Objective:To determine the relationship between the color of vaginal discharge and the volume of vaginal discharge and the types of microorganisms in the genital organs.Methods:Cross-sectional study by conducting vagi...Objective:To determine the relationship between the color of vaginal discharge and the volume of vaginal discharge and the types of microorganisms in the genital organs.Methods:Cross-sectional study by conducting vaginal swab examinations on 56 women with complaints of vaginal discharge in Bareng Lor Village,Klaten,and Sewugalur,Kulon Progo,Indonesia.A vaginal swab was carried out with a Gram examination.Data were coded and analyzed using the chi-c test.Results:The color of vaginal discharge was divided into:non-vaginal discharge 16.1%(9/56),white/clear/mucoid 50%(28/56),greenish/white 14.3%(8/56),brownish white/brown 3.6%(2/56),powdery and white 3.6%(2/56),post coitus bleeding 7.1%(4/56),and other complaints(itching,odor,erosion)5.4%(3/56).The volume of vaginal discharge was divided into:normal 16.1%(9/56),a little 48.2%(27/56),and a lot 35.7%(20/56).The types of microorganisms obtained were:no microorganisms growing 8.9%(5/56),Gram positive cocci/bacilli 7.1%(4/56),Gram negative cocci/bacilli 19.6%(11/56),Gram positive/negative coccobacilli 7.1%(4/56),growth of>2 bacteria 42.9%(24/56),and fungus/yeast cells/clue cells 14.3%(8/56).There is a significant relationship between volume and type of microorganisms(P=0.011),while the relationship between color/type of vaginal discharge and microorganisms is not significantly related.Conclusions:The volume of vaginal discharge reflects the presence of risky microorganisms.展开更多
Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or force...Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.展开更多
Background Sow longevity and reproductivity are essential in the modern swine industry.Although many studies have focused on the genetic and genomic factors for selection,little is known about the associations between...Background Sow longevity and reproductivity are essential in the modern swine industry.Although many studies have focused on the genetic and genomic factors for selection,little is known about the associations between the microbiome and sows with longevity in reproduction.Results In this study,we collected and sequenced rectal and vaginal swabs from 48 sows,nine of which completed up to four parities(U4P group),exhibiting reproductive longevity.We first identified predictors of sow longevity in the rectum(e.g.,Akkermansia)and vagina(e.g.,Lactobacillus)of the U4P group using RandomForest in the early breeding stage of the first parity.Interestingly,these bacteria in the U4P group showed decreased predicted KEGG gene abundance involved in the biosynthesis of amino acids.Then,we tracked the longitudinal changes of the micro-biome over four parities in the U4P sows.LEfSe analysis revealed parity-associated bacteria that existed in both the rectum and vagina(e.g.,Streptococcus in Parity 1,Lactobacillus in Parity 2,Veillonella in Parity 4).We also identi-fied patterns of bacterial change between the early breeding stage(d 0)and d 110,such as Streptococcus,which was decreased in all four parties.Furthermore,sows in the U4P group with longevity potential also showed better reproductive performance.Finally,we discovered bacterial predictors(e.g.,Prevotellaceae NK3B31 group)for the total number of piglets born throughout the four parities in both the rectum and vagina.Conclusions This study highlights how the rectal and vaginal microbiome in sows with longevity in reproduc-tion changes within four parities.The identification of parity-associated,pregnancy-related,and reproductive performance-correlated bacteria provides the foundation for targeted microbiome modulation to improve animal production.展开更多
This is a case report of a rare myoma of the anterior vaginal wall that mimicked a paraurethral diverticulum in a postmenopausal woman. Surgical treatment of the lesion was performed via a transvaginal approach withou...This is a case report of a rare myoma of the anterior vaginal wall that mimicked a paraurethral diverticulum in a postmenopausal woman. Surgical treatment of the lesion was performed via a transvaginal approach without complications, and the material was sent for anatomopathological examination, which confirmed the diagnosis of leiomyoma. Vaginal leiomyomas are a rare lineage of tumors at this gynecological site, with just over 300 reports worldwide. Symptoms can range from totally asymptomatic to genitourinary complaints, such as urinary incontinence to dyspareunia. The diagnosis is based on a physical examination and preoperative imaging tests (MRI, transvaginal ultrasound, cystoscopy, computed tomography), but the definitive diagnosis is histopathological analysis of the specimen. The treatment of choice is surgery with complete excision of the lesion, and in 90% of cases, the transvaginal approach is chosen.展开更多
Background:Human papillomavirus(HPV)infection is a major risk factor of cervical cancer.This study assessed the prevalence and distribution of HPV genotypes in women with cervical or vaginal lesions in Jiangsu Provinc...Background:Human papillomavirus(HPV)infection is a major risk factor of cervical cancer.This study assessed the prevalence and distribution of HPV genotypes in women with cervical or vaginal lesions in Jiangsu Province,China.Methods:A total of 2120 healthy women aged 18–45 years were screened between 2012 and 2013 and 6171 healthy women aged18–45 years were screened between 2020 and 2021 in Jiangsu Province.Cervical specimens collected from each woman were first tested using the HPV DNA enzyme immunoassay method,and positive samples were further tested using the reverse hybridization line probe assay.Differences in HPV prevalence and genotype distribution were compared between women with cervical and vaginal lesions identified during 2 rounds of cross-sectional screening.To account for differences in age composition between the 2 studies,the standardized prevalence of HPV positivity was calculated using the sum of the total number of women diagnosed with cervical or vaginal lesions during both periods as the standard group.Results:Overall,40 women(1.89%)were diagnosed with cervical or vaginal lesions through biopsy during 2012–2013,and 110(1.78%)were diagnosed during 2020–2021.Among women with lesions,the standardized HPV positivity rates were 98.41%in 2012–2013 and99.24%in 2020–2021.Most cases were caused by high-risk HPV,which accounted for 87.18%of the total infections during 2012–2013and 89.91%of those in 2020–2021,with standardized positivity rates of 86.44%and 88.75%,respectively.The standardized positivity rates for single infections were 62.35%in 2012–2013 and 74.95%in 2020–2021.The top 5 high-risk HPV genotypes were HPV type 16(HPV16;29.01%),52(20.63%),18(14.28%),58(13.71%),and 33(12.12%)in 2012–2013,and HPV16(36.95%),58(22.18%),52(13.25%),31(7.63%),and 51(6.81%)in 2020–2021.The standardized positivity rate for HPV18 decreased from 14.28%in2012–2013 to 1.15%in 2020–2021.Among women with cervical or vaginal lesions,the highest proportion was observed in the 36-to 45-year group during 2012–2013,reaching 52.50%,and in the 26-to 35-year group during 2020–2021,peaking at 59.10%.Conclusions:In Jiangsu Province,no significant changes in HPV prevalence among women with cervical or vaginal lesions were observed during 2012–2013 and 2020–2021;however,the distribution of HPV genotypes had changed.展开更多
Dear Editor,The incidence of complications associated with ventriculoperitoneal(VP)shunts ranges from 24%to 47%,with abdominal complications comprising 25%of these cases[1].The shunt may migrate to various body parts,...Dear Editor,The incidence of complications associated with ventriculoperitoneal(VP)shunts ranges from 24%to 47%,with abdominal complications comprising 25%of these cases[1].The shunt may migrate to various body parts,including the abdominal wall,gastrointestinal tract,vagina,bladder,scrotum,mediastinum,and the oral cavity.Cerebrospinal fluid(CSF)leakage through the vagina is an uncommon complication of VP shunts;however,its exact incidence remains unknown.Such complications can result in failure of the shunt procedure,often requiring revision or reinsertion in affected patients[2].展开更多
