Obstetrics and Gynecology International最新文献

{"title":"Comparison of Placenta Previa and Placenta Accreta Spectrum Disorder Following Previous Cesarean Section between Women with a Short and Normal Interpregnancy Interval.","authors":"Uchenna Anthony Umeh,&nbsp;George Uchenna Eleje,&nbsp;Justus Uchenna Onuh,&nbsp;Ogochukwu Theophilus Nwankwo,&nbsp;Ijeoma Victoria Ezeome,&nbsp;Leonard Ogbonna Ajah,&nbsp;Ngozi Regina Dim,&nbsp;Samuel Nnamdi Obi,&nbsp;Chidebe Christian Anikwe,&nbsp;Joseph Ifeanyichukwu Ikechebelu","doi":"10.1155/2022/8028639","DOIUrl":"https://doi.org/10.1155/2022/8028639","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to determine the effect of interpregnancy interval (IPI) on the incidence of placenta previa and placenta accreta spectrum disorders in women with a previous cesarean section.</p><p><strong>Methods: </strong>A prospective cohort three-center study involving parturients who had previous cesarean section was conducted. Participants were included if pregnancy has lasted up to 34 weeks. Parturients with co-existing uterine fibroids, multiple gestations, premature rupture of membranes, and those with prior postcesarean delivery wound infection were excluded. The eligible women recruited were distributed into two groups, namely, short (<18 months) and normal (18-36 months) IPI. The outcome measures were incidences of placenta previa and placenta accreta spectrum disorder and factors associated with the occurrence of placenta previa. A univariate analysis was performed using the chi-square test or Mann-Whitney <i>U</i> test, wherever appropriate, to examine the significance of the differences in clinical variables.</p><p><strong>Results: </strong>A total of 248 women met the inclusion criteria. The incidence of placenta previa by ultrasound was 8.9% and 4.0% for short and normal IPI (odds ratios = 2.32; 95% confidence intervals = 0.78-6.88; <i>p</i> = 0.13), respectively. The incidence of placenta accreta spectrum disorder was 1.6% and 0.8% for short and normal IPI (odds ratios = 2.02; 95% confidence intervals = 0.18-22.13; <i>p</i> = 0.57), respectively. The only observed significant difference between the clinical variables and placenta previa is the number of cesarean sections (<i>p</i> = 0.02) in women with short IPI.</p><p><strong>Conclusion: </strong>A short interpregnancy interval does not significantly affect the incidence of placenta previa and placenta accreta spectrum disorder following a cesarean section. There is a need for further study with large numbers to corroborate these findings in low- and middle-income settings.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40709242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Pandemic and Its Impact on Perinatal Outcomes between Symptomatic and Asymptomatic Women.","authors":"Inas Babic,&nbsp;Faten Alsomali,&nbsp;Sana Aljuhani,&nbsp;Sahar Baeissa,&nbsp;Inam Alhabib,&nbsp;Ebtisam AlAhmari,&nbsp;Magdy Omer,&nbsp;Khalid Alkhalifa","doi":"10.1155/2022/1756266","DOIUrl":"https://doi.org/10.1155/2022/1756266","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19) has been increasing among pregnant women worldwide. Its impact on maternal, fetal, and neonatal health is still scarce in the published literature. As a routine COVID-19 prenatal screening has been established for all women requiring hospitalization, it is not clear whether symptomatic women carry worse pregnancy outcomes than those without symptoms. We aimed to analyze perinatal outcomes between symptomatic and asymptomatic women admitted to our center. <i>Materials and Methods</i>. A single-center retrospective cohort study was conducted for fourteen months. All pregnant women with positive reverse transcriptase-polymerase chain reaction (RT-PCR) test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were enrolled, and their perinatal outcomes were analyzed in two groups based on whether they were symptomatic or not. The primary outcomes were composite adverse fetal, neonatal, and maternal outcomes and their comparison between study groups. <i>Results</i>. Out of 209 included COVID-19 positive pregnant women, 62 (30%) presented with one or more infection-related symptoms. Symptomatic women were older, multiparous, carried ≥1 comorbid condition, and attained infection at earlier gestational