Clinica e Investigacion en Ginecologia y Obstetricia最新文献

{"title":"Evaluation of hopelessness in patients with endometriosis","authors":"M.d.P. Marín Sánchez ,&nbsp;O. Carratalá Pérez ,&nbsp;A. Martínez Gómez ,&nbsp;R. Oliva Sánchez ,&nbsp;A. Nieto Díaz","doi":"10.1016/j.gine.2023.100936","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100936","url":null,"abstract":"<div><h3>Purpose</h3><p>To explore the prevalence of hopelessness in patients diagnosed with endometriosis and how it may influence their relationships.</p></div><div><h3>Material and methods</h3><p>Prospective–descriptive study among patients with a clinical and/or anatomopathological diagnosis of endometriosis. Demographic data (age, religion, educational level, marital status, occupation, etc.) and pain data have been processed. Pain associated with endometriosis has been evaluated with an analogue scale of pain. The Beck Hopelessness Scale (BHS) was used to determine the level of hopelessness. The results have been classified into 0–3 normal; 4–8 mild; 9–14 moderate and 15–20 severe. SPSS Statistics 26 has been used and the statistical significance has been stipulated at <em>p</em> <!-->&lt;<!--> <!-->0.05.</p></div><div><h3>Results</h3><p>One hundred and ten patients have been recruited with an average age of 39.8<!--> <!-->±<!--> <!-->7.09 years. The average on the Beck Hopelessness Scale is 5.08 with a SD 3.14. In our sample, we obtained that 38.2% of women experienced some level of hopelessness at the time the questionnaire was completed (mild<!--> <!-->=<!--> <!-->28.2%, moderate<!--> <!-->=<!--> <!-->9.1%, severe<!--> <!-->=<!--> <!-->0.9%). We found a significant relation between hopelessness and low income but not with regard to education, employment status or marital status.</p><p>Regarding the pain experienced and its relation with hopelessness, we found that it was significantly connected to pain during urination and dyspareunia and not to chronic pelvic pain dysmenorrhea and dyschezia.</p></div><div><h3>Conclusion</h3><p>Four out of ten patients with endometriosis experience hopelessness, mostly mildly. This hopelessness is influenced by demographic factors such as income level and also pain, specifically pain during intercourse and during urination.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100936"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139434418","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":"Aplicación de la clasificación de Robson como método útil para estandarizar el manejo del parto. Un ejercicio que reduce la tasa de cesáreas","authors":"L. Pastor ,&nbsp;R. Garcia-Jimenez ,&nbsp;I. Valero ,&nbsp;C. Borrero ,&nbsp;L. Castro ,&nbsp;J.A. Garcia-Mejido ,&nbsp;J.A. Sainz Bueno","doi":"10.1016/j.gine.2023.100935","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100935","url":null,"abstract":"<div><h3>Background</h3><p>Cesarean section rate is controversial and the Robson classification is a method for standardizing the evaluation of the causes of cesarean section. The aim of this study was to evaluate whether the measures to improve prenatal and intrapartum management implemented after the Robson classification evaluation lead to a decrease in the rate of cesarean sections without increasing the rates of neonatal and maternal morbidity and mortality.</p></div><div><h3>Material and method</h3><p>Quasi-experimental study before-after,between-2019 and 2020, including a total of 2181 patients with delivery at Hospital-Universitario-Valme(1027 patients in Group-2019, and 1154 patients in group-2020)..</p></div><div><h3>Results</h3><p>We observed that there was a statistically significant decrease in the cesarean section rate between 2019 and 2020 (21.0% vs 15.8%; p = 0.001) without the decrease being significant in any study subgroup. There was a lower rate of induced labor(29.3% vs 24.6%; p = 0.01), an increased rate of vaginal delivery (79.0% vs 84.2%; p = 0.001), both eutocic and instrumental deliveries (57.9% vs 60.3%; 21% vs 23.9%; p = 0.005) and a statistically significant decrease in the rate of cesarean sections due to failure of induction or non-progression of labor(34.7% vs 20.9%;p = 0.008). In inductions using the balloon-Cook we observed a decrease in the rate of cesarean section (45.3% versus 22.2% p = 0.001). We found a decrease in the percentage of admission to the Neonatal ICU (10.5% vs 7.6%; p = 0.016) and global neonatal morbidity(11.4% vs 8.2%; p = 0.013) without observing a difference in maternal outcomes.</p></div><div><h3>Conclusions</h3><p>The application of the Robson classification can be a useful method to identify groups that require the application of specific measures aimed at standardizing the management of these patients, thus allowing to reduce the rate of cesarean sections.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100935"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139399298","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":"Gestación tras cáncer","authors":"C. Mula ,&nbsp;C. Galan ,&nbsp;M. López","doi":"10.1016/j.gine.2023.100931","DOIUrl":"10.1016/j.gine.2023.100931","url":null,"abstract":"<div><p>Pregnancy or reproductive desire in people with a previous cancer represents a clinical situation of increasing frequency that requires a global approach.</p><p>Preconceptional counseling is mandatory in these cases and should include a global assessment and multidisciplinary coordination between specialists in oncology, fertility and obstetrics or maternal-fetal medicine. The objective of this assessment includes determining the optimal time-to-pregnancy safe for the mother, without worsening the prognosis of the disease and planning the pregnancy follow-up according to possible maternal or perinatal complications.</p><p>This review details the most relevant reproductive aspects of three of the most frequent types of cancer during reproductive age: breast cancer, cervical cancer and hematological cancers.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100931"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139640884","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":"Tratamiento médico del aborto del primer trimestre: igual eficacia, más eficiencia","authors":"A. Tomaizeh Gómez,&nbsp;A. Armijo Sánchez,&nbsp;J. Boned López,&nbsp;E. Arroyo Estevez","doi":"10.1016/j.gine.2023.100934","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100934","url":null,"abstract":"<div><h3>Background</h3><p>Early pregnancy loss occurs in 10-20% of all clinical pregnancies, 85% being prior to week 12 of amenorrhea. Miscarriage entails a very significant burden on healthcare resources, reaching a national economic cost in the United Kingdom of £471 million per year (€533.06 million), a figure that can be extrapolated to other industrialized countries. According to a recent systematic review, there are no well-designed trials in first-trimester pregnancies that provide consolidated evidence on what is the best first-trimester abortion treatment method, and there are different studies that have tried to demonstrate cost reduction with contradictory results.</p></div><div><h3>Material and methods</h3><p>An observational, retrospective and longitudinal design study was carried out. 892 patients diagnosed with spontaneous abortion during the first trimester of pregnancy were reviewed, in the period between January 2013 and December 2016.</p><p>In our study, we wanted to evaluate the efficacy of vaginal misoprostol as a medical treatment for spontaneous abortion in the first trimester, in comparison with obstetric curettage-evacuator, and to quantify the difference in the costs of both procedures through a cost minimization study. costs.</p></div><div><h3>Results</h3><p>Of the 892 recruited patients, medical treatment with misoprostol was performed in 517 (57.95%) and surgical treatment by curettage in 375 (42.05%).</p><p>The effectiveness of medical treatment was 82% (426/517). With respect to surgical treatment the effectiveness of 100%. The success rate of medical treatment was higher in the subgroup of patients with incomplete abortion (92.9%), compared to the anembryonic gestation (85.7%) and delayed abortion (78.2%) groups.</p></div><div><h3>Conclusions</h3><p>The medical treatment of abortion is a safe management and accepted by the patients. The adequate selection of candidate patients leads to an increase in the success rate and a decrease in costs. In our study, an important total saving of €576,847.92 (37.14%) with respect to surgical treatment will be reduced. Given that the effectiveness is comparable and patient satisfaction is high, although it could be improved, we believe that with adequate information and homogenization of the applied treatment, it is safe.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100934"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139100576","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":"Abortion by request in advanced maternal age: What changes in contraception?","authors":"V. Vieira ,&nbsp;C. Silva ,&nbsp;A. Português Duarte,&nbsp;I. Santos Silva","doi":"10.1016/j.gine.2023.100932","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100932","url":null,"abstract":"<div><h3>Overview and aim</h3><p>Pregnancy at an advanced maternal age has become a reality. The acceptance rate of an unwanted pregnancy in this age group is lower, resulting in a higher proportion of pregnancy interruptions. This study aims to characterize abortion by request (AR) in advanced maternal age.