D. Karoutsos, Z. Fasoulakis, S. Michala, K. Stefanidis, P. Antsaklis
Glycosylated Fibronectin (GFN), a glycoprotein involved in cell adhesion and migration, has been implicated in several physiological and pathological processes. Current literature suggests its altered glycosylation patterns might be associated with various pregnancy complications with recent studies providing new empirical evidence from a cohort study involving more than 2,000 pregnant women. The aim of this review, is to summarize the association of GFN levels and its glycosylation patterns with various outcomes including preeclampsia, gestational diabetes mellitus (GDM), spontaneous preterm birth, and intrauterine growth restriction (IUGR) in order to identify potential patterns of the use of GFN as a biomarker for predicting a wide range of pregnancy-related complications, and to provide evidence for further investigation on new diagnostic tools and therapeutic strategies.
{"title":"Glycosylated Fibronectin as a wide-spectrum biomarker in pregnancy","authors":"D. Karoutsos, Z. Fasoulakis, S. Michala, K. Stefanidis, P. Antsaklis","doi":"10.33574/hjog.0524","DOIUrl":"https://doi.org/10.33574/hjog.0524","url":null,"abstract":"Glycosylated Fibronectin (GFN), a glycoprotein involved in cell adhesion and migration, has been implicated in several physiological and pathological processes. Current literature suggests its altered glycosylation patterns might be associated with various pregnancy complications with recent studies providing new empirical evidence from a cohort study involving more than 2,000 pregnant women. The aim of this review, is to summarize the association of GFN levels and its glycosylation patterns with various outcomes including preeclampsia, gestational diabetes mellitus (GDM), spontaneous preterm birth, and intrauterine growth restriction (IUGR) in order to identify potential patterns of the use of GFN as a biomarker for predicting a wide range of pregnancy-related complications, and to provide evidence for further investigation on new diagnostic tools and therapeutic strategies.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"147 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132195079","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}
Nikolaos Machairiotis, V. Pergialiotis, K. Vlassis, T. Troupis, N. Vrachnis
Neurotrophins have been previously mentioned as potential factors that may alter human growth and result in fetal growth restriction (FGR). As neural growth factors, neurotrophins promote brain development and plasticity and have a significant effect on the synaptic transmission, although the actual mechanisms of their action have not been completely investigated. Several articles have been published in this field denoting the importance of neurotrophins as biomarkers of detection of fetuses with fetal growth restriction. Their findings are contradictory and the purpose of the present systematic review is to summarize existing evidence and provide recommendations for future research.
{"title":"Association of amniotic fluid Neurotrophins levels with intrauterine growth restriction","authors":"Nikolaos Machairiotis, V. Pergialiotis, K. Vlassis, T. Troupis, N. Vrachnis","doi":"10.33574/hjog.0525","DOIUrl":"https://doi.org/10.33574/hjog.0525","url":null,"abstract":"Neurotrophins have been previously mentioned as potential factors that may alter human growth and result in fetal growth restriction (FGR). As neural growth factors, neurotrophins promote brain development and plasticity and have a significant effect on the synaptic transmission, although the actual mechanisms of their action have not been completely investigated. Several articles have been published in this field denoting the importance of neurotrophins as biomarkers of detection of fetuses with fetal growth restriction. Their findings are contradictory and the purpose of the present systematic review is to summarize existing evidence and provide recommendations for future research.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131759916","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}
K. Zacharis, Eirini-Aikaterini Evangelopoulou, Konstantina Balafa, O. Koukoura, A. Daponte
Primary vaginal melanoma is a rare and aggressive entity affecting the vaginal wall without any involvement of the uterine cervix or the vulva. It usually occurs in elderly women. We hereby present an 87-year-old woman who presented with recurrent vaginal bleeding. Vaginal examination revealed a 3cm hyperpigmented lesion on the anterior vaginal wall. The lesion was biopsied and the results of the histopathological examination were compatible with primary malignant vaginal melanoma. The diagnosis of vaginal melanoma is usually established by histology and immunochemistry. The therapeutic management includes surgical and nonsurgical modalities. Although surgery combined with adjuvant radiotherapy or chemotherapy are acceptable therapeutic approaches, further studies are needed in order to assess the optimal management of women with primary vaginal melanoma.
