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Comparison of Maternal and fetal outcomes in mothers with non-congenital mitral valve stenosis and healthy control 非先天性二尖瓣狭窄母亲与健康对照组母亲和胎儿结局的比较
Q1 Medicine Pub Date : 2024-02-27 DOI: 10.1016/j.eurox.2024.100290
Sima sobhani shari , Tubi Kazemi , Ali Bidokhti , Seyed Mohammad Riahi

Background

Physiological changes during pregnancy cause complications in mothers with mitral stenosis and their infants. This study was designed to assess maternal and fetal pregnancy outcomes in women with rheumatic mitral valve stenosis and compare them with the control group.

Materials and methods

This study is a case-control study on 153 pregnant women, including 51 with mitral stenosis (MS) and 102 without MS as the control group, between 2007–2022. For each studied patient, two control participants were selected and matched in residence, age, and year of pregnancy. SPSS version 22 was used for data analysis.

Results

The mean age was 31.7 ± 4.6 years in cases and 31.6 ± 4.7 in the healthy controls. Demographic variables were not significantly different between the case and control groups. The rate of stillbirth (5.9% vs. 0.0%), %), NICU admission (13.7% vs. 2.0%), and IUGR (5.9% vs. 0.0%) were higher in the fetal case group compared with the control group. On the other hand, maternal outcomes, including pulmonary edema (13.7% vs. 0.0%), ICU admission (23.5% vs. 0.0%), limb edema (15.7% vs. 0.0%), dyspnea (37.3% vs. 0.0%), pulmonary hypertension (9.8% vs. 0.0%), palpitations (21.1% vs. 0.0%) and hospital admission during pregnancy (37.2% vs. 4.9%) were statistically more common in the case groups.

Conclusions

Pregnancy is associated with significant fetomaternal morbidities in women with mitral valve heart disease. So they need a multidisciplinary approach in preconception and antenatal care.

背景妊娠期间的生理变化会导致二尖瓣狭窄的母亲及其婴儿出现并发症。本研究旨在评估风湿性二尖瓣狭窄妇女的母体和胎儿妊娠结局,并将其与对照组进行比较。材料和方法本研究是一项病例对照研究,研究对象为 2007-2022 年间的 153 名孕妇,包括 51 名二尖瓣狭窄(MS)患者和 102 名无 MS 的对照组。为每位研究对象选择了两名对照组参与者,并在居住地、年龄和怀孕年份方面进行了配对。结果病例的平均年龄为(31.7±4.6)岁,健康对照组的平均年龄为(31.6±4.7)岁。病例组和对照组的人口统计学变量无明显差异。与对照组相比,胎儿病例组的死胎率(5.9% 对 0.0%)、新生儿重症监护室入院率(13.7% 对 2.0%)和 IUGR(5.9% 对 0.0%)较高。另一方面,产妇的结局包括肺水肿(13.7% 对 0.0%)、入住重症监护室(23.5% 对 0.0%)、肢体水肿(15.7% 对 0.0%)、呼吸困难(37.3% 对 0.0%)、肺动脉高压(9.8% 对 0.0%)、心悸(21.1% 对 0.0%)和入院。结论患有二尖瓣心脏疾病的妇女妊娠与胎儿和产妇的重大疾病相关。因此,她们需要在孕前和产前护理中采用多学科方法。
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引用次数: 0
The effect of pentoxifylline and different types of exercise training on coagulation factors in a rat endometriosis model 喷托塞林和不同类型的运动训练对大鼠子宫内膜异位症模型凝血因子的影响
Q1 Medicine Pub Date : 2024-02-21 DOI: 10.1016/j.eurox.2024.100292
Zahra Salehpoor , Mohamad Rezapourmoghadam , Nader Tanideh , Maryam Koushkie Jahromi

Objectives

This study evaluated the effects of high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), and pentoxifylline (PTX) on coagulation factors, including the amount and percentage of lymphocytes, PLC, PLR, aPTT, PT, PT.I.N. R in a model of rats with endometriosis.

Methods

Endometriosis was surgically induced in female SpragueDawley rats. The rats with confirmed endometrial implants were divided into control, MICT, pentoxifylline (D), HIIT+D, and MICT+D, HIIT groups. D and exercise interventions were performed for eight weeks. Then, the macroscopic size of endometriosis lesions was measured, and inflammatory factors (count and percentage of lymphocytes) and coagulation factors, including PLC, PLR, aPTT, PT, PT.I.N. R, and PLR in blood samples were evaluated.

