International Journal of Gynecology & Obstetrics
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A systematic review and meta‐analysis of venous thrombosis risk among users of combined oral contraception Abstract Background Combined oral contraceptives (COC s) containing various progestogens could be associated with differential risks for venous thromboembolism (VTE ). Objective To evaluate the comparative risks of VTE associated with the use of low‐dose (less than 50 μg ethinyl estradiol) COC s containing different progestogens. Search strategy PubMed and the Cochrane Library were searched from database inception through September 15, 2016, by combining search terms for oral contraception and venous thrombosis. Selection criteria Studies reporting VTE risk estimates among healthy users of progestogen‐containing low‐dose COC s were included. Data collection and analysis A random‐effects model was used to generate pooled adjusted risk ratios and 95% confidence intervals; subgroup and sensitivity analyses assessed the impact of monophasic‐COC use and study‐level characteristics. Main results There were 22 articles included in the analysis. The use of COC s containing cyproterone acetate, desogestrel, drospirenone, or gestodene was associated with a significantly increased risk of VTE compared with the use of levonorgestrel‐containing COC s (pooled risk ratios 1.5–2.0). The analysis restricted to monophasic COC formulations with 30 μg of ethinyl estradiol yielded similar findings. After adjustment for study characteristics, the risk estimates were slightly attenuated. Conclusions Compared with the use of levonorgestrel‐containing COC s, the use of COC s containing other progestogens could be associated with a small increase in risk for VTE .
International Journal of Gynecology & Obstetrics - Tập 141 Số 3 - Trang 287-294 - 2018
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.
International Journal of Gynecology & Obstetrics - 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.
International Journal of Gynecology & Obstetrics - Tập 101 - Trang 172-177 - 2008
Revised FIGO staging for carcinoma of the cervix
International Journal of Gynecology & Obstetrics - Tập 105 Số 2 - Trang 107-108 - 2009
Carcinoma of the Corpus Uteri
International Journal of Gynecology & Obstetrics - Tập 95 - Trang S105-S143 - 2006
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.
International Journal of Gynecology & Obstetrics - 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.
International Journal of Gynecology & Obstetrics - 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.
International Journal of Gynecology & Obstetrics - 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.
International Journal of Gynecology & Obstetrics - Tập 150 Số 2 - Trang 266-267 - 2020
Urinary incontinence as a worldwide problem
International Journal of Gynecology & Obstetrics - Tập 82 Số 3 - Trang 327-338 - 2003
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