{"title":"Primary malignant melanoma of the vagina: A case report and a mini review","authors":"K. Zacharis, Eirini-Aikaterini Evangelopoulou, Konstantina Balafa, O. Koukoura, A. Daponte","doi":"10.33574/hjog.0528","DOIUrl":"https://doi.org/10.33574/hjog.0528","url":null,"abstract":"Primary vaginal melanoma is a rare and aggressive entity affecting the vaginal wall without any involvement of the uterine cervix or the vulva. It usually occurs in elderly women. We hereby present an 87-year-old woman who presented with recurrent vaginal bleeding. Vaginal examination revealed a 3cm hyperpigmented lesion on the anterior vaginal wall. The lesion was biopsied and the results of the histopathological examination were compatible with primary malignant vaginal melanoma. The diagnosis of vaginal melanoma is usually established by histology and immunochemistry. The therapeutic management includes surgical and nonsurgical modalities. Although surgery combined with adjuvant radiotherapy or chemotherapy are acceptable therapeutic approaches, further studies are needed in order to assess the optimal management of women with primary vaginal melanoma.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121456653","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}
Vlora Ademi Ibishi, Hajrullah Latifi, Lena Ibishi, A. Malin
Background: Neurofibromatosis is a genetic disorder with high variability of clinical expression. Cutaneous manifestations such as café-au-lait spots, freckling patterns, and dermal neurofibromas, are the most distinguishable and common signs appearing in the vast majority of individuals with NF-1. Instances where a patient is both pregnant and affected with neurofibromatosis are less common and the information about the maternal-fetal outcomes are mainly from case reports in the literature. Case presentation: A 33-year-old multiparous pregnant patient affected by NF-1 presented to the Obstetrics and Gynecology Clinic in Prishtina in Kosovo in the 36th week of pregnancy. The patient displayed signs of NF-1 exemplified by the growth of existing neurofibromas and the development of new ones. In addition, the patient experienced a placental abruption which is a life-threatening obstetrical complication rarely reported in the literature as a complication associated with maternal NF-1. An emergent cesarean section was performed and a healthy neonate unaffected by NF-1 was born. Conclusions: Pregnant patients with NF-1 are prone to the worsening of NF-1 symptoms and obstetrical complications. Increased antenatal care for these patients is recommended to ensure the well-being of the mother and fetus.
{"title":"Neurofibromatosis type 1 and pregnancy outcome: A case report","authors":"Vlora Ademi Ibishi, Hajrullah Latifi, Lena Ibishi, A. Malin","doi":"10.33574/hjog.0529","DOIUrl":"https://doi.org/10.33574/hjog.0529","url":null,"abstract":"Background: Neurofibromatosis is a genetic disorder with high variability of clinical expression. Cutaneous manifestations such as café-au-lait spots, freckling patterns, and dermal neurofibromas, are the most distinguishable and common signs appearing in the vast majority of individuals with NF-1. Instances where a patient is both pregnant and affected with neurofibromatosis are less common and the information about the maternal-fetal outcomes are mainly from case reports in the literature. Case presentation: A 33-year-old multiparous pregnant patient affected by NF-1 presented to the Obstetrics and Gynecology Clinic in Prishtina in Kosovo in the 36th week of pregnancy. The patient displayed signs of NF-1 exemplified by the growth of existing neurofibromas and the development of new ones. In addition, the patient experienced a placental abruption which is a life-threatening obstetrical complication rarely reported in the literature as a complication associated with maternal NF-1. An emergent cesarean section was performed and a healthy neonate unaffected by NF-1 was born. Conclusions: Pregnant patients with NF-1 are prone to the worsening of NF-1 symptoms and obstetrical complications. Increased antenatal care for these patients is recommended to ensure the well-being of the mother and fetus.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115938008","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}
Caesarean delivery rates have increased globally during the past three decades. Caesarean delivery is the most important obstetrical procedure performed with complications that consist of postpartum hemorrhage, endometritis, thromboembolic events or incision infections. While surgical site infections (SSIs) complicate 1.9% of all surgeries performed, the incidence of SSIs after caesarean delivery is significantly higher, almost 7-10%, constituting an important cause of increased morbidity, mortality, readmission, prolonged hospitalization and increased health care costs worldwide. Incisional infection after caesarean delivery happens in 2-7% of cases, necrotizing fasciitis in 0.18% and endometritis in 2-16%. Many risk factors for SSIs have been described. This review includes the several risk factors that have been identified in women who developed post-caesarean section surgical site infections. We also provide an overview of strategies for prevention of postoperative infections including antibiotic prophylaxis, surgical techniques, management of wound infections. Criteria of diagnosis for SSIs are also given, as well as current treatment regimens. Given the impact of maternal post-caesarean infection, it is important for gynecologists to understand how to prevent these postoperative infections, as well as recognize and treat them.
