Ginekologia polska最新文献

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.

Objectives: Colonization with Group B Streptococcus (GBS) during pregnancy can lead to invasive GBS disease (iGBS) in neonates, including meningitis, pneumonia or sepsis, which carries a high mortality risk. American College of Obstetricians and Gynecologists (ACOG) recommends universal GBS screening for all pregnant individuals between 36 0/7 and 37 6/7 weeks of gestation. However, due to the insufficient population-based studies on universal screening and GBS colonization rates in late periods of pregnancy in Türkiye, we aimed to evaluate the prevalence of GBS and its antibiotic resistance to enhance awareness regarding GBS screening and prophylaxis during pregnancy and promote the use of appropriate antibiotics.

Material and methods: This prospective, single-center study was conducted between May 2017 and December 2017 on 518 pregnant women (363 Turkish and 155 Syrian). Vaginal and rectal samples were collected and cultured in Todd-Hewitt broth. Standard microbiological protocols were used to assess GBS colonization and antibiotic susceptibility.

Results: In the study, we found that 10.6% (n = 55) of pregnant women were colonized with GBS asymptomatically. Group B Streptococcus colonization rates did not differ significantly between Turkish patients (11%, n = 40) and Syrian patients (9.7%, n = 15) (p = 0.756, p > 0.05). All patients colonized with GBS were penicillin-sensitive. However, resistance to at least one non-penicillin antibiotic was observed in 42.5% (n = 17) of Turkish patients and 60% (n = 9) of Syrian patients. Although not statistically significant (p > 0.05), Syrian patients exhibited relatively higher rates of antibiotic resistance, especially to erythrosine and clindamycin.

Conclusions: In our country, implementing universal screening for asymptomatic GBS in pregnant women, as recommended by the Centers for Disease Control and Prevention (CDC), would be more beneficial than a risk-based screening approach. Given the increased resistance patterns observed in antibiogram results, GBS prophylaxis at delivery, especially in patients with penicillin allergies, should be planned based on antibiotic susceptibility testing.

Objectives: In this pilot study the proton Nuclear Magnetic Resonance (¹H NMR)-based metabolomics was applied to explore the serum metabolomes of the patients with high-grade serous ovarian carcinoma (HGSOC) and the patients with benign gynaecological disease and to identify the characteristic biomarkers.

Material and methods: We analyzed serum samples from 17 HGSOC patients and 14 control patients with benign gynecological conditions. Serum metabolites were profiled using 1H NMR spectroscopy, and multivariate data analyses, including Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA), were performed to identify discriminating metabolites.

Results: The multivariate analysis revealed the lower levels of the lipid compounds, choline, branched-chain amino acids, 3-hydroxybutyrate (3HB), acetoacetate, and the higher level of lactate in the sera of the HGSOC patients compared to the control group.

Conclusions: NMR-based metabolomic analysis can serve as a supporting method for the detection of ovarian cancer and may be useful as an adjunct to molecular diagnostics.

Objectives: The purpose of this study was to assess and compare the knowledge, attitudes, and practices of Polish midwives and obstetricians concerning external cephalic version (ECV), with particular attention to how professional qualifications, experience, and the reference level of the healthcare facility influenced these factors across both groups.

Material and methods: An author-created, 22-question online survey was distributed separately to midwives and obstetricians, with each group receiving a questionnaire customized to assess their specific knowledge of ECV, professional experience, and attitudes toward the procedure.

Results: The study included 839 participants: 378 midwives and 461 physicians. Knowledge and experience with ECV varied significantly based on work experience and the reference level of the workplace. When comparing the results between midwives and obstetricians, the median (Q1-Q3) score for correct answers on ECV was highest among obstetrics and gynecology residents (5, 3-6), while the lowest scores were seen among midwives with bachelor's degrees (2, 1-4).

Conclusions: The study identified significant considerable knowledge gaps regarding ECV, particularly among midwives. Educational initiatives targeting both midwives and obstetricians are recommended to encourage the greater use of ECV and potentially reduce the rates of elective cesarean sections in cases of non-cephalic fetal presentations.

Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age, often associated with metabolic alterations. This study assessed serum levels of adipsin, irisin, and osteopontin in patients with PCOS and examined their correlations with metabolic parameters.

Material and methods: A case-control study was conducted involving 96 women with PCOS and 80 healthy controls. Serum levels of adipsin, irisin, and osteopontin were measured; demographic, clinical, and metabolic characteristics were evaluated.

