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Combined effects of high-intensity focused electromagnetic therapy and pelvic floor exercises on pelvic floor muscles and sexual function in postmenopausal women. A randomized controlled trial. 高强度聚焦电磁疗法和盆底运动对绝经后妇女盆底肌肉和性功能的联合影响。随机对照试验。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-05 DOI: 10.5468/ogs.24103
Saher Lotfy Elgayar

Objective: This study aimed to explore the impact of high-intensity focused electromagnetic therapy (HIFEMT) on the pelvic floor muscles (PFM), sexual function, and quality of life (QoL) among postmenopausal women.

Methods: Fifty postmenopausal women with PFM weakness and sexual dysfunction were randomly allocated into two equal groups. The HIFEMT group participated in the PFM training program in addition to HIFEMT, whereas the control group performed PFM training only. For 12 weeks, HIFEMT was scheduled two times a week, while PFM training was performed daily. At baseline and after 12 weeks, PFM strength and endurance were assessed using a perineometer and sexual function was examined using the female sexual function index (FSFI) and menopause-specific quality of life questionnaire (MENQOL).

Results: The HIFEMT and control groups showed significant increases in PFM strength and endurance and FSFI scores, and significant declines in MENQOL compared with baseline measures (P<0.05). Compared to the control group, the HIFEMT group showed substantial improvements in all measured variables after 12 weeks (P<0.05).

Conclusion: Addition of HIFEMT to PFM training improved the PFM strength, endurance, sexual function, and QoL in postmenopausal women with PFM weakness and sexual dysfunction.

研究目的本研究旨在探讨高强度聚焦电磁疗法(HIFEMT)对绝经后妇女盆底肌肉(PFM)、性功能和生活质量(QoL)的影响:将 50 名患有盆底肌无力和性功能障碍的绝经后妇女随机分为两组。HIFEMT 组除参加 HIFEMT 外,还参加 PFM 训练计划,而对照组仅进行 PFM 训练。在为期 12 周的时间里,HIFEMT 每周安排两次,而 PFM 训练则每天进行。在基线和 12 周后,使用会阴计评估 PFM 的强度和耐力,并使用女性性功能指数(FSFI)和更年期生活质量问卷(MENQOL)检查性功能:结果:与基线测量结果相比,HIFEMT 组和对照组的 PFM 力量和耐力以及 FSFI 分数均有显著提高,而 MENQOL 分数则有显著下降:在 PFM 训练的基础上增加 HIFEMT,可改善有 PFM 肌无力和性功能障碍的绝经后妇女的 PFM 肌力、耐力、性功能和 QoL。
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引用次数: 0
Comparative analysis of ferric carboxymaltose and iron sucrose in treating iron deficiency anemia in perimenopausal women with heavy menstrual bleeding: a randomized controlled trial. 羧甲基铁和蔗糖铁治疗月经过多围绝经期妇女缺铁性贫血的比较分析:随机对照试验。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-04 DOI: 10.5468/ogs.24065
Jaya Chaturvedi, Rupendra K, Anupama Bahadur, Ayush Heda, Rajlaxmi Mundhra

Objective: To evaluate the impact of intravenous ferric carboxymaltose (FCM) compared to iron sucrose (ISC) in perimenopausal women with heavy menstrual bleeding (HMB) and anemia.

Methods: This prospective, open-label, randomized controlled trial enrolled perimenopausal women (40-50 years) with HMB and hemoglobin levels between 6-10 g/dL, intolerant or non-compliant to oral iron therapy. The study compared FCM and ISC by assessing hematological parameters, including hemoglobin, ferritin, and iron levels, over a 12-week period. The patients were followed up at 3, 6, and 12 weeks after initiation. The adverse effects were also evaluated.

Results: The study included 60 perimenopausal women, with 30 in each group. The baseline patient characteristics were comparable. FCM demonstrated a statistically significant higher mean increase in hemoglobin (4.97 g/dL) than ISC (4.63 g/dL) over 12 weeks. The proportion of patients achieving correction of anemia (Hb ≥12%) was higher in the FCM group (75.9% vs. 65.5%). Serum ferritin levels were significantly higher in the FCM group after 3 weeks. Adverse effects were minimal and comparable between the groups. Although the direct cost of FCM is high, its ability to be administered in larger doses may result in lower total costs.

Conclusion: In perimenopausal women with heavy menstrual bleeding and iron deficiency anemia, FCM and ISC show comparable efficacy in increasing hemoglobin levels with similar side effect profiles. This study highlights the potential benefits of FCM and calls for further exploration of these therapies in diverse patient populations.

目的评估与蔗糖铁(ISC)相比,静脉注射羧甲基铁(FCM)对患有大量月经出血(HMB)和贫血的围绝经期妇女的影响:这项前瞻性、开放标签、随机对照试验招募了围绝经期妇女(40-50 岁),她们患有 HMB,血红蛋白水平在 6-10 g/dL 之间,不耐受或不遵从口服铁剂治疗。该研究通过评估血液学参数(包括血红蛋白、铁蛋白和铁水平),对 FCM 和 ISC 进行了为期 12 周的比较。在开始治疗后的 3、6 和 12 周对患者进行随访。同时还对不良反应进行了评估:研究包括 60 名围绝经期妇女,每组 30 人。患者的基线特征具有可比性。在 12 周内,FCM 的血红蛋白平均增幅(4.97 克/分升)明显高于 ISC(4.63 克/分升)。在 FCM 组中,贫血得到纠正(Hb ≥12%)的患者比例更高(75.9% 对 65.5%)。3 周后,FCM 组的血清铁蛋白水平明显更高。两组的不良反应极小,不相上下。虽然 FCM 的直接成本较高,但其大剂量给药的能力可能会降低总成本:结论:对于患有大量月经出血和缺铁性贫血的围绝经期妇女,FCM 和 ISC 在提高血红蛋白水平方面的疗效相当,且副作用相似。这项研究强调了 FCM 的潜在益处,并呼吁在不同患者群体中进一步探索这些疗法。
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引用次数: 0
The effect of antioxidant supplementation on dysmenorrhea and endometriosis-associated painful symptoms: a systematic review and meta-analysis of randomized clinical trials. 抗氧化剂补充剂对痛经和子宫内膜异位症相关疼痛症状的影响:随机临床试验的系统回顾和荟萃分析。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-04 DOI: 10.5468/ogs.24228
Sedighe Esmaeilzadeh, Parvaneh Mirabi
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引用次数: 0
A comparative study of self-collected versus clinician-collected specimens in detecting high-risk HPV infection: a prospective cross-sectional study. 自取标本与临床医生采集标本在检测高危 HPV 感染方面的比较研究:一项前瞻性横断面研究。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-10-08 DOI: 10.5468/ogs.24117
Natnipa Parapob, Suree Lekawanvijit, Theera Tongsong, Kittipat Charoenkwan, Charuwan Tantipalakorn

Objective: The primary objective of this study was to compare the detection rate of high-risk human papillomavirus (HPV) infection between self-sampling to collect vaginal specimens and clinician sampling to collect cervical specimens, as well as the correlation between the two techniques. The secondary objective was to assess satisfaction with self-sampling for HPV testing.

Methods: From October 2021 to September 2022, women positive for HPV 16/18 and other 12 high-risk HPV genotypes and cytological ASCUS were enrolled. All participants were instructed on the method for self-collection of HPV samples. Self-collected vaginal samples and clinician-collected cervical samples were subjected to HPV DNA typing.

Results: Paired self- and clinician-collected specimens were obtained from 104 women with positive HPV-positive results. The detection rate of high-risk HPV infection was comparable between the two techniques: 79/98 (80.6%) vs. 81/98 (82.7%) for the self-sampling and clinician-sampling techniques, respectively (McNemar's test; P=0.774). The agreement in detecting HPV infection was substantial, with a kappa coefficient of 0.75. More than 90% of the participants rated self-collection as satisfactory to very satisfactory because of its convenience and safety. Regarding methods of further follow-up, 51% of the participants chose self-sampling, whereas the remaining participants preferred collection by clinicians. No intervention-related complications were observed.

