Česká gynekologie
type: channel
description: Česká gynekologie je oficiální časopis České gynekologické a porodnické společnosti ČLS JEP. Hlavním zaměřením časopisu je postgraduální výuka a informace o současném stavu a vývoji této oblasti medicíny doma a v zahraničí, dále publikace původních studií a zkušeností z klinické praxe a informace o činnosti odborných společností. Dosud publikovaná čísla a informace o časopisu naleznete na této adrese: https://www.cs-gynekologie.cz
publisher: ČLS JEP
language: en
publication name: Česká gynekologie
issn: 1210-7832
items: Status of a lipid accumulation product, triglycerides/glucose index and visceral adiposity index on cardiometabolic risk factors in young polycystic ovary syndrome patients
items: Robotic interposition of the mesorectum during low anterior resection of the rectum for endometriosis using tissue perfusion assessment with indocyanine green
items: Cytological versus histological results in ASCUS cervical dysplasia – a retrospective study
items: Prenatal sonographic features and outcomes of radial ray defects – a 14 case series with a literature review
items: Ovarian cancer and multimodal prehabilitation options – a case study
items: Endometriosis of the spleen – multidisciplinary surgical solution in a patient with a complex picture of deep infiltrating pelvic endometriosis
items: Molar ectopic pregnancy in a cesarean scar treated with methotrexate – a case report and review of the literature
items: Pelvic floor muscles High-Intensity Tesla Stimulation
items: Significance of positive excision margins in therapy of high-grade vulvar precancerosis – analysis of own data and literary review
items: The influence of selected immunohistochemical and clinical-pathological markers on the prognosis of patients with malignant uterine tumors
items: Which causes less pain? A comparison of misoprostol and dinoprostone in labor induction
items: Comparison of the incidence of pelvic girdle pain and back pain in women after vaginal delivery and cesarean section in the Slovak female population
items: Age-specific incidence and mortality of cervical cancer in the Czech Republic – analysis of nationwide data and data from a gynecologic oncology center
items: Cervical cancer screening in the European context – from cytology to primary HPV testing
items: HLA-C and KIR interactions as a possible cause of reproductive failures
items: Negative pressure wound therapy in gynecologic oncology – current knowledge and clinical applications
items: Epidemiological profile of pregnant women and perinatal outcomes of newborns with gastroschisis from a single reference center in Northeastern Brazil
items: Comparative analysis of the histological architecture of ovarian tissue following slow-freezing cryopreservation
items: Atypical placental site nodule detected via hysteroscopy – first case report from Brazil
items: Not every seizure is eclampsia – a rare case of a brain abscess in a pregnant woman caused by Streptococcus pneumoniae from a dental source
items: Sperm navigation mechanisms
items: Arteriovenous malformation developing in a cesarean scar after termination of pregnancy – a case report and review of the literature
items: Twin pregnancy in a caesarean scar – a case study and literature review of therapeutic approaches
items: Postoperative analgesia in breast cancer surgeries – anesthetic techniques and the role of cytokines
items: Vaginal fisting and risk of anogenital injury
items: Placental insufficiency and late-onset growth restriction in fetuses appropriate for gestational age
items: Diabetes mellitus and pregnancy, how to analyze national individual-level data
items: Ovarian vascular malformation – clinical presentation of Cowden syndrome
items: Effect of kisspeptin, neurokinin, and dynorphin neurons on regulation of reproduction
items: Determination of markers of ethyl alcohol consumption in pregnancy

Status of a lipid accumulation product, triglycerides/glucose index and visceral adiposity index on cardiometabolic risk factors in young polycystic ovary syndrome patients
type: item
description: Objective: To determine whether the triglycerides/glucose index (TyG-index), lipid accumulation product (LAP), and visceral adiposity index (VAI) would differ in young polycystic ovary syndrome (PCOS) patients when compared to the non-PCOS group, and to investigate the relationship between these markers and cardiovascular disease (CVD) risk in PCOS patients. Materials and methods: One hundred and ninety two women with PCOS, and 148 age and body mass index (BMI) matched healthy women without PCOS were enrolled. Levels of serum androgens, sex hormones, lipids, fasting glucose, fasting insulin, and N-terminal pro-brain natriuretic peptide (Nt-probnp) were determined. The 75 g oral glucose tolerance test was performed. The Homeostatic Model Assessment-Insulin Resistance Index (HOMA–IR) and Matsuda insulin sensitivity index were calculated. Levels of TyG-index, LAP, and VAI were determined. Results: TyG, LAP, and VAI were significantly higher in PCOS patients than in the control group (P = 0.001 vs. P = 0.001 vs. P = 0.001, resp.). HOMA-IR was significantly higher in PCOS patients and Matsuda ISI was significantly lower in PCOS patients (P = 0.001 vs. P = 0.001, resp.). Levels of Nt-probnp were significantly higher in PCOS patients (P = 0.001). Serum total testosterone and androstenedione levels had significant correlations with TyG, LAP, and VAI. Nt-probnp was significantly correlated with TyG, LAP, and VAI. LDL was positively correlated and HDL was negatively correlated with TyG-index, LAP, and VAI. Conclusion: PCOS patients have increased values of TyG-index, LAP, and VAI. TyG index, LAP, and VAI may indicate an increased risk of CVD and hyperandrogenism in PCOS patients.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: polycystic ovary syndrome
  topic: keywords
subject: triglycerides/ glucose index
  topic: keywords
subject: lipid accumulation product
  topic: keywords
subject: visceral adiposity index
  topic: keywords
subject: cardiovascular disease
  topic: keywords
creator: Gaye Arslan
creator: Gökçenur Karakelleoğlu
creator: Cihan Karadağ
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 457
ending page: 462

Robotic interposition of the mesorectum during low anterior resection of the rectum for endometriosis using tissue perfusion assessment with indocyanine green
type: item
description: Introduction: Rectal endometriosis is a serious disease, and its surgical treatment belongs among demanding procedures, often requiring a multidisciplinary approach. It is associated with a significant risk of peri- and postoperative complications, the most serious being the development of rectovaginal fistula, which may occur in up to 10% of resections for rectal endometriosis. Preventive measures include the choice of surgical technique, such as a two-stage procedure (resection with terminal stoma followed by stoma closure and bowel anastomosis), which is not optimal for the patient due to the necessity of having two surgeries. Another option is the interposition of the patient’s vital tissues into the site of anastomosis or intestinal wall suture. For this purpose, an omental flap is often used, or part of the mesorectum may be utilized. The ability to verify the vitality of such a flap should be considered crucial in preventing anastomotic leakage. Methods: A patient underwent robotic-assisted laparoscopic segmental resection of severe rectal endometriosis involving the rectovaginal septum and vagina, classified as #ENZIAN A3 and C3, with interposition of the mesorectum and intraoperative tissue perfusion assessment using indocyanine green. Conclusion: The use of tissue perfusion assessment when performing interposition of patient-derived flaps may, in the future, improve surgical precision, enhance success rates, and contribute to the prevention of rectovaginal fistula formation.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: deep rectal endometriosis
  topic: keywords
subject: segmental resection
  topic: keywords
subject: rectovaginal fistula
  topic: keywords
subject: mesorectum
  topic: keywords
subject: tissue perfusion
  topic: keywords
subject: indocyanine green
  topic: keywords
creator: Vladimir Balaz
creator: Vladimir Teplan
creator: Kamila Benkova
creator: Jiri Presl
rights: Copyright (c) 2025 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 46
ending page: 51

