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1.
J Clin Med ; 13(9)2024 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-38731115

RESUMO

Background: Cytomegalovirus (CMV) infection represents a major issue worldwide, since it constitutes the most common viral congenital infection, with a prevalence of 0.58% and 1-5% in developed and developing countries, respectively. According to recent studies, prenatal treatment significantly decreases the risk of vertical CMV transmission, and early intervention may even prevent the termination of pregnancy. This study aimed to investigate the level of awareness of CMV among pregnant patients through a semi-systematic review. Methods: We included all of the original articles investigating knowledge and awareness about CMV infection among pregnant women. Our research included the PubMed database. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, the Covidence system automatically guided us to screen the titles and/or abstracts, and then full-texts, followed by data extraction from the eligible studies. Results: We screened 764 studies altogether, with 13 studies included in this analysis. Knowledge about the existence of CMV infection risk varied between the articles, ranging from 11.4% in a study performed in Ireland to 60% reported in a study on the French population. Studies analyzing the impact of educational interventions on patients' knowledge about preventive measures reported significant improvement compared to their level of awareness before the intervention. Conclusions: Patients' awareness and knowledge about CMV seemed to be generally low or very low during the last decade before the development of effective secondary prevention methods. Educational interventions seem to be effective, and therefore their wide use could be of potential benefit. In the era of available secondary prevention of vertical transmission, it is crucial to concentrate the efforts of different stakeholders to increase the awareness of cCMV among pregnant women.

2.
Biomedicines ; 10(10)2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36289716

RESUMO

The evidence of poly (ADP-ribose) polymerase (PARP) association with the immune response could be coherent with the immunological theory of endometriosis and suggests the possibility of a new research direction. The aim of the study was to evaluate the levels of PARP in plasma and peritoneal fluid of patients with and without endometriosis. It was a multicenter, cross-sectional study. Plasma and peritoneal fluid samples were collected from patients with and without endometriosis during planned laparoscopic procedures in eight clinical centers. In total, 84 samples of plasma and 84 samples of the peritoneal fluid were included in the final analyses. Double-antibody sandwich enzyme-linked immunosorbent assay was performed in order to assess levels of PARP in collected samples. No statistically significant differences regarding the detected levels of PARP in plasma and peritoneal fluid comparing patients with and without endometriosis were observed. Patients with a history of infertility had significantly higher plasma PARP concentrations (p = 0.04). We have not observed the potential role of PARP concentration levels in plasma nor peritoneal fluid as an endometriosis biomarker. We have determined an association between a higher plasma PARP concentration and a history of infertility.

3.
Biomedicines ; 10(10)2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36289723

RESUMO

Zinc finger E-box-binding homeobox 1 (ZEB1) and zinc finger E-box-binding homeobox 2 (ZEB2) are transcription factors that regulate epithelial−mesenchymal transformation (EMT). The aim of this study was to compare levels of ZEB1 and ZEB2 in the peritoneal fluid and plasma between patients with and without endometriosis in order to assess their utility in the diagnostic process. Plasma and peritoneal fluid samples were collected from 50 patients with and 48 without endometriosis during planned surgical procedures in eight clinical centers. Quantitative ZEB1 and ZEB2 levels analyses were performed using a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). No significant differences were observed in ZEB1 levels in any of the subanalyses nor any differences regarding ZEB2 levels between patients with and without endometriosis. Plasma ZEB2 levels were significantly higher among patients with infertility compared to fertile women (16.07 ± 12.70 ng/L vs. 12.07 ± 11.92 ng/L; p < 0.04). Both ZEB1 and ZEB2 do not seem to have a significant value in the initial diagnosis of endometriosis as a single marker. The differences in ZEB2 plasma levels between patients with and without infertility indicate the possibility of EMT dysregulation in the pathogenesis of adverse fertility outcomes.

