Obstetrics and Gynecology International最新文献

Purpose: This study aimed to evaluate the effect of COVID-19 infection and vaccination on all the menstrual cycle parameters in the women of reproductive age group, 18-45 years, at a tertiary care hospital. Methods: A single-center, descriptive cross-sectional study was done from January 2, 2023, to June 24, 2023. Sampling was nonprobabilistic and purposeful. Participants were recruited via calls, in-person interviews, and online surveys. A total of 931 participants were recruited, of which 141 participants were eligible for the study. Descriptive statistics were performed for all variables. Pearson's chi-square test was done to compare categorical variables among different groups, and the Wilcoxon matched pair signed-rank test was done to compare the menstrual cycle patterns before and after COVID-19 infection and vaccination. Simple linear regression and multiple linear regression analysis were done wherever necessary. p < 0.05 was considered statistically significant. Results: A total of 931 participants were recruited, of which 141 participants were eligible for the study. The median age was 29 years. Those who reported menstrual abnormalities were mainly of the age group 18-27 (n = 62, 44.0%), resided in an urban locality (n = 123, 87.2%), and were employed (full-time/part-time) (n = 57, 40.4%). Of the 42 participants with menstrual changes, 27 (64.3%) participants experienced changes post-COVID-19 infection before their first vaccination dose and 15 (35.7%) after the first vaccination dose. In this group, 15 (35.7%) continue to experience abnormalities in their cycles. Analysis showed that participants having severe COVID-19 symptoms were more likely to have an earlier onset of menstrual abnormalities (beta = -2.072, p=0.040). Participants with an above-normal BMI were more likely to have increased pain/cramps during menses (beta = 0.236, p=0.0.013). Participants who were students/employed (beta = -0.365, p=0.001) with an above-normal BMI (beta = 0.182, p=0.024) were more likely to experience increased mood swings/tension/irritability. On comparing the onset and duration of menstrual abnormalities in the post-COVID-19 infection and postvaccination groups, it was found that the latter group had a late-onset and short-term effect, while the former group had an early-onset and long-term effect on menses. Conclusion: Our study shows that there is evidence of the onset of menstrual irregularities following COVID-19 infection and vaccination. The study revealed COVID-19 infection and vaccination influence menstrual cycles, the former posing a higher risk, but their effects on menstruation independent of one another are to be studied further.

Background: "No result" after PGT-A is a rare observation. Factors suspected to cause inconclusive diagnoses include poor embryo quality, day of biopsy, biopsy technique, and technical amplification failure due to diluted DNA material. This study aimed to highlight the predisposing factors that could lead to a "no result" observation after PGT-A. Results: This is a retrospective cohort study involving 177 patients and 1335 blastocysts, 1242 of which comprised the control (result) group and 93 comprised the study (no result) group. The predisposing factors studied were the number of blastocysts available for biopsy, the day of biopsy, the grade of the embryo, the degree of expansion of the blastocyst, and the grade of the trophectoderm on biopsy day. The rate of "no result" embryos did not depend on the degree of expansion of the embryo, the trophectoderm quality, the day of biopsy, or embryo grade (p=0.139, 0.34, 0.332, and 0.272, respectively). Regression analysis showed that the studied embryo characteristics were not significant predisposing factors. However, having more blastocysts to biopsy per patient was found to be a significant predictor of "no result" embryos. Conclusion: No clear embryo-related risk factors could be elucidated; however, the biopsy procedure and sample cellularity seem to be crucial components. In addition, having more embryos per patient to biopsy at a given time might increase the risk of having inconclusive biopsy results.

