Pub Date : 2023-08-10DOI: 10.29328/journal.cjog.1001137
O. Otoikhila, S. Seriki
Aim: To evaluate the serum sodium and potassium levels in the three trimesters of pregnancy in women. Methods: Four groups of healthy women between the ages of 20 and 30 years, volunteered for this study. Group 1: Non-pregnant women (control), Group 2: Pregnant women in their first trimester, Group 3: Pregnant women in their second trimester, Group 4: Pregnant women in their third trimester. Blood samples were collected by standard aseptic method and serum samples were analyzed for serum levels of sodium and potassium by the ion selective electrode method. Results were presented as MEAN ± SEM in tables and figures, p < 0.05 was regarded as statistically significant. Results: The serum sodium concentrations in mmol/L were 135.3 ± 3.09, 136.3 ± 1.55, 139.0 ± 0.78, 139.8 ± 0.91 for control, first-trimester, second-trimester, and third-trimester subjects respectively. The potassium concentrations in mmol/L were 3.678 ± 0.26, 3.687 ± 0.13, 3.820 ± 0.11, 3.767 ± 0.07 for control, first-trimester, second trimester and third-trimester subjects respectively. The Bodyweight values in kg were 72.13 ± 2.11, 74.73 ± 2.05, 75.00 ± 1.72, 81.56 ± 4.24 for control, first-trimest, second-trimester, and third-trimester subjects respectively. Conclusion: Results indicate that the hormones of pregnancy altered the body weight of pregnant women, but did not change the serum sodium and potassium level across the three trimesters of pregnancy in women. This is an indication that the kidneys of healthy pregnant women can handle serum electrolyte load during the period of pregnancy.
{"title":"A Comparative Study of Serum Sodium and Potassium Levels across the Three Trimesters of Pregnancy","authors":"O. Otoikhila, S. Seriki","doi":"10.29328/journal.cjog.1001137","DOIUrl":"https://doi.org/10.29328/journal.cjog.1001137","url":null,"abstract":"Aim: To evaluate the serum sodium and potassium levels in the three trimesters of pregnancy in women. Methods: Four groups of healthy women between the ages of 20 and 30 years, volunteered for this study. Group 1: Non-pregnant women (control), Group 2: Pregnant women in their first trimester, Group 3: Pregnant women in their second trimester, Group 4: Pregnant women in their third trimester. Blood samples were collected by standard aseptic method and serum samples were analyzed for serum levels of sodium and potassium by the ion selective electrode method. Results were presented as MEAN ± SEM in tables and figures, p < 0.05 was regarded as statistically significant. Results: The serum sodium concentrations in mmol/L were 135.3 ± 3.09, 136.3 ± 1.55, 139.0 ± 0.78, 139.8 ± 0.91 for control, first-trimester, second-trimester, and third-trimester subjects respectively. The potassium concentrations in mmol/L were 3.678 ± 0.26, 3.687 ± 0.13, 3.820 ± 0.11, 3.767 ± 0.07 for control, first-trimester, second trimester and third-trimester subjects respectively. The Bodyweight values in kg were 72.13 ± 2.11, 74.73 ± 2.05, 75.00 ± 1.72, 81.56 ± 4.24 for control, first-trimest, second-trimester, and third-trimester subjects respectively. Conclusion: Results indicate that the hormones of pregnancy altered the body weight of pregnant women, but did not change the serum sodium and potassium level across the three trimesters of pregnancy in women. This is an indication that the kidneys of healthy pregnant women can handle serum electrolyte load during the period of pregnancy.","PeriodicalId":36268,"journal":{"name":"Journal of Clinical Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80510545","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 : 2023-07-28DOI: 10.29328/journal.cjog.1001136
Kangulu Ignace Bwana, Moyambe Jules Ngwe Thaba, Nzaji Michel Kabamba, Kibibi Ange Assumani, Kazadi Alain Mbayo, Umba Elie Kilolo Ngoy, Lumbule John Ngoy, Zongwe Eric Kiwele, Kalume Xavier Kinenkinda, A'Nkoy Albert Mwembo Tambwe, Sakatolo Jean Baptiste Kakoma
Introduction: Every woman should receive quality antenatal care during pregnancy wherever she lives. We carried out this research with the objective of evaluating the quality of antenatal consultations (ANC) in terms of periodicity, screening, and prophylaxis interventions during antenatal consultations in Kamina and to identify the determinants associated with inadequate ANC. Material and methods: This was a descriptive and analytical cross-sectional study carried out in 6 health facilities in Kamina over a period of 17 months with 476 women who had given birth having attended antenatal consultations at least once. A scoring grid of periodicity standards, screening, and prophylactic interventions with a score of 40 was used to qualify the ANC as adequate. Logistic regression was performed to identify the determinants of inadequate ANC. Results: 40.3% of mothers had reached at least 4 antenatal visits (3.4±1.36); 21.2% had started the ANC no later than 16 weeks for an average age of 22.8 weeks ± 6.19. Overall, 72.5% of pregnant women had benefited from ANC qualified as inadequate. After adjustment, the determinants of inadequate ANC were multigestity (aOR=1.86[1.08-3.19]), low level of education of the mother (aOR=3.93; 95% CI=[2, 08-7.42]), and attendance at a first-level health facility (aOR=3.22; 95% CI=[2.06-5.05]. Conclusion: In the majority of cases, the ANC received by pregnant women in Kamina is inadequate. The determinants thus identified should serve the actors to direct the means to improve the quality of antenatal care in Kamina.
