CLINICAL SIGNIFICANCE AND RISK FACTORS OF DYSTOCIA

Reducing adverse events in labour is one of key tasks of obstetrics at present. Abnormalities in labour, and in particular, dystocia, require further in-depth investigation and coordinated interprofessional effort. The purpose of this study was to determine the risk factors for dystocia in a full-term monocyesis with foetal presentation. We carried out a clinical and statistical analysis of pregnancy and childbirth histories of 550 women at the Kharkiv Municipal Perinatal Centre for 2018-2019 depending on the presence of dystocia by applying descriptive statistics and the odds ratio (OR) methods. Results. The most important factors for dystorcia with OR > 5.0 include diabetes mellitus (OR - 10.023; 95% CI 3.083-32.578), burdened gynecological history (OR - 7.385; 95% CI 2.671 - 20.423), foetus-pelvic imbalances (OR - 6.399; 95% CI 1.506 - 27.180) first birth (OR - 5.878; 95% CI 3.139 - 11.009) and the presence of infectious diseases of the genital tract (OR - 5.071; 95% CI 1.847 - 13.925). The value for preeclampsia was slightly lower (OR - 4.467; 95% CI 1.585 - 12.586). All other indicators had an OR < 3.0, including gestational hypertension (OR - 2.882; 95% CI 1.388 - 6.071), obesity (OR - 2.360; 95% CI 1.118 - 4.98) large foetus (OR - 2.242; 95% CI 1.069 - 4,704) late reproductive age (OR - 2.075; 95% CI 1.144 - 3.765) and the presence of cardiovascular disease (OR - 2.040; 95% CI 1.009 - 4.124). A comprehensive assessment of risk factors is of great clinical importance for predicting dystocia and making decisions about the need for preventive and therapeutic measures.

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Outcomes of Multidetector Computed Tomography Pulmonary Angiography in Pregnant and Postpartum Women With Suspected Pulmonary Embolism

Canadian Association of Radiologists Journal ◽

10.1177/0846537119899552 ◽

2020 ◽

pp. 084653711989955

Author(s):

Simon Sun ◽

Marius Diaconescu ◽

Tian Zhe ◽

Benoit Mesurolle ◽

Alexandre Semionov

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Odds Ratio ◽

Pulmonary Angiography ◽

Reproductive Age ◽

P Value ◽

Postpartum Women ◽

Computed Tomography Pulmonary Angiography ◽

Early Postpartum ◽

Independent Risk Factors

Purpose: Verify whether there is a difference in likelihood of developing pulmonary embolism (PE) between pregnant women, nonpregnant women of reproductive age, and postpartum (up to 6 weeks) women, by comparing their outcomes on computed tomography pulmonary angiography (CTPA) done for suspicion of PE. Materials and Methods: Retrospective cohort study of 1463 CTPA done for suspicion of PE in females of reproductive age (18-40 years), nonpregnant, pregnant (antepartum), and postpartum, from 2 tertiary-care academic hospitals between October 2006 and September 2015. Primary outcome was diagnosis of PE on imaging. Additional assessment was made of technical adequacy of the studies and method of delivery for the postpartum cohort (vaginal vs caesarean birth). Twenty-nine technically nondiagnostic studies were excluded. The effect of any potential variable on PE status was tested using univariate logistic regression. Subgroup analysis was performed after excluding patients with independent risk factors for PE. Results: The rate of CTPA positive for PE was less among pregnant patients compared to early postpartum and nonpregnant women of similar age, 2.9% vs 11.5% and 10.3%, respectively. Pregnancy was associated with statistically significant decreased odds ratio of developing a PE on CTPA, 0.23 (0.09-0.89), P value = .004. After excluding patients with additional independent risk factors for PE, there was no statistically significant odds ratio association between presence of PE on CTPA and pregnancy 0.41 (0.13-1.34), P value = .14. Conclusion: Rate of CTPA positive for PE in pregnant women was lower than in nonpregnant and early postpartum women. Pregnancy was statistically significantly less likely to be associated with positive PE on a CTPA study. The common perception that pregnancy (antepartum state) is associated with an increased risk of PE may require a thorough critical reappraisal.

