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Evaluation and Treatment Strategies for Infertile Patients with Diagnosed Polycystic Ovary Syndrome (PCOS) 对确诊为多囊卵巢综合征 (PCOS) 的不育患者的评估和治疗策略
Pub Date : 2024-07-12 DOI: 10.36348/sijog.2024.v07i07.002
Jafrin Yasmin Choudhury, Dr. Nahid Elora, Dr. Habiba Akther, Dr. Jakia Jahan Chowdhury, Dr. Umme Sayeeda Bilkish, Dr. Mustofa Khalid Ahmed Jaigyrder
Background: PCOS is the most common endocrine disorder in women that can lead to a variety of ailments associated with chronic anovulation and hyperandrogenism, it is also still a common cause of infertility in women. It is the most frequent endocrine and metabolic disorder among reproductive-aged women. PCOS (polycystic ovarian syndrome) is the most frequent cause of anovulatory infertility, accounting for more than 75% of all cases. This widespread problem affects around one in every six marriages and has a variety of causes across countries and social groups. Aims and Objective: The objective of this study was to evaluate the treatment strategies for infertile patients with diagnosed Polycystic Ovary Syndrome (PCOS). Material and Methods: This study looked at 80 cases of infertility caused by polycystic ovarian syndrome. From August 2021 to July 2022, this study evaluated 80 cases of infertility with PCOS at a tertiary medical college. The diagnosis was made using a hormone assay, ultrasound, and laparoscopy. Treatment options included clomiphene citrate, letrozole, and laparoscopic ovarian drilling. Results: In our study, the majority (50%) were between the ages of 26 and 30 years old, and 100% of patients complained of infertility, with 66.25% being of the primary type. Menstrual abnormalities affected 73.75% of women. The LH: FSH ratio was greater than 1.6 in approximately 85% of responders, and 77.5% of women had enlarged polycystic ovaries. Clomiphene citrate had a conception rate of 24%, Letrozole 31% had a rate of 20%, and laparoscopic ovarian drilling followed by Letrozole had a rate of 60%. Conclusion: Polycystic ovarian syndrome is a complex illness that necessitates a variety of treatment techniques based on the reason a patient seeks treatment. Aside from diet and fitness improvements, most patients with good conception rates require lifestyle modification treatment such as C/C and laparoscopic ovarian drilling.
背景:多囊卵巢综合征是女性最常见的内分泌疾病,可导致与慢性无排卵和雄激素过多有关的各种疾病,也是导致女性不孕的常见原因。它是育龄妇女中最常见的内分泌和代谢疾病。多囊卵巢综合征(PCOS)是导致无排卵性不孕的最常见原因,占所有病例的 75% 以上。这个普遍存在的问题影响着大约六分之一的婚姻,其原因在不同国家和社会群体中各不相同。目的和目标:本研究旨在评估确诊为多囊卵巢综合征(PCOS)的不孕患者的治疗策略。材料与方法:本研究调查了 80 例由多囊卵巢综合征引起的不孕症患者。从 2021 年 8 月到 2022 年 7 月,本研究对一所三级医学院的 80 例多囊卵巢综合征不孕症患者进行了评估。诊断采用激素测定、超声波和腹腔镜检查。治疗方案包括枸橼酸克罗米芬、来曲唑和腹腔镜卵巢钻孔术。研究结果在我们的研究中,大多数患者(50%)的年龄在 26 至 30 岁之间,100% 的患者主诉不孕,其中 66.25% 属于原发性不孕。73.75%的女性出现月经异常。约 85% 的应答者 LH 与 FSH 的比值大于 1.6,77.5% 的女性患有多囊卵巢增大。枸橼酸克罗米芬的受孕率为 24%,来曲唑 31% 的受孕率为 20%,而腹腔镜卵巢钻孔术后再使用来曲唑的受孕率为 60%。结论多囊卵巢综合征是一种复杂的疾病,需要根据患者寻求治疗的原因采用不同的治疗技术。除了改善饮食和增强体质外,大多数受孕率较高的患者都需要进行生活方式调整治疗,如C/C和腹腔镜卵巢钻孔术。
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引用次数: 0
Clinical Study of HELLP Syndrome and It's Outcome at Pravara Rural Hospital, Loni 洛尼市普拉瓦拉乡村医院对 HELLP 综合征及其结果的临床研究
Pub Date : 2024-07-08 DOI: 10.36348/sijog.2024.v07i07.001
Dr Pragya Isser, Dr Sai Borawake
Background: HELLP syndrome, a severe pregnancy complication characterized by hemolysis, elevated liver enzymes, and low platelet count, occurs in 0.5 to 0.9% of all pregnancies and in 10–20% of severe preeclampsia cases. It poses significant risks to both mother and fetus, presenting diagnostic and therapeutic challenges. Patients often experience epigastric or right upper quadrant pain, hypertension, proteinuria, fatigue, nausea, vomiting, sudden weight gain, and headaches. HELLP syndrome typically occurs in the second and third trimesters (27-37 weeks) and 15–30% of cases present postpartum. The exact causes remain unclear but may involve placental origins, autoimmune factors, gene mutations, or fatty acid oxidation disorders. Aims and Objectives: To analyze the clinical profile of HELLP syndrome cases and to assess maternal and perinatal outcomes, including morbidity and mortality. Material and Methods: This prospective cross-sectional study was conducted in the Obstetrics and Gynecology department at Pravara Rural Hospital, Loni, involving 45 patients with severe preeclampsia and eclampsia above 28 weeks of gestation diagnosed with HELLP syndrome. Patients were admitted to the ICU, and detailed histories and examinations were recorded. Patients were divided into two groups: those with HELLP syndrome (Group A) and those without (Group B). Results: Group A had a higher representation in the 20-22 age bracket, while Group B had more members aged 22-24. Cesarean sections were more common in Group A, whereas vaginal deliveries were more frequent in Group B. Blood pressure readings were higher in Group A. Maternal complications, such as abruption placentae, DIC, hepatic infarction, acute renal failure, and ascites, were more frequent in Group A, as were neonatal complications like IUGR, preterm delivery, neonatal thrombocytopenia, and RDS. Conclusion: The study reveals significant differences between patients with and without HELLP syndrome. Group A included younger patients, more first-time mothers, and a higher incidence of complications and mortality. These findings highlight the need for tailored management strategies for severe preeclampsia/eclampsia, especially in those with HELLP syndrome, to improve maternal and neonatal outcomes.
背景:HELLP综合征是一种严重的妊娠并发症,以溶血、肝酶升高和血小板计数低为特征,发生率占所有妊娠的0.5%至0.9%,占重度子痫前期病例的10%至20%。它对母亲和胎儿都有很大风险,给诊断和治疗带来挑战。患者通常会出现上腹部或右上腹疼痛、高血压、蛋白尿、乏力、恶心、呕吐、体重骤增和头痛等症状。HELLP 综合征通常发生在孕期的第二和第三季度(27-37 周),15%-30% 的病例在产后出现。确切病因尚不清楚,但可能涉及胎盘起源、自身免疫因素、基因突变或脂肪酸氧化紊乱。目的和目标:分析 HELLP 综合征病例的临床特征,评估产妇和围产期的结局,包括发病率和死亡率。材料与方法:这项前瞻性横断面研究在洛尼市普拉瓦拉农村医院妇产科进行,涉及 45 名妊娠 28 周以上重度子痫前期和子痫并被诊断为 HELLP 综合征的患者。患者被送入重症监护室,并详细记录了病史和检查结果。患者被分为两组:HELLP 综合征患者(A 组)和非 HELLP 综合征患者(B 组)。结果A 组中 20-22 岁年龄段的患者较多,而 B 组中 22-24 岁年龄段的患者较多。产妇并发症,如胎盘早剥、DIC、肝梗塞、急性肾功能衰竭和腹水,以及新生儿并发症,如 IUGR、早产、新生儿血小板减少症和 RDS,在 A 组中更为常见。结论研究显示,HELLP 综合征患者与非 HELLP 综合征患者之间存在明显差异。A 组患者较年轻,初产妇较多,并发症和死亡率较高。这些研究结果突出表明,有必要为重度子痫前期/子痫,尤其是患有 HELLP 综合征的重度子痫前期/子痫患者量身定制管理策略,以改善孕产妇和新生儿的预后。
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引用次数: 0
Triple-Negative Breast Cancer in a Young 23-Year-Old Woman with BRCA Mutation A about A Case and Literature Review 一名 23 岁年轻女性的三阴性乳腺癌(BRCA 基因突变 A)病例及文献综述
Pub Date : 2024-05-03 DOI: 10.36348/sijog.2024.v07i05.001
Ismail Belhaouz, Moad Belouad, Liban Mahdi, Samir Bargach
Triple-negative breast cancer (estrogen receptor negative, progesterone receptor negative and HER2 negative) is a particularly high-risk breast cancer which does not receive specific therapy targeting these proteins. We report the case of a 23-year-old patient diagnosed with triple-negative breast cancer of the left breast with a family history of breast cancer and carrying a BRCA1 mutation. The classification of breast cancer based on genomic data is required to allow us to optimize therapies and improve the management of breast cancer patients.
三阴性乳腺癌(雌激素受体阴性、孕激素受体阴性和 HER2 阴性)是一种特别高危的乳腺癌,目前还没有针对这些蛋白的特异性疗法。我们报告了一例被诊断为左侧乳房三阴性乳腺癌的 23 岁患者,该患者有乳腺癌家族史并携带 BRCA1 基因突变。我们需要根据基因组数据对乳腺癌进行分类,以便优化治疗方法,改善对乳腺癌患者的管理。
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引用次数: 0
Home Delivery in the Monisso Health Area: Tominian Health District 莫尼索卫生区的送货上门服务:托米尼安卫生区
Pub Date : 2024-02-14 DOI: 10.36348/sijog.2024.v07i02.002
Sidibe, S, D. S, D. I, M. K, K. S, D. A, Diallo, M, Diarra, K. K, icko, O. A. A
Unassisted home birth exposes mother and child to the most harmful complications. These complications are identified as one of the main causes of maternal and neonatal morbidity and mortality. Goal: To study the factors favoring home births in the Monisso health area. Method: Descriptive cross-sectional study in the period from January 1 to December 31, 2020 in the Monisso health area. Results: The proportion of home births was 80% (N= 210). The reasons given were respectively: the brevity of the labor of delivery (31.55%), the lack of financial means (25.60%), socio-cultural reasons (23.21%), the long distance between the village and the CSCOM (12 .5%), the high cost of delivery costs in the health center (6.55%). Conclusion: Home births are still very common in rural areas, particularly in developing countries.
无助的家庭分娩使母亲和婴儿面临最有害的并发症。这些并发症被认为是产妇和新生儿发病和死亡的主要原因之一。目标:研究莫尼索卫生保健区有利于在家分娩的因素。方法:描述性横断面研究2020年1月1日至12月31日期间在莫尼索卫生区进行描述性横断面研究。研究结果在家分娩的比例为 80%(N=210)。给出的原因分别是:分娩时间短(31.55%)、缺乏经济能力(25.60%)、社会文化原因(23.21%)、村庄与 CSCOM 之间距离远(12.5%)、医疗中心分娩费用高(6.55%)。结论在农村地区,尤其是在发展中国家,在家分娩仍然非常普遍。
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引用次数: 0
Home Delivery in the Monisso Health Area: Tominian Health District 莫尼索卫生区的送货上门服务:托米尼安卫生区
Pub Date : 2024-02-14 DOI: 10.36348/sijog.2024.v07i02.002
Sidibe, S, D. S, D. I, M. K, K. S, D. A, Diallo, M, Diarra, K. K, icko, O. A. A
Unassisted home birth exposes mother and child to the most harmful complications. These complications are identified as one of the main causes of maternal and neonatal morbidity and mortality. Goal: To study the factors favoring home births in the Monisso health area. Method: Descriptive cross-sectional study in the period from January 1 to December 31, 2020 in the Monisso health area. Results: The proportion of home births was 80% (N= 210). The reasons given were respectively: the brevity of the labor of delivery (31.55%), the lack of financial means (25.60%), socio-cultural reasons (23.21%), the long distance between the village and the CSCOM (12 .5%), the high cost of delivery costs in the health center (6.55%). Conclusion: Home births are still very common in rural areas, particularly in developing countries.
无助的家庭分娩使母亲和婴儿面临最有害的并发症。这些并发症被认为是产妇和新生儿发病和死亡的主要原因之一。目标:研究莫尼索卫生保健区有利于在家分娩的因素。方法:描述性横断面研究2020年1月1日至12月31日期间在莫尼索卫生区进行描述性横断面研究。研究结果在家分娩的比例为 80%(N=210)。给出的原因分别是:分娩时间短(31.55%)、缺乏经济能力(25.60%)、社会文化原因(23.21%)、村庄与 CSCOM 之间距离远(12.5%)、医疗中心分娩费用高(6.55%)。结论在农村地区,尤其是在发展中国家,在家分娩仍然非常普遍。
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引用次数: 0
Evaluation of Cervical Cancer by Colposcopy and HPV-DNA in President Abdul Hamid Medical College, Kishoreganj 基肖尔甘杰阿卜杜勒-哈米德总统医学院通过阴道镜检查和人乳头瘤病毒 DNA 评估宫颈癌情况
Pub Date : 2024-02-12 DOI: 10.36348/sijog.2024.v07i02.001
S. Rajia, Sufia Khatun, Mohammad Maksudur Rahman, Samina Sultana
Introduction: Cervical cancer, a significant public health issue, necessitates reliable diagnostic strategies for early detection and management. In the pursuit of effective cervical cancer screening strategies, the integration of colposcopy and HPV-DNA testing is critical, especially in high-risk populations. The study evaluates the diagnostic efficacy of these methods in patients presenting with symptoms indicative of potential cervical malignancy. Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynecology, President Abdul Hamid Medical College and Hospital, Kishoreganj, Bangladesh. The study included a total of 82 participants collected over a 1-year period from July 2022 to June 2023 following the inclusion and exclusion criteria. Patients with VIA Positive diagnosis, abnormal pap-smear results, contact or abnormal per-vaginal bleeding, foul-smelling per-vaginal discharge, and an unhealthy cervix were included in the study, while currently pregnant women, nulliparous, and postmenopausal women, patients with cervical or vaginal growths, and non-cooperative patients were excluded from the study. Result: The mean age of participants was 36.51 years, with most marriages occurring at an average age of 17.07 years. The study identified a high prevalence of multipara status (50.0% had 2-3 children, 36.6% had more than 3). The majority of first deliveries occurred between ages 16 and 22. A significant correlation was found between age and parity (r = .502, p < .01), and a strong association between age of marriage and age at first delivery (r = .815, p < .01). HPV-DNA positivity was 7.3%, while abnormal colposcopy findings (CIN I-III) were observed in 40.7% of cases. Negative correlations were observed between age of marriage and colposcopy findings (r = -.308, p < .01). Conclusion: This study underscores the importance of age, marital history, and parity in the context of cervical cancer screening. The low HPV-DNA positivity rate compared to the higher incidence of abnormal colposcopy findings suggests the need for a combined diagnostic approach. The findings advocate for tailored cervical cancer screening strategies that integrate both colposcopy and HPV-DNA testing, especially in resource-limited settings.
导言:宫颈癌是一个重大的公共卫生问题,需要可靠的诊断策略来进行早期检测和管理。在寻求有效的宫颈癌筛查策略时,阴道镜检查和 HPV DNA 检测的结合至关重要,尤其是在高危人群中。本研究评估了这些方法对出现潜在宫颈恶性肿瘤症状的患者的诊断效果。研究方法这项前瞻性观察研究在孟加拉国基肖尔甘杰市阿卜杜勒-哈米德总统医学院和医院妇产科进行。根据纳入和排除标准,该研究在 2022 年 7 月至 2023 年 6 月的 1 年期间共收集了 82 名参与者。研究纳入了 VIA 阳性诊断、宫颈涂片结果异常、接触性或异常阴道周围出血、阴道周围有恶臭分泌物以及宫颈不健康的患者,而排除了正在怀孕的妇女、无子宫和绝经后妇女、宫颈或阴道增生患者以及不合作的患者。研究结果参与者的平均年龄为 36.51 岁,大多数人的平均结婚年龄为 17.07 岁。研究发现,多胎妊娠的发生率很高(50.0%有 2-3 个孩子,36.6%有 3 个以上孩子)。首次分娩大多发生在 16-22 岁之间。研究发现,年龄与胎次之间存在明显的相关性(r = .502,p < .01),结婚年龄与初产年龄之间也存在密切联系(r = .815,p < .01)。HPV-DNA阳性率为7.3%,40.7%的病例阴道镜检查结果异常(CIN I-III)。结婚年龄与阴道镜检查结果呈负相关(r = -.308,p < .01)。结论本研究强调了年龄、婚史和胎次在宫颈癌筛查中的重要性。HPV-DNA阳性率较低,而阴道镜检查结果异常的发生率较高,这表明需要采取综合诊断方法。这些研究结果提倡采取有针对性的宫颈癌筛查策略,将阴道镜检查和 HPV-DNA 检测结合起来,尤其是在资源有限的情况下。
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引用次数: 0
Evaluation of Cervical Cancer by Colposcopy and HPV-DNA in President Abdul Hamid Medical College, Kishoreganj 基肖尔甘杰阿卜杜勒-哈米德总统医学院通过阴道镜检查和人乳头瘤病毒 DNA 评估宫颈癌情况
Pub Date : 2024-02-12 DOI: 10.36348/sijog.2024.v07i02.001
S. Rajia, Sufia Khatun, Mohammad Maksudur Rahman, Samina Sultana
Introduction: Cervical cancer, a significant public health issue, necessitates reliable diagnostic strategies for early detection and management. In the pursuit of effective cervical cancer screening strategies, the integration of colposcopy and HPV-DNA testing is critical, especially in high-risk populations. The study evaluates the diagnostic efficacy of these methods in patients presenting with symptoms indicative of potential cervical malignancy. Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynecology, President Abdul Hamid Medical College and Hospital, Kishoreganj, Bangladesh. The study included a total of 82 participants collected over a 1-year period from July 2022 to June 2023 following the inclusion and exclusion criteria. Patients with VIA Positive diagnosis, abnormal pap-smear results, contact or abnormal per-vaginal bleeding, foul-smelling per-vaginal discharge, and an unhealthy cervix were included in the study, while currently pregnant women, nulliparous, and postmenopausal women, patients with cervical or vaginal growths, and non-cooperative patients were excluded from the study. Result: The mean age of participants was 36.51 years, with most marriages occurring at an average age of 17.07 years. The study identified a high prevalence of multipara status (50.0% had 2-3 children, 36.6% had more than 3). The majority of first deliveries occurred between ages 16 and 22. A significant correlation was found between age and parity (r = .502, p < .01), and a strong association between age of marriage and age at first delivery (r = .815, p < .01). HPV-DNA positivity was 7.3%, while abnormal colposcopy findings (CIN I-III) were observed in 40.7% of cases. Negative correlations were observed between age of marriage and colposcopy findings (r = -.308, p < .01). Conclusion: This study underscores the importance of age, marital history, and parity in the context of cervical cancer screening. The low HPV-DNA positivity rate compared to the higher incidence of abnormal colposcopy findings suggests the need for a combined diagnostic approach. The findings advocate for tailored cervical cancer screening strategies that integrate both colposcopy and HPV-DNA testing, especially in resource-limited settings.
导言:宫颈癌是一个重大的公共卫生问题,需要可靠的诊断策略来进行早期检测和管理。在寻求有效的宫颈癌筛查策略时,阴道镜检查和 HPV DNA 检测的结合至关重要,尤其是在高危人群中。本研究评估了这些方法对出现潜在宫颈恶性肿瘤症状的患者的诊断效果。研究方法这项前瞻性观察研究在孟加拉国基肖尔甘杰市阿卜杜勒-哈米德总统医学院和医院妇产科进行。根据纳入和排除标准,该研究在 2022 年 7 月至 2023 年 6 月的 1 年期间共收集了 82 名参与者。研究纳入了 VIA 阳性诊断、宫颈涂片结果异常、接触性或异常阴道周围出血、阴道周围有恶臭分泌物以及宫颈不健康的患者,而排除了正在怀孕的妇女、无子宫和绝经后妇女、宫颈或阴道增生患者以及不合作的患者。研究结果参与者的平均年龄为 36.51 岁,大多数人的平均结婚年龄为 17.07 岁。研究发现,多胎妊娠的发生率很高(50.0%有 2-3 个孩子,36.6%有 3 个以上孩子)。首次分娩大多发生在 16-22 岁之间。研究发现,年龄与胎次之间存在明显的相关性(r = .502,p < .01),结婚年龄与初产年龄之间也存在密切联系(r = .815,p < .01)。HPV-DNA阳性率为7.3%,40.7%的病例阴道镜检查结果异常(CIN I-III)。结婚年龄与阴道镜检查结果呈负相关(r = -.308,p < .01)。结论本研究强调了年龄、婚史和胎次在宫颈癌筛查中的重要性。HPV-DNA阳性率较低,而阴道镜检查结果异常的发生率较高,这表明需要采取综合诊断方法。这些研究结果提倡采取有针对性的宫颈癌筛查策略,将阴道镜检查和 HPV-DNA 检测结合起来,尤其是在资源有限的情况下。
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引用次数: 0
Evaluating the Epidemiological Insights, Etiology, and Clinical Manifestations, of Uterine Fibroids 评估子宫肌瘤的流行病学观点、病因和临床表现
Pub Date : 2024-01-06 DOI: 10.36348/sijog.2024.v07i01.001
Ara I, Sultana F, Najnin R, Afreen S, Tuhin Tb
Objective: This is a cross-sectional study done to identify epidemiological perspectives, etiological factors, and clinical presentations of uterine fibroids. Methods: The study subjects were 50 patients diagnosed as a case of fibroid uterus, and admitted Department of Gynaecology and Obstetrics, Rangpur Medical College and Hospital from March 2011 to March 2012. A pre-selected data sheet was formed to collect relevant information about the women. All the information regarding age, parity, socioeconomic status, detailed menstrual history, obstetrics history, clinical exam, per speculum exam, and pelvic exam & investigations were done according to pre-selected data. Result: Total study population was 50 among them greater frequency was found in the fourth (60%) decades of life and the majority of them (56%) were of middle-class families 92% where 50% were Illiterate. Most (48%) of the patients were in para 3-5 and 72% of patients used contraception. We found that the majority (80%) of patients presented with menstrual abnormalities and out of 50 patients 41 patients had palpable uterus. Maximum (36%) patients suffered from obesity and 96% of patients had a haemoglobin percentage less than 60%. 98% of patients had conclusive USG findings in their clinical diagnosis. Conclusion: The majority of these patients were between 31 to 40 years of age. The common mode of presentation was menstrual disturbances 80% such as menorrhagia and dysmenorrhea. Diagnosis was based on clinical exam and some patients required USG.
研究目的这是一项横断面研究,旨在确定子宫肌瘤的流行病学观点、病因和临床表现。研究方法研究对象为 2011 年 3 月至 2012 年 3 月期间兰布尔医学院和医院妇产科确诊为子宫肌瘤的 50 名患者。为收集妇女的相关信息,我们预先选择了一份数据表。所有关于年龄、奇偶数、社会经济地位、详细月经史、产科史、临床检查、窥器检查、盆腔检查和化验的信息都是根据预选数据进行的。结果研究总人数为 50 人,其中 60% 的患者年龄在 40 岁左右,大多数(56%)患者来自中产阶级家庭,占 92%,其中 50%为文盲。大多数患者(48%)处于 3-5 段,72%的患者采取了避孕措施。我们发现大多数患者(80%)有月经异常,50 名患者中有 41 名患者可触及子宫。最多(36%)的患者患有肥胖症,96%的患者血红蛋白低于 60%。98%的患者在临床诊断中得到了确凿的 USG 结果。结论这些患者的年龄大多在 31 至 40 岁之间。常见的月经紊乱症状占 80%,如月经过多和痛经。诊断基于临床检查,部分患者需要进行 USG 检查。
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引用次数: 0
期刊
Scholars International Journal of Obstetrics and Gynecology
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