Progesterone supplementation for prevention of preterm birth.

Objective: To study the efficacy of Progesterone supplementation for prevention of preterm birth. Study Design: Descriptive Interventional Study. Setting: Department of Obstetrics and Gynecology at Independent University Hospital, Faisalabad. Period: January 2018 to December 2020. Material & Methods: Data collected by using Non probability consecutive sampling techniques. Total 156 patients were included in study. Data was collected after informed consent, on pre designed proforma. Patient presented in 1st trimester and having previous history spontaneous preterm labour and recurrent miscarriages. We included patient presenting after 24 weeks of pregnancy and patient having threatened or actual preterm labour. Results: Among 156 patients, more than 82% of patient were delivered after 34 weeks of gestation and 18% were delivered before 34 weeks of gestation. Fetal outcome was very good in those patients who were delivered after 34 weeks of gestation with the use of Prophylactic progesterone therapy. Conclusion: Prophylactic use of progesterone helps in prolongation of pregnancy beyond 36 weeks and also help in decreasing the morbidity associated with premature delivery.

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Vaginal progesterone in prevention of preterm labour

International Journal of Medical Research and Review ◽

10.17511/ijmrr.2020.i06.13 ◽

2020 ◽

Vol 8 (6) ◽

pp. 449-454

Author(s):

Dr. Prativa Sahoo ◽

◽

Dr. Nayan Kumar Patel ◽

Dr. Ojaswini Patel ◽

Dr. A.K Panigrahi ◽

...

Keyword(s):

Preterm Birth ◽

Pregnant Women ◽

Preterm Labour ◽

Previous History ◽

Neonatal Morbidity ◽

Primary Objective ◽

Vaginal Progesterone ◽

History Of ◽

Secondary Objective

Introduction: Preterm birth, defined as childbirth occurring at less than 37 completed weeks or 259days of gestation since the first day of a woman’s last menstrual period, is one of the leading causesof neonatal morbidity and mortality. Across 184 countries, the rate of preterm birth ranges from 5%to 18% of babies born. Out of 27 million babies born every year (2018 data ) in India, 3.5 millionbabies born are premature. Recent literature review has shown that the use of Progesterone reducesrisk of preterm birth. But there is little information available regarding the role of Progesterone inpreventing preterm labour. Objectives: Primary objective of the study is to find out the incidence ofpreterm labour among pregnant women taking vaginal progesterone. Secondary objective istoassess the safety and efficacy of progesterone in feto-maternal outcome. Methods: This is a crosssectional study where100 prescriptions from IPD of Dept of O&G, VIMSAR, Burla of women who hadrecently undergone labour with singleton gestation and with previous history of preterm labour wereanalysed. Incidence of preterm labour among those taking and not taking vaginal progesterone werecompared. Results: There was decreased incidence of preterm labour as there is prolongation meanGestational age by 9.383 weeks among pregnant women taking vaginal progesterone. Conclusions:In the present study, women taking vaginal progesterone had significantly lowered incidencepreterm birth rate.

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PRETERM LABOUR:

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.09.811 ◽

2017 ◽

Vol 24 (09) ◽

pp. 1376-1379

Author(s):

Tasneem Azher ◽

Iram Aslam ◽

Saadia Bano ◽

Uzma Shahzad

Keyword(s):

