Nkem Ernest Njukang, Thomas Obinchemti EGBE, Nicolas Tendongfor, Tah Aldof Yoah, Kah Emmanuel Nji, M. Sama, Fidelis Atabon AKO, J. Kamgno
Objective: Our study aimed to develop and validate a prediction model for identifying women at increased risk of developing gestational hypertension (GH) in Mezam division, Northwest Region (NWR) of Cameroon. Method: A retrospective cohort design was employed. Data for a cohort of 1183 participants were randomly divided into derivation (n = 578) and validation (n = 585) datasets. Inclusion criterion was women without chronic hypertension. Primary outcome was Gestational hypertension. A questionnaire and data abstraction form were used for data collection. Chi square (χ2) test, independent sample t-test and multivariate logistic regression (to derive the prediction model) were used for data analysis. For each significant variable, a score was calculated by multiplying coefficient (β) by 100 and rounding to the nearest integer. Discrimination was estimated by used of the c-statistic. Results: DBP, SBP, hypertension in previous pregnancy, stress and smoking (scores 10, 6, 210, 56 and 18, respectively) were predictors of incident GH. The model accuracy was assessed by the area under the receiver operating characteristic curve (AUC), with optimal cut-off value 936. With the derivation dataset, sensitivity, specificity and AUC of the model were 75.9%, 80.8% and 0.828 (95% CI 0.772–0.884) respectively. The model was validated by dividing the aggregated scores into three ranges (low, moderate and high) and their cumulative incidence calculated which were; 3.5%, 6.1% and 39.4%, respectively, in the derivation dataset and 4.7%, 6.2% and 30.2%, respectively, in the validation dataset. Calibration was good in both cohorts. The negative predictive value of women in the development cohort at high risk of GH was 92.0% compared to 94.0% in the validation cohort. Conclusions: The prediction model revealed adequate performance after validation in an independent cohort and can be used to classify women into high, moderate or low risk of developing GH. It contributes to efforts to provide clinical decision-making support to improve maternal health and birth outcomes.
目的:本研究旨在建立并验证喀麦隆西北地区Mezam地区妊娠期高血压(GH)风险增加的预测模型。方法:采用回顾性队列设计。1183名参与者的数据随机分为衍生(n = 578)和验证(n = 585)数据集。纳入标准为无慢性高血压的女性。主要结局是妊娠期高血压。采用问卷调查和数据抽象化表格进行数据收集。采用χ2检验、独立样本t检验和多元logistic回归(建立预测模型)进行数据分析。对于每个重要变量，通过将系数(β)乘以100并四舍五入到最接近的整数来计算得分。利用c统计量估计歧视。结果:舒张压、收缩压、妊娠史高血压、压力和吸烟(评分分别为10、6、210、56和18)是GH发生的预测因素。以受试者工作特征曲线下面积(AUC)评价模型精度，最佳截断值为936。使用衍生数据集，模型的灵敏度为75.9%，特异性为80.8%，AUC为0.828 (95% CI 0.772-0.884)。通过将综合得分分为低、中、高三个区间，计算其累计发生率，对模型进行验证;在衍生数据集中，分别为3.5%、6.1%和39.4%;在验证数据集中，分别为4.7%、6.2%和30.2%。两个队列的校准都很好。发展队列中GH高风险妇女的阴性预测值为92.0%，而验证队列为94.0%。结论:该预测模型在独立队列验证后显示出足够的性能，可用于将女性分为高、中、低GH风险。它有助于努力提供临床决策支持，以改善产妇保健和分娩结果。
{"title":"Development and Validation of a Prediction Model for Gestational Hypertension in Mezam Division","authors":"Nkem Ernest Njukang, Thomas Obinchemti EGBE, Nicolas Tendongfor, Tah Aldof Yoah, Kah Emmanuel Nji, M. Sama, Fidelis Atabon AKO, J. Kamgno","doi":"10.26502/ogr0103","DOIUrl":"https://doi.org/10.26502/ogr0103","url":null,"abstract":"Objective: Our study aimed to develop and validate a prediction model for identifying women at increased risk of developing gestational hypertension (GH) in Mezam division, Northwest Region (NWR) of Cameroon. Method: A retrospective cohort design was employed. Data for a cohort of 1183 participants were randomly divided into derivation (n = 578) and validation (n = 585) datasets. Inclusion criterion was women without chronic hypertension. Primary outcome was Gestational hypertension. A questionnaire and data abstraction form were used for data collection. Chi square (χ2) test, independent sample t-test and multivariate logistic regression (to derive the prediction model) were used for data analysis. For each significant variable, a score was calculated by multiplying coefficient (β) by 100 and rounding to the nearest integer. Discrimination was estimated by used of the c-statistic. Results: DBP, SBP, hypertension in previous pregnancy, stress and smoking (scores 10, 6, 210, 56 and 18, respectively) were predictors of incident GH. The model accuracy was assessed by the area under the receiver operating characteristic curve (AUC), with optimal cut-off value 936. With the derivation dataset, sensitivity, specificity and AUC of the model were 75.9%, 80.8% and 0.828 (95% CI 0.772–0.884) respectively. The model was validated by dividing the aggregated scores into three ranges (low, moderate and high) and their cumulative incidence calculated which were; 3.5%, 6.1% and 39.4%, respectively, in the derivation dataset and 4.7%, 6.2% and 30.2%, respectively, in the validation dataset. Calibration was good in both cohorts. The negative predictive value of women in the development cohort at high risk of GH was 92.0% compared to 94.0% in the validation cohort. Conclusions: The prediction model revealed adequate performance after validation in an independent cohort and can be used to classify women into high, moderate or low risk of developing GH. It contributes to efforts to provide clinical decision-making support to improve maternal health and birth outcomes.","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69351894","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}
