OBJECTIVES: This study aimed to compare the effects of the blunt dissection technique (BDT) with finger and the sharp dissection technique (SDT) with scissors during cesarean hysterectomy (CH) in patients with placenta p...OBJECTIVES: This study aimed to compare the effects of the blunt dissection technique (BDT) with finger and the sharp dissection technique (SDT) with scissors during cesarean hysterectomy (CH) in patients with placenta percreta. MATERIAL AND METHODS: We included 70 patients with placenta percreta who underwent CH in a territory hospital between 2020 and 2023. The patients were divided into two groups: Group 1 included 34 patients who underwent blunt bladder dissection, and Group 2 included 36 patients who underwent sharp bladder dissection. Demographic data, operative complications, surgical parameters, and transfusion rates were compared between the two groups. RESULTS: BDT was associated with a statistically significant reduction in operation time compared to SDT (95.62 ± 20.76 min vs 107.08 ± 26.04 min, p = 0.046). Moreover, the rate of bladder injury was significantly lower in the BDT group compared to the SDT group (11.8% vs 33.3%, p = 0.032). Although there were no significant differences in blood transfusion products between the two groups, postoperative transfusion amounts tended to be lower in the BDT group. CONCLUSIONS: BDT may be a proper surgical method to reduce bladder injury rates and operation time compared to SDT in CH of placenta percreta cases.
OBJECTIVES: The purpose of this study was to evaluate the relationship between the incidence of birth canal soft tissue injuries, perineal incision procedure and maternal and neonatal characteristics. MATERIAL AND METHOD...OBJECTIVES: The purpose of this study was to evaluate the relationship between the incidence of birth canal soft tissue injuries, perineal incision procedure and maternal and neonatal characteristics. MATERIAL AND METHODS: It was a retrospective cohort study conducted in a tertiary hospital analyzing deliveries between July 2018 and January 2019. Study group included 726 spontaneous vaginal singleton births in the longitudinal cephalic fetal position after completed 36th gestational week. Characteristics of patients who suffered from cervical ruptures and/or vaginal injuries were compared to those who gave birth without any soft tissue traumas. RESULTS: The perineal incision procedure was performed in 561 (77.3%) women. Soft tissue injuries of the birth canal were found in 220 patients (30.3%). Cervical rupture was more frequent when perineal incision was performed (94.5% vs 74.2%, p = 0.0001), but only in primiparous women (70.6% vs 43.2%, p = 0.01). Vaginal injury happened less frequently when perineal incision was performed (56.5% vs 81.8%, p = 0.001), but only in multiparous women (12.9% vs 34.3%, p = 0.001). Vaginal injury was more common in women with higher pre-pregnancy body weight (69.4 vs 65.4 kg, p = 0.0015), higher prepregnancy BMI (24.5 vs 23.5 kg/m², p = 0.0085), higher body weight and BMI before delivery (82.2 vs 78.1 kg, p = 0.001 and 29.1 vs 28.1 kg/m², p = 0.008, respectively). In multivariate logistic regression analysis neither parity nor perineal incision increased the risk of vaginal injury. Only the obese women, but not diabetic, were at higher risk of vaginal injury, when perineal incision was performed (OR 2.25, CI 1.25-4.05, p = 0.007). CONCLUSIONS: The obese women are at higher risk of vaginal injury during delivery, when perineal incision is performed. The necessity of maintaining normal body weight while planning pregnancy, monitoring gestational weight gain, and avoiding perineal incision remain important issues.
