Clinical Medicine Insights-Reproductive Health最新文献

{"title":"Pregnancy related complications in patients with systemic lupus erythematosus, an egyptian experience.","authors":"S F Hendawy,&nbsp;D Abdel-Mohsen,&nbsp;S E Ebrahim,&nbsp;H Ewais,&nbsp;S H Moussa,&nbsp;D A Khattab,&nbsp;N A Mohamed,&nbsp;H E Samaha","doi":"10.4137/CMRH.S6862","DOIUrl":"https://doi.org/10.4137/CMRH.S6862","url":null,"abstract":"<p><strong>Background: </strong>Systemic Lupus Erythematosus (SLE) has a tendency to occur in women in their reproductive years, causing complications during pregnancy and labour. Conversely, pregnancy can cause flares of disease activity, often necessitating immediate intervention.</p><p><strong>Aim of study: </strong>to study pregnancy related complications in patients with SLE.</p><p><strong>Patients and methods: </strong>The study included 48 SLE pregnant females. 27 patients with 38 pregnancies, their data viewed retrospectively from medical records, and 21 patients with 21 pregnancies followed up prospectively. The laboratory data included ANA, DNA, APL antibodies and anti Ro/SSA. The disease activity was calculated according to the Systemic Lupus Activity Measure. Ultrasound was performed to confirm gestational age and assess for the presence of any congenital fetal malformations, and then repeated monthly to detect any abnormality including intrauterine growth restriction. At 30 weeks gestation and onwards, assessment of fetal wellbeing including daily fetal kick chart and once weekly non stress test was performed. Doppler blood flow velocimetry was done for those with abnormal fetal heart rate pattern. After labour, the neonate was examined for complications including complete heart block and neonatal lupus.</p><p><strong>Results: </strong>Anti dsDNA was found in 95% of the patients, anti Ro/SSA in 6% and anti APL in 30%. 57% of the patients followed up prospectively had active disease in the 1st trimester, 24% in the 2nd and 62% in the 3rd trimester. The most common maternal complication was preeclampsia 33%, followed by spontaneous abortion 20%. Prematurity was the most common fetal complication 37%, followed by intrauterine growth restriction 29%. 2 neonates were born with congenital heart block and 1 with neonatal lupus.</p><p><strong>Conclusion: </strong>Pregnancy in SLE patients is associated with a higher risk of obstetric complications affecting both the mother and the fetus. Preeclampsia was the most common complication followed by prematurity. Preeclampsia was significantly associated with third trimester disease activity.</p>","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":"5 ","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2011-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S6862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32052822","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":"Letrozole versus Clomiphene Citrate for Induction of Ovulation in Patients with Polycystic Ovarian Syndrome Undergoing Intrauterine Insemination.","authors":"Sherif F Hendawy,&nbsp;Hanan E Samaha,&nbsp;Mohamed F Elkholy","doi":"10.4137/CMRH.S6598","DOIUrl":"https://doi.org/10.4137/CMRH.S6598","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting women in the reproductive age group, and is one of the most common causes of hyperandrogenic anovulatory infertility. The aromatase inhibitor, letrozole, has been used for induction of ovulation. The purpose of this study was to compare the effects of letrozole and clomiphene citrate in induction of ovulation among patients with PCOS undergoing intrauterine insemination.</p><p><strong>Methods: </strong>In a double-blind randomized study, 60 infertile patients with PCOS received standard doses of either clomiphene citrate or letrozole as an induction protocol prior to intrauterine insemination. A hormonal profile, pelvic ultrasound, hysterosalpingogram, and/ or laparoscopy were done for all patients. The patients were monitored for ovulation by translational ultrasonographic folliculometry, with measurement of number and size of the follicles, as well as endometrial thickness. Human chorionic gonadotrophin (HCG) was injected intramuscularly when at least one mature follicle ≥18 mm diameter was detected, and intrauterine insemination was performed 32-36 hours later. Transvaginal ultrasound and β-HCG measurement were performed for confirmation of pregnancy.</p><p><strong>Results: </strong>Letrozole and clomiphene citrate achieved follicle maturation within a mean ± standard deviation (SD) of 13.2 ± 1.53 and 14.1 ± 1.35 days, respectively, showing no significant difference (P > 0.05). The mean number of follicles reaching ≥18 mm on the day of HCG administration was significantly higher in patients who received clomiphene citrate (2.9 ± 1.77) than in those receiving letrozole (1.2 ± 0.9). Letrozole had a significantly greater effect than clomiphene citrate on endometrial thickness (9.16 ± 1.36 versus 4.46 ± 1.71). The number of pregnancies achieved in the letrozole group was significantly (P < 0.05) greater than in the clomiphene group.