Ceska Gynekologie-Czech Gynaecology最新文献

{"title":"Early detection of recurrent ovarian cancer, current use of oncomarkers, imaging methods, and future perspectives.","authors":"V Smoligová, J Kosťun, P Stráník, J Presl","doi":"10.48095/cccg2025333","DOIUrl":"https://doi.org/10.48095/cccg2025333","url":null,"abstract":"<p><p>Ovarian carcinoma is one of the most serious types of gynecological tumors. It is usually diagnosed in advanced stages, mainly due to an asymptomatic course or non-specific symptoms in the early stages. It is also characterized by a tendency to recur frequently, thus reducing the overall survival of patients. This article focuses on the possibility of detecting recurrence of the disease during follow-up of patients after complete remission. According to the analyzed literature, the monitoring of CA-125 and HE4 oncomarker levels in combination with imaging methods such as expert ultrasonography, CT, and positron emission techniques offers the potential for early detection of recurrence. The most advanced type of computed tomography, photon-counting CT, with high detection capability and lower radiation burden, also holds promise. The question of further management of early-detected asymptomatic recurrence is open for further discussion.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 4","pages":"333-338"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439515","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":"Arteriovenous malformation developing in a cesarean scar after termination of pregnancy - a case report and review of the literature.","authors":"Yusuf Ziya Kizildemir, Sezin Eda Karsli, Işıl Işık Okuyan, Çağrı Kutlugün Emral, Merve Civelek","doi":"10.48095/cccg2025469","DOIUrl":"10.48095/cccg2025469","url":null,"abstract":"<p><p>Uterine arteriovenous malformations (AVMs) are a rare cause of severe uterine bleeding. Uterine traumas, such as cesarean section or abortion, are known risk factors. In this article, we present a rare case of an AVM that developed in a patient with a history of a previous cesarean section and recent abortion. In this case, we review the pathogenesis, diagnosis, and treatment strategies of AVMs that develop in cesarean scars in light of the current literature. The patient presented with 2 months of vaginal bleeding that led to life-threatening anemia. Doppler ultrasound identified an AVM in the cesarean scar. Given the hemodynamic status of the patient, an emergency surgical intervention was performed and the AVM was successfully treated. This case highlights that AVM should be primarily considered in the differential diagnosis of severe bleeding in patients with a \"double-hit\" risk, such as a cesarean section followed by subsequent uterine trauma, and that emergency surgical intervention can be life-saving.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 6","pages":"469-473"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041732","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":"Prenatal treatment of posterior urethral valves in a newborn with anorectal stenosis.","authors":"D A Miguel, E Araujo Júnior, R Ruano, R A M De Sá","doi":"10.48095/cccg2025323","DOIUrl":"10.48095/cccg2025323","url":null,"abstract":"<p><p>Posterior urethral valves (PUV) account for most cases of lower urinary tract obstruction (LUTO) in male fetuses, with a prevalence of 1 in 5,000 live births. Prenatal ultrasound findings include bladder wall thickening, keyhole sign, oligohydramnios, and ureteral dilatation. If untreated, PUV can cause pulmonary hypoplasia and renal failure, often requiring dialysis or transplantation. Treatment options include vesicoamniotic shunting and fetoscopic laser fulguration. PUV is rarely associated with anorectal malformations, posing a diagnostic and therapeutic challenge. This case report describes a neonate diagnosed prenatally with PUV who underwent intrauterine procedures, followed by preterm cesarean section at 32 weeks. Postnatally, he exhibited renal dysplasia, cryptorchidism, and developed necrotizing enterocolitis. Despite multiple laparotomies and colostomy, the infant improved and was then discharged. At 4 months, imaging confirmed rectal stenosis. We highlight the diagnostic limitations of prenatal ultrasound in differentiating PUV from other LUTO causes and the benefits of fetal magnetic resonance imaging. Anorectal malformations have diverse phenotypic presentations and are linked to environmental risk factors. The rare association of PUV with anorectal anomalies requires careful prenatal counseling due to potential complications. This case highlights the importance of early diagnosis and multidisciplinary management for improved outcomes.