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A Brief Discussion on the Declining Reproductive Intention and Fertility among Chinese Women of Childbearing Age: Causes and Protective Strategies YANG Chen-xia, ZHOU Jian-zheng Journal of International Obstetrics and Gynecology    2025, 52 (1): 46-51.   DOI: 10.12280/gjfckx.20240968 Abstract （1545）   HTML （85）    PDF （824KB）（212）       Knowledge map    Data from the "Seventh National Population Census" indicates that China has entered a period of extremely low fertility, presenting severe challenges stemming from a low birth rate. While the implementation of the "three-child" policy has granted unprecedented reproductive freedom, it has not effectively stemmed the continuous decline in birth rates. Facing declining reproductive intentions and birth rates, along with population aging, various levels of government and relevant departments are actively researching and implementing supportive policies. This article explores the impact of factors such as the shrinking number of women of childbearing age, reduced willingness to marry and have children, and declining fertility on the declining birth rate under the current policy framework. Based on this analysis, we propose practical countermeasures aimed at protecting female fertility, improving the reproductive intention and scale among women of childbearing age, and ultimately increasing the overall fertility rate. These proposals aim to provide a basis for further optimization of fertility policies to address China′s current demographic challenges. Reference | Related Articles | Metrics

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A Randomized Control Trial of Self-Help Mindfulness Based Stress Reduction to Improve Negative Emotion of Advanced Maternal Age ZHANG Miao-miao, WANG Jian, YANG Liang, CHEN Jue, FAN Xia, ZHOU Jian-hong Journal of International Obstetrics and Gynecology    2025, 52 (2): 137-142.   DOI: 10.12280/gjfckx.20241059 Abstract （519）   HTML （27）    PDF （5454KB）（24）       Knowledge map    Objective: To explore the effect of self-help mindfulness based stress reduction (Self-MBSR) on improving negative emotion of advanced maternal age. Methods: A total of 136 pregnant women (age≥35 years) registered in the early pregnancy clinics of 15 community health service centers in Jing′an District, Shanghai from September 2023 to June 2024 were included in the study and randomly divided into a training group and a control group with 68 cases in each group. The training group was trained with Self-MBSR, and the control group was not trained. After 21 days of training (first stage) and 16 weeks of training (second stage), Patient Health Questionnaire-9 items (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Pregnancy Pressure Scale (PPS), and Five Facet Mindfulness Questionnaire (FFMQ) were used to count the scores before intervention (T0), after the first stage of intervention (T1), and after the second stage of consolidation (T2). Results: The completion rate in training group was 76.47%, and the completion rate in control group was 79.41%. Scores of PHQ-9, GAD-7 and PPS in the training group were significantly lower than those in the control group at T1 and T2 (both P<0.05). Scores at T1 and T2 in the training group were significantly lower than baseline (both P<0.01). Scores of PHQ-9 at T2 were significantly lower than those at T1 in the training group (P<0.05). There were no significant differences in GAD-7 and PPS scores at T1 and T2 in the training group (both P>0.05). Scores of FFMQ in observing, describing, acting with awareness, nonreactivity and total scores in the training group were significantly higher than those in the control group at T1 and T2 (all P<0.05). Scores of FFMQ in observing, describing, acting with awareness, nonjudging and total scores at T1 and T2 in the training group were significantly higher than baseline (all P<0.05). Conclusions: Self-MBSR therapy is conducive to improve negative emotion of advanced maternal age, reduce pregnancy stress and enhance their mindfulness. Table and Figures | Reference | Related Articles | Metrics

