The right subclavian artery (RSA)–superior vena cava (SVC) fistula represents a rare arteriovenous fistula characterized by abnormal vascular channels connecting the arterial and venous systems. This report describes the first prenatal diagnosis of an RSA–SVC fistula. Differentiation from supracardiac total anomalous pulmonary venous connection (TAPVC) is challenging; however, three indirect indicators may aid differentiation: simultaneous dilation of the innominate artery and SVC, bi-directional flow within the aortic arch, and a bi-phasic, unidirectional, spiculated flow pattern at the confluence. Timely prenatal diagnosis serves as a vital tool for clinicians and families, paving the way for timely postpartum interventions while significantly enhancing postnatal prognoses.
{"title":"Prenatal Diagnosis of a Rare Congenital Right Subclavian Artery–Superior Vena Cava Fistula","authors":"Linhua Yang, Li Hou, Hui He, Liuying Zhou","doi":"10.1111/jog.70125","DOIUrl":"https://doi.org/10.1111/jog.70125","url":null,"abstract":"<div>\u0000 \u0000 <p>The right subclavian artery (RSA)–superior vena cava (SVC) fistula represents a rare arteriovenous fistula characterized by abnormal vascular channels connecting the arterial and venous systems. This report describes the first prenatal diagnosis of an RSA–SVC fistula. Differentiation from supracardiac total anomalous pulmonary venous connection (TAPVC) is challenging; however, three indirect indicators may aid differentiation: simultaneous dilation of the innominate artery and SVC, bi-directional flow within the aortic arch, and a bi-phasic, unidirectional, spiculated flow pattern at the confluence. Timely prenatal diagnosis serves as a vital tool for clinicians and families, paving the way for timely postpartum interventions while significantly enhancing postnatal prognoses.</p>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384983","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}
K. Kawakami, R. Shimokawa, F. Saito, A. Sagara, S. Yoshimura, Y. Iwagoi, et al., “Pregnancy-Specific Reference Intervals for Complete Blood Count Parameters in a Japanese Cohort,” Journal of Obstetrics and Gynaecology Research 51, no. 7 (2025): e70011, https://doi.org/10.1111/jog.70011.
We apologize for this error.
FIGURE 3 | Hematological changes across body mass index. Statistical significance is indicated as follows: ns, not significant; *p < 0.05; **p < 0.01; ***p < 0.001. If no other significance level is indicated, ****p < 0.0001.
FIGURE 3 | (continued).
FIGURE 4 | Age-related changes in complete blood count parameters during pregnancy. Statistical significance is indicated as follows: *p < 0.05, **p < 0.01, ***p < 0.001, ****p < 0.0001.
FIGURE 4 | (continued).
K. Kawakami， R. Shimokawa， F. Saito, a . Sagara， S. Yoshimura， Y. Iwagoi等，“日本队列全血细胞计数参数的妊娠特异性参考区间”，《妇产科研究杂志》第51期。7 (2025): e70011, https://doi.org/10.1111/jog.70011.We对此错误道歉。图3 | 身体质量指数的血液学变化。统计显著性表示如下：ns，不显著；*p < 0.05；**p < 0.01；***p < 0.001。如果没有其他显著性水平，****p < 0.0001。图3 | ( 继续)。图4 | 妊娠期间全血细胞计数参数与年龄相关的变化。统计学意义为：*p <； 0.05, **p < 0.01, **p < 0.001, ****p < 0.0001。图4 | ( 继续)。
{"title":"Correction to “Pregnancy-Specific Reference Intervals for Complete Blood Count Parameters in a Japanese Cohort”","authors":"","doi":"10.1111/jog.70113","DOIUrl":"https://doi.org/10.1111/jog.70113","url":null,"abstract":"<p>K. Kawakami, R. Shimokawa, F. Saito, A. Sagara, S. Yoshimura, Y. Iwagoi, et al., “Pregnancy-Specific Reference Intervals for Complete Blood Count Parameters in a Japanese Cohort,” <i>Journal of Obstetrics and Gynaecology Research</i> 51, no. 7 (2025): e70011, https://doi.org/10.1111/jog.70011.</p><p>We apologize for this error.</p><p>FIGURE 3 | Hematological changes across body mass index. Statistical significance is indicated as follows: ns, not significant; *<i>p</i> < 0.05; **<i>p</i> < 0.01; ***<i>p</i> < 0.001. If no other significance level is indicated, ****<i>p</i> < 0.0001.</p><p>FIGURE 3 | (continued).</p><p>FIGURE 4 | Age-related changes in complete blood count parameters during pregnancy. Statistical significance is indicated as follows: *<i>p</i> < 0.05, **<i>p</i> < 0.01, ***<i>p</i> < 0.001, ****<i>p</i> < 0.0001.</p><p>FIGURE 4 | (continued).</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/jog.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385038","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}
Hiroaki Kajiyama, Satoshi Tamauchi, Fumiaki Takahashi, Toyomi Satoh, Board Members of the 2025 Committee on Gynecologic Oncology of the Japan Society of Obstetrics and Gynecology
Aim
To provide information including the trend of gynecological malignancies in Japan, we hereby present the Annual Patient Report for 2022 and the Annual Treatment Report for 2017, on the outcomes of patients who started treatment in 2017.
