Objectives: In search of a qualitative indicator of ovarian function, we sought to determine if antral follicles' reproductive competence is correlated with their Follicular Output Rate (FORT), which indicates how sensitive they are to FSH administration. Patients and Methods: After ethical committee approval and informed consent from the patients, this Prospective Cohort study was performed on 300 IVF-ET candidates, aged between 20 and 35, who had undergone controlled ovarian hyper-stimulation with comparable beginning levels of FSH and had primary infertility without apparent cause from January 2020 to June 2022 at Al-Azhar University Hospital and in a private IVF unit in Cairo, Egypt. Antral follicle (3–8 mm) count (AFC) and pre-ovulatory follicle (18–24 mm) count (PFC) were performed, respectively, at the achievement of pituitary suppression (before FSH treatment) and on the day of hCG administration. The FORT was calculated by PFC × 100/AFC. FORT groups were set according to tercile values: low (4.3%; n = 13), average (30.7%; n = 92) and high (65%; n = 195). Results: The odds ratio for clinical pregnancy increases with increasing endometrial thickness, number of collected oocytes, and follicular output rate, with odds ratios of 1.123, 1.121, and 1.312, respectively. Conclusion: The observed association between IVF-ET result and the proportion of antral follicles attaining pre-ovulatory maturity that successfully react to FSH injection shows that FORT may be a qualitative mirror of ovarian follicular competency. More research with broader inclusion criteria and more tailored techniques is required to verify these findings.
{"title":"Male Infertility – An Overview of Management","authors":"Manu Goyal","doi":"10.31579/2578-8965/205","DOIUrl":"https://doi.org/10.31579/2578-8965/205","url":null,"abstract":"Objectives: In search of a qualitative indicator of ovarian function, we sought to determine if antral follicles' reproductive competence is correlated with their Follicular Output Rate (FORT), which indicates how sensitive they are to FSH administration. Patients and Methods: After ethical committee approval and informed consent from the patients, this Prospective Cohort study was performed on 300 IVF-ET candidates, aged between 20 and 35, who had undergone controlled ovarian hyper-stimulation with comparable beginning levels of FSH and had primary infertility without apparent cause from January 2020 to June 2022 at Al-Azhar University Hospital and in a private IVF unit in Cairo, Egypt. Antral follicle (3–8 mm) count (AFC) and pre-ovulatory follicle (18–24 mm) count (PFC) were performed, respectively, at the achievement of pituitary suppression (before FSH treatment) and on the day of hCG administration. The FORT was calculated by PFC × 100/AFC. FORT groups were set according to tercile values: low (4.3%; n = 13), average (30.7%; n = 92) and high (65%; n = 195). Results: The odds ratio for clinical pregnancy increases with increasing endometrial thickness, number of collected oocytes, and follicular output rate, with odds ratios of 1.123, 1.121, and 1.312, respectively. Conclusion: The observed association between IVF-ET result and the proportion of antral follicles attaining pre-ovulatory maturity that successfully react to FSH injection shows that FORT may be a qualitative mirror of ovarian follicular competency. More research with broader inclusion criteria and more tailored techniques is required to verify these findings.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"67 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140663944","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}
Uterine fibroids or Myomas or Leiomyoma of uterus are the most common type of benign tumor of uterus and most common pelvic tumour in women with unclear etiology. Uterine fibroids or Myomas or Leiomyoma of uterus are the most common type of benign tumor of uterus. In India the incidence of fibroids is most common in women of 31- 40 years of age i.e. as more than 1/3 (35%) of them get affected. Recent understanding of etiology suggests increased number of estrogen and Progesterone Receptors, increased COMT gene expression and TGF-B3. Risk factors for developing fibroids are age, early age at menarche, reduced fertility, frequent caffeine consumption, obesity, hypertension, diabetes mellitus, alcohol consumption and previous pelvic inflammatory disease (PID). Rural women are at a much higher risk of uterine fibroids than urban women in India. (37.65% vs.24%) probably due to multiparty at a young age disturbing Estrogen and Progesterone Receptors. Treatment options for symptomatic uterine fibroids include medical, surgical, and radiologically guided interventions. Although curative treatment relies on surgical therapies- either myomectomy or hysterectomy, medical treatments are considered the first-line treatment to preserve fertility and avoid or delay surgery. Medical therapy is in nascent stage in India. Medical treatment must be individualized based on age, signs & symptoms, sustained reduction of the size and sustenance of fertility if desired with minimal side effects. Materials and Methods: This article is based on a literature review on medical therapy being tried on a case the author is managing now. The initial results are encouraging and need to monitor the reduction of the size or volume of the Fibroid in coming months.
