M. Nikolaou, Maria S Katsafarou, Georgios Papadocostakis, T. Katasos
Pubic symphysis diastasis in pregnancy is a rare obstetric complication. A case of a 35 year old primigravid woman with severe pubic symphysis diastasis and sacroiliac joint relaxation during non-operative vaginal delivery is reported and the literature reviewed. The patient was successfully treated by open reduction and internal fixation with plate and screws. During a 5 year follow-up, the patient presented with no pain and complete recovery to pre-injury functional level. Early diagnosis and immediate intervention by pelvic stabilization and in severe cases surgical intervention are the key points for the management of pubic symphyis diastasis, which optimize the maternal outcome.
{"title":"Intrapartum pubic symphysis diastasis in a primigravida woman","authors":"M. Nikolaou, Maria S Katsafarou, Georgios Papadocostakis, T. Katasos","doi":"10.33574/hjog.0405","DOIUrl":"https://doi.org/10.33574/hjog.0405","url":null,"abstract":"Pubic symphysis diastasis in pregnancy is a rare obstetric complication. A case of a 35 year old primigravid woman with severe pubic symphysis diastasis and sacroiliac joint relaxation during non-operative vaginal delivery is reported and the literature reviewed. The patient was successfully treated by open reduction and internal fixation with plate and screws. During a 5 year follow-up, the patient presented with no pain and complete recovery to pre-injury functional level. Early diagnosis and immediate intervention by pelvic stabilization and in severe cases surgical intervention are the key points for the management of pubic symphyis diastasis, which optimize the maternal outcome.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"184 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132171550","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}
Konstantina Papadatou, P. Perros, N. Thomakos, D. Haidopoulos, A. Rodolakis, V. Pergialiotis
Cervical cancer is the fourth most common gynecologic malignancy worldwide with an estimated incidence of approximately 570000 cases worldwide in 2018. Despite the advances that were made in the primary and secondary prevention strategies the last decades, its actual prevalence seems to reach a negative plateau which is attributed to the limited acceptance of vaccination as well as the resources that are available in several low income countries. In the present article we review novel biomarkers that seem to interfere in the pathophysiology of the disease and can, thus, be used as tools for the early identification of patients at risk as well as biomarkers of disease response to the various treatment strategies.
{"title":"Biomarkers in Cervical Cancer","authors":"Konstantina Papadatou, P. Perros, N. Thomakos, D. Haidopoulos, A. Rodolakis, V. Pergialiotis","doi":"10.33574/hjog.0401","DOIUrl":"https://doi.org/10.33574/hjog.0401","url":null,"abstract":"Cervical cancer is the fourth most common gynecologic malignancy worldwide with an estimated incidence of approximately 570000 cases worldwide in 2018. Despite the advances that were made in the primary and secondary prevention strategies the last decades, its actual prevalence seems to reach a negative plateau which is attributed to the limited acceptance of vaccination as well as the resources that are available in several low income countries. In the present article we review novel biomarkers that seem to interfere in the pathophysiology of the disease and can, thus, be used as tools for the early identification of patients at risk as well as biomarkers of disease response to the various treatment strategies.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":" 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134260397","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. Ugwu, A. Oluwole, K. Okunade, S. John-Olabode, N. Ani-ugwu, O. Olumakinwa, Amaobichukwu Anyanwu, E. Ugwu, C. Makwe
Background: Preeclampsia (PE) is a multi-systemic progressive disorder that is unique to human pregnancy, occurring usually after 20 weeks of gestation. Useful biochemical markers to be utilized for early prediction of preeclampsia continue to elude us. The search for biomarkers is aimed identifying women at increased risk of developing PE, so that medical interventions may be instituted very early in pregnancy to ameliorate its occurrence and improve maternal and fetal outcome. Aim: This study aimed to determine the association between serum levels of Cystatin C and/or free β-subunit of hCG measured in early pregnancy and the development of pre-eclampsia and its severity. Methods: This was a prospective cohort study of 290 pregnant women recruited during routine antenatal care, at the gestational age of between 13 and 19 weeks. After obtaining an informed consent from each participant, a structured questionnaire was used to collection relevant information followed by the collection of 5 mL of venous blood sample. Serum cystatin C and free sub unit of β-hCG levels were determined by standard enzyme-linked immunosorbent assay (ELISA) method. All participants were followed up till delivery and those who developed preeclampsia was classified as mild and severe preeclampsia. Data were entered and analyzed using STATA version 16 statistical software. Hypothesis testing was done using chi-square test for categorical variables, and the independent-samples t-test and ANOVA for numerical variables. Results: We found significantly elevated serum levels of cystatin C and free subunit of β-hCG in women who developed preeclampsia, (p < 0.002 and 0.001) respectively. Conclusion: Our study has shown that in a healthy population of pregnant women that elevated serum levels of cystatin C and free beta hCG concentration measured in early second trimester were associated with an increased risk of developing preeclampsia and its severity. This suggests that the combination of these analytes may have a role as a marker of pre-eclampsia and its severity especially when used in combination.