Results

D significantly decreased the volume of lesions and significantly increased PT and PT.I.N. R in blood. HIIT decreased the volume of lesions and significantly increased PT. MICT did not cause significant effects on the target variables. MICT+D decreased the volume of lesions. HIIT+D significantly decreased the volume of lesions and PLC and increased aPTT as well as the count and percentage of lymphocytes, PT, and PT.I.N. R, and decreased PLR.

Conclusions

All interventions(except for MICT) especially HIIT+D and D by priority, induced a significant effect on reducing some indices of inflammation and coagulation.

方法用手术诱导雌性 SpragueDawley 大鼠患子宫内膜异位症。将确诊子宫内膜植入的大鼠分为对照组、MICT 组、戊氧地胆素组(D)、HIIT+D 组和 MICT+D 组、HIIT 组。D组和运动干预组均持续八周。然后,测量子宫内膜异位症病灶的宏观大小,评估血液样本中的炎症因子(淋巴细胞计数和百分比)和凝血因子,包括 PLC、PLR、aPTT、PT、PT.I.N.R 和 PLR。HIIT 减少了病变体积,并明显增加了 PT。MICT 对目标变量无明显影响。MICT+D减少了病变体积。结论所有干预措施(除 MICT 外),尤其是 HIIT+D 和 D(优先),对降低炎症和凝血的某些指标有明显作用。
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引用次数: 0
Correlation between estrogen receptor and programmed death ligand-1 in type I endometrial cancer I 型子宫内膜癌中雌激素受体与程序性死亡配体-1 之间的相关性
Q1 Medicine Pub Date : 2024-02-20 DOI: 10.1016/j.eurox.2024.100293
Setyo Teguh Waluyo , Brahmana Askandar Tjokroprawiro , Anny Setijo Rahaju

Objective

To determine the effect of estrogen receptor (ER) on programmed death-ligand 1 (PD-L1) expression in type I endometrial cancer (EC).

Material and Methods

This retrospective study included 85 patients with type I EC who underwent surgery at Dr. Soetomo Hospital between 2018 and 2022. A random sampling technique was employed. Immunohistochemistry (IHC) with ER and PD-L1 antibodies was performed on all samples. In this study, ER expression served as the independent variable, while PD-L1 expression was considered the dependent variable. Data analysis was performed using Spearman's rank correlation coefficient test.

Results

Out of the 85 patients with type I EC, 58 (68.2%) exhibited positive and 27 (31.8%) exhibited negative ER expression. Meanwhile positive PD-L1 expression was seen in 67 (78.8%) and 18 (21.2%) exhibited negative PD-L1 expression. The study revealed a strong negative correlation between ER and PD-L1 expression in EC (rho value = −0.886, p-value = 0.0001).

Conclusion

ER downregulates PD-L1 in type I EC. The findings of this study can be used as reference data and as the basis for further research, especially investigations of the prognostic and immunotherapeutic value of ER and PD-L1 expression in type I EC.

材料与方法这项回顾性研究纳入了2018年至2022年期间在Dr. Soetomo医院接受手术的85例I型子宫内膜癌患者。采用随机抽样技术。所有样本均使用ER和PD-L1抗体进行免疫组化(IHC)。在本研究中,ER表达为自变量,PD-L1表达为因变量。结果 在 85 例 I 型 EC 患者中,ER 表达阳性的有 58 例(68.2%),阴性的有 27 例(31.8%)。同时,67 例(78.8%)患者 PD-L1 表达阳性,18 例(21.2%)患者 PD-L1 表达阴性。研究显示,ER与PD-L1在EC中的表达呈强负相关(rho值=-0.886,P值=0.0001)。本研究结果可作为进一步研究的参考数据和依据,尤其是研究ER和PD-L1在I型EC中的预后和免疫治疗价值。
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引用次数: 0
Differences in cervical length during the second trimester among normal weight, overweight and obese women: A systematic review and meta-analysis 体重正常、超重和肥胖妇女在怀孕后三个月宫颈长度的差异:系统回顾和荟萃分析
Q1 Medicine Pub Date : 2024-02-15 DOI: 10.1016/j.eurox.2024.100291
Michail Panagiotopoulos, Vasilios Pergialiotis, Konstantina Trimmi, Antonia Varthaliti, Antonios Koutras, Panagiotis Antsaklis, Georgios Daskalakis

Objective

Maternal obesity has been previously linked to increased risk of preterm birth; however, the actual pathophysiology behind this observation remains unknown. Cervical length seems to differentiate among overweight, obese and extremely obese patients, compared to normal weight women. However, to date the actual association between body mass index and cervical length remains unknown. In this systematic review, accumulated evidence is presented to help establish clinical implementations and research perspectives.

