{"title":"Reconstruction of small and moderate defects of the perineum","authors":"Charilaos Ioannidis","doi":"10.33574/hjog.0517","DOIUrl":"https://doi.org/10.33574/hjog.0517","url":null,"abstract":"Introduction: Resection of benign, premalignant or malignant lesions of the perineum result in tissue defects, which are preferably reconstructed with a flap rather than closed primarily or covered with a skin graft. Numerous skin flaps have been utilized with varying success rates. Patients and Methods: The charts of all female patients with perineal defects operated by the author during the past five years were retrospectively reviewed. Two flaps were used: a modified Limberg (rhomboid rotation) flap for small defects and a bilateral medial thigh V-Y advancement flap for moderate defects. Results: Seven patients were found. Two patients were operated because of benign pathology and five because of a pre- or malignant lesion. Two small and five moderate defects resulted after the resection. All flaps survived and there were no major complications. All patients had sensation on the flap postoperatively and were pleased with the functional and aesthetic result. Conclusion: Small perineal defects are satisfactorily restored with a rotation rhomboid flap, whereas moderate sized defects are best reconstructed with bilateral medial thigh V-Y flaps.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122821924","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}
V. Pergialiotis, I. Koutroumpa, D. Haidopoulos, George Daskalakis, A. Rodolakis, N. Thomakos, D. Loutradis
{"title":"Revisiting the effectiveness of a forgotten technique: the value of blue dye on sentinel lymph node biopsies of gynecological cancer","authors":"V. Pergialiotis, I. Koutroumpa, D. Haidopoulos, George Daskalakis, A. Rodolakis, N. Thomakos, D. Loutradis","doi":"10.33574/hjog.0513","DOIUrl":"https://doi.org/10.33574/hjog.0513","url":null,"abstract":"Sentinel lymph node biopsy with blue dye has been used extensively in the past for the evaluation of patients with gynecological cancer. While the technique has been negatively criticized as inaccurate in detecting an appropriate number of lymph nodes bilaterally, novel studies seem to suggest an acceptable detection rate that is directly attributed to the number of cases performed as well as the type of dye that is used. Taking into consideration the significant impact of comprehensive pelvic lymphadenectomy on the quality of life of these patients, it seems reasonable to suggest its use in the absence of appropriate economic resources, such as in low income countries. In the present study we summarize the available evidence concerning the diagnostic performance of the various techniques that are used in sentinel lymph node resection in gynecologic oncology, focusing on the potential benefits of blue dye in specific settings.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":" 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113951787","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}
E. Zachariou, V. Pergialiotis, E. Iliopoulos, D. Haidopoulos
{"title":"Laparoscopic surgery for clear cell endometrial carcinoma, is it a realistic approach?","authors":"E. Zachariou, V. Pergialiotis, E. Iliopoulos, D. Haidopoulos","doi":"10.33574/hjog.0515","DOIUrl":"https://doi.org/10.33574/hjog.0515","url":null,"abstract":"Clear cell endometrial carcinoma is an aggressive form of endometrial cancer that has a poor prognosis for survival. Over the past ten years, laparoscopic surgery has replaced open surgery as the preferred method of treating early-stage endometrial cancer. However, its effect on the prognosis of patients with clear cell carcinoma is still unclear. In the current systematic review, we examined the information that was published in the following databases: Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials, CENTRAL, and Google Scholar. Three studies were found to be significantly diverse; as a result, meta-analysis was not possible. Current research reveals that compared to traditional laparotomy, minimally invasive surgery does not significantly influence progression-free and overall survival rates; nevertheless, given the relative dearth of data, more research is required before the technique’s safety can be determined.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124737090","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":"Ovarian Vein Thrombosis","authors":"T. Kanellopoulou","doi":"10.33574/hjog.0516","DOIUrl":"https://doi.org/10.33574/hjog.0516","url":null,"abstract":"Ovarian vein thrombosis (OVT) is a rare type of venous thromboembolism most common diagnosed in the postpartum period and peaking around 2-6 days after delivery. Clinical symptoms are not specific including fever and abdominal pain and the right ovarian vein is more frequently involved (70-80% of cases). The diagnosis of OVT is a clinical challenge because there are multiple other conditions that can present similarly, including ovarian torsion, tubo-ovarian abscess, pelvic inflammatory disease, puerperal endometritis, appendicitis, inflammatory bowel disease and pyelonephritis. Ultrasound Doppler is the first-line imaging; however, most cases are confirmed with computed tomography or magnetic resonance imaging. Mortality related to ovarian vein thrombosis is low due to the combination treatment of broad-spectrum antibiotics and anticoagulation. Extension of thrombus to inferior vena cava or renal veins and rarely pulmonary embolism could also occur. OVT is actually a type of deep vein thrombosis that could be life-threatening however mortality is low due to the combination treatment of broad-spectrum antibiotics and anticoagulation. Anticoagulant treatment duration of 3 to 6 months has been recommended like typical cases of venous thromboembolism.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125869359","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}
