Ceska Gynekol [JOURNAL]
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200 papers
Fetal total atrioventricular block in transgender man with systemic lupus erythematosus - literature review and establishment of a protocol with management and treatment with terbutaline.
Albrecht MEM, de Miranda NRDCR, Giuberti M … +1 more , Araujo Júnior E
Ceska Gynekol · 2025 · PMID 40117259 · Publisher ↗
This case report describes a case of total atrioventricular block (TAVB) with positive anti-Ro/SSA antibodies in a transgender man who began follow-up at 31 weeks and 3 days of gestation. Despite many disagreements regar...
This case report describes a case of total atrioventricular block (TAVB) with positive anti-Ro/SSA antibodies in a transgender man who began follow-up at 31 weeks and 3 days of gestation. Despite many disagreements regarding treatment, corticosteroids were recommended for this patient. The fetal ventricular rate at the second weekly visit was 50 bpm and terbulin was started to increase heart rate. Hospitalization and intravenous terbutaline for 3 days was chosen to better control maternal symptoms and monitor fetal vital signs, as well as daily monitoring of the ventricular rate. There was an increase in baseline ventricular rate of approximately 15%. After discharge from the hospital, weekly control fetal echocardiography was performed in addition to the indices proposed by Huhta for echocardiographic assessment of fetal cardiac function. Fetal ventricular rate in ambulatory controls did not fall below 55 bpm. Cesarean section was indicated at 35 weeks and 4 days of gestation due to premature rupture of ovular membranes. A male newborn was delivered weighing 2,250 grams with Apgar scores of 8 and 9 at the 1st and 5th minute, respectively. After 88 days of life, the infant was weighing 4,580 grams and a definitive bicameral epicardial pacemaker was implanted without complications. Even if there is a transient increase in fetal ventricular rate with the use of terbutaline, a pacemaker is indicated. Delivery should be at term to allow the fetus to achieve adequate weight and pulmonary maturity for definitive pacemaker implantation.
Uterine torsion during cesarean section coinciding with HELLP syndrome.
Skuhrovcová M, Sládková M, Martan S
Ceska Gynekol · 2025 · PMID 40117258 · Publisher ↗
Uterine torsion belongs to one of the most dangerous labor complications also because of its rarity. As it is not common for an obstetrician to come across this state, it is usually not at the very top of the differentia...
Uterine torsion belongs to one of the most dangerous labor complications also because of its rarity. As it is not common for an obstetrician to come across this state, it is usually not at the very top of the differential diagnostics list when solving acute child delivery complications. However, it is serious enough to pose a lethal threat to both mother and child. In this case, the term gravidity was ended by acute cesarean section because of HELLP syndrome. During the operation, as well as after a complicated delivery and hysterotomy suture uterine torsion of 120 degrees to the right, the patient was diagnosed with detorsion. The rest of the operation was done according to normal standards. Thanks to this very prompt procedure, the aftermath of the described state meant little to no harm to the mother and her child. This case study should highlight the importance of including uterine torsion into differential diagnostics of acute abdominal pain and vomiting to prevent fatal labor complications for the mother and her child.
Prenatal diagnosis of parasitic conjoined twins.
Gašparová P, Ballová Z, Sitáš M … +1 more , Dosedla E
Ceska Gynekol · 2025 · PMID 40117257 · Publisher ↗
Heteropagus or parasitic conjoined twins represent an extremely rare anomaly, occurring in approximately 1 in 1 million cases. This condition is characterized by the presence of a parasitic twin with significant congenit...
Heteropagus or parasitic conjoined twins represent an extremely rare anomaly, occurring in approximately 1 in 1 million cases. This condition is characterized by the presence of a parasitic twin with significant congenital abnormalities attached to an otherwise typically healthy fetus. The well-developed twin is known as the "autosite" or "host," while the severely affected fetus is termed the "parasite." Survival of the defective twin depends on the cardiovascular system of the second, relatively normal fetus. We present the case of a 27-year-old primigravida in her 14th week of pregnancy with ultrasound findings indicating parasitic conjoined twins, specifically omphalopagus.
