History Of Delivery Research Articles

The role of CD138 immunohistochemical marker in the diagnosis of chronic endometritis: causes of female infertility

This article focused on “The role of CD138 immunohistochemical marker in the diagnosis of chronic endometritis: causes of female infertility”. Aims: The aim of the study was to assess the diagnostic efficacy of CD138 in identifying chronic endometritis among infertile patients with endometrial pathology and to examine the association between CE and various factors related to infertility. Methodology: A cross-sectional observational study exploring the utility of the CD138 immunohistochemical marker in diagnosing chronic endometritis and its association with infertility in a sample of 63 couples. The t-test, chi-square test and logistic regression was applied using SPSS 26. Results: The study examined infertility characteristics and chronic endometritis in 63 infertile woman with pathology of endometrium. Results also established a significant association between CE and CD 138 presence, suggesting CD 138 as a potential diagnostic marker for CE. Additionally, the age was identified as a notable factor linked to CE. Factors such as abortion history, intrauterine interventions, delivery experiences, and cervical pathology, mycoplasma infections were found to have a significant correlation with CE. The logistic regression indicated a lower likelihood of CE in certain infertility types. It also identified a significant association between increased CE odds and longer fertility duration, while specific causes of fertility had a modest impact. Overall, CD 138 demonstrated its diagnostic potential for CE, age was associated with CE, and certain factors correlated with CE, emphasising the complexity of CE etiology in infertility patients with endometrial patology. Scientific Novelty: A Gateway to Understanding Female Infertility Conclusion: In conclusion, the research findings underscored the significance of CD 138 as a diagnostic marker for chronic endometritis in infertility patients. The age emerged as a notable factor associated with CE, while specific qualitative factors like delivery history exhibited a correlations with CE status, warranting further investigation

Ultrasonography Findings in Post-Methotrexate Treatment of Cesarean Scar Pregnancy

Background: Cesarean scar pregnancy (CSP) can cause life-threatening complications for pregnant women, so early diagnosis and treatment are crucial for the prevention of maternal mortality. Transvaginal color Doppler ultrasonography, along with serum beta-human chorionic gonadotropin (β-hCG) level follow-up, can be a noninvasive and proper method for the post-treatment follow-up of a CSP. The present study investigated the Doppler resistance index (RI) changes in CSPs after medical management with methotrexate (MTX), evaluated by sac diameter and serum β-hCG level measurement. Methods: Overall, 28 patients with CSP and a history of previous cesarean delivery, a gestational age of less than 9 completed weeks at ultrasonography, the decision to medical management by the gynecologist, and having a β-hCG level before treatment were enrolled and initially examined by ultrasound and Doppler studies. The RI of the closest myometrial artery to the CSP mass and its diameter underwent measurement. After 72 hours, 1 week, and 2 weeks of medical therapy with MTX, the mentioned variables were measured again and compared with the values of the pretreatment time point. Results: RI values were significantly higher at all the follow-up time points compared with the pre-treatment time points, while serum β-hCG levels were significantly lower. Moreover, sac diameter values increased 72 hours post-treatment and then represented a decline. Conclusion: Serial Doppler ultrasound examination can be a useful method to evaluate the success or failure of the medical management of CSPs, as the increase in RI values occurs rapidly after medical treatment and correlates well with serum β-hCG levels.

Analysis of the current state of cervical cancer prevention awareness and its influencing factors among rural women in Luohe City.

