Background: The main goal of this study was to prove that hysteroscopy is a superior method compared to hysterosalpingography in the evaluation of tubal passage and the uterine cavity in infertile women. Methods: The study was carried out on 30 volunteer women for whom evaluation of the uterine cavity and transit through the tubules was required due to infertility. In the evaluation of the hysteroscopic tubal passage, a 6Fr feeding cannula was advanced from the hysteroscope barrel, and firstly methylene blue and then an air bubble were applied to the fluid-filled uterine cavity through this flexible cannula. Results: When the reference method was taken as hysterosalpingography, the specificity of hysteroscopy was found to be 85.71% (95% CI (confidence interval): 42.13%– 99.64%), sensitivity 94.74% (95% CI: 85.38–98.90%). The positive predictive value of hysteroscopy was calculated as 98.18% (95% CI: 89.78%–99.70%) and the negative predictive value was 66.67% (95% CI: 38.96%–86.24%). Observing the bubble and swirl effect together in the evaluation of the tube opening increases the diagnostic accuracy. And benefit of hysteroscopy in the evaluation of tubal passage was statistically significantly higher than hysterosalpingography. Conclusion: Considering the cellular damages that can be caused by hysterosalpingraphy and the real observation power provided by hysteroscopy, simultaneous evaluation and the comfort of making intervention possible, hysteroscopy will be a more useful and useful application.
{"title":"Can hysteroscopy be substituted to hysterosalpingography in the assessment of infertility? Methods of showing tubal transition as hysteroscopic","authors":"Buket Aydın Yanar, E. Pek, M. Unsal","doi":"10.31083/j.ceog4901014","DOIUrl":"https://doi.org/10.31083/j.ceog4901014","url":null,"abstract":"Background: The main goal of this study was to prove that hysteroscopy is a superior method compared to hysterosalpingography in the evaluation of tubal passage and the uterine cavity in infertile women. Methods: The study was carried out on 30 volunteer women for whom evaluation of the uterine cavity and transit through the tubules was required due to infertility. In the evaluation of the hysteroscopic tubal passage, a 6Fr feeding cannula was advanced from the hysteroscope barrel, and firstly methylene blue and then an air bubble were applied to the fluid-filled uterine cavity through this flexible cannula. Results: When the reference method was taken as hysterosalpingography, the specificity of hysteroscopy was found to be 85.71% (95% CI (confidence interval): 42.13%– 99.64%), sensitivity 94.74% (95% CI: 85.38–98.90%). The positive predictive value of hysteroscopy was calculated as 98.18% (95% CI: 89.78%–99.70%) and the negative predictive value was 66.67% (95% CI: 38.96%–86.24%). Observing the bubble and swirl effect together in the evaluation of the tube opening increases the diagnostic accuracy. And benefit of hysteroscopy in the evaluation of tubal passage was statistically significantly higher than hysterosalpingography. Conclusion: Considering the cellular damages that can be caused by hysterosalpingraphy and the real observation power provided by hysteroscopy, simultaneous evaluation and the comfort of making intervention possible, hysteroscopy will be a more useful and useful application.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46248454","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: With the increased frequency of diagnosis of interstitial pregnancy in the early first trimester, non-surgical management of unruptured interstitial pregnancy has become an important issue. However, management of unruptured interstitial pregnancy by uterine artery chemoembolization (UACE)with dactinomycin has never been evaluated via a case series. Methods: With this aim, a retrospective review of electronic chart records over a five-year period was performed, and a series of cases of unruptured interstitial pregnancy during the first trimester was extracted. Diagnostic procedures included ultrasonography, magnetic resonance imaging (MRI), and laparoscopic examination, if necessary. Conservative treatment regimen included UACE. Additional administration of methotrexate (MTX) was considered when an insufficient decline of serum β-hCG was noted. Clinical characteristics and treatment outcomes are described. Results: Among four women diagnosed with unruptured interstitial pregnancy at six weeks of gestation, one case was managed by laparoscopic cornuostomy due to concerns of rupture after the identification of thinning of the myometrium, whereas the other three cases were initially managed by UACE. One case of proximal interstitial pregnancy was diagnosed solely by MRI, whereas two cases of distal interstitial pregnancy was diagnosed by exploratory laparoscopy. Two cases were successfully managed by UACE alone, whereas one case required additional systemic administration of MTX to achieve resolution of gestational products after UACE. Thereafter, one patient conceived spontaneously and experienced a successful vaginal birth. Conclusions: This small case series emphasizes that UACE is a feasible minimally invasive option for the management of unruptured interstitial pregnancy identified in the early first trimester.