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The clinical importance of microscopic hematuria and hydronephrosis in urolithiasis

10.22541/au.162439742.24363477/v1 ◽

2021 ◽

Author(s):

Kamil Kokulu ◽

ekrem taha sert

Keyword(s):

Risk Factors ◽

Odds Ratio ◽

Clinical Importance ◽

Microscopic Hematuria ◽

Ureteral Stones ◽

Stone Size ◽

Factors Associated ◽

Radiology Reports ◽

Contrast Ct ◽

The Relationship

Aim: The aim of this study was to investigate the relationship between the degree of hydronephrosis and the presence of microscopic hematuria in patients that presented to the emergency department (ED) with ureteral stones. Methods: The records of patients who presented to our ED due to urolithiasis between January 2017 and December 2020 were retrospectively analyzed. Patients aged 18 years or older who underwent non-contrast computed tomography (CT abdomen/pelvis) and urinalysis (UA) and were diagnosed with ureteral stones were included in the study. Radiology reports were reviewed for stone size, localization, and degree of hydronephrosis. Patients with and without microscopic hematuria and the degree of hydronephrosis were compared. Results: A total of 476 patients were included, which consisted of 391 with microscopic hematuria and 85 without microscopic hematuria. The median stone size was 4.1 mm in the presence of microscopic hematuria and 5.5 mm in the absence of microscopic hematuria. Logistic regression analysis was performed to determine the factors associated with the development of hydronephrosis. Stone size [odds ratio (OR):2.15, 95% confidence interval (CI):1.12-4.16, p<0.001), presence of pyuria (OR: 2.58, 95%CI: 1.78-3.48, p<0.001), and absence of microscopic hematuria (OR: 1.31, 95%CI 1.04-2.89, p=0.017) were identified as risk factors for moderate and severe hydronephrosis. Conclusion: We consider that non-contrast CT imaging is necessary for the diagnosis and treatment of emergency cases in which microscopic hematuria is not detected in urinalysis since their stone size may be larger and degree of hydronephrosis may be more severe.

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Risk factors for the development of tubo-ovarian abscesses in women with ovarian endometriosis: a retrospective matched case–control study

BMC Women s Health ◽

10.1186/s12905-021-01188-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yang Gao ◽

Pengpeng Qu ◽

Yang Zhou ◽

Wei Ding

Keyword(s):

Risk Factors ◽

Genital Tract ◽

Odds Ratio ◽

Spontaneous Rupture ◽

Genital Tract Infection ◽

Ovarian Endometriosis ◽

Vitro Fertilization ◽

Lower Genital Tract ◽

Lower Genital Tract Infection

Abstract Background The purpose of this study was to assess the risk factors associated with the development of tubo-ovarian abscesses in women with ovarian endometriosis cysts. Methods This retrospective single-center study included 176 women: 44 with tubo-ovarian abscesses associated with ovarian endometriosis and 132 age-matched (1:3) patients with ovarian endometriosis but without tubo-ovarian abscesses. Diagnoses were made via surgical exploration and pathological examination. The potential risk factors of tubo-ovarian abscesses associated with ovarian endometriosis were evaluated using univariate analysis. The results (p ≤ 0.05) of these parameters were analyzed using a multivariate model. Results Five factors were included in the multivariate conditional logistic regression model, including in vitro fertilization, presence of an intrauterine device, lower genital tract infection, spontaneous rupture of ovarian endometriosis cysts, and diabetes mellitus. The presence of a lower genital tract infection (odds ratio 5.462, 95% CI 1.772–16.839) and spontaneous rupture of ovarian endometriosis cysts (odds ratio 2.572, 95% CI 1.071–6.174) were found to be statistically significant risk factors for tubo-ovarian abscesses associated with ovarian endometriosis. Conclusions Among the factors investigated, genital tract infections and spontaneous rupture of ovarian endometriosis cysts were found to be involved in the occurrence of tubo-ovarian abscesses associated with ovarian endometriosis. Our findings indicate that tubo-ovarian abscesses associated with ovarian endometriosis may not be linked to in vitro fertilization as previously thought.