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Research Advancements on the Pathogenesis and Prediction Approaches of Twin Pregnancies Complicated with Preeclampsia FAN Bo-yang, HU Li-yan Journal of International Obstetrics and Gynecology    2024, 51 (6): 611-615.   DOI: 10.12280/gjfckx.20240630 Abstract （358）   HTML （286）    PDF （800KB）（67）       Knowledge map    Preeclampsia(PE) constitutes a prevailing maternal complication that is intricately bound up with adverse maternal and infant outcomes. As one of the important risk factors for the development of PE, the pathogenetic mechanism of twin pregnancy in conjunction with PE is comparable to that of singleton pregnancies, which could potentially be correlated with large placenta size, augmented volume load, vascular endothelial dysfunction, oxidative stress, and immune mechanisms, etc., manifesting early disease onset yet mild disease attributes. However, the mechanism of PE in twin pregnancy remains nebulous, and its specific risk factors embrace assisted reproductive technology and chorionic sex. Clinically, twin pregnancies accompanied by PE hinge upon a solitary predictor, such as soluble fms-like tyrosine kinase-1(sFlt-1), placental growth factor (PlGF), pregnancy associated plasma protein-A (PAPP-A), or ultrasound indicators. Due to shortcomings such as insufficient sample size, the predictive performance of each indicator still needs to be tested. Further research with larger sample sizes is needed to explore the optimal predictive model for twin pregnancies with PE, in order to guide clinical decision-making. Reference | Related Articles | Metrics

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Progress on the Relationship between Apoptosis and Adverse Pregnancy Outcomes MA Ling, LI Ya-xi, ZHAO Min, WANG Jing, LI Hong-li Journal of International Obstetrics and Gynecology    2025, 52 (2): 121-126.   DOI: 10.12280/gjfckx.20241001 Abstract （353）   HTML （478）    PDF （6014KB）（119）       Knowledge map    Apoptosis is a programmed cell death that plays a crucial role in the physiological and pathological processes of pregnancy. Abnormal apoptosis, especially excessive apoptosis of trophoblast cells in the placenta, may lead to trophoblast dysfunction, abnormal vascular remodeling, increased oxidative stress, and immune imbalance, thereby cause adverse pregnancy outcomes such as recurrent spontaneous abortion (RSA), pre-eclampsia (PE), gestational diabetes mellitus (GDM), and preterm birth. The regulation of apoptosis is vital for pregnancy. In the RSA, p53-mediated apoptosis and abnormal expression of miR-184 and miR-27a disrupt the balance between trophoblast proliferation and apoptosis. In PE, the miR-4531/CX3CL1 signaling pathway is involved in the pathogenesis of PE by regulating vascular endothelial injury. In GDM, ghrelin shows potential therapeutic value by downregulating the endoplasmic reticulum stress signaling pathway. In preterm birth, endoplasmic reticulum stress induces apoptosis of alveolar epithelial cells via the inositol-requiring enzyme 1α(IRE1α)/c-Jun N-terminal protein kinase(JNK) pathway. Future research needs to further explore its mechanisms and therapeutic targets to provide new ideas for the prevention and treatment of adverse pregnancy outcomes. Reference | Related Articles | Metrics

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The Relationship Between Ferroptosis and Premature Ovarian Insufficiency GAO Yi-wei, LUO Wei, WU Qiong, MU Yu-lan Journal of International Obstetrics and Gynecology    2024, 51 (5): 497-502.   DOI: 10.12280/gjfckx.20240412 Abstract （299）   HTML （33）    PDF （723KB）（70）       Knowledge map    Premature ovarian insufficiency (POI) is a complex condition that not only leads to perimenopausal symptoms, but also affects female fertility and overall physical and mental health. Once ovarian function is impaired, it is irreversible. Therefore, exploring the pathogenic mechanisms of POI and delaying its progression are paramountly important. Recent studies have revealed a close relationship between ferroptosis and POI. Ferroptosis is an iron-dependent form of cell death that regulates a variety of cellular biological processes in the body. Oxidative stress, autophagy, abnormal iron metabolism, and lipid metabolism disorders can induce ferroptosis, damaging ovarian function. Additionally, abnormal activation of the Hippo/Yes-associated protein (YAP) and tumor protein p53 (TP53) / nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway can also impair ovarian function though ferroptosis. Moreover, research has found that activation of glutathione peroxidase 4 (GPX4), ferrostatin-1 (Fer-1), and Coenzyme Q10 (CoQ10) can effectively reduce ferroptosis, suggesting these as potential therapeutic targets for future treatment of POI. Reference | Related Articles | Metrics

