Background: We aimed to investigate the outcomes of anterior and posterior approaches in patients who underwent sacrospinous ligament fixation for apical prolapse. Methods: The study included hysterectomized women with grade ≥2 apical prolapse according to the Pelvic Organ Prolapse Quantification (POP-Q) system, who presented to our center between 2019 and 2022. Out of the 48 patients included in the study, 24 underwent posterior bilateral sacrospinous ligament fixation (PB-SSLF), while the other 24 underwent anterior bilateral sacrospinous ligament fixation (AB-SSLF). Postoperative anatomical recurrence of anterior vaginal wall prolapse, according to the POP-Q system, was defined as follows: cystocele ≥ stage II (Aa or Ba ≥–1 cm), recurrent apical prolapse ≥ stage II (C ≥–1 cm), and posterior vaginal wall prolapse ≥ stage II (Ap or Bp ≥–1 cm). Postoperative follow-up visits were scheduled routinely at 1, 3, 6, and 12 months after the operation, and then annually. Complications were recorded according to the Clavien-Dindo classification. Rates in the groups were compared using the Chi-square test. Independent two-group comparisons of numerical variables were performed using the Student t-test when the normal distribution assumption was met and the Mann-Whitney U test when the assumption was not met. The significance level (alpha) was set at p < 0.05. Results: No significant difference was observed in terms of postoperative anterior recurrence between the groups that underwent bilateral anterior and posterior SSLF (16.7% each). Regarding the operation durations, the group that underwent AB-SSLF had longer operation times compared to the group that underwent PB-SSLF (80 minutes and 42.5 minutes, respectively). A higher incidence of postoperative urinary dysfunction was observed in patients who underwent anterior bilateral sacrospinous ligament fixation (p = 0.012). No grade 3b or higher complications were observed according to the Clavien-Dindo classification. Conclusions: AB-SSLF is an effective method in the surgical treatment of apical and anterior pelvic prolapse. However, the anterior compartment failure rate is still a limitation. Further research is required to investigate its long-term efficacy.
{"title":"Comparison of Anterior and Posterior Approach Bilateral Sacrospinous Ligament Fixation for Vaginal Vault Prolapse","authors":"Fatih Şahin, Ramazan Adan","doi":"10.31083/j.ceog5010216","DOIUrl":"https://doi.org/10.31083/j.ceog5010216","url":null,"abstract":"Background: We aimed to investigate the outcomes of anterior and posterior approaches in patients who underwent sacrospinous ligament fixation for apical prolapse. Methods: The study included hysterectomized women with grade ≥2 apical prolapse according to the Pelvic Organ Prolapse Quantification (POP-Q) system, who presented to our center between 2019 and 2022. Out of the 48 patients included in the study, 24 underwent posterior bilateral sacrospinous ligament fixation (PB-SSLF), while the other 24 underwent anterior bilateral sacrospinous ligament fixation (AB-SSLF). Postoperative anatomical recurrence of anterior vaginal wall prolapse, according to the POP-Q system, was defined as follows: cystocele ≥ stage II (Aa or Ba ≥–1 cm), recurrent apical prolapse ≥ stage II (C ≥–1 cm), and posterior vaginal wall prolapse ≥ stage II (Ap or Bp ≥–1 cm). Postoperative follow-up visits were scheduled routinely at 1, 3, 6, and 12 months after the operation, and then annually. Complications were recorded according to the Clavien-Dindo classification. Rates in the groups were compared using the Chi-square test. Independent two-group comparisons of numerical variables were performed using the Student t-test when the normal distribution assumption was met and the Mann-Whitney U test when the assumption was not met. The significance level (alpha) was set at p < 0.05. Results: No significant difference was observed in terms of postoperative anterior recurrence between the groups that underwent bilateral anterior and posterior SSLF (16.7% each). Regarding the operation durations, the group that underwent AB-SSLF had longer operation times compared to the group that underwent PB-SSLF (80 minutes and 42.5 minutes, respectively). A higher incidence of postoperative urinary dysfunction was observed in patients who underwent anterior bilateral sacrospinous ligament fixation (p = 0.012). No grade 3b or higher complications were observed according to the Clavien-Dindo classification. Conclusions: AB-SSLF is an effective method in the surgical treatment of apical and anterior pelvic prolapse. However, the anterior compartment failure rate is still a limitation. Further research is required to investigate its long-term efficacy.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135780096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Co-occurrence of complex copy number variants (CNVs) is associated with more severe clinical expressivity of known syndromes. Few studies discuss diagnosis and genetic counseling for fetuses identified with multiple CNVs. This cohort study aims to summarize findings of complex copy number variants identified via prenatal diagnosis along with the results of parental studies. Methods: 2746 pregnant women were included and diagnosed by chromosomal microarray analysis (CMA) according to different clinical indications. A total of 12 fetuses were diagnosed with complex CNVs (a fetus identified with two or more CNVs simultaneously). Parental analysis was performed by CMA, G-band karyotype analysis, and whole-genome low-coverage mate-pair sequencing (WGL-MPS) based on the size of the fetal imbalances and method resolution. Results: Fetuses carrying complex CNVs were identified as being 0.4% (12/2746) in our cohort. The parental validation study was performed in 8 of 12 complex CNVs cases with the permission of the patients. The primary results suggested that 62.5% (5 out of 8) of fetuses with complex CNVs were from parental inheritance. In these cases, 4 out of 5 were derived from maternal or paternal balanced translocation carriers. Recurrent spontaneous abortion was found in balanced translocation carrier family. Conclusion: In this study, in 4/8 of the fetuses detected with complex CNVs was inherited from a parental balanced translocation. Given the risk of parental balanced rearrangements when fetal complex CNVs are identified, genetic counseling for future pregnancies may be useful for these families.
