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Kosinska-Kaczynska K, Torbé A, Kwiatkowski S, Borowski D, Breborowicz G, Czajkowski K, Czuba B, Huras H, Janiak K, Kajdy A, Kalinka J, Kosinski P, Leszczynska-Gorzelak B, Mierzynski R, Ropacka-Lesiak M, Sieroszewski P, Swiatkowska-Freund M, Wielgos M, Zimmer M. The Polish Society of Gynecologists and Obstetricians Guideline for the diagnostic assessment and management of multiple-gestation pregnancy complicated by fetal growth restriction. Ginekol Pol 2022; 93:256-263. [PMID: 35315031 DOI: 10.5603/gp.a2021.0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 11/25/2022] Open
Abstract
The aim of the Guideline is to unify the diagnostic-therapeutic management of multiple-gestation pregnancies complicated by fetal growth restriction in at least one fetus.
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Affiliation(s)
| | - Andrzej Torbé
- Chair of Obstetrics, Gynecology and Neonatology, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Poland
| | - Sebastian Kwiatkowski
- Chair of Obstetrics, Gynecology and Neonatology, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Poland.
| | - Dariusz Borowski
- Chair of Obstetrics, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.,I Chair of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Grzegorz Breborowicz
- Chair of Perinatology and Gynaecology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Bartosz Czuba
- Chair of Woman's Health, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Hubert Huras
- Chair of Gynaecology and Obstetrics, Medical College, Jagiellonian University in Cracow, Poland
| | - Katarzyna Janiak
- Department of Gynaecology, Procreation and Therapy of Fetus Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Anna Kajdy
- Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Jaroslaw Kalinka
- I Chair of Gynecology and Obstetrics, Medical University of Lodz, Poland
| | | | | | - Radzislaw Mierzynski
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland
| | - Mariola Ropacka-Lesiak
- Chair of Perinatology and Gynaecology, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Sieroszewski
- I Chair of Gynecology and Obstetrics, Medical University of Lodz, Poland
| | | | - Miroslaw Wielgos
- I Chair of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Mariusz Zimmer
- I Chair and Clinic of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
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Zgliczynska M, Ostrowska M, Szymusik I, Ciebiera M, Kosinska-Kaczynska K. Maternal thyroid function in multiple pregnancies - a systematic review. Front Endocrinol (Lausanne) 2022; 13:1044655. [PMID: 36733802 PMCID: PMC9887021 DOI: 10.3389/fendo.2022.1044655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The function of the thyroid gland during pregnancy undergoes physiological changes to ensure the proper amount of thyroid hormones for both the pregnant woman and the fetus. Multiple pregnancies (MP) are characterized by specific differences compared to single pregnancies, e.g., higher concentrations of human chorionic gonadotropin, which also affect thyroid function. The aim was to collect available knowledge on maternal thyroid function in MP. METHODS We have systematically searched three databases: the PubMed/MEDLINE, Scopus and the Cochrane Library. The last search was run on the 4th of August 2022. We included full-text original observational and experimental studies written in English. Case reports, editorials, letters, conference abstracts, reviews and meta-analyses were excluded. No time criterion was established. Studies were considered eligible if at least one maternal thyroid function test was performed and reported. Studies on MP with a co-existing mole were excluded. The risk of bias was assessed with the use of the AXIS tool. The qualitative synthesis of evidence was applied. RESULTS The search strategy resulted in the identification of 821 manuscripts. After removing duplicates, we screened the titles and abstracts of 552 articles, out of which 57 were selected for full-text analysis. Finally, 12 articles were included in the review. They were conducted in 6 different countries and published between the years 1997 and 2022. The number of examined women with MP ranged from 9 to 1 626. DISCUSSION AND CONCLUSIONS Thyroid function differs between women with MP and SP. Scarce data are available on the topic, but MPs are most likely characterized by higher HCG levels, which influences thyroid-stimulating hormone and free thyroid hormone levels. These differences are mainly expressed in the 1st trimester of pregnancy. Separate population-based reference ranges are needed to correctly diagnose thyroid diseases in MP and to avoid unnecessary treatment. Further research is needed to fill the knowledge gaps.
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Affiliation(s)
- Magdalena Zgliczynska
- Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Warsaw, Poland
- *Correspondence: Magdalena Zgliczynska,
| | - Magdalena Ostrowska
- Department of Endocrinology, Centre of Postgraduate Medical Education, Warsaw, Warsaw, Poland
| | - Iwona Szymusik
- Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Michal Ciebiera
- Second Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Katarzyna Kosinska-Kaczynska
- Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Warsaw, Poland
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Kwiatkowski S, Torbe A, Borowski D, Breborowicz G, Czajkowski K, Huras H, Kajdy A, Kalinka J, Kosinska-Kaczynska K, Leszczynska-Gorzelak B, Rokita W, Ropacka-Lesiak M, Sieroszewski P, Wielgos M, Zimmer M. Polish Society of Gynecologists and Obstetricians Recommendations on diagnosis and management of fetal growth restriction. Ginekol Pol 2021; 91:634-643. [PMID: 33184833 DOI: 10.5603/gp.2020.0158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Sebastian Kwiatkowski
- Clinical Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland.
| | - Andrzej Torbe
- Clinical Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
| | - Dariusz Borowski
- Clinic of Fetal-Maternal, Gynecology and Neonatolgy, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Poland
| | - Grzegorz Breborowicz
- Department of Perinatology and Gynecology, Poznan University od Medical Sciences, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Hubert Huras
- Jagiellonian Univeristy Collegium Medicum, Department of Obstertics and Perinatology, Cracow, Poland
| | - Anna Kajdy
- Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | | | | | - Wojciech Rokita
- Department and Clinic of Obstetrics and Gynaecology, Collegium Medicum Jan Kochanowski University in Kielce, Poland
| | - Mariola Ropacka-Lesiak
- Department of Perinatology and Gynecology, Poznan University od Medical Sciences, Poland
| | - Piotr Sieroszewski
- Department of Obstetrics and Gynecology, Medical University of Lodz, Poland
| | - Miroslaw Wielgos
- 1st Chair and Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Mariusz Zimmer
- 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
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Zgliczynska M, Kosinska-Kaczynska K. Micronutrients in Multiple Pregnancies-The Knowns and Unknowns: A Systematic Review. Nutrients 2021; 13:nu13020386. [PMID: 33513722 PMCID: PMC7912422 DOI: 10.3390/nu13020386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 12/12/2022] Open
Abstract
Maternal diet and nutritional status are of key importance with regard to the short- and long-term health outcomes of both the mother and the fetus. Multiple pregnancies are a special phenomenon in the context of nutrition. The presence of more than one fetus may lead to increased metabolic requirements and a faster depletion of maternal macro- and micro- nutrient reserves than in a singleton pregnancy. The aim of this systematic review was to gather available knowledge on the supply and needs of mothers with multiple pregnancies in terms of micronutrients and the epidemiology of deficiencies in that population. It was constructed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). The authors conducted a systematic literature search with the use of three databases: PubMed/MEDLINE, Scopus and Embase. The last search was run on the 18 October 2020 and identified 1379 articles. Finally, 12 articles and 1 series of publications met the inclusion criteria. Based on the retrieved studies, it may be concluded that women with multiple pregnancies might be at risk of vitamin D and iron deficiencies. With regard to other microelements, the evidence is either inconsistent, scarce or absent. Further in-depth prospective and population studies are necessary to determine if nutritional recommendations addressed to pregnant women require adjustments in cases of multiple gestations.
