Ginekologia polska最新文献

Objectives: In this study, we aimed to investigate serum alarin levels during the 24th to 28th weeks of gestation in women with newly diagnosed gestational diabetes mellitus (GDM), and to explore the possible correlation between alarin levels and maternal and neonatal clinical outcomes.

Material and methods: A prospective cohort study including 64 women with pregnancies complicated by GDM and 64 women with healthy pregnancies (control group) was performed. Serum alarin levels were quantified using the enzyme-linked immunosorbent assay (ELISA) method, and their diagnostic utility was assessed through receiver operating characteristic (ROC) curve analysis. Furthermore, the relationships between alarin levels and various clinical parameters were statistically analysed.

Results: The mean maternal serum alarin levels were notably elevated in the GDM group compared to the control (12.3 ± 1.4 ng/mL vs 7.8 ± 0.8 ng/mL; p < 0.05). ROC curve analysis demonstrated a high discriminatory capacity, with an AUC of 0.84 (95% CI: 0.77-0.92). However, no statistically significant correlations were observed between alarin levels and obstetric or neonatal parameters, including gestational age at delivery, polyhydramnios, preterm birth, hypertensive complications, fetal growth restriction, APGAR scores and NICU admissions.

Conclusions: Our results highlight the possible role of alarin as a promising biomarker for the identification of GDM.

This review article explores the psychological dimension of gynecological disorders in girls and young women, emphasizing the need for interdisciplinary approaches in medical care. Gynecological conditions such as endometriosis, polycystic ovary syndrome (PCOS), and disorders of sex development (DSD) often co-occur with psychological challenges including depression, anxiety, body image issues, and identity-related stress. The chronic nature of symptoms, delayed diagnosis, and potential implications for fertility intensify the emotional burden, particularly during adolescence - a developmental stage crucial for self-esteem and identity formation. Psychological interventions such as cognitive-behavioral therapy (CBT), progressive muscle relaxation (PMR), mindfulness, psychoeducation, and family support are reviewed for their therapeutic potential. The integration of psychologists into gynecological teams improves communication, treatment adherence, and emotional well-being. The paper also discusses the importance of tailored communication with young patients and their families, addressing stigma, and ensuring privacy and autonomy. Incorporating psychological care into gynecological treatment contributes to a holistic model that not only addresses physical symptoms but also enhances psychological resilience, quality of life, and long-term health outcomes. The authors advocate for routine psychological screening in gynecological settings and the implementation of interdisciplinary standards of care.

Objectives: The aim of our study is to evaluate the tubal patency and pregnancy outcomes after tubal reanastomosis in patients who previously underwent tubal ligation but currently desire fertility.

Material and methods: The study encompassed patients who underwent tubal ligation between January 2015 and November 2021 and were subsequently referred to City Hospital and University Hospital for further fertility treatment. Five patients who had undergone myomectomy with tubal re-anastomosis were excluded from the study. These patients were scheduled for hysterosalpingography (HSG) two months post-operation, and their tubal patency rates were assessed. Additionally, the pregnancy rates and outcomes were analyzed.

Results: The pregnancy rate following tubal re-anastomosis was 50.2%, with a live birth rate of 44.6%. Among the patients who achieved pregnancy, 74.1% reached full term. Hysterosalpingography (HSG) revealed bilateral tubal patency in 35 patients (74.4%) and unilateral tubal patency in 12 patients (25.5%). Finally, 9 patients (15.7%) declined to undergo HSG following the procedure.

Conclusions: Should the patients seeking pregnancy have normal gynecological examinations, ultrasound results, hormone profiles, comorbidity screenings, and a normal spermiogram of the husband, tubal re-anastomosis should be considered, particularly in patients under 40 years of age.

Objectives: Breasts play a significant role in body image and are perceived as a symbol of femininity and sexuality, which makes a cancer diagnosis particularly difficult on an emotional level. Subjective experiences of depression significantly and negatively affect the sexual lives of patients who have undergone mastectomy, thereby reducing their quality of life by influencing physical, social, and emotional aspects.

Material and methods: The study was conducted among 151 women diagnosed with breast cancer and took place from September 2025 to January 2026. The diagnostic survey method was employed, along with the following research tools: Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI), Perceived Stress Scale (PSS-10), the Coping Inventory-Mini-COPE, and self-administered questionnaire.

Results: Among the studied group of patients, 47% reported a subjective feeling of depression, and 68.2% were observed to have sexual dysfunction. The FSFI scale domains correlated significantly negatively with the PSS-10 and Beck Depression Scale. The total FSFI score correlated significantly positively with the Mini-COPE scale. Only one domain, namely self-blame, correlated significantly negatively. Factors influencing sexual dysfunction included the type of treatment (immunotherapy), depressive factors, and the coping strategy of self-blame.

Conclusions: The Female Sexual Function Index (FSFI) showed a negative correlation with both PPS-10 and BDI. Among the coping strategies assessed by the Mini-Cope, only one domain negatively correlated with total FSFI. Mental state and the type of treatment were significant factors influencing sexual dysfunction in women with breast cancer treated surgically.

Objectives: To prospectively assess the association between pre-gestational (BMI), sonographically measured abdominal subcutaneous fat thickness (ASFT), and the total daily insulin dose required to achieve optimal glycemic control in patients diagnosed with gestational diabetes mellitus (GDM).

Material and methods: This prospective, multicenter study included 91 pregnant women with GDM who required insulin therapy, recruited from two tertiary care centers. Demographic data, anthropometric measurements (BMI, ASFT), and laboratory parameters [oral glucose tolerance test (OGTT), HbA1c] were collected. ASFT was measured at the level of the umbilicus using a standardized ultrasound protocol. The relationships between total daily insulin dose, BMI, and ASFT were evaluated using correlation analysis. Statistical analyses were conducted using IBM SPSS Statistics 25.0, with a significance threshold of p < 0.05.