</p><p><strong>Conclusion: </strong>Letrozole in patients with PCOS is as effective as clomiphene citrate in inducing ovulation, and although the number of follicles produced by induction with letrozole were less than those produced by clomiphene, letrozole had a significantly greater effect on endometrial thickness than clomiphene citrate, and the incidence of pregnancy after intrauterine insemination was significantly higher, with a lower incidence of multiple pregnancy.</p>","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":"5 ","pages":"11-6"},"PeriodicalIF":0.0,"publicationDate":"2011-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S6598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32052821","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":"Observational Study to Assess the Therapeutic Value of Four Ovarian Hyperstimulation Protocols in IVF After Pituitary Suppression with GnRH Antagonists in Normally Responding Women.","authors":"Monzó Ana,&nbsp;Montañana Vicente,&nbsp;Rubio José María,&nbsp;García-Gimeno Trinidad,&nbsp;Romeu Alberto","doi":"10.4137/CMRH.S6339","DOIUrl":"https://doi.org/10.4137/CMRH.S6339","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical results of four different protocols of COH for IVF-ICSI in normovulatory women, using in all cases pituitary suppression with GnRH antagonists.</p><p><strong>Materials/methods: </strong>A single center, open label, parallel-controlled, prospective, post-authorization study under the approved conditions for use where 305 normal responders women who were candidates to COH were assigned to r-FSH +hp-hMG (n = 51, Group I), hp-hMG (n = 61, Group II), fixed-dose r-FSH (n = 118, Group III), and r-FSH with potential dose adjustment (n = 75, Group IV) to subsequently undergo IVF-ICSI.</p><p><strong>Results: </strong>During stimulation, Group IV needed significantly more days of stimulation as compared to Group II [8.09 ± 1.25 vs. 7.62 ± 1.17; P < 0.05], but was the group in which more oocytes were recovered [Group I: 9.43 ± 4.99 vs. Group II: 8.96 ± 4.82 vs. Group III: 8.78 ± 3.72 vs. Group IV: 11.62 ± 5.80; P < 0.05]. No significant differences were seen between the groups in terms of clinical and ongoing pregnancy, but among patients in whom two embryos with similar quality parameters (ASEBIR) were transferred, the group treated with hp-hMG alone achieved a significantly greater clinical pregnancy rate as compared to all other groups [Group I: 31.6%, Group II: 56.4%, Group III: 28.7%, Group IV: 32.7%; P < 0.05].</p><p><strong>Conclusions: </strong>Although randomized clinical trials should be conducted to achieve a more reliable conclusion, these observations support the concept that stimulation with hp-hMG could be beneficial in normal responders women undergoing pituitary suppression with GnRH antagonists.</p>","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":"5 ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2011-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S6339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32052820","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":"Link between Periodontal Diseases, Inflammatory Markers and Preterm Low Birth Weight Infants","authors":"M. El-Gharib, M. Nassar, M. T. Elabyary, T. M. Elhawary, S. H. Elshourbagy","doi":"10.4137/CMRH.S5886","DOIUrl":"https://doi.org/10.4137/CMRH.S5886","url":null,"abstract":"Objective To scrutinize the assumed association between chronic periodontal disease and preterm low birth weight (PTLB) infants. Design Prospective study. Setting Tanta University Hospital. Patients The study incorporated 200 pregnant women in the first stage of labor of a single baby with intact membranes. A hundred women had definite preterm labor and delivered, later live infants whose birth weight were < 2500 g and 100 women with full term labor and delivered, later live infants weighting ≥2500 g. Intervention All patients included in the study were subjected to history taking, general, obstetrical examination and periodontal evaluation. The levels of IL-6 and TNF-α were measured in gingival cervicular fluid, maternal serum and amniotic fluid using ELISA technique. Results A significant association between chronic periodontal disease and preterm low birth weight infants. Conclusion Screening of pregnant women chronic periodontal disease seems to be a helpful prediction and consequently prevention of preterm labour.