Ginekologia polska最新文献

Objectives: In this study, our aim is to investigate the effect of CoronaVac vaccine on ovarian reserve in female patients followed up for infertility.

Material and methods: Our study is a retrospective study. Forty-six infertile patients who received two doses of CoronaVac vaccine one month apart and had not had a previous Covid 19 infection were included in the study. Anti-müllerian hormone (AMH) and folliculometry of 46 patients one month before CoronaVac vaccine and one month after the second dose of vaccine were compared.

Results: There was no statistically significant difference in the change of AMH level and follicle number before and after vaccination (respectively p = 0.366; 0.610).

Conclusions: Considering that having a COVID-19 infection has a negative effect on female fertility and causing ovarian damage in recent studies, vaccination is a rational and cost-effective approach to protect ovarian reserve. Knowing that the vaccine does not have a negative effect on fertility may increase the application of the vaccine in women of reproductive age.

Objectives: Tissue inhibitors of metalloproteinase-3 (TIMP-3) and matrix metalloproteinases (MMPs) play a major role in embryo implantation and placentation. This study aimed to investigate the relationship between TIMP-3 serum level and TIMP-3 genetic polymorphism with pregnancy outcome in patients undergoing in vitro fertilization and embryo transfer (IVF-ET).

Material and methods: This project included 100 infertile women who became pregnant after IVF (IVF+) and 100 infertile women who failed to conceive after IVF (IVF-). Genotyping was performed using Restriction Fragments Length Polymorphism Polymerase Chain Reaction (PCR-RFLP), and the serum level was measured by Enzyme-Linked Immunosorbent Assay (ELISA).

Results: The frequencies of TT, TC, and CC in the IVF+ group were 41%, 37% and 22%, respectively, while in the IVF- group were 18%, 43% and 39%, respectively. The C and T allele frequencies were 40.5% and 59.5% in the IVF+ group and 60.5% and 39.5% in IVF- group, respectively. The C allele conferred a 2.25-fold increased risk of IVF failure (OR 2.25; 95% CI 1.5-3.35; p = 0.0001). Also, there was a significant increase in TIMP-3 serum levels in the IVF- group (193.29 ± 29.50 ng/mL), which was higher than the IVF+ group (166.74 ± 17.60 ng/mL; p = 0.00002), was demonstrated. It was shown that the TT genotype is associated with decreased TIMP-3 serum levels in IVF- group (CC, CT, and TT, values were 143.19 ± 88.49 ng/mL, 117.55 ± 15.73 ng/mL, 61.17 ± 44.36 ng/mL, respectively).

Conclusions: It is concluded that there is a relationship between TIMP-3 gene polymorphism and its serum concentration with IVF-ET outcome. We also suggest that the TT genotype might be involved in IVF-ET outcome.

Objectives: Carboprost plays an important role in managing refractory uterine atony and severe postpartum hemorrhage. However, it is associated with challenging adverse reactions. We aimed to evaluate the clinical effects of low dose sufentanil on the prevention of adverse events associated with carboprost during cesarean delivery.

Material and methods: Patients were randomly divided into two groups: a placebo control group (group C, n = 15) that received an intravenous infusion of 1 mL of normal saline 2 min before carboprost and a sufentanil group (group S, n = 15) that received 5 μg of sufentanil. The primary outcome was the incidence of nausea and vomiting following carboprost administration.

Results: The incidence of nausea, vomiting, and gastrointestinal discomfort was significantly lower in group S than in group C (p < 0.05).

Conclusions: The prophylactic use of low dose sufentanil reduces the incidence of gastrointestinal side effects caused by carboprost administration during cesarean section.

Objectives: Newborns of diabetic mothers are at increased risk of abnormal nutritional status at birth, thus developing metabolic disorders. The aim of this study was to evaluate the anthropometric measurements and body composition of newborns born to mothers with gestational diabetes in comparison to newborns born to mothers with normal glucose tolerance in pregnancy, in the first week of their life. Maternal factors affecting the gestational period were also evaluated.

Material and methods: The study included 70 participants: neonates born to mothers with gestational diabetes (GDM) and neonates born to healthy mothers (non-GDM). A set of statistical methods (e.g., ANOVA, Kruskal-Wallis test, Chi-square test, regression, cluster analysis) was used to compare data between the study groups and to find their association with maternal factors.

Results: Our approach resulted in statistically significant classification (p < 0.05) by maternal history of hypothyroidism, weight gain during pregnancy and diagnosis of GDM. Newborns of mothers diagnosed with both GDM and hypothyroidism had lower birth weight and fat mass than newborns of mothers without GDM nor hypothyroidism (p < 0.05), however this finding might be associated with high incidence of excessive gestational weight gain among healthy mothers. No differences in body composition were found between the study groups on account of maternal GDM only (p > 0.05).

