A case of vaginal infection with the formation of haematometra and haematocolpos after the first birth

On February 12, 1893, the peasant woman Shimakova was admitted to the women's department of the Oryol provincial hospital with a complaint of the growth of her abdomen and severe pain in it. She gave birth to the first time 6 months ago. Childbirth is difficult, the child was born dead. After the birth of the ailment 3 weeks. Measurement of the pelvis was given by tr. 29, sp. 25 cr., 26, conj. ext.16.

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Pregnancy and the Risk of Rheumatoid Arthritis in a Highly Predisposed North American Native Population

The Journal of Rheumatology ◽

10.3899/jrheum.120269 ◽

2012 ◽

Vol 39 (12) ◽

pp. 2253-2260 ◽

Cited By ~ 24

Author(s):

CHRISTINE A. PESCHKEN ◽

DAVID B. ROBINSON ◽

CAROL A. HITCHON ◽

IRENE SMOLIK ◽

DONNA HART ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

North American ◽

Shared Epitope ◽

Reproductive History ◽

Early Age ◽

Age At First Birth ◽

Native Population ◽

First Birth ◽

Pregnancy Smoking ◽

First Time

Objective.To examine reproductive history and rheumatoid arthritis (RA) risk in a highly predisposed population of North American Natives (NAN) with unique fertility characteristics.Methods.The effect of pregnancy on the risk of RA was examined by comparing women enrolled in 2 studies: a study of RA in NAN patients and their unaffected relatives; and NAN patients with RA and unrelated healthy NAN controls enrolled in a study of autoimmunity. All participants completed questionnaires detailing their reproductive history.Results.Patients with RA (n = 168) and controls (n = 400) were similar overall in age, education, shared epitope frequency, number of pregnancies, age at first pregnancy, smoking, and breastfeeding history. In multivariate analysis, for women who had ≥ 6 births the OR for developing RA was 0.43 (95% CI 0.21–0.87) compared with women who had 1–2 births (p = 0.046); for women who gave birth for the first time after age 20 the OR for developing RA was 0.33 (95% CI 0.16–0.66) compared with women whose first birth occurred at age ≤ 17 (p = 0.001). The highest risk of developing RA was in the first postpartum year (OR 3.8; 95% CI 1.45–9.93) compared with subsequent years (p = 0.004).Conclusion.In this unique population, greater parity significantly reduced the odds of RA; an early age at first birth increased the odds, and the postpartum period was confirmed as high risk for RA onset. The protective effect of repeated exposure to the ameliorating hormonal and immunological changes of pregnancy may counterbalance the effect of early exposure to the postpartum reversal of these changes.

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SURVIVAL ANALYSIS TO DETERMINE AGE TO GIVE FIRST BIRTH IN WOMEN IN EAST JAVA USING EXTENDED COX REGRESSION

Jurnal Biometrika dan Kependudukan ◽

10.20473/jbk.v10i2.2021.144-152 ◽

2021 ◽

Vol 10 (2) ◽

pp. 144

Author(s):

Santi Wulan Purnami ◽

Fitria Nur Aida ◽

Sutikno Sutikno ◽

Diyah Herowati ◽

Achmad Sjafii ◽

...

Keyword(s):

Cox Regression ◽

Educational Status ◽

Age At First Birth ◽

Childbearing Age ◽

First Birth ◽

Risk Of Death ◽

First Marriage ◽

Age At First Marriage ◽

First Child ◽

First Time

The age of a woman when giving birth to her first child needs to be a concern because it is related to the safety of the mother and baby. A woman being too young or too old increases the risk of death for both the mother and baby. Every woman giving birth for the first time is likely to experience psychological disorders such as anxiety and excessive fear during labor, and even postpartum depression. Given the importance and possible extent of the consequences of women giving birth for the first time, this study intended to assess the factors that influence the age at first birth, especially amongst women of childbearing age in East Java. These factors include the age at first marriage, education, and region. The method used was the extended Cox regression model. The analysis shows that the age at first marriage and education are factors that significantly influence the age at first birth. The more mature the age at first marriage, the more mature the age at first birth. Likewise, the higher the educational status, the higher the potential for giving birth to a first child over the age of 23, especially amongst women who graduated high school and university.

