Pregnancy during adolescence continues to be a frequent situation, mostly in developing countries. Maternal age is a key element to be taken into account when managing obstetric patients, as it is related with obstetric and perinatal outcomes. We conducted a literature review to address the obstetric results of pregnancy in teenage mothers. We reviewed articles for the last 5 years in different databases including ‘Pregnancy’, ‘Teenager’, ‘Adolescent’, ‘Complications’ and ‘Outcomes’ as key words. We obtained 2260 articles after the initial search, but only 28 met the inclusion criteria and were therefore reviewed. Most studies were excluded for not clearly specifying one of more groups of teenage patients, lacking comparison of these groups with no-teenage patients, or not addressing the obstetric outcomes of those pregnancies. The outcomes were divided into complications of pregnancy, childbirth, puerperium and neonatal complications. We found that there is an association between young maternal age and preterm birth, pre-eclampsia/eclampsia, fetal growth restriction and stillbirth, among others. For the newborn we found outcomes such as low APGAR scores and admission to intensive care were more frequent in teenage mothers. We conclude that maternal age is an important feature, as there are several obstetric and perinatal compications that are more frequent in teenage mothers than in other age groups.
Sextech, femtech, women’s health–regardless of the descriptor–is challenging. The barriers have been well-documented–challenges with fundraising for women-owned businesses, specific obstacles for fundraising for women’s sexual health businesses, especially those focused on pleasure and satisfaction, and lack of access to media channels.
Although the vast majority of patients with advanced-stage (stages III and IV) ovarian cancer will achieve a clinical complete response to primary treatment, a large percentage of those (approximately 80%) are at risk for recurrence of their ovarian cancer [1]. Currently, two Poly Aadenosine-diphosphate (ADP)-Ribose Polymerase (PARP) inhibitors, olaparib, and niraparib, are approved for advanced-stage maintenance therapy for BRCA mutated ovarian cancer after completion of first-line treatment. Those caring for patients with ovarian cancer know that it is an unpredictable, unkind, and often relentless disease. The quandary faced by oncologists in treating patients with ovarian cancer is analogous to William Shakespeare’s Hamlet, “whether it is nobler to suffer the slings and arrows of outrageous fortune Or to take arms against a sea of troubles and by opposing end them”
Giant uterine leiomyomata, defined as those greater than 11.4 kg, are a rare presentation of extremely common gynecologic tumors. Most case reports of surgical resection of these tumors describe significant blood loss requiring blood transfusion. The two largest tumors successfully resected as reported in the literature weighed 51 kg and 45.45 Kg. We report a case of a successful surgical resection of a 45 kg myoma originating from the uterine cervix and lower uterine segment with minimal blood loss and no requirement of blood transfusion. The surgical technique of hypogastric and infundibulopelvic artery ligation prior to dissection of the tumor or uterus aided in preventing hemorrhage during this surgery.
Ovarian cancer is the second most common gynecologic cancer. Furthermore, it is associated with the highest mortality of gynecologic cancers in the western world. According to the results, every year, 230 000 new ovarian cancer patients will be diagnosed, and 150 000 of those are likely to die. Due to the lack of warning symptoms and the absence of screening recommendations, approximately 70% of cases diagnosed with advanced disease.
The clinical manifestations of the current pandemic of coronavirus disease-2019 (COVID-19) are diverse. Initially thought to be a disease of the respiratory system, more diverse clinical manifestations surfaced over time after extensive study of the mode of action of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pregnancy, the underlying pathogen of the COVID-19. Pregnant women are prone to the adverse effects of SARS-CoV-2 infection. Infection with SARS-CoV-2 in pregnancy is associated with preeclampsia (PE). There are reports of increased incidence of PE in pregnant women than general population infected with severe SARS CoV-2. However, in most cases: there is misdiagnosis as the clinical features of PE and COVID-19 overlap, making the differential diagnosis challenging. Therefore, physicians, specifically those caring for pregnant women, must be aware of the preeclampsia-like syndrome in pregnant women infected with SARS CoV-2 and managed accordingly as the condition resolve spontaneously once the infection subsides.
Introduction: Pre-eclampsia is one of the major causes of maternal and neonatal morbidity and mortality in the world. The complexity of its etiopathogenesis involves, among other things, age, primi-gravidity, obesity, lack of sensitization to the partner's sperm. Our objective was to describe the socio-clinical profile of the preeclampsia pregnant woman received in consultation in our department and to investigate its influence on certain coagulation parameters (prothrombin level, activated partial thromboplastin time). Methodology: We carried out an analytical cross-sectional study from 01st November 2018 to 31st May 2019, in the gynecology and obstetrics department of the Laquintinie Hospital in Douala. We recruited 150 pregnant women including 50 preeclampsia matched to 100 non-preeclampsia all with a gestational age greater than 20 weeks of amenorrhea. The variables of interest were age, pregnancy, parity, gestational age, marital status and body mass index, Prothrombin Level (PL), and Activated Cephalin Time (ACT). Statistical tests were considered significant for a p-value <0.05. Results: The majority age group in both groups was that of 25-30 years with a mean age of 27.80 ± 5.80 in the pregnant preeclampsia; the latter was predominantly pauci-gravid, nulliparous, and grade 1 obese with a gestational age predominantly ≥ 37 weeks of amenorrhea. In linear regression analysis and unvaried regression analysis, we did not find any socio-clinical factors exposing to coagulation disorders in preeclampsia. Conclusion: Our preliminary study reveals the non-existence of socio-clinical factors exposing to coagulation disorders in preeclampsia in our setting.