{"title":"Prenatal Diagnosis of Complex Copy Number Variants in the Fetus and Associated Cytogenetic Findings in Parents","authors":"Wei Wang, Jing Wang, Ye Shi, Bin Zhang","doi":"10.31083/j.ceog5010215","DOIUrl":"https://doi.org/10.31083/j.ceog5010215","url":null,"abstract":"Background: Co-occurrence of complex copy number variants (CNVs) is associated with more severe clinical expressivity of known syndromes. Few studies discuss diagnosis and genetic counseling for fetuses identified with multiple CNVs. This cohort study aims to summarize findings of complex copy number variants identified via prenatal diagnosis along with the results of parental studies. Methods: 2746 pregnant women were included and diagnosed by chromosomal microarray analysis (CMA) according to different clinical indications. A total of 12 fetuses were diagnosed with complex CNVs (a fetus identified with two or more CNVs simultaneously). Parental analysis was performed by CMA, G-band karyotype analysis, and whole-genome low-coverage mate-pair sequencing (WGL-MPS) based on the size of the fetal imbalances and method resolution. Results: Fetuses carrying complex CNVs were identified as being 0.4% (12/2746) in our cohort. The parental validation study was performed in 8 of 12 complex CNVs cases with the permission of the patients. The primary results suggested that 62.5% (5 out of 8) of fetuses with complex CNVs were from parental inheritance. In these cases, 4 out of 5 were derived from maternal or paternal balanced translocation carriers. Recurrent spontaneous abortion was found in balanced translocation carrier family. Conclusion: In this study, in 4/8 of the fetuses detected with complex CNVs was inherited from a parental balanced translocation. Given the risk of parental balanced rearrangements when fetal complex CNVs are identified, genetic counseling for future pregnancies may be useful for these families.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Na Sun, Weijiao Yan, Linlin Wang, Jing Wang, Lin Wang
Background: The incidence and mortality of endometrial cancer (EC) have increased in recent years. The incidence of psychological disorders induced by EC is also increasing. Fluoxetine is a prescribed antidepressant drug for managing mental illnesses. We retrospectively explored the effect of fluoxetine intervention on symptom checklist 90 (SCL-90), quality of life, Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and nursing satisfaction in patients with EC undergoing surgery. Methods: One hundred patients with EC undergoing hysterectomy were selected. Based on the different clinical nursing intervention methods, the patients were categorized into a control group (n = 50) and an intervention group (n = 50). Patients in the control group were provided routine care, including nutrition guidance, basic psychological nursing, pain care, rehabilitation exercise, and complication prevention, whereas patients in the intervention group were only treated with fluoxetine based on routine nursing protocols. The differences in SCL-90, quality of life, HAMA, HAMD scores, and nursing satisfaction between the two groups were observed. Results: No significant difference was observed in the SCL-90, quality of life score, HAMA, and HAMD between the two groups before treatment. After treatment, all items in the intervention group differed from those in the control group. The SCL-90 scores of the intervention group decreased after treatment, and all subscales of SCL-90 in the intervention group were reduced. All dimensions of quality of life were elevated in the control group after treatment. The HAMA and HAMD scores of patients in the intervention group declined considerably after treatment. Conclusions: Fluoxetine intervention effectively improved the quality of life of patients with EC undergoing hysterectomy, and ameliorated signs of anxiety and depression, thus promoting the recovery of the disease.
