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Fertility and Sterility Aug 2022To study the efficacy of 3 treatment options for type 2 cesarean scar pregnancy (CSP) and establish an optimal treatment strategy for type 2 CSP.
OBJECTIVE
To study the efficacy of 3 treatment options for type 2 cesarean scar pregnancy (CSP) and establish an optimal treatment strategy for type 2 CSP.
DESIGN
Retrospective cohort study.
SETTING
A tertiary hospital.
PATIENTS
The study examined 160 women with type 2 CSP.
INTERVENTIONS
Ultrasound-guided vacuum aspiration after local injection of lauromacrogol, ultrasound-guided vacuum aspiration after uterine artery embolization (UAE), and transabdominal resection or hysteroscopy combined with laparoscopic resection.
MAIN OUTCOME MEASURES
The success rates, duration of hospitalization, hospitalization cost, amount of blood loss, recovery time, and menstruation resuming after recovery.
RESULTS
The success rates of the UAE, lauromacrogol, and surgical groups were 87.1%, 92.5%, and 95.5%, respectively, with no significant differences. The cost and duration of hospitalization in the lauromacrogol group were significantly lower than those in the UAE and surgical groups. Analysis of the causes of treatment failure revealed a significant difference in the gestational age. The area under the receiver operating characteristic curve was 0.660 (95% confidence interval, 0.533-0.788). When the gestational age was 48.5 days, Youden index was the highest. Furthermore, when the diagnostic thresholds were selected as 49, 56, and 63 days of pregnancy, the corresponding areas under the receiver operating characteristic curve were 0.652, 0.541, and 0.510, respectively.
CONCLUSION
Ultrasound-guided vacuum aspiration after local injection of lauromacrogol is recommended for patients with type 2 CSP at <49 days of gestation. Laparotomy or laparoscopy combined with hysteroscopy is suitable for patients with gestation of >49 days, especially for those with >56 days of gestation.
Topics: Cesarean Section; Chorionic Gonadotropin, beta Subunit, Human; Cicatrix; Female; Humans; Polidocanol; Pregnancy; Pregnancy, Ectopic; Retrospective Studies; Treatment Outcome; Uterine Artery Embolization
PubMed: 35691718
DOI: 10.1016/j.fertnstert.2022.04.029 -
Cureus Dec 2023Background There is no sound evidence for the association of blood groups with the risk of endometriosis, and no studies from Saudi Arabia have examined this...
Background There is no sound evidence for the association of blood groups with the risk of endometriosis, and no studies from Saudi Arabia have examined this association. Therefore, the primary aim was to determine whether there is an association between the distribution of ABO and Rh blood groups and the incidence of endometriosis in a cohort from Saudi Arabia and also to evaluate the potential risk factors related to endometriosis among the population. Methods This case-control study included women diagnosed with endometriosis (n = 44) who presented to King Abdulaziz University Hospital Obstetrics and Gynecology Clinic, Jeddah, Saudi Arabia, between 2010 and 2021. Women from the blood donors database of King Abdulaziz University Hospital were included as a control group (n = 184). The total sample size was 228. Demographic data, diagnosis method, ABO blood type, and Rh blood type were obtained from hospital records. In addition, data were collected from self-reported questionnaires, which included family history, dysmenorrhea, age of menarche, age of childbearing, number of children, history of abortion, parity, number of children, use of oral contraceptives for alleviating dysmenorrhea, iron deficiency, duration of menstrual flow, and volume of bleeding during menses. Odds ratio, Pearson chi-squared test (χ2), and independent t-test were used to analyze the associations between variables. Results Most of the participants had blood type O (n = 117, 51.3%), which was followed by blood type A (n = 59, 26.0%), and the majority were Rh+ (n = 215, 94.3%). There was no significant difference in the risk of endometriosis according to ABO (P = 0.237) and Rh (P = 0.283) blood types. However, endometriosis was found to have a significant relationship with dysmenorrhea, heavy bleeding during menses, history of abortion, long duration of menstrual flow, lower number of children, late pregnancy, and use of oral contraceptive pills to relieve dysmenorrhea (p ≤ 0.05). Conclusions The present results indicate that ABO and Rh blood types are not associated with the risk of endometriosis. However, there was a strong, significant association between endometriosis and other factors.
PubMed: 38283422
DOI: 10.7759/cureus.51268 -
Journal of Women's Health (2002) Jan 2022The coronavirus disease 2019 (COVID-19) pandemic has introduced acute and persistent psychosocial stressors for many individuals, with emerging gender differences that...
