Ginekologia polska最新文献

Objectives: Exclusive breastfeeding is recommended until the child is six months of age. However, there are many myths about breastfeeding. The aim of our study was to assess the knowledge of Polish women about breastfeeding.

Material and methods: A cross-sectional survey study was conducted among 1536 Polish women. A self-administered questionnaire was created using Google Forms survey management software and distributed online. The participants were asked about the most common myths in society regarding breastfeeding.

Results: The highest number of correct answers in all age groups were given to questions related to the nutritional value of breast milk (80.9-94.9%). The fewest correct answers in each age group were recorded to questions concerning the possibility of getting pregnant during the first 6 months of breastfeeding (16.1-35.3%), the safety of drinking non-alcoholic beer during lactation (24.4-37.1%), the benefits of brushing the breast while breastfeeding (16.0-37.1%), and the effectiveness of compresses made of cabbage leaves or sage infusions in relieving ailments during milk rush (6.8-12.4%). Higher education and being a mother were associated with a higher number of correct answers. Age below 25 years was associated with lower number of correct answers.

Conclusions: The results of the survey regarding breastfeeding suggest the existence of various beliefs in the population of Polish women which are not evidence based. This indicates the need for spreading adequate information about breastfeeding, especially among younger women and those who did not obtain higher education.

Objectives: The methods of prompting cervical ripening (CR) include mechanical and pharmacological approaches. The former seems safer. However, this superiority may change with the application of a new labor curve. Therefore, we aimed to compare the efficacy and safety of dinoprostone and double-balloon catheters (DBC) in promoting CR in induction of labor (IOL).

Material and methods: A total of 877 primipara women with Bishop score ≤ 6 were divided into the dinoprostone group (n = 502) and DBC group (n = 375) according to the IOL way. The women in the dinoprostone group received dinoprostone to perform IOL, while those in the DBC group received DBC to perform IOL. The natural birth rate, time to labor onset and birth, and maternal and neonatal complications were compared between the two groups. A propensity score match (PSM) was used to eliminate the selection bias.

Results: A total of 516 cases were left after PSM (1:1) to Bishop score. The dinoprostone was associated with an improved Bishop score. However, there were no significant differences in the vaginal delivery rate, the stage of labor, and the time from ripening to labor onset and delivery between the two groups (p > 0.05). The incidence rates of puerperal infection and blood loss were notably higher in the DBC group than in the dinoprostone group (p < 0.05). However, there was no statistical difference in the incidence of postpartum hemorrhage between the two groups (p > 0.05).

Conclusions: Dinoprostone is associated with a lower puerperal infection rate and improved Bishop score in IOL without an increased success rate of vaginal delivery.

Objectives: Vulvar lichen sclerosus (VLS) is defined as a chronic inflammatory skin disease that most often involves lesions on the mucous membranes of the vulva with a tendency to progress to the anal skin. The etiopathogenesis of VLS remains unknown and is likely multifactorial. Data emphasize the role of immunological factors - more than 25% of VLS cases coexist with autoimmune diseases. The purpose of the present study was to determine the correlation of the prevalence of anti-thyroid antibodies - IgG class antibodies against thyroid peroxidase and IgG class antibodies against thyroglobulin in women with vulvar lichen sclerosus, and the appropriateness of screening tests for autoimmune thyroid diseases in women with vulvar lichen sclerosus.

Material and methods: Fifty women with vulvar lichen sclerosus were enrolled in the study. The control group consisted of 41 healthy women. A detailed medical history was taken with all patients, followed by laboratory determinations - anti-thyroid antibodies - IgG class antibodies against thyroid peroxidase and IgG class antibodies against thyroglobulin.

Results: Antibodies to thyroid peroxidase were present in 12% of the study group with vulvar lichen sclerosus and 4.88% of the control group, and this difference was not statistically significant (p = 0.41). Anti-thyroglobulin antibodies were detected in 4% of the patients with vulvar lichen sclerosus and 4.88% of the control group, and this difference was not statistically significant either (p = 0.76).

Conclusions: The study did not confirm the association of VLS with autoimmune thyroid diseases. Undoubtedly, based on the data available in the literature, further studies are needed to determine the mechanisms behind the association between vulvar lichen sclerosus and autoimmune thyroid diseases.

Objectives: Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition involving mainly the genital area with an undetermined aetiology. Recent studies show that in up to 34% of cases in adult women, VLS coexists with allergies or autoimmune diseases like celiac disease (CD), among others. However, literature data relating strictly to the co-occurrence of celiac disease and Duhring's disease (DH) in patients with VLS are very limited.

Material and methods: In our study, we sought to clarify the possible relationship between vulvar lichen sclerosus in adult women and celiac disease in its cutaneous form. The aim of the study was to demonstrate the presence of celiac disease-specific antibodies in women with VLS. The control group consisted of 41 healthy women, and the study group consisted of 50 women aged 24-83 years with diagnosed vulvar lichen sclerosus who were hospitalized in the Department of Gynaecology, Obstetrics and Gynaecologic Oncology of the Bonifraters Medical Centre in Katowice.

