M. Śniadecki, Paweł Guzik, M. Brzeziński, P. Basta
1Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland 2Clinical Department of Gynecology and Obstetrics, City Hospital, 35-241 Rzeszów, Poland 3Department of Gynecologic Oncology, PCK Marine Hospital in Gdynia, 81-519 Gdynia, Poland 4Department of Gynecology and Oncological Gynecology, University Hospital in Krakow, Jagiellonian University, 31-008 Kraków, Poland *Correspondence: marcinsniadecki@gumed.edu.pl (Marcin Śniadecki) Academic Editor: Michael H. Dahan Submitted: 24 November 2021 Revised: 29 December 2021 Accepted: 31 December 2021 Published: 19 January 2022
1波兰医科大学Gdańsk妇科肿瘤科、妇科内分泌科，80-210 Gdańsk 2波兰市立医院临床妇产科，35-241 Rzeszów 3波兰格丁尼亚PCK海洋医院妇科肿瘤科，81-519格丁尼亚4波兰雅吉隆尼亚大学克拉科夫大学医院妇科肿瘤科，31-008 Kraków *通讯:marcinsniadecki@gumed.edu.pl (Marcin Śniadecki)学术编辑:Michael H. Dahan提交:2021年11月24日修订:2021年12月29日接受:2021年12月31日发布:2022年1月19日
{"title":"Senology Manifesto — why the awareness of senology should be increased?","authors":"M. Śniadecki, Paweł Guzik, M. Brzeziński, P. Basta","doi":"10.31083/j.ceog4901025","DOIUrl":"https://doi.org/10.31083/j.ceog4901025","url":null,"abstract":"1Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland 2Clinical Department of Gynecology and Obstetrics, City Hospital, 35-241 Rzeszów, Poland 3Department of Gynecologic Oncology, PCK Marine Hospital in Gdynia, 81-519 Gdynia, Poland 4Department of Gynecology and Oncological Gynecology, University Hospital in Krakow, Jagiellonian University, 31-008 Kraków, Poland *Correspondence: marcinsniadecki@gumed.edu.pl (Marcin Śniadecki) Academic Editor: Michael H. Dahan Submitted: 24 November 2021 Revised: 29 December 2021 Accepted: 31 December 2021 Published: 19 January 2022","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47423954","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 investigate whether hysteroscopic endometrial mechanical stimulation improves pregnancy outcomes in patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).Methods: We conducted a systematic search in electronic databases including PubMed, Embase, Cochrane Library, Web of Science from their inception to Feb 20th, 2021, as well as a manual search. All publications on the impact of hysteroscopic endometrial mechanical stimulation on IVF/ICSI outcomes were retrieved. Two reviewers independently screened the retrieved studies using stringent inclusion and exclusion criteria; data were subsequently extracted, and risk of bias was assessed. Meta-analysis of the selected studies was performed using Revman 5.3. Results: Eight studies involving 1494 patients were eligible for inclusion, including 5 randomized controlled trials and 3 prospective non-randomized simultaneous controlled experimental studies. We found that compared with the control group, hysteroscopic endometrial mechanical stimulation effectively increased live birth rate [risk ratio (RR) = 2.15, 95% confidence interval (CI) (1.78, 2.60), p< 0.00001] and clinical pregnancy rate [RR = 1.95, 95% CI (1.28, 2.98), p = 0.002], and also decreased abortion rate [RR = 0.54, 95% CI (0.35, 0.86), p = 0.009]. Subgroup analyses revealed that, hysteroscopic endometrial mechanical stimulation administered in the luteal phase in patients undergoing their first IVF/ICSI cycle was associated with significantly higher live birth rate and clinical pregnancy rate, as well as a significantly lower abortion rate. Discussion: Endometrial mechanical stimulation may improve live birth rate, clinical pregnancy rate and reduce abortion rate in patients with normal hysteroscopic findings who are undergoing IVF/ICSI. The benefits may be even greater if this therapy is given in the luteal phase and in patients who are in their first IVF/ICSI cycle. However, due to the limited quantity and quality of the included studies and variable stimulation methods, these findings should be interpreted with caution, and more high-quality studies are needed to confirm this conclusion.
