P-746 Obstetric outcomes of singleton birth after hysteroscopic division of septate uterus

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
O Abuzeid ◽  
C Heiselman ◽  
A Fuchs ◽  
J La Chance ◽  
K Herrera ◽  
...  

Abstract Study question The aim of this study is to determine the obstetric outcomes in patients with a singleton birth after hysteroscopic division of septate uterus. Summary answer The data suggest excellent obstetric outcomes for singleton gestation after hysteroscopic division of a septate uterus reaching either the internal or the external cervical os. What is known already Septate uterus is a rare Müllerian anomaly with major impact on reproductive outcomes, particularly with a septum over 10mm. Controversy still exists over the need for surgical correction of the septum due to conflicting data on outcomes, particularly in women with histories of good obstetric outcomes and incidental septum findings. Placental location in relation to the septum may account for such conflicting reports. Most data on reproductive outcomes after hysteroscopic surgical correction combine both septate and subseptate uteri. There is limited published data on obstetric outcomes after hysteroscopic surgical correction of septate uteri, especially septate uteri reaching the external os. Study design, size, duration This retrospective cohort study included 107 patients with infertility and/or recurrent pregnancy loss (RPL) who received treatment between 2002 -2019. The study group included 24 patients with a singleton birth after hysteroscopic correction of septate uterus (Class Va; ASRM classification) that was diagnosed on trans-vaginal 3D ultrasound. The control group included 83 patients with a singleton birth who had normal endometrial cavity on hysteroscopy during the same period of time, before starting treatment. Participants/materials, setting, methods This study was conducted at an infertility clinic affiliated with a teaching hospital. In the study group the septum reached the internal or the external cervical os in 14 and 10 patients respectively. After hysteroscopic correction, all patients were offered various infertility treatments depending on the underlying etiology. The inclusion criterion in this study was to have a singleton birth after hysteroscopy. Demographic and clinical data and obstetric outcomes were compared between the two groups. Main results and the role of chance There was no significant difference in mean age, infertility duration, infertility type and incidence of male infertility or ovulatory disorders between the two groups. There was a significantly higher BMI (0.048), and a higher incidence of history of miscarriage (P=0.002) and history of RPL (P=0.017) in the study group. There was significant lower incidence of tubal factors infertility (P=0.005) and endometriosis (P=0.03) in the study group, therefore there was higher incidence of spontaneous conception (70.8% vs 19.3%; P=0.000) and lower incidence of conception with IVF-ET (20.8% vs 66.3%; P=0.000) in the study group compared to the control group respectively. There was significantly higher incidence of prophylactic cervical cerclage (17.4% vs 0%; P=0.000), and delivery by CS (69.6% vs 41.2%; P=0.019) and lower incidence of vaginal delivery (30.4% vs 58.8%; P=0.019), in the study group compared to the control group. There was no significant difference in gestational age in weeks (38.3 + 1.8 vs 38.6 + 2.0), newborn birth weight in grams (3173.9 + 630.0 vs 3202.1 + 555.6), incidence of premature birth (12.5% vs 12.2%), or other obstetric complications (25% vs 17.6%) between the study and the control groups respectively. For premature births, mean gestational age was 34.3 + 0.47 and 34.6 + 1.2 weeks in the study and control groups respectively. Limitations, reasons for caution A retrospective study has its own inherent bias. Furthermore, the small sample size is explained by the fact that a septate uterus is a rare anomaly leading to difficulties finding cases and organizing a prospective study to achieve a larger sample size. A multicenter prospective study is needed. Wider implications of the findings Regardless of whether the septum reached the internal or external os, there were excellent obstetric outcomes in singleton gestations after hysteroscopic correction of septate uteri. There was no increased risk with septate uteri involving the cervix. Hysteroscopic surgical correction should be the treatment of choice for patients with septate uteri. Trial registration number Not Applicable

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
O Abuzeid ◽  
C Heiselman ◽  
A Fuchs ◽  
J L Chance ◽  
K Herrera ◽  
...  

