Pub Date : 2020-07-02DOI: 10.33552/wjgwh.2020.04.000583
A. A. Mulla
Background: The majority of giant teratomas are symptomatic. The preoperative evaluation for possible malignancy is challengeable, as is the surgical approach. A consensus has not yet been drawn regarding the optimal treatment approach in cases of exceptionally large teratomas. Case presentation: We report a rare case of minimal laparotomy management of a giant ovarian cystic teratoma in a 32-year-old asymptomatic multiparous woman. The patient was diagnosed while performing a fitness-to-work checkup where the physician noted a suspicious abdominal swelling. Subsequently, she was referred to us for further evaluation. Her CA125 level was raised, and an abdominal contrast computed tomography revealed a huge teratoma. After appropriate counselling, laparotomy and adenectomy were performed. Histopathological examination diagnosed a mature cystic teratoma with no malignant transformation. The patient had an uneventful recovery and was discharged on the third post-operative day. Conclusions: We conclude that dermoid cysts can reach enormous sizes in the absence of serious symptoms or evidence of malignancy, although the size is a well-known risk factor for malignant transformation.
{"title":"Minimal Laparotomy Management of a Giant Asymptomatic Ovarian Teratoma in a Woman of Reproductive Age: A Case Report","authors":"A. A. Mulla","doi":"10.33552/wjgwh.2020.04.000583","DOIUrl":"https://doi.org/10.33552/wjgwh.2020.04.000583","url":null,"abstract":"Background: The majority of giant teratomas are symptomatic. The preoperative evaluation for possible malignancy is challengeable, as is the surgical approach. A consensus has not yet been drawn regarding the optimal treatment approach in cases of exceptionally large teratomas. Case presentation: We report a rare case of minimal laparotomy management of a giant ovarian cystic teratoma in a 32-year-old asymptomatic multiparous woman. The patient was diagnosed while performing a fitness-to-work checkup where the physician noted a suspicious abdominal swelling. Subsequently, she was referred to us for further evaluation. Her CA125 level was raised, and an abdominal contrast computed tomography revealed a huge teratoma. After appropriate counselling, laparotomy and adenectomy were performed. Histopathological examination diagnosed a mature cystic teratoma with no malignant transformation. The patient had an uneventful recovery and was discharged on the third post-operative day. Conclusions: We conclude that dermoid cysts can reach enormous sizes in the absence of serious symptoms or evidence of malignancy, although the size is a well-known risk factor for malignant transformation.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44267447","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 : 2020-06-25DOI: 10.33552/wjgwh.2020.04.000582
Alev Aydın
Objective: Vitamin D levels are studied in Gestational Diabetes in many researches. Our aim is to investigate the relationship of vitamin D deficiency with gestational diabetes mellitus (GDM) in pregnancy. Methods: In this study, 210 Pregnant women were included, of them 108 had GDM, 102 were controls. 25-hydroxyvitamin D (25(OH)D) levels of GDM group were compared with healthy pregnant controls. The maternal and fetal outcomes were recorded. Results: GDM group had significantly higher mean 25(OH)D (11.8±8.0 ng/ml) compared to controls (7.7±6.1 ng/ml, p<0.01). There was no correlation of vitamin D levels with; maternal age, Apgar levels, birth week and fetal weight. Furthermore, there was no correlation of 25(OH)D levels with mode of delivery, intensive care need of new-born and macrosomia. Conclusions: Although there are numerous reports about positive correlation between vitamin D deficiency and GDM in pregnancy, we found the opposite. In severe vitamin D deficiency, the mechanisms may differ and should be identified further.
