Ginekol. Pol. [JOURNAL]
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200 papers
Current approach to the use of transvaginal mesh systems in pelvic organ prolapse.
Pycek M, Zarzecka JM, Majkusiak W … +2 more , Barcz EM, Zwierzchowska A
Ginekol Pol · 2025 · PMID 40145699 · Publisher ↗
Pelvic organ prolapse (POP) involves the descent of vaginal walls, uterus, or vaginal apex. Traditional native tissue repair techniques, while low in complications, exhibit significant relapse rates. To enhance durabilit...
Pelvic organ prolapse (POP) involves the descent of vaginal walls, uterus, or vaginal apex. Traditional native tissue repair techniques, while low in complications, exhibit significant relapse rates. To enhance durability of surgical repair, synthetic mesh systems were adopted. However, early generations faced complications such as vaginal mesh exposure and dyspareunia, leading to critical reevaluation and regulatory actions. The Food and Drug Administration issued first warning in 2008 and reclassified mesh as high-risk in 2016, banning it for transvaginal anterior compartment prolapse in 2019. European and Canadian regulations similarly increased scrutiny, with prominent professional organizations and regulatory bodies endorsing limited use and thorough counseling. Subsequent innovations introduced lighter mesh systems with sacrospinous ligament fixation, which improved anatomical outcomes and reduced adverse effects. Recent studies on these systems demonstrate promising success rates, with notable reductions in prolapse recurrence and improved quality of life. Given these developments, current perspectives advocate for selective use of advanced mesh systems in POP surgery, emphasizing rigorous patient selection, informed consent, and meticulous surgical technique. This careful approach, as opposed to a categorical ban, aims to balance the therapeutic benefits with potential risks, ensuring optimized patient outcomes in POP management.
The relationship between major anomalies and chorionicity in twin pregnancies referred for first trimester and second trimester detailed anatomic ultrasonography.
Koçkaya E, Doğan Y, Babaoğlu A
Ginekol Pol · 2025 · PMID 40145698 · Publisher ↗
OBJECTIVES: The purpose of this study is to validate the relationship between chorionicity and congenital anomalies. MATERIAL AND METHODS: A retrospective analysis twin pregnancies that underwent ultrasonographic fetal a...
OBJECTIVES: The purpose of this study is to validate the relationship between chorionicity and congenital anomalies. MATERIAL AND METHODS: A retrospective analysis twin pregnancies that underwent ultrasonographic fetal anatomy screening in the first or second trimester was conducted. Analyzed variables were, gestational age, chorionicity, presence of major fetal structural anomalies, number of affected fetuses, anomaly type, and use of assisted reproductive techniques (ART). RESULTS: Of the 824 twin pregnancies included in the study, 116 (14%) had major fetal anomalies. The frequency of major fetal structural anomalies was higher in monochorionic (MC) twin pregnancies compared to dichorionic (DC) twin pregnancies (p < 0.001). When anomalies were categorized into cardiac, central nervous system, and other system anomalies, no significant correlation was found between chorionicity and anomaly groups (p = 0.794). CONCLUSIONS: In MC twin pregnancies, major fetal structural abnormalities are more prevalent. Prioritizing the evaluation of chorionicity is essential due to the increased risk associated with twin pregnancies.
Magnetic resonance imaging-based radiomic model to predict the risk of intraoperative massive hemorrhage in patients with cesarean scar pregnancy.
Ye B, Chen C, Su K … +2 more , Fan R, Yuan B
Ginekol Pol · 2025 · PMID 40145697 · Publisher ↗
OBJECTIVES: Development of magnetic resonance imaging (MRI)-based radiomic models to predict the risk of intraoperative massive hemorrhage in patients with cesarean scar pregnancy (CSP). MATERIAL AND METHODS: CSP patient...
OBJECTIVES: Development of magnetic resonance imaging (MRI)-based radiomic models to predict the risk of intraoperative massive hemorrhage in patients with cesarean scar pregnancy (CSP). MATERIAL AND METHODS: CSP patients (n = 126) from Center 1 were randomly assigned in a 7:3 ratio into a training set (n = 88) and an internal validation set (n = 38), and patients (n = 32) from Center 2 into an external validation set. Afterward, the clinical and radiomic features related to intraoperative massive hemorrhage were fed into the k-nearest Neighbor (KNN), support vector machine (SVM), Light Gradient Boosting Machine (Light GBM), and Multi- Layer Perception (MLP) to construct predictive clinical, radiomic, and combinatorial models. The performance of these models was assessed using area under curve (AUC), Delong's test, Decision Curve Analysis (DCA), and calibration curves. Youden's index was used to determine the optimal threshold. RESULTS: Eleven radiomic characteristics were found to be substantially linked to intraoperative massive hemorrhage. The combined in the gestational sac and peripheral to the gestational sac (IP) model (AUC = 0.959), constructed by MLP, had the best performance, with an optimal risk threshold of 0.180, as compared to the clinical model (AUC = 0.500) and the nomogram (AUC = 0.283). DCA and calibration curves demonstrated the IP model's good clinical predictive performance. CONCLUSIONS: The IP model for CSP was superior to the other models in this study in predicting the risk of intraoperative massive hemorrhage, which was significantly increased when the risk threshold exceeded 0.180. The model may help clinicians make individualized treatment decisions.
