Clinical obstetrics, gynecology and reproductive medicine最新文献

{"title":"Oxytocin Versus Dinoprostone For Labor Induction in Multiparous Women with Unfavorable Cervix","authors":"G. Buyuk, U. Sert, Z. A. Oskovi Kaplan, S. Kahyaoglu","doi":"10.21613/gorm.2020.1039","DOIUrl":"https://doi.org/10.21613/gorm.2020.1039","url":null,"abstract":"OBJECTIVE: Dinoprostone is a drug of choice in our daily practice for the induction of labor. The aim of our study; to compare the use of oxytocin with dinoprostone (PGE2- Propess©) used in term multiparous pregnant women to ripen the cervix.STUDY DESIGN: A total of 507 patients were included in the study. Group A, consisted of 262 women with term multiparous pregnancy Bishop score ≤6 underwent induction of labor with a vaginal insert containing 10-mg timed-release dinoprostone (Propess© -prostaglandin E2). Group B, consisted of 245 cases of pregnancy with Bishop score ≤6 underwent induction of labor with iv oxytocin and was matched for the patient's age and parity. The following data were recorded: age, gestational age, body mass index, the time from the drug administration to the vaginal labor, delivery mode, indications of induction, cesarean indication, birth weight, Apgar score, and need of neonatal intensive care unit. RESULTS: The primary outcome of the in group B interval from induction to vaginal delivery was similar between the two groups. In group A, 41 patients and in group B, 23 patients had a cesarean section. Cesarean section rate was lower in the oxytocin group (cesarean rate 15.6% versus 9.3%, p<0.05). CONCLUSION: It appears; Dinoprostone ovule increases the cesarean rate in terms, multiparous cases with inappropriate cervical score and does not shorten the duration of delivery. Therefore, the use of oxytocin for cervical ripening in multiparous women may be a more appropriate option.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86078875","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":"Comparison of hCG Versus Gonadotropin-Releasing Hormone Agonist to Induce Oocyte Maturation in Assisted Reproductive Technology Cycles: A Retrospective Cohort Study","authors":"Gulay Beydilli Nacak, Elif Tozkır, E. Ozkaya, E. Cogendez, F. Kaya","doi":"10.21613/gorm.2020.1034","DOIUrl":"https://doi.org/10.21613/gorm.2020.1034","url":null,"abstract":"OBJECTIVE: To compare some cycle characteristics and outcomes using a protocol consisting of a GnRH agonist trigger or hCG trigger after cotreatment with GnRH antagonist.STUDY DESIGN: Thirty-three patients under 35 years of age with polycystic ovarian syndrome, polycystic ovarian morphology, or previous high response who underwent ovulation trigger by GnRH agonist trigger and 132 patients under 35 years of age with the polycystic ovarian syndrome, polycystic ovarian morphology, or previous high response who underwent ovulation trigger by hCG for IVF treatment. Patients were non-randomly assigned to an ovarian stimulation protocol consisting of either GnRH agonist trigger after cotreatment with GnRH antagonist (study group) or hCG trigger after antagonist protocol (control group).RESULTS: The positive pregnancy test was obtained in 70 women in the control group whereas in 13 cases in the study group (p=0.161). No case in the study group needed hospitalization whereas there were 15 cases in the control group who were required to be hospitalized due to ovarian hyperstimulation related symptoms (p=0.04).CONCLUSIONS: The use of a protocol consisting of a GnRH agonist trigger after GnRH antagonist cotreatment and freeze-all strategy reduces the risk of ovarian hyperstimulation syndrome in high-risk patients undergoing IVF without affecting pregnancy rates.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72786341","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":"Index","authors":"","doi":"10.1097/01.grf.0000654136.08696.d8","DOIUrl":"https://doi.org/10.1097/01.grf.0000654136.08696.d8","url":null,"abstract":"","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90487954","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":"Distribution of pathologic smear results and histopathologic agreement in precancerous cervical lesions","authors":"Eser Çolak, Esra Zeynep Coşkunoğlu","doi":"10.21613/gorm.2020.1030","DOIUrl":"https://doi.org/10.21613/gorm.2020.1030","url":null,"abstract":"OBJECTIVES: The accuracy of the Papanicolau smear test is very important in cervical cancer which is preventable cancer. In this study, we aimed to investigate the distribution of smear results and cyto-histopathological correlation and agreement in biopsies.STUDY DESIGN: A retrospective study was performed at the gynecology obstetrics and pathology department of Baskent University Konya Application and Research Hospital, over a 5-year period. The histopathology results of 89 patients who underwent colposcopic biopsy from 273 patients with pathologic Pap smear results were examined. The