Obstetrics and Gynecology International最新文献

Introduction: Female technology or 'femtech' is the availability of mobile applications (apps) to monitor specific aspects of women's health. It touts the benefits of technology to empower women with regards to their health, while also allowing close collaboration between patients and physicians. Endometriosis-specific apps is a channel by which female patients discover their endometriosis diagnosis. However, there is currently a paucity of high-quality and evidence-based endometriosis apps. This study assessed the current state and overall quality of such apps. Materials and Methods: This retrospective study assessed patient-centred endometriosis apps on the Apple iTunes Store, in January 2023, excluding certain categories such as conference guidance, gaming, private healthcare, and clinical trial apps. The key term "endometriosis" was used. All patient-centred apps were included. The apps were assessed using the APPLICATIONS scoring system, considering objective factors like pricing, subscriptions, literature references, in-app purchases, connectivity, advertisements, search fields, interoperability, and subjective elements such as navigation ease and presentation. The maximum score is 16 and all applications were assessed in English. Results: Out of the initial 22 apps, 12 (54.5%) were excluded, leaving 10 (45.5%) for analysis. Most apps lacked comprehensiveness, but two apps (LUNA-endometriosis and Frendo) stood out with high scores. These apps incorporated certified scoring systems, provided recommendations for tests and follow-up visits, and offered evidence-based literature on endometriosis. The remaining apps scored poorly, focusing on alternative treatments, healthy diets, or functioning solely as symptom diaries, with limited information on diagnosis and management. Only a few apps allowed booking follow-up visits, and most lacked the capability to export patient-specific data. Few apps measured the likelihood of endometriosis whilst others relied on previous diagnoses. The majority of apps were free, whilst in-app purchases centred around alternative treatments. Overall, the apps were user-friendly, featuring vibrant colours and intuitive interfaces. Conclusions: Only two patient-centred endometriosis apps scored highly in the APPLICATIONS scoring system as they were high-quality, evidence-based and incorporated valid medical recommendations. Other applications scored low as their recommendations lacked quality scientific evidence.

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: This study evaluated awareness and knowledge of planned oocyte cryopreservation (POC) among Turkish women across diverse sociocultural backgrounds. Design: This is a cross-sectional survey with a 56-item self-administered electronic questionnaire. Setting: Istanbul, Turkiye, June to September 2022. Population: The study evaluated 915 participants between 21 and 45 years. Methods: Women completed a 56-item self-administered online electronic questionnaire survey to identify their demographic information, perspective on family planning, future fertility expectations/plans, oocyte freezing, and degree of knowledge. Main Outcome Measures: Comparison of participants considering and not considering POC. Results: A total of 464 (50.7%) women indicated an intent to undergo POC in the future, with statistically significantly higher university graduates in the group clearly considering POC (p=0.044) and a higher rate of singles indicating an intent to POC. A total of 546 (59.7%) women planned to have children in the future; the participants considered the age of 39.37 (±5.01) as "old" for pregnancy; 748 (81.7%) of the participants thought that the information about age-related fertility decline and POC should be a part of the annual gynecological examination. The level of knowledge about family planning/postponing fertility and POC between the two groups showed that the group considering POC provided significantly more accurate responses to seven items (5th, 6th, 7th, 10th, 11th, 14th, and 17th questions). The group not considering POC answered correctly, "What is the rate of spontaneous female conception?" (p=0.047). Conclusion: The target population expected to benefit from POC in our country had low knowledge and awareness of age-related fertility decline and POC. Most women expected the information to be a part of the annual gynecological examination. The main determinants of the knowledge score and considering POC are education level and relationship status.

Objectives: To determine the effectiveness of perineal massage during the second stage of labour in preventing perineal trauma in nulliparous women. Methods: A randomized control trial involving 104 nulliparous women undergoing vaginal delivery. The participants were randomised into two arms (intervention-group 'A' and control-group 'B') in a 1:1 ratio. The intervention group had perineal massage and routine hands-on technique according to the hospital protocol while the control group received only hands-on technique. The primary outcome measure was the incidence of perineal tears during vaginal delivery, while the secondary outcome measures were the incidence of episiotomy during vaginal delivery, the mean duration of second stage of labour, and perineal pain score. Results: The baseline socio-demographic and maternal characteristics of the participants were similar in both arms. The incidence of perineal lacerations in the intervention group (massage group) was significantly lower than in the control group (27 (54%) vs. 40 (81.6%); p=0.003). Although the incidence of episiotomy (26% vs. 44.9%; RR = 0.66; 95% CI = 0.50-0.88; p=0.060) was not significantly different, mean perineal pain score at 4 h postpartum (4.3 ± 0.3 vs. 6.1 ± 0.50; p=0.03), mean perineal pain score at 24 h postpartum (2.2 ± 0.1 vs. 4.2 ± 0.3; p=0.02), and mean duration of second stage of labour (83.1 ± 17.5 min vs. 94.2 ± 18.9 min; p=0.002) were significantly lower in the intervention-group. There was no significant difference in the neonatal outcomes (head circumference, birth weight, and Apgar scores: p > 0.05) between the two groups. Conclusion: Intrapartum perineal massage significantly decreases the risk of overall perineal trauma, perineal pain, and duration of the second stage of labour among nulliparous parturients during the second stage of labour. Nulliparous women should be counselled on the potential benefits of intrapartum perineal massage, and obstetricians are encouraged to provide the technique to consenting women. Trial Registration: Pan African Clinical Trial Registry (PACTR): PACTR 202207835155214.

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.