Gynecologic and Obstetric Pathologies: From Birth to Menopause (Second Edition)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 25 December 2024 | Viewed by 7352

Special Issue Editor

Special Issue Information

Dear Colleagues,

Carrying on from the success of the Special Issue “Gynecologic and Obstetric Pathologies: From Birth to Menopause”, this second edition aims to continue publishing a broad range of original, peer-reviewed papers covering the full spectrum of obstetrics and gynecology.

The journal invites submissions on current high-quality research, reporting selected original experimental and clinical investigations in the fields of gynecology, obstetrics, and human reproduction. This Special Issue will address significant topics in gynecology and obstetrics through well-referenced review articles, meta-analyses, practice guidelines, and more. Case reports will also be considered if they have the potential to impact women's healthcare practices.

Topics of interest include general gynecology; reproductive medicine; and endocrinology, infertility, pediatric, and adolescent gynecology; menopause; urogynecology; gynecologic oncology; oncofertility; pelvic medicine; sexual medicine; minimally invasive gynecologic surgery; and the pros and cons of various techniques in gynecology and obstetrics; as well as high-risk pregnancy; prenatal diagnosis; maternal–fetal medicine; obstetrics; perinatology; and more. This Special Issue will focus particularly on the diagnosis, prediction, prevention, and treatment of obstetrical and gynecological disorders.

Given our global audience, the aim of the second edition of this Special Issue is to play a significant role in educating physicians worldwide. All published content will be accessible to everyone in an open access format.

Dr. Panagiotis Christopoulos
Guest Editor

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Keywords

  • obstetrics
  • gynecology
  • pathology
  • pediatric and adolescent gynecology
  • menopause
  • urinary disorders
  • infertility
  • gynecologic oncology
  • maternal–fetal medicine
  • incontinence
  • menstruation
  • reproduction
  • polycystic ovarian syndrome
  • endometriosis
  • dysmenorrhea

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Related Special Issue

Published Papers (7 papers)

