Open Journal of Obstetrics and Gynecology

Journal Information
ISSN / EISSN : 21608792 / 21608806
Current Publisher: Scientific Research Publishing, Inc, (10.4236)
Total articles ≅ 1,132
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Vladislav Dobrinov, Desislava Tacheva, Magdalena Rangelova, Milena Dobreva, Gergana Georgieva, Iavor Vladimirov, Dobrinov Vladislav, Tacheva Desislava, Rangelova Magdalena, Dobreva Milena, et al.
Open Journal of Obstetrics and Gynecology, Volume 10, pp 1-12; doi:10.4236/ojog.2020.101001

Abstract:Background: With the accumulating evidence of semen difference between distinct populations we decided to conduct a population-based prospective study to assess the reproductive capabilities of the Bulgarian males. Objective: To evaluate the semen parameters in men from the general population of Bulgaria. To analyze the effects of BMI (Body mass index) and tobacco smoking on semen characteristics. Methods: 482 males without history of reproductive problems were included for the purpose of this study. The duration of our study was from April to May in 2016 and April in 2017. The volunteers were subdivided based on their smoking status and on their BMI. After semen collection, a conventional semen analysis was carried out manually by trained embryologists in an andrology laboratory according to WHO recommendations. The results were statistically analyzed and presented with their mean values. Result(s): After semen analysis we report a mean of 3.29 ml for semen volume, 40.68 × 106/ml for spermatozoa concentration, 128.38 × 106 for total sperm count, 52.54% of total motile spermatozoa in the ejaculate and a mean percentage of morphologically normal sperm standing at 9.6%. We did not find a negative effect of tobacco smoking on semen quality; however higher BMI is associated with lower sperm concentration per ml. Discussion and Conclusion(s): This is the first contemporary study, assessing semen quality in Bulgarians. The results obtained here show the lower quality of semen in Bulgaria, compared to other countries. No statistical differences were found between the semen quality of nonsmokers and smokers. Higher BMI was found to be associated with lower sperm concentration per milliliter.
Vladimir Egorov, Todd Rosen, Heather Van Raalte, Viktors Kurtenoks
Open Journal of Obstetrics and Gynecology, Volume 10, pp 85-99; doi:10.4236/ojog.2020.101008

Abstract:Background: Premature cervical softening and shortening may be considered an early mechanical failure that predisposes to preterm birth. Preliminary clinical studies demonstrate that cervical elastography may be able to quantify this phenomenon and predict spontaneous preterm delivery. Objective: To explore a new approach for cervix elasticity and length measurements with tactile-ultrasound probe. Methods: Cervix probe has tactile array and ultrasound transducer designed to apply controllable load to cervix and acquire stress-strain data for calculation of cervical elasticity (Young’s modulus) and cervical length for four cervix sectors. Average values, standard deviations, intraclass correlation coefficients and the 95% limits of agreement (Bland-Altman plots) were estimated. Results: Ten non-pregnant and ten pregnant women were examined with the probe. The study with non-pregnant women demonstrated a reliable acquisition of the tactile signals. The ultrasound signals had a prolonged appearance; identification of the internal os of the cervix in these signals was not reliable. The study with pregnant women with the gestational age of 25.4 ± 2.3 weeks demonstrated reliable data acquisition with real-time visualization of the ultrasound signals. Average values for cervical elasticity and standard deviations of 19.7 ± 15.4 kPa and length of 30.7 ± 6.6 mm were calculated based on two measurements per 4 sectors. Measurement repeatability calculated as intraclass correlation coefficients between two measurements at the same cervix sector on pregnant women was found to be 0.97 for cervical elasticity and 0.93 for the cervical length. The 95% limits of agreement of 1) cervical elasticity were from ?22.4% to +14.9%, and 2) cervical length from ?13.3% to +16.5%. Conclusions: This study demonstrated clinically acceptable measurement performance and reproducibility. The availability of stress-strain data allowed the computation of cervical elasticity and length. This approach has the potential to provide cervical markers to predict spontaneous preterm delivery.
Essome Henri, Engbang Jean Paul, Ekono Michel Roger, Nana Njamen Theophile, Mve Koh Valere, Boten Merlin, Tocki Toutou Grâce, Fewou Amadou, Engbang Jean Pierre
Open Journal of Obstetrics and Gynecology, Volume 10, pp 76-84; doi:10.4236/ojog.2020.101007

