Previous Abortion Research Articles

Short interbirth interval and adverse pregnancy outcomes: a Bayesian network approach

BackgroundInterbirth interval (IBI), the time between consecutive births, has been tied to perinatal outcomes. ObjectiveTo analyze adverse perinatal events following short IBI in a large South American sample. Study designObservational, retrospective, hospital-based study including malformed and nonmalformed live- and stillbirths. Outcomes were preterm birth (PTB), low birth weight (LBW), and specific birth defects. Logistic regressions were used to evaluate the risk of selected variables for short IBI and for adverse outcomes after short IBI, adjusting by confounders. Bayesian networks exhibited relationships among short IBI, outcomes, and variables. ResultsShort IBI rate was 2%–3%. Maternal age and a previous abortion were the main confounders. A significant high risk for short IBI was found in mothers ≤19 years while mothers ≥30 were at low risk, mediated by a previous abortion. The risk of short IBI, adjusted by confounders, was significant for LBW but not for PTB. An unadjusted risk of short IBI was observed for gastroschisis, which disappeared after adjusting for confounders. Maternal age ≤19 and previous abortion were directly related with gastroschisis; the relationship between gastroschisis and short IBI occurred through any of these two variables. A direct relationship between gastroschisis and maternal age ≥30 was observed. ConclusionsOnly young mothers were directly related with short IBI. In older mothers, a short IBI mainly occurred after a previous abortion. Short IBI was a risk factor only for LBW. The PTB and gastroschisis relationship with short IBI was indirect, mediated by young maternal age and/or a previous abortion.

Unraveling gestational diabetes in Ethiopia: Insights from a cross-sectional study on prevalence and risk factors among Sidama’s pregnant population

BackgroundGestational diabetes mellitus (GDM) is a chronic condition characterized by glucose intolerance during pregnancy and is particularly common in low- and middle-income countries, where it poses significant health risks to both mothers and their fetuses. Research on this topic in Ethiopia has been limited, especially regarding the World Health Organization’s 2013 guidelines for universal screening. This study aims to evaluate the prevalence of GDM and identify its influencing factors among women attending antenatal clinics in the Sidama regional state. MethodsA cross-sectional study in the Sidama Region included 685 pregnant women who underwent a two-hour Oral Glucose Tolerance Test for universal screening and diagnosis of gestational diabetes mellitus (GDM). The prevalence of GDM was evaluated using descriptive statistics and multivariate analysis with the adjusted odds ratio (AOR) at a 95% confidence interval and a significance level of 0.05. ResultsThe study, comprising 685 participants, attained a 92.4 % response rate, indicating a 16.1 % prevalence of GDM overall and an average post-glucose load level of 0.99 mmole/L. Factors such as living in urban areas (AOR = 1.69, 95 % CI (1.011, 2.82)), being widowed (AOR = 2.23,95 % CI (1.00,5.08)), history of previous abortions (AOR = 2.59,95 %CI(1.50,4.50)), prior caesarean section(AOR = 0.14,95 % CI (0.07,0.27)), gravidity (AOR = 0.77,95 % CI (0.64,0.94)), parity (AOR = 1.93, 95 % CI (1.54, 2.42)), and HIV/AIDS status (AOR = 4.06, 95 % CI (2.18, 7.58)) were independently associated with GDM. ConclusionThe study revealed a gestational diabetes mellitus (GDM) prevalence of 16.1% in the Sidama region of Ethiopia, consistent with findings from other recent studies across the country. It also identified several key independent risk factors for GDM, including urban residency, widowhood, prior abortions or cesarean deliveries, HIV status, gravidity, and parity. The results emphasize the critical need for targeted interventions and continuous monitoring of GDM among pregnant women, particularly in regions with high prevalence. To enhance maternal health outcomes in Ethiopia and beyond, it is crucial to incorporate these findings into comprehensive healthcare strategies.