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Application and Prospects of Artificial Intelligence in the Diagnosis and Treatment of Endometrial Cancer HE Qing, HU Hong-bo Journal of International Obstetrics and Gynecology    2024, 51 (5): 572-577.   DOI: 10.12280/gjfckx.20240489 Abstract （297）   HTML （21）    PDF （1559KB）（50）       Knowledge map    The increasing incidence of endometrial cancer has driven innovations in diagnostic and therapeutic approaches. Among these, artificial intelligence (AI) technologies, particularly advances in deep learning and machine learning, have opened up new possibilities for improving diagnostic accuracy and developing personalized treatment plans. AI significantly enhances early detection and diagnostic precision for endometrial cancer through improved medical image analysis, automated pathological image interpretation, and in-depth genomic data analysis. Additionally, AI aids in personalized treatment decisions and prognosis evaluation by integrating multi-source data to accurately predict treatment outcomes. Recent research has focused on data fusion and real-time patient monitoring applications, further exploring AI′s potential in the comprehensive management of endometrial cancer patients. However, the widespread application of AI still faces challenges related to data quality, generalization, interpretability, and associated legal and ethical issues. Therefore, realizing the full potential of AI in the entire management process of endometrial cancer requires continuous technological innovation and interdisciplinary collaboration to ensure the reasonable, transparent, and safe application of these technologies. This presents a positive outlook for the future of healthcare, aiming to optimize treatment outcomes and improve patients′ quality of life through technological advancements. Table and Figures | Reference | Related Articles | Metrics

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Prospective Randomized Controlled Clinical Study on the Efficacy of A Novel Temperature-Controlled Radiofrequency Treatment for Postpartum Vaginal Laxity SHAO Hui, WANG Lu, CHEN Lu-jia, DONG Rui-jia, TANG Jie-ying, LIAO Xue-yin, YANG Jian-min, LI Wei-wei Journal of International Obstetrics and Gynecology    2024, 51 (5): 509-514.   DOI: 10.12280/gjfckx.20240509 Abstract （294）   HTML （25）    PDF （894KB）（17）       Knowledge map    Objective: To investigate the clinical efficacy and safety of a novel temperature-controlled radiofrequency (TCRF) treatment for postpartum vaginal laxity. Methods: A total of 43 female patients with postpartum vaginal laxity, treated at Beijing Tsinghua Changgung Hospital, affiliated with Tsinghua University from June 2022 to June 2023, were selected for this study. The patients were randomly divided into two groups: the experimental group (21 patients) received the novel TCRF treatment, while the control group (22 patients) received a sham treatment (no temperature or energy applied). Clinical efficacy and safety were comprehensively evaluated by comparing subjective scores from the female sexual function index (FSFI), female sexual distress scale-revised (FSDS-R), vaginal laxity questionnaire (VLQ), and sexual satisfaction questionnaire (SSQ) before and after treatment, alongside objective assessments of labia minora basal length, vulvar pigmentation, and elasticity. Results: At the 18th week after the first treatment, the mean change in total FSFI score (△T) in the experimental group was 8.72±3.94 points, while in the control group (△C), it was -0.03±1.28 points. The mean difference in FSFI score change between the two groups (△T-△C) was 8.75 points, with a 95%CI of 6.889-10.613 points, indicating that the lower limit of the 95%CI for the difference between the two groups was greater than 0. The experimental group showed a significant improvement in FSFI scores compared to the control group (t=4.810, P<0.001). Two-factor repeated measures ANOVA demonstrated that the main effects of time (Ftime=24.156, Ptime>0.001), group (Fgroup=12.754, Pgroup=0.001), and the interaction between time and group (Ftime×group= 25.689, Ptime×group>0.001) was statistically significant. Intervention effects, with group as the independent variable, indicated that FSFI scores in the experimental group were significantly higher than those in the control group at 6, 10, and 18 weeks post-treatment (all P<0.05). Time effect analysis, with time as the independent variable, showed that FSFI scores at all post-treatment time points were significantly higher than baseline, with scores at 6, 10, and 18 weeks significantly higher than those at 3 weeks (all P<0.05); however, no significant differences were found between FSFI scores at 6, 10, and 18 weeks post-treatment (all P>0.05). At 10 and 18 weeks post-treatment, FSDS-R scores and labia minora base length in the experimental group were significantly lower, and SSQ scores were significantly higher, than those in the control group (all P<0.05). At 3, 6, 10, and 18 weeks post-treatment, the experimental group showed significantly better VLQ scores, digital assessment of vaginal laxity improvement, and vulvar condition compared to the control group (all P<0.05). No adverse events related to the experimental device were reported in any enrolled patients. Conclusions: The novel TCRF technology effectively improves vaginal laxity and enhances sexual satisfaction, with a high safety profile, making it a promising option for clinical application. Table and Figures | Reference | Related Articles | Metrics

