Gynecology and Obstetrics Clinical Medicine最新文献

{"title":"Comparison of body mass index, anti-müllerian hormone and insulin resistance parameters among different phenotypes of polycystic ovary syndrome","authors":"Türkan Gürsu ,&nbsp;Alper Eraslan ,&nbsp;Berk Angun","doi":"10.1016/j.gocm.2022.10.002","DOIUrl":"10.1016/j.gocm.2022.10.002","url":null,"abstract":"<div><h3>Background</h3><p>Diagnosis of polycystic ovary syndrome (PCOS) depends on 2003 Rotterdam Criteria. According to these criteria there are four possible combinations resulting in various phenotypes. We aimed (i)to confirm that the levels of body mass index (BMI), anti-müllerian hormone (AMH) levels and insulin resistance (IR) are higher in PCOS patients and higher in phenotype-A among PCOS patients, and (ii)to determine cut-off values for the diagnosis of PCOS and phenotype-A.</p></div><div><h3>Materials and methods</h3><p>This study was conducted in an IVF Center, between November 2019 and January 2021. Data of infertile women participating in the study was evaluated retrospectively. Parameters such as menstruation pattern, clinical hyperandrogenism, age, BMI, follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, thyroid stimulating hormone (TSH), prolactin, AMH, dehydroepiandrosterone sulphate (DHEA-S), fasting blood glucose, fasting insulin levels, antral follicle counts (AFC) and ovarian volumes were recorded for each patient. Women were grouped as PCOS and non-PCOS, and PCOS group was further divided into 4 sub-groups according to their phenotypes. Data of infertile patients with PCOS patients were compared with infertile non-PCOS patients and PCOS phenotypes were compared among each other.</p></div><div><h3>Results</h3><p>Data of 244 infertile patients was included in the study. BMI, AMH, AFC, and HOMA-IR were statistically higher in PCOS patients, compared to non-PCOS patients. We found the AMH level of &gt;3.105 ​ng/ml to be having 90.8% sensitivity and 90% specificity to diagnose a patient as PCOS. Among different phenotypes, also BMI, AMH, and insulin resistance index (HOMA-IR) levels were significantly higher in infertile PCOS phenotype-A when compared to other three phenotypes (p:0.003, p:0.000, and p:0.000, respectively). The AMH cut-off value to estimate phenotype-A was found as 6.095 ​ng/ml with 69.2% sensitivity and 86.7% specificity. We did not found threshold levels of BMI and HOMA-IR with high sensitivity to identify phenotype-A.</p></div><div><h3>Conclusion</h3><p>Properly diagnosing PCOS and determining the phenotype are crucial due to the long-term health conditions. Therefore, we suggest that serum AMH level could be included in PCOS diagnosis criteria, and the value of 3.105 ​ng/ml would have a 90.8% sensitivity and 90% specificity. Also, to identify phenotype-A, AMH level could be used. Therefore, we speculate that AMH may serve to identify PCOS and PCOS phenotype-A in places where ultrasound imaging is not straightforward to perform or not easily accessible.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"2 4","pages":"Pages 164-170"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667164622000884/pdfft?md5=fcab2ad18b741eb9f200f836039a2d67&pid=1-s2.0-S2667164622000884-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47113094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced maternal age and adverse obstetrical and neonatal outcomes of singleton pregnancies","authors":"Mitra Shekari ,&nbsp;Malihe Shirzadfardjahromi ,&nbsp;Amene Ranjbar ,&nbsp;Vahid Mehrnoush ,&nbsp;Fatemeh Darsareh ,&nbsp;Nasibeh Roozbeh","doi":"10.1016/j.gocm.2022.10.004","DOIUrl":"10.1016/j.gocm.2022.10.004","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the impact of advanced maternal age on pregnancy and childbirth outcomes of singleton pregnancies.