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Background/Aim: The Word catheter is a silicone device with a balloon system that may be inserted into a Bartholin's cyst or abscess in order to provide drainage and epithelization. The aim of this study was to evaluate the Word catheter as a therapy for Bartholin's cyst and abscess. Both patient and physician satisfaction, as well as the feasibility in an outpatient setting, were examined. Patients and Methods: A total of 51 women with a Bartholin's cyst or abscess were given the option of Word catheter insertion in an outpatient setting between August 2013 and March 2018. Both the patients and the consulting physicians were asked to complete two questionnaires, before, during and after treatment, with a view to evaluating the overall pain level, any discomfort symptoms and sexual activity, as well as satisfaction levels. Results: The insertion procedure seemed to constitute a short yet quite painful procedure. In most cases, the consulting physicians and the patients were content with the results. Nevertheless, dislodgement of the catheter or abscess recurrence were common. The removal of the Word catheter seemed to be short, painless, and uncomplicated. Most patients experienced pain and discomfort after catheter placement over the first days, with the symptoms fading over time. Sexual intercourse appeared to be negatively influenced. Conclusion: The Word catheter was frequently well tolerated for the treatment of Bartholin's cysts and abscesses, with few non-serious side-effects, however, it did interfere with sexual health. Nonetheless, it may not be possible to make general recommendations based on this exploratory study. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate perinatal outcome in singleton pregnancies at term with isolated oligohydramnios, diagnosed by using the single deepest pocket method. Patients and Methods: In this historic cohort study, the perinatal outcomes of 196 women with isolated oligohydramnios at term, diagnosed by using the single deepest pocket method, were compared to 8,676 women with normal amniotic fluid volume. The primary outcome measure was the Cesarean section rate. Further outcome parameters included the rate of induction of labor, abnormal cardiotocography, umbilical cord pH and base excess, Apgar, meconium-stained liquor and admission to neonatal intensive care unit. Results: In the group with isolated oligohydramnios, there were significantly more Cesarean sections (p=0.0081) and more abnormal cardiotocographies (p=0.0005). Univariate and multivariate analyses showed that this difference was seen particularly in nulliparous women (p=0.0025 for Cesarean section and 0.0368 for abnormal cardiotocography). Peripartal and perinatal outcome parameters were not different between the two groups. Conclusion: In women with isolated oligohydramnios at term, there is no impact on fetal outcome. The influence of isolated oligohydramnios on the rate of cesarean section and abnormal cardiotocography is considered to be less than that of parity. [ABSTRACT FROM AUTHOR]