Objective: To describe the incidence of hydatidiform mole in Colombia. Design: Cross-sectional descriptive study. Setting: Colombia. Population or Sample: The total population at risk of hydatidiform mole (15-49 years old) from 2015 to 2023 was 117.890.729 women. Methods: A search of the national database of the Ministry of Health and Social Protection of Colombia using ICD-10 for hydatidiform mole and ectopic pregnancy was conducted from 2015 to 2023. Incidences were calculated using data from the National Department of Statistics of Colombia. Main Outcome Measures: The incidence of hydatidiform mole was calculated by ratios compared with the live births, the proportion of pregnancies, and the incidence rate in the at-risk population. Results: In the reviewed period, 2247 cases of hydatidiform mole were reported. The proportion of unspecified hydatidiform moles during the evaluation period was 78.59% of the reports, the incidence ratio was one hydatidiform mole for every 2486 live births, the proportion was 37.7 × 10⁵ pregnancies and the cumulative incidence was 1.90 × 10⁵ women of 15-49 years. The age range with the highest number of cases was 20-29 years with 1039 cases. Conclusions: The high proportion of unspecified hydatidiform mole far exceeds the diagnoses of complete and partial hydatidiform mole. The descriptive design of the study does not allow us to determine the causes of these results. Future studies with more complex methodological designs are required to explain these findings.

Objective: This study aims to determine the incidence of episiotomy in Kasr Alainy OBGYN Hospital in Cairo, Egypt. The objectives include identifying and examining the reasons behind the notably higher episiotomy rates in this region, and assessing the relevance of general WHO recommendations in lower-middle-income countries. Design: This observational cross-sectional study was conducted between March 1, 2022 and June 30, 2022, to determine the incidence of episiotomy among vaginal deliveries in the hospital. Setting: Data was collected from patient charts at Kasr Alainy OBGYN Hospital in Cairo, Egypt. Patient Sample: The total number of patient charts inspected was 1731, of which 1545 met the inclusion criteria. Methods: Data were manually collected from patient hospital records at the end of each day, and entered into a standardized data-collection form. The data collected was then statistically analyzed using SPSS. Main Outcome Measures: The overall incidence of episiotomy was 64%. Results: When analyzed by gravidity, the incidence was found to be 97% in primigravida patients and 52% in multigravida patients. Additionally, several other associated factors were examined. Conclusions: The incidence of episiotomy at Kasr Alainy OBGYN Hospital surpasses the rate recommended by the WHO. Our observations suggest that the primary contributing factors to this elevated incidence include perineal rigidity, the duration of labor, and local practice standards. Further research is recommended to explore the impact of perineal massage before and during delivery, as well as patients' lifestyle factors, on the necessity for episiotomy.

Background: Pelvic organ prolapse (POP) is a benign condition that can adversely affect women's quality of life. Mesh sacrocolpopexy is an effective surgical treatment for POP, but is considered a complex and risky surgery for obese and elderly women. The objective of this study was to assess the impact of age and obesity on the outcomes of minimally invasive sacrocolpopexy. Methods: We performed a retrospective cohort study reviewing all minimally invasive sacrocolpopexy cases performed between 2003 and 2021. Data on operative time, hospital stay, conversion rate, perioperative injuries, early and late postoperative complications were collected. Surgical success was evaluated by gynecological examination at each follow-up visit. Results: One hundred seventy subjects were included, of whom 44% were older than 65 years and 58% had a body mass index (BMI) above 25 kg/m². Seventy percent presented stage III uterovaginal prolapse. All patients achieved a good subjective outcome with no reported prolapse with a mean follow-up of 6 years. The rate of de novo stress urinary incontinence was 3.2%. Vaginal implant exposure was found in 4% of cases. A bivariate analysis studying the impact of older age (≥ 65 vs. < 65 years) and higher BMI (≥ 25 vs. < 25) on surgical and postoperative outcomes did not show any significant differences between the subgroups (p > 0.05). Conclusion: In experienced hands, laparoscopic sacrocolpopexy can be used as a safe and effective procedure for operable patients with POP, even when patients are between 65 and 80 years or have a BMI of 25 kg/m² and above.

