Algeri Paola, Seca Marta, M. Marco, Clemente Francesco, A. Marco, Ciammella Massimo
{"title":"Meigs Syndrome: A Case Report and Literature Review","authors":"Algeri Paola, Seca Marta, M. Marco, Clemente Francesco, A. Marco, Ciammella Massimo","doi":"10.54646/bijg.001","DOIUrl":"https://doi.org/10.54646/bijg.001","url":null,"abstract":"Introduction: Meigs syndrome is defined by the presence of an ovarian benign tumor, ascites, and pleural effusion. The restoration of normal conditions following the removal of the ovarian mass is typical. Although an increase in CA 125 has been reported in association with Meigs syndrome, a level above 1000 IU/mL is unusual, and there is no clear association between patients’ or tumor/cancer characteristics and CA 125 increment to the best of our knowledge. Materials and methods: We conducted a review of Meigs syndrome cases associated with high CA 125 levels and then divided and compared all cases found in the literature and the one described in the text, taking into account the increase of CA 125 = 1000 IU/mL, to identify any possible factor influencing the CA 125 increase. Results: A 55-year-old woman with Meigs syndrome (hydrothorax, ovarian fibroma, and ascites) presented CA 125 of 1713 IU/mL. In our review, we found 43 articles that collected 55 cases of Meigs syndrome with an increase in CA 125 of 25% or more than 1000 IU/mL. Considering two groups, divided considering the CA 125 value of 1000 IU/mL, we found that the presence of bilateral masses and ascites over 2 L represented independent risk factors for high elevation of CA 125. Conclusion: The presence of bilateral mass and an increase in ascites were associated with an increase in CA 125 of 1000 IU/mL, which could be useful in maintaining a benign lesion hypothesis even if the definitive diagnosis could not be made until after surgery, at histological evaluation.","PeriodicalId":424107,"journal":{"name":"BOHR International Journal on Gynaecology","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126742601","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}
P. Algeri, M. Seca, Paola Fenili, Francesco Clemente, Gaya Selvaggia Bettoni, Patrizia D’Oria, M. Ciammella
{"title":"A First Trimester Scan may Reveal the Presence of Placenta Accreta. Absence of the Anterior Uterine Wall During Caesarean Section: An Unexpected Placenta Accreta that was Treated Conservatively","authors":"P. Algeri, M. Seca, Paola Fenili, Francesco Clemente, Gaya Selvaggia Bettoni, Patrizia D’Oria, M. Ciammella","doi":"10.54646/bijg.007","DOIUrl":"https://doi.org/10.54646/bijg.007","url":null,"abstract":"Objective. Placenta accreta spectrum (PAS) is a rare condition, but it is a potential life threating obstetric event. Case report. A second-time mother, 32 years old, has had a caesarean section before. At 11 weeks, a doubt about scar pregnancy was posed but not confirmed at subsequent serial ultrasound evaluations. A caesarean section was performed at 38.4 weeks for breech presentation. A placenta accreta, diagnosed during surgery and confirmed by histological evaluations, was visible at uterine examination with a lacuna in the anterior uterine wall. After fetal extraction, the surgeons opted for conservative management. Subsequent clinical and ultrasound follow-up described a patient in a good state of health with a progressively reduced intrauterine placenta residual. Conclusions. (1) Even in the absence of typical second- or third-trimester ultrasound signs, first trimester ultrasound played a role in posing the suspect of PAS. (2) Conservative management could be a safe option in cases of undiagnosed PAS, even if reported in the literature as a correlation with possible subsequent complications, which must be explained to the patient with adequate counseling.","PeriodicalId":424107,"journal":{"name":"BOHR International Journal on Gynaecology","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127469886","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}
M. Seca, Bettoni Gaya Selvaggia, Fenili Paola, Clemente Francesco, D’Oria Patrizia, Algeri Paola
{"title":"Uterine Rupture in Nulliparous Woman Without Risk Factors: A Case Report and Literature Review","authors":"M. Seca, Bettoni Gaya Selvaggia, Fenili Paola, Clemente Francesco, D’Oria Patrizia, Algeri Paola","doi":"10.54646/bijg.003","DOIUrl":"https://doi.org/10.54646/bijg.003","url":null,"abstract":"Objective: The aim of this study was to summarize the main features of spontaneous uterine rupture in primigravid patients before the onset of labor, emphasize the possibilities of therapeutic conduct, and offer points of reflection on the post-rupture management. Methods: We performed a literature review of all the individual case reports, retrospective case series, and reviews concerning uterine rupture in peer-reviewed journals from January 1975 to October 2021. Result: The diagnosis of uterine rupture was commonly made by abdominal pain, with or without concomitant nausea and vomiting. Uterine ruptures occur more frequently at the end of pregnancy or in the third trimester. The most frequently involved site is the uterine cornua followed by the posterior wall of the uterus. Other described cases identify the broad ligament, uterus sacral ligament, lower uterine segment, and anterior wall as possible points of rupture. The most frequently used suturing technique is the repair of the breach in two layers. Conclusion: Uterine rupture is an extremely rare obstetric emergency, correlated to life-threatening consequences for both the newborn and the woman. Considering the maternal and fetal risks, a tempestive diagnosis is mandatory.","PeriodicalId":424107,"journal":{"name":"BOHR International Journal on Gynaecology","volume":"08 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121140824","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}
Ranganayagi D., Saranya P., Sharmila M. J., Sujitha S., Annie Nisha T., Shanmugam K.
