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The Effect of "Motivational Interviewing" and "Information, Motivation, and Behavioral Skills Model" Counseling Interventions on the Choice of Delivery Mode in Pregnant Women Using Face-to-Face Training vs. Mobile App: A Randomized Controlled Trial. 动机访谈 "和 "信息、动机和行为技能模型 "咨询干预对孕妇分娩方式选择的影响:面对面培训与移动应用程序:随机对照试验
IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-30 eCollection Date: 2024-01-01 DOI: 10.1155/2024/3071183
Mahboubeh Shirzad, Elham Shakibazadeh, Payam Sheikhatari, Abbas Rahimi Foroushani, Hamid Poursharifi

Objective: To investigate the impact of counseling interventions, using face-to-face training vs. mobile app for choosing mode of delivery.

Design: A four-armed, randomized, controlled parallel-design trial. Setting. Ebnesina Private Hospital in Tehran, Iran. Population. Pregnant women, between 24 and 32 weeks of gestation (n = 120).

Methods: Pregnant women were randomly assigned in three psycho-educational intervention groups: (1) motivational interviewing via face-to-face training, (2) information, motivation, and behavioral skills model via face-to-face training, (3) the same model via a mobile application, and (4) usual antenatal care (control group). To assess the face-to-face and mobile app training method on women's self-efficacy and intention in choosing a mode of delivery. Main Outcome Measures. Mode of delivery (Cesarean section).

Results: While all three intervention groups showed significant increases in women's self-efficacy and intentions to choose vaginal delivery, the increase was particularly noticeable among those using mobile applications: Before the intervention, self-efficacy and intention Mean ± SD were 77.1 ± 38.6 (CI-95%: [62.72, 91.60]) and 1.10 ± 0.305 (CI-95%: [0.99, 1.21]), respectively. After the intervention, these scores increased to 99.7 ± 30.7 (CI-95%: [88.27, 111.20]) for self-efficacy and 1.70 ± 0.466 (CI-95%: [1.53, 1.87]) for intention. Although 56.7% of women in the intervention groups expressed a preference for vaginal delivery, only 37.5% ultimately pursued this birthing method.

Conclusions: Brief psycho-educational interventions, particularly technology-driven interventions (mobile apps) can increase the likelihood of women choosing vaginal delivery. To enhance the effectiveness of such interventions, they can be conducted in conjunction with interventions for doctors and healthcare providers. This trial is registered with IRCT20151208025431N7.

目的调查咨询干预措施的影响,选择面对面培训与手机应用程序的授课方式:设计:四臂随机对照平行设计试验。地点:德黑兰 Ebnesina 私立医院伊朗德黑兰 Ebnesina 私人医院。人群妊娠 24 至 32 周的孕妇(n = 120):孕妇被随机分配到三个心理教育干预组:(1)通过面对面培训进行动机访谈;(2)通过面对面培训进行信息、动机和行为技能模式;(3)通过移动应用程序进行相同模式;(4)常规产前护理(对照组)。评估面对面培训和手机应用培训方法对产妇选择分娩方式的自我效能感和意向的影响。主要结果指标。分娩方式(剖腹产):所有三个干预组的妇女在选择阴道分娩的自我效能感和意向方面都有显著提高,而使用移动应用程序的妇女的提高尤为明显:干预前,自我效能和意向平均值(± SD)分别为 77.1 ± 38.6(CI-95%:[62.72, 91.60])和 1.10 ± 0.305(CI-95%:[0.99, 1.21])。干预后,自我效能感得分增至 99.7 ± 30.7 (CI-95%: [88.27, 111.20]),意向得分增至 1.70 ± 0.466 (CI-95%: [1.53, 1.87])。虽然干预组中有 56.7% 的妇女表示倾向于阴道分娩,但只有 37.5% 的妇女最终选择了这种分娩方式:结论:简短的心理教育干预,尤其是技术驱动的干预(手机应用)可以增加产妇选择阴道分娩的可能性。为提高此类干预措施的效果,可将其与针对医生和医疗服务提供者的干预措施结合起来进行。本试验已注册为 IRCT20151208025431N7。
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引用次数: 0
Factors Influencing Induction of Labor Success in Riyadh, Saudi Arabia. 影响沙特阿拉伯利雅得引产成功的因素。
IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI: 10.1155/2024/1637424
Renad A Alshalan, Rwan K Alarfaj, Yazeed A Almojel, Yara AlHaddad, Rahaf Alsomali, Maysoon Al Adham

Introduction: The physiological process by which the fetus and placenta are delivered from the uterus and pass through the vaginal canal for delivery is known as labor. Induction of labor involves deliberately initiating labor before it occurs naturally, using medical interventions or techniques to stimulate contractions and initiate the birthing process.