The purpose of this cross-sectional study was to identify the current awareness about cervical cancer prevention among rural women in Luohe City as well as its potential influencing factors. Meanwhile, these data were expected to provide a theoretical basis for Luohe future cervical cancer prevention and therapy. Based on geographical distribution, 40 villages in Luohe City were randomly selected, and questionnaires were given to women in each village. In this study, a total of 4665 questionnaires were distributed, and 4561 valid questionnaires were returned, with a recovery rate of 97.98%. The average score was 4.06 ± 2.46 out of 10. It was found that women had a high awareness rate of cervical cancer screening (55.25%) but a low awareness rate of human papillomavirus (HPV) and HPV vaccine (10.17%). Moreover, univariate and multivariable analyses showed that age > 45 years, low household income, low education level, being a farmer, spouse unemployment, no pregnancy or birth delivery history, no family or personal history of cervical disease, and no previous complimentary 2-cancer screening (i.e., breast cancer and cervical cancer) were all factors influencing the cognitive level of rural women in Luohe City (P < .05). However, ethnicity, marital status, and spouse education level were not correlated with cognitive level (P > .05). In conclusion, low awareness of cervical cancer prevention among rural women in Luohe was correlated with individual, family, and social factors. So it was recommended to cultivate the rural population knowledge, optimize screening strategies, and conduct targeted cervical cancer prevention and treatment in rural regions.

Scleral Buckling for Retinopathy of Prematurity: A Case Report

Introduction : Retinopathy of prematurity (ROP) is a vasoproliferative retinal disease that affects premature infants. Patients with advanced ROP require surgery to minimize retinal distortion and prevent total retinal detachment. This case reports the efficacy of scleral buckling (SB) in a patient with stage 4B ROP in both eyes within 3 months.&#x0D; Case Illustration : A 4-month-old female baby presented to the Pediatric Ophthalmology Division in Cipto Mangunkusumo Hospital with the chief complaint of no eye contact in both eyes. Her eyes moved by themselves since the age of 3.5 months and sometimes looked crossed. The patient presented to the pediatrician and was referred to the pediatric ophthalmology division for further management. There was a history of premature delivery at 30 weeks with oxygen therapy for 3 weeks. Pediatric Ophthalmology Division performed ultrasonography and Retcam and diagnosed ROP stage 4B in both eyes. Scleral buckling was performed by vitreoretinal division in the right and left eyes at 49 and 52 weeks postmenstrual age, respectively.&#x0D; Discussion : Vitrectomy and scleral buckling are the surgical options in advanced ROP. Vitrectomy is ideally performed in stage 4A without macular involvement. We considered performing SB because vitrectomy seems to be ineffective in this patient and the patient is more prone to intraocular complications.&#x0D; Conclusion : Scleral buckling is effective in preventing further progression of retinal detachment, reducing vitreoretinal traction and preventing ischemia in the retinal detachment. In short-term follow-up, we found no worsening of progression. However, further follow-up is needed to demonstrate the long- term efficacy of SB in advanced ROP.

Expression of ADAM17 and its clinical value for patients with pernicious placenta previa: A retrospective study of 148 PPP patients underwent cesarean section.

To explore the expression and the diagnostic value of ADAM17 in pernicious placenta previa (PPP) combined placental accreta. A total of 148 PPP patients were enrolled and divided into 2 groups: 62 patients with placenta accrete (PPP with PA group) and 86 patients without placenta accrete (PPP without PA group). In the same period, 74 pregnant women without PPP who had undergone cesarean section were selected as controls. The levels of ADAM17 were detected by qt-PCR. Diagnostic efficiency of ADAM17 were evaluated by receiver operating characteristics curve. ADAM17 was higher expression in PPP patients. Multivariate analysis showed that ADAM17 was related to gravida times (HR = 2.43 95% CI, 1.25-3.31), history of cesarean delivery (HR = 3.44, 95% CI = 2.24-4.28), history of abortions (HR = 2.22, 95% CI = 1.57-3.06) for PPP with PA patients and gravida times (HR = 2.01, 95% CI = 1.45-2.86), history of cesarean delivery (HR = 1.89, 95% CI = 1.33-2.48) for PPP patients without PA. Diagnostic efficiency of ADAM17 indicated that the sensitivity and specificity of ADAM17 detection for PPP with PA were 74.41% and 67.21% and for PPP without PA were 89.29% and 85.52%. Area under curve were 0.7876 (0.7090-0.8661) for PPP with PA and 0.9443 (0.9136-0.9750) for PPP without PA. Insummary, ADAM17 was higher expression in patients with PPP. ADAM17 was associated with gravida times, history of cesarean delivery, history of abortions. It also indicated a better diagnostic efficiency for patients with PPP. Further larger sample, multicenter studies should be conducted to confirm the conclusion from our study.