age (44% vs. 28%; 82% vs. 69%; 28% vs. 16%; and 34 vs. 36 weeks, respectively) (<i>p</i> < 0.05), when compared to asymptomatic women, respectively. Maternal composite adverse outcomes were higher in the symptomatic group and showed either one or more outcomes, positive chest radiological findings, requiring hospitalization with oxygen supplementation, or maternal death (8% vs. 0.7%) (<i>p</i> < 0.05). Composite fetal and neonatal adverse outcomes such as miscarriage, fetal or neonatal death, admission to neonatal intensive care unit, and neonatal COVID-19 infection were not statistically significant (<i>p</i> > 0.05) between symptomatic and asymptomatic women. <i>Conclusion</i>. COVID-19 infection among symptomatic pregnant women may carry a higher risk for adverse maternal outcomes. It may be associated with their advanced age and comorbid conditions. Maternal infection-associated symptoms per se likely do not pose an increased risk for adverse fetal or neonatal outcomes.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40536026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude, and Perceptions about In Vitro Fertilization (IVF) among Women of Childbearing Age in Cape Coast, Ghana.","authors":"Samuel Kofi Arhin,&nbsp;Richard Tang,&nbsp;Aisha Hamid,&nbsp;Delali Dzandu,&nbsp;Bright Kwaku Akpetey","doi":"10.1155/2022/5129199","DOIUrl":"https://doi.org/10.1155/2022/5129199","url":null,"abstract":"<p><strong>Background: </strong>Infertility impacts a lot of considerable negative social effects on the lives of infertile partners, especially females, who repeatedly experience the emotional sequelae of childlessness. The study's goal was to assess women of reproductive ages' awareness of IVF treatments, as well as their attitudes and misunderstandings about them in Cape Coast, Ghana.</p><p><strong>Methods: </strong>A total of 437 reproductive-age women in Cape Coast Metropolis were recruited using a simple random sampling approach for this Cross-Sectional Descriptive study. Data were collected with a semistructured interviewer-administered questionnaire and were analyzed using IBM SPSS version 26.0, and <i>p</i> ≤ 0.05 was considered significant.</p><p><strong>Results: </strong>The mean age was calculated to be 25.33 ± 0.066 years with a greater proportion, 65.7% within 15-24 years, 76.5% had no or had never had a child before. 93.4% were of the Christian faith, 66.8% were aware of IVF, and 74.8% think IVF offers hope. Although 41.4% believe it is not a natural procedure and 44.6% believe IVF children are normal but not natural. While 72.1% believe the treatment is very costly, and 40.7% believe it is not affordable or accessible. The majority believe IVF kids are legitimate (76.9%), and so should be welcomed by society (86.5%). The overall opinion of IVF service acceptability was 81.7% good. Seventy-two and three percent did not know whether IVF services are available in Cape Coast. Also, 48.1% were aware that IVF may result in pregnancy failure, with fewer than half (43.5%) believing it could be linked to genetic problems in the baby. The majority (60.4%) were willing to use IVF services, and 82.8% will utilize just their husband's sperm technique. While others may not want to undergo any form of IVF technique because they desire to conceive naturally (51.0%) and 22.4% may be unable to pay for it. Educational status and awareness of the availability of IVF services were factors that were significantly associated with their overall good perception of IVF services. Also, age, marital status, number of live children, occupation, educational status, awareness, and their overall perception were factors that are significantly associated with their preparedness to utilize IVF services.