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Objective Methods Results Conclusion To evaluate the role of clinical exchange programs in postgraduate obgyn training using the International Federation of Gynecology and Obstetrics (FIGO)–World Association of Trainees in Obstetrics and Gynecology (WATOG) One World Exchange (OWE), a clinical exchange program held in France in October 2023, as a case‐study.This was a cross‐sectional study. A 31‐item structured questionnaire designed with Google Forms was electronically distributed to the 51 obgyn postgraduate trainees (OWE fellows) who participated in the OWE, to collect information about the exchange. Collected data was analyzed using IBM Statistical Product and Service Solutions (SPSS) Statistics for Windows.The survey response rate was 68.6%. The mean age of the respondents was 33.0 ± 4.0 years. Majority of the them were females (26, 74.3%), married (19, 54.3%), at least in their third year of training (30, 85.7%) and from Africa (11, 31.4%). During the period of the exchange program, fellows observed various obstetric and gynecologic procedures, including open and minimal access procedures, with more than one‐fifth (8, 22.9%) of them reporting that they were allowed to assist in some of these procedures. The fellows noted salient differences in practice between their exchange hospitals and their home countries. An overwhelming majority (30, 85.7%) of the fellows believed the OWE was beneficial and would positively impact their clinical practices back in their home countries.Clinical exchange programs like the OWE provide valuable benefits in improving the clinical knowledge and skills of postgraduate obgyn trainees. [ABSTRACT FROM AUTHOR]

Gynecologic cancers remain a frequent and deadly diagnosis. Historically, treatment has focused on a “one size fits all” approach, but there is an urgent need for more personal medicine. Hence, to enhance personal medicine, new biomarkers are needed. Samples from the Danish Cancer Biobank (DCB) may be well‐suited for biomarker studies, as the biobank contains samples from more than 100.000 cancer patients, and the samples are annotated with pre‐analytical variables. The aim of this study was to investigate if the recorded pre‐analytical variables indicate the gynecologic tissue in DCB are suited for biomarker studies. Data on processing time, transport time, and registration‐ and verification status were extracted from all patients with a gynecologic tissue sample collected between 2020 and 2022 in DCB. The mean processing time across centers was found to be 1.03 h (SD = 0.71), and the mean transport time was found to be 0.32 h (SD = 0.70). In total, 69% of the tissue samples were pathologically examined, and 91.5% of the pathologically examined samples were found to be concordant with the patient's final diagnosis. While differences were observed, 98% of the samples were processed within 3 h, indicating the majority of gynecologic tissue samples in DCB are of high quality and optimal for biomarker studies. [ABSTRACT FROM AUTHOR]

Introduction: With the growing population of pancreas transplant recipients followed long‐term, some female recipients are going to require surgical intervention for gynecologic symptoms and pathologies. Currently, there is a lack of literature describing how to approach this population and whether pelvic gynecologic procedures (GYN) can be performed safely given the proximity of the pancreatic (and possibly renal) allograft. In this single‐center retrospective analysis, all pancreas transplant recipients that subsequently underwent GYN were reviewed. Methods: Subjects were identified by cross‐referencing all pancreas transplants performed between January 2003 and December 2022 for any subsequent GYN. Demographics at transplant and GYN, indications and procedure performed, operative time, presence and involvement of a transplant surgeon, complications length of stay, and readmissions were reviewed. Results: Seventeen patients who underwent a total of 19 GYN after pancreas transplantation were identified. Operations performed included tubal ligation (n = 2), total abdominal hysterectomy with (n = 6) or without bilateral salpingectomy (n = 2), oophorectomy versus cyst drainage (n = 2), bilateral oophorectomy (n = 1), and unilateral (n = 4) versus bilateral (n = 2) salpingectomy. Four were performed through an open laparotomy and 15 were performed laparoscopically. In 11 cases, a transplant surgeon was involved intra‐operatively. Eight of the 17 patients developed post‐operative complications including post‐operative fevers, fluid overload, neutropenia, elevated creatinine (n = 2), nephrolithiasis, urinary tract infection, and incisional hernia. Five required readmission. Conclusion: GYN can be performed safely following pancreas transplantation, but careful planning and the involvement of the transplant surgery team are advised. [ABSTRACT FROM AUTHOR]

This study aimed to assess the mental health and quality of life (QOL) in gynaecological cancer patients, and to identify key risk factors for improved management. In addition, during a period of reduced impact of a novel coronavirus (COVID-19) infection, we sought to examine its current impact on mental health and QOL. A cross-sectional study was conducted among 175 gynaecological cancer patients. The survey assessed QOL (The World Health Organization Quality of Life-Bref, anxiety and depression (Hospital Anxiety and Depression Scale (HADS)). Multivariable linear regression was used for analysis. Being diagnosed in the last one year was associated with higher HADS depression score (p < 0.001) and recurrence was associated with both higher HADS anxiety and depression scores (p = 0.004 and p < 0.001). Age ≤60 years old was a significant negative predictor for psychological health (p = 0.002) and overall QOL (p = 0.017). Complications during surgery were identified as a significant negative predictor affecting psychological health (p = 0.018), but did not affect the other domains. Disease recurrence was observed to significantly influence QOL scores in physical health (p = 0.014) and overall QOL (p < 0.001). This study highlights that recurrence has a significant impact on mental health and QOL of gynaecological cancer patients. Patients diagnosed within last year should be carefully assessed for risk of depression. Younger patients and those with surgical complications may experience reduced QOL. Importantly, COVID-19 showed no apparent negative impact on the mental health or QOL in these patients, which is no longer considered a significant contributor to adverse effects. [ABSTRACT FROM AUTHOR]

The most frequent benign gynecological tumor in women who are fertile, uterine myoma significantly lowers quality of life. Endoplasmic reticulum stress (ERS) and oxidative stress (OS) play a role in the development of numerous disease states, including gynecological disorders. In order to determine the ERS and OS levels activated in women with uterine myoma, we sought to measure Total Oxidant Status (TOS) level, Glucose regulatory protein 78 (GRP78), C/EBP homologous protein (CHOP) expression, and protein levels. A total of 40 women with uterine myomas and 40 healthy women were included in the study. Serum levels of TOS, GRP78, CHOP, and protein levels were determined using an enzyme-linked immunosorbent assay (ELISA) kit. Reverse transcription polymerase chain reaction (RT-PCR) performed the mRNA levels of endoplasmic reticulum stress-associated molecules GRP78 and CHOP. The TOS levels, GRP78 and CHOP protein levels were significantly higher in women with myomas than in the controls, with values of p = 0.009, p = 0.001, and p = 0.0001, respectively. GRP78 and CHOP expression increased in women with myomas and were significantly higher than the control group used (p < 0.05). ROC curve analysis showed that GRP78 and CHOP are promising biomarkers for uterine myomas (area under the curve (AUC): 0.953, AUC: 0.969, p < 0.001, respectively). Oxidative and ERS may play a vital role in the pathophysiology of the disease due to the increased levels of oxidative and ERS markers in women with uterine myomas. [ABSTRACT FROM AUTHOR]

