Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.

Factores del estilo de vida predisponentes a displasia cervical en mujeres atendidas en el hospital María Auxiliadora, 2013-2017 / Lifestyle factors predisposing to cervical dysplasia in women attended in the hospital María Auxiliadora, 2013-2017

Introduccion: La displasia cervical es la lesión precursora del cáncer de cuello uterino, en el que se observan alteraciones de las células cervicales sin llegar a adoptar características de malignidad. Objetivo: Identificar los factores predisponentes para displasia cervical en las pacientes atendidas en el hospital María Auxiliadora durante el 2013 al 2017. Métodos: Estudio de diseño casos y controles, analítico y observacional. Se analizaron 216 historias clínicas de pacientes, dividiéndose en 72 casos y 144 controles. Resultados: En el análisis bivariado, resultaron significativos la menarquia temprana (OR=2,071;p=0.024), el inicio temprano de relaciones sexuales (OR=2,213;p=0.017), el tener múltiples parejas sexuales (OR=3,036;p=0.001) y la multiparidad (OR=2,316;p=0.005). En el análisis multivariado las variables independientes fueron el tener múltiples parejas sexuales (OR=2,626; p=0.003) y la multiparidad (OR=2,759;p=0.045) las cuales resultaron significativas. Conclusión: Se concluye que los factores del estilo de vida predisponentes a displasia cervical fueron tener múltiples parejas sexuales y la multiparidad.

Introduction: The cervical clearance is the precursor lesion of cancer of the cervix, in which alterations of the cervical cells are observed. Objective: To identify the predisposing factors for the cervical dispute in the patients treated at the María Auxiliadora Hospital during 2013 to 2017. Methods: Design study, cases, controls, analytical and observational. 216 clinical records of patients will be analyzed, divided into 72 cases and 144 controls. Results: In the bivariate analysis, significant results in early menarche (OR = 2.071, p = 0.024), early onset of sexual relations (OR = 2.213, p = 0.017), having multiple sexual partners (OR = 3.036; = 0.001) and multiparity (OR = 2.316, p = 0.005). In the multivariate analysis, the independent variables were multiple sexual partners (OR = 2.626, p = 0.003) and multiparity (OR = 2.759, p = 0.045). Conclusion: It is concluded that lifestyle factors predispose a cervical dispute.

Premature Presbyopia and its Risk Factors - A Hospital based Study

Introduction: Presbyopia, a physiological insufficiency ofaccommodation, impairs the ability to perform near task.Considered as a disease of the forties, it reduces functionalefficiency of the individual as well as the society since itaffects the majority of working population. This study was aneffort to evaluate the risk factors that can lead to its earlieronset. Purpose of the study was to evaluate the frequencyof risk factors associated with premature presbyopia in ahospital-based study in Sundergarh district, Odisha.Material and Methods: It was a hospital-based study carriedout at Hi-Tech Medical College and Hospital, Rourkela fromOctober 2016 to October 2018. Patients aged 30 years or morewho presented with difficulties in near work were includedin the study. Premature presbyopic was defined as presbyopicperson aged less than 40 years. Premature presbyopics werefurther subjected to a questionnaire and detailed examinationafter taking informed consent.Results: The mean age of presentation in prematurepresbyopics was 36.2 years and the average correction requiredwas 1.22 D. Among the total number of persons presentingwith presbyopia about one-eighth (12.03%) presented before40 years. Female sex, occupation requiring near work,exposure to sunlight for longer duration and hypermetropiawere most common risk factors over all. Among malessmoking, alcohol, exposure to higher temperature (factoryworkers) were significant risk factors. Multiparity, anemia andpremature menopause presented as important risk factors infemales. Smart phone usage was found to be an important riskfactor in urban population.Conclusion: Early presentation of presbyopia reducesthe functional efficiency of the individual. Evaluation ofrisk factors will help to determine the population at risk ofpremature presbyopia and their prompt management can bedone with near correction

Clinical Profile and Etiology of Neonatal Seizures in a Tertiary Care Hospital in North India

