首页 > 最新文献

Obstetrics and Gynecology International最新文献

英文 中文
Still No Substantial Evidence to Use Prophylactic Antibiotic at Operative Vaginal Delivery: Systematic Review and Meta-Analysis. 仍然没有实质性的证据表明在阴道手术分娩中使用预防性抗生素:系统回顾和荟萃分析。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-05-19 eCollection Date: 2020-01-01 DOI: 10.1155/2020/1582653
Yifru Berhan, Sisay Kirba, Achamyelesh Gebre

Background: Postpartum maternal infection is still a common problem worldwide, mainly due to obstetric risk factors. The use of prophylactic antibiotic at operative vaginal delivery (OVD), taking it as a standalone risk factor, has been controversial. The purpose of this review was to rigorously evaluate the association of OVD with postpartum infection and shed light on such highly controversial issue.

Methods: A computer-based literature search was done mainly in the databases of PUBMED, HINARI health research, and the Cochrane library. Systematic review and meta-analysis were done by including 14 articles published between 1990 and August 2019.

Results: The average absolute risk of postpartum infection at OVD from seven large cohort studies was 1%. Few studies showed a weak association of OVD with postpartum infection without being adjusted to perineal wound, but the pooled meta-analysis showed statistically significant association with non-OVD. In the included randomized trial, 97% of the study participants had perineal wound for whom repairs were performed; the risks of maternal infection and perineal wound breakdown were comparable, and maternal infections other than perineal wound infection did not show significant difference between prophylactic antibiotic and placebo groups. The majority of included studies demonstrated a strong association of postpartum infection and perineal wound dehiscence with episiotomy and perineal tear.

Conclusion: Both the relative and absolute risks of postpartum infection at OVD are extremely low unless accompanied by episiotomy and 3rd/4tht degree perineal tear. From previous studies, there is no substantial evidence to use prophylactic antibiotic at OVD, but episiotomy and perineal tear.

背景:产妇产后感染仍是世界范围内的一个常见问题,主要是由产科危险因素引起的。在阴道手术分娩(OVD)中使用预防性抗生素,将其作为一个独立的风险因素,一直存在争议。本综述的目的是严格评估OVD与产后感染的关系,并阐明这一备受争议的问题。方法:计算机检索文献,主要检索PUBMED、HINARI健康研究数据库和Cochrane图书馆。对1990年至2019年8月期间发表的14篇文章进行了系统回顾和荟萃分析。结果:七项大型队列研究中,OVD产后感染的平均绝对风险为1%。很少有研究显示OVD与产后感染的相关性较弱,而没有调整到会阴伤口,但汇总meta分析显示OVD与非OVD的相关性具有统计学意义。在纳入的随机试验中,97%的研究参与者有会阴伤口并进行了修复;母体感染和会阴创面破裂的风险具有可比性,预防性抗生素组和安慰剂组之间除会阴创面感染外的母体感染无显著差异。大多数纳入的研究表明,会阴切开术和会阴撕裂与产后感染和会阴伤口裂开密切相关。结论:除非伴有会阴切开术和会阴3 /4度撕裂术,否则OVD患者发生产后感染的相对和绝对风险极低。从以往的研究来看,没有充分的证据表明OVD可以预防性使用抗生素,但会阴切开和会阴撕裂除外。
{"title":"Still No Substantial Evidence to Use Prophylactic Antibiotic at Operative Vaginal Delivery: Systematic Review and Meta-Analysis.","authors":"Yifru Berhan,&nbsp;Sisay Kirba,&nbsp;Achamyelesh Gebre","doi":"10.1155/2020/1582653","DOIUrl":"https://doi.org/10.1155/2020/1582653","url":null,"abstract":"<p><strong>Background: </strong>Postpartum maternal infection is still a common problem worldwide, mainly due to obstetric risk factors. The use of prophylactic antibiotic at operative vaginal delivery (OVD), taking it as a standalone risk factor, has been controversial. The purpose of this review was to rigorously evaluate the association of OVD with postpartum infection and shed light on such highly controversial issue.</p><p><strong>Methods: </strong>A computer-based literature search was done mainly in the databases of PUBMED, HINARI health research, and the Cochrane library. Systematic review and meta-analysis were done by including 14 articles published between 1990 and August 2019.</p><p><strong>Results: </strong>The average absolute risk of postpartum infection at OVD from seven large cohort studies was 1%. Few studies showed a weak association of OVD with postpartum infection without being adjusted to perineal wound, but the pooled meta-analysis showed statistically significant association with non-OVD. In the included randomized trial, 97% of the study participants had perineal wound for whom repairs were performed; the risks of maternal infection and perineal wound breakdown were comparable, and maternal infections other than perineal wound infection did not show significant difference between prophylactic antibiotic and placebo groups. The majority of included studies demonstrated a strong association of postpartum infection and perineal wound dehiscence with episiotomy and perineal tear.</p><p><strong>Conclusion: </strong>Both the relative and absolute risks of postpartum infection at OVD are extremely low unless accompanied by episiotomy and 3<sup>rd</sup>/4<sup>th</sup>t degree perineal tear. From previous studies, there is no substantial evidence to use prophylactic antibiotic at OVD, but episiotomy and perineal tear.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"1582653"},"PeriodicalIF":1.9,"publicationDate":"2020-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1582653","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38384361","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: 2
Risk Factors for Obstetric Anal Sphincter Injuries among Women Delivering at a Tertiary Hospital in Southwestern Uganda. 在乌干达西南部一家三级医院分娩的妇女产科肛门括约肌损伤的危险因素。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-05-14 eCollection Date: 2020-01-01 DOI: 10.1155/2020/6035974
Mahad Ali, Richard Migisha, Joseph Ngonzi, Joy Muhumuza, Ronald Mayanja, Jolly Joe Lapat, Wasswa Salongo, Musa Kayondo

Background: Obstetric anal sphincter injuries (OASIS) arise from perineal trauma during vaginal delivery and are associated with poor maternal health outcomes. Most OASIS occur in unattended deliveries in resource-limited settings. However, even in facilities where deliveries are attended by skilled personnel, a number of women still get OASIS.

Objectives: To determine the incidence and risk factors for obstetric anal sphincter injuries among women delivering at Mbarara Regional Referral Hospital (MRRH).

Methods: We conducted an unmatched hospital-based case control study, with the ratio of cases to controls of 1 : 2 (80 cases and 160 controls). We defined a case as a mother who got a third- or fourth-degree perineal tear after vaginal delivery while the controls recruited were the next two mothers who delivered vaginally without a third- or fourth-degree perineal tear. A questionnaire and participants' medical records review were used to obtain sociodemographic and clinical data. We estimated the incidence of OASIS and performed univariable and multivariable logistic regression to identify the associated risk factors.