{"title":"Post caesarian section surgical site infections. Review of current literature","authors":"Afroditi Ziogou, Ioannis Kokolakis","doi":"10.33574/hjog.0518","DOIUrl":"https://doi.org/10.33574/hjog.0518","url":null,"abstract":"Caesarean delivery rates have increased globally during the past three decades. Caesarean delivery is the most important obstetrical procedure performed with complications that consist of postpartum hemorrhage, endometritis, thromboembolic events or incision infections. While surgical site infections (SSIs) complicate 1.9% of all surgeries performed, the incidence of SSIs after caesarean delivery is significantly higher, almost 7-10%, constituting an important cause of increased morbidity, mortality, readmission, prolonged hospitalization and increased health care costs worldwide. Incisional infection after caesarean delivery happens in 2-7% of cases, necrotizing fasciitis in 0.18% and endometritis in 2-16%. Many risk factors for SSIs have been described. This review includes the several risk factors that have been identified in women who developed post-caesarean section surgical site infections. We also provide an overview of strategies for prevention of postoperative infections including antibiotic prophylaxis, surgical techniques, management of wound infections. Criteria of diagnosis for SSIs are also given, as well as current treatment regimens. Given the impact of maternal post-caesarean infection, it is important for gynecologists to understand how to prevent these postoperative infections, as well as recognize and treat them.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114792268","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}
A. Oluwole, A. Ugwu, S. Omisakin, Rebecca Opeyemi Akinajo
Background: Dipstick urinalysis is a handy and cost effective method for the early detection of asymptomatic bacteriuria. Asymptomatic bacteriuria occurs in 2-10% of pregnancies and has been associated with low birth weight and preterm delivery in pregnant women if untreated. Objective: To determine the incidence of asymptomatic bacteriuria in pregnancy, the distribution of infecting organisms and the antibiotic sensitivity pattern in pregnant Nigerian women attending the antenatal clinic of the Lagos University Teaching Hospital, Idi- Araba, Lagos. Methodology: This was a prospective study. The study population were 201 consecutive asymptomatic pregnant women, who attended the antenatal clinic of LUTH for booking between 1st July and 31st December, 2021. Two consecutive urine samples were collected and analysed for microscopy, culture and sensitivity and urinalysis. The outcomes of interest were prevalence of asymptomatic bacteriuria at LUTH, bacterial isolates, and their antibiotic sensitivity pattern. Results: The mean age of the population studied was 31years ± 4.56SD. The mean gestational age was 23.8 ± 5.39 SD with a range of 11-34 weeks; and majority of the participants (65.7%) were recruited at gestational ages between 14 and 26 weeks. The prevalence of asymptomatic bacteriuria in this study was 13.9%. The commonest isolated organism was klebsiella (46.4%) followed by Escherichia coli (21.4%). Ceftazidime, ofloxacin, and gentamycin showed good overall sensitivity with 92.9%, 89.3%, and 67.9%% respectively. From the results of urinalysis, nitrites showed a sensitivity of 48.3% and specificity of 98.2% with a positive predictive value of 83.3% while presence of bacterial cells on urine microscopy showed sensitivity of 31.2%, specificity of 85% and a positive predictive value of 27%. Conclusion: The incidence of asymptomatic bacteriuria in this study was considerably high and therefore, there may be need to consider introduction of routine urine culture at booking or in the second trimester.
