Special Issue "Obstetrics-Gynecology and Women's Health"

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

Deadline for manuscript submissions: 30 September 2020.

Special Issue Editors

Prof. Agnieszka Drosdzol-Cop
Guest Editor
Department of Pregnancy Pathology, Medical University of Silesia, Katowice, Poland
Interests: pediatric and adolescent gynecology; menstrual disorders; endometriosis; chronic pelvic pain; endocrine disorders and sexual abuse of minors as well as clinical sexology
Dr. Anna Fuchs

Guest Editor
Department of Pregnancy Pathology, Medical University of Silesia, Katowice, Poland
Interests: perinatal medicine with an emphasis on perinatal infections and methods of labour pain relief; adolescent gynecology; endocrine disorders; endometriosis; aesthetic gynecology; clinical sexology

Special Issue Information

Dear Colleagues,

The purpose of today’s gynecology and perinatal medicine is not merely ending pregnancy and parturition safely. The goal of fostering a healthy next generation is becoming more and more important than ever. This is why, in recent years, there has been an increasing interest in adolescent and young women gynecology worldwide.

First, use of the appropriate techniques to make the patient as comfortable as possible during the first pelvic examination is key to establishing a long-term relationship with this age group. Moreover, preventive health in this patient population is key, and practitioners should become comfortable with providing education about topics as diverse as sexuality, eating disorders, and dating violence. Furthermore, the frequency with which young women report sexual activity and the high unintended pregnancy rate in this age group makes counseling regarding effective contraception essential.

On the other hand, perinatal medicine of young patients with an emphasis on the methods of labour pain relief brings lots of health challenges as well. Nowadays, there has been a growing interest in maternal sexual health and natural parenting styles worldwide.

In young women, menstruation disorders become the most common complaint requiring the attention of the gynecologist. Polycystic ovarian syndrome can develop in early puberty and carry its consequences into adulthood. Infertility, diabetes, and hirsutism mark the most important components of the syndrome and require age-appropriate management. Finally, the consequences of endometriosis on the future fertility of adolescents have brought early intervention to light. Recognition and prompt treatment are advocated to prevent the future implications of this disease.

This Special Issue seeks papers on health science of young women, new clinical approaches for adolescent gynecology, and epidemiological surveys concerning the life of the mother and children. We also welcome high-quality systematic reviews related to these matters. I would be more than happy if this Special Issue serves as a trigger for considering more effective methods in women’s healthcare in the future.

Prof. Agnieszka Drosdzol-Cop
Dr. Anna Fuchs
Guest Editors

Manuscript Submission Information

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  • Young women healthcare
  • Adolescent and pediatric gynecology
  • Menstrual disorders Hirsutism
  • Endometriosis
  • Perinatal care
  • Labour pain relief
  • Maternal sexuality
  • Sexual education
  • Adolescent pregnancy
  • Epidemiological survey for young women

Published Papers (2 papers)