Methods

We searched Medline, Scopus, the Cochrane Central Register of Controlled Trials CENTRAL, Google Scholar, and Clinicaltrials.gov databases from inception till February 2023. Observational studies that reported on women undergone ultrasound assessment of their cervical length during pregnancy were included, when there was data regarding their body mass index. Statistical meta-analysis was performed with RStudio. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS).

Results

Overall, 20 studies were included in this systematic review and 12 in the meta-analysis. Compared to women with normal weight, underweight women were not associated with increased risk of CL < 15 mm or < 30 mm and their mean CL was comparable (MD −1.51; 95% CI −3.07, 0.05). Overweight women were found to have greater cervical length compared to women with normal weight (MD 1.87; 95% CI 0.52, 3.23) and had a lower risk of CL < 30 mm (OR 0.65; 95% CI 0.47, 0.90).

Conclusion

Further research into whether BMI is associated with cervical length in pregnant women is deemed necessary, with large, well-designed, prospective cohort studies with matched control group.

目的:产妇肥胖与早产风险增加有关,但这一观察结果背后的实际病理生理学仍不清楚。与体重正常的女性相比,超重、肥胖和极度肥胖患者的宫颈长度似乎存在差异。然而,迄今为止,身体质量指数与宫颈长度之间的实际联系仍不清楚。我们检索了 Medline、Scopus、Cochrane Central Register of Controlled Trials CENTRAL、Google Scholar 和 Clinicaltrials.gov 数据库中从开始到 2023 年 2 月的数据。如果有妇女体重指数的相关数据,则纳入对孕期妇女宫颈长度进行超声评估的观察性研究。使用 RStudio 进行了统计荟萃分析。采用纽卡斯尔-渥太华质量评估量表(NOS)对纳入研究的质量进行了评估。结果本系统综述共纳入20项研究,荟萃分析共纳入12项研究。与体重正常的女性相比,体重过轻的女性发生 CL < 15 mm 或 < 30 mm 的风险并不增加,而且她们的平均 CL 值相当(MD -1.51; 95% CI -3.07,0.05)。与体重正常的妇女相比,超重妇女的宫颈长度更大(MD 1.87; 95% CI 0.52, 3.23),CL < 30 mm 的风险更低(OR 0.65; 95% CI 0.47, 0.90)。
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引用次数: 0
Exploring the interplay between food security and antenatal care utilization among pregnant women in Southern Ethiopia: Insights from an institution-based cross-sectional study 探索埃塞俄比亚南部孕妇的粮食安全与产前护理利用率之间的相互作用:基于机构的横断面研究的启示
Q1 Medicine Pub Date : 2024-02-13 DOI: 10.1016/j.eurox.2024.100288
Gemeda Wakgari Kitil , Lema Fikadu Wedajo , Gizu Tola Feyisa , Bekem Dibaba Degefa , Shambel Negese Marami , Agmasie Damtew Walle , Alex Ayenew Chereka , Dagne Deresa Dinagde

Background

Ensuring the satisfaction of pregnant women with antenatal care is crucial for positive pregnancy outcomes and their engagement with emerging technologies and alternative care models. Maintaining high satisfaction during the antenatal period significantly impacts the well-being of both the expectant mother and the unborn child. Despite the recognized importance of antenatal care satisfaction, comprehensive information on satisfaction levels and influencing factors in the specific study area is lacking. Therefore, this study aims to assess antenatal care service satisfaction and associated factors among pregnant women in Arba Minch town, southern Ethiopia.

Methods

We conducted an institution-based cross-sectional study among 418 pregnant women from December 2022 to January 30, 2023, using a systematic sampling method. Data were collected using the Kobo Toolbox and analyzed with SPSS Version 26. The threshold for statistical significance was set at a p-value of less than 0.05.

Results

Out of 418 participants, 54.3% (95% CI=49.4–60.4) expressed satisfaction with antenatal care services. Factors significantly associated with women's satisfaction included: being unable to read and write (AOR=2.37; 95% CI: 1.97–3.80), being aged 25–29 years (AOR=3.20; 95% CI: 1.65–6.22), receiving antenatal care at a hospital (AOR=1.81; 95% CI: 1.05–3.12), having a previous history of antenatal visits (AOR=2.59; 95% CI: 1.26–5.30), a monthly income of 2500–5000 ETB (AOR=1.44; 95% CI: 1.21–3.94), waiting times of less than 30 min (AOR=2.59; 95% CI: 1.52–4.41), maintaining a positive attitude towards antenatal care (AOR=2.50; 95% CI: 1.05–3.65), and having a secure food source (AOR=2.06; 95% CI: 1.13–3.78).

