OBJECTIVE: Pregnancy at advanced maternal age has become more common over the last decades. Therefore, the study aimed to describe the characteristics and maternal and perinatal outcomes of women giving birth at advanced maternal age and very advanced age. METHODS: We conducted a retrospective cohort study of 2,300 singleton births that occurred in 2020-2021 at the Department of Gynaecology and Obstetrics of the Louis Pasteur University Hospital in Košice. The control (age 20-34 years), advanced maternal age (35-39 years), and very advanced maternal age (≥ 40 years) groups included 1,851, 382, and 67 women, respectively. Exclusion criteria were multiple pregnancies, maternal age less than 20 years, smoking and alcohol use, foetal malformation and intrauterine foetal death, and birth weight of 500 grams or less. Data on mothers and newborn infants have been reported from the birth book and the reports on mothers at childbirth. The data were analysed using IBM SPSS Statistics 23.0. RESULTS: Our results confirmed statistically significant differences regarding the rate of preterm birth (p = 0.004), very preterm birth (p = 0.010), caesarean delivery rate (p < 0.001), very low birth weight (p = 0.027), extremely low birth weight (p = 0.001), and Apgar score at 5 minutes < 7 (p = 0.020) between newborns in the compared maternal age groups. CONCLUSION: Advanced maternal age is a prognostic factor for poor pregnancy outcomes. Women of advanced maternal age are at higher risk of adverse obstetric and perinatal outcomes.
- MeSH
- Apgar skóre MeSH
- císařský řez statistika a číselné údaje MeSH
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- novorozenec MeSH
- předčasný porod epidemiologie MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- věk matky * MeSH
- výsledek těhotenství * epidemiologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cieľ: Cieľom práce bolo sledovanie vzťahu diastázy m. rectus abdominis (DRA) a bolesti chrbta u žien po pôrode. Desing štúdie: observačná prospektívna štúdia. Konečný súbor pozostával zo 118 žien po pôrode s DRA s priemerným vekom 33,11 rokov. Metodológia: Vyšetrenie diastázy – inter recti distance meraná lineárnou 2D ultrazvukovou sondou, 4,5 cm nad pupkom, v jej oblasti a 4,5 cm pod pupkom. V ľahu na chrbte v pokoji a počas záťažového testu (elevácia dolných končatín). Bolesti chrbta boli hodnotené dotazníkom Oswestry (ODI – Owestry Disability Index). Výsledky: Korelovali sme diastázu m. rectus abdominis nad pupkom, v oblasti pupka a pod ním bez záťaže a pri záťaži s jednotlivými sekciami dotazníka ODI pre hodnotenie bolesti pri aktivitách každodenného života. V sekciách sedenie, státie, sexuálny život, spoločenský život, cestovanie a celkové skóre sme identifikovali niekoľko miernych signifikantných korelácií. Najviac pri diastáze nad pupkom pri záťaži. Následne pri diastáze nad pupkom bez záťaže. Jedna signifikantná korelácia bola zaznamenaná pri diastáze v oblasti pupka. Záver: Intenzita bolesti a bolesť pri aktivitách každodenného života v sledovanom súbore bola minimálna. Bolo potvrdené, že ženy s diastázou majú negatívne pocity pre diastázu pri sexuálnom živote, ale aj v rámci cestovania a spoločenského života, z dôvodu toho, že je to problém aj estetického charakteru.
