Archives of Gynecology (Arch Gynecol Obstet )

Publisher: Deutsche Gesellschaft für Gynäkologie und Geburtshilfe, Springer Verlag

Description

The Archives of Gynecology and Obstetrics was founded in 1870 as "Archiv für Gynaekologie" and has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe and publishes the abstracts and proceedings of their bi-annual meetings. The Archives of Gynecology and Obstetrics is circulated in over 40 countries world wide and is indexed in Current Contents and Index Medicus. The Archives of Gynecology and Obstetrics publishes " invited and submitted reviews " original articles about clinical topics and basic Research " case reports and " preliminary communications from all subspecialities in Gynecology and Obstetrics. All papers are peer-reviewed and published as quickly as possible.

  • Impact factor
    0.91
  • 5-year impact
    0.00
  • Cited half-life
    5.20
  • Immediacy index
    0.14
  • Eigenfactor
    0.00
  • Article influence
    0.00
  • Website
    Archives of Gynecology and Obstetrics website
  • Other titles
    Archives of gynecology and obstetrics (Online)
  • ISSN
    1432-0711
  • OCLC
    42787349
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Springer Verlag

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Author's pre-print on pre-print servers such as arXiv.org
    • Author's post-print on author's personal website immediately
    • Author's post-print on any open access repository after 12 months after publication
    • Publisher's version/PDF cannot be used
    • Published source must be acknowledged
    • Must link to publisher version
    • Set phrase to accompany link to published version (see policy)
    • Articles in some journals can be made Open Access on payment of additional charge
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the influence of gestational diabetes mellitus (GDM) on maternal and neonatal outcomes in twin pregnancies. A retrospective population-based study was conducted, comparing maternal and neonatal outcome in women carrying twins with and without GDM. Deliveries occurred in a tertiary medical center between the years 1988 and 2010. Multivariable analysis was used to control for confounders. The study population included 4,428 twin pregnancies, of these 341 (7.7 %) were complicated with GDM. Twin pregnancies complicated with GDM had higher rates of fertility treatment, chronic hypertension, preeclampsia and cesarean deliveries (CD). Nevertheless, using a multivariable analysis, with CD as the outcome variable, controlling for confounders such as maternal age, fertility treatments and hypertensive disorders, GDM in twins was not found to be an independent risk factor for CD (adjusted OR = 1.8, 95 % CI 0.9-1.4; P = 0.18). Rates of low 5 min Apgar scores (<7) and perinatal mortality were lower among twins with GDM (2.9 % vs. 5.3 %, OR = 0.5, 95 % CI 0.3-0.8 0; P = 0.005 and 2.3 % vs. 4.4 %, OR = 0.5, 95 % CI 0.3-0.8; P = 0.005, respectively). In our population, GDM in twin pregnancies was not associated with increased rates of adverse perinatal outcomes. In addition, GDM was not found to be an independent risk factor for CD in twin pregnancies.
    Archives of Gynecology 05/2014;
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    ABSTRACT: To evaluate the efficacy of the use of oral Prednisolone and heparin versus the use of heparin alone in treatment of patients with unexplained recurrent miscarriage. The study was a double-blind placebo randomized control trial conducted on 160 patients with unexplained recurrent miscarriage. Patients recruited were randomized into two groups. The first group received oral Prednisolone in addition to low dose aspirin and heparin, while the other group received a placebo in addition to low dose aspirin and heparin. A peripheral venous blood sample was taken from all included patients before starting treatment and collected in heparinized tubes. Natural Killer (NK) cells were checked in each sample and then re-checked in another sample at 20 weeks of gestation. We found that in the prednisolone group, 70.3 % of women had successful outcome (defined as an ongoing pregnancy beyond 20 weeks gestation), while 29.7 % miscarried before this gestation. On the contrary, among women in the placebo group, 9.2 % had successful outcome while 90.8 % miscarried before 20 weeks, which was statistically significant. On the other hand, we found that there were no significant paired differences between initial serum levels of the NK cells markers CD16 and CD56 and their levels at 20 weeks gestation in both groups. The addition of prednisolone to heparin and low dose aspirin might be beneficial in patients with unexplained recurrent miscarriage, and this effect might be due to a suppressive effect of steroids on the peripheral CD16 NK cells concentration.
