Obstetrics and gynecology research最新文献_第5页

Status of Vitamin D in Women with Uterine Fibroid and Impact of Vitamin D Supplementation 子宫肌瘤妇女维生素D的状况及补充维生素D的影响

Obstetrics and gynecology research

Pub Date : 2022-01-01 DOI: 10.26502/ogr0105

Shiuly Chowdhury, S. Selim, M. Islam, Shuva Shrestha

Background: Uterine fibroids, also known as leiomyomas, are benign smooth muscle tumors of the uterus. The exact cause of uterine fibroids is indistinct. However, fibroids appear to be partly determined by hormone levels. There is a high prevalence of Vitamin D deficiency for uterine fibroids. Vitamin D from food or from skin synthesis by sunshine becomes biologically inactive. It is activated by two protein enzyme hydroxylation steps. The first in the liver and the second in the kidney. As Vitamin D can be synthesized, it is considered a prohormone. Vitamin D is taken to the liver where it is transformed into 25[OH] D. Objective: The objective of this study was to determine the impact of Vitamin D supplementation in women with fibroids uterus. Methods: This interventional study was conducted in the department of obstetrics & gynecology, BSMMU, Dhaka, Bangladesh. A purposive sampling method was done. A total of 95 patients diagnosed as uterine fibroids with Vitamin D deficiency were included in the study. BMI was measured and the size of the fibroid was determined by ultrasonography and serum Vitamin D level was estimated. Vitamin D was supplemented to the participants. Then repeat ultrasonography and serum Vitamin D level were done after 3 months, to the assessment of vitamin impact. Regression of the size of the fibroid was done. Results: The mean age was 37.31±7.10 years. The majority of the participants were housewives 67.4%. Mean Vitamin D was 21.71±7.32, BMI 27.96±4.72. At the initial stage, among total study population in 11.6% (n=11), 47.4% (n=45) and 41.0% (n=39) patients we found <2.5cm(Small), 2.5-4.9cm (Medium) and (≥5cm (Large) sized fibroids respectively. The mean size of fibroids in a total of 95 patients was 4.99 ± 2.59 and after Vitamin D supplementation it had been reduced to 4.77±3.04. Conclusion: Supplementation with Vitamin D in women with fibroid uterus regress the fibroid size and it is more effective in smaller fibroid sizes. In this study, the size of uterine fibroid was reduced after supplementation of Vitamin D among the patients. It was significant (p<0.05) of fibroid uterus size changed after the Vitamin D supplement.

背景:子宫肌瘤，也称为平滑肌瘤，是子宫的良性平滑肌肿瘤。子宫肌瘤的确切病因尚不清楚。然而，子宫肌瘤似乎部分取决于激素水平。子宫肌瘤患者普遍缺乏维生素D。食物中的维生素D或由阳光合成的皮肤中的维生素D变得没有生物活性。它由两个蛋白酶羟基化步骤激活。第一个在肝脏，第二个在肾脏。由于维生素D可以合成，因此被认为是一种激素原。维生素D被带到肝脏，在那里转化为25[OH] D。目的:本研究的目的是确定补充维生素D对子宫肌瘤妇女的影响。方法:本介入研究在孟加拉国达卡BSMMU妇产科进行。采用有目的的抽样方法。共有95例诊断为子宫肌瘤合并维生素D缺乏症的患者被纳入研究。测量BMI，超声检查肌瘤大小，测定血清维生素D水平。参与者补充了维生素D。3个月后复查超声及血清维生素D水平，评价维生素的影响。缩小肌瘤的大小。结果:患者平均年龄37.31±7.10岁。以家庭主妇居多(67.4%)。平均维生素D为21.71±7.32,BMI为27.96±4.72。在初始阶段，在总研究人群中，分别有11.6% (n=11)、47.4% (n=45)和41.0% (n=39)的患者发现肌瘤大小分别为<2.5cm(小)、2.5-4.9cm(中)和≥5cm(大)。95例患者肌瘤平均大小为4.99±2.59，补充维生素D后肌瘤平均大小降至4.77±3.04。结论:子宫肌瘤患者补充维生素D可使子宫肌瘤缩小，且对小肌瘤更有效。在本研究中，患者补充维生素D后，子宫肌瘤的大小减小。补充维生素D后肌瘤子宫大小变化显著(p<0.05)。

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引用次数: 0

Predictive Models for Emergency Department Triage using Machine Learning: A Review 使用机器学习的急诊科分类预测模型:综述

