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Journal of Gynecology AND Reproductive Medicine

ISSN(p): | ISSN(e): 2576-2842
Journal Papers (26) Details
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Indexed Journal

1 A Heideggerian Hermeneutics Phenomenological Study On the Lived Experience of Nursing Care Rendered to Postpartum Women During Childbirth. , Nahid Deghan Nayeri1 , Manookian Arpi1 , Nicholas Yakubu Danzima2*, Alexis Dun Boib Buunaaim2 and Aliyu Tijani1
Study background: Studies have confirmed that the nurse during the period of delivery would be the deciding factor whether the woman would have a positive or negative birth experience. This experience depends on the quality of nursing care during childbirth. Hence it is important to know their lived experience of nursing care during childbirth. This is because patients’ satisfactory of services rendered is a yardstick for measuring quality of care. However, there is no literature on the lived experience of postpartum women regarding the nursing care rendered to them during childbirth in the context of Ghanaian health system. Accordingly, the objective of the study was to discover postpartum women lived experience of nursing care during childbirth. Methods: Using hermeneutic phenomenological method, this study was conducted on 10 women who had given birth for at least six months from the time of childbirth. A purposive sampling technique was used and data was collected through semi-structured interviews which lasted between 30 to 45 minutes. All participants were made to sign a consent form before participating. Data analysis was done using Diekermann, Allen and Tanner method. Results: Analysis of the interview transcripts depicting the women’s lived experience of nursing care rendered to them during childbirth and their encounter with the health facility and other entities revealed three main themes: 1. Being in the world of pregnant women in labor needing emotional, physical and informational support 2. Encounter with the health facility and practices and needing pampering and nice communication 3. Wishing for an environment of congenial and cordial relationship during childbirth. Conclusions and implications for practice: It is recommended that health professionals who nurse pregnant women during childbirth consider their lived experiences regarding nursing care they received during childbith. The theme of Being in the world of pregnant women in labor needing emotional, physical and informational support, Encounter with health facility, and practices and needing pampering and nice communication and Wishing for an environment of congenial and cordial relationship during childbirth should be taking into consideration when nursing them. This will lead to taking care of them according to their preferences, wishes, needs and values which will lead to their satisfaction and hence quality of care.
2 A Heideggerian Hermeneutics Phenomenological Study On the Lived Experience of Nursing Care Rendered to Postpartum Women During Childbirth. , Nahid Deghan Nayeri1 , Manookian Arpi1 , Nicholas Yakubu Danzima2*, Alexis Dun Boib Buunaaim2 and Aliyu Tijani1
Study background: Studies have confirmed that the nurse during the period of delivery would be the deciding factor whether the woman would have a positive or negative birth experience. This experience depends on the quality of nursing care during childbirth. Hence it is important to know their lived experience of nursing care during childbirth. This is because patients’ satisfactory of services rendered is a yardstick for measuring quality of care. However, there is no literature on the lived experience of postpartum women regarding the nursing care rendered to them during childbirth in the context of Ghanaian health system. Accordingly, the objective of the study was to discover postpartum women lived experience of nursing care during childbirth. Methods: Using hermeneutic phenomenological method, this study was conducted on 10 women who had given birth for at least six months from the time of childbirth. A purposive sampling technique was used and data was collected through semi-structured interviews which lasted between 30 to 45 minutes. All participants were made to sign a consent form before participating. Data analysis was done using Diekermann, Allen and Tanner method. Results: Analysis of the interview transcripts depicting the women’s lived experience of nursing care rendered to them during childbirth and their encounter with the health facility and other entities revealed three main themes: 1. Being in the world of pregnant women in labor needing emotional, physical and informational support 2. Encounter with the health facility and practices and needing pampering and nice communication 3. Wishing for an environment of congenial and cordial relationship during childbirth. Conclusions and implications for practice: It is recommended that health professionals who nurse pregnant women during childbirth consider their lived experiences regarding nursing care they received during childbith. The theme of Being in the world of pregnant women in labor needing emotional, physical and informational support, Encounter with health facility, and practices and needing pampering and nice communication and Wishing for an environment of congenial and cordial relationship during childbirth should be taking into consideration when nursing them. This will lead to taking care of them according to their preferences, wishes, needs and values which will lead to their satisfaction and hence quality of care.