Ginekol Pol
· 2025 Feb · PMID 39932181
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OBJECTIVES: To evaluate the feasibility and outcomes of gasless single-port access (SPA) laparoscopy in overweight patients undergoing adnexal surgery. MATERIAL AND METHODS: A retrospective review was conducted on the me...OBJECTIVES: To evaluate the feasibility and outcomes of gasless single-port access (SPA) laparoscopy in overweight patients undergoing adnexal surgery. MATERIAL AND METHODS: A retrospective review was conducted on the medical records of 118 patients who underwent gasless SPA laparoscopic adnexal surgery using J-shaped or triangular-shaped retractors between May 2017 and June 2022. Patients were categorized into overweight (BMI ≥ 23) and standard-weight (BMI < 23) groups. Surgical characteristics and outcomes were compared between the two groups. RESULTS: Out of 118 patients, 41 were in the overweight group, and 77 were in the standard-weight group. Significant differences were observed in age (p = 0.001), the number of previous abdominal surgeries (p = 0.001), and the number of subjects who had given birth (p = 0.004), all higher in the overweight group. There were no significant differences between the groups in setup time from umbilical skin incision to abdominal wall retraction, use of additional TROCARS: operation time, estimated blood loss, or length of postoperative hospital stay. No serious intraoperative complications, such as urologic, bowel, and vessel injuries were noted in either group. Tumor diameter (p < 0.001), bilaterality (p < 0.001), presence of adhesion (p = 0.026), and setup diameter of the retractor (p = 0.001) significantly correlated with operation time in multivariate analysis (Adjusted R² = 0.645). CONCLUSIONS: Gasless SPA laparoscopic adnexal surgery in overweight patients is a feasible and effective alternative to conventional SPA laparoscopy, mitigating the potential negative effects of carbon dioxide gas.
OBJECTIVES: This study explores the relationship between red blood cell parameters and perinatal outcomes in dinoprostone insert-induced labor at the Department of Obstetrics and Perinatology of the Jagiellonian Universi...OBJECTIVES: This study explores the relationship between red blood cell parameters and perinatal outcomes in dinoprostone insert-induced labor at the Department of Obstetrics and Perinatology of the Jagiellonian University Medical College Cracow, Poland. MATERIAL AND METHODS: Conducted between May 2019 and February 2021, this retrospective analysis included data on maternal age, pre-pregnancy BMI, hemoglobin level, red blood cell count, mean cell volume, and red blood cell distribution width, alongside newborn birthweight and Apgar scores. The study evaluated the impact of anemia, a hemoglobin level lower than 12 g/dL, on the likelihood of cesarean section, labor duration, delivery time, and neonatal outcomes. RESULTS: With 183 participants, findings indicate no significant difference in perinatal outcomes between anemic and non-anemic groups, suggesting that mild anemia may not significantly affect dinoprostone insert-induced labor outcomes. CONCLUSIONS: The study highlights the importance of a nuanced approach to managing anemia in pregnancy, emphasizing the necessity for individualized treatment strategies. Our findings contribute to the ongoing discourse on anemia management during pregnancy, underscoring the need for more targeted research to develop evidence-based guidelines.
OBJECTIVES: To compare the Vcare and SecuFix uterine manipulators (UM) used in total laparoscopic hysterectomy (TLH) with regard to operating time, duration of hospital stay, the time for insertion of the manipulator, ti...OBJECTIVES: To compare the Vcare and SecuFix uterine manipulators (UM) used in total laparoscopic hysterectomy (TLH) with regard to operating time, duration of hospital stay, the time for insertion of the manipulator, time for completion of colpotomy, and maintenance of pneumoperitoneum, estimated blood loss, and perioperative complications. MATERIAL AND METHODS: This prospective, single-center, randomized controlled trial was conducted on patients who underwent TLH for benign indications between June 2023 and January 2024. Patients were randomized to either the Vcare UM or SecuFix UM group. Both groups were compared for operative time, colpotomy time, intrauterine manipulator insertion time, pneumoperitoneum maintenance, blood loss, complications, and length of hospital stay. RESULTS: A total of 100 patients were enrolled, 50 with VcareUM and 50 with SecuFix UM. SecuFix UM demonstrated shorter colpotomy time (p < 0.001) and better pneumoperitoneum maintenance (p = 0.008) compared to VCare. VCare had shorter insertion time (p = 0.001) but a higher uterine rupture rate (p = 0.001). No significant differences were found in operative time, blood loss, complications, or length of hospital stay (p > 0.05). CONCLUSIONS: SecuFix may offer advantages in colpotomy and pneumoperitoneum maintenance during TLH compared to VCare. The Vcare UM demonstrated a shorter insertion time than the SecuFix UMs, yet a higher rate of uterine rupture was observed with its placement.
