Ginekologia polska最新文献

Objectives: This study investigates the relationship between pre-pregnancy body mass index (BMI), BMI before labor, and weight gain during pregnancy with the incidence of cesarean delivery (CD) in dinoprostone-induced labor versus spontaneous labor.

Material and methods: This retrospective analysis was carried out at the Jagiellonian University Hospital's Obstetrics and Perinatology Department, encompassing term singleton pregnancies from May 2019 to February 2021. BMI was categorized following WHO guidelines. Gestational weight gain was assessed against the Institute of Medicine's 2009 recommendations.

Results: Of the 366 cases reviewed, 183 were in the dinoprostone-induced labor group, and 183 were in the spontaneous labor group. The study identified a significant association between higher pre-pregnancy BMI and increased weight gain during pregnancy with elevated CD rates, especially in dinoprostone-induced labor compared to spontaneous labor. Specifically, the dinoprostone-induced labor group showed a 33.9% CD rate compared to 16.9% in the spontaneous labor group. Logistic regression analysis further established that for each 1 kg/m² increase in pre-pregnancy BMI, the odds of undergoing a CD increased by 10%.

Conclusions: Elevated pre-pregnancy BMI and excessive gestational weight gain significantly heighten the risk of cesarean delivery, particularly in induced labor. The findings underline the need for individualized labor management strategies for women with higher BMI to optimize maternal and neonatal outcomes.

Objectives: During the life cycle of a woman, pregnancy is the period when she is most open to changing her behaviour and lifestyle for the benefit of the child's development. Lifestyle changes include also the diet correction. The objective of the study was to assess, through identified dietary patterns, the diets of women in the second and third trimester of pregnancy in relation to their nutritional status before and during pregnancy.

Material and methods: The study was conducted among pregnant women, participants of childbirth education classes at the Institute of Mother and Child, based on food frequency questionnaire. The study involved 392 women in the age 19-40 years (first single pregnancy without complications). Dietary patterns were identified using the k-means method, based on groups of products.

Results: Three dietary patters were identified in the study group of women: dietary pattern 1 - cereal-milk diet, dietary pattern 2 - vegetable-fruit diet and dietary pattern 3 - cottage cheese-vegetable diet. Dietary pattern 3 occurred in 43.9% of underweight women, in 45.5% of women with normal weight and in 43.1% of women with excess body weight. Dietary pattern 1 occurred in about one third of women and dietary pattern 2 in about 20% in each group. A greater diversity in the frequency of identified dietary patterns was observed in relation to weight gain during pregnancy. The identified dietary patterns differed significantly in terms of the profile of macronutrients, most minerals and vitamins - E, C and B group vitamins.

Conclusions: The identified dietary patterns and their energy and nutritional profile indicate the need for monitoring the diets and nutritional education of pregnant women.

Objectives: Pregnancy is a special time that brings both joy and challenges. Among these challenges, anxiety and stress are emotions that can affect the mental wellbeing of the pregnant woman as well as the developing baby.

Material and methods: In response to these challenges, we present the Pregnancy Anxiety and Stress Rating Scale (PASRS), an innovative tool that aims to identify and assess anxiety and stress levels among pregnant women.

Results: The PASRS contains 15 questions that are more comprehensive and cover various aspects of pregnancy, including the health of the baby, the health of the mother, body changes, finances and social support.

Conclusions: In an era where mental health is just as important as physical health, SOLiSC is a step forward in recognising and addressing the unique mental challenges that pregnant women may face.

Objectives: To estimate the prevalence of UI and POP after hysterectomy for benign disease and gynecologic malignancy. This is a retrospective cohort chart review study. Two major urban tertiary care centers between 2006-2010. Women ≥ 18 years undergoing hysterectomy for benign or malignant indications.

Material and methods: Presence of UI and POP was based on patient report in clinic notes, ICD-9 UI and POP diagnosis codes, and CPT codes for treatment. Prevalence of UI and POP after hysterectomy and time to development of UI and POP after hysterectomy.

Results: 1363 (55%) women underwent hysterectomy for benign disease while 1107 (45%) had a hysterectomy for malignancy. Postoperative prevalence of UI and POP in the benign versus the malignant group was 15.1% vs 11.1% (p = 0.001), and 12.1% vs 2.8%, (p < 0.001), respectively. The median time to development of UI in the subset of patients without preoperative UI was 3.5 years in the benign group vs 3 years in the malignant group (p < 0.001). The median time to development of POP in the subset of patients without preoperative POP was 5 years in the benign group and 3.5 years in the malignant group (p < 0.001). There was no significant difference in the risk of developing UI or POP between groups after adjusting for confounders or when accounting for pre-hysterectomy UI or POP.

Conclusions: When pre-hysterectomy UI or POP is taken into consideration, there is no difference in the prevalence of post-hysterectomy UI or POP.

Objectives: This study aims to elucidate the expression patterns of LGALS1 (galectin-1) and LGALS9 (galectin-9) genes in placental tissues of pregnancies affected by preterm prelabor rupture of membranes (PPROM). The overarching goal is to understand the potential roles of these galectins in the pathophysiology of PPROM, particularly in maternal-fetal immune tolerance and placental development.