Conclusion

Over 54% of participants were satisfied with antenatal care services. To improve satisfaction levels, recommended strategies include enhancing healthcare infrastructure, establishing maternity waiting areas, reducing waiting times, and expanding services to remote areas.

背景确保孕妇对产前护理的满意度对积极的妊娠结果以及她们对新兴技术和替代护理模式的参与至关重要。在产前期间保持较高的满意度对孕妇和胎儿的健康都有重大影响。尽管产前护理满意度的重要性已得到公认,但在特定的研究地区,有关满意度水平和影响因素的综合信息却十分匮乏。因此,本研究旨在评估埃塞俄比亚南部阿尔巴明奇镇孕妇对产前护理服务的满意度及相关因素。方法我们于 2022 年 12 月至 2023 年 1 月 30 日采用系统抽样法对 418 名孕妇进行了一项基于机构的横断面研究。数据使用 Kobo 工具箱收集,并使用 SPSS 26 版进行分析。结果在 418 名参与者中,54.3%(95% CI=49.4-60.4)对产前护理服务表示满意。与妇女满意度明显相关的因素包括:不识字(AOR=2.37;95% CI:1.97-3.80)、年龄在 25-29 岁(AOR=3.20;95% CI:1.65-6.22)、在医院接受产前检查(AOR=1.81;95% CI:1.05-3.12)、以前有过产前检查史(AOR=2.59;95% CI:1.26-5.30)、月收入在 2500 美元以上(AOR=1.81;95% CI:1.05-3.12)。结论超过 54% 的参与者对产前护理服务表示满意。为提高满意度,建议采取的策略包括加强医疗保健基础设施、建立产妇候诊区、缩短候诊时间以及将服务扩展到偏远地区。
{"title":"Exploring the interplay between food security and antenatal care utilization among pregnant women in Southern Ethiopia: Insights from an institution-based cross-sectional study","authors":"Gemeda Wakgari Kitil ,&nbsp;Lema Fikadu Wedajo ,&nbsp;Gizu Tola Feyisa ,&nbsp;Bekem Dibaba Degefa ,&nbsp;Shambel Negese Marami ,&nbsp;Agmasie Damtew Walle ,&nbsp;Alex Ayenew Chereka ,&nbsp;Dagne Deresa Dinagde","doi":"10.1016/j.eurox.2024.100288","DOIUrl":"10.1016/j.eurox.2024.100288","url":null,"abstract":"<div><h3>Background</h3><p>Ensuring the satisfaction of pregnant women with antenatal care is crucial for positive pregnancy outcomes and their engagement with emerging technologies and alternative care models. Maintaining high satisfaction during the antenatal period significantly impacts the well-being of both the expectant mother and the unborn child. Despite the recognized importance of antenatal care satisfaction, comprehensive information on satisfaction levels and influencing factors in the specific study area is lacking. Therefore, this study aims to assess antenatal care service satisfaction and associated factors among pregnant women in Arba Minch town, southern Ethiopia.</p></div><div><h3>Methods</h3><p>We conducted an institution-based cross-sectional study among 418 pregnant women from December 2022 to January 30, 2023, using a systematic sampling method. Data were collected using the Kobo Toolbox and analyzed with SPSS Version 26. The threshold for statistical significance was set at a p-value of less than 0.05.</p></div><div><h3>Results</h3><p>Out of 418 participants, 54.3% (95% CI=49.4–60.4) expressed satisfaction with antenatal care services. Factors significantly associated with women's satisfaction included: being unable to read and write (AOR=2.37; 95% CI: 1.97–3.80), being aged 25–29 years (AOR=3.20; 95% CI: 1.65–6.22), receiving antenatal care at a hospital (AOR=1.81; 95% CI: 1.05–3.12), having a previous history of antenatal visits (AOR=2.59; 95% CI: 1.26–5.30), a monthly income of 2500–5000 ETB (AOR=1.44; 95% CI: 1.21–3.94), waiting times of less than 30 min (AOR=2.59; 95% CI: 1.52–4.41), maintaining a positive attitude towards antenatal care (AOR=2.50; 95% CI: 1.05–3.65), and having a secure food source (AOR=2.06; 95% CI: 1.13–3.78).</p></div><div><h3>Conclusion</h3><p>Over 54% of participants were satisfied with antenatal care services. To improve satisfaction levels, recommended strategies include enhancing healthcare infrastructure, establishing maternity waiting areas, reducing waiting times, and expanding services to remote areas.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000085/pdfft?md5=817e874c247436611cba2f08ff465124&pid=1-s2.0-S2590161324000085-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139833220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Female sexuality across the menopausal age group: A cross sectional study 更年期年龄组的女性性行为:一项横断面研究
Q1 Medicine Pub Date : 2024-02-11 DOI: 10.1016/j.eurox.2024.100287
Rajlaxmi Mundhra, Anupama Bahadur, Kavita Khoiwal, Mukesh Kumar, Shivani Singh Chhetri, Jaya Chaturvedi

Background

Female sexual dysfunction (FSD) is an important health issue and its relationship with menopausal symptoms needs special attention.

Objective

To identify the frequency of FSD in middle aged women and assess its relationship with obesity and menopausal symptoms.

Methods

This was a cross sectional study performed at a tertiary care centre in North India over a period of one year from June 2022 to May 2023. Sexually active women aged 40–55 years were included in the study sample. Exclusion criteria included those not willing to participate, having pregnancy, malignancy, mental illness or history of pelvic surgery. Baseline demographic and anthropometric details were noted. Sexual function and menopausal symptoms were assessed using Menopause Rating Scale (MRS) and Female Sexual Function Index Scale (FSFI) questionnaire respectively.

Results

Among one hundred and forty three sexually active middle aged women, 43 women had FSD (30.06%). FSD was observed in 9.09%, 22.73% and 45.45% in- 40–45 years, 46–50 years and 51–55 years respectively. No significant difference was seen in desire (p value=0.281), arousal (p value=0.424), lubrication (p value=0.143), orgasm (p value=0.637), satisfaction (p value=0.675), pain (p value=0.833), total score (p value=0.601) between body mass index (kg/m²). A significant strong negative correlation of somatic, urogenital, psychological and total MRS scores with female sexuality domains was observed excepting non-significant mild negative correlation between somatic with pain and psychological with orgasm and pain.

Conclusion

Female sexual dysfunction are quite common and has negative correlation with menopausal symptoms. Health care providers need to focus on this issue as part of their routine assessment for better quality of life.

背景女性性功能障碍(FSD)是一个重要的健康问题,它与更年期症状之间的关系需要特别关注。方法这是一项横断面研究,于 2022 年 6 月至 2023 年 5 月在印度北部的一家三级医疗中心进行,为期一年。研究样本包括年龄在 40-55 岁之间的性活跃女性。排除标准包括不愿意参加、怀孕、患有恶性肿瘤、精神疾病或有盆腔手术史的女性。研究人员记录了基线人口统计学和人体测量学细节。结果在 143 名性生活活跃的中年女性中,有 43 名女性患有 FSD(30.06%)。在 40-45 岁、46-50 岁和 51-55 岁的妇女中,FSD 分别占 9.09%、22.73% 和 45.45%。体重指数(kg/m²)之间在欲望(p 值=0.281)、唤醒(p 值=0.424)、润滑(p 值=0.143)、高潮(p 值=0.637)、满意度(p 值=0.675)、疼痛(p 值=0.833)和总分(p 值=0.601)方面无明显差异。除躯体与疼痛、心理与性高潮和疼痛之间的轻度负相关外,躯体、泌尿生殖、心理和 MRS 总分与女性性功能领域呈明显的强负相关。医疗保健提供者需要关注这一问题,并将其作为常规评估的一部分,以提高生活质量。
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引用次数: 0
Feasibility of neurosonography in CHD-fetuses and controls in a clinical tertiary setting 在临床三级机构中对患有先天性心脏病的胎儿和对照组进行神经超声检查的可行性
Q1 Medicine Pub Date : 2024-02-10 DOI: 10.1016/j.eurox.2024.100289
Sheila M. Everwijn , Jiska F. van Bohemen , Fenna A. Jansen , Sylke J. Steggerda , Aalbertine K. Teunissen , Monique C. Haak

Objective

Ultrasonographic examination is the first-tier test to detect abnormal development of central nervous system (CNS). In optimal conditions, neurosonography can detect all important hallmarks of CNS development. It is, however, not known how the performance of this modality is in a routine setting. We aimed to evaluate the feasibility of neurosonography in a time-limited routine setting.

Study design

We have performed a prospective study in which we have included a group of pregnant women carrying a fetus with an isolated congenital heart defect (CHD), and a control group of fetuses without structural anomalies. We have performed basic neurosonography examination according to the guideline ‘how to perform a basic screening examination of the CNS’, published by the international society of ultrasound in obstetrics and gynecology in both groups. In all these examinations, 9 brain structures were scored in 3 different planes, by researchers that were blinded for group allocation. A sufficient neurosonogram was performed when 7 or more out of 9 CNS structures were clearly visible during the off-line scoring of the examination.