Results: The cumulative incidence for OASIS during the study period was 6.6%. The risk factors for OASIS were 2nd stage of labour ≥1 hour (aOR 6.07, 95%CI 1.86-19.82, p=0.003), having episiotomy performed during labour (aOR 2.57, 95%CI 1.07-6.17, p=0.035), perineum support during delivery (aOR 0.03, 95%CI 0.01-0.12, p < 0.001), and monthly income of >50,000 shillings (aOR 0.09, 95%CI 0.03-0.28, p < 0.001). Conclusions and Recommendations. The risk factors for obstetric anal sphincter injury were prolonged second stage of labour and performing episiotomies during deliveries while higher monthly income and perineum support during delivery were protective. We recommend routine support to the perineum during delivery. Care should be taken in mothers with episiotomies, as they can extend and cause OASIS.

背景:产科肛门括约肌损伤(OASIS)是由阴道分娩时会阴创伤引起的,与孕产妇健康状况不佳有关。大多数绿洲发生在资源有限的环境中无人值守的分娩。然而,即使在由熟练人员接生的设施中,仍有一些妇女获得OASIS。目的:确定在姆巴拉拉地区转诊医院(MRRH)分娩的妇女产科肛门括约肌损伤的发生率和危险因素。方法:我们进行了一项无与伦比的基于医院的病例对照研究,病例与对照的比例为1:2(80例病例和160例对照)。我们将一个病例定义为阴道分娩后出现三度或四度会阴撕裂的母亲,而招募的对照组是接下来的两个阴道分娩时没有三度或四度会阴撕裂的母亲。使用问卷调查和参与者的医疗记录审查来获得社会人口学和临床数据。我们估计了OASIS的发病率,并进行了单变量和多变量logistic回归来确定相关的危险因素。结果:研究期间OASIS的累计发病率为6.6%。发生OASIS的危险因素为产程第2期≥1小时(aOR 6.07, 95%CI 1.86 ~ 19.82, p=0.003)、产程进行会阴切开术(aOR 2.57, 95%CI 1.07 ~ 6.17, p=0.035)、分娩时会阴支撑(aOR 0.03, 95%CI 0.01 ~ 0.12, p < 0.001)、月收入>5万先令(aOR 0.09, 95%CI 0.03 ~ 0.28, p < 0.001)。结论和建议。产科肛门括约肌损伤的危险因素是第二产程延长和分娩时进行外阴切开术,而较高的月收入和分娩时对会阴的支持是保护性的。我们建议在分娩期间对会阴进行常规支持。外阴切开术的母亲应该小心,因为它们可以延长和引起OASIS。
{"title":"Risk Factors for Obstetric Anal Sphincter Injuries among Women Delivering at a Tertiary Hospital in Southwestern Uganda.","authors":"Mahad Ali,&nbsp;Richard Migisha,&nbsp;Joseph Ngonzi,&nbsp;Joy Muhumuza,&nbsp;Ronald Mayanja,&nbsp;Jolly Joe Lapat,&nbsp;Wasswa Salongo,&nbsp;Musa Kayondo","doi":"10.1155/2020/6035974","DOIUrl":"https://doi.org/10.1155/2020/6035974","url":null,"abstract":"<p><strong>Background: </strong>Obstetric anal sphincter injuries (OASIS) arise from perineal trauma during vaginal delivery and are associated with poor maternal health outcomes. Most OASIS occur in unattended deliveries in resource-limited settings. However, even in facilities where deliveries are attended by skilled personnel, a number of women still get OASIS.</p><p><strong>Objectives: </strong>To determine the incidence and risk factors for obstetric anal sphincter injuries among women delivering at Mbarara Regional Referral Hospital (MRRH).</p><p><strong>Methods: </strong>We conducted an unmatched hospital-based case control study, with the ratio of cases to controls of 1 : 2 (80 cases and 160 controls). We defined a case as a mother who got a third- or fourth-degree perineal tear after vaginal delivery while the controls recruited were the next two mothers who delivered vaginally without a third- or fourth-degree perineal tear. A questionnaire and participants' medical records review were used to obtain sociodemographic and clinical data. We estimated the incidence of OASIS and performed univariable and multivariable logistic regression to identify the associated risk factors.</p><p><strong>Results: </strong>The cumulative incidence for OASIS during the study period was 6.6%. The risk factors for OASIS were 2<sup>nd</sup> stage of labour ≥1 hour (aOR 6.07, 95%CI 1.86-19.82, <i>p</i>=0.003), having episiotomy performed during labour (aOR 2.57, 95%CI 1.07-6.17, <i>p</i>=0.035), perineum support during delivery (aOR 0.03, 95%CI 0.01-0.12, <i>p</i> < 0.001), and monthly income of >50,000 shillings (aOR 0.09, 95%CI 0.03-0.28, <i>p</i> < 0.001). <i>Conclusions and Recommendations</i>. The risk factors for obstetric anal sphincter injury were prolonged second stage of labour and performing episiotomies during deliveries while higher monthly income and perineum support during delivery were protective. We recommend routine support to the perineum during delivery. Care should be taken in mothers with episiotomies, as they can extend and cause OASIS.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"6035974"},"PeriodicalIF":1.9,"publicationDate":"2020-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6035974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38021476","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: 6
Prevalence of Preterm Premature Rupture of Membrane and Its Associated Factors among Pregnant Women Admitted in Debre Tabor General Hospital, North West Ethiopia: Institutional-Based Cross-Sectional Study. 埃塞俄比亚西北部Debre Tabor综合医院住院孕妇的胎膜早破患病率及其相关因素:基于机构的横断面研究
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-05-14 eCollection Date: 2020-01-01 DOI: 10.1155/2020/4034680
Dagne Addisu, Abenezer Melkie, Shimeles Biru

Background: In Ethiopia, preterm premature rupture of membrane is defined as loss of amniotic fluid before the onset of labor in pregnancy >28 weeks of gestation but before 37 weeks. It is a significant cause of perinatal, neonatal, and maternal morbidity and mortality both in high- and low-income countries. Due to different factors associated with the quality of health care given and socioeconomic factors, the effect of preterm premature rupture of membrane is worsen in low-income countries. Little evidence is available about the problem in the study area. Therefore, this study was aimed to determine the prevalence of preterm premature rupture of membrane and its associated factors among pregnant women admitted in Debre Tabor General Hospital.

Methods: Facility-based cross-sectional study was conducted. A total of 424 mothers were included in the study. Systematic random sampling was used to select study participants. A combination of chart review and interview was used to collect the data. Both descriptive and analytical statistics were computed.

Result: The prevalence of preterm premature rupture of membrane was found to be 13.7%. Pregnant women with abnormal vaginal discharge (AOR = 5.30, 95% CI  = 2.07-13.52), urinary tract infection (AOR = 2.62, 95% CI = 1.32-5.19), history of premature rupture of membrane (AOR = 3.31, 95% CI = 1.32-8.27), vaginal bleeding (AOR = 2.58, 95% CI = 1.14-5.82), and mid-upper arm circumference <23 cm (AOR = 6.26, 95% CI = 3.21-12.20) were associated with preterm premature rupture of membrane.

Conclusions: The prevalence of preterm premature rupture of membrane was high. Abnormal vaginal discharge, urinary tract infection, vaginal bleeding, previous premature rupture of membrane, and mid-upper arm circumference <23 cm were associated with preterm premature rupture of membrane. Thus, early screening and treatment of urinary tract infections and abnormal vaginal discharges were recommended to reduce the risk of preterm premature rupture of membrane.

背景:在埃塞俄比亚,胎膜早破被定义为妊娠>28周至37周前分娩前羊水流失。它是高收入和低收入国家围产期、新生儿和孕产妇发病率和死亡率的一个重要原因。由于与医疗质量和社会经济因素相关的不同因素,低收入国家的早产胎膜早破的影响更严重。在研究地区,关于这个问题的证据很少。因此,本研究旨在确定在Debre Tabor总医院住院的孕妇中早产胎膜早破的患病率及其相关因素。方法:采用以医院为基础的横断面研究。共有424位母亲参与了这项研究。采用系统随机抽样的方法选择研究对象。采用图表回顾和访谈相结合的方法收集数据。计算描述性统计和分析性统计。结果:早产胎膜早破的发生率为13.7%。阴道分泌物异常(AOR = 5.30, 95% CI = 2.07-13.52)、尿路感染(AOR = 2.62, 95% CI = 1.32-5.19)、有膜早破史(AOR = 3.31, 95% CI = 1.32-8.27)、阴道出血(AOR = 2.58, 95% CI = 1.14-5.82)、上臂中围的孕妇结论:早产膜早破发生率较高。阴道分泌物异常,尿路感染,阴道出血,既往膜早破,上臂中围
{"title":"Prevalence of Preterm Premature Rupture of Membrane and Its Associated Factors among Pregnant Women Admitted in Debre Tabor General Hospital, North West Ethiopia: Institutional-Based Cross-Sectional Study.","authors":"Dagne Addisu,&nbsp;Abenezer Melkie,&nbsp;Shimeles Biru","doi":"10.1155/2020/4034680","DOIUrl":"https://doi.org/10.1155/2020/4034680","url":null,"abstract":"<p><strong>Background: </strong>In Ethiopia, preterm premature rupture of membrane is defined as loss of amniotic fluid before the onset of labor in pregnancy >28 weeks of gestation but before 37 weeks. It is a significant cause of perinatal, neonatal, and maternal morbidity and mortality both in high- and low-income countries. Due to different factors associated with the quality of health care given and socioeconomic factors, the effect of preterm premature rupture of membrane is worsen in low-income countries. Little evidence is available about the problem in the study area. Therefore, this study was aimed to determine the prevalence of preterm premature rupture of membrane and its associated factors among pregnant women admitted in Debre Tabor General Hospital.</p><p><strong>Methods: </strong>Facility-based cross-sectional study was conducted. A total of 424 mothers were included in the study. Systematic random sampling was used to select study participants. A combination of chart review and interview was used to collect the data. Both descriptive and analytical statistics were computed.</p><p><strong>Result: </strong>The prevalence of preterm premature rupture of membrane was found to be 13.7%. Pregnant women with abnormal vaginal discharge (AOR = 5.30, 95% CI  = 2.07-13.52), urinary tract infection (AOR = 2.62, 95% CI = 1.32-5.19), history of premature rupture of membrane (AOR = 3.31, 95% CI = 1.32-8.27), vaginal bleeding (AOR = 2.58, 95% CI = 1.14-5.82), and mid-upper arm circumference <23 cm (AOR = 6.26, 95% CI = 3.21-12.20) were associated with preterm premature rupture of membrane.</p><p><strong>Conclusions: </strong>The prevalence of preterm premature rupture of membrane was high. Abnormal vaginal discharge, urinary tract infection, vaginal bleeding, previous premature rupture of membrane, and mid-upper arm circumference <23 cm were associated with preterm premature rupture of membrane. Thus, early screening and treatment of urinary tract infections and abnormal vaginal discharges were recommended to reduce the risk of preterm premature rupture of membrane.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"4034680"},"PeriodicalIF":1.9,"publicationDate":"2020-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4034680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38021475","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: 23
Etiology, Clinical Features, and Diagnosis of Vulvar Lichen Sclerosus: A Scoping Review. 外阴硬化苔藓的病因、临床特征和诊断:综述。
IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-04-21 eCollection Date: 2020-01-01 DOI: 10.1155/2020/7480754
Nilanchali Singh, Prafull Ghatage

Objective. Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. With numerous controversies as regards to the nomenclature, diagnosis and its association with neoplastic conditions, we decided to conduct a scoping review on this subject. Data Source. A review protocol was developed, and the Knowledge Resource Services website was used to do a search of articles pertaining to VLS with keywords "Vulvar," "Vulval," "diagnosis," "lichen sclerosus et atrophicus," "kraurosis," "vulvar dystrophy," and "Lichen Sclerosus". Study Selection. The search was limited to published data from the last ten years, i.e., from July 2009 onwards and in the English language. A total of 338 articles pertaining to VLS were obtained. Older data were accessed if particular information was sought for. Results & Conclusion. The presentation is bimodal, i.e., one in prepubertal girls (average age: 7.6 years) and the other in peri- and postmenopausal women (average age: 52.6 years). However, many cases also present during reproductive years. Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal, and local infectious background. It affects the genital labial, perineal, and perianal areas and manifests as a patchy, thin, glistening, ivory-white area. Diagnosis is mainly based on clinical features. Biopsy is seldom required. It has been well established as a precursor lesion of dVIN and vulvar carcinoma.

