Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.4
Journals
IJERPH
Special Issues
Women Health and Gynecology
ijerph-logo
Submit to IJERPH Review for IJERPH Propose a Special Issue

Journal Menu

► Journal Menu

Journal Browser

► Journal Browser
share announcement

Women Health and Gynecology

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 67795

Special Issue Editors

Prof. Dr. Milan Terzic

E-Mail Website
Guest Editor
1. Department of Medicine, Nazarbayev University School of Medicine, Zhanybek-Kerey khans Street, 5/1, Nur-Sultan, Kazakhstan
2. Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Turan ave. 32, Nur-Sultan, Kazakhstan
3. Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, USA
Interests: environmental factors; gynecology; obstetrics; REI; diagnostic procedures; current managements; women’s health
Dr. Antonio Simone Laganà

E-Mail Website
Co-Guest Editor
Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, VA, Italy
Interests: women’s health; minimally invasive procedures; up-to-date management; gynecology; reproductive health; surgery
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Antonio Sarria-Santamera

E-Mail Website
Co-Guest Editor
1. Department of Medicine, Nazarbayev University School of Medicine, Zhanibek-Kerey Khans Street, 5/1, Nur-Sultan 010000, Kazakhstan
2. Spanish Network of Health Services Research and Chronic Diseases, REDISSEC, 28029 Madrid, Spain
3. Instituto Mixto de Investigación Escuela Nacional de Sanidad-Universidad Nacional de Educación a Distancia, IMIENS-UNED, 28029 Madrid, Spain
Interests: women’s health; minimally invasive procedures; up-to-date management; gynecology; reproductive health; surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Environmental pollutants comprise certain chemical, physical and biological substances, that have harmful effects on human well-being. Nowadays, the development of industrialization maximizes the production of these substances and poses a real problem for public health. Moreover, research evidences suggest that the occupational exposure affects the female health by alternating the hormonal levels, decreasing libido, interfering with ovarian function, causing and increasing the risks of menstrual disorders, delayed menarche, early menopause, decreased fertility and disadvantageous pregnancy outcomes. The environmental pollutants refer to air pollution, exposure to heavy metals, endocrine disrupting chemicals, pesticides, polychlorinated biphenyls, ionizing radiation, occupation and working environment. The adverse effects of these environmental factors on the overall health and reproductive health, as well as on women’s well-being depends on the dosage, timing, duration of the exposure through the ingestion, inhalation, transdermal and mucosal absorption. This special issue of International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on the links between Environmental factors & Public health on one side, and Women health and Gynecology, on the another. Original articles, reviews, and case reports are welcome to this issue. Other manuscript types accepted include new approaches to risk assessment and management of environmental factors in OBGYN, methodological papers, position papers, brief reports, and commentaries.

We will accept manuscripts from different disciplines including Obstetrics & Gynaecology, public health, epidemiology, intervention studies, risk and health impact assessment, risk management of environmental factors and issues in OBGYN. Here are some examples of topics that could be addressed in this Special Issue:

  1. Environmental factors and fertility
  2. Infertility as a public health burden
  3. Menopausal problems of healthcare providers impact on a quality of health service
  4. Menopause management options in daily practice
  5. Medicamentous and minimally invasive procedures for uterine fibroids
  6. Burnout in healthcare providers: contemporary management options and proposals for public health interventions
  7. Endometriosis impact on the quality of life and work performance
  8. Environmental factors and current preconceptional diagnostic procedures in daily clinical practice
  9. Infections in obstetrics and gynecology and impact on infertility, early pregnancy loss and preterm birth
  10. Current updates about early markers for pre-eclampsia detection

Professor Dr Milan Terzic

Associate Professor Dr Antonio Simone Laganà

Associate Professor Dr Antonio Sarria-Santamera


Guest Editors


Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • environmental factors
  • public health
  • gynecology
  • quality of life
  • endometriosis
  • infections
  • burnout
  • infertility
  • early pregnancy loss
  • preterm birth

Published Papers (23 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Editorial

Jump to: Research, Review, Other

6 pages, 308 KiB  
Editorial
Women’s Health and Gynecology: Old Challenges and New Insights
by Antonio Sarría-Santamera, Antonio Simone Laganà and Milan Terzic
Int. J. Environ. Res. Public Health 2022, 19(24), 16589; https://doi.org/10.3390/ijerph192416589 - 09 Dec 2022
Viewed by 1283
Abstract
The complexity of women’s health goes far beyond medical and surgical knowledge and the achievements of the clinical specialty of Obstetrics and Gynecology, spanning not just the research dimensions of molecular biology, genetics, epidemiology, or health services but also being influenced by gender, [...] Read more.
The complexity of women’s health goes far beyond medical and surgical knowledge and the achievements of the clinical specialty of Obstetrics and Gynecology, spanning not just the research dimensions of molecular biology, genetics, epidemiology, or health services but also being influenced by gender, social, and psychological relevant factors [...] Full article
(This article belongs to the Special Issue Women Health and Gynecology)

Research

Jump to: Editorial, Review, Other

11 pages, 641 KiB  
Article
Predictive Value of Pelvic Floor Muscle Morphometry Using 3D/4D Ultrasound in Relation to the Success of Pelvic Floor Muscle Training in Women with Stress Urinary Incontinence
by Magdalena Hagovska, Ján Svihra and Peter Urdzik
Int. J. Environ. Res. Public Health 2022, 19(22), 14757; https://doi.org/10.3390/ijerph192214757 - 10 Nov 2022
Cited by 1 | Viewed by 1369
Abstract
The aim of our study was to establish the predictive value of pelvic floor muscle morphometry using 3D/4D ultrasound in relation to the success of pelvic floor muscle training (PFMT) for 12 weeks in women with stress urinary incontinence (SUI). A total of [...] Read more.
The aim of our study was to establish the predictive value of pelvic floor muscle morphometry using 3D/4D ultrasound in relation to the success of pelvic floor muscle training (PFMT) for 12 weeks in women with stress urinary incontinence (SUI). A total of 86 women with SUI from regional gynaecological and urological outpatient clinics were enrolled on this cross-sectional study. SUI symptoms were assessed by the International Consultation on Incontinence Questionnaire (ICIQ-UI SF). Pelvic floor muscle function was evaluated using a perineometer. Pelvic floor muscle morphometry (PFMM) was evaluated by the size of the urogenital hiatus (HA in cm2) at rest (R), at contraction (C) and during the Valsalva manoeuvre, i.e., a strong push (V), by 3D/4D USG. The intervention was PFMT for 12 weeks. After PFMT, we noted significant improvement in SUI symptoms, pelvic floor muscle function and morphometry. Moderately significant (0.001) negative correlations were confirmed between the total ICIQ-UI SF score and strength (−0.236 **) and endurance (−0.326 **) of the maximal voluntary contraction (MvC), the number of MvC lasting 3 s (−0.406 **) and 1 s (−0.338 **). Moderately significant (0.001) positive correlations were confirmed between the total ICIQ-UI SF score and R (r = 0.453 **), C (r = 0.533 **) and V (r = 0.442 **). The predictive value of PFMM reached a positive prediction of a decrease with an ICIQ-UI SF score below 8. HA during V was most strongly associated with SUI reduction, with an area under the curve (AUC) of 0.87 (p ≤ 0.001), a positive predictive value of 83.3%, a negative predictive value of 75.0%, sensitivity of 78.9% and specificity of 80.0%. The predictive values of pelvic floor muscle morphometry using 3D/4D USG confirmed the success of PFMT in women with SUI. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

