Objective: To analyze the incidence and mortality of cervical cancer in individual age cohorts in the Czech Republic using nationwide data and data from the largest national gynecological oncology center.
Materials and methods: Analysis of a single-institution cohort of newly treated cervical cancer cases from 2022-2024, and analysis of incidence and mortality trends in individual age groups using data from the Czech National Cancer Registry (ÚZIS - Institute of Health Information and Statistics) from 2000-2023.
Results: The incidence and mortality of cervical cancer in the Czech Republic have declined significantly over the last 20 years. The decline correlates well with measures that have led to better organization and implementation of changes within the screening program. Analysis in individual age cohorts shows that the largest decline in incidence and mortality occurred in the cohort up to 34 years of age, yet in more than 50% of women with carcinomas in this cohort, cytological screening and subsequent management failed. The upward trend in incidence in the 35-44 and 45-54 age cohorts raises questions about the causes. The high percentage of invasive carcinomas in women examined by a gynecologist in the last three years requires an analysis of the quality of cytology laboratories and management by registering gynecologists. The introduction of high-risk human papillomavirus (HR HPV) testing and referral to expert colposcopy for discrepant findings is one way to improve the situation. Furthermore, audits of diagnosed carcinomas in women who have undergone screening should be introduced. The biggest challenge will be to activate the resistant population of women who underestimate the importance of regular screening examinations.
Conclusion: Even though we can see an overall decline in incidence and mortality, when individual age cohorts are analyzed, it shows us ways for improvement in each specific age group of women individually.
Objective: Mechanisms of sperm navigation are important for understanding the principles of sperm selection prior to fertilization. The aim of this work is to provide an overview of current knowledge about the physiological process of sperm navigation from ejaculation to fertilization of the ovulated oocyte.
Methods: Literature search of the PubMed database published up to June 2025 with terms focusing on "sperm navigation," "fertilization," and "chemoattractants".
Results: The principles of sperm navigation in the in vivo environment are still unclear in humans. Currently, there are simple in vivo studies performed on model animals, as well as a number of in vitro studies on human sperm. Based on these results, three main navigation systems are described: rheotaxis, thermotaxis, and chemotaxis. Rheotaxis acts over the longest distances and stimulates sperm movement against the flow of fluid. Thermotaxis acts over a shorter distance and guides sperm to places with higher temperatures. Chemotaxis acts over the shortest distance, attracting capacitated sperm to places where the ovulated oocyte is located.
Conclusion: Given how massively the sperm microinjection technique is used in the treatment of human infertility, it is important to carefully select sperm prior to fertilization. Knowledge of the principles of human sperm selection in in vivo conditions is crucial for effective sperm selection in the laboratory.
Objective: This study aimed to analyse the risk factors differentiating small for gestational age (SGA) and appropriate for gestational age (AGA) neonates.
Materials and methods: A retrospective-prospective cohort study was conducted from 2019 to 2024 at the 2nd Department of Obstetrics and Gynaecology, University Hospital Bratislava. The study involved 174 term neonates from singleton pregnancies, including 125 SGA and 49 AGA infants. Various maternal, foetal, and placental risk factors were analysed, with a particular focus on congenital cytomegalovirus infection (cCMV).
Results: Neonates' birth weights ranged from 1,480 to 4,470 grams. Of the risk factors assessed, only maternal COVID-19 infection during pregnancy was significantly associated with AGA outcomes (P = 0.009). No significant associations were found between common risk factors (e. g. hypertension, diabetes mellitus) and foetal growth restriction. Congenital CMV infection was not significantly associated with SGA. Logistic regression analysis confirmed the association of COVID-19 infection with foetal weight, while no significant effect was observed for CMV.
Conclusion: Maternal COVID-19 infection was associated with AGA outcomes, potentially due to enhanced medical surveillance and immune responses. However, the study's small sample size limits the interpretation of these findings, and further research is required to fully understand the impacts of COVID-19 on pregnancy. No significant association between congenital CMV infection and foetal growth restriction was found in this cohort, which was most likely due to the low prevalence of cCMV. Moreover, documented risk factors for foetal growth restriction, including hypertension and diabetes mellitus, were not statistically significant in our study population.
The increasing number of caesarean sections represents a significant health, economic, and psychological problem on a global scale. Robson's classification is a comprehensive approach to regularly analyse every operative abdominal delivery. It appears that particularly promoting the vaginal births after a previous caesarean section and reducing this mode of delivery among primiparas, is one of the ways of stopping the rising trend of caesarean sections. Slovak maternity facilities that have adopted Robson's classification reveal a decrease in the number of these obstetric surgeries.
Due to the implementation of sentinel lymph node ultrastaging, the prevalence of isolated tumor cells and micrometastases have increased. This literature review comprises of articles published between January 2019 and September 2024 aiming at low-volume metastases in regional lymph nodes, their prognosis, and links to molecular classification. Micrometastases are currently considered as having metastatic lymph node involvement; however, they have a better prognosis than macrometastases. Accordingly, therapy is tailored. In contrast, isolated tumor cell presence is not considered metastatic involvement according to International Federation of Gynecology and Obstetrics (FIGO) 2023 staging and does not affect the therapeutic procedure because their significant prognostic importance has not been proven so far.
Objective: To map management of different types of ectopic pregnancies in the Czech Republic using a questionnaire-based study.
