European Journal of Obstetrics and Gynecology and Reproductive Biology: X最新文献

{"title":"Intramural ectopic pregnancy: An individual patient data systematic review","authors":"Carnot N. Ntafam ,&nbsp;ItunuOluwa Sanusi-Musa ,&nbsp;Robert D. Harris","doi":"10.1016/j.eurox.2023.100272","DOIUrl":"https://doi.org/10.1016/j.eurox.2023.100272","url":null,"abstract":"<div><p>Intramural pregnancies (IMP) are very rare and represent about 1% of ectopic pregnancies (EPs). Despite a few reported cases, there is limited awareness &amp; knowledge among sonographers and physicians. Moreover, no established diagnostic or treatment protocol exists for such a condition. This study identifies and synthesizes what is known about IMP, including etiology and pathophysiology, common clinical presentations, imaging features, laparoscopic and hysteroscopic findings, and management. PUBMED and Google Scholar were queried to identify eligible studies. All articles on IMP in human subjects available in English and French languages were included. Other types of ectopic pregnancies, including cesarean scar and cervical ectopic pregnancies, were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines and a narrative synthesis approach were used to systematically review the medical literature. 82 cases distributed around 27 countries with an average maternal age of 32.07 years and gestational age of 9.27 weeks were eventually selected for this study. History of curettage was the most common risk factor reported in 30 (36.58%) patients, followed by history of salpingectomy, assisted reproduction with embryo transfer, and previous cesarean delivery, in 10(12.19%), 10(12.19%), and 9(10.97%) patients respectively. Ultrasound was performed in 80(97.56%) cases. Of the 66 reported ultrasound findings, 29 were diagnostic or suggestive of IMP. MRI, laparoscopy (both diagnostic &amp; surgical) and diagnostic hysteroscopy were carried out on 18(21.95%), 36(43.9%) and 22(26.83%) patients respectively. Histopathologic examination mainly performed after surgery was the gold standard for confirming the diagnosis. Management involved conservative (3.65%) approach, medical treatment with methotrexate or potassium chloride (23.17%), and surgical interventions. The latter includes laparoscopic surgery (25.61%), laparotomic surgery (23.17%), and hysterectomy (13.41%). IMP is a rare but potentially lethal clinical entity. A significant proportion of patients are asymptomatic and have no known risk factors. Correlation between clinical history and imaging findings is vital to establish a prompt diagnosis and reduce the risk of a catastrophic outcome.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161323000984/pdfft?md5=d052746804dbda8e181786038c792636&pid=1-s2.0-S2590161323000984-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100646","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":"Effect of pilates on regulating menstrual cycle in females with polycystic ovarian syndrome","authors":"Sumiya Nazir,&nbsp;Sakshi Sadhu","doi":"10.1016/j.eurox.2023.100271","DOIUrl":"https://doi.org/10.1016/j.eurox.2023.100271","url":null,"abstract":"<div><h3>Background</h3><p>Polycystic Ovarian Syndrome (PCOS) is the most common genetic disorder of the endocrine gland among females during the age of reproduction with an estimated prevalence ranging from 2.2 % to 26 %. It is a typical reason for ovulatory infertility, menstrual dysfunction, and hirsutism. It is a condition in which ovarian cysts develop with a diameter of between two and nine millimeters on one or each ovaries and therefore there is an increase in the volume of one is larger than ten millimeters.</p></div><div><h3>Objective</h3><p>To analyze the effect of pilates on pain and regulation of the menstrual cycle in females with PCOS.</p></div><div><h3>Research methodology</h3><p>A single centered, quasi-experimental study, performed in Lovely Professional University, India on a total of 26 participants suffering from PCOS, based on inclusion and exclusion criteria. After a detailed assessment, the Pilates exercise protocol was given for 3 months i.e. 3 times per week. The readings for pain and regulation were taken at baseline, at the end of 1st, 2^nd, and 3rd month using visual analog scale (VAS)and verbal multidimensional score sysem (VMSS).