Symptomatic and Asymptomatic Isthmocele: Impact on Reproductive Outcomes

Author(s):  
Laura Detti
2020 ◽  
Author(s):  
R Zupan ◽  
M Meuli ◽  
U Möhrlen ◽  
L Mazzone ◽  
F Krähenmann ◽  
...  

2019 ◽  
Vol 112 (3) ◽  
pp. e154-e155
Author(s):  
Alyson M. Digby ◽  
Lesley Roberts ◽  
Mary M. Brown ◽  
Megan Dufton ◽  
Renda Bouzayen

Microbiome ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Alexander Munoz ◽  
Matthew R. Hayward ◽  
Seth M. Bloom ◽  
Muntsa Rocafort ◽  
Sinaye Ngcapu ◽  
...  

Abstract Background Cervicovaginal bacterial communities composed of diverse anaerobes with low Lactobacillus abundance are associated with poor reproductive outcomes such as preterm birth, infertility, cervicitis, and risk of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Women in sub-Saharan Africa have a higher prevalence of these high-risk bacterial communities when compared to Western populations. However, the transition of cervicovaginal communities between high- and low-risk community states over time is not well described in African populations. Results We profiled the bacterial composition of 316 cervicovaginal swabs collected at 3-month intervals from 88 healthy young Black South African women with a median follow-up of 9 months per participant and developed a Markov-based model of transition dynamics that accurately predicted bacterial composition within a broader cross-sectional cohort. We found that Lactobacillus iners-dominant, but not Lactobacillus crispatus-dominant, communities have a high probability of transitioning to high-risk states. Simulating clinical interventions by manipulating the underlying transition probabilities, our model predicts that the population prevalence of low-risk microbial communities could most effectively be increased by manipulating the movement between L. iners- and L. crispatus-dominant communities. Conclusions The Markov model we present here indicates that L. iners-dominant communities have a high probability of transitioning to higher-risk states. We additionally identify transitions to target to increase the prevalence of L. crispatus-dominant communities. These findings may help guide future intervention strategies targeted at reducing bacteria-associated adverse reproductive outcomes among women living in sub-Saharan Africa.


Author(s):  
Rodrigo L.O.R. Alves ◽  
Mateus A. Silva ◽  
Carlos E.C. Consentini ◽  
Lucas O. e Silva ◽  
Natália P. Folchini ◽  
...  

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 779
Author(s):  
Kate J. Flay ◽  
Anne L. Ridler ◽  
Chris W. R. Compton ◽  
Paul R. Kenyon

Ewe wastage is the combination of on-farm mortality and premature culling. Internationally, there is limited research on actual wastage incidence and causes in commercial sheep flocks. To the authors’ knowledge, this is the first study that reports both lifetime wastage and detailed annual wastage in a sample of commercial New Zealand flocks. This study utilized data collected from 13,142 ewes from four cohorts on three commercial New Zealand farms (Farm A 2010-born, Farm A 2011-born, Farm B, Farm C), during the period 2011–2017, as they aged from replacement hoggets to 6-year-old ewes (Farm A and Farm B) or 3-year-old ewes (Farm C). Data collection visits occurred at three or four key management times each year, namely pre-mating, pregnancy diagnosis, pre-lambing and weaning. At each visit, body condition score (BCS) was assessed and any ewes that were culled or had died on farm were recorded. As this was a lifetime study, each ewe was assigned an outcome and corresponding ‘exit age’. By the end of the study, all ewes that had exited their respective flocks, were classified as either prematurely culled, or dead/missing, or if still in the flock, as censored, and either the exact date or interval in which they exited the flock was recorded. Semi-parametric competing risk (premature culling vs. dead/missing), interval-censored survival models were developed to: 1. describe the association between hogget reproductive outcomes and risk of subsequent wastage, and 2. assess pre-mating BCS as a predictor of wastage in that production year. Of the 13,142 enrolled ewes, 50.4% exited their respective flocks due to premature culling and 40.0% due to on-farm dead/missing, giving a total of 90.4% that exited due to wastage. Annual mortality incidence ranged from 3.5 to 40.2%. As a hogget, wastage incidence ranged from 7.6 to 45.4%. Pregnancy or rearing a lamb as a hogget did not increase risk of subsequent wastage. In all years, pre-mating BCS was a predictor of ewe wastage, with odds of wastage lower with increasing BCS. Therefore, farmers should focus on improving pre-mating BCS to 3.5/5.0 by assessing ewe BCS at weaning, allowing poorer-BCS ewes to be managed to gain BCS before re-breeding.


2021 ◽  
Vol 10 (1) ◽  
pp. 130
Author(s):  
Ertan Saridogan ◽  
Mona Salman ◽  
Lerzan Sinem Direk ◽  
Ali Alchami

Uterine septum can negatively affect reproductive outcomes in women. Based on evidence from retrospective observational studies, hysteroscopic incision has been considered a solution to improve reproductive performance, however there has been recent controversy on the need for surgery for uterine septum. High quality evidence from prospective studies is still lacking, and until it is available, experts are encouraged to publish their data. We are therefore presenting our data that involves analysis of the patient characteristics, surgical approach and long-term reproductive outcomes of women who received treatment for uterine septum under the care of a single surgeon. This includes all women (99) who underwent hysteroscopic surgery for uterine septum between January 2001 and December 2019. Of those 99 women treated for intrauterine septum who were trying to conceive, 91.4% (64/70) achieved pregnancy, 78.6% (55/70) had live births and 8.6% (6/70) had miscarriages. No statistically significant difference was found in the live birth rates when data was analyzed in subgroups based on age, reason for referral/aetiology and severity of pathology. Our study results support the view that surgical treatment of uterine septa is beneficial in improving reproductive outcomes.


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