3 Impact of The Covid-19 Pandemic On the Activities of the Gynecology-Obstetrics Department of the Ignace DEEN National Hospital of the Conakry CHU. , I S Balde, O Balde, F B Diallo, I Sylla, A II Sow, I T Diallo, T Sy and N Keita
The novel coronavirus pandemic (COVID-19) is the main global health crisis of our time and the greatest threat we have faced in this century. According to the National Agency for Health Security (ANSS), which is the national body for the management of epidemics and pandemics, 12,516 cases of COVID-19 have been confirmed out of 153,609 people tested with 10,879 cured and 74 deaths as of November 11, 2020. The objective of this study was to assess the impact of the COVID-19 pandemic on the activities of the GynecologyObstetrics department of the Ignace Deen National Hospital of the Conakry University Hospital. This was a retrospective, descriptive study from September 13, 2019 to September 12, 2020 on consultation, delivery and hospitalization activities. The study consisted of assessing the impact of the pandemic on the use of the service by patients during the first six (6) months of the pandemic. We recorded the frequency of consultations, deliveries and hospitalizations from September 13, 2019 to March 12, 2020 that we compared to the figures of the same data from March 13, 2020 to September 12, 2020. During the period from September 13, 2019 to March 12, 2020 we recorded 2,732 consultations against 1,358 for the period from March 13 to September 12, 2020 (first six months following the official declaration of the pandemic in Guinea), a decrease of 34.59% (1374 patients). The same remark with a lower proportion this time was made with the deliveries (3,119 during the 6 months preceding the official declaration of the pandemic in Guinea against 2,630 during the first 6 months of the pandemic, ie a decrease of 8.51%) and hospitalization (1,748 patients hospitalized during the 6 months preceding the official declaration of the pandemic in Guinea versus 1501 patients hospitalized during the first 6 of the pandemic, ie a decrease of 7.6%). In this period of the COVID-19 pandemic, we have to recognize a rapid and significant drop in the activities of the gynecology and obstetrics department. 748 patients hospitalized during the 6 months preceding the official declaration of the pandemic in Guinea versus 1501 patients hospitalized during the first 6 of the pandemic, ie a decrease of 7.6%). In this period of the COVID-19 pandemic, we have to recognize a rapid and significant drop in the activities of the gynecology and obstetrics department. 748 patients hospitalized during the 6 months preceding the official declaration of the pandemic in Guinea versus 1501 patients hospitalized during the first 6 of the pandemic, ie a decrease of 7.6%). In this period of the COVID-19 pandemic, we have to recognize a rapid and significant drop in the activities of the gynecology and obstetrics department
4 Vulvar Lesions as A First Manifestation of COVID-19. Case report , Ana Isabel Forte Abad, Alba Torres Cano, Maria Angeles Esteban Moreno, Gabriel Fiol Ruiz and Fatima Amaya Navarro
This case is an atypical manifestation of the COVID-19 disease and may be useful to learn more about the COVID disease.
5 Dydrogesterone is Superior as Luteal Phase Support in selected Previously Failed In-Vitro Fertilisation and Embryo Transfer Patients , Siddhartha Chatterjee, Bishista Bagchi and Arpan Chatterjee
Different forms of exogenous progesterone have been seen to play a very important role in endometrial maturity. Implantation failure appears to be a significant factor in Assisted reproductive technique (ART) procedures. Even a mature endometrium becomes non-receptive, preventing implantation or rejection of implanted embryo in early months of pregnancy. Hence natural micronized progesterone (NMP) and dydrogesterone have been used since decades to improve endometrial maturity and receptivity. The aim of this study was to investigate causes of failed implantation inspite of uneventful Grade I embryo transfer in ART procedure and the role of natural micronized progesterone (NMP) and dydrogesterone for endometrial maturation. 80 women aged range between 25-40 yr old who visited Department of Reproductive Medicine at Calcutta Fertility Mission, over a period of 24 months (January 2017 to December 2019), satisfying the inclusion criteria, were enrolled in this retrospective observational study. Endometrial aspirate histopathology was done during the secretory phase. They were treated with natural micronized progesterone (NMP) or oral dydrogesterone and results of endometrial changes, clinical pregnancy rate, live birth rate and miscarriage rate were statistically analysed.     26.25% and 29.6% of women were seen to have mid-secretory changes of the endometrium after being treated with NMP in one cycle and dydrogesterone in the subsequent cycle, respectively. 62.71% of women had shown early-secretory changes with dydrogesterone which was statistically significant compared to those treated with NMP (p value=0.006).8.5% of these women showed persistent non-secretory endometrium with either of these medications. The Clinical Pregnancy Rate (CPR) was 38.1% and 47% in the group of patients who were treated with NMP and dydrogesterone respectively. Though pregnancy rate was slightly higher in dydrogesterone group, it was not statistically significant (p value = 0.578). 28.5% and 41% women had live births and 9.5% and 5.8% of them had miscarriage in NMP and dydrogesterone group, respectively, though our data appears to be statistically not significant (p value –0.415) (p value – 0.679). In our study 26.25% women had mid-secretory endometrium after treatment with NMP. 29.6% and 62.71% of these women who had non-secretory or early secretory endometrial changes on treatment with intravaginal NMP, showed endometrial mid-secretory and early-secretory changes respectively, on treatment with dydrogesterone, which implies that oral dydrogesterone is superior to NMP when administered for endometrial maturation in selected patients. Clinical pregnancy rate, live birth rate or miscarriage rate were similar with either NMP or dydrogesterone.  