Bacterial Vaginosis ◽

Preterm Labour ◽

Previous History ◽

Health Care Facilities ◽

University Hospital ◽

Intrauterine Death ◽

Inclusion Criteria ◽

Lower Segment Cesarean Section ◽

History Of ◽

Independent University

Objectives: (1) to find out of aetiological factors of preterm labour. (2) To makea proposed remedy for prevention of preterm lobour. Material and Methods: This study wascarried out at Independent University Hospital. This is located at richly populated area ofFaisalabad, providing health care facilities to poor socioeconomic group. The patient who fitinto inclusion criteria was included in study and a well designed Proforma was used to collectthe sample. Duration of study: One year study from 1 May, 2014 to 30 April, 2015. Studydesign: It is a descriptive study. Sampling technique: A purposive random sample techniquewas used to collect the sample. Sample size: A total of 80 cases ware collected who wereadmitted through antenatal outdoor and emergency of IUH. Inclusion Criteria: All patients withdiagnosed preterm labour who had attended outdoor or emergency of Independent UniversityHospital were included in study. Exclusion Criteria: (1) Patients with Iatrogenic preterminduction of labour due to maternal factors like patients on chemo therapy or any debilitatingillness causing threat to maternal life. (2) Patients with congenitally abnormal foetus & intrauterine death of fetus. Results: A total of 80 cases with preterm labour were included in studyat Independent University Hospital. In current study 30 (37.5%) patients had age between 18 –25 years, 30 (37.5%) patients had age between 26-35 years and rest of the 20 (25%) patientshad age > 35 years. Among 80 patients 25 (31.3%) patients had parity b/w 1-3 while 28 (35%)patients had parity b/w 4-5 and rest of the 27 (33.8%) had parity > 5. More patients i.e 50(62.5%) patients were admitted through emergency while 30 (37.5%) patients were admittedthrough Out Patient Department (OPD). 37 (46.3%) patients had Spontaneous vaginal deliveryand 43 (53.8%) patients underwent lower segment cesarean section. In our study, the mostcommon risk factor associated with preterm labour was bacterial vaginosis 20 (25%) patientshad bacterial vaginosis. 10 (12.5%) patients had chorioamniotis. Previous history of pretermbirth was present in 10 (12.5%) patients. History of Preterm Premature ruptures of membranesin 8 (10%) patients. 11(13.5%) patients has history of previous C-section and impending scardehiscence. History of anti partum hemorrhage and pregnancy induce in hypertension waspresent in 5 (6.5%) patients. FGR with oligohydramnios was present in 6 (7.5%) patients. 3((3.75%) patients presented with preterm breech

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Maternal and fetal outcome in pregnant patients with diabetes.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.05.4408 ◽

2021 ◽

Vol 28 (05) ◽

pp. 647-651

Author(s):

Uzma Hassan Shahzad ◽

Uzma Manzoor ◽

Irum Aslam ◽

Saadia Bano

Keyword(s):

Glycemic Control ◽

Adverse Pregnancy Outcome ◽

Challenge Test ◽

Descriptive Study ◽

Fetal Outcome ◽

University Hospital ◽

Premature Delivery ◽

Patients With Diabetes ◽

Prepregnancy Care ◽

Adverse Pregnancy

Objective: To observe maternal and fetal outcome in pregnant patients with diabetes. Aim of my study is to access the poor fetal maternal outcome with diabetes so that we can focus more on early and proper disease and have fair management throughout the pregnancy. Study Design: Descriptive study. Setting: Independent University Hospital Faisalabad. Period: January 2017 to January 2019. Material & Methods: It is descriptive study, 200 patients were selected who were pregnant with diabetes. The patients included who were newly diagnosed by glucose challenge test (GCT) or by glucose tolerance test (GTT) or who already had elevated HbA1c. The study was started after acquiring permission from ethical committee. Result: The above study concluded that the adverse outcome with diabetes is increased in terms of congenital malformation, miscarriage, preterm labour, pre eclampsia and postpartum haemorrhage. There is dire need to concentrate more on early diagnosis and timely management of diabetes with pregnancy. The tenet of management is to maintain euglycemic state throughout pregnancy. Conclusion: Prepregnancy care was associated with improved glycemic control in early pregnancy and significant reductions in adverse pregnancy outcome (malformation, stillbirth, and neonatal death) and very premature delivery. However, prepregnancy care failed to have an impact on glycemic control in later pregnancy or to reduce the risk of macrosomia and preeclampsia.