{"title":"Vitamin D Levels are found to be higher in Gestational Diabetics in Vitamin D Depleted Population","authors":"Alev Aydın","doi":"10.33552/wjgwh.2020.04.000582","DOIUrl":"https://doi.org/10.33552/wjgwh.2020.04.000582","url":null,"abstract":"Objective: Vitamin D levels are studied in Gestational Diabetes in many researches. Our aim is to investigate the relationship of vitamin D deficiency with gestational diabetes mellitus (GDM) in pregnancy. Methods: In this study, 210 Pregnant women were included, of them 108 had GDM, 102 were controls. 25-hydroxyvitamin D (25(OH)D) levels of GDM group were compared with healthy pregnant controls. The maternal and fetal outcomes were recorded. Results: GDM group had significantly higher mean 25(OH)D (11.8±8.0 ng/ml) compared to controls (7.7±6.1 ng/ml, p<0.01). There was no correlation of vitamin D levels with; maternal age, Apgar levels, birth week and fetal weight. Furthermore, there was no correlation of 25(OH)D levels with mode of delivery, intensive care need of new-born and macrosomia. Conclusions: Although there are numerous reports about positive correlation between vitamin D deficiency and GDM in pregnancy, we found the opposite. In severe vitamin D deficiency, the mechanisms may differ and should be identified further.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44489250","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 : 2020-06-24DOI: 10.33552/wjgwh.2020.04.000581
O. Melkozerova
Objective: To analyse the effect of the ultrasonic energy during MRI-guided high-intensity focused ultrasound ablation (HIFU) of uterine fibroids on molecular markers of endometrial receptivity in women of reproductive age. Study design: A prospective comparative cohort study of 60 women of reproductive age was conducted. The main group consisted of 32 patients suffering from the symptomatic course of uterine fibroids who received treatment with HIFU ablation of uterine fibroids: 17 women with node localization at the front wall of the uterus and the reflected action of ultrasonic waves on the endometrium and 15 women with the back wall node localization and penetrating effect of the waves. The control group consisted of 28 healthy fertile women examined voluntarily. The endometrium obtained with pipelle-biopsia on days 20-22 of the cycle was examined by immunohistochemistry before and three months after the treatment. The results were processed by the method of variation statistics using the SPSS 22.0. Results: A significant decrease in the stromal expression of CD95 bright in the endometrium to the level comparable with control values was observed after HIFU ablation of uterine fibroids (from 70.22±9.77 c/s to 48.81±5.47 c/s; p<0.001; the control level – 47.80±2.13 c/s). The ratio and expression of steroid receptors, proliferation markers, p53-dependent apoptosis and itsblockers, regulators and markers of angiogenesis, LIF and LIF-R signalling molecules in thestroma and endometrial glands did not change significantly after treatment (p>0.05 in treatment dynamics). It was demonstrated that focused ultrasound causes an increase in the level of expression of estradiol alpha receptors in the endometrial glands (118.07±14.01 points vs.153.33±11.43 points; p=0.02) and a decrease in stromal p 53 expression (30.80±21.61% vs.14.66±3.74%; p=0.007). No influence of the localization of fibroid node on the stromal expression of CD56 bright+ was demonstrated. A significant increase in the stromal expression of CD34+ to the level statistically comparable with control values (from 26.00±1.63 c/s to 32.47±2.03 c/s; p=0.011; the control level - 37.99±1.23 c/s) was associated with ultrasound action. Conclusion: This study did not reveal any significant negative effects of HIFU ablation of uterine fibroids on endometrial receptivity in women of reproductive age.
