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Determination of menstrual symptoms and genital hygiene behaviors of female healthcare professionals after the earthquake in Türkiye
IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-10 DOI: 10.1111/jog.16231
Reyyan Gürel, Rabia Atilla, Vildan Savaş

Aim

The aim of this study was to describe the post-earthquake menstrual symptoms, genital hygiene behaviors and the relationship between them among female healthcare workers who experienced the devastating earthquake in February 2023.

Methods

The sample of this descriptive and cross-sectional study consists of female healthcare professionals working in a public hospital in Iskenderun. Data were collected through face-to-face interviews between June 7 and September 7, 2023. Sociodemographic Form, Menstrual Symptom Scale, and Genital Hygiene Scale were used as data collection tools.

Results

The mean age of the participants was 34.07 ± 8.08. Before the earthquake, 81.5% had regular menses, while in 58.6% of them the pattern of menses changed after the earthquake. It was found that there was a negative and weakly significant relationship between the total mean scores of “Menstrual Symptom Scale” and “Genital Hygiene Scale” (p < 0.05). Significant differences were found between “age,” “perceived income level,” “marital status,” and “experiencing women's health problems after the earthquake” with menstrual symptoms. Additionally, significant differences were observed between “changes in menstrual regulation after the earthquake,” “the major earthquake's impact on the availability of hygienic products,” and genital hygiene behaviors (p < 0.05).

Conclusions

It was determined that the menstrual symptoms experienced by health workers after the earthquake were above moderate severity and their genital hygiene behaviors were less positive. Furthermore, genital hygiene behaviors were more negatively affected as the severity of menstrual symptoms increased.

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引用次数: 0
Nationwide survey on the transition of treatment protocols after the introduction of insurance coverage for assisted reproductive technology in Japan: The IZANAMI project
IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-09 DOI: 10.1111/jog.16234
Keiji Kuroda, Seung Chik Jwa, Hiromitsu Shirasawa, Miyuki Harada, Yutaka Osuga, Mitsutoshi Yamada

Aim

How has the treatment policy changed since the introduction of health insurance coverage for assisted reproductive technology (ART) in Japan?

Methods

This study was conducted as a nationwide fact-finding survey to determine the current situation of ART treatment in Japan, the IZANAMI project. Among the 616 ART facilities across Japan, 283 (45.9%) that responded to the first (December 2021–February 2022) and second surveys (December 2023–January 2024) were recruited. Information on the clinical practices was collected via a questionnaire survey and analyzed.

Results

Among the facilities with ≤200, 201–500, 501–1000, 1001–2000, and ≥2000 annual oocyte retrieval (OR) cycles, 93.9%, 88.7%, 75.0%, 69.7% and 42.9% performed ≥80% of their OR cycles using health insurance, respectively (p < 0.001), whereas 51.9%, 53.7%, 41.0%, 40.0% and 12.5% exhibited an increase in number of OR cycles, respectively (p = 0.03). Therefore, a significantly higher proportion of smaller-scale institutions than larger clinics had insured treatment and an increase in the number of OR cycles. Significantly more large clinics than small facilities selected mild stimulation, intracytoplasmic sperm injection, and freeze-all embryo cycle; however, no significant transitions were observed in the main policies for ART, regardless of facility size. However, the indication for mild stimulation significantly increased in normal to high responders, and the choice of ovarian stimulation protocol according to the patient's wishes was significantly reduced.

Conclusions

Small-scale institutions were more likely to offer insured treatment and increase the number of OR cycles than large facilities; however, the main protocols did not significantly change.

