Search

Objective: Our study is aimed at evaluating the characteristics of the pelvic floor, assessed through transperineal ultrasound, since it may influence or increase the possibility of having a cesarean delivery, with the objective of acting on those variables that can be modified during pregnancy., Study Design: Transperineal ultrasound was performed on 109 primiparous pregnant women in their first trimester of pregnancy, recruited between May 2018 and February 2019, with the purpose of studying the hiatus area at rest, retention and Valsalva. We have reassessed them at the end of pregnancy and delivery data were recorded. We selected 8 patients as case-study, who had cesarean section delivery due to failure of labor progression. We selected 4 control-cases for each, reaching the total of 32 controls, with similar age and body mass index, to avoid obtaining a biased result from these data., Results: In the study of hiatal areas, patients who delivered by cesarean section had a smaller hiatal area at rest, during levator ani muscle contraction and during Valsalva maneuver, at all visits. In early pregnancy, the range of the resting hiatal area was 13.8 ± 2.0 cm 2 for cesarean sections, compared to 16.2 ± 2.7 cm 2 for vaginal deliveries with an OR of 0.57 (0.34-0.95, 95% CI). For hiatal area on Valsalva, the OR was 0.55 (0.35-0.88, 95% CI). Therefore, the smaller the hiatal area, the greater the possibility of cesarean section. At the end of pregnancy, between 34 and 36 weeks of gestation, the OR of hiatal area on Valsalva was 0.78 (0.60-1.00, 95% CI)., Conclusion: The hiatus area measured by transperineal ultrasonography at the beginning and at the end of the pregnancy may be useful to identify the patients who are at a higher risk of cesarean delivery due to failure of labor progression., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: To evaluate whether administration of analgesic medication one hour before undergoing office hysteroscopy decreased pain and other side effects., Study Design: A prospective randomized study was carried out in 200 patients who underwent office hysteroscopy from November 2011 until May 2012. 100 patients received 1000 mg paracetamol and 600 mg ibuprofen one hour before the procedure and 100 did not receive any medication., Results: We observed significant differences (p = 0.013) regarding the occurrence of non-pain side effects, 6% in the non-medicated group and none of the patients in the medicated group. The main pain score was always slightly higher in the group receiving no medication, though there was no statistically significant difference when compared to the medicated group., Conclusion: Administration of 1 g paracetamol and 600 mg ibuprofen one hour prior to office hysteroscopy decreased statistically the occurrence of non-pain side effects such as nausea, emesis, and hypotension. No differences in pain scores were observed., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

The amino acid homocysteine is of considerable medical importance because it is involved in the etiopathogeny of cardiovascular diseases. Hyperhomocysteinemia is a factor in the vascular damage that predisposes thrombogenesis and arteriosclerosis. It has also been related to a range of obstetric and gynecologic complications. Numerous studies have demonstrated the association between increased levels of homocysteine and neural tube defects (NTD) and other congenital defects, spontaneous miscarriages, intrauterine growth retardation (IGR), preeclampsia and intrauterine fetal death. Folic acid and other B-group vitamins (B6 and B12) take part in the metabolism of homocysteine and the preventive administration of these vitamins may reduce some of the complications., (Copyright 2002 Elsevier Science Ireland Ltd.)