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Progress of Trop-2 and Targeted Trop-2 Antibody-Coupled Drugs in Gynecological Malignant Tumors BAI Yao-jun, WANG Si-yao, LING Fei-fei, ZHANG Sen-huai, LI Hong-li, LIU Chang Journal of International Obstetrics and Gynecology    2025, 52 (1): 1-7.   DOI: 10.12280/gjfckx.20240887 Abstract （288）   HTML （388）    PDF （830KB）（100）       Knowledge map    Cervical cancer, ovarian cancer and endometrial cancer are common gynecological malignancies with increasing incidence and younger age groups, which seriously threatens women′s health. Although the conditions of some patients can be improved after standardized treatment, a large proportion of patients still have deteriorating conditions and poor prognosis, and there is an urgent need to find new targets for precise treatment and improved prognosis. Trophoblast cell surface antigen 2 (Trop-2) is a transmembrane glycoprotein that is highly expressed in various tumor tissues, and plays an important role in the proliferation, invasion and metastasis of cervical, endometrial and ovarian cancers through cell surface receptor signaling, making it an important potential marker for early diagnosis, and can be used to access tumor progression and patient prognosis. In the therapeutic aspect, targeted therapeutic strategies such as antibody-drug conjugate (ADC) against Trop-2 have shown promising applications. For example, sacituzumab govitecan (SG), as an ADC targeting Trop-2, has achieved remarkable efficacy in the treatment of gynecological malignancies and has been incorporated into relevant clinical application guidelines. At present, a number of clinical trials of ADC drugs targeting Trop-2 are actively underway, and Trop-2 is expected to play an increasingly important role in the early detection and treatment of gynecological malignant tumors, and bring patients greater hope for survival. Table and Figures | Reference | Related Articles | Metrics

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Cervical Carcinosarcoma：A Case Report and Literature Review WANG Jing, WANG Xiao-hui Journal of International Obstetrics and Gynecology    2024, 51 (5): 597-600.   DOI: 10.12280/gjfckx.20240193 Abstract （279）   HTML （44）    PDF （671KB）（16）       Knowledge map    Cervical carcinosarcoma is a malignant tumor composed of malignant epithelial tissue and stromal components. Patients typically present with irregular vaginal bleeding and discharge. The etiology and pathogenesis of this condition remain unclear, and it is clinically very rare, making misdiagnosis and missed diagnosis common. This report presents a case of 42-year-old woman with cervical carcinosarcoma. The patient was admitted to the hospital due to contact bleeding accompanied by lower abdominal pain. Pelvic magnetic resonance imaging revealed a significant enlargement of the cervical region, with an initial diagnosis of cervical tumor. The patient subsequently underwent radical hysterectomy, pelvic lymphadenectomy, and omentectomy. Postoperative pathology confirmed the diagnosis of cervical carcinosarcoma, stage Ⅱb. As of March 2, 2024, the patient had undergone three rounds of chemotherapy, with no evidence of recurrence or metastasis detected so far. Cervical carcinosarcoma is highly malignant with nonspecific clinical manifestations, and definitive diagnosis relies mainly on pathological and immunohistochemical examinations. Therefore, early recognition and treatment are crucial for improving patient prognosis. Reference | Related Articles | Metrics