Introduction: Presbyopia, a physiological insufficiency ofaccommodation, impairs the ability to perform near task.Considered as a disease of the forties, it reduces functionalefficiency of the individual as well as the society since itaffects the majority of working population. This study was aneffort to evaluate the risk factors that can lead to its earlieronset. Purpose of the study was to evaluate the frequencyof risk factors associated with premature presbyopia in ahospital-based study in Sundergarh district, Odisha.Material and Methods: It was a hospital-based study carriedout at Hi-Tech Medical College and Hospital, Rourkela fromOctober 2016 to October 2018. Patients aged 30 years or morewho presented with difficulties in near work were includedin the study. Premature presbyopic was defined as presbyopicperson aged less than 40 years. Premature presbyopics werefurther subjected to a questionnaire and detailed examinationafter taking informed consent.Results: The mean age of presentation in prematurepresbyopics was 36.2 years and the average correction requiredwas 1.22 D. Among the total number of persons presentingwith presbyopia about one-eighth (12.03%) presented before40 years. Female sex, occupation requiring near work,exposure to sunlight for longer duration and hypermetropiawere most common risk factors over all. Among malessmoking, alcohol, exposure to higher temperature (factoryworkers) were significant risk factors. Multiparity, anemia andpremature menopause presented as important risk factors infemales. Smart phone usage was found to be an important riskfactor in urban population.Conclusion: Early presentation of presbyopia reducesthe functional efficiency of the individual. Evaluation ofrisk factors will help to determine the population at risk ofpremature presbyopia and their prompt management can bedone with near correction.

Pelvic Inflammatory Disease (pid): A Cross Sectional Prospective Study At A Tertiary Care Centre

Introduction : Pelvic inflammatory disease (PID) is aninfectionof the upper part of thefemale reproductive sys-temnamely theuterus,fallopian tubes, andovaries, and inside of thepelvis. Objective: to find out the clinical profile of PID in a tertiary care centre. Methods:This was a cross sectional, descriptive study conducted at the Department of Obstetrics and Gynaecology, during period from January to December2016. Total 200 patients complaining of low-er abdominal pain, vaginal discharge & having adnexal as well as cervical motion tenderness on bimanual examina-tion between the age group of 18 -45 years were randomly selected for study. Parameters like age, parity, socio-economic status, age of marriage, sexual behavior, Presenting complaints and use of contraceptive were recorded. Results:Most common age group was 20-24 years (29.5%).Maximum number of cases was seen in parity between 2-5 (58%).PID was commonest amongst illiterate women (36%). Maximum number of cases was seen in women from lower socioeconomic class (74%).Out of 200 cases, 79% patients were married, 14 % were remarried.Presenting complaints were pain in abdomen (93.5%), per vaginal discharge (66%), fever (51%).Abdominal tenderness was seen in 95 % of cases. Palpable mass was present in 11 % of cases. Forniceal & cervical motion tenderness were the com-monest Per Vaginal examination findings seen in 89% & 84% cases respectively.Conclusion:Incidence of PID was higher in age group between 20-29 years, multipara, women from lower socioeconomic class & illiterate women. Pain in lower abdomen, per vaginal discharge & fever were the commonest complaints. Most of the patients on ex-amination had forniceal & cervical motion tenderness.

Macrosomía fetal en un hospital del Ministerio de Salud del Perú, de 2010 a 2014 / Fetal macrosomy in a Hospital of the Ministry of Health, Peru, from 2010 to 2014

Resumen Objetivos: Determinar la prevalencia de macrosomía fetal y sus factores de riesgo, y describir las complicaciones en los recién nacidos. Materiales y métodos: Estudio observacional, transversal y retrospectivo efectuado con base en la información registrada en el sistema informático perinatal del Hospital Vitarte. Se incluyeron los nacimientos únicos, a término, atendidos entre los meses de enero de 2010 a diciembre de 2014 y se excluyó a los recién nacidos óbitos. Para el análisis estadístico univariado y bivariado se utilizó X 2 y t de Student para p < 0.05 y regresión logística bivariada y multivariada para razón de momios con IC95%; se utilizó el programa SPSS 23. Resultados: La muestra de estudio fue de 16,060 recién nacidos y la prevalencia de macrosomía fetal de 8.1% (1298 de 16,060) con IC95% de 8.075-8.086%. Los factores de riesgo identificados para macrosomía fetal fueron: obesidad (RM: 2.762; IC95%: 2.370-3.220), postérmino (RM: 2.818; IC95%: 1.201-1.615), sobrepeso (RM: 1.806; IC95%: 1.552-2.102), multiparidad (RM: 1.393; IC95%: 1.201-1.615) y sexo masculino (RM: 1.556, IC95%: 1.382-1.752). En relación con las complicaciones se encontró que el Apgar bajo al minuto y la cesárea fueron más frecuentes en macrosómicos que en no macrosómicos. Conclusiones: La prevalencia de macrosomía fetal en el Hospital Vitarte se encuentra en el promedio mundial; sus principales factores de riesgo son modificables y las complicaciones son prevenibles. Se sugiere mejorar las intervenciones gestacionales y pregestacionales para lograr eficiencia y repercusiones en la prevención de macrosomía fetal.

