Uterine Pressure Research Articles

Clinical characteristics and outcomes of preterm versus term uterine rupture: a nationwide observational study.

To assess and compare the clinical aspects of uterine rupture by dividing the gestational age at uterine rupture occurrence into < 37-week (preterm) and ≥ 37-week (term) groups. This retrospective cohort study analyzed data from 187 acute-care hospitals across Japan and included patients who experienced uterine rupture. Data were sourced from the Diagnosis Procedure Combination inpatient database, spanning July 2010 to March 2022. The patients' characteristics, in-hospital procedures, and outcomes were compared between those with uterine rupture at < 37 and ≥ 37weeks of gestation. The main outcomes were hysterectomy, complications, proportion of blood transfusions, and postoperative length of stay. A total of 298 patients were identified, with 161 in the preterm group and 137 in the term group. Placenta accreta spectrum occurred more frequently in the preterm group than in the term group (18.0% vs. 6.6%, respectively; P = 0.003). Vacuum delivery (19.0% vs. 0.6%, P < 0.001) and uterine fundal pressure (2.9% vs. 0.0%, P = 0.004) were more likely to be applied in the term group. The maternal need for mechanical ventilation (26.3% vs. 12.4%, P = 0.003), the proportion of disseminated intravascular coagulation (40.1% vs. 25.5%, P = 0.009), and the requirement for platelet transfusions (32.8% vs. 15.5%, P < 0.001) were greater in the term. The postoperative hospital stays were also longer in the term group. This study shows that individual characteristics vary with the gestational age at uterine rupture, and maternal morbidity is notably higher in term compared to preterm ruptures.

European Society for Gynaecological Endoscopy (ESGE) Good Practice Recommendations on surgical techniques for removal of fibroids: part 1 abdominal (laparoscopic and open) myomectomy.

Uterine fibroids are the most common benign tumours of the female reproductive tract and can cause a range of symptoms including abnormal uterine bleeding, pain, pressure symptoms and subfertility. Surgery may be required for some symptomatic fibroids via abdominal or transvaginal routes. The European Society for Gynaecological Endoscopy Uterine Fibroids Working Group developed recommendations based on the best available evidence and expert opinion for the surgical treatment of uterine fibroids. In this first part of the recommendations, abdominal approaches to surgical treatment of fibroids including laparoscopic, robot- assisted and open myomectomy are described.

Cardiac biomarkers as tools in the prediction and diagnosis of traumatic pericarditis and traumatic reticuloperitonitis in cattle and buffaloes

BackgroundIn the livestock industry, Foreign Body Syndrome is a devastating disease condition. Feeding management, lacking of food discrimination, and eating chopped food increase the risk of swallowing sharp foreign bodies in bovine species. In addition to the honeycomb cells shape of the reticulum, the contractions of the reticular wall, gravid uterine pressure, and parturition efforts, foreign bodies can penetrate the reticular wall, causing cascade of problems including traumatic reticulitis, traumatic reticuloperitonitis, and traumatic pericarditis. The present study was carried out to evaluate the diagnostic significance of cardiac troponin I rapid test cassette and other cardiac biomarkers including serum cardiac troponin I (cTn I), creatine kinase-myocardial band (CK-MB), lactate dehydrogenase (LDH), and aspartate aminotransferase enzyme (AST), in confirmed cases of traumatic pericarditis (TP) and/or traumatic reticuleoperitonitis (TRP) in cattle and buffaloes.MethodsA total number of 30 animals (22 cattle and 8 buffaloes) with different signs such as anorexia, jugular distension, brisket edema, and signs of pain (reluctance to move, arching back, and abduction of the forelimbs) were included in the present study. Based on case history, clinical signs, ferroscopic, pericardiocentesis, radiographic and ultrasonographic examinations, TP were confirmed in cattle (n = 10) and buffaloes (n = 8) while TRP were confirmed only in cattle (n = 12). Additionally, 20 clinically healthy animals (n = 10 cattle and 10 buffaloes) were used as a control group. Blood samples were collected for determination of blood level of Tn-I, and activity of CK-MB, LDH, and AST.ResultsThe obtained results revealed a highly significant increase in serum cTn I in diseased cattle with TP and TRP (P = 0.00), while buffaloes with TP showed no significant changes in serum cTn I (P = 0.111). Both diseased cattle and buffaloes showed increased serum activities of CK-MB, AST, and LDH enzyme. On the other hand, cardiac troponin I rapid test cassette failed to detect cTn I in diseased animals.ConclusionThe study concluded that the cardiac troponin I rapid test cassette did not have a diagnostic significance and could not be used as a point-of-care under field condition for diagnosis of TP and TRP in large ruminants. However, the serum troponin I level is helpful in diagnosis of TP and TRP in cattle. Although cardiac biomarkers have some diagnostic values in TP and TRP, the traditional diagnostic methods (clinical, radiography and ultrasonography examinations) are crucial for thorough evaluation of TP/TRP cases in bovine.

