Obstetrical complications among adolescent girls at the maternity ward of Ignace Deen National Hospital

Background: The objective of this study was to highlight obstetrical complications that occurred among adolescent girls who delivered at the ward and to identify factors associated with the occurrence of such complications.Methods: This was a prospective study of descriptive and analytical type extending over a period of one year from September 1, 2016 to August 31, 2017 carried out at the maternity ward of Ignace Deen National Hospital at Conakry Teaching Hospital (CHU). It covered a continuous series of 1034 deliveries among adolescent girls.Results: The frequency of childbirth among adolescent girls was 16.7%. The main complications identified were dystocia, severe preeclampsia, eclampsia, retroplacental hematoma, placenta previa, uterine rupture, severe anemia, postpartum hemorrhage and puerperal endometritis. These complications occurred among adolescent girls aged 18 to 19, christian, skin and pelvic bones secondary school or university students. Factors associated with such complications were the marital status (p=0.010), the gestational age (p=0.012), the number of prenatal consultations (p=0.001), the place of prenatal consultation (p=0.001), the reason for admission (p=0.000) and the mode of admission (p=0.000).Conclusions: Childbirth among adolescent girls is frequent in this context; complications are numerous but they are preventable in the vast majority of cases.

Pregnancy, Prenatal Care, and Delivery of Mothers with Disabilities in Korea

The aim of this study was to investigate the whole picture regarding pregnancy, prenatal care, obstetrical complications, and delivery among disabled pregnant women in Korea. Using the data of National Health Insurance Corporation, we extracted the data of women who terminated pregnancy including delivery and abortion from January 1, 2010 to December 31, 2010. Pearson's chi-square test and Student-t test were conducted to examine the difference between disabled women and non-disabled women. Also, to define the factors affecting inadequate prenatal care, logistic regression was performed. The total number of pregnancy were 463,847; disabled women was 2,968 (0.6%) and 460,879 (99.4%) were by non-disabled women. Abortion rates (27.6%), Cesarean section rate (54.5%), and the rate of receiving inadequate prenatal care (17.0%), and the rate of being experienced at least one obstetrical complication (11.3%) among disabled women were higher than those among non-disabled women (P < 0.001). Beneficiaries of Medical Aid (OR, 2.21) (P < 0.001) and severe disabled women (OR, 1.46) (P = 0.002) were more likely to receive inadequate prenatal care. In conclusion, disabled women are more vulnerable in pregnancy, prenatal care and delivery. Therefore, the government and society should pay more attention to disabled pregnant women to ensure they have a safe pregnancy period up until the delivery.

Pregnancy, Prenatal Care, and Delivery of Mothers with Disabilities in Korea

The aim of this study was to investigate the whole picture regarding pregnancy, prenatal care, obstetrical complications, and delivery among disabled pregnant women in Korea. Using the data of National Health Insurance Corporation, we extracted the data of women who terminated pregnancy including delivery and abortion from January 1, 2010 to December 31, 2010. Pearson's chi-square test and Student-t test were conducted to examine the difference between disabled women and non-disabled women. Also, to define the factors affecting inadequate prenatal care, logistic regression was performed. The total number of pregnancy were 463,847; disabled women was 2,968 (0.6%) and 460,879 (99.4%) were by non-disabled women. Abortion rates (27.6%), Cesarean section rate (54.5%), and the rate of receiving inadequate prenatal care (17.0%), and the rate of being experienced at least one obstetrical complication (11.3%) among disabled women were higher than those among non-disabled women (P < 0.001). Beneficiaries of Medical Aid (OR, 2.21) (P < 0.001) and severe disabled women (OR, 1.46) (P = 0.002) were more likely to receive inadequate prenatal care. In conclusion, disabled women are more vulnerable in pregnancy, prenatal care and delivery. Therefore, the government and society should pay more attention to disabled pregnant women to ensure they have a safe pregnancy period up until the delivery.

Tratamento e complicações do refluxo vesicoureteral persistente além da adolescência / Treatment and complicatons of post-adolescent vesicoureteral reflux

Objetivo: Verificar o estado da arte no tratamento dos refluxos vesicoureterais (RVU) persistentes além da infância. Métodos: Revisão de literatura. Resultados: Foram revisados os dados de literatura com relação ao tratamento e às complicações do refluxo vesicoureteral persistente no adolescente e no adulto. Conclusão: Não há dados que permitam aconselhar o tratamento intervencionista (cirúrgico ou endoscópico) do refluxo vesicoureteral no adolescente e adulto, exceto em pacientes com lombalgia secundária à doença e infecção urinária (ITU) febril recorrente mesmo com tratamento clínico correto. A cirurgia aumenta o risco de complicações obstétricas urológicas obstrutivas sem modificar outras variáveis obstétricas, que são primariamente determinadas pela presença de cicatrizes renais e pela maior susceptibilidade a infecções urinárias, independente da presença de RVU em atividade. Não há dados disponíveis para analisar as conseqüências clínicas tardias do tratamento endoscópico do RVU depois da infância. A cirurgia por si mesma nãoimpede que ocorram complicações do RVU na idade adulta.

