ISSN 2736-1594
Research Article
International Journal of Obstetrics and Gynecology ISSN: 2736-1594 Vol. 11 (2), pp. 001-008, February, 2023. © International Scholars Journals
Full Length Research Paper
The use of a linear cutting stapler for hysterotomy during cesarean hysterectomy for patients with placenta accreta spectrum
1Hoang Yen Nguyen, MD, 2Yevgeniya Ioffe, MD, 2Linda Hong, MD,1Alyssa Sanchez, BS, 1Andrea Cragoe, MD,1Alexander Thomas, MD, 3Ruofan Yao, MPH, MD
1Department of Gynecology and Obstetrics, 2Department of Gynecologic Oncology,3Department of Maternal-Fetal Medicine
Loma Linda University School of Medicine, CA, Loma Linda University Children’s Hospital, Loma Linda, CA.
Accepted 13 October, 2022
Abstract
During a cesarean hysterectomy surgery for placenta accreta spectrum, two procedures contributed to the total surgical blood loss, the uterine hysterotomy portion for fetal delivery and the hysterectomy portion. Previous studies had aimed at decreasing blood loss with techniques targeting the hysterectomy portion. We aimed to evaluate the impact of performing hysterotomy utilizing a linear cutting stapler in minimizing blood loss during cesarean hysterectomy compared to the classical hysterotomy technique with scalpel in patients with suspected placenta accreta spectrum disorders. This was a single-center retrospective cohort study including a total of 95 patients undergoing cesarean hysterectomies over a period of 8 year between January 2014 and January 2022. 31 patients in the intervention group underwent hysterotomy performed with a linear cutting stapler. 64 patients in the control group underwent the classical hysterotomy performed with scalpel. The primary outcomes were quantitative total blood loss, units of red blood cell transfusion, length of postoperative stay, and intensive care unit admission. Compared to the classical hysterotomy group, the linear stapler hysterotomy group was associated with a significant reduction in surgical blood loss (1000mL vs 2553mL (p<0.001)), units of red blood cell transfused (1 vs 3 units (p<0.001)), and postoperative length of stay (3 vs 4 days (p<0.001)). The rates of surgical blood loss of >2000ml in the linear stapler hysterotomy group was 22.6% vs 48.4% (adjusted odd ratio 0.23 [0.06-0.79]). The rate of transfusion of >4unit of pRBC in the linear stapler hysterotomy group was 16.1% vs 48.4% (adjusted odd ratio 0.26 [0.07-0.97]). The method of performing hysterotomy utilizing a linear cutting stapler was associated with a significant reduction in surgical blood loss, units of red blood cell transfusions, and postoperative length of stay compared to the classical hysterotomy method via scalpel in patients undergoing cesarean hysterectomy for suspected placenta accreta spectrum.
Keywords: Placenta accreta, placental disorders, cesarean hysterectomy, linear stapler, hysterectomy, blood loss, blood transfusion.
Andrea Cragoe, Hoang Yen Nguyen, Alyssa Sanchez, Linda Hong, Alexander Thomas and Ruofan Yao, Yevgeniya Ioffe
https://doi.org/10.46882/IJOG/1132Research Article
International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 11 (2), pp. 001-007, February, 2023. © International Scholars Journals
Full Length Research Paper
Hepatitis B and C virus co-infection in pregnancy at a Tertiary Hospital, Yenagoa, Bayelsa State, Nigeria
Kotingo E. L.* and Allagoa D.O.
Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
Accepted 08 October, 2022
Abstract
Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections account for a reasonable proportion of liver diseases worldwide. Co-infection with the two viruses is not uncommon because the two viruses share similar modes of transmission. The primary concern with HBV/HCV co-infection is that it can lead to more severe liver disease and an increased risk for progression to Hepatocellular cancer. The objective is to determine the Hepatitis B and C virus co-infection in pregnancy, their seroprevalence and clinico-epidemiological correlates. This is a descriptive cross sectional study. Two hundred and twenty (220) consecutive healthy pregnant women attending the antenatal booking clinic of the hospital who met the inclusion criteria were recruited into this study after pretest counselling and obtaining consent from them. This was tested for both HBsAg and anti-HCV antibodies with commercially available in vitro diagnostic kits (one step test strips). Data was collected via a questionnaire. Data entry and analysis was done using SPSS (statistical package for social sciences) 22 statistical package (SPSS Inc., Illinois, U.S.A). P value less than 0.05 was taken as being significant. The mean age of the pregnant women studied was 28.8 years ± 5.2 while the mean parity was 1.20 ± 1.16. Of the 220 recruited pregnant women, 4.6% (n=10) were seropositive for hepatitis B surface antigen (HBsAg) while 2.7% (n=6) were seropositive for hepatitis C viral (anti-HCV) antibodies. There was 0% Hepatitis B and C virus co-infection in pregnancy. Multiple sexual partners and Female circumcision were the significant risk factors for HBsAg seropositivity (p<0.05). None of the risk factors were significantly associated with hepatitis C viral antibody seropositivity. Hepatitis B and C virus co-infection rate in pregnancy is infinitesimal in our obstetrics population. Routine screening for Hepatitis B virus infection and advocacy for active and passive immunization to infants of seropositive pregnant women is however recommended.
