Swiatkowska-Freund M, Sasak-Cieslar N, Szymaniak M
… +4 more, Bednarek S, Pasikowska A, Zorawska H, Szymanska-Boczek M
Ginekol Pol
· 2026 Jun · PMID 42261729
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OBJECTIVES: Iron deficiency is a common nutritional deficiency. Improved laboratory results, good tolerance, and improvement in deficiency symptoms are associated with patients' decisions to start or continue supplementa...OBJECTIVES: Iron deficiency is a common nutritional deficiency. Improved laboratory results, good tolerance, and improvement in deficiency symptoms are associated with patients' decisions to start or continue supplementation. The aim of the study was to assess the tolerance of iron preparation and the impact of supplementation on the laboratory test results and symptoms of iron deficiency in patients aged 19-70. MATERIAL AND METHODS: The study included 119 patients with iron deficiency who started supplementation with micronized and emulsified ferric pyrophosphate. After signing informed consent, patients completed iron deficiency symptoms questionnaire. A follow-up visit was scheduled after 3 months (+/-14 days) of supplementation. During follow-up visit laboratory results were reviewed, patients completed the iron deficiency symptoms questionnaire and tolerance questionnaire. RESULTS: Of 63 women, an increased iron levels were observed in 39 patients (61.9%; p < 0.001), an increase in ferritin levels in 38 from among 66 patients (57.6%; p < 0.001). Decreased total score for iron deficiency symptoms was reported by 103 patients of 108 (95.4%). In this group, 41 (38%) reported discomfort during supplementation. Overall, 83.2% of participants rated the preparation as good or very good. At the follow-up visit regular medical history was collected from the patients, no hospitalizations nor deaths were reported. CONCLUSIONS: Dietary supplementation with micronized and emulsified ferric pyrophosphate is effective in iron deficiency, in terms of improving laboratory test results and reducing the severity of deficiency symptoms. Good tolerance with few - and mainly low grade - side effects encourage patients to continue supplementation as recommended.
Ginekol Pol
· 2026 Jun · PMID 42261727
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OBJECTIVES: Genetic polymorphism may influence the efficacy of analgesia during labor anesthesia. This study employed a retrospective case-control study design and aimed to investigate the potential influence of the miR-...OBJECTIVES: Genetic polymorphism may influence the efficacy of analgesia during labor anesthesia. This study employed a retrospective case-control study design and aimed to investigate the potential influence of the miR-124 rs531564 polymorphism on the efficacy of labor analgesia in primiparous women. MATERIAL AND METHODS: 100 primiparas were enrolled as study participants, all of whom received epidural sufentanil for analgesia. Genotyping was performed using the PCR-LDR, while RT-qPCR was employed to measure the miR-124 expression. The analgesic efficacy (assessed by VAS score), plasma concentration of sufentanil, and incidence of adverse reactions were compared among parturients with different genotypes. RESULTS: In this study, the CC genotype was observed in 53% of participants, the CG genotype in 36%, and the GG genotype in 11%. Individuals with the CC genotype exhibited a higher VAS score at 1-hour post-administration (indicating a poorer analgesic response) and lower 1-minute Apgar scores. Primiparas carrying the CC genotype had reduced miR-124 expression, suggesting that the C allele might contribute to the physiological mechanisms of labor analgesia through down-regulation of miR-124. Moreover, individuals with the CC genotype showed lower sufentanil blood concentrations during the mid-phase of administration (15-20 minutes), which could be attributed to faster drug metabolism or clearance, leading to suboptimal plasma levels - possibly explaining the observed diminished analgesic effect (as indicated by the elevated VAS score at 1 hour). In contrast, primiparas carrying the G allele demonstrated higher sufentanil concentrations at the same time point, correlating with improved analgesic outcomes. CONCLUSIONS: The miR-124 rs531564 polymorphism may influence the efficacy of labor analgesia.