4.
Ginekol Pol ; 93(8): 655-661, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35894486

RESUMO

OBJECTIVES: Infectious diseases in pregnant women can cause birth defects. Implementing appropriate prevention methods while planning pregnancy can help avoid some of them. MATERIAL AND METHODS: A cross-sectional survey study was performed. The questionnaire investigated attitudes towards vaccinations, as well as opinions on anti-vaccine movements and the so-called "chickenpox parties". The questionnaire was developed for the purpose of this study and the survey was conducted using the google form, which was posted on social media groups for women planning pregnancy, being pregnant or for mothers' groups from Poland. RESULTS: The study group consisted of 2402 women; their median age was 31 years (range 16-54 years). Most women were from cities > 100,000 inhabitants (49.7%, 1194/2402) and had higher education (71.9%, 1726/2402). A positive attitude towards vaccinations was more common among younger, nulliparous women from big cities (p = 0.02, p = 0.04 and p = 0.01, respectively). 2068/2402 (86.1%) of respondents were not vaccinated before pregnancy and 1931/2402 (80.4%) of women were not vaccinated during pregnancy. While most women (1545/2402, 64.3%) considered vaccination safe, and effective (1904/2402, 79.3%) against infectious diseases, many (n = 296/2402 12.3%) have no opinion on the so-called chickenpox party. CONCLUSIONS: Most surveyed women had a positive attitude towards vaccinations and consider vaccines a safe and effective method of protection against infectious diseases. Since a significant proportion of women were not vaccinated before or during pregnancy and about 12% of women are undecided, the physician's role is crucial in educating and persuading the patient to be vaccinated.


Assuntos
Varicela , Criança , Feminino , Gravidez , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Polônia , Vacinação , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde
5.
Int J Gynecol Cancer ; 2022 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-35568382

RESUMO

OBJECTIVE: Both the location of primary disease and treatment side effects may have an impact on sexual function in oncogynecological patients. The aim of this study was to examine the prevalence, strategies, difficulties, and ideas for improvement in sexual counseling among specialists managing patients with gynecologic malignancies. METHODS: This was a cross-sectional survey study performed among healthcare professionals treating patients with gynecologic malignancies. A self-prepared questionnaire included 61 questions concerning general demographic information and different aspects of sexual counseling in the gynecologic oncology practice. Analysis included attitudes, behaviors, management strategies, difficulties, and ideas for possible systemic improvements. Statistical analysis involved descriptive statistics, two-sided chi-square test, and Fisher's exact test. RESULTS: A total of 150 respondents from 46 countries answered the survey. The majority of survey participants stated that sexual counseling of oncological patients is very important (n=73, 49%) or important (n=46, 31%). One hundred and two (68%) respondents agreed that sexual counseling of gynecologic oncology patients should be routinely provided by the specialist managing the primary disease. However, collecting information concerning sexual function is performed often or always by only 21% of respondents and 19% discuss the topic rarely or never. The most frequently indicated barriers leading to difficulties in sexual counseling include lack of time (74%), lack of specialist knowledge (55%), and patient embarrassment (48%). One hundred and seven (71%) respondents expressed interest in participating in sexual counseling workshops organized by the European Society of Gynaecological Oncology (ESGO)/European Network of Young Gynaecological Oncologists (ENYGO), 74 (49%) would like to access webinars on the topic, and 120 (80%) would be interested in materials in the ESGO online educational resources. CONCLUSION: One of the proposed solutions to insufficient access to sexual care for women with gynecologic malignancies is providing access to specialist educational programs for both patients and healthcare specialists.

6.
Ginekol Pol ; 93(12): 999-1005, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35106749

RESUMO

OBJECTIVES: This study aimed to examine whether expectant management in twin pregnancies with preterm premature rupture of membranes (pPROM) is as safe as in singleton pregnancies. MATERIAL AND METHODS: It was a retrospective cohort study comparing pregnancy course and outcome in singleton (n = 299) and twin pregnancies (n = 49) complicated by preterm premature rupture of membranes. Analysed factors included maternal diseases, gestational age at premature rupture of membranes (PROM), management during hospitalization, latency periods between PROM and delivery, gestational age at delivery, neonatal management and outcome. RESULTS: The difference in the proportion of patients with latency up to 72 hours, latency between 72 hours and seven days, and latency exceeding seven days were insignificant. The percentage of patients who received intravenous tocolysis and antenatal corticosteroids were similar; however, patients in twin pregnancies more often received incomplete steroids dose (p = 0.01). The occurrence of the positive non-stress test result and signs of intrauterine infection were similar between the groups. No statistically significant differences in the prevalence of neonatal complications except transient tachypnoea of the newborn were identified (24% in the singleton vs 13% in the twin group, p = 0.03). CONCLUSIONS: Expectant management of pPROM in singleton and twin pregnancies results in similar perinatal and neonatal outcome. Consequently, in case of no evident contraindications, expectant management of twin pregnancies seems to be equally as safe as in singleton pregnancies. Patients in twin pregnancies may be at higher risk of delivery before administration of full antenatal corticosteroids dose, therefore require immediate management initiation and transfer to a tertiary referral centre.