Cytological versus histological results in ASCUS cervical dysplasia – a retrospective study
type: item
description: Aim: The cytological category of atypical squamous cells of undetermined significance describes cellular abnormalities that are more severe than inflammatory changes, but are quantitatively or qualitatively insufficient to be included in the squamous intraepithelial lesion category. This study aims to determine the risk level for the presence of high-grade dysplasia in patients with this cytological abnormality. Methods: We retrospectively searched our database for women with cytologically proven atypical squamous cells of undetermined significance lesions between January 2020 and June 2024. A total of 104 patients who had undergone colposcopy-directed biopsies were included in the study. Results: Among the 104 women with confirmed atypical squamous cells of undetermined significance cytological lesions who had undergone biopsies, 56 cases (53.8%) were negative, while 48 cases (46.2%) demonstrated cervical intraepithelial neoplasia. Cervical intraepithelial neoplasia 2+ was present in 23.1% (N = 24) of the cases. Furthermore, among 77 human papillomavirus positive women, the precancerous condition was not histologically confirmed in almost half of the cases (N = 36), while in 16 of the 23 human papillomavirus negative biopsies, the precancerous condition was not confirmed. Human papillomavirus status was unknown in 4 cases. Conclusion: We identified a 23.1% presence of cervical intraepithelial neoplasia 2+ lesions in patients with atypical squamous cells of undetermined significance cytological findings. Our study also suggests a lower specificity, but a better negative predictive value of the human papillomavirus test in detecting cervical intraepithelial neoplasia in these patients.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: ASCUS
  topic: keywords
subject: cervical dysplasia
  topic: keywords
subject: human papillomavirus
  topic: keywords
creator: Tomas Rokos
creator: Erik Kudela
creator: Terezia Pribulova
creator: Veronika Holubekova
creator: Erik Kozubik
creator: Michal Kalman
creator: Kamil Biringer
rights: Copyright (c) 2026 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 11
ending page: 15

Prenatal sonographic features and outcomes of radial ray defects – a 14 case series with a literature review
type: item
description: Objective: In this study, we aimed to present the demographic, ultrasonographic, genetic, obstetric, and postpartum results of 14 patients diagnosed with radial ray defects. Materials and methods: Fourteen patients diagnosed with radial ray defects. Non-development or hypoplasia of any preaxial part of the upper extremity on ultrasonography was considered a radial ray defect. Maternal age, gestational week at diagnosis, laterality of the radial ray defect, genetic results, presence of comorbid anomalies, termination status, and postpartum prognosis were obtained. Results: The range of maternal age at the time of diagnosis was 17–38 years and the gestational age ranged between 14–26 weeks. Four of the radial ray defects were bilateral, and ten were unilateral. Trisomy 18 was identified in two cases. Eight cases accepted the termination procedure. Three cases rejected termination and had spontaneous intrauterine death during pregnancy follow-up. One case was diagnosed with VACTERL association and died postpartum on the 13th day. One case was monitored due to Fanconi aplastic anemia and one case had amniotic band syndrome in etiology and lives with a prosthetic arm. Conclusion: The frequency of a radial ray defect accompanied by syndromic and congenital anomalies was high, and visualization of the radial bone or other preaxial bone structures on the 1st trimester fetal ultrasonography will ensure the diagnosis of a radial ray defect in early gestational weeks. In the case of a radial ray defect diagnosis, systemic organ screening should be performed with detailed ultrasonography and the necessary invasive procedure for karyotype examination should be advised to all families.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: antenatal care
  topic: keywords
subject: early screening
  topic: keywords
subject: first trimester screening
  topic: keywords
subject: prenatal diagnosis
  topic: keywords
subject: radial ray defect
  topic: keywords
subject: radial ray malformation
  topic: keywords
creator: Gokhan Unver
creator: Sercan Serin
creator: Migraci Tosun
creator: Handan Celik
creator: Mesut Onal
creator: Ummet Abur
creator: Engin Altundag
rights: Copyright (c) 2025 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 35
ending page: 40

Ovarian cancer and multimodal prehabilitation options – a case study
type: item
description: Objective: The aim of this case report is to present the impact of multimodal prehabilitation on the quality of life, cognitive performance, physical fitness, and nutritional status in a patient with advanced ovarian cancer. Methods: A 74-year-old woman with high grade serous ovarian carcinoma pT3bN1a was scheduled for radical surgery following three cycles of neoadjuvant chemotherapy. She underwent a three-week intensive multimodal prehabilitation program in a 4/7 regimen involving physiotherapy, occupational therapy, nutritional counselling, psychological support, and supervision by a rehabilitation physician. The effect was evaluated using functional and cognitive tests, stress and disability scales, and body composition analysis (InBody). Results: Improvement was observed across all major domains: reduction in disability (WHODAS 20 → 5%), enhancement of cognitive function (MoCA 22 → 25), decreased perceived stress (PSS-10 17 → 11), reduction in frailty (FI 3 → 1), and restoration of full independence in activities of daily living (Katz Index 6/6). Physical performance showed marked gains (6MWT +42 m, 5×SST −6.5 s, handgrip strength +4 kg), while pulmonary function tests confirmed improved ventilatory capacity (FVC, FEV1, PEF). Nutritional assessment indicated a reduced risk of malnutrition according to the MUST screening tool, although bioimpedance analysis demonstrated a mild increase in total body fat and visceral adipose tissue. Conclusion: Intensive multimodal prehabilitation positively influenced the patient’s psychosensory-motor potential, reduced disability, enhanced perioperative fitness, and confirmed its indispensable role in oncogynecology.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: oncogynecology
  topic: keywords
subject: prehabilitation
  topic: keywords
subject: quality of life
  topic: keywords
subject: disability
  topic: keywords
creator: Petra Sladkova
creator: Marie Ticha
creator: Michaela Svabenicka
creator: Katerina Kotrbova
creator: Anna Salyova
creator: Zuzana Vlastnikova
creator: Marketa Janatova
creator: Kristyna Hoidekrova
creator: Marketa Polkova
creator: Michal Zikan
creator: Tomas Brtnicky
rights: Copyright (c) 2025 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 41
ending page: 45

Endometriosis of the spleen – multidisciplinary surgical solution in a patient with a complex picture of deep infiltrating pelvic endometriosis
type: item
description: In general, most common localizations of endometriosis are the pelvic organs, until recently, the spleen was mentioned as the only abdominal organ resistant to the development of endometriosis. Our case report describes the differential diagnosis of a splenic cyst as an incidental finding during the examination of endometriosis, its interdisciplinary solution within surgery, gynaecology, radiology and infectious medicine, using robotic-assisted minimally invasive surgery.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: endometriosis
  topic: keywords
subject: spleen
  topic: keywords
subject: robotic surgical procedures
  topic: keywords
creator: Nicole Maceckova
creator: Martin Trhlik
creator: Martin Straka
creator: Jiri Bartos
creator: Barbora Chaloupkova
rights: Copyright (c) 2025 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 52
ending page: 55