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A Case of Early Pregnancy Pulmonary Embolism ZHANG Ming, WANG Han-ting, CAO Yuan-yuan, CHEN Lu-jie, WANG Juan Journal of International Obstetrics and Gynecology    2024, 51 (5): 556-559.   DOI: 10.12280/gjfckx.20240507 Abstract （271）   HTML （32）    PDF （4588KB）（13）       Knowledge map    Pulmonary embolism is a serious complication during pregnancy. It presents suddenly with diverse clinical manifestations and is prone to misdiagnosis. Computed tomography angiography (CTA) is the definitive diagnostic tool. We report a case of pulmonary embolism diagnosed in a patient 40+ days into an assisted reproductive pregnancy, who presented with palpitations, chest tightness, and shortness of breath. Cardiac color Doppler ultrasound estimated the pulmonary artery pressure at 63 mmHg (1 mmHg=0.133 kPa). The diagnosis was confirmed after chest CT and CTA. The patient improved after thrombolytic, anticoagulant, and symptomatic treatment, followed by an induced abortion to terminate the pregnancy. The prognosis is currently favorable. This case aims to heighten clinical awareness of early pregnancy pulmonary embolism. Besides taking a detailed medical history, clinicians must promptly perform relevant tests and examinations to achieve a rapid diagnosis and timely intervention. Table and Figures | Reference | Related Articles | Metrics

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Composition and Research Progress of the Endometrial Microbiota ZHONG Xiao-ying, LIU Hai-yuan Journal of International Obstetrics and Gynecology    2024, 51 (5): 481-485.   DOI: 10.12280/gjfckx.20240451 Abstract （269）   HTML （88）    PDF （721KB）（44）       Knowledge map    In recent years, the research of endometrial microbiota has gradually gained attention. The composition of microbial communities in different proportions is closely related to the occurrence of reproductive system disease and pathological pregnancies. The composition of endometrial microbiota has not yet been fully elucidated. Many studies hold the view that lactobacilli dominate the endometrial microbiome, but this theory remains controversial due to differences in sample collection and analysis methods across studies. The 16S rRNA sequencing technology is currently the most commonly used method for studying the endometrial microbiota, although studies using different omics technologies have also been reported. Endometrial receptivity is crucial for successful embryo implantation, and the dominance of lactobacilli in the endometrium may be associated with improved reproductive outcomes. Chronic endometritis (CE) has been confirmed to be associated with infertility, recurrent miscarriage, and repeated implantation failure. Although the correlation between endometrial microbial imbalance and CE has not yet been established, some studies have found that a decrease in the proportion of lactobacilli in CE patients, suggesting a potential association between the endometrial microbiome and CE. This paper reviews the different research findings and methods on the composition of endometrial microbiome and summarizes the recent impacts and roles of endometrial microbiota on endometrial receptivity and CE. Reference | Related Articles | Metrics

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Research Progress on Low-Dose Aspirin in the Prevention of Preeclampsia DENG Ling-ling, WU Shao-wen, ZHANG Wei-yuan Journal of International Obstetrics and Gynecology    2024, 51 (5): 515-518.   DOI: 10.12280/gjfckx.20240369 Abstract （267）   HTML （37）    PDF （714KB）（34）       Knowledge map    Aspirin prossesses anti-inflammatory, antipyretic, analgesic and antiplatelet aggregation properties. Studies have shown that taking low-dose aspirin during pregnancy can effectively reduce the incidence of preeclampsia (PE) in high-risk pregnant women, and it is now widely used in clinical practice. However, there is still no consensus on the standard for aspirin use in both domestic and international guidelines, leading to possible overextension of indications or blind use in clinical practice, which may prevent achieving the desired outcomes. Based on domestic and international guidelines and recommendations from experts and scholars, this review focuses on the applicable population, timing of administration, recommended dosage and precautions during the use of low-dose aspirin for the prevention of PE, aiming to better guide clinical practice. Reference | Related Articles | Metrics

