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Determination of ovarian transposition through prediction of postoperative adjuvant therapy in young patients with early stage cervical cancer undergoing surgery: a Korean multicenter retrospective study (KGOG 1042). 通过预测接受手术的早期宫颈癌年轻患者的术后辅助治疗来确定卵巢移位:韩国一项多中心回顾性研究(KGOG 1042)。
IF 1.9 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-05-01 Epub Date: 2024-03-14 DOI: 10.5468/ogs.23291
Woo Yeon Hwang, Chel Hun Choi, Kidong Kim, Moon-Hong Kim, Myong Cheol Lim, Banghyun Lee, Myounghwan Kim, Yun Hwan Kim, Seok Ju Seong, Jong-Min Lee

Objective: We aimed to predict the risk of postoperative adjuvant therapy using preoperative variables in young patients with early stage cervical cancer. The predicted risk can guide whether ovarian transposition should be performed during surgery.

Methods: In total, 886 patients with stage IB1-IIA cervical cancer aged 20-45 years who underwent modified radical or radical hysterectomy between January 2000 and December 2008 were included. Preoperative variables, preoperative laboratory findings, International Federation of Gynaecology and Obstetrics stage, tumor size, and pathological variables were collected. Patients with high risk factors or those who met the Sedlis criteria were considered adjuvant therapy risk (+); others were considered adjuvant therapy risk (-). A decision-tree model using preoperative variables was constructed to predict the risk of adjuvant therapy.

Results: Of 886 patients, 362 were adjuvant therapy risk (+) (40.9%). The decision-tree model with four distinct adjuvant therapy risks using tumor size and age were generated. Specifically, patients with tumor size ≤2.45 cm had low risk (49/367; 13.4%), those with tumor size ≤3.85 cm and >2.45 cm had moderate risk (136/314; 43.3%), those with tumor size >3.85 cm and age ≤39.5 years had high risk (92/109; 84.4%), and those with tumor size >3.85 cm and age >39.5 years had the highest risk (85/96; 88.5%).

Conclusion: The risk of postoperative adjuvant therapy in young patients with early stage cervical cancer can be predicted using preoperative variables. We can decide whether ovarian transposition should be performed using the predicted risk.

目的我们旨在利用早期宫颈癌年轻患者的术前变量预测术后辅助治疗的风险。预测的风险可为是否在手术中进行卵巢移位提供指导:这项多中心回顾性研究使用了韩国妇科肿瘤组(KGOG)1028 研究的数据。研究共纳入了 886 例 IB1-IIA 期宫颈癌患者,年龄在 20-45 岁之间,均在 2000 年 1 月至 2008 年 12 月期间接受了改良根治术或根治性子宫切除术。收集了术前变量、术前实验室检查结果、国际妇产科联盟分期、肿瘤大小和病理变量。具有高危因素或符合Sedlis标准的患者被认为具有辅助治疗风险(+);其他患者被认为具有辅助治疗风险(-)。利用术前变量构建了一个决策树模型来预测辅助治疗的风险:结果:在886名患者中,有362人有辅助治疗风险(+)(40.9%)。利用肿瘤大小和年龄生成了四种不同辅助治疗风险的决策树模型。具体来说,肿瘤大小≤2.45厘米的患者风险较低(49/367;13.4%),肿瘤大小≤3.85厘米且>2.45厘米的患者风险中等(136/314;43.3%),肿瘤大小>3.85厘米且年龄≤39.5岁的患者风险较高(92/109;84.4%),肿瘤大小>3.85厘米且年龄>39.5岁的患者风险最高(85/96;88.5%):结论:年轻的早期宫颈癌患者术后辅助治疗的风险可通过术前变量进行预测。结论:可以通过术前变量预测早期宫颈癌年轻患者术后辅助治疗的风险,并根据预测的风险决定是否进行卵巢移位术。
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引用次数: 0
Cell-free DNA screening in twin pregnancies. 双胎妊娠中的无细胞 DNA 筛查
IF 1.9 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2024-01-25 DOI: 10.5468/ogs.23135
Hye Yeon Boo, You Jung Han