背景:先兆子痫(PE)是一种人类妊娠特有的多系统进行性疾病，通常发生在妊娠20周后。有用的生化标志物用于早期预测子痫前期仍然逃避我们。寻找生物标志物的目的是确定发生PE的风险增加的妇女，以便在妊娠早期制定医疗干预措施，以减少其发生并改善母婴结局。目的:本研究旨在确定妊娠早期血清胱抑素C和/或hCG游离β-亚基水平与子痫前期发展及其严重程度之间的关系。方法:这是一项前瞻性队列研究，290名孕妇在常规产前护理期间招募，胎龄在13至19周之间。在获得每位参与者的知情同意后，采用结构化问卷收集相关信息，然后采集5 mL静脉血样本。采用标准酶联免疫吸附法(ELISA)测定血清胱抑素C和β-hCG游离亚基水平。所有的参与者都被随访到分娩，那些出现先兆子痫的人被分为轻度和重度先兆子痫。使用STATA version 16统计软件进行数据录入和分析。对分类变量采用卡方检验，对数值变量采用独立样本t检验和方差分析进行假设检验。结果:我们发现子痫前期妇女血清胱抑素C和β-hCG游离亚基水平显著升高(p < 0.002和0.001)。结论:我们的研究表明，在健康的孕妇人群中，妊娠中期早期血清胱抑素C水平和游离β - hCG浓度升高与发生先兆子痫及其严重程度的风险增加有关。这表明，这些分析物的组合可能具有先兆子痫及其严重程度的标志作用，特别是当组合使用时。
{"title":"The predictive significance of serum cystatin C and free sub unit of β-Human chorionic gonadotropin in pregnant women with preeclampsia in Lagos","authors":"A. Ugwu, A. Oluwole, K. Okunade, S. John-Olabode, N. Ani-ugwu, O. Olumakinwa, Amaobichukwu Anyanwu, E. Ugwu, C. Makwe","doi":"10.33574/hjog.0404","DOIUrl":"https://doi.org/10.33574/hjog.0404","url":null,"abstract":"Background: Preeclampsia (PE) is a multi-systemic progressive disorder that is unique to human pregnancy, occurring usually after 20 weeks of gestation. Useful biochemical markers to be utilized for early prediction of preeclampsia continue to elude us. The search for biomarkers is aimed identifying women at increased risk of developing PE, so that medical interventions may be instituted very early in pregnancy to ameliorate its occurrence and improve maternal and fetal outcome. Aim: This study aimed to determine the association between serum levels of Cystatin C and/or free β-subunit of hCG measured in early pregnancy and the development of pre-eclampsia and its severity. Methods: This was a prospective cohort study of 290 pregnant women recruited during routine antenatal care, at the gestational age of between 13 and 19 weeks. After obtaining an informed consent from each participant, a structured questionnaire was used to collection relevant information followed by the collection of 5 mL of venous blood sample. Serum cystatin C and free sub unit of β-hCG levels were determined by standard enzyme-linked immunosorbent assay (ELISA) method. All participants were followed up till delivery and those who developed preeclampsia was classified as mild and severe preeclampsia. Data were entered and analyzed using STATA version 16 statistical software. Hypothesis testing was done using chi-square test for categorical variables, and the independent-samples t-test and ANOVA for numerical variables. Results: We found significantly elevated serum levels of cystatin C and free subunit of β-hCG in women who developed preeclampsia, (p < 0.002 and 0.001) respectively. Conclusion: Our study has shown that in a healthy population of pregnant women that elevated serum levels of cystatin C and free beta hCG concentration measured in early second trimester were associated with an increased risk of developing preeclampsia and its severity. This suggests that the combination of these analytes may have a role as a marker of pre-eclampsia and its severity especially when used in combination.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130322473","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}
P. Christopoulos, M. Liakopoulou, V. Perdikari, N. Vrachnis, T. Kalampokas, N. Vlachos
Background: Primary dysmenorrhea refers to the symptom of painful menstruation in the absence of identifiable pelvic or uterus pathology. Initial presentation usually occurs in adolescence and early adulthood. Medications used to treat primary dysmenorrhea include anti-inflammatory drugs, principally, ibuprofen and paracetamol. So far there has been no comparison of effectiveness and security profile between the two pharmaceutical substances. Objectives: Purpose of this prospective randomized crossover study was to compare the effectiveness and safety profile between those two pharmaceutical substances. Methods: In this clinical trial, 100 young women were included. The inclusion criteria was: a) age between 18–25 years old, b) no present or previous pelvic pathology, based on their medical history and an ultrasound examination which was performed in the 3–6th day of their menstrual circle, a month before the clinical trial. Vaginal discharge examination and also Papanicolaou test were held to exclude relevant pathology of the genital system. Participants were assessed and divided in two groups. The duration of the study was two months. The first group received ibuprofen for the first month and paracetamol for the second month while