International Journal of Obstetrics and Gynecology

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_josé[email protected]

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: [email protected]

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: [email protected].

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: [email protected]. 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.

International Journal of Obstetrics and Gynecology ISSN: 2326-7234 Vol.  3 (4) pp. 090-094, June, 2015. © International Scholars Journals

Full length Research paper

Intensity of maternal serum leptin in relentless preeclamptic pregnant women in early postpartum stage

*Cemal İpekçi Kutlar, Abdi W. Erberk and Abdulhak M. Jonturk

Department of Gynecology and Obstetrics, Faculty of Medicine, Atatürk University, Erzurum, Turkey.

E-mail: [email protected] 

Accepted 13 May, 2015

Abstract 

The aim of this study is to determine early postpartum maternal serum leptin levels in severe preeclamptic pregnant women. This study was planned as a prospective controlled trial. The patient and control groups in the study were composed in the period between January 2003 and January 2004. The study, performed in the Department of Perinatology of SSK Bakirkoy Maternal Hospital and Women and Child Diseases Education Hospital, consists of forty-four singleton pregnant women giving birth after hospitalized with diagnosis of severe preeclampsia and forty-four normotensive singleton pregnant women who were found to have healthy pregnancy on examination and analysis before given birth. The venous blood of all pregnants was taken from the antecubital region in early postpartum period while they were all hungry. We studied the relation between demographic data, biochemical data, baby weight at birth and the serum leptin levels. Comparing the preeclamptic pregnant women with control group in terms of leptin, although leptin levels in severe preeclamptic pregnant women were found to be higher than control group, statistically, no significant difference was determined (p: 0.069). In severe preeclamptic group, baby weight at birth was found to be significantly lower (p: 0.000). Evaluating all pregnant women, it was determined that there has been a positive significant relation between serum leptin levels and diastolic tension (p: 0.044), urea (p: 0.019), creatinine (p:0.000), uric acid (p: 0.000); and a negative significant relation between serum leptin levels and baby weight at birth (p: 0.038). No relation was found between the leptin level and the gender of infants. No significant difference of early postpartum maternal serum leptin levels between severe preeclamptic group and normotensive group was determined.

Key words: Preeclampsia, early postpartum stage, serum leptin levels, severe preeclamptic pregnant women.

International Journal of Obstetrics and Gynecology ISSN: 2326-7234 Vol.  3 (4) pp. 081-089, June, 2015.  © International Scholars Journals

Full Length Research Paper

Relative assessment of abnormalities patterns in hysterosalpingography, diagnostic laparoscopy and hysteroscopy with infertility cases in women in Nigeria

Omelu Clever, Adajarha Esther, Owungalo Ebuka and Majimeta Anthony

Departments of Radiology, Obstetrics and Gynecology, Delta State University, Abraka, Nigeria.

E-mail: [email protected]

Accepted 5 May, 2015

Abstract 

Laparoscopy and hysteroscopy procedures commenced recently in our center and no study has been done on them yet. Also, there is paucity of information in our environment on comparison of laparoscopy/hysteroscopy findings with hysterosalpingography (HSG) amongst infertile women. The purpose of this study was to evaluate pattern of the abnormalities detected on HSG in infertile women and to compare them with laparoscopy and hysteroscopy findings. A prospective study of 220 consecutive patients who had HSG between December, 2011 and May, 2013, at Department of Radiology, Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria was conducted. Clinical notes and radiological findings were analyzed for demographic data, uterine status, tubal and pelvic abnormalities. Findings were correlated with those of laparoscopy and hysteroscopy. Data was analyzed using EPI Info version 3.3.2 for windows. Of the 72 women with tubal occlusion on HSG, 46 (63.89%) women had laparoscopy with dye test. HSG demonstrated unilateral tubal occlusion in 35 (76.09%) women and bilateral tubal occlusion in 11 (23.91%) women. The laparoscopy with dye test also demonstrated unilateral tubal occlusion in 34 (73.91%) women and bilateral tubal occlusion in 10 (21.74) women. The difference in the findings of both tests on tubal patency was not statistically significant (p>0.05). All the 26 women with uterine adhesion on HSG had diagnostic hysteroscopy which confirmed all the cases. There was no difference in the findings of both tests (p>0.05). Both HSG and diagnostic laparoscopy are effective in evaluating tubal patency with no significant difference in accuracy. Also both HSG and hysteroscopy are effective in evaluating intrauterine adhesions with no difference in accuracy.

Key words: Abnormalities, hysterosalpingography, laparoscopy/hysteroscopy, infertility.