International Journal of Obstetrics and Gynecology

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 4 (3), pp. 131-132, March, 2016. © International Scholars Journals

Short Communication     

Training for providing abortions in Kerala, India: Evidence from a recent survey of obstetric and gynecology professionals

Sunita Chowdhury

Independent Consultant, Public Health, Raj Villa Apartment, Flat no.: 301, 3rd floor, Plot no: 125, Sector: 18A, Nerul- West, Navi Mumbai- 400706, Maharashtra, India. Tel: +91 8879335645. E-mail: sunitachowdhury3@gmail.com.

Accepted 18 December, 2015

Abstract

This brief emphasises that the law on abortion in India will have to specify required skills instead of professional qualifications as it currently does to ensure better access to abortion for women.  It was based on a cross sectional survey among 106 randomly selected obstetrics and gynaecology professionals (OGPs) in two southern districts of Kerala state, India.  Abortion in India has been legalised under certain conditions specified in the Medical Termination of Pregnancy (MTP) Act 2003.  This survey found that four out of the 106 OGPs had not undergone specific training to perform MTPs as part of their graduate training.  However, the act permits professionals with graduate training to provide MTPs.  This raises a concern regarding providers’ ability to offer abortion services to women. 

Key words: Legal, abortion, induced, dilatation, evacuation, providers, training, India. 

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 4 (2), pp. 123-130, February, 2016. © International Scholars Journals

Full Length Research Paper

Comparative outcome of medical and surgical Management of urodynamically-proven mixed urinary incontinence

Tamer F Borg*, Hazem M Sammour**, Mohamed M Shahin***

*Associate Professor in the Obstetrics & Gynecology Department, Ain Shams University, Egypt.

**Professor in the Obstetrics & Gynecology Department, Ain Shams University, Egypt.

***Lecturer in the Obstetrics & Gynecology Department, Ain Shams University, Egypt.

*Corresponding author.E-mail:mmousashahin@yahoo.com

Received 04 February, 2016; Accepted 21 February, 2016

Abstract

This double armed clinical trial aimed to compare the outcome of medical versus surgical management of patients with urodynamically-proven mixed incontinence and to identify risk factors for success of each. 138 patients with mixed urinary incontinence (MUI) were studied. 78 patients with urge predominant were allocated medical treatment, 60 patients were classified as stress predominant and allocated surgical treatment. The primary outcome (Patient Global Impression Index of Improvement (PGI-I)) was analyzed in 129 (93.4%) patients. 63.3% of patients in the surgical group showed improvement of their stress component with 43.3% showing improvement in both stress and urgency components. 51.2% of patients in the medical group showed improvement in their urgency component with 33.3% showing improvement in both stress and urgency components. Maximal detrusor pressure and maximal urethral closure pressure were the only independent predictors of failure of medical treatment while the Valsalva leak point pressure was the only independent predictor of failure of surgical treatment. A prediction regression model can predict the outcome of the medical or surgical route.

Keywords: Incontinence surgery, Mixed urinary incontinence (MUI), Medical management of MUI, Predictors of failure, Prediction regression model, Urodynamic studies.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 4 (1), pp. 117-122, January, 2016. © International Scholars Journals

Full Length Research Paper

An evaluation of the outcome and quality of life after TOT-surgery

Dino José*, Fabio Zoff and Carlo Giovanni Modotti

 Clinic of Obstetrics and Gynecology, University Hospital of Udine, Italy.

*Corresponding author E-mail: dino_josé123@gmail.com

Received 15 May 2015;  Accepted 23 October, 2015

Abstract

TransObturatorTape (TOT) is a surgical technique for the correction of stress urinary incontinence (SUI). We report our experience about clinical outcomes and quality of life of patients who underwent TOT. We collected clinical and instrumental data about 27 patients who underwent TOT during 2006-2007, and investigated their quality of life using the King’s Health Questionnaire (KHQ). We analysed data by R (version2.7.0), considering significant p<0.05.Mean age at surgery was 62.81years (range 39-83), mean BMI was 29.31kg/mq ( ±7.74). 85.19% of patients were in menopause (73.91% spontaneous). Mean parity was 2.19 (±1.11) and only two women were nulliparous. 44.44% of patients had at least one previous gynaecological intervention (34.62% hysterectomy). Relapse prevalence was 44.44%, correlated with higher (worse) KHQ scores (p<0.05), and affected especially women with a mixed urinary incontinence (MUI) (p0.09) or with a coexistent genital prolapse (p<0.05). TOT improved women quality of life, independently by relapse or by the presence of a MUI (p<0.05). Previous gynaecological interventions, and in particular hysterectomy followed by SUI, resulted protective against symptom relapse.TOT does not resolve urge component in case of MUI and may cause urge incontinence after SUI correction. Anyway, women quality of life results strongly improved by TOT, even in case of relapse.

Keywords: Transobturator tape technique, hysterectomy, genital prolapse, stress urinary incontinence, quality of life.

International Journal of Obstetrics and Gynaecology ISSN 2326-7234 Vol. 3 (5), pp. 108-116, July, 2015. © International Scholars Journals

Full Length Research Paper

Pre-induction cervical ripening: A randomized controlled trial of vaginal dinoprostone gel vs double balloon catheter for induction of labour in nulliparous and multiparous women with unfavourable cervix

P. Mazidi¹, A Roman², B. Lim¹

¹Department of Obstetrics and Gynaecology, Royal Hobart Hospital, Hobart, Tasmania, Australia.