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Accuracy of Phosphorylated Insulin-Like Growth Factor Binding Protein-1 in Predicting Preterm Labour

Journal of Biomedical and Clinical Research ◽

10.2478/jbcr-2020-0019 ◽

2020 ◽

Vol 13 (2) ◽

pp. 134-138

Author(s):

Elitsa H. Gyokova ◽

Yordan D. Popov ◽

Yoana G. Ivanova-Yoncheva ◽

Kamelia K. Dimitrova ◽

Klaudia I. Dekova

Keyword(s):

Preterm Birth ◽

Growth Factor ◽

Preterm Labour ◽

Binding Protein ◽

Cervical Length ◽

Morbidity And Mortality ◽

Premature Delivery ◽

Insulin Like Growth Factor ◽

Factor Binding ◽

Clinical Biomarkers

Summary Preterm birth is the most common cause of perinatal morbidity and mortality worldwide. The routine method for predicting premature birth is the measurement of the cervical length. However, to make a better and more precise prognosis, the cervicovaginal fluid (CVF) was widely inspected through many studies. Its content is used nowadays as a diagnostic method for different conditions. One of the clinical biomarkers used to predict preterm labour in the CVF is the phosphorylated insulin-like growth factor binding protein-1 (pIGFBP-1). This study aimed to evaluate the accuracy of pIGFBP-1 as a predictor of preterm labour when used with cervical biometrics. A prospective, cross-sectional study was conducted on pregnant patients, divided into groups: Group A included participants at risk for premature labour, and Group B -women with an uncomplicated pregnancy. All patients underwent a test for pIGFBP-1, followed by a transvaginal measurement of the cervical length. A total of 32 patients were recruited for the study. Their pregnancy outcomes were followed up. In the group of symptomatic patients, the results were positive in 8 patients, and despite the intensive tocolytic therapy given, 5 of them gave preterm birth within 14 days. There were two patients with a cervical length of less than 10 mm. They both had positive results for pIGFBP-1 and gave spontaneous preterm birth within a few hours. The predictive value of pIGFBP-1 in cases with negative results was high. The leading cause for fetal morbidity and mortality in the twenty-first century remains premature delivery. Many investigations are currently carried out, aiming to facilitate preterm labor prediction and quickly estimate a pregnant woman’s ability to carry to time. The patients at highest risk are detected by measuring the cervical length. Newly searched clinical biomarkers such as fetal fibronectin found in the CVF might help predict preterm birth in time.

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The risk of recurrent preterm birth is significantly higher in patients with a previous history of very early premature delivery

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2003.10.545 ◽

2003 ◽

Vol 189 (6) ◽

pp. S206

Author(s):

Erin Clark ◽

Michael S Esplin ◽

Alison Fraser ◽

Elizabeth O'Brien ◽

Geri Mineau ◽

...

Keyword(s):

Preterm Birth ◽

Previous History ◽

Premature Delivery ◽

History Of

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RESULTS OF THE SUTURE OF THE PERFORATION BY SINGLE-PORT LAPAROSCOPIC SURGERY (SPLS) FOR THE PERFORATED DUODENAL ULCER TREATEMENT

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2014.4_5.18 ◽

2014 ◽

pp. 126-132

Author(s):

Huu Tri Nguyen ◽

Van Lieu Nguyen

Keyword(s):

Duodenal Ulcer ◽

Laparoscopic Surgery ◽

Single Port ◽

Previous History ◽

University Hospital ◽

Safe Procedure ◽

Perforated Duodenal Ulcer ◽

Analgesic Requirement ◽

Duodenal Ulcers ◽

The Mean

Background Single-port laparoscopic surgery (SPLS) was increasingly used on several surgical diseases. The aim of this study is evaluation of the results of the suture of the perforation by SPLS for the perforated duodenal ulcer treatement. Methods From January 2012 to July 2014, 35 patients with perforated duodenal ulcers underwent simple suture of the perforations by SPLS at Hue University Hospital and Hue Central Hospital. Results The mean age was 45.9 ± 14.4 years. The sex ratio (male/female) was 16.5 and the mean of BMI was 19.2 ± 2.3. There was one patient (2.9%) with previous history of laparoscopic repair of perforated duodenal ulcer. The duration of the symptoms was 9.9 ± 12.3 hours. 97.1% of patients had the perforations of the anterior wall of the duodenum. The mean size of the perforation was 4.7 ± 3.4 mm (2 – 22mm). 2.9% of patients had the perforations of the posterior wall of the duodenum. The rate of the conversion to the open surgery was 2.9%. The mean operative time was 75.8 ± 33.7min, and the mean hospital stay was 5.8 ± 1.4 days. The mean of the analgesic requirement time was 2.9 ± 0.8 days. The wound length was 1.9 ± 0.1 cm. There was 5.9% of the patients had wound infection. There was no operation-related mortality. Conclusions Simple suture of the perforation by single-port laparoscopic surgery is a feasible and safe procedure, and it may be a scarless surgical technique for perforated duodenal ulcers treatement. Key words: single-port laparoscopic surgery, perforated duodenal ulcer

