Influence of exercise mode on pregnancy outcomes: ENHANCED by mom project

In the ENHANCED by Mom study authors aim to determine the effects of different modes of exercise training (aerobic, circuit, and resistance) throughout pregnancy on childhood health by controlling individual exercise programs and assessing the effects of each on fetal and neonatal health adaptations. A better understanding on the effects of exercise training during pregnancy on fetal and neonatal health could have a profound impact on the prevention and development of chronic diseases such as obesity, hypertension, and diabetes.

ENHANCED by mom is a cross sectional comparison study utilizing 3 intervention groups in comparison to a control group.

Participants will complete three 5 min warmup + 45 min sessions weekly from 16 weeks to 36 weeks gestation of aerobic, resistance, or circuit training, in comparison to non–exercising controls.

Maternal physical measurements will occur every 4 weeks throughout the intervention period.

Fetal morphometric and heart measurements will occur at 34 weeks gestation.

Neonatal measurements will be acquired at birth and at 1 month, 6 months, and 12 months.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Outcomes of transobturator tape surgery with safyre T slings for female stress urinary incontinence after 96 months of follow-up

Authors conducted a clinical follow–up study of 153 patients diagnosed with SUI between January 2005 and December 2014.

Patients were provided with detailed a priori information pertaining to the TOT procedure and were invited to attend follow–up visits at 1, 3, 12, 24, 48, 72 and 96 months.

Follow–up visits included physical examination involving sling palpation, checking of the vaginal mucosa for erosion, cough test, as well as validated Urinary Distress Inventory–6 (UDI–6) and Incontinence Impact Questionnaire–7 (IIQ–7) questionnaires.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Availability of Obstetric And Neonatale Mergency Cares (Emonc) In Benin

Itis a descriptive, analytical and transversal study such as SARA (Service Availability and

ReadinessAssessment) which took place from January 1 to August 31, 2013. The sample consisted of health facilities in public and private sectors located in both urban and rural areas.

Results: The delivery services were available in 82% of health facilities (97.7% of hospitals, 92.2% of Health Centers (HC), 40.5% of Primary Care Centers (PCC), 86.1% of public’s health facilities have and 75.7% of private).Qualified personnel was available in 88.4% of health-centers. Parenteral administration of antibiotics, oxytocic and anticonvulsants were available respectively 94.2%, 94.2% and 76.1%. The assisted vaginal delivery, the manual removal of placenta and uterine evacuation maneuvers were respectively found in 42.6%, 88.4% and 54.8% of health facilities which practice birth. Neonatal resuscitation was available in 83.9% of facilities including all hospitals, 83% of HC and 47% of PCC. Only a quarter of institutions offering delivery (25.8%) were real BEmONC centers.Cesarean section was available in all hospitals and 3.2% HC. Blood transfusion was available in 25.8% of health facilities surveyed. Actual CEmONC health facilities represent 18.1% of all health facilities offering delivery services.

Conclusion: Efforts are still needed to ensure better availability of all EmONC functions to achieve the MDGs.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Hemoperitoneum Caused by Spontaneous Uterine Varicose Vein Rupture in the Third Trimester of Pregnancy-A Case Report

Spontaneous rupture of uterine varicose veins is a rare and poorly understood complication during pregnancy. Its clinical presentation is misleading and non-specific. Due to the high maternal and fetal mortality, the diagnosis of a hemoperitoneum must be done quickly.

We report a case of spontaneous rupture of uterine varicose veins revealed by an abundant hemoperitoneum that occurred in a 35 year-old pregnant patient at 32 weeks of gestation. A laparotomy enabled the diagnosis and the treatment of this complication in addition to the extraction through a cesarean section of a healthy newborn.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

The Relationship between Vitamin D, Insulin Resistance and Infertility in PCOS Women

It has been speculated that the majority of individuals in the India are deficient in Vitamin D and that Vitamin D deficiency has become an epidemic in our country. There is widespread prevalence of varying degrees (50- 90%) of Vitamin D deficiency with low dietary calcium intake in Indian population according to various studies published earlier. A deficiency of Vitamin D not only causes poor bone mineralization but also has been implicated in numerous us chronic diseases. Vitamin D deficiency is common in women with polycystic ovary syndrome (PCOS),

with the 67-85% of women with PCOS having serum concentrations of 25-hydroxy Vitamin D (25OHD) <20 ng/ml. Vitamin D deficiency may intensify symptoms of PCOS, with observational studies showing lower 25OHD levels were associated with insulin resistance, ovulatory and menstrual irregularities, lower pregnancy success rate,hirsutism, hyper-androgenism, obesity and elevated cardiovascular disease risk factors. There is some, but limited,evidence for beneficial effects of Vitamin D supplementation on menstrual dysfunction and insulin resistance in women with PCOS. Vitamin D deficiency may play a role in exacerbating PCOS, and there may be a place for Vitamin D supplementation in the management of this syndrome, but current evidence is limited and additional randomized controlled trials are required to confirm the potential benefits of Vitamin D supplementation in this population.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Outcomes of Pregnancy after Bariatric Surgery