背景：研究宫腔镜子宫内膜机械刺激是否能改善体外受精（IVF）/卵浆内单精子注射（ICSI）患者的妊娠结局。方法：我们从PubMed、Embase、Cochrane Library、Web of Science等电子数据库开始到2021年2月20日进行了系统搜索，并进行了手动搜索。检索所有关于宫腔镜子宫内膜机械刺激对IVF/ICSI结果影响的出版物。两名评审员使用严格的纳入和排除标准对检索到的研究进行了独立筛选；随后提取数据，并评估偏倚风险。使用Revman 5.3对所选研究进行荟萃分析。结果：8项涉及1494名患者的研究符合入选条件，包括5项随机对照试验和3项前瞻性非随机同时对照实验研究。我们发现，与对照组相比，宫腔镜子宫内膜机械刺激有效地提高了活产率[风险比（RR）=2.15，95%置信区间（CI）（1.78，2.60），p<0.00001]和临床妊娠率[RR=1.95，95%CI（1.28，2.98），p=0.002]，还降低了流产率[RR=0.54，95%CI，在接受第一个IVF/ICSI周期的患者中，在黄体期给予宫腔镜子宫内膜机械刺激与显著较高的活产率和临床妊娠率以及显著较低的流产率相关。讨论：子宫内膜机械刺激可以提高IVF/ICSI患者的活产率、临床妊娠率，并降低宫腔镜检查结果正常的流产率。如果在黄体期和第一个IVF/ICSI周期的患者中进行这种治疗，其益处可能会更大。然而，由于纳入的研究和可变刺激方法的数量和质量有限，应谨慎解释这些发现，需要更多高质量的研究来证实这一结论。
{"title":"The impact of endometrial mechanical stimulation in women with normal hysteroscopic findings undergoing IVF/ICSI: a meta-analysis","authors":"Li-jun Lin, Jia Liu, Liang-zhi Xu, Hui Chen","doi":"10.31083/j.ceog4901027","DOIUrl":"https://doi.org/10.31083/j.ceog4901027","url":null,"abstract":"Background: To investigate whether hysteroscopic endometrial mechanical stimulation improves pregnancy outcomes in patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).Methods: We conducted a systematic search in electronic databases including PubMed, Embase, Cochrane Library, Web of Science from their inception to Feb 20th, 2021, as well as a manual search. All publications on the impact of hysteroscopic endometrial mechanical stimulation on IVF/ICSI outcomes were retrieved. Two reviewers independently screened the retrieved studies using stringent inclusion and exclusion criteria; data were subsequently extracted, and risk of bias was assessed. Meta-analysis of the selected studies was performed using Revman 5.3. Results: Eight studies involving 1494 patients were eligible for inclusion, including 5 randomized controlled trials and 3 prospective non-randomized simultaneous controlled experimental studies. We found that compared with the control group, hysteroscopic endometrial mechanical stimulation effectively increased live birth rate [risk ratio (RR) = 2.15, 95% confidence interval (CI) (1.78, 2.60), p< 0.00001] and clinical pregnancy rate [RR = 1.95, 95% CI (1.28, 2.98), p = 0.002], and also decreased abortion rate [RR = 0.54, 95% CI (0.35, 0.86), p = 0.009]. Subgroup analyses revealed that, hysteroscopic endometrial mechanical stimulation administered in the luteal phase in patients undergoing their first IVF/ICSI cycle was associated with significantly higher live birth rate and clinical pregnancy rate, as well as a significantly lower abortion rate. Discussion: Endometrial mechanical stimulation may improve live birth rate, clinical pregnancy rate and reduce abortion rate in patients with normal hysteroscopic findings who are undergoing IVF/ICSI. The benefits may be even greater if this therapy is given in the luteal phase and in patients who are in their first IVF/ICSI cycle. However, due to the limited quantity and quality of the included studies and variable stimulation methods, these findings should be interpreted with caution, and more high-quality studies are needed to confirm this conclusion.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42710716","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}
W. Fageeh, Bana E Fakieh, Majda A. Addas, Rana M Baghdadi, R. Almokri, S. Sait, S. Fagih, S. Alahmadi
Background: We aim to determine the level of general knowledge and attitudes among the population of Saudi Arabia regarding sexually transmitted illnesses (STI). In addition, we aim to educate participants about the most common STIs, and explore how this influences the participants’ attitudes and perceptions. Methods: This study is a cross-sectional web-based survey of the general population of Saudi Arabia. The sample was enrolled randomly by distributing the survey through social media over a two-month period. 420 subjects between the ages of (15–60) participated in the study. Results: Among the 420 total responses, 405 (96%) participants were included based on the absence of missing data in their answers. Most of the participants (77%) were females. More than half of the respondents were single (59%), 24 years old or more (57%), Saudi (52%), and had a bachelor’s degree (65%). Forty-eight percent (48%) of the participants were related to the medical field. Only 11% knew someone previously diagnosed with STIs. The mean score of overall knowledge about STI was 8.79 ± 3.17 (median = 9) out of a maximum score of 20. The scores ranged from 2–16. A higher percentage of the participants (48.6%) had a low level of knowledge. Two-hundred eighty-one participants showed interest in viewing the attached educational material and subsequently completed questions on attitude regarding STI education. The mean score for attitude was 5.89 ± 1.52 out of a total of 7 (median = 6). Around 73% of all participants had a positive attitude towards STI education. Conclusion: Our findings suggest that targeting the younger population by incorporating STI-related educational material into school curricula would overcome the stigma associated with these illnesses by raising awareness and improving attitude towards them.