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Features of pregnancy with gestational diabetes mellitus and prediction of diabetic fetopathy

Journal of obstetrics and women s diseases ◽

10.17816/jowd66414-24 ◽

2017 ◽

Vol 66 (4) ◽

pp. 14-24 ◽

Cited By ~ 1

Author(s):

Elena S. Akhmetova ◽

Natalia V. Lareva ◽

Victor A. Mudrov ◽

Ekaterina E. Gergesova

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Resistance Index ◽

Control Group ◽

C Peptide ◽

Pregnancy And Childbirth ◽

Insulin Resistance Index

Gestational diabetes mellitus (GDM) and its consequences for the mother and child represent a serious not only medical, but also an economic problem. The urgency of studying this problem also lies in the fact that the number of pregnant women suffering from this disease is progressively increasing. The aim of the study was to study the risk factors and features of the course of pregnancy and childbirth in women with gestational diabetes mellitus, as well as to improve methods for diagnosing and predicting the development of diabetic fetopathy (DF). The work was carried out in 3 stages: 1 — prospective study of the course of pregnancy and childbirth in 104 women with GDM and in 50 pregnant women without GDM (control group); 2 — determination in the peripheral blood of the pregnant women of both groups of the level of glycemia, C-peptide, insulin, calculation of the insulin resistance index (HOMA-IR) with an assessment of the prognostic significance of these markers in the development of diabetic fetopathy; 3 — prediction of the development of diabetic fetopathy using a mathematical model that includes risk factors, the results of laboratory and instrumental research methods for this pathology. It was found that the violation of carbohydrate metabolism during pregnancy promotes the development of a large number of obstetric complications and in 36.5% of cases leads to the birth of children with diabetic fetopathy, which is manifested to a greater degree by macrosomia (30%), which increases the risk of perinatal complications and worsens the course of the period newborn in the future. An increase in the level of C-peptide was diagnosed in 87% of pregnant women with gestational diabetes, and an increase in the insulin resistance index in 93%, in contrast to the control group, where these indicators were 4 and 6%, respectively (p < 0.05). Using discriminant analysis, it was determined that the threshold for predicting the development of DF should be considered an increase in HOMA-IR above 7 with a confidence of 73%, but the level of C- peptide does not have a predictive value. The mathematical model, including risk factors, data of laboratory and instrumental methods for studying carbohydrate metabolism in the mother and fetus, created using regression analysis, reflects the probability of development of diabetic fetopathy in pregnant women with gestational diabetes with an accuracy of 91.4%, which will help to prevent this complication in at an earlier stage through insulin therapy.

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Tuberculosis in Northeastern Brasil (2001-2016): trend, clinical profile, and prevalence of risk factors and associated comorbidities

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.9.1196 ◽

2020 ◽

Vol 66 (9) ◽

pp. 1196-1202 ◽

Cited By ~ 1

Author(s):

Alyne Barbosa Brito ◽

Williany Barbosa de Magalhães ◽

João Paulo Silva de Paiva ◽

Thiago Cavalcanti Leal ◽

Leonardo Feitosa da Silva ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Temporal Trend ◽

Public Health Problem ◽

Descriptive Statistics ◽

Clinical Profile ◽

Smear Microscopy ◽

Cure Rate ◽

Male Population ◽

Positive Smear

SUMMARY OBJECTIVE: To describe the temporal trend, clinical profile, and the prevalence of risk factors and associated comorbidities in new cases of tuberculosis in the Northeast (2001-2016). METHODS: A prevalence study involving all tuberculosis cases registered in Northeast Brasil, 2001-2016. Data were obtained from the National System of Notification of Disorders. For statistical analysis, the inflection point regression model and descriptive statistics were used. RESULTS: 331,245 cases of tuberculosis were reported. The overall incidence rate decreased from 44.84/100,000 inhabitants (2001) to 30.92/100,000 inhabitants (2016), with a decreasing trend (AAPC: −2.3; p<0.001). The profile was characterized by men (73.53%), age 20-59 years (73.56%), pulmonary tuberculosis (86.37%), positive smear microscopy (54.78%). The main risk factors and comorbidities were: AIDS (4.64%), HIV (12.10%), Diabetes mellitus (5.46%), alcohol (11.63%), institutionalized, (4.31%) and deprived of liberty (2.30%). The cure rate was 70.66% and the abandonment rate was 9.11%. CONCLUSIONS: Even with a reduced incidence, tuberculosis represents a real public health problem in the Northeast region. The profile was characterized by a male population, in economically-active age, lung smear-positive pulmonary presentation, and the risk factors and comorbidities of Aids, TB/HIV co-infection, diabetes mellitus, alcohol consumption, institutionalized and deprived of freedom reflect the complexity of the challenges in facing the disease.

