Pub Date : 2020-01-01DOI: 10.35248/2161-10932.20.10.516
Hanan Eljabu, I. Elfortia, A. Andisha, Sabah Suliman, Amna Alrayes, Eman Elmahjoub Hussam Habbalreeh
Background: During controlled ovarian hyper-stimulation COH, level of Progesterone on a day of human chorionic gonadotrophin (hCG) trigger for a final ovum maturation has a precious role for implantation of the embryos. Aims: This study aims to investigate the incidence and the effect of Premature Progesteron Rise (PPR) on pregnancy rates PR as well as live birth rate LBR in ICSI cycle. Material and Methods: A total of 710 patients undergoing ICSI cycles with fresh embryo transfer at Misurata National Infertility Centre were retrospectively involved. Patients included in the study who are <40 years with good ovarian response and had long agonist/antagonist ICSI protocols with fresh embryo transfer. Results: The average age of patients was (32.26 years ± 4.924). The cut-off value found in this study to define PPR is (1.064 ng/ml). The overall incidence of serum PPR on hCG administration was 31.32%. The average serum PPR on a day of hCG administration was (1.1 ±1.8) ng/ml. PPR had a negative significant effect on PR (P-value 0.03). Conclusion: In order to improve ICSI outcome, the PR is significantly negatively correlated with PPR. So, when serum P4 level is approaching the cutoff value (1.064 ng/ml) during COH, modification of the clinical treatment might be considered to improve the ICSI outcomes.
{"title":"Pre-Mature Raise of Progesterone and its Effect on Clinical Pregnancy Rate and Live Birth Rate in Intra-Cytoplasmic Sperm Injection (ICSI) Cycles","authors":"Hanan Eljabu, I. Elfortia, A. Andisha, Sabah Suliman, Amna Alrayes, Eman Elmahjoub Hussam Habbalreeh","doi":"10.35248/2161-10932.20.10.516","DOIUrl":"https://doi.org/10.35248/2161-10932.20.10.516","url":null,"abstract":"Background: During controlled ovarian hyper-stimulation COH, level of Progesterone on a day of human chorionic gonadotrophin (hCG) trigger for a final ovum maturation has a precious role for implantation of the embryos. Aims: This study aims to investigate the incidence and the effect of Premature Progesteron Rise (PPR) on pregnancy rates PR as well as live birth rate LBR in ICSI cycle. Material and Methods: A total of 710 patients undergoing ICSI cycles with fresh embryo transfer at Misurata National Infertility Centre were retrospectively involved. Patients included in the study who are <40 years with good ovarian response and had long agonist/antagonist ICSI protocols with fresh embryo transfer. Results: The average age of patients was (32.26 years ± 4.924). The cut-off value found in this study to define PPR is (1.064 ng/ml). The overall incidence of serum PPR on hCG administration was 31.32%. The average serum PPR on a day of hCG administration was (1.1 ±1.8) ng/ml. PPR had a negative significant effect on PR (P-value 0.03). Conclusion: In order to improve ICSI outcome, the PR is significantly negatively correlated with PPR. So, when serum P4 level is approaching the cutoff value (1.064 ng/ml) during COH, modification of the clinical treatment might be considered to improve the ICSI outcomes.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"5 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81151836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2161-10932.20.10.519
A. Abdalla, T. Truong, Jennifer E. Gallagher, John W Schmitt
Title: Alcohol Consumption and the Development of High Grade Cervical Dysplasia. Objective: To investigate the association between alcohol consumption and prevalence of high grade cervical intraepithelial neoplasia in Duke University cervix clinic patients. Methods: Patients presenting to Duke University Cervix Clinic between the ages of 21 and 65 meeting inclusion criteria were identified and approached to participate in the study. Once consented, patients completed the Alcohol Use Disorders Identification Test (AUDIT) validated survey. The primary outcome was defined based on colposcopically directed biopsy results. Patients with no Cervical Dysplasia or low grade dysplasia (CIN 1) were placed in one group and those with high grade dysplasia (CIN 2-3) were placed in the other. Demographic information including age, ethnicity, BMI, smoking history, and number of sexual partners was collected. Demographics and patients with harmful alcohol use (AUDIT score of 8 or higher) were compared between the two groups. Results: Forty-four patients met eligibility criteria and completed the electronic AUDIT survey. Due to a programming error in the RedCap AUDIT questionnaire, 9 surveys were excluded from further analysis. Among 35 patients included in the analysis, 20 patients (57.1%) patients had low grade or no cervical dysplasia and 15 (42.9%) had high grade dysplasia. The proportion of patients with hazardous and harmful alcohol use among those with mild or no cervical dysplasia was 5% (n=1) compared to 6.7% (n=1) among those with high grade cervical dysplasia. There was no significant association between alcohol use and Cervical Dysplasia (p=1.00). There was a significant association between race and high grade cervical dysplasia (p=0.001). Conclusion: In this small pilot study, no statistically significant association was noted between alcohol use per patient’s AUDIT scores and cervical dysplasia. Larger studies are needed to look at this modifiable behavior in decreasing the prevalence of high grade cervical dysplasia and cervical cancer.