</p><p><strong>Conclusion: </strong>Overall, women's opinions of IVF and their readiness to use them were favorable, and they think it offers hope for their condition since they were well-informed about its forms and that infertility may be a result of several factors, all of which may need IVF services. It does not matter if it is difficult to obtain, expensive, or unavailable. It is recommended that the government collaborates with healthcare providers to investigate ways through the mass media in the drive to clear the misconceptions and improve the public understanding of the IVF procedure towards its utilization, thereby reducing the burden of childlessness and ","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40515389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial Distribution and Associated Factors of Institutional Delivery among Reproductive-Age Women in Ethiopia: The Case of Ethiopia Demographic and Health Survey.","authors":"Daniel Sisay, Helen Ali Ewune, Temesgen Muche, Wondwosen Molla","doi":"10.1155/2022/4480568","DOIUrl":"10.1155/2022/4480568","url":null,"abstract":"<p><strong>Background: </strong>Maternal mortality is unacceptably high. About 295,000 women died during and following pregnancy and childbirth in 2017. The vast majority of these deaths (94%) occurred in low-resource settings, and most could have been prevented.</p><p><strong>Methods: </strong>This research is based on a cross-sectional study using 2016 EDHS data. The analysis included 7,590 women who had given birth in the five years prior to the survey. Clusters with high and low hot spots with institutional delivery were found using SatScan spatial statistical analysis. A multilevel multivariable mixed-effect logistic regression was utilized to discover characteristics associated with institutional delivery.</p><p><strong>Result: </strong>In this study, 33.25% of women who gave birth in the last 5 years preceding the survey delivered their babies at health institutions. The finding also indicated that the spatial distribution of institutional delivery was nonrandom in the country. Variables achieving statically significant association with utilization of institutional delivery were as follows: at the individual level, richness (AOR = 2.18, 95%CI: 1.39-3.41), higher education (AOR = 3.89, 95%CI: 1.51-10.01), a number of antenatal care visits of four and above (AOR = 6.57, 95%CI: 4.83-8.94), and parity of more than two children (AOR = 0.48, 95%CI: 0.34-0.68); at the community level, higher education (AOR = 1.70, 95%CI: 1.22-2.36) and urban residence (AOR = 5.30, 95%CI: 3.10-9.06) were variables that had achieved statically significant association for utilization of institutional delivery.</p><p><strong>Conclusions: </strong>This study identified a spatial cluster of institutional delivery with the Somali and Afar region having low utilization rates and Addis Ababa and Tigray regions having the highest utilization rates. The significant individual factors associated with institution delivery were woman antenatal care visits, household wealth index, maternal education, and parity, and the significant community ones were region, place of residence, and educational status. Therefore, to maximize health facility delivery in Ethiopia, the predictors of institutional delivery identified in this study should be given more attention by governmental and nongovernmental stakeholders.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9252845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40576858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Placental Vascular Indices with Macroscopic, Histopathologic, and Intraoperative Blood Loss in Placenta Accreta Spectrum Disorders.","authors":"Mohammad Adya Firmansha Dilmy,&nbsp;Yuditiya Purwosunu,&nbsp;Yudianto Budi Saroyo,&nbsp;Tantri Hellyanti,&nbsp;Noroyono Wibowo,&nbsp;Damar Prasmusinto,&nbsp;Rima Irwinda,&nbsp;Victor Prana Andika Santawi,&nbsp;Hizkia Mangaraja Hasiholan,&nbsp;Rabbania Hiksas","doi":"10.1155/2022/2830066","DOIUrl":"https://doi.org/10.1155/2022/2830066","url":null,"abstract":"Introduction Placenta accreta spectrum is an obstetrical complication with a high level of morbidity. The 3-dimensional (3D) power Doppler method has been widely used to improve the diagnosis. Therefore, this study aims to elucidate better the relationship of quantitative placental vascular indices towards macroscopic findings, histopathological grading, and intraoperative blood loss in the disorder. Methods A preliminary study using a cross-sectional design was conducted on 34 clinically diagnosed women with PAS. The 3D power Doppler with the VOCAL II software was used to measure the level of vascularization index (VI), flow index (FI), and vascularization flow index (VFI). Gross anatomical appearance and histopathology results were categorized as accreta, increta, and percreta. In