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Correlates of diagnosed and probable polycystic ovary syndrome (PCOS) among parous women were assessed in this study. A total of 557 women were recruited from multi-specialty clinics in eastern Massachusetts. The women were categorized as being diagnosed with PCOS based on medical records and self-reported clinician-diagnoses. A category of "probable PCOS" was created for women without a diagnosis but with ≥ 2 of the following: ovulatory dysfunction (cycle length < 21 or ≥ 35 days), hyperandrogenism (free testosterone concentration > 75th percentile), or elevated anti-Müllerian hormone (AMH) concentration (> 75th percentile). The remaining participants were placed in the "no PCOS" category, and characteristics were compared across groups. Of the total cohort, 9.7% had diagnosed and 9.2% had probable PCOS. The frequency of irregular cycles was similar for diagnosed and probable PCOS. Free testosterone and AMH levels were higher in women with probable than with diagnosed PCOS. Frequency of irregular cycles and both hormones were higher for the 2 PCOS groups vs the no PCOS group. Obesity prevalence for diagnosed PCOS was twice that of probable PCOS (43.9% vs 19.6%), yet the 2 groups had similar HbA1c and adiponectin values. Women with probable PCOS are leaner but have comparable glycemic traits to those with a formal diagnosis, highlighting the importance of assessing biochemical profiles among women with irregular cycles, even in the absence of overweight/obesity. [ABSTRACT FROM AUTHOR]

Abstract Background Pregnancy and childbirth have been connected to modified risk of a wide variety of conditions in later life, including neurodegenerative disorders and cancers. The presence, extent, and direction of the effect that childbearing status has on decreasing or increasing the risk of these conditions differs depending on the disease. The mechanisms by which pregnancy and childbirth modify the risk of diseases are still unknown. DNA methylation (DNAm) alterations that occur during pregnancy and persist after childbirth may help us understand this phenomenon. Results Blood DNAm was available from 89 women (28 parous; 61 nulliparous) at ages 18 and 26 years in the Isle of Wight birth cohort; no significant differences in the population characteristics were present between the analyzed population and the full cohort. We performed an epigenome-wide association study on 389,355 CpGs and identified 184 CpGs to be significantly differentially methylated between parous and nulliparous women after adjusting for confounders and multiple testing. Of these CpGs, 105 had regression coefficients in the same direction in an independent Mexico City based ELEMENT cohort, of which 13 were significant (replication P

Background: Pregnancy and childbirth have been connected to modified risk of a wide variety of conditions in later life, including neurodegenerative disorders and cancers. The presence, extent, and direction of the effect that childbearing status has on decreasing or increasing the risk of these conditions differs depending on the disease. The mechanisms by which pregnancy and childbirth modify the risk of diseases are still unknown. DNA methylation (DNAm) alterations that occur during pregnancy and persist after childbirth may help us understand this phenomenon. Results: Blood DNAm was available from 89 women (28 parous; 61 nulliparous) at ages 18 and 26 years in the Isle of Wight birth cohort; no significant differences in the population characteristics were present between the analyzed population and the full cohort. We performed an epigenome-wide association study on 389,355 CpGs and identified 184 CpGs to be significantly differentially methylated between parous and nulliparous women after adjusting for confounders and multiple testing. Of these CpGs, 105 had regression coefficients in the same direction in an independent Mexico City based ELEMENT cohort, of which 13 were significant (replication P < 0.05). These 13 CpGs were associated with 16 unique genes. DNAm levels tracked with gene expression in 3 of the replicated genes, one of which (TM2D3) was differentially expressed in parous vs nulliparous women. Gene disease association analysis identified a network of parous-associated diseases. Conclusions: Our results suggest that pregnancy and childbirth lead to DNAm changes in parous women and these changes persist at least 6 months and up to 8 years postpartum. Parous-related CpG sites may play a role in how childbearing status modifies risk of later life diseases in women. Further studies are needed to explore the linkage and mechanism. [ABSTRACT FROM AUTHOR]

