{"title":"The efficacy and feasibility of fractional CO2 laser therapy for the treatment of urinary incontinence: a multicentric case-control study.","authors":"Daniela Luvero, Roberto Angioli, Yoav Baruch, Stefano Salvatore, Maurizio Filippini, Annalisa Pieralli, Roberto Montera","doi":"10.23736/S2724-606X.23.05290-9","DOIUrl":"10.23736/S2724-606X.23.05290-9","url":null,"abstract":"<p><strong>Background: </strong>Female urinary incontinence is a significant public health problem. Conservative treatments require high patient compliance, while surgery often leads to more complications and recovery time. Our aim is to evaluate the efficacy of microablative fractional CO<inf>2</inf> laser (CO<inf>2</inf>-laser) therapy in women with urinary incontinence (UI).</p><p><strong>Methods: </strong>This is a retrospective analysis of prospectively collected data on women with stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) with predominant SUI subjected to four sessions of CO<inf>2</inf>-laser therapy performed once a month, between February 2017 and October 2017, with a 12-month follow-up. The subjective Visual Analogue Scale (VAS) 0-10 was used to score and variables were evaluated at baseline and at one, six and 12 months after initiation of therapy. Finally, results were compared to a control group.</p><p><strong>Results: </strong>The cohort consisted of 42 women. The proportion of patients with vaginal atrophy among those younger than 55 years was substantially lower (3/23; 13%) than among those older than 55 years (15/19; 78.9%). CO<inf>2</inf> laser treatment was associated with a significant improvement in VAS scores recorded one-month, six-months, and one-year, after conclusion of therapy (P<0.001). VAS scores improved significantly in patients with either SUI (26/42; 61.9%) or mixed UI (16/42; 38.1%). No major post treatment complications were registered. Women with vaginal atrophy demonstrated significantly better results (P<0.001).</p><p><strong>Conclusions: </strong>Results confirm the efficacy and a good safety profile, for CO<inf>2</inf> laser treatment in SUI, mostly in women with postmenopausal vaginal atrophy and should be considered as a treatment option for female patients with concomitant SUI and vaginal atrophy.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"501-508"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9406834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ottavio Cassardo, Francesca Gigli, Giuseppe Perugino, Enrico Ferrazzi, Ilma F Carbone, Gabriele Rossi, Carmela Coppola
{"title":"Use of the Knutson's paste for the treatment of perineal wound dehiscence after vaginal delivery: a single-center clinical experience.","authors":"Ottavio Cassardo, Francesca Gigli, Giuseppe Perugino, Enrico Ferrazzi, Ilma F Carbone, Gabriele Rossi, Carmela Coppola","doi":"10.23736/S2724-606X.24.05588-X","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05588-X","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to retrospectively evaluate the therapeutic efficacy of the Knutson's paste, a solution composed of saccharose and povidone-iodine, in the management of perineal dehiscence following repair of post-partum laceration or episiotomy.</p><p><strong>Methods: </strong>Thirty-seven women with post-partum perineal dehiscence were included in the study, conducted between September 2020 and December 2022. Patients self-applied the Knutson's paste three times per day for 14-21 days. Clinical evaluation was performed weekly; healing was defined as the closure of the wound margins. Recovery of sexual function was investigated with Female Sexual Function Index (FSFI) questionnaires at 6 months.</p><p><strong>Results: </strong>All women achieved complete healing, and no one required resuturing. Full healing was achieved in 16.9±2.6 days. Second-degree dehiscence required significantly more days (24±2.64) to achieve healing compared to first-degree dehiscence (15.8±2.08). A mean of 3.4 outpatient visits was necessary during follow-up. The healing process and time were not associated with age, Body Mass Index (BMI), or birth weight. Around 50% of patients reported satisfying figures on FSFI questionnaires.</p><p><strong>Conclusions: </strong>The Knutson's paste is a valid medicament for conservative treatment of post-partum perineal dehiscence. Due to its low costs and non-invasiveness, it could represent an alternative to the resuturing approach, especially in low-income countries and for women who refuse surgical revisions.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142730269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gloria Guariglia, Cristina Salerno, Beatrice Melis, Martina Benuzzi, Daniela Menichini, Enrica Perrone, Fabio Facchinetti, Antonio La Marca, Isabella Neri, Francesca Monari