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Kozlowski S, Zgliczynska M, Kosinska-Kaczynska K. Biomarkers of angiogenesis in twin gestations and the risk of preeclampsia - review of the current literature. Ginekol Pol 2021; 91:773-776. [PMID: 33447998 DOI: 10.5603/gp.a2020.0133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 07/20/2020] [Indexed: 11/25/2022] Open
Abstract
Twin pregnancy is one of the key risk factors for the development of preeclampsia. Soluble fms-like tyrosine kinase-1, placental growth factor, and soluble endoglin are molecules involved in the process of angiogenesis with a proven role in the pathogenesis of preeclampsia. The aim of the review was to summarize available data on maternal serum levels of the biomarkers of angiogenesis and their usefulness in predicting preeclampsia in twin pregnancies. Most of available data suggest biomarkers concentrations differ between singleton and twin gestation and are related to chorionicity of twin pregnancy. Several algorithms including biomarkers of angiogenesis in prediction of PE in twin pregnancy are available and seem promising, however more large prospective surveys are necessary to assess their usefulness in general clinic use.
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Affiliation(s)
- Szymon Kozlowski
- University Center for Woman and Newborn Health of the Medical University of Warsaw, Poland
| | - Magdalena Zgliczynska
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Poland
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Zgliczynska M, Zasztowt-Sternicka M, Kosinska-Kaczynska K, Szymusik I, Pazdzior D, Durmaj A, Szlachta M, Bartnik P, Wielgos M. Impact of childbirth on women's sexuality in the first year after the delivery. J Obstet Gynaecol Res 2020; 47:882-892. [PMID: 33372310 DOI: 10.1111/jog.14583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/16/2020] [Accepted: 11/15/2020] [Indexed: 12/14/2022]
Abstract
AIM The aim was to compare the quality of sexual life before pregnancy and after delivery and to find out whether and how selected factors affect women's sexuality during this period. METHODS The study group consisted of 433 women who completed the survey containing basic demographic questions and two Female Sexual Function Index (FSFI) questionnaires: a retrospective one, regarding time before pregnancy and the current period. The inclusion criteria: time between 10 weeks and 1 year after delivery, vaginal intercourses before pregnancy and the resumption of vaginal intercourses after delivery. RESULTS We observed the negative impact of labor on the total FSFI score, regardless of the time that had passed since birth and the delivery mode. The decrease by at least 10% of the initial FSFI score was noticed in 44.3% of the participants. FSD (Female Sexual Dysfunction) occurred statistically more commonly after delivery than before pregnancy (45.3% vs 17.1%; P < 0.001). The following factors had an impact on the risk of post-partum FSD: pre-pregnancy FSD (adjusted odds ratio [aOR] = 4.17 [95% confidence interval [CI] 2.38-7.31]) and nulliparity (aOR = 1.67 [95% CI 1.09-2.53]). CONCLUSION Childbirth has an undeniable impact on women's sexuality. The prevention and treatment of sexual dysfunctions is very important, especially in this crucial period of life.
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Affiliation(s)
- Magdalena Zgliczynska
- Second Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Monika Zasztowt-Sternicka
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | | | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Dominika Pazdzior
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Aneta Durmaj
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Szlachta
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Bartnik
- Second Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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Zarychta E, Lepinay K, Szubert S, Jozwicki J, Misiak J, Brozyna AA, Kosinska-Kaczynska K, Lewandowska A, Malicka E, Makarewicz A, Rhone P, Jozwicki W. Wilms' tumor 1 antigen immunoreactivity in epithelial ovarian cancer - diagnostic and prognostic value. Folia Histochem Cytobiol 2020; 58:198-207. [PMID: 32960974 DOI: 10.5603/fhc.a2020.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/29/2020] [Accepted: 09/13/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Ovarian cancer is a heterogeneous disease, with a number of different histological subtypes with various responses to treatment. Wilms' tumor 1 (WT1) immunoreactivity is used to distinguish between OC's various subtypes. However, little is known about the protein's role as a prognostic factor. Thus, the main aim of our study was to evaluate the relationship between WT1 expression and patient overall survival (OS) and lymph node metastases. MATERIALS AND METHODS Study group consisted of 164 women aged 22-84, diagnosed with epithelial ovarian cancer (EOC). WT1 expression in histological slides was assessed by immunohistochemistry. RESULTS Serous tumors were the most common subtype among EOC (n = 126; 76.8%), followed by endometrioid (n = 20; 12.2%), clear-cell (n = 14; 8.5%) and mucinous cancer (n = 4; 2.4%). Of all serous EOC, WT1-positive tumors accounted for 75.6% of cases and this number was significantly higher than in other histological subtypes (p < 0.0001). Patients with lymph node metastases were more likely to have WT1-positive than WT1-negative tumors (p = 0.006). There was no significant correlation between WT1 immunoreactivity and OS across the whole study group of EOC patients (p = 0.6); however, in the group of non-serous (mucinous, endometrioid and clear-cell) EOC subjects, WT1 immunoreactivity was associated with shorter OS (p = 0.046). CONCLUSIONS WT1 immunoreactivity may be helpful in differentiating primary epithelial serous carcinomas from non-serous ovarian cancers; however, its prognostic role in EOC is rather uncertain.
