Safety of Progestogen Hormonal Contraceptive Methods during Lactation: An Overview.

BACKGROUND: Breastfeeding is a process for not only nourishing infants but also for building a unique emotional bond between mother and child. Therefore, the ideal contraception during lactation should not affect lactation (milk composition, milk volume) and offspring development. OBJECTIVES: This study aims to analyze the literature on the safety of progestogen hormonal contraceptive methods during lactation. METHODS: We conducted a thorough search across various databases, including the National Library of Medicine (PubMed), and the Cochrane Database, Drugs and Lactation Database (LactMed). Our search utilized specific phrases such as: "lactation" and "breastfeeding" and "oral contraception" with "drospirenone" or "desogestrel", with "subcutaneous etonogestrel implant" or "etonogestrel implant", with "levonorgestrel-releasing intrauterine system", and "emergency contraception", with "levonorgestrel" or "ulipristal acetate". CONCLUSIONS: Based on published scientific reports, progestogen hormonal contraceptives can be considered a relatively safe solution for women desiring to continue feeding their infant with their milk while using hormonal contraception. It is important to seek guidance on selecting the best contraception method based on the latest medical knowledge, tailored to the individual needs and clinical circumstances of each woman and place of residence. A woman should always be informed of the potential risks of such a treatment and then allowed to make her own decision based on the knowledge received from a specialist.

Quality of Life of Women with Polycystic Ovary Syndrome.

Background and Objectives: Polycystic ovary syndrome (PCOS) is an endocrine disorder characterized by multiple hormonal and metabolic abnormalities, including insulin resistance, hyperandrogenism, and disturbances in lipid and carbohydrate metabolism. The objective of this study is to assess the quality of life of women diagnosed with polycystic ovary syndrome (PCOS) and to identify any factors within the study group that may impact the scores related to quality of life. Materials and Methods: This research was carried out among women diagnosed with PCOS. An original questionnaire, developed through an online Google Forms survey, was utilized as the research instrument and distributed through social networks and support groups to women facing PCOS. This study encompassed a participant pool of 200 women with PCOS, aged 24 years or older. For the analytical component, Pearson's χ2 test was employed-a nonparametric test designed to assess the relationship between two variables measured on a qualitative scale. The chosen level of statistical significance was set at p < 0.05. Results: The analysis revealed that the quality of life of the women under study was not linked to the duration of the disease or comorbidities. However, a significant association was observed with the inconvenience caused by PCOS symptoms. Women experiencing very bothersome symptoms of PCOS reported a lower quality of life compared to those with symptoms rated as not very bothersome. Despite the majority of women with PCOS rating their quality of life as good or very good, they often find the associated symptoms of PCOS bothersome. Women reporting lower quality of life tend to acknowledge the impact of PCOS on their lives, experience a sense of lack of control over the disease, struggle with depression, and do not accept their physical appearance. Conclusions: Hence, the support from specialists like endocrinologists, gynecologists, and nutritionists becomes crucial for many women dealing with PCOS. Adopting a healthy lifestyle, incorporating a balanced diet, and engaging in regular physical activity can assist in managing the troublesome symptoms of PCOS, thereby enhancing overall quality of life. In instances of emotional difficulties, seeking psychological support is equally important, and the significance of support and acceptance from loved ones should not be overlooked.

Factors Affecting Women's Assessment and Satisfaction with Their Childbirth.

Background and Objective: Childbirth is one of the most significant experiences in a woman's life. The manner in which childbirth unfolds and is experienced can be influenced by various factors, including the birthing environment and the woman's attitude and preparation. Taking a holistic view of childbirth, it becomes apparent that addressing the basic physiological needs during childbirth can significantly influence the comfort and sense of security of laboring women. The aim of this research was to assess the level of satisfaction among women with their experience during childbirth and to identify its determinants. Materials and Methods: This study included 275 women who had given birth within the past 15 years and were up to 40 years of age. The research method employed was a diagnostic survey, involving a self-designed questionnaire. Results: discussing the birth plan with the midwife, the ability to ask questions during labor, consuming meals during labor, water immersion, listening to music during labor, assuming vertical positions during the second stage of labor, and skin-to-skin contact are associated with increased satisfaction with the childbirth experience. Conclusions: The study findings revealed that the highest levels of satisfaction were reported in connection with the interactions with medical staff during childbirth and the quality of facilities available during delivery. Conversely, the lowest levels of satisfaction were associated with the possibility of using pain relief methods during labor.

