Ceska Gynekologie-Czech Gynaecology最新文献

{"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":"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":"Coincidental maternal mortality in Slovakia in the years 2007- 2024.","authors":"D Kotríková, M Vargová, A Adamec, A Krištúfková, M Korbeľ","doi":"10.48095/cccg2025278","DOIUrl":"https://doi.org/10.48095/cccg2025278","url":null,"abstract":"<p><strong>Objective: </strong>Analysis of coincidental maternal mortality in Slovakia in the years 2007-2024 from the database of the Slovak Gynecological and Obstetric Society (enhanced surveillance system).</p><p><strong>Methods: </strong>Retrospective population analysis of maternal mortality from 2007 to 2024 focused on coincidental maternal deaths. Analysis of coincidental maternal death cases was carried out according to the International Classification of Diseases (ICD-10) for Maternal Mortality (ICD-MM).</p><p><strong>Results: </strong>Between 2007 and 2024, a total of 123 women died. The maternal mortality ratio (MMR) was 12.46 per 100 000 live births. Fifteen women (12.20%) died from coincidental causes (MMR 1.52 per 100 000 live births). From direct causes, 51 women died (41.46%), from indirect causes, 54 women died (43.90%), and three women died (2.44%) from an unknown cause of death. Out of the coincidental deaths, 80.0% were due to polytrauma - car accidents (66.67%), train accident (6.67%), and entrapment in an elevator shaft (6.67%). Three cases of deaths were due to homicide (domestic violence) - 20%.</p><p><strong>Conclusion: </strong>The study highlights the problem of under-recognition of coincidental maternal deaths, despite its significant impact on public health. The Slovak Gynecological and Obstetrics Society attempts to identify and collect data on coincidental maternal mortality in Slovakia, which is not included in vital statistics. Addressing this overlooked issue is crucial for enhancing maternal health outcomes and ensuring comprehensive maternal safety worldwide.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 4","pages":"278-284"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439484","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":"Sperm navigation mechanisms.","authors":"Michal Ješeta, Karolína Lošťáková, Lenka Mekiňová, Eva Lousová, Kateřina Remundová, Robert Hudeček","doi":"10.48095/cccg2025486","DOIUrl":"10.48095/cccg2025486","url":null,"abstract":"<p><strong>Objective: </strong>Mechanisms of sperm navigation are important for understanding the principles of sperm selection prior to fertilization. The aim of this work is to provide an overview of current knowledge about the physiological process of sperm navigation from ejaculation to fertilization of the ovulated oocyte.</p><p><strong>Methods: </strong>Literature search of the PubMed database published up to June 2025 with terms focusing on \"sperm navigation,\" \"fertilization,\" and \"chemoattractants\".</p><p><strong>Results: </strong>The principles of sperm navigation in the in vivo environment are still unclear in humans. Currently, there are simple in vivo studies performed on model animals, as well as a number of in vitro studies on human sperm. Based on these results, three main navigation systems are described: rheotaxis, thermotaxis, and chemotaxis. Rheotaxis acts over the longest distances and stimulates sperm movement against the flow of fluid. Thermotaxis acts over a shorter distance and guides sperm to places with higher temperatures. Chemotaxis acts over the shortest distance, attracting capacitated sperm to places where the ovulated oocyte is located.</p><p><strong>Conclusion: </strong>Given how massively the sperm microinjection technique is used in the treatment of human infertility, it is important to carefully select sperm prior to fertilization. Knowledge of the principles of human sperm selection in in vivo conditions is crucial for effective sperm selection in the laboratory.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 6","pages":"486-494"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041721","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":"Prevalence and hormonal profiling of secondary amenorrheic patients presenting to a fertility clinic - an observational study.","authors":"Nayab Iqbal, Muhammad Ashfaq, Qasim Khan, Syed Mobasher Ali Abid, Muhammad Junaid Hassan Sharif, Yasser Msa Alkahraman","doi":"10.48095/cccg2025374","DOIUrl":"10.48095/cccg2025374","url":null,"abstract":"<p><strong>Objective: </strong>Amenorrhea is a menstrual disorder than can arise as a result of hormonal dysfunction of the hypothalamic-pituitary--gonadal axis. There is limited data on the most common causes of secondary amenorrhea in Pakistan. Therefore, this study aimed to assess various causative factors along with hormone profiling in patients with secondary amenorrhea.</p><p><strong>Patients and methods: </strong>The present cross-sectional study was conducted in different fertility clinics of Abbottabad. Patients with secondary amenorrhea were included by a non-probability sampling technique. Data related to demographic and other clinical variables were collected via a data collection form. Serum progesterone, estradiol, luteinizing hormone, follicle stimulating hormone, and prolactin were determined using commercially available enzyme-linked immunosorbent assay kits. This study was conducted on 126 patients with a mean age of 28.5 ± 7.8 years.