Hasil untuk "Gynecology and obstetrics"

Chia Hassan Ali, Rozhan Yassin Khalil

Background and objectives: Various methods and devices are currently applicable to diagnose endometrial polyps with different outcomes. This study aimed to compare the efficacy of trans-vaginal ultra-sonography in relation to the rigid hysteroscopy in the diagnosis of endometrial polyps in patients with abnormal vaginal bleeding. Methods: This cross-sectional study enrolled 70 female patients with endometrial polyps at Sulaimani Maternity Teaching Hospital, Iraq, from May 01, 2022 to May 01, 2023. A well-designed questionnaire including the patient's age, gender, residency, educational level, parity, and presentation symptoms. Then, transvaginal ultrasonography and rigid hysteroscopy were done for all enrolled patients to determine the type of endometrial polyp. Results: Most patients (57.14%) were aged 30-40 years, from suburban regions (47%), graduated from preparatory school (47.14%), multipara (91.43%) and had heavy vaginal bleeding (72.86%). Upon transvaginal ultrasonography and rigid hysteroscopy examinations, most females were diagnosed to have simple endometrial polyp (84.21% and 86.84%, respectively), followed by endometrial hyperplasia with atypia (60% and 100, respectively), then pedunculated leiomyoma (70% and 90%, respectively), and benign endometrial polyps (57.14% and 71.42%, respectively). There was no significant difference (p=0.19) between transvaginal ultrasonography and rigid hysteroscopy in sensitivity and specificity for diagnosing simple endometrial polyps. Conclusions: Transvaginal ultrasonography and rigid hysteroscopy methods are preferred to diagnose endometrial polyps; in which rigid hysteroscopy is preferable for endometrial hyperplasia with atypia, and transvaginal ultrasonography is for benign endometrial polyps.

Yanhong Xu, Yizheng Zu, Xiaosi Lu et al.

Abstract Background Preeclampsia (PE) is a complex disorder with significant variability in organ involvement. It remains unclear whether machine learning can identify organ-system-based subclasses of PE. This study aimed to identify novel subclasses of PE using organ-system biomarkers to improve pregnancy outcome prediction. Methods We retrospectively analyzed clinical data from PE patients at Fujian Maternity and Child Health Hospital. K-means clustering was applied using organ system function indicators, with 10-fold cross-validation. Functional indicators and pregnancy outcomes were compared across subclasses. Heatmap and sankey diagrams were used to reveal the distribution of patients across combined organ system clusters. Results The analysis included 7,531 PE patients treated between 2013 and 2023. 10-fold cross-validation confirmed clustering robustness with mean ARI of 0.8806 ± 0.0099 and NMI of 0.7800 ± 0.0123. Three heart function clusters were identified using five indicators, with H-Cluster 1 showing the poorest heart function and the highest complication rates. Five kidney clusters were determined from ten indicators. K-Cluster 1 and K-Cluster 5 showed distinct biomarker patterns but similar complication rates (P > 0.05). Liver function analysis using thirteen indicators revealed four clusters. L-Cluster 1 exhibited elevated liver enzymes and bilirubin with higher severe PE and intrahepatic cholestasis rates, whereas L-Cluster 3 had lower protein levels but higher anemia, fetal distress and hemorrhage incidence (P < 0.05). Five coagulation clusters were determined from nine indicators, showing significant differences in indicators and complication rates (P < 0.05). Heatmap and sankey diagram analyses revealed significant overlap between high-risk clusters, with the most frequent combination being H-Cluster 1, K-Cluster 1, L-Cluster 1 and C-Cluster 5. Conclusions Machine learning identified distinct PE subclasses based on organ system dysfunction patterns, each demonstrating unique pregnancy outcomes. This suggests potential clinical utility of computational approaches for PE subclassification and generates hypotheses for further investigation of its biological mechanisms.

Meng-ke Huang, Yun-long Yang, Lu Hui et al.