The role of ultrasound and mitofusin-2 levels to predict pregnancy outcomes in patients with severe preeclampsia: a case-control study.

The aim of this study was to evaluate mitofusin-2 levels and fetal Doppler ultrasonography effects in patients with severe preeclampsia. This single-center case-control study was conducted in the gynecology service of the university hospital in Van. A total of 90 pregnant women aged 18-40 years were included in the study. Of these, 30 are normal, 30 have mild preeclampsia, and 30 are pregnant with severe preeclampsia. In this study, especially in severe preeclampsia patients, serum mitofusin-2 levels and important fetal Doppler flows such as uterine arterial pressure, umbilical arterial pressure, and 1st and 5th minute Apgar scores, birth weight, and the relationship between postnatal outcomes such as week of birth and the number of patients in the neonatal intensive care unit were investigated. There was a significant difference between the three groups in terms of mitofusin-2 levels, which was the highest in the group (p<0.05). Maternal serum mitofusin-2 levels were positively correlated with uterine arterial pressure (r=0.543, p=0.007), umbilical arterial pressure (r=0.238, p=0.008), diastolic blood pressure, and systolic blood pressure (p<0.001). Receiver operating characteristic curve of mitofusin-2 in predicting preeclampsia is as follows: optimal cutoff 1.6 ng/mL; area under the curve: 0.861; 95%CI: 0.786-0.917; sensitivity: 83.9%; and specificity: 70.0%, (p≤0.001). A one-unit increase in mitofusin-2 resulted in a statistically significant 4.21-fold increase in preeclampsia risk. This study recommends the use of mitofusin-2 together with fetal Doppler ultrasound findings as a reliable indicator of preeclampsia severity.

Prediction of Hypoxic-Ischemic Encephalopathy Using Events in Fetal Heart Rate and Uterine Pressure.

The objective of this work was to evaluate the utility of using intrapartum fetal heart rate (FHR) and uterine pressure (UP) events to detect infants at risk of hypoxic-ischemic encephalopathy (HIE). We analyzed data from 40,976 term births from three groups: 374 infants that developed HIE, 3,056 that developed fetal acidosis without HIE, and 37,546 healthy infants. We counted the transitions between FHR events and the length of FHR and UP events. Then, we used these features to train a random forest classifier to discriminate between the healthy and the pathological (acidosis or HIE) groups. Compared to the Caesarean delivery rates for each group, our system detected 6.9% more HIE cases (54.9% vs 61.8%, p<0.001) and 10.7% more acidosis cases (37.6% vs 48.3%, p<0.001), with no increase in the false positive rates in the healthy group (38.9% vs 38.8%, p=0.26). Importantly, over 3/4 of the HIE detections were made 3 hours or more before delivery. It is reasonable to expect that this would be enough lead time to permit clinical intervention to improve the outcome of birth.

Accounting for Nulliparity in the Prediction of Hypoxic-Ischemic Encephalopathy Using Cardiotocography.

Nulliparous pregnancies, those where the mother has not previously given birth, are associated with longer labors and hence expose the fetus to more contractions and other adverse intrapartum conditions such as chorioamnionitis. The objective of the present study was to test if accounting for nulliparity could improve the detection of fetuses at increased risk of developing hypoxic-ischemic encephalopathy (HIE). During labor, clinicians assess the fetal heart rate and uterine pressure signals to identify fetuses at risk of developing HIE. In this study, we performed random forest classification using fetal heart rate and uterine pressure features from 40,831 births, including 374 that developed HIE. We analyzed a two-path classification approach that analyzed separately the fetuses from nulliparous and multiparous mothers, and a one-path classification approach that included the clinical variable for nulliparity as a classification feature. We compared these two approaches to a one-path classifier that had no information about the parity of the mothers. We also compared our results to the rate of Caesarean deliveries in each group, which is used clinically to interrupt the progression towards HIE. All the classifiers detected more fetuses that developed HIE than the observed Caesarean rate, but accounting for nulliparity did not improve performance.