{"title":"Is it possible to detect women at higher risk of intrapartum stillbirth? An area-based prospective cohort study.","authors":"Gloria Guariglia, Cristina Salerno, Beatrice Melis, Martina Benuzzi, Daniela Menichini, Enrica Perrone, Fabio Facchinetti, Antonio La Marca, Isabella Neri, Francesca Monari","doi":"10.23736/S2724-606X.24.05580-5","DOIUrl":"10.23736/S2724-606X.24.05580-5","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study is to perform an overview of intrapartum stillbirth (SB) at term, assessing risk factors, causes of death and quality of pregnancy care.</p><p><strong>Methods: </strong>This is an area-based, prospective cohort study on pregnant women at ≥37 weeks from 2014 to 2021. We compared intrapartum SB' information to alive birth and to antepartum deaths of the same period. Results of logistic regression are reported as the Odds Ratio (OR) with 95% confidence interval (95% CI) and the P value. A descriptive analysis about the causes of death and quality of pregnancy care is performed.</p><p><strong>Results: </strong>The overall rate of SB at term in Emilia-Romagna was 1.06 ‰ births. Among the 260 cases, 27 (10.4%) occurred during labor, with an intrapartum SB rate of 0.11‰. This SB rate was stable during years. SGA newborn (P=0.005, 95% CI 1.47-9.04, OR 3.63), low level of education (P<0.0001, 95% CI 2.98-16.11, OR 6.93), pre pregnancy BMI ≥ 25 kg/m<sup>2</sup> (P<0.0001, 95% CI 6.61-31.74, OR 14.50) are independent risk factors for intrapartum SB when compared to alive newborns. Compared with antepartum SB, excessive weight gain in pregnancy (RR 2.91, 1.43-3.98, P=0.001) represents a risk factor for intrapartum ones.</p><p><strong>Conclusions: </strong>Preventing intrapartum SB at term in developed country should be based on both the appropriate antenatal management of fetal growth and the avoidance of maternal excessive weight gain. An effort toward pre conceptional intervention of improving maternal shape could be of value.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gilad Karavani, Diana Prus, Anna Elia, Natali Schachter-Safrai, Adiel Cohen, Dvora Bauman, Talya Mordechai-Daniel, Tal Imbar
{"title":"Assessment of ovarian cortex follicles in chemotherapy naïve and chemotherapy exposed patients.","authors":"Gilad Karavani, Diana Prus, Anna Elia, Natali Schachter-Safrai, Adiel Cohen, Dvora Bauman, Talya Mordechai-Daniel, Tal Imbar","doi":"10.23736/S2724-606X.24.05547-7","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05547-7","url":null,"abstract":"<p><strong>Background: </strong>Histological evaluation of ovarian tissue harvested as part of the attempt to preserve fertility might clarify the mechanism by which ovarian failure is caused. The purpose of this study was to compare the histologic appearance of ovarian tissue harvested for ovarian tissue cryopreservation (OTC) in chemotherapy naïve and chemotherapy exposed patients regarding the presence of follicles in different stages of development and to explore ovarian tissue histology in patients exposed to low- and high-cytotoxicity risk chemotherapy.</p><p><strong>Methods: </strong>A cohort of post-pubertal cancer survivors who underwent OTC between 1997 and 2018 was evaluated. An expert pathologist reviewed the pathology slides taken during OTC. The assessment included counting number of primordial, primary, secondary, and antral follicles. A comparison was made between chemotherapy naïve and chemotherapy exposed women and further between women who previously received low- versus high-risk gonadotoxic regimens.</p><p><strong>Results: </strong>Seventy post-pubertal patients were included in the study. Seventeen (24.3%) received chemotherapy prior to OTC, and 53 (75.7%) were chemotherapy naïve at the time of OTC. A significant difference was found only in the number of secondary follicles, which was increased in chemotherapy naïve patients (2.81±4.26 vs. 0.88±1.18, respectively; P=0.005). Similar results were observed in a subgroup analysis of hematologic malignancies separately. Comparison of patients with previous exposure to chemotherapy revealed similar follicular appearance, except for the number of secondary follicles, which was higher in patients receiving low-risk compared to high-risk chemotherapy (1.40±1.28 vs. 0.14±0.35, respectively; P=0.006).