Objectives: Our study aimed to investigate the prevalence of female pelvic floor dysfunction (PFD) in Israeli women who experienced vaginal delivery and are in their reproductive years (premenopausal), as well as to understand their attitudes and health-seeking behavior and barriers towards treating this problem. Methods: In this cross-sectional study, we conducted a questionnaire-based Internet survey. The surveys were sent to Israeli women in their fertile years (18–50 years old). We asked the women about their PFD symptoms, attitudes, and help-seeking behaviors. We used two validated questionnaires, including the USIQ and the PFDI-20. The combined questionnaire was submitted in both Hebrew and Arabic. We assessed the prevalence of PFD symptoms in the study population. Symptomatic women were asked about their help-seeking behaviors and their beliefs, desires, and barriers regarding the clinical management of symptoms. Results: Between July and September 2020, 524 women completed the questionnaire (response rate 44%). In total, 95% reported at least one symptom (mostly urinary-related) at any grade of severeness in at least one category, and 66.8% suffered from at least one moderate to severe symptom in at least one category. Most women (93.7%) reported that they wanted to be asked and offered voluntary information about PFD from physicians and nurses; however, only 16.6% reported receiving such information. Barriers to seeking treatment were mainly related to low awareness. The study's main limitation was selection bias due to the questionnaire's design. Conclusions: These findings show the importance of raising awareness of the different therapeutic solutions to PFD symptoms and designing more available services for this common problem. [ABSTRACT FROM AUTHOR]

Culicoides biting midges (Diptera: Ceratopogonidae) are the main vectors of livestock diseases such as bluetongue (BT) which mainly affect sheep and cattle. In Spain, bluetongue virus (BTV) is transmitted by several Culicoides taxa, including Culicoides imicola , Obsoletus complex, Culicoides newsteadi and Culicoides pulicaris that vary in seasonality and distribution, affecting the distribution and dynamics of BT outbreaks. Path analysis is useful for separating direct and indirect, biotic and abiotic determinants of species' population performance and is ideal for understanding the sensitivity of adult Culicoides dynamics to multiple environmental drivers. Start, end of season and length of overwintering of adult Culicoides were analysed across 329 sites in Spain sampled from 2005 to 2010 during the National Entomosurveillance Program for BTV with path analysis, to determine the direct and indirect effects of land use, climate and host factor variables. Culicoides taxa had species-specific responses to environmental variables. While the seasonality of adult C. imicola was strongly affected by topography, temperature, cover of agro-forestry and sclerophyllous vegetation, rainfall, livestock density, photoperiod in autumn and the abundance of Culicoides females, Obsoletus complex species seasonality was affected by land-use variables such as cover of natural grassland and broad-leaved forest. Culicoides female abundance was the most explanatory variable for the seasonality of C. newsteadi , while C. pulicaris showed that temperature during winter and the photoperiod in November had a strong effect on the start of the season and the length of overwinter period of this species. These results indicate that the seasonal vector-free period (SVFP) in Spain will vary between competent vector taxa and geographic locations, dependent on the different responses of each taxa to environmental conditions. [ABSTRACT FROM AUTHOR]

Purpose: Nulliparity and operative vaginal delivery are established risk factor for obstetric anal sphincter injury (OASI). However, risk factors for OASIS occurrence among parous women delivering vaginally are not well-established. We aimed to study the risk factors for OASI occurrence among parous women. Methods: A retrospective study including all parous women who delivered vaginally at term during 2011–2019 at a university hospital. Deliveries of parous women with OASI were compared to deliveries without OASI. The risk factors associated with OASI were investigated. Results: Overall, 35,397 women were included in the study with an OASI rate of 0.4% (n = 144). A higher rate of only one previous vaginal delivery was noted in the OASI group (78.5% vs. 46.4%, OR [95% CI] 4.20, 2.82–6.25, p < 0.001). The rate of vacuum-assisted deliveries was comparable between the study groups. The median birth weight was higher among the OASI group (3566 vs. 3300 g, p < 0.001), as was the rate of macrosomic neonates (19.4% vs. 5.5%, OR [95% CI] 4.15, 2.74–6.29, p < 0.001). On multivariate logistic regression analysis, only two factors were independently positively associated with the occurrence of OASI: a history of only one previous vaginal delivery (adjusted OR [95% CI] 4.34, 2.90–6.49, p = 0.001), and neonatal birth-weight (for each 500 g increment) (adjusted OR [95% CI] 2.51, 1.84–3.44, p < 0.001). Conclusions: Among parous women, the only factors found to be independently positively associated with OASI were the order of parity and neonatal birth-weight. Vacuum-assisted delivery was not associated with an increased risk of OASI among parous women. [ABSTRACT FROM AUTHOR]

