":"10.1016/j.jogoh.2026.103112","url":null,"abstract":"<div><h3>Introduction</h3><div>In most European countries, if the risk of trisomy 21 exceeds 1/50, Women are offered further investigation through an invasive test. Since the development of the non-invasive test based on circulating free DNA from the entire genome (cfDNA), the use of non-invasive tests in this high-risk population is now being debated. Our study aims to investigate a cohort of women at high risk of isolated trisomy 21 with no ultrasound abnormalities at the first trimester ultrasound scan or nuchal translucency greater than the 99th percentile who underwent invasive sampling with chromosomal microarray analysis (CMA).</div></div><div><h3>Material and methods</h3><div>This retrospective cohort included 159 women with isolated high-risk of Trisomy 21 (T21) screening who underwent invasive testing with CMA between 2017 and 2023. We described chromosomal abnormalities and explored associations with first-trimester markers and ultrasound findings.</div></div><div><h3>Results</h3><div>Chromosomal abnormalities were identified in 24% of cases (38/159), including twenty-seven trisomy 21, two trisomy 18, four true fetal mosaicisms (one trisomy 22, two trisomy 16, and one monosomy X), two cases of confined placental mosaicism (trisomy 22 and trisomy 13), and three copy number variants (two likely benign and one pathogenic). Low PAPP-A levels were significantly associated with chromosomal imbalance (<em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>In a population of women with a high risk of trisomy 21 but without nuchal translucency greater than the 99th percentile or ultrasound signs at the first trimester, the rate of chromosomal abnormalities is 24%. Although these abnormalities are heterogeneous, the majority are aneuploidy; with only large CNVs of 13.9 Mb having a poor neurodevelopmental prognosis.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103112"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-02-03DOI: 10.1016/j.jogoh.2026.103130
Maylis Robin , Camille Durand , Léa Roux , Isabelle Berkelmans , Benoit Peyronnet , Charlène Brochard , Ludivine Dion , Vincent Lavoué , Jean Levêque , Maela Le Lous , Krystel Nyangoh Timoh
Introduction
This study sought to assess the impact of transcutaneous electrical nerve stimulation (TENS) prescribed by gynecologists in routine practice on pain, pelvic sensitization, quality of life, and catastrophization scores in patients with endometriosis and chronic pelvic pain.
Methods
Thirty patients at the University Hospital of Rennes, France, diagnosed with endometriosis and experiencing chronic pelvic pain, received TENS between September 2022 and February 2023. Pain, pelvic sensitization, quality of life, catastrophization, and Brief Pain Inventory (BPI) were assessed using standardized and validated questionnaires before and after 1, 3, and 6 months of TENS device use.
Results
After 1 month of device use, minimal changes occurred as improvement in the perception of treatment effectiveness by patients, sleep quality, and well-being (BPI). However, after 3 months, a significant improvement was observed in all these measures, which persisted at 6 months. Specifically, pain intensity (numerical rating scale) significantly decreased (p = 0.029), pelvic sensitization decreased (p = 0.039), quality of life assessed by the EHP-5 score improved (p = 0.003), and catastrophization scores significantly decreased (p = 0.003). Patients also reported a notable improvement in their perception of treatment effectiveness, particularly in terms of its impact on work and interactions with others (BPI).
Conclusions
TENS prescribed by gynecologists in routine practice may be effective in reducing pain, pelvic sensitization, and improving quality of life and catastrophization scores in patients with endometriosis and chronic pelvic pain. These findings are very useful in daily practice, especially for patients waiting for pain management physicians.