histopathologic results and pathologic Pap smear results were compared and the compatibility between them was examined.RESULTS: Data records were collected for 11,191 women. Overall, the prevalence of cytologic abnormalities was 2.43%. The cytohistopathologic correlation in epithelial lesions was 56% and was statistically significant. In glandular lesions, normal biopsy results were reported in 93% of AGC-NOS cytology results, whereas there was a 100% malignancy correlation with AGC-FN cytology results. In terms of detecting low and high-grade lesions, the false-negative rate was 12% and the false-positive rate was 17%.CONCLUSION: In conclusion, Pap smears can be less cost-effective and easily accessible method. While conservative treatment is appropriate in young patients because of possible regression even in high-grade lesions; in older patients, it should not be hesitated to get biopsy when a suspicious clinic is present.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"16 6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83743547","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 and outcome of Dinoprostone (Propess®) for cervical ripping: A retrospective study","authors":"Hanifah Bukhari, M. Tulbah, G. Molla, Lubna Albader","doi":"10.15761/COGRM.1000302","DOIUrl":"https://doi.org/10.15761/COGRM.1000302","url":null,"abstract":"Background: There are different pharmacological and mechanical types of cervical dilators have been approved to ripen unfavorable cervix. The dinoprostone slow release Prostaglandin E2 (PGE2) (Propess®) is available as vaginal pessary for cervical ripening, which releases 10 mg of dinoprostone over 24 hours. The effect of PGE2 has been investigated and there are many studies in the literature comparing the efficacy of the different formulations available in the market. In our study, we evaluated PGE2 slow release on ripping cervix on different patient varieties and we evaluated the maternal outcome secondary to induction of labor by (Propess®). Material and methods: This retrospective Cohort study included 187 patients whom were induced for labor at term with intact amniotic membrane from first of January till 31 December 2018. The induction was by (Propess®). Result: The Propess® was effective on ripping cervix within 24 hours with high response rate 77.9% on Para (P) ≤2. The Propess® was effective on cervical ripping in 71% of normal body mass index (BMI) and show less response on high BMI. No increased risk of caesarean section on patients with different amniotic fluid index. The vaginal delivery rate was 81.1% of the normal amniotic fluid index, 88.2% of oligohydramnios patients. We had 82.1%of intrauterine fetal growth restriction patients achieved vaginal delivery. Conclusion: The Propess® is an effective method for cervical ripening, but less effective on high parity and high body mass index. No increase of fetal distress and caesarean section on oligohydramnios or intrauterine growth restriction in compare to normal fetus. *Correspondence to: Hanifah Bukhari, Maternal and Fetal Medicine Fellow, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia, E-mail: dr.hanifah@hotmail.com","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88264814","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":"Relationship between hippocampal subfield volumes and memory function in adults born preterm with very low birth weight (VLBW)","authors":"Synne Aanes, K. J. Bjuland, Astrid M. W. Lærum, S. Weider, K. Evensen, M. Indredavik, A. Brubakk, A. Håberg, Gro C C Løhaugen, J. Skranes","doi":"10.15761/cogrm.1000281","DOIUrl":"https://doi.org/10.15761/cogrm.1000281","url":null,"abstract":"Background: Being born preterm with very low birth weight (VLBW) is related to aberrant brain development. Hippocampus is a brain region particularly vulnerable to injury, for instance from consequences following preterm birth. The hippocampus is a complex structure with distinct subfields related to specific memory functions which are differently affected by neuropathological conditions. The relationship between deviations in hippocampal subfields and memory function has not been studied in adults born preterm with VLBW previously. Aims: In this long-term follow-up study of a geographically based cohort (birth years 1986-88) of VLBW individuals and term born controls with normal birth weight, the main aim was to examine group differences in memory function and hippocampal volumes at age 26 years. We also explored hippocampal structurefunction relationships in the VLBW group. Methods: Fifty-two VLBW and 82 control individuals aged 26 years were examined clinically of whom 44 VLBW and 70 controls had high-quality structural cerebral MRI at 3T. The participants were assessed with subtests from Wechsler Memory Scale and Cambridge Neuropsychological Test Automated Battery on verbal, visual and working memory. From the T1 weighted 3D images, hippocampal subfield volumes were estimated in FreeSurfer 6.0. In addition to group comparisons, partial correlations were performed in the VLBW group between hippocampal subfields’ volumes and neonatal risk factors, and between reduced hippocampal subfields’ volumes and performance on the memory tests. Results: Adults with VLBW had lower verbal, visual and working memory scores compared with term born control adults. Absolute hippocampal total and most subfield volumes were smaller in the VLBW group than in the control group, but with different findings in men and women. When adjusting for intracranial volume, left and right cornu ammonis fields and left dentate gyrus were smaller in VLBW women, while the right subiculum was smaller in VLBW men compared with control women and men, respectively. There was a negative correlation between days on mechanical ventilation and volume of the left subiculum in the VLBW group. Smaller left dentate gyrus volume was associated with lower visual memory performance in the VLBW group. Conclusions: Adults born preterm with VLBW had lower performance on memory tests and smaller hippocampi compared with term born controls, and volume of dentate gyrus was associated with visual memory. Hippocampal subfield volumes seem to be differently affected following preterm birth in VLBW men and women. *Correspondence to: Synne Aanes, Department of Clinical & Molecular Medicine, Faculty of Medicine & Health Sciences, Norwegian University of Science & Technology, 7489 Trondheim, Norway, E-mail: Synne.aanes@gmail.com","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75022695","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":"Asymptomatic intrahepatic cholestasis of pregnancy","authors":"J. Uspenskaya, Arkadiy A Sheptulin, Irina V Kuznetsova, Evgeniy P Gitel, Andrey V Murashko, Andrey N Gerasimov, Elena V Melnik, Ekaterina A Korsunskaya, Galina V Tugarinova, Alla A Gindis, Tatjana A. Seredina","doi":"10.15761/cogrm.1000278","DOIUrl":"https://doi.org/10.15761/cogrm.1000278","url":null,"abstract":"Background and Aim: Pruritus is a varying symptom of cholestatic liver diseases. Previous studies suggested that latent intrahepatic cholestasis of pregnancy (ICP) affects a subset of pregnant women. The aim of this study was to assess the characteristics of asymptomatic ICP and its course following treatment. Methods: We used total serum bile acids (BAs) as a laboratory marker of ICP. Patients were evaluated for history and clinical data, pregnancy outcome and laboratory biochemical parameters at baseline and 1 and 2 weeks after treatment with ursodeoxycholic acid (500 mg to 2 g per day). Results: Among 97 pregnant women with laboratory-confirmed ICP, 70 (72.2%) had pruritus, while 27 (27.8%) did not. Among symptomatic and asymptomatic ICP patients, there was no significant difference in clinical and demographic parameters, pre-treatment biochemical parameters or pregnancy outcome. The rate of decrease of liver transaminases was significantly higher in symptomatic than in asymptomatic ICP patients (p <0.001). By comparison, the therapy-associated changes of BAs levels were not significantly different in the two groups. Conclusions: The lack of significant differences in clinical pattern, pregnancy outcome, and laboratory signs of liver damage suggests that asymptomatic ICP is not associated with pruritus. Since asymptomatic ICP and classical ICP carry the same risk to the fetus, it seems appropriate to perform BAs laboratory screening in pregnant women to detect subclinical ICP. *Correspondence to: Arkadiy Sheptulin, Professor, Chair of Internal Diseases Propedeutics, First Moscow State Medical I. M. Sechenov-University, Pogodinskaya Street, 1, Bld. 1, 119435, Moscow, Russian Federation, E-mail: arkalshep@gmail.com","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79575012","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":"The effects of vaginal delivery on urethrovesical junction motility and stress incontinence: ultrasonographic evaluation","authors":"L. Cipullo, G. E. Poto, M. Amato, Cosimo Cosimato, M. Guida","doi":"10.15761/COGRM.1000298","DOIUrl":"https://doi.org/10.15761/COGRM.1000298","url":null,"abstract":"Study objective: To evaluate the anatomical changes of the pelvic floor and urinary system following delivery, and to analyse the relationship to mode of delivery and obstetrical procedures. Furthermore, this study aims to discuss and analyse the performance of transperineal sonography of the urethrovesical junction for the diagnosis of female stress urinary incontinence. Methods: Pubovesical angle (PVA) and retrovesical angle (RVA) were evaluated ultrasonographically in controls and pregnant women 24 hours and then 12 weeks after delivery. All patients completed the ICIQ-SF questionnaire. At 24 hours after the delivery, RVA mean values in pregnant women were higher than controls’ and still higher when compared with RVA values after 12 weeks. Results: A linear relationship between PVA modifications and infant weight at birth was demonstrated, as well as between PVA and neonatal biparietal diameter. Besides, the study confirms the occurrence of changes at the urethrovesical junction following disengagement manoeuvres and shoulder dystocia. The role of BMI in affecting the recovery of perineal anatomy after delivery has also been investigated. Conclusion: PVA has shown to be higher in symptomatic women with a cut-off value for the onset of incontinence of 74°, with a sensitivity of 100% and a specificity of 72.5%.