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Open AccessArticle
Does the Caesarean Section Impact on 11β HSD2 and Fetal Cortisol?
Int. J. Environ. Res. Public Health 2020, 17(15), 5566; https://doi.org/10.3390/ijerph17155566 - 01 Aug 2020
Purpose: Comparison of the activity of 11beta-hydroxysteroid dehydrogenase type 2 in the placenta and the umbilical cord blood cortisol level between caesarean sections with or without uterine contraction and vaginal delivery groups. Cortisol is the main stress hormone responsible for the normal adaptation [...] Read more.
Purpose: Comparison of the activity of 11beta-hydroxysteroid dehydrogenase type 2 in the placenta and the umbilical cord blood cortisol level between caesarean sections with or without uterine contraction and vaginal delivery groups. Cortisol is the main stress hormone responsible for the normal adaptation of the neonate to extrauterine life. The disorders resulting from a dysfunction of the 11β-HSD 2–cortisol system can explain the higher risk of developing diseases in children born by caesarean section. Methods: 111 healthy, pregnant women in singular pregnancy at term of delivery were included into the study. The study comprised 11β-HSD 2 in placental tissue from 49 pregnant women delivering by elective caesarean section and 46 pregnant women delivering by vagina. In 16 cases of the elective caesarean section, regular uterine contractions were declared. Cortisol level was estimated in umbilical cord blood directly after delivery. Results: We found no statistically significant differences in the activity of 11β-HSD 2 in placentas delivered via caesarean sections (29.61 on average in elective caesarean sections and 26.65 on average in intrapartum caesarean sections) compared to vaginal deliveries (31.94 on average, p = 0.381), while umbilical cord blood cortisol in the elective caesarean sections group was significantly lower (29.86 on average) compared to the vaginal deliveries (55.50 on average, p < 0.001) and intrapartum caesarean sections (52.27 on average, p < 0.001). Conclusions: The model of placental 11β-HSD 2 activity and umbilical cord blood cortisol concentration seems to be significant in conditions of stress associated with natural uterine contractions in labour. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
Open AccessArticle
Association between the Genetic Variants of Glutathione Peroxidase 4 and Severity of Endometriosis
Int. J. Environ. Res. Public Health 2020, 17(14), 5089; https://doi.org/10.3390/ijerph17145089 - 15 Jul 2020
It has been reported that oxidative and nitrative stress might be the pathogenesis of endometriosis. This prospective case-control study attempted to check the connection between single nucleotide polymorphism (SNP) of three antioxidant enzymes (glutathione peroxidase 4 (GPX4), thioredoxin 2 (TXN2), thioredoxin reductase 1 [...] Read more.
It has been reported that oxidative and nitrative stress might be the pathogenesis of endometriosis. This prospective case-control study attempted to check the connection between single nucleotide polymorphism (SNP) of three antioxidant enzymes (glutathione peroxidase 4 (GPX4), thioredoxin 2 (TXN2), thioredoxin reductase 1 (TXNRD1)) and endometriosis. We recruited 90 patients with histology-approved endometriosis as the case group and 130 age-matched women for an annual pap smear examination as the control group. The stage of endometriosis was evaluated with revised ASRM score. Both groups were genotyped in the peripheral leukocytes for the SNP of GPX4 (rs713041), TXN2 (rs4821494) and TXNRD1 (rs1128446) by PCR-based methods. An X2 test was used to analysis of the difference of allele frequency and SNP distribution between two groups. The results revealed GPX4 (rs713041) has a significantly different distribution between two groups (C:T = 116 (44.6%):144 (55.4%) in control and C:T = 104 (57.8%): 76 (42.2%) in endometriosis groups, p = 0.007). The SNP in TXN2 (rs4821494) also showed a difference in allele frequency (G:T = 180 (69.2%):80 (30.8%) in control and G:T = 141 (78.3%):39 (21.6%) in endometriosis group, p = 0.030). In addition, the SNP GPX4 (rs713041) was associated with the severity of the endometriosis. Women who have advanced stage endometriosis were different from mild endometriosis in genetic variants of GPX4 gene (p = 0.001). In conclusion, the relationship between endometriosis and SNP of antioxidant enzymes, GPX4 and TXN2, was confirmed by the present study. According to the result, we suggested that the GPX4 might contribute to the pathogenesis of endometriosis. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Impact of perinatal risk factors on the results of treatment of early and late generalized infections in newborns
Authors: Anna Fuchs
Affiliation: Medical University of Silesia
Abstract: BACKGROUND Neonates are at high risk of mortality from infection. Early knowledge of perinatal factors, together with the analysis of the treatment may help to shorten the hospitalisation and improve the final outcome. MATERIAL AND METHODS This is a retrospective registry of 95 consecutive patients with infection admitted to the Pediatric Center, John Paul II (Sosnowiec, Silesia, Poland) Neonatal Intensive Care Unit in the 6-years period between 2007 and 2013. The patients were divided into two groups: I group - 72 (75.8%) neonates with early-onset sepsis. II group - 23 (24,2%) neonates with late-onset sepsis. RESULTS Sex, prematurity, congenital anomalies of cardiovascular and urinary system do not have an influence on the type of infections in newborns. Caesarean section as well as emergency caesarean section were related with late-onset sepsis. Maternal infection and an infection in perinatal period were associated with early-onset sepsis (p = 0.031). Maternal antibiotic therapy significantly increased an incidence of late – onset infections (p = 0.000). Comparison of haematological parameters associated with the infection and the occurrence of sepsis showed no significant differences between the groups. Comparing the number of newborns with borderline results of haematological parameters and levels of acute phase proteins in neonates with early - and late – onset infections, presented no statistically significant differences in both groups. There were no significant differences between both groups in the number of abnormal ultrasound, X-ray, cerebrospinal fluid analysis and positive culture of body fluids. Gram – positive bacteria were more frequent in inoculations from patients with late-onset infection while in neonates with early – onset infection dominated Gram – negative bacteria. In the group of infants with early-onset infection ampicillin and amikacin were used significantly more often. The use of catecholamines due to hypotension did not differ significantly between the groups. Ventilatory support using mechanical ventilation or CPAP was reported in similar rates (p = 0.524) in neonates with early-onset sepsis (91.67%) and late-onset sepsis (95.65%). The median duration of mechanical ventilation in neonates with early-onset infection was 10 days and did not differ significantly (p = 0.530) from a group of patients with late-onset infection – 8.5 days. CONCLUSIONS 1. Birth weight, gestational age and after birth condition of the infant had no impact on the type of infection. 2. Caesarean section and the maternal infection treated with antibiotic were related to late-onset infection. 3.There were no significant clinically differences in haematological and inflammatory parameters between both groups. 4. Gram – positive bacteria were more frequent in infants with late-onset infection. Keywords: infection, newborn, perinatal factors, bacteria

