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: 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: 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: 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
items: Radiation-induced angiosarcoma of the breast – experience from clinical practice
items: Can anti-Müllerian hormone predict positive sperm retrieval in men with idiopathic non-obstructive azoospermia?
items: Robotic-assisted cesarean scar defect repair
items: Prevalence and hormonal profiling of secondary amenorrheic patients presenting to a fertility clinic – an observational study
items: Laser therapy for type III fetal congenital cystic adenomatoid malformation
items: Coincidental maternal mortality in Slovakia in the years 2007–2024
items: Prenatal treatment of posterior urethral valves in a newborn with anorectal stenosis
items: Accuracy of a modified CMT+ for assessing pelvic floor muscle contraction in pregnancy
items: Early detection of recurrent ovarian cancer, current use of oncomarkers, imaging methods, and future perspectives
items: Role of tru-cut biopsy in the management of myometrial lesions
items: Results of the Endometriosis Health Profile-30 questionnaire in women aged 18–30 years in the Czech Republic
items: Laparoscopic management of ovarian torsion at 26 weeks of gestation

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

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

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

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
  topic: keywords
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

Radiation-induced angiosarcoma of the breast – experience from clinical practice
type: item
description: Angiosarcoma (AS) is a rare malignant tumor originating from the endothelial cells of blood or lymphatic vessels. It is characterized by an aggressive course with a high risk of generalization. The most frequent sites of metastasis include the skin, soft tissues, breasts, liver, and heart. Clinical symptoms vary depending on the site of origin. The most common include erythema, skin efflorescence, swelling, and tenderness. Diagnosis of AS is established based on histopathological examination with evidence of atypical endothelial cells and vascular structures. Imaging methods are used as supplementary examinations and help in determining the location and extent of the tumor. In this publication, we focus on the secondary type of angiosarcoma, which has been increasingly described in recent years in the irradiated breast area after breast-conserving surgery. We describe three case reports of patients comprehensively treated at our institution. A relatively long remission, spanning several years, is typical. The essential basis of AS treatment is surgical removal of the tumor with intact resection margins. Due to the size of the defect after resection, simple suturing of the skin cover is often insufficient, and collaboration with a plastic surgeon is necessary for the reconstruction of the resulting defect. Professional literature does not unequivocally state the sufficient width of the healthy tissue margin during resection. The benefit of adjuvant chemotherapy or radiotherapy is debatable. Prognosis is generally poor due to insufficient sensitivity to non-surgical treatment modalities and the speed of metastasis.
subject: Gynecology and Obstetrics
  topic: section
subject: Review article
  topic: category
subject: radiation-induced angiosarcoma of the breast
  topic: keywords
subject: secondary breast angiosarcoma
  topic: keywords
subject: radiotherapy
  topic: keywords
subject: breast cancer
  topic: keywords
subject: radiotherapy complications
  topic: keywords
subject: soft tissue sarcoma
  topic: keywords
subject: malignant vascular tumor
  topic: keywords
subject: post-radiation sarcoma
  topic: keywords
subject: angiosarcoma diagnosis
  topic: keywords
subject: angiosarcoma treatment
  topic: keywords
subject: prognosis
  topic: keywords
subject: breast resection
  topic: keywords
creator: Sabina Frydova
creator: Ivana Meixnerova
creator: Michaela Koblizkova
creator: Dagmar Brancikova
creator: Pavel Rotschein
creator: Lubos Minar
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 407
ending page: 412

Can anti-Müllerian hormone predict positive sperm retrieval in men with idiopathic non-obstructive azoospermia?
type: item
description: Objective: To eval<span class="NormalTextRun SpellingErrorV2Themed SCXW76582303 BCX8" data-ccp-charstyle="nedelit" data-ccp-charstyle-defn="{"ObjectId":"386dc8c1-255b-5a14-a7f1-5777b3628f91|1","ClassId":1073872969,"Properties":[469775450,"nedelit",201340122,"1",134233614,"true",469778129,"nedelit",335572020,"99",134224902,"false",201334293,"17",201342446,"1",201342447,"5",201342448,"1",201342449,"1",469777841,"Calibri",469777842,"",469777843,"Calibri",469777844,"Calibri",201341986,"1",469769226,"Calibri",268442635,"22"]}">uate whether serum anti-Müllerian hormone (AMH) levels can predict sperm retrieval (SR) outcomes in men with idiopathic non-obstructive azoospermia (iNOA) undergoing microdissection testicular sperm extraction (mTESE), and to develop a predictive model that may inform clinical decision-making. Materials and methods: This retrospective, multicenter cohort study included 72 men diagnosed with iNOA who underwent mTESE between December 2022 and May 2023 at two IVF centers in Turkey. Serum AMH and follicle stimulating hormone (FSH) levels were measured prior to surgery. Patients were categorized into TESE-positive (+SR) and TESE-negative (−SR) groups based on the presence of spermatozoa in testicular tissue. Hormonal and clinical parameters were compared between groups, and a multivariate logistic regression model was constructed to identify independent predictors of SR outcome. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic accuracy and optimal cutoff values for AMH and FSH. Results: Out of 72 patients, 37 (51.4%) had successful SR and 35 (48.6%) did not. Median AMH and FSH levels were significantly higher in the −SR group (P = 0.001 and P = 0.044, resp.). Multivariate logistic regression analysis identified serum AMH as the only independent predictor of positive SR outcome (P < 0.001). ROC analysis revealed excellent diagnostic performance for AMH (AUC = 0.909), with an optimal cutoff value of 3.4 ng/m…
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: idiopathic non-obstructive azoospermia
  topic: keywords
subject: Anti-Müllerian hormone
  topic: keywords
subject: microdissection testicular sperm extraction
  topic: keywords
subject: sperm retrieval
  topic: keywords
subject: biomarker
  topic: keywords
subject: male infertility
  topic: keywords
creator: Mehmet Cengiz Çolakoğlu
creator: Jule Eriç Horasanlı
creator: Mesut Tül
creator: Berna Gencel
creator: Fatih Akkuş
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-08-28
publication date: 2025-08-28
starting page: 285
ending page: 292

Robotic-assisted cesarean scar defect repair
type: item
description: The rising global incidence of cesar<span class="NormalTextRun SpellingErrorV2Themed SCXW154722919 BCX8" data-ccp-charstyle="nedelit" data-ccp-charstyle-defn="{"ObjectId":"386dc8c1-255b-5a14-a7f1-5777b3628f91|1","ClassId":1073872969,"Properties":[469775450,"nedelit",201340122,"1",134233614,"true",469778129,"nedelit",335572020,"99",134224902,"false",201334293,"17",201342446,"1",201342447,"5",201342448,"1",201342449,"1",469777841,"Calibri",469777842,"",469777843,"Calibri",469777844,"Calibri",201341986,"1",469769226,"Calibri",268442635,"22"]}">ean deliveries has led to a marked increase in associated obstetric and gynecological complications, notably the cesarean scar defect. Clinical management decisions are predominantly guided by patient-reported symptoms, reproductive goals, and individual anatomical considerations. The literature currently lacks definitive guidelines recommending a singular optimal approach. The recent advent and incremental adoption of robotic surgery has introduced a promising new technique, characterized by enhanced surgical precision, improved visualization, reduced morbidity, and rapid patient recovery. Ultimately, embracing robotic-assisted surgery for cesarean scar defect repair represents a critical advancement in gynecological surgery.
subject: Gynecology and Obstetrics
  topic: section
subject: Review article
  topic: category
subject: Cesarean scar defect, Cesarean scar syndrome, scar defect repair, robotic- assisted scar repair, isthmocele repair
  topic: keywords
subject: defekt jazvy po cisárskom reze, syndróm jazvy po cisárskom reze, oprava jazvy, roboticky asistovaná oprava jazvy, oprava istmokély
  topic: keywords
creator: Erik Dosedla
creator: Zuzana Ballová
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-08-28
publication date: 2025-08-28
starting page: 339
ending page: 342

Prevalence and hormonal profiling of secondary amenorrheic patients presenting to a fertility clinic – an observational study
type: item
description: Objective: Amenorrhea is a menstrual disorder than can arise as a result of hormonal dysfunction of the hypothalamic-pituitary--gonadal axis. There is limited data on the most common causes of secondary amenorrhea in Pakistan. Therefore, this study aimed to assess various causative factors along with hormone profiling in patients with secondary amenorrhea. Patients and methods: The present cross- -sectional study was conducted in different fertility clinics of Abbottabad. Patients with secondary amenorrhea were included by a non-probability sampling technique. Data related to demographic and other clinical variables were collected via a data collection form. Serum progesterone, estradiol, luteinizing hormone, follicle stimulating hormone, and prolactin were determined using commercially available enzyme-linked immunosorbent assay kits. This study was conducted on 126 patients with a mean age of 28.5 ± 7.8 years. Results: Drug-related amenorrhea was observed in 14.3% of patients. Hyperprolactinemia-induced amenorrhea was observed in 31.7% and in 54% of patients with unknown etiology. Of the patients with drug-induced amenorrhea, 38.9% used oral contraceptives, 27.8% used omeprazole, and 33.3% used other drugs. Headache (79.4%) and fatigue (78.6%) were the main symptoms reported in amenorrheic women, while hair loss was reported in 65.9% of patients. Both loss of libido and hirsutism were observed in 45.2% and 42.9% of patients, resp. Breast pain and vaginal dryness occurred in 35.7% and 23.8% of patients, resp. Conclusion: The current study showed that hyperprolactinemia is the most common cause of secondary amenorrhea followed by drug-induced amenorrhea, which must be considered in the clinical management of hormonal imbalances and subsequent amenorrhea.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: amenorrhea
  topic: keywords
subject: drug-induced abnormalities
  topic: keywords
subject: hyperprolactinemia
  topic: keywords
subject: hormones
  topic: keywords
creator: Nayab Iqbal
creator: Muhammad Ashfaq
creator: Qasim Khan
creator: Syed Mobasher Ali Abid
creator: Muhammad Junaid Hassan Sharif
creator: Yasser MSA Alkahraman
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 374
ending page: 379

Laser therapy for type III fetal congenital cystic adenomatoid malformation
type: item
description: Congenital cystic adenomat<span class="NormalTextRun SpellingErrorV2Themed SCXW265162325 BCX8" data-ccp-charstyle="nedelit" data-ccp-charstyle-defn="{"ObjectId":"386dc8c1-255b-5a14-a7f1-5777b3628f91|1","ClassId":1073872969,"Properties":[469775450,"nedelit",201340122,"1",134233614,"true",469778129,"nedelit",335572020,"99",134224902,"false",201334293,"17",201342446,"1",201342447,"5",201342448,"1",201342449,"1",469777841,"Calibri",469777842,"",469777843,"Calibri",469777844,"Calibri",201341986,"1",469769226,"Calibri",268442635,"22"]}">oid malformation (CCAM) is a rare developmental anomaly of the fetal lung that can lead to severe respiratory distress in the neonatal period. Type III CCAM, characterized by solid, microcystic lesions, often poses diagnostic and therapeutic challenges, especially in progressive cases. We report a rare case of antenatal laser therapy used to treat a fetus diagnosed with type III CCAM. Despite two cycles of corticosteroid therapy, the lesion showed no significant regression, leading to the decision to perform ultrasound-guided intrauterine laser ablation. The procedure resulted in a reduction in lesion size, normalization of the fetal cardiac axis, and a favorable perinatal outcome, with the newborn discharged 5 days after birth in stable condition. This case highlights the potential role of fetal laser therapy as a less invasive and effective alternative to surgical excision for selected cases of progressive type III CCAM. Further studies are needed to validate the safety, efficacy, and long-term outcomes of this approach.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: prenatal diagnosis
  topic: keywords
subject: congenital cystic adenomatoid malformation
  topic: keywords
subject: intrauterine therapy
  topic: keywords
subject: ultrasound-guided laser ablation
  topic: keywords
subject: perinatal outcomes
  topic: keywords
creator: Jéssica Brabo Dantas
creator: Carolina Longo
creator: Mauricio Saito
creator: Edward Araujo Júnior
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-08-28
publication date: 2025-08-28
starting page: 315
ending page: 319

Coincidental maternal mortality in Slovakia in the years 2007–2024
type: item
description: Objective: Analysis of c<span class="NormalTextRun SpellingErrorV2Themed SCXW2120621 BCX8" data-ccp-charstyle="nedelit" data-ccp-charstyle-defn="{"ObjectId":"386dc8c1-255b-5a14-a7f1-5777b3628f91|1","ClassId":1073872969,"Properties":[469775450,"nedelit",201340122,"1",134233614,"true",469778129,"nedelit",335572020,"99",134224902,"false",201334293,"17",201342446,"1",201342447,"5",201342448,"1",201342449,"1",469777841,"Calibri",469777842,"",469777843,"Calibri",469777844,"Calibri",201341986,"1",469769226,"Calibri",268442635,"22"]}">oincidental maternal mortality in Slovakia in the years 2007–2024 from the database of the Slovak Gynecological and Obstetric Society (enhanced surveillance system). Methods: Retrospective population analysis of maternal mortality from 2007 to 2024 focused on coincidental maternal deaths. Analysis of coincidental maternal death cases was carried out according to the International Classification of Diseases (ICD-10) for Maternal Mortality (ICD-MM). Results: Between 2007 and 2024, a total of 123 women died. The maternal mortality ratio (MMR) was 12.46 per 100,000 live births. Fifteen women (12.20%) died from coincidental causes (MMR 1.52 per 100,000 live births). From direct causes, 51 women died (41.46%), from indirect causes, 54 women died (43.90%), and three women died (2.44%) from an unknown cause of death. Out of the coincidental deaths, 80.0% were due to polytrauma – car accidents (66.67%), train accident (6.67%), and entrapment in an elevator shaft (6.67%). Three cases of deaths were due to homicide (domestic violence) – 20%. Conclusion: The study highlights the problem of under-recognition of coincidental maternal deaths, despite its significant impact on public health. The Slovak Gynecological and Obstetrics Society attempts to identify and collect data on coincidental maternal mortality in Slovakia, which is not included in vital statistics. Addressing this overlooked issue is crucial for enhancing maternal health outcomes and ensuring…
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: maternal deaths
  topic: keywords
subject: coincidental maternal mortality
  topic: keywords
subject: maternal mortality ratio
  topic: keywords
subject: polytrauma
  topic: keywords
subject: homicide
  topic: keywords
creator: Dominika Kotríková
creator: Mária Vargová
creator: Adam Adamec
creator: Alexandra Krištúfková
creator: Miroslav Korbeľ
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-08-28
publication date: 2025-08-28
starting page: 278
ending page: 284

Prenatal treatment of posterior urethral valves in a newborn with anorectal stenosis
type: item
description: Poster<span class="NormalTextRun SpellingErrorV2Themed SCXW233982101 BCX8" data-ccp-charstyle="nedelit" data-ccp-charstyle-defn="{"ObjectId":"386dc8c1-255b-5a14-a7f1-5777b3628f91|1","ClassId":1073872969,"Properties":[469775450,"nedelit",201340122,"1",134233614,"true",469778129,"nedelit",335572020,"99",134224902,"false",201334293,"17",201342446,"1",201342447,"5",201342448,"1",201342449,"1",469777841,"Calibri",469777842,"",469777843,"Calibri",469777844,"Calibri",201341986,"1",469769226,"Calibri",268442635,"22"]}">ior urethral valves (PUV) account for most cases of lower urinary tract obstruction (LUTO) in male fetuses, with a prevalence of 1 in 5,000 live births. Prenatal ultrasound findings include bladder wall thickening, keyhole sign, oligohydramnios, and ureteral dilatation. If untreated, PUV can cause pulmonary hypoplasia and renal failure, often requiring dialysis or transplantation. Treatment options include vesicoamniotic shunting and fetoscopic laser fulguration. PUV is rarely associated with anorectal malformations, posing a diagnostic and therapeutic challenge. This case report describes a neonate diagnosed prenatally with PUV who underwent intrauterine procedures, followed by preterm cesarean section at 32 weeks. Postnatally, he exhibited renal dysplasia, cryptorchidism, and developed necrotizing enterocolitis. Despite multiple laparotomies and colostomy, the infant improved and was then discharged. At 4 months, imaging confirmed rectal stenosis. We highlight the diagnostic limitations of prenatal ultrasound in differentiating PUV from other LUTO causes and the benefits of fetal magnetic resonance imaging. Anorectal malformations have diverse phenotypic presentations and are linked to environmental risk factors. The rare association of PUV with anorectal anomalies requires careful prenatal counseling due to potential complications. This case highlights the importance of early diagnosis and multidisciplinary management for improved outcomes.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: Posterior urethral valves; Prenatal diagnosis; Intrauterine treatment; Associated anomalies; Postnatal follow-up
  topic: keywords
creator: Daniele de Azevedo Miguel
creator: Edward Araujo Júnior
creator: Rodrigo Ruano
creator: Renato Augusto Moreira Sá
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-08-28
publication date: 2025-08-28
starting page: 323
ending page: 327

Accuracy of a modified CMT+ for assessing pelvic floor muscle contraction in pregnancy
type: item
description: Objective: The ability to locate pelvic fl<span class="NormalTextRun SpellingErrorV2Themed SCXW71503138 BCX8" data-ccp-charstyle="nedelit" data-ccp-charstyle-defn="{"ObjectId":"386dc8c1-255b-5a14-a7f1-5777b3628f91|1","ClassId":1073872969,"Properties":[469775450,"nedelit",201340122,"1",134233614,"true",469778129,"nedelit",335572020,"99",134224902,"false",201334293,"17",201342446,"1",201342447,"5",201342448,"1",201342449,"1",469777841,"Calibri",469777842,"",469777843,"Calibri",469777844,"Calibri",201341986,"1",469769226,"Calibri",268442635,"22"]}">oor muscles (PFM) is essential for the effectiveness of pelvic floor muscle training programs. The aim of this study was to investigate the accuracy of a modified coccygeal movement test that incorporates an objective assessment of abdominal muscle co-activation (CMT+) (Index test) compared to transabdominal ultrasound (TAU) scanning (Gold standard) in diagnosing accurate PFM contraction. Methods: Pregnant women attending the hospital for a routine in the middle 2nd trimester scan who are able to understand the study rationale and information were considered eligible for inclusion. TAUs were performed by one out of two trained operators. CMT+ was performed by an experienced physiotherapist. The CMT+ assessor and participants were blind to the TAU result. Results: A total of 117 participants were recruited into the study with a mean BMI of 30.86 kg/m² (4.5) and 23.16 kg/m² (3.7), resp. CMT+ (Index test) correctly identified 5 out of the 9 participants who were not able to contract and 107 out of the 108 who were able to contract their PFM resp. (sensitivity = 55.6%, specificity = 99.1%, positive predictive value = 83.3% and negative predictive value = 96.4%; LR+ = 60 and LR– = 0.45). Conclusion: CMT+ is an easy to perform test with high specificity and negative predictive value that has the additional benefit of assessing any concomitant abdominal muscle co-activation. Therefore, CMT+ is a potentially useful initial screening…
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: pelvic floor
  topic: keywords
subject: co-activation
  topic: keywords
subject: transabdominal ultrasound
  topic: keywords
subject: pelvic floor muscle
  topic: keywords
subject: CMT
  topic: keywords
creator: Stine Stensgaard
creator: Karl Moeller Bek
creator: Khaled Ismail
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-08-28
publication date: 2025-08-28
starting page: 293
ending page: 298

