Delayed-interval delivery refers to the delivery of the remaining fetus(es) at least 24 h after the delivery of the first fetus. There have been limited case reports of delayed-interval deliveries in twin pregnancies whose delivery of the first twin occurred in the early second trimester. We report a delayed-interval delivery of a dichorionic diamniotic pregnancy complicated by multiple fibroids. A 38-year-old primipara woman delivered the first twin at 15 weeks and 3 days of gestation. She did not have uterine contractions or any signs of infection, then McDonald cerclage was performed at 17 weeks and 1 day of gestation. At 27 weeks and 2 days of gestation, the second twin, 922 g, was delivered by caesarean section after premature rupture of membranes. Delayed-interval delivery may be considered in the early second trimester if there is no evidence of uterine contractions or infection, even in patients at risk for preterm birth.
{"title":"Cervical Cerclage at 17 Gestational Weeks for Delayed-Interval Delivery at 15 and 27 Weeks of Gestation in a Dichorionic Twin Pregnancy: A Case Report","authors":"Motomu Suzuki, Toshiyuki Itai, Ryosuke Shindo, Nozomi Maruiwa, Sayaka Suzuki, Natsumi Ono, Azusa Tochio, Kazunori Mukaida, Soichiro Obata, Etsuko Miyagi, Shigeru Aoki","doi":"10.1111/jog.70193","DOIUrl":"10.1111/jog.70193","url":null,"abstract":"<div>\u0000 \u0000 <p>Delayed-interval delivery refers to the delivery of the remaining fetus(es) at least 24 h after the delivery of the first fetus. There have been limited case reports of delayed-interval deliveries in twin pregnancies whose delivery of the first twin occurred in the early second trimester. We report a delayed-interval delivery of a dichorionic diamniotic pregnancy complicated by multiple fibroids. A 38-year-old primipara woman delivered the first twin at 15 weeks and 3 days of gestation. She did not have uterine contractions or any signs of infection, then McDonald cerclage was performed at 17 weeks and 1 day of gestation. At 27 weeks and 2 days of gestation, the second twin, 922 g, was delivered by caesarean section after premature rupture of membranes. Delayed-interval delivery may be considered in the early second trimester if there is no evidence of uterine contractions or infection, even in patients at risk for preterm birth.</p>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125077","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}
To evaluate the reproductive outcomes associated with chronic intervillositis of unknown etiology (CIUE) and to clarify its clinical relevance in women presenting with recurrent pregnancy loss (RPL).
Methods
A systematic review and meta-analysis were conducted across PubMed, Embase, Cochrane Library, and OVID databases through September 2025. Studies reporting histologically confirmed CIUE with documented RPL outcomes were included. Pooled prevalence estimates were calculated using generalized linear mixed models within random-effects frameworks to account for between-study variability.
Results
Six studies encompassing up to 263 pregnancies were analyzed. The pooled prevalence of RPL was 37.3%, while live birth, CIUE recurrence, intrauterine growth restriction, and perinatal death were 52.6%, 39.6%, 64.1%, and 13.7%, respectively. Maternal autoimmune disease and fetal chromosomal abnormalities were relatively uncommon. Despite substantial heterogeneity, the overall pattern indicated a consistent burden of adverse pregnancy outcomes in affected women.
Conclusions
CIUE is closely associated with pregnancy loss, fetal growth restriction, and perinatal death and is characterized by a high recurrence rate of approximately 40% in subsequent pregnancies, underscoring its clinical importance in women with unexplained RPL. Early pathological recognition and individualized surveillance may improve pregnancy management and counseling. Further multicenter prospective studies are warranted to define optimal diagnostic and therapeutic strategies.
{"title":"Recurrent Pregnancy Loss and Adverse Outcomes in Chronic Intervillositis of Unknown Etiology: A Systematic Review and Meta-Analysis","authors":"Shuang Wu","doi":"10.1111/jog.70195","DOIUrl":"10.1111/jog.70195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the reproductive outcomes associated with chronic intervillositis of unknown etiology (CIUE) and to clarify its clinical relevance in women presenting with recurrent pregnancy loss (RPL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis were conducted across PubMed, Embase, Cochrane Library, and OVID databases through September 2025. Studies reporting histologically confirmed CIUE with documented RPL outcomes were included. Pooled prevalence estimates were calculated using generalized linear mixed models within random-effects frameworks to account for between-study variability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six studies encompassing up to 263 pregnancies were analyzed. The pooled prevalence of RPL was 37.3%, while live birth, CIUE recurrence, intrauterine growth restriction, and perinatal death were 52.6%, 39.6%, 64.1%, and 13.7%, respectively. Maternal autoimmune disease and fetal chromosomal abnormalities were relatively uncommon. Despite substantial heterogeneity, the overall pattern indicated a consistent burden of adverse pregnancy outcomes in affected women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CIUE is closely associated with pregnancy loss, fetal growth restriction, and perinatal death and is characterized by a high recurrence rate of approximately 40% in subsequent pregnancies, underscoring its clinical importance in women with unexplained RPL. Early pathological recognition and individualized surveillance may improve pregnancy management and counseling. Further multicenter prospective studies are warranted to define optimal diagnostic and therapeutic strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119033","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}
To investigate the differences in lipid metabolism and obesity between patients with ovarian endometrioid carcinoma (OEC) and ovarian clear cell carcinoma (OCCC), both of which are classified as endometriosis-associated Type I ovarian cancers.