Introduction: Gynecological primary care is a public health issue, however, there is no French data on the transmasculine population, despite identified needs and a low coverage rate described in the international literature. The objective was to analyze the access of the French transmasculine population to gynecological primary care. Methods: The study "Trans men and Transmasculine non-binary individuals use and access to prevention and sexual health care 2022" is a non-interventional, self-administrated, anonymous online study targeting transmasculine adults living in France. Participants were recruited via social networks, LGBTQIA + associations, the FPATH and a caregivers network Results: A total of 622 surveys were included, the participants were mostly young (mean age: 25 years old), single (77%), students (40%), owners or tenants (73%) and living in large cities (47%). Among them, 77% had a cross-sex hormonal therapy, 41% underwent a torsoplasty and 6% a pelvic surgery. Only 26% of the participants had an up-to-date follow-up, while 40% never had access to a gynecological consultation. Only a quarter (26%) of the 25–65 years old population, targeted by secondary prevention for cervical cancer, had at least one cervical test in their lifetime. Moreover, regarding feedbacks about gynecological follow-up, they expressed its pertinence but also reported a low comfort level. Conclusions: This study highlighted the low access to gynecological primary care of a young transmasculine population in France. There is an urgent need of follow-up within this population, by increasing the education of health professionals and developing prevention programs. [ABSTRACT FROM AUTHOR]

Aim • To explore the influence of online and offline mixed teaching modes based on TPACK on theoretical knowledge and comprehensive ability of tumor gynecology postgraduates. Methods • In this study, a prospective randomized controlled study model was used to select 60 masters of oncology and gynecology who were interned in the Affiliated Hospital of the First Affiliated Hospital of Bengbu Medical College from September 2019 to April 2022 as the research objects. They were divided into a study group and a control group by random number table, with 30 cases in each group. The control group adopted the traditional teaching mode, while the study group adopted the mixed online and offline teaching mode based on TPACK to implement the teaching. The knowledge mastery, problem analysis ability and total ability of the two groups were compared before and after the practice. Results • After the practice, the scores of theoretical knowledge, clinical operation skills and case analysis ability of both groups were improved compared with those before the practice, and the scores of the study group were higher than those of the control group (P < .05). After practice, the scores of problem analysis and clinical work competence in both groups were significantly higher than those before practice, and the study group was higher than the control group (P < .05). After practice, the scores of professional technical knowledge, doctor-patient communication ability, clinical operation skill, disease observation ability and clinical first-aid ability of both groups were improved compared with those before practice, and the scores of the study group were higher than those of the control group (P < .05). Conclusion • In clinical teaching, the online and offline mixed teaching mode based on TPACK has obvious effects on improving the theoretical and clinical operation level of tumor gynecology postgraduates and the total ability of medical staff. [ABSTRACT FROM AUTHOR]

Ectopic pregnancy (EP) is the leading cause of maternal morbidity and mortality in the first trimester. Using an untargeted metabolomic approach, we sought to identify putative plasma biomarkers using tandem liquid chromatography–mass spectrometry for the detection of tubal EP. This case-control study included the prospective recruitment of 50 tubal EP cases and 50 early intrauterine pregnancy controls. To avoid over-fitting, logistic regression models were developed in a randomly selected discovery group (30 cases vs. 30 controls) and validated in the test group (20 cases vs. 20 controls). In total, 585 mass spectral features were detected, of which 221 molecular features were significantly altered in EP plasma (p < 0.05). Molecular networking and metabolite identification was employed using the Global Natural Products Social Molecular Networking (GNPS) database, which identified 97 metabolites at a high confidence level. Top significant metabolites include subclasses of sphingolipids, carnitines, glycerophosphocholines, and tryptophan metabolism. The top regression model, consisting of D-erythro-sphingosine and oleoyl-carnitine, was validated in a test group and achieved an area under receiving operating curve (AUC) (95% CI) = 0.962 (0.910–1) with a sensitivity of 100% and specificity of 95.9%. Metabolite alterations indicate alterations related to inflammation and abnormal placentation in EP. The validation of these metabolite biomarkers in the future could potentially result in improved early diagnosis. [ABSTRACT FROM AUTHOR]

Simple Summary: Established in 2002, the Korean Gynecologic Oncology Group (KGOG) has presented improved clinical outcomes based on multi-center clinical trials. To date, KGOG has approved 156 studies and published 68 KGOG-led studies. The organization aims to advance gynecologic cancer research through sustained efforts and international collaboration. The Korean Gynecologic Oncology Group (KGOG) was established in 2002 and is the only organization in Korea conducting multi-center clinical trials for gynecologic cancers. Since its re-establishment as a non-profit organization in 2021, KGOG has grown significantly, now including 207 gynecologic oncology specialists from 76 hospitals. This growth is a testament to the dedication and hard work of all those involved in the organization. KGOG is committed to maximizing the activation of multi-center clinical research through policies that support patients with rare diseases and gynecologic cancer research, focusing on strengthening institutional capacity, equalizing participation opportunities, and enhancing information sharing. A significant milestone for KGOG was becoming a member of the US Gynecologic Oncology Group (GOG) in 2005, allowing participation in GOG clinical trials. KGOG later joined the Gynecologic Cancer InterGroup (GCIG) and strengthened its capabilities by hosting the first Endometrial Cancer Consensus Conference—Clinical Research (ECCC-CR) in 2023. KGOG holds biannual meetings and symposia, as well as 224 operating committee meetings annually to review the discussions of the Tumor Site Committee. KGOG has conducted 156 investigator-initiated trial (IIT) or sponsor-initiated trial (SIT) studies as KGOG-led or participated in research. Currently, 18 studies are registered, and 10 are in preparation. To date, 68 papers have been published. KGOG conducts six national projects and collaborates with external organizations such as the NRG Oncology Foundation, Gynecologic Oncology Group Partners (GOG-P), GCIG, East Asian Gynecologic Oncology Trial group (EAGOT), and the Japanese Gynecologic Oncology Group (JGOG). Through collaboration with renowned international research institutions, KGOG has significantly expanded the scope of its research, achieving noteworthy clinical outcomes. This report not only introduces the history and recent status of KGOG but also presents the exciting future direction of the organization, filled with potential breakthroughs and advancements in gynecologic oncology research. [ABSTRACT FROM AUTHOR]

Objective: To assess the appropriateness of hysterectomies performed at a large tertiary health system using the 1997 RAND appropriateness classification system and an updated algorithm. Design: We abstracted structured and unstructured data from electronic medical records on patient demographics, primary indication(s) for hysterectomy, diagnosis codes associated with the hysterectomy, previous treatments, and laboratory results. Subjects: Patients aged 18–44 years. Exposure: Receipt of hysterectomy for benign and nonobstetric conditions from October 2014 to December 2017. Main Outcome Measures: Using these data, we provided a RAND-based (dichotomous: inappropriate/appropriate) and Wright-based (3-level: inappropriate/ambiguous/appropriate) appropriateness rating and characterized missing information patterns associated with inappropriate ratings. Results: We analyzed 1,829 hysterectomies across 30 nonmutually exclusive primary indications for surgery. Nearly a third (32.8%) of surgeries had only one primary indication for surgery. Using the RAND-based classifier, 31.3% of hysterectomies were rated as appropriate and 68.7% as inappropriate. Using the Wright-based algorithm, 58.1% of hysterectomies were rated as appropriate, 15.7% as ambiguous, and 26.2% as inappropriate. Missing information on diagnostic procedures was the most common characteristic related to both RAND-based (46.1%) and Wright-based (51.2%) inappropriate ratings. Conclusions: The 1997 RAND classification lacked guidance for several contemporary indications, including gender-affirming care. RAND also has an outdated requirement for diagnostic surgeries such as laparoscopies, which have decreased in practice as diagnostic imaging has improved. Sensitivity analyses suggest that inappropriate surgeries cannot all be attributed to bias from missing electronic medical record data. Accurately documenting care delivery for benign gynecological conditions is key to ensuring quality and equity in gynecological care. [ABSTRACT FROM AUTHOR]

