Pub Date : 2023-05-18DOI: 10.2174/1573404820666230518103039
O. Vasilj, Mateja Vujica Ferenc, A. Šerman, V. Blagaić, Milan Milošević, M. Pavlović, Ivanka Bekavac Vlatković
Pelvic inflammatory disease (PID) is a public health problem that demands rapid diagnosis and treatment and may severely impair female reproductive health. To analyze anamnestic information, laboratory findings, and clinical and microbiological features of patients with severe acute PID that underwent a surgical procedure. This retrospective study enrolled 97 cases that were surgically treated in the Department of Obstetrics and Gynecology, Clinical Hospital „Sveti Duh“ between 2009 and 2019. Most women were within the age group 35-44 (38.14%). Lower abdominal pain was the most common symptom (92.78%). Compared to intraoperatively confirmed PID, C-reactive protein (CRP) yielded the highest sensitivity (88.10%) while cervical motion tenderness possessed the highest specificity (53.85%). The tubo-ovarian abscess was detected in 35.05% of intraoperative specimens, mainly occurring in women between 45-54 years (P=0.017) and absent between 15-24 (P=0.012) and 25-34 years (P=0.049). The length of hospital stay was influenced by the number of symptoms (ρ=0.316, P=0.002), admission CRP levels (ρ=0.620, P<0.001), and admission body temperature (ρ=0.386, P<0.001). Out of 59.30% of positive cultures, one pathogen was isolated in 70.59%, mainly Escherichia coli (41.18%). Admission CRP levels impacted the efficacy of microbiologic isolation (P=0.001). The empirical treatment was mostly based on the clindamycin/gentamicin combination (51.72%). Severe clinical picture that requires surgical treatment can be expected in women >35 years. Longer hospital stay was associated with more symptoms, higher CRP, and temperature values on admission. It is important to have a low threshold for diagnosis and to consider both aerobic and anaerobic pathogens when selecting antibiotic treatment.
{"title":"Characteristics Of Acute Pelvic Inflammatory Disease In Surgically Treated Females Over Ten years - A Single-Center Study","authors":"O. Vasilj, Mateja Vujica Ferenc, A. Šerman, V. Blagaić, Milan Milošević, M. Pavlović, Ivanka Bekavac Vlatković","doi":"10.2174/1573404820666230518103039","DOIUrl":"https://doi.org/10.2174/1573404820666230518103039","url":null,"abstract":"\u0000\u0000Pelvic inflammatory disease (PID) is a public health problem that demands rapid diagnosis and treatment and may severely impair female reproductive health.\u0000\u0000\u0000\u0000To analyze anamnestic information, laboratory findings, and clinical and microbiological features of patients with severe acute PID that underwent a surgical procedure.\u0000\u0000\u0000\u0000This retrospective study enrolled 97 cases that were surgically treated in the Department of Obstetrics and Gynecology, Clinical Hospital „Sveti Duh“ between 2009 and 2019.\u0000\u0000\u0000\u0000Most women were within the age group 35-44 (38.14%). Lower abdominal pain was the most common symptom (92.78%). Compared to intraoperatively confirmed PID, C-reactive protein (CRP) yielded the highest sensitivity (88.10%) while cervical motion tenderness possessed the highest specificity (53.85%). The tubo-ovarian abscess was detected in 35.05% of intraoperative specimens, mainly occurring in women between 45-54 years (P=0.017) and absent between 15-24 (P=0.012) and 25-34 years (P=0.049). The length of hospital stay was influenced by the number of symptoms (ρ=0.316, P=0.002), admission CRP levels (ρ=0.620, P<0.001), and admission body temperature (ρ=0.386, P<0.001). Out of 59.30% of positive cultures, one pathogen was isolated in 70.59%, mainly Escherichia coli (41.18%). Admission CRP levels impacted the efficacy of microbiologic isolation (P=0.001). The empirical treatment was mostly based on the clindamycin/gentamicin combination (51.72%).\u0000\u0000\u0000\u0000Severe clinical picture that requires surgical treatment can be expected in women >35 years. Longer hospital stay was associated with more symptoms, higher CRP, and temperature values on admission. It is important to have a low threshold for diagnosis and to consider both aerobic and anaerobic pathogens when selecting antibiotic treatment.\u0000","PeriodicalId":11030,"journal":{"name":"Current Women s Health Reviews","volume":"438 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76672011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-17DOI: 10.2174/1573404820666230517121653