Abstract Objective Malaria vectors control interventions are designed to cause immediate killing or shorten mosquito lives, therefore does not allow enough time for the development of the parasites to infective stage. The wall lining is new malaria vectors control intervention in Tanzania where its impact on age structure is not well known. Therefore this study aimed at determining the impact of non-pyrethroid durable wall lining on the age structure of malaria vectors. Results Higher proportions of An. gambiae sensu lato (57.1%, z = 2.66, P = 0.0077) and An. funestus (64.8%, z = 3.38, P = 0.001) were collected in the control clusters. Unexpectedly, significantly higher proportion of parous An. gambiae s. l. were collected in the intervention clusters (z = − 2.78, P = 0.0054). The wall lining intervention has demonstrated low impact on age structure of An. gambiae s. l., this call for further studies on the efficacy of the intervention.

Background: Zoonotic cutaneous leishmaniasis (ZCL) is a neglected tropical disease prevailed in many rural areas of 17 out of 31 provinces in Iran. The main vector of the disease is Phlebotomus papatasi and the causative agent is Leishmania major in ZCL foci of Iran. In the current study we investigated the validity of accessory glands secre­tions as an indicator to recognize parous from nulliparous Ph. papatasi females under laboratory conditions. Methods: Over 235 laboratory-reared females of Ph. papatasi were dissected in 6 groups including: newly emerged, one hour, one day, two days, and three days after blood feeding and also after oviposition under stereo microscope for their parity in 2014–2015. Results: Transparent glands were compatible with nulliparous only in newly emerged sand flies. In sand flies dis­sected after oviposition, accessory glands were rather large as a result of oviposition though they were transparent. Conclusion: The accessory glands secretions could not be as an indicator for distinguishing parous from nulliparous of Ph. papatasi females.

Objective: Malaria vectors control interventions are designed to cause immediate killing or shorten mosquito lives, therefore does not allow enough time for the development of the parasites to infective stage. The wall lining is new malaria vectors control intervention in Tanzania where its impact on age structure is not well known. Therefore this study aimed at determining the impact of non-pyrethroid durable wall lining on the age structure of malaria vectors. Results: Higher proportions of An. gambiae sensu lato (57.1%, z = 2.66, P = 0.0077) and An. funestus (64.8%, z = 3.38, P = 0.001) were collected in the control clusters. Unexpectedly, significantly higher proportion of parous An. gambiae s. l. were collected in the intervention clusters (z = - 2.78, P = 0.0054). The wall lining intervention has demonstrated low impact on age structure of An. gambiae s. l., this call for further studies on the efficacy of the intervention. [ABSTRACT FROM AUTHOR]