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Research

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10 pages, 410 KiB  
Article
Validation of the Hungarian Version of the International Consultation on Incontinence Modular Questionnaire on Female Lower Urinary Tract Symptoms (ICIQ-FLUTS)
by Wesam A. Debes, Munseef Sadaqa, Alexandra Makai, Olívia Dózsa-Juhász, Nikolett Tumpek, Judit Kocsis, Pongrác Ács, Réka Laura Szűcs, Zsanett Németh, Viktória Prémusz and Marta Hock
J. Clin. Med. 2024, 13(23), 7389; https://doi.org/10.3390/jcm13237389 - 4 Dec 2024
Viewed by 347
Abstract
Objectives: Urinary incontinence (UI) is a prevalent condition that significantly impacts the quality of life. This study aimed to validate the Hungarian version of the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and assess its psychometric properties in the context [...] Read more.
Objectives: Urinary incontinence (UI) is a prevalent condition that significantly impacts the quality of life. This study aimed to validate the Hungarian version of the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and assess its psychometric properties in the context of the Hungarian population. Study design: A cross-sectional study involved 215 Hungarian-speaking women with a mean age of 67.6 ± 11.9 years. Main outcome measure: Participants were administered both the ICIQ-FLUTS and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). The psychometric analysis included test–retest reliability, convergent validity, and internal consistency. Results: The Hungarian version of ICIQ-FLUTS demonstrated strong psychometric properties. The test–retest reliability analysis showed a high intraclass correlation coefficient (ICC = 0.921), indicating excellent agreement between measurements over a 14-day interval. Convergent validity was supported by a strong positive correlation between the total scores of ICIQ-FLUTS and ICIQ-SF (ρ = 0.686, p < 0.001), emphasizing shared underlying constructs. Furthermore, the ICIQ-FLUTS questionnaire exhibited good internal consistency, with a Cronbach’s α coefficient of 0.862. Conclusions: This study successfully validated the Hungarian version of the ICIQ-FLUTS questionnaire and demonstrated its robust psychometric properties. This tool will enable healthcare practitioners and researchers to effectively assess and address UI’s impact on their quality of life. Full article
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13 pages, 566 KiB  
Article
Dysmenorrhea and Its Impact on Patients’ Quality of Life—A Cross-Sectional Study
by Mihaela Amza, Sebastian Findeklee, Bashar Haj Hamoud, Romina-Marina Sima, Mircea-Octavian Poenaru, Mihai Popescu and Liana Pleș
J. Clin. Med. 2024, 13(19), 5660; https://doi.org/10.3390/jcm13195660 - 24 Sep 2024
Viewed by 1497
Abstract
Background: Dysmenorrhea is a common condition that may have negative effects on social life, couples’ relationships and professional activities. The objectives of this study were to evaluate the prevalence, risk factors and characteristics of dysmenorrhea and its impact on patients’ quality of life [...] Read more.
Background: Dysmenorrhea is a common condition that may have negative effects on social life, couples’ relationships and professional activities. The objectives of this study were to evaluate the prevalence, risk factors and characteristics of dysmenorrhea and its impact on patients’ quality of life using a specific self-questionnaire named “DysmenQoL questionnaire”. We also checked the validity and reliability of this questionnaire in our population. Methods: We conducted a cross-sectional study that included 504 participants of reproductive age between 18 and 45 years of age. The data were collected with an original form divided into three sections. The last section (DysmenQoL questionnaire) included 20 statements scored from 1 (“never”) to 5 (“every time”) that evaluates the effects of menstrual pain on health and feelings, daily activities, relationships and professional activity. We calculated the sum of the scores for each statement and we called it the “DysmenQoL score”. Results: The prevalence of dysmenorrhea was 83.7%. The presence of dysmenorrhea was statistically significant associated with the degree of menstrual bleeding (p = 0.017), the presence of infertility (p = 0.034) and dyspareunia (p = 0.002), but also with the presence of premenstrual syndrome and a family history of dysmenorrhea (p < 0.001). Among the participants with dysmenorrhea, 73.9% considered that this symptom affected their quality of life, and this was correlated with pain intensity and the DysmenQoL score (p < 0.001). A significant difference regarding the DysmenQoL score depending on the pain intensity, frequency and duration of dysmenorrhea and the methods used to reduce the pain was observed. Conclusions: Dysmenorrhea had a high prevalence among the participants included in the study, and its presence was associated with a series of risk factors. Most women considered that dysmenorrhea affected their quality of life. The DysmenQoL questionnaire proved to be a reliable and valid method for evaluating the impact of dysmenorrhea on quality of life. Full article
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13 pages, 648 KiB  
Article
An Evaluation of DNA Methylation Levels and Sleep in Relation to Hot Flashes: A Cross-Sectional Study
by Ipek Betul Ozcivit Erkan, Hasan Hakan Seyisoglu, Gulcin Benbir Senel, Derya Karadeniz, Filiz Ozdemir, Aysel Kalayci, Mehmet Seven and Neslihan Gokmen Inan
J. Clin. Med. 2024, 13(12), 3502; https://doi.org/10.3390/jcm13123502 - 15 Jun 2024
Viewed by 1066
Abstract
Objectives: We aimed to evaluate the DNA methylation levels in perimenopausal and postmenopausal women, measured through Long Interspersed Element-1 (LINE-1) and Alu, and the sleep parameters in relation to the presence of hot flashes (HFs). Methods: This cross-sectional study included 30 peri- or [...] Read more.
Objectives: We aimed to evaluate the DNA methylation levels in perimenopausal and postmenopausal women, measured through Long Interspersed Element-1 (LINE-1) and Alu, and the sleep parameters in relation to the presence of hot flashes (HFs). Methods: This cross-sectional study included 30 peri- or postmenopausal women aged between 45 and 55. The menopausal status was determined according to STRAW + 10 criteria and all participants had a low cardiovascular disease (CVD) risk profile determined by Framingham risk score. The sample was divided into two groups based on the presence or absence of HFs documented in their medical history during their initial visit: Group 1 (n = 15) with HFs present and Group 2 (n = 15) with HFs absent. The patients had polysomnography test and HFs were recorded both by sternal skin conductance and self-report overnight. Genomic DNA was extracted from the women’s blood and methylation status was analyzed by fluorescence-based real-time quantitative PCR. The quantified value of DNA methylation of a target gene was normalized by β-actin. The primary outcome was the variation in methylation levels of LINE-1 and Alu and sleep parameters according to the presence of HFs. Results: LINE-1 and Alu methylation levels were higher in Group 1 (HFs present), although statistically non-significant. LINE-1 methylation levels were negatively correlated with age. Sleep efficiency was statistically significantly lower for women in Group 1 (HFs present) (74.66% ± 11.16% vs. 82.63% ± 7.31%; p = 0.03). The ratio of duration of awakening to total sleep time was statistically significantly higher in Group 1 (HFs present) (22.38% ± 9.99% vs. 15.07% ± 6.93, p = 0.03). Objectively recorded hot flashes were significantly higher in Group 1 (4.00 ± 3.21 vs. 1.47 ± 1.46, p = 0.03). None of the cases in Group 2 self-reported HF despite objectively recorded HFs during the polysomnography. The rate of hot flash associated with awakening was 41.4% in the whole sample. Conclusions: Women with a history of hot flashes exhibited lower sleep efficiency and higher awakening rates. Although a history of experiencing hot flashes was associated with higher LINE-1 and Alu methylation levels, no statistical significance was found. Further studies are needed to clarify this association. This study was funded by the Scientific Research Projects Coordination Unit of Istanbul University-Cerrahpasa. Project number: TTU-2021-35629. Full article
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Review