the second group received them vice versa (cross-over trial). Both groups filled in a questionnaire in regard to how they responded to each therapy. In addition, the security profile of the pharmaceutical drugs was compared as also their effect to the characteristics of menstruation and their probable side-effects. All participants filled in a questionnaire before the assignment into groups. For the comparison of the results, the 10% of the women with not painful menstruation, steadily every month, were removed and paired-samples t-test was used. Results: Ibuprofen has been proven as a safe and more effective therapeutic option than paracetamol in all parameters, when treating women with primary dysmenorrhea. After the administration of analgesics for the two following months, the comparison and statistical analysis of the new questionnaires revealed that, when Ibuprofen was compared to Paracetamol, the analgesic effectiveness was 98,9 and 91,1% respectively. Ibuprofen provided a maximum pain relief in 30 minutes – 53,3% of participants –when Paracetamol demonstrated the maximum pain relief in 60 minutes (64,4%). The pain was decreased “moderate” with the use of Paracetamol (37,8%) and “totally” with Ibuprofen (58,9%). The duration of analgesia with Ibuprofen was 4–8 hours –73,3% of participants– compared to 1–4 hours with Paracetamol (57,4%). Daily activity has been remarkably improved with the use of Ibuprofen (62%) compared to Paracetamol (only 9%). After the administration of Paracetamol 4% of the women appeared side-effects and none of the women appeared with the use of Ibuprofen. All the above results were statistically significant. Conclusions: Ibuprofen provides a significantly improved quality of life when co
{"title":"Comparison between ibuprofen and paracetamol in primary dysmenorrhea","authors":"P. Christopoulos, M. Liakopoulou, V. Perdikari, N. Vrachnis, T. Kalampokas, N. Vlachos","doi":"10.33574/hjog.0305","DOIUrl":"https://doi.org/10.33574/hjog.0305","url":null,"abstract":"Background: Primary dysmenorrhea refers to the symptom of painful menstruation in the absence of identifiable pelvic or uterus pathology. Initial presentation usually occurs in adolescence and early adulthood. Medications used to treat primary dysmenorrhea include anti-inflammatory drugs, principally, ibuprofen and paracetamol. So far there has been no comparison of effectiveness and security profile between the two pharmaceutical substances. Objectives: Purpose of this prospective randomized crossover study was to compare the effectiveness and safety profile between those two pharmaceutical substances. Methods: In this clinical trial, 100 young women were included. The inclusion criteria was: a) age between 18–25 years old, b) no present or previous pelvic pathology, based on their medical history and an ultrasound examination which was performed in the 3–6th day of their menstrual circle, a month before the clinical trial. Vaginal discharge examination and also Papanicolaou test were held to exclude relevant pathology of the genital system. Participants were assessed and divided in two groups. The duration of the study was two months. The first group received ibuprofen for the first month and paracetamol for the second month while the second group received them vice versa (cross-over trial). Both groups filled in a questionnaire in regard to how they responded to each therapy. In addition, the security profile of the pharmaceutical drugs was compared as also their effect to the characteristics of menstruation and their probable side-effects. All participants filled in a questionnaire before the assignment into groups. For the comparison of the results, the 10% of the women with not painful menstruation, steadily every month, were removed and paired-samples t-test was used. Results: Ibuprofen has been proven as a safe and more effective therapeutic option than paracetamol in all parameters, when treating women with primary dysmenorrhea. After the administration of analgesics for the two following months, the comparison and statistical analysis of the new questionnaires revealed that, when Ibuprofen was compared to Paracetamol, the analgesic effectiveness was 98,9 and 91,1% respectively. Ibuprofen provided a maximum pain relief in 30 minutes – 53,3% of participants –when Paracetamol demonstrated the maximum pain relief in 60 minutes (64,4%). The pain was decreased “moderate” with the use of Paracetamol (37,8%) and “totally” with Ibuprofen (58,9%). The