目标。外阴硬化苔藓(VLS)是一种慢性炎症性疾病,影响所有年龄段的女性。由于在命名、诊断及其与肿瘤条件的关系方面存在许多争议,我们决定对这一主题进行范围审查。数据源。制定了一项审查方案,并使用知识资源服务网站搜索与VLS相关的文章,关键词为“外阴”、“外阴”、“诊断”、“硬化性地衣和萎缩性地衣”、“黑痣”、“外阴营养不良”和“硬化性地衣”。研究选择。搜索仅限于最近十年,即从2009年7月起的英文出版数据。共获得338件与VLS有关的物品。如果需要查找特定信息,则访问旧数据。结果与结论。这种表现是双峰的,即一种发生在青春期前的女孩(平均年龄:7.6岁),另一种发生在绝经期和绝经后的妇女(平均年龄:52.6岁)。然而,许多病例也出现在生育年龄。研究表明病因是多因素的,包括遗传、自身免疫、激素和局部感染背景。它影响生殖器的阴唇,会阴和肛周区域,表现为斑驳,薄,闪闪发光,象牙白色的区域。诊断主要依据临床特征。很少需要活检。它已被确定为dVIN和外阴癌的前兆病变。
{"title":"Etiology, Clinical Features, and Diagnosis of Vulvar Lichen Sclerosus: A Scoping Review.","authors":"Nilanchali Singh, Prafull Ghatage","doi":"10.1155/2020/7480754","DOIUrl":"10.1155/2020/7480754","url":null,"abstract":"<p><p><i>Objective</i>. Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. With numerous controversies as regards to the nomenclature, diagnosis and its association with neoplastic conditions, we decided to conduct a scoping review on this subject. <i>Data Source</i>. A review protocol was developed, and the Knowledge Resource Services website was used to do a search of articles pertaining to VLS with keywords \"Vulvar,\" \"Vulval,\" \"diagnosis,\" \"lichen sclerosus et atrophicus,\" \"kraurosis,\" \"vulvar dystrophy,\" and \"Lichen Sclerosus\". <i>Study Selection</i>. The search was limited to published data from the last ten years, i.e., from July 2009 onwards and in the English language. A total of 338 articles pertaining to VLS were obtained. Older data were accessed if particular information was sought for. <i>Results & Conclusion</i>. The presentation is bimodal, i.e., one in prepubertal girls (average age: 7.6 years) and the other in peri- and postmenopausal women (average age: 52.6 years). However, many cases also present during reproductive years. Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal, and local infectious background. It affects the genital labial, perineal, and perianal areas and manifests as a patchy, thin, glistening, ivory-white area. Diagnosis is mainly based on clinical features. Biopsy is seldom required. It has been well established as a precursor lesion of dVIN and vulvar carcinoma.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"7480754"},"PeriodicalIF":1.6,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37904596","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
Determinants of Cesarean Section Deliveries in Public Hospitals of Addis Ababa, Ethiopia, 2018/19: A Case-Control Study. 2018/19年埃塞俄比亚亚的斯亚贝巴公立医院剖宫产的决定因素:一项病例对照研究
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-04-20 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9018747
Areaya Gebreegziabher Hailu, Tsegaye Kebede Fanta, Fissaha Tekulu Welay, Natnael Etsay Assefa, Surafel Aregawi Hadera, Gebrekiros Aregawi Gebremeskel, Hagos Weldeslassie Gebremedhin, Guesh Gebreayezgi Asefa

Objective: The objective of this study was to assess the determinants of cesarean section deliveries in public hospitals of Addis Ababa, Ethiopia, 2019.

Method: A hospital-based unmatched case-control study was conducted to study 780 (260 cases and 520 controls) women who delivered in public hospitals of Addis Ababa from August 22 to September 20, 2019. The cases were all mothers who delivered through caesarean section, and controls were all mothers who delivered vaginally in the same time in the study area. Data were collected from the randomly selected women and looking into their cards. Data were entered on EpiData 3.1 and exported to SPSS version 20 for cleaning and analyzing. Binary logistic regression and AOR with 95% CI were used to assess the determinants of caesarean section.

Results: Majority of the study participants were in the age category 20-34 years. Nearly more than 1/3rd of the participants (32.7% cases and 34.6% controls) have attended primary school. Most of the cases 217 (83.5%) and few of the controls 21 (4%) possess previous caesarean section. One hundred three (52.3%) of the cases and 329 (63.6%) controls were multi-parous. Previous caesarean delivery (AOR = 6.93, 95% CI; (3.39, 14.16)), singleton pregnancy (AOR = 0.34, 95% CI; (0.12, 0.83)), birth weight less than 2500 gm (AOR = 0.29, 95% CI; (0.18, 0.92)), birth weight greater than 4000 gm (AOR = 16.15 (8.22, 31.74)), completely documented partograph (AOR = 0.13, 95% CI; (0.078, 0.23)), and pregnancy-induced hypertension (AOR = 2.44, 95% CI; (1.46, 4.08)) were significant determinants of caesarean delivery in this study.

Conclusion: Previous caesarean section, number of delivery, birth weight, partograph documentation, and pregnancy-induced hypertension had significant association with caesarean section delivery in this study.

目的:本研究的目的是评估2019年埃塞俄比亚亚的斯亚贝巴公立医院剖宫产的决定因素。方法:对2019年8月22日至9月20日在亚的斯亚贝巴公立医院分娩的孕产妇780例(病例260例,对照组520例)进行非匹配病例对照研究。这些病例都是通过剖腹产分娩的母亲,对照组都是在研究区域内同一时间顺产的母亲。研究人员从随机选择的女性中收集数据,并查看她们的卡片。数据在EpiData 3.1上输入,导出到SPSS version 20进行清理和分析。采用二元logistic回归和AOR (95% CI)评估剖腹产的决定因素。结果:大多数研究参与者的年龄在20-34岁之间。近三分之一以上的参与者(32.7%的病例和34.6%的对照组)上过小学。大多数病例217例(83.5%)和少数对照组21例(4%)有过剖宫产史。其中103例(52.3%)为多胎,对照组329例(63.6%)为多胎。既往剖宫产(AOR = 6.93, 95% CI;(3.39, 14.16))、单胎妊娠(AOR = 0.34, 95% CI;(0.12, 0.83)),出生体重小于2500克(AOR = 0.29, 95% CI;(0.18, 0.92)),出生体重大于4000克(AOR = 16.15(8.22, 31.74)),完整记录的分娩(AOR = 0.13, 95% CI;(0.078, 0.23))和妊娠高血压(AOR = 2.44, 95% CI;(1.46, 4.08))是本研究中剖腹产的重要决定因素。结论:本研究中,既往剖宫产、分娩次数、出生体重、产程记录和妊娠高血压与剖宫产有显著相关性。
{"title":"Determinants of Cesarean Section Deliveries in Public Hospitals of Addis Ababa, Ethiopia, 2018/19: A Case-Control Study.","authors":"Areaya Gebreegziabher Hailu,&nbsp;Tsegaye Kebede Fanta,&nbsp;Fissaha Tekulu Welay,&nbsp;Natnael Etsay Assefa,&nbsp;Surafel Aregawi Hadera,&nbsp;Gebrekiros Aregawi Gebremeskel,&nbsp;Hagos Weldeslassie Gebremedhin,&nbsp;Guesh Gebreayezgi Asefa","doi":"10.1155/2020/9018747","DOIUrl":"https://doi.org/10.1155/2020/9018747","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to assess the determinants of cesarean section deliveries in public hospitals of Addis Ababa, Ethiopia, 2019.</p><p><strong>Method: </strong>A hospital-based unmatched case-control study was conducted to study 780 (260 cases and 520 controls) women who delivered in public hospitals of Addis Ababa from August 22 to September 20, 2019. The cases were all mothers who delivered through caesarean section, and controls were all mothers who delivered vaginally in the same time in the study area. Data were collected from the randomly selected women and looking into their cards. Data were entered on EpiData 3.1 and exported to SPSS version 20 for cleaning and analyzing. Binary logistic regression and AOR with 95% CI were used to assess the determinants of caesarean section.</p><p><strong>Results: </strong>Majority of the study participants were in the age category 20-34 years. Nearly more than 1/3<sup>rd</sup> of the participants (32.7% cases and 34.6% controls) have attended primary school. Most of the cases 217 (83.5%) and few of the controls 21 (4%) possess previous caesarean section. One hundred three (52.3%) of the cases and 329 (63.6%) controls were multi-parous. Previous caesarean delivery (AOR = 6.93, 95% CI; (3.39, 14.16)), singleton pregnancy (AOR = 0.34, 95% CI; (0.12, 0.83)), birth weight less than 2500 gm (AOR = 0.29, 95% CI; (0.18, 0.92)), birth weight greater than 4000 gm (AOR = 16.15 (8.22, 31.74)), completely documented partograph (AOR = 0.13, 95% CI; (0.078, 0.23)), and pregnancy-induced hypertension (AOR = 2.44, 95% CI; (1.46, 4.08)) were significant determinants of caesarean delivery in this study.</p><p><strong>Conclusion: </strong>Previous caesarean section, number of delivery, birth weight, partograph documentation, and pregnancy-induced hypertension had significant association with caesarean section delivery in this study.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"9018747"},"PeriodicalIF":1.9,"publicationDate":"2020-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9018747","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37904597","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: 13
Incidence and Predictors of Maternal and Perinatal Mortality among Women with Severe Maternal Outcomes: A Tanzanian Facility-Based Survey for Improving Maternal and Newborn Care. 严重孕产妇结局妇女的孕产妇和围产期死亡率发病率和预测因素:坦桑尼亚一项改善孕产妇和新生儿护理的基于设施的调查。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-04-10 eCollection Date: 2020-01-01 DOI: 10.1155/2020/5390903
Athanase Lilungulu, Deogratius Bintabara, Simon Mujungu, Enid Chiwanga, Paulo Chetto, Mzee Nassoro

