Women In Reproductive Years Research Articles

8417 Knowledge Of PCOS and Its Complications In A Population Of Hispanic Women

Abstract Disclosure: Y.G. Rivera-Rodriguez: None. B. Diaz Rios: None. C.M. Casas Loyola: None. B. Marin Rodriguez: None. P.A. Alicea Reyes: None. J. Romaguera: None. L.A. Gonzalez-Rodriguez: Research Investigator; Self; Eli Lilly & Company. Purpose: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women across their lifespan, with metabolic complications that are often overlooked. Studies have revealed an inadequate understanding of PCOS, its complications, and management. There is also limited information about this condition in Hispanic women. The purpose of this study is to assess the knowledge about PCOS and its complications among a sample of Hispanic women living in Puerto Rico. Methods: This is a descriptive cross-sectional study of Hispanic women aged 21-45 years recruited from the General Endocrinology and Gynecology Clinics at the UPR-RCM Clinics. A self-administered questionnaire assessing their knowledge about PCOS, and its complications was given. Patients were classified according to PCOS diagnosis. Results were compared between the groups. Results: A total of 47 women were included in this study. Approximately 45% of participants had a diagnosis of PCOS. Most participants agreed that PCOS involves a set of symptoms associated with hormonal imbalances (94%) and irregular menses (91%). Only 40% of participants considered PCOS a chronic condition without a cure and only 34% acknowledge weight loss as one of the treatments of this condition. Two-thirds of participants didn’t know that PCOS can be diagnosed with blood tests. When assessing their knowledge about complications related to PCOS, we found that only 36% associated PCOS with an increased risk of cardiovascular disease, 56% with obesity and 62% with abnormal blood glucose levels. When comparing the knowledge about their condition in patients with a diagnosis of PCOS, we found increased knowledge about signs and symptoms such as hirsutism, hair loss and weight gain when compared to controls. However, when assessing their knowledge about complications related to PCOS, neither group recognized PCOS as a chronic condition, or associated PCOS with cardiovascular, metabolic complications and/or increased risk of cancer. Conclusion: Our study suggests that there is a lack of general knowledge about PCOS and its long-term complications among a sample of Hispanic women in reproductive years. Most importantly, our data showed that even patients with a diagnosis of PCOS do not understand their condition or comprehend the associated complications. Our study emphasizes the need to develop educational tools and strategies to improve the general population knowledge about this condition and raise awareness about preventable complications and the importance of early treatment. Presentation: 6/3/2024

8417 Knowledge Of PCOS and Its Complications In A Population Of Hispanic Women

Abstract Disclosure: Y.G. Rivera-Rodriguez: None. B. Diaz Rios: None. C.M. Casas Loyola: None. B. Marin Rodriguez: None. P.A. Alicea Reyes: None. J. Romaguera: None. L.A. Gonzalez-Rodriguez: Research Investigator; Self; Eli Lilly & Company. Purpose: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting women across their lifespan, with metabolic complications that are often overlooked. Studies have revealed an inadequate understanding of PCOS, its complications, and management. There is also limited information about this condition in Hispanic women. The purpose of this study is to assess the knowledge about PCOS and its complications among a sample of Hispanic women living in Puerto Rico. Methods: This is a descriptive cross-sectional study of Hispanic women aged 21-45 years recruited from the General Endocrinology and Gynecology Clinics at the UPR-RCM Clinics. A self-administered questionnaire assessing their knowledge about PCOS, and its complications was given. Patients were classified according to PCOS diagnosis. Results were compared between the groups. Results: A total of 47 women were included in this study. Approximately 45% of participants had a diagnosis of PCOS. Most participants agreed that PCOS involves a set of symptoms associated with hormonal imbalances (94%) and irregular menses (91%). Only 40% of participants considered PCOS a chronic condition without a cure and only 34% acknowledge weight loss as one of the treatments of this condition. Two-thirds of participants didn’t know that PCOS can be diagnosed with blood tests. When assessing their knowledge about complications related to PCOS, we found that only 36% associated PCOS with an increased risk of cardiovascular disease, 56% with obesity and 62% with abnormal blood glucose levels. When comparing the knowledge about their condition in patients with a diagnosis of PCOS, we found increased knowledge about signs and symptoms such as hirsutism, hair loss and weight gain when compared to controls. However, when assessing their knowledge about complications related to PCOS, neither group recognized PCOS as a chronic condition, or associated PCOS with cardiovascular, metabolic complications and/or increased risk of cancer. Conclusion: Our study suggests that there is a lack of general knowledge about PCOS and its long-term complications among a sample of Hispanic women in reproductive years. Most importantly, our data showed that even patients with a diagnosis of PCOS do not understand their condition or comprehend the associated complications. Our study emphasizes the need to develop educational tools and strategies to improve the general population knowledge about this condition and raise awareness about preventable complications and the importance of early treatment. Presentation: 6/3/2024