Conclusion: The self-sampling technique for HPV testing was as effective as the clinician-sampling technique, and both techniques were substantially correlated in detecting high-risk HPV infection. The self-sampling method appears to be highly satisfactory and may provide better compliance for the detection of cervical HPV infection.

研究目的本研究的主要目的是比较自我采样采集阴道标本与临床医生采样采集宫颈标本的高危人乳头瘤病毒(HPV)感染检出率,以及两种技术之间的相关性。次要目标是评估HPV检测自我采样的满意度:方法:从 2021 年 10 月到 2022 年 9 月,对 HPV 16/18 型和其他 12 种高风险 HPV 基因型阳性以及细胞学 ASCUS 的女性进行了登记。所有参与者都接受了HPV样本自取方法的指导。对自取的阴道样本和临床医生采集的宫颈样本进行HPV DNA分型:结果:从 104 名 HPV 阳性的妇女中获得了自取和临床医生采集的配对标本。两种技术的高危 HPV 感染检出率相当:自我采样和临床医生采样技术的检出率分别为 79/98 (80.6%) vs. 81/98 (82.7%)(McNemar 检验;P=0.774)。检测 HPV 感染的一致性很高,卡帕系数为 0.75。超过 90% 的参与者对自我采集的便利性和安全性表示满意或非常满意。关于进一步随访的方法,51%的参与者选择自行采样,而其余参与者则倾向于由临床医生采集。没有观察到与干预相关的并发症:结论:HPV检测的自我采样技术与临床医生采样技术同样有效,两种技术在检测高危HPV感染方面有很大的相关性。自我采样法似乎非常令人满意,而且在检测宫颈 HPV 感染方面具有更好的依从性。
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引用次数: 0
Efficacy of large language models and their potential in Obstetrics and Gynecology education. 大语言模型的功效及其在妇产科教育中的潜力。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-10-02 DOI: 10.5468/ogs.24211
Kyung Jin Eoh, Gu Yeun Kwon, Eun Jin Lee, JoonHo Lee, Inha Lee, Yong Tae Kim, Eun Ji Nam

Objective: The performance of large language models (LLMs) and their potential utility in obstetric and gynecological education are topics of ongoing debate. This study aimed to contribute to this discussion by examining the recent advancements in LLM technology and their transformative potential in artificial intelligence.

Methods: This study assessed the performance of generative pre-trained transformer (GPT)-3.5 and -4 in understanding clinical information, as well as its potential implications for obstetric and gynecological education. Obstetrics and gynecology residents at three hospitals underwent an annual promotional examination, from which 116 of the 170 questions over 4 years (2020-2023) were analyzed, excluding 54 questions with images. The scores achieved by GPT-3.5, -4, and the 100 residents were compared.

Results: The average scores across all 4 years for GPT-3.5 and -4 were 38.79 (standard deviation [SD], 5.65) and 79.31 (SD, 3.67), respectively. For groups R1, R2, and R3, the cumulative annual average scores were 79.12 (SD, 9.00), 80.95 (SD, 5.86), and 83.60 (SD, 6.82), respectively. No statistically significant differences were observed between the scores of GPT-4.0 and those of the residents. When analyzing questions specific to obstetrics, the average scores for GPT-3.5 and -4.0 were 33.44 (SD, 10.18) and 90.22 (SD, 7.68), respectively.

Conclusion: GPT-4 demonstrated exceptional performance in obstetrics, different types of data interpretation, and problem solving, showcasing the potential utility of LLMs in these areas. However, acknowledging the constraints of LLMs is crucial and their utilization should augment human expertise and discernment.

