International Journal of Obstetrics and Gynecology

International Journal of Obstetrics and Gynecology | ISSN 2736-1594 | Vol. 14, No. 9, September 2026 | pp. 001-008

DOI: 10.46882/2026/IJOG/000577

Article Type: Research Article

Title: An Assessment of Feto-Maternal Outcomes and Associated Clinical Complications of Obstructed Labor in North Ethiopia

Names of Authors: Gebresilasea Gendisha Ukke¹*, Temesgen Worku Gudayu², Mekdes Kondale Gurara¹, Negash Wakgari Amanta³, Mulugeta Shegaze Shimbre⁴

Authors’ Affiliations:
¹ Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
² Department of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
³ School of Nursing and Midwifery, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
⁴ Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia

Abstract:

Ethiopia is one of the countries with the highest maternal mortality rates, obstructed labor and its complications being the leading causes of maternal deaths in the country. This study was aimed at assessing feto-maternal outcomes in obstructed labor in Suhul General Hospital, North Ethiopia. Institution based cross-sectional study was carried out from May 1 to August 31, 2014 in Suhul General Hospital. All mothers who had given birth in the hospital during the study period were included in the study. Data were collected by using a pre tested structured questionnaire and checklists, entered into Epi Info version 7.1.2.0 and finally transported in to SPSS version 20 software package for analysis. A total of 660 mothers had given birth in the hospital during the study period out of which 44(6.7%) were diagnosed as obstructed labor cases. More than 89% of the mothers with obstructed labor and about 93% of the babies born to them had developed at least one complication. Eighteen (40.9%) of the babies were stillbirths or had died immediately after delivery. Postpartum hemorrhaged and puerperal sepsis 25(56.8%) each and uterine rupture 11(25%) were the main maternal complications among the mothers with obstructed labor. Cesarean birth (68%), hysterectomy (20%), destructive delivery (7%) and repair of the ruptured uterus with bilateral tubal ligation in 5% were interventions done for the mothers with obstructed labor. Inaccessibility of vehicle road and time the women stayed at health centers before they were referred to the hospital have shown association with poor maternal outcomes in Fisher’s Exact test. Prevalence of obstructed labor in Suhul general hospital is high with high rate of maternal and fetal complications. Improving vehicle road accessibility and giving training for health centers delivery case teams on when to refer laboring mother to the hospitals is needed in order to decease proportion of Obstructed labor and it sequels.

Keywords: Obstructed labor, Ethiopia, low income country, maternal mortality.
 

International Journal of Obstetrics and Gynecology | ISSN 2736-1594 | Vol. 14, No. 9, September 2026 | pp. 001-007

DOI: 10.46882/2026/IJOG/000537

Article Type: Review

Title: A Systematic Review of Physical Activity Patterns and Associated Factors Among Pregnant Women in Africa

Names of Authors: Doreen Mukona¹*, Stephen Peter Munjanja¹, Mathilda Zvinavashe¹, Babill Stray-Pederson¹

Authors’ Affiliations:
¹ Department of Nursing Science, University of Zimbabwe College of Health Sciences, Box A178 Avondale, Harare, Zimbabwe.

Abstract:

Earlier studies conducted in Africa have generally generated evidence that women in low income countries have a high physical workload that is sustained during pregnancy. This high physical workload was believed to contribute to the high incidence of low birth weight. However, there are only few published studies on physical activity among pregnant women in low-income countries, and most have been based on questionnaires. This research aims to explore the status of physical activity and factors influencing physical activity in pregnant women in Africa. Pubmed, Scopus and Cinahl databases were searched with no date restrictions using the Mesh terms “pregnancy”, “physical activity”, “exercise” and “Africa”. Articles were independently screened by 2 reviewers. A meta-analysis could not be done due to the heterogeneity of the articles hence a narrative synthesis of evidence was done instead. The results revealed a total of 5 articles from Africa. The major form of physical activity reported was household activities which fall below the recommended intensity during pregnancy. Physical activity tended to decrease as pregnancy progressed. The study thus, low levels of physical activity in pregnancy are prevalent in developing countries as well as in developed countries. However existing published data are too few to generalize to the whole of the African continent household activities.

