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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: closed (31 May 2021).

Special Issue Editors

Prof. Dr. Agnieszka Drosdzol-Cop
E-Mail Website
Guest Editor
Department of Pregnancy Pathology, Medical University of Silesia, 40-211 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
E-Mail Website
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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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 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

  • 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 (17 papers)

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Research

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Article
Physical Activity Level and Self-Esteem in Middle-Aged Women
Int. J. Environ. Res. Public Health 2021, 18(14), 7293; https://doi.org/10.3390/ijerph18147293 - 08 Jul 2021
Viewed by 367
Abstract
Background: Physical activity (PA) is a behavioral modality that may help decrease negative symptoms of menopause and enhance some positive aspects of mental health, including self-esteem. Reduced self-esteem may put menopausal women at higher risk of negative outcomes of menopause and result [...] Read more.
Background: Physical activity (PA) is a behavioral modality that may help decrease negative symptoms of menopause and enhance some positive aspects of mental health, including self-esteem. Reduced self-esteem may put menopausal women at higher risk of negative outcomes of menopause and result in a more unpleasant and stressful menopausal experience. The objective of this study was to examine the role of physical activity level on self-esteem in middle-aged women. Methods: Women aged 45–60 from Poland took part in this study. The Rosenberg Self-Esteem Scale, the International Physical Activity Questionnaire, the Menopause Rating Scale and Beck Depression Inventory were used in this study. Results: Among the 111 women, the mean age was 51.7 ± 4.7. The most severe symptoms among studied women concerned sexual problems (1.71 ± 1.5), irritability (1.58 ± 1.37) and joint and muscular discomfort (1.56 ± 1.55). Women with higher total PA level had better self-esteem (p = 0.001). Conclusions: The results of this study showed that physical activity levels can be associated with self-esteem. Most middle-aged women reported high physical activity levels. These results have clinical implications for the inclusion of PA in the lives of middle-aged women to improve self-esteem and mental health. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
Article
Copeptin in Patients with Pregnancy-Induced Hypertension
Int. J. Environ. Res. Public Health 2021, 18(12), 6470; https://doi.org/10.3390/ijerph18126470 - 15 Jun 2021
Viewed by 433
Abstract
Pregnancy-induced hypertension (PIH) occurs in 6–8% of pregnancies, and increases the risk of many severe obstetric complications. The etiology of PIH has not been fully explained, and hence, treatment is only palliative in nature, and prevention is not fully effective. It has been [...] Read more.
Pregnancy-induced hypertension (PIH) occurs in 6–8% of pregnancies, and increases the risk of many severe obstetric complications. The etiology of PIH has not been fully explained, and hence, treatment is only palliative in nature, and prevention is not fully effective. It has been proposed that PIH development is influenced by the arginine vasopressin pathway, whose surrogate biomarker is copeptin. The aim of this study is a prospective assessment of the relationship between the level of copeptin in pregnant women and the occurrence of PIH, and to identify its usefulness in predicting complications. The study involved a group of 21 pregnant women who developed PIH and 37 women with uncomplicated pregnancies as a control group. Blood samples were collected at the three trimesters of gestation (<13 HBD, between 13 and 26 and >26 HBD) and then frozen. Copeptin levels [pg/mL] were measured in serum samples obtained in the first, second and third trimesters of gestation from women in the PIH and control groups. The concentration of copeptin in the second and third trimesters of pregnancy was statistically significantly higher in the PIH group (p < 0.05). For copeptin determined in the first trimester, which could be used to screen for PIH, the area under the ROC curve was 0.650. The highest risk of PIH occurred in patients with high concentrations of copeptin in the first trimester of pregnancy and obesity OR = 5.5 (95% CI 1.0–31.3). The risk of PIH was augmented in patients with high levels of copeptin and an abnormal Doppler result of the uterine arteries OR = 28.4 (95% CI 5.3–152). In conclusion, copeptin levels were found to be elevated in pregnant women before the diagnosis of PIH; however, copeptin should not be used as a stand-alone marker. The combination of copeptin concentration with the other risk factors (diabetes, maternal age and preeclampsia in previous pregnancy) did not improve the diagnostic values of the use of copeptin in the PIH risk assessment, but the combination of copeptin concentration with BMI may be useful in clinical practice. Measurement of copeptin together with a Doppler examination of uterine arteries in the first trimester of pregnancy may be a useful marker in predicting the development of PIH. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Article
A Systematic Review of Clinical Trials Assessing Sexuality in Hysterectomized Patients
Int. J. Environ. Res. Public Health 2021, 18(8), 3994; https://doi.org/10.3390/ijerph18083994 - 10 Apr 2021
Viewed by 783
Abstract
In hysterectomized patients, even though there is still controversy, evidence indicates that in the short term, the vaginal approach shows benefits over the laparoscopic approach, as it is less invasive, faster and less costly. However, the quality of sexual life has not been [...] Read more.