In recent years,the obstetrics department has advocated vaginal delivery to reduce the rate of cesarean sections.However,in clinical practice,pregnant women are prone to anxiety before childbirth,making it difficult t...In recent years,the obstetrics department has advocated vaginal delivery to reduce the rate of cesarean sections.However,in clinical practice,pregnant women are prone to anxiety before childbirth,making it difficult to perform a vaginal trial delivery smoothly.The combined approach of ADIET communication and delivery rehearsal for vaginal trial delivery can provide a reference for reducing prenatal anxiety,shortening labor duration,facilitating a smooth delivery,and ensuring the safety of both mothers and babies.AIM To analyze the effect of AIDET communication combined with labor rehearsal on vaginal trial delivery.METHODS A study conducted between January 2023 and December 2023 included 200 vaginal trials.Women were randomly assigned to an observation group(100 women),which received ADIET communication plus delivery intervention,and a control group(100 women),which received routine communication plus delivery intervention.This study aimed to compare antenatal anxiety status as measured using the Maternal Anxiety Scale,labor duration,delivery efficacy as assessed using the simplified Chinese version of the Childbirth Self-Efficacy Inventory,and delivery outcomes.RESULTS After the intervention,the observation group had a lower Maternal Anxiety Scale score and higher Childbirth Self-Efficacy Inventory score(P<0.05)than the control group(P<0.05),whereas the observation group had higher natural delivery,cesarean delivery,vaginal delivery,and neonatal asphyxia rates(P<0.05).CONCLUSION For women undergoing vaginal trial delivery,a combination of AIDET communication and delivery rehearsal can relieve prenatal anxiety,enhance delivery efficiency,shorten labor duration,and somewhat improve delivery outcomes.展开更多
BACKGROUND Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy.However,vaginal cuff dehiscence is a serious c...BACKGROUND Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy.However,vaginal cuff dehiscence is a serious complication after laparoscopic total hysterectomy and so far,there are limited studies on vaginal cuff dehiscence after a total hysterectomy.AIM To investigate the factors influencing vaginal cuff dehiscence after laparoscopic hysterectomy and the psychological state of the patients.METHODS This study retrospectively,univariately,and multivariately analyzed the clinical data of patients who experienced vaginal cuff dehiscence after laparoscopic hysterectomy in Yuyao People’s Hospital from January 2015 to December 2021.Logistic regression was utilized to analyze the high-risk factors of vaginal cuff dehiscence.RESULTS Among 1459 cases with laparoscopic hysterectomy,9 reported vaginal cuff dehiscence postoperatively,with an incidence of 0.617%.Univariate logistic regression analysis revealed that preoperative hemoglobin value[odds ratio(OR)=5.12,P=0.016],vaginal cuff suture method(OR=0.26,P=0.048),and postoperative first sexual lifetime(OR=15.86,P=0.002)were associated with vaginal cuff dehiscence following laparoscopic hysterectomy.Multivariate logistic regression analysis revealed that preoperative hemoglobin value of<90 g/L(OR=5.17,P=0.015)and time interval between postoperative first sexual life and operation of<3 months(OR=54.00,P=0.004)are independent risk factors for vaginal cuff dehiscence after laparoscopic hysterectomy.CONCLUSION Postoperative hemoglobin and the time interval between postoperative first sexual life and operation were the independent factors of developing vaginal cuff dehiscence after laparoscopic hysterectomy.展开更多
The vaginal microbiome plays a pivotal role in maintaining vaginal health and protecting the host from various diseases.There is a broad agreement within the scientific community that the vaginal microbiome exhibits s...The vaginal microbiome plays a pivotal role in maintaining vaginal health and protecting the host from various diseases.There is a broad agreement within the scientific community that the vaginal microbiome exhibits stable bacterial diversity,influenced by age and gonadal hormone levels,and is classified into distinct Community-State Types.A healthy vaginal microbiome is typically characterized by a predominance of Lactobacillus spp.,which acidifies the vaginal environment and is essential in defending against invading microbial pathogens.This review examines the evolution of the vaginal microbiome’s composition throughout a woman’s life.It also explores how exogenous factors influence the homeostasis of this microbiome,leading to either a state of eubiosis or dysbiosis.The main factors supporting eubiosis of the vaginal microbiome include diet,probiotic intake,certain personal hygiene practices,and hormonal contraceptives,while the major contributors to dysbiosis are psychosocial stress,tobacco smoking,and sexual activity.This state of dysbiosis is strongly associated with a range of adverse vaginal health outcomes,including preterm birth,bacterial vaginosis,pelvic inflammatory disease,and a higher risk of sexually transmitted infections.展开更多
BACKGROUND Primary vaginal cancer is rare and most vaginal tumors are metastatic,often arising from adjacent gynecologic structures.Primary vaginal cancers are also more common among postmenopausal women and most of t...BACKGROUND Primary vaginal cancer is rare and most vaginal tumors are metastatic,often arising from adjacent gynecologic structures.Primary vaginal cancers are also more common among postmenopausal women and most of these are squamous cell carcinomas,with adenocarcinomas being relatively rare.Vaginal bleeding is the most common clinical manifestation of vaginal adenocarcinoma.About 70%of vaginal adenocarcinomas are stage I lesions at the time of diagnosis,for which radical surgery is recommended.However,more advanced vaginal cancers are not amenable to radical surgical treatment and have poor clinical outcomes.Optimal treatments modes are still being explored.Here,we report a rare case of stage IIb primary vaginal adenocarcinoma for which an individually designed vaginal applicator for after-loading radiotherapy was used to achieve good tumor control.CASE SUMMARY A 62-year-old woman presented to our clinic after 3 months of abnormal postmenopausal vaginal bleeding.Gynecological examination,computed tomography(CT),and positron emission tomography-CT showed a large mass(about 5 cm)on the anterior vaginal wall.Colposcopy biopsy confirmed adenocarcinoma of vaginal origin.After three cycles of carboplatin plus paclitaxel chemotherapy,the lesion partially shrunk.The patient then received external irradiation of 45 gray(gy)in 25 fractions,which further reduced the vaginal lesion,followed by after-loading radiotherapy of 30 gy in 5 fractions with an individually designed vaginal applicator.Three months later,magnetic resonance imaging showed a slight thickening CONCLUSION Primary vaginal adenocarcinoma is rare,and prognosis is poor in most vaginal cancers of locally advanced stages,which cannot be treated with radical surgery.Better tumor control can be achieved with an individualized vaginal applicator that allows administration of a higher radical dose to the tumor area while protecting normal tissues.展开更多
Objective: To investigate the effects of different concentrations of β-glucan on the repair of damaged vaginal mucosa, the expression of vascular endothelial growth factor (VEGF), and the inflammatory factor-6 (IL-6)...Objective: To investigate the effects of different concentrations of β-glucan on the repair of damaged vaginal mucosa, the expression of vascular endothelial growth factor (VEGF), and the inflammatory factor-6 (IL-6) in vaginal tissues. Methods: Thirty-six adult female specific pathogen free (SPF)-grade Wistar rats were randomly divided into 3 phase groups with 12 rats each. Vaginal inflammation rat models were established by injecting phenol gel into the vagina of each rat at a dose of 0.1 ml/100g body weight. After modeling, rats were divided into 4 groups based on different concentrations of the test agent. The control group was injected with 0.5 ml of saline, experimental group A was injected with 0.375 ml saline 0.125 ml β-glucan, experimental group B was injected with 0.25 ml saline 0.25 ml β-glucan, and experimental group C was injected with 0.50 ml β-glucan. The injection sites were selected at the 3 o’clock and 9 o’clock positions of the vagina. Rats were sacrificed at 7-, 14-, and 28-days post-injection, and tissue samples were collected from the injection sites and prepared for histological analysis. New blood vessels and fibroblast numbers in the tissues were observed after Hematoxylin-eosin (HE) staining. The expression levels of VEGF and IL-6 in the tissues were measured using quantificational reverse transcription polymerase chain reaction (qRT-PCR). Results: Histological examination of vaginal tissue specimens at 7-, 14-, and 28-days post-injection showed that on day 7, there were no significant changes in the experimental groups compared to the control group. However, on days 14 and 28, the experimental groups showed more new blood vessels, macrophages, and fibroblasts with increased activity compared to the control group. The expression levels of VEGF in vaginal tissues were elevated on days 14 and 28 in the experimental groups. The comparison of IL-6 levels in vaginal tissues on day 28 showed that serum IL-6 levels returned to normal, and there was no statistically significant difference between the experimental and control groups. Conclusion: In the 3 experimental phases, the increase in VEGF levels in vaginal tissues on day 14 post-injection was more pronounced with higher concentrations of β-glucan, and IL-6 levels returned to normal on day 28. β-Glucan can enhance VEGF levels in damaged vaginal tissues, promote the repair of damaged vaginal tissues, and higher concentrations of β-glucan have a better effect.展开更多
Background: An abnormal vaginal discharge is a common complaint among women of reproductive age, and it can indicate serious conditions like pelvic inflammatory disease and cervical cancer. This study aimed to assess ...Background: An abnormal vaginal discharge is a common complaint among women of reproductive age, and it can indicate serious conditions like pelvic inflammatory disease and cervical cancer. This study aimed to assess the predictors of abnormal vaginal discharge in women of reproductive age group in Imo State, Southeast Nigeria. Methods: A cross-sectional study was conducted among 368 women of reproductive age group attending the clinic at Federal University Teaching Hospital Owerri, in Imo State, Nigeria. Respondents were recruited using a systematic sampling technique. Data were collected using a pre-tested interviewer-administered questionnaire. Multivariable analysis was performed to determine predictors of abnormal vaginal discharge. Statistical significance was set at p Results: The mean age of the respondents was 30 ± 4.5 years. Predictors of abnormal vaginal discharge were: age 36 - 45 years (OR: 4.5;95% C.I: 1.023 - 8.967, p = 0.041), being a student (OR: 2.4: 95% C.I: 1.496 - 7.336, p = 0.003), use of oral contraceptives (OR: 3.4;95% C.I: 1.068 - 6.932, p = 0.010), use of water cistern (OR: 4.7;C.I: 1.654 - 5.210, p = 0.028) anal hygiene practices (OR: 2.7;95% C.I: 1.142 - 4.809, p Conclusion: These findings suggest that targeted sexual and reproductive health interventions should be provided to reduce the risk of abnormal vaginal discharge in women of reproductive age group.展开更多
BACKGROUND Herlyn-Werner-Wunderlich(HWW)syndrome is a rare Müllerian duct anomaly,characterized by a combination of urogenital abnormalities.The occurrence of primary cervico-vaginal carcinomas in patients with H...BACKGROUND Herlyn-Werner-Wunderlich(HWW)syndrome is a rare Müllerian duct anomaly,characterized by a combination of urogenital abnormalities.The occurrence of primary cervico-vaginal carcinomas in patients with HWW syndrome is excep-tionally rare,posing significant challenges for screening,early diagnosis,and effective management.CASE SUMMARY We report a rare case of primary clear cell carcinoma of the vagina complicated in a 40-year-old woman with HWW syndrome.The patient presented with irregular vaginal bleeding for 4 years.On gynecological examination,an oblique vaginal septum was suspected.Surgical resection of the vaginal septum revealed a com-municating fistula and a tumor on the left vagina and the left side of the septum,which was confirmed as clear cell carcinoma.One month later,she underwent a radical hysterectomy,vaginectomy,bilateral salpingo-oophorectomy,and pelvic lymph node dissection.Due to significant side effects,she completed only one course of chemotherapy.A year later,lung metastasis was detected and continued to grow.A thoracoscopic wedge resection of the right upper lobe was performed 4 years after the initial surgery.We also conducted a systemic review of the lite-rature on primary cervical or vaginal carcinoma in HWW syndrome to explore this rare entity.CONCLUSION Cervico-vaginal adenocarcinomas in patients with HWW syndrome are occult,and require early surgical intervention and regular imaging surveillance.展开更多
Introduction: Vaginal practices include washing, altering, cutting, cleaning, enhancing, drying, tightening, lubricating, or loosening of the vagina, labia, clitoris, or hymen. This study aimed to investigate the diff...Introduction: Vaginal practices include washing, altering, cutting, cleaning, enhancing, drying, tightening, lubricating, or loosening of the vagina, labia, clitoris, or hymen. This study aimed to investigate the different vaginal practices of women using non-pharmaceutical products. Methodology: This was a cross-sectional study with descriptive and analytical purposes that took place from January 15 to April 23, 2023, in the four largest markets in the municipality of Ouagadougou. This was performed using the data collection sheet in the KoboCollect application. Epi info 7.2.5.0. software was used for data analysis. For the analysis of associated factors, a p-value Results: In total, 977 women were surveyed. Among them, 43.19% underwent vaginal procedures using non-pharmaceutical products. The female practitioners were 34.34 ± 7.44 years old. The products used included plants, mineral substances, ointments, tablets, and solutions. Among the practicing women, 40.99% were looking for vaginal tightening. The main purpose was to maintain their partners (45.97%). Three-point thirty-two percent (3.32%) of the women who underwent vaginal procedures had reported adverse events. Conclusion: Raising awareness of the consequences of vaginal practices and encouraging women to go to a health center for any gynecological problem could significantly reduce the prevalence of vaginal practices.展开更多
Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complicati...Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complications. Few studies exist on the comparative prognoses of twins. Our objective was to compare early neonatal complications in first and second twins. Methods: We carried out a cross-sectional prospective study from January 2 to April 30, 2020 (4 months) at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital. Data collected were analyzed using IBM SPSS version 23. Descriptive statistics were done in frequencies and percentages, means and standard deviations. Paired-sample student's t-test were used to compare means. McNemar’s Chi-square and Ficher’s exact tests were used to compare proportions. Statistical significance was set at p-values less than 0.05. Results: Of a total of 2183 deliveries during the study period, 43 (1.96%) were twin vaginal deliveries. Among the 43 women, 41 consented to have their newborns participate in the study. Overall, APGAR scores were better for the first twins at the first (p = 0.004) and fifth (p = 0.031) minutes than for the second twins. Although both twins had complications and that there were 4 neonatal deads of the second twin, there was no relationship between studied complications and the rank of the twin (p = 0.310). Conclusion: As the APGAR score seemed to be better for first twins, clinicians should pay more attention during twin births, in order to improve the prognosis of the second twin.展开更多
Background: Cesarean section (CS) has increased steadily over the last decade, with an estimated one-third of women delivering by cesarean section worldwide. Objective: Our study aimed to investigate the demographic a...Background: Cesarean section (CS) has increased steadily over the last decade, with an estimated one-third of women delivering by cesarean section worldwide. Objective: Our study aimed to investigate the demographic and associated factors influencing vaginal birth after one cesarean (VBAC-1) success focusing on variables like pre-pregnancy BMI, diabetes, hypertension, education, and smoking. Study Design and Methods: In this retrospective study, we analyzed 285 cases (81 unsuccessful VBAC-1, 204 successful VBAC-1) from San Juan City Hospital (Puerto Rico) between January 1, 2019, and December 31, 2020. We used odds ratios and model selection comparison to assess the impact of variables on successful VBAC-1, using a significance threshold of 95% CI. Model selection assessed binomial model combinations using a generalized linear approach to identify key risk factors. Results: Unsuccessful VBAC-1 (a repeat cesarean), was associated with diabetes (OR: 0.376, p = 0.086), hypertension (OR: 0.23, p = 0.006), and university-educated women (OR: 1.372, p = 0.711). High school-educated women had an OR of 3.966 (p = 0.105), while overweight women were 0.481 times more likely to have unsuccessful VBAC-1 (p = 0.041). Significant associations were not found with obesity (OR: 0.574, p = 0.122), underweight/normal (OR: 1.01, p = 0.810), or smoking (OR: 1.227, p = 0.990). Conclusion: Results revealed women with higher education levels, hypertension, or diabetes are less likely to have a successful VBAC-1. Understanding the complex interactions affecting these outcomes is aimed at establishing guidelines for healthcare professionals to conduct systematic risk/benefit assessments. This study lays a foundation for evidence-based practices and policies, offering initial insights into VBAC-1 success factors in Puerto Rico.展开更多
Broad ligament hematoma is typically seen during cesarean section due to rupture of branches of uterine and vaginal vessels and it’s rare to be seen post-normal vaginal delivery. Addressing puerperal hematomas postpa...Broad ligament hematoma is typically seen during cesarean section due to rupture of branches of uterine and vaginal vessels and it’s rare to be seen post-normal vaginal delivery. Addressing puerperal hematomas postpartum presents considerable challenges for obstetric care providers. While hematomas such as those affecting the vulva, vulvovaginal region, or paravaginal area are frequently encountered, retroperitoneal hematomas are rare and notably pose a greater risk to the life of the patient. The medical literature contains scant case reports on retroperitoneal hematomas, with no consensus on a definitive treatment approach. Pelvic arterial embolization has emerged as both a sensible and increasingly preferred method for treating these hematomas recently, but its application is contingent upon the patient maintaining hemodynamic stability and the availability of a specialized interventional embolization unit. In our case, we are presenting a very rare case of a 31-year-old primigravida female with a history of in vitro fertilization pregnancy. She delivered a normal vaginal delivery at 31 weeks gestation. Unfortunately, she experienced multiple complications intrapartum, including preeclampsia and placental abruption. These complications increased her risk of developing a broad ligament hematoma.展开更多
Background: Studies on either postnatal quality of life in general or studies that compare quality of life in new mothers after different mode of delivery are limited. An investigation on health related quality of lif...Background: Studies on either postnatal quality of life in general or studies that compare quality of life in new mothers after different mode of delivery are limited. An investigation on health related quality of life measures in women after different type of delivery showed that women who had vaginal delivery had better health related quality of life compared to those who had caesarean section. However, the best method of delivery, vaginal or caesarean for postpartum quality of life is a difficult question as it is a matter of controversy both from professional’s perspectives and from women’s experience during childbirth. Objective: To compare postpartum quality of life in primiparous women after vaginal delivery versus caesarean section. Methods: Prospective cross-sectional study was conducted at the department of Obstetrics and Gynecology, Salmaniya medical complex in Kingdom of Bahrain. 500 primiparous women who gave birth either vaginally or by cesarean section answered a questionnaire designed to include general information, questions from short form health survey questionnaire (SF-36) and specific questions regarding postnatal related symptoms. Results: Body pain, fatigue, wound pain, headache and backache were significantly higher in cesarean section group as compared to vaginal delivery group (p-value Conclusion: Cesarean delivery has negatively affected the quality of life (QOL) of primiparous women. More studies with larger sample sizes should be conducted to examine the effects of cesarean delivery on QOL in both primiparous and multiparas within a shorter period after delivery. .展开更多
Introduction: Vaginal birth after cesarean (VBAC) plays an essential role in lowering cesarean rates. Despite endorsement, trial of labor after cesarean (TOLAC) attempt rates remain low, in part due to fear of lawsuit...Introduction: Vaginal birth after cesarean (VBAC) plays an essential role in lowering cesarean rates. Despite endorsement, trial of labor after cesarean (TOLAC) attempt rates remain low, in part due to fear of lawsuits. Zavanelli maneuver is a last resort procedure in the management of shoulder dystocia. We discuss a case of a woman determined to have a vaginal birth after her prior birth was complicated by shoulder dystocia requiring a Zavanelli maneuver. Her physicians were reluctant to allow her a TOLAC given her prior obstetric history. Case: A 34-year-old para 1 with prior cesarean delivery due to shoulder dystocia that required Zavanelli maneuver presents determined to pursue VBAC in her current pregnancy. She considered her delivery route options and addressed her modifiable risk factors. She consulted with multiple perinatologists who agreed that a TOLAC was reasonable, however she had to travel more than 70 miles (from Pennsylvania to New Jersey) to find an obstetrical practice and hospital willing to consider VBAC. She transferred care and the remainder of her prenatal course was uncomplicated. She went into labor at 41 weeks and had a successful VBAC without complication. In a thank you letter to her obstetrician, she described her birth experience as euphoric. Conclusion: This case illustrates how a woman’s choice of delivery route may be impacted by fear of litigation. Local providers focused on her prior delivery instead of her overall improved risk profile. Delivery route decisions should be based on a thorough evaluation of all risk factors and individualized to meet the reproductive goals of each woman. .展开更多
Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered ...Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered combination kit, containing 2 g secnidazole, 1 g azithromycin and 150 mg fluconazole (Azimyn FS Kit), has been successfully evaluated in clinical trials and used in several countries for management syndromic vaginal discharge due to infections. Methods: This is a longitudinal study which aimed to verify the clinical efficacy of the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit<sup><sup>®</sup></sup>) in the syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultations in Kinshasa/DR Congo from March to September 2023. Results: Majority of patients had whitish vaginal discharge (51.6%) of average abundance (56.2%), accompanied by pruritus in 72.1% of cases, and dyspareunia in 23.5% of cases and hypogastralgia in 40.2% of cases. One week after treatment with the Azimyn FS<sup><sup>®</sup></sup> combined kit, at the greatest majority of patients (97.3%), abnormal vaginal discharge had decreased by more than 50% (84.1%). Two weeks after treatment with the Azimyn FS<sup><sup>®</sup></sup> combined kit, almost all patients (97.3%) no longer had abnormal vaginal discharge which had completely disappeared. Conclusion: A single dose of secnidazole, azithromycin and fluconazole in the form of an oral combi-kit (Azimyn FS Kit) has shown excellent therapeutic effectiveness in the syndromic treatment of abnormal vaginal discharge wherein patients were treated without diagnostic confirmation.展开更多
基金supported by Hibah pengabdian masyarakat internal UMY tahun 2023/2024(No.ID CJ4487-MyHAM).