    Archives of Gynecology 05/2014;
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    ABSTRACT: This study aimed to correlate pelvic dimensions and fetal size to the risk for cesarean section caused by protracted labor. This is an observational, retrospective cohort study on pregnant women with an increased risk of labor dystocia. After pelvimetry, pelvic adequacy was clinically tested in a trial of labor. A multivariable regression analysis was made to identify the risk factors for cesarean section. Two subgroups were established according to the size of the estimated fetal head circumference (HC) (arbitrary cutoffs of ≤340 and >340 mm), and the pelvic measurements were compared by the mode of delivery. Receiver operating characteristic (ROC) curves were evaluated. Altogether, 274 patients were ultimately included. The mean size of the maternal inlet was 1.0 cm larger in fetal HC >340 mm group compared with ≤340 mm. In the vaginal delivery group, the difference was 1.3 cm. In the multivariable modeling, maternal age (odds ratio [OR] 1.09, 95 % confidence interval [CI] 1.02-1.17), fetal HC (OR 1.05, 95 % CI 1.02-1.09), and maternal inlet circumference (OR 0.95, 95 % CI 0.92-0.97) had significance for the risk of cesarean section. In the ROC analysis, the area under the curve (AUC) value for the pelvic inlet was 0.736 (p < 0.001, 95 % CI 0.656-0.816), and in the subgroups with fetal HC ≤340 and >340 mm, AUCs were 0.634 (p < 0.11, 95 % CI 0.493-0.775) and 0.836 (p < 0.001, 95 % CI 0.751-0921), respectively. Labor arrest was associated with the linear relationship between the maternal pelvic dimensions and the fetal size. Therefore, the approach should be changed from standardized pelvimetric threshold values to passenger-passageway ratio analyzed by multivariable modeling to find more accurate methods to predict cephalopelvic disproportion.
    Archives of Gynecology 05/2014;
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    ABSTRACT: To compare staples with subcuticular sutures for skin closure in emergency Cesarean sections (CS). One hundred and thirty women (undergoing emergency CS without previous abdominal delivery) were randomly assigned to either staples or subcuticular skin closure (monocryl 3-0). Primary outcome of the study was cosmetic outcome [as assessed by patient and independent observer: Patient Scar Assessment Scale (PSAS) and Observer Scar Assessment Scale (OSAS), respectively], 6 weeks post-operative. Secondary outcomes were wound complications, operating time, post-operative pain (visual analogue scale day 3 post-operative and patient assessment of pain in scar 6 weeks post-operative), and duration of hospital stay. 112 women were available for evaluation of scar 6 weeks post-operative. Cosmetic result of staples was significantly better than subcuticular sutures (PSAS and OSAS: p value 0.022 and 0.000, respectively), with significantly lesser duration of surgery (24 vs. 32 min: p value 0.000) and comparable post-operative pain (pain on day 3 and 6 weeks post-operatively: p value 0.474 and 0.179, respectively) and wound complications (p value 0.737). However, duration of stay in hospital was increased (6 vs. 3 days: p value 0.001). Staples are the method of choice for skin closure in emergency CS as they are significantly better than subcuticular sutures with respect to cosmesis and duration of surgery. Post-operative pain and wound complications are comparable in two groups. However, staples are associated with significantly increased duration of hospital stay. Trial registered in clinical trial registry CTRI: REF/2013/05/005087.
    Archives of Gynecology 05/2014;
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    ABSTRACT: About 20 % of all mamma carcinomas are HER2 positive. The overexpression of HER2 is considered to be a negative prognostic factor. Trastuzumab is a monoclonal anti-HER2 antibody developed to target HER2 overexpressing tumor cells. So far, there is only little data available on long-term effects of trastuzumab. This is why we analyzed the medical records of our patient collective with respect to tolerability and oncological outcomes of long-term trastuzumab treatment. Our retrospective observational study included all patients of the Saarland University Hospital with breast cancer who received trastuzumab for more than 18 months between 2003 and 2012. We analyzed the medical records with respect to oncological outcome, tolerability and cardiac side effects. A total of n = 15 patients had been treated with trastuzumab for over 18 months with a mean therapy duration of 57.2 months (range 18-119 months). The mean follow-up time was 113.5 months (range 50-240 months). Three of the patients had a treatment interruption for an average of 2.6 months (range 3-5), which was not due to side effects. The left ventricular ejection fraction (LVEF) was controlled at regular intervals in all of the patients. Upon the beginning of the trastuzumab treatment, the mean LVEF was 68 %. In one patient, the trastuzumab treatment was discontinued after 41 months because of a decrease of the LVEF below normal levels. Trastuzumab is well tolerated even during long-term use. Patients with HER2 overexpression and metastases can be treated well with trastuzumab for up to 119 months.
    Archives of Gynecology 05/2014;
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    ABSTRACT: Laparoscopic salpingotomy has become the gold standard for the treatment of tubal ectopic pregnancy (TEP). Limitations for organ preservation in TEP can result from intra-operative bleeding or potential tubal damage due to application of thermal coagulation. Hemostatic gelatine-thrombin matrix Floseal(®) allows effective local hemostasis when sutures or thermal coagulation are inadequate or impossible. We demonstrate in two cases how tubal preservation following effective hemostasis can be achieved by local application of gelatine-thrombin matrix. In both cases, the ectopic pregnancy was localized in the ampullar part of the right tube, with gestational sac diameter of 38 and 15 mm, respectively, and visible embryos of 25 and 6.5 mm, respectively. After laparoscopic salpingotomy and evacuation of TEP, diffuse bleeding from the implantation site at the tubal wall was treated with the hemostatic matrix. Punctual bipolar coagulation was used only in Case 1 for striking bleeding from incision margins. Both patients were discharged without complications within 24-48 h after operation. Hemostatic gelatine-thrombin matrix Floseal(®) minimizes tissue damage and optimizes local hemostasis. The use of Floseal(®) enhances the chance of organ preservation in the laparoscopic treatment of TEP.
    Archives of Gynecology 05/2014;
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    ABSTRACT: To investigate the effects of miR-1246 on proliferation, invasion, and migration in the human (CSCC) cell line SiHa. SiHa cells were assigned into three groups: miR-1246 analog; miR-1246 antagonist; and control. The MTT, transwell, and wound healing assays were performed to evaluate the proliferation, invasion, and migration abilities of SiHa cells, respectively. Western blot was carried out to detect protein expression of thrombospondin-2 (THBS2) before and after transfection with miR-1246 analog, antagonist, or control. In addition, a THBS2 3'-UTR-containing dual luciferase plasmid was generated and co-transfected with miR-1246, the inhibitor, or non-specific miRNA, into SiHa cells to observe its effects on THBS2-driven luciferase enzyme activity. MTT, transwell, and wound healing assays revealed that proliferation, migration, and invasion were all significantly enhanced (P < 0.01) in SiHa cells transfected with miR-1246 analog, but were suppressed in those transfected with the miR-1246 antagonist. Western blot data showed that miR-1246 analog-transfected SiHa cells had significantly decreased THBS2 expression when compared with control-transfected cells (gray value = 6.28 ± 10.22 vs. 9.58 ± 17.58; P = 0.013) while those transfected with the miR-1246 antagonist had significantly increased THBS2 expression (gray value = 12.90 ± 19.81; P = 0.037). Moreover, SiHa cells co-transfected with miR-1246 and the THBS2 3'-UTR-containing plasmid exhibited decreased luciferase enzyme activity compared with the control. MiR-1246 induced CSCC SiHa cell proliferation, invasion and migration. Preliminary evidence suggests that miR-1246 might promote CSCC tumorigenesis and progression by the suppression of its target gene THBS2.
    Archives of Gynecology 05/2014;
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    ABSTRACT: Hesperidin (HES), a citrus fruit extract, has beneficial effects on various ischemia/reperfusion (I/R) models. We aimed to evaluate the possible positive effects of hesperetin (HPT), an active metabolite of HES, on a rat ovarian I/R model. We divided 24 Wistar Albino rats into four groups. Group I (n = 6) was sham operated, Group II (n = 6) was the I/R group, Group III (n = 6) was the I/R + solvent group and Group IV (n = 6) was the I/R + HPT group. Three hours of ischemia and 3 h of reperfusion were performed on each rat in Groups II, III, and IV. Dimethyl sulfoxide (DMSO) was given intraperitoneally to the rats in the III. Group, and 50 mg/kg of HPT dissolved in DMSO was given intraperitoneally to the rats in the IV. Group 30 min before reperfusion. After 3 h of reperfusion, the ipsilateral ovaries of the rats were examined immunohistochemically to detect apoptosis. Hematoxylin and eosin (H and E) staining demonstrated less edema and hemorrhage in the group where HPT was applied. Caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining showed significantly lower apoptosis in the group where HPT was used when compared to either the I/R or solvent group. To the best of our knowledge, this is the first study that shows the beneficial effects of HPT in an ovarian I/R injury. HPT improved tissue damage and apoptosis caused by I/R injury. To identify the possible positive effects of HPT in ovarian torsion of humans and use in clinical practice, more studies must be performed.