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引用次数: 0
Extraskeletal myxoid chondrosarcoma mimicking mucinous ovarian cancer: A case report
IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-09 DOI: 10.1111/jog.16235
Sebile Güler Çekiç, Ömer Faruk Atay, Volkan Ülker, Özgür Akbayir

Pelvic masses can represent various etiologies, including gynecologic and non-gynecologic conditions. As discussed in this paper, among all pathologies, intraabdominal dissemination of an extraskeletal myxoid chondrosarcoma (ESMC) presenting as a pelvic mass is a rare condition. The case is a 58-year-old woman with a history of soft tissue sarcoma who presented to the gynecologic oncology department with a pelvic mass and was operated on with the suspicion of mucinous ovarian cancer. She underwent complete cytoreductive surgery, and her final pathology was reported as ESMC. Due to several numbers of metastases shown in positron emission tomography-computed tomography, she had chemotherapy and then operated on for tumorectomy from the right leg. ESMC is a rare, aggressive soft tissue neoplasm that rarely has metastasis to the abdomen. This unique case presents a late recurrence of the disease to the pelvis, which can mimic mucinous ovarian cancer.

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引用次数: 0
The impact of oral postbiotics on the restoration of pelvic floor muscle function
IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-09 DOI: 10.1111/jog.16236
Yuan Xu, Yawei Yang, Ruxin Chen, Can Li, Mingdian Li, Qingxi Yuan, He Gao

Aim

To elucidate the efficacy and underlying mechanisms of postbiotics in ameliorating stress urinary incontinence (SUI) in a rat model.

Methods

SUI model was established via pelvic floor injury and bilateral ovariectomy to simulate postmenopausal conditions. Following successful model induction, subjects were randomly allocated into control, model, positive drug, and experimental groups. The positive drug group received midodrine hydrochloride (20 mg/kg), while the experimental group received postbiotics (75 mg/kg) daily for 28 days. Urodynamic and abdominal leak point pressure tests were conducted on days 7, 14, 21, and 28. After 28 days, histopathology and western blot analysis for collagen I (Col I), collagen III (Col III), and elastin, as well as quantitative polymerase chain reaction for gene expression, were performed.

Results

The model group showed abnormal urodynamic waveforms and lower maximum abdominal leak point pressure compared to controls. Histopathology revealed muscle fiber disarray, fiber rupture, and decreased muscle thickness. Both mRNA and protein levels of Col I, Col III, and Elastin were reduced. Midodrine improved urodynamic parameters and pathology, increasing Col I, Col III, and Elastin levels. Postbiotics also improved urodynamic parameters and pathology, with increased protein levels of Col I, Col III, and Elastin, and upregulated mRNA levels of Col I, Col III, Elastin, and transforming growth factor β1.

Conclusion

Postbiotics demonstrate therapeutic potential in alleviating SUI in rats by upregulating the expression of Col I, Col III, Elastin, and transforming growth factor β1 genes, enhancing collagen and elastin protein content in sphincter and pubococcygeus muscles, and consequently restoring muscle contractility and function.

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引用次数: 0
Letter to “A case of third trimester uterine prolapse resulting in vaginal delivery by placement of an intravaginal balloon”
IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-06 DOI: 10.1111/jog.16228
Shigeki Matsubara, Hironori Takahashi
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引用次数: 0
Innovative minimally invasive technique for pelvic organ prolapse: V-Notes lateral suspension
IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-06 DOI: 10.1111/jog.16232
Eralp Bulutlar, Gizem Berfin Uluutku Bulutlar, Gizem Boz Izceyhan, Özgür Aktaş, Ayşe Betül Albayrak Denizli, Çetin Kiliççi

Background

This study aimed to develop a novel antiprolapse surgical technique utilizing minimally invasive methods with lateral suspension in natural orifice surgeries.

Aims

The primary objective of this study was to describe a modified V-Notes lateral suspension (VNLS) technique as a viable alternative for antiprolapse surgery.

Study Design

This was a prospective clinical trial evaluating a new surgical technique.

Methods

Patients indicated for lateral suspension underwent the procedure using the V-Notes technique through natural orifices. No additional incisions were made on the anterior abdominal wall, except for the mesh exit points.

Results

Post-operation, the only incisions present were the two lateral mesh outlet incisions on the anterior abdominal wall. Additionally, there was no need for peritonization as the Alexis wound protector/retractor was used extraperitoneally. The outcomes were comparable to those achieved with laparoscopic lateral suspension (LLS). The VNLS technique demonstrated favorable results, including shorter hospital stays and improved cosmetic outcomes compared to traditional LLS. This innovative approach has the potential to become the new gold standard in antiprolapse surgery, providing benefits such as minimal invasiveness and enhanced aesthetics.

