International Journal of Gynecology & Obstetrics
0020-7292
Cơ quản chủ quản: John Wiley and Sons Ltd , WILEY
Lĩnh vực:
Obstetrics and GynecologyMedicine (miscellaneous)
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Các bài báo tiêu biểu
Risk factors for very preterm delivery and delivery of very‐small‐for‐gestational‐age infants among HIV‐exposed and HIV‐unexposed infants in Botswana Abstract Objective To evaluate risk factors for very preterm delivery (VPTD) and very‐small‐for‐gestational‐age (VSGA) births in a country with a high HIV prevalence. Methods Obstetric records at 6 hospitals across Botswana were reviewed at delivery; VPTD was defined as birth before 32 weeks of pregnancy and VSGA as birth weight below the 3rd percentile for Botswana‐specific norms. Results Of 16 219 live births born after 26 weeks of pregnancy, 701 (4.3%) were delivered very preterm and 607 (3.7%) were VSGA; 4347 (28.4%) were documented as HIV‐exposed. In a multivariable analysis, HIV infection and hypertension during pregnancy were associated with a VPTD (adjusted odds ratio [AOR]: HIV 1.65, hypertension 1.75) and a VSGA birth (AOR: HIV infection 1.90, hypertension 3.44). Among HIV‐infected women, the continuation of highly active antiretroviral therapy (HAART) from before conception was associated with a VSGA birth (AOR 1.75) but not with a VPTD (AOR 0.78). In a secondary analysis, HAART continuation was associated with hypertension during pregnancy (AOR 1.34). Conclusion Hypertension and HIV infection were risk factors for a VPTD and a VSGA birth. Continuation of HAART from before conception was associated with a VSGA birth but not with a VPTD.
Tập 115 - Trang 20-25 - 2011
Effectiveness of cryotherapy treatment for cervical intraepithelial neoplasia Abstract Objective To assess the effectiveness of cryotherapy treatment delivered by general practitioners in primary care settings, as part of a screen‐and‐treat approach for cervical cancer prevention. Method Women aged between 25 and 49 years residing in San Martin, Peru, who were positive on visual inspection screening were treated, if eligible, with cryotherapy following biopsy. At 12 months post cryotherapy treatment the participants were evaluated for treatment effectiveness and examined by visual inspection and Papanicolaou test and, if positive, referred to a gynecologist for colposcopy and biopsy. Results Cryotherapy treatment was performed for 1398 women; of these, 531 (38%) had a histology result of cervical intraepithelial neoplasia (CIN). Cryotherapy effectively cured CIN in 418 (88%) women, including 49 (70%) women with a baseline diagnosis of CIN 3. Conclusion Cryotherapy is an effective treatment for cervical precancerous lesions; it can easily be administered by general practitioners in primary care settings following visual inspection screening.
Tập 101 - Trang 172-177 - 2008
Recurrent pregnancy loss due to familial and non‐familial habitual molar pregnancy Abstract Objectives: To present a series of women with recurrent molar pregnancies, including rare familial cases, and discuss etiology and treatment options. Methods: We performed a detailed clinical evaluation and pedigree analysis of five Egyptian women with recurrent pregnancy loss due to molar pregnancy. Results: The women had a history of four to nine consecutive hydatidiform moles but of no viable pregnancies. Two of the women had molar pregnancies with different husbands who themselves had viable offspring from previous wives; and three of them, who belonged to a family with extensive intermarriage, had a pedigree consistent with an autosomal recessive maternal‐effect mutation. Conclusions: Recurrent pregnancy loss due to habitual molar pregnancy is uncommon and familial cases are extremely rare. The etiology of this disorder is not well understood but likely results from a maternal‐effect mutation. Management options are limited, especially for couples who desire to have their own genetic offspring.
Tập 83 - Trang 179-186 - 2003
Predictors of stillbirths and neonatal deaths in rural western Uganda Abstract Objective To explore pregnancy outcomes at a referral hospital in rural western Uganda. Methods A retrospective study was undertaken using data for all deliveries at Virika Hospital, Fort Portal, Uganda, between July 1, 2009, and October 22, 2011. A detailed review of delivery logs was conducted. Categories were created for obstetric risk factors (e.g. grand multipara, history of hypertension), maternal delivery complications (e.g. eclampsia, hemorrhage), and neonatal complications (e.g. fetal distress, birth defects). Results Overall, 4883 deliveries were included. Of the 517 neonates who did not survive, 430 (83.2%) had been stillborn. After controlling for parity, gestational age, obstetric risk factors, and neonatal complications, risk factors for stillbirth included maternal delivery complications (risk ratio [RR] 3.32, 95% confidence interval [CI] 2.34–4.71; P < 0.001) and living 51–100 km from the hospital (RR 3.37, 95% CI 2.41–4.74; P < 0.001). Risk factors for neonatal death included neonatal complications (RR 5.79, 95% CI 2.49–13.46; P = 0.001) and maternal delivery complications (RR 3.17, 95% CI 1.47–6.82; P = 0.003). Conclusion Qualified providers need to be deployed to rural areas of Uganda to facilitate the prompt identification and management of pregnancy, delivery, and neonatal complications.
Tập 134 - Trang 190-193 - 2016
Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (<scp>COVID</scp>‐19) infection Abstract Objective To provide clinical management guidelines for novel coronavirus (COVID ‐19) in pregnancy. Methods On February 5, 2020, a multidisciplinary teleconference comprising Chinese physicians and researchers was held and medical management strategies of COVID ‐19 infection in pregnancy were discussed. Results Ten key recommendations were provided for the management of COVID ‐19 infections in pregnancy. Conclusion Currently, there is no clear evidence regarding optimal delivery timing, the safety of vaginal delivery, or whether cesarean delivery prevents vertical transmission at the time of delivery; therefore, route of delivery and delivery timing should be individualized based on obstetrical indications and maternal–fetal status.
Tập 149 Số 2 - Trang 130-136 - 2020
Maternal mortality from COVID‐19 in Mexico In this study, we report a 2.3% case fatality rate among parturients with COVID‐19 in Mexico.
Tập 150 Số 2 - Trang 266-267 - 2020
Use of risk of malignancy index to indicate frozen section analysis in the surgical care of women with ovarian tumors Abstract Objective To evaluate the importance of the risk of malignancy index (RMI) in the decision to perform frozen section analysis among women with ovarian tumors. Methods A retrospective study was conducted in 11 centers in the Netherlands. Women who underwent surgical treatment of an ovarian mass with unknown histology between January 2005 and September 2009 were included. The RMI was calculated retrospectively. Frozen section analysis and RMI values were assessed for patients with benign, borderline, and malignant ovarian tumors on final histopathology. Results Overall, 670 women were included. Frozen sections were performed in 323 (48.2%) patients, of whom 206 (63.8%) were diagnosed with benign ovarian tumors, 55 (17.0%) with borderline tumors, and 62 (19.2%) with malignant tumors. Overall, 109 (16.3%) women had an RMI below 20, 106 (97.2%) of whom had benign histology results. Among 235 patients with an RMI over 100, 3 (1.3%) postmenopausal women had malignancies that were missed because frozen sections were not performed. Conclusion Women with an RMI below 20 have a low risk of malignancy and therefore do not require frozen section analysis. Postmenopausal women with an RMI greater than 100 should be referred to centers where frozen sections can be performed, and proper facilities and expertise are available to perform staging procedures if necessary.
Tập 133 - Trang 355-358 - 2016