Molar ectopic pregnancy in a cesarean scar treated with methotrexate – a case report and review of the literature
type: item
description: Objective: To present a rare case of partial molar pregnancy implanted in a previous cesarean section scar and summarize the literature. Case report: A 33-year-old woman (gravida 5, two prior cesarean deliveries, two spontaneous abortions) presented with vaginal spotting and lower abdominal pain at 6 weeks of gestation. Transvaginal ultrasonography revealed a 28 × 19 mm gestational sac at the cesarean scar site, containing a 4mm fetus with positive cardiac activity. Vacuum curettage was performed under ultrasonographic guidance. Ten days postprocedure, rising serum beta-hCG levels and a persistent cystic mass on ultrasound raised suspicion for molar pregnancy. A single systemic dose of methotrexate was administered. Histopathology confirmed a partial molar pregnancy. The patient’s serum beta-hCG levels normalized within 8 weeks. Conclusion: Partial molar pregnancy in a cesarean section scar is an extremely rare condition that may present with vaginal bleeding and pelvic pain. Early recognition through ultrasonography and laboratory evaluation, combined with timely intervention including curettage and methotrexate therapy, can lead to complete resolution. Clinicians should consider this diagnosis in patients with previous cesarean sections to ensure optimal outcomes.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: molar pregnancy
  topic: keywords
subject: partial hydatidiform mole
  topic: keywords
subject: methotrexate
  topic: keywords
subject: vacuum curettage
  topic: keywords
subject: cesarean section scar
  topic: keywords
creator: Ecem Yücel
creator: İbrahim Kale
creator: Osman Şanlı
creator: Ayşe Nur İhvan
rights: Copyright (c) 2025 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 56
ending page: 60

Pelvic floor muscles High-Intensity Tesla Stimulation
type: item
description: Introduction: Stress urinary incontinence (SUI) represents a significant health problem for women, which fundamentally reduces the quality of life. Conservative treatment mainly includes pelvic floor muscle training, where the effectiveness is limited by the patient’s ability to actively engage the muscles and long-term compliance. An alternative is electrical stimulation of the pelvic floor, which, however, is sometimes painful and requires invasive application of probes to the pelvic floor. A new option is high-frequency electromagnetic stimulation using High-Intensity Tesla Stimulation (HITS) technology, which induces intense muscle contractions without the need for insertion of probes or electrodes and with higher patient tolerance. The aim of the study was to evaluate the effectiveness of six HITS sessions in women with SUI – based on subjective assessment by patients and objective assessment of muscle strength according to the modified Oxford scale (MOS) and electromyographic activity of the pelvic floor using the Multiple Array Probe Leiden (MAPLe) probe). Methods: A prospective study was conducted at the urogynecological center Gyn-Line in Brno from February to September 2025. Twenty women with urodynamically proven SUI who did not wish to undergo surgical treatment of the disease were included. Patients underwent six sessions of high-frequency electromagnetic stimulation HITS on the MagRex Pelvic Seat device over 4–5 weeks. The protocol included contractions at frequencies of 25 Hz, 35 Hz, and 35–75 Hz according to tolerance. Evaluation of effectiveness included MOS, electromyographic activity of the pelvic floor muscles measured by the MAPLe probe, and a subjective Patient Global Impression of Improvement (PGI-I) questionnaire. Statistical analysis was performed using a Student’s t-test at a significance level of P < 0.05. Results: All patients (N = 20; age 62.5 ± 9.4 years; parity 2.4 ± 2.7; BMI 29.2 ± 6.4 kg/m²; 90% postmenopausal) completed the series o…
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: stress urinary incontinence
  topic: keywords
subject: pelvic floor muscle training
  topic: keywords
subject: HITS
  topic: keywords
creator: Martin Huser
rights: Copyright (c) 2025 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 5
ending page: 10

Significance of positive excision margins in therapy of high-grade vulvar precancerosis – analysis of own data and literary review
type: item
description: Objective: In many countries, the incidence of vulvar intraepithelial neoplasia as a precursor of vulvar squamous cell carcinoma has highly increased over the last 3 decades, while the incidence of cancer remained relatively unchanged. Among risk factors for recurrence, resp. progression, usually involve positive excision margins. The aim of the paper is to evaluate the risk of recurrence and progression of high-grade vulvar precancerosis in patients with histological margins “non in sano” – analysis of our own data. Materials and methods: The retrospective study included 62 women after surgical resection of high-grade vulvar precancerosis with histological results of positive excision margins. Using the PubMed database, the results were compared with literary data. Results: Total of 35 (56.5%) patients underwent repeated surgery on the vulva. Inhalf of them (18–51.4%), histological results showed recurrence at the same stage, and in the second half of the women, no dysplastic changes were detected. There was no progression to invasive cancer in any of the patients. Conclusion: Beyond positive excision margins, the other predictive factors seem to be even more important for recurrence or progression of vulvar precancerosis including age, smoking, immunosuppression, radiotherapy, concomitant lesions in the vagina or cervix, and bioactivity of the human papilloma-virus. Instead of repeated resection to reach histological negative margins, we prefer the long-time, resp. long-life dispensarisation.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: vulvar intraepithelial neoplasia
  topic: keywords
subject: recurrence
  topic: keywords
subject: progression
  topic: keywords
subject: positive excision margins
  topic: keywords
subject: vulvar squamous cell carcinoma
  topic: keywords
creator: Daniel Driak
creator: Marek Pluta
creator: Miroslav Hricko
creator: Karel Hurt
rights: Copyright (c) 2026 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 16
ending page: 20

The influence of selected immunohistochemical and clinical-pathological markers on the prognosis of patients with malignant uterine tumors
type: item
description: Introduction: Endometrial carcinoma is the most common gynecological malignancy in developed countries, and its incidence has been increasing in recent decades. The prognosis of patients depends on a combination of clinical-pathological characteristics, and more recently, molecular indicators. The aim of this study was to analyze the influence of the selected prognostic markers – immunohistochemical (L1CAM, ER, PR) and classical (FIGO stage, grade, myometrial invasion, lymph node involvement, distant metastases) – on the survival of patients with endometrial carcinoma. Materials and methods: A retrospective evaluation was performed on 143 women with histologically confirmed endometrial cancer treated between 2014 and 2018. All patients underwent primary surgical treatment. Resected specimens were subjected to immunohistochemical analysis of L1CAM, ER, and PR. Data were statistically processed using a Kaplan-Meier analysis and the Cox proportional hazards model, adjusted to age. Results: L1CAM expression was detected in 14% of patients and was associated with shortened survival (HR ≈ 3.9). ER and PR positivity (89% and 85%, resp.) correlated with a more favorable prognosis (HR for ER positivity 0.21; PR 0.23). Classical factors such as higher grade, advanced FIGO stage, cervical and lymphovascular invasion, or presence in nodes were statistically associated with worse survival. An interesting finding was a significantly better prognosis in asymptomatic patients – the presence of symptoms increased the risk of death up to fourfold. Conclusion: L1CAM positivity and loss of hormone receptors are significant adverse prognostic factors. Their inclusion in routine immunohistochemical panel testing improves risk stratification and treatment personalization, which at the time of publication of this paper is already included in the updated ESGO-ESTRO-ESP 2025 guidelines. At the same time, it has been shown that the absence of symptoms at diagnosis is a favorable survival indi…
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: endometrial carcinoma
  topic: keywords
subject: L1 cell adhesion molecule
  topic: keywords
subject: estrogen receptors
  topic: keywords
subject: progesterone receptors
  topic: keywords
subject: survival
  topic: keywords
subject: symptoms
  topic: keywords
creator: Petra Herboltova
creator: Petra Ovesna
creator: Klara Dvorakova
creator: Tibor Focko
creator: Radovan Kastan
creator: Petr Stranik
creator: Vendula Smoligova
creator: Jan Kostun
creator: Jiri Presl
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 425
ending page: 434

