Pub Date : 2021-01-14DOI: 10.15406/ogij.2021.12.00541
Miguel Oliveros Donohue MD
Prudence is very necessary in daily life and it is often necessary to cultivate it. His teaching has been emphasized since the Greek classics. We wonder if enough is taught at home, at school, during the study of medical sciences and we appeal to Haynes, Pellegrino and Maio in search of virtues, acts and clinical habits that link prudence with ethics and humanism. Prudence is all practical knowledge applicable and suitable for the direction of customs. In Greek it is called “fronesis” and in Latin it is called “prudentia”. Reference is made to the man who foresees, who knows in advance, who acts with cautious knowledge, the foresighted, reflective man.1–3 The Royal Spanish Academy defines it in three ways: Temperance, caution, moderation; Sanity, good judgement; and Cardinal Virtue that allows to distinguish good from bad.4
{"title":"Prudence: essential virtue in the field of health","authors":"Miguel Oliveros Donohue MD","doi":"10.15406/ogij.2021.12.00541","DOIUrl":"https://doi.org/10.15406/ogij.2021.12.00541","url":null,"abstract":"Prudence is very necessary in daily life and it is often necessary to cultivate it. His teaching has been emphasized since the Greek classics. We wonder if enough is taught at home, at school, during the study of medical sciences and we appeal to Haynes, Pellegrino and Maio in search of virtues, acts and clinical habits that link prudence with ethics and humanism. Prudence is all practical knowledge applicable and suitable for the direction of customs. In Greek it is called “fronesis” and in Latin it is called “prudentia”. Reference is made to the man who foresees, who knows in advance, who acts with cautious knowledge, the foresighted, reflective man.1–3 The Royal Spanish Academy defines it in three ways: Temperance, caution, moderation; Sanity, good judgement; and Cardinal Virtue that allows to distinguish good from bad.4","PeriodicalId":19389,"journal":{"name":"Obstetrics & Gynecology International Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80222161","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 : 2020-12-30DOI: 10.15406/ogij.2020.11.00540
H. Saleh, Mohamed El-Husseny El Kadosi, El Kadosi
Objective: Termination of second trimester pregnancy is unique obstetric contest due to its difficulty and risky especially if the condition is associated with prior Caesarean deliveries. Aim of the work: To compare the safety and efficacy of two regimens for termination of the second trimester pregnancy in ladies with scarred uterus by prior Caesarean deliveries either by using sublingual and vaginal misoprostol or sublingual misoprostol in a combination with intra cervical Foley’s catheter. Patients and methods: 163 pregnant ladies with second trimester demise pregnancy at14-24 gestational weeks in scarred uterus (≥ one cesarean sections) participated in this prospective randomized comparative study which was performed in obstetric emergency unit in Zagazig University Hospitals, Egypt from June 2019 to May 2020. 140 patients only far-reached the trial through termination of the pregnancy via induction of abortion by sublingual and vaginal misoprostol Group 1 (GI) or Foley’s catheter with vaginal misoprostol Group 2 G (II). Whichever of those methods sustained for 48 hours else the fetus expulsed formerly .Outcomes was determined by comprehensive expulsion of fetus and placenta, Induction Abortion interval, Incidence of side effects, requirement for surgical intervention and complications" rate. Results: The demographic criteria of both groups revealed no significant difference (P-value>0.05). The mean (SD) of Induction to abortion interval (hours) in GI was significant longer than in G II (51.07±23.84, 45.20±31.28) respectively with (P- value 0.021). Total dose (μg) of misoprostol used in GI (1100.72±23.54) was higher than G II (645.35± 322) with p value 0.001. Admission-termination hospitalization (days) was significant longer in G I (4.11±1.02) than in G II (2.371±1.98) with P value 0.004. No significant difference as regard occurrence of adverse effects between both groups except the incidence of fever (17.1%) in G I and (5.7%) in G II with P value 0.01. Success rate in GI and G II were (80%, 95%) respectively with P-value 0.01. Incomplete expulsion was higher in GI (14.3%) in comparison with G II (4.2%) with P value 0.04. Incidence of haemorrhage was significant higher in G II than in GI P value 0.03. No significant differences between both groups as regard incidence of rupture uterus or occurrence of infection. Conclusion: Practice of inserting Foley’s catheter through cervix with misoprostol sublingually for termination of mid-trimester pregnancy in preceding uterine scar(s) is efficient, inexpensive and safe procedure.
