Ceska Gynekologie-Czech Gynaecology最新文献

{"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":"https://doi.org/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":"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":"Acute Sheehan's syndrome.","authors":"Aurel Dobiaš, Andrea Klčovanská, Ivan Dečkov, Róbert Hlávek","doi":"10.48095/cccg202538","DOIUrl":"https://doi.org/10.48095/cccg202538","url":null,"abstract":"<p><strong>Objective: </strong>To present a case of a patient who developed acute Sheehan's syndrome, despite adequate estimated blood loss.</p><p><strong>Case report: </strong>Sheehan's syndrome is a relatively rare disease with various incidences, mainly due to different obstetric care factors in individual countries. Pathogenetic mechanisms are not fully understood. An important factor is reduced blood flow through the pituitary arteries caused by hypotension in the setting of postpartum hemorrhage. Subsequent clinical manifestations depend on the extent of damage to the pituitary gland, and consequently, on the loss of individual hormones, the secretion of which is controlled by the pituitary gland. Most patients are diagnosed years later. Our case describes a patient with Sheehan's syndrome that developed in the early postpartum period. The patient was successfully diagnosed and adequate replacement therapy was started.</p><p><strong>Conclusion: </strong>In summary, acute Sheehan's syndrome is a rare occurrence. Agalactia, amenorrhea, fatigue, and other non-specific symptoms should be considered despite its rarity.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"38-43"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674668","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":"Infertility stress and coping strategies in women and men undergoing in vitro fertilization treatment.","authors":"Gabriela Ďurašková, Radek Hampl, Daniel Dostál","doi":"10.48095/cccg202514","DOIUrl":"https://doi.org/10.48095/cccg202514","url":null,"abstract":"<p><strong>Aim: </strong>To describe coping strategies and infertility stress in men and women undergoing in vitro fertilization (IVF) treatment. To determine whether there are differences in coping strategies between men and women and to identify adaptive and non-adaptive coping strategies for infertility.</p><p><strong>Materials and methods: </strong>A correlational study, where 162 patients (99 women and 63 men) with primary infertility undergoing IVF treatment at Sanus Pardubice completed the Fertility Problem Inventory and COPE Inventory psychological questionnaires.</p><p><strong>Results: </strong>There were no significant differences between women and men in experiencing infertility stress. The coping strategies used most frequently by both men and women were Positive Reinterpretation, Planning, and Acceptance; men used the strategies Restraint, Suppression, and Planning significantly more frequently than women; and women used the strategies Using Emotional Social Support and Religious Coping significantly more frequently than men. For both women and men, level of Global infertility stress significantly correlated with Denial in the positive direction and with Positive Reinterpretation and Acceptance in the negative direction.</p><p><strong>Conclusion: </strong>Involuntarily childless women and men in IVF treatment experience similar infertility stress, but use slightly different coping strategies. For both men and women, Positive Reinterpretation and Acceptance emerged as adaptive strategies, while Denial emerged as non-adaptive.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"14-21"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674679","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":"Uterine torsion during cesarean section coinciding with HELLP syndrome.","authors":"Monika Skuhrovcová, Miroslava Sládková, Stanislav Martan","doi":"10.48095/cccg202548","DOIUrl":"https://doi.org/10.48095/cccg202548","url":null,"abstract":"<p><p>Uterine torsion belongs to one of the most dangerous labor complications also because of its rarity. As it is not common for an obstetrician to come across this state, it is usually not at the very top of the differential diagnostics list when solving acute child delivery complications. However, it is serious enough to pose a lethal threat to both mother and child. In this case, the term gravidity was ended by acute cesarean section because of HELLP syndrome. During the operation, as well as after a complicated delivery and hysterotomy suture uterine torsion of 120 degrees to the right, the patient was diagnosed with detorsion. The rest of the operation was done according to normal standards. Thanks to this very prompt procedure, the aftermath of the described state meant little to no harm to the mother and her child. This case study should highlight the importance of including uterine torsion into differential diagnostics of acute abdominal pain and vomiting to prevent fatal labor complications for the mother and her child.