文摘Objective:To determine the relationship between the color of vaginal discharge and the volume of vaginal discharge and the types of microorganisms in the genital organs.Methods:Cross-sectional study by conducting vaginal swab examinations on 56 women with complaints of vaginal discharge in Bareng Lor Village,Klaten,and Sewugalur,Kulon Progo,Indonesia.A vaginal swab was carried out with a Gram examination.Data were coded and analyzed using the chi-c test.Results:The color of vaginal discharge was divided into:non-vaginal discharge 16.1%(9/56),white/clear/mucoid 50%(28/56),greenish/white 14.3%(8/56),brownish white/brown 3.6%(2/56),powdery and white 3.6%(2/56),post coitus bleeding 7.1%(4/56),and other complaints(itching,odor,erosion)5.4%(3/56).The volume of vaginal discharge was divided into:normal 16.1%(9/56),a little 48.2%(27/56),and a lot 35.7%(20/56).The types of microorganisms obtained were:no microorganisms growing 8.9%(5/56),Gram positive cocci/bacilli 7.1%(4/56),Gram negative cocci/bacilli 19.6%(11/56),Gram positive/negative coccobacilli 7.1%(4/56),growth of>2 bacteria 42.9%(24/56),and fungus/yeast cells/clue cells 14.3%(8/56).There is a significant relationship between volume and type of microorganisms(P=0.011),while the relationship between color/type of vaginal discharge and microorganisms is not significantly related.Conclusions:The volume of vaginal discharge reflects the presence of risky microorganisms.
文摘Background: The maternal and neonatal morbidity caused by prolonged labour, maternal exhaustion and other factors push clinicians to speed up the delivery process by employing equipment such as vacuum suction or forceps to save the newborn. The purpose of this study was to determine the prevalence of vacuum-assisted vaginal delivery (VAVD) and its associated short-term maternal and neonatal outcomes at Ndola Teaching Hospital. Methods: A retrospective cross-sectional descriptive study through the analysis of routine data for women with singleton-term pregnancies who delivered by vacuum compared with spontaneous vaginal delivery was done at a tertiary hospital for the years 2020 and 2021. Chi-square and Logistic regression were used to investigate factors of vacuum delivery and to adjust for potential confounders. Results: Results showed that VAVD was mostly performed in women who had delayed second stage of labour (25.4%), maternal exhaustion (16.0%), foetal distress in the second stage of labour (12.3%). The overall VAVD prevalence was 3.7% (581/15591). Logistic regression showed that multiparous women were noted to be 87.5% (aOR 0.125;95% CI 0.025 - 0.629;p = 0.012) less likely to undergo VAVD compared to nulliparous women. Registrars were almost 6 times (aOR 5.650;95% CI 1.458 - 22.222, p = 0.012) more likely to conduct VAVD compared to midwives. Episiotomy was 3 times (aOR 3.390;95% CI 1.185 - 9.524;p Conclusion: The findings indicate the underutilisation of VAVD at NTH based on the low prevalence of 3.7%. VAVD outcomes were affected by multiparity, skill level and Episiotomy procedure, in addition, VAVD influenced admission to the NICU. Hence, there is a need to increase skills in VAVD among first-line healthcare workers such as midwives and intern doctors.
基金funded by the National Key Research and Development Program of China (2023YFE0124400)the Specific university discipline construction project (2023B10564001)+1 种基金grants administered by the Arkansas Biosciences Institute and the USDAa core grant (P20GM121293, proteogenomics core)。
文摘Background Sow longevity and reproductivity are essential in the modern swine industry.Although many studies have focused on the genetic and genomic factors for selection,little is known about the associations between the microbiome and sows with longevity in reproduction.Results In this study,we collected and sequenced rectal and vaginal swabs from 48 sows,nine of which completed up to four parities(U4P group),exhibiting reproductive longevity.We first identified predictors of sow longevity in the rectum(e.g.,Akkermansia)and vagina(e.g.,Lactobacillus)of the U4P group using RandomForest in the early breeding stage of the first parity.Interestingly,these bacteria in the U4P group showed decreased predicted KEGG gene abundance involved in the biosynthesis of amino acids.Then,we tracked the longitudinal changes of the micro-biome over four parities in the U4P sows.LEfSe analysis revealed parity-associated bacteria that existed in both the rectum and vagina(e.g.,Streptococcus in Parity 1,Lactobacillus in Parity 2,Veillonella in Parity 4).We also identi-fied patterns of bacterial change between the early breeding stage(d 0)and d 110,such as Streptococcus,which was decreased in all four parties.Furthermore,sows in the U4P group with longevity potential also showed better reproductive performance.Finally,we discovered bacterial predictors(e.g.,Prevotellaceae NK3B31 group)for the total number of piglets born throughout the four parities in both the rectum and vagina.Conclusions This study highlights how the rectal and vaginal microbiome in sows with longevity in reproduc-tion changes within four parities.The identification of parity-associated,pregnancy-related,and reproductive performance-correlated bacteria provides the foundation for targeted microbiome modulation to improve animal production.
文摘This is a case report of a rare myoma of the anterior vaginal wall that mimicked a paraurethral diverticulum in a postmenopausal woman. Surgical treatment of the lesion was performed via a transvaginal approach without complications, and the material was sent for anatomopathological examination, which confirmed the diagnosis of leiomyoma. Vaginal leiomyomas are a rare lineage of tumors at this gynecological site, with just over 300 reports worldwide. Symptoms can range from totally asymptomatic to genitourinary complaints, such as urinary incontinence to dyspareunia. The diagnosis is based on a physical examination and preoperative imaging tests (MRI, transvaginal ultrasound, cystoscopy, computed tomography), but the definitive diagnosis is histopathological analysis of the specimen. The treatment of choice is surgery with complete excision of the lesion, and in 90% of cases, the transvaginal approach is chosen.