Title: The awareness of sexually transmitted diseases among adolescents and young adults
Authors: Agnieszka Drosdzol-Cop
Affiliation: Medical University of Silesia
Abstract: In accordance with the World Health Organisation (WHO), sexual health is defined as a state of physical, mental and social well-being in relation to sexuality. In our study we focused on the physical aspect of sexual health, specifically on the awareness of sexually transmitted diseases (STDs) among adolescents and young adults. Statistics show that more than 1 million sexually transmitted infections (STIs) are diagnosed every day, globally, pursuant to WHO (1). Furthermore, the prevalence of many STIs are higher among adolescents and young adults than in the when compared to the rest of the population (2,3). People who decide ( to partake in unprotected sex) to initiate sex in early age are in group of at risk of contracting an STD (3,4). There are many dimensions concurring to this increased risk, for example: disusing of barrier protection the misuse, or lack thereof, of contraceptives such as condoms for example, the intermittent or incorrect use of the aforementioned; having multiple lifetime and concurrent sexual partners; having increased biological susceptibility to infection and struggling with difficulties to get access to health care (3). What more, adolescents and young adults understate their susceptibility to sexually transmitted infections be consistent with your use of this. The ability to correct The evaluation of potentially risky sexual behaviours and their subsequently, the adverse impact on health outcomes is a basic step in preventing the spread of sexual transmitted diseases. (5) Elementary knowledge among youth about STDs is crucial to develop proper ways of prevention. Every adolescent should take cognizance of a the risks associated with indicated unprotected intercourse and having multiple sexual partners, at the very least. It is a minimal range of needed information and it is usually the aim for most prevention programmes (6). Seeing how important the knowledge about STDs is in the context of avoiding infection, crucial point is that adolescent, who initiate sexual life, should know which sources are accurate to obtain reliable information (2,7,8). In addition, adolescents should also know the names and possible symptoms of STDs, especially that they are often unspecific or less pronounced. (3).They need to be aware here can be contracted during all sexual activities and know the most effective prevention methods (3). Furthermore, they need to differentiate between facts and myths about STDs, especially HIV, in order to stop social exclusion of infected people ( 9,10). We asked about these aspects, among others, in an anonymous, voluntary, online survey conducted with polish adolescents and young adults. Our goal was to inquire the aim of which was to discover as well as understand the level of knowledge about STDs among polish adolescents, and to make them aware about the possible lack of knowledge in same areas and engage their attention of the STDs.