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"48-51"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674689","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":"Clinical significance of quantification and immunophenotyping of uterine NK cells in the diagnosis and treatment of infertility.","authors":"Karin Černá, Pavel Otevřel, Štěpánka Luxová, Lenka Sedláčková","doi":"10.48095/cccg20256","DOIUrl":"10.48095/cccg20256","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Uterine NK (uNK) cells, a specialized subpopulation of natural killer (NK) lymphocytes located in the endometrium, play a crucial role in regulating the immune response and in the process of embryo implantation. This study aims to retrospectively analyze the outcomes of in vitro fertilization (IVF) treatment in a cohort of women who underwent uNK cell immunophenotyping with subsequent immunomodulatory therapy applied based on the results.</p><p><strong>Methods: </strong>The study included 122 patients who underwent uNK cell immunophenotyping between April and December 2023. Immunophenotyping was performed using flow cytometry. Patients were categorized into four groups according to their uNK cell phenotypes: normal findings, low absolute and relative numbers of uNK cells (LOW-IMMUNE profile), low numbers of uNK cells combined with the shift towards the cytotoxic uNKc dim immunophenotype (MIXED-IMMUNE profile), and normal numbers of uNK cells, but an undesirable shift in the ratio of cytotoxic to regulatory uNK cells towards the cytotoxic uNK dim phenotype (OVER-IMMUNE profile). Embryo transfer outcomes and the occurrence of miscarriages up to the 12th week of pregnancy were evaluated in each group.</p><p><strong>Results: </strong>The highest clinical pregnancy rate was observed in the treated OVER-IMMUNE group (70%), fol lowed by the MIXED-IMMUNE group (60%). The LOW-IMMUNE group did not differ significantly from the untreated NORMAL group (P = 0.205). Insufficient immune activation (LOW-IMMUNE profile) was significantly associated with first-trimester pregnancy loss (P &lt; 0.0001).</p><p><strong>Conclusion: </strong>This study provides new insights into the potential benefits of uNK cell immunophenotyping and subsequent immunomodulatory therapy in treating fertility disorders. While the results indicate possible clinical advantages, further research is necessary to confirm these findings and elucidate the mechanisms leading to improved outcomes in assisted reproductive techniques.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"6-13"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674670","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":"Fetal total atrioventricular block in transgender man with systemic lupus erythematosus -  literature review and establishment of a protocol with management and treatment with terbutaline.","authors":"Maria Elisa Martini Albrecht, Nicole Rodrigues da Cunha Resende de Miranda, Milena Giuberti, Edward Araujo Júnior","doi":"10.48095/cccg202552","DOIUrl":"https://doi.org/10.48095/cccg202552","url":null,"abstract":"<p><p>This case report describes a case of total atrioventricular block (TAVB) with positive anti-Ro/SSA antibodies in a transgender man who began follow-up at 31 weeks and 3 days of gestation. Despite many disagreements regarding treatment, corticosteroids were recommended for this patient. The fetal ventricular rate at the second weekly visit was 50 bpm and terbulin was started to increase heart rate. Hospitalization and intravenous terbutaline for 3 days was chosen to better control maternal symptoms and monitor fetal vital signs, as well as daily monitoring of the ventricular rate. There was an increase in baseline ventricular rate of approximately 15%. After discharge from the hospital, weekly control fetal echocardiography was performed in addition to the indices proposed by Huhta for echocardiographic assessment of fetal cardiac function. Fetal ventricular rate in ambulatory controls did not fall below 55 bpm. Cesarean section was indicated at 35 weeks and 4 days of gestation due to premature rupture of ovular membranes. A male newborn was delivered weighing 2,250 grams with Apgar scores of 8 and 9 at the 1st and 5th minute, respectively. After 88 days of life, the infant was weighing 4,580 grams and a definitive bicameral epicardial pacemaker was implanted without complications. Even if there is a transient increase in fetal ventricular rate with the use of terbutaline, a pacemaker is indicated. Delivery should be at term to allow the fetus to achieve adequate weight and pulmonary maturity for definitive pacemaker implantation.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"52-57"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674677","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":"Prenatal diagnosis of parasitic conjoined twins.","authors":"Petra Gašparová, Zuzana Ballová, Martina Sitáš, Erik Dosedla","doi":"10.48095/cccg202544","DOIUrl":"10.48095/cccg202544","url":null,"abstract":"<p><p>Heteropagus or parasitic conjoined twins represent an extremely rare anomaly, occurring in approximately 1 in 1 million cases. This condition is characterized by the presence of a parasitic twin with significant congenital abnormalities attached to an otherwise typically healthy fetus. The well-developed twin is known as the \"autosite\" or \"host,\" while the severely affected fetus is termed the \"parasite.