导言:无论生活在何处，每个妇女在怀孕期间都应得到高质量的产前保健。我们开展这项研究的目的是评估卡米纳产前咨询(ANC)的质量，包括定期、筛查和预防性干预措施，并确定与ANC不足相关的决定因素。材料和方法:这是一项描述性和分析性横断面研究，在卡米纳的6个卫生机构进行，为期17个月，对476名至少参加过一次产前咨询的分娩妇女进行了调查。采用周期性标准、筛查和预防性干预的评分网格，得分为40分，以确定ANC是否足够。进行逻辑回归以确定ANC不足的决定因素。结果:40.3%的产妇至少进行了4次产前检查(3.4±1.36)次);21.2%的患者不迟于16周开始ANC，平均年龄为22.8周±6.19周。总体而言，72.5%的孕妇受益于ANC，但被认为是不足的。调整后，多胎性(aOR=1.86[1.08-3.19])、母亲受教育程度低(aOR=3.93;95% CI=[2,08 -7.42])，以及在一级卫生机构就诊(aOR=3.22;95% CI =(2.06 - -5.05)。结论:在大多数情况下，卡米纳孕妇接受的ANC不足。由此确定的决定因素应有助于行为者指导提高卡米纳产前保健质量的手段。
{"title":"Quality of Antenatal Care and its Determinants in the Urban-Rural Environment of Kamina, Democratic Republic of the Congo","authors":"Kangulu Ignace Bwana, Moyambe Jules Ngwe Thaba, Nzaji Michel Kabamba, Kibibi Ange Assumani, Kazadi Alain Mbayo, Umba Elie Kilolo Ngoy, Lumbule John Ngoy, Zongwe Eric Kiwele, Kalume Xavier Kinenkinda, A'Nkoy Albert Mwembo Tambwe, Sakatolo Jean Baptiste Kakoma","doi":"10.29328/journal.cjog.1001136","DOIUrl":"https://doi.org/10.29328/journal.cjog.1001136","url":null,"abstract":"Introduction: Every woman should receive quality antenatal care during pregnancy wherever she lives. We carried out this research with the objective of evaluating the quality of antenatal consultations (ANC) in terms of periodicity, screening, and prophylaxis interventions during antenatal consultations in Kamina and to identify the determinants associated with inadequate ANC. Material and methods: This was a descriptive and analytical cross-sectional study carried out in 6 health facilities in Kamina over a period of 17 months with 476 women who had given birth having attended antenatal consultations at least once. A scoring grid of periodicity standards, screening, and prophylactic interventions with a score of 40 was used to qualify the ANC as adequate. Logistic regression was performed to identify the determinants of inadequate ANC. Results: 40.3% of mothers had reached at least 4 antenatal visits (3.4±1.36); 21.2% had started the ANC no later than 16 weeks for an average age of 22.8 weeks ± 6.19. Overall, 72.5% of pregnant women had benefited from ANC qualified as inadequate. After adjustment, the determinants of inadequate ANC were multigestity (aOR=1.86[1.08-3.19]), low level of education of the mother (aOR=3.93; 95% CI=[2, 08-7.42]), and attendance at a first-level health facility (aOR=3.22; 95% CI=[2.06-5.05]. Conclusion: In the majority of cases, the ANC received by pregnant women in Kamina is inadequate. The determinants thus identified should serve the actors to direct the means to improve the quality of antenatal care in Kamina.","PeriodicalId":36268,"journal":{"name":"Journal of Clinical Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85542612","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 : 2023-07-06DOI: 10.29328/journal.cjog.1001135
Chembukavu Suraj Narayanan, Samreen Sana Syed, Yadav Pankaj
Pre-eclampsia is a pregnancy-associated condition, which is characterized by the onset of hypertension and proteinuria. It is one of the leading causes of maternal and neonatal mortality and this affliction has been recorded in around 8% of all pregnancies in the world. In addition to this, the etiopathology of this condition is very less understood and the resources available to diagnose and treat it are limited. Prior studies suggest more than a hundred possible diagnostic biomarkers that could be used to detect this disease early on. However, most of them are not feasible due to several reasons including stability, cost, safety, etc. Here two biomarkers HtrA3 (high-temperature requirement A3) and NGAL (Neutrophil Gelatinase Associated Lipocalin) are selected for the detection of pre-eclampsia, and we compare their efficacy in the detection of pre-eclampsia based on their specificity, ease of use, speed, stage of detection and source (invasiveness). We found that these two biomarkers are efficient under some parameters, and inefficient under others. The scoring system used in the current study suggests that NGAL is a superior biomarker. The results of this study help to develop a stronger understanding of both these biomarkers in the short and long term to classify the biomarkers more efficiently and understand the complicated pathologies of pre-eclampsia.
{"title":"Comparative Analysis of HtrA3 and NGAL as Viable Biomarkers for Pre-eclampsia","authors":"Chembukavu Suraj Narayanan, Samreen Sana Syed, Yadav Pankaj","doi":"10.29328/journal.cjog.1001135","DOIUrl":"https://doi.org/10.29328/journal.cjog.1001135","url":null,"abstract":"Pre-eclampsia is a pregnancy-associated condition, which is characterized by the onset of hypertension and proteinuria. It is one of the leading causes of maternal and neonatal mortality and this affliction has been recorded in around 8% of all pregnancies in the world. In addition to this, the etiopathology of this condition is very less understood and the resources available to diagnose and treat it are limited. Prior studies suggest more than a hundred possible diagnostic biomarkers that could be used to detect this disease early on. However, most of them are not feasible due to several reasons including stability, cost, safety, etc. Here two biomarkers HtrA3 (high-temperature requirement A3) and NGAL (Neutrophil Gelatinase Associated Lipocalin) are selected for the detection of pre-eclampsia, and we compare their efficacy in the detection of pre-eclampsia based on their specificity, ease of use, speed, stage of detection and source (invasiveness). We found that these two biomarkers are efficient under some parameters, and inefficient under others. The scoring system used in the current study suggests that NGAL is a superior biomarker. The results of this study help to develop a stronger understanding of both these biomarkers in the short and long term to classify the biomarkers more efficiently and understand the complicated pathologies of pre-eclampsia.","PeriodicalId":36268,"journal":{"name":"Journal of Clinical Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88791000","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}
Introduction: Twin pregnancy, compared to a singleton pregnancy, is associated with a higher risk of preterm birth and other neonatal complications. This study aimed to compare neonatal mortality rates and risk factors among births with the gestational age of 34 weeks - 37 weeks in twin and singleton pregnancies. Methods: The study design was cross-sectional and population-based. We extracted the data from the birth information registry in Iran. Mothers' and neonates' information was removed from the registry systems between 2018 and 2020. We used Statistical R software to compare neonatal mortality rate, demographic variables, and risk factors between two groups of twin and singleton neonates. Results: Out of 579,873 live births with a gestational age of 34 weeks - 37 weeks, 729 (1.4/1000) singleton and 54(0.77/1000) twins (one out of two) neonates died in the delivery room in the first hour of life. Of the neonates who left the delivery room alive, 3129 (4.9 per 1000) neonates had died (5.7/1000 singleton and 3.04/1000 twin). The neonatal mortality rate in hospitalized singleton neonates (1.85%) was higher than twin group (1.06%). After adjustment of other variables, the mortality rate in twin pregnancy was significantly lower than in singletons (p value < 1/1000), with an odds ratio of 0.47 (CI: 0.39 - 0.55). Antenatal corticosteroid treatment in the twin group was significantly higher than in singletons. Conclusion: Twin neonatal mortality rate was lower than singletons in the neonates with gestational age 34 weeks - 37 weeks. Clinicians could consider these results for delivery timing in uncomplicated twin pregnancies. Antenatal corticosteroid therapy can be considered to reduce the mortality rate of late preterm neonates in resource-limited countries.
{"title":"Neonatal Mortality Rate among Twin and Singleton Births with the Gestational Age of 34-37 Weeks: A Population-Based Study","authors":"Hantoushzadeh Sedigheh, Mirnia Kayvan, Sadeghi Hananeh Sadat, Sadeghimoghadam Parvaneh, Aghaali Mohammad, Heidarzadeh Mohammad, Habibelahi Abbas, Rafiee Shima, Haddadi Mohammad, Naddaf Amir","doi":"10.29328/journal.cjog.1001134","DOIUrl":"https://doi.org/10.29328/journal.cjog.1001134","url":null,"abstract":"Introduction: Twin pregnancy, compared to a singleton pregnancy, is associated with a higher risk of preterm birth and other neonatal complications. This study aimed to compare neonatal mortality rates and risk factors among births with the gestational age of 34 weeks - 37 weeks in twin and singleton pregnancies. Methods: The study design was cross-sectional and population-based. We extracted the data from the birth information registry in Iran. Mothers' and neonates' information was removed from the registry systems between 2018 and 2020. We used Statistical R software to compare neonatal mortality rate, demographic variables, and risk factors between two groups of twin and singleton neonates. Results: Out of 579,873 live births with a gestational age of 34 weeks - 37 weeks, 729 (1.4/1000) singleton and 54(0.77/1000) twins (one out of two) neonates died in the delivery room in the first hour of life. Of the neonates who left the delivery room alive, 3129 (4.9 per 1000) neonates had died (5.7/1000 singleton and 3.04/1000 twin). The neonatal mortality rate in hospitalized singleton neonates (1.85%) was higher than twin group (1.06%). After adjustment of other variables, the mortality rate in twin pregnancy was significantly lower than in singletons (p value < 1/1000), with an odds ratio of 0.47 (CI: 0.39 - 0.55). Antenatal corticosteroid treatment in the twin group was significantly higher than in singletons. Conclusion: Twin neonatal mortality rate was lower than singletons in the neonates with gestational age 34 weeks - 37 weeks. Clinicians could consider these results for delivery timing in uncomplicated twin pregnancies. Antenatal corticosteroid therapy can be considered to reduce the mortality rate of late preterm neonates in resource-limited countries.","PeriodicalId":36268,"journal":{"name":"Journal of Clinical Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79589650","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 : 2023-06-21DOI: 10.29328/journal.cjog.1001133
Guven Suleyman, Comert Erhan Huseyin, Guven Emine Seda Guvendag, Demir Bulent, Karcaaltincaba Deniz
Aims: There is no study in the literature about ischemia-modified albumin (IMA) and hepatocyte growth factor (HGF) levels in amniotic fluid for Down syndrome cases. The aim of this study was to investigate the changes of IMA and HGF in Down syndrome cases at 16-20 weeks of gestation compared to normal fetuses. Methods: For this prospective case-control study, following reaching the number of 20 women (study group) who had the prenatal diagnosis of Down syndrome, maternal and gestational age-matched pregnant women with normal constitutional karyotype were selected for the control group (n = 74) from the stored amniotic fluid samples. Results: Mean women and gestational ages were comparable between the two groups. Amniotic fluid IMA (1.32 ± 0.13 vs. 1.11 ± 0.11 ABSU, respectively, p < 0.001) and HGF (2743.53 ± 1389.28 vs. 2160.12 ± 654.63 pg/mL, respectively, p = 0.008). Levels were significantly higher in pregnant women having Down syndrome fetuses compared with women having normal fetuses. The amniotic fluid IMA levels for the diagnosis of Down syndrome, and the sensitivity and specificity were calculated as 95.0% and 71.6% for the limit value 1.171 cm3, respectively. Conclusion: In cases with suspected Down syndrome, the diagnosis of Down Syndrome may be made in approximately 1 hour with high sensitivity and specificity by measuring the IMA level in the amniotic fluid sample taken for fetal karyotyping.