Muhammad Irfan Khattak, Samina Naseem khattak, Shumaila Hadi, Samina Rehan Khan, Muhammad Numan Khattak, Adeela Yasmeen
Objective: To determine the true prevalence of anaemia in Pakistani mothers from all four provinces and compare the haematological parameters. Location: Multicentre study at PNS Shifa Karachi (Sind), CMH Kharian (Punjab), CMH Mardan (KPK), CMH Quetta (Balochistan). Duration: Apr-Sep 2021 for 6 months. Study design: prospective observational study. Methods: Four centres were established to collect data on a representative sample of each province. Along with haematological measures, sociodemographic data were obtained and placed into a predefined online proforma. SPSS v 20 was used to analyse the data. Frequencies and percentages were calculated for categorical variables, whereas means and standard deviations were used to represent scales. Results of all four provinces were analysed and compared for similarities and differences. Results: A total of 2060 female patients fulfilling our inclusion criteria from all four provinces were Obstet Gynecol Res 2022; 5 (1): 034-040 DOI: 10.26502/ogr076 Obstetrics and Gynecology Research Vol. 5 No. 1– March 2022. 35 included in the study. Four hundred and sixty (22%) of the total population were in the first trimester, 785 (38%) were in the second, and 815 (40%) were in the third trimester of pregnancy. The study population's mean age was 28 ± 5.033 years. The mean haemoglobin concentration was 10.78 ± 1.49 g/dl. The mean MCV was in the lower limits of normal, 79.73 ± 7.95 3FL. At a cut off haemoglobin concentration of 10.8 g/dl, 50% of the population had Haemoglobin concentrations lower than this value. In terms of mean Haemoglobin levels across Pakistan's provinces, the lowest haemoglobin level was recorded in Sind, at 10.34 ± 1.469 g/dl. It was followed by Punjab, with a mean Haemoglobin concentration of 10.8 g/dl + 1.89. However, the mean Haemoglobin concentration in KPK was significantly high with mean Hb of 11.01 ± 1.330 g/dl. Additionally, comparable Haemoglobin levels were seen in Baloch people, with a mean Hb of 10.95 ± 1.048 g/dl. So according to international standard anaemia was less prevalent in KPK and Balochistan. Conclusion: Anaemia during pregnancy is very common in Pakistani mothers, according to worldwide standards. However, Severe anaemia Hb<8g/dl, on the other hand, is uncommon. Interprovincial variation in haematological parameters is also notable in Pakistan. We may need to formulate local guidelines for diagnosing and managing anaemia.
{"title":"Anaemia in Pregnancy; An Underdeveloped Country’s Perspective (The First Ever Multicentre Trial in Pakistan from all Four Provinces)","authors":"Muhammad Irfan Khattak, Samina Naseem khattak, Shumaila Hadi, Samina Rehan Khan, Muhammad Numan Khattak, Adeela Yasmeen","doi":"10.26502/ogr076","DOIUrl":"https://doi.org/10.26502/ogr076","url":null,"abstract":"Objective: To determine the true prevalence of anaemia in Pakistani mothers from all four provinces and compare the haematological parameters. Location: Multicentre study at PNS Shifa Karachi (Sind), CMH Kharian (Punjab), CMH Mardan (KPK), CMH Quetta (Balochistan). Duration: Apr-Sep 2021 for 6 months. Study design: prospective observational study. Methods: Four centres were established to collect data on a representative sample of each province. Along with haematological measures, sociodemographic data were obtained and placed into a predefined online proforma. SPSS v 20 was used to analyse the data. Frequencies and percentages were calculated for categorical variables, whereas means and standard deviations were used to represent scales. Results of all four provinces were analysed and compared for similarities and differences. Results: A total of 2060 female patients fulfilling our inclusion criteria from all four provinces were Obstet Gynecol Res 2022; 5 (1): 034-040 DOI: 10.26502/ogr076 Obstetrics and Gynecology Research Vol. 5 No. 1– March 2022. 35 included in the study. Four hundred and sixty (22%) of the total population were in the first trimester, 785 (38%) were in the second, and 815 (40%) were in the third trimester of pregnancy. The study population's mean age was 28 ± 5.033 years. The mean haemoglobin concentration was 10.78 ± 1.49 g/dl. The mean MCV was in the lower limits of normal, 79.73 ± 7.95 3FL. At a cut off haemoglobin concentration of 10.8 g/dl, 50% of the population had Haemoglobin concentrations lower than this value. In terms of mean Haemoglobin levels across Pakistan's provinces, the lowest haemoglobin level was recorded in Sind, at 10.34 ± 1.469 g/dl. It was followed by Punjab, with a mean Haemoglobin concentration of 10.8 g/dl + 1.89. However, the mean Haemoglobin concentration in KPK was significantly high with mean Hb of 11.01 ± 1.330 g/dl. Additionally, comparable Haemoglobin levels were seen in Baloch people, with a mean Hb of 10.95 ± 1.048 g/dl. So according to international standard anaemia was less prevalent in KPK and Balochistan. Conclusion: Anaemia during pregnancy is very common in Pakistani mothers, according to worldwide standards. However, Severe anaemia Hb<8g/dl, on the other hand, is uncommon. Interprovincial variation in haematological parameters is also notable in Pakistan. We may need to formulate local guidelines for diagnosing and managing anaemia.","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69352375","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}
