Ginekologia polska最新文献

{"title":"The prevalence of Group B Streptococcus rectovaginal colonization and antimicrobial susceptibility pattern in Turkish and Syrian pregnant women.","authors":"Emine Kirtis, Burak Karadag, Aysel Uysal, Yeşim Çekin, Gul Alkan Bulbul","doi":"10.5603/gpl.102721","DOIUrl":"https://doi.org/10.5603/gpl.102721","url":null,"abstract":"<p><strong>Objectives: </strong>Colonization with Group B Streptococcus (GBS) during pregnancy can lead to invasive GBS disease (iGBS) in neonates, including meningitis, pneumonia or sepsis, which carries a high mortality risk. American College of Obstetricians and Gynecologists (ACOG) recommends universal GBS screening for all pregnant individuals between 36 0/7 and 37 6/7 weeks of gestation. However, due to the insufficient population-based studies on universal screening and GBS colonization rates in late periods of pregnancy in Türkiye, we aimed to evaluate the prevalence of GBS and its antibiotic resistance to enhance awareness regarding GBS screening and prophylaxis during pregnancy and promote the use of appropriate antibiotics.</p><p><strong>Material and methods: </strong>This prospective, single-center study was conducted between May 2017 and December 2017 on 518 pregnant women (363 Turkish and 155 Syrian). Vaginal and rectal samples were collected and cultured in Todd-Hewitt broth. Standard microbiological protocols were used to assess GBS colonization and antibiotic susceptibility.</p><p><strong>Results: </strong>In the study, we found that 10.6% (n = 55) of pregnant women were colonized with GBS asymptomatically. Group B Streptococcus colonization rates did not differ significantly between Turkish patients (11%, n = 40) and Syrian patients (9.7%, n = 15) (p = 0.756, p > 0.05). All patients colonized with GBS were penicillin-sensitive. However, resistance to at least one non-penicillin antibiotic was observed in 42.5% (n = 17) of Turkish patients and 60% (n = 9) of Syrian patients. Although not statistically significant (p > 0.05), Syrian patients exhibited relatively higher rates of antibiotic resistance, especially to erythrosine and clindamycin.</p><p><strong>Conclusions: </strong>In our country, implementing universal screening for asymptomatic GBS in pregnant women, as recommended by the Centers for Disease Control and Prevention (CDC), would be more beneficial than a risk-based screening approach. Given the increased resistance patterns observed in antibiogram results, GBS prophylaxis at delivery, especially in patients with penicillin allergies, should be planned based on antibiotic susceptibility testing.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722961","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":"Current approach to the use of transvaginal mesh systems in pelvic organ prolapse.","authors":"Monika Pycek, Justyna M Zarzecka, Wojciech Majkusiak, Ewa M Barcz, Aneta Zwierzchowska","doi":"10.5603/gpl.101432","DOIUrl":"https://doi.org/10.5603/gpl.101432","url":null,"abstract":"<p><p>Pelvic organ prolapse (POP) involves the descent of vaginal walls, uterus, or vaginal apex. Traditional native tissue repair techniques, while low in complications, exhibit significant relapse rates. To enhance durability of surgical repair, synthetic mesh systems were adopted. However, early generations faced complications such as vaginal mesh exposure and dyspareunia, leading to critical reevaluation and regulatory actions. The Food and Drug Administration issued first warning in 2008 and reclassified mesh as high-risk in 2016, banning it for transvaginal anterior compartment prolapse in 2019. European and Canadian regulations similarly increased scrutiny, with prominent professional organizations and regulatory bodies endorsing limited use and thorough counseling. Subsequent innovations introduced lighter mesh systems with sacrospinous ligament fixation, which improved anatomical outcomes and reduced adverse effects. Recent studies on these systems demonstrate promising success rates, with notable reductions in prolapse recurrence and improved quality of life. Given these developments, current perspectives advocate for selective use of advanced mesh systems in POP surgery, emphasizing rigorous patient selection, informed consent, and meticulous surgical technique. This careful approach, as opposed to a categorical ban, aims to balance the therapeutic benefits with potential risks, ensuring optimized patient outcomes in POP management.