Ginekol Pol
· 2026 Jun · PMID 42261726
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Light exposure plays a fundamental role in human physiology, influencing circadian rhythms, hormonal regulation, and reproductive health. This review examines the multifaceted impact of natural and artificial light on wo...Light exposure plays a fundamental role in human physiology, influencing circadian rhythms, hormonal regulation, and reproductive health. This review examines the multifaceted impact of natural and artificial light on women's reproductive function, with particular emphasis on mechanisms underlying light-mediated biological processes. Evidence demonstrates that light exposure affects melatonin secretion, which in turn modulates reproductive hormones including luteinizing hormone, follicle-stimulating hormone, and sex steroids. Disruption of natural light-dark cycles through shift work, artificial light at night, or circadian misalignment has been associated with menstrual irregularities, ovulatory dysfunction, reduced fertility, and adverse pregnancy outcomes. Conversely, adequate vitamin D synthesis through ultraviolet light exposure supports ovarian function and metabolic health. Recent studies reveal that continuous light exposure can induce anovulation through disruption of the leucine-mTOR-autophagy axis, while circadian rhythm disturbances correlate with polycystic ovary syndrome. This article synthesizes current knowledge on photobiological mechanisms, clinical implications, and therapeutic applications of light modulation in gynecological practice.
BACKGROUND: Vitamin D deficiency in pregnant women constitutes a significant obstetric concern, affecting 40-98% of gravid populations worldwide. Adequate vitamin D status is essential for successful pregnancy outcomes,...BACKGROUND: Vitamin D deficiency in pregnant women constitutes a significant obstetric concern, affecting 40-98% of gravid populations worldwide. Adequate vitamin D status is essential for successful pregnancy outcomes, fetal development, and maternal health. OBJECTIVE: This review analyzes current evidence regarding vitamin D deficiency during pregnancy from an obstetric perspective, focusing on pregnancy complications, fetal outcomes, and evidence-based supplementation strategies for clinical practice. METHODS: A systematic review of PubMed, Scopus, and Cochrane databases was conducted, encompassing publications from 2020-2025. Randomized controlled trials, meta-analyses, and prospective cohort studies examining vitamin D status and pregnancy outcomes were included. RESULTS: Analysis demonstrated significant associations between vitamin D deficiency (< 50 nmol/L) and elevated risk of preeclampsia (OR 0.65), gestational diabetes mellitus (OR 1.61), preterm birth (RR 0.67), and small-for-gestational-age neonates (RR 0.61). Supplementation with 2000-4000 IU/day appears safe and efficacious in achieving optimal concentrations. CONCLUSIONS: Vitamin D assessment and individualized supplementation should be integrated into routine prenatal care. Obstetricians should implement screening protocols particularly for high-risk pregnant women.
Turner syndrome (TS) is associated with delayed puberty, abnormal breast development, and increased risk of certain diseases. The purpose of this article is to present the current state of breast development assessment i...Turner syndrome (TS) is associated with delayed puberty, abnormal breast development, and increased risk of certain diseases. The purpose of this article is to present the current state of breast development assessment in TS patients, focusing on the use of ultrasound (US), mammography, and MRI, regarding their utility in monitoring changes in women with TS. A comprehensive literature review was conducted using databases like PubMed and Medline. There are currently no specific recommendations for breast US in TS patients, and because no conclusive US classification of breast development with distinctive sonographic features in the breast has been established, breast US in women with TS remains a diagnostic challenge. Proposed US scales for breast development in adolescent girls and fibroglandular tissue evaluation in men with gynecomastia are suggested as potential tools for monitoring breast development in women with Turner syndrome. Further research is highlighted as crucial to improving diagnostic and therapeutic approaches.
OBJECTIVES: Placenta accreta spectrum (PAS) involves abnormal trophoblastic invasion into the uterine myometrium, with increasing incidence due to rising cesarean section rates. PAS poses significant risks, including blo...OBJECTIVES: Placenta accreta spectrum (PAS) involves abnormal trophoblastic invasion into the uterine myometrium, with increasing incidence due to rising cesarean section rates. PAS poses significant risks, including blood transfusion, bladder injury, intensive care unit admission, and hysterectomy. This study evaluates the use of transverse uterine compression sutures to provide localized compression in placenta previa and PAS cases. MATERIAL AND METHODS: We retrospectively analyzed medical records of 55 pregnant women diagnosed with placenta previa and PAS. Patients were divided into two groups: placenta accreta (28 women) and placenta increta (27 women). Demographic data, intraoperative, and postoperative outcomes were compared between the groups. RESULTS: In the placenta accreta group, transverse sutures alone were sufficient in all cases. In the placenta increta group, four cases required a Bakri balloon, and two of those also needed uterine artery ligation for successful bleeding control. None of the patients required hysterectomy. Hemoglobin changes, mean arterial pressure, and fever were higher in the placenta increta group, but no statistically significant differences were observed in other parameters. CONCLUSIONS: Transverse uterine compression sutures are highly effective in managing placenta previa and PAS. In severe cases like placenta increta, additional interventions may be necessary to control bleeding.
