AIMS:We compared changes in the perceptions of non-invasive prenatal testing (NIPT) before and after the introduction of a government-involved NIPT certification system in July 2022. METHODS:Web-based surveys of pregnant women who underwent NIPT were conducted in 2020 (pre-certification) and 2023 (post-certification) using a pregnancy-related mobile application. RESULTS:We obtained 1198 and 1227 responses from the 2020 and 2023 surveys, respectively. Compared with 2020 respondents, 2023 respondents who chose non-certified facilities emphasized word-of-mouth reputation, online appointment availability, expanded testing beyond the three major trisomies, low cost, and improved accessibility. The two survey years showed no significant differences in overall trends in facility selection and the tendency to choose certified facilities to prioritize recommendations from their primary care physicians and the availability of pre-test genetic counseling. Additionally, when NIPT results were non-negative, respondents tested at non-certified facilities in 2023 were more likely to report concerns such as "insufficient explanation increased my anxiety" and "I regretted my choice of testing facility." More respondents in 2023 preferred to undergo NIPT at facilities that provide routine prenatal checkups and believed each pregnant woman should make testing decisions. CONCLUSIONS:After introducing the NIPT certification system, those choosing to undergo testing at certified facilities emphasized the importance of comprehensive support, whereas those opting for non-certified facilities prioritized convenience. However, the latter group became increasingly aware of the lack of post-test support when faced with non-negative results.

Background/Objectives: Skin autofluorescence (SAF), a marker of advanced glycation end products (AGEs), reflects cumulative hyperglycemia and may predict vascular complications in diabetes. Continuous glucose monitoring (CGM) also provides detailed glycemic profiles, but their prognostic values in gestational diabetes mellitus (GDM) are unclear. The primary aim was to evaluate whether SAF predicts adverse maternal or neonatal outcomes, whereas secondary exploratory analyses assessed oxidative stress markers and CGM-derived metrics. Methods: We prospectively enrolled 115 Japanese pregnant women with plasma glucose ≥ 140 mg/dL at 60 min after 50-g GCT. At around 29 weeks’ gestation, SAF and diacron-reactive oxygen metabolites (d-ROMs) were measured, and a subset underwent 14-day CGM. Maternal and neonatal outcomes were obtained from medical records. Logistic regression and receiver operating characteristic (ROC) analyses were performed. Results: In the primary analysis of the overall cohort, SAF did not predict adverse outcomes. In the CGM subgroup, mean glucose level (MGL) was significantly higher in women with maternal complications. Multivariate analysis identified MGL as the only independent predictor of maternal adverse events (adjusted OR 10.45 per 10 mg/dL, 95% CI 1.93–56.5; AUC 0.818; cutoff 86.8 mg/dL). No marker predicted neonatal outcomes. Conclusions: The pre-specified primary endpoint was negative (SAF was not predictive), and oxidative stress markers were also not predictive, whereas CGM-derived MGL independently predicted maternal adverse outcomes, underscoring the utility of CGM for risk stratification in pregnant women with abnormal GCT results.

AIM:To clarify the current status of human T-cell leukemia virus type 1 (HTLV-1) among pregnant women in Japan, with a focus on its prevalence by age and region and the contribution of horizontal transmission. METHODS:The Japan Association of Obstetricians and Gynecologists conducted a nationwide questionnaire survey in 2025, collecting 2024 data from 1935 delivery facilities. Facilities reported total deliveries, HTLV-1 carrier cases, and testing details. Information was obtained on birth year, parity, residence, and prior HTLV-1 test results for carriers. Carrier prevalence by region and age group was analyzed, and prior negative results in multiparous carriers were used to estimate horizontal transmission. RESULTS:Responses were received from 1297 facilities (response rate: 67.0%), covering 461 271 deliveries (67.2% of national births). Among these, 331 HTLV-1 carriers were identified (0.07%), with the highest prevalence in Kyushu and Okinawa (0.25%). Carrier prevalence declined in younger cohorts (0.04% in women born ≥ 1990 vs. 0.09% before 1990; OR 0.435, p < 0.001). Among multiparous carriers, 16.3% had previously tested negative, suggesting horizontal transmission, particularly in urban regions (Kanto, Tokai, Kinki). CONCLUSIONS:The prevalence of HTLV-1 among pregnant women in Japan has declined, largely due to effective mother-to-child transmission prevention implemented mainly in HTLV-1 high-prevalence areas. However, horizontal transmission accounts for a notable percentage of cases, highlighting the need to reinforce preventive education and strategies targeting sexual transmission and unsafe medical or cosmetic practices alongside continued perinatal screening and counseling.

