International Journal of Obstetrics and Gynecology

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 7 (1), pp. 001-008, January, 2019. © International Scholars Journals 

Full Length Research Paper

Comparing simulated client experiences with phone survey self-reports for measuring the quality of family planning counseling: The case of DMPA-SC in Nigeria

Kelvin Smith and Rebecca Philips

Department of Obstetrics and Gynaecology, School of Clinical Sciences, University of Lagos, Lagos State, Nigeria.

Corresponding author. E-mail: [email protected]

Accepted 21 January, 2019

Abstract

The quality of family planning services can have important implications for uptake and continued method use. Yet, measuring quality of care is complex, and quality itself is a multifaceted concept. In 2015, a new injectable contraceptive method, DMPA-SC (depot medroxyprogesterone acetate – subcutaneous, also known as Sayana Press®), was introduced through several private sector distribution channels in Nigeria. To examine aspects of quality for DMPA-SC service provision and contraceptive services more broadly, we compared self-reports from follow-up phone surveys with users to simulated client interactions that were designed to measure the same concepts. By using multiple methods, we sought to understand more deeply the biases associated with different data collection methods that ultimately lead to different conclusions regarding quality of contraceptive services, and to further assess to what extent these methods were suitable for detecting differences in quality across sub-groups using the case of married versus unmarried women. We found that simulated clients reported lower levels of quality across all comparable quality indicators than phone survey respondents attending the same facilities. Both methods were able to detect similar differential treatment by marital status. A mixed methods approach can provide differential insights into quality of family planning services, especially when aiming to understand both objective and subjective aspects of quality.

Keyword: Family planning counselling, contraceptive services, pregnancies, abortions, simulated client experiences.

Key words: Granuloma, cancer, metastasis.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 ISSN 2326-7234 Vol. 6 (7), pp. 238-240, July, 2018. © International Scholars Journals

Case Report

A case report of body stalk anomaly at 15 weeks and management in a patient with a previous cesarean

Ayamo Oben, Jason Morris, Angela Boyd and Michael Berkus

Center for Pregnancy and Newborn Research University of Texas Health Sciences Center at San Antonio San Antonio, TX 78229.

Accepted 26 March, 2018

Abstract

Body stalk anomaly is a fatal disfiguring abdominal wall defect resulting from abnormalities in the development of the cephalic, caudal, and lateral embryonic body folds¹. The inability to fold in the correct axes leads to these body wall deformities. Daskalakis et al. reported an incidence of 14/106,727 fetuses². There are few cases of this complex in the United States and little is known about the cause of this abnormality. Proposed mechanisms include early amnion rupture, vascular disruption of the early embryo, or an abnormality in the germinal disk (X). Given that body stalk anomaly is a fatal anomaly, early diagnosis is critical to the counseling and management of affected patients. Herein, we present a case of body stalk syndrome and discuss management in a patient with a history of a prior cesarean delivery who declined termination.

Keywords: Body stalk anomaly, body stalk syndrome, abdominal wall defects.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 6 (4), pp. 219-222, April, 2018. © International Scholars Journals

Full Length Research Paper

Association of angiotensin converting enzyme gene I/D polymorphism with vitiligo in South Indian population

Debi Dutt¹, Nitin Sunil² and Verma Satya²

¹Department of Endocrinology, Faculty of Medicine,  Amity University, Raipur, India

²Department of Gastroenterology, Faculty of Internal Medicine, Kalinga University, Naya Raipur, Chhattisgarh, India.

³Department of Medical oncology, School of Life and Allied Sciences, Naya Raipur, Chhattisgarh, India.

*Corresponding author. E-mail: [email protected].

Accepted 12 February, 2016

Abstract

Vitiligo or leukoderma is a chronic skin condition that causes loss of pigment due to destruction of melanocytes, resulting in irregular pale patches of skin. Vitiligo is polygenic disease and associated with autoimmunity. Angiotensin converting enzyme (ACE) is capable of modulating cutaneous neuro-genic inflammation. An insertion/deletion (I/D) polymorphism of a 287-base pair repetitive sequence in intron 16 of the ACE gene was reported to have been associated with autoimmunity and with the development of vitiligo. In our study, the distribution of ACE gene I/D genotype was investigated in a population of 186 South Indian vitiligo patients and 201 healthy controls using polymerase chain reaction genotyping method. The ACE genotype and allele frequency ( ² = 9.576, P= 0.008) ( ² = 10.68, P = 0.001) were significantly different between vitiligo patients and healthy controls.However there was no significant difference between the segmental and non-segmental vitiligo( ² = 0.182, P = 0.91) detected in ACE gene genotype distribution .This study suggests that the ACE genepolymorphism confers susceptibility to vitiligo.