Title: Sexuality in women during COVID-19 pandemia
Authors: Agnieszka Drosdzol-Cop
Affiliation: Medical University of Silesia
Abstract: Sexuality is an important part of womens life and one of the most important responsible for mental health. It has a huge impact on maintaining interpersonal communication and determines human well-being. Among the benefits of a satisfying sex life mentioned are experiencing pleasure, relieving sexual tension and expressing emotional closeness. Human sexuality is controlled by many internal and external factors such as anatomy, hormones and emotions. [1] Previously unknown infectious diseases, especially those which spread very quickly, may affect the human psyche. Coronavirus disease (COVID-19) , announced as a pandemic by World Health Organization, lately has dominated people lifestyle. Isolation and monotony of everyday life make that time going by significantly different. Moreover, concomitant stress and anxiety might lead to mood swings, depression or decrease of desire. However, due to remote working, many couples spend more time together than usual. Therefore, the impact of COVID-19 seems to be relevant to the sexual health.

Title: Sexual functioning in young women with stress urinary incontinence
Authors: Agnieszka Drosdzol-Cop
Affiliation: Medical University of Silesia
Abstract: INTRODUCTION: Sexual behavior varies due to people's capabilities and restrictions. It is determined by emotional, psychological, hormonal and anatomical factors. When it comes to urinary incontinence, we can relate to all of them. Women are twice as much at risk of developing the condition than men. It is often associated with a significant decrease in sexual activity. AIM: The aim of this study was to establish the level of sexual functioning in women with urinary incontinence.

Title: Assessment of the hormonal profile and concentration of selected adipokines in adolescent girls with oligomenorrhea
Authors: Agnieszka Drosdzol-Cop
Affiliation: Medical University of Silesia
Abstract: To identify and examine the incidence of hormonal disorders, polycystic ovary syndrome (PCOS), insulin resistance and adipokines’ level in adolescent girls with diagnosed oligomenorrhea with regard to body mass index (BMI). Design: Cross-sectional study. Setting: Department of Pediatrics and Pediatric Endocrinology, Medical University of Silesia, Katowice. Participants: Study group: 46 adolescent girls (16-18 years) with oligomenorrhea and a control group: 37 healthy girls (16-18 years) with no diagnosed menstrual disorders. Interventions and Main Outcome Measures: Measurements of hormones, adipokines (LH, FSH, SHBG, DHEA-S, leptin, prolactin, DHEA‑S, testosterone, adiponectin) and insulin resistance (according to Homeostasis Model Assessment) were taken between January and December 2018. Results: Full-blown PCOS was more often in the study group (6.5% vs 0%; p<0.05). Both groups differed in terms of: LH, prolactin, total testosterone, fasting glucose, ratio of LH/FSH and FAI. In study group a negative correlation was observed between SHBG and leptin (r= ‑0.32; p=0.035); between total testosterone and adiponectin (‑0.52; p<0.001); DHEA-S and adiponectin (r= ‑0.32; p=0.033); androstendione and adiponectin (r= ‑0.37; p=0.0118). Positive correlation between free testosterone and leptin concentration (r= 0.31; p=0.036). was observed. Conclusions: Hormonal disorders such as hyperprolactinemia, hyperandrogenaemia and PCOS are more frequently diagnosed in girls with rare menstruation. BMI positively correlated with leptin levels in all studied teenage girls. In girls with oligomenorrhea, elevated levels of leptin and decreased levels of adiponectin may be considered as new biomarkers for insulin resistance and hyperandrogenaemia.