Obstetrics and gynecology research

Pub Date : 2022-01-01 DOI: 10.26502/ogr082

Fei Gao, B. Boukebous, Pozzar Mario, Alaoui Enora, Sano Batourou, Sahar Bayat-Makoei

Predictive Models for Emergency Department Triage using Machine Learning: A Review. Obstetrics Abstract Background: Recently, many research groups have tried to develop emergency department triage decision support systems based on big volumes of historical clinical data to differentiate and prioritize patients. Machine learning models might improve the predictive capacity of emergency department triage systems. The aim of this review was to assess the performance of recently described machine learning models for patient triage in emergency departments, and to identify future challenges. Methods: Four databases (ScienceDirect, PubMed, Google Scholar and Springer) were searched using key words identified in the research questions. To focus on the latest studies on the subject, the most cited papers between 2018 and October 2021 were selected. Only works with hospital admission and critical illness as outcomes were included in the analysis. Results: (hospital admission and critical illness) and developed 55 predictive models. Random Forest and Logistic Regression were the most commonly used prediction algorithms, and the receiver operating characteristic-area under the curve (ROC-AUC) the most frequently used metric to assess the algorithm prediction performance. Random Forest and Logistic Regression were the most discriminant models according to the selected studies. Conclusions: Machine learning-based triage systems could improve decision-making in emergency departments, thus leading to better patients’ outcomes. However, there is still scope for improvement concerning the prediction performance and explicability of ML models.

使用机器学习的急诊科分类预测模型:综述。摘要背景:近年来，许多研究小组试图开发基于大量历史临床数据的急诊科分诊决策支持系统，以区分和优先考虑患者。机器学习模型可以提高急诊科分诊系统的预测能力。本综述的目的是评估最近描述的用于急诊科患者分诊的机器学习模型的性能，并确定未来的挑战。方法:使用在研究问题中确定的关键词检索四个数据库(ScienceDirect、PubMed、谷歌Scholar和施普林格)。为了关注该主题的最新研究，我们选择了2018年至2021年10月期间被引用最多的论文。仅以住院和危重疾病为结果的作品被纳入分析。结果:(住院和危重症)并建立了55个预测模型。随机森林和逻辑回归是最常用的预测算法，接受者工作特征曲线下面积(ROC-AUC)是评估算法预测性能的最常用指标。根据所选研究，随机森林和逻辑回归是最具判别性的模型。结论:基于机器学习的分诊系统可以改善急诊科的决策，从而改善患者的预后。然而，机器学习模型的预测性能和可解释性仍有改进的余地。

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引用次数: 0

Comparing Effects of Amniotomy and Spontaneous Rupture of Membrane on Duration of Labor in Primigravida at Term Pregnancy 羊膜切开与自发性破膜对初生女足月产程的影响

Obstetrics and gynecology research

Pub Date : 2022-01-01 DOI: 10.26502/ogr090

Tanveer Shafqat, Laila Zeb, Sumaira Yasmin

Purpose: Early amniotomy is one of the most important procedures for improving labor progress and preventing dystocia in pregnant women. The study compared the effects of amniotomy and spontaneous rupture of membrane (in early labor in primigravida at term) on the duration of labor. Methodology: Randomized Controlled Trial was conducted at the Department of Obstetrics and Gynecology MTI, Lady Reading Hospital, Peshawar, Pakistan. A total of 80 pregnant women with a single cephalic fetus in early labor were included in the study. Group A included 40 women in whom amniotomy was performed; while group B had 40 women who had spontaneous rupture of membranes. Duration of labor was noted in both groups. Results: The average age of Group A females in labor was 27.17 years and 26.2 years in group B. Gestational age and weight of mothers averaged 38 weeks and 67 kg in both groups respectively. The duration of labor was 5.7 hours in Group A and was prolonged at 7.1 hours in Group B. The mean duration of labor was 5.7 hours in Group A and 7.15 hours in Group B (P-value = 0.01). Regardless of the age of the mothers in either group, the mean duration of labour was 5.7 hours (18- 30 years) and 5.5 hours (above 30 years) in Group A, compared to Group B, 7.1 hours (18-30 years) and 7.0 hours above 30 years). Significant differences (P- value: 0.01) existed between each age group, gestational age, and weights in groups A (amniotomy) and B (spontaneous rupture of membranes) concerning the duration of labor. Conclusion: Artificially rupturing the membranes during active labor in primigravida reduces the length of labor considerably.