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Relaxin for preventing preterm birth in threatened preterm labour

10.1002/14651858.cd010073 ◽

2012 ◽

Cited By ~ 1

Author(s):

Kristin Hsu ◽

Caroline A Crowther ◽

Emer Heatley

Keyword(s):

Preterm Birth ◽

Preterm Labour

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Malaria among migrants in a university hospital in Colombia during 2018: A case series

Tropical Doctor ◽

10.1177/0049475520981301 ◽

2020 ◽

pp. 004947552098130

Author(s):

Fabián R Carreño-Almánzar ◽

Adán Coronado-Galán ◽

Sonia A Cala-Gómez ◽

Agustín Vega-Vera

Keyword(s):

Latin American ◽

Previous History ◽

Case Series ◽

Cross Sectional Study ◽

Imported Malaria ◽

University Hospital ◽

Sectional Study ◽

Cross Sectional ◽

History Of ◽

Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

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P147: International scope of emergency ultrasound: barriers to utilizing ultrasound to guide central venous catheter placement by providers in Kenya

CJEM ◽

10.1017/cem.2016.321 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S127-S127

Author(s):

F. Zaver ◽

K. Boniface ◽

H. Shokoohi ◽

B. Wachira ◽

G. Wanjiku

Keyword(s):

Central Venous Catheter ◽

Previous History ◽

Venous Catheter ◽

Standard Of Care ◽

Comfort Level ◽

Perceived Barriers ◽

University Hospital ◽

Central Venous ◽

International Scope ◽

Survey Responses

Introduction: While ultrasound (U/S) use for internal jugular central venous catheter (CVC) placement is standard of care in many institutions in North America, most developing countries have not adopted this practice. Previous surveys of American physicians who are not currently using U/S to place CVCs have identified lack of training and equipment availability as the most important barriers to the use of U/S. We sought to identify Kenyan physicians’ perceived barriers to the use of U/S to guide CVC insertion in a resource-constrained environment. Methods: The study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Physicians participating in a one-hour course teaching U/S guided CVC placement were asked to complete a survey before beginning training, which was used to assess previous experience with U/S, and evaluate perceived barriers to U/S. Survey responses were analyzed using summary statistics and the Rank-Sum test to compare the difference between participants’ responses based on different specialty, gender and previous history of using U/S. Results: There were 23 physicians who completed the course and the survey. They included 6 internal medicine, 5 critical care, 5 anesthesia, 2 emergency medicine and 5 physicians from other specialties. The mean length of practice was 5 years. 52% (95% CI: 0.30-0.73) had put in >20 CVCs. 21.7% (95% CI: 0.08-0.44) of participants had previous U/S training, but none have received any training on the use of U/S for CVC insertion. The respondents expressed agreement on the ease of the use, improved success rate, and decreased failure rate with U/S guidance. However, less agreement was found regarding the perceived superior convenience and cost effectiveness of U/S CVC placement (see Figure). The lack of training or comfort with the U/S and the availability of U/S and equipment to maintain sterility were reported as the main barriers for use. Neither previous U/S experience nor specialty of the respondent significantly affected responses. Conclusion: Barriers to the use of U/S guidance for the placement of CVCs in Nairobi, Kenya are similar to those found among American physicians. These include training and comfort level with U/S in placement of CVCs, as well as resources required for U/S equipment and to keep the field sterile.

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