Ginekologia polska最新文献

Objectives: Cardiotocography (KTG) is widely used for continuous or intermittent assessment of fetal heart function. This study aimed to compare the effects of continuous and intermittent KTG during labour on selected variables.

Material and methods: In a retrospective study, 4172 medical records of Warsaw Hospital (Poland) patients were analysed. The study group consisted of 2111 women with continuous KTG during labour and the control group of 2061 women with periodic KTG. The median age of the women was 30 years, and the median gestation period was 40 Hbd. Most of the women lived in urban areas (87.15%), were in a relationship (82.05%) and had a higher education (86.60%).

Results: In the group with intermittent OCT, delivery by caesarean section was indistinguishably more frequent (OR = 1.06; 95% CI = 0.87-1.30), there were significantly fewer grade II perineal ruptures (OR = 1.65, 95% CI = 1.07-2.55), grade III- and IV perineal ruptures (OR = 5.13, 95% CI = 1.12-23.53) and oxygen therapy (OR = 1.76, p = 0.004). More infants with Apgar scores ≤ 7 points at the fifth minute (OR = 0.34, 95% CI = 0.12-0.094), requiring nCPAP (Nasal Continuous Positive Airway Pressure) (OR = 0.56, 95% CI = 0.39-0.86) and resuscitation [OR = 0.37, 95% CI = 0.17-0.79]) were born in the group with periodic ECG. The analysis showed that the group of women with continuous OCT during labour had a lower risk of acid-base disorders (OR = 0.45, 95% CI = 0.21-0.98) CONCLUSIONS: Continuous KTG during labour in high-risk women increases the likelihood of instrumental delivery (using vacuum) and perineal incision compared with periodic KTG. The use of intermittent ECG during labour reduces the number of newborns with Apgar scores ≤ 7 points and decreases the number of neonatal interventions such as nCPAP and resuscitation.

Objectives: To evaluate relationship between sFlt-1/PlGF ratio, clinical characteristics and outcomes of pre-eclampsia.

Material and methods: Retrospective analysis of 29 pregnant women with pre-eclampsia who had measured sFlt-1/PlGF ratio was conducted using electronic medical records from Obstetrics and Perinatology ward of University Hospital in Cracow.

Results: Women median age: 33.5 years, number of pregnancies: one 52%, two 15%, three 18%,more than three 15%, number of deliveries: one 59.3%, two 37%, three 3.7%, median body mass index during hospitalization: 29.4 kg/m². Chronic diseases apart from hypertension: 67% of women (diabetes 37%, hypothyroidism 26%, obesity 11%). Median newborns birth weight: 1640 g, median Apgar score at 5 minutes: 8, median umbilical cord blood pH: 7.32. Fetal growth restriction: 28.6% of cases. All deliveries were by c-section. Median gestational age at delivery: 32 weeks. sFlt-1/PlGF ratio was inversely correlated with gestational age at delivery (r = -0.42, p = 0.02). The median sFlt-1/PlGF ratio was higher in women with severe pre-eclampsia (n = 15) than in those with mild pre-eclampsia (n = 14) (211 vs. 57, p < 0.001). sFlt-1/PlGF ratio of > 85 had a sensitivity of 80% and a specificity of 71% for predicting severe pre-eclampsia.

Conclusions: sFlt-1/PlGF ratio is useful in assessing the severity and prognosis of pre-eclampsia. sFlt-1/PlGF ratio should not be used as a sole criterion for making clinical decisions, but as an adjunct to other clinical and laboratory parameters.

Anti-Müllerian hormone (AMH), also known as Müller duct inhibitory factor and primarily known for its role in sexual differentiation. In female fetuses, AMH production by granulosa cells begins around the 36th week of gestation and continues in women until menopause. It is becoming more significant in the endocrine and gynecological diagnosis of adult women. The suppressive effect of AMH on follicle-stimulating hormone (FSH)-induced aromatase production likely plays a role in hyperandrogenism in polycystic ovary syndrome (PCOS) and may increase insulin resistance. Female adolescent with type 1 diabetes (T1D) have an increased likelihood of developing PCOS, but it is not known whether they also show elevated AMH levels. The elevated AMH levels observed in prepubertal girls with T1D suggest that there are more small follicles in their ovaries, probably in response to insulin treatment. Elevated levels of androgens and anti-Müllerian hormone have been previously reported in non-pregnant women with diabetes. The increased AMH concentrations can be associated with reduced systemic inflammation [lower c-reactive protein (CRP) values], irrespective of the type of diet and greater insulin sensitivity in old obese males. AMH can also serve as a valuable marker for granulosa cell tumors (folliculomas) and their recurrence. In these clinical scenarios, AMH levels can be significantly elevated and correspond with the size of the tumor.