Aims: Our research aims to shed light on the connection between histopathological differences that affect the prognosis of endometrial cancer and Doppler indices measured in the uterine arteries. Methods: Seventy‐four women with a confirmed diagnosis of endometrial cancer participated in this prospective study. The flow characteristics of the bilateral uterine arteries were evaluated and recorded using color Doppler sonography. After hysterectomy, a correlation analysis was performed between these factors and histological findings. Results: Patients who complained of menometrorrhagia had significantly higher uterine artery peak systolic flow (p = 0.020) than those who had postmenopausal vaginal bleeding. Endometrioid adenocarcinoma was the most common type (71.4%). Doppler pulsatility index and resistance index in the uterine arteries didn't show statistically significant differences between histologic subtypes, tumor grade, myometrial invasion, lymphovascular invasion, lymph node involvement, malignant peritoneal cytology, genetic mutation, or extrauterine involvement. Those without cervical involvement had higher uterine artery Doppler peak systolic flow/end diastolic flow (p = 0.024). Conclusions: Endometrial cancer made uterine artery, myometrium and endometrium less resistant to blood flow. However, these blood flow indices have not been standardized enough to be utilized as diagnostic tests just yet. Standardization based on more advanced studies would make it possible to use ultrasonography for non‐invasive diagnosis and would accelerate and facilitate clinical management. [ABSTRACT FROM AUTHOR]

Objective: Bullying is common in medical specialist training in Australia. To understand bullying rates across medical specialist training programs, we analyse the recent Medical Training Survey, administered by the Medical Board of Australia to all registered medical practitioners. Methods: Medical Training Survey data were extracted and averaged from 2020 to 2023. Results: Many speciality trainees reported personally experiencing or witnessing bullying. This was lowest in general practice (13% personally experienced and 15% witnessed) and highest in obstetrics and gynaecology (27% and 41%). The highest rate of bullying by supervisors was in surgery: 60% of surgical trainees stated that when they were bullied it was by their supervisor. Within psychiatry, 22% of trainees had personally experienced bullying and 32% of trainees had witnessed bullying. When they were bullied, the perpetrator was less commonly a supervisor (40%). In all specialities, there was a very low percentage of bullying which was reported, and was identified as having a satisfactory outcome: the most satisfactory outcomes (13%) were in general practice. Conclusion: Current rates of bullying for medical specialist trainees, the reluctance to report, as well as the lack of satisfactory outcomes, is of grave concern for Australian healthcare. This requires urgent attention at a systems level. [ABSTRACT FROM AUTHOR]

Introduction: The emergence of handheld ultrasound devices capable of connecting to cell phones or tablets heralds a significant advancement in medical technology, particularly within the field of obstetrics. These devices offer the promise of immediate bedside ultrasound examinations, potentially revolutionizing patient care by enabling fetal assessments in diverse settings. Material and Methods: This prospective study aimed to validate the reliability of non‐piezo, chip‐based handheld ultrasound devices in clinical obstetric practice. Conducted in a university hospital obstetric ward, the study included 100 pregnant women between 17 and 41 weeks of gestation. Participants underwent ultrasound examinations using both conventional and portable point‐of‐care ultrasound (POCUS) devices to compare the accuracy in estimating fetal weight and other parameters, such as cardiac activity, fetal presentation, placental location, and amniotic fluid volume. The reliability and agreement between the devices were assessed using intraclass correlation coefficients, Bland–Altman plots, and Pearson correlation coefficients. Results: The results show a near‐perfect agreement (0.98) and correlation (r = 0.98, p < 0.001) for estimated fetal weight and most biometry measurements between the two types of ultrasound devices, with slight deviations in head circumference and amniotic fluid index measurements. Subgroup analysis revealed variations in agreement and correlation rates with higher BMI and advanced gestational age, indicating areas for further refinement. Conclusions: These findings affirm the high reliability of handheld ultrasound devices for basic obstetric ultrasound evaluations, supporting their integration into daily clinical practice. This technology improves the flexibility and immediacy of prenatal care, although further research is needed to optimize its application across patient populations and treatment settings. [ABSTRACT FROM AUTHOR]

Objective: Global variations in women's health outcomes, increased international migration, and an increase in the number of medical schools underpin the need for global standardization in obstetrics and gynecology curricula for medical students. However, there are currently no recommendations regarding the content of a common curriculum. The aim of this project was to agree the objectives for a common curriculum in obstetrics and gynecology for medical students globally. Methods: The curriculum was developed and agreed by an international taskforce of obstetricians and gynecologists. Published curricula for medical students in a variety of regions globally were reviewed and discussed, and the objectives for a common curriculum in obstetrics and gynecology for medical students were agreed by consensus. Results: The content of the proposed curriculum is classified into three domains: clinical skills, professional behaviors, and knowledge. The recommended curriculum covers health conditions that affect women globally in different social and cultural contexts, and addresses important global health issues of relevance to obstetrics and gynecology. Conclusion: The methods and outcomes of a project by an international taskforce of obstetricians and gynecologists to develop a common curriculum in obstetrics and gynecology for medical students globally are presented. More work is required to identify ways in which the curriculum may be adapted to a minimum essential required curriculum in times of man‐made or natural disasters. Achieving these will facilitate the intended long‐term aims of this curriculum, to improve women's health outcomes globally. Synopsis: This article describes the methods and outcomes of a project by an international taskforce to develop a common curriculum in O&G for medical students globally. [ABSTRACT FROM AUTHOR]

Cisgender women and transgender men are less likely to be assessed for PrEP eligibility, prescribed PrEP, or retained in PrEP care. Thus, this pilot PrEP educational intervention was tailored for healthcare providers (HCPs) in obstetrics/gynecology who provide care to cisgender women and transgender men in an academically-affiliated, public hospital women's health clinic. The three-lecture educational curriculum designed for HCPs focused on PrEP eligibility and counseling, formulations and adherence, and prescription and payment assistance programs. Pre- and post-intervention surveys assessed HCP knowledge and barriers to PrEP counseling and prescription. Among n = 49 participants (mean age = 32.8 years; 85.7% cisgender women, mean years practicing = 4.2 years) pre-intervention, 8.7% had prior PrEP training and 61.2% felt very/somewhat uncomfortable prescribing PrEP. Post-intervention, knowledge of PrEP contraindications, eligibility, follow-up care, and assistance programs all increased. HCPs identified key barriers to PrEP care including lack of a dedicated PrEP navigator, culturally and linguistically appropriate patient materials on PrEP resources/costs, and PrEP-related content integrated into EHRs. Ongoing PrEP educational sessions can provide opportunities to practice PrEP counseling, including information on financial assistance. At the institutional level, incorporating PrEP screening in routine clinical practice via EMR prompts, facilitating PrEP medication monitoring, and enhancing telehealth for follow-up care could enhance PrEP prescription. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusion In the current study, we aimed to establish a quantified scoring system for evaluating consultation quality. Subsequently, using the score system to assess the quality of ChatGPT‐4 consultations, we compared them with physician consultations when presented with the same clinical cases from obstetrics and gynecology.This study was conducted in the Women and Children's Hospital of Chongqing Medical University, a tertiary‐care hospital with approximately 16 000–20 000 deliveries and 8500–12 000 gynecologic surgeries per year. The detailed data from obstetric and gynecologic medical records were analyzed by ChatGPT‐4 and physicians; the consultation opinions were then generated respectively. All consultation opinions were graded by eight junior doctors using the novel score system; subsequently, the correlation, agreement, and comparison between the two types of consultation opinions were then evaluated.A total of 100 medical records from obstetrics and 100 medical records from gynecology were randomly selected. Pearson correlation analysis suggested a noncorrelation or weak correlation between consultations from ChatGPT‐4 and physicians. Bland–Altman plot showed an unacceptable agreement between the two types of consultation opinions. Paired t tests showed that the scores of physician consultations were significantly higher than those generated by ChatGPT‐4 in both obstetric and gynecologic patients.At present, ChatGPT‐4 may not be a substitute for physicians in consultations for obstetric and gynecologic patients. Therefore, it is crucial to pay careful attention and conduct ongoing evaluations to ensure the quality of consultation opinions generated by ChatGPT‐4. [ABSTRACT FROM AUTHOR]

