Breech presentation is the most common form of malpresentation, and associated with perinatal asphyxia and mortality, and maternal morbidity. Data associated with labor induction in breech presentation are limited. The aim of this study was to compare maternal and fetal complication rates in induced and spontaneous vaginal, and cesarean delivery with breech presentation. Pregnant women with breech presentation were grouped: spontaneous vaginal delivery (Group 1, n = 72) induced or augmented vaginal delivery (Group 2, n = 32), and cesarean delivery (Group 3, n = 253). Fetal complications were as follows: clavicle fracture, femur fracture, humerus fracture, brachial plexus injury, cephalic hematoma, pneumothorax, need for intensive care unit (ICU), and 5th minute APGAR 2 g/dL), and postpartum endometritis. Data were collected and analyzed retrospectively. The highest fetal complication rate was in Group 2, and the lowest in Group 3 (p = 0.001). Clavicle fracture was significantly less in Group 3 compared with the other groups (p = 0.024). The rate of lower APGAR scores at the 5th minute was similar in all groups. Maternal complications were significantly higher in Group 2 compared with the other groups (p = 0.001). Fetal complications were 5.66-fold higher in Group 1 than in Group 3 (p = 0.002). Fetal and maternal complications were 9.48-fold and 7.48-fold higher, respectively, in Group 2 than in Group 3 (p < 0.001). This study is the first in literature to have investigated and analyzed neonatal complications in breech delivery according to different delivery modes including induced vaginal delivery. Due to possible complications, the risks and benefits of a specific type of delivery should be considered in breech presentation.
The aim of this study was to assess the knowledge of pregnant women regarding COVID-19 while evaluating the ability of protective measures and their effects on the level of anxiety during this pandemic. Using a prospective cross-sectional survey, 304 pregnant women attending prenatal polyclinics were included in our study between June 10 and July 10, 2020. The mean age of participants was 29.2 ± 6.0 years. The median gestational week was 25, ranging from 25 to 40 weeks of gestation. There was no significant correlation between a gestational week or complicated pregnancy and anxiety. Most participants possessed adequate knowledge and practical skills concerning Covid-19. Women with adequate knowledge were found to be statistically related to a high practice skills score and lower anxiety levels. Good knowledge levels are related to good practice skills and lower anxiety levels. Although pregnancy is not currently considered a risk factor, we believe it is vital to inform pregnant women about COVID-19 since they are naturally prone to mental problems and respiratory infections during pregnancy. Therefore, healthcare professionals should be encouraged to play an active role in this issue, replacing social media, a common source of misinformation for this target demographic.
Objective: Fear of pain during the copper intrauterine device (Cu-IUD) insertion may lead patients to reject this highly effective birth control method. The aim of this study was to investigate the pain scores associated with IUD insertion and the ease of procedure at different times during menstruation. Method: In this prospective cohort trial, eligible women received IUD at three-time segments of menstruation: Group I, at 0.5 to 0.69-time segment (n=53); Group II, at 0.7 to 0.89-time segment (n=67); and Group III, at 0.9 to 1-time segment (n=72). The time segments during menstruation were calculated for each participant by dividing the menstrual cycle day of IUD insertion to total number of menses days. The score of pain experienced at different steps of IUD insertion during and five min. after the procedure measured by Wong-Baker FACES Pain Rating Scale (WBS) and the ease of insertion were compared among groups. Results: There were significant differences in age (p=0.011) and time since the last delivery (p=0.017). After adjusting for potential confounding factors, the mean WBS score and the ease of insertion were not statistically significant among groups, respectively (p=0.664 and p=0.149). The most painful step was observed as uterine sounding (median, 4 [interquartile range {IQR}, 2]). No significant correlation was observed between WBS scores, the ease of insertion, and main characteristics of the participants. Conclusion: The most painful step of IUD insertion was observed as uterine sounding. IUD insertion-related pain and the ease of procedure do not appear to be different at any time in the second half of menstruation.
Non-surgical procedures such as fillers, PRP and derivatives, energy-based devices and adipose derivate mesenchymal stem cell treatments are begun to be used in women genital area for both functional and aesthetic purposes. After theproduction of injectable HA for genital use, patients were able to benefit more effectively from these applications and its use in the vagina became more common. In our study, we aimed to demonstrate a new intravaginal injection technique, Cannulated Intravaginal Injection Technique (CIVIT) that we can perform vaginal injection more homogenously and less traumatic and more effectively to the entire vaginal mucosa. Retrospectively, the data of 44 patients who underwent intravaginal injection of HA manufactured for genital use at a private Female Health Clinic were analyzed. Of the 44 patients, 21 were injected using the random needling technique, and 22 were injected using CIVIT. All patients had symptoms of genitourinary syndrome (GUS), a vaginal health index below 15, and were compared based on the Female Sexual Function Index (FSFI) and visual analogue scale (VAS) for GUS before and after the procedures. It was observed that all post-injection values, except for FSFI arousal (p = 0.539), were statistically significantly higher in the CIVIT group (P = 0.001). Post injection dryness, dyspareunia and discomfort values decreased significantly in the CIVIT group compared to the Random Needling group. Our new technique, CIVIT, and random injection, which is a frequently used technique, are two effective techniques for vaginal rejuvenation. However, CIVIT is significantly more effective than the random technique in improving genitourinary symptoms, vaginal health index and sexual function.
To compare maternal and fetal outcomes of pregnancies complicated and not complicated with hyperemesis gravidarum (HG) necessitating hospitalization. A total of 386 women with singleton deliveries between March 2015 and January 2018 were included in this retrospective single-center study. Of 386 women, 186 women (mean±SD age: 30.7±5.9 years) who were hospitalized with HG within the first 20 weeks of gestation comprised the hyperemetic pregnancy group, while 200 women without HG during pregnancy served as a control group. No significant difference was noted between the HG and control groups in terms of maternal characteristics, gestational age (median 38.6 and 39.0 weeks, respectively), type of delivery (normal spontaneous delivery in 78.0% vs 80.0%), fetal gender (female: 53.2% vs 48.5%), birthweight (median 3250 g vs 3275 g) and 5-min APGAR scores (≥7 in 97.3% vs 97.5%, respectively). Adverse pregnancy outcomes were also similar between groups including preterm birth (8.1% vs 11.0%, respectively), SGA (5.9% vs 9.5%), hypertensive disorder (5.4% vs 7.5%), placental abruption (1.1% vs 0.5%,), stillbirth (0.0% vs 0.5%) and GDM (3.8%vs 2.5%). Weight loss during pregnancy was evident in 91.3% of women in the HG group, while none of women in the control group had weight loss during pregnancy (p<0.001). The findings of this study indicate that HG may not be related with adverse fetal and prenatal outcomes and this conclusion needs to be clarified with large-scale investigations.