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723004","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":"Maternal and neonatal outcomes in dichorionic diamniotic twin pregnancies: a comparison between assisted reproductive technology and spontaneous conception.","authors":"Gizem Berfin Uluutku Bulutlar, Eralp Bulutlar, Büşra Parlak Somuncu, Çetin Kılıççı, Pınar Kumru","doi":"10.5603/gpl.103514","DOIUrl":"https://doi.org/10.5603/gpl.103514","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate and compare maternal and neonatal outcomes in dichorionic diamniotic (DCDA) twin pregnancies conceived via assisted reproductive technology (ART) versus those conceived spontaneously (SC).</p><p><strong>Material and methods: </strong>This single-center, retrospective cohort study included 852 DCDA twin pregnancies, with 591 conceived spontaneously (SC group) and 261 conceived via ART (ART group). Maternal and neonatal outcomes were extracted from the hospital's automation system and analyzed using statistical methods, including chi-square and Mantel-Haenszel chi-square tests, to account for potential confounding factors.</p><p><strong>Results: </strong>Our findings indicate that ART twin pregnancies have significantly poorer outcomes compared to SC twin pregnancies. The risk of cerclage application is 12.6 times higher in the ART group. Furthermore, ART pregnancies exhibit a 19.2-fold increased risk of intrahepatic cholestasis of pregnancy (ICP). The rates of preterm birth, including late preterm, moderate preterm, very preterm, and extremely preterm, are significantly higher in the ART group. Moreover, ART pregnancies are associated with higher incidences of very low birth weight (VLBW), NICU admissions, and neonatal death. The ART group also experiences significantly higher rates of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), postpartum hemorrhage, and cesarean section, with postpartum atony occurring 4 times more frequently.</p><p><strong>Conclusions: </strong>Maternal and neonatal outcomes in ART-conceived DCDA twin pregnancies are markedly worse compared to those conceived spontaneously. The observed disparities underscore the necessity for intensive monitoring and tailored management strategies in ART twin pregnancies. Further research is essential to uncover the mechanisms driving these adverse outcomes.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722927","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":"Postpartum emotional disorders - a narrative review.","authors":"Roza Motyka, Urszula Sioma-Markowska","doi":"10.5603/gpl.104124","DOIUrl":"https://doi.org/10.5603/gpl.104124","url":null,"abstract":"<p><p>Emotional disorders during pregnancy and the postpartum period affect many women worldwide and present a significant challenge in perinatal care. The first year after childbirth is particularly demanding for a woman's emotional well-being, asitismarked by profound physical, emotional, and social changes. The aim of this article is to review and compare the latest data on the prevalence, risk factors, and treatment options for baby blues and postpartum depression. For this purpose, the electronic databases - including PubMed, NLM, MDPI, Europe PMC, and Google Scholar - were searched for recent English-language articles with full-text availability. The search terms included: postpartum depression, baby blues, maternity blues, postpartum depression prevalence, postpartum depression risk factors, postpartum depression treatment, online psychotherapy, and postpartum depression covid. The review was compiled and evaluated using SANRA (Scale for the Assessment of Narrative Review Articles).</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722929","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":"Vitamin D and calcium levels related to bone mineral density during pregnancy and postpartum.","authors":"Wiktor Wojczakowski, Konrad Futyma","doi":"10.5603/gpl.102995","DOIUrl":"https://doi.org/10.5603/gpl.102995","url":null,"abstract":"<p><p>Bone mineral density (BMD) is crucial for bone strength, with even a modest decrease significantly elevating fracture risk. Calcium imbalance during pregnancy contributes to BMD loss, as maternal stores are mobilized to support fetal skeletal development. Vitamin D deficiency exacerbates this issue, with prevalence rates alarming in various populations. Supplementation with vitamin D and calcium aims to mitigate BMD decline; however, optimal dosing and efficacy remain debated. Studies utilizing innovative diagnostic tools like radiofrequency echographic multi spectrometry (REMS) and quantitative ultrasonometry (QUS) shed light on BMD changes during pregnancy, offering safer alternatives to traditional methods such as dual-energy X-ray absorptiometry (DEXA), prohibited during pregnancy due to fetal radiation risks. Despite methodological challenges, research reveals significant BMD reductions during pregnancy, particularly in weight-bearing bones. In conclusion, maintaining maternal bone health during pregnancy and postpartum is critical, requiring comprehensive monitoring and support. Further research is needed to elucidate optimal strategies for preserving BMD throughout the reproductive lifespan, reducing fracture risk and enhancing maternal well-being.