Aim: The aim of the work was to monitor the relationship between rectus abdominis diastasis and back pain in women after childbirth. Study design: observational prospective study. The final cohort consisted of 118 postpartum women with diastasis m. rectus abdominis (DRA) with a mean age of 33.11 years. Methods: Examination of diastasis – inter recti distance (IRD) measured with a linear 2D ultrasound probe, 4.5 cm above the navel, in its area and 4.5 cm below the navel. Lying on the back at rest, and during the stress test (elevation of the lower limbs), back pain was assessed by the Oswestry Disability Index (ODI). Results: We correlated diastasis m. rectus abdominis above the umbilicus, in the area of the umbilicus and below it with and without weight with individual sections of the ODI questionnaire for the assessment of pain during activities of daily living. In the sitting, standing, sex life, social life, travel and total score sections, we identified several moderate significant correlations; mostly with diastasis above the navel during weight bearing, and subsequently with diastasis above the navel without weight. One significant correlation was recorded for diastasis in the navel area. Conclusion: Pain intensity and pain during activities of daily living in the observed group was minimal. It has been confirmed that women with diastasis have negative feelings about diastasis in their sexual life, but also in travel and social life due to the fact that it is also a problem of aesthetic nature.
The increased interest in assisted reproduction through in vitro fertilization (IVF) leads to an urgent need to identify biomarkers that reliably highly predict the success of pregnancy. Despite advances in diagnostics, treatment, and IVF approaches, the 30% success rate of IVF seems insurmountable. Idiopathic infertility does not have any explanation for IVF failure especially when a patient is treated with a healthy competitive embryo capable of implantation and development. Since appropriate intercellular communication is essential after embryo implantation, the emergence of the investigation of embryonic secretome including short non-coding RNA (sncRNA) molecules is crucial. That's why biomarker identification, sncRNAs secreted during the IVF process into the blastocyst's cultivation medium, by the implementation of artificial intelligence opens the door to a better understanding of the bidirectional communication between embryonic cells and the endometrium and so the success of the IVF. This study presents a set of promising new sncRNAs which are revealed to predictively distinguish a high-quality embryo, suitable for an embryo transfer in the IVF process, from a low-quality embryo with 86% accuracy. The identified exact combination of miRNAs/piRNAs as a non-invasively obtained biomarker for quality embryo determination, increasing the likelihood of implantation and the success of pregnancy after an embryo transfer.
Prvé 293 stran : barevné ilustrace ; 24 cm
Vysokoškolská učebnica, ktorá sa zameriava na gynekológiu a pôrodníctvo.
- MeSH
- gynekologie MeSH
- porodnictví MeSH
- Konspekt
- Gynekologie. Porodnictví
- Učební osnovy. Vyučovací předměty. Učebnice
- NLK Obory
- gynekologie a porodnictví
- NLK Publikační typ
- učebnice vysokých škol
OBJECTIVES: Premature birth is a serious pregnancy complication that is affected by many biological as well as psychosocial factors. Several studies have shown that a mother's positive relationship with her child's father reduces the mother's stress, anxiety and depression during pregnancy, promotes a healthier mother's lifestyle and thus has a positive effect on pregnancy as such. This research was therefore aimed at identifying possible differences in the incidence of premature births in mothers depending on the quality of the relationship with the father of their child. METHODS: The research involved 210 mothers after childbirth in the period from October 2020 to September 2021. A questionnaire aimed at obtaining descriptive data about the mother and her child and a questionnaire aimed at determining the quality of the relationship - Quality of Relationship Inventory (QRI) were distributed. Mann-Whitney U tests were used to determine differences between groups. RESULTS: Of 210 children, 44 (21%) were born prematurely, 154 (73.3%) mothers were married and 176 (83.8%) lived with the father of their child in the same household. The results showed that the degree of quality of the mother's relationship with the child's father is approximately the same for mothers who gave birth prematurely and for those who gave birth at term, so there were no differences in this factor between the two groups of mothers. CONCLUSION: The results of other researchers have shown the positive impact of partners on pregnancy and the overall well-being of the mothers. However, our research has not confirmed the positive effect of the quality of the relationship between mother and father of her child on reducing the incidence of premature births. Further research is needed to clarify how specifically and whether the quality of the relationship between parents can affect the incidence of premature births at all.