Membranous Dysmenorrhea: An Underdiagnosed Condition

Dysmenorrhea is the most prevalent gynecological symptom in menopausal women. Currently defined as menstrual cramps, it is on the list of the main complaints in gynecological consultations. A sub-classification forgotten in medical dictionaries is membranous dysmenorrhea (MD), which corresponds to the elimination of membranes through the vaginal canal. The definitive diagnosis requires anatomopathological study, and abortion is the main differential diagnosis. As there are few cases in the literature, this study aims to present a series of eight cases, highlighting the pathophysiology and comparing the data with other studies to encourage discussion on the subject. This is an observational, longitudinal, retrospective study including women with clinical membranous dysmenorrhea (spontaneous elimination of fibroelastic material via the vagina). The results show that of the eight patients, seven had used or were using exogenous female hormones; 62.5% of the total had MD in the 2nd - 3rd decade of life, two had had previous abortions, and one was nulliparous. All these facts have been associated in the literature as etiological or contributing factors to MD. However, while diverging from the literature, our article showed that the infection factor is not mandatory for the occurrence of MD. In conclusion, proposing a single pathophysiological and etiological mechanism based on a series of cases and in comparison with other data in the literature is a challenge. However, consistently with what has been published, most of the cases presented were the result of an increased vascular response of the endometrium when exposed to an exogenous source of estrogen and progesterone, and this could be a hypothesis which, of course, requires further studies to establish the exact casuistry, but which contributes greatly as a source of data for future research.

Effectiveness and Safety of Medical Abortion with Mifepristone and Sublingual Misoprostol up to 63 Days of Gestation

Background: The use of medical abortion increases among unplanned pregnant women. The primary objective of this study is to assess the outcomes of using a combination of Mifepristone followed by sublingual Misoprostol for the termination of pregnancy up to 63 gestational days. The secondary objectives were identifying significant factors that contribute to an increased rate of incomplete abortions resulting in surgical intervention and evaluating the safety of this medical procedure. Methods: This retrospective cohort study was conducted at Siriraj Hospital, a tertiary care center in Thailand, from July 2021 to December 2023. Women were given 200 mg of oral Mifepristone at the clinic, followed by self-administration of 800 μg of sublingual Misoprostol at home 36–48 hours later. A follow-up visit was scheduled approximately 14 days later to confirm the outcome of the procedure. Demographic and medical data were collected from medical records and subsequently analyzed. The primary outcome was defined as the success of the procedure, indicated by complete abortion without the need for surgical intervention. Secondary outcomes included assessing side effects and complications following medication administration, as well as identifying factors associated with an increased rate of incomplete abortions. Results: The final analysis included follow-up data from 205 women. Medical abortion was successful in 70.7% (145 out of 205) of cases, with no ongoing pregancies recorded. No serious side effects or complications were detected. Diarrhea and chills were the most commonly observed side effects. The study found that women with a history of previous abortions and those experiencing significantly heavier bleeding after the procedure were at a higher risk of incomplete abortion, requiring surgical aspiration. Conclusions: The regimen of oral Mifepristone followed by sublingual Misoprostol for medical termination of pregnancy is effective and safe through 63 days of gestation. A history of previous abortion and experiencing heavier bleeding after the procedure were identified as risk factors for incomplete abortion.

Determinants of Infertile of Infertile Women Requesting Assisted Reproduction Techniques in a Low Resource Setting in Western Nigeria

Background: Infertility is an important gynaecological condition with psycho-social, cultural, economic, religious, demographic, and clinical consequences. Although the prevalence of couples having problems with conception has remained relatively stable worldwide, there has been an increase in the proportion of couples seeking fertility services. This substantial increase might reflect the improvement in the advancements in fertility care, improved success rates, increased availability of specialists and or involvement of insurance firms in infertility treatment. Paradoxically, countries in Africa with high infertility burden still lags in fertility care. This study was therefore aims to investigate the types and causes of infertility in patients attending fertility care in an assisted conception Centre in a public tertiary hospital in southwest Nigeria. Methods: This was a retrospective study of patient records who attended Assisted fertility centre (AFC) of Lagos University Teaching Hospital (LUTH), from January 1st, 2015, to December 31st, 2023. Categorical variables were analysed using percentages while continuous variables were analysed using mean and standard deviation and the association between categorical variables was analysed using chi-square test. The statistical significance level was set at p-value < 0.05. Results: The mean age and mean duration of infertility of the participants in the study was 40.89±6.8, and 8.14±3.5 respectively. About 72.9% had more than secondary education while almost two thirds of the participants had secondary infertility, 36.1% had previous pelvic surgeries, 11.4% had chronic pelvic pain and menstrual abnormality. Secondary infertility was more prevalent in women who has chronic pelvic pain, or those who has had previous pelvic surgery, previous infertility or previous abortion. Conclusion: In conclusion our analysis suggests that Secondary infertility is the commonest cause of inability to conceive in our facility. It also revealed that most of our women present late for fertility care at an advanced maternal age.

High-risk factors for massive haemorrhage in medical abortion patients with missed miscarriage

BackgroundRecently, the incidence of missed miscarriage has gradually increased, and medical abortion is a common method to terminate a pregnancy. In the process of medical abortion, massive vaginal bleeding takes place, leading to emergency surgical haemostasis. Emergency surgery may produce infection and organ damage. Our study aimed to investigate the high-risk factors for massive haemorrhage during a medical abortion.MethodsA total of 1062 missed miscarriage patients who underwent medical abortion participated in this retrospective study. According to the amount of bleeding, the patients were divided into a massive haemorrhage group and a control group. By comparing the general conditions of the two groups, such as fertility history, uterine surgery history, uterine fibroids, etc., the high-risk factors for massive haemorrhage during medical abortion were identified.ResultsRelative to the control group, the massive haemorrhage group exhibited a higher proportion of patients with a previous artificial abortion (51.9% vs. 38.1%, P = 0.001). Additionally, the massive haemorrhage group had a lower percentage of first-time pregnant women (32.1% vs. 40.4%) and a higher proportion of women with shorter pregnancy intervals (44.9% vs. 33.1%, P = 0.03). Furthermore, there were notable differences between the two groups regarding maximum fibroid size, the duration of amenorrhea, and gestational week (P < 0.05).ConclusionIn this study, we determined that a history of artificial abortion and an amenorrhea duration of > 11 weeks represented high-risk factors for massive vaginal bleeding during medical abortion in missed miscarriage patients.

Anemia in young pregnant women: A cross-sectional study in Indonesia

Background: The prevalence of anemia among pregnant women in Indonesian remains high at 48.9%, with the highest rates observed among young mothers aged 15-24 years. Anemia is associated with adverse outcomes for both mothers and their children. Understanding the determinants of anemia in young mothers is crucial for taking preventive measures. However, there are currently no national studies in Indonesia on the prevalence and risk factors of anemia in pregnant women aged 15 to 24 years.Objective: To measure the prevalence and factors associated with anemia in young pregnant women in Indonesia.Methods: This cross-sectional study utilized on secondary data from the 2018 Basic Health Research (Riset Kesehatan Dasar= Riskesdas). The subject of this research were pregnant women aged 15 to 24 years who participated in Riskesdas 2018 and had independent variables data including hemoglobin measurement data, age, education, residence, occupation, travel time to health facilities, age at first pregnancy, ownership of the maternal and child health (MCH) handbook, history of previous abortion, gestational age, number of iron supplement tablets, supplementary feeding, and chronic energy deficiency. Univariate analysis was conducted to analyse the subject characteristics and hemoglobin data, while chi-square and logistic regression were used to determine factors associated with anemia in young pregnant women Results: The study found that 36.2% of young pregnant women had anemia. The incidence of anemia was associated with gestational age but not with other factors. Pregnancy in the first trimester poses the highest risk compared to other trimesters (cOR=3.89; 95%CI:1.47-10.30; p=0.006), as confirmed by multivariate analysis (aOR=4.44; 95%CI: 1.41-13.95; p=0.01).Conclusion: Anemia affects 36.2% of pregnant women aged 15 to 24 years in Indonesia. The risk of anemia in young pregnant women is significantly associated with gestational age with the first trimester being the most critical period.

Factors associated with infection-related severe maternal outcomes in pregnant and recently pregnant women: Asecondary analysis of the WHO global maternal sepsis study.

The aim of the present study was to identify the risk factors for severe maternal outcomes (SMO) of women with suspected or confirmed infections using the data from the WHO global maternal sepsis study (GLOSS). We conducted a secondary analysis of the GLOSS cohort study, which involved pregnant or recently pregnant women with suspected or confirmed infection around 713 health facilities in 52 low- and middle-income countries, and high-income countries. A nested case-control study was conducted within the GLOSS cohort. Cases included infection-related maternal deaths or near misses, while controls represented non-SMO. Logistic mixed models, adjusting for country variations, were employed. Using univariate analysis, we calculated crude odds ratios (crude OR) and their 95% confidence interval (95% CI). Variables were identified with less than 16% missing data, and P values less than 0.20 were used to perform the multivariate logistic model multilevel. A total of 2558 women were included in the analysis. As for the cases, 134 patients were found in the pregnant in labor or not in labor group and 246 patients in the postpartum or postabortion group. Pregnant women with prior childbirths faced a 64% increased risk of SMO. Ante- or intrapartum hemorrhage increased risk by 4.45 times, while trauma during pregnancy increased it by 4.81 times. Pre-existing medical conditions elevated risk five-fold, while hospital-acquired infections increased it by 53%. Secondary infections raised risk six-fold. Postpartum/postabortion women with prior childbirths had a 45% elevated risk, and pre-existing medical conditions raised it by 2.84 times. Hospital-acquired infections increased risk by 93%. Postpartum hemorrhage increased risk approximately five-fold, while abortion-related bleeding doubled it. Previous cesarean, abortion, and stillbirth also elevated risk. Key risk factors for SMO include prior childbirths, hemorrhage, trauma, pre-existing conditions, and hospital-acquired or secondary infections. Implementing effective alert systems and targeted interventions is essential to mitigate these risks and improve maternal health outcomes, especially in resource-limited settings.

Incidence of acute transfusion reactions and associated factors among adult blood-transfused patients at Jimma University Medical Center, southwest Ethiopia: A cross-sectional study.

Acute transfusion reaction is mainly related to the infusion of blood or blood products resulting at any time within a day of the intervention. It ranges from a non-specific febrile episode to a life-threatening intravascular hemolysis. The severity of the reaction and the degree of morbidity are usually related to the degree of ABO incompatibility and the volume of blood transfused. Therefore, this study aimed to determine the incidence of acute transfusion reactions and its associated factors in Jimma University Medical Center, southwest Ethiopia. Institution-based cross-sectional study was conducted from 1 October to December 30, 2020. A total of 384 transfused patients were followed in this study. Socio-demographic and clinical data were collected through a structured questionnaire. Baseline measurement and 24-hour periodic vital signs monitoring were conducted after each transfusion. Four milliliters of venous blood were drawn after transfusion intervention from each distrusted patient for complete blood count, blood group phenotype, direct antihuman globulin test (DAT), and crossmatching. Data were entered into Epi data version 3.1 and analyzed using Statistical Package for Social Science software (SPSS) version 20. Descriptive statistics, and bivariable and multivariable logistic regression were employed to test the association between independent and dependent variables. A P value ≤ .05 was considered to indicate statistical significance. Acute transfusion reactions were diagnosed in 5.7% of patients, with most of these reactions were febrile nonhemolytic reactions (63.6%) followed by allergic (36.4%) reactions with mild clinical manifestations (27.3%). Transfusion history, transfused blood that was kept for more than 13 days, abortion history, and number of transfused units (≥3 units of blood/blood component) have 3.3, 3.85, 4.2, and 3.9 times greater odds, respectively, besides their significant association with the incidence of acute transfusion reactions. Patients with a history of previous transfusion, abortion, multi-unit transfusion, and patients transfused with blood stored for ≥14 days should be closely monitored. Starting a hemovigilance system of monitoring, collecting, and evaluating data on adverse effects of blood transfusion locally and nationally will decrease the occurrence of acute transfusion reactions.

Predicting the pregnancy outcome: Uncovering the link between β-hCG, patient factors and live birth in IVF

ObjectiveThe objectives of the study were to correlate live birth rate with the initial level of β-hCG in all patients undergoing embryo transfer and develop a predictive model of live birth based on patients’ and assisted reproductive technology (ART) characteristics. Study designSingle-center retrospective cohort study, including a total of 7587 positive first serum β-hCG from women who performed fresh and frozen embryo transfer.Twenty-one variables related to patient characteristics and treatment modalities were analyzed by step-wise univariate analysis followed by multivariate analysis. The study included women between 18 and 45 years with a positive (>20 IU/L) serum β-hCG between January 2011 and December 2020 while it excluded cycles from donation of gametes, PGT and >3 embryos transferred simultaneously. Main results and the role of chance: Among the positive serum β-hCG measurements 5085 (67.0 %) resulted in live births. β-hCG was higher in the live birth group (691 IU/L) compared to the failed pregnancies group (304 IU/L) (p500 IU/mL provided a positive predictive value for live birth of 85.3 % (95 %CI 84.0–86.4).Failed pregnancies were more common among older maternal and paternal age. Previous abortions were more common in the failed pregnancies group (25.0 %) compared to the live birth group (19.4 %). The most common indication to treatment was male infertility, accounting for a larger portion in the live birth group (41.7 %). At multivariate analysis, the factors independently associated with live birth were: first serum β-hCG (OR 1.35, 95 %CI 1.32–1.37), maternal age (OR 0.93, 95 %CI 0.91–0.95), previous abortions (OR 0.77, 95 % CI 0.68–0.88). The number of embryos transferred showed a positive correlation below a maternal age of 39 (<35 years old OR 1.60, CI 95 % 1.32–1.94; <39 years old OR 1.27 CI 95 % 1.09–1.47). The prediction model incorporating these four variables resulted in a sensitivity and specificity with an area under the ROC curve of 0.798. Conclusion: The study confirms the importance of the first value of β-hCG and proposes a predictive model that takes into account maternal age, number of embryos transferred, and obstetric history, thereby aiding in couples’ counseling and ultimately improve patients’ care.

Incidence and recurrence of bovine abortion in dairy cattle from Costa Rica

The reproductive efficiency and milk yield of cows are crucial factors in a dairy farm's profitability. However, abortions can have a negative impact on these factors. While the morbidity of abortion has been estimated in many countries, information on the burden on dairy cattle in tropical conditions is limited, and Costa Rica is a good example. This study aims to assess the incidence and recurrence of bovine abortion in dairy cattle from Costa Rica. The study analysed the morbidity of abortion in Costa Rican dairy herds between 2010 and 2022. The incidence rate (IR) and the recurrence rate (ReR) were calculated per 100 cow-months at risk using data from the Veterinary Automated Management and Production Control Programme (VAMPP). The dataset comprised 1032,457 lactations from 330,265 cows in 1134 specialized dairy herds. Abortions were classified either as early foetal mortality (EFM) or late foetal mortality (LFM). Rates were estimated based on cow breed, lactation number, and ecological zone to which the farm belongs. The IR of general abortion, EFM, and LFM cases were 0.98, 0.41, and 0.57 per 100 cow-months at risk, respectively. No statistically significant differences were found in the IR between cow breed, lactation number, and ecological zone, nor for the trend of abortions over calving years. The first ReR (for cows that had one previous abortion during the lactation) was 0.95, and the second ReR (for cows that had two previous abortions during the lactation) was 1.41 per 100 cow-months at risk. These results suggest that bovine abortions are an important ongoing problem in dairy farms in Costa Rica with potentially detrimental effects on the reproductive and productive performance of cows and may be representative of other specialized tropical dairy systems in Latin America.

Prevalence and associated factors of bacterial vaginosis among pregnant women in Hue, Vietnam.

Bacterial vaginosis (BV) is the most frequent vaginal infection affecting women of childbearing age worldwide. It is associated with significant adverse healthcare outcomes, especially during pregnancy. Although screening for BV could reduce potential pregnancy-related obstetric complications, there is no routine screening of pregnant women for BV in Vietnam. We aimed to identify the prevalence of BV among pregnant women and the associated factors in two tertiary hospitals in Hue, Vietnam. This cross-sectional descriptive study included 885 pregnant women in third trimester, who received routine antenatal care in the Hue Central Hospital and Hue University Hospital of Medicine and Pharmacy, Hue city, Thua Thien Hue province, Vietnam. Gram-stained vaginal smears were used for calculating the Nugent score and recording the fungal elements. In total, 435 (49.1%) women had a normal BV score, 352 (39.8%) had intermediate vaginal microbiota, and 98 (11.1%) had BV. Among the 98 women with BV, 71 (72.4%) also had fungal infection. There was a significant association of BV with discharge (p = 0.004) and abnormal cervix (p = 0.014). BV was significantly more frequent among the women who reported previous abortion or miscarriage (p = 0.007). About a tenth of women in Thua Thien Hue province have BV in the third trimester of pregnancy being associated with previous adverse outcome. Discharge with fishy odour is still a characteristic feature among subtle clinical presentations of BV. Better awareness about this disease and routine test-and-treat management during pregnancy may improve pregnancy outcome.

The Relationship Between Anti-Mullerian Hormone Levels and Pregnancy Outcomes in Patients with Recurrent Unexplained Miscarriage

Background: This study aimed to assess the correlation between serum levels of anti-Mullerian hormone (AMH), basal follicle-stimulating hormone (FSH), basal luteinizing hormone (LH), and basal estradiol with pregnancy outcomes. Methods: Conducted at Shariati Hospital in Tehran from 2020 to 2021, this prospective cohort study included women under 38 years old with idiopathic recurrent miscarriage (IRM). Individuals with AMH levels below 1 ng/mL were classified as the poor responder group. All participants with IRM received a daily combination of 20 mg prednisolone and 200 mg progesterone vaginal suppositories from the beginning of pregnancy until 12 weeks, along with aspirin and folic acid. Pregnancy was monitored until 36 weeks, and outcomes were evaluated over two years using univariate and multiple logistic regression, with P-values &lt; 0.05 considered significant. Results: The study comprised 128 individuals with a mean age of 36.4 ± 3.9 years. Of these, 80 became pregnant, while 48 did not. Among the pregnant individuals, 34 had terminations before 26 weeks (13 ongoing and 21 clinical), while 46 had pregnancies lasting 26 weeks or longer. Maternal age (RR = 1.23, 95% CI: 1.10 - 1.90, P = 0.001), history of abortion (RR = 1.262, 95% CI: 1.052 - 1.327, P = 0.008), and low serum AMH level (RR = 0.752, 95% CI: 0.227 - 0.934, P = 0.035) were significantly associated with the probability of subsequent pregnancies. Maternal age (RR = 1.108, 95% CI: 1.05 - 1.350, P = 0.025) and history of abortion (RR = 1.097, 95% CI: 1.02 - 1.161, P = 0.042) were the only factors associated with the risk of non-pregnancy. Conclusions: The study findings suggest that AMH levels in women with IRM significantly influence pregnancy outcomes, including abortion and live births at 26 weeks or more. The univariate analysis revealed significant correlations between age, serum AMH levels, previous history of abortion, and the risk of abortion. Additionally, AMH levels were found to relate to follicle storage rather than egg quality, indicating that AMH does not predict live birth after IVF. Overall, this prospective study underscores the importance of maternal age, AMH level, and previous abortion history in predicting pregnancy outcomes.

RISK FACTORS, CLINICAL PRESENTATION AND TREATMENT MODALITIES OF ECTOPIC PREGNANCY: A CROSS SECTIONAL STUDY AT TERTIARY CARE HOSPITAL

Background: Ectopic pregnancy is a pregnancy anywhere other than uterine cavity. Approximately 1-2% pregnancies are ectopic associated with significant morbidity and mortality. Fallopian tube is the commonest site. Present study deals with the analysis of risk factors, clinical presentation and treatment modalities of ectopic pregnancy. Material and Method: A cross sectional study was carried out on 100 cases which were diagnosed and treated at Department of Obstetrics and Gynaecology, J K Lon Hospital, Government Medical College, Kota (Raj.), India. Parameters studied were age, parity, gestation period (weeks), risk factors, clinical presentation, medical management and surgical intervention. Results: Present study included 100 cases in which 72% belonged to age group of 19-30 years. Maximum cases were recorded between parity 0 and 2. Previous abortion (33%) was the most common risk factor. Most of the patients had ruptured (54%) ectopic pregnancy outcome. Tenderness was a common clinical feature on abdominal examination. Medical management was done for 11 patients of which 9 cases were successfully treated (81.8%). In 64% cases, emergency laparotomy with unilateral salpingectomy was applied as surgical intervention. Conclusion: Diagnosis of ectopic pregnancy is a challenging task by its bizarre clinical picture as it is clinically ranging from asymptomatic case to acute abdomen to hemodynamic shock. It is imperative to take close examination with use of advance diagnostic tools and management. Most of the patients of ectopic pregnancy presented ruptured outcome and period of amenorrhea was significantly associated with it. Early diagnosis and advance management would reduce the morbidity and mortality in ectopic pregnancy.

Factors Contributing to Molar Pregnancy Through a Study in Jiblah University Hospital, IBB: Study from 2017 to 2022

Background: The reported prevalence rates of hydatidiform mole (HM) vary greatly across geography and time, making worldwide comparisons challenging, especially in developing countries and resource-limited settings. To date, few studies have been reported in Yemen regarding the epidemiology, management, and outcome of patients with HM. The current study sought to investigate the prevalence of HM among women who visited a large tertiary center at Jiblah University Hospital in Yemen. Method: A retrospective study was conducted between Jun 2017 and Sep 2022 at Jiblah University Hospital, Ibb, Yemen including all women with a diagnosis of HM. Complete medical histories for all HM patients were collected and analyzed. Results: A total of 160 women diagnosed with HM at Jiblah University Hospital -Ibb study from 2017 to 2022 years were included in the study. The mean gestational age on admission was 25.2 years. Sixty-two patients (38.7%) have Hb less than normal range and 94 of patients (58.8 %) have Hb normal range 12- 15g/dl and 4 patients (2.5 %) have Hb more than normal range 15g/dl. However, the percentage blood types (A+, A-, B-, B+, O+, O- and AB+) were 40.6%, 0.6%, 5%, 0.6%, 41.9 %, 7.5% and 3.8%, respectively. On the other hand, among the sample, 4 (2.5%) women were diagnosed histopathologically to have previous V.M and while 156 (97.5%) women were diagnosed histopathologically to have no previous V.M. A number of women who had previous abortion were recorded 46(28.7%) and while the women had not previous abortion was 114(41.4%). Among the women who had smoking and no smoking were recorded 2(1.3%) and 158(98.7%), respectively. Finally, unfortunately the researchers didn’t find following risk factors in the register of patients, such as (Ovulation induction, genes mutation, infertility and birth control pills), by researching the record of patients with HM or registered as having HM. However, our study found the relationship between age groups and the previous abortion about associate risk factors of molar pregnancy. There is statistically significant difference between previous abortion and age, with P-value =0.007. Conclusion: The present study showed that incident hydatidiform mole were higher in 20-29 years of maternal age, so we found that the incidence of HM in younger age patients is the most common. Also, we found that the significant positive correlation was found between age with previous abortions. Therefore, it is recommended that women should undergo health care before pregnancy and further studies are required to provide solutions to reduce the cases of HM.

Comparing Relationship Satisfaction and Body-Image-Related Quality of Life in Pregnant Women with Planned and Unplanned Pregnancies.

This comparative cross-sectional study conducted at the "Pius Brinzeu" healthcare center in Timisoara explored the differential impacts of pregnancy planning status on sexual function, body image, and relationship satisfaction among pregnant women. Employing the Female Sexual Function Index (FSFI), Body Esteem Scale for Adolescents and Adults (BESAQ), and the Beck Depression Inventory (BDI-II), the study analyzed responses from 107 participants divided into groups of planned (n = 59, mean age 28.5 ± 5.2) and unplanned (n = 48, mean age 27.3 ± 4.8) pregnancies. In the first trimester, unplanned pregnancies reported higher median scores in desire (4.7 vs. 3.6, p = 0.005), arousal (4.5 vs. 3.8, p = 0.001), and lubrication (4.6 vs. 3.7, p = 0.015) compared to planned pregnancies. Satisfaction scores also favored unplanned pregnancies in the first trimester (4.8 vs. 3.9, p = 0.009). Similar trends were observed in subsequent trimesters, with unplanned pregnancies consistently reporting higher FSFI scores, indicating a robust sexual function. Risk factors significantly associated with sexual dysfunction were a higher BMI in the first trimester (beta coefficient: -0.124, p = 0.019), unmarried civil status (beta coefficient: -0.323, p = 0.045), history of previous abortion (beta coefficient: -0.451, p = 0.012), irregular menstrual cycles (beta coefficient: -0.384, p = 0.026), and rural living area (beta coefficient: -0.278, p = 0.034). Notably, unplanned pregnancy itself was not a significant risk factor for sexual dysfunction (beta coefficient: -0.054, p = 0.095). Regarding relationship dynamics, planned pregnancies exhibited significantly higher satisfaction with partner support (4.1 ± 0.9 vs. 3.7 ± 1.1, p = 0.041) and communication within the couple (4.0 ± 1.0 vs. 3.5 ± 1.2, p = 0.020), whereas unplanned pregnancies reported higher satisfaction with emotional closeness (4.3 ± 0.7 vs. 3.8 ± 1.0, p = 0.004). Concerns about managing professional activities and household chores were significantly more prevalent in the unplanned pregnancy group (62.50% vs. 33.90%, p = 0.014). Unplanned pregnancies demonstrated better initial sexual function but faced greater challenges in relationship satisfaction and managing pregnancy demands. Identifying and addressing the risk factors associated with sexual dysfunction can provide targeted interventions to improve the well-being of pregnant women, regardless of pregnancy planning status.

The role of color doppler in high risk pregnancies: A prospective comparative study

Pregnancy can be considered as the most beautiful period of a woman’s life. The recent medical advances are helpful in taking very good care of the female throughout her pregnancy. The pregnancy is constantly observed by clinical examination, laboratory investigations, and radiographic examinations at specific intervals throughout its course.To study the role of doppler ultrasound in high-risk pregnancies.This is a prospective comparative study was conducted in department of Obstetrics and Gynaecology at Government medical college, Nagpur. The study period was 12 months. 232 patients were included in this study.In our study, 2 patients had Chronic hypertension, 2 patients had GDM, 1 patient had Gestational hypertension, 3 patients had Anaemia, 6 patients had Heart Disease, 5 patients had HIV positive,15 patients had Hypothyroidism, 2 patients had Increased BP, 1 patient had Overt DM,6 patients had Pre-eclampsia,1 patient had previous abortion, 4 patients had Rh negative, 5 patients had Sickle Cell Disease(SS) and 15 patients had Sickle Cell trait(AS). Distribution of normal doppler changes in cases according to high risk factor was statistically significant (p&amp;#60;0.0001).In our study, NICU Admission with doppler changes was statistically significant and Association of Baby weight in cases according to doppler changes in uterine artery and Baby weight in cases according to doppler changes in umbilical artery was not statistically significant.

