Pub Date : 2026-01-01DOI: 10.1016/j.gine.2025.101088
M. Tarbal Roquer , N. Capdevila Atienza , C. Lesmes Heredia , N. Baena Díez , M. Comas Rovira
Introduction
Beckwith-Wiedemann Syndrome (BWS) is a congenital disorder characterized by excessive growth and a range of clinical manifestations, including macroglossia, macrosomia, polyhydramnios, visceromegaly, and abdominal wall defects, as well as an elevated risk of developing embryonic tumours, such as Wilms tumour. Most cases are sporadic, although about 15% are inherited. Prenatal diagnosis is a challenge due to its wide phenotypic variability.
Main symptoms and clinical findings
This case presents a prenatal and genetic diagnosis of BWS following the detection of bilateral nephromegaly and macroglossia on the second-trimester ultrasound in a 32-year-old pregnant woman, which led to suspicion of BWS.
Main diagnosis
Genetic confirmation was obtained through the analysis of methylation in the IC1 region of chromosome 11p15.5.
Therapeutic intervention and results
The pregnant woman developed severe preeclampsia at 37 weeks, and the pregnancy was terminated. The newborn's physical examination revealed macroglossia without airway involvement and macrosomia. Postnatal management required treatment for neonatal hypoglycemia, medical and surgical treatment for macroglossia, and subsequent early tumour diagnosis follow-up.
Conclusion
This case highlights the importance of prenatal diagnostic suspicion and genetic studies in the early identification of BWS, enabling multidisciplinary follow-up during pregnancy in a tertiary care centre and appropriate postnatal management to prevent complications associated with these cases.
{"title":"Diagnóstico prenatal de síndrome de Beckwith-Wiedemann en un feto con nefromegalia bilateral: a propósito de un caso","authors":"M. Tarbal Roquer , N. Capdevila Atienza , C. Lesmes Heredia , N. Baena Díez , M. Comas Rovira","doi":"10.1016/j.gine.2025.101088","DOIUrl":"10.1016/j.gine.2025.101088","url":null,"abstract":"<div><h3>Introduction</h3><div>Beckwith-Wiedemann Syndrome (BWS) is a congenital disorder characterized by excessive growth and a range of clinical manifestations, including macroglossia, macrosomia, polyhydramnios, visceromegaly, and abdominal wall defects, as well as an elevated risk of developing embryonic tumours, such as Wilms tumour. Most cases are sporadic, although about 15% are inherited. Prenatal diagnosis is a challenge due to its wide phenotypic variability.</div></div><div><h3>Main symptoms and clinical findings</h3><div>This case presents a prenatal and genetic diagnosis of BWS following the detection of bilateral nephromegaly and macroglossia on the second-trimester ultrasound in a 32-year-old pregnant woman, which led to suspicion of BWS.</div></div><div><h3>Main diagnosis</h3><div>Genetic confirmation was obtained through the analysis of methylation in the IC1 region of chromosome 11p15.5.</div></div><div><h3>Therapeutic intervention and results</h3><div>The pregnant woman developed severe preeclampsia at 37 weeks, and the pregnancy was terminated. The newborn's physical examination revealed macroglossia without airway involvement and macrosomia. Postnatal management required treatment for neonatal hypoglycemia, medical and surgical treatment for macroglossia, and subsequent early tumour diagnosis follow-up.</div></div><div><h3>Conclusion</h3><div>This case highlights the importance of prenatal diagnostic suspicion and genetic studies in the early identification of BWS, enabling multidisciplinary follow-up during pregnancy in a tertiary care centre and appropriate postnatal management to prevent complications associated with these cases.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"53 1","pages":"Article 101088"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038141","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}
Pub Date : 2026-01-01DOI: 10.1016/j.gine.2025.101086
D. Rivadulla-Lorenzo , I. Da Cuña-Carrera , A. Alonso-Calvete , D. Tomé-Lage , M. López-Pais
Background
Pelvic organ prolapse is a common dysfunction among adult women worldwide, characterized by the pathological displacement of the uterus, bladder, or other organs from their anatomical position. This condition can lead to urinary, bowel, or sexual symptoms. Physiotherapy, as a conservative treatment, offers significant benefits in alleviating these symptoms. This review aims to analyze the most recent scientific evidence to evaluate the effectiveness of the latest physiotherapy treatments in managing prolapse.
Materials and methods
A literature search was conducted in January 2025 across the databases PubMed®, Web of Science™, Scopus®, PEDro, SciELO, and CINAHL®. The descriptors «Pelvic Organ Prolapse» and «Physical Therapy Modalities» were used. Randomized controlled trials published in the last five years in English or Spanish were included.