18 pages, 6911 KiB  
Article
Cervical Microbiome in Women Infected with HPV16 and High-Risk HPVs
by Thanayod Sasivimolrattana, Wasun Chantratita, Insee Sensorn, Arkom Chaiwongkot, Shina Oranratanaphan, Pattarasinee Bhattarakosol and Parvapan Bhattarakosol
Int. J. Environ. Res. Public Health 2022, 19(22), 14716; https://doi.org/10.3390/ijerph192214716 - 09 Nov 2022
Cited by 4 | Viewed by 1612
Abstract
Human papillomavirus type 16 (HPV16) and/or high-risk (Hr-) HPV are the main causes of cervical cancer. Another element that may contribute to the development of cervical cancer is the microbiota. To date, no study has investigated the entire cervical microbiome, which consists of [...] Read more.
Human papillomavirus type 16 (HPV16) and/or high-risk (Hr-) HPV are the main causes of cervical cancer. Another element that may contribute to the development of cervical cancer is the microbiota. To date, no study has investigated the entire cervical microbiome, which consists of bacteria, fungi, and viruses. In this study, cervical samples with different histopathology (CIN1, CIN2, and CIN3), with or without HPV16 and Hr-HPVs infection, were enrolled. From bacterial community analysis, 115 bacterial species were found and separated into 2 distinct categories based on Lactobacillus abundance: Lactobacilli-dominated (LD) and non-Lactobacilli-dominated (NLD) groups. The LD group had significantly less bacterial diversity than the NLD group. In addition, the variety of bacteria was contingent on the prevalence of HPV infection. Among distinct histological groups, an abundance of L. iners (>60% of total Lactobacillus spp.) was discovered in both groups. A few fungi, e.g., C. albicans, were identified in the fungal community. The viral community analysis revealed that the presence of HPV considerably reduced the diversity of human viruses. Taken together, when we analyzed all our results collectively, we discovered that HPV infection was a significant determinant in the diversity of bacteria and human viruses in the cervix. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

19 pages, 1337 KiB  
Article
The Prevalence, Indications, Outcomes of the Most Common Major Gynecological Surgeries in Kazakhstan and Recommendations for Potential Improvements into Public Health and Clinical Practice: Analysis of the National Electronic Healthcare System (2014–2019)
by Yesbolat Sakko, Gulzhanat Aimagambetova, Milan Terzic, Talshyn Ukybassova, Gauri Bapayeva, Arnur Gusmanov, Gulnur Zhakhina, Almira Zhantuyakova and Abduzhappar Gaipov
Int. J. Environ. Res. Public Health 2022, 19(22), 14679; https://doi.org/10.3390/ijerph192214679 - 09 Nov 2022
Cited by 3 | Viewed by 1625
Abstract
Objectives: Major gynecological surgeries are indicated for the treatment of female genital pathologies. It is key to examine trends in gynecologic surgical procedures and updated recommendations by international gynecological societies to find opportunities for improvement of local guidelines. To date, a very limited [...] Read more.
Objectives: Major gynecological surgeries are indicated for the treatment of female genital pathologies. It is key to examine trends in gynecologic surgical procedures and updated recommendations by international gynecological societies to find opportunities for improvement of local guidelines. To date, a very limited number of reports have been published on the epidemiology of gynecological surgeries in Kazakhstan. Moreover, some local guidelines for gynecological conditions do not comply with the international recommendations. Thus, this study aims to investigate the prevalence, indications, and outcomes of the most common major gynecological surgeries by analyzing large-scale Kazakhstani healthcare data, and identifying possible opportunities for improvement of the local public health and clinical practice. Methods: A descriptive, population-based study among women who underwent a gynecological surgery in healthcare settings across the Republic of Kazakhstan during the period of 2014–2019 was performed. Data were collected from the Unified Nationwide Electronic Health System (UNEHS). Results: In total, 80,401 surgery cases were identified and analyzed in the UNEHS database for a period of 6 years (2014–2019). The median age of the participants was 40 years old, with 61.1% in reproductive age. The most prevalent intervention was a unilateral salpingectomy—29.4%, with 72.6% patients aged between 18–34 years. The proportion of different types of hysterectomies was 49.4%. In 20% of cases, subtotal abdominal hysterectomy was performed due to uterine leiomyoma. The proportion of laparoscopic procedures in Kazakhstani gynecological practice is as low—11.59%. Conclusions: The Kazakhstani public health and gynecological care sector should reinforce implementation of contemporary treatment methods and up-to-date policies and guidelines. The overall trends in surgical procedures performed for gynecological pathologies, including uterine leiomyoma and ectopic pregnancy treatment, should be changed in favor of the minimally invasive methods in order to adopt a fertility-sparing approach. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

11 pages, 2421 KiB  
Article
Expression of Matrix Metalloproteinase-2,-7,-9 in Serum during Pregnancy in Patients with Pre-Eclampsia: A Prospective Study
by Ayibaota Bahabayi, Nan Yang, Tong Xu, Yuting Xue, Lijuan Ma, Xunke Gu, Yongqing Wang and Keke Jia
Int. J. Environ. Res. Public Health 2022, 19(21), 14500; https://doi.org/10.3390/ijerph192114500 - 04 Nov 2022
Cited by 3 | Viewed by 1163
Abstract
Background: Matrix Metalloproteinases (MMPs) have been found to have important roles in vascular pathology and may be involved in the occurrence of pre-eclampsia. In this study, the serum levels of MMP-2, -7, -9 in normal pregnant women and pre-eclampsia patients were analyzed to [...] Read more.
Background: Matrix Metalloproteinases (MMPs) have been found to have important roles in vascular pathology and may be involved in the occurrence of pre-eclampsia. In this study, the serum levels of MMP-2, -7, -9 in normal pregnant women and pre-eclampsia patients were analyzed to assess their predictive value. Methods: A total of 1563 pregnant women from Peking University Third Hospital, from February 2021 to October 2021, were enrolled. Serum samples were collected from patients one to three times, during the different trimesters. Among the 102 singleton pre-eclampsia patients, we collected samples from 33 patients in the first trimester (6–13 GW), 33 in the second trimester (14–28 GW), 41 in the third trimester (29–41 GW) and 28 after onset of pre-eclampsia. Samples from each trimester were collected before the onset of pre-eclampsia. Then we selected 35, 37, 43 and 25 samples from 124 healthy pregnant women by matching their age, BMI and gestational weeks, using these as the control groups. Serum levels of MMP-2, -7, -9 were detected by ELISA. The receiver operating characteristic (ROC) curve was used to evaluate their predictive value. Results: Except for the first trimester, MMP-2 and MMP-7 were significantly higher in the pre-eclampsia group (p < 0.5). Additionally, in the pre-eclampsia group, MMP-9 increased significantly in the first trimester and after the onset of pre-eclampsia but decreased significantly in the second and third trimesters (p < 0.5). The ROC curve indicated that MMP-9, MMP-2 and MMP-7 were the best indicators for predicting pre-eclampsia in the first, second and third trimesters, respectively. Conclusion: Increased MMP-2 and MMP-7 levels and a decreased MMP-9 level seem to be related to the pathogenesis of pre-eclampsia and are expected to be potential predictors of pre-eclampsia. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

