Physicians’ attitudes and views regarding religious fasting during pregnancy and review of the Literature Many patients worldwide seek medical advice regarding safety of fasting during pregnancy. This issue lacks high quality evidence, which makes giving medical advice challenging. To aid decision making on this subject we performed an internet mediated survey to determine the expert opinion on this issue. The survey was answered by one hundred and eight obstetricians and gynecologists (OB/GYN). The questions were aimed at the content of the medical advice given to pregnant patients on Ramadan (for Muslim patients) and Yom Kippur (for Jewish patients) fasts.
Non-invasive embryo evaluation and selection using time-lapse monitoring: results of a randomized controlled study Continuous monitoring of embryos via time-lapse (TL) provides more information on embryo kinetics and morphology compared to standard daily evaluation. Embryo selection by TL could support single embryo transfer (SET). With SET multiple gestations are avoided and perinatal outcome is improved. Our primary goal was to determine whether selection of a single blastocyst based on an algorithm comprising kinetic and morphologic scores assessed through continuous TL monitoring results in superior clinical outcome compared to embryo selection based on morphology alone.
Early fetal ultrasound screening for major congenital heart defects without Doppler Congenital heart defects are the most common major structural fetal abnormalities. Color flow mapping has played a dominant role in the detection of abnormalities during the first trimester, regardless of the International Society of Ultrasound in Obstetrics and Gynecology warning on the use of Doppler during early pregnancy. The aim of our study was to investigate the use of transvaginal two-dimensional sonography without Doppler for assessing the four-chamber view and the outflow tract view of fetuses at 11–13 weeks of gestation for cardiac screening of major congenital heart defects.
Comprehensive assessment the expression of core elements related to IGFIR/PI3K pathway in granulosa cells of women with polycystic ovary syndrome Polycystic ovary syndrome (PCOS) is the most common multisystem endocrinopathy in women, characterized by chronic hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. But its etiology remains elusive. A plethora of information suggests phosphatidylinositol-3-kinase (PI3K) pathway is key to the pathogenesis of PCOS but little is known about the expression pattern and possible role of insulin like growth factor 1 receptor (IGFIR)/PI3K pathway in PCOS. The goal of this study was to determine whether the core elements of the IGF1R/PI3K pathway were differentially expressed in GCs isolated from PCOS.
Uterus-like mass: A case report We report a case of a uterus-like mass. A 28-year-old nulliparous patient presented with increasing dysmenorrhea after discontinuing use of her contraceptive pill. Clinical examination revealed pelvic pain mainly located in the right iliac fossa. A pelvic ultrasound displayed a suspicious uterine mass initially described as a pseudo-unicorn uterus with a rudimentary horn. Magnetic resonance imaging (MRI) revealed a roundel image within the right myometrium appearing to have a cleavage plane with the myometrium.
Perioperative gabapentin and post cesarean pain control: a systematic review and meta-analysis of randomized controlled trials Cesarean delivery occurs in roughly one third of pregnancies. Effective postoperative pain control is a goal for patients and physicians. Limiting opioid use in this period is important as some percentage of opioid naïve individuals will develop persistent use. Gabapentin is a non-opioid medication that has been used perioperatively to improve postoperative pain and limit opioid requirements. The goal of this study is to determine the efficacy of perioperative gabapentin in improving post cesarean delivery pain control.
Abducens nerve palsy as a sign of pre-eclampsia with severe features A 36-year old primigravid woman presented at a gestational age of 33 weeks and 2 days with abrupt reduced vision and headache. Past medical history was negative, except for migraine. At admission, blood pressure readings reached 169/100 mmHg. A urine dipstick indicated significant proteinuria, confirmed with a 24 hours urine collection revealing 971 mg of protein. On clinical examination, hyperreflexia and unilateral abducens nerve palsy was apparent (Fig. 1).
Effects of ethinyl estradiol-containing oral contraception and other factors on body composition and muscle strength among young healthy females in Finland—A cross-sectional study Objective: The aim of this cross-sectional study was to determine the association of hormonal contraception and other life-style factors and habits affecting body composition (BC) and muscle strength.Study design: We measured the body composition of 400 healthy Finnish women (aged 20–40 years) using total body dual energy x-ray absorptiometry (TB-DXA) as well as grip strength (GS [kPa]) with a hand-held dynamometer and knee extension strength (KES [kg]) between 2011 and 2014. Investigated body composition variables were appendicular skeletal mass (ASM [kg]), body mass index (BMI [kg/m2]), relative skeletal muscle index (RSMI [ASM/m2]), total lean mass (TLM [kg]), skeletal muscle index (SMI [TLM/weight × 100]) and fat-%.
Influence of intrauterine dispositive in human papillomavirus clearance Introduction: An important inverse relation between IUD use and risk of cervical cancer has been proved. Women who used IUD had half the risk of developing cervical cancer. The mechanism how IUD is a protector factor is still unknown. Could be improving the clearance of HPV infection or stopping progression to cancer from preneoplasic lesion.The aim of the study is to check if IUD increases HPV clearance, that is, checking if after 1 year HPV infection disappears in more patients using IUD than those not using it.