The coronavirus disease 2019 (COVID-19) pandemic has introduced acute and persistent psychosocial stressors for many individuals, with emerging gender differences that suggest women may be at greater risk for poorer mental health outcomes. This may have unintended consequences for women's overall health and well-being, including disruptions to reproductive function as elevated stress is often associated with menstrual cycle irregularities. The objective of this study was to determine if and how the COVID-19 pandemic and its related stressors have impacted women's menstrual cyclicity. An online survey instrument designed to capture self-reported information on menstrual cycle changes and perceived stress levels was distributed between July and August 2020. A total of 210 women between the ages of 18-45 years met stringent inclusion and exclusion criteria and completed the survey. Of the 210 respondents, more than half (54%) reported changes in their menstrual cycles. These included changes in menstrual cycle length (50%), the duration of menses (34%), and changes in premenstrual symptoms (50%). Respondents with high perceived stress scale (PSS) scores during Covid were more likely to experience a longer duration of menses ( < 0.001) and heavier bleeding during menses ( = 0.028) compared with those with moderate Covid PSS scores. By uncovering a trend in increased menstrual cycle irregularities during the early months of the COVID-19 pandemic, this study contributes to our understanding of the implications that the pandemic may have on women's reproductive health.
Topics: Adolescent; Adult; COVID-19; Cross-Sectional Studies; Female; Humans; Menstrual Cycle; Middle Aged; Pandemics; Periodicity; SARS-CoV-2; Surveys and Questionnaires; Young Adult
PubMed: 34582731
DOI: 10.1089/jwh.2021.0158 -
The Journal of Obstetrics and... Nov 2021To evaluate the efficacy and safety of autologous platelet-rich fibrin (PRF) for the treatment of infertility with intrauterine adhesions. (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
To evaluate the efficacy and safety of autologous platelet-rich fibrin (PRF) for the treatment of infertility with intrauterine adhesions.
METHODS
Forty patients who suffered from infertility with intrauterine adhesions (IUAs) were enrolled in this prospective trial from October 2018 to December 2019. They were randomly divided into a PRF group and a control group. Both groups underwent transcervical resection of adhesions (TCRA) during the follicular phase. PRF group: PRF prepared from autologous venous blood was placed in the uterine cavity after TCRA and after the first menstrual re-fluid; control group: no PRF insertion. After the second menstrual re-fluid, both groups underwent hysteroscopy to reevaluate adhesion severity. Pregnancy rate, intrauterine adhesion score, menstrual volume and duration, and endometrial thickness were assessed and adverse events were recorded.
RESULTS
(1) PRF group pregnancy rate was significantly higher than the control group (55.0% vs. 20.0%). Mean follow-up time was (17.63 ± 2.33) months. All patients fell pregnant naturally. Four (PRF) and one (control) patients delivered live births without placental complications. (2) Intrauterine adhesion scores decreased compared with treatment-before. (3) In the pictorial blood loss assessment chart, score and menstrual duration during the 3rd menstrual cycle showed significant improvements for both groups. (4) Endometrial thickness also showed an increasing trend, and subendometrial bloodflow improved. (5) No treatment-related serious adverse events were noted.
CONCLUSION
Placing PRF into the uterine cavity of infertility patients with IUAs following TCRA is a safe and effective therapeutic method.
Topics: Female; Humans; Hysteroscopy; Infertility; Placenta; Platelet-Rich Fibrin; Pregnancy; Prospective Studies; Tissue Adhesions; Uterine Diseases
PubMed: 34482587
DOI: 10.1111/jog.14964 -
Sleep Advances : a Journal of the Sleep... 2023To explore the relationship among night-time smartphone use, sleep duration, sleep quality, and menstrual disturbances in young adult women.
STUDY OBJECTIVES
To explore the relationship among night-time smartphone use, sleep duration, sleep quality, and menstrual disturbances in young adult women.
METHODS
Women aged 18-40 years were included in the in which they objectively tracked their smartphone use via the app between self-reported sleep onset and offset times ( = 764) and responded to a survey ( = 1068), which included background characteristics, sleep duration, sleep quality (Karolinska Sleep Questionnaire), and menstrual characteristics (International Federation of Gynecology and Obstetrics' definitions).