Results: The mean age of the participants was 31.84 ± 6.22 years. The average BMI was 31.81 ± 5.08 kg/m², and the mean ASFT was 19.36 ± 7.77 mm. The mean total daily insulin dose required to maintain glycemic control was 26.20 ± 14.35 units. Correlation analysis demonstrated a statistically significant positive relationship between the total daily insulin dose and both ASFT (r = 0.294, p < 0.01) and BMI. In addition, ASFT was positively correlated with fasting glucose levels on the OGTT (r = 0.329, p < 0.01) and HbA1c values (r = 0.313, p < 0.01).

Conclusions: Elevated BMI and increased abdominal subcutaneous fat thickness are significantly associated with higher daily insulin requirements in GDM. Abdominal subcutaneous fat thickness, as a non-invasive, readily accessible, and objective ultrasound marker, is a valuable adjunct to BMI for predicting insulin needs in GDM management.

Objectives: This study aimed to compare the effects of traditional childbirth (TC), water birth (WB) and the combination of WB and five-element music therapy (FEMT) on maternal childbirth experiences and clinical outcomes.

Material and methods: A total of 314 women who delivered at our hospital between November 2022 to June 2023 were enrolled and divided into three groups: the TC group (n = 126), the WB group (n = 95) and the WB-FEMT group (n = 93), which included labour pain relief through FEMT and WB. Data were collected, compared and analysed, including labour duration, first-stage labour pain duration, postpartum blood loss, neonatal Apgar scores, scores on the Labour Agentry Scale (LAS) and scores on the Childbirth Experience Questionnaire (CEQ2.0).

Results: The first-stage labour duration and overall labour duration were significantly shorter in the WB and WB-FEMT groups than in the TC group (p < 0.001, respectively). Pain scores in the WB-FEMT group were significantly lower than in the WB and TC groups, and postpartum blood loss was significantly less than that in the TC group (p = 0.007). The WB-FEMT group showed the highest neonatal Apgar score (p < 0.001). Moreover, maternal satisfaction with the childbirth experience in the WB-FEMT group was higher, with significantly better LAS and CEQ2.0 scores than in the TC group (p < 0.001, respectively).

Conclusions: The study demonstrates that WB and WB-FEMT are superior to TC in labour duration, pain management and postpartum recovery. The WB-FEMT combination significantly enhanced maternal psychological comfort. Offering diverse childbirth options can better meet the physiological and psychological needs of mothers, ultimately promoting the health of both mothers and newborns.

Objectives: This study aimed to evaluate the impact of cleavage stage embryo ratings on pregnancy outcomes following frozen embryo transfer (FET) and their correlation with blastocyst grades.

Material and methods: A retrospective cohort study was conducted on 854 FET cycles from January 2018 to August 2024. Participants were women undergoing FET with cryopreserved embryos. Exclusion criteria included multiple initial in vitro fertilization (IVF) attempts, advanced age, chromosomal abnormalities, and uterine anomalies. Embryo quality was assessed at the cleavage and blastocyst stages, and FET protocols were tailored to each patient. The primary outcome was clinical pregnancy rate, defined by ultrasound-detected fetal heartbeat. Data was analyzed using SPSS 19.0, with logistic regression to adjust for confounders.

Results: The overall pregnancy rate was 53.98% (461/854). Significant differences in pregnancy rates were observed among blastocyst grades, with Grade 1 achieving the highest rate (60.37%). Lower cleavage stage embryo grades (Grade 3 and Grade 4) were associated with reduced pregnancy odds (OR = 0.63 and OR = 0.50, respectively, p < 0.05). Other factors influencing pregnancy outcomes included female age and anti-müllerian hormone (AMH) levels. The study underscores the importance of cleavage stage embryo ratings, particularly for Grade 2 embryos, in the context of FET procedures using ovulation induction cycle (OIC) and intracytoplasmic sperm injection (ICSI).

Conclusions: Cleavage stage embryo ratings significantly affect pregnancy outcomes following FET. Higher ratings correlate with better pregnancy rates, highlighting the importance of comprehensive embryo quality assessment.

Objectives: Hysterectomy is the most performed gynecological surgery and one of the most frequent operations worldwide. Although approximately 90% of hysterectomies are performed for non-oncological indications, several surgical approaches are available, including abdominal, laparoscopic, vaginal, robotic-assisted, and vNOTES techniques. With the rapid evolution of minimally invasive procedures, it is crucial to extend their application to hysterectomy, offering patients faster recovery and earlier return to daily activities. To evaluate temporal trends in surgical approaches to hysterectomy in a reference gynecologic center in Poland, with a particular focus on the adoption of minimally invasive techniques.

Material and methods: We retrospectively analyzed hysterectomies performed for non-oncological indications between 2014 and 2024. Different surgical approaches to uterine removal were compared, and temporal trends in the proportion of minimally invasive procedures were assessed.

Results: Over the 10-year study period, 2,421 hysterectomies were performed. The proportion of minimally invasive procedures increased markedly from 23.5% in 2014 to 70.8% in 2024. The Cochran-Armitage trend test confirmed a statistically significant upward trend in the adoption of minimally invasive techniques (Z = 12.22, p < 0.001). Log-linear modeling showed an annual percent change of 9.0% (95% CI 4.9-13.3%) toward increased use of minimally invasive surgical procedures.

Conclusions: The past decade has witnessed a paradigm shift in the surgical management of hysterectomy in our center, with minimally invasive techniques becoming the standard of care. This transition has provided significant benefits, underscoring the importance of further promoting minimally invasive surgery in gynecology.