Cell-free DNA (cfDNA) screening for fetal aneuploidies is clinically available and exhibits better performance than conventional serum screening tests. However, data on the clinical performance of cfDNA screening in twin pregnancies are limited. In this review, we summarized the clinical performance and evaluated the feasibility of cfDNA screening in twin pregnancies based on recent studies and recommendations. The performance of cfDNA screening for trisomy 21 in twin pregnancies is similar to that in singleton pregnancies. Specifically, cfDNA screening has a higher detection rate and lower false-positive rate compared with conventional serum screening. Consequently, recent international guidelines from several academic communities have recommended that cfDNA screening for aneuploidy in twin pregnancies could be considered. Moreover, twin pregnancies can present with specific conditions, such as different zygosities and vanishing twins; therefore, individualized counseling and management are required. Further clinical studies with more twin pregnancies are required for a more accurate analysis.

无细胞 DNA(cfDNA)筛查胎儿非畸形已应用于临床,其性能优于传统的血清筛查试验。然而,有关双胎妊娠中 cfDNA 筛查临床表现的数据还很有限。在这篇综述中,我们总结了双胎妊娠的临床表现,并根据最近的研究和建议评估了无创产前检测在双胎妊娠中的可行性。双胎妊娠中 cfDNA 筛查 21 三体综合征的表现与单胎妊娠相似。与传统的血清筛查相比,cfDNA 筛查的检出率更高,假阳性率更低。因此,最近一些学术团体的国际指南建议,可以考虑对双胎妊娠进行非整倍体的 cfDNA 筛查。此外,双胎妊娠可能会出现一些特殊情况,如不同胎次和消失的双胞胎;因此,需要进行个体化的咨询和管理。要进行更准确的分析,还需要对更多的双胎妊娠进行进一步的临床研究。
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引用次数: 0
Effect of trigger day serum luteinising hormone levels on the in-vitro fertilization outcome: an observational study. 触发日血清黄体生成素水平对试管婴儿结果的影响:一项观察性研究。
IF 1.9 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2024-02-07 DOI: 10.5468/ogs.23215
Harpreet Kaur, Gautham T Pranesh, Vyshnavi Rao, Kamini A Rao

Objective: Controlled ovarian stimulation leads to profound changes in the endocrine characteristics of the ovarian cycle. Serum luteinising hormone (LH) levels on the day of trigger have been shown to correlate with oocyte quality and pregnancy rate in antagonist cycles.

Methods: This is an observational study of 86 women undergoing an antagonist in-vitro fertilisation cycle. Oocyte maturation trigger used was either Inj. human chorionic gonadotropin or Inj. triptorelin 0.2 mg s/c or a combination of both. Women were categorised into four groups based on serum LH levels on the day of trigger i.e., LH ≤0.5 (n=8), LH=0.6- 1.0 international units (IU)/L (n=12), LH=1.0-1.5 IU/L (n=13), and LH >1.6 IU/L (n=53) and the subgroup analysis was done based on type of trigger used.

Results: Mature oocyte (MII) retrieval rate did not show a significant relation with serum LH levels (87%, 89%, 77%, and 76% in groups with LH <0.5, 0.5-1.0, 1.0-1.5, and >1.5 IU/L respectively; P-value=0.243). There was no significant difference in the clinical pregnancy rate either when women were split according to the type of trigger given or according to trigger day LH levels. Women with low LH levels (<0.5 IU/L) required significantly more doses of gonadotropins compared to women with LH levels of 1.0-1.5 IU/L. (3,531+1,133 vs. 2,281+938; P-value=0.01).

Conclusion: Based on the observation from the current study, there was no significant association of serum LH levels with MII retrieval rate and clinical pregnancy rate. The group with low LH levels required slightly longer days of stimulation.