目的:早期羊膜切开术是改善产程和预防难产的重要手术之一。本研究比较了羊膜切开术和自发性破膜术(足月初产妇早期产程)对产程的影响。方法:随机对照试验在巴基斯坦白沙瓦雷丁夫人医院MTI妇产科进行。共有80名孕妇在分娩早期有一个头位胎儿被纳入研究。A组40例行羊膜切开术;而B组有40名妇女自发性破膜。两组均记录分娩时间。结果:A组产妇平均产龄27.17岁，b组产妇平均产龄26.2岁，两组产妇平均胎龄38周，平均体重67 kg。A组产程5.7 h, B组产程延长7.1 h, A组平均产程5.7 h, B组平均产程7.15 h (p值= 0.01)。无论两组母亲的年龄如何，A组的平均分娩时间为5.7小时(18-30岁)和5.5小时(30岁以上)，而B组为7.1小时(18-30岁)和7.0小时(30岁以上)。A组(羊膜切开组)和B组(自发破膜组)的产程在各年龄组、胎龄和体重上存在显著差异(P值:0.01)。结论:初产妇主动产程人工破膜术可明显缩短产程。

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引用次数: 0

NSS-Bridge Device for Post-Cesarean Delivery Analgesia: A Randomized Controlled Trial. NSS桥接装置用于剖宫产后镇痛：一项随机对照试验。

Obstetrics and gynecology research

Pub Date : 2022-01-01 Epub Date: 2022-09-27 DOI: 10.26502/ogr094

Grace Lim, Emma Nowakowski, Kelsea R LaSorda, Valeria Altamirano, Madison Morgan, Mutasim Makeen, Stacy Beck, Elizabeth Krans, Jacques E Chelly

Introduction: Percutaneous auricular nerve stimulation has been used for the treatment of symptoms associated with opioid withdrawal, including abdominal pain, nausea, and general discomfort. However, its potential utility for pain management and opioid minimization after surgery has not been investigated. The purpose of this study was to test the feasibility and acceptability of a trial protocol designed to assess the effectiveness of the NSS2-Bridge device as a non-pharmacologic alternative to opioids after cesarean delivery.

Methods: In a randomized control design, healthy women receiving cesarean delivery were randomized to receive the active device, placebo device, or no device. Devices were placed on the ear following cesarean delivery and left in place for 5 days. Feasibility and acceptability of the device was assessed by patient reports of device tolerability (rated on a 100mm visual analog scale where 0 is not tolerable at all and 100 is the most tolerable) as well as qualitative reporting. Additional outcomes assessed included proportion of patients not using opioids in hospital, as well as pain at rest, pain with movement, and total opioid consumption in the hospital and for the first 5 days after surgery.

Results: There were 60 patients included in the final analysis. Device tolerability was rated highly, with an average daily score of >75 mm on the visual analog scale. The trial retention rate was 89.7% with most exclusions (42.9%) occurring due to unanticipated development of care complexity (e.g., hemorrhage and additional surgical procedures), with only 1 exclusion (14.3%) due to device discomfort. The active device group achieved the highest proportion of opioid-free hospitalizations (40%) compared to placebo (20%) and no device groups (30%). Pain at rest and with movement was similar between treatment groups.

Conclusions: This trial protocol designed to test the efficacy of NSS2-Bridge device for post-cesarean pain management is feasible and acceptable. Larger proportions of patients not using opioids in the active device group justifies additional investigation on device effectiveness in pregnant and postpartum people at highest risk for pain.

引言：经皮耳廓神经刺激已用于治疗与阿片类药物戒断相关的症状，包括腹痛、恶心和全身不适。然而，它在手术后疼痛管理和阿片类药物最小化方面的潜在效用尚未得到研究。本研究的目的是测试一项试验方案的可行性和可接受性，该方案旨在评估NSS2桥接装置作为剖宫产后阿片类药物的非药物替代品的有效性。方法：在随机对照设计中，接受剖宫产的健康女性被随机分为接受活性装置、安慰剂装置或不接受装置。剖宫产后将装置放置在耳朵上，放置5天。该装置的可行性和可接受性通过患者对装置耐受性的报告（在100毫米视觉模拟量表上评定，其中0是完全不耐受的，100是最耐受的）以及定性报告进行评估。评估的其他结果包括在医院不使用阿片类药物的患者比例，以及休息时的疼痛、运动时的疼痛，以及在医院和手术后前5天的阿片类物质总消耗量。结果：纳入最终分析的患者有60例。器械耐受性评价很高，在视觉模拟量表上，平均每日得分>75 mm。试验保留率为89.7%，大多数排除（42.9%）是由于护理复杂性的意外发展（如出血和额外的外科手术），只有1例排除（14.3%）是由于设备不适。与安慰剂组（20%）和无装置组（30%）相比，活性装置组无阿片类药物住院比例最高（40%）。治疗组之间休息和运动时的疼痛相似。结论：本试验方案旨在测试NSS2桥接器用于剖宫产术后疼痛管理的疗效，是可行和可接受的。在活性装置组中，不使用阿片类药物的患者比例更大，因此有理由对疼痛风险最高的孕妇和产后患者的装置有效性进行进一步调查。