    Archives of Gynecology 05/2014;
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    ABSTRACT: Surgical management of posterior vaginal wall prolapse has variable functional outcomes. Synthetic and biological grafts are used to improve outcomes and reduce failures. The objective of this study was to determine the functional outcomes and its implications on patient-reported quality of life of a technique of posterior vaginal wall repair and prespinous colpopexy with biological small intestinal submucosal (SIS) graft in the management of posterior vaginal wall prolapse. This prospective cohort study was conducted in a urogynaecology subspecialty center in the UK. Women with moderate degree rectocele or more, with or without other compartmental prolapse underwent posterior vaginal wall repair and prespinous colpopexy with SIS graft over a 3-year period. ICIQ vaginal symptoms questionnaires were used pre-operatively and at 6 months post-operatively to assess functional outcomes. The Wilcoxon signed R test was used to analyze the results. 50 women underwent posterior repair with SIS graft (27 with concomitant procedures). There was a statistically significant improvement (p < 0.0001) in the vaginal symptoms and sexual matters scores at 6-month follow-up in all the women. The quality of life scores also improved significantly (p < 0.0001) in all the women. Concomitant pelvic surgery did not affect the outcomes (p < 0.0001). There were no significant intra- or post-operative complications. Posterior vaginal wall repair and prespinous colpopexy with biological SIS graft is an effective surgical option for managing women with posterior vaginal wall prolapse with or without other concomitant compartmental defects.
    Archives of Gynecology 05/2014;
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    ABSTRACT: Postpartum readmission after initial hospitalization for delivery can be diminished if better understood. The aim of this study was to determine the risk factors and indications for maternal re-hospitalization after delivery, in order to identify preventable factors. This was a case control study based on retrospective cohort of patients who delivered at our institution. The patients that were readmitted within 2 weeks of their delivery were included in the study group while the control group was conducted from patients who delivered at the same time but were not re-hospitalized and included twice the number of patients. Demographic characteristics as well as pregnancy, labour and postpartum courses were compared between the two groups. A total of 227 women were re-hospitalized within 14 days after initial discharge. The control group consisted of 450 women. The demographic characteristics were similar among the two groups, so were the rates of obesity, gestational weight gain and smoking. The major indication for readmission was postpartum infections, most of which were not related to immediate postpartum febrile morbidity. Emergency cesarean section was found to be an independent risk factor for readmission. The rate of patients with high-risk pregnancies and complicated deliveries is higher among postpartum maternal readmissions. These data might suggest more cautious postpartum care for those patients.
    Archives of Gynecology 05/2014;
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    ABSTRACT: The aim of this work was to assess and compare the overall value of stand-alone FDG PET and PET/CT in diagnosing recurrent cervical cancer with a meta-analysis. All the English published studies which addressed the use of PET whether interpreted with or without the use of CT for the diagnosis of recurrent cervical cancer were collected. Methodological quality of the included studies was evaluated. Pooled sensitivity and specificity were calculated, summary receiver operating characteristics (SROC) curve analysis was used to compare the diagnostic ability of stand-alone PET and PET/CT. A total of 18 studies were included in this meta-analysis, with a total of 762 subjects. Pooled sensitivity and specificity of PET and PET/CT were 0.91 (95 % CI 0.87-0.94) and 0.94 (95 % CI 0.89-0.97), and 0.92 (95 % CI 0.91-0.94) and 0.84 (95 % CI 0.74-0.91), respectively. The areas under the SROC curve (AUCs) of PET and PET/CT were 0.9610 and 0.9491, respectively. There was no statistical significance between the AUC of PET and PET/CT (P > 0.05). Both PET and PET/CT have good performance in the detection of recurrent cervical cancer. However, interpreted CT images may have limited additional value on PET in detecting recurrent cervical cancer.