addition, the intraoperative blood loss level was measured, and 1500 mL was the cutoff for massive hemorrhage. Results The vascularity indexes were VI = 44.2 (23.7–74.9), FI = 35.4 (24.9–57), and VFI = 15.3 (8.5–41.7). The FI value was significant in comparing gross pathological stages (p=0.015) and had a moderate positive correlation in relation to blood loss (r = 0.449). VI, FI, and VFI above the cutoff values were shown to be strongly associated with blood loss ≥ 1500 cc with aOR 7.00 (95% CI 1.23–39.56), aOR 10.00 (95% CI 1.58–63.09), and aOR 9.16 (95% CI 1.53–54.59), respectively. Conclusion This preliminary study demonstrated an initial potential of the FI value from 3D USG power Doppler to predict the depth of PAS invasion before surgery and intraoperative blood loss level.","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40467915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Dietary Diversity Practice among Pregnant Women in the Gurage Zone, Southern Ethiopia, 2021: Community-Based Cross-Sectional Study","authors":"Tolesa Gemeda Gudeta, Ayana Benti Terefe, Girma Teferi Mengistu, Seboka Abebe Sori","doi":"10.1155/2022/8086793","DOIUrl":"https://doi.org/10.1155/2022/8086793","url":null,"abstract":"Background Dietary diversification is considered the proxy indicator of dietary quality and nutrient adequacy during pregnancy. Pregnant women have been considered susceptible to malnutrition because of their increased nutrient demands and thus consuming a variety of foods in their diet plays a lion's role in ensuring adequate nutrient intake. So understanding bottleneck factors associated with dietary diversity practice is very crucial to encouraging adequate dietary diversity practice. Therefore, this paper aimed to assess determinants of dietary diversity practice among pregnant women in the Gurage zone, Southwest Ethiopia. Methods A community-based cross-sectional analytical study was conducted among 726 pregnant women, 13 key informants, and 27 focus group discussion discussants in the Gurage zone, southwest Ethiopia, from 1 September to 1 November 2021. A face-to-face interviewer-administered questionnaire was used to collect the data. According to the Minimum Dietary Diversity Score for Women (MDD-W) tool, women who consumed more than or equal to 5 of 10 food groups in the previous 24 hours had a diverse diet. Epi data version 3.1 was used for data entry, while SPSSversion 26 was used for analysis. To determine factors associated with dietary diversity, bivariate and multivariable logistic regression models were used to obtain crude odds ratio (COR), adjusted odds ratios (AOR), and 95 percent confidence intervals (CIs). Statistical significance was determined using adjusted odds ratios (AORs) with 95 percent confidence intervals (CIs) and p values less than 0.05. In narrative form, qualitative results were triangulated with quantitative data. Results The overall prevalence of the adequate dietary diversity practice was found to be 42.1% with 95% CI (48.4–46.1%) and the mean dietary diversity score was 5.30 ± 1.49 standard deviation (SD). Multivariable analysis revealed that primary school level [AOR = 6.471 (2.905, 12.415)], secondary school level (9–12) [AOR = 7.169 (4.001, 12.846)], college and above level [AOR = 32.27 (15.044, 69.221)], women with higher empowerment [AOR = 3.497 (2.301, 5.315)], women with a favorable attitude toward dietary diversity [AOR = 1.665 (1.095, 2.529)], women from wealthier households [AOR = 2.025 (1.252, 3.278)], and having well-secured food status [AOR = 3.216 (1.003, 10.308)] were variables that influence dietary diversity practice. Three FGD and 13 key informant interviews were conducted, and the results of qualitative data generated three major themes. Conclusion The overall prevalence of adequate dietary diversity practice was found to be low in this study when compared to studies conducted in Ethiopia. Maternal educations, mothers' attitudes toward dietary diversity, women empowerment, food security status, and wealth index level of the household were determinant factors that influence dietary diversity practice in this study. Therefore, programs aimed to improve pregnant women's dietary diversity prac","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80549861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of