18 pages, 15142 KiB  
Article
The Trends and Hotspots in Premature Ovarian Insufficiency Therapy from 2000 to 2022
by Yan Tong, Nan Cheng, Xinran Jiang, Kai Wang, Fei Wang, Xinxin Lin and Fang Wang
Int. J. Environ. Res. Public Health 2022, 19(18), 11728; https://doi.org/10.3390/ijerph191811728 - 17 Sep 2022
Cited by 6 | Viewed by 2437
Abstract
This study aims to map the knowledge structure and themes trends of primary ovarian insufficiency (POI) therapy to help researchers rapidly master the hotspots and prospects of POI therapy from the increasing number of publications. The literature search and bibliometric analyses were performed [...] Read more.
This study aims to map the knowledge structure and themes trends of primary ovarian insufficiency (POI) therapy to help researchers rapidly master the hotspots and prospects of POI therapy from the increasing number of publications. The literature search and bibliometric analyses were performed by using Web of Science Core Collection and VOSviewer. Annual publications from 2000 to 2022 continued to increase with some fluctuations. The most productive country, organization, and journal were the USA, Shanghai Jiao Tong University, and Human Reproduction, respectively. Harvard University was the organization with the highest citation. Fertility and Sterility and Nelson, L.M. were the most influential journal and author, respectively. Seven clusters separated by keywords association showed the extensive scope of POI therapy. The hotspots of POI therapy were hormone replacement therapy and fertility preservation, and the innovative treatment strategies including in vitro activation and mesenchymal stem cells had development potential. In addition, our result showed that the high-cited articles were published in journals with high impact factors. The paper provides a comprehensive overview of the development and hotspots of POI therapy, allowing researchers to recognize the current status and future directions of POI therapy. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

11 pages, 331 KiB  
Article
Prevalence, Knowledge and Awareness of Pelvic Floor Disorder among Pregnant Women in a Tertiary Centre, Malaysia
by Mukhtar Nur Farihan, Beng Kwang Ng, Su Ee Phon, Mohamed Ismail Nor Azlin, Abdul Ghani Nur Azurah and Pei Shan Lim
Int. J. Environ. Res. Public Health 2022, 19(14), 8314; https://doi.org/10.3390/ijerph19148314 - 07 Jul 2022
Cited by 3 | Viewed by 2072
Abstract
Pelvic floor disorders are common and of concern, as the majority of maternity healthcare providers seldom discuss this issue with patients compared to other antenatal issues. The aim of this study is to determine the prevalence and to assess the knowledge and awareness [...] Read more.
Pelvic floor disorders are common and of concern, as the majority of maternity healthcare providers seldom discuss this issue with patients compared to other antenatal issues. The aim of this study is to determine the prevalence and to assess the knowledge and awareness of pelvic floor disorder (PFD) among pregnant women in a tertiary centre in Malaysia. We also aim to assess the association between women’s risk factors regarding their knowledge and awareness of pelvic floor disorder so that primary prevention strategies can be planned, initiated and implemented in the future. This is a cross-sectional study with a total of four hundred twenty-four pregnant women that were recruited over a 6-month duration from May to November 2017 in a tertiary centre in Malaysia. The Pelvic Floor Distress Inventory (PFDI-20) was used to evaluate pelvic floor distress symptoms during pregnancy, namely urinary incontinence, pelvic organ prolapse and faecal incontinence. A validated Prolapse and Incontinence Knowledge Questionnaire (PIKQ), which consists of 24 items, was used to assess respondents’ knowledge about urinary incontinence (UI) and pelvic organ prolapse (POP). A total of 450 participants were approached, but 424 participants agreed to participate, showing a response rate of 94.3%. The median age was 31.5 years old, and 33.3% were primiparity. Overall, 46.1% of pregnant women had at least one symptom of pelvic floor disorder during pregnancy. Of these, 62.3% experienced urinary incontinence, 41.1% experienced symptoms of pelvic organ prolapse, and 37.8% experienced symptoms of faecal incontinence. The overall median score of PIKQ was 12.0 (8.0, 17.0). The median score for PIKQ—UI was 7.0 (5.0, 9.0) and the median score for PIKQ—POP was 6.0 (4.0, 8.0). There were 341 (80.4%) pregnant women that had a low level of knowledge in UI, and 191 (45.0%) had a low level of knowledge in POP. Having a tertiary level of education and receiving antenatal specialist care were both associated with better proficiency in both the PIKQ—UI (p < 0.001) and PIKQ—POP (p < 0.001) subscales. Pelvic floor disorder during pregnancy was common. A knowledge of pelvic floor disorder was lacking among pregnant women in this study. Having a tertiary education and receiving antenatal specialist care were both associated with better knowledge proficiency. This study hopefully serves as a basic platform for future educational programs to bridge the knowledge gaps in PFD among pregnant women. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
11 pages, 337 KiB  
Article
Quality of Life of Gynaeoncology Patients and Family Caregivers
by Raimi Zamriah Hasan, Beng Kwang Ng, Su Ee Phon, Abdul Kadir Abdul Karim, Pei Shan Lim and Abdul Ghani Nur Azurah
Int. J. Environ. Res. Public Health 2022, 19(11), 6450; https://doi.org/10.3390/ijerph19116450 - 26 May 2022
Cited by 2 | Viewed by 1157
Abstract
The quality of life of both gynaeoncology patients and their family caregivers is affected by disease. This was a cross-sectional study of gynaeoncology patients and their caregivers in a gynaeoncology clinic and ward in a tertiary centre from 1 November 2017 until 30 [...] Read more.
The quality of life of both gynaeoncology patients and their family caregivers is affected by disease. This was a cross-sectional study of gynaeoncology patients and their caregivers in a gynaeoncology clinic and ward in a tertiary centre from 1 November 2017 until 30 April 2018. EQ-5D-5L and SF-36 questionnaires were used for the assessment of quality of life. Sociodemographic characteristics and the quality of life of both patients and caregivers were studied. There were 176 patients approached and 7 patients declined to participate in the study, giving the response rate of 95.9%. A total of 169 patients were recruited and consented to this study. Whereas, for SF-36, five domains that were physical functioning, role limitation due to physical health, energy, pain, and general health were statistically significant between both groups (p < 0.05). Factors that favoured a high quality of life in patients were an early stage of cancer and the absence of comorbidities. While for caregivers, being single or educated was associated with a better quality of life. In our study, we found that the quality of life of gynaeoncology patients was lower than their caregivers based on EQ-5D-5L and SF-36 questionnaires. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
10 pages, 358 KiB  
Article
Role of Self-Sampling for Cervical Cancer Screening: Diagnostic Test Properties of Three Tests for the Diagnosis of HPV in Rural Communities of Cuenca, Ecuador
by Bernardo Vega Crespo, Vivian Alejandra Neira, José Ortíz Segarra, Ruth Maldonado Rengel, Diana López, María Paz Orellana, Andrea Gómez, María José Vicuña, Jorge Mejía, Ina Benoy, Tesifón Parrón Carreño and Veronique Verhoeven
Int. J. Environ. Res. Public Health 2022, 19(8), 4619; https://doi.org/10.3390/ijerph19084619 - 12 Apr 2022
Cited by 9 | Viewed by 3271
Abstract
Background: HPV primary screening has shown effectiveness for cancer prevention; however, gynaecological examination is considered uncomfortable. Self-sampling methods increase the acceptance of screening. The aim of this study is to compare the sensitivity and specificity of clinician sampling versus vaginal and urine self-sampling [...] Read more.
Background: HPV primary screening has shown effectiveness for cancer prevention; however, gynaecological examination is considered uncomfortable. Self-sampling methods increase the acceptance of screening. The aim of this study is to compare the sensitivity and specificity of clinician sampling versus vaginal and urine self-sampling for HPV diagnosis. Methods: A diagnostic test study was conducted in a rural parish of Cuenca, Ecuador. A total of 120 women participated. Each participant self-collected urine and vaginal samples and underwent clinician sampling for HPV testing. The latter was considered as the golden standard. All three samples were processed with the same amplification and hybridization protocol for HPV detection (Hybribio) following the manufacturer’s instructions. Results: Characteristics of the participants were: median age 35 years; 40.8% married; 46.7% had a primary level of education; and median age of sexual onset, 17.6 years. The prevalence of any type of HPV with clinician sampling was 15.0%, 17.5% with urine sampling and 18.3% with vaginal self-sampling. Self-sampling sensitivity reached 94.4% (IC 74.2–99.9), and specificity 92.1% (IC 85.2–95.9). Urine sampling had a sensitivity of 88.8% (IC 67.2, 96.9), and specificity 94.1% (IC 67.2–96.9). The negative predictive value was 98.9% (IC 94.2–99.8) for vaginal self-sampling and 97.6% (IC 92.6–99.4) for urine sampling. Conclusions: This study shows that vaginal and urine self-sampling methods have similar sensitivity and specificity compared with clinician sampling for the diagnosis of HPV. The correlation between HPV genotypes among the three tests is satisfactory. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
14 pages, 978 KiB  
Article
Biochemical Characterization and Molecular Determination of Estrogen Receptor-α (ESR1 PvuII-rs2234693 T>C) and MiRNA-146a (rs2910164 C>G) Polymorphic Gene Variations and Their Association with the Risk of Polycystic Ovary Syndrome
by Rashid Mir, Faris J. Tayeb, Jameel Barnawi, Mohammed M. Jalal, Nizar H. Saeedi, Abdullah Hamadi, Malik A. Altayar, Sanad E. Alshammari, Nabil Mtiraoui, Mohammed Eltigani Ali, Faisel M. Abu Duhier and Mohammad Fahad Ullah
Int. J. Environ. Res. Public Health 2022, 19(5), 3114; https://doi.org/10.3390/ijerph19053114 - 06 Mar 2022
Cited by 5 | Viewed by 2995
Abstract
Polycystic ovary syndrome (PCOS) is regarded as one of the most frequently encountered endocrine disorders and affects millions of young women worldwide, resulting in an array of complex metabolic alterations and reproductive failure. PCOS is a risk factor for diabetes mellitus, obstructive sleep [...] Read more.
Polycystic ovary syndrome (PCOS) is regarded as one of the most frequently encountered endocrine disorders and affects millions of young women worldwide, resulting in an array of complex metabolic alterations and reproductive failure. PCOS is a risk factor for diabetes mellitus, obstructive sleep apnea, obesity and depression in patients. Estrogen receptors (ESRs) are significant candidates in endocrine function and ovarian response in women. Moreover, microRNAs and long non-coding RNAs are emerging as principal mediators of gene expression and epigenetic pathways in various disease states. This study has characterized the clinical parameters in PCOS patients with comprehensive biochemical profiling compared to healthy controls and further examined the influence of allelic variations for estrogen receptor-α (ESR1 PvuII-rs2234693 T>C) and miRNA-146a (rs2910164 C>G) gene polymorphism on the risk of and susceptibility to PCOS. In this case-control study, we have used amplification refractory mutation specific (ARMS)-PCR to detect and determine the presence of these polymorphic variants in the study subjects. Our results demonstrated that most of the biochemical markers, which were analyzed in the study, show statistically significant alterations in PCOS patients, including fasting glucose, free insulin, HOMA-IR, LDL, HDL, cholesterol and hormones such as FSH, LH, testosterone and progesterone, which correlate with the established biochemical alterations in the disorder. Further, it is reported that for estrogen receptor-α (ESR1 PvuII-rs2234693 T>C), the frequency of the T allele (fT) was significantly higher among patients (0.64 vs. 0.44) compared to controls, while the frequency of the C allele (fC) was lower in patients (0.36 vs. 0.56) compared to controls. However, it was found that there was no association of an increased risk of PCOS with the ESR1 PvuII-rs2234693 C>T gene polymorphism. On the contrary, the study found strong association of miRNA-146a (rs2910164 C>G) gene polymorphism with an enhanced risk of PCOS. The frequency of the C allele (fC) was significantly higher among patients (0.52 vs. 0.36) compared to controls. The frequency of the G allele (fG) was found to be lower in patients (0.48 vs. 0.64) compared to controls. The codominant, dominant and recessive models display a statistically significant association of polymorphic variations with PCOS. Moreover, the G allele was associated strongly with PCOS susceptibility with an OR = 1.92 (95%) CI = (1.300–2.859), RR = 1.38 (1.130–1.691) p-value < 0.001. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