Abstract Objectives: To determine the prevalence of fetal macrosomia and its risk factors, and to describe complications in newborns. Materials and methods: Observational, cross-sectional and retrospective study carried out based on the information registered in the perinatal computer system of Hospital Vitarte. Single births, at term, attended between the months of January 2010 and December 2014 were included and newborns were excluded. For the univariate and bivariate statistical analysis, X 2 and Student's t were used for p < 0.05 and bivariate and multivariate logistic regression for odds ratio with 95% CI; the SPSS 23 program was used. Results: The study sample was 16,060 newborns and the prevalence of fetal macrosomia was 8.1% (1298 of 16,060) with 95%CI of 8,075-8,086%. The risk factors identified for fetal macrosomia were: obesity (OR: 2,762; CI95%: 2,370- 3,220), post-term (OR: 2,818; CI95%: 1,201-1,615), overweight (OR: 1,806; CI95%: 1,552-2,102). Multiparity (OR: 1,393; 95%CI: 1,201-1,615) and male sex (OR: 1,556; CI95%: 1,382-1,752). In relation to the complications, it was found that the Apgar low to the minute and the caesarean section were more frequent in macrosomic than in non-macrosomic ones. Conclusions: The prevalence of fetal macrosomia in Hospital Vitarte is found in the world average; Its main risk factors are modifiable, and the complications are preventable. It is suggested to improve gestational and pre-gestational interventions to achieve efficiency and repercussions in the prevention of fetal macrosomia.

Effect of multiparity on bone mineral density, evaluated with bone turnover markers / Efeito da multiparidade sobre a densidade mineral óssea, avaliada por marcadores de remodelação óssea

Abstract Objective: Our aim was to investigate the effect of parity on osteoporosis by evaluating bone mineral density, markers of bone turn-over and other factors that are effective in osteoporosis in multiparous (five deliveries or more) and nulliparous women in the post-menopausal period. Methods: A total of 91 multiparous (five deliveries or more) and 31 nulliparous postmenopausal women were included in this study. All patients were interviewed on sociodemographic characteristics, gynecologic history, personal habits, levels of physical activity, and life-long intake of calcium. Bone mineral density was measured at lumbar (L1-4) and femoral neck regions with Dexa. Results: The mean age of multiparous women was 58.79 ± 7.85 years, and the mean age of nulliparous women was 55.84 ± 7.51. The femoral BMD was 0.94 ± 0.16 and lumbar BMD 1.01 ± 0.16 in multiparous women, femoral BMD was 0.99 ± 0.16 and lumbar BMD 1.07 ± 0.14 in nulliparous women. There were no statistical differences between the femoral and lumbar T scores and BMD values of the two groups. Lumbar T scores and lumbar BMD showed a decrease with increasing total duration of breast-feeding in multiparous women. The independent risk factors for osteoporosis in the regression analysis of multiparous women were found to be the duration of menopause and body weight of 65 kg and less. Conclusion: There is no difference between the bone mineral densities of multiparous and nulliparous women. Females with lower body-weight and longer duration of menopause should be followed-up more carefully for development of osteoporosis.