We identified 627,693 singleton pregnancies in the Swedish Medical Birth Register from 2006 through 2011, of which 670 occurred in women who had previously undergone bariatric surgery and for whom presurgery weight was documented. For each pregnancy after bariatric surgery, up to five control pregnancies were matched for the mother’s presurgery body-mass index (BMI; we used early-pregnancy BMI in the controls), age, parity, smoking history, educational level, and delivery year. We assessed the risks of gestational diabetes, large-for-gestational-age and small-for-gestational-age infants, preterm birth, stillbirth, neonatal death, and major congenital malformations.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Goserelin for Ovarian Protection during Breast-Cancer Adjuvant Chemotherapy

We randomly assigned 257 premenopausal women with operable hormone-receptor–negative breast cancer to receive standard chemotherapy with the GnRH agonist goserelin (goserelin group) or standard chemotherapy without goserelin (chemotherapy-alone group). The primary study end point was the rate of ovarian failure at 2 years, with ovarian failure defined as the absence of menses in the preceding 6 months and levels of follicle-stimulating hormone (FSH) in the postmenopausal range. Rates were compared with the use of conditional logistic regression. Secondary end points included pregnancy outcomes and disease-free and overall survival.

Website:  http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

A meta-analysis of risk of pregnancy loss and caffeine and coffee consumption during pregnancy

·         PubMed was searched for reports published before September 2014, with the keywords “caffeine,” “coffee,” “beverage,” “miscarriage,” “spontaneous abortion,” and “fetal loss.”

·         Case–control and cohort studies were included when they had been reported in English, the exposure of interest was caffeine/coffee consumption during pregnancy, the outcome of interest was spontaneous abortion or fetal death, and multivariate–adjusted odds ratios (ORs) or risk ratios were provided or could be calculated.

·         Data were extracted and combined ORs calculated.

Website:  http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynaecology/

Prediction of small for gestational age neonates: Screening by biophysical and biochemical markers at 19-24 weeks

In this study, authors want to investigate the potential value of combined screening, by maternal characteristics and medical history, fetal biometry and biophysical and biochemical markers at 19–24 weeks' gestation, for prediction of delivery of small for gestational age (SGA) neonates in the absence of preeclampsia (PE) and examine the potential value of such assessment in deciding whether the third–trimester scan should be at 32 and / or 36 weeks' gestation. Prenatal prediction of a high proportion of SGA neonates necessitates the undertaking of screening in the third–trimester of pregnancy, in addition to assessment in the second–trimester, and the timing of such screening, at 32 and / or 36 weeks, should be contingent on the results of the assessment at 19–24 weeks.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynaecology/

3. Influence of home and school environments on specific dietary behaviors among postpartum, high-risk teens, 27 states, 2007-2009

The objective of this study was to determine whether perceptions of the home and school food environments are related to food and beverage intakes of postpartum teens. Home and school environments are related to dietary behaviors among postpartum teens, with a positive home environment more strongly associated with healthful behaviors.

Website:  http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynaecology/

Gynaecological issues affecting the obese adolescent

The implications of obesity in childhood and adolescence resonate into adulthood and have implications at different levels that include psychosocial and health issues that impact beyond reproductive performance. This chapter explores the various facets and consequences on gynaecological issues of increased Body Mass Index in childhood, including the link with puberty, pubertal menorrhagia (also affecting children with complex needs) and the all too common problems surrounding hyperandrogenism, insulin resistance and the polycystic ovarian syndrome in particular which need to be seen in the specific context of the adolescent years. The wider ramifications of obesity on the psychosocial welfare of adolescents merits special attention. Finally management strategies are considered in the context of the needs of adolescents.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynaecology/

Contraception and sexual health in obese women

•Obese adult women do not differ from normal-weight women regarding sexual health, sexual behavior, and contraceptive use.

•Body image may lead obese adolescents to engage in riskier behavior, placing them at a greater risk of an unintended pregnancy.

•Evidence is reassuring that most modern contraceptive methods are safe and effective in obese women.

•There is some evidence that oral emergency contraception is less effective in overweight and obese women.

Website:  http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynaecology/