Abstract Female genital mutilation (FGM) remains a major global public health and human rights concern, with recent evidence highlighting a concerning shift toward medicalization. The involvement of health workers in performing FGM creates a false perception of safety, reinforces social acceptance, and threatens progress toward global elimination. This article discusses the drivers and consequences of medicalized FGM, including social pressures, misconceptions of harm reduction, weak enforcement, and professional ethical challenges. Although medicalization is sometimes promoted as a safer alternative, evidence demonstrates that it does not eliminate the physical, psychological, and social harms associated with FGM. Strengthening health worker accountability, integrating prevention into reproductive and maternal health services, enforcing professional regulations, and expanding survivor‐centred care are essential strategies. Sustainable elimination requires coordinated action involving healthcare systems, communities, policymakers, and global health organizations to ensure that health workers become advocates for abandonment rather than facilitators of a harmful practice.
Abstract Objective This study aimed to evaluate the associations of the C‐reactive protein‐to‐albumin ratio (CAR index) and the albumin–bilirubin (ALBI) score with latency duration and adverse perinatal outcomes among patients with preterm premature rupture of membranes (PPROM). Materials and Methods This was a single‐center, retrospective study conducted at a tertiary care center. This study included 218 singleton pregnancies followed by a diagnosis of PPROM before 34 weeks of gestation between January 2022 and December 2025. Patients were divided into three groups according to the latency period: delivery within the first 48 h ( n = 92, 42%—Group 1), delivery between 48 h and 7 days ( n = 56, 25.7%—Group 2), and delivery after 7 days ( n = 70, 32.1%—Group 3). First, the associations of the CAR index and ALBI score with latency period were evaluated across all three groups. Subsequently, the associations of the CAR index and ALBI score with neonatal outcomes were examined. Results The CAR index was significantly higher in Groups 1 and 2 than in Group 3 ( P < 0.001). The CAR index showed discriminatory ability for delivery within 48 h and within 7 days, with sensitivities of 82.3% and 66.2%, respectively. In subgroup analysis, a higher maternal ALBI score was significantly associated with neonatal umbilical artery pH <7.20 and showed discriminatory ability for identifying this outcome, with a sensitivity of 62.2% ( P = 0.004). Conclusion In patients with PPROM, the CAR index was associated with shorter latency and showed discriminatory ability for delivery within the first 48 h and within the first 7 days, whereas a higher ALBI score was significantly associated with neonatal umbilical artery pH <7.20.
Abstract Objective This study investigates the diagnostic utility of venous diameter (d) and volume flow (Q) measurements of the umbilical vein (UmbV), ductus venosus (DV), inferior vena cava (IVC), and subdiaphragmatic vestibulum (SDV) in fetuses with late‐onset fetal growth restriction (FGR). Materials and Methods This prospective case–control study included 54 singleton pregnancies (27 late‐onset FGR and 27 gestational age‐matched controls) between 33 and 37 weeks of gestation. Venous diameters and Doppler‐derived volume flow measurements of the UmbV, DV, IVC, and SDV were assessed using ultrasonography. Correlation, linear regression, and receiver operating characteristic analyses were performed. Results All venous diameter and volume flow parameters were significantly lower in fetuses with FGR than in controls ( P ≤ 0.003 for all). Venous parameters were positively correlated with estimated fetal weight (EFW). In multivariable analysis, UmbV‐d ( B = 1.425, 95% confidence interval CI 0.635–2.214, P = 0.001) and IVC‐d ( B = 2.212, 95% CI 0.944–3.481, P = 0.001) remained independently associated with EFW. UmbV‐d showed the highest discriminative performance for identifying FGR (area under the curve [AUC] 0.947, 95% CI 0.894–0.999, P < 0.001). Among flow parameters, UmbV‐Q demonstrated the highest AUC (0.858, 95% CI 0.756–0.960, P < 0.001), whereas only IVC‐Q remained independently associated with EFW. A combined model including UmbV‐d and IVC‐d achieved an AUC of 0.972. Conclusion Fetal venous diameter and volume flow measurements were significantly reduced in late‐onset FGR. UmbV‐d demonstrated the strongest association with EFW and the highest discriminative performance, whereas UmbV‐Q was the best‐performing flow parameter. Combined assessment of UmbV‐d and IVC‐d demonstrated promising discriminative performance; however, larger studies are required to determine whether these measurements provide information beyond conventional fetal biometry.
Abstract Objective Trauma is the leading non‐obstetric cause of death during pregnancy, and there is an urgent need to improve its management in Japan and the USA. The present study described the patient characteristics, in‐hospital management strategies, and clinical outcomes of pregnant trauma patients across two nations. Methods A retrospective registry‐based study was conducted using the Japan Trauma Data Bank (JTDB) and National Trauma Data Bank (NTDB) between 2007 and 2018. Female trauma patients aged 15 to 49 years were included. Patient characteristics, in‐hospital management, and clinical outcomes were described. Results A total of 156 (0.62%) and 3300 (0.23%) pregnant trauma patients were identified in JTDB and NTDB, respectively. Motor vehicle collision was the most common injury mechanism in both registries. Fall was the second leading mechanism (25.8%), while no gunshot wounds were observed in JTDB. Unintentional injuries were the leading cause of injury in both registries. The second leading cause of injury was self‐inflicted injury in JTDB (15.5%) and assault in NTDB (13.5%). The median Injury Severity Score (ISS) was 9 in JTDB and 4 in NTDB. Computed tomography (CT) scan was performed on 60.9% of patients in JTDB and 28.7% of patients in NTDB, with the head being the most common region. Median hospital length of stay (LOS) was 6.5 days in JTDB and 2 days in NTDB. Mortality rates were 7.6% and 1.4% in JTDB and NTDB, respectively. Conclusion Notable differences in patient characteristics and in‐hospital management strategies and clinical outcomes were observed between the two registries.
