Pub Date : 2025-09-04DOI: 10.1016/j.gine.2025.101066
J.C. Ramírez , K. Cepeda , F. Carmona
Introduction
Myomatosis and uterine adenomyosis are the most common benign uterine pathologies suffered by women of reproductive age and the symptoms they produce are mainly abnormal vaginal bleeding, dysmenorrhea and pelvic pain, but they are rarely associated with spontaneous peritoneal bleeding. The existence of this entity and its etiology is little known in the literature, limited to case reports, generating a difficulty in diagnosis. The objective of this article is to report an infrequent case of spontaneous hemoperitoneum secondary to uterine myomatosis and adenomyosis.
Main symptoms
Prior informed consent and certification from the institution's ethics committee. This is a 50-year-old Colombian patient, in a state of symptomatic perimenopause with hormone replacement therapy, who came to the emergency department with a history of pain in the lower abdomen of three days of severe intensity, only associated with diarrhea.
Main diagnoses
Abdominal computed tomography and transvaginal ultrasound diagnosed hemoperitoneum associated with a probable left adnexal mass, suggestive of a ruptured hemorrhagic cyst.
Therapeutic interventions and results
Exploratory laparoscopy was performed and identify hemoperitoneum secondary to a highly vascularized subserosal fibroid with bleeding from its base, hypervascularized uterus, without obvious ovarian pathology, associated with multiple adhesions between the fibroid, uterine tube and ipsilateral ovary. Due to the patient's age and continuous uncontrolled bleeding, it was decided to perform a total hysterectomy plus unilateral left salpingo-oferectomy.
Conclusion
This case demonstrates that, although extremely rare, uterine fibroids (still coexisting with adenomyosis) can cause spontaneous hemoperitoneum. It is essential to consider this diagnosis within the acute gynecological abdomen, since timely recognition and treatment improve the prognosis.
{"title":"Case report of spontaneous hemoperitoneum secondary to uterine myomatosis and adenomyosis","authors":"J.C. Ramírez , K. Cepeda , F. Carmona","doi":"10.1016/j.gine.2025.101066","DOIUrl":"10.1016/j.gine.2025.101066","url":null,"abstract":"<div><h3>Introduction</h3><div>Myomatosis and uterine adenomyosis are the most common benign uterine pathologies suffered by women of reproductive age and the symptoms they produce are mainly abnormal vaginal bleeding, dysmenorrhea and pelvic pain, but they are rarely associated with spontaneous peritoneal bleeding. The existence of this entity and its etiology is little known in the literature, limited to case reports, generating a difficulty in diagnosis. The objective of this article is to report an infrequent case of spontaneous hemoperitoneum secondary to uterine myomatosis and adenomyosis.</div></div><div><h3>Main symptoms</h3><div>Prior informed consent and certification from the institution's ethics committee. This is a 50-year-old Colombian patient, in a state of symptomatic perimenopause with hormone replacement therapy, who came to the emergency department with a history of pain in the lower abdomen of three days of severe intensity, only associated with diarrhea.</div></div><div><h3>Main diagnoses</h3><div>Abdominal computed tomography and transvaginal ultrasound diagnosed hemoperitoneum associated with a probable left adnexal mass, suggestive of a ruptured hemorrhagic cyst.</div></div><div><h3>Therapeutic interventions and results</h3><div>Exploratory laparoscopy was performed and identify hemoperitoneum secondary to a highly vascularized subserosal fibroid with bleeding from its base, hypervascularized uterus, without obvious ovarian pathology, associated with multiple adhesions between the fibroid, uterine tube and ipsilateral ovary. Due to the patient's age and continuous uncontrolled bleeding, it was decided to perform a total hysterectomy plus unilateral left salpingo-oferectomy.</div></div><div><h3>Conclusion</h3><div>This case demonstrates that, although extremely rare, uterine fibroids (still coexisting with adenomyosis) can cause spontaneous hemoperitoneum. It is essential to consider this diagnosis within the acute gynecological abdomen, since timely recognition and treatment improve the prognosis.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 4","pages":"Article 101066"},"PeriodicalIF":0.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988045","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 : 2025-09-02DOI: 10.1016/j.gine.2025.101065
C. Torrijo Rodrigo, V. Gómez García, C. Giménez Molina
Introduction
Radiofrequency ablation (RFA) is one of the latest minimally invasive treatment options for symptomatic uterine fibroids. The primary goal is to evaluate the feasibility and effectiveness of RFA as a minimally invasive treatment for large uterine fibroids, preserving the uterus and fertility.