A Multicenter Retrospective Cohort Study Assessing the Incidence of Anemia in Patients Associated With Uterine Fibroids.

Uterine fibroids are benign tumors that develop from the smooth muscle tissue of the uterus, typically during a woman's reproductive years. A substantial proportionof women with uterine fibroids exhibit symptoms, including menorrhagiathat considerably compromise theirquality of life. This study aims to characterizethe fibroid subtype most commonly associated with the incidence ofanemia. This retrospective multi-center cohort study investigated the incidence of anemia in premenopausal women who were diagnosed with uterine fibroids between January 2016 and December 2022. Fibroid position, size, location, and number were assessed by trans-abdominal/vaginal ultrasound and hysteroscopy and correlated to the pre-treatment hemoglobin level. Three-quarters of patients (n=6) with submucosal fibroid presented with any form of anemia followed by 59.3% (n=115) of patients with intramural fibroid and only 36.8% (n=25) of patients with sub serousal fibroid. Interestingly, there was no difference between the groups with regard to the severity of anemia at presentation. Most red blood cells (RBCs) and hemoglobin (Hb) indices were comparable between the groups, except for mean corpuscle volume (MCV) as it was significantly lower in patients with intramural fibroids. Moreover, our investigations showed that the submucosal fibroids tend to present in a higher number as well as the biggest in size. The multivariable logistic regression showed that subserosal fibroids are associated with the lowest risk of developing anemia. In conclusion, our results suggest that the occurrence of anemia should always be considered in women with submucosal fibroids. However, after adjusting for other contributing factors such as menorrhagia, submucosal fibroid did not show an increase in the risk of anemia.

Technology advances in diabetes pregnancy: right technology, right person, right time.

This review outlines some of the extraordinary recent advances in diabetes technology, which are transforming the management of type 1 diabetes before, during and after pregnancy. It highlights recent improvements associated with use of continuous glucose monitoring (CGM) but acknowledges that neither CGM nor insulin pump therapy are adequate for achieving the pregnancy glucose targets. Furthermore, even hybrid closed-loop (HCL) systems that are clinically effective outside of pregnancy may not confer additional benefits throughout pregnancy. To date, there is only one HCL system, the CamAPS FX, with a strong evidence base for use during pregnancy, suggesting that the pregnancy benefits are HCL system specific. This is in stark contrast to HCL system use outside of pregnancy, where benefits are HCL category specific. The CamAPS FX HCL system has a rapidly adaptive algorithm and lower glucose targets with benefits across all maternal glucose categories, meaning that it is applicable for all women with type 1 diabetes, before and during pregnancy. For women of reproductive years living with type 2 diabetes, the relative merits of using non-insulin pharmacotherapies vs diabetes technology (dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors) are unknown. Despite the urgent unmet need and potential benefits, studies of pharmacotherapy and technology use are extremely limited in pregnant women with type 2 diabetes.

Conception, pregnancy and inflammatory bowel disease-Current concepts for the practising clinician.