{"title":"Misoprostol only or in combination with intra cervical Foley’s catheter for termination of the second trimester demise pregnancy in patient with previous caesarean sections","authors":"H. Saleh, Mohamed El-Husseny El Kadosi, El Kadosi","doi":"10.15406/ogij.2020.11.00540","DOIUrl":"https://doi.org/10.15406/ogij.2020.11.00540","url":null,"abstract":"Objective: Termination of second trimester pregnancy is unique obstetric contest due to its difficulty and risky especially if the condition is associated with prior Caesarean deliveries. Aim of the work: To compare the safety and efficacy of two regimens for termination of the second trimester pregnancy in ladies with scarred uterus by prior Caesarean deliveries either by using sublingual and vaginal misoprostol or sublingual misoprostol in a combination with intra cervical Foley’s catheter. Patients and methods: 163 pregnant ladies with second trimester demise pregnancy at14-24 gestational weeks in scarred uterus (≥ one cesarean sections) participated in this prospective randomized comparative study which was performed in obstetric emergency unit in Zagazig University Hospitals, Egypt from June 2019 to May 2020. 140 patients only far-reached the trial through termination of the pregnancy via induction of abortion by sublingual and vaginal misoprostol Group 1 (GI) or Foley’s catheter with vaginal misoprostol Group 2 G (II). Whichever of those methods sustained for 48 hours else the fetus expulsed formerly .Outcomes was determined by comprehensive expulsion of fetus and placenta, Induction Abortion interval, Incidence of side effects, requirement for surgical intervention and complications\" rate. Results: The demographic criteria of both groups revealed no significant difference (P-value>0.05). The mean (SD) of Induction to abortion interval (hours) in GI was significant longer than in G II (51.07±23.84, 45.20±31.28) respectively with (P- value 0.021). Total dose (μg) of misoprostol used in GI (1100.72±23.54) was higher than G II (645.35± 322) with p value 0.001. Admission-termination hospitalization (days) was significant longer in G I (4.11±1.02) than in G II (2.371±1.98) with P value 0.004. No significant difference as regard occurrence of adverse effects between both groups except the incidence of fever (17.1%) in G I and (5.7%) in G II with P value 0.01. Success rate in GI and G II were (80%, 95%) respectively with P-value 0.01. Incomplete expulsion was higher in GI (14.3%) in comparison with G II (4.2%) with P value 0.04. Incidence of haemorrhage was significant higher in G II than in GI P value 0.03. No significant differences between both groups as regard incidence of rupture uterus or occurrence of infection. Conclusion: Practice of inserting Foley’s catheter through cervix with misoprostol sublingually for termination of mid-trimester pregnancy in preceding uterine scar(s) is efficient, inexpensive and safe procedure.","PeriodicalId":19389,"journal":{"name":"Obstetrics & Gynecology International Journal","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84188694","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 : 2020-12-29DOI: 10.15406/ogij.2020.11.00539
Elsa María Rodríguez Angulo, Uc Santos Guillermo, Gómez Carro Salvador
Objective: Describe the clinical and sociodemographic characteristics of maternal deaths that occurred in a hospital in Yucatán, Mexico, as well as propose recommendations to improve the care of pregnant women in order to help reduce in-hospital maternal mortality. Material and methods: Retrospective, cross-sectional study conducted in a second-level care concentration hospital. The hospital database of maternal deaths that occurred during the 2014–2018 period was reviewed, as well as clinical summaries, maternal death reports, maternal death ratification forms, and hospital records. Results: There were 54 maternal deaths, the year with the highest percentage was 2018 with 15 (27.8%) deaths. Most of the women resided in municipalities with low and very low degrees of marginalization 23 (42.6%); 48 (88.9%) were engaged in housework; 13 had a history of previous abortion (24.1%), with prenatal control 18 (33.3%), used some contraceptive method 13 (24.1%); and 21 (38.9%) presented some complication during pregnancy. Direct maternal deaths were mainly hypertensive disorders with 9 (32.1%) deaths. Indirect maternal deaths were mainly due to heart disease and arteriovenous disorders 6 (30.0%). The Hospital Mortality Committee issued 98 (55.1%) recommendations to improve emergency care, of which 32 (32. 6%) were related to the training of health personnel in the first level of care; and 22 (22.5%) for the second level of care. Conclusion: It is important to improve the care of the pregnant woman through the permanent training of health personnel to detect warning signs in the prenatal consultation and care of the obstetric emergency, in order to fully detect the problems that arise in the care chain of patients. Likewise, the training and updating of medical personnel for the correct completion of the basic causes of maternal death according to IDC-10 will be necessary for the correct certification of deaths.