Introduction: Maternal and perinatal mortality is still a major public health challenge in Tanzania, despite the ongoing government efforts to improve maternal and newborn care. Among the contributors to these problems is the high magnitude of severe maternal outcomes (maternal near-miss). The current study, therefore, aimed to identify the magnitude and predictors of maternal and perinatal mortality among women with severe maternal outcomes admitted to Dodoma Regional Referral Hospital.

Methods: A retrospective cross-sectional study was conducted from October 2015 to January 2016 at Dodoma Regional Referral Hospital in Dodoma City. All maternal deaths and maternal near-misses based on WHO criteria were included in this study. Three outcome variables have been identified: maternal mortality, perinatal mortality, and neonatal complications. To examine the predictors for the three predetermined outcome variables, the three logit models each containing unadjusted and adjusted findings were fitted. A P-value less than 0.05 was considered indicative of statistically significant.

Results: A total of 3600 pregnant women were admitted for obstetric reasons during the mentioned period. 140 of them were diagnosed with severe maternal outcomes; hence, they were included in this study. The severe maternal outcome incidence ratio was 40.23 per 1000 live births, the institutional maternal mortality ratio was 459.77 per 100000 live births, and the perinatal mortality rate was 10.83 per 1000 total births. Most of the maternal morbidity and mortality were due to direct causes in which postpartum hemorrhage and hypertensive disorders were the leading causes. In adjusted analysis, per-protocol management, maternal age, and mode of birth were predictors of maternal mortality, perinatal mortality, and neonatal complications, respectively.

Conclusion: Establishing and strengthening obstetric ICUs will help reduce maternal mortality as the response time from the onset of obstetric complications, while the provision of high-quality care will be substantially reduced. Furthermore, the study recommends regular provision of in-service refresher training to emphasize the practice and compliance of per-protocol case management through a team approach in order to reduce the burden of maternal and perinatal mortality in Tanzania.

导言:在坦桑尼亚,尽管政府正在努力改善孕产妇和新生儿护理,但孕产妇和围产期死亡率仍然是一个重大的公共卫生挑战。造成这些问题的原因之一是严重的产妇结局(产妇未遂)。因此,目前的研究旨在确定Dodoma地区转诊医院收治的孕产妇严重结局妇女的孕产妇和围产期死亡率的幅度和预测因素。方法:2015年10月至2016年1月在Dodoma市Dodoma地区转诊医院进行回顾性横断面研究。基于世卫组织标准的所有孕产妇死亡和孕产妇未遂死亡均纳入本研究。已经确定了三个结果变量:孕产妇死亡率、围产期死亡率和新生儿并发症。为了检验三个预定结果变量的预测因子,拟合了三个logit模型,每个模型都包含未调整和调整的结果。p值小于0.05被认为具有统计学意义。结果:在此期间因产科原因住院的孕妇共3600例。其中140人被诊断患有严重的产妇结局;因此,他们被纳入本研究。严重孕产妇结局发生率为每1000例活产40.23例,机构孕产妇死亡率为每10万例活产459.77例,围产期死亡率为每1000例活产10.83例。大多数产妇的发病和死亡是直接原因,其中产后出血和高血压疾病是主要原因。在调整分析中,按方案管理、产妇年龄和出生方式分别是产妇死亡率、围产期死亡率和新生儿并发症的预测因子。结论:建立和加强产科icu将有助于降低孕产妇死亡率,因为从产科并发症开始的反应时间将大大缩短,同时提供高质量的护理将大大减少。此外,研究报告还建议定期提供在职进修培训,强调通过小组方式实行和遵守按协议进行的病例管理,以减轻坦桑尼亚孕产妇和围产期死亡率的负担。
{"title":"Incidence and Predictors of Maternal and Perinatal Mortality among Women with Severe Maternal Outcomes: A Tanzanian Facility-Based Survey for Improving Maternal and Newborn Care.","authors":"Athanase Lilungulu,&nbsp;Deogratius Bintabara,&nbsp;Simon Mujungu,&nbsp;Enid Chiwanga,&nbsp;Paulo Chetto,&nbsp;Mzee Nassoro","doi":"10.1155/2020/5390903","DOIUrl":"https://doi.org/10.1155/2020/5390903","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal and perinatal mortality is still a major public health challenge in Tanzania, despite the ongoing government efforts to improve maternal and newborn care. Among the contributors to these problems is the high magnitude of severe maternal outcomes (maternal near-miss). The current study, therefore, aimed to identify the magnitude and predictors of maternal and perinatal mortality among women with severe maternal outcomes admitted to Dodoma Regional Referral Hospital.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted from October 2015 to January 2016 at Dodoma Regional Referral Hospital in Dodoma City. All maternal deaths and maternal near-misses based on WHO criteria were included in this study. Three outcome variables have been identified: maternal mortality, perinatal mortality, and neonatal complications. To examine the predictors for the three predetermined outcome variables, the three logit models each containing unadjusted and adjusted findings were fitted. A <i>P</i>-value less than 0.05 was considered indicative of statistically significant.</p><p><strong>Results: </strong>A total of 3600 pregnant women were admitted for obstetric reasons during the mentioned period. 140 of them were diagnosed with severe maternal outcomes; hence, they were included in this study. The severe maternal outcome incidence ratio was 40.23 per 1000 live births, the institutional maternal mortality ratio was 459.77 per 100000 live births, and the perinatal mortality rate was 10.83 per 1000 total births. Most of the maternal morbidity and mortality were due to direct causes in which postpartum hemorrhage and hypertensive disorders were the leading causes. In adjusted analysis, per-protocol management, maternal age, and mode of birth were predictors of maternal mortality, perinatal mortality, and neonatal complications, respectively.</p><p><strong>Conclusion: </strong>Establishing and strengthening obstetric ICUs will help reduce maternal mortality as the response time from the onset of obstetric complications, while the provision of high-quality care will be substantially reduced. Furthermore, the study recommends regular provision of in-service refresher training to emphasize the practice and compliance of per-protocol case management through a team approach in order to reduce the burden of maternal and perinatal mortality in Tanzania.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"5390903"},"PeriodicalIF":1.9,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5390903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37867029","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: 9
Comparative Retrospective Study of Tension-Free Vaginal Mesh Surgery, Native Tissue Repair, and Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse Repair. 无张力阴道补片手术、自体组织修复和腹腔镜骶髋固定术在盆腔器官脱垂修复中的回顾性比较研究。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-04-10 eCollection Date: 2020-01-01 DOI: 10.1155/2020/7367403
Haruhiko Kanasaki, Aki Oride, Tomomi Hara, Satoru Kyo

Methods: We identified that 308 women who had undergone surgical repair of POP were followed up for at least 6 months. Recurrence rates of POP after tension-free vaginal mesh (TVM) surgery (n = 243), native tissue repair (NTR) (vaginal hysterectomy with colpopexy, anterior and posterior colpoplasty, or circumferential suturing of the levator ani muscles and apical repair by transvaginal sacrospinous ligament fixation (SSLF)) (NTR; n = 31), and laparoscopic sacrocolpopexy after subtotal hysterectomy (LSC; n = 34) were compared. Presence of mesh erosion was also recorded.

Results: Patients who underwent LSC were significantly younger (65.32 ± 3.23 years) than those who underwent TVM surgery (69.61 ± 8.31 years). After TVM surgery, the rate of recurrence (over POP-Q stage II) was 6.17% (15/243) and was highest in patients with advanced POP. The recurrence rate in patients who underwent NTR procedure was 3.23% (1/34) and that in patients who underwent LSC was 11.76% (4/11). There was no statistically significant difference in the recurrence rate between the three types of surgery. There were 13 cases (5.35%) of mesh erosion after TVM surgery and none after LSC surgery. The risk of mesh erosion was correlated with having had total TVM surgery but not with patient age or POP stage. Repeat procedures were performed in 5 women (2.14%) who underwent TVM surgery and 1 (2.94%) who underwent LSC. No patient underwent repeat surgery after NTR. There was no statistically significant difference in the reoperation rate between the three types of surgery.

Conclusion: Our study suggested that TVM surgery, NTR, and LSC have comparable outcomes as for the postoperative recurrence rate and mesh erosion. However, the outcomes of each technique need to be carefully evaluated over a long period of time.

方法:我们对308例行POP手术修复的女性进行了至少6个月的随访。无张力阴道补片(TVM)手术(n = 243)、自然组织修复(NTR)(阴道子宫切除术合并阴道固定术、阴道前后成形术或提肛肌环缝合及经阴道骶棘韧带固定(SSLF)根尖修复)后POP的复发率(NTR;n = 31),子宫次全切除术(LSC;N = 34)进行比较。还记录了网格侵蚀的存在。结果:LSC组患者(65.32±3.23岁)明显低于TVM组(69.61±8.31岁)。TVM术后复发率(超过POP- q期)为6.17%(15/243),以晚期POP患者最高。NTR术后复发率为3.23% (1/34),LSC术后复发率为11.76%(4/11)。三种手术方式的复发率差异无统计学意义。TVM术后补片糜烂13例(5.35%),LSC术后无补片糜烂。补片糜烂的风险与全TVM手术相关,但与患者年龄或POP分期无关。接受TVM手术的5例(2.14%)和接受LSC手术的1例(2.94%)进行了重复手术。NTR后无患者再次手术。三种手术方式的再手术率差异无统计学意义。结论:我们的研究表明TVM手术、NTR和LSC在术后复发率和补片糜烂方面具有相当的结果。然而,每种技术的效果都需要经过长时间的仔细评估。
{"title":"Comparative Retrospective Study of Tension-Free Vaginal Mesh Surgery, Native Tissue Repair, and Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse Repair.","authors":"Haruhiko Kanasaki,&nbsp;Aki Oride,&nbsp;Tomomi Hara,&nbsp;Satoru Kyo","doi":"10.1155/2020/7367403","DOIUrl":"https://doi.org/10.1155/2020/7367403","url":null,"abstract":"<p><strong>Methods: </strong>We identified that 308 women who had undergone surgical repair of POP were followed up for at least 6 months. Recurrence rates of POP after tension-free vaginal mesh (TVM) surgery (<i>n</i> = 243), native tissue repair (NTR) (vaginal hysterectomy with colpopexy, anterior and posterior colpoplasty, or circumferential suturing of the levator ani muscles and apical repair by transvaginal sacrospinous ligament fixation (SSLF)) (NTR; <i>n</i> = 31), and laparoscopic sacrocolpopexy after subtotal hysterectomy (LSC; <i>n</i> = 34) were compared. Presence of mesh erosion was also recorded.</p><p><strong>Results: </strong>Patients who underwent LSC were significantly younger (65.32 ± 3.23 years) than those who underwent TVM surgery (69.61 ± 8.31 years). After TVM surgery, the rate of recurrence (over POP-Q stage II) was 6.17% (15/243) and was highest in patients with advanced POP. The recurrence rate in patients who underwent NTR procedure was 3.23% (1/34) and that in patients who underwent LSC was 11.76% (4/11). There was no statistically significant difference in the recurrence rate between the three types of surgery. There were 13 cases (5.35%) of mesh erosion after TVM surgery and none after LSC surgery. The risk of mesh erosion was correlated with having had total TVM surgery but not with patient age or POP stage. Repeat procedures were performed in 5 women (2.14%) who underwent TVM surgery and 1 (2.94%) who underwent LSC. No patient underwent repeat surgery after NTR. There was no statistically significant difference in the reoperation rate between the three types of surgery.</p><p><strong>Conclusion: </strong>Our study suggested that TVM surgery, NTR, and LSC have comparable outcomes as for the postoperative recurrence rate and mesh erosion. However, the outcomes of each technique need to be carefully evaluated over a long period of time.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"7367403"},"PeriodicalIF":1.9,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7367403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37867030","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: 2
Effects of Glycerol and Sodium Pentaborate Formulation on Prevention of Postoperative Peritoneal Adhesion Formation. 甘油和五硼酸钠制剂对预防术后腹膜粘连形成的影响。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-04-06 eCollection Date: 2020-01-01 DOI: 10.1155/2020/3679585
Erhan Aysan, Fikrettin Sahin, Ruzgar Catal, Mirkhaliq Javadov, Alev Cumbul

Background: Postoperative peritoneal adhesions (PPA) are a serious problem for abdominal surgery. An effective remedy has not been found yet. New formulation of glycerol and sodium pentaborate may be able to solve the problem.

Method: Female Wistar albino rats were randomly assigned into four equal groups. The adhesion model was created on the caecum anterior wall and covered with 2 ml 0.9% NaCl, 3% glycerol, 3% sodium pentaborate, and 3% glycerol plus 3% sodium pentaborate solutions in the groups, respectively. Two weeks later, the rats were sacrificed. PPA were graded macroscopically and microscopically.

Results: Total adhesion scores of the 3% glycerol + 3% sodium pentaborate group were statistically different from the other groups for macroscopic and also microscopic evaluations (p < 0.001).

Conclusion: 3% glycerol plus 3% sodium pentaborate as a new formulation has preventive effects on PPA with a synergistic mechanism.

背景:腹膜术后粘连(PPA)是腹膜外科手术的一个严重问题。目前还没有找到有效的补救办法。甘油和五硼酸钠的新配方也许能解决这个问题。方法:将雌性Wistar白化大鼠随机分为4组。在盲肠前壁建立粘连模型,各组分别用2 ml 0.9% NaCl、3%甘油、3%五硼酸钠、3%甘油+ 3%五硼酸钠溶液覆盖。两周后,这些老鼠被处死。对PPA进行宏观和微观分级。结果:3%甘油+ 3%五硼酸钠组的总黏附评分与其他组在宏观和微观评价上均有统计学差异(p < 0.001)。结论:3%甘油加3%五硼酸钠新剂型对PPA具有协同预防作用。
{"title":"Effects of Glycerol and Sodium Pentaborate Formulation on Prevention of Postoperative Peritoneal Adhesion Formation.","authors":"Erhan Aysan,&nbsp;Fikrettin Sahin,&nbsp;Ruzgar Catal,&nbsp;Mirkhaliq Javadov,&nbsp;Alev Cumbul","doi":"10.1155/2020/3679585","DOIUrl":"https://doi.org/10.1155/2020/3679585","url":null,"abstract":"<p><strong>Background: </strong>Postoperative peritoneal adhesions (PPA) are a serious problem for abdominal surgery. An effective remedy has not been found yet. New formulation of glycerol and sodium pentaborate may be able to solve the problem.</p><p><strong>Method: </strong>Female Wistar albino rats were randomly assigned into four equal groups. The adhesion model was created on the caecum anterior wall and covered with 2 ml 0.9% NaCl, 3% glycerol, 3% sodium pentaborate, and 3% glycerol plus 3% sodium pentaborate solutions in the groups, respectively. Two weeks later, the rats were sacrificed. PPA were graded macroscopically and microscopically.</p><p><strong>Results: </strong>Total adhesion scores of the 3% glycerol + 3% sodium pentaborate group were statistically different from the other groups for macroscopic and also microscopic evaluations (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>3% glycerol plus 3% sodium pentaborate as a new formulation has preventive effects on PPA with a synergistic mechanism.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"3679585"},"PeriodicalIF":1.9,"publicationDate":"2020-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3679585","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37857255","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: 2
Teenage Pregnancy: Obstetric and Perinatal Outcome in a Tertiary Centre in Indonesia. 青少年怀孕:印度尼西亚一家高等教育中心的产科和围产期结果。
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-03-26 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2787602
Junita Indarti, Adly Nanda Al Fattah, Zulfitri Dewi, Rachmat Dediat Kapnosa Hasani, Fitri Adinda Novianti Mahdi, Raymond Surya

Background: The incidence of teenage pregnancy is increasing in the world. It is a high-risk condition leading to adverse perinatal and obstetric outcomes. This study aims to evaluate the obstetric and perinatal outcomes of teenage pregnancy in Indonesian population.

Method: A retrospective study was conducted to evaluate obstetric and perinatal outcomes among teenagers and average maternal age (AMA) women. We assessed all singleton live pregnancies during the year period of 2013 in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.

Results: We studied 1,676 eligible subjects during the one-year period in our centre. The prevalence of teenage pregnancy (12 to 19 years old) was 11.40% (191/1676). We found higher prevalence of eclampsia (AOR: 4.03; 95% CI: 1.73-9.39), preterm delivery (AOR: 1.5; 95% CI: 0.88-2.53), anaemia at labour (AOR: 2.42; 95% CI: 1.60-3.67), postpartum haemorrhage (AOR: 2.59; 95% CI: 0.86-7.37), and low birth weight (AOR: 2.28; 95% CI: 1.60-3.25) among teenagers. However, caesarean section was found to be significantly lower among teenage pregnancies.

Conclusion: Teenage pregnancy carries significant obstetric complications that should draw physicians' serious attention. A holistic, comprehensive antenatal, and preventive program should be conducted to prevent teenage pregnancy-related adverse outcomes.

背景:世界范围内少女怀孕的发生率呈上升趋势。这是一种导致不良围产期和产科结果的高风险病症。本研究旨在评估印度尼西亚人口中少女怀孕的产科和围产期结局。方法:回顾性研究评估青少年和平均产妇年龄(AMA)妇女的产科和围产期结局。我们评估了2013年期间印度尼西亚雅加达Cipto Mangunkusumo博士国立综合医院的所有单胎活产妊娠。结果:在我们中心为期一年的时间里,我们研究了1,676名符合条件的受试者。12 ~ 19岁少女怀孕率为11.40%(191/1676)。我们发现子痫的患病率更高(AOR: 4.03;95% CI: 1.73-9.39),早产(AOR: 1.5;95% CI: 0.88-2.53),分娩时贫血(AOR: 2.42;95% CI: 1.60-3.67),产后出血(AOR: 2.59;95% CI: 0.86-7.37)和低出生体重(AOR: 2.28;95% CI: 1.60-3.25)。然而,发现剖腹产在少女怀孕中的比例明显较低。结论:少女怀孕有严重的产科并发症,应引起医生的高度重视。一个整体的,全面的产前和预防方案应该进行,以防止少女怀孕相关的不良后果。
{"title":"Teenage Pregnancy: Obstetric and Perinatal Outcome in a Tertiary Centre in Indonesia.","authors":"Junita Indarti,&nbsp;Adly Nanda Al Fattah,&nbsp;Zulfitri Dewi,&nbsp;Rachmat Dediat Kapnosa Hasani,&nbsp;Fitri Adinda Novianti Mahdi,&nbsp;Raymond Surya","doi":"10.1155/2020/2787602","DOIUrl":"https://doi.org/10.1155/2020/2787602","url":null,"abstract":"<p><strong>Background: </strong>The incidence of teenage pregnancy is increasing in the world. It is a high-risk condition leading to adverse perinatal and obstetric outcomes. This study aims to evaluate the obstetric and perinatal outcomes of teenage pregnancy in Indonesian population.</p><p><strong>Method: </strong>A retrospective study was conducted to evaluate obstetric and perinatal outcomes among teenagers and average maternal age (AMA) women. We assessed all singleton live pregnancies during the year period of 2013 in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.</p><p><strong>Results: </strong>We studied 1,676 eligible subjects during the one-year period in our centre. The prevalence of teenage pregnancy (12 to 19 years old) was 11.40% (191/1676). We found higher prevalence of eclampsia (AOR: 4.03; 95% CI: 1.73-9.39), preterm delivery (AOR: 1.5; 95% CI: 0.88-2.53), anaemia at labour (AOR: 2.42; 95% CI: 1.60-3.67), postpartum haemorrhage (AOR: 2.59; 95% CI: 0.86-7.37), and low birth weight (AOR: 2.28; 95% CI: 1.60-3.25) among teenagers. However, caesarean section was found to be significantly lower among teenage pregnancies.</p><p><strong>Conclusion: </strong>Teenage pregnancy carries significant obstetric complications that should draw physicians' serious attention. A holistic, comprehensive antenatal, and preventive program should be conducted to prevent teenage pregnancy-related adverse outcomes.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"2787602"},"PeriodicalIF":1.9,"publicationDate":"2020-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2787602","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37819515","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: 26
Incidence of Surgical Site Infection and Factors Associated among Cesarean Deliveries in Selected Government Hospitals in Addis Ababa, Ethiopia, 2019. 2019年埃塞俄比亚亚的斯亚贝巴部分政府医院剖宫产手术部位感染发生率及相关因素分析
IF 1.9 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2020-02-22 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9714640
Hana Lijaemiro, Semarya Berhe Lemlem, Jembere Tesfaye Deressa