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引用次数: 0

The Incidence of Placenta Previa among Women with Subsequent Pregnancy after Previous Cesarean Sections 剖宫产术后再次妊娠妇女前置胎盘的发生率

Obstetrics and gynecology research

Pub Date : 2022-01-01 DOI: 10.26502/ogr086

R. -, Robina Zahoor, Hina Ameer Chughtai, Hania Zafar, Sadia Ilyas, Sohaib Mujahid, Muhammad Abu Bakar

Background: Placenta previa is one of the leading causes of vaginal bleeding in second and third trimester of pregnancy. The risk of placenta previa is also higher among women with previous cesarean section. The purpose of our study was to determine the frequency of placenta previa among patients undergoing repeat cesarean section. Materials and Methods: This Cross-sectional study was conducted at the Department of Gynecology, Lahore General Hospital, Lahore. The calculated sample size was 240 cases recruited through non probability purposive sampling. All the patients underwent an obstetrical scan for the presence of placenta previa. The women who were detected with placenta previa were further enquired for the numbers of previous cesarean section. The data was collected on specifically designed proforma (attached). All the collected data was entered into SPSS version 10 and analyzed. The qualitative data like presence of placenta previa (yes or no) was presented as frequency and percentage. Results: There were 240 females included in the study with the mean age of 30.41 ± 5.47 years. The mean gestational age was 34.50±2.97 weeks. There were 233 (97.08%) females who did not develop placenta previa while 7 (2.92%) females had placenta previa. There was insignificant difference observed for frequency of placenta previa with age of females, parity and cesarean section (P>0.05). Conclusion: The incidence of placenta previa is found to be low in local population who had multiple cesarean section.

背景:前置胎盘是妊娠中期和晚期阴道出血的主要原因之一。有过剖宫产史的女性患前置胎盘的风险也更高。本研究的目的是确定重复剖宫产的患者中前置胎盘的发生频率。材料和方法:本横断面研究在拉合尔总医院妇科进行。计算样本量为240例，采用非概率目的抽样。所有患者都进行了产前检查，以检查是否存在前置胎盘。对检测出前置胎盘的妇女进一步询问既往剖宫产次数。数据是在专门设计的表格(附后)上收集的。将收集到的数据输入SPSS 10进行分析。定性数据，如前置胎盘的存在(是或否)以频率和百分比表示。结果:纳入研究的女性240例，平均年龄30.41±5.47岁。平均胎龄34.50±2.97周。未发生前置胎盘的有233例(97.08%)，发生前置胎盘的有7例(2.92%)。前置胎盘发生频率与女性年龄、胎次、剖宫产差异无统计学意义(P < 0.05)。结论:当地人群多次剖宫产术中前置胎盘的发生率较低。

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引用次数: 0

Correlation of Anti Mullerian Hormone and Antral Follicular Count in Ovarian Reserve Testing 卵巢储备检测中抗苗勒管激素与窦卵泡计数的相关性

Obstetrics and gynecology research

Pub Date : 2022-01-01 DOI: 10.26502/ogr088

A. K, Partha Majumder S, S. R

Background: Ovarian reserve defines a woman’s reproductive ability and the number and quality of oocytes she possesses. It is a complex clinical state dependent on age, genetics, and environmental issues. It can reflect women’s endocrine function and fertility which may gradually decrease with increasing age. Methods: This study was a cross-sectional study conducted at the out-patient department of Obstetrics and Gynae, in Enam Medical College Hospital, Savar and a local private hospital at Savar. The study was conducted during the period of July 2019-December 2019. The sample size for this study was 120. Result: The most respondent 44 (36.7%) were in between 35-40 years. The mean ± SD of BMI was 26.61 ± 1.96 and followed by duration of infertility (years) was 3.75 ± 1.64, total ovarian volume (ml) was 7.66 ± 1.32. Tubal factor was found in 27 (21.7%) cases and followed by male factor was in 24 (20%), PCOS was in 20 (16.7%), endometriosis was in 6 (5%), unexplained infertility was in 22 (18.3%). In low group AFC (mean ± SD) was 07.15 ± 4.82 where AMH (mean ± SD) was 6.66 ± 5.34 and followed by normal was 09.38 ± 3.59 and 9.48 ± 3.91and high was 15.45 ± 5.46 and 16.08 ± 5.23. There was no significance correlation found in these two predictors. Conclusion: AMH is considered as most reliable investigation for ovarian reserve testing. Serum AMH level has strong correlation with comparatively low cost Antral follicular count. Antral follicular count can be done in poor patients for ovarian reserve test.

背景:卵巢储备决定了女性的生殖能力以及她所拥有的卵母细胞的数量和质量。这是一种复杂的临床状态，与年龄、遗传和环境因素有关。它可以反映女性的内分泌功能和生育能力，随着年龄的增长而逐渐下降。方法:本研究是一项横断面研究，在萨瓦尔伊纳姆医学院医院和萨瓦尔当地一家私立医院的妇产科门诊进行。该研究于2019年7月至2019年12月期间进行。本研究的样本量为120人。结果:年龄在35 ~ 40岁之间者44例，占36.7%。BMI平均值±SD为26.61±1.96，不孕持续时间(年)为3.75±1.64，卵巢总体积(ml)为7.66±1.32。输卵管因素27例(21.7%)，其次为男性因素24例(20%)，PCOS 20例(16.7%)，子宫内膜异位症6例(5%)，不明原因不孕22例(18.3%)。低组AFC(平均±SD)为07.15±4.82，其中AMH(平均±SD)为6.66±5.34，正常组次之，分别为09.38±3.59和9.48±3.91，高组分别为15.45±5.46和16.08±5.23。两项预测指标无显著相关。结论:AMH是卵巢储备检测最可靠的指标。血清AMH水平与相对较低的窦腔卵泡计数有很强的相关性。卵巢储备试验条件差的患者可进行腔内卵泡计数。

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引用次数: 1

Barriers and Facilitators for Physical Activity in Pregnancy and Post- Partum? Findings from a Qualitative Study to Inform the Design of an Intervention for Active Women 孕期和产后体力活动的障碍和促进因素?一项定性研究的结果为运动女性干预的设计提供信息

Obstetrics and gynecology research

Pub Date : 2022-01-01 DOI: 10.26502/ogr0102

Murali K P Subramanian, P. V. der Graaf, L. Hayes, Rose I Dawson, Kunj Sachdeva, L. Azevedo

Objectives: The benefits of physical activity during and after pregnancy are well established. However, activity levels decline substantially in both inactive and active women. There is limited information on the barriers and facilitators for physical activity participation in active women, which is vital for the development of tailored interventions. The primary aim of this study is to identify the barriers and facilitators for physical activity (PA) in already active women during pregnancy and postpartum. We also explore their views on, and requirements for, the development of an intervention to support maintenance of or increase in physical activity. Methods: Five focus groups, with a total of 19 participants, were conducted using a topic guide structured around the study objectives. Transcripts were analysed using a thematic analysis approach. Results: Twenty-two codes were generated and grouped into 8 themes: (1) cognizant of PA benefits, (2) sources of advice, (3) reasons to be active during pregnancy, (4) reasons for reducing PA levels during pregnancy, (5) barriers to PA during and after pregnancy, (6) facilitators of PA during and after pregnancy, (7) ideal PA intervention, and (8) evaluation support. Conclusion: Already active women show enthusiasm for continuing PA during and after pregnancy. However, factors such as pregnancy- related body changes, childcare and lack of targeted activities deter participation in PA. A new PA programme with social and group elements, including both familiar and new activities, and providing „satisfaction and fun‟ should be developed for previously active pregnant and postpartum women to help increase or maintain PA levels

目的:怀孕期间和怀孕后体育锻炼的好处已经得到了很好的证实。然而，不运动和运动的女性的运动水平都大幅下降。关于活跃妇女参与体育活动的障碍和促进因素的信息有限，这对于制定有针对性的干预措施至关重要。本研究的主要目的是确定已经活跃的妇女在怀孕和产后进行身体活动(PA)的障碍和促进因素。我们还探讨了他们对发展干预措施以支持维持或增加身体活动的看法和要求。方法:五个焦点小组，共19名参与者，采用围绕研究目标构建的主题指南进行。使用专题分析方法分析转录本。结果:生成了22个代码，并将其分为8个主题:(1)对PA益处的认识，(2)建议来源，(3)怀孕期间积极活动的原因，(4)怀孕期间降低PA水平的原因，(5)怀孕期间和怀孕后PA的障碍，(6)怀孕期间和怀孕后PA的促进因素，(7)理想的PA干预，(8)评估支持。结论:已经运动的妇女在怀孕期间和之后表现出继续PA的热情。然而，诸如怀孕相关的身体变化，儿童保育和缺乏有针对性的活动等因素阻碍了PA的参与。应为以前积极活动的孕妇和产后妇女制订一项新的PA方案，其中包括社会和团体因素，包括熟悉的和新的活动，并提供“满意和乐趣”，以帮助增加或维持PA水平

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引用次数: 0

A Clinicopathological Study: Expression of ER, PR and HER/2neu in Endometrial Carcinoma Published On: 20 子宫内膜癌中ER、PR和HER/2neu表达的临床病理研究

Obstetrics and gynecology research

Pub Date : 2022-01-01 DOI: 10.26502/ogr077

Jasmeen Kaur, A. Suri, M. Kaur

Endometrial carcinoma is a common invasive malignancy of the female genital tract. Investigation of endometrial immunomarkers involved in carcinogenesis may influence early detection and treatment, with direct impact on prognosis by increasing life expectancy. It can often be difficult to distinguish higher grade endometrioid carcinomas from serous carcinomas. Use of immunohistochemistry as an adjunct has been the subject of a number of recent studies. Aims and Objectives: To study the association of endometrial carcinoma with relation to age, parity and other presenting feature. To determine the association between the expression of ER, PR, and Her-2/neu and clinicopathological features of endometrial carcinoma patients. To correlate the endometrial histopathology with immunohistochemistry. Material and methods: The present study comprised of analysis of 50 cases of endometrial carcinoma received in the Department of Pathology, Government Medical College, Patiala from January 2018 to May 2020. Routine Haematoxylin and Eosin and on confirmed cases of endometrial carcinoma , IHC for ER, PR and HER-2/neu was performed. Results: Endometrioid carcinomas showed maximum incidence around the age of 65 with G1 tumours 56%, G2 12%, G3 18 % and non Endometrioid were mostly serous and clear representing Obstet Gynecol Res 2022; 5 (1): 041-053 DOI: 10.26502/ogr077 Obstetrics and Gynecology Research Vol. 5 No. 1– March 2022. 42 14% cases. The predominance of grade-I endometrial carcinoma was found in 56% followed by grade-II in 12% and grade-III in 18% cases. Statistical analysis showed that the degree of differentiation significantly correlated (very highly significant) significant) with histology (p value .000). Out of 50 cases of EMC, 32(64%) cases showed ER positivity. PR positivity was seen in 30(60%) cases and HER-2/neu immunehistochemical expression was positive in 11(22%) cases. Conclusion: A decrease of the hormonal receptors expression, ER and PR was observed in parallel with the decreased histological degree of differentiation, the lowest values occurring in the case of Endometrioid G3 carcinomas and were absent in NonEndometrioid carcinomas. This finding may be of a particular clinical importance because almost half of poorly differentiated endometrial carcinomas contain estrogen/progesterone receptors and they might benefit from a progesterone therapy. PR immuneexpression showed statistically significant association with parity, presenting symptom, type, and grade of EMC. Here by, making it an independent prognostic factor.

子宫内膜癌是一种常见的女性生殖道侵袭性恶性肿瘤。研究参与癌变的子宫内膜免疫标记物可能影响早期发现和治疗，并通过延长预期寿命直接影响预后。通常很难区分高级别子宫内膜样癌和浆液性癌。使用免疫组织化学作为一种辅助手段已成为最近许多研究的主题。目的:探讨子宫内膜癌与年龄、胎次及其他表现特征的关系。探讨子宫内膜癌患者ER、PR、Her-2/neu的表达与临床病理特征的关系。目的探讨子宫内膜组织病理学与免疫组织化学的相关性。材料和方法:本研究包括对2018年1月至2020年5月在帕蒂亚拉政府医学院病理学系接受的50例子宫内膜癌患者的分析。对确诊的子宫内膜癌进行常规血红素和伊红检测，对ER、PR和HER-2/neu进行免疫组化检测。结果:子宫内膜样癌在65岁左右发病率最高，G1为56%，G2为12%，G3为18%，非子宫内膜样癌多为浆液性清晰，代表ob - Gynecol Res 2022;5 (1): 041-053 DOI: 10.26502/ogr077妇产科研究卷5第1号- 2022年3月。42.14%病例。i级子宫内膜癌占56%，其次是ii级(12%)和iii级(18%)。统计学分析显示，分化程度与组织学呈显著相关(p值0.000)。50例EMC中，ER阳性32例(64%)。PR阳性30例(60%)，HER-2/ new免疫组化表达阳性11例(22%)。结论:激素受体、ER、PR的表达与组织学分化程度的降低同时降低，在G3子宫内膜样癌中最低，在非子宫内膜样癌中无表达。这一发现可能具有特殊的临床意义，因为几乎一半的低分化子宫内膜癌含有雌激素/孕激素受体，它们可能从孕激素治疗中受益。PR免疫表达与EMC的胎次、表现症状、类型和分级有统计学意义。让它成为一个独立的预测因素。