Abstract:Introduction: The early detection of precancerous lesions being very important for the preventive management of cervical cancer, we felt it was important to identify these lesions on potential backgrounds including HIV-positive (HIV+) women to suggest control strategies of cervical cancer in Cameroon. Objective: To determine the prevalence of precancerous lesions in women infected with the human immunodeficiency virus (HIV), to investigate the determinants of the HIV and cervical cancer association, and to make recommendations regarding cervical cancer screening in these patients of the city of Douala. Methodology: Our study was a case-control cross-sectional study from July 2017 to December 2017 (6 months) including 108 women among which 34 HIV+ matched with 74 HIV?. HIV serology was done using the complete HIV enzygnost test. Cervical smears for cytological lesions were fixed to the cyto-fixator and then stained by the Papanicolaou technique and read under an optical microscope. The cervical smear slides for viral excretion were fixed with a methanol-acetone mixture of equal volume; HPV testing was done by the indirect immune-peroxidase technique using P16 protein. The excretion of HSV type 1 & 2 was investigated by the indirect immunofluorescence technique using the Simplex Virus type 1 & 2 Rabbit anti-Herpes from DAKO (France). Results: The two groups of women were compared with the chi square test with a significance threshold of P 0.05. The average age was 40.07 with extremes of 21 and 71 years and a standard deviation of 9.99. Of the 34 HIV+ patients, 23 had an abnormal cervix compared to 36 cases of abnormal cervix among HIV? with a statistically significant difference (P = 0.006649). 12 cases of dysplasia were observed in the 34 HIV+ women and distributed as follows: 0% of mild dysplasia, 18.92% of moderate dysplasia and 13.51% of severe dysplasia. In HIV? women we detected 6 cases of dysplasia including 1.35% of mild dysplasia, 4.05% of moderate dysplasia and 2.70% of severe dysplasia. Regarding HPV infection, we observed 21 cases of HPV among 34 HIV+ women (61.76%) against 23 cases in HIV? women (31.08%); we did not detect any cases of HSV. Conclusion: The prevalence of precancerous lesions remains high in HIV+ women, hence the need to include routine screening for precancerous lesions in all HIV+ women at all ages, as well as the routine search for HPV excretion in all those with cellular dysplasia.
Benjamin Hounkpatin, Moufalilou Aboubakar, Patrice Dangbemey, Veronique Tognifode, Clémence Schantz, Alexandre Dumont, René-Xavier René-Perrin
Open Journal of Obstetrics and Gynecology, Volume 10, pp 65-75; doi:10.4236/ojog.2020.101006

Abstract:Objective: To measure for each of the ten (10) groups of women defined in Robson’s classification, the cesarean section rate, group size and its contribution to the overall cesarean section rate in four maternities in Benin. Methods: This was a retrospective study over a period of 3 years, from January 1, 2014 to December 31, 2016. Two workshops were organized for training in data collection and interpretation of results. Results: A total of 5442 files were included for the four health facilities during the study period. The overall cesarean section rate was 43.9%. The most represented group (30.3%) was multiparous women without scarred uterus, with a single term fetus, in cephalic presentation, and spontaneous labour (Group 3). The largest contributor to the overall cesarean section rate was that of multiparous women with at least one uterine scar with a single fetus, eventually in cephalic presentation (Group 5) with 29.5%. Conclusion: Caesarean section rates are high in groups of women with a favourable prognosis for vaginal delivery. It is also high in women with scarred uterus (Group 5).
Félix Essiben, Ngowa Jean Dupont Kemfang, Aline Nganso, Meka Juliette Esther Ngo Um, Etienne Atenguena, Samuel Ojong, Paul Ndom, Emile Telesphore Mboudou
Open Journal of Obstetrics and Gynecology, Volume 10, pp 166-178; doi:10.4236/ojog.2020.1010014

