Global journal of reproductive medicine最新文献

{"title":"Introduction of the Physiological CTG Interpretation & Hypoxia in Labour (HIL) Tool, and its Incorporation into a Software Programme: Impact on Perinatal Outcomes","authors":"E. Chandraharan","doi":"10.19080/gjorm.2021.08.555737","DOIUrl":"https://doi.org/10.19080/gjorm.2021.08.555737","url":null,"abstract":"Each Baby Counts Reports in the UK from 2016-2021 have consistently highlighted that 33% of intrapartum related perinatal deaths and severe hypoxic ischaemic injuries in the UK were due to CTG misinterpretation. Moreover, in approximately 72% of cases, a different care may have given rise to different outcomes. International consensus guidelines on Physiological Interpretation of the CTG produced by 34 CTG experts from 14 countries was aimed at individualisation of care by considering the compensatory response of the individual human fetus to ongoing hypoxic and mechanical stresses during labour and determining the type of ongoing fetal hypoxia. This tool was introduced in a large maternity unit, and it also was incorporated into the Maternity software programme after midwives and obstetricians providing intrapartum care were trained on fetal physiology by conducting Physiological CTG Masterclasses. There was a total elimination of fetal scalp blood sampling (FBS), and a dramatic reduction in the number of babies with severe hypoxic ischaemic encephalopathy.","PeriodicalId":92369,"journal":{"name":"Global journal of reproductive medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45854633","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":"Uterine Tachysystole, Hypertonus and Hyperstimulation: An Urgent Need to get the Definitions Right to Avoid Intrapartum Hypoxic-Ischemic Brain Injury","authors":"E. Chandraharan","doi":"10.19080/gjorm.2021.08.555735","DOIUrl":"https://doi.org/10.19080/gjorm.2021.08.555735","url":null,"abstract":"Onset of labour is due to the hormonal changes initiated by the hypo-thalamo-pituitary axis followed by local changes in the chorio-amnion that result in the production of prostaglandins (PGs). Prostaglandins cause softening and effacement of the cervix and uterine contractions that are key elements for the onset and progress of labour. Uterine contractions have four important parameters: the frequency, strength, duration, and the basal “resting” tone, and if any of these parameters are excessive, a reduction in fetal oxygenation may occur. It is important to understand that any increase in uterine activity (frequency, strength, duration or the basal “resting” tone) can affect the utero-placental oxygenation and the patency of the blood vessels within the umbilical cord. Any disturbance in fetal oxygenation secondary to an increase in the frequency, duration and strength or the basal tone of the uterine contractions sufficient to cause fetal hypoxia can cause changes in the fetal heart rate patterns. There is a wide variation in current National and International Guidelines on what constitutes excessive uterine activity, and most guidelines do not consider the duration, strength or increased basal tone in their definition of uterine hyperstimulation. This may lead to the failure of recognition of an ongoing excessive uterine activity leading to poor maternal and perinatal outcomes.","PeriodicalId":92369,"journal":{"name":"Global journal of reproductive medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46733548","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 Determination of Bile Acids in Women Upon Suspicion of Intrahepatic Cholestasis of Pregnancy","authors":"Mirka Benovska","doi":"10.19080/GJORM.2021.08.555736","DOIUrl":"https://doi.org/10.19080/GJORM.2021.08.555736","url":null,"abstract":"Background: Bile acids are used in testing of women with suspicion of intrahepatic cholestasis of pregnancy, but the influence of their levels on diagnoses, week of delivery and response to treatment remains unclear. Methods: We retrospectively evaluated the serum levels of total bile acids in 217 singleton pregnant women measured by photometric enzymatic method from Dialab. Results: Medians of bile acids in serum of women with intrahepatic cholestasis of pregnancy increased compared to normal pregnancies (23.4 (19.5-28.2) versus 3.7 (3.0-4.2); P<0.0001). ROC analysis for bile acids showed AUC of 0.942 (95% CI, 0.902-0.969), P<0.0001, a sensitivity of 85,9% and a specificity of 94,9% for intrahepatic cholestasis of pregnancy. The statistically significant correlation between levels of bile acids and ALT, AST and ALP was proved. The difference in week of delivery between group with bile acid < 40µmol/L and > 40µmol/L was about 1 week (P=0.01). The dynamics of concentration of bile acids after treatment by hepatoprotectives was monitored as well. We observed mostly either decreased or unchanged concentration of bile acids, but in almost 24% of cases, there was a rapid and significant increase of bile acids concentration, despite the treatment.","PeriodicalId":92369,"journal":{"name":"Global journal of reproductive medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48391238","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":"Benign Phyllodes Tumor During Pregnancy: 2 Cases Report at the University Hospital of Angre, Abidjan","authors":"Cassou Roland Adjoby","doi":"10.19080/gjorm.2021.08.555734","DOIUrl":"https://doi.org/10.19080/gjorm.2021.08.555734","url":null,"abstract":"","PeriodicalId":92369,"journal":{"name":"Global journal of reproductive medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49160813","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 Historical Practice of “Membrane Sweep” to Initiate Labour: Does it Have a Role in Contemporary Obstetric Practice?","authors":"E. Chandraharan","doi":"10.19080/gjorm.2021.08.555733","DOIUrl":"https://doi.org/10.19080/gjorm.2021.08.555733","url":null,"abstract":"Membrane stripping or sweeping involves a vaginal examination during which a finger is introduced into the cervical os to separate the membranes from the lower uterine segment by a circular movement. Membrane sweeping was first suggested by James Hamilton in 1810 [2] for labor induction. Mc Colgin [3] confirmed that the membrane sweep was associated with an increased activity of prostaglandin F2 and phospholipase A. A Bishop’s score [4] to assess the cervical length, dilatation, effacement, consistency position of cervix and fetal descent is used to predict the prognosis of the membrane sweep and the induction process.","PeriodicalId":92369,"journal":{"name":"Global journal of reproductive medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43746174","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":"Assessment of the Quality of Family Planning Counseling Interventionsin Female Solid Organ Transplant Patients","authors":"T. Azeez","doi":"10.19080/gjorm.2020.08.555731","DOIUrl":"https://doi.org/10.19080/gjorm.2020.08.555731","url":null,"abstract":"Objective: To evaluate if women were educated on the potential risks of unplanned post-transplant pregnancy and if the chart had documentation of contraception use and family planning discussions in solid organ transplant (SOT) patients at a major tertiary referral academic transplant center. Methods: This quality improvement study was a retrospective chart review of female patients at SOT center. An anonymous survey to identify potential knowledge gaps regarding post-transplant pregnancy risk was given to health care providers. Result: A total of 62 out of 208 patient charts were screened and included in the study. Exclusions included male gender or not being of child-bearing potential. In the 62 charts, 1.6% had documentation for an oral contraception prescription, 1.6% received instruction to utilize barrier contraception, 3.3% received an intrauterine device (IUD), and 11.5% received surgical sterilization. There was no documentation of any method of contraception in 84% of the charts. There was documented counseling on the teratogenic effects of mycophenolate in 98% of the patient charts, however none had documented counseling on the maternal or fetal risk of pregnancy within two-years post-transplant. There was a 35% response rate to the healthcare provider survey with majority understood and counseled post-transplant regarding the importance of contraception. Conclusion: This study demonstrated that there is an opportunity to address a lack of definitive family planning counseling, potentially by developing a multi-disciplinary approach. By utilizing all the resources and expertise of the multi-disciplinary team, this could improve the quality of patient education and reduce the risk of unplanned pregnancies in the female post-transplant population.","PeriodicalId":92369,"journal":{"name":"Global journal of reproductive medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45195700","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":"Access and Quality of Postnatal Care in Low- and Middle - Income Countries: A Pragmatic Review","authors":"Thomas F Burke","doi":"10.19080/gjorm.2021.08.555740","DOIUrl":"https://doi.org/10.19080/gjorm.2021.08.555740","url":null,"abstract":"","PeriodicalId":92369,"journal":{"name":"Global journal of reproductive medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41608562","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":"Identifying Opportunities to Improve HPV Vaccination in an at-Risk Population","authors":"Judith A Smith","doi":"10.19080/gjorm.2020.08.555729","DOIUrl":"https://doi.org/10.19080/gjorm.2020.08.555729","url":null,"abstract":"The human papillomavirus (HPV) is the most prevalent sexually transmitted disease (STD) worldwide, with 50-80% of sexually active individuals contracting an infection in their lifetime [1]. HPV was first recognized as the cause of the majority of cervical cancer cases in 1980. It is now also known to cause at least five other epithelial surface cancers, including anal, oropharyngeal, penile, vaginal, and vulvar cancers. Globally in 2012, about 580,000 cancer diagnoses in women and 60,000 cancer diagnoses in men were a result of an HPV infection.1 To help