Title: Lichen sclerosus in girls: a review
Authors: Drosdzol-Cop Agnieszka
Affiliation: Medical University of Silesia
Abstract: Lichen sclerosus is a chronic, inflammatory dermatosis that usually affects the anogenital area. It has peaks of incidence in prepubertal girls and postmenopausal women. Early diagnosis and subsequent long-term anti-inflammatory treatment may reduce symptoms or prevent scarring. The objectives of this article are to review symptoms, diagnosis and therapeutic procedures of lichen sclerosus in girls. Key words: Lichen sclerosus, childhood, vulva

Title: The impact of twin pregnancy on female sexual function
Authors: Anna Fuchs; Agnieszka Drosdzol-Cop
Affiliation: Medical University of Silesia
Abstract: The incidence of twin pregnancy is estimated for 1 per 80 single pregnancies. It is assumed that it is going to be even higher over the years, especially taking iatrogenic cases into consideration. The topic of sexual functioning among women with multiple pregnancy is insufficiently developed, which is why we want to raise this subject. Methods: A cross-sectional study was conducted on 100 women during subsequent trimesters of pregnancy. The sexual function of the included women was assessed using the Polish version of the Female Sexual Function Index (FSFI). All respondents filled out the survey concerning socio-demographic characteristics, previous obstetric history, and actual pregnancy medical details. Results: >From randomised group of 100 women, 54 women were primiparous and 46 women had a history of previous delivery. Mean overall FSFI was stated 24.3 ± 6.1 Taking into consideration the results of FSFI in subsequent trimesters we can assume, that mean FSFI was the highest in the first one placing itself at 25,6. The result was diminishing successively to 24.8 ± 7 and 22,6 ± 8.4, second and third trimester respectively. If we compare the results of relevant trimesters we can see, that the difference between first and second trimester (p<0,05) and second and third one (p<0,05) is statistically significant. The place of residence had an crucial impact on FSFI score. The results were considerably higher for residents of small and medium towns or cities - 24.4 ± 3.8 i 25.9 ± 4.9 respectively, while for those living in rural area the FSFI reaches only 21,7 ± 5.4. The difference was statistically significant between the residents of rural areas and small town, as well the difference between the residents of rural area and medium city. The rest of evaluated factors did not have any impact on women’s sexuality. Conclusion: In conclusion, the present study showed that the FSFI diminishes throughout the pregnancy. The lowest observed occurs in the third trimester, while the highest during the first one. In the end, the type of multiple pregnancy did not have an impact on FSFI, nor the number of amnion or chorion. The fact whether the patient was primiparous or had a previous history of delivery was also irrelevant. Key words: twin pregnancy, sexuality/sexual dysfunction, desire, sexual activity in pregnancy

Title: Sexuality in women with endometriosis
Authors: Fuchs Anna; Drosdzol-Cop Agnieszka
Affiliation: Medical University of Silesia
Abstract: Sexual functioning varies due to people's capabilities and restrictions and it is determined by emotional, psychological, hormonal and anatomical factors. When it comes to a endometriosis, we can relate to all of them.AIMThe aim of this study was to establish sexual functioning among women with endometriosis.MATERIALS AND METHODS The survey consisted of 3 parts (39 questions in total). The first one included questions about socio-demographic characteristics, general medical history with basic gynecological information, in particular. The second part contained questions about endometriosis, including ones based on American Fertility Society (rAFS) classification system. The last section was the Polish version of the Female Sexual Function Index (FSFI) questionnaire. The result 26 points or less may indicate some dysfunctions in sexual functioning.RESULTSThe study covered 506 women (median age= 30, IQR 19-62). According to rAFS classification system, 22,7% (n=115) of woman were qualified to the I class, 17,4% (n=88) to II class, 17,4% (n=88) to III class and 14,2% (n=72) to IV class. In 28,3% (n=143) women, the disease class could not be determined based on their medical records. The mean total score of FSFI was 21,9 ± 12,6, in which 77,3% (n=392) had clinically significant sexual dysfunctions and 22,5% (n=114) had no major disorders.CONCLUSIONSBasing on the results, endometriosis is slightly decreasing women's sexual activity satisfaction. This is due to the reduction of desire, subjective arousal, lubrication, orgasm, satisfaction, and high level of pain, caused by the disease. Patients should be thoroughly informed about all the possible options and methods that modern medicine offers

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