The Impact of HPV Diagnosis and the Electrosurgical Excision Procedure (LEEP) on Mental Health and Sexual Functioning: A Systematic Review.

The impact of HPV diagnosis and subsequent treatment with the electrosurgical excision procedure (LEEP) on anxiety, depression, psychosocial quality of life, and sexual functioning has not been thoroughly investigated. The aim of this review was to systematically summarize the available knowledge on this topic, according to PRISMA guidelines. Data from observational and intervention studies were analyzed. A total of 60 records were included, of which 50 papers addressed the impact of HPV diagnosis on patients' psychosocial status, while 10 studies addressed the impact of the implemented LEEP procedure on patients' mental health and sexual functioning. The results indicated a negative impact of HPV diagnosis on the occurrence of depressive and anxiety symptoms, poorer quality of life, as well as on the sexual functioning of the affected women. The results of the studies to date have not confirmed the negative impact of the LEEP procedure on mental health and sexual life, although more research is needed in this area. It is necessary to implement additional procedures to minimize anxiety and distress in patients receiving a diagnosis of HPV or abnormal cytology and to improve awareness of sexually transmitted pathogens.

[Chlamydia trachomatis infection in sexually active teenagers]. / Zakazenie Chlamydia trachomatis u aktywnych seksualnie nastolatek.

BACKGROUND: The prevalence of Chlamydia trachomatis infections among Polish teenagers remains unknown. Sexually active teenagers are exposed at sexually transmitted infections, including Chlamydia trachomatis (CT). Most infections are asymptomatic and, therefore, untreated. Early detection and treatment of cervical chlamydial infections may prevent pelvic inflammatory diseases and prevent later infertility. AIM: to determine the prevalance and risk factors of Chlamydia trachomatis infections among sexually active female teenager. MATERIALS AND METHODS: 243 sexually active girls, 16-19 year-olds, attending the outpatient clinic were enrolled in this study between 2005-2007. The participants filled in a questionnaire containing such information as age, purpose of visit, level of education, age at the first intercourse, number of sexual partners, number of current partners (in the past 3 months), contraceptive methods, use of condoms, past history of STD and obstetric history at the first visit. Pelvic examination was performed to check the following: vaginal discharge, presence of abnormalites of the cervix (ectopy, erythema, tenderness of uterine and adnexal) and to take a Pap smear and a cervical swab for Chlamydia trachomatis. Cervical swabs for Chlamydia trachomatis were tested by polymerase chain reaction (PCR). RESULTS: The prevalence of CT genital infection in the studied group was 2,9%. Adolescent females infected by CT less frequently admitted to the use of condom and more often did not use any contraception at all, in comparison with the girls without CT genital infections (29% and 57% vs. 37% and 19%). There were statistically significant differences in the results of the abnormal Pap smears (ASCUS, LGSIL) between the two groups.

Chlamydia trachomatis infection in pregnant women hospitalised in the Institute of Mother and Child in Warsaw, Poland.

UNLABELLED: Chlamydia trachomatis infection is the most common sexually transmitted disease. It concerns both epidemiologists and clinicians as it is often asymptomatic and can cause permanent sequelae. Chlamydia trachomatis infection in women causes nongonococcal cervicitis, endometritis, urethritis, inflammation of the Bartholin's gland, acute and chronic pelvic inflammatory disease, Fitz-Hugh-Curtis syndrome and can lead to Fallopian tube obstruction, infertility and ectopic pregnancy. During pregnancy it can cause chorioamnionitis, premature rupture of membranes, premature delivery, intrauterine growth restriction, low birth weight. post partum endometritis and also infection in the newborn. AIM: To assess the prevalence and to describe risk factors (behavioural and clinical) of genital infection caused by Chlamydia trachomatis in the population of pregnant women attending the Obstetrics Clinic at the Institute of Mother and Child and to study the impact of this infections of pregnancy outcome. METHODS: We have tested 80 pregnant women attending the clinic of obstetrics and gynaecology of the Mother and Child Institute in Warsaw: The presence of C. trachomatis in cervical swabs was assessed using the Polymerase Chain reaction (PCR). RESULTS: We found two cases of C. trachomatis infection, which represents 2.5% of the tested population. CONCLUSIONS: controversial data on the prevalence of C. trachomatis in pregnant women and its influence on pregnancy duration justify further investigations despite the observed law prevalence in this study. This will allow to determine the role and usefulness of routine screening for C. trachomatis in pregnant women in Poland.

Chlamydia trachomatis infection in sexually active adolescents and young women.