Exploring Risk Factors and Perinatal Outcomes of Preterm Birth in a Tertiary Care Hospital: A Comprehensive Analysis.

Background Preterm birth before 37 weeks of gestation is a global public health challenge, particularly in India, where the prevalence varies regionally. Understanding risk factors, such as maternal age and complications like hypertensive disorders, is vital. India's diverse healthcare landscape and regional disparities further complicate this issue. Preterm infants face increased mortality and morbidity risks like respiratory distress and intraventricular hemorrhage. This study in a tertiary care hospital aimed to analyze risk factors, assess perinatal outcomes, and contribute to the understanding of preterm birth in this complex context, providing valuable insights for maternal and child health strategies. Methods This retrospective cohort study was conducted at the Venkateshwara Institute of Medical Science, Rajabpur, over one year, extracting data from electronic health records. The study aimed to analyze risk factors associated with preterm delivery and assess perinatal outcomes. The study included diverse pregnancies, both singleton and multiple gestations, and employed sample size calculations to ensure statistical validity. Trained medical personnel collected extensive data on maternal characteristics, obstetric history, antenatal care, perinatal outcomes, and mode of delivery. Statistical analysis, utilizing SPSS (IBM, Chicago, USA), involved descriptive statistics, comparative analysis, chi-square tests, t-tests, Mann-Whitney U tests, and multivariate logistic regression models. Findings with a p-value <0.05 were considered significant. Results The study included 2042 deliveries, with a preterm birth prevalence of 14.2%. Multiparous women had higher preterm birth rates than primigravida (72.92% vs. 27.08%). Maternal age, history of preterm delivery, hypertensive disorders, inadequate antenatal care compliance, previous cesarean section, multiple gestations, antepartum hemorrhage (APH), polyhydramnios, oligohydramnios, and premature rupture of membranes (PROM) were significantly associated with preterm birth. Apgar scores at one minute and five minutes, neonatal complications, and mortality rates were notably worse among preterm births. Vaginal delivery rates were significantly lower in the preterm group (36.3%) compared to full-term deliveries (48.8%), with a higher rate of emergency cesarean sections (19.7% vs. 10.8%). Conclusion This study provides valuable insights into the risk factors and perinatal outcomes of preterm delivery at a tertiary care hospital, with precise values illustrating the extent of associations. The findings such as history of preterm delivery, hypertensive disorders, and inadequate antenatal care compliance as the most commonly associated conditions with preterm birthand management of such associated conditions may help reduce the rate of premature birth.

Predictors of postpartum hemorrhage at public hospitals in Addis Ababa, Ethiopia: A case-control study

IntroductionPostpartum hemorrhage (PPH) is responsible for half of all maternal deaths during childbirth. Despite being preventable and curable, PPH remains the leading cause of maternal death in Ethiopia. Therefore, the aim of this study was to identify the determinants of PPH among women delivered at public hospitals in Addis Ababa, Ethiopia, in 2022. MethodsA facility-based, unmatched case control study with 378 study participants was carried out in selected public hospitals in Addis Ababa, Ethiopia. Women who gave birth and developed PPH were considered cases, while women who gave birth in public hospitals in Addis Ababa and did not develop PPH were controls. Binary and multivariable logistic regression analyses were used to identify independent predictors of PPH. Variables was considered statistically significant in the final model if their p-value was less than 0.05. ResultsThe result of this study identified that antenatal care follow-up (AOR: 2.58; 95% CI: 1.12, 5.96), history of cesarean delivery (AOR: 3.47; 95% CI: 1.40, 8.58), prolonged labor (AOR: 5.14; CI: 2.07, 12.75), and genital trauma apart from episiotomy (AOR: 4.39; CI: 1.51, 12.81) were determinants of PPH. ConclusionAccording to the finding of this study duration of labor, history of cesarean section, antenatal care follow-up, and genital trauma other than episiotomy were independent determinants of PPH. Therefore, it is crucial to screen and closely monitor high-risk mothers during antepartum care visit, including those who have a history of cesarean delivery.

Clinical and historical features of cesarean scar pregnancies in a tertiary hospital with a high rate of cesarean section: A case-control survey.

Cesarean scar pregnancy (CSP) is a rare medical condition accounting for 1:2000 of all pregnancies with prior history of cesarean deliveries (CS). As the rate of CS is increasing worldwide, it is important to know the nature of CSP and its complications. In this retrospective case-control study, we evaluated 264 pregnant women; 86 cases with ultra-sonographic findings of CSP and 178 controls: normal pregnancies with gestational age less than 12 weeks. The variables consisted of demographic characteristics, the features and causes of the prior CS, the time distance to the current pregnancy, sonographic features, and the final management. All data analyzed using SPSS version 21. There was a significant difference between the two study groups regarding to parity, abortions and D&Cs (p < 0.001). In the case group, 19.8% of patients had positive results for STDs versus 16.3% in the control group (p > 0.990). The mean average of intervals between the last CS and current pregnancies were 48.22 ± 37.03 in the case group versus 61.25 ± 36.25 months in the control group (p < 0.001). Regression Logistic analysis showed advanced maternal age (p < 0.001), positive history of abortions and D&C (p < 0.001), elective type of prior c/s (p < 0.001) and the short time interval between prior CS and current pregnancy (p < 0.001) could significantly predict the patients at higher risk of presenting CSP in the case group. Based on our findings, advanced maternal age, positive history of abortion, the elective type of the former CS, and short time intervals between previous CS and current pregnancy are the main risk factors of CSP.

Respectful maternity care at caesarean delivery: Experiences of mothers in a primary referral hospital in Ghana

AbstractBackgroundRespectful, dignified care is a human right for all women that impacts skilled birth attendance and outcomes. This study aimed to assess the prevalence of respectful maternity care (RMC) provided at caesarean deliveries in a Ghanaian referral hospital and determine associated factors influencing care provision. We sought to elucidate RMC prevalence and drivers specific to the caesarean experience, to promote rights‐based, patient‐centred caesarean delivery care.MethodsA cross‐sectional study was conducted from June to November 2022, among women who delivered via caesarean section at the hospital. Interviews of participants were conducted using structured questionnaires, capturing respondents' sociodemographic and obstetric features and perceptions of RMC. Quantitative data were summarised using means, medians, frequencies and proportions. Bivariable and multivariable logistic regression models were employed to determine factors associated with RMC at 95% confidence interval (CI) and a p &lt; 0.05.ResultsA total of 308 women were included in the study. The mean age of mothers was 29.9 (±6.8) years. Of the mothers, 67.9% (95% CI: 62.3, 73.0) received RMC and 32.1% reported disrespectful and abusive care. Several factors were associated with higher likelihood of receiving RMC at caesarean delivery, including being married, adjusted odds ratio (aOR) 2.45 (95% CI: 1.17, 5.12), having average monthly income between Ghana cedis 501 and 1500, aOR = 1.94 (95% CI: 1.07, 3.50), having a previous delivery history of spontaneous vaginal delivery only, aOR 2.04 (95% CI: 1.02, 4.08) and receiving anaesthesia from a male anaesthetist, aOR 2.04 (95% CI: 1.22, 3.42).ConclusionThough the majority of women at caesarean delivery received RMC, close to one‐third may attribute a negative caesarean birth experience to disrespectful care. Respectful and abusive‐free care at service delivery should thus be emphasised for healthcare givers and form part of antenatal education.

Incidence and Predictors of Successful Vaginal Birth Among Women With a History of Cesarean Section in Public Health Facilities of Southern Ethiopia in 2021

BACKGROUND:Even though a cesarean section (CS) performed greater than 15% has no significant association with a reduction in maternal and neonatal mortality, repeat elective CS continues to play a major role in unnecessary CS worldwide. Trial of labor after cesarean (TOLAC) is one of the strategies to reduce the rate of unnecessary CS. However, the selection of candidates for a TOLAC is not an easy task without evidence. This study was conducted to determine the incidence of successful vaginal birth after one CS and the associated factors in public health facilities in southern Ethiopia.METHODS:An institutional-based cross-sectional study was conducted from June 10, 2020, to December 10, 2021, on laboring women, and the data were collected using a pretested interviewer-administered questionnaire and a data extraction sheet. A binary logistic regression model was used to assess the factors associated with successful vaginal birth after cesarean (VBAC) section using SPSS version 25. Bivariate and multivariate analyses were performed, and independent variables withp&lt; .05 along with an odd ratio and 95% confidence interval (CI) declare the associated factors.RESULTS:A total of 417 women participated in this study making a response rate of 98.8%. The incidence of vaginal births after cesarean was 51.1% (CI, 46%–56%). The likelihood of successful VBAC was observed in women with a history of vaginal delivery before CS (AOR, 3.7, CI = 1.06, 13.19), favorable Bishop score at admission (AOR, 19.1, CI = 2.69, 134.98), greater than 4-cm cervical dilation at admission (AOR, 171.3, CI = 1.8, 16,722), and clear color of amniotic fluid (AOR, .096, CI = .02, .38).CONCLUSION:The incidence of VBAC in this study is promising and should be practiced. In choosing a woman for the TOLAC, health professionals might need to pay attention to intrapartum variables, such as cervical dilation, Bishop score, and color of the amniotic fluid.

Incidence, risk factors and maternal outcomes of unsuspected placenta accreta spectrum disorders: a retrospective cohort study

BackgroundTo identify incidence and underlying risk factors for unsuspected placenta accreta spectrum (PAS) and compare the maternal outcomes between suspected and unsuspected cases in three large academic referral centers.MethodsA retrospective cohort study was conducted in three university-based tertiary referral centers from Jan 1st, 2013, to Dec 31st, 2022. All cases of PAS confirmed by pathology were included in the study. Unsuspected PAS cases were diagnosed at the time of delivery, while suspected cases served as the control group. Potential risk factors were compared between the two groups. Multivariable regression model was also performed to identify risk factors. Maternal outcomes were also evaluated.ResultsA total of 339 pathology-confirmed PAS cases were included in the study out of 415,470 deliveries, of which 35.4% (n = 120) were unsuspected cases. Unsuspected PAS cases were 7.9 times more likely to have a history of intrauterine adhesions (adjusted odds ratio [aOR] 7.93; 95% confidence interval [CI] 2.35–26.81), 7.0 times more likely to have a history of clinically confirmed PAS (aOR, 6.99; 95% CI 2.85–17.18), 6.3 times more likely to have a posterior placenta (aOR, 6.30; 95% CI 3.48–11.40), and 3.4 times more likely to have a history of placenta previa (aOR, 3.41; 95% CI 1.18–9.82). On the other hand, cases with gravidity > 3, placenta previa, and/or a history of previous cesarean delivery were more likely to be diagnosed antenatally (aOR 0.40, 0.19, 0.36; 95% CI 0.22–0.74, 0.09–0.40, 0.19–0.70). Although the suspected PAS group had a higher proportion of invasive cases and abdominal and pelvic organ injuries (74.4% vs. 25.8%, p < 0.001; 6.8% vs. 1.7%, p = 0.037), the maternal outcomes were more favorable in the sPAS group, with a lower median volume of 24-hour blood loss and blood product transfusion (estimated blood loss in 24 h, 1000 [800–2000] vs. 2000 [1400–2400], p < 0.001; RBC unit transfusion, 0 [0-800] vs. 800 [600–1000], p < 0.001; fresh-frozen plasma transfusion, 0 [0-450] vs. 600 [400–800], p < 0.001).ConclusionsOur findings indicate that 35% of patients with PAS were unsuspected prior to delivery. Factors associated with PAS being unsuspected prior to delivery include a history of intrauterine adhesions, a history of clinically confirmed PAS, a posterior placenta, and a history of placenta previa. Additionally, gravidity > 3, a history of previous cesarean delivery, and placenta previa increase the likelihood of antenatal diagnosis.

The Relationship Between Breastfeeding Frequency and Neonatal Dehydration Hypernatremia

Objective:Inadequate breastfeeding is the most important cause of neonatal dehydration hypernatremia (NDH). This study aimed to define the relationship between breastfeeding frequency and NDH.Methods:A total of 934 infants (574 isonatremic and 360 with NDH) were enrolled in this cross-sectional study at Ghaem Hospital, Mashhad, Iran, in 2014–2022, assigned into low feeding frequency (&lt;8 times/day) and proper feeding frequency (≥8 times/day) groups, and compared for NDH intensity according to a researcher-made questionnaire.Results:The admission age (p= .001) and weight (t(931) = 1.864, p = .063), urination frequency (t(931) = −8.742, p = .001), defecation frequency (t(931) = −5.372, p = .001), serum sodium (t(931) = 13.541, p = .001), urea (t(931) = 9.721, p = .001), and creatinine levels (t(931) = 7.613, p = .001) showed significant differences between the two groups. Interestingly, 56.27% of infants with NDH and only 10.28% of isonatremic infants had low feeding frequencies.Conclusions:Low feeding frequency and duration were associated with weight loss and increased serum sodium levels. A group of infants who had a feeding frequency of less than eight times a day, a history of cesarean delivery, breast problems, and a lack of let-down reflex was associated with an increased incidence of low weight; higher levels of serum sodium, urea, and creatinine; and reduced frequency of urination and stool passage.

Development of antepartum risk prediction model for postpartum hemorrhage in Lagos, Nigeria: A prospective cohort study (Predict-PPH study).

There is currently a limited ability to accurately identify women at risk of postpartum hemorrhage (PPH). We conducted the "Predict-PPH" study to develop and evaluate an antepartum prediction model and its derived risk-scoring system. This was a prospective cohort study of healthy pregnant women who registered and gave birth in five hospitals in Lagos, Nigeria, from January to June 2023. Maternal antepartum characteristics were compared between women with and without PPH. A predictive multivariable model was estimated using binary logistic regression with a backward stepwise approach eliminating variables when P was greater than 0.10. Statistically significant associations in the final model were reported when P was less than 0.05. The prevalence of PPH in the enrolled cohort was 37.1%. Independent predictors of PPH such as maternal obesity (adjusted odds ratio [aOR] 3.25, 95% confidence interval [CI] 2.47-4.26), maternal anemia (aOR 1.32, 95% CI 1.02-1.72), previous history of cesarean delivery (aOR 4.24, 95% CI 3.13-5.73), and previous PPH (aOR 2.65, 95% CI 1.07-6.56) were incorporated to develop a risk-scoring system. The area under the receiver operating characteristic curve (AUROC) for the prediction model and risk scoring system was 0.72 (95% CI 0.69-0.75). We recorded a relatively high prevalence of PPH. Our model performance was satisfactory in identifying women at risk of PPH. Therefore, the derived risk-scoring system could be a useful tool to screen and identify pregnant women at risk of PPH during their routine antenatal assessment for birth preparedness and complication readiness.

Gestational age at birth in pregnancies with antenatal corticosteroid administration in relation to risk factors: a retrospective cohort study.

The aim was to investigate gestational age at birth of women after induction of fetal lung maturation (antenatal corticosteroids = ACS) because of imminent preterm birth (PTB), and to quantify incidence of late PTB (gestational age < 260 days) and extreme immaturity (gestational age < 196 days) in relation to several diagnoses (PPROM, placental bleeding, premature labor, preeclampsia, oligohydramnios, amniotic infection syndrome (AIS), cervical insufficiency) and risk factors (age > 35, history of preterm delivery, multifetal gestation, gestational diabetes, hypertension, nicotine abuse). The study was designed as a retrospective cohort trial, in which the data of all births taking place in 2016 in the German federal state Rhineland-Palatinate were evaluated. Frequency analyses, subgroup analysis (Chi-square tests and Friedman's tests), as well as multinomial logistic regressions and linear regressions were used to determine odds ratios (OR). In total, N = 1,544 patients were included who had been hospitalized due to an imminent PTB and had received ACS, of whom 52% had a late PTB and 8% a PTB with extreme immaturity. Regarding the gestational age at birth, there were only minor differences between the individual risk factors and diagnoses, only AIS patients showed a significantly lower gestational age (mean: 207 days). A significantly increased risk of PTB with extreme immaturity was found in patients with AIS (OR = 5.57) or placental bleeding (OR = 2.10). There is a need for further research in order to be able to apply therapeutic measures more accurately in relation to risk factors and diagnoses.

Duration time of labor progression for pregnant women of vaginal birth after cesarean in Hubei, China.

There have been limited reports on the duration of labor progression in pregnant women undergoing vaginal birth after cesarean (VBAC). This study aimed to investigate the duration of labor progression during VBAC in Hubei, China. A total of 359 pregnant women undergoing VBAC were enrolled as the VBAC group, meeting the following criteria: singleton pregnancy, gestational age ≥ 37weeks, live birth, history of cesarean delivery, and a willingness to attempt a vaginal delivery. At the same time, 359 primiparas successfully undergoing vaginal delivery were randomly enrolled in the control group at a 1:1 ratio. Subsequently, the durations of the first, second, and third stages of labor were comparatively analyzed between the two groups. The duration of the first, second, and total stages of labor in the VBAC group was significantly shorter than that in the control group (p < 0.05). There was no significant difference in the duration of the third stage of labor between the two groups (p > 0.05). The amount of blood loss, the rate of postpartum hemorrhage (PPH), and episiotomy were higher in the VBAC group than in the control group (p < 0.05). The rate of labor analgesia and intrapartum fever in the VBAC group was significantly lower than that in the control group (p < 0.05). The duration of labor progression of the first, second, and total stages of VBAC is shorter than that in primiparous women in our observation in China.

Prevalence of Pelvic Floor Disorders in Parous Women from the Tibet Autonomous Region: A Cross-Sectional Study.

Pelvic floor disorder (PFD) seriously affects the everyday life of women. This cross-sectional study aimed to evaluate the prevalence and risk factors for postpartum PFD in women living in the Tibet Autonomous Region (TAR). Parous women who attended the outpatient gynaecology clinic at our hospital between June 2022 and August 2022 were screened in this study. The demographic and clinical data of these women were collected. Their pelvic floor functions were evaluated via a pelvic organ prolapse (POP) quantification examination, the Pelvic Floor Distress Inventory Questionnaire-20 (PFDI-20) and the Overactive Bladder Symptom Score (OABSS). A total of 201 women were included in this study, of whom 81.09% (163/201) were Tibetan. Twenty-seven women (13.43%) were diagnosed with POP stage ≥2 and 27 women (13.43%) with an OABSS score ≥3. The median PFDI-20 total score was 4.17 (range 0-43.75). Han women (n = 38) in the TAR had much lower PFDI-20 total scores, compared with Tibetan women (n = 163) (p < 0.05). The results of the multiple linear regression models showed that the PFDI-20 scores obtained from women living in the TAR were closely related to parity, history of heavy weight lifting, age, history of instrumental deliveries, ethnicity and number of caesarean sections. Pelvic floor disorder is common among parous women living in the TAR. Ethnicity, parity, history of heavy weight lifting, age, history of instrumental deliveries and number of caesarean sections are the factors closely related to the PFDI-20 scores.

Person-centered maternity care and associated factors among women who give birth at public hospitals in South Gondar zone, North West Ethiopia, 2023.

Person-centered maternity care (PCMC) is the process of maternity care that is responsive to and respectful of each woman's choices, values, and needs. It reflects the quality of maternal health services. The provision of PCMC is influenced by the maternal sociodemographic and obstetric-related variables However, there is little information about person-centered maternity care in Ethiopia; particularly, communication & autonomy, and supportive care are not well investigated. Therefore, the purpose of this study was to assess the proportion of person-centered maternity care and associated factors among women who give birth at the public hospital, in North West, Ethiopia, 2023. A facility-based cross-sectional study was conducted among 763 mothers who give birth at public hospitals in the South Gondar zone. The study participants were selected using a systematic random sampling technique. Data were collected through exit interviews using a structured pretested Amharic version questionnaire. EPI- Data version 4.6 was used for data entry and SPSS Version 25 for analysis. Bivariable & multivariable linear regression analysis was computed. Predictor variables were identified by using unstandardized β and a 95% confidence interval. A variable that has a p-value < 0.05 was considered statistically significant. The mean person-centered maternity care was 42.33 out of 90. Mothers living in rural areas (β = -1.43, 95% CI: -2.76,-0.11), 3-4 providers present during labor and delivery (β = -1.58, 95% CI:-3.67,-0.27), had no history of facility delivery (β = -2.28,95% CI:-4.43,-0.13), two days length of stay at hospitals (β = 1.69,95% CI:0.40,2.48), and highest wealth (β = 1.05,95% CI:0.42,1.41) were factors significantly associated with person-centered maternity care (PCMC). The mean score of PCMC was low in the study area compared to studies done in low- and middle-income countries. Highest wealth, 3-4 health providers present during labor and delivery, had no history of facility delivery, and had two-day lengths of stay at hospitals were predictors for PCMC. Therefore, strengthening facility delivery and promoting hospital stays for more than a day as a part of first postnatal care is paramount for increasing PCMC.

Seroprevalence of hepatitis B, C, and its associated risk factors among clinically suspected patients attending poly and Maraki Health Centers, Gondar City, North West Ethiopia.

Hepatitis B and C viruses are major global health problems with a high mortality rate, mostly due to serious liver diseases such as liver cirrhosis, liver failure, and hepatocellular carcinoma. The objective of this study was to determine the prevalence of the hepatitis B and C viruses and associated risk factors among clinically suspected patients attending Poly and Maraki Health Centers in Gondar City. An institution-based cross-sectional study was conducted to recruit 422 clinically suspected patients attending Poly and Maraki Health Centers between June and August 2020. The blood sample was tested for hepatitis B surface antigen and anti-Hepatitis C virus antibodies using commercially available rapid test kits. We used logistic regression and chi-square analysis to assess factors associated with Hepatitis B virus and Hepatitis C virus infections. The overall prevalence of hepatitis B surface antigen and anti-Hepatitis C virus antibodies was 29 (6.9%) and 5 (1.2%), respectively. The prevalence of Hepatitis B virus and Hepatitis C virus was found to be significantly higher at Maraki Health Center. Multiple sexual partners (adjusted odd ratio (AOR = 12.299; 95% CI = 2.515-60.142), history of delivery by traditional birth attendants (AOR = 6.284; 95% CI = 2.373-16.637), surgical history (AOR = 3.679; 95% CI = 1.009-13.417), previous hepatitis infections (AOR = 10.374; 95% CI = 1.128-95.444), and upper abdominal pain (AOR = 3.382; 95% CI = 1.215-9.414) were significantly associated with an increased risk of Hepatitis B virus infections. On the other hand, a history of blood transfusion (AOR = 43.132; 95% CI = 1.385-1343.176) and a history of kidney dialysis (AOR = 71.199; 95% CI = 2.074-2444.646) were significantly associated with Hepatitis C virus infection. According to the WHO endemicity classification, the prevalence of the hepatitis B virus was intermediate, while that of the hepatitis C virus was low. Therefore, it is necessary to strengthen the efforts to control and prevent Hepatitis B virus and Hepatitis C virus infections.

240 Isthmocele in patients with history of cesarean delivery followed by pregnancy complicated with placenta accreta

240 Isthmocele in patients with history of cesarean delivery followed by pregnancy complicated with placenta accreta

Evaluating the efficacy of vaginal misoprostol as a pre-insertion adjunct for intrauterine contraceptive device placement in women with a history of previous cesarean deliveries

Evaluating the efficacy of vaginal misoprostol as a pre-insertion adjunct for intrauterine contraceptive device placement in women with a history of previous cesarean deliveries