Abstract Background The aim of this study was to investigate the epidemiological characteristics and antibiotic resistance patterns of Ureaplasma urealyticum (UU) infection among women and children in southwest China. Methods A total of 8,934 specimens, including urogenital swabs and throat swabs were analyzed in this study. All samples were tested using RNA-based Simultaneous Amplification and Testing (SAT) methods. Culture and drug susceptibility tests were performed on UU positive patients. Results Among the 8,934 patients, the overall positive rate for UU was 47.92%, with a higher prevalence observed among women of reproductive age and neonates. The majority of UU positive outpatients were women of reproductive age (88.03%), while the majority of UU positive inpatients were neonates (93.99%). Overall, hospitalization rates due to UU infection were significantly higher in neonates than in women. Further analysis among neonatal inpatients revealed a higher incidence of preterm birth and low birth weight in UU positive inpatients (52.75% and 3.65%, respectively) than in UU negative inpatients (44.64% and 2.89%, respectively), especially in very preterm and extremely preterm neonates. Moreover, the incidence rate of bronchopulmonary dysplasia (BPD) among hospitalized neonatal patients was significantly higher in the UU positive group (6.89%) than in the UU negative group (4.18%). The drug susceptibility tests of UU in the neonatology, gynecology and obstetrics departments exhibited consistent sensitivity patterns to antibiotics, with high sensitivity to tetracyclines and macrolides, and low sensitivity to fluoroquinolones. Notably, UU samples collected from the neonatology department exhibited significantly higher sensitivity to azithromycin and erythromycin (93.8% and 92.9%, respectively) than those collected from the gynecology and obstetrics departments. Conclusions This study enhances our understanding of the current epidemiological characteristics and antibiotic resistance patterns of UU infection among women and children in southwest China. These findings can aid in the development of more effective intervention, prevention and treatment strategies for UU infection.

Yali Liu, Yan Wang, Yumei Li et al.

V.V. Bila, O.S. Zahorodnia

Синдром фетальної запальної відповіді (СФЗВ) - неадекватна реакція імунної системи плода на запальний процес у плаценті, яка супроводжується зростанням рівнів неонатальної смертності та захворюваності. Мета - оцінити залежність СФЗВ від маркерів запального процесу матері при передчасних пологах у різні гестаційні терміни для визначення терміну розродження. Матеріали та методи. Обстежено 405 роділь із передчасними одноплідними пологами та їхніх недоношених новонароджених. Методом кореляції Спірмена обчислено залежність між вмістом інтерлейкіна-6 (ІЛ-6) у пуповинній крові новонародженого та лабораторними маркерами материнського запалення в периферійній крові (вмістом лейкоцитів і паличкоядерних нейтрофілів, С-реактивного білка, прокальцитоніну, прозапальних інтерлейкінів), амніотичній рідині (вмістом глюкози, секреторного інгібітора лейкоцитарної протеїнази (СІЛП) і прозапальних інтерлейкінів) та цервікальному слизі (прозапальних інтерлейкінів). Результати. Між показниками периферійного кровообігу матері та значенням ІЛ-6 виявлено зв’язок лише помірної сили, а вміст ІЛ-6 в амніотичній рідині вказує на сильну кореляцію з концентрацією ІЛ-6 у пуповинній крові екстремально недоношених новонароджених. У цервікальному слизі для СІЛП визначено негативну кореляцію з ІЛ-6 пуповинної крові. Ознаки інфікування новонародженого показують сильну залежність від концентрації С-реактивного білка та прокальцитоніну периферійної крові матері, але цього не виявлено для екстремально недоношених новонароджених. Сильний показник кореляції встановлено між концентрацією глюкози в амніотичній рідині та ознаками інфікування недоношених в обох гестаційних категоріях. Висновки. Серед показників периферійного кровообігу вагітної жоден не демонструє вагомої кореляції з СФЗВ. Концентрація СІЛП в амніотичній рідині має сильну кореляцію з ознаками плодового запалення незалежно від гестаційного терміну. Вміст СІЛП у цервікальному слизі має сильну негативну кореляцію з критерієм СФЗВ у недоношених від пологів на тлі цілих плодових оболонок. Виявлено сильний кореляційний зв’язок між вмістом глюкози в амніотичній рідині та ознаками інфікування недоношеного. Отже, для екстремально недоношених новонароджених жодний показник периферійної крові матері не корелює з ознаками інфікування. Дослідження виконано згідно з принципами Гельсінської декларації. Протокол дослідження ухвалено Локальним етичним комітетом зазначеної в роботі установи. На проведення досліджень отримано інформовану згоду жінок. Автори заявляють про відсутність конфлікту інтересів.