</p></div><div><h3>Results</h3><p>The result findings indicates suggested that there is significant change in the pain (Wilk’s Lambda =.117, F(3,23) = 58.109, P &lt; 0.05), variable during the menstruation in PCOS over the time of three months. The menstrual cycles were regularised and the cycle was shifted towards the normal parameters. The VMSS also shows changes that signify that Pilates is effective in PCOS complications.</p></div><div><h3>Conclusion</h3><p>This study concluded that Pilates is effective in reducing the pain in PCOS cases which improves the working ability of the females and also regulates the menstrual cycles which were irregular at the beginning of the treatment.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161323000972/pdfft?md5=a2617a646bfa0f58d12810a3a50e9cef&pid=1-s2.0-S2590161323000972-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138713444","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":"How does the need for IVF affect pregnancy complications among multiple gestations? The study of a large American population database including almost 100,000 multiple gestations","authors":"Samar Mandourah ,&nbsp;Ahmad Badeghiesh ,&nbsp;Haitham Baghlaf ,&nbsp;Michael H. Dahan","doi":"10.1016/j.eurox.2023.100270","DOIUrl":"https://doi.org/10.1016/j.eurox.2023.100270","url":null,"abstract":"<div><h3>Objective</h3><p>This study’s aim is to compare pregnancy outcomes in multifetal gestations that were conceived spontaneously compared to in vitro fertilization (IVF). Few population-based studies have addressed this topic.</p></div><div><h3>Study design</h3><p>This is a retrospective cohort study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) database. Our study cohort included 90,552 multifetal gestations conceived spontaneously and 3219 IVF conceptions, from 2008 to 2014, inclusively. Multivariate logistic regression analyses were performed comparing maternal and neonatal outcomes, whilst adjusting for confounding variables. Subject was conducted using ICD-9 codes for multifetal gestation: 651. X and 76.1 and ICD-9 code for IVF: 23.85. Each pregnancy was included once.</p></div><div><h3>Results and conclusion</h3><p>IVF multifetal gestations had increased risk of pregnancy-induced hypertension (aOR 1.31, 95 % CI 1.20–1.43), gestational hypertension (aOR 1.21, 95 % CI 1.04–1.41), preeclampsia (aOR 1.31, 95 % CI 1.19–1.45), gestational diabetes (aOR 1.26, 95 % CI 1.13–1.41) and placenta previa (aOR 1.7, 95 % CI 1.32–2.19). IVF delivery outcomes were more likely complicated by cesarean section (aOR 1.21, 95 % CI 1.10–1.33), preterm premature rupture of membranes (aOR 1.33, 95 % CI 1.16–1.52), chorioamnionitis (aOR 1.71, 95 % CI 1.37–2.14), postpartum hemorrhage (aOR 1.44, 95 % CI 1.26–1.63) and transfusions (aOR 1.48, 95 %CI 1.26–1.74). IVF neonatal outcomes were more likely complicated by small for gestational age (aOR 1.26, 95 % CI 1.12–1.41) and congenital anomalies (aOR 1.82, 95 % CI 1.29–2.57). IVF was not found to increase risks of eclampsia, preterm delivery, operative vaginal delivery, hysterectomy, or intrauterine fetal demise.</p><p>IVF increased the risk of pregnancy, delivery, and neonatal outcomes in multifetal pregnancies with risks increased from 20 % to 70 %. The role of infertility versus the need for IVF and the type of IVF protocol used should be further evaluated.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161323000960/pdfft?md5=a809bc4cfa00b9ac7202efb35e98ec2d&pid=1-s2.0-S2590161323000960-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138713391","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":"A low total motile sperm count in donor sperm obtained from commercial banks does not affect pregnancy rates from intrauterine insemination","authors":"Alyssa Hochberg ,&nbsp;Michael H. Dahan ,&nbsp;Trish Dinh ,&nbsp;William Buckett ,&nbsp;Jacob Ruiter-Ligeti","doi":"10.1016/j.eurox.2023.100267","DOIUrl":"https://doi.org/10.1016/j.eurox.2023.100267","url":null,"abstract":"<div><h3>Objective</h3><p>Women are often concerned about the absolute quantity and quality of sperm in a thawed donor sample at the time of intrauterine insemination (IUI). The aim of this study was to determine how the total motile sperm count (TMSC) of donor sperm obtained from commercial sperm banks affects the pregnancy rate after IUI.