Clinical and experimental obstetrics & gynecology最新文献

{"title":"Prediction of intrauterine inflammation in patients with preterm premature rupture of membranes at 28 to 34 weeks of gestation","authors":"Yunxia Wang, Yanlong Xu, Sha Wang, Xiaoliang Wang, Yongzhong Gu, Ye Zhang","doi":"10.31083/j.ceog4902042","DOIUrl":"https://doi.org/10.31083/j.ceog4902042","url":null,"abstract":"Background: To analyze the influence of white blood cells (WBC), serum C-reactive protein (CRP), procalcitonin (PCT), and other risk factors on the prognosis of patients with preterm premature rupture of membranes (PPROM) from 28 to 34 weeks of gestation. Methods: We performed a retrospective study of 425 patients with PPROM from 28 to 34 weeks of gestation who delivered infants at Shandong Provincial Hospitals between January 1, 2013 and December 31, 2019. Risk factors for puerperal infection were analyzed using a logistic regression model. A receiver operating characteristic (ROC) curve was constructed, and the area under the curve (AUC) was estimated. Results: Of the 425 patients (mean ± SD age, 34.69 ± 5.55 years), 104 (24.47%) had chorioamnionitis. The CRP level (odds ratio [OR], 1.009; 95% Confidence Interval (CI), 1.003–1.014; P = 0.002), WBC count (OR, 1.170; 95% CI, 1.092–1.254; P < 0.001) and gestational age (OR, 0.772; 95% CI, 0.648–0.921; P = 0.004) were risk factors of chorioamnionitis. Patients who did not undergo previous cesarean section had twice the risk of developing chorionic inflammation (P = 0.022). The cut-off value of CRP level for prediction of chorioamnionitis was 19.69 mg/L with a sensitivity of 65.4%, a specificity of 75.7%, a positive predictive value (PPV) of 46.58%, and a negative predictive value (NPV) of 90.24%. The cut-off value of WBC count was 12.99 × 10/L with a sensitivity of 62.4%, a specificity of 65.8%, a PPV of 36.65%, and an NPV of 84.61%. The cut-off value of PCT level was 0.054 ng/mL with a sensitivity of 81.0%, a specificity of 75.7%, a PPV of 32.08%, and an NPV of 90.67%. The AUC for CRP was 0.731. Conclusions: Study results suggested that CRP level (<19.69 mg/L), WBC count (<12.99 × 10/L) and PCT level (<0.054 ng/mL) had good NPVs for chorioamnionitis, whereas their PPVs were low. The CRP level was found to have the most accurate prediction of chorioamnionitis among patients with PPROM from 28 to 34 weeks of gestation.","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":"47418855","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":"Enhanced recovery after gynecologic surgery: review of the literature","authors":"M. Ibanoglu, T. Kınay, Y. Engin-Ustun","doi":"10.31083/j.ceog4902046","DOIUrl":"https://doi.org/10.31083/j.ceog4902046","url":null,"abstract":"Objective: Enhanced Recovery After Surgery (ERAS) includes practices aimed at providing rapid recovery by standardizing pre-and post-surgical care in patients undergoing colon surgery and reducing the metabolic stress response. The ERAS program is a systematic application that includes surgeons, anesthetists, nurses, and assistant healthcare professionals in the care process and has been successfully implemented in the international arena. Studies on ERAS protocols show that this system can be actively applied in different surgical areas. Mechanism: This review article discusses the main reviews and recommendations of the medical community on ERAS and valuable publications in the literature. Findings in brief: Guidelines of the ERAS Society for peri-operative care in gynecological procedures were first published in 2016 and updated in 2019. ERAS Society recommended 12 items for pre-and intra-operative care and 10 post-operative care items. The objectives of these applications are to provide patient education and consultancy services before surgery, to stop oral intake shortly before surgery and to start fast nutrition after surgery, to maintain a balanced body temperature and fluid level to maintain normal physiology, to increase mobilization, to provide pain control with painkillers, prophylaxis of nausea and vomiting and reduction of unnecessary or prolonged use of catheters. Conclusions: Studies suggest that increased compliance with ERAS agents in colon surgery has a positive effect on operation results, but more studies are needed to reach this affirmation in gynecological surgery.","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":"47418611","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":"Identification and characteristics of drug resistance and genotypes of methicillin-resistant Staphylococcus aureus isolated from intensive care units