Women's Awareness of Reproductive Health.

Background and Objectives: reproductive disorders are a serious global concern in medical, social, and demographic contexts. According to estimates, approximately 10-15% of couples around the world suffer from infertility. Numerous studies have shown that modifiable lifestyle factors, such as a high-fat diet, a postponed decision to start a family, tobacco smoking, alcohol consumption, risky sexual behavior, psychiatric diseases, and chronic stress, have a negative influence on the fertility of women. The main goal of this study is to assess the knowledge of women about reproductive health, infertility risk factors, and causes of infertility and to determine whether the level of this knowledge varies based on sociodemographic variables. Materials and Methods: a survey was conducted among 111 patients who anonymously filled in a questionnaire comprising questions regarding fertility and its deficiencies. The results were analyzed using the Chi-square test and Fisher's test. Results: the survey results indicated that women had a good or very good level of knowledge of the causes of infertility. The obtained test results were statistically significant (p < 0.05), but the studied group did not possess sufficient knowledge of the symptoms characterizing the diseases related to limited fertility (p > 0.05). The level of knowledge on the diagnosis of infertility did not depend on the age of the examined people, their educational level, or personal experience in this field (p > 0.05). The results also revealed that the awareness of women on reproductive health was poor. The studied women had a low level of knowledge of infertility risk factors, and their knowledge did not correlate with age, educational level, or personal experiences. Conclusions: information on the aspects of reproductive health should be widely disseminated through public educational campaigns, aimed at correcting erroneous convictions among women about the risk factors for infertility and assisting them in improving fertility.

New Possibilities for Hormonal Vaginal Treatment in Menopausal Women.

Hormonal vaginal therapy is an effective treatment option for women who experience vaginal symptoms related to hormonal changes. Estrogen and prasterone are widely used as vaginal treatments, particularly for urogenital atrophy. These symptoms may include vaginal dryness, itching, burning, and pain during sexual intercourse, all of which can significantly affect a woman's quality of life. Previous studies have indicated that such treatment improves tissue elasticity, moisturizes the vagina, and can have a substantial impact on urine incontinence and vaginal microflora and decreases dyspareunia. Hormonal therapy is also useful and commonly used before vaginal surgical treatment. Prasterone is quite a new option for vaginal therapy in Poland and is mainly recommended for dyspareunia in menopausal women. The study related to prasterone therapy emphasizes its effectiveness and safety, making it advantageous to explore its beneficial impact. This paperwork aims to summarize the mechanism of action as well as the effects of both drugs and their beneficial action during vaginal treatment.

Interstitial Ectopic Pregnancy-Case Reports and Medical Management.

The term intramural (interstitial) ectopic pregnancy refers to a pregnancy developing outside the uterine cavity, with a gestational sac implanted into the interstitial part of the Fallopian tube, surrounded by a layer of the myometrium. The prevalence rate of interstitial pregnancy (IP) is 2-4% of all ectopic pregnancies. Surgery is the primary treatment for interstitial ectopic pregnancy; the pharmacological management of ectopic pregnancy, including IP, in asymptomatic patients includes systemic administration of methotrexate. In this report, we present two cases of this rare pregnancy type, reviewing our management technique and treatment ways presented in the literature. In our patients, the management was initially conservative and included methotrexate, administered as intravenous bolus injection, regular beta-human chorionic gonadotropins (ß-HCG) level measurements in peripheral blood, and monitoring of the patient's general condition. Due to signs of intra-abdominal bleeding in patient A and inadequate ß-HCG level reduction in patient B, both patients eventually underwent laparoscopic cornual resection. Pregnancy, implanted into the interstitial part of the Fallopian tube and surrounded by myometrial tissue with myometrial invasion of the trophoblast, poses a serious diagnostic challenge to modern gynecology due to particularly low sensitivity and specificity of symptoms, and may require both pharmacological and surgical treatment.

