Obstetrics and Gynecology International最新文献

{"title":"Nonpuerperal Uterine Inversion: What the Gynaecologists Need to Know?","authors":"R P Herath,&nbsp;M Patabendige,&nbsp;M Rashid,&nbsp;P S Wijesinghe","doi":"10.1155/2020/8625186","DOIUrl":"https://doi.org/10.1155/2020/8625186","url":null,"abstract":"<p><strong>Introduction: </strong>Nonpuerperal uterine inversion (NPUI) is a rare clinical problem with diagnostic and surgical challenges. The objective of our study was to review the literature on NPUI and describe causative pathologies, diagnosis, and different surgical options available for treatment.</p><p><strong>Materials and methods: </strong>A comprehensive literature review was carried out on MEDLINE and Google Scholar databases to look for NPUI using the term \"non-puerperal uterine inversion,\" and further went through the cross-references of the published articles. Data are published case reports from 1911 to September 2018. Of the 153 published cases, 133 reports had adequate details of surgery for analysis. These reports were analyzed, concerning the clinical presentation, methods of diagnosis, and surgical treatment.</p><p><strong>Results: </strong>Mean age of the women was 46.3 years (standard deviation: 18, <i>N</i> = 153). Leiomyoma remained the commonest (56.2%) aetiology. While malignancies contributed to 32.02% of cases, 9.2% were idiopathic. High degree of clinical suspicion and identification of unique features on ultrasonography and magnetic resonance imaging enable prompt diagnosis. In cases of uncertainty, laparoscopy or biopsy of the mass was used to confirm the diagnosis. Hysterectomy or repositioning and repair of the uterus are the only treatment options available. The surgical methods implemented were analyzed in three aspects: route of surgical access, method of repositioning, and final surgical procedure undertaken. The majority (48.8%) had only abdominal access, while 27.1% had both abdominal and vaginal access. Haultain procedure was the most useful procedure for reposition (18.0%) of the uterus. The majority (39.7%) required abdominal hysterectomy with or without debulking of the tumour abdominally, while 15.0% had uterine repair after repositioning. We reviewed the different surgical techniques and described and proposed a treatment algorithm.</p><p><strong>Conclusions: </strong>Fibroids were the commonest cause for NPUI. Malignancies accounted for one-third of cases. A combined abdominal and vaginal approach, followed by hysterectomy or repair after repositioning, seems to be better for nonmalignant cases.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"8625186"},"PeriodicalIF":1.9,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8625186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38072489","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":"Midgut Volvulus: A Rare but Fatal Cause of Abdominal Pain in Pregnancy-How Can We Diagnose and Prevent Mortality?","authors":"Eelyn Chong,&nbsp;David S Liu,&nbsp;Neil Strugnell,&nbsp;Vishnupriya Rajagopal,&nbsp;Krinal K Mori","doi":"10.1155/2020/2185290","DOIUrl":"https://doi.org/10.1155/2020/2185290","url":null,"abstract":"<p><p>Midgut volvulus in pregnancy is rare but life-threatening, resulting in high maternal and fetal mortality. This surgical emergency commonly masquerades as symptoms of pregnancy, which together with its low incidence often leads to delay in diagnosis and definitive treatment. Here, we review the last three decades of the literature, discuss the challenges in managing this rare condition, and raise awareness among clinicians to minimise loss of life.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"2185290"},"PeriodicalIF":1.9,"publicationDate":"2020-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2185290","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38056904","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":"Quality of Life among Obstetric Fistula Patients at Kitovu Mission Hospital: A Health Facility-Based Cross-Sectional Study in Masaka District, Uganda.","authors":"Samuel Kakembo,&nbsp;Christine Atuhairwe,&nbsp;Ivan Mugisha Taremwa","doi":"10.1155/2020/7953915","DOIUrl":"https://doi.org/10.1155/2020/7953915","url":null,"abstract":"<p><strong>Background: </strong>Obstetric fistula (OF) remains a silent neglected maternal challenge associated with devastating life consequences. Living with OF presents far-reaching physical, social, psychosocial, and emotional concerns, which negatively impact a woman's quality of life. This study evaluated the quality of life among obstetric fistula patients in Masaka district, Uganda.</p><p><strong>Method: </strong>A cross-sectional study was conducted among 63 women diagnosed with OF at Kitovu Mission Hospital. Data were collected using a questionnaire, observation, in-depth interviews, and focus group discussions. Data were analyzed at univariate, bivariate, and multivariate levels, where the ordinal logistic regression model was applied. The qualitative data was transcribed and analyzed using qualitative content analysis.