Abstract Study question The aim of this study is to determine the obstetric outcomes in patients with a singleton birth after hysteroscopic division of septate uterus. Summary answer The data suggest excellent obstetric outcomes for singleton gestation after hysteroscopic division of a septate uterus reaching either the internal or the external cervical os. What is known already Septate uterus is a rare Müllerian anomaly with major impact on reproductive outcomes, particularly with a septum over 10mm. Controversy still exists over the need for surgical correction of the septum due to conflicting data on outcomes, particularly in women with histories of good obstetric outcomes and incidental septum findings. Placental location in relation to the septum may account for such conflicting reports. Most data on reproductive outcomes after hysteroscopic surgical correction combine both septate and subseptate uteri. There is limited published data on obstetric outcomes after hysteroscopic surgical correction of septate uteri, especially septate uteri reaching the external os. Study design, size, duration This retrospective cohort study included 107 patients with infertility and/or recurrent pregnancy loss (RPL) who received treatment between 2002 –2019. The study group included 24 patients with a singleton birth after hysteroscopic correction of septate uterus (Class Va; ASRM classification) that was diagnosed on trans-vaginal 3D ultrasound. The control group included 83 patients with a singleton birth who had normal endometrial cavity on hysteroscopy during the same period of time, before starting treatment. Participants/materials, setting, methods This study was conducted at an infertility clinic affiliated with a teaching hospital. In the study group the septum reached the internal or the external cervical os in 14 and 10 patients respectively. After hysteroscopic correction, all patients were offered various infertility treatments depending on the underlying etiology. The inclusion criterion in this study was to have a singleton birth after hysteroscopy. Demographic and clinical data and obstetric outcomes were compared between the two groups. Main results and the role of chance There was no significant difference in mean age, infertility duration, infertility type and incidence of male infertility or ovulatory disorders between the two groups. There was a significantly higher BMI (0.048), and a higher incidence of history of miscarriage (P = 0.002) and history of RPL (P = 0.017) in the study group. There was significant lower incidence of tubal factors infertility (P = 0.005) and endometriosis (P = 0.03) in the study group, therefore there was higher incidence of spontaneous conception (70.8% vs 19.3%; P = 0.000) and lower incidence of conception with IVF-ET (20.8% vs 66.3%; P = 0.000) in the study group compared to the control group respectively. There was significantly higher incidence of prophylactic cervical cerclage (17.4% vs 0%; P = 0.000), and delivery by CS (69.6% vs 41.2%; P = 0.019) and lower incidence of vaginal delivery (30.4% vs 58.8%; P = 0.019), in the study group compared to the control group. There was no significant difference in gestational age in weeks (38.3 + 1.8 vs 38.6 + 2.0), newborn birth weight in grams (3173.9 + 630.0 vs 3202.1 + 555.6), incidence of premature birth (12.5% vs 12.2%), or other obstetric complications (25% vs 17.6%) between the study and the control groups respectively. For premature births, mean gestational age was 34.3 + 0.47 and 34.6 + 1.2 weeks in the study and control groups respectively. Limitations, reasons for caution A retrospective study has its own inherent bias. Furthermore, the small sample size is explained by the fact that a septate uterus is a rare anomaly leading to difficulties finding cases and organizing a prospective study to achieve a larger sample size. A multicenter prospective study is needed. Wider implications of the findings: Regardless of whether the septum reached the internal or external os, there were excellent obstetric outcomes in singleton gestations after hysteroscopic correction of septate uteri. There was no increased risk with septate uteri involving the cervix. Hysteroscopic surgical correction should be the treatment of choice for patients with septate uteri. Trial registration number Not applicable


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K M Diab ◽  
R M Mohamed ◽  
A G Abdelhay

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p < 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p < 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p < 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p < 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p < 0.001), Reduction in Hematocrite was significantly less in study group than control group (p < 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Farideh Akhlaghi ◽  
Seyyed Majid Bagheri ◽  
Omid Rajabi

In this paper, we studied the relation between the micronutrient and gestational diabetes. Therefore, we measured micronutrient concentration including Ni, Al, Cr, Mg, Fe, Zn, Cu, and Se in serum of women with gestational diabetes between 24 and 28 weeks of gestational age (study group) who had inclusion criteria and comparison with micronutrient levels in normal pregnant women with same gestational age (control group). Results showed that there was no significant difference between the serum micronutrient level (Ni, Al, Cr, Mg, Zn, Cu, Se) in study and control groups except serum level of iron which in serum of gestational diabetic women was lower than normal pregnant women and difference was significant.


2017 ◽  
Vol 5 (3) ◽  
pp. 305-309 ◽  
Author(s):  
Javad Ghaffari ◽  
Ghasem Rahmatpour Rokni ◽  
Armaghan Kazeminejad ◽  
Hosein Abedi

BACKGROUND: Alopecia areata is a non-scarring hair loss, which typically starts quickly. Atopy is one of the possible predisposing risk factors for this condition.AIM: This study aimed to evaluate the prevalence of thyroid disease, atopic dermatitis and allergic diseases in children with alopecia areata and compare the results with healthy individuals.METHODS: This case-control study was conducted on 50 patients with alopecia areata, diagnosed by a dermatologist, and 150 healthy individuals as the control group. Participants filled the questionnaires, and necessary tests were performed.RESULTS: In this study, the mean age of the participants was 2.55 ± 14.26 and 3.19 ± 11.92 in the case and control groups, respectively. Prevalence of asthma was 22% in the case group and 12.5% in control group (P = 0.109). Also, allergic rhinitis and eczema were observed in 20% and 22% of the subjects of the case group, whereas they were reported to be 8% and 10% in the control group (PV = 0.03 and 0.175, respectively). Moreover, 28% and 8% of the participants in the case and control groups had a family history of atopy and allergic disorders, respectively (P = 0.046). A significant difference was observed between the two groups regarding gender, type of delivery and contact with animals.CONCLUSIONS: According to the results of this study, a significant association was observed between the prevalence of alopecia areata and atopic conditions, such as allergic rhinitis and history of atopic dermatitis.


2018 ◽  
Vol 28 (1) ◽  
pp. 80-86
Author(s):  
Caner Kara ◽  
Pınar Ç. Özdal ◽  
Emrullah Beyazyıldız ◽  
Nurgül E. Özcan ◽  
Mehmet Y. Teke ◽  
...  

Purpose: To investigate the levels of circulating CD34+ stem cells in patients with neovascular type age-related macular degeneration (AMD) and its relation with clinical and optical coherence tomography (OCT) findings. Methods: The study consisted of 55 patients: 28 patients (18 male and 10 female) with neovascular type AMD as a study group and 27 patients (12 male and 15 female) scheduled for cataract surgery as a control group. The level of CD34+ stem cells was measured by flow cytometry. Demographic and clinical data were recorded. Results: The mean ages of patients in the study and control groups were 71 ± 8 and 68 ± 6 years, respectively. There was no statistically significant difference in terms of age, sex, or systemic disease association between study and control groups. However, smoking status was significantly higher in the study group (67.9% vs 37.0%; p = 0.02). Stem cell levels were significantly higher in the study group (1.5 ± 0.9 vs 0.5 ± 0.3; p<0.001), but there was no relation between stem cell levels and clinical and OCT findings. Conclusions: Increased circulating CD34+ stem cell levels were observed in patients with choroidal neovascular membrane associated with AMD, but no significant relation was found between cell levels and clinical and OCT findings.


2019 ◽  
Vol 7 (17) ◽  
pp. 2917-2923
Author(s):  
Khalid T. Aboalshamat ◽  
Assim M. Banjar ◽  
Mahmoud I. Al-Jaber ◽  
Noor M. Turkistani ◽  
Mohammed T. Al-Amoudi

AIM: This study aimed to assess the effectiveness of a recognised antimicrobial resistance (AMR) online module on knowledge and perception among dental students, using a randomised controlled trial study design. METHODS: Dental students (n = 64, aged 21-25 years) in clinical years agreed to participate in this triple-blinded, parallel, randomised controlled trial. There were 34 students in the study group and 30 students in the control group. The study group participated in an online course covering information about AMR, while students in the control group received another online course about microorganisms in dentistry. Both groups were assessed three times using online questionnaires: before the intervention (T1), after the intervention (T2), and two months later (T3). Each one of T1, T2 and T3 had 22 questions. The questions were repeated each time in T1, T2, and T3 asking about AMR but with different question format, to avoid the possibility of students to memorise the answers. RESULTS: The mean (m) of correct answers for all students on T1 was 12.56, with standard deviation (SD) of 3.2. On T2, m = 14.03 and SD = 3.85, and on T3, m = 14.36 and SD = 3.71. Scores ranged from 0 to 22. The participants in the study and control groups showed significant score improvements from T1 to T2, immediately after the intervention, but there was no significant difference between T2 and T3. The study group students’ scores did not improve significantly from T1 to T3, in contrast to the control group students’ scores. More importantly, there was no significant difference in improvement from T1 to T2 when comparing the study and control groups. CONCLUSION: Online courses might not be reliable learning methods for ensuring the optimal levels of AMR knowledge that are needed by dental practitioners.