{"title":"Knowledge and attitudes towards sexually transmitted illnesses (STIs) among the general population of Saudi Arabia","authors":"W. Fageeh, Bana E Fakieh, Majda A. Addas, Rana M Baghdadi, R. Almokri, S. Sait, S. Fagih, S. Alahmadi","doi":"10.31083/j.ceog4901026","DOIUrl":"https://doi.org/10.31083/j.ceog4901026","url":null,"abstract":"Background: We aim to determine the level of general knowledge and attitudes among the population of Saudi Arabia regarding sexually transmitted illnesses (STI). In addition, we aim to educate participants about the most common STIs, and explore how this influences the participants’ attitudes and perceptions. Methods: This study is a cross-sectional web-based survey of the general population of Saudi Arabia. The sample was enrolled randomly by distributing the survey through social media over a two-month period. 420 subjects between the ages of (15–60) participated in the study. Results: Among the 420 total responses, 405 (96%) participants were included based on the absence of missing data in their answers. Most of the participants (77%) were females. More than half of the respondents were single (59%), 24 years old or more (57%), Saudi (52%), and had a bachelor’s degree (65%). Forty-eight percent (48%) of the participants were related to the medical field. Only 11% knew someone previously diagnosed with STIs. The mean score of overall knowledge about STI was 8.79 ± 3.17 (median = 9) out of a maximum score of 20. The scores ranged from 2–16. A higher percentage of the participants (48.6%) had a low level of knowledge. Two-hundred eighty-one participants showed interest in viewing the attached educational material and subsequently completed questions on attitude regarding STI education. The mean score for attitude was 5.89 ± 1.52 out of a total of 7 (median = 6). Around 73% of all participants had a positive attitude towards STI education. Conclusion: Our findings suggest that targeting the younger population by incorporating STI-related educational material into school curricula would overcome the stigma associated with these illnesses by raising awareness and improving attitude towards them.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48995948","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}
Jin Young Choi, Miseon Kim, B. Kwon, Sunyoung Jeong, D. Suh, Kidong Kim, Y. B. Kim, J. No
Background: This study aimed to assess the human papillomavirus (HPV) vaccine uptake rate in South Korean women and to identify factors affecting vaccination rate before initiation of the national HPV vaccination as a National Immunization Program (NIP) in Korea. Materials and methods: We conducted online survey in February 2016 with questions to 2000 women aged between 9 and 59 years in South Korea by distribution of age and region, to assess HPV uptake and associated correlates such as age, residential region, education, and socioeconomic status. Results: The overall HPV vaccine received at least 1 dose rate was 23.1%, and the highest rate of vaccination was observed in women aged 20–29 years (38.6%), followed by those aged 30–39 years (36.9%), 9–19 years (16.9%), 40–49 years (14.2%), and 50–59 years (12.5%). Factors affecting HPV vaccination included metropolitan cities (odds ratio [OR] = 1.44, 95% confidence interval [CI], 1.15–1.80), university graduate (OR = 1.45, 95% CI, 1.06–2.00), regular influenza vaccination (OR = 2.11, 95% CI, 1.64–2.70), visited clinic within the last 6 months (OR = 1.73, 95% CI, 1.20–2.51) and high family income (OR = 1.55, 95% CI, 1.01–2.37). Conclusion: HPV vaccine uptake is low in South Korean women. Correct publicity, education and economic support programs for HPV vaccine could play an important role in increasing HPV vaccine uptake in South Korea.