A. Beckley, J. Klein, John Park, A. Eyvazzadeh, G. Levy, Alexandra Koudele
Background: Progesterone is essential for establishing and maintaining a pregnancy. However, premature atresia of the corpus luteum (CL) or suboptimal progesterone secretion after ovulation may result in the decreased ability to establish or maintain a pregnancy. The current limitations of serum hormone testing fail to give a complete picture of progesterone production across the luteal phase required for pregnancy. Results: Of the 185 enrolled women, 172 had complete cycles. Of the 172 women who demonstrated complete cycles, 54 (31.4%) women reported pregnancies. Thirty-five (64.8%) of these pregnancies resulted from a PdG positive cycle with a miscarriage rate of 14.3% (5/35). Nineteen pregnancies (35.2%) resulted from PdG negative cycles with a miscarriage rate of 89.5% (17/19). The association of a negative or positive cycle with pregnancy outcome was significant (two-sided p=0.0001). Positive PdG cycles are associated with increased pregnancy rates and lower odds of a first-trimester pregnancy loss. Conclusion: A consideration for luteal phase support with progesterone or ovulation induction in women with negative PdG cycles can be of benefit to increase pregnancy rates. Furthermore, the use of LH and PdG testing prior to conception can be used as a screening tool to potentially identify women who are at risk of subfertility and at a higher risk of first-trimester pregnancy loss related to low progesterone.
{"title":"The Predictive Value of Urinary Progesterone Metabolite PdG Testing in Pregnancy Outcomes","authors":"A. Beckley, J. Klein, John Park, A. Eyvazzadeh, G. Levy, Alexandra Koudele","doi":"10.26502/ogr092","DOIUrl":"https://doi.org/10.26502/ogr092","url":null,"abstract":"Background: Progesterone is essential for establishing and maintaining a pregnancy. However, premature atresia of the corpus luteum (CL) or suboptimal progesterone secretion after ovulation may result in the decreased ability to establish or maintain a pregnancy. The current limitations of serum hormone testing fail to give a complete picture of progesterone production across the luteal phase required for pregnancy. Results: Of the 185 enrolled women, 172 had complete cycles. Of the 172 women who demonstrated complete cycles, 54 (31.4%) women reported pregnancies. Thirty-five (64.8%) of these pregnancies resulted from a PdG positive cycle with a miscarriage rate of 14.3% (5/35). Nineteen pregnancies (35.2%) resulted from PdG negative cycles with a miscarriage rate of 89.5% (17/19). The association of a negative or positive cycle with pregnancy outcome was significant (two-sided p=0.0001). Positive PdG cycles are associated with increased pregnancy rates and lower odds of a first-trimester pregnancy loss. Conclusion: A consideration for luteal phase support with progesterone or ovulation induction in women with negative PdG cycles can be of benefit to increase pregnancy rates. Furthermore, the use of LH and PdG testing prior to conception can be used as a screening tool to potentially identify women who are at risk of subfertility and at a higher risk of first-trimester pregnancy loss related to low progesterone.","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69352453","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}
Itamar D. Futterman, Liel Navi, Hae-Young Kim, R. Mendonca, Michael Girshin, Alexander Shilkrut
Objective: To examine how increased body mass index (BMI) class impacts time to delivery interval in the setting of emergent cesarean birth. Study Design: A cohort study of all emergent cesarean births at our institution from 2012-2018. Three comparison groups were divided by BMI category: Primary outcomes were time interval from decision-to-delivery interval and from skin-incision-to-delivery interval. Results: The mean time interval (minutes +/- standard deviation (SD)) from arrival at the OR to delivery was 25.1 ± 9.7, 26.1 ± 10.6 and 30.2 ±12.2, highlighting that as patient BMI class increased, the interval time to arrival to the OR and to delivery increased (beta coefficient 95% CI 5.15 (1.01,9,30) p=0.037). The mean time interval (minutes +/- SD) from skin incision to delivery was 8.7 ± 5.6, 9.0 ± 6.4 and 11.7 ±7.0, again showing a positive correlation between time interval and increasing BMI class (beta coefficient 95% CI 3.02 (0.65,5.40) p=0.025). Conclusion: This study describes the challenge of urgent cesarean births in obese patients, manifested in longer decision-to-delivery and skin-to-delivery intervals as BMI class increases. These findings support prior literature that describe a longer transport and surgical times in obese patients undergoing cesarean birth.