目的:控制性卵巢刺激会导致卵巢周期的内分泌特征发生剧烈变化。在拮抗剂周期中,触发卵巢刺激日的血清黄体生成素(LH)水平与卵母细胞质量和妊娠率相关:这项观察性研究的对象是在印度一家三级试管婴儿医院接受拮抗剂体外受精(IVF)周期治疗的 86 名妇女,她们的适应症各不相同。为了促使卵母细胞成熟,主治医生决定注射人绒毛膜促性腺激素或曲普瑞林 0.2 mg/s/c,或两者的组合。根据触发当天的血清 LH 水平,妇女被分为四组,即 LH ≤0.5 IU/L (人数=08)、LH=0.6-1.0 IU/L (人数=12)、LH=1.0-1.5 IU/L (人数=13)和 LH >1.6 IU/L (人数=53)。根据所使用的触发器类型进行了分组分析:成熟卵母细胞(MII)获取率与血清 LH 水平无显著相关性(LH 为 1.5 IU/L 的组别中,成熟卵母细胞获取率为 87%;P=0.243)。LH水平低(触发日为1.5 IU/L)的妇女(五分之四报告流产):我们的研究结果表明,血清 LH 水平、MII 取卵率和临床妊娠率之间没有明显的关联。低 LH 水平组所需的刺激天数稍长,而在触发日 LH 水平大于 1.5 IU/L 的妇女中,流产次数有增加的趋势。
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引用次数: 0
Potential applications of ChatGPT in obstetrics and gynecology in Korea: a review article. ChatGPT 在韩国妇产科中的潜在应用:综述文章。
IF 1.9 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2024-01-22 DOI: 10.5468/ogs.23231
YooKyung Lee, So Yun Kim

The use of chatbot technology, particularly chat generative pre-trained transformer (ChatGPT) with an impressive 175 billion parameters, has garnered significant attention across various domains, including Obstetrics and Gynecology (OBGYN). This comprehensive review delves into the transformative potential of chatbots with a special focus on ChatGPT as a leading artificial intelligence (AI) technology. Moreover, ChatGPT harnesses the power of deep learning algorithms to generate responses that closely mimic human language, opening up myriad applications in medicine, research, and education. In the field of medicine, ChatGPT plays a pivotal role in diagnosis, treatment, and personalized patient education. Notably, the technology has demonstrated remarkable capabilities, surpassing human performance in OBGYN examinations, and delivering highly accurate diagnoses. However, challenges remain, including the need to verify the accuracy of the information and address the ethical considerations and limitations. In the wide scope of chatbot technology, AI systems play a vital role in healthcare processes, including documentation, diagnosis, research, and education. Although promising, the limitations and occasional inaccuracies require validation by healthcare professionals. This review also examined global chatbot adoption in healthcare, emphasizing the need for user awareness to ensure patient safety. Chatbot technology holds great promise in OBGYN and medicine, offering innovative solutions while necessitating responsible integration to ensure patient care and safety.

聊天机器人技术,尤其是拥有 1,750 亿个惊人参数的聊天生成预训练变换器(ChatGPT),在包括妇产科(OBGYN)在内的各个领域都引起了广泛关注。本综合评论深入探讨了聊天机器人的变革潜力,并特别关注了作为领先人工智能(AI)技术的 ChatGPT。此外,ChatGPT 利用深度学习算法的强大功能,生成近似人类语言的回复,在医疗、研究和教育领域开辟了无数应用前景。在医学领域,ChatGPT 在诊断、治疗和个性化患者教育方面发挥着举足轻重的作用。值得注意的是,该技术已经展现出非凡的能力,在妇产科检查中超越了人类的表现,并提供高度准确的诊断。然而,挑战依然存在,包括需要验证信息的准确性,解决伦理问题和局限性。在聊天机器人技术的广泛应用中,人工智能系统在医疗保健流程中发挥着至关重要的作用,包括记录、诊断、研究和教育。虽然前景广阔,但其局限性和偶尔的不准确性需要医疗保健专业人员的验证。本综述还研究了全球在医疗保健领域采用聊天机器人的情况,强调需要提高用户意识以确保患者安全。聊天机器人技术在妇产科和医疗领域大有可为,在提供创新解决方案的同时,还需要负责任地进行整合,以确保患者护理和安全。
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引用次数: 0
Robotic sacrocolpopexy. 机器人骶骨整形术
IF 1.9 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2024-01-18 DOI: 10.5468/ogs.23226
Al-Otaibi Mozon, Ju Hee Kim, Sa Ra Lee

