Ginekologia polska最新文献

{"title":"FIGO 2023 - too soon or just in time? Evolution or a revolution? Review of the newest endometrial cancer staging classification.","authors":"Marcin Misiek, Agnieszka Picheta, Kaja Michalczyk, Tomasz Kluz, Andrzej Wrobel, Rafal Stojko, Anita Chudecka-Glaz","doi":"10.5603/gpl.102620","DOIUrl":"10.5603/gpl.102620","url":null,"abstract":"<p><p>The FIGO staging system is an integral part of the therapeutic and treatment process in female genital tumors. It cements the knowledge gained to date to plan patient treatment prognosis and the course of the disease and compare treatment outcomes between centers in the most individualized yet systematic way. In response to these assumptions, the FIGO Committee on Gynaecological Oncology updated the endometrial cancer staging classification in June 2023. The new endometrial cancer staging classification includes multiple clinicopathological prognostic factors and molecular findings for the first time. In this review, we summarize the differences between the new and the old FIGO classification and comment on its everyday real-world application.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"314-320"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752663","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 obesity, more than diabetes mellitus, predisposes to soft tissue injuries of the birth canal during vaginal delivery.","authors":"Aneta Malinowska-Polubiec, Malgorzata Kujko-Wisniewska, Ewa Romejko-Wolniewicz, Julia Zareba-Szczudlik, Agnieszka Dobrowolska-Redo, Joanna Kacperczyk-Bartnik, Krzysztof Czajkowski","doi":"10.5603/gpl.100252","DOIUrl":"10.5603/gpl.100252","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to evaluate the relationship between the incidence of birth canal soft tissue injuries, perineal incision procedure and maternal and neonatal characteristics.</p><p><strong>Material and methods: </strong>It was a retrospective cohort study conducted in a tertiary hospital analyzing deliveries between July 2018 and January 2019. Study group included 726 spontaneous vaginal singleton births in the longitudinal cephalic fetal position after completed 36th gestational week. Characteristics of patients who suffered from cervical ruptures and/or vaginal injuries were compared to those who gave birth without any soft tissue traumas.</p><p><strong>Results: </strong>The perineal incision procedure was performed in 561 (77.3%) women. Soft tissue injuries of the birth canal were found in 220 patients (30.3%). Cervical rupture was more frequent when perineal incision was performed (94.5% vs 74.2%, p = 0.0001), but only in primiparous women (70.6% vs 43.2%, p = 0.01). Vaginal injury happened less frequently when perineal incision was performed (56.5% vs 81.8%, p = 0.001), but only in multiparous women (12.9% vs 34.3%, p = 0.001). Vaginal injury was more common in women with higher pre-pregnancy body weight (69.4 vs 65.4 kg, p = 0.0015), higher prepregnancy BMI (24.5 vs 23.5 kg/m², p = 0.0085), higher body weight and BMI before delivery (82.2 vs 78.1 kg, p = 0.001 and 29.1 vs 28.1 kg/m², p = 0.008, respectively). In multivariate logistic regression analysis neither parity nor perineal incision increased the risk of vaginal injury. Only the obese women, but not diabetic, were at higher risk of vaginal injury, when perineal incision was performed (OR 2.25, CI 1.25-4.05, p = 0.007).</p><p><strong>Conclusions: </strong>The obese women are at higher risk of vaginal injury during delivery, when perineal incision is performed. The necessity of maintaining normal body weight while planning pregnancy, monitoring gestational weight gain, and avoiding perineal incision remain important issues.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"294-303"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392809","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":"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":"247-255"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","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":"Evaluation of prognostic nutritional status and lipid profile in gestational diabetes.","authors":"Betül Tokgöz Çakır, Gizem Aktemur, Gulsan Karabay, Zeynep Şeyhanlı, Serap Topkara Sucu, Aslihan Coşkun, Seval Yılmaz Ergani, Hande Esra Koca Yildrim, Yildiz Akadaş Reis, Can Tekin İskender","doi":"10.5603/gpl.99832","DOIUrl":"10.5603/gpl.99832","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the relationship between controlling nutritional status index (CONUT) and prognostic nutrition index (PNI) scores that are used to evaluate nutritional status and GDM. Also, lipid abnormalities and albumin levels in pregnant women with normal glucose tolerance and GDM were researched.