Conclusion

While the optimal treatment for pelvic organ prolapse remains undetermined, natural orifice surgeries like V-Notes offer promising advantages, including reduced invasiveness and superior cosmetic results, suggesting their potential for future standard practice.

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引用次数: 0
List of reviewers for The Journal of Obstetrics and Gynaecology Research 2024
IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-06 DOI: 10.1111/jog.16227
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引用次数: 0
Assessment of intra-amniotic colonization based on copy numbers of 16S ribosomal deoxyribonucleic acid: A diagnostic and prognostic study
IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-05 DOI: 10.1111/jog.16223
Daichi Urushiyama, Chihiro Kiyoshima, Toyofumi Hirakawa, Mami Shibata, Shiori Imi, Masamitsu Kurakazu, Kohei Miyata, Takashi Setoue, Shinichiro Nagamitsu, Makoto Nomiyama, Kazuhiko Nakabayashi, Fusanori Yotsumoto, Kenichiro Hata, Shingo Miyamoto

Aim

This study aimed to assess amniotic fluid bacterial load using the copy number of 16S ribosomal deoxyribonucleic acid and to clarify its association with perinatal outcomes.

Methods

This retrospective diagnostic and prognostic study included 63 patients with preterm labor and suspected intra-amniotic infection who underwent amniocentesis before 34 weeks of gestation. We measured the copy number of 16S ribosomal deoxyribonucleic acid in 1 mL of amniotic fluid using droplet digital polymerase chain reaction and graded infections as Grade (G) 0, 1, 2, or 3. Case–control analysis was performed to compare G3 (N = 29), G1–2 (N = 18), and G0 (N = 17) patients. The main outcome measures were histologic chorioamnionitis, funisitis, and amniocentesis-to-delivery time windows.

Results

The frequency of histologic chorioamnionitis (Stage III) and funisitis was as follows: G3, 86% and 79%; G1–2, 28% and 56%; and G0, 0% and 6%, respectively. The rate of post-amniocentesis delivery within 1 and 2 days was as follows: G3, 62% and 83%; G1–2, 56% and 78%; G0, 13% and 25%, respectively. Comparisons between the G3 and G0 groups revealed significant differences in all criteria (p < 0.05). Additionally, significant differences were noted in pathological inflammatory findings between the G3 and G1–2 groups, as well as in all perinatal outcomes between the G1–2 and G0 groups (p < 0.05).

Conclusions

Our diagnostic method, based on the copy number of 16S ribosomal deoxyribonucleic acid, supports intra-amniotic colonization assessment, guiding clinical decisions regarding the timing of delivery and potentially informing antimicrobial interventions.