ASUHAN KEBIDANAN KEHAMILAN DENGAN PENERAPAN PIJAT DAN RENDAM KAKI DENGAN AIR HANGAT CAMPURAN KENCUR TERHADAP EDEMA KAKI PADA IBU HAMIL

Edema of the legs or swelling of the legs is found in about 80% of pregnant women in the third trimester; this occurs due to uterine pressure, which inhibits venous return, and the pull of gravity, which causes more excellent fluid retention. Edema in pregnancy can be treated through massage therapy. The working principle of massage therapy is to apply direct pressure and focus on the part of the body with edema. This midwifery care aims to provide care for pregnant women by applying massage and soaking the feet with warm water mixed with galingale against leg edema in pregnant women. The midwifery care method used a case study of one pregnant woman with swollen feet. The results of this midwifery care show that leg edema is a common complaint in the third trimester; this is caused by increasing uterine pressure and affecting fluid circulation, with uterine pressure and gravity causing more excellent fluid retention. This therapy helps improve blood circulation by widening blood vessels so that more oxygen is supplied to swollen tissues, so it can be concluded that massage therapy and foot soak with warm water mixed with kencur are safe for pregnant women and are beneficial for reducing swelling.

Surgical techniques for mini-laparotomy myomectomy

The prevalence of uterine fibroids is estimated to be approximately 80%. Fibroids can be associated with abnormal uterine bleeding, pressure symptoms, and infertility. Given this high prevalence, approximately 30,000 myomectomies are performed in the United States per year. Minimally invasive approaches are preferred, if feasible. The minimally invasive techniques include laparoscopic, robot-assisted, hysteroscopic, and mini-laparotomy. To discuss the multiple techniques for optimizing the use of mini-laparotomy in minimally invasive myomectomy. We use intraoperative surgical video to demonstrate techniques that optimize the use of the mini-laparotomy for myomectomy. Cleveland Clinic. Patient's undergoing fertility preserving, minimally invasive myomectomy at the Cleveland Clinic. The patient(s) included in this video gave consent for publication of the video and posting of the video online, including social media, the journal website, scientific literature websites (such as PubMed, ScienceDirect, and Scopus), and other applicable sites. After the surgeon has selected to proceed with mini-laparotomy myomectomy, different techniques can be employed to optimize management. We demonstrate and discuss these techniques to ensure that surgeons have a set of tools to tackle a fibroid uterus. These techniques include direct palpation of the fibroids, use of a uterine manipulator to visualize the endometrial cavity, use of the uterine manipulator to aid in repair of the cavity if entered, suturing technique that avoids the endometrial cavity and therefore limits foreign body exposure and decreases intrauterine adhesion formation, utilization of barbed suture in a layered fashion, in-situ debulking to avoid injury to fallopian tubes and other critical uterine structures, easy identification of the optimal enucleation plane, use of single hysterotomy for multiple fibroids, visualization of the "Tortuga" sign, and evaluation of the abdominal cavity using the mini-laparotomy site as a port site. To limit postoperative adhesion formation, the investigators place cellulose-based adhesion barriers with peritoneum closure. Although the need for prolonged postoperative observation can be made on a case-by-case basis, we consider this as an outpatient surgery and anticipate same-day discharge for our patients. In this video, we perform a mini-laparotomy myomectomy optimally and describe the techniques employed. Specific techniques employed in mini-laparotomy myomectomy make the case safe, effective, and can lead to same-day discharge. Mini-laparotomy myomectomy is a technique used to perform minimally invasive myomectomy. Following the discussed steps, surgeons can be more confident in performing this method of myomectomy.

