Conference Paper

Das fetale Geburtsgewicht korreliert mit einer erhöhten Rate an sekundären Kaiserschnitten, jedoch nicht mit einer erhöhten perinatalen Morbidität bei vaginal angestrebten Geburten aus Beckenendlage

October 2018
Geburtshilfe und Frauenheilkunde 78(10)

DOI:10.1055/s-0038-1671651

Conference: 62. Kongress der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe – DGGG'18

Authors:

Lukas Jennewein

Goethe University Frankfurt

Ulrikke Kielland-Kaisen

Goethe University Frankfurt

Bettina Paul

University Hospital Frankfurt

Charlotte Johanna Möllmann

University Hospital Frankfurt

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ResearchGate has not been able to resolve any references for this publication.

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Background: the rate of caesarean in Australia is twice that of Sweden. Little is known about women's attitudes towards birth in countries where the caesarean rate is high compared to those where normal birth is a more common event. Objectives: to compare attitudes and beliefs towards birth in a sample of Australian and Swedish women in mid-pregnancy. Participants: women from rural towns in ... [Show full abstract] mid Sweden (n=386) and north-eastern Victoria in Australia (n=123). Methods: questionnaire data was collected from 2007 to 2009. Levels of agreement or disagreement were indicated on sixteen attitude and belief statements regarding birth. Principal components analysis (PCA) identified the presence of subscales within the attitudes inventory. Using these subscales, attitudes associated with preferred mode of birth were determined. Odds ratios were calculated at 95% CI by country of care. Results: the Australian sample was less likely than the Swedish sample to agree that they would like a birth that: 'is as pain free as possible' OR 0.4 (95% CI: 0.2-0.7), 'will reduce my chance of stress incontinence' OR 0.2 (95% CI: 0.1-0.8), 'will least affect my future sex life' OR 0.3 (95% CI: 0.2-0.6), 'will allow me to plan the date when my baby is born' OR 0.4 (95% CI: 0.2-0.7) and 'is as natural as possible' OR 0.4 (95% CI: 0.2-0.9). They were also less likely to agree that: 'if a woman wants to have a caesarean she should be able to have one under any circumstances' OR 0.4 (95% CI: 0.2-0.7) and 'giving birth is a natural process that should not be interfered with unless necessary' OR 0.3 (95% CI: 0.1-0.7). Four attitudinal subscales were found: 'Personal Impact of Birth', 'Birth as Natural Event', 'Freedom of Choice' and 'Safety Concerns'. Women who preferred a caesarean, compared to those who preferred a vaginal birth, across both countries were less likely to think of 'Birth as a natural event'. Key conclusions: the Australian women were less likely than the Swedish women to hold attitudes and beliefs regarding the impact of pregnancy and birth on their body, the right to determine the type of birth they want and to value the natural process of birth. Women from both countries who preferred caesarean were less likely to agree with attitudes related to birth as a natural event.

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Study design: Data collected from a postutilization questionnaire were used to evaluate the usability of the OfficeSPEC disposable vaginal speculum, specifically the effectiveness, efficiency, and acceptability, in clinical, hospital, and austere environments. Results: Usability data analysis showed the OfficeSPEC speculum had an effectiveness rating of 4.6/5, efficiency rating of 4.5/5, and ... [Show full abstract] acceptability rating of 4.6/5; overall usability in deployed environments was favorable. The overall rankings were 3.4 for plastic, 4.2 for metal (p < 0.001), and 4.5 for OfficeSPEC (p < 0.001). Cost analysis of the OfficeSPEC placed the disposable speculum as a reasonable alternative with yearly cost of

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Introduction: Heterotopic pregnancy occurs when there is coexisting intrauterine and ectopic pregnancy. Usually it happens after using of assisted reproductive techniques and it is very rare in natural conception. Immediately diagnosis and treatmem of this condition is very important and could prevent morbidity and mortality of these patients. The goal of this study was to report a case of ... [Show full abstract] heterotopic pregnancy in a natural conception. Case Report: The patient was a 33 year old woman, primipara, 8 weeks of pregnancy, without positive history of infertility or using assisted reproductive technique. Her chief complaint was vaginal spotting and acute abdominal pain. in physical examination there was generalized abdominal, adnexal and cervical motion tenderness. Results: The patient was in shock. A ruptured right ampullary tube ectopic pregnancy was detected, which led to right salpingectomy. There was also a dead fetus in the uterus in emergency ultrasonograph which was completely aborted after 30 minites. However heterotopic pregnancy is a rare type of pregnancy especially during natural conception but it could happen even without any risk factors. Keyword: Heterotopic Pregnancy, Ectopic Pregnancy, Natural conceptaion