²Department of Obstetrics and Gynaecology, Royal Women’s Hospital, Melbourne, Victoria, Australia.

Corresponding author. E-mail: peyman.mazidi@hotmail.com

Accepted 06 July, 2015

Abstract

The main aim of this study is to compare the efficacy and patient satisfaction of two methods of labour induction in terms of singleton pregnancies of both nulliparous and multiparous women with an unfavourable cervix. The primary outcome was caesarean section rates between groups. The study used Randomised Controlled trial. The population of nulliparous and multiparous women with an unfavourable cervix requiring induction at term is (n=251). Two study arms were used: double-balloon catheter (n=116) and Dinoprostone gel (n=130). Five women, who were eligible, declined intervention. Three women from Dinoprostone gel group and six from the double-balloon catheter group were excluded from analysis due to protocol violations. There is no significant difference in delivery outcomes or rates of caesarean section between the interventions. Induction with Dinoprostone gel resulted in significantly more uterine hyperstimulation with no increase neonatal morbidity. Overall there was no difference in patient’s pain score or satisfaction between interventions regardless of parity. Labour induction with Dinoprostone gel or double-balloon catheter is equally efficacious and acceptable to women. We suggest that the method of induction should be dictated by clinicians' experience, facilities available and women’s preference. Further evaluation of cost and neonatal outcomes are important ongoing research areas.

Key words: Induction of labour, double balloon catheter, mechanical ripening, prostaglandin, nulliparous, multiparous, unfavourable cervix.

International Journal of Obstetrics and Gynaecology ISSN 2326-7234 Vol. 3 (5), pp. 100-107, July, 2015. © International Scholars Journals

Full Length Research Paper

Screening for Chlamydia trachomatis infection among the infertile women

Remah M Kamel, PhD, MRCOG, FICS

Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Jazan, Saudi Arabia. E-mail: remahmoustafa@hotmail.com.

Accepted 21 July, 2015

Abstract

Chlamydia trachomatis infection is a worldwide distributed sexually-transmitted infection that may lead to infertility. This study aims to report the prevalence of Chlamydia trachomatis infection among infertile women in Saudi Arabia. A community-based study, carried out at obstetrics and gynaecology clinic at Jazan General Hospital, Saudi Arabia. The study-group included 640 infertile women who aged between 18 and 40 years-old and attended the gynaecology clinic for infertility work-up throughout the one year of the study. The control-group include a randomized 100 fertile women who attended the obstetric clinic for routine antenatal-care. All recruited women were screened for Chlamydiainfection by enzyme-linked immunosorbent assay (ELIZA) for detection of serum specific antibodies and then re-tested by McCoy cell culture technique. The prevalence of Chlamydia trachomatis infection among infertile women was high, 15.0%. The rate of chlamydia infection detected by ELIZA was 9.84% while it was 12.03% by the culture method (p = 0.2443). The high prevalence of Chlamydia trachomatis infection among infertile women demands a national screening programme for early detection. ELIZA is a simple alternative screening test to the culture method.

Key words: Chlamydia trachomatis, ELIZA, McCoy cell culture, infertility.

Full Length Research paper 

Feto-maternal outcome in patients with sickle cell anaemia at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria: A ten year retrospective review

*John C.O¹. MBBS, FWACS Orazulike N.²MBBS, FWACS, FICS Ijeoma C.²MBBS,

Feto-Maternal Unit, Department of Obstetrics and Gynaecology. University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.

Department of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, PMB 6173, Port Harcourt, Nigeria. 

Corresponding author. E-mail: drojay1@yahoo.co.uk. Tel.+2348038391519.

Abstract

Sickle cell anaemia is associated with adverse feto-maternal outcome especially in less resource countries with poor obstetrics care. The objective of this study was to evaluate the feto-maternal outcome in pregnant women with sickle cell anaemia at the University of Port Harcourt Teaching Hospital, Port Harcourt. A retrospective review of 17 pregnancies in 13 patients with sickle cell anaemia over a 10-year period was conducted at the University of Port Harcourt Teaching Hospital, Port Harcourt between January 2003 and December 2012. The data retrieved from the case notes of the patients were analysed using SPSS version 17.0. The mean age of the women with sickle cell anaemia reviewed was 29.3 years. Most (76.5%) of them were booked and delivered at term (70.6%). All the women were anaemic out of which 9 had blood transfusion. Other complications ranged from vaso occlusive crises (100%), through urinary tract infection (64.8%), to lobar pneumonia (17.7%) and hypertensive disorders (17.7%). A maternal mortality rate of 9.7 per 100,000 deliveries was found. The mean birth weight was 2752.9g. The major fetal complications were neonatal jaundice (47.1%) and neonatal sepsis (23.5%).The stillbirth rate was 0.1 per 1000 live births. Sickle cell anaemic patients are at increased risk of adverse feto maternal outcomes in pregnancy especially in less resource centres and therefore should be managed in centres with adequate personnel and facilities.

Key words: Sickle cell anaemia, Vaso-occlusive crisis, Preterm delivery, feto-maternal outcome, Complications.