Clinical and experimental obstetrics & gynecology最新文献

{"title":"Development and Validation of Models to Predict Cesarean Delivery among Low-Risk Nulliparous Women at Term: A Retrospective Study in China","authors":"Fangcan Sun, Fangfang Wu, Huiyun Chen, Qianqian Shen, Youguo Chen, Minhong Shen, Bing Han","doi":"10.31083/j.ceog5008166","DOIUrl":"https://doi.org/10.31083/j.ceog5008166","url":null,"abstract":"Background: Intrapartum cesarean delivery has been the focus of many researchers. We derived and validated a model to predict cesarean for low-risk Chinese nulliparous undergoing induction of labor. Methods: We developed a risk model for cesarean by including variables in univariate and multivariable logistic regression using the development set (3841 pregnant women). The performance of the model was assessed for the receiver operating characteristic (ROC) curve, calibration and decision curve analysis (DCA). Additionally, we validated the model externally using an independent dataset (3421 pregnant women). Results: Multivariable logistic regression analysis showed that age, height, body mass index (BMI), weight change during pregnancy, gestational age, premature rupture of membranes (PROM), meconium-stained amniotic fluid and neonatal sex were independent factors affecting cesarean outcome. Two models were established, depending on whether the sex of the fetus was included. The area under the ROC curve of two models were 0.755 and 0.748, respectively. We verified externally, and the area under the ROC curve of two models were 0.758 and 0.758, respectively. The calibration plots demonstrated a good correlation. DCA demonstrated that two models had clinical application value. The online web servers were constructed based on the nomograms for convenient clinical use. Conclusions: These two models can be used as useful tools to assess the risk of cesarean for low-risk Chinese nulliparous undergoing induction of labor.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135697717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality of Life with Cervical Cancer and Precancer: A Cross-Sectional Study in Yunnan Province, China","authors":"Min Zhao, Meng-Jiao Zhang, Lian-Ju He, Chun-Mei Zuo, Song-Rui Ding, Allison Rabkin Golden, Le Cai","doi":"10.31083/j.ceog5008161","DOIUrl":"https://doi.org/10.31083/j.ceog5008161","url":null,"abstract":"Background: Cervical cancer is the fourth most common cancer in women, with an estimated 600,000 new cases and 340,000 deaths worldwide in 2020. However, there remains limited understanding of the association between individual socioeconomic status, clinical characteristics, and health-related quality of life (HRQoL) of women with cervical precancerous lesions. This study investigates socioeconomic and clinical variations in HRQoL of women with cervical precancerous lesions and cervical cancer in Yunnan Province, China. Methods: The present study employed a cross-sectional survey design. An EuroQol Five Dimensions Five Level (EQ-5D-5L) questionnaire was used to assess HRQoL of 400 patients with cervical precancerous lesions and cervical cancer in Yunnan Province, China, from 2019 to 2020. Analysis of variance (ANOVA) and independent samples t-tests were performed to identify the independent variables associated with EQ-5D-5L utility scores and visual analogue scale (VAS) scores. Predictors of utility scores were confirmed using a Tobit regression model. Results: The mean EQ-5D-5L utility scores of cervical precancerous lesions and cervical cancer patients was 0.939 (standard deviation (SD), 0.104), and the mean VAS score was 80.84 (SD, 16.551). Patients aged 40–59 years (β = –0.037, p = 0.005), patients who were not aware of the human papillomavirus (HPV) vaccine (β = –0.032, p = 0.004), and patients who underwent radical hysterectomy (β = –0.036, p = 0.006) had significantly lower utility scores, whereas having high monthly household income (β = 0.023, p = 0.033) was significantly associated with higher EQ-5D-5L utility scores. Age (p = 0.023) was statistically significant in differences in patients’ VAS scores. Anxiety/depression was the most frequently reported issue (35.75%) among participants. Conclusions: Future cervical cancer prevention and treatment guidelines should focus on low-income women, women aged 40–59 years, and those lacking knowledge about cervical cancer prevention.