Obstetrics and Gynecology

  • FEELING OF REFUSAL OF A PREGNANT IN FACE OF A GESTACIONAL LOSS: EXPERIENCE REPORT

    Introduction: The Project of Interdisciplinary Actions in Maternal and Child Health proposes actions directed to the health of the mother-baby binomial, accompanying from the prenatal to the infantile development, from an interdisciplinary perspective, involving Nursing, Psychology and Social Assistance courses of Federal University of Alagoas, Campus Arapiraca. Situations of gestational loss are often accompanied in the design practices. When considering the aspects of attachment and affection already present in the mother by the child, fetal or neonatal death brings to the surface the suffering expected before the death of a loved one, mourning being a natural process of passing through loss. Considering the stages of mourning pointed out by Elizabeth Klub-Ross, one of our experiences observed the phase of negation of a mother during the situation of gestational loss. Objective: This study aims to report the performance and importance of the interdisciplinary team in the face of gestational loss. Methodology: Descriptive study of the type of experience report based on the experience of students of Nursing and Psychology, Federal University of Alagoas. The experience in question happened in September of 2018, in a maternity hospital in the city of Arapiraca-Alagoas. Results: During a prepartum visit, we were confronted with a young woman at the 33rd gestational week who had received the news that her baby during the second trimester of pregnancy diagnosed with microcephaly was anencephalic and had almost no beating auscultation. The pregnant woman was 3 centimeters dilated and was informed of the remote possibilities of her son surviving. Faced with the news that her son’s chances of being born dead were high, she presented herself by caressing her belly and resistance to dialogue, by confining herself to reporting that her pregnancy was high risk. The elusive behavior evidenced the anticipation of mourning. The members of this project, being…

  • IDENTIFICATION AND REVELATION OF GESTACIONAL LOSS: EXPERIENCE REPORT

    Introduction: The Project for Interdisciplinary Actions in Maternal and Child Health consists of a strategy focused on maternal and child health care, as an extension project of the Federal University of Alagoas, Campus Arapiraca, with a focus on interdisciplinarity encompassing the courses: Nursing, Psychology and Social assistance. From the experiences in the project, a gestational loss situation caught the attention of the members of the same. According to the Ministry of Health fetal death is characterized as the death of the product of gestation before expulsion or complete extraction of the maternal body. The fact that, after separation, the fetus shows no sign of life indicates death. Objectives: To report the experience of a woman who suffered gestational loss accompanied by project members during action in a maternity. Methodology: Descriptive study of the type of experience report based on the experience of students of Nursing and Psychology, Federal University of Alagoas. The experience in question happened in May of 2018, in a maternity in the city of Arapiraca-Alagoas. Results: During the project actions we had contact for two consecutive days with a pregnant woman, term, primípara, accompanied by the husband and the mother. She reported pain in the lower back and lower belly. The first day was in the latency phase of labor and was advised by the nurse on call to wander to help in uterine dynamics. The next day, the parturient was in active labor, she was accompanied by her mother and the psychology student, until then everything went without complications. On this occasion the nurse asked us to listen to the fetal heartbeat, however, we could not detect them and we informed her that she was initially able to perceive fetal bradycardia and then no longer identified them. With this, the parturient was referred to the surgical…

  • Getting Rid of “Bomb Pushing the Womb”: Dysmenorrhea Management

    As indicated by the American Academy of Family Physicians, up to 20% of women experience the ill effects of menstrual cramping extreme enough to meddle with every day exercises. On the off chance that prostaglandins levels are higher, more pain is regularly connected with the issues. Cycle length, blood misfortune, period-related symptoms, liquid shading, and consistency are on the whole profoundly factor, notwithstanding for only one individual. Be that as it may, serious menstrual pain is probably going to be brought about by a medical problem, for example, PMS, fibroids, or endometriosis and needs medical help. At the point when scientists examined recurrence and span of exercise and contrasted it with reports of period pain, they discovered exercise did little to lessen discomfort, and in truth this persevered notwithstanding when a scope of different components—including weight, ethnicity, smoking and utilization of the birth control pill—were mulled over. A few women may likewise incline toward not to utilize hormonal contraceptives, as they can bring undesirable reactions, for example, variances in weight and disposition. A few strategies can likewise somewhat raise the danger of specific cancers, including bosom cancer (despite the fact that they diminish the danger of others, including womb cancer).