{"title":"Alcohol Consumption and the Development of High Grade Cervical Dysplasia","authors":"A. Abdalla, T. Truong, Jennifer E. Gallagher, John W Schmitt","doi":"10.35248/2161-10932.20.10.519","DOIUrl":"https://doi.org/10.35248/2161-10932.20.10.519","url":null,"abstract":"Title: Alcohol Consumption and the Development of High Grade Cervical Dysplasia. Objective: To investigate the association between alcohol consumption and prevalence of high grade cervical intraepithelial neoplasia in Duke University cervix clinic patients. Methods: Patients presenting to Duke University Cervix Clinic between the ages of 21 and 65 meeting inclusion criteria were identified and approached to participate in the study. Once consented, patients completed the Alcohol Use Disorders Identification Test (AUDIT) validated survey. The primary outcome was defined based on colposcopically directed biopsy results. Patients with no Cervical Dysplasia or low grade dysplasia (CIN 1) were placed in one group and those with high grade dysplasia (CIN 2-3) were placed in the other. Demographic information including age, ethnicity, BMI, smoking history, and number of sexual partners was collected. Demographics and patients with harmful alcohol use (AUDIT score of 8 or higher) were compared between the two groups. Results: Forty-four patients met eligibility criteria and completed the electronic AUDIT survey. Due to a programming error in the RedCap AUDIT questionnaire, 9 surveys were excluded from further analysis. Among 35 patients included in the analysis, 20 patients (57.1%) patients had low grade or no cervical dysplasia and 15 (42.9%) had high grade dysplasia. The proportion of patients with hazardous and harmful alcohol use among those with mild or no cervical dysplasia was 5% (n=1) compared to 6.7% (n=1) among those with high grade cervical dysplasia. There was no significant association between alcohol use and Cervical Dysplasia (p=1.00). There was a significant association between race and high grade cervical dysplasia (p=0.001). Conclusion: In this small pilot study, no statistically significant association was noted between alcohol use per patient’s AUDIT scores and cervical dysplasia. Larger studies are needed to look at this modifiable behavior in decreasing the prevalence of high grade cervical dysplasia and cervical cancer.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"AES-9 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84512037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2161-0932.2020.10.517
Shallon Atuhaire, J. Mugisha, A. Odukogbe, O. Ojengbede
Background: Obstetric fistula is a debilitating childbirth injury. Patients live in despair and self-stigmatize. Studies highlight beliefs and perceptions about the cause of the disease and how it can be cured. Experiences among both treated and untreated patients are also discussed vastly but there is limited information on negative perceptions and beliefs among obstetric fistula patients towards their spouses, families, and communities and how these affect social reintegration. This study determined the relationship between self-fulfilling prophecies and social reintegration among obstetric fistula patients in different repair categories. Methods: A cross-sectional mixed-methods survey was done among the obstetric fistula patients (n=398) at St. Joseph Kitovu Hospital in Uganda. Also, 12 key informants participated. A semi-structured questionnaire and an in-depth interview were used to get data from the patients. The interviews covered patients’ expectations and beliefs on reacceptance, interaction, self-satisfaction and comfort with others. The hypothesis: “there was a significant relationship between self-fulfilling prophecies and social reintegration among obstetric fistula patients in different repair categories” was tested by Pearson chi-square at a 95% confidence interval. Results: Accordingly, 51.5%, 14.4% and 9.0% of the 398 participants felt that their spouses, communities, and parents respectively would not reaccept them. Again, 33.6% were not satisfied with their lives and 47.7% felt uncomfortable around others. A major difference was observed in the relationship between their self-perceived stigma, sense of loss, self-worth, achievement, the expectation of reacceptance, perception of others’ attitudes towards them, labeling, moods, self-satisfaction, comfort with others and social reintegration. A relationship with the patients’ repair category was noted across all variables: P-values less than 0.001 at a 95% confidence interval. Conclusion: A relationship was found between the patient’s negative beliefs, perceptions, and social reintegration. Negative beliefs and expectations could be transformed into positive ones through the promotion of personal hygiene and comprehensive counseling.