Results

A total of 574 neurosonographic examinations were performed in 151 fetuses, 90 in the CHD-group and 61 in the control group. A sufficient neurosonogram could be performed in 79% (234/294) of cases in a clinical setting (CHD cases) and in 90% (253/280) of control pregnancies. Higher maternal BMI (>30), maternal age, fetal cephalic position, fetal gender and placental position did not significantly influence neurosonography scores.

Conclusion

In clinical setting, basic fetal neurosonography can be sufficiently performed in the majority of cases. This was not significantly influenced by maternal or fetal factors. The optimal gestational age for neurosonography is between 22 and 34 weeks.

目的 超声波检查是检测中枢神经系统(CNS)发育异常的第一级检查。在最佳条件下,神经超声检查可检测出中枢神经系统发育的所有重要标志。然而,这种模式在常规环境下的表现如何尚不得而知。我们进行了一项前瞻性研究,其中包括一组怀有孤立性先天性心脏缺陷(CHD)胎儿的孕妇和一组无结构异常胎儿的对照组。我们根据国际妇产科超声学会发布的 "如何进行中枢神经系统基本筛查 "指南,对两组孕妇进行了基本的神经超声检查。在所有这些检查中,研究人员在 3 个不同平面上对 9 个脑部结构进行评分,并对组别分配进行盲测。结果 151 名胎儿共进行了 574 次神经超声检查,其中 CHD 组 90 次,对照组 61 次。79%(234/294)的临床病例(CHD 病例)和 90%(253/280)的对照组妊娠可进行充分的神经超声检查。较高的产妇体重指数(30)、产妇年龄、胎儿头位、胎儿性别和胎盘位置对神经电图评分没有显著影响。结论在临床上,大多数病例都能进行基本的胎儿神经电图检查,母体或胎儿因素对其影响不大。进行神经电图检查的最佳孕周为 22 至 34 周。
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引用次数: 0
Methotrexate as the first-line treatment of unruptured tubular ectopic pregnancies with high initial human chorionic gonadotropin levels: A retrospective cohort 将甲氨蝶呤作为初始人类绒毛膜促性腺激素水平较高的未破裂输卵管异位妊娠的一线治疗方法:回顾性队列
Q1 Medicine Pub Date : 2024-02-07 DOI: 10.1016/j.eurox.2024.100286
Fatemeh Keikha , Shireen Shams Ardekani , Mohammadamin Parsaei , Nikan Zargarzadeh , Alireza Hadizadeh , Azadeh Tarafdari

Objectives

To evaluate the effectiveness of the first-line medical management with Methotrexate (MTX) in the treatment of patients with stable tubal Ectopic Pregnancies (EPs) and varying ranges of Beta-Human Chorionic Gonadotropin (β-HCG) levels.

Materials and methods

In this retrospective cohort study, we reviewed the medical records of a total of 184 patients with the diagnosis of tubal EP, who received MTX as their first-line treatment. Patients with a baseline β-HCG< 4800 mIU/mL received single-dose MTX (n = 136) and those with an initial β-HCG≥ 4800 mIU/mL underwent the double-dose MTX regimen (n = 48). The treatment success was determined by evaluating the reported weekly β-HCG levels of the patients.

Results

Baseline β-HCG and mass size in the single-dose group were 1895.1 ± 1463.4 mIU/mL and 2.2 ± 1.1 cm, respectively, compared to 17,867.6 ± 31,870.5 mIU/mL and 2.3 ± 1.1 cm in the double-dose group. Treatment duration was 30.6 ± 16.9 days for single dose and 41.0 ± 27.0 days for double dose, with additional MTX in 27.2% and 12.5% in respective groups. Single dose achieved a 92.6% success rate, and double dose, 81.3%, without serious adverse effects. No significant effects were seen for either baseline β-HCG and mass size on the treatment success rates of both groups (p-value>0.05). However, the presence of Fetal Heart Rate (FHR) was associated with poorer responses only in the single-dose group (p-value=0.034).

Conclusions

Medical management with MTX shows promise as a first-line treatment for tubal EPs with β-HCG> 2000, suggesting a potential reassessment of existing guidelines in light of this emerging evidence. However, further research seems crucial in this field.