{"title":"Uterine artery chemoembolization for management of unruptured interstitial pregnancy diagnosed in the early first trimester","authors":"A. Takeda, S. Iyoshi, S. Tamauchi, W. Koike","doi":"10.31083/j.ceog4901011","DOIUrl":"https://doi.org/10.31083/j.ceog4901011","url":null,"abstract":"Background: With the increased frequency of diagnosis of interstitial pregnancy in the early first trimester, non-surgical management of unruptured interstitial pregnancy has become an important issue. However, management of unruptured interstitial pregnancy by uterine artery chemoembolization (UACE)with dactinomycin has never been evaluated via a case series. Methods: With this aim, a retrospective review of electronic chart records over a five-year period was performed, and a series of cases of unruptured interstitial pregnancy during the first trimester was extracted. Diagnostic procedures included ultrasonography, magnetic resonance imaging (MRI), and laparoscopic examination, if necessary. Conservative treatment regimen included UACE. Additional administration of methotrexate (MTX) was considered when an insufficient decline of serum β-hCG was noted. Clinical characteristics and treatment outcomes are described. Results: Among four women diagnosed with unruptured interstitial pregnancy at six weeks of gestation, one case was managed by laparoscopic cornuostomy due to concerns of rupture after the identification of thinning of the myometrium, whereas the other three cases were initially managed by UACE. One case of proximal interstitial pregnancy was diagnosed solely by MRI, whereas two cases of distal interstitial pregnancy was diagnosed by exploratory laparoscopy. Two cases were successfully managed by UACE alone, whereas one case required additional systemic administration of MTX to achieve resolution of gestational products after UACE. Thereafter, one patient conceived spontaneously and experienced a successful vaginal birth. Conclusions: This small case series emphasizes that UACE is a feasible minimally invasive option for the management of unruptured interstitial pregnancy identified in the early first trimester.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47006004","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}
M. Le, Minh Thang Tran, T. Nguyen, D. T. Tran, Quang Vinh Truong, Quoc Huy Vu Nguyen
Background: Pregnant womenwith cardiac diseases present a challenge for both obstetricians and cardiologists, especially in developing countries with limited medical resources. This study aimed to determine the clinical features and pregnancy outcomes of pregnant women with cardiac diseases in Vietnam. Methods: In this patient registry descriptive study, pregnant women with heart disease, admitted to the Department of Obstetrics and Gynecology, Hue Central Hospital, Vietnam, between January 2017 and December 2020, were recruited. Pregnant women were classified into the high-risk group if at least one of the following risk clinical features was present: (1) left ventricular ejection fraction (EF)<50%, and (2) New York Heart Association—NYHA classification—NYHA class>II or cyanosis, or (3) left heart obstruction; patients without these risk conditions were categorized into the low-risk group. Results: A total of 134 pregnant women were included, with a mean age of 27.8 ± 4.8 years old; 32.1% had mitral valve disease, 23.9% had rhythm disorders, 15.7% had congenital heart disease, 9.0% had aortic valve disease, and 3.0% had both mitral and aortic valve disease. Maternal complications during pregnancy included heart failure (37.3%), irregular heart rhythm (35.8%), thrombosis (0.7%), and valve blockage (0.7%). A total of 66.7% of the high-risk patients underwent cesarean section, 22.2% with therapeutic abortion, and 11.1% with miscarriage. The frequency of gestational age over 35 weeks in the high-risk and low-risk groups were 55.6% and 92.8%, respectively (Odds ratios = 0.097, 95% Confidence Interval: 0.02–0.43, p < 0.05). The mean birth weight in the high-risk and low-risk groups was 2800.0 ± 438.2 and 2988.4± 390.6 g, p> 0.05, respectively. Conclusions: Cardiovascular disorders in pregnant women have a higher rate of complications that affect mother and fetus. Risk stratification plays an important role in management during pregnancy and is essential to improve the outcomes in developing countries with limited medical