Pelvic organ prolapse (POP) is a common cause of gynecological disease in elderly women. The prevalence of POP has increased with an aging society. Abdominal sacrocolpopexy (ASC) is safer and more effective than the vaginal approach in patients with apical compartment POP because it has a higher anatomical cure rate, a lower recurrence rate, less dyspareunia, and improved sexual function. Laparoscopic sacrocolpopexy (LSC) has replaced ASC. Robotic sacrocolpopexy (RSC) also helps overcome the challenges of LSC by facilitating deep pelvic dissection and multiple intracorporeal suturing. The RSC is technically easy to apply, has a steep learning curve, and offers many advantages over the LSC. However, insufficient data led us to conclude that the LSC is superior overall, especially in terms of costeffectiveness. The present review provides insights into different aspects of RSC, highlighting the most common benefits and concerns of this procedure. We searched for eligible articles discussing this issue from January 2019 to March 2022 to reveal the outcomes of RSC.

盆腔器官脱垂(POP)是老年妇女妇科疾病的常见病因。随着老龄化社会的到来,盆腔器官脱垂的发病率也在增加。腹腔镜骶尾部结扎术(ASC)比阴道法更安全、更有效,因为腹腔镜骶尾部结扎术解剖学治愈率更高、复发率更低、排便困难更少、性功能更佳。腹腔镜骶尾部结扎术(LSC)已经取代了腹腔镜骶尾部结扎术。机器人骶尾部结扎术(RSC)也有助于克服腹腔镜骶尾部结扎术的挑战,因为它便于盆腔深部解剖和多次体腔内缝合。RSC 在技术上易于应用,学习曲线陡峭,与 LSC 相比具有很多优势。然而,由于数据不足,我们得出结论认为 LSC 总体上更具优势,尤其是在成本效益方面。本综述深入探讨了 RSC 的各个方面,重点介绍了该手术最常见的优点和问题。我们搜索了2019年1月至2022年3月期间讨论该问题的符合条件的文章,以揭示RSC的结果。
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引用次数: 0
Clinical relevance of vaginal natural orifice transluminal endoscopic surgery (vNOTES) in gynecology. 妇科阴道自然孔腔镜内窥镜手术(vNOTES)的临床意义。
IF 1.9 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2024-01-16 DOI: 10.5468/ogs.23205
Jung Chul Kim, Ga Won Yim, Young Tae Kim

This study reviews the progress and recent advances in vaginal natural orifice transluminal endoscopic surgery (vNOTES) as a minimally invasive gynecologic procedure. The proposed advantages of vaginal natural orifice transluminal surgery include enhanced cosmesis due to a scarless procedure, better exposure compared with the pure vaginal approach, tolerable pain scores, fewer perioperative complications, and a shorter hospital stay. Recent advances in surgical instrumentation and technology have improved the feasibility of vNOTES as an innovative treatment option for gynecological conditions. However, technical challenges and training issues must be overcome before its widespread use. As a promising surgical innovation, further randomized comparative studies are required to clarify the safety and effectiveness of vNOTES in gynecology.

本研究回顾了阴道自然腔道内窥镜手术(vNOTES)作为微创妇科手术的进展和最新进展。阴道自然孔腔镜手术的优点包括:无疤痕手术改善了外观;与纯阴道手术相比,暴露效果更好;疼痛评分可耐受;围手术期并发症少;住院时间短。手术器械和技术的最新进展提高了 vNOTES 作为妇科疾病创新治疗方案的可行性。然而,在广泛应用之前,还必须克服技术挑战和培训问题。作为一种前景广阔的外科创新技术,还需要进一步的随机对比研究来明确vNOTES在妇科领域的安全性和有效性。
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引用次数: 0
Vulval premalignant lesions: a review article. 外阴癌前病变:综述文章。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2024-01-23 DOI: 10.5468/ogs.23274
Sumedha Gupta, Sana Ahuja, Dheer Singh Kalwaniya, Saritha Shamsunder, Shalu Solanki

Vulvar intraepithelial neoplasia (VIN) is a noninvasive squamous lesion that is a precursor of vulvar squamous cell cancer. Currently, no screening tests are available for detecting VIN, and a biopsy is performed to confirm the clinical diagnosis. Despite sharing many risk factors with cervical intraepithelial neoplasia, the diagnosis of VIN is poses challenges, contributing to its increasing prevalence. This study aimed to analyze the underlying risk factors that contribute to the development of VIN, identify specific populations at risk, and define appropriate treatment approaches. Differentiated VIN (dVIN) and usual VIN (uVIN) are the classifications of VIN. While dVIN is associated with other vulvar inflammatory disorders, such as lichen sclerosis, the more prevalent uVIN is associated with an underlying human papillomavirus infection. Patients with differentiated VIN have an increased risk of developing invasive malignancies. Few effective surveillance or management techniques exist for vulvar intraepithelial neoplasia, a preinvasive neoplasm of the vulva. For suspicious lesions, a thorough examination and focused biopsy are necessary. Depending on the specific needs of each patient, a combination of surgical and medical approaches can be used.

外阴上皮内瘤变(VIN)是一种非侵入性鳞状病变,是外阴鳞状细胞癌的前兆。目前还没有检测 VIN 的筛查试验,需要进行活组织检查来确诊。尽管外阴鳞状细胞癌与宫颈上皮内瘤变有许多共同的风险因素,但其诊断仍面临挑战,这也是其发病率不断上升的原因之一。本研究旨在分析导致 VIN 发生的潜在风险因素,识别特定高危人群,并确定适当的治疗方法。分化型 VIN(dVIN)和普通型 VIN(uVIN)是 VIN 的分类。分化型外阴阴道炎(dVIN)与其他外阴炎症性疾病(如苔藓硬化症)有关,而更常见的普通型外阴阴道炎(uVIN)则与潜在的人类乳头瘤病毒感染有关。分化型 VIN 患者罹患侵袭性恶性肿瘤的风险更高。外阴上皮内瘤变是外阴的一种浸润性肿瘤,目前几乎没有有效的监测或管理技术。对于可疑病变,必须进行彻底检查和重点活检。根据每位患者的具体需求,可采用手术和药物治疗相结合的方法。
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引用次数: 0
Additional low-pressure pulmonary recruitment for reducing post-laparoscopic shoulder pain in gynecologic laparoscopy: a randomized controlled trial. 减少妇科腹腔镜手术后肩部疼痛的额外低压肺募集:随机对照试验。
IF 1.9 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2024-01-18 DOI: 10.5468/ogs.23197
Amornrat Temtanakitpaisan, Teerayut Temtanakitpaisan, Chaiyaporn Pratipanawatr, Pranom Buppasiri, Monsicha Somjit

Objective: To evaluate the effectiveness of additional low-pressure pulmonary recruitment in reducing postoperative shoulder pain.

Methods: A double-blind randomized controlled trial was conducted at Srinagarind Hospital between May 2021 and October 2021. Forty patients who underwent laparoscopic gynecologic surgery were randomized into either an intervention group that received additional low-pressure pulmonary recruitment (30 cmH2O) (n=20) or a control group (n=20). Shoulder pain was evaluated using a numerical rating scale from 0 to 10, 24, and 48 hours after the operation.

Results: The mean±standard deviation of shoulder pain at 24 hours after the operation of both the intervention and control groups were 2.10±2.27 and 1.45±1.73 points, respectively. The shoulder pain at 48 hours after the operation of the intervention and control groups were 1.15±1.46 and 0.85±1.73 points, respectively. There were no statistical differences in the mean difference between the two groups at 24 and 48 hours after operation (P=0.49; 95% confidence interval [CI], -0.61 to 1.91 and P=1.00; 95% CI, -0.96 to 1.56, respectively). No statistically significant differences were observed in additional analgesic medications used in either group, such as intravenous morphine or oral acetaminophen.

Conclusion: Additional low-pressure pulmonary recruitment to reduce shoulder pain after laparoscopic surgery for benign gynecologic diseases did not show a significant benefit compared to the control group, especially when administering postoperative around-the-clock analgesia.