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Affiliation(s)
- Elzbieta Zarychta
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Katarzyna Lepinay
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Sebastian Szubert
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland.
| | - Jakub Jozwicki
- Department of Clinical Pathomorphology, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
| | - Jan Misiak
- Department of Tumor Pathology and Pathomorphology, Department of Oncology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland, Torun, Poland
| | - Anna A Brozyna
- Department of Human Biology, Institute of Biology, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, Torun, Poland
| | | | - Agnieszka Lewandowska
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Ewa Malicka
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Adrianna Makarewicz
- Department of Oncology, The Franciszek Lukaszczyk Oncological Center, Bydgoszcz, Poland
| | - Piotr Rhone
- Department of Clinical Breast Cancer and Reconstructive Surgery, The Franciszek Lukaszczyk Oncological Center,, Bydgoszcz, Poland
| | - Wojciech Jozwicki
- Department of Tumor Pathology and Pathomorphology, Department of Oncology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland, Torun, Poland
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Zgliczynska M, Kocaj K, Szymusik I, Dutsch-Wicherek MM, Ciebiera M, Kosinska-Kaczynska K. Levonorgestrel-Releasing Intrauterine System as a Contraceptive Method in Nulliparous Women: A Systematic Review. J Clin Med 2020; 9:jcm9072101. [PMID: 32635369 PMCID: PMC7408997 DOI: 10.3390/jcm9072101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/15/2020] [Accepted: 06/29/2020] [Indexed: 01/16/2023] Open
Abstract
The aim of this review was to summarize the available evidence about the use of levonorgestrel-releasing intrauterine system (LNG-IUS) as a contraceptive method in nulliparous women. For this purpose, studies evaluating the efficacy, safety, bleeding pattern, satisfaction and discontinuation of the levonorgestrel-releasing intrauterine system in nulliparous women were analyzed. Only original research articles published in English between 1990–27th March 2020 were considered eligible. Reviews, book chapters, case studies, conference papers, opinions, editorials and letters were excluded. The systematic literature search of PubMed/MEDLINE, Scopus, Embase and Cochrane Library databases identified 816 articles, 23 of which were analyzed. The available evidence indicates that LNG-IUS is an effective and safe contraceptive method for nulliparous women that achieves high levels of satisfaction among patients. Moreover, nulliparous women seem to experience fewer expulsions than parous ones. Bleeding pattern is acceptable for the majority of patients, and bleeding disorders mainly occur in the first months after the insertion. More in-depth, long-term prospective studies are needed in this patient group to determine risk factors for the occurrence of side effects and associated discontinuations, which should not, however, delay the wider use of the method in this group, given the number of advantages.
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Affiliation(s)
- Magdalena Zgliczynska
- 2nd Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (M.Z.); (K.K.-K.)
| | - Karol Kocaj
- Medical University of Silesia, 40-055 Katowice, Poland;
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland;
| | | | - Michal Ciebiera
- 2nd Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (M.Z.); (K.K.-K.)
- Correspondence: ; Tel.: + 48-22-5690274
| | - Katarzyna Kosinska-Kaczynska
- 2nd Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland; (M.Z.); (K.K.-K.)
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Kosinska-Kaczynska K, Zgliczynska M, Kozlowski S, Wicherek L. Maternal Serum Placental Growth Factor, Soluble Fms-Like Tyrosine Kinase-1, and Soluble Endoglin in Twin Gestations and the Risk of Preeclampsia-A Systematic Review. J Clin Med 2020; 9:jcm9010183. [PMID: 31936659 PMCID: PMC7019581 DOI: 10.3390/jcm9010183] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/16/2019] [Accepted: 01/07/2020] [Indexed: 11/16/2022] Open
Abstract
Multiple gestation is one of the key risk factors for the occurrence of preeclampsia (PE). Soluble fms-like tyrosine kinase-1, placental growth factor, and soluble endoglin are molecules involved in the process of angiogenesis with a proven role in the pathogenesis of PE. The aim of the review was to summarize available data on maternal serum levels of the above-mentioned factors and their usefulness in predicting PE in twin pregnancies. Only original research articles written in English were considered eligible. Reviews, chapters, case studies, conference papers, experts’ opinions, editorials, and letters were excluded from the analysis. No publication date limitations were imposed. The systematic literature search using PubMed/MEDLINE, Scopus, Embase, and Cochrane Library databases identified 338 articles, 10 of which were included in the final qualitative analyses. The included studies showed significant differences in maternal serum levels of the discussed factors between women with twin pregnancies with PE and those who did not develop PE, and their promising performance in predicting PE, alone or in combination with other factors. The identification of the most effective algorithms, their prompt introduction to the clinical practice, and further assessment of the real-life performance should become a priority.
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Affiliation(s)
| | - Magdalena Zgliczynska
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-809 Warsaw, Poland
- Chair and Department of Experimental and Clinical Physiology, Laboratory of the Centre for Preclinical Research, Medical University of Warsaw, 02-106 Warsaw, Poland
- Correspondence:
| | - Szymon Kozlowski
- University Center for Woman and Newborn Health of the Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Lukasz Wicherek
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-809 Warsaw, Poland
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Kosinska-Kaczynska K, Dabrowski FA, Mazanowska N, Kosiński P, Skórka A, Kostrzewa G, Michalak E, Górnicka B, Płaza O, Zgliczynska M, Wielgos M. Post-zygotic diploidization of triploidy in human is possible? - a case of triploid partial molar pregnancy resulting in a premature live-born diploid female infant. Neuro Endocrinol Lett 2019; 40:227-232. [PMID: 32112547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 10/12/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE During the treatment of our patient we found that reports covering possible complications and their treatment are very scarce. Due to advancement in ultrasound diagnosis most of molar pregnancies are terminated in first trimester of pregnancy. There is the gap in knowledge concerning pregnancy complications in case of partial mole discovered in advanced pregnancy. This is why we incorporated extensive and up-to-date review of literature in our manuscript. METHOD We described a case of previously healthy, 25 year old primigravida who delivered live daughter at 27 weeks of gestation, complicated with unusual ultrasound appearance of the placenta, severe hypotrophy, and subsequent post-partum eclampsia. RESULTS Healthy diploid female infant, now two years old and healthy mother taking care of her. CONCLUSIONS In clinical practice early diagnosis of this complication usually lead to pregnancy termination. In modern medicine, decisions should be based on evidence and patient-doctor mutual understanding. Termination of pregnancy with suspicion of molar placenta can be specially difficult in gestation in older nulliparous women or after ART. We sincerely hope that this report will be useful for physicians across the world in counseling and treating their patients.
