Clinica e Investigacion en Ginecologia y Obstetricia最新文献

{"title":"From fasting to feasting: Unraveling the postoperative benefits of preoperative carbohydrate intake in cesarean delivery—A systematic review and meta-analysis","authors":"R.A. Kasem ,&nbsp;A. Attalla ,&nbsp;A. Ramadan ,&nbsp;A. Tawfik ,&nbsp;A. Salmona ,&nbsp;M.K. AbdElhaseeb","doi":"10.1016/j.gine.2025.101039","DOIUrl":"10.1016/j.gine.2025.101039","url":null,"abstract":"<div><h3>Objectives</h3><div>Preoperative fasting is a common practice in cesarean section deliveries, but prolonged fasting can have negative effects on patient outcomes. Preoperative carbohydrate intake has been proposed as a way to mitigate these effects. The purpose of this systematic review and meta-analysis is to assess the potential benefits and complications of preoperative oral carbohydrates in women undergoing cesarean section (CS).</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Cochrane, Web of Science, and Scopus databases until August 2023. Randomized controlled trials (RCTs) that compared preoperative oral carbohydrates to a placebo or fasting group in pregnant women undergoing CS were included. The outcomes included vomiting, insulin resistance, amount of bleeding, plasma glucose and serum insulin.</div></div><div><h3>Results</h3><div>We included five RCTs with a total of 2275 cases. According to the meta-analysis results, preoperative oral carbohydrates significantly reduced postoperative serum insulin levels (SMD<!--> <!-->=<!--> <!-->−0.58, 95% CI [−0.95 to −0.21], <em>P</em> <!-->=<!--> <!-->0.002) and insulin resistance (SMD<!--> <!-->=<!--> <!-->−0.32, 95% CI [−0.58 to −0.07], <em>P</em> <!-->=<!--> <!-->0.01) compared to control groups. However, preoperative oral carbohydrates did not have a significant effect on postoperative vomiting (RR<!--> <!-->=<!--> <!-->0.96, 95% CI [0.77–1.20], <em>P</em> <!-->=<!--> <!-->0.73), the amount of bleeding (SMD<!--> <!-->=<!--> <!-->−0.17, 95% CI [−0.52 to 0.18], <em>P</em> <!-->=<!--> <!-->0.34) or plasma glucose levels (SMD<!--> <!-->=<!--> <!-->−0.12, 95% CI [−0.29 to 0.05], <em>P</em> <!-->=<!--> <!-->0.17).</div></div><div><h3>Conclusion</h3><div>Preoperative oral carbohydrates can improve metabolic outcomes, specifically reducing postoperative serum insulin levels and insulin resistance in women undergoing CS, without increasing the risk of vomiting. However, they did not significantly affect the amount of bleeding or plasma glucose levels.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101039"},"PeriodicalIF":0.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090266","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":"Radiofrequency treatment value for uterine fibroids in pregnant and infertile women","authors":"M. Bonet-Sánchez ,&nbsp;I. Pelayo-Delgado","doi":"10.1016/j.gine.2025.101052","DOIUrl":"10.1016/j.gine.2025.101052","url":null,"abstract":"<div><div>Radiofrequency ablation of uterine fibroids is a technique based on the application of a high-frequency electrical current, causing a coagulative necrosis of the fibroid. The aim of this review is to analyse the influence of radiofrequency treatment of fibroids in women with gestational desire and its influence on pregnancy, through the compilation and study of recent articles. Radiofrequency has achieved a similar number of full-term births compared to that of surgical myomectomy, which until now has been the gold standard treatment for women with myomas desiring pregnancy. It also seems to increase obstetric security in pregnant women previously treated compared to other techniques, with fewer rate of preterm deliveries, spontaneous abortions and placental changes. However, more randomized clinical trials focusing specifically on pregnancy are necessary to reach definitive conclusions.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101052"},"PeriodicalIF":0.1,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937202","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":"Impact of deep endometriosis with and without ovarian involvement on quality of life compared to exclusive ovarian endometriosis","authors":"M.d.P. Marín Sánchez ,&nbsp;M. Martínez-Esparza ,&nbsp;P. García-Peñarrubia ,&nbsp;A.J. Ruiz-Alcaraz ,&nbsp;J.J. Arense-Gonzálo","doi":"10.1016/j.gine.2025.101053","DOIUrl":"10.1016/j.gine.2025.101053","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate potential differences in quality of life between patients with deep endometriosis, with or without ovarian involvement (DE), and those with exclusive ovarian endometriosis (OMA).