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Early Diagnosis and Treatment of Vesicouterine Fistula Using Low-Tech Methods in Low Resource Setting of Northern Ghana. A Case Report 加纳北部低资源环境下膀胱外瘘的早期诊断和低技术方法治疗。病例报告
Pub Date : 2021-09-24 DOI: 10.33140/jgrm.05.02.15
Vesicouterine fistula is a rare but increasing phenomenon in obstetric practice. Early diagnosis and treatment will go a long way to reduce the associated morbidity as well as improve the quality of life of its victims. Our case exemplifies how the use of simple techniques can diagnose and bring great relief to such patients.
膀胱外瘘是产科实践中罕见但日益增加的现象。早期诊断和治疗将大大有助于减少相关的发病率,并改善其受害者的生活质量。我们的病例说明了如何使用简单的技术来诊断并给这类患者带来极大的缓解。
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引用次数: 0
Need for Intrapartum Antibiotic Prophylaxis in Women with Prior History of Group B Streptococcus Carriage 有B群链球菌携带史的妇女产时预防抗生素的必要性
Pub Date : 2021-09-24 DOI: 10.33140/jgrm.05.02.14
The incidence of early onset neonatal GBS(EOGBS) disease in the UK and Ireland is 0.57/1000 births. Intrapartum antibiotic prophylaxis (IAP) reduces the risk. Previous colonisation is associated with 50% carriage in the current pregnancy. In these women, RCOG recommends IAP with a history of neonatal infection, otherwise offering the option of screening at 35-37 weeks. In Ireland, there is no national consensus on IAP in prior GBS colonisation. Currently at University Hospital Waterford (UHW), all women with prior GBS colonisation receive IAP. Studies examining the use of point-of-care testing have shown reduction in the use of IAP and EOGBS rates. We aimed to examine the screening and IAP administration in maternal prior GBS colonisation and the incidence of GBS in this cohort in UHW. Data was collected retrospectively from laboratory, medical records and electronic patient manager systems. Women who received IAP between 1stJuly 2020 and 31stDecember 2020 were identified. Women who received IAP for current and prior GBS colonisation were included. Women who received IAP for preterm labour, preterm prelabour rupture of membranes and pyrexia in labour were excluded. Ninety-two women with current or prior GBS colonisation received IAP, of which only 15(16.30%) were current and 77(83.69%) were prior GBS colonisation. In women with prior GBS colonisation, 49(63.63%) were screened, 3/49(6.12%) were positive, 28 were not screened. Seventy-eight (84.78%) received benzyl-penicillin. Six (6.52%) received clindamycin. Twenty-two (23.91%) babies were admitted to the Neonatal Unit, however, only one cultured positive for gram-positive cocci. The incidence of EOGBS in this cohort is low. A risk-based approach or point-of-care testing should be considered to reduce unnecessary IAP administration.
早发新生儿GBS(EOGBS)疾病在英国和爱尔兰的发病率为0.57/1000个新生儿。产时抗生素预防(IAP)可降低风险。先前的殖民化与当前妊娠中50%的产率有关。在这些妇女中,RCOG建议在有新生儿感染史的情况下进行IAP,否则可在35-37周进行筛查。在爱尔兰,在以前的GBS殖民中,IAP没有全国共识。目前在沃特福德大学医院(UHW),所有既往有GBS定植的妇女都接受IAP。检查即时检测使用情况的研究表明,IAP和EOGBS的使用率有所降低。我们的目的是检查筛查和IAP给药在母体之前的GBS定植和GBS在UHW队列中的发病率。回顾性地从实验室、医疗记录和电子患者管理系统收集数据。确定了在2020年7月1日至2020年12月31日期间接受IAP的女性。纳入了目前和以前接受过IAP的GBS定殖的妇女。因早产、早产前胎膜破裂和分娩时发热而接受IAP的妇女被排除在外。92名目前或既往有GBS定植的妇女接受了IAP,其中只有15名(16.30%)是目前的,77名(83.69%)是既往的GBS定植。在既往有GBS定植的女性中,49例(63.63%)筛查,3/49(6.12%)阳性,28例未筛查。78例(84.78%)接受苄青霉素治疗。6例(6.52%)接受克林霉素治疗。22例(23.91%)新生儿入住新生儿科,但仅有1例革兰氏阳性球菌培养阳性。EOGBS在该队列中的发病率较低。应考虑采用基于风险的方法或即时检测,以减少不必要的IAP管理。
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引用次数: 0
Prevalence, Risk Factors and Management of Hypertensive Disorders of Pregnancy Among Pregnant Women in University of Benin Teaching Hospital, Benin City, Nigeria 尼日利亚贝宁市贝宁大学教学医院孕妇妊娠期高血压疾病的患病率、危险因素及管理
Pub Date : 2021-07-29 DOI: 10.33140/jgrm.05.02.12