{"title":"Effect of Fluoxetine on Post-Hysterectomy Nursing of Patients with Endometrial Cancer: A Retrospective Study","authors":"Na Sun, Weijiao Yan, Linlin Wang, Jing Wang, Lin Wang","doi":"10.31083/j.ceog5010213","DOIUrl":"https://doi.org/10.31083/j.ceog5010213","url":null,"abstract":"Background: The incidence and mortality of endometrial cancer (EC) have increased in recent years. The incidence of psychological disorders induced by EC is also increasing. Fluoxetine is a prescribed antidepressant drug for managing mental illnesses. We retrospectively explored the effect of fluoxetine intervention on symptom checklist 90 (SCL-90), quality of life, Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and nursing satisfaction in patients with EC undergoing surgery. Methods: One hundred patients with EC undergoing hysterectomy were selected. Based on the different clinical nursing intervention methods, the patients were categorized into a control group (n = 50) and an intervention group (n = 50). Patients in the control group were provided routine care, including nutrition guidance, basic psychological nursing, pain care, rehabilitation exercise, and complication prevention, whereas patients in the intervention group were only treated with fluoxetine based on routine nursing protocols. The differences in SCL-90, quality of life, HAMA, HAMD scores, and nursing satisfaction between the two groups were observed. Results: No significant difference was observed in the SCL-90, quality of life score, HAMA, and HAMD between the two groups before treatment. After treatment, all items in the intervention group differed from those in the control group. The SCL-90 scores of the intervention group decreased after treatment, and all subscales of SCL-90 in the intervention group were reduced. All dimensions of quality of life were elevated in the control group after treatment. The HAMA and HAMD scores of patients in the intervention group declined considerably after treatment. Conclusions: Fluoxetine intervention effectively improved the quality of life of patients with EC undergoing hysterectomy, and ameliorated signs of anxiety and depression, thus promoting the recovery of the disease.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136038349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Özlem Kayacık Günday, Oya Aldemir, Runa Özelçi, Serdar Dilbaz, Emre Başer, Özlem Moraloğlu Tekin
Background: Repeated implantation failure (RIF) after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) can be a devastating reality for some patients with infertility. Our objective was to evaluate the potential role of the complete blood count (CBC) parameters, on treatment outcome in patients with repeated IVF implantation failure. Methods: This retrospective clinical study, involving a total of 173 patients, consisted of 64 patients with RIF who underwent a fresh IVF-ET cycle, underwent 3 or more IVF cycles, and 109 patients in the control group who became pregnant in the first IVF-ET cycle. Results: Duration of infertility, number of grade 2 embryos and red cell distribution width (RDW) were significantly higher in RIF patients (p < 0.001, p < 0.001, p = 0.02). The number of 2 pronucleus (PN) showed a significant positive correlation with the fertilization rate (FR) (r: 0.6; p < 0.001). To understand the effects of CBC parameters on FR, the model established with the number of RDW, number of grade 2 embryos and the number of 2 PN proved to be significant (ANOVA, p < 0.001). Conclusions: RIF patients have higher RDW, longer duration of infertility, and higher number of grade 2 embryos. Elevated RDW may negatively impact FR. The number of 2 PN increased FR.
背景:体外受精/胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)后的重复植入失败(RIF)对一些不孕症患者来说是一个毁灭性的现实。我们的目的是评估全血细胞计数(CBC)参数对反复IVF植入失败患者治疗结果的潜在作用。方法:本回顾性临床研究共纳入173例患者，其中64例首次IVF- et周期的RIF患者和3个及以上IVF周期的RIF患者，以及109例首次IVF- et周期怀孕的对照组患者。结果:RIF患者的不孕持续时间、2级胚胎数量和红细胞分布宽度(RDW)显著高于RIF患者(p <0.001, p <0.001, p = 0.02)。2原核数(PN)与受精率(FR)呈极显著正相关(r: 0.6;p & lt;0.001)。为了了解CBC参数对FR的影响，以RDW数、2级胚胎数和2个PN数建立的模型被证明是显著的(ANOVA, p <0.001)。结论:RIF患者的RDW较高，不孕症持续时间较长，2级胚胎数量较多。RDW升高可能对FR有负面影响。2pn的数量增加FR。
{"title":"Is Red Blood Cell Distribution Width (RDW) a Negative Predictor of Repeated Implantation Failure?","authors":"Özlem Kayacık Günday, Oya Aldemir, Runa Özelçi, Serdar Dilbaz, Emre Başer, Özlem Moraloğlu Tekin","doi":"10.31083/j.ceog5010214","DOIUrl":"https://doi.org/10.31083/j.ceog5010214","url":null,"abstract":"Background: Repeated implantation failure (RIF) after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) can be a devastating reality for some patients with infertility. Our objective was to evaluate the potential role of the complete blood count (CBC) parameters, on treatment outcome in patients with repeated IVF implantation failure. Methods: This retrospective clinical study, involving a total of 173 patients, consisted of 64 patients with RIF who underwent a fresh IVF-ET cycle, underwent 3 or more IVF cycles, and 109 patients in the control group who became pregnant in the first IVF-ET cycle. Results: Duration of infertility, number of grade 2 embryos and red cell distribution width (RDW) were significantly higher in RIF patients (p < 0.001, p < 0.001, p = 0.02). The number of 2 pronucleus (PN) showed a significant positive correlation with the fertilization rate (FR) (r: 0.6; p < 0.001). To understand the effects of CBC parameters on FR, the model established with the number of RDW, number of grade 2 embryos and the number of 2 PN proved to be significant (ANOVA, p < 0.001). Conclusions: RIF patients have higher RDW, longer duration of infertility, and higher number of grade 2 embryos. Elevated RDW may negatively impact FR. The number of 2 PN increased FR.