Affective disorders in the first week after the delivery: prevalence and risk factors

Summary Objectives: The aim of the study was to evaluate the incidence of affective disorders in women 3 to 5 days after childbirth and the influence of sociodemographic, psychiatric and obstetric factors on the prevalence of maternity blues. Material and methods: The study was conducted at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between January and July 2007. 350 women between 3rd and 5th day of puerperium were asked to fill in a questionnaire, designed especially for the purpose of the study, containing10 items from the Edinburgh Postnatal Depression Scale. 344 questionnaires were filled in properly. Results: 132 mothers (38,4%) had an EPDS score ≥10. It has been revealed that low educational level, lack of family support, pregnancy complications and patient’s history of depression had strong influence on postpartum mood. Parity, cesarean delivery, place of residence, occupation, marital status, socioeconomic level, preterm delivery and breast feeding showed no relationship with maternity blues. There were no differences in newborns’ condition according to Apgar scale. Conclusions: Every third mother is at risk of developing maternity blues. The implementation of screening for early postpartum affective disorders seems to be crucial in singling out women at risk of postpartum depression

Sexual function in women with pelvic organ prolapse and surgery influence on their complaints

Sexual health is an essential component of women’s wellbeing. Women with pelvic organ prolapse (POP) often suffer from sexual dysfunction. The current review focuses on the impact of POP as well as surgical POP repair on sexual function. A variety of techniques are discussed in relation to this issue, including native tissue repair (NTR), transvaginal mesh (TVM) and sacrocolpopexy (SCP). The majority of studies utilise validated questionnaires to assess sexual function in women pre- and post-POP repair and FSFI (Female Sexual Function Index) and PISQ-IR (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-IUGA revised) are among the most commonly used. According to the available data, surgical management of POP usually results in improved or unchanged scores in sexual function, regardless of the type of procedure used. SCP appears to be the preferred surgical management for women with apical vaginal prolapse that minimises the risk of dyspareunia as compared to vaginal techniques

Glassy cell carcinoma szyjki macicy – opis przypadku i przegląd literatury

Abstract Background: Glassy cell carcinoma of the uterine cervix is a rare neoplasm, first described by Gluksman and Cherry in 1956. It is a poorly differentiated adenosquamous carcinoma, comprising about 1-2% of all cervical cancers. Case presentation: We report a case of glassy cell carcinoma of the uterine cervix in 67-year old female, nullipara, diagnosed two months after symptom onset, in IV-B stage of the disease according to the FIGO classification scale. Cervical smear test obtained three years previously was normal. She was offered a palliative antihemorrhagic radiotherapy of the pelvis and palliative chemotherapy with paclitaxel-carboplatin combination. The patient died within six months of diagnosis. Conclusions: We present a case of a rare carcinoma of the uterine cervix with quick progression and poor outcome.Streszczenie Wprowadzenie: Glassy cell carcinoma szyjki macicy jest rzadkim nowotworem, po raz pierwszy opisanym przez Gluksmana i Cherry’ego w 1956 roku, stanowiącym około 1-2 % wszystkich raków szyjki macicy. Jest to nowotwór niskozróżnicowany, wykazujący cechy zarówno struktur gruczołowych, jak i płaskonabłonkowych. Opis przypadku: U 67-letniej kobiety, nieródki, dwa miesiące po pojawieniu się pierwszych objawów, zdiagnozowano glassy cell carcinoma szyjki macicy w stopniu IV-B według FIGO. Wynik poprzedniej cytologii pobranej przed trzema laty był prawidłowy. Pacjentkę poddano paliatywnej radioterapii miednicy mniejszej oraz chemioterapii dwulejkowej palitakselem i karboplatyną. Chora zmarła w ciągu 6 miesięcy od rozpoznania choroby. Wniosek: Przedstawiony przypadek prezentuje gwałtowny przebieg i złe rokowanie charakterystyczne dla tego rzadkiego nowotworu

Affective disorders in the first week after the delivery: prevalence and risk factors

