Ginekologia polska最新文献

The campaign to promote the natural feeding of infants, at least for the first six months of life, conducted over recent years has deep justification from a medical point of view. Numerous gynecological and pediatric societies around the world recommend breastfeeding as the most appropriate way of feeding infants. It has been proven that the benefits of this type of nutrition go beyond nutritional aspects, proper growth and development. The list of long-term metabolic benefits, which include reducing the incidence of obesity, allergies, infections and diabetes, is constantly growing. It has been shown that the method of feeding infants using various mechanisms may influence the tendency of the liver to accumulate fatty compounds and develop fatty liver disease with its metabolic consequences leading to liver failure, cirrhosis and hepatocellular carcinoma. This is an important discovery due to the growing obesity epidemic in adults and children. Metabolic dysfunction - associated fatty liver disease (MAFLD) has become the most common cause of chronic liver disease, affecting 25% of the global population. The results of studies conducted in recent years have shown the protective effect of breastfeeding on the risk of developing MAFLD later in life in both children and breastfeeding women. New scientific reports provide the basis for qualifying breastfeeding as a modifiable risk factor for MAFLD.

Congenital malformations of the female genital organs are rare anomalies and their incidence is estimated to be up to 7% in the general population. Müllerian ducts abnormalities are one of the causes of infertility and occur in approximately 16% of women with recurrent miscarriages. Sex development disorders are diagnosed at different stages of the patient's life depending on the accompanying ailments. Alarming signs of genital malformations include primary amenorrhea or dysmenorrhea, dyspareunia, and periodic abdominal pain.

Objectives: Thyroid cancer is observed more frequently in women than men, possibly due to the influence of hormonal factors. This study aims to conduct a meta-analysis encompassing both prospective and retrospective observational studies to examine the risk of thyroid cancer in women who have undergone hysterectomy surgery.

Material and methods: The literature search identified 356 articles by May 2022, and eight reported hazard ratios for thyroid cancer in women who underwent hysterectomy surgery. After the eliminations, we performed three different meta-analyses with studies that included patients who underwent only total abdominal hysterectomy (TAH), total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO), and underwent hysterectomy with or without BSO. The reporting of this study has been conducted in accordance with the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the Methodological Quality of Systematic Reviews).

Results: Our study showcases a comprehensive meta-analysis that includes eight observational studies, both retrospective and prospective, exploring the link between hysterectomy and the likelihood of developing thyroid cancer. This analysis is based on data from more than 12 million individuals, encompassing over 24,000 cases. Women who had undergone TAH (HR = 1.586, 95% CI: 1.382-1.819, p < 0.001), women who had undergone TAH and BSO (HR = 1.420, 95% CI: 1.205-1.675, p < 0.001), and women who had undergone hysterectomy with or without BSO had an increased risk (HR = 1.623, 95% CI: 1.387-1.899, p < 0.001) of developing thyroid cancer later in life.

Conclusions: We found that hysterectomy had a statistically significant risk effect on the development of thyroid cancer. The limited number of previous studies, the low amount of information, the lack of homogeneous distribution of the patients in the studies, and the unknown characteristics of thyroid cancer developing after hysterectomy were the limitations of this study. Nevertheless, our findings can positively affect public health because of the potential to enlighten the etiological mechanisms leading to thyroid cancer. Future researches should first aim to explain the underlying mechanisms of developing thyroid cancer after hysterectomy.

Objectives: To explore the image characteristics and main types of abnormal branching of fetal pulmonary artery in prenatal echocardiography.

Material and methods: A retrospective analysis of 41 cases diagnosed with abnormal branching of fetal pulmonary artery by prenatal echocardiography was made. The image characteristics of the abnormalities, their combination with intra- or extra-cardiac malformations and chromosomal anomalies were analyzed.

Results: The results of prenatal echocardiography showed that, among the 41 cases, 1) 4 cases were with anomalous origin of single pulmonary artery, 8 cases with pulmonary artery agenesis, 9 cases with pulmonary artery sling; 20 cases with crossed pulmonary arteries. 2) 11 cases were complicated with intracardiac malformations and 10 with extracardiac malformations. 3) Only 7 case underwent chromosomal examination and 1 tested abnormal. 4) Pregnancy outcomes: 25 fetuses were born and their abnormalities confirmed by echocardiography (MRI or surgery) to be consistent with prenatal ultrasound diagnosis; 16 cases had their pregnancy terminated due to their combination with other severe malformations, which were confirmed by pathological anatomy after induced abortion.

Conclusions: Prenatal echocardiography can provide detailed images for the diagnosis of abnormal branching of fetal pulmonary artery, which can be complicated by intra- and extracardiac malformations and chromosomal anomalies and should be alerted.