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.

Purpose The aim of this study was to measure the blood levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) before and after tadalafil treatment in patients with fetal growth restriction. Materials and methods Maternal blood was collected from 13 women before and 2 weeks after tadalafil administration in the TADAFER II trial. The tadalafil treatment was conducted in addition to the conventional FGR treatment. As a control, maternal blood was also collected from 11 women before and 2 weeks after conventional treatment for fetal growth restriction. Blood sFlt-1 and PlGF were measured and the sFlt-1/PlGF ratio was calculated. Student's t-test was used to statistically analyze differences in the sFlt-1 and PlGF levels, and in the sFlt-1/PlGF ratios. Results In both treatment groups, the levels of sFlt-1 and PlGF before and after treatment were not significantly different from each other. The sFlt-1/PlGF ratio was 2.0 +/- 1.0 before and 17.6 +/- 11.3 after treatment in the control group (p=.04). The sFlt-1/PlGF ratio was 2.2 +/- 1.1 before and 22.2 +/- 10.6 after tadalafil treatment in the tadalafil group (p=.06). The sFlt-1/PlGF ratios before and after tadalafil treatment were significantly increased in the control group. In both treatment groups, the sFlt-1/PlGF ratios before and after treatment were less than 38. Conclusions We conclude that the levels of sFlt-1 and PlGF were not significantly different as a result of tadalafil treatment. Further studies are needed to understand the mechanism of action of tadalafil in the treatment of fetal growth restriction.

•AGEs at 11 to 13 weeks of gestation were significantly higher in patients with EOPE.•AUROC curve for the AGE-to-PlGF ratio was significantly higher than that of AGEs.•The AGE-to-PlGF ratio and MAP detected EOPE with 100% accuracy (FPR of 10%).

In the near future, hypertensive disorders of pregnancy (HDP) have been diagnosed by home blood pressure monitoring (HBPM) instead of clinic BP monitoring. A multicenter study of HBPM was performed in pregnant Japanese women in the non-high risk group for HDP. Participants were women (n = 218), uncomplicated pregnancy who self-measured and recorded their HBP daily. Twelve women developed HDP. HBP was appropriate (100 mmHg in systole and 63 mmHg in diastole), bottoming out at 17 to 21 weeks of gestation. It increased after 24 weeks of gestation and returned to non-pregnant levels by 4 weeks of postpartum. The upper limit of normal HBP was defined as the mean value +3 SD for systolic and mean +2 SD for diastolic with reference to the criteria for non-pregnant women. Using the polynomial equation, the hypertensive cut-off of systolic HBP was 125 mmHg at 15 weeks and 132 mmHg at 30 weeks of gestation, while it for diastolic HBP was 79 mmHg at 15 weeks and 81 mmHg at 30 weeks of gestation. Systolic HBP in women who developed HDP was higher after 24 weeks of gestation, and diastolic HBP was higher during most of the pregnancy compared to normal pregnancy. When the variability of individual HBP in women developed HDP compared to normal pregnant women was examined using the coefficient of variation (CV), the CV was lower in HDP before the onset of HDP. HBPM can be used not only for HDP determination, but also for early detection of HDP.