</p><p><strong>Results: </strong>Drug-related amenorrhea was observed in 14.3% of patients. Hyperprolactinemia-induced amenorrhea was observed in 31.7% and in 54% of patients with unknown etiology. Of the patients with drug-induced amenorrhea, 38.9% used oral contraceptives, 27.8% used omeprazole, and 33.3% used other drugs. Headache (79.4%) and fatigue (78.6%) were the main symptoms reported in amenorrheic women, while hair loss was reported in 65.9% of patients. Both loss of libido and hirsutism were observed in 45.2% and 42.9% of patients, resp. Breast pain and vaginal dryness occurred in 35.7% and 23.8% of patients, resp.</p><p><strong>Conclusion: </strong>The current study showed that hyperprolactinemia is the most common cause of secondary amenorrhea followed by drug-induced amenorrhea, which must be considered in the clinical management of hormonal imbalances and subsequent amenorrhea.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 5","pages":"374-379"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423064","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":"Can anti-Müllerian hormone predict positive sperm retrieval in men with idiopathic non-obstructive azoospermia?","authors":"M C Çolakoğlu, J E Horasanlı, M Tül, B Gencel, F Akkuş","doi":"10.48095/cccg2025285","DOIUrl":"10.48095/cccg2025285","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether serum anti-Müllerian hormone (AMH) levels can predict sperm retrieval (SR) outcomes in men with idiopathic non-obstructive azoospermia (iNOA) undergoing microdissection testicular sperm extraction (mTESE), and to develop a predictive model that may inform clinical decision-making.</p><p><strong>Materials and methods: </strong>This retrospective, multicenter cohort study included 72 men diagnosed with iNOA who underwent mTESE between December 2022 and May 2023 at two IVF centers in Turkey. Serum AMH and follicle stimulating hormone (FSH) levels were measured prior to surgery. Patients were categorized into TESE-positive (+SR) and TESE-negative (-SR) groups based on the presence of spermatozoa in testicular tissue. Hormonal and clinical parameters were compared between groups, and a multivariate logistic regression model was constructed to identify independent predictors of SR outcome. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic accuracy and optimal cutoff values for AMH and FSH.</p><p><strong>Results: </strong>Out of 72 patients, 37 (51.4%) had successful SR and 35 (48.6%) did not. Median AMH and FSH levels were significantly higher in the -SR group (P = 0.001 and P = 0.044, resp.). Multivariate logistic regression analysis identified serum AMH as the only independent predictor of positive SR outcome (P &lt; 0.001). ROC analysis revealed excellent diagnostic performance for AMH (AUC = 0.909), with an optimal cutoff value of 3.4 ng/mL yielding 75.68% sensitivity, 91.43% specificity, 90.32% positive predictive value, and 78.05% negative predictive value (P = 0.001). Higher AMH levels were significantly associated with negative SR outcomes.</p><p><strong>Conclusion: </strong>Serum AMH level is a reliable, non-invasive biomarker for predicting SR outcomes in men with iNOA undergoing mTESE. An AMH level &gt; 3.4 ng/mL is significantly associated with a lower probability of sperm retrieval. Incorporating AMH into preoperative assessment may help avoid unnecessary surgical procedures and guide clinical counseling in male infertility management.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 4","pages":"285-292"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439517","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":"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":"Eff ect of hCG fol low-up on anxiety, depression, and quality of life in women with gestational trophoblastic dissease.","authors":"G M Grecco, E De Sá V Abuchaim, F P Dittmer, I Maestá, A Braga, E Araujo Júnior, S Y Sun","doi":"10.48095/cccg2025299","DOIUrl":"https://doi.org/10.48095/cccg2025299","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effect of normalization of the hormone, human chorionic gonadotropin, on anxiety, symptoms of depression, and quality of life in patients with gestational trophoblastic disease, and to identify risk factors associated with these outcomes.</p><p><strong>Methods: </strong>This longitudinal study included 51 women under postmolar follow-up or during treatment for gestational trophoblastic neoplasia between 2017 and 2019 in two Brazilian trophoblastic disease centers.</p><p><strong>Results: </strong>The normalization of human chorionic gonadotropin led to a significant reduction in the depression scores and increased physical health domain scores in both study groups, namely the hydatidiform mole and gestational trophoblastic neoplasia groups. Having children and the desire for children were associated with lower scores for depression and anxiety, and higher scores for the psychological health domain of quality of life. Perceiving health as \"very poor\" was associated with higher scores for depression and anxiety, and lower scores for quality of life with respect to physical health, psychological health, and social relationship domains.</p><p><strong>Conclusion: </strong>Disease remission was associated with reduced depression symptoms and better quality of life in the physical health domain. While having a negative perception of health was associated with higher anxiety and depression scores and poor quality of life, having children and the desire for children improved anxiety and depression symptoms and quality of life in the psychological health domain.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 4","pages":"299-308"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439469","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}