\" Survival of the defective twin depends on the cardiovascular system of the second, relatively normal fetus. We present the case of a 27-year-old primigravida in her 14th week of pregnancy with ultrasound findings indicating parasitic conjoined twins, specifically omphalopagus.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"44-47"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674683","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":"Vascular endothelial growth factor D potential predictor and screening marker in ovarian carcinoma.","authors":"Monika Náležinská, Josef Chovanec","doi":"10.48095/cccg202522","DOIUrl":"https://doi.org/10.48095/cccg202522","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Until now, it is still true that late detection of ovarian cancer is a major cause of its poor prognosis. So far, no sufficiently sensitive and specific marker or combination of markers and imaging methods has been identified that would unambiguously allow the detection of early potentially highly-curable stages and furthermore prebioptically differentiate a group of poorly distinguishable benign lesions from malignant tumours on ultrasound. In a retrospective study design, serum levels of vascular endothelial growth factor D (VEGF-D) were investigated. VEGF-D is related to tumour-induced angiogenesis, lymphangiogenesis, and vascular remodelling with the effect of facilitating metastasis and improved oxygen and nutrient distribution into tumour tissue. On the other hand, the lymphatic network serves as a barrier against tumour dissemination and is a transport system for immune-active elements in suppressing tumorigenesis. The aim of this study was to investigate that there is a difference in serum VEGF-D levels in a group of patients with malignant tumours, benign ovarian lesions, and healthy controls without pathological findings in the adnexa.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;162 sera collected preoperatively and preserved by a freezing process in a biobank in 2022-2023 were retrospectively evaluated. The test set was stratified on the basis of histopathological results of the adnexal examination into the malignant tumour group (N = 54), benign lesion group (N = 47), and healthy control group (N = 61). Descriptive statistical analysis methods were used for the statistical evaluation of the parameters. Nonparametric tests were used to compare serum VEGF-D levels. All analyses were considered at a significance level of 5%. Serum VEGF-D was analysed by ELISA Quantikine® Human VEGF D R&D Systems and values were read spectrophotometrically on a TECAN reader.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The result of the comparison of descriptive statistical parameters was statistically significant (P = 0.00067) for the difference between serum VEGF-D levels in the set of benign lesions and malignant tumours. Furthermore, there was a statistically significant difference between the values of patients with malignant tumours and healthy controls (P = 0.0008). No statistically significant difference was found between the values of patients with benign lesions and healthy controls (P = 0.4308). Compared to the conventional marker CA125, pathologically elevated serum CA125 levels correlated with low serum VEGF-D levels in patients with malignant tumours. The same concordance was observed in comparison with the HE4 marker: high serum HE4 levels were accompanied by low VEGF-D levels in the group of patients with malignant tumours; moreover, the dot plot clearly stratified the group of patients with malignant tumours from the group of benign lesions and healthy controls.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In view of the results obtained, ","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"22-37"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674694","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":"Cost-effectiveness of mental health screening in pregnancy.","authors":"Kristýna Hrdličková, Lucie Nováková, Hana Němcová, Antonín Šebela","doi":"10.48095/cccg202558","DOIUrl":"https://doi.org/10.48095/cccg202558","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview of recent literature on the cost-effectiveness of mental health screening for women during pregnancy.</p><p><strong>Results: </strong>1,988 publications were retrieved from databases, of which four were included in the systematic review. Models of care with screening are cost-effective compared with standard care without screening. Multi-level screening models are more cost-effective than single-level models. Effectiveness is affected by the number of false-positive cases, which decreases in multi-level models.</p><p><strong>Conclusion: </strong>Mental health screening in pregnancy appears to be cost-effective. We recommend its use in comprehensive health care for pregnant women in our country.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"58-63"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674672","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}