基金supported by Xiamen University,which played a key role in the collection and analysis of the datafunded by National Natural Science Foundation of China(grants 82341031,82173584,and 82222062)+2 种基金Major Research Plan of the National Natural Science Foundation of China(grant 92269205)Science Fund for Distinguished Young Scholars of Jiangsu Province(grant BK20220064)Jiangsu Provincial Key Project of Science and Technology Plan(grants BE2021738 and BE2023601)。
文摘Background:Human papillomavirus(HPV)infection is a major risk factor of cervical cancer.This study assessed the prevalence and distribution of HPV genotypes in women with cervical or vaginal lesions in Jiangsu Province,China.Methods:A total of 2120 healthy women aged 18–45 years were screened between 2012 and 2013 and 6171 healthy women aged18–45 years were screened between 2020 and 2021 in Jiangsu Province.Cervical specimens collected from each woman were first tested using the HPV DNA enzyme immunoassay method,and positive samples were further tested using the reverse hybridization line probe assay.Differences in HPV prevalence and genotype distribution were compared between women with cervical and vaginal lesions identified during 2 rounds of cross-sectional screening.To account for differences in age composition between the 2 studies,the standardized prevalence of HPV positivity was calculated using the sum of the total number of women diagnosed with cervical or vaginal lesions during both periods as the standard group.Results:Overall,40 women(1.89%)were diagnosed with cervical or vaginal lesions through biopsy during 2012–2013,and 110(1.78%)were diagnosed during 2020–2021.Among women with lesions,the standardized HPV positivity rates were 98.41%in 2012–2013 and99.24%in 2020–2021.Most cases were caused by high-risk HPV,which accounted for 87.18%of the total infections during 2012–2013and 89.91%of those in 2020–2021,with standardized positivity rates of 86.44%and 88.75%,respectively.The standardized positivity rates for single infections were 62.35%in 2012–2013 and 74.95%in 2020–2021.The top 5 high-risk HPV genotypes were HPV type 16(HPV16;29.01%),52(20.63%),18(14.28%),58(13.71%),and 33(12.12%)in 2012–2013,and HPV16(36.95%),58(22.18%),52(13.25%),31(7.63%),and 51(6.81%)in 2020–2021.The standardized positivity rate for HPV18 decreased from 14.28%in2012–2013 to 1.15%in 2020–2021.Among women with cervical or vaginal lesions,the highest proportion was observed in the 36-to 45-year group during 2012–2013,reaching 52.50%,and in the 26-to 35-year group during 2020–2021,peaking at 59.10%.Conclusions:In Jiangsu Province,no significant changes in HPV prevalence among women with cervical or vaginal lesions were observed during 2012–2013 and 2020–2021;however,the distribution of HPV genotypes had changed.
文摘Dear Editor,The incidence of complications associated with ventriculoperitoneal(VP)shunts ranges from 24%to 47%,with abdominal complications comprising 25%of these cases[1].The shunt may migrate to various body parts,including the abdominal wall,gastrointestinal tract,vagina,bladder,scrotum,mediastinum,and the oral cavity.Cerebrospinal fluid(CSF)leakage through the vagina is an uncommon complication of VP shunts;however,its exact incidence remains unknown.Such complications can result in failure of the shunt procedure,often requiring revision or reinsertion in affected patients[2].
文摘In recent years,the obstetrics department has advocated vaginal delivery to reduce the rate of cesarean sections.However,in clinical practice,pregnant women are prone to anxiety before childbirth,making it difficult to perform a vaginal trial delivery smoothly.The combined approach of ADIET communication and delivery rehearsal for vaginal trial delivery can provide a reference for reducing prenatal anxiety,shortening labor duration,facilitating a smooth delivery,and ensuring the safety of both mothers and babies.AIM To analyze the effect of AIDET communication combined with labor rehearsal on vaginal trial delivery.METHODS A study conducted between January 2023 and December 2023 included 200 vaginal trials.Women were randomly assigned to an observation group(100 women),which received ADIET communication plus delivery intervention,and a control group(100 women),which received routine communication plus delivery intervention.This study aimed to compare antenatal anxiety status as measured using the Maternal Anxiety Scale,labor duration,delivery efficacy as assessed using the simplified Chinese version of the Childbirth Self-Efficacy Inventory,and delivery outcomes.RESULTS After the intervention,the observation group had a lower Maternal Anxiety Scale score and higher Childbirth Self-Efficacy Inventory score(P<0.05)than the control group(P<0.05),whereas the observation group had higher natural delivery,cesarean delivery,vaginal delivery,and neonatal asphyxia rates(P<0.05).CONCLUSION For women undergoing vaginal trial delivery,a combination of AIDET communication and delivery rehearsal can relieve prenatal anxiety,enhance delivery efficiency,shorten labor duration,and somewhat improve delivery outcomes.
文摘BACKGROUND Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy.However,vaginal cuff dehiscence is a serious complication after laparoscopic total hysterectomy and so far,there are limited studies on vaginal cuff dehiscence after a total hysterectomy.AIM To investigate the factors influencing vaginal cuff dehiscence after laparoscopic hysterectomy and the psychological state of the patients.METHODS This study retrospectively,univariately,and multivariately analyzed the clinical data of patients who experienced vaginal cuff dehiscence after laparoscopic hysterectomy in Yuyao People’s Hospital from January 2015 to December 2021.Logistic regression was utilized to analyze the high-risk factors of vaginal cuff dehiscence.RESULTS Among 1459 cases with laparoscopic hysterectomy,9 reported vaginal cuff dehiscence postoperatively,with an incidence of 0.617%.Univariate logistic regression analysis revealed that preoperative hemoglobin value[odds ratio(OR)=5.12,P=0.016],vaginal cuff suture method(OR=0.26,P=0.048),and postoperative first sexual lifetime(OR=15.86,P=0.002)were associated with vaginal cuff dehiscence following laparoscopic hysterectomy.Multivariate logistic regression analysis revealed that preoperative hemoglobin value of<90 g/L(OR=5.17,P=0.015)and time interval between postoperative first sexual life and operation of<3 months(OR=54.00,P=0.004)are independent risk factors for vaginal cuff dehiscence after laparoscopic hysterectomy.CONCLUSION Postoperative hemoglobin and the time interval between postoperative first sexual life and operation were the independent factors of developing vaginal cuff dehiscence after laparoscopic hysterectomy.
文摘The vaginal microbiome plays a pivotal role in maintaining vaginal health and protecting the host from various diseases.There is a broad agreement within the scientific community that the vaginal microbiome exhibits stable bacterial diversity,influenced by age and gonadal hormone levels,and is classified into distinct Community-State Types.A healthy vaginal microbiome is typically characterized by a predominance of Lactobacillus spp.,which acidifies the vaginal environment and is essential in defending against invading microbial pathogens.This review examines the evolution of the vaginal microbiome’s composition throughout a woman’s life.It also explores how exogenous factors influence the homeostasis of this microbiome,leading to either a state of eubiosis or dysbiosis.The main factors supporting eubiosis of the vaginal microbiome include diet,probiotic intake,certain personal hygiene practices,and hormonal contraceptives,while the major contributors to dysbiosis are psychosocial stress,tobacco smoking,and sexual activity.This state of dysbiosis is strongly associated with a range of adverse vaginal health outcomes,including preterm birth,bacterial vaginosis,pelvic inflammatory disease,and a higher risk of sexually transmitted infections.
文摘BACKGROUND Primary vaginal cancer is rare and most vaginal tumors are metastatic,often arising from adjacent gynecologic structures.Primary vaginal cancers are also more common among postmenopausal women and most of these are squamous cell carcinomas,with adenocarcinomas being relatively rare.Vaginal bleeding is the most common clinical manifestation of vaginal adenocarcinoma.About 70%of vaginal adenocarcinomas are stage I lesions at the time of diagnosis,for which radical surgery is recommended.However,more advanced vaginal cancers are not amenable to radical surgical treatment and have poor clinical outcomes.Optimal treatments modes are still being explored.Here,we report a rare case of stage IIb primary vaginal adenocarcinoma for which an individually designed vaginal applicator for after-loading radiotherapy was used to achieve good tumor control.CASE SUMMARY A 62-year-old woman presented to our clinic after 3 months of abnormal postmenopausal vaginal bleeding.Gynecological examination,computed tomography(CT),and positron emission tomography-CT showed a large mass(about 5 cm)on the anterior vaginal wall.Colposcopy biopsy confirmed adenocarcinoma of vaginal origin.After three cycles of carboplatin plus paclitaxel chemotherapy,the lesion partially shrunk.The patient then received external irradiation of 45 gray(gy)in 25 fractions,which further reduced the vaginal lesion,followed by after-loading radiotherapy of 30 gy in 5 fractions with an individually designed vaginal applicator.Three months later,magnetic resonance imaging showed a slight thickening CONCLUSION Primary vaginal adenocarcinoma is rare,and prognosis is poor in most vaginal cancers of locally advanced stages,which cannot be treated with radical surgery.Better tumor control can be achieved with an individualized vaginal applicator that allows administration of a higher radical dose to the tumor area while protecting normal tissues.