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Affiliation(s)
| | - Filip A Dabrowski
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
| | - Natalia Mazanowska
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
| | - Przemysław Kosiński
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
| | - Agata Skórka
- Department of Pediatrics, Medical University of Warsaw; Department of Medical Genetics, The Children's Memorial Health Institute, Poland
| | - Grażyna Kostrzewa
- Department of Forensic Medicine, Medical University of Warsaw, Poland
| | - Elżbieta Michalak
- Department of Pathology, Institute of Mother and Child, Warsaw, Poland
| | - Barbara Górnicka
- Department of Pathology, Medical University of Warsaw, Warsaw, Poland
| | - Olga Płaza
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Magdalena Zgliczynska
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Mirosław Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
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Kobryn E, Szymusik I, Zgliczynska M, Szarla K, Kopylowska N, Piatek S, Kosinska-Kaczynska K, Wielgos M. The efficacy of misoprostol in the first trimester miscarriage treatment - an individual patients' data analysis. Neuro Endocrinol Lett 2019; 40:152-158. [PMID: 31816221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/23/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The study aimed to detect factors predicting a successful pharmacological induction of first-trimester miscarriage. MATERIAL AND METHODS A prospective, cohort research was conducted at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between years 2011-2015. 642 women diagnosed with first trimester miscarriage qualified for pharmacological induction with misoprostol were included in the study. Each patient underwent repeatable doses of 800mcg misoprostol vaginally. The endpoint was complete excretion of all tissues, with no need to perform surgical curettage. Type of miscarriage, gravidity, parity, number of doses, time of drug administration and side effects were analysed as possible factors influencing the results. The statistical analysis was performed with STATISTICA 10.0 software. RESULTS The percentage of successful miscarriage induction was 83.6%. Two main factors corresponded with successful pharmacological treatment in regression analysis: number of administered doses (adjusted OR 1.64; 95% CI 1.18-2.29) and week of gestation (aOR 1.22; 95%CI 1.03-1.44). The success of the pharmacological induction of miscarriage was significantly decreased if the woman had a history of caesarean section (aOR 0.34; 95% CI 0.2-0.57). 2.2% of patients experienced benign side effects of the therapy. CONCLUSIONS Pharmacological induction is an effective and safe treatment method of first trimester abortion in the majority of cases. The knowledge of factors influencing the efficacy of misoprostol may help clinicians in proper counselling and individualisation of therapy.
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Affiliation(s)
- Eliza Kobryn
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
| | - Magdalena Zgliczynska
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Katarzyna Szarla
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Natalia Kopylowska
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Szymon Piatek
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
| | | | - Miroslaw Wielgos
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Zgliczynska M, Szymusik I, Sierocinska A, Bajaka A, Rowniak M, Sochacki-Wojcicka N, Wielgos M, Kosinska-Kaczynska K. Contraceptive Behaviors in Polish Women Aged 18-35-a Cross-Sectional Study. Int J Environ Res Public Health 2019; 16:E2723. [PMID: 31366184 PMCID: PMC6695758 DOI: 10.3390/ijerph16152723] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/26/2019] [Accepted: 07/28/2019] [Indexed: 12/17/2022]
Abstract
The aim was to evaluate contraceptive behaviors, and factors affecting them, in the population of Polish-speaking women. A cross-sectional study was performed on 6763 women, current contraceptive users, aged 18 to 35. An anonymous and voluntary questionnaire written in Polish, containing 33 questions, was distributed online from January to February 2017. The Internet and doctors were the most popular sources of information about contraception (82% and 73%, respectively). Upon choosing contraception, women paid the most attention to its efficacy (85%) and its impact on health (59%). The most common methods were combined oral contraceptives (38%) and condoms (24%). In total, 51% had chosen hormonal contraception, of which 68% experienced side effects. The most frequent were decreased libido (39%) and weight gain (22%). Factors associated with the usage of hormonal or non-hormonal contraception were: education, relationship status, parenthood, number of sexual partners, frequency of intercourses, sources of information about contraception, and factors considered most important when choosing a contraceptive method. The choice between short-acting and long-acting reversible contraception was influenced by age, relationship status, parenthood, smoking, sources of information about contraception, and factors considered most important when choosing a contraceptive method. Wide access to contraception, high-quality education, and counselling should become priorities in family planning healthcare.
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Affiliation(s)
- Magdalena Zgliczynska
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicz Square 1/3, P.O. Box 02-015 Warsaw, Poland
| | - Iwona Szymusik
- st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicz Square 1/3, P.O. Box 02-015 Warsaw, Poland.
| | - Aleksandra Sierocinska
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicz Square 1/3, P.O. Box 02-015 Warsaw, Poland
| | - Armand Bajaka
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicz Square 1/3, P.O. Box 02-015 Warsaw, Poland
| | - Martyna Rowniak
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicz Square 1/3, P.O. Box 02-015 Warsaw, Poland
| | - Nicole Sochacki-Wojcicka
- st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicz Square 1/3, P.O. Box 02-015 Warsaw, Poland
| | - Miroslaw Wielgos
- st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicz Square 1/3, P.O. Box 02-015 Warsaw, Poland
| | - Katarzyna Kosinska-Kaczynska
- st Department of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicz Square 1/3, P.O. Box 02-015 Warsaw, Poland
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Warzecha D, Szymusik I, Pietrzak B, Kosinska-Kaczynska K, Sierdzinski J, Sochacki-Wojcicka N, Wielgos M. Sex education in Poland - a cross-sectional study evaluating over twenty thousand polish women's knowledge of reproductive health issues and contraceptive methods. BMC Public Health 2019; 19:689. [PMID: 31159803 PMCID: PMC6547576 DOI: 10.1186/s12889-019-7046-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 05/24/2019] [Indexed: 11/16/2022] Open
Abstract
Background Reproductive health is a part of a comprehensive definition of complete physical, mental and social well-being. Sex education is an important aspect of public health. Ignorance, due to the lack of sex education leads to risky sexual behaviors. Methods: Our cross-sectional study was aimed at investigating a representative group of Polish women’s knowledge about the physiology of the menstrual cycle, contraceptive methods, infertility and cervical cancer prevention. The data were collected by face-to-face interviews and an anonymous electronic questionnaire. Results The study group involved 20,002 respondents. Most of the women were of reproductive age (mean 27.7), parous (60.8%), of higher education (71%) and living in large cities (> 500 k citizens, 36.8%). 62.2% of the women gave correct answers to at least 5 of 7 questions concerning the physiology of the menstrual cycle. Three factors had a significant influence on the number of correct answers: higher education (p = 0.0001), more frequent gynecological appointments (p = 0.0001) and living in a larger city (p = 0.002). Women of higher education level had more often used some form of contraceptive method previously (87% vs. 78.4%, p = 0.001), recommended natural family planning methods to their peers (18.4% vs. 15%, p = 0.001) and regularly attended gynecological appointments (85.7% vs. 78.8%, p = 0.001) when compared with those women with lower educational levels. The three most effective contraceptive methods identified by respondents were: oral contraceptives (71.1% answers), intrauterine devices (50.2%) and parenteral hormonal contraceptives (30.4%). The effectiveness of natural family planning was more often emphasized by women who had never used any contraceptives before (20.1% vs 6.7%). Most of the participants (80.8%) believed that in-vitro fertilization is an effective infertility treatment and should be reimbursed in Poland. Also, 95.2% of the respondents reported that they had undergone a Papanicolaou test within the past 3 years, but only 3% of these women were aware of all the risk factors for cervical cancer mentioned in our survey. Conclusions It is very important to improve comprehensive reproductive health education in Poland, especially among women of lower educational levels and living in small centers. In future, educational programs and gynecologists should focus on implementing and improving these aforementioned issues. Electronic supplementary material The online version of this article (10.1186/s12889-019-7046-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Damian Warzecha
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland.