Feasibility of continuous intra-uterine pressure measurements during amnioreduction in twin-to-twin transfusion syndrome therapy

IntroductionThis work explores the feasibility of simultaneous and continuous intra-abdominal, intra-uterine, and arterial blood pressure measurements to examine the hemodynamic perturbation expected during therapeutic amnioreduction and to better understand the protective role of the placenta during that treatment. MethodsPatients with twin-to-twin transfusion syndrome were treated with fetoscopic laser ablation followed by amnioreduction. Intra-abdominal, intra-uterine, and mean arterial pressures were simultaneously recorded during amnioreduction performed in steps of 200 mL. Placental thickness and uterine dimensions were measured before and after amnioreduction by ultrasonography. ResultsUseful pressure recordings were obtained between volume reduction steps and short hands-off periods in four studies. Median amnioreduction volume was 1400 mL corresponding to a median uterine volume reduction of 1121 mL. Mean intra-uterine pressure significantly fell from 24.8 to 13.6 mmHg (p = 0.011) and intra-abdominal pressure significantly decreased from 13.4 to 9.2 mmHg after amnioreduction (p = 0.015). Uterine pressure recordings revealed transient contractions (A, in mmHg) following individual amnioreduction steps, which increased with fractional amnioreduction (F, no dimension) (A = 17.23*F + 11.81; r = 0.50, p = 0.001). DiscussionSimultaneous and continuous measurement of intra-abdominal, intra-uterine, and arterial blood pressures during amnioreduction is feasible. The dynamics reveal transient uterine contractions reaching levels comparable to those seen during childbirth which seem to oppose impending maternal hypovolemia by placental steal at the expense of temporarily reducing placental perfusion pressure and underline the importance of uterine and placental interaction.

Timely Detection of Infants at Risk of Intrapartum Acidosis and Hypoxic-Ischemic Encephalopathy Using Cardiotocography.

This work aims to improve the intrapartum detection of fetuses with an increased risk of developing fetal acidosis or hypoxic-ischemic encephalopathy (HIE) using fetal heart rate (FHR) and uterine pressure (UP) signals. Our study population comprised 40,831 term births divided into 3 classes based on umbilical cord or early neonatal blood gas assessments: 374 with verified HIE, 3,047 with acidosis but no encephalopathy and 37,410 healthy babies with normal gases. We developed an intervention recommendation system based on a random forest classifier. The classifier was trained using classical and novel features extracted electronically from 20-minute epochs of FHR and UP. Then, using the predictions of the classifier on each epoch, we designed a decision rule to determine when to recommended intervention. Compared to the Caesarean rates in each study group, our system identified an additional 5.68% of babies who developed HIE (54.55% vs 60.23%, p < 0.01) with a specific alert threshold. Importantly, about 75% of these recommendations were made more than 200 minutes before birth. In the acidosis group, the system identified an additional 17.44% (37.15% vs 54.59%, p < 0.01) and about 2/3 of these recommendations were made more than 200 minutes before birth. Compared to the Caesarean rate in the healthy group, the associated false positive rate was increased by 1.07% (38.80% vs 39.87%, p<0.01).Clinical Relevance- This method recommended intervention in more babies affected by acidosis or HIE, than the intervention rate observed in practice and most often did so 200 minutes before delivery. This was early enough to expect that interventions would have clinical benefit and reduce the rate of HIE. Given the high burden associated with HIE, this would justify the marginal increase in the normal Cesarean rate.

The Effect of Foot Massage and Warm Footbath with Kencur Aromatic (Kaempferia galanga) on Foot Edema among Pregnant Women

Foot edema or swelling is found in about 80% of pregnant women in the third trimester; it occurs due to uterine pressure which inhibits venous return, and the pull of gravity which causes greater fluid retention. The incidence of edema at the Nagrak Health Center, Cianjur Regency, in May 2021 was 20.9%. Management of foot edema can be done in a non-pharmacological way, one of which is a foot massage and warm footbath with mixed with kencur (Kaempferia galanga) aromatic. The objective was to determine the effect of foot massage and warm footbaths with kencur aromatic on foot edema among pregnant women at the Nagrak Health Center, Cianjur Regency. This research was a quasi-experimental study using one group pretest and posttest design. The sample was 20 respondents. The sampling technique used was purposive sampling. The instrument was the SOP and the pitting scale observation sheet. The data normality test using the Shapiro Wilk found that the data were not normally distributed, so the data analysis used the Wilcoxon test. The results were average degree of foot edema before the intervention was 3+ and the average after the intervention was 1+. Based on the Wilcoxon test, the result of the 2-tailed sign with p-value=0.000 (p&lt;0.05), then statistically there was a significant reduction of foot edema between before and after foot massage and warm footbath with kencur aromatic performed among third-trimester pregnant women. The conclusion was that there was an effect of foot massage and a warm footbath with kencur aromatic on foot edema among pregnant women at the Nagrak Health Center, Cianjur Regency. The suggestion is expected that pregnant women and health workers can practice foot massage and warm foot baths with kencur aromatic to reduce foot edema.

Concurrent Diagnosis of Adenomyosis and Congenital Uterine Anomalies: A Review.

Background: Adenomyosis and congenital uterine anomalies (CUAs) can compromise reproductive potential and may coexist in the same patient, especially in cases of infertility. This review (CRD42022382850) aims to evaluate the published cases of concurrent adenomyosis and syndromic and nonsyndromic CUAs. Methods: A literature search for suitable articles published in the English language was performed using the following databases from inception to 30 November 2022: MEDLINE, EMBASE, Global Health, the Cochrane Library, Health Technology Assessment Database, and Web of Science. Articles including both CUAs and adenomyosis, with data about their potential relationship, were included. Results: The literature search retrieved 14 articles that met the purpose of this review and summarized the most recent findings regarding the concurrent diagnosis of adenomyosis and CUAs. Conclusions: Adenomyosis can be found in both syndromic and nonsyndromic CUAs, and may arise from several etiologies. The hypothesis that obstructions in CUAs increase uterine pressure and promote the development of adenomyosis remains to be further elucidated, and additional findings may also play a role. The patient's genetic, epigenetic, and hormonal patterns, as well as normal physiological processes, such as pregnancy, may influence the growth of adenomyosis.

Biomimetic Janus Collagen Patch with Antideformation, Antiadhesion, and Prohealing Properties for Rehabilitation of Full‐Layer Uterine Injuries, Toward Efficient Live Births

AbstractUterine abnormalities infertility can be treated with implantable patches for tension‐free healing. However, the existing clinical patches are still limited in effective uterus recovery, resulting in low pregnancy and live birth rates. Herein, a novel engineered, and biocompatible Janus collagen patch (JCOP) is developed to achieve excellent uterine defect recovery and increase effective live births. The JCOP can highly match the structure, micromorphology, and mechanical properties of a natural uterus due to homologous‐like tissue homogeneity. JCOP's rough surface and loose‐extracellular‐matrix‐like porosity promote fibroblast adhesion and tissue regeneration, whereas its smooth surface reduces fibroblast adhesion and prevents visceral adhesions. Additionally, it exhibits exceptional resistance to swelling and deformation along with stable mechanical strength for long‐term preservation in the body and can withstand the highest uterine pressure in a humid interior environment attributed to its superior structural layout. Moreover, JCOP@bF, a functional JCOP linked to basic fibroblast growth factor (bFGF) via a specific collagen‐binding domain, significantly promotes repair of the injured uterus, restores the ability of the endometrium to accept embryos, and supports their development to a viable stage in a rat model of uterine damage. This study shows great promise for treating infertility caused by uterine damage.

A machine learning pipeline to classify foetal heart rate deceleration with optimal feature set

Deceleration is considered a commonly practised means to assess Foetal Heart Rate (FHR) through visual inspection and interpretation of patterns in Cardiotocography (CTG). The precision of deceleration classification relies on the accurate estimation of corresponding event points (EP) from the FHR and the Uterine Contraction Pressure (UCP). This work proposes a deceleration classification pipeline by comparing four machine learning (ML) models, namely, Multilayer Perceptron (MLP), Random Forest (RF), Naïve Bayes (NB), and Simple Logistics Regression. Towards an automated classification of deceleration from EP using the pipeline, it systematically compares three approaches to create feature sets from the detected EP: (1) a novel fuzzy logic (FL)-based approach, (2) expert annotation by clinicians, and (3) calculated using National Institute of Child Health and Human Development guidelines. The classification results were validated using different popular statistical metrics, including receiver operating characteristic curve, intra-class correlation coefficient, Deming regression, and Bland-Altman Plot. The highest classification accuracy (97.94%) was obtained with MLP when the EP was annotated with the proposed FL approach compared to RF, which obtained 63.92% with the clinician-annotated EP. The results indicate that the FL annotated feature set is the optimal one for classifying deceleration from FHR.