OBJECTIVE: To explore the differences in clinical and cosmetic efficacy between transumbilical single-port laparoscopy (TSPLS) and traditional laparoscopy for type II and III cesarean scar pregnancy (CSP). METHODS: We re...OBJECTIVE: To explore the differences in clinical and cosmetic efficacy between transumbilical single-port laparoscopy (TSPLS) and traditional laparoscopy for type II and III cesarean scar pregnancy (CSP). METHODS: We retrospectively included 39 patients with type II and III CSP who were admitted to Hubei Maternal and Child Health Hospital for surgical treatment between June 2018 and June 2021 and classified them into Groups A and B according to patients' wishes. Patients in Group A (n = 15) were treated with TSPLS, and those in Group B (n = 24) were treated with traditional laparoscopy. Both groups underwent CSP resection and lower uterine segment repair via plastic surgery. Based on their condition and intraoperative bleeding, the patients were treated with uterine artery preligation. The operative time, preoperative pretreatment, intraoperative blood loss, decrease in beta-human chorionic gonadotropin (β-hCG) level, postoperative vaginal bleeding time, postoperative intestinal ventilation time, length of hospital stays, complications, and scar cosmesis assessment were compared. RESULTS: The scar cosmesis score was significantly lower in Group A than in Group B (p < 0.01). No significant differences in intraoperative blood loss, absolute decrease in β-hCG level, absolute decrease in blood hemoglobin level, absolute increase in blood C-reactive protein level, postoperative vaginal bleeding time, postoperative intestinal ventilation time, length of hospital stay, and complications were observed between the two groups (p > 0.05). The operative time in the experimental group was slightly longer than that in the control group (p < 0.05). CONCLUSION: TSPLS had better cosmetic effects than traditional multi-port laparoscopy, without surgical results and postoperative recovery difference, making it valuable for clinical application.
Hernia is a well-known problem by almost every surgeon, often showing symptoms during pregnancy. There are a lot of discussions regarding the tactics of treating hernias in pregnancy. For this purpose, we made a detailed...Hernia is a well-known problem by almost every surgeon, often showing symptoms during pregnancy. There are a lot of discussions regarding the tactics of treating hernias in pregnancy. For this purpose, we made a detailed review of the literature data in PubMed, Web of Science, Scopus, as well as an additional article found in the references of each reviewed article and analysed it synthesized to give a guideline for fast and correct treatment. The approach is strictly individualized and depends on two main and important factors: the state of emergency and the gestational week of the pregnancy.
OBJECTIVES: To compare the effects of using 11 mm trocar and 5 mm trocar as primary ports on postoperative pain in benign gynecological laparoscopic surgeries. MATERIAL AND METHODS: The patients were divided into two gro...OBJECTIVES: To compare the effects of using 11 mm trocar and 5 mm trocar as primary ports on postoperative pain in benign gynecological laparoscopic surgeries. MATERIAL AND METHODS: The patients were divided into two groups as the primary port, group I (5 mm trocar) and group II (11 mm trocar) by block randomization. RESULTS: In the 5 mm trocar group, postoperative pain score and need for analgesia were less in level I and level II operations. Patient satisfaction was significantly higher in the 5 mm trocar group. The postoperative pain score was higher in patients who had trocar insertion attempts 3 times with the direct trocar method compared to patients with 1 or 2 trocar entry attempts. CONCLUSIONS: The use of a 5 mm laparoscope in benign gynecological operations is an advantageous method due to low postoperative pain score, analgesic requirement, and high patient satisfaction.
