Pregnancy school education program in mother friendly training and research hospital impact on stress and anxiety.

OBJECTIVE: This study aimed to investigate prenatal education and its relationship with anxiety and stress in pregnant women. METHODS: This research was carried out between July 1, 2022, and December 1, 2023, at Giresun Gynecology and Pediatrics Training and Research Hospital. Women aged >18 years at >20 weeks of pregnancy were included. Patients were randomized into two groups, and one group received a 4 week training on meditation, breathing exercises, and pregnancy-related health issues. A questionnaire was applied to both groups to analyze sociodemographic characteristics, pregnancy, birth, medical history, the Pregnancy Stress Rating Scale, and the State Trait Anxiety Inventory. RESULT: The groups were similar in terms of age, educational status, anthropometric characteristics, occupation, economic status, and gestational week. There was no difference between the trained and nontrained groups in terms of the Pregnancy Stress Rating Scale score and the State Trait Anxiety Inventory-state score. The State Trait Anxiety Inventory-trait was significantly lower in the trained group (p=0.033). There were weak positive correlations between Pregnancy Stress Rating Scale score and medication use and between State Trait Anxiety Inventory-state score and age. A negative correlation was found between the State Trait Anxiety Inventory-state score and working status, showing that employed women had lower anxiety scores irrespective of training. Another weak positive correlation was found between the State Trait Anxiety Inventory-trait score and the presence of comorbidities. CONCLUSION: State Trait Anxiety Inventory-trait anxiety was lower in pregnant women who received training on prenatal meditation, exercise, and pregnancy health; however, State Trait Anxiety Inventory-state and Pregnancy Stress Rating Scale scores were similar in the two groups. Unemployed pregnant women and those with chronic diseases appear to need closer follow-up to reduce anxiety levels.

Diagnostic accuracy and validity of the O-RADS MRI score based on a simplified MRI protocol: a single tertiary center retrospective study.

BACKGROUND: Adnexal masses (AM) are a common gynecological problem. It is important to use a reliable imaging method in the differentiation of benign and malignant AMs. PURPOSE: To assess the accuracy and validity of the O-RADS magnetic resonance imaging (MRI) score for characterizing AM using a simplified MRI protocol. MATERIAL AND METHODS: The study population comprised 332 women who underwent MRI due to the detection of indeterminate AM on ultrasonography between January 2018 and June 2020. An experienced radiologist calculated the O-RADS MRI score into five categories, using an MRI protocol with a simplified dynamic study. Sensitivity, specificity, positive and negative predictive values, and area under the curve (AUC) were calculated (cutoff for malignancy, score ≥ 4). The reference standard was histopathologic diagnosis or imaging findings during >24 months of follow-up. RESULTS: Of 237 AMs, 28 (11.9%) were malignant. The malignancy rates of AMs with scores of 1, 2, 3, 4, and 5 were 0% (0/12), 0% (0/111), 1.2% (1/77), 50% (10/20), and 100% (17/17), respectively. The O-RADS MRI score showed 96.3% sensitivity, 95.2% specificity, and 95.3% accuracy in malignancy prediction. The AUC for the differentiation of benign and malignant masses were 0.983. False positivity rate was high in cases with an O-RADS MRI score of 4 (50%). CONCLUSION: The O-RADS MRI score, based on a simplified MRI protocol, has high accuracy and validity in distinguishing benign from malignant sonographically indeterminate AMs. Its use in clinical practice can classify the malignancy risks of masses and prevent unnecessary surgery in benign lesions.

Does LH supplementation in poor responders affect granulosa cells apoptosis rate in ART? A prospective randomised controlled trial.

The aim was to compare granulosa cell's (GCs) apoptosis rate with (group A) or without (group B) luteinising hormone (LH) supplementation in poor ovarian responders (PORs) during controlled ovarian stimulation (COS). After oocyte retrieval, the follicular fluid was analysed by cytoflowmetry. Primary outcomes were GCs apoptosis rate in terms of viability, early apoptosis, late apoptosis and necrosis. Secondary outcome was clinical pregnancy rate. The viability was 96.7{IQR: 8} and 83.5{IQR: 20} for groups A and B, respectively (p < .001). Late apoptosis rates were significantly lower in group A (median 1.5, {IQR: 3.1}) than group B (median 9.5, {IQR: 20.6}) (p < .001). Median early apoptosis rates were 1.4 {IQR: 2.9} and 5.2 {IQR: 6.5} for group A and B respectively (p = .04). No significant difference was observed in the clinical pregnancy rate. Although LH seems necessary in PORs to decrease late granulosa apoptosis rates, this does not improve clinical pregnancy rates.IMPACT STATEMENTWhat is already known on this subject? LH supplementation during COS has long been an issue in PORs to overcome the rFSH responsiveness due to the LH polymorphism. LH receptors have also been on GCs and their expression increases in preovulatory follicles. GCs apoptosis rates may show the oocyte quality and reproductive potential of oocyte retrieved and the requirement for LH supplementation.What do the results of this study add? The present study shows that LH supplementation during COS for PORs promotes the GC viability and reduces early/late apoptosis rates. Similarly, the number of MII oocytes was significantly higher in the LH regimen group. However, there was no significant difference in terms of clinical pregnancy rates.What are the implications of these findings for clinical practice and/or further research? The oocyte quality parameters such as higher GC viability and lower GC early/late apoptosis rates verify the LH supplementation in PORs during COS. However, the limited size of this study requires further multi-centre research in a larger cohort of patients. Results obtained with a sensitive and validated method will help clinicians to make better decisions in patient care.