{"title":"Assessment of intra-amniotic colonization based on copy numbers of 16S ribosomal deoxyribonucleic acid: A diagnostic and prognostic study","authors":"Daichi Urushiyama,&nbsp;Chihiro Kiyoshima,&nbsp;Toyofumi Hirakawa,&nbsp;Mami Shibata,&nbsp;Shiori Imi,&nbsp;Masamitsu Kurakazu,&nbsp;Kohei Miyata,&nbsp;Takashi Setoue,&nbsp;Shinichiro Nagamitsu,&nbsp;Makoto Nomiyama,&nbsp;Kazuhiko Nakabayashi,&nbsp;Fusanori Yotsumoto,&nbsp;Kenichiro Hata,&nbsp;Shingo Miyamoto","doi":"10.1111/jog.16223","DOIUrl":"10.1111/jog.16223","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to assess amniotic fluid bacterial load using the copy number of 16S ribosomal deoxyribonucleic acid and to clarify its association with perinatal outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective diagnostic and prognostic study included 63 patients with preterm labor and suspected intra-amniotic infection who underwent amniocentesis before 34 weeks of gestation. We measured the copy number of 16S ribosomal deoxyribonucleic acid in 1 mL of amniotic fluid using droplet digital polymerase chain reaction and graded infections as Grade (G) 0, 1, 2, or 3. Case–control analysis was performed to compare G3 (<i>N</i> = 29), G1–2 (<i>N</i> = 18), and G0 (<i>N</i> = 17) patients. The main outcome measures were histologic chorioamnionitis, funisitis, and amniocentesis-to-delivery time windows.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The frequency of histologic chorioamnionitis (Stage III) and funisitis was as follows: G3, 86% and 79%; G1–2, 28% and 56%; and G0, 0% and 6%, respectively. The rate of post-amniocentesis delivery within 1 and 2 days was as follows: G3, 62% and 83%; G1–2, 56% and 78%; G0, 13% and 25%, respectively. Comparisons between the G3 and G0 groups revealed significant differences in all criteria (<i>p</i> &lt; 0.05). Additionally, significant differences were noted in pathological inflammatory findings between the G3 and G1–2 groups, as well as in all perinatal outcomes between the G1–2 and G0 groups (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our diagnostic method, based on the copy number of 16S ribosomal deoxyribonucleic acid, supports intra-amniotic colonization assessment, guiding clinical decisions regarding the timing of delivery and potentially informing antimicrobial interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189387","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}
引用次数: 0
Awareness and attitude toward cardio-oncology among Japanese gynecologic oncologists in managing patients with endometrial cancer: The Japanese Gynecologic Oncology Group (JGOG) questionnaire surveys
IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-05 DOI: 10.1111/jog.16225
Yoichi Kobayashi, Mikiko Asai-Sato, Shiho Kuji, Hitomi Sakai, Ken Yamaguchi, Nao Suzuki, Yoshio Yoshida

Aim

This study aimed to assess the awareness of the concept of “cardio-oncology” and cardiovascular disease (CVD) in patients with endometrial cancer (EC) among the Japanese Gynecologic Oncology Group members.

Methods

An online anonymous survey, which consisted of questions about respondent attributes and cardio-oncology, was conducted twice, in 2022 and 2024. During these surveys, guidelines for the treatment of uterine body neoplasm were published in July 2023.

Results

In 2022, significantly numerous physicians were unaware of cardio-oncology or the increased risk of developing CVD in patients with EC, and 25.3% of them answered that they had no idea about cardio-oncology at all. However, in 2024, the percentage significantly dropped to 8.7%. The number of physicians who were aware that CVD is more common as the cause of death in patients with low-grade EC than the cancer itself was significantly higher in 2024 than in 2022. Similarly, the number of physicians who were aware that the usage of platinum agents could become a risk factor for CVD was significantly higher in 2024. Furthermore, this study reported challenges in the collaboration between oncologists and primary care physicians in the region and in the provision of guidance for preventing metabolic syndrome.

Conclusion

Japanese Gynecologic Oncology Group members' awareness of cardio-oncology was inadequate, but it seemed to be improving, especially after publishing the guideline for the treatment of uterine body neoplasm. Thus, raising awareness of cardio-oncology and managing CVD risk in patients with EC are necessary to improve long-term survival after cancer diagnosis.

{"title":"Awareness and attitude toward cardio-oncology among Japanese gynecologic oncologists in managing patients with endometrial cancer: The Japanese Gynecologic Oncology Group (JGOG) questionnaire surveys","authors":"Yoichi Kobayashi,&nbsp;Mikiko Asai-Sato,&nbsp;Shiho Kuji,&nbsp;Hitomi Sakai,&nbsp;Ken Yamaguchi,&nbsp;Nao Suzuki,&nbsp;Yoshio Yoshida","doi":"10.1111/jog.16225","DOIUrl":"https://doi.org/10.1111/jog.16225","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to assess the awareness of the concept of “cardio-oncology” and cardiovascular disease (CVD) in patients with endometrial cancer (EC) among the Japanese Gynecologic Oncology Group members.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online anonymous survey, which consisted of questions about respondent attributes and cardio-oncology, was conducted twice, in 2022 and 2024. During these surveys, guidelines for the treatment of uterine body neoplasm were published in July 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2022, significantly numerous physicians were unaware of cardio-oncology or the increased risk of developing CVD in patients with EC, and 25.3% of them answered that they had no idea about cardio-oncology at all. However, in 2024, the percentage significantly dropped to 8.7%. The number of physicians who were aware that CVD is more common as the cause of death in patients with low-grade EC than the cancer itself was significantly higher in 2024 than in 2022. Similarly, the number of physicians who were aware that the usage of platinum agents could become a risk factor for CVD was significantly higher in 2024. Furthermore, this study reported challenges in the collaboration between oncologists and primary care physicians in the region and in the provision of guidance for preventing metabolic syndrome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Japanese Gynecologic Oncology Group members' awareness of cardio-oncology was inadequate, but it seemed to be improving, especially after publishing the guideline for the treatment of uterine body neoplasm. Thus, raising awareness of cardio-oncology and managing CVD risk in patients with EC are necessary to improve long-term survival after cancer diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248660","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}
引用次数: 0
Postpartum period according to Roy adaptation model: Assessment of fatigue, self-esteem, functional status, and dyadic adjustment
IF 1.6 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-02-05 DOI: 10.1111/jog.16221
Ayşe Nur Ataş, Habibe Bay Özçalik, Nebahat Özerdoğan

Objective

The study was conducted to examine the relationship between fatigue, self-esteem, functional status, and dyadic adjustment in the postpartum period and the factors affecting them.

Methods

The study was designed in cross-sectional type. It was carried out in the postpartum follow-up clinic of a hospital in the Central Anatolian Region of Turkey between November 2021 and July 2022. Responses from a total of 328 mothers in the first 6 months postpartum were analyzed. Data were collected using a “Descriptive Information Form,” the “Chalder Fatigue Scale,” the “Rosenberg Self-Esteem Scale,” the “Inventory of Functional Status after Childbirth,” and the “Revised Dyadic Adjustment Scale.”

Results

The mean scores of the mothers participating in the study on the total Chalder fatigue scale, Rosenberg self-esteem scale, Inventory of functional status after childbirth, and Revised dyadic adjustment scale were 13.65 ± 6.13, 1.33 ± 1.33, 10.57 ± 2.02, and 51.51 ± 9.49, respectively. It was determined that fatigue had a positive effect and dyadic adjustment had a negative effect on the postpartum self-esteem levels of the mothers. The progress of the postpartum period affects the functional status of mothers positively and significantly.

Conclusions

According to the results of the research, the decrease in fatigue and the increase in dyadic adjustment in women positively affect the increase in self-esteem.

{"title":"Postpartum period according to Roy adaptation model: Assessment of fatigue, self-esteem, functional status, and dyadic adjustment","authors":"Ayşe Nur Ataş,&nbsp;Habibe Bay Özçalik,&nbsp;Nebahat Özerdoğan","doi":"10.1111/jog.16221","DOIUrl":"https://doi.org/10.1111/jog.16221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study was conducted to examine the relationship between fatigue, self-esteem, functional status, and dyadic adjustment in the postpartum period and the factors affecting them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was designed in cross-sectional type. It was carried out in the postpartum follow-up clinic of a hospital in the Central Anatolian Region of Turkey between November 2021 and July 2022. Responses from a total of 328 mothers in the first 6 months postpartum were analyzed. Data were collected using a “Descriptive Information Form,” the “Chalder Fatigue Scale,” the “Rosenberg Self-Esteem Scale,” the “Inventory of Functional Status after Childbirth,” and the “Revised Dyadic Adjustment Scale.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean scores of the mothers participating in the study on the total Chalder fatigue scale, Rosenberg self-esteem scale, Inventory of functional status after childbirth, and Revised dyadic adjustment scale were 13.65 ± 6.13, 1.33 ± 1.33, 10.57 ± 2.02, and 51.51 ± 9.49, respectively. It was determined that fatigue had a positive effect and dyadic adjustment had a negative effect on the postpartum self-esteem levels of the mothers. The progress of the postpartum period affects the functional status of mothers positively and significantly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>According to the results of the research, the decrease in fatigue and the increase in dyadic adjustment in women positively affect the increase in self-esteem.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248658","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}
引用次数: 0
期刊
Journal of Obstetrics and Gynaecology Research
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