  • ASSOCIATION BETWEEN SINGLE NUCLEOTIDE POLYMORPHISM RS4919510 (C>G) IN MIRNA-608 AND BREAST CANCER IN VIETNAMESE POPULATION

    Breast cancer (BC) is a complex disease throughout the world and it is one of the most common cancer among women both in developed and developing countries. To enhance the survival of BC patients, genetic factors are used for early diagnosis because they are non-changed factors and present ability of cells to proliferate and metastasize. MiR-608 targets many genes which are vital for development, differentiation, motility, apoptosis and angiogenesis. The SNP rs4919510 (C/G) affects the processing of the pre-miRNA to its mature form and the ability to regulate target genes. This SNP has been demonstrated to relate to breast cancer in Chinese and Iranian population. Our study aimed to investigate the association between the SNP rs4919510 and BC in Vietnamese population. 106 cases and 101 controls were genotyped using optimized tetra-ARMs-PCR method, then statistical analysis was applied to examine the correlation of the SNP. The results show that this SNP is high polymorphism with the frequencies of minor allele C is 24.8% and major allele G is 75.2% in Vietnamese population. Statistic result revealed an obvious increased risk of BC among Vietnamese women when compared of heterozygote model and dominant model (CG vs. GG: OR=1.93, 95% CI: 1.09-3.45, p= 0.02; CC+CG vs. GG: OR=1.83, 95%CI: 1.05-3.17, p=0.03). Our study suggested that the polymorphism of rs4919510 may be associated with BC risk in Vietnamese individuals.

  • MATERNAL MORTALITY IN A MATERNITY WARD AT A REGIONAL HOSPITAL CENTER IN SOUTHERN SENEGAL

    Objectives: -to determine the maternal mortality ratio at the Kolda Regional Hospital; -to describe the socio-demographic characteristics of the deceased patients; -to clarify the causes of maternal mortality and to identify the associated risk factors. Materials and method: This was a prospective, descriptive and analytical study conducted between January 1st, 2012 and December 31st, 2016 at the Kolda Regional Hospital Center. We collected data from maternity records, resuscitation records, anesthesia records and the operating protocol register. Results: During this study period, we recorded 120 maternal deaths out of 4116 living births, a maternal mortality ratio of 2915.4 per 100,000 living births. The average age of our patients was 27 years old. The average parity was 4 deliveries and multiparas accounted for half of the patients. In our series, 84% of patients were evacuated; high blood pressure (35.8%) and obstructed labor (18.8%) were the most common reasons for evacuation. More than half of the deaths (52.5%) occurred in the postpartum and 32.5% in the 3rd quarter. More than half of the deaths occurred within the first 24 hours after of admission (52%). Just over a third of patients (39%) had delivered by caesarean section and we had 58.8% of perinatal deaths. The conclusions of the audit were a delay in consultation (57%) followed by a delay in evacuation (28%) and a delay in the management of patients (25%). Conclusion: The multiple factors influencing the high maternal mortality rate in this region of Senegal can be attributed to the community, the medical team, and / or the health system. Strategic interventions to reduce this mortality rate should be based on community education on safe motherhood, on the improvement of the level of education, on communication systems and better transportation, on access to quality reproductive health services and availability of emergency obstetric care.

  • Genital Prolapse on Pregnancy: Case Study and Literature Review

    Genital prolapse is a common gynecological condition, but it is exceptional during pregnancy. It can be pre-existent or else manifest in the course of pregnancy. Complications resulting from prolapse of the uterus in pregnancy vary from minor cervical infection to spontaneous abortion, and include preterm labor and maternal and fetal mortality as well as acute urinary retention and urinary tract infection. Moreover, affected women may be at particular risk of dystocia during labor that could necessitate emergency intervention for delivery. We report the case of a third third-generation 32-year-old third gesture second pare with no particular health history. The last two pregnancies proceeded normally with stage 2 genital prolapse occurring in the second trimester of pregnancy that was aggravated by abdominal expression during childbirth.

  • Term Abdominal Pregnancy with Live Fetus: about a Case and Review of the Literature

    Objectives: To specify the diagnostic difficulties and the criteria allowing a conservative load taking. Observation: We report a case of abdominal pregnancy with live fetus diagnosed ultrasonically at 23WA in a context of abdominal urgency on the background of secondary amenorrhea with prospective follow-up and birth at 36WA. Ultrasound is essential to diagnosis. The treatment is always surgical and the difficulty is dominated by the removal of the placenta. The fetal prognosis is reserved and the maternal mortality is not negligible. Conclusion: Abdominal pregnancy is a rare event. Her diagnosis is difficult and a conservative attitude of pregnancy is possible.

