Ginekologia polska最新文献

Objectives: To investigate the effects of antenatal magnesium sulfate administration on preterm gastrointestinal feeding intolerance and necrotizing enterocolitis in preterm infants.

Material and methods: This observational cohort, single-centre study included preterm infants < 30 weeks gestational age or < 1250 g, who were admitted to the neonatal intensive care unit of a university hospital. These infants were divided into two groups on the basis of having received antenatal magnesium sulfate or not.

Results: Overall, 118 preterm infants were enrolled. Fifty-four of these infants had received prenatal magnesium sulfate (Group 1), and 64 (42%) had not (Group 2) before their neonatal intensive care unit (NICU) admission. The number of days to full eneteral feeding and the days of total parenteral nutrition were significantly higher in Group 2 than in Group 1 (p < 0.05). When gestational age, birth weight, and small for gestational age (SGA) were included as factors affecting feeding intolerance, the logistic regression analysis results showed that the administration of magnesium sulfate was an independent risk factor (adjusted OR: 3.5; 95% CI: 1.462-8.615; p < 0.05). Antenatal magnesium sulfate administration was not observed to have an effect on spontaneous intestinal perforation and necrotising enterocolitis.

Conclusions: The administration of antenatal magnesium sulfate has proven tocolytic and neuroprotective effects on preterm births. However, it must be taken into consideration that it can cause feeding intolerance in preterm infants without causing intestinal injury.

Objectives: The goal is for investigating the correlation between ultrasound features and molecular pathological markers such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), tumor protein p53, nuclear proliferation factor Ki-67, DNA topoisomerase IIα (Topo II), and cytokeratin CK5/6 in non mass infiltrating ductal carcinoma of the breast.

Material and methods: A total of 125 sufferers with non mass infiltrating ductal carcinoma of the breast were included in the ultrasound images and immunohistochemical results. This study analyzed the characteristics of ultrasound images, including maximum cross-sectional diameter, morphology, peripheral hyperechoic halo, hair prick sign, and micro-calcification, as well as the positive expression of molecular pathological markers (ER, PR, HER-2, p53, Ki-67, Topo II, CK5/6); It uses statistical methods for evaluating the correlation between ultrasound features and molecular pathological markers.

Results: In 125 patients, the maximum cross-sectional diameter was markedly related to positive expression of CK5/6 (r = 0.176, p < 0.05), Ki-67 (r = 0.328, p < 0.05), and HER-2 (r = 0.468, p < 0.05). There is a marked relation between posterior echo attenuation and ER positivity (r = 0.096, p < 0.05) and Topo II positivity (r =-0.021, p < 0.05). However, there was no marked relation in morphology, peripheral hyperechoic halo, hairline sign, and micro-calcification with prognostic molecular pathological markers (p > 0.05).

Conclusions: This study found a marked relation in the maximum cross-sectional diameter of non mass infiltrating ductal carcinoma of the breast and the positive expression of CK5/6, Ki-67, and HER-2. This finding suggests that the maximum cross-sectional diameter may serve as a potential indicator for prognostic evaluation and is closely related to the expression of cytokeratin CK5/6, nuclear proliferation factor Ki-67, and HER-2 in tumors. Posterior echo attenuation is closely related to ER positive and Topo II expression. No significant correlation was observed between morphology, peripheral hyperechoic halo, hairline sign, and micro-calcification with prognostic molecular pathological markers. These results provide new insights for the prognosis evaluation of patients with non mass infiltrating ductal carcinoma of the breast and contribute to the development of individualized treatment strategies, but further research and validation are still needed.

Objectives: We investigated the correlation of plasma Afamin levels with gestational diabetes mellitus (GDM) during pregnancy and assessed its predictive value for the risk and prognosis of GDM.

Material and methods: A total of 993 pregnant women were included in this nested case-control study. The fasting blood samples in their first trimester were collected. Ninety-one women were diagnosed with GDM, and they were subdivided into insulin treatment group (Group A1, 30 cases) and non-insulin treatment group (Group A2, 61 cases) according to whether they needed to treat with insulin. Another 91 pregnant women with normal glucose tolerance were as the control group (NC group). The plasma and umbilical cord blood levels of Afamin were measured in the first and second trimesters using enzyme-linked immunosorbent assay (ELISA). The correlation of Afamin levels with GDM during pregnancy and its predictive value were assessed.

Results: Plasma Afamin levels in both GDM groups (A1 and A2) were significantly higher than in the control group at all pregnancy stages (p < 0.01). Afamin levels in the second trimester were significantly higher in Group A1 than those in Group A2 (p < 0.05). Multivariate logistic regression identified that plasma Afamin levels in the first trimester (OR = 1.126, 95% CI: 1.032-1.228, p = 0.008) and in the second trimester (OR = 1.173, 95% CI: 1.092-1.259, P = 0.000) were the independent risk factors for GDM, along with insulin resistance index (OR = 1.62, 95% CI: 1.036-2.534, p = 0.034). ROC analysis showed optimal cut-off value of plasma Afamin was 65.90 mg/L in the first trimester (AUC = 0.858, sensitivity = 75.8%, specificity = 85.7%) and 85.09 mg/L in the second trimester (AUC = 0.874, sensitivity = 92.3%, specificity = 76.9%).

Conclusions: Elevated plasma Afamin levels during the first and second trimesters are associated with GDM, supporting Afamin level as a potential biomarker for early GDM risk prediction.

Iatrogenic endometriosis, a rare form of endometriosis resulting from surgical interventions, has become increasingly recognized as a complication of cesarean sections. This study examines the development of clear cell carcinoma (CCC) arising from endometrial tissue implanted in cesarean section scars. Based on a review of 41 clinical cases, the study highlights the challenge in diagnosis and management of this uncommon aggressive malignancy. The average delay from cesarean section to diagnosis was 18 years, with common symptoms being painful masses and scar tenderness. Imaging modalities such as magnetic resonance imaging (MRI) and computed tomography (CT) were the first diagnostic tools, while biopsy confirmed malignancy in most cases. The outlook for patients who had CCC in cesarean scars was extremely poor, and scant long-term survival data existed. These observations serve to reemphasize the necessity of increased awareness by gynecologists and obstetricians of the risk potential associated with cesarean delivery. Improved diagnostic scrutiny, especially in the patient who comes to the doctor with unexplained symptoms involving the scar, is recommended in this study. A strong role is also supported in informed choice before surgical modes of delivery are attempted.

Objectives: Streptococcus agalactiae (GBS) infection is significant in obstetric and neonatal complications. Maternal age, particularly adolescent pregnancy, may influence the prevalence of GBS colonization and associated clinical outcomes. This study aimed to evaluate the impact of maternal age on obstetric and neonatal outcomes, with a specific focus on the modifying effect of GBS status. The analysis explored whether the associations between maternal age and selected outcomes remained statistically significant after adjusting for GBS interactions.

Material and methods: A retrospective matched cohort study was conducted with 582 participants, comprising a study group and a matched control group selected through propensity score matching. The study group included adolescents (≤ 19 years, n = 194) and older individuals (> 19 years, n = 388). Inclusion criteria required GBS screening after the 35th week of gestation, bacterial culture upon hospital admission, and delivery during the same hospitalization. Statistical analyses included logistic and linear regression models adjusted for interactions with GBS.

Results: In unadjusted analyses, adolescent mothers showed a higher likelihood of postpartum hemorrhage (OR = 2.715, p = 0.02), uterine atony (OR = 3.594, p = 0.043), transient tachypnea of the newborn (TTN) (OR = 6.16, p = 0.027), and shorter neonatal length (Estimation = -0.791, p = 0.001). However, after adjusting for interactions with GBS, these associations lost statistical significance: postpartum hemorrhage (AOR = 0.67, p = 0.711), uterine atony (AOR = 2.417, p = 0.315), TTN (AOR = 4.87, p = 0.117), and neonatal length (Estimation = -0.207, p = 0.584).

Conclusions: These findings indicate that GBS colonization confounds the observed relationships between maternal age and these outcomes. These results underscore the importance of accounting for GBS status in assessing age-related risks during pregnancy and tailoring clinical management accordingly.

Objectives: The nursing and midwifery professions are potential influences on life satisfaction and self-efficacy, especially in obstetric settings dealing with fetal demise or severe congenital anomalies. This study aimed to assess how sociodemographic factors (e.g., workplace, marital status, financial situation, occupation, and tenure) and specific job exposures (frequency of neonatal death and caregiving for newborns with lethal defects) impact life satisfaction and self-efficacy among nurses and midwives. The study further explored the role of employer-provided psychological support in influencing job satisfaction and self-efficacy.

Material and methods: A diagnostic survey with a custom questionnaire, supplemented by the General Self-Efficacy Life satisfaction and self-efficacy (GSES) and Satisfaction with Life Scale (SWLS), was conducted in level II and III referral centers in Poland's Silesian region in 2023. Participants included nurses and midwives in various neonatal and obstetric departments. Statistical analyses encompassed descriptive statistics, chi-square tests, and Spearman correlations, with significance set at p < 0.05.

Results: A majority of participants reported moderate to high life satisfaction (41.7%) and self-efficacy (59.0%). Key factors impacting life satisfaction included marital status, financial situation, education, tenure, and caregiving frequency for newborns with lethal defects. High self-efficacy was significantly associated with job satisfaction, tenure, and workplace environment but was unaffected by marital status, financial situation, or psychological support.

Conclusions: The findings highlight the emotional burden on nurses and midwives in neonatal care. Enhanced psychological support, stress-coping training, and policy adjustments are recommended to support this workforce. Further studies should broaden regional scope and examine links between life satisfaction, self-efficacy, and job satisfaction.

Objectives: To evaluate the feasibility and outcomes of gasless single-port access (SPA) laparoscopy in overweight patients undergoing adnexal surgery.

Material and methods: A retrospective review was conducted on the medical records of 118 patients who underwent gasless SPA laparoscopic adnexal surgery using J-shaped or triangular-shaped retractors between May 2017 and June 2022. Patients were categorized into overweight (BMI ≥ 23) and standard-weight (BMI < 23) groups. Surgical characteristics and outcomes were compared between the two groups.

Results: Out of 118 patients, 41 were in the overweight group, and 77 were in the standard-weight group. Significant differences were observed in age (p = 0.001), the number of previous abdominal surgeries (p = 0.001), and the number of subjects who had given birth (p = 0.004), all higher in the overweight group. There were no significant differences between the groups in setup time from umbilical skin incision to abdominal wall retraction, use of additional TROCARS: operation time, estimated blood loss, or length of postoperative hospital stay. No serious intraoperative complications, such as urologic, bowel, and vessel injuries were noted in either group. Tumor diameter (p < 0.001), bilaterality (p < 0.001), presence of adhesion (p = 0.026), and setup diameter of the retractor (p = 0.001) significantly correlated with operation time in multivariate analysis (Adjusted R² = 0.645).

Conclusions: Gasless SPA laparoscopic adnexal surgery in overweight patients is a feasible and effective alternative to conventional SPA laparoscopy, mitigating the potential negative effects of carbon dioxide gas.

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.