Ceska Gynekologie-Czech Gynaecology最新文献

{"title":"Low-volume regional lymph node metastasis in endometrial cancer - 2024 update.","authors":"Dita Münzová, Petra Bretová, Jitka Hausnerova, Markéta Bednaříková, Luboš Minář, Vít Weinberger","doi":"10.48095/cccg2025158","DOIUrl":"https://doi.org/10.48095/cccg2025158","url":null,"abstract":"<p><p>Due to the implementation of sentinel lymph node ultrastaging, the prevalence of isolated tumor cells and micrometastases have increased. This literature review comprises of articles published between January 2019 and September 2024 aiming at low-volume metastases in regional lymph nodes, their prognosis, and links to molecular classification. Micrometastases are currently considered as having metastatic lymph node involvement; however, they have a better prognosis than macrometastases. Accordingly, therapy is tailored. In contrast, isolated tumor cell presence is not considered metastatic involvement according to International Federation of Gynecology and Obstetrics (FIGO) 2023 staging and does not affect the therapeutic procedure because their significant prognostic importance has not been proven so far.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 2","pages":"158-162"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151687","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":"Management of various types of ectopic pregnancy - a questionnaire study.","authors":"Barbora Švédová, Martin Hruda, Vít Drochýtek, Michael Jiří Halaška, Kateřina Maxová, Nikola Janovská, Helena Součková, Anna Babková, Lukáš Rob, Borek Sehnal","doi":"10.48095/cccg2025141","DOIUrl":"https://doi.org/10.48095/cccg2025141","url":null,"abstract":"<p><strong>Objective: </strong>To map management of different types of ectopic pregnancies in the Czech Republic using a questionnaire-based study.</p><p><strong>Methods: </strong>In 2023, a total of 95 obstetrics and gynecology departments across the Czech Republic were surveyed using an online questionnaire, which inquired about the management strategies for various types of ectopic pregnancies. The departments were categorized based on the number of hysterectomies performed annually. Differences in responses between large centers and other departments were statistically compared.</p><p><strong>Results: </strong>A total of 45 departments of all sizes completed the questionnaire. Two-thirds of all departments always perform salpingectomy in cases of tubal pregnancy (78% of large, 58% of medium-sized, and 40% of small departments). Systemic methotrexate administration for the treatment of intact tubal pregnancy is used by one-fifth of departments (22% of large, 23% of medium-sized, and 0% of small departments). In cases of atypical ectopic pregnancy localization, methotrexate treatment is used by 33% of large, 42% of medium-sized, and 40% of small departments. A statistically significant difference was observed in the clearly preferred laparoscopic approach for surgical management of cesarean scar pregnancy in large centers compared to smaller departments (P = 0.036). No other statistically significant differences were observed between the departments in other parameters.</p><p><strong>Conclusion: </strong>In cases of intact tubal pregnancy, four-fifths of obstetric and gynecological departments perform laparoscopic salpingectomy, while only one-fifth utilize systemic methotrexate for treatment. On the other hand, methotrexate is used by one-third to two-fifths of departments of all sizes in cases of atypical ectopic pregnancy localization.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 2","pages":"141-148"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151699","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":"Sexual function in women with pelvic organ prolapse.","authors":"Samuel Tvarožek, Martina Szypulová, Anežka Šteflová, Martin Huser, Zdeněk Rušavý","doi":"10.48095/cccg202564","DOIUrl":"10.48095/cccg202564","url":null,"abstract":"<p><p>A woman's sexuality is a complex phenomenon involving several factors, among which age and health are the most important. However, other aspects are not negligible. The impact of pelvic organ prolapse on sexual function cannot be ignored, as the reported prevalence of pelvic organ prolapse in female population exceeds 50%. This article presents a systematic review of articles dealing with the impact of pelvic organ prolapse on female sexual function. Sexual dysfunction is common in women with pelvic organ prolapse, regardless of prolapse stage or the compartment affected. Estrogen therapy has no effect on sexuality in women with prolapse, while pelvic floor muscle training may provide some improvement. There is no evidence that conservative therapy using a pessary is associated with negative impact on sexual function. Native tissue repair tends to improve sexual function in general, except for posterior colporrhaphy, which was frequently associated with dyspareunia. No correlation between postoperative vaginal length and change in sexual function was identified. The impact of transvaginal mesh repair on sexuality remains unclear. In contrast, there is enough evidence proving that sacrocolpopexy significantly improves sexual function in women.