International Journal of Obstetrics and Gynecology

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 423–434

DOI: 10.46882/2026/IJOG/000516

Original Research Article

Title: Diagnostic Accuracy of Magnetic Resonance Imaging versus Transvaginal Ultrasound in Mapping Deep Infiltrating Endometriosis

Names of Authors: Anita P. Nwosu¹, Samuel T. Kudoyin²

Authors’ Affiliations:
¹ Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, Lagos State University Teaching Hospital, Ikeja, Nigeria
² Department of Radiology, College of Medicine, University of Lagos, Lagos, Nigeria

Abstract:
Deep Infiltrating Endometriosis (DIE) is characterized by lesions penetrating greater than 5 mm beneath the peritoneal surface, necessitating accurate preoperative mapping. This prospective diagnostic study compared the accuracy of Magnetic Resonance Imaging (MRI) against transvaginal ultrasound (TVUS) optimized with a bowel preparation protocol for mapping specific DIE locations. One hundred and twenty symptomatic women scheduled for laparoscopic excision of pelvic endometriosis underwent both TVUS and 1.5-T pelvic MRI preoperatively. Findings from both modalities were verified against surgical visualization and histopathological confirmation, which served as the gold standard. DIE was confirmed pathologically in 84 patients (70.0%). For rectosigmoid colon lesions, TVUS and MRI demonstrated comparable sensitivities (85.2% vs. 88.9%, p = 0.54) and specificities (94.1% vs. 95.6%, p = 0.62). However, for detecting uterosacral ligament lesions, MRI achieved a significantly higher sensitivity than TVUS (89.3% vs. 71.4%, p = 0.008), though specificities remained statistically equivalent (88.9% vs. 90.5%, p = 0.74). For bladder lesions, MRI also trended toward higher diagnostic precision (sensitivity 87.5% vs. 62.5%, p = 0.046). The overall accuracy for mapping overall posterior compartment lesions was 90.8% for MRI and 81.7% for TVUS (p = 0.012). While TVUS optimized with bowel preparation remains an excellent, highly cost-effective first-line diagnostic modality for intestinal mapping, pelvic MRI provides superior diagnostic accuracy for tracking deep infiltrating endometriosis within the uterosacral and anterior retroperitoneal spaces.

Keywords: Deep Infiltrating Endometriosis; Magnetic Resonance Imaging; Transvaginal Ultrasound; Diagnostic Sensitivity; Preoperative Mapping; Pelvic Laparoscopy.

Manuscript Timeline: Received: May 15, 2026; Revised: July 03, 2026; Accepted: July 22, 2026; Published: August 06, 2026.

Citation: Nwosu AP, Kudoyin ST. Diagnostic Accuracy of Magnetic Resonance Imaging versus Transvaginal Ultrasound in Mapping Deep Infiltrating Endometriosis. International Journal of Obstetrics and Gynecology. 2026; 14(8): 423–434.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 397–408

DOI: 10.46882/2026/IJOG/000510

Original Research Article

Title: Efficacy and Safety of Intravaginal Isoflavone Gel versus Estriol Cream for the Treatment of Genitourinary Syndrome of Menopause

Names of Authors: Mariam T. Bello¹, Grace E. Effiong²

Authors’ Affiliations:
¹ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University Hospital, Ibadan, Nigeria
² Department of Public Health, University of Calabar, Calabar, Nigeria

Abstract:
Genitourinary Syndrome of Menopause (GSM) is characterized by chronic vulvovaginal atrophy that requires effective local therapy. This randomized active-controlled trial compared the non-hormonal efficacy of an intravaginal isoflavone gel against topical estriol cream for mitigating GSM symptoms in postmenopausal women with contraindications to systemic hormone therapies. One hundred and sixty postmenopausal patients presenting with moderate-to-severe vaginal dryness or dyspareunia were randomized into two equal groups (n = 80 per group) to apply either 4% isoflavone gel or 0.1% estriol cream three times weekly for 12 weeks. Primary outcomes included changes in the Vaginal Health Index (VHI) score, vaginal pH, and subjective symptom relief. After 12 weeks of treatment, the mean VHI score increased significantly in both groups (isoflavone: 12.4 ± 1.5 to 19.8 ± 2.1, p < 0.001; estriol: 12.1 ± 1.4 to 21.4 ± 2.3, p < 0.001). Mean vaginal pH dropped below 5.0 in both arms (p < 0.001). Subjective improvement in vaginal dryness was reported by 78.8% of the isoflavone cohort and 85.0% of the estriol cohort, demonstrating non-inferiority of the phytoestrogen gel (p = 0.31). No significant variations in endometrial thickness were noted on transvaginal ultrasound in either group (p > 0.05). Local burning sensations were slightly more frequent in the estriol cream cohort (p = 0.042). Intravaginal isoflavone gel represents an effective, safe non-hormonal alternative that successfully restores vaginal epithelial health and mitigates genitourinary symptoms in postmenopausal women.

