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1.
Turk J Obstet Gynecol ; 21(2): 91-97, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38853484

RESUMO

Objective: This study explored the relationship between reduced ovarian reserve and the psychological state of infertile women. Materials and Methods: This cross-sectional, single-center study was conducted with 106 infertile women. The Beck Depression Inventory (BDI) was used to assess patients' propensity for depression. The data relating to infertility, such as causes of infertility, type of infertility (primary or secondary), duration of infertility, and treatment status [previous assisted reproductive technologies (ART) treatment and ART treatment failure] were recorded for each patient. The ovarian reserve was determined using laboratory tests [anti-Mullerian hormone (AMH); follicle-stimulating hormone (FSH)] and transvaginal ultrasonography to measure the antral follicle count (AFC) in each ovary. Results: There was no significant relationship between the total score obtained from the Beck depression scale and AFC, AMH, thyroid-stimulating hormone, FSH, estradiol, and prolactin measurements (p>0.05). There was no significant difference between the groups regarding depression levels based on the cause of infertility (p=0.412). Additionally, the type of infertility (primary, secondary) did not differ between the groups (p=0.586). There were no differences on the BDI scale regarding the level of depression between patients who underwent in vitro fertilization (IVF) treatment (history of previous IVF treatment failure) and those who did not. Conclusion: There was no significant association between AFC and AMH levels and the depression state of infertile patients.

2.
Rev Assoc Med Bras (1992) ; 69(4): e20221455, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37075369

RESUMO

OBJECTIVE: This study aimed to evaluate the effectiveness of skin appearance, striae gravidarum severity, and ultrasonographic "sliding sign" in predicting preoperative adhesions before repeat cesarean section delivery on the same patient and find the most useful one. METHODS: This was a prospective cohort study conducted on pregnant women with a history of cesarean section delivery. Davey's scoring system was used for stria evaluation. The scar was assessed using their visual appearance, and transabdominal ultrasonography was applied to detect sliding sign existence. Surgeons blinded to preoperative assessment graded the severity of intra-abdominal adhesions intraoperatively using Nair's scoring system. RESULTS: Of the 164 pregnant women with at least one previous cesarean section delivery, 73 (44.5%) had filmy or dense intra-abdominal adhesions. Statistically significant association was found between three groups regarding parity, previous cesarean number, scar appearance, total stria score, and sliding sign existence. Negative sliding sign had a likelihood ratio of 4.198 (95%CI 1.178-14.964) for the detection of intra-abdominal adhesions. Stria score and scar appearance were also valuable for detection adhesions with likelihood ratios of 1.518 (95%CI 1.045-2.205) and 2.405 (95%CI 0.851-6.796), respectively. After receiver operator characteristics curve analysis, striae score cutoff value in adhesion prediction was determined as 3.5. CONCLUSION: Stria score, scar appearance, and sliding sign are all significant predictors for intraperitoneal adhesions, and sliding sign, as an easy-to-apply, inexpensive, useful sonographic marker, is the most effective adhesion predictor before repeat cesarean section delivery compared to other known adhesion markers.


Assuntos
Cesárea , Cicatriz , Gravidez , Feminino , Humanos , Cesárea/efeitos adversos , Cicatriz/diagnóstico por imagem , Recesariana , Estudos Prospectivos , Aderências Teciduais/diagnóstico por imagem
3.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 69(4): e20221455, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1431222

