Ceska Gynekologie-Czech Gynaecology最新文献

{"title":"HIV infection and adverse perinatal outcomes - a meta-analysis of premature births, low birth weights, and small for gestational age newborns.","authors":"K Hurt, J Rakovic, J Matěcha, M Mojhova, F Zahálka, M Zikán","doi":"10.48095/cccg2025269","DOIUrl":"10.48095/cccg2025269","url":null,"abstract":"<p><p>HIV remains a significant global public health challenge, affecting millions of individuals with a disproportionate burden in sub-Saharan Africa. Despite advancements in antiretroviral therapy (ART) and global efforts to control transmission, the impact of HIV on pregnancy outcomes remains a topic of concern.</p><p><strong>Aim: </strong>This study aims to evaluate the association between maternal HIV infection and adverse pregnancy outcomes, specifically preterm birth (PTB), low birth weight (LBW), and small for gestational age (SGA) infants through a comprehensive meta-analysis.</p><p><strong>Materials and methods: </strong>A systematic search of English-language databases, including Medline, Web of Science, Ovid, Scopus, and Google Scholar, was conducted to identify relevant studies published between 2014 and 2024. Eligible studies included retrospective and prospective cohort studies with well-defined control groups of HIV-negative mothers. Studies that lacked appropriate control groups, included multiple pregnancies, or did not report adjusted statistical outcomes were excluded. A total of eight studies met the inclusion criteria for PTB analysis, five studies for LBW analysis, and five studies were selected for SGA analysis.</p><p><strong>Results: </strong>Meta-analysis using a random-effects model demonstrated a statistically significant association between maternal HIV infection and PTB (OR = 1.55; 95% CI 1.38-1.74; p &lt; 0.001), LBW (OR = 1.57; 95% CI 1.24-1.98; p &lt; 0.001), and an increased risk of SGA (OR = 1.24; 95% CI 1.10-1.40; p &lt; 0.001). Heterogeneity was moderate for PTB (I² = 38.2%) and LBW (I² = 55.9%) while it was low for SGA (I² = 7.6%), indicating consistency across studies. Egger's test showed minimal publication bias.</p><p><strong>Discussion: </strong>These findings highlight the adverse effects of HIV on pregnancy outcomes, emphasizing the need for continued monitoring and optimization of ART regimens to mitigate risks. Further research is warranted to explore the influence of different ART combinations and immune system dynamics on fetal development.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 4","pages":"269-277"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439091","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":"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":"Effect of kisspeptin, neurokinin, and dynorphin neurons on regulation of reproduction.","authors":"Jana Racková","doi":"10.48095/cccg2025413","DOIUrl":"https://doi.org/10.48095/cccg2025413","url":null,"abstract":"<p><p>Gonadotropin-releasing hormone pulsatility is under the influence of hypothalamic neuropeptides, especially neurons expressing kisspeptin, neurokinin B, and dynorphin. These hypothalamic cells are called KNDy neurons. By integrating hormonal and environmental stimuli in the brain, they modulate the effects on neuropeptide release and control the frequency and amplitude of pulses. The relationship between KNDy neurons and gonadal hormones is essential for the initiation of puberty, regulation of the menstrual cycle, and reproduction. Steroid hormones have a feedback effect on the modulation of the activity of KNDy neurons, as their membrane and cell nucleus express receptors for estradiol, progesterone, and testosterone. Recent research suggests a close relationship with the pathophysiology of infertility, pathological pregnancy, menstrual cycle disorders, polycystic ovary syndrome, endometriosis, and vasomotor symptoms in perimenopause.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 5","pages":"413-417"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423030","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":"Sclerotherapy of endometrioma and its impact on ovarian reserve - a narrative review.","authors":"Katarína Ivánková, Hynek Heřman, Jan Drahoňovský, Lucie Hájková Hympánová","doi":"10.48095/cccg2025163","DOIUrl":"https://doi.org/10.48095/cccg2025163","url":null,"abstract":"<p><p>To summarize current knowledge on the use of sclerotherapy in the treatment of endometriomas and its effect on ovarian reserve. Endometriosis affects 10-15% of women of reproductive age. The presence and treatment of endometriomas influence ovarian reserve, and therefore the conception possibilities of patients. The management is further complicated by frequent recurrences. All standard surgical methods lead to a reduction in ovarian reserve. Current clinical research is focused on developing methods that minimize the reduction of ovarian reserve. Ethanol sclerotherapy is a relatively new alternative to the currently used surgical methods, mainly extirpation. It is not yet a standard procedure. This article aims to summarize the current knowledge regarding the use of sclerotherapy in the treatment of endometriomas and its effect on ovarian reserve. The studies included in this review article are based on PubMed and Scopus databases. According to published works, sclerotherapy is a relatively simple method that allows treating endometriomas without surgery and general anaesthesia if performed under ultrasound guidance. It has a similar recurrence rate as laparoscopic extirpation and does not lead to a greater reduction in ovarian reserve compared to the latter. Sclerotherapy can be performed trans-vaginally, trans-abdominally, or laparoscopically. This paper summarizes the current knowledge on the impact of sclerotherapy on ovarian reserve.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 2","pages":"163-166"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152147","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":"Investigation of serum phoenixin-14 and phoenixin-20 levels in pregnant women with preeclampsia.","authors":"Zeynep Baki, İbrahim Kale","doi":"10.48095/cccg2025122","DOIUrl":"https://doi.org/10.48095/cccg2025122","url":null,"abstract":"<p><strong>Objective: </strong>Phoenixin has endothelial protective and anti-inflammatory properties, but has been associated with the development of hypertension. Given that endothelial dysfunction plays a significant role in the pathophysiology of preeclampsia, we aimed to investigate the serum levels of phoenixin-14 and phoenixin-20 in pregnant women diagnosed with preeclampsia.</p><p><strong>Materials and methods: </strong>In this cross-sectional case-control study, 45 pregnant women diagnosed with preeclampsia comprised the preeclampsia group, while 45 healthy pregnant women, matched to the preeclampsia group by age, body mass index, and gestational age, served as the control group. Commercial kits were used to analyze phoenixin-14 and phoenixin-20 levels in serum samples.</p><p><strong>Results: </strong>Serum phoenixin-14 level was 390.3 pg/mL in the preeclampsia group and 393.2 pg/mL in the control group (P = 0.434). While the serum phoenixin-20 level was 346.6 pg/mL in the preeclampsia group, it was 379.9 pg/mL in the control group (P = 0.278). When the preeclampsia group was divided into subgroups according to the severity of the disease and the onset of the disease and compared with the control group, no significant difference was found between the groups regarding serum phoenixin-14 and phoenixin-20 levels.</p><p><strong>Conclusion: </strong>In this study, serum levels of phoenixin-14 and phoenixin-20 were similar in both the preeclampsia and control groups. Although the sample size is too small to draw a definitive conclusion, findings suggest that phoenixin-14 and phoenixin-20 do not play a role in the pathophysiology of preeclampsia.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 2","pages":"122-128"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152372","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":"Twin pregnancy in a caesarean scar - a case study and literature review of therapeutic approaches.","authors":"Lukáš Vaněk, Jan Zapletal, Borek Sehnal, Lukáš Rob, Michael J Halaška","doi":"10.48095/cccg2025463","DOIUrl":"https://doi.org/10.48095/cccg2025463","url":null,"abstract":"<p><p>Caesarean scar pregnancy is a rare form of ectopic pregnancy. It can be reliably diagnosed through transvaginal ultrasonography, typically during the 1st or early 2nd trimester. While one-third of patients remain asymptomatic, others may develop severe complications. The most common symptoms are vaginal bleeding and abdominal pain, with rare cases involving uterine rupture or the development of placenta accreta spectrum. Caesarean scar pregnancy is associated with a risk of various complications and poses a risk factor for future pregnancies. In many cases, surgical intervention cannot be avoided. Treatment options include surgical management or medical therapy. In some cases, an expectant management approach may be chosen. No single treatment method has yet been definitively established as sufficiently rapid, safe, and effective. This case report presents a patient with twin pregnancy in a caesarean scar, in whom a conservative approach was chosen due to the low gestational age. Additionally, we provide a literature review of the current therapeutic options for managing this challenging condition.