目的:探讨体重指数(BMI)分级增加对剖宫产紧急分娩时间间隔的影响。研究设计:对我院2012-2018年所有紧急剖宫产进行队列研究。按BMI分类分为三个对照组:主要结果为从决定到分娩的时间间隔和从皮肤切口到分娩的时间间隔。结果:到达手术室到分娩的平均时间间隔(分钟+/-标准差(SD))为25.1±9.7,26.1±10.6和30.2±12.2，随着患者BMI等级的增加，到达手术室和分娩的间隔时间增加(β系数95% CI 5.15 (1.01,9,30) p=0.037)。从皮肤切口到分娩的平均时间间隔(minutes +/- SD)分别为8.7±5.6、9.0±6.4和11.7±7.0，时间间隔与BMI分级增加呈正相关(β系数95% CI 3.02 (0.65,5.40) p=0.025)。结论:本研究描述了肥胖患者紧急剖宫产的挑战，表现为随着BMI等级的增加，从决定到分娩和皮肤到分娩的时间间隔更长。这些发现支持了先前的文献，即肥胖患者接受剖宫产需要更长的运输和手术时间。
{"title":"Decision-To-Delivery Interval in Obese Patients Undergoing Emergent Cesarean Birth","authors":"Itamar D. Futterman, Liel Navi, Hae-Young Kim, R. Mendonca, Michael Girshin, Alexander Shilkrut","doi":"10.26502/ogr095","DOIUrl":"https://doi.org/10.26502/ogr095","url":null,"abstract":"Objective: To examine how increased body mass index (BMI) class impacts time to delivery interval in the setting of emergent cesarean birth. Study Design: A cohort study of all emergent cesarean births at our institution from 2012-2018. Three comparison groups were divided by BMI category: Primary outcomes were time interval from decision-to-delivery interval and from skin-incision-to-delivery interval. Results: The mean time interval (minutes +/- standard deviation (SD)) from arrival at the OR to delivery was 25.1 ± 9.7, 26.1 ± 10.6 and 30.2 ±12.2, highlighting that as patient BMI class increased, the interval time to arrival to the OR and to delivery increased (beta coefficient 95% CI 5.15 (1.01,9,30) p=0.037). The mean time interval (minutes +/- SD) from skin incision to delivery was 8.7 ± 5.6, 9.0 ± 6.4 and 11.7 ±7.0, again showing a positive correlation between time interval and increasing BMI class (beta coefficient 95% CI 3.02 (0.65,5.40) p=0.025). Conclusion: This study describes the challenge of urgent cesarean births in obese patients, manifested in longer decision-to-delivery and skin-to-delivery intervals as BMI class increases. These findings support prior literature that describe a longer transport and surgical times in obese patients undergoing cesarean birth.","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69352518","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/Introduction:Cardiotocography (CTG) is an important obstetric tool to assess fetal wellbeing. Interns are exposed to a lot of fetal heart traces during their internship. Knowledge on this is gained by (undergraduate) teaching and by working with clinicians. With this prospective cohort study we aim to investigate if introducing a CTG e-learning makes interns feel better prepared and more competent in interpreting CTG. Methods: We evaluated a 1-hour CTG e-learning containing basic principles and interpretation skills. We used anonymous evaluation questionnaires. The answers of the questionnaires were entered in and examined with IBM® SPSS® statistics version 26. Results: Students with access to the CTG e-learning felt better prepared (p=0.001), more competent (p=0.001) and were more satisfied with the education (p=0.000). Students with or without access to the e-learning scored the same on the knowledge test (p=0.504). Conclusions: Providing a CTG e-learning at the start of the obstetrics/ gynecology internship makes students feel more prepared and more competent on interpreting CTG’s. They are satisfied with the education. Affiliation: 1Obstetric and Gynecology department, AmsterdamUMC, The Netherlands *Corresponding author: SPC Verkleij, Meibergdreef 9 (H4-250), NL-1105 AZ Amsterdam, Netherlands. Citation: S P C Verkleij, I M de Graaf, P C A M Bakker. How to prepare obstetric interns for cardiotocography interpretation? Obstetrics and Gynecology Research 5 (2022): 319-324. Received: July 20, 2022 Accepted: July 27, 2022 Published: December 09, 2022
背景/介绍:心脏造影(CTG)是评估胎儿健康的重要产科工具。实习生在实习期间会接触到很多胎心痕迹。这方面的知识是通过(本科)教学和与临床医生的合作获得的。通过这项前瞻性队列研究，我们旨在调查引入CTG电子学习是否使实习生在解释CTG方面准备得更好，更有能力。方法:我们评估了一个1小时的CTG电子学习，包括基本原理和口译技巧。我们使用匿名评估问卷。问卷的答案被输入和IBM®SPSS®统计版本26检验。结果:参与CTG网络学习的学生备课能力更强(p=0.001)，学习满意度更高(p=0.000)。使用或不使用电子学习的学生在知识测试中的得分相同(p=0.504)。结论:在妇产科实习开始时提供CTG电子学习，使学生对CTG的解读有更充分的准备和更强的能力。他们对教育很满意。通讯作者:SPC Verkleij, Meibergdreef 9 (H4-250)， NL-1105 AZ Amsterdam, Netherlands。引用本文:S P C Verkleij, I M de Graaf, P C A M Bakker。如何为产科实习生做好心脏摄影解读的准备?妇产科研究5(2022):319-324。收稿日期:2022年7月20日收稿日期:2022年7月27日发表日期:2022年12月09日
{"title":"How to Prepare Obstetric Interns for Cardiotocography Interpretation?","authors":"S. Verkleij, I. Graaf, P. Bakker","doi":"10.26502/ogr0106","DOIUrl":"https://doi.org/10.26502/ogr0106","url":null,"abstract":"Background/Introduction:Cardiotocography (CTG) is an important obstetric tool to assess fetal wellbeing. Interns are exposed to a lot of fetal heart traces during their internship. Knowledge on this is gained by (undergraduate) teaching and by working with clinicians. With this prospective cohort study we aim to investigate if introducing a CTG e-learning makes interns feel better prepared and more competent in interpreting CTG. Methods: We evaluated a 1-hour CTG e-learning containing basic principles and interpretation skills. We used anonymous evaluation questionnaires. The answers of the questionnaires were entered in and examined with IBM® SPSS® statistics