6 Prevalence of Comorbidity and Impact On Survival in Women with Lung, Breast and Cervical Cancer , Madelaine Sarria Castro, Orlando Parellada Joa, Shivani Samlall, Juan Jesus Lence Anta, Priscila Torres Barbie, Solveing Rousseaux Lamothe, Eldier Rodriguez Herrera, Luis Eduardo Martin Rodriguez and Juan Mario Silveira Pablos
Background: The relationship between cancer incidence and mortality, and the resulting comorbidities of the elderly reflects current demographics trends Objective: The study aimed to investigate the prevalence of comorbidities and their impact on survival of women diagnosed with: NSCLC, breast and cervical cancer, at the National Institute of Oncology and Radiobiology in Havana, Cuba. Methods: Data were collected retrospectively from patients' clinical charts. The study involved 138 NSCLC, 1 598 breast cancer and 631 cervical cancer registered during 2007-2011. Comorbidity was classified according to the ICD-10 diagnosis code and was measured using Charlson Comorbidity Index. Associations between comorbidities and mortality by all causes were analyzed in Cox regression models. Results: The highest prevalence of comorbidities was in NSCLC (68.8%). The 3-year OS for NSCLC were 44.5% (95%CI: 29.3–59.7) and 23.3% (95%CI: 13.2–33.4) in patients without and with comorbidity, respectively (p=.01). The 5-year OS for breast cancer in the no comorbidity group was 91.4% (95%CI: 89.6–91.6) compared with 37.2% (95%CI: 32.7-59.9) in the comorbodity group (p=.00). The 5-year OS for cervical cancer in patients without diseases was (55.8% [95%CI: 50.7 – 59.9]), in women with comorbidity (27.7% [95%CI: 15.9–29.5]) (p =.00). Comorbidity was an independent predictor for overall survival: NSCL (HR Adjusted: 2.28 [95%CI: 1.43 - 3.65], p=.000), breast cancer (HR Adjusted: 3.16 [95%CI: 2.69–3.71], p=.000), cervical cancer (HR Adjusted: 1.38 [95%CI: 1.10–1.86], p=.032)   Conclusions: Comorbidity is an important prognostic factor for women diagnosed with lung, breast and cervical cancer.
7 Spontaneous and Successful Pregnancies After Premature Ovarian Insufficiency: Case Series , Lukman Yusuf and Shiferaw Negash
Premature ovarian insufficiency (POI) formerly referred to as premature menopause, premature ovarian failure or primary ovarian failure (POF) implies quantitative and qualitative alterations in the functional integrity of the ovarian follicles leading to irregularity of menses, clinical manifestations of signs and symptoms of menopause and impaired fertility performance. This phenomenon tends to occur in about 1% of the women population in their reproductive years and arbitrarily below the age of 40 years.   We hereby present case series of seven subjects who were specifically complaining of infertility or low fertility from a total of 242 women with presumed diagnosis of premature ovarian insufficiency. These were extracted from a pool of 10,090 clients that were documented over a year’s period i.e. from January 1, 2020 up to December 31, 2020. Our patients achieved spontaneous pregnancies and underwent a normal course of the pregnancies that culminated in uneventful childbirths. The deliveries invariably took place in private setups. We maintained a close contact telemetrically and physically; and followed them up during their course of the delivery and the postpartum period since they were denoted as very high risk pregnancy.   To the best of our knowledge, there is no isolated similar case report or publication in the Ethiopian setting. The objective of the case series presentation is linked with the intention of adding to the world literature highlighting its relevance, desire to create more awareness and establish the basis for further inspiration to develop future undertakings in the understanding of diminished ovarian reserve vis-a-vis premature ovarian insufficiency and spontaneous pregnancy.  
