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Rigos I, Athanasiou V, Vlahos N, Papantoniou N, Siristatidis C. P–413 The combination of endometrial injury and Freeze-All strategy in women with repeated implantation failures. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Can the combination of hysteroscopic endometrial injury (EI) and freeze-all strategy improve pregnancy parameters, mainly live birth, in women with repeated implantation failures (RIF)?
Summary answer
The combination of Endometrial Injury and freeze-all strategy has no significant effect on live birth, clinical and miscarriage rates in RIF patients undergoing ART.
What is known already
A variety of strategies and approaches for RIF patients undergoing ART have been used and proposed. Currently there is insufficient evidence in the literature concerning the effect of either EI or freeze-all strategy in IVF cycles and very limited on the combination of these two approaches in RIF patients.
Study design, size, duration
This is a two-center two-arm cohort study conducted at both University and Private Assisted Reproductive Units in Greece, encompassing 60 cycles with vitrification as the cryopreservation method from 60 participants during the last three years.
Participants/materials, setting, methods
The study group comprised of 30 patients with RIF and underwent a hysteroscopic endometrial injury in the menstrual cycle prior that to the embryo transfer. The control group comprised of patients with RIF and underwent a standard cycle with no adjuvant treatment. Our primary analysis was performed to provide a direct comparison between groups. Logistic and Poisson Regression models were further employed to examine possible confounding effects.
Main results and the role of chance
Live birth did not differ between groups (p = 0.0953); similarly, clinical pregnancy and miscarriage rates were comparable among them (p = 0.3472 and p = 0.2542, respectively). The number of retrieved oocytes was the only significant confounder for biochemical pregnancy (p = 0.0481, 95% CI: (0.0014, 0.3223)].
Limitations, reasons for caution
Limitations of the study include the lack of randomization that is linked with known and unknown biases and the small cohort size.
Wider implications of the findings: The combination of both endometrial injury and freeze-all strategy does not appear to improve pregnancy rates, including live birth, in patients with RIF undergoing ART.
The number of retrieved oocytes was the only significant confounder for biochemical pregnancy.
Trial registration number
NCT04597463
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Affiliation(s)
- I Rigos
- IVF Athens Center, IVF Athens Center, Athens, Greece
| | - V Athanasiou
- IVF Athens Center, IVF Athens Center, Athens, Greece
| | - N Vlahos
- Second Department of Obstetrics and Gynecology- “Aretaieion Hospital”- Medical School- National and Kapodistrian University of Athens, Assisted Reproduction Unit, Athens, Greece
| | - N Papantoniou
- Third Department of Obstetrics and Gynecology- “Attikon Hospital”- Medical School- National and Kapodistrian University of Athens, Assisted Reproduction Unit, Athens, Greece
| | - C Siristatidis
- Second Department of Obstetrics and Gynecology- “Aretaieion Hospital”- Medical School- National and Kapodistrian University of Athens, Assisted Reproduction Unit, Athens, Greece
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Rigos I, Athanasiou V, Vlahos N, Papantoniou N, Profer D, Siristatidis C. The Addition of Endometrial Injury to Freeze-All Strategy in Women with Repeated Implantation Failures. J Clin Med 2021; 10:jcm10102162. [PMID: 34067637 PMCID: PMC8156614 DOI: 10.3390/jcm10102162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/04/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Recurrent implantation failure (RIF) after IVF remains a challenging topic for fertility specialists and a frustrating reality for patients with infertility. Various approaches have been investigated and applied towards the improvement of clinical outcomes. Through a nonrandomized clinical trial, we evaluated the effect of the combination of hysteroscopic endometrial injury and the freeze-all technique on pregnancy parameters in a cohort of RIF patients; (2) Methods: The study group comprised of 30 patients with RIF that underwent a hysteroscopic endometrial injury prior to a frozen embryo transfer cycle; another 30 patients with RIF, comprising the control group, underwent a standard frozen cycle with no adjuvant treatment before. Live birth comprised the primary outcome. Logistic and Poisson regression analyses were implemented to reveal potential independent predictors for all outcomes. (3) Results: Live birth rates were similar between groups (8/30 vs. 3/30, p = 0.0876). Biochemical and clinical pregnancy and miscarriages were also independent of the procedure (p = 0.7812, p = 0.3436 and p = 0.1213, respectively). The only confounding factor that contributed to biochemical pregnancy was the number of retrieved oocytes (0.1618 ± 0.0819, p = 0.0481); (4) Conclusions: The addition of endometrial injury to the freeze-all strategy in infertile women with RIF does not significantly improve pregnancy rates, including live birth. A properly conducted RCT with adequate sample size could give a robust answer.
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Affiliation(s)
- Ioannis Rigos
- Assisted Reproduction Unit, IVF Athens Center, Leof. Kifisias 5, 15123 Athens, Greece;
- Correspondence: ; Tel.: +30-693-820-1060
| | - Vasileios Athanasiou
- Assisted Reproduction Unit, IVF Athens Center, Leof. Kifisias 5, 15123 Athens, Greece;
| | - Nikolaos Vlahos
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (N.V.); (C.S.)
| | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynecology, “Attikon Hospital”, Medical School, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12642 Athens, Greece;
| | | | - Charalampos Siristatidis
- Assisted Reproduction Unit, Second Department of Obstetrics and Gynecology, “Aretaieion Hospital”, Medical School, National and Kapodistrian University of Athens, Vas. Sofias 76, 11528 Athens, Greece; (N.V.); (C.S.)
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Pergialiotis V, Bellos I, Vrachnis N, Papantoniou N, Loutradis D, Daskalakis G. Early versus delayed oxytocin infusion following amniotomy for induction of labor: a meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med 2021; 35:4889-4896. [PMID: 33441039 DOI: 10.1080/14767058.2021.1872535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Oxytocin infusion prior to confirmation of delay in labor is discouraged by the World Health Organization. However, evidence from the Cochrane library seems to support early amniotomy and oxytocin to reduce the rates of cesarean sections (CS). OBJECTIVES To investigate differences in mode of delivery among parturient receiving early versus delayed oxytocin infusion following amniotomy as a mean for augmentation of labor. SEARCH STRATEGY We searched Medline, Scopus, EMBASE, Cochrane Central Register of Controlled Trials and Google Scholar databases from inception till February 2020. Selection criteria: Randomized controlled trials. DATA COLLECTION AND ANALYSIS Data were collected using a modified Cochrane data collection form for intervention reviews. Meta-analysis was performed using the meta function in RStudio. MAIN RESULTS Five studies were included that involved 1.232 parturient. The meta-analysis did not reveal significant differences in the mode of delivery among women that were randomized to receive immediate oxytocin infusion and those that received delayed oxytocin infusion (operative vaginal delivery OR 1.14, 95% CI 0.48, 2.69) and CS OR 0.81, 95% CI 0.53, 1.25)). The interval from amniotomy to delivery was significantly smaller in the immediate oxytocin infusion group; however, prediction intervals were not significant. CONCLUSIONS The results of our meta-analysis suggest that there is no difference in the mode of delivery and interval from amniotomy to delivery when oxytocin is delayed for at least one hour following amniotomy. Taking in mind this information as well as current recommendations drawn from the WHO physicians should consider withholding oxytocin infusion at least until protracted labor is confirmed.
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Affiliation(s)
- Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, Athens, Greece.,1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athinon, Greece
| | - Ioannis Bellos
- Laboratory of Experimental Surgery and Surgical Research N.S Christeas, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Vrachnis
- 3rd Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Chaidari, Greece
| | - Nikolaos Papantoniou
- 3rd Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Chaidari, Greece
| | - Dimitrios Loutradis
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athinon, Greece
| | - George Daskalakis
- 1st Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athinon, Greece
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Pergialiotis V, Kotrogianni P, Koutaki D, Christopoulos-Timogiannakis E, Papantoniou N, Daskalakis G. Umbilical cord coiling index for the prediction of adverse pregnancy outcomes: a meta-analysis and sequential analysis. J Matern Fetal Neonatal Med 2020; 33:4022-4029. [PMID: 30870055 DOI: 10.1080/14767058.2019.1594187] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose: To evaluate the potential association of abnormal cord coiling with adverse pregnancy outcomes.Materials and methods: We used the Medline (1966-2018), Scopus (2004-2018), Clinicaltrials.gov (2008-2018), Embase (1980-2018), Cochrane Central Register of Controlled Trials CENTRAL (1999-2018), and Google Scholar (2004-2018) databases. The date of last search was set on 31 May 2018. Language, country, or date restrictions were not applied during the literature research to prevent bias. All observational (both prospective and retrospective) studies that reported maternal and neonatal antenatal and perinatal outcomes based on the umbilical coiling index (UCI) status were considered as eligible for inclusion. Meta-analysis of the risk ratio (RR) and mean differences (MD) among hypocoiled/hypercoiled and normocoiled cases was performed with RevMan 5.3 software. Univariate metaregression and leave-one-out meta-analysis was performed with Open Meta-Analyst statistical software. Trial sequential analysis was performed with the trial sequential analysis (TSA) software.Results: Twenty four studies were finally included that involved 9553 pregnant women. Umbilical cord coiling was evaluated with the use of the umbilical coiling index (UCI). Values of the UCI below the 10th percentile were evaluated as hypocoiled and above the 90th percentile as hypercoiled. Hypocoiled cords were significantly associated with increased prevalence of preterm birth < 37 weeks, need for interventional delivery due to fetal distress, meconium stained liquor, Apgar scores < 7 at 5 min, small for gestational age (SGA) neonates, fetal anomalies, need for admission in the neonatal intensive care unit (NICU), fetal heart rate abnormalities, and fetal death. Hypercoiled cords were significantly associated with increased prevalence of preterm birth < 37 weeks, need for interventional delivery due to fetal distress, meconium stained liquor, Apgar scores < 7 at 5 min, small for gestational age (SGA) neonates, fetal anomalies, fetal growth restriction fetal heart rate abnormalities, fetal acidosis, and fetal death.Conclusions: The findings of our meta-analysis underline the correlation of UCI abnormalities with antenatal and perinatal pathology. More studies are needed, however, to elucidate whether antenatal assessment of the UCI can be used as routine in clinical practice as well as its value in uncomplicated pregnancies.
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Affiliation(s)
- Vasilios Pergialiotis
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi Kotrogianni
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Diamanto Koutaki
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Daskalakis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Gkamprana AM, Despotidi A, Maroudias G, Michalitsi V, Papantoniou N, Pergialiotis V. Training the trainees: a pilot study of inter-observer discrepancy and learning curve in the maternal foetal unit of a tertiary centre. J OBSTET GYNAECOL 2020; 41:746-749. [PMID: 33054457 DOI: 10.1080/01443615.2020.1798904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Our study aims to present the preliminary findings of an ongoing prospective cohort study that assesses the trainees' ability to perform foetal biometry during the third trimester of pregnancy. Sixty-three women with third-trimester singleton pregnancies were included. A biometry scan was performed byboth residents and a foetal medicine specialist in the Third department of Obstetrics and Gynaecology of Attikon University Hospital. For each case, the ultrasonographic measurements of the two operator groups were compared. The mean difference of the resident group compared to the specialist group was: for the biparietal diameter +1.3 mm (CI 95%, range -10.6 to +13,3, ±1.96 SD), for the occipitofrontal diameter -2.6 mm (CI 95%, range -31.5 to +26.2), for the anterior-posterior abdominal diameter -2.6 mm (CI 95%, range -17.9 to +12.8), for the transverse abdominal diameter -0.7 mm (CI 95%, range -17.1 to +15.7) and for the femur length -1.1 mm (CI 95%, range -11.7 to +9.6). We observed that, among all biometric parameters, the most accurate -based on the specialist group were the head circumference measurements. The highest discrepancy was noted for the abdominal assessment. Given that foetal biometry is of utmost importance in obstetrical clinical evaluation and management, a study that highlights the weaknesses of residents in this field could open new horizons in optimising the learning procedure.Impact statementWhat is already known on this subject? After review of the literature, we found only a few studies on inter- and intra-observer discrepancy in foetal biometry measurements among specialists.What the results of this study add? To our knowledge, our study is the first to evaluate residents' capacity of performing a biometry scan, by comparing their measurements to those of MFM specialists.What the implications are of these findings to clinical practice and/or further research? The need for constant evaluation of residents is indisputable. Our study could help to improve their ultrasound skills by giving emphasis on residents' weaknesses. With further research on this subject, a standard system of evaluation could be formed and determine the duration and type of training required for each resident.