Peripartum prolactin and cortisol level changes. A prospective pilot study.

OBJECTIVES: Although the role of prolactin and cortisol in the human lactation process seems to be undisputed, the changes in postpartum serum concentrations in mothers make data interpretation difficult. MATERIAL AND METHODS: To determine the factors that possibly influence these hormones, we examined a group of patients who were admitted to the Gynecology-Obstetrics Clinical Hospital in Poznan for labor induction and/or in the active phase of the first labor period. The serum levels of cortisol and prolactin were assessed in these full-term pregnant women during admission to labor, in the third stage of labor, and on the second day postpartum. The prolactin and cortisol levels were also measured in the umbilical cord for the assessment of newborn babies. RESULTS: The results showed a significant relationship between maternal age and the level of prolactin measured before childbirth and fluctuations in cortisol level with respect to labor duration. In addition, we observed a strong correlation between the level of prolactin assessed before childbirth and the pH and base excess of the umbilical cord artery. Most importantly, a correlation was noted between breastfeeding within 2 hours after the labor and the level of cortisol measured after childbirth. CONCLUSIONS: We observed a significant correlation between a summarized labor duration and maternal and umbilical cord cortisol levels measured right after the labor. The fact of breastfeeding within 2 hours after the labor strongly correlated with lower levels of maternal cortisol as well as a cortisol level in umbilical cord blood and it suggests that immediate initiation of breastfeeding reduces stress level for both, mother and newborn.

Clinical Outcomes of Mid-Urethral Sling (MUS) Procedures for the Treatment of Female Urinary Incontinence: A Multicenter Study.

Introduction: Stress urinary incontinence (SUI) has a significant impact on the quality of life of many women. Due to embarrassment, most women do not seek medical attention for this condition. The treatment of this problem includes preventive therapies, and in the more advanced stage of urinary incontinence, surgery is a solution. Despite doubts regarding the implantation of urological tapes, the use of tension-free minimally invasive methods constitutes the "gold standard" in the treatment of stress urinary incontinence in women. Objective: The purpose of this article was to evaluate the efficacy and safety of ultralight, polypropylene urogynecological tape (Dallop® NM ULTRALIGHT, Tricomed S.A., Poland) in the surgical treatment of female stress urinary incontinence and mixed urinary incontinence. Methods: This is a multicenter, retrospective cohort study. The included women were adults with stress urinary incontinence (Grade 2 with a positive cough test or Grade 3) or had mixed urinary incontinence and who had undergone "retropubic" or "transobturator" surgery and completed a postoperative follow-up. Results: The study included 68 women from three hospitals. All women completed <6-month and >6-month follow-ups. The median age was 55 (range 36−80). The average value of BMI in the "retropubic" group was 28.6 ± 5.58, and in the "transobturator" group, it was 26.1 ± 4.60. Sixty-three percent (63%, n = 43) of patients were operated on using the "transobturator" method, while thirty-seven percent (37%, n = 25) were operated on using the "retropubic" method. Both the "retropubic" and "transobturator" groups had comparable results in the treatment of SUI. The study showed efficiencies of 84% for the "transobturator" method and 80% for the "retropubic" method. In the "retropubic" group, intraoperative complications were reported in three patients (7%), in comparison to none in the "transobturator" group. There were no tape-related adverse events or infections reported in any case. Conclusions: The presented research confirms the safety and efficacy of retropubic and transobturator tape methods in both short- and long-term follow-up­the success rate was over 80%. In addition to the surgical method used, the experience of the surgeons also has an impact on the final outcome of the surgery. The conducted multi-center study offers the opportunity to eliminate the influence of the human factor on the effectiveness of the procedure.