New Peripudendal Block (PPB) in the Second Stage of Labour on Perineal Relaxation and on the Reduction of Episiotomy Rate: A Randomized Control Trial","authors":"A. Beke","doi":"10.1155/2022/9352540","DOIUrl":"https://doi.org/10.1155/2022/9352540","url":null,"abstract":"Methods In a prospective randomized study, we examined the extent to which the PPB we developed changed the rate of episiotomies, injury rates. Results A total of 333 primiparas and 324 multiparas were included in the study. In the case of primiparas, we used the PPD procedure in 133 cases, while in the case of multiparas, we used it in 103 cases. The rate of episiotomy in primiparas was 89/133 (66.9%) with PPD and 181/200 (90.5%) without PPD (p < 0.02). In multiparas, the episiotomy rate was 30/103 (29.1%) with PPD and 140/221 (63.3%) without PPD (p < 0.02). In the case of primiparas, the rate of perineal injury and lesion was 33/133 (24.8%) with PPD, while without PPD it was 12/200 (6.0%). Examining the need for all surgical care (due to episiotomy and/or injury), a total of 103/133 cases of operative surgery were required with PPD (77/4%) while 183/200 cases were required without PPD (91.5%)(p < 0.02). In the case of multiparas, the rate of perineal injury and lesion was 11/103 (10.7%) with PPD, while without PPD it was 9/221 (4.1%). In the case of multiparas, a total of 41/103 cases required surgical care with PPD (39.8%), while without PPD, 147/221 cases required surgical care (66.5%)(p < 0.02). Conclusion The PPB is simpler, requires less medication, can be easily mastered, and perineal relaxation can also be observed, reducing the need for an episiotomy.","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81929653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Expectant and Excisional/Ablative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in the Era of HPV Testing","authors":"K. Tjandraprawira, A. Olaitan, A. Petrie, N. Wilkinson, A. Rosenthal","doi":"10.1155/2022/7955290","DOIUrl":"https://doi.org/10.1155/2022/7955290","url":null,"abstract":"Objective To investigate conservative and excisional/ablative treatment outcomes for cervical intraepithelial neoplasia grade 2 (CIN2) following introduction of virological test of cure. Methods This was a retrospective study of prospectively collected data at a teaching hospital colposcopy unit. 331 sequential biopsy-proved CIN2 cases were involved. CIN2 cases diagnosed between 01/07/2014 and 31/12/2017 were either conservatively managed or treated with excision/ablation and then were followed up until discharge from colposcopy clinic and then using the national cervical cytology database. Outcomes were defined: cytological/histological regression was absence of high-grade CIN on biopsy and/or high-grade dysplasia; virological regression was cytological/histological regression and negative human papillomavirus testing; persistence was biopsy-proven CIN2 and/or moderate dyskaryosis; progression was biopsy-proven CIN3+ and/or severe dyskaryosis. Results Median follow-up was 22.6 months (range: 1.9–65.1 months). Among 175 (52.9%) patients initially managed conservatively, 77.3% (133/172) regressed, 13.4% (23/172) persisted, 9.3% (16/172) progressed to CIN3+, and 97 (56.4%) patients achieved virological regression. 156 (47.1%) patients underwent initial excision/ablation, with an 89.4% (110/123) virological cure rate. After discharge, 7 (4.0%) and 3 (1.9%) patients redeveloped CIN in the conservative and treatment groups, respectively, during a median period of 17.2 months. Conclusion Conservative management is a reasonable and effective management strategy in appropriately selected women with CIN2. High rates of histological and virological regression should be expected. The previously mentioned data provide useful information for deciding management options.","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83793509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the Risk of Maternal Death at Admission: A Predictive Model from a 5-Year Case Reference Study in Northern Uganda.","authors":"Gasthony Alobo, Cristina Reverzani, Laura Sarno, Barbara Giordani, Luigi Greco","doi":"10.1155/2022/4419722","DOIUrl":"10.1155/2022/4419722","url":null,"abstract":"<p><strong>Background: </strong>Uganda is one of the countries in the Sub-Saharan Africa with a very high maternal mortality ratio estimated at 336 deaths per 100,000 live births. We aimed at exploring the main factors affecting maternal death and designing a predictive model for estimation of the risk of dying at admission at a major referral hospital in northern Uganda.