Pub Date : 2024-03-07eCollection Date: 2024-01-01DOI: 10.1155/2024/8351132
Demetrio Larraín, Javier Caradeux
In the last decade, the widespread use of transvaginal ultrasound and the availability of highly specific serum assays of human chorionic gonadotropin (hCG) have become mainstays in the evaluation of early pregnancy. These tests have revolutionized the management of pregnancies of unknown location and markedly reduced the morbidity and mortality associated with the misdiagnosis of ectopic pregnancy. However, despite several advances, their misuse and misinterpretations are still common, leading to an increased use of healthcare resources, patient misinformation, and anxiety. This narrative review aims to succinctly summarize the β-hCG dynamics in early gestation and provide general gynecologists a practical approach to patients with first-trimester symptomatic pregnancy.
{"title":"<i>β</i>-Human Chorionic Gonadotropin Dynamics in Early Gestational Events: A Practical and Updated Reappraisal.","authors":"Demetrio Larraín, Javier Caradeux","doi":"10.1155/2024/8351132","DOIUrl":"10.1155/2024/8351132","url":null,"abstract":"<p><p>In the last decade, the widespread use of transvaginal ultrasound and the availability of highly specific serum assays of human chorionic gonadotropin (hCG) have become mainstays in the evaluation of early pregnancy. These tests have revolutionized the management of pregnancies of unknown location and markedly reduced the morbidity and mortality associated with the misdiagnosis of ectopic pregnancy. However, despite several advances, their misuse and misinterpretations are still common, leading to an increased use of healthcare resources, patient misinformation, and anxiety. This narrative review aims to succinctly summarize the <i>β</i>-hCG dynamics in early gestation and provide general gynecologists a practical approach to patients with first-trimester symptomatic pregnancy.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2024 ","pages":"8351132"},"PeriodicalIF":1.9,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10940029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132231","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}
Pub Date : 2024-02-21eCollection Date: 2024-01-01DOI: 10.1155/2024/3057597
Melissa A Rodriguez, Roderick S Hooker, Kasey K Puckett, Andrzej Kozikowski
As of 2020, maternal and infant health in the US has worsened. At the same time, the number of health professionals available to manage female health issues is changing; the number of physicians in obstetrics and gynecology (Ob-Gyn) and midwives is decreasing, whereas the number of Ob-Gyn physician associates (PAs) is growing. We analyzed PAs practicing in the Ob-Gyn discipline, drawing on the PA Professional Profile, a database maintained by the National Commission on Certification of PAs. In 2021, there were 1,322 Ob-Gyn PAs (1.2% of all clinically active PAs). This health profession has grown by 66.9% since 2013, when only 792 PAs practiced in this specialty. As of 2021, their median age was 38, and 98.0% were female (70.1% of all PAs were female). The practice setting was between office (54.7%) and hospital (34.0%) employment, with 11.3% described as "other." In 2021, the median annual income of Ob-Gyn PAs was $105,000. With the reduction of obstetrician-gynecologists, the relative growth of PAs in this area of medicine and surgery is a natural part of the solution to the projected obstetrical physician deficit.
{"title":"Demographics of Physician Associates (PAs) in Obstetrics and Gynecology: Where They Work and How They Compare to Other PAs.","authors":"Melissa A Rodriguez, Roderick S Hooker, Kasey K Puckett, Andrzej Kozikowski","doi":"10.1155/2024/3057597","DOIUrl":"10.1155/2024/3057597","url":null,"abstract":"<p><p>As of 2020, maternal and infant health in the US has worsened. At the same time, the number of health professionals available to manage female health issues is changing; the number of physicians in obstetrics and gynecology (Ob-Gyn) and midwives is decreasing, whereas the number of Ob-Gyn physician associates (PAs) is growing. We analyzed PAs practicing in the Ob-Gyn discipline, drawing on the PA Professional Profile, a database maintained by the National Commission on Certification of PAs. In 2021, there were 1,322 Ob-Gyn PAs (1.2% of all clinically active PAs). This health profession has grown by 66.9% since 2013, when only 792 PAs practiced in this specialty. As of 2021, their median age was 38, and 98.0% were female (70.1% of all PAs were female). The practice setting was between office (54.7%) and hospital (34.0%) employment, with 11.3% described as \"other.\" In 2021, the median annual income of Ob-Gyn PAs was $105,000. With the reduction of obstetrician-gynecologists, the relative growth of PAs in this area of medicine and surgery is a natural part of the solution to the projected obstetrical physician deficit.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2024 ","pages":"3057597"},"PeriodicalIF":1.9,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990783","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}
Pub Date : 2023-12-11eCollection Date: 2023-01-01DOI: 10.1155/2023/9970818
Kemas Yusuf Effendi, Excellena Nasrul, Iskandar Zulqarnain, Theodorus, Rizani Amran, Heriyadi Manan, Adnan Abadi, Fatimah Usman, Cindy Kesty
Background: Endometriosis is a benign disorder that is generally defined as the presence of endometrial glands and stroma outside their normal location. TGF-β1 is found in stromal cells and its expression is increased in epithelial cells of endometriotic cysts. Endometriosis diagnostics take a long time, so new markers are needed to diagnose endometriosis. This study aims to determine the diagnostic value of TGF-β1 in menstrual blood in diagnosing endometriosis.