{"title":"Maternal hospital deaths: clinical and sociodemographic characteristics in Yucatán, México","authors":"Elsa María Rodríguez Angulo, Uc Santos Guillermo, Gómez Carro Salvador","doi":"10.15406/ogij.2020.11.00539","DOIUrl":"https://doi.org/10.15406/ogij.2020.11.00539","url":null,"abstract":"Objective: Describe the clinical and sociodemographic characteristics of maternal deaths that occurred in a hospital in Yucatán, Mexico, as well as propose recommendations to improve the care of pregnant women in order to help reduce in-hospital maternal mortality. Material and methods: Retrospective, cross-sectional study conducted in a second-level care concentration hospital. The hospital database of maternal deaths that occurred during the 2014–2018 period was reviewed, as well as clinical summaries, maternal death reports, maternal death ratification forms, and hospital records. Results: There were 54 maternal deaths, the year with the highest percentage was 2018 with 15 (27.8%) deaths. Most of the women resided in municipalities with low and very low degrees of marginalization 23 (42.6%); 48 (88.9%) were engaged in housework; 13 had a history of previous abortion (24.1%), with prenatal control 18 (33.3%), used some contraceptive method 13 (24.1%); and 21 (38.9%) presented some complication during pregnancy. Direct maternal deaths were mainly hypertensive disorders with 9 (32.1%) deaths. Indirect maternal deaths were mainly due to heart disease and arteriovenous disorders 6 (30.0%). The Hospital Mortality Committee issued 98 (55.1%) recommendations to improve emergency care, of which 32 (32. 6%) were related to the training of health personnel in the first level of care; and 22 (22.5%) for the second level of care. Conclusion: It is important to improve the care of the pregnant woman through the permanent training of health personnel to detect warning signs in the prenatal consultation and care of the obstetric emergency, in order to fully detect the problems that arise in the care chain of patients. Likewise, the training and updating of medical personnel for the correct completion of the basic causes of maternal death according to IDC-10 will be necessary for the correct certification of deaths.","PeriodicalId":19389,"journal":{"name":"Obstetrics & Gynecology International Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74338564","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 : 2020-12-17DOI: 10.15406/ogij.2020.11.00538
Y. Kurban, Y. Alan, M. Alan, M. Kurt, B. Gurlek, Burak Cegilli, C. Taner, Abdulmecit Öktem
Aim: To evaluate whether serum platelets Mean Platelet Volum (MPV), and Red Cell Distribution width (RDW) are useful as predictors of preterm labour (PL) in patients with preterm labour (PL), and to compare the clinical efficacy of various serum inflammatory markers to predict the risk of preterm delivery (PD). Materials, and methods: The main group consisted of pregnant women who were earlier than the 37th gestational week. The control group has consisted of pregnant bigger than 37th weeks of gestation. The patients with PL who participated in the study group were divided into early preterm labour (EPL), and late preterm labour (LPL) groups. The two groups were investigated in terms of clinical aspects of RDW, and MPV and serum markers studied at admission. ROC curve analysis was used to determine the optimal MPV, RDW cut-off levels predicting PL. Results: Neutrophil (NEU), MPW, RDW, and neutrophil to lymphocyte ratio (NLR) were significantly higher in LPL than in women who gave birth at term (p=0.006, OR=1.411; p<0.001, OR=1.410; 0.002, OR=1.612, p=0.035, OR=1.294). In multivariate regression analysis, MPV positive was the strongest predictor variable. Besides, there was a significant correlation between MPV and RDW elevation, and neonatal intensive care needs (NICU) in women who delivered between 34 weeks, and 37 weeks. Conclusion: High RDW and MPV are independent predictors of preterm delivery in patients with LPL. In our study, we found that the increase of RDW and MPV was higher in women with high PL risk more than in healthy individuals. MPV has the highest area for prediction of preterm birth, and RDW>14,5, and MPV>9,6 have the highest sensitivity and specificity. RDW may be more significant than measuring any of the individual markers in the simultaneous use of preterm delivery. The simultaneous use of RDW and MPV with existing markers to increase our identifying abilities of preterm labour may be stronger than that of any of the individual markers.
{"title":"A new marker in preterm labor: RDW and MPV","authors":"Y. Kurban, Y. Alan, M. Alan, M. Kurt, B. Gurlek, Burak Cegilli, C. Taner, Abdulmecit Öktem","doi":"10.15406/ogij.2020.11.00538","DOIUrl":"https://doi.org/10.15406/ogij.2020.11.00538","url":null,"abstract":"Aim: To evaluate whether serum platelets Mean Platelet Volum (MPV), and Red Cell Distribution width (RDW) are useful as predictors of preterm labour (PL) in patients with preterm labour (PL), and to compare the clinical efficacy of various serum inflammatory markers to predict the risk of preterm delivery (PD). Materials, and methods: The main group consisted of pregnant women who were earlier than the 37th gestational week. The control group has consisted of pregnant bigger than 37th weeks of gestation. The patients with PL who participated in the study group were divided into early preterm labour (EPL), and late preterm labour (LPL) groups. The two groups were investigated in terms of clinical aspects of RDW, and MPV and serum markers studied at admission. ROC curve analysis was used to determine the optimal MPV, RDW cut-off levels predicting PL. Results: Neutrophil (NEU), MPW, RDW, and neutrophil to lymphocyte ratio (NLR) were significantly higher in LPL than in women who gave birth at term (p=0.006, OR=1.411; p<0.001, OR=1.410; 0.002, OR=1.612, p=0.035, OR=1.294). In multivariate regression analysis, MPV positive was the strongest predictor variable. Besides, there was a significant correlation between MPV and RDW elevation, and neonatal intensive care needs (NICU) in women who delivered between 34 weeks, and 37 weeks. Conclusion: High RDW and MPV are independent predictors of preterm delivery in patients with LPL. In our study, we found that the increase of RDW and MPV was higher in women with high PL risk more than in healthy individuals. MPV has the highest area for prediction of preterm birth, and RDW>14,5, and MPV>9,6 have the highest sensitivity and specificity. RDW may be more significant than measuring any of the individual markers in the simultaneous use of preterm delivery. The simultaneous use of RDW and MPV with existing markers to increase our identifying abilities of preterm labour may be stronger than that of any of the individual markers.","PeriodicalId":19389,"journal":{"name":"Obstetrics & Gynecology International Journal","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90655112","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 : 2020-11-30DOI: 10.15406/ogij.2020.11.00537