Methods
This retrospective study included 133 patients who underwent surgery for OEC (n = 50) or OCCC (n = 83) between 2010 and 2022. Preoperative serum lipid markers (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) and body mass index (BMI) were compared between the two groups. Associations with menopausal status and disease stage were examined, and independent predictors were evaluated by multivariate logistic regression.
Results
Patients with OEC had significantly higher TC (215 vs. 199.5 mg/dL, p = 0.040), LDL-C (139 vs. 120.6 mg/dL, p = 0.026), and BMI (22.1 vs. 20.4 kg/m2, p = 0.020) compared with those with OCCC. No significant differences were observed for HDL-C. In premenopausal women, TC and LDL-C were significantly higher in patients with OEC, whereas no intergroup differences were found in postmenopausal women. Among patients with OEC, those with advanced-stage disease had higher TC and LDL-C, whereas no stage-related differences were observed in patients with OCCC. Multivariate analysis identified BMI and LDL-C as independent factors associated with OEC.
Conclusion
Lipid metabolism abnormalities and obesity were more strongly associated with OEC than with OCCC, suggesting subtype-specific metabolic mechanisms of carcinogenesis and progression. These findings highlight the importance of metabolic factors in OEC, warranting further prospective studies.
目的探讨子宫内膜异位症相关I型卵巢癌卵巢内膜样癌（OEC）和卵巢透明细胞癌（OCCC）患者脂质代谢和肥胖的差异。方法：本回顾性研究纳入2010年至2022年间接受OEC手术（n = 50）或OCCC手术（n = 83）的133例患者。比较两组患者术前血脂指标（总胆固醇[TC]、低密度脂蛋白胆固醇[LDL-C]、高密度脂蛋白胆固醇[HDL-C]）及体重指数（BMI）。研究了与绝经状态和疾病分期的关系，并通过多变量logistic回归评估独立预测因子。结果OEC患者的TC （215 vs. 199.5 mg/dL, p = 0.040）、LDL-C （139 vs. 120.6 mg/dL, p = 0.026）和BMI （22.1 vs. 20.4 kg/m2, p = 0.020）均显著高于OCCC患者。HDL-C无显著性差异。绝经前妇女中，OEC患者的TC和LDL-C显著升高，而绝经后妇女组间无差异。在OEC患者中，晚期疾病患者的TC和LDL-C较高，而OCCC患者没有观察到与分期相关的差异。多因素分析发现BMI和LDL-C是与OEC相关的独立因素。结论脂质代谢异常和肥胖与OEC的相关性强于与OCCC的相关性，提示肿瘤发生和发展具有亚型特异性的代谢机制。这些发现强调了代谢因素在OEC中的重要性，值得进一步的前瞻性研究。
{"title":"Associations of Lipid Metabolism Abnormalities and Obesity With Endometriosis-Associated Ovarian Cancer","authors":"Fumio Asano, Mai Momomura, Hiromi Shibuya, Hironori Matsumoto, Tohru Morisada, Yoichi Kobayashi","doi":"10.1111/jog.70185","DOIUrl":"https://doi.org/10.1111/jog.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate the differences in lipid metabolism and obesity between patients with ovarian endometrioid carcinoma (OEC) and ovarian clear cell carcinoma (OCCC), both of which are classified as endometriosis-associated Type I ovarian cancers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 133 patients who underwent surgery for OEC (<i>n</i> = 50) or OCCC (<i>n</i> = 83) between 2010 and 2022. Preoperative serum lipid markers (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) and body mass index (BMI) were compared between the two groups. Associations with menopausal status and disease stage were examined, and independent predictors were evaluated by multivariate logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with OEC had significantly higher TC (215 vs. 199.5 mg/dL, <i>p</i> = 0.040), LDL-C (139 vs. 120.6 mg/dL, <i>p</i> = 0.026), and BMI (22.1 vs. 20.4 kg/m<sup>2</sup>, <i>p</i> = 0.020) compared with those with OCCC. No significant differences were observed for HDL-C. In premenopausal women, TC and LDL-C were significantly higher in patients with OEC, whereas no intergroup differences were found in postmenopausal women. Among patients with OEC, those with advanced-stage disease had higher TC and LDL-C, whereas no stage-related differences were observed in patients with OCCC. Multivariate analysis identified BMI and LDL-C as independent factors associated with OEC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lipid metabolism abnormalities and obesity were more strongly associated with OEC than with OCCC, suggesting subtype-specific metabolic mechanisms of carcinogenesis and progression. These findings highlight the importance of metabolic factors in OEC, warranting further prospective studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146136881","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}
Shigetaka Matsunaga, Eishin Nakamura, Yasushi Takai, Atsuo Itakura, Perinatal committee of the Japanese Society of Obstetrics and Gynecology