In hysterectomized patients, even though there is still controversy, evidence indicates that in the short term, the vaginal approach shows benefits over the laparoscopic approach, as it is less invasive, faster and less costly. However, the quality of sexual life has not been systematically reviewed in terms of the approach adopted. Through a systematic review, we analyzed (CRD42020158465 in PROSPERO) the impact of hysterectomy on sexual quality and whether there are differences according to the surgical procedure (abdominal or vaginal) for noncancer patients. MEDLINE (through PubMed), Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Scopus were reviewed to find randomized clinical trials assessing sexuality in noncancer patients undergoing total hysterectomy, comparing vaginal and abdominal (laparoscopic and/or open) surgery. Three studies that assessed the issue under study were finally included. Two of these had a low risk of bias (Cochrane risk of bias tool); one was unclear. There was significant variability in how sexuality was measured, with no differences between the two approaches considered in the review. In conclusion, no evidence was found to support one procedure (abdominal or vaginal) over another for non-oncological hysterectomized patients regarding benefits in terms of sexuality. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Article
Polycystic Ovary Syndrome and Endometriosis as Reasons for Women’s Admission to Outpatient Specialist Care in Poland—A Retrospective Analysis
Int. J. Environ. Res. Public Health 2021, 18(4), 1442; https://doi.org/10.3390/ijerph18041442 - 04 Feb 2021
Viewed by 774
Abstract
This study aimed at presenting selected aspects of outpatient specialist care for women diagnosed with polycystic ovary syndrome (PCOS) or endometriosis. The study was carried out using a retrospective analysis of the services provided under Outpatient Specialist Care (AOS) for women, based on [...] Read more.
This study aimed at presenting selected aspects of outpatient specialist care for women diagnosed with polycystic ovary syndrome (PCOS) or endometriosis. The study was carried out using a retrospective analysis of the services provided under Outpatient Specialist Care (AOS) for women, based on data from the National Health Fund (NFZ). The study included data on women with PCOS or endometriosis based on the International Statistical Classification of Diseases and Related Health Problems (ICD-10) in Poland from 2016 to 2018. The average age of women in the study group with PCOS was 25.31 (±7.02) years and, for those with endometriosis, 38.21 (±10.79). AOS patients with diagnosed PCOS most often made 2–3 visits (34.60%) to a specialist doctor, and those with diagnosed endometriosis most often made one visit (39.95%). Significant differences between patients with PCOS and endometriosis using AOS were found concerning the women’s age, the year, season, place of treatment, type of clinic, mode of admission, number of visits, and their place of residence or macroregion. With increasing age, women with PCOS made more visits to AOS, and women with endometriosis made fewer visits to the AOS specialist. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Article
The Turnover Intention among Grassroots Family Planning Staff in the Context of China’s Universal Two-Child Policy: A Case Study of the Xi’an City
Int. J. Environ. Res. Public Health 2020, 17(22), 8478; https://doi.org/10.3390/ijerph17228478 - 16 Nov 2020
Cited by 1 | Viewed by 771
Abstract
The introduction of the universal two-child policy in 2016 marked a major social transition in China and raised a requirement for family planning services; however, the turnover in family planning staff poses a challenge to satisfying the requirement. Thus far, after implementation of [...] Read more.