</p><p><strong>Conclusions: </strong>The ovarian follicular pool at OTC appears comparable between chemotherapy naïve individuals and those post-exposure, as well as among patients receiving low versus high-risk gonadotoxic regimens, with the exception of secondary follicles, which are presented in increased numbers in chemotherapy naïve and those exposed to low-risk gonadotoxic chemotherapy.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Kovacs, David U Nagy, Szabolcs Matyas, Elizabeth Culberson, Chantal Kinsey, Yao Lu, Steven R Lindheim
{"title":"In-vitro fertilization experience with follitropin-delta in poor responders identified by POSEIDON Classification.","authors":"Peter Kovacs, David U Nagy, Szabolcs Matyas, Elizabeth Culberson, Chantal Kinsey, Yao Lu, Steven R Lindheim","doi":"10.23736/S2724-606X.24.05576-3","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05576-3","url":null,"abstract":"<p><strong>Background: </strong>Controlled ovarian stimulation during in-vitro fertilization (IVF) is personalized based on anticipated hyper, normal, poor response. With respect to poor responders, who are often treated using higher gonadotropin dosing and combination of urinary and recombinant gonadotropins (rFSH) with marginal benefit, we report our experience with a newer, more potent rFSH (Follitropin-δ) undergoing IVF.</p><p><strong>Methods: </strong>Retrospective analysis of all IVF cycles in which follitropin-δ was used alone or combined with urinary gonadotropins over a 3-year period. Patients were grouped according to the POSEIDON Classification as expected low responders (POSEIDON 3-4; AMH<1.2; N.=45), unexpected low responders (POSEIDON 1-2; retrieval of ≤9 oocytes; N.=67) and those with a normal response (N.=93). Demographic, stimulation (including target number of retrieved oocytes [8 to14]), embryology and clinical outcome parameters (clinical pregnancy rate [CPR], live birth rate [LBR], cumulative live birth rate [cLBR]) were compared.</p><p><strong>Results: </strong>Those categorized as POSEIDON patients were older, had lower ovarian reserve, were more likely to use a mixed protocol, less likely to reach the target oocytes retrieved (35.7% vs. 51.6%, P<0.001), and had a lower cLBR per patient (29.5% vs. 38.7%, P=0.006) when compared to non-POSEIDON patients. Expected low responders (POSEIDON 3-4) were older and had lower AMH when compared to unexpected low responders (POSEIDON 1-2), but no differences in the target of oocytes retrieved (33.3% vs. 37.3%, P=0.66) and cLBR (28.9% vs. 37.3%, P=0.06) were noted.</p><p><strong>Conclusions: </strong>In expected low responders, follitropin-δ can be used to optimize oocyte collection and clinical outcome though one may need to deviate from the algorithm-suggested dose. Future studies should explore stimulation modifications in unexpected low responders.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah M Kyllo, Wyanet Bresnitz, Mayu Bickner, Morgan A Matous, Nelly M Mulenga, Elizabeth A O'Brien, Sophie M Whitehead, Nana S Fordwuo, Erica M Wong, Katlynn Adkins, Tyler M Muffly
{"title":"Access to general obstetrics and gynecology care among Medicaid beneficiaries and the privately insured: a nationwide mystery caller study in the USA.","authors":"Hannah M Kyllo, Wyanet Bresnitz, Mayu Bickner, Morgan A Matous, Nelly M Mulenga, Elizabeth A O'Brien, Sophie M Whitehead, Nana S Fordwuo, Erica M Wong, Katlynn Adkins, Tyler M Muffly","doi":"10.23736/S2724-606X.24.05497-6","DOIUrl":"10.23736/S2724-606X.24.05497-6","url":null,"abstract":"<p><strong>Background: </strong>The mean wait time for new patient appointments has been growing across specialties, including obstetrics and gynecology, in recent years. This study aimed to assess the impact of insurance type (Medicaid versus commercial insurance) on new patient appointment wait times in general obstetrics and gynecology practices.</p><p><strong>Methods: </strong>A cross-sectional study used covert mystery calls to general obstetrician gynecologists. Physicians were selected from the American College of Obstetricians and Gynecologists directory and stratified by districts to ensure nationwide representation. Wait times for new patient appointments were collected and analyzed.