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722965","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":"A multiple male and female pregnancy in a patient with stage IV endometriosis undergoing single embryo transfer after IVF-ICSI.","authors":"Piotr Olcha, Lukasz Nowakowski, Lechoslaw Putowski, Iwona Radzik, Michal Ciebiera","doi":"10.5603/gpl.100073","DOIUrl":"https://doi.org/10.5603/gpl.100073","url":null,"abstract":"","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722808","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 relationship between major anomalies and chorionicity in twin pregnancies referred for first trimester and second trimester detailed anatomic ultrasonography.","authors":"Ercan Koçkaya, Yasemin Doğan, Abdulkadir Babaoğlu","doi":"10.5603/gpl.102670","DOIUrl":"https://doi.org/10.5603/gpl.102670","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study is to validate the relationship between chorionicity and congenital anomalies.</p><p><strong>Material and methods: </strong>A retrospective analysis twin pregnancies that underwent ultrasonographic fetal anatomy screening in the first or second trimester was conducted. Analyzed variables were, gestational age, chorionicity, presence of major fetal structural anomalies, number of affected fetuses, anomaly type, and use of assisted reproductive techniques (ART).</p><p><strong>Results: </strong>Of the 824 twin pregnancies included in the study, 116 (14%) had major fetal anomalies. The frequency of major fetal structural anomalies was higher in monochorionic (MC) twin pregnancies compared to dichorionic (DC) twin pregnancies (p < 0.001). When anomalies were categorized into cardiac, central nervous system, and other system anomalies, no significant correlation was found between chorionicity and anomaly groups (p = 0.794).</p><p><strong>Conclusions: </strong>In MC twin pregnancies, major fetal structural abnormalities are more prevalent. Prioritizing the evaluation of chorionicity is essential due to the increased risk associated with twin pregnancies.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722963","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":"Dermabond-adhesive glue versus polypropylene sutures for cesarean section-skin closure.","authors":"Zainab Abdul Ameer Jaafar, Zhanslu Sarkulova, Ainur Tokshilykova, Ibrahim A Abdelazim, Marat Sarkulov, Yersulu Sagidanova, Farida Balmaganbetova, Ainur Donayeva","doi":"10.5603/gpl.102862","DOIUrl":"https://doi.org/10.5603/gpl.102862","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the Dermabond-adhesive glue versus polypropylene sutures for cesarean section (CS) skin closure.</p><p><strong>Material and methods: </strong>One hundred women admitted for elective CSs (ECSs) were randomized into two groups; Dermabond group including women underwent CS-skin closure using Dermabond-adhesive glue and polypropylene group including women underwent CS-skin closure using polypropylene sutures. Participants were evaluated weekly for two months after the ECSs to detect the post-CS surgical site infection (SSI). Participants were asked to complete a modified Patient Scar Assessment Scale (PSAS) to detect the CS-scar related symptoms and overall satisfaction.</p><p><strong>Results: </strong>The superficial post-CS SSI was reported in 10% (5/50) of participants; 2 cases (4%) in Dermabond group and 3 cases (6%) in polypropylene group (p = 0.6). No statistical differences were reported between studied groups regarding, ECS duration (44.78 ± 3.44 min for Dermabond group vs 45.6 ± 3.78 for polypropylene group) (p = 0.7) or CS-skin closure duration (2.46 ± 0.34 min for Dermabond group vs 3.6 ± 0.36 for polypropylene group) (p = 0.6). Third-day post-CS pain score was statistically lower, and overall satisfaction was statistically higher when Dermabond group was compared to polypropylene group [2.34 ± 0.47 and 2.9 ± 0.3, respectively (p = 0.02) vs 2.86 ± 0.35 and 2.34 ± 0.47, respectively (p = 0.001)].</p><p><strong>Conclusions: </strong>Dermabond-adhesive glue was a safe and successful alternative to polypropylene for CS-skin closure. Third-day post-CS pain score was statistically lower, and overall satisfaction was statistically higher when Dermabond group was compared to polypropylene group.