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 6","pages":"463-468"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041719","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":"Possible use of indocyanine green in the management of endometriosis.","authors":"Vladimír Baláž, Martin Syrůček, Jiří Presl","doi":"10.48095/cccg2025238","DOIUrl":"10.48095/cccg2025238","url":null,"abstract":"<p><p>Endometriosis affects approximately 10% of women of fertile age and its deep infiltrating form causes serious consequences for fertility, clinical problems depending on which organs are affected (urinary and digestive tract) and causes serious pain which seriously impairs quality of life. Resection of the affected tissue tend to be complex and often require multidisciplinary approach. Resection in the field of severe deep infiltrating endometriosis is complicated by the difficulty of resection line identification. Although we are able to perform most of the resections laparoscopically, there is still significant risk of intra and postoperative complications, the most serious of which is the formation of rectovaginal fistulas. Identification of boundaries of the endometrial nodule and preservation of tissue vitality is crucial in resection procedures. Endometriotic nodules, based on the pathogenesis of the lesion, have various vascularity and therefore different perfusion patterns. According to nature of tissue and the degree of vascularization, most deep infiltrating nodules have rather hypoperfusion pattern. A substance that would be able to guide the resection by live monitoring of the tissue perfusion, could have useful therapeutic applications. Such substance could be the fluorescent dye indocyanine green. With resection guidance by fluorescence dye, we could be able of pathogenesis oriented management of the disease and therefore perform more gentle tissue preparation, with less collateral damage, reduction of intra and postoperative complications, and thus improvement of the quality of life of patients in terms of pain, risk of recurrence, and preservation of fertility.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 3","pages":"238-246"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643784","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":"Occupational therapy in oncogynecology - a pilot study.","authors":"Petra Sládková, Tomáš Brtnický, Lenka Hormandlová, Markéta Polková, Vojtěch Malina, Peter Koliba, Michal Zikán, Petr Hubka, Pavel Kabele, Olga Dubová, Marie Tichá","doi":"10.48095/cccg2025113","DOIUrl":"https://doi.org/10.48095/cccg2025113","url":null,"abstract":"<p><strong>Objective: </strong>Overview of the possibilities of using non-medical occupational therapy in oncogynecology, description of the role of an occupational therapist in prehabilitation, and evaluation of data from a pilot study.</p><p><strong>Methods: </strong>The study cohort consisted of 18 patients enrolled between November 2023 and October 2024. The prospective study was conducted over a period of nine months. Patients were admitted for a 3-week intensive multimodal prehabilitation program scheduled on a 4/7 basis prior to elective surgery for primary or recurrent malignant ovarian, endometrial, or cervical cancer. In addition to the physicians, patients received prehabilitation by a physiotherapist, psychologist, nutritionist, and occupational therapist. Clinical work of the occupational therapist was measured upon examination and subsequent therapy in the areas of cognitive function, fine motor skills of the upper limbs, self-sufficiency, and quality of life. The occupational therapist applied selected functional tests and questionnaires (MKF classification, Hand grip test, MoCA test, 5× Sit-to-Stand test, WHODAS 2.0) to determine the effect of the rehabilitation intervention.</p><p><strong>Results and conclusions: </strong>Important indicators were selected functional abilities that have a significant impact on the quality of life of patients. The results of functional tests showed a significant improvement of key parameters due to intensive prehabilitation, confirming the essential role of occupational therapist intervention in oncogynecological prehabilitation.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 2","pages":"113-121"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151830","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":"10.48095/cccg202522","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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}