Which causes less pain? A comparison of misoprostol and dinoprostone in labor induction
type: item
description: Objective: Effective labor pain management is essential in prenatal care. Identifying factors that contribute to increased pain in patients undergoing labor induction is essential for optimizing pain control. This study assesses pain levels in labor induction patients receiving vaginal misoprostol or dinoprostone for cervical ripening using a visual analogue scale (VAS). Materials and methods: This prospective study includes 60 volunteer women who received either vaginal dinoprostone (50%) or vaginal misoprostol (50%) as cervical ripening agents. Group 1 consists of patients who received misoprostol, while Group 2 includes those who were administered dinoprostone. VAS scores were recorded during both active labor and crowning. In addition to these pain assessments, birth outcomes and patient characteristics were documented, and comparative analyses were conducted between the groups. Results: According to VAS scores, pain intensity was significantly lower in Group 1 compared to Group 2 at both stages of labor (during active labor: 6.67 ± 2.68 vs. 7.77 ± 1.59, P < 0.05; during crowning: 8.9 ± 1.32 vs. 9.8 ± 0.55, P < 0.05). All participants’ pain scores recorded during crowning were significantly higher than those recorded during active labor (P < 0.05). No statistically significant difference was observed between the two agents in terms of oxytocin administration or the interval from drug administration to delivery (P > 0.05). Conclusions: Pain scores should be considered when selecting a cervical ripening agent. Misoprostol may be associated with lower pain levels.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: cervical ripening
  topic: keywords
subject: dinoproston
  topic: keywords
subject: labor pain
  topic: keywords
subject: misoprostol
  topic: keywords
subject: visual analogue scale
  topic: keywords
creator: Sultan Canan
creator: Sare Cansu Kalkan
creator: Selçuk Özden
creator: Hilal Uslu Yuvacı
creator: Mehmet Sühha Bostancı
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 442
ending page: 446

Comparison of the incidence of pelvic girdle pain and back pain in women after vaginal delivery and cesarean section in the Slovak female population
type: item
description: Background: A common problem in women after childbirth is the frequent occurrence of pelvic girdle pain (PGP) and back pain (LBP). To date, no study has been conducted to determine the prevalence of these types of pain. The aim of our study was to compare the incidence of PGP and LBP in women after vaginal delivery and cesarean section in the Slovak Republic over the course of one year in 2024. Methods: Cross-sectional study, the research sample consisted of 791 women 12 weeks to one year after delivery. The average age was 31.43 years. Standardized questionnaires were used for the Slovak version Pelvic Gridle questionnaire and Oswestry Disability Index. Conclusion: Based on the type of delivery, the sample was divided into a group with spontaneous delivery comprising 633 women and a group with cesarean section comprising 158 women. Significant differences were observed in the incidence of pain and disability in the spine and in its intensity, with stronger pain in the cesarean section group. The type of delivery did not affect the incidence of pelvic girdle pain after delivery. Cesarean section was associated with greater pain intensity and disability in the spine. Disruption of the integrity of the abdominal wall, increased sensitivity in the area of the cesarean section scar, and a restricted movement regime may explain the higher incidence of pain in the spine in women after cesarean section.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: childbirth
  topic: keywords
subject: pain
  topic: keywords
subject: spine
  topic: keywords
subject: pelvic girdle
  topic: keywords
creator: Michaela Hroncova
creator: Magdalena Hagovska
creator: Katarina Oravcová
creator: Viliam Knap
creator: Jan Svihra
rights: Copyright (c) 2025 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 21
ending page: 25

Age-specific incidence and mortality of cervical cancer in the Czech Republic – analysis of nationwide data and data from a gynecologic oncology center
type: item
description: Objective: To analyze the incidence and mortality of cervical cancer in individual age cohorts in the Czech Republic using nationwide data and data from the largest national gynecological oncology center. Materials and methods: Analysis of a single-institution cohort of newly treated cervical cancer cases from 2022–2024, and analysis of incidence and mortality trends in individual age groups using data from the Czech National Cancer Registry (ÚZIS – Institute of Health Information and Statistics) from 2000–2023. Results: The incidence and mortality of cervical cancer in the Czech Republic have declined significantly over the last 20 years. The decline correlates well with measures that have led to better organization and implementation of changes within the screening program. Analysis in individual age cohorts shows that the largest decline in incidence and mortality occurred in the cohort up to 34 years of age, yet in more than 50% of women with carcinomas in this cohort, cytological screening and subsequent management failed. The upward trend in incidence in the 35–44 and 45–54 age cohorts raises questions about the causes. The high percentage of invasive carcinomas in women examined by a gynecologist in the last three years requires an analysis of the quality of cytology laboratories and management by registering gynecologists. The introduction of high-risk human papillomavirus (HR HPV) testing and referral to expert colposcopy for discrepant findings is one way to improve the situation. Furthermore, audits of diagnosed carcinomas in women who have undergone screening should be introduced. The biggest challenge will be to activate the resistant population of women who underestimate the importance of regular screening examinations. Conclusion: Even though we can see an overall decline in incidence and mortality, when individual age cohorts are analyzed, it shows us ways for improvement in each specific age group of women individually.
subject: Gynecology and Obstetrics
  topic: section
subject: Review article
  topic: category
subject: cervical cancer
  topic: keywords
subject: screening
  topic: keywords
subject: incidence
  topic: keywords
subject: mortality
  topic: keywords
subject: cytology quality
  topic: keywords
subject: HR HPV test
  topic: keywords
creator: Karolina Robova
creator: Tomas Pichlik
creator: Lukas Rob
creator: Helena Robova
creator: Nikola Janovska
creator: Ruth Tachezy
creator: Michael J Halaska
rights: Copyright (c) 2026 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 61
ending page: 68