duration of analgesia with Ibuprofen was 4–8 hours –73,3% of participants– compared to 1–4 hours with Paracetamol (57,4%). Daily activity has been remarkably improved with the use of Ibuprofen (62%) compared to Paracetamol (only 9%). After the administration of Paracetamol 4% of the women appeared side-effects and none of the women appeared with the use of Ibuprofen. All the above results were statistically significant. Conclusions: Ibuprofen provides a significantly improved quality of life when co","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"145 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133950155","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}
An interdisciplinary and individualized approach should be implemented with regard to the management of severe COVID-19 in pregnancy. The present study deals with the clinical course of 2 pregnant women who have been diagnosed with this disease and needed admission to an ICU and mechanical respiratory support in Cyprus. The data collection took place in a general ICU of the General Hospital of Nicosia.In certain regions of the world, up to 15% of pregnant women were found to have a positive result on polymerase chain reaction testing for SARS-CoV-2 upon admission for delivery. While pregnant women do not appear to be at substantially higher risk of severe manifestations from COVID-19 compared with non-pregnant adults, the disease has resulted in severe maternal morbidity and mortality in both high- and low-resource settings.
{"title":"Two critically ill pregnant patients with SARS-CoV-2: A clinical cases report from the Republic of Cyprus","authors":"Andria Syka, K. Alexandrou, L. Palazis","doi":"10.33574/hjog.0306","DOIUrl":"https://doi.org/10.33574/hjog.0306","url":null,"abstract":"An interdisciplinary and individualized approach should be implemented with regard to the management of severe COVID-19 in pregnancy. The present study deals with the clinical course of 2 pregnant women who have been diagnosed with this disease and needed admission to an ICU and mechanical respiratory support in Cyprus. The data collection took place in a general ICU of the General Hospital of Nicosia.In certain regions of the world, up to 15% of pregnant women were found to have a positive result on polymerase chain reaction testing for SARS-CoV-2 upon admission for delivery. While pregnant women do not appear to be at substantially higher risk of severe manifestations from COVID-19 compared with non-pregnant adults, the disease has resulted in severe maternal morbidity and mortality in both high- and low-resource settings.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130787511","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 Mitsopoulou, Angeliki-Astero Papathanasiou, E. Kalampokas, N. Vlahos
Background/Aim: Human papilloma virus (HPV) and uterine cervical cancer (UCC) are causatively related. In Greece, evidence-based guidelines for primary and secondary prevention of UCC have yet to be developed and applied in clinical practice. Our purpose here is to present such guidelines together with up-to-date data on HPV screening protocols. Methods: We surveyed current literature on UCC prevention, national and international data on UCC, and national guidelines on UCC preventive measures in various countries, as well as their role in UCC control. Results: It is well known that clinical practice guidelines optimize patient care. Introduction of guidelines regarding primary and secondary prevention of UCC express a favorable outcome of control and elimination of the disease. This is outlined in screening protocols of several countries worldwide. The lack of such guidelines in Greece in previous years led to misinformation of both healthcare professionals and general population. The development of clear and up-to-date guidelines in Greece during 2021 constitutes an important step that will play a pivotal role in UCC prevention in Greece. What needs to be ensured is on the one hand that all healthcare professionals are informed about these guidelines and on the other hand the application of these guidelines an everyday clinical practice. Conclusions: Systematic use of primary and secondary preventive measures and screening protocols are efficient in both control and elimination of UCC. Based on our search and our clinical experience, it is imperative for all Obstetrics and Gynecology clinicians in Greece to be familiar with all relevant screening and vaccination programs available.