Aim: This study aimed to investigate the factors that influence the success of labor induction procedures in Riyadh, Saudi Arabia, from January to April 2023. Subject and Methods. This retrospective chart review was conducted at the National Guard Hospital in Riyadh, Saudi Arabia. Data were collected from the patient chart of those who underwent labor induction from January to April 2023. The collected data were tabulated and cleaned in MS Excel. Final data were transferred to SPSS for subsequent data analysis.

Results: Five hundred and thirty-one pregnant women were analyzed. 52.7% were aged 30 years or below. The most common indication of IOL was post-dated pregnancy (26.2%). 62% were normal deliveries, indicative of IOL success, while 31.1% were cesarean deliveries, indicative of IOL failure. In univariate analysis, women with lower gravidity (≤3) and who had received Propess were associated with cesarean delivery. In a multivariate regression analysis, women who received Prostin and increased parity were identified as the significant independent predictors of IOL success.

Conclusion: IOL's success was dependent primarily on increasing parity and Prostin administration. However, lower gravidity (≤3) and Propess medication could lead to operative procedures among pregnant women. Hence, it is necessary to carefully assess the condition of pregnant women before directing them to IOL.

导言:胎儿和胎盘从子宫娩出并通过阴道分娩的生理过程称为分娩。引产是指在自然分娩之前故意启动分娩,使用医疗干预措施或技术刺激子宫收缩并启动分娩过程。研究对象和方法。这项回顾性病历审查在沙特阿拉伯利雅得国民卫队医院进行。数据来自 2023 年 1 月至 4 月期间接受引产手术的患者病历。收集到的数据在 MS Excel 中进行制表和清理。最终数据转入 SPSS 进行后续数据分析:对 531 名孕妇进行了分析。52.7%的孕妇年龄在 30 岁或以下。最常见的人工晶体植入指征是过期妊娠(26.2%)。正常分娩占 62%,表明人工晶体植入术成功,而剖宫产占 31.1%,表明人工晶体植入术失败。在单变量分析中,孕酮较低(≤3)和接受过 Propess 的妇女与剖宫产有关。在多变量回归分析中,接受过前列腺素治疗的产妇和胎次增加被认为是人工晶体植入术成功的重要独立预测因素:结论:人工晶体植入术的成功与否主要取决于胎次的增加和前列腺素的使用。结论:人工晶体植入术的成功与否主要取决于胎次的增加和前列腺素的使用,但胎次较低(≤3)和前列腺素的使用可能导致孕妇进行手术。因此,在指导孕妇使用人工晶体前,有必要仔细评估她们的情况。
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引用次数: 0
Assessment of COVID-19 Vaccine Impact on Women's Menstrual Health within an 18-Month Follow-Up. 评估 COVID-19 疫苗在 18 个月随访期间对妇女月经健康的影响。
IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7344506
Mona Sadat Larijani, Sana Eybpoosh, Delaram Doroud, Anahita Bavand, Ladan Moradi, Fatemeh Ashrafian, Parinaz Tajmehrabi Namini, Mahsan Zali, Amitis Ramezani

Considering menstruation as a crucial factor in females' health and fertility, any factor that could change its cycle is important. This study was conducted from April 2021 to October 2022 on females who got 3 doses of vaccines against SARS-CoV-2 through different platforms. The participants were requested to provide the trained experts with any changes regarding menstrual cycles after each dose of the vaccine up to 6 months after the booster shots. The disturbances related to the vaccines were identified by the adverse events committee to find possible associations with the applied vaccines. Of 308 women who participated until the end of the study, 22 (7.1%) complained about at least one abnormality in their menstrual patterns. The most common disturbance was metrorrhagia as 10 (48%) incidences followed by menorrhagia as 6 events (24.2%). Notably, the identified complaints were persistent in 59% of the patients. In addition, 14 studied cases developed COVID-19 infection after menstrual disorders. In these cases, COVID-19 could also play a role in the persistence of postvaccine menstrual disturbances. COVID-19 vaccination could affect menstrual cycle in women with no remarkable previous medical history. More longitudinal studies are required regarding this issue.

