Number Of Childbirths Research Articles

Maternal Serological Screening for Congenital Toxoplasmosis During Pregnancy and Evaluating the Pregnant Women’s Knowledge on Toxoplasmosis in Qazvin, Iran

Background: The present study was designed to determine the prevalence of Toxoplasma gondii seronegative pregnant women, estimate the frequency of fetuses at risk of congenital toxoplasmosis in the study area, and also to investigate the awareness of the studied mothers about T. gondii disease.Methods: A total of 740 pregnant women referred to two health centers in Qazvin province were surveyed voluntarily for anti-T. gondii IgG and IgM antibodies by enzyme-linked immunosorbent assay (ELISA). IgG avidity test was used as a confirmatory test for samples showing positive or borderline results for IgM antibodies. Data on socioeconomic, demographic, and knowledge of participants about toxoplasmosis were collected using questionnaires and through face-to-face interviews. Multivariable logistic regression modeling was used to identify the potential predictor variables for T. gondii infection. Results: Overall, 21.2% (157/740) and 0.27% (2/740) of pregnant women were positive for T. gondii IgG and IgM antibodies, respectively. Only 1.7% (13/740) of expectant mothers had prior information on toxoplasmosis. Among socioeconomic and demographic variables, contact with soil was the merely cause of a significant association with T. gondii infection. Other variables including age, occupation, education level, residential area, source of drinking water, abortion history, number of childbirth, consumption of raw/undercooked meat, having home cat and and consumption of raw vegetables failed to establish significant associations. Conclusion: Our results clarified that the prevalence of T. gondii has remarkably reduced in the study area. This finding indicates a low risk of congenital toxoplasmosis in this region.

Determinants of Pelvic Floor Disorders among Women Visiting the Gynecology Outpatient Department in Wolkite University Specialized Center, Wolkite, Ethiopia.

Background Pelvic floor disorders encompass a broad range of interrelated clinical conditions. Pelvic floor disorders are a common public health concern that affects the lives of millions of adult females. This disorder is expected to be more widespread and probably more severe among women in low-income countries. However, there is limited knowledge about pelvic floor disorders and their determinants among women in Ethiopia. Objective The purpose of the study was to assess the determinants of pelvic floor disorders among women who visited the gynecology outpatient service at the Wolkite University Specialized Hospital, Wolkite, Ethiopia, in 2021. Methods A cross-sectional hospital study was conducted on 275 randomly chosen women from June 1 to July 1, 2021. A systematic sampling technique was used when selecting the study subjects. The data were gathered using interviewer administered structured questionnaires. The data collected was entered in version 3.1 of EpiData, and version 23 of Statistical Package for Social Sciences was used for the analysis. The variables with a P-value <0.25 in the bivariate analysis were considered for a subsequently built multivariable model, and factors with P < 0.05 in the final model were statistically significant. The results were presented in an adjusted odds ratio with a 95% confidence interval. Result The prevalence of pelvic floor disorder was reported to be 17.8% with 9.3% of the women experiencing urinary incontinence, 8.9% experiencing pelvic organ prolapse, and 5.9% experiencing anal incontinence. Two hundred thirty-two (85.9%) were currently married, while 110 (40.7%) were housewives. Statistically, a significant association was found between age at first pregnancy (AOR = 5.193; 95% CI = 1.905–14.157), many vaginal deliveries (AOR = 15.858; 95% CI = 5.305–47.400), history of episiotomy (AOR = 7.508 95% CI = 1.556–36.224), and menopause (AOR = 7.665; 95% CI = 2.440–24.078) when analyzed with a multivariate logistic regression model. Conclusion In this study, age at first pregnancy, number of vaginal births, history of episiotomy, and menopause were independently associated with pelvic floor disorder. Therefore, educating women about the year of their first pregnancy, promoting family planning, and advice on the prevention of routine episiotomy by a health professional is recommended.

Is it Possible to Increase the Quality of Sexual Life After Spontaneous Birth?

Abstract The decrease in number of vaginal births may also be due to the discomfort caused by the episiotomy wounds. Episiotomy wounds are characterized by discomfort, stinging, vulvodynia. The decrease in immunity, the increase in vaginal pH during pregnancy and pregnancy, can cause the appearance of bacterial vulvovaginitis and can lead to poor healing of the episiotomy wound. The patients will be initially evaluated by means of a questionnaire at 24 hours postpartum and then reevaluated at 7 days, when the suture material is removed, by completing the same questionnaire. Bacteriological vaginal secretion examination will also be collected both at 24 hours postpartum and at 40 days. Visual scales will also be used (REEDA scale, VANCOUVER), at 7 days and at 40 days. Thus, starting from the question, is postpartum sexual life influenced by episiotomy wounds, we will try to find an answer to this question by applying a questionnaire prepared by us.

P-783 Fertility treatment and risk of ovarian cancer in a large nationwide cohort of 151,821 infertile Danish women

Abstract Study question Do use of fertility drugs increase the risk of ovarian cancer among infertile women Summary answer Use certain types of fertility drugs may modify the risk of ovarian cancer among infertile women, primarily for serous ovarian tumors and among parous women. What is known already Even though most previous studies on the association between fertility treatment and ovarian cancer have not been able to show a convincing association, some studies have found an increased risk of this malignancy among women undergoing fertility treatment. However, many of the previous studies have had methodological limitations including selection bias and potential confounding due to missing information of important factors, such as parity status and hormonal contraceptive use, small sample size as well as short- and incomplete follow-up time. Furthermore, only few studies have assessed the association between fertility treatment and ovarian cancer according to histological type. Study design, size, duration This retrospective register-based cohort study included virtually all 20-45 year old infertile women in Denmark between 1971 and 2017 as identified in the Danish Infertility Cohort. All women were followed from entry in the cohort (i.e. the date of first infertility diagnosis) to occurrence of ovarian cancer, any other cancer (except non-melanoma skin cancer), death, emigration, bilateral oophorectomy or end of follow-up (December 31, 2017), whichever occurred first. The median follow-up length was 10.3 years Participants/materials, setting, methods In total, 332 women were diagnosed with ovarian cancer during the follow-up period. Information on the use of specific fertility drugs (clomiphene citrate, gonadotropins, hCGs, GnRH receptor modulators and progesterone), ovarian cancer, covariates and vital status was obtained from the Danish Infertility Cohort and various Danish national registers. Cox proportional hazard regression models were used to calculate hazard ratios (HRs) and 95% CIs for ovarian cancer overall and for serous ovarian tumors. Main results and the role of chance After adjustment for attained age (as the underlying time scale), calendar year of study entry, highest obtained level of education, maternal age at first childbirth, number of childbirths, hormonal contraceptive use as well as mutual adjustment for treatment with any other specific fertility drugs, ever use of hCG (HR 0.62, 95% CI 0.44-0.89) and GnRH receptor modulators (HR 0.63, 95% CI 0.40-1.00) were associated with a decreased risk of overall ovarian cancer. In contrast, ever use of gonadotropins (HR 1.43; 95% CI 0.91-2.24) and especially progesterone (HR 1.81; 95% CI 1.18-2.78) increased the risk of overall ovarian cancer. No marked association was observed for clomiphene citrate (HR 1.07, 95% CI 0.80-1.44)). The rates for serous ovarian cancer generally resembled those observed for overall ovarian cancer; however only the association for progesterone reached statistical significance (HR 2.89; 95% CI 1.67-4.99). The observed associations existed mainly among parous women and did not vary with time since first use of the fertility drug in question and no statistically significant associations were observed with cumulative dose of the specific fertility drugs. Limitations, reasons for caution The median age at the end of follow-up was only 42.5 years, which is markedly lower than the usual peak age for ovarian cancer in Denmark (mid 60s). Hence, we were not able to capture the true, potential long-term association between use of fertility drugs and ovarian cancer. Wider implications of the findings Use of certain specific types of fertility drugs in fertility treatment may modify the risk of ovarian cancer among subgroups of women. However, although this study is by far the largest to date, additional large epidemiological studies with longer follow-up time are needed to further clarify the observed associations. Trial registration number Not applicable.

The rs2165241 polymorphism of the Loxl1 gene in postmenopausal women with pelvic organ prolapse

Objective This study aimed to verify the presence of polymorphism rs2165241 of the lysyl oxidase-like 1 (Loxl1) gene and its association with pelvic organ prolapse (POP) in Brazilian women and determine risk factors for POP development. Methods The study was previously approved by the local research and ethics board. Postmenopausal women were included and divided into POP (stages III and IV) and control (stages 0 and I) groups. Peripheral blood samples were collected, and the DNA sequence of interest was analyzed by real-time reverse-transcriptase polymerase chain reaction. We used logistic regression and considered a recessive model of inheritance for the analysis, with p < 0.05 for significance. Results A total of 836 women were assessed: 426 POP cases and 410 controls. The frequencies of CC, CT and TT genotypes were similar in both groups. Age (odds ratio [OR] = 1.1, 95% confidence interval [CI] = 1.07; 1.14), number of vaginal births (OR = 17.06, 95% CI = 5.94; 48.97), family history (OR = 2.87, 95% CI = 1.57; 5.22) and weight of largest newborn (OR = 1.001, 95% CI = 1.0003; 1.001) were independent risk factors for POP, while multiple cesarean sections (two or more) was protective (OR = 0.17, 95% CI = 0.07; 0.42). Conclusion No association was detected between rs2165241 of the Loxl1 gene and POP.

How do reproductive history and anthropometry in midlife relate to later risk of pelvic organ prolapse? A prospective cohort study.

The objective was to examine the association between reproductive and anthropometric factors and later risk of pelvic organ prolapse (POP). We carried out a prospective cohort study including 11,114 female nurses > 44years from the Danish Nurse Cohort. In 1993, the study population was recruited through the Danish Nurse Organization and self-reported data on age, height, weight, age at menarche, age at first birth and number of childbirths were obtained. POP diagnosis was obtained from the National Patient Registry. Risk of POP was estimated using COX regression and presented as hazard ratios (HR) with 95% confidence intervals (CI). Overall, 10% of the women received a diagnosis of POP within a median follow-up of 22years. A 4% increase in risk of POP was seen for each increasing BMI (kg/m2) unit at baseline. Compared to women of normal weight, higher risks of POP were seen in overweight (HR 1.18: 1.02-1.36) and obese women (HR 1.33: 1.02-1.74), while underweight had a lower risk (HR 0.51: 0.27-0.95). Compared to women with one childbirth, women with no childbirths had a reduced risk of 57% while increased risks of 46%, 78% and 137% were observed in women with two, three and four childbirths. Women with menarche before the age of 12 tended to have a higher risk of POP as did women who were 30-33years at their first childbirth. POP is a common health problem in women, and BMI and number of childbirths are strong predictors.

High Prevalence of Asymptomatic Intracranial Atherosclerosis in Elder Women With Tubal Ligation: Result From a Community-Based Study in Shandong, China.

BackgroundIn addition to traditional cardiovascular risk factors, gender-specific factors may also contribute to intracranial atherosclerosis. This study aimed to comprehensively investigate the association between asymptomatic intracranial atherosclerosis (aICAS) and menstrual or reproductive history (MRH), namely, menstruation, pregnancy, childbirth, menopause, and contraception.MethodsParticipants in this study were selected from the Kongcun town aICAS study. MRH was collected through structured case report forms, in which menarche age, menstrual regularity, dysmenorrhea, number of pregnancies, number of childbirths, age of first pregnancy, breastfeeding, menopause, menopause age, and contraceptive methods were all involved. All characteristics were compared by chi-squared and nonparametric tests as applicable. Logistic regression model and sensitivity analysis were used to analyze the association between aICAS and MRH.ResultsA total of 1,052 female participants were involved in this study, of which 5.7% had moderate to severe aICAS. Tubal ligation was significantly associated with aICAS in univariate analysis [crude odds ratio (OR), 2.85; 95% CI, 1.22–6.62; P = 0.015]. This association was still significant among female participants over 60 years old after multivariate adjustment (adjusted OR, 4.36; 95% CI, 1.55–12.24; P = 0.005). Sensitivity analysis showed a similar result (adjusted OR, 3.76; 95% CI, 1.24–11.41; P = 0.020). Menopause lost significant association with aICAS after multivariate adjustment (adjusted OR, 1.68; 95% CI, 0.66–4.24; P = 0.275). No other MRH factors were found to be associated with aICAS.ConclusionTubal ligation may be associated with a higher prevalence of aICAS in Chinese elderly women. This provides a new perspective to study the epidemiological characteristics of ICAS.

Vaginal pressure sensor measurement during maximal voluntary pelvic floor contraction correlates with vaginal birth and pelvic organ prolapse-A pilot study.

To measure the force applied along the anterior and posterior vaginal walls in a cohort of 46 patients measured by a fiber-optic pressure sensor and determine if this correlates with vaginal parity and pelvic organ prolapse (POP). An intravaginal fiber-optic sensor measured pressure at nine locations along the anterior and posterior vaginal walls during a maximal voluntary pelvic floor muscle contraction (MVC). An automated probe dilation cycle measured the tissue resistance incorporating the vagina and surrounding anatomy. MVC and resting tissue resistance (RTR) were assessed between subjects grouped by the number of vaginal births and prolapse stage. A previous vaginal birth was associated with a significant threefold decrease in the overall anterior pressure measurement during MVC. Decreased anterior pressure measurements were observed at Sensors 1 and 3 (distal vagina) and, posteriorly at Sensors 4-6 (midvagina). Women with Stage 2 posterior prolapse exhibited a decreased MVC pressure in the midvagina than those with Stage 0/1. In this pilot study, there was no difference in the vaginal wall RTR according to previous vaginal birth or stage of prolapse. This pilot study found that a decrease in vaginal pressure measured during MVC is associated with vaginal birth and with posterior POP. Greater sample size is required to assess the role of resting tissue pressure measurement.

Long-term association of pregnancy and maternal brain structure: the Rotterdam Study

The peripartum period is the highest risk interval for the onset or exacerbation of psychiatric illness in women’s lives. Notably, pregnancy and childbirth have been associated with short-term structural and functional changes in the maternal human brain. Yet the long-term effects of pregnancy on maternal brain structure remain unknown. We investigated a large population-based cohort to examine the association between parity and brain structure. In total, 2,835 women (mean age 65.2 years; all free from dementia, stroke, and cortical brain infarcts) from the Rotterdam Study underwent magnetic resonance imaging (1.5 T) between 2005 and 2015. Associations of parity with global and lobar brain tissue volumes, white matter microstructure, and markers of vascular brain disease were examined using regression models. We found that parity was associated with a larger global gray matter volume (β = 0.14, 95% CI = 0.09–0.19), a finding that persisted following adjustment for sociodemographic factors. A non-significant dose-dependent relationship was observed between a higher number of childbirths and larger gray matter volume. The gray matter volume association with parity was globally proportional across lobes. No associations were found regarding white matter volume or integrity, nor with markers of cerebral small vessel disease. The current findings suggest that pregnancy and childbirth are associated with robust long-term changes in brain structure involving a larger global gray matter volume that persists for decades. Future studies are warranted to further investigate the mechanism and physiological relevance of these differences in brain morphology.

Influence of parity and Body Mass Index (BMI) on endometry thickness variation in women of Lokossa, Benin

The thickness of the endometrium is also an important parameter in the clinical management of women. It is often influenced by several parameters which are important to determine. This is why the present study looked at the factors that influence the variation in the thickness of the endometrium of women in Lokossa in the Republic of Benin. This descriptive, prospective and cross-sectional study concerns 166 women aged 15 to 40 in Lokossa. Ultrasound examination measured the thickness of the endometrium on the longitudinal section through the suprapubic route. Anthropometric parameters were taken by other equipment from each woman. Analysis of one-way proc glm ANOVA variants and Student-Newman-Keuls (SNK) tests identified factors associated with variation in endometrial thickness in women. At the end of the study, the minimum, average and maximum values ​​of the thickness of the endometrium obtained are respectively Vm = 3.50 mm, VMoy = 6.73 ± 1.38 mm, MV = 10.00 mm during the pre-ovulatory phase, Vm = 7.30 mm, MV avg = 10.75 ± 2.11 mm, MV = 16.00 mm during the post-ovulatory period. There is an association between the thickness of the endometrium and parameters such as age, weight, Body Mass Index, parity. BMI has been found to be associated with changes in endometrial thickness. And this variation in the thickness of the endometrium of the woman's uterus is related to the number of deliveries. Thus, the higher the number of childbirth, the greater the thickness of the endometrium deprived.

Association between breastfeeding and breast, thyroid, and cervical cancer among Korean adult women based on the Korean Genome and Epidemiology Study: a cohort study.

PurposeThe purpose of this study was to explore the association between breastfeeding and the prevalence of breast, thyroid, and cervical cancer among Korean adult women.MethodsThe study was a secondary analysis of data from the Korea Genome and Epidemiology Study. The final samples were 113,944 Korean women among 173,205 urban-based cohort participants collected between 2004 and 2013 for adults aged forty and over. To determine the association between female cancers and breastfeeding experience, the number of childbirth, and total breastfeeding duration, logistic regression analysis was done. The demographic characteristics, health behavior, and female history were adjusted.ResultsThe prevalence of breast cancer was 1.37 times higher in the non-breastfeeding group than in the breastfeeding group. Compared to having breastfed for more than 36 months, the prevalence of thyroid cancer was 1.68 times higher at breastfeeding for 13 to 36 months, 1.67 times higher at breastfeeding for 6 to 12 months, and 2.06 times higher at breastfeeding less than 6 months. Also, the prevalence of cervical cancer was 1.54 times higher at breastfeeding for 13 to 36 months, compared to breastfeeding for more than 36 months.ConclusionThis study found that breastfeeding experience and a longer breastfeeding duration are associated with reduced risk of breast, thyroid, and cervical cancer in Korean women. It can be used as a basis for encouraging breastfeeding, and suggests further research on modifiable factors that reduce cancer risks.

Impact of Treatment Modality on Pelvic Floor Dysfunction for Uterine Cancer Survivors

<h3>Purpose/Objective(s)</h3> Long-term adverse effects of uterine cancer patients are not well reported. In this single-institution, cross-sectional study we compared pelvic floor dysfunction (PFD) in uterine cancer survivors across different treatment modalities. <h3>Materials/Methods</h3> Patients with uterine cancer treated from 2006-2018 were eligible. Three cohorts with no recurrence of cancer were identified through the institutional tumor registry, including patients who: underwent hysterectomy/bilateral salpingo-oophorectomy (BSO) alone; hysterectomy/BSO and adjuvant brachytherapy; or, hysterectomy/BSO and adjuvant external beam radiation therapy (EBRT). A non-cancer cohort who had a hysterectomy/BSO for benign indications was also identified. To compare PFD, we utilized the Pelvic Floor Distress Inventory (PFDI-20), a validated 20-item measure to assess lower urinary distress (UDI-6), colorectal distress (CRAD-8), and pelvic organ prolapse dysfunction (POPDI-6). The three subscale scores ranged from 0-100, with an overall summary score ranging from 0-300. Treatment, BMI, comorbidities, and number of vaginal births were obtained from medical records. A generalized linear model with γ-distribution and subsequent multivariable model was used to assess treatment modalities and covariate effects on PFDI-20 results. <h3>Results</h3> A total of 302 patients completed the PFDI-20 (hysterectomy/BSO alone, n = 64; brachytherapy, n = 77; EBRT, n = 96; benign hysterectomy/BSO, n = 65). Median time from surgery to completion of survey was 6.7 years. Median age was 65.9 years (range 34-92), median BMI at surgery 30.9 (range 18.1-68), median current BMI 29.9 (range 16.8-64.3), and median number of vaginal births 1.28 (range 0-10). Most uterine cancers were endometroid (73%, n = 173); 45% (n = 105) were treated with concurrent chemotherapy. Any PFD symptoms were reported in 76% of patients with a median total PFDI-20 score of 38.7. Overall, lower urinary tract symptoms were the most predominant (median 20.1), followed by colorectal-anal distress (median 11.8), then uterovaginal prolapse (median 6.8). The EBRT cohort had the highest median PFDI-20 score (48.9), followed by the benign hysterectomy group (median 43.5), surgery only group (median 34.6), and brachytherapy group (median 27.5). Among the treatment groups, the EBRT cohort had a statistically significant increase in PFD (<i>P</i> = 0.011). Number of vaginal births was associated with significantly worsened overall pelvic floor dysfunction (<i>P</i> = 0.015). Upon multivariable analysis which included treatment cohort, BMI at surgery, current age, number of vaginal births, and Charlson Comorbidity Index, only number of vaginal births remained significant (<i>P</i> = 0.003). <h3>Conclusion</h3> This study highlighted the effect of treatment modality on pelvic floor dysfunction in uterine cancer survivors and underscores the impact of EBRT on late pelvic floor symptoms and need to screen survivors for symptoms to improve long-term quality of life.

An Audit of Maternal Mortality at a Tertiary Care Hospital

Objective:To find causes of maternal deaths and to calculate maternal mortality ratio at tertiary care hospital Karachi. Study Design and setting:An observational study was conducted from1st January 2019 to 31stDecember 2020 at theDepartment of Obstetrics &amp; Gynecology Unit 1, JPMC Karachi. Methodology:Patients were selected according to inclusion criteria after ethical approval through non probability consecutivesampling technique. Details of patients were obtained from filesand record registers. Their demographic feature like age,parity, gestational age, booking status and presence or absence of medical disorders, their status of delivery and direct andindirect reasons of maternal deaths were noted and their frequency and percentages were calculated. Brought dead patientsand those who died accidently were excluded from the study. Results:During the period of two years the total numbers of deaths certified in the department were 90. Total number ofchild birth and live births were 19084 and 17892 respectively. The maternal mortality ratio was estimated as 503.01 per100,000 live births. Most of the patients 74(82.3%) were un booked. Direct Causes were about 67(74.5%). Haemorrhagewas found to be most common reason of maternal deaths in about21(23.3%). Eclampsia among18(20%) deaths. Anemia, cardiac disease, hepatic failure were the indirect causes of maternal deaths responsible for 23 (25.5%) of maternal deaths. Conclusion:Maternal Death rate is persistently elevated in JPMC, being tertiary care hospital mostly due to serious and referred complicated cases. Haemorrhage and eclampsia are still major killers of mothers as before.

Do obstetric factors have an effect on success of medical treatment of anal fissure seen in women?

Objective: The aim of this study is to examine the effect of obstetric factors on the medical treatment success of anal fissure in women.&#x0D; Material and methods: A total of 324 women, who were diagnosed with anal fissure, who applied to the General Surgery outpatient clinic between 2015 and 2020, were included in the study. The patients were divided into two groups; group I (medical treatment was successful) and group II (medical treatment failed - surgery performed). Both groups were compared in terms of age, body mass index (BMI), number of births, delivery type, birth weight, breastfeeding rate, constipation, diarrhea, smoking and anal fissure symptoms.&#x0D; Results: Medical treatment was applied to all of the 324 patients we included in our study, and it was observed that 45.7% of them had successful medical treatment and 54.3% had undergone surgical treatment (lateral internal sphincterotomy) because of unsuccessful medical treatment. It was found that age, BMI, number of births, number of vaginal births, breastfeeding rate, constipation rates were higher in those who failed medical treatment (p 0.05). While gas incontinence was observed in 44.1% of those who underwent surgical treatment, this rate was found to be 1.4% in those who benefited from medical treatment.&#x0D; Conclusion: In our study, it was found that while maternal age, number of births, vaginal delivery and breastfeeding rates had a negative effect on the success of anal fissure medical treatment, cesarean delivery and baby birth weight were not effective.

Correlation between Anemia and Preeclampsia in Universitas Airlangga Hospital in 2017

Introduction: One of the causes of acute kidney injury that is increasingly soaring is preeclampsia syndrome. Globally, the maternal mortality rate reaches 287,000 per year, and preeclampsia is a major contributor. From East Java Provincial Health Office data, per 100,000 pregnancies, 114 had preeclampsia syndrome. Anemia is one of the highest causes of maternal death, the global prevalence of anemia in pregnant women reaches 55.9%. There have not been many significant studies on the effect of anemia with the incidence of preeclampsia.Methods: This was observational analytic study with a case and control design which used a chi-square and fisher exact measurement tool. The data samples were patients of pregnant women who had preeclampsia syndrome categorized as cases, and those who did not have preeclampsia were categorized as controls. The data has been obtained from medical records; these include ages, the number of parities, the number of pregnancies, body mass index (BMI), the number of childbirths, types of preeclampsia, and hemoglobin levels. The data has been obtained from the result of the medical record observations that were processed and analyzed in descriptive of statistics which used percentage and cross tab.Results: The case study group or preeclampsia pregnant women who experienced anemia were 34 patients or 50% of 68 pregnant women and in the control group were 53 patients or 39% of anemia patients out of 136 patients. The chi-square statistical test obtained values (p = 0.133). The samples needed were 68 case groups and 136 cases as controls.Conclusion: There was no relationship between anemia and preeclampsia.

Examining Prevalence of Fetal Defects and Related Factors in Neonates Born and Hospitalized in Kerman Reference Hospital: A 66-Month Study

Background: Congenital malformations are one of the most important causes of disability and mortality of neonates. Many of these defects can be prevented. Therefore, recognizing and preventing the threatening factors that cause the adverse outcomes of pregnancy can prevent excessive costs to the family and society. The present study was performed to determine the prevalence of congenital malformations and some related factors in Afzalipour Hospital in Kerman, Iran. Materials and Methods: In this cross-sectional study and historical cohort, 1089 neonatal files were selected from 43076 files in the period of March 2014 to September 2019 by stratified sampling method with proportional allocation. Maternal and neonatal information including gender of infant, maternal and neonatal blood type, first and fifth minute Apgar score, LMP-based gestational week, maternal underlying disease, history of disease in pregnancy, maternal addiction, maternal number of pregnancies, number of childbirths, number of live children, number of stillbirths, history of abortion and stillbirth, type of childbirth and the congenital anomalies and its type were extracted from the files and recorded in the researcher-made checklist. Results: The prevalence of congenital malformations in neonates was 16.6%. The most common malformations were cardiovascular malformations (55.3%) and genitourinary malformations (19.3%). Girl gender, lack of maternal addiction, increasing maternal pregnancy, low Apgar score, and hospitalization in NICUs increase the chances of congenital malformations in neonates. Conclusion: The prevalence of congenital malformations in neonates was 16.6%. The most common malformations included cardiovascular malformations and genitourinary malformations.

Human papillomavirus genotyping and vaginal microbial metabolites in 276 patients with atypical cervical squamous cells and the clinical effect of nano-silver after loop electrosurgical excision procedure

Cervical intraepithelial neoplasia (CIN) is a precancerous lesion of cervical malignant tumors. CIN is closely related to persistent human papillomavirus (HPV) infection, sexual behavior, and number of childbirths. The effect of vaginal microbial metabolites (VMM) on CIN is unclear; hence, we studied the effects of VMM and high-risk HPV (HR-HPV) infection on CIN and the clinical effects of nano-silver after loop electrosurgical excision procedure (LEEP). We selected the patients who went to the obstetrics and gynecology department of our hospital from January 2019 to November 2020, and we conducted vaginal microbiology, HPV typing, and histopathological examination on 282 patients. Among them, six patients had cervical cancer, 136 patients with CIN were regarded as the CIN group, and 140 patients with normal pathological tissue were regarded as the normal group. The results showed that H2O2and HR-HPV infection were significantly correlated with the risk of CIN (P&lt; 0.05). LEEP was performed on CIN patients, and the treatment with nano-silver gynecological antibacterial suppository was postoperatively compared with patients without special treatment. The results show that postoperative treatment with nano-silver can shorten the bleeding and exudation time of the wound and promote wound healing. It can simultaneously reduce wound infection and promote HPV to become negative, which can effectively reduce postoperative complications and recurrence.

19 The impact of obesity on native tissue repair outcomes: A secondary analysis of the OPTIMAL trial data

The Operations and Pelvic Muscle Training in the Management of Apical Support Loss (OPTIMAL) trial was a multi-site, prospective randomized trial which compared sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) surgical outcomes, and also evaluated the impact of perioperative pelvic muscle training (PMT). Increasing body mass index (BMI) is associated with increased risk of pelvic organ prolapse and the prevalence of obesity is increasing worldwide. The purpose of this study is to better understand the impact of obesity on the results of native tissue vaginal apical suspension procedures. This study is a secondary analysis of data collected during the OPTIMAL trial, which is now a deidentified public dataset in the NIH Data and Specimen Hub database. Subgroup analysis of patients who received SSLF or ULS procedures and PMT or usual care was performed to determine if there were differences in surgical failure rates across a range of BMIs after two years. The sample size in this analysis was 297; not all of the original OPTIMAL data was available due to the deidentification process. Data were analyzed using ANOVA test, Tukey’s HSD post-hoc analysis, Fisher’s exact test, and Wald correct proportion risk difference test which is a method of identifying 95% confidence intervals. There were 75, 120, 63, and 39 patients in the normal, overweight, class 1 obesity, and class 2 obesity or greater BMI subgroups, respectively. The groups were not significantly different based on surgical arm or PMT arm, smoking, estrogen use, menopausal status, or number of cesarean sections (Table 1). However, there were differences in age, race, and number of vaginal births. In each BMI subgroup, the surgical failure rates and risk differences were not significantly different for the surgical or PMT arms (Table 2). Interestingly, the surgical failure rate increased in the ULS group with increasing BMI (normal = 30.56%, overweight = 30.16%, class 1 obese = 40.63%, class 2 obese or greater = 45%). Additionally, the risk difference between ULS and SSLF groups increased with BMI (normal = 5.34%, overweight = 8.44%, class 1 obesity = 1.92%, class 2 obesity or greater = 23.95%). The risk of surgical failure between ULS and SSLF, or PMT and usual care, is not significantly associated with increasing BMI. However, the increasing failure rate of ULS and difference in failure rates of ULS compared to SSLF with increasing BMI in our study may indicate an association if analyzed for a longer time period.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Impact of parity on the incidence of ovarian cancer subtypes: a population-based case–control study

Background Parity is known to have a protective effect as regards ovarian cancer, but its effect on the different histological subtypes of ovarian cancer is not well known. The impact of parity on the incidence of ovarian cancer subtypes was studied. Material and methods All Finnish women diagnosed 1994–2013 with ovarian cancer for the first time were included. Altogether, 5412 cases of ovarian cancer were identified in the Finnish Cancer Registry and stratified according to morphology into serous, mucinous, endometrioid, clear cell and others. Five age-matched controls were randomly selected for each case from the Finnish National Population Registry. Data on postmenopausal hormonal therapy were derived from the Registry of Prescribed drugs and used as cofactors. Multivariate conditional logistic regression for matched case-control data was used to examine the associations between parity parameters and ovarian cancer risk. Results Parous women had lower risk than nulliparous women in getting ovarian cancer of any type under age of 55 years. The odds ratio (OR) for serous cancer was 0.65 (95% confidence interval 0.56–0.77), for mucinous cancer 0.66 (0.52–0.83), for endometrioid cancer 0.52 (0.40–0.68), for clear-cell cancer 0.30 (0.19–0.46) and for other types 0.59 (0.43–0.80). In women aged 55 or older, the respective ORs were 0.86 (0.75–0.99), 0.78 (0.57–1.07), 0.61 (0.47–0.79), 0.44 (0.29–0.66) and 0.74 (0.57–0.95), adjusted for hormone therapy. Number of childbirths was associated with a trend toward reduction of risk, especially in serous and clear-cell cancers. Higher age at first birth was associated with higher risk of clear-cell cancer but otherwise age at first or last birth did not have an impact on the incidence of cancer subtypes. Conclusions Childbirths decrease the risk of all histologic subtypes of epithelial ovarian cancer in women in premenopausal and postmenopausal age.

Inappropriate pelvic floor muscle activation during forced exhalation and coughing in elderly female inpatients with urinary incontinence

BackgroundReduced pelvic floor muscle (PFM) contraction strength is a common condition in elderly female patients with urinary incontinence (UI). However, little data exist to demonstrate the importance of appropriate PFM activation during exhaling and coughing. ObjectivesTo analyse breathing and coughing patterns in elderly female inpatients with UI, and to assess PFM activation patterns during exhalation and coughing. DesignRetrospective chart data analysis. Patients and methodsData from 177 elderly female inpatients with UI were analysed to determine voluntary PFM contraction strength, as well as PFM activation and displacement of the pelvic floor (PF) and abdominal wall during forced exhalation and coughing. Clinical data were obtained by means of inspection and digital palpation in the course of a routine clinical UI assessment. Data collected were correlated with age, body mass index and number of childbirths, and categorised by predominant UI symptoms, history of previous hysterectomy and history of PFM training. ResultsIndependent of voluntary PFM contraction strength, nearly all patients (n=168) demonstrated bulging of the abdominal wall and PF during forced exhalation and coughing instead of contracting the PFMs and consequently lifting the PF, which would be in accordance with physiological breathing synergies. None of the nine women who reflexively contracted the PFM physiologically in accordance with an expiratory breathing pattern complained of symptoms of stress UI alone. ConclusionA high percentage of elderly females with UI do not activate their PFMs appropriately during forced exhalation and coughing, possibly contributing to or exacerbating UI.