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Affiliation(s)
- Athanasia M Gkamprana
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasia Despotidi
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Maroudias
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassiliki Michalitsi
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios Pergialiotis
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Pergialiotis V, Karampetsou N, Bellos I, Papantoniou N, Daskalakis G. Nocturnal blood pressure alterations in patients with preeclampsia – Do they really matter? A systematic review of the literature. Eur J Obstet Gynecol Reprod Biol 2019; 239:39-44. [DOI: 10.1016/j.ejogrb.2019.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 01/12/2023]
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Papaioannou GK, Evangelinakis N, Despotidou A, Papadopoulos S, Papantoniou N. Management of TRAP syndrome at first trimester with interstitial laser. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Migklis K, Troboukis P, Papapanagiotou I, Dalivigkas I, Papantoniou N. Laparoscopic sacrocolpopexy with the use of a mesh for treatment of uterine prolapse. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Chrelias G, Pergialiotis V, Damaskou V, Parthenis C, Oikonomou M, Pappa V, Panayiotides I, Papantoniou N. Investigation of the potential association of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in postmenopausal patients with evidence of endometrial pathology. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Sotiriadis A, Figueras F, Eleftheriades M, Papaioannou GK, Chorozoglou G, Dinas K, Papantoniou N. First-trimester and combined first- and second-trimester prediction of small-for-gestational age and late fetal growth restriction. Ultrasound Obstet Gynecol 2019; 53:55-61. [PMID: 29573501 DOI: 10.1002/uog.19055] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/16/2018] [Accepted: 03/13/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To develop a first-trimester or combined first- and second-trimester screening algorithm for the prediction of small-for-gestational age (SGA) and late fetal growth restriction (FGR). METHODS This was a retrospective study of women with singleton pregnancy, who underwent routine first-, second- and third-trimester ultrasound assessment. Late FGR was defined, at ≥ 32 weeks' gestation in the absence of congenital anomalies, as either (i) estimated fetal weight (EFW) or birth weight (BW) < 3rd centile, or (ii) EFW < 10th centile and either uterine artery mean pulsatility index (UtA-PI) > 95th centile or cerebroplacental ratio (CPR) < 5th centile. Neonates with BW < 10th centile, regardless of prenatal parameters, were defined as SGA. The predictive effectiveness of maternal and first- and second-trimester factors was tested using logistic regression and receiver-operating characteristics curve analyses. RESULTS A total of 3520 fetuses were included (late FGR, n = 109 (3.1%); SGA, n = 292 (8.3%)). Of the late FGR cases, 56 (1.6%) fulfilled the antenatal criteria (EFW < 3rd centile or EFW < 10th centile plus abnormal UtA-PI or CPR) and were defined as prenatally detected late FGR. A first-trimester screening model (comprising conception method, smoking status, maternal height, pregnancy-associated plasma protein-A (PAPP-A) and UtA-PI) could predict 50.0% of the prenatally diagnosed and 36.7% of the overall late FGR fetuses for a 10% false-positive rate (FPR). A model combining first- and second-trimester screening parameters (conception method, smoking status, PAPP-A, second- trimester EFW, head circumference/abdominal circumference ratio and UtA-PI) could predict 78.6% of the prenatally detected, and 59.6% of the overall late FGR fetuses, for a 10% FPR (area under the curve 0.901 (95% CI, 0.856-0.947) and 0.855 (95% CI, 0.818-0.891), respectively). The prediction of SGA was suboptimal for both first-trimester and combined screening. CONCLUSIONS A simple model combining maternal and first- and second-trimester predictors can detect 60% of fetuses that will develop late FGR, and 79% of those fetuses that will be classified prenatally as late FGR, for a 10% FPR. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- A Sotiriadis
- Second Department of Obstetrics and Gynecology, Aristotle University Medical School, Thessaloniki, Greece
| | - F Figueras
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clinic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Center for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - M Eleftheriades
- Second Department of Obstetrics and Gynecology, National & Kapodistrian University of Athens, Athens, Greece
| | - G K Papaioannou
- Third Department of Obstetrics and Gynecology, National & Kapodistrian University of Athens, Athens, Greece
| | - G Chorozoglou
- Second Department of Obstetrics and Gynecology, Aristotle University Medical School, Thessaloniki, Greece
| | - K Dinas
- Second Department of Obstetrics and Gynecology, Aristotle University Medical School, Thessaloniki, Greece
| | - N Papantoniou
- Third Department of Obstetrics and Gynecology, National & Kapodistrian University of Athens, Athens, Greece
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Di Renzo GC, Cabero Roura L, Facchinetti F, Helmer H, Hubinont C, Jacobsson B, Jørgensen JS, Lamont RF, Mikhailov A, Papantoniou N, Radzinsky V, Shennan A, Ville Y, Wielgos M, Visser GHA. Preterm Labor and Birth Management: Recommendations from the European Association of Perinatal Medicine. J Matern Fetal Neonatal Med 2018; 30:2011-2030. [PMID: 28482713 DOI: 10.1080/14767058.2017.1323860] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- G C Di Renzo
- a Department of Obstetrics and Gynecology , University of Perugia , Perugia , Italy
| | - L Cabero Roura
- b Department of Obstetrics and Gynecology , Hospital Vall D'Hebron , Barcelona , Spain
| | - F Facchinetti
- c Mother-Infant Department, School of Midwifery , University of Modena and Reggio Emilia , Italy
| | - H Helmer
- d Department of Obstetrics and Gynaecology , General Hospital, University of Vienna , Vienna , Austria
| | - C Hubinont
- e Department of Obstetrics , Saint Luc University Hospital, Université de Louvain , Brussels , Belgium
| | - B Jacobsson
- f Department of Obstetrics and Gynecology , Institute of Clinical Sciences, University of Gothenburg , Gothenburg , Sweden
| | - J S Jørgensen
- g Department of Obstetrics and Gynaecology , Odense University Hospital , Odense , Denmark
| | - R F Lamont
- h Department of Gynaecology and Obstetrics , University of Southern Denmark, Odense University Hospital , Odense , Denmark.,i Division of Surgery , University College London, Northwick Park Institute of Medical Research Campus , London , UK
| | - A Mikhailov
- j Department of Obstetrics and Gynecology , 1st Maternity Hospital, State University of St. Petersburg , Russia
| | - N Papantoniou
- k Department of Obstetrics and Gynaecology , Athens University School of Medicine , Athens , Greece
| | - V Radzinsky
- l Department of Medicine , Peoples' Friendship University of Russia , Moscow , Russia
| | - A Shennan
- m St. Thomas Hospital, Kings College London , UK
| | - Y Ville
- n Service d'Obstétrique et de Médecine Foetale , Hôpital Necker Enfants Malades , Paris , France
| | - M Wielgos
- p Department of Obstetrics and Gynecology , Medical University of Warsaw , Warsaw , Poland
| | - G H A Visser
- o Department of Obstetrics , University Medical Center , Utrecht , The Netherlands
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Pergialiotis V, Kotrogianni P, Christopoulos-Timogiannakis E, Koutaki D, Daskalakis G, Papantoniou N. Bisphenol A and adverse pregnancy outcomes: a systematic review of the literature. J Matern Fetal Neonatal Med 2018; 31:3320-3327. [PMID: 28805116 DOI: 10.1080/14767058.2017.1368076] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Bisphenol A is a chemical compound related to adverse maternal and neonatal outcomes. The purpose of the present systematic review is to summarize the current knowledge in the field. MATERIALS AND METHODS We systematically searched the Medline (1966-2017), Scopus (2004-2017), Clinicaltrials.gov (2008-2017), Cochrane Central Register of Controlled Trials CENTRAL (1999-2017) databases. RESULTS Thirty-five studies were included in the present systematic review. According to our findings, BPA has a direct negative impact on maternal, fetal, and neonatal outcomes, including birthweight, rates of preterm birth, developmental defects, and recurrent miscarriage. Data in the field of preeclampsia and gestational diabetes mellitus remain inconclusive because current research is very limited. CONCLUSIONS BPA exposure during pregnancy can result in significant antenatal pathology; hence, occupational exposure should be at least discouraged during this period. However, cross-sectional studies in the field that would assess the levels of exposure at timely intervals are still lacking, therefore, the actual impact of BPA remains unclear.
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Affiliation(s)
- Vasilios Pergialiotis
- a Laboratory of Experimental Surgery and Surgical Research NS Christeas , National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - Paraskevi Kotrogianni
- a Laboratory of Experimental Surgery and Surgical Research NS Christeas , National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - Evangelos Christopoulos-Timogiannakis
- a Laboratory of Experimental Surgery and Surgical Research NS Christeas , National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - Diamanto Koutaki
- a Laboratory of Experimental Surgery and Surgical Research NS Christeas , National and Kapodistrian University of Athens, Medical School , Athens , Greece
| | - Georgios Daskalakis
- b First Department of Obstetrics/Gynaecology , National and Kapodistrian University of Athens, Alexandra Hospital , Athens , Greece
| | - Nikolaos Papantoniou
- c Third Department of Obstetrics/Gynaecology , National and Kapodistrian University of Athens, Attikon Hospital , Athens , Greece
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Lozano R, Fullman N, Abate D, Abay SM, Abbafati C, Abbasi N, Abbastabar H, Abd-Allah F, Abdela J, Abdelalim A, Abdel-Rahman O, Abdi A, Abdollahpour I, Abdulkader RS, Abebe ND, Abebe Z, Abejie AN, Abera SF, Abil OZ, Aboyans V, Abraha HN, Abrham AR, Abu-Raddad LJ, Abu-Rmeileh NM, Abyu GY, Accrombessi MMK, Acharya D, Acharya P, Adamu AA, Adebayo OM, Adedeji IA, Adedoyin RA, Adekanmbi V, Adetokunboh OO, Adhena BM, Adhikari TB, Adib MG, Adou AK, Adsuar JC, Afarideh M, Afshari M, Afshin A, Agarwal G, Aghayan SA, Agius D, Agrawal A, Agrawal S, Ahmadi A, Ahmadi M, Ahmadieh H, Ahmed MB, Ahmed S, Akalu TY, Akanda AS, Akbari ME, Akibu M, Akinyemi RO, Akinyemiju T, Akseer N, Alahdab F, Al-Aly Z, Alam K, Alam T, Albujeer A, Alebel A, Alene KA, Al-Eyadhy A, Alhabib S, Ali R, Alijanzadeh M, Alizadeh-Navaei R, Aljunid SM, Alkerwi A, Alla F, Allebeck P, Allen CA, Almasi A, Al-Maskari F, Al-Mekhlafi HM, Alonso J, Al-Raddadi RM, Alsharif U, Altirkawi K, Alvis-Guzman N, Amare AT, Amenu K, Amini E, Ammar W, Anber NH, Anderson JA, Andrei CL, Androudi S, Animut MD, Anjomshoa M, Ansari H, Ansariadi A, Ansha MG, Antonio CAT, Anwari P, Appiah LT, Aremu O, Areri HA, Ärnlöv J, Arora M, Aryal KK, Asayesh H, Asfaw ET, Asgedom SW, Asghar RJ, Assadi R, Ataro Z, Atique S, Atre SR, Atteraya MS, Ausloos M, Avila-Burgos L, Avokpaho EFGA, Awasthi A, Ayala Quintanilla BP, Ayele HT, Ayele Y, Ayer R, Azarpazhooh MR, Azzopardi PS, Azzopardi-Muscat N, Babalola TK, Babazadeh A, Badali H, Badawi A, Balakrishnan K, Bali AG, Banach M, Banerjee A, Banoub JAM, Banstola A, Barac A, Barboza MA, Barker-Collo SL, Bärnighausen TW, Barrero LH, Barthelemy CM, Bassat Q, Basu A, Basu S, Battista RJ, Baune BT, Baynes HW, Bazargan-Hejazi S, Bedi N, Beghi E, Behzadifar M, Behzadifar M, Béjot Y, Bekele BB, Belachew AB, Belay AG, Belay SA, Belay YA, Bell ML, Bello AK, Bennett DA, Bensenor IM, Benzian H, Berhane A, Berhe AK, Berman AE, Bernabe E, Bernstein