Ginekologia polska最新文献

{"title":"The effect of hCG day progesterone in 1318 cycles on pregnancy outcomes: ongoing discussion.","authors":"Özlem Kayacik Günday, Oya Aldemir, Runa Özelçi, Serdar Dilbaz, Emre Başer, Özlem Moraloğlu Tekin","doi":"10.5603/GP.a2022.0114","DOIUrl":"10.5603/GP.a2022.0114","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of human chorionic gonadotropin day progesterone (hCG-P) level on pregnancy outcomes in in vitro fertilization (IVF) cycles.</p><p><strong>Material and methods: </strong>This study is an analysis of a cohort of 1318 fresh IVF- embryo transfer cycles, including 579 agonists and 739 antagonists, performed at a single IVF center between 2007 and 2018. For fresh cycles, we performed Receiver Operating Characteristic analysis (ROC) to calculate the threshold value of hCG-P, which affects pregnancy outcomes. We divided patients below and above the determined threshold value into two groups, then, correlation analysis and we performed logistic regression analysis.</p><p><strong>Results: </strong>According to ROC curve analysis of hCG-P, AUC was 0.537 (95% CI: 0.510-0.564, p < 0.05) for LBR, and the threshold value for P was 0.78. The hCG-P threshold value of 0.78 proved to be significant in relation to BMI, type of drug used during induction, the hCG day E2, the total number of oocytes, the number of oocytes and the subsequent pregnancy outcome between the two groups (p < 0.05). However, the model we built, which accounted for hCG-P, total number of oocytes, age, BMI, induction protocol, total dose of gonadotropin used in induction did not prove significant in terms of its effect on LBR.</p><p><strong>Conclusions: </strong>The threshold value of hCG-P that we found to have an effect on LBR was quite low compared with the p value generally recommended in the literature. Therefore, further studies are needed to determine an accurate p-value that reduces success in managing fresh cycles.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":"616-624"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9363631","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":"Anterior uterocervical angle: is it an ultrasonographic screening tool that estimates the latent phase duration in post term pregnancies?","authors":"Nefise Nazli Yenigul, Fedi Ercan, Hakan Sager, Elif Yuce Bilgin, Emin Ustunyurt","doi":"10.5603/GP.a2022.0126","DOIUrl":"10.5603/GP.a2022.0126","url":null,"abstract":"<p><strong>Objectives: </strong>In recent years, in addition to cervical length measurement, a new ultrasonographic parameter has been defined as uterocervical angle (UCA), which can be used in the prediction of preterm labor. In this study,we evaluated the place of uterocervical angle in predicting the latent phase duration in postterm pregnancies.</p><p><strong>Material and methods: </strong>This prospective study consists of 90 pregnant women aged between 18 to 40 years who were hospitalized with a diagnose of late term pregnancy. Pregnant women with a latent phase duration of 1200 minutes or less were defined as Group 1. Patients with latent phase duration over 1200 minutes were defined as Group 2. All patients' age, BMI, smoke, cervical length measurements, uterocervical angle, latent and active phase of labor durations, length of the third stage and delivery types were compared.</p><p><strong>Results: </strong>The UCA median value of group 1 was 120 (94-147), and group 2 was 99 (94-105) (p < 0.001). CL medians of Groups 1 and 2 were 29 (17-43) and 28 (27-41) respectively (p: 0.871). UCA (AUC: 0.917, p < 0.0001) significantly predicted prolonged latent phase duration. Optimal cut off value was obtained at the value of 105 degree (100% sensitivity, 75% specificity) for UCA. Kaplan-Meier survival analysis showed that duration of labor was significantly higher in a group with low UCA (p: 0.013).</p><p><strong>Conclusions: </strong>UCA can be a successful tool that can be used to predict duration of labor in cases of postterm pregnancies with medical induction.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":"852-857"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9121330","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 nightmare of obstetricians - the placenta accreta spectrum in primiparous pregnant women.","authors":"Ülkü Ayşe Türker Aras,&nbsp;Engin Korkmazer,&nbsp;Emin Üstünyurt","doi":"10.5603/GP.a2022.0141","DOIUrl":"https://doi.org/10.5603/GP.a2022.0141","url":null,"abstract":"<p><strong>Objectives: </strong>The incidence of PAS is increasing day by day as a life-threatening condition. The purpose of the present study was to determine the factors affecting PAS formation in primiparous pregnant women and to define possible risk factors for the mother and the baby.