The peak incidence of inflammatory bowel disease (IBD) coincides with a woman's prime reproductive years. The management of IBD during pregnancy can be challenging for healthcare professionals, underpinning the need for a multi-disciplinary approach with shared decision-making with the patient. Pre-conception counselling can address patient concerns, improve pregnancy specific IBD patient knowledge and provide a personalized risk assessment, to ensure optimal maternal and fetal outcomes. Most women with IBD have fertility rates comparable with the general population, although voluntary childlessness is common among women with IBD. IBD disease activity at conception and during pregnancy is a key determinant of the course of IBD during pregnancy. Active IBD during pregnancy is associated with adverse pregnancy-related outcomes, including spontaneous abortion, small for gestational age baby and preterm birth, emphasizing the importance of ensuring disease remission prior to conception. Most IBD medications (5-aminosalicylates, thiopurines if already initiated pre-conception, corticosteroids and biologic medications) are considered safe and low risk during pregnancy and breastfeeding, except for methotrexate, JAK-inhibitors, ozanimod and allopurinol and maintaining remission throughout gestation should be the priority. Most women with IBD can have a vaginal delivery, but cesarean section should be considered in active perianal disease and history of ileal pouch surgery. This narrative review outlines the current evidence for themanagement of IBD in pregnancy, as well as considering the pre-conceptual and post-partum period.

Evaluate the Effectiveness of Video Assisted Teaching Programme on Knowledge and Attitude towards Early Identification and Management of Polycysticovarian Syndrome among Adolescent Girls

Polycystic ovarian syndrome (PCOS) is one of the most common reproductive endocrinological disorders with a broad spectrum of clinical manifestations affecting about 6-8% of women of reproductive years. The study was conducted to evaluate the effectiveness of video assisted teaching programme on PCOS among Adolescent’s girls at Puducherry. The aim of the study to evaluate the VATP on PCOS. Methodology using quantitative approach quasi-experimental (one group pre-test post-test) research design. A total of 65 subjects were selected for study by using probability simple random sampling technique. Self-Structured questionnaire and modified attitude scale regarding early identification and management of PCOS were used as the tool.Results The findings revealed that in the pre-test, regarding the level of knowledge, in adequate 19(29.2%),and moderate 45 (69.2%) had adequate, 1 (1.6%). had unfavourable attitude 0(0%) ,moderate favourable 59(90.8%) of them favourable 6 (9.2%) . In the Post- test, regarding the level of knowledge inadequate0 (0%) of them had moderate and 5 (7.7%) had adequate level oknowledge,97(97%) of them had favourable and 3(3%) had moderate favourable attitude, regarding the practice, majority 65 (92.3%) . had unfavourable attitude 0(0%) and moderate favourable 36(55.4) had favourable 29(44.6%). Conclusion Study concluded that selective nursing intervention showed that the video assisted teaching programme is effective to improve knowledge for students. Key words: PCOS, VATP, Adolescents girls.

Gene variants polymorphisms and uterine leiomyoma: an updated review.

Uterine leiomyoma, commonly referred to as fibroids, is a benign tumor that develops in the muscular wall of the uterus. These growths are non-cancerous and can vary in size, ranging from tiny nodules to larger masses. Uterine leiomyomas often occur during a woman's reproductive years and can lead to symptoms such as heavy menstrual bleeding, pelvic pain, and pressure on nearby organs. While the exact cause is not fully understood, hormonal factors, particularly estrogen and progesterone, are believed to play a role in their development. The exploration of connections between genetic variants and uterine leiomyoma has captivated scientific attention for numerous years. The results from investigations remain a subject of intrigue within the scientific community. To date, the findings regarding the relationships between single nucleotide polymorphisms (SNPs) and uterine leiomyoma have exhibited some inconsistencies. However, amidst these inconsistencies, several promising outcomes have emerged that hold the potential to shape future research endeavors. These promising leads could pave the way for the development of innovative targeted therapies and novel prognostic biomarkers. This review specifically centers on accentuating the existing literature data concerning genetic variants that have been explored for their potential connections to uterine leiomyoma. Additionally, it underscores the prospects of employing genetic variations as diagnostic and prognostic biomarkers for individuals diagnosed with uterine leiomyoma.