    Archives of Gynecology 05/2014;
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    ABSTRACT: This study was conducted to retrospectively compare the efficacy and safety of irinotecan (CPT-11) and pegylated liposomal doxorubicin (PLD) in patients with platinum-resistant or -refractory recurrent epithelial ovarian and primary peritoneal carcinoma. Nineteen patients who received CPT-11 and eleven patients who received PLD were enrolled. CPT-11 was intravenously administered at a starting dose of 60-100 mg/m(2) on day 1, 8, and 15 every 28 days, and PLD was administered at a starting dose of 40-50 mg/m(2) on day 1 every 28 days. Primary outcomes were overall response rate (complete response [CR] + partial response [PR]), disease control rate (CR + PR + stable disease), and progression-free survival (PFS) in each group. Clinical response was evaluated every two or three cycles using the Response Evaluation Criteria in Solid Tumors criteria; CA125 analysis was not performed. The overall response rate was 21.1 % (PR, four cases) and 0 % (p = 0.10) in the CPT-11 and PLD groups, respectively, and the disease control rate was 73.7 and 45.5 % (p = 0.12), respectively. Median PFS was 25.3 (range 5.4-69.9) weeks and 12.7 (range 4.0-43.1) weeks in the CPT-11 and PLD groups, respectively; however, this difference was not statistically significant (p = 0.064). Major adverse events in the CPT-11 group were neutropenia, nausea, and diarrhea, whereas those in the PLD group included thrombocytopenia, anemia, stomatitis, and hand-foot syndrome. This retrospective study demonstrated comparable efficacy outcomes for CPT-11 and PLD. The overall response rate, disease control rate, and median PFS were more favorable in the CPT-11 group compared to the PLD group, although the difference was not significant. The adverse event profiles were different between groups. These results suggest that CPT-11 might be a feasible choice as single-agent salvage chemotherapy for platinum-resistant or -refractory recurrent epithelial ovarian and primary peritoneal carcinoma beside established regimen like PLD.
    Archives of Gynecology 05/2014;
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    ABSTRACT: To investigate pregnancy outcome after minor trauma and to identify risk factors at admission that may predict adverse pregnancy outcome. A retrospective study held between January-2005 and December-2011. Pregnant women at 23 weeks or more, who were admitted due to minor trauma, were included. A standard protocol was applied: physical examination, lab tests and a fetal heart rate monitoring (FHRM) and tocometer for 1 h. In cases of symptomatic women, abnormal FHRM or presence of uterine contractions, the length of monitoring was extended. All women were admitted for 24 h of observation. The primary outcome was a composite adverse outcome that included at least one of the following: placental abruption, preterm birth and birthweight <2,500 g. To investigate pregnancy outcome and identify risk factors that may predict pregnancy outcome, matched (1:2) non-trauma controls were included. Risk factors examined included maternal obstetric variables, complaints at admission, clinical findings, lab test results, FHRM and tocometer findings. A total of 512 women with minor trauma and 1,024 non-trauma controls were included. Composite outcome occurred in 48 (9.4 %) and 131 (12.9 %) of the study and the control groups, respectively (p = 0.04; OR 0.71; 95 % CI, 0.5-0.99). None of the parameters examined at admission predicted the occurrence of the composite outcome. Pregnant women after minor trauma have a favorable pregnancy outcome. None of the parameters examined at admission were predictive of adverse outcome. Extensive evaluation at admission and observation for 24 h are probably unnecessary following minor trauma, particularly for asymptomatic women.
    Archives of Gynecology 05/2014;
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    ABSTRACT: Determination of early disease recurrence in patients with early-stage endometrial cancer operated laparoscopically without pelvic or paraaortic lymphadenectomy. Retrospective chart review of all patients with endometrial carcinoma operated with laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy between 2004 and 2008. 81 patients were eligible for data analysis. The operation time varied between 32 and 284 min. None of the patients suffered serious intraoperative complications. All patients had endometrial carcinoma of endometrioid type. As adjuvant therapy, patients received no further therapy (n = 30), radiation with brachytherapy with an afterloading technique alone (n = 36) or brachytherapy in combination with percutaneous radiation (n = 15). The observation period varied between 19 and 28 months (median 26 months). No patients were lost to follow-up. During the observation period, none of the patients had recurrence of disease or died. Laparoscopic-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy without pelvic or paraaortic lymphadenectomy combined with stage-adapted postoperative irradiation is a safe and efficient treatment option for patients with early-stage endometrial cancer of the endometriod type regarding early disease recurrence.