Efficacy of Yoga therapy as Non-pharmacological management in Women with High-risk Pregnancy: A Single Case Report

This present case study is about a High-risk Pregnancy that includes Pregnancy-induced Hypertension and an abnormal range of Uterine artery pressure, 22 years old female consulted to Gynaecologist for a complaint of missing menstrual cycle. They were diagnosed with Pregnancy positive with the help of a urinary pregnancy test (UPT). In the 13th week, as per a routine follow-up gone for an antenatal ultrasound scan report shows a There is a single live intrauterine gestation with an abnormal range of Right uterine artery PI and left uterine artery PI and diagnosed as a high-risk pregnancy. After a week, time patient has given a blood sample for a thyroid profile. Reports revealed that TRI IODO THYRONINE (T3)-2.13H and THYROXINE (T4) 21.9 H are in the higher range and noticed blood pressure range in higher side diagnosed as Pregnancy induced Hypertension (PIH) High-risk pregnancy will affect both mother and fetus in its way, on mother side, it increases blood pressure called preeclampsia and affects fetal growth result in Intrauterine growth restriction, premature birth, Stillbirth (1). After the 13th week of Pregnancy diagnosed with high-risk Pregnancy, patients are introduced to yoga therapy, including Asana, Pranayama, Meditation, etc., for three days a week regularly till the date of delivery and followed case till delivery. Yoga helps normalize blood pressure and impacts pregnancy outcomes as a standard range of APGAR score in babies and healthy birth weight. Does not show any complications of High-risk Pregnancy on the maternal and fetal side.

The Nonlinear Dynamic Response of Intrapartum Fetal Heart Rate to Uterine Pressure.

The research objective of our group is to improve the intrapartum detection of cardiotocography tracings associated with an increased risk of developing fetal acidosis and subsequent hypoxic-ischemic encephalopathy (HIE). The detection methods that we aim to develop must be sensitive to abnormal tracings without causing excessive unnecessary interventions. Past studies showed that the dynamic response of fetal heart rate (FHR) to uterine pressure (UP) during the intrapartum could be modelled using linear systems. In this study, we examined the assumption of linearity by comparing the performance of linear dynamic and nonlinear dynamic models of the UP-FHR system. The linear systems were defined by second-order state-space models. The nonlinear systems were defined by Hammerstein models: a cascade of a static nonlinearity and a linear second-order state-space model. Our results showed that nonlinear dynamic models were better than linear systems in 81.8% of UP-FHR segments.

THE The Effect of Foot Massage and Warm Water Mixed with Aromatic Ginger Foot Bath on Edema in Pregnancy

Swelling or edema in the legs often occurs in third trimester pregnant women because uterine pressure inhibits venous return causing fluid retention. The incidence of edema in RSIA Kemang Medical Care between December 2021 and January 2022 was third ranked in cases of discomfort for pregnant women. Handling swollen feet by means of complementary therapies, one of which is foot massage and warm water foot bath mixed with aromatic ginger.This quasi-experimental study used a two-group pretest and posttest design with control group. The population of this study was all registered pregnant women with third trimester edema which was 80 people. There are 20 experimental samples and 20 control samples. The sampling technique used purposive sampling. The instrument was SOP and pitting scale tables. Data analysis had been done by using Wilcoxon and Mann Whitney test.&#x0D; The average degree of leg edema was 3+ before the intervention and 1+ after the intervention. According to Wilcoxon, the results showed pvalue =0.000 (&lt;0.05) so that statistically there was a significant decrease in leg edema before and after foot massage and footbath in warm water mixed with aromatic ginger in third trimester pregnant women. The Mann-Whitney test for the significant difference p = 0.000 &lt; 0.05 there was a difference between the post- experimental group and the post control group, which means that statistically there was a decrease in swelling in the third trimester of RSIA Kemang Medical Care 2022 with foot massage

An Experiment Study to Evaluate the Effectiveness of Carom Seed Oil on reduction of Menstrual Cramps among the Adolescent girls of selected Nursing Colleges, Bangalore

Carom seed oil has been found to relieve the menstrual discomfort by relaxing the uterine muscles and decreasing the intra uterine pressure. Leaves and their essence are aromatic, stimulant, carminative and antispasmodic. This is also used in case of vomiting, gastric colic, diarrhea and menstrual cramps. Therefore, it was intended to do an experimental study to examine the effect of Carom seed oil on menstrual cramps with an assumption that this therapy may relieve menstrual cramps. The research design selected for the present study is experimental research design. The study was conducted in the Global College of Nursing at Bangalore. The criteria for the selection of the setting are the availability of subjects, feasibility of conducting the study. The target population in the present study was adolescent girls studying in Global College of Nursing at Bangalore. The sample of this study comprised of 60 adolescent girls. Simple random sampling (Random table number) method was used to draw the sample. A Visual Analogues Scale (VSA) to assess the pain intensity of the students. The findings revealed that in experimental group, majority of the subjects, 24 (80%) had severe pain, 6 (20%) subjects had moderate pain, none had severe pain, and in control group majority of the subjects, 22 (73.3%) had severe pain, 8 (26.6%) subjects had moderate pain, none had pain. After the intervention, in experimental group, majority of the subjects, 24 (80%) had mild pain, 6 (20%) subjects had moderate pain, none had severe and in control group majority of the subjects, 25 (83.3%) had moderate pain, 5 (16.6%) subjects had mild pain and none severe pain. The adolescent girls had reduction in the menstrual cramps as evidenced by the results shown. Hence carom seed oil is effective in the reduction of menstrual cramps and it was found to be less cost effective procedure. Therefore, carom seed oil should be used as a supportive therapy among adolescent girls to alleviate menstrual cramps.

Hysteroscopic management of a "hernia-like" uterine myoma within the uterine cavity

To introduce a case of a uterus "hernia-like" myoma within the uterine cavity that was successfully treated with hysteroscopy. Step-by-step explanation of the case and surgical procedure using a video and slides. The Medical Ethics Committee of Women and Children's Hospital of Chongqing Medical University approved the study and decided for this video to be exempt from formal approval, and informed consent was obtained from the patient. Hospital. A 37-year-old woman, gravida 1, para 1, with a history of secondary infertility for 2 years and heavy menstrual bleeding for 7 months, which eventually resulted in anemia, was diagnosed with a type 1 (International Federation of Gynecology and Obstetrics leiomyoma subclassification system) myoma approximately 4 cm in diameter using ultrasonography. Her hemoglobin level was 8.6 g/dL (11.5-15.0 g/dL), red blood cell count was 3.6 ×10-12/L (3.8-5.1 ×10-12/L), and hematocrit was 26.7% (35%-45%). Hysteroscopic myomectomy with bipolar resectoscope and transabdominal ultrasound guidance was used to resect the hernia-like myoma. Blunt dissection combined with oxytocin (20 U I.V.) and uterine dilation pressure reduction was used to induce the hernial content (myoma) protrusion into the uterine cavity. The hernia-like myoma was completely resected by hysteroscopy, and all symptoms disappeared. The hernia-like myoma was successfully and completely resected by hysteroscopy. The operative time was 37 minutes. No surgical-related or anesthesia-related complications occurred. During the follow-up period, the patient had regular menstrual cycles without hypermenorrhea, and her anemia had improved. The 5-month follow-up ultrasound examination and hysteroscopy revealed that the uterine cavity had recovered well. The patient conceived 7 months after the procedure and delivered at term (39 weeks 1 day) via cesarean section. A hernia-like myoma covered with endometrium is a degenerative myoma that herniates into the myometrium and forms a hernia sac-like defect. Hysteroscopy is an effective and feasible method for treating hernia-like myoma.

Addressing the high prevalence of uterine fundal pressure in low-middle income country during vaginal delivery through a quality improvement initiative: Road to respectful maternity care.

Intrapartum care is of paramount importance in overall respectful maternity care (RMC). Uterine fundal pressure maneuver (UFPM) is the most controversial obstetric maneuver considered obsolete in many countries. UFPM is associated with adverse life threatening maternal and fetal effects. The baseline prevalence of UFPM in our tertiary care teaching hospital with a heavy patient load was 78.4% which was quite high. Our aim was to reduce the prevalence of UFPM by 75% from baseline over a period of 10months. After root cause analysis, we formulated the departmental Standard Operating Procedures on safe vaginal delivery and birth practices and initiated the Labour Room Quality Improvement Initiative. We sensitized and created awareness among the resident doctors and nursing staff regarding the high prevalence of UFPM through dedicated lectures, intercommunication via WhatsApp groups and strict vigilance in the labor wards. The point of care quality improvement (QI) methodology was used. The primary outcome was decrease in the prevalence of UFPM. The prevalence of UFPM reduced from the baseline value of 78.4%-4% over the period of 7months. Post intervention it gradually increased and sustained at 21.2% over a follow-up period of 3months. QI methods can effectively and rapidly improve the acceptance and adherence to newer initiatives in a busy tertiary care health facility to reduce the prevalence of UFPM and eventually improve the overall RMC.