</p></div><div><h3>Study design</h3><p>We retrospectively assessed singleton pregnant mothers who gave birth at Khaleej-e-Fars Hospital in Bandar Abbas, Iran, from January 2020 to January 2022. Demographic and obstetrical factors include educational level, medical insurance, residency place, access to prenatal care facilities, number of prenatal care visits, smoking status, gestational age, parity, infertility, maternal comorbidities, preeclampsia, eclampsia, preterm birth, low birth weight (LBW), intrauterine growth restriction (IUGR), macrosomia, placenta abnormalities (previa/acreta), placenta abruption, chorioamnionitis, meconium fluid, fetal distress, methods of delivery, rate of cesarean section (CS), perineal lacerations, postpartum hemorrhage, childbirth injury, shoulder dystocia, congenital malformation, neonatal asphyxia, and unfavorable maternal and neonatal outcome were compared between two groups. The Chi-square test assessed the relationship between categorical factors and maternal age groups. The influence of advanced maternal age on the risk of unfavorable pregnancy outcomes was evaluated using bivariate and multivariate logistic regression.</p></div><div><h3>Results</h3><p>Of 8354 singleton deliveries, 22.2% belonged to advanced-age mothers. Advanced-age mothers had less education than those aged 20–34 years old. Chronic hypertension, cardiovascular disease, overt diabetes, and thyroid dysfunction were more prevalent among advanced-age mothers. Compared with mothers aged 20–34 years, mothers aged 35 years and higher had a significantly higher risk of gestational diabetes (aOR: 3.18, 95%CI: 1.56–6.95), preeclampsia (aOR: 2.91, 95%CI: 1.35–4.72), placenta abnormalities (aOR: 1.09, 95%CI: 0.77–1.94), CS (aOR: 3.16, 95%CI: 1.51–3.87), postpartum hemorrhage (aOR: 1.94, 95%CI: 1.24–2.61), intensive care unit admission (aOR: 1.36, 95% CI: 1.15–1.99), LBW (aOR: 1.35, 95%CI: 0.97–2.96), preterm birth (aOR: 2.36, 95%CI: 1.65–4.83), stillbirth (aOR: 1.18, 95%CI: 1.01–3.16), and neonatal intensive care admission (aOR: 2.09, 95%CI: 0.73–3.92). According to bivariate regression, the risk of meconium fluid was lower in advanced-age mothers; however, the result of multivariate logistic regression found no correlation between advanced age and the Incidence of meconium fluid.</p></div><div><h3>Conclusion</h3><p>Advanced-age mothers are at increased risk of adverse pregnancy and childbirth outcomes, which persist even after adjusting for several potential confounders.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"2 4","pages":"Pages 175-180"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667164622000902/pdfft?md5=3ad8485f0b0e87ae6d0171fa886430e4&pid=1-s2.0-S2667164622000902-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49514729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of anti-mullerian hormone and free androgen index level on response to clomiphene citrate in PCOS infertile women","authors":"Jasmine Kavitha Washington ,&nbsp;Jayasree Manivasakan ,&nbsp;Poomalar Gunasekaran Kala ,&nbsp;Sasikala R.","doi":"10.1016/j.gocm.2022.11.003","DOIUrl":"10.1016/j.gocm.2022.11.003","url":null,"abstract":"<div><h3>Background</h3><p>Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility. Clomiphene citrate, insulin-sensitizing drugs, aromatase inhibitors, gonadotropins, or laparoscopic ovarian drilling are various methods used for ovulation induction in women with PCOS. PCOS women with high levels of anti-mullerian hormone (AMH) and free androgen index (FAI) do not respond well to ovulation induction. This prospective observational study explores the relationship between FAI and AMH levels on ovarian response to clomiphene citrate in infertile women with PCOS.</p></div><div><h3>Methods</h3><p>This prospective observational study included 40 infertile with PCOS who underwent ovulation induction with clomiphene citrate with dose ranging from 50 to 150 ​mg. Participants were classified into four phenotypes by NIH(National Institute of Health) consensus panel criteria. The clinical and endocrine parameters of participants who were sensitive to clomiphene were compared to those who were resistant.</p></div><div><h3>Results</h3><p>The most common phenotype was A, with all three features of PCOS: hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. There was no significant difference in clinical and endocrine parameters among the different phenotypes of PCOS except AMH and FAI values. The mean FAI was 9.39 ​± ​1.11 and AMH 7.26 ​± ​0.48 (ng/ml) in clomiphene resistant and 5.31 ​± ​1.93 and 3.69 ​± ​1.84 (ng/ml) respectively in clomiphene-sensitive women. Women with FAI &gt; 7.5 and AMH &gt;7 ​ng/ml might be resistant to clomiphene.