Prevalnce of Anemia and Associated Factors in Jashore District of Bangladesh – A Cross-Sectional Study

Background: Anemia is a global public health problem affecting both developing and developed countries with major consequences on human health as well as social and economic development. It occurs at all stages of the life cycle but is more prevalent in pregnant women and young children. Anemia during pregnancy is a major cause of morbidity and mortality of pregnant women in developing countries and has both maternal and fetal consequences. Therefore, this study aimed to assess the prevalence and factors associated with anemia in Bangladeshi human subjects, especially women. Methodology: This cross-sectional survey was held on human subjects (N=528), of which 4% were children (n=27), 27% male (n=141), 33% non-pregnant female (n=173) and 36% pregnant female (n=187). The signs and symptoms of participants were also considered. The study participants for this study were people who were categorized as: children 6-59 months, children 5-11 years, children 12-14 years, men (15 years of age and above), non-pregnant women (15 years of age and above) and female (pregnant). The survey was held on 528 patients of children (27), male (141), non-pregnant female (173) and pregnant female (187). The questionnaire had been developed including the basic information about anemia associated with dietary habits and relevant factors in details. The questionnaire contained seven section: background information, personal information, history of patients, dietary information, signs and symptoms, diagnostic information and pregnancy status for females. Blood samples of the subjects had been tested for percentage value of hemoglobin. Results: The anemic children were affected by thalassemia genetically. Among the people, more than 50% were below 6 months of age. More than 80% of anemic patients had been found suffering from different diseases. Of them, 10% patients suffered from accidental blood loss. Among the female anemic patients, 63% had been habituated with excessive menstrual bleeding. Pregnant women had been found suffering from mild to moderate anemia (characterized by hemoglobin concentration) but non-pregnant had been noticed with moderate anemia. This might be due to the undiagnosed mild anemic condition in non-pregnant female. Almost 65% of pregnant women had children and among them, 58% had previous pregnancy within last 2 years. In our observation, 25% of the anemic pregnant women had previous abortion history and 34% affected by bleeding during pregnancy. The education level was below secondary in 55% of anemic adult patient. Conclusion: Mild to moderate anemia prevails among the study subjects. Their lifestyle modification especially intake of iron rich food and suppliments seem apt in overcoming this crisis.

Placenta accreta outcomes and risk factors in a referral hospital in north of Iran: A case control study.

Placenta accreta syndrome (PAS) may led to heavy blood loss and maternal death. Here we analyzed the main risk factors of PAS+ pregnancies and its complications in a referral hospital in the north of Iran. In a case control study, all pregnant women with PAS referred to our department during 2016 till 2021 were enrolled and divided in two groups case (PAS+) and control (PAS-) based on preoperative imaging, intraoperative findings, and pathological reports. The sociodemographic features and neonatal-maternal outcomes also were recorded. The most frequent reason for cesarean (C/S) was repeated C/S (62.9%, 56/89). A significant difference showed up in the time lag between previous C/S and the present delivery (p < 0.001) which shows that when the time distance is longer, the risk of PAS rises (OR: 1.01 [95% CI: 1.003-1.017]). Also, a positive history of prior abortion and elective type of previous C/S were related to PAS+ pregnancies. Our other finding showed that PAS+ pregnancies will end in lower gestational age and have a longer duration of operation and hospitalization, heavy blood transfusion, and hysterectomy. Also, PAS+ pregnancies were not related to poor neonatal outcomes. It seems that, in addition to repeated C/S as a strong risk factor, previous abortion is a forgotten key which leads to incomplete evacuation or damage the endometrial-myometrial layers.

Incidence of and factors associated with emergency caesarean section in pregnant women with gestational diabetes mellitus: A retrospective cohort study.

The incidence of factors associated with emergency cesarean section (ECS) in patients with gestational diabetes mellitus (GDM) have not been well investigated. We conducted a retrospective cohort study of patients diagnosed with GDM between 2011 and 2020 at a tertiary care hospital in Japan. Clinical data, vital signs, and laboratory results of the patients were collected from electronic medical records. We constructed a multivariate logistic regression model to identify the clinical characteristics associated with ECS. We included 1189 patients diagnosed with GDM, the mean maternal age was 33 years, and 507 (42.6%) patients were aged ≥35 years. In total, 114 patients underwent ECS (9.6%). The previous assisted reproductive technology (ART) use (odds ratio [OR], 1.81; 95% confidence interval [CI], 1.12-2.93), previous artificial abortion (OR, 1.94; 95% CI, 1.13-3.33), high pre-pregnancy body mass index (BMI) (OR, 1.07; 95% CI, 1.02-1.11), and late diagnosis of GDM (OR, 1.02; 95% CI, 1.003-1.05) were independently associated with ECS. One of every 10 GDM patients required ECS. Previous ART use, previous artificial abortion, high pre-pregnancy BMI, and late diagnosis of GDM were risk factors for ECS in GDM patients.