Background/Objectives: Postpartum hemorrhage (PPH) remains a leading cause of maternal death. This review summarizes clinical evidence on chitosan-covered tamponade (CCT), distinguishing mechanistic rationale from demonstrated clinical benefit. Methods: A structured narrative review following SANRA recommendations used updated PubMed, Scopus, and Web of Science records (publication years 2000–2026; October 2026 update). Results were synthesized descriptively. Results: Twelve clinical publications concerned PPH; two reports of other obstetric hemorrhage were retained separately for context, and six safety publications were catalogued. In a single uncontrolled registry cohort (n = 230), hemorrhage control without further invasive procedures was reported in 210 women (91.3%). Separately, vaginal or vulvar CCT controlled lower genital tract trauma bleeding in 25/26 women; these findings do not establish intrauterine effectiveness. Retrospective balloon comparisons do not establish equivalence or non-inferiority. Historical hysterectomy findings are vulnerable to confounding. Six PPH publications originated from one institution, with possible patient overlap. No direct comparison with conventional gauze was identified, and reports of ocular and audiovestibular inflammation raise safety concerns. Conclusions: A clinical advantage over conventional gauze has not been demonstrated. Current international PPH guidance remains applicable and does not recommend uterine packing with plain or hemostatic-agent-impregnated gauze. Comparative effectiveness and safety require prospective evaluation before routine CCT use can be supported.
Background/Objectives: To describe clinical phenotypes, assisted reproductive technology (ART) laboratory findings, management pathways, and patient-level reproductive outcomes in women with severe uterine factor infertility managed at a public tertiary referral hospital in Viet Nam. Methods: This retrospective case series included patients with severe uterine factor infertility who underwent ART management between January 2020 and December 2025. Outcomes were reported at the patient level and stratified by management pathway: self-uterine embryo transfer, defined as embryo transfer into the patient’s own uterus, or gestational surrogacy. Descriptive statistics were used. Results: Fourteen patients were included in the descriptive cohort, and 13 were included in the pathway/outcome analysis. Nine patients (64.3%) had an absent or nonfunctional uterus, and five (35.7%) had major congenital uterine anomalies with potential for self-uterine embryo transfer. Median ART laboratory outcomes were 11 retrieved oocytes, 9.5 oocytes used for intracytoplasmic sperm injection, 9 fertilized oocytes, and 4 blastocysts. In the pathway/outcome cohort, five patients were managed through the self-uterine pathway and eight through gestational surrogacy, leading to a total of 11/13 patients (84.6%) who underwent at least one embryo transfer. Clinical pregnancy occurred in 8/13 patients (61.5%), resulting in five live births, two pregnancy losses after ongoing pregnancy, and one ongoing pregnancy at data cutoff. Conclusions: Severe uterine factor infertility required individualized, pathway-specific reproductive management. Patient-level reporting by management pathway and embryo transfer exposure provided a description of outcomes in this rare patient group, including in a setting where gestational surrogacy for humanitarian purposes is restricted to authorized hospitals and ART centers.
Background/Objectives: Determining when to stop septal incision is a practical issue in hysteroscopic metroplasty (HM). We describe a combined intraoperative approach targeting an approximately 5 mm residual septum. Methods: This single-center retrospective case series included 32 consecutive patients undergoing HM by one surgeon between May 2024 and April 2026. Electrode-based semi-quantitative assessment was combined with sonohysterographic fundal thickness monitoring. Postoperative morphology was assessed at 2 months. Stored final intraoperative ultrasound images were retrospectively evaluated when available. Results: All 32 patients completed postoperative imaging and second-look hysteroscopy. Median postoperative residual septum length was 7.0 mm (interquartile range, 5.7–8.6; range, 2.9–10.0); 30 patients (93.8%) had a residual length below 10 mm and two had a length of 10.0 mm. Final intraoperative images were available in 16 patients: median full fundal thickness was 13.9 mm (range, 11.2–15.8), and the calculated residual length was 3.6 mm (range, 0.6–5.5). No adhesions occurred at the uterine-body incision site; one cervical adhesion required subsequent excision. No uterine perforation or major intraoperative hemorrhage occurred. No postoperative infection or repeat surgery for a residual septum was recorded through second-look hysteroscopy (median, 62 days; range, 59–93 days). Conclusions: This series describes the application and feasibility of two complementary intraoperative assessments. Measurement accuracy, reproducibility, and comparative safety or effectiveness remain untested and require prospective evaluation.
Platelet-rich plasma (PRP) is being investigated for direct sperm exposure, cryopreservation, and intratesticular treatment, but nominal concentration does not identify the delivered cellular and plasma product. We critically searched PubMed/MEDLINE from inception to 24 September 2026 and screened 115 records, identifying 18 original human reports: 14 ex vivo direct-contact, cryopreservation, or derivative-product studies and four intratesticular studies. Small split-sample experiments report study-specific signals in motility, viability, redox, mitochondrial, and post-thaw endpoints, whereas one healthy-donor dose-ranging study found no benefit. A 2026 randomized trial in 160 men with oligoasthenoteratozoospermia reported adjusted improvements in several semen and hormonal outcomes after intratesticular PRP but contained reporting inconsistencies and did not assess pregnancy or live birth; an uncontrolled non-obstructive-azoospermia cohort achieved sperm retrieval in 4/25 men after PRP and repeat microdissection testicular sperm extraction. Human sperm–neutrophil experiments support quantifying and minimizing neutrophil carryover during direct-contact research but do not establish a clinical depletion threshold. PBMC-mediated Nrf2, AMPK–PGC-1α, macrophage, Treg, telomere, or DNA-repair effects have not been demonstrated in human sperm under the conditions studied. We therefore propose a hypothesis-generating product vector based on delivered platelet and leukocyte-subset doses, erythrocyte burden, plasma/fibrinogen, activation or lysis, residual particles, physicochemical compatibility, exposure, and washout. This is a research-reporting framework, not a validated classification or clinical algorithm; effectiveness requires outcome-linked validation through cumulative live birth and offspring safety.
Background/Objectives: Cord clamping guidance relies on a fixed interval or on subjective cessation of cord pulsation. The umbilical artery carries blood from the neonate towards the placenta, and the moment its Doppler signal is first lost has rarely been timed directly. We assessed its reproducibility and its variation with gestational age. Methods: In this prospective single-centre study, 200 women with singleton vaginal deliveries at 34 to 41 weeks (100 late preterm, 100 term) were enrolled consecutively. An 8 MHz continuous-wave vascular Doppler was held over an umbilical artery from complete delivery until the signal was absent beyond 3 s, when the cord was clamped. Sixty randomly selected recordings were re-scored offline by a blinded second observer and the operator. Results: The time to first sustained signal loss (UAFCT) was 39.9 ± 10.8 s in preterm and 60.6 ± 11.2 s in term births (difference 20.8 s, 95% CI 17.7 to 23.8; Cohen d = 1.89). UAFCT rose with gestational age (adjusted β = 6.10 s per week, 95% CI 5.23 to 6.97). Intra- and inter-observer intraclass correlation coefficients were 0.95 (95% CI 0.92 to 0.97) and 0.94 (0.90 to 0.96), with limits of agreement of about ±10 s. At 30 s, a signal persisted in 81% of preterm and all term newborns. Conclusions: The first sustained loss of the umbilical artery Doppler signal can be timed reproducibly from a recording and occurs later with increasing gestational maturity, so a fixed clamping interval falls at different points of this time course in preterm and term newborns.