Background: The onset of menopause leads to diminished estrogen exposure, resulting in a high morbidity burden related to menopausal symptoms. Menopausal hormonal therapy is an effective therapy that offers more advantages than disadvantages for women aged less than 60 years or who have had menopause for less than 10 years. Objective: This study aimed to assess the prevalence of menopausal symptoms, identify factors associated with menopausal symptoms, and assess the use of menopausal hormone therapy among women aged 40–60 who visited the gynecological clinics of three hospitals in Addis Ababa, Ethiopia. Methods: A facility-based cross-sectional study was conducted from January 2022 to June 2022 at Gandhi Memorial Hospital, Tikur Anbessa Hospital, and Zewditu Memorial Hospital on 296 middle-aged women. Data were collected using an interviewer-administered structured questionnaire and analyzed for sociodemographic factors, utilization of menopausal hormone therapy, and prevalence of menopausal symptoms using the menopause rating scale. Data were analyzed using SPSS version 25. Bivariate and multivariate logistic regression analyses were performed to identify independent predictors of each subscale of menopausal symptoms. The strength of the association was measured using odds ratios with 95% confidence intervals, and statistical significance was set at a value of P < 0.05. Result: The prevalence of menopausal symptoms was 89.9%. According to the menopausal rating scale, the frequency of reported symptoms was hot flushes (54.7%), muscle and joint pain (32.1%) on the somatic subscale; physical and mental exhaustion (55.1%), irritability (48.6%) on psychological subscale; and sexual problems (41.3%), bladder problems (39.2%) on urogenital subscale. This study also showed that the age of women [aOR: 0.317, 95%CI (0.102, 0.990)], and monthly family income [aOR = 0.182, 95% CI (0.041, 0.912)] were significantly associated with somatic menopausal symptoms. There was no utilization of menopausal hormonal therapy to treat menopausal symptoms and to prevent complications. Conclusion: The prevalence of menopausal symptoms is high; however, the utilization of individualized administration of menopausal hormone therapy according to symptoms is negligible. It appears essential for these institutions to work on service availability and delivery of menopausal hormone therapy for those in need of wider benefits for their clients. [ABSTRACT FROM AUTHOR]

Background: Retaining midwives and registered nurses in the Obstetrics and Gynecology department/unit (OB/GYN) is not just a matter of organizational effectiveness and financial wellness. It's a crucial aspect of ensuring quality healthcare delivery. This study aimed to discuss the degree to which midwives and nurses in OB/GYN departments are structurally empowered, resilient, and committed to remaining at the organizations and to examine whether nurses' and midwives'sense of structural empowerment and resilience is a good predictor of their decision to stay with the organization. Methods: This study employed a unique convergent parallel mixed methods approach. The research was conducted in two distinct phases. The first phase involved a cross-sectional quantitative survey with a convenience sample of 200 midwives and nurses in OB/GYN departments. The second phase was a qualitative study utilizing semi-structured, open-ended interviews. Eighteen nurses and midwives, specifically chosen as the target population, were invited to participate in individual interviews. The data collection took place at three major hospitals in Saudi Arabia, starting in January 2023 and concluding in February 2023. Results: The study results revealed that structural empowerment and resilience were statistically significant predictors of the intent to stay in the organization (F = 35.216, p < 0.001), with 26.3% variation, the structural empowerment is higher predictor (β = 0.486, p < 0.000) to intent to stay if compared to resilience (β = 0.215, p < 0.008). Five major themes emerged from the narratives of the nurses and midwives: the nurturing of the physical and physiological, the development of the psychological, the managing finances, the restructuring of the organization, and the enrichment of the professional and occupational. Conclusion: The study's findings have significant implications for healthcare organizations. They highlight the importance of cultivating a culture of empowerment and resilience, which can serve as a powerful tool to encourage registered nurses and midwives to remain in their organizations. This insight empowers healthcare administrators, human resource managers, and obstetrics and gynecology professionals to take proactive steps toward improving retention rates. [ABSTRACT FROM AUTHOR]

Background: During gynecological laparoscopic surgery, pneumoperitoneum and the Trendelenburg position (TP) can lead to increased intracranial pressure (ICP). However, it remains unclear whether perioperative fluid therapy impacts ICP. The purpose of this research was to evaluate the impact of restrictive fluid (RF) therapy versus conventional fluid (CF) therapy on ICP in gynecological laparoscopic surgery patients by measuring the ratio of the optic nerve sheath diameter (ONSD) to the eyeball transverse diameter (ETD) using ultrasound. Methods: Sixty-four patients who were scheduled for laparoscopic gynecological surgery were randomly assigned to the CF group or the RF group. The main outcomes were differences in the ONSD/ETD ratios between the groups at predetermined time points. The secondary outcomes were intraoperative circulatory parameters (including mean arterial pressure, heart rate, and urine volume changes) and postoperative recovery indicators (including extubation time, length of post-anaesthesia care unit stay, postoperative complications, and length of hospital stay). Results: There were no statistically significant differences in the ONSD/ETD ratio and the ONSD over time between the two groups (all p > 0.05). From T2 to T4, the ONSD/ETD ratio and the ONSD in both groups were higher than T1 (all p < 0.001). From T1 to T2, the ONSD/ETD ratio in both groups increased by 14.3%. However, the extubation time in the RF group was shorter than in the CF group [median difference (95% CI) -11(-21 to -2) min, p = 0.027]. There were no differences in the other secondary outcomes. Conclusion: In patients undergoing laparoscopic gynecological surgery, RF did not significantly lower the ONSD/ETD ratio but did shorten the tracheal extubation time, when compared to CF. Trial registration: ChiCTR2300079284. Registered on December 29, 2023. [ABSTRACT FROM AUTHOR]

Acute intermittent porphyria (AIP) is a rare metabolic disorder primarily caused by a deficiency in hydroxymethylbilane synthase (HMBS), which severely impairs heme biosynthesis. AIP is characterized by severe abdominal pain and neurological symptoms, with acute attacks potentially leading to serious complications and life-threatening conditions. Although the prevalence of AIP is low, patients experience a significant decline in quality of life and bear considerable psychological burden, warranting close clinical attention. Diagnosis of AIP primarily relies on laboratory testing. Preventive and therapeutic strategies include avoidance of triggering factors, heme replacement therapy, and hormonal regulation. gonadotropin-releasing hormone agonists (GnRH-a) and hormone replacement therapy have shown efficacy in managing AIP attacks associated with the menstrual cycle, but close monitoring is necessary to mitigate adverse effects. This article reviews the pathophysiology, clinical features, and diagnostic approach of AIP, and explores its prevention and treatment strategies. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the level of awareness of sexual reproductive health and rights (SRHR) among the members of the Japan Society of Obstetrics and Gynecology (JSOG) and identify what the JSOG should do to address SRHR issues. Methods: A survey questionnaire on JSOG members' awareness of SRHR and what the JSOG should address regarding SRHR was administered in 2019 and 2023. Changes in awareness and the issues that should be addressed from the first to the second survey were evaluated. Results: Seven hundred twelve members responded to the first survey and 506 to the second. Response rates were 4.2% and 2.9%, respectively. There was a significant increase in the number of respondents in the second survey who were aware of sexual reproductive health (SRH) and Sustainable Development Goals (SDGs) compared with the first survey (SRH: 72.6%–86.4%; SDGs: 33.8%–86.4%). Most respondents agreed that SRHR should be promoted. In the first survey, cervical cancer was the most important issue, followed by women's right to self‐determination and family planning/contraception. In the second survey, women's right to self‐determination was the most important issue. Several free responses highlighted the importance of comprehensive sexuality education as a significant concern for SRHR. Conclusion: Between 2019 and 2023, the level of awareness of SRHR among JSOG members increased. The identification of SRHR issues that should be addressed by the JSOG was confirmed. The JSOG and individual obstetricians and gynecologists are responsible for being involved in achieving SRHR. [ABSTRACT FROM AUTHOR]

