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1دورية أكاديمية
المصدر: Journal of Family Medicine and Primary Care, Vol 13, Iss 6, Pp 2507-2510 (2024)
مصطلحات موضوعية: fetal anemia, hydrops fetalis, intrauterine transfusion, maternal isoimmunization, rh alloimmunization, Medicine
الوصف: Maternal isoimmunization occurs when a pregnant woman develops an immune reaction due to the inheritance of a red-cell antigen, which is paternally derived and can result in fetal anemia, hemolysis, fetal death, and hydrops fetalis as the antibodies might travel through the placenta and get adhered to the antigens present in the erythrocytes of the fetus. This report highlights a rare case of Rh isoimmunization leading to fetal anemia in a 26-year-old female and evaluates the impact of intrauterine transfusion (IUT) in terms of the gestational age at delivery along with the mode of delivery, procedural complications, and overall survival rate of the fetus. In conclusion, the most frequent cause of fetal anemia is Rh alloimmunization, which should be taken into consideration while making a differential diagnosis throughout the assessment. Improvements in IUT procedures and earlier detection of the MCA-PSV by Doppler ultrasonographic examination have also contributed to better results.
وصف الملف: electronic resource
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2دورية أكاديمية
المؤلفون: Deepika Gupta, Sukanya Mitra, Swati Jindal, Puja Saxena
المصدر: Journal of Obstetric Anaesthesia and Critical Care, Vol 14, Iss 1, Pp 78-80 (2024)
مصطلحات موضوعية: blood loss, intrauterine vasopressin, myomectomy, Anesthesiology, RD78.3-87.3, Gynecology and obstetrics, RG1-991
الوصف: Blood loss is one of the major complications in myomectomy. There are several methods to reduce blood loss, one of which that is commonly being used is intramyometrial injection of vasopressin, but there are many adverse events reported with its use. We hereby report two such cases of myomectomy in which patients had bradycardia and cardiac standstill following the use of vasopressin. We hereby discuss the anesthetic concerns and the safe limit of vasopressin for its use in myomectomy.
وصف الملف: electronic resource
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3دورية أكاديمية
المؤلفون: Sangeeta Rawat, Rajender Singh, Garima Mittal
المصدر: Journal of Family Medicine and Primary Care, Vol 12, Iss 12, Pp 3326-3331 (2023)
مصطلحات موضوعية: intrauterine devices, vaginal discharge, vulvovaginal candidiasis, Medicine
الوصف: Introduction: Vulvovaginal candidiasis (VVC) is considered a common gynecological problem among females of reproductive age group. 70–75% of women report having had candidal vulvovaginitis at some point in their lifetimes and 40–50% suffer recurrent candidal vulvovaginitis. Objectives: This study aims to identify the Candida species involved in VVC and to determine their antifungal susceptibility pattern. Materials and Methods: The present study was a cross-sectional study conducted on 257 females (18–55 yr) with complaints of abnormal vaginal discharge. For detection of Candida, the swab samples were subjected to Gram stain, 10% KOH mount, and culture on Sabouraud dextrose agar (SDA). Candida species identification was done by subculturing Candida isolates onto CHROMagar, corn meal agar (Himedia), and further confirmation was done by MALDI-TOF MS. Antifungal testing was done using the disk diffusion method. Results: A total of 257 females with complaints of abnormal discharge were enrolled in this study. Out of 257, C. albicans 37 (58.7%) and 26 (41.3%) isolates were identified as non-albicans Candida. Out of 63 positive cases, a maximum number of study subject belongs to the age group 26–35 years (50.8%). Along with vaginal discharge, itching (65.37%) is the most common complaint. VVC was found to be most predominant in patients with prolonged antibiotic therapy (38.1%), and in pregnant females (15.9%). Conclusion: Understanding the emerging fungal pathogens and their drug susceptibility patterns is essential for the effective management of infections. Drug resistance can lead to treatment failure and highlights the need for alternative treatment options or strategies.