Keywords: Hepatitis B virus, Hepatitis C virus, Hepatitis in pregnancy.
Kotingo E. L.*, Allagoa D.O.
https://doi.org/10.46882/IJOG/1131Research Article
International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 11 (2), pp. 001-003, February, 2023. © International Scholars Journals
Full Length Research Paper
Microbiological profile of breast abscess in the Gynecology and Obstetrics Care Service of a Philanthropic Hospital in Vitória, ES, Brazil
Bassetti, Bil Randerson¹*, Scherre, Flávia de Souza Freitas2, Pontello, Mariana Andreata Rocha2, Mattede Maria das Graças Silva3 and Chambo Filho Antônio3
1Master’s in Biotechnology, Infectious Disease and Infection Control of Hospital Estadual Central
2Intern of Gynecology and Obstetrics of Santa Casa de Misericórdia de Vitória.
3Graduation in Farmácia e Bioquímica Ph.D. in Ciencias de la educacion.
Accepted 13 November, 2022
Abstract
Mastitis is frequent and may lead to severe mutilations if initial treatment is not adequate. Community-acquired MRSA infections have been increasing in prevalence and incidence, including mastitis. We conducted a prospective observational study to evaluate the incidence of MRSA infections in community mastitis in Vitória, Espírito Santo. In the 24 months of study conducted at the genecology and obstetrics emergency room of the Santa Casa de Misericórdia hospital, 52 patients with mastitis and indication of drainage had the etiological agent identified. The most important was Staphylococcus aureus, with 96% (50 / 52), of these 72% (36/50) were MRSA. Half of these patients were lactating. In the community mastitis treated in this service, there is a high incidence of MRSA, with potential failure in the initial treatments and risk of colonization and infection in newborns in the puerperal mastitis.
Keywords: Mastitis; MRSA infections; antibiotics.
Mariana Andreata Rocha, Pontello , Bil Randerson*, Flávia de Souza Freitas, Mattede Maria das Graças Silva and Chambo Filho Antônio, Scherre , Bassetti
https://doi.org/10.46882/IJOG/1130Research Article
International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 11 (1), pp. 001-010, January, 2023. © International Scholars Journals
Full Length Research Paper
Low birth weight, metabolic syndrome and their associations with the global crisis of 1930 - 1945, rapidly growing economy and coronary heart disease in Central Africa
B. Longo-Mbenza1,2*, D. Vangu Ngoma3 and S. Mbungu Fuele3
1Department of Internal Medicine, University of Kinshasa, DRC.
2Faculty of Health Sciences, Walter Sisulu University, South Africa.
3Biostatistics Unit, Lomo Medical Center and Heart of Africa Center of Cardiology, Kinshasa, DRC.
Accepted 26 October, 2022
Abstract
The purpose of this study is to determine the prevalence of low birth weight (LBW) and metabolic syndrome (Mets) and their associations with 1930 - 1945 years of global crisis and cardiovascular risk factors in Central Africans. The study was a hospital-based cross-sectional study conducted on Central African patients born between 1930 and 1977. Mets was diagnosed using WHO criteria. Of 407 patients, 262 (64. 6%) and 77 (18.9%) met the criteria of LBW and Mets, respectively. There was association between birth during 1930 global crisis and 1945 second war period; adulthood hypertension, low economic growth, high pulse pressure, type 2 diabetes, decline of renal function, hypercholesterolemia, left ventricular hypertrophy and LBW. There was a U-shaped relationship between current body mass index and Mets in all patients and men, but a linear relationship between current body mass index and Mets in women. Coronary heart disease (OR = 2.3 95%CI 1.1 - 4.8; P = 0.024), LBW (OR = 10 95%CI 3.9 - 25.5; P < 0.0001), elevated fibrinogen (OR = 3.5 95%CI 2 - 6.1; P < 0.0001) were the independent risk factors of Mets in all patients. LBW effect on Mets was lower in men (OR = 7.5 95%IC 2.6 - 22.1; P < 0.0001) than in women (OR = 18 95%CI 2.3 - 37; P = 0.005). In a separate multivariate analysis for only continuous variables, Mets in all patients was independently determined as follows: Y = -1.523 + 0.003 fibrinogen + 0.01 total cholesterol - 0.001 birth weight. LBW, coronary heart disease, malnutrition, elevated fibrinogen, total cholesterol and urea nitrogen may be considered as additional components of Mets in the African patients born between 1930 and 1945 and more in women than in men.