材料和方法在这项回顾性队列研究中,我们回顾了共 184 名诊断为输卵管异位妊娠(EP)并接受 MTX 作为一线治疗的患者的病历。基线β-HCG< 4800 mIU/mL的患者接受单剂量MTX治疗(n = 136),初始β-HCG≥ 4800 mIU/mL的患者接受双剂量MTX治疗(n = 48)。结果单剂量组的基线β-HCG和肿块大小分别为1895.1 ± 1463.4 mIU/mL和2.2 ± 1.1 cm,而双剂量组的基线β-HCG和肿块大小分别为17867.6 ± 31870.5 mIU/mL和2.3 ± 1.1 cm。单剂量治疗持续时间为 30.6 ± 16.9 天,双剂量治疗持续时间为 41.0 ± 27.0 天,两组分别有 27.2% 和 12.5% 的患者需要额外服用 MTX。单剂量成功率为 92.6%,双剂量为 81.3%,且无严重不良反应。基线β-HCG和胎块大小对两组的治疗成功率均无明显影响(p值>0.05)。结论使用MTX进行医疗管理有望成为输卵管EP伴β-HCG> 2000的一线治疗方法,这表明有可能根据这一新兴证据对现有指南进行重新评估。然而,在这一领域开展进一步研究似乎至关重要。
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引用次数: 0
Tourniquet on the low segment of the uterus reduces blood loss in postpartum hemorrhage during hysterectomy for placenta accreta: Old but gold 在因胎盘早剥而进行子宫切除术时,子宫低段的止血带可减少产后出血的失血量:老而弥新。
Q1 Medicine Pub Date : 2024-02-02 DOI: 10.1016/j.eurox.2024.100285
Hassine S. Abouda , Sofiene B. Marzouk , Yecer Boussarsar , Haithem Aloui , Hatem Frikha , Rami Hammami , Badis Chennoufi , Hayen Maghrebi

Objectives

To investigate the feasibility, safety, and efficiency after application of a cervical tourniquet during caesarian hysterectomy owing to placenta accreta

Study design

It was a monocentric prospective observational study for 3 years. Patients were allocated into two group: Group Tourniquet: (TG) in which a cervical tourniquet was systematically applied during hysterectomy, control group (CG) when the caesarian hysterectomy was performed without.

Results

20 patients in the TG and 23 patients in the CG. Tourniquet application significantly reduced per operative estimated blood loss volume (TG: 530 ± 135 vs 940 ± 120 ml in the CG, p = 0.0074), ΔHB (0.6 [0.3–1.9] vs 2.5[2.5–3.6] g/dl in the CG, p = 0.006) RBC transfusion requirements’ (TG: 2 ± 1.7 vs 4.3 ± 2.1 units in the CG, p = 0.046) procedure duration (TG: 98 ± 21 vs 137 ± 33 min in the CG, p = 0.015), clotting disorders (TG: 1 (5%) vs 6 (26,1%) in the CG, p = 0.013) and the incidence of bladder wounds (TG: 1 (5%) vs 5 (21,7%) in the CG, p = 0.048). There was no significant difference regarding ICU transfer rate (TG: 16 (80%) vs 20 (86.9%) in the CG, p = 0.53) or length of stay (TG: 1.4 [2,3] vs 2.3 [1–4] days in the CG, p = 0.615) and digestive wound (TG: 0 vs 2 (8,7%) in the CG, p = 0.641).

Conclusion

In case of a radical management of placenta accreta. A strategy that involves the application of a cervical Tourniquet should be considered as a feasible, safe and above all efficient alternative to prevent blood spoliation.

研究设计这是一项为期 3 年的单中心前瞻性观察研究。患者被分为两组:止血带组:(TG)在子宫切除术中系统地使用宫颈止血带;对照组(CG)在不使用止血带的情况下进行剖腹子宫切除术。使用止血带明显减少了每次手术的估计失血量(TG:530 ± 135 对 CG:940 ± 120 毫升,P = 0.0074)、ΔHB(0.6 [0.3-1.9] 对 CG:2.5 [2.5-3.6] g/dl,P = 0.006)和红细胞输血需求(TG:2 ± 1.7 对 CG:4.手术时间(TG:98 ± 21 分钟 vs CG:137 ± 33 分钟,p = 0.015)、凝血障碍(TG:1 (5%) vs CG:6 (26.1%),p = 0.013)和膀胱伤口发生率(TG:1 (5%) vs CG:5 (21.7%),p = 0.048)。在 ICU 转院率(TG:16(80%) vs CG:20(86.9%),p = 0.53)、住院时间(TG:1.4 [2,3] 天 vs CG:2.3 [1-4] 天,p = 0.615)和消化道伤口(TG:0 vs CG:2(8.7%),p = 0.641)方面没有明显差异。在对胎盘早剥进行根治性处理时,应考虑使用颈部止血带,这是一种可行、安全且最有效的防止血液溢出的替代方法。
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引用次数: 0
Factors affecting sexual-self-esteem among Iranian women 影响伊朗妇女性自尊的因素
Q1 Medicine Pub Date : 2024-01-26 DOI: 10.1016/j.eurox.2024.100284
Sahar Safshekan, Zahra Bostani Khalesi

Introduction

The quality of marital relationships is positively impacted by women's sexual self-esteem. This study aims to determine the factors that affect sexual self-esteem among Iranian women.