version 26. Results: Students with access to the CTG e-learning felt better prepared (p=0.001), more competent (p=0.001) and were more satisfied with the education (p=0.000). Students with or without access to the e-learning scored the same on the knowledge test (p=0.504). Conclusions: Providing a CTG e-learning at the start of the obstetrics/ gynecology internship makes students feel more prepared and more competent on interpreting CTG’s. They are satisfied with the education. Affiliation: 1Obstetric and Gynecology department, AmsterdamUMC, The Netherlands *Corresponding author: SPC Verkleij, Meibergdreef 9 (H4-250), NL-1105 AZ Amsterdam, Netherlands. Citation: S P C Verkleij, I M de Graaf, P C A M Bakker. How to prepare obstetric interns for cardiotocography interpretation? Obstetrics and Gynecology Research 5 (2022): 319-324. Received: July 20, 2022 Accepted: July 27, 2022 Published: December 09, 2022","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69351916","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}
Ramkrishna Purohit, Jay Gopal Sharma, Devajani Meher
Background: Recurrent massive secondary postpartum haemorrhage (PPH) due to uterine wound dehiscence with uterine artery erosion following LSCS causes management challenges. Case: Primiparous of 26 years had three recurrent episodes of severe PPH within 37 days after LSCS. Hysteroscopy visualized features of uterine scar dehiscence on the left angle side and excluded other causes of PPH after the 2nd episode on the 24th day and found bleeding through the wound gap. Laparoscopy after 3rd episode on 37th day revealed bleeding eroded left uterine artery. Bipolar coagulation of the left uterine artery sealed bleeding and conserved the uterus. Conclusion: Recurrent massive PPH may occur from uterine artery erosion following LSCS scar dehiscence. Abdominal sonography, a quick hysteronscopy, and an emergency laparoscopic bipolar seal of the eroded uterine artery can serve the purpose of minimally invasive surgery in a stable patient.
{"title":"A Case of Recurrent Massive Secondary Postpartum Haemorrhage following Caesarean Section Due to the Eroded Left Uterine Artery Sealed by Laparoscopic Bipolar Coagulation","authors":"Ramkrishna Purohit, Jay Gopal Sharma, Devajani Meher","doi":"10.26502/ogr078","DOIUrl":"https://doi.org/10.26502/ogr078","url":null,"abstract":"Background: Recurrent massive secondary postpartum haemorrhage (PPH) due to uterine wound dehiscence with uterine artery erosion following LSCS causes management challenges. Case: Primiparous of 26 years had three recurrent episodes of severe PPH within 37 days after LSCS. Hysteroscopy visualized features of uterine scar dehiscence on the left angle side and excluded other causes of PPH after the 2nd episode on the 24th day and found bleeding through the wound gap. Laparoscopy after 3rd episode on 37th day revealed bleeding eroded left uterine artery. Bipolar coagulation of the left uterine artery sealed bleeding and conserved the uterus. Conclusion: Recurrent massive PPH may occur from uterine artery erosion following LSCS scar dehiscence. Abdominal sonography, a quick hysteronscopy, and an emergency laparoscopic bipolar seal of the eroded uterine artery can serve the purpose of minimally invasive surgery in a stable patient.","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69352385","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 : Wound infection is one of the most prevalent problems associated with surgical therapy, accounting for a large amount of morbidity in gynaecologic surgical hospitalizations. To avoid potential problems like surgical-site infections and wound dehiscence, it's critical to care for post-operative wounds properly in the community. Objective : The objective of the study was to assess the prevalence of wound infection and its management system in gynecological surgery in a tertiary care hospital in Bangladesh . Method : This cross - sectional study was conducted from January 2019 to December 2020 at Uttara Adhunik Medical College & Medical College Hospital, Dhaka, Bangladesh . This study was purposively conducted aecological wounds & their infections . Results : Among 220 patients, 12.7 % of patients were below 20 years old and the maximum number of patients (46.3%) were between 20 to 29 years old . 60 % of patients’ socioeconomic status was a middle-class state . The rate of antibiotic prophylaxis was higher (31%) in combined surgery patients, length of hospital stay was higher among vaginal surgery patients, rehospitalization was observed higher (29%) among abdominal surgery patients, and most repeated surgeries were found to be higher (24%) in abdominal surgery patients. Maximum patients (31.8%) had hypertension and minimum patients (3.86%) had fever on admission. Maximum patients (33%) had operative site infection and minimum patients (6%) had postoperative ileus. Conclusion : Optimal surgical wound management is a crucial component of post-operative recovery, and health care practitioners should keep an eye on the progress of acute wound healing, prevent wound problems, and treat them correctly if they occur.