Background: Zoonotic cutaneous leishmaniasis (ZCL) is a neglected tropical disease prevailed in many rural areas of 17 out of 31 provinces in Iran. The main vector of the disease is Phlebotomus papatasi and the causative agent is Leishmania major in ZCL foci of Iran. In the current study we investigated the validity of accessory glands secretions as an indicator to recognize parous from nulliparous Ph. papatasi females under laboratory conditions. Methods: Over 235 laboratory-reared females of Ph. papatasi were dissected in 6 groups including: newly emerged, one hour, one day, two days, and three days after blood feeding and also after oviposition under stereo microscope for their parity in 2014-2015. Results: Transparent glands were compatible with nulliparous only in newly emerged sand flies. In sand flies dis- sected after oviposition, accessory glands were rather large as a result of oviposition though they were transparent. Conclusion: The accessory glands secretions could not be as an indicator for distinguishing parous from nulliparous of Ph. papatasi females. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are among the leading threats to global health because of their association with increased risk of morbidity and mortality. Much of the research on overweight and obesity among women largely generalize without due cognisance to differences in their reproductive history. This study explored differences in trends in overweight/obesity, and associated factors between parous and nulliparous women in Ghana. Methods: Anthropometric measurements from three nationally representative Ghana Demographic and Health Surveys (2003, 2008 and 2014) were analysed using descriptive statistics and multivariate binary logistic regression. Results: Over all, overweight/obesity increased between 2003 and 2014, with disproportionately higher rates among parous women (from about 30 % in 2003 to about 48 % in 2014) than nulliparous women (from about 15 % in 2003 to about 24 % in 2014). Age, wealth quintile and marital status were associated with overweight/obesity similarly in both women groups. However, there were variations in the association between parous and nulliparious women by educational level, type of locality, occupation and ethnicity. Conclusion: The trend of overweight/obesity in Ghana warrants urgent national level public health attention to help curb the situation. Such interventions should be tailored bearing in mind the peculiar differences in associated factors between parous and nulliparous women. [ABSTRACT FROM AUTHOR]

The suction light trap ( LT) is a standard tool used to capture Culicoides biting midges, when estimating abundances, and mapping species ranges. The exact range of attraction of the LT is in dispute, however, with several studies indicating the range to vary widely, between 4 and 50 m. In this study, the attractant range of a LT, set at various distances (0, 1, 2, 3, 5 and 8 m) from a cow tethered at pasture, is assessed in two trials conducted on a dairy farm in the Netherlands in 2013 and 2014. In the first trial, sweep-netting and light-trapping was performed concurrently. Although a Spearman Rank correlation of 0.89 (P = 0.03) showed the two sets of abundance results to be highly correlated, species prevalence differed significantly according to the method used: the Culicoides obsoletus complex dominated the LT observations, whereas Culicoides chiopterus and Culicoides dewulfi were more abundant in those obtained by sweep-net, due to the former taxon being largely nocturnal, the latter diurnal. There is a distinct negative logarithmic relationship between Culicoides abundance and distance from the vertebrate host, with midge abundance, in the LT, increasing significantly only when it is placed very close to the bait animal, at a distance of 0-1 m. The sharp decay function in the number of Culicoides caught with increasing distance from the LT, limits the comparison of LT surveillance data obtained under various settings, even from within a climatically homogeneous geographical region such as north-western Europe. [ABSTRACT FROM AUTHOR]

Background: Awareness and demand for neuraxial pain relief for labor are on the increase, but epidural technique appears to be the preferred option among anesthetists in Nigeria. We describe our experience with combined spinalepidural (CSE) analgesia to fill the gap in knowledge in order to boost its utilization. Materials and Methods: In this retrospective observational study, data were collected from the obstetric analgesia proforma completed for all CSE analgesia performed for labor pain relief between January 1, 2011 and June 30, 2014. Results: Thirty parturients (21 nulliparous: 9 parous) with a singleton gestation in labor with a mean age of 31.0 ± 4.1 years were studied. In all, 56.7% of parturients requested for analgesia following oxytocin augmentation. The overall mean onset of analgesia and cervical os dilatation at initiation of analgesia were 2.23 ± 0.43 min and 3.4 ± 1.3 cm respectively, with no significant difference between groups. Overall analgesia was adequate in 90% of cases, and 76.7% had spontaneous vaginal delivery; although only nulliparous parturients (23.3%) had cesarean delivery, it was not significant (P = 0.07). There was a significant difference in Apgar score at 1-min between nulliparous and parous groups (7.7 vs. 8.9; P = 0.03), but no difference at 5-min. The side effects observed were vomiting and shivering. Conclusion: CSE technique can be safely used in every laboring parturient irrespective of parity either in early or late labor situations. [ABSTRACT FROM AUTHOR]