8 Pregnancy on a Rudimentary Unbroken Horn of a Pseudo-Unicornuate Uterus: A Case Report at The University Hospital of Angre Abidjan , Koffi Soh Victor, Kouakou-Kouraogo Ramata, Soro Ngolo Alassane, Akobe Privat, Gbary-Lagaud Eleonore, Effoh Ndrin Denis and Adjoby Cassou Roland
The pseudo-unicornuate uterus which is a rare uterine malformation, that can be the site of a pregnancy. Pregnancies in the rudimentary horn usually result in a rupture due to a uterine wall not adapted to the level of the horn, but especially diagnostic difficulties. Their discovery is most often made in intraoperative, when an indication of laparotomy is made for hemoperitoneum in emergency. They are therefore responsible for high maternal-fetal mortality and morbidity. We report in this observation a case of pregnancy in a rudimentary unruptured horn, in a 28-year-old, 4th gesture 2nd parous, the discovery of which was made incidentally, during an indication of qlaparotomy posed for suspected abdominal pregnancy complicated by a surgical abdomen
9 Outcome of Pregnancies During COVID-19 Infection: 7 Cases Report at The University Hospital of Angre/Abidjan , Koffi Soh Victor, Gbary Lagaud Eleonore, Loba Okoin Paul Jose, Akobe Privat, Soumahoro Zingbe Gondo, Kouakou-Kouraogo Ramata, Aye Yikpe Denis and Adjoby Cassou Roland
The third coronavirus outbreak (SARS-CoV-2) after SARS-COV in 2003 in China and MERSCOV in 2012 in the Middle East, which occurred in December 2019 in China, spread rapidly to all countries of the world bringing the World Health Organization (WHO) to declare a pandemic on March 11, 2020. This condition, in addition to its low lethality in young people, remains a psychosis for the general population. Current data on COVID-19 and pregnancy have evolved significantly, so the outcome of Covid-19 pregnancies is unpredictable and varies from woman to woman. Through the first 7 observed cases of COVID-19 during pregnancy for 2170 births at the Teaching Hospital of Angre during 1 year, from April 2020 to March 2021, the authors wanted to expose the outcome of these pregnancies. The management was carried out in collaboration with the Department of Infectious and Tropical Diseases (DITD), we observed: 1 spontaneous abortion, 2 low-birth by induction, 2 cesarean sections, 2 gestants died in a context of acute respiratory distress (1 during pregnancy and the other postpartum).
10 Impact of The Covid-19 Pandemic On the Activities of the Gynecology-Obstetrics Department of the Ignace DEEN National Hospital of the Conakry CHU. , I S Balde, O Balde, F B Diallo, I Sylla, A II Sow, I T Diallo, T Sy and N Keita
The novel coronavirus pandemic (COVID-19) is the main global health crisis of our time and the greatest threat we have faced in this century. According to the National Agency for Health Security (ANSS), which is the national body for the management of epidemics and pandemics, 12,516 cases of COVID-19 have been confirmed out of 153,609 people tested with 10,879 cured and 74 deaths as of November 11, 2020. The objective of this study was to assess the impact of the COVID-19 pandemic on the activities of the GynecologyObstetrics department of the Ignace Deen National Hospital of the Conakry University Hospital. This was a retrospective, descriptive study from September 13, 2019 to September 12, 2020 on consultation, delivery and hospitalization activities. The study consisted of assessing the impact of the pandemic on the use of the service by patients during the first six (6) months of the pandemic. We recorded the frequency of consultations, deliveries and hospitalizations from September 13, 2019 to March 12, 2020 that we compared to the figures of the same data from March 13, 2020 to September 12, 2020. During the period from September 13, 2019 to March 12, 2020 we recorded 2,732 consultations against 1,358 for the period from March 13 to September 12, 2020 (first six months following the official declaration of the pandemic in Guinea), a decrease of 34.59% (1374 patients). The same remark with a lower proportion this time was made with the deliveries (3,119 during the 6 months preceding the official declaration of the pandemic in Guinea against 2,630 during the first 6 months of the pandemic, ie a decrease of 8.51%) and hospitalization (1,748 patients hospitalized during the 6 months preceding the official declaration of the pandemic in Guinea versus 1501 patients hospitalized during the first 6 of the pandemic, ie a decrease of 7.6%). In this period of the COVID-19 pandemic, we have to recognize a rapid and significant drop in the activities of the gynecology and obstetrics department. 748 patients hospitalized during the 6 months preceding the official declaration of the pandemic in Guinea versus 1501 patients hospitalized during the first 6 of the pandemic, ie a decrease of 7.6%). In this period of the COVID-19 pandemic, we have to recognize a rapid and significant drop in the activities of the gynecology and obstetrics department. 748 patients hospitalized during the 6 months preceding the official declaration of the pandemic in Guinea versus 1501 patients hospitalized during the first 6 of the pandemic, ie a decrease of 7.6%). In this period of the COVID-19 pandemic, we have to recognize a rapid and significant drop in the activities of the gynecology and obstetrics department.
11 Vulvar Lesions as A First Manifestation of COVID-19. Case report. , Ana Isabel Forte Abad, Alba Torres Cano, Maria Angeles Esteban Moreno, Gabriel Fiol Ruiz and Fatima Amaya Navarro
This case is an atypical manifestation of the COVID-19 disease and may be useful to learn more about the COVID disease.