Postpartum emotional disorders - a narrative review.
Motyka R, Sioma-Markowska U
Ginekol Pol · 2025 · PMID 40145696 · Publisher ↗
Emotional disorders during pregnancy and the postpartum period affect many women worldwide and present a significant challenge in perinatal care. The first year after childbirth is particularly demanding for a woman's em...
Emotional disorders during pregnancy and the postpartum period affect many women worldwide and present a significant challenge in perinatal care. The first year after childbirth is particularly demanding for a woman's emotional well-being, asitismarked by profound physical, emotional, and social changes. The aim of this article is to review and compare the latest data on the prevalence, risk factors, and treatment options for baby blues and postpartum depression. For this purpose, the electronic databases - including PubMed, NLM, MDPI, Europe PMC, and Google Scholar - were searched for recent English-language articles with full-text availability. The search terms included: postpartum depression, baby blues, maternity blues, postpartum depression prevalence, postpartum depression risk factors, postpartum depression treatment, online psychotherapy, and postpartum depression covid. The review was compiled and evaluated using SANRA (Scale for the Assessment of Narrative Review Articles).
The prevalence of Group B Streptococcus rectovaginal colonization and antimicrobial susceptibility pattern in Turkish and Syrian pregnant women.
Kirtis E, Karadag B, Uysal A … +2 more , Çekin Y, Alkan Bulbul G
Ginekol Pol · 2025 · PMID 40145695 · Publisher ↗
OBJECTIVES: Colonization with Group B Streptococcus (GBS) during pregnancy can lead to invasive GBS disease (iGBS) in neonates, including meningitis, pneumonia or sepsis, which carries a high mortality risk. American Col...
OBJECTIVES: Colonization with Group B Streptococcus (GBS) during pregnancy can lead to invasive GBS disease (iGBS) in neonates, including meningitis, pneumonia or sepsis, which carries a high mortality risk. American College of Obstetricians and Gynecologists (ACOG) recommends universal GBS screening for all pregnant individuals between 36 0/7 and 37 6/7 weeks of gestation. However, due to the insufficient population-based studies on universal screening and GBS colonization rates in late periods of pregnancy in Türkiye, we aimed to evaluate the prevalence of GBS and its antibiotic resistance to enhance awareness regarding GBS screening and prophylaxis during pregnancy and promote the use of appropriate antibiotics. MATERIAL AND METHODS: This prospective, single-center study was conducted between May 2017 and December 2017 on 518 pregnant women (363 Turkish and 155 Syrian). Vaginal and rectal samples were collected and cultured in Todd-Hewitt broth. Standard microbiological protocols were used to assess GBS colonization and antibiotic susceptibility. RESULTS: In the study, we found that 10.6% (n = 55) of pregnant women were colonized with GBS asymptomatically. Group B Streptococcus colonization rates did not differ significantly between Turkish patients (11%, n = 40) and Syrian patients (9.7%, n = 15) (p = 0.756, p > 0.05). All patients colonized with GBS were penicillin-sensitive. However, resistance to at least one non-penicillin antibiotic was observed in 42.5% (n = 17) of Turkish patients and 60% (n = 9) of Syrian patients. Although not statistically significant (p > 0.05), Syrian patients exhibited relatively higher rates of antibiotic resistance, especially to erythrosine and clindamycin. CONCLUSIONS: In our country, implementing universal screening for asymptomatic GBS in pregnant women, as recommended by the Centers for Disease Control and Prevention (CDC), would be more beneficial than a risk-based screening approach. Given the increased resistance patterns observed in antibiogram results, GBS prophylaxis at delivery, especially in patients with penicillin allergies, should be planned based on antibiotic susceptibility testing.
A multiple male and female pregnancy in a patient with stage IV endometriosis undergoing single embryo transfer after IVF-ICSI.
