Brain metastases from endometrial carcinoma are extremely rare and associated with poor prognosis. We present a 43-year-old woman with mismatch repair deficient endometrial cancer who developed multiple brain metastases refractory to cytotoxic chemotherapy and without extracranial involvement. After stereotactic radiotherapy, combination therapy with lenvatinib and pembrolizumab resulted in sustained partial remission for 16 months, with no evidence of brain hemorrhage. This case demonstrates that lenvatinib plus pembrolizumab may offer an effective and safe therapeutic option for brain metastases from endometrial cancer, even in patients resistant to conventional therapy. Remarkably, this outcome challenges the traditionally poor prognosis of such cases and underscores the potential for novel targeted and immunotherapeutic strategies to redefine the standard of care for this rare and devastating complication.
{"title":"Long Term Disease Control of Brain Metastases From Chemotherapy-Resistant Endometrial Cancer With Lenvatinib and Pembrolizumab: A Case Report","authors":"Ayaka Fujioka, Akimasa Takahashi, Tsukuru Amano, Yuji Tanaka, Yutaka Yoneoka, Shunichiro Tsuji","doi":"10.1111/jog.70102","DOIUrl":"10.1111/jog.70102","url":null,"abstract":"<p>Brain metastases from endometrial carcinoma are extremely rare and associated with poor prognosis. We present a 43-year-old woman with mismatch repair deficient endometrial cancer who developed multiple brain metastases refractory to cytotoxic chemotherapy and without extracranial involvement. After stereotactic radiotherapy, combination therapy with lenvatinib and pembrolizumab resulted in sustained partial remission for 16 months, with no evidence of brain hemorrhage. This case demonstrates that lenvatinib plus pembrolizumab may offer an effective and safe therapeutic option for brain metastases from endometrial cancer, even in patients resistant to conventional therapy. Remarkably, this outcome challenges the traditionally poor prognosis of such cases and underscores the potential for novel targeted and immunotherapeutic strategies to redefine the standard of care for this rare and devastating complication.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292424","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 clarify the causes of maternal death due to complications related to labor analgesia.
Methods
A nationwide retrospective study was conducted to investigate intrapartum maternal deaths in Japan between 2010 and 2022. The obstetric and anesthetic characteristics of women with (cases) and without (controls) labor analgesia were compared.
Results
Of the 558 maternal deaths in Japan during the study period, 161 occurred intrapartum. Among these, 24 (15%) patients received labor analgesia (cases), 117 did not receive labor analgesia (controls), and 20 underwent elective cesarean section. Regarding the causes of maternal death, the incidence of amniotic fluid embolism was 71% among the cases and 56% among the controls. The incidence of uterine rupture/laceration was 13% among the cases and 9% among the controls (nonsignificant difference). Moreover, among the patients who received labor analgesia, there were two cases of maternal deaths directly related to neuraxial labor analgesia (due to high spinal anesthesia and local anesthetic toxicity). Induction of labor was attempted in 96% of the cases with labor analgesia compared to 55% of the controls (p < 0.01).
Conclusion
Among the cases of maternal deaths, amniotic fluid embolism, uterine rupture/laceration, and complications of the labor analgesia itself were likely causes in patients who had received labor analgesia. These results may be related to the higher frequency of induction of labor in labor analgesia.