وصف الملف: electronic resource
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4دورية أكاديمية
المؤلفون: Arunav Sharma, Mustajib Ali, Rajesh Sharma
المصدر: Journal of Marine Medical Society, Vol 25, Iss 2, Pp 193-197 (2023)
مصطلحات موضوعية: infertility, intrauterine insemination, outcome, Naval Science, Medicine
الوصف: Background: Primary infertility is a serious condition that has a profound impact on the mental and physical health of the couple, and the condition forms a significant proportion of cases seeking treatment at gynecological centers across the world. Intrauterine insemination (IUI) forms the cornerstone in the management of most of such cases. However, there has been an ongoing debate regarding whether single IUI or double IUI: which is better. This randomized control trial aims at comparing the outcomes of both the techniques. Materials and Methods: In this randomized control trial, 150 couples having a valid indication for IUI were randomized into two groups. In the first group, single IUI was done at 36 h after human chorionic gonadotropin (HCG) trigger, and in the second group, double IUI was done at 24 and 48 h post-HCG trigger. The outcome measured was pregnancy which was confirmed by urine pregnancy test done on the 18th day after IUI and later followed up till appearance of gestation sac with fetal pole on ultrasound. The Fisher's exact test for statistical analysis was used to analyze the data for statistical significance. Results: In the single IUI cohort of 75 women, 11 tested positive for urine beta-HCG on day 18 and all had confirmed pregnancy (gestational sac with fetal pole). The pregnancy positivity rate for this cohort was 14.67% (11/75 × 100%). In the double IUI cohort of 75 women, 13 tested positive for urine beta-HCG on day 18 and all had confirmed pregnancy (gestational sac with fetal pole); the pregnancy positivity rate for this cohort was 17.33% (13/75 × 100%). Although the double IUI group had a higher yield of positive outcomes, the result was not statistically significant (statistic test value is 0.8242). Conclusion: The outcome of single versus double IUI is almost similar. In a resource-poor situation, it will be prudent to stick to single IUI in all cases requiring IUI. However, in a resource-rich situation, one might resort to double IUI in male factor abnormalities such as asthenozoospermia or borderline oligozoospermia.
وصف الملف: electronic resource
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5دورية أكاديمية
المؤلفون: Zeki Dogan, Emine Seda Guvendag Guven, Mehmet Albayrak, Suleyman Guven
المصدر: Journal of Medical Ultrasound, Vol 31, Iss 3, Pp 201-205 (2023)
مصطلحات موضوعية: fetal thymus volume, intrauterine growth restriction, screening, second trimester, virtual organ computer-assisted analysis, Medical technology, R855-855.5
الوصف: Background: Intrauterine growth restriction (IUGR) refers to fetuses that are small for their gestational age. There is no effective test to predict this disease. The aim of our study is whether fetal three-dimensional (3D) ultrasonography (USG)-assisted thymus volume (TV) measurement predicts IUGR cases. Methods: Fetal 3D USG thymus measurement between 15 and 24 weeks of gestation was performed in a total of 100 women of reproductive age. Fetal TV was measured using the virtual organ computer-assisted analysis system program. All cases were followed up in terms of pregnancy complications until delivery. Results: IUGR was developed in six cases in total. In cases with IUGR, mean fetal TV was found to be statistically significantly lower than in healthy cases without it. When the fetal TV was taken as 0.1645, the sensitivity was calculated as 89.5% and the specificity as 50% for predicting IUGR. The use of low fetal volume parameters is a significant and good indicator for predicting IUGR according to the binary logistic regression analysis result. Conclusion: According to the results of this study, 3D fetal TV measurement may be used in routine second-trimester sonographic anomaly screening to predict the development of fetal IUGR. In this way, fetal mortality and morbidity caused by IUGR may be reduced.