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First Birth at Home or in Hospital in Aotearoa/New Zealand: Intrapartum Midwifery Care and Related Outcomes

10.26686/wgtn.16959079.v1 ◽

2021 ◽

Author(s):

◽

Suzanne Claire Miller

Keyword(s):

New Zealand ◽

Focus Group ◽

Emotional Health ◽

Care Provision ◽

First Birth ◽

Aotearoa New Zealand ◽

Foetal Monitoring ◽

First Time Mothers ◽

First Time ◽

At Home

<p>A woman's first birth experience can be a powerfully transformative event in her life, or can be so traumatic it affects her sense of 'self' for years. It can influence her maternity future, her physical and emotional health, and her ability to mother her baby. It matters greatly how her first birth unfolds. Women in Aotearoa/New Zealand enjoy a range of options for provision of maternity care, including, for most, their choice of birth setting. Midwives who practice in a range of settings perceive that birth outcomes for first-time mothers appear to be 'better' at home. An exploration of this perception seems warranted in light of the mainstream view that hospital is the optimal birth setting. The research question was: "Do midwives offer the same intrapartum care at home and in hospital, and if differences exist, how might they be made manifest in the labour and birth events of first-time mothers?" This mixed-methods study compared labour and birth events for two groups of first-time mothers who were cared for by the same midwives in a continuity of care context. One group of mothers planned to give birth at home and the other group planned to give birth in a hospital where anaesthetic and surgical services were available. Labour and birth event data were collected by a survey which was generated following a focus group discussion with a small group of midwives. This discussion centred around whether these midwives believed their practice differed in each setting, and what influenced care provision in each place. Content analysis of the focus group data saw the emergence of four themes relating to differences in practice: midwives' use of space, their use of time, the 'being' and 'doing' of midwifery and aspects relating to safety. Survey data were analysed using SPSS. Despite being cared for by the same midwives, women in the hospital-birth group were more likely to use pharmacological methods of pain management, experienced more interventions (ARM, vaginal examinations, IV hydration, active third stage management and electronic foetal monitoring) and achieved spontaneous vaginal birth less often than the women in the homebirth group. These findings strengthen the evidence that for low risk first-time mothers a choice to give birth at home can result in a greater likelihood of achieving a normal birth. The study offers some insights into how the woman's choice of birth place affects the care provided by midwives, and how differences in care provision can relate to differences in labour and birth event outcomes.</p>

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Medical and social aspects in women of reproductive age with chronic pelvic pain

Reproductive health of woman ◽

10.30841/2708-8731.6.2021.244386 ◽

2021 ◽

Vol 6 ◽

pp. 71-76

Author(s):

S.О. Shurpyak ◽

O.B. Solomko

Keyword(s):

Vitamin D ◽

Pelvic Pain ◽

Severe Pain ◽

Chronic Pelvic Pain ◽

Previous Treatment ◽

Reproductive Age ◽

Medical Documentation ◽

Social Characteristics ◽

Irritable Bowel ◽

First Time

The objective: a study of the medical and social characteristics of women in reproductive age with chronic pelvic pain on the basis of retrospective analysis.Materials and methods. The analysis of medical documentation of 314 patients in reproductive age with a verified diagnosis of chronic pelvic pain (CPP) was performed on the basis of studying of case histories and outpatient cards. Data were analyzed: anthropometric data, age, body mass index, place of residence, gynecological pathology, duration and nature of the menstrual cycle, comorbidities, previous treatment, disease duration, pain intensity, bad habits, number of pregnancies and births, reproductive plans and other methods examination.Results. It was found that more than a third of women, who were treated for pathologies that cause CPP, need medical help again. 58 % of patients sought help for CPP for the first time, 42 % had already received treatment for CPP. Concomitant non-gynecological pathology is more often observed in such patients (48.7 %).The most commonly diagnosed were interstitial cystitis (42 %) and irritable bowel syndrome (34 %). The combination of gynecological, urological and surgical pathology was found in 22 % of patients. Patients with CPP had deficiency in vitamin D (68 % of the 162 patients tested for vitamin D) and had subjectively more severe pain. At the same time, the lack of routine examination of thyroid function and vitamin D status attracted attention. Simultaneously, women with CPP are much more likely than the general population to have infertility (56.4 %), and the incidence of miscarriage is twice as high as the population, with a tendency to recurrent pregnancy loss.Conclusions. Concomitant non-gynecological pathology, infertility, miscarriage, vitamin D deficiency and subjectively more severe pain are more common in women with chronic pelvic pain. However, the level of diagnosing thyroid pathology and determining the concentration of vitamin D in such patients is insufficient.

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"Moving things forward": Birthing Suite culture and labour augmentation for healthy first-time mothers.

10.26686/wgtn.17148548 ◽

2021 ◽

Author(s):

◽

Suzanne Miller

Keyword(s):

Continuity Of Care ◽

Tertiary Hospital ◽

First Birth ◽

Good Doctor ◽

Normal Birth ◽

Healthy Women ◽

First Time Mothers ◽

Generative Mechanisms ◽

The Impact ◽

First Time

<p>In Aotearoa New Zealand, healthy women giving birth for the first time may plan to give birth in range of settings - from home to a tertiary hospital where surgical and anaesthetic services are available. Each birth location has its own culture, and the extent to which this culture influences the birth experience lies at the heart of this research. Just twenty-three percent of first-time mothers experience a normal birth with no obstetric interventions, and the chosen place of birth is implicated in this statistical outcome. Tertiary maternity settings report the highest rates of birth interventions, even for healthy women who can anticipate straightforward labour experiences. Among the most frequently used birth interventions are labour augmentation procedures - artificial rupture of membranes and administration of synthetic oxytocin infusions. My critical realist ethnography aims to explore the cultural landscape within one tertiary birthing suite and in doing so to identify the generative mechanisms that influence the likelihood of labour augmentation for well first-time mothers. I begin with a retrospective chart review to uncover the magnitude of the use of augmentation procedures for a sample of healthy women presenting in labour to the birthing suite over one calendar year. Interviews with women who experienced long labours yield insights about their decision-making with respect to augmentation. Focus groups and interviews with midwives and obstetric doctors contribute an understanding of factors associated with their use of augmentation, and a period of non-participant observation in the birthing suite illuminates the nuanced ways the unit culture contributes to the permissive use of augmentation procedures in this birthing environment. Findings reveal that sixty percent of women experienced labour augmentation procedures and for one third of them, the augmentation was not indicated according to the clinical guideline in use at the time. Pressure to be “moving things forward” characterises the birthing suite culture. The identified generative mechanisms that combine to influence the likelihood of augmentation include a lack of belief in birth, not valuing midwives, the education and socialisation of midwives and doctors, and the industrialisation of birth - all underpinned by available social discourses about being a good mother, a good midwife or a good doctor. Ironically, the very attributes that make the tertiary hospital the ideal place to be when birth is complex or the unexpected happens (‘poised-ness’ for action, being a ‘well-oiled machine’ for emergency care, surveillance and control) are the same attributes that create a dis-abling environment for physiological first birth to unfold at its own pace. The ‘perfect system’ is in place; a well-embedded midwifery-led continuity of care model incorporating seamless and integrated secondary referral processes. But despite this potentially enabling model of maternity care, once ‘nested’ within the tertiary hospital setting the impact of social, professional and industrial discourses overwhelms the salutogenic factors that should protect normal birth. A re-focussed commitment to providing continuity of care across the labour continuum, home visiting in early labour, enhancing physiological birth support in both the relational and environmental realms, averting the obstetric gaze and prioritising women’s needs over institutional needs represent the best way forward as strategies to resist the inexorable rise of obstetric intervention. Midwives are well-positioned to respond to this call. Reclaiming their expertise in support of physiological first birth by driving the practice and research agenda presents the optimal way to “move things forward” for women.</p>

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The role of the miR1976/CD105/integrin αvβ6 axis in vaginitis induced by Escherichia coli infection in mice

Scientific Reports ◽

10.1038/s41598-019-50902-w ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Lisha Jiang ◽

Lingling Zhang ◽

Can Rui ◽

Xia Liu ◽

Zhiyuan Mao ◽

...