</div></div><div><h3>Material and method</h3><div>A prospective observational study was conducted on patients diagnosed with endometriosis through clinical assessment and imaging techniques, or histological confirmation. Patients were labeled as OMA or DE. Clinical data such as pain (visual analogue scale), demographic and anthropometric data, and QoL (SF-12v2 scale) were evaluated. Statistical analysis was performed using IBM SPSS 25.0.</div></div><div><h3>Results</h3><div>A total of 307 patients were enrolled, 109 with OMA and 198 with DE. Patients with OMA were younger than those with DE. QoL in the physical domain was lower in DE compared to OMA (46<!--> <!-->±<!--> <!-->11.91 vs 49.9<!--> <!-->±<!--> <!-->9.4; <em>p</em> <!-->&lt;<!--> <!-->0.02). No statistically significant differences were observed in the mental domain (41.5<!--> <!-->±<!--> <!-->10.2 vs 42.8<!--> <!-->±<!--> <!-->11; <em>p</em> <!-->&lt;<!--> <!-->0.276). Pain scores on the visual analogue scale did not differ significantly between groups. However, in the pain domain of the SF-12v2 scale, significant differences were found, with lower scores in DE (61.4<!--> <!-->±<!--> <!-->32.7 vs 73.6<!--> <!-->±<!--> <!-->28.6; <em>p</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>QoL scales should be utilized in clinical practice as they provide valuable insights into how the disease impacts patients’ lives. Patients with deep endometriosis have a poorer QoL in the physical domain compared to those with exclusive ovarian endometriosis.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101053"},"PeriodicalIF":0.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929403","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":"How to perform a fetal neurosonography: Key points","authors":"B. Puerto ,&nbsp;P. Azumendi ,&nbsp;C. Corrales ,&nbsp;G. Azumendi","doi":"10.1016/j.gine.2025.101050","DOIUrl":"10.1016/j.gine.2025.101050","url":null,"abstract":"<div><div>Congenital anomalies of the Central Nervous System are one of the most important and numerous groups of congenital malformations. They constitute the second cause of disability in childhood and more than 95% occur in a population without known risk. The most effective strategy for its detection is to differentiate between 2 levels of care. The first level, the BASIC ULTRASONOGRAPHY, is performed on all pregnant women, while the second level, the DETAILED FETAL NEUROSONOGRAPHY, is performed in cases selected due to the risk of anomaly based on a list of indications or because an abnormality has been detected or suspected. CNS abnormality on basic ultrasound. Its purpose is to perform a complete morphological and biometric multiplanar analysis of all accessible and recognizable brain structures from the axial, coronal and sagittal planes, ideally through transabdominal and transvaginal access. In the 3 plans, an attempt should be made to evaluate the same structures, assuming the limitations posed by the different perspective provided by each of them. When performing it, it is essential to take into account the indication and gestational age, know the morphological patterns, have reference tables of the normality of the different intracranial structures for GD and follow the systematics proposed by scientific societies. The objective of this article is to describe the different planes and provide readers with the key points for the ultrasound detection of the most important and frequent malformations of the CNS.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101050"},"PeriodicalIF":0.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929404","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":"Abdominal access following insufflation with Veress needle at high pressure: A security maneuver for the reduction of surgical complications during laparoscopic access","authors":"F. Palomo-Rodriguez ,&nbsp;J. Gallardo-Martinez ,&nbsp;R.D. Brenner-Anidjar ,&nbsp;Z. Frias-Sanchez ,&nbsp;S. Rojo-Novo ,&nbsp;M. Pantoja-Garrido ,&nbsp;F.J. Pantoja-Rosso ,&nbsp;J.J. Fernandez-Alba","doi":"10.1016/j.gine.2025.101051","DOIUrl":"10.1016/j.gine.2025.101051","url":null,"abstract":"<div><h3>Introduction</h3><div>Up to 50% of laparoscopic complications arise during access maneuvers to abdominal cavity. Our aim is to determine whether elevated pressures of 20–25<!--> <!-->mmHg during these maneuvers, by increasing the distance between the abdominal wall and intracavitary organs, can help reduce the risk of entry-related complications, without an increase in anesthetic adverse effects.</div></div><div><h3>Methods and materials</h3><div>Prospective observational analytic multi-centered cohort study with 703 patients. The exposed-cohort consisted of patients undergoing gynecological laparoscopic surgeries in which an intra-abdominal pressure of 20–25<!--> <!-->mmHg was used (<em>group 20–25<!--> <!-->mmHg</em>) as opposed to the unexposed-cohort, in which usual<!--> <!-->&lt;<!--> <!-->15<!--> <!-->mmHg pressures (<em>group</em> <!-->&lt;<!--> <em>15<!--> <!-->mmHg</em>) were used. All surgeries were performed using the Veress needle as the method of insufflation.</div></div><div><h3>Results</h3><div>Patients in whom access was performed at pressures<!--> <!-->&lt;<!--> <!-->15<!--> <!-->mmHg had a higher risk of complications than those in whom elevated pressures of 20–25<!--> <!-->mmHg were used, which was statistically significant (OR 3.08, 95% CI95% 1.42–6.65, <em>p</em> <!-->=<!--> <!-->0.004), without finding differences regarding anesthetic complications (<em>p</em> <!-->=<!--> <!-->0.9).</div></div><div><h3>Conclusion</h3><div>The use of high intraabdominal pressure during access maneuvers serves as an effective technique for the prevention of complications, especially major complications, when compared with standard-used pressures, without increasing the incidence of anesthetic adverse effects, due to their temporary maintenance.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101051"},"PeriodicalIF":0.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143924578","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":"Peripartum anxiety symptoms and breastfeeding duration: Prospective observational study","authors":"M.J. Rol ,&nbsp;M.J. Cuerva ,&nbsp;A. Briones ,&nbsp;J.L. Bartha","doi":"10.1016/j.gine.2025.101038","DOIUrl":"10.1016/j.gine.2025.101038","url":null,"abstract":"<div><h3>Introduction</h3><div>There's a lack of effective screening methods to predict early breastfeeding cessation. Our study aimed to assess whether a simple screening of anxiety symptoms after the early postpartum period could help identify those families who discontinue exclusive and mixed breastfeeding early, despite their desire to breastfeed.</div></div><div><h3>Methods</h3><div>This prospective observational study, conducted at a single center, included women who were admitted to the postpartum ward following vaginal term births. Each participant was accompanied by their companions and babies and expressed a desire to breastfeed. Participants were divided into two groups based on whether they exhibited peripartum anxiety symptoms, assessed using the Hospital Anxiety and Depression scale (HADS). Follow-up assessments of the breastfeeding practices were conducted up to three years postpartum.</div></div><div><h3>Results</h3><div>A total of 113 eligible women participated in the study, with 92 women successfully followed up for three years. At six months postpartum, 56.5% of the women were exclusively breastfeeding, and 78.3% were still breastfeeding. No significant differences were observed in breastfeeding practices between the group exhibiting peripartum anxiety symptoms and the group without such symptoms.</div></div><div><h3>Conclusion</h3><div>Our approach, which concentrated on anxiety, did not yield an implementable screening tool for early breastfeeding cessation.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101038"},"PeriodicalIF":0.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881960","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":"Vólvulo del sigmoide secundario a torsión ovárica: reporte de caso","authors":"V. Monsalvo ,&nbsp;J.C. Corredor ,&nbsp;D. Pinzón","doi":"10.1016/j.gine.2025.101037","DOIUrl":"10.1016/j.gine.2025.101037","url":null,"abstract":"<div><div>Sigmoid volvulus is one of the main causes of intestinal obstruction in the world, leading to consequences that derive from the decrease in mesenteric blood supply that can condition partial intestinal resection, leading to important changes in the quality of life of patients. Ovarian torsion is a gynecological emergency that becomes important in the short, medium and long term due to the crucial role of ovarian function in hormonal regulation and fertility. Both entities can generate an acute surgical abdomen, however few cases have been described in the literature on the simultaneous presence of these pathologies. We present a case of sigmoid volvulus secondary to adnexal cyst with torsion, with successful surgical management with partial salpingo-oophorectomy + sigmoidectomy + terminal colostomy in a 33 year-old woman with no important medical history, in the Regional Hospital of Duitama (Boyacá, Colombia).</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101037"},"PeriodicalIF":0.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844242","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":"Development of a gynecological robotic surgery program with the Da Vinci system: Beginnings and consolidation","authors":"M.R. Noguero ,&nbsp;A. Azcoaga ,&nbsp;C. Valentín ,&nbsp;M. De Matías ,&nbsp;J.A. Rueda ,&nbsp;S. Bartolomé ,&nbsp;E. Abreu ,&nbsp;R. Barba ,&nbsp;A.B. Cuesta","doi":"10.1016/j.gine.2025.101035","DOIUrl":"10.1016/j.gine.2025.101035","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to evaluate the operative time, hospital stay and complications in patients undergoing robotic gynaecological surgery before and after completing the surgical team's learning curve.