Neonatal breast-suckling skills in the context of lactation and peripartum hormonal changes and additional factors-a pilot study.

BACKGROUND: Childbirth and lactation are intricate processes, involving several hormones, the most important of which are prolactin (a protein hormone) and cortisol (one of the glucocorticoids). The early postpartum period is crucial for both mother and newborn and has an impact on the lactation and breastfeeding process. METHODS: The study included 78 patients who were admitted to the Gynecology-Obstetrics Clinical Hospital in Poznan for labor induction and/or in the active phase of the first labor stage. The levels of cortisol and prolactin in serum were assessed in these women during admission in labor, during the third labor stage, and on the second day postpartum. The levels of cortisol and prolactin in the umbilical cord serum were assessed immediately after cord clamping. The "Protocol for the assessment of breast-suckling skills" was used to assess the neonatal breast-suckling skills on the second day postpartum. Some additional parameters were evaluated in mothers via a telephone interview at three and six months postpartum. The study was conducted from January to August 2020, however the study was suspended during April-July 2020 due to the SARS-CoV-2 pandemic, which led to restrictions in the hospital limiting access to the hospital wards unless necessary. RESULTS: Early breastfeeding with skin-to-skin contact was associated with low levels of hormones, cortisol levels were lower in serum (p = 0.0108) and umbilical vein (p = 0.0273) in mothers who breastfed immediately after childbirth. At three months postpartum, 88% of the mothers who did not offer a pacifier to the child during the first few days of life breastfed the child naturally (p = 0.037), and at six months, 96% of those who did not offer a pacifier continued to breastfeed (p = 0.0008). Multiple, statistically significant correlations were observed between the variables assessed according to the "Protocol for the assessment of breast-suckling skills" and breastfeeding after three months. CONCLUSIONS: Breastfeeding immediately after childbirth, appropriate assessment of the breast-suckling skills of newborns, avoiding pacifiers and infant formula feeding, and offering support to new mothers in the early days after childbirth seem to be important factors for sustaining breastfeeding after three and six months of childbirth.

Health-related quality of life (Nottingham Health Profile) of women with normal and pathological pregnancy and during delivery: correlation with clinical variables and self-reported limitations.

OBJECTIVE: Pregnancy is often associated with changes in the psychological functioning of women. The present study aimed to analyze the incidence of health problems in pregnant mothers and the influence of these problems on their daily functioning using a survey. MATERIAL AND METHODS: The study included a total of 232 women aged 19-42 years. The tools used in the study were a self-developed questionnaire and the NHP questionnaire. The study was performed among women with pathological pregnancies and healthy pregnancies who delivered. Women with pathological pregnancies had pregnancy-induced hypertension, fetal hypotrophy, cholestasis, or gestational diabetes mellitus. Women with healthy pregnancies were recruited from the hospital ambulatory and cooperating private practices or during admission for delivery. RESULTS: Group K had significantly lowest "TOTAL" intensity in relation to the other groups. For variable "PROBLEMS," a statistically significant difference was found between group K and group P (p=.001) and between group D and group P. CONCLUSIONS: Every woman may experience a different level of satisfaction with life during pregnancy. This is typically determined by the personality of the given individual, as well as by pregnancy-associated emotions. It is important that health care personnel should provide psychological support and follow individual approach for each pregnant woman.

Management of birth, postpartum care and breastfeeding - Polish recommendations and guidelines during SARS-CoV-2 pandemic.