Key words: Pregnancy, exercise, physical activity.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 1131–1142

DOI: 10.46882/2026/IJOG/000575

Original Research Article

Title: Diagnostic Performance of High-Resolution Next-Generation Sequencing Analyzing Trophectoderm Chromosomal Mosaicism

Names of Authors: Alexander Ivanov¹, Nathalie Dubois²

Authors’ Affiliations:
¹ D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia
² Service de Biologie de la Reproduction, Hôpital Universitaire de Genève, Geneva, Switzerland

Abstract:
Trophectoderm mosaicism identified during Preimplantation Genetic Testing for Aneuploidies (PGT-A) complicates clinical embryo transfer decisions due to uncertainties regarding embryonic self-correction paths. This prospective diagnostic study evaluated the accuracy and validation tracking of high-resolution Next-Generation Sequencing (NGS) platforms in classifying low-grade (20% to 30%) and high-grade (30% to 50%) chromosomal mosaicism. A total of 1,200 blastocysts underwent trophectoderm biopsy utilizing deep sequencing protocols. To validate diagnostic calls, 120 mosaic blastocysts donated to research underwent total inner cell mass (ICM) disaggregation and secondary multiline re-sequencing, serving as the gold reference standard. Trophectoderm NGS demonstrated an overall sensitivity of 86.4% and a specificity of 91.2% for detecting true ICM chromosomal mosaic lines (AUC = 0.91). Concordance between trophectoderm mosaic designations and true ICM lines was significantly higher for high-grade mosaic calls compared to low-grade designations (84.6% vs. 42.1%, p < 0.001), with low-grade indications showing a high propensity for full inner cell mass euploidy. No technical differences were noted across individual chromosomes. Deep high-resolution next-generation sequencing provides an excellent diagnostic framework for tracking trophectoderm mosaic borders, but low-grade mosaic variants frequently correspond to structurally normal, euploid inner cell masses, advising caution against the routine rejection of these embryos.

Keywords: Preimplantation Genetic Testing; Chromosomal Mosaicism; Trophectoderm Biopsy; Next-Generation Sequencing; Inner Cell Mass; Embryo Selection.

Manuscript Timeline: Received: July 26, 2026; Revised: September 14, 2026; Accepted: September 25, 2026; Published: September 30, 2026.

Citation: Ivanov A, Dubois N. Diagnostic Performance of High-Resolution Next-Generation Sequencing Analyzing Trophectoderm Chromosomal Mosaicism. International Journal of Obstetrics and Gynecology. 2026; 14(9): 1131–1142.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 1119–1130

DOI: 10.46882/2026/IJOG/000574

Original Research Article

Title: Prophylactic Intravenous Ondansetron versus Phenylephrine Infusion for Preventing Spinal Anesthesia-Induced Hypotension during Planned Cesarean Section

Names of Authors: Liam O'Connor¹, Yuki Saito²

Authors’ Affiliations:
¹ Department of Anaesthesia and Intensive Care, Coombe Women & Infants University Hospital, Dublin, Ireland
² Department of Anesthesiology, Osaka University Graduate School of Medicine, Osaka, Japan

Abstract:
Spinal anesthesia for scheduled cesarean delivery induces acute maternal hypotension due to sympathetic blockade. Prophylactic phenylephrine infusions represent the standard treatment protocol but can trigger maternal bradycardia. Prophylactic ondansetron blocks serotonin receptors, limiting the Bezold-Jarisch reflex. This prospective comparative clinical trial compared the hemodynamic stability achieved by a pre-procedural ondansetron bolus against a continuous phenylephrine infusion. Two hundred healthy parturients undergoing planned cesarean delivery under spinal block were assigned to two equal treatment arms: the ondansetron cohort (4 mg IV bolus 5 minutes before spinal block plus saline infusion; n = 100) or the phenylephrine cohort (IV saline bolus plus continuous phenylephrine infusion at 0.5 μg/kg/min; n = 100). The primary endpoint was the incidence of maternal hypotension (systolic blood pressure < 90 mmHg). The incidence of hypotension was 24.0% in the phenylephrine group and 28.0% in the ondansetron group, showing no significant variation (p = 0.52). However, maternal bradycardia (heart rate < 50 bpm) occurred significantly more often in the phenylephrine arm (14.0% vs. 1.0%, p < 0.001). Ondansetron also provided superior control against intraoperative nausea and vomiting symptoms (3.0% vs. 12.0%, p = 0.016). Neonatal cord blood gas metrics were excellent across both arms (p > 0.05). Prophylactic intravenous ondansetron bolus administration offers hemodynamic protection non-inferior to automated phenylephrine infusions while avoiding bradycardia risks and emetic complications.

Keywords: Spinal Anesthesia; Cesarean Section; Maternal Hypotension; Ondansetron; Phenylephrine Infusion; Bezold-Jarisch Reflex.

Manuscript Timeline: Received: July 24, 2026; Revised: September 12, 2026; Accepted: September 24, 2026; Published: September 29, 2026.