{"title":"The Effect of High-Intensity Focused Ultrasound Rays in the Treatment of Uterine Fibroids on Tissue Parameters of Endometrial Receptivity","authors":"O. Melkozerova","doi":"10.33552/wjgwh.2020.04.000581","DOIUrl":"https://doi.org/10.33552/wjgwh.2020.04.000581","url":null,"abstract":"Objective: To analyse the effect of the ultrasonic energy during MRI-guided high-intensity focused ultrasound ablation (HIFU) of uterine fibroids on molecular markers of endometrial receptivity in women of reproductive age. Study design: A prospective comparative cohort study of 60 women of reproductive age was conducted. The main group consisted of 32 patients suffering from the symptomatic course of uterine fibroids who received treatment with HIFU ablation of uterine fibroids: 17 women with node localization at the front wall of the uterus and the reflected action of ultrasonic waves on the endometrium and 15 women with the back wall node localization and penetrating effect of the waves. The control group consisted of 28 healthy fertile women examined voluntarily. The endometrium obtained with pipelle-biopsia on days 20-22 of the cycle was examined by immunohistochemistry before and three months after the treatment. The results were processed by the method of variation statistics using the SPSS 22.0. Results: A significant decrease in the stromal expression of CD95 bright in the endometrium to the level comparable with control values was observed after HIFU ablation of uterine fibroids (from 70.22±9.77 c/s to 48.81±5.47 c/s; p<0.001; the control level – 47.80±2.13 c/s). The ratio and expression of steroid receptors, proliferation markers, p53-dependent apoptosis and itsblockers, regulators and markers of angiogenesis, LIF and LIF-R signalling molecules in thestroma and endometrial glands did not change significantly after treatment (p>0.05 in treatment dynamics). It was demonstrated that focused ultrasound causes an increase in the level of expression of estradiol alpha receptors in the endometrial glands (118.07±14.01 points vs.153.33±11.43 points; p=0.02) and a decrease in stromal p 53 expression (30.80±21.61% vs.14.66±3.74%; p=0.007). No influence of the localization of fibroid node on the stromal expression of CD56 bright+ was demonstrated. A significant increase in the stromal expression of CD34+ to the level statistically comparable with control values (from 26.00±1.63 c/s to 32.47±2.03 c/s; p=0.011; the control level - 37.99±1.23 c/s) was associated with ultrasound action. Conclusion: This study did not reveal any significant negative effects of HIFU ablation of uterine fibroids on endometrial receptivity in women of reproductive age.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41939231","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 : 2020-06-12DOI: 10.33552/wjgwh.2020.04.000580
A. A. Mulla
The purpose of this study was to detect the prevalence of dyslipidemia among polycystic ovary syndrome (PCOS) women with different BMIs. Study design: We conducted a cross-sectional study whereby one hundred and fifteen women diagnosed with PCOS were recruited from a fertility clinic in a 6-month period. All participants had their weight and height measured and body mass index (BMI) calculated. Thereafter, they were divided into two groups: normal BMI (BMI ≤25 kg/m2) and high BMI (BMI >25 kg/m2). Fasting blood samples were obtained and total cholesterol, triglycerides, LDL-C, HDL-C, glucose, and insulin levels were measured in both groups. Insulin resistance was calculated using the homeostasis model assessment of insulin resistance (HOMA-IR) equation. Differences in these variables were assessed using the Chi-square test and Fisher’s exact test. Results: No statistically significant differences were found between both groups of women in terms of total cholesterol, triglycerides, LDL-C, and HDL-C levels. Insulin resistance was significantly more prevalent in the high BMI (78.3%) than in the normal BMI group (59.1%) (P < 0.05). Conclusions: Dyslipidemia in women with PCOS is not related to their BMI. Early detection and treatment of dyslipidemia in this group of women will protect them from cardiovascular diseases.