目的:大型语言模型(LLMs)的性能及其在妇产科教育中的潜在用途一直是争论不休的话题。本研究旨在通过研究 LLM 技术的最新进展及其在人工智能领域的变革潜力,为这一讨论做出贡献:本研究评估了生成式预训练变换器(GPT)-3.5 和-4 在理解临床信息方面的表现,以及其对妇产科教育的潜在影响。三家医院的妇产科住院医师参加了每年一次的晋升考试,对其中四年(2020-2023 年)170 道题中的 116 道题进行了分析,不包括 54 道带图像的题目。对 GPT-3.5、-4 和 100 名住院医师的得分进行了比较:GPT-3.5和-4的4年平均得分分别为38.79(标准差[SD],5.65)和79.31(标准差,3.67)。R1、R2 和 R3 组的累积年平均得分分别为 79.12(标准差,9.00)、80.95(标准差,5.86)和 83.60(标准差,6.82)。GPT-4.0 的得分与住院医师的得分在统计学上无明显差异。在分析产科的具体问题时,GPT-3.5 和 -4.0 的平均得分分别为 33.44(标准差,10.18)和 90.22(标准差,7.68):GPT-4 在产科、不同类型的数据解读和问题解决方面表现优异,显示了 LLM 在这些领域的潜在作用。不过,认识到 LLM 的局限性至关重要,使用 LLM 应增强人类的专业知识和辨别力。
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引用次数: 0
RSVpreF vaccination in pregnancy: a meta-analysis of maternal-fetal safety and infant efficacy. 孕期 RSVpreF 疫苗接种:母胎安全性和婴儿疗效的荟萃分析。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-27 DOI: 10.5468/ogs.24213
Greg J Marchand, Ahmed Taher Massoud, Ahmed Taha Abdelsattar, Peter A McCullough

In May 2023, The United States Food and Drug Administration (FDA) approved a Pfizer©-sponsored (COMPANY, CITY, STATE, COUNTRY) bivalent RSVpreF (respiratory syncytial virus prefusion F protein-based vaccine) RSV vaccine (AbrysvoTM [COMPANY, CITY, STATE, COUNTRY]) for use during pregnancy to prevent neonatal/infant RSV infection. In February of 2022, FDA trials sponsored by GSK© (COMPANY, CITY, STATE, COUNTRY) on a similar RSVpreF RSV vaccine were halted because of the identification of a safety signal related to preterm births. As these vaccines use nearly identical pre-fusion F-protein technology, we sought to synthesize and evaluate the existing high-quality literature on their effectiveness and safety. From inception until March 15, 2024, we searched for randomized controlled trials (RCTs) on this topic. We used Review Manager (RevMan 5.4.1) (COMPANY, CITY, STATE, COUNTRY) to perform the analysis with 95% confidence intervals and risk ratios (RR). Our search yielded three large RCTs. From a safety perspective, many maternal side effects were greater in the RSVpreF group, with an increased incidence of local reactions (RR, 5.98 [3.68, 6.83]; P=0.01; I2=0%), blood disorders (RR, 1.07 [0.69, 1.66]; P=0.78; I2=0%), fatigue (RR, 1.05 [1.00, 1.10]; P=0.07; I2=0%), joint pain (RR, 1.60, 1.39 [0.68, 2.86]; P=0.37; I2=59%), cardiac disorders (RR, 1.19 [0.80, 1.77]; P=0.38; I2=0%), headache (RR, 0.80 [0.30, 2.10]; P=0.65; I2=0%), fever (RR, 0.90 [0.20, 4.16]; P=0.89; I2=57%), gastrointestinal disorders (RR, 1.04 [0.70, 1.56]; P=0.83; I2=0%), and pregnancy complications (RR, 1.01 [0.65, 1.56]; P=0.97; I2=17%). The vaccinated group demonstrated significant reduction RSV-lower respiratory tract disease (LRTD) cases (RR, 0.44 [0.33, 0.57]; P=0.01), severe LRT illness (RR, 0.29 [0.19, 0.44]; P=0.01), and hospitalizations (RR, 0.40 [0.24, 0.67]; P=0.005). RSVpreF vaccination was associated with a higher incidence of preterm delivery (RR, 1.24 [1.08, 1.44]; P=0.03); however, no significant difference in neonatal deaths was observed (RR, 1.42 [0.70, 2.89]; P=0.34). RSVpreF vaccination results in systemic adverse events and an increase in preterm delivery. Vaccination appeared to have acceptable short-term safety for newborns, but did not produce a significant decrease in neonatal death.

