Minerva ginecologica最新文献

{"title":"Role of single-site and mini-laparoscopy in gynecologic surgery.","authors":"Elsa Delgado-Sánchez, John A. PEAY-PINACHO, A. Hernández Gutiérrez, Julio Álvarez Bernardi, I. Zapardiel","doi":"10.23736/S0026-4784.20.04607-9","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04607-9","url":null,"abstract":"INTRODUCTION\u0000Laparoscopy is a surgical procedure that has been used widely in medicine over the last thirty years. In gynecology, laparoscopy is the \"gold standard\" for the majority of gynecological procedures, as its superiority over laparotomy has been widely demonstrated. In recent years, the current trend of gynecologists is to make laparoscopy surgery even less invasive by reducing the number of incisions in the skin, as it happens with laparoendoscopic single-site surgery, or by reducing the size of them as in mini-laparoscopy. The aim of this work was to perform an extensive review and update of the evolution of single-port surgery and mini laparoscopic surgery in gynecology as well as to evaluate its current role in this field.\u0000\u0000\u0000EVIDENCE ACQUISITION\u0000A systematic review was performed during April and May 2020. PRISMA guidelines were followed for the literature search.\u0000\u0000\u0000EVIDENCE SYNTHESIS\u0000The main objective of performing less invasive procedures is to reduce both intraoperative complications (decreased risk of bleeding or damage to internal organs), and postoperative ones (hernias through the trocar) and improve cosmetic results. Results of studies about LESS and Mini-LPS showed encouraging results, being both of them safe with a similar perioperative and postoperative outcomes. They have the approval of the international surgical community as well as patients' satisfaction with cosmetic results.\u0000\u0000\u0000CONCLUSIONS\u0000Minimally invasive surgery is the present and future in gynecological surgery. More prospective randomized trials are needed in order to obtain valid results and affirm that both LESS and Mini-LPS are superior to conventional laparoscopy.","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2020-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42115992","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":"The current status of sacrocolpopexy in the management of apical prolapse.","authors":"Chunbo Li,&nbsp;Keqin Hua","doi":"10.23736/S0026-4784.20.04477-9","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04477-9","url":null,"abstract":"<p><p>Pelvic organ prolapse (POP) is a prevalent condition that negatively affects women' s quality of life. There is growing recognition that adequate support for the vaginal apex is an important component of a durable surgical repair for women with advanced prolapse, including the anterior and posterior wall prolapse. Surgical treatment options include abdominal and vaginal approaches, the former of which can be performed open, laparoscopically, and robotically. Sacrocolpopexy is a common procedure designed for the treatment of prolapse including uterine or vaginal vault prolapse and multiple-compartment prolapse. Although traditionally performed as an open abdominal procedure, minimally invasive sacrocolpopexy, whether laparoscopic or robotic, has been successfully performed in the clinical practice by many pelvic reconstructive surgeons. In order to require an outstanding cosmetic result, transumbilical/transvaginal single-port sacrocolpopexy has been developed to achieve the goal and initial outcomes have demonstrated their efficacy, safety and feasibility. However, up to date, there are many variations to these procedures, with different levels of evidence to support each of them. Herein we reviewed the current literatures on current surgical choices for women with apical prolapse.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 3","pages":"165-170"},"PeriodicalIF":1.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37854567","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 lateral neck cysts.","authors":"Roberta Amadori,&nbsp;Viviana Stampini,&nbsp;Alberto De Pedrini,&nbsp;Raffaella Ribaldone,&nbsp;Marco Tosi,&nbsp;Raffaele Tinelli,&nbsp;Daniela Surico","doi":"10.23736/S0026-4784.20.04516-5","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04516-5","url":null,"abstract":"","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 3","pages":"181-184"},"PeriodicalIF":1.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37855001","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":"Genitopelvic pain: retrospective evaluation of a multimodal treatment efficacy.","authors":"Anna Ghizzani,&nbsp;Stefano Luisi,&nbsp;Alessandra Cartocci,&nbsp;Gabriele Cevenini","doi":"10.23736/S0026-4784.20.04555-4","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04555-4","url":null,"abstract":"BACKGROUND Genitopelvic and sexual pain penetration disorder (GPPD) recognizes a multifaceted etiology. As with syndromes of chronic pain, it responds poorly to medications and its management is difficult. Clinicians consequently favor a multimodal comprehensive approach to tackle the different aspects of the disorder. To treat GPPD women, we chose a multimodal regimen including topical and systemic medications associated with physical interventions and behavioral couple therapy. Our aim was to evaluate the regimen efficacy and the influence that demographic, clinical, and pain characteristics may have on the outcome. METHODS Sixty self -referred women requesting medical care for GPPD, who were free of debilitating illness, in stable heterosexual relationships and with healthy and sexually functional partners, were treated according with the multimodal regimen we tailored on the specific needs of these women. As said, it associated topical and systemic medications combined with physical exercises used in behavioral sex therapy, and behavioral couple therapy. Past sexual history, characteristics of pain, vestibular hyperreactivity, pelvic floor hypertonicity, general health, and couple harmony were evaluated and statistically analyzed to determine which characteristics were associated with therapy outcome. RESULTS The statistical analysis of an association between demographic, reproductive, pain and medical conditions on one hand and therapy outcome on the other did not find any significance. CONCLUSIONS The lack of association between the investigated characteristics and treatment outcome is disappointing; on the other hand, the statistically significant impact of couple harmony (evaluated as partner presence and participation) on the treatment results may be the answer to our search for factors predicting outcome.","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 3","pages":"123-131"},"PeriodicalIF":1.