R. S. Florêncio
Research question: We have demonstrated that plasmatic estradiol in mid-luteal phasel has prognostic value for clinical and ongoing pregnancy rate. This study investigated the possible factors that could interfere in the value of estradiol-progesterone in the mid luteal phase of cycles of IVF/ICSI Design: Retrospective study, including patients ≤39years old and with dosage of estradiol-progesterone and beta hCG 6-7 days after fresh embryo transfer and the influence of several factors or variables upon these hormones. Results: Of 189 cycles of IVF/ICSI with complete hormonal evaluation in mid-luteal phase, we studied the probably influence of ten factors upon plasmatic concentration of estradiol-progesterone. Only four factors had significant influence. Of them, the most important variable was beta hCG concentration (consequence of trophoblastic mass and number of implanted embryos), followed for number collected oocytes, and of litlle importance, scheme of final maturation with luteal phase correction (did not reach statistical difference), and day of transfer. Conclusion: The estradiol-progesterone in the mid-luteal phase, in this research, were influenced by hCG, number of collected oocytes, scheme for final maturation, but the main influence factor was the beta hCG concentration, although not had been a good correlation coefficient between these hormones, due to a large difference in the their concentrations, as seen in the high values observed on the Standard Deviation. The high percentages of clinical and ongoing pregnancies in the ≥500g/ml group, were the result of higher beta hCG levels, due to the larger number of twin pregnancy in this group.
{"title":"Factors that may interfere in estradiol-progesterone plasmatic concentration in the mid-luteal phase of hyperstimulated cycles for IVF/ICSI","authors":"R. S. Florêncio","doi":"10.15406/ogij.2020.11.00537","DOIUrl":"https://doi.org/10.15406/ogij.2020.11.00537","url":null,"abstract":"Research question: We have demonstrated that plasmatic estradiol in mid-luteal phasel has prognostic value for clinical and ongoing pregnancy rate. This study investigated the possible factors that could interfere in the value of estradiol-progesterone in the mid luteal phase of cycles of IVF/ICSI Design: Retrospective study, including patients ≤39years old and with dosage of estradiol-progesterone and beta hCG 6-7 days after fresh embryo transfer and the influence of several factors or variables upon these hormones. Results: Of 189 cycles of IVF/ICSI with complete hormonal evaluation in mid-luteal phase, we studied the probably influence of ten factors upon plasmatic concentration of estradiol-progesterone. Only four factors had significant influence. Of them, the most important variable was beta hCG concentration (consequence of trophoblastic mass and number of implanted embryos), followed for number collected oocytes, and of litlle importance, scheme of final maturation with luteal phase correction (did not reach statistical difference), and day of transfer. Conclusion: The estradiol-progesterone in the mid-luteal phase, in this research, were influenced by hCG, number of collected oocytes, scheme for final maturation, but the main influence factor was the beta hCG concentration, although not had been a good correlation coefficient between these hormones, due to a large difference in the their concentrations, as seen in the high values observed on the Standard Deviation. The high percentages of clinical and ongoing pregnancies in the ≥500g/ml group, were the result of higher beta hCG levels, due to the larger number of twin pregnancy in this group.","PeriodicalId":19389,"journal":{"name":"Obstetrics & Gynecology International Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84787179","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 : 2020-11-17DOI: 10.15406/OGIJ.2020.11.00535
V. Manuel, Luján Irastorza Jesús Estuardo, D. Carlos, K. Alejandro, H. Roberto, Ávila Pérez Felipe de Jesús, G. Juan, Á. Daniela, P. Maruxa, Paredes Núñez María Angélica
Background: Recurrent gestational loss (RPL) is defined by the ESHRE as the loss of 2 or more consecutive pregnancies. The objective of this study is to evaluate the relationship of Factor V Leiden (FVL, G1691A), prothrombin G20210A (PRT, G20210A), methylenetetrahydrofolate reductase G677A (MTHFR C677AT) and plasminogen activator inhibitor-1 (4G/5G) (PAI-1, 4G/5G); with recurrent gestational loss and perinatal data of Mexican women. Material and method: Retrospective, observational and cross-sectional study, which includes 277 pregnancies of 95 women and three groups were formed: 1) Control: deliveries of patients without pregnancy loss, without problems during the development of pregnancy and with a study of hereditary thrombophilias, 2) idiopathic fetal death : Deliveries of patients with idiopathic gestational loss (=1) and with study of thrombophilias, and 3) recurrent pregnancy loss. Deliveries of patients with idiopathic recurrent pregnancy loss and with study of hereditary thrombophilias; patient data was collected; age, weight and height, newborn data, weeks of gestation, weight and height, which are reported with mean ± standard error and analyzed with the student's t test, and thrombophilias, cesarean sections, deliveries and spontaneous abortions are reported in percentages and analyzed with chi2, in both cases the SPSS version 25 statistical package was used. Results: Of the 95 women included there were no significant differences in age, weight and height in the different rates of each group; one of the thrombophilias to be evaluated in the different populations, it was observed that FVL-G1691A only occurs in recurrent pregnancy loss (15.4%); the translation of homozygous and heterozygous, it was observed that FVL-G1691A only appeared in recurrent pregnancy loss, perinatal data showed a decrease in the weeks of gestation in newborns of mothers with recurrent pregnancy loss, with a decrease in weight and size. Conclusions: the presence of inherited maternal thrombophilias increases the risk of recurrent pregnancy loss, premature birth, and decreased weight and height at birth.