2023 年 5 月,美国食品和药物管理局(FDA)批准辉瑞公司© 赞助的二价 RSVpreF(呼吸道合胞病毒前体 F 蛋白疫苗)RSV 疫苗(AbrysvoTM [公司、城市、州、国家])用于孕期预防新生儿/婴儿 RSV 感染。2022 年 2 月,FDA 停止了由葛兰素史克公司(GSK© [公司、城市、州、县])赞助的类似 RSVpreF RSV 疫苗的试验,原因是发现了与早产有关的安全信号。由于这些疫苗使用了几乎完全相同的前融合 F 蛋白技术,我们试图综合并评估有关其有效性和安全性的现有高质量文献。从开始到 2024 年 3 月 15 日,我们检索了有关这一主题的随机对照试验 (RCT)。我们使用Review Manager (RevMan 5.4.1)(公司、城市、州、国家)进行了95%置信区间和风险比(RR)分析。我们的搜索结果显示有三项大型 RCT。从安全性角度来看,RSVpreF 组的许多产妇副作用更大,局部反应(RR,5.98 [3.68, 6.83];P=0.01;I2=0%)、血液紊乱(RR,1.07 [0.69, 1.66];P=0.78;I2=0%)、疲劳(RR,1.05 [1.00, 1.10];P=0.07;I2=0%)、关节疼痛(RR,1.60, 1.39 [0.68,2.86];P=0.37;I2=59%)、心脏疾病(RR,1.19 [0.80,1.77];P=0.38;I2=0%)、头痛(RR,0.80 [0.30,2.10];P=0.65;I2=0%)、发热(RR,0.90 [0.20,4.16];P=0.89;I2=57%)、胃肠功能紊乱(RR,1.04 [0.70,1.56];P=0.83;I2=0%)和妊娠并发症(RR,1.01 [0.65,1.56];P=0.97;I2=17%)。接种疫苗组的 RSV 下呼吸道疾病(LRTD)病例(RR,0.44 [0.33,0.57];P=0.01)、严重下呼吸道疾病(RR,0.29 [0.19,0.44];P=0.01)和住院治疗(RR,0.40 [0.24,0.67];P=0.005)显著减少。接种 RSVpreF 疫苗与较高的早产发生率有关(RR,1.24 [1.08,1.44];P=0.03);但在新生儿死亡方面未观察到显著差异(RR,1.42 [0.70,2.89];P=0.34)。接种 RSVpreF 疫苗会导致全身性不良事件和早产率上升。接种疫苗似乎对新生儿具有可接受的短期安全性,但并没有显著减少新生儿死亡。
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引用次数: 0
Lenvatinib and pembrolizumab versus platinum doublet chemotherapy as second-line therapy for advanced or recurrent endometrial cancer. 作为晚期或复发性子宫内膜癌的二线疗法,乐伐替尼和pembrolizumab与铂类双联化疗的比较。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-27 DOI: 10.5468/ogs.24075
Yutaka Yoneoka, Tsukuru Amano, Akimasa Takahashi, Hiroki Nishimura, Mari Deguchi, Hiroyuki Yamanaka, Yuji Tanaka, Shunichiro Tsuji, Takashi Murakami

Objective: There is no consensus on whether platinum doublet chemotherapy or lenvatinib and pembrolizumab (LEN/PEM) is superior for advanced or recurrent endometrial cancer. Thus, this study aimed to compare the prognosis and adverse events in patients with advanced or recurrent endometrial cancer treated with platinum doublet chemotherapy or LEN/PEM.

Methods: We retrospectively reviewed the medical records of patients who received platinum doublet chemotherapy or LEN/PEM at our institution for advanced or recurrent endometrial cancer and had a history of platinum-based chemotherapy between January 2013 and August 2023.