{"title":"Prevalence of Dyslipidemia among Women with Polycystic Ovary Syndrome Based on Body Mass Index","authors":"A. A. Mulla","doi":"10.33552/wjgwh.2020.04.000580","DOIUrl":"https://doi.org/10.33552/wjgwh.2020.04.000580","url":null,"abstract":"The purpose of this study was to detect the prevalence of dyslipidemia among polycystic ovary syndrome (PCOS) women with different BMIs. Study design: We conducted a cross-sectional study whereby one hundred and fifteen women diagnosed with PCOS were recruited from a fertility clinic in a 6-month period. All participants had their weight and height measured and body mass index (BMI) calculated. Thereafter, they were divided into two groups: normal BMI (BMI ≤25 kg/m2) and high BMI (BMI >25 kg/m2). Fasting blood samples were obtained and total cholesterol, triglycerides, LDL-C, HDL-C, glucose, and insulin levels were measured in both groups. Insulin resistance was calculated using the homeostasis model assessment of insulin resistance (HOMA-IR) equation. Differences in these variables were assessed using the Chi-square test and Fisher’s exact test. Results: No statistically significant differences were found between both groups of women in terms of total cholesterol, triglycerides, LDL-C, and HDL-C levels. Insulin resistance was significantly more prevalent in the high BMI (78.3%) than in the normal BMI group (59.1%) (P < 0.05). Conclusions: Dyslipidemia in women with PCOS is not related to their BMI. Early detection and treatment of dyslipidemia in this group of women will protect them from cardiovascular diseases.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45919557","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 : 2020-06-02DOI: 10.33552/wjgwh.2020.04.000579
A. Gabra
Hypertensive disorders of pregnancy are among the most common medical problems during pregnancy and they are associated with significant mortality and morbidity rate. Low dose Aspirin is already approved by many societies like ACOG and WHO to be used as prophylaxis for preeclampsia in high-risk patients. Recent studies showed a possible reduction in the incidence of preeclampsia and intrauterine growth restriction for high-risk mothers who taking LMWH during pregnancy. Although, the published evidence supporting LMWH is characterized by profound heterogeneity and inconsistency in terms of selection criteria and treatment regimens. Antepartum treatment with a combination of LMWH with low-dose ASA is endorsed by the American College of Chest Physicians and The American College of Obstetricians and Gynecologists for treatment of Antiphospholipid syndrome during pregnancy. WHO recommends Calcium as the first nutritional supplementation to prevent preeclampsia among population with low calcium in the diet. Folic acid and statins showed possible reduction in incidence of preeclampsia in high-risk patients but there is a need for further studies to confirm that. Dietary and lifestyle interventions have the potential to reduce the risk of preeclampsia. Both Metformin and vascular endothelial growth factors has promising preventive role that has been found through recent studies. Pravastatin. These results show that Pravastatin reduced sFlt-1 and the production of soluble endoglin and decreased endothelial dysfunction in primary human tissues(67). examined 21 pregnant women with an Antiphospholipid who experienced preeclampsia intrauterine growth during low-dose aspirin (LDA) molecular weight Low dose the control
{"title":"Updates in the Prevention of Preeclampsia, What’s Beyond Aspirin?","authors":"A. Gabra","doi":"10.33552/wjgwh.2020.04.000579","DOIUrl":"https://doi.org/10.33552/wjgwh.2020.04.000579","url":null,"abstract":"Hypertensive disorders of pregnancy are among the most common medical problems during pregnancy and they are associated with significant mortality and morbidity rate. Low dose Aspirin is already approved by many societies like ACOG and WHO to be used as prophylaxis for preeclampsia in high-risk patients. Recent studies showed a possible reduction in the incidence of preeclampsia and intrauterine growth restriction for high-risk mothers who taking LMWH during pregnancy. Although, the published evidence supporting LMWH is characterized by profound heterogeneity and inconsistency in terms of selection criteria and treatment regimens. Antepartum treatment with a combination of LMWH with low-dose ASA is endorsed by the American College of Chest Physicians and The American College of Obstetricians and Gynecologists for treatment of Antiphospholipid syndrome during pregnancy. WHO recommends Calcium as the first nutritional supplementation to prevent preeclampsia among population with low calcium in the diet. Folic acid and statins showed possible reduction in incidence of preeclampsia in high-risk patients but there is a need for further studies to confirm that. Dietary and lifestyle interventions have the potential to reduce the risk of preeclampsia. Both Metformin and vascular endothelial growth factors has promising preventive role that has been found through recent studies. Pravastatin. These results show that Pravastatin reduced sFlt-1 and the production of soluble endoglin and decreased endothelial dysfunction in primary human tissues(67). examined 21 pregnant women with an Antiphospholipid who experienced preeclampsia intrauterine growth during low-dose aspirin (LDA) molecular weight Low dose the control","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48692530","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 : 2020-05-22DOI: 10.33552/wjgwh.2020.04.000577
J. Piazze
duct dilatation. A magnetic resonance imaging (MRI) was performed a week after, which confirmed the ultrasound scan diagnosis of congenital hepatic cyst.