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135064469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality of Life in perimenopausal women with PCOS","authors":"M. Forslund, K. Landin-Wilhelmsen, E. Krantz, Penelope Trimpou, Johanna Schmidt, M. Brännström, E. Dahlgren","doi":"10.31083/j.ceog4902052","DOIUrl":"https://doi.org/10.31083/j.ceog4902052","url":null,"abstract":"Background: Several studies have shown that younger women with polycystic ovary syndrome (PCOS) have decreased Health-Related Quality of Life (HRQoL) compared with women in general. Method: In this study periand postmenopausal women previously diagnosed with PCOS (n = 27) were compared with randomly selected, age-matched controls (n = 94). Mean age of the study participants was 52 years. Structured interviews and Short Form (SF)-36 questionnaires were used. Results: No differences in SF-36 scores were found, median for the physical summary score was 54 vs. 57, for women with PCOS and controls, respectively; and 53 vs. 53 for the mental summary score, with no differences in any of the eight dimensions of HRQoL. There were no significant difference in prevalence of depression and/or anxiety. The use of drugs for mood disorders was 22% in both groups. Conclusion: PCOS women of periand postmenopausal ages had similar HRQoL compared with age-matched controls.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46853084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Urinary Incontinence on Women’s Sexuality","authors":"S. Escura Sancho, L. Ribera-Torres, C. Castelo-Branco, S. Anglès-Acedo","doi":"10.31083/j.ceog4902049","DOIUrl":"https://doi.org/10.31083/j.ceog4902049","url":null,"abstract":"Objective: Globally, the prevalence of urinary incontinence (UI) in women is estimated to be in the range of 25% to 45%. Different types of UI exist, being the most frequent ones stress UI, urgency UI and mixed UI. Being affected by UI is associated with a higher risk of sexual inactivity, regardless of its type. Mechanism: It is estimated that 5–38% patients with UI are sexually inactive due to UI, whereas 25–38% sexually active women would restrict their sexual activity due to UI. The prevalence of sexual dysfunction within sexually active women with UI is 23–56%. Findings in brief: In patients with UI, the most frequent sexual dysfunctions are dyspareunia (44%), female sexual interest/arousal disorder (34%) and orgasmic disorder (11%). Therefore, UI has a negative impact on the sexual function of sexually active women with UI. Coital incontinence is defined as the complaint of involuntary loss of urine during or after intercourse. UI with penetration represents any complaint of involuntary loss of urine with vaginal stimulation (either with a sexual toy, manually or with penetration). Orgasmic UI refers to any complaint of involuntary loss of urine occurring at orgasm, regardless of the sexual behaviour that has triggered it. Due to the high prevalence of coital UI (50–60%) in the female population and its strongly negative impact on women’s sexuality, patients should be specifically asked for coital UI in the gynecologic visits. Conclusions: UI affects between one in four and one in two women and had a negative impact on quality of life. Not only UI has an impact on female sexuality, but also different treatments which are offered to treat it can play a role. The reduction of sexual problems with pelvic floor muscle training in women with stress UI has been proved, being the rate of sexual activity doubled. A significant improvement of the overactive bladder associated to urgency UI and female sexual function has been described after the pharmacological treatment or botulinum toxin. Finally, significant improvement of the sexual function has also been found after midurethral slings for stress UI, as well as for coital UI.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41857248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is ovarian cystectomy feasible for patients with borderline ovarian tumors? A retrospective study and review of the literature","authors":"Seongmin Kim, K. Min, Sanghoon Lee, J. Hong, J. Song, Jae Kwan Lee, N. Lee","doi":"10.31083/j.ceog4902051","DOIUrl":"https://doi.org/10.31083/j.ceog4902051","url":null,"abstract":"Background: Given that borderline ovarian tumors (BOTs) are usually found in young, fertile women without a history of childbirth, fertility preservation should be considered in the treatment plan. This retrospective study aimed to evaluate the safety of ovarian cystectomy in patients with BOTs. Methods: Patients with BOTs treated between August 2007 and August 2016 at our institution were divided into two groups according to the type of surgery: the cystectomy group and the oophorectomy group with or without salpingectomy, and differences in surgical outcomes were compared. The cumulative disease recurrence was also compared using Kaplan–Meier curves. Results: Of the 162 patients enrolled, 128 (79.0%) underwent an oophorectomy with or without salpingectomy and 34 (21.0%) underwent an ovarian cystectomy. The patients in the cystectomy group were younger than those in the oophorectomy group (29.2 years vs. 46.5 years, p< 0.001), and the proportion of patients who underwent minimally invasive surgery was higher in the cystectomy group than in the oophorectomy group (88.2% vs. 46.9%, p < 0.001). During the mean follow-up period of 44 months, six patients (3.70%) developed disease recurrence (five [3.9%] and one [2.9%] in the oophorectomy and cystectomy groups, respectively). The two-year disease-free survival rate was 97.1% and 97.6% in the cystectomy and oophorectomy groups, respectively, and did not differ between the groups (p = 0.818). Discussion: Ovarian cystectomy can be considered a safe and effective option for young women with BOTs who wish to preserve their fertility.