Journal of Obstetrics and Gynaecology Research最新文献

Women with Swyer syndrome must be informed that pregnancy is possible through oocyte donation, although it carries medical risks and requires careful preparation, including hormone treatment and gonadectomy. We present two cases of Swyer syndrome in which live births were achieved through oocyte donation and reviewed prior reports identifying a high rate of preeclampsia and Caesarean section as significant outcomes. Oocyte donation carries medical risks, such as preeclampsia, raises social issues which are unsolved yet, especially in Japan, where oocyte donation is usually anonymous. Nevertheless, strengthened collaboration between reproductive medicine and perinatal care is necessary, as is the development of social support systems to enable women with Swyer syndrome to achieve pregnancy more safely.

Objective: To assess the impact of Roy Adaptation Model (RAM)-based nursing on postpartum recovery in primiparous women after vaginal delivery.

Methods: 258 primiparous women were randomly assigned using a computer-generated random sequence to a control group (routine nursing, n = 133) or an intervention group (routine nursing plus RAM interventions, n = 125) for 8 weeks. Outcomes included pelvic floor function (PFDI-20, nocturia frequency, vaginal dynamic pressure), pelvic floor muscle strength (vaginal contraction duration, contraction/resting EMG values), psychological status (SAS, SDS, EPDS), quality of life (QOL), and complications.

Results: Compared to the control group, the intervention group demonstrated significantly higher vaginal dynamic pressure, vaginal contraction duration, contraction EMG values, and resting EMG values (all p < 0.05). They also showed significantly lower nocturia frequency, PFDI-20 scores, breast swelling/pain scores, shorter lochia resolution and uterine involution times, and reduced incidences of stress urinary incontinence, pelvic organ prolapse, and sexual dysfunction (all p < 0.05). SAS, SDS, and EPDS scores were significantly lower (p < 0.05), while QOL scores were significantly higher (p < 0.05) in the intervention group.

Conclusion: RAM-based nursing promotes postpartum physical recovery, alleviates psychological distress, and enhances quality of life in primiparous women after vaginal delivery.

Synchronous human papillomavirus-independent gastric-type adenocarcinoma in situ affecting both cervical and vaginal epithelium constitutes an ultrarare preinvasive disease. The diagnostic complexity arises from asymptomatic presentation and skip lesions that obscure the true extent of the disease. We report the case of a 26-year-old woman diagnosed with atypical glandular cells during routine cervical cancer screening. Sequential conizations consistently demonstrated gastric-type adenocarcinoma in situ with persistently positive surgical margins. Post-conization colposcopic assessment and histopathology revealed extensive multifocal disease involving residual cervix and vaginum. Considering the substantial disease burden and potential for occult invasion, surgical intervention was undertaken, including type B1 radical hysterectomy, bilateral salpingectomy, bilateral ovarian tissue cryopreservation, total vaginectomy, and vaginal reconstruction. At 20 months of follow-up, the patient remains completely disease-free with no evidence of recurrence.

Aim: Guided by the Developmental Origins of Health and Disease framework, maternal nutrition influences perinatal outcomes and lifelong offspring health. This commentary summarizes the pregnant and lactating women's section of Dietary Reference Intakes for Japanese (2025), contextualizes them within current Japanese evidence, and identifies priorities for future research and revisions.

Methods: We conducted a narrative synthesis of the Dietary Reference Intakes and recent Japanese studies on maternal diet, fetal growth, anemia, folate, vitamin D, calcium, gestational weight gain, lactation, and preconception health, with attention to guideline-practice gaps.

Results: The Dietary Reference Intakes provide trimester-based additional energy and nutrient targets. However, Japanese cohort data show suboptimal intakes of energy, macro- and micronutrients, with persistently low folate awareness and intake. Anemia (Hb < 11 g/dL) is associated with adverse outcomes, and low vitamin D/calcium status impacts maternal bone health. While medical nutrition therapy is standard for gestational diabetes, nutrient targets have not been set yet. Guidance for hypertensive disorder of pregnancy recommends sodium restriction but lacks comprehensive nutrient specifications. Evidence gaps include body mass index-specific energy needs for appropriate gestational weight gain, robust diet-fetal growth relationships, and actionable guidance for lactation and the preconception period.

Conclusions: The Dietary Reference Intakes for Japanese (2025) provide a necessary framework, yet significant implementation and evidence gaps remain. Research defining body mass index-stratified energy needs, nutrient-outcome dose responses, and preconception/lactation guidance, paired with education and surveillance, is critical for improving intergenerational health.

A 33-year-old woman with secondary infertility after a term emergency cesarean delivery due to cesarean scar disorder (CSDi) underwent combined hysteroscopic and laparoscopic cesarean scar repair. Eight months later, at 34 years of age, she conceived spontaneously. Cervical length was 28.3 mm in early pregnancy (unchanged from preconception) but shortened to 20.5 mm at 13 + 5 weeks of gestation, and cervical insufficiency was suspected. A Shirodkar cerclage was performed at 15 + 4 weeks of gestation. Thereafter, cervical shortening did not progress and the pregnancy remained uncomplicated. Elective cesarean delivery at 37 + 1 weeks of gestation resulted in a healthy female infant, and both maternal and neonatal courses were uneventful. Cesarean scar repair may affect cervical competence; thus, pregnancies after CSDi repair should include close cervical length surveillance and consideration of cerclage when significant shortening is detected. Further evidence is needed to optimize postoperative pregnancy management.

Aim: This study aimed to examine the relationship between sexual health literacy and sexual myths among health science students studying at a public university in Türkiye.