  • Male infertility : immunological and clinical aspects at the University Health Center of Brazzaville

    Summary : The objective of this study is to contribute to the knowledge of the immunological and clinical aspects of the male infertility at the University Health Center of Brazzaville. Patients and methods : it was a descriptive, transversal and analytical study over a period ranging from the 1st november 2015 to the 31st october 2016. All patients with infertlity were concerned among them we distinguished between those having agglutinates of sperm in the semen on the one hand (G1) from those who did not have any (G2). So we looked for the presence of the antisperm antibodies in the two groups. Results : During the period of study, 1889 spermograms had been realised, and 67 among them were pathological approximately 3,5 % and among them there were 18% with the ASA. The patients were on average 37,4 +/- 5,8 years old, extreme (27-56 years old). They consulted after a delay of 5,3 +/3,7 years on average, extremes (1-16 years). The infertlity was primary in 50,7% and secondary in 49,3%. As far as the scrotum is concerned, the varicocele was more found in 34,3%. In the spermogram, 18 % had agglutinates of sperm against 82 %. The. oligoasthenozoospermias represented 41,8% followed by azoospermia, 20 %. The stigmata of infection have been noticed, they are alkaline PH (9,9%),many leukocytes (10%) and hyperspermia (0,9%). For the 9 patients who had sperm with antispermatozoïd antibodies, 1 patient had IgA, 2 patients had IgG and 6 patients had both IgA and IgG. The age of those having agglutinates ranged between 50 and 56 years (58,%) versus 30 and 39 years at 60 % (p˂0,05). The story of uro genital infecion was more present. The ASA were more identified in those having agglutinates in 58,33% of cases (p=0,0001). The average of the percentages of the…

  • The Development of Rs2853826 Genotyping and the Initial Association with Breast Cancer Risk in Vietnamese Women

    Breast cancer (BC) is known as the leading cause of dead in women through worldwide including Vietnam. Recently, mitochondrial genome mutations concerned to breast cancer has been screened in order to propose new potential biomarkers. The SNP rs2853826 located at 10398-nucleotide position within the NADH-dehydrogenase3 has been demonstrated to be associated with BC in populations such as Malaysian, Northern Indian, Poland, Banglasdesh, African-American, Eropean-American, but Vietnam. Thus, rs2853826 was selected as the candidate SNP for investigation in Vietnamese population. In this study, the High Resolution Melting method is optimized for genotyping 100/100 cases/controls samples, then determined the association between this SNP and the disease. The genotyping results revealed SNP rs2853826 has high polymorphism with the minor allele frequency, G allele, was 17.2%. risk allele G was 17.2 %. The association result between rs2853826 and BC revealed that G allele tend to increases risk of BC among Vietnamese when comparing A allele (OR[95%CI]=1.224[0.818-1.832]); and homozygote and heterozygote model also showed this trend when compared to dominant model. Since the p-values were larger 0.05 (p=0.326), our results only show a trend correlation rather than a significant association between SNP rs2853826 and BC risk. However, the reliability of this association analysis result is low (7.57%), so this research needs to be conducted with a larger sample size to reach the greater power (>90%) for therelation.

  • To observe changes of female sex hormones after chemical induction of Diabetes Mellitus

    Introduction: Diabetes Mellitus is a heterogeneous group of metabolic disorders characterized by chronic hyperglycemia and glucose intolerance, able to cause metabolic changes. Objective: To observe changes of female sex hormones in mice, after chemical induction of Diabetes Mellitus, in intervals of 15, 30 and 45 days. Methods: Adult females of the Swiss mice (35-40 g) had their weight and glucose levels evaluated. Animals were divided into three groups diabetics (D-15, D-30 and D-45) with their respective controls. Chemical induction of diabetes was held by alloxan monohydrate-solution (60 mg/mL), intraperitoneal, in concentration of 120g/kg. The control group was given saline solution. Ten days after induction, the animals underwent 8 hours of fasting and reassessed their weights and blood glucose levels. Were considered diabetic animals with blood glucose under 200 mg/dL. Animals which have not obtained this index were again submitted to the induction protocol. Blood glucose levels were measured at weekly intervals during the study period. The animals were sacrificed and blood collected immediately by cardiac puncture, packaged in gel tube and centrifuged to obtain serum. Hormone concentrations were determined by chemiluminescence method, in duplicate. The research was submitted to the Ethics Committee and approved (CEP 123-2013, UFCG-CTRS Campus Patos). The results that showed homogeneity and normality were evaluated by analysis of variance (ANOVA), with a significance level of 5% (p < 0.05). Results and discussion: The values for the Luteinizing Hormones (p = 0.000) and Estradiol (p = 0.029) showed significant only within 15 days of chemical induction. The Follicle Stimulating Hormone was significant in the periods of 15 and 45 days (p = 0.023 and p = 0.036, respectively) when compared to the control. Conclusion: The chemically induced diabetes probably set off hormonal changes, however, additional studies are required in a larger number of animals.