Method: Diagnostic tests to compare eutopic endometrial TGF-β1 levels from menstrual blood of patients with suspected endometriosis were undertaken in the Obstetrics and Gynecology Department of Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Sriwijaya University, Palembang, from July 2019 to November 2020. 50 patients who were suspected with endometriosis met the inclusion criteria. Comparison of TGF-β1 levels between endometriosis and nonendometriosis patients was analyzed using the Mann-Whitney test. The cutoff point of the TGF-β1 level towards the histopathological outcome was obtained using the ROC curve. Data analysis was performed by using SPSS version 22.0.
Results: In this study, endometriosis patients were 31.6 ± 6.55 years of age with a range of 20 to 46 years. In statistical analysis, there was no difference in BMI (p = 0.181) and BMI classification (p = 0.207), the history of contraception (p = 0.097), infertility (p = 1.000), and dysmenorrhoea (p = 1.000) between endometriosis and nonendometriosis patients. In the study, there were differences in TGF-β1 between endometriosis and nonendometriosis patients (p ≤ 0.001). By using the ROC curve, the cutoff point for TGF-β1 levels has the best sensitivity and specificity, which is 515 ng/ml. The TGF-β1 level has a sensitivity of 80%, a specificity of 90%, a positive predictive value (PPV) of 0.969, a negative predictive value (NPV) of 0.529, a positive likelihood ratio of 8, a negative likelihood ratio of 0.222, and an accuracy of 0.820 to the endometriosis outcome.
Conclusion: It can be concluded that the TGF-β1 level has a very good diagnostic value in establishing endometriosis diagnostics. This trial is registered with ISRCTN72218532.
{"title":"Diagnostic Test of <i>Transforming Growth Factor-Beta</i> 1 (TGF-<i>β</i>1) in Menstrual Blood with Endometriosis.","authors":"Kemas Yusuf Effendi, Excellena Nasrul, Iskandar Zulqarnain, Theodorus, Rizani Amran, Heriyadi Manan, Adnan Abadi, Fatimah Usman, Cindy Kesty","doi":"10.1155/2023/9970818","DOIUrl":"10.1155/2023/9970818","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a benign disorder that is generally defined as the presence of endometrial glands and stroma outside their normal location. TGF-<i>β</i>1 is found in stromal cells and its expression is increased in epithelial cells of endometriotic cysts. Endometriosis diagnostics take a long time, so new markers are needed to diagnose endometriosis. This study aims to determine the diagnostic value of TGF-<i>β</i>1 in menstrual blood in diagnosing endometriosis.</p><p><strong>Method: </strong>Diagnostic tests to compare eutopic endometrial TGF-<i>β</i>1 levels from menstrual blood of patients with suspected endometriosis were undertaken in the Obstetrics and Gynecology Department of Dr. Mohammad Hoesin General Hospital, Faculty of Medicine, Sriwijaya University, Palembang, from July 2019 to November 2020. 50 patients who were suspected with endometriosis met the inclusion criteria. Comparison of TGF-<i>β</i>1 levels between endometriosis and nonendometriosis patients was analyzed using the Mann-Whitney test. The cutoff point of the TGF-<i>β</i>1 level towards the histopathological outcome was obtained using the ROC curve. Data analysis was performed by using SPSS version 22.0.</p><p><strong>Results: </strong>In this study, endometriosis patients were 31.6 ± 6.55 years of age with a range of 20 to 46 years. In statistical analysis, there was no difference in BMI (<i>p</i> = 0.181) and BMI classification (<i>p</i> = 0.207), the history of contraception (<i>p</i> = 0.097), infertility (<i>p</i> = 1.000), and dysmenorrhoea (<i>p</i> = 1.000) between endometriosis and nonendometriosis patients. In the study, there were differences in TGF-<i>β</i>1 between endometriosis and nonendometriosis patients (<i>p</i> ≤ 0.001). By using the ROC curve, the cutoff point for TGF-<i>β</i>1 levels has the best sensitivity and specificity, which is 515 ng/ml. The TGF-<i>β</i>1 level has a sensitivity of 80%, a specificity of 90%, a positive predictive value (PPV) of 0.969, a negative predictive value (NPV) of 0.529, a positive likelihood ratio of 8, a negative likelihood ratio of 0.222, and an accuracy of 0.820 to the endometriosis outcome.</p><p><strong>Conclusion: </strong>It can be concluded that the TGF-<i>β</i>1 level has a very good diagnostic value in establishing endometriosis diagnostics. This trial is registered with ISRCTN72218532.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2023 ","pages":"9970818"},"PeriodicalIF":1.9,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10728358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138797674","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}
Pub Date : 2023-10-28eCollection Date: 2023-01-01DOI: 10.1155/2023/1121227
Min Zheng, Mei Liu, Cong Zhang
Background: Ovarian hyperstimulation syndrome (OHSS) is one of the most severe complications after ovarian stimulation during assisted reproductive technology (ART). However, its pathogenesis still remains unclear. Melatonin is an important antioxidant factor in female reproduction and Sestrin-2 (SESN2) is reported to be involved in cellular response to different stress conditions. Whether or not melatonin and SESN2 are involved in OHSS is still a question to us clinicians.