Keywords: Genitourinary Syndrome of Menopause; Phytoestrogens; Isoflavone Gel; Estriol Cream; Vulvovaginal Atrophy; Vaginal pH.

Manuscript Timeline: Received: June 03, 2026; Revised: July 22, 2026; Accepted: August 07, 2026; Published: August 26, 2026.

Citation: Bello MT, Effiong GE. Efficacy and Safety of Intravaginal Isoflavone Gel versus Estriol Cream for the Treatment of Genitourinary Syndrome of Menopause. International Journal of Obstetrics and Gynecology. 2026; 14(8): 397–408.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 409–420

DOI: 10.46882/2026/IJOG/000511

Original Research Article

Title: Evaluation of Single-Incision Laparoscopic Surgery versus Conventional Laparoscopy for Total Hysterectomy in Benign Uterine Disease

Names of Authors: Chidi E. Eze¹, Aisha M. Umar²

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
² Department of Obstetrics and Gynecology, Federal Medical Centre, Katsina, Nigeria

Abstract:
Single-Incision Laparoscopic Surgery (SILS) aims to minimize operative entry morbidity by consolidating access ports within a single umbilical incision. This prospective randomized trial compared the perioperative results, postoperative pain patterns, and cosmetic satisfaction scores of SILS total laparoscopic hysterectomy (TLH) against standard multi-port conventional laparoscopy (CL) for benign uterine conditions. One hundred and forty women requiring hysterectomy for symptomatic uterine fibroids or adenomyosis (uterine size ≤ 14 weeks) were randomized to either the SILS-TLH group (n = 70) or the CL-TLH group (n = 70). The mean operative time was significantly longer in the SILS cohort due to instrument crowding and restricted triangulation features (84.5 ± 15.2 minutes vs. 62.8 ± 11.4 minutes, p < 0.001). However, SILS-TLH patients experienced significantly lower visual analog scale pain scores at 12 hours post-surgery (2.4 ± 0.6 vs. 3.8 ± 1.1, p < 0.001), leading to a 30.0% reduction in postoperative ward analgesic use. The cosmetic outcome score evaluated 6 weeks postoperatively was significantly higher in the single-incision arm (9.6 ± 0.4 vs. 7.8 ± 0.9, p < 0.001). The frequencies of vault hematoma, wound infection, and secondary readmissions did not show clinical divergence between the groups (p > 0.05). SILS for total laparoscopic hysterectomy is a technically demanding yet safe procedure that increases operative duration but offers lower early postoperative pain and superior cosmetic outcomes compared to conventional multi-port laparoscopy.

Keywords: Single-Incision Laparoscopic Surgery; Total Laparoscopic Hysterectomy; Benign Uterine Disease; Postoperative Pain; Cosmetic Satisfaction; Port Morbidity.

Manuscript Timeline: Received: June 05, 2026; Revised: July 24, 2026; Accepted: August 08, 2026; Published: August 30, 2026.

Citation: Eze CE, Umar AM. Evaluation of Single-Incision Laparoscopic Surgery versus Conventional Laparoscopy for Total Hysterectomy in Benign Uterine Disease. International Journal of Obstetrics and Gynecology. 2026; 14(8): 409–420.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 385–396

DOI: 10.46882/2026/IJOG/000509

Original Research Article

Title: A Randomized Trial of Double-Lumen versus Single-Lumen Needle for Oocyte Retrieval in Women with Low Ovarian Reserve

Names of Authors: Anita P. Nwosu¹, Samuel T. Kudoyin²

Authors’ Affiliations:
¹ Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, Lagos State University Teaching Hospital, Ikeja, Nigeria
² Department of Radiology, College of Medicine, University of Lagos, Lagos, Nigeria