2018 ◽  
Vol 14 (2) ◽  
pp. 13-26
Author(s):  
Anna Duda ◽  
Wojciech Stós

This study assesses the upper respiratory tract width at the level of the adenoid in patients with a normal (nasal) and abnormal (oral or mixed) breathing route. <b>Aim</b>. To compare the upper respiratory tract width in the study group (abnormal breathing route) and control group (normal breathing route) and to determine the cut-off point and mean limit values in order to conduct a differential diagnosis between a habitual and constitutional breathing route. <b>Material and methods</b>. The study included 221 patients treated at the Aquadent-Ortoestetyka Clinic in Kielce. Based on the medical history taken, clinical examination and subjective evaluation of the upper respiratory tract width according to Holmberg 112 patients were enrolled into the study group and 109 patients into the control group. The upper respiratory tract width was measured with two different linear methods: a modified method by Holmberg. and Linder-Aronson, and the Linder-Aronson and Henricson method (AD1-PNS, AD2-PNS).<b> Results</b>. In the study group the mean value of the Holmberg measurement is 4.25 mm, and in the control group – 14.1 mm. Mean values of AD1- PNS and AD2-PNS measurements in the study group are 8.1 mm and 9.5 mm, respectively, and they can be regarded as mean limit values. The 6 mm Holmberg measurement is the cut-off value between the study and control groups, and it should be monitored. In relation to the Holmberg measurement a difference between the study and control groups is 9.85 mm. Regarding AD1-PNS and AD2-PNS measurements a difference between the study and control groups is 11.4 mm and 10.0 mm, respectively.<b> Conclusions</b>. The upper respiratory tract width at the level of the adenoid shows a statistically significant difference between the study and control groups. It may indicate significant narrowing of the upper respiratory tract at the level of the adenoid in the study group or a different type of morphology of the facial skeleton. Limit values obtained in the study allow differentiation of a habitual and constitutional breathing route. <b>(Duda A, Stós W. Comparison of the upper respiratory tract width at the level of the adenoid in patients with normal and abnormal breathing route. Orthod Forum 2018; 14: 106-18)</b>.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1431.2-1432
Author(s):  
O. Hamdi ◽  
M. Sellami ◽  
M. Yasmine ◽  
A. Fazaa ◽  
S. Miladi ◽  
...  

Background:Rheumatic diseases such as rheumatoid arthritis (RA) and spondyloarthritis (SA) may occur among women of childbearing age. Adverse events during pregnancy including disease flare, preterm delivery, and neonatal or fetal death have been reported.Objectives:Our aim was to assess the impact of rheumatic diseases on the course of pregnancy.Methods:We conducted a cross-sectional study involving patients with RA (2010 ACR/EULAR criteria) and SA (2009 ASAS criteria) (study group) as well as healthy controls (control group) matched by age and gender. All women included had at least one pregnancy. Data were collected through telephonic interviews. We used the Student t test to compare the study group and the control group.Results:We enrolled 57 patients (30 RA and 27 SA) and 57 controls. The mean age in the study and the control groups were respectively 43.2 ± 8.2 years [26-48] and 37.5 ± 6 years. The mean chronic inflammatory rheumatisms duration was 13.81 ± 6.2 years. A history of primary sterility was found in 3 patients (1 RA and 2 SA) and none in the control group. The mean age during the first pregnancy was significantly higher in the study group (28 ± 6.2 years versus 24 ± 7 years in the control group) (p=0.01). Eight patients (5 RA and 3 SA) had a history of spontaneous miscarriage. A terminated pregnancy was noted in 3 patients (1 RA and 2 SA). Complications during pregnancy in the study group were gestational diabetes (0.3%), premature delivery (0.3), premature rupture of membranes (0.3%), abortion threat (0.3%) and pre-eclampsia (6%). Pregnancy was more associated with complications in the study group (p=0.05). Cesarean section was more used in the study group (28 patients versus 9 in the control group; p= 0.00). The main indications of cesarean section in the study group were macrosomia (11 patients), scar uterus (6 patients), sacroiliitis (4 SA patients), twin pregnancy (2 patients), and undetermined reasons (6 patients). Fetal presentation in the study group was the seat presentation (3%), top presentation (4%), face (2%), and forehead presentation (0.3%) with no significant difference with the control group. Complications of childbirth in the study group were hemorrhage of delivery (10.3%), cord widening (6.6%), perinatal asphyxia (4.9%), and dystocia (1.9%). However, no statistically significant differences were found between the two groups in the prevalence of complications of childbirth. During pregnancy, 5 patients were on salazopyrine, 2 on corticosteroids and, 1 on non-steroidal anti-inflammatories.Conclusion:Our study showed that pregnancies with rheumatic diseases were at increased risk of having maternal complications and adverse neonatal outcomes.Disclosure of Interests:None declared