N. Jahani, M. Hasanzadeh, Sara Mirzaeian, M. Esmaeilpour, M. Farazestanian
Hydatiform mole can progress to gestational trophoblastic neoplasia (GTN), and we are looking for non-invasive methods to predict it. Old age, higher serum BHCG levels, and expression of genes, such as VEGF-EG, HIF-1α, and TGF-ß are known as predictive factors. We performed this study to evaluate the role of bilateral uterine artery doppler ultrasound in predicting postmolar- GTN. In this prospective cohort study, 42 patients with complete molar pregnancy were examined. Inclusion criteria confirmed molar pregnancy by histopathological examination. Exclusion criteria were patients more than 40 years old, patients with completed family childbearing planning, and diagnosis of GTN during the routine histopathological study. Before molar evacuation and four weeks later, bilateral uterine artery doppler sonography to determine the PI, RI, and PSV was performed. Serum BHCG levels were also measured before molar evacuation and weekly after evacuation until it exhibited spontaneous remission or developed GTN. About 36 patients were cured, and six others developed post-molar GTN. The bilateral uterine artery doppler sonography between the two groups showed a lower UA RI in the post-molar-GTN group before evacuation (P=0.048). Data demonstrated significant increases in Right.UA.RI (P=0/008), Left.UA.PI (P=0/037), and Right.UA.PSV (P=0/024) in the spontaneous remission group during 28 days follow-up period. There were no significant differences in these parameters in the GTN group throughout the time of follow-up. It seems that Doppler ultrasound plays a role in predicting GTN following uterine evacuation. A lower resistance in the uterine artery before evacuation and the remaining uterine artery blood flow constant after evacuation is associated with the development of post-molar- GTN.
{"title":"Comparative Investigation of Color Doppler Ultrasonography Parameters\u0000of the Uterine Artery in Patients with Post-molar GTN and Patients Recovered\u0000from Molar Pregnancy and its Role in Predicting the Probability\u0000of Occurrence","authors":"N. Jahani, M. Hasanzadeh, Sara Mirzaeian, M. Esmaeilpour, M. Farazestanian","doi":"10.2174/1573404820666230517121653","DOIUrl":"https://doi.org/10.2174/1573404820666230517121653","url":null,"abstract":"\u0000\u0000Hydatiform mole can progress to gestational trophoblastic neoplasia (GTN),\u0000and we are looking for non-invasive methods to predict it. Old age, higher serum BHCG levels, and\u0000expression of genes, such as VEGF-EG, HIF-1α, and TGF-ß are known as predictive factors. We performed\u0000this study to evaluate the role of bilateral uterine artery doppler ultrasound in predicting postmolar-\u0000GTN.\u0000\u0000\u0000\u0000In this prospective cohort study, 42 patients with complete molar pregnancy were examined.\u0000Inclusion criteria confirmed molar pregnancy by histopathological examination. Exclusion criteria\u0000were patients more than 40 years old, patients with completed family childbearing planning, and diagnosis\u0000of GTN during the routine histopathological study. Before molar evacuation and four weeks later,\u0000bilateral uterine artery doppler sonography to determine the PI, RI, and PSV was performed. Serum\u0000BHCG levels were also measured before molar evacuation and weekly after evacuation until it exhibited\u0000spontaneous remission or developed GTN.\u0000\u0000\u0000\u0000About 36 patients were cured, and six others developed post-molar GTN. The bilateral uterine\u0000artery doppler sonography between the two groups showed a lower UA RI in the post-molar-GTN\u0000group before evacuation (P=0.048). Data demonstrated significant increases in Right.UA.RI\u0000(P=0/008), Left.UA.PI (P=0/037), and Right.UA.PSV (P=0/024) in the spontaneous remission group\u0000during 28 days follow-up period. There were no significant differences in these parameters in the GTN\u0000group throughout the time of follow-up.\u0000\u0000\u0000\u0000It seems that Doppler ultrasound plays a role in predicting GTN following uterine evacuation.\u0000A lower resistance in the uterine artery before evacuation and the remaining uterine artery blood flow constant\u0000after evacuation is associated with the development of post-molar- GTN.\u0000","PeriodicalId":11030,"journal":{"name":"Current Women s Health Reviews","volume":"55 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90096889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}