OBJECTIVES: To assess safety, feasibility, and aesthetic outcomes in patients undergoing suprasymphyseal transverse skin incision (SSTI), at 0 cm from the pubic symphysis, during cesarean section (CS). The primary goal w...OBJECTIVES: To assess safety, feasibility, and aesthetic outcomes in patients undergoing suprasymphyseal transverse skin incision (SSTI), at 0 cm from the pubic symphysis, during cesarean section (CS). The primary goal was to evaluate patients' satisfaction regarding the aesthetic effect of the CS scar by using a patient survey. MATERIAL AND METHODS: This single-center study included 500 female patients who underwent CS delivery using the SSTI technique. Patient data were collected from institutional records, including operative notes, follow-up records, and patient surveys. A patient survey regarding satisfaction with the CS scar was conducted for 3 months postoperatively. It included a visual analog scale ranging from 1 (very dissatisfied) to 10 (strongly satisfied), a question about objective scar problems, and about willingness to recommend this incision. RESULTS: The SSTI was successfully used in all patients with no intraoperative conversions to higher incisions. Among patients, 382 had primary cesarean deliveries, 115 had second repeat cesareans using the same skin incision, and 3 had third-time cesareans also utilizing the same incision. The overall wound complication rate was low (4.4%), with no significant differences across the number of cesarean deliveries. Aesthetic outcomes and scar concealment were subjectively rated as highly satisfactory by patients, with 9.6 out of 10 points. CONCLUSIONS: The SSTI technique appears to be a safe, feasible, and cosmetically favorable option for CS, even in repeated procedures. Wound complications occurred in a small percentage, while aesthetic outcomes, especially scar position at the pubic line, were subjectively rated as highly satisfactory by patients.
OBJECTIVES: This study evaluated the long-term outcomes after tension-free vaginal tape (TVT) surgery and examined whether 3D transvaginal ultrasound (US) mesh position parameters (providing multiplanar visualization and...OBJECTIVES: This study evaluated the long-term outcomes after tension-free vaginal tape (TVT) surgery and examined whether 3D transvaginal ultrasound (US) mesh position parameters (providing multiplanar visualization and improved measurement reproducibility compared with 2D imaging) are associated with urinary symptoms and quality-of-life changes in women with stress urinary incontinence (SUI). We hypothesized that mesh position would correlate with long-term patient-reported outcomes. MATERIAL AND METHODS: In this retrospective cohort, 30 women underwent TVT surgery for SUI between 2012 and 2014 at a tertiary referral center. In 2024, at a median follow-up of 11 years (interquartile range [IQR] 10-12), all patients had clinical evaluation, completed the Urinary Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and Overactive Bladder Questionnaire Short Form (OAB-q SF), and underwent 3D transvaginal US to measure total urethral length, mesh-to-bladder neck distance, mesh-to-midurethra ratio, and minimal mesh-to-urethral lumen distance. Preoperative and follow-up scores were compared using paired t-tests or Wilcoxon signed-rank tests. Correlations between mesh parameters and score changes were analyzed with Spearman's correlation. RESULTS: Long-term treatment success was achieved in all patients, with negative postoperative stress tests and no retreatment. UDI-6, IIQ-7, and OAB-q SF scores improved significantly from baseline (p < 0.001 for all). No mesh erosion occurred. De novo overactive bladder (OAB) developed in six patients (20%). No strong correlations were found between mesh parameters and score changes (all |ρ| < 0.30). CONCLUSIONS: TVT surgery provided excellent long-term outcomes with sustained symptom and quality-of-life improvement. Mesh position measured by 3D US at long-term follow-up was not strongly associated with patient-reported outcomes.