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136039734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: A preclinical animal model is an imperative tool for uncovering and understanding the tumourigenic hallmarks of human ovarian cancer; the disease is often lethal because it is commonly diagnosed in the advanced stage, where widespread cancer nodules mainly reside within peritoneal regions. Mouse models as a xenograft tumour host or genetic manipulation ovarian cancer-derived mice are widely used for studying specific hypothesis rationale in ovarian cancer. However, limited information associated with disease progression is obtained from such studies; whether it is the best model to study advanced ovarian cancer phenotype or suitable preclinical biomarkers for detecting and monitoring ovarian cancer progression is under study. This study used an ID-8 syngeneic mouse ovarian cancer model with immunocompetence. We monitored cancer growth and development using combination modalities of cancer-specific cancer antigen-125 (CA-125), interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) blood markers, which are well-known for their association with tumour progression in humans. Methods: Ten C57/BL6 female mice were intraperitoneally implanted with ID-8 Trp53 wild-type and monitored the progression of the tumour, until mice developed clinical ascites. Blood was taken at the time of intraperitoneal (IP) implantation (Day 0) and then collected weekly, and levels of biomarkers were analysed with enzyme-linked immunosorbent assay (ELISA). In addition, tumour tissue was collected and proceeded with histological staining. Results: We found that blood biomarkers CA-125, IL-6 and VEGF were not readily correlated with tumour progression. However, these biomarkers were markedly elevated in ascitic fluid at the advanced stage of the disease. Conclusions: We conclude that blood biomarkers in a syngeneic mouse model are, to some extent, not readily found in the blood as opposed to human ovarian cancer. Model anatomical and physiological differences between rodents and humans might explain this discrepancy.
{"title":"Predicting Tumour Progression of ID-8 Syngeneic Mouse Ovarian Cancer with Blood Biomarkers of CA-125, IL-6 and VEGF: A Prospective Laboratory-Based Study","authors":"Kenny Chitcholtan, Arron Dyer, Peter Sykes","doi":"10.31083/j.ceog5010212","DOIUrl":"https://doi.org/10.31083/j.ceog5010212","url":null,"abstract":"Background: A preclinical animal model is an imperative tool for uncovering and understanding the tumourigenic hallmarks of human ovarian cancer; the disease is often lethal because it is commonly diagnosed in the advanced stage, where widespread cancer nodules mainly reside within peritoneal regions. Mouse models as a xenograft tumour host or genetic manipulation ovarian cancer-derived mice are widely used for studying specific hypothesis rationale in ovarian cancer. However, limited information associated with disease progression is obtained from such studies; whether it is the best model to study advanced ovarian cancer phenotype or suitable preclinical biomarkers for detecting and monitoring ovarian cancer progression is under study. This study used an ID-8 syngeneic mouse ovarian cancer model with immunocompetence. We monitored cancer growth and development using combination modalities of cancer-specific cancer antigen-125 (CA-125), interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) blood markers, which are well-known for their association with tumour progression in humans. Methods: Ten C57/BL6 female mice were intraperitoneally implanted with ID-8 Trp53 wild-type and monitored the progression of the tumour, until mice developed clinical ascites. Blood was taken at the time of intraperitoneal (IP) implantation (Day 0) and then collected weekly, and levels of biomarkers were analysed with enzyme-linked immunosorbent assay (ELISA). In addition, tumour tissue was collected and proceeded with histological staining. Results: We found that blood biomarkers CA-125, IL-6 and VEGF were not readily correlated with tumour progression. However, these biomarkers were markedly elevated in ascitic fluid at the advanced stage of the disease. Conclusions: We conclude that blood biomarkers in a syngeneic mouse model are, to some extent, not readily found in the blood as opposed to human ovarian cancer. Model anatomical and physiological differences between rodents and humans might explain this discrepancy.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136182235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ottavia D'Oria, Andrea Giannini, Aris Raad Besharat, Donatella Caserta
IMR Press is a leading publisher of open access peer-reviewed biomedical and life sciences journals. We aim to facilitate the dissemination of high-quality research in the area of biomedical science. With a long tradition and wide readership, IMR Press is dedicated to making positive contributions to academics, corporate libraries as well as to readers and authors. All the editors in IMR Press will provide the best service for researchers, allowing them to have a easy and smooth publication experience and helping maximize the impact and visibility of their research.
