scholarly journals Do Large Uterine Fibroids Impact Pregnancy Outcomes?

2021 ◽  
Vol 36 (4) ◽  
pp. e292-e292
Author(s):  
Ruqaiya Al Sulaimani ◽  
Lovina Machado ◽  
Munira Al Salmi
Keyword(s):  
Preterm Delivery ◽  
Postpartum Hemorrhage ◽  
Uterine Fibroids ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
History Of ◽  
The Mean ◽  
Cesarean Myomectomy

Objectives: We sought to assess the prevalence of fibroids complicating pregnancy among Omani women who delivered and were followed-up at Sultan Qaboos University Hospital (SQUH) and correlate the presence of large fibroids (> 5 cm) with maternal and neonatal outcomes. Methods: This retrospective cohort study was conducted at the Department of Obstetrics and Gynecology, SQUH, from 1 January 2011 to 31 December 2016. Demographic data included maternal age, gravidity, parity, body mass index (BMI), and history of preterm delivery. Ultrasonographic data included the total number of fibroids, number of fibroids > 5 cm in diameter, and location. The main outcomes measured were preterm delivery, preterm premature rupture of membranes (PPROM), malpresentation, intrauterine growth restriction (IUGR), mode of delivery, postpartum hemorrhage, retained placenta, and cesarean myomectomy. Fetal outcomes included birth weight and Apgar score. We used the chi-square test and t-test to calculate significant outcomes. Results: The total number of deliveries over the study period was 24 800. Among these, 62 women had fibroids complicating pregnancy, giving an overall prevalence of 0.3%. Of the 62 women with documented uterine fibroids, 41 had fibroids > 5 cm in diameter and formed the study group, while the control group included 88 women with no fibroids and normal singleton pregnancies. The mean age, parity, BMI, and history of preterm delivery were comparable. The mean age of the study group was 32.6 years. There was no statistically significant difference in obstetric outcomes between the study and control group in terms of preterm labor (p =0.381), PPROM (p =0.536), malpresentation (p =0.237), IUGR (p =0.059), and retained placenta (p =0.296). Postpartum hemorrhage was significantly higher in the study group (p =0.018), the commonest cause was uterine atony (p =0.007). Women with large fibroids had a significantly increased cesarean section rate (p =0.002), the main indications were obstructed labor and failure to progress (62.5%). Five of the 44 women in the study group (12.8%) underwent cesarean myomectomy. Regarding neonatal outcomes, a statistically significant difference was noted in the Apgar scores. Conclusions: Fibroids measuring > 5 cm in diameter are more likely to cause obstetric complications and are associated with higher cesarean rates. Pre-conception myomectomy is recommended for women with large fibroids.

scholarly journals AB0814 PREGNANCY COURSE ASSESSMENT IN PATIENTS WITH RHEUMATIC DISEASES COMPARED TO CONTROLS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1431.2-1432
Author(s):  
O. Hamdi ◽  
M. Sellami ◽  
M. Yasmine ◽  
A. Fazaa ◽  
S. Miladi ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Rheumatic Diseases ◽  
Premature Delivery ◽  
Control Group ◽  
Study Group ◽  
Childbearing Age ◽  
Significant Difference ◽  
History Of ◽  
The Mean ◽  
The Impact