</p><p><strong>Results: </strong>Regardless of insurance type, the mean wait time for all obstetrician gynecologists was 29.9 business days. Medicaid patients experienced a marginally longer wait time of 4.8% (Ratio: 1.048). While no statistically significant difference in wait times based on insurance type was observed (P=0.39), the data revealed other impactful factors. Younger physicians and those in university-based practices had longer wait times. The gender of the physician also influenced wait times, with female physicians having a mean wait time of 34.7 days compared to 22.7 days for male physicians (P=0.03). Additionally, geographical variations were noted, with physicians in American College of Obstetricians and Gynecologists District I (Atlantic Provinces, CT, ME, MA, NH, RI, VT) having the longest mean wait times and those in District III (DE, NJ, PA) the shortest.</p><p><strong>Conclusions: </strong>While the type of insurance did not significantly influence the wait times for general obstetrics and gynecology appointments, physician demographic and geographic factors did.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"444-451"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gianluca R Damiani, Antonella Vimercati, Daniele DI Gennaro, Amerigo Vitagliano, Pierluigi Giampaolino, Antonio Malvasi, Anna M Perrone, Antonio Pellegrino, Miriam Dellino, Ettore Cicinelli
{"title":"Cesarean scar pregnancy: a practical overview and our series of combined double step procedure management.","authors":"Gianluca R Damiani, Antonella Vimercati, Daniele DI Gennaro, Amerigo Vitagliano, Pierluigi Giampaolino, Antonio Malvasi, Anna M Perrone, Antonio Pellegrino, Miriam Dellino, Ettore Cicinelli","doi":"10.23736/S2724-606X.23.05291-0","DOIUrl":"10.23736/S2724-606X.23.05291-0","url":null,"abstract":"<p><strong>Background: </strong>Cesarean scar pregnancy (CSP), a rare iatrogenic form of ectopic pregnancy (EP), cause of severe maternal morbidity. Each subtype of CSP needs different treatment and there is no consensus about this topic. Despite improvements, the lack of universally accepted therapeutic management and discordance present in literature indicates that treatment has been mainly based on experiences reported.</p><p><strong>Methods: </strong>A case series of our double combined approach with methotrexate (MTX) administration followed by vacuum aspiration or resectoscopic approach was reported, with an overview of literature. Eleven patients with CSP underwent a double-step treatment: systemic MTX therapy followed by vacuum aspiration or by resectoscopy, if the gestational sac was embedded deeply in myometrium. For CSP type 1, according to Delphi sonographic classification, with minor potentially risk of complications with a myometrial thickness >3.5 mm, we preferred to adopt vacuum aspiration, while type 2-3 of CSP and myometrial thickness ≤3.5mm were managed with resectoscopy.</p><p><strong>Results: </strong>The average gestational age was 59.1±7.22 days. On the seventh day after MTX administration, the serum β hCG levels decreased in 80% of all patients. After the MTX injection, the CSP mass did not disappear in any patient. MTX therapy was followed by vacuum aspiration in six and by resectoscopy in five cases. In one case bleeding was controlled by Foley balloon treated with vacuum. In type II-III, CSP was performed UAE (uterine artery embolization) followed by resectoscopy procedure.</p><p><strong>Conclusions: </strong>Compared with the results in previous studies, MTX administration followed by suction curettage was more effective than dilatation and curettage and systemic MTX in treatment of CSP. We consider very useful this procedure in case of slow absorption and when the camera was embedded deeply in myometrium (CSP2-3), because that hysteroscopy evaluation of uterine cavity under direct vision is highly accurate in identifying the real cleavage of the gestational camera. We have only used vacuum aspiration in CSP type 1 for minor risk of bleeding.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"416-422"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9639125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Highlights of the September-October 2024 issue.","authors":"Antonio La Marca","doi":"10.23736/S2724-606X.24.05652-5","DOIUrl":"https://doi.org/10.23736/S2724-606X.24.05652-5","url":null,"abstract":"","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":"76 5","pages":"399-402"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gina M Riana, Nugraha U Pelupessy, Sriwijaya Qadar, Upik Miskad, Andi A Zainuddin, Fatmawati Madya, Efendi Lukas