Results
A total of 466 results were obtained, of which 10 were selected after meeting the inclusion criteria. The articles under review developed different physiotherapy interventions, among which the favorable effects of pelvic floor muscle training in reducing the degree of prolapse and improving quality of life and sexuality stand out.
Conclusion
Physiotherapy appears to have beneficial effects in improving quality of life, prolapse severity, and pelvic floor muscle strength.
盆腔器官脱垂是全球成年女性常见的一种功能障碍，其特征是子宫、膀胱或其他器官从其解剖位置发生病理性移位。这种情况可导致泌尿、肠道或性症状。物理治疗作为一种保守治疗，在缓解这些症状方面有显著的益处。本综述旨在分析最新的科学证据，以评估最新的物理治疗方法在治疗脱垂中的有效性。材料和方法于2025年1月在PubMed®、Web of Science™、Scopus®、PEDro、SciELO和CINAHL®数据库中进行了文献检索。使用了描述词“盆腔器官脱垂”和“物理治疗方式”。在过去的五年中，用英语或西班牙语发表的随机对照试验被纳入其中。结果共获得466份结果，其中10份符合纳入标准。所回顾的文章发展了不同的物理治疗干预措施，其中盆底肌肉训练在减少脱垂程度和改善生活质量和性行为方面的有利效果最为突出。结论物理治疗在改善生活质量、脱垂严重程度和骨盆底肌力方面具有有益作用。
{"title":"Actualización de los efectos de la fisioterapia en el manejo de prolapsos de órganos pélvicos. Una revisión sistemática","authors":"D. Rivadulla-Lorenzo , I. Da Cuña-Carrera , A. Alonso-Calvete , D. Tomé-Lage , M. López-Pais","doi":"10.1016/j.gine.2025.101086","DOIUrl":"10.1016/j.gine.2025.101086","url":null,"abstract":"<div><h3>Background</h3><div>Pelvic organ prolapse is a common dysfunction among adult women worldwide, characterized by the pathological displacement of the uterus, bladder, or other organs from their anatomical position. This condition can lead to urinary, bowel, or sexual symptoms. Physiotherapy, as a conservative treatment, offers significant benefits in alleviating these symptoms. This review aims to analyze the most recent scientific evidence to evaluate the effectiveness of the latest physiotherapy treatments in managing prolapse.</div></div><div><h3>Materials and methods</h3><div>A literature search was conducted in January 2025 across the databases PubMed®, Web of Science™, Scopus®, PEDro, SciELO, and CINAHL®. The descriptors «Pelvic Organ Prolapse» and «Physical Therapy Modalities» were used. Randomized controlled trials published in the last five years in English or Spanish were included.</div></div><div><h3>Results</h3><div>A total of 466 results were obtained, of which 10 were selected after meeting the inclusion criteria. The articles under review developed different physiotherapy interventions, among which the favorable effects of pelvic floor muscle training in reducing the degree of prolapse and improving quality of life and sexuality stand out.</div></div><div><h3>Conclusion</h3><div>Physiotherapy appears to have beneficial effects in improving quality of life, prolapse severity, and pelvic floor muscle strength.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"53 1","pages":"Article 101086"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885126","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}
Pub Date : 2026-01-01DOI: 10.1016/j.gine.2025.101087
E. Balkan Kuru , E. Aslan
Introduction
Despite patient-centered care has positive effects on treatment and increases the quality of care, healthcare workers do not emphasize patient-centered care enough and this situation may negatively affect the treatment-related QoL. This study aimed to investigate the perceptions of infertile women regarding patient-centered fertility care and treatment-related quality of life.
Methods
Descriptive Information Form, Patient-Centered Fertility Care Questionnaire for Infertile Women, and FertiQol Treatment Module were used to collect data from 160 infertile women in Türkiye between July and October 2020.
Results
The mean patient-centered care perception score was 7.49 ± 1.91, and participants received a mean score of 65.96 ± 15.65 on FertiQol Treatment Module. A statistically significant positive correlation existed between patient-centered fertility care perception and the FertiQol Treatment Module scores. Nearly half of the women received sufficient attention and support from the nurses, and more than half of the women stated that the nurses were considerate toward them. However, 48.8% of the women reported were not informed about the side effects of the drugs, and 36.9% of them were not informed about the injection methods.
Conclusion
The components of patient-centered fertility care were included in fertility treatment. Patient-centered fertility care approach has been found to correlate to the treatment-related QoL. But due to the lack of received information about the fertility treatments, it is suggested that healthcare professionals in fertility clinics should provide therapeutic education to improve the patient-centered care perceptions and treatment related QoL of the infertile individuals.
