Hasil untuk "Gynecology and obstetrics"

Yaara Bashan, Elior Shalev Maman, Ron Rosenberg et al.

Abstract Objectives To estimate the success rates and risks of vaginal birth after cesarean delivery (VBAC) based on the number of prior successful VBACs. Methods A retrospective cohort study of women with one cesarean section in the past who attempted vaginal delivery between 2013 and 2022, using data from our Medical Center registry. Outcomes were compared based on the number of prior successful VBACs. Results Among 2912 deliveries meeting the eligibility criteria, the success rate of VBAC increased with the number of prior VBACs: 73.2% for those with no prior VBAC, rising to 92.3%, 94.7%, 94.0%, and 97.0% for individuals with 1, 2, 3, 4, and 5 or more prior VBACs, respectively. The history of at least one prior VBAC was associated with a 5.17-fold higher likelihood of achieving VBAC success. However, no significant differences in success rates were observed between groups with higher numbers of prior VBACs (≥ 2) compared to individuals with only one prior VBAC. In addition, the duration of hospitalization for both mother and neonate was longer in cases with no prior VBAC history. There was also a higher risk of requiring blood transfusion in the group without a prior history of VBAC. Conclusions Women with prior successful VBAC have a high likelihood of achieving another successful VBAC. After two prior VBACs, the success rate remains stable. In addition, women with one or more previous VBACs experience a reduced risk of blood transfusion and shorter hospitalization durations for both the mother and newborn.

Andrea D. Dorbu, Hannah B. Waddel, Manpreet K. Chadha et al.

ABSTRACT Food fortification can deliver essential micronutrients to populations at a large scale, thereby reducing nutritional anemia. This study aimed to review and meta‐analyze the literature on the impact of wheat flour, maize flour, rice, and oil (singly or combined) fortification on women's (10–49 years) hemoglobin and anemia. A search of 17 databases yielded 2284 results. Longitudinal, pre‐post cross‐sectional, efficacy, and effectiveness studies were included. Primary outcomes were changes in hemoglobin concentration and anemia prevalence. Studies were synthesized using arm‐based network meta‐analysis. In women who consumed fortified rice, hemoglobin mean change was 3.24 g/L (95% credibility interval (CrI) 0.9, 5.98), higher than for women in the control, with a 99.1% probability that the true mean difference was > 0. Hemoglobin was 2.08 g/L (95% CrI −0.76, 4.35) higher in women who consumed wheat flour versus control, with a 93.5% probability that the true mean difference was > 0. After rice fortification, anemia prevalence in women was 1.38 percentage points (95% CrI −106.6, 99.2) lower than for control women, with a 51.2% probability that the true mean difference was < 0. Wheat flour fortification decreased anemia prevalence by 1.84 percentage points (95% CrI −93.4, 92.4) with a 52.72% probability that the true mean difference was < 0. The treatment effects of fortified maize flour and fortified oil could not be calculated due to the absence of control arms compared to the intervention arms. Fortified rice and wheat flour appear likely to modestly increase hemoglobin and may also reduce anemia in women of childbearing age.

Vukosi Marivate, Kayode Olaleye, Sitwala Mundia et al.

This paper introduces Swivuriso, a 3000-hour multilingual speech dataset developed as part of the African Next Voices project, to support the development and benchmarking of automatic speech recognition (ASR) technologies in seven South African languages. Covering agriculture, healthcare, and general domain topics, Swivuriso addresses significant gaps in existing ASR datasets. We describe the design principles, ethical considerations, and data collection procedures that guided the dataset creation. We present baseline results of training/finetuning ASR models with this data and compare to other ASR datasets for the langauges concerned.

Yichang Tian, Jialin Sun, Ying Fang et al.

Ultraviolet filters (UVFs) are widely used in personal care products, their occurrence in the environment and potential detrimental effects on human health have raised significant concerns. This case-control study included 102 women—34 with diminished ovarian reserve (DOR) and 68 healthy controls—and aimed to investigate the association between UVF exposure and DOR. We collected and analyzed follicular fluid (FF) samples from women diagnosed with DOR and compared them to samples from a control group, measuring the concentrations of 16 different UVFs. Four individual compounds showed significantly higher concentrations in the DOR group: octyl methoxycinnamate (OMC), UV-P, UV-328, and Ensulizole. The cumulative concentration of ten UVFs with detection frequencies above 50 % was also markedly elevated in the DOR group (median ΣUVFs: 178.96 ng/mL vs. 23.93 ng/mL, p < 0.001). OMC exhibited the highest median concentration (170.81 ng/mL in DOR vs. 20.77 ng/mL in controls, p < 0.001), followed by UV-P, UV-328, and Ensulizole. Spearman analysis revealed significant negative correlations between OMC concentrations with ovarian reserve biomarkers such as anti-Müllerian hormone (AMH), antral follicle count (AFC), and the number of oocytes retrieved during ovarian stimulation cycles, while exhibiting a positive correlation with follicle-stimulating hormone (FSH) levels. Adjusted logistic regression models demonstrated that elevated OMC levels were associated with a 3.8-fold increased risk of DOR (95 % CI: 1.943–9.782, p < 0.001). These results highlight the urgent need for further investigation into the mechanisms by which UVFs affect ovarian reserve, as well as their potential long-term implications for fertility.

Manasik Abdaldeen Mohamed Ahmed, Mustafa Sabir Abakar Awad, Abdelmhmoud Atalmanan Abdelsadig et al.

Abstract Background Atypical presentation of preeclampsia and eclampsia refers to cases where symptoms may not follow the typical signs of high blood pressure and proteinuria rendering them difficult to diagnose leading to potential delays in treatment. Hence our aim was to study the atypical presentations of preeclampsia and eclampsia and their possible outcomes. Methods The study was a descriptive cross-sectional hospital-based study conducted from November 2022 to April 2023 at Al Saudi Hospital in Khartoum, Sudan. The study focused on pregnant women with atypical presentations of preeclampsia and eclampsia. A total of 57 participants were included using a total coverage approach. Data was collected using a pre-designed close-ended questionnaire and analyzed using SPSS software and results were presented in tables and figures. Results A total of 57 patients were included. The majority (78.9%) were between 20 and 35 years old, and most of them (80.7%) resided in urban areas. In terms of education, 56.1% had completed secondary education. The presentation varies between edema 50.9%, epigastric pain 40.3%, headache 29.8% and visual disturbance 7%. About 49.1% of the patients received regular antenatal care. Family history of preeclampsia or eclampsia was present in only 8.8% of the participants. All participants (100%) recovered after delivery, with no reported deaths. Maternal complications included abruptio placentae (29.8%). The majority of infants (96.5%) were born alive and well, with few reported cases of preterm birth or birth asphyxia. Cesarean section was the most common mode of delivery (80.7%). Conclusion The results of this study demonstrate positive maternal and fetal outcomes in the management of atypical preeclampsia and eclampsia cases at Al Saudi Hospital in Khartoum State, Sudan. The high rate of live births and low prevalence of preterm birth and birth asphyxia signify effective healthcare interventions. The study also demonstrated the association between the regularity of regularity of antenatal care visits and the patients’ risk factors for developing preeclampsia or eclampsia. Further research addressing the risk factors, complications, and long-term consequences of atypical preeclampsia and eclampsia in the Sudanese population is warranted.

Jing Zeng, Sheng-Bin Guo, Qing-Xiang Zheng et al.

Abstract Background Posttraumatic stress symptoms are prevalent mental phenomenon in women with previous perinatal loss due to high grief, high perinatal depression and anxiety or low social support. Although posttraumatic stress symptoms are known to have serious negative implications for women with previous perinatal loss, families and society, the mechanism through which it functions is less clear. Objective The aim of this study was to examine the moderated mediating effect of social support on perinatal anxiety and depression and its associations with grief and posttraumatic stress symptoms in women with previous perinatal loss. We hypothesized that perinatal depression and anxiety would mediate relationships between grief and posttraumatic stress symptoms and that its mediating effects would differ depending on social support. Methods This study was a multicentre cross-sectional survey conducted from December 2021 to October 2022, involving 346 women during hospitalization for perinatal loss as participants from two public hospitals in China. Self-reported scales were used to measure the level of perinatal depression and anxiety, grief, posttraumatic stress symptoms and social support. The Pearson’s correlation analysis, the PROCESS Macro Model 4 and Model 14 on SPSS were used to analyse the available data. Results The positive effect of perinatal grief on posttraumatic stress symptoms was found to be mediated by perinatal depression and anxiety, and this mediating effect was moderated according to social support: the more social support, the weaker the mediating effect of perinatal depression and anxiety was between perinatal grief and posttraumatic stress symptoms. The positive effect of perinatal depression and anxiety on posttraumatic stress symptoms was lowest in the high social support group. Conclusions Healthcare providers should closely monitor the psychological well-being of pregnant individuals and implement targeted interventions-such as antenatal education course, group-based prenatal care models, and mindfulness-based therapies (e.g., cognitive behaviour therapy) -to mitigate perinatal anxiety and depression. These measures may also significantly reduce post-traumatic stress symptoms in women with previous perinatal loss and high perinatal grief, particularly among those with insufficient social support.

Omar Suljagić, Emir Tupković, Kenana Ljuca et al.

Aim Any aesthetic procedure in the head and/or in the face might have an impact on psychological status of the treated participants. Aim of this study was to investigate whether Botulinum toxin treatment for aesthetic purpose in the face influences on the level of happiness, depression and anxiety. Methods This prospective cohort observational study included 30 participants, who were treated by botulinum toxin (Botox) due to aesthetic corrections. The treatment included laugh lines, frown lines and horizontal forehead lines. Preprocedural, three and six months after the treatment the participants were assessed by The Oxford Happiness Questionnaire (OHQ), The Beck Depression Inventory (BDI) and The Beck Anxiety Inventory (BAI) to determine the level of happiness, anxiety and depression was used. Results Three months after the treatment by Botox the level of happiness was significantly increased (5.26&plusmn;0.43 vs 4.3&plusmn;0.34; p&lt;0.0001). The levels of depression (7.6&plusmn;6.0 vs 14.2&plusmn;8.3; p&lt;0.0001) and anxiety (8.8&plusmn;6.3 vs 16.4&plusmn;8.8; p&lt;0.0001) were significantly decreased compared with preprocedural level. Significant increased level of happiness and decreased levels of depression and anxiety remained six months after the treatment, but attenuated. A dose of applied botulinum toxin was negatively correlated with the level of depression (r = -0.394; p=0.0421) and anxiety (r = -0.387; p=0.0302). Conclusion Botulinum toxin treatment for aesthetic purpose in the face positively influences psychological status of the treated individual in the short-therm.

Getahun Tiruye, Getahun Tiruye, Daba Kejela et al.

IntroductionObstetric fistula is a serious and tragic childbirth injury that mainly affects women in resource-limited areas, often leading to social isolation and stigma. While optimal knowledge among women about the prevention, contributing factors, and available treatments for obstetric fistula is crucial for reducing its overall burden, many women in Ethiopia continue to be affected by it and endure its consequences because of a persistent knowledge gap. Therefore, this study aimed to assess the level of knowledge about obstetric fistula and its associated factors among women of reproductive age in Ejere Woreda, West Shewa Zone, Oromia Region, Ethiopia.MethodsA community-based cross-sectional study was conducted among reproductive-age women in Ejere Woreda, West Shewa Zone, Ethiopia, from 1 to 30 June 2024. A systematic random sampling technique was employed to recruit 770 participants. Data were collected using a pretested structured questionnaire, which was then coded and analyzed using SPSS version 27. Variables with a p-value &lt;0.25 in bivariate logistic regression were included in a multivariable logistic regression to identify significant predictors of women's knowledge about obstetric fistula. A p-value &lt;0.05 at a 95% confidence interval (CI) was used to determine statistically significant associations.ResultsThe study found that 46.6% (95% CI: 43.1–50.3) of women had good knowledge about obstetric fistula. Factors significantly associated with the knowledge level of obstetric fistula included being an urban resident [adjusted odds ratio (AOR) = 4.12, 95% CI: 2.36–7.19], access to a TV/radio at home (AOR = 2.51, 95% CI: 1.19–5.25), proximity to health facilities (AOR = 4.88, 95% CI: 2.37–10.04), giving birth at health institutions (AOR = 4.62, 95% CI: 2.56–8.33), attending pregnant women's conferences (AOR = 3.42, 95% CI: 1.88–6.22), and having a history of modern contraceptive use (AOR = 4.82, 95% CI: 2.77–8.37).Conclusion and recommendationsNearly one in two women of childbearing age are knowledgeable about obstetric fistula. The study underscores the need to address the urban–rural disparity in healthcare access and information, enhancing media access, and promoting women's participation in pregnancy conferences to enhance knowledge of obstetric fistula.

Xingyu Liu, Ming Li, Yingjun Zhao et al.

Abstract Background Preoperative immunonutritional status can influence postoperative complications. Malnutrition in ovarian cancer patients diminishes the body’s resilience to abdominal surgery, resulting in inferior surgical outcomes and increased postoperative complications. We aim to investigate the effect of preoperative immunonutritional status, including NLR, PLR, LMR, TCLR, FAR, FLR, SII, PNI and CONUT on postoperative complications in epithelial ovarian cancer (EOC) in a large population. Methods A multicenter real-world study included 922 patients with histologically confirmed EOC who received comprehensive staged surgery or debulking surgery at seven tertiary hospitals in China between 2012 and 2023. Logistic regression and Lasso regression analyses were employed to identify variables associated with postoperative complications. A predictive nomogram model was developed based on multivariate modeling. Results The study included a total of 922 patients diagnosed with epithelial ovarian cancer across seven medical centers with 565 (61.3%) patients experiencing postoperative complications. Significant differences were found in the distribution of inflammatory and nutritional risk indicators, including NLR, PLR, LMR, TCLR, FAR, FLR, SII, PNI and CONUT between the two groups (all P < 0.01). A multivariable model identified several predictive factors for postoperative complications: PNI > 46.73 (odds ratio [OR] = 0.49, P < 0.001), FAR > 10.77 (OR = 1.60, P = 0.019), LMR > 3.70 (OR = 0.68, P = 0.044), hydrothorax (OR = 2.60, P = 0.005), laparoscopy (OR = 0.59, P = 0.010 vs. laparotomy), enterectomy (OR = 2.50, P = 0.001). Conclusion Poor immunonutritional status can increase the risk of postoperative complications. These findings suggest that prompt nutritional interventions may reduce the incidence of postoperative complications and improve surgical outcomes. The risk prediction model, including PNI, FAR, LMR, hydrothorax, laparoscopy vs. laparotomy, and enterectomy, might facilitate patient-centered decision-making and risk stratification. Clinical trial registration The study was registered in the Clinical trial registry: NCT06483399. ( https://clinicaltrials.gov/study/NCT06483399 )

M. Ghavam, M. D. Filipović, R. Z. E. Alsaberi et al.

We present new Australia Telescope Compact Array (ATCA) radio observations toward N49, one of the brightest extragalactic Supernova remnants (SNRs) located in the Large Magellanic Cloud. Our new and archival ATCA radio observations were analysed along with $Chandra$ X-ray data. These observations show a prominent `bullet' shaped feature beyond the southwestern boundary of the SNR. Both X-ray morphology and radio polarisation analysis support a physical connection of this feature to the SNR. The 'bullet' feature's apparent velocity is estimated at $\sim$1300 km s$^{-1}$, based on its distance ($\sim$10 pc) from the remnant's geometric centre and estimated age ($\sim$7600 yrs). we estimated the radio spectral index, $α= -0.55 \pm 0.03$ which is typical of middle-age SNRs. Polarisation maps created for N49 show low to moderate levels of mean fractional polarisation estimated at 7$\pm$1% and 10$\pm$1% for 5.5 and 9 GHz, respectively. These values are noticeably larger than found in previous studies. Moreover, the mean value for the Faraday rotation of SNR N49 from combining CABB data is 212$\pm$65 rad m$^{-2}$ and the maximum value of RM is 591$\pm$103 rad m$^{-2}$.

V. I. Galkin, C. G. Azra, E. A. Bonvech et al.

A new Cherenkov telescope of the SPHERE type is under development. Its main goal is to promote the solution of the problem of the primary cosmic ray mass composition at ultra high energies (1--100 PeV) using a newly developed technique of the primary mass assignment to EAS event on event-by-event basis. The telescope will carry out measurements of both the Cherenkov light reflected from the snow surface as well as the direct one. Sensitivity of the direct Cherenkov images' shapes to the primary mass is demonstrated.

Carolina Godoy, Igor Radel, Laís Ribeiro Mota et al.

Abstract Introduction: cystic fibrosis newborn screening must enable its earlier diagnosis, which may enhance outcomes. This study was a series case of delayed-diagnosis children submitted to cystic fibrosis newborn screening. Description: fourteen children were included; eight (57.1%) were due to false-negative screening, while six (42.9%) were due to processing errors. Two samples collected after 30 days of life were incorrectly classified as negative, and four infants with a positive test could not be located due to screening processing errors. Cystic fibrosis diagnosis was confirmed at a median (IQR) age of 5.3 (4.2-7.4) months. Poor nutritional status was the most prevalent clinical sign at diagnosis, being present in 78.6% of infants. The mean (SD) weight-for-length and length-for-age Z-scores were -3.46 (0.84) and -3.99 (1.16), respectively. Half of the children had Pseudo-Bartter syndrome, and 42.9% had breathing difficulties. Twelve children (85.7%) required hospitalization, with a median (IQR) length of stay of 17.0 (11.5-26.5) days. Discussion: newborn screening had some faults, from incorrect collections to inefficient active search. Early identification of these children in which screening was unsatisfactory is essential, emphasizing the importance and efforts to not miss them. In the case of a failed test, healthcare professionals must be prepared to recognize the main symptoms and signs of the disease.

Mohmed Fathy Abohashim, Waleed M. Etman, Mohamed A. Wasfy et al.

Abstract Background Surgery is the main line of treatment of endometriosis. Patients with stage IV endometriosis have more extensive adhesions, which make the surgery difficult. There are no accurate non-invasive predictive preoperative parameters of stage IV endometriosis and no consensus has been reached. Therefore, the aim of the present study was to evaluate and detect preoperative non-invasive parameters for the detection of stage IV endometriosis. Patients and methods In the present study, we included 150 females admitted for surgical removal of endometriosis. We scored and classified endometriosis into four stages according to the revised ASRM classification. We compared between baseline characteristics of patients with different stages of endometriosis, and then we selected the best combination of diagnostic and predictive parameters of stage IV endometriosis. Results Predictors of stage IV endometriosis and indicators for safety surgery were as follows: VAS ≥ 4 (p < 0.001), fixed uterus (p = 0.005), fixed ovarian cysts (p < 0.001), tender uterosacral ligament nodule (p < 0.001), tender rectovaginal septum nodule (p = 0.003), bilateral endometriosis (p < 0.001), and sum of sizes of endometriotic nodules (p < 0.001). Conclusion Fixed uterus, fixed ovarian cysts, tender uterosacral ligament nodule, tender rectovaginal septum nodule, bilateral endometriosis, and indications for surgery were significantly considered adequate predictive markers for stage IV endometriosis.

Jia Yan, Ling Zhou, Mengya Liu et al.

Summary: Ovarian endometriosis is characterized by the growth of endometrial tissue within the ovary, causing infertility and chronic pain. However, its pathophysiology remains unclear. Utilizing high-precision single-cell RNA sequencing, we profile the normal, eutopic, and ectopic endometrium from 34 individuals across proliferative and secretory phases. We observe an increased proportion of ciliated cells in both eutopic and ectopic endometrium, characterized by a diminished expression of estrogen sulfotransferase, which likely confers apoptosis resistance. After translocating to ectopic lesions, endometrial epithelium upregulates nicotinamide N-methyltransferase expression that inhibits apoptosis by promoting deacetylation and subsequent nuclear exclusion of transcription factor forkhead box protein O1, thereby leading to the downregulation of the apoptotic gene BIM. Moreover, epithelial cells in ectopic lesions elevate HLA class II complex expression, which stimulates CD4+ T cells and consequently contributes to chronic inflammation. Altogether, our study provides a comprehensive atlas of ovarian endometriosis and highlights potential therapeutic targets for modulating apoptosis and inflammation.

V. Seltzer, B. Drukker, B. Gillespie et al.

E. Jauniaux, A. Hussein, B. Einerson et al.

E. JAUNIAUX1* , A. M. HUSSEIN2, B. D. EINERSON3 and R. M. SILVER3 1EGA Institute for Women’s Health, Faculty of Population Health Sciences, University College London, London, UK; 2Department of Obstetrics and Gynecology, University of Cairo, Cairo, Egypt; 3Department of Obstetrics and Gynecology, University of Utah Health Sciences Center (UUHSC), Salt Lake City, UT, USA *Correspondence. (e-mail: e.jauniaux@ucl.ac.uk)

A. Ludwin, S. Tudorache, W. Martins

A. LUDWIN1,2* , S. TUDORACHE3 and W. P. MARTINS4 1Department of Gynecology and Oncology, Jagiellonian University, Krakow, Poland; 2Ludwin & Ludwin Gynecology, Private Medical Center, Krakow, Poland; 3Department of Obstetrics and Gynecology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, Romania; 4SEMEAR Fertilidade, Reproductive Medicine, Ribeirão Preto, Brazil *Correspondence. (e-mail: ludwin@cm-uj.krakow.pl)

C. Verberkt, I. Jordans, T. van den Bosch et al.

C. VERBERKT1 , I. P. M. JORDANS1 , T. VAN DEN BOSCH2,3 , D. TIMMERMAN2,3 , T. BOURNE3,4 , R. A. DE LEEUW5 and J. A. F. HUIRNE5 1Department of Obstetrics and Gynecology, Research Institute Amsterdam Reproduction and Development, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands; 2Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium; 3Department of Development and Regeneration, KU Leuven, Leuven, Belgium; 4Department of Obstetrics and Gynaecology, Queen Charlotte’s and Chelsea Hospital, Imperial College London, London, UK; 5Department of Obstetrics and Gynecology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands

J. Roeckner, K. Pressman, L. Odibo et al.

The recent international guidelines by the Society for Maternal–Fetal Medicine (SMFM) and the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) differ in their definitions of fetal growth restriction (FGR). Our aim was to compare the performance of the two definitions in predicting neonatal small‐for‐gestational age (SGA) and composite adverse neonatal outcome (ANO).

Xuan Li, Tao Yu, Muxin Zhai et al.

Cadmium is a ubiquitous environmental pollutant, which can increase the risk of preeclampsia. This study was designed to determine the mechanism of cadmium exposure during pregnancy impaired placental angiogenesis that was associated with the occurrence of preeclampsia. The effects of cadmium exposure on placental thyroid hormone receptor signaling were explored. JEG3 cells were treated with CdCl2 (20 μM) and the Dio2 inhibitor, IOP (100 μM). Cadmium levels in maternal blood and placentae were increased in preeclampsia group. Placental angiogenesis of preeclampsia was decreased with decreased expression of PLGF and VEGF and increased expression of sFlt1. Meanwhile, the expression and nuclear translocation of thyroid hormone receptor α were decreased in preeclampsia placenta, as well as the expression of Dio2, but not the expression and nuclear translocation of thyroid hormone receptor β. Furthermore, we found that cadmium exposure downregulated the expression of thyroid hormone receptor α and Dio2, but not the expression of thyroid hormone receptor β in JEG3 cells. Also, we found that cadmium exposure decreased the expression of PLGF and VEGF and increased the expression of sFlt1 in JEG3 cells. IOP pretreatment decreased the expression of PLGF and increased the expression of sFlt1. In conclusion, our results elucidated that cadmium exposure would impair placental angiogenesis in preeclampsia through disturbing thyroid hormone receptor signaling.