{"title":"Wound Management in Gynaecological Surgery: A Tertiary Care Hospital Study in Bangladesh","authors":"Sabrin Farhad, Bipul Kumar Biswas, Shamima Haque Chowdhury, Roknuzzman .","doi":"10.26502/ogr083","DOIUrl":"https://doi.org/10.26502/ogr083","url":null,"abstract":"Background : Wound infection is one of the most prevalent problems associated with surgical therapy, accounting for a large amount of morbidity in gynaecologic surgical hospitalizations. To avoid potential problems like surgical-site infections and wound dehiscence, it's critical to care for post-operative wounds properly in the community. Objective : The objective of the study was to assess the prevalence of wound infection and its management system in gynecological surgery in a tertiary care hospital in Bangladesh . Method : This cross - sectional study was conducted from January 2019 to December 2020 at Uttara Adhunik Medical College & Medical College Hospital, Dhaka, Bangladesh . This study was purposively conducted aecological wounds & their infections . Results : Among 220 patients, 12.7 % of patients were below 20 years old and the maximum number of patients (46.3%) were between 20 to 29 years old . 60 % of patients’ socioeconomic status was a middle-class state . The rate of antibiotic prophylaxis was higher (31%) in combined surgery patients, length of hospital stay was higher among vaginal surgery patients, rehospitalization was observed higher (29%) among abdominal surgery patients, and most repeated surgeries were found to be higher (24%) in abdominal surgery patients. Maximum patients (31.8%) had hypertension and minimum patients (3.86%) had fever on admission. Maximum patients (33%) had operative site infection and minimum patients (6%) had postoperative ileus. Conclusion : Optimal surgical wound management is a crucial component of post-operative recovery, and health care practitioners should keep an eye on the progress of acute wound healing, prevent wound problems, and treat them correctly if they occur.","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69352426","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: Given how important pregnancy is to a woman's life, both the mother's and the unborn child's health and wellbeing are greatly influenced by the mother's dietary habits during and throughout pregnancy. Therefore, the objective of the study was to investigate the effect of behavior change communication (BCC) through the health development armies on the dietary practices of pregnant women. Methods: A two-arm parallel cluster randomized controlled community trial with baseline and endline measurements using quantitative data collection methods was conducted in Ambo district among 770 pregnant women (385 in control and 385 in intervention groups). Endpoint data from 372 intervention and 372 control groups were gathered, respectively. In the intervention group, health development armies delivered the BCC main message based on intervention protocol. The intervention began in July 2018, and data collection for the endline began in October, 2018. The control group received the standard care provided by the healthcare system during an ANC visit. The study of effect measure was done using a log-binomial model to estimate the adjusted relative risk and its 95% confidence interval (CI) of the risk factors for suboptimal dietary practice. Result: At the end of the study, the overall optimal dietary practice among the intervention group was 65.1%, while among the control group it was 34.9% (p< 0.001). Pregnant women who received intervention were 41.0% less likely to be at risk of being suboptimal in dietary practice compared to pregnant women who were in the control group (ARR = 0.591, 95%CI: 0.510-0.686). Conclusions: This study revealed that behavior change communication (BCC) through the health development armies is effective in improving the dietary practices of pregnant women. As a result, BCC through the Health Development Army is recommended to enhance the dietary practices of pregnant women.
{"title":"Effect of Behavior Change Communication through the Health Development Army on Dietary Practice of Pregnant Women in Ambo District, Ethiopia: A Cluster Randomized Controlled Community Trial","authors":"Mitsiwat Abebe Gebremichael, T. B. Lema","doi":"10.26502/ogr096","DOIUrl":"https://doi.org/10.26502/ogr096","url":null,"abstract":"Background: Given how important pregnancy is to a woman's life, both the mother's and the unborn child's health and wellbeing are greatly influenced by the mother's dietary habits during and throughout pregnancy. Therefore, the objective of the study was to investigate the effect of behavior change communication (BCC) through the health development armies on the dietary practices of pregnant women. Methods: A two-arm parallel cluster randomized controlled community trial with baseline and endline measurements using quantitative data collection methods was conducted in Ambo district among 770 pregnant women (385 in control and 385 in intervention groups). Endpoint data from 372 intervention and 372 control groups were gathered, respectively. In the intervention group, health development armies delivered the BCC main message based on intervention protocol. The intervention began in July 2018, and data collection for the endline began in October, 2018. The control group received the standard care provided by the healthcare system during an ANC visit. The study of effect measure was done using a log-binomial model to estimate the adjusted relative risk and its 95% confidence interval (CI) of the risk factors for suboptimal dietary practice. Result: At the end of the study, the overall optimal dietary practice among the intervention group was 65.1%, while among the control group it was 34.9% (p< 0.001). Pregnant women who received intervention were 41.0% less likely to be at risk of being suboptimal in dietary practice compared to pregnant women who were in the control group (ARR = 0.591, 95%CI: 0.510-0.686). Conclusions: This study revealed that behavior change communication (BCC) through the health development armies is effective in improving the dietary practices of pregnant women. As a result, BCC through the Health Development Army is recommended to enhance the dietary practices of pregnant women.","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69352528","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}