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Risk factors for delayed graft function in deceased donor kidney transplantation; a potential preventive role for intraoperative thymoglobulin

Journal of Renal Injury Prevention ◽

10.15171/jrip.2019.29 ◽

2019 ◽

Vol 8 (2) ◽

pp. 157-163

Author(s):

Neda Naderi ◽

Azam Alamdari ◽

Mahboob Lessan-Pezeshki ◽

Simin Dashti-Khavidaki ◽

Mehran Heydari-Seradj ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Kidney Transplantation ◽

Odds Ratio ◽

Graft Function ◽

Deceased Donor ◽

Donor Kidney ◽

Deceased Donor Kidney ◽

Donor Kidney Transplantation ◽

Deceased Donor Kidney Transplantation

Introduction: Delayed graft function (DGF) is associated with significant adverse outcomes in deceased donor kidney transplantation (KT) including lower graft survival. However, risk factors and potential preventive strategies like intraoperative rabbit antithymocyte globulin (rATG; thymoglobulin) have not yet been fully evaluated. Objectives: The aim of this study was to investigate DGF risk factors and determine the association of intraoperative rATG with the risk of DGF in deceased donor kidney recipients. Patients and Methods: We retrospectively examined medical records of 163 first time deceased donor kidney transplant recipients at two major kidney transplant centers from 2014 to 2016. All the donors were standard heart-beating, brain death donors. Risk factors for DGF in recipients were evaluated using multivariate logistic regression analysis. Results: The mean recipients’ age was 43±13 years and the majority of participants were male (64%). The overall rate of DGF was 27%. Intraoperative rATG was significantly associated with a lower rate of DGF (adjusted odds ratio [AOR], 0.33, 95% CI, 0.11-0.95). Intraoperative transfusion (AOR, 3.7, 95% CI, 1.4-9.9) and diabetes mellitus (AOR, 3.7, 95% CI, 1.5-8.9) were significantly associated with higher risk of DGF. Conclusion: This study showed that intraoperative blood transfusion and diabetes mellitus were associated with increased risk of DGF. Meanwhile, administration of intraoperative rATG was associated with reduced odds ratio of DGF. Future studies are needed to evaluate the potential role of rATG in DGF-related renal outcomes.

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Prevention of gestational diabetes in pregnant women with risk factors for gestational diabetes: a systematic review and meta-analysis of randomised trials

Obstetric Medicine ◽

10.1177/1753495x15576673 ◽

2015 ◽

Vol 8 (2) ◽

pp. 68-85 ◽

Cited By ~ 10

Author(s):