{"title":"Maternal Death due to Complications Related to Labor Analgesia: Report From Maternal Death Exploratory Committee in Japan","authors":"Junichi Hasegawa, Hiroaki Tanaka, Kayo Tanaka, Tatsuya Arakaki, Masamitsu Nakamura, Rie Kato, Toshiyuki Okutomi, Hiroyuki Sumikura, Masahiko Nakata, Takeshi Murakoshi, Akihiko Sekizawa, Akihito Nakai, Isamu Ishiwata, Tomoaki Ikeda","doi":"10.1111/jog.70103","DOIUrl":"10.1111/jog.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To clarify the causes of maternal death due to complications related to labor analgesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A nationwide retrospective study was conducted to investigate intrapartum maternal deaths in Japan between 2010 and 2022. The obstetric and anesthetic characteristics of women with (cases) and without (controls) labor analgesia were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 558 maternal deaths in Japan during the study period, 161 occurred intrapartum. Among these, 24 (15%) patients received labor analgesia (cases), 117 did not receive labor analgesia (controls), and 20 underwent elective cesarean section. Regarding the causes of maternal death, the incidence of amniotic fluid embolism was 71% among the cases and 56% among the controls. The incidence of uterine rupture/laceration was 13% among the cases and 9% among the controls (nonsignificant difference). Moreover, among the patients who received labor analgesia, there were two cases of maternal deaths directly related to neuraxial labor analgesia (due to high spinal anesthesia and local anesthetic toxicity). Induction of labor was attempted in 96% of the cases with labor analgesia compared to 55% of the controls (<i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among the cases of maternal deaths, amniotic fluid embolism, uterine rupture/laceration, and complications of the labor analgesia itself were likely causes in patients who had received labor analgesia. These results may be related to the higher frequency of induction of labor in labor analgesia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292517","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}
Ying Cheng, Yi Tai, Liuyuan Ge, Xingshuo Qiu, Jiayin Wang, Yujuan Chang
Aim
This study investigates the longitudinal correlations between immune constituents of human breast milk and potential allergy protection in the neonatal immune system, focusing on immunoglobulins, cytokines, and microbial composition. It has been hypothesized that specific immune components in breast milk are associated with neonatal immune maturation and a reduced incidence of early allergic manifestations.
Methods
A prospective descriptive observational cohort study was conducted with 120 mother-neonate dyads. Breast milk and blood samples were collected at multiple time points within 6 months postpartum. Immunoglobulins (IgA), cytokines (TGF-β), lactoferrin, and microbial composition were quantified. Neonatal immune markers, including CD4+ and CD8+ T lymphocytes, were measured. Maternal factors such as age, dietary intake, and allergy history were analyzed for their impact on breast milk composition and neonatal immune development.
Results
Immune factors in breast milk, including IgA, lactoferrin, and TGF-β, demonstrated a declining trend over time, while neonatal circulating CD4+ and CD8+ T lymphocytes increased, indicating immune system maturation. Maternal characteristics such as age, diet, and allergies were significantly associated with breast milk composition changes, influencing neonatal immune responses. Microbial diversity in breast milk also varied across time points, suggesting potential effects on immune tolerance development.
Conclusions
The study highlights the crucial role of breast milk in shaping neonatal immune tolerance and reducing allergy risk during infancy. Maternal health, nutrition, and allergic conditions significantly influence breast milk composition, thereby impacting neonatal immune development. These findings emphasize the importance of maternal well-being and breastfeeding in promoting infant immune health.
{"title":"Study on the Correlation Between Breast Milk Immune Factors and Neonatal Immune Development and the Prevention of Allergic Diseases","authors":"Ying Cheng, Yi Tai, Liuyuan Ge, Xingshuo Qiu, Jiayin Wang, Yujuan Chang","doi":"10.1111/jog.70104","DOIUrl":"10.1111/jog.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study investigates the longitudinal correlations between immune constituents of human breast milk and potential allergy protection in the neonatal immune system, focusing on immunoglobulins, cytokines, and microbial composition. It has been hypothesized that specific immune components in breast milk are associated with neonatal immune maturation and a reduced incidence of early allergic manifestations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective descriptive observational cohort study was conducted with 120 mother-neonate dyads. Breast milk and blood samples were collected at multiple time points within 6 months postpartum. Immunoglobulins (IgA), cytokines (TGF-β), lactoferrin, and microbial composition were quantified. Neonatal immune markers, including CD4+ and CD8+ T lymphocytes, were measured. Maternal factors such as age, dietary intake, and allergy history were analyzed for their impact on breast milk composition and neonatal immune development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Immune factors in breast milk, including IgA, lactoferrin, and TGF-β, demonstrated a declining trend over time, while neonatal circulating CD4+ and CD8+ T lymphocytes increased, indicating immune system maturation. Maternal characteristics such as age, diet, and allergies were significantly associated with breast milk composition changes, influencing neonatal immune responses. Microbial diversity in breast milk also varied across time points, suggesting potential effects on immune tolerance development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study highlights the crucial role of breast milk in shaping neonatal immune tolerance and reducing allergy risk during infancy. Maternal health, nutrition, and allergic conditions significantly influence breast milk composition, thereby impacting neonatal immune development. These findings emphasize the importance of maternal well-being and breastfeeding in promoting infant immune health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286415","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}
Jing Lu, Huihui Zhu, Xilian Guo, Yan Jia, Jian Liu, Can Cui, Yang Deng
Background
To investigate the predictive role of a risk assessment model constructed using Caprini score combined with D-dimer in gynecological postoperative patients for the occurrence of deep vein thrombosis.