{"title":"Medical Management of Uterine Fibroids-A hope for Fertile Women!","authors":"Suresh K","doi":"10.31579/2578-8965/207","DOIUrl":"https://doi.org/10.31579/2578-8965/207","url":null,"abstract":"Uterine fibroids or Myomas or Leiomyoma of uterus are the most common type of benign tumor of uterus and most common pelvic tumour in women with unclear etiology. Uterine fibroids or Myomas or Leiomyoma of uterus are the most common type of benign tumor of uterus. In India the incidence of fibroids is most common in women of 31- 40 years of age i.e. as more than 1/3 (35%) of them get affected. Recent understanding of etiology suggests increased number of estrogen and Progesterone Receptors, increased COMT gene expression and TGF-B3. Risk factors for developing fibroids are age, early age at menarche, reduced fertility, frequent caffeine consumption, obesity, hypertension, diabetes mellitus, alcohol consumption and previous pelvic inflammatory disease (PID). Rural women are at a much higher risk of uterine fibroids than urban women in India. (37.65% vs.24%) probably due to multiparty at a young age disturbing Estrogen and Progesterone Receptors. Treatment options for symptomatic uterine fibroids include medical, surgical, and radiologically guided interventions. Although curative treatment relies on surgical therapies- either myomectomy or hysterectomy, medical treatments are considered the first-line treatment to preserve fertility and avoid or delay surgery. Medical therapy is in nascent stage in India. Medical treatment must be individualized based on age, signs & symptoms, sustained reduction of the size and sustenance of fertility if desired with minimal side effects. Materials and Methods: This article is based on a literature review on medical therapy being tried on a case the author is managing now. The initial results are encouraging and need to monitor the reduction of the size or volume of the Fibroid in coming months.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"24 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140660078","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}
Objective Prenatal screening for developmental and chromosomal fetal defects during both the first and second trimesters of pregnancy is considered standard practice. In the second trimester, screening for spinal cord malformations, such as spina bifida and anencephaly (a type of neural tube defect), involves measuring alpha-fetoprotein levels in maternal blood. The cutoffs used to identify increased risks for neural tube defects are typically tailored for factors like race, multiple fetuses, reported smoking, and the presence of maternal insulin-dependent diabetes. What remains unclear is the impact of assisted reproductive technology, commonly known as in vitro fertilization procedures, on alpha-fetoprotein levels and other measured analytes. Method This report presents a retrospective study that examines the impact of reported in vitro fertilization procedures on second-trimester levels of alpha-fetoprotein. The study utilizes consecutive data from March 20, 2019, through March 29, 2023, sourced from laboratory records. Result We illustrate elevated levels of maternal serum alpha-fetoprotein across all racial subgroups undergoing in vitro fertilization procedures. Additionally, we demonstrate that maternal serum alpha-fetoprotein levels rise with maternal age. Conclusion This study underscores the significance of our findings in evaluating the risk of neural tube defects, such as spina bifida, Down syndrome, and other genetic anomalies. It holds considerable value in guiding clinical practices. Furthermore, it highlights the need for further investigation to evaluate how our findings impact the assessment of fetal well-being.