Abstract:
Oocyte retrieval in poor responders requires maximum technical optimization to avoid follicle loss. This randomized clinical trial compared the efficacy and safety profiles of a double-lumen follicle aspiration needle (enabling continuous flushing) against a standard single-lumen needle in women with poor ovarian reserve undergoing assisted reproductive treatments. One hundred subfertile women meeting the Bologna criteria for poor ovarian reserve (Antral Follicle Count ≤ 5 or Anti-Müllerian Hormone ≤ 1.1 ng/mL) were randomized to either the double-lumen needle group (n = 50) or the single-lumen needle group (n = 50) during transvaginal ultrasound-guided oocyte retrieval. The primary endpoint was the total number of oocytes retrieved per dominant follicle. The mean number of retrieved oocytes did not differ significantly between the double-lumen and single-lumen cohorts (2.8 ± 1.1 vs. 2.6 ± 1.2, p = 0.38). The oocyte retrieval rate per punctured follicle was also statistically comparable (68.5% vs. 65.2%, p = 0.44). However, the mean operative duration was significantly longer in the double-lumen needle arm due to the repetitive flushing steps (16.4 ± 3.5 minutes vs. 9.2 ± 2.1 minutes, p < 0.001). Postoperative pelvic pain scores measured on a visual analog scale were higher in the double-lumen group (p = 0.012), though severe bleeding risks were similar (p > 0.05). Utilizing a double-lumen needle for follicular flushing does not increase the oocyte yield in women with low ovarian reserve but prolongs surgical timelines and increases immediate postoperative discomfort compared to a simple single-lumen needle.

Keywords: Poor Ovarian Reserve; Oocyte Retrieval; Follicular Flushing; Double-Lumen Needle; Single-Lumen Needle; IVF Outcomes.

Manuscript Timeline: Received: June 01, 2026; Revised: July 19, 2026; Accepted: August 06, 2026; Published: August 24, 2026.

Citation: Nwosu AP, Kudoyin ST. A Randomized Trial of Double-Lumen versus Single-Lumen Needle for Oocyte Retrieval in Women with Low Ovarian Reserve. International Journal of Obstetrics and Gynecology. 2026; 14(8): 385–396.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 373–384

DOI: 10.46882/2026/IJOG/000508

Original Research Article

Title: Maternal Serum Zinc and Copper Levels in Early Pregnancy and their Association with Fetal Growth Restriction

Names of Authors: Bukola R. Omotayo¹, David C. Iwuala¹

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria

Abstract:
Trace elements play essential structural and catalytic roles in placental development and embryonic cellular proliferation. This prospective observational study evaluated the relationship between first-trimester maternal serum concentrations of zinc (Zn) and copper (Cu) and the subsequent development of Fetal Growth Restriction (FGR) in low-risk singleton pregnancies. Serum samples were collected from 600 pregnant women between 11 and 13⁺⁶ weeks of gestation, and trace element concentrations were quantified via inductively coupled plasma mass spectrometry. All participants were followed longitudinally until delivery. FGR was defined postnatally as a customized birth weight below the 10th percentile. Sixty-eight pregnancies (11.3%) were complicated by FGR. First-trimester maternal serum zinc levels were significantly lower in the FGR group compared to normotensive, appropriate-for-gestational-age controls (58.4 ± 12.2 μg/dL vs. 74.6 ± 14.5 μg/dL, p < 0.001). Conversely, the mean copper concentration and the Cu/Zn ratio were significantly elevated in the FGR cohort (Cu/Zn: 2.15 ± 0.45 vs. 1.42 ± 0.32, p < 0.001), indicating altered antioxidant balance. Adjusting for maternal age, smoking status, and BMI, logistic regression analysis revealed that maternal zinc levels below 60 μg/dL were associated with a fourfold increase in FGR risk (OR = 4.12; 95% CI, 2.18 to 7.82, p < 0.001). Low maternal serum zinc levels and an elevated Cu/Zn ratio in the first trimester are strongly associated with impaired fetal growth, highlighting potential targets for early nutritional assessment.

Keywords: Fetal Growth Restriction; Zinc Deficiency; Copper; Trace Elements; Placental Development; Nutritional Biomarkers.

Manuscript Timeline: Received: May 28, 2026; Revised: July 16, 2026; Accepted: August 05, 2026; Published: August 21, 2026.

Citation: Omotayo BR, Iwuala DC. Maternal Serum Zinc and Copper Levels in Early Pregnancy and their Association with Fetal Growth Restriction. International Journal of Obstetrics and Gynecology. 2026; 14(8): 373–384.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 361–372

DOI: 10.46882/2026/IJOG/000507

Original Research Article

Title: Prophylactic Intravenous Ondansetron versus Metoclopramide for Preventing Spinal Anesthesia-Induced Hypotension and Nausea during Cesarean Section

Names of Authors: Emeka J. Obi¹, Funmilayo R. Adeyemi², Zainab H. Dogara¹

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
² Maternal Health Division, Federal Ministry of Health, Abuja, Nigeria