Resumo Objetivo: Investigar o efeito da paridade sobre a osteoporose por meio da avaliação da densidade mineral óssea, marcadores de remodelação óssea e outros fatores eficazes na avaliação da osteoporose em multíparas (cinco partos ou mais) e nulíparas no período pós-menopausa. Métodos: Foram incluídas neste estudo 91 multíparas (cinco partos ou mais) e 31 nulíparas, todas na pós-menopausa. As pacientes foram entrevistadas para a determinação das características sociodemográficas, história ginecológica, hábitos pessoais, níveis de atividade física e ingestão de cálcio ao longo da vida. A densidade mineral óssea foi medida na região lombar (L1-4) e do colo femoral com a Dexa. Resultados: A média de idade das multíparas e nulíparas foi de 58,79 ± 7,85 anos e 55,84 ± 7,51, respectivamente. Nas multíparas, a DMO femoral e lombar foi de 0,94 ± 0,16 e 1,01 ± 0,16, respectivamente; nas nulíparas, a DMO femoral e lombar foi de 0,99 ± 0,16 e 1,07 ± 0,14, respectivamente. Não houve diferença estatisticamente significativa entre os T-escores femoral e lombar e os valores de DMO dos dois grupos. O T-escore e a DMO lombar mostraram uma diminuição em caso de aumento na duração total da lactação materna em multíparas. Encontrou-se que os fatores de risco independentes para a osteoporose na análise de regressão das multíparas são a duração da menopausa e o peso corporal menor ou igual a 65 kg. Conclusão: Não há diferença entre a densidade mineral óssea de multíparas e nulíparas. As mulheres com menor peso corporal e maior duração da menopausa devem ser acompanhadas com mais atenção para determinar se há desenvolvimento de osteoporose.

Observe and Analyze the Rehabilitation of Multiparous Pelvic Floor Muscles in Postpartum / 实用妇产科杂志

Objective:To analyze the effects of mutiparity on the pelvic floor muscle and the best time of postpartum for pelvic floor rehabilitation intervention.Methods:By questionnaire survey and pelvic floor functional checking on women with 42 days postpartum clinic routine health checking,and following up pelvic floor muscles force exam in postpartum 3 months,6 months and 1 year,426 cases were included in the puerpera group,including primipara 325 cases as primiparous group,two birth multipara 101 cases as multiparous group,the damage of pelvic floor muscles(≤level Ⅱ) was compared between the two groups,the difference between multiparity and primiparity were compared.Results:①In postpartum 42 days,type Ⅰ muscle fiber damage rate was lower in multiparous group than that in primiparous group(P ＜0.05),there was no significant difference on the muscle fiber damage ratio (muscles force below Ⅲ) between the two groups (P ＞ 0.05).②)In postpartum 3 months,6 months,1 year there was no significant difference in proportion of muscle damage between the two groups (P ＞ 0.05).③Multiparous group pelvic floor muscle damage ratio decreased slowly and gradually in the four periods,there was no statistical difference between adjacent period (P ＞ 0.05),the pelvic muscle damage ratio appeared significant statistical difference between postpartum 6 months and postpartum 42 days(P ＜ 0.01).④In primiparous group,pelvic floor muscle damage ratio decreased significantly in postpartum 6 months,postpartum 42 days、3 months,6 months,the differces were statistically significant among the three times(P ＜ 0.05),there was no statistical difference between postpartum 6 months and 1 year(P＞0.05).Conclusions:Type Ⅰ muscle fibers suffer injury more in Primipara than that in multipara,multiparous pelvic floor muscle recovery process is more slowly than primipara's,we should pay attention to pelvic muscle recovery within 6 months after delivery.

Productive performance of sows fed increasing levels of distillers dried grains with solubles (DDGS) across parities / Comportamiento productivo de cerdas alimentadas con niveles crecientes de granos secos de destilería con solubles (DDGS) durante varios partos / Desempenho produtivo de porcas alimentadas com níveis crescentes de grãos secos de destilaria com solúveis (DDGS) durante vários partos