RS, Bertolacci GJ, Beuran M, Beyranvand T, Bhala N, Bhalla A, Bhansali A, Bhattarai S, Bhaumik S, Bhutta ZA, Biadgo B, Biehl MH, Bijani A, Bikbov B, Bililign N, Bin Sayeed MS, Birlik SM, Birungi C, Bisanzio D, Biswas T, Bitew H, Bizuneh H, Bjertness E, Bobasa EM, Boufous S, Bourne R, Bozorgmehr K, Bragazzi NL, Brainin M, Brant LC, Brauer M, Brazinova A, Breitborde NJK, Briant PS, Britton G, Brugha T, Bukhman G, Busse R, Butt ZA, Cahuana-Hurtado L, Callender CSKH, Campos-Nonato IR, Campuzano Rincon JC, Cano J, Car J, Car M, Cárdenas R, Carrero JJ, Carter A, Carvalho F, Castañeda-Orjuela CA, Castillo Rivas J, Castro F, Causey K, Çavlin A, Cercy KM, Cerin E, Chaiah Y, Chalek J, Chang HY, Chang JC, Chattopadhyay A, Chattu VK, Chaturvedi P, Chiang PPC, Chin KL, Chisumpa VH, Chitheer A, Choi JYJ, Chowdhury R, Christensen H, Christopher DJ, Chung SC, Cicuttini FM, Ciobanu LG, Cirillo M, Claro RM, Claßen TKD, Cohen AJ, Collado-Mateo D, Cooper C, Cooper LT, Cornaby L, Cortinovis M, Costa M, Cousin E, Cromwell EA, Crowe CS, Cunningham M, Daba AK, Dadi AF, Dandona L, Dandona R, Dang AK, Dargan PI, Daryani A, Das SK, Das Gupta R, das Neves J, Dasa TT, Dash AP, Davis AC, Davitoiu DV, Davletov K, Dayama A, de Courten B, De Leo D, De Neve JW, De Steur H, Degefa MG, Degenhardt L, Degfie TT, Deiparine S, Dellavalle RP, Demoz GT, Demtsu B, Denova-Gutiérrez E, Deribe K, Dervenis N, Dessie GA, Dey S, Dharmaratne SD, Dhimal M, Dicker D, Dinberu MT, Ding EL, Djalalinia S, Do HP, Dokova K, Doku DT, Douwes-Schultz D, Driscoll TR, Duan L, Dubey M, Dubljanin E, Duken EE, Duncan BB, Duraes AR, Ebrahimpour S, Edvardsson D, El Bcheraoui C, Eldrenkamp E, El-Khatib Z, Elyazar IRF, Enayati A, Endries AY, Eshrati B, Eskandarieh S, Esteghamati A, Esteghamati S, Estep K, Fakhar M, Fakhim H, Fanzo J, Faramarzi M, Fareed M, Farhadi F, Farid TA, Farinha CSES, Farioli A, Faro A, Farvid MS, Farzadfar F, Farzaei MH, Farzam H, Fazaeli AA, Fazeli MS, Feigin VL, Feigl AB, Fekadu W, Feldman R, Fentahun N, Fereshtehnejad SM, Fernandes E, Fernandes JC, Feyissa GT, Fijabi DO, Filip I, Finegold S, Finger JD, Fischer F, Fitzmaurice C, Flor LS, Foigt NA, Foreman KJ, Frank TD, Franklin RC, Fukumoto T, Fukutaki K, Fuller JE, Fürst T, Furtado JM, Gakidou E, Gallus S, Gankpe FG, Gansevoort RT, Garcia AC, Garcia-Basteiro AL, Garcia-Gordillo MA, Gardner WM, Gebre AK, Gebre T, Gebregergs GB, Gebrehiwot TT, Gebremedhin AT, Gebremichael B, Gebremichael TG, Gelano TF, Geleijnse JM, Geramo YCD, Getachew S, Gething PW, Gezae KE, Ghadami MR, Ghadimi R, Ghadiri K, Ghasemi-Kasman M, Ghiasvand H, Ghimire M, Ghoshal AG, Giampaoli S, Gill PS, Gill TK, Giussani G, Gnedovskaya EV, Goldberg EM, Goli S, Gona PN, Goodridge A, Gopalani SV, Gorman TM, Goto A, Goulart AC, Goulart BNG, Grada A, Griswold MG, Grosso G, Gugnani HCC, Guillemin F, Guimaraes ALS, Guo Y, Gupta PC, Gupta R, Gupta R, Gupta T, Ha GH, Haagsma JA, Hachinski V, Hafezi-Nejad N, Haghparast Bidgoli H, Hagos TB, Haile MT, Hailegiyorgis TT, Hailu GB, Haj-Mirzaian A, Haj-Mirzaian A, Hamadeh RR, Hamidi S, Hankey GJ, Harb HL, Harikrishnan S, Haririan H, Haro JM, Hasan M, Hassankhani H, Hassen HY, Havmoeller R, Hawley CN, Hay SI, He Y, Hedayatizadeh-Omran A, Hegazy MI, Heibati B, Heidari B, Heidari M, Hendrie D, Henok A, Heredia-Pi I, Herteliu C, Heydarpour B, Heydarpour F, Heydarpour S, Hibstu DT, Híjar M, Hoek HW, Hoffman DJ, Hole MK, Homaie Rad E, Hoogar P, Horita N, Hosgood HD, Hosseini SM, Hosseinzadeh M, Hostiuc M, Hostiuc S, Hotez PJ, Hoy DG, Hsairi M, Hsiao T, Hu G, Huang JJ, Hughes C, Huynh CK, Igumbor EU, Ikeda CT, Ilesanmi OS, Iqbal U, Irvani SSN, Irvine CMS, Islam SMS, Islami F, Ivers RQ, Izadi N, Jacobsen KH, Jahangiry L, Jahanmehr N, Jain SK, Jakovljevic M, Jalu MT, Jamal AA, James SL, Jassal SK, Javanbakht M, Jayatilleke AU, Jeemon P, Jha RP, Jha V, Ji JS, Johnson CO, Johnson SC, Jonas JB, Jonnagaddala J, Jorjoran Shushtari Z, Joshi A, Jozwiak JJ, Jungari SB, Jürisson M, K M, Kabir Z, Kadel R, Kahsay A, Kahssay M, Kalani R, Kapil U, Karami M, Karami Matin B, Karanikolos M, Karimi N, Karimi SM, Karimi-Sari H, Kasaeian A, Kassa DH, Kassa GM, Kassa TD, Kassa ZY, Kassebaum NJ, Katikireddi SV, Kaul A, Kawakami N, Kazemi Z, Karyani AK, Kazi DS, KC P, Kebede S, Keiyoro PN, Kemmer L, Kemp GR, Kengne AP, Keren A, Kesavachandran CN, Khader YS, Khafaei B, Khafaie MA, Khajavi A, Khalid N, Khalil IA, Khan EA, Khan MS, Khan MA, Khang YH, Khanna T, Khater MM, Khatony A, Khazaeipour Z, Khazaie H, Khoja AT, Khosravi A, Khosravi MH, Khubchandani J, Kiadaliri AA, Kiarie HW, Kibret GD, Kiirithio DN, Kim D, Kim JY, Kim YE, Kim YJ, Kimokoti RW, Kinfu Y, Kinra S, Kisa A, Kissimova-Skarbek K, Kissoon N, Kivimäki M, Kocarnik JM, Kochhar S, Kokubo Y, Kolola T, Kopec JA, Kosek MN, Kosen S, Koul PA, Koyanagi A, Kravchenko MA, Krishan K, Krohn KJ, Kuate Defo B, Kucuk Bicer B, Kudom AA, Kulikoff XR, Kumar GA, Kumar M, Kumar P, Kutz MJ, Kyu HH, Lachat C, Lad DP, Lad SD, Lafranconi A, Lagat AK, Lal DK, Lalloo R, Lam H, Lami FH, Lamichhane P, Lan Q, Lang JJ, Lansingh VC, Lansky S, Larson HJ, Larsson AO, Laryea DO, Lassi ZS, Latifi A, Lau KMM, Laxmaiah A, Lazarus JV, Leasher JL, Lebedev G, Ledesma JR, Lee JB, Lee PH, Leever AT, Leigh J, Leinsalu M, Leshargie CT, Leung J, Lewycka S, Li S, Li X, Li Y, Liang J, Liang X, Liben ML, Lim LL, Limenih MA, Linn S, Liu S, Liu Y, Lodha R, Logroscino G, Lopez AD, Lorkowski S, Lotufo PA, Lucchesi LR, Lyons RA, Macarayan ERK, Mackay MT, Maddison ER, Madotto F, Maghavani DP, Magis-Rodriguez C, Mahotra NB, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malta DC, Mamun AA, Manda AL, Mandarano-Filho LG, Mangalam S, Manguerra H, Mansournia MA, Mapoma CC, Maravilla JC, Marcenes W, Marks A, Martin RV, Martins SCO, Martins-Melo FR, Martopullo I, Mashamba-Thompson TP, Massenburg BB, Mathur MR, Maulik PK, Mazidi M, McAlinden C, McGrath JJ, McKee M, McMahon BJ, Mehata S, Mehndiratta MM, Mehrotra R, Mehta KM, Mehta V, Mejia-Rodriguez F, Mekonen T, Mekonnen TCC, Meles HG, Melese A, Melku M, Memiah PTN, Memish ZA, Mendoza W, Mengistu DT, Mengistu G, Mensah GA, Mensink GBM, Mereta ST, Meretoja A, Meretoja TJ, Mestrovic T, Mezgebe HB, Miazgowski B, Miazgowski T, Millear AI, Miller TR, Miller-Petrie MK, Milne GJ, Mini GK, Minnig SP, Mirabi P, Mirarefin M, Mirrakhimov EM, Misganaw AT, Mitchell PB, Moazen B, Moghadamnia AA, Mohajer B, Mohammad KA, Mohammadi M, Mohammadifard N, Mohammadnia-Afrouzi M, Mohammed MA, Mohammed S, Mohan MBV, Mohan V, Mohebi F, Moitra M, Mokdad AH, Molokhia M, Monasta L, Montañez JC, Moosazadeh M, Moradi G, Moradi M, Moradi-Lakeh M, Moradinazar M, Moraga P, Morawska L, Morgado-da-Costa J, Morisaki N, Morrison SD, Mosapour A, Moschos MM, Mountjoy-Venning WC, Mouodi S, Mousavi SM, Muche AA, Muchie KF, Mueller UO, Muhammed OSS, Mukhopadhyay S, Mullany EC, Muller K, Mumford JE, Murhekar M, Murthy GVS, Murthy S, Musa J, Musa KI, Mustafa G, Muthupandian S, Nabhan AF, Nachega JB, Nagarajan AJ, Nagel G, Naghavi M, Naheed A, Nahvijou A, Naidoo K, Naik G, Naik N, Najafi F, Naldi L, Nam HS, Nangia V, Nansseu JR, Nascimento BR, 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M, Pond CD, Postma MJ, Pourshams A, Poustchi H, Prabhakaran D, Prakash S, Prasad N, Purcell CA, Pyakurel M, Qorbani M, Quansah R, Radfar A, Rafay A, Rafiei A, Rahim F, Rahimi K, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman M, Rahman MS, Rahman MHU, Rahman MA, Rahman SU, Rai RK, Rajati F, Rajsic S, Ram U, Rana SM, Ranabhat CL, Ranjan P, Rasella D, Rawaf DL, Rawaf S, Razo-García C, Reddy KS, Reiner RC, Reis C, Reitsma MB, Remuzzi G, Renzaho AMN, Resnikoff S, Reynales-Shigematsu LM, Rezaei S, Rezaeian S, Rezai MS, Riahi SM, Ribeiro ALP, Rios-Blancas MJ, Roba KT, Roberts NLS, Roever L, Ronfani L, Roshandel G, Rostami A, Roth GA, Roy A, Rubagotti E, Ruhago GM, Sabde YD, Sachdev PS, Saddik B, Sadeghi E, Safari H, Safari Y, Safari-Faramani R, Safdarian M, Safi S, Safiri S, Sagar R, Sahebkar A, Sahraian MA, Sajadi HS, Salam N, Salama JS, Salamati P, Saldanha RDF, Saleem Z, Salimi Y, Salimzadeh H, Salomon JA, Salvi SS, Salz I, Sambala EZ, Samy AM, Sanabria J, Sanchez-Niño MD, Santos IS, Santric Milicevic MM, Sao Jose BP, Sardana M, Sarker AR, Sarrafzadegan N, Sartorius B, Sarvi S, Sathian B, Satpathy M, Savic M, Sawant AR, Sawhney M, Saxena S, Saylan M, Sayyah M, Schaeffner E, Schmidt MI, Schneider IJC, Schöttker B, Schutte AE, Schwebel DC, Schwendicke F, Seedat S, Sekerija M, Sepanlou SG, Serván-Mori E, Seyedmousavi S, Shabaninejad H, Shackelford KA, Shafieesabet A, Shaheen AA, Shaikh MA, Shams-Beyranvand M, Shamsi MB, Shamsizadeh M, Sharafi H, Sharafi K, Sharif M, Sharif-Alhoseini M, Sharma J, Sharma R, Sharma SK, She J, Sheikh A, Shey MS, Shi P, Shibuya K, Shields C, Shifa GT, Shiferaw MS, Shigematsu M, Shiri R, Shirkoohi R, Shirude S, Shishani K, Shiue I, Shokraneh F, Shoman H, Shrime MG, Shukla SR, Si S, Siabani S, Sibai AM, Siddiqi TJ, Sigfusdottir ID, Silpakit N, Silva DAS, Silva JP, Silva NTD, Silveira DGA, Singh JA, Singh NP, Singh OP, Singh PK, Singh V, Sinha DN, Skiadaresi E, Sliwa K, Smith AE, Smith M, Soares Filho AM, Sobaih BH, Sobhani S, Soljak M, Soofi M, Soosaraei M, Sorensen RJD, Soriano JB, Soshnikov S, Soyiri IN, Spinelli A, Sposato LA, Sreeramareddy CT, Srinivasan RG, Srinivasan V, Stanaway JD, Starodubov VI, Stathopoulou V, Steckling N, Stein DJ, Stewart LG, Stockfelt L, Stokes MA, Straif K, Sudaryanto A, Sufiyan MB, Sunguya BF, Sur PJ, Sutradhar I, Sykes BL, Sylaja PN, Sylte DO, Szoeke CEI, Tabarés-Seisdedos R, Tabuchi T, Tadakamadla SK, Tamirat KS, Tandon N, Tanser FC, Tassew AA, Tassew SG, Tavakkoli M, Taveira N, Tawye NY, Tehrani-Banihashemi A, Tekalign TG, Tekle MG, Temesgen H, Temsah MH, Temsah O, Terkawi AS, Teshale MY, Teshome DF, Tessema B, Teweldemedhin M, Thakur JS, Thankappan KR, Theis A, Thirunavukkarasu S, Thomas LA, Thomas N, Thomson AJ, Thrift AG, Tilahun B, To QG, Tobe-Gai R, Tonelli M, Topor-Madry R, Torre AE, Tortajada-Girbés M, Tovani-Palone MR, Towbin JA, Tran BX, Tran KB, Tran TT, Tripathy SP, Troeger CE, Truelsen TC, Tsadik AG, Tudor Car L, Tuzcu EM, Tymeson HD, Ukwaja KN, Ullah I, Updike RL, Usman MS, Uthman OA, Vaduganathan M, Vaezi A, Vaidya G, Valdez PR, van Donkelaar A, Varavikova E, Vasankari TJ, Venketasubramanian N, Vidavalur R, Villafaina S, Violante FS, Vladimirov SK, Vlassov V, Vollmer S, Vollset SE, Vos T, Vosoughi K, Vujcic IS, Wagner GR, Wagnew FS, Waheed Y, Walson JL, Wang Y, Wang YP, Wassie MM, Weiderpass E, Weintraub RG, Weiss J, Weldegebreal F, Weldegwergs KG, Werdecker A, Werkneh AA, West TE, Westerman R, Whisnant JL, Whiteford HA, Widecka J, Widecka K, Wijeratne T, Wilner LB, Winkler AS, Wiyeh AB, Wiysonge CS, Wolde HF, Wolfe CDA, Wu S, Xavier D, Xu G, Xu R, Yadollahpour A, Yahyazadeh Jabbari SH, Yakob B, Yamada T, Yan LL, Yano Y, Yaseri M, Yasin YJ, Ye P, Yearwood JA, Yeshaneh A, Yimer EM, Yip P, Yirsaw BD, Yisma E, Yonemoto N, Yonga G, Yoon SJ, Yotebieng M, Younis MZ, Yousefifard M, Yu C, Zaman SB, Zamani M, Zare Z, Zavala-Arciniega L, Zegeye DT, Zegeye EA, Zeleke AJ, Zendehdel K, Zerfu TA, Zhang AL, Zhang X, Zhou M, Zhu J, Zimsen SRM, Zodpey S, Zoeckler L, Zucker I, Zuhlke LJJ, Lim SS, Murray CJL. Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392:2091-2138. [PMID: 30496107 PMCID: PMC6227911 DOI: 10.1016/s0140-6736(18)32281-5] [Citation(s) in RCA: 264] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/06/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of "leaving no one behind", it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. METHODS We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. FINDINGS The global median health-related SDG index in 2017 was 59·4 (IQR 35·4-67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6-14·0) to a high of 84·9 (83·1-86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. INTERPRETATION The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains-curative interventions in the case of NCDs-towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions-or inaction-today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030. FUNDING Bill & Melinda Gates Foundation.
