Obstetrics and Gynecology

  • Gestational Diabetes Mellitus: highlights about biochemical agents that subscribe its physiopathological mechanism during gestational trimesters

    Gestational Diabetes Mellitus (GDM) is a common complication in which hyperglycemia goes by physiological state, beneficial to the embryo, to metabolic condition that causes damage to both mother and child. Placental hormones, insulin resistance, visceral fat tissue, dyslipidemia, and other biochemical agentes, subscribe the physiopathological mechanisms that lead to GDM. Nowadays, there are mRNAs, proteins, and even vitamins being associated with GDM risk and its pathophysiology. These new pathways usher a new horizon to discover and describe other important parts of metabolism that play a key role to GDM. With a larger picture of pregnant women metabolism prior and after GDM, better predictors and efficient treatment can be managed.

  • Gestational diabetes: diagnosis, care, and influence on fetus

    Gestational diabetes mellitus (GDM) is characterized by the WHO as a condition of hyperglycemia detected for the first time during pregnancy, with blood glucose levels that do not meet the diagnostic criteria for DM. There are some hormones produced by the placenta and increased by pregnancy, such as placental lactogen, cortisol, and prolactin. In which, they can reduce the performance of insulin at its receptors and, consequently, increase insulin production in healthy pregnant women. Prenatal care is essential to prevent complications for women and children. Thus, an individualized diet should be indicated, exercise during pregnancy, and delivery should be monitored. If the recommendations do not normalize the condition of GDM, spontaneous abortions, the formation of excess amniotic fluid, congenital malformations, restricted fetal growth, and even the death of the mother and fetus may occur.

  • Clinical Symptoms and Manifestations of Gestational Diabetes

    Although there is medical care focused on obstetric and neonatal care, Gestational Diabetes Mellitus (MDG) is still considered one of the main gestational complications, due to numerous metabolic, hematological and anatomical risks for pregnant women, fetuses and newborns. In this chapter, the symptoms and clinical manifestations of pregnant women diagnosed with MDG and their offspring during and after pregnancy will be addressed, presenting the probable sequelae, in addition to the pathogenesis of the main clinical complications.

  • Treatment of Gestational Diabetes Mellitus and postpartum care

    Treatment for Gestational Diabetes Mellitus comprises a series of Clinical-therapeutic protocols, which are necessary for proper attention to the patient with this pathology. In this sense, this chapter will address treatment care and postpartum care for Gestational Diabetes Mellitus, taking into account pharmacotherapeutic protocols and adverse effects of non-recommended treatments.

  • Morphofunctional changes of the placenta in pregnant women with GDM

    Morphofunctional changes of the placenta during the gestational period may be influenced by the pathological condition of Gestational Diabetes Mellitus. From this perspective, this chapter will address this theme as a way to evaluate the placental differences caused by this pathology.

  • Gestacional Diabetes Mellitus (GDM)

    The existence of different types of diabetes contributes to a varied therapy, conditioned to the advance that this pathology is. In Gestational Diabetes Mellitus this condition is no different. In this context, this chapter will address Gestational Diabetes Mellitus, as well as its risk factors, prevention and consequences of this pathological condition.

  • Homeopathic treatment for Female infertility

    In this review article the writer contends that homeopathy is best effective methodology in barrenness of female’s Nowadays greater part of couples are deferring pregnancies for 1 to 2 years after marriage and subsequently when they are arranging pregnancy, around one fourth of them face issue in considering. Presently clinical field is a lot of cutting edge and bring to the table a ton in fruitlessness, similar to astute homeopathy is a most current framework which can fix the malady from the root, Homeopathy depends on side effect likeness and by sacred medication we can even treat barrenness of obscure etiology likewise, Here an endeavor is made to pass on the methodology of homeopathy in fruitlessness and its regular causes.

