OBJECTIVE: To assess risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic using Mind-COVID, a prospective cross-sectional study that compares outcomes in middle-income economies and high-income economies. METHODS: A total of 7102 pregnant women from 12 high-income economies and nine middle-income economies were included. The web-based survey used two standardized instruments, General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). RESULT: Pregnant women in high-income economies reported higher PHQ-9 (0.18 standard deviation [SD], P < 0.001) and GAD-7 (0.08 SD, P = 0.005) scores than those living in middle-income economies. Multivariate regression analysis showed that increasing PHQ-9 and GAD-7 scales were associated with mental health problems during pregnancy and the need for psychiatric treatment before pregnancy. PHQ-9 was associated with a feeling of burden related to restrictions in social distancing, and access to leisure activities. GAD-7 scores were associated with a pregnancy-related complication, fear of adverse outcomes in children related to COVID-19, and feeling of burden related to finances. CONCLUSIONS: According to this study, the imposed public health measures and hospital restrictions have left pregnant women more vulnerable during these difficult times. Adequate partner and family support during pregnancy and childbirth can be one of the most important protective factors against anxiety and depression, regardless of national economic status.

• MeSH
• COVID-19 * epidemiologie   psychologie   MeSH
• deprese etiologie   MeSH
• dítě MeSH
• internet MeSH
• komplikace těhotenství * epidemiologie   psychologie   MeSH
• lidé MeSH
• pandemie MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• SARS-CoV-2 MeSH
• těhotenství MeSH
• těhotné ženy psychologie   MeSH
• úzkost etiologie   MeSH
• úzkostné poruchy epidemiologie   MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: To evaluate the effect of iatrogenic menopause on the physiology of the vagina of the ewe and to evaluate if vaginal changes in ewes can be translated to women with genitourinary syndrome of menopause (GSM). METHODS: Preclinical research with Dohne Merino ewes. Iatrogenic menopause was induced by bilateral ovariectomy (OVX). Animals were randomized for surgery, blinded for allocation and outcome assessment. Differences between groups were determined by linear regression analyses at 5 months after OVX. Outcome measures were vaginal epithelial thickness, pH, vaginal maturation value, vaginal maturation index, epithelial glycogen accumulation, content of elastin fibers, collagen, and vascularity. RESULTS: OVX ewes (n = 20) showed epithelial thinning of the vaginal wall from 146 μm to 47 μm (mean, P < 0.001). Furthermore, epithelial glycogen accumulation and vascularity of the vaginal wall significantly decreased (43% and 23%, respectively) as compared with the control group (no intervention; n = 5). No significant differences were found for other outcome measures. CONCLUSION: This study established the ewe as a suitable large animal model for GSM. Furthermore, the similar relevant outcomes in humans and ewes hold great value for future translational research for the evaluation and optimization of different treatment modalities for GSM.

• MeSH
• glykogen MeSH
• iatrogenní nemoci MeSH
• lidé MeSH
• menopauza * MeSH
• modely u zvířat MeSH
• ovarektomie škodlivé účinky   MeSH
• ovce MeSH
• vagina * chirurgie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• laparoskopie * MeSH
• leiomyom * chirurgie   MeSH
• lidé MeSH
• miniinvazivní chirurgické výkony MeSH
• myomektomie * MeSH
• nádory dělohy * chirurgie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

BACKGROUND: There is a substantial variation in rates of preterm delivery between different parts of the world. The understanding of these variations, as well as the biological mechanisms behind spontaneous preterm delivery, is limited. Although the benefit of antenatal interventions has been shown to be limited, using well-known risk factors for spontaneous preterm delivery to select the correct pregnant women for targeted interventions is important from both a medical and caregiving perspective. OBJECTIVE: To provide an introduction to a substantial research area dealing with risk factors of spontaneous preterm delivery. METHODS: Risk factors in this review were classified as demographical, obstetrical, and gynecological and those related to the current pregnancy according to high-quality evidence of recent literature. RESULTS AND CONCLUSION: An introduction to a substantial research area in maternal and fetal medicine was provided that might help clinicians to better understand the risk factors related to preterm delivery and select the correct pregnant women for targeted interventions.