Methods

A total of 1176 eligible women who have been referred to comprehensive healthcare centers of Rasht, participated in this analytical cross-sectional study. A stratified two-stage cluster sampling methodology was applied to achieve samples. Data were collected using a validated Persian version of the Sexual Self-Esteem Inventory in Women-Short Form and related factors checklist.

Results

The mean sexual self-esteem score of the respondents was 103.97(SD =5.29) in this study. Education level of the woman (B = 2.622, P < 0.032), employment status of the woman (B= 9.24, P < 0.01), duration of the marriage (B = 11.47, P < 0.01), body image (B = 3.446, P < 0.01), childhood sexual abuse experiences (B = −0.363, P < 0.01), was related with sexual self-esteem. The sexual self-esteem score increased with an increase in higher levels of education, employment of women, an increase in the duration of the marriage, and a positive body image. However, there was an inverse relationship between the experience of childhood sexual abuse and sexual self-esteem.

Conclusions

The findings revealed that sexual self-esteem in women is influenced by background, intrapersonal, and interpersonal factors that should be approached in education, counseling, and therapy.

导言:妇女的性自尊会对婚姻关系的质量产生积极影响。本研究旨在确定影响伊朗妇女性自尊的因素。方法 共有 1176 名符合条件的妇女参与了这项分析性横断面研究,她们被转诊到拉什特的综合医疗中心。研究采用分层两阶段聚类抽样法获得样本。数据收集采用了经过验证的波斯语版《女性性自尊量表--简表》和相关因素核对表。结果在这项研究中,受访者的平均性自尊得分为 103.97(标准差=5.29)。女性受教育程度(B=2.622,P< 0.032)、女性就业状况(B=9.24,P< 0.01)、婚姻持续时间(B=11.47,P< 0.01)、身体形象(B=3.446,P< 0.01)、童年性虐待经历(B=-0.363,P< 0.01)与性自尊有关。性自尊得分随着受教育程度的提高、女性就业率的提高、婚姻持续时间的延长以及积极的身体形象而增加。结论研究结果表明,女性的性自尊受背景、人内和人际因素的影响,应在教育、咨询和治疗中加以关注。
{"title":"Factors affecting sexual-self-esteem among Iranian women","authors":"Sahar Safshekan,&nbsp;Zahra Bostani Khalesi","doi":"10.1016/j.eurox.2024.100284","DOIUrl":"10.1016/j.eurox.2024.100284","url":null,"abstract":"<div><h3>Introduction</h3><p>The quality of marital relationships is positively impacted by women's sexual self-esteem. This study aims to determine the factors that affect sexual self-esteem among Iranian women.</p></div><div><h3>Methods</h3><p>A total of 1176 eligible women who have been referred to comprehensive healthcare centers of Rasht, participated in this analytical cross-sectional study. A stratified two-stage cluster sampling methodology was applied to achieve samples. Data were collected using a validated Persian version of the Sexual Self-Esteem Inventory in Women-Short Form and related factors checklist.</p></div><div><h3>Results</h3><p>The mean sexual self-esteem score of the respondents was 103.97(SD =5.29) in this study. Education level of the woman (B = 2.622, P &lt; 0.032), employment status of the woman (B= 9.24, P &lt; 0.01), duration of the marriage (B = 11.47, P &lt; 0.01), body image (B = 3.446, P &lt; 0.01), childhood sexual abuse experiences (B = −0.363, P &lt; 0.01), was related with sexual self-esteem. The sexual self-esteem score increased with an increase in higher levels of education, employment of women, an increase in the duration of the marriage, and a positive body image. However, there was an inverse relationship between the experience of childhood sexual abuse and sexual self-esteem.</p></div><div><h3>Conclusions</h3><p>The findings revealed that sexual self-esteem in women is influenced by background, intrapersonal, and interpersonal factors that should be approached in education, counseling, and therapy.</p></div>","PeriodicalId":37085,"journal":{"name":"European Journal of Obstetrics and Gynecology and Reproductive Biology: X","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590161324000048/pdfft?md5=01a6ada1e23a7eec18970ef2a119a66a&pid=1-s2.0-S2590161324000048-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139637718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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European Journal of Obstetrics and Gynecology and Reproductive Biology: X
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