| | - Bronislawa Pietrzak
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland
| | - Katarzyna Kosinska-Kaczynska
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland
| | - Janusz Sierdzinski
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Nicole Sochacki-Wojcicka
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Pl. Starynkiewicza 1/3, 02-015, Warsaw, Poland
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Rowicki L, Zgliczynska M, Majewska A, Zasztowt-Sternicka M, Szymusik I, Kosinska-Kaczynska K. 077 What Factors Affect the Incidence of Female Sexual Dysfunction in Young Women? Cross-sectional Study. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zgliczynska M, Zasztowt-Sternicka M, Szymusik I, Rowicki L, Majewska A, Kosinska-Kaczynska K. 065 How Does Selected Factors Associated with Pregnancy and Childbirth Affect Women's Sexuality? Female Sexual Function Index before Pregnancy and After Delivery. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Szymusik I, Kosinska-Kaczynska K, Krowicka M, Sep M, Marianowski P, Wielgos M. Perinatal outcome of in vitro fertilization singletons - 10 years' experience of one center. Arch Med Sci 2019; 15:666-672. [PMID: 31110532 PMCID: PMC6524192 DOI: 10.5114/aoms.2019.82670] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 03/12/2017] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION In vitro fertilization (IVF) singletons have a worse perinatal outcome than spontaneously conceived singletons, especially in terms of preterm birth and its complications. MATERIAL AND METHODS An observational retrospective case control study was carried out. The study population consisted of 644 women in singleton pregnancies (336 IVF/intracytoplasmic sperm injection (ICSI); 308 controls) who delivered > 22 weeks of gestation at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, between 2004 and 2014. Controls were initially matched by age and parity and drawn from the group of deliveries following each IVF delivery. Collected data included maternal characteristics, incidence of pregnancy complications, time and mode of delivery, and neonatal outcome at delivery. RESULTS The two study groups were initially matched for age and parity and were also similar with regard to BMI and gestational weight gain. The IVF treatment increased the odds of having vaginal bleeding in the first trimester (OR = 1.68; 95% CI: 1.0-2.86), placenta previa (OR = 5.15; 95% CI: 1.1-33.9), preterm delivery (OR = 2.06; 95% CI: 1.16-3.68), newborn's low birth weight (OR = 2.27; 95% CI: 1.19-4.36) and elective cesarean section (OR = 2.39; 95% CI: 1.7-3.4). CONCLUSIONS The IVF singleton pregnancies have an increased risk of adverse perinatal outcome, among which prematurity remains the greatest problem. Therefore, they should be managed as high risk not only due to psychological reasons.
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Affiliation(s)
- Iwona Szymusik
- 1 Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | | | - Maria Krowicka
- Students’ Research Group at the 1 Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Milena Sep
- Students’ Research Group at the 1 Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Marianowski
- 1 Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Miroslaw Wielgos
- 1 Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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Szymusik I, Kosinski P, Kosinska-Kaczynska K, Warzecha D, Karwacka A, Kaczynski B, Wielgos M. The first trimester aneuploidy biochemical markers in IVF/ICSI patients have no additional benefit compared to spontaneous conceptions in the prediction of pregnancy complications. J Perinat Med 2018; 46:953-959. [PMID: 29216009 DOI: 10.1515/jpm-2017-0199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The aim of this study was to determine if the levels of biochemical aneuploidy markers in in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) pregnancies differ from those in spontaneous pregnancies and to verify if biochemical markers could predict pregnancy outcome in IVF/ICSI gestations. METHODS This was a prospective observational study performed in a group of 551 patients who underwent a combined first trimester prenatal screening (ultrasound scan and serum markers). All patients were divided into two groups according to the mode of conception: IVF/ICSI pregnancies (study group) and spontaneous conceptions (control group). The concentrations of first trimester biochemical markers were presented as multiples of median (MoM) and were compared between the study and control groups. Analysed pregnancy complications included: preterm delivery (PTD), small for gestational age (SGA), gestational hypertension (GH), preeclampsia (PE) and gestational diabetes (GDM). RESULTS The analysis was performed on 183 IVF/ICSI and 368 spontaneously conceived gestations, with complete data regarding obstetric outcome. There were no significant differences in the concentrations of biochemical markers between the analysed groups. Pregnancy-associated plasma protein-A (PAPP-A) levels were lower in hypertensive than in normotensive patients, although the difference was not significant. Twenty-three patients had GDM (12.5%), 16 had GH or PE (8.7%), SGA was diagnosed in 18 (9.8%) and 25 delivered preterm (13.6%). CONCLUSIONS The trend for lower PAPP-A MoM was visible in all affected patients, although the results did not reach statistical significance. The first trimester biochemical markers in assisted reproduction technique (ART) pregnancies do not seem to have additional effect on predicting the risk of pregnancy complications.
