Clinical and experimental obstetrics & gynecology最新文献

{"title":"Immunological aspects of ovarian malignancy","authors":"Agrimaldo Martins-Filho, M. P. Jammal, Eddie Fernando Cândido Murta, R. Nomelini","doi":"10.31083/j.ceog4902035","DOIUrl":"https://doi.org/10.31083/j.ceog4902035","url":null,"abstract":"Objective: Evidence shows that the host’s immune system interacts with tumor development and may be responsible for delaying tumor growth or even for its progression. Chronic inflammation has been identified as a key factor in the pathogenesis of ovarian cancer. The objective of this study is to carry out a comprehensive review of immunological aspects of ovarian cancer. Mechanism: A search of the following keywords was conducted in the PubMed database: ”ovarian cancer”, ”prognostic factors”, ”immunotherapy”, ”immune system”. The articles identified were published between 1992 and 2021. Findings in brief: A total of 75 articles were selected for further examination. Conclusions: The understanding of tumor immune escape mechanisms will improve immunotherapy treatments. This will allow personalization or treatment not only in accordance with the biology of the tumor, but also with the characteristics of the tumor microenvironment, expanding the benefit of immunotherapy and providing more effective responses.","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":"46975861","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":"Low serum triiodothyronine and potassium levels are associated with increased risk of eclampsia among women in the Eastern Cape Province of South Africa","authors":"C. Businge, B. Longo-Mbenza, Andre Pascal Kengne","doi":"10.31083/j.ceog4902032","DOIUrl":"https://doi.org/10.31083/j.ceog4902032","url":null,"abstract":"Background: There is paucity of data on the relationship between thyroid hormones, potassium and eclampsia. Moderate-to-severe iodine deficiency that worsens during pregnancy leads to decreased thyroid hormone output and bioavailability to the brain. Apart from metabolic functions, T3 and T4 are essential fast acting cytosolic and synaptosomal neural transmitters that also regulate neuronal excitatory-inhibitory mechanisms. T3 also regulates the Na + -K + -ATPase pump that maintains the membrane ionic gradient. Hence altered serum potassium, thyroxine and triiodothyronine levels could increase the risk of eclamptic seizures. Methods: Forty-five women with eclampsia, 45 severe preeclampsia and 90 normotensive pregnant controls were enrolled into this study. Levels of thyroid hormones, thyroglobulin and urine iodine concentration (UIC) were measured and compared between the three groups. Results: Eclamptic participants had significantly lower median serum potassium (K), triiodothyronine (FT3), urinary iodine concentration (UIC) but higher serum thyroglobulin (Tg) (K = 3.7 mmol/L; FT3 = 3.8 pmol/L; UIC = 69.5 μg/L; Tg = 39.0 μg/L) than normotensive pregnant controls (K = 4.3 mmol/L; T3 = 4.7 pmol/L; UIC = 169.5 μg/L; Tg = 19.5 μg/L) and participants with severe preeclampsia (K = 4.2 mmol/L; T3 = 4.4 pmol/L; UIC = 95.7 μg/L; Tg = 22.4 μg/L), p < 0.05. Low UIC, low serum T3 and potassium and elevated Tg were independent predictors of eclampsia. Conclusions: Women with iodine deficiency in pregnancy may be at increased risk of eclampsia secondary to the ensuing rapid peripheral turnover of thyroid hormones leading to hypothyroxinaemia and reduced triiodothyronine bioavailability to the central nervous system that can be exacerbated by hypokalaemia.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46009886","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":"Coagulopathy complicating intraoperative blood salvage in patients receiving cesarean section: three case reports and a literature review","authors":"Yang Zhang, Weiling Gu, Xi-rong Xiao","doi":"10.31083/j.ceog4902033","DOIUrl":"https://doi.org/10.31083/j.ceog4902033","url":null,"abstract":"Background: Intraoperative cell salvage (ICS) has been used in more than 1100 published obstetrics cases and can reduce the need for allogeneic transfusion effectively. However, ICS could lead to a life-threatening coagulopathy called salvaged blood syndrome (SBS). SBS was reported in several non-obstetric cases but has rarely been reported in obstetric patients. Cases: We reviewed all 841 cell savage cases that occurred in our hospital prior to October 2018. Here, we present 3 cases of coagulopathy in patients who received ICS after cesarean section. The rate of obstetrical SBS in our hospital was 0.46%. Dicussion: Cesarean section was performed without severe hemorrhage, and we performed the surgical hemostatic procedures as usual. Then, several hours after the surgery and after ICS, bleeding occurred, in which hypofibrinogenemia was more severe than expected based on the amount of postpartum hemorrhage. In addition, other marked changes in coagulation function-related parameters, including a decline in the platelet count and obvious prolongation of the PT and aPTT levels, were also observed. More specific and in-depth studies concerning obstetric SBS are needed.