The introduction of the universal two-child policy in 2016 marked a major social transition in China and raised a requirement for family planning services; however, the turnover in family planning staff poses a challenge to satisfying the requirement. Thus far, after implementation of the policy, there have been few surveys investigating turnover intention and the underlying motivations in grassroots family planning staff, the major component of China’s family planning system. A survey conducted in Xi’an in 2019 shows that nearly one in three grassroots members had an explicit or implicit turnover intention. Basically consistent with our conceptual framework, the structural equation modeling further indicates that the affective organizational commitment had the largest direct effect on turnover intention and also partly mediated effects of other significant factors (ranked by the size of total effect): Age, specific job satisfactions (i.e., satisfactions with job prospects, relationship with colleagues, and working environment), frequency of working overtime, length of service, and opportunity of professional training. As predicted, turnover behavior in colleagues also directly affected turnover intention in such staff. The above findings have important policy implications for the sustainable development of family planning work in China. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Article
Interactions of Cortisol and Prolactin with Other Selected Menstrual Cycle Hormones Affecting the Chances of Conception in Infertile Women
Int. J. Environ. Res. Public Health 2020, 17(20), 7537; https://doi.org/10.3390/ijerph17207537 - 16 Oct 2020
Cited by 1 | Viewed by 726
Abstract
One of the major problems of success in infertility treatment could depend on the understanding how the potential factors may affect the conception. The aim of this study was to evaluate present understanding of such factors or hormonal causes that may induce infertility. [...] Read more.
One of the major problems of success in infertility treatment could depend on the understanding how the potential factors may affect the conception. The aim of this study was to evaluate present understanding of such factors or hormonal causes that may induce infertility. We studied the interactions between the two menstrual cycle hormones i.e., cortisol (COR) and prolactin (PRL), along with the ultrasonographic ovulation parameters in a group of N = 205 women with diagnosed infertility. The control group consisted of N = 100 women with confirmed fertility. In both groups, follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH), thyroid stimulating hormone (TSH), PRL, COR were examined on the third day of the cycle, and estradiol (E2), progesterone (P), and COR were examined during ovulation and 7-days afterwards. In the infertile group, higher levels of PRL and COR were observed than that of in the control group. Cortisol levels at all phases of the menstrual cycle and PRL negatively correlated with E2 secretion during and after ovulation, thus contributed to the attenuation of the ovulatory LH surge. Infertile women who conceived presented with higher levels of E2 during and after ovulation, higher P after ovulation, and thicker endometrium than that of the women who failed to conceive. In conclusion, elevated secretion of COR and PRL in infertile women impairs the menstrual cycle by decreasing the pre-ovulatory LH peak and E2 and postovulatory E2 levels that affect the endometrial growth, and consequently reduce the chances to conceive. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Article
The Impact of COVID−19 on Female Sexual Health
Int. J. Environ. Res. Public Health 2020, 17(19), 7152; https://doi.org/10.3390/ijerph17197152 - 30 Sep 2020
Cited by 17 | Viewed by 1949
Abstract
Introduction: Coronavirus disease (COVID−19), announced as a pandemic by the World Health Organization, recently has dominated people’s lifestyle. The impact of COVID−19 seems to be relevant to the sexual health as well. Methods: This prospective study was conducted on two occasions involving 764 [...] Read more.
Introduction: Coronavirus disease (COVID−19), announced as a pandemic by the World Health Organization, recently has dominated people’s lifestyle. The impact of COVID−19 seems to be relevant to the sexual health as well. Methods: This prospective study was conducted on two occasions involving 764 female patients between March and April 2020—before and during the time of social quarantine. The sexual function was assessed using the Polish version of the Female Sexual Function Index (FSFI). Every patient filled out the survey concerning socio-demographic characteristics as well as the influence of SARS-CoV−2 pandemic on their lives. Results: The overall FSFI score before the pandemic was 30.1 ± 4.4 and changed to 25.8 ± 9.7 during it. Scores of every domain: desire, arousal, lubrication, orgasm, satisfaction and pain decreased as well (p < 0.001). There was statistically significant association between the workplace and the change of FSFI scores before and during COVID−19 pandemic (p < 0.01). We noticed the biggest decrease in FSFI score in the group of women who did not work at all (5.2 ± 9.9). Religion had a statistically important impact on level of anxiety (p < 0.01). Conclusion: The main finding of our study was the influence of COVID−19 pandemic on the quality of sexual lifestyle and frequency of intercourse among Polish women. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Article
Pregnancy in Patients with Type One Diabetes Mellitus Treated with Continuous Subcutaneous Insulin Infusion—Preconception Basal Insulin Dose as a Potential Risk Factor for Fetal Overgrowth?