Acute Sheehan's syndrome.
Dobiaš A, Klčovanská A, Dečkov I … +1 more , Hlávek R
Ceska Gynekol · 2025 · PMID 40117256 · Publisher ↗
OBJECTIVE: To present a case of a patient who developed acute Sheehan's syndrome, despite adequate estimated blood loss. CASE REPORT: Sheehan's syndrome is a relatively rare disease with various incidences, mainly due to...
OBJECTIVE: To present a case of a patient who developed acute Sheehan's syndrome, despite adequate estimated blood loss. CASE REPORT: Sheehan's syndrome is a relatively rare disease with various incidences, mainly due to different obstetric care factors in individual countries. Pathogenetic mechanisms are not fully understood. An important factor is reduced blood flow through the pituitary arteries caused by hypotension in the setting of postpartum hemorrhage. Subsequent clinical manifestations depend on the extent of damage to the pituitary gland, and consequently, on the loss of individual hormones, the secretion of which is controlled by the pituitary gland. Most patients are diagnosed years later. Our case describes a patient with Sheehan's syndrome that developed in the early postpartum period. The patient was successfully diagnosed and adequate replacement therapy was started. CONCLUSION: In summary, acute Sheehan's syndrome is a rare occurrence. Agalactia, amenorrhea, fatigue, and other non-specific symptoms should be considered despite its rarity.
Vascular endothelial growth factor D potential predictor and screening marker in ovarian carcinoma.
Náležinská M, Chovanec J
Ceska Gynekol · 2025 · PMID 40117255 · Publisher ↗
INTRODUCTION: Until now, it is still true that late detection of ovarian cancer is a major cause of its poor prognosis. So far, no sufficiently sensitive and specific marker or combination of markers and imaging methods...
INTRODUCTION: Until now, it is still true that late detection of ovarian cancer is a major cause of its poor prognosis. So far, no sufficiently sensitive and specific marker or combination of markers and imaging methods has been identified that would unambiguously allow the detection of early potentially highly-curable stages and furthermore prebioptically differentiate a group of poorly distinguishable benign lesions from malignant tumours on ultrasound. In a retrospective study design, serum levels of vascular endothelial growth factor D (VEGF-D) were investigated. VEGF-D is related to tumour-induced angiogenesis, lymphangiogenesis, and vascular remodelling with the effect of facilitating metastasis and improved oxygen and nutrient distribution into tumour tissue. On the other hand, the lymphatic network serves as a barrier against tumour dissemination and is a transport system for immune-active elements in suppressing tumorigenesis. The aim of this study was to investigate that there is a difference in serum VEGF-D levels in a group of patients with malignant tumours, benign ovarian lesions, and healthy controls without pathological findings in the adnexa. METHODS: 162 sera collected preoperatively and preserved by a freezing process in a biobank in 2022-2023 were retrospectively evaluated. The test set was stratified on the basis of histopathological results of the adnexal examination into the malignant tumour group (N = 54), benign lesion group (N = 47), and healthy control group (N = 61). Descriptive statistical analysis methods were used for the statistical evaluation of the parameters. Nonparametric tests were used to compare serum VEGF-D levels. All analyses were considered at a significance level of 5%. Serum VEGF-D was analysed by ELISA Quantikine® Human VEGF D R&D Systems and values were read spectrophotometrically on a TECAN reader. RESULTS: The result of the comparison of descriptive statistical parameters was statistically significant (P = 0.00067) for the difference between serum VEGF-D levels in the set of benign lesions and malignant tumours. Furthermore, there was a statistically significant difference between the values of patients with malignant tumours and healthy controls (P = 0.0008). No statistically significant difference was found between the values of patients with benign lesions and healthy controls (P = 0.4308). Compared to the conventional marker CA125, pathologically elevated serum CA125 levels correlated with low serum VEGF-D levels in patients with malignant tumours. The same concordance was observed in comparison with the HE4 marker: high serum HE4 levels were accompanied by low VEGF-D levels in the group of patients with malignant tumours; moreover, the dot plot clearly stratified the group of patients with malignant tumours from the group of benign lesions and healthy controls. CONCLUSION: In view of the results obtained, the investigation of serum VEGF-D levels has the potential of a diagnostic test with a contribution to the stratification of the difficult of prebioptically differentiating adnexal tumours.