文摘Objective: To investigate the effects of different concentrations of β-glucan on the repair of damaged vaginal mucosa, the expression of vascular endothelial growth factor (VEGF), and the inflammatory factor-6 (IL-6) in vaginal tissues. Methods: Thirty-six adult female specific pathogen free (SPF)-grade Wistar rats were randomly divided into 3 phase groups with 12 rats each. Vaginal inflammation rat models were established by injecting phenol gel into the vagina of each rat at a dose of 0.1 ml/100g body weight. After modeling, rats were divided into 4 groups based on different concentrations of the test agent. The control group was injected with 0.5 ml of saline, experimental group A was injected with 0.375 ml saline 0.125 ml β-glucan, experimental group B was injected with 0.25 ml saline 0.25 ml β-glucan, and experimental group C was injected with 0.50 ml β-glucan. The injection sites were selected at the 3 o’clock and 9 o’clock positions of the vagina. Rats were sacrificed at 7-, 14-, and 28-days post-injection, and tissue samples were collected from the injection sites and prepared for histological analysis. New blood vessels and fibroblast numbers in the tissues were observed after Hematoxylin-eosin (HE) staining. The expression levels of VEGF and IL-6 in the tissues were measured using quantificational reverse transcription polymerase chain reaction (qRT-PCR). Results: Histological examination of vaginal tissue specimens at 7-, 14-, and 28-days post-injection showed that on day 7, there were no significant changes in the experimental groups compared to the control group. However, on days 14 and 28, the experimental groups showed more new blood vessels, macrophages, and fibroblasts with increased activity compared to the control group. The expression levels of VEGF in vaginal tissues were elevated on days 14 and 28 in the experimental groups. The comparison of IL-6 levels in vaginal tissues on day 28 showed that serum IL-6 levels returned to normal, and there was no statistically significant difference between the experimental and control groups. Conclusion: In the 3 experimental phases, the increase in VEGF levels in vaginal tissues on day 14 post-injection was more pronounced with higher concentrations of β-glucan, and IL-6 levels returned to normal on day 28. β-Glucan can enhance VEGF levels in damaged vaginal tissues, promote the repair of damaged vaginal tissues, and higher concentrations of β-glucan have a better effect.
文摘Background: An abnormal vaginal discharge is a common complaint among women of reproductive age, and it can indicate serious conditions like pelvic inflammatory disease and cervical cancer. This study aimed to assess the predictors of abnormal vaginal discharge in women of reproductive age group in Imo State, Southeast Nigeria. Methods: A cross-sectional study was conducted among 368 women of reproductive age group attending the clinic at Federal University Teaching Hospital Owerri, in Imo State, Nigeria. Respondents were recruited using a systematic sampling technique. Data were collected using a pre-tested interviewer-administered questionnaire. Multivariable analysis was performed to determine predictors of abnormal vaginal discharge. Statistical significance was set at p Results: The mean age of the respondents was 30 ± 4.5 years. Predictors of abnormal vaginal discharge were: age 36 - 45 years (OR: 4.5;95% C.I: 1.023 - 8.967, p = 0.041), being a student (OR: 2.4: 95% C.I: 1.496 - 7.336, p = 0.003), use of oral contraceptives (OR: 3.4;95% C.I: 1.068 - 6.932, p = 0.010), use of water cistern (OR: 4.7;C.I: 1.654 - 5.210, p = 0.028) anal hygiene practices (OR: 2.7;95% C.I: 1.142 - 4.809, p Conclusion: These findings suggest that targeted sexual and reproductive health interventions should be provided to reduce the risk of abnormal vaginal discharge in women of reproductive age group.
文摘BACKGROUND Herlyn-Werner-Wunderlich(HWW)syndrome is a rare Müllerian duct anomaly,characterized by a combination of urogenital abnormalities.The occurrence of primary cervico-vaginal carcinomas in patients with HWW syndrome is excep-tionally rare,posing significant challenges for screening,early diagnosis,and effective management.CASE SUMMARY We report a rare case of primary clear cell carcinoma of the vagina complicated in a 40-year-old woman with HWW syndrome.The patient presented with irregular vaginal bleeding for 4 years.On gynecological examination,an oblique vaginal septum was suspected.Surgical resection of the vaginal septum revealed a com-municating fistula and a tumor on the left vagina and the left side of the septum,which was confirmed as clear cell carcinoma.One month later,she underwent a radical hysterectomy,vaginectomy,bilateral salpingo-oophorectomy,and pelvic lymph node dissection.Due to significant side effects,she completed only one course of chemotherapy.A year later,lung metastasis was detected and continued to grow.A thoracoscopic wedge resection of the right upper lobe was performed 4 years after the initial surgery.We also conducted a systemic review of the lite-rature on primary cervical or vaginal carcinoma in HWW syndrome to explore this rare entity.CONCLUSION Cervico-vaginal adenocarcinomas in patients with HWW syndrome are occult,and require early surgical intervention and regular imaging surveillance.
文摘Introduction: Vaginal practices include washing, altering, cutting, cleaning, enhancing, drying, tightening, lubricating, or loosening of the vagina, labia, clitoris, or hymen. This study aimed to investigate the different vaginal practices of women using non-pharmaceutical products. Methodology: This was a cross-sectional study with descriptive and analytical purposes that took place from January 15 to April 23, 2023, in the four largest markets in the municipality of Ouagadougou. This was performed using the data collection sheet in the KoboCollect application. Epi info 7.2.5.0. software was used for data analysis. For the analysis of associated factors, a p-value Results: In total, 977 women were surveyed. Among them, 43.19% underwent vaginal procedures using non-pharmaceutical products. The female practitioners were 34.34 ± 7.44 years old. The products used included plants, mineral substances, ointments, tablets, and solutions. Among the practicing women, 40.99% were looking for vaginal tightening. The main purpose was to maintain their partners (45.97%). Three-point thirty-two percent (3.32%) of the women who underwent vaginal procedures had reported adverse events. Conclusion: Raising awareness of the consequences of vaginal practices and encouraging women to go to a health center for any gynecological problem could significantly reduce the prevalence of vaginal practices.