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19 pages, 612 KiB  
Review
Impact of Maternal Smoking on Obstetric and Neonatal Outcomes in Twin Pregnancies: A Narrative Review
by Cristina Juliá-Burchés, Alicia Martínez-Varea, José Morales-Roselló and Vicente Diago-Almela
J. Clin. Med. 2024, 13(23), 7329; https://doi.org/10.3390/jcm13237329 - 2 Dec 2024
Viewed by 326
Abstract
Maternal smoking, including both traditional cigarettes and electronic ones, is a significant modifiable risk factor associated with adverse perinatal outcomes, especially in twin pregnancies. This narrative review aims to explore the impact of maternal smoking on obstetric and neonatal outcomes in twin pregnancies, [...] Read more.
Maternal smoking, including both traditional cigarettes and electronic ones, is a significant modifiable risk factor associated with adverse perinatal outcomes, especially in twin pregnancies. This narrative review aims to explore the impact of maternal smoking on obstetric and neonatal outcomes in twin pregnancies, which inherently carry a higher risk of complications. A literature search was conducted using the PubMed and EMBASE databases, selecting studies published between January 1994 and October 2024. The findings demonstrate a clear association between smoking and increased risks of preterm birth and fetal growth restriction (FGR) in twin pregnancies. These risks are exacerbated when smoking is combined with other factors, such as preeclampsia and elevated body mass index (BMI). Smoking was also associated with long-term post-natal complications, including respiratory problems like asthma, as well as cognitive and behavioral disorders. However, an association with preeclampsia was not found, and further studies are needed to clarify the relationship in the fields of preterm premature rupture of membranes (PPROM) and fetal death. The adverse effects of smoking are primarily due to reduced oxygen supply to the fetus, caused by nicotine-induced vasoconstriction and carbon monoxide exposure, leading to placental insufficiency and fetal hypoxia. These effects are amplified in twin pregnancies due to the increased physiological demands. The review highlights that smoking cessation interventions during pregnancy are crucial to mitigate these risks and improve maternal and neonatal health outcomes. Full article
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16 pages, 342 KiB  
Review
Visceral Leishmaniasis in a Twin Pregnancy: A Case Report and Review of the Literature
by Grigorios Karampas, Sevasti Koulouraki, George L. Daikos, Christina Nanou, Leon Aravantinos, Makarios Eleftheriades, Dimitra Metallinou and Panagiotis Christopoulos
J. Clin. Med. 2024, 13(8), 2400; https://doi.org/10.3390/jcm13082400 - 20 Apr 2024
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Abstract
Visceral leishmaniasis (VL), often referred to as kala-azar, is quite rare in developed countries during pregnancy. Only few studies have evaluated its impact on perinatal outcome. It is caused primarily by Leishmania donovani or Leishmania infantum and presents with a wide spectrum of [...] Read more.
Visceral leishmaniasis (VL), often referred to as kala-azar, is quite rare in developed countries during pregnancy. Only few studies have evaluated its impact on perinatal outcome. It is caused primarily by Leishmania donovani or Leishmania infantum and presents with a wide spectrum of clinical manifestations from cutaneous ulcers to multisystem disease. Differential diagnosis is challenging as symptoms and signs are insidious, mimicking other diseases. Misdiagnosis can result in severe adverse perinatal outcomes, even maternal/neonatal death. Early treatment with liposomal amphotericin-B (LAmB) is currently the first choice with adequate effectiveness. We report a rare case of VL in a twin pregnancy with onset at the second trimester, presenting with periodic fever with rigors, right flank pain, and gradual dysregulation of all three cell lines. The positive rK39 enzyme-linked immunosorbent assay test confirmed the diagnosis. Treatment with LAmB resulted in clinical improvement within 48 h and in the delivery of two late-preterm healthy neonates with no symptoms or signs of vertical transmission. The one-year follow-up, of the mother and the neonates, was negative for recurrence. To our knowledge, this is the first reported case of VL in a twin pregnancy, and consequently treatment and perinatal outcome are of great importance. Full article