RESULTS
The median tracking time was four nights (interquartile range: 2-8). Higher frequency ( = .05) and longer duration ( = .02) of night-time smartphone use were associated with long sleep duration (≥9 h), but not with poor sleep quality or short sleep duration (<7 h). Short sleep duration was associated with menstrual disturbances (OR = 1.84, 95% confidence interval [CI] = 1.09 to 3.04) and irregular menstruation (OR = 2.17, 95% CI = 1.08 to 4.10), and poor sleep quality was associated with menstrual disturbances (OR = 1.43, 95% CI = 1.19 to 1.71), irregular menstruation (OR = 1.34, 95% CI = 1.04 to 1.72), prolonged bleedings (OR = 2.50, 95% CI = 1.44 to 4.43) and short-cycle duration (OR = 1.40, 95% CI = 1.06 to 1.84). Neither duration nor frequency of night-time smartphone use was associated with menstrual disturbances.
CONCLUSIONS
Night-time smartphone use was associated with longer sleep duration, but not with menstrual disturbances in adult women. Short sleep duration and sleep quality were associated with menstrual disturbances. Further investigation of the effects of night-time smartphone use on sleep and female reproductive function in large prospective studies is needed.
PubMed: 37193274
DOI: 10.1093/sleepadvances/zpad013 -
Journal of Obstetrics and Gynaecology :... Feb 2020The aim of this study was to investigate the relationship between stature and menstrual pattern. Nine hundred and seventy six girls were selected from regions within two...
The aim of this study was to investigate the relationship between stature and menstrual pattern. Nine hundred and seventy six girls were selected from regions within two cities in north-eastern Iran in 2015. They were assessed with respect to: their stature and menstrual pattern, age of menstruation, severity of dysmenorrhoea, duration of their menstrual cycle and flow. 841 girls had experienced menarche. 10.5% had a short stature. There were significant differences in age, height, weight and body mass index between those who had experienced their first menstrual cycle and others ( < .001). There were weak and negative correlation between age of menarche and height percentiles ( = -0.12, < .001). Premenstrual syndrome, duration of menstruation cycle and bleeding period did not differ between these two groups ( > .05). We found that dysmenorrhoea was significantly influenced by height. Although the mean age at menarche was statistically significant among different statures, the range was narrow (12.2-12.7). Further studies considering environmental factors, including socioeconomic status and nutrition concurrently, are also required.Impact statement Various menstrual characteristics, including age of menarche, severity of dysmenorrhoea and duration of menstrual period may be associated with height. But, there have been few studies on the relationship between short stature and its impact on health status and menstrual patterns in adolescents. There were significant differences in age, height, weight and body mass index between adolescent girls who had experienced their first menstrual cycle, and others. There were weak, negative, significant correlations between age of menarche and height percentiles. Dysmenorrhoea was significantly influenced by height. Life style modification and nutritional interventions that optimise the height of girls may resolve their menstrual problems and dysmenorrhoea.
Topics: Adolescent; Age Factors; Body Height; Case-Control Studies; Cohort Studies; Cross-Sectional Studies; Dysmenorrhea; Female; Humans; Iran; Menarche; Menstrual Cycle; Premenstrual Syndrome
PubMed: 31339388
DOI: 10.1080/01443615.2019.1621806 -
Therapeutic Advances in Gastroenterology 2020Many female inflammatory bowel disease (IBD) patients report symptoms exacerbation before and during menses. Our aim was to characterize their symptoms and specific risk...
BACKGROUND AND AIM
Many female inflammatory bowel disease (IBD) patients report symptoms exacerbation before and during menses. Our aim was to characterize their symptoms and specific risk factors in comparison with healthy controls.
METHODS
Female IBD patients aged 18-50 years were asked to fill out a questionnaire recording their demographic and disease characteristics, menstruation history and symptoms. Disease activity was defined by Harvey-Bradshaw index (HBI) for Crohn's disease (CD) patients and modified mayo score for ulcerative colitis (UC) patients. Healthcare providers answering an internet survey assessing bowel symptoms during menstruation served as healthy controls.
RESULTS
A total of 139 IBD patients, of whom 100 were CD patients, filled the questionnaire. The mean age was 30.4 [±7.7 standard deviation (SD)], mean disease duration was 7.8 (±6 SD), mean HBI was 4.7 (±3.8 SD), and mean Mayo score was 2.1 (±2.5 SD). A change in bowel habits during menstruation was reported by 72% of CD patients compared with 56% of UC patients ( = 0.07). Out of 258 healthy controls, 93% reported a change in bowel habits during menstruation compared with 68% of IBD patients ( < 0.001). However, other abdominal and constitutional symptoms were significantly more prevalent among IBD patients compared with healthy controls ( < 0.01 for most parameters). Smoking status, biologic treatment, and previous abdominal operation were found to significantly aggravate symptoms during menses in IBD patients.