prevent this, the HPV vaccine was developed and first licensed in 2006 by the U.S. Food and Drug Administration (FDA) as a quadrivalent HPV (4vHPV) vaccine effective against HPV 6/11/16/18 strains Abstract","PeriodicalId":92369,"journal":{"name":"Global journal of reproductive medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48527068","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":"Vertical Transmission of COVID 19 During Pregnancy","authors":"S. Nikose","doi":"10.19080/gjorm.2020.08.555727","DOIUrl":"https://doi.org/10.19080/gjorm.2020.08.555727","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) is highly infectious disease associated to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Information regarding COVID-19 is advancing rapidly, and various organizations are continually updating and improving on interim guidelines. The current discussion will address the matters associated with COVID-19 during pregnancy and particularly the vertical transmission from mother to neonate. The data regarding maternal outcomes with COVID-19 infections during pregnancy are limited. However, data from other viral diseases such as SARS, MERS and influenza are more likely for pregnant women to develop viral pneumonitis [1]. Additionally, viral pneumonia is considered to be among the most serious non-obstetric infectious disease correlated with maternal and neonatal morbidity and mortality during pregnancy1. A typical coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, is highly infectious and is currently spreading rapidly across the world. It caused thousands of morbidities and deaths worldwide after SARS-COV-2 emerged in Wuhan, Hubei Province, China in December 2019 [2]. Many investigations have concentrated on general population infected patients; however, information of the COVID-19 female pregnancy outcomes are limited. Chen et al. [3] reported the maternal and neonatal outcome of COVID-19 pneumonia in pregnant women and the potential for vertical transmission. Their research focused on pregnant women who only delivered babies by C-section, and no case for normal vaginal delivery was identified. Moreover, Healthcare staff has also not been included, since healthcare workers are at greater risk of infection and psychological consequences. The ICMR (Indian Council of Medical Research) recently in their report stated that antenatal and intrapartum vertical transmission from mother to baby is possible. However, the proportion of affected pregnancies and the significance for neonates is still to be established. There are currently no recorded cases of positive COVID 19 vaginal secretions test, and no recorded cases of positive COVID 19 breast milk test [4]. Women experience immunological and physiological changes during pregnancy that could make them more susceptible to viral respiratory infections, such as influenza, and severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) adverse outcomes of pregnancy have been observed [5]. There are no current definitive data in pregnant women regarding the clinical characteristics, morbidity, and mortality of coronavirus disease 19 (COVID-19). The question of vertical transmission has been addressed and no evidence of vertical transmission has been presented by the available literature (although with small groups of mothers infected with COVID-19). Some common viral infections, like as HIV, predispose to intrapartum neonatal transmission [3]. Very few evidences is available till date for the vertical transmission of COVID 19","PeriodicalId":92369,"journal":{"name":"Global journal of reproductive medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45049992","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":"Giant Condyloma Acumina or Tumor of Buschke And Lowenstein During Pregnancy: About A Case at The University Hospital of Angré, Abidjan","authors":"Effoh N’Drin Denis","doi":"10.19080/gjorm.2020.08.555726","DOIUrl":"https://doi.org/10.19080/gjorm.2020.08.555726","url":null,"abstract":"We are reporting a rare case of giant condyloma diagnosed in a young woman with a full-term pregnancy. It is a benign tumor of viral origin that may constitute a dystocia of soft tissue during pregnancy. It is transmitted mainly by sexual transmission and the virus responsible is Human Papilloma Virus (HPV) of the types 6 and 11. It is a tumor whose benignity is related to the presence of non-oncogenic HPV. It is characterized by its recurrent and invasive evolutionary power enabling to classify it as a borderline tumor, which could explain its severity. It is a tumor that most often occurs in an immunocompromised area, but in our observation, retroviral serology was negative. The treatment is essentially surgical and must be early and radical. Its prevention is imperative, based on the treatment of acuminated condylomas and the fight against sexually transmitted diseases.","PeriodicalId":92369,"journal":{"name":"Global journal of reproductive medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49234745","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}