Effects of the use of contraceptives: a case of women in the Greater Accra and Ashanti regions of Ghana

Background: Contraceptive use during a woman's reproductive years can help prevent unintended pregnancies, maternal deaths, and other non-reproductive problems. However, there is also a risk of running into various health challenges. The study aimed at finding out if women in the Greater Accra and Ashanti regions of Ghana encounter health issues during and after use of contraceptives was conducted. Methods: Questionnaires were administered to 600 women out of which 401 responses were carefully gleaned for analysis using SPSS version 25. The questionnaire probed side and adverse effects women encountered in their use of contraceptives as well as the types of contraceptives they preferred. Results: The study revealed that the use of contraceptives was widely prevalent, especially amongst women aged 21-30 years (61.8%). The preferred types of contraceptives were the oral-progestin only (42.9%) and combined oral contraceptives (31.4%). Spotting or bleeding between periods (menstrual-related) was the highest reported side effect (33.2%), followed by weight gain (metabolic-related), 21.7%. Pearson’s Chi squared test showed an association between the age of respondents and the choice of contraceptive type at p<0.01. Hypertension and deep vein thrombosis (DVT) were the highest reported adverse effect (10.2% and 9.2% respectively). Conclusions: It was concluded that contraceptive use (especially the oral type) may cause discomfort with the side effects reported in women of reproductive age and it may be a contributing factor to other health conditions in susceptible women.

Evaluation of stroke in pregnant and non-pregnant women of reproductive years: A multicenter ambispective cohort study in a low- to middle-income country.

Early recognition of stroke symptoms and risk factors is important for timely intervention to improve outcomes. This study aimed to investigate differences in stroke frequency, risk factors, and presentation in pregnant and non-pregnant women of reproductive years. This multicenter ambispective cohort study, conducted from 4th August 2021 to 4th March 2023, examined strokes in women of reproductive years at the neurology outpatient/emergency department of five busiest/referred neuro-medical facilities in Karachi, Pakistan, where patients from across the nation are assessed. In all, 1210 patients were enrolled via consecutive or convenient sampling retrospectively from January 2017 to August 2021 and prospectively from August 2021 to March 2023. Pregnancy-related and non-pregnancy-related stroke occurrence and characteristics were compared using the chi-square/Fischer's exact test. 56% were non-pregnancy-related strokes and 44% were pregnancy-related strokes with non-pregnancy-related strokes approximately equal throughout the reproductive years (15-24 years = 34%, 25-34 years = 25%, 35-45 years = 41%) and pregnancy-related stroke between 15 and 35 years (82%). In the non-pregnancy-related stroke, arterial stroke dominated (96.4%); while in pregnancy-related stroke, arterial stroke accounted for 61.4% and venous stroke for 38.6% of cases. Middle cerebral artery was a typical stroke site (66%). Infarction was the most significant CT/MRI finding (PRS = 89%, NPRS = 66%), with pregnancy-related stroke hemorrhagic stroke occurring in only 11% of cases and non-pregnancy-related stroke comprising one-third (34%). The most prevalent etiologies were eclampsia in pregnancy-related stroke (32%), hypertension in non-pregnancy-related stroke (40%), and cardiac problems among both groups (25%:33%). Weakness and headache were the common clinical manifestations among both groups. In the pregnancy-related and non-pregnancy-related stroke groups, the initial presentation of stroke resulted in severe disability for 91% and 75%, respectively. With timely treatment, the outcome improved significantly. The mortality rate was 7% for the pregnancy-related stroke group and 4% for the non-pregnancy-related stroke group. Our findings show that stroke is prevalent among reproductive-year women, posing a significant mortality risk if not adequately recognized and treated. Awareness, research, and screening of stroke risk factors and their often-overlooked early presentation (i.e., headache and weakness) in reproductive years are essential to reducing stroke occurrence among reproductive-year women.

Grading of Hashimoto’s thyroiditis in cytology and its association with ultrasonographic and biochemical parameters

Introduction and Aim: In the post-iodization period, Hashimoto's thyroiditis (HT) is most likely the most prevalent cause of goitre and hypothyroidism, particularly in women of reproductive years. This study was undertaken to grade HT on Fine Needle Aspiration Cytology smears and determine their usefulness in predicting thyroid damage in association with clinical history, radiological and biochemical findings. Materials and Methods: Total of 151 cases were diagnosed cytologically in duration of over 2 years as Hashimoto’s thyroiditis/lymphocytic thyroiditis. Cytology scoring technique was used to analyse smears and were correlated with radiological, biochemical findings and were evaluated statistically by ANOVA and Kruskal Wallis tests. Results: In the current study, the most frequent group of individuals with Hashimoto's thyroiditis were between the ages of 40 and 50. Females (145 cases, 96%) were commonly affected and the commonest presentation was a diffuse (125 cases ,82.8%) thyroid enlargement. Cytological grading of Hashimoto’s thyroiditis were as follows,54 (35.8%) patients were Grade I, 81(53.6%) patients were Grade II thyroiditis and 16 (10.6%) patients were Grade III thyroiditis. Biochemically, 78 (56.5%) of the cases were hypothyroid, 51 (37%), euthyroid, and 9 (6.5%) were hyperthyroid. Ultrasonography revealed 76 (50.3%) patients with hypoechoic micronodules, 71 (47%) with echogenic septae, 101 (66.9%) with increased vascularity, and 6 (4%) with normal findings. The grades of lymphocytic thyroiditis and the biochemical data were found to be statistically significant (p=0.001). Furthermore, there was a strong correlation between the grades and specific ultrasound findings, such as echogenic septae (p=0.042) and diffuse hypoechogenicity (p=0.046). Conclusion: Cytological scoring system in Hashimoto’s thyroiditis can predict thyroid functional status and aid in determining the severity of the disease.

Polycystic Ovarian Syndrome among Young Women of a University in Central Gujarat - A Cross-sectional Study.

Polycystic ovarian syndrome (PCOS) is one of the most common reproductive endocrinological disorders affecting 6%-8% of women in reproductive years. An early liberal PCOS screening appears to be a cost-effective strategy, benefiting earlier diagnosis and intervention. The objectives are to measure the prevalence of PCOS and factors associated with PCOS among young girl students of a University in Central Gujarat. All consenting girl medical students enrolled in MBBS curriculum during 2013-2017 were given a self-administered questionnaire (for signs and symptoms of PCOS), taking due prior permissions; during January 2018-June 2019. Using Rotterdam (2006) criteria, those who were screened for PCOS were subjected to abdominal ultrasonography (USG) and if required, laboratory investigations (random blood sugar, thyroid-stimulating hormone, and free testosterone). The proportion of young women having PCOS as per the Rotterdam and European Society for Human Reproduction and Embryology (EHSRE) Criteria are reported. The study enrolled 308 girl medical students. More than one-tenth of the study participants (11.7%, 36/308) had confirmed PCOS (Rotterdam Criteria). As per the EHSRE criteria, 24/36 had classic PCOS, 11/36 had ovulatory phenotype, and 01/36 had the non-hyperandrogenic phenotype PCOS. USG was required in 123/308 (39%); of which 91 consented and 16/91 (18%) had conclusive PCOS. Twenty-three girls required laboratory investigations, of which two had abnormal values suggestive of PCOS. Irregular menses and hirsutism were significantly associated with the PCOS (P < 0.05). The proportion of young medical students with PCOS was 12%. Irregular menses and hirsutism were significantly associated with PCOS.

OR12-03-23 Weight Trajectories Across Women's Reproductive Years and Risk of Adverse Pregnancy Outcomes

OR12-03-23 Weight Trajectories Across Women's Reproductive Years and Risk of Adverse Pregnancy Outcomes

Testosterone: the highly misunderstood hormone in women. How to navigate its importance during a women's reproductive years into menopause

Testosterone is one of the most abundant hormones in women but it is hardly ever discussed or given it’s just due in the treatment of peri-menopause/menopausal women. During this lecture, the provider will learn how testosterone deficiency affects women’s daily quality of life but also put them at risk for chronic illness. They will also learn how birth control pills impact testosterone levels in women and how to consider them in relation to not only the reproductive system but the overall body. We review the affects that testosterone has on breast health and the role of testosterone in treating patients with breast cancer. Lastly, we will review the blatant gender bias that occurs in medicine and in particular the bias in the hormonal treatment of women.

Pathogenesis of endometrium-related diseases based on genomic alterations in normal uterine endometrium.

The human endometrium is a dynamically remodeling tissue that undergoes more than 400 cycles of regeneration, differentiation, shedding, and rapid healing during a woman's reproductive years. The endometrium is also the origin of various gynecologic diseases, such as endometriosis, adenomyosis, and uterine corpus cancer. Cancer-associated gene mutations are detected in endometriosis, adenomyosis, and normal endometrium. Some reports have demonstrated that the accumulation of genomic alterations is a critical carcinogenic mechanism in the progression from normal endometrium to ovarian clear cell carcinoma via endometriosis. In this review, we discuss the clinical importance of genomic alterations in the normal endometrium, contributing to the elucidation of the pathogenesis of endometrium-related diseases.

Obstetric Outcomes of Pregnant Women with Eclampsia

Introduction: Over half a million women die each year from pregnancy-related causes, 99% in low and middle-income countries. In many low-income countries, complications of pregnancy and childbirth are the leading cause of death amongst women of reproductive years. Overall, 10% to 15% of direct maternal deaths are associated with pre-eclampsia and eclampsia, where maternal mortality is high; most deaths are attributable to eclampsia, rather than pre- eclampsia. This study aimed to analyze the obstetric outcomes of pregnant women with eclampsia. Methods: This prospective study was conducted at the Department of Obstetrics &amp; Gynecology in Uttara Adhunik Medical College &amp; Hospital, Dhaka, Bangladesh for 6 months; from June 2019- November 2019. A total of 50 subjects were included in this study. Informed written consent was taken from the study subjects. Data was collected using a pre-formed data sheet. Data processing and analysis were done by using SPSS version 17. All patients underwent necessary investigations. All information was kept confidential and used only for this study purpose. The ethical Clearance Certificate was obtained from Bangladesh Medical College. Result: In this study, most of the patients (30, 60.0%) belong to the age group of 18- 25 years, followed by 12 patients (24.0%) were from the&gt;35 years age group and the rest 08 (16.0%) patients belonged to 26-35 years, age group. Most of the patients (35, 70.0%) were nulliparous followed by multiparous (15, 30.0%). Maximum respondents (26, 52.0%) developed seizures at the antepartum stage, followed by 18 patients (36.0%) at the intrapartum stage and the rest 03 (6.0%) patients developed seizures at the postpartum stage. Concerning complications, maximum patients (08, 16.0%) suffered from hemorrhage, followed by anemia (7, 14.0%), abruptio placenta (6, 12.0%), sepsis (5, 10.0%), obstructed labor (4, 8.0%). Regarding maternal and fetal outcomes in eclampsia, this study revealed satisfactory outcomes in 37 (74.0%) patients with prompt actions taken during the condition. However, perinatal death occurred in 2 (4.0%) cases, and maternal death occurred in 1 (2.0%) case. Preterm delivery was done on 10 (20.0%) patients. Conclusion: Obstetric outcome was somewhat satisfactory in this study due to immediate diagnosis and actions taken during eclampsia, however, perinatal death occurred in 2 (4.0%) cases and maternal death occurred in 1 (2.0%) case and 10 (20.0%) cases underwent preterm delivery.

Comprehensive evaluation of the incidence and prevalence of surgically diagnosed pelvic endometriosis in a complete population.

The incidence and prevalence of pelvic endometriosis is still being debated. Population-based studies have shown annual incidences between 0.1% and 0.3%, which translates to a prevalence of symptom-giving disease of between 2% and 6% over a 20-year span in the reproductive years. However, a prevalence of 10% or higher is often assumed. We used Iceland's extensive record linkage possibilities, secure access to patient data and personal identification numbers to search for all cases with a surgical and/or histological first diagnosis over a 15-year study period. Information was obtained from all healthcare facilities where an operative and/or histological diagnosis of pelvic endometriosis might have been made during 2001-2015. Hospital discharge diagnostic data and private clinic data sources were scrutinized and double-checked through a central register. Individual medical records, operation notes and pathology records were inspected. Visually and pathologically diagnosed cases were included. The data covered women aged 15-69 years, but the age range 15-49 (reproductive years) was specifically considered. Annual incidence was estimated per 10000 person-years and prevalence possibilities calculated for varying disease durations. Disease severity was staged (revised American Society for Reproductive Medicine classification) and main lesion sites determined. A total of 1634 women 15-69 years old were diagnosed; 1487 of them between 15 and 49 years old. Histological verification was obtained for 57.1%. The age-standardized annual incidence for all confirmed endometriosis diagnoses was 12.5/10 000 person-years among women in their reproductive years. The overall estimate of prevalence was 0.6%-3.6%, dependent on duration of symptoms from 5 up to 30 years. The most common sites by order of frequency were ovaries, deep pelvis, central pelvis, vesicouterine pouch and uterine appendages. Of the women, 1080 (66.1%) had minimal/mild and 553 (33.8%) moderate/severe disease. We have in a comprehensive study covering a recent 15-year period confirmed an annual incidence of pelvic endometriosis of between 0.1% and 0.15% in the female population of reproductive age. Endometriosis is variably severe but, depending on the duration of symptomatic disease, the approximated prevalence during women's reproductive years could range from 1% to 4%.

Psychological Experiences in Women with Polycystic Ovary Syndrome: A Qualitative Study.

Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder among women of reproductive years. In addition to multiple physical problems, this syndrome has many psychological complications. Thus, the present study attempted to explore the psychological experiences of women with PCOS in Iran's sociocultural context. The study was carried out in Isfahan, Iran, using a qualitative content analysis method. The participants were selected through purposive sampling from women with PCOS, their spouses, and healthcare providers in hospitals, clinics, workplaces, universities, and physicians' offices between September 2018 and November 2019. Data collection was performed through semi-structured interviews until data saturation. Data analysis was based on conventional content analysis. The interviews were transcribed and coded. Afterward, categories and concepts were extracted by grouping similar codes. A total of 13 women with PCOS, four spouses, and 13 healthcare providers participated in this study. Data analysis yielded five main categories, including the patient's psychological reactions following infertility and its probability, psychological issues following menstrual disorders, patients' fear and concerns about the probability of developing chronic diseases, psychological problems following the disease, and psychological problems resulting from body appearance. The results of this study showed that women with PCOS were exposed to multiple psychological problems. Therefore, preventing and controlling the psychological consequences of PCOS and its complications requires healthcare providers' support and comprehensive and long-term planning to promote the mental health of these women.