SARS-CoV-2 pandemic is an unusual phenomenon in the modern obstetric and midwifery history. Hospital staff from the isolation wards were trained in the safety and proper use of the hazardous materials suit and the proper managing of the biohazard materials. We were not expecting the situation, so we started to create more restrictions than facilities for mothers giving birth. In the context of infection risk for the fetus, scientists still search for vertical transmission evidence, but available data are ambiguous, and more research is needed. Concerning the infant safety and to minimalize the infection risk for medical teams, the first Polish guidelines published by the national consultants in obstetrics, midwifery, neonatology, and perinatology regarding the safest formula of birth were as the following: in the case of confirmed SARS-CoV-2 infection, the cesarean section for epidemic indications should be considered, except in an advanced or rapid labor. In the lately updated consensus (14th May), it was written that because the risk of vertical and intranatal SARS-CoV-2 transmission seemed to be low, the SARS-CoV-2 infection was not the main indication to perform cesarean section for any longer. Regardless of the birth formula, the newborns are separated from their mothers immediately after the labor in Polish obstetrician hospitals. The Polish Lactation Study Centre, consociating International Breastfeeding Certified Lactation Consultant, recommends feeding the newborn with its own mother's milk, even if she is infected with SARS-CoV-2 and isolated from her infant.

Women's Healthcare Services since the COVID-19 Pandemic Outbreak in Poland.

The COVID-19 pandemic had a direct impact on the extent of guaranteed healthcare services. Many gynecologists', obstetricians', and midwives' offices were closed, laboratories suspended their activities, the collection of necessary tests was delayed, and women had to wait much longer for test results than they had to previously. General women's healthcare prophylactic programs were suspended or delayed. In 2020, screening financed by public funds covered less than one-seventh of the female population in Poland. As medical teams, professionals, clinicians, and scientists, we have been facing a challenge to help, protect, and care for one of the most vulnerable population groups, pregnant women. A significant part of that challenge has been in preventing the spread of severe COVID-19, along with other preventable diseases, among women who are pregnant, who are in labor, or who have recently given birth.

Skeletal system evaluation using RTG absorptiometry in women with bone mineral density disorders.

INTRODUCTION: Osteoporosis is a metabolic disease of the skeleton, characterized by decreased bone mass and abnormal microarchitecture, which contribute to an increased risk of fractures. Currently, over 200 million people are struggling with it worldwide, and therefore it is considered a social disease. Many of the affected require constant help from others, which is often associated with an increase in the cost of health care. AIM OF THE STUDY: To analyze the role of prophylaxis in the improvement of bone mass density and the evaluation of various methods of treating bone mineral density (BMD) disorders in women. MATERIAL AND METHODS: The cohort study includes retrospective analysis of 105 patients documentation which were examined using the DXA densitometric method (Dual Energy X-Ray Absorptiometry) using LUNAR DPX equipment. The test results were given in g/cm2 and presented using a T-score (SD average result for peak bone mass in young healthy women) and Z-score (SD mean score for the same group of women). The study included only women with BMD disorders. The analysis, the evaluation and statistical analysis are presented in Microsoft Excel, 2010. The bioethical commission agreement was not needed in this case. RESULTS: The largest group (55 surveyed patients) - 52.4%, were women suffering from osteoporosis. Decreased BMD was less common in patients living in urban areas. Among patients who suffered from osteoporosis, severe bone pain in the whole body occurred most often. CONCLUSIONS: In Polish society, the incidence of osteoporosis is increasing. The main reason is the aging of the population. The number of fractures associated with this ailment increases after the age of 60. Analyzing the methods of treatment and assessing their effects on the reduced density of bone mass shows that the process of bone tissue disorders has deepened in non-treated patients.

Health-related quality of life (Nottingham Health Profile) in patients with endometriomas: correlation with clinical variables and self-reported limitations.