{"title":"Characteristics of maternal cardiac disease and pregnancy outcomes: results from a 4-year observational cohort survey in Central Vietnam","authors":"M. Le, Minh Thang Tran, T. Nguyen, D. T. Tran, Quang Vinh Truong, Quoc Huy Vu Nguyen","doi":"10.31083/j.ceog4901013","DOIUrl":"https://doi.org/10.31083/j.ceog4901013","url":null,"abstract":"Background: Pregnant womenwith cardiac diseases present a challenge for both obstetricians and cardiologists, especially in developing countries with limited medical resources. This study aimed to determine the clinical features and pregnancy outcomes of pregnant women with cardiac diseases in Vietnam. Methods: In this patient registry descriptive study, pregnant women with heart disease, admitted to the Department of Obstetrics and Gynecology, Hue Central Hospital, Vietnam, between January 2017 and December 2020, were recruited. Pregnant women were classified into the high-risk group if at least one of the following risk clinical features was present: (1) left ventricular ejection fraction (EF)<50%, and (2) New York Heart Association—NYHA classification—NYHA class>II or cyanosis, or (3) left heart obstruction; patients without these risk conditions were categorized into the low-risk group. Results: A total of 134 pregnant women were included, with a mean age of 27.8 ± 4.8 years old; 32.1% had mitral valve disease, 23.9% had rhythm disorders, 15.7% had congenital heart disease, 9.0% had aortic valve disease, and 3.0% had both mitral and aortic valve disease. Maternal complications during pregnancy included heart failure (37.3%), irregular heart rhythm (35.8%), thrombosis (0.7%), and valve blockage (0.7%). A total of 66.7% of the high-risk patients underwent cesarean section, 22.2% with therapeutic abortion, and 11.1% with miscarriage. The frequency of gestational age over 35 weeks in the high-risk and low-risk groups were 55.6% and 92.8%, respectively (Odds ratios = 0.097, 95% Confidence Interval: 0.02–0.43, p < 0.05). The mean birth weight in the high-risk and low-risk groups was 2800.0 ± 438.2 and 2988.4± 390.6 g, p> 0.05, respectively. Conclusions: Cardiovascular disorders in pregnant women have a higher rate of complications that affect mother and fetus. Risk stratification plays an important role in management during pregnancy and is essential to improve the outcomes in developing countries with limited medical","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48483824","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: To assess the accuracy of ultrasound in diagnosing acute appendicitis in pregnant women. Mechanism: The National Library of Medicine (MEDLINE, 1990–2020), Excerpta Medica Database (EMBASE,1946–2020) and the Cochrane Controlled Trials Register (CENTRAL)were used to extract articles that were published in English. A total of five studies involving 521 patients were selected. The DerSimonian and Laird random-effects model and Quality Assessment Tool for Diagnostic Accuracy (QUADAS-2) were used to analyze the data. Findings in brief: We identified 140 related articles and included 5 articles enrolling 521 patients. The values obtained using ultrasound for appendicitis during pregnancy were sensitivity of 0.62 (95% Confidence interval (CI): 0.43–0.78), the specificity of 0.91 (95% CI: 0.74–0.97), and the Positive Likelihood Ratio of 7.0 (95% CI: 2.5–19.7), the Negative Likelihood Ratio of 0.41 (95% CI: 0.27–0.63) and the Diagnostic Odds Ratio of 17 (95% CI : 6–49). Conclusion: Ultrasound had medium-level sensitivity and high specificity for the diagnosis of appendicitis in pregnant women.