Impact of a digital health literacy intervention and risk predictors for multimorbidity among poor women of reproductive years: Results of a randomized-controlled trial

Objective The objective of this study was to deliver an intervention to improve health awareness for infection prevention, hygiene, and sanitation to assess its impact. Furthermore, it aimed to identify the risk of multimorbidity in women of reproductive years from low socio-economic background. Methods A randomized control trial was conducted in Pakistan among women aged 15–45 years. Overall, 820 women participated in the baseline survey; 388 women were part of the control group and 360 of the intervention group. A digital health literacy intervention was delivered by 91 trained community health workers. Data were analyzed using descriptive statistics and multivariate logistic regression. Results About 35.9% of women suffered from multimorbidity. The intervention group showed higher odds of confidence in managing health with respect to skill and technique acquisition (AOR = 2.21; 95% CI 1.01–4.84), self-monitoring and insight (AOR = 2.97; 95% CI 1.29–6.80) as well as sanitation and hygiene (AOR = 1.42; 95% CI 1.07–1.93). Two primary outcomes related to hand hygiene and protective behavior against infection did not show any significant improvement. The secondary outcomes of the study related to impact on overall health-related quality of life, social integration and support, and emotional well-being also did not show any significant improvement. Conclusions Digital health literacy interventions and multimorbidity management for women of reproductive years at the primary level are a way forward to alleviate communicable and non-communicable disease burden in developing countries like Pakistan. These efforts are also critical to improve maternal and child health in developing regions.

Strategies for modelling endometrial diseases.

Each month during a woman's reproductive years, the endometrium undergoes vast changes to prepare for a potential pregnancy. Diseases of the endometrium arise for numerous reasons, many of which remain unknown. These endometrial diseases, including endometriosis, adenomyosis, endometrial cancer and Asherman syndrome, affect many women, with an overall lack of efficient or permanent treatment solutions. The challenge lies in understanding the complexity of the endometrium and the extensive changes, orchestrated by ovarian hormones, that occur in multiple cell types over the period of the menstrual cycle. Appropriate model systems that closely mimic the architecture and function of the endometrium and its diseases are needed. The emergence of organoid technology using human cells is enabling a revolution in modelling the endometrium in vitro. The goal of this Review is to provide a focused reference for new models to study the diseases of the endometrium. We provide perspectives on the power of new and emerging models, from organoids to microfluidics, which have opened up a new frontier for studying endometrial diseases.

Frequency and Types of Uterine Anomalies during Caesarean Section Done for Abnormal Presentation

Background: Congenital uterine abnormalities are caused by abnormal fusion or canalisation of the mullerian duct during embryonic development. Congenital uterine abnormalities affect about 2% to 4% of women in reproductive years, and 5 to 25% of women who have had a difficult pregnancy. Ultrasonography, magnetic resonance imaging, hysterosalpingogram, and hysterolaparoscopy are some of the diagnostic modalities used to diagnose uterine anomalies. This observational study is conducted to determine the frequency and types of congenital uterine anomalies discovered during Caesarean section done for abnormal presentations. Aims and Objectives: 1) To determine the frequency and types of congenital uterine anomalies during caesarean section done for abnormal presentations. 2) To find out relationship between abnormal presentation and uterine anomaly. Material and Methods: This is a retrospective observational study conducted in the Department of Obstetrics and Gynaecology, FAAMCH Barpeta. A total number of 176 cases were included in the study over a period of 1 year. Patients who underwent Caesarean section due to abnormal presentation were included in the study. After delivery of the foetus and the placenta, uterus was examined for the presence or absence of congenital malformations by digital palpation of the uterine cavity and inspection of fundus of uterus after exteriorisation. Demographic characteristics and obstetric outcomes were noted. Results: Out of 176 patients, 24 (13.63%) were diagnosed with uterine anomalies and 152 (86.36%) patients had normal uterus. Majority of the patients with uterine anomalies who underwent Caesarean section were primigravida (79.16%) and majority of them belonged to the age group of 25 - 30 years (70.83%). The most commonly observed uterine anomaly during the study period was arcuate uterus. Our study included cases only with abnormal presentation, 17 out of 24 (70.83%) had breech presentation and 6 (25%) had transverse lie.