{"title":"Human papillomavirus vaccine uptake in South Korea","authors":"Jin Young Choi, Miseon Kim, B. Kwon, Sunyoung Jeong, D. Suh, Kidong Kim, Y. B. Kim, J. No","doi":"10.31083/j.ceog4901022","DOIUrl":"https://doi.org/10.31083/j.ceog4901022","url":null,"abstract":"Background: This study aimed to assess the human papillomavirus (HPV) vaccine uptake rate in South Korean women and to identify factors affecting vaccination rate before initiation of the national HPV vaccination as a National Immunization Program (NIP) in Korea. Materials and methods: We conducted online survey in February 2016 with questions to 2000 women aged between 9 and 59 years in South Korea by distribution of age and region, to assess HPV uptake and associated correlates such as age, residential region, education, and socioeconomic status. Results: The overall HPV vaccine received at least 1 dose rate was 23.1%, and the highest rate of vaccination was observed in women aged 20–29 years (38.6%), followed by those aged 30–39 years (36.9%), 9–19 years (16.9%), 40–49 years (14.2%), and 50–59 years (12.5%). Factors affecting HPV vaccination included metropolitan cities (odds ratio [OR] = 1.44, 95% confidence interval [CI], 1.15–1.80), university graduate (OR = 1.45, 95% CI, 1.06–2.00), regular influenza vaccination (OR = 2.11, 95% CI, 1.64–2.70), visited clinic within the last 6 months (OR = 1.73, 95% CI, 1.20–2.51) and high family income (OR = 1.55, 95% CI, 1.01–2.37). Conclusion: HPV vaccine uptake is low in South Korean women. Correct publicity, education and economic support programs for HPV vaccine could play an important role in increasing HPV vaccine uptake in South Korea.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46743587","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}
L. Nappi, S. Angioni, Vincenzo De Feo, P. Greco, G. Stabile, F. Greco, M. D'alterio, F. Sorrentino
Background: Endometrial hyperplasia (EH) is considered a heterogeneous pre-neoplastic clinical entity characterized by an abnormal glandular proliferation, with less than half of the tissue area occupied by the stroma. The aim of this retrospective study was to evaluate the correlation between the histological diagnosis of atypical endometrial hyperplasia (AEH) obtained through office hysteroscopy (OH) or uterine dilation and curettage (D&C) and the definitive histological evaluation after hysterectomy. Methods: Among 112 patients with atypical EH, 45 (40%) underwent hysteroscopy and 67 (60%) curettage. Results: The diagnostic accuracy of OH was very high: in particular, it showed a diagnostic coincidence in 87% of cases with the definitive histological diagnosis through hysteroscopy. The curettage, instead, had diagnostic coincidence only in 14% of cases. Conclusion: Office hysteroscopy is the ideal procedure for both diagnosis and follow-up of endometrial hyperplasia.