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S5886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697807","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":"A study of Gonadal Arteries in 30 Adult Human cadavers","authors":"A. Wadhwa, S. Soni","doi":"10.4137/CMRH.S3680","DOIUrl":"https://doi.org/10.4137/CMRH.S3680","url":null,"abstract":"The gonadal arteries normally arise from the abdominal aorta. There are reports about the variant origin of these arteries. In the present study, we investigated the origin and course of the gonadal arteries and clinical implications of variant gonadal arteries are discussed. Out of 60 dissections, in 55 cases the gonadal artery was seen arising from abdominal aorta. In the remaining 5 cases, gonadal artery of renal origin was present in 3 cases, two on right and one on left side and of middle suprarenal origin was present in 2 cases on the left side. The present study agreed with the text book account i.e. right testicular artery passing anterior to inferior vena cava in majority of the cases i.e. 27 (90%). In the remaining 3 cases (10%), the right testicular artery was posterior to inferior vena cava. In our study, out of a total of 60 dissections, 57 dissections confirmed to type I pattern (95%). In 2 cases (3.3%) (11 M, 16 M) a type II pattern was seen on the right side. In 1 case (1.7%) (20 M), the left testicular artery arose directly from the aorta and arched over the renal vein giving a type III pattern. Awareness of variations of the testicular arteries such as those presented here becomes important during surgical procedures like varicocele and undescended testes. The variations described here are unique and provide significant information to surgeons dissecting the abdominal cavity.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S3680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697728","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":"Anti-annexin V Antibodies in Women with Recurrent Miscarriage","authors":"M. El-Gharib, T. M. Elhawary, S. H. Elshourbagy, M. Morad","doi":"10.4137/CMRH.S5835","DOIUrl":"https://doi.org/10.4137/CMRH.S5835","url":null,"abstract":"Objective To determine the role of anti-annexin V antibodies (a-A5) as an etiologic factor in recurrent pregnancy failure. Study design Prospective observational study. Material and methods The study included ninety first trimester pregnant women who had a history of unexplained recurrent miscarriage (group I) with ninety well-matched pregnant women with a history of normal reproductive outcome allocated as control group (GII) and another ninety nonpregnant women (GIII). Sera from all women controls were analyzed for anti-annexin antibody measured by Elisa. Results The mean value of a-A5 was 11.37 ± 6.78, 7.7 ± 1.40 and 6.20 ± 0.95 ng/ml in groups I, II and III respectively. There was a significant increase in the mean value a-A5 among women with a history of recurrent miscarriage, compared with controls. The mean value was 13.92 ± 2.42 ng/ml among patients with unfavourable outcome, compared with a corresponding value of 6.95 V 0.58 ng/ml among women with favourable outcome. The receiver operator characteristic curve revealed that the cutoff value of a-A5 was 8.61 ng/ml. Conclusion This study emphasizes the relationship between anti-annexin V antibodies and recurrent miscarriage.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S5835","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697805","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":"Hysterectomy for Uterine Disease in 2010: From past to Future","authors":"L. Mettler, Wael Sammur, T. Schollmeyer","doi":"10.4137/CMRH.S2980","DOIUrl":"https://doi.org/10.4137/CMRH.S2980","url":null,"abstract":"Hysterectomies were unknown in the field of obstetrics and gynaecology until the 19th century. In the 20th century they were perhaps too frequently performed whereas the 21st century has witnessed a steep decline in hysterectomy numbers. It is therefore an opportune time to review the indications for hysterectomies, hysterectomy techniques and the present and future status of this surgical procedure. There is a widespread consensus that hysterectomies are primarily to be performed in cancer cases and obstetrical chaos situations even though minimal invasive surgical technologies (MIS) have made the procedure more patient friendly than the classical abdominal opening. Today, minimally invasive hysterectomies are performed as frequently as vaginal hysterectomies and the vaginal approach is the first choice if the correct indications are given. It is no longer necessary to open the abdomen; this procedure has been replaced by laparoscopic surgery. Laparoscopic and robotic-assisted laparoscopic surgery can also be indicated for hysterectomies in selected patients with gynaecological cancers. For women of reproductive age, laparoscopic myomectomies and numerous other uterine- preserving techniques are applied in a first treatment step of meno-metrorrhagia, uterine adenomyosis and submucous myoma. These interventions are only followed by a hysterectomy if the pathology prevails.