{"title":"Patient-centered fertility care perceptions and treatment-related quality of life with infertility","authors":"E. Balkan Kuru , E. Aslan","doi":"10.1016/j.gine.2025.101087","DOIUrl":"10.1016/j.gine.2025.101087","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite patient-centered care has positive effects on treatment and increases the quality of care, healthcare workers do not emphasize patient-centered care enough and this situation may negatively affect the treatment-related QoL. This study aimed to investigate the perceptions of infertile women regarding patient-centered fertility care and treatment-related quality of life.</div></div><div><h3>Methods</h3><div>Descriptive Information Form, Patient-Centered Fertility Care Questionnaire for Infertile Women, and FertiQol Treatment Module were used to collect data from 160 infertile women in Türkiye between July and October 2020.</div></div><div><h3>Results</h3><div>The mean patient-centered care perception score was 7.49<!--> <!-->±<!--> <!-->1.91, and participants received a mean score of 65.96<!--> <!-->±<!--> <!-->15.65 on FertiQol Treatment Module. A statistically significant positive correlation existed between patient-centered fertility care perception and the FertiQol Treatment Module scores. Nearly half of the women received sufficient attention and support from the nurses, and more than half of the women stated that the nurses were considerate toward them. However, 48.8% of the women reported were not informed about the side effects of the drugs, and 36.9% of them were not informed about the injection methods.</div></div><div><h3>Conclusion</h3><div>The components of patient-centered fertility care were included in fertility treatment. Patient-centered fertility care approach has been found to correlate to the treatment-related QoL. But due to the lack of received information about the fertility treatments, it is suggested that healthcare professionals in fertility clinics should provide therapeutic education to improve the patient-centered care perceptions and treatment related QoL of the infertile individuals.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"53 1","pages":"Article 101087"},"PeriodicalIF":0.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927167","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}
Pub Date : 2025-12-17DOI: 10.1016/j.gine.2025.101074
R.G. Anwar , M.E. Ahmed , I.B. Sherif , A.M. Maaty , R. Ali , M.H. Kolaib , M. Barakat , W. Elsayed
Background
Cesarean section scar defect (CSD), also known as a niche, is a myometrial discontinuity or defect at the site of a previous Cesarean section (CS) incision on the lower segment of the uterus.
Objective
Primarily to assess the agreement between three-dimensional transvaginal (3D TVUS) and saline-infused sonohysterography (SIS) for the diagnosis and evaluation of the parameters of CSD. The secondary objective was to evaluate patients’ satisfaction and tolerability with each procedure, in addition to the cost.
Methods
We did a prospective agreement study between 3D TVUS and SIS. We included 72 women with a history of cesarean section within the past 6 months to 5 years, and complaining of infertility, dysmenorrhea, lower abdominal/pelvic pain, irregular uterine bleeding, or repeated miscarriages. Recruitment from the ultrasound unit at the Obstetrics and Gynecology department, Ain Shams University, between July 2021 and October 2023. After gaining consent, participants underwent both 3D TVUS and SIS examinations.
Results
3D TVUS and SIS showed nearly good agreement regarding the detection of CSD with a kappa (κ) of 0.780 (p < 0.001). Regarding the assessment of the parameters, no significant differences were observed between the two modalities regarding depth, length, and width of CSD (p > 0.05), but there was a significant difference in the assessment of the volume (p = 0.004). 3D TVUS was considerably more expensive (300.00 ± 0.00 LE) than SIS (231.11 ± 31.65 LE, p < 0.001), but it took less time (5.94 ± 0.79 min vs. 14.85 ± 1.32 min, p < 0.001). With 3D TVUS, all patients (100%) expressed high levels of tolerability and satisfaction, but with SIS, tolerability and satisfaction were 8.3% and 90.3% (p < 0.001 and p = 0.007, respectively).
Conclusion
The comparison between 3D-TVUS and SIS in evaluating cesarean scar defects (CSD) demonstrated a high level of agreement. Moreover, the findings highlight the advantages of 3D-TVUS over SIS in terms of ease of use and patient preference, offering greater satisfaction, better tolerance, and improved time efficiency.