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Pergialiotis V, Pouliakis A, Parthenis C, Damaskou V, Chrelias C, Papantoniou N, Panayiotides I. The utility of artificial neural networks and classification and regression trees for the prediction of endometrial cancer in postmenopausal women. Public Health 2018; 164:1-6. [DOI: 10.1016/j.puhe.2018.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/23/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
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Pergialiotis V, Karampetsou N, Zoumpourlis P, Papantoniou N, Thomakos N, Daskalakis G. Serum neopterin levels in women with preeclampsia: a systematic review. Hypertens Pregnancy 2018; 37:220-226. [DOI: 10.1080/10641955.2018.1526300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens, Athens, Greece
- 2nd department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikoleta Karampetsou
- Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Zoumpourlis
- Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- 2nd department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Thomakos
- 1st dpt of Obstetrics and Gynecology, Alexandra University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Daskalakis
- 1st dpt of Obstetrics and Gynecology, Alexandra University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Tsevis K, Trakakis E, Pergialiotis V, Alhazidou E, Peppa M, Chrelias C, Papantoniou N, Panagopoulos P. The influence of thyroid disorders on bone density and biochemical markers of bone metabolism. Horm Mol Biol Clin Investig 2018; 35:/j/hmbci.2018.35.issue-1/hmbci-2018-0039/hmbci-2018-0039.xml. [PMID: 30218603 DOI: 10.1515/hmbci-2018-0039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/15/2018] [Indexed: 12/30/2022]
Abstract
Background Thyroid dysfunction, predominantly hyperthyroidism, has been previously linked to impaired bone mass density (BMD) and increased risk of fractures. On the other hand, data in the field of hypothyroidism (HT) are missing. The purpose of the present study was to investigate the impact of thyroid disorders on bone density serum and urine calcium (Ca) and phosphate (P) as well as serum osteocalcin and alkaline phosphatase and urine hydroxyproline in a series of post-menopausal women. Materials and methods The study was conducted in the Reproductive Endocrinology Outpatient Clinic of our hospital. A consecutive series of post-menopausal women was included, after excluding patients under hormone treatment (including levothyroxine supplementation) and those who received raloxifene, tamoxifen or tibolone during the study period as well as those who received treatment during the previous 12 months were excluded from the present study. Results Overall, 188 women were included in the present study. Among them, 143 women had normal thyroid function, 32 women had hyperthyroidism and 13 women had HT. Correlation of thyroid function indices with osteoporosis indices revealed statistically significant correlations between thyroxine (T4) and free triiodothyronine (T3) with T-, Z-scores and BMD. Logistic regression analysis concerning the impact of HT and hyperthyroidism on T-score, Z-score and bone mass density revealed that both pathological entities negatively affect bone health (p < 0.05). Conclusion The findings of our study suggest that not only hyperthyroidism, but also HT negatively affects BMD. Future studies should investigate this association and corroborate our findings.
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Affiliation(s)
- Konstantinos Tsevis
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eftihios Trakakis
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios Pergialiotis
- Third Department of Obstetrics and Gynecology, University of Athens, Attikon University Hospital Athens Greece, Rimini 1 Chaidari, Athens, PC 12461, Greece, Phone: +2105832244, Fax: +2105326447
| | - Eleni Alhazidou
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Melpomeni Peppa
- Endocrine and Metabolic Bone Disorders Unit, 2nd Department of Internal Medicine and Research Institute and Diabetes Center, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalampos Chrelias
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Periklis Panagopoulos
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Daskalakis G, Zacharakis D, Theodora M, Antsaklis P, Papantoniou N, Loutradis D, Antsaklis A. Reply to: Cervical pessary combined with vaginal progesterone for the prevention of spontaneous preterm birth: is evidence sufficient? J Perinat Med 2018; 46:693-694. [PMID: 29672275 DOI: 10.1515/jpm-2018-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 03/09/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Georgios Daskalakis
- First Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian, University of Athens, 8 I. Metaxa Street, 15236-P. Penteli, Athens, Greece, Tel.: +30-6945-235757, Fax: +30210-5317224
| | - Dimitrios Zacharakis
- First Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian, University of Athens, Athens, Greece
| | - Marianna Theodora
- First Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian, University of Athens, Athens, Greece
| | - Panagiotis Antsaklis
- First Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian, University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- First Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian, University of Athens, Athens, Greece
| | - Dimitris Loutradis
- First Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian, University of Athens, Athens, Greece
| | - Aris Antsaklis
- First Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian, University of Athens, Athens, Greece
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Papaioannou GK, Evangelinakis N, Kourtis P, Konstantinidou A, Papantoniou N. Giant chorioangioma treated with interstitial laser coagulation. Ultrasound Obstet Gynecol 2018; 52:280-281. [PMID: 29072331 DOI: 10.1002/uog.18941] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 10/02/2017] [Accepted: 10/14/2017] [Indexed: 06/07/2023]
Affiliation(s)
- G K Papaioannou
- 3rd Department of Obstetrics and Gynecology, General University Hospital "Attikon", Rimini 1, Chaidari, Athens, Greece
| | - N Evangelinakis
- 3rd Department of Obstetrics and Gynecology, General University Hospital "Attikon", Rimini 1, Chaidari, Athens, Greece
| | - P Kourtis
- Private Fetal Medicine Clinic, Athens, Greece
| | - A Konstantinidou
- Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - N Papantoniou
- 3rd Department of Obstetrics and Gynecology, General University Hospital "Attikon", Rimini 1, Chaidari, Athens, Greece
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Daskalakis G, Zacharakis D, Theodora M, Antsaklis P, Papantoniou N, Loutradis D, Antsaklis A. Safety and efficacy of the cervical pessary combined with vaginal progesterone for the prevention of spontaneous preterm birth. J Perinat Med 2018; 46:531-537. [PMID: 29055173 DOI: 10.1515/jpm-2017-0009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 09/18/2017] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the safety and efficacy of the combined treatment of cervical pessary and endovaginal progesterone for the prevention of spontaneous preterm birth (SPB) in women with a short cervical length (CL) between 20 and 24 weeks of gestation. MATERIALS AND METHODS This is a prospective study of women with a singleton pregnancy and a sonographically detected mid-trimester CL ≤25 mm. The primary outcome measure was spontaneous delivery before 34 weeks (238 days) of gestation. RESULTS The study sample consisted of 90 women with a mean CL of 14.2 mm (SD=6.5 mm). Of the women, 34.4% had at least one risk factor for SPB; 7.8% delivered preterm before 34 weeks of gestation, and 25.6%, before 37 weeks. Neonatal death occurred in two (2.2%) cases due to respiratory distress syndrome. Lower body mass index values, history of preterm delivery and number of second trimester miscarriages were independently associated with delivery before 34 weeks. CONCLUSION The combination of vaginal progesterone and cervical pessary for the prevention of SPB in women with a short cervix is safe and well tolerated. This therapy was associated with pregnancy prolongation, reduced prematurity rate and a low rate of perinatal complications.
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Affiliation(s)
- Georgios Daskalakis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, 8 I. Metaxa Street, 15236-P. Penteli, Athens, Greece, Tel.: +30-6945-235757, Fax: +30210-5317224
| | - Dimitrios Zacharakis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Marianna Theodora
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Antsaklis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Loutradis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Aris Antsaklis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Bellos I, Fitrou G, Pergialiotis V, Papantoniou N, Daskalakis G. Mean platelet volume values in preeclampsia: A systematic review and meta-analysis. Pregnancy Hypertens 2018; 13:174-180. [DOI: 10.1016/j.preghy.2018.06.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/23/2018] [Indexed: 12/29/2022]
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Parthenis C, Panagopoulos P, Margari N, Kottaridi C, Spathis A, Pouliakis A, Konstantoudakis S, Chrelias G, Chrelias C, Papantoniou N, Panayiotides IG, Tsiodras S. The association between sexually transmitted infections, human papillomavirus, and cervical cytology abnormalities among women in Greece. Int J Infect Dis 2018; 73:72-77. [PMID: 29902519 DOI: 10.1016/j.ijid.2018.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/04/2018] [Accepted: 06/05/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the diagnosis of sexually transmitted infections (STIs) with human papillomavirus (HPV) infection and the presence of cytological changes in the cervix in a cohort of sexually active women in Greece. METHODS Cervical cytology testing and the molecular typing of HPV and other STIs were performed for 345 sexually active women aged between 18 and 45 years (mean 33.2±7.2years) visiting a gynaecology clinic for routine cervical screening. The association of HPV and STI detection with cytological findings was investigated. RESULTS HPV was detected in 61 women (17.7%) and STIs in 82 (23.8%). Ureaplasma spp was the most frequently detected pathogen, which was found in 63 (18.2%) women, followed by Mycoplasma spp (21 women, 25.6%) and Chlamydia trachomatis (five women, 6.1%). HPV positivity only (with no co-presence of STI) was associated with an abnormal cytology (odds ratio 6.9, p<0.001), while women who were negative for both HPV and STIs had a higher probability of a normal cytology (odds ratio 0.36, p<0.01). Sixteen out of the 63 (25.4%) women who tested positive for Ureaplasma spp, harboured a high-risk HPV type (odds ratio 2.3, p=0.02). CONCLUSIONS In a population with a high prevalence of Ureaplasma spp, there was an association of this pathogen with high-risk HPV infection, a finding that needs further elucidation.
