Oldrich Sottner

A multicenter, randomized, prospective, controlled study comparing sacrospinous fixation and transvaginal mesh in the treatment of posthysterectomy vaginal vault prolapse

OBJECTIVE The objective of the study was to compare recurrence and complication rates for sacrospinous fixation (SSF) and prolene mesh techniques for the primary treatment of posthysterectomy vaginal vault prolapse. STUDY DESIGN Patients undergoing surgery for vault prolapse were included in a multicenter, randomized, controlled study comparing SSF or total mesh (Prolift; Gynecare/Ethicon, Somerville, NJ). The examination included pelvic organ prolapse quantification, urodynamics, ultrasound, and quality-of-life (QoL) questionnaires before and 3 and 12 months after surgery. RESULTS Of 168 randomized patients, 83 underwent SSF and 85 mesh repair. Prolapse recurrence after 12 months occurred in 39.4% of the SSF group and in 16.9% of the mesh group (P = .003). The mesh exposure rate was 20.8%. No difference in QoL improvement as well as of de novo stress urinary incontinence and overactive bladder onset was found. CONCLUSION Mesh exposure occurrence was balanced against a lower prolapse recurrence rate in the patients undergoing mesh surgery compared with those undergoing SSF.

Comparison of labor course and women's sexuality in planned and unplanned pregnancy.

Objective. This study compares several parameters of sexual life and course of labor in women with planned and unplanned pregnancy. Methods. 339 primiparas participated in our study; they filled in a questionnaire concerning their sexual life during pregnancy on the second or third day after the delivery. One question also stressed planning of pregnancy. 246 women (i.e., 72.6%) indicated planned pregnancy, 93 pregnancies (i.e., 27.4%) were not planned. Results. Significant decrease of coital activity and number of orgasms and increase of sexual dysfunctions were observed in the whole study group during pregnancy. Significant differences between women with planned and unplanned pregnancy were observed only in frequency of vaginal dryness and pelvic pain. Conclusions. According to the results of this study, unplanned pregnancy has no adverse effect on parameters of the labor. The equal rate of partners presence at delivery shows a high involvement of the partners of unmarried women.

Postpartum examination, breastfeeding, and contraception in the postpartum period in the Czech Republic

In the majority of recent textbooks of obstetrics, a routine follow-up examination at the end of the postpartum period is recommended. To date, no studies have been done in the Czech Republic addressing use of contraception and follow-up care in the postpartum period. Questionnaires were sent to 672 participants who gave birth in the year 2008, inquiring about follow-up examinations in the postpartum period and use of contraception. In total, 458 (68.2%) questionnaires were returned. 430 women (93.9%) underwent routine examinations at 6 weeks into the postpartum period. At the time of examination, 36 women were asked about their particular health problems (8.4%). In 130 instances, the question most often addressed by the outpatient gynecologist concerned use of contraception (30.2%). However, only 34 physicians expressed concern about changes in sexual life or other sexually related problems. 426 women (93.0%) were sexually active and 310 women (72.8%) did not use any contraception with the exception of breastfeeding. The current practice of outpatient gynecological visits at 6 weeks postpartum and advice on contraception both seem inadequate.

OP03.04: Measurement of the brain stem diameter at the 11–14 week scan

V. Frisova1, Z. Bejlkova1, M. Kyncl1, B. Prosova1, R. Vlk2, D. Smetanova3, L. Haakova4, L. Hornofová5, M. Rocek1 1Clinic of Imaging Methods, Faculty Hospital Motol and Charles University, Prague 5, Czech Republic; 2Department of Gynaecology and Obstetrics, Faculty Hospital Motol and Charles University, Prague 5, Czech Republic; 3Fetal Medicine Unit, GENNET, Prague 7, Czech Republic; 4Fetal Medicine Unit, Institute for the Care of Mother and Child, Prague 4, Czech Republic; 5Institute for Pathological Anatomy and Molecular Medicine, Faculty Hospital Motol and Charles University, Prague 5, Czech Republic

P17.10: Internal audit of the first trimester screening programme

USG markers found. Effectiveness was assessed based on 24 cases found due to 1st trimester calculations. Our 1st trimester screening sensitivity is 85.71%, false negative results-14.29%, false positive results-2.72%, specificity-98.32%, accuracy-98.19%. Found CA case/invasive procedure ratio is 1/1.3 in fact. In 2 cases (8.3%) from 24 cases of CA we found confined placental mosaicism. Conclusions: 1) Personal risks assessment of CA according to FMF recommendations showed high accuracy; 2) it resulted in significant decreasing of invasive procedures number; 3) to avoid possible diagnostic mistakes because of confined placental mosaicism amniocentesis should be preferred.