{"title":"Asymptomatic bacteriuria in pregnant Nigerian women at the Lagos University Teaching Hospital, south west Nigeria","authors":"A. Oluwole, A. Ugwu, S. Omisakin, Rebecca Opeyemi Akinajo","doi":"10.33574/hjog.0521","DOIUrl":"https://doi.org/10.33574/hjog.0521","url":null,"abstract":"Background: Dipstick urinalysis is a handy and cost effective method for the early detection of asymptomatic bacteriuria. Asymptomatic bacteriuria occurs in 2-10% of pregnancies and has been associated with low birth weight and preterm delivery in pregnant women if untreated. Objective: To determine the incidence of asymptomatic bacteriuria in pregnancy, the distribution of infecting organisms and the antibiotic sensitivity pattern in pregnant Nigerian women attending the antenatal clinic of the Lagos University Teaching Hospital, Idi- Araba, Lagos. Methodology: This was a prospective study. The study population were 201 consecutive asymptomatic pregnant women, who attended the antenatal clinic of LUTH for booking between 1st July and 31st December, 2021. Two consecutive urine samples were collected and analysed for microscopy, culture and sensitivity and urinalysis. The outcomes of interest were prevalence of asymptomatic bacteriuria at LUTH, bacterial isolates, and their antibiotic sensitivity pattern. Results: The mean age of the population studied was 31years ± 4.56SD. The mean gestational age was 23.8 ± 5.39 SD with a range of 11-34 weeks; and majority of the participants (65.7%) were recruited at gestational ages between 14 and 26 weeks. The prevalence of asymptomatic bacteriuria in this study was 13.9%. The commonest isolated organism was klebsiella (46.4%) followed by Escherichia coli (21.4%). Ceftazidime, ofloxacin, and gentamycin showed good overall sensitivity with 92.9%, 89.3%, and 67.9%% respectively. From the results of urinalysis, nitrites showed a sensitivity of 48.3% and specificity of 98.2% with a positive predictive value of 83.3% while presence of bacterial cells on urine microscopy showed sensitivity of 31.2%, specificity of 85% and a positive predictive value of 27%. Conclusion: The incidence of asymptomatic bacteriuria in this study was considerably high and therefore, there may be need to consider introduction of routine urine culture at booking or in the second trimester.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114548846","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}
Dimitra Gourma, E. Kalampokas, O. Triantafyllidou, T. Kalampokas, Nikolaos Vlachos
Background: Low levels of testosterone and sexual desire loss are common characteristics of hypogonadism, which is an endocrine disorder often occurring in men. Sexual dysfunction is an uncomfortable condition that both hypogonadal and diabetic men experience nowadays, however the diagnosis and treatment strategies are limited. Type II diabetes is a lifelong disorder of abnormal glucose metabolism with devastating health effects on patients. Sex-related hormones, that normally regulate the reproductive cycle, are found significantly reduced in conditions where the functional activity of the gonads is decreased. An imbalance in the levels of these hormones is also associated with metabolic abnormalities, such as hyperglycemia and insulin resistance. The effectiveness of the existing therapies for sexual dysfunction treatment and the restoration of reproductive hormones in hypogonadal men with type II diabetes remain unexplored. Methods: We searched the Cochrane Library, Scopus, Science Direct and the Web Search engine “Google Scholar” from January 2011 to July 2021. Randomized controlled trials (RCTs) were included, comparing the treatment of sexual dysfunction and the restoration of sex-related hormones in hypogonadal men with type II diabetes with testosterone replacement or administration of vardenafil or clomiphene citrate, versus placebo treatment. Fixed effect meta-analysis was performed to estimate pooled proportions with 95% confidence intervals (CI). Results: The review includes nine RCTs regarding: a) Testosterone replacement therapy (five RCTs) and administration of b) Vardenafil (one RCT) or c) Clomiphene citrate (three RCTs) for the treatment of sexual dysfunction in diabetic men with hypogonadism. The aspects of sexual function were evaluated by estimating the: a) Aging male’s symptoms’ (AMS) rating scale, b) Erectile Function, c) Intercourse Satisfaction, d) Orgasmic Function, e) Sexual Desire, f) Overall Sexual Satisfaction, g) levels of E2 (pg/mL), h) levels of FHS (mU/mL), i) levels of LH (mU/mL), j) levels of SHBG (nmol/L) and k) levels of free testosterone (nmol/L). Our findings suggest that a) testosterone replacement therapy or administration of vardenafil resulted in improved erectile function (95% Cl -0.485 to -0.165; 6 RCTs; I2=94,8%, p=6.5e-05), b) testosterone supplementation ameliorated intercourse satisfaction (95% Cl -0.4 to -0.064; 4 RCTs; I2=54,5%, p=0.006783), orgasmic function (95% Cl -0.674 to -0.325; 4 RCTs; I2=94,6%, p=0) and sexual desire (95% Cl -0.446 to -0.124; 5 RCTs; I2=94,3%, p=0.00509), but had no impact on AMS rating scale (95% Cl -0.286 to 0.057; 4 RCTs; I2=93,1%, p = 0.191643) and overall satisfaction (95% Cl 0.03 to 0.402; 3 RCTs; I2=95%, p=0.023112) and c) administration of clomiphene citrate led in elevated levels of E2 (95% Cl -1.531 to -0.756; 3 RCTs; I2=0%, p=0), LH (95% Cl -0.674 to -0.325; 3 RCTs; I2=0%, p=0), FSH (95% Cl -1.372 to -0.612; 3 RCTs; I2=0%, p=0), SHBG (95% Cl -0.938 to -0.207; 3
{"title":"Various interventions for infertility in men with type II diabetes and hypogonadism","authors":"Dimitra Gourma, E. Kalampokas, O. Triantafyllidou, T. Kalampokas, Nikolaos Vlachos","doi":"10.33574/hjog.0519","DOIUrl":"https://doi.org/10.33574/hjog.0519","url":null,"abstract":"Background: Low levels of testosterone and sexual desire loss are common characteristics of hypogonadism, which is an endocrine disorder often occurring in men. Sexual dysfunction is an uncomfortable condition that both hypogonadal and diabetic men experience nowadays, however the diagnosis and treatment strategies are limited. Type II diabetes is a lifelong disorder of abnormal glucose metabolism with devastating health effects on patients. Sex-related hormones, that normally regulate the reproductive cycle, are found significantly reduced in conditions where the functional activity of the gonads is decreased. An imbalance in the levels of these hormones is also associated with metabolic abnormalities, such as hyperglycemia and insulin resistance. The effectiveness of the existing therapies for sexual dysfunction treatment and the restoration of reproductive hormones in hypogonadal men with type II diabetes remain unexplored. Methods: We searched the Cochrane Library, Scopus, Science Direct and the Web Search engine “Google Scholar” from January 2011 to July 2021. Randomized controlled trials (RCTs) were included, comparing the treatment of sexual dysfunction and the restoration of sex-related hormones in hypogonadal men with type II diabetes with testosterone replacement or administration of vardenafil or clomiphene citrate, versus placebo treatment. Fixed effect meta-analysis was performed to estimate pooled proportions with 95% confidence intervals (CI). Results: The review includes nine RCTs regarding: a) Testosterone replacement therapy (five RCTs) and administration of b) Vardenafil (one RCT) or c) Clomiphene citrate (three RCTs) for the treatment of sexual dysfunction in diabetic men with hypogonadism. The aspects of sexual function were evaluated by estimating the: a) Aging male’s symptoms’ (AMS) rating scale, b) Erectile Function, c) Intercourse Satisfaction, d) Orgasmic Function, e) Sexual Desire, f) Overall Sexual Satisfaction, g) levels of E2 (pg/mL), h) levels of FHS (mU/mL), i) levels of LH (mU/mL), j) levels of SHBG (nmol/L) and k) levels of free testosterone (nmol/L). Our findings suggest that a) testosterone replacement therapy or administration of vardenafil resulted in improved erectile function (95% Cl -0.485 to -0.165; 6 RCTs; I2=94,8%, p=6.5e-05), b) testosterone supplementation ameliorated intercourse satisfaction (95% Cl -0.4 to -0.064; 4 RCTs; I2=54,5%, p=0.006783), orgasmic function (95% Cl -0.674 to -0.325; 4 RCTs; I2=94,6%, p=0) and sexual desire (95% Cl -0.446 to -0.124; 5 RCTs; I2=94,3%, p=0.00509), but had no impact on AMS rating scale (95% Cl -0.286 to 0.057; 4 RCTs; I2=93,1%, p = 0.191643) and overall satisfaction (95% Cl 0.03 to 0.402; 3 RCTs; I2=95%, p=0.023112) and c) administration of clomiphene citrate led in elevated levels of E2 (95% Cl -1.531 to -0.756; 3 RCTs; I2=0%, p=0), LH (95% Cl -0.674 to -0.325; 3 RCTs; I2=0%, p=0), FSH (95% Cl -1.372 to -0.612; 3 RCTs; I2=0%, p=0), SHBG (95% Cl -0.938 to -0.207; 3","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131258771","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}
I. Sapantzoglou, A. Psarris, P. Perros, A. Varthaliti, P. Antsaklis, M. Theodora, M. Syndos, G. Daskalakis
Background: Euglycaemic ketoacidosis is a rare type of metabolic acidosis, with increased production of ketonic bodies and normal serum glucose. When it occurs during pregnancy, it might lead to adverse maternal and fetal outcomes. Pregnancy itself is a diabetogenic state that might predispose the patient to develop ketoacidosis following even relatively short periods of starvation and as such, a high index of suspicion is required for the diagnosis to be made and for the management plan to be established. Case presentation: We present a case of euglycaemic ketoacidosis in a twin pregnancy, which occurred in the second trimester, necessitating prompt and aggressive management, that eventually required early delivery due to the development of preeclampsia. Discussion/Conclusion: The physiology and pathology of euglycaemic ketoacidosis during pregnancy and the management required to avoid the potential maternal and fetal risks that such a condition might be complicated with.