</p><p><strong>Results: </strong>Majority (87%) of the women diagnosed with OF reportedly had a poor quality of life. Bivariate analysis indicated that level of education (<i>P</i> < 0.001), employment status (<i>P</i> < 0.001), energy for everyday life (<i>P</i> < 0.001), capacity to work (<i>P</i> < 0.001), satisfaction with personal relationships (<i>P</i> < 0.001), feelings of loneliness (<i>P</i> < 0.001), negative feelings (<i>P</i> = 0.002), and self-confidence (<i>P</i> < 0.001) were significantly associated with good QoL. Multivariate analysis showed increased odds of good QoL increased among women with self-confidence (OR = 32.320; CI = 2.019-517.467), formal education (OR = 9.9497; CI = 1.075-92.048), women who did not experience difficulties in mobility (OR = 19.144; CI = 0.149-2456.770), and women who were satisfied with their personal relationships (OR = 5.785; CI = 0.447-74.824).</p><p><strong>Conclusion: </strong>A holistic fistula treatment approach is required that takes into consideration all aspects of life to address the consequences of obstetric fistula to realize improved quality of life among patients.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"7953915"},"PeriodicalIF":1.9,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7953915","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38039797","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":"Still No Substantial Evidence to Use Prophylactic Antibiotic at Operative Vaginal Delivery: Systematic Review and Meta-Analysis.","authors":"Yifru Berhan,&nbsp;Sisay Kirba,&nbsp;Achamyelesh Gebre","doi":"10.1155/2020/1582653","DOIUrl":"https://doi.org/10.1155/2020/1582653","url":null,"abstract":"<p><strong>Background: </strong>Postpartum maternal infection is still a common problem worldwide, mainly due to obstetric risk factors. The use of prophylactic antibiotic at operative vaginal delivery (OVD), taking it as a standalone risk factor, has been controversial. The purpose of this review was to rigorously evaluate the association of OVD with postpartum infection and shed light on such highly controversial issue.</p><p><strong>Methods: </strong>A computer-based literature search was done mainly in the databases of PUBMED, HINARI health research, and the Cochrane library. Systematic review and meta-analysis were done by including 14 articles published between 1990 and August 2019.</p><p><strong>Results: </strong>The average absolute risk of postpartum infection at OVD from seven large cohort studies was 1%. Few studies showed a weak association of OVD with postpartum infection without being adjusted to perineal wound, but the pooled meta-analysis showed statistically significant association with non-OVD. In the included randomized trial, 97% of the study participants had perineal wound for whom repairs were performed; the risks of maternal infection and perineal wound breakdown were comparable, and maternal infections other than perineal wound infection did not show significant difference between prophylactic antibiotic and placebo groups. The majority of included studies demonstrated a strong association of postpartum infection and perineal wound dehiscence with episiotomy and perineal tear.</p><p><strong>Conclusion: </strong>Both the relative and absolute risks of postpartum infection at OVD are extremely low unless accompanied by episiotomy and 3^rd/4^tht degree perineal tear. From previous studies, there is no substantial evidence to use prophylactic antibiotic at OVD, but episiotomy and perineal tear.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"1582653"},"PeriodicalIF":1.9,"publicationDate":"2020-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1582653","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38384361","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":"Risk Factors for Obstetric Anal Sphincter Injuries among Women Delivering at a Tertiary Hospital in Southwestern Uganda.","authors":"Mahad Ali,&nbsp;Richard Migisha,&nbsp;Joseph Ngonzi,&nbsp;Joy Muhumuza,&nbsp;Ronald Mayanja,&nbsp;Jolly Joe Lapat,&nbsp;Wasswa Salongo,&nbsp;Musa Kayondo","doi":"10.1155/2020/6035974","DOIUrl":"https://doi.org/10.1155/2020/6035974","url":null,"abstract":"<p><strong>Background: </strong>Obstetric anal sphincter injuries (OASIS) arise from perineal trauma during vaginal delivery and are associated with poor maternal health outcomes. Most OASIS occur in unattended deliveries in resource-limited settings. However, even in facilities where deliveries are attended by skilled personnel, a number of women still get OASIS.</p><p><strong>Objectives: </strong>To determine the incidence and risk factors for obstetric anal sphincter injuries among women delivering at Mbarara Regional Referral Hospital (MRRH).</p><p><strong>Methods: </strong>We conducted an unmatched hospital-based case control study, with the ratio of cases to controls of 1 : 2 (80 cases and 160 controls). We defined a case as a mother who got a third- or fourth-degree perineal tear after vaginal delivery while the controls recruited were the next two mothers who delivered vaginally without a third- or fourth-degree perineal tear. A questionnaire and participants' medical records review were used to obtain sociodemographic and clinical data. We estimated the incidence of OASIS and performed univariable and multivariable logistic regression to identify the associated risk factors.</p><p><strong>Results: </strong>The cumulative incidence for OASIS during the study period was 6.6%. The risk factors for OASIS were 2^nd stage of labour ≥1 hour (aOR 6.07, 95%CI 1.86-19.82, <i>p</i>=0.003), having episiotomy performed during labour (aOR 2.57, 95%CI 1.07-6.17, <i>p</i>=0.035), perineum support during delivery (aOR 0.03, 95%CI 0.01-0.12, <i>p</i> < 0.001), and monthly income of >50,000 shillings (aOR 0.09, 95%CI 0.03-0.28, <i>p</i> < 0.001). <i>Conclusions and Recommendations</i>. The risk factors for obstetric anal sphincter injury were prolonged second stage of labour and performing episiotomies during deliveries while higher monthly income and perineum support during delivery were protective. We recommend routine support to the perineum during delivery. Care should be taken in mothers with episiotomies, as they can extend and cause OASIS.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"6035974"},"PeriodicalIF":1.9,"publicationDate":"2020-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6035974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38021476","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":"Prevalence of Preterm Premature Rupture of Membrane and Its Associated Factors among Pregnant Women Admitted in Debre Tabor General Hospital, North West Ethiopia: Institutional-Based Cross-Sectional Study.","authors":"Dagne Addisu,&nbsp;Abenezer Melkie,&nbsp;Shimeles Biru","doi":"10.1155/2020/4034680","DOIUrl":"https://doi.org/10.1155/2020/4034680","url":null,"abstract":"<p><strong>Background: </strong>In Ethiopia, preterm premature rupture of membrane is defined as loss of amniotic fluid before the onset of labor in pregnancy >28 weeks of gestation but before 37 weeks. It is a significant cause of perinatal, neonatal, and maternal morbidity and mortality both in high- and low-income countries. Due to different factors associated with the quality of health care given and socioeconomic factors, the effect of preterm premature rupture of membrane is worsen in low-income countries. Little evidence is available about the problem in the study area. Therefore, this study was aimed to determine the prevalence of preterm premature rupture of membrane and its associated factors among pregnant women admitted in Debre Tabor General Hospital.</p><p><strong>Methods: </strong>Facility-based cross-sectional study was conducted. A total of 424 mothers were included in the study. Systematic random sampling was used to select study participants. A combination of chart review and interview was used to collect the data. Both descriptive and analytical statistics were computed.</p><p><strong>Result: </strong>The prevalence of preterm premature rupture of membrane was found to be 13.7%. Pregnant women with abnormal vaginal discharge (AOR = 5.30, 95% CI  = 2.07-13.52), urinary tract infection (AOR = 2.62, 95% CI = 1.32-5.19), history of premature rupture of membrane (AOR = 3.31, 95% CI = 1.32-8.27), vaginal bleeding (AOR = 2.58, 95% CI = 1.14-5.82), and mid-upper arm circumference <23 cm (AOR = 6.26, 95% CI = 3.21-12.20) were associated with preterm premature rupture of membrane.</p><p><strong>Conclusions: </strong>The prevalence of preterm premature rupture of membrane was high. Abnormal vaginal discharge, urinary tract infection, vaginal bleeding, previous premature rupture of membrane, and mid-upper arm circumference <23 cm were associated with preterm premature rupture of membrane. Thus, early screening and treatment of urinary tract infections and abnormal vaginal discharges were recommended to reduce the risk of preterm premature rupture of membrane.