Main symptoms and/or clinical findings
Two women, aged 47 and 40, with very large fibroids (approximately 10 cm in length) exhibited symptoms such as hypermenorrhea, urinary symptoms, back pain, and a painful mass.
Main diagnoses, therapeutic interventions, and outcomes
Uterine leiomyomas or fibroids. RFA was performed using a 35 cm monopolar electrode with a 17 gauge and a 10 mm active tip. The sizes of the fibroids were reduced by more than half, and symptoms disappeared after the procedure.
Case 1: A 47-year-old woman with a 10 cm fibroid showed a significant reduction in fibroid size (from 437 to 9 cm3) and complete resolution of symptoms within one year.
Case 2: A 40-year-old woman with a 10.5 cm fibroid experienced a notable reduction in fibroid size (from 472 to 33 cm3) and resolution of symptoms within six months.
Conclusion
These cases demonstrate that RFA is a safe and effective method for treating large uterine fibroids, with significant reductions in fibroid volume and resolution of symptoms. The procedure should be performed by gynecologists experienced in minimally invasive techniques.
{"title":"Ablación por radiofrecuencia exitosa de miomas uterinos muy grandes: estudio de 2 casos","authors":"C. Torrijo Rodrigo, V. Gómez García, C. Giménez Molina","doi":"10.1016/j.gine.2025.101065","DOIUrl":"10.1016/j.gine.2025.101065","url":null,"abstract":"<div><h3>Introduction</h3><div>Radiofrequency ablation (RFA) is one of the latest minimally invasive treatment options for symptomatic uterine fibroids. The primary goal is to evaluate the feasibility and effectiveness of RFA as a minimally invasive treatment for large uterine fibroids, preserving the uterus and fertility.</div></div><div><h3>Main symptoms and/or clinical findings</h3><div>Two women, aged 47 and 40, with very large fibroids (approximately 10<!--> <!-->cm in length) exhibited symptoms such as hypermenorrhea, urinary symptoms, back pain, and a painful mass.</div></div><div><h3>Main diagnoses, therapeutic interventions, and outcomes</h3><div>Uterine leiomyomas or fibroids. RFA was performed using a 35<!--> <!-->cm monopolar electrode with a 17 gauge and a 10<!--> <!-->mm active tip. The sizes of the fibroids were reduced by more than half, and symptoms disappeared after the procedure.</div><div>Case 1: A 47-year-old woman with a 10<!--> <!-->cm fibroid showed a significant reduction in fibroid size (from 437 to 9<!--> <!-->cm<sup>3</sup>) and complete resolution of symptoms within one year.</div><div>Case 2: A 40-year-old woman with a 10.5<!--> <!-->cm fibroid experienced a notable reduction in fibroid size (from 472 to 33<!--> <!-->cm<sup>3</sup>) and resolution of symptoms within six months.</div></div><div><h3>Conclusion</h3><div>These cases demonstrate that RFA is a safe and effective method for treating large uterine fibroids, with significant reductions in fibroid volume and resolution of symptoms. The procedure should be performed by gynecologists experienced in minimally invasive techniques.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 4","pages":"Article 101065"},"PeriodicalIF":0.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925251","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 : 2025-08-25DOI: 10.1016/j.gine.2025.101064
Carlos Dragonas-Romo , Silvia Caballero-Delgado , Jorge Luis Rodríguez-Sánchez , José Juan Quilantán-Cabrera , Karla Fabiola Rodríguez-Gómez , Luis Enrique Colunga-Lozano
Background
The objective is to describe a technique for placing a negative pressure wound therapy system using central suction as a treatment for infected surgical wounds in low-resource settings.
Methods
A retrospective cohort study was conducted at the General Hospital of Zapopan from November 2021 to May 2023. We included patients from the Gynecology and Obstetrics Department with infected and dehiscence surgical wound who consented underwent placement of a central suction system. Surgical time, intraoperative bleeding, complications, morbidity, and mortality were analyzed. We evaluated the patients in the preoperative, immediate postoperative, and 3-month follow-up.
Results
Ten patients were included, comprising 8 post-cesarean section patients, one post-hysterectomy patient, and one patient with Fournier's gangrene. The mean age was 29.91 years (± 12.97), with 5 patients having comorbidities. All patients with infected surgical wounds had wound dehiscence. Variations in the results of wound secretion cultures were found with the following pathogens: Staphylococcus lugdunensis, Staphylococcus epidermidis, Streptococcus gallolyticus and Klebsiella oxytoca, indicating no particular etiological agent. Length of hospital stay depended on the case, wound extent and depth, and the number of required changes.