Assuntos
Ruptura Prematura de Membranas Fetais , Gravidez de Gêmeos , Recém-Nascido , Gravidez , Humanos , Feminino , Estudos Retrospectivos , Conduta Expectante , Ruptura Prematura de Membranas Fetais/epidemiologia , Ruptura Prematura de Membranas Fetais/terapia , Ruptura Prematura de Membranas Fetais/etiologia , Idade Gestacional , Corticosteroides/uso terapêutico , Resultado da Gravidez/epidemiologia
7.
Ginekol Pol ; 93(5): 345-350, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34263917

RESUMO

OBJECTIVES: The study was conducted in order to determine the impact of the COVID-19 pandemic on the fertility intentions among the Polish population. MATERIAL AND METHODS: A cross-sectional, questionnaire-based online study was carried out among Polish adults in order to determine the impact of the COVID-19 pandemic on the reproductive plans of the Polish society. A total of 984 participants correctly completed the survey. RESULTS: The pandemic has affected the reproductive intentions of 22% (n = 216) of the respondents, most of them want to have a child later than they previously planned (74.1%). The relationship between the change in reproductive intentions and the concerns about the pandemic was found. Most of those who changed their plans were afraid that the access to prenatal care and delivery services could be limited (86.6%) or were afraid about giving birth at the hospital (81%). More than half (51.9%) of those who changed reproductive plans were afraid of losing their income and 40.3% had already experienced a decrease in their income. The change in partner's emotional relationships was also observed. More than half of respondents (56.7%) admitted that during the pandemic they had developed a deeper emotional relationship with their partners or felt more emotionally supported (56.6%). Most participants responded that the frequency of their sexual intercourses was not affected (66.7%) and that they had not experienced limited access to contraceptives (95.1%) during the pandemic. CONCLUSIONS: The COVID-19 pandemic has affected Polish people's reproductive intentions. Concerns related to healthcare access and the economic difficulties have the most significant impact.


Assuntos
COVID-19 , Adulto , COVID-19/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Intenção , Pandemias , Polônia/epidemiologia , Gravidez
8.
Sci Rep ; 11(1): 21120, 2021 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-34702910

RESUMO

Pregnancy after bariatric surgery is known to be associated with a higher risk of small for gestational age infants (SGA) and maternal anemia. 71 patients with a history of bariatric surgery, who had at least one pregnancy ended with a delivery of a single live-born neonate after the bariatric surgery were included in the study. The main endpoints were gestational weight gain (GWG), GWG as % of the maternal weight at the beginning of pregnancy (GWG%), maternal anemia, SGA and large for gestational age infants (LGA), neonatal intensive care unit admission (NICU). GWG% was 23.8% ± 14.1 in the LGA group vs 13.9% ± 11.0 in the normal weight neonates group; p < 0.03. Patients diagnosed with anemia before pregnancy had higher GWG% than patients without pre-pregnancy anemia (20.1% ± 11.1 vs 13.4% ± 11.6); p < 0.05. GWG% was higher in patients, whose infants were admitted to NICU (25.3% ± 17.6 vs 14.1% ± 11.0; p < 0.04). GWG% can be considered a risk predictor of the LGA and NICU admissions in bariatric patients. Anemia diagnosed before pregnancy is associated with higher GWG%.