Infertility stress and coping strategies in women and men undergoing in vitro fertilization treatment.
Ďurašková G, Hampl R, Dostál D
Ceska Gynekol · 2025 · PMID 40117254 · Publisher ↗
AIM: To describe coping strategies and infertility stress in men and women undergoing in vitro fertilization (IVF) treatment. To determine whether there are differences in coping strategies between men and women and to i...
AIM: To describe coping strategies and infertility stress in men and women undergoing in vitro fertilization (IVF) treatment. To determine whether there are differences in coping strategies between men and women and to identify adaptive and non-adaptive coping strategies for infertility. MATERIALS AND METHODS: A correlational study, where 162 patients (99 women and 63 men) with primary infertility undergoing IVF treatment at Sanus Pardubice completed the Fertility Problem Inventory and COPE Inventory psychological questionnaires. RESULTS: There were no significant differences between women and men in experiencing infertility stress. The coping strategies used most frequently by both men and women were Positive Reinterpretation, Planning, and Acceptance; men used the strategies Restraint, Suppression, and Planning significantly more frequently than women; and women used the strategies Using Emotional Social Support and Religious Coping significantly more frequently than men. For both women and men, level of Global infertility stress significantly correlated with Denial in the positive direction and with Positive Reinterpretation and Acceptance in the negative direction. CONCLUSION: Involuntarily childless women and men in IVF treatment experience similar infertility stress, but use slightly different coping strategies. For both men and women, Positive Reinterpretation and Acceptance emerged as adaptive strategies, while Denial emerged as non-adaptive.
Clinical significance of quantification and immunophenotyping of uterine NK cells in the diagnosis and treatment of infertility.
Černá K, Otevřel P, Luxová Š … +1 more , Sedláčková L
Ceska Gynekol · 2025 · PMID 40117253 · Publisher ↗
INTRODUCTION AND OBJECTIVE: Uterine NK (uNK) cells, a specialized subpopulation of natural killer (NK) lymphocytes located in the endometrium, play a crucial role in regulating the immune response and in the process of e...
INTRODUCTION AND OBJECTIVE: Uterine NK (uNK) cells, a specialized subpopulation of natural killer (NK) lymphocytes located in the endometrium, play a crucial role in regulating the immune response and in the process of embryo implantation. This study aims to retrospectively analyze the outcomes of in vitro fertilization (IVF) treatment in a cohort of women who underwent uNK cell immunophenotyping with subsequent immunomodulatory therapy applied based on the results. METHODS: The study included 122 patients who underwent uNK cell immunophenotyping between April and December 2023. Immunophenotyping was performed using flow cytometry. Patients were categorized into four groups according to their uNK cell phenotypes: normal findings, low absolute and relative numbers of uNK cells (LOW-IMMUNE profile), low numbers of uNK cells combined with the shift towards the cytotoxic uNKc dim immunophenotype (MIXED-IMMUNE profile), and normal numbers of uNK cells, but an undesirable shift in the ratio of cytotoxic to regulatory uNK cells towards the cytotoxic uNK dim phenotype (OVER-IMMUNE profile). Embryo transfer outcomes and the occurrence of miscarriages up to the 12th week of pregnancy were evaluated in each group. RESULTS: The highest clinical pregnancy rate was observed in the treated OVER-IMMUNE group (70%), fol lowed by the MIXED-IMMUNE group (60%). The LOW-IMMUNE group did not differ significantly from the untreated NORMAL group (P = 0.205). Insufficient immune activation (LOW-IMMUNE profile) was significantly associated with first-trimester pregnancy loss (P < 0.0001). CONCLUSION: This study provides new insights into the potential benefits of uNK cell immunophenotyping and subsequent immunomodulatory therapy in treating fertility disorders. While the results indicate possible clinical advantages, further research is necessary to confirm these findings and elucidate the mechanisms leading to improved outcomes in assisted reproductive techniques.