2021 ◽  
Vol 36 (4) ◽  
pp. e292-e292
Author(s):  
Ruqaiya Al Sulaimani ◽  
Lovina Machado ◽  
Munira Al Salmi

Objectives: We sought to assess the prevalence of fibroids complicating pregnancy among Omani women who delivered and were followed-up at Sultan Qaboos University Hospital (SQUH) and correlate the presence of large fibroids (> 5 cm) with maternal and neonatal outcomes. Methods: This retrospective cohort study was conducted at the Department of Obstetrics and Gynecology, SQUH, from 1 January 2011 to 31 December 2016. Demographic data included maternal age, gravidity, parity, body mass index (BMI), and history of preterm delivery. Ultrasonographic data included the total number of fibroids, number of fibroids > 5 cm in diameter, and location. The main outcomes measured were preterm delivery, preterm premature rupture of membranes (PPROM), malpresentation, intrauterine growth restriction (IUGR), mode of delivery, postpartum hemorrhage, retained placenta, and cesarean myomectomy. Fetal outcomes included birth weight and Apgar score. We used the chi-square test and t-test to calculate significant outcomes. Results: The total number of deliveries over the study period was 24 800. Among these, 62 women had fibroids complicating pregnancy, giving an overall prevalence of 0.3%. Of the 62 women with documented uterine fibroids, 41 had fibroids > 5 cm in diameter and formed the study group, while the control group included 88 women with no fibroids and normal singleton pregnancies. The mean age, parity, BMI, and history of preterm delivery were comparable. The mean age of the study group was 32.6 years. There was no statistically significant difference in obstetric outcomes between the study and control group in terms of preterm labor (p =0.381), PPROM (p =0.536), malpresentation (p =0.237), IUGR (p =0.059), and retained placenta (p =0.296). Postpartum hemorrhage was significantly higher in the study group (p =0.018), the commonest cause was uterine atony (p =0.007). Women with large fibroids had a significantly increased cesarean section rate (p =0.002), the main indications were obstructed labor and failure to progress (62.5%). Five of the 44 women in the study group (12.8%) underwent cesarean myomectomy. Regarding neonatal outcomes, a statistically significant difference was noted in the Apgar scores. Conclusions: Fibroids measuring > 5 cm in diameter are more likely to cause obstetric complications and are associated with higher cesarean rates. Pre-conception myomectomy is recommended for women with large fibroids.


2017 ◽  
Vol 5 (5) ◽  
pp. 667-672
Author(s):  
Zana Lila-Krasniqi ◽  
Kujtim Shala ◽  
Teuta Pustina Krasniqi ◽  
Teuta Bicaj ◽  
Enis Ahmedi ◽  
...  

BACKGROUND: The aetiology of Temporomandibular disorder is multifactorial, and numerous studies have addressed that occlusion may be of great importance in the pathogenesis of Temporomandibular disorder.AIM: The aim of this study is to determine if any direct relationship exists between balanced occlusion and Temporomandibular disorder and to evaluate the differences between subjective balanced occlusion and measurements reported with T-scan III electronic system.MATERIAL AND METHODS: A total of 54 subjects were divided into three groups, selection based on anamnesis-responded to a Fonseca questionnaire and clinical measurements analysed with electronic system T-scan III. In the I study group were participants with fixed dentures with prosthetic ceramic restorations. In the II study group were symptomatic participants with TMD. In the third control group were healthy participants with full arch dentition that completed a subjective questionnaire that documented the absence of jaw pain, joint noise, locking and subjects without a history of TMD. The occlusal balance was reported subjectively through Fonseca questionnaire and compared with occlusion analysed with electronic system T-scan III.RESULTS: For attributive data were used percentage of the structure. Differences in P < 0.05 were considered significant. After distributing attributive data of occlusal balance subjectively reported and compared with measurements analysed with electronic system T-scan III were found significant difference P < 0.001 in all three groups.CONCLUSION: In our study, it was concluded that there were statistically significant differences of balanced occlusion in all three groups. Also it was concluded that subjective data are not exact with measurements reported with electronic device T-scan III.


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