{"title":"Euglycaemic ketoacidosis during pregnancy: More common than you think","authors":"I. Sapantzoglou, A. Psarris, P. Perros, A. Varthaliti, P. Antsaklis, M. Theodora, M. Syndos, G. Daskalakis","doi":"10.33574/hjog.0523","DOIUrl":"https://doi.org/10.33574/hjog.0523","url":null,"abstract":"Background: Euglycaemic ketoacidosis is a rare type of metabolic acidosis, with increased production of ketonic bodies and normal serum glucose. When it occurs during pregnancy, it might lead to adverse maternal and fetal outcomes. Pregnancy itself is a diabetogenic state that might predispose the patient to develop ketoacidosis following even relatively short periods of starvation and as such, a high index of suspicion is required for the diagnosis to be made and for the management plan to be established. Case presentation: We present a case of euglycaemic ketoacidosis in a twin pregnancy, which occurred in the second trimester, necessitating prompt and aggressive management, that eventually required early delivery due to the development of preeclampsia. Discussion/Conclusion: The physiology and pathology of euglycaemic ketoacidosis during pregnancy and the management required to avoid the potential maternal and fetal risks that such a condition might be complicated with.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124479558","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}
Maria-Elisavet Arampatzopoulou, I. Tsakiridis, T. Dagklis, A. Mamopoulos, A. Athanasiadis
Introduction: The present retrospective study aims to examine the course of ventriculomegaly (VM) during gestation, the association between the degree of VM and the presence of additional sonographic fetal malformations, as well as to inspect the prevalence of VM with reference to fetal gender. Materials and Methods: The databases of two maternal-fetal ultrasound units were reviewed from 2010 to 2021. All cases were classified as either mild (10 to <12mm), moderate (12 to <15mm), or severe (≥15mm) according to the fetal posterior ventricle width measurement upon VM diagnosis, at 20-24 weeks of gestation. Furthermore, cases with additional fetal sonographic abnormalities were registered as cases of non-isolated VM, whereas those cases without further fetal malformations on ultrasound (US) scan were documented as cases of isolated VM. The final sonographic record of every participant, following VM diagnosis, was registered so that the evolution of VM during gestation could be monitored. Results: The sonographic and medical records of 81 women diagnosed with fetal VM were studied. The prevalence of VM is about 0.24% and the male/female ratio was 2; 88.9% of the cases were mild, 9.9% moderate, while only 1 (1.2%) was severe at diagnosis. Among the initial 62 cases of mild VM, 24 (38.7%) regressed, 16 (25.8%) remained unchanged and 22 (35.5%) progressed. There was an association between a higher degree of VM and the presence of additional fetal abnormalities. Conclusions: The majority of VM cases are mild at diagnosis and in isolated about one third resolves in the third trimester and about one third progresses but not to severe. Therefore, a follow up scan is useful to reassure most parents and identify those cases that may progress to moderate.