</p></div><div><h3>Study design</h3><p>We performed a retrospective cohort study including single women and women in same-sex relationships undergoing IUI at a single academic fertility center between January 2011 and March 2018. Our primary outcome was pregnancy rates per IUI cycle, stratified by post-washed TMSC. The data was analyzed according to TMSC and included three different groups: samples with a TMSC less than 5 million; TMSC of 5–10 million; and a TMSC greater than 10 million. Pregnancies were defined by a serum Beta-human chorionic gonadotropin (Beta-HCG) of greater than 5 mIU/mL. Chi-squared analyses and correlation coefficients were performed.</p></div><div><h3>Results</h3><p>Overall, 9341 IUIs were conducted during the study period. Of these, 1080 (11.56%) were performed for single women and women in a same-sex relationship using commercially available donor sperm. We found that there were no differences in the pregnancy rates per insemination based on TMSC. The pregnancy rates per cycle were 15/114 (13.3%) for the group with a TMSC of less than 5 million; 34/351(9.5%) with a TMSC of 5–10 million; and 61/609 (10.0%) for samples with a TMSC greater than 10 million (p = 0.52). We found an insignificant correlation (r = −0.072) between donor sperm TMSC and pregnancy after IUI (p = 0.46). Furthermore, a reassuring beta-HCG level (&gt;100IU/L) drawn 16 days after IUI was unrelated to TMSC (r = 0.0071, p = 0.94).</p></div><div><h3>Conclusion</h3><p>The pregnancy rate following IUI is unaffected by the TMSC of commercially available donor sperm. This result is useful in reassuring patients when freshly thawed donor sperm is found to have a lower TMSC. Frozen sperm samples from commercial banks typically represent just a portion of an ejaculate produced by a donor who meets the banks’ standards for age, health and sperm quality. As such, exaggerated sperm death caused by freezing does not result in worse outcomes with donor sperm.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161323000935/pdfft?md5=71d1a08ef8a6d9b821a3ab4717445cae&pid=1-s2.0-S2590161323000935-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138713445","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":"Evaluation of amniotic fluid neutrophil gelatinase-associated lipocalin and L-type fatty acid-binding protein levels during pregnancy","authors":"Daisuke Katsura,&nbsp;Shunichiro Tsuji,&nbsp;Shinsuke Tokoro,&nbsp;Ayako Inatomi,&nbsp;Takako Hoshiyama,&nbsp;Nobuyuki Kita,&nbsp;Takashi Murakami","doi":"10.1016/j.eurox.2023.100269","DOIUrl":"https://doi.org/10.1016/j.eurox.2023.100269","url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to examine amniotic fluid neutrophil gelatinase-associated lipocalin (NGAL) and L-type fatty acid-binding protein (L-FABP) levels during pregnancy.</p></div><div><h3>Study design</h3><p>This study included singleton pregnancies. Amniotic fluid samples were collected at the time of vaginal delivery, cesarean section, amniocentesis, amnioreduction, and amnioinfusion. We analyzed changes of the NGAL and L-FABP levels during pregnancy and the factors affecting these values and their association with clinical outcomes.</p></div><div><h3>Results</h3><p>Three hundred and one pregnancies were analyzed. Respective Pearson correlation coefficients for the NGAL and L-FABP levels and gestational age at inspection were − 0.351 and − 0.819 (p &lt;0.001 and p &lt; 0.001, respectively); weak and strong negative correlation were observed. The NGAL level was significantly higher in the intra-amniotic infection group than in the control group (p &lt; 0.001). The L-FABP level was significantly higher in the fetal blood flow abnormalities group than in the control group (p &lt; 0.001). The NGAL and L-FABP levels were significantly higher in the adverse outcomes group than in the control group (p = 0.019 and p &lt; 0.001, respectively), and the respective areas under the concentration-time curve, with optimal cutoff values, for the NGAL and L-FABP levels were 0.693 (14,800 µg/gCr) and 0.864 (378 µg/gCr).