Methods
The Japan Society of Obstetrics and Gynecology maintains an annual tumor registry, where information on gynecological malignancies from various participating institutions is gathered. The data of patients whose treatment with gynecologic malignancies was initiated in 2022 were analyzed retrospectively. Survival of the patients who started treatment with cervical, endometrial, and ovarian cancer in 2017 was analyzed by using the Kaplan–Meier, log–rank, and Wilcoxson tests.
Results
Treatment was initiated in 2022 for 8039 patients with cervical cancer, 14 518 with endometrial cancer, 8524 with ovarian, tubal, and peritoneal cancer, 2360 with ovarian borderline tumors, and with the others (270 vulvar cancer, 179 vaginal cancer, 539 uterine sarcoma, 48 uterine adenosarcoma, 158 trophoblastic diseases). This clinicopathological information was summarized as the Patient Annual Report. The 5-year survival rates of the patients who initiated treatment in 2017 were as follows. For cervical cancer, the rates were 93.0%, 76.1%, 59.5%, and 28.3% for Stages I, II, III, and IV, respectively. For endometrial cancer, the rates were 94.9%, 88.8%, 72.7%, and 28.9% for Stages I, II, III, and IV, respectively. For ovarian cancer, the rates were 91.7%, 76.6%, 54.4%, and 45.2% for Stages I, II, III, and IV, respectively.
Conclusion
The annual tumor report is an important survey that provides knowledge on gynecological malignancy trends in Japan.
{"title":"Annual Report of the Committee on Gynecologic Oncology, the Japan Society of Obstetrics and Gynecology: Annual Patient Report for 2022 and Annual Treatment Report for 2017","authors":"Hiroaki Kajiyama, Satoshi Tamauchi, Fumiaki Takahashi, Toyomi Satoh, Board Members of the 2025 Committee on Gynecologic Oncology of the Japan Society of Obstetrics and Gynecology","doi":"10.1111/jog.70124","DOIUrl":"https://doi.org/10.1111/jog.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To provide information including the trend of gynecological malignancies in Japan, we hereby present the Annual Patient Report for 2022 and the Annual Treatment Report for 2017, on the outcomes of patients who started treatment in 2017.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Japan Society of Obstetrics and Gynecology maintains an annual tumor registry, where information on gynecological malignancies from various participating institutions is gathered. The data of patients whose treatment with gynecologic malignancies was initiated in 2022 were analyzed retrospectively. Survival of the patients who started treatment with cervical, endometrial, and ovarian cancer in 2017 was analyzed by using the Kaplan–Meier, log–rank, and Wilcoxson tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Treatment was initiated in 2022 for 8039 patients with cervical cancer, 14 518 with endometrial cancer, 8524 with ovarian, tubal, and peritoneal cancer, 2360 with ovarian borderline tumors, and with the others (270 vulvar cancer, 179 vaginal cancer, 539 uterine sarcoma, 48 uterine adenosarcoma, 158 trophoblastic diseases). This clinicopathological information was summarized as the Patient Annual Report. The 5-year survival rates of the patients who initiated treatment in 2017 were as follows. For cervical cancer, the rates were 93.0%, 76.1%, 59.5%, and 28.3% for Stages I, II, III, and IV, respectively. For endometrial cancer, the rates were 94.9%, 88.8%, 72.7%, and 28.9% for Stages I, II, III, and IV, respectively. For ovarian cancer, the rates were 91.7%, 76.6%, 54.4%, and 45.2% for Stages I, II, III, and IV, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The annual tumor report is an important survey that provides knowledge on gynecological malignancy trends in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385034","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}
This study aims to analyze the incidence, risk factors, clinical presentations, and maternal-perinatal outcomes of complete uterine rupture at a major tertiary hospital in China over a decade.