Cervical cancer screening in the European context – from cytology to primary HPV testing
type: item
description: Cervical cancer remains a major global health challenge, despite the availability of effective preventive measures such as human papillomavirus (HPV) vaccination, early detection and treatment of precancerous lesions, and timely management of early-stage disease. In recent years, several European countries have introduced substantial changes to their screening strategies –shifting from conventional cytology to primary HPV testing. This shift, supported by the World Health Organization and International Agency for Research on Cancer recommendations, is underpinned by numerous clinical studies demonstrating the superior sensitivity of HPV testing for detecting high-grade cervical lesions. This article provides an up-to-date overview of cervical cancer screening across Europe, with a focus on screening methods, testing intervals, program organization, and the emerging role of self-sampling.
subject: Gynecology and Obstetrics
  topic: section
subject: Review article
  topic: category
subject: cervical cancer
  topic: keywords
subject: human papillomavirus
  topic: keywords
subject: screening
  topic: keywords
subject: oncologic cytology
  topic: keywords
subject: prevention
  topic: keywords
creator: Nikola Janovska
creator: Lukas Rob
creator: Tomas Pichlik
creator: Borek Sehnal
creator: Karolina Robova
creator: Michael J. Halaska
creator: Helena Robova
rights: Copyright (c) 2026 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 69
ending page: 76

HLA-C and KIR interactions as a possible cause of reproductive failures
type: item
description: Objective: Despite advancements in assisted reproduction, the cause of up to 50% of cases of idiopathic fertility disorders remains unclear. The immune system, particularly the interaction between human leukocyte antigen-C (HLA-C) molecules on the trophoblast and killer--cell immunoglobulin-like receptors (KIR) on uterine natural killer (NK) cells, plays a crucial role in implantation and placental development. The aim of this analysis was to evaluate our experience with testing KIR/HLA-C compatibility and its potential role in personalizing infertility treatment. Methods: This is an interventional study examining the success of therapy in 23 couples who underwent infertility treatment with donated gametes between 1/2023 and 12/2024, with additional consideration of KIR/HLA-C compatibility between the recipient and the donor. For better homogeneity of the sample, patients in the intervention group were divided into two subgroups. The first subgroup consisted of 14 couples undergoing their first therapy with donated gametes. The second subgroup consisted of 9 couples with a history of repeated unsuccessful embryo transfers from donated gametes. A control group of 320 single embryo transfers with donated gametes from couples treated using standard methods between 1/2023 and 12/2024 was used for comparison. Results: In both intervention subgroups, success rates were comparable. Clinical pregnancy was achieved in 62.5% and 63.6%, resp., which exceeded the average success rate of 55.2% in the control group. Conclusion: The high number of achieved clinical pregnancies in a prognostically unfavorable group, burdened by repeated unsuccessful embryo transfers, appears to be a therapeutic success. It is important to bear in mind the low number of evaluated transfers; however, this result suggests that testing KIR/HLA-C compatibility between the recipient and the donor and taking it into account when selecting a donor may significantly increase the success of therapy in indica…
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: killer-cell immunoglobulin-like receptors
  topic: keywords
subject: human leukocyte antigen-C
  topic: keywords
subject: uterine natural killer cells
  topic: keywords
subject: infertility
  topic: keywords
subject: repeated implantation failure
  topic: keywords
subject: granulocyte-colony stimulating factor
  topic: keywords
subject: immunogenetics
  topic: keywords
creator: Eva Stastna
creator: Hana Visnova
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 435
ending page: 441

Negative pressure wound therapy in gynecologic oncology – current knowledge and clinical applications
type: item
description: Negative pressure wound therapy is a modern and effective method for the prevention and treatment of postoperative wound healing complications, with growing applications in gynecology and especially in gynecologic oncology. Its mechanism of action includes enhanced drainage, reduction of edema, promotion of angiogenesis, and stimulation of granulation tissue formation, ultimately contributing to faster healing and a lower risk of infection, seroma, and wound dehiscence. Negative pressure wound therapy has been shown to be effective in the therapeutic management of complex, infected, or dehiscent wounds following gynecologic‑oncologic surgery. Recent studies also suggest that its prophylactic application to primarily closed incisions after laparotomy or vulvectomy may significantly reduce surgical complications, shorten hospitalization, and accelerate recovery, which is particularly important in patients scheduled for adjuvant therapy. However, because most available evidence is based on retrospective studies, further prospective randomized trials are needed to confirm the role of this method in both therapeutic and prophylactic use and to guide its integration into standard perioperative care in gynecologic oncology.
subject: Gynecology and Obstetrics
  topic: section
subject: Review article
  topic: category
subject: negative pressure wound therapy
  topic: keywords
subject: wound healing
  topic: keywords
subject: surgical wound dehiscence
  topic: keywords
subject: gynecologic surgery
  topic: keywords
subject: gynecologic malignancies
  topic: keywords
creator: Klara Balcarova
creator: Petra Bretova
creator: Munachiso Iheme Ndukwe
creator: Daniel Lesko
creator: Martin Stepan
creator: Jiri Spacek
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 495
ending page: 502

Epidemiological profile of pregnant women and perinatal outcomes of newborns with gastroschisis from a single reference center in Northeastern Brazil
type: item
description: Objective: To determine the maternal epidemiological profile and perinatal outcomes of fetuses with gastroschisis at a reference center in Northeastern Brazil. Methods: A retrospective cohort study was conducted between January 2014 and December 2022 using medical records. Inclusion criteria comprised of pregnancies ≥ 24 weeks, with a prenatal diagnosis of gastroschisis confirmed in the postnatal period. Results: During the study period, 1,773 newborns with congenital anomalies were born at the service center, 50 were identified as having gastroschisis and four cases were excluded. Prevalence of gastroschisis was 11.5/10,000. Regarding the maternal sociodemographic profile, the mean age was 21 years, 38/46 (83%) were mixed, 34/46 (74%) had a partner, and 32/46 (70%) had high school education. Regarding associated maternal diseases, only 6/46 (13%) had hypertension, none had pre-existing diabetes mellitus, and 4/46 (8.7%) developed gestational diabetes mellitus. As for gastroschisis type, 33/46 (71%) were classified as simple, 11/46 (23.9%) as complex and 2/46 (4.4%) had no information. In 36/46 newborns with gastroschisis, primary closure was performed in the first surgery. The mean time of use of mechanical ventilation was 13 days, the mean time interval between surgery and ambient air was 8 days, the mean time of use of parenteral nutrition was 35 days, and the mean length of stay in the neonatal intensive care unit (NICU) was 39 days. Clinical complications in newborns with gastroschisis included neonatal infection in 35/46 (76%), blood transfusion in 33/46 (72%), hydroelectrolytic disorders and sepsis in 29/46 (63%), and cholestasis and fungal infection/sepsis in 8/46 (17%). Neonatal death occurred in 16/46 (34.8%). Conclusion: Newborns with gastroschisis presented high rates of surgery with primary closure, blood transfusion and neonatal infection. Furthermore, we identified prolonged use of parenteral nutrition, long stay in the NICU, and prolonged use of anti…
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: gastroschisis
  topic: keywords
subject: prevalence
  topic: keywords
subject: epidemiological profile
  topic: keywords
subject: perinatal outcomes
  topic: keywords
subject: reference center
  topic: keywords
creator: Cinthia Maria Gomes da Costa Escoto Esteche
creator: Edward Araujo Junior
creator: Beatriz da Costa Escoto Esteche
creator: Liliam Cristine Rolo
rights: Copyright (c) 2025 Česká gynekologie
date: 2026-03-12
publication date: 2026-03-12
starting page: 26
ending page: 34