Platelet-rich plasma (PRP) promotes the wound-healing process and reduces pain. Cord blood platelet-rich plasma (CB-PRP), which can be easily collected from the umbilical cord and reapplied to a cesarean section wound, has been proposed to have similar effects as PRP. This paper hypothesizes that CB-PRB would provide beneficial effects in terms of wound healing and pain reduction in women undergoing cesarean section. This study is a randomized controlled trial involving 52 pregnant women who underwent cesarean sections. Participants were assigned to either the intervention group (n = 26) or the control group (n = 26) at the Obstetrics and Gynecology Clinic of Police General Hospital. Cord blood PRP was applied to the subcutaneous layer and the surgical wound immediately following the cesarean section. The efficacy of wound healing was evaluated using the REEDA scale score on days 1 and 3 postoperatively, and the Vancouver Scar Scale (VSS) was assessed in the 8th week postoperation. The efficacy in reducing pain was measured using a Visual Analog Scale on days 1 and 3 postoperatively. The mean REEDA scale on day 1 (mean ± SD: 1.5 ± 0.2561.5 ± 0.256 in the CB-PRP group and 2.5 ± 0.267 in the control group; p=0.009) and the mean VSS score at the 8th week (mean ± SD: 2.577 ± 2.003 in the CB-PRP group and 6.962 ± 2.441 in the control group; p < 0.001) were significantly lower in the CB-PRP group than those in the control group. However, there were no differences in Visual Analog Scale values between the two groups. The findings indicate that CB-PRP potentially promotes wound healing following cesarean sections but does not reduce pain. Further research is needed to confirm the beneficial effects of CB-PRP.

Background: Over 768 million cases of COVID-19 infection have been reported worldwide, with pregnant women being the most vulnerable members of society during such an infectious disease outbreak. In the United Arab Emirates, there are limited studies explaining the effects of COVID-19 on pregnant women and their fetuses. In this study, the maternal and fetal outcomes in pregnant women with COVID-19 in a tertiary maternal hospital, United Arab Emirates, were examined. Materials and Methods: A descriptive study was conducted in a tertiary hospital for Obstetrics and Gynecology in Ras Al Khaimah, UAE. The study included all pregnant women who tested positive for COVID-19 infection from April 2020 to September 2021. Results: The study revealed that a higher number of COVID-19-infected pregnant patients presented in their third trimester (69.1%). The comorbidity of body mass index (BMI) had the most effect on the severity/hospitalization status of the patients (p=0.018). In the nonhospitalized group, fever was the most common symptom (26%), whereas in the hospitalized group, cough was the most common symptom (94%). Emergency cesarean delivery was found to be significant (p=0.0007) in hospitalized patients. COVID-19 pneumonia was the prevailing adverse maternal outcome. NICU admission and prematurity were the most frequent neonatal outcomes. Conclusions: In conclusion, our findings show that adverse maternal outcomes, obesity, and mode of delivery were related to COVID-19 severity in pregnant patients. However, there was no effect generally on the adverse fetal outcomes except for jaundice and birth weight.

Background: BRCA1 gene dysfunction seen in epithelial ovarian carcinomas often results from germline mutations, somatic mutations, and promoter methylation. Identification of tumors with loss of BRCA1 protein expression has shown to have therapeutic and prognostic implications. The aim of this study was to determine the expression of BRCA1 protein in epithelial ovarian cancer (EOC) and the associated clinicopathological characteristics. Methods and Results: This was a cross-sectional laboratory-based study that used paraffin-embedded tissue blocks of patients histologically diagnosed with EOC from January 2010 to August 2018. Tissue sections were stained with hematoxylin and eosin (H&E) for histological confirmation and with immunohistochemistry (IHC) using a mouse-derived monoclonal antibody MS110 for BRCA1 protein expression. The association between BRCA1 protein expression and independent variables was determined using Pearson's Chi-square test. A total of 104 tissue blocks from patients with EOC were included in the study with a mean age of 48.7 ± 12.8 years. Serous tumors were the most common which comprised 74.0% (77/104) of all the tumors and majority of them 75.3% (58/77) were high grade. Loss of expression of BRCA1 protein expression was found in 33.7% (33/98) of all the cases. There was no statistically significant association between BRCA1 expression and age of patients, tumor grade, and histological subtype. Conclusion: There is a high expression of altered BRCA1 expression in tissues of EOC. Although it has not shown association with age of patients, histology types, and tumor grade, further studies need to assess its influence of the survival of cancer patients with EOC.

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.