P Madhuvrata ◽

Gemma Govinden ◽

R Bustani ◽

S Song ◽

TA Farrell

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Standard Care ◽

Dietary Intervention ◽

Gestational Hypertension ◽

Meta Analysis ◽

Lifestyle Changes ◽

Randomised Trials

Background Gestational diabetes mellitus can be defined as ‘glucose intolerance or hyperglycaemia with onset or first recognition during pregnancy.’ Objective The objective of our systematic review was to see if there was any intervention that could be used for primary prevention of gestational diabetes mellitus in women with risk factors for gestational diabetes mellitus. Search strategy Major databases were searched from 1966 to Aug 2012 without language restriction. Selection criteria Randomised trials comparing intervention with standard care in women with risk factors for gestational diabetes were included. Meta-analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. The primary outcome assessed was the incidence of gestational diabetes. Data collection and analysis Data from included trials were extracted independently by two authors and analysed using Rev-Man 5. Main results A total of 2422 women from 14 randomised trials were included; which compared diet (four randomised trials), exercise (three randomised trials), lifestyle changes (five randomised trials) and metformin (two randomised trials) with standard care in women with risk factors for gestational diabetes mellitus. Dietary intervention was associated with a statistically significantly lower incidence of gestational diabetes (Odds ratio 0.33, 95% CI 0.14 to 0.76) and gestational hypertension (Odds ratio 0.28, 95% CI 0.09, 0.86) compared to standard care. There was no statistically significant difference in the incidence of gestational diabetes mellitus or in the secondary outcomes with exercise, lifestyle changes or metformin use compared to standard care. Conclusions The use of dietary intervention has shown a statistically significantly lower incidence of gestational diabetes mellitus and gestational hypertension compared to standard care in women with risk factors for gestational diabetes mellitus.

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Socio-demographic and modifiable risk factors of diabetes and hypertension among resource constrained patients from rural areas in Mdantsane Township in South Africa

African Health Sciences ◽

10.4314/ahs.v20i3.41 ◽

2020 ◽

Vol 20 (3) ◽

pp. 1344-1354

Author(s):

Lettilia Xhakaza ◽

Zainonesa Abrahams-October ◽

Mohammedmekin Mohammedseid Mohammednur ◽

Brendon Pearce ◽

Oladele Vincent Adeniyi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

South Africa ◽

Rural Areas ◽

Odds Ratio ◽

Salt Intake ◽

Overweight And Obesity ◽

Lifestyle Changes ◽

Modifiable Risk Factors ◽

Life Years

Background: Recently, developing countries have shown a dramatic increase in non-communicable diseases (NCDs). The burden of NCDs in South Africa has increased over the past years resulting in an estimated 37% of all- cause mortality and 16% of disability-adjusted life years. Currently, diabetes mellitus (DM) and hypertension (HTN) are the two most prevalent NCDs associated with the rapid increase in mortality. Objective: To demonstrate the socio-demographic and modifiable risk factors of diabetes mellitus (DM) and hypertension (HTN) among South African adults. Methods: A cross-sectional analytical study was conducted in the Cecilia Makiwane Hospital serving the residents of Mdantsane. Relevant socio-demographic data, anthropometric measurements, triplicate blood pressure, fasting blood glu- cose and lipogram analysis were obtained from 265 outpatients. Results: Multivariate anlysis shows that; salt intake, smoking, elevated triglycerides and decreased high-density lipoprotein levels were significantly associated with DM with adjusted odds ratio of 0.18 (p=0.002), 0.26 (p=0.048), 2.19 (p=0.006) and 0.38 (p=0.001), respectively. Overweight and obesity were significantly associated with hypertension with odds ratio of 0.03 (p=0.01) and 0.06 (p=0.006), respectively. Conclusion: The burden of DM and HTN on society can be drastically reduced with simple lifestyle changes, development of preventative strategies, large-scale screening and better disease management in South Africa. Keywords: Diabetes; hypertension; rural areas; Mdantsane Township; South Africa.

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The factors of risk for endomyometritis development after labor

Journal of obstetrics and women s diseases ◽

10.17816/jowd89015 ◽

1999 ◽

Vol 48 (4) ◽

pp. 46-49

Author(s):

A. F. Kupert ◽

P. V. Solodun ◽

L. A. Kravchuk ◽

M. A. Kupert

Keyword(s):

Risk Factors ◽

Genital Tract ◽

Preventive Measures ◽

Reproductive Age ◽

Lower Section ◽

Leading Role ◽

In Pregnancy

The risk factors for endometritis development after labor was studied. Different factors of risk in research and in comparative groups was present in number on the base scale of a prognosis purulent-septic disease in pregnant and parturiens for comparison of their significance. It is confirmed that the significance of preventive measures, that carry out during pregnancy, results in lowering of the endometritis after labor. Endometritis after labor is determined to develop more frequently in women of early reproductive age. The leading significance of the risk factors connected with delivery was confirmed. The leading role in pregnancy belongs to the focus infection both in the extragenital organs and in lower section genital tract. More the threat interrupting in different periods of pregnancy and combination of two and more extragenital diseases in one woman are of significance risk factors.

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