{"title":"Evaluating the efficacy of transcutaneous electrical nerve stimulation in managing chronic pelvic pain in endometriosis patients","authors":"Maylis Robin , Camille Durand , Léa Roux , Isabelle Berkelmans , Benoit Peyronnet , Charlène Brochard , Ludivine Dion , Vincent Lavoué , Jean Levêque , Maela Le Lous , Krystel Nyangoh Timoh","doi":"10.1016/j.jogoh.2026.103130","DOIUrl":"10.1016/j.jogoh.2026.103130","url":null,"abstract":"<div><h3>Introduction</h3><div>This study sought to assess the impact of transcutaneous electrical nerve stimulation (TENS) prescribed by gynecologists in routine practice on pain, pelvic sensitization, quality of life, and catastrophization scores in patients with endometriosis and chronic pelvic pain.</div></div><div><h3>Methods</h3><div>Thirty patients at the University Hospital of Rennes, France, diagnosed with endometriosis and experiencing chronic pelvic pain, received TENS between September 2022 and February 2023. Pain, pelvic sensitization, quality of life, catastrophization, and Brief Pain Inventory (BPI) were assessed using standardized and validated questionnaires before and after 1, 3, and 6 months of TENS device use.</div></div><div><h3>Results</h3><div>After 1 month of device use, minimal changes occurred as improvement in the perception of treatment effectiveness by patients, sleep quality, and well-being (BPI). However, after 3 months, a significant improvement was observed in all these measures, which persisted at 6 months. Specifically, pain intensity (numerical rating scale) significantly decreased (<em>p</em> = 0.029), pelvic sensitization decreased (<em>p</em> = 0.039), quality of life assessed by the EHP-5 score improved (<em>p</em> = 0.003), and catastrophization scores significantly decreased (<em>p</em> = 0.003). Patients also reported a notable improvement in their perception of treatment effectiveness, particularly in terms of its impact on work and interactions with others (BPI).</div></div><div><h3>Conclusions</h3><div>TENS prescribed by gynecologists in routine practice may be effective in reducing pain, pelvic sensitization, and improving quality of life and catastrophization scores in patients with endometriosis and chronic pelvic pain. These findings are very useful in daily practice, especially for patients waiting for pain management physicians.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103130"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-02-05DOI: 10.1016/j.jogoh.2026.103133
Yuan-Cheng Jin , Yu-Hua Wu , Xue-Song Ma , Wen Shi , Miao-Lian Wu , Qing-Qing Hu
Background
Semaglutide, a glucagon-like peptide-1 receptor agonist, is increasingly used for the treatment of diabetes and weight loss, including in women of reproductive age. However, its impact on pregnancy outcomes remains largely unknown, with limited data available. The manufacturer advises against using semaglutide within two months prior to planned pregnancy, but some patients may unknowingly use it during early pregnancy.
Case Presentation
We report the case of a 37-year-old woman with a pre-pregnancy Body Mass Index (BMI) of 27.73 kg/m². She received semaglutide 0.5 mg once weekly, initiated before conception and continued until approximately 7 weeks of gestation, and discontinued treatment immediately upon recognition of pregnancy. All prenatal screenings, including nuchal translucency and four-dimensional color Doppler ultrasound, were normal. She delivered a healthy male infant at nearly 40 weeks of gestation. The infant showed no adverse outcomes during follow-up assessments at 1 and 3 months of age.
Conclusions
This case suggests that semaglutide exposure during early pregnancy may not necessarily lead to adverse outcomes in obese women. However, larger studies are needed to confirm these findings and to better understand the impact of semaglutide on pregnancy outcomes. This case report contributes to the limited literature on this topic and may inform future clinical decision-making.
{"title":"Semaglutide exposure in early pregnancy and pregnancy outcomes: A case report and review of literature","authors":"Yuan-Cheng Jin , Yu-Hua Wu , Xue-Song Ma , Wen Shi , Miao-Lian Wu , Qing-Qing Hu","doi":"10.1016/j.jogoh.2026.103133","DOIUrl":"10.1016/j.jogoh.2026.103133","url":null,"abstract":"<div><h3>Background</h3><div>Semaglutide, a glucagon-like peptide-1 receptor agonist, is increasingly used for the treatment of diabetes and weight loss, including in women of reproductive age. However, its impact on pregnancy outcomes remains largely unknown, with limited data available. The manufacturer advises against using semaglutide within two months prior to planned pregnancy, but some patients may unknowingly use it during early pregnancy.</div></div><div><h3>Case Presentation</h3><div>We report the case of a 37-year-old woman with a pre-pregnancy Body Mass Index (BMI) of 27.73 kg/m². She received semaglutide 0.5 mg once weekly, initiated before conception and continued until approximately 7 weeks of gestation, and discontinued treatment immediately upon recognition of pregnancy. All prenatal screenings, including nuchal translucency and four-dimensional color Doppler ultrasound, were normal. She delivered a healthy male infant at nearly 40 weeks of gestation. The infant showed no adverse outcomes during follow-up assessments at 1 and 3 months of age.</div></div><div><h3>Conclusions</h3><div>This case suggests that semaglutide exposure during early pregnancy may not necessarily lead to adverse outcomes in obese women. However, larger studies are needed to confirm these findings and to better understand the impact of semaglutide on pregnancy outcomes. This case report contributes to the limited literature on this topic and may inform future clinical decision-making.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103133"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-28DOI: 10.1016/j.jogoh.2026.103127
Leila Mandalou , Ali Aghebati-Maleki , Amirhossein Mardi , Mehdi Yousefi , Leili Aghebati-Maleki
Background
Reproductive health is essential to women's well-being. Rising infertility rates are influenced by environmental and lifestyle factors. Aging significantly reduces ovarian reserve and oocyte quality, especially after age 35. Anti-Müllerian hormone (AMH) is a reliable marker for assessing ovarian reserve. Air pollution, particularly exposure to particulate matter (PM) and nitrogen oxides (NOx), may be negatively associated with ovarian reserve and reproductive health.