目的:尚没有文献报道唐氏综合征患者羊水中缺血修饰白蛋白(IMA)和肝细胞生长因子(HGF)水平的变化。本研究的目的是研究与正常胎儿相比，唐氏综合征患者在妊娠16-20周时IMA和HGF的变化。方法:本前瞻性病例对照研究，在产前诊断为唐氏综合征的妇女达到20名(研究组)后，从储存的羊水样本中选择母体与胎龄匹配的正常体质核型孕妇(n = 74)作为对照组。结果:两组的平均妇女和胎龄具有可比性。羊水IMA(1.32±0.13比1.11±0.11 ABSU, p < 0.001)和HGF(2743.53±1389.28比2160.12±654.63 pg/mL, p = 0.008)。与正常胎儿的孕妇相比，患有唐氏综合症胎儿的孕妇的水平明显更高。羊水IMA水平诊断唐氏综合征的敏感性和特异性分别为95.0%和71.6%，极限值为1.171 cm3。结论:在疑似唐氏综合征的病例中，通过测定胎儿核型羊水样本中的IMA水平，可在约1小时内做出唐氏综合征的诊断，具有较高的敏感性和特异性。
{"title":"Amniotic Fluid Ischemia Modified Albumin as a Novel Prenatal Diagnostic Marker for Down Syndrome: A Prospective Case-Control Study","authors":"Guven Suleyman, Comert Erhan Huseyin, Guven Emine Seda Guvendag, Demir Bulent, Karcaaltincaba Deniz","doi":"10.29328/journal.cjog.1001133","DOIUrl":"https://doi.org/10.29328/journal.cjog.1001133","url":null,"abstract":"Aims: There is no study in the literature about ischemia-modified albumin (IMA) and hepatocyte growth factor (HGF) levels in amniotic fluid for Down syndrome cases. The aim of this study was to investigate the changes of IMA and HGF in Down syndrome cases at 16-20 weeks of gestation compared to normal fetuses. Methods: For this prospective case-control study, following reaching the number of 20 women (study group) who had the prenatal diagnosis of Down syndrome, maternal and gestational age-matched pregnant women with normal constitutional karyotype were selected for the control group (n = 74) from the stored amniotic fluid samples. Results: Mean women and gestational ages were comparable between the two groups. Amniotic fluid IMA (1.32 ± 0.13 vs. 1.11 ± 0.11 ABSU, respectively, p < 0.001) and HGF (2743.53 ± 1389.28 vs. 2160.12 ± 654.63 pg/mL, respectively, p = 0.008). Levels were significantly higher in pregnant women having Down syndrome fetuses compared with women having normal fetuses. The amniotic fluid IMA levels for the diagnosis of Down syndrome, and the sensitivity and specificity were calculated as 95.0% and 71.6% for the limit value 1.171 cm3, respectively. Conclusion: In cases with suspected Down syndrome, the diagnosis of Down Syndrome may be made in approximately 1 hour with high sensitivity and specificity by measuring the IMA level in the amniotic fluid sample taken for fetal karyotyping.","PeriodicalId":36268,"journal":{"name":"Journal of Clinical Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88768369","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 : 2023-06-20DOI: 10.29328/journal.cjog.1001132
Eléonore Gbary-Lagaud, Carine Houphouet-Mwandji, D. Effoh, R. Adjoby
Objective: To evaluate the surgical management of myomas at the Teaching Hospital of Angré according to the FIGO (International Federation of Gynecology and Obstetrics) classification. Patients and methods: This was a cross-sectional study at the Teaching Hospital of Angre from January 1, 2020, to December 31, 2022. Patients whose operative indication was clearly identified were included in the study. Incomplete files were not included. The variables studied were anthropometric parameters, clinical characteristics of myomas, and surgery. Due to the large size and multifocal location of uterine myomas, the therapeutic option remained surgery by laparotomy. Results: Most patients were over 35 years old (71.5%) and nulliparous (52.8%). The first indication for surgery was menometrorrhagia (88.6%), followed by the desire for motherhood (37.8%) and dysmenorrhoea (20.2%) for myomas most often FIGO type 4 (p = 0.0031). Myomectomy under cervical-isthmic tourniquet was the most common procedure for FIGO type 4 myomas (66.1%; p = 0.0543). Hysterectomy was most frequently performed for FIGO type 7 myomas (43.9%; p = 0.0543). For myomectomy, the first complication was anaemia (3.5%) followed by uterine suture haemorrhage (1.7%) (p = 0.5139). Conclusion: Our surgical practice at the Teaching Hospital of Angre is in accordance with FIGO recommendations. However, an effort should be made to promote the minimally invasive surgical approach (laparoscopic, hysteroscopic, transvaginal ablation) for small fibroids (≤ 5 cm) or FIGO type 0 to 3, which is not very frequent in our current practice.
