Ginekologia polska最新文献

Objectives: The cross-sectional survey was conducted aiming to evaluate the knowledge and experiences of the Polish obstetricians and gynecologists regarding the External Cephalic Version (ECV) and investigate their practices concerning this procedure.

Material and methods: An online survey constituting author-created questionnaire with 22 questions, was distributed among gynecologists and obstetricians. The questionnaire evaluated participants' knowledge about ECV, work experiences, and workplace practices.

Results: Out of 461 respondents, 56.20% were specialists in gynecology and obstetrics. Elective cesarean section (CS) was preferred by 78.70% for primiparas and 73.50% for multiparas with non-cephalic presentation, while ECV would be chosen by 21.3% and 23.6%, respectively. While 73.80% knew centers performing ECV, only 16.70% had actively participated in the procedure. Major differences in the experiences and knowledge regarding ECV were observed based on work experience, and workplace reference level. Experienced physicians showed higher concerns about ECV complications and emergency CS risks. The most common concerns regarding the procedure referred to periprocedural pain, perceived low efficacy, and complications, and were more prevalent among respondents with longer experience and from lower-reference centers.

Conclusions: The study demonstrated that among Polish obstetricians for term pregnancies with non-cephalic presentation, elective cesarean section is preferred over ECV, especially among experienced practitioners. Knowledge about ECV was relatively low, indicating a need for improved educational efforts. Addressing concerns about ECV's safety and efficacy, particularly through enhanced training and anesthesia options, could promote its adoption and reduce CS rates.

Objectives: Vein of Galen Malformation (VGAM) is a rare congenital cerebrovascular anomaly. Early detection and monitoring of concurrent fetal heart failure in VGAM are crucial for improving outcomes. The study aims to evaluate heart anatomy, systolic and diastolic heart function, and indicators of heart failure in fetuses referred to a tertiary center due to VGAM detected in the second or third trimester.

Material and methods: This single-center retrospective study of echocardiographic data from five fetuses with VGAM examined between 2008 and 2023. Parameters analyzed included gestational age, reason for referral, cardiovascular profile score (CVPS), systolic and diastolic heart function and selected cardiac parameters RESULTS: Cardiomegaly as a sign of congestive heart failure was the main reason for referral most of the fetuses (4/5 - 80%) diagnosed later as VGAM in our center. Abnormal cerebral vessel flow was visualized in all cases, with normal umbilical arterial flow. Three fetuses were treated prenatally with digoxin due to congestive heart failure. Monophasic tricuspid valve inflow and decreased shortening fraction (SF) were observed in three fetuses (60%) at the time of diagnosis. CVPS scores ranged from 2 to 10, correlating with the severity of cardiac compromise. All five patients demised, three died in utero, and two shortly after birth.

Conclusions: This study emphasizes the severe cardiac implications of VGAM detected in utero and the need for early and comprehensive fetal assessment. Despite early diagnosis, outcomes remain poor, necessitating further research into effective prenatal treatments and management protocols to enhance survival for affected fetuses.

The FIGO staging system is an integral part of the therapeutic and treatment process in female genital tumors. It cements the knowledge gained to date to plan patient treatment prognosis and the course of the disease and compare treatment outcomes between centers in the most individualized yet systematic way. In response to these assumptions, the FIGO Committee on Gynaecological Oncology updated the endometrial cancer staging classification in June 2023. The new endometrial cancer staging classification includes multiple clinicopathological prognostic factors and molecular findings for the first time. In this review, we summarize the differences between the new and the old FIGO classification and comment on its everyday real-world application.

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.