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"64-70"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674686","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":"Analysing risk factors for foetal growth outcomes - the influence of maternal conditions and congenital cytomegalovirus infection.","authors":"Miroslava Mandžáková, Jozef Záhumenský, Eva Vajdová, Zuzana Matušíková, Monika Rosoľanková, Peter Papcun","doi":"10.48095/cccg2025189","DOIUrl":"https://doi.org/10.48095/cccg2025189","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyse the risk factors differentiating small for gestational age (SGA) and appropriate for gestational age (AGA) neonates.</p><p><strong>Materials and methods: </strong>A retrospective-prospective cohort study was conducted from 2019 to 2024 at the 2nd Department of Obstetrics and Gynaecology, University Hospital Bratislava. The study involved 174 term neonates from singleton pregnancies, including 125 SGA and 49 AGA infants. Various maternal, foetal, and placental risk factors were analysed, with a particular focus on congenital cytomegalovirus infection (cCMV).</p><p><strong>Results: </strong>Neonates' birth weights ranged from 1,480 to 4,470 grams. Of the risk factors assessed, only maternal COVID-19 infection during pregnancy was significantly associated with AGA outcomes (P = 0.009). No significant associations were found between common risk factors (e. g. hypertension, diabetes mellitus) and foetal growth restriction. Congenital CMV infection was not significantly associated with SGA. Logistic regression analysis confirmed the association of COVID-19 infection with foetal weight, while no significant effect was observed for CMV.</p><p><strong>Conclusion: </strong>Maternal COVID-19 infection was associated with AGA outcomes, potentially due to enhanced medical surveillance and immune responses. However, the study's small sample size limits the interpretation of these findings, and further research is required to fully understand the impacts of COVID-19 on pregnancy. No significant association between congenital CMV infection and foetal growth restriction was found in this cohort, which was most likely due to the low prevalence of cCMV. Moreover, documented risk factors for foetal growth restriction, including hypertension and diabetes mellitus, were not statistically significant in our study population.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 3","pages":"189-193"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643778","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":"Robsonova klasifikácia - cesta k zníženiu počtu cisárskych rezov.","authors":"Tomáš Debnár, Veronika Kováčová, Mária Kubalová, Miloš Mlynček","doi":"10.48095/cccg2025254","DOIUrl":"https://doi.org/10.48095/cccg2025254","url":null,"abstract":"<p><p>The increasing number of caesarean sections represents a significant health, economic, and psychological problem on a global scale. Robson's classification is a comprehensive approach to regularly analyse every operative abdominal delivery. It appears that particularly promoting the vaginal births after a previous caesarean section and reducing this mode of delivery among primiparas, is one of the ways of stopping the rising trend of caesarean sections. Slovak maternity facilities that have adopted Robson's classification reveal a decrease in the number of these obstetric surgeries.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 3","pages":"254-260"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643785","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":"Gastroschisis - current options for prenatal diagnosis and subsequent management.","authors":"Anna Jouzová, Lenka Kučerová, Romana Gerychová, Jakub Turek, Ondřej Marek, Martin Jouza, Lukáš Hruban","doi":"10.48095/cccg2025247","DOIUrl":"https://doi.org/10.48095/cccg2025247","url":null,"abstract":"<p><p>Gastroschisis is a congenital abdominal wall defect characterized by the eventration of bowel loops through a right-sided paraumbilical opening. Prenatal detection of gastroschisis is generally straightforward due to advanced ultrasound techniques, and it is essential for optimizing both prenatal care and subsequent management. The prognosis for this condition is generally favorable, with positive long-term outcomes for most children. However, 10-15% of cases may follow a complicated course with an elevated risk of neonatal mortality or significant morbidity. Early detection enables effective monitoring of fetal development, risk assessment for potential complications, and risk minimization by planning childbirth at a tertiary center equipped with intensive neonatal care and the possibility of prompt surgical intervention.