Comparative analysis of the histological architecture of ovarian tissue following slow-freezing cryopreservation
type: item
description: Objective: The aim of this study was to validate the methodology of ovarian tissue cryopreservation using the slow freezing technique as a fertility preservation approach and to assess its potential implementation in clinical practice at the Assisted Reproduction Centre of the University Hospital Olomouc. In parallel, the technical procedure of cryopreservation was optimized and standardized. Materials and methods: The study was conducted between April 2022 and December 2024 at the Department of Obstetrics and Gynecology, University Hospital Olomouc, and included six transgender patients aged 19–25 years who underwent laparoscopic hysterectomy with bilateral adnexectomy as part of gender--affirming surgery. Ovarian tissue obtained during the procedure was immediately processed and cryopreserved using the slow freezing method at the Assisted Reproduction Centre of the University Hospital Olomouc. Histopathological evaluation of the ovarian tissue was performed both prior to cryopreservation and after thawing at the Department of Clinical and Molecular Pathology. Results: Morphological assessment of the ovarian tissue after cryopreservation confirmed preservation of structural characteristics of follicles and stromal components, without signs of significant degeneration. Conclusion: The results confirm that the applied slow freezing protocol for ovarian tissue cryopreservation is appropriate and sufficiently gentle for clinical use. This method represents a reliable option for fertility preservation in patients undergoing gonadectomy, with potential applications in subsequent autologous transplantation or in vitro follicle culture.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: fertility preservation
  topic: keywords
subject: ovarian tissue cryopreservation
  topic: keywords
subject: slow-freezing
  topic: keywords
subject: oncofertility
  topic: keywords
subject: assisted reproduction
  topic: keywords
subject: in vitro fertilization
  topic: keywords
subject: transgender
  topic: keywords
creator: Veronika Honcova
creator: Jan Vodicka
creator: Zuzana Slobodova
creator: Radovan Pilka
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 349
ending page: 359

Atypical placental site nodule detected via hysteroscopy – first case report from Brazil
type: item
description: Atypical placental site nodule (APSN) is a rare form of gestational trophoblastic disease (GTD) originating from the proliferation of intermediate trophoblasts, with uncertain clinical behavior. It is considered a potential precursor to rare forms of gestational trophoblastic neoplasia (GTN), such as placental site trophoblastic tumor (PSTT) and epithelioid trophoblastic tumor (ETT). This report describes the first Brazilian case of APSN diagnosed via hysteroscopy in a 43-year-old woman following miscarriage. Histopathological analysis revealed a circumscribed, hyalinized aggregate of intermediate trophoblasts with nuclear atypia, positive immunostaining for PLAP and p63, and a Ki-67 index > 5%. The patient declined hysterectomy, opting for conservative management with close monitoring. After 12 months of follow-up, no progression was observed. This case emphasizes the diagnostic challenges of APSN, given its subtle presentation and overlap with benign placental site nodules or even PSTT/ETT. Hysteroscopy proved valuable for both diagnosis and fertility-preserving management. Although hysterectomy remains the definitive treatment in many cases, individualized approaches balancing oncologic safety and reproductive goals are increasingly considered. Long-term clinical vigilance is essential, as APSN may precede aggressive GTN forms. Multicenter studies and registries are urgently needed to establish evidence-based guidelines for the diagnosis, treatment, and follow-up of this rare lesion, improving patient outcomes in these uncommon forms of GTD.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: atypical placental site nodule
  topic: keywords
subject: gestational trophoblastic disease
  topic: keywords
subject: gestational trophoblastic neoplasia
  topic: keywords
subject: placental site trophoblastic tumor
  topic: keywords
subject: epithelioid trophoblastic tumor
  topic: keywords
creator: Antonio Braga
creator: Gabriela Paiva
creator: Lilian Padron
creator: Aretha Nobre
creator: Juliana Soares Pereira
creator: Gustavo Yano Callado
creator: Joffre Amin Junior
creator: Sue Yazaki Sun
creator: Edward Araujo Júnior
creator: Jorge Rezende-Filho
creator: Neil Horowitz
creator: Ross Berkowitz
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 479
ending page: 485

Not every seizure is eclampsia – a rare case of a brain abscess in a pregnant woman caused by Streptococcus pneumoniae from a dental source
type: item
description: We present a rare case of a brain abscess in a pregnant woman due to an untreated dental abscess, initially presenting as a new-onset seizure. This article highlights the need for a broad differential diagnosis for seizures in pregnancy, extending beyond the common assumption of eclampsia, and further emphasizing the importance of thorough history-taking and physical examination. We suggest integrating routine dental care into prenatal healthcare to reduce the risk of such serious events. Informed consent was obtained, and all identifiable information has been de-identified to protect patient confidentiality.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: seizure
  topic: keywords
subject: brain abscess
  topic: keywords
subject: pregnancy
  topic: keywords
creator: Dania M. Moamar
creator: Mus'ab Mustafa
creator: Reema Ismaeel
creator: Farah Alshamasneh
creator: Nedal S. Abusidreh
creator: Osama M. Jamous
creator: Naser Aldain A. A. Abu Lehyah
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 474
ending page: 478

Sperm navigation mechanisms
type: item
description: Objective: Mechanisms of sperm navigation are important for understanding the principles of sperm selection prior to fertilization. The aim of this work is to provide an overview of current knowledge about the physiological process of sperm navigation from ejaculation to fertilization of the ovulated oocyte. Methods: Literature search of the PubMed database published up to June 2025 with terms focusing on “sperm navigation,” “fertilization,” and “chemoattractants”. Results: The principles of sperm navigation in the in vivo environment are still unclear in humans. Currently, there are simple in vivo studies performed on model animals, as well as a number of in vitro studies on human sperm. Based on these results, three main navigation systems are described: rheotaxis, thermotaxis, and chemotaxis. Rheotaxis acts over the longest distances and stimulates sperm movement against the flow of fluid. Thermotaxis acts over a shorter distance and guides sperm to places with higher temperatures. Chemotaxis acts over the shortest distance, attracting capacitated sperm to places where the ovulated oocyte is located. Conclusion: Given how massively the sperm microinjection technique is used in the treatment of human infertility, it is important to carefully select sperm prior to fertilization. Knowledge of the principles of human sperm selection in in vivo conditions is crucial for effective sperm selection in the laboratory.
subject: Gynecology and Obstetrics
  topic: section
subject: Review article
  topic: category
subject: navigace spermií
  topic: keywords
subject: chemoatraktanty
  topic: keywords
subject: oocyt
  topic: keywords
subject: spermie
  topic: keywords
subject: fertilizace
  topic: keywords
creator: Michal Ješeta
creator: Karolina Lostakova
creator: Lenka Mekinova
creator: Eva Lousova
creator: Katerina Remundova
creator: Robert Hudecek
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 486
ending page: 494