Shengnan Meng, Yanling Cao, Qingwei Shen et al.

IntroductionThis study was to analyze the dynamics of tissue damage and inflammatory response markers perioperatively and whether these differ between robotic laparoscopy and conventional laparoscopy in early endometrial cancer.MethodsIn a randomized controlled trial conducted at SHANGHAI FIRST MATERNITY and INFANT HOSPITAL, eighty women with early-stage, low-risk endometrial cancer were randomly assigned to receive either robotic or conventional laparoscopy. Blood samples were collected at admission, immediately before surgery, 2 h after surgery, 24 h after surgery, 48 h after surgery, and 1 week after surgery. The samples were analyzed for various biomarkers associated with inflammatory processes and tissue damage. These included high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBC), platelet count, interleukin-6 (IL-6), cortisol, creatine kinase (CK), and tumor necrosis factor-alpha (TNF-α). These markers provide insights into the underlying physiological responses and potential tissue-level changes within the study participants.ResultsThere was no significant difference in clinical and preoperative data between two groups. The results showed that the patients who underwent robotic laparoscopy had a longer pre-surgical time compared to the conventional laparoscopy group. However, the robotic group had shorter operating times, quicker vaginal cuff closures, and lower estimated blood loss compared to the conventional laparoscopy group. The hospital stays, Visual Analog Scale (VAS) score and drainage volume on the first day after operation were lower in robotic group compared to conventional laparoscopy group. hs-CRP, WBC, IL-6 and cortisol were significantly lower in the robotic group, though the differences were transient.DiscussionThis study demonstrated that robotic laparoscopy, used in early endometrial cancer treatment, leads to a reduced inflammatory response, less tissue damage, and lower stress levels, as evidenced by decreased levels of hs-CRP, IL-6, and cortisol, compared to conventional laparoscopy. These findings suggest that robot- laparoscopy may facilitate a quicker recovery and improve patient-reported outcomes.

Jenny Wu, Melissa Greene, Allison Bickett et al.

1Department of Obstetrics & Gynecology, Duke University Medical Center, Durham, North Carolina, USA 2Duke School of Medicine, Durham, North Carolina, USA 3Division of Minimally Invasive Gynecology, Department of Obstetrics & Gynecology, Duke University Medical Center, Durham, North Carolina, USA 4Division of Women's Community and Population Health, Department of Obstetrics & Gynecology, Duke University Medical Center, Durham, North Carolina, USA

Mayur K. Virarkar, S. S. Vulasala, Taher Daoud et al.

Simple Summary Primary vulvar malignancy is a rare gynecological neoplasm constituting 5–8% of cases. Considering the prognostic capability of staging, FIGO has introduced the revised 2021 staging for vulvar cancer. We review the etiopathogenesis revised 2021 International Federation of Gynecology and Obstetrics (FIGO) classification and emphasize imaging in the staging of vulvar cancer. Abstract Vulvar cancer is a rare gynecological malignancy. It constitutes 5–8% of all gynecologic neoplasms, and squamous cell carcinoma is the most common variant. This article aims to review the etiopathogenesis revised 2021 International Federation of Gynecology and Obstetrics (FIGO) classification and emphasize imaging in the staging of vulvar cancer. The staging has been regulated by FIGO since 1969 and is subjected to multiple revisions. Previous 2009 FIGO classification is limited by the prognostic capability, which prompted the 2021 revisions and issue of a new FIGO classification. Although vulvar cancer can be visualized clinically, imaging plays a crucial role in the staging of the tumor, assessing the tumor extent, and planning the management. In addition, sentinel lymph node biopsy facilitates the histopathological staging of the draining lymph node, thus enabling early detection of tumor metastases and better survival rates.