Methods
Patients scheduled for gynecological surgery at our hospital between January 2018 and April 2024 were included. This study included 136 patients, with 35 cases in the DVT group and 101 cases in the non-DVT group. General information, intraoperative parameters, D-dimer levels, Caprini Score, lower extremity Doppler ultrasonography, and intervention methods were collected. Logistic regression analysis and a combined model were employed to analyze the factors influencing the occurrence of DVT.
Results
Compared to non-DVT patients, the DVT group had a significantly older age (p = 0.035), higher hypertension prevalence (p = 0.025), and more complex surgeries (p = 0.004). Pre-discharge D-dimer levels and pre-/postoperative Caprini scores were markedly elevated in DVT patients (p < 0.05). Critically, logistic regression identified pre-discharge D-dimer levels (p < 0.001), preoperative Caprini score (p = 0.003), and postoperative Caprini score (p < 0.001) as independent risk factors for DVT. The combined prediction model integrating these factors achieved an AUC of 0.812, demonstrating high discriminative power for postoperative DVT occurrence.
Conclusion
The predictive value of the DVT prediction model constructed using the Caprini score in combination with D-dimer for the occurrence of DVT is high. The combined predictive model can be further promoted in clinical practice to take appropriate preventive measures to reduce the likelihood of DVT occurrence and to intervene promptly in existing risk factors.
{"title":"Construction and evaluation of a risk prediction model for postoperative deep vein thrombosis in gynecological patients","authors":"Jing Lu, Huihui Zhu, Xilian Guo, Yan Jia, Jian Liu, Can Cui, Yang Deng","doi":"10.1111/jog.70036","DOIUrl":"10.1111/jog.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To investigate the predictive role of a risk assessment model constructed using Caprini score combined with D-dimer in gynecological postoperative patients for the occurrence of deep vein thrombosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients scheduled for gynecological surgery at our hospital between January 2018 and April 2024 were included. This study included 136 patients, with 35 cases in the DVT group and 101 cases in the non-DVT group. General information, intraoperative parameters, D-dimer levels, Caprini Score, lower extremity Doppler ultrasonography, and intervention methods were collected. Logistic regression analysis and a combined model were employed to analyze the factors influencing the occurrence of DVT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to non-DVT patients, the DVT group had a significantly older age (<i>p</i> = 0.035), higher hypertension prevalence (<i>p</i> = 0.025), and more complex surgeries (<i>p</i> = 0.004). Pre-discharge D-dimer levels and pre-/postoperative Caprini scores were markedly elevated in DVT patients (<i>p</i> < 0.05). Critically, logistic regression identified pre-discharge D-dimer levels (<i>p</i> < 0.001), preoperative Caprini score (<i>p</i> = 0.003), and postoperative Caprini score (<i>p</i> < 0.001) as independent risk factors for DVT. The combined prediction model integrating these factors achieved an AUC of 0.812, demonstrating high discriminative power for postoperative DVT occurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The predictive value of the DVT prediction model constructed using the Caprini score in combination with D-dimer for the occurrence of DVT is high. The combined predictive model can be further promoted in clinical practice to take appropriate preventive measures to reduce the likelihood of DVT occurrence and to intervene promptly in existing risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280466","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}
Tamami Tsuzuki, Marina Minami, Ryuhei Nagai, Yusuke Oki, Hedeyuki Miyachi, Masamitsu Eitoku, Narufumi Suganuma, Nagamasa Maeda, The Japan Environment and Children's Study Group
Aim
Ulcerative colitis primarily affects individuals of reproductive age, raising concerns regarding its impact on pregnancy, lactation, and postpartum outcomes. Although numerous international studies exist, research on the Japanese population remains limited. This study aimed to analyze data from a large-scale nationwide cohort in Japan.