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Affiliation(s)
- Iwona Szymusik
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Przemyslaw Kosinski
- First Department Of Obstetrics and Gynecology, Medical University of Warsaw, Starynkiewicza Square 1/3;02-015 Warsaw, Poland, Tel.: +48 22 5830300, Fax: +48 22 5830302
| | | | - Damian Warzecha
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | | | - Bartosz Kaczynski
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Miroslaw Wielgos
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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Kosinska-Kaczynska K, Lipa M, Szymusik I, Bomba-Opon D, Brawura-Biskupski-Samaha R, Kozlowski S, Tollenaar L, Oepkes D, Wielgos M, Lopriore E. Sudden Fetal Hematologic Changes as a Complication of Amnioreduction in Twin-Twin Transfusion Syndrome. Fetal Diagn Ther 2018; 44:311-314. [DOI: 10.1159/000487187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 01/23/2018] [Indexed: 11/19/2022]
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Kosinska-Kaczynska K, Szymusik I, Kaczynski B, Wielgos M. Observational study of associations between gestational weight gain and perinatal outcomes in dichorionic twin pregnancies. Int J Gynaecol Obstet 2017; 138:94-99. [DOI: 10.1002/ijgo.12171] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/20/2017] [Accepted: 04/05/2017] [Indexed: 11/11/2022]
Affiliation(s)
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology; Medical University of Warsaw; Warsaw Poland
| | - Bartosz Kaczynski
- Department of Medical Informatics and Telemedicine; Medical University of Warsaw; Warsaw Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology; Medical University of Warsaw; Warsaw Poland
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Warzecha D, Gajda S, Kosinska-Kaczynska K, Szymusik I, Wielgos M. Risk factors for depressive symptoms in early postpartum period and after puerperium - are they the same? Neuro Endocrinol Lett 2016; 37:452-460. [PMID: 28315630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 10/08/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Correlation between the occurrence of postnatal depressive symptoms at 5 days and 6 weeks postpartum is well established. The objective of the study was to determine the influence of psychosocial and perinatal factors on the occurrence of postpartum depressive symptoms 2 to 5 days and 6 weeks after delivery. METHODS 373 women in early postpartum (EPG) and 107 women 6 weeks after delivery (late postpartum group - LPG) completed a questionnaire including questions concerning mothers' characteristics, obstetric and neonatal complications during pregnancy, psychiatric factors and Edinburgh Postnatal Depression Scale (EPDS). RESULTS 21.6% of mothers from EPG and 14.2% in LPG achieved ≥10 points in EPDS. In both groups patients with ≥10 points reported stressful situations during pregnancy, sedative agents usage and a history of suicidal attempts. In EPG women with ≥10 points significantly more frequent delivered preterm, were hospitalized during pregnancy and their newborns had more health problems. In LPG mothers with ≥10 points more often reported several obstetric complications. Maternal comorbidity or sociodemographic factors did not correlate with the risk of depressive symptoms. CONCLUSION The risk factors for depressive symptoms after delivery vary in different time intervals. Therefore screening for PD should not be performed once in a single selected risk group.
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Affiliation(s)
- Damian Warzecha
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Sylwia Gajda
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | | | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Kosinska-Kaczynska K, Wielgos M. Do normal-weight women pregnant with twins are at the lowest risk of developing preeclampsia? J Matern Fetal Neonatal Med 2016; 30:191-193. [DOI: 10.3109/14767058.2016.1166358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kosinska-Kaczynska K, Szymusik I, Urban P, Zachara M, Wielgos M. Relation between time interval from antenatal corticosteroids administration to delivery and neonatal outcome in twins. J Obstet Gynaecol Res 2016; 42:625-31. [DOI: 10.1111/jog.12966] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/27/2015] [Accepted: 01/10/2016] [Indexed: 11/29/2022]
Affiliation(s)
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology; Medical University of Warsaw; Warsaw Poland
| | - Paulina Urban
- Students' Scientific Association at the 1st Department of Obstetrics and Gynecology; Medical University of Warsaw; Warsaw Poland
| | - Maria Zachara
- Students' Scientific Association at the 1st Department of Obstetrics and Gynecology; Medical University of Warsaw; Warsaw Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology; Medical University of Warsaw; Warsaw Poland
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Szymusik I, Bartnik P, Wypych K, Kolaczkowska H, Kosinska-Kaczynska K, Wielgos M. The association of first trimester bleeding with preterm delivery. J Perinat Med 2015; 43:525-9. [PMID: 25822321 DOI: 10.1515/jpm-2015-0063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 03/03/2015] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Preterm birth (PTB) is a predictor of perinatal morbidity and mortality, and prematurity continues to burden public healthcare with growing expenses. First trimester bleeding (FTB) has a well-known association with PTB; however, the relationship with severity of PTB is less obvious. AIM The primary aim of the study was to analyze the influence of FTB on the risk and severity of PTB, as well as to assess the connection of FTB and other pregnancy complications. METHODS It was an observational case control study. The material consisted of medical records of patients who delivered between 2010 and 2013. Two groups were formed - 497 women with FTB and 500 women without bleeding. RESULTS Women with FTB were more likely to deliver preterm in general (OR=2.11; 95% CI 1.43-3.10). The risk of extremely PTB (<28 weeks) was almost four-fold (OR=3.76; 95% CI 0.97-17.06) and very PTB (28-31 weeks) more than three-fold (OR=3.41; 95% CI 0.86-15.69). FTB increased the risk of placenta previa (OR=4.81; 95% CI 1.29-20.53; P=0.007). CONCLUSION FTB is a risk factor of PTB and is associated with greater risk of PTB-related pregnancy complications. Management of FTB pregnancies should include thorough screening for both preterm delivery and placental pathologies.
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Kosinska-Kaczynska K, Bomba-Opon D, Zygula A, Kaczynski B, Wegrzyn P, Wielgos M. Adjunctive Pessary Therapy after Emergency Cervical Cerclage for Cervical Insufficiency with Protruding Fetal Membranes in the Second Trimester of Pregnancy: A Novel Modification of Treatment. Biomed Res Int 2015; 2015:185371. [PMID: 26413506 PMCID: PMC4564585 DOI: 10.1155/2015/185371] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/20/2015] [Accepted: 05/24/2015] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the effectiveness of adjunctive pessary therapy after emergency cervical cerclage (ECC) in improving perinatal outcome in cervical insufficiency with fetal membranes protruding into the vagina. MATERIAL AND METHODS A retrospective analysis of patients treated at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between 2008 and 2013. The study group consisted of 15 women treated with ECC and a pessary and the control group consisted of 17 patients treated with cerclage only. RESULTS The mean gestational age at delivery was significantly higher in the study group (34.7 versus 29.7 weeks, p = 0.03). The period between cerclage insertion and delivery was significantly longer in the study group (82.9 versus 52.1 days, p = 0.045). The mean neonatal birthweight and neonatal "discharge alive" ratio were higher in the study group, although not statistically significant (2550 g versus 1883 g, p = 0.14, and 93.3% versus 70.5%, p = 0.18, resp.). NICU hospitalization rates were comparable (33.3% versus 35.3%, p = 0.9). CONCLUSIONS Adjunctive pessary therapy allows delaying delivery in women treated with ECC due to cervical insufficiency with protruding fetal membranes. It also seems to improve neonatal outcome, although the differences are not statistically significant. Further prospective study is required to prove these findings.