Key words: Low birth weight, fibrinogen, cardiovascular risk factors, metabolic syndrome, Sub-Saharan Africa.
B. Longo-Mbenza*, D. Vangu Ngoma and S. Mbungu Fuele
https://doi.org/10.46882/IJOG/1129Research Article
International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 11 (1), pp. 001-006, January, 2023. © International Scholars Journals
Full Length Research Paper
Microbial agents of abnormal vaginal discharge in pregnant mothers attending Primary Health Care Centers of Jos, Nigeria
S. I. Nwadioha1*, D. Z. Egah2, E. B. Banwat2 and O. O. Alao3
1Department of Medical Microbiology and Parasitology, College of Health Sciences, Benue State University, Makurdi, Nigeria.
2Department of Medical Microbiology and Parasitology, Jos University Teaching, Hospital, Jos, Nigeria.
3Department of Haematology and Blood transfusion, College of Health Sciences, Benue State University, Makurdi, Nigeria.
Accepted 26 October, 2022
Abstract
Infective genital discharge in a pregnant mother poses a greater risk of transmission of HIV to the unborn child and other complications such as abortion, premature rupture of membrane, prematurity and low birth weight. To detect some common microbial agents of abnormal vaginal discharge in pregnant women in order to improve the early diagnosis and prompt treatment in line with current syndromic management. A prospective study of female genital swabs from pregnant women collected from Primary Health Care Centers, Jos and analysed for microscopy, culture and sensitivity in Jos University Teaching Hospital, December 2006 to December 2007. Data on epidemiologic indices were collected from the patients, using structured interviewer- administered questionnaires. Microbial agents were detected in 54.3% (n = 380) of a total 700 female genital swab from the pregnant mothers studied. Candida species were at the peak of the group of causative agents with 80.0% (n = 304) of the 380 positive genital swab samples, other causative agents were Gardnerella vaginalis, an agent of bacteria vaginosis with 7.6% and Trichomonas vaginalis, 1.8%. The distribution of abnormal vaginal discharge was highest in the multigravida (73.3%) and is commonest in the first and third trimesters of pregnancy with 44.7 and 39.5% respectively. Abnormal vaginal discharge was prevalent in the multigravida group and the commonest microbial agents of infective vaginal discharge among the pregnant mothers were Candida species. We recommend early diagnosis, prompt treatment and prevention of infective female genital discharge in pregnant mothers in order to curtail the transmission of HIV.
Key words: Microbial agents, abnormal vaginal discharge, pregnant mothers.
D. Z. Egah, S. I. Nwadioha*, E. B. Banwat and O. O. Alao
https://doi.org/10.46882/IJOG/1128Research Article
750 cases of home delivery and its outcomes in Koohdasht-Iran
International Journal of Obstetrics and Gynecology ISSN 2736-1594, Vol. 11 (1), pp. 001-004, January, 2023. © International Scholars Journals
Full Length Research Paper
750 cases of home delivery and its outcomes in Koohdasht-Iran
Abbasi marani Fatemeh1, Safari Saeed2, 3* and Forogirad Parveen1
1Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
2Department of Emergency Medicine, Imam hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3Department of Nephrology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Accepted 21 October, 2022
Abstract
In 1986, World Health Organization (WHO) suggested the home as a suitable place for delivery process of pregnant women. Home delivery (HD) has been considered less or not at all in developing countries. Based on official reports the rate of HD in Iran 2000 was 5.2% for urban areas. This study reports the reasons and outcomes of HD in 750 pregnant women of Koohdasht- Iran. All the women who resided in Koohdasht and had experienced HD during the study period were enrolled. The data were gathered through a questionnaire that filled in by the researcher while interviewing these women or their relatives. Seven hundred and fifty cases of HD were detected during the study period. The mean age of women was 28 ± 0.7 years. Financial problems, personal willingness, and pervious history of HD were the most common reasons for HD. The majority of unpleasant outcomes of HD were precocious bleeding after HD, looseness of womb, and precocious rapture of sack which occurred in cases who were conducted by a local uneducated midwife and among the mothers who had their first delivery. Screening and selection of the pregnant women at low risk for HD can reduce the unpleasant outcomes. It is suggested to arrange some training program about HD for uneducated lay midwives and to the family planning units to emphasize the training mothers about the delivery process. Relevance to clinical practice: HD can be noted as an alternative choice for pregnant women.
Key words: Home delivery, home birth, out of hospital birth, Iran, Koohdasht.
Safari Saeed* and Forogirad Parveen, Abbasi marani Fatemeh
https://doi.org/10.46882/IJOG/1127