17 pages, 9234 KiB  
Article
An Update on Planned Oocyte Cryopreservation (POC) in Italy: Medical, Epidemiological and Legal Consideration
by Jessica Cremonese, Marianna Marcon, Laura Oppi, Giulia Paletti, Vincenzo Romolo, Pamela Tozzo and Luciana Caenazzo
Int. J. Environ. Res. Public Health 2022, 19(4), 2371; https://doi.org/10.3390/ijerph19042371 - 18 Feb 2022
Cited by 2 | Viewed by 2731
Abstract
Starting with a brief socioeconomic analysis of the phenomenon of female fertility, this narrative review aims to provide an analysis of the use and possibilities of medically assisted reproductive technology in combating fertility issues, adopting socioeconomic, legal and medical perspectives in Italy. The [...] Read more.
Starting with a brief socioeconomic analysis of the phenomenon of female fertility, this narrative review aims to provide an analysis of the use and possibilities of medically assisted reproductive technology in combating fertility issues, adopting socioeconomic, legal and medical perspectives in Italy. The authors mainly employ data from the annual reports of the National Registry of Medically Assisted Reproduction (PMA Registry) and the Italian Statistical Institute (ISTAT) to understand the evolution of oocyte use in medically assisted reproductive technology in Italy from 2015 to 2018 and in particular to dissect the possibilities of oocyte cryopreservation as a measure to counteract age-related infertility, specifically through Planned Oocyte Cryopreservation (POC), also known as “social freezing”. It seems that the best course of action in the context of medically assisted reproduction would be the use of young and healthy cryopreserved oocytes (autologous or donated), preferably before the age of 40, while encouraging donation of oocytes whenever possible. Italy’s dependence on foreign biobanks for donated oocytes calls for the institution of a national biobank and further specific regulation of gamete donation. For this reason, it would be useful to encourage the acceptance of Planned Oocyte Cryopreservation to allow greater availability of healthy, younger oocytes. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

12 pages, 368 KiB  
Article
Levels of Trace Elements in Erythrocytes as Endocrine Disruptors in Obese and Nonobese Women with Polycystic Ovary Syndrome
by Kamila Pokorska-Niewiada, Agnieszka Brodowska, Jacek Brodowski and Małgorzata Szczuko
Int. J. Environ. Res. Public Health 2022, 19(2), 976; https://doi.org/10.3390/ijerph19020976 - 16 Jan 2022
Cited by 7 | Viewed by 2001
Abstract
Introduction: Polycystic ovary syndrome (PCOS) is one of the most commonly recognized endocrinopathies in women. The literature lacks clear data that allow any meaningful conclusions to be drawn about the influence of trace elements in erythrocytes on the biochemical parameters of PCOS. Materials [...] Read more.
Introduction: Polycystic ovary syndrome (PCOS) is one of the most commonly recognized endocrinopathies in women. The literature lacks clear data that allow any meaningful conclusions to be drawn about the influence of trace elements in erythrocytes on the biochemical parameters of PCOS. Materials and methods: This study was conducted among 47 women meeting the Rotterdam criteria for the diagnosis of polycystic ovary syndrome. The research groups included women with PCOS with different BMI values (body mass index): obese women with PCOS (PCOS with BMI ≥ 30, mean BMI index 35.4 ± 4.4 kg/m2), nonobese PCOS women (PCOS with BMI < 30, mean BMI index 25.2 ± 2.8 kg/m2), and healthy control group (CG) with a mean BMI of 23.57 ± 0.9 kg/m2. The contents of trace elements in erythrocytes were determined with an inductively coupled plasma atomic emission spectrometer. Results: The only trace element showing significant differences in concentration between the studied groups was nickel (Ni). The level of nickel in the obese women with PCOS (BMI ≥ 30) was significantly higher than in nonobese women (BMI < 30). The content of other trace elements in erythrocytes did not differ significantly between the studied groups. Several significant correlations were found within each of the studied PCOS groups: in the group of obese women, the content of zinc (Zn) in erythrocytes positively correlated with prolactin, the content of magnesium (Mg) positively correlated with testosterone, and the content of manganese (Mn) negatively correlated with thyroid-stimulating hormone. In the group of nonobese women, Zn content correlated positively with testosterone, Ni with luteinizing hormone (LH) and estradiol, and Mg negatively correlated with estradiol. Conclusions: The relationship between the level of trace elements and the level of hormones suggests that, in obese women with PCOS, nickel may play a role in inhibiting the processes of folliculogenesis and ovulation. Research on trace elements and their relationship to ovulatory cycles and the development of PCOS may contribute to reducing the consequences of PCOS and, therefore, should be extended. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
17 pages, 417 KiB  
Article
Asymmetric Power Relations in Gynaecological Consultations for Cervical Cancer Prevention: Biomedical and Gender Issues
by Carla Freijomil-Vázquez, Denise Gastaldo, Carmen Coronado and María-Jesús Movilla-Fernández
Int. J. Environ. Res. Public Health 2021, 18(15), 7850; https://doi.org/10.3390/ijerph18157850 - 24 Jul 2021
Cited by 3 | Viewed by 2424
Abstract
A generic qualitative research, using a poststructuralist feminist perspective, was conducted in a Spanish gynaecology unit with the following aims: (a) to analyse how asymmetric power relations in relation to biomedical knowledge and gender shape the medical encounters between gynaecologists and women diagnosed [...] Read more.
A generic qualitative research, using a poststructuralist feminist perspective, was conducted in a Spanish gynaecology unit with the following aims: (a) to analyse how asymmetric power relations in relation to biomedical knowledge and gender shape the medical encounters between gynaecologists and women diagnosed with cervical intraepithelial neoplasia and (b) to explore the cognitive, moral, and emotional responses expressed by patients. A total of 21 women diagnosed with cervical intraepithelial neoplasia were recruited through purposive sampling. Semi-structured interviews were recorded and transcribed, and a thematic analysis was carried out. Two major themes were identified: (a) gendered relations in cervical intraepithelial neoplasia medical encounters are based on hidden, judgmental moral assumptions, making women feel irresponsible and blamed for contracting the human papillomavirus infection; (b) biomedical power is based on the positivist assumption of a single truth (scientific knowledge), creating asymmetric relations rendering women ignorant and infantilised. Women reacted vehemently during the interviews, revealing a nexus of cognitive, moral, and emotional reactions. In medical encounters for management of cervical intraepithelial neoplasia, patients feel they are being morally judged and given limited information, generating emotional distress. Healthcare professionals should question whether their practices are based on stereotypical gender assumptions which lead to power asymmetries during encounters. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
14 pages, 5616 KiB  
Article
Spatial Patterns of Endometriosis Incidence. A Study in Friuli Venezia Giulia (Italy) in the Period 2004–2017
by Dolores Catelan, Manuela Giangreco, Annibale Biggeri, Fabio Barbone, Lorenzo Monasta, Giuseppe Ricci, Federico Romano, Valentina Rosolen, Gabriella Zito and Luca Ronfani
Int. J. Environ. Res. Public Health 2021, 18(13), 7175; https://doi.org/10.3390/ijerph18137175 - 05 Jul 2021
Cited by 3 | Viewed by 1992
Abstract
Background: Diagnosis of endometriosis and evaluation of incidence data are complex tasks because the disease is identified laparoscopically and confirmed histologically. Incidence estimates reported in literature are widely inconsistent, presumably reflecting geographical variability of risk and the difficulty of obtaining reliable data. Methods: [...] Read more.
Background: Diagnosis of endometriosis and evaluation of incidence data are complex tasks because the disease is identified laparoscopically and confirmed histologically. Incidence estimates reported in literature are widely inconsistent, presumably reflecting geographical variability of risk and the difficulty of obtaining reliable data. Methods: We retrieved incident cases of endometriosis in women aged 15–50 years using hospital discharge records and pathology databases of the Friuli Venezia Giulia region in the calendar period 2004–2017. We studied the spatial pattern of endometriosis incidence applying Bayesian approaches to Disease Mapping, and profiled municipalities at higher risk controlling for multiple comparisons using both q-values and a fully Bayesian approach. Results: 4125 new cases of endometriosis were identified in the age range 15 to 50 years in the period 2004–2017. The incidence rate (x100 000) is 111 (95% CI 110–112), with a maximum of 160 in the age group 31–35 years. The geographical distribution of endometriosis incidence showed a very strong north-south spatial gradient. We consistently identified a group of five neighboring municipalities at higher risk (RR 1.31 95% CI 1.13; 1.52), even accounting for ascertainment bias. Conclusions: The cluster of 5 municipalities in the industrialized and polluted south-east part of the region is suggestive. However, due to the ecologic nature of the present study, information on the patients’ characteristics and exposure histories are limited. Individual studies, including biomonitoring, and life-course studies are necessary to better evaluate our findings. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