{"title":"Thrombofilias and the risk of recurring pregnancy loss in a Mexican population","authors":"V. Manuel, Luján Irastorza Jesús Estuardo, D. Carlos, K. Alejandro, H. Roberto, Ávila Pérez Felipe de Jesús, G. Juan, Á. Daniela, P. Maruxa, Paredes Núñez María Angélica","doi":"10.15406/OGIJ.2020.11.00535","DOIUrl":"https://doi.org/10.15406/OGIJ.2020.11.00535","url":null,"abstract":"Background: Recurrent gestational loss (RPL) is defined by the ESHRE as the loss of 2 or more consecutive pregnancies. The objective of this study is to evaluate the relationship of Factor V Leiden (FVL, G1691A), prothrombin G20210A (PRT, G20210A), methylenetetrahydrofolate reductase G677A (MTHFR C677AT) and plasminogen activator inhibitor-1 (4G/5G) (PAI-1, 4G/5G); with recurrent gestational loss and perinatal data of Mexican women. Material and method: Retrospective, observational and cross-sectional study, which includes 277 pregnancies of 95 women and three groups were formed: 1) Control: deliveries of patients without pregnancy loss, without problems during the development of pregnancy and with a study of hereditary thrombophilias, 2) idiopathic fetal death : Deliveries of patients with idiopathic gestational loss (=1) and with study of thrombophilias, and 3) recurrent pregnancy loss. Deliveries of patients with idiopathic recurrent pregnancy loss and with study of hereditary thrombophilias; patient data was collected; age, weight and height, newborn data, weeks of gestation, weight and height, which are reported with mean ± standard error and analyzed with the student's t test, and thrombophilias, cesarean sections, deliveries and spontaneous abortions are reported in percentages and analyzed with chi2, in both cases the SPSS version 25 statistical package was used. Results: Of the 95 women included there were no significant differences in age, weight and height in the different rates of each group; one of the thrombophilias to be evaluated in the different populations, it was observed that FVL-G1691A only occurs in recurrent pregnancy loss (15.4%); the translation of homozygous and heterozygous, it was observed that FVL-G1691A only appeared in recurrent pregnancy loss, perinatal data showed a decrease in the weeks of gestation in newborns of mothers with recurrent pregnancy loss, with a decrease in weight and size. Conclusions: the presence of inherited maternal thrombophilias increases the risk of recurrent pregnancy loss, premature birth, and decreased weight and height at birth.","PeriodicalId":19389,"journal":{"name":"Obstetrics & Gynecology International Journal","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85946978","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 : 2020-11-11DOI: 10.15406/OGIJ.2020.11.00534
S. Aishima, S. Fukushima, Y. Nakayama, Katsuyuki Hanashima, Mariko Hashiguchi, M. Yokoyama
Ovarian carcinosarcoma (OCS) is a rare malignancy accounting for only 1‒4% of all ovarian cancers. A 44-year-old premenopausal woman presented at the Obstetrics and Gynecology Department of the University Hospital of Saga, with the chief complaint of sudden abdominal pain. Tumor markers present in her serum were cancer antigen (CA) 19-9 (103U/mL), and CA 125 (114U/mL). Transvaginal ultrasound examination showed a complex mass (74×71×67mm) with solid and cystic components in the left abdominal area. Abdominopelvic computed tomography images showed a polycystic mass with a long diameter of 94 mm in the left adnexal area. The patient underwent a laparotomy immediately after the appropriate evaluation of examinations, leading to total abdominal hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy. Due to the emergency surgery, intraoperative histological diagnosis for ovarian tumor was not performed. The preoperative evaluation of radiological imaging revealed no evidence of lymph node swelling, therefore lymph node resection was omitted. The left ovarian tumor already showed a partial rupture. Pathological examination following surgery revealed tubular and solid growth of the epithelial component and fascicular growth of spindle-shaped mesenchymal cells. Immunohistochemistry identified the epithelial component as endometrioid carcinoma (EC) and the mesenchymal component as endometrial stromal sarcoma (ESS). Endometriotic tissue was attached to the malignant tumor. The patient was successfully treated with adjuvant chemotherapy (paclitaxel plus carboplatin) after surgery. The patient is still alive without recurrence at 9 months after surgery. Considering the rarity of OCS with EC and ESS, we present an overview of the literature and discuss several histological and clinical issues. The etiology and pathogenesis of such tumors require further investigation (words; 228).
