IntroductionPostpartum haemorrhage (PPH) is the most serious clinical problem of childbirth that contributes significantly to maternal mortality worldwide. This systematic review aims to identify predictors of PPH based on a machine learning (ML) approach.Methods and analysisThis review adhered to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol. The review is scheduled to begin on 10 January 2023 and end on 20 March 2023. The main objective is to identify and summarise the predictive factors associated with PPH and propose an ML-based predictive algorithm. From inception to December 2022, a systematic search of the following electronic databases of peer-reviewed journal articles and online search records will be conducted: Cochrane Central Register, PubMed, EMBASE (via Ovid), Scopus, WOS, IEEE Xplore and the Google Scholar search engine. All studies that meet the following criteria will be considered: (1) they include the general population with a clear definition of the diagnosis of PPH; (2) they include ML models for predicting PPH with a clear description of the ML models; and (3) they demonstrate the performance of the ML models with metrics, including area under the receiver operating characteristic curve, accuracy, precision, sensitivity and specificity. Non-English language papers will be excluded. Data extraction will be performed independently by two investigators. The PROBAST, which includes a total of 20 signallings, will be used as a tool to assess the risk of bias and applicability of each included study.Ethics and disseminationEthical approval is not required, as our review will include published and publicly accessible data. Findings from this review will be disseminated via publication in a peer-review journal.PROSPERO registration numberThe protocol for this review was submitted at PROSPERO with ID number CRD42022354896.
Objectives: Due to hormonal changes during the menopause, women experience a variety of perimenopause and postmenopause symptoms. This review examines the various aspects of nanostructured hormone therapy and its application in the treatments of menopausal symptoms. Material and methods:Excerpta Medica DataBase, Medical Literature Analysis and Retrieval System Online, Web of Science, and Google Scholar were searched basing on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seven eligible studies out of 51 related papers, which satisfied the initial search criteria, were extracted and carefully reviewed to clarify the role of nanomedicine in maintaining postmenopausal women's health.Results: Review of the seven eligible studies confirmed nanostructured hormone therapy as a safe and effective method for the alleviation of menopausal symptoms. According to the existing studies, nanostructured hormone therapy decreased the mean daily frequency and severity of menopausal symptoms. Conclusion:The use of transdermal nanoformulations in hormone therapy can relieve climacteric symptoms and prevent other postmenopausal symptoms.
Background: Thrombophilia is an inherited or acquired predisposition for development of thrombosis. One of the common thrombophilia polymorphisms is Factor V Leiden (FVL) mutation, which may contribute to negative pregnancy outcomes. This systematic review study seeks to describe the potential effects of factor V Leiden mutation on adverse pregnancy outcomes. Methods: Pubmed, Embase, ISI Web of Sciences, Scopus, ScienceDirect, Proquest and Google Scholar, for articles published during 1996-2017. Articles were evaluated by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for standard reporting. As well, the quality of studies was assessed by the Newcastle-Ottawa Scale (NOS). Results: A total of 14 studies were eligible based on the inclusion criteria. The papers were scored by the STROBE checklist. The range of STROBE score was 15-20. Only 37.5% of the studies confirmed the relationship between fetal loss and FVL. The effect of FVL mutation on spontaneous abortions and In Vitro Fertilization (IVF) failures was demonstrated in all the studies. In the reviewed studies, there was no observed relationship between FVL mutation with intrauterine growth restriction (IUGR), preeclampsia, placental abruption or small for gestational age (SGA).
BackgroundLittle is known about potential urban-rural differences in adverse pregnancy outcomes. The purpose of this study is to look into the urban-rural differences in the trend of adverse maternal and neonatal outcomes.MethodsWe retrospectively assessed the pregnancy outcome of singleton pregnant mothers who gave birth at a tertiary hospital in Bandar Abbas, Iran, between January 1st, 2020, and January 1st, 2022. Mothers were divided into two groups based on living residency: 1) urban groupand 2) rural group.Demographic factors, obstetrical factors, maternal comorbidities, and adverse maternal and neonatal outcomeswere extracted from the electronic data of each mother. The Chi-square testwas used to compare differences between the groups for categorical variables. Logistic regression models were used to assess the association of adverse pregnancy, childbirth, and neonatal outcome with living residency.ResultsOf 8888 mothers that gave birth during the study period, 2989 (33.6%) lived in rural areas. Adolescent pregnancy was more common in the rural area. Urban mothers had a higher education than rural mothers. Rural mothers were at higher risk for preterm birth aOR 1.81 (CI:1.24-2.99), post-term pregnancy aOR 1.5 (CI: 1.07-2.78), anemia aOR 2.02 (CI:1.07-2.34), low birth weight (LBW) aOR 1.89 (CI: 1.56-2.11), need for neonatal resuscitation aOR 2.66 (CI: 1.78-3.14), and neonatal intensive care unit (NICU) admission aOR 1.98 (CI:1.34-2.79). On the other hand, the risk of cesarean section was significantly lower compared to urban mothers aOR 0.58 (CI: 0.34-0.99).ConclusionsOur study discovered that mothers living in rural areas had a higher risk of developing anemia, preterm birth, post-term pregnancies, LBW, need for neonatal resuscitation, and NICU admission, but a lower risk of cesarean section.
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