剖宫产瘢痕缺损（CSD），也被称为小位，是子宫下段剖宫产术（CS）切口部位的子宫肌膜不连续性或缺损。目的初步探讨三维经阴道超声（3D TVUS）与盐水灌注超声（SIS）对CSD诊断及参数评价的一致性。次要目标是评估患者对每个手术的满意度和耐受性，以及成本。方法对3D电视超声与SIS进行前瞻性一致性研究。我们纳入了72名在过去6个月至5年内有剖宫产史的妇女，她们有不孕、痛经、下腹部/盆腔疼痛、不规则子宫出血或反复流产的主诉。2021年7月至2023年10月，从艾因沙姆斯大学妇产科超声科室招聘。获得同意后，参与者接受3D TVUS和SIS检查。结果3d TVUS与SIS对CSD的检测一致，kappa （κ）为0.780 （p < 0.001）。在参数评估方面，两种模式在CSD的深度、长度和宽度方面无显著差异（p > 0.05），但在体积评估方面有显著差异（p = 0.004）。3D TVUS的成本（300.00±0.00 LE）明显高于SIS(231.11±31.65 LE, p < 0.001)，但所需时间更短（5.94±0.79 min vs. 14.85±1.32 min, p < 0.001）。使用3D TVUS时，所有患者（100%）表示高水平的耐受性和满意度，而使用SIS时，耐受性和满意度分别为8.3%和90.3% （p <； 0.001和p = 0.007）。结论3D-TVUS与SIS对剖宫产瘢痕缺损（CSD）的评价具有较高的一致性。此外，研究结果强调了3D-TVUS在易用性和患者偏好方面优于SIS的优势，提供了更高的满意度，更好的耐受性，并提高了时间效率。
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Pub Date : 2025-12-16DOI: 10.1016/j.gine.2025.101073
L. Esmalian Khamseh , J. Jomeen , R. Cousins , M. Aruguete , V. Sharma
Tokophobia, the intense fear of childbirth, is increasingly recognized as a significant global health concern with serious implications for women's mental well-being and reproductive decisions. This narrative review explores its worldwide incidence and prevalence, revealing notable variations across regions—moderate to high rates are reported in Asia, Australia, the Middle East, and Africa, while lower rates are observed in European countries. Tokophobia is associated with adverse mental health outcomes such as anxiety, depression, and post-traumatic stress disorder, and it also influences reproductive behavior, including reduced fertility and increased preference for elective cesarean sections. A comprehensive literature search was conducted using databases such as PubMed, Web of Science, and Google Scholar, focusing on studies published between 2013 and 2023. The findings highlight the urgent need for early detection and targeted interventions to mitigate the psychological and reproductive consequences of tokophobia. Greater awareness and research into its complex interplay with maternal mental health are essential to inform clinical practice and public health strategies.
分娩恐惧症，即对分娩的强烈恐惧，越来越被认为是一个重大的全球健康问题，对妇女的精神健康和生育决定产生严重影响。这篇叙述性综述探讨了其在世界范围内的发病率和流行率，揭示了各区域之间的显著差异——亚洲、澳大利亚、中东和非洲报告了中高发病率，而欧洲国家的发病率较低。恐惧症与焦虑、抑郁和创伤后应激障碍等不良心理健康结果有关，还会影响生殖行为，包括生育率下降和选择性剖宫产偏好增加。利用PubMed、Web of Science和b谷歌Scholar等数据库进行了全面的文献检索，重点研究了2013年至2023年间发表的研究。研究结果强调，迫切需要早期发现和有针对性的干预措施，以减轻恐惧症的心理和生殖后果。提高对其与孕产妇心理健康的复杂相互作用的认识和研究，对于为临床实践和公共卫生战略提供信息至关重要。
{"title":"Tokophobia: A narrative review of etiology, prevalence, and treatment options","authors":"L. Esmalian Khamseh , J. Jomeen , R. Cousins , M. Aruguete , V. Sharma","doi":"10.1016/j.gine.2025.101073","DOIUrl":"10.1016/j.gine.2025.101073","url":null,"abstract":"<div><div>Tokophobia, the intense fear of childbirth, is increasingly recognized as a significant global health concern with serious implications for women's mental well-being and reproductive decisions. This narrative review explores its worldwide incidence and prevalence, revealing notable variations across regions—moderate to high rates are reported in Asia, Australia, the Middle East, and Africa, while lower rates are observed in European countries. Tokophobia is associated with adverse mental health outcomes such as anxiety, depression, and post-traumatic stress disorder, and it also influences reproductive behavior, including reduced fertility and increased preference for elective cesarean sections. A comprehensive literature search was conducted using databases such as PubMed, Web of Science, and Google Scholar, focusing on studies published between 2013 and 2023. The findings highlight the urgent need for early detection and targeted interventions to mitigate the psychological and reproductive consequences of tokophobia. Greater awareness and research into its complex interplay with maternal mental health are essential to inform clinical practice and public health strategies.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"53 1","pages":"Article 101073"},"PeriodicalIF":0.1,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760739","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}
Pub Date : 2025-12-16DOI: 10.1016/j.gine.2025.101072
A. Ruano , J. Munrós , L. Mañalich , S. Monreal , D. Guerrero , E. Suárez
Introduction
The association between ultrasonographic features and symptom burden in patients with deep infiltrating endometriosis (DIE) remains unclear. This study aimed to evaluate whether specific transvaginal ultrasound (TVUS) markers are associated with health-related quality of life (HRQoL) in women with DIE.