</p></div><div><h3>Methods</h3><p>Descriptive study of AR requested by women aged 40 years old or older, over a period of six years, in an Obstetrics service of a Portuguese tertiary hospital. Descriptive data analysis was performed using SPSS® version 26.</p></div><div><h3>Results</h3><p>194 women were included in the study (<em>n</em> <!-->=<!--> <!-->194), with a median age of 42 years, most of them Portuguese (94.3%) and with no history of performing AR (75.2%). The contraceptive methods used prior to AR were used oral contraception (47.0%) and barrier contraception (39.1%). Medical abortion was performed in the entire sample, with a success rate of 96.9%. After AR, intrauterine contraception (44.3%), oral contraception (22.7%) and the vaginal ring (7.2%) were the preferred contraceptive methods.</p></div><div><h3>Discussion/Conclusions</h3><p>Changes in women's health and contraceptive needs motivate new approaches and contraceptive strategies. After AR, a significant percentage of woman chose long-term and non-user-dependent methods. Particularly in women aged 40 or over, these methods, in addition to their highly effective and safe contraceptive role, may bring additional non-contraceptive benefits, namely the therapeutic effect in abnormal uterine bleeding.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100932"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0210573X23001028/pdfft?md5=2a39d6613839ea23fb7cce7ca55d9a37&pid=1-s2.0-S0210573X23001028-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139033777","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":"Conceptos de criobiología y fisiología ovárica en la preservación de la fertilidad","authors":"M. Méndez ,&nbsp;Y. Cívico ,&nbsp;G. Casals","doi":"10.1016/j.gine.2024.100948","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100948","url":null,"abstract":"<div><p>Cryobiology focuses on understanding how biological materials react to very low temperatures. This field has experienced significant advances, particularly in the field of assisted reproduction, where programs have been developed to preserve fertility. These developments are of critical importance for those exploring alternatives in fertility and gamete preservation. Fertility preservation aims to protect a person's reproductive capacity under various health conditions, medical treatments, and social reasons that may compromise it. Accepted techniques for human fertility preservation include the cryopreservation of gametes and embryos. There is growing promising evidence on different experimental techniques within this field, such as cryopreservation of gonadal tissue or in vitro maturation strategies, as well as new methodologies in cryogenic protocols that will optimize results and mark a turning point in the field of assisted reproduction. This work aims to explore the current state-of-the-art strategies offered to women in the context of fertility preservation, review advances in cryobiology, and its role in the evolution of this area.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100948"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941622","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":"Fertility preservation in endometriosis: Review of current evidence and best practices","authors":"M. Carbonell,&nbsp;M.A. Perelló,&nbsp;J. Herrero","doi":"10.1016/j.gine.2024.100951","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100951","url":null,"abstract":"<div><p>In recent decades, the field of female fertility preservation has experienced substantial growth. Reliable techniques such as cryopreservation of oocytes and ovarian tissue have emerged, along with more established methods such as embryo freezing. Among the group of patients who can benefit from these new techniques are patients with endometriosis, a common disease capable of compromising ovarian reserve and fertility prospects. Unfortunately, comprehensive recommendations for fertility preservation in patients with endometriosis are still lacking.</p><p>This narrative review comprehensively explores fertility preservation in patients with endometriosis, using a range of relevant literature, including available national and international guidelines. Additionally, it explains the weight of several factors that contribute to the decision-making process for fertility preservation, including age, severity of endometriosis, ovarian reserve, and previous or future surgery.</p><p>This manuscript summarizes available recommendations that provide guidance for this vital but challenging aspect of reproductive medicine. Underlines the need for personalized care for patients with an early diagnosis of endometriosis and initial medical treatment to try to reduce the deterioration of ovarian reserve and emphasizes the importance of research to refine fertility preservation strategies in people with endometriosis.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100951"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139898684","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":"Estudio de la microbiota vaginal en los resultados de la terapia de reproducción asistida","authors":"J. Rodríguez Sánchez-Reyman,&nbsp;P. Luque González,&nbsp;M. Pineda Mateo","doi":"10.1016/j.gine.2023.100930","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100930","url":null,"abstract":"<div><p>The microbiome of the female genital tract is essential to maintenance a healthy environment. The normal vaginal microbiota is defined by the abundance of <em>Lactobacillus</em>. These microbes confer the host vagina protection from potentially pathogenic microorganisms that may cause urinary tract infections and sexually transmitted diseases. Changes in the vaginal microbiota due to inherent factors, such as age or menstrual period, or external factors like sexual activity or pregnancy, can lead to microbial dysbiosis and the development of pathologies in relation of reduced rates of conception. It has also been suggested that vaginal microbiota may play a key role in the success of assisted reproductive therapies. The objective of this review is to identify and evaluate trials of the vaginal microbiota role in women's health and human reproduction.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100930"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139033778","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":"Impacto de la fragmentación del ADN espermático y la tecnología de microfluidos en los resultados de fecundación in vitro","authors":"S. Cívico Vallejos,&nbsp;Y. Cívico Vallejos,&nbsp;B. Hernández Dacruz","doi":"10.1016/j.gine.2023.100937","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100937","url":null,"abstract":"<div><p>An accurate diagnosis in infertile patients is key to determine the treatment of choice in an assisted reproduction program. In the case of the male, the initial diagnosis is based on the result of the semen analysis. The semen analysis can detect problems related to the couple's infertility, but it is insufficient for the correct diagnosis of male infertility, since it does not predict the functional capacity of the spermatozoa. In recent years, multiple studies have appeared that relate sperm ADN integrity to fertility. At the same time, IVF laboratories have within their reach new methods of sperm selection, such as microfluidics, which would make it possible to reduce the degree of ADN fragmentation in the sample. In this paper we review the impact of sperm ADN fragmentation and the use of microfluidic devices on IVF outcomes based on a selection of relevant studies published up to February 2023.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 2","pages":"Article 100937"},"PeriodicalIF":0.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139434419","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":"Herlyn–Werner–Wünderlich syndrome: A case series","authors":"M. Castillo Lara,&nbsp;L. De Pablo Zamora,&nbsp;E. Pozuelo Solis","doi":"10.1016/j.gine.2023.100912","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100912","url":null,"abstract":"<div><h3>Introduction</h3><p>Herlyn–Werner–Wünderlich syndrome is a uterine malformation characterized by uterus didelphys, obstructed hemivagina and ipsilateral renal agenesis.</p></div><div><h3>Clinical findings</h3><p>The manifestation of the disease is widely diverse; it is usually diagnosed after menarche, with dysmenorrhea and abnormal uterine bleeding; it is also associated with infertility.</p></div><div><h3>Main diagnosis</h3><p>Four clinical cases, their diagnosis are reported here.</p></div><div><h3>Therapeutic interventions and results</h3><p>The treatment and results of these four patients are described here.</p></div><div><h3>Conclusion</h3><p>When studying uterine malformation it is important to consider this rare disease to avoid possible complications and giving the patient a correct diagnose and treatment. The hysteroscopy resection of the longitudinal vaginal septum in those symptomatic patients with hematocolpos should be considered as a good option for treatment.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100912"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49851026","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}