</p><p><strong>Material and methods: </strong>This study was conducted as a retrospective study at Ankara Etlik City Hospital, Turkey. The study included 67 pregnant women with singleton pregnancies (32 pregnant diagnosed with GDM and 35 pregnant known to be normoglycemic).</p><p><strong>Results: </strong>There were no statistical differences between the groups in terms of maternal age, gravidity, parity, history of miscarriage and weight gain during pregnancy. Body mass index (BMI) was higher in the GDM group (p = 0.001). There was no difference in the CONUT score between the groups (p = 0.254). The PNI score was lower in the GDM group (p = 0.003). Of the laboratory data, only fasting blood glucose, triglycerides (TG) and total cholesterol (TC) were statistically significantly higher, and albumin was lower in the GDM group (p = 0.026, p = 0.007, p = 0.003 and p = 0.003, respectively).</p><p><strong>Conclusions: </strong>PNI has the potential to be a useful predictor of GDM, whereas CONUT does not. Low albumin levels and increased TG, and TC in the first trimester seem to be significant in the development of GDM.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"58-64"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484046","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 value of miRNAs as a biomarker for the diagnosis of gestational diabetes mellitus: a meta-analysis.","authors":"Feng Zhao, Guolei Wang","doi":"10.5603/gpl.100165","DOIUrl":"10.5603/gpl.100165","url":null,"abstract":"<p><strong>Objectives: </strong>The present meta-analysis evaluated the value of miRNAs in the diagnosis of gestational diabetes mellitus (GDM).</p><p><strong>Material and methods: </strong>Eligible studies were gathered from MEDLINE, EMBASE, PubMed, Chinese National Knowledge Infrastructure (CNKI), WanFang, and CQVIP information databases. Combined sensitivity, specificity, and summary receiver operating characteristic (SROC) curves of enrolled studies were analyzed using STATA 12.0. Diagnostic accuracy was examined by diagnostic likelihood ratio (DLR), diagnostic score, and diagnostic odds ratio (DOR). Publication bias was calculated using Deeks' funnel plot.</p><p><strong>Results: </strong>18 articles (29 studies) were included in this meta-analysis. The pooled sensitivity of overall miRNAs was 0.83 (95% CI = 0.77-0.88), and the specificity was 0.79 (95% CI = 0.72-0.84). The area under SROC curve (AUC) was 0.88 (95% CI = 0.85-0.90). The positive DLR was 3.94 (95% CI = 2.98-5.21), and the negative DLR was 0.22 (95% CI = 0.16-0.30). The diagnostic score was 2.91 (95% CI = 2.44-3.37), and the DOR was 18.27 (95% CI = 11.44-29.17). These results suggest that miRNAs have high diagnostic accuracy for GDM. High heterogeneity may be caused by study design, gestational age, and cutoff value. Subgroup analysis indicates that sensitivity and specificity are higher in case-control studies than in cohort studies. Specificity differs significantly in the cutoff value subgroup.</p><p><strong>Conclusions: </strong>Overall, miRNAs showed high accuracy in diagnosing of metabolic changes in GDM patients. High heterogeneity may be caused by study design, sampling gestational age, and cutoff value.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"420-430"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607571","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":"Uterus-preserving treatment of placenta accreta spectrum in the first pregnancy.","authors":"Daniel Lipka, Gabriela Wilczynska-Postek, Magdalena Kolak, Andrzej Jaworowski, Hubert Huras","doi":"10.5603/gpl.99622","DOIUrl":"10.5603/gpl.99622","url":null,"abstract":"","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"225-227"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484112","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 case of a patient at reproductive age with BRCA2 and CHEK2 mutations and multiple uterine fibroids.","authors":"Artur Skowyra, Lidia Korczynska, Jakub Kociuba, Sylwia Szczesniewska, Michal Ciebiera","doi":"10.5603/gpl.95221","DOIUrl":"10.5603/gpl.95221","url":null,"abstract":"","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"228-229"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607677","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":"Cost-effectiveness of nonavalent vs bivalent HPV vaccine in Polish setting.","authors":"Michal Jakubczyk, Joanna Bieganska, Katarzyna Kowalczuk, Rafal Jaworski, Marcin Czech, Andrew Pavelyev, Vincent Daniels, Maciej Niewada","doi":"10.5603/gpl.101325","DOIUrl":"10.5603/gpl.101325","url":null,"abstract":"<p><strong>Objectives: </strong>Human papillomavirus (HPV) is a prevalent sexually transmitted infection with significant implications for public health. In Poland, a nationwide vaccination program offers a choice between the 9-valent (9v) and 2-valent (2v) HPV vaccines. We aimed to assess the cost-effectiveness of the 9v vs 2v vaccine from the public payer perspective in Poland.