Aim: This study aims to investigate the impact of integrating molecular and histopathological findings into the revised International Federation of Gynecology and Obstetrics (FIGO) 2023 staging system on patients initially diagnosed with stage I endometrial cancer (EC) according to the FIGO 2009 criteria. Methods: A cohort of 197 EC patients, initially classified as stage I under FIGO 2009, underwent restaging based on the updated FIGO 2023 criteria. The patients' molecular and histopathological characteristics were documented, and their impact on upstaging was analyzed. Results: Molecular profiling was conducted for 81.2% (160/197) of the patients, revealing that 55.3% (109/197) were classified as non‐specific molecular profile, 14.7% (29/197) as mismatch repair deficiency, 11.2% (22/197) as p53 abnormality (p53abn), and 18.8% (37/197) as unknown. Upstaging was identified in 26.9% (43/160) of the 160 patients with known molecular profiles. Among the upstaged patients, 51.2% experienced upstaging due to p53 abnormality, 20.9% due to substantial lymphovascular space invasion (LVSI), 20.9% due to aggressive histological types, and 6.9% due to high grade. Conclusions: The introduction of the molecular profile into the revised FIGO 2023 staging system for stage I EC has led to notable changes in the staging of approximately one‐fifth of patients. While p53 abnormalities have emerged as the most influential factor contributing to the upstaging, LVSI and aggressive histological types also represent significant contributing factors. [ABSTRACT FROM AUTHOR]

Background: Despite physical and emotional distress in patients with gynecologic malignancies, palliative care (PC) is underutilized. Objectives: We characterize referral practices, symptom burden and functional status at the time of initial PC encounter for patients with gynecologic cancer. Design: Data were extracted from the standardized Quality Data Collection Tool for Palliative Care (QDACT-PC). We describe symptom burden and performance status. Results: At initial specialty PC encounter, patients with gynecologic cancers reported a mean of 3.3 moderate/severe symptoms. Outpatients experienced the most moderate/severe symptoms (mean 3.9) versus inpatient (mean 2.1) or home (mean 1.5). A total of 72.7% of patients had significantly impaired functional status (palliative performance scale [PPS] <70) at initial encounter. Inpatients had a more impaired functional status (mean PPS 48.8) than outpatients (mean PPS 67.0). Conclusions: The symptom burden for gynecologic cancer patients at initial PC encounter is high. Despite better functional status, patients referred in the outpatient setting had the highest symptom burden. [ABSTRACT FROM AUTHOR]

Intraoperative laparoscopic ultrasound (IOLUS), a dynamic imaging technique, has emerged as a valuable instrument for guiding surgery in various medical specialties. As IOLUS provides accuracy, improved visualization, and real-time guidance, the integration of IOLUS into many surgical procedures has occurred and IOLUS assists surgeons during advanced procedures. Today, laparoscopic myomectomy has become a prominent surgical procedure in gynecology. Despite its benefits, laparoscopic myomectomy presents certain challenges. The risk of residual fibroids is higher in laparoscopic myomectomy compared to abdominal surgery. The limited depth perception and restricted range of motion can also be obstacles for surgeons, especially when dealing with deeply embedded fibroids. IOLUS has the potential to overcome these limitations. In this study, our aim was to conduct a review of the literature concerning the use of IOLUS during laparoscopic myomectomy. [ABSTRACT FROM AUTHOR]

Objective: To determine the reliability of the Carousel simulator in medical education for obstetric examinations. Cervical dilation examination training in pregnant women exposes patients to additional uncomfortable and health‐risk procedures, a gold standard, and does not objectively evaluate the medical student's competence. Method: We studied the reliability of training internship medical students in obstetrics. Participating students were assigned to take the examination of digital assessment of the cervical dilation on the simulator. Classes performed 12 consecutive randomly blind predetermined cervical dilation examinations using the Carousel simulator. The exact answer and the answer with certainty within ±1 cm were registered and analyzed. Incorrect or outlier answers were considered with a cutoff of ≥2 cm from the dilation. A dispersion graph for each centimeter of dilation simulation was constructed. Results: Sixty‐six medical obstetricians took part, performing 396 examinations. Thus, we observed 49 outliers (12.37%) in simulated assessments. According to the analysis, we did not observe outliers from dilation 1 to 4 cm; dilation 7 to 9 cm had a higher index of outlier measurements. We did not consider any dilation simulation dispersion graphic as a null correlation. A strong correlation was seen in the dilation 1 to 6 cm and the dilation 10 cm. The dilations 7, 8, and 9 cm showed a weak correlation. Conclusion: The Carousel simulator model is a reliable method for student learning. The simulator is an essential study tool capable of reducing the embarrassment and possible harm caused by the excessive and repetitive number of in vivo digital vaginal examinations. Novel studies are proposed to improve the simulator device and method, mainly to estimate the adequate repetitions and training needed before in vivo practice. Synopsis: We demonstrated the reliability of a novel simulator device used for digital vaginal examination of cervical dilation during labor for medical education. [ABSTRACT FROM AUTHOR]

Just like all aspects of the American experience, racism has had a significant presence in Obstetrics and Gynecology (OBGYN). Black physicians in OBGYN face unique challenges in training programs, having to learn a specialty while combating racial macroaggression and microaggressions constantly and, often, in isolation. We present the stories of black OBGYNs who have sustained such an experience while also offering equitable and actionable solutions to improve clinical training environments. [ABSTRACT FROM AUTHOR]

We sought to determine the subspecialty interests of fourth-year medical students (MS4s) matched to Ob/Gyn and evaluate their attitudes towards residency tracking. Matched MS4s completed a survey regarding subspecialization, confidence in that choice, and desire for tracking. A total of 922 MS4s completed the survey. Of these, 474 (51.4%) desired subspecialty training, but were less confident in their choice compared with those desiring generalist careers (60.0/100 vs. 64.9/100, P =0.003). Those seeking subspecialty training were more likely to desire tracking (15.2% vs. 39.5%, P<0.001). In conclusion, 51% of MS4s desired subspecialty training over generalist careers. Almost 40% of these students are interested in tracking. [ABSTRACT FROM AUTHOR]

Gender inequity persists in academic medicine. This article reviews the historical context, ongoing leadership challenges, and societal biases. The persistent barriers to gender equity in leadership roles, pay, and professional recognition are considered through the lens of obstetrics and gynecology where these issues persist despite a significant presence of women in the field. The impact of gender stereotypes, the role of intersectionality, and the need for systemic change are evident. Embracing diverse leadership styles and creating inclusive pathways to leadership will help actualize the potential benefits of a genderdiverse workforce, enhancing health care outcomes and fostering innovation. [ABSTRACT FROM AUTHOR]

This article aims to describe contemporary parental leave among obstetrics and gynecology trainees and early-career faculty. Here, we present results of a survey that collected information about parental leave policies and contemporary practice, as well as beliefs about surgical and clinical experience for those who take leave. Faculty and trainees were equally well represented among respondents, with half of each group self-identifying as a parent. Most reported that childbearing trainees currently take 6 weeks or less of parental leave and believed that childbearing and nonchildbearing residents should be able to take 12 weeks of leave without extending training. [ABSTRACT FROM AUTHOR]