Conclusion
Our technique is a cost-effective alternative for managing surgical wounds with favorable outcomes, suitable for replication in low-resource hospitals. However, further studies with a larger number of patients are needed.
{"title":"Adaptación de un sistema de presión negativa con succión central de bajo costo para el tratamiento de heridas ginecoobstétricas infectadas. Un estudio de cohorte retrospectivo","authors":"Carlos Dragonas-Romo , Silvia Caballero-Delgado , Jorge Luis Rodríguez-Sánchez , José Juan Quilantán-Cabrera , Karla Fabiola Rodríguez-Gómez , Luis Enrique Colunga-Lozano","doi":"10.1016/j.gine.2025.101064","DOIUrl":"10.1016/j.gine.2025.101064","url":null,"abstract":"<div><h3>Background</h3><div>The objective is to describe a technique for placing a negative pressure wound therapy system using central suction as a treatment for infected surgical wounds in low-resource settings.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted at the General Hospital of Zapopan from November 2021 to May 2023. We included patients from the Gynecology and Obstetrics Department with infected and dehiscence surgical wound who consented underwent placement of a central suction system. Surgical time, intraoperative bleeding, complications, morbidity, and mortality were analyzed. We evaluated the patients in the preoperative, immediate postoperative, and 3-month follow-up.</div></div><div><h3>Results</h3><div>Ten patients were included, comprising 8 post-cesarean section patients, one post-hysterectomy patient, and one patient with Fournier's gangrene. The mean age was 29.91 years (±<!--> <!-->12.97), with 5 patients having comorbidities. All patients with infected surgical wounds had wound dehiscence. Variations in the results of wound secretion cultures were found with the following pathogens: <em>Staphylococcus lugdunensis, Staphylococcus epidermidis, Streptococcus gallolyticus</em> and <em>Klebsiella oxytoca,</em> indicating no particular etiological agent. Length of hospital stay depended on the case, wound extent and depth, and the number of required changes.</div></div><div><h3>Conclusion</h3><div>Our technique is a cost-effective alternative for managing surgical wounds with favorable outcomes, suitable for replication in low-resource hospitals. However, further studies with a larger number of patients are needed.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 4","pages":"Article 101064"},"PeriodicalIF":0.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893562","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 : 2025-07-04DOI: 10.1016/j.gine.2025.101054
D. Guavita-Navarro , L.C. Guavita , V. Barbosa-Prieto , C. Sanmiguel-Reyes
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that frequently experiences flares during pregnancy due to the physiological and immunological changes characteristic of this period. These alterations can present as lupus activity or obstetric complications, particularly hypertensive disorders, necessitating precise clinical assessment and multidisciplinary management to minimize maternal and fetal risks. Given the importance of accurately identifying disease activity during pregnancy and the postpartum period, this review examines the main available indices for evaluating lupus activity in pregnant patients.
{"title":"Escalas de evaluación de la actividad lúpica en el embarazo","authors":"D. Guavita-Navarro , L.C. Guavita , V. Barbosa-Prieto , C. Sanmiguel-Reyes","doi":"10.1016/j.gine.2025.101054","DOIUrl":"10.1016/j.gine.2025.101054","url":null,"abstract":"<div><div>Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that frequently experiences flares during pregnancy due to the physiological and immunological changes characteristic of this period. These alterations can present as lupus activity or obstetric complications, particularly hypertensive disorders, necessitating precise clinical assessment and multidisciplinary management to minimize maternal and fetal risks. Given the importance of accurately identifying disease activity during pregnancy and the postpartum period, this review examines the main available indices for evaluating lupus activity in pregnant patients.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 4","pages":"Article 101054"},"PeriodicalIF":0.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557491","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 : 2025-05-20DOI: 10.1016/j.gine.2025.101039
R.A. Kasem , A. Attalla , A. Ramadan , A. Tawfik , A. Salmona , M.K. AbdElhaseeb
Objectives
Preoperative fasting is a common practice in cesarean section deliveries, but prolonged fasting can have negative effects on patient outcomes. Preoperative carbohydrate intake has been proposed as a way to mitigate these effects. The purpose of this systematic review and meta-analysis is to assess the potential benefits and complications of preoperative oral carbohydrates in women undergoing cesarean section (CS).