Obstetric disseminated intravascular coagulation (DIC) onset is indicated by a bleeding tendency; however, its quantitative evaluation is difficult. Here, we quantitatively evaluated coagulability using the blood viscoelasticity test, TEG6s, for determining the threshold at which bleeding tendency occurs based on coagulation function test results and bleeding volume. This retrospective, observational study included 33 cases with potential obstetric DIC. For the coagulation blood test, we evaluated fibrinogen, fibrin/fibrinogen degradation products (FDP), platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), hemoglobin, and bleeding amount. We evaluated using TEG6s blood viscoelasticity. Among the measurement items related to viscoelasticity in TEG6s, we used MA (maximum amplitude)-CRT. The causes of bleeding among the 33 cases included: atonic hemorrhage, 13; placenta previa, 11; amniotic fluid embolism, three; hypertension disorder of pregnancy, two; and others, four. Bivariate analysis showed a significant positive correlation between MA-CRT and fibrinogen and FDP. Inverse estimated values calculated using a nonlinear regression model for each test item showed the following results: MA-CRT < 46.6 mm and MA-CRT < 50 mm: fibrinogen, 135.4 mg/dL and 157.7 mg/dL; and FDP, 79.5 μg/mL and 60.8 μg/mL. In summary, fibrinogen and FDP indicated bleeding tendency, with recommended threshold values being 150 mg/dL and 60 μg/mL, respectively.
{"title":"Quantitative Evaluation of Coagulability in Obstetric DIC Using TEG6s for New Japanese Diagnostic Criteria of Obstetrical Disseminated Intravascular Coagulation","authors":"Shigetaka Matsunaga, Eishin Nakamura, Yasushi Takai, Atsuo Itakura, Perinatal committee of the Japanese Society of Obstetrics and Gynecology","doi":"10.1111/jog.70188","DOIUrl":"10.1111/jog.70188","url":null,"abstract":"<p>Obstetric disseminated intravascular coagulation (DIC) onset is indicated by a bleeding tendency; however, its quantitative evaluation is difficult. Here, we quantitatively evaluated coagulability using the blood viscoelasticity test, TEG6s, for determining the threshold at which bleeding tendency occurs based on coagulation function test results and bleeding volume. This retrospective, observational study included 33 cases with potential obstetric DIC. For the coagulation blood test, we evaluated fibrinogen, fibrin/fibrinogen degradation products (FDP), platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), hemoglobin, and bleeding amount. We evaluated using TEG6s blood viscoelasticity. Among the measurement items related to viscoelasticity in TEG6s, we used MA (maximum amplitude)-CRT. The causes of bleeding among the 33 cases included: atonic hemorrhage, 13; placenta previa, 11; amniotic fluid embolism, three; hypertension disorder of pregnancy, two; and others, four. Bivariate analysis showed a significant positive correlation between MA-CRT and fibrinogen and FDP. Inverse estimated values calculated using a nonlinear regression model for each test item showed the following results: MA-CRT < 46.6 mm and MA-CRT < 50 mm: fibrinogen, 135.4 mg/dL and 157.7 mg/dL; and FDP, 79.5 μg/mL and 60.8 μg/mL. In summary, fibrinogen and FDP indicated bleeding tendency, with recommended threshold values being 150 mg/dL and 60 μg/mL, respectively.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12851829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erhan Şimşek, Gülşen Doğan Durdağ, Didem Alkaş Yağınç, Şirin Aydın, Seda Yüksel Şimşek, Hüsnü Çelik
Aim
Laparoscopic myomectomy with power morcellation is a common approach for the management of uterine myomas. However, besides myoma recurrence, rare complications such as peritoneal leiomyomatosis may arise postoperatively. The histopathological subtype of fibroids—particularly cellular leiomyoma—may impact the risk of recurrence and dissemination, though current evidence remains limited. The aim of this study is to evaluate the impact of power morcellation on the development of disseminated peritoneal leiomyomatosis and to assess the association between the histopathological subtype of myoma and patient outcomes during follow-up.
Methods
This retrospective cohort study analyzed 997 patients who underwent laparoscopic myomectomy with power morcellation at a single tertiary center between 2012 and 2024. Patients were followed through clinical evaluations and ultrasonography. Peritoneal leiomyomatosis was evaluated in relation to surgical technique (confined vs. unconfined morcellation) and histopathological subtype.