导管扩张。一周后进行了核磁共振成像（MRI），证实了先天性肝囊肿的超声扫描诊断。
{"title":"Fetal Congenital Hepatic Cyst","authors":"J. Piazze","doi":"10.33552/wjgwh.2020.04.000577","DOIUrl":"https://doi.org/10.33552/wjgwh.2020.04.000577","url":null,"abstract":"duct dilatation. A magnetic resonance imaging (MRI) was performed a week after, which confirmed the ultrasound scan diagnosis of congenital hepatic cyst.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43802960","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 : 2020-05-20DOI: 10.33552/wjgwh.2020.04.000576
Kramarskiy Vladimir
The Average age of the women surveyed was 36.8±1.7 years. All the women had a history of childbirth. Medical abortions in 52 women. Complications after a medical abortion in 18. Uterine fibroids in 20 women. The coincidence of the cytological conclusion and histological examination was noted in 47 (53.4%) observations. In 41(46.6%) cases, the findings of histological examination and liquid Cytology did not match. Out of 7 cases histologically diagnosed with endometrial adenocarcinoma, the result of liquid Cytology coincided with the histological conclusion only in 3 (42.9%) cases. In the presence of endometrial hyperplasia (37 cases), according to histological research, the identical pathology was confirmed by liquid Cytology only in 12 (32.4%) cases [3]. Atrophic endometrium was detected in 39 women based on histological examination. Cytological confirmation of the histological result of the study in these women was confirmed in 22 (56.4%) cases.
{"title":"Experience in Using Liquid Cytology in the Diagnosis of Endometrial Pathologies","authors":"Kramarskiy Vladimir","doi":"10.33552/wjgwh.2020.04.000576","DOIUrl":"https://doi.org/10.33552/wjgwh.2020.04.000576","url":null,"abstract":"The Average age of the women surveyed was 36.8±1.7 years. All the women had a history of childbirth. Medical abortions in 52 women. Complications after a medical abortion in 18. Uterine fibroids in 20 women. The coincidence of the cytological conclusion and histological examination was noted in 47 (53.4%) observations. In 41(46.6%) cases, the findings of histological examination and liquid Cytology did not match. Out of 7 cases histologically diagnosed with endometrial adenocarcinoma, the result of liquid Cytology coincided with the histological conclusion only in 3 (42.9%) cases. In the presence of endometrial hyperplasia (37 cases), according to histological research, the identical pathology was confirmed by liquid Cytology only in 12 (32.4%) cases [3]. Atrophic endometrium was detected in 39 women based on histological examination. Cytological confirmation of the histological result of the study in these women was confirmed in 22 (56.4%) cases.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46288547","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 : 2020-05-13DOI: 10.33552/wjgwh.2020.03.000575
Orazov Мr, Radzinsky Ve, Balan Ve, Khamoshina Мв, Toktar Lr, Smetnik Aa
Introduction: Genitourinary syndrome of menopause (GSM) is a pressing gynecological problem since the condition leads to the deterioration in the quality of life of postmenopausal women. Objective: compare the efficacy of relief of GSM with intravaginal use of estriol monoproduct and a combination product containing estriol, micronized progesterone and Lactobacillus casei rhamnosus Doderleini. Materials and Methods: the study enrolled 69 postmenopausal women aged 53.6±2.1 diagnosed with postmenopausal atrophic vaginitis. After screening, the patients were randomized into 2 groups: Group 1 (n=34) used 0.5 mg/day of estriol monoproduct intravaginal