Angeliki Rouvali, I. Sapantzoglou, S. Stavros, P. Antsaklis, M. Theodora, Georgios Daskalakis
{"title":"Adverse pregnancy outcomes in twins and their association with the conception method","authors":"Angeliki Rouvali, I. Sapantzoglou, S. Stavros, P. Antsaklis, M. Theodora, Georgios Daskalakis","doi":"10.33574/hjog.0514","DOIUrl":"https://doi.org/10.33574/hjog.0514","url":null,"abstract":"Assisted reproductive technology (ART) has given the opportunity of conception to a large proportion of subfertile women and, at the same time, has led to a substantial increase of multiple pregnancies. Several studies have shown that in vitro fertilization conceived twin pregnancies carry a significant risk of perinatal morbidity and complications. However, it remains unknown whether IVF per se actually increases the risk of pregnancy complications in twin pregnancies or if these should be attributed to the maternal characteristics. In the present review we summarize the findings of published studies related to the most common pregnancy complications encountered in IVF conceived twin pregnancies.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114319847","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}
I. Tsakiridis, A. Mamopoulos, I. Kalogiannidis, Nikolaos Dagklis, A. Athanasiadis, T. Dagklis
{"title":"Indications for admission in a high-risk pregnancy unit in Greece: Comparison between native and migrant women. A single-center experience","authors":"I. Tsakiridis, A. Mamopoulos, I. Kalogiannidis, Nikolaos Dagklis, A. Athanasiadis, T. Dagklis","doi":"10.33574/hjog.0510","DOIUrl":"https://doi.org/10.33574/hjog.0510","url":null,"abstract":"Introduction: Migrant pregnant women may require antenatal hospitalization due to complications of pregnancy. The aim of this study was to investigate the indications for admission, the baseline and the obstetric characteristics of migrant women hospitalized in a high-risk pregnancy unit (HRPU) and compare them with the native-Greek individuals. Materials and Methods: A retrospective cohort study was conducted during the period 2005-2019. All pregnant women at ≥ 24 gestational weeks admitted in a University hospital HRPU were eligible for the study. Epidemiological characteristics, along with the indications for admission were studied and comparisons of several parameters between native-Greek and migrant pregnant women were conducted. Results: Overall, 3,823 women were included in the study, of which 838 (21.9%) were migrant women. The main indication for hospital admission was threatened preterm labor (38.0%). When we compared the two groups in terms of indications for admission, we found that maternal indications were more common in migrants than Greek pregnant women (32.8% vs 26.8%; p=0.001; OR:1.332; 95% CI:1.129-1.571). Compared to native women, migrants were younger (28.7±6.1 vs 30.9±6.4 years, p<0.001), more often multiparous (p<0.001; OR:3.883 95% CI:3.307-4.561), reported more often spontaneous conception (p<0.001; OR:0.425 95% CI:0.271-0.667) and were more likely to smoke during pregnancy (p=0.043; OR:1.209 95% CI:1.006-1.452). Conclusions: During the study period, threatened preterm labor followed by maternal complications were the most common indications for hospitalization. Migrant women were admitted to the HRPU more often than Greek ones for maternal complications. Finally, migrant status was associated with the method of conception, parity and smoking.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127358620","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}
Vasilis Theodoulidis, A. Prodromidou, K. Aggelou, Anastasia Mortaki, K. Trimmi, N. Thomakos
{"title":"The lockdown effect on gynaecological cancer surgeries during the COVID-19 pandemic","authors":"Vasilis Theodoulidis, A. Prodromidou, K. Aggelou, Anastasia Mortaki, K. Trimmi, N. Thomakos","doi":"10.33574/hjog.0511","DOIUrl":"https://doi.org/10.33574/hjog.0511","url":null,"abstract":"The COVID-19 outbreak increased significantly the burden of hospital based services in an international setting. Facilities dealing with cancer cases had to cope with the burden of the disease and with the waiting lists that continuously grow as cancer patients tend to refer with increasing rates in referral centers. Surgical departments with oncological patients had to prioritize patients in order to help provide optimal care, without posing them at risk of a potential infection during their hospitalization. In the present article we report the experience of the Gynecologic oncology section of the First Department of Obstetrics and Gynecology of the National and Kapodistrian University of Athens during the first 12 months of the pandemic.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"161 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114141583","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}
S. Stavros, G. Kalabalikis, D. Mavrogianni, D. Loutradis, P. Drakakis, Isabella Spyropoulou