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Research Progress on Exosomes in the Diagnosis and Treatment of Premature Ovarian Failure GUO Pei-yi, ZHU Xue-hong, LIU Hui-xing, LU Li-miao, LIN Zhong Journal of International Obstetrics and Gynecology    2024, 51 (5): 492-496.   DOI: 10.12280/gjfckx.20240378 Abstract （267）   HTML （45）    PDF （718KB）（34）       Knowledge map    Premature ovarian failure (POF) is an endocrine disorder with an increasing incidence in recent years, often leading to decreased female fertility and various postmenopausal symptoms. The etiology of POF remains unclear, and current treatment options are limited, necessitating new approaches to improve ovarian function and enhance fertility in affected women. Exosomes are nano-vesicles that carry a variety of active substances and participate in intercellular signal transmission, exhibiting strong targeting and specificity. Studies have revealed significant differences in certain exosomes between normal and PDF tissues, suggesting their potential as biomarkers for diagnosing POF. Additionally, exosomes may play a crucial role in POF treatment by affecting granulosa cells, promoting hormone secretion, angiogenesis, and combating oxidative stress. This review summarizes the research progress on the relationship between exosomes and POF, aiming to provide a reference for future studies on the role of exosomes in POF. Table and Figures | Reference | Related Articles | Metrics

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Advances in Exosome-Based Therapy for Chronic Endometritis by Modulating the Immune Microenvironment LI Heng-bing, YUAN Hai-ning, ZHANG Yun-jie, ZHANG Jiang-lin, GUO Zi-zhen, SUN Zhen-gao Journal of International Obstetrics and Gynecology    2025, 52 (1): 72-78.   DOI: 10.12280/gjfckx.20240908 Abstract （267）   HTML （53）    PDF （714KB）（31）       Knowledge map    Chronic endometritis (CE) is characterized by abnormal infiltration of CD138+ endometrial stromal plasma cells. This persistent inflammatory state can disrupt immune cell infiltration, cytokine expression, and endometrial decidualization, negatively impacting embryo implantation and attracting significant research interest. Exosomes, nano-sized vesicles mediating intercellular communication, have shown considerable promise in modulating the immune microenvironment. This review summarizes the progress of exosome-based therapies for CE, focusing on their mechanism of action in improving the endometrial microenvironment through immune modulation. This may guide the development of novel therapeutic strategies for CE. Reference | Related Articles | Metrics

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A Case of Parasitic Leiomyoma with Massive Ascites and Elevated CA125 LIU Yan-jun, ZHANG Ying Journal of International Obstetrics and Gynecology    2024, 51 (5): 588-592.   DOI: 10.12280/gjfckx.20240156 Abstract （264）   HTML （30）    PDF （17176KB）（18）       Knowledge map    Parasitic leiomyoma is a benign solid tumor formed by ectopic implantation of uterine fibroids, and it is rarely associated with ascites and elevated carbohydrate antigen 125 (CA125). This case reported presents a rare instance of parasitic leiomyoma, which was complicated by massive ascites and significantly elevated CA125 levels. Imaging examination suggested a large adnexal mass and multiple nodules in the pelvic-abdominal cavity, leading to a preoperative misdiagnosis of ovarian malignancy with peritoneal metastasis. The patient′s symptoms were alleviated, and CA125 levels returned to normal following surgical treatment. This case highlights the importance of thoroughly considering the patient′s surgical and medication history, along with a comprehensive evaluation that includes tumor markers, pelvic-abdominal MRI, ascitic fluid biochemical and cytological analysis, and intraoperative frozen section pathology, in order to avoid misdiagnosis. Table and Figures | Reference | Related Articles | Metrics

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A Case of Recurrent Cellular Uterine Leiomyoma with Peritoneal Dissemination after Surgery MING Yang, HU Yuan-yuan, FENG Tong-fu Journal of International Obstetrics and Gynecology    2024, 51 (5): 593-596.   DOI: 10.12280/gjfckx.20240285 Abstract （262）   HTML （33）    PDF （9295KB）（20）       Knowledge map    Cellular uterine leiomyoma is relatively rare in clinical practice and often resembles the clinical presentation of common uterine fibroids, leading to frequent preoperative misdiagnosis. This report presents a case of a patient with cellular uterine leiomyoma treated at Maternal and Child Health Hospital of Hubei Province, who underwent a single-port gasless myomectomy. In June 2022, the patient was readmitted due to a recurrence of the leiomyoma two years post-surgery and underwent a laparoscopic total hysterectomy and bilateral salpingectomy. During surgery, tumors were found in the pelvic peritoneum, omentum, mesocolon and abdominal wall. Pathological and immunohistochemical examinations indicated that all the tumors were cellular uterine leiomyomas. Preoperative diagnosis requires comprehensive consideration of blood flow signals, and imaging results to improve diagnostic accuracy. During surgery, strict adherence to the principle of tumor-free techniques and close postoperative follow-up are essential to reduce the risk of recurrence and iatrogenic dissemination. Table and Figures | Reference | Related Articles | Metrics

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Effects of Intraspinal Labor Analgesia on Maternal and Neonatal Outcomes TANG Shi-cheng, ZHANG Guo-ying Journal of International Obstetrics and Gynecology    2024, 51 (5): 519-524.   DOI: 10.12280/gjfckx.20240594 Abstract （260）   HTML （35）    PDF （698KB）（31）       Knowledge map    Intraspinal labor analgesia is a primary method for alleviating labor pain in women. Administering intraspinal labor analgesia during the latent phase of the first stage of labor can significantly reduce labor pain, making women more willing to attempt vaginal delivery and thereby reducing the rate of cesarean sections, especially those without clear medical indications due to pain factors. It can also decrease the incidence of severe maternal morbidity (SMM) and postpartum hemorrhage, thus improving the quality of delivery. However, intraspinal labor analgesia may have some adverse effects on maternal and neonatal outcomes. While it can accelerate cervical dilation during the latent phase of the first stage of labor, it may prolong the active phase of the first stage and the second stage of labor. Intraspinal analgesia increases the risk of instrumental vaginal delivery and postpartum urinary retention, with the latter potentially leading to urinary tract infections and postpartum hemorrhage. Additionally, intrapartum fever may be associated with intraspinal labor analgesia. Risk factors for intrapartum fever include premature rupture of membranes, excessive vaginal examinations, prolonged labor duration, prolonged time from rupture of membranes to delivery, high maternal body mass index, and prolonged duration of intraspinal labor analgesia. Intrapartum fever may increase the risk of low Apgar scores and neonatal infections, leading to adverse neonatal outcomes. This review examines the impact of intraspinal labor analgesia on labor progress, delivery mode, and maternal and neonatal outcomes, providing a reference for improving delivery quality and reducing adverse maternal and neonatal outcomes. Reference | Related Articles | Metrics

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Progress in the Diagnosis and Treatment of Pregnancy Complicated by Krukenberg Tumor HUANG Mo-ya, ZHAO Ya-qian, HE Yin-fang Journal of International Obstetrics and Gynecology    2024, 51 (5): 531-535.   DOI: 10.12280/gjfckx.20240516 Abstract （259）   HTML （19）    PDF （681KB）（98）       Knowledge map    Krukenburg tumor refers to an ovarian malignancy that metastasizes from a primary site, and its incidence is relatively low. Pregnancy complicated by Krukenberg tumor is even rarer in clinical practice, often associated with a poor prognosis. Most patients exhibit nonspecific early clinical symptoms, which are easily masked by physiological and hormonal changes during pregnancy, making early diagnosis challenging, leading to delayed diagnosis and missed optimal treatment timing. To date, there is no consensus on the diagnosis and treatment of pregnancy complicated by Krukenburg tumor. According to domestic and international studies, diagnosis should be confirmed based on clinical manifestations and imaging examinations, treatment should be individualized according to the patient′s condition, gestational age, maternal-fetal status. Therefore, more research is needed on this rare disease to provide recommendations for early detection, diagnosis and treatment methods. This review summarizes the progress in the diagnosis and treatment of Krukenberg tumor during pregnancy, providing a valuable reference for clinical practice. Reference | Related Articles | Metrics

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Successful Delivery after Pharmacological Expectant Management without the Opportunity for Emergency Cervical Cerclage: A Case Report LIU Ya-xin, ZHANG Shu-ning, CHEN Xiao-jun, YU Yi-si, FU Shuai Journal of International Obstetrics and Gynecology    2024, 51 (5): 552-555.   DOI: 10.12280/gjfckx.20240452 Abstract （259）   HTML （17）    PDF （1817KB）（92）       Knowledge map    Cervical incompetence is a significant factor leading to recurrent mid-trimester miscarriages and preterm births, resulting in serious complications for preterm infants and neonatal mortality, which can severely impact the physical and mental health of women of childbearing age and their families. This paper reports a case of a pregnant woman who had previously undergone hysteroscopic septum resection and cold knife conization of the cervix. During her pregnancy, cervical length was not monitored, and at 24+3 weeks of gestation, painless cervical dilation was discovered, with the amniotic sac prolapsing into the vagina. Due to the inability to palpate the cervical edge during speculum and vaginal examinations, an emergency cervical cerclage could not be performed. The patient was managed with antibiotics, tocolytics, and other medications for expectant management until preterm premature rupture of membranes (PPROM) occurred at 29+5 weeks, leading to oligohydramnios. An emergency cesarean section was performed, resulting in the successful delivery of a live infant who was eventually discharged home. This case review summarizes the clinical management and highlights recent advancements in the diagnosis and treatment of cervical incompetence, providing a new treatment option for similar cases in clinical practice. Table and Figures | Reference | Related Articles | Metrics

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Analysis of the Disease Burden and Projections of Polycystic Ovary Syndrome in China and Globally from 1990 to 2021 YAN Hui-bo, ZHANG Lin Journal of International Obstetrics and Gynecology    2025, 52 (2): 228-233.   DOI: 10.12280/gjfckx.20241018 Abstract （257）   HTML （20）    PDF （6352KB）（56）       Knowledge map    Objective: To analyze and predict the disease burden of polycystic ovary syndrome (PCOS) in China, providing evidence-based guidance for its prevention and treatment. Methods: Using the Global Burden of Disease 2021 (GBD 2021) data, this study conducted a comparative analysis of the incidence rate, prevalence rate, and disability adjusted life year (DALY) rate of PCOS in China and globally from 1990 to 2021, and employed the autoregressive integrated moving average (ARIMA) model to project the disease burden of PCOS and PCOS-associated infertility from 2022 to 2041. Results: Compared with 1990, the global age-standardized incidence, prevalence, and DALY rate of PCOS in 2021 increased by 27.93%, 28.05%, and 27.48%, respectively. In China, these rates surged by 85.36%, 85.39%, and 87.10%, exhibiting a persistent upward trend with significantly higher growth rates than the global average (all P<0.000 1). Furthermore, ARIMA model projections further indicate that by 2041, the age-standardized incidence, prevalence, and DALY rate of PCOS in both China and globally will continue to rise from 2022 to 2041, with China′s growth rate remaining markedly above global levels (all P<0.000 1). Similarly, the age-standardized incidence and YLDs rate of infertility attributable to PCOS are projected to increase through 2041, with China again demonstrating faster growth than the global trend (all P<0.000 1). Conclusions: From 1990 to 2021, the disease burden of PCOS exhibited a sustained upward trend both globally and in China, with projections indicating further increases. Notably, China′s PCOS disease burden has grown at a significantly faster rate than the global average. It is imperative for China to prioritize evidence-based strategies to strengthen prevention and treatment efforts targeting PCOS. Table and Figures | Reference | Related Articles | Metrics