Methods and results: We collected the granulosa cells of OHSS patients and focused on the role of SESN2 in OHSS. We also studied the role and mechanism of melatonin plays in OHSS patients. We found that the expression of SESN2 was increased in the granulosa cells of OHSS patients (n = 24) than those in controls (n = 15). Incubation with angiotensin II (1 μM, 2 μM) in HUVECs and H2O2 (0.1 mM, 0.2 mM) in KGNs increased the generation of ROS concurrent with the increased expression of SESN2, while melatonin treatment partly restored SESN2 levels. The mechanism study demonstrated that SESN2 was deeply involved in the regulation of AMPK and mTOR, whereas melatonin partially restored angiotensin II or H2O2 induced the activation of AMPK phosphorylation and the inhibition of mTOR, 4EBP1 and S6K1 phosphorylation, all of which could trigger cell apoptosis.
Conclusions: These findings indicated that melatonin attenuated ROS-induced apoptosis through SESN2-AMPK-mTOR in OHSS. Thus, melatonin is likely to be a potential and important therapeutic agent for treating and preventing OHSS.
{"title":"Melatonin Ameliorates Ovarian Hyperstimulation Syndrome (OHSS) through SESN2 Regulated Antiapoptosis.","authors":"Min Zheng, Mei Liu, Cong Zhang","doi":"10.1155/2023/1121227","DOIUrl":"10.1155/2023/1121227","url":null,"abstract":"<p><strong>Background: </strong>Ovarian hyperstimulation syndrome (OHSS) is one of the most severe complications after ovarian stimulation during assisted reproductive technology (ART). However, its pathogenesis still remains unclear. Melatonin is an important antioxidant factor in female reproduction and Sestrin-2 (SESN2) is reported to be involved in cellular response to different stress conditions. Whether or not melatonin and SESN2 are involved in OHSS is still a question to us clinicians.</p><p><strong>Methods and results: </strong>We collected the granulosa cells of OHSS patients and focused on the role of SESN2 in OHSS. We also studied the role and mechanism of melatonin plays in OHSS patients. We found that the expression of SESN2 was increased in the granulosa cells of OHSS patients (<i>n</i> = 24) than those in controls (<i>n</i> = 15). Incubation with angiotensin II (1 <i>μ</i>M, 2 <i>μ</i>M) in HUVECs and H2O2 (0.1 mM, 0.2 mM) in KGNs increased the generation of ROS concurrent with the increased expression of SESN2, while melatonin treatment partly restored SESN2 levels. The mechanism study demonstrated that SESN2 was deeply involved in the regulation of AMPK and mTOR, whereas melatonin partially restored angiotensin II or H2O2 induced the activation of AMPK phosphorylation and the inhibition of mTOR, 4EBP1 and S6K1 phosphorylation, all of which could trigger cell apoptosis.</p><p><strong>Conclusions: </strong>These findings indicated that melatonin attenuated ROS-induced apoptosis through SESN2-AMPK-mTOR in OHSS. Thus, melatonin is likely to be a potential and important therapeutic agent for treating and preventing OHSS.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2023 ","pages":"1121227"},"PeriodicalIF":1.9,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71484512","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}
Methods: A retrospective single-centre cohort study of patients with early-stage endometrioid endometrial cancer undergoing staging surgery (total hysterectomy, bilateral salpingo-oophorectomy with/without pelvic lymph node, and/or para-aortic lymph node dissection (PLND)) with either SLN mapping or routine lymphadenectomy between July 2017 and December 2018.
Results: 203 cases with clinical and radiological International Federation of Gynaecology and Obstetrics (FIGO) stage I endometrioid endometrial cancer were included, out of which 109 cases underwent SLN mapping and 94 cases complete lymphadenectomy. Compared to the PLND group, the SLN group had shorter operative time (129 vs. 162 minutes), less blood loss (100 vs. 300 ml), and decreased length of postoperative hospital stay (3 vs. 4 days) (p < 0.001). The lymph node metastases detection rate was 4.6% and 7.4% for the SLN and PLND groups, respectively (p = 0.389). With a median follow-up of 14 months for the SLN and 15 months for the PLND group, the disease-free (DFS) and overall survival (OS) were comparable for both at 13 months (p = 0.538 and p = 0.333, respectively).