12 Choosy Corona: Females are at an Advantage , P D Gupta
Tiny Corona has no brain but still it is very choosy, it does not infect equally to all the human population. It infects more men than women more older population than younger one. There are reasons for that. Men are on the priority list because of certain reasons; if they are bald more venerable. However, the subjects who are carrying blood group ‘O’ they can be spared. Bald man with blood group ’A’ is worst hit. It is not yet certain but data show that sex steroid hormones and X chromosome products are able to keep this virus away besides immunity, life style, environment and genetic reasons. Strong immunity can certainly fight with this virus as it does for all infections.
13 COVID-19 and Preeclampsia , Mufareh Asiri
COVID-19 is RNA virus with many systemic effects, including hypertension. Preeclampsia leads to maternal and fetal morbidity and mortality. In addition, Preeclampsia and COVID -19 aggravate the risk of ICU admission and maternal death.
14 Ginsenoside Rg3 Inhibit The Proliferation And Metastasis of Cervical Cancer Cells in Vitro By Regulating NF-κB Signaling Pathway , Keli You and Haiyan Ye
Objective: To investigate the effect and mechanism of ginsenoside Rg3 on the proliferation and metastasis of cervical. Methods: Cervical cancer cells HeLa were treated with different concentrations (0, 0.12, 0.24, 0.48 mmol/L) of ginsenoside Rg3, and then the survival rate of HeLa cells was detected by CCK-8 method, and the migration and invasion of HeLa cells were assessed using Transwell test, and expression of E-cadherin, N-cadherin, vimentin, Toll receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), phosphorylated nuclear transcription factor κB p65 (P-NF-κB p65) proteins were calculated by Western blot. Results: After ginsenoside Rg3 (0.12, 0.24, 0.48 mmol/L) treatment, the survival rate, migration number, invasion number, and N-cadherer number, and N-cadherin, Vimentin, TLR4, MyD88, p-NF-κB p65 protein expression of HeLa cells were significantly reduced (P<0.05) Ginsenoside protein expression was significantly increased (P<0.05), and showed a concentration-dependent relationship. Conclusion: Ginsenoside Rg3 could inhibit the proliferation and metastasis of cervical cancer cells in vitro, and its mechanism might be related to the inhibition of NF-κB signaling pathway.
15 Maternal Continuum of Care as Independent Determinants for Timely Initiation of Modern Contraceptive Methods Utilization Among Postnatal Women in Arba Minch Zuria District, Southern Ethiopia , Dereje Haile
Background: Initiation of family planning use during the postpartum period is crucial for both maternal and child health. Moreover, this period is the extension of maternal health care and its level of uptake is built up on the level of continuum of care of maternal health care utilization. Continuum of maternal health care including, antenatal care, skilled delivery and postnatal care is crucial for women’s reproductive health. Despite that, there was no data regarding with the importance of continuum of care of maternal health care on the postpartum modern contraceptive utilization. Thus, the aim of this study was to assess the association of the continuum of maternal care on subsequent timely use of postpartum family planning. Methods: a community based cross sectional study was employed on 828 women. A multistage sampling technique was used to enroll the study participants. The data were collected by a semi-structured and pretested, face-toface, interviewer administered questionnaire. Data were entered into EpiData 3.1 and analyzed by using SPSS 23 software. Bivariate and multivariable logistic regression analyses were used to declare the association between dependent and independent variables. Odds ratio, its 95% confidence interval (CI) and P-value <0.05 were used to determine the significance level. Results: the prevalence of timely initiation of postpartum contraceptive methods was 16.1%. Having of postpartum care (AOR: 2.0(95%CI: 1.2, 3.2)), completion of delivery level continuum of care (AOR: 2.9(95%CI: 1.4, 6.1)), and completion of postnatal level continuum of care (AOR: 4.0(95%CI: 2.0, 7.8)) were factors of timely intuition of postpartum contraceptive methods. Conclusion and recommendation: The prevalence of timely initiation of postpartum contraceptive methods was low. The finding of this study implies that the need of strengthening the connection between maternal continuum of care and reproductive components of continuum of care.
16 Pregnancy on a Rudimentary Unbroken Horn of a Pseudo-Unicornuate Uterus: A Case Report at The University Hospital of Angre Abidjan , Koffi Soh Victor, Kouakou-Kouraogo Ramata, Soro Ngolo Alassane, Akobe Privat, Gbary-Lagaud Eleonore, Effoh Ndrin Denis and Adjoby Cassou Roland
The pseudo-unicornuate uterus which is a rare uterine malformation, that can be the site of a pregnancy. Pregnancies in the rudimentary horn usually result in a rupture due to a uterine wall not adapted to the level of the horn, but especially diagnostic difficulties. Their discovery is most often made in intraoperative, when an indication of laparotomy is made for hemoperitoneum in emergency. They are therefore responsible for high maternal-fetal mortality and morbidity. We report in this observation a case of pregnancy in a rudimentary unruptured horn, in a 28-year-old, 4th gesture 2nd parous, the discovery of which was made incidentally, during an indication of laparotomy posed for suspected abdominal pregnancy complicated by a surgical abdomen.