INTRODUCTION: Endometriosis is a chronic disease that involves the development of endometrium outside the uterine cavity with pain component predominance. The aim of the study was to discuss the occurrence of health problems in patients with endometriomas and simple cysts and the effect of these problems on the daily functioning of the patients. MATERIAL AND METHODS: The study included patients (n = 40) treated laparoscopically and/or by laparotomy due to lesions in the form of endometriomas or simple cysts. The control group (n = 36) consisted of healthy patients of the Gynecological Clinic, with no changes in adnexa confirmed in vaginal ultrasound examination. The original authors' questionnaire and the Nottingham Health Profile Questionnaire (NHP) were used as research tools. RESULTS: Analysis of the correlation with Spearman's test demonstrated a statistically significant relationship between the size of the tumor and the occurrence of sleep disorders only in the group of women suffering from endometriomas (r = -0.348; p = 0.041). Women with endometriomas significantly more often reported problems (Cramer's V) in the sphere of "paid work" (p < 0.001), "housework" (p < 0.001), in social life (p < 0.001), problems in sexual life (p < 0.001) as well as problems in continuing hobbies (p < 0.001) and in spending free time (p < 0.001). CONCLUSIONS: Since the stage of endometriosis does not correlate with subjective complaints, it seems that an additional routine evaluation of quality of life, including an assessment of the severity of the disease, is warranted. Routine use of the Nottingham Health Profile Questionnaire in patients with endometriosis can improve also the assessment of the treatment.

Modifiable lifestyle factors and ovarian cancer incidence in women.

INTRODUCTION: A correct diet plays an important role in the prevention of malignant tumours. The risk of the disease may be reduced by introducing a number of changes to the daily diet. The most important changes concern the amount of fat in the diet, dietary fibre, antioxidants in the food and the reduction of substances having a significant impact on the development of malignant tumours. OBJECTIVE: The aim of the study is to analyse the role of selected modifiable lifestyle factors affecting the development of ovarian cancer. MATERIAL AND METHODS: The study covered healthy women and women with diagnosed ovarian cancer. A total of 850 women aged between 21-84 were studied. The study included women visiting the Gynaecology and Obstetrics Hospital of the University of Medical Sciences in Poznan, Poland, between 2011-2013. Patients recognized with malignant ovarian cancer were qualified into the study based on the histopathological examination of the material obtained during surgery. RESULTS: Respondents who consumed fruit and vegetables several times a week have the odds ratio OR = 0.29 level; 95% CI 0.04-2.01 (p =.2085), compared to women not consuming fruit and vegetables at all. Consumption of 100 g of French fries and potato chips several times a week, results in a 2-fold increase in ovarian cancer. The OR for this group of women amounts to 2.06; 95% CI 0.53-7.99 (p=.2966). CONCLUSIONS: A diet rich in fruit and vegetables, including bulb vegetables, and grain products containing whole grains, should be introduced. It is recommended that the consumption of popular fast foods be eliminated.

Maternal health-related behaviours during pregnancy: a critical public health issue.

AIM: The aim of the study was to investigate the health-related behaviours of pregnant women. Maternal health-related habits, use of psychoactive medicines, diet, prevention of neural tube defects, oral cavity hygiene, chronic diseases and physical activity were analysed in a group of pregnant women attending antenatal classes. METHODS: Hundred pregnant women recruited from various antenatal classes in Poznan, Poland, were investigated using a questionnaire based on the Pregnancy Risk Assessment Monitoring System. RESULTS: The results showed that 29% of pregnancies were unplanned. In women with higher education, 62% reported that they were taking folic acid supplements during pregnancy, in contrast with 35% women with a lower level of education (p = .012). The study showed that 24% of women were exposed to second-hand smoke during pregnancy, and this was more common among younger study participants (p = .038). Nine percentage of women admitted drinking alcohol during pregnancy. Pre-pregnancy alcohol consumption was more frequent among women with higher education (p = .011). Only 46.7% of women informed their dentist about their pregnancy, and these were more often older participants (p = .023). CONCLUSION: The study found low maternal awareness regarding health-related behaviours, which presents a serious challenge to public health care in Poland. Pregnant women and those who wish to conceive need to be educated effectively about preventive measures in order to maintain optimal maternal and reproductive health, as well as normal fetal development.

Threatened preterm labour - analysis of the cytokine profile and progesterone treatment efficiency.