{"title":"Management of Endometrial Cancer: Molecular Identikit and Tailored Therapeutic Approach","authors":"Ottavia D'Oria, Andrea Giannini, Aris Raad Besharat, Donatella Caserta","doi":"10.31083/j.ceog5010210","DOIUrl":"https://doi.org/10.31083/j.ceog5010210","url":null,"abstract":"IMR Press is a leading publisher of open access peer-reviewed biomedical and life sciences journals. We aim to facilitate the dissemination of high-quality research in the area of biomedical science. With a long tradition and wide readership, IMR Press is dedicated to making positive contributions to academics, corporate libraries as well as to readers and authors. All the editors in IMR Press will provide the best service for researchers, allowing them to have a easy and smooth publication experience and helping maximize the impact and visibility of their research.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Hemodynamic monitoring plays a crucial way in guiding the clinical decision-making process for the management of critically ill neonates. Noninvasive hemodynamic monitoring is characterized by continuous, convenient, and accurate assessment, presenting a viable option for implementation in neonatal intensive care units (NICU). This review article summarizes the research advancements made in noninvasive hemodynamic monitoring and electronic cardiometry (EC) applications in neonates, providing valuable reference resource for studies in the field of hemodynamic monitoring. Mechanism: The clinical significance of hemodynamic monitoring in neonates is first introduced and followed by a comprehensive description of both invasive and noninvasive techniques employed in hemodynamic monitoring. Furthermore, the research progress of EC in neonates is discussed, focusing particularly on its feasibility and accuracy. Finally, the application and influencing factors of EC in diverse diseases, encompassing neonatal conditions, are presented. Findings in Brief: Due to the risks associated with invasive cardiac output monitoring, noninvasive or minimally invasive alternative techniques are needed for hemodynamic monitoring. In recent years, noninvasive and minimally invasive techniques, such as ultrasound cardiac output monitor (USCOM) and impedance cardiography have been utilized. EC, as an impedance-based monitoring, facilitates noninvasive and real-time assessment of hemodynamic parameters. The integration of EC enables real-time and continuous monitoring of dynamic changes in cardiac and vascular functions in patients, thereby assisting in clinical evaluation and guiding the clinical decision-making. Conclusion: EC is a noninvasive, highly sensitive, and accurate monitoring technique that holds important guiding significance in clinical practice.