</p></div><div><h3>Conclusions</h3><p>Amniotic fluid NGAL and L-FABP levels reflect fetal and neonatal immaturity. Additionally, the NGAL level is a useful predictive factor of intra-amniotic infection, and the L-FABP level is a useful predictive factor of fetal condition and short- and long-term prognoses.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161323000959/pdfft?md5=c8547c778fb9592ed70740ede192ad50&pid=1-s2.0-S2590161323000959-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138713390","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":"Re-evaluation of umbilical cord coiling index in adverse pregnancy outcome – Does it have role in obstetric management?","authors":"Nikhila Singireddy ,&nbsp;Amey Chugh ,&nbsp;Himadri Bal ,&nbsp;S.L. Jadhav","doi":"10.1016/j.eurox.2023.100265","DOIUrl":"https://doi.org/10.1016/j.eurox.2023.100265","url":null,"abstract":"<div><h3>Introduction</h3><p>The placenta with the umbilical cord is a vital link between the mother and fetus. Umbilical cord supplies water, nutrients and oxygen from the mother to the fetus. The most unique character of the umbilical cord is its coiling, where the contents of the cord course in a coiled helical fashion. The umbilical coiling index(UCI) can be measured antenatally using ultrasonography. In the present study we have attempted to assess the UCI antenatally by ultrasound screening and correlate abnormal antenatal UCI with the adverse maternal and neonatal outcome of pregnancy.</p></div><div><h3>Aims</h3><p>To study umbilical coiling index ultrasonographically and to correlate it with pregnancy outcome.</p></div><div><h3>Methodology</h3><p>150 antenatal cases in the second trimester of pregnancy between 22 and 28weeks of gestation attending the outpatient department were included for the study in a continuous manner and subjected to antenatal UCI measurement. The cases were followed up till delivery and various factors were noted.</p></div><div><h3>Results</h3><p>We confirmed that maternal medical comorbidities ( gestational hypertension and anemia) have a significant correlation with abnormal umbilical cord coiling index, either hyper-coiling or hypo-coiling or both.</p><p>Some studies have shown a particular adverse effect being manifested in both hypo and hypercoiling. In the present study significant correlation of abnormal coiling has been found with only anaemia and hypertension in pregnancy. The question, therefore, arises:</p><p>“Does abnormal UCI have any significant role in prediction of adverse outcome in pregnancy or is it just a random association?” This study does not reflect any significant role of abnormal UCI in the prediction of adverse perinatal outcome. Hence efforts to monitor UCI in the antenatal period may not have any justification in the present scenario. The latest edition of William’s Obstetrics also makes a similar comment. A population based larger study to generate cut offs for hypo and hyper coiling and finding any association between abnormal coiling and perinatal outcome may throw more light on the utility of UCI as a predictor of adverse outcome in pregnancy.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161323000911/pdfft?md5=660da2e57f8c689e04a302763389aa19&pid=1-s2.0-S2590161323000911-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138570189","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":"Retraction notice to “Comparing delayed cord clamping and umbilical cord milking during elective cesarean section for the neonatal outcome” [Eur. J. Obstet. Gynecol. Reprod. Biol. X 18 (2023) 100200]","authors":"Tamer A. Hosny ,&nbsp;Amal Z. Azzam ,&nbsp;Mohga Ashraf Said ,&nbsp;Bahaa Salah Hammad","doi":"10.1016/j.eurox.2023.100262","DOIUrl":"https://doi.org/10.1016/j.eurox.2023.100262","url":null,"abstract":"","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161323000881/pdfft?md5=9c80908f210a9071aa7555b48c95c3e3&pid=1-s2.0-S2590161323000881-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138472117","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":"Bacterial abundance and antimicrobial resistance