Background: of distillers dried grains with solubles (DDGS) in lactation diets may contribute to productive performance of lactating sows of different parities. Objective: the objective of this study was to determine the effects of feeding diets containing different levels of DDGS on productive performance of lactating sows of different parities. Methods: a total of 245 sows were divided into 3 parity groups of 1 to 2, 3 to 5, and over 5 parities. Within each parity group, sows were allotted to 1 of 4 dietary treatments that were prepared by inclusion of 0, 10, 20, and 30% DDGS in lactation diets. Diets were fed to sows during the whole lactation period. Results: average piglet weaning weight tended (quadratic, p<0.10) to increase by feeding diets containing increasing levels of DDGS to lactating sows of 3 to 5 and over 5 parities. Likewise, increasing levels of DDGS in diets tended (quadratic, p<0.10) to increase average piglet weight gain in all sow parity groups. The improvement of average piglet weaning weight and average piglet weight gain was the greatest when sows of 3 to 5 parities were fed diets containing 20% DDGS or when sows of over 5 parities were fed diets containing 10% DDGS compared with other dietary treatments. Feeding diets containing different levels of DDGS had no negative effects on other productive performance of lactating sows, regardless of parity. Conclusions: DDGS can be included up to 30% in diets fed to lactating sows of different parities.

Antecedentes: la inclusión de granos secos de destilería con solubles (DDGS) en las dietas de lactancia puede contribuir al desempeño productivo entre cerdas lactantes de diferentes partos. Objetivo: determinar los efectos de varios niveles dietarios de DDGS en el comportamiento productivo de cerdas lactantes de diferentes partos. Métodos: un total de 245 cerdas fueron divididas en 3 grupos según el número de partos: de 1 a 2, 3 a 5, y más de 5 partos. Dentro de cada grupo de partos, las cerdas se asignaron a 1 de 4 tratamientos dietarios que incluían 0, 10, 20, o 30 % de DDGS en la dieta de lactancia. Las dietas fueron administradas a las cerdas durante todo el período de lactancia. Resultados: el peso al destete de los lechones tendió (cuadrática, p<0,10) a aumentar con el consumo creciente de DDGS por cerdas lactantes de 3 a 5 o de más de 5 partos. Del mismo modo, los niveles crecientes de DDGS tendieron (cuadrática, p<0,10) a aumentar la ganancia media de peso de los lechones en todos los partos. La mejora del peso promedio al destete y ganancia de peso de los lechones fue mayor para las cerdas de 3 a 5 partos que consumieron 20 % de DDGS, o para cerdas de más de 5 partos consumiendo 10 % de DDGS. Las dietas con diferentes niveles de DDGS no tuvieron efectos negativos sobre otros parámetros productivos de las cerdas lactantes, independientemente de la paridad. Conclusiones: los DDGS se pueden incluir hasta un 30% en las dietas de cerdas lactantes de diferente orden de parto.

Antecedentes: a inclusão de grãos secos de destilaria com solúveis (DDGS) em dietas de amamentação pode contribuir para o desempenho produtivo de porcas lactantes com diferentes partos. Objetivo: determinar os efeitos de diferentes níveis dietéticos de DDGS no desempenho produtivo de porcas em lactação com diferente número de partos. Métodos: um total de 245 fêmeas foram divididas em três grupos segundo seu número de partos: 1-2, 3-5, e mais de 5 partos. Dentro de cada grupo de parição, as porcas foram designadas para um de quatro tratamentos de diferentes dietas que forneciam 0, 10, 20, ou 30% de DDGS na dieta de amamentação. As dietas foram fornecidas às porcas durante o período de lactação. Resultados: o peso ao desmame dos leitões tendeu (quadrática, p<0,10) a incrementar com o aumento do consumo de DDGS das porcas lactantes dos grupos 3-5 e mais de 5 partos. Do mesmo jeito, os níveis crescentes de DDGS (quadrática, p<0,10) aumentaram o ganho de peso médio dos leitões das porcas dos três grupos avaliados. A melhora do peso médio a desmama e o ganho de peso médio dos leitões foi maior nas porcas de 3-5 partos que consumiram 20% de DDGS e nas porcas de mais de 5 partos que consumiram 10% de DDGS. As dietas com diferentes níveis de DDGS não tiveram efeitos negativos sobre os outros parâmetros produtivos das porcas em lactação, independentemente do número de partos. Conclusões: os DDGS se podem incluir nas dietas das porcas com diferentes números de partos até num 30%.

A Case-control Study of Pelvic Inflammatory Disease and Its Association with Multiparity among Patients Attending SSG Hospital, Vadodara, Gujarat.