{"title":"Research Progress of Noninvasive Cardiac Output Monitor (NICOTM) and Hemodynamic Monitor in Neonates","authors":"Fengying Li, Wenbin Dong","doi":"10.31083/j.ceog5010211","DOIUrl":"https://doi.org/10.31083/j.ceog5010211","url":null,"abstract":"Objective: Hemodynamic monitoring plays a crucial way in guiding the clinical decision-making process for the management of critically ill neonates. Noninvasive hemodynamic monitoring is characterized by continuous, convenient, and accurate assessment, presenting a viable option for implementation in neonatal intensive care units (NICU). This review article summarizes the research advancements made in noninvasive hemodynamic monitoring and electronic cardiometry (EC) applications in neonates, providing valuable reference resource for studies in the field of hemodynamic monitoring. Mechanism: The clinical significance of hemodynamic monitoring in neonates is first introduced and followed by a comprehensive description of both invasive and noninvasive techniques employed in hemodynamic monitoring. Furthermore, the research progress of EC in neonates is discussed, focusing particularly on its feasibility and accuracy. Finally, the application and influencing factors of EC in diverse diseases, encompassing neonatal conditions, are presented. Findings in Brief: Due to the risks associated with invasive cardiac output monitoring, noninvasive or minimally invasive alternative techniques are needed for hemodynamic monitoring. In recent years, noninvasive and minimally invasive techniques, such as ultrasound cardiac output monitor (USCOM) and impedance cardiography have been utilized. EC, as an impedance-based monitoring, facilitates noninvasive and real-time assessment of hemodynamic parameters. The integration of EC enables real-time and continuous monitoring of dynamic changes in cardiac and vascular functions in patients, thereby assisting in clinical evaluation and guiding the clinical decision-making. Conclusion: EC is a noninvasive, highly sensitive, and accurate monitoring technique that holds important guiding significance in clinical practice.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"179 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136014740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Cervical length measurement is still the most widely used method to predict preterm labor. Recent studies have reported that in addition to cervical length, uterocervical angle (UCA) may also be useful in predicting preterm labor. The main purpose of this study was to evaluate the use of the anterior UCA to predict preterm labor in symptomatic pregnant women with a cervical length of 20 to 30 mm. Methods: In this prospective cohort study, 48 patients with a cervical length of 20 to 30 mm who applied to the emergency department with any preterm labor symptoms, between September 2019 and February 2020, were included as the study group. Cervical length and anterior UCA were measured at the first admission. Of these 48 patients, 12 patients who gave birth before 37 weeks were called the ‘preterm labor group’, and 36 patients who gave birth at 37 weeks or later were named the ‘preterm threatened but delivered at term’ group. The control group consisted of 46 healthy pregnant women who were matched with the study group in terms of age, body mass index (BMI), and the gestational week at which anterior UCA was measured. The three groups were compared in terms of anterior UCA values. Results: The cervical lengths of the ‘preterm labor’ and ‘preterm threatened but delivery at term’ groups were similar and shorter than the control group (25.4 mm, 25.1 mm, and 35 mm, respectively, p < 0.001). Anterior UCA value in the ‘preterm labor’ group (116.1) was found to be significantly higher than both ‘preterm threatened but delivered at the term’ group (100.2) and the control group (98.6) (p = 0.001). Receiver operating curve (ROC) analysis was performed to determine a threshold value of anterior UCA that could predict preterm labor in symptomatic pregnant women with a cervical length of 20 to 30 mm. Area under curve (AUC) analysis of anterior UCA for estimation of preterm labor was 0.647 (p = 0.014, 95% confidence interval (CI) = 0.52–0.77). According to this analysis, the threshold value of anterior UCA was determined as 95.3, with 72% sensitivity, and 63% specificity. Conclusion: The anterior UCA can be used to better predict preterm labor in symptomatic pregnant women with a cervical length of 20 to 30 mm without cervical effacement and dilation.
{"title":"Anterior Uterocervical Angle and Prediction of Preterm Labor in Cases with an Inconclusive Cervical Length: A Prospective Cohort Pilot Study","authors":"İlgi Esen, İbrahim Kale, Ebru Alıcı Davutoğlu, Merve Dizdar, Rahime Nida Bayık","doi":"10.31083/j.ceog5010205","DOIUrl":"https://doi.org/10.31083/j.ceog5010205","url":null,"abstract":"Background: Cervical length measurement is still the most widely used method to predict preterm labor. Recent studies have reported that in addition to cervical length, uterocervical angle (UCA) may also be useful in predicting preterm labor. The main purpose of this study was to evaluate the use of the anterior UCA to predict preterm labor in symptomatic pregnant women with a cervical length of 20 to 30 mm. Methods: In this prospective cohort study, 48 patients with a cervical length of 20 to 30 mm who applied to the emergency department with any preterm labor symptoms, between September 2019 and February 2020, were included as the study group. Cervical length and anterior UCA were measured at the first admission. Of these 48 patients, 12 patients who gave birth before 37 weeks were called the ‘preterm labor group’, and 36 patients who gave birth at 37 weeks or later were named the ‘preterm threatened but