Background: This facility-based retrospective cross sectional design study examined the prevalence, risk factors and management of hypertensive disorders of pregnancy among pregnant women attending antenatal clinic in the University of Benin Teaching Hospital, Benin City Materials and Methods: A stratified proportionate sampling technique were adopted to review a total of 358 secondary data of patients who were managed for hypertensive disorders of pregnancy from June 2015 – June 2020 in the study institution. Data were analyzed using descriptive statistics, multinomial regression analysis at 0.05 the level of significance for all measured variables. Results: The mean ± SD = 31.15 ± 5.954 years. More than half 60.3% of them were multigravida. 60.1% were in second trimester. Mean BP at booking was 146/95 mmHg. 56.1% were overweight while 17.6% were obese. The mean ± SD ANC visits was 10.71 ± 5.411 times. The five-year prevalence rate of hypertensive disorders of pregnancy among pregnant women in the study setting is 10.9%. Conclusion: There is high prevalence of HDP in the study institution with preeclampsia most prevalent. Therefore, we strongly recommend the utilization of screening tools for the prediction, early diagnoses as well as timely intervention HDP
背景:本研究是一项基于医院的回顾性横断面设计研究,旨在调查在贝宁市贝宁大学教学医院产前门诊就诊的孕妇妊娠期高血压疾病的患病率、危险因素和管理情况。采用分层比例抽样技术,对2015年6月- 2020年6月在该院接受妊娠期高血压疾病管理的358例患者的二级资料进行回顾性分析。数据分析采用描述性统计,多项回归分析,所有测量变量的显著性水平为0.05。结果:平均±SD = 31.15±5.954年。其中超过一半(60.3%)为多胎妊娠。60.1%为妊娠中期。预约时的平均血压为146/95 mmHg。56.1%的人超重,17.6%的人肥胖。平均±SD ANC访问次数为10.71±5.411次。研究中孕妇妊娠期高血压疾病的5年患病率为10.9%。结论:本研究机构HDP患病率较高,以子痫前期患病率最高。因此,我们强烈建议使用筛查工具来预测、早期诊断和及时干预HDP
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引用次数: 0
Management of PPH (Placental Site Bleeding) by a Direct Haemostatic Suture in True PPH during Caesarean section: A New Approach 直接止血缝线治疗剖宫产术中PPH(胎盘部位出血):一种新方法
Pub Date : 2021-07-10 DOI: 10.33140/jgrm.05.02.04
This study includes 20 cases of PPH seen during Caesarean section by a single surgeon Dr. Sadhna Mathur during the last 11 years where this hemostatic suture was used to control PPH from placental site in uterine cavity, after the medical measures failed to control the bleeding from placental site (uterine cavity). The bleeding point was localized and a haemostatic suture in the overlying uterine musculature was applied. It was found to be completely effective hence it is being shared through this paper
本研究包括在过去11年中由Sadhna Mathur医生在剖宫产术中发现的20例PPH,在医学措施未能控制胎盘部位(子宫腔)出血后,使用止血缝合来控制子宫腔胎盘部位的PPH。将出血点定位,并在上覆子宫肌肉组织处进行止血缝合。它被发现是完全有效的,因此它是通过这篇论文分享
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引用次数: 0
Barriers to Respectful Maternity Care from Mother’s, Provider’s and Administrator’s Perspective: An Exploratory Qualitative Study 从母亲、提供者和管理者的角度来看,恭敬的产妇护理的障碍:一项探索性质的研究
Pub Date : 2021-07-10 DOI: 10.33140/jgrm.05.02.07
Respectful maternity care (RMC) is an approach to care based on personal choice and preferences, which supports and promotes, and doesn’t undermine a person’s self-respect [1]. During the past three decades, maternal mortality has decreased nearly by half but is still alarmingly high, particularly in sub-Saharan African countries. More than half of maternal mortality is associated with poor quality of care, and most maternal mortality is preventable if timely quality maternity care is delivered and evidence-based action is taken [2-4]. Responding to this, the 2030 Sustainable Development Goals include reducing the maternal mortality rate below 77 per 100,000 live births and eliminating all forms of violence against women, particularly during labor and delivery [5]. The mistreatment of women during institutional delivery could be an obstacle to these ambitious goals, especially in a low-income country like Ethiopia[6].
