International Journal of Women's Health and Reproduction Sciences
Year:2015 | Volume:3 | Issue:2|Papers Count:12

I have been conducting qualitative breastfeeding research regarding the experiences of African American families who have parented breastfed children. One comment has been stated over and over again in response to questions regarding perceived challenges with breastfeeding, "My breasts belong to my baby now and my husband will get them back after weaning," or fathers have said, "It is an adjustment to have to share her breasts with my child." I also frequently hear these comments in clinical practice as well, and not just from African American parents. As a lactation consultant and breastfeeding advocate I find these comments frustrating. In fact, the more I hear them the more bothered I become. My emotional response and the increasing frequency with which I hear these statements warrant discussion and inquiry.

Boron neutron capture therapy (BNCT) was introduced in 1960’s, but showed little development, as the thermal and epithermal neutron sources were not economical. Nuclear reactors, and recently cyclotrons are being used as neutron sources, thus enabling its widespread utilization (1).Gamma rays are utilized for the irradiation of tumor tissues, and fractional doses up to 50-60 Gray required for tumor ablation in conventional radiation therapy. Such high doses naturally irradiate healthy tissues, and thus result in healthy tissue injury.

Objectives: Gestational weight gain is important for optimal maternal and neonatal outcomes. New Institute of Medicine (IOM) recommendations for gestational weight gain define obesity as body mass index (BMI)³30 and do not differentiate between maternal obesity classes. The recommended weight gain is 11-20 lbs. for obese women. The purpose of this study is to document prevalence of maternal obesity, excess gestational weight gain, and negative maternal and neonatal outcomes prior to 2009 IOM recommendations for gestational weight gain.Materials and Methods: This was a retrospective cohort study using Texas birth/infant death certificate data for 2005 through 2009, inclusive. The study population included 419, 028 women. Those with excess (>20 lbs.) gestational weight gain were compared with those who gained the recommended 11-20 lbs.Results: Compared to the recommended weight-gain group, women in the excessive weight-gain group had lower percentage of gestational diabetes, across three obesity classes. Women with excessive weight gain had higher percentage of pre-eclampsia and Cesarean delivery (C-section) than women in the recommended weight-gain group. Babies of women with excessive weight gain in Obesity Class III had higher percentages of Neonatal Intensive Care Unit (NICU) admission, assisted ventilation>6 hours, surfactant therapy, and antibiotics for suspected sepsis than babies of women in Obesity Class III, gaining within the IOM recommendation.Conclusion: Findings suggest that the relationships between maternal obesity classification, gestational weight gain, and maternal and neonatal outcomes are complex. Further evidence is needed to make recommendations on gestational weight gain for obese women, stratified by the severity of obesity.

Objectives: To estimate the incidence of perineal trauma in primiparous women with spontaneous vaginal delivery and to identify the factors associated with second-degree lacerations.Materials and Methods: A subset analysis of women with spontaneous vaginal deliveries (n=489) from an institutional review board-approved parent study in healthy, nulliparous, continent pregnant women, attending the public health care system of Catalonia (northeast Spain). Primary outcome measure was perineal trauma according to the RCOG classification. For the bivariate analysis, the Student’s t-test, ANOVA and the chi-squared test, or the corresponding non-parametric tests were used. Rates, relative risks and odds ratios (multivariate analysis) were estimated along with 95% confidence intervals (CI).Results: About 91% (95% CI: 88-93%) of women with vaginal deliveries showed some degree of perineal trauma. Nulliparous women with spontaneous deliveries who did not undergo an episiotomy were 9 times more likely to present a tear (any grade) than those who received an episiotomy [Relative risks (RR)=9.6, 95% CI: 6.3%-14.6%, P<0.001]. Only episiotomy reached statistical significance in bivariate and multivariate analyses (P<0.0001), revealing the protective effect of episiotomy respect to second-degree tear.Conclusion: The absence of episiotomy was the only variable independently associated with second degree perineal tears, showing a clear protective effect.