Assuntos
Anemia/fisiopatologia , Cirurgia Bariátrica , Índice de Massa Corporal , Ganho de Peso na Gestação , Obesidade , Resultado da Gravidez , Adulto , Feminino , Humanos , Obesidade/fisiopatologia , Obesidade/cirurgia , Gravidez
9.
Postepy Dermatol Alergol ; 38(3): 366-370, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34377114

RESUMO

Vulvar intraepithelial lesions are a heterogenic group of diseases, which can be easily misdiagnosed. The case of a 61-year-old woman with a history of genital intraepithelial lesions and infection with HPV is presented. Her main complaint was vulvar pruritus. Vulvoscopy revealed the presence of two skin lesions: the first one had the morphology of lichen sclerosus, and the second of a Bowenoid lesion. The biopsy of the first lesion revealed vulvar intraepithelial neoplasia, whereas cells of squamous vulvar cancer were identified in the second lesion. After staging, the patient was advised to undergo hemivulvectomy and lymphadenectomy. The coexistence of morphologically diverse vulvar skin lesions may cause difficulties with diagnosis and the selection of an adequate treatment. Long-term follow-up and regular examination are essential for diagnosis of vulvar malignancies in the early stage.

10.
Medicina (Kaunas) ; 57(8)2021 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-34440962

RESUMO

Background: the COVID-19 pandemic and the implemented restrictions have changed the functioning of healthcare systems worldwide. The purpose of the study was to evaluate the impact of the present epidemiological situation on patients' decisions about undergoing weight loss surgery. Methods: data were collected from 906 bariatric patients by the means of a national online survey, the majority of whom were women (87.9%). The survey started on 9 April 2020 and was open until 28 April 2020. The questionnaire included multiple choice and open questions, divided into three chapters: general information about the patient, life during the COVID-19 pandemic, and bariatric care during the COVID-19 pandemic. Results: despite the pandemic and the associated risk of COVID-19 infection, 443 responders (48.9%) would have decided to undergo bariatric surgery. Awareness of the negative impact of obesity on the course of COVID-19 illness had only marginable impact on patients' decision-making (76.6% vs. 75.3%; p < 0.80). Contact with COVID-19 prior to the survey had a negative impact on the willingness to undergo bariatric surgery (3.0% vs. 4.4%; p < 0.55). There was a positive correlation between the BMI and preference for bariatric surgery in the time of the pandemic (37.4 ± 9.0 vs. 34.9 ± 8.7; p < 0.001). Conclusions: the level of awareness about the advantages of operative treatment of obesity is high among bariatric patients. The majority of patients awaiting bariatric surgery at the moment of the survey were positive about undergoing bariatric surgery despite the increased risk of a serious course of COVID-19 infection. Therefore, a large proportion of patients was determined to have bariatric treatment even during the pandemic, being aware of the increased risk of worse pace of COVID-19 disease in case of obesity and related diseases.


Assuntos
Cirurgia Bariátrica , COVID-19 , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Obesidade/cirurgia , Pandemias , SARS-CoV-2
11.
Medicina (Kaunas) ; 57(5)2021 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-34067534

RESUMO

Background and Objectives: Social isolation and lockdown due to the COVID-19 pandemic have influenced dietary habits and physical activity of all the population, but the obese population is the most vulnerable to weight gain. Material and Methods: A group of 189 patients (166 female and 23 male) from the bariatric surgery waiting list filled in a survey about the influence of COVID-19 pandemic lockdown on their dietary habits, physical activity, and the possibility of contact with their bariatric care center. Results: The majority of patients with weight gain declared a decrease in physical activity, compared to half of the patients without weight gain (50.5% vs. 74.5%, p < 0.05). The continuation of bariatric care and the possibility of contact with a bariatric surgeon, dietician, and psychologist had each significant influence on reducing the risk of patients' weight gain (p < 0.05). Conclusions: Maintaining physical activity and contact with bariatric care specialists are important factors in allowing to avoid weight gain in patients waiting for bariatric surgery.