Conclusion: SLN mapping has been shown to be an acceptable alternative to routine lymphadenectomy in the surgical staging of early-stage endometrial cancer in our centre, with a comparable lymph node metastases detection rate, DFS and OS, and reduction in operative morbidity. Our results with SLN mapping reproduce comparable outcomes to those reported in the literature.
{"title":"Comparing Surgical and Oncological Outcomes between Indocyanine Green (ICG) Sentinel Lymph Node Mapping with Routine Lymphadenectomy in the Surgical Staging of Early-Stage Endometrioid Endometrial Cancer.","authors":"Krystal Miao Lin Koh, Zheng Yuan Ng, Felicia Hui Xian Chin, Wai Loong Wong, Junjie Wang, Yong Kuei Lim","doi":"10.1155/2023/9949604","DOIUrl":"10.1155/2023/9949604","url":null,"abstract":"<p><strong>Methods: </strong>A retrospective single-centre cohort study of patients with early-stage endometrioid endometrial cancer undergoing staging surgery (total hysterectomy, bilateral salpingo-oophorectomy with/without pelvic lymph node, and/or para-aortic lymph node dissection (PLND)) with either SLN mapping or routine lymphadenectomy between July 2017 and December 2018.</p><p><strong>Results: </strong>203 cases with clinical and radiological International Federation of Gynaecology and Obstetrics (FIGO) stage I endometrioid endometrial cancer were included, out of which 109 cases underwent SLN mapping and 94 cases complete lymphadenectomy. Compared to the PLND group, the SLN group had shorter operative time (129 vs. 162 minutes), less blood loss (100 vs. 300 ml), and decreased length of postoperative hospital stay (3 vs. 4 days) (<i>p</i> < 0.001). The lymph node metastases detection rate was 4.6% and 7.4% for the SLN and PLND groups, respectively (<i>p</i> = 0.389). With a median follow-up of 14 months for the SLN and 15 months for the PLND group, the disease-free (DFS) and overall survival (OS) were comparable for both at 13 months (<i>p</i> = 0.538 and <i>p</i> = 0.333, respectively).</p><p><strong>Conclusion: </strong>SLN mapping has been shown to be an acceptable alternative to routine lymphadenectomy in the surgical staging of early-stage endometrial cancer in our centre, with a comparable lymph node metastases detection rate, DFS and OS, and reduction in operative morbidity. Our results with SLN mapping reproduce comparable outcomes to those reported in the literature.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2023 ","pages":"9949604"},"PeriodicalIF":1.9,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10597725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162381","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}
Pub Date : 2023-02-09eCollection Date: 2023-01-01DOI: 10.1155/2023/9056489
Iqbal Al-Zirqi, Siri Vangen
Objective: To study the outcomes of new pregnancies after a previous complete uterine rupture.
Design: Descriptive study based on population data from the Medical Birth Registry of Norway, the Patient Administration System, and the medical records. Sample. Maternities with a previous complete uterine rupture in Norway during the period 1967-2011 (N = 72), extracted from 2 455 797 maternities.
Method: We measured the rate of new complete ruptures and partial ruptures, as well as the maternal and perinatal outcomes of these pregnancies. The characteristics of both previous ruptures and new ruptures were described.
Results: Among 72 maternities, there were thirty-seven with previous ruptures in the lower segment (LS) and 35 outside the LS. We found three new complete ruptures and six uneventful partial ruptures, resulting in a rate of 4.2% and 8.3%, respectively. All three complete ruptures occurred preterm in scars outside the LS. The rate of the new complete rupture was 0% in those with previous ruptures in the LS and 8.6% in those with previous ruptures outside the LS. The corrected perinatal mortality was 1.3%, and prematurity (<37 weeks) was high (36.1%); this was noticed even in the absence of new ruptures and was mostly iatrogenic. Two hysterectomies were performed in the absence of rupture and two cases had abnormal invasive placenta.
Conclusion: The prognosis for pregnancies after a previous complete uterine rupture is favorable. Prematurity is a problem caused by both obstetrician and mother's anxiety; therefore, the timing of delivery is the most challenging. Management should include careful counseling, vigilance for symptoms, and immediate delivery when a rupture is suspected.