Abstract:Context: In Cameroon, breast cancer (BC) is usually diagnosed late in the disease course. About a third of women affected are aged less than 40 years. Chemotherapy (CT) could alter ovarian function and thereby compromise future fertility in these women. We therefore described the fertility of women following CT for BC in women treated at the Yaounde General Hospital (YGH). Methods: It was a retrospective, descriptive, cross-sectional study conducted over 8 months, from January to August 2017. We used the files of patients managed for BC from January 2011 to December 2015 in the medical oncology unit of the YGH. Results: We included 265 patients for the study following at least one year of CT. The mean age at the onset of CT was 35.9 ± 6.9 years. Most of the patients had fewer than 2 deliveries (68.3%). Intraductal carcinoma was the most frequent histological lesion (90.6%) and most often diagnosed in advanced stages (73.5%). As per CT, the FAC protocol was the most used (44.5%). The menstrual cycles of the patients were more regular prior to the onset of chemotherapy (89.4% vs. 58.9%), while the mean period of resumption of menstrual activity following cessation of chemotherapy was 6.3 ± 2.0 months. Chemotherapy-related amenorrhoea was observed in 29.1% of patients after 12 months of treatment. More than half of these women (51.3%) complained of a drop in libido and 6.4% achieved pregnancy within 13 months following cessation of chemotherapy. Conclusion: Following chemotherapy for BC, menstrual cycle disorders are more frequent and this can affect the patients’ reproductive potential. Fertility consultations should be integrated into the management plan of such patients.
Der Adolphe Some, P. Aline Tougma, Souleymane Ouattara, Caroline Yonaba Okenge, Gandaaza Armel E. Poda, R. Barnabé Yameogo, Semon Paulin Kam, Bintou Traore, Sansan Rodrigue Sib, Blandine Thieba Bonane, et al.
Open Journal of Obstetrics and Gynecology, Volume 10, pp 135-150; doi:10.4236/ojog.2020.1010012

Abstract:Objective: The neonatal mortality rate remains a serious problem in most countries in sub-Saharan Africa such as Burkina Faso, where, in 2010 this mortality rate was 28 per 1000 live births [1] [2]. Its reduction is possible and passes first by the strict prevention of infections in birth rooms. The objective of this study was to describe the practices of infection prevention in the birth rooms of seven referral hospitals in Ouagadougou from April 1 to July 31, 2016. Materials and Methods: This was a cross-sectional study on the knowledge, attitudes and practices of the rules of prevention and control of healthcare associated infections (PCHAI) among 123 consenting health workers who provided birth room care in 7 hospitals in Ouagadougou. Data were collected through individual interviews and direct observations. The study was authorized by the Institutional Ethics Committee in 2015 under the number 32. The data analysis was done with the Epi Info software version 2000. Results: The “five clean in the birth room” were known by 26.83%. Regarding the equipment used for PCHAI, sterile gloves were mentioned by 75.61% of the agents, the source of clean water by 62.60% and soap by 57.11%; in practice, 17.07% of the respondents had not washed their hands and 42 providers (34%) had not performed with complete mastery the wearing of sterile gloves before giving birth, and 55.28% had not cleaned the perineum. Conclusion: Deficiencies in the prevention and control of healthcare-associated infections have been identified. Training on infection prevention in the neonatal period is needed for the benefit of hospital providers.
Onome B. Oghenetega, Godson R. E. E. Ana, Michael A. Okunlola, Oladosu A. Ojengbede
Open Journal of Obstetrics and Gynecology, Volume 10, pp 187-199; doi:10.4236/ojog.2020.1010016

Abstract:Oil spills and gas flaring are major environmental problems and pose major source of adverse health outcomes to communities hosting oil wells and natural gas. As oil is spilt and gas is flared; air, soil and water in affected communities are polluted. Due to this, members of these communities are exposed to higher health risks. One vulnerable group that is usually affected in this regard is pregnant women. This systematic review identified and reviewed past studies on oil pollution and different types of pregnancy outcomes within a twenty-year gap, which is between 1999 and 2019. The review also discussed the exposure pathways of oil pollution. From a literature search on scientific databases conducted in August 2019 for articles relating to the objectives of the review, data were extracted from articles which met the inclusion criteria and contents were systematically analyzed based on types of pregnancy outcomes. This review showed that oil spill and gas flaring may put pregnant women at high risk of hypertensive disorders of pregnancy, gestational diabetes mellitus, maternal depression, miscarriages via three pathways. This review may be of some use in making policy in this area.
De Seta Francesco, Wayne Lowery Jonathan, Ogunbekun Oms Ii Oladipupo, Larsen Bryan, Francesco De Seta, Jonathan Wayne Lowery, Oladipupo Ogunbekun Oms Ii, Bryan Larsen
Open Journal of Obstetrics and Gynecology, Volume 10, pp 151-165; doi:10.4236/ojog.2020.1010013