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Pregnancy and the events surrounding it are generally viewed as feminine issues exclusively for women. In sub-Saharan Africa, believing that pregnancy and the events that follow are guided by nature, a lot of superstition is attributed in the event of complications, which result in poor maternal outcomes. Maternal mortality remains a public health challenge worldwide, and Nigeria has one of the highest levels of maternal mortality in the world (545 per 100,000 live births). The involvement of men in ensuring and enhancing maternal health was a great idea hatched at the Cairo conference in 1994, but since then, not much has been done in practical terms in most of the developing world. This study is aimed at assessing the level of male involvement in their spouses' reproductive health events before pregnancy, during pregnancy, delivery and peuperium. A descriptive cross-sectional study design in which questionnaires were incorporated with an in-depth interview was used and a multistage sampling technique was used to select respondents. After house numbering, a total of 400 houses were selected from a cluster of four quarters in Patani Town. Participants were systematically sampled from each household using random number table. Results from data collected on the study indicated that (61.1 %) of men were aware of maternal health issues and the level of education was shown to have significant relationship (χ² = 5.139, df = 3, p = 0.162) with the knowledge of maternal health issues. Though the level of male involvement in safe motherhood was shown to be of good proportion, strategies to create awareness on male support for their parous spouses should be given a broader frontier, both in clinics, household and community levels. Men should be more involved than before, as they have a priceless role to play towards a significant improvement in maternal health. The Government, development partners and NGOs at all levels should be committed with a strong political will in this regard. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to assess the relation between fear of childbirth and previous birth experiences. Design A prospective study of pregnant women. Setting Akershus University Hospital, Norway. Population Parous women ( n = 1357) scheduled to give birth at Akershus University Hospital in Norway during 2009-2011. Methods Data were collected using two self-completed questionnaires at pregnancy weeks 17 and 32. Fear of childbirth was assessed by the Wijma Delivery Expectancy Questionnaire. Previous overall birth experience was measured using a numeric rating scale, and previous obstetric complications were assessed using an index of seven obstetric complications: emergency cesarean section, instrumental vaginal delivery, extensive blood loss, retained placenta, serious maternal infection during labor, thrombosis, and anal sphincter tears. Main outcome measure Fear of childbirth. Results The odds ratio of fear of childbirth was 4.8 (95% confidence interval ( CI) 2.8-8.3) for a previous negative overall birth experience, 1.9 (95% CI 1.2-3.1) for one obstetric complication and 2.6 (95% CI 1.2-5.5) for two or more complications. The estimates were adjusted for mental health, labor pain, time since last delivery, age, and education. Almost 80% of women who experienced obstetric complications neither considered the birth a negative overall experience nor developed a fear of childbirth. Conclusions The association between a previous subjectively negative birth experience and fear of childbirth was high and was greater than the association between previous obstetric complications and fear of childbirth. [ABSTRACT FROM AUTHOR]

Objective To estimate the association between elective induction of labor and cesarean section in low-risk parous women, and to assess whether the association is influenced by induction method. Design Cohort study. Setting University hospital in Sweden. Population Parous women without pregnancy complications or previous cesarean section, and with a planned vaginal term (37-41 weeks), singleton birth, in vertex position were included. Methods Information was collected from a local database containing prospectively entered antenatal and delivery data. Odds ratios for cesarean section were calculated using generalized estimating equations logistic regression and adjusted for parity, maternal age, gestational length, birthweight, use of epidural anesthesia and year of birth. Main outcome measures Emergency cesarean section. Results Among 7973 pregnancies that fulfilled the inclusion criteria, 343 (4%) had an elective induction of labor. Intravenous oxytocin was administered in 5% of these inductions, amniotomy was performed in 62%, and a cervical ripening agent was used in 33%. Electively induced labor more than doubled the risk of cesarean section compared with spontaneous labor onset ( OR 2.5, 95% CI 1.4-4.2) and this risk was more than tripled when cervical ripening was used ( OR 3.6, 95% CI 1.7-7.6). Conclusions In low-risk parous women, electively induced labor has an increased risk of emergency cesarean section compared with spontaneous onset labor. This risk increase is more pronounced if cervical ripening agents are required. Women need to be counseled about these risks before elective induction of delivery is decided. [ABSTRACT FROM AUTHOR]