The ongoing pandemic of COVID-19 brought challenges to many sectors of life, including healthcare. In the pace of the current pandemic, the usual face-to-face interaction between physician and patient, health services diverted to virtual care across diverse domains of healthcare, including antenatal services. Virtual care has its pros and cons in antenatal care. Evidence suggests that virtual care in antenatal care is an easy-to-approach intervention specifically in low-risk pregnancies. Despite its limitations, virtual care not only provides safe antenatal care but helps in minimizing the spread of the SARS CoV-2 virus responsible for the COVID-19 pandemic.
Introduction: Low Birth Weight (LBW) is a major global health problem because of its magnitude and strong association with child morbidity and mortality. The objective of this study was to identify the risk factors for low birth weight in urban areas in Cotonou (Benin) in 2019. Methods: This was a cross-sectional and analytical study conducted in an urban setting (Cotonou). It covered 571 mothers and their children born in the period from 01 January 2019 to 28 February 2019. The data was collected during the period from 02 June 2020 to 12 June 2020. The data analysis was carried out using Software R 3.6.0. A binary logistic regression was carried out. The significance threshold was p<0.05. Results: The frequency of FPN was 17.16%. The associated factors were maternal age below 20 years (ORa=8.37 95% CI:{3.41-21.17}), prematurity (ORa=4.53 95% CI:{2.24-9.32}), the presence of maternal pathology (ORa= 28.35 95% CI:{3.41-21.17}):{13,28-64,72}), lack of antenatal care (ORa=7,07 95% CI:{2,22-23,74}), and finally multiple pregnancy (ORa=28,69 95% CI:{10,54-85,03}). Conclusion: With the exception of the non-modifiable physiological determinants, many important determinants of LBW remain accessible. Well-targeted and coordinated education and awareness raising could have a positive impact on improving the rate of underweight births.
Background: The days and weeks following childbirth – the postnatal period – is a critical phase in the lives of mothers and new born babies. But in low and middle income countries, postnatal care utilization is still low and maternal and neonatal mortality is high. Therefore, the aim of this study was to assess postnatal care service utilization and associated factors among mothers in primary health care units of Bahir Dar Zuria district, Northwest Ethiopia, 2019. Methods: A Community based quantitative cross-sectional study was conducted from December 1, 2018 to January 30, 2019 among 708 women who gave birth six months prior to the data collection. Multistage sampling was used to select study participants. Pre-tested semi-structured questionnaire was used to collect data. The data were entered in EPI info version 3.5.1 and analysed using SPSS version 20.0. Adjusted Odds ratio with 95 % confidence interval was computed to identify the relative association of explanatory variables on postnatal care service utilization. Results: The study revealed that the prevalence of postnatal care service utilizations was 35.6%, (95% CI: 31.90, 39.30). Being involved in women’s health development army (AOR=11.3, 95% CI: 6.41, 19.79), being graduated in health extension packages (AOR=5.1, 95%: 2.88, 8.87), history of antenatal care attendance (AOR=6.8, 95% CI: 3.26, 14.27), institutional delivery (AOR=3.3, 95% CI: 1.92, 5.68), giving still birth (AOR=0.22, 95% CI: 0.1, 0.5), and good knowledge on postnatal care (AOR=16.7, 95%: 9.08, 30.86) showed statistical significant association. Conclusions: Postnatal care utilization in the study area is lower than what is planned to achieve in the Ethiopia growth and transformation plan two. Therefore, increasing women involvement in the health development army and increasing coverage of health extension packages graduated households are recommended to improve postnatal care utilization.
Background: The management of infertile women with advanced endometriosis is difficult and controversial. Medications like cabergoline and dydrogesterone which reduce endometriosis-associated pelvic inflammation but do not prevent ovulation can be an alternative to surgery in these women. Objective: To assess and compare the efficacy of cabergoline and dydrogesterone in infertile women with endometriosis. Methods: A parallel design randomized clinical trial was carried out on 18 infertile women with clinically diagnosed endometriosis. They were randomly allocated either to cabergoline (0.5 mg twice weekly for 6 months, plus timed intercourse) or dydrogesteron (20 mg daily from day 5 to day 25 of menstrual cycle for 6 months, plus timed intercourse). The woman was assessed by telephone interview, face-to-face consultation, and transvaginal sonogram at 3 months and 6 months. Results: Four women receiving cabergoline (36.4%) had a pregnancies from the 3rd month onwards. Fourteen women,7 in each group were available for final analysis. The reduction in visual analog scale score of pain in those given cabergoline was 3 times that in those given dydrogesterone. Adequate reduction in the size of endometrioma was achieved in 28.6% of women given dydrogesterone, but not in those given cabergoline. Conclusion: Cabergoline, compared to dydrogesterone has significant pain reduction over a short period of time in infertile women with endometriosis, and in addition promotes pregnancy.
