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Sekulic S, Stilinovic N, Baturan B, Krsman A, Tesic I, Vejnovic A, Petrovic D, Nikolasevic Z, Mijavec A, Pesic V, Petkovic B. Corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus. Front Med (Lausanne) 2023; 10:1160229. [PMID: 37415764 PMCID: PMC10320854 DOI: 10.3389/fmed.2023.1160229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
Background Breech presentation (BP) results from at random filling of the intrauterine cavity, with an equal probability for a BP or cephalic presentation (CP). Each fetus in BP has its "pair" in CP randomly assumed CP. Direct comparison of BP and CP makes bias to less expressed differences between these two groups. It is therefore necessary to subtract the number of fetuses/newborns from the CP set that are identical to the number of fetuses/newborns in the BP set, with identical characteristics, and add this group to the BP set before comparing them to the rest of the CP fetuses/newborns in the matching process. Methods The procedure encompasses nine variables in pregnancies with a congenitally malformed uterus (CMU) identified at the Department of Obstetrics (1985-2014): gestational age, birth mass, birth length, head circumference, shoulders circumference, umbilical length, placental weight, newborn mass/newborn length ratio, and newborn mass/placental mass ratio. Firstly, the probability of BP was determined and its relation to gestational age, physical characteristics, and previous presentations. Then direct comparison as well as case-control matching of the CP and BP were performed. Case-control matching was based on either a single specific variable (M1) or all combined variables (M2). Findings 462 deliveries were identified with CMU. In 81 cases of multiparity, a fetal presentation was found to be an independent event regardless of the previous presentation, gestational age, and newborn physical characteristics. In four types of CMU with 337 deliveries (Bicornuate, Didelphys, Unicornuate, Arcuate), 9 variables with 36 instances of comparison were observed. M1 in 10 instances and M2 in 6 instances showed a statistically significant lower value of breech/random presentation compared with CP. CP have lower value in 2 instances in M1 and 1 in M2. Statistically significant differences were absent without the matching process. Interpretations The study confirms the maximum probability for the BP is 50%. The case-control matching procedure shows that it is able to detect the difference between the breech/random presentation and CP, while the classic method of direct comparison was unable to detect any differences. The outcome of the breech/random presentation in CMU should be evaluated with the described case-control matching procedure.
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Affiliation(s)
- Slobodan Sekulic
- Department of Neurology, University Clinical Center of Vojvodina, Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Nebojsa Stilinovic
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Branislava Baturan
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Department of Obstetrics and Gynecology, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Anita Krsman
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Department of Obstetrics and Gynecology, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Igor Tesic
- Department of Obstetrics and Gynecology, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Aleksandra Vejnovic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Department of Obstetrics and Gynecology, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Djordje Petrovic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Department of Obstetrics and Gynecology, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Zeljka Nikolasevic
- Department of Psychology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | | | - Vesna Pesic
- Institute for Biological Research “Sinisa Stankovic“, National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Branka Petkovic
- Institute for Biological Research “Sinisa Stankovic“, National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
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Matsushima T, Kaseki H, Iida S, Asakura H. Laser Hysterofiberscopic Intrauterine Surgery Guided by Laparoscopically Assisted Intra-Abdominal Sonohysterography: A Retrospective Review of 65 Patients. J Gynecol Surg 2014. [DOI: 10.1089/gyn.2013.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Takashi Matsushima
- Department of Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Nakahara-ku, Kawasaki, Kanagawa, Japan
| | - Hisayuki Kaseki
- Department of Gynecology, Flowers & Forest Tokyo Hospital, Kita-ku, Tokyo, Japan
| | - Shinya Iida
- Department of Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Nakahara-ku, Kawasaki, Kanagawa, Japan
| | - Hirobumi Asakura
- Department of Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Nakahara-ku, Kawasaki, Kanagawa, Japan
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Garbin O. [Septate uteri: must we treat all of them?]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2010; 38:553-6. [PMID: 20832345 DOI: 10.1016/j.gyobfe.2010.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Accepted: 07/15/2010] [Indexed: 10/19/2022]
Abstract
Septate uterus is the most common female genital malformation. It can be responsible for recurrent miscarriages and infertility. Hysteroscopic septoplasty is an effective procedure. It can prevent abortions and probably increase fertility. The hysteroscopic section of the septum has become a simple and safe technique, with the use of small hysteroscopes and that of bipolar energy with trained surgeons. These are the reasons why hysteroscopic septoplasty can be proposed to women with septate uterus and a desire for pregnancy.
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Affiliation(s)
- O Garbin
- Service de gynécologie, SIHCUS-CMCO, pôle de gynécologie et d'obstétrique des hôpitaux universitaires de Strasbourg, 19, rue Louis-Pasteur, 67300 Schiltigheim, France.
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Rongières C. Utérus malformé et Assistance médicale à la procréation: prévention du défaut d'implantation? ACTA ACUST UNITED AC 2007; 35:842-7. [PMID: 17766163 DOI: 10.1016/j.gyobfe.2007.07.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Accepted: 07/24/2007] [Indexed: 11/24/2022]
Abstract
The infertility in women with an abnormal uterus seems a subject of controversy. The prognosis of in vitro fertilization among these patients with such an anomaly is even less founded. The results of in vitro fertilization have been only studied with few patients and recently. Through the literature, we will focus step by step, on the impact of uterine anomalies on natural reproduction, then the impact of metroplasty on natural reproduction, the role of anomalies on the endometrium quality and lastly, the results of Assisted Rerpoductive Techniques with women with such an anomaly. It seems that the main risk is obstetric complications such as spontaneous abortion or premature delivery, not implantation failure. However, when infertility exists, surgical treatment tends to improve the pregnancy rate for some.
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Affiliation(s)
- C Rongières
- Service d'Assistance médicale à la procréation, CMCO-SIHCUS, 19, rue Louis-Pasteur, BP 120, 67303 Schiltigheim cedex, France.
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