• MeSH
• lidé MeSH
• novorozenec MeSH
• předčasný porod diagnóza   etiologie   MeSH
• prenatální péče metody   MeSH
• rizikové faktory MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

OBJECTIVE: To compare the Copenhagen Index (CPH-I) and the Risk of Ovarian Malignancy Algorithm (ROMA) in the differential diagnosis of ovarian tumors. METHODS: In a retrospective study, data were reviewed from women with ovarian tumors who attended University Hospital Brno, Czech Republic, between July 2011 and June 2015. The women were classified into the benign tumor group or malignant tumor group (borderline and malignant tumors). Serum levels of CA125 and HE4 were extracted from medical records. The two tumor indices were calculated using relevant clinical data. RESULTS: Among 267 included women, 110 had benign tumors, 42 had borderline ovarian tumors, and 115 had malignant tumors. The two indices showed similar discriminatory performance with no significant differences (P>0.05). In the differentiation of benign tumors from all stages of borderline tumor and ovarian cancer, ROMA showed a sensitivity of 71% at a specificity of 88%, whereas CPH-I showed a sensitivity of 69% at a specificity of 85%. CONCLUSION: CPH-I is a potential tumor index that is independent of menopausal status. It might be applied as a simple alternative to ROMA in settings of basic medical care.

• MeSH
• algoritmy * MeSH
• antigen CA-125 krev   MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádorové biomarkery krev   MeSH
• nádory vaječníků krev   klasifikace   diagnóza   patologie   MeSH
• retrospektivní studie MeSH
• riziko MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVE: To compare the prevalence of pelvic floor dysfunction symptoms, including pelvic organ prolapse (POP), urinary incontinence (UI), and fecal incontinence (FI) among primiparous women after vaginal and cesarean delivery. METHODS: In a prospective cohort study at a University hospital in the Czech Republic, singleton primiparas with cephalic presentation who delivered at term were enrolled between 2002 and 2007. In 2013, 5-10 years after delivery, women who had not delivered again completed an internet-based survey about current symptoms of POP, UI, and FI, which were evaluated using validated questionnaires. The relative risk (RR) of POP, UI, and FI symptoms was calculated. RESULTS: Complete questionnaire data were obtained from 641 women who delivered vaginally and 224 who delivered by cesarean. The mean UI score (ICIQ-SF) was 2.3 ± 3.6 in the vaginal group and 1.0 ± 2.7 in the cesarean group (P=0.005). The mean POP scores (POPDI-6) were 2.2 ± 2.3 and 2.1 ± 2.0, respectively (P=0.944). The mean Wexner scores to evaluate FI were 1.3 ± 1.7 and 1.0 ± 1.5, respectively (P=0.220). The RR of pelvic floor dysfunction after vaginal delivery was highest for women with UI symptoms (RR 1.15, 95% confidence interval 0.92-1.42). CONCLUSION: Significant differences in the occurrence of symptoms of UI were observed after vaginal delivery as compared with cesarean delivery. ClinicalTrials.gov: NCT02661867.

• MeSH
• císařský řez škodlivé účinky   MeSH
• dospělí MeSH
• internet MeSH
• lidé MeSH
• onemocnění dna pánevního epidemiologie   etiologie   MeSH
• parita * MeSH
• poruchy v puerperiu epidemiologie   MeSH
• prolaps pánevních orgánů epidemiologie   etiologie   MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky MeSH
• stupeň závažnosti nemoci MeSH
• těhotenství MeSH
• vedení porodu škodlivé účinky   MeSH
• zdraví žen MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