{"title":"Diagnostic accuracy of hysteroscopy vs dilation and curettage (D&C) for atypical endometrial hyperplasia in patients performing hysterectomy or serial follow-up","authors":"L. Nappi, S. Angioni, Vincenzo De Feo, P. Greco, G. Stabile, F. Greco, M. D'alterio, F. Sorrentino","doi":"10.31083/j.ceog4901024","DOIUrl":"https://doi.org/10.31083/j.ceog4901024","url":null,"abstract":"Background: Endometrial hyperplasia (EH) is considered a heterogeneous pre-neoplastic clinical entity characterized by an abnormal glandular proliferation, with less than half of the tissue area occupied by the stroma. The aim of this retrospective study was to evaluate the correlation between the histological diagnosis of atypical endometrial hyperplasia (AEH) obtained through office hysteroscopy (OH) or uterine dilation and curettage (D&C) and the definitive histological evaluation after hysterectomy. Methods: Among 112 patients with atypical EH, 45 (40%) underwent hysteroscopy and 67 (60%) curettage. Results: The diagnostic accuracy of OH was very high: in particular, it showed a diagnostic coincidence in 87% of cases with the definitive histological diagnosis through hysteroscopy. The curettage, instead, had diagnostic coincidence only in 14% of cases. Conclusion: Office hysteroscopy is the ideal procedure for both diagnosis and follow-up of endometrial hyperplasia.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49522809","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}
Suya Kang, Liping Zhou, Li-ping Zhu, Yun Wang, Yongfei Yue, Li-ping Yan
Background: To evaluate the efficacy and safety of carbetocin compared with oxytocin for prevention of postpartum hemorrhage (PPH) after elective cesarean section in Chinese high risk women. Methods: This was a single-center, prospective, randomized, open-label, controlled trial recruiting 852 pregnant women with one or more PPH risk factors between April 2017 and August 2019. Pregnant woman who was scheduled for an elective cesarean section were randomly assigned to receive carbetocin or oxytocin for prevention of PPH. The primary efficacy endpoint was the proportion of additional uterotonics. Results: A total of 852 pregnant women were randomly assigned to receive carbetocin (n = 442) or oxytocin (n = 410). The baseline characteristics were comparable between the two groups. The carbetocin group had lower proportion of requiring additional uterotonics (18.4% vs. 24.4%, p = 0.03 in full analysis set [FAS] analysis) to the oxytocin group. The amount of blood loss (intrapartum or postpartum) was no statistically significant difference (all p > 0.05). There were no significant differences in the postpartum hemoglobin, rate of hemostatics, blood transfusion, additional surgical interventions or uterine massage between the two groups. The rates of mild asphyxia in carbetocin and oxytocin groups were 2.1% and 1.3%, respectively. No other poor maternal and neonatal outcomes were observed in two groups. Conclusions: Carbetocin required lower rate of additional uterotonics than oxytocin for prevention of PPH after elective cesarean section in Chinese high risk women. Carbetocin was comparable to oxytocin in postpartum blood loss, postpartum hemoglobin, hemostatics, blood transfusion, additional surgical interventions or uterine massage.
{"title":"Carbetocin versus oxytocin for the prevention of postpartum hemorrhage after elective caesarean section in high risk women: a prospective, randomized, open-label, controlled trial in China","authors":"Suya Kang, Liping Zhou, Li-ping Zhu, Yun Wang, Yongfei Yue, Li-ping Yan","doi":"10.31083/j.ceog4901023","DOIUrl":"https://doi.org/10.31083/j.ceog4901023","url":null,"abstract":"Background: To evaluate the efficacy and safety of carbetocin compared with oxytocin for prevention of postpartum hemorrhage (PPH) after elective cesarean section in Chinese high risk women. Methods: This was a single-center, prospective, randomized, open-label, controlled trial recruiting 852 pregnant women with one or more PPH risk factors between April 2017 and August 2019. Pregnant woman who was scheduled for an elective cesarean section were randomly assigned to receive carbetocin or oxytocin for prevention of PPH. The primary efficacy endpoint was the proportion of additional uterotonics. Results: A total of 852 pregnant women were randomly assigned to receive carbetocin (n = 442) or oxytocin (n = 410). The baseline characteristics were comparable between the two groups. The carbetocin group had lower proportion of requiring additional uterotonics (18.4% vs. 24.4%, p = 0.03 in full analysis set [FAS] analysis) to the oxytocin group. The amount of blood loss (intrapartum or postpartum) was no statistically significant difference (all p > 0.05). There were no significant differences in the postpartum hemoglobin, rate of hemostatics, blood transfusion, additional surgical interventions or uterine massage between the two groups. The rates of mild asphyxia in carbetocin and oxytocin groups were 2.1% and 1.3%, respectively. No other poor maternal and neonatal outcomes were observed in two groups. Conclusions: Carbetocin required lower rate of additional uterotonics than oxytocin for prevention of PPH after elective cesarean section in Chinese high risk women. Carbetocin was comparable to oxytocin in postpartum blood loss, postpartum hemoglobin, hemostatics, blood transfusion, additional surgical interventions or uterine massage.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46673710","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}
Geoffrey E. Johnson, Lauren Kan, Jennifer H. Nguyen, Kim Campbell, L. Ralph, Nicole Koenig, M. Sanaee, Ciana Maher, G. Cundiff
Background: Current quality improvement models in obstetrics focus on prevention of adverse perinatal outcomes. The development of these metrics was based on expert opinion that did not account for patients’ values. The ultimate aim of our research is to develop performance indicators for labour and birth that reflect the patient perspective. Methods: A qualitative interview design was used to engage a convenience sample, of recent (<1 year) postpartum patients, in semi-structured interviews, where they shared their experiences of their recent birth. Patients were also asked to assess descriptions of adverse perinatal outcomes for readability and comprehension, towards developing accurate unbiased descriptions for a subsequent survey of patients to weight complications. Responses were recorded, transcribed, coded and analyzed using thematic analysis. thematic analysis. Results: Five themes emerged during the analysis: (1) desire for patient-centred care, (2) improved communication, (3) labour/birth, expectations and outcomes, (4) care team support during labour and birth, (5) continuing emotional and physical postpartum care. Conclusions: Patient-centred care and good health outcomes were the major values expressed by the patients in this study. Good communication and shared decision making led to patients describing their labour and birth as a satisfying experience. This study lays the foundation for developing a quality tool to measure the outcomes of birth and adverse outcomes from the patients’ perspective.