    Archives of Gynecology 05/2014;
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    ABSTRACT: Literature is scarce regarding the use of clopidogrel during pregnancy and the potential hazard to maternal and fetal health. We report a 33-year-old female, who presented to our clinic at 40 weeks gestation with a history of multiple prior ischemic strokes and transient ischemic attacks. The patient was placed on clopidogrel for secondary stroke prophylaxis prior to conception and maintained therapy throughout pregnancy without interruption or complication. Clopidogrel was discontinued 7 days prior to induction of labor, and a healthy baby was vaginally delivered without bleeding complications or congenital anomalies. Clopidogrel was restarted 12 hours postpartum without an incident. To our knowledge, this is the first report of clopidogrel use in pregnancy for secondary stroke prophylaxis. We also provide a current review of the literature of the use of clopidogrel in pregnancy. Based on the limited data available, clopidogrel use in pregnancy has not demonstrated significant toxicity to either the mother or the newborn. However, additional studies are needed to further assess the efficacy and safety of this medication in this patient population.
    Archives of Gynecology 05/2014;
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    ABSTRACT: We compare the results of total laparoscopic hysterectomy (TLH) operations conducted using standard 2-D and 3-D high definition laparoscopic vision systems and discuss the findings with regard to the recent literature. Data from 147 patients who underwent TLH operations with 2-D or 3-D high definition laparoscopic vision systems in Department of Obstetrics and Gynecology, Bagcilar Training and Research Hospital, during 2 year period between December 2010 and December 2012, were reviewed retrospectively. TLH operations were divided into two groups as those performed using 2-D, and those performed using 3-D high definition laparoscopic vision systems. A statistically significant difference was found between the two groups in the operation times (p = 0.037 < 0.05). The mean operation time of the 2-D laparoscopy group (134.2 ± 61.8 min) was higher than the 3-D laparoscopy group (116.8 ± 38.5 min). No statistically significant difference was found between the 2-D and 3-D groups with respect to major, minor and total complication rates (p = 0.641 > 0.05). The operation time among obese patients was significantly shorter in those in the 3-D laparoscopy group than those in the 2-D group (p = 0.041 < 0.05). Recent literature indicates that 3-D laparoscopy vision system needs to be utilized more often and a higher number of ex vivo and in vivo studies have to be conducted. Furthermore, we believe that the prevalent problems encountered during laparoscopy can be overcome by the development of real-time vision devices and the appropriate training of the laparoscopists. 3-D high definition laparoscopic vision system will help to improve surgical performance and outcome of patients undergoing gynecological minimal invasive surgery.
    Archives of Gynecology 05/2014;
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    ABSTRACT: To investigate whether endometrial injury (EI) increases pregnancy rates in subjects undergoing frozen-thawed embryo transfer (FET) cycles. We conducted a prospective study of 80 consecutive subjects at a private fertility center. All women were undergoing frozen embryo transfer after one or more unsuccessful in vitro fertilization and embryo transfer cycle(s). Subjects in the experimental group underwent endometrial biopsy in the luteal phase of the cycle preceding the frozen embryo transfer cycle. The primary outcomes were chemical and clinical pregnancy rates. The 40 subjects who underwent EI in the cycle preceding their FET cycle were compared with 40 controls. There were differences in the groups' baseline characteristics; the average age was slightly higher and the duration of infertility was longer in the EI group. Chemical pregnancy rates between the two groups were similar, 27 % (range 17-40 %) in the injury group and 26 % (16-40 %) in the control group (OR for chemical pregnancy = 1.05, 95 % CI 0.42-2.12). The difference in clinical pregnancy rate was not statistically significant: 40 % (25-57 %) in the injury group versus 33 % (19-49 %) in the control group (OR for clinical pregnancy = 1.38, 95 % CI 0.55-3.46). Based on the results of this pilot study, EI in the luteal phase of the cycle preceding the frozen embryo transfer cycle does not appear to significantly improve implantation or clinical pregnancy rates.