for 14 days, followed by a gradual dose reduction based on symptom relief until a maintenance dose was reached (i.e. 1 suppository 2 times a week), Group 2 (n=35) used intravaginal combination product in the form of capsules containing 0.2 mg of estriol, 2.0 mg of micronized progesterone and lyophilized culture of L. casei rhamnosus Doderleini – 341mg (2*107 CFU) (Trioginal, Besins Healthcare SA, Belgium). The product was prescribed to be taken at a dose of 2 capsules intravaginal 1 time/day for 20 days, then 1 capsule/day. Total duration of therapy in both groups was 12 weeks. After the end of therapy, patients were monitored for 12 weeks. To determine the efficacy of the treatment, subjective and objective clinical symptoms of GSM were evaluated using the adapted Nappi RE scale at the study visits. 5-point D. Barlow scale, vaginal pH, Bachmann’s Vaginal Health Index was additionally used. The main software for statistical analysis was the IBM SPSS 22 statistical package. Results: After 12 weeks of treatment, complaints of dyspareunia resolved completely in 18 (52.9%) patients in Group 1 and 25 (71.5%) in Group 2, p<0.05; 12 weeks after the end of therapy: in 24 (70.6%) patients in Group 1 and in 34 (97.1%) patients in Group 2, p<0.05. Improvement in elasticity after 12 weeks of therapy was observed in 19 (55.9%) and 27 (77.1%) patients of Group 1 and Group 2, respectively (p<0.05); normal epithelial thickness was observed in 26 (76.5%) and 30 (85.7%) patients, respectively (p<0.05). 12 weeks after the end of treatment in Group 1 and Group 2, improvement in elasticity was observed in 22 (64.7%) and 30 (85.7%) patients; normal epithelial thickness was observed in 22 (64.7%) and 27 (77.1%) patients, respectively (p<0.05). For the rest of analysed parameters (D. Barlow scale, pH, Bachmann’s Vaginal Health Index) statistical analysis did not reveal any statistically significant differences between the groups in the dynamics of treatment and follow-up. Conclusion: Thus, local combination hormone therapy with probiotic support can be an effective treatment option for genitourinary syndrome of menopause since it helps to enhance proliferative processes, improve blood circulation, restore biocenosis and relieve symptoms of coital pain. Compared with local estriol monotherapy, having a comparable effect on the c
{"title":"Combination Local Therapy of Genitourinary Menopausal Syndrome Symptoms","authors":"Orazov Мr, Radzinsky Ve, Balan Ve, Khamoshina Мв, Toktar Lr, Smetnik Aa","doi":"10.33552/wjgwh.2020.03.000575","DOIUrl":"https://doi.org/10.33552/wjgwh.2020.03.000575","url":null,"abstract":"Introduction: Genitourinary syndrome of menopause (GSM) is a pressing gynecological problem since the condition leads to the deterioration in the quality of life of postmenopausal women. Objective: compare the efficacy of relief of GSM with intravaginal use of estriol monoproduct and a combination product containing estriol, micronized progesterone and Lactobacillus casei rhamnosus Doderleini. Materials and Methods: the study enrolled 69 postmenopausal women aged 53.6±2.1 diagnosed with postmenopausal atrophic vaginitis. After screening, the patients were randomized into 2 groups: Group 1 (n=34) used 0.5 mg/day of estriol monoproduct intravaginal for 14 days, followed by a gradual dose reduction based on symptom relief until a maintenance dose was reached (i.e. 1 suppository 2 times a week), Group 2 (n=35) used intravaginal combination product in the form of capsules containing 0.2 mg of estriol, 2.0 mg of micronized progesterone and lyophilized culture of L. casei rhamnosus Doderleini – 341mg (2*107 CFU) (Trioginal, Besins Healthcare SA, Belgium). The product was prescribed to be taken at a dose of 2 capsules intravaginal 1 time/day for 20 days, then 1 capsule/day. Total duration of therapy in both groups was 12 weeks. After the end of therapy, patients were monitored for 12 weeks. To determine the efficacy of the treatment, subjective and objective clinical symptoms of GSM were evaluated using the adapted Nappi RE scale at the study visits. 