Assuntos
Cirurgia Bariátrica , COVID-19 , Controle de Doenças Transmissíveis , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , SARS-CoV-2 , Listas de Espera
12.
Ginekol Pol ; 92(11): 784-791, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34105754

RESUMO

OBJECTIVES: The aim of the study was to obtain information on the knowledge, opinions and attitudes of Polish women in terms of functioning of human milk banks, as well as the possibility to be a donor. Specific objectives included consideration of responses in the sociodemographic aspect and identification of factors influencing donation decisions. MATERIAL AND METHODS: A cross-sectional survey was conducted, obtaining 871 responses. Women were asked to provide basic sociodemographic data, information related to pregnancy and lactation. Knowledge and opinion about breast milk banks as well as the impact of various factors on a potential donation decision were investigated. RESULTS: Of all women participating in the study, 604 (69%) were aware of the breast milk banks existence. 69% of respondents indicated the Internet, 10% - a nurse or midwife, while only 4% - a doctor as source of knowledge about human breast milk donation. Among women who had children (n = 453), only 9 (2%) donated breast milk in the past. The indicated reasons for not donating were no milk excess (38%), insufficient knowledge about the procedure or unawareness of its existence (33% and 25%, respectively), long distance to affiliated facility (17%). CONCLUSIONS: The awareness of breast milk banks existence, possibilities and terms of donation in the studied group is not satisfactory. Widely sharing reliable information on banking and promoting the idea of donating human breast milk in society can lead to impressive results. There is a need for further development of human breast milk banks and continuous improvement of their availability in Poland.


Assuntos
Bancos de Leite Humano , Leite Humano , Criança , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Polônia , Gravidez
13.
Ginekol Pol ; 92(11): 804-811, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33914330

RESUMO

OBJECTIVES: Regular and moderate physical activity during uncomplicated pregnancy has been considered beneficial for both the expectant mother and her unborn child. It reduces the risk of gestational diabetes mellitus (GDM) and preeclampsia. The aim of the study was to assess women's knowledge concerning specific aspects of physical activity during uncomplicated pregnancy. MATERIAL AND METHODS: A cross-sectional survey study on a sample of Polish women in a tertiary referral centre was performed. A questionnaire that was validated in the Polish language was based on the Committee Opinion of American College of Obstetricians and Gynaecologists, which was published in December 2015. Sociodemographic parameters in relation to specific aspects of physical activity during pregnancy were analysed. RESULTS: A total of 259 (92.5%) women were aware of the beneficial impact of physical activity on the course of pregnancy. Higher education was associated with greater awareness (p = 0.001). Regarding the optimal frequency and recommended duration of exercise, the overall rates of correct answers were only 106 (38.1%) and 167 (59.6%), respectively. The most common sources of information on physical activity during pregnancy were the Internet (81, 50.0%) and books (62, 38.3%). Doctors and midwives instructed the respondents only in 36 (22.4%) and 31 (18.9%) cases, respectively. CONCLUSIONS: Women's knowledge about physical activity during pregnancy seems satisfactory. However, awareness concerning the optimal duration and frequency of exercise, as well as recommended voluntary activities during pregnancy, should be improved. Medical professionals may also reinforce their role as a provider of reliable information, resulting in the prevention of many pregnancy complications.


Assuntos
Diabetes Gestacional , Idioma , Estudos Transversais , Exercício Físico , Feminino , Humanos , Polônia , Gravidez
14.
Cell Tissue Bank ; 22(4): 587-596, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33751309

RESUMO

Umbilical cord blood (UCB) is considered as a valuable potential source of hematopoietic stem and progenitor cells. A process of collecting and storing UCB in the immediate period after the birth is called UCB banking. The study was conducted in order to determine women's knowledge, awareness, preferences and attitude towards UCB banking in Poland, considering the sociodemographic and obstetric factors. A cross-sectional, self-administered, online questionnaire-based study including mostly multiple choice questions concerning attitude and awareness regarding UCB banking was conducted entirely online among Facebook female users in Poland. A total of 1077 participants correctly completed the survey. Most participants (n = 911, 84.6%) were aware of the possibility of UCB banking. Social media were considered as the main source of information (47.5%). However, the participants mostly indicated the doctor as their preferred source of reliable information (86.8%). The majority of women (61.8%) assessed their level of knowledge of UCB banking as still insufficient. Among the participants who supported UCB banking (70%), the following reasons were considered as the most vital: potential possibility of helping their child (93.9%) and helping other relatives (64.4%). More than half of the respondents (66.9%), who have not stored and are not willing to store their children's UCB, indicated the high cost of UCB banking as the main reason of this decision. The knowledge and awareness of UCB storage and banking possibilities amongst women in Poland could be improved. The professional medical personnel should be a source of reliable information.