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"4034680"},"PeriodicalIF":1.9,"publicationDate":"2020-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4034680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38021475","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":"Etiology, Clinical Features, and Diagnosis of Vulvar Lichen Sclerosus: A Scoping Review.","authors":"Nilanchali Singh, Prafull Ghatage","doi":"10.1155/2020/7480754","DOIUrl":"10.1155/2020/7480754","url":null,"abstract":"<p><p><i>Objective</i>. Vulvar lichen sclerosus (VLS) is a chronic inflammatory disorder, which affects women of all ages. With numerous controversies as regards to the nomenclature, diagnosis and its association with neoplastic conditions, we decided to conduct a scoping review on this subject. <i>Data Source</i>. A review protocol was developed, and the Knowledge Resource Services website was used to do a search of articles pertaining to VLS with keywords \"Vulvar,\" \"Vulval,\" \"diagnosis,\" \"lichen sclerosus et atrophicus,\" \"kraurosis,\" \"vulvar dystrophy,\" and \"Lichen Sclerosus\". <i>Study Selection</i>. The search was limited to published data from the last ten years, i.e., from July 2009 onwards and in the English language. A total of 338 articles pertaining to VLS were obtained. Older data were accessed if particular information was sought for. <i>Results & Conclusion</i>. The presentation is bimodal, i.e., one in prepubertal girls (average age: 7.6 years) and the other in peri- and postmenopausal women (average age: 52.6 years). However, many cases also present during reproductive years. Studies suggest a multifactorial origin as far as etiology is concerned, including a genetic, autoimmune, hormonal, and local infectious background. It affects the genital labial, perineal, and perianal areas and manifests as a patchy, thin, glistening, ivory-white area. Diagnosis is mainly based on clinical features. Biopsy is seldom required. It has been well established as a precursor lesion of dVIN and vulvar carcinoma.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"7480754"},"PeriodicalIF":1.6,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37904596","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 Cesarean Section Deliveries in Public Hospitals of Addis Ababa, Ethiopia, 2018/19: A Case-Control Study.","authors":"Areaya Gebreegziabher Hailu,&nbsp;Tsegaye Kebede Fanta,&nbsp;Fissaha Tekulu Welay,&nbsp;Natnael Etsay Assefa,&nbsp;Surafel Aregawi Hadera,&nbsp;Gebrekiros Aregawi Gebremeskel,&nbsp;Hagos Weldeslassie Gebremedhin,&nbsp;Guesh Gebreayezgi Asefa","doi":"10.1155/2020/9018747","DOIUrl":"https://doi.org/10.1155/2020/9018747","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to assess the determinants of cesarean section deliveries in public hospitals of Addis Ababa, Ethiopia, 2019.</p><p><strong>Method: </strong>A hospital-based unmatched case-control study was conducted to study 780 (260 cases and 520 controls) women who delivered in public hospitals of Addis Ababa from August 22 to September 20, 2019. The cases were all mothers who delivered through caesarean section, and controls were all mothers who delivered vaginally in the same time in the study area. Data were collected from the randomly selected women and looking into their cards. Data were entered on EpiData 3.1 and exported to SPSS version 20 for cleaning and analyzing. Binary logistic regression and AOR with 95% CI were used to assess the determinants of caesarean section.</p><p><strong>Results: </strong>Majority of the study participants were in the age category 20-34 years. Nearly more than 1/3^rd of the participants (32.7% cases and 34.6% controls) have attended primary school. Most of the cases 217 (83.5%) and few of the controls 21 (4%) possess previous caesarean section. One hundred three (52.3%) of the cases and 329 (63.6%) controls were multi-parous. Previous caesarean delivery (AOR = 6.93, 95% CI; (3.39, 14.16)), singleton pregnancy (AOR = 0.34, 95% CI; (0.12, 0.83)), birth weight less than 2500 gm (AOR = 0.29, 95% CI; (0.18, 0.92)), birth weight greater than 4000 gm (AOR = 16.15 (8.22, 31.74)), completely documented partograph (AOR = 0.13, 95% CI; (0.078, 0.23)), and pregnancy-induced hypertension (AOR = 2.44, 95% CI; (1.46, 4.08)) were significant determinants of caesarean delivery in this study.</p><p><strong>Conclusion: </strong>Previous caesarean section, number of delivery, birth weight, partograph documentation, and pregnancy-induced hypertension had significant association with caesarean section delivery in this study.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"9018747"},"PeriodicalIF":1.9,"publicationDate":"2020-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9018747","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37904597","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":"Incidence and Predictors of Maternal and Perinatal Mortality among Women with Severe Maternal Outcomes: A Tanzanian Facility-Based Survey for Improving Maternal and Newborn Care.","authors":"Athanase Lilungulu,&nbsp;Deogratius Bintabara,&nbsp;Simon Mujungu,&nbsp;Enid Chiwanga,&nbsp;Paulo Chetto,&nbsp;Mzee Nassoro","doi":"10.1155/2020/5390903","DOIUrl":"https://doi.org/10.1155/2020/5390903","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal and perinatal mortality is still a major public health challenge in Tanzania, despite the ongoing government efforts to improve maternal and newborn care. Among the contributors to these problems is the high magnitude of severe maternal outcomes (maternal near-miss). The current study, therefore, aimed to identify the magnitude and predictors of maternal and perinatal mortality among women with severe maternal outcomes admitted to Dodoma Regional Referral Hospital.