{"title":"Potential of ultrasound in the evaluation of acute appendicitis during pregnancy: a systematic review and meta-analysis","authors":"Yunlong Li, Shikuan Li","doi":"10.31083/j.ceog4901015","DOIUrl":"https://doi.org/10.31083/j.ceog4901015","url":null,"abstract":"Objective: To assess the accuracy of ultrasound in diagnosing acute appendicitis in pregnant women. Mechanism: The National Library of Medicine (MEDLINE, 1990–2020), Excerpta Medica Database (EMBASE,1946–2020) and the Cochrane Controlled Trials Register (CENTRAL)were used to extract articles that were published in English. A total of five studies involving 521 patients were selected. The DerSimonian and Laird random-effects model and Quality Assessment Tool for Diagnostic Accuracy (QUADAS-2) were used to analyze the data. Findings in brief: We identified 140 related articles and included 5 articles enrolling 521 patients. The values obtained using ultrasound for appendicitis during pregnancy were sensitivity of 0.62 (95% Confidence interval (CI): 0.43–0.78), the specificity of 0.91 (95% CI: 0.74–0.97), and the Positive Likelihood Ratio of 7.0 (95% CI: 2.5–19.7), the Negative Likelihood Ratio of 0.41 (95% CI: 0.27–0.63) and the Diagnostic Odds Ratio of 17 (95% CI : 6–49). Conclusion: Ultrasound had medium-level sensitivity and high specificity for the diagnosis of appendicitis in pregnant women.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43327405","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}
H. Kim, H. Cho, S. Jeong, Sung-taek Park, Sung-Ho Park
Background: Lymphocyte to neutrophil ratio (NLR) is a rapid and simple marker for systemic inflammation and stress after major surgery. In this study, we aimed to compare NLR changes according to surgical methods of hysterectomy. Methods: A retrospective chart review for all patients who underwent hysterectomy for benign uterine disease from 2016 to 2020 was performed. A total of 1549 women were assigned to total laparoscopic hysterectomy (TLH) (n = 419), vaginal hysterectomy (VH) (n = 608), and total abdominal hysterectomy (TAH) (n = 522) groups. Patient characteristics, surgical outcomes, and NLR changes were compared among women who underwent TLH, VH, and TAH. Results: Preoperative mean NLR was similar among three groups (p = 0.056). However, mean NLR on postoperative day 1 (p < 0.0001) and day 3 (p = 0.011) was significantly lower in TLH group than others. Also, mean NLR change on postoperative day 1 was significantly lesser in TLH group than others (1.9 in TLH vs. 5.4 in VH vs. 4.7 in TAH; p < 0.0001). Mean NLR change on postoperative day 3 was greater in TAH group than others, although there were no statistically significant differences (0.2 in TLH vs. 0.3 in VH vs. 0.7 in TAH; p = 0.354). Multivariate analysis revealed that massive NLR change (>5.0) on postoperative day 1 was significantly associated with types of hysterectomy (p < 0.0001). Conclusion: Our data showed that acute NLR change was lesser in TLH group comparing to VH and TAH group, which suggests that TLH might be associated with less systemic inflammation and tissue trauma after surgery.
{"title":"A retrospective comparative analysis of systemic inflammatory response after laparoscopic, vaginal, and abdominal hysterectomy","authors":"H. Kim, H. Cho, S. Jeong, Sung-taek Park, Sung-Ho Park","doi":"10.31083/j.ceog4901010","DOIUrl":"https://doi.org/10.31083/j.ceog4901010","url":null,"abstract":"Background: Lymphocyte to neutrophil ratio (NLR) is a rapid and simple marker for systemic inflammation and stress after major surgery. In this study, we aimed to compare NLR changes according to surgical methods of hysterectomy. Methods: A retrospective chart review for all patients who underwent hysterectomy for benign uterine disease from 2016 to 2020 was performed. A total of 1549 women were assigned to total laparoscopic hysterectomy (TLH) (n = 419), vaginal hysterectomy (VH) (n = 608), and total abdominal hysterectomy (TAH) (n = 522) groups. Patient characteristics, surgical outcomes, and NLR changes were compared among women who underwent TLH, VH, and TAH. Results: Preoperative mean NLR was similar among three groups (p = 0.056). However, mean NLR on postoperative day 1 (p < 0.0001) and day 3 (p = 