Background:Rheumatic diseases such as rheumatoid arthritis (RA) and spondyloarthritis (SA) may occur among women of childbearing age. Adverse events during pregnancy including disease flare, preterm delivery, and neonatal or fetal death have been reported.Objectives:Our aim was to assess the impact of rheumatic diseases on the course of pregnancy.Methods:We conducted a cross-sectional study involving patients with RA (2010 ACR/EULAR criteria) and SA (2009 ASAS criteria) (study group) as well as healthy controls (control group) matched by age and gender. All women included had at least one pregnancy. Data were collected through telephonic interviews. We used the Student t test to compare the study group and the control group.Results:We enrolled 57 patients (30 RA and 27 SA) and 57 controls. The mean age in the study and the control groups were respectively 43.2 ± 8.2 years [26-48] and 37.5 ± 6 years. The mean chronic inflammatory rheumatisms duration was 13.81 ± 6.2 years. A history of primary sterility was found in 3 patients (1 RA and 2 SA) and none in the control group. The mean age during the first pregnancy was significantly higher in the study group (28 ± 6.2 years versus 24 ± 7 years in the control group) (p=0.01). Eight patients (5 RA and 3 SA) had a history of spontaneous miscarriage. A terminated pregnancy was noted in 3 patients (1 RA and 2 SA). Complications during pregnancy in the study group were gestational diabetes (0.3%), premature delivery (0.3), premature rupture of membranes (0.3%), abortion threat (0.3%) and pre-eclampsia (6%). Pregnancy was more associated with complications in the study group (p=0.05). Cesarean section was more used in the study group (28 patients versus 9 in the control group; p= 0.00). The main indications of cesarean section in the study group were macrosomia (11 patients), scar uterus (6 patients), sacroiliitis (4 SA patients), twin pregnancy (2 patients), and undetermined reasons (6 patients). Fetal presentation in the study group was the seat presentation (3%), top presentation (4%), face (2%), and forehead presentation (0.3%) with no significant difference with the control group. Complications of childbirth in the study group were hemorrhage of delivery (10.3%), cord widening (6.6%), perinatal asphyxia (4.9%), and dystocia (1.9%). However, no statistically significant differences were found between the two groups in the prevalence of complications of childbirth. During pregnancy, 5 patients were on salazopyrine, 2 on corticosteroids and, 1 on non-steroidal anti-inflammatories.Conclusion:Our study showed that pregnancies with rheumatic diseases were at increased risk of having maternal complications and adverse neonatal outcomes.Disclosure of Interests:None declared

Effectiveness of neurobic exercise program on memory and depression among elderly residing at old age home

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Divya Raj ◽  
Subramaniam Santhi ◽  
G. J. Sara Sapharina
Keyword(s):  
Old Age ◽  
Depression Scale ◽  
Exercise Program ◽  
The Elderly ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
The Mean ◽  
Interventional Group ◽  
Old Age Homes

AbstractObjectivesThis study finds out the effectiveness of neurobic exercise program on memory and depression among elderly residing in old age homes.MethodsThe non-probability purposive sampling technique was used for sample selection. Wechsler's memory scale (WMS-IV) and Geriatric depression scale (GDS) were the instruments used to assess the memory and depression among elderly during the pretest and posttest, respectively and the researcher had developed data sheet to collect information about the background variables using interview technique.ResultsThe neurobic exercise program was found to be effective in reducing depression among elderly residing in old age homes. There was a significant difference (p<0.001) in the level of depression had been found during the pretest and posttest in the interventional group. There was a statistically significant difference (p<0.001) found between the study group and in the control group. There was significant correlation (r=0.417, p<0.05) found between the memory and depression during the pretest in the study group among the elderly. A statistically significant association (p<0.05) found in the mean scores of depression and marital status of the elderly during the pretest in the study group and there was a significant association (p<0.01) found in the mean scores of depression and the gender of the elderly during the pretest and posttest in the non interventional group were found.ConclusionsThe findings suggested that neurobic exercise program is an effective intervention in improving memory and reducing depression.

Investigation the Effects of Adding Intravenous Transoxalic Acid and Its Complications in the Prevention of Postpartum Hemorrhage after Vaginal Delivery in Patients Admitted to Ali-ibn-Abitaleb Hospital in Zahedan

2021 ◽  
Author(s):  
Tahereh Hajian ◽  
Maryam Razavi ◽  
Ali Dashipour
Keyword(s):  
Side Effects ◽  
Postpartum Hemorrhage ◽  
Intervention Group ◽  
Vital Signs ◽  
Control Group ◽  
Drug Side Effects ◽  
Blood Samples ◽  
Significant Difference ◽  
The Mean ◽  
Uterine Fundus

Background: This study was designed to investigate the effect of tranexamic acid and its side effects in preventing postpartum hemorrhage in patients referred to Ali ibn Abitaleb Hospital in Zahedan during 2020-2021. Methods: Patients were divided into two groups of 85 patients. Vital signs as well as drug side effects related to tranexamicity are monitored and recorded every15 minutes in the first hour and every 30 minutes in the second hour. Also, blood samples are taken from patients to measure hemoglobin and hematocrit within6 hours after delivery. The number and weight difference of droschitis used during 2 hours after delivery are also measured. In addition, PPH (Postpartum hemorrhage) cases in both groups were checked by repeated examination of the uterine fundus during the first 2 hours and after 6 weeks. Results: There was no statistically significant difference between the two groups in terms of the number of deliveries and further decrease in hemoglobin levels in the control group compared to the intervention group. Nausea, vomiting, and dizziness were observed in the intervention group and thrombosis was not observed in any group. According to the independent samples t-test, there was a statistically significant difference between the mean blood volume lost between the two groups. The mean hematocrit drop was statistically significant between the two groups. No blood transfusion was observed in any of the patients. Conclusion: Tranxamic acid injections can effectively reduce postpartum hemorrhage and reduce maternal hemoglobin and hematocrit following this complication.

scholarly journals Effect of Foetal Movement Counting on Prenatal Attachment and Maternal Worries among Primigravidas- A Longitudinal Study

2021 ◽  
Author(s):  
Jignya Vinodbhai Asari ◽  
Anjali Pushkar Tiwari
Keyword(s):  
Longitudinal Study ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Prenatal Attachment ◽  
Study Results ◽  
Significant Difference ◽  
The Mean ◽  
Foetal Movement ◽  
And Control

Introduction: Pregnant woman experience various physical, emotional, and hormonal changes that may cause anxiety. The anxiety and worries can be decreased by sharing information about the developing child, like foetal body movement. Aim: To assess effect of Foetal Movement Counting (FMC) on prenatal attachment and maternal worries among primigravida mothers. Materials and Methods: A longitudinal study was carried out among primigravida mothers of selected Hospitals of Central Gujarat using proforma of Cranley’s maternal foetal attachment scale and Cambridge worry scale. The study was conducted from March 2019 to July 2020. Eighty participants were recruited by convenient sampling 40 in each study group and control group. The study group were provided with foetal movement chart and the participants were asked to record foetal movements for seven consecutive days, twice a day for 20 minutes. Post assessment of prenatal attachment and maternal worries was done using tools of data collection for both study and control group. Chi- square test was used to test the significance (p-value <0.05). Results: The study results revealed that in study group mean score for prenatal attachment was 79.43 at the start and improved to 101.25 (p-value <0.001) after seven days of FMC. In control group, the mean score for prenatal attachment did not show significant difference pre-test and post-test (74.20 vs 74.85, p-value=0.077). In study group, the mean Cambridge worry scale score was 36.55 which came down to 20.28 (p-value <0.001) after seven days, while in control group it was 41.38 at the beginning and 41.30 after seven days (p-value=0.998). Conclusion: Foetal Movement Counting was found to improve maternal foetal attachment and reduce maternal worries. FMC can be routinely and effectively promoted among the pregnant population to help them achieve a positive pregnancy experience and outcome.

scholarly journals Outcome of using a modified surgical technique for the repair of complex vesicovaginal fistulas in Nigeria

2017 ◽  
Vol 30 (1) ◽  
Author(s):  
Aniefiok J. Umoiyoho ◽  
Emmanuel C. Inyang-Etoh
Keyword(s):  
Obstetric Fistula ◽  
Conventional Technique ◽  
Control Group ◽  
Study Group ◽  
Success Rates ◽  
Modified Technique ◽  
Repair Technique ◽  
Significant Difference ◽  
The Mean ◽  
Repair Techniques

The relatively low effectiveness of available surgical repair techniques for complex obstetric fistula has justified the need for continued exploration of more effective repair techniques. Subjects who presented at a vesicovaginal fistula referral centre in Nigeria were randomized into the study group (modified technique) and the control group (conventional technique). Success rates between the two groups were compared. The study comprised 29 patients in each arm of the study. The mean age of patients in the study group was 23.9 ± 9.6 years and 24.4 ± 2.1 years among patients in the control group with the vast majority of the patients in the both groups being married, 75.9% and 86.2% respectively. In both groups, the majority were secundipara, 55.2% in the study group and 44.8% in the control group. The majority (41.4% in the study group and 44.8% in the control group) of the patients in both groups had attained primary level of education. The mean duration of the fistulas among patients in the study population was 1.1 ± 0.3 years with over half (50.0% among patients in the study group and 53.5% of patients in the control group) of the patients had their fistula for less than one year. A highly statistically significant difference in success rate between patients in the study group and patients in the control group was obtained (p=0.0004). The modified repair technique presented by this study has proved to produce superior results when compared to the conventional repair technique in the management of complex obstetric fistulas in Nigeria.

Impact of Whatsapp in improving learning among 9th semester MBBS students

2021 ◽  
Vol 19 (1) ◽  
pp. 27-30
Author(s):  
Y Satish Reddy ◽  
Keyword(s):  
Undergraduate Students ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Opinion Poll ◽  
Didactic Teaching ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
The Impact

Background: Interactive Teaching learning can be used in clinical subjects like surgery for better participation of students as one-way didactic lectures do not involve active participation of students. WhatsApp is one of the most famous messaging services which everyone use and it is easy, cheaper, and faster. Objective: the purpose of the study was to study the impact of whatsapp in improving learning in general surgery among 9th semester medical students. Methods: This study was conducted among 9th semester MBBS students in Surgery department. Students were divided into group a (study group) and group b(control group) by a simple random sampling. Gastric cancer was discussed among students of both Groups through didactic teaching. after didactic teaching, only Group A students were exposed to social media type of learning, i.e., using WhatsApp, after the session a multiple-choice questionnaire having 10 MCQs was given to both groups and an additional poll was conducted among the Study-group students to assess their perception towards Whatsapp intervention. the mean score obtained by both the groups were compared with unpaired t test. P-value <0.05 is taken as statistically significant. Results: The mean (SD) score of the Study-group was 8.58(1.18) and the mean (SD) score of the Control-group was 5.41(1.32) and statistically significant difference was found between the two groups scores with a p-value less than 0.05 opinion poll found that the intervention of whatsapp among study group was effective. Conclusion: we observed that the usage of WhatsApp in addition to the didactic teaching was found advantageous and enhanced learning in undergraduate students

scholarly journals The effect of the progressive muscle relaxation combined withs lavender aromatherapy on insomnia of hemodialysis patients

2021 ◽  
Vol 24 (1) ◽  
pp. 39-46
Author(s):  
Ida Rosdiana ◽  
Yanti Cahyati
Keyword(s):  
Muscle Relaxation ◽  
Sampling Technique ◽  
Routine Care ◽  
Hemodialysis Patients ◽  
Progressive Muscle Relaxation ◽  
Control Group ◽  
Daily Routine ◽  
Study Group ◽  
Significant Difference ◽  
The Mean

disorder in hemodialysis patients, which will cause a decrease in quality of life. Aromatherapy combined with progressive muscle relaxation are expected to increase the effects of relaxation on the patient so that the patient's sleep quality can improve optimally.Objective: The study aimed to investigate the effect of the progressive muscle relaxation combined with lavender aromatherapy on insomnia among patients undergoing hemodialysis. Material and Methods: The design of this study included a quasi-experiment with a pretest-posttest control group approach. The sample selection was performed using a consecutive sampling technique and involved 50 respondents, divided into two equal control and study group. Patients in study group recommended to do progressive muscle relaxation at least four times per week for three weeks and were told to drop two – three drops lavender aromatherapy on a pillow 30 minutes before bedtime at least 4 nights per week for three weeks. The control group recommended to do muscle relaxation and daily routine care at least four times per week for three weeks. Results: The results showed that both study and control groups were equal in terms of demographics, and scores of insomnia at the baseline. There no significant difference between the mean insomnia scores of two group before intervention, while the difference was statistically significant after the intervention. The mean insomnia scores were lower in study group than in the control group.Conclusion: Progressive muscle relaxation and lavender aromatherapy were effective in decreasing insomnia scores among patients undergoing hemodialysis.

scholarly journals Association of gestational age, Apgar score and neonatal outcomes in newborns with meconium stained amniotic fluid

2019 ◽  
Vol 6 (4) ◽  
pp. 1563
Author(s):  
Preeti Garg ◽  
Devendra Barua ◽  
Shruti Saxena
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Apgar Score ◽  
Tertiary Care ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Study Group ◽  
Increased Risk ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: Infants born with meconium stained fluid are at increased risk of fetal hypoxia, evidenced by increased rates of abnormalities indicated by fetal monitoring in labor, low neonatal Apgar scores, and fetal deaths. The study is conducted to determine association of gestational age, Apgar score and neonatal outcomes in newborn born with meconium stained amniotic fluid in tertiary care centre of central India.Methods: The study was conducted over a period of 2 years from January 2012 to January 2014 in Department of Pediatrics, Sri Aurobindo Medical College and Hospital, Indore, Madhya Pradesh, India. One hundred newborns with meconium stained amniotic fluid (study group) and one hundred newborns with clear amniotic fluids (control group) were studied in this period. Gestational age, Apgar score and neonatal outcomes were compared among two groups.Results: The mean gestational age in study group was 38.89±1.14 weeks and in control group was 38.59±0.99 weeks. The mean Apgar score at 1 min was 5.80±1.59 in study group and in the control group was 7.86±0.35. 32 babies in meconium stained liquor had hypoxia of which 11 had respiratory distress, 11 required mechanical ventilation (MAS 08, sepsis 03), 2 newborns had HIE stage 2 and 5 patients died. The above findings suggest higher gestational age, lower Apgar score and poor neonatal outcomes are associated with meconium stained liquor.Conclusions: The study depicts significant co-relation with higher gestational age, lower Apgar at 1 and 5 minutes and poor neonatal outcome in babies with meconium stained amniotic fluid.

P-746 Obstetric outcomes of singleton birth after hysteroscopic division of septate uterus

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
O Abuzeid ◽  
C Heiselman ◽  
A Fuchs ◽  
J La Chance ◽  
K Herrera ◽  
...  
Keyword(s):  
Lower Incidence ◽  
Surgical Correction ◽  
Obstetric Outcomes ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Septate Uterus ◽  
Significant Difference ◽  
Singleton Birth ◽  
History Of