Background/Aim: The manifestation and severity of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) infections show a clear correlation to the age of a patient. The younger a person, the less likely the infection results in significant illness. To explore the immunological characteristics behind this phenomenon, we studied the course of SARS-CoV-2 infections in 11 households, including 8 children and 6 infants/neonates of women who got infected with SARS-CoV-2 during pregnancy. Materials and Methods: We investigated the immune responses of peripheral blood mononuclear cells (PBMCs), umbilical cord blood mononuclear cells (UCBCs), and T cells against spike and nucleocapsid antigens of SARS-COV-2 by flow cytometry and cytokine secretion assays. Results: Upon peptide stimulation, UCBC from neonates showed a strongly reduced IFN-γ production, as well as lower levels of IL-5, IL-13, and TNF-α alongside with decreased frequencies of surface CD137/PD-1 co-expressing CD4+ and CD+8 T cells compared with adult PBMCs. The PBMC response of older children instead was characterized by elevated frequencies of IFN-γ+ CD4+ T cells, but significantly lower levels of multiple cytokines (IL-5, IL-6, IL-9, IL-10, IL-17A, and TNF-α) and a marked shift of the CD4+/CD8+ T-cell ratio towards CD8+ T cells in comparison to adults. Conclusion: The increased severity of SARS-CoV-2 infections in adults could result from the strong cytokine production and lower potential to immunomodulate the excessive inflammation, while the limited IFN-γ production of responding T cells in infants/neonates and the additional higher frequencies of CD8+ T cells in older children may provide advantages during the course of a SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Background/Aim: We investigated the impact of the timing of antenatal corticosteroid (ACS) administration on the clinical outcome of preterm infants. Patients and Methods: Two hundred and fifty-five preterm infants between 28+0 and 34+0 weeks of gestation were retrospectively assigned to one of two groups: In the first group, ACS was given within 7 days before birth; the second group, did not receive ACS during that period. The primary outcome parameter was respiratory failure (defined by need for continuous positive airway pressure or mechanical ventilation) due to grade 1-4 respiratory distress syndrome (RDS). Secondary outcomes included the rates of intraventricular hemorrhage (IVH), periventricular leukomalacia, and necrotizing enterocolitis. Results: The rate of RDS was significantly higher in the no ACS group (40% vs. 62%, p=0.0009), especially of the more severe grades 2- 4 (n=37 vs. n=48, p=0.0121). In addition, IVH (1% vs. 9%, p=0.0041) and neonatal infections (72% vs. 89%, p=0.0025) were significantly increased. Univariable and multivariable regression analyses showed a lower likelihood of RDS in the ACS group [odds ratio (OR)=0.295] in infants born closer to term (OR=0.907) and following preterm onset of labor (OR=0.495). Similarly, we observed a lower probability of IVH in the ACS group (OR=0.098), with a higher probability of occurrence of IVH in pre-eclampsia/HELLP syndrome (hemolysis, elevated liver enzyme levels, low platelet count) (OR=7.914). Conclusion: ACS treatment within the last 7 days before birth significantly reduced the risk of RDS and IVH in preterm. These data emphasize that the timing of ACS administration determines its success. [ABSTRACT FROM AUTHOR]

Background/Aim: Even though vaginal delivery is a feasible option in patients with preeclampsia, the cesarean section rate in those patients is high. The aim of this study was to evaluate the influence of preeclampsia on induction of labor at term. Patients and Methods: This historical cohort study analyzed inductions of labor in women at term having preeclampsia versus women who were induced due to other reasons. The primary outcome measure was the cesarean section rate. Results: The cesarean section rate was higher in the preeclampsia group for both nulliparous and multiparous women after induction of labor but failed to reach statistical significane. The induction-to-delivery interval was longer in nulliparous women and the rate of vaginal birth within 48 h was lower in the nulliparous patiens with preeclampsia. However, the impact of preeclampsia on the cesarean section rate was not significant in the multivariable analysis following adjustment for BMI and parity. Conclusion: Preeclampsia at term did not influence the cesarean section rate in nulliparous and parous women when labor was induced. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to provide information for better obstetric counselling by analyzing the impact of fetal birth weight on the caesarean section rate and fetal outcome after induction of labor., Materials and Methods: In this retrospective study from January 2010 to December 2013, 1,474 singleton deliveries with labor induction at or greater than 37 gestational weeks were analyzed for their impact of fetal birth weight on delivery outcome. The normal birth weight group was defined as 2,500 g to less than 4,000 g. For comparison, further birth weight groups were defined as: group 1 <2,500 g, group 2 4,000 to <4,250 g; group 3 ≥4,250 g. The primary outcome was the caesarean section rate; secondary outcome measures were fetal complications monitored by pH and base excess (BE) of the umbilical cord artery, Apgar score after 5 min (Apgar-5) and postpartum transfer to the Neonatal Care Unit. The set of controlling variables included maternal body mass index and age, gestational age, neonatal sex, maternal diabetes, maternal hypertension disorder, parity and method of induction of labor., Results: Second-stage caesarean section is significantly more likely when fetal birth weight is below 2,500 g (42.9% vs. 24.2% in the normal birth weight group, odds ratio=3.11, 95% confidence interval=1.48-6.51, p=0.003). A birth weight of 4,000 g or more did not have a significant influence on the caesarean section rate. Only the mean Apgar-5 for group 1 was significantly lower (p=0.044). The non-parametric tests and regression analyzes of pH and BE of the umbilical cord and of the Apgar-5 for adverse fetal outcome (pH<7.05, BE<-12 or Apgar-5 <7) showed no significant differences in the three birth weight groups when compared to the normal group. Neonates were significantly more often transferred to the Neonatal Care Unit after delivery when birth weight was below 2,500 g (odds ratio=9.68, 95% confidence interval=4.33-21.65, p<0.001) or above 4,250 g (odds ratio=2.68, 95% confidence interval=1.34-5.36, p=0.005)., Conclusion: Although a fetal birth weight of under 2500 g and a birth weight over 4,250 g are associated with some risks, there is no general contraindication against performing induction of labor in regards to fetal birth weight., (Copyright © 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)

