Ginekologia polska最新文献

Objectives: The integration of high-risk human papillomavirus (HPV) detection into cervical cancer screening in Poland aims to improve early detection, yet challenges in coverage and adherence persist. Innovative approaches, like sampling for HPV testing and cytology outside medical settings, have been proposed. This study assesses the feasibility and agreement of results between traditional and novel sampling methods.

Material and methods: A cohort of 50 women aged 25-74 underwent HPV DNA and liquid-based cytology sampling both in-office using standard method and outside the medical setting by trained personnel. Samples were analyzed for HPV DNA using Real-Time PCR and cytology according to the Bethesda System.

Results: Cytology and HPV DNA positivity rates showed substantial agreement between methods, with almost perfect agreement for high-risk HPV types. Visual assessment of the cervix was successfully conducted in all cases. Preliminary results suggest remote sampling for HPV DNA and cytology is a viable alternative to traditional methods, with the effectiveness in detecting HPV and cytological abnormalities comparable to this reported in literature, offering potential benefits for individuals with mobility limitations or logistical barriers to attending medical appointments.

Conclusions: The study highlights the potential role of remote sampling for HPV DNA and cytology in enhancing cervical cancer screening accessibility and adherence. Implementation of such methods could improve coverage, particularly among underserved populations. Further research is needed to validate and optimize these approaches for broader clinical use.

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: 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.