</p><p><strong>Material and methods: </strong>A cost-effectiveness analysis was conducted to compare the public health and economic benefits of using 9v vs 2v vaccine in Poland over 100-year horizon using a previously published deterministic dynamic transmission model. A target population of girls and boys aged 12-13 years was considered. The model was populated with local epidemiological inputs, utilities, and costs, including vaccine and administration costs, as well as costs related to medical procedures for HPV-related diseases.</p><p><strong>Results: </strong>The 9v vaccine reduced the prevalence of HPV infections and HPV-related diseases substantially more than 2v vaccine when both are compared to no vaccination strategy. The total discounted cost savings of using the 9v vaccine instead of 2v, excluding the vaccine costs, amounted to EUR 66 million. The incremental cost-effectiveness ratio amounted to 8094 EUR per quality-adjusted life year, much below the official cost-effectiveness threshold in Poland set up at the three times the annual gross domestic product per capita. 9v cost-effectiveness ratio remained unchanged when shorter time-horizons of 20, 40, 60, or 80 years were considered.</p><p><strong>Conclusions: </strong>Using 9v HPV vaccine in Poland is highly cost-effective compared to the 2v vaccine.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"119-125"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484044","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 blunt and sharp dissection techniques during cesarean hysterectomy in placenta percreta.","authors":"Seyhun Sucu, Ibrahim Taskum, Furkan Cetin, Muhammed Hanifi Bademkiran, Ozge Komurcu Karuserci, Huseyin Caglayan Ozcan","doi":"10.5603/gpl.101542","DOIUrl":"10.5603/gpl.101542","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the effects of the blunt dissection technique (BDT) with finger and the sharp dissection technique (SDT) with scissors during cesarean hysterectomy (CH) in patients with placenta percreta.</p><p><strong>Material and methods: </strong>We included 70 patients with placenta percreta who underwent CH in a territory hospital between 2020 and 2023. The patients were divided into two groups: Group 1 included 34 patients who underwent blunt bladder dissection, and Group 2 included 36 patients who underwent sharp bladder dissection. Demographic data, operative complications, surgical parameters, and transfusion rates were compared between the two groups.</p><p><strong>Results: </strong>BDT was associated with a statistically significant reduction in operation time compared to SDT (95.62 ± 20.76 min vs 107.08 ± 26.04 min, p = 0.046). Moreover, the rate of bladder injury was significantly lower in the BDT group compared to the SDT group (11.8% vs 33.3%, p = 0.032). Although there were no significant differences in blood transfusion products between the two groups, postoperative transfusion amounts tended to be lower in the BDT group.</p><p><strong>Conclusions: </strong>BDT may be a proper surgical method to reduce bladder injury rates and operation time compared to SDT in CH of placenta percreta cases.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"192-199"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392802","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":"Hernias and pregnancy - when and how to manage?","authors":"Svetlana Yasenova Shumarova, Anton Gospodinov Koichev, Tsvetelina Mihaylova, Vesela Karamisheva","doi":"10.5603/gpl.100750","DOIUrl":"10.5603/gpl.100750","url":null,"abstract":"<p><p>Hernia is a well-known problem by almost every surgeon, often showing symptoms during pregnancy. There are a lot of discussions regarding the tactics of treating hernias in pregnancy. For this purpose, we made a detailed review of the literature data in PubMed, Web of Science, Scopus, as well as an additional article found in the references of each reviewed article and analysed it synthesized to give a guideline for fast and correct treatment. The approach is strictly individualized and depends on two main and important factors: the state of emergency and the gestational week of the pregnancy.</p>","PeriodicalId":94021,"journal":{"name":"Ginekologia polska","volume":" ","pages":"214-219"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191638","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}