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 3","pages":"247-253"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643781","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":"Diagnosis and treatment of peripartum haemorrhage, consensus of the interdisciplinary working group by the modified ACCORD method.","authors":"Vladimír Černý, Antonín Pařízek, Jan Bláha, Jan Blatný, Petr Dulíček, Jaromír Gumulec, Petr Janků, Marian Kacerovský, Petr Křepelka, Marek Ľubušký, Jitka Mannová, Dagmar Seidlová, Ondřej Šimetka, Petr Štourač","doi":"10.48095/cccg202572","DOIUrl":"10.48095/cccg202572","url":null,"abstract":"&lt;p&gt;&lt;p&gt;of recommendations Preventive measures and procedures We recommend monitoring of blood loss in women with risk factors for PPH during labor using calibrated blood collectors or their equivalents. (Good Clinical Practice) We recommend that women with significant risk factors for PPH (e.g., placenta acrreta spectrum or hematologic disorders requiring consultative hematologic care) deliver in a perinatal intensive care center or perinatal intermediate care center. (Good Clinical Practice) We recommend formulating a plan of care in collaboration with a multidisciplinary team at a reasonable time prior to delivery for patients at high risk of PPH. (Good Clinical Practice) We recommend treating anemia antepartally. Pregnant women should be given iron supplements if the haemoglobin level falls to &lt; 110 g/L in the 1st trimester or &lt; 105 g/L at 28 weeks of pregnancy. (Good Clinical Practice) We suggest considering parenteral iron administration in women with sideropenic anemia unresponsive to oral iron supplementation. The cause of anemia should be identified as soon as possible after termination of pregnancy. (Weak recommendation) If the baby adapts well, we do not recommend cord ligation in less than 1 min. (Strong recommendation) In all vaginal deliveries, we recommend prophylactic administration of uterotonics in the third postpartum period after the delivery of the baby and cord ligation to reduce the risk of PPH. The first-choice drug is oxytocin. (Strong recommendation) If the third stage of labor has not been actively managed, we suggest that uterine massage and controlled umbilical cord traction be considered to shorten the duration of the third stage of labor and to reduce blood loss during vaginal delivery, if performed by a qualified healthcare professional. (Weak recommendation) We recommend the administration of uterotonics to prevent the development of PPH in women after the delivery of a child by caesarean section and umbilical cord ligation. (Strong recommendation) We suggest considering carbetocin administration in women at increased risk of PPH. (Weak recommendation) We recommend a single-dose administration of tranexamic acid (TXA) in women at increased risk of PPH undergoing a caesarean section. Clinical note: The use of TXA prior to the caesarean section is not explicitly stated in the product's SPC. A recent meta-analysis states the most common dosage to be 1 g i.v. (Strong recommendation) Organization of care We recommend that every health care facility with an OB/GYN unit should have the PPH management protocol (guided document is not specific or really used at all, I am not sure if my suggestion is sufficient) defining the organizational and professional procedure for PPH situations. (Good Clinical Practice) We recommend that the PPH management protocol (i.e. the crisis action plan) should clearly define the organizational and professional roles of the individual members of the crisis team in the event of PPH (non-medical s","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"72-89"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674675","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":"Molecular mechanisms leading to fibrosis in endometriosis.","authors":"Zdeňka Lisá, Radoslav Janoštiak, Kristýna Hlinecká, Adéla Richtárová, David Kužel, Michal Mára, Michael Fanta","doi":"10.48095/cccg2025167","DOIUrl":"https://doi.org/10.48095/cccg2025167","url":null,"abstract":"<p><p>Endometriosis is a complex chronic disorder with a high prevalence among women of reproductive age, significantly affecting both their quality of life and ability to conceive. In clinical settings, there is an increasing incidence of advanced disease stages, particularly deep infiltrating endometriosis, which not only produces severe clinical symptoms, but also results in organ involvement. This article aims to synthesize current insights into the pathological mechanisms underlying fibrotic remodelling, which is associated with the most severe manifestations of the disease. Furthermore, it provides the theoretical framework for an ongoing research project aimed at identifying molecular biomarkers implicated in the most advanced forms of endometriosis, with the potential to enhance prediction of disease progression.