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  • ISSN: 2333-6439
    Volume 5, Issue 4
    Research Article
    Ketut Suryanegara, and Stella Kawilarang*
    Objective: This study was designed to investigate the difference of maternal serum interleukin-8 (IL-8) in preterm labor and normal pregnancy, to know the cut off point of maternal serum IL-8 in preterm labor and normal pregnancy, and also to evaluate the relative risk of preterm labor.
    Methods: This study was conducted in analytical cross-sectional method within September 2010 - May 2011. The inclusion sample was singleton pregnancy, within 28- 37 weeks gestational age, cervical dilation ≤ 2 cm, and willing to join the study.
    Results: There were 65 pregnant women, with 32 case of preterm labor and 33 control cases of normal pregnancy or not in labor state. The subject characteristics such as maternal age, gestational age, and gravid status were not significantly different (p > 0.05). While the mean rate of maternal IL-8 in the preterm labor was 34.98 ± 34.79 and the mean rate of maternal IL-8 in the normal pregnancy was 11.41 ± 3.32, and they were significantly different (t = 3.81 and p = 0.001). Based on the analysis using ROC curve, the cutoff point was 15.30 pg/ml, with sensitivity 81.8% and specificity 75%. Based on that cut off point, there was significant difference between IL-8 among two group, with x2= 21.104 and p = 0.001. The relative risk of preterm labor of maternal serum IL-8 > 15.30 pg/ml was 3-4 times (RR = 3.50, 95% CI = 1.86 – 6.60).
    Conclusion: This study showed that there was no difference of the sample characteristics, with significant differences of IL-8 value between the two groups. In the ROC curve, the cutoff point was 15.30 pg/ml with sensitivity 81.8% and specificity 75%. Based on that cut off point value, the relative risk of preterm labor was 3-4 times (RR = 3.50, 5% CI = 1.86-6.60). It could be concluded that high maternal serum IL-8 level in preterm pregnancy could induce the spontaneous preterm labor.
    Prathima Chowdary*, Michael Makary, Jenny McDougall, and Brendan Buckley
    Objective: To examine the effect of prophylactic iliac artery occlusion balloon catheters on bleeding morbidity among women with a prenatal diagnosis of placenta accreta.
    Methods: In a prospective trial (Canadian Task Force Classification II), women with a prenatal diagnosis of placenta accreta underwent a Multi-disciplinary Advisory Group (MDAG) review process and a decision was made regarding iliac artery occlusion balloons (IAOB) and caesarean hysterectomy. The primary study outcome was the measurement of blood loss. To detect difference in the blood loss between the prospective and retrospective group.
    Results: Between March 2010 and March 2015, 14 patients were prospectively followed after MDAG review and decision to offer IAOB. During the same period 26 patients with abnormal placentation who did not have MDAG group review and in whom IAOB were not used were retrospectively studied. Demographic and obstetric characteristics were similar between the groups. All statistical tests were two-sided at a 5% significance level. Demographic and clinical characteristics of all patients were summarized by cohorts. Continuous variables were presented as mean, standard deviation, median and range. For those measured on both cohorts, statistical difference was assessed using the Fisher’s exact test on categorical variables, and two sample t-test on continuous variables. Model-estimated difference between the means was tested, with associated 95% confidence interval and p-value.
    Conclusion: In women with preoperative suspicion of placenta accreta, MDAG review with an operative plan and placement of prophylactic balloon catheters significantly reduced the estimated blood loss operation.
    Saptarshi Chakraborty*, Veena Acharya, and Surabhi Saharan
    Hypertensive disorder in pregnancy (HDP) is one of the major causes of maternal and perinatal mortality & morbidity worldwide particularly in developing countries. In developed countries, maternal mortality rate varies from 4-40 per 1 lakh live birth. In developing countries, it varies from 100-700 with India having 178 per 1 lakh live birth.
    Objective: Study of biochemical markers and uterine artery Doppler for the prediction of hypertensive disorders and its severity. Sensitivity and Specificity of biochemical markers and Uterine Artery Doppler and their comparison for the prediction and the severity of hypertensive disorders during pregnancy.
    Material and methods: This is a prospective study. Approximately hundred patients with hypertensive disorders during pregnancy attending the OPD (Out patients Department) and IPD (In patient Department) in Obstetrics and Gynecology department will be included.
    All the patients in this study group will be subjected to biochemical markers tests and Ultrasonographic evaluation of the pregnancy along with the Arterial Doppler of both the Uterine Artery and Umbilical Artery will be done.
    Conclusion: Using biochemical markers (Inhibin-A and PAPP-A) and Uterine Artery Doppler Study in combination is significantly useful in early prediction of PIH having specificity and sensitivity of Inhibin-A as 88.89% and 83.33%, PAPP-A as 89.29% and 71.43%, Uterine artery Doppler study – Pi Index as 91.67% and 85.71 %, Ri Index as 87.5% and 71.43% and diastolic notch as 94.44% and 92.85 % respectively. The use of biochemical markers and uterine artery Doppler Study as an important tool for early prediction of PIH and has a lot of prognostic value.
    Case Report
    Emmanuel Dziwornu*, Michael McCarthy, and Stella Dzifa Monu Awudi
    Effective Health care rests on strong collaboration among different specialties. One of these collaborations is one between the physician and the clinical psychologist. This paper presents a collaborative treatment of genitor-pelvic pain/penetration disorder (formally called vaginismus) suffered by a couple for two whole years after their marriage in Ghana. The collaboration involved a gynecologist and clinical psychologist. Data on such cases are rarely presented in this part of the world. It is therefore important to present such cases in order to inform future treatment options and procedures.
    Short Communication
    Amelie Cayzeele-Decherf*, Fanny Pelerin, and Peter Justen
    Vulvovaginal candidiasis (VVC) is a common and burdensome fungal infection in women. Although conventional therapies exert satisfactory results in curing acute VVC, prevention of relapse remains a concern. The objective of this double-blind, randomized, placebo-controlled pilot study was to evaluate the effect of oral administration of S. cerevisiae CNCM I-3856 in women conventionally treated for VVC. The women received a single conventional antifungal treatment and consumed a placebo or S. cerevisiae CNCM I-3856 once a day for 56 days. Vaginal Candida load was measured at each visit by a vaginal swab, and the proportion of relapses was assessed after 8 weeks (W8). Twenty-two (22) women with confirmed VVC were allocated to a verum (n=13) or a placebo group (n=9). Characteristics were similar at baseline except for vaginal Candida load. Compliance was excellent (98.8 ± 8.0%) and probiotic supplementation was well tolerated. In the verum group, Candida vaginal load significantly decreased from W0 to W4 (p <0.01) and from W0 to W8 (p <0.01) while remaining stable in the placebo group. At W8, 4/13 subjects (31%) relapsed in the verum group vs 6/9 subjects (67%) in the placebo group. S. cerevisiae strain CNCM I-3856 is efficient in the control of vaginal Candida proliferation and in preventing VVC recurrence. This probiotic yeast is well-tolerated and easy to use by oral administration.
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