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89457134","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":"Reproductive outcomes after treatment of patients with gestational trophoblastic neoplasia","authors":"S. Srijaipracharoen, S. Tangjitgamol","doi":"10.15761/COGRM.1000289","DOIUrl":"https://doi.org/10.15761/COGRM.1000289","url":null,"abstract":"Objectives : To assess reproductive outcomes of gestational trophoblastic neoplasia (GTN) patients after treatment. Methods : Patients with GTN who had treatment in our institution during January 2003 to December 2018 were identified. The patients must have had conservative treatment with intact uterus. Data collected were age at GTN diagnosis, menstrual and obstetrical history, characteristics of GTN, treatment, reproductive outcomes including menstrual and fertility function after treatment. Results : From 80 GTN patients, 74 patients had available clinical data. Total of 50 patients met inclusion criteria. Their mean age was 30.8 ± 7.7 years old; 88.0% were 40 years or younger. Thirty-nine of 50 patients (78%) were in stage I and the other 11 patients (22%) were in stage III. Most patients were in low risk group with only 2 (4%) were high risk. All except one had chemotherapy. Methotrexate was the most common first line chemotherapy, 86.0%. Only 5 of 50 (10%) had abnormal menstruation: delayed menstrual resumption, abnormal pattern, or amenorrhea. The 41 patients who desired pregnancy had younger age and lower parity than the other nine who did not want further fertility: mean age of 28.7 years old and parity of 0.5 compared to 40.4 years and 2.1, respectively (P<0.001 both). Total of 22 patients of 41 patients who desired for pregnancy (53.6%) got pregnant. The median interval time after complete treatment to pregnancy was 2.7-97.2 months (median 43.6 months). Total of 33 pregnancies were achieved resulting in 28 live births (84.8%), 4 abortions (12.1%), and one repeated molar pregnancy (3.0%). Conclusions : Almost all GTN patients (90%) could resume normal menstruation. Slightly more than half of the patients who desired for pregnancy could have at least 1 pregnancy after treatment with chemotherapy. Normal live births were achieved in 84.8% without perinatal adverse events.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81744714","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":"Angiomyofibroblastoma: A rare benign gynecologic tumor mistaken for a bartholin cyst","authors":"R. Beavers, Daphne Arena Goncharov, C. Degraffenreid, Mahmoud A. Abdelwahab, Xiao‐yan Du, E. Eyzaguirre, K. E. Lewis","doi":"10.15761/COGRM.1000308","DOIUrl":"https://doi.org/10.15761/COGRM.1000308","url":null,"abstract":"Background: Angiomyofibroblastoma is a rare, benign superficial vulvar lesion of the middle-aged female. Most cases in the literature are initially misdiagnosed as Bartholin gland cysts with final diagnosis ascertained via pathology at the time of surgical excision. Case: A 45-year-old female presented with a large, painless vulvar mass. This mass had formed five years prior to presentation to our clinic, and the patient underwent a procedure to attempt to drain the mass 2-3 years following its initial formation. At her initial visit, a 15 X 10 cm mass was found on the posterior aspect of the right labia minora at the level of the vaginal vestibule. This mass extended inferiorly to the perineum. Needle aspiration was attempted in office but was unsuccessful. The mass was removed under general anesthesia in the operating room en bloc from the vulva without complication and the patient was discharged on postoperative day 0. The pathology of this mass was reported as angiomyofibroblastoma. Conclusion: Differentiating angiomyofibroblastoma from other potential soft tissue masses of the vulva, especially from the commonly mistaken Bartholin gland cyst or rare aggressive angiomyxoma, is essential for preventing unnecessary procedural workup or treatment miss of a malignant mass. Noting the key distinguishing pathological and clinical features of the tumor and considering risk factors for malignancy will aid in correct diagnosis without exposing the patient to extraneous procedures and potential harm.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90273106","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}