OBJECTIVES: Benign hysterectomy can be performed using multiple surgical approaches, each associated with distinct perioperative and postoperative outcomes. Comparative real-world data across commonly used techniques rem...OBJECTIVES: Benign hysterectomy can be performed using multiple surgical approaches, each associated with distinct perioperative and postoperative outcomes. Comparative real-world data across commonly used techniques remain limited. To evaluate the association between surgical approach and perioperative outcomes after benign hysterectomy and to describe differences in safety profiles across five hysterectomy techniques. MATERIAL AND METHODS: This retrospective single-center cohort study included consecutive women undergoing hysterectomy for benign indications between January 2023 and December 2025. Outcomes of vaginal, laparoscopic, and abdominal surgical approaches were compared. RR with 95% CI was calculated for perioperative and postoperative outcomes, with vaginal hysterectomy as the reference group. RESULTS: A total of 793 patients were included. Perioperative and postoperative outcomes differed significantly among hysterectomy approaches, including operative time, complication rates, rehospitalization, reoperation, conversion, and length of hospital stay. Vaginal hysterectomy was associated with the shortest operative time, shortest hospital stays, and lowest complication rates, whereas total laparoscopic and total abdominal hysterectomy were associated with the highest complication rates. RR analysis suggested an increased risk of perioperative and postoperative complications after total laparoscopic and total abdominal hysterectomy compared with vaginal hysterectomy. CONCLUSIONS: Perioperative and postoperative outcomes after benign hysterectomy differ significantly according to surgical approach. These findings suggest that surgical approach may be associated with differences in perioperative outcomes and support individualized route selection.
OBJECTIVES: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects many women, including adolescents, around the world. While PCOS is primarily known for its reproductive and metabolic implications...OBJECTIVES: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects many women, including adolescents, around the world. While PCOS is primarily known for its reproductive and metabolic implications, growing evidence suggests that it is also associated with an increased risk of cardiovascular disease (CVD). The aim of the study was to evaluate the concentrations of vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9), and visfatin in adolescent girls with PCOS in respect to their central obesity status. MATERIAL AND METHODS: Thirty-six PCOS patients were qualified for the study (mean age 15.97 ± 0.91 years, BMI 24.78 ± 5.83 kg/m²). 17 girls with abdominal obesity were included in the AO-PCOS group and 19 girls with waist circumference < 80 cm were classified into the NAO-PCOS group. Each patient had biochemical and hormonal tests performed. Furthermore, markers of endothelial dysfunction: VEGF, MMP-9, and visfatin were measured in all adolescents. RESULTS: In the study, the AO-PCOS exhibited significantly higher levels of ALT, fasting insulin, HOMA-IR, LDL cholesterol and testosterone. This group also showed statistically significantly higher systolic and diastolic blood pressure. Moreover, higher concentrations of MMP-9, and VEGF and lower visfatin level were found in the group of adolescent patients with PCOS and abdominal obesity. However, significant differences were observed only in relation to MMP-9 concentration (p < 0.0001). Ssignificant positive correlation was found between MMP-9 concentration and body weight (R = 0.37; p = 0.03), waist circumference (R = 0.38; p = 0.02), BMI (R = 0.36; p = 0.03), and LDL concentration (R = 0.43; p = 0.01). Visfatin concentration showed a statistically significant negative correlation with androstenedione concentration (R = -0.53; p = 0.01). However, VEGF concentration did not show statistically significant correlations with any parameters. CONCLUSIONS: The study results suggest that abdominal obesity, coexisting in adolescent girls with PCOS, may constitute a risk factor for cardiovascular complications in this patient group.