目的评估额外的低压肺招募对减轻术后肩部疼痛的效果:2021 年 5 月至 2021 年 10 月期间,大学医院开展了一项双盲随机对照试验。40名接受腹腔镜妇科手术的患者被随机分为干预组(20人)和对照组(20人),干预组接受额外的低压肺通气(30 cmH2O)。术后24小时和48小时,采用0至10分的数字评分表对肩部疼痛进行评估:干预组和对照组术后 24 小时肩痛的平均值(标准差)分别为 2.10±2.27 分和 1.45±1.73 分。干预组和对照组术后 48 小时肩痛的平均值(1.15±1.46)分和标准差(0.85±1.73)分分别为(2.10±2.27)分和(1.45±1.73)分。两组在术后 24 小时和 48 小时的平均差异无统计学意义(P=0.49,95% 置信区间[CI],分别为-0.61 至 1.91 和 P=1.00,95% CI,-0.96 至 1.56)。两组额外使用的镇痛药物(如静脉注射吗啡或口服对乙酰氨基酚)在统计学上无明显差异:结论:与对照组相比,为减轻妇科良性疾病腹腔镜手术后肩部疼痛而进行的额外低压肺通气并未显示出明显的益处,尤其是在术后全天候镇痛的情况下。
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引用次数: 0
Hydroxychloroquine in obstetrics: potential implications of the prophylactic use of hydroxychloroquine for placental insufficiency during pregnancy. 产科中的羟氯喹:妊娠期胎盘功能不全预防性使用羟氯喹的潜在影响》。
IF 2 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2024-01-19 DOI: 10.5468/ogs.23252
Yoo-Min Kim, Ji-Hee Sung, Hyun-Hwa Cha, Soo-Young Oh

Proper placentation during early pregnancy is a key factor for maintaining a healthy pregnancy. Placental insufficiency leads to critical complications such as preeclampsia, fetal growth restriction, and fetal demise. These complications are often associated with pathological findings of restricted remodeling and obstructive lesions of the myometrial spiral arteries, which have high recurrence rates during subsequent pregnancies. Currently, there are no pharmacological interventions other than aspirin for the prevention of preeclampsia. Hydroxychloroquine (HCQ), a well-known antimalarial drug, reduces inflammatory and thrombotic changes in vessels. For decades, the use of HCQ for autoimmune diseases has resulted in the successful prevention of both arterial and venous thrombotic events and has been extended to the treatment of lupus and antiphospholipid antibody syndrome during pregnancy. HCQ reduces the risk of preeclampsia with lupus by up to 90%. Several recent studies have investigated whether HCQ improves pregnancy outcomes in women with a history of poor outcomes. In addition, in vitro and animal studies have demonstrated the beneficial effects of HCQ in improving endothelial dysfunction and alleviating hypertension and proteinuria. Therefore, we hypothesized that HCQ has the potential to attenuate the vascular inflammatory and thrombogenic pathways associated with placental insufficiency and conducted a multicenter clinical trial on the efficacy of combining aspirin with HCQ for pregnancies at high risk for preeclampsia in Korea. This study summarizes the potential effects of HCQ on pregnancies with placental insufficiency and the implications of HCQ treatment in the field of obstetrics.