Early detection of recurrent ovarian cancer, current use of oncomarkers, imaging methods, and future perspectives
type: item
description: Ovar<span class="NormalTextRun SpellingErrorV2Themed SCXW143741059 BCX8" data-ccp-charstyle="nedelit" data-ccp-charstyle-defn="{"ObjectId":"386dc8c1-255b-5a14-a7f1-5777b3628f91|1","ClassId":1073872969,"Properties":[469775450,"nedelit",201340122,"1",134233614,"true",469778129,"nedelit",335572020,"99",134224902,"false",201334293,"17",201342446,"1",201342447,"5",201342448,"1",201342449,"1",469777841,"Calibri",469777842,"",469777843,"Calibri",469777844,"Calibri",201341986,"1",469769226,"Calibri",268442635,"22"]}">ian carcinoma is one of the most serious types of gynecological tumors. It is usually diagnosed in advanced stages, mainly due to an asymptomatic course or non-specific symptoms in the early stages. It is also characterized by a tendency to recur frequently, thus reducing the overall survival of patients. This article focuses on the possibility of detecting recurrence of the disease during follow-up of patients after complete remission. According to the analyzed literature, the monitoring of CA-125 and HE4 oncomarker levels in combination with imaging methods such as expert ultrasonography, CT, and positron emission techniques offers the potential for early detection of recurrence. The most advanced type of computed tomography, photon-counting CT, with high detection capability and lower radiation burden, also holds promise. The question of further management of early-detected asymptomatic recurrence is open for further discussion.
subject: Gynecology and Obstetrics
  topic: section
subject: Review article
  topic: category
subject: ovarian carcinoma
  topic: keywords
subject: reccurence
  topic: keywords
subject: follow-up
  topic: keywords
subject: tumor markers
  topic: keywords
subject: early diagnosis
  topic: keywords
subject: diagnostic imaging
  topic: keywords
creator: Vendula Smoligová
creator: Jan Kosťun
creator: Petr Stráník
creator: Jiří Presl
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-08-28
publication date: 2025-08-28
starting page: 333
ending page: 338

Role of tru-cut biopsy in the management of myometrial lesions
type: item
description: The aim of this article was to summarize current knowledge regarding ultras<span class="NormalTextRun SpellingErrorV2Themed SCXW135965931 BCX8" data-ccp-charstyle="nedelit" data-ccp-charstyle-defn="{"ObjectId":"386dc8c1-255b-5a14-a7f1-5777b3628f91|1","ClassId":1073872969,"Properties":[469775450,"nedelit",201340122,"1",134233614,"true",469778129,"nedelit",335572020,"99",134224902,"false",201334293,"17",201342446,"1",201342447,"5",201342448,"1",201342449,"1",469777841,"Calibri",469777842,"",469777843,"Calibri",469777844,"Calibri",201341986,"1",469769226,"Calibri",268442635,"22"]}">ound-guided tru-cut biopsy, with a focus on its applicability in preoperative diagnosis of myometrial lesions. Tru-cut biopsy is used in gynecologic oncology for the management of pelvic and abdominal tumors; however, its application in the diagnostic algorithm for uterine tumors has been validated by only a limited number of studies. Nevertheless, this literature review highlights that tru-cut biopsy of uterine smooth muscle lesions demonstrates high sample adequacy for histological examination, diagnostic accuracy, and a low complication rate. Leiomyomas are among the most common benign uterine tumors, whereas uterine sarcomas are rare and aggressive malignancies. Symptoms of these conditions do not differ significantly. Their differentiation relies on imaging methods such as ultrasonography and magnetic resonance imaging. However, distinguishing between benign and malignant tumors remains challenging, as criteria for differentiating benign and malignant lesions using these imaging methods have not yet been sufficiently validated. Incorporating tru-cut biopsy into the standard diagnostic algorithm for uterine tumors could provide valuable insights into the oncological nature of atypical tumors on ultrasonography or magnetic resonance imaging, leading to optimized and personalized treatment strategies for each patient.
subject: Gynecology and Obstetrics
  topic: section
subject: Review article
  topic: category
subject: biopsy
  topic: keywords
subject: leiomyoma
  topic: keywords
subject: sarcoma
  topic: keywords
subject: uterine neoplasms
  topic: keywords
subject: differential diagnosis
  topic: keywords
creator: Adela Richtarova
creator: Kristyna Hlinecka
creator: Zdenka Lisa
creator: Vojtech Lukavec
creator: Veronika Vaisova
creator: Michal Mara
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-08-28
publication date: 2025-08-28
starting page: 328
ending page: 332