Objective: To know the association between pelvic inflammatory disease (PID) and multiparity. Study design: Case control study. Setting: Shree Sayaji General (SSG) Hospital, Government Medical College, Vadodara. Participants: Women attending Gynec Clinics and Curative Practice and General Practice (CPGP) OPD. Sample size: One hundred fifty cases and 150 controls. Statistical analysis: Chi-square test. Results: The odds ratio (OR) for PID with multiparity as risk factor was 0.69 with 95% confidence interval (CI) being 0.42-1.09. Among 143 cases multiparity was present in 63 cases (44.05), while in 150 controls it was in 80 (53.33%). The difference was not statistically significant (p = 0.141). But, the OR with untrained person as a risk factor for PID was 2.41 with 95% CI being 1.78-3.27. This suggests etiological fraction of 58.5% (CI 43.9-69.4%) among untrained persons. The delivery by untrained person was significantly higher in cases than in controls (p 0.00001). Conclusions: Present study did not show multiparity as risk factor but delivery conducted by untrained persons emerged as a risk factor.

Uterine Rupture -- Experience of 30 Cases at Faridpur Medical College Hospital.

Rupture uterus is a rare and often catastrophic condition. It is associated with a high incidence of fetal and maternal mortality and morbidity. Our objective in this study is to determine incidence, etiology, trend, management, maternal and fetal outcome of uterine rupture in Faridpur Medical College Hospital. This is a prospective cross-sectional study of patients with ruptured uterus from the period of January 2011 to December 2011 admitted at Faridpur Medical College Hospital. All the cases of ruptured uterus who were either admitted with uterine rupture or who developed it in hospital were included in the study. Patients having ruptured uterus due to congenital anomaly were excluded from the study. Patients were initially assessed in labour ward, relevant sociodemographic data, previous antenatal and surgical history recorded. Ways of management, maternal and fetal outcome were taken for analysis. There were 30 cases of ruptured uterus out of total 3606 deliveries (including 1809 caesarian sections) over a one year time period, with a prevalence of 0.83%. The most common age group was 21-30 years. A majority of patients 16(53.3%) were cases of unscarred uterus presenting with rupture; the common cause of rupture in scarred uterus was injudicious use of oxytocin (13,43.33%). Proper antenatal care, appropriate counseling of patients with history of previous caesarian section for hospital delivery, training of skilled birth attendant can reduce mortality and morbidity due to rupture uterus.

Reincidência de gravidez em adolescentes: retrato de uma realidade / Recurrence of pregnancy in adolescents: portrait of a reality

Este estudo objetivou identificar as características socioeconômicas e educacionais de adolescentes com reincidência de gravidez e as variáveis da vida sexual que contribuíram para a reincidência. Trata-se de um estudo de natureza descritiva, do tipo levantamento, cujos dados foram obtidos junto às fichas do Sistema de Informação sobre Nascidos Vivos (SINASC) da Vigilância Epidemiológica do município de Catanduva-SP e através de entrevistas com 33 adolescentes que deram à luz entre janeiro e dezembro de 2006. A média de idade da menarca foi de 12 anos e a da primeira relação sexual de 14 anos. Os métodos contraceptivos mais utilizados foram o anticoncepcional oral (78,7%) e a camisinha (51,5%). A média de idade da segunda gestação foi de 17 anos. A mediana de idade dos companheiros foi de 24 anos, sendo que 84,9% das adolescentes viviam com eles. A renda familiar de 84,9% foi de um a três salários mínimos. 66,7% das adolescentes possuíam apenas o ensino fundamental, 63,6% receberam orientação sexual, sendo que 45,5% delas na escola. 78,5% estavam na primeira união conjugal e 24,2% na segunda ou terceira. Quanto ao número de gestações, 66,7% estavam na segunda gravidez, 30,3% na terceira e 3% na quarta. A ocorrência de abortos prévios às gestações foi de 21,2%, na faixa etária entre 13 e 17 anos. As adolescentes deste estudo enquadram-­se no modelo de vulnerabilidade social.