Assuntos
Bancos de Sangue , Sangue Fetal , Estudos Transversais , Feminino , Humanos , Polônia , Gravidez , Inquéritos e Questionários
15.
Wideochir Inne Tech Maloinwazyjne ; 16(1): 30-37, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33786114

RESUMO

The purpose of this review was to analyze the literature about pregnancy after bariatric surgery. We searched for available articles on the subject from the last decade (2010 to 2020). The positive impact of bariatric surgery on the level of comorbidities and pregnancy and neonatal outcomes cannot be overrated. Weight loss after bariatric surgery reduces the incidence of obesity-related conditions in pregnancy. A pregnancy in a woman after bariatric surgery should be considered a high-risk pregnancy and taken care of by a multidisciplinary team with appropriate micronutrient and vitamin supplementation provided. Optimum time to conception should be chosen following the international recommendations. Every woman after bariatric surgery should be aware of symptoms of surgical complications and immediately contact their surgeon in case of abdominal pain.

16.
Ginekol Pol ; 92(3): 226-229, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33576472

RESUMO

Bariatric surgery is associated with a higher risk of intrauterine growth retardation (IUGR) and small for gestational age neonates. We present two examples of IUGR after laparoscopic Roux-en-Y gastric bypass, both associated with excessive restriction in patients caloric intake, one due to obstetrician's indications and the other resulting from patient's anxiety of weight gain in pregnancy. IUGR was observed accordingly in the 35th and 28th week of pregnancy. The first patient had an urgent cesarean section due to pathological cardiotocography tracings in the 35th week of pregnancy, with the newborn's weight of 1690 g (< 1st percentile). The second patient, admitted in the 28th week with suspected IUGR, had an elective cesarean section in the 36th week, with the newborn's weight of 2095 g (5th percentile). Although malabsorptive mechanisms are known to be involved in the impaired fetal growth after bariatric surgery, patients' and obstetricians' adherence to nutrition and supplementation regimen are of utmost importance. The problem of optimum daily caloric intake, vitamin and micronutrients supplementation in pregnancies after bariatric surgery is presently discussed in the literature. Optimum care and advice for bariatric patients have to be diversified as malabsorptive and restrictive operations lead to changes in metabolism, nutrition and hormonal balance.


Assuntos
Cirurgia Bariátrica , Derivação Gástrica , Laparoscopia , Cesárea , Feminino , Retardo do Crescimento Fetal/etiologia , Derivação Gástrica/efeitos adversos , Derivação Gástrica/métodos , Humanos , Recém-Nascido , Laparoscopia/efeitos adversos , Gravidez
17.
Ginekol Pol ; 92(4): 333-334, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33576473

RESUMO

The prevalence of clinically symptomatic cervical leiomyomas in pregnancy is lower than 0.1%. Surgical intervention is necessary in extremely rare cases and only few are described in the literature. This study presents a case of successful vaginal myomectomy in the 13th week of pregnancy followed by a delivery of a healthy neonate in term by cesarean section.


Assuntos
Leiomioma , Complicações Neoplásicas na Gravidez , Miomectomia Uterina , Neoplasias Uterinas , Cesárea , Feminino , Humanos , Recém-Nascido , Leiomioma/cirurgia , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico por imagem , Complicações Neoplásicas na Gravidez/cirurgia , Neoplasias Uterinas/cirurgia
18.
Ginekol Pol ; 92(1): 24-29, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33576488

RESUMO

OBJECTIVES: The purpose of this study was to determine the risk factors for caesarean sections in the second stage of labour after a previous caesarean section among women who underwent trial of labour (TOL). MATERIAL AND METHODS: From a total of 639 women who experienced one caesarean section, 456 women were qualified for TOL. From this group, 105 women were subjected to a caesarean section in the first stage of labour and another 351 women reached the second stage of labour. From the latter group, 309 women delivered naturally and 42 were subjected to a caesarean section. RESULTS: Risk factors for the necessity of performing a caesarean section in the second stage of labour after a previous caesarean section was the weight gain during pregnancy (OR = 1.07), the height of fundus uteri (OR = 1.25) before delivery, and the estimated foetal weight (OR = 1.01), a past delivery of a child with a birth weight exceeding 4.000 g (OR = 2.14), the presence of pre-gestational diabetes (OR = 15.4) and gestational diabetes (OR = 2.22), necessity of applying a delivery induction (OR = 2.52), stimulation of uterine activity during delivery (OR = 2.43) and application of epidural analgesia (OR = 4.04). A factor reducing the risk of a caesarean section in the second stage was a vaginal delivery in a woman's history (OR = 0.21). CONCLUSIONS: Women should be encouraged to deliver naturally after a previous caesarean section, especially when their history includes a vaginal delivery and if there is no need for labour induction.