Methods
We conducted a prospective observational study including 114 patients with confirmed DIE, evaluated by both magnetic resonance and TVUS. HRQoL was assessed using the Endometriosis Health Profile-5 (EHP-5) questionnaire. TVUS markers included diffuse adenomyosis, bilateral ovarian adhesions, and large DIE lesions. Bivariate and multivariate linear regression analyses were performed to identify ultrasound features independently associated with HRQoL.
Results
Diffuse adenomyosis and bilateral ovarian adhesions were significantly associated with higher EHP-5 scores in both bivariate and multivariate analyses. Patients with diffuse adenomyosis had a mean EHP-5 score of 47.3 ± 17.9 versus 36.2 ± 21.5 in those without (mean difference: 11.09; p = 0.005). Bilateral ovarian adhesions were associated with scores of 45.4 ± 20.1 versus 34.1 ± 20.2 (mean difference: 11.38; p = 0.006). In the adjusted model, both markers remained independently associated with impaired HRQoL. The presence of large (>3 cm) posterior DIE lesions showed no significant association. The model's explanatory power was modest (R2 = 0.112).
Conclusion
Diffuse adenomyosis and bilateral ovarian adhesions are independent ultrasonographic predictors of impaired HRQoL in patients with DIE. Identifying these features during routine TVUS may help guide individualized management strategies.
{"title":"Diffuse adenomyosis and bilateral ovarian adhesions on ultrasound are associated with impaired quality of life in patients with deep infiltrating endometriosis","authors":"A. Ruano , J. Munrós , L. Mañalich , S. Monreal , D. Guerrero , E. Suárez","doi":"10.1016/j.gine.2025.101072","DOIUrl":"10.1016/j.gine.2025.101072","url":null,"abstract":"<div><h3>Introduction</h3><div>The association between ultrasonographic features and symptom burden in patients with deep infiltrating endometriosis (DIE) remains unclear. This study aimed to evaluate whether specific transvaginal ultrasound (TVUS) markers are associated with health-related quality of life (HRQoL) in women with DIE.</div></div><div><h3>Methods</h3><div>We conducted a prospective observational study including 114 patients with confirmed DIE, evaluated by both magnetic resonance and TVUS. HRQoL was assessed using the Endometriosis Health Profile-5 (EHP-5) questionnaire. TVUS markers included diffuse adenomyosis, bilateral ovarian adhesions, and large DIE lesions. Bivariate and multivariate linear regression analyses were performed to identify ultrasound features independently associated with HRQoL.</div></div><div><h3>Results</h3><div>Diffuse adenomyosis and bilateral ovarian adhesions were significantly associated with higher EHP-5 scores in both bivariate and multivariate analyses. Patients with diffuse adenomyosis had a mean EHP-5 score of 47.3<!--> <!-->±<!--> <!-->17.9 versus 36.2<!--> <!-->±<!--> <!-->21.5 in those without (mean difference: 11.09; <em>p</em> <!-->=<!--> <!-->0.005). Bilateral ovarian adhesions were associated with scores of 45.4<!--> <!-->±<!--> <!-->20.1 versus 34.1<!--> <!-->±<!--> <!-->20.2 (mean difference: 11.38; <em>p</em> <!-->=<!--> <!-->0.006). In the adjusted model, both markers remained independently associated with impaired HRQoL. The presence of large (>3<!--> <!-->cm) posterior DIE lesions showed no significant association. The model's explanatory power was modest (<em>R</em><sup>2</sup> <!-->=<!--> <!-->0.112).</div></div><div><h3>Conclusion</h3><div>Diffuse adenomyosis and bilateral ovarian adhesions are independent ultrasonographic predictors of impaired HRQoL in patients with DIE. Identifying these features during routine TVUS may help guide individualized management strategies.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"53 1","pages":"Article 101072"},"PeriodicalIF":0.1,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760740","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}
Pub Date : 2025-10-01DOI: 10.1016/j.gine.2025.101070
R. Sarabia Ochoa , J.P. García de la Torre , A. Canosa Fernández
Introduction
Clear cell adenocarcinoma of the cervix is a rare histological variant that is usually associated with intrauterine exposure to diethylstilbestrol (DES).
Main symptoms and/or clinical findings
A 15-year-old girl, virgin, with vaginal bleeding and leucorrhea. There was no history of exposure to diethylstilbestrol. Gynecological examination revealed a 7 cm, solid, irregular, polypoid mass in the vagina, based on the anterior lip of the cervix.
