Special Issue "Women Health and Gynecology"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Women's Health".

Deadline for manuscript submissions: 28 February 2022.

Special Issue Editors

Prof. Dr. Milan Terzic
E-Mail Website
Guest Editor
1. Department of Medicine, Nazarbayev University School of Medicine, Zhanybek-Kerey khans Street, 5/1, Nur-Sultan, Kazakhstan
2. Clinical Academic Department of Women’s Health, National Research Center of Mother and Child Health, University Medical Center, Turan ave. 32, Nur-Sultan, Kazakhstan
3. Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, USA
Interests: environmental factors; gynecology; obstetrics; REI; diagnostic procedures; current managements; women’s health
Prof. Dr. Antonio Sarria-Santamera
E-Mail Website
Co-Guest Editor
1. Department of Medicine, Nazarbayev University School of Medicine, Zhanibek-Kerey Khans Street, 5/1, Nur-Sultan 010000, Kazakhstan
2. Spanish Network of Health Services Research and Chronic Diseases, REDISSEC, 28029 Madrid, Spain
3. Instituto Mixto de Investigación Escuela Nacional de Sanidad-Universidad Nacional de Educación a Distancia, IMIENS-UNED, 28029 Madrid, Spain
Interests: women’s health; minimally invasive procedures; up-to-date management; gynecology; reproductive health; surgery
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Special Issue Information

Dear Colleagues,

Environmental pollutants comprise certain chemical, physical and biological substances, that have harmful effects on human well-being. Nowadays, the development of industrialization maximizes the production of these substances and poses a real problem for public health. Moreover, research evidences suggest that the occupational exposure affects the female health by alternating the hormonal levels, decreasing libido, interfering with ovarian function, causing and increasing the risks of menstrual disorders, delayed menarche, early menopause, decreased fertility and disadvantageous pregnancy outcomes. The environmental pollutants refer to air pollution, exposure to heavy metals, endocrine disrupting chemicals, pesticides, polychlorinated biphenyls, ionizing radiation, occupation and working environment. The adverse effects of these environmental factors on the overall health and reproductive health, as well as on women’s well-being depends on the dosage, timing, duration of the exposure through the ingestion, inhalation, transdermal and mucosal absorption. This special issue of International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on the links between Environmental factors & Public health on one side, and Women health and Gynecology, on the another. Original articles, reviews, and case reports are welcome to this issue. Other manuscript types accepted include new approaches to risk assessment and management of environmental factors in OBGYN, methodological papers, position papers, brief reports, and commentaries.

We will accept manuscripts from different disciplines including Obstetrics & Gynaecology, public health, epidemiology, intervention studies, risk and health impact assessment, risk management of environmental factors and issues in OBGYN. Here are some examples of topics that could be addressed in this Special Issue:

  1. Environmental factors and fertility
  2. Infertility as a public health burden
  3. Menopausal problems of healthcare providers impact on a quality of health service
  4. Menopause management options in daily practice
  5. Medicamentous and minimally invasive procedures for uterine fibroids
  6. Burnout in healthcare providers: contemporary management options and proposals for public health interventions
  7. Endometriosis impact on the quality of life and work performance
  8. Environmental factors and current preconceptional diagnostic procedures in daily clinical practice
  9. Infections in obstetrics and gynecology and impact on infertility, early pregnancy loss and preterm birth
  10. Current updates about early markers for pre-eclampsia detection

Professor Dr Milan Terzic

Associate Professor Dr Antonio Simone Laganà

Associate Professor Dr Antonio Sarria-Santamera


Guest Editors


Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • environmental factors
  • public health
  • gynecology
  • quality of life
  • endometriosis
  • infections
  • burnout
  • infertility
  • early pregnancy loss
  • preterm birth

Published Papers (7 papers)

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Research

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Article
Asymmetric Power Relations in Gynaecological Consultations for Cervical Cancer Prevention: Biomedical and Gender Issues
Int. J. Environ. Res. Public Health 2021, 18(15), 7850; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18157850 - 24 Jul 2021
Viewed by 756
Abstract
A generic qualitative research, using a poststructuralist feminist perspective, was conducted in a Spanish gynaecology unit with the following aims: (a) to analyse how asymmetric power relations in relation to biomedical knowledge and gender shape the medical encounters between gynaecologists and women diagnosed [...] Read more.
A generic qualitative research, using a poststructuralist feminist perspective, was conducted in a Spanish gynaecology unit with the following aims: (a) to analyse how asymmetric power relations in relation to biomedical knowledge and gender shape the medical encounters between gynaecologists and women diagnosed with cervical intraepithelial neoplasia and (b) to explore the cognitive, moral, and emotional responses expressed by patients. A total of 21 women diagnosed with cervical intraepithelial neoplasia were recruited through purposive sampling. Semi-structured interviews were recorded and transcribed, and a thematic analysis was carried out. Two major themes were identified: (a) gendered relations in cervical intraepithelial neoplasia medical encounters are based on hidden, judgmental moral assumptions, making women feel irresponsible and blamed for contracting the human papillomavirus infection; (b) biomedical power is based on the positivist assumption of a single truth (scientific knowledge), creating asymmetric relations rendering women ignorant and infantilised. Women reacted vehemently during the interviews, revealing a nexus of cognitive, moral, and emotional reactions. In medical encounters for management of cervical intraepithelial neoplasia, patients feel they are being morally judged and given limited information, generating emotional distress. Healthcare professionals should question whether their practices are based on stereotypical gender assumptions which lead to power asymmetries during encounters. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
Article
Spatial Patterns of Endometriosis Incidence. A Study in Friuli Venezia Giulia (Italy) in the Period 2004–2017
Int. J. Environ. Res. Public Health 2021, 18(13), 7175; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18137175 - 05 Jul 2021
Viewed by 746
Abstract
Background: Diagnosis of endometriosis and evaluation of incidence data are complex tasks because the disease is identified laparoscopically and confirmed histologically. Incidence estimates reported in literature are widely inconsistent, presumably reflecting geographical variability of risk and the difficulty of obtaining reliable data. Methods: [...] Read more.
Background: Diagnosis of endometriosis and evaluation of incidence data are complex tasks because the disease is identified laparoscopically and confirmed histologically. Incidence estimates reported in literature are widely inconsistent, presumably reflecting geographical variability of risk and the difficulty of obtaining reliable data. Methods: We retrieved incident cases of endometriosis in women aged 15–50 years using hospital discharge records and pathology databases of the Friuli Venezia Giulia region in the calendar period 2004–2017. We studied the spatial pattern of endometriosis incidence applying Bayesian approaches to Disease Mapping, and profiled municipalities at higher risk controlling for multiple comparisons using both q-values and a fully Bayesian approach. Results: 4125 new cases of endometriosis were identified in the age range 15 to 50 years in the period 2004–2017. The incidence rate (x100 000) is 111 (95% CI 110–112), with a maximum of 160 in the age group 31–35 years. The geographical distribution of endometriosis incidence showed a very strong north-south spatial gradient. We consistently identified a group of five neighboring municipalities at higher risk (RR 1.31 95% CI 1.13; 1.52), even accounting for ascertainment bias. Conclusions: The cluster of 5 municipalities in the industrialized and polluted south-east part of the region is suggestive. However, due to the ecologic nature of the present study, information on the patients’ characteristics and exposure histories are limited. Individual studies, including biomonitoring, and life-course studies are necessary to better evaluate our findings. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
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Review

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Review
Postcoital Vaginal Perforation and Evisceration in Women with No Prior Pelvic Surgery: Laparoscopic Management and Systematic Review of the Literature
Int. J. Environ. Res. Public Health 2021, 18(18), 9746; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189746 - 16 Sep 2021
Cited by 2 | Viewed by 503
Abstract
Objective: to evaluate risk factors, causes, management and surgical therapy of postcoital vaginal perforation and evisceration in women with no prior pelvic surgery. Data sources: We used MEDLINE (PubMed), Scopus, Embase and Web of Science for our research. Our review includes all reports [...] Read more.
Objective: to evaluate risk factors, causes, management and surgical therapy of postcoital vaginal perforation and evisceration in women with no prior pelvic surgery. Data sources: We used MEDLINE (PubMed), Scopus, Embase and Web of Science for our research. Our review includes all reports from 1980 to November 2020. The research strategy adopted included different combinations of the following terms: (intercourse) AND (coitus) AND (vaginal perforation). Methods of study selection: we report a case of vaginal evisceration after consensual intercourse in a young and healthy woman. In addition, we performed a systematic review of vaginal perforations with or without evisceration in women without prior surgery or any other predisposing disease. All studies identified were listed by citation, title, authors and abstract. Duplicates were identified by an independent manual screening, performed by one researcher and then removed. For the eligibility process, two authors independently screened the title and abstracts of all non-duplicated papers and excluded those not pertinent to the topic. Tabulation, integration and results: We have followed the PRISMA guidelines. Five manuscripts were detected through the references of the works that had been identified with the research on MEDLINE (PubMed), Scopus, Embase and Web of Science. We found 16 cases between 1980 and 2020. The young age and the virginal status represent the principal risk factors and all the lacerations occurred in the posterior vaginal fornix. The most common surgical technique was the laparotomic approach and, in the remaining cases, the laparoscopic and vaginal route was performed. Conclusions: Post-coital vaginal perforation and evisceration in women with no prior pelvic surgery is a rare condition in the clinical practice and, when it is associated with evisceration it is a surgical emergency. Usually, these injuries are not life-threatening conditions but, a delay in diagnosis, can lead to severe complications. In consideration of the high heterogeneity of the data in the literature, it is essential to define a diagnostic–therapeutic management for the patients with vaginal perforation. With our review, we try to identify the associated risk factors, the best and fastest diagnosis, and the best surgical approach. We believe that a combined vaginal and laparoscopic approach can be the best surgical treatment, useful to diagnose injuries of the abdominal organs and to improve postoperative outcome. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
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Review
The Management of the Cotyledonoid Leiomyoma of the Uterus: A Narrative Review of the Literature
Int. J. Environ. Res. Public Health 2021, 18(16), 8521; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168521 - 12 Aug 2021
Viewed by 596
Abstract
Cotyledonoid leiomyoma is an unusual uterine myoma due to some ultrasound features that mimic a malignant lesion facilitating the choice of radical surgery. This study aims to summarize the ultrasound and the magnetic resonance imaging aspects of this atypical lesion, and also discuss [...] Read more.
Cotyledonoid leiomyoma is an unusual uterine myoma due to some ultrasound features that mimic a malignant lesion facilitating the choice of radical surgery. This study aims to summarize the ultrasound and the magnetic resonance imaging aspects of this atypical lesion, and also discuss surgical treatment and pathological exam. It included all English case reports or case series until August 2021 found through PubMed, Google Scholar, and Scopus. A total of 94 cotyledonoid leiomyomas were reported, with a median tumor size of 12 cm. The typical ultrasound image is characterized by a large solid heterogeneous mass, with high vascularity, no shadowing, and indistinct margins within the myometrium. Magnetic resonance imaging shows the presence of merging isointense nodules to the myometrium in T1-weighted images, hyperintense in T2-weighted images, and contrast agent enhancement. Surgical treatment consists of hysterectomy (75 cases, 80%) or myomectomy (19 cases, 20%), without evidence of recurrence if complete. The placenta-like appearance observed during surgery supports this rare fibroid hypothesis. The intraoperative frozen section can be considered. Microscopically, no atypical cells, signs of mitotic activity or cell necrosis are found. To conclude, some preoperative and intraoperative aspects of this lesion are distinctive and may lead surgeons to opt for conservative surgery. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
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Review
The Gender Gap in the Diagnostic-Therapeutic Journey of the Infertile Couple
Int. J. Environ. Res. Public Health 2021, 18(12), 6184; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126184 - 08 Jun 2021
Cited by 1 | Viewed by 993
Abstract
Medical procreation impairs both the biological and psychological lives of couples. However, male and female attitudes to infertility are different and require a different approach during the IVF journey. Thus, the gender impact assessment (GIA) method was used to analyse original studies present [...] Read more.
Medical procreation impairs both the biological and psychological lives of couples. However, male and female attitudes to infertility are different and require a different approach during the IVF journey. Thus, the gender impact assessment (GIA) method was used to analyse original studies present in the literature. We found some gender-related differences and, subsequently, possible outcomes of intervention to improve healthy reproduction management and prevent infertility. In particular, it became apparent that there was the need for an in-depth male infertility assessment and a gender-specific follow-up. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
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Review
The Rare, Unexpected Condition of a Twisted Leiomyoma in Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome: Etiopathogenesis, Diagnosis and Management. Our Experience and Narrative Review of the Literature
Int. J. Environ. Res. Public Health 2021, 18(11), 5895; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115895 - 31 May 2021
Viewed by 1003
Abstract
Uterine leiomyomas are a common finding in medical practice, but their frequency changes drastically when contextualized in a syndrome, as in the following case. A 50-year-old woman with a known Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome presented at our clinic with abdominal pain located in the [...] Read more.
Uterine leiomyomas are a common finding in medical practice, but their frequency changes drastically when contextualized in a syndrome, as in the following case. A 50-year-old woman with a known Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome presented at our clinic with abdominal pain located in the lower quadrants and scarcely responsive to analgesic therapy. A twisted gynecological pelvic mass was diagnosed, and management for prompt resolution was adopted. Histologically the mass was described as a leiomyoma. The aim of the present study is to share our experience and to review the literature to compare different manifestation of the disease and different approach used in the various centers. The additional novelty of the paper is the immunohistochemical study we carried out on the leiomyoma that is contrasted with the current etiopathogenetic theories. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
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Other

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Systematic Review
Breast Cancer Care Quality Indicators in Spain: A Systematic Review
Int. J. Environ. Res. Public Health 2021, 18(12), 6411; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126411 - 13 Jun 2021
Viewed by 1089
Abstract
Breast cancer (BC) management care requires an increment in quality. An initiative to improve the BC quality care is registered, and quality indicators (QIs) are studied. We appraised the appearance of QIs and their standards systematically in Spain. A prospective systematic search (Prospero [...] Read more.
Breast cancer (BC) management care requires an increment in quality. An initiative to improve the BC quality care is registered, and quality indicators (QIs) are studied. We appraised the appearance of QIs and their standards systematically in Spain. A prospective systematic search (Prospero no: CRD42021228867) for clinical pathways and integrated breast cancer care processes was conducted through databases and the World Wide Web in February 2021. Duplicate data extraction was performed with 98% reviewer agreement. Seventy-four QIs (QI per document mean: 11; standard deviation: 10.59) were found in 15 documents. The Catalonian document had the highest number of QIs (n = 30). No QI appeared in all the documents. There were 9/74 QIs covering structure (12.16%), 53/74 covering process (71.62%), and 12/74 covering outcome (16.22%). A total of 22/66 (33.33%) process and outcome QIs did not set a minimum standard of care. QIs related to primary care, patient satisfaction, and shared decision making were deficient. Most of the documents established a BC QI standard for compliance, but the high variability hinders the comparison of outcomes. Establishing a consensus-based set of QIs needs urgent attention. Full article
(This article belongs to the Special Issue Women Health and Gynecology)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Women's strategies for managing the pain and discomfort associated with menstruation
Authors: Witkoś J, Hartman-Petycka M
Affiliation: Andrzej Frycz Modrzewski Krakow University Medical University in Silesia
Abstract: About 200 women and girls in their reproductive period are participating in it. We ask, among others, about the length of and disruptions to their monthly cycle as well as breakthrough spotting, etc. However, the main area of concern is the pain and discomfort experienced with menstruation and the ways in which the women deal with it. We will be analysing what factors influence the severity of pain and the women's pain management strategies. Another aspect is physical activity during menstruation. One of the strategies, often quoted in literature, for coping with the pain associated with menstruation, is exercise. In this study, we plan to find out how often women choose physical activity to reduce the severity of their menstrual pain. Is physical activity considered to be an effective form of relieving menstrual pain and what type of activity, if any, indeed, is undertaken, is preferred by the women at this time? We plan to distribute the questionnaires on-line e.g. through social network sites etc. with the participation of students, colleagues and their families and friends.

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