17 Management of PPH (Placental Site Bleeding) by a Direct Haemostatic Suture in True PPH during Caesarean section: A New Approach , Dr. Sadhna Mathur, Dr. Megha Solanki, Dr. Komal Yadav and Dr. Shubham Mehtani
This study includes 20 cases of PPH seen during Caesarean section by a single surgeon Dr. Sadhna Mathur during the last 11 years where this hemostatic suture was used to control PPH from placental site in uterine cavity, after the medical measures failed to control the bleeding from placental site (uterine cavity). The bleeding point was localized and a haemostatic suture in the overlying uterine musculature was applied. It was found to be completely effective hence it is being shared through this paper
18 Ectopic Pregnancy - Is It Always a Threat to A Woman’s Life? , Marcin Przybylski, Klaudia Kotynia and Victoria MusiaÅ‚owicz
Ectopic pregnancy is a condition in which the fertilized ovum implants outside the uterus or attaches to an abnormal portion of the uterus, like cervix, cornea, myometrium. Such state occurs in 2% of all reported pregnancies. There are plenty of risk factors for this state. Fallopian tube surgery in the past, pelvic inflammatory disease is one of them. Undiagnosed ectopic pregnancy may lead to serious complications, like rupturing of the fallopian tube and massive internal bleeding. We would like to present a case, in which the patient was not aware of being pregnant, until she got the histopathology results after laparoscopic surgery because of tumor in the rectouterine pouch.
19 Acute Fatty Liver of Pregnancy Presenting as Fulminant Hepatic Failure: An Uncommon Disease , Richmond Ronald Gomes
Acute Fatty Liver of Pregnancy (AFLP), though rare, is an obstetric emergency which carries a high incidence of maternal and perinatal mortality, despite optimal care. It is a catastrophic disease affecting women in the third trimester of pregnancy or in the post-partum period. It is usually a diagnosis of exclusion and requires a strong index of suspicion for a timely diagnosis and prompt intervention. We report a case of 24-year-old prime at 34- week gestation, presented with malaise, nausea, vomiting, jaundice, disorientation and absent fetal movements. Intrauterine death of fetus occurred. Supportive management in an intensive care unit resulted in successful outcome. By this case report we once again wish to emphasize the value of a timely diagnosis with a high level of clinical suspicion and supportive laboratory investigations including imaging; the need for early termination of pregnancy; and adequate supportive care as the key management options for AFLP. Further, we wish to explore the current treatment options available for AFLP and discuss a few novel therapeutic strategies such as plasma exchange in treating such cases and the pros and cons associated with these treatment modalities.
20 Barriers to Respectful Maternity Care from Mother’s, Provider’s and Administrator’s Perspective: An Exploratory Qualitative Study , Yonas Azanaw Wubetu, Nigissie Tadesse Sharew and Osman Yimer Mohammed
Respectful maternity care (RMC) is an approach to care based on personal choice and preferences, which supports and promotes, and doesn’t undermine a person’s self-respect [1]. During the past three decades, maternal mortality has decreased nearly by half but is still alarmingly high, particularly in sub-Saharan African countries. More than half of maternal mortality is associated with poor quality of care, and most maternal mortality is preventable if timely quality maternity care is delivered and evidence-based action is taken [2-4]. Responding to this, the 2030 Sustainable Development Goals include reducing the maternal mortality rate below 77 per 100,000 live births and eliminating all forms of violence against women, particularly during labor and delivery [5]. The mistreatment of women during institutional delivery could be an obstacle to these ambitious goals, especially in a low-income country like Ethiopia[6].
21 Perception of Post-Partum Women Towards Birth Companions at a Tertiary Hospital and its Catchment Health Centers in Addis Ababa, Ethiopia , Kidist Gizachew, Tewodros Getinet and Delayehu Bekele
Background: Birth companion refers to a person who provides support to laboring women during child birth. Various studies have shown the benefits of birth companions. The objective of this study was to assess the attitude of mothers towards the involvement of birth companions during child birth at St Paul’s Hospital Millennium Medical College (SPHMMC) and its selected catchment health centers. Methodology: The study used a cross-sectional study to determine the perception of postpartum mothers on the involvement of birth companions during child birth. Result: The study included a total of 393 postpartum women. The finding from the study showed majority of the post-partum women (98.7%) were not allowed to have companions during labor. Among postpartum women 27.3 % has negative attitude towards involvement of birth companions. The commonest reasons mentioned by postpartum women for having negative attitude to this practice included need for privacy, religious values and fear of overburdening family members with stress. Conclusion: The findings from this study showed that majority of women were denied the option of having a birth companion. The study has also shown the desire to have birth companion isn’t universal among laboring women in our setup. There is a need to understand the socio-cultural values of the community before embarking on widespread implementation of involvement of birth companions.