Methods
A comprehensive search was conducted in PubMed, Cochrane, Web of Science, and Scopus databases until August 2023. Randomized controlled trials (RCTs) that compared preoperative oral carbohydrates to a placebo or fasting group in pregnant women undergoing CS were included. The outcomes included vomiting, insulin resistance, amount of bleeding, plasma glucose and serum insulin.
Results
We included five RCTs with a total of 2275 cases. According to the meta-analysis results, preoperative oral carbohydrates significantly reduced postoperative serum insulin levels (SMD = −0.58, 95% CI [−0.95 to −0.21], P = 0.002) and insulin resistance (SMD = −0.32, 95% CI [−0.58 to −0.07], P = 0.01) compared to control groups. However, preoperative oral carbohydrates did not have a significant effect on postoperative vomiting (RR = 0.96, 95% CI [0.77–1.20], P = 0.73), the amount of bleeding (SMD = −0.17, 95% CI [−0.52 to 0.18], P = 0.34) or plasma glucose levels (SMD = −0.12, 95% CI [−0.29 to 0.05], P = 0.17).
Conclusion
Preoperative oral carbohydrates can improve metabolic outcomes, specifically reducing postoperative serum insulin levels and insulin resistance in women undergoing CS, without increasing the risk of vomiting. However, they did not significantly affect the amount of bleeding or plasma glucose levels.
目的术前禁食是剖宫产的常见做法,但长时间禁食会对患者的预后产生负面影响。术前碳水化合物摄入被认为是减轻这些影响的一种方法。本系统综述和荟萃分析的目的是评估剖宫产(CS)妇女术前口服碳水化合物的潜在益处和并发症。方法截至2023年8月,在PubMed、Cochrane、Web of Science、Scopus等数据库中进行综合检索。随机对照试验(rct)比较术前口服碳水化合物与安慰剂组或禁食组在接受CS的孕妇中。结果包括呕吐、胰岛素抵抗、出血量、血浆葡萄糖和血清胰岛素。结果纳入5项随机对照试验,共2275例。meta分析结果显示,与对照组相比,术前口服碳水化合物显著降低了术后血清胰岛素水平(SMD = - 0.58, 95% CI [- 0.95 ~ - 0.21], P = 0.002)和胰岛素抵抗(SMD = - 0.32, 95% CI [- 0.58 ~ - 0.07], P = 0.01)。然而,术前口服碳水化合物对术后呕吐(RR = 0.96, 95% CI [0.77-1.20], P = 0.73)、出血量(SMD = - 0.17, 95% CI[- 0.52至0.18],P = 0.34)或血浆葡萄糖水平(SMD = - 0.12, 95% CI[- 0.29至0.05],P = 0.17)没有显著影响。结论术前口服碳水化合物可改善CS患者的代谢结局,特别是降低术后血清胰岛素水平和胰岛素抵抗,且不增加呕吐风险。然而,它们并没有显著影响出血量或血浆葡萄糖水平。
{"title":"From fasting to feasting: Unraveling the postoperative benefits of preoperative carbohydrate intake in cesarean delivery—A systematic review and meta-analysis","authors":"R.A. Kasem , A. Attalla , A. Ramadan , A. Tawfik , A. Salmona , M.K. AbdElhaseeb","doi":"10.1016/j.gine.2025.101039","DOIUrl":"10.1016/j.gine.2025.101039","url":null,"abstract":"<div><h3>Objectives</h3><div>Preoperative fasting is a common practice in cesarean section deliveries, but prolonged fasting can have negative effects on patient outcomes. Preoperative carbohydrate intake has been proposed as a way to mitigate these effects. The purpose of this systematic review and meta-analysis is to assess the potential benefits and complications of preoperative oral carbohydrates in women undergoing cesarean section (CS).</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Cochrane, Web of Science, and Scopus databases until August 2023. Randomized controlled trials (RCTs) that compared preoperative oral carbohydrates to a placebo or fasting group in pregnant women undergoing CS were included. The outcomes included vomiting, insulin resistance, amount of bleeding, plasma glucose and serum insulin.</div></div><div><h3>Results</h3><div>We included five RCTs with a total of 2275 cases. According to the meta-analysis results, preoperative oral carbohydrates significantly reduced postoperative serum insulin levels (SMD<!--> <!-->=<!--> <!-->−0.58, 95% CI [−0.95 to −0.21], <em>P</em> <!-->=<!--> <!-->0.002) and insulin resistance (SMD<!--> <!-->=<!--> <!-->−0.32, 95% CI [−0.58 to −0.07], <em>P</em> <!-->=<!--> <!-->0.01) compared to control groups. However, preoperative oral carbohydrates did not have a significant effect on postoperative vomiting (RR<!--> <!-->=<!--> <!-->0.96, 95% CI [0.77–1.20], <em>P</em> <!-->=<!--> <!-->0.73), the amount of bleeding (SMD<!--> <!-->=<!--> <!-->−0.17, 95% CI [−0.52 to 0.18], <em>P</em> <!-->=<!--> <!-->0.34) or plasma glucose levels (SMD<!--> <!-->=<!--> <!-->−0.12, 95% CI [−0.29 to 0.05], <em>P</em> <!-->=<!--> <!-->0.17).</div></div><div><h3>Conclusion</h3><div>Preoperative oral carbohydrates can improve metabolic outcomes, specifically reducing postoperative serum insulin levels and insulin resistance in women undergoing CS, without increasing the risk of vomiting. However, they did not significantly affect the amount of bleeding or plasma glucose levels.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101039"},"PeriodicalIF":0.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090266","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 : 2025-05-13DOI: 10.1016/j.gine.2025.101052