Objectives
To evaluate current evidence on the effects of air pollution on AMH levels.
Methods
We systematically searched PubMed, Embase, and Web of Science for studies published from January 2000 until December 29, 2024, using specific keywords. Two reviewers independently screened studies based on predefined inclusion criteria, focusing on original articles examining the relationship between air pollutants and AMH levels. Data were extracted using Google Sheets. Study quality was assessed using the AXIS tool for cross-sectional studies and the Newcastle-Ottawa Scale for cohort studies.
Results
Twelve studies were included. Nine reported a significant association between air pollution and reduced AMH levels. The methodological quality of studies ranged from fair to good, supporting the robustness of findings.
Conclusion
Air pollution may significantly reduce ovarian reserve. Reducing exposure to PM2.5 and NOx is crucial for fertility preservation, especially in polluted urban areas.
背景：生殖健康对妇女的福祉至关重要。不断上升的不孕率受到环境和生活方式因素的影响。衰老会显著降低卵巢储备和卵母细胞质量，尤其是35岁以后。抗勒氏激素（AMH）是评估卵巢储备的可靠指标。空气污染，特别是接触颗粒物（PM）和氮氧化物（NOx），可能与卵巢储备和生殖健康负相关。目的：评价目前关于空气污染对AMH水平影响的证据。方法：系统检索PubMed、Embase和Web of Science，检索2000年1月至2024年12月29日期间发表的论文。两名审稿人根据预先确定的纳入标准独立筛选研究，重点是研究空气污染物与AMH水平之间关系的原创文章。使用谷歌Sheets提取数据。研究质量评估采用横断面研究的AXIS工具和队列研究的纽卡斯尔-渥太华量表。结果：纳入12项研究。9个国家报告了空气污染与抗微生物药物耐药性水平降低之间的显著关联。研究的方法学质量从一般到良好，支持研究结果的稳健性。结论：空气污染可显著降低卵巢储备功能。减少PM2.5和氮氧化物的暴露对于保持生育力至关重要，尤其是在污染严重的城市地区。
{"title":"Associations of air pollution exposure with anti-Müllerian hormone as an ovarian reserve biomarker: A systematic review","authors":"Leila Mandalou , Ali Aghebati-Maleki , Amirhossein Mardi , Mehdi Yousefi , Leili Aghebati-Maleki","doi":"10.1016/j.jogoh.2026.103127","DOIUrl":"10.1016/j.jogoh.2026.103127","url":null,"abstract":"<div><h3>Background</h3><div>Reproductive health is essential to women's well-being. Rising infertility rates are influenced by environmental and lifestyle factors. Aging significantly reduces ovarian reserve and oocyte quality, especially after age 35. Anti-Müllerian hormone (AMH) is a reliable marker for assessing ovarian reserve. Air pollution, particularly exposure to particulate matter (PM) and nitrogen oxides (NOx), may be negatively associated with ovarian reserve and reproductive health.</div></div><div><h3>Objectives</h3><div>To evaluate current evidence on the effects of air pollution on AMH levels.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, and Web of Science for studies published from January 2000 until December 29, 2024, using specific keywords. Two reviewers independently screened studies based on predefined inclusion criteria, focusing on original articles examining the relationship between air pollutants and AMH levels. Data were extracted using Google Sheets. Study quality was assessed using the AXIS tool for cross-sectional studies and the Newcastle-Ottawa Scale for cohort studies.</div></div><div><h3>Results</h3><div>Twelve studies were included. Nine reported a significant association between air pollution and reduced AMH levels. The methodological quality of studies ranged from fair to good, supporting the robustness of findings.</div></div><div><h3>Conclusion</h3><div>Air pollution may significantly reduce ovarian reserve. Reducing exposure to PM2.5 and NOx is crucial for fertility preservation, especially in polluted urban areas.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103127"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-04-01Epub Date: 2026-01-27DOI: 10.1016/j.jogoh.2026.103128
Sandra Lynn Jaya-Bodestyne, Ashton Kai Sheng Yin, Christopher Jer Wei Low, Ashley Shuen Ying Hong, Yvonne Wan Yu Wong, Joella Xiaohong Ang, Jason Shau Khng Lim, Ravichandran Nadarajah
Introduction
Vaginal natural orifice transluminal surgery (vNOTES) is a promising tool in gynecology and is being increasingly adopted in minimally invasive surgery. The aim of this study is to assess the feasibility and outcomes of vNOTES for morbidly obese patients for gynecological surgeries.