The conveyance of a sound newborn child to a similarly solid mother achieves the fulfillment to both the family and the obstetrician. The consideration that is given is custom fitted to fit the various requirements that the pregnancy of each lady, to permit a protected conveyance of a newborn child. The vulnerability of the course and result of every Pregnancy prompts expectation of each difficult that may emerge.
Women with leukemia have vague manifestations and some of them could likewise be attributed to pregnancy. Antineoplastic chemotherapy utilizes cytotoxic specialists with possible unfriendly consequences for the baby, Particularly in the primary trimester causing distortions or weight acquire limitation in the second and third Trimester and deferral in neurological advancement during all the pregnancy, however on the off chance that the treatment is postponed until birth the forecast for the mother is basic. During pregnancy, it is critical to consider the metabolic changes related with pregnancy that could affect the bio distribution and drug clearance.
BACKGROUND:No data exist to suggest PARP inhibitor (PARPi) therapy as first-line maintenance is superior to PARPi therapy as second-line maintenance.OBJECTIVE:To determine the efficacy and cost of primary versus secondary olaparib or niraparib maintenance in Epithelial Ovarian Cancer (EOC).METHODS:A retrospective cohort study was performed in women with EOC to determine the survival following primary or secondary PARPi maintenance. We modeled the costs of olaparib and niraparib based on previously published costs and duration of therapy based on the Solo 1/Solo 2 and Prima and Nova trials, respectively.RESULTS:Among 40 patients treated with PARPi as primary or secondary maintenance there was no difference in overall survival (p=0.97). Among 166 women with stage III/IV germ-line BRCA mutated EOC, 28.8% were disease free for >3 years (18.6% never recurred and 10.2% recurred >3 years after chemotherapy). Since 29% of the BRCA mutated patients did not recur within 3 years, primary olaparib maintenance therapy was significantly more expensive than secondary olaparib maintenance therapy by 260%. Primary niraparib maintenance therapy was slightly more expensive than secondary niraparib maintenance therapy by 4%, 51%, and 15% for BRCA mutated, HR deficient, and HR proficient patients, respectively. By eliminating the overtreatment of patients with primary PARPi therapy, the cost savings for 100 women with EOC with BRCA mutations would be $37,335,360 for olaparib and $8,197,592 for niraparib.CONCLUSION:Up to 29% of BRCA mutated patients may be overtreated with primary PARPi maintenance with significantly increased treatment costs.
Acute pancreatitis during pregnancy is an extremely rare condition with an estimated incidence rate of 1 case per 1000 to 10000 pregnancies. The disease often emerges during the third trimester of pregnancy or the early postpartum period, and symptoms like upper abdominal pain, nausea or vomiting, anorexia, fever and elevated serum amylase or lipase activities are experienced. We experienced a case of acute pancreatitis identified during her treatment of threatened preterm labor which had a favorable course thanks to urgent diagnosis and rapid intensive care. Early diagnosis and rapid treatment contributes to good prognosis though the condition may lead to serious courses.
Objective: The aim of this study is to conclude the clinical manifestations of SARS-CoV-2 during pregnancy and the risk of vertical transmission in the newborn. Material and methods: This is a prospective study conducted in 40 pregnant women with positive COVID-19, admitted to Liaquat National Hospital and Medical College Karachi, Pakistan from 2nd June 2020 to 18th June 2020. All 40 patients were tested positive for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) by use of quantitative RT-PCR (q RT-PCR) on sample from nasal and oral swab. We assessed the clinical manifestations of SARS-CoV-2 during pregnancy and the risk of vertical transmission in the newborn. Results: A total of forty pregnant women with COVID-19 were included in this study. The twenty eight patients underwent lower caesarean section and twelve patients had spontaneous vaginal delivery. Twelve of the forty patients presented with fever and their body temperature ranges within 38-39℃, but none had postpartum fever. Other symptoms of upper respiratory tract infection were also found: Fifteen patients had a cough, thirty-two had shortness of breath, twelve reported sore throat and twenty indicated malaise, five had diarrhea and four had loss of taste. Twenty pregnant women with COVID-19 pneumonia had elevated white cell count (>11.0X10^9), while five showed leucopenia (<4.0X10^9). The presence of SARS-CoV-2 was tested in all neonates through sample taken from nasal and oral swab; however none the test detected SARS-CoV- 2 in these samples. Conclusion: The COVID-19 symptoms in pregnant women were various, with main symptoms being shortness of breath, malaise and cough. We found no evidence of vertical transmission in neonates