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38440402","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":"Qualitative assessment of patient-provider communication and provider reporting on misclassification of stillbirths and early neonatal deaths in Ethiopia.","authors":"Andreea A Creanga,&nbsp;Madeline Woo,&nbsp;Abiy Seifu Estifanos,&nbsp;Hanna Feleke,&nbsp;Dorka Woldesenbet,&nbsp;Eskinder Kebede,&nbsp;Habibat Oguntade,&nbsp;Li Liu,&nbsp;Mahlet Y Gebremariam","doi":"10.23736/S0026-4784.20.04549-9","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04549-9","url":null,"abstract":"<p><strong>Background: </strong>Poor communication between patients and providers can lead to misunderstanding and misclassification of clinical information, including pregnancy outcomes by women. This qualitative study with maternity care providers explores patient-provider communications regarding stillbirths (SB) and early neonatal deaths (END) and potential SB-END misclassification in Ethiopia.</p><p><strong>Methods: </strong>Qualitative data were collected through 8 in-depth interviews and 3 focus group discussions with maternity care providers at Tikur Anbessa and Gandhi Memorial hospitals in Addis-Ababa.</p><p><strong>Results: </strong>Twenty-six maternity care providers (10 physicians;16 nurses/midwives) were interviewed. Providers noted that high patient loads negatively influence their provision of quality care to patients. Yet, despite patients generally not asking many questions during their delivery hospitalization, maternity care providers reported offering information about pregnancy outcomes at hospital discharge. The level of education was the most cited factor influencing patients' understanding of the information communicated to them, especially with regard to adverse pregnancy outcomes. Respondents reported that women do not have significant misconceptions about either SB or END. Nevertheless, they also revealed that both purposeful and accidental SB-END misclassification occurs. Reports of the direction of such misclassification differed by type of provider - physicians noted that misclassification of SB as END is most common, while nurses and midwives identified the opposite direction for this type of misclassification.</p><p><strong>Conclusions: </strong>Maternity care providers' reporting practices and the quality of their communication with patients contribute to the SB-END misclassification in Ethiopia. There is need to increase providers' awareness of the importance of capturing and reporting reliable and valid information on pregnancy outcomes.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 3","pages":"138-148"},"PeriodicalIF":1.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38444449","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":"Diagnostic value of sonographic fetal anthropometries and anthropometric formulas to identify macrosomia: a meta-analysis.","authors":"Eita Goto","doi":"10.23736/S0026-4784.20.04535-9","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04535-9","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated whether sonographic fetal anthropometries and anthropometric formulas can identify macrosomia, with increases in mortality and morbidity rates in infanthood and probably later in life.</p><p><strong>Evidence acquisition: </strong>Meta-analysis including good-quality studies determined summarized sensitivity, specificity, and positive and negative likelihood ratios (PLR and NLR, respectively) and area under the curve (AUC). PLR and NLR divided informational usability into exclusion and confirmation strategies (10<PLR and NLR<0.1), confirmation strategies only (10<PLR and NLR>0.1), exclusion strategies only (10>PLR and NLR<0.1), or neither exclusion nor confirmation strategies (10>PLR and NLR>0.1). Subgroup and meta-regression analyses were performed.</p><p><strong>Evidence synthesis: </strong>Abdominal circumference showed moderately high sensitivity and moderately high specificity (N.=4). However, informational usability classified it as a neither exclusion nor confirmation strategy. Anthropometric formulas showed high specificity (N.=21). However, use of anthropometric formulas showed low sensitivity, and informational usability classified it as a neither exclusion nor confirmation strategy. On the other hand, limiting to Hadlock IV (1985) formula changed this to a confirmation strategy only (N.=7). Hadlock IV (1985) formula versus other formulas may have been a true confounder.</p><p><strong>Conclusions: </strong>Abdominal circumference and varying anthropometric formulas are not highly useful for identification of macrosomia. However, Hadlock IV (1985) formula may be useful for secondary screening of macrosomia.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 3","pages":"157-164"},"PeriodicalIF":1.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37855003","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":"Clinical implications and economic effects of the Coronavirus pandemic on gynecology, obstetrics and reproductive medicine in Germany: learning from Italy.","authors":"Sebastian Findeklee,&nbsp;Emanuela Morinello","doi":"10.23736/S0026-4784.20.04558-X","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04558-X","url":null,"abstract":"<p><p>The infection with the novel SARS Cov-2 Coronavirus, the cause of severe acute respiratory distress syndrome, possessing its origin in the Chinese province Hubei, has reached the extent of a global pandemic within a few months. After aerosol infection, most people experience mild respiratory infection with cold symptoms such as cough and fever, and healing within two weeks. In about 5% of those infected, however, a severe course develops with the occurrence of multiple subpleural bronchopulmonary infiltrates and even death as a result of respiratory failure. The Coronavirus pandemic has multiple impacts on social life that have not been seen before. For example, the government adopted measures to curb the exponential spread of the virus, which included a significant reduction in social contacts. Furthermore, the specialist societies recommended that no elective treatments be carried out during the pandemic period. This review article considers epidemiological aspects of novel Coronavirus infection and presents both the clinical as well the possible economic effects of the pandemic on gynecology, obstetrics and reproductive medicine in Germany in the past, present and future. In addition, useful preventive measures for daily clinical work and the previously known scientific findings dealing with the impact of Coronavirus on pregnancy and birth are discussed.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 3","pages":"171-177"},"PeriodicalIF":1.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37931351","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":"Endometrioma and reproductive issues: a well-informed patient may be the driver for change.","authors":"Gustavo N Cecchino,&nbsp;Mauro Cozzolino,&nbsp;Matheus Roque,&nbsp;Juan A García-Velasco","doi":"10.23736/S0026-4784.20.04595-5","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04595-5","url":null,"abstract":"<p><p>Endometriosis affects a great proportion of women during their reproductive years and may impair female fertility in several ways. Ovarian endometrioma (OE) is the most frequent phenotype and growing evidence suggest an endometrioma-mediated damage to the ovary, ovarian reserve and oocyte quality. Traditionally, surgery has been the first-line treatment in cases of OE. Great advances in assisted reproduction and fertility preservation techniques opened new possibilities towards a more conservative approach. Herein we discuss multiple mechanisms responsible for the deterioration of the reproductive capacity in cases of OE as well as the pros and cons of different treatment options. The management of endometrioma-related subfertility remains controversial and it will depend on patient's intentions and priorities. In the \"internet era\" patients tend to be hyper-informed and more participative, but they are often misguided and misinformed. Thus, doctors should be able to convert these individuals into well-informed patients in order to facilitate the process of shared decision making, which is extremely relevant in the context of OEs.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 3","pages":"149-156"},"PeriodicalIF":1.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38444450","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":"Can estrogens protect against COVID-19? The COVID-19 puzzling and gender medicine.","authors":"Gloria Bonaccorsi,&nbsp;Marco Gambacciani,&nbsp;Donato Gemmati","doi":"10.23736/S0026-4784.20.04594-3","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04594-3","url":null,"abstract":"","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 3","pages":"178-179"},"PeriodicalIF":1.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38444452","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":"Anti-Müllerian hormone and embryo quality as determined by time-lapse imaging.","authors":"Ann Korkidakis,&nbsp;Kristy K Cho,&nbsp;Arianne Albert,&nbsp;Jason Au,&nbsp;Jill Mellon,&nbsp;Caitlin M Dunne","doi":"10.23736/S0026-4784.20.04546-3","DOIUrl":"https://doi.org/10.23736/S0026-4784.20.04546-3","url":null,"abstract":"<p><strong>Background: </strong>There is conflicting evidence as to whether serum anti-Mullerian hormone (AMH) is a biomarker of oocyte quality in addition to its known role in assessing ovarian reserve. This study aims to examine the relationship between AMH and embryo potential as assessed by time-lapse imaging (TLI).</p><p><strong>Methods: </strong>A total of 106 embryos from 67 patients were included in the study. All subjects were women with recorded pre-treatment AMH levels who underwent in vitro fertilization using a TLI embryo incubator. Exclusion criteria included cases of donor oocytes, rescue-ICSI, and >2 embryos transferred. Individual time measures, presence of multinucleation (MN), and composite TLI score were analyzed in relation to patient AMH. Linear regression was used to model AMH among embryo TLI parameters while controlling for age as a continuous covariate.</p><p><strong>Results: </strong>There was no statistically significant difference in the mean AMH levels between patients in the normal and abnormal time frames for CC2, S2, and T5. Similarly, there was no significant difference in AMH levels based on composite TLI score or presence/absence of multinucleation. The lack of association between AMH levels and embryo TLI variables persisted after controlling for age (Grade P=0.19, CC2 P=0.47, S2 P=0.52, t5 P=0.34, MN P=0.92).</p><p><strong>Conclusions: </strong>Serum AMH is not predictive of embryo quality as assessed by TLI standardized time intervals, composite score, and presence of MN. From a clinical perspective, these findings suggest that diminished ovarian reserve alone does not imply poorer quality of individual embryos.</p>","PeriodicalId":18745,"journal":{"name":"Minerva ginecologica","volume":"72 3","pages":"132-137"},"PeriodicalIF":1.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37855004","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}