Results: Patients with PCOS were significantly younger than controls (p < 0.001). The PCOS group included a significantly greater proportion of obese individuals (p = 0.013). Patients with PCOS exhibited elevated serum adipsin (p = 0.020) and reduced osteopontin (p < 0.001) levels relative to controls; obesity and age influenced these differences. Osteopontin demonstrated superior predictive power for PCOS diagnosis [area under the curve (AUC) = 0.802] compared with adipsin (AUC = 0.602). A combination of osteopontin and adipsin yielded the highest predictive value (AUC = 0.817) among double or triple biomarker combinations.

Conclusions: This study identified potential associations among adipsin, osteopontin, irisin, and PCOS. Further research is warranted to elucidate their roles and clinical implications in PCOS and its metabolic alterations. The findings highlight the impact of age and obesity on these biomarkers and their relationships with PCOS, providing insight into the syndrome's complex pathophysiology.

Objectives: The global pandemic caused by the SARS-CoV-2 virus resulted in a deterioration of access to healthcare services, with the increased utilization of telemedicine. The global pandemic has also had a significant impact on women's experiences of maternity care, which may have affected gestational diabetes perinatal outcomes, which are associated with the glycemic control of the mother. The objective of this study was to present and compare the results of maternal and neonatal perinatal outcomes in pregnancies affected by gestational diabetes mellitus (GDM) in the years preceding and during the period of the COVID-19 pandemic.

Material and methods: The study was conducted as a retrospectively analyzed cohort study of neonates born from pregnancies complicated with GDM and their mothers born at gestational age of at least 34 + 0/7 weeks. The detailed analysis encompassed both neonatal and maternal perinatal outcomes. The patients' feedback was obtained regarding the availability of necessary consultations and the quality of care provided.

Results: There was a notable decline in breastfeeding rates (p < 0.05). Few other perinatal outcomes differed between the years 2017-2019 and 2020-2021.

Conclusions: The degree of maternal glycemic control, the quality of medical care provided, and the effectiveness of maternal treatment constitute crucial factors influencing maternal and neonatal outcomes, as well as breastfeeding rates.

Introduction: The most prevalent condition affecting the metabolism of carbohydrates during pregnancy is gestational diabetes mellitus (GDM). Continuous glycemia monitoring systems that use sensors are currently replacing the conventional self-monitoring of glycemia with a glucometer. Poland's insurance coverage has made new technologies possible for continuous glycemia monitoring. Our retrospective study compared the effects of two glycemic measurement techniques on patient preferences and maternal and pediatric clinical outcomes: traditional methods using a glucometer and utilizing a sensor for scanning continuous glycemic monitoring (flash glucose monitoring, or FGM).

Material and methods: In a retrospective analysis of 277 women with GDM treated in the Department of Metabolic Diseases, University Hospital in Cracow, Poland, in January 2023 we compared the effectiveness of using of sensor FreeStyle Libra (FGM) vs self-blood glucose monitoring (SBGM) by glucometer in improving clinical maternal outcomes measured by daily insulin dose, body weight gain, mean blood glucose and newborns outcomes assessed by body weight, APGAR score, caesarean sections.

Results: We examined 224 women from the SBGM group, 53 from the FGM group, and 277 from the GDM ladies. The SBGM group was diagnosed with GDM later in pregnancy [24 (10-25) vs 11 (8-23.5) weeks; p < 0.001], was admitted at the first pregnancy visit [26 (14-29) vs 20 (12-27) weeks; p = 0.001], and was slightly older [33 (30-36) vs 32 (29-34) years; p = 0,027]. The pre-pregnancy body weight [70 (60-83) vs 67 (59-79) kg; p = 0.358] and the number of pregnancies [2 (1-3) vs 2 (1-3); p = 0.118] did not differ between the two groups. Women who used SMGB gained less weight throughout pregnancy [10 (5.5-13.0) vs 12 (8-14.8) kg; p = 0.0333] and had fewer prenatal checkups [5 (4-7) vs 8 (5-9) weeks; p < 0.001], including fewer teleconsultations [1 (0-3)]. Women in the FGM group received insulin treatment earlier [15 (11.5-27) vs 27 (16-30) week of pregnancy; p < 0,001] and used it more often [52 (98.1%) vs 183 (81.3%); p = 0.005]. There was no significant difference in daily insulin dose per kg of weight [26.5 (11.5-39.2) vs 21 (9-39) U/d; p = 0.325]. The groups did not differ in birth weight [SBGM 3243 ± 485 vs FGM 3331 ± 359 g; p = 0.206] and a gestational week at delivery [38 (38-39) vs 39 (38-39) week; p = 0.092], There was no difference in obstetric outcomes: caesarean sections, preterm births, week of delivery, mean birth weight or prevalence of perinatal complications.

Conclusions: When comparing traditional SBGM to flash continuous glucose monitoring in this real-world observation, we have found no changes in the outcomes for mothers and newborns between the groups. There were more teleconsultations for women who used FCGM.