Olcha P, Nowakowski L, Putowski L … +2 more , Radzik I, Ciebiera M
Ginekol Pol · 2025 · PMID 40145694 · Publisher ↗
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Classification of hemostatic methods and their efficacy in placenta increta.
Hu C, Zhang W, Liu L … +4 more , Zhang X, Zeng H, Li Q, Huang J
Ginekol Pol · 2025 · PMID 40070260 · Publisher ↗
INTRODUCTION: Placenta increta is a serious complication of pregnancy that needs a variety of intraoperative hemostatic methods to stop bleeding. However, the efficacy of different hemostatic methods is still not known....
INTRODUCTION: Placenta increta is a serious complication of pregnancy that needs a variety of intraoperative hemostatic methods to stop bleeding. However, the efficacy of different hemostatic methods is still not known. This study aimed to evaluate the efficacy of different hemostatic methods in placenta increta. MATERIAL AND METHODS: A total of 187 placenta increta patients that underwent treatment at Xiangya Hospital Central South University from March 1, 2017 to January 31, 2021 were included in this retrospective study. Perioperative data of patients with placenta increta were retrospectively analyzed. The patients were distributed into two groups according to the hemostasis methods, namely permanent group (n = 29), permanent plus temporary group (n = 158). Permanent hemostasis included the subgroups of uterine hemostasis (e.g., uterine tamponade, B-Lynch suture, and uterine local suture) and vascular hemostasis (e.g., uterine artery ligation and internal iliac artery ligation). The clinical information and maternal-fetal outcomes of the groups and subgroups were analyzed. RESULTS: A significant difference in blood loss was detected between the permanent hemostasis group and the permanent plus temporary hemostasis group. Compared with the uterine hemostatic, the vascular, and combined hemostatic methods had a significant reduction in postpartum blood loss (p < 0.05). No differences were found within these subgroups in the permanent plus temporary group. Pregnancy outcomes did not differ significantly among the subgroups. CONCLUSIONS: Vascular hemostasis and combined hemostasis may be better than uterine hemostasis alone for placenta increta without temporary hemostasis. Prospective and large-scale studies are needed to investigate long-term outcomes and confirm the efficacy of these hemostatic techniques.
Two-sample Mendelian randomization analysis of the causal relationship between lipid metabolism/fatty acid metabolism and pre-eclampsia.
Yang D, Chen J, Wang X … +4 more , Zhuang L, Feng H, Liao X, Mo T
Ginekol Pol · 2025 · PMID 40070259 · Publisher ↗
OBJECTIVES: A causal relationship has been found between the abundance of some flora in the gut microbiota and the development of pre-eclampsia (PE). Short-chain fatty acids in gut microbes are an important source of lip...
OBJECTIVES: A causal relationship has been found between the abundance of some flora in the gut microbiota and the development of pre-eclampsia (PE). Short-chain fatty acids in gut microbes are an important source of lipids. The causal effect of lipid metabolism/fatty acid metabolism pathways on PE exposure is unknown. MATERIAL AND METHODS: This study was based on single nucleotide polymorphism (SNP) data related to lipid metabolism/fatty acid metabolism and PE from the genome-wide association study (GWAS) in the GWAS Catalog database and finngen database, and a two-sample Mendelian randomization (MR) analysis was performed to explore the causal relationship between lipid/fatty acid metabolism and PE exposure. Five MD analysis methods were used in this study, inverse-variance weighted (IVW), MR-Egger regression, weighted median (WM), weighted median estimator (WME), MR-PRESSO. The intercept term of MR-Egger regression was tested for the presence of genetic pleiotropy between SNPs and PEs. Cochran's Q test was performed to investigate the heterogeneity between variables. The leave-one-out method was used for sensitivity analysis to determine the robustness of the results. RESULTS: Inverse-variance weighted results showed that gamma-glutamyl glutamine levels [odds ratio (OR) = 0.40, 95% confidence interval (CI): 0.21-0.78; p = 0.01], 1-arachidonoylglycerophosphocholine [1-arachidonoyl-sn-glycero-3-phosphocholine levels (OR = 0.57; 95% CI: 0.38-0.87; p = 0.01), X-14304--leucylalanine levels (OR = 0.72; 95% CI :0.56-0.93; p = 0.01), citrulline levels (OR = 0.48; 95% CI: 0.26-0.89; p = 0.02), inosine levels (OR = 0.88; 95% CI: 0.78-0.98; p = 0.02), and HWESASXX levels (OR = 0.64; 95% CI: 0.42-1.00; p = 0.05) were negatively correlated with PE. There was a positive trend for X-14205--alpha-glutamyltyrosine levels (OR = 1.55; 95% CI: 1.12-2.14; p = 0.01), X-11787 levels (OR = 3.29; 95% CI: 1.23-8.78; p = 0.02) to be associated with PE. No significant heterogeneity or pleiotropy was found for instrumental variables or levels pleiotropy. CONCLUSIONS: This study demonstrated a causal relationship between eight fatty acid metabolisms and PE. Follow-up in-depth randomized controlled trials are needed to reveal the promotional or protective effects of fatty acid metabolism on PE.
The one-center experience comparing glucose monitoring in patients with gestational diabetes mellitus utilizing flash glucose monitoring (FGM) versus traditional self-blood glucose monitoring (SBGM).
Kwiatkowska MK, Kopka M, Cyganek N … +4 more , Matejko B, Krawczyk M, Witek P, Cyganek K
Ginekol Pol · 2025 · PMID 40070258 · Publisher ↗
INTRODUCTION: The most prevalent condition affecting the metabolism of carbohydrates during pregnancy is gestational diabetes mellitus (GDM). Continuous glycemia monitoring systems that use sensors are currently replacin...
INTRODUCTION: The most prevalent condition affecting the metabolism of carbohydrates during pregnancy is gestational diabetes mellitus (GDM). Continuous glycemia monitoring systems that use sensors are currently replacing the conventional self-monitoring of glycemia with a glucometer. Poland's insurance coverage has made new technologies possible for continuous glycemia monitoring. Our retrospective study compared the effects of two glycemic measurement techniques on patient preferences and maternal and pediatric clinical outcomes: traditional methods using a glucometer and utilizing a sensor for scanning continuous glycemic monitoring (flash glucose monitoring, or FGM). MATERIAL AND METHODS: In a retrospective analysis of 277 women with GDM treated in the Department of Metabolic Diseases, University Hospital in Cracow, Poland, in January 2023 we compared the effectiveness of using of sensor FreeStyle Libra (FGM) vs self-blood glucose monitoring (SBGM) by glucometer in improving clinical maternal outcomes measured by daily insulin dose, body weight gain, mean blood glucose and newborns outcomes assessed by body weight, APGAR score, caesarean sections. RESULTS: We examined 224 women from the SBGM group, 53 from the FGM group, and 277 from the GDM ladies. The SBGM group was diagnosed with GDM later in pregnancy [24 (10-25) vs 11 (8-23.5) weeks; p < 0.001], was admitted at the first pregnancy visit [26 (14-29) vs 20 (12-27) weeks; p = 0.001], and was slightly older [33 (30-36) vs 32 (29-34) years; p = 0,027]. The pre-pregnancy body weight [70 (60-83) vs 67 (59-79) kg; p = 0.358] and the number of pregnancies [2 (1-3) vs 2 (1-3); p = 0.118] did not differ between the two groups. Women who used SMGB gained less weight throughout pregnancy [10 (5.5-13.0) vs 12 (8-14.8) kg; p = 0.0333] and had fewer prenatal checkups [5 (4-7) vs 8 (5-9) weeks; p < 0.001], including fewer teleconsultations [1 (0-3)]. Women in the FGM group received insulin treatment earlier [15 (11.5-27) vs 27 (16-30) week of pregnancy; p < 0,001] and used it more often [52 (98.1%) vs 183 (81.3%); p = 0.005]. There was no significant difference in daily insulin dose per kg of weight [26.5 (11.5-39.2) vs 21 (9-39) U/d; p = 0.325]. The groups did not differ in birth weight [SBGM 3243 ± 485 vs FGM 3331 ± 359 g; p = 0.206] and a gestational week at delivery [38 (38-39) vs 39 (38-39) week; p = 0.092], There was no difference in obstetric outcomes: caesarean sections, preterm births, week of delivery, mean birth weight or prevalence of perinatal complications. CONCLUSIONS: When comparing traditional SBGM to flash continuous glucose monitoring in this real-world observation, we have found no changes in the outcomes for mothers and newborns between the groups. There were more teleconsultations for women who used FCGM.
Effects of gestational diabetes mellitus with different birth weight on genetic metabolism of newborns. A retrospective cohort study.
Xia D, Wang H, Yang Y … +1 more , Wang W
Ginekol Pol · 2025 · PMID 40070257 · Publisher ↗
OBJECTIVES: To investigate the effects of gestational diabetes mellitus (GDM) with different birth weights on neonatal genetic metabolism. MATERIAL AND METHODS: 1252 patients with GDM diagnosed at Changzhou Maternal and...