Review

Jump to: Editorial, Research, Other

18 pages, 1457 KiB  
Review
Educational Interventions to Promote Cervical Cancer Screening among Rural Populations: A Systematic Review
by Mengyue Zhang, Janet W. H. Sit, Dorothy Ngo Sheung Chan, Oluwadamilare Akingbade and Carmen W. H. Chan
Int. J. Environ. Res. Public Health 2022, 19(11), 6874; https://doi.org/10.3390/ijerph19116874 - 04 Jun 2022
Cited by 11 | Viewed by 3613
Abstract
The urban–rural gap in cervical cancer screening uptake is a significant public health consideration. Educational interventions are commonly adopted to promote cervical cancer screening among females in rural areas; however, the characteristics and effectiveness of these educational interventions remain unclear. In this review, [...] Read more.
The urban–rural gap in cervical cancer screening uptake is a significant public health consideration. Educational interventions are commonly adopted to promote cervical cancer screening among females in rural areas; however, the characteristics and effectiveness of these educational interventions remain unclear. In this review, we aimed to identify the characteristics of educational interventions used in rural populations and to evaluate the effects of these interventions on cervical cancer screening-related outcomes. Seven English databases were searched in January 2022. Randomized controlled trials (RCTs) and quasi-experimental studies were included. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Randomized Controlled Trials and the JBI Critical Appraisal Checklist for Quasi-Experimental Studies were used for quality appraisal. RevMan 5.4 software was used for the meta-analysis. A narrative synthesis was conducted in instances where a meta-analysis was inappropriate. Three RCTs and seven quasi-experimental studies conducted in six countries were included. A social cognitive theory-based framework, the community setting, group sessions, healthcare professional-led approaches, and culture-tailored materials were implemented in the educational interventions for cervical cancer screening. The educational content mainly included basic information on cervical cancer screening, psychological issues, barriers and strategies to overcome them, and locally available resources. Educational interventions increased the knowledge and uptake of cervical cancer screening in the rural population. However, the studies only evaluated the short-term effects of these educational interventions, with the cervical screening behavior only being assessed in one instance for each participant. Educational interventions promote cervical cancer screening among females in rural areas. Theory-driven, community-involved, group-based, and healthcare professional-led approaches should be prioritized in the application of educational interventions in rural populations. Both the short- and long-term, influences of educational interventions on the cervical cancer screening behavior of females in rural areas need to be recognized. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

12 pages, 1867 KiB  
Review
Postcoital Vaginal Perforation and Evisceration in Women with No Prior Pelvic Surgery: Laparoscopic Management and Systematic Review of the Literature
by Guglielmo Stabile, Denise Mordeglia, Federico Romano, Stefania Carlucci, Francesco Paolo Mangino, Luigi Nappi, Felice Sorrentino, Nicolò De Manzini and Giuseppe Ricci
Int. J. Environ. Res. Public Health 2021, 18(18), 9746; https://doi.org/10.3390/ijerph18189746 - 16 Sep 2021
Cited by 14 | Viewed by 4989
Abstract
Objective: to evaluate risk factors, causes, management and surgical therapy of postcoital vaginal perforation and evisceration in women with no prior pelvic surgery. Data sources: We used MEDLINE (PubMed), Scopus, Embase and Web of Science for our research. Our review includes all reports [...] Read more.
Objective: to evaluate risk factors, causes, management and surgical therapy of postcoital vaginal perforation and evisceration in women with no prior pelvic surgery. Data sources: We used MEDLINE (PubMed), Scopus, Embase and Web of Science for our research. Our review includes all reports from 1980 to November 2020. The research strategy adopted included different combinations of the following terms: (intercourse) AND (coitus) AND (vaginal perforation). Methods of study selection: we report a case of vaginal evisceration after consensual intercourse in a young and healthy woman. In addition, we performed a systematic review of vaginal perforations with or without evisceration in women without prior surgery or any other predisposing disease. All studies identified were listed by citation, title, authors and abstract. Duplicates were identified by an independent manual screening, performed by one researcher and then removed. For the eligibility process, two authors independently screened the title and abstracts of all non-duplicated papers and excluded those not pertinent to the topic. Tabulation, integration and results: We have followed the PRISMA guidelines. Five manuscripts were detected through the references of the works that had been identified with the research on MEDLINE (PubMed), Scopus, Embase and Web of Science. We found 16 cases between 1980 and 2020. The young age and the virginal status represent the principal risk factors and all the lacerations occurred in the posterior vaginal fornix. The most common surgical technique was the laparotomic approach and, in the remaining cases, the laparoscopic and vaginal route was performed. Conclusions: Post-coital vaginal perforation and evisceration in women with no prior pelvic surgery is a rare condition in the clinical practice and, when it is associated with evisceration it is a surgical emergency. Usually, these injuries are not life-threatening conditions but, a delay in diagnosis, can lead to severe complications. In consideration of the high heterogeneity of the data in the literature, it is essential to define a diagnostic–therapeutic management for the patients with vaginal perforation. With our review, we try to identify the associated risk factors, the best and fastest diagnosis, and the best surgical approach. We believe that a combined vaginal and laparoscopic approach can be the best surgical treatment, useful to diagnose injuries of the abdominal organs and to improve postoperative outcome. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