Methods
We conducted a single-center retrospective cohort study of all women who delivered at our hospital, from March 2012 to February 2022. Cases of complete uterine rupture, defined as a full-thickness tear of the uterine wall confirmed intraoperatively, were identified. Data on demographics, obstetric history, clinical manifestations, management, and outcomes were extracted and analyzed using descriptive statistics.
Results
Out of 232,563 total deliveries, 38 cases of complete uterine rupture were confirmed, yielding an incidence of 0.016% (1.6 per 10,000 deliveries). The median maternal age was 31 years (range, 23–38), and the median gestational age at rupture was 36+4 weeks (range, 13+6–40+6). A prior uterine scar was the predominant risk factor, present in 32 cases (84.2%), primarily from previous cesarean sections. Rupture occurred in unscarred uteri in 6 cases (15.8%). Clinical presentation was highly variable: acute abdominal pain was the most common symptom (n = 20, 52.6%), followed by vaginal bleeding (n = 8, 21.1%) and fetal heart rate abnormalities (n = 10, 26.3%). Notably, 8 patients (21.1%) were asymptomatic, with the rupture discovered incidentally during elective cesarean section. Maternal morbidity was significant, although all mothers survived; however, the perinatal mortality rate was high at 27.5% (11 of 40 fetuses/newborns). Thirty-seven (97.4%) patients underwent uterine repair, and one (2.6%) required a hysterectomy.
Conclusion
A prior uterine scar is the leading risk factor for complete uterine rupture. However, the heterogeneous clinical presentation, including a significant proportion of asymptomatic cases, poses a major diagnostic challenge. A high index of suspicion is crucial for timely intervention to mitigate adverse maternal and perinatal outcomes.
{"title":"Incidence, Risk Factors, and Outcomes of Complete Uterine Rupture: A 10-Year Single-Center Retrospective Study","authors":"Zhexia Hu, Hong Zhang, Yun Rong, Biyun Luo, Mengjia Wang, Xueling Zhang, Tianhong Gao","doi":"10.1111/jog.70122","DOIUrl":"https://doi.org/10.1111/jog.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to analyze the incidence, risk factors, clinical presentations, and maternal-perinatal outcomes of complete uterine rupture at a major tertiary hospital in China over a decade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-center retrospective cohort study of all women who delivered at our hospital, from March 2012 to February 2022. Cases of complete uterine rupture, defined as a full-thickness tear of the uterine wall confirmed intraoperatively, were identified. Data on demographics, obstetric history, clinical manifestations, management, and outcomes were extracted and analyzed using descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 232,563 total deliveries, 38 cases of complete uterine rupture were confirmed, yielding an incidence of 0.016% (1.6 per 10,000 deliveries). The median maternal age was 31 years (range, 23–38), and the median gestational age at rupture was 36<sup>+4</sup> weeks (range, 13<sup>+6</sup>–40<sup>+6</sup>). A prior uterine scar was the predominant risk factor, present in 32 cases (84.2%), primarily from previous cesarean sections. Rupture occurred in unscarred uteri in 6 cases (15.8%). Clinical presentation was highly variable: acute abdominal pain was the most common symptom (<i>n</i> = 20, 52.6%), followed by vaginal bleeding (<i>n</i> = 8, 21.1%) and fetal heart rate abnormalities (<i>n</i> = 10, 26.3%). Notably, 8 patients (21.1%) were asymptomatic, with the rupture discovered incidentally during elective cesarean section. Maternal morbidity was significant, although all mothers survived; however, the perinatal mortality rate was high at 27.5% (11 of 40 fetuses/newborns). Thirty-seven (97.4%) patients underwent uterine repair, and one (2.6%) required a hysterectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A prior uterine scar is the leading risk factor for complete uterine rupture. However, the heterogeneous clinical presentation, including a significant proportion of asymptomatic cases, poses a major diagnostic challenge. A high index of suspicion is crucial for timely intervention to mitigate adverse maternal and perinatal outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385033","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 efficacy and safety of concurrent chemoradiotherapy prior to systemic chemotherapy in patients with stage IVB cervical cancer.