A. Giannini, O. D’Oria, V. Chiantera et al.

aDepartment of Medical and surgical sciences and translational Medicine, PhD Course in “translational Medicine and oncology”, sapienza university, rome, Italy; bunit of gynecologic oncology, arnas "Civico – Di Cristina – Benfratelli", Palermo, Italy; cDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical specialties (ProMIse), university of Palermo, Palermo, Italy; d2nd academic Department of obstetrics and gynaecology, Hippokration general Hospital, aristotle university of thessaloniki, thessaloníki, greece; eDepartment of surgical, oncological and oral sciences (Di.Chir.on.s.), university of Palermo, Palermo, Italy; fDepartment of Medicine, school of Medicine, nazarbayev university, nur-sultan, Kazakhstan; gDepartment of obstetrics and gynecology, lebanese american university, Beirut, lebanon

Malia S Q Murphy, D. Fell, A. Sprague et al.

Data Resource Profile: Better Outcomes Registry & Network (BORN) Ontario Malia SQ Murphy, Deshayne B Fell, Ann E Sprague, Daniel J Corsi , Shelley Dougan, Sandra I Dunn, Vivian Holmberg, Tianhua Huang, Moya Johnson, Michael Kotuba, Lise Bisnaire, Pranesh Chakraborty, Susan Richardson, Mari Teitelbaum and Mark C Walker * OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research, Institute, Ottawa, Canada, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada, CHEO Research Institute, Ottawa, Canada, BORN Ontario, Children’s Hospital of Eastern Ontario, Ottawa, Canada, School of Nursing, University of Ottawa, Ottawa, Canada, Genetics Program, North York General Hospital, Toronto, Canada, Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Canada, Department of Pediatrics, University of Ottawa, Ottawa, Canada, Newborn Screening Ontario, Children’s Hospital of Eastern Ontario, Ottawa, Canada, Children’s Hospital of Eastern Ontario, Ottawa, Canada, Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, Canada and Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada

Fariba Mousavi, Sakineh Mohammad-Alizadeh-Charandabi, Mojgan Mirgafourvand et al.

Introduction: Early symptoms of menopause are very common and often very bothersome. Considering the increasing number of women experiencing these symptoms in the world and Iran, there is a growing need to use methods to reduce these symptoms. Therefore, this study was performed with aim to determine the effect of the combined herbal capsules (Menohelp) on reducing the early symptoms of menopause, number and intensity of hot flashes (primary outcomes), and improving sleep quality and quality of life (secondary outcomes) in menopausal women. Methods: In this double-blind trial in Tabriz, 100 women aged 50 to 59 years suffering from early symptoms of menopause were randomly assigned into two groups of receiving capsules of either Menohelp or placebo. The randomization was done using blocked randomization stratifying by duration of menopause with allocation ratio of 1:1. The outcomes were assessed using the Green Climacteric Scale, a checklist including the number and severity of hot flashes, Pittsburgh sleep quality and the Menopause-Specific Quality of Life (MENQOL). Data were analyzed by SPSS statistical software (version 21) and repeated measures ANOVA, ANCOVA and Mann-Whitney U. P<0.05 was considered statistically significant. Results: There were no statistically significant differences between the two groups in terms of mean score of Green at 4 and 12 weeks of intervention (adjusted mean difference 0.60, 95% CI -2.9 to 4.0), but, mean rank number (p = 0.003 and p = 0.008, respectively) and mean intensity (0.59, 0.3 to 0.9) of hot flashes were higher in the Menohelp group than the placebo group. The mean rank score of Pittsburgh (p = 0.29) at 4 weeks and mean score of MENQOL (p = 0.64) at 12 weeks of intervention were not significantly different between the two groups. Conclusion: The results of the present study could show the positive effects of Menohelp herbal capsule on improving the early symptoms of menopause.