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 4","pages":"323-327"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439450","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":"Hematological parameters and colposcopic lesion area in precursor lesions of cervical cancer.","authors":"P T S Mantoani, G A Melo, J H Vieira, T Corrêa Magalhães, M P O Franco, A C Mac Do Barcelos, M A Michelin, E F Candido Murta, R Simões Nomelini","doi":"10.48095/cccg2025309","DOIUrl":"https://doi.org/10.48095/cccg2025309","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether there is an association between the colposcopic lesion area and hematological parameters in patients with cervical intraepithelial neoplasia (CIN) 2/3.</p><p><strong>Material and methods: </strong>Women with CIN 2/3 were included in the study (N = 62). Colposcopic lesion area was measured by Image J software. Genotyping for human papillomavirus (HPV) 16, 18, 45 and 52 was performed by PCR. Hematologic parameters were evaluated.</p><p><strong>Results: </strong>The cut-off value of monocytes was ≤ 490.77/mm3, with a sensitivity of 92.3%, and a specificity of 44% (AUC = 0.662; P = 0.048). For red cell distribution width (RDW), the cut-off value was &gt; 12.9%, with a sensitivity of 84.6% and a specificity of 55.1% (AUC = 0.661; P = 0.028). In univariate analysis, monocyte count ≤ 490.77/mm3 and RDW &gt; 12.9% were associated with a colposcopic area &gt; 0.88 cm2 (P = 0.035; P = 0.015, resp.). After multivariate analysis, considering the cofactors age, CIN grade, smoking and HPV type, only RDW remained independent factor OR (95% CI) = 12.825 (1.348-121.971), P = 0.026.</p><p><strong>Conclusion: </strong>Monocyte count and RDW are associated with the lesion colposcopic area. The blood count is a simple, minimally invasive and inexpensive test, associated with the growth of precursor lesions of cervical cancer, and may, in the future, have the potential to be used in the public health system.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 4","pages":"309-314"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439538","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":"<p><p>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 < 110 g/L in the 1st trimester or < 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":"Vaginal fisting and risk of anogenital injury.","authors":"Daniel Driák, Albert Zajíček, Zlatko Pastor","doi":"10.48095/cccg2025385","DOIUrl":"10.48095/cccg2025385","url":null,"abstract":"<p><p>Vaginal fisting is an uncommon and risky sexual practice. It consists of penetrating the vagina with one or both hands. Fisting is practiced as heterosexual, homosexual, or autoerotic activity and may be the cause of vaginal injury and circumjacent organs. The article describes the case of a 33-year old pornographic film actress who developed vaginal injury and heavy bleeding during fisting while filming. Rupture of the vagina was sutured and blood loss was replenished with transfusions.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 5","pages":"385-387"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423182","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":"Which causes less pain? A comparison of misoprostol and dinoprostone in labor induction.","authors":"Sultan Canan, Sare Cancu Kalkan, Selçuk Özden, Hilal Uslu Yuvaci, Mehmet Sühha Bostanci","doi":"10.48095/cccg2025442","DOIUrl":"10.48095/cccg2025442","url":null,"abstract":"<p><strong>Objective: </strong>Effective labor pain management is essential in prenatal care. Identifying factors that contribute to increased pain in patients undergoing labor induction is essential for optimizing pain control. This study assesses pain levels in labor induction patients receiving vaginal misoprostol or dinoprostone for cervical ripening using a visual analogue scale (VAS).</p><p><strong>Materials and methods: </strong>This prospective study includes 60 volunteer women who received either vaginal dinoprostone (50%) or vaginal misoprostol (50%) as cervical ripening agents. Group 1 consists of patients who received misoprostol, while Group 2 includes those who were administered dinoprostone. VAS scores were recorded during both active labor and crowning. In addition to these pain assessments, birth outcomes and patient characteristics were documented, and comparative analyses were conducted between the groups.</p><p><strong>Results: </strong>According to VAS scores, pain intensity was significantly lower in Group 1 compared to Group 2 at both stages of labor (during active labor: 6.67 ± 2.68 vs. 7.77 ± 1.59, P < 0.05; during crowning: 8.9 ± 1.32 vs. 9.8 ± 0.55, P < 0.05). All participants’ pain scores recorded during crowning were significantly higher than those recorded during active labor (P < 0.05). No statistically significant difference was observed between the two agents in terms of oxytocin administration or the interval from drug administration to delivery (P > 0.05).</p><p><strong>Conclusions: </strong>Pain scores should be considered when selecting a cervical ripening agent. Misoprostol may be associated with lower pain levels.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 6","pages":"442-446"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041769","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}