背景:产科瘘是一种使人衰弱的分娩损伤。病人生活在绝望和自我羞辱中。研究强调了对这种疾病的病因以及如何治愈的信念和看法。也广泛讨论了治疗和未治疗患者的经历，但关于产科瘘患者对其配偶、家庭和社区的负面看法和信念以及这些看法和信念如何影响重返社会的信息有限。本研究确定了不同修复类别的产科瘘患者的自我实现预言与社会重新融入之间的关系。方法:对乌干达St. Joseph Kitovu医院的产科瘘患者(n=398)进行了横断面混合方法调查。此外，还有12名关键线人参加。采用半结构化问卷和深度访谈的方式从患者中获取数据。访谈内容包括患者对重新接受、互动、自我满足和与他人的舒适的期望和信念。假设:“在不同修复类别的产科瘘患者中，自我实现预言与社会融合之间存在显著关系”，采用Pearson卡方检验，置信区间为95%。结果:在398名参与者中，分别有51.5%、14.4%和9.0%的人认为他们的配偶、社区和父母不会接受他们。同样，33.6%的人对自己的生活不满意，47.7%的人对周围的人感到不舒服。在他们自我感知的耻辱感、失落感、自我价值感、成就、重新接受的期望、对他人对他们的态度的感知、标签、情绪、自我满足、与他人的舒适感和重新融入社会之间的关系中观察到重大差异。在所有变量中都注意到与患者修复类别的关系:在95%置信区间内p值小于0.001。结论:患者的消极信念、认知与社会重新融入之间存在一定的关系。消极的信念和期望可以通过个人卫生的促进和全面的咨询转化为积极的信念和期望。
{"title":"The Relationship Between Self-fulfilling Prophecies and Social Reintegration Among Obstetric Fistula Patients in Different Repair Categories at St. Joseph Kitovu Hospital, Uganda","authors":"Shallon Atuhaire, J. Mugisha, A. Odukogbe, O. Ojengbede","doi":"10.35248/2161-0932.2020.10.517","DOIUrl":"https://doi.org/10.35248/2161-0932.2020.10.517","url":null,"abstract":"Background: Obstetric fistula is a debilitating childbirth injury. Patients live in despair and self-stigmatize. Studies highlight beliefs and perceptions about the cause of the disease and how it can be cured. Experiences among both treated and untreated patients are also discussed vastly but there is limited information on negative perceptions and beliefs among obstetric fistula patients towards their spouses, families, and communities and how these affect social reintegration. This study determined the relationship between self-fulfilling prophecies and social reintegration among obstetric fistula patients in different repair categories. Methods: A cross-sectional mixed-methods survey was done among the obstetric fistula patients (n=398) at St. Joseph Kitovu Hospital in Uganda. Also, 12 key informants participated. A semi-structured questionnaire and an in-depth interview were used to get data from the patients. The interviews covered patients’ expectations and beliefs on reacceptance, interaction, self-satisfaction and comfort with others. The hypothesis: “there was a significant relationship between self-fulfilling prophecies and social reintegration among obstetric fistula patients in different repair categories” was tested by Pearson chi-square at a 95% confidence interval. Results: Accordingly, 51.5%, 14.4% and 9.0% of the 398 participants felt that their spouses, communities, and parents respectively would not reaccept them. Again, 33.6% were not satisfied with their lives and 47.7% felt uncomfortable around others. A major difference was observed in the relationship between their self-perceived stigma, sense of loss, self-worth, achievement, the expectation of reacceptance, perception of others’ attitudes towards them, labeling, moods, self-satisfaction, comfort with others and social reintegration. A relationship with the patients’ repair category was noted across all variables: P-values less than 0.001 at a 95% confidence interval. Conclusion: A relationship was found between the patient’s negative beliefs, perceptions, and social reintegration. Negative beliefs and expectations could be transformed into positive ones through the promotion of personal hygiene and comprehensive counseling.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"117 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82245372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.35248/2161-10932.20.10.525
N. Garg
Background: Cervical ectopy is a common entity among women attending gynaecological OPD for various complaints which itself could be the cause or present otherwise. The treatment modalities currently available are electrocoagulation, cry cauterization, laser cauterization, and drug treatment. Most of these procedures require a high learning curve, associated with side-effects, and are costly. Furthermore, routine treatment for ectopy has long been debated and there are no current guidelines for the same. Tranexamic acid, with its easy applicability, availability, and minimal costs could be an effective alternative. Objective: To evaluate the therapeutic effectiveness and safety of topical tranexamic acid for the treatment of cervix erosion. Methodology: A total of 75 cases of cervical erosion were taken who satisfied the inclusion and exclusion criteria of the study. Patients were randomized into two groups. Local application of tranexamic acid (Group A, n=38) or povidone-iodine solution (Group B, n=37) for 5 minutes were applied with the patient position kept constant for 15 minutes and daily dosage were given for 10 days. All the patients were followed up at the end of 2nd and 4th week and after 3 months for complete healing, relief of symptoms like chronic pelvic pain, recurrent vaginitis, contact bleeding, and vaginal discharge, and possible side effects. Results: In group A, all 7 and 20 patients complaining of chronic pelvic pain and contact bleeding respectively were cured of it (100% cure). For the other symptoms such as recurrent vaginitis and vaginal discharge, cure rates were 81.25% and 87.5% respectively. In group B, the cure was seen only in vaginal discharge with 12 patients getting cured out of 33 (36.36%) and no response in other symptoms. Side effect in the form of vaginal irritation was found only in group B in 17 patients (45.94%) whereas none were observed in group A who received the tranexamic acid application. We observed a positive correlation between cervical erosion and tranexamic acid application in terms of healing and side effects. Conclusion: Tranexamic acid application is a promising new treatment modality of cervical erosion in symptomatic women.
{"title":"Clinical Study of Tranexamic Acid in Treatment of Cervical Ectopy-AnInstitutional Experience","authors":"N. Garg","doi":"10.35248/2161-10932.20.10.525","DOIUrl":"https://doi.org/10.35248/2161-10932.20.10.525","url":null,"abstract":"Background: Cervical ectopy is a common entity among women attending gynaecological OPD for various complaints which itself could be the cause or present otherwise. The treatment modalities currently available are electrocoagulation, cry cauterization, laser cauterization, and drug treatment. Most of these procedures require a high learning curve, associated with side-effects, and are costly. Furthermore, routine treatment for ectopy has long been debated and there are no current guidelines for the same. Tranexamic acid, with its easy applicability, availability, and minimal costs could be an effective alternative. Objective: To evaluate the therapeutic effectiveness and safety of topical tranexamic acid for the treatment of cervix erosion. Methodology: A total of 75 cases of cervical erosion were taken who satisfied the inclusion and exclusion criteria of the study. Patients were randomized into two groups. Local application of tranexamic acid (Group A, n=38) or povidone-iodine solution (Group B, n=37) for 5 minutes were applied with the patient position kept constant for 15 minutes and daily dosage were given for 10 days. All the patients were followed up at the end of 2nd and 4th week and after 3 months for complete healing, relief of symptoms like chronic pelvic pain, recurrent vaginitis, contact bleeding, and vaginal discharge, and possible side effects. Results: In group A, all 7 and 20 patients complaining of chronic pelvic pain and contact bleeding respectively were cured of it (100% cure). For the other symptoms such as recurrent vaginitis and vaginal discharge, cure rates were 81.25% and 87.5% respectively. In group B, the cure was seen only in vaginal discharge with 12 patients getting cured out of 33 (36.36%) and no response in other symptoms. Side effect in the form of vaginal irritation was found only in group B in 17 patients (45.94%) whereas none were observed in group A who received the tranexamic acid application. We observed a positive correlation between cervical erosion and tranexamic acid application in terms of healing and side effects. Conclusion: Tranexamic acid application is a promising new treatment modality of cervical erosion in symptomatic women.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"41 19 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88755949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-09DOI: 10.24015/2161-0932/9.511
L. Tarrats, I. Páez, Isabel Navarri, R. Cabrera, M. Puig, S. Alonso
Background: Midwives from the Obstetrics and Gynaecology Unit at University Hospital Germans Trias i Pujol, Badalona, have developed a device for the application of thermal therapy on lumbar and suprapubical areas when labour pain appears. Objective: To assess the beneficial effects of heat application on lumbo-suprapubical pain during initial stages of labour. Study design: Randomized, parallel, open, non-blind clinical trial. Methods: Participants were pregnant women in the prodromal, early and active labour (up to 4-5 cm of dilation), with lumbo-suprapubic pain. The study was conducted in the delivery ward of Hospital Universitari Germans Trias I Pujol, in Badalona (Catalonia, Spain) during 2017-2018. One hundred and thirty-four childbearing women giving birth between September 2017 and March 2018 participated. The intervention group (n=67) received local heat at a temperature between 38-39°C on the lumbo-suprapubic areas for 30 minutes using an elastic pelvic belt as a pain relief device and was compared to a control group in which no heat was used. Primary outcomes were: pain level perception measured with a Visual Analogic Scale and a satisfaction index regarding the utilization of the belt device in the intervention group by using a specific ad-hoc non-validated questionnaire designed for the study. Results: Among the 134 participants: 41% (55) were in prodromal labour, 53.7% (72) in early labour and 5.2% (7) in active labour (up to ≤ 4-5 cm); groups were not balanced for the phases of labour. The pre-intervention pain level in the intervention group was 0.71 points higher (6.28 ± 1.59) than in the control group (5.57 ± 1.87) p=0.02. At 30 minutes of heat application, pain level in the study group decreased 0.65 points (5.88 ± 1.82) while it increased in the control group (6.53 ± 1.85) p=0.046. The difference between basal pain level and post-intervention, was 0.39 ± 1.35 in the intervention group while in the control group it was 0.95 ± 1.11 (p=0.000) in the Visual Analogic Scale. The global satisfaction index for the pelvic elastic belt was 15.38 ± 2.15 (range 5-19) which corresponds to 80.94% over 100% of the maximal punctuation. Conclusion: Heat application on both lumbar and suprapubic areas in case of labour pain is effective in relieving pain. The heat pads subjection device, a new abdominal two-pocket belt, obtained positive feedback from women in the study group who used it and answered the satisfaction questionnaire.
背景:来自德国大学医院Trias i Pujol妇产科的助产士，Badalona，已经开发出一种设备，用于在分娩疼痛出现时对腰椎和耻骨上区域进行热疗法。目的:探讨热敷对分娩初期腰耻骨上疼痛的有益作用。研究设计:随机、平行、开放、非盲临床试验。方法:参与者是前驱，早期和主动分娩(高达4-5厘米的扩张)的孕妇，伴有腰耻骨上疼痛。该研究于2017-2018年在巴达洛纳(西班牙加泰罗尼亚)德国大学Trias I Pujol医院的分娩病房进行。2017年9月至2018年3月期间分娩的134名育龄妇女参与了这项研究。干预组(n=67)采用弹性骨盆带作为镇痛装置，对腰耻骨上区域进行38-39°C局部加热30分钟，并与不使用加热的对照组进行比较。主要结果是:通过视觉类比量表测量疼痛水平感知，并通过为研究设计的特殊的非验证问卷，对干预组中皮带装置的使用满意度指数进行测量。结果:134名参与者中，41%(55名)为前驱分娩，53.7%(72名)为早期分娩，5.2%(7名)为活动性分娩(长度≤4-5 cm);在分娩阶段，分组并不均衡。干预组患者干预前疼痛水平(6.28±1.59)比对照组(5.57±1.87)高0.71分(p=0.02)。热敷30 min时，研究组疼痛水平降低0.65点(5.88±1.82)，对照组疼痛水平升高(6.53±1.85)，p=0.046。干预组的基础疼痛水平与干预后的差异为0.39±1.35，对照组的差异为0.95±1.11 (p=0.000)。骨盆松紧带整体满意度为15.38±2.15(范围5-19)，占最大标点≥100%的80.94%。结论:产痛时腰部及耻骨上热敷能有效缓解疼痛。热垫降服装置，一种新的腹部双口袋腰带，得到了研究组中使用它的女性的积极反馈，并回答了满意度问卷。
{"title":"Heat Application on Lumbar and Suprapubic Pain During the Onset of Labour Using a New Abdominal Two-Pocket Belt: A Randomised and Controlled Trial","authors":"L. Tarrats, I. Páez, Isabel Navarri, R. Cabrera, M. Puig, S. Alonso","doi":"10.24015/2161-0932/9.511","DOIUrl":"https://doi.org/10.24015/2161-0932/9.511","url":null,"abstract":"Background: Midwives from the Obstetrics and Gynaecology Unit at University Hospital Germans Trias i Pujol, Badalona, have developed a device for the application of thermal therapy on lumbar and suprapubical areas when labour pain appears. \u0000Objective: To assess the beneficial effects of heat application on lumbo-suprapubical pain during initial stages of labour. \u0000Study design: Randomized, parallel, open, non-blind clinical trial. \u0000Methods: Participants were pregnant women in the prodromal, early and active labour (up to 4-5 cm of dilation), with lumbo-suprapubic pain. The study was conducted in the delivery ward of Hospital Universitari Germans Trias I Pujol, in Badalona (Catalonia, Spain) during 2017-2018. One hundred and thirty-four childbearing women giving birth between September 2017 and March 2018 participated. The intervention group (n=67) received local heat at a temperature between 38-39°C on the lumbo-suprapubic areas for 30 minutes using an elastic pelvic belt as a pain relief device and was compared to a control group in which no heat was used. Primary outcomes were: pain level perception measured with a Visual Analogic Scale and a satisfaction index regarding the utilization of the belt device in the intervention group by using a specific ad-hoc non-validated questionnaire designed for the study. \u0000Results: Among the 134 participants: 41% (55) were in prodromal labour, 53.7% (72) in early labour and 5.2% (7) in active labour (up to ≤ 4-5 cm); groups were not balanced for the phases of labour. The pre-intervention pain level in the intervention group was 0.71 points higher (6.28 ± 1.59) than in the control group (5.57 ± 1.87) p=0.02. At 30 minutes of heat application, pain level in the study group decreased 0.65 points (5.88 ± 1.82) while it increased in the control group (6.53 ± 1.85) p=0.046. The difference between basal pain level and post-intervention, was 0.39 ± 1.35 in the intervention group while in the control group it was 0.95 ± 1.11 (p=0.000) in the Visual Analogic Scale. The global satisfaction index for the pelvic elastic belt was 15.38 ± 2.15 (range 5-19) which corresponds to 80.94% over 100% of the maximal punctuation. \u0000Conclusion: Heat application on both lumbar and suprapubic areas in case of labour pain is effective in relieving pain. The heat pads subjection device, a new abdominal two-pocket belt, obtained positive feedback from women in the study group who used it and answered the satisfaction questionnaire.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"5 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2019-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78112777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-12DOI: 10.31080/aspe.2020.03.pregnancy-outcome-in-fresh-and-frozen-embryo-transfer-in-women-with-high-estra
S. Archana
{"title":"Pregnancy outcome in fresh and frozen embryo transfer in women with high estradiol levels","authors":"S. Archana","doi":"10.31080/aspe.2020.03.pregnancy-outcome-in-fresh-and-frozen-embryo-transfer-in-women-with-high-estra","DOIUrl":"https://doi.org/10.31080/aspe.2020.03.pregnancy-outcome-in-fresh-and-frozen-embryo-transfer-in-women-with-high-estra","url":null,"abstract":"","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75302805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Performance of feminine cleansers can be improved by increasing antimicrobial potency and favouring the prolonged contact on vulvo-vaginal mucosa of active ingredients, that permits the increase of the persistence of their activity, and consequently of their efficacy. The presence of specific polymers in topical formulations allows the cleansing solution to adhere to mucosal substrates. The associations of xanthan gum with lambda carrageenan from Chondrus crispus has a high mucoadhesive potential. The aim of our study was to evaluate the mucoadhesive potential and the safety of an innovative cleanser for feminine hygiene (SA3) compared with a reference cleanser (SA) in a double-blind design. Material and Methods: The cleansers were provided at dilutions: the reference product containing thymol from Thymus vulgaris extract at pH 3.5 (SA), and the test one with Zinc Coco Sulfate for its antimicrobial action, and Xanthan gum and Chondrus crispus extract as mucoadhesive agents (SA3) added to SA. The pro-sensitizing test was performed on cultures of human monocytes THP-1. The expression of two membrane markers, CD86 and CD54, was evaluated and compared with the sensitizing 2,4-dinit rochlorobenzene as a positive control, and with untreated cells as a negative control. Light scattering images were used to analyze the morphology of THP-1 cells. The mucoadhesivity was assessed as percentage of inhibition of the lectin-binding glycoprotein. Results: No changes in CD86 and CD54 expression were evidenced in the cells exposed to the test product, compared to the untreated cells. Furthermore, no significant alteration of the cell morphology was observed for SA3. Mucoadhesion% values showed a statistically significant difference in favor of SA3 even at 1:2 and 1:5 dilutions. At the higher dilution, SA3 lost only 23.2% of mucoadhesion versus the lower one, compared to the 45% lost between the two SA dilutions. Conclusion: No pro-sensitizing potential and no significant alteration of the cell morphology were observed for SA3 compared to the untreated cells. SA3 is safe, with high mucoadhesion to the vulvo-vaginal mucosa, significant even at higher dilution.
{"title":"Mucoadhesive Properties of a New Intimate Hygiene Cleanser againstVulvovaginal Candidiasis","authors":"C. Benvenuti, F. Gasparri, A. Zanardi","doi":"10.24015/2161-0932/513","DOIUrl":"https://doi.org/10.24015/2161-0932/513","url":null,"abstract":"Objective: Performance of feminine cleansers can be improved by increasing antimicrobial potency and favouring the prolonged contact on vulvo-vaginal mucosa of active ingredients, that permits the increase of the persistence of their activity, and consequently of their efficacy. The presence of specific polymers in topical formulations allows the cleansing solution to adhere to mucosal substrates. The associations of xanthan gum with lambda carrageenan from Chondrus crispus has a high mucoadhesive potential. The aim of our study was to evaluate the mucoadhesive potential and the safety of an innovative cleanser for feminine hygiene (SA3) compared with a reference cleanser (SA) in a double-blind design. Material and Methods: The cleansers were provided at dilutions: the reference product containing thymol from Thymus vulgaris extract at pH 3.5 (SA), and the test one with Zinc Coco Sulfate for its antimicrobial action, and Xanthan gum and Chondrus crispus extract as mucoadhesive agents (SA3) added to SA. The pro-sensitizing test was performed on cultures of human monocytes THP-1. The expression of two membrane markers, CD86 and CD54, was evaluated and compared with the sensitizing 2,4-dinit rochlorobenzene as a positive control, and with untreated cells as a negative control. Light scattering images were used to analyze the morphology of THP-1 cells. The mucoadhesivity was assessed as percentage of inhibition of the lectin-binding glycoprotein. Results: No changes in CD86 and CD54 expression were evidenced in the cells exposed to the test product, compared to the untreated cells. Furthermore, no significant alteration of the cell morphology was observed for SA3. Mucoadhesion% values showed a statistically significant difference in favor of SA3 even at 1:2 and 1:5 dilutions. At the higher dilution, SA3 lost only 23.2% of mucoadhesion versus the lower one, compared to the 45% lost between the two SA dilutions. Conclusion: No pro-sensitizing potential and no significant alteration of the cell morphology were observed for SA3 compared to the untreated cells. SA3 is safe, with high mucoadhesion to the vulvo-vaginal mucosa, significant even at higher dilution.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"115 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84866081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2161-0932.1000503
S. Alouini, J. Martin, P. Mégier, O. Esper, ieu
Objective: To evaluate prenatal ultrasound findings of Skeletal Dysplasia (SD) and examine the contribution of radiological, histological and genetic exams. Methods: Retrospective study including all cases of SD managed in a tertiary maternity center between 1996 and 2010. Results: Eight cases of SD were diagnosed (1.4/10,000 births) by ultrasonography (USE). Three (38%) cases of SD were discovered in the first trimester, and five in the second trimester. We found short femurs in all cases. Anomalies consisted of the thickness of the femoral diaphysis, broad epiphysis, short and squat long bones, costal fractures, thinned coasts, anomalies of the profile and vertebrae, and a short and narrow thorax. Associated anomalies consisted of ventriculomegaly, hygroma, hydramnios, and thick nuchal fold. We found mutations of the FGFR3 gene in achondroplasia, of the Delta 8/7 sterol isomerase in a case of chondrodysplasia punctata and deletion of the DTSDT gene in a case of IB achondrogenesis. USE diagnosed the type of SD in 6 cases. Five patients underwent termination, and 3 were delivered by cesarean section. Skeletal radiography or fetal autopsy confirmed the bone anomalies and the type of SD. Final diagnoses included 4 cases of osteogenesis imperfecta, 2 cases of achondroplasia,1 case of IB achondrogenesis and 1 case of punctata chondrodysplasia. Conclusion: USE allowed the prenatal diagnosis of SD since the first trimester and, in most cases, identified the type of SD. Skeletal radiography, genetic testing, or fetal autopsy in cases of termination confirmed the diagnosis and type of SD. USE diagnosed the type of SD in 6 cases. Five patients underwent termination, and 3 were delivered by cesarean section. Skeletal radiography or fetal autopsy confirmed the bone anomalies and the type of SD. Final diagnoses included 4 cases of osteogenesis imperfecta, 2 cases of achondroplasia, 1 case of IB achondrogenesis and 1 case of punctata chondrodysplasia.
{"title":"Prenatal Diagnosis, Management and Outcomes of Skeletal Dysplasia","authors":"S. Alouini, J. Martin, P. Mégier, O. Esper, ieu","doi":"10.4172/2161-0932.1000503","DOIUrl":"https://doi.org/10.4172/2161-0932.1000503","url":null,"abstract":"Objective: To evaluate prenatal ultrasound findings of Skeletal Dysplasia (SD) and examine the contribution of radiological, histological and genetic exams. Methods: Retrospective study including all cases of SD managed in a tertiary maternity center between 1996 and 2010. Results: Eight cases of SD were diagnosed (1.4/10,000 births) by ultrasonography (USE). Three (38%) cases of SD were discovered in the first trimester, and five in the second trimester. We found short femurs in all cases. Anomalies consisted of the thickness of the femoral diaphysis, broad epiphysis, short and squat long bones, costal fractures, thinned coasts, anomalies of the profile and vertebrae, and a short and narrow thorax. Associated anomalies consisted of ventriculomegaly, hygroma, hydramnios, and thick nuchal fold. We found mutations of the FGFR3 gene in achondroplasia, of the Delta 8/7 sterol isomerase in a case of chondrodysplasia punctata and deletion of the DTSDT gene in a case of IB achondrogenesis. USE diagnosed the type of SD in 6 cases. Five patients underwent termination, and 3 were delivered by cesarean section. Skeletal radiography or fetal autopsy confirmed the bone anomalies and the type of SD. Final diagnoses included 4 cases of osteogenesis imperfecta, 2 cases of achondroplasia,1 case of IB achondrogenesis and 1 case of punctata chondrodysplasia. Conclusion: USE allowed the prenatal diagnosis of SD since the first trimester and, in most cases, identified the type of SD. Skeletal radiography, genetic testing, or fetal autopsy in cases of termination confirmed the diagnosis and type of SD. USE diagnosed the type of SD in 6 cases. Five patients underwent termination, and 3 were delivered by cesarean section. Skeletal radiography or fetal autopsy confirmed the bone anomalies and the type of SD. Final diagnoses included 4 cases of osteogenesis imperfecta, 2 cases of achondroplasia, 1 case of IB achondrogenesis and 1 case of punctata chondrodysplasia.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"4 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85407163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2161-0932.1000496
Yirga Wondu, B. Dibaba, Roza Amdemichael
Objective: To determine the prevalence and associated factors with the maternal delay in seeking emergency obstetrics services among pregnant women, Arsi Zone, Oromiya, Ethiopia, 2016.Methods: A Facility based Cross-sectional study design using a quantitative method was conducted at public health facilities of Arsi Zone. Sample size, 847 was determined using a single population proportion formula. A total of 10 health centers which provide obstetric care selected randomly and sample size proportionally allocated to each facility. Data entered in Epi Info version 3.3.2 software and exported to SPSS version 20 for statistical analysis. p<0.05 considered to declare a statistically significant variable with a 95% confidence interval.Result: From the total 775 participants, 203 (27.2%) of the respondents reported that they faced problem in making a decision to seek emergency obstetric care. The mean time for delay was 90 minutes with a range of 30 minutes to 18 hours. Maternal age, educational level, monthly income, and ANC follow up status were significant predictors of maternal delay in seeking emergency obstetric care.Conclusion: Husbands took the lines to share in making the decision to seek obstetric care. This implies independent decision-making power of women on their own health is low. In order to address maternal delay one health extension workers along with health centers staffs, district officers and programmers should give emphasis for awareness creation, income generating mechanism and capacitating decision making the power of mothers need to be strengthened and expanded in the community.
目的:了解2016年埃塞俄比亚奥罗米亚Arsi地区孕妇延迟寻求产科急诊服务的发生率及其相关因素。方法:采用定量方法，采用基于设施的横断面研究设计，对Arsi区公共卫生机构进行调查。样本量为847，采用单一总体比例公式确定。共有10个提供产科护理的保健中心被随机选择，并按比例分配给每个设施。数据输入Epi Info 3.3.2版本软件，导出到SPSS 20版本进行统计分析。P <0.05被认为是具有95%置信区间的统计学显著变量。结果:在总共775名参与者中，203人(27.2%)的受访者报告说，他们在决定寻求紧急产科护理时遇到了问题。平均延误时间为90分钟，范围为30分钟至18小时。产妇年龄、受教育程度、月收入和ANC随访状况是产妇延迟寻求产科急诊的重要预测因素。结论:在决定是否寻求产科护理时，丈夫愿意参与。这意味着妇女对自身健康的独立决策权较低。为了解决产妇延误问题，保健推广工作人员以及保健中心工作人员、地区官员和方案编制人员应重视提高认识、建立创收机制和促进决策，需要加强和扩大社区中母亲的权力。
{"title":"Prevalence and Associated Factors with Maternal Delays in Seeking Emergency Obstetric Care in Arsi Zone, Oromiya, Ethiopia Cross-sectional Study Design","authors":"Yirga Wondu, B. Dibaba, Roza Amdemichael","doi":"10.4172/2161-0932.1000496","DOIUrl":"https://doi.org/10.4172/2161-0932.1000496","url":null,"abstract":"Objective: To determine the prevalence and associated factors with the maternal delay in seeking emergency obstetrics services among pregnant women, Arsi Zone, Oromiya, Ethiopia, 2016.Methods: A Facility based Cross-sectional study design using a quantitative method was conducted at public health facilities of Arsi Zone. Sample size, 847 was determined using a single population proportion formula. A total of 10 health centers which provide obstetric care selected randomly and sample size proportionally allocated to each facility. Data entered in Epi Info version 3.3.2 software and exported to SPSS version 20 for statistical analysis. p<0.05 considered to declare a statistically significant variable with a 95% confidence interval.Result: From the total 775 participants, 203 (27.2%) of the respondents reported that they faced problem in making a decision to seek emergency obstetric care. The mean time for delay was 90 minutes with a range of 30 minutes to 18 hours. Maternal age, educational level, monthly income, and ANC follow up status were significant predictors of maternal delay in seeking emergency obstetric care.Conclusion: Husbands took the lines to share in making the decision to seek obstetric care. This implies independent decision-making power of women on their own health is low. In order to address maternal delay one health extension workers along with health centers staffs, district officers and programmers should give emphasis for awareness creation, income generating mechanism and capacitating decision making the power of mothers need to be strengthened and expanded in the community.