O: BJECTIVES: Circular RNAs (circRNAs) are known to be associated with the progression of gestational diabetes mellitus (GDM). Thus, the objective of this study was to unveil the influnce and potential mechanism of hsa_circ_0002768 in GDM. M: ATERIAL AND: METHODS: Levels of hsa_circ_0002768 were quantified by RT-qPCR. Placental hsa_circ_0002768 levels were analyzed after pregnancies. Trophoblast cell (HTR-8/SVneo) functions, including oxidative stress, mitochondrial dysfunction, cell viability, autophagy, and invasion, were evaluated upon hsa_circ_0002768 knockdown. Finally, the downstream miRNA for hsa_circ_0002768 was investigated. RESULTS: Hsa_circ_0002768 levels increased as high glucose-induced, and in GDM placenta. In vitro experiments showed that hsa_circ_0002768 knockdown positively regulated trophoblast oxidative stress and mitochondrial functions, thus inducing cell viability and invasion, but inhibiting autophagy. miR-339-5p was a downstream molecular for hsa_circ_0002768, which targeted to TLE3. CONCLUSIONS: This study reveals a physiological role for hsa_circ_0002768 during GDM.

Objectives: Postpartum depression is a common and serious mental health problem which is associated with maternal distress and negative consequences for the offspring. Research confirms the presence of differences in the prevalence of postpartum depression in different social groups. The aim of this study was to compare the severity of maternal symptoms in Poland and Zimbabwe and to identify risk factors occurring in both groups.

Material and methods: The survey was conducted in 2022 among mothers who gave birth at the Department of Neonatology and Rare Diseases and at the Mpilo Central Hospital Maternity Clinic. The Edinburgh Postnatal Depression Scale was used to assess the risk of postnatal depression. A total of 945 patients were included.

Results: The study indicated statistically significant differences in the percentage of women with an increased risk of postpartum depression, with the percentage for the Polish group being 13.54 % and the Zimbabwean group 35.74 %. For the Zimbabwean group, the risk of depression was associated with a problem in obtaining breastmilk and these were women in informal partnerships or those without a stable partner. In the group of Polish patients there was evidence of a correlation between increased risk and having a stable, non-formalised relationship.

Conclusions: According to the analysis, women in Zimbabwe are more likely to be at risk of postpartum depression than Polish women. PPD remains an important issue in obstetric practice, and it is necessary to sensitize health care personnel to the risk of PPD to make timely and appropriate clinical interventions.

Objectives: Due to the increasingly faster pace of life and responsibilities, stress has become an integral part of daily life. Every year, numerous social campaigns in the media raise the issue of increasing alcohol consumption. Endometriosis is a chronic, causally incurable, estrogen-dependent and inflammatory gynecological disorder, described as presence of ectopic endometrial tissue outside the uterine cavity. Some studies suggest that alcohol may aggravate the symptoms of the disease. The aim of the study is to present a comprehensive review reffering to the role of ethanol in the course of endometriosis.

Material and methods: A review of the literature available in the PubMed database between 2000 and 2024 was conducted, using the following keywords: "endometriosis", "alcohol", "ethanol". The search included articles published in English. Publications without full text access and duplicates were rejected. 247 records were screened of which 15 met the eligilibity criteria, and 12 were included in this article.

Results: Alcohol may affect estrogen production (by increasing the activity of aromatase and interacting with luteinizing hormone), promotes pro-inflammatory pathways and oxidative stress. It is also perceived as a form of self-management therapy resulting from pain, anxiety, and low self-esteem. Patients who are alcohol-dependent more often experience infertility, miscarriages, anovulation and ovarian pathologies.

Conclusions: Although there is no clear evidence suggesting the adverse effect of ethanol on the course of endometriosis, the substance may be life-destroying in alcohol-dependent women. It may cause more severe course of endometriosis affecting many ascpectcts of life.

Sexual education is a vital process of teaching and learning about various aspects of human sexuality, including physical, emotional, social, and cultural dimensions. Its primary goal is to equip individuals, especially adolescents, with the necessary knowledge, skills, and values to make informed, responsible, and safe decisions regarding their sexual and reproductive lives. This article examines sexual education programs in Australia, Oceania, and Europe, addressing the current state, the unique challenges, and recommendations for enhancing these programs to meet the needs of modern society.