Methods
Data were derived from a prospective birth cohort study conducted between 2011 and 2014 that recruited pregnant women in early pregnancy across Japan. Of the 97 075 pregnancies, 214 were complicated by ulcerative colitis. These were compared with 96 861 pregnancies without a history of ulcerative colitis in terms of background characteristics, perinatal outcomes, and neonatal findings.
Results
Pregnant women with ulcerative colitis were older and had a lower smoking rate than those without the condition. Gestational weight gain was lower in the ulcerative colitis group than in the control group. The proportion of small-for-gestational-age infants was higher in pregnancies complicated by ulcerative colitis. This risk is further elevated in patients with anemia or inflammation during early pregnancy.
Conclusions
There is limited research on the impact of ulcerative colitis on pregnancy in Japan. This study found that pregnancies complicated by ulcerative colitis were associated with a higher risk of delivering small-for-gestational-age infants. Further studies with more detailed data on disease status are needed to assess disease activity and perinatal risk better.
{"title":"Pregnant Women With Ulcerative Colitis Have a Higher Risk of Delivering Small-For-Gestational-Age Infants: The Japan Environment and Children's Study (JECS)","authors":"Tamami Tsuzuki, Marina Minami, Ryuhei Nagai, Yusuke Oki, Hedeyuki Miyachi, Masamitsu Eitoku, Narufumi Suganuma, Nagamasa Maeda, The Japan Environment and Children's Study Group","doi":"10.1111/jog.70109","DOIUrl":"https://doi.org/10.1111/jog.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Ulcerative colitis primarily affects individuals of reproductive age, raising concerns regarding its impact on pregnancy, lactation, and postpartum outcomes. Although numerous international studies exist, research on the Japanese population remains limited. This study aimed to analyze data from a large-scale nationwide cohort in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were derived from a prospective birth cohort study conducted between 2011 and 2014 that recruited pregnant women in early pregnancy across Japan. Of the 97 075 pregnancies, 214 were complicated by ulcerative colitis. These were compared with 96 861 pregnancies without a history of ulcerative colitis in terms of background characteristics, perinatal outcomes, and neonatal findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pregnant women with ulcerative colitis were older and had a lower smoking rate than those without the condition. Gestational weight gain was lower in the ulcerative colitis group than in the control group. The proportion of small-for-gestational-age infants was higher in pregnancies complicated by ulcerative colitis. This risk is further elevated in patients with anemia or inflammation during early pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is limited research on the impact of ulcerative colitis on pregnancy in Japan. This study found that pregnancies complicated by ulcerative colitis were associated with a higher risk of delivering small-for-gestational-age infants. Further studies with more detailed data on disease status are needed to assess disease activity and perinatal risk better.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/jog.70109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273025","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 describe how decreased fetal movement (DFM) was managed in patients with fetomaternal hemorrhage (FMH) and to evaluate the diagnostic limitations of this condition in real-world settings.
Methods
This retrospective cohort study included individuals who developed FMH with cerebral palsy from the Japanese nationwide cerebral palsy registry between 2009 and 2022. We investigated whether patients experienced DFM or were prenatally diagnosed with FMH. Furthermore, we assessed how DFM was managed.
Results
This study included 57 patients who developed FMH with cerebral palsy, and none were prenatally diagnosed with FMH. DFM was present in 43/57 (75.4%) patients. A sinusoidal pattern was observed in 29/57 (50.9%) patients, and elevated middle cerebral artery peak systolic velocity (MCA-PSV) was detected in 6/10 (60.0%) patients who underwent this test. Of the 43 patients with DFM, 42 (97.7%) sought medical care for this symptom; however, only 12 (27.9%) underwent examinations on the same day as the onset of DFM, and 9 (20.9%) were admitted on that same day. Furthermore, 6/43 (14.0%) were instructed to stay home after telephone consultation or medical examination for this symptom. In five of the 43 patients (11.6%) who experienced DFM, the initial non-stress test was reactive. However, all these patients eventually developed either a non-reactive or non-reassuring fetal status.
Conclusions
DFM was prevalent among pregnancies complicated by FMH; however, it was often inadequately managed, resulting in diagnostic delays. Furthermore, fetal heart rate monitoring and MCA-PSV evaluations had diagnostic limitations. To facilitate early treatment, clinicians need to promptly assess preceding DFM while recognizing the limitations of existing tests.