وصف الملف: electronic resource
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6دورية أكاديمية
المؤلفون: John Ekenedirichukwu Okwara, Joseph Eberendu Ahaneku, Charles Chinedum Onyenekwe, Gerald Okanandu Udigwe, Joseph Ifeanyichukwu Ikechebelu, Emmanuel Chidiebere Okwara, Nuratu Adejumoke Okwara, Jude Anaelechi Onuegbu, Japhet Madu Olisekodiaka
المصدر: Nigerian Journal of Medicine, Vol 32, Iss 3, Pp 259-267 (2023)
مصطلحات موضوعية: oestriol, human immunodeficiency virus, intrauterine foetal death, pregnancy-associated plasma protein-a, pregnancy outcome, progesterone, Medicine
الوصف: Background: Pregnancy is associated with biochemical alterations and may be compounded by human immunodeficiency virus (HIV) infection potentially affecting pregnancy outcome such as birth weight, Apgar score, and foetal viability (stillbirth or intrauterine foetal death [IUFD]). Aims: This prospective case–control study evaluated some biochemical parameters and their possible effects on pregnancy outcome in HIV-seropositive subjects. Patients, Materials and Methods: The study involved 136 HIV seropositives on highly active antiretroviral therapy and 137 HIV-seronegative pregnant women, recruited from the Antenatal Clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Pregnancy-associated plasma protein-A (PAPP-A), oestriol (E3), and progesterone were analysed using an enzyme-linked immunosorbent assay method, and the delivery outcomes were reported. Results: Progesterone was significantly higher (P = 0.002) in HIV-seropositive individuals (59.3 ± 17.84 ng/mL) compared to controls (54.89 ± 8.24 ng/mL). There were no significant differences in the levels of E3 and PAPP-A between the two groups. In HIV seronegatives, there were no significant changes in measured biochemical parameters between trimesters (P > 0.05). There were no significant differences in measured biochemical parameters between subjects with IUFD and subjects with live births (P > 0.05) for both the test and control groups. Subjects with significantly lower PAPP-A in HIV seropositives had babies with higher Apgar score. The incidence of IUFD was 7.31% among HIV seropositives and 7.47% among HIV seronegatives. Conclusion: HIV infection affects some biochemical indices such as progesterone and PAPP-A but does not adversely affect pregnancy outcomes in HIV seropositives under antiretroviral therapy.
وصف الملف: electronic resource
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7دورية أكاديمية
المؤلفون: Roze Isono-Taniguchi, Hiroshi Tsubamoto, Kayo Inoue, Tomoko Ueda, Shinichiro Saeki, Yumi Takimoto, Yu Wakimoto, Hiroaki Shibahara
المصدر: Gynecology and Minimally Invasive Therapy, Vol 12, Iss 3, Pp 175-178 (2023)
مصطلحات موضوعية: atypical endometrial hyperplasia, endometrial cancer, levonorgestrel intrauterine system, preoperative management, weight-loss interventions, Gynecology and obstetrics, RG1-991
الوصف: Endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) are associated with obesity, which increases the perioperative morbidity and surgical difficulties in laparoscopic and robotic surgery. Weight-loss interventions (WLIs) are likely to reduce morbidity; however, delayed surgery may cause cancer progression. To minimize the tumor progression, levonorgestrel intrauterine system (LNG-IUS) with minimal side effects was used until the planned surgery. During 2016 and 2021, we conducted preoperative management of WLI using LNG-IUS for seven highly obese women with a body mass index (BMI) ≥35 kg/m2 who had AEH and EC with Grade 1 and no myometrial invasion on magnetic resonance imaging. In three of the seven patients, the BMI decreased by more than 5. Two patients with AEH achieved remission after LNG-IUS placement and requested conservative management. Five patients with EC underwent laparoscopic hysterectomy, without perioperative complications.
وصف الملف: electronic resource
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8دورية أكاديمية
المؤلفون: Fatemeh Eghbalian, Ensiyeh Jenabi, Saeid Bashirian, Salman Khazaei, Maryam Shokouhi, Behnaz Basiri, Mohammad Kazem Sabzehei, Shobo Sheikhahmadi, Homa Babaei, Mazyar Vakiliamini, Nahid Jafari, Maryam Jafari
المصدر: Advances in Human Biology, Vol 13, Iss 1, Pp 48-52 (2023)
مصطلحات موضوعية: covid-19, intrauterine transmission, iran, manifestations, neonate, outcome, Biology (General), QH301-705.5
الوصف: Introduction: So far, no study has been conducted in Iran on the effect of COVID-19 on neonates. Therefore, the present cross-sectional study has been evaluated to determine the clinical manifestations and outcomes in neonates infected with COVID-19 in the west of Iran. Materials and Methods: The present cross-sectional study was conducted among neonates infected with COVID-19 in six provinces of Hamadan, Kermanshah, Kurdistan, Ilam, Zanjan and Lorestan, located in the west of Iran, from 1 March to 1 July 2020. In these neonates, the polymerase chain reaction test was positive. The data were collected by a checklist and were analysed using SPSS Statistics Software. Result: During the study period, 16 neonates infected with COVID-19 were identified including Kurdistan Province with five cases, Hamadan Province four cases, Kermanshah with three cases, and Lorestan and Zanjan provinces with two cases. Neonate gender of them had equal distribution. Two (15.38%) of them needed CPR after delivery. The delivery method for 9 (56.25%) was vaginal, and one of them died during the study period. The medical care used for these neonates was as follows: 87.5% were hospitalized in the intensive care unit and antibiotics were used for 68.75%. 12.5% underwent COVID-19-specific treatment, and for 25%, a ventilator was used. The laboratory findings in neonates infected with COVID-19 showed that in 18.75%, blood urea nitrogen has increased. 46.15% of neonates reported lymphocytopenia. The blood haematocrit and haemoglobin decreased by 31.35% and 56.25%, respectively. Conclusion: The coronavirus disease 2019 has occurred among neonates, but they seemed to have a milder disease course and better prognosis than adults. Findings showed that there is a possibility of vertical intrauterine transmission from pregnant mothers to newborns.