delivered at term’ group. The control group consisted of 46 healthy pregnant women who were matched with the study group in terms of age, body mass index (BMI), and the gestational week at which anterior UCA was measured. The three groups were compared in terms of anterior UCA values. Results: The cervical lengths of the ‘preterm labor’ and ‘preterm threatened but delivery at term’ groups were similar and shorter than the control group (25.4 mm, 25.1 mm, and 35 mm, respectively, p < 0.001). Anterior UCA value in the ‘preterm labor’ group (116.1) was found to be significantly higher than both ‘preterm threatened but delivered at the term’ group (100.2) and the control group (98.6) (p = 0.001). Receiver operating curve (ROC) analysis was performed to determine a threshold value of anterior UCA that could predict preterm labor in symptomatic pregnant women with a cervical length of 20 to 30 mm. Area under curve (AUC) analysis of anterior UCA for estimation of preterm labor was 0.647 (p = 0.014, 95% confidence interval (CI) = 0.52–0.77). According to this analysis, the threshold value of anterior UCA was determined as 95.3, with 72% sensitivity, and 63% specificity. Conclusion: The anterior UCA can be used to better predict preterm labor in symptomatic pregnant women with a cervical length of 20 to 30 mm without cervical effacement and dilation.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mustafa Gazi Uçar, Abdül Hamid Güler, Tolgay Tuyan İlhan, Feyza Nur Çintesun, Çetin Çelik, Mehmet Kulhan
Background: The main purpose of this study was to investigate the feasibility and safety of performing a laparoscopic intervention for the conservative management of uterine rupture (UR) during pregnancy. This study also provides a brief overview on the challenges and understanding of the management of UR in pregnancy. Methods: Patients diagnosed with UR between 2011–2021 at Selçuk University, Faculty of Medicine were evaluated, retrospectively. The reproductive history, clinical characteristics, UR symptoms and signs, predisposing factors, operative findings, complications and outcomes were assessed. The choice of treatment was determined according to the patients’ age, fertility desire, the severity of disease, and hemodynamic status. A variety of options ranging from surgical rupture repair, to hysterectomy via minimally invasive surgery or laparotomy, were employed. Laparotomy was preferred in all patients with viable fetuses, and in those with hemodynamic instability. Results: A total of 23 cases of UR were operated over a 10-year period. Nine of them underwent laparoscopic surgery and the remaining 14 underwent laparotomy. The presenting signs and symptoms of UR, in order of decreasing frequency were: abdominal pain, vaginal bleeding, fetal distress/demise, non-reassuring fetal status, signs of hemodynamic changes, elevation of the fetal presenting parts and/or the absence of station changes with contractions, and the early detection of hemoperitoneum on ultrasound. The primary risk factors for UR were a history of uterine surgery, use of misoprostol during abortion and labor, obstructed labor, curettage, congenital uterine malformations and trauma. Total ruptures included 17 in the lower segment (Kerr incision) and 6 outside the lower segment. There were considerable differences in the incidence of Kerr incision site ruptures and UR in other sites. The major complication rates were higher in ruptures outside the lower segment (6/6, 100%) than lower segment ruptures (5/17, 29.4%). Hysterectomy rates in lower segment ruptures and other rupture sites were 5/17 (29.4%) and 4/6 (66.6%), respectively. Kerr incision site ruptures are easier to manage and with less catastrophic complications compared to cases of UR after trauma, and those of unscarred uteri or those with a history of uterine scars other than from a Kerr incision. Conclusions: This study provides evidence of the safety and feasibility of laparoscopic management of UR, and this may encourage surgeons to consider minimally invasive surgery in hemodynamically stable patients prior to more aggressive and radical treatments. With the appropriate skill set, laparoscopy may be considered the preferred route of intervention, even in potentially life-threatening conditions such as UR.
{"title":"Uterine Rupture during Pregnancy: Can Laparoscopy be Performed Safely and Effectively?","authors":"Mustafa Gazi Uçar, Abdül Hamid Güler, Tolgay Tuyan İlhan, Feyza Nur Çintesun, Çetin Çelik, Mehmet Kulhan","doi":"10.31083/j.ceog5010202","DOIUrl":"https://doi.org/10.31083/j.ceog5010202","url":null,"abstract":"Background: The main purpose of this study was to investigate the feasibility and safety of performing a laparoscopic intervention for the conservative management of uterine rupture (UR) during pregnancy. This study also provides a brief overview on the challenges and understanding of the management of UR in pregnancy. Methods: Patients diagnosed with UR between 2011–2021 at Selçuk University, Faculty of Medicine were evaluated, retrospectively. The reproductive history, clinical characteristics, UR symptoms and signs, predisposing factors, operative findings, complications and outcomes were assessed. The choice of treatment was determined according to the patients’ age, fertility desire, the severity of disease, and hemodynamic status. A variety of options ranging from surgical rupture repair, to hysterectomy via minimally invasive surgery or laparotomy, were employed. Laparotomy was preferred in all patients with viable fetuses, and in those with hemodynamic instability. Results: A total of 23 cases of UR were operated over a 10-year period. Nine of them underwent laparoscopic surgery and the remaining 14 underwent laparotomy. The presenting signs and symptoms of UR, in order of decreasing