Key words: Angiotensin converting enzyme, gene polymorphism, vitiligo, autoimmunity.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 6 (3), pp. 211-218, March, 2018. © International Scholars Journals

Full Length Research Paper

Interobserver agreement and reliability in intrapartum cardiotocography interpretation, using the 2015 FIGO consensus guidelines

Louise PARET^1,2, Virginie EHLINGER^1, Catherine ARNAUD¹ and Christophe VAYSSIERE^1,2

¹Inserm, UMR1027, team SPHERE, Toulouse, France.

²Département de gynécolgie-obstétrique, hôpital Paule-de-Viguier, CHU de Toulouse, France.

Corresponding author E-mail: [email protected]; Tel. +33567771282

Accepted 05 December, 2017

Abstract

To assess interobserver reliability and agreement in the classification of cardiotocograms (CTGs) according to the 2015 revision of the FIGO (International Federation of Gynecology and Obstetrics) CTG classification. Six observers (3 obstetricians and 3 midwives) applied the 2015 FIGO guidelines and independently interpreted 60 intrapartum CTGs, randomly selected after stratification for arterial umbilical pH (pHa) at birth: 1/3 with pHa>7.15, 1/3 with pHa=7.05-7.15, and 1/3 with metabolic acidosis defined by pHa<7.05 and base deficit>10 mmol/L. Interobserver reliability was assessed by the Fleiss kappa coefficient and interobserver agreement by the proportion of agreement (Pa), calculated according to Grant. The overall interobserver reliability was good (kappa=0.62, 95%CI=0.52-0.73). Interobserver agreement was good for CTGs classified as normal by the observers (Pa=71.5%, 95%CI=67.5-75.2), moderate for those classified as pathological (Pa=57.4%, 95%CI=51.3-63.5) and poor for those classified as suspicious (Pa=36.4%, 95%CI=30.9-41.9). Interobserver reliability was good for baseline, moderate for variability assessment and presence of decelerations, but poor for classifying the decelerations. Results did not differ significantly between obstetricians and midwives. Application of this FIGO classification produced good interobserver reliability and agreement on CTG classification overall, but poor reliability for suspicious CTGs and for determination of the type of deceleration.

Keywords: Fetal heart rate, cardiotocography, interobserver variability, interobserver agreement, reliability, reproducibility.

International Journal of Obstetrics and Gynecology ISSN 2326-7234 Vol. 6 (2), pp. 207-210, February, 2018. © International Scholars Journals

Full Length Research Paper

Fetomaternal outcome in second stage Caesarean section - An audit

Sandya MR^1*, Shirley George² and Lissy Varghese³

Senior Resident^1*, Professor and HOD², Junior Resident³

Department of Obstetrics and Gynaecology, St John’s Medical College Hospital Bangalore, Karnataka, India.

Corresponding author. Email: [email protected]

Accepted 05 January, 2017

Abstract

Caesarean section (CS) at full dilatation of cervix has many implications for maternal & neonatal morbidity and mortality. The objective of the study was to analyse the indication for second stage CS & its associated fetomaternal outcome. This cohort study was carried out in the Department of Obstetrics & Gynaecology for a period of one year during which we analysed 42 women who underwent second stage CS. Data was obtained by reviewing medical records. During the study period total number of CS performed were 1951 (36.42%), of these 42 (2.15%) was performed at full dilatation of cervix. Majority were primigravidae (92.8%), mean age was 25.38 ± 3.72 years and mean gestational age was 38.8 ± 1.16 wks. Duration of second stage was <2hrs in 47.6% & >2hrs in 26.2%. Significant caput was present in 85.7%. The most common indication for second stage CS was secondary arrest of descent seen in 54.7%. Commonest maternal complications were haematuria 76.1%, atonic PPH 26.1% and extension of uterine incision in 14.3%. Fourteen babies (33.3%) required NICU care. There was no maternal or perinatal mortality in the present study. Involvement of skilled obstetrician in decision making and delivery is crucial to minimise the complications.

Keywords: Second stage caesarean section, Fetomaternal outcome, maternal complications, neonatal complications.