{"title":"Primary and secondary prevention of uterine cervical cancer: Up-To-Date Information, Guidelines, and the need for their application in Greece","authors":"Dimitra Mitsopoulou, Angeliki-Astero Papathanasiou, E. Kalampokas, N. Vlahos","doi":"10.33574/hjog.0301","DOIUrl":"https://doi.org/10.33574/hjog.0301","url":null,"abstract":"Background/Aim: Human papilloma virus (HPV) and uterine cervical cancer (UCC) are causatively related. In Greece, evidence-based guidelines for primary and secondary prevention of UCC have yet to be developed and applied in clinical practice. Our purpose here is to present such guidelines together with up-to-date data on HPV screening protocols. Methods: We surveyed current literature on UCC prevention, national and international data on UCC, and national guidelines on UCC preventive measures in various countries, as well as their role in UCC control. Results: It is well known that clinical practice guidelines optimize patient care. Introduction of guidelines regarding primary and secondary prevention of UCC express a favorable outcome of control and elimination of the disease. This is outlined in screening protocols of several countries worldwide. The lack of such guidelines in Greece in previous years led to misinformation of both healthcare professionals and general population. The development of clear and up-to-date guidelines in Greece during 2021 constitutes an important step that will play a pivotal role in UCC prevention in Greece. What needs to be ensured is on the one hand that all healthcare professionals are informed about these guidelines and on the other hand the application of these guidelines an everyday clinical practice. Conclusions: Systematic use of primary and secondary preventive measures and screening protocols are efficient in both control and elimination of UCC. Based on our search and our clinical experience, it is imperative for all Obstetrics and Gynecology clinicians in Greece to be familiar with all relevant screening and vaccination programs available.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"2008 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129047273","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}
D. Zacharakis, Thomas Ntounis, M. Diakosavvas, N. Kathopoulis, C. Kalantzis, S. Athanasiou, T. Grigoriadis
Introduction: Enhanced Recovery After Surgery (ERAS) protocols consist of several evidence-based interventions that have been adopted to ameliorate perioperative care. Until this day, no such specific protocols suggested for urogynecology patients, exist. However, there are recent efforts towards the development of such protocols, as it has been shown to have beneficial effects among patients undergoing other gynecological procedures. This review aims to collect and analyze data in the published literature regarding implementation of an enhanced recovery after surgery pathway in a urogynecology population. Material and Methods: An extensive search of the PubMed/Medline and the Cochrane Database was conducted using the following terms: Enhance Recovery After Surgery combined with pelvic floor reconstructive surgery and urogynecology. Related articles from the latest two decades up to May 2021 were scanned for relevance. Results: The interventions concerning the implementation of an enhanced recovery pathway after urogynecologic procedures include preoperative, intraoperative, and postoperative recommendations. The main key items in these protocols comprise of patient education, optimization of comorbid conditions, diet, bowel preparation, antibiotic prophylaxis, fluid intake, anesthesiologic agents, early ambulation, postoperative analgesia, thromboprophylaxis and guidance after discharge. Conclusions: Implementation of an ERAS protocol in urogynecology-specific population has been proven to have a beneficial effect on decreasing hospital stay without increasing the rate of post-operative complications. Nonetheless, the scarcity of evidence-based studies in the literature, regarding the implementation of an ERAS protocol in gynecologic pelvic floor reconstructive surgery is apparent. Hence, further research is required with studies targeted towards urogynecology for safer conclusions to be made.