Results: There were no significant differences in blood serum levels of CD-specific antibodies between both groups.

Conclusions: The study conducted did not confirm the association between vulvar lichen sclerosus and celiac disease or Duhring's disease. The main limitation of the research was the small size of the study and control groups. Further studies on a larger group of patients are needed. They could clarify the possible mechanisms behind the co-occurrence of these two conditions. Earlier diagnostic will help prevent the development of severe and irreversible complications.

Objectives: To evaluate and validate the safety and efficacy of modified laparoscopic sacrocolpopexy for advanced posterior vaginal wall prolapse at up to 3 years of follow-up.

Material and methods: As a prospective observational study, we collected 56 cases with advanced posterior vaginal wall prolapse and performed modified laparoscopic sacrocolpopexy (MLSC) with self-cut mesh. The main improvement is the cutting and fixing of the mesh. Patients were followed up at 6, 12, 24 and 36 months. The main indicators of follow-up were postoperative anatomic success rate and Pelvic organ prolapse quantitation (POP-Q) score, and secondary indicators were related to quality-of-life scales and postoperative complication rates.

Results: All patients completed the operation through minimally invasive surgery, and there were no vital organs and blood vessel damage during the operation. The mean age was (58.32 ± 7.63) years. There was no recurrence of stage I or lower during the follow-up maximum of 36 months (median 24 months), and the anatomic success rate was 100%. The quality-of-life scores improved significantly (p < 0.001) and the quality of sexual life was not affected (p = 0.5). There was 1 case of continuous vaginal mesh exposure at 12 months (2.86%) and 1 case of severe infection with poor healing of vaginal stump within 6 months (1.79%). No one had urinary incontinence (UI) requiring reoperation.

Conclusions: In patients with advanced posterior vaginal wall prolapse, MLSC can provide good and durable pelvic floor anatomical recovery and functional outcomes with no specific complications.

Background: The pre- and intra-operative diagnoses of malignant uterine vascular perivascular epithelioid cell tumors (PEComas) can be challenging, for which the literature is limited. Some cases have been shown to have TSC gene mutations or rearrangements of the MiT factor family, resulting in variable responses to mTOR inhibitors. We report a case of a TFE-positive malignant PEComa of the uterus with pulmonary metastases that responded favorably to the mTOR inhibitor, everolimus.

Case presentation: A 52-year-old female underwent a total hysterectomy 5 years ago for suspected sub-serosal or broad ligament fibroids. The intraoperative pathologic diagnosis was leiomyosarcoma of the uterus and the postoperative diagnosis was malignant PEComa of the uterus. The patient declined genetic testing and further treatment. In December 2020 the patient presented with a pelvic mass and underwent open abdominal mass resection and pelvic adhesiolysis. The pathologic findings confirmed recurrent malignant PEComa of the uterus. The pulmonary lesions gradually progressed during the follow-up period, so treatment with everolimus was initiated. Close follow-up evaluation for nearly 3 years showed disease remission without recurrence or progression.

Conclusion: The patient described herein had a TFE-positive uterine malignant PEComa with lung metastasis and responded well to the mTOR inhibitor, everolimus. Close follow-up in the last 3 years showed remission without recurrence or progression.

Objectives: This study aims to investigate the impact of Pilates exercises on premenstrual syndrome (PMS) symptoms, perceived stress levels, and pain intensity.

Material and methods: Forty-six women with PMS participated in this study and were assigned to the intervention and control groups based on their willingness to participate. The intervention group undertook Pilates practices via video recording twice a week for 8 weeks, while the control group did not engage in regular exercise during the same period. PMS symptoms were assessed using the Premenstrual Syndrome Scale (PMSS), premenstrual stress levels were evaluated using the Perceived Stress Scale (PSS), and premenstrual pain levels were assessed using the McGill Melzack Pain Questionnaire (MPQ) at both the beginning and end of the study.

Results: There was a significant difference observed in the PMSS, PSS and MPQ evaluations of the intervention group following their participation in Pilates practices (p < 0.05). Conversely, no significant difference was observed in the PMSS, PSS and MPQ evaluations of the control group at the end of the study (p > 0.05). There was no statistically significant difference between the two groups in PMSS evaluation (p > 0.05) at the end of the study. However, a statistically significant difference was detected in PSS and MPQ evaluations (p < 0.05).

Conclusions: Pilates exercise can affectively decrease the perceived stress level and pain severity in PMS affected women. This study highlights the efficacy of Pilates for physiotherapists in PMS symptom reduction. Moreover, the implementation of a self-guided video-based home exercise program could provide patients with practical and time-efficient alternatives.