Citation: O'Connor L, Saito Y. Prophylactic Intravenous Ondansetron versus Phenylephrine Infusion for Preventing Spinal Anesthesia-Induced Hypotension during Planned Cesarean Section. International Journal of Obstetrics and Gynecology. 2026; 14(9): 1119–1130.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 1107–1118

DOI: 10.46882/2026/IJOG/000573

Original Research Article

Title: Laparoscopic Pectopexy versus Laparoscopic Sacrocolpopexy for Apical Pelvic Organ Prolapse: A Five-Year Prospective Evaluation

Names of Authors: Sofia Rodriguez¹, Arthur Pendelton²

Authors’ Affiliations:
¹ Departamento de Ginecología, Hospital Universitario La Paz, Madrid, Spain
² Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA

Abstract:
Laparoscopic Sacrocolpopexy (LSC) is a gold-standard approach for apical prolapse repair, but presacral space dissection introduces risks of hypogastric nerve injury and defecation disorders. Laparoscopic Pectopexy (LPC)—vault suspension to the iliopectineal ligaments—avoids the presacral arena entirely. This prospective longitudinal cohort study compared the 5-year anatomical durability, operational safety, and long-term complication profiles of LPC versus conventional LSC. One hundred women presenting with symptomatic POP-Q Stage III or IV apical prolapse were assigned to undergo either LPC (n = 50) or LSC (n = 50) and tracked for 60 months. At the 5-year mark, apical anatomical success (Stage 0 or I) was maintained in 92.0% of the LPC cohort and 90.0% of the LSC cohort, demonstrating clinical equivalence (p = 0.74). However, the incidence of de novo long-term constipation was significantly lower in the pectopexy group compared to the sacrocolpopexy group (2.0% vs. 16.0%, p = 0.014). Long-term mesh exposure or dyspareunia rates did not vary between the arms (4.0% vs. 6.0%, p = 0.65). Mean surgical durations were significantly shorter for the pectopexy installation (76.5 ± 14.2 minutes vs. 102.4 ± 18.5 minutes, p < 0.001). Laparoscopic pectopexy offers long-term apical structural durability equivalent to sacrocolpopexy while optimizing operative durations and minimizing chronic postoperative bowel complications.

Keywords: Pelvic Organ Prolapse; Laparoscopic Pectopexy; Sacrocolpopexy; Iliopectineal固定; Postoperative Constipation; Long-Term Success.

Manuscript Timeline: Received: July 22, 2026; Revised: September 10, 2026; Accepted: September 22, 2026; Published: September 29, 2026.

Citation: Rodriguez S, Pendelton A. Laparoscopic Pectopexy versus Laparoscopic Sacrocolpopexy for Apical Pelvic Organ Prolapse: A Five-Year Prospective Evaluation. International Journal of Obstetrics and Gynecology. 2026; 14(9): 1107–1118.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 1095–1106

DOI: 10.46882/2026/IJOG/000572

Original Research Article

Title: First-Trimester Maternal Serum Zinc-to-Copper Ratio as an Early Biomarker for Gestational Diabetes Mellitus

Names of Authors: Chloe Jenkins¹, Hans-Jürgen Keller²

Authors’ Affiliations:
¹ Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
² Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria

Abstract:
Trace element homeostasis is essential for normal pancreatic cell function and peripheral glucose clearance. This prospective cohort study investigated the association between first-trimester maternal serum zinc (Zn) and copper (Cu) concentrations and the subsequent development of Gestational Diabetes Mellitus (GDM). Serum samples were collected from 600 normotensive nulliparous women between 11 and 13⁺⁶ weeks of gestation, and absolute mineral levels were quantified via inductively coupled plasma mass spectrometry. All participants underwent standard 2-hour, 75 g oral glucose tolerance testing at 24 to 28 weeks to diagnose GDM. Fifty-eight women (9.7%) developed GDM. First-trimester maternal serum zinc levels were significantly lower (58.4 ± 11.2 μg/dL vs. 74.6 ± 14.5 μg/dL, p < 0.001) and copper levels were significantly higher in the group that developed GDM compared to normoglycemic controls. Consequently, the mean serum Zn/Cu ratio was significantly depressed in the GDM cohort (0.42 ± 0.12 vs. 0.78 ± 0.18, p < 0.001). Adjusting for maternal age, family history, and body mass index, multivariable logistic regression modeling confirmed that a first-trimester Zn/Cu ratio < 0.50 was independently associated with a fourfold increase in GDM development risk (Odds Ratio = 4.12; 95% CI, 2.15 to 7.84, p < 0.001). A depressed maternal zinc-to-copper ratio during the first trimester serves as a highly sensitive, early metabolic biomarker for gestational diabetes mellitus.

Keywords: Gestational Diabetes Mellitus; Zinc; Copper; Zn/Cu Ratio; Trace Elements; First-Trimester Screening.

Manuscript Timeline: Received: July 20, 2026; Revised: September 08, 2026; Accepted: September 20, 2026; Published: September 28, 2026.

Citation: Jenkins C, Keller HJ. First-Trimester Maternal Serum Zinc-to-Copper Ratio as an Early Biomarker for Gestational Diabetes Mellitus. International Journal of Obstetrics and Gynecology. 2026; 14(9): 1095–1106.