International Journal of Gynecology & Obstetrics最新文献

Objective: To assess variations in the presentation and clinical implications of pre-eclampsia between Iranian and Afghan mothers at a maternity center in Tehran.

Methods: We conducted a cross-sectional study of Iranian and Afghan mothers diagnosed with pre-eclampsia. Data were collected from March 2021 to February 2023 at a maternity center in Tehran, Iran. Demographic information, clinical characteristics, and laboratory findings were extracted from medical records. Statistical analyses were employed to compare differences between Iranian and Afghan mothers, including Mann-Whitney U, Pearson χ² tests, and logistic regression models.

Results: We included 822 pregnant women with pre-eclampsia, predominantly Iranian (75.5%) and Afghan (24.5%). Regarding the multivariate logistic regression model, Iranian mothers were older, with a higher proportion over 35 years. Although Afghan mothers showed higher gravidity counts and greater gestational ages at delivery, they had lower rates of hypothyroidism. Iranian women were more often categorized as obese than Afghan women, and the difference was statistically significant. Serum levels of alkaline phosphatase were significantly greater in Afghan women.

Conclusion: Pre-eclampsia poses significant maternal health risks, especially among Afghan refugees in Iran. Variances in age, gravidity, and hypothyroidism prevalence highlight the need for tailored healthcare strategies. Addressing cultural barriers and implementing targeted interventions can improve maternal and fetal outcomes in these populations.

Klippel-Trenaunay Syndrome (KTS) is a rare congenital vascular disorder characterized by extensive capillary and venous malformations that pose unique challenges during pregnancy. This case report discusses the successful management of a 34-year-old pregnant woman with KTS who had two caesarean sections, resulting in the birth of two healthy babies. Despite the lack of evidence-based guidelines for obstetrical management in KTS, a multidisciplinary team collaborated to devise a high-risk thrombosis management plan, involving the use of compression stocking and low molecular weight heparin prophylaxis. The patient's elevated risk of thrombosis, exacerbated during pregnancy, informed the decision of caesarean sections, aligning with finding that in most KTS pregnancies, this method of delivery based on obstetric indications and arteriovenous malformations is chosen. This case highlights the importance of systematic and patient-centered care, advocating for comprehensive obstetric management guidelines to address the unique challenges posed by KTS during pregnancy. Further research is warranted to enhance our understanding and refine guidelines for individuals with vascular abnormalities linked to KTS.

Objective: The present study examined the effects of a nurse-led family empowerment program on the quality of life of Palestinian pregnant adolescents.

Methods: This was a randomized controlled trial with a two-group pre-/post-test design. The sample consisted of 58 pregnant adolescents recruited from six governmental primary health care clinics in Palestine. Participants were randomly allocated in equal numbers to either the control group (n = 29), which received routine care, or the experimental group (n = 29), which received both routine care and the study program. Data collection instruments included a demographic form and the WHO Quality of Life-BREF (WHOQoL-BREF). Data were collected twice: at 32 or 33 weeks' gestation to establish a baseline and at 36 or 37 weeks' gestation post-test. Statistical analyses were performed and included descriptive statistics, chi-square and t-tests.

Results: The study findings indicated a significant increase in the mean quality of life scores of the experimental group in the post-test compared to the pre-test (P < 0.001). Additionally, pregnant adolescents in the experimental group demonstrated significantly higher post-test QoL scores than those in the control group (P < 0.001).

Conclusion: The nurse-led family empowerment program emerges as a viable and efficacious alternative intervention for improving the quality of life among Palestinian pregnant adolescents.

Clinicaltrials: The study was registered with the NIH U.S. National Library of Medicine ClinicalTrials.gov on 01/09/2021 with the registration code NCT05031130. It can be accessed via this link: https://classic.

Clinicaltrials: gov/ct2/show/NCT05031130.

For surgeons and clinicians, nonobstetric surgery during pregnancy has certain difficulties and considerations. In order to aid in decision-making in these situations, this manuscript offers a thorough review of the guidelines currently in place from renowned obstetric and surgical societies, such as the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians & Gynecologists, and others. Using AGREE II-S methodology, a comprehensive analysis of guidelines reveals differences in recommendations for anesthetics, surgical procedures, imaging modalities, and thromboembolic prophylaxis. Furthermore, a thorough discussion of strategic surgical planning is provided, covering aspects such as patient positioning, trocar placement, pneumoperitoneum generation, and thromboembolic risk management. The publication highlights that in order to maximize the results for both the mother and the fetus after nonobstetric surgery performed during pregnancy, a multidisciplinary approach and evidence-based decision-making are essential.

Retraction: M. M. A. Shehata, A. M. Maged, A. Kotb, A. I. Ogila, Y. Lasheen, N. Salah, R. A. Mohsen, M. Fouad, and AS. S. Abd-Elazeim, "Whole-body Vibration Versus Supervised Aerobic Exercise on Hormonal Parameters and Inflammatory Status in Women with Premenstrual Syndrome: A Randomized Controlled Trial," International Journal of Gynecology & Obstetrics 162, no. 2 (2023): 493-501. https://doi.org/10.1002/ijgo.14737. The above article, published online on 23 February 2023, in Wiley Online Library (wileyonlinelibrary.com), and has been retracted by agreement between the journal Editor-in-Chief, Professor Michael Geary; the International Federation of Gynecology and Obstetrics; and John Wiley and Sons Ltd. A third party raised concerns regarding highly unlikely averages of patient data in the published article, which indicated potential data fabrication. The journal began an investigation and requested an independent review of the available dataset, which found consistent patterns in patient data that are statistically implausible. The authors confirmed that there were errors in the listed BMI of participants, but they denied that the data has been fabricated. The retraction has been agreed to because the editors have concluded that, as the data show highly improbable patterns of similar patients, neither the data nor the results presented in the article can be considered reliable. The authors disagree with the retraction.

Objective: The aim of this study was to evaluate the clinical characteristics and outcomes of pregnant women with COVID-19 and to compare with pregnant women without COVID-19. In addition, in the subgroup of patients who were symptomatic at the time of diagnosis, the persistence of symptoms was assessed.

Methods: This was a retrospective cohort study. All pregnant women aged ≥18 years, admitted to the maternity ward from March 2020 to September 2023 were included in the study. All patients admitted were routinely screened for SARS-CoV-2. Clinical characteristics and outcomes were registered.

Results: During the study period, 880 patients met the inclusion and were included in the analysis: 385 were COVID-19 positive and 495 were COVID-19 negative. In a multivariate analysis of the outcomes associated with COVID-19 among pregnant women, hospitalization and the Apgar score at 5 min were independently associated with COVID-19. Cesarean delivery, preterm birth, Apgar scores at 1 and 5 min <7, and maternal death were more frequent in pregnant women with COVID-19 admitted to ICU than in those not admitted to ICU. Approximately 30% of patients had persistence of symptoms, for at least 6 months in almost 60%.

Conclusion: The findings of the present study suggest that COVID-19 was associated with increased morbidity and mortality among pregnant women. In addition, pregnant women with SARS-CoV-2 infection were at significantly higher risk of adverse perinatal outcomes, especially preterm birth.