0.011) was significantly lower in TLH group than others. Also, mean NLR change on postoperative day 1 was significantly lesser in TLH group than others (1.9 in TLH vs. 5.4 in VH vs. 4.7 in TAH; p < 0.0001). Mean NLR change on postoperative day 3 was greater in TAH group than others, although there were no statistically significant differences (0.2 in TLH vs. 0.3 in VH vs. 0.7 in TAH; p = 0.354). Multivariate analysis revealed that massive NLR change (>5.0) on postoperative day 1 was significantly associated with types of hysterectomy (p < 0.0001). Conclusion: Our data showed that acute NLR change was lesser in TLH group comparing to VH and TAH group, which suggests that TLH might be associated with less systemic inflammation and tissue trauma after surgery.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43768096","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 relationship between oral contraceptive (OC) use and breast cancer risk is highly debated. Recent publications support a slight increase in overall breast cancer risk among OC user women, in particular among the current users. Women with inherited BRCA1 (Breast cancer type 1) or BRCA2 (Breast cancer type 2) gene mutations are at increased risk of breast and ovarian cancers, which is often mistakenly attributed to their elevated endogenous estrogen levels. The aim of presented meta-analysis was to assess the effects of OC use on breast cancer risk in BRCA mutation carrier women with minimal bias.Methods: A systematic search strategy was used to identify relevant studies, Stata (version 15) was used for meta-analysis. Results: Individual datasets from 13 studies totaling 20,202 patients were analyzed. The combined results showed no significant increase in risk of breast cancer in BRCA mutation carriers who had ever used oral contraceptive (HR = 1.09, 95% CI: 0.71–1.69 among BRCA1 mutation carriers and HR = 1.19, 95% CI: 0.73–1.95 among BRCA2 mutation carriers, respectively). However, in correlation with long-term (>5 years) OC users, the breast cancer risk was significantly increased in both BRCA1 mutation carriers (HR = 1.39, 95% CI: 1.19–1.60) and BRCA1 mutation carriers (HR = 1.61, 95% CI: 1.25–1.96). Conclusion: The presented results indicate that in BRCA mutation carriers women who have defective liganded activation of estrogen receptors (ERs), the use of synthetic estrogens means an additive factor for ER deregulation further increasing the risk for breast cancer. Long term OC use in BRCA mutation carriers results in a significantly increased risk for breast cancer by exhausting the compensatory genome defending process.
{"title":"Long term use of oral contraceptives comprising synthetic estrogens induces an excessive breast cancer risk in BRCA mutation carrier women: a meta-analysis","authors":"Hongling Peng, Xiaorong Qi, Qiao Wang","doi":"10.31083/j.ceog4901009","DOIUrl":"https://doi.org/10.31083/j.ceog4901009","url":null,"abstract":"Background: The relationship between oral contraceptive (OC) use and breast cancer risk is highly debated. Recent publications support a slight increase in overall breast cancer risk among OC user women, in particular among the current users. Women with inherited BRCA1 (Breast cancer type 1) or BRCA2 (Breast cancer type 2) gene mutations are at increased risk of breast and ovarian cancers, which is often mistakenly attributed to their elevated endogenous estrogen levels. The aim of presented meta-analysis was to assess the effects of OC use on breast cancer risk in BRCA mutation carrier women with minimal bias.Methods: A systematic search strategy was used to identify relevant studies, Stata (version 15) was used for meta-analysis. Results: Individual datasets from 13 studies totaling 20,202 patients were analyzed. The combined results showed no significant increase in risk of breast cancer in BRCA mutation carriers who had ever used oral contraceptive (HR = 1.09, 95% CI: 0.71–1.69 among BRCA1 mutation carriers and HR = 1.19, 95% CI: 0.73–1.95 among BRCA2 mutation carriers, respectively). However, in correlation with long-term (>5 years) OC users, the breast cancer risk was significantly increased in both BRCA1 mutation carriers (HR = 1.39, 95% CI: 1.19–1.60) and BRCA1 mutation carriers (HR = 1.61, 95% CI: 1.25–1.96). Conclusion: The presented results indicate that in BRCA mutation carriers women who have defective liganded activation of estrogen receptors (ERs), the use of synthetic estrogens means an additive factor for ER deregulation further increasing the risk for breast cancer. Long term OC use in BRCA mutation carriers results in a significantly increased risk for breast cancer by exhausting the compensatory genome defending process.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45291565","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}