Int. J. Environ. Res. Public Health 2020, 17(18), 6566; https://doi.org/10.3390/ijerph17186566 - 09 Sep 2020
Viewed by 806
Abstract
Despite widespread use of technology, type one diabetes mellitus (T1DM) is still a great clinical challenge during pregnancy. This study aims to assess how prenatal variables of T1DM patients using continuous subcutaneous insulin infusion (CSII) influence pregnancy outcomes. We performed a retrospective study [...] Read more.
Despite widespread use of technology, type one diabetes mellitus (T1DM) is still a great clinical challenge during pregnancy. This study aims to assess how prenatal variables of T1DM patients using continuous subcutaneous insulin infusion (CSII) influence pregnancy outcomes. We performed a retrospective study of 35 patients with T1DM treated with CSII during pregnancy. Alterable preconception variables (A1C, body mass index, basal and bolus insulin dose) were analysed as possible contributors to birth weight and large-for-gestational-age (LGA) prevalence. Inclusion criteria were presence of T1DM for more than two years, A1C < 7.4% and treatment with CSII for at least three months prior to conception. The preconception basal insulin dose and A1C had a significant correlation to the neonatal birth weight (p = 0.01, r = 0.4 and p = 0.04, r = 0.3, respectively) and were significant in regression analysis together contributing 22% of the variance in birth weight percentiles (sig = 0.17, R square = 0.22). Prevalence of LGA was 46%. Women who had LGA neonates also had a higher preconception basal insulin dose compared to women with non-LGA neonates (26 ± 9 vs. 18 ± 7 IU (international units), p = 0.01). The LGA group had a higher preconception A1C, but it did not reach statistical significance (6.5 ± 0.5% vs. 6.2 ± 0.9%, respectively, p = 0.2). Women with T1DM treated with CSII who had unregulated glycaemia and more basal insulin were at greater risk for development of LGA neonates. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Article
Perception of Menstrual Normality and Abnormality in Spanish Female Nursing Students
Int. J. Environ. Res. Public Health 2020, 17(17), 6432; https://doi.org/10.3390/ijerph17176432 - 03 Sep 2020
Cited by 1 | Viewed by 931
Abstract
Menstrual problems are usually taboo; and often, some, such as dysmenorrhea, are presumed normal. This study seeks to compare the menstrual characteristics and symptoms of female university students reporting self-perceived normality concerning their cycles and menstruation with those who perceive their menstruation as [...] Read more.
Menstrual problems are usually taboo; and often, some, such as dysmenorrhea, are presumed normal. This study seeks to compare the menstrual characteristics and symptoms of female university students reporting self-perceived normality concerning their cycles and menstruation with those who perceive their menstruation as being abnormal. A cross-sectional descriptive study was conducted among 270 nursing students using a self-report questionnaire that included sociodemographic and gynecological issues, together with Visual Analog Scale, the Andersch and Milsom Scale, and the Spanish version of the EuroQol-5 Dimension (EuroQol-5D) to measure self-perceived health status. A bivariate analysis was performed using the chi-square test, linear trend chi-square, and Student’s t-test, and a multivariate analysis of stepwise binary logistic regression was performed to predict the perception of cycle abnormality. In total, 77.4% of participants displayed normality; however, in self-reporting of menstrual characteristics, 67.4% identified alterations. Young women suffering from menstrual dizziness were 1.997 (CI95% = 1.010–3.950; p = 0.047) more likely to manifest abnormal menstruation, 4.518 (CI95% = 1.239–16.477; p = 0.022) more likely if they suffered from Grade 3 menstrual pain, and 2.851 (CI95% = 1.399–5.809; p = 0.004) more likely if they perceived that menstruation interfered with their daily lives. Many menstrual changes and symptoms are still considered normal, making it difficult to identify and address these issues. Therefore, it is necessary to develop health policies and strategies to improve menstrual health literacy for increased knowledge and earlier diagnosis. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
Article
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
Cited by 2 | Viewed by 842
Abstract
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)
Article
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
Cited by 3 | Viewed by 711
Abstract
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)

Review

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Review
Efficacy of Physiotherapy Treatment in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2021, 18(15), 7832; https://doi.org/10.3390/ijerph18157832 - 23 Jul 2021
Viewed by 362
Abstract
Primary dysmenorrhea (PD) refers to painful cramps before and/or during menstruation. There is a need for emphasis on alternative methods of conservative treatment, so as to reduce the dependence on drugs for alleviating the symptoms. The aim was to find out the effectiveness [...] Read more.
