Furkan Çetin, Seyhun Sucu, Hüseyin Çağlayan Özcan, Özge Kömürcü Karuserci, Çağdaş Demiroğlu, Muhammed Hanifi Bademkiran, Emin Sevinçler
{"title":"The potential role of preoperative cystoscopy for determining the depth of invasion in the placenta accreta spectrum.","authors":"Furkan Çetin, Seyhun Sucu, Hüseyin Çağlayan Özcan, Özge Kömürcü Karuserci, Çağdaş Demiroğlu, Muhammed Hanifi Bademkiran, Emin Sevinçler","doi":"10.5603/GP.a2023.0012","DOIUrl":"https://doi.org/10.5603/GP.a2023.0012","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to determine the role of preoperative cystoscopy in specifying the degree of placental invasion to the bladder in the placenta accreta spectrum (PAS), especially in percreta.</p><p><strong>Material and methods: </strong>This prospective observational cohort study included 78 PAS patients. All included patients underwent the preoperative cystoscopy before the cesarean hysterectomy operation. The preoperative cystoscopy procedure identified markers of PAS as neovascularization, arterial pulsatility in neovascularized zones, and posterior bladder wall bulging. Then the patients were divided into subgroups according to the histopathological results of their cesarean hysterectomy specimens. Finally, the histopathological subgroups of PAS were estimated using preoperative cystoscopy signs in the designed logistic regression analysis model.</p><p><strong>Results: </strong>The preoperative cystoscopic signs such as neovascularization, the posterior bladder wall bulging, and the arterial pulsatility in neovascularized zones were approximately associated with a 17-fold [OR = 16.9 (95% CI, 5.7-49.8)], 26-fold [OR = 26.1 (95% CI, 8.17-83.8)], and 9-fold [OR = 8.94 (95% CI, 2.94-27.1)] increase in the likelihood of placenta percreta, respectively.</p><p><strong>Conclusions: </strong>Preoperative cystoscopy may significantly contributions to other standard imaging modalities to identify the degree of placental invasion, especially placenta percreta. Experienced obstetricians trained in hysteroscopic visualization may safely perform this preoperative cystoscopy procedure under the guidance of a specialist urologist. Accordingly, it may be possible to estimate the degree of invasion and the course of surgery in patients with PAS using the preoperative cystoscopy procedure.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9121335","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}
Marek Pokulniewicz, Marcin Januszewski, Kamil Pluta, Alicja Jakimiuk, Tomasz Oleksik, Joanna Zytynska-Daniluk, Malgorzata Santor-Zaczynska, Artur Jakimiuk
{"title":"Assessment of the birth status of children born by elective caesarean section before and after 39 weeks of gestation following in vitro fertilization.","authors":"Marek Pokulniewicz, Marcin Januszewski, Kamil Pluta, Alicja Jakimiuk, Tomasz Oleksik, Joanna Zytynska-Daniluk, Malgorzata Santor-Zaczynska, Artur Jakimiuk","doi":"10.5603/GP.a2022.0137","DOIUrl":"10.5603/GP.a2022.0137","url":null,"abstract":"<p><p>The collected material presents 512 mothers with children whose pregnancies were ended by caesarean section at the Department of Obstetrics, Women's Diseases and Oncological Gynecology Central Clinical Hospital of the Ministry of Internal Affairs in Warsaw in the years 2004-2016. The study group consisted of 362 mothers in pregnancies following in vitro fertilization and 150 mothers in spontaneous pregnancy, without the use of assisted reproductive technology. For the purposes of the project, only single pregnancies ending within weeks 37 to 41 of pregnancy were selected. Planned delivery by elective cesarean section (ECS) currently takes place after the 39th week of pregnancy, in line with current common recommendations. This is related to studies finding an overall better birth condition of newborns in the general population, and especially regarding the maturation of the lungs. Currently, there are no specific recommendations regarding cesarean section and the timing of delivery in pregnancies resulting from in vitro fertilization. The aim of this study was to assess the optimal time of an elective cesarean section at full term in an IVF pregnancy. Consistent with findings in the general population and prevailing recommendations, the expected result would be the better condition of the baby born by ECS following the 39th week of gestation. However, our statistical analysis of the collected material shows that the group delivered by ECS prior to the end of 39 weeks of pregnancy may have fewer respiratory system interventions and higher Apgar scores. Nevertheless, results lack statistical significance. In conclusion these findings may indicate a need for a bigger database.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10852358","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}
