Hellenic Journal of Obstetrics and Gynecology最新文献

{"title":"Timing of recurrence and overall survival in epithelial ovarian cancer: A 10-year retrospective review","authors":"K. Okunade, A. Soibi-Harry, T. Onyeka, John Ogunyemi, Olufemi Thomas-Ogodo, A. Adejimi, Austin C Okoro, Benedetto Osunwusi, Sunusi Garba, R. Anorlu","doi":"10.33574/hjog.0508","DOIUrl":"https://doi.org/10.33574/hjog.0508","url":null,"abstract":"Background: The timing of recurrence of epithelial ovarian cancer (EOC) after a standard primary treatment is an important indicator of the degree of response of the tumour to treatment. It, however, remains unclear if the timing of recurrence will predict survival outcomes. Aim: This study explored the impact of timing of recurrence after an initial response to standard primary treatment on the overall survival (OS) of patients with EOC. Methods: Data was extracted from the records of patients who underwent standard primary treatment and follow-up after EOC diagnosis between January 2011 and December 2020. The Kaplan-Meier survival estimates and Cox proportional hazards model adjusted for covariates were used for analyses. Results: The risks of recurrence of EOC increased steadily with increasing time from the start of primary treatment from 13.6% in 6-months to 71.0% after 12-months. In the final multivariate analyses, recurrence within 6 months of treatment was a significant independent predictor of poor OS in EOC patients (hazard ratio=7.23, 95%CI: 3.87–13.51, P<0.01). Conclusion: Our study suggests that recurrence within 6-months is an important prognostic predictor of poor OS in EOC. Early tumour recurrence may be a useful surrogate of OS and thus this information should be considered in the design of future tailored randomized controlled trials. Future strategies to improve OS in EOC patients should focus on identifying effective measures to prevent early tumour recurrence.","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":"131091128","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":"Rare case of 4 times ectopic pregnancy on the same site","authors":"Ahmed El Gogari","doi":"10.33574/hjog.0506","DOIUrl":"https://doi.org/10.33574/hjog.0506","url":null,"abstract":"In the present case report we discuss the factors that contribute to the recurrence of ectopic pregnancy in the interstitial area of the uterus. Interstitial pregnancies account for 2-6% of all ectopic pregnancies and carry a 2-5% mortality rate due to their potential to cause a life-threatening haemorrhage. Identification of early signs and symptoms of ectopic pregnancy is of paramount importance for the optimal management of these women.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124253320","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":"Comparison of survival outcomes among patients with uterine carcinosarcoma and those with grade 3 uterine carcinoma: A systematic review of the literature","authors":"V. Pergialiotis, N. Thomakos, Nikol-Natalia Armata, Efthimia Eirini Gkotsi, Andreas Konstantinos Gousias, Ioanna Kaisari, M. Marra, A. Rodolakis, D. Haidopoulos","doi":"10.33574/hjog.0501","DOIUrl":"https://doi.org/10.33574/hjog.0501","url":null,"abstract":"Introduction: Endometrial carcinosarcoma is an aggressive form of cancer that has been classified in type II endometrial carcinomas. However, survival outcomes seem to differ considerably compared to grade 3 endometrioid adenocarcinoma, the predominant form of cancer in this group of patients. The purpose of the present systematic review is to investigate overall and progression free survival in patients with endometrial carcinosarcoma to those of patients with grade 3 endometrioid adenocarcinoma. Methods: We used Medline, Scopus, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL, Clinicaltrials.gov and Google Scholar databases. Statistical analysis was performed using the Sidik-Jonkman random effect model (REM) in Rstudio. Findings: Overall, 10.121 patients from 8 studies were investigated. The results of the present meta-analysis indicate that patients with Gr3EC had better overall survival rates HR 2.41 (95% CI 1.29, 4.51). However, this effect might be influenced by selection bias and underpowered studies as following adjustment of the aggregated estimate for small study effects we observed that it was not significant (HR 1.00, 95%CI 0.96, 1.05, p=.858). Although it was not possible to accumulate data concerning the progression free survival, individual studies reported worse outcomes in patients with carcinosarcoma. Conclusions: Carcinosarcoma is a particularly aggressive form of endometrial cancer and deserves further attention from researchers as current treatment alternatives do not seem to reach survival outcomes of patients suffering from grade 3 endometrioid adenocarcinoma.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"146 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129822105","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":"Perinatal outcomes following assisted reproductive technology: A Review of the Literature","authors":"Konstantina Papadatou, E. Zachariou, V. Pergialiotis, George Daskalakis","doi":"10.33574/hjog.0503","DOIUrl":"https://doi.org/10.33574/hjog.0503","url":null,"abstract":"Nowadays, infertility affects approximately 8-12% of the population. Μultiple causative factors are leading to the failure of subfertile couples to achieve a normal pregnancy, as well as various types of assisted reproductive techniques that have developed globally in order to confront infertility. Over the past few years, especially after the birth of the world’s first baby to be conceived by In Vitro Fertilization (IVF) in 1978, numerous studies have been conducted concerning the risk of obstetric and perinatal complications. In this review, we aimed to detail the perinatal outcomes in relation to the ART procedures routinely applied. Consequently, the above-mentioned procedures have been associated with the presentation of hypertensive disorders and gestational diabetes mellitus in women, multiple pregnancy, preterm birth and low birth weight. Furthermore, studies indicate that infants born from assisted reproductive technologies appear to suffer much more frequently not only by congenital or epigenetic abnormalities, but also by neurodevelopmental disorders and specific types of cancer. Indisputably, artificial fertilization methods still continue growing worldwide with new medical technologies’ evolvement. It becomes, therefore, evident that the possible long-term, adverse neonatal outcomes have not been completely clarified yet. Taking into consideration that the number of the couples that undergo fertility treatments is constantly rising, more research is of vital importance so that their potential impact of such exposure on maternal and neonatal health can be understood.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134400767","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":"Botryoid Rhabdomyosarcoma of the cervix: A systematic review of the literature from 1937 to 2017 – all registered cases","authors":"E. Zachariou, I. Bellos, Konstantina Papadatou, Kalliopi Rodolaki, N. Thomakos, D. Haidopoulos, A. Rodolakis, V. Pergialiotis","doi":"10.33574/hjog.0502","DOIUrl":"https://doi.org/10.33574/hjog.0502","url":null,"abstract":"Purpose: Embryonal rhabdomyosarcoma of the cervix (RMS) is a rare malignancy and occurs mainly in the first two decades of life. Botryoid rhabdomyosarcoma is a subtype of embryonal rhabdomyosarcoma and is an aggressive malignancy that arises from embryonal rhabdomyoblasts. It is often found in the genital tract of infants and young children. Study design: we conducted a systematic review to accumulate the available evidence in the international literature. We searched Medline (1966–2021), Scopus (2004–2021), Clinicaltrials.gov (2008–2021), EMBASE (1980-2021), Cochrane Central Register of Controlled Trials CENTRAL (1999-2021), and Google Scholar (2004-2021) for relevant observational studies and case reports. Results: We retrieved 156 cases with a mean age of 24.4 years with the oldest patient at the age of 89 years and the youngest 67-day-old infant. Twenty-four patients died. Ninety-seven patients were free of disease (85%). Of those 11 (11.3%) patients died. Fifteen patients (15%) developed relapse and 13 (86.6%) of them died. In 42 cases we could not extract information concerning their survival. Discussion: The findings of our study are mainly limited to case reports and small case series, and there are no standard treatment guidelines available and no consensus on how to manage these cases. Surgery should be guided by the response to initial chemotherapy and should attempt to conserve the function of the bladder, rectum, vagina, and ovaries. As this is a disease of adolescence, fertility preservation in well-selected cases is of paramount importance.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133960183","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":"Performing double episiotomy for shoulder dystocia management. Case report","authors":"E. Kostoglou","doi":"10.33574/hjog.0505","DOIUrl":"https://doi.org/10.33574/hjog.0505","url":null,"abstract":"Shoulder dystocia is an obstetric emergency that occurs in approximately 1% of vaginal deliveries. This situation is related with neonatal morbidity and mortality as long as maternal complications. The management of shoulder dystocia should be quick in order to avoid serious consequences. This case report is about the immediate diagnosis and successful management of shoulder dystocia through performing a second episiotomy after the HELPER mnemonic failed.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129883834","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":"Serum relaxin in preeclamptic and normotensive pregnant women at the Lagos University Teaching Hospital","authors":"A. Ugwu, K. Okunade, A. Oluwole, Sarah Ajibola John Olabode, N. Ani-ugwu, C. Makwe, E. Ugwu, Sunusi Garba","doi":"10.33574/hjog.0504","DOIUrl":"https://doi.org/10.33574/hjog.0504","url":null,"abstract":"Background: Preeclampsia is a pregnancy-specific multi-systemic progressive disorder that is unique to human pregnancy occurring in the second half of pregnancy. Reliable biochemical markers for prediction, diagnosis and management of preeclampsia would have a great impact on maternal health and several of these markers have been suggested. Relaxin is a peptide that has shown promising effect in the treatment of cardiovascular diseases and it is believed to increase vascular endothelial growth factor and placenta growth factor both of which promote angiogenesis and placentation in pregnancy. Thus, relaxin may play an important regulatory role in maternal vascular adaptations during pregnancy. Aim: This study therefore aimed to find out the difference, if any, in serum relaxin levels in preeclamptic and normotensive pregnant women at Lagos University Teaching Hospital. Methods: This was an analytical comparative cross-sectional study involving pregnant women with preeclampsia (study group- 48 had mild preeclampsia while 42 had severe preeclampsia) and age-, parity- and gestational age-matched women without preeclampsia (comparative group). Venous samples were collected from eligible participants after counselling and obtaining informed consent. Serum relaxin was determined using the Quantikine Human Relaxin-2 Immunoassay according to manufacturer’s instructions. A structured questionnaire was also administered to collect relevant sociodemographic and clinical information. Data were entered and analyzed using the IBM Statistical Package for Social Sciences (SPSS Statistics) Version 23. Armonk, NY: IBM Corp. Categorical variables were summarized and presented as frequency and percentages. The test of normality of continuous variables was performed using the Kolmogorov-Smirnov test. The continuous variables such as age that were normally distributed were presented as mean (± standard deviation). All tests were two- tailed and statistical significances was set at p < 0.05. Results: The mean level of serum relaxin in women with preeclampsia was significantly lower than that of the normotensive women (0.24+0.03ng/ml vs. 0.42±0.05ng/ml; p < 0.001). However, there was no significant difference in the mean serum relaxin levels in participants with mild preeclampsia when compared to those with severe preeclampsia (0.24 + 0.02ng/ml vs. 0.23ng/ml + 0.01; p = 0.271). Conclusion: Women with pre-eclampsia have significantly lower levels of serum relaxin than normotensive pregnant women. However, there is no significant difference in mean serum relaxin levels in women with mild when compared to those with severe preeclampsia. Therefore, development of pre-eclampsia is associated with lower serum levels of relaxin, though the relaxin levels may not indicate the severity of disease.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127105046","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":"A 13-week tubal pregnancy with live fetus","authors":"D. Polychroni, Ioannis D. Stefanidis, Asterios Nidimos, Petros Macheras, Sofia Apanozidou, Panagiotis Provetzas","doi":"10.33574/hjog.0406","DOIUrl":"https://doi.org/10.33574/hjog.0406","url":null,"abstract":"Second trimester unruptured tubal pregnancy is rare among ectopic pregnancies. Ultrasonography is still a diagnostic modality. Early diagnosis can avert rupture and potential mortality and morbidity. We report a case of a woman presented to our department with abdominal pain, vaginal spotting and three-months amenorrhea. Transvaginal ultra-sonography showed a gestational sac in left adnexa, with a live 13-weeks fetus. Exploratory laparotomy and left sided salpingectomy was performed. Patient’s post-operative course was uneventful. Our case demonstrates that ectopic pregnancy may be diagnosed in advanced gestational age, making emergency surgical management the choice of treatment in most of the patients.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124293016","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":"Association of IL1B -511T>C, IL6 -634G>C, IL-6 -174G > C, miR -149 T>C AND miR-27aA>G gene polymorphisms with recurrent pregnancy loss risk in greek population","authors":"S. Stavros, D. Mavrogianni, Lamprini Ntetsika, P. Drakakis","doi":"10.33574/hjog.0402","DOIUrl":"https://doi.org/10.33574/hjog.0402","url":null,"abstract":"Introduction: Recurrent pregnancy loss (RPL) is defined as the spontaneous loss of two or more idiopathic consecutive clinical pregnancies prior to 22 completed weeks of gestation. Association of miRNA polymorphisms with RPL has been investigated as a genetic determinant for the risk of idiopathic RPL. Moreover, mutations in several interleukins’ genes have been also related to RPL. Material and Methods: The study was carried out between September 2019 and September 2021 in Alexandra Maternity Hospital. Two hundred women with at least two consecutive spontaneous abortions (RPL) and 200 women as a control group who have completed one pregnancy were included in this study. Blood samples were collected from which genomic DNA was extracted, and PCR was performed to identify the IL1B -511T>C, IL6 -634G>C, IL-6 -174G > C, miR -149 T>C AND miR-27aA>G genotypes. Results: Of the 5 genes tested, genotype and group correlation were found in IL-1b-511 and miR-27. In specific, in the IL-1b-511 gene, cases have a 77.2% statistically significantly higher relative probability of having the polymorphism (CC genotype) than the control group (OR = 1.772, p = 0.007). In addition, in the miR-27 gene, cases are 3.2 times statistically significantly more likely to have polymorphism (GG) compared to controls (OR = 3.283, p <0.001). Conclusions: A genetic panel related to recurrent abortions is proposed. Gynecologists and researchers may apply it to establish a personalized treatment in women with RPL. The establishment of genetic panels related to infertility issues leads to more efficient solutions for the achievement of a pregnancy.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127875516","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":"Factors affecting breastfeeding in rural and urban population of Greece: Preliminary analysis of a prospective cohort study","authors":"Panagoula Katzeni, E. Zachariou, D. Papageorgiou, G. Daskalakis, V. Pergialiotis","doi":"10.33574/hjog.0403","DOIUrl":"https://doi.org/10.33574/hjog.0403","url":null,"abstract":"Introduction: Breastfeeding is the unparalleled way to provide infants the ideal nutrients they need for their healthy growth. The World Health Organization (WHO) recommends exclusive breastfeeding until 6 months old, starting within 1 hour of birth. All infants should start receiving foods in addition to breast milk from 6 months onwards, while breastfeeding continues until 2 years old or more. Purpose: The purpose of this study is to investigate those factors that may influence the onset of breastfeeding in the first few days after birth and during the hospitalization in the maternity ward, as well as the establishment of breastfeeding 6 weeks after birth, along with studying the weight of the newborn. Material and Method: This was a prospective study with a convenience sample taking place in the General Hospital of Argolis and the Elena Venizelou maternity hospital in Athens. In the presented pilot study 75 women that delivered at full term completed the questionnaire. We chose to exclude women that delivered during the preterm period as well as those that delivered twins as these factors independently affect the possibility of discontinuing breastfeeding. A self-report questionnaire with closed and open-ended questions was used and was completed in two phases. Results: Overall, 75 women completed the questionnaire. Of those 3 women delivered within the early term period (37+0 – 38+6 weeks). The majority of women (74.67%) initiated breastfeeding within 2 hours from delivery. Rooming in was allowed within the first hour in a large proportion of participants (62.67%). Breastfeeding difficulties were encountered in approximately half of participants and the predominant reason was some form of breast pathology. Twenty-two mothers (29.3%) discontinued breastfeeding within the study period. Early rooming in significantly increased the possibility of continuing breastfeeding after the first month. Of all the factors that were investigated during the puerperal period only the amount of formula meals significantly affected the rates of continuous breastfeeding. Conclusion: Early rooming-in significantly increases breastfeeding practices. Unstructured educational activities from healthcare providers and accompanying brochures do not seem to enhance breastfeeding duration, indicating the need for adoption of specific programs that will be tested in forthcoming studies.","PeriodicalId":194739,"journal":{"name":"Hellenic Journal of Obstetrics and Gynecology","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131013697","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}