Objectives: Rupture of membranes prior to the onset of labor is known as Premature Rupture of Membranes (PROM). Early and correct diagnosis is crucial in order to prevent fetal and maternal risks that can be life threatening. We aimed to investigate the diagnostic ability of the tests in PROM.Materials and Methods: Nitrazine test, fern test, amnio-dye test, biochemical tests (insulin-like growth factor binding protein-1 and placental alpha microglobulin-1) were evaluated in terms of effectiveness in diagnosis of PROM.Results: A gold standard method has not yet been defined in PROM. Diagnostic tests (nitrazine test, fern test, Insulin-like Growth Factor Binding Protein-1 "IGFBP-1" and Placental Alpha Microglobulin-1 "PAMG-1") should be used when the diagnosis is not certain following history, examination with sterile speculum and ultrasonography evaluation.Conclusion: IGFBP-1 and PAMG-1 are tests based on bedside immunochromatographic method. Especially, PAMG-1 comes into prominence with its high sensitivity and specificity.

Objectives: The African culture seems to play a major prohibiting role in physical exercise during pregnancy and immediate postpartum. This study was designed to assess practice and pattern of antenatal and postnatal exercise among Nigerian women.Materials and Methods: Three hundred and sixty-five women (189 pregnant women and 179 nursing mothers) from six selected hospitals in south-west Nigeria participated in this cross-sectional study. Data were obtained on socio-demographic and obstetric characteristics, and practice of antenatal and postnatal exercise. Descriptive and inferential statistics were used to analyze data at P<0.05 alpha level.Results: The mean age of all the respondents was 28.9±4.63 years. A majority of the pregnant women responders were nulliparous (39.2%) while the nursing mother responders were mostly multiparous (54.5%). Prevalence for engagement in physical exercise was 81.9% and mostly based on self-prescription (35.5%) and prescription by nurses (28.8%). Antenatal and postnatal exercise practice was 84.7% (160/189) and 79.0% (139/176), respectively. Aerobic (43.5%) and stretching (33.4%) were the most common type of physical exercises. Exercise frequency was mostly 1-2 times per week (40.8%). There was significant association between exercise practice and education level (c2=18.795; P=0.001).Conclusion: Engagement in antenatal and postnatal exercise among Nigerian pregnant and nursing women was high and mostly based on self-prescription. Education level significantly influence physical exercise practice among Nigerian women with aerobic and stretching as the predominant exercises in pregnancy and postpartum.

Objectives: Making a decision on the extent of surgery for ovarian tumors depends on the intraoperative diagnosis. The aim of this study was to compare the intraoperative cytology and frozen section (FS) for diagnosis of ovarian masses.Materials and Methods: One hundred and thirty-one patients with ovarian masses who underwent surgery for ovarian neoplasms were evaluated by intraoperative scrape and FS techniques and compared to final pathologic diagnoses.Results: Scrape cytology for intraoperative diagnosis of benign ovarian tumors had sensitivity of 89.06% compared to 90.62% for FS. Specificity of both scrape and FS techniques for benign tumors was 94.91%. Sensitivity and specificity of scrape for malignant ovarian tumors were 94.91% and 89.06%, respectively. The related values for FS were 94.91% and 90.62%. The overall accuracy percentage of scrape and FS for diagnosis of ovarian neoplasms was 91.86% and 92.68%, respectively.Conclusion: Intraoperative scrape cytology has high accuracy in diagnosis of ovarian tumors and is comparable with FS.

Objectives: Sperm cell preparation is an important step in the advanced treatment of infertility. Among the different methods introduced, none are considered to be ideal. The common methods are based on utilizing centrifugal separation which has been proven to be harmful to the sperm cell. We developed a method, based on the motion against the flow of sperm cell, which can successfully separate active sperm cells.Materials and Methods: In this study, we investigated the efficacy of this approach with a randomized clinical trial. Fifty-one candidates for the intra uterine insemination (IUI) treatment participated in our study. Twenty-five cases were assigned to our test group, separating the sperm cells using the proposed method (upstream method), and the conventional swim-up method was applied to 26 cases in our control group. The entire process of IUI treatment in both groups was exactly the same except for the methods of separating sperm cells.Results: Results showed that the pregnancy rate using the new method was 20%, while the common method of sperm cell preparation resulted in 15.3% pregnancy rate.Conclusion: The new sperm preparation method (Upstream method) can be used as a simple, quick and effective method of sperm cell separation in fertility treatment especially in IUI procedure.