{"title":"A case of ovarian carcinosarcoma composed of endometrioid carcinoma and endometrial stromal sarcoma","authors":"S. Aishima, S. Fukushima, Y. Nakayama, Katsuyuki Hanashima, Mariko Hashiguchi, M. Yokoyama","doi":"10.15406/OGIJ.2020.11.00534","DOIUrl":"https://doi.org/10.15406/OGIJ.2020.11.00534","url":null,"abstract":"Ovarian carcinosarcoma (OCS) is a rare malignancy accounting for only 1‒4% of all ovarian cancers. A 44-year-old premenopausal woman presented at the Obstetrics and Gynecology Department of the University Hospital of Saga, with the chief complaint of sudden abdominal pain. Tumor markers present in her serum were cancer antigen (CA) 19-9 (103U/mL), and CA 125 (114U/mL). Transvaginal ultrasound examination showed a complex mass (74×71×67mm) with solid and cystic components in the left abdominal area. Abdominopelvic computed tomography images showed a polycystic mass with a long diameter of 94 mm in the left adnexal area. The patient underwent a laparotomy immediately after the appropriate evaluation of examinations, leading to total abdominal hysterectomy, bilateral salpingo-oophorectomy and partial omentectomy. Due to the emergency surgery, intraoperative histological diagnosis for ovarian tumor was not performed. The preoperative evaluation of radiological imaging revealed no evidence of lymph node swelling, therefore lymph node resection was omitted. The left ovarian tumor already showed a partial rupture. Pathological examination following surgery revealed tubular and solid growth of the epithelial component and fascicular growth of spindle-shaped mesenchymal cells. Immunohistochemistry identified the epithelial component as endometrioid carcinoma (EC) and the mesenchymal component as endometrial stromal sarcoma (ESS). Endometriotic tissue was attached to the malignant tumor. The patient was successfully treated with adjuvant chemotherapy (paclitaxel plus carboplatin) after surgery. The patient is still alive without recurrence at 9 months after surgery. Considering the rarity of OCS with EC and ESS, we present an overview of the literature and discuss several histological and clinical issues. The etiology and pathogenesis of such tumors require further investigation (words; 228).","PeriodicalId":19389,"journal":{"name":"Obstetrics & Gynecology International Journal","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81307833","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 : 2020-11-04DOI: 10.29328/JOURNAL.CJOG.1001069
S. DeMiguelManso, E. GarcíaGarcía, Gobernado Tejedor Ja, Badillo Bercebal Ce, D. ViruegaCuaresma, González Martín Ji
Objetive: The objective is to identify factors associated with the risk of recurrence of stress urinary incontinence at 4years, after surgical treatment with transobturator suburethral tape. Methods: A prospective four-year follow-up observational study (2015-2019, n=341) was performed in women who underwent SUI using the tension-free vaginal tape-obturator. The sample was 71 patients with recurrence of SUI. Statistics: T-Test or U-Mann and ROC for quantitative variables, Chi-Square and OR for qualitative variables. Results: The frecuency of SUI recidive was 11.27% (8 patients). Of all the variables analyzed, they only showed a significant association with the SUI recurrence: age, fetal macrosomia and mixed urinary incontinence. The frequency of recurrence in case mixed incontinence amounted to 19.5%, if the patient had 1 delivery >4 kg to 22% and if the antecedent was ≥2 macrosomal deliveries it increased up to 50%. Conclusion: Advanced age, macrosomic delivery and mixed urinary incontinence have shown a significant association with the risk of relapse of SUI after tension-free vaginal tape-obturator at 4 years. Therefore, it would be necessary to inform them of a greater risk of failure in the medium term in the preoperative interview.
