ObjectiveThe primary aim of this study is to investigate the relationship between vitamin D serum level and the incidence of postpartum hemorrhage (PPH). The secondary objective is to determine the relative risk of low vitamin D associated with PPH.MethodsThis was a retrospective observational study. A total of 600 women who had delivered their babies in a single tertiary teaching hospital were enrolled. Serum blood test for 25(OH)D was performed at 35 + 0 to 36 + 6 weeks of pregnancy to measure vitamin D. A 25(OH)D level < 20 ng/mL was defined as vitamin D deficient, and a level 21–29 ng/mL as insufficient.ResultsVitamin D levels were deficient in 145 (24.1%) and insufficient in 254 (42.3%) of the women tested. Women with deficient and insufficient vitamin D levels were significantly younger than those with sufficient vitamin D levels (p < 0.001). The overall rates of PPH in the deficient and insufficient groups were 6.9% (10/145) and 6.7% (17/254), respectively, and were significantly higher than the rate of the normal vitamin D group (1.5%, p = 0.009). Women with sufficient vitamin D levels had significantly higher hemoglobin levels than those with low vitamin D levels. Higher vitamin D levels were associated with a significantly low risk of PPH (AOR: 0.93, CI: 0.89–0.98, p = 0.006).ConclusionOur results suggest that a low vitamin D level is a risk factor for PPH. Low vitamin D also related to high risk of low hemoglobin before delivery. Thus, antepartum care should include vitamin D supplements for all women if possible.
Pelvic Organ Prolapse (POP) is a disabling and chronic condition that affects women of all ages. Pelvic organs can protrude outside the body through the vagina due to weakness in the pelvic floor. POP affects patients both physically and psychologically. Most women with POP suffer from at least one other pelvic floor disorder, such as incontinence. Pelvic organ prolapse increases nationwide, namely, anterior, posterior and middle compartments prolapse. Plenty of different kits had created in recent years for reconstruction surgery. Among those surgical kits, synthetic material augmentation plays a major role, for last Decade, however, Food and Drug Administ-ration raised (FDA) a red flag due to massive complication, such as spontaneous vaginal pain, extrution, there-fore, Nowdays, selection of proper material for reconstruction surgery is important for life quality. it divides into two systems: anchor non-anchor system. Hence, we attempt to compare a novel modified surgical technique involving a non-anchor system with the conventional anchor approach to determine the effectiveness of these two systems for treating POP. In this study, we compared the benefit, disadvantage, side effects, and complications for the two systems. Then we found that the modified tiling approach can be used to prevent the aforementioned surgical risks. Furthermore, if patients cannot bear the cost of using the required instruments, they can consider undergoing the modified nonanchor surgical procedure.
1. Background and Purpose Compared with multiple births, single embryo transfer pregnancies are not as high as risk of significant child morbidity, particularly cerebral palsy, after high-order fetal reduction. This is termed the vanishing-twin syndrome, and is an important etiology of cerebral palsy. Antenatal corticosteroid therapy (CCT) is widely used during preterm labor to enhance lung maturity, the use of dexamethasone, however, increase the risk for detrimental long-term neurodevelopmental effects. Thus, in this study we assess the effect of CCT on neurological disability and congenital abnormality in SET and control group after fetal reduction and over 2 years of age. 2. Methods The CCT (38 sets of SET) and control (56 sets) groups were compared for the incidences of cerebral palsy and congenital abnormalities, as well as mean birth weight, maternal age, and mean gestational age at delivery and at fetal reduction using records from Shin-Kong Memorial Hospital for the period 2008-2017. 3. Results There were 94 quadruplet-reduced sets of SET in our study. All of these SET were alive and aged over 2 years at the time of this writing. The gestational age at the time of delivery was 39+-2.4 weeks for the SET group vs. 36 ± 2.9 weeks for the controls, with mean birth weights of 2798 ± 555g vs. 2685 ± 519g, respectively (p<0.01). All 94 sets of twins were delivered by cesarean section, with only 1 case of cerebral palsy in Control group, while the others had developed normally by the age of 2 years. Only mean birth weight and gestational age at delivery showed significant differences in comparisons of the 2 groups of twins. 4. Conclusion The reasons why IVF treatment sometimes results in twin or triplet births – even though only one embryo is used – have been found by the largest study to date on single embryo transfer (SET) and multiple pregnancy. However, despite performing SET, multiple pregnancies do happen due to a phenomenon known as ‘zygotic splitting’, when one embryo divides resulting in twins or triplets. It is more prevalent following SET than in spontaneous conception.
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