• MeSH
• ampicilin terapeutické užití   MeSH
• antibakteriální látky terapeutické užití   MeSH
• apendicitida chirurgie   MeSH
• dehiscence operační rány * MeSH
• dospělí MeSH
• lidé MeSH
• peritonitida farmakoterapie   MeSH
• předčasná porodní činnost * MeSH
• těhotenství MeSH
• vaginální porod po císařském řezu * MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVE: To investigate anal incontinence following mediolateral or lateral episiotomy during a first vaginal delivery. METHODS: The present prospective follow-up study enrolled primiparous patients who underwent vaginal delivery including mediolateral or lateral episiotomy between April 1, 2010 and March 31, 2012. Participants completed interviews before delivery, and were given anal-incontinence questionnaires to be returned for analysis at 3 months and 6 months postpartum. Anal incontinence was defined as a St Mark's incontinence score above four and individual anal-incontinence components were analyzed separately; results were compared between the two episiotomy techniques. RESULTS: Questionnaires were returned by 300 and 366 patients who underwent mediolateral and lateral episiotomies, respectively; baseline characteristics were similar. Anal incontinence at 3 months and 6 months was recorded among 21 (7.0%) and 9 (3.0%) patients who underwent mediolateral and 27 (7.4%) and 20 (5.5%) who underwent lateral episiotomy, respectively. The study was underpowered to confirm equivalence between the groups; however, no statistically significant differences were observed in the rates of anal incontinence, flatus, solid or liquid incontinence, and de novo incontinence. Fecal urgency (P=0.017) and de novo fecal urgency (P=0.008) were more prevalent among patients who underwent lateral episiotomies at 6 months. CONCLUSION: Anal incontinence was comparable between primiparous patients who underwent mediolateral or lateral episiotomy. The association between lateral episiotomy and fecal urgency merits further scientific interest.

• MeSH
• dospělí MeSH
• epiziotomie škodlivé účinky   MeSH
• fekální inkontinence epidemiologie   etiologie   MeSH
• komplikace porodu epidemiologie   MeSH
• lidé MeSH
• mladý dospělý MeSH
• následné studie MeSH
• parita MeSH
• perineum chirurgie   MeSH
• poporodní období MeSH
• prospektivní studie MeSH
• průzkumy a dotazníky MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

OBJECTIVE: To investigate whether self-rated health (SRH) in pregnancy can predict childbirth complications, adverse birth outcomes, and maternal health problems up to 3 years after delivery. METHODS: A retrospective analysis was performed of data obtained in a prospective longitudinal population-based birth cohort study. Pregnant women resident in the Brno or Znojmo regions in the Czech Republic were included if they were expected to deliver between March 1991 and June 1992. SRH data were collected between 1991 and 1995 via pen-and-paper questionnaires administered in mid-pregnancy, and at 6 months, 18 months, and 3 years after delivery. Medical records were reviewed for pregnancy complications, childbirth complications, and birth outcomes. Multivariate regression analysis was performed. RESULTS: Overall, 4811 women were included. Better SRH in pregnancy predicted fewer childbirth complications (b=-0.03; P=0.036); lower odds of cesarean delivery (odds ratio 0.81; P=0.003); and fewer maternal health problems at 6 months (b=-0.32; P<0.001), 18 months (b=-0.28; P<0.001), and 3 years after delivery (b=-0.30; P<0.001). The effects of SRH were independent of diagnosed complications and self-reported health problems in pregnancy. CONCLUSION: SRH in pregnancy has predictive value for subsequent health outcomes, and might be an additional tool for assessment of pregnant women's health.

• MeSH
• dospělí MeSH
• komplikace porodu epidemiologie   MeSH
• komplikace těhotenství epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• multivariační analýza MeSH
• odds ratio MeSH
• prediktivní hodnota testů MeSH
• regresní analýza MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• těhotenství MeSH
• vedení porodu statistika a číselné údaje   MeSH
• výsledek těhotenství epidemiologie   MeSH
• zdraví matek * MeSH
• zpráva o sobě * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• MeSH
• dospělí MeSH
• endometrióza komplikace   chirurgie   MeSH
• komplikace porodu etiologie   chirurgie   MeSH
• lidé MeSH
• rektovaginální píštěl etiologie   chirurgie   MeSH
• rektum zranění   chirurgie   MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH