Pub Date : 2024-01-29DOI: 10.18203/2320-1770.ijrcog20240145
Fernando P. Ramirez, Theoneste Hakizimana, Ubarnel A. Naranjo, Yarine Fajardo, Llanelys de L. A. G. Torres
Vaginal dehiscence after pelvic surgery is an extremely rare gynecological emergency world over. Without a high index of suspicion, it can easily be missed with grave consequences. We present an extremely rare case of this post abdominal hysterectomy case for which if immediate suspicion and timely intervention were not ensured, the patient would have suffered serious morbidity and/or death.
{"title":"Coitus induced colpo evisceration in a 3-months post hysterectomy patient: an unusual tale in gynecology","authors":"Fernando P. Ramirez, Theoneste Hakizimana, Ubarnel A. Naranjo, Yarine Fajardo, Llanelys de L. A. G. Torres","doi":"10.18203/2320-1770.ijrcog20240145","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240145","url":null,"abstract":"Vaginal dehiscence after pelvic surgery is an extremely rare gynecological emergency world over. Without a high index of suspicion, it can easily be missed with grave consequences. We present an extremely rare case of this post abdominal hysterectomy case for which if immediate suspicion and timely intervention were not ensured, the patient would have suffered serious morbidity and/or death.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140489442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.18203/2320-1770.ijrcog20240159
Sheela Sharma, Nashra Afaq
Numerous systematic probes, clinical studies and research papers have been published to depict, interpret, explain and understand the impacts and underlying mechanism of the coronavirus disease 2019 (COVID-19) pandemic and its long-term effects on the female body. COVID-19 affects a number of organs, including the female reproductive function and hormonal profile. However, less attention has been given to the effects of COVID-19 on the female reproductive system due to their low morbidity. The available results of studies involving correlation that COVID-19 infection and ovarian function holds in women of reproductive age has been shown as harmless in most cases. Although, several studies have reported the involvement of COVID-19 infection in oocyte quality, ovarian function, and dysfunctions in the uterine endometrium and the menstrual cycle. The findings of these studies indicate that COVID-19 infection negatively affects the follicular microenvironment and dysregulate ovarian function. Although the COVID-19 pandemic and female reproductive health have been studied in humans and other animals, very few studies have examined how COVID-19 affects the female reproductive system. Our objective in this review is to enumerate, illustrate and categorize the effects of COVID-19 on the female reproductive system, including the ovaries, uterus, and hormonal profiles. We tried to bring forth the possible impact COVID-19 may have caused from the current literature and surveys published in various scientific reports and peer reviewed journal articles. The effects on oocyte maturation, oxidative stress, which causes chromosomal instability and apoptosis in ovaries, in vitro fertilization cycle, high-quality embryos, premature ovarian insufficiency, ovarian vein thrombosis, hypercoagulable state, women’s menstrual cycle, the hypothalamus-pituitary-ovary axis, and sex hormones, including estrogen, progesterone, and the anti- Müllerian hormone, are circled around here. The COVID-19 pandemic has significantly impacted the health of women. The scientific community encourages the development of recommendations for specialized care for women and strategies to prevent and respond to violence during and after the COVID-19 pandemic.
{"title":"Unforeseen effects of COVID-19 on reproductive hormones and health of Indian women","authors":"Sheela Sharma, Nashra Afaq","doi":"10.18203/2320-1770.ijrcog20240159","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240159","url":null,"abstract":"Numerous systematic probes, clinical studies and research papers have been published to depict, interpret, explain and understand the impacts and underlying mechanism of the coronavirus disease 2019 (COVID-19) pandemic and its long-term effects on the female body. COVID-19 affects a number of organs, including the female reproductive function and hormonal profile. However, less attention has been given to the effects of COVID-19 on the female reproductive system due to their low morbidity. The available results of studies involving correlation that COVID-19 infection and ovarian function holds in women of reproductive age has been shown as harmless in most cases. Although, several studies have reported the involvement of COVID-19 infection in oocyte quality, ovarian function, and dysfunctions in the uterine endometrium and the menstrual cycle. The findings of these studies indicate that COVID-19 infection negatively affects the follicular microenvironment and dysregulate ovarian function. Although the COVID-19 pandemic and female reproductive health have been studied in humans and other animals, very few studies have examined how COVID-19 affects the female reproductive system. Our objective in this review is to enumerate, illustrate and categorize the effects of COVID-19 on the female reproductive system, including the ovaries, uterus, and hormonal profiles. We tried to bring forth the possible impact COVID-19 may have caused from the current literature and surveys published in various scientific reports and peer reviewed journal articles. The effects on oocyte maturation, oxidative stress, which causes chromosomal instability and apoptosis in ovaries, in vitro fertilization cycle, high-quality embryos, premature ovarian insufficiency, ovarian vein thrombosis, hypercoagulable state, women’s menstrual cycle, the hypothalamus-pituitary-ovary axis, and sex hormones, including estrogen, progesterone, and the anti- Müllerian hormone, are circled around here. The COVID-19 pandemic has significantly impacted the health of women. The scientific community encourages the development of recommendations for specialized care for women and strategies to prevent and respond to violence during and after the COVID-19 pandemic.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"13 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140489804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Male’s inability to impregnate a fertile female is referred as male factor infertility. It accounts for 40-50% of infertile couples and affects almost 7% of all men. Male comorbidities and conditions, which negatively affect men’s health, have been repeatedly associated with impaired reproductive functioning. Cholesterol is the main substrate for steroid synthesis and it plays crucial role in formation of sperm plasma membrane and thus in spermatogenesis, highlighting the role of serum lipids in male fecundity. Purpose of the study is to evaluate correlation lipid profile of male partners with abnormal semen parameters in infertile couples. Methods: A cross sectional study was carried out in the infertility clinic of a tertiary care hospital for over 18 months and 151 infertile men with abnormal semen parameters (as per WHO 2010 criteria) were enrolled. Evaluation of lipid profile was done and its relationship with abnormal semen parameters was analyzed. Results: Significant positive correlation was seen between LDL and Triglyceride with sperm concentration and total sperm count. However, significant negative correlation was seen between Triglyceride and sperm motility and TMSC. Total and progressive motility was found to be significantly associated with total cholesterol (p<0.05). Infertile men having higher total cholesterol were found to have better total and progressive motility compared to men with less total cholesterol. Conclusions: Our findings demonstrated that lipid profile has significant correlation with semen parameters, specifically sperm concentration, count and motility.
{"title":"Correlation of lipid profile of infertile men with abnormal semen parameters","authors":"Lovely Singh, Bindu Bajaj, Monika, K. Rani, Megha Panwar, Sunil Ranga","doi":"10.18203/2320-1770.ijrcog20240132","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240132","url":null,"abstract":"Background: Male’s inability to impregnate a fertile female is referred as male factor infertility. It accounts for 40-50% of infertile couples and affects almost 7% of all men. Male comorbidities and conditions, which negatively affect men’s health, have been repeatedly associated with impaired reproductive functioning. Cholesterol is the main substrate for steroid synthesis and it plays crucial role in formation of sperm plasma membrane and thus in spermatogenesis, highlighting the role of serum lipids in male fecundity. Purpose of the study is to evaluate correlation lipid profile of male partners with abnormal semen parameters in infertile couples.\u0000Methods: A cross sectional study was carried out in the infertility clinic of a tertiary care hospital for over 18 months and 151 infertile men with abnormal semen parameters (as per WHO 2010 criteria) were enrolled. Evaluation of lipid profile was done and its relationship with abnormal semen parameters was analyzed.\u0000Results: Significant positive correlation was seen between LDL and Triglyceride with sperm concentration and total sperm count. However, significant negative correlation was seen between Triglyceride and sperm motility and TMSC. Total and progressive motility was found to be significantly associated with total cholesterol (p<0.05). Infertile men having higher total cholesterol were found to have better total and progressive motility compared to men with less total cholesterol.\u0000Conclusions: Our findings demonstrated that lipid profile has significant correlation with semen parameters, specifically sperm concentration, count and motility.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"81 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140488267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.18203/2320-1770.ijrcog20240122
Amuche V. Nwafor, Odidika UgochukwuJoannes Umeora, A. C. Ikeotuonye, V. Obi, N. Adiele, Nkechinyere Onwe, B. Onwe
Background: Gynaecological emergencies are common causes of emergency hospital presentation/admission. Majority of the emergencies are mostly pregnancy related and pose threat to two lives as well as the women’s future reproductive careers. There is therefore need to evaluate them to make better preparations in managing them. Methods: This was a 10 year (from 01 January 2012 to 31 December 2021) retrospective study of gynaecological emergencies managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), evaluating their management and outcomes. Results: The commonest cause of gynaecological emergency at AEFUTHA was miscarriage accounting for up to 69.1% out of which incomplete miscarriage contributed 70.8% and majority had manual vacuum aspiration with good outcome. Ruptured ectopic pregnancies were the commonest surgical emergencies with the incidence of 7.1% and all had laparotomy and partial salpingectomy. Gestational trophoblastic diseases accounted for 2.0% of gynaecological emergencies. The commonest non-pregnancy related gynaecological emergency was acute pelvic inflammatory diseases which accounted for 9.3% of cases. Other gynaecological emergencies reviewed were ovarian accidents (2.9%), abnormal uterine bleeding (3.9%), gynaecological malignancies (2.3%), coital laceration (1.5%), sexual assault (2.4%) and Bartholin’s abscess (0.2%). Factors that affected the outcome were the age of the patients, marital status and disease type and were statistically significant (p<0.05). Conclusions: Management outcomes of gynaecological emergencies were optimum. Mortality occurred in 1.3% of cases, with gynaecological malignancies accounting for 81.4%. There is usually a good prognosis when prompt, accurate diagnosis and treatment are administered.
{"title":"Evaluating the management outcomes of gynaecological emergencies at a tertiary hospital, Abakaliki Southeast, Nigeria","authors":"Amuche V. Nwafor, Odidika UgochukwuJoannes Umeora, A. C. Ikeotuonye, V. Obi, N. Adiele, Nkechinyere Onwe, B. Onwe","doi":"10.18203/2320-1770.ijrcog20240122","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240122","url":null,"abstract":"Background: Gynaecological emergencies are common causes of emergency hospital presentation/admission. Majority of the emergencies are mostly pregnancy related and pose threat to two lives as well as the women’s future reproductive careers. There is therefore need to evaluate them to make better preparations in managing them.\u0000Methods: This was a 10 year (from 01 January 2012 to 31 December 2021) retrospective study of gynaecological emergencies managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), evaluating their management and outcomes.\u0000Results: The commonest cause of gynaecological emergency at AEFUTHA was miscarriage accounting for up to 69.1% out of which incomplete miscarriage contributed 70.8% and majority had manual vacuum aspiration with good outcome. Ruptured ectopic pregnancies were the commonest surgical emergencies with the incidence of 7.1% and all had laparotomy and partial salpingectomy. Gestational trophoblastic diseases accounted for 2.0% of gynaecological emergencies. The commonest non-pregnancy related gynaecological emergency was acute pelvic inflammatory diseases which accounted for 9.3% of cases. Other gynaecological emergencies reviewed were ovarian accidents (2.9%), abnormal uterine bleeding (3.9%), gynaecological malignancies (2.3%), coital laceration (1.5%), sexual assault (2.4%) and Bartholin’s abscess (0.2%). Factors that affected the outcome were the age of the patients, marital status and disease type and were statistically significant (p<0.05).\u0000Conclusions: Management outcomes of gynaecological emergencies were optimum. Mortality occurred in 1.3% of cases, with gynaecological malignancies accounting for 81.4%. There is usually a good prognosis when prompt, accurate diagnosis and treatment are administered.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"20 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140488686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.18203/2320-1770.ijrcog20240130
Syed Masuma Rizvi, Zeenat U. Shah, Sofia Farooq
Background: Emergency peripartum hysterectomy is a vital surgical procedure performed at the time of vaginal or caesarean delivery or in the immediate postpartum period in cases of intractable postpartum haemorrhage unresponsive to other conservative measures. Such hemorrhage may be due to atonic uterus, uterine trauma, coagulation disorders, abnormal placentation, not treatable by conservative measures. Methods: This study was conducted for a time period of 1.5 years from March 2016 to September 2017, in the department of Obstetrics and Gynecology, GMC Srinagar, Jammu and Kashmir, India. All such patients in our hospital were included in this study. The incidence, risk factors, age, parity, gestational age, indications for performing hystrectomy, pre and post-operative complications were studied. Results: The incidence was 3.2/1000 deliveries. The average age of the patients in our study was 31.18±2.80 years. Most patients were delivered at gestation of 37-38 weeks (61.17%). Among the patients undergoing peripartum hysterectomy 87.38% had caesarean delivery and 12.62% had vaginal delivery. The commonest indication of peripartum hystrectomy in our study was abnormal placentation (67.96%) with accreta accounting for most of these cases (53.40%). Conclusions: The incidence of peripartum hystrectomy in our centre has increased with time, which can be accounted by increase in the rate of caesarean sections over time which has led to the emergence of morbidly adherent placentation as the commonest risk factor for peripartum hysterectomy.
{"title":"Peripartum hysterectomy: prospective observational study in a tertiary care centre of north India","authors":"Syed Masuma Rizvi, Zeenat U. Shah, Sofia Farooq","doi":"10.18203/2320-1770.ijrcog20240130","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240130","url":null,"abstract":"Background: Emergency peripartum hysterectomy is a vital surgical procedure performed at the time of vaginal or caesarean delivery or in the immediate postpartum period in cases of intractable postpartum haemorrhage unresponsive to other conservative measures. Such hemorrhage may be due to atonic uterus, uterine trauma, coagulation disorders, abnormal placentation, not treatable by conservative measures.\u0000Methods: This study was conducted for a time period of 1.5 years from March 2016 to September 2017, in the department of Obstetrics and Gynecology, GMC Srinagar, Jammu and Kashmir, India. All such patients in our hospital were included in this study. The incidence, risk factors, age, parity, gestational age, indications for performing hystrectomy, pre and post-operative complications were studied.\u0000Results: The incidence was 3.2/1000 deliveries. The average age of the patients in our study was 31.18±2.80 years. Most patients were delivered at gestation of 37-38 weeks (61.17%). Among the patients undergoing peripartum hysterectomy 87.38% had caesarean delivery and 12.62% had vaginal delivery. The commonest indication of peripartum hystrectomy in our study was abnormal placentation (67.96%) with accreta accounting for most of these cases (53.40%).\u0000Conclusions: The incidence of peripartum hystrectomy in our centre has increased with time, which can be accounted by increase in the rate of caesarean sections over time which has led to the emergence of morbidly adherent placentation as the commonest risk factor for peripartum hysterectomy.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"55 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.18203/2320-1770.ijrcog20240141
Koffi Abdoul Koffi, Kacou Edèle Aka, Ana Toure-Ecra, A. Brou, Arnold Gomez Zoua, N. Olou
Uterine leiomyomas or fibromyomas, more commonly known as fibroid are the most common tumours of the female reproductive tract. Sometimes a submucosal leiomyoma may become pedunculated and progressively externalize from the uterine cavity, causing increased uterine irritability, metrorrhagia and anaemia, pelvic pain and heaviness, and perception of a vaginal mass. Prevalence of this clinical form is rare. We report our experience of taking a series of twenty-three patients, which objectives was contributed to improvement of management of uterine fibroids. We reported our observation in the epidemiological, clinical and therapeutic aspects of cervical delivered forms. It took place from November 2017 to November 2021. These were housewives with an average age of 41.30 years (27-56 years). 63.61% of whom were over 40 years old, the majority of whom were pauciparous (45.46%) with an average parity of 2.91. Nulliparous women accounted for 18.18% of the total. The average duration of the disease was 7.56 months and could reach 48 months. The reason for consultation was dominated by anaemia with 77.27%. The fibroids varied in size (mean 7 cm) and sometimes exceeded 15 cm. Transfusion of concentrated red blood cells was almost constant (88.24%). Surgical treatment was myomectomy by twisting with 53.33% followed by hysterectomy in 26.67%. Management of fibroma delivered through the cervix were anemia frequently requiring a prior blood transfusion. Treatment remains surgery. Informing and educating patients about early consultation would improve the morbidity associated with this condition.
{"title":"Uterine fibroid delivered through the cervix: diagnostic and therapeutic management about 23 cases collected at Yopougon teaching hospital, Abidjan, Côte d’Ivoire","authors":"Koffi Abdoul Koffi, Kacou Edèle Aka, Ana Toure-Ecra, A. Brou, Arnold Gomez Zoua, N. Olou","doi":"10.18203/2320-1770.ijrcog20240141","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240141","url":null,"abstract":"Uterine leiomyomas or fibromyomas, more commonly known as fibroid are the most common tumours of the female reproductive tract. Sometimes a submucosal leiomyoma may become pedunculated and progressively externalize from the uterine cavity, causing increased uterine irritability, metrorrhagia and anaemia, pelvic pain and heaviness, and perception of a vaginal mass. Prevalence of this clinical form is rare. We report our experience of taking a series of twenty-three patients, which objectives was contributed to improvement of management of uterine fibroids. We reported our observation in the epidemiological, clinical and therapeutic aspects of cervical delivered forms. It took place from November 2017 to November 2021. These were housewives with an average age of 41.30 years (27-56 years). 63.61% of whom were over 40 years old, the majority of whom were pauciparous (45.46%) with an average parity of 2.91. Nulliparous women accounted for 18.18% of the total. The average duration of the disease was 7.56 months and could reach 48 months. The reason for consultation was dominated by anaemia with 77.27%. The fibroids varied in size (mean 7 cm) and sometimes exceeded 15 cm. Transfusion of concentrated red blood cells was almost constant (88.24%). Surgical treatment was myomectomy by twisting with 53.33% followed by hysterectomy in 26.67%. Management of fibroma delivered through the cervix were anemia frequently requiring a prior blood transfusion. Treatment remains surgery. Informing and educating patients about early consultation would improve the morbidity associated with this condition.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"21 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140489274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.18203/2320-1770.ijrcog20240123
Anu N. Joseph, Sabarinath Panthrandil Sreedharan, Nila Theresa Davis
Background: Vaginal bleeding is the most common symptom of vault relapse in gynecological cancers. This symptom may be overlooked or attributed to other causes, such as atrophy, infection, or post-radiation changes. Colposcopy allows direct magnified visualization of vaginal mucosa and abnormal vasculature though its role in detecting relapse is unclear. Methods: It is a retrospective observational study of 31 patients who were referred for colposcopy and biopsy with complaints of abnormal vaginal bleeding during follow up of endometrial or cervical cancer. Results: Among 31 patients, 19 patients were diagnosed to have primary cervical cancer and 12 endometrial cancers. Primary treatment was surgery alone (n=10, 32.2%), chemo-radiation alone (n=4, 12.9%) and both (n=17, 54.8%). Abnormal colposcopic findings were atropic features (n=21, 67.7%), radiation changes (n=8, 25.8%), erosion (n=9, 29.0%), acetowhite areas (n=9, 29.0%), abnormal vessels (n=8, 25.8%) and iodine staining abnormality (n=16, 51.6%). According to Swede scoring system, 77.1% (n=24) were normal or low grade lesions, 22.6% (n=7) were high grade lesions. Total of 6 recurrence cases identified out of which 5 cases had high grade (Swede score >7) and one had low grade (Swede score 5-7) colposcopic features. On taking Swede score cut off of 5 or more, the sensitivity of colposcopy in detecting vault recurrence is 100%, specificity 96%, positive likelihood ratio of 25%and negative likelihood ratio of 0%. Overall the accuracy of colposcopy in detecting relapse was 96.8%. Conclusions: In our experience colposcopy is worth in detecting the cause of abnormal vaginal bleeding after treatment for endometrial and cervical cancer. Swede score is a good measure to decide on taking biopsy among these patients. Furthermore, larger studies are needed for better clarification.
{"title":"The utility of colposcopy in detecting relapse after treatment of gynaecological malignancies","authors":"Anu N. Joseph, Sabarinath Panthrandil Sreedharan, Nila Theresa Davis","doi":"10.18203/2320-1770.ijrcog20240123","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240123","url":null,"abstract":"Background: Vaginal bleeding is the most common symptom of vault relapse in gynecological cancers. This symptom may be overlooked or attributed to other causes, such as atrophy, infection, or post-radiation changes. Colposcopy allows direct magnified visualization of vaginal mucosa and abnormal vasculature though its role in detecting relapse is unclear.\u0000Methods: It is a retrospective observational study of 31 patients who were referred for colposcopy and biopsy with complaints of abnormal vaginal bleeding during follow up of endometrial or cervical cancer.\u0000Results: Among 31 patients, 19 patients were diagnosed to have primary cervical cancer and 12 endometrial cancers. Primary treatment was surgery alone (n=10, 32.2%), chemo-radiation alone (n=4, 12.9%) and both (n=17, 54.8%). Abnormal colposcopic findings were atropic features (n=21, 67.7%), radiation changes (n=8, 25.8%), erosion (n=9, 29.0%), acetowhite areas (n=9, 29.0%), abnormal vessels (n=8, 25.8%) and iodine staining abnormality (n=16, 51.6%). According to Swede scoring system, 77.1% (n=24) were normal or low grade lesions, 22.6% (n=7) were high grade lesions. Total of 6 recurrence cases identified out of which 5 cases had high grade (Swede score >7) and one had low grade (Swede score 5-7) colposcopic features. On taking Swede score cut off of 5 or more, the sensitivity of colposcopy in detecting vault recurrence is 100%, specificity 96%, positive likelihood ratio of 25%and negative likelihood ratio of 0%. Overall the accuracy of colposcopy in detecting relapse was 96.8%.\u0000Conclusions: In our experience colposcopy is worth in detecting the cause of abnormal vaginal bleeding after treatment for endometrial and cervical cancer. Swede score is a good measure to decide on taking biopsy among these patients. Furthermore, larger studies are needed for better clarification.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"63 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.18203/2320-1770.ijrcog20240121
S. Munira, Nastaran Lasker, Rawnok Laila, Asma Akter, J. Banu, Shakeela Ishrat
Background: Oligozoospermia is the cause of male infertility in 33.3% of cases. Omega-3 fatty acid has been utilized in infertility because of its widespread availability, low cost, and high safety profile. We intended to conduct a study to evaluate the efficacy of omega-3 fatty acid in oligozoospermia. Methods: A prospective comparative study was conducted in the outdoor of the department of reproductive endocrinology and infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2022 to August 2023. A total of 70 Infertile males with oligozoospermia, were enrolled in the study. The participants were assigned to the omega-3 fatty acid group who was treated with omega-3 fatty acid 1 gm orally twice daily for 12 weeks. The other group was treated with placebo orally twice daily for 12 weeks. Sixty patients completed the 12 weeks of treatment. The changes in sperm count were determined. Results: The mean age of the participants was 35.6±4.59 years. Following treatment with omega-3 fatty acid significant improvement was observed in sperm count from 11.10±2.81 million/ml to 34.2±31.36 million/ml. Significant improvement in total motile sperm count was also observed. At the end of 12 weeks of treatment 76.7% of participants in the omega 3 fatty acid group and 10.0% in the placebo group had normozoospermia. Conclusions: Supplementation with omega-3 fatty acid results in improvement of sperm concentration and total motile sperm count in infertile men with oligozoospermia.
{"title":"Effect of omega 3 fatty acid in infertile males with oligozoospermia","authors":"S. Munira, Nastaran Lasker, Rawnok Laila, Asma Akter, J. Banu, Shakeela Ishrat","doi":"10.18203/2320-1770.ijrcog20240121","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240121","url":null,"abstract":"Background: Oligozoospermia is the cause of male infertility in 33.3% of cases. Omega-3 fatty acid has been utilized in infertility because of its widespread availability, low cost, and high safety profile. We intended to conduct a study to evaluate the efficacy of omega-3 fatty acid in oligozoospermia.\u0000Methods: A prospective comparative study was conducted in the outdoor of the department of reproductive endocrinology and infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2022 to August 2023. A total of 70 Infertile males with oligozoospermia, were enrolled in the study. The participants were assigned to the omega-3 fatty acid group who was treated with omega-3 fatty acid 1 gm orally twice daily for 12 weeks. The other group was treated with placebo orally twice daily for 12 weeks. Sixty patients completed the 12 weeks of treatment. The changes in sperm count were determined.\u0000Results: The mean age of the participants was 35.6±4.59 years. Following treatment with omega-3 fatty acid significant improvement was observed in sperm count from 11.10±2.81 million/ml to 34.2±31.36 million/ml. Significant improvement in total motile sperm count was also observed. At the end of 12 weeks of treatment 76.7% of participants in the omega 3 fatty acid group and 10.0% in the placebo group had normozoospermia.\u0000Conclusions: Supplementation with omega-3 fatty acid results in improvement of sperm concentration and total motile sperm count in infertile men with oligozoospermia.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"70 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140486330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.18203/2320-1770.ijrcog20240139
Mahendra Meena, S. Panda
Background: Women with PCOS usually suffer from metabolic disturbances and IR, which might be associated with vitamin D metabolism. The objectives of this study are to determine the association of Vitamin-D with metabolic and endocrine parameters in PCOS women and to evaluate specific role of Vitamin-D in PCOS and to correlate the serum Vitamin-D level with various demographic, anthropometric, biochemical, metabolic and hormonal parameters in PCOS patient. Methods: This case control study was carried out between July 2014 and June 2016 in the Department of Obstetrics and Gynaecology, IMS, BHU got ethical clearance from the institute. The study involved 192 patients with polycystic ovarian syndrome based on Rotterdam criteria and 200 healthy age matched women as controls. The data analysis was performed with the help of SPSS 16.0 version for windows. Results: When study subjects are compared according to vitamin-D level (sufficiency, insufficiency and deficiency) there was significant difference for BMI (kg/m2), Waist Hip ratio and TRG (mg/dl). Vitamin-D had significant negative correlation with BMI (p=0.000); Waist:Hip ratio (p=0.012); Triglyceride (p=0.022). Conclusions: Our study found an association between the high prevalence of obesity and metabolic dysfunction in women with PCOS, and vitamin-D deficiency could be secondary to obesity in such patients. Thus, vitamin-D deficiency cannot be considered as an independent factor through the development of metabolic disorders in PCOS patients.