{"title":"Challenges in the Management of Decreased Fetal Movement in Fetomaternal Hemorrhage With Cerebral Palsy: A Nationwide Registry Study","authors":"Yoshimitsu Wada, Hironori Takahashi, Manabu Ogoyama, Kenji Horie, Hirotada Suzuki, Rie Usui, Seung Chik Jwa, Akihide Ohkuchi, Hiroyuki Fujiwara","doi":"10.1111/jog.70106","DOIUrl":"https://doi.org/10.1111/jog.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe how decreased fetal movement (DFM) was managed in patients with fetomaternal hemorrhage (FMH) and to evaluate the diagnostic limitations of this condition in real-world settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included individuals who developed FMH with cerebral palsy from the Japanese nationwide cerebral palsy registry between 2009 and 2022. We investigated whether patients experienced DFM or were prenatally diagnosed with FMH. Furthermore, we assessed how DFM was managed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 57 patients who developed FMH with cerebral palsy, and none were prenatally diagnosed with FMH. DFM was present in 43/57 (75.4%) patients. A sinusoidal pattern was observed in 29/57 (50.9%) patients, and elevated middle cerebral artery peak systolic velocity (MCA-PSV) was detected in 6/10 (60.0%) patients who underwent this test. Of the 43 patients with DFM, 42 (97.7%) sought medical care for this symptom; however, only 12 (27.9%) underwent examinations on the same day as the onset of DFM, and 9 (20.9%) were admitted on that same day. Furthermore, 6/43 (14.0%) were instructed to stay home after telephone consultation or medical examination for this symptom. In five of the 43 patients (11.6%) who experienced DFM, the initial non-stress test was reactive. However, all these patients eventually developed either a non-reactive or non-reassuring fetal status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DFM was prevalent among pregnancies complicated by FMH; however, it was often inadequately managed, resulting in diagnostic delays. Furthermore, fetal heart rate monitoring and MCA-PSV evaluations had diagnostic limitations. To facilitate early treatment, clinicians need to promptly assess preceding DFM while recognizing the limitations of existing tests.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272661","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}
Yali Yang, Qiaofang Yang, Shanyan Lai, Mianbo Lin, Lichao Yuan, Guilan Nie, Xufei Fan
Purpose
To study the function of pregnancy-specific glycoprotein 1 (PSG1) in regulating proliferation, migration, and vascular tone of human umbilical vein endothelial cells (HUVECs), and further explore its role in placental development and potential molecular mechanisms through co-culturing HUVECs with HTR8/svneo cells.
Methods
HUVECs were treated with 2, 4, and 8 μg/mL PSG1. The Cell Counting Kit-8 assay was used to test cell proliferation, apoptosis by Annexin V/PI staining, and intracellular calcium and nitric oxide (NO) levels by fluorescence microscopy. Western blotting quantified the expression of vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), endothelial nitric oxide synthase (eNOS), calcium release-activated calcium channel protein 3 (Orai3), and PSG1. To study PSG1's effect on placental development, HUVECs were co-cultured with HTR8/svneo cells. siRNA-mediated knockdown of PSG1 was performed in both cell types to evaluate its impact on endothelial function, vascular tone, and trophoblast-endothelial cell interactions.
Results
PSG1 treatment enhanced HUVEC proliferation, with high concentrations reducing apoptosis. PSG1 upregulated the expression of VEGF, TGF-β, eNOS, and Orai3, and significantly increased both intracellular calcium and NO levels. Knockdown of PSG1 reduced these effects in HUVECs, and co-culture with PSG1-deficient trophoblast cells further diminished HUVEC proliferation, enhanced apoptosis, and decreased NO release. Our study highlighted the crucial role of PSG1 in endothelial cell function and vascular tone regulation. Furthermore, PSG1 modulation influenced eNOS activity, enhancing NO release, which contributed to vascular dilation.
Conclusions
PSG1 promotes HUVEC proliferation, inhibits apoptosis, and regulates vascular tone through the TGF-β/Orai3 signaling pathway, primarily by modulating NO production.