尊重母婴护理(RMC)是一种基于个人选择和偏好的护理方式,它支持和促进而不是损害一个人的自尊[1]。在过去三十年中,孕产妇死亡率下降了近一半,但仍然高得惊人,特别是在撒哈拉以南非洲国家。一半以上的孕产妇死亡与护理质量差有关,如果及时提供高质量的孕产妇护理并采取循证行动,大多数孕产妇死亡是可以预防的[2-4]。为此,《2030年可持续发展目标》包括将孕产妇死亡率降至每10万例活产77例以下,并消除一切形式的暴力侵害妇女行为,特别是在分娩和分娩期间[5]。在机构分娩过程中对妇女的虐待可能是实现这些雄心勃勃的目标的障碍,特别是在像埃塞俄比亚这样的低收入国家[6]。
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引用次数: 2
Maternal Continuum of Care as Independent Determinants for Timely Initiation of Modern Contraceptive Methods Utilization Among Postnatal Women in Arba Minch Zuria District, Southern Ethiopia 在埃塞俄比亚南部Arba Minch Zuria地区,产妇连续护理作为产后妇女及时开始使用现代避孕方法的独立决定因素
Pub Date : 2021-07-05 DOI: 10.33140/jgrm.05.02.02
D. Haile
Background: Initiation of family planning use during the postpartum period is crucial for both maternal and child health. Moreover, this period is the extension of maternal health care and its level of uptake is built up on the level of continuum of care of maternal health care utilization. Continuum of maternal health care including, antenatal care, skilled delivery and postnatal care is crucial for women’s reproductive health. Despite that, there was no data regarding with the importance of continuum of care of maternal health care on the postpartum modern contraceptive utilization. Thus, the aim of this study was to assess the association of the continuum of maternal care on subsequent timely use of postpartum family planning. Methods: a community based cross sectional study was employed on 828 women. A multistage sampling technique was used to enroll the study participants. The data were collected by a semi-structured and pretested, face-toface, interviewer administered questionnaire. Data were entered into EpiData 3.1 and analyzed by using SPSS 23 software. Bivariate and multivariable logistic regression analyses were used to declare the association between dependent and independent variables. Odds ratio, its 95% confidence interval (CI) and P-value <0.05 were used to determine the significance level. Results: the prevalence of timely initiation of postpartum contraceptive methods was 16.1%. Having of postpartum care (AOR: 2.0(95%CI: 1.2, 3.2)), completion of delivery level continuum of care (AOR: 2.9(95%CI: 1.4, 6.1)), and completion of postnatal level continuum of care (AOR: 4.0(95%CI: 2.0, 7.8)) were factors of timely intuition of postpartum contraceptive methods. Conclusion and recommendation: The prevalence of timely initiation of postpartum contraceptive methods was low. The finding of this study implies that the need of strengthening the connection between maternal continuum of care and reproductive components of continuum of care.