Methods
This retrospective observational study included 40 patients diagnosed with stage IVB cervical cancer who received concurrent chemoradiotherapy as first-line therapy at the Yokohama City University Hospital between 2007 and 2021. The evaluated outcomes included concurrent chemoradiotherapy response rate, chemotherapy initiation rate, adverse events, and overall survival.
Results
The disease control rate of concurrent chemoradiotherapy was 72.5%, with no significant differences across the subgroups defined by the number of metastatic sites, presence of out-of-field lesions, parenchymal involvement, or histological subtype. Systemic chemotherapy was initiated in 89% of the patients, with a median interval of 39 days after concurrent chemoradiotherapy completion, except in one patient (3.6%) due to disease progression. Including recurrent cases, 91% of patients ultimately received systemic chemotherapy. Grade 3 or higher toxicity that significantly delayed chemotherapy initiation occurred in only one patient (3.6%). The median overall survival was 23 months, with no significant differences based on lesion distribution, parenchymal involvement, histological subtype, or metastatic burden.
Conclusions
Concurrent chemoradiotherapy may be a feasible first-line treatment option for stage IVB cervical cancer with manageable toxicity, acceptable disease control, and the potential to allow a timely transition to systemic chemotherapy.
{"title":"Efficacy and Safety of Concurrent Chemoradiotherapy as First-Line Treatment for Stage IVB Cervical Cancer: A Single-Center Retrospective Observational Study","authors":"Yumi Ishidera, Takayoshi Iijima, Masahiro Aichi, Yuki Ogawara, Yuichi Imai, Madoka Sugiura, Masaharu Hata, Etsuko Miyagi, Taichi Mizushima","doi":"10.1111/jog.70119","DOIUrl":"https://doi.org/10.1111/jog.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of concurrent chemoradiotherapy prior to systemic chemotherapy in patients with stage IVB cervical cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study included 40 patients diagnosed with stage IVB cervical cancer who received concurrent chemoradiotherapy as first-line therapy at the Yokohama City University Hospital between 2007 and 2021. The evaluated outcomes included concurrent chemoradiotherapy response rate, chemotherapy initiation rate, adverse events, and overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The disease control rate of concurrent chemoradiotherapy was 72.5%, with no significant differences across the subgroups defined by the number of metastatic sites, presence of out-of-field lesions, parenchymal involvement, or histological subtype. Systemic chemotherapy was initiated in 89% of the patients, with a median interval of 39 days after concurrent chemoradiotherapy completion, except in one patient (3.6%) due to disease progression. Including recurrent cases, 91% of patients ultimately received systemic chemotherapy. Grade 3 or higher toxicity that significantly delayed chemotherapy initiation occurred in only one patient (3.6%). The median overall survival was 23 months, with no significant differences based on lesion distribution, parenchymal involvement, histological subtype, or metastatic burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Concurrent chemoradiotherapy may be a feasible first-line treatment option for stage IVB cervical cancer with manageable toxicity, acceptable disease control, and the potential to allow a timely transition to systemic chemotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/jog.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385036","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}
A 25-year-old pregnant woman (gravida 2, para 1) presented with progressive anemia unresponsive to iron supplementation, ultimately developing pancytopenia at 37 weeks of gestation. Despite adequate caloric intake, her diet consisted primarily of ultra-processed and frozen foods. Laboratory findings showed hemoglobin of 5.5 g/dL, mean corpuscular volume of 102.9 fL, and elevated lactate dehydrogenase. Her serum folate, vitamin B12, and zinc levels were 1.3 ng/mL, 131 pg/mL, and 57 μg/dL, respectively. A healthy infant was delivered via cesarean section at 38 weeks, and the mother's pancytopenia improved with supplementation. To our knowledge, few reports have described concurrent folate- and zinc-deficiency–associated pancytopenia during pregnancy without significant weight loss or overt dietary restriction, particularly in the context of a diet high in ultra-processed foods but with sufficient caloric intake. This case highlights the risks of poor micronutrient intake despite adequate macronutrient consumption and underscores the importance of nutritional monitoring during pregnancy.