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723006","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":"A retrospective analysis of the characteristics of acquired uterine arteriovenous malformations associated with retained products of conception.","authors":"Yu Sun, Min Yang, Wenpei Bai","doi":"10.5603/gpl.101558","DOIUrl":"https://doi.org/10.5603/gpl.101558","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the clinical characteristics and imaging manifestations of retained products of conception (RPOC) with retained products of conception combined with uterine arteriovenous malformation (UAVM-RPOC), to provide a basis for the early identification and clinical treatment of UAVM-RPOC.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted on women of reproductive age (89 cases) for retained products of conception. Among the cases, 28 were identified with UAVM-RPOC through ultrasound diagnosis, while 61 were diagnosed with RPOC. The clinical and imaging characteristics of the two groups of women were analyzed, and the treatment methods and prognosis of UAVM-RPOC were also analyzed.</p><p><strong>Results: </strong>71.43% women with UAVM-RPOC had a history of two or more previous pregnancies, which was significantly higher than the 45.8% observed in the RPOC group (p < 0.05). The median serum level of β-human chorionic gonadotropin (β-HCG) was 128.7 (16.32-977) mIU/mL. The median time for detecting RPOC in women was 23 days, while the median time to diagnose UAVM-RPOC was 39.5 days. In transvaginal sonography (TVS), 92.86% of women with UAVM-RPOC exhibited low-resistance (RI < 0.5) ultrasound manifestations of the lesion, which was significantly higher than that in the RPOC group (32.79%), p < 0.0001. The contrast-enhanced ultrasound (CEUS) features of UAVM-RPOC were characterized by early-stage lesions showing rapid enhancement, which was followed by a late-stage delay in the washout of the contrast agent compared to the myometrium, leading to sustained enhancement. Out of 28 cases, only one woman underwent hysteroscopic surgery following pre-treatment with uterine artery embolization; the remaining female did not receive pre-treatment, and the surgical success rate for all women was 100%.</p><p><strong>Conclusions: </strong>Our study revealed the clinical and imaging characteristics of UAVM-RPOC. Transvaginal ultrasound is the preferred examination for diagnosing UAVM-RPOC, but for cases with rich local blood flow signals, further refinement with CEUS examination can be beneficial. The combined examination can better assess the depth of muscle layer infiltration of the lesion, further evaluate the risk level of UAVM-RPOC, and guide clinical treatment.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722897","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":"Magnetic resonance imaging-based radiomic model to predict the risk of intraoperative massive hemorrhage in patients with cesarean scar pregnancy.","authors":"Bingjie Ye, Chenyu Chen, Ke Su, Rujia Fan, Bo Yuan","doi":"10.5603/gpl.102853","DOIUrl":"https://doi.org/10.5603/gpl.102853","url":null,"abstract":"<p><strong>Objectives: </strong>Development of magnetic resonance imaging (MRI)-based radiomic models to predict the risk of intraoperative massive hemorrhage in patients with cesarean scar pregnancy (CSP).</p><p><strong>Material and methods: </strong>CSP patients (n = 126) from Center 1 were randomly assigned in a 7:3 ratio into a training set (n = 88) and an internal validation set (n = 38), and patients (n = 32) from Center 2 into an external validation set. Afterward, the clinical and radiomic features related to intraoperative massive hemorrhage were fed into the k-nearest Neighbor (KNN), support vector machine (SVM), Light Gradient Boosting Machine (Light GBM), and Multi- Layer Perception (MLP) to construct predictive clinical, radiomic, and combinatorial models. The performance of these models was assessed using area under curve (AUC), Delong's test, Decision Curve Analysis (DCA), and calibration curves. Youden's index was used to determine the optimal threshold.</p><p><strong>Results: </strong>Eleven radiomic characteristics were found to be substantially linked to intraoperative massive hemorrhage. The combined in the gestational sac and peripheral to the gestational sac (IP) model (AUC = 0.959), constructed by MLP, had the best performance, with an optimal risk threshold of 0.180, as compared to the clinical model (AUC = 0.500) and the nomogram (AUC = 0.283). DCA and calibration curves demonstrated the IP model's good clinical predictive performance.</p><p><strong>Conclusions: </strong>The IP model for CSP was superior to the other models in this study in predicting the risk of intraoperative massive hemorrhage, which was significantly increased when the risk threshold exceeded 0.180. The model may help clinicians make individualized treatment decisions.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722924","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}