{"title":"Surgical Management of Uterine Fibroids at the Teaching Hospital of Angre Abidjan Cote d’Ivoire: 193 Cases Report","authors":"Eléonore Gbary-Lagaud, Carine Houphouet-Mwandji, D. Effoh, R. Adjoby","doi":"10.29328/journal.cjog.1001132","DOIUrl":"https://doi.org/10.29328/journal.cjog.1001132","url":null,"abstract":"Objective: To evaluate the surgical management of myomas at the Teaching Hospital of Angré according to the FIGO (International Federation of Gynecology and Obstetrics) classification. Patients and methods: This was a cross-sectional study at the Teaching Hospital of Angre from January 1, 2020, to December 31, 2022. Patients whose operative indication was clearly identified were included in the study. Incomplete files were not included. The variables studied were anthropometric parameters, clinical characteristics of myomas, and surgery. Due to the large size and multifocal location of uterine myomas, the therapeutic option remained surgery by laparotomy. Results: Most patients were over 35 years old (71.5%) and nulliparous (52.8%). The first indication for surgery was menometrorrhagia (88.6%), followed by the desire for motherhood (37.8%) and dysmenorrhoea (20.2%) for myomas most often FIGO type 4 (p = 0.0031). Myomectomy under cervical-isthmic tourniquet was the most common procedure for FIGO type 4 myomas (66.1%; p = 0.0543). Hysterectomy was most frequently performed for FIGO type 7 myomas (43.9%; p = 0.0543). For myomectomy, the first complication was anaemia (3.5%) followed by uterine suture haemorrhage (1.7%) (p = 0.5139). Conclusion: Our surgical practice at the Teaching Hospital of Angre is in accordance with FIGO recommendations. However, an effort should be made to promote the minimally invasive surgical approach (laparoscopic, hysteroscopic, transvaginal ablation) for small fibroids (≤ 5 cm) or FIGO type 0 to 3, which is not very frequent in our current practice.","PeriodicalId":36268,"journal":{"name":"Journal of Clinical Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77724356","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 : 2023-06-16DOI: 10.29328/journal.cjog.1001131
Chanda Kasonde, Lian Liang Sheng, Yan Kong Yi, Qian Huang, Abulikem Gulidiya, Nonde Royd Nkalamo, Yan Ying Xiao
Background: 800 women die and 2.6 million stillbirths occur worldwide related to pregnancy complications. Racial/ethnic disparities in pregnancy-related mortality have continued to be significantly higher among black than whites due to various factors. We sought to investigate complications among pregnant women of different race/ethnicity. Methods: Cross-sectional observational study of 2030 obstetric cases randomly selected for the period January 1 to December 31, 2021. Data was collected from the hard copy and electronic inpatients’ records. Analysis was performed using SPSS version 23. Descriptive statistics analyzed the pregnancy complication frequencies, standard deviations, range, minimum and maximum values. Maternal characteristics were analyzed using an independent samples t-test. Maternal characteristics were evaluated using the two samples t-test. The odds ratios and confidence intervals were calculated as measures of association between ethnicity/race and pregnancy complications using a binary logistic regression model. Confidence interval was set at 95% and p < 0.05 (2-tailed) was considered statistically significant. Results: 76.25% of Chinese and 67.86% of Zambians were affected by one or more complications. The mean ± standard deviation for MGH [age (26.69 ± 7.33), gravidity (3.35 ± 2.08), and parity (2.07 ± 1.68)] and for 2nd affiliated hospital was [age (30.04 ± 4.29), gravidity (2.19 ± 1.38) and parity (0.45 ± 0.55)]. Prevalence of top five pregnancy complications in the Chinese group was gestational diabetes mellitus at 18.41%, hypothyroidism at 15.91%, oligohydramnios at 14.39%, premature rupture of membranes at 12.17%, and anemia at 5.73%. The prevalence of the top five pregnancy complications in the Zambian group was preeclampsia at 13.80%, PIH at 12.74%, PROM at 12.45%, eclampsia at 7.53%, and placenta abruption at 7.43%. Statistical significance findings were noted as follows: Oligohydramnios [OR 0.02, CI (0.01 - 0.05), p = 0.000], placenta praevia [OR 0.08, CI (0.01 - 0.61), p = 0.015], preeclampsia [OR 13.10, CI (7.22 - 23.78), p = 0.000], placenta abruptio [OR 79.73, CI (11.07 - 574.38), p = 0.000], PIH [OR 11.95, CI (6.57 - 21.73), p = 0.005], eclampsia [OR 162.90, CI (10.08 - 2631, p = 0.000), PPROM [OR 0.03, CI (0.00 - 0.45), p = 0.012], GDM [OR 0.11, CI (0.07 - 0.17), p = 0.000], hypothyroidism [OR 0.01(0.00-0.03), p = 0.000], anemia [OR 0.18, CI (0.92-0.34), p = 0.000], ICP [OR 0.03, CI (0.00 - 0.48), p = 0.013], syphilis [OR 7.17, CI (2.14 - 24.02), p = 0.001], UTI [OR 22.55, CI (3.04 - 17.26), p = 0.002], HBV [OR 0.05, CI (0.00 - 0.86), p = 0.039] and GBS [OR 0.06, CI (0.00 - 1.11), p = 0.059]. Conclusion: Highest odds for obstetrical and infection-related pregnancy complications were associated with Zambian cases. The highest odds for medical complications were associated with Chinese cases.