背景：患有多囊卵巢综合征的妇女通常会出现代谢紊乱和内分泌失调，这可能与维生素 D 代谢有关。本研究旨在确定维生素 D 与多囊卵巢综合征女性代谢和内分泌参数的关系，评估维生素 D 在多囊卵巢综合征中的特殊作用，并将多囊卵巢综合征患者的血清维生素 D 水平与各种人口统计学、人体测量、生化、代谢和激素参数相关联：这项病例对照研究于 2014 年 7 月至 2016 年 6 月期间在 BHU IMS 妇产科开展，并获得了研究所的伦理许可。根据鹿特丹标准，研究涉及 192 名多囊卵巢综合征患者和 200 名年龄匹配的健康女性作为对照。数据分析在 SPSS 16.0 视窗版本的帮助下进行：根据维生素-D水平（充足、不足和缺乏）对研究对象进行比较后发现，BMI（kg/m2）、腰臀比和TRG（mg/dl）有显著差异。维生素 D 与体重指数（P=0.000）、腰臀比（P=0.012）和甘油三酯（P=0.022）呈显著负相关：我们的研究发现，患有多囊卵巢综合症的妇女中肥胖和代谢功能障碍的发病率很高，而维生素 D 缺乏可能是此类患者继发肥胖的原因。因此，维生素 D 缺乏不能被视为导致多囊卵巢综合症患者出现代谢紊乱的独立因素。
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Pub Date : 2024-01-29DOI: 10.18203/2320-1770.ijrcog20240147
Birke C. Bauer, Thomas Römer
Caesarean scar ectopic pregnancy (CSEP) is a very rare form of ectopic pregnancy. If not diagnosed and treated accordingly it can lead to life-threatening complications. Hitherto there is no standardised treatment established because of the rarity and diversity of the disease. We present the case of a 35-year-old third gravida primi para with caesarean scar pregnancy in 7th week of gestation. Since the patient declined a Methotrexate treatment, we performed hysteroscopic and laparoscopic resection of the ectopic pregnancy in combination with repair of the isthmocele. Because human chorionic gonadotrophin (hCG)-level showed no proper decline three weeks after the initial surgery a second look hysteroscopy and laparoscopy were performed with laparoscopic injection of MTX around the uterine suture, resulting in a full decline of hCG-level. The ultrasound performed before discharge shows a well-adapted uterine scar. A pregnancy can be aspired six-month post-surgery.
{"title":"Cesarean scar ectopic pregnancy management with simultaneous isthmocele repair","authors":"Birke C. Bauer, Thomas Römer","doi":"10.18203/2320-1770.ijrcog20240147","DOIUrl":"https://doi.org/10.18203/2320-1770.ijrcog20240147","url":null,"abstract":"Caesarean scar ectopic pregnancy (CSEP) is a very rare form of ectopic pregnancy. If not diagnosed and treated accordingly it can lead to life-threatening complications. Hitherto there is no standardised treatment established because of the rarity and diversity of the disease. We present the case of a 35-year-old third gravida primi para with caesarean scar pregnancy in 7th week of gestation. Since the patient declined a Methotrexate treatment, we performed hysteroscopic and laparoscopic resection of the ectopic pregnancy in combination with repair of the isthmocele. Because human chorionic gonadotrophin (hCG)-level showed no proper decline three weeks after the initial surgery a second look hysteroscopy and laparoscopy were performed with laparoscopic injection of MTX around the uterine suture, resulting in a full decline of hCG-level. The ultrasound performed before discharge shows a well-adapted uterine scar. A pregnancy can be aspired six-month post-surgery.","PeriodicalId":14225,"journal":{"name":"International journal of reproduction, contraception, obstetrics and gynecology","volume":"224 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140489932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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