Keyword(s):

Escherichia Coli ◽

Inflammatory Diseases ◽

Vaginal Infection ◽

Childbearing Age ◽

Vaginal Infections ◽

E Coli ◽

Integrin Αvβ6 ◽

Increased Risk ◽

Escherichia Coli Infection ◽

First Time

Abstract Vaginitis is very common among women, especially women of childbearing age, and is associated with significantly increased risk of preterm birth and pelvic inflammatory diseases. An imbalance in the vaginal flora, the primary cause of vaginitis, promotes the initiation and progression of vaginal infections. However, the responsible mechanisms are still poorly understood. Using a murine vaginitis model of Escherichia coli infection, we demonstrated that decreased expression of microRNA1976 and increased expression of CD105 and integrin αvβ6 were closely associated with the progression of vaginal infection. Importantly, we demonstrated for the first time that the microRNA1976/CD105/integrin αvβ6 axis regulates E. coli-mediated vaginal infection in mice, as evidenced by the finding that E. coli-induced vaginal infection was reversed by microRNA1976 overexpression and exacerbated by CD105 overexpression. The regulation of CD105 and integrin αvβ6 by microRNA1976 was further confirmed in a murine model of vaginitis with adenoviral vector treatment. Taken together, our data suggested that microRNA1976 negatively regulates E. coli-induced vaginal infection in mice at least in part by suppressing CD105 and integrin αvβ6 expression. These findings may provide new insight into the mechanisms of E. coli-induced vaginitis, identify a novel diagnostic biomarker and a potential therapeutic target for flora imbalance-associated vaginitis.

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OBSTETRIC GYNECOLOGICAL SOCIETY IN BERLIN. Meeting on January 8, 1892

Journal of obstetrics and women s diseases ◽

10.17816/jowd66603-612 ◽

2020 ◽

Vol 6 (6) ◽

pp. 603-612

Author(s):

V. N. Massen

Keyword(s):

Ectopic Pregnancy ◽

Severe Pain ◽

Tubal Pregnancy ◽

Irregular Bleeding ◽

The Right ◽

First Time ◽

Bilateral Tubal Pregnancy

Mackenrodt presented a case of a bilateral tubal pregnancy, which he operated on with good success in November 1891. A 32-year-old patient, 6 years ago, got married for the first time and in the course of three years of her marriage gave birth 2 times safely and once there was a miscarriage. Since then, she was no longer pregnant. After the death of her first husband, she remained a widow for 2 years, then remarried. In May 1890, the regulations were absent, in June there were irregular bleeding and severe pain on the right side, and the temperature rose to 40 . The doctor diagnosed a right-sided ectopic pregnancy.

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Romanian government’s health spending will fall short

Emerald Expert Briefings ◽

10.1108/oxan-db259824 ◽

2021 ◽

Keyword(s):

Emergency Care ◽

Healthcare Workers ◽

Health Spending ◽

Third Wave ◽

Content Type ◽

Provincial Hospital ◽

The Third ◽

North Eastern ◽

First Time

Significance The November 14 fire happened at a very old provincial hospital in Piatra Neamt in north-eastern Romania, but the January 29 tragedy was at one of Romania’s most modern and well-funded units in Bucharest -- the Matei Bals hospital. Both exposed long-term problems in the healthcare system. Impacts When the more infectious variant of COVID-19 becomes prevalent, the third wave of the pandemic will push emergency care closer to collapse. Recent austerity measures will generate public-sector discontent including among healthcare workers, but will not trigger massive protests. Disenchantment with governing parties may turn people to the radical AUR party that entered parliament in December for the first time.

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