</div></div><div><h3>Methods</h3><div>Observational retrospective study that included 185 patients who underwent Da Vinci robot-assisted gynaecological surgery from January 2013 to December 2021 at the Gynaecology and Obstetrics Department of the Rey Juan Carlos University Hospital (Spain). The sample was divided into two groups: those conducted before and after the completion of the established learning curve, set at 35 procedures per surgeon.</div></div><div><h3>Results</h3><div>During the study period, 185 patients underwent robot-assisted gynaecological surgery, 77 (41.6%) during period one and 108 (58.4%) during period two after. The median reduction in operative time was 43<!--> <!-->min (95% CI 17–70) in period two compared to period one. The median length of hospital stay was two days (IQR<!--> <!-->=<!--> <!-->2–3) and one day (IQR<!--> <!-->=<!--> <!-->1–2) (<em>p</em> <!-->=<!--> <!-->0.001) respectively. There were no statistically significant differences in transfusion rates, complications, and readmissions.</div></div><div><h3>Conclusions</h3><div>Completing the learning curve significantly reduced the operative time and hospital stay. While there were fewer complications during the second period, these differences were not statistically significant.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101035"},"PeriodicalIF":0.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839377","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":"Pregnancy after uterine transplantation. What can we tell to women?","authors":"L. Melo,&nbsp;C. Sousa,&nbsp;I. Santos Silva","doi":"10.1016/j.gine.2025.101036","DOIUrl":"10.1016/j.gine.2025.101036","url":null,"abstract":"<div><div>Until 2014, the options available for women suffering from absolute uterine factor infertility (AUFI) to experience motherhood were adoption or surrogacy and uterine transplantation (UTx) changes this paradigm, emerging as a possible treatment for these patients and despite being associated with a significant risk of morbidity, with 3 or 4 surgeries and immunosuppression being indispensable until hysterectomy is performed, studies prove that pregnancy after UTx is possible, safe and capable of creating healthy newborns.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101036"},"PeriodicalIF":0.1,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823606","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":"Investigating the impact of sleep disorders on intracytoplasmic sperm injection outcome: A prospective observational study","authors":"M.K. Abd El-Haseeb,&nbsp;O.A. Soliman Sallam,&nbsp;M.S. Abd El-Hamed","doi":"10.1016/j.gine.2025.101034","DOIUrl":"10.1016/j.gine.2025.101034","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between sleep quality and outcomes of assisted reproductive technologies (ART), particularly intracytoplasmic sperm injection (ICSI), remains relatively unexplored. Understanding this association is crucial for optimizing fertility treatments and improving success rates. This study aimed to investigate the impact of sleep quality on ICSI outcomes and explore potential correlations with various variables.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted on 150 infertile couples undergoing ICSI treatment. Demographic, clinical, and sleep quality data were collected. Statistical analyses, including Spearman's correlation and multiple linear regression, were performed to assess the relationships between sleep quality, treatment variables, and outcomes.</div></div><div><h3>Results</h3><div>The mean age of participants was 32.71 years, with a majority residing in rural areas. No significant differences were found in pregnancy rates or embryo characteristics across different sleep quality groups. However, moderate positive correlations were observed between sleep quality scores and fertilization rates (<em>p</em> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>While sleep quality did not significantly impact ICSI outcomes in this study, moderate correlations were found with fertilization rates. Further research is needed to elucidate the complex interplay between sleep quality, reproductive treatments, and outcomes to optimize fertility care.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101034"},"PeriodicalIF":0.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815340","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}