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Affiliation(s)
- Katarzyna Kosinska-Kaczynska
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland
| | - Dorota Bomba-Opon
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland
| | - Aleksandra Zygula
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland
| | - Bartosz Kaczynski
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Ulica Banacha 1A, 02-097 Warsaw, Poland
| | - Piotr Wegrzyn
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland
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Wielgos A, Szymusik I, Bartnik P, Kacperczyk J, Kosinska-Kaczynska K, Pietrzak B. Pregnancy beyond the age of 40 - the influence of parity on perinatal outcome. Neuro Endocrinol Lett 2015; 36:387-393. [PMID: 26454496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 09/01/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of the study was to compare the pregnancy course and neonatal outcome in women at least 40 years old during conception. DESIGN Data were collected on the basis of medical records of patients who gave birth between 2009-2014 at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw. Women enrolled were at least 40 years old at the moment of conception and delivered after 22 completed weeks of gestation - they were also assigned into 2 groups: primiparas and multiparas. Demographic features, pregnancy and delivery complications, mode of delivery and neonatal outcome were analyzed and compared. RESULTS 9760 women delivered at the Department during the study period, among them 193 met the inclusion criteria for the study: 40 primiparas (average age 40.9 ± 1.14) and 153 multiparas (average age 41.3 ± 1.35). No relation between parity and preterm delivery was observed (5% primiparas vs 11.1% multiparas; p>0.05). However, gestational age at delivery was associated with the number of pregnancies - the higher the pregnancy number, the lower the gestational age (p=0.009; R=-0.188). Primiparity was associated with an increased rate of oligohydramnios (RR=4.78; 95% CI 1.15-20.63) and pregnancy induced hypertension (RR=2.34; 95% CI 0.93-5.58). Primiparas had a significantly greater risk of operative delivery (RR=1.83; 95% CI 1.42-2.12) and unsuccessful labor inductions (RR=3.60; 95% CI 1.04-5.29). They were more often diagnosed with fibroids (RR=3.04; 95%CI 1.15-7.81). No relations between parity and birth weight, fetal abnormalities or Apgar score were observed. CONCLUSIONS Delayed childbearing of a first child seems to increase the risk of perinatal complications, which is important for counseling purposes.
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Affiliation(s)
- Aleksandra Wielgos
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Pawel Bartnik
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Joanna Kacperczyk
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | | | - Bronislawa Pietrzak
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Kosinska-Kaczynska K, Ciechanowicz P, Saletra A, Szymusik I, Wielgos M. Two methods of cervix ripening: intracervical Foley catether and dinoprostone - which one is actually more efficient? Neuro Endocrinol Lett 2015; 36:257-261. [PMID: 26313393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 05/12/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim was to evaluate which of the two analyzed methods of preinduction: intracervical Foley catether and intracervical dinoprostone is related to higher rate of successful vaginal delivery in shorter time and to shorter hospitalization after the delivery. DESIGN A retrospective analysis of 198 patients with unfavorable cervix for labor induction (Bishop score ≤ 6), hospitalized at 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, was carried out. In 105 patients labor preinduction was conducted with Foley catheter (study group) and in 93 with intracervical dinoprostone (control group). RESULTS There were no significant differences regarding patients' age, body mass index (BMI), weight gain during the pregnancy, duration of pregnancy and parity between the groups. 68.6% of patients in the study group and 65.6% in the control group delivered vaginally (p=0.65). In the study group significantly less women developed spontaneous onset of labor (36.2% vs 66.7%; p<0.001). The time from preinduction to delivery onset and from preinduction to vaginal delivery were longer in the study group (780 min vs 489 min; 1682 min vs 920 min; p<0.001). The time of hospitalization after the delivery was significantly shorter in the study group (4.1 days vs 6.8; (p<0.001). CONCLUSION Both Foley catheter and dinoprostone seem to be equally effective in achieving vaginal delivery. In terms of time effectiveness Foley catheter preinduction is related to longer time from preinduction to delivery, nevertheless shorter time of hospitalization.
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Affiliation(s)
| | - Piotr Ciechanowicz
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Aleksandra Saletra
- Students' Research Group at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Wielgos M, Bomba-Opon D, Kociszewska-Najman B, Brawura-Biskupski-Samaha R, Kaminski A, Piotrowska A, Kosinska-Kaczynska K. Minimally conjoined monochorionic diamniotic twins - a case report. Eur J Obstet Gynecol Reprod Biol 2014; 180:206-7. [PMID: 25064577 DOI: 10.1016/j.ejogrb.2014.06.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 06/15/2014] [Accepted: 06/26/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Dorota Bomba-Opon
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Bozena Kociszewska-Najman
- Neonatal Ward, 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | | | - Andrzej Kaminski
- Department of Pediatric Surgery and Urology, Medical University of Warsaw, Warsaw, Poland
| | - Anna Piotrowska
- Department of Pediatric Surgery and Urology, Medical University of Warsaw, Warsaw, Poland
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Micek M, Kosinska-Kaczynska K, Godek B, Krowicka M, Szymusik I, Wielgos M. Birth after a previous cesarean section - what is most important in making a decision? Neuro Endocrinol Lett 2014; 35:718-723. [PMID: 25702301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 11/27/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE A retrospective analysis of the course of labour in patients after one caesarean section (CS) and of factors influencing successful attempt of vaginal birth after caesarean (VBAC). DESIGN A group of 296 patients after one CS was divided into: group G1 (206 patients) - elective CS, group G2 (90) - VBAC attempt, and G2 to: G2a (35) - VBAC and G2b (55) - CS after an unsuccessful VB attempt. A comparative analysis between the groups and logistic regression analysis of factors influencing a successful VBAC was made. RESULTS There were no differences regarding age, BMI, weight gain during pregnancy or gestational age between groups G1 and G2, as well as G2a and G2b. G2a patients had more often already given VB previously (28.6% vs 10.9%; p=0.03). The most frequent indication for a repeat elective CS was the lack of informed consent for VBAC (29.13% of all indications). The mean neonatal birthweight was highest in G1 (3 410 g), and in G2b higher than in G2a (3 275 g vs 3 098 g; p=0.009). There were no differences in newborns' general condition between the group. There were no cases of uterine rupture and 4 cases of uterine scar dehiscence in G1 and 1 in G2. Of all the analysed factors only spontaneous delivery onset (OR 7.78) and previous vaginal birth after the caesarean (OR 1.99) or before the caesarean (OR 2.03) had significant influence on successful VBAC trial. CONCLUSION The right classification of patients is a significant factor having effect on the success of a VB attempt after CS.
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Affiliation(s)
- Martyna Micek
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | | | - Bartosz Godek
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Maria Krowicka
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Szymusik I, Kosinska-Kaczynska K, Krolik A, Skurnowicz M, Pietrzak B, Wielgos M. The usefulness of the universal culture-based screening and the efficacy of intrapartum prophylaxis of group B Streptococcus infection. J Matern Fetal Neonatal Med 2013; 27:968-70. [PMID: 24047083 DOI: 10.3109/14767058.2013.845659] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the usefulness of universal culture-based GBS screening at 35-37 weeks of gestation, assess the efficacy of intrapartum antibiotic administration (IAP) and investigate factors influencing the infection rate in neonates. METHODS Out of 1653 pregnant women 304 (18.4%) further analyzed were GBS positive directly before the delivery, among them 69 were false GBS negative on antenatal screening. Various variables regarding parturients' and newborns' characteristics were taken into account in order to achieve the objective of the study. RESULTS Out of 304 GBS-positive patients directly before the delivery, culture-based screening was positive in 72.4%, while 22.7% presented with GBS-negative screening and received no IAP. No single culture-confirmed early-onset GBS disease was observed. CONCLUSIONS IAP is an effective way of early-onset GBS disease prevention, however prenatal screening would be most efficient if performed intrapartal.
