Current Issue : July - September Volume : 2016 Issue Number : 3 Articles : 5 Articles
Introduction. In Sub-Saharan Africa, excessive foetal head moulding is commonly associated with cephalopelvic disproportion and\nobstructed labour.This study set out to determine the associations of maternal pelvis height and maternal height with intrapartum\nfoetal head moulding. Methods. This was a multisite secondary analysis of maternal birth records of mothers with singleton\npregnancies ending in a spontaneous vertex delivery. A summary of the details of the pregnancy and delivery records were reviewed\nand analysed using multilevel logistic regression respect to foetal head moulding. The alpha level was set at ...
Introduction.D-dimer levels increase throughout pregnancy, hampering the usefulness of the conventional threshold for dismissing\nthromboembolism. This study investigates the biological fluctuation of D-dimer in normal pregnancy. Methods. A total of 801\nhealthy women with expected normal pregnancies were recruited. D-dimer was repeatedly measured during pregnancy, at active\nlabor, and on the first and second postpartum days. Percentiles for each gestational week were calculated. Each individual D-dimer\nwas normalized by transformation into percentiles for the relevant gestational age or delivery group. Therange in percentage points\nduring the pregnancy and the delivery was calculated, and reference intervals were calculated for each pregnancy trimester, during\nvaginal delivery and scheduled and emergency cesarean section, and for the first and second day postpartum. Results. D-dimer\nincreased during pregnancy; the maximal fluctuation was approximately 20 percentile points in approximately half of the women.\nIn one out of ten women, the D-dimer values fluctuated by more than 50 percentile points. Conclusions. Due to the biological\nvariation in D-dimer within each individual woman during normal pregnancy, repeated D-dimer measurements are of no clinical\nuse in the evaluation of thromboembolic events during pregnancy....
To retrospectively evaluate the causes, the management and neonatal outcome in pregnancies complicated with late antepartum hemorrhage (APH), defined as vaginal bleeding during the third trimester of pregnancy. Methods: We retrospectively identified all eligible patients at a single institution from January 1990 to December 2012. A thorough research was made through patients� medical and obstetrical records. The various causes of late APH were compared to each other regarding the parameters of the neonatal outcome. Multiple regression models were applied for gestational age (GA) at birth, birth weight, Apgar score at first and fifth minute and selection of modus of delivery. Results: 480 patients were included in the study, in a total of 7221 pregnancies. The causes of APH were: cervical dilatation (n = 54, 11.3%), central placental abruption (n = 57, 11.9%), peripheral placental abruption (n = 59, 12.3%), placenta previa (n = 140, 29.2%), others non-related to pregnancy (n = 42, 8.8%), uterine rupture (n = 2, 0.4%) and unknown etiology (n = 126, 26.3%). Overall, 253 neonates (52.7%) were born prematurely at gestational age below 37th week. 37 pregnancies (7.7%) resulted in giving birth prior to 32 weeks of gestation. In multivariable analysis, the cause of hemorrhage was found to be an important independent predictive factor for gestational age (GA) at birth, birth weight, Apgar scores at first and fifth minute and modus of delivery. Preeclampsia, diabetes, thyroid disorder and smoking were associated with decrease of GA at birth. Birth weight below 1500 gr and GA at birth was found to be significant independent factors for Apgar score at first and fifth minute respectively. Modus of delivery did not significantly alter Apgar score. Conclusions: Late APH required immediate evaluation of the general condition of the pregnant woman and the fetus. The cause of APH was important in the prognosis of the neonatal outcome. As long as maternal and fetal status were ensured, expectant management, instead of emergency CS, seemed to be more beneficial even for late preterm neonates....
Although ovarian mature cystic teratomas are the commonest adnexal masses occurring in premenopausal women, there are many\nchallenges faced by gynecologists on deciding upon the best surgical management. There is uncertainty, lack of consensus, and\nvariation in surgical practices. This paper critically analyzes various surgical approaches and techniques used to treat these cysts\nin an attempt to outline a unified guidance. MEDLINE and EMBASE databases were searched in January 2015 with no date limit\nusing the key words ââ?¬Å?ovarian teratomaââ?¬Â and ââ?¬Å?ovarian dermoid.ââ?¬Â The search was limited to articles in English language, humans,\nand female. The two authors conducted the search independently. The laparoscopic approach is generally considered to be the gold\nstandard for the management. Oophorectomy should be the standard operation except in younger women with a single small cyst.\nThe risk of chemical peritonitis after contents spillage is extremely rare and can certainly be overcome with thorough peritoneal\nlavage using warmed fluid.There is a place for surveillance in some selected cases....
Infertility of tubal origin is the most frequent in sub-Saharan area. It is due to tuboperitoneal lesions\nmainly because of infection; especially sexually transmitted infection. Worldwide, Chlamydia\ntrachomatis is the main pathogen. In our setting, some studies failed to establish the link between\ntubal infertility and chlamydia trachomatis. The current study aimed to determine the local\ndata related to chlamydia trachomatis role in tubal infertility and the usefulness of Chlamydia\ntrachomatis antibody titer test (CAT) in discrimination of the patients with and without tuboperitoneal\nlesions. Patientsâ�� average age was 33.9 �± 4.8 years, average coitarche 19.4 �± 4.4 years and\naverage number of partners: 3.1 �± 1.6. The level of CAT is correlated to the tuboperitoneal severity.\nCAT was more specific (93.3%; CI 95%: 81.7 - 98.6) than sensitive (72.7% CI 95%: 49.8 - 89.3) and\ndiscriminated correctly 89% (AUC = 0.89) of the patients with or without tuboperitoneal lesions.\nIn conclusion, as it is stated worldwide, Chlamydia trachomatis is the most frequent sexually\ntransmitted pathogen associated with tubal infertility. CAT has to be used as a tool to select patients\nto be submitted to invasive investigation, like laparoscopy....
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