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Affiliation(s)
- Christos Parthenis
- Third Department of Obstetrics and Gynaecology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Periklis Panagopoulos
- Third Department of Obstetrics and Gynaecology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Niki Margari
- Second Department of Pathology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Christine Kottaridi
- Second Department of Pathology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Aris Spathis
- Second Department of Pathology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Abraham Pouliakis
- Second Department of Pathology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Stefanos Konstantoudakis
- Second Department of Pathology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - George Chrelias
- Third Department of Obstetrics and Gynaecology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Charalambos Chrelias
- Third Department of Obstetrics and Gynaecology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynaecology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Ioannis G Panayiotides
- Second Department of Pathology, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Sotirios Tsiodras
- Fourth Department of Internal Medicine, 'Attikon' University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
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Daskalakis G, Fotinopoulos P, Pergialiotis V, Theodora M, Antsaklis P, Sindos M, Papantoniou N, Loutradis D. Delayed interval delivery of the second twin in a woman with altered markers of inflammation. BMC Pregnancy Childbirth 2018; 18:206. [PMID: 29866067 PMCID: PMC5987477 DOI: 10.1186/s12884-018-1848-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 05/23/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Delayed interval intertwin delivery rates are expected to rise during the next years as potent and targeted tocolytic agents are employed and antenatal surveillance methods become more sophisticated and specific in predicting the critical delivery timepoint of optimal perinatal outcome. CASE PRESENTATION We present a case of delayed intertwin delivery after delivery of the first twin due to premature prelabor rupture of the membranes. Maternal serum White Blood Cells and C-Reactive Protein levels remained high until delivery of the second twin (34 days after the first was delivered), although maternal temperature remained constant. The mother underwent close antenatal surveillance and she was hospitalized. She had an uncomplicated delivery of the second twin at 29+ 2 weeks by cesarean section due to an abnormal Non-Stress Test. CONCLUSION We strongly suggest future evaluation of maternal serum inflammatory markers among these rare cases as these could predict intraamniotic infection.
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Affiliation(s)
- George Daskalakis
- 1st Department of Obstetrics and Gynecology, Athens Medical School , Alexandra General Hospital, 9 Aristeidou Street , 17563 P. Faliro, Athens, Greece
| | - Panagiotis Fotinopoulos
- 1st Department of Obstetrics and Gynecology, Athens Medical School , Alexandra General Hospital, 9 Aristeidou Street , 17563 P. Faliro, Athens, Greece
| | - Vasilios Pergialiotis
- 3rd Department of Obstetrics and Gynecology, Athens Medical School, Attikon General Hospital, Athens, Greece
| | - Mariana Theodora
- 1st Department of Obstetrics and Gynecology, Athens Medical School , Alexandra General Hospital, 9 Aristeidou Street , 17563 P. Faliro, Athens, Greece
| | - Panagiotis Antsaklis
- 1st Department of Obstetrics and Gynecology, Athens Medical School , Alexandra General Hospital, 9 Aristeidou Street , 17563 P. Faliro, Athens, Greece
| | - Michail Sindos
- 1st Department of Obstetrics and Gynecology, Athens Medical School , Alexandra General Hospital, 9 Aristeidou Street , 17563 P. Faliro, Athens, Greece
| | - Nikolaos Papantoniou
- 3rd Department of Obstetrics and Gynecology, Athens Medical School, Attikon General Hospital, Athens, Greece
| | - Dimitrios Loutradis
- 1st Department of Obstetrics and Gynecology, Athens Medical School , Alexandra General Hospital, 9 Aristeidou Street , 17563 P. Faliro, Athens, Greece
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Bellos I, Fitrou G, Pergialiotis V, Perrea DN, Papantoniou N, Daskalakis G. Random urine uric acid to creatinine and prediction of perinatal asphyxia: a meta-analysis. J Matern Fetal Neonatal Med 2018; 32:3864-3870. [PMID: 29712490 DOI: 10.1080/14767058.2018.1471677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: The purpose of the present review is to evaluate whether urine uric acid to creatinine ratio is increased in perinatal asphyxia and hypoxic-ischemic encephalopathy (HIE), as well as to assess its predictive accuracy in the disease. Methods: We used the Medline (1966-2017), Scopus (2004-2017), Clinicaltrials.gov (2008-2017), Embase (1980-2017), Cochrane Central Register of Controlled Trials CENTRAL (1999-2017), and Google Scholar (2004-2017) databases in our primary search along with the reference lists of electronically retrieved full-text papers. The hierarchical summary receiver operating characteristic (HSROC) model was used for the meta-analysis of diagnostic accuracy. Results: Fourteen studies were finally included in the present review, that investigated 1226 neonates. Urinary uric acid to creatinine ratio was significantly higher in neonates with perinatal asphyxia than in healthy controls (mean differences (MD): 1.43 95%CI [1.17, 1.69]). Specifically, the mean difference for Sarnat stage 1 was 0.70 (95%CI [0.28, 1.13]), for stage 2 1.41 (95%CI [0.99, 1.84]), and for stage 3 2.71 (95%CI [2.08, 3.35]). The estimated sensitivity for the summary point was 0.90 (95%CI (0.82-0.95)), the specificity was 0.88 (95%CI (0.73-0.95)) and the diagnostic odds ratio was calculated at 63.62 (95%CI (17.08-236.96)). Conclusions: Urinary uric acid to creatinine ratio is a rapid and an easily detected biomarker that may help physicians identify neonates at risk of developing perinatal asphyxia and HIE. However, large-scale prospective studies are still needed to determine its value in predicting mortality, as well as short- and long-term adverse neurological outcomes.
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Affiliation(s)
- Ioannis Bellos
- a Laboratory of Experimental Surgery and Surgical Research , National and Kapodistrian University of Athens , Athens , Greece
| | - Georgia Fitrou
- a Laboratory of Experimental Surgery and Surgical Research , National and Kapodistrian University of Athens , Athens , Greece
| | - Vasilios Pergialiotis
- a Laboratory of Experimental Surgery and Surgical Research , National and Kapodistrian University of Athens , Athens , Greece
| | - Despina N Perrea
- a Laboratory of Experimental Surgery and Surgical Research , National and Kapodistrian University of Athens , Athens , Greece
| | - Nikolaos Papantoniou
- b 2nd Department of Obstetrics and Gynecology , Attikon University Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Georgios Daskalakis
- c 1st Department of Obstetrics and Gynecology , Alexandra University Hospital, National and Kapodistrian University of Athens , Athens , Greece
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Pergialiotis V, Trakakis E, Parthenis C, Hatziagelaki E, Chrelias C, Thomakos N, Papantoniou N. Correlation of platelet to lymphocyte and neutrophil to lymphocyte ratio with hormonal and metabolic parameters in women with PCOS. Horm Mol Biol Clin Investig 2018; 34:/j/hmbci.ahead-of-print/hmbci-2017-0073/hmbci-2017-0073.xml. [PMID: 29694329 DOI: 10.1515/hmbci-2017-0073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/05/2017] [Indexed: 02/04/2023]
Abstract
Background The purpose of our study is to evaluate the association of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) with hormonal and metabolic parameters in patients with polycystic ovarian syndrome (PCOS) in order to assess whether these ratios may become useful tools during the evaluation of the severity of low grade inflammation. Methods The present study is based in secondary outcomes from a prospectively collected patient database. A total of 266 women with PCOS participated in this study and blood a complete blood count examination (CBC) that was used for the calculation of PLR and NLR was available in 182 patients. Results Association statistics revealed that PLR had a significant correlation to 17-OH progesterone (r = -0.177, p = 0.024) and Matsuda index values (r = 0.234, p = 0.009), whereas NLR was correlated with follicle stimulating hormone (FSH) (r = -0.204, p = 0.007), free testosterone (r = 320, p < 0.001), Δ4-androstendione (r = 0.234, p = 0.003), sex hormone binding globulin (SHBG) (r = -0.350, p < 0.002) and high-density lipoprotein (HDL) (r = -0.171, p = 0.039). Conclusion According to the findings of our study, both PLR and NLR seem to be correlated with some hormonal and metabolic indices. This association is clearer in the case of NLR and serum androgens as it seems to be positively affected by their levels. PLR and NLR were not affected by the presence of obesity.
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Affiliation(s)
- Vasilios Pergialiotis
- Third Department of Obstetrics and Gynecology, University of Athens, Attikon University Hospital, Rimini 1 Chaidari, Athens, PC 12461, Greece, Phone: +2105832244, Fax: +2105326447
| | - Eftihios Trakakis
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Parthenis
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Erifili Hatziagelaki
- Second Department of Internal Medicine, Research Institute and Diabetes Center, "Attikon" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalampos Chrelias
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Thomakos
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Pergialiotis V, Trakakis E, Chrelias C, Papantoniou N, Hatziagelaki E. The impact of mild hypercholesterolemia on glycemic and hormonal profiles, menstrual characteristics and the ovarian morphology of women with polycystic ovarian syndrome. Horm Mol Biol Clin Investig 2018; 34:/j/hmbci.ahead-of-print/hmbci-2018-0002/hmbci-2018-0002.xml. [PMID: 29596052 DOI: 10.1515/hmbci-2018-0002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 02/28/2018] [Indexed: 11/15/2022]
Abstract
Background The severity of polycystic ovarian syndrome (PCOS) has been clearly associated with insulin resistance, obesity and metabolic syndrome. The purpose of the present cross-sectional study is to investigate whether mild hypercholesterolemia alters the biochemical and clinical profile of PCOS patients. Methods Our study is based on a prospectively collected population of women of reproductive age who were diagnosed with PCOS according to the definition of the Rotterdam European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine (ASRM/ESHRE) criteria. For the correlation analysis we used the non-parametric Spearman's rank correlation coefficient. Partial correlation was also performed to control for potential confounders observed in the univariate analysis. Results Overall, 235 patients were included. Their mean age ranged between 14 and 45 years old and the body mass index (BMI) between 17 and 54. Women with mild hypercholesterolemia had a higher BMI and their fasting insulin was increased as well as indices of insulin resistance [Homeostatic model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI), Matsuda index] compared to women with PCOS with normal cholesterol levels. Correlation statistics suggested that the effect of serum lipids on the hormonal profile of patients was weak. Both low-density lipoprotein (LDL) and high-density lipoprotein (HDL) exerted a significant mild negative correlation to glucose and insulin. However, after controlling the results for BMI and age (the two variables that were found significantly different in the univariate analysis) we observed that this effect was non-significant. Conclusion Mild hypercholesterolemia does not affect the hormonal profile of patients with PCOS; hence, to date, there is no evidence to suggest its treatment for the correction of menstrual and hormonal abnormalities in PCOS women.
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Affiliation(s)
- Vasilios Pergialiotis
- Third Department of Obstetrics and Gynecology, University of Athens, Attikon University Hospital Athens Greece, Rimini 1 Chaidari, Athens, PC 12461, Greece, Phone: +302105832244, +306947326459, Fax: 2105326447
| | - Eftihios Trakakis
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalampos Chrelias
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Erifili Hatziagelaki
- Second Department of Internal Medicine, Research Institute and Diabetes Center, "Attikon" Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Milonas N, Touzopoulos P, Zafeiris CP, Papantoniou N, Koutsoubeli E, Chatzigiannakis A. Bilateral transient osteoporosis of the knees during pregnancy. A case report and review of the literature. JRPMS 2018. [DOI: 10.22540/jrpms-02-018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Siristatidis C, Dafopoulos K, El-Khayat W, Salamalekis G, Anifandis G, Vrantza T, Elsadek M, Papantoniou N. Administration of prednisolone and low molecular weight heparin in patients with repeated implantation failures: a cohort study. Gynecol Endocrinol 2018; 34:136-139. [PMID: 28949261 DOI: 10.1080/09513590.2017.1380182] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Conflicting results exist for low molecular weight heparin (LMWH) and prednisolone when tested as separate adjuncts for the improvement of the clinical outcomes in patients with repeated implantation failures (RIF) undergoing IVF/ICSI treatment. Through a cohort study, we evaluated the combined effect of both drugs on pregnancy parameters in 115 women with RIF. Clinical pregnancy rate was the primary end point while the sample size was calculated through the results of a pilot study. Clinical and IVF cycle characteristics were also compared between the groups. Baseline and cycle characteristics were comparable between groups. Biochemical and clinical pregnancy rates were similar in both groups [23/57 (40.4%) vs. 14/58 (24.1%), and 17/57 (29.8%) vs. 11/58 (19%), p = .063, and .175, respectively]. Similarly, miscarriage rates were comparable between the groups (35.7% vs. 34.8%), as well as live birth rates [15/57 (26.3%) vs. 9/58 (15.5%), p = .154]. In conclusion, the administration of LMWH with prednizolone in subfertile women with RIF seems not to improve clinical pregnancy rates, but a full-scaled RCT would definitely be more accurate.