{"title":"The Effect of In-vitro Fertilization Procedures on Alpha-fetoprotein Levels in Second Trimester Screening for Fetal Defects","authors":"Lawrence A. Kaplan","doi":"10.31579/2578-8965/212","DOIUrl":"https://doi.org/10.31579/2578-8965/212","url":null,"abstract":"Objective Prenatal screening for developmental and chromosomal fetal defects during both the first and second trimesters of pregnancy is considered standard practice. In the second trimester, screening for spinal cord malformations, such as spina bifida and anencephaly (a type of neural tube defect), involves measuring alpha-fetoprotein levels in maternal blood. The cutoffs used to identify increased risks for neural tube defects are typically tailored for factors like race, multiple fetuses, reported smoking, and the presence of maternal insulin-dependent diabetes. What remains unclear is the impact of assisted reproductive technology, commonly known as in vitro fertilization procedures, on alpha-fetoprotein levels and other measured analytes. Method This report presents a retrospective study that examines the impact of reported in vitro fertilization procedures on second-trimester levels of alpha-fetoprotein. The study utilizes consecutive data from March 20, 2019, through March 29, 2023, sourced from laboratory records. Result We illustrate elevated levels of maternal serum alpha-fetoprotein across all racial subgroups undergoing in vitro fertilization procedures. Additionally, we demonstrate that maternal serum alpha-fetoprotein levels rise with maternal age. Conclusion This study underscores the significance of our findings in evaluating the risk of neural tube defects, such as spina bifida, Down syndrome, and other genetic anomalies. It holds considerable value in guiding clinical practices. Furthermore, it highlights the need for further investigation to evaluate how our findings impact the assessment of fetal well-being.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"113 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140659498","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: The impact of various methods of endometrial scratch during assisted reproductive technology (ART) is not well established. Objective: To compare patient-reported pain scores and ART outcomes following two types of endometrial scratch prior to embryo transfer. Study design: In this prospective, non-blinded, randomized controlled trial, patients were assigned to either Pipelle or Shepard catheter. The primary outcome was mean pain score. Secondary outcomes included implantation rate (IR) and clinical pregnancy rate (CPR). Results: One hundred seventy transfers were included (Pipelle: n=78, Shepard: n=92). Mean pain scores were significantly lower in the Shepard group compared to the Pipelle group (3.0±2.4 vs. 3.9±2.2, respectively; p=0.01). There was no significant difference in IR (Shepard: 59.7%±52 and Pipelle: 56.5%±48; p=0.9) and CPR (Shepard: 67.6%±47 and Pipelle: 71.8%±45; p=0.6). Conclusions: In our study, the Shepard catheter was a less painful method of endometrial scratch without compromising ART outcomes.
背景：辅助生殖技术（ART）过程中各种子宫内膜划痕方法的影响尚未得到充分证实。目的比较胚胎移植前两种子宫内膜刮宫术后患者报告的疼痛评分和 ART 结果。研究设计：在这项前瞻性、非盲法、随机对照试验中，患者被分配到 Pipelle 或 Shepard 导管。主要结果是平均疼痛评分。次要结果包括植入率（IR）和临床妊娠率（CPR）。结果：共纳入 170 例转运患者（Pipelle：78 例；Shepard：92 例）。Shepard组的平均疼痛评分明显低于Pipelle组（分别为3.0±2.4 vs. 3.9±2.2；P=0.01）。IR（Shepard：59.7%±52 和 Pipelle：56.5%±48；p=0.9）和 CPR（Shepard：67.6%±47 和 Pipelle：71.8%±45；p=0.6）无明显差异。结论在我们的研究中，Shepard 导管是一种痛苦较小的子宫内膜刮宫方法，且不会影响 ART 的结果。
{"title":"Comparison of Two Types of Endometrial Scratch before Embryo Transfer and Patient-Reported Pain Scores: A Prospective Randomized Pilot Study","authors":"Bradley S Hurst","doi":"10.31579/2578-8965/211","DOIUrl":"https://doi.org/10.31579/2578-8965/211","url":null,"abstract":"Background: The impact of various methods of endometrial scratch during assisted reproductive technology (ART) is not well established. Objective: To compare patient-reported pain scores and ART outcomes following two types of endometrial scratch prior to embryo transfer. Study design: In this prospective, non-blinded, randomized controlled trial, patients were assigned to either Pipelle or Shepard catheter. The primary outcome was mean pain score. Secondary outcomes included implantation rate (IR) and clinical pregnancy rate (CPR). Results: One hundred seventy transfers were included (Pipelle: n=78, Shepard: n=92). Mean pain scores were significantly lower in the Shepard group compared to the Pipelle group (3.0±2.4 vs. 3.9±2.2, respectively; p=0.01). There was no significant difference in IR (Shepard: 59.7%±52 and Pipelle: 56.5%±48; p=0.9) and CPR (Shepard: 67.6%±47 and Pipelle: 71.8%±45; p=0.6). Conclusions: In our study, the Shepard catheter was a less painful method of endometrial scratch without compromising ART outcomes.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140664910","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: Pregnancy-induced hypertension (PIH) is a significant health issue that affects maternal and fetal outcomes. Antithrombin-III (AT-III) and platelet count alterations could serve as pivotal indicators for the management and prognosis of PIH. Objective: This study aimed to assess AT-III activity and platelet counts in pregnant women with and without PIH at the Federal Medical Centre (FMC), Owerri, Imo State, Nigeria. Methods: A case-control cross-sectional analytical study design was employed, including 135 pregnant women with PIH and 135 age-matched normotensive pregnant women. Exclusion criteria comprised chronic hypertension, known thrombophilic disorders, or anticoagulant therapy before pregnancy. AT-III levels and platelet counts were compared between groups using SPSS version 20.0, with significance set at p ≤ 0.05. Results: AT-III activity was significantly lower in the PIH group (75.45±6.23%) compared to the normotensive group (96.84±9.64%, p=0.028). Similarly, platelet count was significantly reduced in the PIH group (170.90 ±8.78 x109/L) versus the normotensive group (191.56±6.54 x109/L, p=0.032). No significant differences were found in sociodemographic variables except for the trimester of antenatal care registration and history of preeclampsia in previous pregnancies. Conclusion: This study highlights significant reductions in AT-III activity and platelet count among pregnant women with PIH, suggesting these parameters' potential role in PIH management and prognosis. These findings emphasize the importance of monitoring AT-III levels and platelet count as part of the antenatal care protocol in pregnant women, particularly those with or at risk for PIH.
{"title":"Evaluation of Antithrombin-III Activity and Platelet Count in Pregnancy-Induced Hypertension among Pregnant Women attending Antenatal care in a Tertiary Health Facility in Southeast, Nigeria","authors":"A. I. Airaodion","doi":"10.31579/2578-8965/214","DOIUrl":"https://doi.org/10.31579/2578-8965/214","url":null,"abstract":"Background: Pregnancy-induced hypertension (PIH) is a significant health issue that affects maternal and fetal outcomes. Antithrombin-III (AT-III) and platelet count alterations could serve as pivotal indicators for the management and prognosis of PIH. Objective: This study aimed to assess AT-III activity and platelet counts in pregnant women with and without PIH at the Federal Medical Centre (FMC), Owerri, Imo State, Nigeria. Methods: A case-control cross-sectional analytical study design was employed, including 135 pregnant women with PIH and 135 age-matched normotensive pregnant women. Exclusion criteria comprised chronic hypertension, known thrombophilic disorders, or anticoagulant therapy before pregnancy. AT-III levels and platelet counts were compared between groups using SPSS version 20.0, with significance set at p ≤ 0.05. Results: AT-III activity was significantly lower in the PIH group (75.45±6.23%) compared to the normotensive group (96.84±9.64%, p=0.028). Similarly, platelet count was significantly reduced in the PIH group (170.90 ±8.78 x109/L) versus the normotensive group (191.56±6.54 x109/L, p=0.032). No significant differences were found in sociodemographic variables except for the trimester of antenatal care registration and history of preeclampsia in previous pregnancies. Conclusion: This study highlights significant reductions in AT-III activity and platelet count among pregnant women with PIH, suggesting these parameters' potential role in PIH management and prognosis. These findings emphasize the importance of monitoring AT-III levels and platelet count as part of the antenatal care protocol in pregnant women, particularly those with or at risk for PIH.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"55 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140662323","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}
An increasing number of patients without family history of genetic disease are referred for preimplantation genetic testing of monogenic disorders (PGT-M) after ascertainment through population (expanded) carrier screening (ECS), increasing the proportion of non-lethal correctable genetic conditions in PGT-M indication profile. The aim of this paper is to analyze the current dynamics of these changes in our PGT-M series, which is the world’s largest PGT-M experience. This was analyzed using our PGT-M for two prevalent examples of non-lethal correctable genetic conditions, phenylketonuria (PKU) and hereditary hearing loss (HHL) during the period of 2005-2022. During this period, 91 PGT-M cycles were performed for PKU, involving testing for 108 mutant alleles in PAH gene, and 262 PGT-M cycles for HHL, involving testing for up to 300 mutations in 13 different genes causing hearing loss. PGT-M for these non-lethal correctable conditions resulted in the birth of 54 babies free of PKU and 134 children free of HHL. Dynamics of PGT-M referrals during this period of 17 years demonstrated the shift from retrospective to prospective application of PGT-M for both conditions, with 87% of prospective PGT-M performed for PKU, and 82% for HHL, performed for couples who had no affected relatives with PKU or HHL. These at-risk couples were ascertained through ECS in the last decade, making it possible to provide the option of prospective PGT-M for these non-lethal correctable conditions.
