Porównanie urazu tkanek podczas brzusznej, pochwowej i laparoskopowej histerektomii

Objective: The aim of the study was to compare the extent of tissue trauma after abdominal hysterectomy(AH), vaginal hysterectomy (VH), and total laparoscopic hysterectomy (TLH) using biochemical markers. Material and methods: Seventy-one patients requiring hysterectomy for benign uterine diseases were enrolled in the study and divided into three treatment groups: AH (n=24), VH (n=23), and TLH (n=24). Blood samples for assay of interleukin-6 (IL-6) and creatine phosphokinase (CPK) were collected pre-, intra-operatively, and 2, 6 and 24 h after surgery. Results: Serum levels of IL-6, and CPK were significantly elevated over basal values after surgery in all groups. IL-6 and CPK levels were significantly higher after AH as compared to VH and TLH. IL-6 concentrations were significantly higher in the VH group than the TLH group (p=0.001). There were no significant differences in CPK levels between the VH and TLH groups (p=0.824). TLH group had the smallest decrease in blood hemoglobin concentration and the shortest hospital stay. Conclusions: AH causes more tissue trauma as compared to VH and TLH. Owing to the fact that TLH is associated with less tissue trauma and offers significant clinical benefits, including less blood loss and shorter hospital stay, it should be considered in women with benign gynecologic conditions, especially in experienced centers.Cel pracy: Celem badania było porównanie rozległości urazu tkanek podczas brzusznej histerektomii (AH), pochwowej (VH) i laparoskopowej (TLH) przy pomocy biochemicznych markerów. Materiał i metoda: Do badania włączono siedemdziesiąt jeden pacjentek wymagających usunięcia macicy z powodu niezłośliwej patologii, które podzielono na trzy grupy badane: AH (n=24), VH (n=23), i TLH (n=24). Próbki krwi do badania w kierunku interleukiny 6 i kinazy fosfokreatynowej (CPK) pobierano przed-, podczas operacji, I 2,6 oraz 24 godziny po zabiegu. Wyniki: Poziom Il-6 i CPK w surowicy po operacji był istotnie podwyższony w porównaniu do poziomu wyjściowego we wszystkich grupach badanych. Poziom IL-6 i CPK były istotnie wyższe po AH niż po VH i TLH. Stężenie IL-6 było istotnie wyższe w grupie VH niż w grupie TLH (p=0.001). Nie stwierdzono istotnych różnic w poziomie CPK pomiędzy grupą VH i TLH (p=0.824). W grupie TLH odnotowano najmniejszy spadek hemoglobin I najkrótszy pobyt w szpitalu. Wnioski: AH powoduje większy uraz tkanek niż VH i TLH. Dzięki temu, że TLH jest związane z mniejszym urazem tkanek i daje istotne klinicznie korzyści, między innymi mniejszą utratę krwi i krótszy pobyt w szpitalu, powinno być rozważane u kobiet z niezłośliwą patologią, zwłaszcza w doświadczonych ośrodkach

Sociodemographic and clinical features of postpartum depression among Turkish women: a prospective study

WOS: 000369821100001#REF!Background: Postpartum depression (PPD) is moderate to severe depression in a woman after she has given birth. Findings from several well-designed studies reflect great variability in rates, from 10 to 22%, and also in risk factors for PPD. This variability may reflect geographical location. The incidence and risk factors for PPD among Turkish women are not well documented. It is, however, important to understand the risk factors to develop preventive intervention strategies. This study aims to examine the prevalence of PPD and associated risk factors among a sample of women receiving services at a tertiary obstetrics hospital in Ankara, Turkey. Methods: A sample of 671 women, between 36 and 40 gestational weeks, were enrolled and screened for depressive symptomatology using the Hospital Depression Inventory. Sociodemographic and clinical data were also collected. At a subsequent postpartum evaluation, 6-8 weeks post-delivery, 540 of the 671 were screened using the Edinburgh Postnatal Depression Scale (EPDS) for PPD. Results: Eighty-three (15.4%) of the 540 women had scores above the cutoff point (> 13) on the EPDS. Statistically significant correlations were found between antenatal, prenatal and postpartum depression scores (r = 0.24). Women reporting suicidal thoughts during pregnancy (OR: 6.99), history of past PPD (OR: 6.64), physical violence during pregnancy (OR: 6.20) or during the postpartum period (OR: 5.87), previous psychiatric history (OR: 4.16), depressive symptoms during pregnancy (OR: 1.70), subjectively lower level of satisfaction with the pregnancy (OR: 0. 69), a history of premenstrual syndrome (PMS) (OR: 2.05), and unplanned pregnancy (OR: 1.69) had higher odds for developing PPD. Conclusion: One in six mothers screened as positive for PPD. Women who had previously been diagnosed with PPD, reported suicidal thoughts during pregnancy, or had been exposed to physical violence were at especially high risk for postpartum depression. To prevent and treat postpartum depression, special attention should be paid to women reporting these characteristics