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S2980","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697695","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":"Ricinus Communis Var Minor Inhibits Follicular Development and Possibly Ovulation in Human Subjects as Shown by Ultrasound Follicle Tracking","authors":"H. Goncim, E. S. Mador, J. Ogunranti","doi":"10.4137/CMRH.S4185","DOIUrl":"https://doi.org/10.4137/CMRH.S4185","url":null,"abstract":"There is no evidence from literature to show the use of ultrasound follicle tracking to monitor ovulation in women on Ricinus communis contraception. In the present study 20 women desiring contraception, gave an informed consent to be scanned from day 9 to day 16 of one of their menstrual cycle to track for follicles. After taking one seed of Ricinus communis, the women were again scanned for the same duration. The result obtained showed normal follicular development before the administration of Ricinus communis and the abolition of follicular development in all the 20 volunteers after taking one seed of Ricinus communis (Figs. 1a and 1b). This result showed that one seed of Ricinus communis taken orally is capable of preventing ovulation in humans and hence its anticonceptive effect may be due in part to the prevention of ovulation.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S4185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697750","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":"The Knowledge and Attitudes of University Students concerning HPV Vaccine and Cervical Screening","authors":"L. Elit, K. Trim, R. Mohan, S. Nastos, D. Harnish","doi":"10.4137/CMRH.S2973","DOIUrl":"https://doi.org/10.4137/CMRH.S2973","url":null,"abstract":"Background Cervical cancer is preventable with regular PAP tests and the human papillomavirus (HPV) vaccine. Objective Identify factors influencing initiation into regular sexual health examinations within a group of undergraduate health science students who have high parental SES. Methods After reviewing the literature, a survey of knowledge, attitudes and behaviors about HPV exposure and cervical cancer prevention through vaccination and cervical cancer screening was developed. The survey was circulated using a web-based survey tool to undergraduate Faculty of Health Sciences student. Results Two hundred and three students at McMaster University completed the survey. The sample included 72% women and 28% men. The mean age was 19.4 years. This sample represents a population of young adults who the previous literature would suggest are most likely to have regular health care since they are affluent (FAS greater than 6.7 ∓ 1.4). This group is also motivated in health education as 83.3% knew about the HPV vaccine and 76.4% could define the purpose of a PAP smear. Both male and female students were more likely to consult their family doctor about sexual health than their family. More than half of sexually active females have a family doctor, 82.1% of which visit them regularly. Sexually active women visit more regularly than sexually inactive women (p ≤ 0.01). The majority (66%) are comfortable discussing sexual health with their family doctor, yet only 62.5% of women have had this discussion. 57% of sexually active women and less that 1% of non-sexually active women had had a PAP smear or a pelvic exam. Conclusion These affluent and well educated students do not appear to be able to apply their knowledge of HPV and PAP smears to their own sexual health. Thus they require access to tools that help motivate university students to personalize information and make important health decisions.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S2973","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697641","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":"Coping and Suicidal Ideations in Women with Symptoms of Postpartum Depression","authors":"S. Doucet, N. Letourneau","doi":"10.4137/CMRH.S3801","DOIUrl":"https://doi.org/10.4137/CMRH.S3801","url":null,"abstract":"Objective To explore the relationship between coping mechanisms and suicidal ideations among women who experience symptoms of postpartum depression. Design This exploratory descriptive study used secondary data from a study of women who experienced symptoms of postpartum depression. Participants Convenience and purposive sampling were used to obtain the community sample of 40 women who experienced symptoms of postpartum depression. Methods Binary logistic regression was employed to explore emotion-focused coping, avoidance-focused coping, problem-focused coping, and religious coping as predictors of suicidal ideations. Results Approximately 27% of the sample reported suicidal ideations within the past seven days. The results showed that lower levels of emotion-focused coping and higher levels of avoidance-focused and religious coping predicted suicidal ideations in participants. Problem-focused coping did not predict suicidal ideations. Conclusion Overall, our findings provide support for the importance of coping mechanisms as predictors of suicidal ideations among women who experience symptoms of postpartum depression. The results illustrate the need for health professionals to conduct routine assessments on coping strategies and thoughts of suicide when caring for postpartum women, as well as the need to integrate coping approaches in the prevention and treatment of suicidal ideations.","PeriodicalId":44130,"journal":{"name":"Clinical Medicine Insights-Reproductive Health","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMRH.S3801","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70697735","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}