考虑到月经是女性健康和生育的关键因素,任何可能改变其周期的因素都很重要。这项研究于 2021 年 4 月至 2022 年 10 月进行,对象是通过不同平台接种了 3 剂 SARS-CoV-2 疫苗的女性。参与者需要向经过培训的专家提供每次接种疫苗后至加强注射后 6 个月内月经周期的任何变化。不良事件委员会对与疫苗有关的异常情况进行了鉴定,以找到与所使用疫苗可能存在的关联。在 308 名参与研究直至研究结束的妇女中,有 22 人(7.1%)抱怨她们的月经模式至少出现过一次异常。最常见的月经紊乱是月经过多,有 10 例(48%),其次是月经过多,有 6 例(24.2%)。值得注意的是,59% 的患者的症状持续存在。此外,有 14 例患者在月经紊乱后感染了 COVID-19。在这些病例中,COVID-19 也可能是造成疫苗接种后月经紊乱持续存在的原因之一。接种 COVID-19 疫苗可能会影响既往无明显病史的妇女的月经周期。关于这个问题,需要进行更多的纵向研究。
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引用次数: 0
Association of Hormonal Contraceptives with Depression among Women in Reproductive Age Groups: A Cross-Sectional Analytic Study. 生殖年龄组女性荷尔蒙避孕药与抑郁症的关系:一项横断面分析研究
IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-20 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7309041
Sadia Sultan, Md Abu Bashar, Rahma M Bazhair, Doaa O Abdurahman, Renad A Alrehaili, Meimouna E Ennahoui, Yasmeen S Alsulaiman, Seba D Alamri, Elgawhara F A Mohamed

Introduction: Hormonal contraceptives (HCs) are used for birth control, menstrual disturbances, and premenopausal syndrome. Most women stop using hormonal contraceptives due to changes in their mood. The evidence regarding the association of hormonal contraception with depression shows mixed results. Therefore, we aim to establish the association between the use of hormonal contraception and depressive symptoms.

Methods: A cross-sectional study was conducted on 326 women of the reproductive age group (15-49 years) attending the family planning unit of the obstetrics and gynecology department of a medical college in Saudi Arabia. Their sociodemographic and medical details along with the current use of any contraceptives (hormonal, nonhormonal, or not using any) with duration were collected. Beck depression inventory-II (BDI-II) was applied to the women to assess for depression along with its severity, and a BDI score of >16 was taken to denote clinical depression. Women were stratified by type of contraceptive used, and its association with depression category was assessed.

Results: A total of 326 consenting eligible women in the age group of 15-49 years were enrolled in the study of which 165 (50.6%) were currently using a hormonal contraceptive and 49 (15.0%) were using a nonhormonal contraceptive and the rest 112 (34.4%) were not using any contraceptives. There was no significant difference in the mean BDI scores (p=0.79) and degrees of depression (p=0.06) between the HC users and HC nonusers. However, individual symptoms of depression such as sadness (p=0.01), reduced libido (p=0.0002), feelings of pessimism (p=0.02), and failure (p=0.003) were found to be significantly higher in the HC users than non-HC users.

Conclusion: We conclude that there was no significant difference in mean depression scores between groups. However, a few individual symptoms of depression were high in HC users suggesting depression as a potential side effect of hormonal contraceptive use.