Arteriovenous malformation developing in a cesarean scar after termination of pregnancy – a case report and review of the literature
type: item
description: Uterine arteriovenous malformations (AVMs) are a rare cause of severe uterine bleeding. Uterine traumas, such as cesarean section or abortion, are known risk factors. In this article, we present a rare case of an AVM that developed in a patient with a history of a previous cesarean section and recent abortion. In this case, we review the pathogenesis, diagnosis, and treatment strategies of AVMs that develop in cesarean scars in light of the current literature. The patient presented with 2 months of vaginal bleeding that led to life-threatening anemia. Doppler ultrasound identified an AVM in the cesarean scar. Given the hemodynamic status of the patient, an emergency surgical intervention was performed and the AVM was successfully treated. This case highlights that AVM should be primarily considered in the differential diagnosis of severe bleeding in patients with a ”double-hit” risk, such as a cesarean section followed by subsequent uterine trauma, and that emergency surgical intervention can be life-saving.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: uterine arteriovenous malformation
  topic: keywords
subject: cesarean scar
  topic: keywords
subject: induced abortion
  topic: keywords
subject: uterine hemorrhage
  topic: keywords
subject: case report
  topic: keywords
subject: literature review
  topic: keywords
creator: Yusuf Ziya Kızıldemir
creator: Sezin Eda Karslı
creator: Işıl Işık Okuyan
creator: Çağrı Kutlugün Emral
creator: Merve Civelek
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 469
ending page: 473

Twin pregnancy in a caesarean scar – a case study and literature review of therapeutic approaches
type: item
description: Caesarean scar pregnancy is a rare form of ectopic pregnancy. It can be reliably diagnosed through transvaginal ultrasonography, typically during the 1st or early 2nd trimester. While one-third of patients remain asymptomatic, others may develop severe complications. The most common symptoms are vaginal bleeding and abdominal pain, with rare cases involving uterine rupture or the development of placenta accreta spectrum. Caesarean scar pregnancy is associated with a risk of various complications and poses a risk factor for future pregnancies. In many cases, surgical intervention cannot be avoided. Treatment options include surgical management or medical therapy. In some cases, an expectant management approach may be chosen. No single treatment method has yet been definitively established as sufficiently rapid, safe, and effective. This case report presents a patient with twin pregnancy in a caesarean scar, in whom a conservative approach was chosen due to the low gestational age. Additionally, we provide a literature review of the current therapeutic options for managing this challenging condition.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: Review article
  topic: category
subject: ectopic pregnancy
  topic: keywords
subject: caesarean scar pregnancy
  topic: keywords
subject: twin pregnancy
  topic: keywords
subject: pregnancy
  topic: keywords
creator: Lukas Vanek
creator: Jan Zapletal
creator: Borek Sehnal
creator: Lukas Rob
creator: Michael J. Halaska
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 463
ending page: 468

Postoperative analgesia in breast cancer surgeries – anesthetic techniques and the role of cytokines
type: item
description: Objectives: To examine the relationships between postoperative pain and anesthetic technique and analgesic use, to compare preoperative and postoperative serum cytokine levels, and to determine the influence of the anesthetic technique on these levels in patients undergoing breast cancer surgery. Materials and methods: Thirty-six patients undergoing oncological breast surgery were allocated to general anesthesia only (G; N = 20) and general anesthesia with erector spinae plane block (ESPB, E; N = 16) groups. Postoperative pain intensity was evaluated using a visual analogue scale at three periods (M): 2, 24, and 48 hours after the end of surgery (M2, M24, and M48, resp.). Blood was collected preoperatively, before the induction of general anesthesia (M0), and at M24 and M48. Plasma interleukin (IL) -1, IL-8, and tumor necrosis factor-α (TNF-α) levels were determined by enzyme-linked immunosorbent assay. Associations between categorical variables were evaluated using the Fisher’s exact test. Pain scores and cytokine levels were compared between groups G and E and between patients undergoing mastectomy and quadrantectomy using repeated-measures analysis of variance. The significance level adopted for all tests was 5.0%. Results: Moderate to severe pain was more frequent in group G than in group E at M24 (P = 0.016). The IL-8 level was lower in group E than in group G (P = 0.029). In the whole cohort, TNF-α level was reduced at M48 (P = 0.010), IL-8 level was reduced at M24 (P < 0.001), and IL-1 level was increased at M48 (P < 0.001). Conclusions: ESPB is an effective alternative in cases with contraindications or technical difficulties with other anesthetic techniques, such as epidurals. Its use could improve women’s quality of life and health after breast cancer surgery.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: mastectomy
  topic: keywords
subject: segmental mastectomy
  topic: keywords
subject: cytokines
  topic: keywords
subject: neuromuscular blockade
  topic: keywords
subject: general anesthesia
  topic: keywords
creator: Paula Borela Perfeito Abud
creator: Flora Margarida Barra Bizinoto
creator: Natália Nunes Santos
creator: Letícia Tereza Dornelas de Melo
creator: Rafaela Barcelos Andrade
creator: Bruno Henrique Gomes Parizzi
creator: Millena Prata Jammal
creator: Douglas Côbo Micheli
creator: Eddie Fernando Candido Murta
creator: Rosekeila Simões Nomelini
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-12-29
publication date: 2025-12-29
starting page: 447
ending page: 456

Vaginal fisting and risk of anogenital injury
type: item
description: Vaginal fisting is an uncommon and risky sexual practice. It consists of penetrating the vagina with one or both hands. Fisting is practiced as heterosexual, homosexual, or autoerotic activity and may be the cause of vaginal injury and circumjacent organs. The article describes the case of a 33-year old pornographic film actress who developed vaginal injury and heavy bleeding during fisting while filming. Rupture of the vagina was sutured and blood loss was replenished with transfusions.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: fisting
  topic: keywords
subject: vaginal injury
  topic: keywords
subject: hemorrhage
  topic: keywords
creator: Daniel Driak
creator: Albert Zajicek
creator: Zlatko Pastor
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 385
ending page: 387

Placental insufficiency and late-onset growth restriction in fetuses appropriate for gestational age
type: item
description: Fetal growth restriction is a condition in which the fetus fails to reach its genetically determined growth potential, most often as a result of impaired placental function. The late-onset form, which develops after 32 weeks of gestation, poses a significant diagnostic challenge due to its subtle clinical and sonographic manifestations. Placental insufficiency is usually associated with pregnancies that meet the established diagnostic criteria for fetal growth restriction. However, there is increasing evidence to suggest that even fetuses with an estimated weight appropriate for gestational age may be affected by a subclinical form of this condition. Typical features of advanced placental dysfunction include abnormal Doppler flow patterns, a slowed fetal growth trajectory, altered levels of maternal serum biomarkers, and specific histopathological findings in the placenta. Despite advances in prenatal diagnostics, there is still no reliable tool capable of identifying pregnancies complicated by placental insufficiency in a timely manner, especially in cases without overt fetal growth deviation. This diagnostic gap limits our ability to identify fetuses at increased risk of adverse perinatal outcomes.
subject: Gynecology and Obstetrics
  topic: section
subject: Review article
  topic: category
subject: placental insufficiency
  topic: keywords
subject: doppler ultrasound
  topic: keywords
subject: biochemical markers
  topic: keywords
subject: placental histopathology
  topic: keywords
subject: late-onset fetal growth restriction
  topic: keywords
creator: Ludek Kostka
creator: Marta Jezova
creator: Zuzana Mikulenkova
creator: Anna Jouzova
creator: Lukas Hruban
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 398
ending page: 406