Methods: A cross-sectional study was conducted with 678 students enrolled in various health science departments during the 2023-2024 academic year. Data were collected online using a Personal Information Form, the Sexual Health Literacy Scale (SHLS), and the Sexual Myths Scale (SMS). Descriptive statistics, independent samples t-test, one-way ANOVA, and linear regression analyses were performed to assess differences and predictive factors.

Results: Among the participants, 35.3% were studying midwifery, 17.8% nursing, 14.3% emergency aid, 9.4% medical documentation and secretarial studies, 8.8% child development, 6.9% elderly care, and 4.9% physiotherapy. Most students (91.9%) reported not having received any sexual health education. The mean SHLS and SMS total scores were 50.26 ± 7.85 and 68.50 ± 17.76, respectively. Sexual health literacy and sexual myth levels differed significantly according to age, department, year of study, and marital status (p < 0.05). The knowledge and attitude subdimensions of the SHLS significantly predicted total sexual myth scores (F = 9.03; p < 0.001).

Conclusions: Sexual myths among health science students are influenced by their level of sexual health literacy. Providing scientifically based and accurate sexual health education during university training may contribute to improving the quality of future sexual and reproductive health services delivered by these students as healthcare professionals.

Aim: Human breast milk is known to contain a variety of bioactive components, including stem and progenitor cells; however, their in vitro propagation is often constrained by limited adherence and yield. The use of conventional serum supplementation raises concerns regarding unnatural interactions and potential pathogen exposure. This study aims to assess the effects of serum and growth factors on the adhesion, proliferation, and propagation of human breast milk-derived cells (hBMCs).

Methods: We cultured cells in four media: M1 (DMEM + 10% FBS), M2 (DMEM/F12 + 20% KnockOut Serum Replacement [KSR] + 10 ng/mL bFGF), M3 (DMEM/F12 + 10% KSR + 10 ng/mL bFGF), and M4 (DMEM + 10% FBS + 5% HS). Cell adhesion, proliferation, and morphology were evaluated using bright-field microscopy, fluorescence imaging, and cell viability assays.

Results: Our findings indicated postpartum-dependent variations in hBMC numbers and demonstrated that serum-free conditions with KSR significantly enhanced cell adhesion and proliferation. Specifically, M2 and M3 facilitated increased proliferation with reduced doubling time, resulting in higher cell yield. Furthermore, the study underscored the impact of contamination and fat globules on lower adhesion efficiency.

Conclusions: Overall, these results identify KSR-based media as a promising alternative to FBS, providing optimized conditions for the propagation of hBMCs and paving the way for their future therapeutic and experimental applications.

Background: Uterine smooth muscle tumor of uncertain malignant potential (STUMP) is a rare "gray-zone" entity characterized by unpredictable postoperative behavior and the absence of standardized surveillance strategies.

Objective: To describe postoperative clinical course, recurrence patterns, and fertility-related outcomes in patients with STUMP managed at a tertiary center.

Methods: We conducted a retrospective observational study including 27 patients with a final pathology diagnosis of STUMP who underwent surgery and had postoperative follow-up available between 2009 and 2025. Clinical, surgical, and pathological variables were collected from hospital records. Recurrence was defined as radiologic evidence of a new lesion during follow-up and categorized by anatomic site. Outcomes included recurrence status, time to recurrence, recurrence histology, subsequent management, and pregnancy outcomes after uterus-sparing surgery.

Results: Median follow-up was 58 months (IQR 17-79; range 4-136). Recurrence occurred in six patients (22.2%), with a median time to recurrence of 36 months (IQR 8-66.3). Recurrences were local (n = 4) or pulmonary (n = 2); one patient with lung recurrence also had wrist soft-tissue involvement. Histology at recurrence included leiomyosarcoma (n = 2), STUMP (n = 2), and leiomyoma (n = 2). All recurrent cases underwent secondary surgery. One death occurred during follow-up. Uterus-sparing surgery was performed in nine patients (33.3%); recurrence occurred in four, all local. Two pregnancies were recorded, including one live birth.

Conclusion: STUMP shows heterogeneous postoperative behavior, including late and occasionally malignant or distant recurrences. Long-term surveillance is warranted, and uterus-sparing management may be considered in carefully selected patients with fertility goals under close follow-up.

Aim: This study aimed to evaluate reproductive health (RH) protective attitudes among married women and to identify predictors of these attitudes using the Reproductive Health Protective Attitudes Scale (RHPAS).

Materials and methods: This analytical and cross-sectional study was conducted with 372 married women who visited the gynecology outpatient clinic of a training and research hospital in İzmir, western Türkiye, between May and December 2023. Data were collected using the Individual Identification Form and the RHPAS. Descriptive statistics were used to assess socio-demographic, obstetric, and RH characteristics. Group differences in RHPAS scores were analyzed with t-tests and ANOVA. Correlation and multiple linear regression analyses were conducted to identify relationships and predictors of RH protective attitudes. A significance level of p < 0.05 was accepted.

Results: The mean RHPAS score was 133.11 ± 17.45, indicating a generally positive attitude toward RH protection. Significant differences in RHPAS scores were found by living place, family type, income level, and contraceptive use (p < 0.05). Negative correlations were observed between RHPAS scores and both the number of pregnancies (r = -0.104, p = 0.045) and number of living children (r = -0.152, p = 0.003). Regression analysis showed that living in urban areas, nuclear family type, higher income, pregnancy experience, contraceptive use, fewer children, and having an RH diagnosis were significant predictors of higher RHPAS scores (p < 0.05, R² = 0.173).

Conclusion: Married women showed favorable RH protective attitudes. Education and counseling should be prioritized to improve awareness and access to RH services, especially by addressing influencing socio-demographic and obstetric factors.