背景:全世界有800名妇女死亡，260万死产与妊娠并发症有关。由于各种因素，黑人在与怀孕有关的死亡率方面的种族/族裔差异继续明显高于白人。我们试图调查不同种族/民族孕妇的并发症。方法:随机选取2021年1月1日至12月31日期间的2030例产科病例进行横断面观察研究。数据从纸质和电子住院病历中收集。采用SPSS version 23进行分析。描述性统计分析妊娠并发症的发生频率、标准差、范围、最小值和最大值。采用独立样本t检验分析母体特征。采用两样本t检验评价产妇特征。使用二元logistic回归模型计算比值比和置信区间，以衡量族裔/种族与妊娠并发症之间的关系。置信区间为95%，认为p < 0.05(双尾)有统计学意义。结果:76.25%的中国人和67.86%的赞比亚人有一种或多种并发症。MGH的平均±标准差为年龄(26.69±7.33)、妊娠(3.35±2.08)、胎次(2.07±1.68)，附属第二医院的平均±标准差为年龄(30.04±4.29)、妊娠(2.19±1.38)、胎次(0.45±0.55)。中国组前5大妊娠并发症发生率依次为妊娠期糖尿病(18.41%)、甲状腺功能减退(15.91%)、羊水过少(14.39%)、胎膜早破(12.17%)、贫血(5.73%)。赞比亚组前5大妊娠并发症患病率分别为:先兆子痫(13.80%)、妊高征(12.74%)、胎膜早破(12.45%)、子痫(7.53%)、胎盘早剥(7.43%)。统计显著性发现如下:羊水过少(CI(0.01 - 0.05)或0.02,p = 0.000),前置胎盘(CI(0.01 - 0.61)或0.08,p = 0.015),子痫前期(CI(7.22 - 23.78)或13.10,p = 0.000),胎盘分开(CI(11.07 - 574.38)或79.73,p = 0.000), PIH (CI(6.57 - 21.73)或11.95,p = 0.005),惊厥(或162.90,CI (10.08 - 2631, p = 0.000), PPROM (CI(0.00 - 0.45)或0.03,p = 0.012), GDM (CI(0.07 - 0.17)或0.11,p = 0.000),甲状腺功能减退(或0.01 (0.00 - -0.03),p = 0.000),贫血(或0.18,CI (0.92 - -0.34),p = 0.000]、ICP [OR 0.03, CI (0.00 - 0.48)， p = 0.013]、梅毒[OR 7.17, CI (2.14 - 24.02)， p = 0.001]、UTI [OR 22.55, CI (3.04 - 17.26)， p = 0.002]、HBV [OR 0.05, CI (0.00 - 0.86)， p = 0.039]和GBS [OR 0.06, CI (0.00 - 1.11)， p = 0.059]。结论:产科和感染相关妊娠并发症的最高几率与赞比亚病例有关。中国病例出现医疗并发症的几率最高。
{"title":"Racial and Ethnic Disparities in Pregnancy-related Complications: Findings at Mansa General Hospital and 2nd Affiliated Hospital of Nanjing Medical University","authors":"Chanda Kasonde, Lian Liang Sheng, Yan Kong Yi, Qian Huang, Abulikem Gulidiya, Nonde Royd Nkalamo, Yan Ying Xiao","doi":"10.29328/journal.cjog.1001131","DOIUrl":"https://doi.org/10.29328/journal.cjog.1001131","url":null,"abstract":"Background: 800 women die and 2.6 million stillbirths occur worldwide related to pregnancy complications. Racial/ethnic disparities in pregnancy-related mortality have continued to be significantly higher among black than whites due to various factors. We sought to investigate complications among pregnant women of different race/ethnicity. Methods: Cross-sectional observational study of 2030 obstetric cases randomly selected for the period January 1 to December 31, 2021. Data was collected from the hard copy and electronic inpatients’ records. Analysis was performed using SPSS version 23. Descriptive statistics analyzed the pregnancy complication frequencies, standard deviations, range, minimum and maximum values. Maternal characteristics were analyzed using an independent samples t-test. Maternal characteristics were evaluated using the two samples t-test. The odds ratios and confidence intervals were calculated as measures of association between ethnicity/race and pregnancy complications using a binary logistic regression model. Confidence interval was set at 95% and p < 0.05 (2-tailed) was considered statistically significant. Results: 76.25% of Chinese and 67.86% of Zambians were affected by one or more complications. The mean ± standard deviation for MGH [age (26.69 ± 7.33), gravidity (3.35 ± 2.08), and parity (2.07 ± 1.68)] and for 2nd affiliated hospital was [age (30.04 ± 4.29), gravidity (2.19 ± 1.38) and parity (0.45 ± 0.55)]. Prevalence of top five pregnancy complications in the Chinese group was gestational diabetes mellitus at 18.41%, hypothyroidism at 15.91%, oligohydramnios at 14.39%, premature rupture of membranes at 12.17%, and anemia at 5.73%. The prevalence of the top five pregnancy complications in the Zambian group was preeclampsia at 13.80%, PIH at 12.74%, PROM at 12.45%, eclampsia at 7.53%, and placenta abruption at 7.43%. Statistical significance findings were noted as follows: Oligohydramnios [OR 0.02, CI (0.01 - 0.05), p = 0.000], placenta praevia [OR 0.08, CI (0.01 - 0.61), p = 0.015], preeclampsia [OR 13.10, CI (7.22 - 23.78), p = 0.000], placenta abruptio [OR 79.73, CI (11.07 - 574.38), p = 0.000], PIH [OR 11.95, CI (6.57 - 21.73), p = 0.005], eclampsia [OR 162.90, CI (10.08 - 2631, p = 0.000), PPROM [OR 0.03, CI (0.00 - 0.45), p = 0.012], GDM [OR 0.11, CI (0.07 - 0.17), p = 0.000], hypothyroidism [OR 0.01(0.00-0.03), p = 0.000], anemia [OR 0.18, CI (0.92-0.34), p = 0.000], ICP [OR 0.03, CI (0.00 - 0.48), p = 0.013], syphilis [OR 7.17, CI (2.14 - 24.02), p = 0.001], UTI [OR 22.55, CI (3.04 - 17.26), p = 0.002], HBV [OR 0.05, CI (0.00 - 0.86), p = 0.039] and GBS [OR 0.06, CI (0.00 - 1.11), p = 0.059]. Conclusion: Highest odds for obstetrical and infection-related pregnancy complications were associated with Zambian cases. The highest odds for medical complications were associated with Chinese cases.","PeriodicalId":36268,"journal":{"name":"Journal of Clinical Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78603371","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 : 2023-06-14DOI: 10.29328/journal.cjog.1001130