{"title":"Development of patient-centered outcomes for labour and birth: a qualitative study","authors":"Geoffrey E. Johnson, Lauren Kan, Jennifer H. Nguyen, Kim Campbell, L. Ralph, Nicole Koenig, M. Sanaee, Ciana Maher, G. Cundiff","doi":"10.31083/j.ceog4901021","DOIUrl":"https://doi.org/10.31083/j.ceog4901021","url":null,"abstract":"Background: Current quality improvement models in obstetrics focus on prevention of adverse perinatal outcomes. The development of these metrics was based on expert opinion that did not account for patients’ values. The ultimate aim of our research is to develop performance indicators for labour and birth that reflect the patient perspective. Methods: A qualitative interview design was used to engage a convenience sample, of recent (<1 year) postpartum patients, in semi-structured interviews, where they shared their experiences of their recent birth. Patients were also asked to assess descriptions of adverse perinatal outcomes for readability and comprehension, towards developing accurate unbiased descriptions for a subsequent survey of patients to weight complications. Responses were recorded, transcribed, coded and analyzed using thematic analysis. thematic analysis. Results: Five themes emerged during the analysis: (1) desire for patient-centred care, (2) improved communication, (3) labour/birth, expectations and outcomes, (4) care team support during labour and birth, (5) continuing emotional and physical postpartum care. Conclusions: Patient-centred care and good health outcomes were the major values expressed by the patients in this study. Good communication and shared decision making led to patients describing their labour and birth as a satisfying experience. This study lays the foundation for developing a quality tool to measure the outcomes of birth and adverse outcomes from the patients’ perspective.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41787258","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: The similarities in clinical features between ruptured corpus luteum cyst (RCLC) with undiagnosed intrauterine pregnancy in the early first trimester (RCLC-P) and ruptured ovarian pregnancy are well established. However, the identification of differences between these two morbid conditions is important to determine the causes and manage the hemoperitoneum without devastation of pregnancy in RCLC-P. Furthermore, the pregnancy outcomes after laparoscopic surgery in women with RCLC-P are not recognized. Methods: Retrospective observational study of six women with RCLC-P and seven women with ruptured ovarian pregnancy. Results: All cases were referred under strong suspicion of ruptured ectopic pregnancy due to lower abdominal pain and positive urinary pregnancy test after spontaneous conception. The estimated median number of gestational weeks in RCLC-P (5 weeks) was significantly lower than that for ruptured ovarian pregnancy (7 weeks). At triage, the median serum levels of beta-human chorionic gonadotropin (β -hCG) were significantly lower in RCLC-P (592 IU/L) than ruptured ovarian pregnancy (3723 IU/L) (p = 0.01). In all six cases with RCLC-P, laparoscopic ovary-sparing surgerywas performed. Among the four womenwho received postoperative supplementation of progesterone, uneventful vaginal delivery occurred at term in three cases. Conclusions: Early gestational age and lower serum β -hCG levels at triage, as well as non-declining levels of serum β -hCG on the day after surgery, were significant predictors of RCLC-P rather than ruptured ovarian pregnancy. Laparoscopic surgery was a feasible option for the management of RCLC-P with appropriate postoperative luteal support to achieve successful obstetric outcomes.
{"title":"Differential-diagnostic and therapeutic challenges in the management of ruptured corpus luteum cyst with undiagnosed intrauterine pregnancy in the early first trimester and ruptured ovarian pregnancy","authors":"A. Takeda, Shiori Tsuge, S. Iyoshi","doi":"10.31083/j.ceog4901019","DOIUrl":"https://doi.org/10.31083/j.ceog4901019","url":null,"abstract":"Background: The similarities in clinical features between ruptured corpus luteum cyst (RCLC) with undiagnosed intrauterine pregnancy in the early first trimester (RCLC-P) and ruptured ovarian pregnancy are well established. However, the identification of differences between these two morbid conditions is important to determine the causes and manage the hemoperitoneum without devastation of pregnancy in RCLC-P. Furthermore, the pregnancy outcomes after laparoscopic surgery in women with RCLC-P are not recognized. Methods: Retrospective observational study of six women with RCLC-P and seven women with ruptured ovarian pregnancy. Results: All cases were referred under strong suspicion of ruptured ectopic pregnancy due to lower abdominal pain and positive urinary pregnancy test after spontaneous conception. The estimated median number of gestational weeks in RCLC-P (5 weeks) was significantly lower than that for ruptured ovarian pregnancy (7 weeks). At triage, the median serum levels of beta-human chorionic gonadotropin (β -hCG) were significantly lower in RCLC-P (592 IU/L) than ruptured ovarian pregnancy (3723 IU/L) (p = 0.01). In all six cases with RCLC-P, laparoscopic ovary-sparing surgerywas performed. Among the four womenwho received postoperative supplementation of progesterone, uneventful vaginal delivery occurred at term in three cases. Conclusions: Early gestational age and lower serum β -hCG levels at triage, as well as non-declining levels of serum β -hCG on the day after surgery, were significant predictors of RCLC-P rather than ruptured ovarian pregnancy. Laparoscopic surgery was a feasible option for the management of RCLC-P with appropriate postoperative luteal support to achieve successful obstetric outcomes.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47222880","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}
T. Georgescu, R. Bohîlțea, V. Varlas, O. Munteanu, F. Furtunescu, A. Lisievici, C. Grigoriu
Objective: Primary ovarian carcinoids are neuroendocrine tumors, representing up to 1% of all ovarian tumors. In this paper, the authors aimed at analyzing the clinical and pathological aspects of all recently published ovarian carcinoid, providing new correlations regarding them. Mechanism: The authors have reviewed all cases of primary ovarian carcinoid reported in international journals since 2005 to date. A total of 99 cases published in 68 articles have been found and analyzed. Findings in brief: Our results up to 29.31% of patients presented with carcinoid heart disease, and 17.24% had an abdominal mass, which caused them to present to the physician. Patients presenting with metastases had more frequently the insular subtype (33.33%) and had similar median age as those without metastases. A teratoma component was noticed in 58.9% of cases and was also associated with the insular pattern of carcinoid. To our best knowledge, this paper includes the largest review of primary ovarian carcinoid to date. Conclusions: The incidence of carcinoid heart disease might have been underestimated up to this moment, thus, requiring further imagistic investigations of patients presenting with these symptoms. Additionally, the insular variant was most frequently associated with the presence of both teratoma (52.94%) and metastases (33.33%), although previous reports have noticed a higher incidence of teratoma in the mucinous variant. In our opinion, these apparently divergent results warrant further studies of this rare subtype of ovarian tumor.