Abstract Study question The aim of this study is to determine the obstetric outcomes in patients with a singleton birth after hysteroscopic division of septate uterus. Summary answer The data suggest excellent obstetric outcomes for singleton gestation after hysteroscopic division of a septate uterus reaching either the internal or the external cervical os. What is known already Septate uterus is a rare Müllerian anomaly with major impact on reproductive outcomes, particularly with a septum over 10mm. Controversy still exists over the need for surgical correction of the septum due to conflicting data on outcomes, particularly in women with histories of good obstetric outcomes and incidental septum findings. Placental location in relation to the septum may account for such conflicting reports. Most data on reproductive outcomes after hysteroscopic surgical correction combine both septate and subseptate uteri. There is limited published data on obstetric outcomes after hysteroscopic surgical correction of septate uteri, especially septate uteri reaching the external os. Study design, size, duration This retrospective cohort study included 107 patients with infertility and/or recurrent pregnancy loss (RPL) who received treatment between 2002 -2019. The study group included 24 patients with a singleton birth after hysteroscopic correction of septate uterus (Class Va; ASRM classification) that was diagnosed on trans-vaginal 3D ultrasound. The control group included 83 patients with a singleton birth who had normal endometrial cavity on hysteroscopy during the same period of time, before starting treatment. Participants/materials, setting, methods This study was conducted at an infertility clinic affiliated with a teaching hospital. In the study group the septum reached the internal or the external cervical os in 14 and 10 patients respectively. After hysteroscopic correction, all patients were offered various infertility treatments depending on the underlying etiology. The inclusion criterion in this study was to have a singleton birth after hysteroscopy. Demographic and clinical data and obstetric outcomes were compared between the two groups. Main results and the role of chance There was no significant difference in mean age, infertility duration, infertility type and incidence of male infertility or ovulatory disorders between the two groups. There was a significantly higher BMI (0.048), and a higher incidence of history of miscarriage (P=0.002) and history of RPL (P=0.017) in the study group. There was significant lower incidence of tubal factors infertility (P=0.005) and endometriosis (P=0.03) in the study group, therefore there was higher incidence of spontaneous conception (70.8% vs 19.3%; P=0.000) and lower incidence of conception with IVF-ET (20.8% vs 66.3%; P=0.000) in the study group compared to the control group respectively. There was significantly higher incidence of prophylactic cervical cerclage (17.4% vs 0%; P=0.000), and delivery by CS (69.6% vs 41.2%; P=0.019) and lower incidence of vaginal delivery (30.4% vs 58.8%; P=0.019), in the study group compared to the control group. There was no significant difference in gestational age in weeks (38.3 + 1.8 vs 38.6 + 2.0), newborn birth weight in grams (3173.9 + 630.0 vs 3202.1 + 555.6), incidence of premature birth (12.5% vs 12.2%), or other obstetric complications (25% vs 17.6%) between the study and the control groups respectively. For premature births, mean gestational age was 34.3 + 0.47 and 34.6 + 1.2 weeks in the study and control groups respectively. Limitations, reasons for caution A retrospective study has its own inherent bias. Furthermore, the small sample size is explained by the fact that a septate uterus is a rare anomaly leading to difficulties finding cases and organizing a prospective study to achieve a larger sample size. A multicenter prospective study is needed. Wider implications of the findings Regardless of whether the septum reached the internal or external os, there were excellent obstetric outcomes in singleton gestations after hysteroscopic correction of septate uteri. There was no increased risk with septate uteri involving the cervix. Hysteroscopic surgical correction should be the treatment of choice for patients with septate uteri. Trial registration number Not Applicable

The effects of plasma viscosity in thromboembolic events among patients with essential thrombocytosis: A case-control study

2021 ◽  
pp. 1-8
Author(s):  
Tekin Güney ◽  
Ferda Can ◽  
Afra Alkan ◽  
Sema Akıncı ◽  
İmdat Dilek
Keyword(s):  
Myeloproliferative Neoplasms ◽  
Philadelphia Chromosome ◽  
Plasma Viscosity ◽  
World Health ◽  
Control Group ◽  
Study Group ◽  
Thromboembolic Events ◽  
History Of ◽  
Patient Groups ◽  
The Mean

INTRODUCTION: Essential thrombocythemia (ET) is an entity of classic Philadelphia chromosome-negative myeloproliferative neoplasms (MPNs), characterized by thrombocytosis with megakaryocytic hyperplasia where in the thrombocytes are increased with abnormal function. Thrombotic events are seen frequently and represent the main cause of morbidity and mortalityin patients with MPNs, mainly polycythemia vera and ET. This study has aimed to research the effects of clonally increased thrombocytes on plasma viscosity (PV) levels among patients with ET and the relationship between PV and thromboembolism history, according to the hypotheses about the effects of PV in thromboembolic events among patients with ET. METHODS: A total of 55 patients were enrolled in the study group, 18 of who had been newly diagnosed with ET according to 2016 World Health Organization criteria and had not previously been treated. 37 of them had already been diagnosed with ET and had been treated. There were 47 healthy volunteers in the control group. 5 cc blood samples were taken from the patients into tubes including an anticoagulant to measure their PV levels. RESULTS: PV of the control group was found to be lower than in the study group and both each patient groups (p <  0.05). No relationship was found between the patient groups in terms of PV (p = 0.404). The mean PV levels of the 16 patients with a history of thromboembolism and the 39 patients with no such history were 2.42±0.17 cP and 2.33±0.20 cP, respectively. The mean PV levels were found to be similar according to their history of thromboembolism in all patient groups and in treated patients (p = 0.572 vs p = 0.991). CONCLUSION: We have found that PV levels were increased in clonally increased thrombocytes in patients with ET when compared with the control group. This is the first study in this field according to our knowledge.

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