Results
Of the 553 patients with available follow-up, myoma recurrence was observed in 130 (23.5%), reoperation in 53 (9.6%), and peritoneal leiomyomatosis in 8 patients (1.4%). All peritoneal leiomyomatosis cases occurred in the unconfined morcellation group. Cellular leiomyoma was identified in 5 of the 8 peritoneal leiomyomatosis cases (62.5%). One peritoneal leiomyomatosis case was diagnosed as leiomyosarcoma after surgery for disseminated leiomyomatosis. Overall myoma recurrence was significantly higher in patients with multiple myomas and in those with cellular leiomyoma.
Conclusion
Peritoneal leiomyomatosis is a rare complication of laparoscopic myomectomy and increased incidence after unconfined morcellation is a serious concern. Confined (in-bag) morcellation appears to reduce the risk of peritoneal leiomyomatosis and should be the standard of care. Diagnosis of myomas as cellular leiomyoma subtype on histopathology merits high clinical suspicion for possibility of subsequent peritoneal leiomyomatosis in patients with unconfined morcellation. Therefore, close and long-term follow-up of these patients is essential.
{"title":"Impact of Power Morcellation and Histopathological Subtypes on the Development of Peritoneal Leiomyomatosis Following Laparoscopic Myomectomy","authors":"Erhan Şimşek, Gülşen Doğan Durdağ, Didem Alkaş Yağınç, Şirin Aydın, Seda Yüksel Şimşek, Hüsnü Çelik","doi":"10.1111/jog.70189","DOIUrl":"https://doi.org/10.1111/jog.70189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Laparoscopic myomectomy with power morcellation is a common approach for the management of uterine myomas. However, besides myoma recurrence, rare complications such as peritoneal leiomyomatosis may arise postoperatively. The histopathological subtype of fibroids—particularly cellular leiomyoma—may impact the risk of recurrence and dissemination, though current evidence remains limited. The aim of this study is to evaluate the impact of power morcellation on the development of disseminated peritoneal leiomyomatosis and to assess the association between the histopathological subtype of myoma and patient outcomes during follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study analyzed 997 patients who underwent laparoscopic myomectomy with power morcellation at a single tertiary center between 2012 and 2024. Patients were followed through clinical evaluations and ultrasonography. Peritoneal leiomyomatosis was evaluated in relation to surgical technique (confined vs. unconfined morcellation) and histopathological subtype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 553 patients with available follow-up, myoma recurrence was observed in 130 (23.5%), reoperation in 53 (9.6%), and peritoneal leiomyomatosis in 8 patients (1.4%). All peritoneal leiomyomatosis cases occurred in the unconfined morcellation group. Cellular leiomyoma was identified in 5 of the 8 peritoneal leiomyomatosis cases (62.5%). One peritoneal leiomyomatosis case was diagnosed as leiomyosarcoma after surgery for disseminated leiomyomatosis. Overall myoma recurrence was significantly higher in patients with multiple myomas and in those with cellular leiomyoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Peritoneal leiomyomatosis is a rare complication of laparoscopic myomectomy and increased incidence after unconfined morcellation is a serious concern. Confined (in-bag) morcellation appears to reduce the risk of peritoneal leiomyomatosis and should be the standard of care. Diagnosis of myomas as cellular leiomyoma subtype on histopathology merits high clinical suspicion for possibility of subsequent peritoneal leiomyomatosis in patients with unconfined morcellation. Therefore, close and long-term follow-up of these patients is essential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140021","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}
There is an increasing demand for fertility-sparing treatment (FST) among young women with gynecological cancer. This study aimed to clarify the current status of FST implementation across Japan by focusing on institutional practice patterns and clinical protocols for cervical, endometrial, and ovarian cancers.
Methods
A nationwide cross-sectional survey was conducted between August and September 2024. An online questionnaire was distributed to 481 gynecologic tumor registry institutions through the Japan Society of Obstetrics and Gynecology mailing list. Data on institutional characteristics, specific FST eligibility criteria, treatment methods, and post-treatment management were collected.
Results
Responses were received from 226 institutions (response rate: 47.0%), and all respondent institutions (100%) performed FST for at least one gynecological cancer. Although FST is widely available, significant heterogeneity in clinical protocols was observed across all three cancers. Key variations among respondent institutions included a low implementation rate of radical trachelectomy for cervical cancer (20.8%), a high rate of post-FST hysterectomy for endometrial cancer (63.6%) compared to cervical cancer and ovarian cancer, and exclusion criteria for patients with hereditary cancer syndromes.
Conclusion
FST is an established practice in Japan; however, there is a lack of consensus regarding its clinical application. These findings provide a critical benchmark for future efforts to standardize care and develop collaborative networks to optimize this essential treatment modality for young patients with gynecological cancer.