At the 73rd Annual Congress of the Japan Society of Obstetrics and Gynecology, young doctors from Japan and South Korea made presentations on the present condition of risk-reducing surgery for hereditary breast and ovarian cancer (RRSO) in their respective country. RRSO was insured in Japan in April 2020, whereas in South Korea, it was insured 7 years earlier in 2013. In Japan, certification criteria have been set for facilities that perform RRSO, and the number of facilities is increasing, but regional disparities still exist in its distribution. The number of gBRCA1/2 testing facilities is larger, and the cost is more affordable in South Korea than in Japan. Additionally, South Korea provides genetic counseling to a wider range of relatives compared to Japan. In the future, as the indications for the gBRCA1/2 test have expanded as a companion diagnostic for the use of PARP inhibitors, it is expected that the number of candidates for the gBRCA1/2 mutation test and RRSO will increase in Japan. It is important to increase the number of BRCA tests while maintaining the quality of genetic counseling in order to provide adequate information on BRCA mutations and RRSO for patients to support their decision. For the development of hereditary breast and ovarian cancer (HBOC) medical care, it is necessary to publish a nationwide database in Japan and continue to analyze and discuss the data based on the results.

Since the combustion process in spray flames is a highly complex multi-phase phenomenon, which involves several simultaneous processes such as atomization, vaporization, and chemical kinetics, it is still not fully understood. In the present work, an experimental investigation has been performed for three different hydrocarbon fuels (n-Heptane, n-Decane, n-Dodecane), in order to understand the effect of varying co-flow conditions, fuel mass flow rate, and fuel type on both the flame lift-off height and soot formation. The fuels were injected through a hollow-cone spray injector, with a nominal spray cone angle of 80∘ and orifice diameter of 120μm in an annular non-swirled preheated air co-flow. The flame lift-off height was determined by recording the OH* chemiluminescence, whereas soot formation has been determined through the color diffused back-illumination extinction technique. From the results, it has been observed for a certain fuel that the flame lift-off height is mainly controlled by the co-flow velocity and air co-flow temperature. The results also show that the fuel that yields largest droplet size and that possesses the lowest volatility exhibits the highest flame lift-off height. Furthermore, the results evidence a strong influence of the co-flow velocity on the soot formation. With an increase in co-flow velocity, the flame lift-off height is increased and so the amount of air entrainment, leading to a less rich reaction zone just downstream of the lift-off height, which in turn results in less soot formation. Finally, the comparison among different fuels shows that their differences in soot formation are likely related to fuel sooting tendency. This property, in turn, depends on the fuel molecular structure playing an important role on its determination.

In this paper, we consider fractional CR Yamabe type equations of order 2γ, 0<γ

A Correction to this paper has been published: https://doi.org/10.1038/s41440-021-00653-x

Polymyositis-dermatomyositis is extremely rare during pregnancy, and immunosuppressive therapy should be administered after carefully considering the effects on both the mother and fetus. Several reports have associated the disease activity with fetal prognosis, higher rates of eclampsia, preterm births, and fetal deaths. We report our experience with a patient who was diagnosed with polymyositis-dermatomyositis complicated by interstitial lung disease during pregnancy and was treated with a combination-immunosuppressant regimen. To the best of our knowledge, this is the first case wherein cyclosporine was used concomitantly with a steroid for the treatment of polymyositis diagnosed during pregnancy, with successful outcome of childbirth without any complications.