Haiyu Deng, Suqing Wang, Zhijie Li et al.

This study evaluated the effect of intrauterine perfusion of autologous platelet-rich plasma (PRP) on pregnancy outcomes in women with recurrent implantation failure (RIF). Key biomedical databases were searched to identify relevant clinical trials and observational studies. Outcomes included clinical pregnancy rate, chemical pregnancy rate, implantation rate, live birth rate, and abortion rate. Data was extracted from ten studies (six randomised controlled trials, four cohort studies) involving 1555 patients. Pregnancy outcomes were improved in women treated with PRP compared to controls: clinical pregnancy rate (RR = 1.96, 95% CI [1.67, 2.31], p < 0.00001, I2 = 46%), chemical pregnancy rate (RR = 1.79, 95% CI [1.54, 2.08], p < 0.00001, I2 = 29%), implantation rate (RR = 1.90, CI [1.50, 2.41], p < 0.00001, I2 = 0%), live birth rate (RR = 2.83, CI [1.45, 5.52], p = 0.0007, I2 = 83%), abortion rate (RR = 0.40, 95% CI [0.18, 0.90], p = 0.03, I2 = 59%). These data imply PRP has potential to improve pregnancy outcomes in women with RIF, suggesting a promising role in assisted reproductive technology.IMPACT STATEMENT What is already known on this subject? Platelet-rich plasma (PRP) is an autologous blood product that contains platelets, various growth factors, and cytokines at concentrations above the normal baseline level. Recent studies have shown that intrauterine infusion of autologous PRP can improve pregnancy outcomes in infertile women. What do the results of this study add? This systematic review and meta-analysis of data from ten studies (n = 1555; 775 cases and 780 controls) investigated the effect of intrauterine perfusion of autologous PRP on pregnancy outcomes in women with recurrent implantation failure (RIF). Findings suggest that pregnancy outcomes, including clinical pregnancy rate, chemical pregnancy rate, implantation rate, live birth rate and abortion rate were improved in women treated with PRP compared to controls. What are the implications of these findings for clinical practice and/or further research? RIF remains a challenge for researchers, clinicians, and patients. Our study identified PRP as a potential intervention in assisted reproduction. As an autologous blood preparation, PRP eliminates the risk of an immune response and transmission of disease. PRP is low cost and effective and may represent a new approach to the treatment of patients with RIF.

Mengwei Han, Luni Hu, Di Wu et al.

Abstract Tissue-resident Natural Killer (trNK) cells are crucial components of local immunity that activate rapidly upon infection. However, under steady state conditions, their responses are tightly controlled to prevent unwanted tissue damage. The mechanisms governing their differentiation and activation are not fully understood. Here, we characterise uterine trNK cells longitudinally during pregnancy by single cell RNA sequencing and find that the combined expression pattern of 4-1BB and CD55 defines their three distinct stages of differentiation in mice. Mechanistically, an IL-21R-STAT3 axis is essential for initiating the trNK cell differentiation. The fully differentiated trNK cells demonstrate enhanced functionality, which is necessary for remodelling spiral arteries in the decidua. We identify an apoptotic program that is specific to the terminal differentiation stage, which may preclude tissue damage by these highly activated trNK cells. In summary, uterine trNK cells become intensely active and effective during pregnancy, but tightly controlled via a differentiation program that also limits potential harm, suggesting an intricate mechanism for harnessing trNK cells in maintaining pregnancy.