Summary Objectives: The aim of the study was to evaluate the incidence of affective disorders in women 3 to 5 days after childbirth and the influence of sociodemographic, psychiatric and obstetric factors on the prevalence of maternity blues. Material and methods: The study was conducted at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between January and July 2007. 350 women between 3rd and 5th day of puerperium were asked to fill in a questionnaire, designed especially for the purpose of the study, containing10 items from the Edinburgh Postnatal Depression Scale. 344 questionnaires were filled in properly. Results: 132 mothers (38,4%) had an EPDS score ≥10. It has been revealed that low educational level, lack of family support, pregnancy complications and patient’s history of depression had strong influence on postpartum mood. Parity, cesarean delivery, place of residence, occupation, marital status, socioeconomic level, preterm delivery and breast feeding showed no relationship with maternity blues. There were no differences in newborns’ condition according to Apgar scale. Conclusions: Every third mother is at risk of developing maternity blues. The implementation of screening for early postpartum affective disorders seems to be crucial in singling out women at risk of postpartum depression

The Outcome of Repeated Mid Urethral Sling in SUI Treatment after Vaginal Excisions of Primary Failed Sling: Preliminary Study

Mid urethral sling is the standard in SUI treatment. Nevertheless, the risk of reoperation reaches 9%. There is no consensus as to the best treatment option for complications. A question is raised: what is the optimal way to achieve the best result in patients after primary failure? The aim of the study was to evaluate the outcomes of repeat MUS surgery in patients after excision of the sling with recurrent SUI. We compared its effectiveness with uncomplicated cases treated with TVT. 27 patients who underwent the repeated MUS and 50 consecutive patients after primary TVT were enrolled in the study. After 6 months, we have found that 24 (88.46%) patients from repeat sling group and 48 (96%) patients after primary sling were dry (1-hour pad test, 2 g or less). The difference between groups was not significant. We showed statistically significant improvement of quality of life in both groups. In conclusion, we showed that repeated sling after MUS excision is almost as effective as primary MUS. We postulate that sling excision and repeated MUS may be the best option for persistent SUI and/or complications after MUS procedures. Further multicenter observations are ongoing as to provide results on bigger group of cases

Demographic risk factors for mid-urethral sling failure. Do they really matter?

Age, obesity and vaginal deliveries (VD) are recognized risk factors for stress urinary incontinence (SUI). According to many authors, the abovementioned risk factors for incontinence also increase the risk of mid-urethral sling (MUS) failure. Our aim was to evaluate the objective and subjective effectiveness of retropubic MUS in 12 months observation, relative to the three potential risk factors of failure: obesity, age and VDs. A prospective observational study including 238 women who underwent retropubic MUS implantation was performed. Patients were divided into subgroups: obese vs non-obese, <65 vs ≥65 years old and no history of VD vs ≥1 VD. Follow-up took place between 6 and 12 months post-surgery. Cough test, 1-hour pad test, pelvic floor ultrasound examination, and Incontinence Impact Questionnaire 7 (IIQ-7) results were assessed pre- and post-operatively. Of the 238 patients, 208 (86.3%) completed a minimum follow-up period of 12 months. Significant improvement in the pad test was observed in all patients (83.2 ± 78.6 g vs 0.7 ± 3.3 g). Negative cough test results were obtained in over 94% of patients. Significant improvement in the IIQ7 results was observed in all patients (74.2 ± 17.7 vs 5.5 ± 13.4). No significant differences in all the analyzed parameters with regard to BMI, age and parity were observed. No combination of risk factors influenced the objective and subjective cure rates. Our study demonstrated that older age, obesity and history of VDs have no impact on objective and subjective sling effectiveness in a short term observation. There is no influence of combined demographic features on the failure risk

Państwo i Społeczeństwo nr 4, 2016 : Medycyna i zdrowie publiczne : Suplement 1

Materiały konferencji naukowo-szkoleniowej „Akademia kontroli zakażeń szpitalnych