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 2","pages":"167-172"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151748","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":"Patient satisfaction and ease of use of a novel method for electronic administration of validated quality of life questionnaires.","authors":"Zdeněk Rušavý, Martin Smažinka, Martin Havíř, Vladimír Kališ","doi":"10.48095/cccg2025149","DOIUrl":"https://doi.org/10.48095/cccg2025149","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of the quality of life using validated measures is an essential part of urogynecology examination and follow-up. Questionnaires administered in paper form generate paper waste or high demands for storage. Score calculation for some questionnaires may be demanding and time-consuming. The electronic format of completing questionnaires simplifies data collection and processing, but may be challenging for older patients. We developed a Medical Electronic Survey System (MESS), which facilitates completion of questionnaires on a tablet PC with an emphasis on data protection and user-friendliness for the elderly.</p><p><strong>Objective: </strong>To compare patient satisfaction and ease of use between Google Forms and MESS.</p><p><strong>Methods: </strong>This was a prospective cohort study comparing the answers to a satisfaction questionnaire completed using Google Forms (193 questionnaires between 2013-2015) and MESS (329 questionnaires between 2019-2020), along with other clinically used validated questionnaires. The answers to the questionnaire were compared using a Fisher's Exact Test or a Wilcoxon Two Sample test, with a significance level of P &lt; 0.05.</p><p><strong>Results: </strong>The electronic form of questionnaire completion suited more women in case of MESS (84.5 vs. 65.6%; P &lt; 0.05). Completing questionnaires electronically was rated as easy or very easy by 89.1% of patients using MESS compared to 68.7% using Google Forms; P &lt; 0.05. The electronic form of filling-in the questionnaires was very difficult or impossible especially for women using Google Forms (31 vs. 11%; P &lt; 0.05). The major difference in questionnaire completion without any help was observed in the age group 60-69 years. No differences were observed in women under 60 years of age. All clinicians observed significant facilitation of their work.</p><p><strong>Conclusion: </strong>MESS has made the method of electronic questionnaire completion available even to elderly patients with pelvic floor disorders. It was positively accepted even by patients who are not familiar with any electronic devices.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 2","pages":"149-153"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151787","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":"Effectiveness of physiotherapy on pain relief and functional recovery post-cesarean section.","authors":"Svitlana Ostafiichuk, Nataliia Drohomyretska, Olena Kusa, Oksana Zhukuliak, Olha Neiko, Taras Kotyk","doi":"10.48095/cccg2025204","DOIUrl":"https://doi.org/10.48095/cccg2025204","url":null,"abstract":"<p><strong>Background: </strong>Cesarean section (CS) rates are rising globally, with associated postpartum complications significantly higher compared to vaginal delivery. Addressing these complications through optimized management and targeted physiotherapy is crucial for improving maternal outcomes and quality of life.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of physiotherapy on pain relief and restoration of functional activity in women after CS.</p><p><strong>Material and methods: </strong>91 patients, who were admitted to an obstetric hospital for elective CS, were involved in the study. The control group (47 women) received standard pre- and postoperative supervision. The intervention group (44 patients), in addition to standard care, underwent physiotherapy, which included preoperative care (physiotherapy training, educational training), and postoperative exercises (breathing, circulation, and pelvic exercises, along with connective tissue massage). The results were analyzed after CS for 3 days.</p><p><strong>Results: </strong>A lower intensity of postoperative pain and easier walking from the 1st day, a lower level of difficulty in performing functional activities on the 2nd day (easier turning in bed and transition to a sitting position), faster recovery of intestinal motility due to the passage of flatus in 3.5 hours and the act of defecation after 10.0 hours, decreased requirement of extra analgesics by 4.21-fold (OR = 0.24; 95% CI 0.10-0.58; P = 0.02), and a significant reduction in the length of hospital stay (OR = 0.24; 95% CI 0.09-0.57; P = 0.02) were established.</p><p><strong>Conclusion: </strong>The study revealed the effectiveness of the proposed physiotherapy program in the early post-cesarean period in terms of reducing pain and improving restoration of the body's functional activity.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 3","pages":"204-211"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643780","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}