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Wulwodynia is defined as a discomfort or pain in the entrance to the vagina, urethra, perineum or anus without perceptible pathological changes. Postmenopausal women often experience vaginal dryness (45%), and burning (10%), whereas pain during sexual intercourse feels 1/3 of women after menopause (provoked wulwodynia). Differences in the management of patient with post-menopausal wulwodynia is ... [Show full abstract] getting a biopsy of the vulva in justified cases, which is obviously not necessary in the vulvar pain patients of childbearing age. Another difference is that the most effective treatment consisting of local estrogenotherapy. The article presents the spectrum of therapeutic intervention.

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T M ABBAS

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Contribution à l'étude des tumeurs fibreuses du vagin /

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F. Boursier de la Roche

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Anatomy and Histology of the Cervix

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The cervix (term taken from the Latin, meaning neck) is the most inferior portion of the uterus, protruding into the upper vagina. The vagina is fused circumferentially and obliquely around the distal part of the cervix, dividing it into an upper, supravaginal and lower, vaginal portion.19 The cervix measures 2.5–3.0 cm in length in the adult nulligravida, and its normal position is slightly ... [Show full abstract] angulated downward and backward. The vaginal portion (portio vaginalis) of the cervix, also referred to as the exocervix, is delimited by the anterior and posterior fornices and has a convex elliptical surface. It is centered by the external os, a circular (in the nulligravida) or slit-like (in the parous woman) opening (Fig. 5.1). The portio may be divided into anterior and posterior lips, of which the anterior is shorter and projects lower than its posterior counterpart. The external os is interconnected with the isthmus (internal os) by the cervical canal. The canal is an elliptical cavity, measuring in its greatest width 8 mm, and contains longitudinal mucosal ridges, the plicae palmatae (Fig. 5.2). The area between the endocervical and endometrial cavity is called the isthmus or lower uterine segment. The latter term is used principally for descriptive purposes during gestation and labor. The use of the terms anatomic and histologic internal os seems arbitrary, as no convincing morphologic evidence is offered to support such a geographic subdivision. The uterus is best divided into corpus, isthmus, and cervíx. The muscular layer in the region of the isthmus is less well developed than in the corpus, a feature that facilitates effacement and dilatation during labor.

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July 2009 · The American Journal of Emergency Medicine

Early diagnosis of sexually transmitted infections (STI) such as Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG) is crucial in reducing complications. Vaginal bleeding (VB) has been suggested as a possible presentation of STI. To identify the rate of STI in sexually active women presenting to the emergency department (ED) with VB. Prospective observational study of females 18-55 ... [Show full abstract] years-old presenting to two affiliated urban EDs with VB (convenience sample). Patients with recent STI or antibiotic use (< 3 months) were excluded. To estimate the background rate of STI, we enrolled women with no genitourinary complaints as controls. Specimens for CT and NG were obtained during speculum exam from cases and by self administered vaginal swab in controls. All specimens were analyzed by polymerase chain reaction. Continuous data was presented as mean +/- standard deviation and categorical data as percentages with 95% confidence intervals CI). Fisher's exact test was used to compare the rate of STI between the groups. From 09.06 to 08.07 a total 273 subjects were enrolled (174 VB and 99 controls, mean age: 33 +/- 10). Groups were similar with regards to baseline characteristics. The majority of STI cases were due to CT: 5.8% in VB group (95% CI, 3.2%-10.4%) vs. 7.1% in controls (95% CI, 3.5%-14.0%). The STI rate was 6.3% (95% CI, 3.5%-11.1%) in VB patients and 8% (95% CI, 3.9%-15.3%) in controls. Our ED patients with and without vaginal bleeding had comparable rate of STI.

Last Updated: 22 Oct 2024

Das fetale Geburtsgewicht korreliert mit einer erhöhten Rate an sekundären Kaiserschnitten, jedoch nicht mit einer erhöhten perinatalen Morbidität bei vaginal angestrebten Geburten aus Beckenendlage

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