{"title":"Pregnancies in Women with a Previous Complete Uterine Rupture.","authors":"Iqbal Al-Zirqi, Siri Vangen","doi":"10.1155/2023/9056489","DOIUrl":"10.1155/2023/9056489","url":null,"abstract":"<p><strong>Objective: </strong>To study the outcomes of new pregnancies after a previous complete uterine rupture.</p><p><strong>Design: </strong>Descriptive study based on population data from the Medical Birth Registry of Norway, the Patient Administration System, and the medical records. <i>Sample</i>. Maternities with a previous complete uterine rupture in Norway during the period 1967-2011 (<i>N</i> = 72), extracted from 2 455 797 maternities.</p><p><strong>Method: </strong>We measured the rate of new complete ruptures and partial ruptures, as well as the maternal and perinatal outcomes of these pregnancies. The characteristics of both previous ruptures and new ruptures were described.</p><p><strong>Results: </strong>Among 72 maternities, there were thirty-seven with previous ruptures in the lower segment (LS) and 35 outside the LS. We found three new complete ruptures and six uneventful partial ruptures, resulting in a rate of 4.2% and 8.3%, respectively. All three complete ruptures occurred preterm in scars outside the LS. The rate of the new complete rupture was 0% in those with previous ruptures in the LS and 8.6% in those with previous ruptures outside the LS. The corrected perinatal mortality was 1.3%, and prematurity (<37 weeks) was high (36.1%); this was noticed even in the absence of new ruptures and was mostly iatrogenic. Two hysterectomies were performed in the absence of rupture and two cases had abnormal invasive placenta.</p><p><strong>Conclusion: </strong>The prognosis for pregnancies after a previous complete uterine rupture is favorable. Prematurity is a problem caused by both obstetrician and mother's anxiety; therefore, the timing of delivery is the most challenging. Management should include careful counseling, vigilance for symptoms, and immediate delivery when a rupture is suspected.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2023 ","pages":"9056489"},"PeriodicalIF":1.6,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9935781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10826747","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}
Abubakari Wuni, Brenda Abena Nyarko, Mudasir Mohammed Ibrahim, Issahaka Abdulai Baako, Iddrisu Sisala Mohammed, Camillus Buunaaisie
Background: Dysmenorrhea is the most common gynecological problem affecting the majority of female students in the nursing profession today. They often experience severe pain that is not only incapacitating but also has a significant impact on their day-to-day college life, academic, and clinical performance.
Aim: This study was conducted to assess the prevalence, management, and impact of dysmenorrhea on the lives of nurse and midwife trainees in northern Ghana.
Methods: A descriptive cross-sectional design with a quantitative approach to data collection was employed to collect data from nurse and midwife trainees in three colleges of nursing and/or midwifery in the northern region of Ghana. A proportionate stratified random sampling technique was used to recruit 303 respondents for the study. After gaining permission from various institutions, data were collected by using a structured questionnaire from 13th September to 28th October, 2022. Stata (special edition) for Windows version 17.0 was used for the statistical analyses.
Results: The study revealed a high prevalence of dysmenorrhea among female nursing students (66.7% and 95% CI: 0.611-0.720). More than half of the respondents (67.3%) experienced loss of appetite for food. The most common site of most intense pain was the pelvis and lower abdomen (98.0%). A greater proportion of students (65.8%) used antispastic drugs to reduce pain. The respondents' concentration in the classroom was greatly affected (77.2%) as well as normal physical activities (58.4%). A multivariable logistic regression analysis revealed that the odds of dysmenorrhea are 2.67 times higher when the duration of menstruation is 4-5 days (AOR = 1.82, 95% CI = 1.13-6.28, and p = 0.024) than a duration of 1-3 days. Having urinary tract infections was associated with 3.56 times higher odds of dysmenorrhea (AOR = 3.56, 95% CI = 0.98-12.86, and p = 0.053). Again, the odds of dysmenorrhea were also four times higher among respondents with a family history of the same condition (AOR = 4.05, 95% CI = 2.16-7.61, and p = 0.001).
Conclusion: The current study revealed a high prevalence of dysmenorrhea among nurse and midwife trainees in the northern part of Ghana. The majority of the respondent experienced loss of appetite and intense pain in the pelvis and lower abdomen, and their concentration during lectures was also significantly affected. The most predominant nonpharmacological method used for reducing the pain was sleep and the application of warm objects on the abdomen.