Results: During the study period, 11 regimens were identified in the platinum doublet chemotherapy group, and 11 regimens were identified in the LEN/PEM group. The objective response rates of the platinum doublet chemotherapy and LEN/PEM groups were 36.4% and 54.5% (P=0.67), respectively. The 6-month progression-free survival (PFS) rates of the platinum doublet chemotherapy and LEN/PEM groups were 27.3% (95% confidence interval [CI], 13.8-40.7%) and 70.0% (95% CI, 55.5-84.5%), respectively. The differences were significant between the two groups. Multivariate analyses of histology, prior lines of chemotherapy, platinum-free intervals, and regimens revealed that the LEN/PEM group had significantly better PFS rates.

Conclusion: Treatment with LEN/PEM resulted in significantly longer PFS than that of treatment with platinum doublet chemotherapy in patients with advanced and recurrent endometrial cancer. However, further large-scale studies are required to validate these findings.

目的:对于铂类双药化疗或来那替尼和彭博利珠单抗(LEN/PEM)治疗晚期或复发性子宫内膜癌是否更优,目前尚未达成共识。因此,本研究旨在比较晚期或复发性子宫内膜癌患者接受铂类双药化疗或来那替尼/PEM治疗后的预后和不良事件:我们回顾性审查了2013年1月至2023年8月期间在我院接受铂类双药化疗或LEN/PEM治疗的晚期或复发性子宫内膜癌患者的病历,这些患者均有铂类化疗史:在研究期间,铂双药化疗组确定了11种方案,LEN/PEM组确定了11种方案。铂双t化疗组和LEN/PEM组的客观反应率分别为36.4%和54.5%(P=0.67)。铂双药化疗组和LEN/PEM组的6个月无进展生存期(PFS)分别为27.3%(95%置信区间[CI],13.8-40.7%)和70.0%(95% CI,55.5-84.5%)。两组之间差异显著。对组织学、之前的化疗方案、无铂间隔和治疗方案进行多变量分析后发现,LEN/PEM组的PFS率明显更高:结论:在晚期和复发性子宫内膜癌患者中,LEN/PEM治疗的PFS明显长于铂双联化疗。结论:在晚期和复发性子宫内膜癌患者中,LEN/PEM治疗的PFS明显长于铂类双药化疗。
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引用次数: 0
Creation of neovagina in women with Müllerian agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome) using fresh human amnion. 利用新鲜人类羊膜为患有穆勒氏管缺失症(Mayer-Rokitansky-Kuster-Hauser 综合征)的妇女创建新阴道。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-25 DOI: 10.5468/ogs.24114
Abdulrahim Gari, Saeed Baradwan, Radiah Iskandarani, Ammar Y Alkhiary, Abdulmalik Abumohssin, Ahmed Abu-Zaid

Objective: Several graft options can be used to construct a neovagina. This study aimed to evaluate the efficacy of creating a neovagina using a fresh human amnion in women with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome.

Methods: Ten patients were analyzed retrospectively. Anatomical success was defined by a postoperative vaginal length ≥5 cm, and a width sufficient to comfortably accommodate the insertion of two fingers. Functional success was achieved when a score of >26.5 was attained on the Arabic validated version of the functional sexual function index (FSFI).

Results: The mean vaginal length before surgery was 2.15±0.85 cm (range, 1.5-4.5). The mean vaginal length after surgery was 5.5±0.53 cm (range, 5-6), and all patients (n=10) achieved anatomical success. The FSFI score after surgery was 29.2±2.4, and eight patients achieved functional success. The mean operative time and estimated blood loss were 83.5±50.31 minutes (range, 42-210) and 122.0±75.69 mL (range, 20-250), respectively. None of the patients required intraoperative blood transfusion or experienced injury to vital organs. Four patients developed postoperative leukocytosis within 48 hours, and one patient experienced chronic pelvic pain that lasted more than 6 months postoperatively. No major postoperative complications, such as pelvic abscesses, open wounds, chronic vaginal discharge, or reoperation, were reported.

Conclusion: Surgical dissection of the vesicorectal space and utilization of fresh human amnion to create a neovagina over a vaginal mold are technically feasible and safe, and are linked to favorable anatomical and functional outcomes in MRKH patients with vaginal agenesis.