{"title":"A 15-year comprehensive literature review of 99 primary ovarian carcinoid tumors","authors":"T. Georgescu, R. Bohîlțea, V. Varlas, O. Munteanu, F. Furtunescu, A. Lisievici, C. Grigoriu","doi":"10.31083/j.ceog4901016","DOIUrl":"https://doi.org/10.31083/j.ceog4901016","url":null,"abstract":"Objective: Primary ovarian carcinoids are neuroendocrine tumors, representing up to 1% of all ovarian tumors. In this paper, the authors aimed at analyzing the clinical and pathological aspects of all recently published ovarian carcinoid, providing new correlations regarding them. Mechanism: The authors have reviewed all cases of primary ovarian carcinoid reported in international journals since 2005 to date. A total of 99 cases published in 68 articles have been found and analyzed. Findings in brief: Our results up to 29.31% of patients presented with carcinoid heart disease, and 17.24% had an abdominal mass, which caused them to present to the physician. Patients presenting with metastases had more frequently the insular subtype (33.33%) and had similar median age as those without metastases. A teratoma component was noticed in 58.9% of cases and was also associated with the insular pattern of carcinoid. To our best knowledge, this paper includes the largest review of primary ovarian carcinoid to date. Conclusions: The incidence of carcinoid heart disease might have been underestimated up to this moment, thus, requiring further imagistic investigations of patients presenting with these symptoms. Additionally, the insular variant was most frequently associated with the presence of both teratoma (52.94%) and metastases (33.33%), although previous reports have noticed a higher incidence of teratoma in the mucinous variant. In our opinion, these apparently divergent results warrant further studies of this rare subtype of ovarian tumor.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49010133","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}
J. Sierra, Andrea Espiau Romera, M. J. Puente Luján, Rebeca Herrero Serrano, Maria Jesús Franco Royo, Carlos De Bonrostro Torralba, Belén Rodríguez Solanilla
Background: Heterotopic pregnancy is the condition in which intrauterine and ectopic pregnancy coexist. The conservative management of the ectopic pregnancy, with the intrauterine pregnancy preserved, has been reported. Case(s): Here, we report a very rare case: intrauterine and cervical pregnancy coexist: intrasacular Potassium chloride (KCL) injection successfully terminated cervical pregnancy with intrauterine pregnancy preserved, but later massive bleeding occurred from the cervix. A 39-year-old woman at 7 weeks was diagnosed with a heterotopic cervical gestation, with intrauterine and cervical sac, both with live embryos. The ectopic pregnancy was successfully terminated with intrasacular injection of KCl, preserving the intrauterine pregnancy. At 32 weeks of gestation the patient started with a profuse bleeding from the cervical sac, causing maternal hypotension (80/45 mmHg) and tachycardia (160 bpm) and a decelerative pattern in the cardiotocographic fetal monitoring, prompting us to perform caesarean section. The cessation of bleeding was achieved using a double balloon intracervical catheter, which was withdrawn 24 hours after its insertion without observing a new bleeding episode. The patient was discharged after 8 days and the newborn after 35 days of life, both in good health. Conclusions: Conservative treatment of a heterotopic gestation is possible, managing to preserve the viability of the intrauterine pregnancy.
{"title":"A case of heterotopic pregnancy with intrauterine and cervical pregnancy coexisting: intrasacular KCl injection, intrauterine pregnancy being preserved, and then massive bleeding at 32 weeks","authors":"J. Sierra, Andrea Espiau Romera, M. J. Puente Luján, Rebeca Herrero Serrano, Maria Jesús Franco Royo, Carlos De Bonrostro Torralba, Belén Rodríguez Solanilla","doi":"10.31083/j.ceog4901012","DOIUrl":"https://doi.org/10.31083/j.ceog4901012","url":null,"abstract":"Background: Heterotopic pregnancy is the condition in which intrauterine and ectopic pregnancy coexist. The conservative management of the ectopic pregnancy, with the intrauterine pregnancy preserved, has been reported. Case(s): Here, we report a very rare case: intrauterine and cervical pregnancy coexist: intrasacular Potassium chloride (KCL) injection successfully terminated cervical pregnancy with intrauterine pregnancy preserved, but later massive bleeding occurred from the cervix. A 39-year-old woman at 7 weeks was diagnosed with a heterotopic cervical gestation, with intrauterine and cervical sac, both with live embryos. The ectopic pregnancy was successfully terminated with intrasacular injection of KCl, preserving the intrauterine pregnancy. At 32 weeks of gestation the patient started with a profuse bleeding from the cervical sac, causing maternal hypotension (80/45 mmHg) and tachycardia (160 bpm) and a decelerative pattern in the cardiotocographic fetal monitoring, prompting us to perform caesarean section. The cessation of bleeding was achieved using a double balloon intracervical catheter, which was withdrawn 24 hours after its insertion without observing a new bleeding episode. The patient was discharged after 8 days and the newborn after 35 days of life, both in good health. Conclusions: Conservative treatment of a heterotopic gestation is possible, managing to preserve the viability of the intrauterine pregnancy.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45028415","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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