Objectives The angle of progression (AOP), measured by transperineal ultrasound, has been used to assess fetal head descent during labor. Our aim was to assess whether, before onset of labor, parous women have a narrower AOP than do nulliparous women and if a narrow AOP is associated with a higher rate of Cesarean delivery. Methods In this prospective, observational study, we performed transperineal ultrasound in pregnant women not yet in labor at ≥ 39 weeks' gestation who delivered within 1 week of sonography. The AOP was compared as follows: in nulliparous women, between those who had a Cesarean section and those who delivered vaginally; and among women who delivered vaginally, between those who were nulliparous and those who were parous. Results Included in the study were 100 nulliparous and 71 parous women. Among those who delivered vaginally ( n = 161), the median AOP before onset of labor was narrower in parous than in nulliparous women (98° (interquartile range (IQR)), 90-107° vs 104° (IQR, 97-113°), P < 0.001). Among the 100 nulliparous women, (1) the median AOP before onset of labor was narrower in those who went on to deliver by Cesarean section ( n = 9) than in those delivered vaginally ( n = 91) (90° (IQR, 85.5-93.5°) vs 104° (IQR, 97-113°), P < 0.001); (2) an AOP ≥ 95° (derived from the receiver-operating characteristics curve) was associated with vaginal delivery in 99% of women; and (3) 89% (8/9) of women who delivered by Cesarean section had an AOP < 95°. Among the 71 parous women, only one delivered by Cesarean section and all of those with an AOP < 95° delivered vaginally. Conclusion A narrow AOP (< 95°) in non-laboring nulliparous women at term is associated with a high rate of Cesarean delivery. Parous women have a narrower AOP than do nulliparous women before the onset of labor; however, unlike in nulliparous women, a narrow AOP in parous women does not appear to be associated with Cesarean delivery and most parous women with such an angle go on to deliver vaginally. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background and objective: Poor endurance of the back extensor muscles has been reported among more women than men. There are several reported reasons for its predilection but the influence of parity has not been investigated. The objective of this study was to investigate the influence of parity on back extensor muscles' endurance between nulliparous and parous women. Methods and Results: 146 women whose ages ranged between 21 to 60 years were recruited into the study using sampling of convenience. This consisted of 77 nulliparous women group (21–42 years) with a mean age of 32.7 ± 5.7 years and the parous women group (26–60 years) with a mean age of 41.2 ± 9.9 years. The participants performed the Biering-Sørenson test of Static Muscular Endurance (BSME) and their height, weight and percentage body fat were measured using standard procedures. Body Mass Index (BMI) and lean body mass (LBM) and body fat mass (BFM) were calculated. Data were summarized using the descriptive statistics of mean and standard deviation, Pearson's Chi-square, Independent t-test, and Analysis of Variance were used as applicable. The α level was set at 0.05. The finding of this study showed that parous women were significantly older, heavier and had greater level of adiposity than their nulliparous counterparts. The result indicated a significant association between parity and endurance time (X^{2} = 88.05; P=0.020), nulliparous women have significantly greater back extensor muscles' endurance (t=4.902; P=0.000) when compared to parous women. The results suggested that the significant age and anthropometric difference between the nulliparous and parous women could contribute to the endurance differences. Number of parity is much related to back extensor muscle endurance (F= 22.32; P=0.000). Back extensor muscles' endurance decreases as the number of parity increases. Conclusion: Our results suggest that parity is an important factor in the aetiology of low back extensor muscles endurance among women. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The objective of the study was to evaluate ease of insertion, contraceptive performance and safety, in parous and nulliparous women, of two new T-shaped levonorgestrel (LNG)-releasing intrauterine systems (LNG-IUS), Femilis™ (parous women) and Femilis™ Slim (nulliparous women), releasing 20 μg of LNG per day. An ancillary objective was to evaluate expulsion and user continuation. Design and methods: An open, prospective, noncomparative study (interim analysis). Two hundred thirty-five insertions were performed in fertile women seeking contraception. Of these, 143 (60.8%) parous women were fitted with Femilis and 92 (39.2%) nulliparous women were fitted with Femilis Slim. The LNG-IUS was inserted using a simplified push-in technique (without folding the cross-arms in the insertion tube). Results: This paper is the first report with the Femilis LNG-IUS. The push-in technique of insertion was considered simple and safe. Insertion was reported “easy” in virtually all women (97.9%). Pain at insertion was absent in 24.7% and “mild” in 67.7% of women. With respect to pain, there were no statistical differences between the parous and nulliparous group. At the time of study analysis, the total number of women-months of use was 1769.7. Seventy-six women had the Femilis IUS in place for periods in excess of 1 year. The study was well followed up with lost to follow-up of only two women. No pregnancies were observed. There was one expulsion in the nulliparous and one in the parous group. Ten removals were performed for medical reasons (mainly bleeding and pain). One pelvic infection occurred in a nulliparous woman caused by Chlamydia trachomatis, which was resolved without removing the IUS. There were no other serious adverse events reported. Both Femilis and Femilis Slim were well tolerated, which resulted in a high continuation rate (94.04%). Conclusion: The Femilis LNG-IUS is an effective contraceptive and is easily inserted. The simple and safe insertion procedure could be an advantage for use by nonspecialist providers such as nurses, midwives, general practitioners, and for those not inserting intrauterine devices regularly. Femilis Slim could be an attractive long-term contraceptive option in young and adolescent women. [Copyright &y& Elsevier]