RESUMO

SUMMARY OBJECTIVE: This study aimed to evaluate the effectiveness of skin appearance, striae gravidarum severity, and ultrasonographic "sliding sign" in predicting preoperative adhesions before repeat cesarean section delivery on the same patient and find the most useful one. METHODS: This was a prospective cohort study conducted on pregnant women with a history of cesarean section delivery. Davey's scoring system was used for stria evaluation. The scar was assessed using their visual appearance, and transabdominal ultrasonography was applied to detect sliding sign existence. Surgeons blinded to preoperative assessment graded the severity of intra-abdominal adhesions intraoperatively using Nair's scoring system. RESULTS: Of the 164 pregnant women with at least one previous cesarean section delivery, 73 (44.5%) had filmy or dense intra-abdominal adhesions. Statistically significant association was found between three groups regarding parity, previous cesarean number, scar appearance, total stria score, and sliding sign existence. Negative sliding sign had a likelihood ratio of 4.198 (95%CI 1.178-14.964) for the detection of intra-abdominal adhesions. Stria score and scar appearance were also valuable for detection adhesions with likelihood ratios of 1.518 (95%CI 1.045-2.205) and 2.405 (95%CI 0.851-6.796), respectively. After receiver operator characteristics curve analysis, striae score cutoff value in adhesion prediction was determined as 3.5. CONCLUSION: Stria score, scar appearance, and sliding sign are all significant predictors for intraperitoneal adhesions, and sliding sign, as an easy-to-apply, inexpensive, useful sonographic marker, is the most effective adhesion predictor before repeat cesarean section delivery compared to other known adhesion markers.

4.
J Obstet Gynaecol Res ; 48(6): 1348-1354, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35304802

RESUMO

AIM: This study aimed to evaluate the difference in fetal thymus diameter, which we measured ultrasonographically, between the healthy pregnant group and the pregnant group with gestational diabetes. METHOD: Fetal thymus and thymus/thorax ratio parameters were assessed in this case-control study. Patients were examined in two groups. They included 49 diabetics (study group) women and 71 nondiabetic (control group). We performed a binary logistic regression analysis to determine the predictive value of ultrasonographic measurements. We completed the receiver curve characteristic analysis to evaluate the cut-off thymus diameter. RESULTS: The median age of pregnant women was 27. Thymus diameter and thymus-thorax ratio were smaller in fetuses of diabetic mothers than in the nondiabetic group (p <0.05). Thymus diameter was found to be more predictive of gestational diabetes prediction (p: 0.019). There was no correlation between fasting blood glucose and thymus diameter. CONCLUSION: Decreased fetal thymus anterior-posterior diameter seems to be associated with diabetic pregnancy.


Assuntos
Diabetes Gestacional , Estudos de Casos e Controles , Diabetes Gestacional/diagnóstico por imagem , Feminino , Feto , Idade Gestacional , Humanos , Gravidez , Ultrassonografia Pré-Natal
5.
J Obstet Gynaecol Res ; 48(1): 94-102, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34655258

RESUMO

AIM: To investigate whether increased fetal adiposity diagnosed ultrasonographical is associated with labor dystocia, and increased risk of operative delivery. METHOD: This was a prospective study and included 400 pregnant women between 37 and 41 weeks of gestation. In addition to standard ultrasonographic measurements, we evaluated fetal soft tissue thickness before delivery. We also recorded data on delivery method, shoulder dystocia, fetal birthweight and labor duration. We considered the period between 6 and 10 cm cervical opening as the active phase, and the period from full dilation to birth as the second stage. RESULTS: While the vaginal delivery rate was 77.3%, a cesarean was performed in 22.7% of pregnant women. We found a positive correlation between fetal adipose tissue components and durations of the active phase and second-stage labor and the baby's birthweight. Also, we examined and determined that cesarean section and labor dystocia increased as the fetus adipose tissue thickness increased. We investigated the effect of parameters on the study results with logistic regression analysis and possible threshold values with receiver operating characteristics analysis. CONCLUSION: Our study evaluated the fetal adipose tissue complex during delivery was significant in terms of labor dystocia and operative delivery. We think it may be a guide for future studies in the literature.


Assuntos
Cesárea , Distocia , Tecido Adiposo/diagnóstico por imagem , Distocia/diagnóstico por imagem , Feminino , Feto , Humanos , Gravidez , Estudos Prospectivos
6.
J Coll Physicians Surg Pak ; 31(9): 1046-1050, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34500519