OBJECTIVES: To investigate the effects of gestational diabetes mellitus (GDM) with different birth weights on neonatal genetic metabolism. MATERIAL AND METHODS: 1252 patients with GDM diagnosed at Changzhou Maternal and Child Health Care Hospital from 2017 to 2021 were categorized into three groups: fetal growth restriction (G1), normal birth weight (G2), and macrosomia (G3). The levels of amino acids, free carnitine (CO) and acylcarnitine in neonates were detected using tandem mass spectrometry. RESULTS: There were no differences in age, height, predelivery weight or gravida across groups. G3 had the highest parity and fasting blood glucose levels (p < 0.0001). G1 exhibited the highest rates of cesarean section, neonatal asphyxia, and insulin utilization (p < 0.0001). Neonatal genetic metabolism analysis revealed that in G1 citrulline levels were the highest, with significantly elevated levels of leucineornithine and valine (p < 0.001). CO was also the highest (p < 0.001). The levels of isovalerylcarnitine, octanoylcarnitine and 18-carbodienoylcarnitine increased, while malonylcarnitine/3-hydroxy-butyrylcarnitine, hexadecanoylcarnitine, hexadecenoylcarnitine, 3-hydroxy-hexadecenoylcarnitine and 3-hydroxy-hexadecanoylcarnitine decreased (p < 0.05). In G2, methionine levels decreased (p < 0.001), whereas decenoylcarnitine, dodecanoylcarnitine, dodecenoylcarnitine and myristoylcarnitine levels increased (p < 0.001). In G3, proline decreased significantly (p < 0.001), and CO was the lowest (p < 0.001). Propionylcarnitine and octenoylcarnitine levels increased, whereas butyrylcarnitine decreased (p < 0.05). CONCLUSIONS: Gestational diabetes mellitus with different birth weights influences neonatal genetic metabolism in distinct ways. Therefore, neonatal screening for inherited metabolic disorders provides insights into the metabolic levels of offspring of patients with GDM in early life.
Major opinion about motherhood among women with Turner syndrome.
Wiecek M, Kempinska W, Gawlik-Starzyk A
Ginekol Pol · 2025 · PMID 40070256 · Publisher ↗
OBJECTIVES: Turner syndrome (TS) is associated with ovarian dysgenesis leading to infertility in most of the cases. There are some options for fertility preservation (FP) in patients with sufficient follicle numbers. The...
OBJECTIVES: Turner syndrome (TS) is associated with ovarian dysgenesis leading to infertility in most of the cases. There are some options for fertility preservation (FP) in patients with sufficient follicle numbers. The most recently studied are oocyte and ovarian tissue preservation. Due to premature ovarian failure among TS girls, the procedure should be performed as early as possible. The aim of this study is to gain the opinions of women with TS about motherhood based on the web-survey. MATERIAL AND METHODS: The survey, hosted on SurveyMonkey.com, targeted women over 18 years with TS. It comprised 16 single-choice questions, ensuring anonymity and consent for data usage. RESULTS: The answers of a total of 152 women were analyzed. When asked if they had discussed motherhood options with their physicians, 72/152 of the participants responded negatively. Asked about the desire of maternity, 85/152 expressed a desire to have children. 5/152 had biological children from spontaneous pregnancies, 5/152 had biological children through oocyte donation, 1/152 through embryo donation, and 12/152 had adopted children. 75/150 respondents answered yes to the question of whether they desired to use ovarian tissues if they had been preserved during adolescence. CONCLUSIONS: The findings suggest that a significant number of women with TS who aspire to become mothers would be inclined to use preserved cells if this option were available. This underscores the necessity for further exploration of FP techniques for individuals with TS.
The value of miRNAs as a biomarker for the diagnosis of gestational diabetes mellitus: a meta-analysis.
Zhao F, Wang G
Ginekol Pol · 2025 · PMID 40070255 · Publisher ↗
OBJECTIVES: The present meta-analysis evaluated the value of miRNAs in the diagnosis of gestational diabetes mellitus (GDM). MATERIAL AND METHODS: Eligible studies were gathered from MEDLINE, EMBASE, PubMed, Chinese Nati...