22 Drug Susceptibility Pattern and Associated Factors of Bacteria Isolated from Urinary Tract Infection among Pregnant Women Attending Antenatal Care in Teaching Referral Hospital, Southeast Ethiopia , Eshetu Nigussie, Meseret Mitiku, Alelign Tasew, Biniam Sahiledengel, Damtew Solomon, Habtamu Gezahegn, Aklil Astatike and Getahun Negash
Background: Urinary tract infection (UTI) is caused by bacteria from the digestive tract which climbs the opening of the urethra and begins to multiply to cause infection. UTI in pregnancy is associated with significant morbidity for both mother and baby. In most developing countries including Ethiopia, screening for UTI in pregnancy is not considered an essential part of Antenatal Care. This study aimed to assess the bacterial profile and antibiotic susceptibility pattern and associated risk factors among pregnant women in Madda Walabu University Goba Referral Hospital, Southeast Ethiopia. Methods: An institution-based cross-sectional study was conducted from June-August, 2020 . A total of 234 pregnant women were enrolled; data were collected using a structured questionnaire by a trained interviewer. Urine samples were collected from all pregnant women and culture on cysteine lysine electrolytes deficiency medium. Data were analyzed using SPSS 20.0. Descriptive statistics were used to explain the study participants with relevant variables. Logistic regression was used for data comparison. P-value <0.05 was accepted as statistically significant. Results: The overall prevalence of UTI was 23.9% among both asymptomatic and symptomatic groups. Of this screened midstream urine samples showed that 16% and 32.2%, had significant bacteriuria in the asymptomatic and symptomatic groups respectively. The prevalence of UTI was significantly associated with previous history of catheterization and urinary tract infection (p<0.05). E. coli was the most frequently isolated organism (42.9%) followed by coagulase-negative Staphylococcus (26.8%), and S. aureus (12.5%). Gram-negative and Gram-positive bacteria accounted for (59%) and (41%) respectively. Gram-negative isolates showed resistance to ampicillin, naldixic acid and trimethoprim/sulfamethoxazole. Also, all Gram-negative bacterial isolates revealed a high level of resistance against trimethoprim/sulfamethoxazole. Conclusion: Significant bacteriuria has been observed from both symptomatic and asymptomatic pregnant women.The majority of the isolates were resistant to commonly prescribed antibiotics. This calls for an early screening of all pregnant women for UTI and those found to be infected need treatment with an appropriate drug to avoid complications.
23 High Risk Behavior, Knowledge and Attitudes of Adolescent Health: A Study from Rajshahi City Corporation Area of Bangladesh. , Rashed Alam and Tapan Kumar Roy
Background: Adolescence is one of the most dynamic stages of human growth and development. It is an important issue in Bangladesh as well as in the world. Reproductive health of adolescents is strongly affected by sociodemographic factors. The purpose of this study was to establish the factors that influence on high-risk behavior, knowledge and attitudes of adolescent, which were regarded as determinants. Data and Methods: Socio-demographic, health related behavior was collected from 1084 adolescence girls in Rajshahi City Corporation (RCC) area, Bangladesh. Bivariate analysis has been used to show the association between the reproductive health knowledge with some socio-demographic and health related characteristics. In multivariate analysis, binary logistic regression analysis was used to determine the effects of the various factors to reproductive health knowledge among female adolescent. Findings: Education is an important determinant of adolescent health. Most the respondent is secondary level of education, which was 64.2%. The study result shows that 37.6% adolescent girl has knowledge about adolescent health care. It also shown that very few numbers of adolescent have idea about abortion, reproductive health knowledge about pregnancy avoids method and family planning method but maximum respondent heard about idea about sex, marriage and knowledge about HIV/AIDS. Logistic regression analysis findings specify that respondent in the age group 15-19 years is more expected to in turn ever having accomplished knowledge about adolescent health. Sexual violence is directly related to the duration of marriage. Married respondents have 0.221 (27.9%) times lower experienced to knowledge about adolescent health than that of the unmarried respondents. Conclusion: This study needs to strengthen public-private sector partnership and stakeholder participation, active involvement of adolescents in their reproductive health matters. Respondent educational qualification has positively significant effect on knowledge about adolescent reproductive health. Age of respondents, Idea about pregnancy, Idea about abortion, Physical problem during menstruation, knowledge about pregnancy has also significant effect on knowledge about adolescent reproductive health. The most effective interventions are probably structural changes to improve people daily life with families and peers and access to improve education.