目的:有几种移植物可用于构建新阴道。本研究旨在评估在患有 Mayer-Rokitansky-Kuster-Hauser (MRKH) 综合征的女性中使用新鲜人类羊膜构建新阴道的疗效:方法:对十名患者进行了回顾性分析。解剖学成功的定义是术后阴道长度≥5厘米,宽度足以舒适地插入两根手指。当阿拉伯语验证版的性功能指数(FSFI)达到 26.5 分以上时,即为功能成功:手术前的平均阴道长度为 2.15±0.85厘米(范围为 1.5-4.5)。术后阴道平均长度为(5.5±0.53)厘米(范围:5-6),所有患者(10 人)都获得了解剖学上的成功。术后FSFI评分为(29.2±2.4)分,8名患者获得了功能性成功。平均手术时间和估计失血量分别为 83.5±50.31 分钟(范围 42-210)和 122.0±75.69 毫升(范围 20-250)。没有患者需要术中输血或重要器官受伤。四名患者术后 48 小时内出现白细胞增多,一名患者术后出现持续 6 个月以上的慢性盆腔疼痛。术后未出现盆腔脓肿、开放性伤口、慢性阴道分泌物或再次手术等重大并发症:结论:对膀胱直肠间隙进行手术剥离,并利用新鲜人类羊膜在阴道模具上制作新阴道,在技术上是可行和安全的,而且对阴道缺失的 MRKH 患者来说,在解剖学和功能上都有良好的效果。
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引用次数: 0
Navigating the thyroid-gynecologic interplay: a systematic review and meta-analysis thyroid-gynecologic interaction. 甲状腺与妇科相互作用的导航:甲状腺与妇科相互作用的系统回顾和荟萃分析。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-24 DOI: 10.5468/ogs.24185
Heba Ramadan

Thyroid disorders are considered to be linked to various health issues, including gynecologic cancers. Studying this association is crucial in clinical practice. This approach was applied through searches in Scopus, WOS, PubMed, and Google Scholar. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was followed. The quality assessment was checked. The meta-analyses were performed using R-4.3.2 (COMPANY, CITY, STATE, COUNTRY) and SPSS version 28 (COMPANY, CITY, STATE, COUNTRY). The results demonstrated that 19 studies investigated the association between thyroid disorders and gynecologic cancers in adult females. The studies were categorized into two groups: group 1 examined thyroid status in various gynecologic cancers, while group 2 comprised case-control studies examining gynecologic cancer incidence in females with thyroid disorders compared to control. Among females with gynecologic cancers, 13% (95% confidence interval [CI], 10-17%) had hypothyroidism. When comparing hypothyroidism and hyperthyroidism across studies, the overall percentage for hypothyroidism was 14% (95% CI, 9-22%), while for hyperthyroidism, it was 3% (95% CI, 2-5%). The odds ratio for hypothyroidism in females with uterine cancer was 2.65 (P<0.05). Additionally, hypothyroidism showed a significant risk ratio of 1.3 (P<0.05) for different gynecologic cancers. However, hyperthyroidism was significantly associated with increased ovarian cancer mortality (RR, 2.14; P=0.03); conversely, hypothyroidism showed no significant relationship (RR, 1.35; P=0.26). The findings concluded that hypothyroidism is significantly associated with various gynecologic cancers, suggesting a potential role in its pathogenesis. Conversely, hyperthyroidism is linked to an increased risk of ovarian cancer mortality. Further research is needed to clarify whether hyperthyroidism predisposes females to ovarian cancer.