Main diagnoses, therapeutic interventions, and results
The tumor was excised in fragments by colposcopy. Histologically it corresponded to a malignant epithelial neoplasm with a tubulocystic pattern, with papillary and solid areas. Composed of clear or hobnail cells, atypical vesicular nuclei and frequent nucleoli. Psammomatous microcalcifications and foci of tumor necrosis were present. Immunoreactivity for PAX8, CKAE1/3AE, EMA, CA-125, CK7, and Napsin-A was present. The diagnosis was clear cell adenocarcinoma.
The patient was treated with radical hysterectomy and is disease-free three years later.
Conclusion
Clear cell adenocarcinoma of the cervix is a rare tumor lacking clear guidelines for effective treatment. The clinical manifestations are basically the same as those of cervical squamous cell carcinoma, and in young patients, they can be confused with dysfunctional uterine bleeding, requiring a correct differential diagnosis. Our patient received primary treatment with colposcopic electrosurgical excision biopsy, followed by radical hysterectomy without chemotherapy or radiation therapy. This could be a new treatment approach for early-stage patients given the positive results observed.
{"title":"Adenocarcinoma de células claras primario del cuello uterino sin exposición intrauterina al dietilestilbestrol en una adolescente de 15 años. Un caso clinicopatológico","authors":"R. Sarabia Ochoa , J.P. García de la Torre , A. Canosa Fernández","doi":"10.1016/j.gine.2025.101070","DOIUrl":"10.1016/j.gine.2025.101070","url":null,"abstract":"<div><h3>Introduction</h3><div>Clear cell adenocarcinoma of the cervix is a rare histological variant that is usually associated with intrauterine exposure to diethylstilbestrol (DES).</div></div><div><h3>Main symptoms and/or clinical findings</h3><div>A 15-year-old girl, virgin, with vaginal bleeding and leucorrhea. There was no history of exposure to diethylstilbestrol. Gynecological examination revealed a 7<!--> <!-->cm, solid, irregular, polypoid mass in the vagina, based on the anterior lip of the cervix.</div></div><div><h3>Main diagnoses, therapeutic interventions, and results</h3><div>The tumor was excised in fragments by colposcopy. Histologically it corresponded to a malignant epithelial neoplasm with a tubulocystic pattern, with papillary and solid areas. Composed of clear or hobnail cells, atypical vesicular nuclei and frequent nucleoli. Psammomatous microcalcifications and foci of tumor necrosis were present. Immunoreactivity for PAX8, CKAE1/3AE, EMA, CA-125, CK7, and Napsin-A was present. The diagnosis was clear cell adenocarcinoma.</div><div>The patient was treated with radical hysterectomy and is disease-free three years later.</div></div><div><h3>Conclusion</h3><div>Clear cell adenocarcinoma of the cervix is a rare tumor lacking clear guidelines for effective treatment. The clinical manifestations are basically the same as those of cervical squamous cell carcinoma, and in young patients, they can be confused with dysfunctional uterine bleeding, requiring a correct differential diagnosis. Our patient received primary treatment with colposcopic electrosurgical excision biopsy, followed by radical hysterectomy without chemotherapy or radiation therapy. This could be a new treatment approach for early-stage patients given the positive results observed.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 4","pages":"Article 101070"},"PeriodicalIF":0.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424604","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}
Pub Date : 2025-10-01DOI: 10.1016/j.gine.2025.101067
A. Rodríguez-Alonso , I. Da Cuña-Carrera , A. Alonso-Calvete , L. Núñez-Remiseiro , M. Fernández-Paz
Breastfeeding is defined as the act of transferring milk between mother and child, constituting the ideal and physiological food for neonates. Female sexual dysfunction is established as a disorder of sexual desire, arousal, orgasm and/or sexual pain. The objective of this work is to review and analyze the existing literature to find out if there is a relationship between breastfeeding and the presence of sexual dysfunctions in the postpartum. A bibliographic search was carried out between the months of November and December 2023 in the PubMed, Web of Science (WOS), Scopus, Cochrane Library and Cinahl databases. The descriptors from the Medical Subject Headings (MeSH) thesaurus “Lactation”, “Breast Feeding”, “Postpartum Period”, “Sexual Dysfunction, Physiological” and “Sexual Dysfunctions, Psychological” were used. Articles published in English or Spanish that met the criteria were included. the objective of this review. Of the 123 articles identified, only 9 met the eligibility criteria and were included in the review. Breastfeeding seems to have a relationship with the presence of female sexual dysfunctions in the postpartum, with lower scores being observed in the sexual function questionnaires in lactating women compared to those of non-lactating women. However, it seems difficult to discern between sexual dysfunctions due to breastfeeding and those due to postpartum.