Material and methods: Conducted as a prospective, single-center study at the Gynecology and Obstetrics Clinical Hospital in Poznan, Poland, from June 2021 to May 2023, the research involved 25 participants, including 12 with PPROM and 13 healthy controls. Placental tissues were obtained, and RNA extraction was performed. Galectin gene expression (LGALS1 and LGALS9) was analyzed using quantitative real-time PCR. Demographic and clinical data were collected, and statistical analyses were employed to assess correlations between galectin expression and clinical parameters.

Results: While significant differences were observed in gestational age at delivery and birth weight between the PPROM and control groups, the expression levels of LGALS1 and LGALS9 did not show statistically significant variations. Correlation analyses revealed no significant associations between galectin expression and various clinical parameters.

Conclusions: Contrary to the hypothesis, this study did not identify significant alterations in galectin-1 and galectin-9 expression in placentas affected by PPROM. Despite the limitations of a small sample size, these findings provide initial insights into the potential roles of galectins in PPROM. Further research on larger cohorts is warranted to comprehensively understand the implications of galectin involvement in the pathophysiology of PPROM.

Objectives: Though laparoscopic surgery is effective for the treatment of deep endometriosis (DE), postoperative management remains controversial. Dienogest therapy after surgery may improve spontaneous pregnancy rates and decrease the severity of dysmenorrhea in infertile patients with DE. To determine the efficacy of postsurgical therapy with dienogest for improving fertility and reducing the intensity of dysmenorrhea in infertile patients with DE.

Material and methods: This open label, randomized controlled trial was conducted involving 88 women aged 21-38 years with infertility who underwent surgery for DE. Three patients were lost to follow-up. After surgery, eligible patients were randomly divided into two groups. Forty-four patients who received dienogest for three months following surgery were enrolled in group 1. The remaining 41 patients comprised group 2 and did not receive any postsurgical treatment over the same period. The primary outcome measure was the pregnancy rate calculated nine months after surgery, while the mean intensity of dysmenorrhea was measured before and nine months after surgery.

Results: The pregnancy rate in group 1 was significantly higher than in group 2 (47.7% vs 22%, p = 0.013) nine months following surgical intervention. Patients in group 1 exhibited a more statistically significant reduction in the mean score of dysmenorrhea intensity compared to group 2, from 8.7 to 2.8 vs 8.76 to 5.63, respectively (p < 0.001).

Conclusions: The use of dienogest as an add-on therapy for treating DE may show significantly higher effectiveness compared to surgical intervention alone for improving fertility and reducing the severity of dysmenorrhea.

Objectives: Genitourinary tract infections in pregnant women are one of the causes of abnormal pregnancy development including miscarriages, premature labor or premature rupture of membranes (PPROM). Atypical bacteria responsible for reproductive tract infections include Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum. Identification of pathogens and appropriately selected therapy can improve obstetric outcomes in patients with symptoms of threatened miscarriage or threatened preterm labor. The purpose of our study is to analyze the impact of reproductive tract infections with ureaplasma and mycoplasma bacteria during pregnancy.

Material and methods: In the presented study, we retrospectively analyzed the cases of 201 pregnant patients hospitalized in the Obstetrics and Gynecology Department of Poznan Regional Hospital in 2019-2022, who had a swab taken from external os area of the cervix for atypical bacteria - Ureaplasma and Mycoplasma. Only patients with symptoms of threatened miscarriage or threatened preterm labor were included in the study group. Microbiological tests were performed in the hospital laboratory with the Mycoplasma IST 3 test from Biomerieux.

Results: We found a higher incidence of preterm labor in patients with symptoms of threatened preterm labor and a genital tract infection with Ureaplasma/Mycoplasma bacteria, compared to patients not infected with Mycoplasma/Ureaplasma - 31.1% vs 20% (p = 0.098). This observation in the case of Ureaplasma/Mycoplasma monoinfection group applied to 6 patients. - 75% of the group. Pregnant patients who had co-infection with other types of bacteria (48 patients in total) gave birth before 37 weeks of pregnancy in 27.1% of cases. We obtained a significant difference (p = 0.007) when comparing groups with positive and negative cultures for Ureaplasma/Mycoplasma by the presence of monoinfection/coinfection and the week of pregnancy in which delivery occurred. We also noted the effect of atypical bacterial infection for PPROM - this complication preceded preterm delivery in 40% of ureaplasma-positive patients, compared to 20% of PPROM without infection. We found a similar rate of preterm labor and pregnancy loss in Ureaplasma/Mycoplasma-positive patients who received antibiotic therapy (35.7%) compared to a group of pregnant women who did not receive treatment (31.6%).

Conclusions: Infection of the genital tract with atypical bacteria Ureaplasma and Mycoplasma has a negative impact on the course of pregnancy. Identification of the type of microorganisms in cervical canal secretions of pregnant patients with symptoms of threatened miscarriage or preterm labor seems crucial. The impact of antibiotic therapy though, requires further analysis.