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted from October 2015 to January 2016 at Dodoma Regional Referral Hospital in Dodoma City. All maternal deaths and maternal near-misses based on WHO criteria were included in this study. Three outcome variables have been identified: maternal mortality, perinatal mortality, and neonatal complications. To examine the predictors for the three predetermined outcome variables, the three logit models each containing unadjusted and adjusted findings were fitted. A <i>P</i>-value less than 0.05 was considered indicative of statistically significant.</p><p><strong>Results: </strong>A total of 3600 pregnant women were admitted for obstetric reasons during the mentioned period. 140 of them were diagnosed with severe maternal outcomes; hence, they were included in this study. The severe maternal outcome incidence ratio was 40.23 per 1000 live births, the institutional maternal mortality ratio was 459.77 per 100000 live births, and the perinatal mortality rate was 10.83 per 1000 total births. Most of the maternal morbidity and mortality were due to direct causes in which postpartum hemorrhage and hypertensive disorders were the leading causes. In adjusted analysis, per-protocol management, maternal age, and mode of birth were predictors of maternal mortality, perinatal mortality, and neonatal complications, respectively.</p><p><strong>Conclusion: </strong>Establishing and strengthening obstetric ICUs will help reduce maternal mortality as the response time from the onset of obstetric complications, while the provision of high-quality care will be substantially reduced. Furthermore, the study recommends regular provision of in-service refresher training to emphasize the practice and compliance of per-protocol case management through a team approach in order to reduce the burden of maternal and perinatal mortality in Tanzania.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"5390903"},"PeriodicalIF":1.9,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5390903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37867029","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":"Comparative Retrospective Study of Tension-Free Vaginal Mesh Surgery, Native Tissue Repair, and Laparoscopic Sacrocolpopexy for Pelvic Organ Prolapse Repair.","authors":"Haruhiko Kanasaki,&nbsp;Aki Oride,&nbsp;Tomomi Hara,&nbsp;Satoru Kyo","doi":"10.1155/2020/7367403","DOIUrl":"https://doi.org/10.1155/2020/7367403","url":null,"abstract":"<p><strong>Methods: </strong>We identified that 308 women who had undergone surgical repair of POP were followed up for at least 6 months. Recurrence rates of POP after tension-free vaginal mesh (TVM) surgery (<i>n</i> = 243), native tissue repair (NTR) (vaginal hysterectomy with colpopexy, anterior and posterior colpoplasty, or circumferential suturing of the levator ani muscles and apical repair by transvaginal sacrospinous ligament fixation (SSLF)) (NTR; <i>n</i> = 31), and laparoscopic sacrocolpopexy after subtotal hysterectomy (LSC; <i>n</i> = 34) were compared. Presence of mesh erosion was also recorded.</p><p><strong>Results: </strong>Patients who underwent LSC were significantly younger (65.32 ± 3.23 years) than those who underwent TVM surgery (69.61 ± 8.31 years). After TVM surgery, the rate of recurrence (over POP-Q stage II) was 6.17% (15/243) and was highest in patients with advanced POP. The recurrence rate in patients who underwent NTR procedure was 3.23% (1/34) and that in patients who underwent LSC was 11.76% (4/11). There was no statistically significant difference in the recurrence rate between the three types of surgery. There were 13 cases (5.35%) of mesh erosion after TVM surgery and none after LSC surgery. The risk of mesh erosion was correlated with having had total TVM surgery but not with patient age or POP stage. Repeat procedures were performed in 5 women (2.14%) who underwent TVM surgery and 1 (2.94%) who underwent LSC. No patient underwent repeat surgery after NTR. There was no statistically significant difference in the reoperation rate between the three types of surgery.</p><p><strong>Conclusion: </strong>Our study suggested that TVM surgery, NTR, and LSC have comparable outcomes as for the postoperative recurrence rate and mesh erosion. However, the outcomes of each technique need to be carefully evaluated over a long period of time.</p>","PeriodicalId":19439,"journal":{"name":"Obstetrics and Gynecology International","volume":"2020 ","pages":"7367403"},"PeriodicalIF":1.9,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7367403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37867030","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}