Hasil untuk "Gynecology and obstetrics"

A. Viswanathan, B. Thomadsen

Aleksandra Korzeniewska-Eksterowicz, Hanna Moczulska, Mariusz Grzesiak et al.

Abstract Background The parents with a diagnosis of life-limiting fetal condition should receive medical information about the nature of defect, prognosis, possibilities of care and obstetric complications and receive psychological, spiritual, legal support. In our model of care, the perinatal hospice - functioning outside the hospital structure - offers a multidisciplinary support and coordinates care in close cooperation with hospitals. The aims of study are: analysis of the birth outcome in patients with life-limiting fetal conditions, perinatal palliative care model evaluation and analysis of factors affecting earlier contact of patients with perinatal hospice. Methods We conducted retrospective reviews of medical records of perinatal hospice patients in 2014–2020. The study population was divided into two groups. Group 1 comprised deliveries which ended with the birth of a living newborn; Group 2: pregnancies with intrauterine fetal death and death during delivery. Separately, we analysed patients who underwent cesarean birth. Results Out of 72 families, 68 decided to continue pregnancy. The most common diagnoses were trisomies 18 and 13. In 47 cases, deliveries resulted in a live-born newborn; in 21 pregnancies, fetal death occurred. Nineteen pregnancies were delivered via cesarean on obstetric indications. The time interval from diagnosis to first palliative consultation was, on average, 48 days in group 1 vs. 33 in group 2. Women with stillbirths contacted the hospice at an earlier stage of pregnancy (p = 0.0469), and multidisciplinary team consultation in the hospital took place earlier (p = 0.0045) and in a shorter time interval from the first consultation in hospice (p = 0.0298). Patients who were older and lived in large cities contacted hospice earlier. Conclusion System solutions should be considered, obliging the physician to refer the pregnant woman to a perinatal palliative care program. Shortening the interval between diagnosis and palliative care consultation would allow for more effective professional support and more time to prepare the parents for losing a child.

Akbar Ibrahimov

Abstract Objective To evaluate the technical feasibility of isolating fetal trophoblasts and detecting fetal chromosomal anomalies (trisomy 21 and XY chromosomes) using cervical smear samples obtained during routine prenatal care, and to explore the potential of this approach as a preliminary step towards a cost-effective alternative to current non-invasive prenatal testing methods. Study design Prospective cohort study with fluorescence in situ hybridization (FISH) analysis of cervical smear samples for chromosomal screening. Place and duration Department of Obstetrics and Gynecology, Caspian International Hospital, Azerbaijan, conducted in 2024. Methods Fifty pregnant women between 5 and 15 gestational weeks underwent cervical smear collection via cytobrush during routine prenatal visits. Samples were processed for the isolation of extravillous trophoblasts (EVTs). Successful isolation of EVTs was confirmed by morphological assessment and the presence of HLA-G markers. Samples were then analyzed using FISH methodology with probes specific for chromosomes 21, X, and Y. Ultrasound confirmation of fetal sex and nuchal translucency measurements was performed for initial correlation (Interim Correlation Standard). Automated scanning systems and manual verification were employed for accurate chromosomal analysis. Results Extravillous trophoblasts were successfully isolated in all 50 samples (100% success rate (95% CI: 92.9%-100%)). XY chromosomes were detected in 17 cases (34%), with ultrasound confirming male sex in 6 of 7 eligible cases (85.7% concordance). XX chromosomes were identified in 33 cases (66%), with ultrasound confirming female sex in 12 of 14 cases (85.7% concordance). No trisomy 21 cases were detected in this cohort, precluding the calculation of sensitivity for Trisomy 21 detection. One case presented with nuchal translucency ≥ 3 mm and was referred for amniocentesis, with subsequent normal karyotype confirmed by amniocentesis. FISH analysis demonstrated 100% specificity for chromosomal detection with no false-positive results for the sex chromosomes when correlated with the interim ultrasound standard. Conclusion Cervical smear-based FISH analysis represents a promising non-invasive, cost-effective approach for early fetal chromosomal screening that leverages existing clinical infrastructure. While demonstrating excellent specificity for sex chromosome determination, and technical feasibility of EVT isolation, the absence of Trisomy 21 cases in this pilot cohort limits the assessment of sensitivity for aneuploidy detection. A key limitation of this feasibility study is the use of ultrasound as an interim standard for sex determination; we lacked definitive postnatal follow-up data. Definitive validation will require a subsequent publication with full newborn follow-up data. Larger multicenter studies with known aneuploidy cases are essential to validate sensitivity for trisomy 21 detection and establish clinical implementation protocols. This methodology offers potential advantages in resource-limited settings and could complement current prenatal screening strategies as a preliminary screening tool.

Kirill Vishniakov, Boulbaba Ben Amor, Engin Tekin et al.

We introduce Gene42, a novel family of Genomic Foundation Models (GFMs) designed to manage context lengths of up to 192,000 base pairs (bp) at a single-nucleotide resolution. Gene42 models utilize a decoder-only (LLaMA-style) architecture with a dense self-attention mechanism. Initially trained on fixed-length sequences of 4,096 bp, our models underwent continuous pretraining to extend the context length to 192,000 bp. This iterative extension allowed for the comprehensive processing of large-scale genomic data and the capture of intricate patterns and dependencies within the human genome. Gene42 is the first dense attention model capable of handling such extensive long context lengths in genomics, challenging state-space models that often rely on convolutional operators among other mechanisms. Our pretrained models exhibit notably low perplexity values and high reconstruction accuracy, highlighting their strong ability to model genomic data. Extensive experiments on various genomic benchmarks have demonstrated state-of-the-art performance across multiple tasks, including biotype classification, regulatory region identification, chromatin profiling prediction, variant pathogenicity prediction, and species classification. The models are publicly available at huggingface.co/inceptionai.

RTH Supraptomo

Angka Kematian Ibu di Indonesia terhitung 305:100.000 kelahiran dan 25% penyebabnya adalah hipertensi. Preeklampsia berat (PEB) adalah kondisi munculnya hipertensi dan proteinuria setelah usia kehamilan 20 minggu. PEB dapat diukur keparahannya dengan hipoalbumin dan dapat menyebabkan hemolisis. Sindrom HELLP merupakan komplikasi dari PEB. Sectio Caesarea Transperitoneal Profunda (SCTP) adalah persalinan buatan di mana janin dilahirkan melalui insisi dinding depan perut di segmen bawah rahim. Indikasi dilakukannya SCTP diantaranya adanya PEB disertai dengan tanda gawat ibu (Sindrom HELLP, tanda impending). Wanita 31 tahun G2P1A0 usia kehamilan 32+4 minggu dengan Preeklampsia Berat Superimposed, HELLP Syndrome hipoksia fetal, riwayat SC 11 tahun lalu, belum dalam persalinan, dengan konjungtivitis sinistra, hipoalbumin (2,8), status fisik ASA IIE direncanakan untuk dilakukan SCTP emergensi. Regional Anesthesia Subarachnoidal Block (RASAB) digunakan pada tindakan SCTP dengan kombinasi levobupivacaine dan fentanyl. Persalinan dengan SCTP menggunakan anestesi regional karena prosesnya cepat, nyaman selama operasi, kualitas analgesia lebih baik pada post operasi, dan fluktuasi hemodinamik lebih stabil. Levobupivacaine memblokade natrium channel neuronal yang mencegah depolarisasi dan bersifat reversibel pada saraf sensorik dan motorik. Kombinasi fentanyl menghasilkan efek blok sensorik lebih lama dengan onset spinal anestesi yang sama. Selain itu, ia juga memperpanjang durasi blok sensorik tanpa memperpanjang durasi blok motorik sehingga nyeri pada pasien dapat berkurang tanpa mengganggu fungsi motoriknya.

H. Shehata, A. Elfituri, S. Doumouchtsis et al.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. Conflicts of interest Ramesh Ganapathy declares a UK patent granted for medical apparatus, unrelated to the present publication. Moshe Hod declares a lecture honorarium from Abbott Pharmaceuticals. All other authors have no conflicts of interest to declare.

C. McCollough, B. Schueler, T. Atwell et al.

R. Beigi, C. Krubiner, D. Jamieson et al.

UPMC Magee-Womens Hospital, Dept Ob/GYN/RS, University of Pittsburgh School of Medicine, United States Center for Global Development, Washington, DC, United States c Johns Hopkins Berman Institute of Bioethics, United States Department of Gynecology & Obstetrics, Emory University School of Medicine, United States Department of Social Medicine and Center for Bioethics, University of North Carolina at Chapel Hill, United States Department of Obstetrics and Gynecology, Duke University School of Medicine, United States Department of Obstetrics and Gynecology, Weill Cornell School of Medicine, United States Center for Immunization Research, Department of International Health, Johns Hopkins Bloomberg School of Public Health, United States

Charles F. Gillespie, B. Bradley, K. Mercer et al.

Y. Dabi, T. Thubert, F. Fuchs et al.

INTRODUCTION The French College of Gynecology and Obstetrics (CNGOF) has created an Ethical Review Board called the CEROG that aim to ensure the research projects are in conformity with the regulation and the laws, as well as to allow their publication in international scientific journals. The aim of this work was to analyze the work of this committee through the application received and to review the ethical procedures required by type of research project. METHODS We conducted a national retrospective study of all applications from 2018 to 2021 received by the CEROG Ethical Review Board. Each application must contain a verification of conformity with the MR004 regulation, a submission form and an information form to the patients involved. At reception, the documents are anonymized and then addressed to the members of one of the two independent sections (Obstetric and Prenatal diagnosis or Gynecology and Assisted Reproductive Therapy). RESULTS Two hundred and sixty applications were received, including 52% in the Gynecology section and 48% in the Obstetrics' section. Only 10% (14/136) and 8% (10/124) were disapproved, respectively. In total, 35% of the applications to the Gynecology section leaded to publications in scientific journals but only 23% did so in the Obstetrics section. Most publications (60.8%) were in low impact factors journals (rank D and E). CONCLUSION The Ethical Review Board CEROG is essential to ensure the conformity of the research projects with French regulations and allow fast publication in international journals.

S. Araji, Ashley Griffin, L. Dixon et al.

Sarah Araji1, Ashley Griffin2, Laura Dixon3,4, Shauna-Kay Spencer1, Charlotte Peavie1, Kedra Wallace1,5* 1Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson, MS, 39216, USA 2Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS, 39216 USA 3Department of Psychology, University of Mississippi, Oxford, MS 38677 USA; 4Department of Dermatology, University of Mississippi Medical Center, Jackson, MS, 39216 USA 5Department of Neurobiology & Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS, 39216 USA

J. Potter, A. Stevenson, K. Coleman-Minahan et al.

d.University of Colorado College of Nursing, 13120 East 19th Avenue, Aurora, CO, 80045 e.Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, 1720 2nd Ave South RPHB 320, Birmingham, AL, 35294 f.Ibis Reproductive Health, 1330 Broadway Suite 1100, Oakland, CA, 94612 g.Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 1330 Broadway Suite 1100, Oakland, CA, 94612

Domenica Lorusso, Domenica Lorusso, Romano Danesi et al.

Monireh Rezaee Moradali, Sepideh Hajian, Hamid Alavimajd et al.

Background & aim: Job satisfaction of midwives plays an important role in the efficiency and performance of health centers and the quality of midwifery services. This study reviewed job satisfaction and its related factors among midwives working in health systems in Iran.Methods: In this systematic review, the databases of Web of Science, Scopus, PubMed, PsycINFO, Embase, Google Scholar and Magiran, were searched between 2000 and 2021 using keywords of midwife, job satisfaction, occupational stress, and Iran. The research steps were based on PRISMA. For quality assessment, the articles were evaluated according to the inclusion criteria by two researchers with the Newcastle-Ottawa scale. Results: A total of 23 articles including 3,352 midwives working in the health and medical centers were reviewed. The level of job satisfaction was moderate, and the job satisfaction of midwives working in hospitals was lower than that of those working in health centers. The highest level of satisfaction was related to the job positions and relationships with colleagues, and the lowest level was in relation to the salary and job benefits. Marital status, age, income, salary, organizational position, education, employment status, interest in the field of education, and workplace had a relationship with increasing job satisfaction. Tensions in the workplace environment was associated with decreasing job satisfaction.Conclusion: It is necessary to provide conditions to improve job satisfaction of midwives in order to identify and removing barriers and improving professional belonging to promote occupational health and optimize the quality of providing midwifery services.

Rei Enokiya, Hidetoshi Sano, Miroslav D. Filipovic et al.

The youngest known Galactic supernova remnant (SNR) G1.9+0.3 has high-velocity supernova shock beyond 10000 km s-1, and it is considered to be one of the major candidates of a PeVatron. Despite these outstanding properties, the surrounding interstellar matter of this object is poorly understood. We investigated the interstellar gas toward G1.9+0.3 using the 12CO(J=3-2) data with the angular resolution of 15" obtained by the CHIMPS2 survey by the James Clerk Maxwell Telescope, and discovered three individual clouds at -1, 7, and 45 km s-1. From its morphological and velocity structures, the -1 km s-1 cloud, having the largest velocity width >20 km s-1 and located at the distance of the Galactic Center, is possibly associated with the SNR. The associated cloud shows a cavity structure both in space and velocity and coincides well with the SNR. We found that the associated cloud has higher column densities toward three bright, radio synchrotron-emitted rims where the radial expansion velocity of the supernova shock is decelerated, and the cloud is faint in the other parts of the SNR. This is the first direct evidence indicating that the highly anisotropic expansion of G1.9+0.3 observed by previous studies results from the deceleration by the interaction between the supernova shock and surrounding dense interstellar medium.

Susanna I. Lee, M. Atri

Imaging plays a central role in the 2018 International Federation of Gynecology and Obstetrics staging system for uterine cervical cancer. The revision calls for a more precise measurement of primary tumor size, best assessed with imaging. Evaluation for abdominopelvic retroperitoneal lymphadenopathy, either with imaging alone or with pathologic analysis, is now also part of staging. Choice of modality depends on the technology available within the practice setting. In high-resource settings, pelvic MRI (to assess tumor size and central pelvic spread) and torso fluorodeoxyglucose PET/CT (to assess lymphadenopathy and distant metastases) are used to assign stage and to plan therapy. In lower-resource settings, analogous modalities are pelvic US and chest radiography. Although imaging is already a part of pretreatment planning in some high-resource settings, its incorporation into assigning stage is a new development.

A. Mariani, M. J. Webb, G. Keeney et al.

G. Calỉ, F. Forlani, C. Lees et al.

To develop a prenatal ultrasound staging system for placenta accreta spectrum (PAS) disorders in women with placenta previa and to evaluate its association with surgical outcome, placental invasion and the clinical staging system for PAS disorders proposed by the International Federation of Gynecology and Obstetrics (FIGO).

The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience.To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on bmj.com and will also be published in the Lancet, Obstetrics and Gynecology, PLoS Medicine, Annals of Internal Medicine, Open Medicine, Journal of Clinical Epidemiology, BMC Medicine, and Trials.