OBJECTIVES: The present meta-analysis evaluated the value of miRNAs in the diagnosis of gestational diabetes mellitus (GDM). MATERIAL AND METHODS: Eligible studies were gathered from MEDLINE, EMBASE, PubMed, Chinese National Knowledge Infrastructure (CNKI), WanFang, and CQVIP information databases. Combined sensitivity, specificity, and summary receiver operating characteristic (SROC) curves of enrolled studies were analyzed using STATA 12.0. Diagnostic accuracy was examined by diagnostic likelihood ratio (DLR), diagnostic score, and diagnostic odds ratio (DOR). Publication bias was calculated using Deeks' funnel plot. RESULTS: 18 articles (29 studies) were included in this meta-analysis. The pooled sensitivity of overall miRNAs was 0.83 (95% CI = 0.77-0.88), and the specificity was 0.79 (95% CI = 0.72-0.84). The area under SROC curve (AUC) was 0.88 (95% CI = 0.85-0.90). The positive DLR was 3.94 (95% CI = 2.98-5.21), and the negative DLR was 0.22 (95% CI = 0.16-0.30). The diagnostic score was 2.91 (95% CI = 2.44-3.37), and the DOR was 18.27 (95% CI = 11.44-29.17). These results suggest that miRNAs have high diagnostic accuracy for GDM. High heterogeneity may be caused by study design, gestational age, and cutoff value. Subgroup analysis indicates that sensitivity and specificity are higher in case-control studies than in cohort studies. Specificity differs significantly in the cutoff value subgroup. CONCLUSIONS: Overall, miRNAs showed high accuracy in diagnosing of metabolic changes in GDM patients. High heterogeneity may be caused by study design, sampling gestational age, and cutoff value.
Unmasking metabolic clues: adipsin, irisin and osteopontin as biomarkers in polycystic ovary syndrome and their impact on metabolic dynamics: a case-control study.
Duzenli FN, Yurtcu E, Keyif B … +1 more , Basbug A
Ginekol Pol · 2025 · PMID 40070254 · Publisher ↗
OBJECTIVES: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age, often associated with metabolic alterations. This study assessed serum levels of adipsin, irisin, and osteopontin...
OBJECTIVES: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age, often associated with metabolic alterations. This study assessed serum levels of adipsin, irisin, and osteopontin in patients with PCOS and examined their correlations with metabolic parameters. MATERIAL AND METHODS: A case-control study was conducted involving 96 women with PCOS and 80 healthy controls. Serum levels of adipsin, irisin, and osteopontin were measured; demographic, clinical, and metabolic characteristics were evaluated. RESULTS: Patients with PCOS were significantly younger than controls (p < 0.001). The PCOS group included a significantly greater proportion of obese individuals (p = 0.013). Patients with PCOS exhibited elevated serum adipsin (p = 0.020) and reduced osteopontin (p < 0.001) levels relative to controls; obesity and age influenced these differences. Osteopontin demonstrated superior predictive power for PCOS diagnosis [area under the curve (AUC) = 0.802] compared with adipsin (AUC = 0.602). A combination of osteopontin and adipsin yielded the highest predictive value (AUC = 0.817) among double or triple biomarker combinations. CONCLUSIONS: This study identified potential associations among adipsin, osteopontin, irisin, and PCOS. Further research is warranted to elucidate their roles and clinical implications in PCOS and its metabolic alterations. The findings highlight the impact of age and obesity on these biomarkers and their relationships with PCOS, providing insight into the syndrome's complex pathophysiology.
Is it possible to predict severe postpartum hemorrhage and the need for massive transfusion in placenta previa cases?
Köle E, Akar B, Doğer E … +3 more , Çakır Köle M, Anık Y, Çalışkan E
Ginekol Pol · 2025 · PMID 40070253 · Publisher ↗
OBJECTIVES: The aim was to construct a reliable working model for patients with placenta previa (PP) that aids in the prediction of postpartum bleeding potential with data from antenatal imaging studies using both ultras...
OBJECTIVES: The aim was to construct a reliable working model for patients with placenta previa (PP) that aids in the prediction of postpartum bleeding potential with data from antenatal imaging studies using both ultrasound (US) and magnetic resonance imaging (MRI). MATERIAL AND METHODS: Forty-three patients with PP were evaluated initially with the US and then by 3-Tesla MRI. The Placenta Accreata Index (PAI) was used during the US evaluation in order to define the risks. Uterine bulging, heterogeneous signal, dark placental bands, focal interruption of myometrium and tenting of bladder wall were regarded as predictive criteria in MRI evaluation. The correlation between the findings from US and MRI studies and subsequent haemorrhage, < 1000 mL, > 1000 mL and severe haemorrhage ( > 2000 mL) and massive transfusion [ > 5 units of red blood cells (RBC)] were used to build this predictive model. The findings from the imaging studies were also confirmed histopathologically. RESULTS: In the multivariate analysis of data from patients stratified by bleed size either < 1000 mL or > 1000 mL, none of the MRI and ultrasound findings were found to be predictive. The multivariate analysis was done using the second stratification cut-point of 2000 mL, in patients bleeding > 2000 mL PAI values [OR: 2.3 (1.4-3.8)] and overall MRI reported placenta accreata spectrum [OR: 4.9 (1.8-12.9)] were found to be predictive. While MRI findings were not discriminative between transfusion groups, grade 3 loculation on US examination was found to be predictive for the need of transfusion of > 5 units [OR: 67.5 (8.2-549.4)]. There were no cases needing hysterectomy. CONCLUSIONS: Ultrasound and MRI findings in cases of PP can be helpful in predicting postpartum bleeding.