</p></div><div><h3>Conclusion</h3><p>FAI and AMH values were significantly higher in women resistant to clomiphene induction. AMH and FAI may help women with PCOS to tailor their ovulation induction protocol.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"2 4","pages":"Pages 203-207"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667164622000963/pdfft?md5=6329b8b0d21fd16d7f1ab8c7c788e9f3&pid=1-s2.0-S2667164622000963-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42955867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidental bilateral ovarian paraganglioma of uterine fibroid with widespread adenomyosis: A case report","authors":"Zaibun Nisa,&nbsp;Dhafir Al-Okati,&nbsp;Olugbenga Duroshola,&nbsp;Deepali Bhatte","doi":"10.1016/j.gocm.2022.10.003","DOIUrl":"10.1016/j.gocm.2022.10.003","url":null,"abstract":"","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"2 4","pages":"Pages 208-210"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667164622000896/pdfft?md5=3111780181de735675fe1fbcc7b28292&pid=1-s2.0-S2667164622000896-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48092313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Florid cystic endosalpingiosis of the uterine subserosa: A case report","authors":"Yuanpu Yao,&nbsp;Shiguang Zhou,&nbsp;Lijun Lu,&nbsp;Lin Dai,&nbsp;Lei Shi,&nbsp;Yunzhong Hui","doi":"10.1016/j.gocm.2022.11.001","DOIUrl":"10.1016/j.gocm.2022.11.001","url":null,"abstract":"","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"2 4","pages":"Pages 211-213"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266716462200094X/pdfft?md5=f72d56371e567c4a9988d7c9306b7c79&pid=1-s2.0-S266716462200094X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43800627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility preservation for female patients with childhood and adolescent cancer","authors":"Yanru Hou ,&nbsp;Li Tian ,&nbsp;Huai L. Feng","doi":"10.1016/j.gocm.2022.11.002","DOIUrl":"10.1016/j.gocm.2022.11.002","url":null,"abstract":"","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"2 4","pages":"Pages 161-163"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667164622000951/pdfft?md5=fe84d8e6747f3ceeeae579ef85821533&pid=1-s2.0-S2667164622000951-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45790506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with premenstrual syndrome of emergency nurse: A multicenter study in China","authors":"Yiqian Chen ,&nbsp;Xin Yang ,&nbsp;Xiaodan Li ,&nbsp;Xiaoting Wei ,&nbsp;Lianhua Bai","doi":"10.1016/j.gocm.2022.10.007","DOIUrl":"10.1016/j.gocm.2022.10.007","url":null,"abstract":"<div><h3>Objective</h3><p>To study the factors associated with premenstrual syndrome (PMS) in emergency department (ED) nurses.</p></div><div><h3>Methods</h3><p>A multicenter cross-sectional study was conducted in female ED nurses in China. Data gathering questionnaires included the Daily Record of Severity of Problems, Chinese Nurses Stressor Scale, Social Support Rating Scale, and Self-Rating Anxiety Scale. All questionnaires were used to assess the symptoms prospectively over 2 months.</p></div><div><h3>Results</h3><p>A total of 289 ED nurses were recruited. The incidence of PMS was 67.47%. The most common symptoms were tiredness (76.90%), anger (76.90%), restlessness (75.40%), snoring (69.20%). Univariate analysis showed that the BMI and occupational stress score was significantly higher, and the age was significantly younger in the PMS group compared with the non-PMS group. According to the multiple linear regression, the symptoms of PMS were positively associated with the occupational stress score and anxiety score, and negatively with the level of education received.</p></div><div><h3>Conclusions</h3><p>occupational stress, anxiety, and education level may associated with the occurrence of PMS in ED nurses.