Confidence A. Alemajo, Gregory E. Halle-Ekane, Elvis A. Nkengasong, Emmanuel A. Asongalem
Background: Neural tube defects(NTDs) are among the most common birth defects, contributing to miscarriages, infant mortality, severe congenital abnormalities, and serious disabilities. The protective effect of peri-conceptional folic acid (PFA) supplementation in reducing the risk of NTDs and other adverse pregnancy outcomes has been scientifically confirmed. Methods: A cross-sectional study was conducted using a structured questionnaire administered to 393 pregnant women seeking routine antenatal care between February to April 2020. Multivariate logistic regression was used to model factors associated with awareness, knowledge, and use of PFA. Results: Approximately 55% of women reported that they had heard of folic acid and only 6.1% had knowledge of folic acid (its benefit in preventing birth defects and the appropriate time to start using it). However, only 5.1% reported that they started using folic acid before pregnancy. Folic acid awareness showed a significant relationship with university education and above (OR=4.30, 95% CI [2.60, 7.30], P<0.001). There was also a significant difference in the odds of knowledge among those with a university education and above (OR=5.06, 95% CI [1.65, 19.0], P=0.0076). There was a statistically significant difference in the odds of awareness and knowledge of folic acid among women who had a history of folic acid education from a healthcare provider before pregnancy compared to those who did not, (OR=23.7, 95% CI [4.84, 430], P=0.002), (OR=12.0, 95% CI [4.31, 35.1], P<0.001) respectively. Even though women who planned their pregnancy (OR=4.89,
背景:神经管缺陷(NTDs)是最常见的出生缺陷之一，可导致流产、婴儿死亡、严重先天性异常和严重残疾。围孕期补充叶酸(PFA)在降低NTDs风险和其他不良妊娠结局方面的保护作用已得到科学证实。方法:采用结构化问卷对2020年2月至4月期间寻求常规产前保健的393名孕妇进行横断面研究。多变量逻辑回归用于模拟与PFA的意识、知识和使用相关的因素。结果:大约55%的女性报告说她们听说过叶酸，只有6.1%的女性了解叶酸(它在预防出生缺陷和开始使用叶酸的适当时间方面的好处)。然而，只有5.1%的人报告说她们在怀孕前开始服用叶酸。叶酸意识与大学及以上教育程度有显著关系(OR=4.30, 95% CI [2.60, 7.30]， P<0.001)。大学及以上学历人群的知识知晓率也存在显著差异(OR=5.06, 95% CI [1.65, 19.0]， P=0.0076)。怀孕前接受过医疗保健提供者叶酸教育的妇女与未接受过医疗保健提供者叶酸教育的妇女相比，对叶酸的认识和知识的几率有统计学意义的差异(OR=23.7, 95% CI [4.84, 430]， P=0.002)， OR=12.0, 95% CI [4.31, 35.1]， P<0.001)。即使计划怀孕的女性(OR=4.89)，
{"title":"Peri-conceptional folic acid supplementation: A Cross-Sectional Study to Assess the Awareness, Knowledge, Use and Associated Factors Among Pregnant Women Attending Antenatal Care in Two Secondary Health Care Facilities, Southwest Region, Cameroon","authors":"Confidence A. Alemajo, Gregory E. Halle-Ekane, Elvis A. Nkengasong, Emmanuel A. Asongalem","doi":"10.26502/ogr098","DOIUrl":"https://doi.org/10.26502/ogr098","url":null,"abstract":"Background: Neural tube defects(NTDs) are among the most common birth defects, contributing to miscarriages, infant mortality, severe congenital abnormalities, and serious disabilities. The protective effect of peri-conceptional folic acid (PFA) supplementation in reducing the risk of NTDs and other adverse pregnancy outcomes has been scientifically confirmed. Methods: A cross-sectional study was conducted using a structured questionnaire administered to 393 pregnant women seeking routine antenatal care between February to April 2020. Multivariate logistic regression was used to model factors associated with awareness, knowledge, and use of PFA. Results: Approximately 55% of women reported that they had heard of folic acid and only 6.1% had knowledge of folic acid (its benefit in preventing birth defects and the appropriate time to start using it). However, only 5.1% reported that they started using folic acid before pregnancy. Folic acid awareness showed a significant relationship with university education and above (OR=4.30, 95% CI [2.60, 7.30], P<0.001). There was also a significant difference in the odds of knowledge among those with a university education and above (OR=5.06, 95% CI [1.65, 19.0], P=0.0076). There was a statistically significant difference in the odds of awareness and knowledge of folic acid among women who had a history of folic acid education from a healthcare provider before pregnancy compared to those who did not, (OR=23.7, 95% CI [4.84, 430], P=0.002), (OR=12.0, 95% CI [4.31, 35.1], P<0.001) respectively. Even though women who planned their pregnancy (OR=4.89,","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69352532","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 : 2021-05-26DOI: 10.21203/RS.3.RS-498935/V1
A. Salahat, Taha Aa, N. Almasri, E. Sweity