CONCLUSION
IBD patients experience various symptoms during menses significantly more commonly than healthy women. Smoking, biologic treatment, and previous abdominal operations are risk factors for higher symptomatic burden. Following future validation and research, these results can help in patients' risk stratification and possibly in risk reduction.
PubMed: 32577133
DOI: 10.1177/1756284820929806 -
Psychosomatic Medicine Oct 2020Amenorrhea is a disabling medical consequence of anorexia nervosa (AN); therefore, resumption of menses (ROM) represents an important goal in the treatment for these...
OBJECTIVE
Amenorrhea is a disabling medical consequence of anorexia nervosa (AN); therefore, resumption of menses (ROM) represents an important goal in the treatment for these patients. The aim of the present study was to evaluate possible clinical, psychopathological, and biological predictors of ROM, including age, body mass index (BMI), AN subtype, childhood abuse, duration of illness, general and eating disorder (ED)-specific psychopathology, and sex hormones.
METHODS
Fifty amenorrheic patients with AN were enrolled. Baseline clinical data and information on childhood abuse were collected. Questionnaires to evaluate general and ED-specific psychopathology were administered, and blood samples were drawn. All patients received treatment as usual and underwent regular follow-up visits for 4 years or until ROM. Time to ROM, BMI at last evaluation, and data regarding diagnostic crossover into bulimia nervosa were collected.
RESULTS
Twenty-nine (58.0%) patients recovered menses. Diagnostic crossover was associated with a higher probability of ROM (odds ratio = 10.3, p = .030). Time-to-event analysis showed that a shorter duration of illness (χ(1) = 11.00, p = .001), binge-eating/purging subtype (χ(1) = 7.01, p = .008), and history of childhood abuse (χ(1) = 4.03, p = .045) were associated with an earlier ROM. Furthermore, higher baseline ED-specific psychopathology was associated with a reduced likelihood for ROM, whereas higher general psychopathology and follicle-stimulating hormone levels predicted an earlier ROM (all, p < .050). Age, BMI, luteinizing hormone, and estrogen hematic levels had no predictive value with respect to ROM.
CONCLUSIONS
The present study provides data in support of an integrated model, emphasizing the importance of duration of illness, childhood abuse, and psychopathological characteristics of amenorrheic patients with AN in predicting ROM.
Topics: Amenorrhea; Anorexia Nervosa; Body Mass Index; Bulimia Nervosa; Child; Female; Humans; Longitudinal Studies; Menstruation
PubMed: 32796334
DOI: 10.1097/PSY.0000000000000849 -
Cureus Jun 2023Chronic heart failure (HF) is one of the conditions commonly seen in the medical outpatient departments, and iron deficiency (ID) has been reported as the commonest...
BACKGROUND
Chronic heart failure (HF) is one of the conditions commonly seen in the medical outpatient departments, and iron deficiency (ID) has been reported as the commonest nutritional deficiency in these patients. The presence of ID may interfere with the clinical parameters of chronic HF. The relationship between iron status and chronic HF needs more attention and should be given more consideration in the evaluation of patients with chronic HF.
AIM
The aim of the study was to determine the relationship, if any, between iron status and clinical/echocardiographic variables in chronic HF.
METHODS AND MATERIALS
A cross-sectional descriptive study was carried out at the Lagos University Teaching Hospital (LUTH), Nigeria, where 88 patients with chronic HF were recruited to participate in this study. The participants underwent clinical and laboratory assessments. Iron status was assessed with full blood count parameters; serum ferritin and transferrin saturation (Tsat) and its relationship with clinical parameters among these participants were also studied.