Results of the Endometriosis Health Profile-30 questionnaire in women aged 18–30 years in the Czech Republic
type: item
description: Aim: The aim of the study is to obtain valid data on the quality of life of women aged 18–30 years with endometriosis using the certified questionnaire the Endometriosis Health Profile-30 (EHP-30). The Czech version of the EHP-30 was used in the study. A total of 184 women completed the questionnaire. Mean age of the women was 26.6 years (± 2.8 years). Materials and methods: Data were collected from 10 February 2023 to 8 October 2023 using the online platform Click4survey. Results: Summary index of the EHP-30 group was 57.0 points (± 20.43 points). The domain of powerlessness to control the disease had the greatest impact on women‘s quality of life at 66.4 points, followed by Social support at 58.4 points, then Emotional well-being at 58.2 points. With Pain at 51.3 points, and Self-image at 50.7 points as the final domain. Results showed that perception of pain did not increase with increasing age, and on the contrary, women in the youngest age group of 18–20 years perceived pain as the worst. The age of women did not statistically significantly affect the final index of the questionnaire or its individual dimensions. Conclusion: Based on the analysis and results obtained, we have obtained data on the domains of endometriosis, which can significantly contribute to a more effective understanding of the possibility of improving the quality of life of women aged 18–30 years with endometriosis and the procedures for their treatment.
subject: Gynecology and Obstetrics
  topic: section
subject: Original article
  topic: category
subject: EHP-30
  topic: keywords
subject: endometriosis
  topic: keywords
subject: pain
  topic: keywords
subject: control and powerlessness
  topic: keywords
subject: social support
  topic: keywords
creator: Ingrid Palascakova Springrova
creator: Martin Nemec
creator: Martina Kadlecova
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 380
ending page: 384

Laparoscopic management of ovarian torsion at 26 weeks of gestation
type: item
description: Objective: We report a case of ovarian torsion at 26 weeks of gestation that was successfully managed laparoscopically. Case report: A 29-year-old woman at 26 weeks of pregnancy presented to the emergency department with left lower quadrant pain. Ultrasound examination revealed a 64 × 60 mm cyst in the left ovary, and Doppler imaging could not detect blood flow in the left ovary. The patient was diagnosed with left ovarian torsion and subsequently underwent laparoscopic left ovarian detorsion and cystectomy. The patient experienced no postoperative surgical or obstetric complications and had an uncomplicated vaginal delivery at 39 weeks of gestation. Conclusion: In the surgical management of adnexal torsion during pregnancy, laparoscopy can be safely performed not only in the 1st and 2nd trimesters but also in the 3rd trimester, provided that adequate surgical expertise and appropriate equipment are available.
subject: Gynecology and Obstetrics
  topic: section
subject: Kazuistika
  topic: category
subject: laparoscopy
  topic: keywords
subject: ovarian torsion
  topic: keywords
subject: pregnancy
  topic: keywords
creator: İbrahim Kale
creator: Cem Yalçınkaya
creator: Gülten Merve Özalp Çelikçi
rights: Copyright (c) 2025 Česká gynekologie
date: 2025-10-30
publication date: 2025-10-30
starting page: 395
ending page: 397