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45902882","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":"Vaping in pregnancy: a geographically focused assessment of OBGYN provider knowledge regarding the safety and usage of electronic nicotine delivery systems","authors":"Madeleine Craig, A. Tamirisa, R. Madhavan, Ellen Jochum, Ariel Cohen, D. Zoorob","doi":"10.31083/j.ceog4902031","DOIUrl":"https://doi.org/10.31083/j.ceog4902031","url":null,"abstract":"Background: Electronic nicotine delivery systems (ENDS), or vaping, usage has become increasingly popular and generally has a positive perception by the public. However, ENDS are known to contain harmful chemicals and teratogens that induce numerous health consequences to both the pregnant mother and fetus. Despite this, physician knowledge and discussion of ENDS with their pregnant patients remains limited. Themain objective of this study was to assess the knowledge of Obstetrics and Gynecology (OBGYN) providers regarding the safety and usage of ENDS in pregnancy. A secondary objective was to understand providers’ practices to increase patient education and awareness of the effects of ENDS on pregnant women and developing fetuses. Methods: A 40-question online anonymous survey was developed for this study. The survey aimed at assessing OBGYN providers’ understanding of the usage of ENDS and potential harms. The questionnaire was distributed to OBGYN providers in the Midwest and South of the United States of America. Results: One Hundred and four respondents completed the survey (95% response rate). While 96% of providers investigated alcohol and tobacco use during prenatal visits, only 44% routinely inquired about ENDS use. Most providers noted that they had received no formal education about ENDS usage and 55% of providers reported an insufficient understanding of vaping. Conclusions: These results demonstrate that providers lack the education and knowledge about ENDS usage in pregnancy. This is concerning as ENDS usage is rapidly increasing in the United States of America. It is essential to develop educational resources for providers about the risks of vaping and incorporate questions ENDS usage into the social history, especially in pregnancy.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47615851","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":"Cervical balloon combined with oxytocin improves clinical efficacy and safety for induction of labor with scarred uterus","authors":"Dong-ha Ji, J. Ding, Xiaoqiong Li, Gang Li, D. Yin","doi":"10.31083/j.ceog4901029","DOIUrl":"https://doi.org/10.31083/j.ceog4901029","url":null,"abstract":"Background: To evaluate cervical balloon combined with oxytocin improves clinical efficacy and safety for induction of labor with scarred uterus. Methods: The clinical data of pregnant women undergoing vaginal trial delivery after cesarean section in Huai’an Maternal and Child Health Hospital, from January 2020 to January 2021 were retrospectively analyzed. Among them, 80 pregnant women with scarred uterus who were induced by cervical balloon combined with oxytocin were considered as CBO group. 80 pregnant women with natural delivery scar uterus were considered as control, who were matched to CBO group for age, gestational age, and pre-pregnancy BMI. In CBO group, Bishop score before and after induction of labor was compared. Between the CBO and control groups, mode of delivery and duration of labor were analyzed, and maternal and infant outcomes were compared. Results: The overall effective rate of cervical maturation after labor induction was 88.8%, and the proportion of vaginal delivery in the CBO group were significantly higher than that in the control group. Besides, the induced labor time, first stage of labor time and the total stage of labor time in the CBO group were significantly shorter than those in the control group. There was no significant difference in maternal and infant outcomes between the two groups. Conclusion: Cervical balloon combined with oxytocin could significantly improve the clinical effect of parturients with scar uterine without increasing maternal and infant complications, which is a safe and effective strategy that can be applied in clinical practice.