Conclusions: Thus, well-controlled gestational diabetes mellitus as an individual factor does not significantly affect neonatal anthropometric measurements and body composition.

Objectives: Luteal phase support with gonadotropin-releasing hormone agonist (GnRH-a) has been considered in terms of its potential beneficial effects on in vitro fertilisation (IVF) cycles. In our study, we assessed the effectiveness of single-dose GnRH-a administration in dual-triggered cycles on pregnancy outcomes.

Material and methods: Eighty women who underwent intra cytoplasmic sperm injection (ICSI) cycle and had fresh blastocyst transfer were divided into two groups in terms of luteal phase support. The study group (Group A) consisted of patients (n = 40) who received a single-dose GnRH-a injection (0.1 mg of triptorelin acetate) subcutaneously 6 days after oocyte retrieval in addition to 600 mg daily of micronised progesterone, and the control group (Group B) comprised of patients (n = 40) taking 600 mg micronised progesterone daily from the first day after oocyte retrieval. GnRH-a and human chorionic gonadotropin (hCG; dual trigger) were administered to all patients. Comparison of the clinical pregnancy and live birth rates was our main goal.

Results: There was no significant difference between the two groups in terms of β-hCG positivity rates, clinical pregnancy rates and live birth rates (p value for beta-hCG = 0.25, clinical pregnancy = 0.80, live birth = 0.45).

Conclusions: Our study demonstrated that in dual triggered cycles administration of a single dose of GnRH-a on the transfer day of a single blastocyst in addition to routine luteal phase support with progesterone does not statistically increase implantation, clinical pregnancy or live birth rates.

Objectives: The prognosis of ovarian cancer (OC), among other factors, depends on residual disease after primary debulking surgery (PDS) and initial disease advancement. The main aim of our study was to evaluate the survival benefits of splenectomy and diaphragmatic surgery in OC patients, when the procedures result in resection to no macroscopic residual disease or minimal residual disease [tumor nodules below 2.5 mm according to Sugarbaker's completeness of cytoreduction score (CC) = 1].

Material and methods: The study included 25 OC patients after splenectomy procedures, 28 patients after diaphragmatic surgery and 17 patients who had undergone both splenectomy and diaphragmatic surgery. Patients' overall survival (OS) was compared with residual disease-matched controls (47 patients) who had upper abdomen involvement but no requirement for splenectomy and/or diaphragmatic surgery.

Results: Overall survival of patients after splenectomy was not significantly different from OS of patients who did not required splenectomy (36.1 vs 31.6 months; p = 0.85). No differences in OS were observed between patients who did and did not require diaphragmatic surgery (31.3 vs 41.8; p = 0.33). Similarly, we found no differences in OS between patients who underwent both splenectomy and diaphragmatic surgery and those patients who did not require either procedure (20.1 vs 31.6 months; p = 0.45). Splenectomies and diaphragmatic surgeries were associated with prolonged hospitalization and length of surgery, however, no specific morbidity related to the procedures was observed.

Conclusions: In the cases of advanced OC, diaphragm and spleen involvement do not hamper patient prognosis when adequately resected.

Objectives: To explore the application effect of virtual reality (VR) combined with moderate perineal protection on singleton primipara delivery.

Material and methods: The study utilised a two-group design intervention and a randomised clinical trial. A total of 200 singleton primiparas who had a regular prenatal examination in a third-class hospital (between 1 September 2018 and 30 December 2018) and were willing to give birth naturally were randomly divided into treatment (traditional prenatal health mission combined with desktop VR health education system mode) and control (traditional health education mode) groups. The delivery conditions of the two groups were surveyed, recorded, analysed and compared.

Results: There was no significant difference in the time of the second stage of labour between the treatment and control groups, and the comparison of neonatal Apgar scores and neonatal weight between the two groups showed that the different modes of prenatal education had no effect on newborns (p > 0.05). The amount of postpartum haemorrhage in 2 h and the pain score in the treatment group were significantly lower than in the control group, and the degree of perineal injury in the treatment group was not as serious as that in the control group. Meanwhile, there was a statistically significant difference in the anxiety score, self-efficacy score and quality of life satisfaction between the treatment and control groups (p < 0.05).

Conclusions: VR technology combined with moderate perineal protection could improve the delivery outcome of a primipara, maternal self-confidence of delivery and the quality of vaginal delivery; effectively alleviate the anxiety of a primipara; have no adverse effects on both mothers and newborns; and be widely used in clinical settings.