RESUMO

OBJECTIVE: To investigate the relationship of beta-hCG changes between the first, fourth and seventh days as a predictor of the additional dose requirement in single-dose methotrexate protocol in tubal ectopic pregnancy. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Obstetrics and Gynecology, Bursa Yüksek Ihtisas Training and Research Hospital, between January 2017 and June 2020. METHODOLOGY: Data of 123 patients with tubal ectopic pregnancy, treated with a single-dose methotrexate protocol, were retrospectively analysed. Patients who received methotrexate on the first day and achieved treatment success constituted one group. Patients who received additional doses on the seventh day and achieved treatment success, constituted the other group. Treatment success was defined as normalisation of beta-hCG levels without surgical intervention. RESULTS: The percentage of beta-hCG change between day-one and day-four was a significant independent variable for the additional dose treatment requirement (OR:1.07, CI:1.01-1.13, p=0.022). The cut-off value of the beta-hCG change percentage between the first and fourth day, was calculated as 4% (sensitivity 72.9%, specificity 78.9%, positive predictive value [PPV] 88.6%, negative predictive value [NPV] 56.6%). CONCLUSION: In the single-dose methotrexate protocol applied in the medical treatment of tubal ectopic pregnancy, the change in beta-hCG value between the first and fourth days may predict the need for additional doses. Administration of an additional dose of methotrexate on the fourth day may be considered, if there is less than a 4% decrease or any increase in beta-hCG value between the first and fourth days. Key Words: Ectopic pregnancy, Methotrexate, Beta human chorionic gonadotropin, Tubal pregnancy, Single-dose protocol.


Assuntos
Metotrexato/uso terapêutico , Gravidez Ectópica , Gravidez Tubária , Gonadotropina Coriônica Humana Subunidade beta , Feminino , Humanos , Metotrexato/administração & dosagem , Gravidez , Gravidez Ectópica/tratamento farmacológico , Gravidez Tubária/tratamento farmacológico , Estudos Retrospectivos
7.
J Matern Fetal Neonatal Med ; 34(22): 3782-3789, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34225532

RESUMO

INTRODUCTION: One of the approaches to diagnose Gestational Diabetes Mellitus (GDM) is to detect two or more elevated values in 3-h Glucose Tolerance Test (OGTT) after an abnormal 50 gr Glucose Challenge Test (GCT). Patients with single elevated OGTT generally postulated as healthy; however, these patients could experience adverse perinatal and maternal issues more frequently. We aimed to investigate the maternal and neonatal outcomes of women with single abnormal OGTT primarily by comparing these women with healthy controls and GDM patients. Secondarily; Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) which were defined as novel inflammatory markers recently, were evaluated among these women within the first trimester and before delivery values whether these markers could use as a predictive marker of GDM. MATERIALS AND METHODS: A retrospective cohort study was achieved in Bursa Yuksek Ihtisas Education and Training Hospital between January 2016 and April 2020. Patients who had GCT and OGTT at 24th-28th weeks of gestation were reviewed. Patients with GDM, women with single elevated OGTT value, and women with normal OCT values were recruited at the study as groups 1, 2, and 3 respectively. Maternal-neonatal outcomes and postpartum complications were reviewed from hospital registry system. Each complication were accumulated in a group entitled peripartum complication (a patient who had more than 1 complication for example preeclampsia and acute fetal distress was added in the peripartum complication group as one patient).The novel inflammatory markers were evaluated as NLR and PLR, and thrombocyte parameters as MPV and PDW were compared within the groups, and between the groups individually in the time period of first trimester and before delivery. RESULTS: A total of 10,579 patients were screened with OCT, of these a total of 1718 patients' results were between 140 mg/dl and 199 mg/dl. The numbers of the women who diagnosed GDM and who had single elevated OGTT were 508 and 469 respectively. Numbers of the patients who gave birth in our hospital and whose data were reviewed adequately were 464 in groups 1, 406 in group 2, and 768 in group 3.Patients with single elevated OGTT had increased rates of peripartum complication, acute fetal distress (AFD), IUGR, preterm delivery, cesarean delivery rate, macrosomia, labor arrest, blood component transfusion, post-partum complication and stillbirth than healthy controls. Statistical analysis of comparison between group 2 and 3 has revealed that; patients with single elevated OGTT had more peripartum complication (p = .032; odds ratio [OR] = 1.2, 95% CI: 1.02-1.54), had more babies with macrosomia (p < .001; [OR] = 1.7, 95% CI: 1.2-2.4), had more postpartum complication (p = .040; [OR] = 3, 95% CI: 0.997-9.1), and had higher cesarean rates (p < .001; [OR] = 1.29, 95% CI: 1.1-1.4).Evaluating the first trimester CBC parameters between groups; only PLR differed statistically significant in GDM patients. These parameters before delivery were also analyzed PLR and NLR values did not differ between all groups, on the other hand; MPV values were higher and PDW values were lower in healthy controls comparing GDM and single elevated OGTT group. CONCLUSION: Patients with single elevated OGTT had a higher risk of maternal and neonatal consequences than women with normal OCT, which was comparable levels to patients with GDM. These patients should not be underestimated and could be classified as an individual diagnose such as "Borderline GDM." To intervene in these patients with dietary advice and lifestyle changes like exercise could decrease neonatal and maternal adverse outcomes.