</p><p><strong>Material and methods: </strong>Bursa Yüksek İhtisas Training and Research Hospital, department of obstetrics and gynecology, Bursa, Turkey, between June 2016 and December 2020. A total of 58,895 patients were included in the study. After the exclusion criteria, the study was continued with 27 primiparous PAS and 54 non-primiparous PAS patients. The primary purpose is to evaluate PAS risk factors. The secondary aim is to examine maternal and neonatal characteristics.</p><p><strong>Results: </strong>When the parameters that are significant in terms of PAS risk factors were analyzed by Logistic Regression Analysis, it was found that the increase in age also increased the development of PAS 1.552 times (95% CI: 1.236-1.948) and a history of abortion was 7.928. times (95% CI: 1.408-44.654) and 11,007 times (95% CI: 2.059-58.832) with history of myomectomy; postoperative HB values (p < 0.001), an estimated amount of bleeding (p < 0.001), need for transfusion (p = 0.002), and use of drains ( < 0.001) were statistically significant different between two groups. When the neonatal results between patients with and without PAS were examined, birth weight (p < 0.001) and gestational week ( < 0.001) were statistically significant.</p><p><strong>Conclusions: </strong>PAS does not occur only in multiparous patients who have a history of previous cesarean section. It may also occur in primiparous patients and is a life-threatening condition.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 2","pages":"135-140"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9278808","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":"Metastatic gastric cancer in a full-term pregnancy.","authors":"Jorge Aparicio-Ponce,&nbsp;Sandra Salcedo-Hermoza,&nbsp;Sandra Aparicio-Salcedo,&nbsp;Gustavo Cerrillo,&nbsp;Carlos Nureña,&nbsp;Jose S Lazarte,&nbsp;Ericson L Gutierrez","doi":"10.5603/GP.a2022.0159","DOIUrl":"https://doi.org/10.5603/GP.a2022.0159","url":null,"abstract":"","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 2","pages":"167-168"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9280999","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 importance of β-hCG values in prediction of the effectiveness of single dose methotrexate therapy in tubal ectopic pregnancy.","authors":"Askın Yıldız,&nbsp;Oznur Bilge","doi":"10.5603/GP.a2021.0247","DOIUrl":"https://doi.org/10.5603/GP.a2021.0247","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the importance of β-hCG values on the day of onset and on the fourth and seventh day after treatment in the effectiveness of treatment in tubal ectopic pregnancies treated with a single dose of methotrexate (MTX).</p><p><strong>Material and methods: </strong>One hundred sixty-two patients with tubal ectopic pregnancy treated with a single dose MTX treatment were retrospectively evaluated. β-hCG values and changes on Days 0, 4 and 7 of the MTX treatment successful group and the unsuccessful group were analyzed.</p><p><strong>Results: </strong>MTX treatment was successful in 125 (77.2%) and unsuccessful in 37. When the β-hCG values on Days 0, 4 and 7 were compared in pairs, the differences between groups were statistically significant (p < 0.001). The mean β-hCG value was 783.0 in the MTX successful group and 1802.0 in unsuccessful group (p < 0.001). There was a 21.6% decrease in β-hCG values between Days 0 and day 4 in the MTX successful group and a 25.7% increase in the MTX unsuccessful group (p < 0.001). On Days 0, 4 and 7, ROC curve analysis's values are , respectively; 755/939/486 for cut off, 86.49/83.78/94.59% for sensitivity and 48.80/69.60/72.36% for specificity.</p><p><strong>Conclusions: </strong>Success rates of single-dose MTX treatment increase in tubal ectopic pregnancies with low initial β-hCG value. Patients with a decrease in β-hCG value and/or a cut-off decrease of 20% or more on the fourth day of treatment can be called for weekly β-hCG monitoring without the need for close follow-up. The change in β-hCG between Day 0 and Day 4 can be used to predict the efficacy of treatment.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 4","pages":"303-308"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110151","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":"A case of successful delivery after IVF-ET in a patient with a history of full-thickness uterine rupture and subsequent reconstructive surgery.","authors":"Monika Baczkowska,&nbsp;Artur Skowyra,&nbsp;Michal Ciebiera","doi":"10.5603/GP.a2022.0072","DOIUrl":"https://doi.org/10.5603/GP.a2022.0072","url":null,"abstract":"Uterine rupture is a full-thickness uterine wall defect occurring during pregnancy. It is a rare but life-threatening condition for both the mother and the newborn. Myomectomy is a common gynecological procedure performed due to symptomatic uterine fibroids. The incidence of uterine rupture after myomectomy is estimated at < 1%. Our patient underwent laparoscopic myomectomy as a part of infertility treatment. After several unsuccessful IVF-ET attempts and dietary treatment a spontaneous pregnancy was confirmed in the patient. The pregnancy was uneventful until 36 weeks of pregnancy when