Continuous professional development (CPD) in health care refers to the process of lifelong learning including the acquisition of new competencies, knowledge, and professional growth throughout the career of a health care professional. Since implementation, there has seen little change or innovation in CPD. This perspective will review the current state of CPD, including the challenges in traditional CPD models, foundations and strategies for redesign to meet the needs of current and future physicians, and suggestions for changes to modernize CPD. Precision education and the use of technology, including artificial intelligence, and their application to CPD will be discussed. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the epidemiological characteristics and antibiotic resistance patterns of Ureaplasma urealyticum (UU) infection among women and children in southwest China. Methods: A total of 8,934 specimens, including urogenital swabs and throat swabs were analyzed in this study. All samples were tested using RNA-based Simultaneous Amplification and Testing (SAT) methods. Culture and drug susceptibility tests were performed on UU positive patients. Results: Among the 8,934 patients, the overall positive rate for UU was 47.92%, with a higher prevalence observed among women of reproductive age and neonates. The majority of UU positive outpatients were women of reproductive age (88.03%), while the majority of UU positive inpatients were neonates (93.99%). Overall, hospitalization rates due to UU infection were significantly higher in neonates than in women. Further analysis among neonatal inpatients revealed a higher incidence of preterm birth and low birth weight in UU positive inpatients (52.75% and 3.65%, respectively) than in UU negative inpatients (44.64% and 2.89%, respectively), especially in very preterm and extremely preterm neonates. Moreover, the incidence rate of bronchopulmonary dysplasia (BPD) among hospitalized neonatal patients was significantly higher in the UU positive group (6.89%) than in the UU negative group (4.18%). The drug susceptibility tests of UU in the neonatology, gynecology and obstetrics departments exhibited consistent sensitivity patterns to antibiotics, with high sensitivity to tetracyclines and macrolides, and low sensitivity to fluoroquinolones. Notably, UU samples collected from the neonatology department exhibited significantly higher sensitivity to azithromycin and erythromycin (93.8% and 92.9%, respectively) than those collected from the gynecology and obstetrics departments. Conclusions: This study enhances our understanding of the current epidemiological characteristics and antibiotic resistance patterns of UU infection among women and children in southwest China. These findings can aid in the development of more effective intervention, prevention and treatment strategies for UU infection. [ABSTRACT FROM AUTHOR]

Background: Previous literature has shown that women physicians are less likely to be involved in medical malpractice litigation than male physicians. Methods: This study sought to examine the differences in malpractice experience by provider gender by using closed medical malpractice claims from 2011 through 2020. Results: We found that after adjusting for the number of claims and dollar losses per full time equivalents worked, female physicians experienced fewer and less costly claims than male physicians (p <.001). Specific specialties had a significant relationship between claim frequency and provider gender, which included general surgery (p =.01), obstetrics (p =.001), gynecology (p =.04), internal medicine and family general practice (p <.001). Conclusion: The results from this analysis support the prior findings that male physicians experience a higher rate of malpractice claims. Therefore, there is an opportunity to learn how women providers achieve lower malpractice risk to inform clinical practice recommendations. [ABSTRACT FROM AUTHOR]

Introduction: Neurological disorders in pregnancy pose a major diagnostic challenge as they are a significant contributor to mortality and morbidity in pregnancy. Neurological complications may manifest at any time during pregnancy or puerperium even after what seemed to be a normal pregnancy. A thorough understanding of the patterns of these diseases is essential for prediction and early identification. Aim: To study the aetiology, clinical profile, morbidity and mortality patterns of acute neurological emergencies in postpartum women. Materials and Methods: This hospital- based descriptive study was conducted in the Department of Obstetrics and Gynaecology at Government Vellore Medical College and Hospital, Vellore, Tamil Nadu, India between February 2021 and August 2022. A total of 76 postnatal mothers who met the inclusion criteria were selected using consecutive sampling. Details pertaining to personal, demographic, antenatal risk factors, labour/delivery and postnatal events were recorded using a pretested semistructured questionnaire. The data were entered into Microsoft Excel and analysed using Statistical Package for the Social Sciences (SPSS) 21.0, with the data expressed as frequency and proportion. [ABSTRACT FROM AUTHOR]

This was an age-stratified, retrospective, cohort study of patients between the ages of 65–69, 70–75 and ≥76 years diagnosed with high grade serous ovarian cancer of FIGO (2014) Stage 3a or higher between 01 January 2017 and April 2020. The study aimed to examine and compare patient characteristics, treatments and outcomes, including survival, of elderly patients within a single cancer centre in the south of England. Data collection began in January 2021 and concluded in March 2022. Ninety patients were eligible for the study. A correlation was observed between increasing age and worsening performance status (p = 0.044). Other variables assessed included age at diagnosis and time between decision to treatment, however, there was no evidence of correlations. The majority of patients studied received neoadjuvant chemotherapy followed by cytoreductive surgery as their primary treatment modality, however, 53% of our eldest cohort underwent treatment types that did not involve surgery. Of those who did undergo surgery, there was no observed correlation between age and the rates of complete cyto-reductive surgery, intra-operative complications, admission to High Dependency Unit, or length of hospital stay. Median length of stay across all age groups was 5 days. Patients ≥76 years were more likely to receive singleagent carboplatin (p = 0.009) than dual-agent chemotherapy. There was no increase in chemo-toxicity events with increasing age. While primary cytoreductive surgery is favoured by many gynaecological oncology teams, neoadjuvant chemotherapy still offers a viable treatment alternative for elderly and frail patients with advanced stage ovarian cancer by minimising operative times, reducing admissions to high dependency units and shortening lengths of hospital stay. Geriatric assessments, in combination with performance status, may aid treatment decisions made by the multi-disciplinary team. [ABSTRACT FROM AUTHOR]

Background: Modern management of preeclampsia can be optimized by tailoring the targeted treatment of hypertension to an individual's hemodynamic profile. Growing evidence suggests different phenotypes of preeclampsia, including those with a hyperdynamic profile and those complicated by uteroplacental insufficiency. Fetal growth restriction (FGR) is believed to be a result of uteroplacental insufficiency. There is a paucity of research examining the characteristics of patients with severe preeclampsia who do and who do not develop FGR. We aimed to elucidate which hemodynamic parameters differed between these two groups. Methods: All patients admitted to a single referral center with severe preeclampsia were identified. Patients were included if they had a live birth at 23 weeks of gestation or higher. Multiple gestations and pregnancies complicated by fetal congenital anomalies and/or HELLP syndrome were excluded. FGR was defined as a sonographic estimation of fetal weight (EFW) < 10th percentile or abdominal circumference (AC) < 10th percentile. Results: There were 76% significantly lower odds of overall pulse pressure upon admission for those with severe preeclampsia comorbid with FGR (aOR = 0.24, 95% CI = 0.07–0.83). Advanced gestational age on admission was associated with lower odds of severely abnormal labs and severely elevated diastolic blood pressure in preeclampsia also complicated by FGR. Conclusions: Subtypes of preeclampsia with and without FGR may be hemodynamically evaluated by assessing pulse pressure on admission. [ABSTRACT FROM AUTHOR]