5-point D. Barlow scale, vaginal pH, Bachmann’s Vaginal Health Index was additionally used. The main software for statistical analysis was the IBM SPSS 22 statistical package. Results: After 12 weeks of treatment, complaints of dyspareunia resolved completely in 18 (52.9%) patients in Group 1 and 25 (71.5%) in Group 2, p<0.05; 12 weeks after the end of therapy: in 24 (70.6%) patients in Group 1 and in 34 (97.1%) patients in Group 2, p<0.05. Improvement in elasticity after 12 weeks of therapy was observed in 19 (55.9%) and 27 (77.1%) patients of Group 1 and Group 2, respectively (p<0.05); normal epithelial thickness was observed in 26 (76.5%) and 30 (85.7%) patients, respectively (p<0.05). 12 weeks after the end of treatment in Group 1 and Group 2, improvement in elasticity was observed in 22 (64.7%) and 30 (85.7%) patients; normal epithelial thickness was observed in 22 (64.7%) and 27 (77.1%) patients, respectively (p<0.05). For the rest of analysed parameters (D. Barlow scale, pH, Bachmann’s Vaginal Health Index) statistical analysis did not reveal any statistically significant differences between the groups in the dynamics of treatment and follow-up. Conclusion: Thus, local combination hormone therapy with probiotic support can be an effective treatment option for genitourinary syndrome of menopause since it helps to enhance proliferative processes, improve blood circulation, restore biocenosis and relieve symptoms of coital pain. Compared with local estriol monotherapy, having a comparable effect on the c","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45165261","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 : 2020-05-05DOI: 10.33552/wjgwh.2020.03.000573
V. Gnetetskaya
Cell-free DNA has been utilized as a novel analyse for the development of non-invasive approaches to prenatal genetic testing using different methodologies [1-4]. Following the publication of a number of major research and clinical studies that revealed high accuracy to detect fetal aneuploidies, the use of noninvasive prenatal testing (NIPT) has been widely adopted in clinical practice. NIPT technologies provide significant improvements over conventional invasive prenatal testing and consequently, international bodies endorse NIPT as a routine screening option [5,6]. This has resulted in many institutions adopting NIPT within the scope of standard of care for autosomal and sex chromosomal aneuploidy detection (SCA). Mother and Child Clinic is a primary clinical centre certified by the Russian Ministry of Health and specialises in screening and diagnosing prenatal chromosomal aneuploidies. NIPT has been offered as a prenatal screening option in our clinic since (May 2017). This study aims to summarize the NIPT results and clinical performance of NIPT in the detection of trisomy 13,18,21 and SCAs using the Veracity non-invasive prenatal test in a cohort of 1382 samples among mixed-risk participants. In this report we convey a complete and robust clinical picture of the performance of Veracity under routine NIPT testing conditions and describe examples of unique clinical cases.