Methods: In 2023, a total of 95 obstetrics and gynecology departments across the Czech Republic were surveyed using an online questionnaire, which inquired about the management strategies for various types of ectopic pregnancies. The departments were categorized based on the number of hysterectomies performed annually. Differences in responses between large centers and other departments were statistically compared.
Results: A total of 45 departments of all sizes completed the questionnaire. Two-thirds of all departments always perform salpingectomy in cases of tubal pregnancy (78% of large, 58% of medium-sized, and 40% of small departments). Systemic methotrexate administration for the treatment of intact tubal pregnancy is used by one-fifth of departments (22% of large, 23% of medium-sized, and 0% of small departments). In cases of atypical ectopic pregnancy localization, methotrexate treatment is used by 33% of large, 42% of medium-sized, and 40% of small departments. A statistically significant difference was observed in the clearly preferred laparoscopic approach for surgical management of cesarean scar pregnancy in large centers compared to smaller departments (P = 0.036). No other statistically significant differences were observed between the departments in other parameters.
Conclusion: In cases of intact tubal pregnancy, four-fifths of obstetric and gynecological departments perform laparoscopic salpingectomy, while only one-fifth utilize systemic methotrexate for treatment. On the other hand, methotrexate is used by one-third to two-fifths of departments of all sizes in cases of atypical ectopic pregnancy localization.
A woman's sexuality is a complex phenomenon involving several factors, among which age and health are the most important. However, other aspects are not negligible. The impact of pelvic organ prolapse on sexual function cannot be ignored, as the reported prevalence of pelvic organ prolapse in female population exceeds 50%. This article presents a systematic review of articles dealing with the impact of pelvic organ prolapse on female sexual function. Sexual dysfunction is common in women with pelvic organ prolapse, regardless of prolapse stage or the compartment affected. Estrogen therapy has no effect on sexuality in women with prolapse, while pelvic floor muscle training may provide some improvement. There is no evidence that conservative therapy using a pessary is associated with negative impact on sexual function. Native tissue repair tends to improve sexual function in general, except for posterior colporrhaphy, which was frequently associated with dyspareunia. No correlation between postoperative vaginal length and change in sexual function was identified. The impact of transvaginal mesh repair on sexuality remains unclear. In contrast, there is enough evidence proving that sacrocolpopexy significantly improves sexual function in women.
Objective: Analysis of coincidental maternal mortality in Slovakia in the years 2007-2024 from the database of the Slovak Gynecological and Obstetric Society (enhanced surveillance system).
Methods: Retrospective population analysis of maternal mortality from 2007 to 2024 focused on coincidental maternal deaths. Analysis of coincidental maternal death cases was carried out according to the International Classification of Diseases (ICD-10) for Maternal Mortality (ICD-MM).
Results: Between 2007 and 2024, a total of 123 women died. The maternal mortality ratio (MMR) was 12.46 per 100 000 live births. Fifteen women (12.20%) died from coincidental causes (MMR 1.52 per 100 000 live births). From direct causes, 51 women died (41.46%), from indirect causes, 54 women died (43.90%), and three women died (2.44%) from an unknown cause of death. Out of the coincidental deaths, 80.0% were due to polytrauma - car accidents (66.67%), train accident (6.67%), and entrapment in an elevator shaft (6.67%). Three cases of deaths were due to homicide (domestic violence) - 20%.
Conclusion: The study highlights the problem of under-recognition of coincidental maternal deaths, despite its significant impact on public health. The Slovak Gynecological and Obstetrics Society attempts to identify and collect data on coincidental maternal mortality in Slovakia, which is not included in vital statistics. Addressing this overlooked issue is crucial for enhancing maternal health outcomes and ensuring comprehensive maternal safety worldwide.
Objective: Amenorrhea is a menstrual disorder than can arise as a result of hormonal dysfunction of the hypothalamic-pituitary--gonadal axis. There is limited data on the most common causes of secondary amenorrhea in Pakistan. Therefore, this study aimed to assess various causative factors along with hormone profiling in patients with secondary amenorrhea.
Patients and methods: The present cross-sectional study was conducted in different fertility clinics of Abbottabad. Patients with secondary amenorrhea were included by a non-probability sampling technique. Data related to demographic and other clinical variables were collected via a data collection form. Serum progesterone, estradiol, luteinizing hormone, follicle stimulating hormone, and prolactin were determined using commercially available enzyme-linked immunosorbent assay kits. This study was conducted on 126 patients with a mean age of 28.5 ± 7.8 years.
Results: Drug-related amenorrhea was observed in 14.3% of patients. Hyperprolactinemia-induced amenorrhea was observed in 31.7% and in 54% of patients with unknown etiology. Of the patients with drug-induced amenorrhea, 38.9% used oral contraceptives, 27.8% used omeprazole, and 33.3% used other drugs. Headache (79.4%) and fatigue (78.6%) were the main symptoms reported in amenorrheic women, while hair loss was reported in 65.9% of patients. Both loss of libido and hirsutism were observed in 45.2% and 42.9% of patients, resp. Breast pain and vaginal dryness occurred in 35.7% and 23.8% of patients, resp.
Conclusion: The current study showed that hyperprolactinemia is the most common cause of secondary amenorrhea followed by drug-induced amenorrhea, which must be considered in the clinical management of hormonal imbalances and subsequent amenorrhea.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：