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MESH Headings
- Adult
- Anticoagulants/adverse effects
- Anticoagulants/therapeutic use
- Cohort Studies
- Combined Modality Therapy/adverse effects
- Drug Therapy, Combination/adverse effects
- Egypt/epidemiology
- Family Characteristics
- Female
- Fertility Agents, Female/adverse effects
- Fertility Agents, Female/therapeutic use
- Fertilization in Vitro
- Glucocorticoids/adverse effects
- Glucocorticoids/therapeutic use
- Heparin, Low-Molecular-Weight/adverse effects
- Heparin, Low-Molecular-Weight/therapeutic use
- Hospitals, University
- Humans
- Infertility, Female/drug therapy
- Infertility, Female/therapy
- Infertility, Male
- Intention to Treat Analysis
- Male
- Outpatient Clinics, Hospital
- Ovulation Induction/adverse effects
- Prednisolone/adverse effects
- Prednisolone/therapeutic use
- Pregnancy
- Pregnancy Rate
- Retrospective Studies
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Affiliation(s)
- Charalampos Siristatidis
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology , "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Konstantinos Dafopoulos
- b Assisted Reproduction Unit, Department of Obstetrics and Gynecology , University of Thessaly, School of Health Sciences, Faculty of Medicine , Larissa , Greece
| | - Waleed El-Khayat
- c Department of Obstetrics and Gynecology , Faculty of Medicine, Cairo University , Egypt
- d Middle East Fertility Center , Giza , Egypt
| | - George Salamalekis
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology , "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - George Anifandis
- b Assisted Reproduction Unit, Department of Obstetrics and Gynecology , University of Thessaly, School of Health Sciences, Faculty of Medicine , Larissa , Greece
| | - Tereza Vrantza
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology , "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Mostafa Elsadek
- c Department of Obstetrics and Gynecology , Faculty of Medicine, Cairo University , Egypt
- d Middle East Fertility Center , Giza , Egypt
| | - Nikolaos Papantoniou
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology , "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
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Siristatidis C, Dafopoulos K, Christoforidis N, Anifandis G, Pergialiotis V, Papantoniou N. Corifollitropin alfa compared with follitropin beta in GnRH-antagonist ovarian stimulation protocols in an unselected population undergoing IVF/ICSI. Gynecol Endocrinol 2017; 33:968-971. [PMID: 28508691 DOI: 10.1080/09513590.2017.1323203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Recombinant DNA technologies have produced Corifollitropin alfa (CFa) used during IVF/ICSI in order to keep the circulating FSH levels above the threshold necessary to support multi-follicular growth for a week. In this prospective case-control study, we compared 70 participants treated with 150 μg CFa combined with 150 IU of follitropin beta (study group) with 70 subfertile participants with matching baseline characteristics, conforming with the same inclusion criteria and treated with an antagonist protocol using follitropin beta (control group). Live birth was the primary outcome, while secondary outcome measures were IVF/ICSI cycles characteristics, including adverse events and complications. Live birth was determined in reduced rates in the study compared to the control group, reaching statistical significance [6/70 versus 20/70, p = 0.002], as also in the respective number of clinical pregnancies [9/70 versus 23/70, p = 0.005], although the incidence of miscarriage was similar for both groups [6/70 versus 5/70, p > 0.99]. Most of the secondary parameters examined were similar between groups. Logistic regression revealed that protocol and AFC had a direct impact on live birth. Ovarian stimulation with CFa does not seem to constitute an equally effective method as compared with follitropin beta to be offered in a general subfertile population seeking IVF/ICSI treatments.
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Affiliation(s)
- Charalampos Siristatidis
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Konstantinos Dafopoulos
- b Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Thessaly, School of Health Sciences , Larissa , Greece
| | | | - George Anifandis
- b Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Thessaly, School of Health Sciences , Larissa , Greece
| | - Vasileios Pergialiotis
- d Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Nikolaos Papantoniou
- d Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece
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Alhazidou E, Pergialiotis V, Panagopoulos P, Chrelias C, Hatziagelaki E, Papantoniou N, Trakakis E. The impact of the metabolic syndrome on bone mass density: a prospective case control study. Horm Mol Biol Clin Investig 2017; 33:/j/hmbci.ahead-of-print/hmbci-2017-0053/hmbci-2017-0053.xml. [PMID: 29087956 DOI: 10.1515/hmbci-2017-0053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/13/2017] [Indexed: 12/25/2022]
Abstract
Background Obesity and metabolic syndrome (MetS) during the perimenopausal period and in menopause have been linked to altered bone mass density (BMD) in various experimental studies. However, current clinical studies provide conflicting results in this field. The purpose of the present study was to evaluate this association. Materials and methods We conducted a prospective case control study that was based on a consecutive series of menopausal women who attended the Reproductive Endocrinology Outpatient Clinic of our hospital between January 2013 and December 2016. Results One hundred and forty post-menopausal women were included in the present study. After stratifying the women in two groups according to the presence of MetS we observed that bone turnover markers remained unaffected by the presence of MetS (p > 0.05). On the other hand, both the T- and Z-scores of women with MetS were significantly higher compared to healthly postmenopausal women [T-score: 0.4 (-0.7 to 1.3) vs. -1 (-1.62 to -0.1), p < 0.001] [Z-score: 0.55 (-0.3 to 1.7) vs. -0.4 (-1.1 to 0.4), p = 0.003]. Conclusions According to the findings of our study the presence of MetS during the perimenopausal years seems to have a mild benefit on bone mass density. The pathophysiology that underlies this effect remains unclear as bone turnover markers seem to be unaffected by MetS.
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Affiliation(s)
- Eleni Alhazidou
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios Pergialiotis
- Third Department of Obstetrics and Gynecology, University of Athens, Attikon University Hospital Athens Greece, Rimini 1 Chaidari, PC 12461, Athens, Greece, Phone: +2105832244, Fax: +2105326447
| | - Periklis Panagopoulos
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalampos Chrelias
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Erifili Hatziagelaki
- Second Department of Internal Medicine, Research Institute and Diabetes Center, "Attikon" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eftihios Trakakis
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Daskalakis G, Antsaklis P, Gourounti K, Theodora M, Sindos M, Papantoniou N, Loutradis D. Chorionic Villus Sampling in Assisted Versus Spontaneous Conception Twins. Ultraschall Med 2017; 38:437-442. [PMID: 26529352 DOI: 10.1055/s-0041-108566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Purpose To compare the outcome of chorionic villus sampling (CVS) in twin pregnancies following assisted reproduction technology (ART) versus twins that have been conceived spontaneously. Materials and Methods Retrospective analysis of dichorionic twin pregnancies that underwent CVS between 1986 and 2013 at our department which is a tertiary center for fetal medicine. 32 twin pregnancies after ART and 130 spontaneously conceived twin pregnancies, which underwent CVS, were analyzed. Results No difference was observed in the pregnancy loss rate between the two groups (0 % in the ART group vs. 3 % in the spontaneous twins group). The rate of preterm delivery before 28 weeks was higher in the ART group (18.8 %) compared to the control group (1.6 %). The perinatal mortality rate was similar in the two groups. Conclusion The pregnancy loss rate following CVS is similar in ART twins and in spontaneous twins. However, the risk of prematurity before 28 weeks is significantly higher in the ART group.
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Siristatidis C, Dafopoulos K, Vrantza T, Salamalekis G, Basios G, Vogiatzi P, Pergialiotis V, Papantoniou N. Mild versus conventional antagonist ovarian stimulation protocols in expected normal responders undergoing IVF/ICSI: a case-control study. Gynecol Endocrinol 2017; 33:553-556. [PMID: 28277113 DOI: 10.1080/09513590.2017.1296128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Mild controlled ovarian hyperstimulation (COH) protocols combining clomiphene citrate (CC) or letrozole with gonadotropins were introduced as an effective alternative of conventional COH in normal responders undergoing IVF/ICSI. In this case-control study, we compared 41 participants treated with a mild stimulation protocol receiving gonadotropins combined with either CC (n = 24) or letrozole (n = 17) with 71 subfertile participants with matching baseline characteristics, conforming with the same inclusion criteria and treated with a conventional antagonist protocol. Live birth was determined in reduced rates in the study group compared to the control group, reaching marginal statistical significance [4/41 versus 19/71, p = 0.050], as also in the respective number of clinical pregnancies [6/41 versus 22/71, p = 0.054], although the incidence of miscarriage was similar for both groups [2/41 versus 5/71, p = 0.714]. Most of the secondary parameters examined, favored the conventional antagonist protocol. There was no difference in any of the outcomes reported between the three different stimulation groups in post-hoc analysis. Mild stimulation regimens with the aid of either CC or letrozole employing GnRH antagonists do not seem to constitute an equally effective method as compared to the conventional antagonist protocol to be offered in good prognosis subfertile women seeking an induced cycle toward IVF/ICSI.
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Affiliation(s)
- Charalampos Siristatidis
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece and
| | - Konstantinos Dafopoulos
- b Assisted Reproduction Unit, Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly , Larissa , Greece
| | - Tereza Vrantza
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece and
| | - George Salamalekis
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece and
| | - George Basios
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece and
| | - Paraskevi Vogiatzi
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece and
| | - Vasileios Pergialiotis
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece and
| | - Nikolaos Papantoniou
- a Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens , Athens , Greece and
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Affiliation(s)
- Ioannis Bellos
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios Pergialiotis
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Trakakis E, Pergialiotis V, Hatziagelaki E, Panagopoulos P, Salloum I, Papantoniou N. Subclinical hypothyroidism does not influence the metabolic and hormonal profile of women with PCOS. Horm Mol Biol Clin Investig 2017; 31:/j/hmbci.ahead-of-print/hmbci-2016-0058/hmbci-2016-0058.xml. [PMID: 28672734 DOI: 10.1515/hmbci-2016-0058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/07/2017] [Indexed: 11/15/2022]
Abstract
Background Subclinical hypothyroidism (SCH) is present in 5%-10% of polycystic ovary syndrome (PCOS) patients. To date, its impact on the metabolic and hormonal profile of those women remains controversial. The purpose of our study is to evaluate the impact of SCH on the glycemic, lipid and hormonal profile of PCOS patients. Materials and methods We conducted a prospective case control study of patients that attended the Department of Gynecological Endocrinology of our hospital. Results Overall, 280 women with PCOS were enrolled during a time period of 7 years (2009-2015). Twenty-one patients (7.5%) suffered from SCH. The anthropometric characteristics were comparable among women with PCOS and those with SCH + PCOS. The prevalence of acne, hirsutism and anovulation did not differ. Significant differences were observed in the 2-h oral glucose tolerance test (OGTT) (p = 0.003 for glucose and p = 0.046 for insulin). The QUICKI, Matsuda and homeostatic model assessment-insulin resistance (HOMA-IR) indices where, however, similar. No difference in serum lipids was observed. Slightly elevated levels of follicle stimulating hormone (FSH) and testosterone were noted. The remaining hormonal parameters remained similar among groups. Similarly, the ovarian volume and the endometrial thickness did not differ. Conclusions The impact of SCH on the metabolic and hormonal profile of PCOS patients seems to be negligible. Future studies are needed in the field and their conduct in a multi-institutional basis seems to be required, given the small prevalence of SCH among women with PCOS.