Other

Jump to: Research, Review

19 pages, 2430 KiB  
Systematic Review
Low PAPPA and Its Association with Adverse Pregnancy Outcomes in Twin Pregnancies: A Systematic Review of the Literature and Meta-Analysis
by Ioakeim Sapantzoglou, Maria Giourga, Afroditi Maria Kontopoulou, Vasileios Pergialiotis, Maria Anastasia Daskalaki, Panagiotis Antsaklis, Marianna Theodora, Nikolaos Thomakos and George Daskalakis
J. Clin. Med. 2024, 13(22), 6637; https://doi.org/10.3390/jcm13226637 - 5 Nov 2024
Viewed by 644
Abstract
Background: It is well established in the literature that pregnancy-associated plasma protein-A (PAPP-A) is linked to several adverse pregnancy outcomes, including pre-eclampsia (PE), fetal growth restriction (FGR), and preterm birth (PTB) in singleton pregnancies. However, data regarding such an association in twin [...] Read more.
Background: It is well established in the literature that pregnancy-associated plasma protein-A (PAPP-A) is linked to several adverse pregnancy outcomes, including pre-eclampsia (PE), fetal growth restriction (FGR), and preterm birth (PTB) in singleton pregnancies. However, data regarding such an association in twin pregnancies are lacking. The primary goal of this systematic review and meta-analysis was to assess the potential value of low PAPP-A levels in the prediction of the subsequent development of hypertensive disorders of pregnancy (HDPs), PTB, and small for gestational age (SGA)/FGR fetuses in twin pregnancies and investigate its association with the development of gestational diabetes, intrauterine death (IUD) of at least one twin, and birth weight discordance (BWD) among the fetuses. Methods: Medline, Scopus, CENTRAL, Clinicaltrials.gov, and Google Scholar databases were systematically searched from inception until 31 July 2024. All observational studies reporting low PAPP-A levels after the performance of the first-trimester combined test as part of the screening for chromosomal abnormalities with reported adverse pregnancy outcomes were included. Results: The current systematic review encompassed a total of 11 studies (among which 6 were included in the current meta-analysis) that enrolled a total of 3741 patients. Low PAPP-A levels were not associated with HDPs (OR 1.25, 95% CI 0.78, 2.02, I-square test: 13%). Low PAPP-A levels were positively associated with both the development of preterm birth prior to 32 (OR 2.85, 95% CI 1.70, 4.77, I-square test: 0%) and 34 weeks of gestational age (OR 2.09, 95% CI 1.34, 3.28, I-square test: 0%). Furthermore, low PAPP-A levels were positively associated with SGA/FGR (OR 1.58, 95% CI 1.04, 2.41, I-square test: 0%). Prediction intervals indicated that the sample size that was used did not suffice to support these findings in future studies. Conclusions: Our study indicated that low PAPP-A levels are correlated with an increased incidence of adverse perinatal outcomes in twin pregnancies. Identifying women at elevated risk for such adversities in twin pregnancies may facilitate appropriate management and potential interventions, but additional studies are required to identify the underlying mechanism linking PAPP-A with those obstetrical complications. Full article
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17 pages, 3271 KiB  
Case Report
Intrauterine Contraceptive Device Migrated in the Urinary Tract: Case Report and Extensive Literature Review
by Valentin Nicolae Varlas, Andreea Ioana Meianu, Andra Ioana Rădoi, Irina Balescu, Nicolae Bacalbasa and Roxana Georgiana Varlas
J. Clin. Med. 2024, 13(14), 4233; https://doi.org/10.3390/jcm13144233 - 19 Jul 2024
Viewed by 1375
Abstract
The migration or translocation of an intrauterine device (IUD) in the urinary tract is a rare event. Here, we present the case of a 55-year-old woman who accidentally discovered the ectopic presence of an IUD following a radiological examination for pelvic pain caused [...] Read more.
The migration or translocation of an intrauterine device (IUD) in the urinary tract is a rare event. Here, we present the case of a 55-year-old woman who accidentally discovered the ectopic presence of an IUD following a radiological examination for pelvic pain caused by a lumbar discopathy. Over the years, the patient had several IUDs inserted without being able to specify which one had migrated. The removal of the IUD was performed laparoscopically with the minimum resection of the bladder wall and the subsequent cystorrhaphy. The evolution of the patient was favorable. To better analyze these events, we conducted an all-time extensive electronic search of the PubMed database and identified 94 eligible articles, with a total of 115 cases. The literature analysis on the IUD migrations shows either the simultaneous existence of the second IUD or of a maximum number of up to two IUD insertions during the life of patients. Thus, in the presented case, we identified five IUD insertions over time, which explained the chronic inflammatory process by forming an important mass of adherents that included the urinary bladder, uterus, omentum, sigmoid colon, and abdominal wall. Therapeutic management must be adapted to each case depending on the intra/extravesical location of the migrated IUD evaluated by imaging. Full article
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