M. Bonet-Sánchez , I. Pelayo-Delgado
Radiofrequency ablation of uterine fibroids is a technique based on the application of a high-frequency electrical current, causing a coagulative necrosis of the fibroid. The aim of this review is to analyse the influence of radiofrequency treatment of fibroids in women with gestational desire and its influence on pregnancy, through the compilation and study of recent articles. Radiofrequency has achieved a similar number of full-term births compared to that of surgical myomectomy, which until now has been the gold standard treatment for women with myomas desiring pregnancy. It also seems to increase obstetric security in pregnant women previously treated compared to other techniques, with fewer rate of preterm deliveries, spontaneous abortions and placental changes. However, more randomized clinical trials focusing specifically on pregnancy are necessary to reach definitive conclusions.
{"title":"Radiofrequency treatment value for uterine fibroids in pregnant and infertile women","authors":"M. Bonet-Sánchez , I. Pelayo-Delgado","doi":"10.1016/j.gine.2025.101052","DOIUrl":"10.1016/j.gine.2025.101052","url":null,"abstract":"<div><div>Radiofrequency ablation of uterine fibroids is a technique based on the application of a high-frequency electrical current, causing a coagulative necrosis of the fibroid. The aim of this review is to analyse the influence of radiofrequency treatment of fibroids in women with gestational desire and its influence on pregnancy, through the compilation and study of recent articles. Radiofrequency has achieved a similar number of full-term births compared to that of surgical myomectomy, which until now has been the gold standard treatment for women with myomas desiring pregnancy. It also seems to increase obstetric security in pregnant women previously treated compared to other techniques, with fewer rate of preterm deliveries, spontaneous abortions and placental changes. However, more randomized clinical trials focusing specifically on pregnancy are necessary to reach definitive conclusions.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101052"},"PeriodicalIF":0.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937202","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 : 2025-05-10DOI: 10.1016/j.gine.2025.101053
M.d.P. Marín Sánchez , M. Martínez-Esparza , P. García-Peñarrubia , A.J. Ruiz-Alcaraz , J.J. Arense-Gonzálo
Objective
To evaluate potential differences in quality of life between patients with deep endometriosis, with or without ovarian involvement (DE), and those with exclusive ovarian endometriosis (OMA).
Material and method
A prospective observational study was conducted on patients diagnosed with endometriosis through clinical assessment and imaging techniques, or histological confirmation. Patients were labeled as OMA or DE. Clinical data such as pain (visual analogue scale), demographic and anthropometric data, and QoL (SF-12v2 scale) were evaluated. Statistical analysis was performed using IBM SPSS 25.0.
Results
A total of 307 patients were enrolled, 109 with OMA and 198 with DE. Patients with OMA were younger than those with DE. QoL in the physical domain was lower in DE compared to OMA (46 ± 11.91 vs 49.9 ± 9.4; p < 0.02). No statistically significant differences were observed in the mental domain (41.5 ± 10.2 vs 42.8 ± 11; p < 0.276). Pain scores on the visual analogue scale did not differ significantly between groups. However, in the pain domain of the SF-12v2 scale, significant differences were found, with lower scores in DE (61.4 ± 32.7 vs 73.6 ± 28.6; p < 0.001).
