Planning and preparation for pregnancy among women with and without a history of infertility

Objectives: Preconception counseling, maternal health-related habits, diet, folic acid consumption, substances abuse, may all impact the outcome of pregnancy. The aim of this study was to compare the planning and preparation for pregnancy among pregnant women with and without infertility. Material and methods: A survey of health behaviors prior to and during pregnancy that could affect pregnancy outcomes, including laboratory tests performed, stimulant usage, initiation of prenatal care, and folic acid intake, was conducted among 400 pregnant women. The study group included 121 women (30.25%) diagnosed with prior infertility, while the control group included 279 women (69.74%) who did not report any problems conceiving. Results: All patients (100%) from the study group and 70,97% from the control group planned their pregnancy(p < 0.0001). Patients in the study group performed significantly more laboratory tests prior to pregnancy, including: complete blood count, urine analysis, fasting blood glucose concentration, testing for toxoplasmosis, and Pap smear, compared with the control group (p < 0.0001). There was no difference between groups regarding the knowledge of when and why folic acid supplementation is required (p > 0.05). Conclusions: Effective education of women, regarding pregnancy planning and behaviours, that may impact pregnancy outcome is still a serious challange to public health in Poland. Our study indicates that reaching general population with the education is most important to achieve best results in preconceptional care

Evaluation of Stress Hormone Levels, Preoperative Anxiety, and Information Needs before and after Hysteroscopy under Local Anesthesia in Relation to Transvaginal Procedures under General, Short-Term Anesthesia

Background: Hysteroscopy is currently the gold-standard procedure in the evaluation of the uterine cavity and treatment of intrauterine lesions as it is minimally invasive and has high diagnostic efficiency. According to previous observations, many patients are afraid of minimally invasive procedures performed under general anesthesia. They are also afraid of procedures that, according to them, may be associated with pain. To address this issue, in this study, the levels of stress and anxiety, and biochemical parameters indicating the hormonal response in terms of the stress response in hysteroscopic procedures under local anesthesia were compared with those of traditional surgical procedures and uterine cavity curettage procedures under general, short-term anesthesia. Methods: This study included 184 participants: 153 women undergoing diagnostic or operative mini-hysteroscopy procedures with the use of a hysteroscope of a reduced diameter under local, paracervical anesthesia without the participation of an anesthesiologist, and 31 women undergoing hysteroscopy or uterine cavity curettage under general, intravenous, short-term anesthesia with the participation of an anesthesiologist. To determine cortisol and prolactin levels using electrochemiluminescence, blood was collected from the patients on the day of admission to the hospital, i.e., the day of surgery, in the morning, while fasting. An original survey questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the Visual Analogue Scale (VAS) were used as research tools. The questionnaires were completed by the patients themselves 60 min before the surgery. Results: APAIS: no significant differences in anxiety and information demand scores were observed between the study groups. Anxiety before surgery was significantly higher than that before anesthesia in both groups. Similarly, information demand for surgery was significantly higher than that for anesthesia in both groups. VAS: no significant differences in anxiety and stress scores were observed between the groups. No significant differences in prolactin and cortisol levels were observed between the groups. Conclusions: It can be concluded that it is necessary to apply the interventions that reduce the anxiety of the patients and inform patients about the planned course of the procedure, since higher levels of anxiety before the procedure result in a significant increase in procedure duration, which in turn can increase the pain experienced by the patients

Relationship of Postoperative Pain and PONV after Minimally Invasive Surgery with the Serotonin Concentrations and Receptors’ Gene Polymorphisms

(1) Background: there is a steady increase in the number of procedures performed via minimally invasive surgery, which have many benefits, but post-operative nausea and vomiting (PONV) and significant pain are still a common problem (2) Methods: 300 infertile women (18–40 years old) undergoing minimal invasive surgery. Interventions: laparoscopy and hysteroscopy performing, evaluation of postoperative symptoms, serotonin concentrations assessment, identify genetic polymorphisms. (3) Results: serotonin concentrations were significantly lower among women who required opioids (p = 0.006). The presence of the GG genotype in the rs6318 polymorphism of the 5HTR2C gene had a protective effect on PONV (OR = 0.503; C.I. = [0.300–0.841]; p = 0.008), when the GG variant of the rs11214763 polymorphism of the 5HTR3B gene, when the risk of PONV was 1.65-fold higher (OR = 1.652; C.I. = [1.003–2.723]; p = 0.048). Pain intensity was significantly higher among women with GG genotype of the rs6296 polymorphism of the 5HTR1B gene (OR = 1.660; C.I. = [1.052–2.622]; p = 0.029).; (4) Conclusions: the evaluation of serotonin concentration predicts requirement for opioid pain relief medication. The polymorphisms of the serotonin receptors affect the intensity of postoperative complaints