Estrogenic treatment and liver functions.
Slíva J
Ceska Gynekol · 2024 · PMID 39800550 · Publisher ↗
Estrogens are key hormones that play a vital role in the physiology of the reproductive system in women. However, their therapeutic use in hormonal treatment, contraception, and the treatment of hormone-dependent disease...
Estrogens are key hormones that play a vital role in the physiology of the reproductive system in women. However, their therapeutic use in hormonal treatment, contraception, and the treatment of hormone-dependent diseases may be associated with a number of side effects, especially on the liver. This article focuses on the mechanisms of action of estrogens and their potential hepatotoxic effects, as well as risk factors and possible differences between representatives.
Pudendal neuralgia and imaging methods.
Duchoňová T, Fučík T, Dvořák J … +4 more , Tintěra J, Kautznerová D, Švabík K, Mašata J
Ceska Gynekol · 2024 · PMID 39800549 · Publisher ↗
OBJECTIVE: To create a comprehensive overview of imaging methods for diagnosing pudendal neuralgia. METHODOLOGY: Literature review. CONCLUSION: Pudendal neuralgia is a chronic pain condition that is difficult to diagnose...
OBJECTIVE: To create a comprehensive overview of imaging methods for diagnosing pudendal neuralgia. METHODOLOGY: Literature review. CONCLUSION: Pudendal neuralgia is a chronic pain condition that is difficult to diagnose. On average, it takes 5 years from the onset of symptoms to the correct diagnosis. Diagnosis is based on symptoms described by the patient, neuropelveological physical examination, and presence of the 5 Nantes criteria. Imaging methods, especially ultrasound and magnetic resonance imaging of the pudendal nerve, show great promise for a more accurate and faster diagnosis. These methods can assist in diagnosing issues and excluding other pathologies that may cause symptoms.
Gynecological aspects that may affect the risk of preterm birth and the success of embryo transfers after uterus transplantation.
Chmel R, Nováčková M, Pastor Z
Ceska Gynekol · 2024 · PMID 39800548 · Publisher ↗
Absolute uterine factor infertility is conditioned by the congenital or acquired absence of the uterus or the presence of a nonfunctioning uterus in women who wish to become biological mothers. Uterine transplantation al...
Absolute uterine factor infertility is conditioned by the congenital or acquired absence of the uterus or the presence of a nonfunctioning uterus in women who wish to become biological mothers. Uterine transplantation along with assisted reproductive techniques can provide this option for women without a uterus. In the early research period, to minimize the risk of preterm birth and other pregnancy-related complications, the uterus of a donor with a history of one to three successfully completed pregnancies was recommended for transplantation. We believe that insisting on a singleton pregnancy is necessary to reduce the risk of premature birth in uterus recipients, rather than insisting on donating a uterus from a woman with a history of at least one birth. Mild post-transplant narrowing of the vaginal-neovaginal anastomosis was expected; however, the first severe vaginal stricture revealed soon after transplantation was an unpleasant surprise. To prevent post-transplant vaginal stricture, gynecologic surgeons should evaluate the shape and size of the donor's cervix, compare it with the size of the recipient's neovagina and vaginal vault, and perform a vaginal-neovaginal anastomosis to ensure free access for post-transplant cervical biopsies to reveal signs of subclinical rejection and smooth insertion of the embryo transfer catheter into the uterine cavity.
Malignant transformation of extragenital endometriosis.
Hruda M, Robová H, Sehnal B … +6 more , Babková A, Pichlík T, Drozenová J, Malíková H, Halaška MJ, Rob L
Ceska Gynekol · 2024 · PMID 39800547 · Publisher ↗
Endometriosis is a chronic disease characterised by the presence of endometrial tissue outside the uterine cavity, affecting 5-15% of women, especially those of reproductive age. The disease may manifest itself as dysmen...