{"title":"4-year recurrence risk factors after tension-free vaginal tape-obturator as a treatment of stress urinary incontinence","authors":"S. DeMiguelManso, E. GarcíaGarcía, Gobernado Tejedor Ja, Badillo Bercebal Ce, D. ViruegaCuaresma, González Martín Ji","doi":"10.29328/JOURNAL.CJOG.1001069","DOIUrl":"https://doi.org/10.29328/JOURNAL.CJOG.1001069","url":null,"abstract":"Objetive: The objective is to identify factors associated with the risk of recurrence of stress urinary incontinence at 4years, after surgical treatment with transobturator suburethral tape. Methods: A prospective four-year follow-up observational study (2015-2019, n=341) was performed in women who underwent SUI using the tension-free vaginal tape-obturator. The sample was 71 patients with recurrence of SUI. Statistics: T-Test or U-Mann and ROC for quantitative variables, Chi-Square and OR for qualitative variables. Results: The frecuency of SUI recidive was 11.27% (8 patients). Of all the variables analyzed, they only showed a significant association with the SUI recurrence: age, fetal macrosomia and mixed urinary incontinence. The frequency of recurrence in case mixed incontinence amounted to 19.5%, if the patient had 1 delivery >4 kg to 22% and if the antecedent was ≥2 macrosomal deliveries it increased up to 50%. Conclusion: Advanced age, macrosomic delivery and mixed urinary incontinence have shown a significant association with the risk of relapse of SUI after tension-free vaginal tape-obturator at 4 years. Therefore, it would be necessary to inform them of a greater risk of failure in the medium term in the preoperative interview.","PeriodicalId":19389,"journal":{"name":"Obstetrics & Gynecology International Journal","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76554575","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 : 2020-10-26DOI: 10.15406/ogij.2020.11.00532
B. Afolabi, Abayomi B Ajayi, T. Ajayi, Victor D Ajayi, I. Oyetunji, A. Atiba, Fo Adeyemo, Nnena Okoro, R. Obasa, Vivian Berenibara, Adepeju Osanaiye, T. Balogun, Grace Bisi-Akinlabi, O. Balogun, Chukwudi Eze, O. Obasanya, Oluseyi Abawunmi
Introduction: COVID-19 pandemic has taken the world by storm and consequently, various reproductive medicine societies had since issued guidelines based on best judgement for the safety of IVF patients and attending health staffs Objective: The objective of this study was to assess the opinions of IVF staff in sub-Sahara Africa on the awareness of COVID-19 on Assisted Reproductive Technology. The study also evaluated some of the measures that can mitigate the effects of the virus in IVF clinics. Methodology: Different cadres of staff at Nordica Fertility Center (NFC) in Lagos, Nigeria were interviewed. Those interviewed included the Medical Director, Clinicians/Gynecologists, Clinic Manager, Nurses, Embryologists, Counsellor, Business Developing Unit, Client Liaison Officers and Accounts Officer. Their responses were collated, and the key points were documented. Each staff in face mask was visited by one interviewer who observed all government-recommended sanitary precautions including wearing a facemask and maintaining social distance between her and the interviewee. Result: The response of the MD on the fate of IVF clinic in Africa within the next 6 months to 1 year of the Covid-19 pandemic was that the overall economy is a major determinant of the ability of clients to pay for IVF services. Infertile women would still want to have children but “how would they pay for the services?” since ART is not subsidized by the government but mostly paid as out-of-pocket expense in this part of the world. The main points were that IVF clinics are not immune to the economy and vaccine may or may not favor IVF, reasons being; The virus is about 5 months old hence still much to be discovered There is no solid evidence that the virus affects reproduction No evidence of mother-to-child transmission and The virus can survive in cold environment therefore, it could survive cryopreservation. The embryologist was of the opinion that IVF clinics in Africa need to understand the virus more to decide whether: Attend to COVID-19 patients or not and if so, how best to care for them Better prepare modalities of cryopreservation such as Appropriate equipment Batching gametes together with HIV or Hepatitis patients In same or separate equipment and Getting special cryo-tanks for Covid-19 patients. Embryologist agreed that clinics will be able to perform other adjunct fertility treatment such as Pre-implantation Genetic Diagnosis (PGD), dependent on clinics’ ability to have separate equipment for Covid19-positive and negative patients. Conclusion: Africa is not left behind in experiencing the effects of COVID-19 and ART, for which concerns for the survival of privately owned clinics to ensure and safeguard the health and safety of patients, staff and the unborn babies are expressed. As of now, no-one is sure of patients that are symptomatic and those not symptomatic, as testing in the country, just like in most parts of the world, are still inadequate. When a vaccine is av