Aim: To investigate the validity and reproducibility of touch imprint cytology (TIC) of core needle biopsies (CNBs) in the assessment of conspicuous breast findings., Materials and Methods: One hundred and fifty-eight conspicuous breast findings were assessed by CNB during a two-year period in this prospective study. TIC of the CNBs was used for cytological analysis. The performance of this technique was evaluated by comparing the results with the histology of the CNB, and in cases of a subsequent surgery, with the final histology. In addition, inter-observer reproducibility was analyzed., Results: The inter-observer variability was very high (kappa-value of 0.8508; excluding inadequate imprints, 0.9502). Inadequate cellularity for cytological analysis was found in 11.4% (18/158) of findings. Compared with CNB histology, the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of TIC was 99%, 100%, 100%, 94%, and 99%, respectively., Conclusion: TIC of CNB specimens of the breast may be a valid option for providing a diagnosis without delay for a histological procedure, assuming good quality of the specimen.

Aim: To generate reference values for bioelectrical impedance analysis (BIA) in a German collective of healthy pregnant women., Materials and Methods: A total of 90 women with a singleton gestation from 23+0 to 40+6 weeks of pregnancy were enrolled from April 2012 until May 2013. Each week of gestation was represented by the same number of women (n=5). Mean BIA indices were generated for all patients and according to gestational age so that three collectives <30, 30 to 35 and >35 weeks of gestation were formed. Multiple regression analysis was implemented using maternal height, weight, body-mass index, gestational age, hematocrit and abdominal circumference to generate formulae to calculate individualized reference values for resistance, reactance, phase angle, height(2)/resistance, and total body water adjusted for gestation., Results: Individualised reference values using the new formulae led to results which are more accurate than general mean values or mean values corresponding to the gestational age only., Conclusion: As far as we are aware of the present study is the first to report reference values for BIA indices in a German collective of healthy pregnant women. The new formulae generated by multiple regression analysis enabled for assessment of individualized reference values for BIA indices.

Background/aim: To analyze the influence of intraoperative cervical dilatation and curettage during elective Caesarean section (CS) on maternal morbidity., Patients and Methods: A total of 1,003 elective CS were retrospectively evaluated. Primary outcome measure was the influence of cervical dilatation and curettage on postpartum haemorrhage (PPH). Several subgroup analyses were performed and a multiple logistic regression model was used in order to identify risk factors affecting PPH., Results: Multiple pregnancy (p=0.0025) and body mass index (p=0.0251) were identified as risk factors for PPH. Curettage, cervical dilatation, prior CS, age, and duration of pregnancy were statistically not significant at a level of α=0.10. There was a significantly higher proportion of women suffering from uterine sub-involution when the cervix was dilated (p=0.0482). The operating time was significantly longer when curettage and/or dilatation were performed (p<0.0001)., Conclusion: Routine cervical dilatation and/or curettage in elective Caesarean section are not beneficial. Accomplishment of either or both of these measures led to a prolonged operating time, without improving the postoperative outcome.

Background: We investigated the influence of age on short-term complications in women undergoing intraoperative radiotherapy (IORT) for early breast cancer., Patients and Methods: We retrospectively analyzed data of 188 women who underwent IORT during breast-conserving surgery (BCS). The study group consisted of 54 patients aged 70 years or older. One hundred and thirty four patients aged less than 70 years served as the control group., Results: In both collectives, the acute toxicity was low. There were no significant differences regarding type and duration of surgery, and type of radiation treatment, comparing both collectives. The most frequent postoperative side-effects were haematoma/suggillation (13/54, 24.1% vs. 28/134, 20.9%; p=0.633). There was a significantly higher incidence of postoperative axillary haematoma in the study group (10/54, 18.5% vs. 10/134, 7.5%; p=0.026)., Conclusion: Acute toxicity after BCS with IORT in women aged 70 years and older does not seem to be higher compared to younger patients.