at obstetrics & gynaecology departments: a retrospective analysis","authors":"Zhong-Kun Huo, Binxian Li, Xue Meng, Peiyao Li, Mingcheng Li","doi":"10.31083/j.ceog4902047","DOIUrl":"https://doi.org/10.31083/j.ceog4902047","url":null,"abstract":"Background: The aim of this study was to investigate the prevalence and characteristics of SCCmec genotypes and drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) isolated from intensive care units (ICU) at obstetrics & gynaecology departments in a tertiary hospital. Methods: MRSA obtained from patients admitted to the ICU were isolated and identified by using the Vitek 2 Compact System with GP21 342 cards. Antimicrobial susceptibility profiles and MRSA screening were determined by using the broth microdilution method according to CLSI guidelines. Determination of resistant genes and SCCmec genotypes were performed by multiplex PCR. Results: Of the 283 patients evaluated, 120 (42.4%) isolates were phenotypically and genotypically confirmed to be MRSA. Among 120 strains, 15 (12.5%) strains were SCCmec type II, 96 (80%) strains were SCCmec type III and 9 (7.5%) strains were undifferentiated type. All MRSA strains were recognized as multidrug resistant, exhibiting 100% resistance to cefoxitin and oxacillin, followed by erythromycin and levofloxacin (more than 80% and 90% respectively). Different SCCmec genotypes in MRAS isolates showed distinct antimicrobial agent patterns. SCCmec type II was highly resistant to clindamycin (93.3%) with lower resistance to tetracycline (26.7%) with SCCmec type III being highly resistant to gentamicin (91.7%). Undifferentiated strains were resistant to Cotrimoxazole (77.8%). There was a statistical difference among type II, type III and Undifferentiated strains (P < 0.05). Of interest, a high prevalence of resistance to rifampicin (more than 75%) was also noted in the hospital. With different SCCmec genotypes, MRSA isolates were sensitive to minocycline, quinupristin, teicoplanin, vancomycin and nitrofurantoin. Conclusions: Our data indicate that SCCmec type II and SCCmec type III of MRSA are circulating in the ICU and constitute a major source for the infection spread. It is necessary to increase surveillance of MRSA in the ICU and develop adequate infection prevention strategies.","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":"44621781","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":"Rare extragenital endometriosis: pathogenesis and therapy","authors":"Francesco Fedele, Simona Di Fatta, A. Busnelli, A. Bulfoni, S. Salvatore, M. Candiani","doi":"10.31083/j.ceog4902043","DOIUrl":"https://doi.org/10.31083/j.ceog4902043","url":null,"abstract":"Background: In the context of extragenital endometriosis, the gastrointestinal, urinary tract, abdominal wall, and thorax localizations are considered relatively frequent, while the umbilical, inguinal, sciatic nerve, liver, and pancreas are instead ”rare”. Methods: Online searches were carried out in PubMed database of the last 20 years for these terms: extragenital endometriosis, umbilical endometriosis, inguinal endometriosis, sciatic nerve endometriosis, hepatic and pancreatic endometriosis. The following exclusion criteria were used: (1) Personal surgical history unspecified. (2) Nonspecific histological diagnosis for each type of endometriosis examined. (3) Inability to distinguish between the personal series of the author and the case reports described. (4) Proceedings of scientific meetings were not included. Tables that are easy to consult were compiled. Results: 810 titles were found among which 162 studies were selected for reading in full text and finally 114 papers were included, which met the objective of the revision. The so-called ”rare” forms of extragenital endometriosis show an unsuspected frequency, an extreme variability of presentation, and uncertain treatment guidelines. Discussion: Gynecologists, general surgeons, and neurologists should be well acquainted with these pathologies to avoid confusing diagnostic paths and to set up adequate therapies.","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":"45593103","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":"Perceived Elementary Grid (PEG) proposal for dyadic coping evaluation in the infertile couple during assisted reproductive treatments","authors":"G. Buzzaccarini, A. Vitagliano, A. Busnelli, M. Noventa, L. Marin, A. Laganà, G. Gullo, Marco Inghilleri, Simona Luciani, G. Ambrosini, A. Andrisani","doi":"10.31083/j.ceog4902040","DOIUrl":"https://doi.org/10.31083/j.ceog4902040","url":null,"abstract":"1Department of Women