{"title":"Pancytopenia in the Third Trimester of Pregnancy: A Case of Concurrent Folate and Zinc Deficiencies due to Unbalanced Dietary Habits","authors":"Minori Tanabe, Yusuke Kurokawa, Megumi Muto, Maki Yamaguchi, Toshiyuki Yoshizato, Koji Nagafuji, Naotake Tsuda","doi":"10.1111/jog.70114","DOIUrl":"https://doi.org/10.1111/jog.70114","url":null,"abstract":"<div>\u0000 \u0000 <p>A 25-year-old pregnant woman (gravida 2, para 1) presented with progressive anemia unresponsive to iron supplementation, ultimately developing pancytopenia at 37 weeks of gestation. Despite adequate caloric intake, her diet consisted primarily of ultra-processed and frozen foods. Laboratory findings showed hemoglobin of 5.5 g/dL, mean corpuscular volume of 102.9 fL, and elevated lactate dehydrogenase. Her serum folate, vitamin B<sub>12</sub>, and zinc levels were 1.3 ng/mL, 131 pg/mL, and 57 μg/dL, respectively. A healthy infant was delivered via cesarean section at 38 weeks, and the mother's pancytopenia improved with supplementation. To our knowledge, few reports have described concurrent folate- and zinc-deficiency–associated pancytopenia during pregnancy without significant weight loss or overt dietary restriction, particularly in the context of a diet high in ultra-processed foods but with sufficient caloric intake. This case highlights the risks of poor micronutrient intake despite adequate macronutrient consumption and underscores the importance of nutritional monitoring during pregnancy.</p>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385140","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}
{"title":"Letter to “Predicting Fetal Distress in Growth-Restricted Fetuses: The Role of Umbilical Vein Diameter”","authors":"Hiroyuki Tokue, Yoshito Tsushima","doi":"10.1111/jog.70126","DOIUrl":"https://doi.org/10.1111/jog.70126","url":null,"abstract":"","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385037","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}
Lynch syndrome (LS) is an autosomal-dominant hereditary cancer syndrome caused by defective mismatch repair (MMR) genes. This report presents two cases of LS with rare intronic variants in MLH1 and MSH2 that affect splicing, leading to diagnostic challenges and implications for management. The first case involves a 50-year-old woman with a history of colorectal and endometrial cancers, identified with a MSH2 c.2458+976A>G variant, resulting in pseudo-exon inclusion. The second case describes a 70-year-old woman with synchronous endometrial and cecal cancers, carrying an MLH1 c.545+4_545+5del variant, which caused exon 6 skipping. Both cases have strong familial and/or medical histories of LS-related cancers, but no pathogenic variant has been detected by conventional genetic testing. In these cases, RNA sequencing played a crucial role in establishing a definitive diagnosis. These findings highlight the need for genetic testing beyond conventional exon-focused sequencing to ensure accurate diagnosis and management.
{"title":"Rare Intronic Variants Altering Splicing Cause Lynch Syndrome: Two Case Reports","authors":"Yumi Takimoto, Hiroshi Tsubamoto, Tomokazu Wakatsuki, Riyo Yoshii, Gou Yamamoto, Hideaki Sawai, Ikuo Matsuda, Naohiro Tomita, Seiji Mabuchi, Kiwamu Akagi","doi":"10.1111/jog.70117","DOIUrl":"https://doi.org/10.1111/jog.70117","url":null,"abstract":"<div>\u0000 \u0000 <p>Lynch syndrome (LS) is an autosomal-dominant hereditary cancer syndrome caused by defective mismatch repair (MMR) genes. This report presents two cases of LS with rare intronic variants in MLH1 and MSH2 that affect splicing, leading to diagnostic challenges and implications for management. The first case involves a 50-year-old woman with a history of colorectal and endometrial cancers, identified with a MSH2 c.2458+976A>G variant, resulting in pseudo-exon inclusion. The second case describes a 70-year-old woman with synchronous endometrial and cecal cancers, carrying an MLH1 c.545+4_545+5del variant, which caused exon 6 skipping. Both cases have strong familial and/or medical histories of LS-related cancers, but no pathogenic variant has been detected by conventional genetic testing. In these cases, RNA sequencing played a crucial role in establishing a definitive diagnosis. These findings highlight the need for genetic testing beyond conventional exon-focused sequencing to ensure accurate diagnosis and management.</p>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385039","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}
Ke Wang, Huiping Liu, Huiyan Gan, Meiling Shang, Jing Yang, Tongtong Fan, Jixin Liu, Yihao Peng, Ming Zhang, Wanghuan Dun
Purpose
Primary dysmenorrhea (PDM) affects 45%–95% of menstruating women. However, the mechanism of PDM is still unclear; abnormal uterine structure may be one of the causes of PDM. But the subtle structural changes of the uterus during the menstrual phase cannot be seen by the naked eye. Here, we perform magnetic resonance imaging (MRI) texture analysis to precisely quantify the subtle changes of the uterus in patients with PDM.
Methods
Fifty-one patients with PDM and 49 healthy controls (HCs) underwent pelvic MRI during the menstrual and periovulatory phases and were included in this study. Sagittal T2-weighted images were uploaded into 3D slicer software for textural analysis of uterine structures (myometrium, junctional zone, endometrium). SPSS software was used for all statistical analyses of demographics and texture parameters.
Results
We found a phase × group interaction in small-zone emphasis (SZE) (p = 0.006, = 0.144) and zone percentage (ZP) (p = 0.007, = 0.148). The changes of textural characteristics of the myometrium were smaller in patients with PDM from preovulatory to menstrual phase compared with HCs. Additionally, we found the changes in SZE and ZP in the myometrium across the menstrual cycle were positively correlated with pain intensity in patients with PDM during menstrual phase.
Conclusions
Our study demonstrates that patients with PDM exhibit persistent subtle uterine abnormalities across the menstrual cycle, suggesting that PDM represents a continuous pathophysiological state rather than a transient menstrual-phase disorder. We propose texture analysis may provide a novel objective method for the early detection and prevention of PDM.
目的原发性痛经（PDM）影响45%–95% of menstruating women. However, the mechanism of PDM is still unclear; abnormal uterine structure may be one of the causes of PDM. But the subtle structural changes of the uterus during the menstrual phase cannot be seen by the naked eye. Here, we perform magnetic resonance imaging (MRI) texture analysis to precisely quantify the subtle changes of the uterus in patients with PDM. Methods Fifty-one patients with PDM and 49 healthy controls (HCs) underwent pelvic MRI during the menstrual and periovulatory phases and were included in this study. Sagittal T2-weighted images were uploaded into 3D slicer software for textural analysis of uterine structures (myometrium, junctional zone, endometrium). SPSS software was used for all statistical analyses of demographics and texture parameters. Results We found a phase × group interaction in small-zone emphasis (SZE) (p = 0.006, η p 2 $$ {eta}_p^2 $$ = 0.144) and zone percentage (ZP) (p = 0.007, η p 2 $$ {eta}_p^2 $$ = 0.148). The changes of textural characteristics of the myometrium were smaller in patients with PDM from preovulatory to menstrual phase compared with HCs. Additionally, we found the changes in SZE and ZP in the myometrium across the menstrual cycle were positively correlated with pain intensity in patients with PDM during menstrual phase. Conclusions Our study demonstrates that patients with PDM exhibit persistent subtle uterine abnormalities across the menstrual cycle, suggesting that PDM represents a continuous pathophysiological state rather than a transient menstrual-phase disorder. We propose texture analysis may provide a novel objective method for the early detection and prevention of PDM.