母乳喂养被定义为在母亲和孩子之间传递乳汁的行为，构成了新生儿理想和生理的食物。女性性功能障碍是一种性欲紊乱、性唤起、性高潮和/或性疼痛。本研究的目的是回顾和分析现有文献，以了解母乳喂养与产后出现性功能障碍之间是否存在关系。在2023年11月至12月期间，在PubMed、Web of Science （WOS）、Scopus、Cochrane Library和Cinahl数据库中进行了书目检索。使用医学主题词（MeSH）词库中的描述词“哺乳”、“母乳喂养”、“产后”、“生理性功能障碍”和“心理性功能障碍”。以英语或西班牙语发表的符合标准的文章被包括在内。本综述的目的。在确定的123篇文章中，只有9篇符合资格标准并被纳入审查。母乳喂养似乎与产后女性性功能障碍的存在有关，在性功能问卷调查中，哺乳期妇女的得分低于非哺乳期妇女。但是，很难区分母乳喂养引起的性功能障碍和产后引起的性功能障碍。
{"title":"Relación entre la lactancia materna y las disfunciones sexuales en el posparto. Una revisión sistemática","authors":"A. Rodríguez-Alonso , I. Da Cuña-Carrera , A. Alonso-Calvete , L. Núñez-Remiseiro , M. Fernández-Paz","doi":"10.1016/j.gine.2025.101067","DOIUrl":"10.1016/j.gine.2025.101067","url":null,"abstract":"<div><div>Breastfeeding is defined as the act of transferring milk between mother and child, constituting the ideal and physiological food for neonates. Female sexual dysfunction is established as a disorder of sexual desire, arousal, orgasm and/or sexual pain. The objective of this work is to review and analyze the existing literature to find out if there is a relationship between breastfeeding and the presence of sexual dysfunctions in the postpartum. A bibliographic search was carried out between the months of November and December 2023 in the PubMed, Web of Science (WOS), Scopus, Cochrane Library and Cinahl databases. The descriptors from the Medical Subject Headings (MeSH) thesaurus “Lactation”, “Breast Feeding”, “Postpartum Period”, “Sexual Dysfunction, Physiological” and “Sexual Dysfunctions, Psychological” were used. Articles published in English or Spanish that met the criteria were included. the objective of this review. Of the 123 articles identified, only 9 met the eligibility criteria and were included in the review. Breastfeeding seems to have a relationship with the presence of female sexual dysfunctions in the postpartum, with lower scores being observed in the sexual function questionnaires in lactating women compared to those of non-lactating women. However, it seems difficult to discern between sexual dysfunctions due to breastfeeding and those due to postpartum.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 4","pages":"Article 101067"},"PeriodicalIF":0.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145264980","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}
Pub Date : 2025-10-01DOI: 10.1016/j.gine.2025.101068
I. Agustí , G. Altinier , G. Casals
Introduction
Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of controlled ovarian stimulation, with risk of multi-organ involvement. We present a clinical case of severe OHSS that initially manifested with symptoms suggestive of cardiac involvement and transient troponin elevation, in which cardiac pathology was ultimately ruled out.
Main symptoms and/or clinical findings
A 26-year-old woman, with no cardiovascular history, presented with abdominal distension, nausea, and acute epigastric pain after follicular puncture in the context of controlled ovarian stimulation for egg donation.
Main diagnoses, therapeutic interventions, and outcomes
Severe OHSS was diagnosed with tense ascites, hemoconcentration, altered renal profile, and marked elevation of troponin I (1098 ng/L) and D-dimer. Given the suspicion of myocardial ischemia, cardiological studies were performed, ruling out cardiac pathology. Medical treatment with albumin and diuretics was initiated, with clinical resolution without the need for paracentesis. The patient was discharged after four days, with normalization of laboratory and echocardiographic parameters.
Conclusion
Severe OHSS may present with clinical signs and biomarkers suggestive of cardiac disease. This finding highlights the importance of considering troponin elevation in OHSS within the context of hemodynamic and/or endothelial dysfunction, rather than as a specific marker of myocardial ischemia. This is especially relevant in severe multi-organ clinical presentations where differential diagnosis is crucial.