{"title":"Preimplantation Genetic Testing (PGT) for Non-Lethal Correctable Conditions Through Population Carrier Screening","authors":"A. Kuliev","doi":"10.31579/2578-8965/182","DOIUrl":"https://doi.org/10.31579/2578-8965/182","url":null,"abstract":"An increasing number of patients without family history of genetic disease are referred for preimplantation genetic testing of monogenic disorders (PGT-M) after ascertainment through population (expanded) carrier screening (ECS), increasing the proportion of non-lethal correctable genetic conditions in PGT-M indication profile. The aim of this paper is to analyze the current dynamics of these changes in our PGT-M series, which is the world’s largest PGT-M experience. This was analyzed using our PGT-M for two prevalent examples of non-lethal correctable genetic conditions, phenylketonuria (PKU) and hereditary hearing loss (HHL) during the period of 2005-2022. During this period, 91 PGT-M cycles were performed for PKU, involving testing for 108 mutant alleles in PAH gene, and 262 PGT-M cycles for HHL, involving testing for up to 300 mutations in 13 different genes causing hearing loss. PGT-M for these non-lethal correctable conditions resulted in the birth of 54 babies free of PKU and 134 children free of HHL. Dynamics of PGT-M referrals during this period of 17 years demonstrated the shift from retrospective to prospective application of PGT-M for both conditions, with 87% of prospective PGT-M performed for PKU, and 82% for HHL, performed for couples who had no affected relatives with PKU or HHL. These at-risk couples were ascertained through ECS in the last decade, making it possible to provide the option of prospective PGT-M for these non-lethal correctable conditions.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139320703","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}
Introduction: early post-caesarean rehabilitation could be an ideal alternative in terms of direct health savings for the parturient and indirect for the community. Objective: Studying the effects of early rehabilitation after caesarean section in women at Yalgado Ouedraogo teaching hospital (YOTH) Methodology: This was a cohort study comparing two groups of patients who underwent a scheduled caesarean section from 7th May to 4th September, 2020 in the obstetrics department of YOTH. Group 1 consisted of women benefiting from the early rehabilitation protocol (n=124) and group 2 consisted of non-rehabilitated women (n=124). Results: The times of first getting up (p=0.01), walking (p<0.05), first drink (p=0.0001), removal of the urinary catheter (p<0.05), and urination (p<0.05) were significantly reduced in group 1. There was no statistically significant difference in postoperative pain. The mean time to first urination after removal of the urinary catheter was 18.8 ± 4.3 hours in the rehabilitated operated group versus 28 ± 10.5 hours in the non-rehabilitated group (p < 0.05). The first rise took place on average 7.2 ± 1.5 hours after the cesarean section in the rehabilitated group versus 8.1 ± 3.7 hours in the non-rehabilitated group (p=0.01). There was a significant reduction in length of stay (p < 0.05) and cost of treatment (p=0.) Conclusion: The early rehabilitation protocol after caesarean allows a significant improvement in terms of functional recovery, length of stay and cost of treatment.
{"title":"Early Post-Cesarean Rehabilitation in A Tertiary Hospital in Burkina Faso","authors":"Komboigo Be","doi":"10.31579/2578-8965/166","DOIUrl":"https://doi.org/10.31579/2578-8965/166","url":null,"abstract":"Introduction: early post-caesarean rehabilitation could be an ideal alternative in terms of direct health savings for the parturient and indirect for the community. Objective: Studying the effects of early rehabilitation after caesarean section in women at Yalgado Ouedraogo teaching hospital (YOTH) Methodology: This was a cohort study comparing two groups of patients who underwent a scheduled caesarean section from 7th May to 4th September, 2020 in the obstetrics department of YOTH. Group 1 consisted of women benefiting from the early rehabilitation protocol (n=124) and group 2 consisted of non-rehabilitated women (n=124). Results: The times of first getting up (p=0.01), walking (p<0.05), first drink (p=0.0001), removal of the urinary catheter (p<0.05), and urination (p<0.05) were significantly reduced in group 1. There was no statistically significant difference in postoperative pain. The mean time to first urination after removal of the urinary catheter was 18.8 ± 4.3 hours in the rehabilitated operated group versus 28 ± 10.5 hours in the non-rehabilitated group (p < 0.05). The first rise took place on average 7.2 ± 1.5 hours after the cesarean section in the rehabilitated group versus 8.1 ± 3.7 hours in the non-rehabilitated group (p=0.01). There was a significant reduction in length of stay (p < 0.05) and cost of treatment (p=0.) Conclusion: The early rehabilitation protocol after caesarean allows a significant improvement in terms of functional recovery, length of stay and cost of treatment.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139320320","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}
Primary amenorrhea with ambiguous genitalia is a diagnostic challenge to physicians. Ovotesticular disorder of sexual development is a one cause for that which need gonadectomy followed by histological assessment to confirm the diagnosis. This is a case of ovotesticular disorder of sexual development which presented with primary amenorrhea with ambiguous genitalia.