{"title":"Association of high expression of CD44 in clinicopathological factors of endometrial cancer.","authors":"Gina M Riana, Nugraha U Pelupessy, Sriwijaya Qadar, Upik Miskad, Andi A Zainuddin, Fatmawati Madya, Efendi Lukas","doi":"10.23736/S2724-606X.23.05279-X","DOIUrl":"10.23736/S2724-606X.23.05279-X","url":null,"abstract":"<p><strong>Background: </strong>Clinical stages, histologic type, degree of cell differentiation, myometrial invasion, and lymph-vascular space invasion (LVSI) have been identified as clinicopathological factors that are predictive for endometrial cancer, however, further prognostic indicators are still required to account for the heterogeneity of this cancer. Adhesion molecule CD44, affects the invasion, metastasis, and prognosis of many forms of cancer. The purpose of this study is to examine the expression of CD44 in endometrial cancer and its correlation with established prognostic variables.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 64 samples of endometrial cancer from Wahidin Sudirohusodo Hospital and Hasanuddin University Hospital. Immunohistochemical analysis was used to detect CD44 expression using mouse anti-human CD44 monoclonal antibody. Differences in Histoscore were studied to determine the association between CD44 expression and clinicopathological factors of endometrial cancer.</p><p><strong>Results: </strong>Of the overall sample, 46 samples were in the early stage, whereas 18 samples were in the advanced stage. High expression of CD44 was associated with advanced stage compare than early stage (P=0.010), poor differentiation compare than well-moderate differentiation (P=0.001), myometrial invasion ≥50% compare than myometrial invasion <50% (P=0.004), and positive LVSI compare than negative LVSI (P=0.043) in endometrial cancer, but not associated with histological type of endometrial cancer (P=0.178).</p><p><strong>Conclusions: </strong>High expression of CD44 may be considered as a poor prognostic marker and predictive marker for targeted therapy in endometrial cancer.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"410-415"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9091350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fetal hyperechogenic pancreas and gestational diabetes mellitus: a meta-analysis.","authors":"Megan K Taylor, Giovanni Sisti","doi":"10.23736/S2724-606X.23.05341-1","DOIUrl":"10.23736/S2724-606X.23.05341-1","url":null,"abstract":"<p><strong>Introduction: </strong>Gestational diabetes mellitus is the most common metabolic disorder in pregnancy, and it is associated with detrimental short- and long-term consequences to both the fetus and the mother. Some studies in the literature have found an association between the identification of fetal hyperechogenic pancreas via prenatal ultrasound and the presence of gestational diabetes mellitus. The aim of our study was to assess the association of fetal hyperechogenic pancreas with gestational diabetes mellitus using the meta-analytic method.</p><p><strong>Evidence acquisition: </strong>We searched electronic databases for articles describing association (or lack of) between fetal hyperechogenic pancreas and gestational diabetes mellitus. For each study, we identified patients with or without fetal hyperechogenic pancreas and with or without gestational diabetes mellitus. We then calculated risk ratios for gestational diabetes mellitus using the meta-analytic Mantel-Haenszel method with a random effect to estimate the risk ratio.</p><p><strong>Evidence synthesis: </strong>We identified 286 patients in 2 studies. The risk ratio of gestational diabetes mellitus in women with fetal hyperechogenic pancreas was 3.34, P<0.0001 (95% CI, 1.56-7.17; I<sup>2</sup>=82% [95% CI 22.7-95.7%]).</p><p><strong>Conclusions: </strong>The presence of a fetal hyperechogenic pancreas was associated with gestational diabetes mellitus. We concluded that the detection of fetal pancreas echogenicity may be a promising indicator of gestational diabetes mellitus that, pending further research studies, can potentially help the clinician in making this diagnosis.</p>","PeriodicalId":18572,"journal":{"name":"Minerva obstetrics and gynecology","volume":" ","pages":"452-457"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}