Assuntos
Diabetes Gestacional , Glicemia , Diabetes Gestacional/diagnóstico , Feminino , Macrossomia Fetal , Teste de Tolerância a Glucose , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos
8.
Eur J Obstet Gynecol Reprod Biol ; 258: 253-257, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33482459

RESUMO

INTRODUCTION: We aimed to identify factors that would predict the success of antibiotic treatment and the need for surgical treatment in tubo-ovarian abscess (TOA) patients. MATERIALS AND METHODS: The data of 146 patients with a diagnosis of TOA were analyzed retrospectively. Patients were separated into two groups; successfully treated with antibiotics and going under surgery after antibiotic treatment failure. Demographic, clinical and laboratory data of patients were examined between both groups that could determine the success of treatment. RESULTS: In the surgical treatment group, age, body mass index (BMI), and C-reactive protein (CRP) values ​​were higher than the antibiotic treatment group (p = 0.017, p = 0.026, and p < 0.001 respectively). Patients who underwent surgery had a significantly larger abscess than those who received antibiotic therapy (79.4 ± 21.1 mm vs. 50.9 ± 13.2 mm, p < 0.001). Cut-off values of the findings, which were identified as risk factors in predicting the failure of antibiotic treatment, were found with ROC analyses. This cut-off was 41.5 years for age (sensitivity 71.3 %, specificity 60 %), 26.72 kg/m2 for BMI (sensitivity 51.5 %, specificity 71.1 %), and 143.5 mg/L for CRP value on admission (sensitivity 68.3 %, specificity 71.1 %). The cut-off for abscess diameter was 62.5 mm (sensitivity 88.1 %, specificity 82.2 %). CONCLUSION: Especially in large tubo-ovarian abscesses, early surgical intervention should be preferred considering the age, BMI, and CRP values.


Assuntos
Doenças das Tubas Uterinas , Doenças Ovarianas , Doença Inflamatória Pélvica , Abscesso/tratamento farmacológico , Abscesso/cirurgia , Antibacterianos/uso terapêutico , Doenças das Tubas Uterinas/tratamento farmacológico , Doenças das Tubas Uterinas/cirurgia , Feminino , Humanos , Doenças Ovarianas/tratamento farmacológico , Doenças Ovarianas/cirurgia , Doença Inflamatória Pélvica/tratamento farmacológico , Estudos Retrospectivos
9.
Minim Invasive Ther Allied Technol ; 28(1): 46-50, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29741420

RESUMO

BACKGROUND: The aim of this study was to compare single-incision laparoscopic surgery (SILS) and conventional laparoscopy in ectopic pregnancies accompanied by severe hemoperitoneum. MATERIAL AND METHODS: The main outcome measures were duration of surgery, intraoperative bleeding quantity, complications, post-operative pain scores, additional analgesic requirements, and length of hospital stay. RESULTS: A total of 53 women, 28 in the conventional laparoscopy group and 25 in the SILS group, participated in the study. There were no differences in demographic characteristics between the two groups. There were no differences in terms of variables including gestational week, beta human chorionic gonadotropin (ßhCG) levels, and operation time. No intraoperative complications were observed in either group. The groups exhibited no significant differences regarding additional analgesic requirements or postoperative pain scores. However, pain at the sixth postoperative hour was lower in the SILS group. This effect was not observed at 12 and 24 hours. CONCLUSION: SILS appears to be effective and safe for the treatment of ruptured ectopic pregnancies accompanied by hemoperitoneum.