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49543631","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":"Retained products of conception in placenta previa without placenta accreta spectrum: who requires transarterial embolization and/or hysterectomy?","authors":"M. Ohashi, Hironori Takahashi, Y. Baba, Hirotada Suzuki, S. Nagayama, K. Horie, M. Ogoyama, R. Usui, A. Ohkuchi, S. Matsubara","doi":"10.31083/j.ceog4901028","DOIUrl":"https://doi.org/10.31083/j.ceog4901028","url":null,"abstract":"Background: To characterize patients with retained products of conception (RPOC) in placenta previa (PP), and to determine who requires transarterial embolization (TAE) and/or hysterectomy after cesarean section (CS). We focused on RPOC in PP without placenta accreta spectrum. Methods: The retrospective cohort study was performed in patients with RPOC in PP between April 2006 and June 2019 in our institute. Results: Of 498 patients with PP, RPOC were observed in 25. The median RPOC length was 4.4 cm (interquartile range: 2.8–5.7). RPOC hypervascularity was observed in 10 (10/18, 56%) patients. Of the 25 patients, an additional hemostatic intervention (TAE and/or hysterectomy) was required in 12 (48%). The duration between CS and TAE and/or hysterectomy ranged from 0–66 days. Of those, eight (8/12: 67%) patients needed the interventions on the day of surgery (day 0). Univariate analyses showed that patients having received TAE and/or hysterectomy bled more at CS (p = 0.011) and more frequently required blood transfusions at CS (p = 0.011), and were more likely to have hypervascular RPOC (p = 0.036). Conclusion: Hypervascular RPOC and bleeding episodes at CS may predict the requirement of TAE and/or hysterectomy after CS in patients with PP.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45979540","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":"Concurrent hysterectomy and umbilical hernia repair via transvaginal notes among morbidly obese patients","authors":"M. Altıntaş, Betul Kuru, H. Küçük, S. Kaya, E. Mat, Ayhan Cevik","doi":"10.31083/j.ceog4901030","DOIUrl":"https://doi.org/10.31083/j.ceog4901030","url":null,"abstract":"Background: Umbilical hernias are especially common along with overweight, multiparous women. Laparoscopic hernia repair is preferred due to many advantages. On the other hand, the risk of trocar site hernia is disadvantageous. Trocars do not go through the abdominal wall via transvaginal natural orifice transluminal endoscopic surgery (V-NOTES). We investigate the V-NOTES hysterectomy and concomitant umbilical hernia repairment feasibility and outcomes. Methods: Six morbidly obese patients underwent V-NOTES hysterectomy and concurrent umbilical hernia repair between April 2020 and January 2021. Demographic features of patients, operating time, hernia size, complications, hospitalization time, recurrence of the hernia, visual analog scale (VAS) at 6th, 12th, and 24th hours, first, fourth, 12th weeks, and sixth months were recorded. Results: The average age of patients was 47.667 ± 2.422 (45–52). Mean body mass index (BMI), hernia and operating time size were 44.367 ± 3.217 kg/m (40.3–48.5), 6.167 ± 1.722 cm (4–9) and 88 ± 12.791 minutes (75–110), respectively. Intraoperative complications did not occur. Seroma was detected in one patient(16.6%). In six month follow-up period, we did not establish a diagnosis of hernia recurrence and postoperative chronic pain. Conclusion: Our study offers a novel perspective on V-NOTES umbilical hernia repair and hysterectomy in morbidly obese patients. According to our study, performing V-NOTES umbilical hernia repairment in a risky patient population is feasible and has promising outcomes.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44614914","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":"Senology Manifesto — why the awareness of senology should be increased?","authors":"M. Śniadecki, Paweł Guzik, M. Brzeziński, P. Basta","doi":"10.31083/j.ceog4901025","DOIUrl":"https://doi.org/10.31083/j.ceog4901025","url":null,"abstract":"1Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdańsk, 80-210 Gdańsk, Poland 2Clinical Department of Gynecology and Obstetrics, City Hospital, 35-241 Rzeszów, Poland 3Department of Gynecologic Oncology, PCK Marine Hospital in Gdynia, 81-519 Gdynia, Poland 4Department of Gynecology and Oncological Gynecology, University Hospital in Krakow, Jagiellonian University, 31-008 Kraków, Poland *Correspondence: marcinsniadecki@gumed.edu.pl (Marcin Śniadecki) Academic Editor: Michael H. Dahan Submitted: 24 November 2021 Revised: 29 December 2021 Accepted: 31 December 2021 Published: 19 January 2022","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47423954","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 impact of endometrial mechanical stimulation in women with normal hysteroscopic findings undergoing IVF/ICSI: a meta-analysis","authors":"Li-jun