Endometriosis is a chronic disease characterised by the presence of endometrial tissue outside the uterine cavity, affecting 5-15% of women, especially those of reproductive age. The disease may manifest itself as dysmenorrhoea, dyspareunia, sterility and chronic pelvic pain, among other symptoms. Although it is not malignant, it shares some characteristics with cancer and can lead to epithelial ovarian carcinoma. The risk of malignant transformation of endometriosis is estimated at 1% in premenopausal women and 1-2.5% in postmenopausal women. Our case report describes a 46-year-old female patient with long-standing abdominal pain and a history of surgically confirmed endometriosis. Imaging revealed a cystic mass in the left mesogastrium, which was subsequently surgically removed. Histological examination confirmed the presence of a low-grade endometrioid carcinoma arising from an extragenital endometriosis lesion. Following surgical treatment, the patient underwent adjuvant chemotherapy, after which she was in complete remission. The diagnosis of malignant transformation of endometriosis is complex, requiring a combination of thorough clinical examination, imaging, and histopathological verification. Therapy involves radical surgery and possibly adjuvant chemotherapy, similar to ovarian carcinomas. Despite advances in treatment and research, endometriosis remains a complex disease with unclear aetiology, heterogeneous clinical presentation, and risk of malignant transformation.
Type I congenital vaginal atresia with multiple organ malformations.
Luo C, Niu X, Mei L … +1 more , Chen Y
Ceska Gynekol · 2024 · PMID 39800546 · Publisher ↗
BACKGROUND: Vaginal atresia (VA) is a rare female genital tract malformation characterized by the absence or incomplete development of the vagina, often leading to cyclic abdominal pain and menstrual blood retention in a...
BACKGROUND: Vaginal atresia (VA) is a rare female genital tract malformation characterized by the absence or incomplete development of the vagina, often leading to cyclic abdominal pain and menstrual blood retention in adolescent patients. Vaginal atresia is often accompanied by multiple organ malformations. The condition poses significant challenges in diagnosis and management, requiring a multidisciplinary approach. CASE DESCRIPTION: Herein, we report a case of type I congenital VA in a 13-year-old female presenting with congenital biliary atresia and urinary system malformation. Upon initial evaluation, the patient exhibited VA incision and laparoscopic excision of a left ovarian cyst under general anesthesia. By the 2-month follow-up, the patient reported normal menstrual flow without accompanying abdominal pain. CONCLUSION: This case underscores the complexity of type I congenital VA concurrent with multiple organ malformations. Timely identification and proper management strategies are crucial for securing the best possible patient outcomes. Further research is warranted to elucidate the underlying mechanisms and improve treatment modalities for such cases.
Hydrops of a fetus of unknown etiology with the development of severe intracranial hemorrhage.
Brandejsová A, Heřman H, Hanulíková P … +4 more , Hašlík L, Regendová A, Krofta L, Feyereisel L
Ceska Gynekol · 2024 · PMID 39800545 · Publisher ↗
Prenatally diagnosed intracranial hemorrhage in the fetus is associated with a wide range of neonatal disorders, from completely uncomplicated physiological development to severe neurological impairment or death. The inc...
Prenatally diagnosed intracranial hemorrhage in the fetus is associated with a wide range of neonatal disorders, from completely uncomplicated physiological development to severe neurological impairment or death. The incidence is 0.6-1/1,000 births. Intracranial hemorrhage, depending on the anatomical location, is classified as intraventricular, intracerebral, cerebral, subarachnoid, and subdural. In this case report, we describe a rare case of spontaneous intracranial hemorrhage in a fetus monitored for hydrops and pregnancy complicated by polyhydramnios. A literature research was carried out. In the discussion, we present the diagnostic algorithm and the results of the examinations performed. To complete the case report, we add information about the management of childbirth and early death of the newborn.