背景:痛经是当今影响大多数护理专业女学生的最常见妇科问题。他们经常经历严重的疼痛,这不仅使他们丧失能力,而且对他们的日常大学生活、学业和临床表现也有重大影响。目的:本研究旨在评估加纳北部护士和助产士培训生痛经的患病率、管理和影响。方法:采用描述性横断面设计和定量数据收集方法,从加纳北部地区三所护理和/或助产学院的护士和助产士学员中收集数据。采用比例分层随机抽样技术,共招募303名调查对象。在获得各机构的许可后,于2022年9月13日至10月28日通过结构化问卷收集数据。统计分析采用Windows 17.0版本的Stata (special edition)软件。结果:护生女生痛经发生率较高(66.7%,95% CI: 0.611 ~ 0.720)。超过一半的受访者(67.3%)经历过食欲不振。最常见的剧烈疼痛部位是骨盆和下腹部(98.0%)。使用抗痉挛药物减轻疼痛的学生比例更高(65.8%)。调查对象在课堂上的注意力(77.2%)和正常的身体活动(58.4%)受到很大影响。多变量logistic回归分析显示,月经持续时间为4 ~ 5天的患者发生痛经的几率是月经持续时间为1 ~ 3天的患者的2.67倍(AOR = 1.82, 95% CI = 1.13 ~ 6.28, p = 0.024)。尿路感染与痛经发生率高3.56倍相关(AOR = 3.56, 95% CI = 0.98-12.86, p = 0.053)。同样,有相同家族史的受访者患痛经的几率也高出四倍(AOR = 4.05, 95% CI = 2.16-7.61, p = 0.001)。结论:目前的研究显示痛经在加纳北部的护士和助产士培训生中非常普遍。大多数受访者经历了食欲不振,骨盆和下腹部剧烈疼痛,他们在讲课时的注意力也受到了显著影响。用于减轻疼痛的最主要的非药物方法是睡眠和在腹部敷暖物。
{"title":"Prevalence, Management, and Impact of Dysmenorrhea on the Lives of Nurse and Midwife Trainees in Northern Ghana.","authors":"Abubakari Wuni, Brenda Abena Nyarko, Mudasir Mohammed Ibrahim, Issahaka Abdulai Baako, Iddrisu Sisala Mohammed, Camillus Buunaaisie","doi":"10.1155/2023/8823525","DOIUrl":"https://doi.org/10.1155/2023/8823525","url":null,"abstract":"<p><strong>Background: </strong>Dysmenorrhea is the most common gynecological problem affecting the majority of female students in the nursing profession today. They often experience severe pain that is not only incapacitating but also has a significant impact on their day-to-day college life, academic, and clinical performance.</p><p><strong>Aim: </strong>This study was conducted to assess the prevalence, management, and impact of dysmenorrhea on the lives of nurse and midwife trainees in northern Ghana.</p><p><strong>Methods: </strong>A descriptive cross-sectional design with a quantitative approach to data collection was employed to collect data from nurse and midwife trainees in three colleges of nursing and/or midwifery in the northern region of Ghana. A proportionate stratified random sampling technique was used to recruit 303 respondents for the study. After gaining permission from various institutions, data were collected by using a structured questionnaire from 13<sup>th</sup> September to 28<sup>th</sup> October, 2022. Stata (special edition) for Windows version 17.0 was used for the statistical analyses.</p><p><strong>Results: </strong>The study revealed a high prevalence of dysmenorrhea among female nursing students (66.7% and 95% CI: 0.611-0.720). More than half of the respondents (67.3%) experienced loss of appetite for food. The most common site of most intense pain was the pelvis and lower abdomen (98.0%). A greater proportion of students (65.8%) used antispastic drugs to reduce pain. The respondents' concentration in the classroom was greatly affected (77.2%) as well as normal physical activities (58.4%). A multivariable logistic regression analysis revealed that the odds of dysmenorrhea are 2.67 times higher when the duration of menstruation is 4-5 days (AOR = 1.82, 95% CI = 1.13-6.28, and <i>p</i> = 0.024) than a duration of 1-3 days. Having urinary tract infections was associated with 3.56 times higher odds of dysmenorrhea (AOR = 3.56, 95% CI = 0.98-12.86, and <i>p</i> = 0.053). Again, the odds of dysmenorrhea were also four times higher among respondents with a family history of the same condition (AOR = 4.05, 95% CI = 2.16-7.61, and <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>The current study revealed a high prevalence of dysmenorrhea among nurse and midwife trainees in the northern part of Ghana. The majority of the respondent experienced loss of appetite and intense pain in the pelvis and lower abdomen, and their concentration during lectures was also significantly affected. The most predominant nonpharmacological method used for reducing the pain was sleep and the application of warm objects on the abdomen.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2023 ","pages":"8823525"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10442185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10413885","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}
The International Federation of Gynaecology and Obstetrics recommend digital insertion of the copper intrauterine device (IUD) during caesarean delivery and note the risk of thread inclusion in the uterotomy closure and nonvisibility of threads at follow-up. We describe a novel method of inserting the IUD with the insertion straw and directing the lower end of the straw through the cervix for retrieval after the operation, to protect and ensure alignment of the threads. We also describe a simple method of lengthening one thread with part of the other thread, to avoid risks associated with braided suture extensions.