- MeSH
- dítě MeSH
- komplikace těhotenství * MeSH
- lidé MeSH
- matky MeSH
- novorozenec MeSH
- předčasný porod * epidemiologie MeSH
- průzkumy a dotazníky MeSH
- těhotenství MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: Low birth weight (LBW) is one of the major factors affecting child morbidity and mortality worldwide. Every day, approximately 800 women die from causes related to pregnancy and childbirth worldwide. Maternal ill health increases the risk of LBW. This study seeks to investigate determinants and incidence of LBW. METHODS: This study was conducted based on the medical records of mothers and their 1,946 infants born in 2016-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. Data on mothers and newborn infants were obtained from the Reports on mothers at childbirth. The inclusion criteria were singleton births and birth weight > 500 g. The exclusion criteria were twins or multiple births, congenital anomalies and stillbirths, birth weight ≥ 4,000 g or ≤ 500 g, and Roma ethnicity. Roma children are more likely to be born prematurely, with low birth weight. Roma mothers have different lifestyle. Univariate analysis was employed to evaluate the association between the independent variables and LBW. Variables that were found to be statistically significant were then further analysed using multivariable logistic analysis for each dependent variable. The implementation of the research was approved by the Ethics Committee. RESULTS: Of 1,946 newborns, 271 (13.90%) have low birth weight. The mean of birth weight at delivery was 3,068.62 (SD 671.16) grams. Factors that were associated with LBW were primary maternal education (OR = 2.98, 95% CI: 1.08-8.21, p = 0.034), marital status single (OR = 2.88, 95% CI: 1.68-4.94, p < 0.001), number of prenatal care visits less than 8 (OR = 1.62, 95% CI: 1.01-2.61, p = 0.047), and preterm birth (OR = 74.94, 95% CI: 45.44-123.61, p < 0.001). CONCLUSION: The reducing of LBW requires strategies to improve maternal lifestyle, maternal care before, during and after birth and to strengthen social support.
- MeSH
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- novorozenec s nízkou porodní hmotností MeSH
- novorozenec MeSH
- porodní hmotnost MeSH
- předčasný porod * MeSH
- prenatální péče MeSH
- rizikové faktory MeSH
- těhotenství MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: Smoking during pregnancy is causally associated with reduced birth weight and is strongly related to preterm birth. This study analyses the differences in birth outcomes between non-smokers and women who continued to smoke during pregnancy. METHODS: We conducted a study of 1,359 mothers who gave birth in 2017-2019 at the Department of Gynaecology and Obstetrics of Louis Pasteur University Hospital in Košice. Data on mothers and newborn infants have been reported from the birth book and from the reports on mothers at childbirth. For low birth weight we considered the weight of a newborn being less than 2,500 g and as for premature birth we referred to childbirth before pregnancy week 37. Two groups of mothers were classified according to the smoking habit during pregnancy and statistically processed in IBM SPSS Statistics 23.0. RESULTS: Infants born by women who smoked during pregnancy had the lower birth weight (2,769.0 grams on average) compared to non-smokers (3,224.1 grams) (p < 0.001). The differences in prevalence of premature birth have not been confirmed as statistically significant. Women who continued smoking during pregnancy were significantly more likely to be very young (OR = 5.9; 95% CI: 3.9-8.9; p < 0.001), unmarried (OR = 9.3; 95% CI: 6.1-14.0; p < 0.001), of lower level of education (OR = 39.6; 95% CI: 22.6-69.5; p < 0.001), and more likely to consume alcohol (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01), and drugs (OR = 6.6; 95% CI: 5.8-7.5; p < 0.01) during pregnancy. When pregnant, they were most likely to see a doctor for the first time after the first trimester (OR = 0.1; 95% CI: 0.1-0.2; p < 0.001) and were more likely to see a doctor less than 8 times (OR = 6.1; 95% CI: 4.2-8.8; p < 0.001) during pregnancy. CONCLUSION: Tobacco prevention and cessation campaigns should focus on improving pregnancy outcomes in the future.