the patient presented at the emergency department with abdominal pain. Emergency laparotomy was performed exposing extensive uterine rupture. The child did not survive, but, fortunately, uterus-sparing surgery was successful. Afterwards, due to the thinning of the uterine wall at the site of the postoperative scar, a reconstructive surgery was performed, resulting in a properly healed uterus six months after surgery. During the subsequent pregnancy the patient was admitted to the hospital at the 32nd week of pregnancy and an elective cesarean section was performed at 36 weeks of pregnancy. A healthy girl was born. The presented case draws attention to the importance of careful qualification for uterine surgeries in women of reproductive age and proper informing about the possible complications, as pregnancies after uterine surgeries come with new management challenges. Nonetheless, appropriate care may lead to the birth of a healthy child and delighted parents.","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 4","pages":"339-340"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10197912","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":"Platelet to lymphocyte and neutrophil to lymphocyte ratios in endometrial pathologies.","authors":"Orkun Ilgen,&nbsp;Sefa Kurt,&nbsp;Resmiye Irmak Yuzuguldu,&nbsp;Onur Ada,&nbsp;Alper Mankan","doi":"10.5603/GP.a2021.0141","DOIUrl":"https://doi.org/10.5603/GP.a2021.0141","url":null,"abstract":"<p><strong>Objectives: </strong>Aim of this study was to evaluate the relationship between platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and endometrial pathologies.</p><p><strong>Material and methods: </strong>The database of our institution was reviewed. Cases with endometrial pathology including endometrial cancer (EC), endometrial hyperplasia with atypia and without atypia, normal endometrial findings, between January 2015 to January 2020, were collected. Their CBC results and clinicopathologic data were determined. The relation between the platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and endometrial pathologies was evaluated.</p><p><strong>Results: </strong>NLR was significantly higher in patients with endometrial cancer compared to other endometrial pathologies including endometrial hyperplasia with and without atypia and patients with normal endometrial findings. NLR cut-off value was determined 3.55 to discriminate cancer among other endometrial pathologies. PLR had not a significant difference between the endometrial pathologies.</p><p><strong>Conclusion: </strong>NLR seems to be an effective and simple marker to discriminate endometrial cancer among endometrial pathologies by contrast with PLR.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 4","pages":"269-274"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10215811","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 efficacy of thermocoagulation in women with biopsy-confirmed cervical low-grade squamous intraepithelial lesions (LSILs) or less after colposcopy referral.","authors":"Xiaoying Chen,&nbsp;Jian An,&nbsp;Jianfang Zhu","doi":"10.5603/GP.a2022.0055","DOIUrl":"https://doi.org/10.5603/GP.a2022.0055","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical efficacy of thermocoagulation in women with biopsy-confirmed cervical low-grade squamous intraepithelial lesions (LSIL) or less after colposcopy referral.</p><p><strong>Material and methods: </strong>A longitudinal study was performed. Women who were diagnosed with cervical LSIL or chronic cervicitis underwent scheduled follow-up examinations with cytology and human papilloma virus (HPV) genotyping for two years after the initial management with thermocoagulation or observation without treatment. All women underwent scheduled follow-up with combined cytology and HPV test at 6th months, 12th months, and 24th months after the initial management. Both HPV clearance and cytological regression were included in the analysis, with clinical cure defined as normal cytology and negative HPV results.</p><p><strong>Results: </strong>A total of 221 women were included. The histopathological results identified 136 (61.54%) patients with LSIL and 85 (38.46%) with chronic cervicitis. Of these, 113 (51.13%) received thermocoagulation therapy, and 108 (48.87%) chose observation. The 2-year follow-up rate was 91.40%. Women who received thermocoagulation presented a significantly higher probability of cure for two years than those who chose observation (62.86% vs 39.18%, p < 0.001). This preponderance was not observed in the subgroup analysis regarding women with cervical cervicitis (54.17% vs 41.38%, p = 0.277) but was observed in women with LSILs (70.18% vs 38.24%, p < 0.001).</p><p><strong>Conclusions: </strong>Thermocoagulation may be indicated for patients with cervical LSILs as an effective outpatient procedure in clinical practice.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 7","pages":"511-517"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458122","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":"Prognostic significance of omental disease and the role of omentectomy in non-endometrioid endometrial cancer.","authors":"Sevtap Seyfettinoglu, Ghanim Khatib, Ümran Küçükgöz Güleç, Ahmet Barış Güzel, Derya Gümürdülü, Mehmet Ali Vardar","doi":"10.5603/gpl.92225","DOIUrl":"10.5603/gpl.92225","url":null,"abstract":"<p><strong>Objectives: </strong>Non-endometrioid endometrial cancers (non-EEC) have different management from endometrioid endometrial cancers. The purpose of this study was to investigate the prognostic significance of omental disease and the role of omentectomy in non-endometrioid endometrial cancer and discuss the current literature with the findings.</p><p><strong>Material and methods: </strong>The study included two hundred-three patients with non-EEC who underwent surgical treatment and follow-up between January 1996 and December 2018 in a University Hospital Gynecologic Oncology Center. The patients were divided into three groups according to whether omentectomy was performed and the presence of omental metastasis. The patient's demographics, clinical characteristics such as stage, grade, histopathologic type, lymphovascular space invasion (LVSI), myometrial invasion, lymph node involvement, and survival outcomes were compared between the groups.</p><p><strong>Results: </strong>The study included 203 patients. Twenty-five patients (12%) had omental metastases. LVSI was reported in 57.3%, 88.0%, and 43.2% of the non-omentectomy, no-omental metastasis, and omental metastatic groups, respectively (p = 0.001). The 5-year disease-free survival (DFS) and overall survival (OS) rates according to the tumor grade, peritoneal cytology, and lymphadenectomy were also compared and were found to be statistically similar. The five-year OS rates were 70.6% for the group without omental metastases and 16.2% for the group with omental metastases, respectively (p = 0.001). In the group of omentectomy, the five-year DFS rates were 62.2% in cases without omental metastasis and 13.0% in cases with omental metastasis (p = 0.001). The five-year OS rates of 86.3% and DFS rates of 80.0% in the group without omentectomy.</p><p><strong>Conclusions: </strong>In non-endometrioid tumors, the survival rate was better in the group that did not undergo omentectomy. Based on these results, we can say that omentectomy may not be necessary for non-endometrioid tumors whose omentum is found to be normal in intraoperative visual examination.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":"823-830"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031967","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":"SARS-CoV-2 infection during pregnancy - single-center retrospective study.","authors":"Malgorzata Skalska-Swistek, Magdalena Kolak, Andrzej P Jaworowski, Rafal Swistek, Agnieszka Micek, Hubert Huras","doi":"10.5603/gpl.95565","DOIUrl":"10.5603/gpl.95565","url":null,"abstract":"<p><strong>Objectives: </strong>The SARS-CoV-2 virus infection has spread to almost all countries in the last two years. Pregnancy complicated with COVID-19 is a unique situation and challenge for doctors. The study aimed to evaluate obstetric results, and biochemical test results and to analyze the treatment used in pregnant patients complicated with COVID-19 infection.</p><p><strong>Material and methods: </strong>A retrospective analysis of 146 pregnant patients hospitalized at the Department of Obstetrics and Perinatology Jagiellonian University Medical College (JUMC) in Krakow was conducted from July 2020 to August 2021.</p><p><strong>Results: </strong>In the analyzed group respiratory failure occurred in 19.19% of cases and intravascular coagulation syndrome (DIC) in 1.37%. One patient died (0.68%). 16.6% of cases were transferred to the Intensive Care Unit (ICU) and required intubation. The remaining cases were mild: 39.04% were asymptomatic, 41.78% reported cough, 30.82% dyspnoea and 23.97% myalgia. In the laboratory tests increased values of CRP and IL-6 were observed with normal levels of leukocytes. Additionally, a decreased level of total protein and an increased level of d-dimers were detected. 98.63% of patients received a prophylactic dose of low molecular weight heparin. 46.58% of cases needed additional antibiotic therapy. Cesarean sections were performed in 59.59% of cases. The children were born in good general condition. Vertical transmission of SARS-CoV-2 to the newborn has not been confirmed.</p><p><strong>Conclusions: </strong>Data from the above study show a significant effect of COVID-19 on pregnant patients. Almost one in five pregnant women occurred respiratory failure and most of them had to be transferred to the ICU department and had to be intubated.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":"831-838"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031968","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}