Vascular endothelial growth factor165 (VEGF165) demonstrates increased expression in uterine fibroids. This study aimed to investigate the relationship between serum VEGF165 levels and uterine fibroid volume.On a prospective observational basis, 80 women with symptomatic uterine fibroids underwent hysterectomy. Uterine weight was determined after hysterectomy. Six hours before and 48 h after hysterectomy, serum VEGF165 levels were measured using an enzyme-linked immunosorbent assay.Logistic regression analysis showed no correlation between serum VEGF165 levels and uterine weight (r = 0.0037;P > 0.05). The mean serum VEGF165 level declined significantly from 716.31 ± 457.99 to 581.81 ± 403.32 pg/mL after hysterectomy (P < 0.0001). Controlling for age, body mass index, uterine weight, proliferative or secretory phase, and parity, only parous patients (n = 58) were found to have significantly decreased serum VEGF165 levels after hysterectomy (P = 0.000035), in contrast to nulliparous patients (n = 22;P = 0.15).Serum VEGF165 levels do not correlate with uterine fibroid volume, but demonstrate a significant decrease after hysterectomy. The decrease in serum VEGF165 levels after hysterectomy was significant in parous but not in nulliparous patients with uterine fibroids. Serum VEGF165 levels may not predict uterine fibroid development. [ABSTRACT FROM AUTHOR]