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88433685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Tarrats Velasco, Rafael Jaime, C. R. Liria, N. M. Ras, M. Puig-Domingo
Background: When labor pain appears, pharmacological and non-pharmacological techniques can be offered as pain relief methods. Midwives may offer local heat application as a pain relief method. This paper presents the design, implementation and evaluation of the prototypes of a non-pharmacological method consisting of a thermal belt designed by midwives, which provides comfort and pain relief through the application of thermotherapy on both lumbar and suprapubic areas during labour. Method: Prototypes of a thermal belt were designed, tested and protected as a business model. A randomized, parallel, open, non-blind clinical trial was conducted at the University Hospital Germans Trias i Pujol, from Badalona (Barcelona) to assess the beneficial effects of heat application on lumbo-suprapubic pain during initial stages of labour. Participants were pregnant women in the prodromal, early and active labour (up to 4-5 cm of dilation), with lumbo-suprapubic pain. The intervention group received local heat at a temperature between 38-39°C on the lumbo-suprapubic areas for 30 minutes using an elastic pelvic belt as a pain relief device and was compared to a control group in which no heat was used. Results: show that the application of local heat on lumbo-suprapubic areas during labour is effective since, after the intervention, pain level in the study group decreased significantly in the Visual Analogic Scale; and the thermal belt obtained a positive response amongst pregnant women who used it: tested with a global satisfaction index mean score of 80,94% over 100%. Conclusion: Heat application on both lumbar and suprapubic areas in case of labor pain is effective in relieving pain. The heat pads subjection device, a new abdominal two-pocket belt, obtained positive feedback from women in the study group who used it and answered the satisfaction questionnaire.
背景:当分娩疼痛出现时，药物和非药物技术都可以作为缓解疼痛的方法。助产士可以提供局部热敷作为缓解疼痛的方法。本文介绍了一种由助产士设计的非药物方法的原型的设计、实施和评估，该方法通过在分娩过程中腰椎和耻骨上区域应用热疗法来提供舒适和疼痛缓解。方法:设计、测试和保护一个热传导带的原型作为商业模型。一项随机、平行、开放、非盲的临床试验在巴达洛纳(巴塞隆纳)的德国Trias i Pujol大学医院进行，以评估热应用对分娩初期腰耻骨上疼痛的有益影响。参与者为前驱、早期和活动性分娩的孕妇(扩张至4-5厘米)，伴有腰耻骨上疼痛。干预组使用弹性骨盆带对腰耻骨上区域进行38-39°C的局部加热30分钟，并与不使用加热的对照组进行比较。结果:分娩时腰耻骨上区域局部加热是有效的，干预后，实验组的疼痛水平在视觉类比量表上明显下降;并且在使用它的孕妇中获得了积极的反应:测试的全球满意度指数平均得分为80,94%超过100%。结论:产痛时腰部及耻骨上热敷能有效缓解疼痛。热垫降服装置，一种新的腹部双口袋腰带，得到了研究组中使用它的女性的积极反馈，并回答了满意度问卷。
{"title":"An Elastic Two-Pocket Pelvic Belt for the Application of Local Lumbo-Pelvic Heat in Labour","authors":"Laura Tarrats Velasco, Rafael Jaime, C. R. Liria, N. M. Ras, M. Puig-Domingo","doi":"10.24015/2161-0932/515","DOIUrl":"https://doi.org/10.24015/2161-0932/515","url":null,"abstract":"Background: When labor pain appears, pharmacological and non-pharmacological techniques can be offered as pain relief methods. Midwives may offer local heat application as a pain relief method. This paper presents the design, implementation and evaluation of the prototypes of a non-pharmacological method consisting of a thermal belt designed by midwives, which provides comfort and pain relief through the application of thermotherapy on both lumbar and suprapubic areas during labour. Method: Prototypes of a thermal belt were designed, tested and protected as a business model. A randomized, parallel, open, non-blind clinical trial was conducted at the University Hospital Germans Trias i Pujol, from Badalona (Barcelona) to assess the beneficial effects of heat application on lumbo-suprapubic pain during initial stages of labour. Participants were pregnant women in the prodromal, early and active labour (up to 4-5 cm of dilation), with lumbo-suprapubic pain. The intervention group received local heat at a temperature between 38-39°C on the lumbo-suprapubic areas for 30 minutes using an elastic pelvic belt as a pain relief device and was compared to a control group in which no heat was used. Results: show that the application of local heat on lumbo-suprapubic areas during labour is effective since, after the intervention, pain level in the study group decreased significantly in the Visual Analogic Scale; and the thermal belt obtained a positive response amongst pregnant women who used it: tested with a global satisfaction index mean score of 80,94% over 100%. Conclusion: Heat application on both lumbar and suprapubic areas in case of labor pain is effective in relieving pain. The heat pads subjection device, a new abdominal two-pocket belt, obtained positive feedback from women in the study group who used it and answered the satisfaction questionnaire.","PeriodicalId":22164,"journal":{"name":"Surgery, gynecology & obstetrics","volume":"15 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82020352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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