14 pages, 2961 KiB  
Review
The Management of the Cotyledonoid Leiomyoma of the Uterus: A Narrative Review of the Literature
by Francesca Buonomo, Sofia Bussolaro, Clarice de Almeida Fiorillo, Giorgio Giorda, Federico Romano, Stefania Biffi and Giuseppe Ricci
Int. J. Environ. Res. Public Health 2021, 18(16), 8521; https://doi.org/10.3390/ijerph18168521 - 12 Aug 2021
Cited by 6 | Viewed by 4413
Abstract
Cotyledonoid leiomyoma is an unusual uterine myoma due to some ultrasound features that mimic a malignant lesion facilitating the choice of radical surgery. This study aims to summarize the ultrasound and the magnetic resonance imaging aspects of this atypical lesion, and also discuss [...] Read more.
Cotyledonoid leiomyoma is an unusual uterine myoma due to some ultrasound features that mimic a malignant lesion facilitating the choice of radical surgery. This study aims to summarize the ultrasound and the magnetic resonance imaging aspects of this atypical lesion, and also discuss surgical treatment and pathological exam. It included all English case reports or case series until August 2021 found through PubMed, Google Scholar, and Scopus. A total of 94 cotyledonoid leiomyomas were reported, with a median tumor size of 12 cm. The typical ultrasound image is characterized by a large solid heterogeneous mass, with high vascularity, no shadowing, and indistinct margins within the myometrium. Magnetic resonance imaging shows the presence of merging isointense nodules to the myometrium in T1-weighted images, hyperintense in T2-weighted images, and contrast agent enhancement. Surgical treatment consists of hysterectomy (75 cases, 80%) or myomectomy (19 cases, 20%), without evidence of recurrence if complete. The placenta-like appearance observed during surgery supports this rare fibroid hypothesis. The intraoperative frozen section can be considered. Microscopically, no atypical cells, signs of mitotic activity or cell necrosis are found. To conclude, some preoperative and intraoperative aspects of this lesion are distinctive and may lead surgeons to opt for conservative surgery. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

10 pages, 2256 KiB  
Review
The Gender Gap in the Diagnostic-Therapeutic Journey of the Infertile Couple
by Giuseppe Gullo, Gaspare Cucinella, Antonio Perino, Domenico Gullo, Daniela Segreto, Antonio Simone Laganà, Giovanni Buzzaccarini, Zaira Donarelli, Angelo Marino, Adolfo Allegra, Marianna Maranto, Andrea Roberto Carosso, Piernicola Garofalo and Rossella Tomaiuolo
Int. J. Environ. Res. Public Health 2021, 18(12), 6184; https://doi.org/10.3390/ijerph18126184 - 08 Jun 2021
Cited by 35 | Viewed by 4140
Abstract
Medical procreation impairs both the biological and psychological lives of couples. However, male and female attitudes to infertility are different and require a different approach during the IVF journey. Thus, the gender impact assessment (GIA) method was used to analyse original studies present [...] Read more.
Medical procreation impairs both the biological and psychological lives of couples. However, male and female attitudes to infertility are different and require a different approach during the IVF journey. Thus, the gender impact assessment (GIA) method was used to analyse original studies present in the literature. We found some gender-related differences and, subsequently, possible outcomes of intervention to improve healthy reproduction management and prevent infertility. In particular, it became apparent that there was the need for an in-depth male infertility assessment and a gender-specific follow-up. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

13 pages, 17379 KiB  
Review
The Rare, Unexpected Condition of a Twisted Leiomyoma in Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome: Etiopathogenesis, Diagnosis and Management. Our Experience and Narrative Review of the Literature
by Federico Romano, Stefania Carlucci, Guglielmo Stabile, Giuseppe Mirenda, Mariateresa Mirandola, Francesco Paolo Mangino, Andrea Romano and Giuseppe Ricci
Int. J. Environ. Res. Public Health 2021, 18(11), 5895; https://doi.org/10.3390/ijerph18115895 - 31 May 2021
Cited by 6 | Viewed by 5583
Abstract
Uterine leiomyomas are a common finding in medical practice, but their frequency changes drastically when contextualized in a syndrome, as in the following case. A 50-year-old woman with a known Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome presented at our clinic with abdominal pain located in the [...] Read more.
Uterine leiomyomas are a common finding in medical practice, but their frequency changes drastically when contextualized in a syndrome, as in the following case. A 50-year-old woman with a known Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome presented at our clinic with abdominal pain located in the lower quadrants and scarcely responsive to analgesic therapy. A twisted gynecological pelvic mass was diagnosed, and management for prompt resolution was adopted. Histologically the mass was described as a leiomyoma. The aim of the present study is to share our experience and to review the literature to compare different manifestation of the disease and different approach used in the various centers. The additional novelty of the paper is the immunohistochemical study we carried out on the leiomyoma that is contrasted with the current etiopathogenetic theories. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

Other

18 pages, 2674 KiB  
Systematic Review
Reproductive and Obstetric Outcomes after UAE, HIFU, and TFA of Uterine Fibroids: Systematic Review and Meta-Analysis
by Ayazhan Akhatova, Gulzhanat Aimagambetova, Gauri Bapayeva, Antonio Simone Laganà, Vito Chiantera, Peter Oppelt, Antonio Sarria-Santamera and Milan Terzic
Int. J. Environ. Res. Public Health 2023, 20(5), 4480; https://doi.org/10.3390/ijerph20054480 - 02 Mar 2023
Cited by 6 | Viewed by 2856
Abstract
Novel treatment options for uterine fibroids, such as uterine artery embolization (UAE), ultrasound-guided and magnetic resonance-guided high-intensity focused ultrasound (USgHIFU and MRgHIFU), and transcervical radiofrequency ablation (TFA) methods, are widely used in clinical practice. This systematic review and meta-analysis (CRD42022297312) aims to assess [...] Read more.
Novel treatment options for uterine fibroids, such as uterine artery embolization (UAE), ultrasound-guided and magnetic resonance-guided high-intensity focused ultrasound (USgHIFU and MRgHIFU), and transcervical radiofrequency ablation (TFA) methods, are widely used in clinical practice. This systematic review and meta-analysis (CRD42022297312) aims to assess and compare reproductive and obstetric outcomes in women who underwent these minimally invasive approaches for uterine fibroids. The search was performed in PubMed, Google Scholar, ScienceDirect, Cochrane Library, Scopus, Web of Science and Embase. Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) and Cochrane guidelines. The articles were selected to meet the following eligibility criteria: (1) research article, (2) human subject research, and (3) the study of pregnancy outcomes after the treatment of uterine fibroids by either one of three methods—UAE, HIFU, and TFA. The analysis of 25 eligible original articles shows a similar rate of live births for UAE, USgHIFU, MRgHIFU, and TFA (70.8%, 73.5%, 70%, and 75%, respectively). The number of pregnancies varied considerably among these studies, as well as the mean age of pregnant women. However, the results of pregnancy outcomes for TFA are insufficient to draw firm conclusions, since only 24 women became pregnant in these studies, resulting in three live births. The miscarriage rate was highest in the UAE group (19.2%). USgHIFU was associated with a higher rate of placental abnormalities compared to UAE (2.8% vs. 1.6%). The pooled estimate of pregnancies was 17.31% to 44.52% after UAE, 18.69% to 78.53% after HIFU, and 2.09% to 7.63% after TFA. The available evidence confirmed that these minimally invasive uterine-sparing treatment options for uterine fibroids are a good approach for patients wishing to preserve their fertility, with comparable reproductive and obstetric outcomes among the different techniques. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