NG Yan Shun, Goh Marlene Samantha Sze Minn, Mathur Manisha
There are few reported cases of meningitis in pregnancy and presentation can be variable in each patient which may cause diagnostic challenges and potential delays in treatment. Here, we discuss a case of aseptic meningitis - a 36 years old Gravida 2 Para 1 pediatric physician with “the worst headache of her life” at 31+5 weeks of gestation. At presentation, she did not have any of the classic triads of meningitis (fever, neck stiffness, and/or a change in mental status) and did not report any neurological symptoms. In view of persistent headache, development of pyrexia, and evolving symptoms of photophobia, she was referred to a neurology specialist, and a lumbar puncture was performed. Findings were in line with meningitis and the polymerase chain reaction confirmed enterovirus meningitis. Although aseptic meningitis is rare, it should be considered as a differential diagnosis in patients with persistent complaints, development of associated symptoms of pyrexia, photophobia, and neck pain, as well as in patients with increased risk of exposure to viral illnesses.
{"title":"Aseptic Meningitis in Pregnancy – A Case Study Detailing Potential Diagnostic Dilemmas","authors":"NG Yan Shun, Goh Marlene Samantha Sze Minn, Mathur Manisha","doi":"10.29328/journal.cjog.1001130","DOIUrl":"https://doi.org/10.29328/journal.cjog.1001130","url":null,"abstract":"There are few reported cases of meningitis in pregnancy and presentation can be variable in each patient which may cause diagnostic challenges and potential delays in treatment. Here, we discuss a case of aseptic meningitis - a 36 years old Gravida 2 Para 1 pediatric physician with “the worst headache of her life” at 31+5 weeks of gestation. At presentation, she did not have any of the classic triads of meningitis (fever, neck stiffness, and/or a change in mental status) and did not report any neurological symptoms. In view of persistent headache, development of pyrexia, and evolving symptoms of photophobia, she was referred to a neurology specialist, and a lumbar puncture was performed. Findings were in line with meningitis and the polymerase chain reaction confirmed enterovirus meningitis. Although aseptic meningitis is rare, it should be considered as a differential diagnosis in patients with persistent complaints, development of associated symptoms of pyrexia, photophobia, and neck pain, as well as in patients with increased risk of exposure to viral illnesses.","PeriodicalId":36268,"journal":{"name":"Journal of Clinical Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80420469","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}
Background: Exclusive breastfeeding has great benefits for both the mother and the child. Few studies have been carried out on interventions to improve Exclusive Breastfeeding (EBF) practice by childbearing mothers. No study has formulated and/or implemented a hospital-based maternal counseling guide intervention to improve EBF practice. This baseline study assessed the knowledge, attitude, and practice of EBF on mothers who were enrolled in antenatal clinics for a cluster randomized trial and the disparity in the knowledge of EBF based on lactation, age, sex, and source of income. Methods: We formulated a hospital-based counseling guide on exclusive breastfeeding, which is under implementation by prenatal and nursing mothers, to promote EBF practice in the study area. A cross-sectional study was conducted in two hospitals randomly selected from twelve hospitals in Anambra State. The study was among pregnant women who were in their second trimester. The data collection took place from March to April 2022. The data were analyzed using descriptive statistics and Chi-Square. The test of significance was set at p < 0.05. Results: The control and the intervention arms had an equal number of enrolees (144) each and more than half of the participants were between the ages of 23 – 32 years. The majority of the participants showed adequate knowledge of exclusive breastfeeding as over 90% knew that EBF is important and capable of improving their baby's immunity. The participants demonstrated a positive attitude to exclusive breastfeeding and they had a significantly high level of practice of daily consumption of galactagogues. The study suggested that the majority did not practice breast milk extraction mainly because the process of extraction is painful and some do not know how to carry out the extraction. Conclusion: The mothers have the requisite knowledge of the benefits of exclusive breastfeeding to their infants and themselves. However, they do not practice EBF. Interventions to improve EBF practice should focus on educating mothers on proper breast milk extraction and storage techniques.
{"title":"A baseline assessment of the knowledge, attitude, and practices of exclusive breastfeeding among women enrolled in a cluster randomized trial in Anambra State Nigeria","authors":"Ejie Izuchukwu Loveth, Anetoh Maureen Ugonwa, Atakulu Rita Oluebubechukwu, Ogbonna Brian Onyebuchi, Nwabanne Amarachi Triumph, Agujiobi Chinazom Cynthia, Aniugbo Benjamin Maduabuchukwu, Umeh Ifeoma Blessing, Ofomata Chijioke Maxwell, Chigbo Chisom God’swill, Agbapuonwu Noreen Ebelechukwu Noreen Ebelechukwu, Eleje Lydia Ijeoma, Onubogu Chinyere Ukamaka, Eleje George Uchenna, Ekwunife Obinna Ikechukwu, I. Mbagwu Sonne","doi":"10.29328/journal.cjog.1001129","DOIUrl":"https://doi.org/10.29328/journal.cjog.1001129","url":null,"abstract":"Background: Exclusive breastfeeding has great benefits for both the mother and the child. Few studies have been carried out on interventions to improve Exclusive Breastfeeding (EBF) practice by childbearing mothers. No study has formulated and/or implemented a hospital-based maternal counseling guide intervention to improve EBF practice. This baseline study assessed the knowledge, attitude, and practice of EBF on mothers who were enrolled in antenatal clinics for a cluster randomized trial and the disparity in the knowledge of EBF based on lactation, age, sex, and source of income. Methods: We formulated a hospital-based counseling guide on exclusive breastfeeding, which is under implementation by prenatal and nursing mothers, to promote EBF practice in the study area. A cross-sectional study was conducted in two hospitals randomly selected from twelve hospitals in Anambra State. The study was among pregnant women who were in their second trimester. The data collection took place from March to April 2022. The data were analyzed using descriptive statistics and Chi-Square. The test of significance was set at p < 0.05. Results: The control and the intervention arms had an equal number of enrolees (144) each and more than half of the participants were between the ages of 23 – 32 years. The majority of the participants showed adequate knowledge of exclusive breastfeeding as over 90% knew that EBF is important and capable of improving their baby's immunity. The participants demonstrated a positive attitude to exclusive breastfeeding and they had a significantly high level of practice of daily consumption of galactagogues. The study suggested that the majority did not practice breast milk extraction mainly because the process of extraction is painful and some do not know how to carry out the extraction. Conclusion: The mothers have the requisite knowledge of the benefits of exclusive breastfeeding to their infants and themselves. However, they do not practice EBF. Interventions to improve EBF practice should focus on educating mothers on proper breast milk extraction and storage techniques.","PeriodicalId":36268,"journal":{"name":"Journal of Clinical Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84199847","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 : 2023-05-08DOI: 10.29328/journal.cjog.1001128
Moridi Irene
Reproductive health care disparity is a significant public health issue that affects many populations. This disparity stems from various factors, including race, ethnicity, socioeconomic status, geographic location, and education level. Such inequality results in adverse health outcomes such as unintended pregnancy, infertility and sexually transmitted infections among certain populations. Therefore, addressing reproductive health care disparities requires increasing access to affordable and comprehensive reproductive health services, promoting culturally competent care, improving access to family planning services and addressing barriers to care. Furthermore, promoting comprehensive sexuality education and addressing the root causes of inequality are also crucial in eliminating reproductive health care disparities. By addressing these disparities, we can ensure that all individuals have equal access to quality reproductive health care and services, leading to improved health outcomes for everyone.
{"title":"Addressing reproductive healthcare disparities: strategies for achieving health equity","authors":"Moridi Irene","doi":"10.29328/journal.cjog.1001128","DOIUrl":"https://doi.org/10.29328/journal.cjog.1001128","url":null,"abstract":"Reproductive health care disparity is a significant public health issue that affects many populations. This disparity stems from various factors, including race, ethnicity, socioeconomic status, geographic location, and education level. Such inequality results in adverse health outcomes such as unintended pregnancy, infertility and sexually transmitted infections among certain populations. Therefore, addressing reproductive health care disparities requires increasing access to affordable and comprehensive reproductive health services, promoting culturally competent care, improving access to family planning services and addressing barriers to care. Furthermore, promoting comprehensive sexuality education and addressing the root causes of inequality are also crucial in eliminating reproductive health care disparities. By addressing these disparities, we can ensure that all individuals have equal access to quality reproductive health care and services, leading to improved health outcomes for everyone.","PeriodicalId":36268,"journal":{"name":"Journal of Clinical Obstetrics and Gynecology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78932401","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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