导言:荷尔蒙避孕药(HCs)用于节育、月经紊乱和绝经前综合征。大多数女性因情绪变化而停止使用激素避孕药。荷尔蒙避孕药与抑郁症的关系证据不一。因此,我们旨在确定使用激素避孕药与抑郁症状之间的关联:我们对沙特阿拉伯一所医学院妇产科计划生育科的 326 名育龄妇女(15-49 岁)进行了横断面研究。研究收集了她们的社会人口学和医疗详情,以及目前使用任何避孕药具(激素、非激素或未使用任何避孕药具)的情况和持续时间。对妇女采用贝克抑郁量表-II(BDI-II)评估抑郁及其严重程度,BDI 得分大于 16 分表示临床抑郁。根据使用的避孕药类型对妇女进行分层,并评估其与抑郁类别的关系:共有 326 名年龄介于 15-49 岁之间的符合条件的女性参与了研究,其中 165 人(50.6%)目前正在使用激素避孕药,49 人(15.0%)正在使用非激素避孕药,其余 112 人(34.4%)未使用任何避孕药具。在 BDI 平均得分(P=0.79)和抑郁程度(P=0.06)方面,使用 HC 和不使用 HC 的人没有明显差异。然而,我们发现使用 HC 者的个别抑郁症状,如悲伤(p=0.01)、性欲减退(p=0.0002)、悲观(p=0.02)和失败(p=0.003)明显高于未使用 HC 者:我们得出的结论是,各组之间的平均抑郁评分没有明显差异。结论:我们得出的结论是,各组间的平均抑郁评分无明显差异,但 HC 使用者的个别抑郁症状较高,这表明抑郁是使用激素避孕药的潜在副作用。
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引用次数: 0
Comparison of Time to Pregnancy in In Vitro Fertilisation between Endometriosis and Nonendometriosis. 子宫内膜异位症与非子宫内膜异位症体外受精怀孕时间的比较。
IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-09-06 eCollection Date: 2024-01-01 DOI: 10.1155/2024/4139821
Hartanto Bayuaji, Artha Falentin Putri Susilo, Kevin Dominique Tjandraprawira

Background: This study is to compare the time to pregnancy (TTP) between patients with endometriosis and nonendometriosis undergoing in vitro fertilisation (IVF).Material and Methods.This is an observational retrospective cohort study. We included 291 patients (53 with endometriosis and 238 without endometriosis) achieving biochemical pregnancy, whether singleton or multifetal (serum beta-hCG >5 mIU/mL), between 1st January 2014 and 31st March 2020. We excluded patients with incomplete case notes and those declining participation. Time to pregnancy is the interval between the time when infertility was established to the date of confirmed biochemical pregnancy, expressed in months. Endometriosis diagnosis includes any form of endometriosis through surgical confirmation. A statistical analysis was done through the Mann-Whitney U test. Time to pregnancy was assessed through the Kaplan-Meier test. A p value <0.05 is considered statistically significant.

Results: Endometriosis patients had a shorter infertility duration (4 years vs. 5 years, p=0.024). Both groups had similar median age and body mass index at presentation. There was no significant difference in the TTP between endometriosis and nonendometriosis groups (57.7 vs. 70.9 months, p=0.060), further confirmed by a Cox regression test incorporating confounders (IVF protocol (OR: 1.482, 95% CI 0.667-3.292, and p=0.334) and type of the cycle (OR 1.071, 95% CI 0.803-1.430, and p=0.640)). The endometriosis group reached the maximum cumulative pregnancy rate at around 169 months postinfertility diagnosis, whilst the nonendometriosis group at around 255 months postinfertility diagnosis.

Conclusion: Time to pregnancy between endometriosis and nonendometriosis is not significantly different. However, infertility among patients with endometriosis tends to be shorter.