Abstract:
Spinal anesthesia for cesarean section routinely induces maternal hypotension and intraoperative nausea due to sympathetic blockade. This double-blind randomized controlled trial compared the clinical efficacy of prophylactic intravenous ondansetron versus metoclopramide in mitigating spinal-induced hypotension and emetic symptoms. Two hundred and forty healthy parturients scheduled for elective cesarean birth were randomized into two equal groups (n = 120 per group). Group A received 4 mg of intravenous ondansetron, while Group B received 10 mg of intravenous metoclopramide 5 minutes before the initiation of spinal anesthesia. Vital signs were checked at 2-minute intervals during the first 20 minutes following spinal injection. The primary outcome was the incidence of maternal hypotension (systolic blood pressure < 90 mmHg or a drop > 20% from baseline). The incidence of spinal anesthesia-induced hypotension was significantly lower in the ondansetron group compared to the metoclopramide group (31.7% vs. 52.5%, p = 0.001). Consequently, the total requirement for rescue phenylephrine doses was reduced in the ondansetron arm (1.4 ± 0.5 mg vs. 2.6 ± 0.8 mg, p < 0.001). Ondansetron also provided superior protection against intraoperative nausea and vomiting (5.8% vs. 17.5%, p = 0.004). Neonatal Apgar scores and umbilical cord blood gas parameters were excellent and comparable across both cohorts (p > 0.05). Prophylactic administration of 4 mg intravenous ondansetron minimizes the incidence and severity of maternal hypotension and intraoperative nausea, stabilizing cardiovascular hemodynamics during cesarean delivery under spinal anesthesia.

Keywords: Spinal Anesthesia; Cesarean Section; Hypotension; Ondansetron; Metoclopramide; Vasopressor Requirement.

Manuscript Timeline: Received: May 25, 2026; Revised: July 15, 2026; Accepted: August 04, 2026; Published: August 18, 2026.

Citation: Obi EJ, Adeyemi FR, Dogara ZH. Prophylactic Intravenous Ondansetron versus Metoclopramide for Preventing Spinal Anesthesia-Induced Hypotension and Nausea during Cesarean Section. International Journal of Obstetrics and Gynecology. 2026; 14(8): 361–372.

International Journal of Obstetrics and Gynecology | Vol. 14, No. 8, August 2026 | pp. 349–360

DOI: 10.46882/2026/IJOG/000506

Original Research Article

Title: A Randomized Controlled Trial of Laparoscopic Radical Hysterectomy versus Open Radical Hysterectomy for Early-Stage Cervical Cancer: The 10-Year Follow-up

Names of Authors: Olayinka O. Cole¹, Nesta C. Chuka¹

Authors’ Affiliations:
¹ Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, National Hospital, Abuja, Nigeria

Abstract:
Recent landmark trials have questioned the oncological safety of minimally invasive surgery for cervical cancer. This retrospective analysis presents the final 10-year long-term survival outcomes of a randomized clinical trial comparing Laparoscopic Radical Hysterectomy (LRH) to Open Radical Hysterectomy (ORH) in early-stage (Stage IA2 to IB1) cervical carcinoma. Long-term follow-up profiles of 150 patients randomized between 2014 and 2016 were analyzed: LRH (n = 75) and ORH (n = 75). The primary outcomes were 10-year disease-free survival (DFS) and overall survival (OS) rates. At 10 years, the DFS rate was significantly lower in the LRH group compared to the open surgical group (72.0% vs. 85.3%; Hazard Ratio [HR] = 1.94; 95% CI, 1.12 to 3.37; p = 0.016). The 10-year overall survival rate was also lower in the laparoscopic cohort (77.3% vs. 89.3%, p = 0.038). Locoregional pelvic recurrence occurred in 18.7% of LRH patients compared to 6.7% of open surgery patients (p = 0.024). Subgroup analysis indicated that the risk of recurrence was most pronounced in tumors exceeding 2 cm in diameter. Perioperative benefits (lower blood loss and shorter hospital stay) in the LRH group did not offset the long-term oncological deficit. In conclusion, long-term 10-year tracking confirms that laparoscopic radical hysterectomy is associated with significantly lower disease-free and overall survival rates compared to open abdominal radical hysterectomy in early-stage cervical cancer, confirming that the open approach remains the preferred standard.

Keywords: Cervical Cancer; Radical Hysterectomy; Laparoscopy; Open Laparotomy; Long-Term Survival; Disease Recurrence.

Manuscript Timeline: Received: May 22, 2026; Revised: July 12, 2026; Accepted: August 03, 2026; Published: August 15, 2026.

Citation: Cole OO, Chuka NC. A Randomized Controlled Trial of Laparoscopic Radical Hysterectomy versus Open Radical Hysterectomy for Early-Stage Cervical Cancer: The 10-Year Follow-up. International Journal of Obstetrics and Gynecology. 2026; 14(8): 349–360.