Lin, Jia Liu, Liang-zhi Xu, Hui Chen","doi":"10.31083/j.ceog4901027","DOIUrl":"https://doi.org/10.31083/j.ceog4901027","url":null,"abstract":"Background: To investigate whether hysteroscopic endometrial mechanical stimulation improves pregnancy outcomes in patients undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).Methods: We conducted a systematic search in electronic databases including PubMed, Embase, Cochrane Library, Web of Science from their inception to Feb 20th, 2021, as well as a manual search. All publications on the impact of hysteroscopic endometrial mechanical stimulation on IVF/ICSI outcomes were retrieved. Two reviewers independently screened the retrieved studies using stringent inclusion and exclusion criteria; data were subsequently extracted, and risk of bias was assessed. Meta-analysis of the selected studies was performed using Revman 5.3. Results: Eight studies involving 1494 patients were eligible for inclusion, including 5 randomized controlled trials and 3 prospective non-randomized simultaneous controlled experimental studies. We found that compared with the control group, hysteroscopic endometrial mechanical stimulation effectively increased live birth rate [risk ratio (RR) = 2.15, 95% confidence interval (CI) (1.78, 2.60), p< 0.00001] and clinical pregnancy rate [RR = 1.95, 95% CI (1.28, 2.98), p = 0.002], and also decreased abortion rate [RR = 0.54, 95% CI (0.35, 0.86), p = 0.009]. Subgroup analyses revealed that, hysteroscopic endometrial mechanical stimulation administered in the luteal phase in patients undergoing their first IVF/ICSI cycle was associated with significantly higher live birth rate and clinical pregnancy rate, as well as a significantly lower abortion rate. Discussion: Endometrial mechanical stimulation may improve live birth rate, clinical pregnancy rate and reduce abortion rate in patients with normal hysteroscopic findings who are undergoing IVF/ICSI. The benefits may be even greater if this therapy is given in the luteal phase and in patients who are in their first IVF/ICSI cycle. However, due to the limited quantity and quality of the included studies and variable stimulation methods, these findings should be interpreted with caution, and more high-quality studies are needed to confirm this conclusion.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42710716","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":"Knowledge and attitudes towards sexually transmitted illnesses (STIs) among the general population of Saudi Arabia","authors":"W. Fageeh, Bana E Fakieh, Majda A. Addas, Rana M Baghdadi, R. Almokri, S. Sait, S. Fagih, S. Alahmadi","doi":"10.31083/j.ceog4901026","DOIUrl":"https://doi.org/10.31083/j.ceog4901026","url":null,"abstract":"Background: We aim to determine the level of general knowledge and attitudes among the population of Saudi Arabia regarding sexually transmitted illnesses (STI). In addition, we aim to educate participants about the most common STIs, and explore how this influences the participants’ attitudes and perceptions. Methods: This study is a cross-sectional web-based survey of the general population of Saudi Arabia. The sample was enrolled randomly by distributing the survey through social media over a two-month period. 420 subjects between the ages of (15–60) participated in the study. Results: Among the 420 total responses, 405 (96%) participants were included based on the absence of missing data in their answers. Most of the participants (77%) were females. More than half of the respondents were single (59%), 24 years old or more (57%), Saudi (52%), and had a bachelor’s degree (65%). Forty-eight percent (48%) of the participants were related to the medical field. Only 11% knew someone previously diagnosed with STIs. The mean score of overall knowledge about STI was 8.79 ± 3.17 (median = 9) out of a maximum score of 20. The scores ranged from 2–16. A higher percentage of the participants (48.6%) had a low level of knowledge. Two-hundred eighty-one participants showed interest in viewing the attached educational material and subsequently completed questions on attitude regarding STI education. The mean score for attitude was 5.89 ± 1.52 out of a total of 7 (median = 6). Around 73% of all participants had a positive attitude towards STI education. Conclusion: Our findings suggest that targeting the younger population by incorporating STI-related educational material into school curricula would overcome the stigma associated with these illnesses by raising awareness and improving attitude towards them.","PeriodicalId":10312,"journal":{"name":"Clinical and experimental obstetrics & gynecology","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48995948","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}