Diabetes mellitus and pregnancy, how to analyze national individual-level data
type: item
description: Objective: This study aims to present the methodological framework and analytical approaches for utilizing national individual- -level data on diabetes mellitus in pregnancy, a condition that poses a significant risk to the health of both mother and child. Materials and methodology: The National Health Information System serves as the central repository for data on the Czech healthcare system. Through the integration of various recorded datasets, it enables detailed analysis of the incidence of diabetes mellitus in connection with pregnancy, provided that an appropriate analytical algorithm is applied. The input dataset for the analysis consisted of births recorded between 2012 and 2023 in the National Register of Reproductive Health, specifically the Mothers module. In total, 1,240,227 births were included in the analysis. For each case, the presence of the disease was verified using records from the National Register of Reimbursed Health Services. Results and conclusion: Based on the defined criteria, including specific medications, reported medical procedures, medical devices, and disease diagnoses, the prevalence of diabetes mellitus among parturient women was determined to be 15.4%. Thanks to the interconnected structure of the National Health Information System and newly established definition of a pregnant woman with diabetes, it will be possible to continue analyzing the prevalence and health impacts of this condition at the national level.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: diabetes mellitus
  topic: keywords
subject: continuous glucose monitoring
  topic: keywords
subject: gestational diabetes
  topic: keywords
subject: glycemic control
  topic: keywords
subject: pregnancy
  topic: keywords
creator: Jitka Jirova
creator: Katerina Anderlova
creator: Hana Krejci
creator: Vratislav Krejci
creator: Patrik Simjak
creator: Lenka Szczukova
creator: Jiri Jarkovsky
creator: Antonin Parizek
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 366
ending page: 372

Ovarian vascular malformation – clinical presentation of Cowden syndrome
type: item
description: Objective: We describe a case of a young girl diagnosed with vascular malformation of the left ovary and genetically confirmed Cowden syndrome. Case report: Clinically, the girl had no gynecological problems, but there was swelling of the right knee after physical exercise. The predominant finding on imaging was a venolymphatic malformation arising from the musculus vastus medialis detected by magnetic resonance imaging. After puncture of the lesion, the biopsy specimen was subjected to genetic examination, which revealed a heterozygous PTEN gene mutation. This proved Cowden syndrome at the molecular level. At the same time, heterogeneous expansion in the region of the left ovary was described on magnetic resonance imaging. Based on staging, diagnostic laparoscopy with lavage was indicated. Perioperatively, multiple adhesions in the small pelvis and a tumor arising from the left ovary were detected. Partial resection of the left ovary was performed, and perioperative cryobiopsy confirmed a vascular malformation, with no concomitant findings of a benign tumor or malignancy. Definitive histological examination of the resected left ovary showed the presence of vascular malformations, which clinically corresponds to possible symptoms of Cowden syndrome. Conclusion: Cowden syndrome is a rare genetic disorder whose diagnosis is based on clinical manifestations, imaging studies, and subsequent genetic testing. Follow-up of patients abides by the National Comprehensive Cancer Network recommendations and requires a multidisciplinary approach.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: Review article
  topic: category
subject: Cowden syndrome
  topic: keywords
subject: PTEN hamartoma tumor syndrome
  topic: keywords
subject: breast and endometrial tumors
  topic: keywords
subject: vascular malformations
  topic: keywords
creator: Jana Pavlacka
creator: Michal Felsinger
creator: Lubos Minar
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 388
ending page: 394

Effect of kisspeptin, neurokinin, and dynorphin neurons on regulation of reproduction
type: item
description: Gonadotropin-releasing hormone pulsatility is under the influence of hypothalamic neuropeptides, especially neurons expressing kisspeptin, neurokinin B, and dynorphin. These hypothalamic cells are called KNDy neurons. By integrating hormonal and environmental stimuli in the brain, they modulate the effects on neuropeptide release and control the frequency and amplitude of pulses. The relationship between KNDy neurons and gonadal hormones is essential for the initiation of puberty, regulation of the menstrual cycle, and reproduction. Steroid hormones have a feedback effect on the modulation of the activity of KNDy neurons, as their membrane and cell nucleus express receptors for estradiol, progesterone, and testosterone. Recent research suggests a close relationship with the pathophysiology of infertility, pathological pregnancy, menstrual cycle disorders, polycystic ovary syndrome, endometriosis, and vasomotor symptoms in perimenopause.
subject: Gynecology and Obstetrics
  topic: section
subject: Review article
  topic: category
subject: kisspeptin
  topic: keywords
subject: neurokinin
  topic: keywords
subject: dynorphin
  topic: keywords
subject: menstrual cycle
  topic: keywords
subject: reproduction
  topic: keywords
subject: menopause
  topic: keywords
subject: polycystic ovary syndrome
  topic: keywords
subject: endometriosis
  topic: keywords
creator: Jana Rackova
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 413
ending page: 417

Determination of markers of ethyl alcohol consumption in pregnancy
type: item
description: Prenatal alcohol exposure (PAE), with a global prevalence of approximately 10%, is the most common preventable cause of fetal morbidity, with fetal alcohol syndrome representing its most severe manifestation. The current gold standard for diagnosing PAE relies on self-reported questionnaires; however, underreporting remains a significant limitation. Consequently, there is a need for objective diagnostic methods. Among the most promising biomarkers are ethanol metabolites present in the first stool of newborns (meconium). In this preliminary study, we quantified ethyl glucuronide (EtG) and ethyl sulfate (EtS) in meconium samples and compared the results with self-reported PAE data from questionnaires. The study included 51 pregnant women. A meconium sample was collected from each newborn and analyzed using liquid chromatography-mass spectrometry. All participants were asked to complete a questionnaire regarding alcohol consumption during pregnancy. EtG was detected in 41 samples (80.3%) and EtS was present in all 51 samples (100%). Three of the 51 women did not complete the questionnaire. Of the remaining 48, six (11.7%) reported alcohol consumption during pregnancy. The median concentrations of EtG and EtS were 49.6 ng/g and 13.9 ng/g, respectively. Median levels of both biomarkers were higher among women who reported alcohol use compared to those who denied it. Notably, EtG concentrations exceeding 30 ng/g – previously suggested in the literature as a potential cutoff for PAE – were found in 82.35% of women who reported no alcohol use. This study confirms that EtG and EtS are reliable markers of ethanol exposure in meconium. However, we were unable to determine definitive cutoff values for PAE based on these biomarkers. Elevated EtG levels in women who denied alcohol consumption may be attributable to alternative sources of ethanol exposure or endogenous ethanol production. The possibility of underreporting PAE also cannot be ruled out.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: fetal alcohol syndrome
  topic: keywords
subject: meconium
  topic: keywords
subject: biomarkers
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subject: prenatal alcohol exposure
  topic: keywords
creator: Maros Boda
creator: Andrej Chyba
creator: Jozef Zahumensky
creator: Petra Psenkova
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 360
ending page: 365