{"title":"Current Status of Fertility-Sparing Treatment for Gynecological Cancers in Japan: A Nationwide Survey","authors":"Ayumi Shikama, Hiroshi Nishio, Kaoru Okugawa, Hiroaki Kajiyama, Nao Suzuki, Hiroyuki Fujiwara, Hidemichi Watari, Hiroaki Komatsu, Wataru Yamagami, Toyomi Satoh, Kei Kawana, Kiyoko Kato","doi":"10.1111/jog.70187","DOIUrl":"https://doi.org/10.1111/jog.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>There is an increasing demand for fertility-sparing treatment (FST) among young women with gynecological cancer. This study aimed to clarify the current status of FST implementation across Japan by focusing on institutional practice patterns and clinical protocols for cervical, endometrial, and ovarian cancers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A nationwide cross-sectional survey was conducted between August and September 2024. An online questionnaire was distributed to 481 gynecologic tumor registry institutions through the Japan Society of Obstetrics and Gynecology mailing list. Data on institutional characteristics, specific FST eligibility criteria, treatment methods, and post-treatment management were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Responses were received from 226 institutions (response rate: 47.0%), and all respondent institutions (100%) performed FST for at least one gynecological cancer. Although FST is widely available, significant heterogeneity in clinical protocols was observed across all three cancers. Key variations among respondent institutions included a low implementation rate of radical trachelectomy for cervical cancer (20.8%), a high rate of post-FST hysterectomy for endometrial cancer (63.6%) compared to cervical cancer and ovarian cancer, and exclusion criteria for patients with hereditary cancer syndromes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FST is an established practice in Japan; however, there is a lack of consensus regarding its clinical application. These findings provide a critical benchmark for future efforts to standardize care and develop collaborative networks to optimize this essential treatment modality for young patients with gynecological cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146136882","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}
To identify clinical risk factors for endometrial malignancy in postmenopausal women and develop a predictive model for early detection and personalized intervention.
Methods
This study analyzed 1146 postmenopausal women undergoing diagnostic hysteroscopy. Inclusion required: confirmed menopause (age ≥ 40) with recent endometrial thickness measurement, successful hysteroscopy, histopathological verification, and complete records. Exclusions involved incomplete data, type II carcinoma, hormonally active tumors, or prior hysteroscopy indications. Demographics, clinical features, comorbidities, imaging data, and biomarkers were analyzed. Histology was confirmed via standard pathology. Risk factors were identified through univariate and multivariate logistic regression. The resultant predictive nomogram for endometrial malignancy risk stratification underwent rigorous validation using: (1) receiver operating characteristic curve analysis (discriminative power); (2) calibration plotting (prediction accuracy); and (3) decision curve analysis (clinical net benefit).
Results
Among 1146 postmenopausal women undergoing diagnostic hysteroscopy, histopathological analysis identified 69 cases (6.0%) of endometrial carcinoma (EC) and 15 cases (1.3%) of atypical endometrial hyperplasia, with the remaining cases (92.7%) demonstrating benign pathology. Multivariate analysis identified seven independent risk factors for EC: elevated fibrinogen and D-dimer levels, hypertriglyceridemia, decreased high-density lipoprotein, postmenopausal bleeding, ultrasonography blood-flow signals, and increased endometrial thickness. The predictive nomogram incorporating these parameters demonstrated outstanding diagnostic performance, with area under the curve values of 0.955 in the training cohort and 0.960 in the validation cohort, indicating excellent discriminative ability for EC risk stratification.
Conclusion
We developed and validated a novel 7-indicator prediction model for assessing endometrial malignancy risk in postmenopausal women undergoing hysteroscopy biopsy.