{"title":"Primary Amenorrhea Due to Ovotesticular Disorder of Sexual Development","authors":"Walawe Nayaka S","doi":"10.31579/2578-8965/188","DOIUrl":"https://doi.org/10.31579/2578-8965/188","url":null,"abstract":"Primary amenorrhea with ambiguous genitalia is a diagnostic challenge to physicians. Ovotesticular disorder of sexual development is a one cause for that which need gonadectomy followed by histological assessment to confirm the diagnosis. This is a case of ovotesticular disorder of sexual development which presented with primary amenorrhea with ambiguous genitalia.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139320584","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/Aim: Adolescent pregnancy is considered as a public health issue. This study aims at describing the epidemiological and clinical aspects, as well as the maternal and perinatal prognosis of adolescent childbirth. Materials and Methods: This was a descriptive and analytical study. Data were collected prospectively. The study population included all women admitted for delivery. Adolescents were sampled exhaustively. In order to identify factors associated with adolescent childbirth, we selected a control group of women aged between 20 and 39. Results: Adolescent deliveries accounted for 12.6% of all deliveries. The average age was estimated at 18.2 years. Patients aged 19 accounted for 55.1% of cases. Upon admission, 88.9% of adolescent girls were nulliparous. Adolescents were referred in 93.5% of cases. As for admission reasons, abdominopelvic pain with uterine contractions accounted for 39.81% of cases. In 21.3% of cases the gestational age as below 37 weeks of amenorrhea. Fetal breech presentation was observed in 8.3% of cases. Caesarean section was the mode of delivery in 60.2%. In our series, two adolescent girls presented a hemorrhage of deliverance. One case of maternal death was recorded. The prematurity birth rate was estimated at 20.4% and neonatal resuscitation concerned 24.9% of newborns. The perinatal mortality rate is estimated at 11.2% corresponding 112 deaths per thousand births. Conclusion: Adolescent childbirth, compared to that of adult women is still associated with a poor prognosis. There is the need to enhance appropriate measures in education, contraception, prenatal care and the fight against early marriage need to reduce the rates of early pregnancy and obstetric complications in this high-risk population.
{"title":"Adolescent Childbirth: Epidemiological and Clinic Aspects, Maternal and Perinatal Prognosis in Tengandogo Teaching Hospital, Burkina Faso","authors":"Dantola Paul Kain","doi":"10.31579/2578-8965/186","DOIUrl":"https://doi.org/10.31579/2578-8965/186","url":null,"abstract":"Background/Aim: Adolescent pregnancy is considered as a public health issue. This study aims at describing the epidemiological and clinical aspects, as well as the maternal and perinatal prognosis of adolescent childbirth. Materials and Methods: This was a descriptive and analytical study. Data were collected prospectively. The study population included all women admitted for delivery. Adolescents were sampled exhaustively. In order to identify factors associated with adolescent childbirth, we selected a control group of women aged between 20 and 39. Results: Adolescent deliveries accounted for 12.6% of all deliveries. The average age was estimated at 18.2 years. Patients aged 19 accounted for 55.1% of cases. Upon admission, 88.9% of adolescent girls were nulliparous. Adolescents were referred in 93.5% of cases. As for admission reasons, abdominopelvic pain with uterine contractions accounted for 39.81% of cases. In 21.3% of cases the gestational age as below 37 weeks of amenorrhea. Fetal breech presentation was observed in 8.3% of cases. Caesarean section was the mode of delivery in 60.2%. In our series, two adolescent girls presented a hemorrhage of deliverance. One case of maternal death was recorded. The prematurity birth rate was estimated at 20.4% and neonatal resuscitation concerned 24.9% of newborns. The perinatal mortality rate is estimated at 11.2% corresponding 112 deaths per thousand births. Conclusion: Adolescent childbirth, compared to that of adult women is still associated with a poor prognosis. There is the need to enhance appropriate measures in education, contraception, prenatal care and the fight against early marriage need to reduce the rates of early pregnancy and obstetric complications in this high-risk population.","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"186 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139320531","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}