{"title":"Influence of the awareness of COVID-19 pandemic on assisted reproductive technology clinic in Africa, South of the Sahara","authors":"B. Afolabi, Abayomi B Ajayi, T. Ajayi, Victor D Ajayi, I. Oyetunji, A. Atiba, Fo Adeyemo, Nnena Okoro, R. Obasa, Vivian Berenibara, Adepeju Osanaiye, T. Balogun, Grace Bisi-Akinlabi, O. Balogun, Chukwudi Eze, O. Obasanya, Oluseyi Abawunmi","doi":"10.15406/ogij.2020.11.00532","DOIUrl":"https://doi.org/10.15406/ogij.2020.11.00532","url":null,"abstract":"Introduction: COVID-19 pandemic has taken the world by storm and consequently, various reproductive medicine societies had since issued guidelines based on best judgement for the safety of IVF patients and attending health staffs Objective: The objective of this study was to assess the opinions of IVF staff in sub-Sahara Africa on the awareness of COVID-19 on Assisted Reproductive Technology. The study also evaluated some of the measures that can mitigate the effects of the virus in IVF clinics. Methodology: Different cadres of staff at Nordica Fertility Center (NFC) in Lagos, Nigeria were interviewed. Those interviewed included the Medical Director, Clinicians/Gynecologists, Clinic Manager, Nurses, Embryologists, Counsellor, Business Developing Unit, Client Liaison Officers and Accounts Officer. Their responses were collated, and the key points were documented. Each staff in face mask was visited by one interviewer who observed all government-recommended sanitary precautions including wearing a facemask and maintaining social distance between her and the interviewee. Result: The response of the MD on the fate of IVF clinic in Africa within the next 6 months to 1 year of the Covid-19 pandemic was that the overall economy is a major determinant of the ability of clients to pay for IVF services. Infertile women would still want to have children but “how would they pay for the services?” since ART is not subsidized by the government but mostly paid as out-of-pocket expense in this part of the world. The main points were that IVF clinics are not immune to the economy and vaccine may or may not favor IVF, reasons being; The virus is about 5 months old hence still much to be discovered There is no solid evidence that the virus affects reproduction No evidence of mother-to-child transmission and The virus can survive in cold environment therefore, it could survive cryopreservation. The embryologist was of the opinion that IVF clinics in Africa need to understand the virus more to decide whether: Attend to COVID-19 patients or not and if so, how best to care for them Better prepare modalities of cryopreservation such as Appropriate equipment Batching gametes together with HIV or Hepatitis patients In same or separate equipment and Getting special cryo-tanks for Covid-19 patients. Embryologist agreed that clinics will be able to perform other adjunct fertility treatment such as Pre-implantation Genetic Diagnosis (PGD), dependent on clinics’ ability to have separate equipment for Covid19-positive and negative patients. Conclusion: Africa is not left behind in experiencing the effects of COVID-19 and ART, for which concerns for the survival of privately owned clinics to ensure and safeguard the health and safety of patients, staff and the unborn babies are expressed. As of now, no-one is sure of patients that are symptomatic and those not symptomatic, as testing in the country, just like in most parts of the world, are still inadequate. When a vaccine is av","PeriodicalId":19389,"journal":{"name":"Obstetrics & Gynecology International Journal","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87710633","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 : 2020-10-16DOI: 10.15406/OGIJ.2020.11.00531
Vivian de Oliveira Rodrigues Brum, Denise Gasparetti Drumond, N. Speck, G. D. Pannain, Giovana Moreira Bordim
Vulvar cancer is a recurrent subject in gynecological cancer. Vulvar Intraepithelial Neoplasia is known for being a precursor lesion of vulvar cancer and can be divided in three different subtypes: Low-grade Vulvar Intraepithelial Lesion (vulvar LSI), High-grade Vulvar Intraepithelial Lesion (vulvar HSIL) and Differentiated Vulvar Intraepithelial Neoplasia (dVIN). These subtypes differ in several aspects, and this article aims to present those differences in order to facilitate its treatment and the final diagnosis. The HSIL is the most associated with cronic Human Papilloma Virus (HPV) infection and can be related to other environment factors. As for dVIN, it’s more frequent in post-menopausal women with sclerosis lichen and it has a higher rate of progression to vulvar squamous carcinoma. The difference must be made in order to choose what is the best treatment, once there are various modalities, such as simple excision, CO2 ablation and topical application of imiquimod or fluoracil. This differences is also important for the development of measures that seek specific prevention, such as HPV vaccine for the HSIL and the proper treatment of vulvar conditions for the dVIN.
{"title":"The main differences between vulvar intraepithelial neoplasia and vulvar intraepithelial lesion","authors":"Vivian de Oliveira Rodrigues Brum, Denise Gasparetti Drumond, N. Speck, G. D. Pannain, Giovana Moreira Bordim","doi":"10.15406/OGIJ.2020.11.00531","DOIUrl":"https://doi.org/10.15406/OGIJ.2020.11.00531","url":null,"abstract":"Vulvar cancer is a recurrent subject in gynecological cancer. Vulvar Intraepithelial Neoplasia is known for being a precursor lesion of vulvar cancer and can be divided in three different subtypes: Low-grade Vulvar Intraepithelial Lesion (vulvar LSI), High-grade Vulvar Intraepithelial Lesion (vulvar HSIL) and Differentiated Vulvar Intraepithelial Neoplasia (dVIN). These subtypes differ in several aspects, and this article aims to present those differences in order to facilitate its treatment and the final diagnosis. The HSIL is the most associated with cronic Human Papilloma Virus (HPV) infection and can be related to other environment factors. As for dVIN, it’s more frequent in post-menopausal women with sclerosis lichen and it has a higher rate of progression to vulvar squamous carcinoma. The difference must be made in order to choose what is the best treatment, once there are various modalities, such as simple excision, CO2 ablation and topical application of imiquimod or fluoracil. This differences is also important for the development of measures that seek specific prevention, such as HPV vaccine for the HSIL and the proper treatment of vulvar conditions for the dVIN.","PeriodicalId":19389,"journal":{"name":"Obstetrics & Gynecology International Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88025049","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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