Background: One-third to two-thirds of operated patients in low-income countries acquire surgical site infection, which is nine times higher when compared to high-resource countries. Identifying the incidence and risk factors that contribute to surgical site infection following cesarean delivery is a step ahead for preventing and reducing the problem. Nonetheless, the distribution of the problem in Addis Ababa, where the rate of cesarean delivery is relatively high compared to other parts of the country, is under investigation.

Objective: The aim of this study is to assess the incidence of surgical site infection among cesarean deliveries and factors associated with it in selected governmental hospitals found in Addis Ababa, Ethiopia, in 2019.

Method: A hospital-based prospective cohort study design was employed to follow 175 women, who gave birth by cesarean delivery in selected government hospitals in Addis Ababa, from March 11 to April 9, 2019. Convenience sampling method was used to select study units from the randomly selected hospitals. Descriptive statistics were run for determining the rate of cesarean delivery surgical site infection. Presence and degree of association between outcome and independent variables were computed through bivariate logistic regression analysis and factors that had p < 0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis.

Result: From 166 participants who completed 30-day follow-up, 25 (15%) of the participants developed surgical site infection. Age, gestational age, duration of operation, and ≥5 vaginal examinations showed a significant association with the outcome variable with AOR (95% CI) of ((AOR = 1.504, 95% CI: (1.170 - 1.933, p < 0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. p < 0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. p < 0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. p < 0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. Conclusion and recommendation. Surgical site infection rate is higher and certain associations lost due to small sample size. Further interventional studies with vast sample size are recommended.

背景:低收入国家三分之一至三分之二的手术患者发生手术部位感染,与资源丰富的国家相比,这一比例高出九倍。确定导致剖宫产后手术部位感染的发生率和危险因素是预防和减少这一问题的一步。尽管如此,正在调查亚的斯亚贝巴的问题分布情况,亚的斯亚贝巴的剖宫产率与该国其他地区相比相对较高。目的:本研究的目的是评估2019年埃塞俄比亚亚的斯亚贝巴选定的政府医院剖宫产手术部位感染的发生率及其相关因素。方法:采用基于医院的前瞻性队列研究设计,对2019年3月11日至4月9日在亚的斯亚贝巴选定的政府医院剖宫产的175名妇女进行随访。采用方便抽样法从随机选取的医院中选取研究单位。对剖宫产手术部位感染的发生率进行描述性统计。通过双变量logistic回归分析计算结果与自变量之间的存在及关联程度,在多变量logistic回归分析中考虑双变量logistic回归分析中p < 0.2显著性水平的因素。结果:在完成30天随访的166名参与者中,25名(15%)参与者发生手术部位感染。年龄、胎龄、手术时间、≥5次阴道检查与结局变量有显著相关性,AOR (95% CI)为((AOR = 1.504, 95% CI为(1.170 ~ 1.933,p < 0.2),多变量logistic回归分析考虑双变量logistic回归分析的显著性水平。多变量logistic回归分析考虑双变量logistic回归分析中P < 0.2的显著性水平。多变量logistic回归分析考虑双变量logistic回归分析中P < 0.2的显著性水平。多变量logistic回归分析考虑双变量logistic回归分析中P < 0.2的显著性水平。结论和建议。手术部位感染率较高,由于样本量小,某些关联丢失。建议进一步开展大量样本量的干预性研究。
{"title":"Incidence of Surgical Site Infection and Factors Associated among Cesarean Deliveries in Selected Government Hospitals in Addis Ababa, Ethiopia, 2019.","authors":"Hana Lijaemiro,&nbsp;Semarya Berhe Lemlem,&nbsp;Jembere Tesfaye Deressa","doi":"10.1155/2020/9714640","DOIUrl":"https://doi.org/10.1155/2020/9714640","url":null,"abstract":"<p><strong>Background: </strong>One-third to two-thirds of operated patients in low-income countries acquire surgical site infection, which is nine times higher when compared to high-resource countries. Identifying the incidence and risk factors that contribute to surgical site infection following cesarean delivery is a step ahead for preventing and reducing the problem. Nonetheless, the distribution of the problem in Addis Ababa, where the rate of cesarean delivery is relatively high compared to other parts of the country, is under investigation.</p><p><strong>Objective: </strong>The aim of this study is to assess the incidence of surgical site infection among cesarean deliveries and factors associated with it in selected governmental hospitals found in Addis Ababa, Ethiopia, in 2019.</p><p><strong>Method: </strong>A hospital-based prospective cohort study design was employed to follow 175 women, who gave birth by cesarean delivery in selected government hospitals in Addis Ababa, from March 11 to April 9, 2019. Convenience sampling method was used to select study units from the randomly selected hospitals. Descriptive statistics were run for determining the rate of cesarean delivery surgical site infection. Presence and degree of association between outcome and independent variables were computed through bivariate logistic regression analysis and factors that had <i>p</i> < 0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis.</p><p><strong>Result: </strong>From 166 participants who completed 30-day follow-up, 25 (15%) of the participants developed surgical site infection. Age, gestational age, duration of operation, and ≥5 vaginal examinations showed a significant association with the outcome variable with AOR (95% CI) of ((AOR = 1.504, 95% CI: (1.170 - 1.933, <i>p</i> < 0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. <i>p</i> < 0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. <i>p</i> < 0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. <i>p</i> < 0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. <i>Conclusion and recommendation</i>. Surgical site infection rate is higher and certain associations lost due to small sample size. Further interventional studies with vast sample size are recommended.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"9714640"},"PeriodicalIF":1.9,"publicationDate":"2020-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9714640","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37718070","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: 13
期刊
Obstetrics and Gynecology International
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1