To identify knowledge gaps in business education among obstetrics and gynecology fellows An online anonymous survey was distributed to obstetrics and gynecology subspecialty fellows, including pediatric and adolescent gynecology, minimally invasive gynecologic surgery, and reproductive endocrinology and infertility fellows. Of the 483 fellows who received the questionnaire, 159 completed the surveys, resulting in a response rate of 32.9%. A total of 80 reproductive endocrinology and infertility fellows (50.3%), 47 minimally invasive gynecologic surgery fellows (29.6%), and 32 pediatric and adolescent gynecology (20.1%) fellows completed the survey. Over half reported debt from either undergraduate or medical school (52.2%). Over half (58.5%) reported 0 hours of finance education in their residency or fellowship training. In general, fellows reported relatively higher levels of confidence in nonmedical aspects of business, such as purchasing a home (63.9%), life and disability insurance (57.2%), and making financial plans for the future (57.9%). Conversely, a large portion of fellows reported feeling "not at all confident" in business topics related to the field of medicine, including contract negotiation (24.7%), non-competes (27.1%), relative value units system–based pay (32.0%), general office practice management (58.2%), legal aspects of business (71.8%), accounting and billing (54.4%), and marketing (55.7%). Our survey demonstrates an unmet demand among obstetrics and gynecology fellows to learn topics related to the business of medicine. Knowledge of these topics is critical for those pursuing private practice or academic medicine. Future initiatives should evaluate other subspecialties and prioritize creating a standardized education tool to better prepare trainees entering medical practice. [ABSTRACT FROM AUTHOR]

Aim: To establish cut‐off values for anti‐Müllerian hormone (AMH) and antral follicle count (AFC) in the diagnostic criteria for polycystic ovary syndrome (PCOS) applicable to the Japan Society of Obstetrics and Gynecology (JSOG) 2024 criteria and the Rotterdam/International Evidence‐Based Guideline for the assessment and management of PCOS (IEBG) 2023 criteria based on a nationwide survey, respectively, taking into account age, assays, and structure of the diagnostic criteria. Methods: Data were collected for 986 PCOS cases and 965 control cases using a national survey in Japan and used to establish cut‐off values for AMH and AFC. Results: Serum AMH levels were significantly higher in the PCOS group compared to the control group. Serum AMH showed a significant negative correlation with age and significant positive correlation with AFC in both groups. In multiple regression analysis, serum AMH level was independently affected by AFC and total testosterone. AMH cut‐off values suitable for the JSOG 2024 criteria and the Rotterdam/IEBG 2023 criteria were separately established for the 20–29 and 30–39 years of age groups, respectively, and for Access, Lumipulse and Elecsys/ECLusys, respectively. AFC cut‐off values suitable for the JSOG 2024 criteria and Rotterdam/IEBG 2023 criteria were also established separately. AFC exhibited statistically greater variability than AMH. Conclusion: The serum AMH level is the biochemical representation of ovarian findings in PCOS and considered objective and highly reliable. Therefore, it could serve as a surrogate for AFC as a marker of polycystic ovarian morphology in diagnostic criteria. [ABSTRACT FROM AUTHOR]

The use of hormonal contraception can be considered to aid in the timing of assisted reproductive technology cycles, reduce the risk of ovarian cysts at in vitro fertilization cycle initiation, and optimize visualization before hysteroscopy. [ABSTRACT FROM AUTHOR]

This 10-year retrospective cohort study at a single-center clinic in Germany aimed to analyze the outcomes of endometrial cancer patients and explore the impact of lymphovascular invasion (LV) on patient outcomes and disease-free survival (DFS). Identifying correlations among demographic data, tumor characteristics, treatment modalities, and survival outcomes could enhance patient management and improve survival rates. The study encompassed patients diagnosed and treated for endometrial cancer from January 2010 to December 2020. Clinical and pathological data were extracted from medical records for 311 patients, focusing on variables such as age, histological type, tumor grade, type of surgical treatment, and adjuvant therapies. Survival analysis was conducted using the Kaplan–Meier method and multivariate Cox proportional hazard models to identify factors independently associated with survival. The study demonstrated that lymphovascular invasion significantly impacted survival outcomes on Kaplan–Meier analysis (log-rank p-value = 0.0058). Patients with LV showed a marked decrease in DFS compared to those without LV invasion, with a median DFS of 3.2 years and a hazard ratio of 2.18 (95% CI: 1.56–3.04, p < 0.001). Furthermore, high-grade tumors and p53 positivity were strongly associated with reduced DFS, with hazard ratios of 1.93 (p = 0.001) and 2.11 (p < 0.001), respectively. Patients with distant metastasis exhibited the most significant decline in survival, with a hazard ratio of 5.56 (95% CI: 2.45–10.18, p < 0.001). Despite comprehensive surgical and adjuvant therapies, these high-risk factors dictated poorer outcomes. The presence of lymphovascular invasion, high-grade tumors, and genetic markers like MSI and p53 are pivotal in predicting the course of endometrial cancer. This study underscores the necessity for aggressive management strategies in patients exhibiting these high-risk features to potentially improve prognosis and survival outcomes. The findings advocate for enhanced therapeutic strategies tailored to the biological behavior of the tumor, thereby aiming to elevate the overall survival rates for women diagnosed with endometrial cancer. [ABSTRACT FROM AUTHOR]

A questionnaire-based study was jointly organised by European Board and College of Obstetrics and Gynaecology and European Society of Contraception to evaluate the current status as regards access and quality of care regarding contraception, abortion care, and pre-conceptional counselling and care among the 26 European countries. There are considerable variations among these countries as regards the provision of contraceptive services and abortion care. There is ample room for improvement through European training and education programs. However, the most important difference is the absence of a comprehensive network of healthcare providers in various countries to deliver these services at different points of access. There is notable absence of educational programs and instructional materials tailored specifically for nurses and midwives in several countries. This deficiency impedes the professional development and skills enhancement of these healthcare professionals, potentially compromising the quality of healthcare services provided to women in these countries. [ABSTRACT FROM AUTHOR]

Maternal mortality data and review are important indicators of the effectiveness of maternity healthcare systems and an impetus for action. Recently, a rising incidence of maternal mortality in high income countries has been reported. Various publications have raised concern about data collection methods at country level, as this usually relies mainly on national vital statistics. It is therefore essential that the collected data are complete and accurate and conform to international definitions and disease classification. Accurate data and review can only be truly available when an Enhanced Obstetric Surveillance System is in place. EBCOG calls for action by national societies to work closely with their respective ministries of health to ensure that high quality surveillance systems are in place. [ABSTRACT FROM AUTHOR]

This EBCOG guidance reviews the current and future status of genomics within fetal and maternal medicine. This document addresses the clinical uses of genetic testing in both screening and diagnostic testing prenatally. The role of genomics within fetal and maternal medicine is described. The research and future implications of genetic testing as well as the educational, ethical and economic implications of genomics are discussed. [ABSTRACT FROM AUTHOR]

Preoperative sonographic staging in patients with suspected parametrial endometriosis is essential to plan surgical intervention and anticipate the need for a multidisciplinary approach, and thus optimize surgical outcome. The results of a recent meta‐analysis suggest that there is a need to define more accurately the ultrasonographic criteria for parametrial involvement in endometriosis. This addendum to the International Deep Endometriosis Analysis (IDEA) consensus highlights the sonographic characteristics of the parametrium and identifies ultrasound techniques to diagnose deep endometriosis in this area. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to evaluate the reliability and quality of videos on YouTube about labiaplasty procedures. Material and Methods: A search was carried out on YouTube using the search terms 'labiaplasty' and 'labia minora reduction'. The first 100 videos for each keyword were evaluated and 42 videos were analyzed. The distribution of video types was examined. The videos were scored by a five-member committee using the global quality scale (GQS) and modified DISCERN (mDISCERN) scales. Videos uploaded by physicians and academicians were classified as professional, and patients, commercial entities, and allied health personnel were classified as non-professional groups. Results: The mean mDISCERN score of all videos was 2.29±0.65, while the mean GQS score was 2.75±0.67. When professional and non-professional groups were compared, the mDISCERN and GQS scores were significantly higher in the professional group (p=0.017 and p=0.010, respectively). When surgical technique videos and videos providing information about the disease or surgery were compared, there was a significant difference in video power index (VPI), viewing rate, and number of comments (p=0.001, p=0.001, and p=0.003, respectively), while there was no significant difference in terms of mDISCERN and GQS scores. Weak negative correlations were observed between the mDISCERN score and VPI (rs=-0.326, p=0.037), between the GQS score and viewing rate (rs=-0.392, p=0.010), and between the GQS score and VPI (rs=-0.382, p=0.014). Conclusion: YouTube is not a reliable source of information about labiaplasty. Low-quality videos receive more engagement. Obstetrics and gynecology associations should produce content on YouTube about this subject. [ABSTRACT FROM AUTHOR]