Conclusion
QoL scales should be utilized in clinical practice as they provide valuable insights into how the disease impacts patients’ lives. Patients with deep endometriosis have a poorer QoL in the physical domain compared to those with exclusive ovarian endometriosis.
目的评价深部子宫内膜异位症伴或不伴卵巢受累(DE)患者与排他性卵巢子宫内膜异位症(OMA)患者生活质量的潜在差异。材料与方法对经临床评估、影像学检查或组织学证实的子宫内膜异位症患者进行前瞻性观察研究。将患者标记为OMA或DE。评估临床数据,如疼痛(视觉模拟量表)、人口统计学和人体测量数据以及生活质量(SF-12v2量表)。采用IBM SPSS 25.0进行统计学分析。结果共纳入307例患者,其中OMA患者109例,DE患者198例,OMA患者年龄小于DE患者,DE患者的生理生活质量低于OMA患者(46±11.91 vs 49.9±9.4;p & lt;0.02)。两组在心理领域的差异无统计学意义(41.5±10.2 vs 42.8±11;p & lt;0.276)。视觉模拟量表疼痛评分组间无显著差异。然而,在SF-12v2量表的疼痛域,发现有显著差异,DE得分较低(61.4±32.7 vs 73.6±28.6;p & lt;0.001)。结论生活质量量表对疾病如何影响患者生活提供了有价值的见解,值得在临床实践中使用。与排他性卵巢子宫内膜异位症患者相比,深部子宫内膜异位症患者在物理领域的生活质量较差。
{"title":"Impact of deep endometriosis with and without ovarian involvement on quality of life compared to exclusive ovarian endometriosis","authors":"M.d.P. Marín Sánchez , M. Martínez-Esparza , P. García-Peñarrubia , A.J. Ruiz-Alcaraz , J.J. Arense-Gonzálo","doi":"10.1016/j.gine.2025.101053","DOIUrl":"10.1016/j.gine.2025.101053","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate potential differences in quality of life between patients with deep endometriosis, with or without ovarian involvement (DE), and those with exclusive ovarian endometriosis (OMA).</div></div><div><h3>Material and method</h3><div>A prospective observational study was conducted on patients diagnosed with endometriosis through clinical assessment and imaging techniques, or histological confirmation. Patients were labeled as OMA or DE. Clinical data such as pain (visual analogue scale), demographic and anthropometric data, and QoL (SF-12v2 scale) were evaluated. Statistical analysis was performed using IBM SPSS 25.0.</div></div><div><h3>Results</h3><div>A total of 307 patients were enrolled, 109 with OMA and 198 with DE. Patients with OMA were younger than those with DE. QoL in the physical domain was lower in DE compared to OMA (46<!--> <!-->±<!--> <!-->11.91 vs 49.9<!--> <!-->±<!--> <!-->9.4; <em>p</em> <!--><<!--> <!-->0.02). No statistically significant differences were observed in the mental domain (41.5<!--> <!-->±<!--> <!-->10.2 vs 42.8<!--> <!-->±<!--> <!-->11; <em>p</em> <!--><<!--> <!-->0.276). Pain scores on the visual analogue scale did not differ significantly between groups. However, in the pain domain of the SF-12v2 scale, significant differences were found, with lower scores in DE (61.4<!--> <!-->±<!--> <!-->32.7 vs 73.6<!--> <!-->±<!--> <!-->28.6; <em>p</em> <!--><<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>QoL scales should be utilized in clinical practice as they provide valuable insights into how the disease impacts patients’ lives. Patients with deep endometriosis have a poorer QoL in the physical domain compared to those with exclusive ovarian endometriosis.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101053"},"PeriodicalIF":0.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929403","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 : 2025-05-10DOI: 10.1016/j.gine.2025.101050
B. Puerto , P. Azumendi , C. Corrales , G. Azumendi
Congenital anomalies of the Central Nervous System are one of the most important and numerous groups of congenital malformations. They constitute the second cause of disability in childhood and more than 95% occur in a population without known risk. The most effective strategy for its detection is to differentiate between 2 levels of care. The first level, the BASIC ULTRASONOGRAPHY, is performed on all pregnant women, while the second level, the DETAILED FETAL NEUROSONOGRAPHY, is performed in cases selected due to the risk of anomaly based on a list of indications or because an abnormality has been detected or suspected. CNS abnormality on basic ultrasound. Its purpose is to perform a complete morphological and biometric multiplanar analysis of all accessible and recognizable brain structures from the axial, coronal and sagittal planes, ideally through transabdominal and transvaginal access. In the 3 plans, an attempt should be made to evaluate the same structures, assuming the limitations posed by the different perspective provided by each of them. When performing it, it is essential to take into account the indication and gestational age, know the morphological patterns, have reference tables of the normality of the different intracranial structures for GD and follow the systematics proposed by scientific societies. The objective of this article is to describe the different planes and provide readers with the key points for the ultrasound detection of the most important and frequent malformations of the CNS.