研究背景本研究旨在比较接受体外受精(IVF)的子宫内膜异位症患者和非子宫内膜异位症患者的妊娠时间(TTP)。我们纳入了2014年1月1日至2020年3月31日期间获得生化妊娠的291名患者(53名子宫内膜异位症患者和238名非子宫内膜异位症患者),无论是单胎还是多胎(血清β-hCG >5 mIU/mL)。我们排除了病例记录不完整的患者和拒绝参与的患者。怀孕时间是指从确定不孕到确认生化妊娠的时间间隔,以月为单位。子宫内膜异位症诊断包括经手术确诊的任何形式的子宫内膜异位症。统计分析采用 Mann-Whitney U 检验。通过 Kaplan-Meier 检验对怀孕时间进行评估。P 值 结果子宫内膜异位症患者的不孕时间较短(4 年对 5 年,P=0.024)。两组患者发病时的中位年龄和体重指数相似。子宫内膜异位症组和非子宫内膜异位症组的 TTP 无明显差异(57.7 个月 vs. 70.9 个月,P=0.060),Cox 回归检验进一步证实了这一点,该检验纳入了混杂因素(IVF 方案(OR:1.482,95% CI 0.667-3.292,P=0.334)和周期类型(OR 1.071,95% CI 0.803-1.430,P=0.640))。子宫内膜异位症组在确诊不孕后约 169 个月达到最高累积妊娠率,而非子宫内膜异位症组在确诊不孕后约 255 个月达到最高累积妊娠率:结论:子宫内膜异位症和非子宫内膜异位症患者的怀孕时间没有明显差异。结论:子宫内膜异位症和非子宫内膜异位症患者的怀孕时间没有明显差异,但子宫内膜异位症患者的不孕时间往往较短。
{"title":"Comparison of Time to Pregnancy in <i>In Vitro</i> Fertilisation between Endometriosis and Nonendometriosis.","authors":"Hartanto Bayuaji, Artha Falentin Putri Susilo, Kevin Dominique Tjandraprawira","doi":"10.1155/2024/4139821","DOIUrl":"https://doi.org/10.1155/2024/4139821","url":null,"abstract":"<p><strong>Background: </strong>This study is to compare the time to pregnancy (TTP) between patients with endometriosis and nonendometriosis undergoing <i>in vitro</i> fertilisation (IVF).<i>Material and Methods.</i>This is an observational retrospective cohort study. We included 291 patients (53 with endometriosis and 238 without endometriosis) achieving biochemical pregnancy, whether singleton or multifetal (serum beta-hCG >5 mIU/mL), between 1st January 2014 and 31st March 2020. We excluded patients with incomplete case notes and those declining participation. Time to pregnancy is the interval between the time when infertility was established to the date of confirmed biochemical pregnancy, expressed in months. Endometriosis diagnosis includes any form of endometriosis through surgical confirmation. A statistical analysis was done through the Mann-Whitney <i>U</i> test. Time to pregnancy was assessed through the Kaplan-Meier test. A <i>p</i> value <0.05 is considered statistically significant.</p><p><strong>Results: </strong>Endometriosis patients had a shorter infertility duration (4 years vs. 5 years, <i>p</i>=0.024). Both groups had similar median age and body mass index at presentation. There was no significant difference in the TTP between endometriosis and nonendometriosis groups (57.7 vs. 70.9 months, <i>p</i>=0.060), further confirmed by a Cox regression test incorporating confounders (IVF protocol (OR: 1.482, 95% CI 0.667-3.292, and <i>p</i>=0.334) and type of the cycle (OR 1.071, 95% CI 0.803-1.430, and <i>p</i>=0.640)). The endometriosis group reached the maximum cumulative pregnancy rate at around 169 months postinfertility diagnosis, whilst the nonendometriosis group at around 255 months postinfertility diagnosis.</p><p><strong>Conclusion: </strong>Time to pregnancy between endometriosis and nonendometriosis is not significantly different. However, infertility among patients with endometriosis tends to be shorter.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11398961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Two Postpartum Blood Collection Devices: The Brass-V Drape and MaternaWell Tray-As Experienced by Birth Attendants and Birthing Women-A Questionnaire-Based Randomised Study. 两种产后采血设备:助产士和产妇对胸罩 V 型帘布和 MaternaWell 托盘的体验--基于问卷的随机研究。
IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-14 eCollection Date: 2024-01-01 DOI: 10.1155/2024/6605833
Jade Esau, Timothy Morris, Chris Muller, Christine Els, Liesl de Waard

Background: Postpartum haemorrhage is the leading cause of preventable maternal mortality worldwide. Early identification and prompt management of postpartum haemorrhage improve outcomes. Objective assessment of postpartum blood loss is an important step in identifying postpartum haemorrhage. The Brass-V drape and MaternaWell tray have been designed for routine measurement of postpartum blood loss. The perceived utility and acceptability of these devices to the parturients and birth attendants still begged exploring.

Objective: To assess the perceived usefulness and ease of use of a Brass-V drape versus a MaternaWell tray for the collection of postpartum blood loss.

Methods: We conducted a prospective parallel randomised trial, employing a questionnaire to assess the experiences of birth attendants and birthing women who used these devices. The study was conducted at site B midwife obstetric unit in Khayelitsha Cape Town. Pregnant women presenting in early labour were approached for voluntary participation. After informed consent was obtained, participants were randomly assigned to the Brass-V drape or the MaternaWell tray, which the birth attendant placed after the birth of the baby.