Meiotic spindle as a marker of optimal time for oocyte vitrification - presentation of successful infertility treatment and literature review.
Mašata J, Teplá O, Jirsová S … +4 more , Pšeničková A, Moosová M, Fajmonová E, Kratochvílová I
Ceska Gynekol · 2024 · PMID 39800544 · Publisher ↗
AIM: Within the in vitro fertilization (IVF) process, to evaluate the possibility of using the state of the meiotic spindle of oocytes as an indicator of maturity in order to optimize the timing of vitrification. PATIENT...
AIM: Within the in vitro fertilization (IVF) process, to evaluate the possibility of using the state of the meiotic spindle of oocytes as an indicator of maturity in order to optimize the timing of vitrification. PATIENTS AND METHODS: In the presented report, the cause of couple infertility was a combination of a 38-year-old female and 43-year-old male with azoospermia, which was an indication for oocyte vitrification. Oocyte polar bodies and optically birefringent meiotic spindles were visualized by polarized light microscopy and their states and relative positions were used as indicators of oocyte maturation, i.e. readiness for vitrification. Oocytes which had an angle between the polar body and meiotic spindle a ≤ 30° or had a poorly visible meiotic spindle were vitrified 4 hours post-meiotic spindle evaluation (8 hours after ovum pick-up). RESULTS: After thawing, oocytes were fully maturated and prepared for intracytoplasmic sperm injection (ICSI). Following treatment with tamoxifen, vital sperm were retrieved from the patient's partner, the oocytes were thawed and fertilized with the obtained sperm, with subsequent embryo transfer and delivery of a healthy baby at term. CONCLUSION: The meiotic spindle can be used as an oocyte maturation pointer in older women. After thawing, the oocytes were fully matured and ready for fertilization by ICSI.
Comparing highly purified human menopausal gonadotropin and recombinant follicle stimulating hormone in poor ovarian reserve patients undergoing intracytoplasmic sperm injection.
Korucu DG, Akgun H, Tutar MS … +2 more , Doğru S, Gunenc O
Ceska Gynekol · 2024 · PMID 39800543 · Publisher ↗
OBJECTIVE: We aimed to compare highly purified human menopausal gonadotropin (hp-hMG) and recombinant follicle stimulating hormone (rFSH) in short antagonist in vitro fertilization (IVF) cycles of patients with poor ovar...
OBJECTIVE: We aimed to compare highly purified human menopausal gonadotropin (hp-hMG) and recombinant follicle stimulating hormone (rFSH) in short antagonist in vitro fertilization (IVF) cycles of patients with poor ovarian reserve (POR). Limited research exists on this comparison in short antagonist cycles for this patient group. MATERIALS AND METHODS: This retrospective cohort study involved 165 POR patients aged 18-45 years who underwent IVF between 2018 and 2022. Patients were divided into two groups based on their GnRH antagonist protocol: hp-hMG (group 1 = 72) and rFSH (group 2 = 93). We compared pregnancy outcomes, number of oocytes collected, mature oocytes retrieved, mean fertilized oocytes, top quality embryos transferred, and serum estradiol (E2) and progesterone (P) levels on human chorionic gonadotropin (hCG) administration day. RESULTS: : No significant differences were found in E2 and P levels on hCG trigger day, endometrial thickness on transfer day, stimulation duration, total oocyte number, and mature oocyte number (P > 0.05). The total gonadotropin dose was significantly higher in the rFSH group (P < 0.001). The number of top-quality embryos transferred and clinical pregnancy and live birth rates did not diff er significantly between groups (P = 0.320; P = 0.310; P = 0.652; and P = 0.662, resp.). CONCLUSION: Neither hp-hMG nor rFSH showed superiority in patients with POR, indicating similar effectiveness in this population.