OBJECTIVES: The aim of this study is to review the current state of knowledge on the role of melatonin in the pathophysiology and treatment of intrauterine growth restriction (IUGR) based on recent clinical and experimen...OBJECTIVES: The aim of this study is to review the current state of knowledge on the role of melatonin in the pathophysiology and treatment of intrauterine growth restriction (IUGR) based on recent clinical and experimental studies. MATERIAL AND METHODS: A systematic review of scientific literature published between 2012-2025 in PubMed, Cochrane Library and Web of Science databases was conducted. Studies on melatonin mechanisms of action, their levels in IUGR, and results of experimental and clinical studies were analyzed. RESULTS: Melatonin is synthesized not only by the pineal gland but also by the placenta, where it plays a crucial role as an antioxidant and modulator of inflammatory processes. Women with IUGR showed significantly lower melatonin levels in umbilical cord blood. The MT2 melatonin receptor regulates placental angiogenesis through the STAT3/VEGFR2/PI3K/AKT pathway. Experimental studies demonstrated that melatonin improves fetal oxygenation, reduces oxidative stress, and protects the brain and heart from damage. CONCLUSIONS: Melatonin shows promising neuroprotective and cardioprotective properties in IUGR fetuses. The PROTECT Me trial, which completed recruitment in 2025, will provide crucial data on melatonin's clinical efficacy. Until then, melatonin use in IUGR should be limited to controlled clinical trials.
OBJECTIVES: A diagnosis of breast cancer is considered a highly psychologically distressing event, and coping with the disease constitutes a major challenge. Levels of psychological distress are often very high immediate...OBJECTIVES: A diagnosis of breast cancer is considered a highly psychologically distressing event, and coping with the disease constitutes a major challenge. Levels of psychological distress are often very high immediately after diagnosis. Cervical cancer is the most common malignant tumor in the global gynecological reproductive tract system among. MATERIAL AND METHODS: The study was conducted among 155 females diagnosed with breast cancer and cervical cancer who underwent surgical treatment and took place between January 2024 and December 2025. The diagnostic survey method was employed, along with the following research tool: the Mental Adjustment to Cancer Scale (Mini-MAC), and self-administered questionnaire. RESULTS: Patients diagnosed with breast cancer achieved the highest scores in the fighting spirit domain (M = 22.1; SD = 3.0), whereas patients with cervical cancer obtained the highest scores in the anxious preoccupation strategy (M = 20.1; SD = 2.4). The domains of anxious preoccupation, fighting spirit, helplessness-hopelessness, and positive reappraisal, analyzed in relation to the type of total surgical procedure performed in breast cancer were most frequently differentiated by the sociodemographic factor of education level. Other sociodemographic variables influenced only individual coping strategies. The education level of the respondents in breast cancer also significantly affected the constructive and destructive coping styles as defined by the Mini-MAC. CONCLUSIONS: The Mini-MAC showed that women with breast cancer more often activated a constructive coping style, and the highest scores in this group were observed for positive strategies. In contrast, women with cervical cancer more frequently activated a destructive coping style and negative strategies.
OBJECTIVES: To assess long-term efficacy and safety of uterine artery embolization for symptomatic uterine fibroids. MATERIAL AND METHODS: This retrospective cohort study included women undergoing uterine artery emboliza...OBJECTIVES: To assess long-term efficacy and safety of uterine artery embolization for symptomatic uterine fibroids. MATERIAL AND METHODS: This retrospective cohort study included women undergoing uterine artery embolization for symptomatic fibroids from 2012 to 2023. A validated questionnaire assessed symptoms (e.g., heavy menstrual bleeding, pelvic pain) pre- and post- uterine artery embolization. Data on fibroid characteristics, follow-up duration, menopause status, and complications were collected. Patients were stratified into follow-up terciles. Statistical analyses included Wilcoxon signed-rank tests, linear regression with menopause adjustment, and Spearman correlations tests (p < 0.05). RESULTS: Uterine artery embolization significantly reduced symptoms, particularly bleeding-related complaints, with sustained efficacy across short-, mid-, and long-term follow-up, even after menopause adjustment. Menopause enhanced symptom relief. No correlations were found between symptom reduction and age, fibroid size, or prior treatment. Complications, mostly minor, occurred in a notable proportion, with rare major events. A small subset achieved successful pregnancies post-embolization. CONCLUSIONS: Uterine artery embolization is an effective, minimally invasive treatment for fibroid-related symptoms, with sustained benefits over time; menopause significantly predicts greater symptom improvement.