Abstract:Background: The need for products that treat or prevent urinary tract infections without resort to antibiotics that may select for resistant bacterial strains has created a need to develop antibiotic-free therapeutics. Objective: To conduct an exploratory evaluation of intrinsic antimicrobial activity of a panel of compounds alone or in combination against urinary pathogens and probiotic organisms as well as their effect on biofilm formation and immune activity in infected cultured bladder epithelial cells. Results: Of the compounds tested, 1% citric acid was most consistently inhibitory to urinary pathogens as were combinations containing citric acid. Two combinations of compounds were tested and both showed antimicrobial activity when challenged with 1 × 105 bacteria/mL. The two combination products and D-mannose did not inhibit probiotic microorganisms and one composition increased the inhibitory potential of probiotic organisms. Results obtained with biofilm studies were variable, but probiotic biofilm was enhanced under some circumstances. Biofilms of some urinary pathogens were reduced by antimicrobial mixtures. A strong cytokine response was elicited when T24 bladder epithelial cells were infected for one hour with urinary pathogens and a modest reduction in cytokine response was recorded with some combinations of test compounds. Conclusion: Citric acid alone and mixtures of various compositions containing citric acid inhibited the growth and biofilm formation by 4 uropathogens. Probiotic organisms grew in the presence of mannose and citric acid-containing combinations. One of the combinations enhanced probiotic activity of Lactobacilli against uropathogens. When infecting T24 cell monolayers with uropathogens, potential modulation of inflammatory activity was demonstrated.
Yehia A. Wafa, Ahmed T. Abd Alfattah, Mohammed Sayed Korany
Open Journal of Obstetrics and Gynecology, Volume 10, pp 13-24; doi:10.4236/ojog.2020.101002

Abstract:Background: Post-menopausal bleeding is a warning sign that accounts for about 5% of all outpatient gynaecologic visits and is a common indication for referral to rapid access clinics because of the fear of underlying malignancy. Endometrial malignancies differ from other malignancies in that early symptomization is common, allowing early cure. Patients and Methods: During the study period, 100 women with post-menopausal bleeding having inclusion criteria were evaluated in Al Hussein University Hospital. For each patient full history, general, abdominal and pelvic examination was performed. Routine pre-operative investigations were done. Patients were divided into four groups: Group 1 included 29 patients with endometrial polyp. Group 2 included 34 patients with endometrial hyperplasia. Group 3 included 21 patients with atrophic endometrium. Group 4 included 16 patients with endometrial carcinoma. Results: As regards the predictive value of BMI, in the study there was a high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. When discussing the predictive value of blood glucose level, in the study there was a high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. It is worth to mention that the predictive value of endometrial thickness, in the study, was with high statistical significance in comparison between the endometrial carcinoma group and all other benign groups providing the highest specificity and sensitivity. At the last the predictive value of uterine artery velocimetry, in the study, was with high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. Conclusion: BMI, blood glucose level, endometrial thickness and uterine artery velocimetry indices, improve the prediction of endometrial carcinoma in women with post-menopausal bleeding.
Babacar Biaye, Jacque Raiga, Moussa Diallo, Reda Jafer, Abdoul Aziz Diouf, Bernard Benoit, Bruno Carbone, Biaye Babacar, Raiga Jacque, Diallo Moussa, et al.
Open Journal of Obstetrics and Gynecology, Volume 10, pp 25-40; doi:10.4236/ojog.2020.101003

Abstract:The diagnosis and management of ovarian cystic tumor is sometimes difficult. In this manuscript, we wish to summarize this issue by showing three cases. Ultrasound and Color Doppler are very useful to diagnose the presence of this tumor but also to distinguish between benign and malignant. Pelvic MRI is also a strong tool and is sometimes mandatory. HE4 and CA125 are often useful as a serum diagnostic marker of malignancy, but not always so. Recently, laparoscopic management has gained popularity; however, great caution should be exercised during laparoscopic operative procedures, as this may lead to intraperitoneal malignant cell spreading/proliferation when the tumor is malignant. During the surgery of malignant tumor, irrespective of laparoscopic or laparotomic, intraperitoneal rupture should be avoided. Since the final diagnosis must be made by histological examination, the patient must always be informed of this possibility.