{"title":"Síndrome de hiperestimulación ovárica grave con elevación transitoria de troponina I: a propósito de un caso","authors":"I. Agustí , G. Altinier , G. Casals","doi":"10.1016/j.gine.2025.101068","DOIUrl":"10.1016/j.gine.2025.101068","url":null,"abstract":"<div><h3>Introduction</h3><div>Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of controlled ovarian stimulation, with risk of multi-organ involvement. We present a clinical case of severe OHSS that initially manifested with symptoms suggestive of cardiac involvement and transient troponin elevation, in which cardiac pathology was ultimately ruled out.</div></div><div><h3>Main symptoms and/or clinical findings</h3><div>A 26-year-old woman, with no cardiovascular history, presented with abdominal distension, nausea, and acute epigastric pain after follicular puncture in the context of controlled ovarian stimulation for egg donation.</div></div><div><h3>Main diagnoses, therapeutic interventions, and outcomes</h3><div>Severe OHSS was diagnosed with tense ascites, hemoconcentration, altered renal profile, and marked elevation of troponin I (1098 ng/L) and D-dimer. Given the suspicion of myocardial ischemia, cardiological studies were performed, ruling out cardiac pathology. Medical treatment with albumin and diuretics was initiated, with clinical resolution without the need for paracentesis. The patient was discharged after four days, with normalization of laboratory and echocardiographic parameters.</div></div><div><h3>Conclusion</h3><div>Severe OHSS may present with clinical signs and biomarkers suggestive of cardiac disease. This finding highlights the importance of considering troponin elevation in OHSS within the context of hemodynamic and/or endothelial dysfunction, rather than as a specific marker of myocardial ischemia. This is especially relevant in severe multi-organ clinical presentations where differential diagnosis is crucial.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 4","pages":"Article 101068"},"PeriodicalIF":0.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332345","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}
Pub Date : 2025-10-01DOI: 10.1016/j.gine.2025.101071
M.M.A. Abdelhafez , K.A.M. Ahmed , N.A.M. Ahmed , M.H. Ismail , M.N. Bin Mohd Daud , A.M. Eldiasty , M.F. Bin Amri , M.S. Jeffree , F. Kadir , D.M. Pg Baharuddin , M.F. Bin Bolong , F. Hayati , N.B. Azizan , D. Sumpat , S.S. Syed Abdul Rahim , W.W. Than , M. Yusof Ibrahim , L. Zhen Zhen , M. Zoe Soe
Premature ovarian insufficiency is defined as the loss of ovarian function before the age of 40. It is linked to hypoestrogenism and the loss of remaining follicles, which causes irregular menstruation, infertility, and a decline in health-related quality of life. This article goal is to highlight and analyse the various contemporary strategies for the diagnosis and treatment of the disease with reference to the most recent and evidence-based interventions in this context. A comprehensive review of the literature was conducted using database searches in EMBASE, Science Direct, Google Scholar, Scopus, and PubMed to obtain the objectives and aim of the study. The results of the search found that menopause affects about 5% of women between the ages of 40 and 45, while it affects about 1% of women before the age of 40. Under the age of 30, the disease affects about 1 in 1000 women, sometimes as early as adolescence. Our study concluded that: premature ovarian insufficiency is a condition of oestrogen deficiency that has both immediate and long-term effects on health and mental well-being. The physical, psychological, and emotional difficulties brought on by the disease's diagnosis must be handled, and the short- and long-term wellness of these young women must be safeguarded, by healthcare professionals managing these complicated entities successfully.
{"title":"Premature ovarian insufficiency: An update. A literature review","authors":"M.M.A. Abdelhafez , K.A.M. Ahmed , N.A.M. Ahmed , M.H. Ismail , M.N. Bin Mohd Daud , A.M. Eldiasty , M.F. Bin Amri , M.S. Jeffree , F. Kadir , D.M. Pg Baharuddin , M.F. Bin Bolong , F. Hayati , N.B. Azizan , D. Sumpat , S.S. Syed Abdul Rahim , W.W. Than , M. Yusof Ibrahim , L. Zhen Zhen , M. Zoe Soe","doi":"10.1016/j.gine.2025.101071","DOIUrl":"10.1016/j.gine.2025.101071","url":null,"abstract":"<div><div>Premature ovarian insufficiency is defined as the loss of ovarian function before the age of 40. It is linked to hypoestrogenism and the loss of remaining follicles, which causes irregular menstruation, infertility, and a decline in health-related quality of life. This article goal is to highlight and analyse the various contemporary strategies for the diagnosis and treatment of the disease with reference to the most recent and evidence-based interventions in this context. A comprehensive review of the literature was conducted using database searches in EMBASE, Science Direct, Google Scholar, Scopus, and PubMed to obtain the objectives and aim of the study. The results of the search found that menopause affects about 5% of women between the ages of 40 and 45, while it affects about 1% of women before the age of 40. Under the age of 30, the disease affects about 1 in 1000 women, sometimes as early as adolescence. Our study concluded that: premature ovarian insufficiency is a condition of oestrogen deficiency that has both immediate and long-term effects on health and mental well-being. The physical, psychological, and emotional difficulties brought on by the disease's diagnosis must be handled, and the short- and long-term wellness of these young women must be safeguarded, by healthcare professionals managing these complicated entities successfully.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 4","pages":"Article 101071"},"PeriodicalIF":0.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145525816","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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