{"title":"How to perform a fetal neurosonography: Key points","authors":"B. Puerto , P. Azumendi , C. Corrales , G. Azumendi","doi":"10.1016/j.gine.2025.101050","DOIUrl":"10.1016/j.gine.2025.101050","url":null,"abstract":"<div><div>Congenital anomalies of the Central Nervous System are one of the most important and numerous groups of congenital malformations. They constitute the second cause of disability in childhood and more than 95% occur in a population without known risk. The most effective strategy for its detection is to differentiate between 2 levels of care. The first level, the BASIC ULTRASONOGRAPHY, is performed on all pregnant women, while the second level, the DETAILED FETAL NEUROSONOGRAPHY, is performed in cases selected due to the risk of anomaly based on a list of indications or because an abnormality has been detected or suspected. CNS abnormality on basic ultrasound. Its purpose is to perform a complete morphological and biometric multiplanar analysis of all accessible and recognizable brain structures from the axial, coronal and sagittal planes, ideally through transabdominal and transvaginal access. In the 3 plans, an attempt should be made to evaluate the same structures, assuming the limitations posed by the different perspective provided by each of them. When performing it, it is essential to take into account the indication and gestational age, know the morphological patterns, have reference tables of the normality of the different intracranial structures for GD and follow the systematics proposed by scientific societies. The objective of this article is to describe the different planes and provide readers with the key points for the ultrasound detection of the most important and frequent malformations of the CNS.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101050"},"PeriodicalIF":0.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929404","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 : 2025-05-09DOI: 10.1016/j.gine.2025.101051
F. Palomo-Rodriguez , J. Gallardo-Martinez , R.D. Brenner-Anidjar , Z. Frias-Sanchez , S. Rojo-Novo , M. Pantoja-Garrido , F.J. Pantoja-Rosso , J.J. Fernandez-Alba
Introduction
Up to 50% of laparoscopic complications arise during access maneuvers to abdominal cavity. Our aim is to determine whether elevated pressures of 20–25 mmHg during these maneuvers, by increasing the distance between the abdominal wall and intracavitary organs, can help reduce the risk of entry-related complications, without an increase in anesthetic adverse effects.
Methods and materials
Prospective observational analytic multi-centered cohort study with 703 patients. The exposed-cohort consisted of patients undergoing gynecological laparoscopic surgeries in which an intra-abdominal pressure of 20–25 mmHg was used (group 20–25 mmHg) as opposed to the unexposed-cohort, in which usual < 15 mmHg pressures (group < 15 mmHg) were used. All surgeries were performed using the Veress needle as the method of insufflation.
Results
Patients in whom access was performed at pressures < 15 mmHg had a higher risk of complications than those in whom elevated pressures of 20–25 mmHg were used, which was statistically significant (OR 3.08, 95% CI95% 1.42–6.65, p = 0.004), without finding differences regarding anesthetic complications (p = 0.9).
Conclusion
The use of high intraabdominal pressure during access maneuvers serves as an effective technique for the prevention of complications, especially major complications, when compared with standard-used pressures, without increasing the incidence of anesthetic adverse effects, due to their temporary maintenance.