Robot-assisted transabdominal cerclage for the prevention of preterm birth: A multicenter experience High-risk pregnancy stratification and the use of Progesterone and prophylactic cerclage based on prior obstetrical outcomes and cervical length screening have been successful in curbing the impact of preterm birth. However, a large number of women will still suffer from preterm delivery even with optimal management. Experts agree that a transabdominal cerclage is the next best option for women who fail a transvaginal cerclage in a prior pregnancy. Our primary objective with this study is to assess the obstetric benefits and feasibility of robotic-assisted transabdominal cerclage in high-risk women projected to have poor obstetric outcomes.
Smoking cessation support and obstetric outcomes in an Irish maternity hospital Maternal cigarette smoking is a recognised risk factor for maternal and fetal morbidity and mortality and remains a significant problem in the Irish maternity system. Approximately 11% of Irish women will continue to smoke in pregnancy, despite awareness of the negative impact on their pregnancy. Although recommendations exist for the management of pregnant smokers, information on the antenatal care of Irish smokers in pregnancy has not been described. We reviewed the care given to smokers in a large urban maternity hospital.
Diverting stoma-related complications following colorectal endometriosis surgery: a 163-patient cohort Deep endometriosis may simultaneously infiltrate the vagina and the rectosigmoid, which associated resection may increase the risk of postoperative complications. Among these complications, rectovaginal fistula is one of the worst. To reduce the risk of rectovaginal fistula and related complications, surgeons may employ diverting stoma. The literature is rich in data concerning the usefulness of stoma in patients managed for low rectal cancer. However, extrapolation of these data to patients managed for rectal endometriosis is disputable.
A review of the reproductive consequences of consanguinity Consanguinity is the close union, sexual relationship or marriage between persons who have common biological ancestors usually up to about 2nd cousins. Contrary to general opinion consanguinity is quite common and is practiced worldwide. It is an important topic as while rates of consanguineous unions in certain society have decreased over time, rates have remained stable or increased in other societies with rates as high as 80.6% in some communities. Our aim was to conduct a review looking at general aspects of consanguinity and any published reproductive outcomes in literature.
Ethical and religious dilemmas of modern reproductive choices and the Islamic perspective Advances in the field of Assisted Reproductive Technologies (ART) are constantly evolving, starting from Artificial Insemination (AI) and in-vitro fertilization (IVF), to the current state of the art technologies that enable embryo biopsy for Pre-implantation Genetic Testing (PGT). The future includes gene mapping and DNA replacement technologies with the potential for the so-called “designer babies.” In other words, shortly, a modern couple may be in a position to decide how to procreate and with whom; which pregnancy to keep and which one to terminate depending on their prior knowledge about the pregnancy and the available choices.
Osteogenesis imperfecta type VIII: Association with increased nuchal translucency and prenatal diagnosis by targeted exome sequencing Osteogenesis imperfecta (OI) is a genetically heterogeneous skeletal dysplasia that affects approximately 1 in 10,000–20,000 births . Although most of the time prenatal diagnosis of OI can be confirmed by molecular testing, sonography is still the primary diagnostic modality. Criteria for the prenatal diagnosis of OI using second-trimester sonography include hypomineralization of the skull, early onset of bone shortening, and bowing due to multiple fractures involving long bones. However, the sonographic detection of OI at the first trimestr of pregnancy is challenging.
EBCOG Position Statement – Travelling when pregnant Pregnant women may want to travel to go on holiday, to visit friends or family or for work related purposes. For the majority of pregnant women, travelling long distances will be safe and a short flight may be a safer alternative to a long car, coach or train ride.With any type of travelling, seatbelts should be worn when directed to do so, with the upper belt above the uterus and the lower belt across the upper thighs, therefore ensuring that either belt avoids the pregnant uterus [1,2].
Successful angioembolization treatment in a patient with a mechanical heart valve with hemorrhagic corpus luteum A 23 year-old nulliparous patient presented to our emergency department due to lower abdominal pain lasting for 3 weeks with aggravation two days prior to her admission after coitus. Her history was remarkable for prosthetic aortic valve replacement 4 years ago due to regurgitating congenital bicuspid aortic valve. She was recently switched from warfarin treatment to enoxaparin, a low molecular weight heparin, as the patient was trying to conceive. At presentation, the patient was in severe pain.
Plasmapheresis—A lifesaving treatment for life threatening HELLP syndrome Hemolysis, Elevated Liver Enzymes, and Low Platelets (HELLP) Syndrome is a rare and serious complication of pregnancy characterized by microangiopathic hemolytic anemia, increased levels of liver enzymes, and thrombocytopenia. The optimal management approach of women with HELLP is highly controversial. We herein present a case of successful treatment of life threatening HELLP by plasmapheresis.
Health care service in paediatric and adolescent gynaecology throughout Europe: A review of the literature Paediatric and adolescent gynaecology is a special field of interest within general gynaecology and obstetrics. The care for children and young people differs from adults. In gynaecology, children should not be treated like little adults. Within Europe, there is great variability in the provision of care, availability of clinical networks and lack of national standards within paediatric and adolescent gynaecology. Therefore, this review aims to summarize the current evidence regarding best clinical practice within Europe.
The future of paediatric and adolescent gynaecology in Europe Paediatric and Adolescent Gynaecology (PAG) is a subspecialty under the umbrella of Obstetrics and Gynaecology but linked to other branches of medicine including Paediatrics, Surgery, Endocrinology and Urology. Therefore future developments in clinical care and education requires a multidisciplinary approach combining aspects of all the above medical specialties, and also with inputs from Public Health, Genetics, Radiology and Psychology. A multidisciplinary collaboration among different specialists is as important as the establishment and adoption of standards in education, training and management.
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