Aim: The aim of this investigation was to analyze the feasibility and postoperative outcome of laparoscopic supracervical hysterectomy (LASH) with and without bilateral salpingectomy., Patients and Methods: Between February and October 2012, a total of 25 patients were prospectively enrolled to undergo LASH with bilateral salpingectomy. A retrospective cohort of 25 matched patients who underwent LASH without bilateral salpingectomy at our Institution, performed by the same surgeon, served as the control collective., Results: Comparing both collectives, there were no statistically significant differences concerning overall hospital stay, duration of surgery and blood loss., Conclusion: LASH with bilateral salpingectomy is a fast and safe procedure.

Aim: To evaluate the feasibility and safety of vaginal surgery for treatment of genital prolapse in overweight compared to normal weight patients aged 50 years or older., Patients and Methods: We retrospectively reviewed the perioperative data of 93 patients aged between 50 and 87 years undergoing surgery due to pelvic floor disorders. A total of 54 women had a body mass index (BMI) of 25 kg/m(2) or higher and were defined as the study collective. Thirty-nine patients undergoing similar surgical procedures during the same period of time had a BMI less than 25 kg/m(2) and served as the control group. Operating time, duration of hospital stay, intra- and postoperative complications were evaluated as comorbidities. χ(2)-test, Fisher's exact test, Student's t-test and non-parametric Mann-Whitney U-test were applied to compare the results of both collectives., Results: There were no significant differences between study and control collectives regarding time of surgery, duration of hospital stay or intra- and postoperative complications, although a significant difference was found with regard to the prevalence of pre-existing diabetes mellitus (17% in the study group, versus 5% in the control group, respectively, Fisher's exact test: p=0.04)., Conclusion: Overweight in elderly patients undergoing vaginal surgery due to pelvic floor disorders does not affect the perioperative outcome and is not a risk factor for perioperative complications.

Aim: To evaluate the influence of gender in neonates with congenital diaphragmatic hernia (CDH) on survival and to assess the necessity of extracorporeal membrane oxygenation (ECMO) therapy., Patients and Methods: All parturients with newborns suffering from CDH were included. A total of 425 infants with CDH were analyzed. The primary outcome parameters evaluated were the necessity of ECMO and the survival. Secondary outcome parameters were the mode of delivery, the arterial umbilical cord pH value, the Apgar score, and the postpartum day of death. Cases with incomplete data were excluded., Results: An analysis of the gender distribution of neonates in our study revealed that more males (n=248) than females (n=177) suffered from CDH. This represented a male versus female gender ratio of 58.4% to 41.6%, a significantly different ratio from that for neonates without CDH (p=0.003). Comparing both groups, statistical analysis showed no significant differences in mode of delivery, arterial umbilical cord blood pH, Apgar score, or CDH-relevant parameters of postpartum survival, including the need for ECMO therapy., Conclusion: CDH occurred significantly more frequently in male newborns. However, there were no significant differences in postnatal survival nor in the necessity of ECMO therapy.

Background: Umbilical cord blood haematopoietic stem cell donation (UCBD) has increased in recent years. While performing UCBD during caesarean section, suturing the uterotomy is delayed for a few minutes. The aim of our study was to analyse if this causes an increase in maternal blood loss., Patients and Methods: In this retrospective study, we compared pre- and postpartal haemoglobin levels of 100 patients who delivered by caesarean, either with UCBD (study group) or without UCBD (control group). P-values < or = 0.05 were regarded as significant., Results: The main clinical characteristics did not show any significant differences between the two groups. There was no significant difference of decrease in haemoglobin between the study group and the control group (p=0.747)., Conclusion: UCBD during caesarean section does not lead to increased maternal blood loss. Objections to the safety of UCBD regarding increased maternal blood loss during caesarean section can be dispelled.