- MeSH
- komplikace těhotenství * epidemiologie MeSH
- kouření epidemiologie MeSH
- lidé MeSH
- novorozenec s nízkou porodní hmotností MeSH
- novorozenec MeSH
- porodní hmotnost MeSH
- předčasný porod * epidemiologie MeSH
- těhotenství MeSH
- výsledek těhotenství epidemiologie MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The aim of this study was to explore the personal views of female gynecologists regarding the management of POP with a particular focus on the issue of uterine sparing surgery. METHODS: A questionnaire based survey of practicing female gynecologists in the Czech Republic, Slovenia and Slovakia. RESULTS: A total of 140 female gynecologists from 81 units responded to our questionnaire. The majority of respondents stated they would rely on a urogynecologist to aid them with their choice of POP management options. The most preferred options for POP management were sacrocolpopexy and physiotherapy. Almost 2/3 of respondents opted for a hysterectomy together with POP surgery, if they were menopausal, even if the anatomical outcome was similar to uterine sparing POP surgery. Moreover, 81.4% of respondents, who initially opted for a uterine sparing procedure, changed their mind if the anatomical success of POP surgery with concomitant hysterectomy was superior. Discussing uterine cancer risk in relation to other organs had a less significant impact on their choices. CONCLUSIONS: The majority of female gynecologists in our study opted for hysterectomy if they were postmenopausal at the time of POP surgery. However, variation in information provision had an impact on their choice.
- MeSH
- chirurgické síťky MeSH
- hysterektomie metody statistika a číselné údaje MeSH
- léčba šetřící orgány metody statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- porodnické chirurgické výkony škodlivé účinky metody MeSH
- prolaps pánevních orgánů chirurgie MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovinsko MeSH
Východiská: Vyšetrenie funkcie svalov panvového dna je veľmi dôležité pred zahájením cvičenia u pacientok s únikom moču a ďalšími dysfunkciami panvového dna. V súčasnosti sa používa vyšetrenie perineometrom a palpáciou. Novým trendom vo fyzioterapii je ultrazvukové vyšetrenie svalov panvového dna. Vyšetrenie môže byť realizované abdominálnym prístupom alebo perineálnym prístupom. Zhodnocujeme 2D a 3/4D zobrazenia svalov panvového dna. Metódy: Dotazník medzinárodnej konzultácie o inkontinencii ICIQ-UI SF. OAB-q krátky dotazník príznakov urgentnej inkontinencie moču. I-QoL sebahodnotiaca škála pre hodnotenie kvality života pacientov s inkontinenciou moču. Upravená Oxfordská stupnica na hodnotenie sily svalov panvového dna. PERFECT schéma podľa Laycocka a Jerwooda. Vyšetrenie panvového dna perineometrom (Peritron-Ontario, L4V, Canada). Vyšetrenie panvového dna 2D a 3/4D ultrazvukom (Volunson-i BT 11 Console, VCI volume contrast imaging softvér (GE Healthcare Austria GmbH Co OG, Zipf, Austria), sonda RAB4-8-RS 3D/4D 4-8 MHz). Cvičenie svalov panvového dna vysokej intenzity s prvkami stabilizácie. Záver: Efekt tréningu svalov panvového dna bol objektívne dokázaný prostredníctvom vyššie uvedených objektivizačných metód so subjektívnym zlepšením kvality života. Bol zistený aj významný efekt edukácie pri cvičení prostredníctvom USG.
Background: Examination of pelvic floor muscle function is very important before starting exercises in patients with urine leakage and other pelvic floor dysfunctions. Perineometer and palpation examination is currently being used. A new trend in physiotherapy is the ultrasound examination of pelvic floor muscles. The examination can be performed by abdominal approach or perineal approach. We evaluate 2D and 3/4D images of pelvic floor muscles. Methods: The International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF). OAB-q - overactive bladder questionnaire - short form. The Urinary Incontinence Quality of Life scale (I-QoL) self-assessment scale for assessing the quality of life of patients with urinary incontinence. Adjusted Oxford scale to assess pelvic floor muscle strength. PERFECT scheme by Laycock and Jerwood. Pelvic floor examination by perineometer (Peritron-Ontario, L4V, Canada). Pelvic floor examination by 2D and 3/4D ultrasound examination (Volunson-i BT 11 Console, VCI volume contrast imaging software, (GE Healthcare Austria GmbH Co OG, Zipf, Austria, RAB4-8-RS 3D/4D 4-8 MHz probe). High intensity exercise of pelvic floor muscles with stabilization elements. Conclusion: The effect of pelvic floor muscle training was objectively proved by the above mentioned objectivization methods with subjective improvement of quality of life. There was also a significant effect of education in USG exercise.