{"title":"Texture Analysis of Uterine-Derived T2-Weighted Imaging in Patients With Primary Dysmenorrhea Across Different Menstrual Phases","authors":"Ke Wang, Huiping Liu, Huiyan Gan, Meiling Shang, Jing Yang, Tongtong Fan, Jixin Liu, Yihao Peng, Ming Zhang, Wanghuan Dun","doi":"10.1111/jog.70123","DOIUrl":"https://doi.org/10.1111/jog.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Primary dysmenorrhea (PDM) affects 45%–95% of menstruating women. However, the mechanism of PDM is still unclear; abnormal uterine structure may be one of the causes of PDM. But the subtle structural changes of the uterus during the menstrual phase cannot be seen by the naked eye. Here, we perform magnetic resonance imaging (MRI) texture analysis to precisely quantify the subtle changes of the uterus in patients with PDM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-one patients with PDM and 49 healthy controls (HCs) underwent pelvic MRI during the menstrual and periovulatory phases and were included in this study. Sagittal T2-weighted images were uploaded into 3D slicer software for textural analysis of uterine structures (myometrium, junctional zone, endometrium). SPSS software was used for all statistical analyses of demographics and texture parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found a phase × group interaction in small-zone emphasis (SZE) (<i>p</i> = 0.006, <span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 <msubsup>\u0000 <mi>η</mi>\u0000 <mi>p</mi>\u0000 <mn>2</mn>\u0000 </msubsup>\u0000 </mrow>\u0000 <annotation>$$ {eta}_p^2 $$</annotation>\u0000 </semantics></math> = 0.144) and zone percentage (ZP) (<i>p</i> = 0.007, <span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 <msubsup>\u0000 <mi>η</mi>\u0000 <mi>p</mi>\u0000 <mn>2</mn>\u0000 </msubsup>\u0000 </mrow>\u0000 <annotation>$$ {eta}_p^2 $$</annotation>\u0000 </semantics></math> = 0.148). The changes of textural characteristics of the myometrium were smaller in patients with PDM from preovulatory to menstrual phase compared with HCs. Additionally, we found the changes in SZE and ZP in the myometrium across the menstrual cycle were positively correlated with pain intensity in patients with PDM during menstrual phase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study demonstrates that patients with PDM exhibit persistent subtle uterine abnormalities across the menstrual cycle, suggesting that PDM represents a continuous pathophysiological state rather than a transient menstrual-phase disorder. We propose texture analysis may provide a novel objective method for the early detection and prevention of PDM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385042","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 valproic acid (VPA) safety in pregnancy versus other antiepileptic drugs (AEDs), focusing on fetal malformation risks.
Methods
A literature search was conducted across PUBMED, MEDLINE, EMBASE, and Web of Science databases. Two researchers independently screened studies, extracted data, assessed quality, and analyzed VPA safety.
Results
This meta-analysis of 25 safety studies showed that compared with other AEDs, VPA's teratogenic risks were as follows: combined major congenital malformations (RR = 2.36, 95% CI: 2.17–2.56), neural tube defects (RR = 6.54, 95% CI: 4.51–9.47), congenital heart defects (RR = 2.53, 95% CI: 2.16–2.96), cleft lip and/or palate (RR = 4.31, 95% CI: 3.06–6.08), genitourinary anomalies (RR = 3.32, 95% CI: 2.67–4.14), and musculoskeletal anomalies (RR = 2.88, 95% CI: 1.98–4.19). Additional analyses stratified by calendar era yielded consistent results, with the corresponding RR values for the above malformations being 2.43 (95% CI: 2.13–2.77), 6.64 (95% CI: 4.50–9.79), 2.64 (95% CI: 2.14–3.26), 4.27 (95% CI: 2.98–6.12), 3.45 (95% CI: 2.76–4.31), and 2.99 (95% CI: 2.00–4.46), indicating a higher risk of multiple malformations with VPA.
Conclusion
VPA monotherapy significantly increases teratogenic risk, especially for neural tube defects and cleft lip/palate. Newer AEDs with lower risk profiles are preferred for epilepsy treatment during pregnancy. If VPA use is unavoidable, low doses and blood concentration monitoring are recommended to mitigate risk.
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