孕早期适当的胎盘植入是维持孕期健康的关键因素。胎盘功能不全可导致子痫前期、胎儿生长受限和胎儿死亡等严重并发症。这些并发症通常与子宫肌层螺旋动脉重塑受限和阻塞性病变的病理结果有关,这些病变在以后的妊娠中复发率很高。目前,除阿司匹林外,还没有其他药物干预措施来预防子痫前期。羟氯喹(HCQ)是一种著名的抗疟药物,可减少血管的炎症和血栓变化。几十年来,使用 HCQ 治疗自身免疫性疾病已成功预防了动脉和静脉血栓事件,并已扩展到治疗妊娠期狼疮和抗磷脂抗体综合征。HCQ 可将狼疮先兆子痫的风险降低高达 90%。最近有几项研究调查了 HCQ 是否能改善有不良妊娠结局病史的妇女的妊娠结局。此外,体外和动物实验也证明了 HCQ 在改善内皮功能障碍、缓解高血压和蛋白尿方面的有益作用。因此,我们假设 HCQ 有可能减轻与胎盘功能不全相关的血管炎症和血栓形成途径,并在韩国开展了一项多中心临床试验,研究阿司匹林与 HCQ 联合使用对子痫前期高危妊娠的疗效。本研究总结了 HCQ 对胎盘功能不全妊娠的潜在影响,以及 HCQ 治疗在产科领域的意义。
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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 : 2024-03-01 Epub Date: 2024-01-15 DOI: 10.5468/ogs.23210
Saeed Baradwan, Abdulrahim Gari, Hussein Sabban, Majed Saeed Alshahrani, Khalid Khadawardi, Ibtihal Abdulaziz Bukhari, Abdullah Alyousef, Ahmed Abu-Zaid

This study aimed to review randomized controlled trials (RCTs) investigating the effects of dietary antioxidant supplements on the severity of endometriosis-related pain symptoms. The PubMed/Medline, Scopus, and Web of Science databases were searched until April 2022. Additionally, we manually searched the reference lists. Endpoints were summarized as standardized mean difference (SMD) with 95% confidence intervals (CIs) in a random-effects model. The I2 statistic was used to assess heterogeneity. Ten RCTs were included in this meta-analysis. Overall, 10 studies were related to dysmenorrhea, four to dyspareunia, and four to pelvic pain. Antioxidants significantly reduced dysmenorrhea (SMD, -0.48; 95% CI, -0.82 to -0.13; I2=75.14%). In a subgroup analysis, a significant reduction of dysmenorrhea was observed only in a subset of trials that administered vitamin D (SMD, -0.59; 95% CI, -1.13 to -0.06; I2=69.59%) and melatonin (SMD, -1.40; 95% CI, -2.47 to -0.32; I2=79.15%). Meta-analysis results also suggested that antioxidant supplementation significantly improved pelvic pain (SMD, -1.51; 95% CI, -2.74 to -0.29; I2=93.96%), although they seem not to have a significant beneficial impact on the severity of dyspareunia. Dietary antioxidant supplementation seems to beneficially impact the severity of endometriosis-related dysmenorrhea (with an emphasis on vitamin D and melatonin) and pelvic pain. However, due to the relatively small sample size and high heterogeneity, the findings should be interpreted cautiously, and the importance of further well-designed clinical studies cannot be overstated.

本研究旨在回顾调查膳食抗氧化剂补充剂对子宫内膜异位症相关疼痛症状严重程度影响的随机对照试验(RCT)。我们检索了 PubMed/Medline、Scopus 和 Web of Science 数据库,检索时间截止到 2022 年 4 月。此外,我们还人工检索了参考文献列表。在随机效应模型中,终点以标准化均值差异(SMD)和95%置信区间(CI)进行总结。I2统计量用于评估异质性。本次荟萃分析共纳入了 10 项研究。总体而言,10 项研究与痛经有关,4 项研究与排便困难有关,4 项研究与盆腔疼痛有关。抗氧化剂可明显减少痛经(SMD,-0.48;95% CI,-0.82 至 -0.13;I2=75.14%)。在一项亚组分析中,仅在服用维生素 D(SMD,-0.59;95% CI,-1.13 至 -0.06;I2=69.59%)和褪黑素(SMD,-1.40;95% CI,-2.47 至 -0.32;I2=79.15%)的试验中观察到痛经明显减少。元分析结果还表明,补充抗氧化剂可明显改善骨盆疼痛(SMD,-1.51;95% CI,-2.74 至 -0.29;I2=93.96%),尽管它们似乎对排便困难的严重程度没有显著的有益影响。补充膳食抗氧化剂似乎对子宫内膜异位症相关痛经(重点是维生素 D 和褪黑激素)和盆腔疼痛的严重程度有好处。然而,由于样本量相对较小,异质性较高,因此应谨慎解读研究结果,进一步开展设计良好的临床研究的重要性无论如何强调都不为过。
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Obstetrics and Gynecology Science
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