Primary dysmenorrhea (PD) refers to painful cramps before and/or during menstruation. There is a need for emphasis on alternative methods of conservative treatment, so as to reduce the dependence on drugs for alleviating the symptoms. The aim was to find out the effectiveness of some physiotherapy techniques in the treatment of PD. A systematic review and meta-analysis was conducted according to PRISMA standards. The descriptors were “dysmenorrhea”, “physical the-rapy”, “physiotherapy”, and “manual therapy”. The search was performed in five databases: Scopus, PubMed, PEDro, Web of Science, and Medline, in February 2021. The inclusion criteria were randomized controlled trials over the last six years. Articles not related to the treatment of PD or using pharmacology as the main treatment were excluded. Nine articles met the objectives and criteria, with a total of 692 participants. The most used scale to measure pain was the VAS (visual analogue scale). The main techniques were isometric exercises, massage therapy, yoga, electrotherapy, connective tissue manipulation, stretching, kinesio tape, progressive relaxation exercises and aerobic dance. Meta-analysis shows benefits of physiotherapy treatment for pain relief compared with no intervention or placebo (MD: −1.13, 95% CI: −1.61 to −0.64, I2: 88%). The current low-quality evidence suggests that physiotherapy may provide a clinically significant reduction in menstrual pain intensity. Given the overall health benefits of physiotherapy and the low risk of side effects reported, women may consider using it, either alone or in conjunction with other therapeutic modalities. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Review
Pediatric Vulvar Lichen Sclerosus—A Review of the Literature
Int. J. Environ. Res. Public Health 2021, 18(13), 7153; https://doi.org/10.3390/ijerph18137153 - 04 Jul 2021
Viewed by 427
Abstract
Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition affecting the anogenital region, which may present in a prepubertal or adolescent patient. The most popular theories are its autoimmune and genetic conditioning, although theories concerning hormonal and infectious etiology have also been raised. [...] Read more.
Vulvar lichen sclerosus (VLS) is a chronic inflammatory condition affecting the anogenital region, which may present in a prepubertal or adolescent patient. The most popular theories are its autoimmune and genetic conditioning, although theories concerning hormonal and infectious etiology have also been raised. The most common presenting symptoms of VLS is vulva pruritus, discomfort, dysuria and constipation. In physical examination, a classic “Figure 8” pattern is described, involving the labia minora, clitoral hood, and perianal region. The lesions initially are white, flat-topped papules, thin plaques, or commonly atrophic patches. Purpura is a hallmark feature of VLS. The treatment includes topical anti-inflammatory agents and long-term follow-up, as there is a high risk of recurrence and an increased risk of vulvar cancer in adult women with a history of lichen sclerosus. This article reviews vulvar lichen sclerosus in children and provides evidence-based medicine principles for treatment in the pediatric population. A systematic search of the literature shows recurrence of VLS in children. Maintenance regimens deserve further consideration. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Review
Endometriosis: New Perspective for the Diagnosis of Certain Cytokines in Women and Adolescent Girls, as Well as the Progression of Disease Outgrowth: A Systematic Review
Int. J. Environ. Res. Public Health 2021, 18(9), 4726; https://doi.org/10.3390/ijerph18094726 - 29 Apr 2021
Viewed by 746
Abstract
Endometriosis is a common chronic gynecological disorder that undoubtedly impacts on quality of life, and is one of the more complex and mysterious illnesses of our century, which is associated with the improper growth of endometrial tissue outside of the uterine cavity. This [...] Read more.