BACKGROUND: The prevalence of Chlamydia trachomatis infections among Polish teenagers is unknown. Sexually active adolescents are at a greater risk for sexually transmitted infections, including Chlamydia trachomatis (ChT). Most inflections are asymptomatic and therefore untreated. Early detection and treatment of cervical chlamydial infections can prevent pelvic inflammatory disease and has a strong protective effect against infertility. AIM: To determine the prevalence and risk factors of Chlamydia trachomatis infections among sexually active female adolescents attending the outpatient gynaecological clinic of the Institute of Mother and Child in Warsaw. MATERIALS AND METHODS: 249 sexually active girls, 16-19 years old, attending the outpatient clinic of the Institute of Mother and Child in Warsaw were enrolled in this study from December 2002 to May 2004, The participants filled out a questionnaire containing informations on age, purpose of the visit, level of education, age of the first intercourse, number of lifetime sexual partners, number of current partners (in the last 3 months), number of sexual partners in the past (patients' partner), contraceptive methods, use of condoms at the first and the last intercourse, past history of STD and obstetric history at first visit. Pelvic examination was done for the following reasons: checking vaginal discharge, presence of abnormalities of the cervix such as ectopy, erythroplakia and uterine tenderness and taking a Pap smear and a cervical swab for Chlamydia trachomatis detection. Cervical swabs for Chlamydia trachomatis were tested by Polymerase Chain Reaction (PCR). RESULTS: The prevalence of ChT genital infection in the studied group was 3.2%. Adolescent females infected by ChT less frequently reported the use of condom and more often did not use any contraception in comparison with the girls without ChT genital infections (42.8% and 42.8% vs. 49% and 12.8%), The existence of other STDs was more frequently noted in adolescents with Chlamydial infection in comparison to healthy girls (14.2% vs. 8.3%). There were no statistically significant differences in results of the Pap smears and the incidence of cervical ectopy between the two groups.

[Usefulness of determination of granulocyte elastase plasma level, c-reactive protein and white blood cell count in prediction in intrauterine infection in pregnant women after PROM]. / Ocena przydatnosci oznaczania elastazy granulocytarnej, bialka C--reaktywnego i calkowitej liczby krwinek bialych w rozpoznaniu zakazenia wewnatrzmacicznego u ciezarnych po przedwczesnym peknieciu blon plodowych (PROM).

UNLABELLED: The main markers of intrauterine infection: C-reactive protein and white blood cell count are dependent on medical management as steroids or antibiotics therapy. Granulocyte elastase is independent variable from influence of tocolysis, steroids, antibiotics, chemiotherapeutics, hours since PROM. The aim of the study was to evaluate and compare the usefulness of determination granulocyte elastase, (EG) C-reactive protein (CRP) and white blood cell count (WBC) in prediction of chorioamninitis in pregnant women after premature rupture of fetal membranes. MATERIALS AND METHODS: 67 women with single pregnancy between 24-36 week of gestation after PPROM were included into the study group. All women were managed expectantly (tocolysis, antibiotics, steroids, intravaginal chemiotherapeutics, bed rest), maternal and fetal (KTG, USG) vital signs were monitored every day. EG, CRP and WBC blood test were performed every day. Histopathologic examinations of all placentas were performed for chorioamnionitis confirmation or exclusion. Normal range for EG--88 micrograms/l, CRP--15 micrograms/l, WBC--15 x 10(9). RESULTS: The usefulness of granulocyte elastase plasma serial determination as biochemical marker of chorioamnionitis in cases of PPROM was confirmed: sensitivity--100%, specificity--33%, PPV--64.9%, NPV--100% in comparison with CRP: sensitivity--27%, specificity--80%, PPV--62.5%, NPV--47% and white blood cell count: sensitivity--27%, specificity--66.7%, PPV--50%, NPV-42.5%. CONCLUSIONS: We confirmed statistical correlation (p < 0.001) between granulocyte elastase plasma level > 88 micrograms/l and histological signs of intrauterine infection in pregnant women after PPROM. Granulocyte elastase determination in plasma is most sensitive indicator of histologic confirmed chorioamnionitis.

[Thyroid function in pregnant women with pregnancy induced hypertension]. / Ocena funkcji tarczycy u ciezarnych z nadcisnieniem indukowanym ciaza.