and Children’s Health, University of Padua, 35128 Padua, Italy 2Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center-IRCCS, Rozzano, 20089 Milan, Italy 3Department of Obstetrics and Gynecology, ”Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, Italy 4Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90133 Palermo, Italy 5Interattivamente, Center for Legal Psychology–Clinical Sexology–Psicoterapy, 35139 Padova, Italy *Correspondence: giovanni.buzzaccarini@gmail.com (Giovanni Buzzaccarini) Academic Editor: Michael H. Dahan Submitted: 20 August 2021 Accepted: 7 September 2021 Published: 9 February 2022","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41932641","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":"Prenatal identification of novel HSPG2 variants associated with dyssegmental dysplasia Silverman-Handmaker type","authors":"Yunxia Wang, Hui Wang","doi":"10.31083/j.ceog4902037","DOIUrl":"https://doi.org/10.31083/j.ceog4902037","url":null,"abstract":"Background: We aimed to analyze mutations of the pathogenic gene in dyssegmental dysplasia Silverman-Handmaker (DDSH) type associated with the Heparin sulfate proteoglycan 2 (HSPG2) gene. Case: Prenatal testing for genetic mutations associated with fetal DDSH were performed on a pregnant woman with previous history of carrying a fetus with short limb malformation at the 17th week of gestation. DNA was extracted from amniotic fluid and next-generation sequencing-based deep panel sequencing was performed on the Illumina NextSeq platform to identify possible causative mutations of DDSH. Results: Two novel heterozygous mutations in HSPG2 gene, c.6001dupC (p. R2001pfs*19) and c.11207G>A (p. R373Q), were identified and associated with the DDSH diagnosis. Conclusion: This is the first report to prenatally identify novel mutations in HSPG2 that confirms a DDSH diagnosis.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42771219","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":"Evaluation of the clinical significance of serum pentraxin-3 levels in patients with polycystic ovary syndrome","authors":"F. Yesil, K. Deveci, P. Karlı","doi":"10.31083/j.ceog4902038","DOIUrl":"https://doi.org/10.31083/j.ceog4902038","url":null,"abstract":"Background: Polycystic ovary syndrome (PCOS) is commonly associated with insulin resistance (IR), hyperinsulinemia, and dyslipidemia, which play a role in the development of endothelial dysfunction and promote the early onset of cardiovascular diseases. The aim of this study was to evaluate the clinical importance of pentraxin-3 levels in PCOS patients. Methods: Forty-five female patients diagnosed with PCOS according to the 2003 Rotterdam criteria and 42 healthy women were included in the study. All women studied were tested within 3 and 5 days of their menstrual cycle. Ultrasonographic evaluation of each patient was first conducted using the suprapubic method. Serum PTX-3, endothelin 1 (ET-1), vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and nitric oxide levels were measured using the enzyme-linked immunosorbent assay method. Results: Pentraxine-3 (PTX-3) levels in the patient group were significantly lower than those in the control group (p < 0.05). PTX-3 levels in the group with hirsutism were significantly higher than those in the nonhirsutism group (p < 0.05). Homeostatic model assessment for IR (HOMA-IR) levels in the patient group were significantly higher than those in the control group (p < 0.01). A weak negative correlation was found between PTX-3 and HbA1c levels. The accuracy rate of the PTX-3 test in distinguishing patients and nonpatients was moderate with a 0.634 area-under-the-curve value. Conclusions: During the follow-up of patients with PCOS, a decrease in serum PTX-3 levels associated with hirsutism and IR may be observed.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49358196","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":"Predicting factors of clomiphene citrate responsiveness in infertile women with normogonadotropic anovulation (WHO group II anovulation)","authors":"Theeraporn Areetheerapas, Artitaya Singwongsa, K. Suwannarurk, J. Pattaraarchachai","doi":"10.31083/j.ceog4902039","DOIUrl":"https://doi.org/10.31083/j.ceog4902039","url":null,"abstract":"Background: Clomiphene responsiveness has been varied in WHO group II anovulatory patients. Our study evaluates factors associated with clomiphene citrate responsiveness in this population. Various parameters were studied, including anthropometric, hormonal and transvaginal ultrasonographic measurements. Methods: A retrospective case-control study was done over a period of three years. A total of 260 women with WHO group II anovulatory related infertility treated with clomiphene citrate 100 mg/d for five consecutive days were enrolled. 