[Polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM) risk]. / Zespól policystycznych jajników (PCOS), a ryzyko wystepowania cukrzycy ciaziowej (GDM).

Gestational diabetes mellitus (GDM) is a common complication of pregnancy In the course of pregnancy elevated levels of hormones and other proteins having insulin-antagonistic effects lead to higher insulin resistance in peripheral tissues, followed by hyperinsulinemia. Risk factors for the development of GDM have been well-established. However, the debate whether polycystic ovary syndrome (PCOS) may predispose to GDM continues. Patients with PCOS are often affected by obesity dyslipidemia, hyperinsulinemia, and tissue-specific insulin resistance. Obesity occurs in 50% of the cases, while tissue-specific insulin resistance is observed in 20-40% of the affected patients. This paper aims at systematizing risk factors that could contribute to the development of GDM, as well as reviewing literature reports and analyses on the occurrence of a potential correlation.

A randomized, single blind, placebo-controlled trial for the pain reduction during the outpatient hysteroscopy after ketoprofen or intravaginal misoprostol.

STUDY OBJECTIVE: To assess the efficacy of ketoprofen vs intravaginal misoprostol for pain relief during outpatient hysteroscopy. DESIGN: Prospective, randomized, single-blind, placebo-controlled clinical trial (Canadian Task Force classification I). SETTING: Tertiary medical center. PATIENTS: One hundred fifty women referred for hysteroscopy between January and October 2013. INTERVENTIONS: Women were randomized to receive vaginal misoprostol, 400 µg, with 100 mL of 5% intravenous glucose (misoprostol arm); intravenous ketoprofen, 50 mg/mL, in 100 mL 5% glucose with intravaginal placebo (ketoprofen arm); or vaginal placebo tablets, 100 mL 5% intravenous glucose (placebo arm) before outpatient hysteroscopy. MEASUREMENTS AND MAIN RESULTS: A visual analog scale (VAS) was used for 1-dimensional pain assessment. Patients were asked to mark a VAS score before, during, and at 5 and 15 minutes after the procedure. Median VAS scores during and directly after the anesthesia-free hysteroscopy were significantly lower in the misoprostol group than in the ketoprofen (p = .02) or placebo (p = .006) groups. There were no statistical differences between the 3 arms in median VAS score assessed at 15 minutes after the procedure (p = .16). There were no differences in procedure time between groups (p = .16). CONCLUSION: When administrated 4 hours before the procedure, 400 µg vaginal misoprostol seems to reduce the pain during and immediately after hysteroscopy. The effect does not depend on patient age, hormone status, parity, or type of outpatient hysteroscopy (operative or diagnostic).

Risk factors for cesarean section after using the Foley catheter for labor induction.

OBJECTIVE: The aim of the study was to investigate the value of the Bishop score and ultrasound examination of the cervix in predicting the success of labor induction with the use of the Foley catheter determined by the mode of delivery MATERIAL AND METHODS: Foley catheter induction of labor was performed in 135 pregnancies between 38 to 42 weeks gestation. The study group was divided into two groups, depending of the mode of delivery: vaginal vs. cesarean. RESULTS: The Bishop score was significantly higher in the vaginal delivery group when compared to the caesarean section group (5.2; 95%CI: 4.4 - 6.2 vs. 3.9; 95%CI: 2.8-4.9). Cervical length was not statistically significantly different between the two groups. Multivariate logistic regression showed that patient-specific risk for caesarean section decreases with increasing maternal age and the Bishop score (Detection Rate [DR] of 52% at fixed False Positive Rate [FPR] of 10%). CONCLUSIONS: Failure of labor induction with the use of the Foley catheter can be predicted by maternal age and pre-induction Bishop score.

Early spontaneous preterm deliveries before 34 weeks' gestation in a tertiary care centre: analysis of maternal factors and obstetric history.

OBJECTIVE: The aim of this study is to investigate risk factors associated with spontaneous early preterm delivery. METHODS: The study included 1865 singleton pregnancies with 31 spontaneous deliveries between 23 and 35 weeks' gestation compared to 1834 deliveries at the term analysed between 2008 and 2009. Both groups were 100% Caucasian. RESULTS: Spontaneous early delivery occurred in 31(1.2%) of the 2528 pregnancies. In the preterm delivery group, compared with unaffected pregnancies, there was an increased incidence of maternal anaemia (OR 2.8, 95%CI: 1.8-4.5; p < 0.001). Previous preterm delivery between 23 and 34 weeks' gestation (OR 10.7, 95%CI: 5.2-21.7; p < 0.001) as well as vaginal bleeding beyond the first trimester (OR 3.8, 95%CI: 1.2-12.1; p = 0.039), assisted conception (4.1, 95%CI: 2.0-8.4; p = 0.001) and fetal loss before 16 weeks' gestation (OR 4.2, 95%CI: 2.5-7.1; p < 0.001) are strongly associated with spontaneous preterm delivery. CONCLUSIONS: Previous preterm delivery as well as fetal loss before 16 weeks' gestation, assisted conception, vaginal bleeding beyond the first trimester and maternal anaemia are strongly associated with an increased risk for spontaneous early preterm delivery.