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O'Gorman N, Wright D, Poon LC, Rolnik DL, Syngelaki A, Wright A, Akolekar R, Cicero S, Janga D, Jani J, Molina FS, de Paco Matallana C, Papantoniou N, Persico N, Plasencia W, Singh M, Nicolaides KH. Accuracy of competing-risks model in screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks' gestation. Ultrasound Obstet Gynecol 2017; 49:751-755. [PMID: 28067011 DOI: 10.1002/uog.17399] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To examine the diagnostic accuracy of a previously developed model for prediction of pre-eclampsia (PE) by a combination of maternal factors and biomarkers at 11-13 weeks' gestation. METHODS This was a prospective first-trimester multicenter study of screening for PE in 8775 singleton pregnancies. A previously published algorithm was used for the calculation of patient-specific risk of PE in each individual. The detection rates (DRs) and false-positive rates (FPRs) for delivery with PE < 32, < 37 and ≥ 37 weeks were estimated and compared with those for the dataset used for development of the algorithm. RESULTS In the study population, 239 (2.7%) cases developed PE, of which 17 (0.2%), 59 (0.7%) and 180 (2.1%) developed PE < 32, < 37 and ≥ 37 weeks, respectively. With combined screening by maternal factors, mean arterial pressure, uterine artery pulsatility index and serum placental growth factor, the DR was 100% (95% CI, 80-100%) for PE < 32 weeks, 75% (95% CI, 62-85%) for PE < 37 weeks and 43% (95% CI, 35-50%) for PE ≥ 37 weeks, at a 10% FPR. These DRs were similar to the estimated rates for the dataset used for development of the model: 89% (95% CI, 79-96%) for PE < 32 weeks, 75% (95% CI, 70-80%) for PE < 37 weeks and 47% (95% CI, 44-51%) for PE ≥ 37 weeks. CONCLUSION Assessment of a combination of maternal factors and biomarkers at 11-13 weeks provides effective first-trimester screening for preterm PE. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- N O'Gorman
- Harris Birthright Centre for Fetal Medicine, King's College Hospital, London, UK
| | - D Wright
- Institute of Health Research, University of Exeter, Exeter, UK
| | - L C Poon
- Harris Birthright Centre for Fetal Medicine, King's College Hospital, London, UK
- Chinese University of Hong Kong, Hong Kong, China
| | - D L Rolnik
- Harris Birthright Centre for Fetal Medicine, King's College Hospital, London, UK
| | - A Syngelaki
- Harris Birthright Centre for Fetal Medicine, King's College Hospital, London, UK
| | - A Wright
- Institute of Health Research, University of Exeter, Exeter, UK
| | - R Akolekar
- Harris Birthright Centre for Fetal Medicine, King's College Hospital, London, UK
- Medway Maritime Hospital, Gillingham, UK
| | - S Cicero
- Homerton University Hospital, London, UK
| | - D Janga
- North Middlesex University Hospital, London, UK
| | - J Jani
- Centre Hospitalier Universitaire Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - F S Molina
- Hospital Universitario San Cecilio, Granada, Spain
| | | | | | - N Persico
- Ospedale Maggiore Policlinico, Milan, Italy
| | - W Plasencia
- Hospiten Group, Tenerife, Canary Islands, Spain
| | - M Singh
- Southend University Hospital, Essex, UK
| | - K H Nicolaides
- Harris Birthright Centre for Fetal Medicine, King's College Hospital, London, UK
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Pergialiotis V, Karampetsou N, Panagopoulos P, Trakakis E, Papantoniou N. The effect of Vitamin D supplementation on hormonal and glycaemic profile of patients with PCOS: A meta-analysis of randomised trials. Int J Clin Pract 2017; 71. [PMID: 28524342 DOI: 10.1111/ijcp.12957] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is frequently manifested in women with polycystic ovarian syndrome (PCOS). To date, supplementation of deficient patients has not been correlated with the hormonal and metabolic status of these patients. PURPOSE We aimed to investigate the impact of vitamin D supplementation on the hormonal and metabolic profile of PCOS women. MATERIALS AND METHODS We searched Medline, Scopus, ClinicalTrials.gov and Cochrane Central Register databases for published randomised controlled trials. The meta-analysis was performed with the RevMan 5.3.5 software. RESULTS Nine studies were included in the present meta-analysis which investigated the impact of vitamin D supplementation in 647 patients. According to our meta-analysis neither serum testosterone (MD 0.04 ng/mL, 95% CI -0.09 to 0.17) nor serum LH (MD -0.48 IU/mL, 95% CI -1.97 to 1.00) were significantly affected by vitamin D supplementation in any of the subgroup comparisons. On the contrary, serum DHEAS was significantly affected by vitamin D (MD -32.24 μg/dL, 95% CI -32.24 to -14.01) an effect which was mainly affected by the vitamin D vs placebo comparison. Vitamin D supplementation did not have an impact on fasting glucose (MD 0.42 mg/dL, 95% CI -2.75 to 3.60) or fasting insulin (MD 1.27 μU/mL, 95% CI -1.42 to 3.97) levels. HOMA-IR was, however, increased among patients that received placebo compared to vitamin D (MD 0.52, 95% CI 0.39-0.65). CONCLUSION There is no evidence to support that vitamin D supplementation significantly benefits PCOS patients. However, given the relatively small number of enrolled patients further studies are needed to elucidate this field.
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Affiliation(s)
- Vasilios Pergialiotis
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Periklis Panagopoulos
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eftihios Trakakis
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynecology, "Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Siristatidis C, Salamalekis G, Dafopoulos K, Basios G, Vogiatzi P, Papantoniou N. Mild Versus Conventional Ovarian Stimulation for Poor Responders Undergoing IVF/ICSI. ACTA ACUST UNITED AC 2017; 31:231-237. [PMID: 28358705 DOI: 10.21873/invivo.11050] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/21/2017] [Accepted: 01/24/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND/AIM Mild stimulation protocols have been implemented to be offered to subfertile patients who respond poorly to ovarian stimulation. We aimed to compare the efficacy of mild versus conventional gonadotropin-releasing hormone (GnRH)-agonist and antagonist protocols in poor responders undergoing in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) cycles. PATIENTS AND METHODS A total of 58 poorly-responding patients were divided into two groups: mild group (n=33), receiving clomiphene citrate 100 mg and 0.25 mg of cetrorelix with 150 IU of gonadotrophins daily; conventional group (n=25), undergoing the long GnRH-agonist or -antagonist protocols. The primary outcome was the number of cumulus oocyte complexes (COCs) retrieved. RESULTS A lower number of COCs [median (range)=1 (0-4) vs. 3 (0-8.4), p<0.001] was retrieved in the mild stimulation compared to the conventional group. Secondary outcomes favored the conventional group, whereas live birth (9.1% vs. 12%), clinical pregnancy (12.1% vs. 20%) and miscarriage rate (40% vs. 40%) were similar in the two groups. CONCLUSION Mild ovarian stimulation is inferior to conventional regimes when applied to poor responders undergoing IVF/ICSI, in terms of the numbers of retrieved COCs.
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Affiliation(s)
- Charalampos Siristatidis
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Salamalekis
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Dafopoulos
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, University of Thessaly, School of Health Sciences, Faculty of Medicine, Larissa, Greece
| | - George Basios
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi Vogiatzi
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Siristatidis C, Kreatsa M, Koutlaki N, Galazios G, Pergialiotis V, Papantoniou N. Endometrial injury for RIF patients undergoing IVF/ICSI: a prospective nonrandomized controlled trial. Gynecol Endocrinol 2017; 33:297-300. [PMID: 27910711 DOI: 10.1080/09513590.2016.1255325] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
To evaluate the effect of endometrial injury on clinical outcomes in subfertile women with repeated implantation failures (RIF) undergoing assisted reproduction. In this prospective nonrandomized controlled trial, 103 subfertile women with RIF were included. Fifty-one underwent endometrial injury through hysteroscopy in the early follicular phase of the previous cycle and 52 underwent the standard protocol without any intervention. Live birth and miscarriage were the primary outcomes. Clinical and in vitro fertilization (IVF) cycle characteristics, were also compared between groups. Both groups were comparable in terms of baseline and cycle characteristics. Live birth rates were significantly higher in the study, compared with the control group (18/51 vs. 8/52, odds ratio (OR) = 0.25; 95% confidence interval (CI) = 0.10-0.64; p = 0.020), although miscarriage rates were similar (7/51 vs. 10/52, OR= 0.25; 95%CI= 0.12-0.66; p = 0.452). The rest of the outcomes parameters were comparable between groups. Logistic regression analysis revealed that endometrial injury and duration of subfertility were independent predictors of live birth after control of other variables (OR = 2.818; 95%CI = 1.044-7.605; p = 0.041 and OR = 0.674; 95%CI = 0.461-0.985, p = 0.042, respectively). Endometrial injury induced through office hysteroscopy in the preceding cycle in subfertile women with RIF improves live birth rates.
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Affiliation(s)
- Charalampos Siristatidis
- a Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens , Chaidari , Athens , Greece
| | - Maria Kreatsa
- a Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens , Chaidari , Athens , Greece
| | - Nikoleta Koutlaki
- b Department of Obstetrics and Gynaecology , Medical School, Democritus University of Thrace , Alexandroupolis , Greece , and
| | - George Galazios
- b Department of Obstetrics and Gynaecology , Medical School, Democritus University of Thrace , Alexandroupolis , Greece , and
| | - Vasileios Pergialiotis
- c 3rd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens , Chaidari , Athens , Greece
| | - Nikolaos Papantoniou
- c 3rd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens , Chaidari , Athens , Greece
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Pergialiotis V, Konstantopoulos P, Prodromidou A, Florou V, Papantoniou N, Perrea DN. MANAGEMENT OF ENDOCRINE DISEASE: The impact of subclinical hypothyroidism on anthropometric characteristics, lipid, glucose and hormonal profile of PCOS patients: a systematic review and meta-analysis. Eur J Endocrinol 2017; 176:R159-R166. [PMID: 28007842 DOI: 10.1530/eje-16-0611] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/02/2016] [Accepted: 12/22/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Subclinical hypothyroidism (SCH) is encountered in 10-25% of women with PCOS. To date, it remains unclear whether this coexistence influences the severity of metabolic and hormonal profile of these patients. The purpose of our systematic review is to investigate this potential relation. METHODS We systematically searched Medline, Scopus, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar databases together with reference lists from included studies. All prospective and retrospective observational cohort studies that investigated the impact of subclinical hypothyroidism on hormonal and metabolic parameters of PCOS patients were included. The methodological quality of studies was assessed with the Ottawa-Newcastle criteria. Statistical meta-analysis was performed with the RevMan 5.3 software. RESULTS Twelve studies were finally included in the present review, which enrolled 2341 PCOS patients. Among them, 577 had subclinical hypothyroidism, whereas the remaining 2077 were PCOS women with normal thyroid function. The presence of SCH significantly affected HDL (MD -3.92 mg/dL 95% CI: -6.56, -1.29) and triglycerides levels (26.91 mg/dL 95% CI: -3.79, 50.02). HOMA-IR was also affected (MD 0.82 95% CI: 0.15, 1.50). On the other hand, LDL, fasting glucose and 2-h OGTT were not influenced. Similarly, prolactin, FSH, LH, LH/FSH ratio and sex hormone-binding globulin remained unaffected. CONCLUSION Subclinical hypothyroidism does not influence the hormonal profile of women with PCOS. On the other hand, it results in mild metabolic abnormalities, which are not clinically important in a short-term setting.
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Affiliation(s)
- Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research N.S. ChristeasAthens University Medical School, Athens, Greece
- Third Department of Obstetrics/GynaecologyAthens University Medical School, Attikon Hospital, Athens, Greece
| | - Panagiotis Konstantopoulos
- Laboratory of Experimental Surgery and Surgical Research N.S. ChristeasAthens University Medical School, Athens, Greece
| | - Anastasia Prodromidou
- Laboratory of Experimental Surgery and Surgical Research N.S. ChristeasAthens University Medical School, Athens, Greece
| | - Venetia Florou
- Laboratory of Experimental Surgery and Surgical Research N.S. ChristeasAthens University Medical School, Athens, Greece
| | - Nikolaos Papantoniou
- Third Department of Obstetrics/GynaecologyAthens University Medical School, Attikon Hospital, Athens, Greece
| | - Despina N Perrea
- Laboratory of Experimental Surgery and Surgical Research N.S. ChristeasAthens University Medical School, Athens, Greece
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Christodoulaki C, Trakakis E, Pergialiotis V, Panagopoulos P, Chrelias C, Kassanos D, Sioutis D, Papantoniou N, Xirofotos D. Dehydroepiandrosterone-Sulfate, Insulin Resistance and Ovarian Volume Estimation in Patients With Polycystic Ovarian Syndrome. J Family Reprod Health 2017; 11:24-29. [PMID: 29114265 PMCID: PMC5664986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To investigate the potential association of DHEA-S with metabolic and hormonal alterations and with disorders of ovarian morphology. Materials and methods: The present study was based on women with PCOS that attended the Gynaecological Endocrinology - Paediatric and Adolescence Endocrinology Department of our clinic. Overall, 321 patients who met the Rotterdam ESHRE/ ASRM - Sponsored criteria for the definition of PCOS were included. Women's personal medical history was recorded, anthropometric parameters were assessed and blood was drawn for analysis of metabolic and hormonal parameters. A gynaecological ultrasound was also performed to evaluate ovarian morphology. Results: Correlation analysis revealed a significant negative correlation of DHEA-S with the mean volume of the right and left ovary and with the maximum volume of the largest ovary. This finding remained significant after adjusting for age and BMI (β ± SE = -0.39 ± 0.17, p = 0.023 in the case of mean ovarian volume and β ± SE = -0.36 ± 0.17, p = 0.032 in the case of the maximum volume of the maximum ovarian volume). Conclusion: The findings of our study reveal a clear negative association of DHEA-S with ovarian volume. To date, however, current evidence in this field are restricted to experimental animal models. Future clinical studies are needed in this field to corroborate our findings.
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Makris GM, Pouliakis A, Siristatidis C, Margari N, Terzakis E, Koureas N, Pergialiotis V, Papantoniou N, Karakitsos P. Image analysis and multi-layer perceptron artificial neural networks for the discrimination between benign and malignant endometrial lesions. Diagn Cytopathol 2017; 45:202-211. [DOI: 10.1002/dc.23649] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/15/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Georgios-Marios Makris
- Unit of Gynecological Oncology, Third Department of Obstetrics and Gynecology; General Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens; Athens Greece
| | - Abraham Pouliakis
- Department of Cytopathology; General Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens; Athens Greece
| | - Charalampos Siristatidis
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology; General Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens; Athens Greece
| | - Niki Margari
- Department of Cytopathology; General Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens; Athens Greece
| | | | | | - Vasilios Pergialiotis
- Unit of Gynecological Oncology, Third Department of Obstetrics and Gynecology; General Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens; Athens Greece
| | - Nikolaos Papantoniou
- Unit of Gynecological Oncology, Third Department of Obstetrics and Gynecology; General Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens; Athens Greece
| | - Petros Karakitsos
- Department of Cytopathology; General Hospital “Attikon”, Medical School, National and Kapodistrian University of Athens; Athens Greece
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Makris GM, Chrelias C, Papanota A, Battista MJ, Papantoniou N. Ovarian tumors: Should the cervix be examined first? EUR J GYNAECOL ONCOL 2017; 38:462-464. [PMID: 29693893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There is a controversy regarding ovarian metastasis in early-stage adenocareinoma of the uterine cervix. The authors present the case of a 5 1-year-old woman that at the time of diagnosis was thought to suffer from a Stage II cervical carcinoma and a synchronous ovarian carcinoma, that turned out to be an ovarian metastasis from the endocervical adenocarcinoma, as attested morphologically, histochemically, and immunohistochemically. Radical hysterectomy with oophorectomy, excision of the omentum, lymph node excision, and cytological sampling of the peritoneal cavity were carried out. It is important to always bear in mind that even low-grade adenocarcinomas of the cervix can be metastatic to the ovaries. Clinicians have to be careful when managing those cases, while further investigation is needed in order to determine the exact mechanism of those metastases and the criteria needed in order to preserve the ovaries in young patients.
