Purpose
To evaluate the role of single-step universal screening in first trimester and its effectiveness.Materials and methods
Three thousand women attending antenatal clinic of Pt JNM Medical College, Raipur, were screened with 75 gm OGTT in their first trimester irrespective of their last meal, and those who were screened negative were again subjected to OGTT at 24–28 weeks. The women were followed throughout pregnancy till delivery. Any maternal or perinatal complications were noted.Result
Overall incidence of GDM was 5.2 %. About 61.54 % women screened positive in first trimester. At 24–28 weeks, 38.46 % women were diagnosed with GDM. Women diagnosed in first trimester showed significantly low incidence of cesarean section rate (20.83 %), PIH (2.08 %), and macrosomia (14.44 %), in comparison to women diagnosed later in pregnancy.Conclusion
The role of first trimester screening was found effective in reducing adverse maternal and perinatal outcomes in GDM.Study Objective
Polycystic ovary syndrome (PCOS) is a common endocrinopathy among female adolescents and young women. The aim of this study was to investigate the relationship between serum 25-hydroxy vitamin D (25[OH] D) levels and metabolic parameters and other characteristics of PCOS and non-PCOS adolescents.Design
Case-control study.Setting and Participants
We analyzed 31 girls with PCOS as defined using the Rotterdam criteria and 35 girls were non-PCOS control participants.Interventions and Main Outcome Measures
The serum 25(OH) D level was measured. Anthropometric, clinical, endocrine, and metabolic components were determined in both groups.Results
The group with PCOS showed no difference in the level of serum 25(OH) D (14.58 ± 6.15 vs 16.02 ± 7.87; P = .414). In addition to this, no significant correlations were found between serum 25(OH) D levels and endocrine or metabolic parameters in either PCOS patients or control participants.Conclusion
There was no difference in the level of serum 25(OH) D between PCOS patients and matched control participants. Vitamin D deficiency was common among the patients as well as in the control participants. Also, we did not find any relationship between serum 25(OH) D levels and clinical or metabolic profiles in the 2 groups. 相似文献Background
Women’s empowerment is often used to explain changes in reproductive behavior, but no consideration is given to how reproductive events can shape women’s empowerment over time. Fertility may cause changes in women’s empowerment, or they may be mutually influencing. Research on women’s empowerment and fertility relies on cross-sectional data from South Asia, which limits the understanding of the direction of association between women’s empowerment and fertility in other global contexts. This study uses two waves of a panel survey from a prominent Middle Eastern country, Egypt, to examine the trajectory of women’s empowerment and the relationship between first and subsequent births and empowerment over time.Methods
Using longitudinal data from the 2006 and 2012 Egyptian Labor Market Panel Survey, a nationally representative sample of households in Egypt, for 4660 married women 15 to 49 years old, multilevel negative binomial, ordinary least squares, and logistic regression models estimate women’s empowerment and consider whether a first and subsequent births are associated with empowerment later in life. Women’s empowerment is operationalized through four measures of agency: individual household decision-making, joint household decision-making, mobility, and financial autonomy.Results
A first birth and subsequent births are significantly positively associated with all measures of empowerment except financial autonomy in 2012. Women who have not had a birth make 30% fewer individual household decisions and 14% fewer joint household decisions in 2012 compared to women with a first birth. There is also a positive relationship with mobility, as women with a first birth have more freedom of movement compared to women with no births. Earlier empowerment is also an important predictor of empowerment later in life.Conclusions
Incorporating the influence of life events like first and subsequent births helps account for the possibility that empowerment is dynamic and that life course experiences shape women’s empowerment. This and the notion that empowerment builds over time helps portray women’s lives more completely, demonstrates the importance of empowerment early in the life course, and addresses issues of temporality in empowerment fertility research.Granulosa cell tumor (GCT) is a rare entity of ovarian malignancies. Juvenile GCT is considered a malignant tumor with an indolent course and tendency toward late recurrence. However, the association of this tumor and multiple enchondromas has been reported.
Case PresentationA 17-year-old female with abnormal uterine bleeding was referred to our center. Ultrasonographic evaluation revealed a mass with origin in right ovary. Patient was worked up to undergo salpingo-oophorectomy, she felt a dull pain in her left lower limb. X-ray imaging was indicative for Ollier’s disease at the distal part of femur and proximal part of tibia. Postoperative pathological review was compatible with juvenile granulosa tumor of the right ovary.
ConclusionThis case was the first of its kind that ovarian tumor was contralateral to the side involved by enchondromatosis.