Huanhuan Ding, Weizeng Zheng, Xinfen Xu, Baohua Li
Background: When a fetus is diagnosed with facial deformities, most Chinese couples choose to terminate the pregnancy. However, these couples commonly regret their decision after the termination of the pregnancy, display a heavier degree of grief, and these feelings persist for a long time. The purpose of this study was to investigate factors that influence parental pregnancy decisions regarding fetuses diagnosed with a non-syndromic orofacial cleft (NSOFC), and to provide the preliminary basis for a formulation of interview outlines useful in further qualitative research in this area. Methods: We collected medical records of 400 couples from the obstetrical units of a women’s hospital in China whose fetuses were diagnosed with Orofacial clefts (OFCs) from January 2013 to July 2019. After excluding those records reporting chromosomal or other abnormalities, 311 cases were included in this study. After univariate analysis, factors that may have affected the parental pregnancy decision were analyzed using binary classification regression analysis. Results: Among the 311 couples, 71.7% (223/311) decided to terminate the pregnancy, whereas 28.3% (88/311) decided to continue. The registered residence, family history of NSOFC, maternal high-risk factors that may lead to the fetus suffering from NSOFC, maternal age, paternal age, doctor’s suggestion, prenatal diagnosis, and first diagnosed gestational week all influenced pregnancy decision makings (p< 0.05). Among these, the registered residence, family history of NSOFC, maternal high-risk factors, maternal age, prenatal diagnosis, and first diagnosed gestational week substantially affected the parental pregnancy decision. Discussion: The couples with registered residence in rural areas, no family history of NSOFC, no maternal high-risk factors, younger maternal age, younger gestational age at first diagnosis are at greater relative risk of pregnancy termination. Prenatal diagnosis is a protective factor.
{"title":"Factors influencing parental pregnancy decision-making due to fetuses with non-syndromic orofacial clefts: a study of Chinese couples","authors":"Huanhuan Ding, Weizeng Zheng, Xinfen Xu, Baohua Li","doi":"10.31083/j.ceog4901008","DOIUrl":"https://doi.org/10.31083/j.ceog4901008","url":null,"abstract":"Background: When a fetus is diagnosed with facial deformities, most Chinese couples choose to terminate the pregnancy. However, these couples commonly regret their decision after the termination of the pregnancy, display a heavier degree of grief, and these feelings persist for a long time. The purpose of this study was to investigate factors that influence parental pregnancy decisions regarding fetuses diagnosed with a non-syndromic orofacial cleft (NSOFC), and to provide the preliminary basis for a formulation of interview outlines useful in further qualitative research in this area. Methods: We collected medical records of 400 couples from the obstetrical units of a women’s hospital in China whose fetuses were diagnosed with Orofacial clefts (OFCs) from January 2013 to July 2019. After excluding those records reporting chromosomal or other abnormalities, 311 cases were included in this study. After univariate analysis, factors that may have affected the parental pregnancy decision were analyzed using binary classification regression analysis. Results: Among the 311 couples, 71.7% (223/311) decided to terminate the pregnancy, whereas 28.3% (88/311) decided to continue. The registered residence, family history of NSOFC, maternal high-risk factors that may lead to the fetus suffering from NSOFC, maternal