173 women were categorized in clomiphene citrate resonsive group (CCR), defined as patients with at least one dominant follicle ≥17 mm or at least 2 dominant follicles ≥15 mm. 87 women were categorized in the non-ovulatory group (NCCR), defined as patients who not meet the responsive group criteria. Various clinical, metabolic, hormonal and ultrasound features were compared between two groups. Logistic regression analysis was used to analyze the significant factors. Results: Among all participants, the mean age was 32.6 ± 4.0 years. The mean body mass index in CCR and NCCR group was 23.9 ± 10.7 kg/m and 24.0 ± 4.0 kg/m, respectively. The mean waist-hip ratio (WHR) of the NCCR group was higher than that of the CCR group, i.e., 0.83 ± 0.06 vs 0.81 ± 0.05 (p = 0.004). The waist-hip ratio was the most sensitive anthropometric predictor of non-responsiveness to clomiphene: cut-off value of 0.775 (90.8% sensitivity and 20.2% specificity) and cut-off value of 0.805 (73.6% sensitivity and 42.2% specificity). Age, clinical hyperandrogenism, polycystic ovarian morphology, low antral follicle count (≤5 follicles), baseline follicle-stimulating hormones and estradiol levels were not significantly different. Conclusions: Thewaist-hip ratio is a clinically useful parameter in predicting clomiphene responsiveness in normogonadotropic anovulatory women (WHO group II anovulation).","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44506494","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":"Progesterone: the key to success?","authors":"A. Riva, G. Buzzaccarini, A. Vitagliano, A. Laganà, G. Cucinella, G. Gullo","doi":"10.31083/j.ceog4902036","DOIUrl":"https://doi.org/10.31083/j.ceog4902036","url":null,"abstract":"1Department of Woman and Child’s Health, Obstetrics and Gynecology Unit, University Hospital of Padua, 35128 Padua, Italy 2Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, Italy 3Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF Unit, University of Palermo, 90100 Palermo, Italy *Correspondence: harianna.riva@gmail.com (Arianna Riva) Academic Editor: Michael H. Dahan Submitted: 16 October 2021 Revised: 8 November 2021 Accepted: 10 November 2021 Published: 8 February 2022","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45591634","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":"Vanishing twin after 12 gestational weeks is associated with adverse perinatal outcomes in in vitro fertilization cycles","authors":"Jun Liu, Chun-Lin Liu, Qinhong Luo, Zhufeng Wu, Fengxiang Li, D. Chen, Chao Li, Ling Sun","doi":"10.31083/j.ceog4902034","DOIUrl":"https://doi.org/10.31083/j.ceog4902034","url":null,"abstract":"Background: To assess the associations between vanishing gestational age and the adverse perinatal outcomes following in vitro fertilization cycles. Methods: This is a retrospective cohort study conducted in Guangzhou Women and children hospital from January 2011 to January 2019. We identified 350 vanishing twin pregnancies including 54 secondary fetal deaths and 296 singleton deliveries compared to 2080 infants from single gestations. The children detected by transvaginal ultrasonography in gestational week 6. By linking with the hospital’s registries, the main endpoints were gestational age (weeks), birth weight (g), low birth weight (LBW), preterm birth and neonatal malformation rate. Perinatal outcomes were compared among study groups and controls. Results: Of the 350 vanishing twin, there were 15.4% (54) secondary fetal death. Of the 2376 singleton deliveries, 12.5% (296) originated from a twin gestation. In the assessment of perinatal outcome, there were no significant differences between the singleton cohort and vanishing twin before the presence of fetal cardiac activity cohort (VT before CA) and early vanishing cohort. The late vanishing twin group had a higher risk of preterm delivery (P < 0.001) and LBW (P < 0.001). There were no significant differences between all cohorts in assessing neonatal malformation rate (P> 0.05). Conclusion: Vanishing twin after 12 weeks is a predictor of adverse perinatal outcome. The couples with a viable fetus or a non-viable fetus and an empty gestational sac in early pregnancy (<12 weeks) have a similar outcome as the baby from a singleton delivery without vanishing.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42764003","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}