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47396689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of intraoperative antiemetics on postoperative nausea and vomiting in patients receiving intrathecal morphine for elective caesarean deliveries","authors":"M. Kanczuk, N. Lightfoot, Y. Ohashi, J. Chong, H. Mace, David W. Hoppe, E. O’Loughlin","doi":"10.31083/j.ceog4902050","DOIUrl":"https://doi.org/10.31083/j.ceog4902050","url":null,"abstract":"Background: The incidence of postoperative nausea and vomiting (PONV) when intrathecal morphine (ITM) is used for caesarean delivery (CD) is up to 80% without antiemetic prophylaxis. Prophylactic antiemetics can reduce this rate by 50%, except for dexamethasone that did not show to be effective in this context. Combinations showed divergent results. We investigated the incidence of PONV when different combinations of antiemetics were used for CD in parturients receiving ITM.Methods: Retrospective, single centre cohort study of patients undergoing elective CD with ITM between January 2016 and October 2017. The primary outcome was the incidence of PONV requiring treatment in the first 24 hours following CD. Interactions were sought using multivariate modelling for predictors of PONV following surgery. Results: Overall, 598 women were included in the study. The rate of PONV requiring treatment was 29.1%. The rate of PONV decreased with increasing numbers of prophylactic medications (p < 0.001). Women who did not experience PONV received a greater number of antiemetics in the operating room (p < 0.001). There was a dose response relationship between ITM dose and PONV rate (p < 0.001). Dexamethasone, either alone or in combination with other agents was not protective against PONV when compared with other drug combinations (p = 0.08). Conclusions: We have demonstrated an inverse relationship between the number of prophylactic antiemetics given and the rates of PONV after caesarean delivery in the context of intrathecal morphine use. Dexamethasone use, either alone or in conjunction with other drugs did not offer advantages over other combinations where dexamethasone was avoided.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44141206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrial receptivity and PCOS; endometrial gene expression specificities — literature review","authors":"M. Alebić","doi":"10.31083/j.ceog4902048","DOIUrl":"https://doi.org/10.31083/j.ceog4902048","url":null,"abstract":"Objectives: The purpose of this review is to provide an overview of existing studies on the specificities of gene expression in the endometrium in PCOS and possible molecular mechanisms linking those specificities with reproductive and obstetric consequences of PCOS. Mechanism: Polycystic ovary syndrome (PCOS) is a complex disorder combining features of reproductive, metabolic, and psychological disturbances. The effect of metabolic, inflammatory, and endocrine abnormalities on ovulatory function and oocyte quality has been seen as the main reproductive issue in PCOS women. However, even after the restoration of ovulation, this group exhibits lower than expected reproductive outcomes. Functionally relevant sequence alterations in genes involved in regulating endometrial receptivity could also be relevant in PCOS as a property independent of extra-endometrial influences. Findings: Hyperandrogenism, ovulatory dysfunction, and insulin resistance are associated with the alterations in endometrial gene expressions leading to suboptimal endometrial receptivity in PCOS. Endometrial steroid receptor malfunction seems to be a contibuting factor to the intrinsic suboptimal endometrial receptivity in PCOS. Conclusion: epigenetic or epigenomics mechanisms altering gene expressions on the endometrial level in PCOS should not be ruled out. Future studies should focus on investigating specificities of each PCOS phenotype and developing individual treatment strategies to meet the specific needs of every PCOS patient.