甲状腺疾病被认为与包括妇科癌症在内的各种健康问题有关。研究这种关联对临床实践至关重要。该方法通过在 Scopus、WOS、PubMed 和 Google Scholar 中进行检索。研究遵循了《系统综述和元分析首选报告项目》清单。对质量评估进行了检查。荟萃分析使用 R-4.3.2 版(公司、城市、州、国家)和 SPSS 28 版(公司、城市、州、国家)进行。结果显示,19 项研究调查了成年女性甲状腺疾病与妇科癌症之间的关系。这些研究被分为两组:第一组研究了各种妇科癌症中的甲状腺状况,第二组包括病例对照研究,研究了甲状腺疾病女性与对照组相比的妇科癌症发病率。在罹患妇科癌症的女性中,13%(95% 置信区间 [CI],10%-17%)患有甲状腺功能减退症。如果比较不同研究中的甲状腺功能减退症和甲状腺功能亢进症,甲状腺功能减退症的总体比例为14%(95% CI,9-22%),而甲状腺功能亢进症为3%(95% CI,2-5%)。患有子宫癌的女性甲状腺机能减退的几率比为 2.65(P
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引用次数: 0
Incidence of excessive gestational weight gain among overweight and obese women. 超重和肥胖妇女妊娠体重增加过多的发生率。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-01 Epub Date: 2024-08-21 DOI: 10.5468/ogs.24122
Suphisara Maimaen, Kusol Russameecharoen, Dittakarn Boriboonhirunsarn

Objective: To determine the incidence of excessive gestational weight gain (GWG) among overweight and obese pregnant women, its associated factors, and pregnancy outcomes.

Methods: A total of 355 overweight or obese singleton pregnant women who were included. Obstetric characteristics, weight gain, and pregnancy outcomes, were extracted from medical records. GWG was categorized according to the Institute of Medicine recommendation. Comparisons were made between individuals with inadequate, normal, and excessive GWG. Logistic regression analysis was performed to determine independent associated factors for excessive GWG.

Results: Majority of the women were overweight (68.7%), 38.9% were nulliparous, and mean pre-pregnancy body mass index was 28.9 kg/m2. Excessive GWG was observed in 53% of the women. Women with excessive GWG had significantly higher weight gain in every trimester. Risk of excessive GWG increased in women ≤30 years, while gestational diabetes (GDM) significantly decreased the risk. Women with excessive GWG had a significantly higher primary cesarean section rate. Both women with normal and excessive GWG showed higher rate of having large for gestational age (LGA) infants (P=0.003). Maternal age of ≤30 years significantly increased the risk of excessive GWG (adjusted odds ratio [aOR], 1.91; 95% confidence interval [CI], 1.11-3.27) and GDM significantly decreased this risk (aOR, 0.40; 95% CI, 0.24-0.67).

Conclusion: The incidence of excessive GWG among overweight and obese women was 53%. Maternal age of ≤30 years significantly increased this risk while women with GDM were significantly decreased risk. Primary cesarean section and fetal LGA significantly increased in women with excessive GWG.

目的确定超重和肥胖孕妇妊娠体重增加过多(GWG)的发生率、相关因素和妊娠结局:方法:共纳入 355 名超重或肥胖的单胎孕妇,这些孕妇在 Siriraj 医院接受产前护理并分娩。产科特征、体重增加和妊娠结局等数据均来自医疗记录。GWG根据医学研究所的建议进行分类。对 GWG 不足、正常和过高的个体进行比较。进行了逻辑回归分析,以确定 GWG 过高的独立相关因素:结果:大多数妇女超重(68.7%),38.9%为无子宫,孕前平均体重指数为 28.9 kg/m2。53%的妇女体重超标。体重增长过快的妇女在每个孕期的体重增长都明显较高。妊娠体重超标的风险在年龄小于 30 岁的女性中有所增加,而妊娠糖尿病(GDM)则明显降低了这一风险。GWG过高的妇女的初次剖宫产率明显较高。GWG正常和GWG过高的妇女都有较高的胎龄儿巨大儿(LGA)率(P=0.003)。产妇年龄小于 30 岁会显著增加 GWG 超标的风险(调整后的几率比 [OR],1.91;95% 置信区间 [95%CI],1.11-3.27),而 GDM 会显著降低这一风险(调整后的几率比,0.40;95% CI,0.24-0.67):结论:超重和肥胖妇女的 GWG 过高发生率为 53%。结论:超重和肥胖妇女的 GWG 过高发生率为 53%,产妇年龄≤30 岁会显著增加这一风险,而患有 GDM 的妇女的风险则显著降低。初次剖宫产率和胎儿 LGA 率在 GWG 过高的妇女中明显增加。
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引用次数: 0
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Obstetrics and Gynecology Science
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