patterns of uropathogens among pregnant women with asymptomatic bacteriuria: Association with glycemic status","authors":"Dalia Rafat ,&nbsp;Anubha Agrawal ,&nbsp;Shamsi Khalid ,&nbsp;Asad U. Khan ,&nbsp;Tabassum Nawab ,&nbsp;Asfia Sultan","doi":"10.1016/j.eurox.2023.100263","DOIUrl":"https://doi.org/10.1016/j.eurox.2023.100263","url":null,"abstract":"<div><h3>Objectives</h3><p>Antimicrobial resistance (AMR), a growing global menace, poses a significant threat to maternal and fetal health. Gestational diabetes mellitus (GDM) causes double trouble in pregnancy, increasing the risk of a variety of infectious morbidities while also raising the possible association with AMR. Asymptomatic bacteriuria (ASB) is a common problem in pregnancy, but little research has been done to date explicitly examining the relationship between GDM and ASB and yielded conflicting results. Even fewer studies have specifically examined the relationship between GDM and AMR in women with ASB. Retrieving the most recent information on the disease burden, the range of causative pathogens, their patterns of AMR, and associated risk factors in pregnant women is crucial to stop the exponential rise in AMR in pregnancy and improve maternal and neonatal outcomes of infectious morbidities. Hence, this study was planned to investigate the association between glycemic status and the contemporary bacterial profile, antimicrobial resistance(AMR), and associated variables among pregnant women with ASB</p></div><div><h3>Study design</h3><p>This prospective, hospital-based, cross-sectional study was conducted among 320 pregnant women; divided into two groups, GDM and non-GDM. Data regarding sociodemographic and clinical characteristics were collected using a structured questionnaire. Clean-catch midstream urine samples were investigated for the presence of significant bacterial uropathogens and their AMR pattern was determined using recommended culture methods.</p></div><div><h3>Results</h3><p>We found ASB in 46.25% of study participants with significantly higher occurrence in the GDM group. Dominant isolates were Escherichia coli followed by Klebsiella pneumoniae. AMR was noted in 51.35% and multidrug resistance(MDR) in 23.65% of isolates. Overall AMR, MDR and higher degrees of AMR were higher among uropathogens isolated from the GDM group as compared to the non GDM group, although the difference was not statistically significant.</p></div><div><h3>Conclusion</h3><p>The high occurrence of ASB in pregnancy along with substantially high AMR in this study suggests the need for effective infection control and stewardship programmes. By defining the association of ASB and AMR with hyperglycemia, our study calls for the exploitation of this potential association in halting the pandemic of AMR and in improving the management of infectious morbidities, thus in-turn alleviating their undesired maternal and infant outcomes.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161323000893/pdfft?md5=1164be3aeedc2586e93496439f4e6fdf&pid=1-s2.0-S2590161323000893-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138490904","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":"Pre-delivery fibrinogen level is a predictor for severity of placental abruption","authors":"Nadiye Köroğlu ,&nbsp;Ahmet Tayyar ,&nbsp;Ali Soydar ,&nbsp;Nazli Albayrak ,&nbsp;Turgut Aydın ,&nbsp;Berna Aslan Çetin","doi":"10.1016/j.eurox.2023.100264","DOIUrl":"https://doi.org/10.1016/j.eurox.2023.100264","url":null,"abstract":"<div><h3>Objective</h3><p>To determine pre-delivery fibrinogen levels in predicting adverse maternal or neonatal outcomes in patients with placental abruption.</p></div><div><h3>Materials and method</h3><p>We conducted a retrospective study of all women admitted for placental abruption between January 2012 and May 2018. Postpartum hemorrhage (PPH), disseminated intravascular coagulation (DIC), massive blood transfusion and hospitalization in intensive care unit parameters were evaluated for maternal outcomes. For the neonatal outcomes, the 5th minute APGAR score, umbilical artery pH and stillbirth were evaluated.