背景:产后实施计划生育对母婴健康都至关重要。此外,这一时期是产妇保健的延伸,其吸收水平取决于产妇保健利用的连续护理水平。连续的孕产妇保健,包括产前保健、熟练接生和产后护理,对妇女的生殖健康至关重要。尽管如此,没有关于产妇保健连续护理对产后现代避孕药具使用的重要性的数据。因此,本研究的目的是评估连续的产妇护理与随后及时使用产后计划生育的关系。方法:采用基于社区的横断面研究对828名妇女进行调查。采用多阶段抽样技术对研究参与者进行登记。数据是通过半结构化和预先测试,面对面,采访者管理问卷收集的。数据录入EpiData 3.1,采用SPSS 23软件进行分析。使用双变量和多变量逻辑回归分析来声明因变量和自变量之间的关联。采用优势比、95%置信区间(CI)和p值<0.05确定显著性水平。结果:及时启动产后避孕措施的患病率为16.1%。是否有产后护理(AOR: 2.0(95%CI: 1.2, 3.2))、完成分娩水平连续护理(AOR: 2.9(95%CI: 1.4, 6.1))和完成产后水平连续护理(AOR: 4.0(95%CI: 2.0, 7.8))是影响产后避孕方法及时直觉的因素。结论与建议:产后及时采取避孕措施的比例较低。这项研究的发现意味着需要加强产妇连续护理和连续护理的生殖组成部分之间的联系。
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引用次数: 0
Pregnancy on a Rudimentary Unbroken Horn of a Pseudo-Unicornuate Uterus: A Case Report at The University Hospital of Angre Abidjan 假独角子宫未破裂角的初步妊娠:阿比让大学医院一例报告
Pub Date : 2021-07-05 DOI: 10.33140/jgrm.05.02.03
The pseudo-unicornuate uterus which is a rare uterine malformation, that can be the site of a pregnancy. Pregnancies in the rudimentary horn usually result in a rupture due to a uterine wall not adapted to the level of the horn, but especially diagnostic difficulties. Their discovery is most often made in intraoperative, when an indication of laparotomy is made for hemoperitoneum in emergency. They are therefore responsible for high maternal-fetal mortality and morbidity. We report in this observation a case of pregnancy in a rudimentary unruptured horn, in a 28-year-old, 4th gesture 2nd parous, the discovery of which was made incidentally, during an indication of laparotomy posed for suspected abdominal pregnancy complicated by a surgical abdomen.
伪独角子宫是一种罕见的子宫畸形,可能是怀孕的部位。由于子宫壁不适应子宫角的水平,在初生角妊娠通常导致破裂,但特别难以诊断。它们通常是在术中发现的,当紧急情况下腹腔积血需要开腹手术的指征时。因此,它们是造成母婴死亡率和发病率高的原因。我们报告一例未破裂角妊娠,28岁,第4位,第2次分娩,这是偶然发现的,在剖腹指征期间,因怀疑腹部妊娠合并手术腹部。
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引用次数: 0
Acute Fatty Liver of Pregnancy Presenting as Fulminant Hepatic Failure: An Uncommon Disease 妊娠期急性脂肪肝表现为暴发性肝衰竭:一种罕见的疾病
Pub Date : 2021-07-05 DOI: 10.33140/jgrm.05.02.06
Acute Fatty Liver of Pregnancy (AFLP), though rare, is an obstetric emergency which carries a high incidence of maternal and perinatal mortality, despite optimal care. It is a catastrophic disease affecting women in the third trimester of pregnancy or in the post-partum period. It is usually a diagnosis of exclusion and requires a strong index of suspicion for a timely diagnosis and prompt intervention. We report a case of 24-year-old prime at 34- week gestation, presented with malaise, nausea, vomiting, jaundice, disorientation and absent fetal movements. Intrauterine death of fetus occurred. Supportive management in an intensive care unit resulted in successful outcome. By this case report we once again wish to emphasize the value of a timely diagnosis with a high level of clinical suspicion and supportive laboratory investigations including imaging; the need for early termination of pregnancy; and adequate supportive care as the key management options for AFLP. Further, we wish to explore the current treatment options available for AFLP and discuss a few novel therapeutic strategies such as plasma exchange in treating such cases and the pros and cons associated with these treatment modalities.
急性妊娠脂肪肝(AFLP)虽然罕见,但它是一种产科急诊,尽管得到了最佳护理,但孕产妇和围产期死亡率很高。这是一种影响妊娠晚期或产后妇女的灾难性疾病。它通常是一种排除性诊断,需要强烈的怀疑指数才能及时诊断和迅速干预。我们报告一例24岁的孕妇在妊娠34周时,表现为不适、恶心、呕吐、黄疸、定向障碍和胎动缺失。发生胎儿宫内死亡。在重症监护室的支持性管理取得了成功的结果。通过本病例报告,我们再次希望强调及时诊断的价值,具有高度的临床怀疑和支持性实验室调查,包括影像学检查;早期终止妊娠的必要性;以及适当的支持性护理作为AFLP的关键管理选择。此外,我们希望探讨目前可用于AFLP的治疗方案,并讨论一些新的治疗策略,如血浆置换治疗此类病例,以及与这些治疗方式相关的利弊。
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引用次数: 0
Ectopic Pregnancy - Is It Always a Threat to A Woman’s Life? 宫外孕——是否总是对女性的生命构成威胁?