Objective: To perform a scoping review of the literature in which ultrasound elastography (UE) has been used in benign gynecology and identify avenues for its use in future research and clinical implementations. Methods: A structured search of EMBASE, Medline and Cochrane databases was conducted (last search date April 15th, 2022). Eligible studies included adult participants with female pelvic anatomy. English language papers focusing on the utility of ultrasound elastography applied to benign gynecology were included. Narrative reviews, conference abstracts, and letters to the editor were excluded. Two independent reviewers screened titles and abstracts for inclusion, a third reviewer was consulted in cases of disagreement. Study quality was assessed by a checklist for study implementation and elastography technique. Extracted data included elastography technology, gynecologic application, opportunities for clinical implementation, and strengths and limitations. Results: The search returned 2026 studies. A total of 40 studies, published between 2013 and 2022, were retained for data extraction. Studies most frequently used shear wave elastography as the method of UE (n = 23), followed by strain elastography (n = 13) and acoustic radiation force impulse (n = 4). Most common clinical applications for UE were the diagnosis of adenomyosis and uterine fibroids (27.5%), assessment of pelvic floor muscle function (22.5%), and describing the elastic properties of polycystic ovaries (17.5%) and the uterine cervix (15.0%). Limitations of the technology were identified as the lack of published reference values for gynecologic organs and difficulties in assessing tissues deep to the transducer. Conclusion: Future research is needed to validate the use of ultrasound elastography in gynecology under both normal and pathologic conditions. [ABSTRACT FROM AUTHOR]

Introduction. Tumors and tumor-like lesions of the uterine adnexa in children and adolescents are uncommon but may carry devastating consequences. Methods. We conducted an observational retrospective cohort study, to describe patients aged 0 to 19 years diagnosed with tumors and tumor-like lesions of the uterine adnexa at our institution between 2000 and 2018. Results. Eighty-nine patients with 105 adnexal lesions were included. Thirty-seven (42%) patients presented with benign tumors, 13 (15%) with borderline tumors, 25 (28%) with malignant tumors and 14 (16%) with tumor-like lesions. Germ cell tumors (n = 45|43%) were the most frequent, followed by epithelial tumors (n = 30|29%). No significant differences were found in the age distribution of the lesions by malignant potential or histologic group. Most patients (n = 80|90%) were treated primarily with conservative surgery, including cystectomy (n = 25|28%) and unilateral oophorectomy/adnexectomy (n = 54|61%). Thirty-four (38%) underwent surgical staging (partial omentectomy and peritoneal biopsies). Twenty (23%) patients with borderline and malignant tumors were submitted to chemotherapy. Four (5%) patients with borderline or malignant tumors relapsed, one of whom died from disease. Conclusion. Gynecological lesions in children and adolescents encompass a wide range of rare histological tumor subtypes, requiring evaluation by experienced pathologists. Most tumors were diagnosed at early stages, with low relapse and mortality rates. Conservative management, with fertility sparing surgery and limited use of adjuvant chemotherapy, is of utmost importance. [ABSTRACT FROM AUTHOR]

Because some stakeholders within medicine seek to diversify and attain greater workforce equity, it is critical to understand gender-based divisions within specialization. Radiation oncology (RO) has one of the smallest proportions of women representation of all specialties, and to our knowledge, no prior studies have investigated gender differences in all the disease site specializations within RO. Thus, we analyzed the relationship between gender and disease site(s) treated in academic RO (ARO). Faculty gender and disease site(s) treated by faculty from ARO departments were collected via publicly available department websites in January 2020. X2 analyses were conducted to assess differences between the proportions of women faculty treating each disease site. Of 1337 ARO faculty, 408 (30.5%) were identified as women. Breast, gynecology, and pediatrics had the largest proportions of women faculty (all >40%; P <.001). A majority (53%; P <.001) of women ARO faculty treated breast. Genitourinary, thoracic, and head and neck had the smallest proportions of women faculty (all <25%; P <.001). Women ARO faculty were twice as likely to treat breast and gynecologic malignancies compared with men faculty (risk ratio [RR] with 95% CI, 2.01 [1.75-2.50]; P <.001 and RR [95% CI], 2.06 [1.72-2.79]; P <.001, respectively). Men ARO faculty were 3 times more likely to treat genitourinary cancer compared with women faculty (RR [95% CI], 0.40 [0.34-0.48]; P <.001). There was no difference in the mean number of disease sites treated between women and men ARO faculty (2.63 vs 2.53; P =.29). Gender differences in disease site specialization were observed in ARO. Future research into the drivers of disease site selection should be explored. [ABSTRACT FROM AUTHOR]

Introduction: Hysterectomy is a common surgery with discernible practice variations that could be influenced by socioeconomic factors. We examined the association between level of educational attainment and the occurrence and timing of hysterectomy in Canadian women. Material and Methods: We conducted a prospective cohort study of 30 496 females in the Alberta's Tomorrow Project (2000–2015) followed approximately every 4 years using self‐report questionnaires. Educational attainment was defined as high school diploma or less, college degree, university degree (reference group), and postgraduate degree. We used logistic regression analyzing hysterectomy occurrence at any time and before menopause, separately, and flexible parametric survival models analyzing hysterectomy timing with age as the time scale. Multivariable models controlled for race/ethnicity, rural/urban residence, parity, oral contraceptive use, and smoking. Results: Overall, 39.1% of females reported a high school diploma or less, 28.9% reported a college degree, 23.5% reported a university degree, and 8.5% reported a postgraduate degree. A graded association was observed between lower education and higher odds of hysterectomy (high school or less: adjusted odds ratio [AOR] 1.68, 95% CI 1.55–1.82; college degree: AOR 1.58, 95% CI 1.45–1.72); results were similar for premenopausal hysterectomy. A graded association between lower education and earlier timing of hysterectomy was also observed up to approximately age 60 (eg at age 40: high school or less adjusted hazard ratio [AHR] 1.61, 95% CI 1.49–1.75; college degree AHR 1.53, 95% CI 1.40–1.67). Conclusions: Women with lower levels of education were more likely to experience hysterectomy, including hysterectomy before menopause and at younger ages. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the capacity of chat-generative pre-trained transformer (Chat-GPT) to understand the S2k guideline of the German Society for Gynecology and Obstetrics on intrauterine growth restriction. Methods: The German-language free Chat-GPT version was used to test the ability of Chat-GPT to understand the definition of small for gestational age and intrauterine growth restriction, to indicate the correct time and place of delivery and to evaluate ist ability to recommend a spontaneous delivery versus a primary caesarean section in accordance with the guideline recommendations. In order to objectively evaluate the suggestions a simple three-color 'traffic light' evaluation system was employed. Results: Almost all Chat-GPT's suggestions in the context of definition of small for gestational age/intrauterine growth restriction as well as correct time of delivery were adequate, whereas more than half of the suggestions made in terms of correct delivery mode needed reformulation or even correction. Conclusion: Chat-GPT appears to be a valuable form of artificial intelligence that could be integrated into everyday clinical practice. [ABSTRACT FROM AUTHOR]