{"title":"PSG1 in Regulating Proliferation and Migration of Human Umbilical Vein Endothelial Cells Through the TGF-β/Orai3 Signaling Pathway","authors":"Yali Yang, Qiaofang Yang, Shanyan Lai, Mianbo Lin, Lichao Yuan, Guilan Nie, Xufei Fan","doi":"10.1111/jog.70092","DOIUrl":"10.1111/jog.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To study the function of pregnancy-specific glycoprotein 1 (PSG1) in regulating proliferation, migration, and vascular tone of human umbilical vein endothelial cells (HUVECs), and further explore its role in placental development and potential molecular mechanisms through co-culturing HUVECs with HTR8/svneo cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>HUVECs were treated with 2, 4, and 8 μg/mL PSG1. The Cell Counting Kit-8 assay was used to test cell proliferation, apoptosis by Annexin V/PI staining, and intracellular calcium and nitric oxide (NO) levels by fluorescence microscopy. Western blotting quantified the expression of vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), endothelial nitric oxide synthase (eNOS), calcium release-activated calcium channel protein 3 (Orai3), and PSG1. To study PSG1's effect on placental development, HUVECs were co-cultured with HTR8/svneo cells. siRNA-mediated knockdown of PSG1 was performed in both cell types to evaluate its impact on endothelial function, vascular tone, and trophoblast-endothelial cell interactions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PSG1 treatment enhanced HUVEC proliferation, with high concentrations reducing apoptosis. PSG1 upregulated the expression of VEGF, TGF-β, eNOS, and Orai3, and significantly increased both intracellular calcium and NO levels. Knockdown of PSG1 reduced these effects in HUVECs, and co-culture with PSG1-deficient trophoblast cells further diminished HUVEC proliferation, enhanced apoptosis, and decreased NO release. Our study highlighted the crucial role of PSG1 in endothelial cell function and vascular tone regulation. Furthermore, PSG1 modulation influenced eNOS activity, enhancing NO release, which contributed to vascular dilation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PSG1 promotes HUVEC proliferation, inhibits apoptosis, and regulates vascular tone through the TGF-β/Orai3 signaling pathway, primarily by modulating NO production.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258304","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}
Patients who experience grade 3 and 4 infusion reactions during pembrolizumab treatment should discontinue treatment, per the prescribing guidelines. We report a case of successful rechallenge with pembrolizumab after a grade 3 infusion reaction with a slow infusion rate and premedication. A Japanese woman in her 60s with recurrent endometrial cancer was treated using a combination of pembrolizumab and lenvatinib. During the second cycle of pembrolizumab treatment, delayed and recurrent grade 3 infusion reactions associated with systematic flushes and elevated body temperature occurred. Pembrolizumab rechallenge was performed, accompanied by the administration of premedication (histamine receptor inhibitors and acetaminophen) and reduction of the infusion rate. The flow rate was reduced to 25% of the normal rate, followed by a 50% reduction of the normal infusion rate; no recurrence of the infusion reaction was noted. Proper management of severe-grade infusion reactions may allow the continuation of pembrolizumab treatment, thereby improving patient prognosis.
{"title":"Successful Rechallenge With Pembrolizumab After a Grade 3 Infusion Reaction With a Far Slower Infusion Rate and Premedication: A Case Report","authors":"Takashi Uehara, Kanae Tahatsu, Satomi Aoyama, Ryutaro Yamada, Shinichiro Minobe","doi":"10.1111/jog.70101","DOIUrl":"10.1111/jog.70101","url":null,"abstract":"<div>\u0000 \u0000 <p>Patients who experience grade 3 and 4 infusion reactions during pembrolizumab treatment should discontinue treatment, per the prescribing guidelines. We report a case of successful rechallenge with pembrolizumab after a grade 3 infusion reaction with a slow infusion rate and premedication. A Japanese woman in her 60s with recurrent endometrial cancer was treated using a combination of pembrolizumab and lenvatinib. During the second cycle of pembrolizumab treatment, delayed and recurrent grade 3 infusion reactions associated with systematic flushes and elevated body temperature occurred. Pembrolizumab rechallenge was performed, accompanied by the administration of premedication (histamine receptor inhibitors and acetaminophen) and reduction of the infusion rate. The flow rate was reduced to 25% of the normal rate, followed by a 50% reduction of the normal infusion rate; no recurrence of the infusion reaction was noted. Proper management of severe-grade infusion reactions may allow the continuation of pembrolizumab treatment, thereby improving patient prognosis.</p>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251504","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}
Gynecologic cancers, comprising 14.4% of newly diagnosed cancer cases in women globally, are substantial causes of both mortality and morbidity, with a profound impact on the quality of life (QoL) of survivors. Therefore, it is crucial to strengthen education for both healthcare providers and patients. However, there remains a limited amount of comprehensive, systematic analysis on global research trends and key developments in this area, so this study aims to investigate global research trends and key focus areas in gynecologic oncology education through bibliometric analysis and network visualization, providing data-driven support and valuable academic insights for future research.