In women after hematopoietic stem cell transplantation (HSCT), complications associated with the original disease and therapies used both before and after transplantation often occur, which significantly affects their quality of life. The most common gynaecological complications include secondary cancers, premature ovarian insufficiency (POI), infertility and chronic graft-versus-host disease (cGVHD). Cervical cancer is the most common secondary genital cancer in patients after HSCT. Regular screening and vaccination against HPV (Human Papillomavirus) can significantly reduce the risk for its occurrence. The specific complication after allogeneic hematopoietic stem cell transplantation is graft-versus-host disease (GVHD), the genital form of which can lead to labial and vaginal adhesions, significantly reducing the women's quality of life. The basis of treatment is local steroid therapy and immunosuppression. A consequence of chemotherapy and radiation therapy may be damage to the gonads leading to premature ovarian insufficiency and the onset of menopause symptoms. The basis of treatment is systemic hormone therapy used until middle age when natural menopause is reached. Women after HSCT who are of reproductive age also suffer from infertility. An important role of the doctor is to educate patients about the risk for infertility and to suggest appropriate methods of preserving fertility before starting treatment. The recommended procedure for fertility preservation is cryopreservation of embryos or oocytes. The freezing and retransplantation of ovarian tissue is becoming an increasingly popular method of fertility protection. Preventive examinations and early detection and treatment of gynaecological complications significantly improve the comfort of life and health of women after HSCT.

Objectives: To investigate the roles of the systemic inflammatory response index (SIRI) and other biochemical markers obtained from maternal blood in determining the diagnosis and severity of pregnancy cholestasis.

Material and methods: In this retrospective case-control study, a total of 815 pregnant women including 546 healthy pregnant women [serum total bile acid (TBA) level < 10 μmol/L, control group], 185 patients with mild cholestasis [serum TBA level < 40 μmol/L, mild intrahepatic cholestasis of pregnancy (ICP) group] and 84 patients with severe cholestasis (serum TBA level ≥ 40 μmol/L, severe ICP group) were evaluated. The groups were compared regarding demographic data, clinical characteristics, SIRI (neutrophilcount*monocytecount/lymphocyte count), and other laboratory data. Cut-off values that could predict ICP were calculated.

Results: The average neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) were found to be statistically significantly higher in the severe ICP group compared with the control group and mild ICP group (p < 0.01 and p < 0.05). The best SIRI cut-off value was 2.3302 (60.3% sensitivity and 52.2% specificity) [area under the curve: 0.590 ± 0.023, 95% confidence interval (CI): 0.546-0.634; p < 0.001].

Conclusions: SIRI may be a useful marker in determining the diagnosis and severity of ICP. However, were commend that studies be conducted in larger groups and indifferent trimesters.

Objectives: To investigate the outcomes of central cystocele and rectocele repair using natural tissue layers. To describe a novel technique (Dogan technique).

Material and methods: This is a retrospective cohort study. Between January 2021 and January 2023, patients who had central cystocele and rectocele higher than stage1 were included in the study. The Pelvic Organ Prolapse Quantification (POP-Q) score was used to determine the degree of the prolapsus. All cystocele and rectocele repair surgeries were performed by the same physician. The patients' voiding habits were assessed using ICIQ-SF and OAB-V8. Sexual function results were assessed with FSFI questionnaire before and after the operation. Transperineal ultrasonography was performed to examine mobility of the anterior and posterior compartments.

Results: Total of 36 patients were diagnosed with grade 2 and above central cystocele (19, 52%) and rectocele (n = 17, 48%). After the operation the anatomical cure of anterior and posterior compartments was achieved for all patients in the two-years follow-up. According to voiding habits before the surgery, there were symptoms of stress urinary incontinence (SUI),urge urinary incontinence (URGE), both SUI and URGE, and no incontinence at the patients; 7 (36.8%), 14 (73.7%), 5 (26.3%), 3 (15.7%) respectively. Of those URGE patients (n = 5/14, 35.7%) incontinence symptoms were mixed-type. After the cystocele operation, significant improvement was seen in their voiding problems according to the ICIQ-SF and OAB-V8 questionnaires (p < 0.05). As well as significant improvement was found in sexual function according to the FSFI questionnaire (p < 0.05).