وصف الملف: electronic resource
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9دورية أكاديمية
المؤلفون: Xuan Huang, Qin Sun, Xu Tang, Meiling Li, Cheng Zhou, Xi Cheng, Bing Yao, Li Chen
المصدر: Journal of Human Reproductive Sciences, Vol 16, Iss 1, Pp 42-49 (2023)
مصطلحات موضوعية: anti-müllerian hormone, clinical pregnancy rate, endometrial thickness, intrauterine insemination, ovarian stimulation, Gynecology and obstetrics, RG1-991
الوصف: Background: Many factors were reported associated with the pregnancy rate of intrauterine insemination (IUI), which played key role is still debated. Aims: The aim of this study was to explore related clinical pregnancy outcome factor in IUI cycles of non-male factor. Settings and Design: The clinical data of 1232 IUI cycles in 690 couples experiencing infertility who attended the Reproductive Center of Jinling Hospital between July 2015 and November 2021 were retrospectively analysed. Materials and Methods: Female and male age, body mass index (BMI), anti-Müllerian hormone (AMH), male semen parameters before and after wash, endometrial thickness (EMT), artificial insemination timing and ovarian stimulation (OS) protocols were compared between the pregnant group and the non-pregnant group in order to explore any correlation. Statistical Analysis Used: Continuous variables were analysed using independent-samples t-test, and Chi-square test was used for comparison of measurement data between the two groups. P 4.5 ng/ml, EMT between 8 and 12 mm and letrozole + human menopausal gonadotropin stimulation with higher clinical pregnancy. However, there were no differences between the pregnant group and the non-pregnant group amongst the female and male age, BMI, hormones on baseline and day of human chorionic gonadotrophin, number of ovulated oocytes, sperm parameters before and after wash, treatment protocols and the timing of IUI (P > 0.05). Furthermore, there were 240 couples who not pregnant received one or more cycles of in vitro fertilisation/intracytoplasmic sperm injection/ pre-implantation genetic technology treatment, and another 182 couples forgo follow-up treatment. Conclusion: The results of the present study demonstrate that the clinical IUI pregnancy rate is correlated with the factors of female AMH, EMT and OS protocol; more studies and samples are necessary to evaluate whether other factors affect pregnancy rate.
وصف الملف: electronic resource
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10دورية أكاديمية
المؤلفون: Chun-Cheng Lin, Meng-Hung Shih, Chih-Wei Tsao
المصدر: Journal of Medical Sciences, Vol 43, Iss 2, Pp 93-96 (2023)
مصطلحات موضوعية: case report, intrauterine contraceptive device, urinary tract infection, uterine myoma, vesical stone, Medicine, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
الوصف: Intrauterine devices (IUDs) are one of the most popular reversible contraception methods. However, if an event related to them is unanticipated, or if they are not located when missing, it can be dangerous. We present a case of chronic lower abdomen pain and recurrent urinary tract infection ongoing for 1.5 years. Despite the patient undergoing laparoscopic uterine myomectomy, her symptoms had not improved. The patient visited a genitourinary clinic for lower urinary tract symptoms and accepted cystoscopy and electrohydraulic lithotomy. Incidentally, a part of an IUD was found in the calculus. This case highlights the need for careful diagnosis and for locating missing IUDs to avoid serious complications.
وصف الملف: electronic resource
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