Pap smear and colposcopy findings in female inmates of a prison unit in the state of São Paulo, Brazil.
de Andrade FM, de Amorim Andrade SG, Araujo Júnior E … +4 more , Campaner AB, da Silva MALG, Fernandes GL, Aldrighi JM
Ceska Gynekol · 2024 · PMID 39800542 · Publisher ↗
OBJECTIVE: The objective of this study was to evaluate the Pap smear and colposcopy findings in female inmates in a prison unit in the state of São Paulo, Brazil. METHODS: A retrospective cross-sectional study was carrie...
OBJECTIVE: The objective of this study was to evaluate the Pap smear and colposcopy findings in female inmates in a prison unit in the state of São Paulo, Brazil. METHODS: A retrospective cross-sectional study was carried out by analyzing the Pap smear and colposcopy examinations of female inmates in a prison unit. The following socio-demographic data were assessed: age, nationality, level of education, marital status, height, weight, ethnicity, occupation, religion, sexual orientation, and presence of tattoos. RESULTS: The sample consisted of 894 women who had a Pap smear, the majority of whom were Brazilian (93.6%), 41.1% had an incomplete primary education, 58.5% were single, 50.1% were white, 60.7% had tattoos, and the predominant religion was Catholicism at 42.8%. Regarding sexual orientation, 124 (13.9%) women identified as bisexual, 640 (71.6%) as heterosexual, and 127 (14.2%) as homosexual. Most Pap smears showed benign findings (86.5%). Of the female inmates who had a Pap smear, 121 (13.5%) were referred for colposcopy. Altered colposcopy findings occurred in 95 (10.6%), with the most common findings being high-grade squamous intraepithelial lesions 36 (4.0%) and low-grade squamous intraepithelial lesions 27 (3.0%). The majority of women (96.0%) had no clinical signs of human papillomavirus - HPV (anogenital verrucous lesions) and only 36 (4.0%) had lesions suggestive of HPV on Pap smears. There were more HIV cases in the group with HPV verrucous lesions (P = 0.013). CONCLUSION: We observed 13.5% and 78.5% of abnormal findings in Pap smears and colposcopy, resp.), in female inmates in a prison unit in the state of São Paulo, Brazil.
Comparison of Veress needle and direct trocar technique during laparoscopic initial entry via Palmer's point.
Minareci Y, Yuvanc HO
Ceska Gynekol · 2024 · PMID 39800541 · Publisher ↗
OBJECTIVE: In laparoscopic surgery, initial entry into the abdomen becomes more risky in patients with a history of abdominal surgery. In such cases, initial entry is usually performed with a Veress needle via Palmer's p...
OBJECTIVE: In laparoscopic surgery, initial entry into the abdomen becomes more risky in patients with a history of abdominal surgery. In such cases, initial entry is usually performed with a Veress needle via Palmer's point (PP). However, it is associated with an increased failure rate, especially in obese patients. On the other hand, direct trocar entry is a convenient and safe technique with a low failed entry rate. Direct trocar entry via PP may be the preferred approach for initial abdominal entry in patients with a history of abdominopelvic surgery. MATERIALS AND METHODS: The present study included 438 patients with a previous history of abdominopelvic surgery undergoing laparoscopic gynecological surgery, during which two different entry techniques via PP were tested. RESULTS: There were 88 patients (20.1%) in the Veress needle group and 350 patients (79.9%) in the direct trocar group. The time to create a pneumoperitoneum was significantly shorter in the direct trocar group (P < 0.001). Successful entry was achieved at the initial attempt in 78 patients (88.6%) from the Veress needle group and in 347 patients (99.1%) from the direct trocar group (P = 0.012). Minor complication rates were similar in both groups. However, one major complication was observed in the direct trocar group, while no major complications were noted in the Veress needle group. CONCLUSION: Provided that the basic surgical principles are respected, direct trocar entry technique via PP is a safe, effective, and fast initial entry approach into the abdomen and may be preferred in patients with previous abdominopelvic surgery.
Investigating obstetrics and gynecology forensic cases at a tertiary health center in Turkey to demonstrate the significance of forensic evaluation.
Ateş Ç, Dilbaz B
Ceska Gynekol · 2024 · PMID 39800540 · Publisher ↗
OBJECTIVES: To assess the diagnostic rates of forensic case patients who sought gynecological and obstetrics care, as well as the differences in forensic report production based on the event. STUDY DESIGN: The following...
OBJECTIVES: To assess the diagnostic rates of forensic case patients who sought gynecological and obstetrics care, as well as the differences in forensic report production based on the event. STUDY DESIGN: The following factors were looked into: age of the patients, time between the incident and consultation, reason for consultation (pregnancy determination during the post-divorce waiting period, sexual assault, hymen examination, physical violence, other), time of the consultation (in-hours or out-of-hours), place of referral (prosecutor's office/court, police station, own request), and type of report (final or preliminary). The data were obtained retrospectively. RESULTS: When 651 forensic cases admitted to the emergency department were examined, 234 (36%), 199 (30.6%), 66 (10.6%), and 34 (5.2%) requested waiting period removal, physical assault against women, sexual assault, and hymen examination, respectively. The study revealed that 62.1% of sexual assault incidents were perpetrated by an acquaintance, 19.1% by a distant relative, and 12.1% by a first-degree family member. It was determined that the patient's partner was responsible for 63.8% of the physical violence against women, while 24.6% was committed by a first-degree relative and 6.5% was perpetrated by other acquaintances. CONCLUSION: If the legislator revises the provision on the modern legal system's waiting period, which prevents women from remarrying, judicial reports may drop rapidly. Examining cases referred to gynecologists and obstetricians in centers with forensic medicine specialists and medical staff trained in forensic medicine will ensure safer forensic examinations and medical investigations.
Risk of atrial fibrillation in endometrial cancer patients.
Münzová D, Bretová P, Pešl M … +3 more , Weinberger V, Minář L, Felsinger M
Ceska Gynekol · 2024 · PMID 39800539 · Publisher ↗
OBJECTIVE: The study aimed to define atrial fibrillation frequency in endometrial cancer patients, identify risk factors, and propose preventive steps for early detection and treatment leading to decreasing cardiovascula...
OBJECTIVE: The study aimed to define atrial fibrillation frequency in endometrial cancer patients, identify risk factors, and propose preventive steps for early detection and treatment leading to decreasing cardiovascular risk. Secondly, we aimed to highlight this topic by presenting a systematic literature review. METHODOLOGY: Retrospective analysis of endometrial cancer patients treated at the Department of Gynecology and Obstetrics at University Hospital Brno between 2006 and 2023 complemented by a systematic literature review. RESULTS: The incidence of atrial fibrillation in endometrial cancer patients in our study group (1,101 patients) was 10.4%. Overall, 27% of patients suffered from obesity, hypertension, and diabetes, 26% from both hypertension and obesity, and 10% from diabetes and obesity. The incidence of other risk factors and their combination was less than 10%. CONCLUSION: Endometrial cancer patients are at a higher risk of developing atrial fibrillation compared with the general population. The risk is enhanced by the presence of other common risk factors such as hypertension, diabetes, and obesity.
Inherited thrombophilia and risk of venous thromboembolism in females in association with contraceptive use.
Dulíček P
Ceska Gynekol · 2024 · PMID 39537381 · Publisher ↗
Venous thromboembolism is a multifactorial dis ease and major cause of morbidity and mortality. Absolute risk of venous thromboembolism is less than 1 per 10,000 per year in women of reproductive age. Hormonal contracept...
Venous thromboembolism is a multifactorial dis ease and major cause of morbidity and mortality. Absolute risk of venous thromboembolism is less than 1 per 10,000 per year in women of reproductive age. Hormonal contraception is a common risk situation for venous thromboembolism in this part of the population. The risk of venous thrombosis depends on many factors, mainly female characteristics and also the type of contraception. Hematologists can help with the choice of contraception in females with inherited thrombophilia and females experiencing thrombosis. Intrauterine devices with levonorgestrel seem to be the best option in these settings.
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