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引用次数: 0

Perspectives of Obstetricians and Women with a History of Prior Cesarean Birth Regarding Subsequent Mode of Birth in Trifinio and Coatepeque, Guatemala. 在危地马拉特里菲尼奥和科特佩克，产科医生和有剖宫产史的妇女对以后分娩方式的看法。

Obstetrics and gynecology research

Pub Date : 2022-01-01 Epub Date: 2022-01-21 DOI: 10.26502/ogr074

Andrea Jimenez-Zambrano, Kathryn Feller, Claudia Rivera, Angela Marchin, Antonio Guillermo Bolanos, Edwin Asturias, Hector Rodas, Margo S Harrison

Background: The decision regarding delivery in the context of a prior cesarean birth is complex because both trial of labor after cesarean and elective repeat cesarean birth have risks and benefits.

Purpose: Our research objective was to understand the perspective of women and obstetricians regarding factors influencing mode of birth for women with a history of prior cesarean.

Methods: In February 2020, qualitative data was collected at Coatepeque Hospital in Coatepeque, Guatemala. In-depth interviews were conducted with obstetricians and women at the Center for Human Development in the Southwest Trifinio region. Interviews were recorded, transcribed, translated, and analyzed using conceptual content analysis of key informant interviews to analyze the meaning of themes and concepts related to mode of delivery for women with a history of prior cesarean birth.

Results: Women described feeling conflicted about their preferences on the location and attendant of their future births, but suggested that the hospital setting, and physician providers were more capable of managing complications. Physicians felt trial of labor after cesarean was the safer option but described multiple reasons that made repeat cesarean birth the more common mode of birth.

Conclusions: There is a need for innovative approaches to patient messaging and education around mode of delivery after a prior cesarean in the Southwest Region in Guatemala. Findings from this study underscore the need to improve the quality and dissemination of the educational information given, medical history collected during prenatal care, and pain control during labor. Finally, there is a need for obstetric training to support vaginal birth in the facility setting for the successful implementation of evidence-based practices around trial of labor after cesarean at Coatepeque Hospital.

背景:有剖宫产史的患者是否分娩的决定是复杂的，因为剖宫产后试产和选择性重复剖宫产都有风险和益处。目的:我们的研究目的是了解妇女和产科医生对有剖宫产史妇女分娩方式影响因素的看法。方法:2020年2月，在危地马拉科特佩克的科特佩克医院收集定性数据。对特里菲尼奥西南地区人类发展中心的产科医生和妇女进行了深入的访谈。对访谈进行记录、转录、翻译，并使用关键信息访谈的概念内容分析进行分析，以分析有剖宫产史的妇女分娩方式相关主题和概念的含义。结果:女性描述了她们对未来分娩地点和助产士的偏好的矛盾，但建议医院环境和医生提供者更有能力处理并发症。医生们认为剖宫产后试产是更安全的选择，但也有多种原因使重复剖宫产成为更常见的分娩方式。结论:在危地马拉西南地区，有必要采用创新的方法来向患者传达信息，并围绕先前剖宫产后的分娩方式进行教育。本研究的结果强调需要提高教育信息的质量和传播，产前护理期间收集的病史，以及分娩过程中的疼痛控制。最后，需要进行产科培训，以支持在设施环境中进行阴道分娩，以便在科特佩克医院成功实施围绕剖宫产后分娩试验的循证做法。

