Current Women's Health Reviews - Online First
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The Role of Visfatin in Female Reproduction and Various Types of Gynecological Cancers
Authors: Kalliopi Koutsoura, George Kaparos, Olga Triantafyllidou and Stavroula BakaAvailable online: 06 March 2025More LessIntroductionVisfatin is a 52-kDa protein produced mainly by adipose tissue. It is one of the cytokines known as adipokines. There is a correlation between visfatin and female reproductive health, pregnancy complications, and gynecological cancers. This mini-review summarizes the existing knowledge of the role of visfatin in female reproduction and in various types of gynecological cancers.
MethodsWe performed a literature search in the PubMed database up to December 2023. We reviewed the identified articles and included those that were relevant to our objective.
ResultsVisfatin has been implicated in the pathogenesis of polycystic ovary syndrome, while alterations in visfatin levels have been correlated with pregnancy complications, including gestational diabetes mellitus, acute pyelonephritis, preeclampsia, and reduced fetal growth. First trimester maternal visfatin levels are associated with infant weight. The role of visfatin has also been investigated in relation to steroidogenesis as well as breast, ovarian, and endometrial cancers. In those types of gynecological cancers, high visfatin levels were observed. Visfatin has also been detected in the follicular fluid, and it has been correlated with the number of retrieved oocytes in in vitro fertilization.
ConclusionThe results from published studies are contradictory because visfatin levels vary across conditions due to its complex mode of action. Visfatin could potentially serve as a prognostic biomarker in various reproductive conditions and as a therapeutic target in various types of gynecological cancers. Additional studies are needed to clarify visfatin’s role in female reproduction because its effects can vary depending on the tissue in which it is present.
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Enhanced Myometrial Vascularity: A Case Report and Diagnostic Insights
Available online: 04 March 2025More LessIntroductionRetained products of conception (RPOC) are a common cause of secondary postpartum haemorrhage. They pose both immediate and long-term health risks, such as abnormal bleeding, infection, and fertility issues. Ultrasound (USG) is the first line of imaging used to diagnose RPOC. Enhanced myometrial vascularity (EMV) is thought to result from placental site subinvolution due to remnants of conception products. In ultrasound imaging, endometrial vascularity (EMV) is characterized by a network of enlarged, twisted blood vessels that extend from the myometrium into the endometrium. On spectral Doppler, these vessels can exhibit varying degrees of elevated peak systolic velocities and increased diastolic flows. On ultrasound, EMV can appear ominous and is often mistaken for an arteriovenous malformation (AVM).
Case presentationA twenty-five-year-old woman presented with continuous bleeding per vagina following a surgical termination of a 10-week gestation. Transvaginal ultrasound showed a heterogeneous lesion in the endometrial cavity and multiple dilated vessels in the subjacent myometrium. Doppler imaging showed a high velocity and low resistance pattern suggestive of EMV. Ipsilateral parametrium showed enlarged uterine artery branches. Imaging differentials include RPOC with EMV and AVM. In this case, we discuss the imaging features of RPOC, EMV, and their differentials. We also discuss the implications of the imaging findings on treatment protocols.
ConclusionTreatment options for RPOC should be tailored to individual clinical circumstances and the grade of RPOC. Enhanced myometrial vascularity is a physiological phenomenon observed in the placental bed and should not be mistaken for AVM.
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Maternal and Perinatal Outcome in Acute Fatty Liver of Pregnancy
Authors: Shubhada Karnamadakala, Shraddha Shetty K and Suprajna ShettyAvailable online: 15 January 2025More LessBackgroundAcute Fatty Liver of Pregnancy (AFLP) is a rare obstetric condition that can lead to maternal and perinatal complications.
Aim and ObjectivesThis study aimed to study the pregnancy outcome in Acute fatty liver of Pregnancy (AFLP). In particular, this study aimed to study the clinical features of the condition and its effect on maternal and perinatal outcomes.
Materials and MethodsA retrospective analysis of seven cases diagnosed with AFLP over a span of three years was performed. The clinical records of these women were reviewed for clinical features, laboratory investigations, and maternal and perinatal outcomes.
ResultsThe incidence of AFLP was 4/10,000 births. A total of 6(85.7%) women presented during the third trimester of pregnancy. A total of 4(57%) of them presented after 36 weeks of gestation. A total of 6(85.7%) women presented with jaundice, and all presented with sudden onset nonspecific symptoms, including abdominal pain and vomiting. Pregnancy was terminated by cesarean section in 6 cases. Maternal mortality was noted in 6(85.7%) of women. All six women were diagnosed with Acute kidney injury and coagulopathy. One woman had developed encephalopathy and altered sensorium. Further, 2(28.5%) women had intrauterine fetal demise at the time of presentation, and 1(14.3%) had an early neonatal death.
ConclusionAFLP is a rare clinical syndrome with rapid and dramatic progression, beginning initially with non-specific symptoms and evolving into coagulopathy, acute kidney injury, and death, resulting in alarming maternal and perinatal mortality. Early diagnosis is challenging due to the non-specificity of symptoms, but crucial and prompt termination of pregnancy is the need of the hour. Nonetheless, supportive treatment and a multidisciplinary approach may significantly improve prognosis.
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The Impact of Health Literacy on Knowledge, Attitude, and Practice Toward COVID-19 among Elderly Women: A Cross-Sectional Study in Iran
Available online: 01 January 2025More LessBackground and ObjectivesThe coronavirus has become a significant danger to human health. Health literacy is a major factor influencing health outcomes. The aim of this study was to assess health literacy and knowledge, attitude, and practice (KAPs) toward COVID-19 among elderly women.
MethodsThis descriptive-analytical study was conducted on elderly women living in Jahrom City in 2022. Participants responded to questions regarding sociodemographics, the Health Literacy Scale, and a researcher-developed knowledge, attitude, and practice (KAP) questionnaire. Descriptive statistics, one-way analysis of variance, independent sample T-test, Tukey post hoc test, and multiple linear regression were employed to analyze the data.
ResultsThe study participants had a mean age of 69.73 ± 7.17 years, with 38.53% aged over 70 years. Notably, 83.3% of participants expressed trust in information from friends and relatives. The average health literacy score among the women was 75.79 ± 20.36, and 40.7% had high health literacy, 25.3% had adequate health literacy, 18% had somewhat insufficient health literacy, and 16% had inadequate health literacy. The majority, 96%, had good awareness, 94.7% had a positive attitude, and 87.4% had good performance regarding the prevention of COVID-19. The results revealed that an increase of one unit in knowledge and practice scores corresponded to a respective increase of 0.485 (p<0.001) and 0.274 (p=0.001) in the average health literacy score. Furthermore, age (<0.001), education (<0.001), and occupation (<0.001) of participants were significantly associated with knowledge and practice related to COVID-19.
ConclusionThe study findings underscored the positive correlation between high health literacy and individuals' awareness, practices, age of women, education, occupation, source of information, and marital status. Enhancing people's awareness emerges as a key strategy to bolster health literacy levels in the population.
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