RESULTS
No correlations existed between the duration of chronic HF and iron status when compared using Tsat. However, a significant weak negative correlation was observed between the duration of HF and the serum ferritin levels. The clinical characteristics of the HF participants with and without ID were compared. There was no significant difference in the frequency of prior hospitalization in both groups. However, a higher proportion of participants with severe HF (New York Heart Association (NYHA) classes III/IV) (n = 14; 46.7%) were iron-deficient compared to those with moderate chronic HF (NYHA II) (n = 11; 36.7%). This relationship was statistically significant. Left ventricular ejection fraction (LVEF) was similar in the iron-deficient and iron-replete groups (using serum ferritin or Tsat) both when compared as means and when compared after categorizing LVEF as HF with preserved ejection fraction (HFpEF) vs HF with reduced ejection fraction (HFrEF). There was no statistically significant correlation between the severity of ID and LVEF. Conclusion: A spectrum of clinical changes occurs in patients with chronic HF. ID can make these changes more profound and the condition less amenable to standard HF treatments. These patients may therefore benefit from further evaluation for this nutritional deficiency. Laboratory measurements including Tsat and serum ferritin may help in further assessment of select patients with worse and/or non-responsive clinical parameters.
PubMed: 37415988
DOI: 10.7759/cureus.39998 -
BMC Women's Health Mar 2022Premenstrual syndrome (PMS) is used to describe physical, cognitive, affective, and behavioral symptoms that affect young and middle-aged women occurring cyclically...
BACKGROUND
Premenstrual syndrome (PMS) is used to describe physical, cognitive, affective, and behavioral symptoms that affect young and middle-aged women occurring cyclically during the luteal phase of the menstrual cycle. Despite the considerable prevalence and impact of PMS on individuals, their families and communities that interferes with the development of nations, many professionals are still unaware of it and little attention has been given in developing countries like Ethiopia, especially for university students. Therefore, this study was aimed for assessing the magnitude of premenstrual syndrome, associated factors and coping mechanisms among Wolkite university female regular students, 2021.
METHODS
Institutional-based cross sectional study was conducted among Wolkite University regular female students from June 15/10/2021 to 30/10/2021 by using simple random and multistage with systematic random sampling technique to select the study participants (n = 591). Data were collected using a self-administered, pre-tested, semi-structured questionnaire. Premenstrual syndrome scales comprised of 40 questions with three sub-scales were used to determine Premenstrual syndrome. Data were cleaned, coded and entered into Epi-data version-3.1, and analyzed using SPSS software version 25. Descriptive statistics were computed for independent variables as well as for coping mechanisms and presented in narration, tables and graphs. Analytic analysis schemes including bi-variable and multivariable logistic regression were computed to identify factors associated with premenstrual syndrome and those variables with a P value of < 0.05 in multivariable analysis were declared as statistically significant.
RESULT
From the total of 631 study subjects, only 591 had completed the questionnaire, giving a response rate of 93.7%. From 591 study participants, 224 (37.9%) [95% CI: (34, 40.9)] of them had premenstrual syndrome. Abdominal cramp (78.8%), depression (73.3%) and fatigue (72.9%) were frequent premenstrual symptoms experienced by students. Having family history of PMS [AOR: 4.05; 95% CI: (2.49, 6.58)], no history of sexual intercourse [AOR: 2; 95% CI: (1.12, 3.47)], severe menstrual pain intensity [AOR: 3.09; 95% CI: (1.58, 6.05)], irregular menstrual cycle [AOR: 2.26; 95% CI: (1.41, 3.62)], early age of menarche (< 13 years) [AOR: 2.64; 95% CI: (1.34, 5.19)], long duration of menses (≥ 7 days) [AOR: 3.56; 95% CI: (1.53, 8.37)] and using many pads (> 8) during menstruation [AOR: 4.44; 95% CI: (2.16, 9.12)] were factors significantly associated with premenstrual syndrome. 93.4% of students apply at least one coping mechanism for premenstrual symptoms, of which; taking rest (67.6%) and sleeping (60.7%) were common strategies.
CONCLUSION
In this study, premenstrual syndrome was found to be a problem of many students. Abdominal cramp, depressed feeling and fatigue were the predominant premenstrual symptoms experienced by students. Taking rest and sleeping were mostly applied by students as a coping mechanism. Family history of PMS, no history of sexual intercourse, intense menstrual pain, use of many pads during menstruation, irregular menstrual cycle, early menarche, and long duration of menses were found to be predictors of premenstrual syndrome. PMS needs great attention as part of the health care service in Ethiopia by involving all stockholders, including policy makers and health care professionals, to reduce its impact on the academic performance of university students.
Topics: Adaptation, Psychological; Adolescent; Colic; Cross-Sectional Studies; Dysmenorrhea; Ethiopia; Fatigue; Female; Humans; Menstruation Disturbances; Middle Aged; Premenstrual Syndrome; Students; Surveys and Questionnaires; Universities
PubMed: 35321710
DOI: 10.1186/s12905-022-01658-5