    Archives of Gynecology 05/2014;
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    ABSTRACT: Endometriosis as a benign disease appears frequently in premenopausal women with highly variable symptoms. In advanced stages bowel involvement is common. In symptomatic disease the adequate treatment requires complete resection of all residues. Indications of colorectal resection for endometriosis remain controversial because of the risk of major complications. The purpose of this study was to show the feasibility of planned complete laparoscopic management of symptomatic deep pelvic endometriosis with bowel involvement performing segmental colorectal resection in a center of excellence. Between 2007 and 2012 all patients treated for symptomatic colorectal endometriosis in our institution were included and retrospectively evaluated. Laparoscopic excision of all visible disease was planned. Data analysis included age, previous history of endometriosis, intraoperative findings, operative procedure and intra- and postoperative complications. In this time period 35 patients with bowel infiltrating endometriosis were treated. Affected locations were the rectovaginal space in 31 patients (89 %), the rectum in 32 patients (91 %), the sigmoid colon in 10 patients (29 %), the coecum in 2 patients (5.7 %), the appendix in 3 patients (8.6 %) and the terminal ileum in 1 patient (2.9 %). In the majority of patients (85.7 %) the resection was achieved laparoscopically, in 3 patients a conversion to laparotomy was necessary and in 2 patients a primary laparotomia was performed. Complications occurred in 2 cases with anastomotic leakage in 1 patient (2.8 %) and a rectovaginal fistula in another patient. Radical resection was achieved in almost all patients (97 %). A well-trained interdisciplinary team can perform treatment of deep infiltrating endometriosis laparoscopically with low incidence of major complications as anastomotic leakage or rectovaginal fistula. Criteria of complete endometriosis restoration of the rectum can be achieved by total or subtotal rectal excision.
    Archives of Gynecology 05/2014;
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    ABSTRACT: To assess the impact of transobturator tape (TOT) procedure on female sexual function as well as their male partners. Sexually active 28 women and their partners included for the study. Before TOT operation, the patients completed incontinence impact questionnaire (IIQ-7) and urogenital distress inventory (UDI-6) to assess the effect of surgery on incontinence. Also the women and their partners completed a self-administered questionnaire evaluating the female sexual function index (FSFI) and international index of erectile function (IIEF-5), respectively. Three months after TOT surgery, the women were asked to complete IIQ-7 and UDI-6 questionnaires to measure the success of TOT procedure. Also, FSFI and IIEF forms were completed by the women and their partners to assess TOT-related sexual life change. After TOT procedure, the mean value of IIQ-7 and UDI-6 questionnaires was lower than the mean scores that measured before treatment (p < 0.001). The mean values of FSFI scores before and 3 months after the operation were 23.15 ± 8.21 vs. 30.01 ± 9.13, respectively (p < 0.001). The mean values of IIEF before and 3 months after the operation were 50.14 ± 5.21 vs. 60.96 ± 10.03, respectively (p < 0.001). According to our results, both women and their partners' sexual life improved after TOT surgery for incontinence.
    Archives of Gynecology 05/2014;
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    ABSTRACT: The objective of this study was to evaluate the safety and efficacy of SprayShield™ Adhesion Barrier in preventing and/or reducing postoperative adhesion during gynecological surgery. This was a prospective, controlled, blinded, and randomized study. Patient blinding was performed intraoperatively. Subjects were randomly assigned to the SprayShield™ or the control group in a 2:1 ratio. The study was conducted at the Clinic of Gynaecology and Obstetrics, at the University Hospital for Gynecology in Germany. Fifteen patients participated in this study; nine patients were assigned to the SprayShield™ and six patients to the control group. During first operation (FLL) in the SprayShield™ group, the agent was applied to all myomectomy suture lines. Patients in the control group did not receive any anti-adhesion treatment, only good surgical practice. A second-look laparoscopy (SLL) was performed 8-12 weeks after myomectomy to evaluate adhesion formation. Main outcome measures were incidence, severity, and extent of uterine adhesions. No significant differences were found between the two study groups. SprayShield™ is easy to use. No serious adverse event related to SprayShield™ was observed. Efficacy data are inconclusive regarding the performance of SprayShield™. Further studies are needed to better understand this performance.
    Archives of Gynecology 04/2014;