{"title":"Enhanced recovery protocols after pelvic floor reconstructive surgery","authors":"D. Zacharakis, Thomas Ntounis, M. Diakosavvas, N. Kathopoulis, C. Kalantzis, S. Athanasiou, T. Grigoriadis","doi":"10.33574/hjog.0302","DOIUrl":"https://doi.org/10.33574/hjog.0302","url":null,"abstract":"Introduction: Enhanced Recovery After Surgery (ERAS) protocols consist of several evidence-based interventions that have been adopted to ameliorate perioperative care. Until this day, no such specific protocols suggested for urogynecology patients, exist. However, there are recent efforts towards the development of such protocols, as it has been shown to have beneficial effects among patients undergoing other gynecological procedures. This review aims to collect and analyze data in the published literature regarding implementation of an enhanced recovery after surgery pathway in a urogynecology population. Material and Methods: An extensive search of the PubMed/Medline and the Cochrane Database was conducted using the following terms: Enhance Recovery After Surgery combined with pelvic floor reconstructive surgery and urogynecology. Related articles from the latest two decades up to May 2021 were scanned for relevance. Results: The interventions concerning the implementation of an enhanced recovery pathway after urogynecologic procedures include preoperative, intraoperative, and postoperative recommendations. The main key items in these protocols comprise of patient education, optimization of comorbid conditions, diet, bowel preparation, antibiotic prophylaxis, fluid intake, anesthesiologic agents, early ambulation, postoperative analgesia, thromboprophylaxis and guidance after discharge. Conclusions: Implementation of an ERAS protocol in urogynecology-specific population has been proven to have a beneficial effect on decreasing hospital stay without increasing the rate of post-operative complications. Nonetheless, the scarcity of evidence-based studies in the literature, regarding the implementation of an ERAS protocol in gynecologic pelvic floor reconstructive surgery is apparent. Hence, further research is required with studies targeted towards urogynecology for safer conclusions to be made.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121097799","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. Ugwu, C. Makwe, S. Omisakin, N. Ani-ugwu, Egba Augustine, L. Ojiefoh, I. Okafor
We report a case of a 45-year-old woman with successful management of cervical ectopic pregnancy using ultrasound guided suction evacuation and balloon tamponade. The case report owes its significance to the high morbidity and mortality associated with this form of ectopic pregnancy in our environment, because of misdiagnosis and late presentation.
{"title":"Successful management of cervical ectopic pregnancy following invitro fertilisation","authors":"A. Ugwu, C. Makwe, S. Omisakin, N. Ani-ugwu, Egba Augustine, L. Ojiefoh, I. Okafor","doi":"10.33574/hjog.0307","DOIUrl":"https://doi.org/10.33574/hjog.0307","url":null,"abstract":"We report a case of a 45-year-old woman with successful management of cervical ectopic pregnancy using ultrasound guided suction evacuation and balloon tamponade. The case report owes its significance to the high morbidity and mortality associated with this form of ectopic pregnancy in our environment, because of misdiagnosis and late presentation.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"180 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115921949","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}
Effrosine Tsekoura, Kleopatra Chrelia, A. Pouliakis, A. Attilakos, P. Matsota
The idea that the newborn is an uncharted and therefore pliable organism, which can be formed according to the will of its parents, has long been rejected, especially after the existence of rules of behavior not only in full-term but also in marginally premature newborns, which are affected by various both prenatal and perinatal factors. The ability of newborns to determine the rules of their behavior according to the stimuli they receive from internal and external factors, has been the subject of many years of research and has led pediatricians and other health professionals to develop a model for grading these newborn abilities. Thus, the Neonatal Behavioral Assessment Scale (NBAS) was created, and it has been used by researchers for more than 40 years. It is a research tool with wide application, as many of the points it addresses, can be integrated into other means of assessing the newborn’s abilities. This scale also has an ever-evolving application as a clinical tool in parental assessment.