Method
Articles on gynecologic oncology education published between 2014 and 2024 were retrieved from the Web of Science Core Collection database. We used bibliometric software (VOSviewer and CiteSpace) for quantitative analysis of co-citation, co-authorship, and co-occurrence patterns, focusing on geographical distribution, key authors, references, and keywords.
Results
Research in this field has grown modestly since 2014, with annual publications exceeding 10 only after 2018. The author's analysis indicates that Ignacio Zapardiel, Lisa Singer, Manchanda, Ranjit and others are the core authors in this field. Western nations such as the United States and Germany lead in publication volume and citation impact, while Asian countries rarely appear in leading rankings. Keyword analysis indicates a recent focus on “education” within training frameworks.
Conclusion
Gynecologic oncology education remains nascent yet promising. Fostering international interdisciplinary collaboration—especially with Asian nations—is critical. Future priorities include high-fidelity bioprinting, intraoperative navigation systems, multicenter technology standardization, specialized sexual health rehabilitation, and culturally adapted interventions.
背景：妇科癌症占全球女性新诊断癌症病例的14.4%，是死亡率和发病率的重要原因，对幸存者的生活质量（QoL）产生深远影响。因此，加强对医疗保健提供者和患者的教育至关重要。然而，对该领域的全球研究趋势和关键进展的全面、系统的分析仍然有限，因此本研究旨在通过文献计量分析和网络可视化来调查妇科肿瘤学教育的全球研究趋势和重点领域，为未来的研究提供数据驱动的支持和有价值的学术见解。方法：从Web of Science Core Collection数据库中检索2014 - 2024年发表的妇科肿瘤学教育相关文章。我们使用文献计量软件（VOSviewer和CiteSpace）对共被引、合著和共现模式进行定量分析，重点关注地理分布、关键作者、参考文献和关键词。结果：自2014年以来，该领域的研究略有增长，2018年之后年度出版物才超过10篇。笔者的分析表明，Ignacio Zapardiel、Lisa Singer、Manchanda、Ranjit等人是这一领域的核心作者。美国和德国等西方国家在论文发表量和引用影响力方面处于领先地位，而亚洲国家很少出现在排名前列。关键词分析表明，最近在培训框架内关注“教育”。结论：妇科肿瘤教育仍处于初级阶段，但前景广阔。促进国际跨学科合作——尤其是与亚洲国家的合作——至关重要。未来的重点包括高保真生物打印、术中导航系统、多中心技术标准化、专门的性健康康复和适应文化的干预措施。
{"title":"Global research trends and focus areas in gynecologic oncology education: A bibliometric and network visualization study","authors":"Xianye Zhu, Yingchao Zhao","doi":"10.1111/jog.70083","DOIUrl":"10.1111/jog.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gynecologic cancers, comprising 14.4% of newly diagnosed cancer cases in women globally, are substantial causes of both mortality and morbidity, with a profound impact on the quality of life (QoL) of survivors. Therefore, it is crucial to strengthen education for both healthcare providers and patients. However, there remains a limited amount of comprehensive, systematic analysis on global research trends and key developments in this area, so this study aims to investigate global research trends and key focus areas in gynecologic oncology education through bibliometric analysis and network visualization, providing data-driven support and valuable academic insights for future research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Articles on gynecologic oncology education published between 2014 and 2024 were retrieved from the Web of Science Core Collection database. We used bibliometric software (VOSviewer and CiteSpace) for quantitative analysis of co-citation, co-authorship, and co-occurrence patterns, focusing on geographical distribution, key authors, references, and keywords.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Research in this field has grown modestly since 2014, with annual publications exceeding 10 only after 2018. The author's analysis indicates that Ignacio Zapardiel, Lisa Singer, Manchanda, Ranjit and others are the core authors in this field. Western nations such as the United States and Germany lead in publication volume and citation impact, while Asian countries rarely appear in leading rankings. Keyword analysis indicates a recent focus on “education” within training frameworks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gynecologic oncology education remains nascent yet promising. Fostering international interdisciplinary collaboration—especially with Asian nations—is critical. Future priorities include high-fidelity bioprinting, intraoperative navigation systems, multicenter technology standardization, specialized sexual health rehabilitation, and culturally adapted interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238909","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}
Trachelectomy is a fertility-preserving surgical approach for early-stage cervical cancer. To enhance oncological safety, intraoperative sentinel lymph node (SN) evaluation has been incorporated. This study aimed to evaluate the long-term oncological and obstetric outcomes of trachelectomy with SN biopsy.