文摘Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complications. Few studies exist on the comparative prognoses of twins. Our objective was to compare early neonatal complications in first and second twins. Methods: We carried out a cross-sectional prospective study from January 2 to April 30, 2020 (4 months) at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital. Data collected were analyzed using IBM SPSS version 23. Descriptive statistics were done in frequencies and percentages, means and standard deviations. Paired-sample student's t-test were used to compare means. McNemar’s Chi-square and Ficher’s exact tests were used to compare proportions. Statistical significance was set at p-values less than 0.05. Results: Of a total of 2183 deliveries during the study period, 43 (1.96%) were twin vaginal deliveries. Among the 43 women, 41 consented to have their newborns participate in the study. Overall, APGAR scores were better for the first twins at the first (p = 0.004) and fifth (p = 0.031) minutes than for the second twins. Although both twins had complications and that there were 4 neonatal deads of the second twin, there was no relationship between studied complications and the rank of the twin (p = 0.310). Conclusion: As the APGAR score seemed to be better for first twins, clinicians should pay more attention during twin births, in order to improve the prognosis of the second twin.
文摘Background: Cesarean section (CS) has increased steadily over the last decade, with an estimated one-third of women delivering by cesarean section worldwide. Objective: Our study aimed to investigate the demographic and associated factors influencing vaginal birth after one cesarean (VBAC-1) success focusing on variables like pre-pregnancy BMI, diabetes, hypertension, education, and smoking. Study Design and Methods: In this retrospective study, we analyzed 285 cases (81 unsuccessful VBAC-1, 204 successful VBAC-1) from San Juan City Hospital (Puerto Rico) between January 1, 2019, and December 31, 2020. We used odds ratios and model selection comparison to assess the impact of variables on successful VBAC-1, using a significance threshold of 95% CI. Model selection assessed binomial model combinations using a generalized linear approach to identify key risk factors. Results: Unsuccessful VBAC-1 (a repeat cesarean), was associated with diabetes (OR: 0.376, p = 0.086), hypertension (OR: 0.23, p = 0.006), and university-educated women (OR: 1.372, p = 0.711). High school-educated women had an OR of 3.966 (p = 0.105), while overweight women were 0.481 times more likely to have unsuccessful VBAC-1 (p = 0.041). Significant associations were not found with obesity (OR: 0.574, p = 0.122), underweight/normal (OR: 1.01, p = 0.810), or smoking (OR: 1.227, p = 0.990). Conclusion: Results revealed women with higher education levels, hypertension, or diabetes are less likely to have a successful VBAC-1. Understanding the complex interactions affecting these outcomes is aimed at establishing guidelines for healthcare professionals to conduct systematic risk/benefit assessments. This study lays a foundation for evidence-based practices and policies, offering initial insights into VBAC-1 success factors in Puerto Rico.
文摘Broad ligament hematoma is typically seen during cesarean section due to rupture of branches of uterine and vaginal vessels and it’s rare to be seen post-normal vaginal delivery. Addressing puerperal hematomas postpartum presents considerable challenges for obstetric care providers. While hematomas such as those affecting the vulva, vulvovaginal region, or paravaginal area are frequently encountered, retroperitoneal hematomas are rare and notably pose a greater risk to the life of the patient. The medical literature contains scant case reports on retroperitoneal hematomas, with no consensus on a definitive treatment approach. Pelvic arterial embolization has emerged as both a sensible and increasingly preferred method for treating these hematomas recently, but its application is contingent upon the patient maintaining hemodynamic stability and the availability of a specialized interventional embolization unit. In our case, we are presenting a very rare case of a 31-year-old primigravida female with a history of in vitro fertilization pregnancy. She delivered a normal vaginal delivery at 31 weeks gestation. Unfortunately, she experienced multiple complications intrapartum, including preeclampsia and placental abruption. These complications increased her risk of developing a broad ligament hematoma.
文摘Background: Studies on either postnatal quality of life in general or studies that compare quality of life in new mothers after different mode of delivery are limited. An investigation on health related quality of life measures in women after different type of delivery showed that women who had vaginal delivery had better health related quality of life compared to those who had caesarean section. However, the best method of delivery, vaginal or caesarean for postpartum quality of life is a difficult question as it is a matter of controversy both from professional’s perspectives and from women’s experience during childbirth. Objective: To compare postpartum quality of life in primiparous women after vaginal delivery versus caesarean section. Methods: Prospective cross-sectional study was conducted at the department of Obstetrics and Gynecology, Salmaniya medical complex in Kingdom of Bahrain. 500 primiparous women who gave birth either vaginally or by cesarean section answered a questionnaire designed to include general information, questions from short form health survey questionnaire (SF-36) and specific questions regarding postnatal related symptoms. Results: Body pain, fatigue, wound pain, headache and backache were significantly higher in cesarean section group as compared to vaginal delivery group (p-value Conclusion: Cesarean delivery has negatively affected the quality of life (QOL) of primiparous women. More studies with larger sample sizes should be conducted to examine the effects of cesarean delivery on QOL in both primiparous and multiparas within a shorter period after delivery. .
文摘Introduction: Vaginal birth after cesarean (VBAC) plays an essential role in lowering cesarean rates. Despite endorsement, trial of labor after cesarean (TOLAC) attempt rates remain low, in part due to fear of lawsuits. Zavanelli maneuver is a last resort procedure in the management of shoulder dystocia. We discuss a case of a woman determined to have a vaginal birth after her prior birth was complicated by shoulder dystocia requiring a Zavanelli maneuver. Her physicians were reluctant to allow her a TOLAC given her prior obstetric history. Case: A 34-year-old para 1 with prior cesarean delivery due to shoulder dystocia that required Zavanelli maneuver presents determined to pursue VBAC in her current pregnancy. She considered her delivery route options and addressed her modifiable risk factors. She consulted with multiple perinatologists who agreed that a TOLAC was reasonable, however she had to travel more than 70 miles (from Pennsylvania to New Jersey) to find an obstetrical practice and hospital willing to consider VBAC. She transferred care and the remainder of her prenatal course was uncomplicated. She went into labor at 41 weeks and had a successful VBAC without complication. In a thank you letter to her obstetrician, she described her birth experience as euphoric. Conclusion: This case illustrates how a woman’s choice of delivery route may be impacted by fear of litigation. Local providers focused on her prior delivery instead of her overall improved risk profile. Delivery route decisions should be based on a thorough evaluation of all risk factors and individualized to meet the reproductive goals of each woman. .
文摘Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered combination kit, containing 2 g secnidazole, 1 g azithromycin and 150 mg fluconazole (Azimyn FS Kit), has been successfully evaluated in clinical trials and used in several countries for management syndromic vaginal discharge due to infections. Methods: This is a longitudinal study which aimed to verify the clinical efficacy of the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit<sup><sup>®</sup></sup>) in the syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultations in Kinshasa/DR Congo from March to September 2023. Results: Majority of patients had whitish vaginal discharge (51.6%) of average abundance (56.2%), accompanied by pruritus in 72.1% of cases, and dyspareunia in 23.5% of cases and hypogastralgia in 40.2% of cases. One week after treatment with the Azimyn FS<sup><sup>®</sup></sup> combined kit, at the greatest majority of patients (97.3%), abnormal vaginal discharge had decreased by more than 50% (84.1%). Two weeks after treatment with the Azimyn FS<sup><sup>®</sup></sup> combined kit, almost all patients (97.3%) no longer had abnormal vaginal discharge which had completely disappeared. Conclusion: A single dose of secnidazole, azithromycin and fluconazole in the form of an oral combi-kit (Azimyn FS Kit) has shown excellent therapeutic effectiveness in the syndromic treatment of abnormal vaginal discharge wherein patients were treated without diagnostic confirmation.