{"title":"Perspectives of Obstetricians and Women with a History of Prior Cesarean Birth Regarding Subsequent Mode of Birth in Trifinio and Coatepeque, Guatemala.","authors":"Andrea Jimenez-Zambrano, Kathryn Feller, Claudia Rivera, Angela Marchin, Antonio Guillermo Bolanos, Edwin Asturias, Hector Rodas, Margo S Harrison","doi":"10.26502/ogr074","DOIUrl":"https://doi.org/10.26502/ogr074","url":null,"abstract":"Background: The decision regarding delivery in the context of a prior cesarean birth is complex because both trial of labor after cesarean and elective repeat cesarean birth have risks and benefits.Purpose: Our research objective was to understand the perspective of women and obstetricians regarding factors influencing mode of birth for women with a history of prior cesarean.Methods: In February 2020, qualitative data was collected at Coatepeque Hospital in Coatepeque, Guatemala. In-depth interviews were conducted with obstetricians and women at the Center for Human Development in the Southwest Trifinio region. Interviews were recorded, transcribed, translated, and analyzed using conceptual content analysis of key informant interviews to analyze the meaning of themes and concepts related to mode of delivery for women with a history of prior cesarean birth.Results: Women described feeling conflicted about their preferences on the location and attendant of their future births, but suggested that the hospital setting, and physician providers were more capable of managing complications. Physicians felt trial of labor after cesarean was the safer option but described multiple reasons that made repeat cesarean birth the more common mode of birth.Conclusions: There is a need for innovative approaches to patient messaging and education around mode of delivery after a prior cesarean in the Southwest Region in Guatemala. Findings from this study underscore the need to improve the quality and dissemination of the educational information given, medical history collected during prenatal care, and pain control during labor. Finally, there is a need for obstetric training to support vaginal birth in the facility setting for the successful implementation of evidence-based practices around trial of labor after cesarean at Coatepeque Hospital.","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":"5 1","pages":"10-19"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8863362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39645508","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

Views and experiences of infertile women regarding the role of gluten in their infertility 不孕症妇女对麸质在不孕症中的作用的看法和经验

Obstetrics and gynecology research

Pub Date : 2022-01-01 DOI: 10.26502/ogr0104

J. Bold, D. Diamantopoulou

Background: Prevalence rates for infertility have increased globally. Untreated coeliac disease (CD) and gluten sensitivity can affect fertility. Guidelines encourage testing of women with unexplained infertility for CD and case studies demonstrate pregnancies after introducing a gluten-free diet (GFD). Aims: To understand the experiences of women diagnosed with infertility, investigating the potential role of gluten, including testing and implementation of a GFD. Methods: Participants completed an online survey that included open and closed questions which were coded inductively and analysed using thematic and content analysis. Findings: 29 UK based women completed the survey. The majority identified as White, with one Asian/Asian British, one Mixed, and one Arab participant. Only four had not undergone fertility treatment. Twelve had unexplained infertility, while seven had no diagnosis. Five had primary infertility and five had a secondary infertility diagnosis. TA identified six themes: (1) Experience with gluten in infertility, (2) Experiences with testing for CD, (3) Health beliefs/concerns regarding gluten, (4) Other interventions to help with infertility, (5) Nutritional support for women with infertility, (6) Infertility experience. A GFD alleviated symptoms for those with both intestinal and extra-intestinal symptoms. Participants felt unprepared for CD testing and that healthcare personnel did not treat symptoms seriously. Conclusion: Awareness of extraintestinal manifestations of CD, including unexplained infertility, should be increased amongst healthcare professionals. Women with unexplained infertility should be screened for CD, even without the presence of intestinal symptoms. Women with infertility choosing to implement a GFD need to be better supported.

背景:全球不孕症患病率有所上升。未经治疗的乳糜泻(CD)和麸质敏感性会影响生育能力。指南鼓励对患有不明原因不孕症的妇女进行乳糜泻检测，案例研究表明，在引入无谷蛋白饮食(GFD)后怀孕。目的:了解诊断为不孕症的妇女的经历，调查谷蛋白的潜在作用，包括GFD的测试和实施。方法:参与者完成一项在线调查，包括开放式和封闭式问题，这些问题被归纳编码，并使用主题和内容分析进行分析。调查结果:29名英国女性完成了这项调查。大多数被认为是白人，有一个亚裔/亚裔英国人，一个混血儿，一个阿拉伯人。只有4人没有接受过生育治疗。12人患有不明原因的不孕症，7人没有诊断。5例为原发性不孕症，5例为继发性不孕症。TA确定了六个主题:(1)在不孕症中使用谷蛋白的经验，(2)乳糜泻检测的经验，(3)关于谷蛋白的健康信念/关注，(4)帮助不孕症的其他干预措施，(5)对不孕症妇女的营养支持，(6)不孕症经验。GFD减轻了肠道和肠道外症状的患者的症状。参与者对乳糜泻检测没有做好准备，医护人员也没有认真对待症状。结论:应提高医护人员对乳糜泻肠外表现的认识，包括不明原因的不孕症。不明原因不孕的妇女应进行乳糜泻筛查，即使没有出现肠道症状。选择实施GFD的不孕妇女需要得到更好的支持。

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引用次数: 0