Introduction: The copper-containing intra-uterine device IUD (cIUD) is a non-hormonal, effective, long-acting method of contraception, which is not widely used in nulliparous patients in France. The objectives of the study are to compare the safety of the cIUD by the rate of continuation at 6 months between nulliparous and parous patients, and to assess the complications and side effects at insertion and during follow-up. Material and method This is a multicenter prospective epidemiological study with follow-up for 6 months. The adult patients were included in Nantes from February 2019 to October 2019 during the insertion of a IUD in different centers: the student health service (SUMPPS) (Nantes), the Clotilde de Vautier center in the Clinic Jules Verne (Nantes) and in the gynecological offices of the city of Nantes., Results: A total of 94 patients were included during the insertion of the cIUD. At 6 months, 77 patients answered the second questionnaire, 49 patients were nulliparous and 28 were parous. The pain on insertion was greater in nulliparous patients with a VAS of 6.5±2.4 (0-10) versus 3.9±2.2 (0-8) for multiparous patients (P<10 -4 ). The 6-month continuation rate for the cIUD was 92.8% for 83.4% for nulliparous patients, and parous patients with no significant difference (P=0.25). Expulsion was the only complication found with 12.2% in nulliparous and 3.5% in parous (P=0.40). Otherwise, 64% of the patients observed heavy bleeding than before without difference with the parity, and 72% of the nulliparous declared to have dysmenorrhea requiring the use of analgesics, against 47% of the parous (P=0.025). The nulliparous were very satisfied or satisfied for 89% in daily life and 96% of them in sex life, without difference compared to parous (97% and 100% respectively)., Conclusion: There is no difference in the rate of continuation at 6 months between nulliparous and parous. Nulliparous complained more often of dysmenorrhea in comparison to the period before the cIUD. The satisfaction rates were comparable., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Abstract: The method of segregating nulliparous and parous females of Culicoides spp. based on the presence of burgundy-red pigment inside the abdominal wall of parous Culicoides midges, is used worldwide. Out of 320 females of Culicoides imicola trapped by emergence traps, set over an artificial breeding site for 10 and 24 days, 73 (22.8%) showed a red-pigmentation despite the fact that they were nulliparous. This finding indicated that 23% of the “parous” females that are examined for the presence of arboviruses and other pathogens or for age-grading purposes, are actually old nulliparous females, which had no chance of acquiring pathogens. This bias in parous rate distorts upward the calculation of vectorial capacity. [Copyright &y& Elsevier]

Background: Parous women have a lower risk for pregnancy complications, such as preeclampsia or delivery of small-for-gestational-age neonates. However, parous women are a heterogeneous group of patients because they contain a low-risk cohort with previously uncomplicated pregnancies and a high-risk cohort with previous pregnancies complicated by preeclampsia and/or small for gestational age. Previous studies examining the effect of parity on maternal hemodynamics, including cardiac output and peripheral vascular resistance, did not distinguish between parous women with and without a history of preeclampsia or small for gestational age and reported contradictory results.Objective: The objective of the study was to compare maternal hemodynamics in nulliparous women and in parous women with and without previous preeclampsia and/or small for gestational age.Study Design: This was a prospective, longitudinal study of maternal hemodynamics, assessed by a bioreactance method, measured at 11+0 to 13+6, 19+0 to 24+0, 30+0 to 34+0, and 35+0 to 37+0 weeks' gestation in 3 groups of women. Group 1 was composed of parous women without a history of preeclampsia and/or small for gestational age (n = 632), group 2 was composed of nulliparous women (n = 829), and group 3 was composed of parous women with a history of preeclampsia and/or small for gestational age (n = 113). A multilevel linear mixed-effects model was performed to compare the repeated measures of hemodynamic variables controlling for maternal characteristics, medical history, and development of preeclampsia or small for gestational age in the current pregnancy.Results: In groups 1 and 2, cardiac output increased with gestational age to a peak at 32 weeks and peripheral vascular resistance showed a reversed pattern with its nadir at 32 weeks; in group 1, compared with group 2, there was better cardiac adaptation, reflected in higher cardiac output and lower peripheral vascular resistance. In group 3 there was a hyperdynamic profile of higher cardiac output and lower peripheral vascular resistance at the first trimester followed by an earlier sharp decline of cardiac output and increase of peripheral vascular resistance from midgestation. The incidence of preeclampsia and small for gestational age was highest in group 3 and lowest in group 1.Conclusion: There are parity-specific differences in maternal cardiac adaptation in pregnancy. [ABSTRACT FROM AUTHOR]