{"title":"Antenatal and perinatal factors associated with newborn behavior: A prospective cohort study","authors":"Effrosine Tsekoura, Kleopatra Chrelia, A. Pouliakis, A. Attilakos, P. Matsota","doi":"10.33574/hjog.0304","DOIUrl":"https://doi.org/10.33574/hjog.0304","url":null,"abstract":"The idea that the newborn is an uncharted and therefore pliable organism, which can be formed according to the will of its parents, has long been rejected, especially after the existence of rules of behavior not only in full-term but also in marginally premature newborns, which are affected by various both prenatal and perinatal factors. The ability of newborns to determine the rules of their behavior according to the stimuli they receive from internal and external factors, has been the subject of many years of research and has led pediatricians and other health professionals to develop a model for grading these newborn abilities. Thus, the Neonatal Behavioral Assessment Scale (NBAS) was created, and it has been used by researchers for more than 40 years. It is a research tool with wide application, as many of the points it addresses, can be integrated into other means of assessing the newborn’s abilities. This scale also has an ever-evolving application as a clinical tool in parental assessment.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"22 5-6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130557832","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}
Objective: To evaluate the effectivity of laparoscopic ovarian drilling procedures at the East Sussex Healthcare Trust, UK, over the past decade on sub-fertile women with polycystic ovary syndrome, regardless of clomiphene resistance. Design: Retrospective case note review of LOD procedures Methods: Study 1: Evaluating a systematic literature review investigating ovulation and pregnancy rates following LOD. Study 2: An audit of 58 women with LOD treated for ovulation induction at the ESHT fertility clinic between 2005-2014. Main outcome measures: Ovulation, pregnancy, live birth, miscarriage rates; tubal patency; associated pathologies; previous treatments compared with Cochrane Review 2012. Results: Study 1: From the literature review, 71% achieved ovulation, whereas the pregnancy, live birth and miscarriage rates were 25-51%, 24-44% and 4-9% respectively. Study 2: Of the 58 patients studied, ovulation rate was 69%, pregnancy rate was 39.4% and live birth rate was 30.3%. The miscarriage rate was 15.4%. Pregnancy outcome after LOD, irrespective of further treatment, showed 34 pregnancies. Including 17 spontaneous pregnancies and 17 pregnancies after further treatment. Of the 34 pregnancies, 85.3% were live birth, 11.7% miscarriages and 1 ectopic pregnancy. Conclusion: No significant difference in ovulation rates post-LOD in ESHT, which is comparable to published studies. The low pregnancy and live birth rates indicate that additional factors affect the success of LOD. Co-existing pathology is associated with lower pregnancy rate post-LOD. Novel theories are postulated to explain underlying pathologies, thus PCOS treatment may change and open a fascinating area of research.
{"title":"Outcome of laparoscopic ovarian drilling (LOD) for women with polycystic ovary syndrome (PCOS): A retrospective case note review","authors":"Rifat Syed, J. Zaidi, Nabeha Dhar","doi":"10.33574/hjog.0303","DOIUrl":"https://doi.org/10.33574/hjog.0303","url":null,"abstract":"Objective: To evaluate the effectivity of laparoscopic ovarian drilling procedures at the East Sussex Healthcare Trust, UK, over the past decade on sub-fertile women with polycystic ovary syndrome, regardless of clomiphene resistance. Design: Retrospective case note review of LOD procedures Methods: Study 1: Evaluating a systematic literature review investigating ovulation and pregnancy rates following LOD. Study 2: An audit of 58 women with LOD treated for ovulation induction at the ESHT fertility clinic between 2005-2014. Main outcome measures: Ovulation, pregnancy, live birth, miscarriage rates; tubal patency; associated pathologies; previous treatments compared with Cochrane Review 2012. Results: Study 1: From the literature review, 71% achieved ovulation, whereas the pregnancy, live birth and miscarriage rates were 25-51%, 24-44% and 4-9% respectively. Study 2: Of the 58 patients studied, ovulation rate was 69%, pregnancy rate was 39.4% and live birth rate was 30.3%. The miscarriage rate was 15.4%. Pregnancy outcome after LOD, irrespective of further treatment, showed 34 pregnancies. Including 17 spontaneous pregnancies and 17 pregnancies after further treatment. Of the 34 pregnancies, 85.3% were live birth, 11.7% miscarriages and 1 ectopic pregnancy. Conclusion: No significant difference in ovulation rates post-LOD in ESHT, which is comparable to published studies. The low pregnancy and live birth rates indicate that additional factors affect the success of LOD. Co-existing pathology is associated with lower pregnancy rate post-LOD. Novel theories are postulated to explain underlying pathologies, thus PCOS treatment may change and open a fascinating area of research.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116300662","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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