ABSTRACTObjectivesTo (i) evaluate the applicability of the European‐derived biomarker multiples of the median (MoM) formulae for risk assessment of preterm pre‐eclampsia (PE) in seven Asian populations, spanning the east, southeast and south regions of the continent, (ii) perform quality‐assurance (QA) assessment of the biomarker measurements and (iii) establish criteria for prospective ongoing QA assessment of biomarker measurements.MethodsThis was a prospective, non‐intervention, multicenter study in 4023 singleton pregnancies, at 11 to 13 + 6 weeks' gestation, in 11 recruiting centers in China, Hong Kong, India, Japan, Singapore, Taiwan and Thailand. Women were screened for preterm PE between December 2016 and June 2018 and gave written informed consent to participate in the study. Maternal and pregnancy characteristics were recorded and mean arterial pressure (MAP), mean uterine artery pulsatility index (UtA‐PI) and maternal serum placental growth factor (PlGF) were measured in accordance with The Fetal Medicine Foundation (FMF) standardized measurement protocols. MAP, UtA‐PI and PlGF were transformed into MoMs using the published FMF formulae, derived from a largely Caucasian population in Europe, which adjust for gestational age and covariates that affect directly the biomarker levels. Variations in biomarker MoM values and their dispersion (SD) and cumulative sum tests over time were evaluated in order to identify systematic deviations in biomarker measurements from the expected distributions.ResultsIn the total screened population, the median (95% CI) MoM values of MAP, UtA‐PI and PlGF were 0.961 (0.956–0.965), 1.018 (0.996–1.030) and 0.891 (0.861–0.909), respectively. Women in this largely Asian cohort had approximately 4% and 11% lower MAP and PlGF MoM levels, respectively, compared with those expected from normal median formulae, based on a largely Caucasian population, whilst UtA‐PI MoM values were similar. UtA‐PI and PlGF MoMs were beyond the 0.4 to 2.5 MoM range (truncation limits) in 16 (0.4%) and 256 (6.4%) pregnancies, respectively. QA assessment tools indicated that women in all centers had consistently lower MAP MoM values than expected, but were within 10% of the expected value. UtA‐PI MoM values were within 10% of the expected value at all sites except one. Most PlGF MoM values were systematically 10% lower than the expected value, except for those derived from a South Asian population, which were 37% higher.ConclusionsOwing to the anthropometric differences in Asian compared with Caucasian women, significant differences in biomarker MoM values for PE screening, particularly MAP and PlGF MoMs, were noted in Asian populations compared with the expected values based on European‐derived formulae. If reliable and consistent patient‐specific risks for preterm PE are to be reported, adjustment for additional factors or development of Asian‐specific formulae for the calculation of biomarker MoMs is required. We have also demonstrated the importance and need for regular quality assessment of biomarker values. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Objective To evaluate the reasons for nonreportable cell-free DNA (cfDNA) results in noninvasive prenatal testing (NIPT), we retrospectively studied maternal characteristics and other details associated with the results. Methods A multicenter retrospective cohort study in pregnant women undergoing NIPT by massively parallel sequencing (MPS) with failed cfDNA tests was performed between April 2013 and March 2017. The women's data and MPS results were analyzed in terms of maternal characteristics, test performance, fetal fraction (FF), z scores, anticoagulation therapy, and other details of the nonreportable cases. Results Overall, 110 (0.32%) of 34 626 pregnant women had nonreportable cfDNA test results after an initial blood sampling; 22 (20.0%) cases had a low FF (<4%), and 18 (16.4%) cases including those with a maternal malignancy, were found to have altered genomic profile. Approximately half of the cases with nonreportable results had borderline z score. Among the women with nonreportable results because of altered genomic profile, the success rate of retesting using a second blood sampling was relatively low (25.0%-33.3%). Thirteen (11.8%) of the women with nonreportable results had required hypodermic heparin injection. Conclusions The classification of nonreportable results using cfDNA analysis is important to provide women with precise information and to reduce anxiety during pregnancy.

1Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, 2Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, 3Department of Obstetrics and Gynecology, Ehime University School of Medicine, 4Department of Obstetrics, Osaka City General Hospital, 5Perinatal Center, Divisions of Maternal and Fetal Medicine, Saitama Medical Center, Jichi Medical University, 6Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, 7Department of Obstetrics and Gynecology, Showa University School of Medicine, 8Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 9Department of Obstetrics, Hokkaido University Graduate School of Medicine, 10Department of Obstetrics and Gynecology, St. Barnabas’ Hospital, 11Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, 12Department of Obstetrics and Gynecology, Tokyo Medical University, 13Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, 14Department of Obstetrics and Gynecology, Tokyo Women’s Medical University, 15Department of Obstetrics and Gynecology, Palmore Hospital, 16Department of Endocrinology and Hypertension, Tokyo Women’s Medical University, 17Department of Obstetrics and Gynecology, University of Toyama, 18Department of Obstetrics and Gynecology, Saitama Medical University Hypertension Research In Pregnancy