frequency were: abdominal pain, vaginal bleeding, fetal distress/demise, non-reassuring fetal status, signs of hemodynamic changes, elevation of the fetal presenting parts and/or the absence of station changes with contractions, and the early detection of hemoperitoneum on ultrasound. The primary risk factors for UR were a history of uterine surgery, use of misoprostol during abortion and labor, obstructed labor, curettage, congenital uterine malformations and trauma. Total ruptures included 17 in the lower segment (Kerr incision) and 6 outside the lower segment. There were considerable differences in the incidence of Kerr incision site ruptures and UR in other sites. The major complication rates were higher in ruptures outside the lower segment (6/6, 100%) than lower segment ruptures (5/17, 29.4%). Hysterectomy rates in lower segment ruptures and other rupture sites were 5/17 (29.4%) and 4/6 (66.6%), respectively. Kerr incision site ruptures are easier to manage and with less catastrophic complications compared to cases of UR after trauma, and those of unscarred uteri or those with a history of uterine scars other than from a Kerr incision. Conclusions: This study provides evidence of the safety and feasibility of laparoscopic management of UR, and this may encourage surgeons to consider minimally invasive surgery in hemodynamically stable patients prior to more aggressive and radical treatments. With the appropriate skill set, laparoscopy may be considered the preferred route of intervention, even in potentially life-threatening conditions such as UR.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: To assess breastfeeding techniques and identify the relevant factors among postpartum women in hospital. Methods: A cross-sectional study was conducted from March, 2022 to April, 2022 at a general hospital in China. A total of 331 postpartum women were investigated using a questionnaire survey that included the LATCH (latch, audible swallowing, type of nipple, comfort, and hold) scoring system, a general information and behavior questionnaire, a breastfeeding knowledge questionnaire, and the Chinese version of the maternal breastfeeding evaluation scale. Multiple regression analysis was used to identify independent factors for in-hospital breastfeeding techniques. Results: The average score for breastfeeding techniques before discharge was 7.88. In the bivariate analysis, the factors found to be significantly associated with scores for breastfeeding technique were parity, number of births, participation in online antenatal classes during pregnancy, mastery of the hand expression technique, nipple cracking and satisfaction with breastfeeding (each p < 0.05). The result displayed parity, participation in online antenatal classes, and satisfaction with breastfeeding were included in a multiple linear regression model (p < 0.05). Conclusions: Although breastfeeding techniques prior to discharge are improving, more improvements can be made. Clinical medical staff should therefore pay particular attention to primiparas, postpartum women who did not participate in online antenatal courses during pregnancy, and postpartum women with a low satisfaction for breastfeeding. Measures that promote breastfeeding techniques, publicize online antenatal training courses, provide breastfeeding guidance shortly after delivery, and provide timely evaluation and targeted guidance should help to improve breastfeeding techniques before discharge and increase the exclusive breastfeeding rate.
{"title":"The Identification of Relevant Factors for Breastfeeding Techniques in Postpartum Women Before Discharge in China: A Cross-Sectional Study","authors":"Sen Li, Dan Zhu, Guoli Liu","doi":"10.31083/j.ceog5010209","DOIUrl":"https://doi.org/10.31083/j.ceog5010209","url":null,"abstract":"Background: To assess breastfeeding techniques and identify the relevant factors among postpartum women in hospital. Methods: A cross-sectional study was conducted from March, 2022 to April, 2022 at a general hospital in China. A total of 331 postpartum women were investigated using a questionnaire survey that included the LATCH (latch, audible swallowing, type of nipple, comfort, and hold) scoring system, a general information and behavior questionnaire, a breastfeeding knowledge questionnaire, and the Chinese version of the maternal breastfeeding evaluation scale. Multiple regression analysis was used to identify independent factors for in-hospital breastfeeding techniques. Results: The average score for breastfeeding techniques before discharge was 7.88. In the bivariate analysis, the factors found to be significantly associated with scores for breastfeeding technique were parity, number of births, participation in online antenatal classes during pregnancy, mastery of the hand expression technique, nipple cracking and satisfaction with breastfeeding (each p < 0.05). The result displayed parity, participation in online antenatal classes, and satisfaction with breastfeeding were included in a multiple linear regression model (p < 0.05). Conclusions: Although breastfeeding techniques prior to discharge are improving, more improvements can be made. Clinical medical staff should therefore pay particular attention to primiparas, postpartum women who did not participate in online antenatal courses during pregnancy, and postpartum women with a low satisfaction for breastfeeding. Measures that promote breastfeeding techniques, publicize online antenatal training courses, provide breastfeeding guidance shortly after delivery, and provide timely evaluation and targeted guidance should help to improve breastfeeding techniques before discharge and increase the exclusive breastfeeding rate.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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