Assuntos
Hemoperitônio/etiologia , Laparoscopia/métodos , Gravidez Ectópica/cirurgia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Laparoscopia/efeitos adversos , Tempo de Internação , Duração da Cirurgia , Dor Pós-Operatória/etiologia , Gravidez , Estudos Prospectivos , Resultado do Tratamento
10.
Ginekol Pol ; 88(10): 517-522, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29192411

RESUMO

Neuregulin 4 (NRG4) is an adipokine that is synthesized in many tissues and has been shown to be associated with the development of obesity and metabolic disorders in animals and humans. The aim of this study is to investigate the relationship between serum NRG4 levels and various metabolic parameters in women with PCOS. This cross-sectional study included 40 women with PCOS and 40 age- and BMI-matched controls without PCOS. NRG4, fasting blood glucose (FBG), insulin, hs-CRP, LDL-C, HDL-C, SHBG, DHEA-SO4 and total-testosterone levels were measured in all the participants. HOMA-IR was used to calculate the insulin resistance. Serum NRG4 levels were higher in women with PCOS than in healthy women (24.89 ± 9.32 [ng/mL] vs. 18.98 ± 6.40 [ng/mL], p = 0.002). FBG, LDL-C, HDL-C, LH, SHBG, FAI, DHEA-SO4, insulin, hs-CRP, HOMA-IR and total-testosterone levels were significantly higher in women with PCOS than controls. Circulating NRG4 levels were positively correlated with HOMA-IR, insulin and hs-CRP for both groups. There was a positive correlation between NRG4 and FBG in the PCOS group. HOMA-IR and hs-CRP were associated with NRG4. The high concentration of circulating NRG4 in PCOS may be associated with insulin resistance and low-grade chronic inflammation.


Assuntos
Biomarcadores/sangue , Resistência à Insulina , Neurregulinas/sangue , Síndrome do Ovário Policístico/sangue , Adulto , Glicemia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos
11.
Minim Invasive Ther Allied Technol ; 26(5): 278-283, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28290726

RESUMO

BACKGROUND: Our aim was to compare single incision and conventional laparoscopic surgeries performed for benign adnexal masses with regard to their intraoperative characteristics and postoperative pain levels. MATERIAL AND METHODS: The main outcome measures were laparoscopic entry time, total operation time, amount of bleeding, intraoperative complications, post-operative pain scores, additional analgesic requirements, and length of hospital stay. RESULTS: A total of 71 women, 39 in the conventional laparoscopy group and 32 in the SILS group, participated in the study. Demographic findings did not differ between the two groups. Similarly, rates of intraoperative complications, rates of conversion to laparotomy, pre- and postoperative hematocrit levels were not significantly different between the groups. Laparoscopic entry time was shorter in the SILS group (10.4 ± 5.9 min. vs. 5.28 ± 1.7 min.). However, total operation time was similar in the two groups. The groups did not show significant differences regarding additional analgesic requirements, or postoperative pain scores after 24 h. However, pain scores in the recovery room and after six and 12 h were lower in the SILS group. CONCLUSION: SILS seems to be effective and safe for the treatment of benign adnexal masses. SILS appears to be advantageous regarding postoperative pain especially in the early period.


Assuntos
Laparoscopia/métodos , Neoplasias das Glândulas Suprarrenais , Adulto , Feminino , Humanos , Medição da Dor , Dor Pós-Operatória/etiologia , Adulto Jovem
12.
Int Urogynecol J ; 28(3): 417-422, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27549224