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49537933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of knotless barbed suture in cesarean section using postpartum ultrasound: a retrospective cohort study","authors":"Ju Yeon Hong, Ho-Yeon Kim, G. Cho, K. Ahn, S. Hong, M. Oh, H. Kim, H. Baek","doi":"10.31083/j.ceog4902041","DOIUrl":"https://doi.org/10.31083/j.ceog4902041","url":null,"abstract":"Background: While speed, safety, and efficacy are necessary in the operation of cesarean section (CS), a number of new devices have been introduced to support the technique. This retrospective study was conducted to assess the usability and safety of knotless barbed suture, compared to conventional method, for closure of uterine myometrium during cesarean section. Methods: Patients who underwent cesarean delivery at Korea University Ansan Hospital between August 2018 and December 2019 were reviewed. Surgical outcomes including uterine closure time, operating time, estimated blood loss, and sonographic results of residual myometrial thickness at the site of incision at 6 to 8 weeks after operation were analyzed. Results: Out of total 78 women, 44 patients had knotless barbed suture and 34 patients underwent conventional suture. Compared to conventional method, the uterine closure time was significantly reduced (p = 0.012). Operative time, estimated blood loss during operation, hemoglobin difference on the third operative day, and the number of cases with transfusion, postpartum infection, and bleeding demonstrated no significant differences between the two groups. At 6 to 8 weeks after operation, transvaginal ultrasound revealed no differences in residual myometrial scar thickness. Conclusion: Knotless barbed suture resulted in significantly shorter uterine closure time and no increased rate of perioperative complications. Our work supports that knotless barbed suture can be effectively used for cesarean section.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43262223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical data analysis of nine years of experience with twin pregnancy: a tertiary hospital-based retrospective study","authors":"Yuan Ting, Zhang Ting, Wang Yan-Yan, Li Xue-Lan, Han Zhen","doi":"10.31083/j.ceog4902045","DOIUrl":"https://doi.org/10.31083/j.ceog4902045","url":null,"abstract":"Background: The incidence of twin pregnancy has been increasing worldwide and in China. This study provided a comprehensive analysis of the clinical data of twins in a Chinese tertiary hospital and summarized the clinical characteristics. Methods: A retrospective collection of data was carried out for 717 cases of twins in the Obstetrics Department of the First Affiliated Hospital of Xi’an Jiaotong University from 2011 to 2020. A comprehensive analysis of baseline information and maternal and perinatal outcomes was conducted, and the twin birth rate of the study population was also calculated. Results: The average twin delivery rate was 2.61%. A total of 206 cases were monochorionic, and 511 cases were dichorionic. Premature delivery, hypertensive disorder complicating pregnancy and premature rupture of membranes were the three most common complications. Caesarean section rates from 2011 to 2019 were maintained at 70%–80%. A total of 144 cases (20.08%) of 717 twin cases were complicated twins. Birthweight discordance ≥25% accounted for 13.53% of cases. Adverse neonatal outcomes with higher incidences were neonatal respiratory distress syndrome, small for gestational age and 1 min Apgar score ≤7. Conclusions: Twin pregnancy has different and unique clinical features. Obstetricians should pay close attention to its clinical management to obtain better perinatal outcomes.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43207066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of office hysteroscopy in the diagnosis of chronic endometritis","authors":"Mohamed Elmahdy Abdel Moneim, Amany Abdelbary Abdel Latif, Marwa Shehata, I. Ghanem","doi":"10.31083/j.ceog4902044","DOIUrl":"https://doi.org/10.31083/j.ceog4902044","url":null,"abstract":"Background: To test the accuracy of office hysteroscopy in the diagnosis of chronic endometritis (CE) as compared to histopathological diagnosis. Methods: This prospective cohort study was conducted in a private hospital from July 2018 to January 2020. 220 infertile women were scheduled for first attempt of intracytoplasmic sperm injection (ICSI). Patients ranging in age from 20–40 with history of primary infertility scheduled for ICSI for the first time were included, while patients with chronic diseases, severe vaginal bleeding, previous failed ICSI, polycystic ovary syndrome (PCOS), or endometriosis were excluded. All patients received postmenstrual office hysteroscopy to rule out the presence of CE; at the same setting, endometrial biopsy was taken and sent for histopathological examination. Results: 174 cases (79.1%) were diagnosed as CE at hysteroscopy, while 162 (73.6%) cases were positive at histopathology. 99.4% of the cases presented with hyperaemia, followed by oedema in 74.7% and micro-polypi in 58.6% of cases with CE. There was a significant difference between the hysteroscopic and the histopathologic diagnosis of CE (p < 0.001). The sensitivity, specificity, and positive and negative predictive values of hysteroscopy were 93.83%, 62.07%, 87.36% and 78.26% respectively. Conclusions: Office hysteroscopic evaluation is relatively accurate on its own but can be further confirmed by CD138 staining.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47132048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}