</p><p><strong>Methods: </strong>This was a retrospective matched case-control study, carried out at Lacor Hospital in northern Uganda, including 130 cases and 336 controls, from January 2015 to December 2019. Multivariate logistic regression was used to estimate the net effect of the associated factors. A cumulative risk score for each woman based on the unstandardised canonical coefficients was obtained by the discriminant equation.</p><p><strong>Results: </strong>The average maternal mortality ratio was 328 per 100,000 live births. Direct obstetric causes contributed to 73.8% of maternal deaths; the most common were haemorrhage (42.7%), sepsis (24.0%), hypertensive disorders (18.7%) and complications of abortion (2.1%), whereas malaria (23.5%) and HIV/AIDS (20.6%) were the leading indirect causes. The odds of dying were higher among women who were aged 30 years or more (OR 1.12; 95% CI, 1.04-1.19), did not attend antenatal care (OR 3.11; 95% CI, 1.36-7.09), were HIV positive (OR 3.13; 95% CI, 1.41-6.95), had a caesarean delivery (OR 2.22; 95% CI 1.13-4.37), and were referred from other facilities (OR 5.57; 95% CI 2.83-10.99).</p><p><strong>Conclusion: </strong>Mortality is high among mothers referred late from other facilities who are HIV positive, aged more than 30 years, lack antenatal care attendance, and are delivered by caesarean section. This calls for prompt and better assessment of referred mothers and specific attention to antibiotic therapy before and after caesarean section, especially among HIV-positive women.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86288616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Ruptured Ectopic Pregnancy: A 10-Year Review at a District Hospital in Ghana","authors":"Promise E. Sefogah, Nana E Oduro, A. Swarray-Deen, H. G. Nuamah, Raphael B. Takyi, M. Nuamah, S. Oppong","doi":"10.1155/2022/1491419","DOIUrl":"https://doi.org/10.1155/2022/1491419","url":null,"abstract":"Background Approximately 1–2% of all pregnancies are ectopic. Despite a decline in ectopic pregnancy-related mortality, there is still a paucity of information on the factors associated with clinical presentation and outcomes in Sub-Saharan Africa which is essential in determining the most appropriate treatment modalities. Methods We performed a ten-year retrospective chart review of cases of ectopic pregnancies managed at the Lekma hospital and assessed them for peculiar risk factors, clinical presentation, and outcomes. Associations between patients' sociodemographic characteristics, clinical presentation, and treatment outcome were evaluated using multiple logistic regression and reported as adjusted odds ratios (AOR). The confidence interval (CI) was set at 95%, and a p value <0.05 were considered significant. Results Over the ten-year period, there were 115 ectopic pregnancies and 14,450 deliveries (7.9/1,000). The mean age ± standard deviation of the 115 patients was 27.61 ± 5.56. More than half of the patients were single (59/115, 51.3%). The majority (71.3%) of the patients presented with a ruptured ectopic pregnancy. After adjusting for covariates, the odds of an ectopic pregnancy presenting as ruptured among single patients was 2.63 times higher than that of married patients (AOR = 3.63, 95% CI: 1.33–9.93, p=0.01). Ectopic pregnancies located in the isthmic region of the tube had a 77% lower odds of presenting as ruptured than those located in the ampullary region (AOR = 0.23, 95% CI: 0.07–0.74, p=0.01). The odds of rupturing were 1.69 times increased for every additional week after the missed period (AOR = 2.69, 95% CI: 1.56–4.64, p < 0.01). No mortalities were reported as a result of an ectopic pregnancy. Conclusion Most of the cases of ectopic pregnancy presented ruptured. Marital status and period of amenorrhoea were significantly associated with rupture.","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80930859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}