OBJECTIVE: Preterm labour is defined as the onset of labour between weeks 23 and before 37 of gestation. The purpose of this study was to compare the cytokine profile in the blood serum of patients experiencing threatened premature labour, along with the time of delivery and the foetus body mass at birth. METHODS: The study included 89 women hospitalised at the Obstetrics and Gynaecology Clinical Hospital in the period 2011-2013. Group 1 comprised 31 patients diagnosed with threatened preterm labour, prior to tocolytic treatment. Group 2 comprised 32 patients with tocolytic treatment. Group 3 constituted the control group. RESULTS: Groups 1, 2 and 3 differed considerably in terms of the week of delivery of pregnancy (p = 0.006). Analogous results were obtained by analysing the body mass at birth, where a statistically significant difference in body mass at birth was found between Groups 1, 2 and 3 (p < 0.001). Our analysis focussed on the cytokine profile of the women included in the study, but no considerable changes in cytokine concentration were observed. CONCLUSIONS: No statistically significant differences were found in the cytokine profile among those patients in normally progressing pregnancy or in threatened preterm labour. No suitability of progesterone treatment in threatened preterm labour was observed.

Knowledge assessment of women living in the Wielkopolska region concerning risk factors for cervical cancer.

INTRODUCTION: Cervical cancer (CC) is a malignant tumor which for many years has been a serious epidemiological problem in Poland. This issue is important because CC is the second most common type of malignant tumor, after breast cancer, and the second most common cause of death among women. The aim of this study was to assess the knowledge and awareness of women living in the Wielkopolska region (Gniezno district) of risk factors for cervical cancer. MATERIAL AND METHODS: The study used the diagnostic poll method, based on a previously developed survey questionnaire. The study was carried out between March and April 2013. The study group consisted of 100 women, involving schoolgirls from the secondary school in Gniezno (Group I), workers (doctors, nurses and midwives) of two outpatient clinics in the Gniezno district (Group II) and patients of the same clinics (Group III). RESULTS: According to the respondents, the main cause of CC is human papillomavirus (Group II - 36%) and genetic predisposition (Group III - 35%). It is alarming that 26% of women did not know the risk factors for CC. CONCLUSIONS: It is necessary to improve health education, especially concerning the main factors affecting the development of CC, in order to reduce the morbidity and mortality rates related to this cancer.

Novel markers in the diagnostics of endometriomas: Urocortin, ghrelin, and leptin or leukocytes, fibrinogen, and CA-125?

OBJECTIVE: CA-125 protein is used as a marker in clinical practice for the diagnosis of endometriomas. The aim of this study was to determine whether endometriomas are accompanied by an increased level of urocortin, ghrelin, and leptin, as well as the increased parameters of blood cell count, fibrinogen, and CA-125. MATERIALS AND METHODS: The study included 86 women aged 18-38 years who had been treated laparoscopically for lesions in the adnexa with the characteristics of endometriomas and mature teratoma, during the period September 2009 to November 2012. The statistical analysis was performed using the nonparametric Mann-Whitney U test and the Spearman rank correlation coefficients (p ≤ 0.05). RESULTS: The medians were 105.31 pg/mL versus 120.84 pg/mL for urocortin, 7.16 pg/mL versus 9.13 pg/mL for leptin and 584.33 pg/mL versus 657.82 pg/mL for ghrelin (p > 0.05), respectively. Analyzing the parameters of blood cell count, statistically significant differences were shown in the respective groups for leucocyte level (5.35 × 10(9)/L vs. 6.7 × 10(9)/L; p = 0.029), fibrinogen level (3.12 mg% vs. 2.57 mg%; p = 0.001), and CA-125 (36.50 U/mL vs. 15.08 U/mL; p = 0.001). CONCLUSION: In conclusion, the prognostic values for CA-125, leukocytes, and fibrinogen may prove a very useful tool for the diagnosis of lesions in the adnexa of the type endometriomas.