{"title":"Evolution of fetal ventriculomegaly diagnosed in the second trimester of pregnancy: A retrospective study in Northern Greece","authors":"Maria-Elisavet Arampatzopoulou, I. Tsakiridis, T. Dagklis, A. Mamopoulos, A. Athanasiadis","doi":"10.33574/hjog.0520","DOIUrl":"https://doi.org/10.33574/hjog.0520","url":null,"abstract":"Introduction: The present retrospective study aims to examine the course of ventriculomegaly (VM) during gestation, the association between the degree of VM and the presence of additional sonographic fetal malformations, as well as to inspect the prevalence of VM with reference to fetal gender. Materials and Methods: The databases of two maternal-fetal ultrasound units were reviewed from 2010 to 2021. All cases were classified as either mild (10 to <12mm), moderate (12 to <15mm), or severe (≥15mm) according to the fetal posterior ventricle width measurement upon VM diagnosis, at 20-24 weeks of gestation. Furthermore, cases with additional fetal sonographic abnormalities were registered as cases of non-isolated VM, whereas those cases without further fetal malformations on ultrasound (US) scan were documented as cases of isolated VM. The final sonographic record of every participant, following VM diagnosis, was registered so that the evolution of VM during gestation could be monitored. Results: The sonographic and medical records of 81 women diagnosed with fetal VM were studied. The prevalence of VM is about 0.24% and the male/female ratio was 2; 88.9% of the cases were mild, 9.9% moderate, while only 1 (1.2%) was severe at diagnosis. Among the initial 62 cases of mild VM, 24 (38.7%) regressed, 16 (25.8%) remained unchanged and 22 (35.5%) progressed. There was an association between a higher degree of VM and the presence of additional fetal abnormalities. Conclusions: The majority of VM cases are mild at diagnosis and in isolated about one third resolves in the third trimester and about one third progresses but not to severe. Therefore, a follow up scan is useful to reassure most parents and identify those cases that may progress to moderate.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123398534","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}
Athanasios Kontopanos, I. Tsakiridis, T. Dagklis, Eirini Boureka, A. Mamopoulos, A. Athanasiadis
Introduction: There is a national trend in increasing cesarean section rates in Greece. The purpose of this study was to determine the frequency of cesarean sections per district of the Greek territory. Materials and Methods: In this retrospective observational study, the records of all births in Greece between 2019-2020 from the official archives of the Hellenic Statistical Authority were processed and analyzed. The NUTS-1 classification according to the EUROSTAT was used for the division of the Greek territory into districts. Based on this classification, Greece is divided into four major districts: Northern Greece, Central Greece, Attica and Aegean Islands-Crete. Results: In total, 169,417 births were recorded in Greece during the two-year period from 1/1/2019 to 31/12/2020. Of these, 55.79% were performed by cesarean section, 40.24% by vaginal delivery, 0.02% by a combination of vaginal delivery and cesarean section, while the mode of procedure was not reported in 3.95% of all deliveries. The highest frequency of cesarean sections was observed in Attica with a rate of 58.86%. The corresponding rates in the other districts were 55.50% (Aegean Islands and Crete), 53.55% (Northern Greece) and 51.49% (Central Greece). Notably, the mode of delivery was not reported in 13.75% of births in Central Greece, while the respective rates in the other districts ranged between 1.02% and 2.1%. Conclusions: The frequency of cesarean sections in Greece was high, with a rate of 55.79% of all births, during the study period. The district with the highest frequency of cesarean section was Attica, with a rate over 58%.
{"title":"Cesarean section rates in each region of Greece: A retrospective analysis","authors":"Athanasios Kontopanos, I. Tsakiridis, T. Dagklis, Eirini Boureka, A. Mamopoulos, A. Athanasiadis","doi":"10.33574/hjog.0522","DOIUrl":"https://doi.org/10.33574/hjog.0522","url":null,"abstract":"Introduction: There is a national trend in increasing cesarean section rates in Greece. The purpose of this study was to determine the frequency of cesarean sections per district of the Greek territory. Materials and Methods: In this retrospective observational study, the records of all births in Greece between 2019-2020 from the official archives of the Hellenic Statistical Authority were processed and analyzed. The NUTS-1 classification according to the EUROSTAT was used for the division of the Greek territory into districts. Based on this classification, Greece is divided into four major districts: Northern Greece, Central Greece, Attica and Aegean Islands-Crete. Results: In total, 169,417 births were recorded in Greece during the two-year period from 1/1/2019 to 31/12/2020. Of these, 55.79% were performed by cesarean section, 40.24% by vaginal delivery, 0.02% by a combination of vaginal delivery and cesarean section, while the mode of procedure was not reported in 3.95% of all deliveries. The highest frequency of cesarean sections was observed in Attica with a rate of 58.86%. The corresponding rates in the other districts were 55.50% (Aegean Islands and Crete), 53.55% (Northern Greece) and 51.49% (Central Greece). Notably, the mode of delivery was not reported in 13.75% of births in Central Greece, while the respective rates in the other districts ranged between 1.02% and 2.1%. Conclusions: The frequency of cesarean sections in Greece was high, with a rate of 55.79% of all births, during the study period. The district with the highest frequency of cesarean section was Attica, with a rate over 58%.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126200149","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}
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