{"title":"Novel Concepts for Intrauterine Device Placement at Caesarean Delivery: Description of Technique and Video Recording.","authors":"G Justus Hofmeyr, Kyungu M Kime","doi":"10.1155/2023/4410984","DOIUrl":"https://doi.org/10.1155/2023/4410984","url":null,"abstract":"<p><p>The International Federation of Gynaecology and Obstetrics recommend digital insertion of the copper intrauterine device (IUD) during caesarean delivery and note the risk of thread inclusion in the uterotomy closure and nonvisibility of threads at follow-up. We describe a novel method of inserting the IUD with the insertion straw and directing the lower end of the straw through the cervix for retrieval after the operation, to protect and ensure alignment of the threads. We also describe a simple method of lengthening one thread with part of the other thread, to avoid risks associated with braided suture extensions.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2023 ","pages":"4410984"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9475845","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}
Andinet Ayele, Neil Abdurashid, Mickiale Hailu, Bereket Tefera
Background: Unintended pregnancy refers to a pregnancy that is either mistimed or unwanted. Unintended pregnancy has been a troubling public health and reproductive health issue, which imposes appreciable adverse consequences on the mother, child, and the public in general. Globally 121 million unplanned pregnancies occurred from 2015 to 2019. A significant proportion (61%) of these pregnancies ended in abortions each year. In Ethiopia, the challenges of unintended pregnancy and its related complications still exist because of the high rate of unmet need for contraceptives. In addition, no research has been conducted on unintended pregnancy among pregnant women in Dire Dawa city administration.
Objective: To determine the prevalence of unintended pregnancy and associated factors among pregnant women attending antenatal care public health facilities in Dire Dawa in 2021.
Methods: A facility-based cross-sectional study was conducted. After being chosen randomly, 382 pregnant women were interviewed at 9 urban public health facilities. A pretested questionnaire was used to collect data, entered into Epi Info 7, and exported into SPSS version 25 for analysis. The variables, which were significant at P ≤ 0.25 in bivariate analysis, were included in multivariable analysis. Statistical significance was declared at a P value <0.05 and a 95% CI.
Results: In this study, the prevalence of unintended pregnancy was 23.8% at 95% CI (19.8-28.3). The following factors were associated with unintended pregnancy: single women (AOR = 10.93, 95% CI 3.65-32.74), low family income (2000 ETB) (AOR = 4.01, 95% CI 1.73-9.28), parity 3 (AOR = 10.3, 95% CI 4.07-25.84), no history of family planning use (AOR = 5.91, 95% CI 2.46-14.21), and husband decision-making role on reproductive health (AOR = 2.956, 95% CI 1.048-8.340). Conclusion and Recommendations. The prevalence of unintended pregnancy was relatively high in this study. Efforts should be made to scale up women's decision-making power on family planning services and give support to empower women economically. There is the need to promote family planning services to minimize unintended pregnancy and to decrease parity and family size.
背景:意外怀孕是指不合时宜或不想要的怀孕。意外怀孕一直是一个令人不安的公共卫生和生殖健康问题,对母亲、儿童和一般公众造成明显的不利后果。2015年至2019年,全球发生了1.21亿例意外怀孕。每年这些怀孕中有很大比例(61%)以堕胎告终。在埃塞俄比亚,由于避孕药具需求未得到满足的比例很高,意外怀孕及其相关并发症的挑战仍然存在。此外,没有对迪勒达瓦市政府孕妇的意外怀孕进行研究。目的:了解2021年在迪勒达瓦省产前保健公共卫生机构就诊的孕妇中意外怀孕的发生率及其相关因素。方法:以医院为基础进行横断面研究。随机抽取382名孕妇,在9个城市公共卫生机构进行访谈。采用预测问卷收集数据,输入Epi Info 7,导出到SPSS 25进行分析。双变量分析中P≤0.25显著的变量纳入多变量分析。结果:本研究中,意外妊娠发生率为23.8%,95% CI(19.8 ~ 28.3)。以下因素与意外妊娠相关:单身女性(AOR = 10.93, 95% CI 3.65 ~ 32.74)、家庭收入低(AOR = 4.01, 95% CI 1.73 ~ 9.28)、胎次3 (AOR = 10.3, 95% CI 4.07 ~ 25.84)、无计划生育史(AOR = 5.91, 95% CI 2.46 ~ 14.21)、丈夫对生殖健康的决策作用(AOR = 2.956, 95% CI 1.048 ~ 8.340)。结论和建议。在本研究中,意外怀孕的发生率相对较高。扩大妇女在计划生育服务方面的决策权,支持增强妇女经济权能。有必要促进计划生育服务,以尽量减少意外怀孕和减少胎次和家庭规模。
{"title":"Unintended Pregnancy and Associated Factors among Pregnant Women Attending Antenatal Care Unit in Public Health Facilities of Dire Dawa City, Eastern Ethiopia, 2021.","authors":"Andinet Ayele, Neil Abdurashid, Mickiale Hailu, Bereket Tefera","doi":"10.1155/2023/8100462","DOIUrl":"https://doi.org/10.1155/2023/8100462","url":null,"abstract":"<p><strong>Background: </strong>Unintended pregnancy refers to a pregnancy that is either mistimed or unwanted. Unintended pregnancy has been a troubling public health and reproductive health issue, which imposes appreciable adverse consequences on the mother, child, and the public in general. Globally 121 million unplanned pregnancies occurred from 2015 to 2019. A significant proportion (61%) of these pregnancies ended in abortions each year. In Ethiopia, the challenges of unintended pregnancy and its related complications still exist because of the high rate of unmet need for contraceptives. In addition, no research has been conducted on unintended pregnancy among pregnant women in Dire Dawa city administration.</p><p><strong>Objective: </strong>To determine the prevalence of unintended pregnancy and associated factors among pregnant women attending antenatal care public health facilities in Dire Dawa in 2021.