相似文献Objective
We aimed to investigate the association of pregnancy associated plasma protein A (PAPP-A) levels in late first trimester with small for gestational age (SGA) neonates and adverse pregnancy outcomes in a low-income setting.Methods
The inclusion criteria were late first trimester (11–13 + 6 weeks) women with singleton and non-anomalous pregnancy. Enrolled participants were sampled for PAPP-A and prospectively followed up for delivery outcome and antenatal complications. A multiple of median (MoM) was calculated and statistically compared between groups.Results
Out of total 284 subjects, 14.54% delivered SGA babies and formed cases (Group A), 66.5% delivered appropriate for gestational age (AGA) neonates with uneventful antenatal period (controls, Group B), and 19.3% were AGA group with adverse pregnancy complications (Group C). The late first trimester median PAPP-A MoM was significantly lower (0.61) in Group A compared to Group B (1.47). Using receiver operating characteristic (ROC) curve for PAPP-A MoM, optimal cutoff value was found at 0.45 MoM, with positive predictive value of 56.2%, specificity of 92.6% and sensitivity of 45%. The median interquartile range (IQR) of PAPP-A MoM value in Group C in comparison with Group B was significantly lower except for abruption. At PAPP-A MoM cutoff value <1, <0.8, <0.6 and <0.4, the odds ratio for adverse pregnancy outcome was 8.30, 7.29, 10.97 and 10.60, respectively, indicating an inverse relationship.Conclusion
With 0.45 MoM cutoff of PAPP-A, the detection rate, specificity and positive predictive value for SGA were 45, 92.6 and 56.2%, respectively. As PAPP-A MoM values decreased, the odds ratio of having adverse pregnancy outcomes increased.Methods: An exploratory anonymous online survey was distributed among Dutch women who underwent a trial of labor and gave birth to a living term child in the previous six months. Unadjusted odds ratios are calculated to establish associations between women’s characteristics and reporting a negative experience with VE's.
Results: Of the 159 women who met the inclusion criteria, 56 women (35.2%) reported a negative experience with the VE. These women reported more pain, embarrassment, not being able to relax, not feeling respected and not feeling the possibility to stop the examination. The odds of reporting negative experiences increased by giving birth in hospital, an instrumental delivery, more examinations, more different caretakers performing the examination and caregivers not introducing themselves before the examination. About 41.7% of the women reported being examined more often than advised in national and international guidelines (every two to four hours).
Discussion: Although our study is limited, it shows that experiences with the VE during labor can be negative and should be considered carefully. We promote research of and teaching the use of additional noninvasive methods to assess progression of labor in daily clinical practice. We conclude that the number of VE’s during labor should be restricted as much as possible. VE’s should only be performed in the interest of the woman in labor, after her informed consent and preferably performed by as few different caregivers as possible. 相似文献
Objectives
To evaluate whether women with Ebstein’s anomaly can tolerate pregnancy and whether the perinatal outcomes are influenced by the severity of Ebstein’s anomaly.Methods
Data of four women with Ebstein’s anomaly delivered in our unit were collected and analyzed retrospectively.Results
(1) Two women with Ebstein’s anomaly had uneventful pregnancies, cesarean section and puerperium. (2) The patient with the most serious Ebstein’s anomaly (with central cyanosis and clubbing) had an episode of paroxysmal ventricular tachycardia and spontaneous cardioversion to sinus rhythm on day 4 postpartum. She developed intracerebral hemorrhage on day 25 postpartum. (3) One of them suffered from atrial flutter on 38?+?3?weeks of gestation which was restored to sinus rhythm after being treated with verapamil and remained stable afterward. (4) All neonatal birth weights were more than 2,500?g, and all neonatal Apgar scores were 10 at 1?min. (5) The gestational age at delivery of our cases was from week 36?+?4 to week 38?+?4. The mean duration of follow-up was 56?days postpartum.Conclusions
(1) The clinical features of pregnant women with Ebstein’s anomaly vary. They might have good perinatal outcomes when given appropriate treatment. (2) Those with cyanosis should be given more attention, as they can have more complications during pregnancy, delivery and puerperium. (3) All women with Ebstein’s anomaly should be offered fetal echocardiography during pregnancy. (4) Vaginal delivery is advised for most cases with Ebstein’s anomaly. 相似文献Study design: An observational study was designed at the Gynaecological Endocrinology Unit of Hospital Clinic in Barcelona. Patients diagnosed with TS by blood karyotype were included, between 20 and 50 years of age. A new 50-cell count blood karyotype and a urethral cell karyotype from urine samples were performed. Data on some TS-related comorbidities were collected.
Results: Twenty-seven TS patients were included. Urine cultures of 12 patients were contaminated by microorganisms. With 50-cell count blood karyotype, three cryptic mosaicisms were found. Six patients with mosaicism in blood karyotype showed pure monosomy in urine karyotype. Correlations exist between blood karyotype and phenotype where spontaneous menarche, height, dysmorphology, congenital malformations and hypothyroidism are concerned, whereas they did not appear in urine analysis.
Conclusions: Karyotyping T-lymphocytes in blood samples is the gold standard technique. 50-cell count may be considered if TS or ovarian failure is suspected, in order to detect cryptic mosaicisms. Urethral cell culture from urine samples presents technical difficulties and some limitations, due to the easier lost of abnormal X-chromosome. A partial correlation between blood karyotype and phenotype exists. 相似文献