Assuntos
Recesariana , Cesárea/efeitos adversos , Diabetes Gestacional/epidemiologia , Prova de Trabalho de Parto , Nascimento Vaginal Após Cesárea , Adolescente , Adulto , Dilatação , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Fatores de Risco , Adulto Jovem
19.
J Obstet Gynaecol Res ; 47(3): 882-892, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33372310

RESUMO

AIM: The aim was to compare the quality of sexual life before pregnancy and after delivery and to find out whether and how selected factors affect women's sexuality during this period. METHODS: The study group consisted of 433 women who completed the survey containing basic demographic questions and two Female Sexual Function Index (FSFI) questionnaires: a retrospective one, regarding time before pregnancy and the current period. The inclusion criteria: time between 10 weeks and 1 year after delivery, vaginal intercourses before pregnancy and the resumption of vaginal intercourses after delivery. RESULTS: We observed the negative impact of labor on the total FSFI score, regardless of the time that had passed since birth and the delivery mode. The decrease by at least 10% of the initial FSFI score was noticed in 44.3% of the participants. FSD (Female Sexual Dysfunction) occurred statistically more commonly after delivery than before pregnancy (45.3% vs 17.1%; P < 0.001). The following factors had an impact on the risk of post-partum FSD: pre-pregnancy FSD (adjusted odds ratio [aOR] = 4.17 [95% confidence interval [CI] 2.38-7.31]) and nulliparity (aOR = 1.67 [95% CI 1.09-2.53]). CONCLUSION: Childbirth has an undeniable impact on women's sexuality. The prevention and treatment of sexual dysfunctions is very important, especially in this crucial period of life.


Assuntos
Disfunções Sexuais Fisiológicas , Sexualidade , Feminino , Humanos , Parto , Gravidez , Estudos Retrospectivos , Comportamento Sexual , Disfunções Sexuais Fisiológicas/epidemiologia , Inquéritos e Questionários
20.
Ginekol Pol ; 91(9): 528-538, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33030733

RESUMO

OBJECTIVES: The aim of this study was to evaluate pregnancy outcome of patients with prelabor rupture of membranes receiving expectant management and giving birth prematurely in comparison to preterm births of patients with intact membranes. MATERIAL AND METHODS: It was a retrospective cohort study comparing maternal and neonatal outcome in two groups of preterm births. The first group included 299 consecutive singleton preterm births complicated by prelabor rupture of membranes. The second group consisted of 349 consecutive singleton preterm births without prelabor rupture of membranes. RESULTS: Patients without pPROM underwent Caesarean sections more often than women from the pPROM group (65.3% vs 45.2%; p < 0.001). No statistically significant differences regarding the gestational age during delivery were identified. Lower birth weight was detected in the group with no history of pPROM (p < 0.001). No differences regarding early-onset sepsis were identified and higher percentage of late-onset infections was observed in infants with no history of pPROM (8.9% vs 4.7%; p = 0.04). Pulmonary hypertension was more common in the infants from the pPROM group (4% vs 1.4%; p = 0.049). Neonatal respiratory distress syndrome and respiratory failure were more prevalent in cases of no pPROM history - 20% vs 12.7% (p = 0.02) and 40% vs 25.8% (p < 0.001), respectively. CONCLUSIONS: Development of multiple complications in preterm neonates may be more associated with the management, gestational age at birth, and birth weight than with the occurrence of preterm prelabor rupture of membranes.


Assuntos
Ruptura Prematura de Membranas Fetais , Recém-Nascido Prematuro , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Adulto , Cesárea/estatística & dados numéricos , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Masculino , Polônia/epidemiologia , Gravidez , Resultado da Gravidez , Cuidado Pré-Natal , Estudos Retrospectivos
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