{"title":"Validation and Clinical Use of the Non-Invasive Prenatal Test “Veracity”","authors":"V. Gnetetskaya","doi":"10.33552/wjgwh.2020.03.000573","DOIUrl":"https://doi.org/10.33552/wjgwh.2020.03.000573","url":null,"abstract":"Cell-free DNA has been utilized as a novel analyse for the development of non-invasive approaches to prenatal genetic testing using different methodologies [1-4]. Following the publication of a number of major research and clinical studies that revealed high accuracy to detect fetal aneuploidies, the use of noninvasive prenatal testing (NIPT) has been widely adopted in clinical practice. NIPT technologies provide significant improvements over conventional invasive prenatal testing and consequently, international bodies endorse NIPT as a routine screening option [5,6]. This has resulted in many institutions adopting NIPT within the scope of standard of care for autosomal and sex chromosomal aneuploidy detection (SCA). Mother and Child Clinic is a primary clinical centre certified by the Russian Ministry of Health and specialises in screening and diagnosing prenatal chromosomal aneuploidies. NIPT has been offered as a prenatal screening option in our clinic since (May 2017). This study aims to summarize the NIPT results and clinical performance of NIPT in the detection of trisomy 13,18,21 and SCAs using the Veracity non-invasive prenatal test in a cohort of 1382 samples among mixed-risk participants. In this report we convey a complete and robust clinical picture of the performance of Veracity under routine NIPT testing conditions and describe examples of unique clinical cases.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46832632","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 : 2020-04-27DOI: 10.33552/wjgwh.2020.03.000569
A. Abbas
The study aims to create a nomogram for prediction of risk factors for preeclampsia (PE) during antenatal care (ANC) in a tertiary maternity hospital. Materials and Methods: A cross-sectional study was conducted between May 2016 and December 2017 in a tertiary maternity hospital. Two hundred thirty pregnant women were included, at first visit, personal data, family history of risk factors for PE, maternal medical, and obstetric history was collected. Physical examination, including blood pressure, weight, signs of edema, and urine analysis were done. Then follow up at 24 weeks and after 32 weeks gestation to know if she developed PE or not through the physician. Included nomogram, which was built based on the data of regression analysis, was used to predict the value of one or more responses from a set of predictors. Results: The study included 230 women. Cases diagnosed with PE during all the follow up are 37 cases (16.1%). Five factors were not significant; maternal age (P=0.154, OR=1.076), consanguinity (P=0.821, OR=1.104), age at marriage (P=0.266, OR=1.404), age at first pregnancy (P=0.319, OR=0.735) and order of pregnancy (3rd or more) (P=0.951, OR=0.984). Only two factors significant; a history of diabetes mellitus (P=0.010, OR=5.923) and history of hypertension (P=0.045, OR=7.838). Probability of PE based on the finding of the nomogram was 68% with good discrimination. Conclusion: History of diabetes mellitus and hypertension were the predictors in the final model among pregnant women for the development of preeclampsia.
{"title":"A Nomogram for Prediction of Risk Factors for Preeclampsia during Antenatal Care at a Tertiary Maternity Hospital","authors":"A. Abbas","doi":"10.33552/wjgwh.2020.03.000569","DOIUrl":"https://doi.org/10.33552/wjgwh.2020.03.000569","url":null,"abstract":"The study aims to create a nomogram for prediction of risk factors for preeclampsia (PE) during antenatal care (ANC) in a tertiary maternity hospital. Materials and Methods: A cross-sectional study was conducted between May 2016 and December 2017 in a tertiary maternity hospital. Two hundred thirty pregnant women were included, at first visit, personal data, family history of risk factors for PE, maternal medical, and obstetric history was collected. Physical examination, including blood pressure, weight, signs of edema, and urine analysis were done. Then follow up at 24 weeks and after 32 weeks gestation to know if she developed PE or not through the physician. Included nomogram, which was built based on the data of regression analysis, was used to predict the value of one or more responses from a set of predictors. Results: The study included 230 women. Cases diagnosed with PE during all the follow up are 37 cases (16.1%). Five factors were not significant; maternal age (P=0.154, OR=1.076), consanguinity (P=0.821, OR=1.104), age at marriage (P=0.266, OR=1.404), age at first pregnancy (P=0.319, OR=0.735) and order of pregnancy (3rd or more) (P=0.951, OR=0.984). Only two factors significant; a history of diabetes mellitus (P=0.010, OR=5.923) and history of hypertension (P=0.045, OR=7.838). Probability of PE based on the finding of the nomogram was 68% with good discrimination. Conclusion: History of diabetes mellitus and hypertension were the predictors in the final model among pregnant women for the development of preeclampsia.","PeriodicalId":87379,"journal":{"name":"World journal of gynecology & womens health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42760658","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}
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：