Few potentially remediable risk factors are associated with the occurrence of preterm PROM.
Background: The primary aim of this study was to measure the prevalence of pregnant women who fast during Ramadan. The secondary outcome was their beliefs and motivations regarding fasting during Ramadan in addition to the consequences of fasting on maternal and neonatal outcome.Methods: A retrospective review of pregnant patients aged between 18-45 years who presented for antenatal care in the private clinic in Beirut, Lebanon during or after the month of Ramadan between 2010 and 2019 was performed.Results: A total of 502 pregnant patients were included in the study, of which 426 (84.9%) fasted during Ramadan and 76 (15.1%) did not fast at all. Of those who fasted, 148 (34.7%) fasted between 1 and 15 days while 278 (65.3%) fasted more than 15 days. Multiparous and non-Lebanese women had significantly higher rate of fasting compared to primiparous and Lebanese women. Adherence to fasting was associated with the spiritual environment that accompanies the month of Ramadan while non-adherence was mainly related to the fear from adverse effects on the mother and fetus. Fasting was not significantly associated with maternal complications or decreased neonatal birth weight.Conclusions: The present study showed that Ramadan fasting is important to pregnant Muslim women. This was manifested by the relatively high rate of fasting even in summer and spring seasons. Understanding the beliefs and motivations of pregnant women would provide valuable insight to physicians to appropriately advise these women without compromising the maternal or fetal well-being.
Background: The COVID-19 outbreak has affected pregnant women. The aim of this study was to examine the effect of COVID-19 outbreak and lockdown on maternal complications in pregnant women.Methods: A retrospective review of pregnant patients who presented for antenatal care to the private clinic in Beirut, Lebanon before or during the COVID-19 lockdown which started in March 2020. The first group consisted of women before the lockdown between September 1, 2019 and February 29, 2020. The second group included women during or after the lockdown between March 1, 2020 and August 31, 2020.Results: A total of 97 women were included, 48 in the before lockdown group and 49 during or after lockdown group. The percentage of epigastric pain was significantly lower in the first group (12.5% vs. 71.4% respectively, p-value<0.0001). Anemia was significantly lower in the before group (60.4% vs. 83.7%, respectively p-value=0.01). Vomiting and hypotension were significantly higher in the after group. Around 87% of women in the before group had flu-like symptoms such as muscle ache and dizziness compared to 44.9% and 46.9% in the after group (p-value<0.0001). None of the patients in the after group visited the emergency department or were hospitalized during pregnancy. Almost 43% of patients in the after group had severe anxiety compared to 14.6% in the before group (p-value=0.001).Conclusions: Lockdown influenced maternal complications during pregnancy and resulted in anxiety for many women. Management practices regarding pregnancy and childbirth after lockdown are necessary to minimize the associated negative consequences.
The intrauterine device (IUD) is a contraceptive method which are tiny, T-shaped plastic, that is placed within the uterus and left there, is used all throughout the world with more than 99% effectiveness rate. Pregnancy with a levonorgestrel-releasing intrauterine system (LNG-IUS) in situ is very rare. Intracavitary pregnancy with an IUD can lead to a higher risk of infection and preterm birth. We described a case of a live birth with an IUD inserted into the placenta. A 27-year-old Syrian woman in G4P3 with a history of healthy vaginal deliveries arrived in our delivery room at 39+3 weeks gestation complaining of labor pain A vaginal examination revealed bulging membranes and a fully dilated cervix. She delivered a live baby boy, weighing 3100 g and being sent to the nursery with an APGAR score of 9 to 10. When the placenta was examined, a white foreign object that was embedded there was discovered to be an intrauterine device. Although intrauterine pregnancy is a potential problem that must be taken into account, ectopic pregnancy is a reasonably common complication of intrauterine contraceptive devices. Although several studies have shown that term pregnancies with excellent prognoses can occur after the removal of intrauterine devices, close monitoring is necessary to detect misplaced copper-T and prevent undesired births.
Background: Stress Urinary Incontinence (SUI), has been always linked to normal vaginal delivery (NVD) or operative vaginal delivery (OVD). Many women get concerned about this issue before giving birth and tend to deliver by cesarean delivery. However, the increased frequency of cesarean deliveries poses health concerns especially in the absence of solid risk factors. Methods: This is a retrospective observational cohort study conducted at Rafic Hariri University Hospital (RHUH) between 2011 and 2013. Forty primiparous women undergoing cesarean delivery were involved. They were evenly divided into 2 groups. The first involved those who underwent elective cesarean delivery and those with failure to progress. The second group involved women who underwent cesarean delivery for arrested second stage of labor. Statistical analysis was performed using the statistical program SPSS version 20. Results: The prevalence of SUI in group 1 was 25% compared to 35% in group 2. Cesarean delivery was not found to have any protective role against SUI in group 1 patients and the frequency of SUI in selective cesarean patients was nearly the same as those performing cesarean for failure to progress. However, patients undergoing cesarean for arrested second stage of labor > 2hours had a significant higher frequency of SUI as compared to patients undergoing cesarean delivery for arrested second stage of labor < 2hours. Conclusion: Cesarean delivery cannot be proposed to women who fear to suffer from SUI post-partum. However, it should be done if the cervix fully dilated for > 2hours in order to decrease the risk of SUI
The rate of cesarean section is increasing worldwide. It decreases maternal and fetal mortality when complications happen. However, it is a major surgery that could be associated with maternal and fetal risks especially after repeat cesarean deliveries. We report a case of a woman who had her 9th C-section.
Objective: The goal of this study was to examine the clinical and ultrasonographic features of females who presented with abdominal discomfort and had ovarian torsion against those who did not. Methods: This was a cohort study that looked back included all female patients who presented to a referral private clinic with pelvic and/or abdominal pain between January 2017 and December 2020. Patients who were clinically diagnosed with torsion but had negative intra-operative findings were excluded. Patients who met the criteria were separated into two groups (ovarian torsion vs. no torsion).Symptoms including the type, location and duration of pain, presence of nausea and vomiting, abdominal tenderness, presence of adnexal masses at digital examination, ultrasound findings, pre-operative diagnosis, final diagnosis, as well as surgical management were recorded. Results: During the research period, a total of 65 female patients came with abdominal discomfort, with 17 (26.2%) having ovarian torsion and 48 (73.8%) not having torsion. 1 (5.9%) of the 17 patients with torsion were in their teenage years, 14 (87.4%) were in their reproductive years, and 2 (11.8%) were 51 years or older. All patients who had torsion presented with nausea and vomiting while none of the patients who did not have torsion had nausea and vomiting (p-value<0.0001). As for pain, 38 (79.2%) had moderate pain in the no torsion group compared to none in those who had torsion since all patients who had torsion had severe pain compared to 10 (20.8%) of those who did not have torsion (p-value<0.0001). Eight patients were pregnant, 5 without torsion and 3 with torsion. The length of discomfort in the torsion group was substantially longer than in the non-torsion group (52.6555.02 days vs. 16.3115.85, p-value0.0001, respectively). Three patients were menopausal, 1 with no torsion and 2 had torsion. Around 58% of the patients without torsion had negative Doppler findings for simple cyst compared to 23.5% of those with torsion. All patients who had torsion underwent surgery and all patients without torsion had regression of pelvic mass. For those who had torsion, 35.3% had their ovary removed, 58.8% had the cyst removed while ovary conserved, and 5.9% had drainage for the cyst. Conclusion: Using a combination of presenting symptoms and ultrasonography, ovarian masses may be identified and ovarian torsion suspected. Torsion must be detected early in order to get conservative therapy and maintain the reproductive capacity of younger girls.
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