Results: There were 63 participants, of which 33 were assigned to the MaternaWell tray and 30 to the Brass-V drape. Birth attendants indicated a desire to use the MaternaWell tray (30 (90%)) or Brass-V drape (26 (87%)) in future deliveries. The parturients were also in favour of the future use of MaternaWell tray (33 (100%)) and Brass-V drape (28 (93%)). Ease of measurement favoured the Brass V-drape, and ease of placement favoured the MaternaWell tray. Five (8%) participants experienced postpartum haemorrhage, two with the MaternaWell tray and three with the Brass-V drape. One parturient required hospital transfer.

Conclusion: The responses of the birth attendants and parturients were positive. The MaternaWell tray has the benefit of reuse and lower cost and is an acceptable alternative to the Brass-V drape. Both devices aid in the early recognition of postpartum haemorrhage.

背景:产后出血是全球可预防的孕产妇死亡的主要原因。早期识别和及时处理产后出血可改善预后。客观评估产后失血量是识别产后出血的重要步骤。Brass-V 帷幔和 MaternaWell 盘是为常规测量产后失血量而设计的。但这些设备在产妇和助产士心目中的实用性和可接受性仍有待探讨:目的:评估在收集产后失血量时,Brass-V 纱巾和 MaternaWell 盘的实用性和易用性:我们进行了一项前瞻性平行随机试验,采用问卷调查的方式对使用这些设备的助产士和产妇的经验进行评估。这项研究在开普敦卡耶利沙(Khayelitsha)的 B 助产士产科病房进行。研究人员与早产孕妇进行了自愿接触。在获得知情同意后,参与者被随机分配到Brass-V帘布或MaternaWell托盘,由助产士在婴儿出生后放置:结果:共有 63 名参与者,其中 33 人被分配到 MaternaWell 托盘,30 人被分配到胸罩 V 型帘布。助产士表示希望在今后的分娩中使用 MaternaWell 托盘(30 人(90%))或胸罩-V(26 人(87%))。产妇也赞成今后使用 MaternaWell 托盘(33 人(100%))和黄铜 V 型产妇巾(28 人(93%))。黄铜 V 型帘布更易于测量,而 MaternaWell 托盘更易于放置。五名参与者(8%)出现产后大出血,其中两人使用了 MaternaWell 托盘,三人使用了黄铜 V 型帘布。一名产妇需要转院:结论:助产士和产妇的反应是积极的。MaternaWell 托盘具有重复使用和成本较低的优点,是可接受的胸罩-V 俯卧撑的替代品。这两种设备都有助于早期识别产后出血。
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引用次数: 0
Single Institution Experience with Immune Checkpoint Inhibitors in Vulvar and Vaginal Melanomas. 免疫检查点抑制剂治疗外阴和阴道黑色素瘤的单机构经验。
IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-08-13 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7327692
Amrita Ladwa, Omar Elghawy, Varinder Kaur

Objectives: This study aimed to report clinical outcomes of patients with vaginal melanoma (VaM) or vulvar melanoma (VuM) who were treated with immune checkpoint inhibitors (ICI) and discuss the development of immune-related adverse events (irAE).

Materials and methods: This is a retrospective case series of patients diagnosed with VaM or VuM between July 2011 and September 2022 at the University of Virginia, Emily Couric Clinical Cancer Center. Patient demographics, disease characteristics, treatment outcomes, and adverse events were abstracted. The primary outcome was incidence of irAE.

Results: Eight patients were included in this study, four with VaM and four with VuM. Most (n = 6) had local or regional disease at first presentation, and 25% (n = 2) presented with distant metastasis. All patients received a CTLA-4 inhibitor and 75% (n = 6) received PD-1 inhibitor alone or in combination with a CTLA-4 inhibitor. Most (75%, n = 6) patients experienced irAE. Of those who had irAE, 83% (n = 5) required therapy interruption or discontinuation. Most (66%, n = 4) underwent ICI rechallenge of which 75% (n = 3) experienced subsequent irAE. Of all patients in the series, 75% of patients (n = 6) had partial or complete response to ICI.

Conclusion: This series is the first to detail incidence of irAEs and ICI rechallenges in vulvovaginal melanoma. Our findings indicate that while ICIs are effective, their use is associated with significant irAE development. Rechallenge of ICI after irAE is feasible but associated with risk of recurrent/new irAE. Further studies are needed to better quantify this risk.

研究目的本研究旨在报告接受免疫检查点抑制剂(ICI)治疗的阴道黑色素瘤(VaM)或外阴黑色素瘤(VuM)患者的临床结果,并讨论免疫相关不良事件(irAE)的发生情况:这是一项回顾性病例系列研究,研究对象是2011年7月至2022年9月期间在弗吉尼亚大学艾米丽-库里克临床癌症中心确诊为VaM或VuM的患者。研究人员收集了患者的人口统计学资料、疾病特征、治疗结果和不良事件。主要结果是虹膜不良事件的发生率:本研究共纳入了八名患者,其中四人患有VaM,四人患有VuM。大多数患者(6 例)首次发病时为局部或区域性疾病,25% 的患者(2 例)出现远处转移。所有患者都接受了CTLA-4抑制剂治疗,75%的患者(6人)接受了PD-1抑制剂单独治疗或与CTLA-4抑制剂联合治疗。大多数患者(75%,n = 6)都出现了 irAE。在出现 irAE 的患者中,83%(5 人)需要中断或中止治疗。大多数患者(66%,n = 4)接受了 ICI 再挑战,其中 75% (n = 3)随后出现了 irAE。在该系列的所有患者中,75%的患者(6 例)对 ICI 有部分或完全反应:该系列研究首次详细介绍了外阴阴道黑色素瘤的虹膜AE和ICI再挑战发生率。我们的研究结果表明,虽然 ICIs 疗效显著,但使用 ICIs 会导致严重的虹膜异位症。在发生虹膜睫状体异常后重新挑战 ICI 是可行的,但与复发/新的虹膜睫状体异常风险相关。需要进一步研究以更好地量化这一风险。
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引用次数: 0
Reproductive Outcomes of Dual Trigger versus hCG Alone in Women Undergoing In Vitro Fertilization with Fresh Embryo Transfer Cycles. 在接受体外受精和新鲜胚胎移植周期的妇女中,双重触发器与单用 hCG 的生殖结果对比。
IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-07-09 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9972437
Fatma Ceren Guner, Murat Ozekinci, Ibrahim Inanc Mendilcioglu, Zeliha Kasabali

Aim: To investigate the effect of the triggering method on the results of fresh embryo transfer in patients who underwent gonadotropin-releasing hormone antagonist cycles.

Methods: The study was conducted retrospectively at a university-based tertiary reproductive center. The sample consisted of a total of 295 patients, of whom 111 were in the human chorionic gonadotropin (hCG) trigger group and 184 were in the dual trigger group. The main outcome measure of this study was the live birth rate, and secondary outcomes were the implantation rate, clinical pregnancy rate, miscarriage rate, and good-quality embryo rate.

Results: Patient demographics and baseline characteristics did not significantly differ between the dual and hCG trigger groups. The results also indicated statistically nonsignificant differences between the two groups in terms of the number of oocytes retrieved (p > 0.05), the number of mature oocytes (p > 0.05), and the fertilization rate (p > 0.05). The number of good-quality embryos (p=0.002) was higher in the dual trigger group compared with the hCG trigger group. However, the rates of clinical pregnancy and live births did not significantly differ between the groups (p > 0.05).

Conclusions: Although the number of total and high-quality embryos obtained was higher in the dual trigger group, there were no significant differences between the two groups in terms of pregnancy outcomes. The fresh embryo transfer yielded similar rates of implantation and live births in both trigger groups.

目的:研究促性腺激素释放激素拮抗剂周期患者的触发方法对新鲜胚胎移植结果的影响:研究在一所大学的三级生殖中心以回顾性方式进行。样本共包括 295 名患者,其中 111 人属于人绒毛膜促性腺激素(hCG)触发组,184 人属于双触发组。这项研究的主要结果是活产率,次要结果是植入率、临床妊娠率、流产率和优质胚胎率:双重触发组和 hCG 触发组的患者人口统计学和基线特征无明显差异。结果还显示,两组在取卵数(P > 0.05)、成熟卵母细胞数(P > 0.05)和受精率(P > 0.05)方面的差异无统计学意义。与 hCG 触发组相比,双触发组的优质胚胎数量更高(p=0.002)。然而,两组的临床妊娠率和活产率没有显著差异(P > 0.05):结论:虽然双触发组获得的总胚胎数和优质胚胎数更多,但两组在妊娠结局方面没有显著差异。新鲜胚胎移植的植入率和活产率在两组中相似。
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引用次数: 0
Postoperative Chylous Ascites in Gynecological Malignancies: Two Case Reports and a Literature Review. 妇科恶性肿瘤术后乳糜腹水:两个病例报告和文献综述。
IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-06-25 eCollection Date: 2024-01-01 DOI: 10.1155/2024/1810634
Xin Tan, GuoLin Luo, Guangdong Liao, Hong Liao

Aim: To explore the potential factors that influence the presentation and recovery of postoperative chylous ascites (CA) in gynecological malignancies.

Methods: We reported two cases of postoperative CA following gynecological surgery and reviewed the clinical features of 140 patients from 16 relevant papers. Patients' clinicopathological characteristics, surgical approach, and management were summarized. The onset and resolution times of postoperative CA in different groups were analyzed separately.

Results: The two patients in our report had recovery after conservative treatments. According to the literature review, the median time of onset of postoperative CA was 5 days (range, 0-75 days) after surgery. The median resolution time was 9 days (range, 2-90 days). Among patients, 87.14% of them had lymphadenectomy during gynecological surgeries, while 92.86% of the patients had resolution after conservative treatments.

Conclusions: Lymphadenectomy during surgery may be relevant to the postoperative CA. Conservative management could be the initial choice for postoperative CA treatment.

目的:探讨影响妇科恶性肿瘤术后乳糜腹水(CA)的表现和恢复的潜在因素:我们报告了两例妇科手术后糜烂性腹水病例,并回顾了 16 篇相关论文中 140 例患者的临床特征。总结了患者的临床病理特征、手术方式和处理方法。分别分析了不同组别术后 CA 的发病和缓解时间:结果:我们报告中的两名患者经保守治疗后痊愈。根据文献回顾,术后 CA 的中位发病时间为术后 5 天(0-75 天)。中位缓解时间为 9 天(2-90 天)。其中,87.14%的患者在妇科手术中进行了淋巴腺切除,而92.86%的患者在保守治疗后症状得到缓解:结论:手术中的淋巴结切除可能与术后CA有关。结论:手术中的淋巴腺切除可能与术后 CA 有关,保守治疗可能是术后 CA 治疗的首选。
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引用次数: 0
Prediction of Adverse Maternal Outcomes in Women with Early-Onset Preeclampsia with Severe Features in Mexico: Validation of the Full-PIERS Model 墨西哥早发重度子痫前期孕产妇不良预后预测:全PIERS模型的验证
IF 1.9 Q2 Medicine Pub Date : 2024-05-15 DOI: 10.1155/2024/5520312
Eduardo Ponce Nájera, Marcela Montoya Hinojosa, Rogelio Armando Lozano Galván, Diego González Oropeza
Objective. Validate the full-PIERS model in predicting adverse maternal outcomes in women with early-onset preeclampsia with severe features in our population. Methods. Retrospective cohort study. We applied the full-PIERS model on 130 women with severe early-onset preeclampsia who were treated at a second-level hospital in Nuevo León, México. We validated the full-PIERS model in its ability to discriminate through the AUROC. Results. The full-PIERS model applied to the data obtained in our study had good discrimination, revealing an AUC of 0.718 (95% CI 0.515–0.921; P=0.017). A cut-off of 7.95 was identified as the cut-off point with the best diagnostic performance, with the highest Youden index, presenting a sensitivity of 54.5% and specificity of 99.2% for the development of complications. Conclusion. The full-PIERS model can predict adverse maternal outcomes in women admitted to our hospital with severe early-onset preeclampsia within 48 hours of admission.
目的验证全 PIERS 模型在预测我国早发重度子痫前期产妇不良预后方面的有效性。方法:回顾性队列研究。回顾性队列研究。我们对 130 名在墨西哥新莱昂州一家二级医院接受治疗的重度早发型子痫前期妇女应用了全 PIERS 模型。我们通过 AUROC 验证了全 PIERS 模型的分辨能力。结果。应用于本研究数据的全 PIERS 模型具有良好的判别能力,其 AUC 为 0.718(95% CI 0.515-0.921;P=0.017)。7.95分界点被认为是诊断效果最好的分界点,尤登指数最高,对并发症发生的敏感性为54.5%,特异性为99.2%。结论全PIERS模型可以预测我院重度早发型子痫前期产妇在入院48小时内的不良预后。
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引用次数: 0
期刊
Obstetrics and Gynecology International
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