Endometriosis is a common chronic gynecological disorder that undoubtedly impacts on quality of life, and is one of the more complex and mysterious illnesses of our century, which is associated with the improper growth of endometrial tissue outside of the uterine cavity. This pathologically implanted tissue can be found most frequently in the minor pelvis, but also in the peritoneal cavity, and can affect many organs, leading to chronic pelvic pain syndrome, infertility, and dysmenorrhea. Endometrial tissue is a particularly dynamic tissue that has a direct impact on the progression of the disease, with altered immunity, as well as cytokine storms within the metaplastic endometriotic site, as possible key factors. Currently, diagnosis of this mysterious chronic illness relies on performing a laparoscopic procedure with tissue sampling. One of the most troublesome outcomes of this unintended progression is that we lack any specific, sensitive, non-invasive diagnostic tools. Currently, the vast majority of regime stewardship options rely on anti-contraceptive drugs, or other remedies that suppress the release of estrogen through the gonads—although in most clinical trials, endometriosis is a chronic progressive disorder that depends mostly on the high concentration of estrogen. Moreover, many specific trials have demonstrated that the eutopic endometrial cells in individuals with endometriosis remain much more resistant to the immunological annihilation process caused by certain elements of the immune system. Nevertheless, eutopic endometrial cells have the potential to similarly escalate the expression of aromatase receptors on the surface of the pathological cells, which in the final cascade cause an increase in the concentration of estrogen, as well as other inflammatory proteins that contribute to pathological outgrowth. Data reveal occurrence among first-degree relatives, suggesting that the specific cascade could be related to inherited as well as epigenetic (acquired) mechanisms. In women with the disease, confirmed by laparoscopic procedures, diagnosis of endometriosis can be established also via detection by gene polymorphism in the genes which are responsible for responsible for the detoxification phase of estrogen receptors and other immunomodulator components. A recent publication aims to reveal a new prospect for the non-invasive diagnosis, detection, and estimation of certain biomarkers for much more specific investigation of the disease’s progression. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Review
Effectiveness of Communication Interventions in Obstetrics—A Systematic Review
Int. J. Environ. Res. Public Health 2021, 18(5), 2616; https://doi.org/10.3390/ijerph18052616 - 05 Mar 2021
Cited by 1 | Viewed by 942
Abstract
(1) Background: Obstetric work requires good communication, which can be trained through interventions targeting healthcare providers and pregnant women/patients. This systematic review aims to aggregate the current state of research on communication interventions in obstetrics. (2) Methods: Using the PICOS scheme, we searched [...] Read more.
(1) Background: Obstetric work requires good communication, which can be trained through interventions targeting healthcare providers and pregnant women/patients. This systematic review aims to aggregate the current state of research on communication interventions in obstetrics. (2) Methods: Using the PICOS scheme, we searched for studies published in peer-reviewed journals in English or German between 2000 and 2020. Out of 7018 results, 71 studies were included and evaluated in this synthesis using the Oxford Level of Evidence Scale. (3) Results: The 63 studies that included a communication component revealed a positive effect on different proximal outcomes (i.e., communication skills). Three studies revealed a beneficial effect of communication trainings on distal performance indicators (i.e., patient safety), but only to a limited extent. Most studies simultaneously examined different groups, however, those addressing healthcare providers were more common than those with students (61 vs. 12). Only nine studies targeted expectant mothers. Overall, the evidence level of studies was low (only 11 RCTs), with 24 studies with an evidence level I-II, 35 with level III, and 10 with level IV. (4) Conclusions: Communication trainings should be more frequently applied to improve communication of staff, students, and pregnant women and their partners, thereby improving patient safety. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Review
Pediatrics Consequences of Caesarean Section—A Systematic Review and Meta-Analysis
Int. J. Environ. Res. Public Health 2020, 17(21), 8031; https://doi.org/10.3390/ijerph17218031 - 31 Oct 2020
Cited by 7 | Viewed by 1040
Abstract
Background: Cesarean section is a surgical procedure, which is the most frequently performed in gynecology and obstetrics. It is commonly believed that an operative delivery is a less painful and safer mode of delivery, which translates into an increasing number of the procedures [...] Read more.