OBJECTIVE: The aim of this study is to investigate thyroid's function in pregnant women with pregnancy induced hypertension. MATERIALS AND METHODS: 42 pregnant women with PIH diagnosed after 20 weeks of gestation (between 22-30 hbd) were hospitalized in Department of Obstetrics and Gynecology of Mother and Child Institute in Warsaw. This group consisted 20 multiparous and 22 primiparous. We measured thyroid hormone levels: TSH, fT4, fT3 and TBG. RESULTS: In 8 pregnant women (5 primiparous and 3 multiparous) thyroid function was normal (normal level of TSH, fT3, fT4) and middle blood pressure in term of beginning of the study was 155/100 mmHg. 34 pregnant women (19 primiparous and 15 multiparous) had abnormal thyroid function. 3 (1 primiparous and 2 multiparous) pregnant women of this group had subclinical hyperthyroidism (middle blood pressure in the beginning of the study was 155/105) and 31 (21 primiparous and 10 multiparous) had fT4 and fT3 levels lower then normal range with normal TBG levels. In this group only one patient TSH level was higher then 5 mlU/l, which allows to recognize overt hypothyroidism. In other cases the results indicate the subclinical hypothyroidism. The middle blood pressure was 140/95 mmHg. CONCLUSION: 1. Thyroid dysfunction in pregnant women was concluded in 78.2% of tested group. 2. Subclinical hypothyroidism was concluded the most frequent in the tested group. 3. The middle blood pressure at the term of beginning of the study was the lowest in pregnant women with hypothyroidism. 4. The thyroid function tests should be performed in all pregnant women with PIH.

[External cephalic version at term]. / Obrót zewnetrzny plodu w ciazy donoszonej.

About 3 - 4 % of all pregnancies reach term with a foetus in the breech presentation. Because of higher risk of complications for mother and foetus during the vaginal breech birth, only 50% of patients try to deliver vaginally - at the end 40 - 70% of labours are finished by caesarean section. In other cases planned caesarean sections are performed, and finally 10 - 20% of patients with breech presentation at term deliver vaginally. Prenatal mortality and serious complications after breech vaginal birth are 5% and after planned caesarean section 1.6%. This is the reason why the caesarean section is chosen as a final way of delivery with breech presentation. At present, after a period of increasing percentage of caesarean section one can observe a tendency to decrease this number. One of the procedures performed to decrease the number of complications and cost of perinatal management is external cephalic version (ECV). An indication to ECV is breech presentation at term, while there is no contraindication to ECV. Multiple pregnancy, significant third - trimester bleeding, uteroplacental insufficiency, IUGR, oligohydramnion, PROM, PIH, nonreassuring foetal monitoring patterns and all contraindications to vaginal birth are concerned to execute ECV. The real number of patients with breech presentation at term, after ECV, is according to the literature about 1 - 1.5%. The risk of serious complications during ECV, which are the indications for urgent caesarean section, is 1 - 3%. The risk of intrauterine death of foetus after ECV is about 0.0001%. According to the literature it appears that ECV at term seems to be useful and it is safe both for the mother and the foetus and helps to avoid a significant number of caesarean sections.

[Fibrinolytic therapy of pulmonary embolism in pregnant women]. / Fibrynolityczne leczenie zatorowosci plucnej w ciazy -- wspólczesne poglady.

Fibrinolytic therapy has an established position in the treatment of pulmonary embolism. Its use has proven to decrease patients' mortality. However, in pregnant women such treatment is considered risky, due to possible fatal haemorrhagic events. In spite of such disadvantages, fibrinolytic therapy has been used in pregnant women with good results: from definite improvement of clinical status to complete recovery. No severe haemorrhagic events were observed in these cases and overall mortality was significantly decreased. These findings show that the use of fibrinolytic therapy in emergency situations is an efficient and safe method, when applied in accordance with standard procedures. In this publication we present the general review of current knowledge regarding the use of fibrinolytic therapy in pregnant women.

[Determination of beta-hexosaminidase and gamma-glutamyltranspeptidase activities in urine of pregnant women to monitor alcohol consumption]. / Oznaczanie aktywnosci beta-heksozoaminidazy oraz gamma-glutamylotranspeptydazy w moczu jako markerów spozycia alkoholu przez kobiety ciezarne - doniesienie wstepne.

BACKGROUND: Drinking of alcohol by pregnant women provokes many fetal development disorders, first of all the function of central nervous system and can lead to Fetal Alcohol Syndrome - FAS. AIM: Aims of investigation were to determine beta - hexosaminidase (HEX) and gamma - glutamyltranspeptidase (GGT) activity in the urine to monitoring consumption of alcohol by pregnant women in first trimester and to assess the effect of ethyl alcohol on fetus development. MATERIAL AND METHODS: 22 pregnant women, who did not declare consumption of ethanol containing drinks. The level of creatinine, GGT and HEX in urine was analysed. RESULTS: Preliminary results of our study indicate that determination of GGT and HEX activities could be useful in monitoring of alcohol consumption during pregnancy.