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"2 4","pages":"Pages 199-202"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667164622000938/pdfft?md5=5adb4e16855bde5d399df728d57d731d&pid=1-s2.0-S2667164622000938-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45250987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress of CA125 in endometriosis: Teaching an old dog new tricks","authors":"Yonghua Chen ,&nbsp;Meixia Pan ,&nbsp;Ying Zuo ,&nbsp;Bin Yang ,&nbsp;Shaoguang Wang","doi":"10.1016/j.gocm.2022.10.006","DOIUrl":"10.1016/j.gocm.2022.10.006","url":null,"abstract":"<div><p>After decades of research, we still face great challenges on endometriosis in terms of diagnosis and management. Serum CA125 has been used in the clinical practice in endometriosis, and many large-scale clinical trials have been conducted or are underway to determine potential use of serum CA125 levels in endometriosis. In this article, relevant articles that addressed endometriosis associated with CA125 were searched for and retrieved from the databases PubMed, Embase and the Cochrane Library. Here we provide an in-depth literature review to depict CA125 dynamic expression in female reproductive tract and to highlight the practical value of CA125 in diagnosing endometriosis, distinguishing the severity of the disease, monitoring the effect of treatment and reflecting malignant transformation. So far, the development of a risk stratification system based on biomarker CA125 for endometriosis may help clinicians in making novel and more efficient strategies for the detection and treatment of endometriosis. In order to improve CA125 specificity and sensitivity, further research is needed to determine its diagnostic cut-off value.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"2 4","pages":"Pages 191-198"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667164622000926/pdfft?md5=98131ce14ced041c0cfa5b20d9db71d6&pid=1-s2.0-S2667164622000926-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43086235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive advance of fertility preservation in patients with early endometrial carcinoma or endometrial atypical hyperplasia","authors":"Jiao Yu,&nbsp;Yangyang Zhang,&nbsp;Huixia Yang,&nbsp;Yang Xu","doi":"10.1016/j.gocm.2022.10.005","DOIUrl":"10.1016/j.gocm.2022.10.005","url":null,"abstract":"<div><p>Endometrial cancer (EC) is the fourth common cancer in women worldwide with its incidence rising each year. 10%–15% young patients are diagnosed of EC. For patients of childbearing age with early endometrial cancer or atypical hyperplasia, it is necessary to consider surgical removal of uterus after they have given birth. It is a big challenge for reproductive doctors and oncologists to help such patients get pregnant safely as soon as possible. In this article, we will review the latest progress in conservative treatment and candidates for fertility preservation, application of molecular detection, the fertility outcome and follow-up treatment which aims to stimulate more thinking.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"2 4","pages":"Pages 186-190"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667164622000914/pdfft?md5=5f2ccaf730fc05c09fcda776467be852&pid=1-s2.0-S2667164622000914-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47627479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of immune cells and cytokines on the endometrial immune microenvironment in polycystic ovary syndrome","authors":"Zhenhong Ye ,&nbsp;Jie Zhao ,&nbsp;Rong Li","doi":"10.1016/j.gocm.2022.10.001","DOIUrl":"10.1016/j.gocm.2022.10.001","url":null,"abstract":"<div><p>Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder in women of reproductive age, and its pathogenesis is still unclear. More and more studies have shown that PCOS patients were often accompanied by obesity, insulin resistance and chronic, low-grade inflammation, which were closely related to the endometrial dysfunction. Besides, obesity and insulin resistance also exacerbate inflammatory responses. Therefore, this review provides a summary of the effects of immune cells and inflammatory cytokines on the immune microenvironment of PCOS endometrium, and the impacts of obesity and insulin resistance on endometrial inflammatory homeostasis and possible drug interventions.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":"2 4","pages":"Pages 181-185"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667164622000872/pdfft?md5=06cb24bd5afa97291bbfbc2becf92483&pid=1-s2.0-S2667164622000872-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45803188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}