M. Di Nisio, E. Valeriani, Nicoletta Riva et al.

1Department of Vascular Medicine, Academic Medical Centre, Amsterdam, the Netherlands 2Department of Medicine and Ageing Sciences, “G. D'Annunzio” University, Chieti-Pescara, Italy 3Department of Medical, Oral and Biotechnological Sciences, “G. D'Annunzio” University, Chieti, Italy 4Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta 5Department of Medicine, McMaster University and the Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada 6Department of Obstetrics and Gynecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia 7Division of Hematology and Hemostaseology, Department of Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany 8Department of Medicine and Surgery, University of Insubria, Varese, Italy

K. F. Schulz, Douglas G. Altman, David Moher

The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience. To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on bmj.com and will also be published in the Lancet, Obstetrics and Gynecology, PLoS Medicine, Annals of Internal Medicine, Open Medicine, Journal of Clinical Epidemiology, BMC Medicine, and Trials.

J. Cleland, A. CONDE-AGUDELO, H. Peterson et al.

I. Fraser, H. Critchley, M. Broder et al.

Bertil Dawid Sascha Michaela Peggy Steffen Klaus M. Chris Bouillon Pieper Flohé Eikermann Prengel Ruchholtz , B. Bouillon, D. Pieper et al.

German Trauma Society (DGU) (lead) Office in Langenbeck-Virchow House Luisenstr. 58/59 10117 Berlin German Society of General and Visceral Surgery German Society of Anesthesiology and Intensive Care Medicine German Society of Endovascular and Vascular Surgery German Society of Hand Surgery German Society of Oto-Rhino-Laryngology, Head and Neck Surgery German Interdisciplinary Association for Emergency and Acute Care Medicine German Society of Oral and Maxillofacial Surgery German Society of Neurosurgery German Society of Thoracic surgery German Society of Urology German Radiology Society German Society of Plastic, Reconstructive and Aesthetic Surgeons German Society of Gynecology and Obstetrics German Society of Pediatric Surgery German Society for Transfusion Medicine and Immunohematology German Society for Burn Medicine German Interdisciplinary Association for Intensive and Emergency Medicine German Professional Association of Emergency Medical Services Society of Pediatric Radiology

B. Toth, W. Würfel, M. Bohlmann et al.

Abstract Purpose Official guideline of the German Society of Gynecology and Obstetrics (DGGG), the Austrian Society of Gynecology and Obstetrics (ÖGGG) and the Swiss Society of Gynecology and Obstetrics (SGGG). The aim of this guideline was to standardize the diagnosis and treatment of couples with recurrent miscarriage (RM). Recommendations were based on the current literature and the views of the involved committee members. Methods Based on the current literature, the committee members developed the statements and recommendations of this guideline in a formalized process which included DELPHI rounds and a formal consensus meeting. Recommendations Recommendations for the diagnosis and treatment of patients with RM were compiled based on the international literature. Specific established risk factors such as chromosomal, anatomical, endocrine, hemostatic, psychological, infectious and immunological disorders were taken into consideration. Zusammenfassung Ziel Offizielle Leitlinie der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG), der Österreichischen Gesellschaft für Gynäkologie und Geburtshilfe (ÖGGG) und der Schweizerischen Gesellschaft für Gynäkologie und Geburtshilfe (SGGG). Ziel der Leitlinie ist es, die Diagnostik und Therapie des wiederholten Spontanaborts (WSA) anhand der aktuellen Literatur sowie der Erfahrung der Mitglieder der Leitlinienkommission evidenzbasiert zu standardisieren. Methoden Anhand der internationalen Literatur entwickelten die Mitglieder der beteiligten Fachgesellschaften in einem formellen Prozess einen Konsensus. Empfehlungen und Statements der Leitlinie wurden in einem formalen Prozess (DELPHI-Prozess, Konsenstreffen mit moderiertem Abstimmungsprozess) erarbeitet und konsentiert. Empfehlungen Es wurden Empfehlungen zur Diagnostik und Therapie von Paaren mit WSA anhand der internationalen Literatur erarbeitet. Insbesondere wurde auf die bekannten Risikofaktoren wie chromosomale, anatomische, endokrinologische, gerinnungsphysiologische, psychologische, infektiologische und immunologische Störungen eingegangen.

S. Javadi, D. Ganeshan, A. Qayyum et al.