OBJECTIVES: This study aimed to identify the effects of acute aerobic exercise combined with resistance exercise on maternal glucose metabolism and sympathetic nervous system-regulated cardiovascular function in overweig...OBJECTIVES: This study aimed to identify the effects of acute aerobic exercise combined with resistance exercise on maternal glucose metabolism and sympathetic nervous system-regulated cardiovascular function in overweight or obese pregnancies. MATERIAL AND METHODS: We conducted a randomized controlled trial of aerobic exercise combined with resistance training (aerobic + resistance; n = 25) compared with aerobic exercise (aerobic, n = 21) beginning at 16 wk and continuing until 36 wk of gestation in overweight or obese pregnant women. At preintervention and postintervention assessments, the glycometabolism, muscle sympathetic nervous system activity (MSNA) and cardiovascular parameters were measured and analyzed, containing fasting blood glucose (FBG), fasting blood insulin (FBI), 2 h glucose, glycosylated hemoglobin (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), MSNA bursts/min, MSNA bursts/100 heartbeats, resting heart rate (HR); diastolic blood pressure (DBP), mean arterial pressure (MAP), systolic blood pressure (SBP), cardiac index (CI), cardiac output (CO), stroke volume (SV), total peripheral resistance (TPR) and total peripheral resistance index (TPRI). RESULTS: Compared to aerobic group, the overweight or obese pregnant women in aerobic + resistance group showed lower FBG, FBI, 2 h glucose, HbA1c and HOMA-IR (p < 0.05). Moreover, both MSNA bursts/min and MSNA burst/100 heartbeats level were reduced in aerobic + resistance group compared to aerobic group (p < 0.0001). Finally, the resting HR, DBP, SBP, MAP, CI, CO and TPRI were significantly decreased in aerobic + resistance group compared to aerobic group (p < 0.05). CONCLUSIONS: In summary, aerobic exercise combined with resistance training was associated with improved glycometabolism, MSNA and cardiovascular function in overweight or obese pregnant women compared to aerobic exercise alone.
OBJECTIVES: To evaluate and compare the treatment results of folinic acid (FA) and folic acid (F) added to the chemotherapy protocol to reduce the toxicity due to methotrexate (MTX) in the treatment of low-risk gestation...OBJECTIVES: To evaluate and compare the treatment results of folinic acid (FA) and folic acid (F) added to the chemotherapy protocol to reduce the toxicity due to methotrexate (MTX) in the treatment of low-risk gestational trophoblastic neoplasia (GTN) patients. MATERIAL AND METHODS: Patients treated for low-risk GTN at two reference centers between January 2000 and March 2023 were included in this retrospective study. Patients were divided into two groups, MTX/FA and MTX/F. Both groups received 50 mg/day MTX on days 1, 3, 5, 7 of treatment. On days 2, 4, 6, 8 of treatment 0.1 mg/kg folinic acid was administered to the MTX/FA group, and 20 mg/day folic acid was administered to the MTX/F group to reduce MTX toxicity. The groups were compared according to treatment success, resistance, and the development of toxicity. RESULTS: Among 102 low-risk GTN patients included in the study, 64.7% (n = 66) were in the MTX/FA, while the remaining 35.3% (n = 36) were in the MTX/F group. There was no significant difference between MTX/FA and MTX/F groups regarding treatment success, resistance, and toxicity rates (84.8%, 13.6%, 1.6% vs 83.3%, 13.8%, 2.7%), respectively. CONCLUSIONS: Replacement of folinic acid with folic acid in low-risk GTN patients to reduce the toxicity that may develop associated with MTX treatment resulted in similar treatment success rates. Still, no significant change was observed regarding toxicity and resistance. There is a need for comprehensive prospective studies to further elucidate this relationship.