RESUMO

INTRODUCTION AND HYPOTHESIS: The aim of the study was to investigate the correlation between mean bladder wall thickness (BWT) and treatment success in patients diagnosed with urinary incontinence, based on urodynamic test results. METHODS: In this prospective study, patient urinary incontinence type was identified using urodynamic tests. Patients (N = 125) were categorized into three groups: urodynamic stress incontinence (SUI), detrusor over-activity (DO) and mixed urinary incontinence. Measurements from the bladder dome, anterior wall and trigone were averaged to calculate BWT. Student's t test and Mann-Whitney U test were used to compare pre-treatment BWT. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values for BWT to predict treatment success. RESULTS: Mean pre-treatment BWT significantly differed between success and non-success groups for each urinary incontinence type (p value for the SUI, DO and MUI groups was 0.043, 0.001 and 0.002 respectively). Using ROC curves to anticipate the treatment success, a threshold was calculated for mean pre-treatment BWT; 5.05 mm for SUI (sensitivity 74 %, specificity 66 %, positive predictive value [PPV] 85 %, negative predictive value [NPV] 50 %), 4.98 mm for DO (sensitivity 73 %, specificity 92 %, PPV 95 %, NPV 63 %) and 5.31 mm for mixed type (sensitivity 88 %, specificity 73 %, PPV 79 %, NPV 85 %). CONCLUSIONS: The study results suggest a significant relationship between the pre-treatment BWT and the success of urinary incontinence treatment. The mean BWT may be used as a benchmark in assessing the responsiveness to treatment of urinary incontinence types.


Assuntos
Bexiga Urinária/patologia , Incontinência Urinária/terapia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Estatísticas não Paramétricas , Inquéritos e Questionários , Resultado do Tratamento , Ultrassonografia/métodos , Bexiga Urinária/diagnóstico por imagem
13.
Ginekol Pol ; 87(5): 390-4, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27304657

RESUMO

OBJECTIVES: The effect of exogenous progesterone on fetal nuchal translucency (NT) has been proposed recently. In this study, we aimed to compare the thickness of NT of patients receiving and not receiving progesterone for threatened miscarriage. MATERIAL AND METHODS: This study was designed as a retrospective comparative study. Ninety five women treated with progesterone constituted the study group whereas 97 women who were not treated with progesterone constituted the control group. An ultrasonographic examination was performed on all of the women to measure NT. All patients were treated with oral micronized progesterone in the study group. The main parameters recorded for each woman were; age, body mass index (BMI), obstetrical characteristics, and gestational age at first examination, treatment duration of progesterone therapy, and results of combined and triple tests. RESULTS: A total of 192 pregnant women with threatened miscarriage were included in this study. The mean NT thickness was statistically significantly higher in the study group (p < 0.001), and mean serum level of human chorionic gonadotropin (hCG) was also higher in this group (p < 0.05). There was no statistically significant difference between groups in terms of age, BMI, and gestational age at first examination. ROC curve analysis demonstrated that only increased NT (area under the curve: 0.634, p = 0.005, 95% CI: 0.541-0.727) was a discriminative factor for women receiving progesterone for threatened miscarriage. Also there was a positive correlation between NT and treatment duration (r = 0.269; p < 0.001). CONCLUSIONS: We think that oral progesterone therapy may increase NT depending on treatment duration without causing abnormal prenatal screening test results.


Assuntos
Ameaça de Aborto/prevenção & controle , Medição da Translucência Nucal , Progesterona , Ameaça de Aborto/diagnóstico , Administração Oral , Adulto , Gonadotropina Coriônica/análise , Feminino , Idade Gestacional , Humanos , Medição da Translucência Nucal/métodos , Medição da Translucência Nucal/estatística & dados numéricos , Gravidez , Progesterona/administração & dosagem , Progesterona/efeitos adversos , Progestinas/administração & dosagem , Progestinas/efeitos adversos , Curva ROC , Estudos Retrospectivos , Estatística como Assunto , Ultrassonografia Pré-Natal/métodos
14.
J Chin Med Assoc ; 78(8): 481-5, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26143387

