临床妇产科杂志》上

平滑肌肉瘤在怀孕:偶然fi连接在常规剖腹产

08/16/2021

& lt; h2> Abstract< / h2>

Uterine leiomyosarcoma (LMS) is uncommon tumour arising from the female reproductive tract. Incidence of LMS in pregnancy is extremely rare, with only 10 cases reported thus far in medical literature.

We present a case of myomectomy performed during elective caesarean section for breech presentation, due to its easy accessibility and well contracted uterus. Subsequent histology revealed LMS on final specimen. Patient subsequently underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy. No chemotherapy was given as she opted for close clinical- radiological monitoring instead.

This case report highlights the importance of discussion with patients regarding the risk of occult malignancy in a fibroid uterus. Appropriate management of uterine leiomyosarcoma in pregnancy remains unclear. Consideration of removing an enlarging leiomyoma during caesarean section might be ideal in view of its malignant potential, just like in this case; however, location of the tumour and risk of bleeding needs to be weighed. Ultimately, management of such cases needs proper discussion between obstetrician and the patient.

比较分析使用罗布森剖腹产的十个特征的组分类系统(RTCGS)在私人和公共医院,埃塞俄比亚的亚的斯亚贝巴

06/29/2021

& lt; h2> Abstract< / h2>

Objectives: We analyzed the indications of cesarean section (CS) using Robson Ten-Group.

Classification Systems (RTGCS) and comparison between private and public health facilities in Addis Abeba hospitals, Ethiopia, 2017.

Methods: Facility-based retrospective cross-sectional study was carried out between January 1 and December 31, 2017, including 2411 mothers who delivered by CS were classified using the RTGCS. Data were entered into SPSS version 20 for cleaning and analyzing. Binary logistic regression and AOR with 95% CI were used to assess the determinants of the CS.

Results: The overall CS rate was 41% (34.8% and 66.8% in public & private respectively, p < .0001). The leading contributors for CS rate in the private were Robson groups 5,1,2,3 whereas in the public 5,1,3,2 on descending order. Robson group 1 (nulliparous, cephalic, term, spontaneous labor) and group 3 [Multiparous (excluding previous cesarean section), singleton, cephalic, ≥ 37 weeks’ gestation& spontaneous labor], the CS rate was over two-fold higher in the private than the public sector. Women in Robson groups 1, 2, 5 & 9 are two and more times higher for the absolute contribution of CS in private than public. The top medical indications of CS were non-reassuring fetal status (NRFS, 39.1%) and repeat CS for previous CS scars (39.4%) in public and private respectively. Mothers who delivered by CS in private with history of previous CS scar (AOR 2.9, 95% CI 1.4-6.2), clinical indications of maternal request (AOR 7.7, 95% CI 2.1-27.98) and pregnancy-induced hypertension (AOR 4.2, 95% CI 1.6-10.7), induced labor (AOR 2.5, 95% CI 1.4-4.6) and pre-labored (AOR 2.2, 95% CI 1.6-3.0) were more likely to undergo CS than in public hospital.

Conclusion: The prevalence of CS was found to be high, and was significantly higher in private hospitals than in a public hospital. Having CS scar [having previous CS scar, Robson group 5(Previous CS, singleton, cephalic, ≥ 37 weeks’ gestation) and an indication of repeat CS for previous CS scar] is the likely factor that increased the CS rate in private when compared within the public hospital.

Recommendation: It is important that efforts to reduce the overall CS rate should focus on reducing the primary CS, encouraging vaginal birth after CS (VBAC). Policies should be directed at the private sector where CS indication seems not to be driven by medical reasons solely.

与女性生殖器切割相关的因素在女儿的生育年龄女性在学术慈善教学医院(ACTH)

06/11/2021

& lt; h2> Abstract< / h2>

Introduction: It is estimated that more than 200 million girls and women alive today have undergone female genital mutilation. Female genital mutilation still remains to be a serious problem for large proportion of women in most sub-Saharan Africa countries including Sudan, with a high prevalence of 88%.

Objective: The main objective was to identify the factors associated with FGM among daughters of reproductive aged woman.

Materials and methods: A community based cross-sectional study was conducted on 200 mothers, the total sample was collected in ACTH based on the number of reproductive age mothers with at least one daughter older than 5 years. A structured and interviewer administered questionnaire was used to collect data. The data obtained was analyzed by the use of the SPSS software.

Results: Out of 200 mothers, 113 (56.5%) had at least one circumcised daughter. Knowledge about genital mutilation (AOR = 4.29, 95% CI: 1.13-15.37), attitude (AOR = 48.53, 95% CI: 14.45-198.69) and mothers circumcision status (AOR = 14.03, 95% CI: 2.81- 95.45) were the most significantly associated with FGM. Furthermore, having good knowledge, positive attitude, high socio-economic status, being literate, being of Christian religion and living in urban area had lower odds of having a circumcised daughter.

Conclusion: In this study, more than half of the mothers had at least one circumcised daughter. Mothers’ knowledge, attitude, circumcision status, socio-economic status, age, residence, educational level and religion were significantly associated with female genital mutilation.

会阴部的脂肪瘤:一种罕见的肿瘤

05/05/2021

A 26 year nulliparous woman presented to the OPD with complaint of painless swelling in the vulva for the last 1.5 years which gradually increased in size causing difficulty in walking. Physical examination revealed a well-defined soft, non-tender ellipsoidal swelling with smooth margins in vulvar region measuring 9*6*4 cm lateral to right labia majora extending from clitoris to external anal orifice, which was mobile and not fixed to overlying skin or underlying bone.

月经来潮主要脐部皮肤子宫内膜异位:病例报告和文献回顾

05/05/2021

& lt; h2> Abstract< / h2>

Primary umbilical cutaneous endometriosis is a rare umbilical endometrioma that affects women who are within the reproductive age group. It may be associated with infertility and severe dysmenorrhea and can be difficult to diagnosed in an asymptomatic patient.

We report a case of a 38-year-old nulliparous with seven years history of infertility and severe dysmenorrhea. Her hormonal profile assay and hysterosalpingogram results were normal while her husband semen analysis was also within normal range. She complained of monthly bleeding from a painful rubbery multilobate cutaneous nodule on the umbilicus of one year duration. She was diagnosed of cutaneous endometriosis. The diagnosis was confirmed histologically and she had surgical excision with good outcome.

性气颅致硬膜外镇痛劳动之后,一种罕见的病例报告

05/05/2021

& lt; h2> Abstract< / h2>

The lumbar epidural analgesia is commonly used for labour analgesia. The “loss of resistance to air” LORA technique is commonly used for recognition of epidural space. One of the rare complications of this technique is Pneumocephalus (PC). We want to present a case of Pneumocephalus which the mother developed during epidural analgesia in labour. The patient complained of severe headache immediately after attempt at epidural catheter insertion. The symptoms progressively worsened following delivery. A postnatal anaesthetic review was performed and an urgent CT scan of the brain was arranged that showed pneumocephalus. A conservative management pathway was followed with liberal analgesia, oxygen inhalation and keeping the patient mostly in supine position. Her symptoms regressed in severity over the next three days and subsided after one week. We believe that the amount of air used for LORA should be minimized; LORA should not be used after dural puncture and the use of normal saline would alleviate the risk.

的健康决定因素寻求行为的女性与产科瘘在南-南和南东,尼日利亚:回顾卫生保健服务的可用性和质量的影响,通过一个横断面研究

05/04/2021

& lt; h2> Abstract< / h2>& lt; p>背景:产科瘘是一种条件,结果难产,这发生在婴儿不能通过mother&,年代产道,因为它不头或太大她的骨盆。促使医疗干预,通常还包括剖腹产,允许对母亲和儿童安全的交付。尽管这种可能性,每年全国各地成千上万的女性接受他们没有这样的援助和劳动是一种无谓的痛苦持续三到五天,与子宫收缩不断地强迫孩子,通常头,对盆腔的器官和不屈的骨盆骨导致Vesico阴道瘘(自)。本研究的主要目的是考察卫生系统因素影响健康寻求行为的女性与产科瘘在印度木棉邦和Ebonyi州,尼日利亚灵活;/ p>& lt; p>方法:定性研究和描述性研究方法采用和总样本二百一十六(216)受访者包括一百五十(150)后瘘修复手术患者和六十六(66)卫生工作者使用简单随机技术有目的的选择。数据分析使用主题分析和频率表。你们;/ p>& lt; p>结果:治疗中心的受访者的观点表明,可用性和医疗服务质量影响健康寻求行为的女性与产科瘘在尼日利亚。;/ p>& lt; p>结论:这项研究表明,健康寻求行为的女性与产科瘘在尼日利亚是一个主要的挑战。产科瘘治疗中心的建立和适当的设备,以及治疗费用的补助,允许妇女与健康问题获得卫生保健服务是强烈推荐。 Therefore, government at all level and non-governmental organizations need to educate the women and create awareness on the causes and dangers of VVF.

孕妇胎儿畸形的优势:multi-centric观察研究

04/28/2021

& lt; h2> Abstract< / h2>

Objective: To observe the predominance of fetal anomalies in pregnant women in a multi-centric setting.

Methods: This prospective observational study included 20225 pregnant women who came for antenatal care in University Hospital and fetal medicine units from 2016 to 2019. Fetal anatomical scanning was done for all participants.

Results: One hundred eighty-three cases had fetal congenital anomalies, yielding a prevalence of around 0.9%. Third of cases had positive consanguinity, this increased in cases of skeletal and thoracic anomalies. The presence of past history of anomalies was evident in 8.2% mostly with skeletal and heart anomalies. History of drug intake was only verified in 1.6% of cases. Sixty-three women out of 183 (34.4%) were diagnosed to have anomalies in fetal nervous system.

Conclusion: Prenatal diagnosis are recommended for early detection of congenital anomalies and counselling.

送货上门后子宫反演的病例报告

04/26/2021

& lt; h2> Abstract< / h2>

Puerperal acute uterine inversion is a rare obstetric condition observed as a serious complication during the third stage of labor. Reported as one of the causes of postpartum haemorrhage, it commonly requires quick diagnosis and surgical treatment in order to reduce morbidity and lethality. The authors describe a case of uterine inversion with hypovolemic shock after home birth, brought to Hospital Leonor Mendes de Barros. The purpose of this article is to describe a case of acute uterine inversion and its management and a review of aetiology, predictive and risk factors, diagnosis and treatment.

研究多普勒测速技术在子痫前期患者中,和他们的围产期结果

04/21/2021

& lt; h2> Abstract< / h2>& lt; p>子痫前和IUGR孕产妇和围产期发病率和死亡率的重要原因。子痫前是一种多系统疾病,在正常妊娠滋养层的入侵将高阻动脉螺旋转换成低阻抗子宫胎盘血液循环。这个子宫胎盘血液循环在pre子痫和IUGR仍然不完整。本研究相关的多普勒发现胎儿子痫病人以前的结果,并帮助确定合适的时间交付与围产期发病率。;/ p>

连续法和中断法比较研究外阴切开术的手术伤口的愈合

04/21/2021

& lt; h2> Abstract< / h2>

Episiotomy is a most commonly performed minor procedure. There are various type of episiotomy suturing, in this study two most common types of episiotomy suturing techniques were compare in terms of healing rate. This study concluded that the continuous method of episiotomy suturing is although faster, cosmetically better and associated with less post-operative pain but it heals significantly better than interrupted method of suturing.

精子影响细菌的协同互动:在小鼠模型对妊娠结局的影响

04/09/2021

& lt; h2> Abstract< / h2>

Earlier in our laboratory, the role of various individual sperm impairing microorganisms on sperm parameters and female infertility has been elucidated at higher doses. As, multiple bacterial species tend to exert more pathogenic effect in comparison to single organism hence, present study was carried out to evaluate that if consortia of these sperm impairing organisms can lead to infertility in female mice at sub fertility dose. For this, impact of individual bacterial strains of Escherichia coli, Serratia marcescens, Pseudomonas aeruginosa, Klebsiella pneumoniae and consortia of Escherichia coli and Pseudomonas aeruginosa, Escherichia coli and Serratia marcescens, Escherichia coli and Klebsiella pneumoniae was examined on the motility, viability of mouse spermatozoa and fertility outcome. The results showed that the individual bacterial strains of E. coli, S. marcescens and K. pneumoniae could led to immobilization of spermatozoa by agglutination and P. aeruginosa led to immobilization of spermatozoa without agglutination. Also, all of them led to 100% sperm death in 45 min of incubation. In case of consortia of bacterial strains, the results showed sperm agglutination in all the cases and they were able to induce 100% sperm death at 30 min of incubation time. Further, in vivo studies were carried out to evaluate the impact of individual bacterial strains and consortia of bacterial strains on the fertility outcome in female Balb/c mice. For this, female mice were administered intravaginally with 101cfu/20µl of individual bacterial strains or consortia of strains for 10 consecutive days or PBS. The results showed that both individual bacterial strains and consortia of bacterial strains were able to efficiently colonize the mouse vagina. Further, control group receiving phosphate buffer saline and groups receiving individual bacterial strains showed all the pregnancy related changes viz. abdominal distension, string of pearls on palpation as well as delivery of pups on completion of gestation period and delivery of pups. The histological examination of reproductive organs viz. uterus and ovary, of the female mice receiving PBS or individual bacterial strains showed the formation of corpus luteum in the ovary and the formation of decidua’s in the uterus, indicative of pregnancy. However, mice receiving consortia of bacterial strains did not show any pregnancy related changes throughout the experiment. Thus, these results indicate that the presence of consortia of sperm impairing microorganisms in vaginal milieu is efficient in provoking infertility even at subfertility doses.

女性在怀孕期间使用社交网络网络吗?

03/31/2021

& lt; h2> Abstract< / h2>

Internet has become an important part of our life, including during pregnancy where it is broadly used to find information (84%). The aims of this study were (1) to describe the proportion of women using Internet Social Networks (ISN) concerning their pregnancy, during pre or postpartum hospital stay, (2) to define how ISN users refer to their pregnancy and delivery on these social networks, (3) to compare anxiety level, social sustain level, sociodemographic characteristics of the both population (4) and to determine profiles of the ISN users with multiple correspondence analysis.

Methods: 399 questionnaires were distributed in the postpartum wards of two academic hospitals in Paris, and 258 fully filled were retrieved. Tools: Anxiety scale (STAI- A and B), Cutrona Social Provisions Scale, sociodemographic and obstetrical questionnaire.

Results: 76% (n = 195) were ISN users. We compared ISN users versus ISN non users women. Demographically, the two populations were comparable. Anxiety scores were similar in both groups, whereas social support scores showed a statistical difference in social integration.

In the global population, 84% use Internet for information concerning pregnancy; this rate is higher for ISN users than ISN non users (tendency 0.058).

ISN were used in priority for sharing with relatives, and 10% with other pregnant women. Concerning pregnancy, patients posted in priority the birth announcement (28%), the pregnancy announcement (23%), and the newborn’s pictures (12%). 6% posted their fetuses’ ultrasound pictures.

Three clusters of ISN users were extracted with statistically different social support scores (p = 0.019) and comparable anxiety scores. The third one, with at risk profile, used ISN as social support. For all women, but specifically for younger and more socially fragile women, Internet gives to professional new perspectives to develop information and prevention tools during the perinatal period.

腹腔镜边缘型卵巢肿瘤的分期€”技术和结果

03/17/2021

& lt; h2> Abstract< / h2>

Borderline Ovarian Tumors (BOT) tend to present more frequently nowadays, especially in younger women. Furthermore fertility preservation and laparoscopic management is often desired and therefore appropriate counselling is challenging and the treatment selection must be made on evidence based medicine.

Adnexal mass could be a random finding when a typical gynecologic examination is performed. The diagnostic algorithm for possible BOT is the same as for any ovarian tumor, but the treatment options and techniques may vary based on patient’s willing to preserve her fertility or not. Laparoscopic or laparotomy approach has similar results although intraoperative findings and frozen section may redirect the primary treatment planning.

When an initial conservative approach is chosen, a secondary approach including total hysterectomy and bilateral salpingo-oophorectomy with staging should be considered. Hence a full counselling is recommended before any primary approach.

严重的hypertriglycerdemia怀孕

02/12/2021

31 year old female presented with abdominal pain and respiratory distress in the third trimester of her second pregnancy.

流行病学方面和相关危险因素不孕女性接受辅助生殖技术(ART)在伊朗北部

01/20/2021

& lt; h2> Abstract< / h2>

Objective: This study aimed to investigating of the epidemiological aspects of infertility and related risk factors in infertile women.

Materials and methods: This cross-sectional study, carried out on 330 infertile women referred to two infertility treatment center of Imam Khomeini Hospital and Mother center in Sari, Iran, from April 2015 to March 2017.

Results: 54.5% of these women were in the age of 30-39 years, infertility duration in 55.2% was 1-5 years, Body mass index (BMI) in 44.5% of samples was 26-30 kg/m2, 54.5% had diploma and associate degree. 63.6% lived in urban areas. 74.5 % of patients reported primary infertility. History of polycystic ovarian syndrome (PCOs) and pelvic inflammatory disease (PID) and poor ovarian reserve were the most common causes and risk factors for the infertility with prevalence 19.42%, 16.81% and 13.91%, respectively. Most underlying disease was thyroid disorders (54.5%). There was found statistically significant relationship between residents of urban areas and infertility duration, endometriosis and educational levels, miscarriage with thyroid. Data analysis performed using IBM SPSS 21 software and Chi-Square test (p < 0.05).

Conclusion: The results showed that women with infertility in north of Iran were more likely to be older, less educated, and also had overweight. They are more possible to have ovarian disorders. In these area, thyroid disease more common like Iodine deficient regions. Future research should be focused on the reasons why majority of women don’t seek treatment for the underline significant diseases that may be effects on ovarian function and fertility.

一种罕见的巨大卵巢浆液性囊腺瘤表现为psuedo-meigs综合症

01/18/2021

& lt; h2> Abstract< / h2>

Meigs’ syndrome is a rare condition characterized by the presence of a benign fibroma of the ovary, ascites and pleural effusion. Other benign cysts of the ovary (such as struma ovarii, mucinous cystadenoma, serous cystadenoma and teratomas), leiomyoma of the uterus, and secondary metastatic tumours to ovary if associated with hydro thorax and ascites are referred to as ‘Pseudo-Meigs” syndrome. It very uncommon and diagnosis is made difficult by symptoms that usually mimic disseminated malignancy or tuberculosis. The gold standard treatment is laparotomy and, by definition of the syndrome, after tumor removal, the symptoms resolves and the patients become asymptomatic. We presented an 18 years old girl with giant ovarian serous cystadenoma with associated pseudo-meigs syndrome, successfully managed in a low resources setting.

三个有远见的荷尔蒙替代疗法

01/15/2021

When a woman consults a doctor about Hormone Replacement Therapy (HRT), the first concern is that there is an increased risk of breast cancer with HRT. And this sole reason might be the reason for refusing the offer of HRT. However, this practice has minimal basis and evidence to support it.

审计在门诊宫腔镜€“宫颈扩张,失败率和病人满意度

01/12/2021

& lt; h2> Abstract< / h2>

Aims: To audit the use of cervical dilators, local anaesthetic, and failure rates in outpatient hysteroscopy over a two-year period in University Hospital Kerry. To review the experiences of women attending the outpatient hysteroscopy clinic (OHC) over a two-year period in University Hospital Kerry.

Methods: Retrospective data review was carried out. Green-top Guideline No. 59: Best Practice in Outpatient Hysteroscopy, published by the Royal College of Obstetricians and Gynaecologists (RCOG), was the standard used for comparison.

Results: Two hundred and twenty women were seen over a two-year period. The average age was forty-eight. The most common complaint being of menorrhagia/irregular bleeding per vaginum (PV).

Local anaesthetic was used in just under one third of cases of which half required cervical dilatation. Most women reported experiencing mild to moderate levels of discomfort however most would opt for an outpatient hysteroscopic procedure again if required.

Discussion/Conclusion: Outpatient hysteroscopy is a well-tolerated and safe procedure. Suitability for outpatient hysteroscopy is not predictable based on parity of menopausal status. Women would elect to undergo outpatient hysteroscopy again if required and this is likely due to several reasons including convenience and lack of requirement for general anaesthetic.

NLP-based教学方法的影响手术高级职业居民

01/04/2021

Each individual has a unique way of learning which is based on personal background [1]. Neuro Linguistic Programming is an ideology of communicating with an individual. It can be applied in social relations like teaching fields [2]. Each medical student deals with a set of new information in his unique way. For example with regard to the following text on vacuum extraction, one learner focuses on definition, while the other focuses on spelling, and the third one just on shapes [3] (Figures 1-3).

单侧胸腔积液为唯一的卵巢过度刺激综合征(主要)

12/01/2020

A 44-year-old G4P2+1 presented to the emergency department on the 10th day following embryo transfer (with two fresh, day 5, blastocysts transferred in a hospital abroad) with the complaints of difficulty breathing, chest discomfort and cough for one day.

慢性子宫内膜炎患者体外受精失败

12/01/2020

& lt; h2> Abstract< / h2>

Introduction: Chronic endometritis (CE) is a common cause of infertility in asymptomatic patients and its diagnosis and treatments improved assisted reproduction technique outcome in most of the specialized centers. Diagnosis of CE in endometrial biopsy by Hematoxylin and Eosin (H&E) stain is hard to identify chronic inflammatory cells from the stroma and the use of plasma cells-specific stains is helpful.

Aim of the work: Evaluation of the use of CD138 in the identification of plasma cells in endometrial biopsy of patients with previous IVF trial failure.
Material and methods: Hysteroscopic and curettage endometrial biopsies from fifty-five females with previous IVF trial failure were stained with H&E and CD138 immunostaining for detection of plasma cells.

Results: Plasma cells were identified in 52.7% of cases by H&E and in 6/55 by CD138 immunostaining. CD138 is more sensitive in detecting plasma cells in endometrial biopsy than H&E stain. There was a significant statistical correlation between CE and abnormal uterine bleeding, abortion and primary infertility (p > 0.5).

Conclusion: Diagnosis of CE is helpful in infertility patients with IVF trial failure to improve the outcome of the maneuver. CD138 is more sensitive for plasma cells specially in endometrial biopsies than H&E.

经验与反式径向为子宫肌瘤子宫动脉embolisation三级中心在沙特阿拉伯

12/01/2020

& lt; h2> Abstract< / h2>

Trans-radial uterine artery embolization (UAE) is acknowledged as a non- invasive, cost-effective and safe procedure for the treatment of symptomatic fibroids. However, it is associated with the recurrence of symptoms like abnormal uterine bleeding and pressure symptom in some patients. This is a comparative study of our data with other international data, in the context of percentage reduction in fibroid size, accompanying controlling factors, short and long term follow up data analysis of the first two years was done. Careful pre-procedural counseling of future possibility of fibroid recurrence and means of management should be stressed.

Materials and methods: A retrospective cohort study at the Security Forces Hospital in Riyadh, Saudi Arabia, was conducted. The study was done from 1st November 2017 - 31st October 2019, on symptomatic patients diagnosed with fibroids, who refused surgical treatment.

The outcomes included: fibroid site, size and anatomical position, patients’ symptoms, general condition, and early and delayed complications. These data were compared with those from other international studies.

Results: The study involved 23 patients (mean age: 39 years). The average percentage reduction in fibroid volume was 49%. There were no major complications and no recurrence of symptoms during the covered period. Data analysis revealed a poor correlation between the overall percentage reduction of fibroid size with fibroid number, age of patients’, and body mass indices.

Conclusion: Despite poor correlation, we provided preliminary data of the first two years out of the total five-year projected period of the study where it showed effectiveness and relative safety of radial - UAE for fibroid.

临床特点、管理七个严重和危重孕产妇和新生儿的结果在孕妇COVID-19肺炎

11/30/2020

& lt; h2> Abstract< / h2>& lt; p>新型冠状病毒引起的肺炎疾病2019 (COVID-19)是一种高传染性疾病和疫情已经宣布大流行的世界卫生组织。肺炎是一种严重的疾病在怀孕,需要及时关注。病毒性肺炎具有较高的发病率和死亡率相比,怀孕的细菌性肺炎。一切努力都对理解新出现疾病的特性,但仍有些地区是灰色的。你们;/ p>& lt; p>与抗病毒药物治疗主要是支持,类固醇、抗凝和继发性细菌感染的抗生素。严重的病例需要重症监护和氧监测的支持,机械通风。临床实验的疗法包括恢复期的等离子体,释放细胞因子抑制剂和其他免疫调节药物如干扰素。死亡率出现由存在严重成人呼吸综合症(ARDS)和器官衰竭。;/ p>& lt; p> COVID大流行是一个充满挑战和压力的社会经济形势普遍担心感染,疾病和死亡。 In the specialty of obstetrics and gynecology, studies are being conducted to ascertain the manifestation of disease in pregnant women and the fetal outcome.

The aim of our case series is to describe the demographics, clinical characteristics, laboratory and radiological findings, feto- maternal outcome of severe and critical COVID pneumonia in pregnant women in Latifa Hospital.

概述当前方法对复发性流产,流产的威胁

11/30/2020

& lt; h2> Abstract< / h2>

Miscarriage is a frequent outcome of pregnancy, with major emotional implications to the couple experiencing such an event. Threatened miscarriage is the commonest complication of early pregnancy and affects about 20% of pregnancies. It presents with vaginal bleeding with or without abdominal cramps. On the other hand recurrent miscarriages are post implantation failures in natural conception. Increasing age of women, smoking, obesity or polycystic ovary syndrome (PCOS) and a previous history of miscarriage are risk factors for threatened miscarriage. The pathophysiology has been associated with changes in levels of cytokines or maternal immune dysfunction. Clinical history and examination, maternal serum biochemistry and ultrasound findings are important to determine the treatment options and provide valuable information for the prognosis. Many surgical and non-surgical interventions are used in the management of threatened and recurrent miscarriages. In this review, we present available evidence-based guidance on the incidence, pathophysiology, investigation and clinical management of recurrent miscarriage and threatened miscarriage, focusing mainly on the first trimester of pregnancy and primary healthcare settings. The review is structured to be clinically relevant. We have critically appraised the evidence to produce a concise answer for clinical practice.

四年复发危险因素后张力阴道tape-obturator治疗压力性尿失禁

11/04/2020

& lt; h2> Abstract< / h2>

Objectives: Tension-free vaginal tapes are the gold standard of the surgical treatment of stress urinary incontinence (SUI); however, long-term recurrence of SUI after this surgery has been a matter of problem. Here, we attempted to determine the incidence of its recurrence and to identify the risk factors of 4-year-recurrence of SUI after this surgery.

Methods: Of all patients undergoing this surgery (n = 341, 2015-2019), 71 patients were met the study inclusion criteria. Of 71, SUI recurred in 8 patients, with the recurrence rate being 11.3%. The following three were identified to be independent risk factors: older age, history of delivery of macrosomic baby (>4 kg), and the presence of mixed urinary incontinence. The frequency of recurrence in cases with mixed incontinence amounted for 19.5%. Recurrence was 22 and 50% for women with macrosomic delivery once and more than twice, respectively.

Conclusion: Advanced age, macrosomic delivery and mixed urinary incontinence have shown to be independent risk factors of recurrence of SUI after tension-free vaginal tape-obturator at 4 years.

Key message: Stress urinary incontinence can recur so investigate possible risk factors is a priority. Our paper relates recurrence with: advanced age, fetal macrosomia and mixed incontinence.

实验小说与镍four-spherical宫内避孕器

10/20/2020

& lt; h2> Abstract< / h2>

The aim of this study was to develop a novel four-spherical intrauterine contraceptive device (4-SIUD) with nickel-titanium (Ni-Ti) for human, and to evaluate the contraceptive effect. The 4-SIUD composed of 4 mesh spheres and 5 support arms. The shape of 4-SIUD was like a “T”. The height (H), upper width (D) and thickness of the 4-SIUD for macaques were 0.8 cm, 0.5 cm and 0.3 cm, and for human were 4.5 cm, 4.0 cm and 0.8 cm, respectively. The 4-SIUD was inserted into 5 macaques and pregnancy was not observed at 12 months. Three women used the 4-SIUD for 12 months, uterine perforations, expulsion, pain, and pelvic inflammatory did not occur. The results suggested that the 4-SIUD is appropriate for rhesus macaques and human use, and has a good contraceptive effect.

子宫破裂的孕产妇和围产期结果在卢本巴希,刚果民主共和国

10/20/2020

& lt; h2> Abstract< / h2>

Introduction: Uterine rupture is one of the peripartum complications, which cause nearly about one out of thirteen maternal deaths. This study aimed to assess the prevalence and associated factors of mortality among women with uterine rupture in referral hospitals of Lubumbashi, in the south east part of the Democratic Republic of Congo.

Methods: Institution based cross sectional study was conducted from December 1st, 2012 to 31st, 2016 on uterine rupture. During the study selected 158 women were included by using exhaustive sampling method. Data were checked, coded and analyzed into STATA version 12. Chi-square test was used to identify the predictors of maternal and perinatal mortalities in women with uterine rupture and 95% Confidence Interval of odds ratio at p-value less than 0.05 was taken as a significance level.

Results: The overall prevalence of uterine rupture was 0.49%. The average age of the patients was 29.5 ± 6.2 years and 71.52% of them were between 20 and 34 years old; more than 60% had a parity ≥4 (average parity: 4.7 ± 2.5). 81.17% of the cases had a fully ruptured uterus and 51.17% of the uterine ruptures were located in the lower segment. Repair of the pregnant ruptured uterus was performed in 93.04% of the cases and hysterectomy in 5.06%. Maternal and perinatal mortalities were 8.86% and 72.04% respectively. Regarding maternal mortality, no parameter showed a significant association with maternal death. As for perinatal mortality, parity ≥4, complete rupture and segmento-corporeal lesion were significantly associated with perinatal death (p < 0.05).

Conclusion: Uterine rupture remains one of the causes of maternal and perinatal mortality in Lubumbashi. The place occupied by uterine ruptures in obstetric activity requires joint and urgent action by all stakeholders in the health system in order to combat this scourge, witness to poor quality obstetric care.

子宫内膜厚度和冻结解冻胚胎移植:一种前瞻性研究

10/14/2020

& lt; h2> Abstract< / h2>

Aim and objectives: Endometrial Window of Implantation (WOI) is open in the midsecretory phase wherein the markers of invasion and cell adhesion are manifested .The primary objective was to find out the predictive value of Endometrial thickness and profile as a prognostic factors for embryo transfers during ART.

Materials and Methods: Endometrial thickness assessment was performed with grey scale ultrasound on the day of transfer just before thawing the embryos in patients undergoing Frozen embryo transfer cycle after endometrial preparation.

Results: The mean age and standard deviation of study population was is 33.26+5.95.Out of 69 patients there was clinical pregnancy in 33 patients , miscarriage in 10 patients and ongoing pregnacy in 23 patients. So the implantation rate was 47.83% (33/69), early miscarriage rate (pregnancy ending before 12 weeks) was 14.49%(10/69) and the ongoing pregnancy rate was 33.33% (23/69). Endometrial thickness < 6 mm had comparable implantation rates but low ongoing pregnancy rates.

Conclusion: The ultrasound morphological and vascular grading of endometrial thickness and vascularity is useful to synchronise Day 5 embryo transfer and window and implantation thereby minimizing the loss of good embryos in nonreceptive endometrium.

影响ICSI精子DNA碎片的结果:一个前瞻性研究

10/14/2020

& lt; h2> Abstract< / h2>

Aim and objectives: The primary aim was to measure the sperm DNA damage and to study the magnitude of sperm DNA damage. Secondary objective was to study the effect of sperm DNA fragmentation on Day 5 Blastocyst expansion (graded 1-5).

Results: There is an increase in sperm DNA fragmentation with an increase in age. Increased sperm DNA fragmentation is also associated with abnormal motility and morphology in semen samples. However, there is no reduction in expansion or grade of blastocyst.

Conclusion: Sperm DNA fragmentation testing is a useful investigation in unexplained infertility. However, Sperm DNA fragmentation has no significant association with Day 5 embryo grade in ICSI cycles.

Thesis work of Fellowship in Reproductive Medicine student: Dr. Ramya Harish

卵母细胞成熟率进行比较,在重组人类绒毛膜促性腺激素(HCG)和醋酸曲普瑞林触发器:一项前瞻性随机研究

10/13/2020

& lt; h2> Abstract< / h2>& lt; p>促黄体激素(LH)像暴露在中期周期诱导卵母细胞成熟的成功是非常关键的一步ICSI治疗。引入涌开促黄体激素促性腺我¬nal卵母细胞成熟感应,可能更生理而促管理。因为促性腺激素会引起FSH飙升也随着LH激增,发生在自然循环。然而,给予人类绒毛膜促性腺的影响引发诱导只有LH激增,给促性腺引发诱导LH和FSH飙升,与GnRH拮抗剂ICSI治疗的病人需要更多的研究。子的病人计划ICSI,满足入选标准的要求,从第二天开始重组FSH的月经周期。GnRH拮抗剂都开始从6天的刺激。FSH剂量调整根据个人的反应。触发计划当导致卵泡达到24毫米。触发,100名患者被随机分配接受重组促触发和醋酸曲普瑞林触发。 Oocyte retrieval was done 36 hours after Recombinant hCG Trigger and 35 hours after Triptorelin acetate trigger. The oocyte maturity rate was assessed by the number of metaphase II oocytes retrieved.

在妊娠病毒性脑膜炎:一个案例报告

10/13/2020

& lt; h2> Summary< / h2>

Ms X is a 34 year old para 1 woman who presented at 26+5 weeks’ gestation with fever, neurological symptoms and history of a viral illness. She was treated empirically for bacterial meningitis and transferred to a tertiary maternity hospital. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) was positive for enteroviral ribonucleic acid (RNA), confirming viral meningitis. Ms X improved clinically and was discharged after six days. A high index of suspicion is required for diagnosis of meningitis in pregnancy. Thorough history, examination and workup is vital for timely treatment. Prognosis in viral meningitis is excellent with no clear adverse fetal or neonatal outcomes.

阴道和子宫内膜癌转移的原发性皮肤恶性黑色素瘤

09/16/2020

建立一个新参考线2 d transperineal urogynecology超声波

09/08/2020

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>The purpose of this study was to establish a new, reliable and reproducible reference line for assessing bladder neck descent using 2-dimensional transperineal ultrasound. Therefore, we created a novel line, named Symphysis-Levator Line (SLL) and defined it as the connecting line between the hyperechogenic, dorsocaudal edge of the symphysis pubis and the hyperechogenic anterior margin of the puborectalis muscle, posterior to the anorectal junction.

Methods: A retrospective study was performed including 111 patients, who underwent a transperineal ultrasound as part of an urogynecological examination in the department of Urogynecology at the University Medical Center of the Johannes Gutenberg University Mainz. We calculated the bladder neck decent using the SLL and compared our results with the measurements assessed using a horizontal line through the infero-posterior margin of the symphysis pubis, as previously described by Dietz (Horizontal Symphysis Line, HSL). In addition, we calculated the intra- and interobserver reliability of the two methods and examined the influence of various patient characteristics on the obtained values.

Results: Both methods demonstrated a high intra- and interobserver reliability. Even though the HSL produced slightly higher numerical values for the bladder neck descent, the novel SLL was more precise. Our data support that the 2-point fixation of the SLL on two anatomical structures ensures the stability of the reference plane during the functional changes of the pelvic floor.

Conclusion: The Symphysis-Levator Line could be a useful tool for urogynecologists in the future.

通用检测严重急性呼吸系统综合症冠状病毒2在入学三圣克拉拉县劳动和交付单位CA

08/31/2020

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>目的:& lt; / strong>确定严重急性呼吸系统综合症患者冠状病毒的流行2 (SARS-CoV-2)劳动和交付单位西海岸。你们的核心地区之一;/ p>& lt; p> & lt; strong>研究设计:& lt; / strong>这是一个回顾性图表review&,病人承认劳动和交付于4月15日,2020年5月15日,2020年实现的通用测试分娩。你们政策;/ p>& lt; p> & lt; strong>结果:& lt; / strong>,,严重急性呼吸系统综合症患者冠状病毒的流行2 (SARS-CoV-2)承认分娩人口为2.5%,其中87.5%是无症状的。你们;/ p>& lt; p> & lt; strong>结论:& lt; / strong>我们提出额外的数据在无症状的患病率SARS-CoV-2怀孕患者在西海岸,与其他地区相比要低得多,可能由于咄咄逼人,而避难所place&,政策。普遍筛查不足以发现无症状SARS-CoV-2,从而快速、通用测试劳动和交付单位应优先保护病人和医护人员,并更好地分配适当的资源灵活;/ p>& lt; p>要点:& lt; br /比; 1.   2.5% of 320 patients tested positive for SARS-CoV-2.
2.   87.5% of positive patients were asymptomatic.
3.   Universal testing on labor and delivery is necessary.
4.   ‘Shelter-in-place’ policies reduced SARS-CoV-2.

怀孕复杂与抗凝血酶的缺陷:对当前文学

08/31/2020

& lt; h2> Abstract< / h2>& lt; p>抗凝血酶缺乏症,虽然稀有血栓形成倾向,血栓栓塞的风险最高。这种风险增加尤其是怀孕妇女由于生理凝怀孕的变化。因此,在这种情况下积极的个人和/或血栓栓塞事件以及家族史的复发性流产妇女应做抗凝血酶缺乏症。抗凝血酶缺乏症是由众多分支C的serpin肽酶抑制剂1基因的突变(SERPINC)和分类根据血浆抗凝血酶活动和抗原水平为I型(定量缺陷)和II型(质量缺陷)。孕期并发症可分为那些关于母亲和胎儿。抗凝血酶的主要临床表现缺乏关于怀孕期间母亲是血栓发生自发地或循环。许多主要的妊娠并发症如流产、宫内生长受限或胎儿死亡,胎盘早剥,子痫前期和溶血,肝酶升高,血小板低(临床上妊娠)综合征可能与抗凝血酶缺乏症。密切监测与早期和适当的预防和治疗现在可以主要保证积极的怀孕母亲和孩子的结果。预防/治疗低分子量肝素和抗凝血酶集中怀孕就应该开始计划或者至少尽可能早在怀孕和持续到结束的产褥期。;/ p>

乙肝病毒和丙肝病毒感染在怀孕的影响

08/14/2020

& lt; h2> Abstract< / h2>

The incidence of HBV infections among the pregnant in Europe falls within the range of 1% - 7%,

whereas it is 1.7% - 4.3% for HCV.

The aim was to assess the course of pregnancy among women infected with HBV or HCV, and the condition of neonates in the fifth minute after the birth.
The study included 157 pregnant individuals infected with HBV, 53 infected with HCV, and 330 healthy pregnant women. None of the women infected with HBV and HCV as well as from the control group were infected with HIV, and none of them took intoxicants.

Weight of neonates delivered by healthy women was higher as compared with children born by women infected with HBV or HCV (3,517 vs. 3,347 and 3,366). The Apgar score of neonates delivered by women with HBV and HCV infections was lower as compared with the children born by healthy women (9.4 vs. 9.3 vs. 9.7; p < 0.05). Premature births occurred more often in HBV and HCV-infected women than in the control group (14.6% and 24.5% vs. 6.96%; p < 0.05). Miscarriages were significantly more common among the pregnant with HCV infections as compared with the pregnant who were healthy (9.4% vs. 1.8%; p < 0.05). In comparison with the healthy individuals, this group of patients experienced pruritus (10.5% vs. 4.2%; p < 0.05), oedemas (9.4% vs. 2.4%; p < 0.05), and hypertension (9.4% vs. 1.5%; p < 0.05) more often.

An increase in HBV loads was observed between the 6th and 28th – 32nd week of pregnancy among the infected with HBV, and then, a decrease was observed in the 6th months after the delivery.

The pregnant infected with HBV without HBsAg (-) and the infected with HCV are subject to common incidence of premature births. Women infected with HCV often experience oedemas, hypertension, and pruritus.

子宫内膜异位作为结直肠癌的风险因素

08/12/2020

& lt; h2> Abstract< / h2>

Endometriosis is a common benign disease in women of reproductive age, it has been associated with an increased risk of various malignancies that is defined by certain histological criteria mainly 80% in ovary and 20% in extragonadal sites such as intestine, rectovaginal septum, abdominal wall, pleura and others; the greatest risk for colorectal cancer is women with adenomyosis or endometriosis; Several genetic alterations have been found in the risk of endometriosis associated with cancer; The symptomatology, imaging and endoscopic characteristics simulate other inflammatory and malignant lesions that make the preoperative diagnosis of extragonadal endometriosis difficult. This is a review of the knowledge about endometriosis and its potential risk of malignancy, particularly with colorectal cancer.

血小板减少症患者的案例系列评审和Absent-Radii综合症(水手)和怀孕期间他们的管理

08/12/2020

& lt; h2> Abstract< / h2>

Bleeding diatheses due to platelet-related disorders can present challenges to treating clinicians especially in the context of peri- and post-partum patients in the obstetric setting. TARS is an inherited disorder characterised by reduced bone marrow platelet production, skeletal deformities affecting radii and other limbs; cardiac, renal, and other heterogeneous anomalies may occur. It is caused by co-inheritance of a microdeletion and a nucleotide polymorphism in the RBM8A gene on chromosome 1.

Bleeding phenotype is more severe than platelet numbers might predict especially in infants but improves with age. There is minimal literature regarding impact in pregnancy and puerperium.

We describe management of three pregnancies in the haematology-obstetrics clinic. As platelet counts normally decrease through pregnancy, close monitoring is required in TAR syndrome. No major bleeding was seen antenatally but two required platelet transfusion during labour. No other treatment definitely improves bleeding, although case reports of steroids claim variable success.

Tranexamic acid may be helpful, and thrombopoietin agonists represent a potential future option.

出血性休克由于不可约在晚期妊娠双子宫扭转:一个案例报告

07/07/2020

& lt; h2> Abstract< / h2>

Uterine torsion is a rare life-threatening event that happens at any age or any gestational age. By definition, it consists of a rotation of more than 45 degrees around the long axis of the uterus. The reported cases have variable presentations. The uterine torsion can happen without any sequelae either for the fetus or the mother. However, fetal and maternal mortalities were also reported in such a case.

We hereby, report the case of a 29-year-old female patient, with previous four Normal Vaginal Deliveries, pregnant with twins, presenting at 36 weeks gestation with an irreducible uterine torsion at the third trimester of her pregnancy complicated by maternal and fetal deaths.

We concluded that the prognosis is improved as long as the management is done rapidly. More data is needed to know about the genetic predilection and the characteristics of imaging workup for a rapid preoperative diagnosis of this condition.

刮除术是边际脐带插入一个风险因素

07/02/2020

& lt; h2> Abstract< / h2>& lt; p>目的:识别风险因素的边际线插入(MCI)。你们;br /比;材料和方法:病例对照研究进行了2月1日至2019年6月30日。单身者有或没有MCI在交付被招募。主要变量分析包括母亲的年龄,平价,先前的扩张和刮除术(D&音箱;C)或手动真空吸尘(MVA),每个程序和概念之间的时间间隔,线插入。Fisher&,精确测试,t检验和逻辑回归是用来比较两组数据灵活;/ p>& lt; p>结果:我们发现60例MCI (4.1%)。显著(p, lt;0.05)风险因素MCI的历史D&音箱;C(优势比5.97,95%可信区间1.95 - -18.25)尤其是当概念发生E‚D&后5个月;音箱;C(或10.5,95%可信区间1.36 - -81.05),胎儿女性性(优势比3.82,95% CI 1.41 - -10.32),奇偶校验,通用电气;4(优势比为2.63,95%可信区间1.05 - -12.71)和历史MVA(优势比2.06,95%可信区间1.23 - -8.76)。;/ p>

Conclusion: Women should be advised to conceive at least five months after D&C.

子宫肌瘤栓塞Covid-19的时间

07/02/2020

& lt; p>冠状病毒大流行造成了重大变化在社会在世界各地,特别是在医疗保健系统。各种疾病患者和条件将接受选择性治疗在大流行性流感到来之前,想知道如果他们仍然应该遵循它。首先,如果一个程序可以被推迟没有导致大量额外发病率病人,应该灵活;/ p>

三阴性乳腺癌:管理和发展早期阶段,一个两年经验的CHSF乳腺癌

06/30/2020

& lt; h2> Abstract< / h2>

Breast cancer is the most common cancer in women and is a major public health problem. It is divided into several subtypes, including triple negatives. The general objective of our study is to establish the profile and the management of patients with triple negative breast cancer over a period of 2 years, operated in our department.

During our study period, triple-negative breast cancers accounted for 10% of our population. The most affected age group ranges from 50 to 60. The majority of patients in our sample are pauciparous. In the group of patients who received hormone therapy, it was mainly HRT for 4 to 6 years. 96.77% of patients consulted a health worker within 3 months of the discovery of the signs. Adenopathies are frequently present at the time of diagnosis. 93.54% of the cases have an invasive ductal carcinoma. Triple negative cancers are essentially poorly differentiated. Triple-negative cancer has a high rate of cell renewal. In our study, neoadjuvant chemotherapy is mostly indicated for triple-negative breast cancers ≥ 30 mm at diagnosis and a delayed lumpectomy is then performed in 23.52% of the patients. For tumors of < 30 mm size, a lumpectomy is performed immediately in 76.47% of the patients, followed by adjuvant chemotherapy.

Mastectomy was performed in 45.16% of patients; it was mainly indicated in front of a large tumor size associated with a small breast volume, then multifocal breast tumors. Breast reconstruction was performed in 21.42%. Radiation therapy is indicated in the majority of patients, postoperatively. In our population, 11 patients were proposed to have an oncogenetic survey; it was mainly indicated based on the Manchester criteria in front of a young age and a family history of cancer. There are two BRCA 1 mutations, one BRCA 2 mutation, and one case of absence of mutation. The therapeutic intake in case of a mutation is directed towards a prophylactic bilateral mastectomy and adnexectomy, proposed at the age of 40. Two patients had presented triple negative recurrences of their already treated breast cancer; first case PDL1 positive PD-L1 ≥ 1% treated with immunotherapy combined with chemotherapy (atezolizumab/abraxane) while the second and second PDL1 negative treated with chemotherapy alone.

Despite their low frequency, triple negative breast cancers represent a subgroup marked by pejorative characteristics, a reserved prognosis, with limited treatment options.

COVID-19怀孕:我们的经验在一个三级妇产科在法国

06/24/2020

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>目标:& lt; / strong>我们的主要目标是揭示妊娠COVID-19感染和新生儿的影响,比较的结果报告在文献中灵活;br /比;方法和材料:承认怀孕患者COVID-19积极的特点,他们最初表示,短期课程在医院,和后续的接触。相关的年龄和胎龄与疾病的严重程度进行了计算。你们;/ p>& lt; p> & lt; strong>结果:& lt; / strong>三十五COVID-19正怀孕的患者之间呈现的开始3月和2020年4月的结束。从5周直到妊娠41周,三学期制都包括在内。平均年龄是32和体重指数= 28.2。相关并发症不仅包括糖尿病和高血压还PCOS。 The symptomatology was considered mild in most of the cases. The distribution of the symptoms included cough in 86%. 10 out of 35 delivered and cesarean was performed in 50% of the cases. The mean length of stay is 6 days. Neither maternal nor neonatal deaths occurred. There is a significant correlation between the age of the patient and the severity of the disease but this is not the case with gestational age.

Conclusion: Our results were comparable to the literature in terms of initial presentation, associated comorbidities and the length of stay. Despite the fact that the cesarean rate was high, it was far below that of the literature. More data is still needed about COVID-19 in pregnancy.

决定因素的新生儿附近小姐在新生儿读经台大学录取和读经台综合医院转诊医院,埃塞俄比亚,2019

06/24/2020

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>Neonatal Near-miss is defined as complications of neonates so severe as to be imminently life-threatening but survived due to chance or treatment. The number of neonates who survived morbidities were approximately 3 to 6 times greater than those who died. There was little evidence about neonatal near miss in Ethiopia. This study attempted to identify the determinants of neonatal near miss among neonates admitted to the Ambo University Referral Hospital and Ambo General Hospital.

Methods: Hospital-based quantitative unmatched case-control study was conducted at the Ambo University Referral Hospital and Ambo General Hospital from March 1 to 28, 2019. The respondents, 134 cases and 268 controls were recruited by simple random technique. Data were coded, entered and cleaned in EpiInfo version 7 and exported to SPSS. Both Bivariable and multivariable logistic regression was computed at 95% CI and the final model was checked by Hosmer and Lemeshow goodness -of-fit test. Multi collinearity and cofounders were not detected.

Result: Multivariate analysis showed that distance more than 15km away from health facilities [AOR=2.11, 95% CI: (1.09, 4.095)], Unwanted, and unplanned current pregnancy [AOR=3.71, 95% CI: (1.28, 10.79)], less than four Antenatal care visit [AOR=6.55, 95% CI: (3.07, 13.98)], Instrumental delivery [AOR=4.62, 95% CI: (1.78, 11.98)] were positively associated with Neonatal Near Miss. Whereas Term Neonates [AOR= 87%, 95% CI: (0.05, 0.32)], and Normal birth weight [AOR=91%, 95% CI: (0.03, 0.28)] were negatively associated with Neonatal Near Miss.

Conclusion: Distance from health facilities, Antenatal care visit, current pregnancy type, birth weight, gestational age and mode of delivery were determinants of Neonatal Near Miss. Therefore, providing adequate Antenatal services, health education and training is needed to improve neonatal health.

孕产妇、新生儿和childrenA´s健康在撒哈拉以南的非洲东部

05/29/2020

& lt; h2> Summary< / h2>

The Czech model for reducing maternal and neonatal mortality for countries in sub-Saharan East Africa was created on the basis of the Archdiocesan Charity Prague project for a specific region-subcounty Buikwe, Diocese of Lugazi, Mukono Region in Uganda, a region with about 30,000 inhabitants. The aim of the first phase of the project was to build a new hospital, equip it completely for obstetric and surgical operations from the Czech Republic, ensure its activities with Czech and Slovak doctors experts, junior Ugandan doctors and Ugandan medical staff, provide obstetric training for villagers, ensure connections with villages and possibility of fast transport and urgent solution of all acute pathologies in the hospital, capable of 24-hour surgical readiness. In the second phase of the project, a school for midwifery was to be established. This second part of the project has not yet been implemented. The project could serve as an example and guide for similar humanitarian activities in other regions of Uganda and other countries in equatorial Africa.

劳动审判后剖腹产与妊娠体重增加过多的结果

05/06/2020

& lt; h2> Summary< / h2>

The success of vaginal birth after cesarean section (VBAC) has been correlated with a variety of maternal characteristics such as age, ethnicity, and body mass index (BMI, calculated as weight in kilograms divided by height in meters squared). The patient’s BMI just prior to delivery has been shown to be a better prognostic indicator of success than pre-pregnancy BMI. Gestational weight gain was previously associated with a decreased rate of successful VBAC. More recent research has not supported such an association. The objective of our study was to further validate these findings with a larger population.

We performed a retrospective cohort study of women undergoing trial of labor after cesarean (TOLAC) at our institution from January 2010 to December 2019. Women were divided into three groups based on weight gain in pregnancy as compared to the American College of Obstetrics and Gynecology (ACOG) recommendations (i.e. < 25 pounds (lbs), 25-35 lbs, > 35 lbs). We further subdivided the pregnancies between term and preterm deliveries. The primary outcome was a successful VBAC. Of 1087 patients attempting a TOLAC, 772 (71%) were successful and 315 (29%) failed VBAC. When grouped according to ACOG weight gain recommendations, 303 (31%) women were below ACOG guidelines, 318 (33%) met guidelines, and 339 (35%) exceeded guidelines. There was no difference in the rate of VBAC success among the three groups. When counseling patients, providers should still promote healthy dietary habits but should not correlate excess weight gain with chance of TOLAC success.

防腐剂:爱——恨分子

05/02/2020

& lt; p>苯甲酸酯的酯para-hydroxybenzoic酸[1],模仿雌激素荷尔蒙使一个女人一个女人;女人喜欢和男人讨厌它。然而,过量使用这种化合物,甚至女性雌激素敏感器官。你们可以开发癌症;/ p>

Amenorrhea-An异常停止正常的月经周期

04/09/2020

& lt; h2> Abstract< / h2>

Amenorrhea is the absence or abnormal cessation of menstrual cycles in a woman of reproductive age. Prolonged cessation of menstrual cycles might results in complications such as infertility, psychosocial developmental delays, Osteoporosis, fractures etc. Better understanding of physiology of menstruation is essential to understand the various causes of primary and secondary amenorrhea. Any disruption or functional abnormality in the hypothalamic-pituitary-ovarian axis can result in abnormal menstruation or amenorrhea. Therefore it is crucial to identify this menstrual distress in women at early age to minimize the risks of reproductive dysfunction in premenstrual and postmenstrual conditions.

及时和相关因素之间的母亲母乳喂养婴儿的年龄不到6个月Gunchire镇,2019年埃塞俄比亚南部

04/09/2020

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>及时开始母乳喂养的定义是分娩后一个小时内开始母乳喂养。在全球范围内进行母乳喂养的母亲在一个小时不到一半的百分比。在东部和南部非洲等不发达国家包括埃塞俄比亚婴儿母乳喂养在一小时内练习很低。本研究的目的是评估及时和相关因素之间的母亲母乳喂养6个月以下的婴儿年龄Gunchire镇上,埃塞俄比亚南部。;/ p>& lt; p> & lt; strong>方法:& lt; / strong>研究从5月1日到28日,2019年Gunchire小镇。数据是通过使用一个结构化收集面对面访谈问卷。社区为基础的横断面研究采用333名女性。研究参与者选择简单随机抽样技术。 The data were coded, entered, cleaned and analyzed by SPSS with windows version 21.0. Binary and multivariable logistic regression statistical model was used. Adjusted odds ratio with 95% CI was computed to see the strength of association.

Results: In this study the magnitude of timely initiation of breastfeeding was 80.5%. Governmental employed mothers (AOR=2.914, 95% CI: 1.139, 7.46), Antenatal care follow up (AOR=5.99, 95% CI: 1.29, 27.81), Baby skin to skin contact (AOR=2.4, 95% CI: 1.092, 5.34), Vaginal delivery (AOR=5.82 95% CI: 1.68, 20.14) Institutional delivery (AOR=5.5, 95 CI%: 1.66, 18.3), Good knowledge of breastfeeding (AOR=4.02, 95% CI: 1.04, 15.59) and Breast disease (AOR=0.24, 95% CI: 0.08, 0.73) were significantly associated with timely starting of breastfeeding.

Conclusion: More than two third of the mothers timely initiated breastfeeding within one hour after birth. Being governmentally employed, having Antenatal care follows up, skin to skin contact, mode of delivery, knowledge of mothers about breastfeeding and place of delivery were positively and significantly associated with timely initiation of breast feeding, whereas, breast disease was protective against timely starting of breast feeding. Therefore, we would like to recommend Enamore woreda health office and Gunchire primary Hospital staffs work at MCH clinic to provide appropriate services and stimulate the mothers to initiate breastfeeding, skin to skin contact enhancing within the first hour of birth.

产前强化辅导的有效性在知识、态度和接受后胎盘在母亲子宫内避孕器

03/27/2020

& lt; h2> Abstract< / h2>

Introduction: Contraception is a method or device used to prevent pregnancy. In the first year of postpartum period around 65% of women are having unmet need of family planning. Post Placental Intrauterine Contraceptive Device is not only advantageous to the women and couples; even the service providers benefit from PPIUCD. PPIUCD insertion on the same delivery table saves time and separate clinical procedure is not required.

Methodology: The Quantitiative Pre-Experimental One Group Pre and Post Test research design was used. 70 Antenatal mothers were selected by using Purposive Sampling Technique who fulfilled the inclusion criteria and who were available during the period of data collection at selected hospital, Puducherrry. Data was collected by using Structured Interview Schedule.

Result: The Pre test mean score of Knowledge was 9.98 ± 2.38 and Post Test mean score of Knowledge was 14.91 ± 1.15. The calculated paired‘t’ value was (-20.82) found to be statistically significant at p < 0.001 level. The Pretest mean score of Attitude was 34.67 ± 5.67 and Post test mean score of Attitude was 44.27 ± 4.70. The calculated paired‘t’ value was (-17.25) found to be statistically significant at p < 0.001 level. The Pretest mean score of Acceptance was 0.11 ± 0.320 and Post Test mean score of Acceptance was 0.29 ± 0.455. The paired‘t’ value of t = -3.778 found to be statistically significant at p < 0.001 level. The Demographic and Obstetrical Variables like age at marriage, previous childbirth and decision maker of family about family planning have shown significant association with Post Test level of Knowledge, Attitude and Acceptance of PPIUCD at p < 0.05 and p < 0.001.

Conclusion: The researcher concluded that Prenatal Intensive Counselling increases the mother’s Knowledge, Attitude and Acceptance of PPIUCD. So Prenatal Intensive Counselling on PPIUCD can be given to Antenatal Mothers during their antenatal visits to meet the unmet needs of family planning.

胎儿酒精谱系障碍€”这是什么意思?

03/17/2020

& lt; p> Prenatal&, alcohol&接触,是可预防的认知障碍的最重要原因之一。发展中神经系统敏感伤害从amp;, alcohol&,现在也有实证that&,酒精伤害可以超越个人,导致表观遗传变异和代际脆弱性和劣势[1]。;/ p>

分子的肝毒性和肾毒性标记dysmenorrheic(治疗)的学生

02/18/2020

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>Dysmenorrhea is menstrual disorder that affects about 40% - 90% of women worldwide, it is associated with oxidative stress. The current treatment of this condition is administration of non-steroidal anti-inflammatory drugs, which when frequently used, may affect organs.

Objective: Assess the hepatotoxicity and nephrotoxicity side effects related to dysmenorrhea and its treatment

Materials and methods: A survey (questionnaire) was designed and implemented on 689 female students of the University of Dschang. After this, and following the inclusion criteria, 191 blood samples were collected for assay of hepatotoxicity markers (transaminases, albumin), nephrotoxicity indicators (creatinine, urea, total protein) and the inflammation associated indicators. The measurements were performed on fully automated Olympus AU 400 Analyzer, using standard reagent kits.

Results: Subjects with untreated dymenorrhea lasting more than five years had a significantly high level (p < 0.05) of ALT (39.47 ± 15.74 IU/L) and AST (44.37 ± 13.74 IU/L). Transaminases levels were significantly associate (p < 0.01) and positively correlate (0.251 for ALT and 0. 223 for AST) with the disease duration. Dysmenorrheic individuals on medication for more than 9 years had significantly higher ALT (25.14 ± 7.85 IU/L) and AST (35.26 ± 0.70 IU/L) levels (p < 0.05) compared to those under treatment for less than 5 years (19.37 ± 8.27 UI/L and 27.68 ± 8.56 UI/L). The use of analgesics, regardless of the duration of treatment, had normal creatinine clearance (107.44 ± 30.86 ml/min), compared to those treated with either anti-inflammatory drugs (71.56 ± 26.44 ml/min), or a combination of analgesics and anti-inflammatory drugs (81.34 ± 31.97 ml/min), which was significantly reduced (p < 0.05).

Conclusion: Dysmenorrhea duration, type and duration of treatment potentially expose participants to liver and kidney disorders.

患者肛门细胞学在免疫活性的高档上皮内瘤(CIN II和III CIN)

02/13/2020

& lt; h2> Abstract< / h2>

Introduction: Anal cancer is directly related to the presence of high-grade HPV. Immunocompromised patients have defined conducts, something which is not observed in immunocompetent patients.

Objective: To study the anal cytology of patients with high-grade intraepithelial neoplasia (CINII and III) in order to propose a protocol to be followed by the Oncology Gynaecology Service at the Samuel Libânio Clinical Hospital (HCSL).

Methods: Clinical, prospective, transversal and single-centered study. Sampling was by convenience within one year. A total of 150 patients were studied. Out of these, 76 were patients with high-grade cervical intraepithelial lesions diagnosed through histopathological examination of the uterine cervix (Study Group) and 74 without high-grade intraepithelial lesions and with cervical cytology negative for neoplasia (Control Group). The following variables were analyzed: age, sexarc, tobacco use, alcohol consumption, STD history (not HPV), menopause, Hormone Replacement Therapy, anal sex practice, parity, number of sexual partners and contraceptive use.

Results: There was no significant difference between the number of cases in altered anal cancer oncology in the study group, in comparison with the control group.

Conclusion: There were changes in the anal cytology of the study group and these should be evaluated due to the risk of dealing with pre-neoplastic anal lesion. Clinical Trials: NCT03241680.

口服克林霉素和甲硝唑治疗细菌性阴道炎怀孕的黑人女性:比较疗效和怀孕的结果

01/10/2020

& lt; h2> Abstract< / h2>

Bacterial vaginosis (BV) is associated with adverse pregnancy outcomes with various treatment options.

Objective: To compare the efficacy and effect on pregnancy outcome of Metronidazole and Clindamycin in women with bacterial vaginosis in Port Harcourt, Nigeria.

Methodology: Randomized controlled study of 136 pregnant women diagnosed with BV at the University of Port Harcourt Teaching Hospital. A structured proforma was used to obtain socio-demographic characteristics and other relevant data. Treatment was with either oral Metronidazole or oral Clindamycin for seven days. A secondary test and evaluation of the effect on adverse pregnancy outcomes were determined. Data analysis was done using the SPSS statistical package version 22.0.

Results: BV prevalence was 23%, with similar cure rates with both medications. The failure rates of clindamycin and metronidazole were 10.4% and 13% respectively (p = 0.639). The mean gestational age at delivery in the metronidazole treated group was 38.67 weeks ± 1.69 compared to 38.68 weeks ± 1.64 in the oral clindamycin group (p = 0.96). Pre-labour rupture of membranes and preterm delivery rates with both medications were similar (p = 0.73; OR 1.3; 95% CI 0.3-4.9) and (p = 0.73; OR 1.3; 95% CI 0.3-4.9) respectively.

Conclusion: Both medications have comparable efficacy and similar pregnancy outcomes in the treatment of bacterial vaginosis in low-risk asymptomatic pregnant Nigerian women and thus can be used interchangeably.

蛇在怀孕期间表面变质

12/23/2019

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>We report our experience with management and treatment of pregnant women who were admitted at our institution for snake envenomation.

Methods: We reviewed the charts and recorded the management, treatment, and outcome of 51 pregnant women admitted to our high-risk obstetric service with a diagnosis of snakebite.

Results: One patient experienced spontaneous abortion, 2 had intrauterine fetal death due to placental abruption, 2 delivered malformed babies, 1 had premature birth of twins with low birthweight. There were no maternal deaths.

Conclusion: Snake-venom poisoning in pregnancy is a complex medical emergency that involves complications at the site of the bite and may also involve dysfunction of multiple organ systems in both mother and fetus.

比较影响钙补充剂的先兆子痫和子痫的发生率primigravid女性

12/17/2019

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>Pre-eclampsia is a frequent and serious pregnancy complication contributing for the increasing maternal morbi-mortality rates. This study was designed to evaluate the effect of calcium supplementation during pregnancy, on the incidence of pre-eclampsia and eclampsia among primigravid women.

Method: In a hospital-based, opened, randomized and controlled clinical trial carried out in the city of Yaounde, 70 women were randomized to either 1.5 g daily calcium supplements (n = 35) or vitamins at the same time (n = 35) from 20 weeks gestation till delivery. Were included all singleton healthy, primigravid women who offered their signed inform consent and were excluded, all women with any chronic condition. Primary outcomes were pre-eclampsia and eclampsia.

Results: No significant difference was observed between the two study groups with respect to the baseline characteristics obtained at enrollment. We recorded a sevenfold decrease in the incidence of preeclampsia in the calcium group (RR = 0.26, CI 0.06 – 0.44, p = 0.024). The onset of pre-eclampsia was delayed 3 weeks in the calcium group. Meanwhile the mean diastolic blood pressure at delivery was of no significant difference (p = 0.126), the mean systolic blood pressure at delivery however, presented a significant difference between both groups (p = 0.009).

Conclusion: A 1.5 g daily calcium supplementation of healthy normotensive primigravid women during pregnancy seems to be effective in reducing the incidence of pre-eclampsia.

脑出血的脑干三怀孕后由接收捐赠卵子体外受精:病例报告和审查

12/16/2019

& lt; h2> Abstract< / h2>

Deliveries prior to 28 weeks’ gestation (extreme preterm birth) pose a global health concern, according to the World Health Organization (WHO). Extreme preterm birth is associated with several complications in the newborn and management in neonatal intensive care unit would incur high expenses. In parallel, advancements in in vitro fertilization will give an opportunity for women to conceive in cases of ovarian failure. At the same time, health providers also encourage patients to receive more than one embryo simultaneously during an embryo transfer. Here we report a case of a patient in coma condition of triplet pregnancy, post ovum donation with three-embryo transfer. Following stabilization, cranial computed tomography (CCT) was performed. The result showed bleeding in the brainstem and into intraventricular spaces at 25+4 gestation weeks. Furthermore, ICH during pregnancy is considered as a rare case in obstetrical field, especially involving the brainstem. This could lead to life-threatening conditions and serious disability in the future. On the fifth day of hospitalization, she suffered from pneumonia and pulmonary edema. On the eight day (26+5 gestations weeks), an emergency caesarean section was performed due to fully dilated of the cervix with breech presentation of all fetuses. Mother and the children survived with some non-life-threatening disabilities.

This is the very first case reported of intracerebral hemorrhage in the brainstem in triplet pregnancy after receiving ovum donation. Heterologous conception could be an iceberg phenomenon of gestational complications among the population. Reproductive tourism could still become greater in the future.

阿片类药物的影响微观结构组织的墙上白色实验室大鼠的子宫

12/11/2019

& lt; h2> Introduction< / h2>& lt; p>药物成瘾是一个燃烧的问题在现代社会。每年有一个稳定的增长水平的药物滥用。联合国毒品和犯罪办公室发布,“2018年世界毒品报告,”,,,据报道,大约有2.75亿人(几乎5.6%的世界人口)年龄在15 - 64使用药物至少一次在他们的生活中,和鸦片产量增加了65%在2016 - 2017年[1 - 3]。的问题因此,研究药物对器官的结构组织的影响仍然是开放和有关(4、5)。;/ p>

Meckel格鲁伯综合症:一种罕见的和致命的异常

12/06/2019

Case Report

We wish to present our case of the rare Meckel-Gruber syndrome, diagnosed prenatally at 18 weeks’ gestation. Informed consent was obtained from both parents for publishing this case and including photos.

以前的抗生素治疗复发性酵母菌病的一个危险因素

12/03/2019

& lt; h2> Abstract< / h2>

The incidence of recurrent vulvovaginal candidiasis (RVVC) is extremely high. RVVC is likely to have a greater impact on patients. The aim of the study was to explore the risk factors of recurrent vulvovaginal candidiasis (RVVC) in the tropical coastal area. In this case-control study, a questionnaire survey was conducted in patients with VVC in the Sanya area from July 2014 to December 2016. The data included demographic characteristics, host factors, and behavioural characteristics. According to the maximum number of symptomatic episodes per year, the participants were classified into a non-recurrent VVC (NRVVC; < 4 episodes/year, including the current one) group or a RVVC group (≥ 4 episodes/year, including the current one). Crude odds ratios were calculated for potential risk factors and were adjusted using logistic regression. All vaginal secretions of patients with RVVC were cultured. Of the 728 cases of VVC, 69.0% (502/728) were NRVVC, and 31.0% (226/728) were RVVC. Previous antibiotic treatment (adjusted OR: 4.41, p < 0.01), repeat abortion (p < 0.05), and vaginal lavage (adjusted OR: 1.62, p < 0.05) were significantly associated with RVVC. A total of 230 yeasts isolates were obtained from 226 patients. C. albicans were the predominant Candida species (194 strains) in all patients of VVC. Our results demonstrate that in the tropical coastal area, a significant association was found between previous antibiotic treatment and incident RVVC. Host factors may be the most important factors in the occurrence of RVVC.

之间的相关性存在孕产妇妊娠期或pre-gestational病态和产后时期听力障碍

11/22/2019

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>目的:& lt; / strong>To evaluate whether the occurrence of maternal pathologies, mainly Diabetes Mellitus and Hypertensive Syndromes in the gestational or pre-gestational period may be related to hearing impairment in postpartum women.

Methods: Observational, prospective study including 361 puerperal women who had their deliveries at a reference University Hospital for pregnant women with clinical history of risk. Auditory evaluation was performed by Distortion Product Otoaccoustic Emissions (DPOAE) within 14 days after delivery. Measures of central tendency and absolute and relative frequencies were used to describe the sample and the chi-square test and binary logistic regression to assess the correlation among variables. Significance higher than 95% was observed and the study was approved by the Research Ethics Committee.

Results: A total of 361 postpartum women were studied and 7.5% had hearing impairment. The frequency of gestational hypertension was 13.9%, that of gestational diabetes was 8.6% and that of pre-pregnancy diabetes mellitus was 5.8%. The presence of hearing impairment was significantly correlated with the occurrence of pre-pregnancy diabetes mellitus (OR: 4.5 - CI: 1.51-1.47), and maternal age greater than 29 years (OR: 3.72 - 1, 58-8.76); A correlation was also found between maternal age and the presence of pre-pregnancy diabetes mellitus (OR: 3.84 - CI: 1.45-10.15).

Conclusion: In the population of postpartum women evaluated, having Diabetes Mellitus prior to pregnancy and belonging to the age group older than 29 years increases the chance of having hearing loss.

前三个月增长延迟:早期三倍性的标志

11/21/2019

& lt; h2> Introduction< / h2>

Triploidy is one the most common chromosomal abnormality in humans, complicating about 1% of all human pregnancies. Most affected conceptions undergo spontaneous abortion in the first trimester, making the prevalence of second trimester triploidy low. Viable triploidy is associated with high rates of maternal morbidity, including hypertensive disorders, hemorrhage, and persistent trophoblasic disease, as well as fetal and neonatal severe adverse outcomes. Given these complications, early identification of triploidy in ongoing pregnancies may inform patient counseling and management.

妇科恶性肿瘤后乳腺癌的诊断:一项以人群为基础的研究

10/31/2019

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>Breast cancer (BC) is one of the most prevalent malignancies. BC survivors have higher risk of second primary cancers than the general population. There is an increased interest in BC survivor management, including the prevention of these second cancers. The aim of this study was to assess the risk of gynaecological malignancy (GM) as second neoplasm among BC patients in our population.

Methods: Patients with invasive BC diagnosed from 1980 to 2014 included in the Girona Cancer Registry were included. The incidence of second GM in these patients was compared to those in the general population. Second primary cancer was stated as a tumour diagnosed after 2 months from the BC diagnosis. Standardized incidence ratios (SIR) and absolute excess of risk (AER) were calculated.

Results: 9,717 patients were diagnosed with invasive BC during this period, with a median age at diagnosis of 61 years, and a median follow-up of 7.9 years. 117 of them developed a second GM. By tumour type, the only statistically significant higher SIR was observed for corpus uteri cancer (SIR:2.28 95% CI 1.82-2.83; AER:6.43 95% CI 4.13-9.14). After reviewing the histology of the CUC cases, we found that 71.4% were type I (endometrioid adenocarcinoma), 15.5% type II (serous adenocarcinomas and clear cell carcinomas), 10.7% carcinosarcomas, 2.4% sarcomas and there were no unspecified malignant neoplasms.

Conclusion: BC survivors have an increased risk of corpus uteri cancer, with an increase in unfavourable histologies compared to the general population. Lifelong primary and secondary prevention interventions should be recommended for these patients.

下腰痛诱发残疾的女性主要简单的怀孕

09/18/2019

& lt; h2> Abstract< / h2>

Study design: A consecutive case series study

Purpose: To investigate whether Low Back Pain (LBP) in women with primary singleton pregnancy induces disability.

Background: LBP is reported to be increased in pregnants than in non-pregnant women. Different outcome measures have been used to search for correlations between pain and disability.

Methods: 167 pregnant women aged 30 ± 3.5 years participated. Two equal categorial age groups were constructed: Group A included women aged 23 - 29 years, and Group B women aged 30-39 years. Their weight was 76 ± 13 kg prepartum and the Body Mass index (BMI) was 28 ± 4 prepartum. Visual Analogue Scale (VAS) was used for LBP pain intensity and Oswestry Disability Scale (ODI) for disability estimation in the last three months prepartum and in the first three months postpartum.

Results: The women weight was 67 ± 13 kg postpartum. The BMI was 24 ± 4 postpartum. There was no difference in VAS and ODI scores versus BMI, weight and height between the two age groups in both periods of observation: prepartum and postpartum. Prepartum, 81.4% of women claimed LBP that dropped to 55.5% postpartum. ODI score dropped from 19.5 ± 13.6% prepartum to 11 ± 12% postpartum. The ODI subscales that showed significant reduction postpartum were: Pain intensity (P = 0.002); working (P = 0.009); sitting (P = 0.004); standing (P = 0.003); sleeping (P = 0.008); and traveling (P = 0.006). VAS prepartum was increasing as the weight was increasing in both periods of observation (P = 0.015 and P=0.051) respectively. VAS prepartum was significantly correlated with BMI prepartum (P = 0.019) and postpartum (P = 0.028).

Discussion: Physical disability in pregnant women was low and reduced following delivery. Disability was linked with LBP intensity, weight, BMI and height, but not with age or educational level.

后腹腔镜输卵管切除术对后续的影响卵巢反应控制卵巢过度刺激

09/18/2019

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>输卵管切除术对卵巢反应的影响是一个有争议的问题。由于相互矛盾的数据,替代技术开发执行hydrosalpinges不育患者的输卵管切除术治疗。本研究旨在评估输卵管切除术对卵巢反应的影响与促性腺激素刺激后。;/ p>& lt; p> & lt; strong>方法:& lt; / strong>回顾性分析,一百五十七例输卵管不孕患者分为三组根据他们的外科手术史:双边输卵管切除术(b组);单侧输卵管切除术(美国公司);没有历史的输卵管切除术(NS组)。卵巢反应和体外受精结果组间方差分析进行了比较分析。卵巢癌的预后因素响应估计线性回归模型灵活;/ p>

Results: In the BS group, the total numbers of oocytes retrieved, and embryos obtained were significantly lower than those in the NS group (p = 0.02). Poor ovarian response was also more frequent in the BS group (p = 0.02). In the US group, follicle development was reduced on the operated side. This effect was more pronounced when salpingectomies were performed for hydrosalpinges than when performed for ectopic pregnancies, and significant decreases were observed in follicle recruitment (p = 0.005) and oocyte retrieval (p = 0.02) on the operated side.

Conclusion: Salpingectomy could have a minor negative effect on ovarian response. This is particularly true with bilateral salpingectomies, in which the ovarian blood supply could be disrupted, with no possible compensation by the contralateral side.

孕酮水平的有效性hCG注射一天在预测IVF / ICSI cyclesa€™结果

09/11/2019

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>Previous studies highlighted the negative effect of premature progesterone elevation (PE) during IVF cycles on the cycle outcomes. The aim of this study was to assess the validity of progesterone level on hCG day (P4) in the prediction of IVF/ICSI cycles’ outcome.

Methods: In a retrospective cohort study, all fresh cycles of 256 patients who underwent IVF or ICSI cycles in 2017 at reproductive endocrinology & infertility unit/ Obg/Gyn department at King Abdulaziz Medical city, Riyadh, Saudi Arabia, were followed up. They were started on gonadotropin medications for ovarian hyperstimulation, followed by serial transvaginal U/S and serum estrogen levels each visit. Patients having 2 or more 18mm follicles were triggered by hCG 10,000 IU and ovum pickup was done 34-36 hrs after. Data were collected on patients’ characteristics [age, BMI infertility type], cycles’ characteristics [number of follicles and endometrium thickness on hCG day, P4 and estrogen levels], rates of pregnancy and pregnancy outcomes. Receiver operating characteristic curve was applied to determine the cut-off of P4 that corresponds with a negative pregnancy test. Logistic regression analysis was used and significance was considered at p - value of ≤0.05.

Results: Pregnancy rate in the study sample was 36.7%. The mean P4 level in cycles with negative pregnancy tests was significantly higher than the mean in cycles with positive tests (p = 0.018). After adjusting for confounders, significant negative association between P4 and pregnancy rate was evident (p < 0.03). The optimum trade-off of P4 for prediction of a negative pregnancy test was 1.5nmol/L. This cut-off level had a 59% sensitivity, 51% specificity and 68% positive predictive value and 10% & 15% absolute and relative risk reductions respectively. Cycles with mean P4 of ≥1.5nmol/L were significantly associated with primary infertility (p = 0.011), lower mean BMI (p = 0.009) higher mean estrogen level (p < 0.001), lower live birth rate (p = 0.048), higher abortion rate (p = 0.039), and higher ovarian hyperstimulation rate (p = 0.027).

Conclusion: Premature elevation of progesterone level on the hCG day in IVF/ICSI cycles may have adversely impacted the pregnancy rate and pregnancy outcome. The cutoff point of 1.5nmol/L for this P4 was not valid in predicting pregnancy outcomes.

甲氨蝶呤在病态附着胎盘Latifa医院管理,DHA,迪拜、阿联酋。:病例报告

07/12/2019

& lt; h2> Abstract< / h2>

Morbidly adherent placenta (MAP) includes the spectrum of placenta accreta, increta, and percreta. It is a major cause of obstetric hemorrhage. Caesarean section is main risk factor for MAP. Ultrasound scan is highly sensitive method for MAP diagnosis and sometime Magnetic resonance image is of choice. Early diagnosis timed elective planned intervention after preparation under skillful multidisciplinary team improve the outcome and minimize the morbidity. Caesarean hysterectomy, major arteries ligation, arteries embolization and leave the placenta in-situ all are choices of management. Use of Methotrexate for the placenta in-situ in MAP is still debatable. We present a case of MAP in which placenta left in- situ followed by multiple Methotrexate injection during postpartum with good outcome and acceptability.

家族性高胆固醇血症妊娠高胆固醇血症有助于检测和防止妊娠晚期并发症

07/02/2019

& lt; h2> Abstract< / h2>

Introduction: In this retrospective study, we comment on the cause and diagnostic potential of the elevated serum total cholesterol and some non-cholesterol sterols in a population of healthy pregnant women from Prague, Czech Republic.

Methods: Based on a total of 21,000 clinical biochemistry tests of healthy pregnant women with hypercholesterolemia observed during pregnancy, a testing group of 84 women with a total cholesterol (TC) above 7.0 mmol/l was established to analyze their non-cholesterol sterols (NCS) by Gas Chromatography–Mass Spectrometry. Lathosterol (Lat) and desmosterol (Des) were evaluated as markers of endogenous cholesterol synthesis, whereas campesterol (Cam) and sitosterol (Sit) were analysed as markers of intestinal absorption.

Results: In the basic population, the frequency of gestational hypercholesterolemia with the serum TC levels > 7.0mmol/l was 1 to 136.The mean values were: TC 6.8 mmol/l, LDL-C 4.6 mmol/l, and HDL-C 2.2 mmol/l. In the selected testing group of 84, the mean values were: Lat 7.8+/-1.7 μmol/l, Des 4.7+/-0.9 μmol/l, Cam 9.8+/-2.6 μmol/l, and Sit 9.6+/-3.8 μmol/l. Lat correlated with TC (r = 0.53), LDL-C (r = 0.36), and non-HDL-C (r = 0.35). No such correlations were observed for Cam or Sit.

Conclusion: Our findings prove that gestational hypercholesterolemia is caused by increased endogenous cholesterol synthesis via lathosterol. Subsequently, we demonstrate how a single cholesterol test taken in the fifth to sixth month gestation can efficiently help detect familial hypercholesterolemia, and prevent related late pregnancy circulatory complications.

孕产妇死亡率和影响因素,在南部阿贝奥库塔孕妇中,尼日利亚

07/02/2019

& lt; h2> Abstract< / h2>

This observational study assessed the knowledge of pregnant women attending antenatal clinics at two selected hospitals in Abeokuta South, Nigeria on the causes and risk factors of maternal mortality, identified barriers to knowledge acquisition, and examined the influence of parity of respondents on their knowledge of factors causing maternal mortality. Maternal mortality is extremely high in Nigeria, it is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. Descriptive research design was used in this study and qualitative data from 136 respondents selected randomly, were obtained through a self-designed questionnaire that comprised three sections. Data were analyzed and indicated that parity of the pregnant women do not have an influence on their knowledge of factors responsible for maternal mortality. Findings revealed that majority (67.6%) of the respondents had high knowledge on the causes of maternal mortality – haemorrhage, sepsis, prolonged/obstructed labour, anaemia, unsafe abortion, infection, hypertensive disorders, care rendered by unskilled medical practitioners and its risk factors - parity, poverty, place of last delivery and low attendance at antenatal clinic. Educational background, marital status, irregular antenatal visits, socio-cultural practices and occupational status were identified as barriers to knowledge acquisition. This paper concluded that pregnant women may have a high knowledge about the factors responsible for maternal mortality. This is probably due to the fact that all respondents had formal education and because they were interviewed on antenatal clinic days, which suggests that they might have heard about the causes and risk factors for maternal mortality during their visits. Authors recommended that government should employ qualified health professionals and provide medical subsidy, it is hoped that this will ensure that pregnant women get quality care throughout the period of pregnancy and delivery.

肠系膜囊肿:一种罕见的情况

07/02/2019

& lt; h2> Abstract< / h2>

Mesenteric cysts are rare benign intra-abdominal tumors with an incidence of 1 case per 250,000 hospital admission. This lesion occurs most frequently in women in the reproductive period.The etiology of such cysts remains unknown but several theories regarding their development exist. Most of these lesions present with vague abdominal pain and nausea. Less commonly they will present with bowel obstruction due to external compression. The diagnosis of these tumors is by abdominal ultrasound or computed tomography. We report a case of Mesenteric cyst in 51-year-old female patient.

重点城市加纳的产前保健:定性研究物理孕产妇健康服务的可访问性Kwabre东部直辖市

07/02/2019

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>背景:& lt; / strong>Accessibility to healthcare is a major component of primary health care campaign for maintaining population health. Owing to this, the government of Ghana has instituted the free maternal care and focused antenatal care policies into the maternal health care policies to woefully control maternal mortality, morbidity and to ensure improved access, quality and continuous ANC use among pregnant women. Despite these interventions, pregnant women in the Kwabre East Municipality do not fully use ANC services as recommended by the World Health Organization.

Methods: Using an in-depth interview and two focus groups conducted with women of reproductive age (15-49) in the Kwabre East Municipality. The study investigated women’s opinions, perceptions and experiences on their ANC visits.

Results: The study revealed that physical accessibility and the social context of pregnant women continue to influence their ANC use even after the introduction of the free maternal care and focused antenatal care policies.

Conclusion: The study suggests that in order to fully utilize ANC visits as recommended by the WHO in the Kwabre East Municipality, the Municipal Health Directorate should liaise with collaborating stakeholders if not eliminating to limit the influence of restrictive factors to women’s quest of using ANC. It is further recommended that management do away with hindrances that delay women who seek for ANC services in health facilities and adopt strategies and procedures that aim at increasing ANC uptake.

决定因素的妇女€™s感知满意度在产前保健城市加纳:横断面研究

07/02/2019

& lt; h2> Abstract< / h2>

Despite evidence on major interventions on the uptake and scale up of interventions meant to promote maternal health care services, little is known about adequate use of such program in urban Ghana among reproductive aged women. This study examined the determinants of women’s Satisfaction on antenatal care use in selected health facilities in the Kwabre East Municipality of Ghana. Using facility-based cross-sectional survey design, a three-stage sampling technique was conducted to sample 220 women attending postnatal care at selected public health facilities. Open-ended questionnaires were used to obtain data from respondents. Descriptive statistics and inferential statistics including binary logit regression model were used to analyze the data with the help of SPSS and STATA software. Logit analytical framework was computed to determine equations of variance. The association between antenatal care use and women’s satisfaction was determined and assessed using Pearson’s χ2 (2) test indicating 1% was run. Most women (92.7%) had at least four ANC visits during their entire pregnancy. The results indicate standard deviation of 7 with 81% regular ANC visits and 19% irregular. Most women (55%) received care by one caregiver, followed by women (35%) who received care by two caregivers and women (10%) who were cared for by three caregivers. The regression results showed varying utilization levels of 10%, 5% & 1% ANC satisfaction. System induced factors aimed at promoting maternal care use satisfaction are suggested.

13个步骤办公室子宫镜检查以最小的不适

06/27/2019

& lt; h2> Abstract< / h2>办公室& lt; p>子宫镜检查诊断(哦)是一个重要的过程,有时,治疗,子宫内的病理,没有让患者手术室。其优点是众所周知:更少的成本,快速诊断,看到和治疗和其他几个人。它;,主要困难是在手术过程中不适。stimule成长的妇科医生离开或和去办公室子宫镜检查,我们建议13步骤与最小不适。你们办公室子宫镜检查;/ p>

利用邮政abortal避孕和相关因素对堕胎的女性来服务德勃雷Berhan医院,德勃雷Berhan,埃塞俄比亚2019年3月:机构为基础的横断面研究

06/20/2019

& lt; h2> Abstract< / h2>

Background: Post abortion family planning (PAFP) is the initiation and use of family planning methods immediately after, and within 48 hours of an abortion, before fertility returns. In most women fertility returns on average about two weeks after an abortion; however, ovulation can occur as early as 11 days post-abortion.

Objective: To assess utilization of post abortal contraceptive use and associated factors among women who came for abortion service at Debre Berhan Referral Hospital, Debre Berhan, Ethiopia March 2019.

Methodology: Institutional based cross sectional study design was conducted using hospital data obtained from Gynecology ward in Debre Berhan Referral Hospital, Debre Berhan, Ethiopia, from March 1 -10, 2019. A systematic random sampling technique was used from the abortion register log book. Data was cleaned manually, coded and entered into Epi-data version 3.1 then exported to and analyzed by SPSS version 21 software. Multivariate analysis with AOR, 95% CI and p-value< 0.05 were used to identify variables which have significant association.

Result: The finding of the current study showed that among 371 study subjects 170(45.8%) utilized post abortal family planning. There was a significant association between utility of post abortal family planning and post abortion family planning counseling [AOR: 19.245, 95% CI: (10.199, 36.313), p-value= 0.001] and women who were primiparous had 5 times more likely to utilize post abortal family planning as compared to the women who were nullyparous [AOR: 5.314, 95%CI (1.089, 24.210), p value=0.001].

Conclusion and Recommendation: From a total of 371 study subjects 45.8% have utilize contraceptive after abortion service received. This study also showed that parity and counseling’s of family planning were statistically significant associated with utilization of post abortal family planning. We recommend Debre Berhan hospital to scale up activities on post abortal care to increase the number of clients who post abortal family planning.

经腹宫颈环扎术重新审视

06/18/2019

& lt; h2> Summary< / h2>& lt; p>现代产科和妇科实践的变化与超声宫颈筛查妊娠期间,intra-epithelial宫颈肿瘤的治疗和腹腔镜手术导致的利用率增加腹cervico-isthmic环扎术,以减少mid-trimester和早期早产的发病率在女性反复流产。;/ p>

自身免疫性脑炎与29岁女性的卵巢畸胎瘤

05/15/2019

& lt; h2> Abstract< / h2>& lt; p> NMDA受体脑炎是一种罕见的疾病在2007年第一次描述了。Anti-NMDA受体脑炎影响主要是年轻女性肿瘤,主要是卵巢畸胎瘤、是根本原因。这种疾病是由于抗体绑定到细胞外神经细胞表面的抗原表位,从而导致门冬氨酸受体的内化。综合症患者的特点anti-NMDAR及其恢复遵循一定的模式。治疗包括免疫的免疫疗法和删除触发器。这个病例报告描述了一名年轻女性anti-NMDA受体脑炎所致卵巢畸胎瘤。;/ p>

高甘油三酯血症诱发急性胰腺炎在怀孕:病例报告的学习经验和挑战

05/14/2019

& lt; h2> Summary< / h2>

Hyperglyceridemia induced pancreatitis in pregnancy accounts for 4% of all cases of acute pancreatitis. Though rare, hypertriglyceridemia induced pancreatitis may lead to fatal maternal and fetal complications, even maternal death. Its management during pregnancy remains a challenge for many physicians. Management options are limited in pregnancy. In the refractory cases, management options and timing of delivery is debatable. Here we report a case of hyperglyceridemia induced pancreatitis and the challenges faced in the management.

巨型细胞angiofi去油可可豆的阴户:病例报告

05/09/2019

细胞血管纤维瘤是一种罕见的良性间叶肿瘤没有性别偏好。It is usually a small (<3cm), well-circumscribed, mostly asymptomatic and typically slow growing. Surgical removal of the mass with its capsule is the preferred treatment, not only helps guarantee complete excision and prevent its recurrence but also minimize blood loss. We present the case of a 76-year-old woman with a giant vulvar mass.

管理癫痫女性怀孕

04/02/2019

Opinion

Epilepsy is commonly seen in women of reproductive age and it is affecting their reproductive and pregnancy outcomes in an adverse manner [1]. It has seen that there are increased numbers of maternal deaths of pregnant women with epilepsy than those who have no any epilepsy symptoms or episodes.

立即postplacental插入子宫内避孕器(铜375)及其并发症的驱逐,感染和穿孔

12/27/2018

& lt; h2> Abstract< / h2>

Objective: To determine the complications (infection, perforation and expulsion rate) of immediate postplacental insertion of intrauterine contraceptive device (Multiload Copper375) in postnatal patients.

Methods: A case series study was conducted between October 28, 2014 to April 30, 2018 in obstetrics and gynaecology department, Civil Hospital Karachi,-+ Informed consent was taken. Intrauterine contraceptive device (Multiload) was inserted immediately within 10 min after delivery of placenta. These women were observed to determine outcome (infection, perforation and expulsion) at the time of discharge and 6 weeks postpartum. Absence of all these were taken as satisfactory outcome.

Results: A total of 435 women were included in this study. 165 (38%) were delivered through cesarean section and 270 (62%) were delivered through vaginally. There were 36 (8.3%) cases of infection. The cumulative rate of expulsion and perforation at the end of sixth week of post insertion was 39 (9%) and 0% respectively and 360 (82.8%) had satisfactory outcome. Post-placental placements during cesarean delivery are associated with lower expulsion rates than post-placental vaginal insertions without increasing rates of postoperative complications like perforation, slightly increase infection rate following vaginal delivery.

Conclusions: Immediate postpartum insertion of IUCD is an effective, safe and easily reversible method of contraception. Rates of the complications (Infection, expulsion and perforation) are remarkably low.

术前诊断测试的预测价值在卵巢成熟囊性畸胎瘤

12/19/2018

& lt; h2> Abstract< / h2>

Aim: The aim of this study was to determine the sensitivity of the tumor markers and diagnostic methods used in the preoperative period for dermoid cysts, the most common benign neoplasm of the ovary.

Material and Methods: 136 patients who were operated for any reason and reported as ovarian dermoid cyst in the Department of Obstetrics and Gynecology, Ankara Atatürk Training and Research Hospital between January 2004 and September 2005 were included in the study. The medical records of the cases were obtained retrospectively from Ankara-Atatürk Training and Research Hospital, HIS, archive files and patient numbers where necessary.

Results: In the preoperative period, 119 patients underwent ultrasonographic examination, 33 underwent Computed Tomography, and 17 underwent Magnetic Resonance Imaging.10 of the cases only underwent CT, while 3 of the cases underwent only MRI 22 of them underwent both USG and CT, USG and MRI were performed on 13 cases and only 1 case underwent all three of the imaging methods. Tumor markers were CEA, CA 125, CA 19-9, CA 15-3 and AFP.

Conclusions: The reviews of ultrasonography and / or computed tomography and / or magnetic resonance imaging (n = 132) revealed that 103 of the cases were put into operation and the sensitivity of the preoperative screening methods were calculated to be 75.5%. The sensitivity of the tumor marker CA 19-9 was calculated to be 31%.

动态血压测量值在妊娠高血压

11/09/2018

& lt; h2> Abstract< / h2>& lt; p>它还不知名心血管预后的价值24小时动态血压监测孕妇的高血压。;/ p>& lt; p> & lt; strong>目标:& lt; / strong>评估的预后价值ABPM参数在预测maternofetal事件。;/ p>& lt; p> & lt; strong>方法:& lt; / strong>回顾和观察研究,包括166名孕妇。;/ p>& lt; p> & lt; strong>结果:& lt; / strong>作者发现,夜间是最好的类似不良事件的预测。Non-dipper概要文件在跟进,直到交付更糟糕的生存相比七星概要。你们;/ p>& lt; p> & lt; strong>结论:& lt; / strong>与HT ABPM是怀孕的工具,因为这是唯一的方法,分析了夜间血压。;/ p>

当前anesthesA±for剖腹产审理中的案件±

10/29/2018

& lt; h2> Abstract< / h2>

The choice of anesthesia for cesarean section should depend on the urgency of the procedure, in addition to the condition of the mother and fetus. It is widely accepted that regional anesthesia for cesarean section is preferable to general anesthesia. Regional techniques have several advantages. They lessen the risk of gastric aspiration, avoid the use of depressant anesthetic drugs and allow the mother to remain awake during delivery. The most common type of regional anesthesia for cesarean section is spinal anesthesia because of its simplicity, cost-effectiveness and speed of onset. It is suitable for cases of an emergent cesarean delivery. Hypotension during spinal anesthesia is a common that is associated with morbidity for both mother and fetus. Epidural anesthesia is preferred when physicians want to minimize the maternal hypotension or when intense motor blockage of the thoracoabdominal segments is not desired. General anesthesia still leads to a higher maternal mortality and should be reserved for absolute emergencies and cases where neuroaxial blockade is contraindicated.

脓毒性关节炎怀孕后小调左肩的手受伤

10/23/2018

& lt; p>肩关节的脓毒性关节炎是罕见,可能会影响大约3%的普通人群[1]。延误诊断可能会增加发病率和导致骨头和软骨破坏[2]。脓毒性关节炎是一个不同寻常的妊娠并发症,可以进步永久关节病和残疾[3]。;/ p>& lt; p>感染性关节病在怀孕需要多学科小组的参与对于及时识别和治疗改善孕产妇和胎儿的结果。高度怀疑的心理指标时是至关重要的临床和实验室研究表明脓毒性关节炎。有多种诱发因素之前报道的脓毒性关节炎肩在医疗条件等怀孕,肾盂肾炎和创伤。我们报告一个37岁的女士在怀孕26周急性左肩疼痛和高温后小左手掌创伤。她也离开了乳房切除术与腋窝间隙十年前。她接受了关节镜洗掉她的左肩关节和布满了抗生素迅速改善和恢复。我们加强早期多学科参与的重要性当脓毒性关节炎的肩膀怀孕怀疑特别是以前妇女乳房切除术和腋窝间隙可以这样一个罕见的诱发因素和严重关节在怀孕条件灵活;/ p>

生活方式的修改在预防和控制的有效性性传播疾病(性病):关注伊斯兰的生活方式

10/15/2018

Text

The advancement of human researches and scientific activities in the field of diseases prevention and treatment, has not diminished the importance of sexually transmitted diseases (STDs). Despite the continuous efforts for prevention and control of them, many peoples suffers from STD with very considered wasted expenses for anybody and for community [1,2].

一种罕见的同步胆囊和卵巢的主要恶性肿瘤

06/09/2018

& lt; h2> Introduction< / h2>& lt; p>恶性肿瘤有能力快速增长,转移到身体的其他部位。卵巢是常见的器官辅助血液传播引起的肿瘤和展览的组织病理学的主要肿瘤。你们;/ p>

围产期发病率和死亡率重复剖腹产后由于5个或更多以前剖腹产在三级中心KSA完成

07/31/2018

& lt; h2> Abstract< / h2>

Objectives: To highlight and determine the maternal and neonatal outcome and associated risks for patients who have undergone their 6th and more caesarean sections.

Design: Case control study.

Setting: Tertiary Centre (Security Forces Hospital – Riyadh – Saudi Arabia).

Patients: 80 patients selected to study group who have undergone their sixth and more caesarean sections in Security Forces Hospital. Between June 2006 and May 2010. This group was compared to 80 patients who have undergone their third to fifth caesarean sections during the same time period and immediately following the studied case.

Main outcome measured: Age and parity of women in study and the control group were correlated with the number of previous caesarean sections. Intra operative and post-operative maternal complications including presence and grade of adhesions, intra partum and postpartum hemorrhage, use of measurement and methods (both medical and surgical) to control bleeding such as Bakry balloon, Internal iliac artery ligation, etc., were highlighted. Bowel injury, blood transfusion, admission to surgical intensive care, incidence of placenta previa and accreta, post-operative complications like paralytic ileus, wound infection were also noted. Further, neonatal outcome including birth weight, Apgar score, and need for neonatal intensive care unit admission were reviewed.

Results: Patients in the study group had higher incidence of extensive adhesions (41.25%) compared to (12.25%) in the control group. Bowel injury was (2.5%) in study group with none in the control group. The incidence of placenta previa was (8.75%) in the study group as compared to (2.5%) in the control group, with placenta accreta complicating (28.57%) of placenta previa seen only in the study group. Blood transfusion was higher in the study group (20%) as compared to (5%) in the control group.

Neonatal admission to NICU was higher in the study group (27.5%) in comparison to the control group (12.5%). Also birth weight was lower in the study group.

Conclusion: The more the number of caesarean sections, the more the maternal and neonatal morbidity.

Patients should have proper counselling during antenatal follow up about the risks of repeated caesarean sections, and offered bilateral tubal ligation after the third or fourth caesarean sections.

卵巢小细胞癌与血钙过多:病例报告和文献之回顾

03/07/2018

& lt; h2> Abstract< / h2>& lt; p>我们在这里描述的情况下一个23岁的女人,小细胞癌的卵巢hypercalcemic类型(SCCOHT) SMARC-A4突变谁受益于两个步骤导致手术与双边输卵管卵巢切除术,子宫全切术网膜切除术、盆腔和lombo-aortic淋巴结解剖。她也收到了6课程poly-chemotherapy手术后。密切随访是每三个月由临床检查与测定血清钙和CA125水平以及与thoraco-abdominal CT扫描成像。迄今为止,患者的无病生存期超过9年。我们也回顾了关于这个主题的文献和discuted新的诊断和预后的基因工具SMARC-A4突变。你们;/ p>

孕产妇和胎儿的结果之间的比较研究,采用新的价值筛查妊娠糖尿病的三级中心在沙特阿拉伯

05/18/2018

& lt; h2> Abstract< / h2>& lt; p> & lt; strong>目标:& lt; / strong>To check if there is any significant difference in the immediate outcome of pregnancy with diabetes using the new values of FBS & 2hrs post prandial with 75g OGTT for 1 year (from 1st June 2013-31st May 2014) in comparison to the previous data done in the same institute with other values and with international figures.

The data in our study included fetal, maternal morbidities, intra partum and postnatal outcomes, in order to help, if possible, on deciding the best values to use for screening for gestational diabetes mellitus. Furthermore, to know the new percentages of gestational diabetes mellitus in SFH by utilizing the new values of Blood Sugar readings

Design: Retrospective cohort study

Setting: Security Forces Hospital-Riyadh-Saudi Arabia

Patients: Done (from 1st June 2013 – 31st May 2014), on patients who had attended Security Forces Hospital, Riyadh, Saudi Arabia. This chosen year’s data was compared with data collected in the three previous years using different figures.

Main Outcome measured: Average age of mother, maternal aspects of parity, history of GDM, number of abortions estimated blood loss in labor, associated medical disorder, complications of previous pregnancies, methods of control of GDM, gestational age for IOL and associated intrapartum complications. Immediate neonatal outcome in cases of GDM, comparison of birth weights of babies & any specific congenital abnormalities and delayed causes of admission to NICU in the 4 years studied were also reviewed.

Results: The percentage of diagnosed cases of gestational diabetes mellitus (GDM) after screening was 24 % as compared with 14.5% in previous study of 2003-2004 & with the number of screened patients amounting to 93% out of the total number of deliveries between 2013-2014 (in both years universal method of screening was used). The multidisciplinary set up of our GDM specialized clinic which was composed of dieticians, diabetic educators, endocrinologists and obstetric physicians operating together, helped to reduced the use of insulin in combination with diet to only 24% in comparison to 76% of patient using diet and exercise alone. The study showed a mean age of 33years and weight of 77kg. It was also noted that 16% of the patients diagnosed with GDM were multiparous averaging 1-5 deliveries. Almost 62% of patient didn’t give any history of GDM and no history of previous medical diseases. The majority of the patient with GDM delivered without complications during labor, with 30% having vaginal lacerations & 73% of patient had an estimated blood loss of less than 500cc. NICU admissions secondary to hyperbilirubinaemia averaged almost 17% in comparison to previous studies and only one baby expired in a GDM patient. Our study revealed a good fetal and maternal out come with less delivery complications and less incidence of postpartum hemorrhage (5.7%).

Conclusion: It is concluded that Universal Screening of Pregnant women whether with previously used glucose value or new ones for gestational diabetes mellitus is a better option, which has proven to improve both maternal and fetal outcomes. The 75 OGTT test is a cost effective test and with both easy accessibility and good screening pick up number (92.5%) of the patients in Security Forces Hospital, Riyadh.

Recommendation: We recommend annual follow up for patients, both the mother and the baby after postpartum, to prevent the development of type 2 diabetes.

幽灵的滋养层的肿瘤

04/19/2018

& lt; h2> Summary< / h2>

This report provides an insight into a very unusual problem in the First trimester of pregnancy, and describes the unfolding of a series of potential blunders.

We all know that most problems in gynecologic oncology become terribly magnified when the patient is pregnant. HB had a routine ultrasound in the first trimester of pregnancy, and a large, extremely vascular mass occupying most of the lower anterior abdominal wall, was found (Figure 1). Because she had received methotrexate two years earlier for a persistent elevation of the hCG titer following surgery for an ectopic pregnancy, she was referred to the gynecologic-oncology service with the working diagnosis of metastatic gestational trophoblastic disease (GTD). An MRI showed a vascular mass in the subcutaneous tissue invading the rectus sheath and muscle, but not attached to the uterus (Figure 2). The report stated, in no uncertain terms, that the mass was strongly indicative of a metastasis from GTD. However, the hCG level was consistent with the estimated gestational age, and a mass such as this would represent an extremely unusual way for this disease to present. She had been told that she would need the have the pregnancy terminated, followed by chemotherapy to reduce the size of the mass prior to its removal.

妊娠期糖尿病的筛查

04/04/2018

& lt; h2> Abstract< / h2>& lt; p>妊娠糖尿病是成为一个非常常见的医学障碍与怀孕特别是在中东和更多所以在沙特阿拉伯,因此把妇女和胎儿的风险增加孕产妇和新生儿发病率和死亡率。;/ p>& lt; p>妊娠期糖尿病筛查推荐,因为它是无症状的性质和良好的患者比例没有经典的风险因素。我们建议普遍筛查因为筛选的有益作用,诊断和后续治疗。你们;/ p>& lt; p>在安全部队医院最近的研究显示,发病率和死亡率明显降低与应用程序的新值检查,尽管增加了妊娠期糖尿病的发病率从2005年的14.5%的研究中,23.9%在2015年的最近的研究。;/ p>& lt; p> & lt; strong>目标:& lt; / strong>强调和确定最佳筛查方法的值的边后卫和2 hrspp用于诊断妊娠期糖尿病。;/ p>& lt; p>孕产妇,amp;新生儿过来相关的风险,患者妊娠期糖尿病,审视。;/ p>& lt; p>研究了在2013年6月1日—2014年5月31日。;/ p>

Design: Retrospective cohort study.

Setting: Tertiary centre (Security Forces hospital _Riyadh_Saudi Arabia).

Patients: Out of 6849 patients who had their delivery in Security Forces Hospital between June 2013 and May 2014 (one year), 6340 patients (92.5 %) were screened for gestational diabetes mellitus, and out of these 1516 patients (23.9 %) were labeled as Gestational diabetes mellitus after exclusion of cases of IDDM and NIDDM.

Main outcome measured: The purpose of this study is to advise on using new values for diagnosis of gestational diabetes and to assess the outcome of pregnancy after new values are implemented in security forces hospital for diagnosis. The outcome included ages of mothers, parities, number of abortions, associated medical disorders, and estimated blood loss. Control methods were also reviewed, gestational age of induction of labor. Associated intrapartum complications as well as fetal outcome were also reviewed. The weight of babies, congenital abnormalities, admission to neonatal intensive care unit were also studied. The different values used , and percentages of diagnosed values of last 3 studies done in Security Forces Hospital in comparison to the most recent study with new values(2014-2015) as shown in table 11.

Results: The incidence of gestational diabetes mellitus increased from 14.5 % in the year 2003 - 2004 to reach 23.9 % in 2014, in the same institute (Security Forces Hospital), where the study was done using different values. In our study in Security Forces Hospital we recorded a significant decrease in morbidity and mortality on applying the new values.

A significant reduction in the number of expired babies of mothers who were diagnosed as gestational diabetes with new values with a decrease from 5.6 % in previous years studied to reach 1.5 % in 2014, reflecting the effective control and the good catch for the new values.

Conclusion: Universal screening, with whatever values to blood sugar used, is a better method screening than the selective one: Using 75 gram of Oral Glucose Tolerance Test proved to be cost effective, easily accessible, and with good pickup rate of up to 93 % of patients in Security Forces Hospital.

Recommendations: To continue using the new values that will be universally implemented, with long term follow-up of mothers and newborn.

有可能结束在非洲女性割礼?

03/22/2018

& lt; h2> Abstract< / h2>

Female genital mutilation / cutting remains a widespread practice throughout Africa. There has been a worldwide effort to do away with FMG/C, but tensions exist between those who aim to abolish FGM/C and those who desire to perpetuate the tradition. While many Western and African experts and organizations agree on the health risks and human rights concerns with FGM/C, others fear that Westerners are imposing their ideas and lack of cultural understanding, trying to eliminate a practice central to the identity of many Africans. The issue must be approached respectfully and collaboratively, with great effort on the part of Westerners to understand the cultural context and rationale of this tradition. Ultimately, if FGM/C is to be eradicated in the foreseeable future, whole African communities and international support agencies must be engaged and empowered to collectively evaluate the implications of the practice and accelerate its demise.

TMD和怀孕吗?

03/14/2018

& lt; h2> Abstract< / h2>

Pregnancy is a happy stage in life of every woman, but at the same time it is a rather difficult period, since pregnancy represents a serious strain on the body. In the body of a woman during this period there are significant physiological changes that ensure the correct development of the fetus, prepare the body for the upcoming delivery. In this difficult period, the burden on all organs and systems of the woman’s body is significantly increased. Especially often suffer joints; there is a risk of permanent pain, the development of diseases or exacerbation of existing diseases. One of the most common problems is Temporomandibular Dysfunction or Disorder (TMD) which many women face, but still hasn’t been explained.