OBJECTIVES: Cardiotocography (CTG) is widely used for continuous or intermittent assessment of fetal heart function. This study aimed to compare the effects of continuous and intermittent CTG during labour on selected va...OBJECTIVES: Cardiotocography (CTG) is widely used for continuous or intermittent assessment of fetal heart function. This study aimed to compare the effects of continuous and intermittent CTG during labour on selected variables. MATERIAL AND METHODS: In a retrospective study, 4172 medical records of Warsaw Hospital (Poland) patients were analysed. The study group consisted of 2111 women with continuous CTG during labour and the control group of 2061 women with intermittent CTG. RESULTS: In the group with intermittent CTG, a higher odds ratio of caesarean section (OR = 1.06, 95% CI = 0.87-1.30), second-degree perineal tear (OR = 1.65, 95% CI = 1.07-2.55),third- and fourth-degree perineal tears (OR = 5.13, 95% CI = 1.12-23.53) and oxygen therapy (OR = 1.76, 95% CI = 1.19-2.59) were noted. In the group with intermittent CTG, a lower odds ratio of a newborn with an Apgar score of ≤ 7 points in the fifth minute of life (OR = 0.34, 95% CI = 0.12-0.94), nCPAP (Nasal Continuous Positive Airway Pressure) (OR = 0.56, 95% CI = 0.36-0.86) and resuscitation (OR = 0.37, 95% CI = 0.17-0.79)) were observed. The analysis shows that in the group of women with intermittent CTG during labour, the odds ratio of abnormal BE result was lower (OR=0.45, 95% CI = 0.21-0.98). CONCLUSIONS: Continuous CTG during labour in high-risk women increases the likelihood of instrumental delivery (using vacuum) and perineal incision compared with intermittent CTG. The use of intermittent CTG during labour reduces the number of newborns with Apgar scores ≤ 7 points and decreases the number of neonatal interventions such as nCPAP and resuscitation.
OBJECTIVES: To evaluate relationship between sFlt-1/PlGF ratio, clinical characteristics and outcomes of pre-eclampsia. MATERIAL AND METHODS: Retrospective analysis of 29 pregnant women with pre-eclampsia who had measure...OBJECTIVES: To evaluate relationship between sFlt-1/PlGF ratio, clinical characteristics and outcomes of pre-eclampsia. MATERIAL AND METHODS: Retrospective analysis of 29 pregnant women with pre-eclampsia who had measured sFlt-1/PlGF ratio was conducted using electronic medical records from Obstetrics and Perinatology ward of University Hospital in Cracow. RESULTS: Women median age: 33.5 years, number of pregnancies: one 52%, two 15%, three 18%,more than three 15%, number of deliveries: one 59.3%, two 37%, three 3.7%, median body mass index during hospitalization: 29.4 kg/m². Chronic diseases apart from hypertension: 67% of women (diabetes 37%, hypothyroidism 26%, obesity 11%). Median newborns birth weight: 1640 g, median Apgar score at 5 minutes: 8, median umbilical cord blood pH: 7.32. Fetal growth restriction: 28.6% of cases. All deliveries were by c-section. Median gestational age at delivery: 32 weeks. sFlt-1/PlGF ratio was inversely correlated with gestational age at delivery (r = -0.42, p = 0.02). The median sFlt-1/PlGF ratio was higher in women with severe pre-eclampsia (n = 15) than in those with mild pre-eclampsia (n = 14) (211 vs. 57, p < 0.001). sFlt-1/PlGF ratio of > 85 had a sensitivity of 80% and a specificity of 71% for predicting severe pre-eclampsia. CONCLUSIONS: sFlt-1/PlGF ratio is useful in assessing the severity and prognosis of pre-eclampsia. sFlt-1/PlGF ratio should not be used as a sole criterion for making clinical decisions, but as an adjunct to other clinical and laboratory parameters.
Anti-Müllerian hormone (AMH), also known as Müller duct inhibitory factor and primarily known for its role in sexual differentiation. In female fetuses, AMH production by granulosa cells begins around the 36th week of ge...Anti-Müllerian hormone (AMH), also known as Müller duct inhibitory factor and primarily known for its role in sexual differentiation. In female fetuses, AMH production by granulosa cells begins around the 36th week of gestation and continues in women until menopause. It is becoming more significant in the endocrine and gynecological diagnosis of adult women. The suppressive effect of AMH on follicle-stimulating hormone (FSH)-induced aromatase production likely plays a role in hyperandrogenism in polycystic ovary syndrome (PCOS) and may increase insulin resistance. Female adolescent with type 1 diabetes (T1D) have an increased likelihood of developing PCOS, but it is not known whether they also show elevated AMH levels. The elevated AMH levels observed in prepubertal girls with T1D suggest that there are more small follicles in their ovaries, probably in response to insulin treatment. Elevated levels of androgens and anti-Müllerian hormone have been previously reported in non-pregnant women with diabetes. The increased AMH concentrations can be associated with reduced systemic inflammation [lower c-reactive protein (CRP) values], irrespective of the type of diet and greater insulin sensitivity in old obese males. AMH can also serve as a valuable marker for granulosa cell tumors (folliculomas) and their recurrence. In these clinical scenarios, AMH levels can be significantly elevated and correspond with the size of the tumor.