RESUMO

BACKGROUND: Hysterosalpingography (HSG) is an invasive, uncomfortable, and painful procedure. Patients often experience considerable anxiety and stress before the procedure. In this study, we aimed to evaluate the effect of preprocedure anxiety on postprocedure pain scores and clinical outcomes in women undergoing HSG. METHODS: This study was designed as a prospective randomized study. Women undergoing HSG were asked to complete the Beck Anxiety Inventory before the procedure. Patients were classified into two groups according to the anxiety score (Group 1: anxiety score ≤ 25; n = 84 and Group 2: anxiety score > 25, n = 25). All of the patients were asked to state the severity of their pain during the procedure using a visual analogue scale immediately after the procedure. Then, postprocedure pain scores and clinical features were evaluated. Data analyzed were: age, gravidity, parity, durations of marriage and infertility, body mass index, procedure time, amount of contrast media used, operator sex, history of surgery, educational level, and HSG results. RESULTS: A total of 109 women were enrolled into this prospective study. There was no statistically significant difference between the groups in terms of age, body mass index, durations of marriage and infertility, procedure time, amount of contrast media used, operator sex, history of surgery, educational level, and patency of the one and/or two fallopian tubes (p > 0.05). The median parity and pain scores after the procedure were lower in Group 1 (p < 0.05). There was also a positive correlation between anxiety scores and postprocedure pain scores (r = 0.289, p = 0.002). Receiver operator characteristics curve analysis demonstrated that operator sex was an important risk factor for postprocedure pain in patients with a preprocedure Beck Anxiety Inventory > 25. Logistic regression method demonstrated that higher parity, preprocedure anxiety score > 25, and male operator were risk factors for increased postprocedure visual analogue scale scores. CONCLUSION: According to this study, preprocedure anxiety levels have an effect on postoperative pain scores in women undergoing HSG procedure. Multiparity, male operator, and higher preprocedure anxiety scores also may have an effect on postoperative pain scores.


Assuntos
Ansiedade/fisiopatologia , Histerossalpingografia/psicologia , Dor Pós-Operatória/etiologia , Feminino , Humanos , Masculino , Medição da Dor , Paridade , Gravidez , Estudos Prospectivos , Escala Visual Analógica
15.
J Obstet Gynaecol Res ; 41(6): 932-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25656315

RESUMO

AIM: To evaluate the risk factors for adenomyosis, leiomyoma and concomitant adenomyosis and leiomyoma in patients with treatment-resistant menometrorrhagia. METHODS: A retrospective study was conducted on 129 women who underwent abdominal hysterectomy for treatment-resistant menometrorrhagia. The patients were divided into four groups according to the postoperative histopathology: concomitant adenomyosis and leiomyoma (n = 33), adenomyosis only (n = 26), leiomyoma only (n = 48) and controls (n = 22). Patients without any organic uterine pathology constituted the control group. RESULTS: Age at menarche was higher in the concomitant adenomyosis and leiomyoma group compared to the adenomyosis only group (P = 0.006). The mean age (P = 0.007), age at menarche (P = 0.001) and gravidity (P = 0.001) were higher in the concomitant adenomyosis and leiomyoma group compared to the leiomyoma only group. Preoperative hemoglobin was lower in the concomitant adenomyosis and leiomyoma, adenomyosis only, and leiomyoma only groups than the control group (P < 0.008). On receiver operating characteristic analysis, hemoglobin <10.9 mg/dL had a sensitivity and specificity of 77% and 70%, respectively, in discrimination of any uterine organic pathology, including adenomyosis only, leiomyoma only, and concomitant adenomyosis and leiomyoma, from the control group. Patients in the adenomyosis group were older (OR, 1.20; 95%CI: 1.05-1.50) and had a lower age at menarche (OR, 0.42; 95%CI: 0.19-0.89) than the other groups. CONCLUSIONS: Preoperative anemia may be a useful predictor of adenomyosis. Older patients, and patients who had a lower age at menarche, were also more likely to have adenomyosis.


Assuntos
Adenomiose/epidemiologia , Leiomioma/epidemiologia , Neoplasias Uterinas/epidemiologia , Útero/patologia , Adenomiose/complicações , Adenomiose/patologia , Fatores Etários , Feminino , Humanos , Histerectomia , Leiomioma/complicações , Leiomioma/patologia , Menarca , Metrorragia/complicações , Metrorragia/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Turquia/epidemiologia , Neoplasias Uterinas/complicações , Neoplasias Uterinas/patologia , Útero/cirurgia
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