Objective: Homeless people have significantly more health needs and higher rates of morbidity and mortality, as well as more hospitalizations and / or rehospitalizations than the general population, caused by factors such as extreme poverty, poor access to medical care and the challenges in adherence to medications, for which the present study set out to apply an educational intervention on type 2 diabetes, aimed at homeless people living in a shelter, in order to improve self-control and self-care techniques of this chronic disease. Materials and methods: The educational intervention was conducted in a Miami Dade homeless shelter with 250 participants and consisted of three diabetes self-management and self-care sessions and a list of community resources in the preferred language of the community. person (English or Spanish). The evaluations included a survey before and after the intervention and a pre- and post-evaluation using the Diabetes Knowledge questionnaire (DKQ-24). Results: Demographic data: 88% male and 12% female, 40% Hispanic, 36% African American, 26% Caucasian, 64% English and 36% Spanish language. There was a significant difference in the measurement before and after two months of the educational intervention (p less than 0.001). Conclusions: Educational intervention to improve the quality of life, self-control, and self-care of homeless patients with type 2 diabetes had a positive effect and these results may provide the basis for future interventions that help health professionals to identify needs and address them through context-specific educational interventions. Approval n. IRB 17-OR-372-ME of the Institutional Review Board (IRB).
目的：与普通人群相比，无家可归者的健康需求明显更多，发病率和死亡率也更高，住院和/或再次住院的人数也更多，造成这些问题的因素包括极端贫困、难以获得医疗服务以及在坚持服药方面面临挑战。材料和方法：教育干预在迈阿密戴德区的一个无家可归者收容所进行，有 250 人参加，包括三节糖尿病自我管理和自我护理课程，以及一份社区资源清单，使用社区首选语言（英语或西班牙语）。评估包括干预前后的调查，以及使用糖尿病知识问卷（DKQ-24）进行的前后评估。评估结果人口统计学数据：88%为男性，12%为女性，40%为西班牙裔，36%为非洲裔，26%为白种人，64%为英语，36%为西班牙语。教育干预两个月前后的测量结果有明显差异（P 小于 0.001）。结论教育干预对改善无家可归的 2 型糖尿病患者的生活质量、自我控制和自我护理有积极作用，这些结果可为今后的干预提供依据，帮助医疗专业人员确定需求，并通过针对具体情况的教育干预来满足这些需求。机构审查委员会（IRB）批准 n. IRB 17-OR-372-ME。
{"title":"Educational Intervention on Dm2in a Miami-Dade Homeless Population","authors":"Sara Concepción Maury-Mena","doi":"10.31579/2578-8965/180","DOIUrl":"https://doi.org/10.31579/2578-8965/180","url":null,"abstract":"Objective: Homeless people have significantly more health needs and higher rates of morbidity and mortality, as well as more hospitalizations and / or rehospitalizations than the general population, caused by factors such as extreme poverty, poor access to medical care and the challenges in adherence to medications, for which the present study set out to apply an educational intervention on type 2 diabetes, aimed at homeless people living in a shelter, in order to improve self-control and self-care techniques of this chronic disease. Materials and methods: The educational intervention was conducted in a Miami Dade homeless shelter with 250 participants and consisted of three diabetes self-management and self-care sessions and a list of community resources in the preferred language of the community. person (English or Spanish). The evaluations included a survey before and after the intervention and a pre- and post-evaluation using the Diabetes Knowledge questionnaire (DKQ-24). Results: Demographic data: 88% male and 12% female, 40% Hispanic, 36% African American, 26% Caucasian, 64% English and 36% Spanish language. There was a significant difference in the measurement before and after two months of the educational intervention (p less than 0.001). Conclusions: Educational intervention to improve the quality of life, self-control, and self-care of homeless patients with type 2 diabetes had a positive effect and these results may provide the basis for future interventions that help health professionals to identify needs and address them through context-specific educational interventions. Approval n. IRB 17-OR-372-ME of the Institutional Review Board (IRB).","PeriodicalId":19413,"journal":{"name":"Obstetrics Gynecology and Reproductive Sciences","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139320708","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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