Nonpharmacological mental health interventions for adolescent patients with polycystic ovary syndrome: a scoping review.
Zheng T, Li J, Chao J … +3 more , Wang HL, Hui Y, Shen L
Ginekol Pol · 2025 · PMID 40070252 · Publisher ↗
OBJECTIVES: This study aimed to summarize nonpharmacological mental health interventions that are beneficial for adolescent patients with polycystic ovary syndrome (PCOS) and to identify the limitations of existing studi...
OBJECTIVES: This study aimed to summarize nonpharmacological mental health interventions that are beneficial for adolescent patients with polycystic ovary syndrome (PCOS) and to identify the limitations of existing studies. MATERIAL AND METHODS: Following the recommendations of the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-SCR), we conducted a scoping review of nonpharmacological interventions aimed at improving mental health in adolescents with PCOS. RESULTS: Six randomized controlled trials (RCTs), two quasiexperimental studies, two case reports, one prospective study, one predictive correlation study, and one field trial study were included, resulting in 13 articles. Nonpharmacological interventions encompass a range of psychotherapies, dietary modifications, physical exercise, and traditional Chinese medicine therapies. Except for one study that has not yet reported findings, all included studies reported significant improvements in patients' mental health through nonpharmacological interventions. CONCLUSIONS: The evidence summarized in this study suggests that nonpharmacological interventions may be efficacious in improving the mental well-being of adolescent patients with PCOS. However, existing studies have limitations, including small sample sizes, the limited use of outcome indicators, and a lack of postintervention follow-up evaluations. Therefore, further RCTs should be conducted to validate the effectiveness and safety of current or alternative nonpharmacological interventions.
Professional perspectives on external cephalic version: survey results among Polish midwives and obstetricians.
Manasar-Dyrbus M, Jendyk C, Janik A … +3 more , Drosdzol-Cop A, Stojko R, Staniczek J
Ginekol Pol · 2025 · PMID 40070251 · Publisher ↗
OBJECTIVES: The purpose of this study was to assess and compare the knowledge, attitudes, and practices of Polish midwives and obstetricians concerning external cephalic version (ECV), with particular attention to how pr...
OBJECTIVES: The purpose of this study was to assess and compare the knowledge, attitudes, and practices of Polish midwives and obstetricians concerning external cephalic version (ECV), with particular attention to how professional qualifications, experience, and the reference level of the healthcare facility influenced these factors across both groups. MATERIAL AND METHODS: An author-created, 22-question online survey was distributed separately to midwives and obstetricians, with each group receiving a questionnaire customized to assess their specific knowledge of ECV, professional experience, and attitudes toward the procedure. RESULTS: The study included 839 participants: 378 midwives and 461 physicians. Knowledge and experience with ECV varied significantly based on work experience and the reference level of the workplace. When comparing the results between midwives and obstetricians, the median (Q1-Q3) score for correct answers on ECV was highest among obstetrics and gynecology residents (5, 3-6), while the lowest scores were seen among midwives with bachelor's degrees (2, 1-4). CONCLUSIONS: The study identified significant considerable knowledge gaps regarding ECV, particularly among midwives. Educational initiatives targeting both midwives and obstetricians are recommended to encourage the greater use of ECV and potentially reduce the rates of elective cesarean sections in cases of non-cephalic fetal presentations.
Retained intrauterine device as cause of thrombotic thrombocytopenic purpura.
Klimek M, Machnik A, Bialowas M … +2 more , Nowosielski K, Witek A
Ginekol Pol · 2025 · PMID 39963901 · Publisher ↗
Abstract loading — click title to view on PubMed.
The impact of mismatch repair (MMR), p53, and LCAM-1 immunohistochemical expression on prognosis in low-risk endometrial cancer.
Gezer Ş, Bayrak BY, Eser MD … +1 more , Tunce EB
Ginekol Pol · 2025 · PMID 39963900 · Publisher ↗
OBJECTIVES: To investigate the relationship between mismatch repair (MMR) deficiency, TP53, and L1 cell adhesion molecule (L1CAM) immunohistochemical staining and their impact on progression-free survival (PFS) and overa...
