Deep Infiltrating Endometriosis and Adenomyosis: Implications on Pregnancy and Outcome

Endometriosis (EM), especially deep infiltrating endometriosis (DIE) and adenomyosis (AM), are known to cause pain and sterility in young women. More recently, they have also been described as risk factors for obstetric complications. While the pathophysiology is not yet completely understood, they seem to share a common origin: archimetrosis. Methods: A systematic literature review was conducted to summarize the existing evidence on DIE and AM as risk factors for obstetric complications. Results: Preterm birth, caesarean section delivery (CS) and placental abnormalities are associated with the diagnosis of DIE and AM. Women with AM seem to experience more often hypertensive pregnancy disorders, premature rupture of membranes and their children are born with lower birth weights than in the control groups. However, many of the studies tried to evaluate AM, EM and DIE as separate risk factors. Moreover, often they did not adjust for important confounders such as multiple pregnancies, parity, mode of conception and maternal age. Therefore, prospective studies with larger numbers of cases and appropriate adjustment for confounders are needed to explore the pathophysiology and to prove causality.

Self-error-rejecting multipartite entanglement purification for electron systems assisted by quantum-dot spins in optical microcavities

We present a self-error-rejecting multipartite entanglement purification protocol (MEPP) for N-electron-spin entangled states, resorting to the single-side cavity-spin-coupling system. Our MEPP has a high efficiency containing two steps. One is to obtain high-fidelity N-electron-spin entangled systems with error-heralded parity-check devices (PCDs) in the same parity-mode outcome of three electron-spin pairs, as well as M-electron-spin entangled subsystems (2 ≤ M < N) in the different parity-mode outcomes of those. The other is to regain the N-electron-spin entangled systems from M-electron-spin entangled states utilizing entanglement link. Moreover, the quantum circuits of PCDs make our MEPP works faithfully, due to the practical photon-scattering deviations from the finite side leakage of the microcavity, and the limited coupling between a quantum dot and a cavity mode, converted into a failed detection in a heralded way.

Climatic niche differences among Zootoca vivipara clades with different parity modes: implications for the evolution and maintenance of viviparity

Parity mode (oviparity/viviparity) importantly affects the ecology, morphology, physiology, biogeography and evolution of organisms. The main hypotheses explaining the evolution and maintenance of viviparity are based on bioclimatic predictions and also state that the benefits of viviparity arise during the reproductive period. We identify the main climatic variables discriminating between viviparous and oviparous Eurasian common lizard (Zootoca vivipara) occurrence records during the reproductive period and over the entire year.Analyses based on the climates during the reproductive period show that viviparous clades inhabit sites with less variable temperature and precipitation. On the contrary, analyses based on the annual climates show that viviparous clades inhabit sites with more variable temperatures.Results from models using climates during reproduction are in line with the “selfish-mother hypothesis”, which can explain the success of viviparity, the maintenance of the two reproductive modes, and why viviparous individuals cannot colonize sites inhabited by oviparous ones (and vice versa). They suggest that during the reproductive period viviparity has an adaptive advantage over oviparity in less risky habitats thanks to the selfish behaviour of the mothers. Moreover, the results from both analyses stress that hypotheses about the evolution and maintenance of viviparity need to be tested during the reproductive period.

Maternal and perinatal outcome in Rh-Negative women

Aim: To find out the Maternal and perinatal outcomes in Rh-Negative mothers. Methods: This is a cross sectional study of all Rhesus negative mothers giving childbirth at Department of Obstetrics and Gynecology, Nobel Medical Col- lege Teaching Hospital from March 2020 to February 2021. Maternal variables like age, parity, mode of delivery, and complications were recorded. Fetal vari- ables like period of gestation, fetal outcomes, hemoglobin, indirect bilirubin, fetal weight were noted. Results: There were 108 cases of Rh negative pregnancy and 95 of them deliv- ered Rh positive fetuses. Prevalence of Rh negative pregnancy was 1.68%. Half of them (51; 53.6%) underwent caesarean section due to obstetric indications with 20 repeat cesarean sections and 9 (17.7%) cases for fetal distress. Gross perinatal death was 9; none of the patients received antepartum im- munoprophylaxis; and 86 received postpartum Anti-D Rh IgG. There was only one case of proven isoimmunisation presented as hydrops fetalis in a grand multiparous woman with positive Indirect Coomb Test; and two newborn re- ceived exchanged transfusion. Conclusion: Rhesus negative rate was 1.68% and proven isoimmunization rate was 1%.

Facultative oviparity in a viviparous skink ( Saiphos equalis )

Facultative changes in parity mode (oviparity to viviparity and vice versa) are rare in vertebrates, yet offer fascinating opportunities to investigate the role of reproductive lability in parity mode evolution. Here, we report apparent facultative oviparity by a viviparous female of the bimodally reproductive skink Saiphos equalis —the first report of different parity modes within a vertebrate clutch. Eggs oviposited facultatively possess shell characteristics of both viviparous and oviparous S. equalis , demonstrating that egg coverings for viviparous embryos are produced by the same machinery as those for oviparous individuals. Since selection may act in either direction when viviparity has evolved recently, squamate reproductive lability may confer a selective advantage. We suggest that facultative oviparity is a viable reproductive strategy for S. equalis and that squamate reproductive lability is more evolutionarily significant than previously acknowledged.

Genomic and transcriptomic investigations of the evolutionary transition from oviparity to viviparity

Viviparous (live-bearing) vertebrates have evolved repeatedly within otherwise oviparous (egg-laying) clades. Over two-thirds of these changes in vertebrate reproductive parity mode happened in squamate reptiles, where the transition has happened between 98 and 129 times. The transition from oviparity to viviparity requires numerous physiological, morphological, and immunological changes to the female reproductive tract, including eggshell reduction, delayed oviposition, placental development for supply of water and nutrition to the embryo by the mother, enhanced gas exchange, and suppression of maternal immune rejection of the embryo. We performed genomic and transcriptomic analyses of a closely related oviparous–viviparous pair of lizards (Phrynocephalus przewalskii and Phrynocephalus vlangalii) to examine these transitions. Expression patterns of maternal oviduct through reproductive development of the egg and embryo differ markedly between the two species. We found changes in expression patterns of appropriate genes that account for each of the major aspects of the oviparity to viviparity transition. In addition, we compared the gene sequences in transcriptomes of four oviparous–viviparous pairs of lizards in different genera (Phrynocephalus, Eremias, Scincella, and Sphenomorphus) to look for possible gene convergence at the sequence level. We discovered low levels of convergence in both amino acid replacement and evolutionary rate shift. This suggests that most of the changes that produce the oviparity–viviparity transition are changes in gene expression, so occasional reversals to oviparity from viviparity may not be as difficult to achieve as has been previously suggested.

Awareness, attitude and preference of long-acting reversible contraceptives by Tanta University contraceptive clinic attendants

Background: Long Acting Reversible Contraceptives (LARC) had a very high efficacy in lowering unintended pregnancies and their poor health sequalae. Although their reported efficacy, these methods are not widely used among patient’s due to non-awareness and faulty concepts linked to these methods.Methods: This cross-sectional study was conducted to determine the degree of awareness, attitude and preference of LARC by attendants of Tanta University contraceptive clinic in the period from January 1, 2016 to December 31, 2016. All patients were counseled with thorough discussion about LARC methods. The following issues were determined: age, parity, mode of previous delivery, residence, medical diseases, socioeconomic state of family, type of LARC method used, how she know about this method and why she preferred that type.Results: 391 women underwent this study with age range of 21-46 years, and BMI range of 20.46-31.87. LARC were preferred by 72.38% of patients and mainly IUDS (52.94%) while other LARC methods were of very low awareness. Most patients take their knowledge from paramedical staffs (49.87%). Occupation, education, residence and religion were not affecting patients' attitude and preference of one LARC over the other methods. Age was the most effective factor for determining whether to use LARC or not. Counseling revert a lot of faulty concepts and misbelieves about LARC.Conclusions: LARC were not widespread among Tanta University attendants for contraception except for IUDs. Young patients had no motivations towards LARC due to a lot of faulty concepts that need a lot of work to be eradicated.

The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

Background: Neonatal hypoglycemia is a common metabolic problem especially in cases like prematurity, sepsis and small gestational age. Episodes of asymptomatic hypoglycemia may occur due to many risk factors. The present study aimed to evaluate the incidence of asymptomatic hypoglycemia in term new born babies weighing more than 2 kg, to study the plasma sugar level at various time points during first 48 hours of life and to study the effect of maternal factors like parity, mode of delivery, glucose infusion during labour, and time since last feed on plasma sugar level.Methods: A hospital based longitudinal study was conducted over a period of one year from April 2005 to March 2006 in Kilpauk Medical College Hospital, Chennai. 400 babies born of consecutive deliveries were included in the study. Their plasma glucose levels were assessed in cord blood, 3 hr, 12 hr and 36 hr of life. Plasma glucose levels were analysed with regards to distribution, variables like parity, mode of delivery, dextrose infusion during labour and time since last feed. The plasma glucose levels were statistically analysed by paired student ‘t’ test, multiple analysis of variance (ANOVA), chi- square test using SPSS (version 7.5) statistical package.Results: The overall incidence of hypoglycemia was seen in 20% of the neonate’s in which 29.7% in small gestational age (SGA) and 16.7% in appropriate gestational age (AGA) babies. A significant (p <0.01) association between hypoglycemia and birth weight was observed. The association between hypoglycemia with parity, mode of delivery, sex of the baby and glucose infusion received by the mother was studied, but no significant association was found. A significant difference in plasma glucose based on birth weight at 3rd hour, 12th hour and 36th hour was observed (p <0.05). None of the infants showed any clinical signs of hypoglycemia.Conclusions: The incidence of hypoglycemia was noted in 20% of the neonates. Low birth weight was considered as risk factor. A significant association was also observed between plasma glucose, mode of delivery and time since last fed.

Puerperal Morbidities After Delivery in a Tertiary Care Referral Hospital of Nepal

Introduction: : In a developing country like Nepal maternal morbidity in the post partum period is a major healthcare concern. This study aims to analyze the maternal morbidities in women following delivery at Shree Birendra Hospital.Methods: This is a prospective, observational, hospital based study, carried out at Shree Birendra Hospital from 13th August 2012 to 13th Feb 2016. Women who underwent delivery in Shree Birendra Hospital with subsequent morbidities within the study period were included in this study. The variables considered in this study were pattern of postpartum morbidities, age, parity, mode of delivery and average duration of hospital stay.Results: During the study period, a total number of 3407 deliveries were conducted in Shree Birendra Army Hospital. Out of these, 54 patients (1.58%) had postpartum morbidities. Puerperal sepsis was the most frequent diagnosis seen in 18 patients (33.3%), followed by surgical wound infection in 14 (25.9%) and secondary postpartum hemorrhage (PPH) in 10 (18.5%).Conclusion: Puerperal sepsis remains the most common cause of postpartum morbidity.