Tomasz Sylwestrzak, Jaroslaw Debniak, Dariusz Wydra, Tomasz Jastrzebski
{"title":"The analysis of the therapeutic decisions in a patient with gigantic ovarian leiomyoma.","authors":"Tomasz Sylwestrzak, Jaroslaw Debniak, Dariusz Wydra, Tomasz Jastrzebski","doi":"10.5603/GP.a2022.0152","DOIUrl":"10.5603/GP.a2022.0152","url":null,"abstract":"<p><p>Complicated or unusual cases appear in clinical practice. It's important to know how to react when we face clinical difficulty. The more unusual the case, the longer or more demanding the decision-making process is. In this case we present a patient with a gigantic ovarian tumor whose diagnosis was overturned, and the choice of the surgical procedure changed, which makes this case a very educative example of why we should consult our patients, whenever we may encounter doubts or difficulties in a therapeutic process.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10533202","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}
Ülkü Ayşe Türker Aras, Engin Korkmazer, Emin Üstünyurt
{"title":"The nightmare of obstetricians - the placenta accreta spectrum in primiparous pregnant women.","authors":"Ülkü Ayşe Türker Aras, Engin Korkmazer, 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":null,"pages":null},"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}
Jorge Aparicio-Ponce, Sandra Salcedo-Hermoza, Sandra Aparicio-Salcedo, Gustavo Cerrillo, Carlos Nureña, Jose S Lazarte, Ericson L Gutierrez
{"title":"Metastatic gastric cancer in a full-term pregnancy.","authors":"Jorge Aparicio-Ponce, Sandra Salcedo-Hermoza, Sandra Aparicio-Salcedo, Gustavo Cerrillo, Carlos Nureña, Jose S Lazarte, 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":null,"pages":null},"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, 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":null,"pages":null},"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, Artur Skowyra, 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":null,"pages":null},"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, Sefa Kurt, Resmiye Irmak Yuzuguldu, Onur Ada, 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":null,"pages":null},"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, Jian An, 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":null,"pages":null},"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":"Perinatal and neonatal outcomes of adolescent pregnancies over a 10-year period.","authors":"Bahadir Yazicioglu, Nazan Yurtcu, Huri Guvey, Canan Soyer Caliskan, Samettin Celik, Andrea Tinelli","doi":"10.5603/GP.a2022.0085","DOIUrl":"https://doi.org/10.5603/GP.a2022.0085","url":null,"abstract":"<p><strong>Objectives: </strong>Poor overall neonatal outcomes, small neonatal head circumference, neonatal hypoglycemia, need for Neonatal Intensive Care Unit and late-onset neonatal sepsis are more common in adolescents. The aim of this study is to draw attention to the outcomes of adolescent pregnancies.</p><p><strong>Material and methods: </strong>This retrospective study was conducted in adolescent singleton pregnancies with maternal age < 15 years (n = 20, group 1), 16-19 years (n = 1929, group 2), and 20 years (n = 866, group 3). Age, gravidity, parity, and body mass index (BMI) measurements of mothers; mode of delivery, maternal and neonatal outcomes were evaluated and compared.</p><p><strong>Results: </strong>The rate of preterm birth, postpartum hemorrhage, asymmetrical intra-uterine growth restriction (IUGR, as 3% percentile), macrosomia, and height of newborn of Group 3 was significantly higher. The rate of asymmetrical IUGR (as 10% percentile) was significantly lower in Group 3. The rate of severe preeclampsia and cesarean section was significantly higher in Group 3. The rate of Small for Gestational Age newborn, neonatal hypoglycemia, and late-onset neonatal sepsis was significantly higher in Group 1.</p><p><strong>Conclusions: </strong>Neonatal problems with poor obstetric outcomes are common in adolescent pregnant women, so that a family planning and baby care social trainings are important in achieving good long-term maternal and neonatal outcomes.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840538","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}