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Makris GM, Marinelis A, Battista MJ, Chrelias C, Papantoniou N. An ovarian mass after breast cancer: Metachronous carcinoma or metastasis? A case report. Int J Surg Case Rep 2016; 31:106-108. [PMID: 28129608 PMCID: PMC5266487 DOI: 10.1016/j.ijscr.2016.12.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 12/28/2016] [Indexed: 01/02/2023] Open
Abstract
In the presence of an ovarian mass after breast cancer, differentiating between primary and secondary lesions can be a difficult task. This case report presents a 45-year-old patient with an ovarian mass two years after the diagnosis of breast cancer. Imaging, histology and predominantly immunohistochemistry may provide valuable tools in the assessment of ambiguous cases. Differences in the immunohistochemical profile of primary tumor and metastases should be anticipated.
Introduction Differentiating between primary and secondary ovarian cancer can be a difficult task. In hereditary conditions breast malignancies and primary ovarian cancer often coexist. Presentation of case We present a 45-year-old patient with an ovarian mass two years after the diagnosis of a lobular, triple negative breast carcinoma. There was concern whether the lesion represented a metachronous ovarian cancer or a metastasis of the lobular carcinoma. The final histological examination showed a metastatic lesion, deriving from the lobular breast carcinoma, as evidenced by the immunohistochemical profile; nevertheless, there were changes in hormonal receptor expression in the metastatic lesion compared to the primary, triple negative tumor. The patient underwent genetic testing for BRCA1 and BRCA2 mutations and was negative. In the adjuvant setting the patient received 6 cycles of chemotherapy with carboplatin and paclitaxel; eighteen months later, the patient remains without disease recurrence. Discussion and conclusion This case report highlights the role of imaging, histology and predominantly immunohistochemistry as valuable tools in the assessment of ambiguous ovarian lesions after breast cancer.
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Affiliation(s)
- Georgios-Marios Makris
- Department of Obstetrics and Gynecology, Athens Euroclinic Hospital, Athens Greece; Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Athens, Greece.
| | - Alexandros Marinelis
- Department of Obstetrics and Gynecology, Athens Euroclinic Hospital, Athens Greece
| | | | - Charalampos Chrelias
- Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Athens, Greece
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Christodoulopoulou V, Trakakis E, Pergialiotis V, Peppa M, Chrelias C, Kassanos D, Papantoniou N. Clinical and Biochemical Characteristics in PCOS Women With Menstrual Abnormalities. J Family Reprod Health 2016; 10:184-190. [PMID: 28546817 PMCID: PMC5440817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: The purpose of the present study was to examine the impact of menstrual cycle abnormalities among patients with polycystic ovary syndrome (PCOS) on biochemical and anthropometric characteristics. Materials and methods: We conducted a prospective observational study of patients 17-35 years of age with PCOS that attended the department of Gynecological Endocrinology of our hospital. Results: A total of 309 women with PCOS participated in the study. In total, 72.2% suffered from menstrual cycle disorders. In our study 15.1% of women were overweight and 24% were obese. Also, 36% of the sample had androgenetic alopecia and 56.4% had acne. According to the stepwise discriminant analysis, we observed that glucose displayed the strongest association to the menstrual status (F to eliminate = 14.13), followed by endometrial thickness (F to eliminate = 10.89), waist circumference (F to eliminate = 10.17), LH levels (F to eliminate = 8.15) and PRL (F to eliminate = 4.45). Significantly higher levels of LH and TSH and lower levels of prolactin were found in women with menstrual disorders compared to those with normal menstrual cycles. Fasting glucose was also considerably higher among these patients although markers of insulin resistance such as the Matsuda, Quicki and HOMA-IR indices did not differ. Conclusion: According to the findings of our study PCOS patients with menstrual disorders exhibit hormonal alterations and elevated fasting glucose. Future studies are needed in this field to corroborate our findings and determine the anthropometric and biochemical profile of patients with menstrual cycle irregularities.
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Affiliation(s)
- Vasiliki Christodoulopoulou
- 3rd Department of Obstetrics and Gynaecology, Attiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eftihios Trakakis
- 3rd Department of Obstetrics and Gynaecology, Attiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasilios Pergialiotis
- 3rd Department of Obstetrics and Gynaecology, Attiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Melpomeni Peppa
- 2nd Department of Internal Medicine, Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, Athens, Greece
| | - Charalampos Chrelias
- 3rd Department of Obstetrics and Gynaecology, Attiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Kassanos
- 3rd Department of Obstetrics and Gynaecology, Attiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- 3rd Department of Obstetrics and Gynaecology, Attiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Makris GM, Charalampopoulos A, Siristatidis C, Fexi D, Chrelias C, Battista MJ, Papantoniou N. Y-type Anovulvar Fistula Complicating Inflammatory Bowel Disease. Am Surg 2016. [DOI: 10.1177/000313481608201106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Georgios-Marios Makris
- Gynecological Oncology Unit Third Department of Obstetrics and Gynecology General University Hospital “Attikon” University of Athens Athens, Greece
| | - Anestis Charalampopoulos
- Third Department of Surgery General University Hospital “Attikon” University of Athens Athens, Greece
| | - Charalampos Siristatidis
- Assisted Reproduction Unit Third Department of Obstetrics and Gynecology General University Hospital “Attikon” University of Athens Athens, Greece
| | - Dimitra Fexi
- Gynecological Oncology Unit Third Department of Obstetrics and Gynecology General University Hospital “Attikon” University of Athens Athens, Greece
| | - Charalampos Chrelias
- Gynecological Oncology Unit Third Department of Obstetrics and Gynecology General University Hospital “Attikon” University of Athens Athens, Greece
| | | | - Nikolaos Papantoniou
- Gynecological Oncology Unit Third Department of Obstetrics and Gynecology General University Hospital “Attikon” University of Athens Athens, Greece
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Siristatidis C, Salamalekis G, Vogiatzi P, Basios G, Pergialiotis V, Vrantza T, Papantoniou N. Clomiphene Citrate vs. Letrozole as mild stimulation regimes in women with expected normal ovarian response undergoing IVF. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Makris GM, Charalampopoulos A, Siristatidis C, Fexi D, Chrelias C, Battista MJ, Papantoniou N. Y-type Anovulvar Fistula Complicating Inflammatory Bowel Disease. Am Surg 2016; 82:305-307. [PMID: 28206918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Georgios-Marios Makris
- Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Athens, Greece
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Siristatidis C, Basios G, Salamalekis G, Vogiatzi P, Pergialiotis V, Vrantza T, Papantoniou N. Effect of total dose of gonadotrophins in the number of oocytes retrieved in mild ovarian stimulation protocols. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Siristatidis C, Vogiatzi P, Pouliakis A, Trivella M, Papantoniou N, Bettocchi S. Predicting IVF Outcome: A Proposed Web-based System Using Artificial Intelligence. In Vivo 2016; 30:507-512. [PMID: 27381616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 04/11/2016] [Indexed: 06/06/2023]
Abstract
AIM To propose a functional in vitro fertilization (IVF) prediction model to assist clinicians in tailoring personalized treatment of subfertile couples and improve assisted reproduction outcome. MATERIALS AND METHODS Construction and evaluation of an enhanced web-based system with a novel Artificial Neural Network (ANN) architecture and conformed input and output parameters according to the clinical and bibliographical standards, driven by a complete data set and "trained" by a network expert in an IVF setting. RESULTS The system is capable to act as a routine information technology platform for the IVF unit and is capable of recalling and evaluating a vast amount of information in a rapid and automated manner to provide an objective indication on the outcome of an artificial reproductive cycle. CONCLUSION ANNs are an exceptional candidate in providing the fertility specialist with numerical estimates to promote personalization of healthcare and adaptation of the course of treatment according to the indications.
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Affiliation(s)
- Charalampos Siristatidis
- Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Athens, Greece
| | - Paraskevi Vogiatzi
- Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Athens, Greece
| | - Abraham Pouliakis
- Department of Cytopathology, University of Athens, Attikon University Hospital, Athens, Greece
| | - Marialenna Trivella
- Centre for Statistics in Medicine, University of Oxford, Botnar Research Centre, Oxford, U.K
| | - Nikolaos Papantoniou
- Third Department of Obstetrics and Gynecology, University of Athens, Attikon Hospital, Athens, Greece
| | - Stefano Bettocchi
- First Unit of Obstetrics and Gynecology, Department of Biomedical Sciences and Human Oncology, University "Aldo Moro", Bari, Italy
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Pergialiotis V, Konstantopoulos P, Karampetsou N, Koutaki D, Gkioka E, Perrea DN, Papantoniou N. Calprotectin levels in necrotizing enterocolitis: a systematic review of the literature. Inflamm Res 2016; 65:847-852. [PMID: 27328832 DOI: 10.1007/s00011-016-0963-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/12/2016] [Accepted: 06/14/2016] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Fecal calprotectin has been extensively investigated as a screening marker for the detection of necrotizing enterocolitis (NEC). However, there is a complete lack of consensus regarding its efficacy as a diagnostic test. OBJECTIVE The purpose of the present systematic review is to evaluate the effectiveness of fecal calprotectin as a screening marker for the detection of NEC. MATERIALS AND METHODS We conducted a systematic review of studies published in the Medline (1966-2016), Scopus (2004-2016), ClinicalTrials.gov (2008-2016), Cochrane Central Register of Controlled Trials CENTRAL (1999-2016), and Google Scholar (2004-2016) databases, combined with studies found in the reference lists of the included studies. All prospective and retrospective observational cohort studies were included. RESULTS Thirteen studies that included 601 neonates were identified in the international literature. The presence and severity of NEC was evaluated with the modified Bell's criteria. Ten studies found significantly elevated fecal calprotectin levels among infants with NEC (p < 0.05). One study found that this effect was observed irrespective of the stage of the disease. Five studies evaluated the efficacy of fecal calprotectin as a diagnostic test. The reported sensitivity ranged between 76 and 100 %, and the specificity varied from 39 to 96.4 %. However, the proposed cut-off values were not similar. CONCLUSION Current evidence suggests that fecal calprotectin is elevated in newborns suffering from NEC. However, its significance as an early screening marker remains unknown. Future studies are needed and should focus on the identification of specific cut-off values.
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Affiliation(s)
- Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, 6, Danaidon str., Chalandri, 15232, Athens, Greece.
| | - Panagiotis Konstantopoulos
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, 6, Danaidon str., Chalandri, 15232, Athens, Greece
| | - Nikoleta Karampetsou
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, 6, Danaidon str., Chalandri, 15232, Athens, Greece
| | - Diamanto Koutaki
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, 6, Danaidon str., Chalandri, 15232, Athens, Greece
| | - Eleana Gkioka
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, 6, Danaidon str., Chalandri, 15232, Athens, Greece.,Third dpt of Ob/Gyn, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina N Perrea
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, 6, Danaidon str., Chalandri, 15232, Athens, Greece
| | - Nikolaos Papantoniou
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, 6, Danaidon str., Chalandri, 15232, Athens, Greece
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Siristatidis C, Vaidakis D, Rigos I, Chrelias G, Papantoniou N. Leiomyomas and infertility. Minerva Ginecol 2016; 68:283-296. [PMID: 26824506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Leiomyomas are the commonest benign tumor in the female reproductive tract. Even though their role on infertility is still questionable, evidence to date suggest that the anatomic location may be related to reproductive outcomes. Several possible mechanisms suggest that leiomyomas may affect fertility, especially in terms of the anatomical distortion of endometrial cavity, the abnormal uterine contractility, reduced blood supply to the endometrium and altered endometrial receptivity. The effect of leiomyomas on IVF outcomes has been the subject of many studies; however, a definitive direction is yet required to adjust clinical management accordingly. Management of leiomyomas is challenging in terms of clinical decision, especially among subfertile patients, since potential treatment complications and their consequences in endometrial dynamics should be also accounted. Expectant management is recommended for asymptomatic patients, whereas in symptomatic subfertile patients, medical and/ or surgical management is usually recommended.
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