{"title":"Effect of estradiol levels after hCG trigger on embryo quality, implantation, and IVF outcome, using donor ovarian stimulation protocols","authors":"S. Stavros, G. Kalabalikis, D. Mavrogianni, D. Loutradis, P. Drakakis, Isabella Spyropoulou","doi":"10.33574/hjog.0509","DOIUrl":"https://doi.org/10.33574/hjog.0509","url":null,"abstract":"In this study, we aimed at delineating the possible effect of estradiol (E2) levels on the day of β-hCG administration on the ovary by analysingthe Embryo Score (ES) of early day 2, 44hrs post insemination. Oocyte donor ovarian stimulation protocols were thus used in order to avoid any possible counteractions of E2 with the endometrium. All oocytes were microinjected and all embryo transfers were fresh.E2 and E2/oocyte correlated positively with the ES on day 2 of embryo development. In contrast, the E2 and E2/oocyte do not appear to significantly affect the implantation and clinical pregnancy rates. Furthermore, E2 levels on the day of β-hCG administration were positively associated with fast and slowly dividing embryos compared to “ideally” dividing embryos on day 2. E2 levels corresponding to the “ideal” ES (E216) on day 2 sonographically translated into 12 mature oocytes. Embryos with “ideal” ES on day 2 were positively associated with implantation and gestational sac rates, as well as lower spontaneous miscarriage rates, in comparison to the fast and slowly dividing embryos. We propose that a) ES on day 2 of embryo development, 44hrs post insemination, is a valuable prognostic marker of embryo quality in ovarian stimulation protocols and b) an ovarian stimulation protocol may most likely be successful if not more than 12 oocytes are collected, i.e. E2 levels do not exceed 3.309pg/ml or on the day of hCG administration.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114336163","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}
S. Stavros, Eleni Papamattheou, Styliani Preka, D. Mavrogianni, E. Domali, P. Drakakis
{"title":"Risk Factors for Intrauterine Deaths in The Third Trimester of Pregnancy. A holistic approach of case series and literature review","authors":"S. Stavros, Eleni Papamattheou, Styliani Preka, D. Mavrogianni, E. Domali, P. Drakakis","doi":"10.33574/hjog.0507","DOIUrl":"https://doi.org/10.33574/hjog.0507","url":null,"abstract":"Objectives: There is a plethora of references in the international bibliography regarding correlation of various risk factors and intrauterine death in the third trimester, such as gestational diabetes mellitus, preeclampsia, endometrial infections as well as endometrial growth restriction. The purpose of the present study is to analyze demographic and socio-economic factors to draw conclusions on improving health services for pregnant women. Methods: 41 cases of intrauterine deaths, after 28 weeks of pregnancy, were studied retrospectively from the archives of the 1st Department of Obstetrics and Gynecology Alexandra Hospital, during a 3-year period (2015-2018). The risk factors assessed, were the age, the race (White/Caucasian, Ethnic, Asian, and Black), the socio-economic status, smoking, body mass index (BMI), educational level, gestational age, monitoring (or lack) of the pregnancy, and pathology observed during the pregnancy though. Results: The average age of women was 31 years old, the average body mass index (BMI) was 27.4, while most of them were White-Caucasian (75,6 %) The majority of women had a low educational and socio-economic level, 68,3 % (28/41) and 61% (25/41) respectively. On top of that, 14/41 (34.1 %) were smokers, the mean age of gestation was the 32 weeks of pregnancy, and the fetal gender was female (63.41%). The gestational preeclampsia was found to be the most important factor for intrauterine death and most of the women had not monitoring during the pregnancy (61%). Conclusions: Interpretation of the results showed that low educational level and low socio-economic level were independent risk factors for endometrial third trimester deaths. On the contrary preeclampsia was the leading cause of death.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128158574","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}
T. Liakakos, K. Papakonstantinou, Michail Panagiotopoulos, D. Papageorgiou
{"title":"Laparoscopic treatment of a complex adnexal mass of the retroperitoneal space: A case report","authors":"T. Liakakos, K. Papakonstantinou, Michail Panagiotopoulos, D. Papageorgiou","doi":"10.33574/hjog.0512","DOIUrl":"https://doi.org/10.33574/hjog.0512","url":null,"abstract":"Complex adnexal cystic masses in women of reproductive age should be carefully evaluated before the final diagnosis is set. Adnexal cystic masses are not necessary malignant. On the contrary, they usually refer to a benign and not cancerous pathology. A certain benign pathology behind adnexal masses is endometriosis. Endometriosis occurs in 10-15% of women of reproductive age and presents great diversity both in the way it manifests and in its location. We report a case of a multiparous woman of reproductive age that was referred to our clinic due to abdominal and back pain. The imaging examinations revealed a cystic mass of the left parametrium that was laparoscopically removed. The histopathology set the diagnosis of endometrioma. The aim of our work is to highlight the endometrioma of the retroperitoneal space as part of the differential diagnosis of the cystic masses of the parametrium.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128303448","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}