14 pages, 20398 KiB  
Protocol
Effect of Pelvic Floor Workout on Pelvic Floor Muscle Function Recovery of Postpartum Women: Protocol for a Randomized Controlled Trial
by Hongmei Zhu, Di Zhang, Lei Gao, Huixin Liu, Yonghui Di, Bing Xie, Wei Jiao and Xiuli Sun
Int. J. Environ. Res. Public Health 2022, 19(17), 11073; https://doi.org/10.3390/ijerph191711073 - 04 Sep 2022
Cited by 7 | Viewed by 4896
Abstract
Background: There is a risk of pelvic floor dysfunction (PFD) from baby delivery. Many clinical guidelines recommend pelvic floor muscle training (PFMT) as the conservative treatment for PFD because pelvic floor muscles (PFMs) play a crucial role in development of PFD. However, there [...] Read more.
Background: There is a risk of pelvic floor dysfunction (PFD) from baby delivery. Many clinical guidelines recommend pelvic floor muscle training (PFMT) as the conservative treatment for PFD because pelvic floor muscles (PFMs) play a crucial role in development of PFD. However, there is disagreement about the method and intensity of PFM training and the relevant measurements. To pilot the study in PFM training, we designed a Pelvic Floor Workout (PEFLOW) for women to train their pelvic through entire body exercises, and we planned a trial to evaluate its effectiveness through comparing the outcomes from a group of postpartum women who perform PELFLOW at home under professional guidance online with the control group. Methods/design: The randomized controlled trial was projected to be conducted from November 2021 to March 2023. A total of 260 postpartum women would be recruited from the obstetrics departments of the study hospital and women would be eligible for participation randomized into experimental or control groups (EG/CG) if their PFM strength are scaled by less than Modified Oxford grading Scale (MOS) to be less than grade 3. Women in EG would perform a 12-week PEFLOW online under the supervision and guidance of a physiotherapist, while women in CG would have no interventions. Assessments would be conducted at enrollment, post intervention (for EG) or 18th to 24th week postpartum (for CG), and 1 year postpartum. Assessment would be performed in terms of pelvic floor symptoms, including MOS, cough stress test, urinary leakage symptoms, pelvic organ prolapse quantitation (POP-Q), and vaginal relaxation, clinic examinations including Pelvic floor electrophysiological test, Pelvic floor ultrasound and Spine X-ray, overall body test including trunk endurance test, handgrip test, body composition test, and questionnaires including International Physical Activity Questionnaire Score-Short Form(IPAQ-SF), Pelvic Floor Distress Inventory Questionnaire-20 (PFDI-20), Pelvic Floor Impact Questionnaire-7 (PFIQ-7), the 6-item Female Sexual Function Index (FSFI-6), and the Pittsburgh Sleep Quality Index (PSQI). Primary analysis will be performed to test our main hypothesis that PEFLOW is effective with respect to strengthen PFM strength. Discussion: This trial will demonstrate that pelvic floor-care is accessible to most women and clinical practice on PFD may change relevantly should this study find that Online PEFLOW approach is effective to improve PFMs. Trial registration: ClinicalTrials.gov, NCT05218239. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

10 pages, 552 KiB  
Protocol
Effect of the App-Based Video Guidance on Prenatal Pelvic Floor Muscle Training Combined with Global Postural Re-education for Stress Urinary Incontinence Prevention: A Protocol for a Multicenter, Randomized Controlled Trial
by Lei Gao, Di Zhang, Shiyan Wang, Yuanyuan Jia, Haibo Wang, Xiuli Sun and Jianliu Wang
Int. J. Environ. Res. Public Health 2021, 18(24), 12929; https://doi.org/10.3390/ijerph182412929 - 08 Dec 2021
Cited by 7 | Viewed by 2623
Abstract
Background: As the effectiveness on stress urinary incontinence (SUI) prevention of pelvic floor muscle training (PFMT) for pregnant women has been inconclusive, we are planning to conduct a trial to evaluate a video program designed for prevention of SUI developed through combining PFMT [...] Read more.
Background: As the effectiveness on stress urinary incontinence (SUI) prevention of pelvic floor muscle training (PFMT) for pregnant women has been inconclusive, we are planning to conduct a trial to evaluate a video program designed for prevention of SUI developed through combining PFMT with global postural reeducation (GPR). Methods: As a randomized controlled trial, eligible participants will be randomized (1:1) into an exercise group and a control group to perform PFMT regularly following video guidance or with no intervention, respectively. The experimental stage will be from the 16th gestation week (GW) to the 12th month postpartum, with eight appointments at the 16th, 28th, 37th GW, delivery, the 6th week and the 3rd, 6th, and 12th month postpartum. Data will be collected regarding urinary leakage symptoms, the stress test, the modified Oxford Scale, pelvic floor ultrasound, perineal laceration classification at delivery, neonatal Apgar score, and questionnaires (PISQ-12, ICIQ-UI SF, I-QOL, OABSS). The primary outcome is the occurrence of the symptomatic SUI and positive stress test at the 6th week postpartum. Discussion: This protocol is anticipated to evaluate the efficacy of the intervention via video app for the design of a future randomized control trial (RCT). Trial registration: The trial has been registered at Chinese Clinical Trial Registry (registration number: ChiCTR2000029618). Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

14 pages, 6119 KiB  
Systematic Review
Breast Cancer Care Quality Indicators in Spain: A Systematic Review
by Marta Maes-Carballo, Yolanda Gómez-Fandiño, Carlos Roberto Estrada-López, Ayla Reinoso-Hermida, Khalid Saeed Khan, Manuel Martín-Díaz and Aurora Bueno-Cavanillas
Int. J. Environ. Res. Public Health 2021, 18(12), 6411; https://doi.org/10.3390/ijerph18126411 - 13 Jun 2021
Cited by 5 | Viewed by 3345
Abstract
Breast cancer (BC) management care requires an increment in quality. An initiative to improve the BC quality care is registered, and quality indicators (QIs) are studied. We appraised the appearance of QIs and their standards systematically in Spain. A prospective systematic search (Prospero [...] Read more.
Breast cancer (BC) management care requires an increment in quality. An initiative to improve the BC quality care is registered, and quality indicators (QIs) are studied. We appraised the appearance of QIs and their standards systematically in Spain. A prospective systematic search (Prospero no: CRD42021228867) for clinical pathways and integrated breast cancer care processes was conducted through databases and the World Wide Web in February 2021. Duplicate data extraction was performed with 98% reviewer agreement. Seventy-four QIs (QI per document mean: 11; standard deviation: 10.59) were found in 15 documents. The Catalonian document had the highest number of QIs (n = 30). No QI appeared in all the documents. There were 9/74 QIs covering structure (12.16%), 53/74 covering process (71.62%), and 12/74 covering outcome (16.22%). A total of 22/66 (33.33%) process and outcome QIs did not set a minimum standard of care. QIs related to primary care, patient satisfaction, and shared decision making were deficient. Most of the documents established a BC QI standard for compliance, but the high variability hinders the comparison of outcomes. Establishing a consensus-based set of QIs needs urgent attention. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-23
Back to TopTop