</p></div><div><h3>Results</h3><p>The mean predelivery fibrinogen levels were 221.3 ± 111.6 mg/dL. In multivariate logistic regression analysis, fibrinogen level was determined as an independent indicator for PPH, red cell concentrate (RCC) and fresh frozen plasma (FFP) transfusion. When fibrinogen levels decreased below 130 mg/dL, the risk of PPH increased and when fibrinogen levels decreased below 100 mg/dL, the risk of overt DİC and also the risk of red cell concentrate and fresh frozen plasma transfusion increased. In terms of the fetal results, there may be adverse neonatal outcomes when fibrinogen levels are below 250 mg/dL.</p></div><div><h3>Conclusion</h3><p>Predelivery fibrinogen levels are good indicators for predicting adverse maternal outcomes in placental abruption cases. In addition, fibrinogen levels might be a guide for management of placental abruption cases.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259016132300090X/pdfft?md5=6cbf3f8db750b46ac47ba7b5d27671d3&pid=1-s2.0-S259016132300090X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138439720","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":"Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in gynecological emergencies","authors":"Rafael Ferro ,&nbsp;Yannick Hurni ,&nbsp;Stéphanie Seidler ,&nbsp;Daniela Huber","doi":"10.1016/j.eurox.2023.100261","DOIUrl":"https://doi.org/10.1016/j.eurox.2023.100261","url":null,"abstract":"<div><h3>Objective</h3><p>Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) is an emerging minimally invasive approach increasingly applied to perform many gynecological procedures. Despite a still limited level of evidence, compared to conventional laparoscopy, vNOTES seems to be associated with reduced blood loss, shorter operative time, less postoperative pain, shorter hospitalization time, better cosmetic results and decreased postoperative morbidity. Although growing evidence supports the effectiveness of vNOTES for elective adnexal surgeries, there is still limited knowledge regarding its feasibility and safety in emergency settings. In the present study, we report our experience performing vNOTES in gynecological emergency cases.</p></div><div><h3>Study design</h3><p>We prospectively collected and analyzed data from patients who underwent vNOTES for gynecological emergencies between November 2021 and June 2023. Demographic and perioperative characteristics were collected and analyzed.</p></div><div><h3>Results</h3><p>Seventeen patients were included. Interventions were realized for suspicion of ectopic pregnancy in 7 cases (41.2%), for suspicion of adnexal torsion in 7 cases (41.2%), for post-hysterectomy hemoperitoneum in 2 cases (11.8%), and for uncontrollable uterine bleeding in 1 case (5.9%). Emergency procedures included unilateral salpingectomy (35.3%), ovarian cystectomy (23.5%), ovarian cystotomy (17.6%), adnexal detorsion (11.8%), hemoperitoneum drainage (11.8%), hysterectomy (5.9%), and appendectomy (5.9%). The overall median operative time was 38 [18–72] minutes. The median estimated intraoperative blood loss was 30 [5−150] mL, and no intraoperative complications occurred. Conversion to conventional laparoscopy or laparotomy was never needed. Patients stayed hospitalized for a median time of 30 [4−144] hours after the intervention. The median visual analog scale value for postoperative pain evaluation was 2 [0−5] at 12, 24, and 48 postoperative hours. No complications associated with the procedure occurred.</p></div><div><h3>Conclusions</h3><p>This study demonstrated the feasibility of performing vNOTES procedures for managing gynecological emergencies such as tubal ectopic pregnancy, adnexal torsion, painful ovarian lesions, post-hysterectomy hemoperitoneum, and uncontrollable uterine bleeding. Associated with data reported in the available literature, our results suggest potential benefits in treating gynecological emergencies by vNOTES over conventional laparoscopy. However, stronger evidence from larger studies is needed to confirm it.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161323000868/pdfft?md5=eeac0ea831b35ff28f79a35bc4d660f5&pid=1-s2.0-S2590161323000868-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138412814","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}