{"title":"A Novel Nomogram for Predicting Endometrial Malignancy in Postmenopausal Women","authors":"Hongrong Zhu, Fangfang Ai, Peilin Liu, Lili Ma, Xiaoqian He, Liane Zhou, Shijun Wang","doi":"10.1111/jog.70182","DOIUrl":"10.1111/jog.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify clinical risk factors for endometrial malignancy in postmenopausal women and develop a predictive model for early detection and personalized intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study analyzed 1146 postmenopausal women undergoing diagnostic hysteroscopy. Inclusion required: confirmed menopause (age ≥ 40) with recent endometrial thickness measurement, successful hysteroscopy, histopathological verification, and complete records. Exclusions involved incomplete data, type II carcinoma, hormonally active tumors, or prior hysteroscopy indications. Demographics, clinical features, comorbidities, imaging data, and biomarkers were analyzed. Histology was confirmed via standard pathology. Risk factors were identified through univariate and multivariate logistic regression. The resultant predictive nomogram for endometrial malignancy risk stratification underwent rigorous validation using: (1) receiver operating characteristic curve analysis (discriminative power); (2) calibration plotting (prediction accuracy); and (3) decision curve analysis (clinical net benefit).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1146 postmenopausal women undergoing diagnostic hysteroscopy, histopathological analysis identified 69 cases (6.0%) of endometrial carcinoma (EC) and 15 cases (1.3%) of atypical endometrial hyperplasia, with the remaining cases (92.7%) demonstrating benign pathology. Multivariate analysis identified seven independent risk factors for EC: elevated fibrinogen and D-dimer levels, hypertriglyceridemia, decreased high-density lipoprotein, postmenopausal bleeding, ultrasonography blood-flow signals, and increased endometrial thickness. The predictive nomogram incorporating these parameters demonstrated outstanding diagnostic performance, with area under the curve values of 0.955 in the training cohort and 0.960 in the validation cohort, indicating excellent discriminative ability for EC risk stratification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We developed and validated a novel 7-indicator prediction model for assessing endometrial malignancy risk in postmenopausal women undergoing hysteroscopy biopsy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145989550","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}
Akitoshi Yamamura, Asuka Okunomiya, Akihiro Yanai, Koji Yamanoi, Mana Taki, Tsutomu Ohara, Taito Miyamoto, Masumi Sunada, Yukiko Okada, Masaki Mandai
Aim
To clarify live birth outcomes among women receiving extended or repeated high-dose medroxyprogesterone acetate (MPA) therapy for fertility-sparing management of atypical endometrial hyperplasia or endometrioid carcinoma grade 1.
Methods
We conducted a single-center retrospective case series of 53 patients undergoing MPA therapy between 2005 and 2023. Patients were stratified into three groups: (i) complete response (CR) within 6 months (standard group), (ii) CR after extended treatment beyond 6 months (extended group), and (iii) CR after MPA retreatment for first intrauterine recurrence (retreatment group). Primary outcome was the live birth rate (LBR). Secondary outcomes included the effect of initial reproductive intentions, interval from CR to conception, recurrence rates, and recurrence-free interval (RFI).
Results
LBRs were 33% (10/30) in the standard group, 8% (1/12) in the extended group, and 17% (2/12) in the retreatment group. Among eight patients undergoing MPA retreatment for a second or subsequent recurrence, none achieved live birth. Patients with an initial desire for prompt conception had significantly higher LBRs than those without (38% vs. 5%, p < 0.01). Median time from CR to conception leading to live birth was 12 months. Patients achieving live birth had significantly longer RFIs than those without (p < 0.01).
Conclusions
Live birth is most likely when CR is achieved within 6 months of MPA therapy; nonetheless, extended or repeated MPA treatment may still result in live birth. These findings suggest the importance of appropriate patient selection and careful monitoring during extended or repeated therapy and attempting conception promptly in fertility-sparing management of endometrial neoplasia.
目的：阐明在不典型子宫内膜增生或1级子宫内膜样癌患者中接受延长或重复大剂量醋酸甲羟孕酮（MPA）治疗以保留生育能力的妇女的活产结局。方法：我们对2005年至2023年间接受MPA治疗的53例患者进行了单中心回顾性病例系列研究。将患者分为三组：(i) 6个月内完全缓解（CR）（标准组），（ii）延长治疗超过6个月后完全缓解（延长组），（iii）首次宫内复发再用MPA治疗后完全缓解（再治疗组）。主要终点为活产率（LBR）。次要结局包括初始生育意愿的影响，从CR到受孕的时间间隔，复发率和无复发时间间隔（RFI）。结果：标准组lbr为33%(10/30)，延长组为8%(1/12)，再治疗组为17%（2/12）。在8例因第二次或随后复发而接受MPA再治疗的患者中，没有一例获得活产。最初希望迅速受孕的患者的lbr显著高于没有愿望的患者（38% vs. 5%, p）。结论：在MPA治疗6个月内达到CR时，活产的可能性最大；尽管如此，延长或重复MPA治疗仍可能导致活产。这些发现表明，在延长或重复治疗期间，适当的患者选择和仔细监测以及在保留生育能力的子宫内膜瘤管理中及时尝试受孕的重要性。
{"title":"Live Birth Outcomes After Extended or Repeated High-Dose Medroxyprogesterone Acetate Therapy for Fertility-Sparing Management of Endometrial Neoplasia: A Single-Center Retrospective Case Series","authors":"Akitoshi Yamamura, Asuka Okunomiya, Akihiro Yanai, Koji Yamanoi, Mana Taki, Tsutomu Ohara, Taito Miyamoto, Masumi Sunada, Yukiko Okada, Masaki Mandai","doi":"10.1111/jog.70178","DOIUrl":"10.1111/jog.70178","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To clarify live birth outcomes among women receiving extended or repeated high-dose medroxyprogesterone acetate (MPA) therapy for fertility-sparing management of atypical endometrial hyperplasia or endometrioid carcinoma grade 1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-center retrospective case series of 53 patients undergoing MPA therapy between 2005 and 2023. Patients were stratified into three groups: (i) complete response (CR) within 6 months (standard group), (ii) CR after extended treatment beyond 6 months (extended group), and (iii) CR after MPA retreatment for first intrauterine recurrence (retreatment group). Primary outcome was the live birth rate (LBR). Secondary outcomes included the effect of initial reproductive intentions, interval from CR to conception, recurrence rates, and recurrence-free interval (RFI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LBRs were 33% (10/30) in the standard group, 8% (1/12) in the extended group, and 17% (2/12) in the retreatment group. Among eight patients undergoing MPA retreatment for a second or subsequent recurrence, none achieved live birth. Patients with an initial desire for prompt conception had significantly higher LBRs than those without (38% vs. 5%, <i>p</i> < 0.01). Median time from CR to conception leading to live birth was 12 months. Patients achieving live birth had significantly longer RFIs than those without (<i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Live birth is most likely when CR is achieved within 6 months of MPA therapy; nonetheless, extended or repeated MPA treatment may still result in live birth. These findings suggest the importance of appropriate patient selection and careful monitoring during extended or repeated therapy and attempting conception promptly in fertility-sparing management of endometrial neoplasia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12803870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To explore the association between D-dimer/fibrinogen ratio (DFR) and outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in normocoagulable women.
Methods
This retrospective cohort study included 869 women undergoing their first single blastocyst frozen-thawed embryo transfer (FET) cycles at Beijing Chao-Yang Hospital. Data were collected from the medical records of FET cycles performed at the reproductive medicine center between January 2016 and November 2022. Eligible participants were normocoagulable women aged 22–38 years with a body mass index (BMI) < 30 kg/m2, those with metabolic or uterine disorders or incomplete records were excluded. The primary outcomes were live birth and miscarriage. Participants were stratified by live birth status to assess the association between DFR and pregnancy outcomes.
Results
Participants were categorized into live birth group (n = 357) and non-live birth group (n = 512). Compared to the non-live birth group, the live birth group had lower D-dimer (0.19 vs. 0.23 mg/L, p = 0.010) and DFR (0.07 vs. 0.08, p = 0.003). Logistic regression revealed that elevated DFR increased pregnancy failure risk. Receiver operating characteristic (ROC) analysis indicated that DFR predicted live birth with a cut-off value of 0.085. Stratified by this cut-off value, the DFR > 0.085 group had a higher miscarriage rate (26.40% vs. 15.04%), a lower clinical rate (46.98% vs. 54.51%), and a lower live birth rate (34.38% vs. 46.31%).
Conclusions
A higher pre-pregnancy DFR is associated with adverse pregnancy outcomes in normocoagulable women and may serve as a predictor for IVF/ICSI.
目的：探讨d -二聚体/纤维蛋白原比值（DFR）与正常凝血女性体外受精/胞浆内单精子注射（IVF/ICSI）结果的关系。方法：本回顾性队列研究包括869名在北京朝阳医院接受首次单囊胚冷冻解冻胚胎移植（FET）周期的妇女。数据收集自2016年1月至2022年11月在生殖医学中心进行的FET周期的医疗记录。符合条件的参与者是年龄在22-38岁、身体质量指数（BMI）为2、可正常凝固的女性，排除有代谢或子宫疾病或记录不完整的女性。主要结局为活产和流产。根据活产状况对参与者进行分层，以评估DFR与妊娠结局之间的关系。结果：参与者分为活产组（n = 357）和非活产组（n = 512）。与非活产组相比，活产组d -二聚体（0.19 vs. 0.23 mg/L, p = 0.010）和DFR （0.07 vs. 0.08, p = 0.003）较低。Logistic回归分析显示，DFR升高会增加妊娠失败风险。受试者工作特征（ROC）分析显示，DFR预测活产的临界值为0.085。按该临界值分层，DFR bb0 0.085组流产率较高（26.40%比15.04%），临床率较低（46.98%比54.51%），活产率较低（34.38%比46.31%）。结论：较高的孕前DFR与正常凝血妇女的不良妊娠结局相关，可作为IVF/ICSI的预测指标。
{"title":"Association Between D-Dimer/Fibrinogen Ratio and Pregnancy Outcomes in Normocoagulable Women Undergoing Frozen-Thawed Embryo Transfer Cycles: A Retrospective Cohort Study","authors":"Lina Wang, Huanhuan Li, Wenhui Zhou","doi":"10.1111/jog.70147","DOIUrl":"10.1111/jog.70147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore the association between D-dimer/fibrinogen ratio (DFR) and outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in normocoagulable women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 869 women undergoing their first single blastocyst frozen-thawed embryo transfer (FET) cycles at Beijing Chao-Yang Hospital. Data were collected from the medical records of FET cycles performed at the reproductive medicine center between January 2016 and November 2022. Eligible participants were normocoagulable women aged 22–38 years with a body mass index (BMI) < 30 kg/m<sup>2</sup>, those with metabolic or uterine disorders or incomplete records were excluded. The primary outcomes were live birth and miscarriage. Participants were stratified by live birth status to assess the association between DFR and pregnancy outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants were categorized into live birth group (<i>n</i> = 357) and non-live birth group (<i>n</i> = 512). Compared to the non-live birth group, the live birth group had lower D-dimer (0.19 vs. 0.23 mg/L, <i>p</i> = 0.010) and DFR (0.07 vs. 0.08, <i>p</i> = 0.003). Logistic regression revealed that elevated DFR increased pregnancy failure risk. Receiver operating characteristic (ROC) analysis indicated that DFR predicted live birth with a cut-off value of 0.085. Stratified by this cut-off value, the DFR > 0.085 group had a higher miscarriage rate (26.40% vs. 15.04%), a lower clinical rate (46.98% vs. 54.51%), and a lower live birth rate (34.38% vs. 46.31%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A higher pre-pregnancy DFR is associated with adverse pregnancy outcomes in normocoagulable women and may serve as a predictor for IVF/ICSI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966147","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}
Ovarian cancer (OC) is a growing public health challenge in Asia, with rising incidence and regional disparities. Using the Global Burden of Disease (GBD) 2021 dataset, this study assessed temporal trends, spatial patterns, and determinants of OC burden in Asia from 1990 to 2021, with projections to 2036.
Methods
Data were extracted from GBD 2021 for all Asian regions. Three indicators were analyzed: age-standardized incidence rate (ASIR), mortality rate (ASMR), and disability-adjusted life years rate (ASDR). Trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression. Decomposition analysis examined contributions of population aging, growth, and epidemiological shifts. Age–period–cohort (APC) analysis was performed to disentangle the effects of age, period, and cohort on OC incidence. Future burden (2022–2036) was projected with an autoregressive integrated moving average (ARIMA) model.
Results
From 1990 to 2021, OC burden increased markedly. Southeast, South, and Central Asia had the greatest rises in ASIR, ASMR, and ASDR, while East Asia and high-income Asia Pacific showed stable or declining trends, likely due to healthcare advances and early detection. Higher sociodemographic index (SDI) correlated with greater incidence and mortality. Decomposition revealed aging as the main driver in East Asia and high-income Asia Pacific, while population growth dominated in South Asia. APC analysis highlighted age as the primary risk factor, with a rising period effect and a declining cohort effect. ARIMA projections (2022–2036) show steady ASIR growth and U-shaped trajectories (initial decline then rise) for ASMR and ASDR.
Conclusion
The increasing OC burden in Southeast, South, and Central Asia underscores the urgent need for region-specific strategies. Interventions focusing on early diagnosis, equitable healthcare, and addressing demographic and epidemiological drivers are essential to mitigate the projected rise by 2036.
{"title":"Regional Heterogeneity and Future Challenges in Ovarian Cancer Burden in Asia","authors":"Heng Zhang, Jian Chen, Dongzi Li","doi":"10.1111/jog.70186","DOIUrl":"10.1111/jog.70186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ovarian cancer (OC) is a growing public health challenge in Asia, with rising incidence and regional disparities. Using the Global Burden of Disease (GBD) 2021 dataset, this study assessed temporal trends, spatial patterns, and determinants of OC burden in Asia from 1990 to 2021, with projections to 2036.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were extracted from GBD 2021 for all Asian regions. Three indicators were analyzed: age-standardized incidence rate (ASIR), mortality rate (ASMR), and disability-adjusted life years rate (ASDR). Trends were evaluated using estimated annual percentage change (EAPC) and Joinpoint regression. Decomposition analysis examined contributions of population aging, growth, and epidemiological shifts. Age–period–cohort (APC) analysis was performed to disentangle the effects of age, period, and cohort on OC incidence. Future burden (2022–2036) was projected with an autoregressive integrated moving average (ARIMA) model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1990 to 2021, OC burden increased markedly. Southeast, South, and Central Asia had the greatest rises in ASIR, ASMR, and ASDR, while East Asia and high-income Asia Pacific showed stable or declining trends, likely due to healthcare advances and early detection. Higher sociodemographic index (SDI) correlated with greater incidence and mortality. Decomposition revealed aging as the main driver in East Asia and high-income Asia Pacific, while population growth dominated in South Asia. APC analysis highlighted age as the primary risk factor, with a rising period effect and a declining cohort effect. ARIMA projections (2022–2036) show steady ASIR growth and U-shaped trajectories (initial decline then rise) for ASMR and ASDR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The increasing OC burden in Southeast, South, and Central Asia underscores the urgent need for region-specific strategies. Interventions focusing on early diagnosis, equitable healthcare, and addressing demographic and epidemiological drivers are essential to mitigate the projected rise by 2036.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"52 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966142","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}
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