{"title":"Abdominal access following insufflation with Veress needle at high pressure: A security maneuver for the reduction of surgical complications during laparoscopic access","authors":"F. Palomo-Rodriguez , J. Gallardo-Martinez , R.D. Brenner-Anidjar , Z. Frias-Sanchez , S. Rojo-Novo , M. Pantoja-Garrido , F.J. Pantoja-Rosso , J.J. Fernandez-Alba","doi":"10.1016/j.gine.2025.101051","DOIUrl":"10.1016/j.gine.2025.101051","url":null,"abstract":"<div><h3>Introduction</h3><div>Up to 50% of laparoscopic complications arise during access maneuvers to abdominal cavity. Our aim is to determine whether elevated pressures of 20–25<!--> <!-->mmHg during these maneuvers, by increasing the distance between the abdominal wall and intracavitary organs, can help reduce the risk of entry-related complications, without an increase in anesthetic adverse effects.</div></div><div><h3>Methods and materials</h3><div>Prospective observational analytic multi-centered cohort study with 703 patients. The exposed-cohort consisted of patients undergoing gynecological laparoscopic surgeries in which an intra-abdominal pressure of 20–25<!--> <!-->mmHg was used (<em>group 20–25<!--> <!-->mmHg</em>) as opposed to the unexposed-cohort, in which usual<!--> <!--><<!--> <!-->15<!--> <!-->mmHg pressures (<em>group</em> <!--><<!--> <em>15<!--> <!-->mmHg</em>) were used. All surgeries were performed using the Veress needle as the method of insufflation.</div></div><div><h3>Results</h3><div>Patients in whom access was performed at pressures<!--> <!--><<!--> <!-->15<!--> <!-->mmHg had a higher risk of complications than those in whom elevated pressures of 20–25<!--> <!-->mmHg were used, which was statistically significant (OR 3.08, 95% CI95% 1.42–6.65, <em>p</em> <!-->=<!--> <!-->0.004), without finding differences regarding anesthetic complications (<em>p</em> <!-->=<!--> <!-->0.9).</div></div><div><h3>Conclusion</h3><div>The use of high intraabdominal pressure during access maneuvers serves as an effective technique for the prevention of complications, especially major complications, when compared with standard-used pressures, without increasing the incidence of anesthetic adverse effects, due to their temporary maintenance.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101051"},"PeriodicalIF":0.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924578","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 : 2025-04-28DOI: 10.1016/j.gine.2025.101038
M.J. Rol , M.J. Cuerva , A. Briones , J.L. Bartha
Introduction
There's a lack of effective screening methods to predict early breastfeeding cessation. Our study aimed to assess whether a simple screening of anxiety symptoms after the early postpartum period could help identify those families who discontinue exclusive and mixed breastfeeding early, despite their desire to breastfeed.
Methods
This prospective observational study, conducted at a single center, included women who were admitted to the postpartum ward following vaginal term births. Each participant was accompanied by their companions and babies and expressed a desire to breastfeed. Participants were divided into two groups based on whether they exhibited peripartum anxiety symptoms, assessed using the Hospital Anxiety and Depression scale (HADS). Follow-up assessments of the breastfeeding practices were conducted up to three years postpartum.
Results
A total of 113 eligible women participated in the study, with 92 women successfully followed up for three years. At six months postpartum, 56.5% of the women were exclusively breastfeeding, and 78.3% were still breastfeeding. No significant differences were observed in breastfeeding practices between the group exhibiting peripartum anxiety symptoms and the group without such symptoms.
Conclusion
Our approach, which concentrated on anxiety, did not yield an implementable screening tool for early breastfeeding cessation.
{"title":"Peripartum anxiety symptoms and breastfeeding duration: Prospective observational study","authors":"M.J. Rol , M.J. Cuerva , A. Briones , J.L. Bartha","doi":"10.1016/j.gine.2025.101038","DOIUrl":"10.1016/j.gine.2025.101038","url":null,"abstract":"<div><h3>Introduction</h3><div>There's a lack of effective screening methods to predict early breastfeeding cessation. Our study aimed to assess whether a simple screening of anxiety symptoms after the early postpartum period could help identify those families who discontinue exclusive and mixed breastfeeding early, despite their desire to breastfeed.</div></div><div><h3>Methods</h3><div>This prospective observational study, conducted at a single center, included women who were admitted to the postpartum ward following vaginal term births. Each participant was accompanied by their companions and babies and expressed a desire to breastfeed. Participants were divided into two groups based on whether they exhibited peripartum anxiety symptoms, assessed using the Hospital Anxiety and Depression scale (HADS). Follow-up assessments of the breastfeeding practices were conducted up to three years postpartum.</div></div><div><h3>Results</h3><div>A total of 113 eligible women participated in the study, with 92 women successfully followed up for three years. At six months postpartum, 56.5% of the women were exclusively breastfeeding, and 78.3% were still breastfeeding. No significant differences were observed in breastfeeding practices between the group exhibiting peripartum anxiety symptoms and the group without such symptoms.</div></div><div><h3>Conclusion</h3><div>Our approach, which concentrated on anxiety, did not yield an implementable screening tool for early breastfeeding cessation.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101038"},"PeriodicalIF":0.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881960","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}