Background: Cesarean section is a surgical procedure, which is the most frequently performed in gynecology and obstetrics. It is commonly believed that an operative delivery is a less painful and safer mode of delivery, which translates into an increasing number of the procedures performed without medical indications. The maternal sequelae of cesarean sections are well elucidated and widely discussed in the literature, while long-term neonatal consequences still remain the issue of research and scientific dispute. The aim of the present paper was to perform a systematic review of current literature regarding pediatrics consequences of cesarean section. Methods: We reviewed available data from PubMed, Science Direct as well as Google Scholar bases concerning early and long-term neonatal sequelae of operative deliveries. The following key words were used: “cesarean section”, “caesarean section”, “neonatal outcomes”, “respiratory disorders”, “asthma”, “obesity”, “overweight”, and “neurological disorders”. A total of 1636 papers were retrieved out of which 27 were selected for the final systematic review whereas 16 articles provided data for meta-analysis. Statistical analyses were performed using RevMan 5.4. To determine the strength of association between the caesarean section and respiratory tract infections, asthma, diabetes type 1 as well as obesity the pooled odds ratios (OR) with the 95% confidence intervals (CI) were calculated. Results: Conducted meta-analyses revealed that caesarean section is a risk factor for respiratory tract infections (pooled OR = 1.30 95%CI 1.06–1.60, p = 0.001), asthma (pooled OR = 1.23 95%CI 1.14–1.33, p < 0.00001) as well as obesity (pooled OR = 1.35 95%CI 1.29–1.41, p < 0.00001) in offspring. Conclusions: The results of the studies included indicated that children delivered by cesarean section more commonly developed respiratory tract infections, obesity and the manifestations of asthma than children delivered vaginally. The risk of developing diabetes mellitus type 1 or neurological disorders in offspring after caesarean section is still under discussion. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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Case Report
SARS-CoV-2 Infection and Inflammatory Response in a Twin Pregnancy
Int. J. Environ. Res. Public Health 2021, 18(6), 3075; https://doi.org/10.3390/ijerph18063075 - 17 Mar 2021
Viewed by 807
Abstract
There is growing literature about the SARS-CoV-2 pathogenetic effects exerted during pregnancy and whether vertical transmission or premature birth is possible. It is not well known whether changes in the immune system of pregnant women may lead to a marked susceptibility to infectious [...] Read more.
There is growing literature about the SARS-CoV-2 pathogenetic effects exerted during pregnancy and whether vertical transmission or premature birth is possible. It is not well known whether changes in the immune system of pregnant women may lead to a marked susceptibility to infectious processes and the risk of adverse maternal and neonatal complications such as preterm birth, spontaneous abortion, hospitalization in an intensive care unit, transmission to the fetus or newborns, and fetal mortality are poorly understood. Along with this ongoing debate, it is not well defined whether, during pregnancy, the role of host susceptibility in producing a specific inflammatory response to SARS-CoV-2 may represent distinctive markers of risk of vertical transmission. Furthermore, SARS-CoV-2 impact on the vaginal microbiome has not yet been described, despite mounting evidence on its possible effect on the gastrointestinal microbiome and its influence on infectious diseases and preterm labor. This report describes the impact of SARS-CoV-2 on a twin pregnancy diagnosed with infection at the third trimester of gestation including tissue infections, inflammatory response, antibody production, cytokine concentration, and vaginal microbiome composition. We identified a pattern of cytokines including IL1-Ra, IL-9 G-CSF, IL-12, and IL-8 differently expressed, already associated with previously infected patients. We detected a similar concentration of almost all the cytokines tested in both twins, suggesting that the SARS-CoV-2-induced cytokine storm is not substantially impaired during the placental passage. The analysis of the vaginal microbiome did not show relevant signs of dysbiosis, similar to other healthy pregnant women and twin healthy pregnancies. The aim of this report was to analyze the immunological response against SARS-CoV-2 infection and virus tissue tropism in a twin pregnancy. Full article
(This article belongs to the Special Issue Obstetrics-Gynecology and Women's Health)
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