age, paternal age, doctor’s suggestion, prenatal diagnosis, and first diagnosed gestational week all influenced pregnancy decision makings (p< 0.05). Among these, the registered residence, family history of NSOFC, maternal high-risk factors, maternal age, prenatal diagnosis, and first diagnosed gestational week substantially affected the parental pregnancy decision. Discussion: The couples with registered residence in rural areas, no family history of NSOFC, no maternal high-risk factors, younger maternal age, younger gestational age at first diagnosis are at greater relative risk of pregnancy termination. Prenatal diagnosis is a protective factor.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45559556","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. Viola, S. Marzinotto, M. Bertacchi, A. Londero, M. Orsaria, S. Bertozzi, L. Driul, C. di Loreto, M. Studer, L. Mariuzzi, A. Fruscalzo
Background: Chicken Ovalbumin Upstream Promoter-Transcription Factor I (COUP-TFI) is a member of the steroid/thyroid nuclear receptor superfamily. The aim of this study was to investigate whether absence of this gene affects placental development and fetal growth in a COUP-TFI knockout mouse model. Methods: Placentas of COUP-TFI-knockout (COUP-TFI KO) and wild-type (WT) were collected at 18.5 days post-coitum. The expression level of the following genes known to be involved in different key molecular pathways was evaluated: BCL2Associated X (Bax) and B-cell lymphoma 2 (Bcl-2) (apoptosis), p21, p53 andα subunit of inhibin (INHA) (proliferation and apoptosis), vascular endothelial growth factor A (VEGF-A), placental growth factor (PlGF), hypoxia-inducible factor 1-alpha (HIF1α), Fms related receptor tyrosine kinase 1 (Flt-1), and endoglin (ENG) (angiogenesis). Mouse litter weight at birth was also assessed. Results: RT-qPCR analysis showed increased mRNA expression of VEGF-A and Bax in placental tissue of COUP-TFI KO mice compared to WT mice. We also found a loss in the positive correlation between Bcl-2 and INHA, p21 and ENG, as well as HIF1α and Flt-1 mRNA expression in COUP-TFI mutants. Finally, KO mice were lighter than WT littermates (respectively, the mean weight of COUP-TFI KOmice was 1.3 grams,± 0.13, compared to 1.6 g,± 0.14 ofWTmice, p< 0.05). Conclusions: Our results show that COUP-TFI deletion is associated with a lower birth weight in mice and increased placental transcript expression of pro-apoptotic Bax and pro-angiogenetic VEGF-A genes.
{"title":"COUP-TFI deletion affects angiogenesis and apoptosis related gene expression in mouse placenta: results of an explorative study","authors":"L. Viola, S. Marzinotto, M. Bertacchi, A. Londero, M. Orsaria, S. Bertozzi, L. Driul, C. di Loreto, M. Studer, L. Mariuzzi, A. Fruscalzo","doi":"10.31083/j.ceog4901007","DOIUrl":"https://doi.org/10.31083/j.ceog4901007","url":null,"abstract":"Background: Chicken Ovalbumin Upstream Promoter-Transcription Factor I (COUP-TFI) is a member of the steroid/thyroid nuclear receptor superfamily. The aim of this study was to investigate whether absence of this gene affects placental development and fetal growth in a COUP-TFI knockout mouse model. Methods: Placentas of COUP-TFI-knockout (COUP-TFI KO) and wild-type (WT) were collected at 18.5 days post-coitum. The expression level of the following genes known to be involved in different key molecular pathways was evaluated: BCL2Associated X (Bax) and B-cell lymphoma 2 (Bcl-2) (apoptosis), p21, p53 andα subunit of inhibin (INHA) (proliferation and apoptosis), vascular endothelial growth factor A (VEGF-A), placental growth factor (PlGF), hypoxia-inducible factor 1-alpha (HIF1α), Fms related receptor tyrosine kinase 1 (Flt-1), and endoglin (ENG) (angiogenesis). Mouse litter weight at birth was also assessed. Results: RT-qPCR analysis showed increased mRNA expression of VEGF-A and Bax in placental tissue of COUP-TFI KO mice compared to WT mice. We also found a loss in the positive correlation between Bcl-2 and INHA, p21 and ENG, as well as HIF1α and Flt-1 mRNA expression in COUP-TFI mutants. Finally, KO mice were lighter than WT littermates (respectively, the mean weight of COUP-TFI KOmice was 1.3 grams,± 0.13, compared to 1.6 g,± 0.14 ofWTmice, p< 0.05). Conclusions: Our results show that COUP-TFI deletion is associated with a lower birth weight in mice and increased placental transcript expression of pro-apoptotic Bax and pro-angiogenetic VEGF-A genes.