This study aimed to identify the socio­economic and educational profile and the variables of the sexual life of adolescents with a recurrence of pregnancy. It is a descriptive study of epidemiological data, obtained from the Epidemiological Surveillance of the municipality of Catanduva­SP through the SINASC (Information System on Live Births) and of in­home interviews of 33 adolescents who had given birth between January and December, 2006. Mean age at menarche was 12 years and first sexual intercourse was at 14 years of age. The contraceptive methods most used were oral contraceptives by 78.7% and condoms by 51.5%. The mean age at the 2nd pregnancy was 17 years. The median age of sexual partners was 24 years, with 84.9% of them living with their partners. The family income of 84.9% of the group was 1 to 3 minimum wages. Concerning education, 66.7% of the adolescents had only a primary level; 63.6% had received sex education, at school in 45.5% of the cases; 78.5% were in their 1st marital union and 24.2% in their 2nd or 3rd union. On the number of pregnancies, 66.7% were in their 2nd pregnancy, 30.3% in their 3rd, and 3% in their 4th pregnancy. The occurrence of abortions prior to pregnancy was 21.2%, in the age group between 13 and 17 years. The adolescents in this study fall into the model of social vulnerability

Gravidez recorrente na adolescência e vulnerabilidade social no Rio de Janeiro (RJ, Brasil): uma análise de dados do Sistema de Nascidos Vivos / Repeated pregnancy among adolescents and social vulnerability in Rio de Janeiro (RJ, Brazil): data analysis of Information System on Live Births

A recorrência da gravidez na adolescência é tema pouco estudado no Brasil, sendo necessário o debate dos direitos reprodutivos dessa parcela da população. Realizou-se estudo transversal com dados das Declarações de Nascidos Vivos de mães adolescentes residentes na cidade do Rio de Janeiro (RJ) do ano de 2005, com o objetivo de conhecer a magnitude e as características associadas à gravidez recorrente (GR). Foram estimadas razões de prevalência de GR com intervalos de confiança (IC) de 95 por cento para variáveis selecionadas através de regressão multivariada log-binomial. Entre 12.168 adolescentes, identificou-se prevalência de GR de 29,1 por cento. Os principais fatores associados à GR foram: idade 15-19 anos (RP=5,42 IC95 por cento 3,72-7,81); não realizar pré-natal (RP=2,36 IC95 por cento 2,16-2,58); escolaridade<4anos (RP=1,48 IC95 por cento 1,25-1,76); ocupação dona de casa (RP=1,8 IC 95 por cento 1,57-2,15) ou outra (RP=1,9 IC95 por cento 1,73-2,10). Parto cesáreo e baixo peso foram associados negativamente a GR com RP iguais a 0,94 (IC95 por cento 0,86-0,99) e 0,69 (IC95 por cento 0,62-0,77). As adolescentes com gravidez recorrente tiveram indicadores socioeconômicos e assistenciais piores do que aquelas na primeira gravidez. Políticas sociais específicas para adolescentes mães em situação de vulnerabilidade possibilitariam melhores condições para o exercício de seus direitos reprodutivos.

Repeated pregnancy (RP) among adolescents is seldom researched in Brazil, even tough the debate on the reproductive rights is important for this extract of population. A transversal study was developed with data from the Declaration of Live Births of adolescent mothers, living in Rio de Janeiro (RJ, Brazil), in 2005. The aim was to estimate the magnitude and features associated with RP. Prevalence ratios (PR) of RP, with 95 percent confidence interval (CI) for selected variables, were estimated through log-binomial multivariate regression. Among 12,168 adolescents, a RP prevalence of 29.1 percent was identified and the principal factors associated were: age 15-19 anos (PR=5.42; RI 95 percent 3.72-7.81); not doing prenatal consultation (RP=2.36; CI 95 percent 2.16-2.58); educational status<4anos (PR=1.48; CI 95 percent 1.25-1.76); housewife job (PR=1.8; CI 95 percent 1.57-2.15) or other (PR=1.9; CI 95 percent; 1.73-2.10). Giving birth by cesarean section and low birth weight were negatively associated to repeated pregnancy with RP equal to 0,94 (CI 95 percent; 0,86-0,99) and 0.69 (CI 95 percent; 0.62-0.77). The adolescents with RP had worst socioeconomic and assistance indicators than those on their first pregnancy. Specific social policies for adolescent mothers, in vulnerable situation, will enable them to have better conditions to exercise their reproductive rights.