OBJECTIVES: To investigate the relationship between mismatch repair (MMR) deficiency, TP53, and L1 cell adhesion molecule (L1CAM) immunohistochemical staining and their impact on progression-free survival (PFS) and overall survival (OS) in low-risk endometrial cancer. MATERIAL AND METHODS: A total of 253 low-risk endometrial cancer patients were retrospectively screened. Immunohistochemical stains were applied to tumor tissue samples to assess MMR deficiency, TP53, and L1CAM expression, and survival analysis were performed. RESULTS: The expected PFS time was 78.6 months for the MMR-proficient group and 70.3 months for the MMR-deficient group (p = 0.011). OS was 71.6 months for the MMR-proficient group and 68.2 months for the MMR-deficient group (p = 0.755). L1CAM overexpression was associated with a poorer PFS, 62.7 months compared to 77.7 months (p = 0.039). However, there was no statistically significant difference in OS, 58.5 months versus 72.1 months, respectively (p = 0.242). p53 abnormal (p53-abn) staining was associated with a worse prognosis in terms of PFS, 62.8 months versus 77.7 months (p = 0.035), and OS, 43.4 months versus 73 months, respectively (p < 0.001), compared to patients with wild-type staining. No significant statistical relationship was observed in survival times concerning tumor diameter, grade, and lymphadenectomy status. In a multivariate analysis, MMR deficiency emerged as an independent poor prognostic factor for PFS, while p53-abn was identified as an independent poor prognostic factor for OS. CONCLUSIONS: p53-abn staining was associated with a poor prognosis for both PFS and OS in low-risk endometrial cancer patients. Meanwhile, MMR deficiency and L1CAM positivity were found to be associated solely with a poorer prognosis for PFS.
Prognostic evaluation of systemic immune inflammatory index and hematological parameters in postpartum hemorrhage: a retrospective analysis.
Akay E, Şirin Donbalıoğlu G, Yeniocak AS … +3 more , Dağdeviren E, Tercan C, Polat İ
Ginekol Pol · 2025 · PMID 39963899 · Publisher ↗
OBJECTIVES: Postpartum hemorrhage (PPH) is a significant global health risk for mothers. This study investigated the predictive capacity of the systemic immune inflammatory index (SII) to assess the risk of PPH. The SII,...
OBJECTIVES: Postpartum hemorrhage (PPH) is a significant global health risk for mothers. This study investigated the predictive capacity of the systemic immune inflammatory index (SII) to assess the risk of PPH. The SII, which is predicated on cell types of integral to inflammatory processes, correlates with high values of increased inflammatory activity and potentially adverse prognoses. MATERIAL AND METHODS: This retrospective cohort study included female patients aged 15-49 diagnosed with PPH who continued to bleed post-treatment, received transfusions of four or more units of erythrocyte suspension, or underwent laparotomy/re-laparotomy. RESULTS: The study found that Hemoglobin, hematocrit, platelet, and SII values were significantly lower, and lymphocyte counts were elevated in the PPH group. Both univariate and multivariate analyses identified hemoglobin and SII levels as significant determinants of PPH. An SII cutoff value of 915 proved to be an effective predictor of PPH. In subjects with an SII ≥ 915, leukocyte, platelet, and neutrophil values were higher, and lymphocyte counts were lower. Furthermore, the rates of PPH and Intensive Care Unit admissions increased in this cohort. CONCLUSIONS: The findings suggest that the SII is a potentially significant marker for PPH risk prediction. Elevated SII levels beyond the threshold of 915 were associated with heightened PPH risk of PPH.
Neoadjuvant chemotherapy in patients with vulvar carcinoma: a systematic review.
Piechowicz M, Staskiewicz W, Spaczyska J … +2 more , Pietrus M, Pitynski K
Ginekol Pol · 2025 · PMID 39963898 · Publisher ↗
Neoadjuvant chemotherapy is one of the options of treating patients with vulvar carcinoma. In this systematic review we searched three databases (Medline, EMBASE, Cochrane Library) for literature regarding this method of...
Neoadjuvant chemotherapy is one of the options of treating patients with vulvar carcinoma. In this systematic review we searched three databases (Medline, EMBASE, Cochrane Library) for literature regarding this method of therapy. Additional sources were also searched. We included primary studies of any design with no language or date restrictions. Fourteen full-text studies were found; due to heterogeneity of data no quantitative synthesis was performed. Quality of evidence was very low, mainly due to population sizes and no available comparative data with other types of treatment. The results were mixed, however some of the studies reported promising results regarding survival and possibility of more conservative surgery. In general chemotherapy was well-tolerated, but in some studies regimens containing bleomycin and methotrexate presented particularly severe toxicity.
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