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48681537","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 evaluate both the impact of hepatitis B virus (HBV)-DNA copies in women with HBV infection on the ovarian reserve function and outcomes of in vitro fertilization (IVF).Methods: We conducted a retrospective study on a total of 9927 couples undergoing their first IVF cycle. After filtering, 1570 couples (546 HBV-seropositive women and 1024 HBV-seronegative women whose partners were HBV-seronegative) failed to meet inclusion criteria. According to the HBV-DNA titers in serum, the HBV-seropositive group was divided into three groups: DNA-high copy group (n = 139), DNA-low copy group (n = 241), and DNA-negative group (n = 166). All patients underwent controlled ovarian hyperstimulation using the long downregulation protocol followed by IVF. Results: Compared with the HBV-negative group, HBV-positive women with high DNA copy exhibited lower antral follicle count (AFC) (11.9 ± 4.3 vs 13.3± 3.2), lower number of oocyte retrieved (9.2± 5.7 vs 13.1± 6.1), larger proportion of AFC<8 (7.9% vs 3.1%) and anti-mullerian hormone (AMH) <2 μg/L (8.6% vs 4.3%). Both high-DNA copy and low-DNA copy groups exhibited a lower fertilization rate (70.9% and 72.5% vs 75.1%), lower high-grade embryo rate (51.5% and 53.8% vs 56.9%), lower implantation rate (31.3% and 32.7% vs 38.5%), lower clinical pregnancy rate (40.3% and 42.3% vs 49.6% per cycle with OR; 45.5% and 48.8% vs 56.8% per cycle with ET) than the HBV-negative group. Moreover, a higher early abortion rate (19.6% and 15.7% vs 7.1%) was observed in the above two groups. Conclusion: HBV-DNA may have a negative effect on women’s ovarian reserve function which in turn results in poor fertilization rate, clinical pregnancy rate and high early abortion rate in IVF treatment.
{"title":"Analyzing the detrimental effects of female chronic hepatitis B virus DNA on ovarian reserve function and results of in vitro fertilization","authors":"Liu Liu, Hua Liang, J. Yang, Fujin Shen, Wei Li","doi":"10.31083/j.ceog4901004","DOIUrl":"https://doi.org/10.31083/j.ceog4901004","url":null,"abstract":"Background: To evaluate both the impact of hepatitis B virus (HBV)-DNA copies in women with HBV infection on the ovarian reserve function and outcomes of in vitro fertilization (IVF).Methods: We conducted a retrospective study on a total of 9927 couples undergoing their first IVF cycle. After filtering, 1570 couples (546 HBV-seropositive women and 1024 HBV-seronegative women whose partners were HBV-seronegative) failed to meet inclusion criteria. According to the HBV-DNA titers in serum, the HBV-seropositive group was divided into three groups: DNA-high copy group (n = 139), DNA-low copy group (n = 241), and DNA-negative group (n = 166). All patients underwent controlled ovarian hyperstimulation using the long downregulation protocol followed by IVF. Results: Compared with the HBV-negative group, HBV-positive women with high DNA copy exhibited lower antral follicle count (AFC) (11.9 ± 4.3 vs 13.3± 3.2), lower number of oocyte retrieved (9.2± 5.7 vs 13.1± 6.1), larger proportion of AFC<8 (7.9% vs 3.1%) and anti-mullerian hormone (AMH) <2 μg/L (8.6% vs 4.3%). Both high-DNA copy and low-DNA copy groups exhibited a lower fertilization rate (70.9% and 72.5% vs 75.1%), lower high-grade embryo rate (51.5% and 53.8% vs 56.9%), lower implantation rate (31.3% and 32.7% vs 38.5%), lower clinical pregnancy rate (40.3% and 42.3% vs 49.6% per cycle with OR; 45.5% and 48.8% vs 56.8% per cycle with ET) than the HBV-negative group. Moreover, a higher early abortion rate (19.6% and 15.7% vs 7.1%) was observed in the above two groups. Conclusion: HBV-DNA may have a negative effect on women’s ovarian reserve function which in turn results in poor fertilization rate, clinical pregnancy rate and high early abortion rate in IVF treatment.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46211861","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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