Methods
We enrolled 53 patients who underwent trachelectomy with intraoperative SN assessment at Kagoshima University Hospital between 2014 and 2022. The preoperative and intraoperative eligibility criteria were strictly applied. Surgical and obstetric outcomes were evaluated, and recurrence-free survival (RFS) and overall survival (OS) were calculated using the Kaplan–Meier analysis.
Results
Among the 78 candidates, 53 met all criteria and successfully underwent trachelectomy. The 5-year RFS and OS rates were both 98%. Bilateral SNs were detected in 98% of patients, and intraoperative SN biopsy-guided surgical decisions were made. Postoperative complications occurred in 6% of the patients. Of the 19 patients who attempted conception, 10 (53%) became pregnant, leading to 8 live births (five preterm, three term). In vitro fertilization and embryo transfer were used in 60% of the pregnancies. Pregnancy was associated with a high risk of preterm delivery.
Conclusions
Trachelectomy with intraoperative SN biopsy is a feasible and safe treatment option for appropriately selected patients with early-stage cervical cancer. It offers excellent oncological outcomes and acceptable fertility potential. However, the risk of obstetric complications, particularly preterm births, remains high. Structured postoperative and perinatal management is crucial. Further prospective multicenter studies are warranted to validate and refine this approach.
{"title":"Fertility-Sparing Trachelectomy With Sentinel Node Mapping in Early-Stage Cervical Cancer: Oncological Safety and Obstetric Outcomes From a Single-Institution Study","authors":"Shinichi Togami, Nozomi Furuzono, Yusuke Kobayashi, Mika Fukuda, Shintaro Yanazume, Hiroaki Kobayashi","doi":"10.1111/jog.70091","DOIUrl":"10.1111/jog.70091","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Trachelectomy is a fertility-preserving surgical approach for early-stage cervical cancer. To enhance oncological safety, intraoperative sentinel lymph node (SN) evaluation has been incorporated. This study aimed to evaluate the long-term oncological and obstetric outcomes of trachelectomy with SN biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 53 patients who underwent trachelectomy with intraoperative SN assessment at Kagoshima University Hospital between 2014 and 2022. The preoperative and intraoperative eligibility criteria were strictly applied. Surgical and obstetric outcomes were evaluated, and recurrence-free survival (RFS) and overall survival (OS) were calculated using the Kaplan–Meier analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 78 candidates, 53 met all criteria and successfully underwent trachelectomy. The 5-year RFS and OS rates were both 98%. Bilateral SNs were detected in 98% of patients, and intraoperative SN biopsy-guided surgical decisions were made. Postoperative complications occurred in 6% of the patients. Of the 19 patients who attempted conception, 10 (53%) became pregnant, leading to 8 live births (five preterm, three term). In vitro fertilization and embryo transfer were used in 60% of the pregnancies. Pregnancy was associated with a high risk of preterm delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Trachelectomy with intraoperative SN biopsy is a feasible and safe treatment option for appropriately selected patients with early-stage cervical cancer. It offers excellent oncological outcomes and acceptable fertility potential. However, the risk of obstetric complications, particularly preterm births, remains high. Structured postoperative and perinatal management is crucial. Further prospective multicenter studies are warranted to validate and refine this approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238888","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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