Objectives: To find modern guidelines to treat vesicoureteral reflux persisting in adolescents and adults. Methods: Literature review. Results: We reviewed literature data concerning treatment and complications related to persistent vesicoureteral reflux in adolescents and adults. Conclusion: There are no data to advocate surgical treatment of adolescent/ adult persistent vesicoureteral reflux, except for cases with lumbar pain secondary to reflux and recurrent febrile urinary infections despite correct clinical treatment. Surgery increases the incidence of obstructive ureterohydronephrosis and does not modify other obstetrical risks, which are primarily related to reflux sequelae (kidney scars) and susceptibility to urinary infections (independent of reflux). There are no data concerning late clinical consequences of endoscopic treatment for reflux in adolescents and adults. The surgery itself does not necessarily prevent later complications from reflux.

Some remarks on pregnancy having a fetus weighing 4000g and more

In the year 2002 at the central hospital of Obstetrics and Gynecoligy. The number of newborn babies of > 4000g accounted for 2,6% of all obstetric cases, among them the male number was 1,9 fold higher than the female and the multiparum delivering cases was 1,7 folds higher than the monoparum. In delivering heavy babies > 4000g, Caesarian section was the method of large choice (78,5%) but in normal delivery, complication is the most common (70,6%) and hypoglycemia is the complication of highest frequency (78,3%)

An Association of ADHD and Their Risk Factors in Pregnancy, Delivery, Perinatal Stage / 신경정신의학

OBJECTIVE: Many researchers reported that obstetrical complications during late pregnancy or delivery may be related to major psychiatric illnesses, especially schizophrenia. We hypothesized that obstetrical complications are among the most important factors which precipitate onset of attentiondeficit hyperactivity disorder. We studied retrospectively obstetrical complications of the Attention deficit-hyperactivity disorder(ADHD) patients who were diagnosed and treated at the outpatient and inpatient clinics of Ajou University Hospital. METHOD: The subjects were composed of 94 ADHD patients who were diagnosed by DSM-IV and 65 normal subjects. ADHD patients were divided into two groups; the familial group (n=27) consisted of those who have a family history of ADHD, and the non-familial group(n=65) consisted of those without a family history of ADHD. The authors examined gestational age, birth weight, type of delivery, and type of obstetrical complications. Obstetrical complications were divided into maternal, intrapartal and neonatal factors. RESULTS: 1) Non-familial ADHD patients have significantly higher NSVD(normal spont-aneous vaginal delivery) than normal controls. 2) Familial ADHD patients have significantly higher intrapartal obstetrical complications than normal controls. 3) ADHD patients have no significantly higher maternal and neonatal complications than normal controls. CONCLUSION: This study suggests that obstetrical complications are related to the onset of ADHD, possibly when combined with genetic predispositions.

Early Development and Premorbid Social Adjustment during Childhood and Adolescence in Schizophrenic Patients / 신경정신의학

OBJECTIVES: Schizophrenia, one of the major mental illnesses, shows abnormal developmental patterns such as delayed developmental milestones, impaired language and motor function, and poor premorbid social adjustment long before the onset of clinical symptoms of illness. In this study, we tried to find out developmental patterns and premorbid adjustment during childhood and adolescence in Schizophrenic patients. METHODS: The subjects were 56 inpatients (26 male patients and 30 female patients) who met the diagnostic criteria for schizophrenia by DSM-IV and 52 healthy control subjects (25 male patients and 26 female patients). Interview with subjects and their families and the review of medical records were done to assess sociodemographic factors, timing of developmental milestones, language and motor function of childhood, and timing of sexual maturational events. Obstetrical Complication Scale of Lewis was used to get information on the subjects' prenatal and perinatal history, and Premorbid Social Adjustment Scale (PSAS) to assess premorbid adjustment. RESULTS: 1) There were no significant differences in the rates of obstetrical complications. The deveolpmental milestones during infancy such as sitting, walking, age of first sentence were significantly delayed in the Schizophrenics than in the controls (p<0.05). 2) Disturbances of speech and language development were significantly more common in the schizophrenics than in the controls (p<0.05), but there were no significant differences in the rates of disturbance in motor development. Mean ages of reading and writing were significantly delayed in schizophrenics than in the controls (p<0.05). No significant differences were found between males and females for either language disturbance or motor disturbance in the Schizophrenics. 3) During adolescence, premorbid adjustment was poorer in Schizophrenic patients (p<0.05). The Schizophrenic patients scored significantly worse than the controls on both sociability and schooling domains (p<0.05). There was a trend for correlation between poor premorbid functioning and early age of onset, but it failed to achieve statistical significance (Spearman's coeff =-0.27, p=.07). 4) Male Schizophrenic subjects showed poorer premorbid functioning on schooling domain than female Schizophrenic subjects (p<0.05). No significant difference was recogni ed in timing of sexual maturational events between Schizophrenics and controls. CONCLUSION: In summary, the Schizophrenics were significantly delayed in infantile developmental milestones, impaired in development of language, delayed mean age of reading and writing, and showed poorer premorbid social adjustment than the controls.