OBJECTIVES: Due to the increasingly faster pace of life and responsibilities, stress has become an integral part of daily life. Every year, numerous social campaigns in the media raise the issue of increasing alcohol con...OBJECTIVES: Due to the increasingly faster pace of life and responsibilities, stress has become an integral part of daily life. Every year, numerous social campaigns in the media raise the issue of increasing alcohol consumption. Endometriosis is a chronic, causally incurable, estrogen-dependent and inflammatory gynecological disorder, described as presence of ectopic endometrial tissue outside the uterine cavity. Some studies suggest that alcohol may aggravate the symptoms of the disease. The aim of the study is to present a comprehensive review reffering to the role of ethanol in the course of endometriosis. MATERIAL AND METHODS: A review of the literature available in the PubMed database between 2000 and 2024 was conducted, using the following keywords: "endometriosis", "alcohol", "ethanol". The search included articles published in English. Publications without full text access and duplicates were rejected. 247 records were screened of which 15 met the eligilibity criteria, and 12 were included in this article. RESULTS: Alcohol may affect estrogen production (by increasing the activity of aromatase and interacting with luteinizing hormone), promotes pro-inflammatory pathways and oxidative stress. It is also perceived as a form of self-management therapy resulting from pain, anxiety, and low self-esteem. Patients who are alcohol-dependent more often experience infertility, miscarriages, anovulation and ovarian pathologies. CONCLUSIONS: Although there is no clear evidence suggesting the adverse effect of ethanol on the course of endometriosis, the substance may be life-destroying in alcohol-dependent women. It may cause more severe course of endometriosis affecting many ascpectcts of life.
Ginekol Pol
· 2025 Jan · PMID 39878754
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Publisher ↗
O: BJECTIVES: Circular RNAs (circRNAs) are known to be associated with the progression of gestational diabetes mellitus (GDM). Thus, the objective of this study was to unveil the influnce and potential mechanism of hsa_c...O: BJECTIVES: Circular RNAs (circRNAs) are known to be associated with the progression of gestational diabetes mellitus (GDM). Thus, the objective of this study was to unveil the influnce and potential mechanism of hsa_circ_0002768 in GDM. M: ATERIAL AND:METHODS: Levels of hsa_circ_0002768 were quantified by RT-qPCR. Placental hsa_circ_0002768 levels were analyzed after pregnancies. Trophoblast cell (HTR-8/SVneo) functions, including oxidative stress, mitochondrial dysfunction, cell viability, autophagy, and invasion, were evaluated upon hsa_circ_0002768 knockdown. Finally, the downstream miRNA for hsa_circ_0002768 was investigated. RESULTS: Hsa_circ_0002768 levels increased as high glucose-induced, and in GDM placenta. In vitro experiments showed that hsa_circ_0002768 knockdown positively regulated trophoblast oxidative stress and mitochondrial functions, thus inducing cell viability and invasion, but inhibiting autophagy. miR-339-5p was a downstream molecular for hsa_circ_0002768, which targeted to TLE3. CONCLUSIONS: This study reveals a physiological role for hsa_circ_0002768 during GDM.