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Affiliation(s)
- Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw , Warsaw , Poland
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Bumbul E, Starek M, Szymusik I, Pietrzak B, Bumbuliene Z, Kosinska-Kaczynska K, Wielgos M. Advantages and disadvantages of over-the-counter availability of emergency contraception. Neuro Endocrinol Lett 2013; 34:655-659. [PMID: 24463999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 12/04/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To compare usage patterns, accessibility and knowledge about over-the counter (OTC) emergency contraception (EC) in comparison to prescription-only EC. DESIGN AND SETTING Self-designed, paper-based validated questionnaires containing 26 questions were distributed among students and high school pupils in Poland (PL) - 1000 questionnaires and in Lithuania (LT) - 650. In Lithuania EC is available OTC, whereas in Poland EC is a prescription-only drug. Statistical analysis was performed using SAS software with p<0.05 considered significant. RESULTS 74.01% of Poles and 70.89% of Lithuanians reported a history of sexual activity. About one third of the respondents in both countries used EC at least once in a lifetime (PL: 29.01%, LT: 32.2%; p>0.05). The main reason for EC usage in both countries was a broken condom (PL: 60.63%, LT: 57.66 %; p>0.05). In case of emergency more than half of the questioned women in both countries would use EC pill. The knowledge about EC was significantly lower in Poland (PL median - 8 out of 16; LT - 10 out of 16 true/false statements; p<0.01). CONCLUSIONS Over-the-counter availability of EC does not cause repetitive or increased usage. Moreover, an easier access to EC improves patients' knowledge about the drug.
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Affiliation(s)
- Elzbieta Bumbul
- Students' Research Group at the 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, Poland.
| | - Magdalena Starek
- Students' Research Group at the 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, Poland
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
| | - Bronislawa Pietrzak
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Zana Bumbuliene
- Clinic of Obstetrics and Gynaecology, Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | | | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Szymusik I, Kosinska-Kaczynska K, Bomba-Opon D, Wielgos M. IVF versus spontaneous twin pregnancies – which are at higher risk of complications? J Matern Fetal Neonatal Med 2012; 25:2725-8. [DOI: 10.3109/14767058.2012.705398] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bomba-Opon DA, Kosinska-Kaczynska K, Kosinski P, Wegrzyn P, Kaczynski B, Wielgos M. Vaginal progesterone after tocolytic therapy in threatened preterm labor. J Matern Fetal Neonatal Med 2012; 25:1156-9. [DOI: 10.3109/14767058.2011.629014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kosinska-Kaczynska K, Bartkowiak R, Kaczynski B, Szymusik I, Wielgos M. Autonomous adrenocorticotropin reaction to stress stimuli in human fetus. Early Hum Dev 2012; 88:197-201. [PMID: 21925813 DOI: 10.1016/j.earlhumdev.2011.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 06/12/2011] [Accepted: 08/07/2011] [Indexed: 11/18/2022]
Abstract
The aim of the study was to determine whether human fetuses show ACTH response to stress stimuli, to define the gestational age from which these reactions may be present and to analyze the relationship between hormone concentrations and their changes, both in fetuses and in pregnant women. The study included 81 intrauterine transfusions carried out in 19 pregnant women. 52 procedures were performed directly into the umbilical vein, which is not innervated, so neutral for the fetus (the PCI group) and 29 transfusions into the intrahepatic vein -which puncture is stressful for the fetus (the IHV group). ACTH and cortisol concentrations in fetal and maternal plasma obtained during the procedures were assayed. The initial mean plasma ACTH concentration in the PCI group equaled 18.94pg/mL, but in the IHV group it was significantly higher and amounted 75.17pg/mL (p<0.001). There was no significant change in the hormone concentration during the transfusion both in the IHV group (95.8pg/mL, p>0.05) and in the PCI group (22.36pg/mL, p>0.05). The observed hormonal response in the IHV group proves the existence of fetal pituitary reaction to stress. The initial fetal ACTH concentration in the IHV group correlated with the number of transfusions performed on a single fetus (R=0.41; p=0.04). No correlation with parity, gestational weeks or the volume of transfused packed red blood cells was found. There was also no correlation between fetal and maternal ACTH concentrations in any group. Presented data suggest that the human fetus shows autonomous ACTH reaction to stress stimulation.
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Matusiak R, Szymusik I, Banaszek-Wysoczanska A, Kosinska-Kaczynska K, Kaminski P. O595 The assessment of double transobturator approach (D-TOT) technique in stress urinary incontinence (SUI). Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60968-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Szymusik I, Matusiak R, Kosinska-Kaczynska K, Wielgos M, Luterek K. O915 The influence of epidural analgesia on the course of labor. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61288-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Matusiak R, Szymusik I, Kosinska-Kaczynska K, Matusiak K, Horosz E. P736 Contraceptive consciousness among Polish population at the beginning of 21st century. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)62227-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wielgos M, Szymusik I, Kosinska-Kaczynska K, Suchonska B, Kaminski P, Banaszek-Wysoczanska A, Bomba-Opon D, Szpotanska M. The influence of dinoprostone on uterine cervix ripening and the course of labor. Neuro Endocrinol Lett 2007; 28:513-7. [PMID: 17693987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Accepted: 07/07/2007] [Indexed: 05/16/2023]
Abstract
OBJECTIVES The aim of the study was to estimate the influence of dinoprostone in two different forms on the ripening of uterine cervix and the course of labor. MATERIAL AND METHODS 128 pregnant women with indications for labor induction and uterine cervix Bishop's scores <6, divided into 2 groups: I--62 patients who had dinoprostone in the form of a gel applied for labor preinduction; II--66 women who were administered dinoprostone in the form of vaginal inserts. The effectiveness of both forms of dinoprostone were estimated and compared. RESULTS No differences in Bishop's score changes were noticeable between the groups after 6-8 hours from application, however they were significant at the beginning of induction: I - 7.8+/-1.3 vs. II - 6.9+/-1.6 (p=0.0007). Almost half of the patients from group II had spontaneous contractions and required no labor induction at all. The average time from dinoprostone application till delivery was shorter in group II. CONCLUSIONS Dinoprostone vaginal inserts seem to influence both uterine cervix and muscle, while gel-prepare uterine cervix for delivery more effectively.
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Affiliation(s)
- Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland.
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