24 Prevalence, Risk Factors and Management of Hypertensive Disorders of Pregnancy Among Pregnant Women in University of Benin Teaching Hospital, Benin City, Nigeria , Rosemary Ngozi Osunde
Background: This facility-based retrospective cross sectional design study examined the prevalence, risk factors and management of hypertensive disorders of pregnancy among pregnant women attending antenatal clinic in the University of Benin Teaching Hospital, Benin City Materials and Methods: A stratified proportionate sampling technique were adopted to review a total of 358 secondary data of patients who were managed for hypertensive disorders of pregnancy from June 2015 – June 2020 in the study institution. Data were analyzed using descriptive statistics, multinomial regression analysis at 0.05 the level of significance for all measured variables. Results: The mean ± SD = 31.15 ± 5.954 years. More than half 60.3% of them were multigravida. 60.1% were in second trimester. Mean BP at booking was 146/95 mmHg. 56.1% were overweight while 17.6% were obese. The mean ± SD ANC visits was 10.71 ± 5.411 times. The five-year prevalence rate of hypertensive disorders of pregnancy among pregnant women in the study setting is 10.9%. Conclusion: There is high prevalence of HDP in the study institution with preeclampsia most prevalent. Therefore, we strongly recommend the utilization of screening tools for the prediction, early diagnoses as well as timely intervention HDP
25 Evaluation of the Impact of Educational Status and Cultural Beliefs on the Health Seeking Behavior of Women with Obstetric Fistula in South-South and South Eastern Nigeria , Peters Grace E, Ononokpono N Dorathy, Assi, Victor E and Oko Nnabuike E
Background: Obstetric fistula is a serious health problem affecting women in low and middle-income countries. It continues to exist in Nigeria because the health care system has failed to provide quality, accessible and affordable maternal health care including family planning, skilled care at birth, basic and comprehensive emergency obstetric care and inadequate access to treatment of obstetric fistula cases. The purpose of this study was to evaluate the impact of educational status and cultural beliefs on the health seeking behavior of women with obstetric fistula in South-South and South Eastern Nigeria. Methods: This was a cross-sectional study. Non-probability sampling involving purposive and simple random sampling technique was adopted in the selection of one hundred and fifty (150) post-operative patients. The data was analyzed using thematic analysis frequency tables and percentage distribution. Results: The findings were that educational status and cultural belief exert significant influence on the health seeking behavior of women with obstetric fistula. Conclusion: The study indicated that obstetric fistula is a major reproductive health challenge affecting women of childbearing age in Nigeria. Based on the findings of the study, educational status and cultural belief of women with obstetric fistula are the major serious challenges to health seeking behaviour of the women with Vesico-vaginal fistula (VVF). It was therefore recommended that more awareness on obstetric fistula should be created using strategies such as sex education programmed in secondary schools and churches so as to educate them on issues concerning obstetric fistula as well as health talk on VVF for youths.
26 Need for Intrapartum Laila Khalid, Azriny S Khalid and Hibah RashidAntibiotic Prophylaxis in Women with Prior History of Group B Streptococcus Carriage , Laila Khalid, Azriny S Khalid and Hibah Rashid
The incidence of early onset neonatal GBS(EOGBS) disease in the UK and Ireland is 0.57/1000 births. Intrapartum antibiotic prophylaxis (IAP) reduces the risk. Previous colonisation is associated with 50% carriage in the current pregnancy. In these women, RCOG recommends IAP with a history of neonatal infection, otherwise offering the option of screening at 35-37 weeks. In Ireland, there is no national consensus on IAP in prior GBS colonisation. Currently at University Hospital Waterford (UHW), all women with prior GBS colonisation receive IAP. Studies examining the use of point-of-care testing have shown reduction in the use of IAP and EOGBS rates. We aimed to examine the screening and IAP administration in maternal prior GBS colonisation and the incidence of GBS in this cohort in UHW. Data was collected retrospectively from laboratory, medical records and electronic patient manager systems. Women who received IAP between 1stJuly 2020 and 31stDecember 2020 were identified. Women who received IAP for current and prior GBS colonisation were included. Women who received IAP for preterm labour, preterm prelabour rupture of membranes and pyrexia in labour were excluded. Ninety-two women with current or prior GBS colonisation received IAP, of which only 15(16.30%) were current and 77(83.69%) were prior GBS colonisation. In women with prior GBS colonisation, 49(63.63%) were screened, 3/49(6.12%) were positive, 28 were not screened. Seventy-eight (84.78%) received benzyl-penicillin. Six (6.52%) received clindamycin. Twenty-two (23.91%) babies were admitted to the Neonatal Unit, however, only one cultured positive for gram-positive cocci. The incidence of EOGBS in this cohort is low. A risk-based approach or point-of-care testing should be considered to reduce unnecessary IAP administration.