Factores epidemiológicos relacionados con la placenta previa: Hospital "Abel Santamaría Cuadrado", abril 2006- 2007 / Epidemiological factors associated with Placenta Previa: "Abel Santamaría Cuadrado" Hospital, April 2006-2007

Con el objetivo de identificar los factores epidemiológicos relacionados con la placenta previa se realizó un estudio retrospectivo, transversal y analítico (casos y controles) en el Hospital General Universitario "Abel Santamaría Cuadrado", en el período comprendido abril 2006 - 2007. El grupo estudio lo conformaron 19 pacientes con el diagnóstico de placenta previa y el grupo control 60 gestantes excluidas de este diagnóstico. Se estudiaron variables de la madre, del embarazo, nacimiento y neonato. Se utilizó el método empírico de medición usando la estadística descriptiva y deductiva. Se empleó la medición porcentual y Ji cuadrado (X²), con un nivel de significación de p < 0,05; además la prueba Odds ratio (OR) con un intervalo de confianza del 95% (IC 95%). La edad materna más frecuente de asociación con la placenta previa se encontró en el grupo de edades de 25 a 34 años. Los principales factores epidemiológicos a su vez catalogados como riesgos fueron: la procedencia urbana (OR=1,7), la desnutrición por defecto (OR=6,61) y por exceso (OR=3,93), la multiparidad (OR=1,55), antecedentes de aborto (OR=5,08) y de cesárea anterior (OR=3,21), así como la operación cesárea como modo de terminación del embarazo (OR=13,67**). Fue un terreno propicio para la morbilidad materno-neonatal.

Aimed at identifying the epidemiological factors associated with placenta previa a retrospective, cross-sectional and analytical study (cases and controls) was conducted at "Abel Santamaria Cuadrado" University Hospital during April 2006-2007. The study group was comprised of 19 pregnant patients with placenta previa and 60 belonging to control group that were not included in the diagnosis. Variables of mothers, pregnancy, birth and newborn were studied. The empirical method of measurement using the descriptive and inferential statistics was applied; as well as percentage, chi square test (X²), a level of significance p <0,05; also the odds ratio (OR) with a confidence interval of 95% (CI 95%). The maternal age frequently associated with placenta previa was 25-34 years old. The main epidemiological factors taken as risks were: urban origin (OR=1,7), malnutrition for lack (OR=6,61) and for excess (OR=3,93), multiparity (OR=1,55), history of abortions (OR=5,08) and a previous cesarean section (OR=3,21); besides cesarean section as a way to end pregnancy (OR=13,67**) it was very conducive for child-maternal morbility and mortality.

Positive Rate of HLA Class I Antibodies in Multiparous Korean Women / 대한임상병리학회지

BACKGROUND: Anti-HLA antibodies are most frequently induced by transfusion or pregnancy, and these anibodies can be used as antisera for HLA typing. However these antibodies may elicit adverse reactions such as transfusion reaction or rejection of transplanted organs. In this study, frequency and specificities of antibodies against HLA class I antigens were determined in multiparous Korean women. METHODS: Sera from 671 multiparous women were tested for anti-HLA antibody screening by standard microlymphocytotoxicity test using 49~50 lymphocyte panels. PRA(panel reactive antibody) values were calculated as percentage of postive panels among total lymphocyte panels tested. HLA antibody specificities and reaction strengths were determined by analysis of serologic reaction patterns. RESULTS: A total of 671 sera were tested and 124 sera(18.5%) were positive for HLA antibodies. Among HLA antibody-positive sera(n=124), 117(94.4%) showed PRA values of 50%. Specificities of HLA antibodies were identified in 51 sera(41.1%) and 18 sera(14.5%) contained reagent quality antibodies(r> or =0.8, SI> or =70%), corresponding to 2.7% of total multiparous women. Among these, 4 sera had monospecific HLA antibodies and 14 sera had HLA antibodies against two or more antigens: 4 sera containing HLA antibodies against 7 CREG(cross reactive group), 5 sera containing antibodies against 5 CREG. CONCLUSION: Through the analysis of frequency and specificity of HLA antibodies in 671 multiparous women, it is concluded that HLA antisera can be obtained from multiparous women as effectively as from pregnant women. The frequency of high level of sensitization(PRA>50%), which can elicit problems in relation to transfusion or organ transplantation, is very low(1.0%).