  • Effects of Sublingual Misoprostol as Adjunct to Oxytocin for Active Management of Third Stage of Labour in Paturients at Risk of Post-partum Haemorrhage in Abakaliki : a Comparison of 200 Versus 400 Micrograms

    Background: Postpartum Haemorrhage (PPH) still remains a major cause of maternal mortality despite adequate knowledge of its causes and treatment. Oxytocin administration is one of the major components of active management of third stage of labour (AMTSL). Evidence suggest benefit of misoprostol as an adjunct however optimal dose is yet to be determine considering the dose depended side effect profile of misoprostol. . Objective: This study evaluated the efficacy and side effect profile of 200µg versus 400µg of prophylactic sublingual misoprostol as adjunct to AMTSL among parturient at risk for PPH. Methods: This was a double blinded, single centre, randomized controlled trial involving two hundred and forty parturient with 2.1% drop out rate , thus 235 of them were analyzed; 117 (48.8%) and 118(49.2%) for 200 and 400 microgram group respectively. Data was analyzed using Statistical Package for Social Science (IBM SPSS) software (version 24, Chicago II, USA). Continuous variables were presented as mean and standard deviation (Mean ± 2SD), while categorical variables were presented as numbers and percentages. Chi-square test (X2) was used for comparison between groups for qualitative variables while t-test was used for comparison between groups for quantitative variables. A difference with a P value

  • Premature rupture of membrane and its associated factors among pregnant women admitted to public hospitals

    Background: Premature rupture of membrane is the common complication of pregnancy which is an important cause for perinatal and maternal morbidity and mortality. However most of the studies done on its prevalence had showed a variation with the global prevalence of premature rupture of membrane. The study was aimed to assess prevalence and associated factors of premature rupture of membrane among pregnant women admitted to public hospitals in Nekemte town, Western Ethiopia. Method: An institution based cross-sectional study was carried out from June 1 to July 30, 2019. A systematic random sampling technique was used to select 284 study participants. Interviewer administered structured questionnaires and standardized checklists were used to collect data. Data was entered into Epi.data 3.1 and exported to SPSS version 25.0. Results: About, 121(42.6%) of respondents were found in between the age group of 25-29 years, with the mean of 26.41 and standard deviation of 4.64 (26.41+4.64). The prevalence of premature rupture of membrane was 13.4%with 95% CI (9.9, 17.3). Women who had history of abortion (AOR=3.47, 95% CI: 1.44, 8.37), history of previous premature rupture of membrane (AOR=2.95, 95% CI: 1.15, 7.54), history of cesarean section (AOR=3.56, 95% CI: 1.23, 10.31) and sexually transmitted infection (AOR=7.26, 95% CI: 1.99, 26.46) and ANC follow up (AOR= 0.07, 95% CI: 0.01, 0.63) were significantly associated with premature rupture of membrane. Conclusion: The prevalence of premature rupture of membrane among the participants was considered to be high compared to the global prevalence. An intervention that focuses on strengthening the integration of messages on health promotion and disease prevention to maintain normal pregnancies for pregnant women is recommended.

  • Review of Maternal Mortality Cases at Loandjili General Hospital in Pointe-Noire

    Objectives: A major global public health problem, maternal mortality remains high, especially in the sub-Saharan countries, despite the efforts of the various health systems. Thus, this work was intended to describe the epidemiological profile of deceased patients, to identify the causes of maternal mortality, and to report dysfunctions in relation to management facilities. Methods: Descriptive cross-sectional study, conducted from 1 January 2012 to 31 December 2014 at Loandjili General Hospital, including cases of maternal deaths occurring in the Obstetrics Gynecology Department. Maternal mortality has been defined in accordance with the World Health Organization, as “the death of a woman occurring during pregnancy or within 42 days after delivery, regardless of the cause or aggravated by the pregnancy or the care she has motivated, but neither accidental nor fortuitous “. The review of each file allowed us to analyse the epidemiological, clinical and therapeutic variables, and to deduce dysfunctions related to the commodities (human, material and financial) of management. Results: Eighty-three maternal deaths were recorded out of 8,115 live births, representing a maternal mortality ratio of 1022 / 100,000 live births. Patients who died had a median age of 28.8 years [23.5; 34], secondary school (54%), pauciparous (2.9 ± 1.4 years), unemployed (75%), and referred (64%) in poor condition (76%). Caesarean section was performed in 29% of cases. The causes of death were haemorrhage (46%), complications of arterial hypertension (25%) and abortion (17%). In 60% of the cases, the deceased patients would have benefited from a surgical intervention, but only 37% of them were operated on. The deaths occurred during pregnancy (48%), childbirth (16%) and in the postpartum (36%). The unavailability of blood products and inputs was reported in 60% and 23% of cases, respectively. The third delay was noted in 90% of cases. Conclusion: The maternal mortality in our maternity…