</p><p><strong>Methods: </strong>A facility-based cross-sectional study was conducted. After being chosen randomly, 382 pregnant women were interviewed at 9 urban public health facilities. A pretested questionnaire was used to collect data, entered into Epi Info 7, and exported into SPSS version 25 for analysis. The variables, which were significant at <i>P</i> ≤ 0.25 in bivariate analysis, were included in multivariable analysis. Statistical significance was declared at a <i>P</i> value <0.05 and a 95% CI.</p><p><strong>Results: </strong>In this study, the prevalence of unintended pregnancy was 23.8% at 95% CI (19.8-28.3). The following factors were associated with unintended pregnancy: single women (AOR = 10.93, 95% CI 3.65-32.74), low family income (2000 ETB) (AOR = 4.01, 95% CI 1.73-9.28), parity 3 (AOR = 10.3, 95% CI 4.07-25.84), no history of family planning use (AOR = 5.91, 95% CI 2.46-14.21), and husband decision-making role on reproductive health (AOR = 2.956, 95% CI 1.048-8.340). <i>Conclusion and Recommendations</i>. The prevalence of unintended pregnancy was relatively high in this study. Efforts should be made to scale up women's decision-making power on family planning services and give support to empower women economically. There is the need to promote family planning services to minimize unintended pregnancy and to decrease parity and family size.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2023 ","pages":"8100462"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10495237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10295045","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}
Marta Horvat, Doroteja Pavan Jukić, Lovro Marinović, Dina Bursać, Rosana Ribić, Marijana Neuberg, Danijel Bursać
Background: Dysmenorrhoea is one of the most common gynaecological problems. Therefore, it is important to investigate its impact during the COVID-19 pandemic which has a great impact on the lives of menstruating people all over the world.
Aim: To determine the prevalence and impact of primary dysmenorrhoea on academic performance among students during the pandemic.
Materials and methods: This cross-sectional study was conducted in April 2021. All data were collected by an anonymous self-assessed web-based questionnaire. Due to voluntary participation in the study, 1210 responses were received, but 956 were left for analysis after exclusion criteria were applied. Descriptive quantitative analysis was performed and Kendall rank correlation coefficient was used.
Results: The prevalence of primary dysmenorrhoea was 90.1%. Menstrual pain was mild in 7.4% of cases, moderate in 28.8%, and severe in 63.8%. The study found that primary dysmenorrhoea has a great perceived impact on all included aspects of academic performance. Most affected were concentration in class in 810 (94.1%) and doing homework and learning in 809 (94.0%) female students. There is also a correlation between menstrual pain intensity and its impact on academic performance (p < 0.001).
Conclusions: Our study found that the prevalence of primary dysmenorrhoea among students at the University of Zagreb is high. Painful menstruation greatly impacts academic performance and therefore it is important to do more research on this topic.
{"title":"Prevalence of Primary Dysmenorrhoea and Its Impact on Academic Performance among Croatian Students during the COVID-19 Pandemic.","authors":"Marta Horvat, Doroteja Pavan Jukić, Lovro Marinović, Dina Bursać, Rosana Ribić, Marijana Neuberg, Danijel Bursać","doi":"10.1155/2023/2953762","DOIUrl":"https://doi.org/10.1155/2023/2953762","url":null,"abstract":"<p><strong>Background: </strong>Dysmenorrhoea is one of the most common gynaecological problems. Therefore, it is important to investigate its impact during the COVID-19 pandemic which has a great impact on the lives of menstruating people all over the world.</p><p><strong>Aim: </strong>To determine the prevalence and impact of primary dysmenorrhoea on academic performance among students during the pandemic.</p><p><strong>Materials and methods: </strong>This cross-sectional study was conducted in April 2021. All data were collected by an anonymous self-assessed web-based questionnaire. Due to voluntary participation in the study, 1210 responses were received, but 956 were left for analysis after exclusion criteria were applied. Descriptive quantitative analysis was performed and Kendall rank correlation coefficient was used.</p><p><strong>Results: </strong>The prevalence of primary dysmenorrhoea was 90.1%. Menstrual pain was mild in 7.4% of cases, moderate in 28.8%, and severe in 63.8%. The study found that primary dysmenorrhoea has a great perceived impact on all included aspects of academic performance. Most affected were concentration in class in 810 (94.1%) and doing homework and learning in 809 (94.0%) female students. There is also a correlation between menstrual pain intensity and its impact on academic performance (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Our study found that the prevalence of primary dysmenorrhoea among students at the University of Zagreb is high. Painful menstruation greatly impacts academic performance and therefore it is important to do more research on this topic.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2023 ","pages":"2953762"},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10257551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9975932","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}