- MeSH
- dospělí MeSH
- inkontinence moči * diagnóza psychologie rehabilitace MeSH
- kvalita života MeSH
- lidé MeSH
- pánevní dno * diagnostické zobrazování fyziologie MeSH
- stresová inkontinence moči diagnóza psychologie rehabilitace MeSH
- terapie cvičením * metody MeSH
- ultrasonografie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
Accurate prediction of early treatment response to systemic therapy (ST) with tyrosine kinase inhibitors (TKI) in patients with metastatic renal cell carcinoma (mRCC) could help avoid ineffective and expensive treatment with serious side effects. Neither RECIST v.1.1 nor Choi criteria successfully discriminate between patients with mRCC who received ST having a short or long time to progression (TTP). There is no biomarker, which is able to predict early therapeutic response to TKIs application in patients with mRCC. The goal of our study was to investigate the potential of apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) of MRI in prediction of early therapeutic response to ST with pazopanib in patients with mRCC. The retrospective study enrolled 32 adult patients with conventional mRCC who received pazopanib (mean duration-7.5 ± 3.45). The mean duration of follow-up was 11.85 ± 4.34 months. In all patients as baseline examination and 1 month after treatment, 1.5T MRI including DWI sequence was performed followed by ADC measurement of the main renal lesion. For assessment of the therapeutic response, RECIST 1.1 is used. Partial response (PR), stable disease (SD) and progressive disease (PD) were observed in 12 (37.50%), 10 (31.25%) and 10 (31.25%) cases with mean TTP of 10.33 ± 2.06 months (95% confidence interval, CI = 9.05-11.61), 7.40 ± 2.50 months (95% CI = 5.61-9.19) and 4.20 ± 1.99 months (95% CI = 2.78-5.62) accordingly (p < 0.05). There was no difference in change of main lesions' longest size 1 month after ST in patients with PR, SD and PD. Comparison of mean ADC values before and 1 month after systemic treatment showed significant decrease by 19.11 ± 10.64% (95% CI = 12.35-25.87) and by 7.66 ± 6.72% (95% CI = 2.86-12.47) in subgroups with PR and SD, respectively (p < 0.05). There was shorter TTP in patients with mRCC if ADC of the main renal lesion 1 month after the ST increased from the baseline less than 1.73% compared to patients with ADC levels above this threshold: 5.29 ± 3.45 versus 9.50 ± 2.04 months accordingly (p < 0.001). Overall, our findings highlighted the use of ADC as a predictive biomarker for early therapeutic response assessment. Use of ADC will be effective and useful for reliable prediction of responders and non-responders to systemic treatment with pazopanib.
- MeSH
- difuzní magnetická rezonance metody MeSH
- inhibitory angiogeneze terapeutické užití MeSH
- Kaplanův-Meierův odhad MeSH
- karcinom z renálních buněk diagnostické zobrazování farmakoterapie mortalita patologie MeSH
- ledviny diagnostické zobrazování MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory ledvin diagnostické zobrazování farmakoterapie mortalita patologie MeSH
- pyrimidiny terapeutické užití MeSH
- retrospektivní studie MeSH
- ROC křivka MeSH
- senioři MeSH
- sulfonamidy terapeutické užití MeSH
- výsledek terapie MeSH
- zdraví dobrovolníci pro lékařské studie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