Material and methods
Morbidly obese patients (BMI≥40kg/m2) who underwent vNOTES for gynecological conditions from March 2021 to June 2025 were identified. Data on patient demographics, operative factors, complications and postoperative outcomes were collected and analyzed. A literature review on gynecology vNOTES in morbidly obese patients was also performed.
Results
32 patients were identified. The median BMI was 42.1kg/m2 (range 40.0 – 72kg/m2). Their age ranged from 23 to 77 years old. 50% of them had a previous abdominal or pelvic surgery. 50% were nulliparous. The most common procedure performed was total hysterectomy bilateral salpingoophorectomy (81.3%). One patient underwent pelvic lymph node dissection. The median operative time was 150mins (range 75 – 475mins). The median blood loss was 200mL (range 0 – 1700mL). The median length of stay was 2 days (range 1 – 38 days) and postoperative pain scores were low. One patient developed a postoperative pelvic collection that was treated conservatively. In the literature review comparing 3 other studies, the perioperative and postoperative complication rates and median operation time were generally comparable, although this interpretation is limited by the small sample sizes.
Conclusion
vNOTES is a feasible approach in morbidly obese patients for various gynaecological surgeries, demonstrating favourable outcomes.
{"title":"vNOTES (vaginal natural orifice transluminal surgery) gynecological procedures in morbidly obese patients BMI≥40kg/m2: An experience in a Southeast Asian tertiary centre","authors":"Sandra Lynn Jaya-Bodestyne, Ashton Kai Sheng Yin, Christopher Jer Wei Low, Ashley Shuen Ying Hong, Yvonne Wan Yu Wong, Joella Xiaohong Ang, Jason Shau Khng Lim, Ravichandran Nadarajah","doi":"10.1016/j.jogoh.2026.103128","DOIUrl":"10.1016/j.jogoh.2026.103128","url":null,"abstract":"<div><h3>Introduction</h3><div>Vaginal natural orifice transluminal surgery (vNOTES) is a promising tool in gynecology and is being increasingly adopted in minimally invasive surgery. The aim of this study is to assess the feasibility and outcomes of vNOTES for morbidly obese patients for gynecological surgeries.</div></div><div><h3>Material and methods</h3><div>Morbidly obese patients (BMI≥40kg/m<sup>2</sup>) who underwent vNOTES for gynecological conditions from March 2021 to June 2025 were identified. Data on patient demographics, operative factors, complications and postoperative outcomes were collected and analyzed. A literature review on gynecology vNOTES in morbidly obese patients was also performed.</div></div><div><h3>Results</h3><div>32 patients were identified. The median BMI was 42.1kg/m<sup>2</sup> (range 40.0 – 72kg/m<sup>2</sup>). Their age ranged from 23 to 77 years old. 50% of them had a previous abdominal or pelvic surgery. 50% were nulliparous. The most common procedure performed was total hysterectomy bilateral salpingoophorectomy (81.3%). One patient underwent pelvic lymph node dissection. The median operative time was 150mins (range 75 – 475mins). The median blood loss was 200mL (range 0 – 1700mL). The median length of stay was 2 days (range 1 – 38 days) and postoperative pain scores were low. One patient developed a postoperative pelvic collection that was treated conservatively. In the literature review comparing 3 other studies, the perioperative and postoperative complication rates and median operation time were generally comparable, although this interpretation is limited by the small sample sizes.</div></div><div><h3>Conclusion</h3><div>vNOTES is a feasible approach in morbidly obese patients for various gynaecological surgeries, demonstrating favourable outcomes.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"55 4","pages":"Article 103128"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号