Background: Spinal anesthesia is the preferred method of anesthesia for caesarean section; however, it is associated with dangerous adverse effects on both mother and fetus, this includes: spinal anesthesia induced shivering and hypotension. Previous studies suggest serotonin may have a role in hypotension, bradycardia, and shivering occurrence perioeratively. In this prospective double-blind randomized control trial study, we evaluated the efficacy of the ondansetron, a serotonin receptor antagonist, on the incidence of spinal anesthesia-induced shivering, hypotension, nausea, vomiting and other possible complications in elective caesarean sections. This study conducted in Palestine, West Bank, Nablus city in the caesarean section operation rooms, and post-anesthesia care unit at Rafidia governmental hospital. Eighty full-term elective caesarean section parturient (Age 18-50 years) with ASA 1 or 2 classification were recruited and randomly allocated into two groups: prophylactic IV ondansetron treatment group and placebo 0.9% saline control group. The primary outcomes were the incidence of spinal anesthesia-induced shivering and hypotension, while secondary outcomes were perioperative bradycardia, nausea, vomiting, headache, pain, pruritus, dizziness and respiratory depression and parturient satisfaction. Results: Incidence of intraoperative hypotension and dizziness in the ondansetron group was significantly lower than which occurred in the control group (22.5% vs. 62.5% respectively; P < 0.001), the incidences and intensity of intraoperative shivering in the ondansetron group was lower than the control group (12.5 % vs. 32.5 % respectively; P = 0.032), Intraoperative nausea intensity in the ondansetron group was lower than control group (P = 0.049). Postoperatively, the incidence of postoperative dizziness in the ondansetron group was lower than the control group (5% vs. 37.5 % respectively; P = 0.001), the incidence and intensity of postoperative shivering in the ondansetron group was lower than the control group (12.5% vs. 37.5 % respectively; P = 0.01). Incidence and intensity of postoperative nausea in the ondansetron group was lower than the control group (17.5% vs. 40 % respectively; P = 0.026), the incidence of postoperative vomiting in the ondansetron group was lower than the control group (25.5% vs. 2.5 % respectively; P = 0.014).Conclusion: Prophylactic 4 mg IV ondansetron can significantly attenuate the incidences of spinal anesthesia-induced shivering and hypotension, dizziness, nausea, and vomiting occurrence and increase parturient satisfaction scale for parturient who undergo caesarean section.
{"title":"Effect of Prophylactic Ondansetron on the Incidence of Spinal Anesthesia-Induced Shivering and Hypotension in Elective Cesarean Sections:Double-Blind, Placebo-Controlled, Randomized Clinical Trial","authors":"A. Salahat, Taha Aa, N. Almasri, E. Sweity","doi":"10.21203/RS.3.RS-498935/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-498935/V1","url":null,"abstract":"\u0000 Background: Spinal anesthesia is the preferred method of anesthesia for caesarean section; however, it is associated with dangerous adverse effects on both mother and fetus, this includes: spinal anesthesia induced shivering and hypotension. Previous studies suggest serotonin may have a role in hypotension, bradycardia, and shivering occurrence perioeratively. In this prospective double-blind randomized control trial study, we evaluated the efficacy of the ondansetron, a serotonin receptor antagonist, on the incidence of spinal anesthesia-induced shivering, hypotension, nausea, vomiting and other possible complications in elective caesarean sections. This study conducted in Palestine, West Bank, Nablus city in the caesarean section operation rooms, and post-anesthesia care unit at Rafidia governmental hospital. Eighty full-term elective caesarean section parturient (Age 18-50 years) with ASA 1 or 2 classification were recruited and randomly allocated into two groups: prophylactic IV ondansetron treatment group and placebo 0.9% saline control group. The primary outcomes were the incidence of spinal anesthesia-induced shivering and hypotension, while secondary outcomes were perioperative bradycardia, nausea, vomiting, headache, pain, pruritus, dizziness and respiratory depression and parturient satisfaction. Results: Incidence of intraoperative hypotension and dizziness in the ondansetron group was significantly lower than which occurred in the control group (22.5% vs. 62.5% respectively; P < 0.001), the incidences and intensity of intraoperative shivering in the ondansetron group was lower than the control group (12.5 % vs. 32.5 % respectively; P = 0.032), Intraoperative nausea intensity in the ondansetron group was lower than control group (P = 0.049). Postoperatively, the incidence of postoperative dizziness in the ondansetron group was lower than the control group (5% vs. 37.5 % respectively; P = 0.001), the incidence and intensity of postoperative shivering in the ondansetron group was lower than the control group (12.5% vs. 37.5 % respectively; P = 0.01). Incidence and intensity of postoperative nausea in the ondansetron group was lower than the control group (17.5% vs. 40 % respectively; P = 0.026), the incidence of postoperative vomiting in the ondansetron group was lower than the control group (25.5% vs. 2.5 % respectively; P = 0.014).Conclusion: Prophylactic 4 mg IV ondansetron can significantly attenuate the incidences of spinal anesthesia-induced shivering and hypotension, dizziness, nausea, and vomiting occurrence and increase parturient satisfaction scale for parturient who undergo caesarean section.","PeriodicalId":74336,"journal":{"name":"Obstetrics and gynecology research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41569400","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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