{"title":"Pre-eclampsia Risk Monitoring and Alert System Using Machine Learning and IoT","authors":"Ranganayagi D., Saranya P., Sharmila M. J., Sujitha S., Annie Nisha T., Shanmugam K.","doi":"10.54646/bijg.006","DOIUrl":"https://doi.org/10.54646/bijg.006","url":null,"abstract":"After 20 weeks of gestation, pre-eclampsia is characterized by newly developing hypertension. Preventative interventions only moderately lower a woman’s risk of pre-eclampsia due to its prevalence, the risk variables that have been found to be accurate in predicting its beginning, and the occurrence of pre-eclampsia. The signs and symptoms typically become visible toward the end of pregnancy (late second to early third trimester). Some of these tests are straightforward, while others are invasive; some have undergone significant research, while others are still being investigated in clinical settings. Pre-eclampsia has been linked, in particular, to cardiovascular sequelae in the fetus, such as hypertension and impaired vascular function. In our project, a system and an algorithm for evaluating the health status of pregnant women are proposed. Pre-eclampsia can cause major diseases and issues during pregnancy; thus, the system’s goal is to diagnose the condition early and monitor its risk. Our research examines the diagnostic options for early risk assessment to identify pregnant women at high risk for pre-eclampsia and the possible advantages for the women, the unborn child, and health-care systems. A system like this will be widely used in clinical obstetric practice. It is designed to be implemented to monitor pregnant women’s status updates through the Internet of Things based on machine learning.","PeriodicalId":424107,"journal":{"name":"BOHR International Journal on Gynaecology","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116224152","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}
Prethi Mallick, Sanchari Chakraborty, Randrita Pal, Ankita Samaddar, S. Saha, B. Basu
{"title":"Readdressing pathophysiology of polycystic ovary syndrome in post-COVID new normal era: A pilot study","authors":"Prethi Mallick, Sanchari Chakraborty, Randrita Pal, Ankita Samaddar, S. Saha, B. Basu","doi":"10.54646/bijg.2023.08","DOIUrl":"https://doi.org/10.54646/bijg.2023.08","url":null,"abstract":"Background: Polycystic ovary syndrome or PCOS is a complex endocrinopathy in women of reproductive age. The diversified expression pattern of this polygenic syndrome and its complex association with modulation in nutritional status, anthropometric indices, and biochemical parameters are still in puzzle. The COVID-19 pandemic has worsened the existing crosstalk by changing lifestyle management toward more home confinement as well as sedentary. Aims and objectives: This study aimed to understand the effect of altered dietary patterns, anthropometric parameters like various adiposity indices, and biochemical parameters related to hyperandrogenism (HA) on the penetrance of PCOS in a new normal situation. Design: PCOS individuals (n = 50) and their age- and gender (18–36 years)-matched healthy control (n = 50) were recruited in this study. Materials and methods: A food frequency questionnaire (FFQ), a bioimpedance analyzer (BIA), and biochemical assays were used to estimate different indices of the participants. Statistical analysis: IBM SPSS (Statistical Package for the Social Sciences), Version 20.0, Armonk, NY, was applied for analyzing quantitative variables (P < 0.05 and P < 0.01 indicate significance level). Results: Consumption of dietary fat (P < 0.01) and carbohydrates (P < 0.05) was significantly higher in PCOS individuals compared to the control one; 94% of PCOS patients were found to be under oligomenorrhea+polycystic ovaries (O+PCO) category. The body fat content (P < 0.01 and 0.05) along with androgen exposure (digit ratio2D:4D, P = 0.000) was significantly higher in PCOS individuals relative to the control group. HA was highly prevalent in the PCOS group where 100% of them manifested alopecia, and significant (P < 0.01) correlation between free testosterone (free T) and free sex-hormone-binding-globulin (free SHBG). Low-density lipoprotein (LDL) was strongly associated with waist-to-height ratio (WHtR, P = 0.02) and body mass index (BMI, P = 0.041) in the same way as homeostatic model assessment for insulin resistance (HOMA-IR) with visceral adiposity index (VAI, P = 0.002) and lipid accumulation product (LAP, P = 0.014) index in PCOS individuals. Additionally, the triglyceride glucose (TyG) index was normally distributed (Kolmogorov–Smirnov test = 0.20) in PCOS individuals. Conclusion: Abnormal alternation in dietary patterns and anthropometric and biochemical indices could be promising indicators for early detection and better prognosis of this multifaceted syndrome.","PeriodicalId":424107,"journal":{"name":"BOHR International Journal on Gynaecology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130696810","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":"Diagnostic Accuracy in the Detection of Depth of Myometrial Invasion with MRI in Early-Stage Endometrial Cancer","authors":"Ujwala Prakash Wakpaijan","doi":"10.54646/bijg.004","DOIUrl":"https://doi.org/10.54646/bijg.004","url":null,"abstract":"Objective: To study the diagnostic accuracy of pre-operative magnetic resonance imaging (MRI) in early-stage endometrial cancer with postoperative International Federation of Gynecology and Obstetrics (FIGO) staging after comprehensive staging surgery. Methods: Retrospectively, the medical records of 78 patients with early-stage endometrial cancer were analysed for the involvement of the myometrium with the tumour by diagnostic MRI and compared with histopathological reports after surgical staging. Results: The median age of patients was 56 years (ranging from 32 to 73). The median body mass index (BMI) of these women was 29 (ranging from 20 to 40). On histopathology, 72 women (92.3%) had type I endometroid endometrial cancer and 6 (7.7%) had type II carcinoma; four had papillary serous carcinoma, one had clear cell carcinoma and one had undifferentiated carcinoma. However, 43 (55.1%) had a grade I tumour, 12 (15.1%) had a grade II tumour and 17 (21.6%) had a grade III tumour. Further, 35 (44.8%) were staged laparoscopically, and 43 (55.1%) underwent open staging laparotomies. Pre-operative MRI radiological staging was carried out on all patients before surgery. However, 52 (66.7%) had stage IA disease, which suggested less than half of myometrial infiltration by tumour. Further, 21 (26.9%) showed more than half myometrial infiltration stage IB. One (1.2%) patient had stage IIIC1 disease with pelvic nodes of 2.5 × 2 cm near the obturator fossa; one (1.2%) patient had retroperitoneal nodes and para-aortic nodes of the largest 2 × 2 cm; three patients (3.8%) showed involvement of the endocervix with the tumour. Patients were histopathologically staged postoperatively according to the FIGO classification following complete staging surgery. Further, 46 (59%) were stage IA, 26 (33.3%) were stage IB, 3 (3.8%) showed stage II and 3 (3.8%) had stage IIIC1. The sensitivity for MRI for stage IA was 95.65% with (85% to 99.4%) 95% CI. The specificity was 75%, with 56.6% to 88.55 of the 95% CI. The positive likelihood ratio was 3.83, with a 95% confidence interval of 2.09 to 6.99. The sensitivity of MRI for stage IB was 69.23%, ranging from 48.2% to 85.6% of the 95% CI. The specificity was 94.23%, with 84% to 98% of the 95% CI. The positive likelihood ratio was 12, with a 95% confidence interval of 3.8 to 37. Conclusion: A pre-operative MRI contributes to the accurate staging of endometrial cancer to allow planning for the scale of the surgery. This is important for pre-operative counselling. The depth of myometrial infiltration aids in the planning of pelvic and para-aortic lymphadenectomy. Our study is comparable with the results of previous studies.","PeriodicalId":424107,"journal":{"name":"BOHR International Journal on Gynaecology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132208245","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}
P. Algeri, Maria Donata Spazzini, Nina Pinna, M. Seca, T. Tomaselli, Riccardo Campanile Garruto, Antonella Villa
{"title":"Large Anechogenic “Holes” in the Uterus: The Utility of Contextual Combination of Ultrasound and Hysteroscopy","authors":"P. Algeri, Maria Donata Spazzini, Nina Pinna, M. Seca, T. Tomaselli, Riccardo Campanile Garruto, Antonella Villa","doi":"10.54646/bijg.005","DOIUrl":"https://doi.org/10.54646/bijg.005","url":null,"abstract":"Cystic adenomyosis is a rare occurrence, especially in young patients. We report a challenging case of a 44-year-old African patient, in which the ultrasound described a large bilobate anechogenic cyst in the myometrium. The combination of ultrasound, contextual hysteroscopy, and subsequent magnetic resonance imaging helped to clarify the case, reducing the risk of complications for the patient, potentially due to misdiagnosis.","PeriodicalId":424107,"journal":{"name":"BOHR International Journal on Gynaecology","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128309300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Study to Examine the Relationship Between Mothers’ Psychosocial Status and Pregnancy Outcome","authors":"Minal Milind Patharkar","doi":"10.54646/bijg.002","DOIUrl":"https://doi.org/10.54646/bijg.002","url":null,"abstract":"Pregnancy is the most wonderful experience of a woman’s life. A mother’s physical fitness is just as important as her mental health. A non-experimental and correlational study was conducted to examine the relationship between mothers’ psychosocial status and pregnancy outcome among 50 antenatal mothers in their third trimester. The aim of the study is to assess the psychosocial status of antenatal care (ANC) mothers, assess the pregnancy outcome, and find out the correlation between psychosocial status and pregnancy outcome. Result: In this study, using the ALPHA scale to assess the psychosocial status of antenatal mothers, the majority of them had a higher psychosocial score, and some had a middle psychosocial score, but none had a low psychosocial score. Conclusion: From this study, we conclude that there was an association between psychosocial status and pregnancy outcome.","PeriodicalId":424107,"journal":{"name":"BOHR International Journal on Gynaecology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131416786","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}