Current Issue : April - June Volume : 2020 Issue Number : 2 Articles : 5 Articles
Context: Polycystic ovary syndrome (PCOS) is considered a syndrome related\nto the metabolic syndrome with a high risk for developing diabetes mellitus.\nThe evaluation of the glycated hemoglobin (HbA1c) seems to be an interesting\ntool to detect states of hyperglycemia that may be associated with this\nsyndrome and to understand her pathophysiology. Aims: The purposes of\nthis study are to determine the profile of HbA1c in Congolese women with\nPCOS, to determine the frequency of states of hyperglycemia and to assess the\nimpact of this marker on clinical signs on this syndrome. Material and methods:\nThis is a case-control study of 130 Congolese subfertile women; 65\nwith a diagnosis of PCOS and 65 others without PCOS. This is conducted\nfrom June 2016 to June 2019 among Congolese women of childbearing age.\nAll these women were recruited at the subfertility outpatient clinic of the\nUniversity Hospital of UNIKIN as well of the YANGA medical centers in\nKinshasa, Democratic Republic of Congo. Sickle cell disease was excluded as\nalso the cases of anemia. HbA1c was assayed via the immunoturbidimetric\nmethod and the results interpreted according to the ADA recommendations\nwith a pathological cut-off point greater than equal to 6.5%. Results: Mean hemoglobin was 11.6 Â}\n1.2 g/dl (11.5 Â} 1.1 g/dl vs. 11.8 Â} 1.4 g/dl, P = 0.568). The proportion of diabetics\nwas 1.6% (1.6% vs. 1.5%, P = 0.74). Higher HbA1c values were noted\nin the PCOS group compared to the control group (7.3% Â} 2.1% vs. 5.6% Â}\n0.6%, P < 0.001). The multivariate analysis showed a strong correlation between\nelevated HbA1c levels and PCOS (OR 14.79 (CI 5.43 - 40.32), P <\n0.001). In the PCOS group, higher HbA1c values were significantly correlated\nwith a higher socio-economic status (OR 3.38 (1.67 - 8.47), P = 0.018) and\nwith obesity (OR 3.48 IC (1.31 - 7.13) P = 0.029). A perfect, positive and significant\nlinear correlation was found between HbA1c and fasting blood glucose\n(r = 0.807). 60% of women in the PCOS group had pathological values of\nHbA1c (greater than equal to 6.5%) compared to 7.7% in the control group (P < 0.001). Oligomenorrhea\nwas found more significantly in patients with pathological HbA1c\nvalues (greater than equal to 6.5%) compared to those with values < 6.5% (P = 0.003). Conclusion:\nThis study found that in our population 60% of women with PCOS had\nstates of hyperglycemia, demanding systematic screening of glucose metabolism\ndisorders in women with this syndrome....
Interstitial ectopic pregnancies are very rare, however, they are extremely\ndangerous. Treatment consists of either surgical or medical management.\nThis patient presented with no prior pregnancies, an inappropriately rising\nb-hCG, and eventually had ultrasound findings consistent with interstitial\nectopic pregnancy. She was seen through the Emergency Department and had\nno insurance. She strongly desired to avoid surgery, and was successfully\ngiven a multi-dose regimen of methotrexate. Contraindication to methotrexate\nmanagement includes an inability to follow-up, so a close therapeutic alliance\nwas maintained to enable safe resolution of this case. She has since\nsuccessfully carried an uncomplicated intrauterine pregnancy to term....
Background: The consumption of dietary supplements (DS) has increased by\nalmost 10% last decade. This trend may be true also for pregnant women;\nhowever, it was reported that pregnant women do not sufficient and correct\nknowledge on nutritional needs during pregnancy. Thus, we here attempted\nto determine the French situation of how French pregnant women take DS\nand its social-clinical significance using questionnaires, with special reference\nto vitamin D (VD) overtaking. Materials and Methods: A prospective multi-\ncentric study was performed in three maternities in Paris. One hundred-fifty\nquestionnaires were administered to pregnant women by midwife. Results:\nThirty-four patients were interviewed at the maternity ward of the Deaconesses,\n61 at the Pitie-Salpetriere and 55 at Armand Trousseau. During pregnancy,\nDS started mainly during the first trimester. Frequently, doctors initially\nprescribe them and women tended to continue to take them thereafter.\nPossible VD overdosage was observed. Conclusion: We here characterized\nFrench pregnant women in terms of DS during pregnancy and also, to our\nknowledge, for the first time emphasized the risk of vitamin D overdose during\npregnancy in France. However, since the cumulative dose throughout the\npregnancy was not determined here, definite conclusion of whether women really\ntake overdose of this supplement may not be made. Women of higher socio-\nprofessional society tended to consume more DS during pregnancy, and,\nthus, further monitoring may be needed especially to this fraction of pregnant\nwomen....
Perineal trauma is a non-surgical solution of continuity of posterior perineal\ncommitting under the effect of a violent exertion during childbirth. It occurs\nat the time of disengagement, either from the head or the posterior shoulder.\nObjectives: To calculate the perinea trauma during childbirth, describe the\nsocio demographic profile of the women in childbed, identify contributory\neffects and appreciate the maternal prognostic. Methodology: It was a prospective\nstudy, descriptive type of 6 months (from May 19 to November 20,\n2014). It took place at the maternity ward of Donka National Hospital. It\nconcerned all received parturient, women in bed of a single fetus in the unit\nand having had a perineum traumatism. The real ones were epidemiologic,\ntherapeutic clinical and prognostic. Results: We have recorded 110 perinea\ntraumatism cases over 3496 childbirth let say a frequency of 3%. The socio\ndemographic profile of the woman who did perinea traumatism was a teenager\n(42.7%), professional occupation (29.1%), married (88.2%), schooled,\nsecondary and Technical level (42.7%), primary (70%) having had more than\n3 prenatal consultations (73.6%). Contributory effects were: prim parity,\nyoung age, instrumental extraction by obstetrical forceps and the fetal weight\nbetween 2500 to 3999 g. Surgical management was (100%). The following\nwere simple in 88.2% cases versus 11. 8% of complications. Conclusion: The\nreduction of this frequency requests systematical practice and corrects recentered\nprenatal consultations and the respect of episiotomy indications....
Premature rupture of membranes (PROM) complicates 3% of preterm pregnancies\nand occurs in 60% to 80% of term pregnancies. However, its management\nremains largely controversial. The objective of this study was to establish\nthe epidemiological profile, to study the management and the prognosis\nof Premature rupture of membranes (PROM) in our practice. Patients\nand methods: It was a prospective, descriptive and analytical study from May\n1st 2016 to January 31st 2017 at the Pikine National Hospital Center. The\ntarget population consisted of all patients received at the hospital with premature\nrupture of membranes and who had given birth in the structure. The\nvariables studied were: marital status, mode and reason for admission; risk\nfactors; antecedents; prenatal care; the clinical and paraclinical examinations;\nsupport and immediate maternal and fetal neonatal complications. Results\nand comments: The mean maternal age was 27.34 years and the majority of\nwomen were aged between 18 and 39 years (94.4%). Fifty-one point three\npercent of patients were primiparous, large multiparous represented only\n2.5%. The majority of patients (385 patients or 66.9%) had consulted in the\nfirst 12 hours following the onset of fluid flow. For 20.1% of them this flow\nwas associated with uterine contractions. Hidden risk factors were dominated\nby the twin pregnancy. The blood count showed that 38.8% of patients had\nleukocytosis and CRP was positive in 18.3% of patients. An ampicillin-based\nantibiotics was established in 42.6% of cases, corticosteroid therapy in 5.2%\nand 1% in tocolysis. An expectation was adopted in 65.7% of cases, induction\nof labor in 7.3% and a cesarean section immediately in 27% of cases. In total,\n65.7% of patients had vaginal delivery and 34.3% cesarean. The perinatal\nmortality rate was 3.6% or 22 newborns on 610. Two cases of endometritis\nwere observed and one case of immediate postpartum hemorrhage. No\nmaternal deaths were recorded. Conclusion: These results show that the\nprognosis of premature rupture of membranes remains favorable in our\npractice. To improve this prognosis, we recommend sensitization of patients\nduring prenatal care regarding signs of danger, a systematic bacteriological\nsample from all pregnant at the end of their pregnancy and the health\npersonnel to direct patientsâ?? references to structures in case of PROM....
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