Anxiety and depression among infertile women: a cross-sectional survey from Hungary

BACKGROUND: Infertility is often associated with a chronic state of stress which may manifest itself in anxiety-related and depressive symptoms. The aim of our study is to assess the psychological state of women with and without fertility problems, and to investigate the background factors of anxiety-related and depressive symptoms in women struggling with infertility. METHODS: Our study was conducted with the participation of 225 (134 primary infertile and 91 fertile) women, recruited in a clinical setting and online. We used the following questionnaires: Spielberger Trait Anxiety Inventory (STAI-T), Shortened Beck Depression Inventory (BDI) and Fertility Problem Inventory (FPI). We also interviewed our subjects on the presence of other sources of stress (the quality of the relationship with their mother, financial and illness-related stress), and we described sociodemographic and fertility-specific characteristics. We tested our hypotheses using independent-samples t-tests (M +/- SD) and multiple linear regression modelling (ss). RESULTS: Infertile women were younger (33.30 +/- 4.85 vs. 35.74 +/- 5.73, p = .001), but had significantly worse psychological well-being (BDI = 14.94 +/- 12.90 vs. 8.95 +/- 10.49, p < .0001; STAI-T = 48.76 +/- 10.96 vs. 41.18 +/- 11.26, p < .0001) than fertile subjects. Depressive symptoms and anxiety in infertile women were associated with age, social concern, sexual concern and maternal relationship stress. Trait anxiety was also associated with financial stress. Our model was able to account for 58% of the variance of depressive symptoms and 62% of the variance of trait anxiety. CONCLUSIONS: Depressive and anxiety-related symptoms of infertile women are more prominent than those of fertile females. The measurement of these indicators and the mitigation of underlying distress by adequate psychosocial interventions should be encouraged

Placenta percreta: Report of two cases and review of the literature

PubMed ID: 12731751Placenta percreta is a serious complication of pregnancy. Two cases of placenta percreta confirmed histologically were treated by supravaginal hysterectomy. Case 1: A case of uterine rupture secondary to placenta percreta was diagnosed in a 29-year-old term primigravida during an elective abdominal delivery of a healthy fetus. Spontaneous rupture of the primigravid uterus due to placenta percreta without a history of trauma or infection is a very rare occurrence. Case 2: A 33-year-old previously healthy G4P2 woman was admitted at 29 weeks of gestation with acute abdominal pain and hemorrhagic shock. There was a history of one induced abortion and two cesarean section deliveries. A review of risk factors, diagnostic tools and treatment possibilities are given

Evaluation of LOOP electrosurgical excisional procedure: Case series

PubMed ID: 21061801Objective: To evaluate the loop electrosurgical excisional procedure (LEEP) which is performed to treat high-grade cervical intraepithelial lesions (HGSIL). Material and Methods: Twenty-one cases diagnosed as LGSIL and HGSIL after histopathological examination were included in the study among patients who had cervical colposcopy-directed biopsies after an abnormal cytology report at Ege University School of Medicine, Obstetrics and Gynecology Department between the years of 2007 and 2009. The patients underwent LEEP or LEEP-cone procedures. Results: The patients with cervical smear results of ten ASCUS, eight LGSIL, and three HGSIL underwent colposcopy-guided punch biopsies. Those with the result of CIN 1 and CIN 2 underwent LEEP or LEEP-cone procedures. Pathologic examination correlated with biopsy results and surgical margins were all negative. All patients were followed-up with cervical cytology. Conclusion: LEEP and LEEP-cone procedures are therapeutic procedures in cervical intraepithelial lesions

Multiple pregnancies and their complications [Çogul gebeli·kler ve kompli·kasyonlari]

Objective: To investigate the complications observed in multiple pregnancies which are increasing in day by day. Material and methods: We reviewed 173 multiple pregnancies that were followed up in the Department of Obstetric and Gynecology in Ege University during one year period and determined the preterm delivery ratio, discordance between fetuses and investigated the complications which occurred during pregnancy. Results: 148 twin, 24 triplet and 1 quadriplet pregnancies had been followed in a year. While 56 of twin pregnancies and 4 of the triplet pregnancies occurred spontaneously, others conceived with medical treatment or with assisted reproductive technology. Cerclage was performed in 11 pregnancies. Preeclampsia, gestational diabetes mellitus and cholestasis were observed in 12,26 and 8 patients respectively. Twin-to-twin transfusion syndrome was present in 4 patients and one patient had acardiac-acephalic twin pregnancy. Four patients had emergency cesarean section due to ablatio placenta. While 54 patients were hospitalized for one to twelve weeks because of preterm labour 36 women had preterm premature rupture of the membranes. Only 38 patients had no any problem during pregnancy. Discussion: Developments in assisted reproductive technology have been increasing the number of multiple gestations and their complications. The complications due to preterm labor, increased requirement of neonatal intensive care units and hospital payments are all burden on the families as well as on the social insurance companies

Vaginal fluid pH, cervicovaginitis and cervical length in pregnancy

PubMed ID: 21077504Aim: The purpose of this prospective study was to determine the possible association among vaginal fluid pH, cervicovaginitis and cervical length in singleton pregnancies at 16-22 weeks of gestation. Methods: A total of 240 asymptomatic singleton pregnancies at 16-22 weeks of gestation were included to the study. Vaginal fluid pH was determined using pH paper in a sterile speculum examination, and cervical length was examined by transvaginal ultrasonographic measurement. Vaginitis was diagnosed by pH determination and wet mount smear; cervicitis was diagnosed by cervical examination. Patients were followed to delivery and hospital records were reviewed to extract obstetric information. Preterm delivery was defined as delivery at or prior to 36 weeks of gestation. Abnormal pH was defined as a pH of > 5.0. Patients with cervicovaginitis (n = 72) were compared with those without any trace of infection (n = 60). Results: The mean gestational age was 20.3 ± 1.4. We found an significant association among cervicovaginitis, cervical length and vaginal pH. There was a significant correlation between an elevated vaginal pH (> 5.0) and a shortened cervical length (r = -0.59, p 5.0 was associated with increased risk of preterm delivery (OR 4.3, 95% CI 2.0, 9.3; p = 0.001) as well as delivering an infant of less than 2,500 g (OR 4.0, 95% CI 1.4, 11.0; p = 0.009). Conclusions: Elevated vaginal fluid pH in women at 16-22 weeks of gestation seems to be associated with a decreased cervical length and increased risk of preterm delivery

Abdominal skin metastasis of endometrial adenocarcinoma: case report

WOS: 000176196700023PubMed ID: 12094968Skin metastasis from endometrial adenocarcinoma in the radiotherapy field is reported. A 60-year-old woman with FIGO stage IB, grade 2 endometrial adenocarcinoma presented 24 months after initial surgery with skin metastasis located on the abdomen