Pub Date : 2021-07-05 DOI: 10.33140/jgrm.05.02.05
Ectopic pregnancy is a condition in which the fertilized ovum implants outside the uterus or attaches to an abnormal portion of the uterus, like cervix, cornea, myometrium. Such state occurs in 2% of all reported pregnancies. There are plenty of risk factors for this state. Fallopian tube surgery in the past, pelvic inflammatory disease is one of them. Undiagnosed ectopic pregnancy may lead to serious complications, like rupturing of the fallopian tube and massive internal bleeding. We would like to present a case, in which the patient was not aware of being pregnant, until she got the histopathology results after laparoscopic surgery because of tumor in the rectouterine pouch.
异位妊娠是指受精卵植入子宫外或附着在子宫的异常部位,如子宫颈、角膜、子宫肌层。这种情况在所有报告的怀孕中占2%。这种状态有很多风险因素。在过去的输卵管手术中,盆腔炎就是其中之一。未确诊的异位妊娠可能导致严重的并发症,如输卵管破裂和大量内出血。我们想提出一个病例,患者不知道怀孕,直到她得到组织病理结果后腹腔镜手术,因为肿瘤在直肠子宫袋。
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引用次数: 0
Ginsenoside Rg3 Inhibit The Proliferation And Metastasis of Cervical Cancer Cells in Vitro By Regulating NF-κB Signaling Pathway 人参皂苷Rg3通过调节NF-κB信号通路抑制体外宫颈癌细胞增殖和转移
Pub Date : 2021-07-05 DOI: 10.33140/jgrm.05.02.01
Objective: To investigate the effect and mechanism of ginsenoside Rg3 on the proliferation and metastasis of cervical. Methods: Cervical cancer cells HeLa were treated with different concentrations (0, 0.12, 0.24, 0.48 mmol/L) of ginsenoside Rg3, and then the survival rate of HeLa cells was detected by CCK-8 method, and the migration and invasion of HeLa cells were assessed using Transwell test, and expression of E-cadherin, N-cadherin, vimentin, Toll receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), phosphorylated nuclear transcription factor κB p65 (P-NF-κB p65) proteins were calculated by Western blot. Results: After ginsenoside Rg3 (0.12, 0.24, 0.48 mmol/L) treatment, the survival rate, migration number, invasion number, and N-cadherer number, and N-cadherin, Vimentin, TLR4, MyD88, p-NF-κB p65 protein expression of HeLa cells were significantly reduced (P<0.05) Ginsenoside protein expression was significantly increased (P<0.05), and showed a concentration-dependent relationship. Conclusion: Ginsenoside Rg3 could inhibit the proliferation and metastasis of cervical cancer cells in vitro, and its mechanism might be related to the inhibition of NF-κB signaling pathway.
目的:探讨人参皂苷Rg3对宫颈细胞增殖转移的影响及其机制。方法:采用不同浓度(0、0.12、0.24、0.48 mmol/L)人参皂苷Rg3处理宫颈癌HeLa细胞,CCK-8法检测HeLa细胞存活率,Transwell法检测HeLa细胞的迁移和侵袭能力,Western blot法检测E-cadherin、N-cadherin、vimentin、Toll受体4 (TLR4)、髓样分化因子88 (MyD88)、磷酸化核转录因子κB p65 (P-NF-κB p65)蛋白的表达。结果:人参皂苷Rg3(0.12、0.24、0.48 mmol/L)处理后,HeLa细胞的存活率、迁移数、侵袭数、N-cadherer数以及N-cadherin、Vimentin、TLR4、MyD88、P - nf -κB p65蛋白表达均显著降低(P<0.05),人参皂苷蛋白表达显著升高(P<0.05),且呈浓度依赖关系。结论:人参皂苷Rg3具有体外抑制宫颈癌细胞增殖和转移的作用,其机制可能与抑制NF-κB信号通路有关。
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引用次数: 0
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Journal of gynecology, clinical obstetrics and reproductive medicine
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