OBJECTIVES: Postpartum depression is a common and serious mental health problem which is associated with maternal distress and negative consequences for the offspring. Research confirms the presence of differences in the...OBJECTIVES: Postpartum depression is a common and serious mental health problem which is associated with maternal distress and negative consequences for the offspring. Research confirms the presence of differences in the prevalence of postpartum depression in different social groups. The aim of this study was to compare the severity of maternal symptoms in Poland and Zimbabwe and to identify risk factors occurring in both groups. MATERIAL AND METHODS: The survey was conducted in 2022 among mothers who gave birth at the Department of Neonatology and Rare Diseases and at the Mpilo Central Hospital Maternity Clinic. The Edinburgh Postnatal Depression Scale was used to assess the risk of postnatal depression. A total of 945 patients were included. RESULTS: The study indicated statistically significant differences in the percentage of women with an increased risk of postpartum depression, with the percentage for the Polish group being 13.54 % and the Zimbabwean group 35.74 %. For the Zimbabwean group, the risk of depression was associated with a problem in obtaining breastmilk and these were women in informal partnerships or those without a stable partner. In the group of Polish patients there was evidence of a correlation between increased risk and having a stable, non-formalised relationship. CONCLUSIONS: According to the analysis, women in Zimbabwe are more likely to be at risk of postpartum depression than Polish women. PPD remains an important issue in obstetric practice, and it is necessary to sensitize health care personnel to the risk of PPD to make timely and appropriate clinical interventions.
OBJECTIVES: Hyperandrogenism is a frequently recognized endocrine imbalance in which there is excessive production of androgens. The purpose of the study was to investigate the impact of vitamin D receptor (VDR) gene pol...OBJECTIVES: Hyperandrogenism is a frequently recognized endocrine imbalance in which there is excessive production of androgens. The purpose of the study was to investigate the impact of vitamin D receptor (VDR) gene polymorphisms on chosen bone metabolism and biochemical parameters in women with hyperandrogenism. MATERIAL AND METHODS: Eighty young females with hyperandrogenism were enrolled in the study, in whom selected parameters of bone turnover, endocrine and metabolic parameters were determined. Two polymorphisms of the VDR gene were analyzed: rs731236 (TaqI) and rs1544410 (BsmI), using real-time polymerase chain reaction (PCR). Statistical tests were performed in this research with the program SPSS Statistics 17.0 for Windows. RESULTS: The rs731236 and rs1544410 polymorphisms of the VDR gene turned out to be statistically significantly related to the concentration of insulin determined in the 60 'glucose tolerance test. There was no relationship between the studied polymorphisms of the VDR gene and the determined parameters of bone metabolism and other biochemical parameters. CONCLUSIONS: The research presented that VDR gene variants may influence disturbances in carbohydrate metabolism in young women with hyperandrogenism.
OBJECTIVES: This study investigates the relationship between serum homocysteine, blood lipids, and perinatal outcomes in patients with diet-controlled gestational diabetes mellitus (GDM) and those with normal glucose tol...OBJECTIVES: This study investigates the relationship between serum homocysteine, blood lipids, and perinatal outcomes in patients with diet-controlled gestational diabetes mellitus (GDM) and those with normal glucose tolerance (NGT). MATERIAL AND METHODS: A prospective cohort of 150 diet-controlled GDM patients and 150 pregnant women with NGT, all delivering at our hospital, were selected based on predefined criteria. Data on demographics, physical parameters, and perinatal outcomes were compiled. Blood samples for fasting plasma glucose (FPG), homocysteine (Hcy), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB), and apolipoprotein A1 (apoA1) were collected before delivery. RESULTS: GDM patients exhibited higher levels of FPG, Hcy, and the apoB/apoA1 ratio, but lower HDL-C and apoA1 levels compared to the NGT group. Adverse outcomes such as macrosomia, premature rupture of membranes, and postpartum hemorrhage were more prevalent in the GDM group. In GDM patients, neonatal birth weight positively correlated with FPG and TG levels. Stratified Hcy analysis in GDM showed no significant differences in perinatal outcomes. However, the third quartile of the apoB/apoA1 ratio had a lower incidence of macrosomia compared to the first quartile, and the second quartile showed a higher incidence of birth asphyxia. CONCLUSIONS: GDM patients demonstrated increased levels of Hcy, FPG, and the apoB/apoA1 ratio, correlating with more adverse perinatal outcomes than healthy pregnant individuals. The relationships between Hcy, lipids, and these outcomes remain inconclusive, highlighting the need for further research.