Objectives: Achillea biebersteinii Afan. has been used as antispasmodic and sedative agent to treat dysmenorrhoea in traditional medicine of Golestan province. The present study was conducted to evaluate the antioxidant activity. It is also an ethno pharmacological survey of Achillea biebersteinii Afan., as antispasmodic and sedative agent in treating dysmenorrhoea in traditional medicine of Golestan province.Materials and Methods: Ethno pharmacological data was obtained as field observation among well-known indigenous rural healers (68-82 ages) in southwest of Golestan province in August 2011. The data gathered evaluated the potential of Achillea biebersteinii in preventing or treating dysmenorrhoea. Flowers of the plant were collected in July 2012 at an altitude of 2600 meters, ethanol extract was obtained by Maceration and antioxidant capacity was obtained by 1, 1-diphenyl-2-picryl hydrazyl radical scavenging (DPPH).Results: Results showed that in traditional medicine of Golestan province, the flowers of Achillea biebersteinii has been used in combination with Peganum harmala, Mentha aquatica, Cuminum cyminum, Foeniculum vulgare and Nigella sativa as antispasmodic, anti-inflammation and sedative agent to treat stomach ache, dysmenorrhoea, facial flushing, cramps and menopause. Also the ethanol extract of the plant is a very good free radical scavenging with the highest antioxidant activity (IC50=1.27±0.1 mg/ml in dry weight).Conclusion: These finding not only confirm the use of the plant in the traditional medicine of Golestan province, but also can serve as a basis for phytochemical and pharmaceutical researches to identify and produce effective herbal drugs in prevention or treatment of common dysmenorrhoea.

Objectives: To review the role of trachelectomy as a method of fertility preservation instead of traditional radical hysterectomy in early cervical cancer.Materials and Methods: We conducted our original study through research in PubMed for all original studies and reviews published in the last 10 years. We reviewed the data available on trachelectomy in early stage cervical cancer whether through abdominal route or vaginal route and laparoscopic lymphadenectomy. Moreover, we reviewed the oncologic outcome, recurrence rate and its effect on subsequent pregnancies.Results: We found that recurrence and death rates seem to be comparable between radical trachelectomy (RT) and radical hysterectomy. Complications of RT include chronic vaginal discharge, abnormal uterine bleeding, dysmenorrhea, inflammation and ulcer due to cerclage, amenorrhea, and cervical stenosis. Although around 70% can get pregnant after RT, there are increased complications of pregnancy after this procedure mainly 2nd trimester miscarriages and preterm deliveries.Conclusion: RT is a useful technique associated with an excellent pregnancy rate in fertility-preserving surgery to treat early stage cervical cancer. Selection of suitable patients for conservative treatment is the best important point for getting a good result without any recurrence or complication.

Introduction: Rudimentary horn pregnancy (RHP), an entity with a diagnostic dilemma is known to rupture most commonly in second trimester, sometimes in early third trimester. This case of ectopic rudimentary horn (RH) presented acutely in the first trimester.Case Presentation: A 30 years old G3P2L2 with previous two vaginal deliveries presented with acute abdominal pain and features of hemorrhagic shock at 8 weeks 5 days gestational age. With clinical diagnosis of ruptured ectopic pregnancy, the patient immediately underwent laparotomy, which revealed hemoperitoneum with a unicornuate uterus along with ruptured RHP. RH excision with ipsilateral salpingectomy and right tubal ligation was done and the maternal life salvaged.Conclusion: High index of suspicion based on clinical history and examination complemented with diagnostic radiological modalities can help in prenatal and pre-rupture diagnosis of RHP, hence its prompt treatment to alleviate scope of any emergency situation and the disastrous consequences leading to maternal morbidity and mortality.

Dear Editor: The accumulated data related to the recently discovered functions of laminin receptor 1 (LR1) in the early stages of placentation (1-5) made us to think that it may also have an important role in human reproduction, which may be regarded as a very new job for this multifunctional protein overexpressed in many types of cancer and is very well known for its important roles in tumour-cell migration and invasion.