Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 11 de 11
Filter
1.
J Biosoc Sci ; 55(2): 213-223, 2023 03.
Article in English | MEDLINE | ID: mdl-35703331

ABSTRACT

This study aimed to evaluate the proportion of contraception users among Lebanese youth, and the extent of knowledge and perception on birth control; and to raise awareness and sensitise young adults to sexual health, which remains taboo in Lebanon. The 30-item questionnaire was broadcasted to students in private and public universities in Lebanon, through social media and it collected information on contraception use and student knowledge. Over 30% of responders were medical students, and 41% have ever used contraceptives (mostly women); among which, 52.1% for contraception versus 47.9% for medical reasons. According to responders, the pill ranked high in terms of effectiveness (72.4% of responders perceive the pill as effective), followed by the male condom (69.1%) and the hormonal intrauterine device (29.6%). Some would not use contraception in the future, for religious reasons (30.8%) or for fear of complications (46.2%); indeed, around a third of contraceptive users (all female) have experienced adverse effects. Finally, students expressed concern about long-term complications of contraceptive use (pulmonary embolism/phlebitis, breast/endometrial/ovarian cancer, stroke, depression and myocardial infarction). Though less frequent than in the Western world, contraception use in Lebanon is non-negligible and gaps in university students' knowledge on contraception were identified; which should prompt sexual education and family planning initiatives in Lebanon.


Subject(s)
Contraception , Health Knowledge, Attitudes, Practice , Adolescent , Young Adult , Female , Male , Humans , Universities , Sexual Behavior , Students , Contraceptive Agents
2.
Int J Gynaecol Obstet ; 161(1): 314-319, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36479965

ABSTRACT

OBJECTIVE: To evaluate the efficiency of the Robson classification as an internal clinical audit and feedback of the high rate of cesarean delivery at Hotel Dieu de France, a tertiary referral hospital. METHODS: A pre-post study was conducted, with a retrospective approach in 2018 and 2019, identified as the pre-period (before the implementation of the Robson classification), and with a prospective approach in 2020 and 2021, labeled the post-period. RESULTS: The total number of deliveries during the study period was 2560; 1305 patients were included in the pre-period and 1255 patients delivered in the post-period. No significant differences between the two groups were found. No significant difference was found in the overall rate of cesarean delivery between the first and second periods (57.86% vs 56.72%; P = 0.2). However, a significant decrease in the absolute contribution of groups 3 and 4 (multiparous women without a previous uterine scar with a single cephalic pregnancy, ≥37 weeks of gestation, with spontaneous labor or induced labor) in the overall rate of cesarean delivery was remarked (P = 0.02 and 0.01, respectively). CONCLUSION: The Robson classification seems to be appropriate to monitor and audit the rate of cesarean delivery, but not sufficient to decrease the rate and change the practice.


Subject(s)
Cesarean Section , Labor, Obstetric , Humans , Female , Cesarean Section/statistics & numerical data , Clinical Audit , Tertiary Care Centers , Retrospective Studies , Lebanon , Adolescent , Young Adult , Adult , Pregnancy
3.
Int J Gynaecol Obstet ; 156(2): 298-303, 2022 Feb.
Article in English | MEDLINE | ID: mdl-33615472

ABSTRACT

OBJECTIVE: To evaluate the cesarean section rate using the Robson Classification for the first time in Lebanon, at Hôtel-Dieu de France University Hospital, a tertiary referral center in Beirut. METHODS: Routine medical record data that included all live births from January 1, 2018 to September 30, 2020 was investigated. The overall cesarean section rate was recorded, and the size, cesarean section rate, and absolute and relative contributions were calculated within each group. RESULTS: The overall cesarean section rate was 56.8%. The highest relative contribution to this rate came from Robson groups 5, 2 and 10, respectively. A decrease in cesarean section rate was noted in 2020 among women admitted for induction of labor (groups 2 and 4) following the implementation of new department policies and the restrictions caused by the coronavirus disease 2019 pandemic. CONCLUSION: More than 50% of the deliveries in our department were by cesarean sections (CS). Strategies to reduce this rate should include stricter departmental policies for avoidance of unindicated primary CS and raising practitioners' and patients' awareness about trial of labor after cesarean section.


Subject(s)
COVID-19 , Labor, Obstetric , Cesarean Section , Female , Humans , Pregnancy , SARS-CoV-2 , Tertiary Care Centers
4.
BMC Med Ethics ; 19(1): 33, 2018 05 02.
Article in English | MEDLINE | ID: mdl-29720150

ABSTRACT

BACKGROUND: We analyzed the patients' perception of prenatal diagnosis of fetal cardiac pathology, and the reasons for choosing to continue with pregnancy despite being eligible to receive a medical termination of pregnancy. We also identified the challenges, the motives interfering in decision-making, and the consequences of the decisions on pregnancy, child and mother. METHODS: This descriptive, prospective and longitudinal study was conducted in France, amongst pregnant women who wished to continue their pregnancy despite an unfavorable medical advice (incurable fetal cardiac pathologies). Socio-demographic data were collected through a questionnaire. Such questionnaire covered information assessing the parents/mother's perception of prenatal diagnosis, and medical termination of pregnancy, their interpretation of the established diagnosis and their motives for not considering pregnancy termination. RESULTS: 72 eligible patients were analyzed over one year: mean age 33 ± 6.89 years, 47 patients had already given birth to ≥1 healthy child. Mean gestational age at the detection of fetal cardiac pathologies was 30 ± 4.37 weeks of amenorrhea. Patients decided to keep the child after 3 ± 1.25 consultations. 56 (77.78%) patients made their decision with their husbands and 16 made their decision alone. Reasons for declining the medical termination were culpability and responsibility (n = 36), ideologies and convictions (n = 24), mistrust and hope (n = 12). Newborns of 67 patients died with a mean survival duration of 38 days. CONCLUSIONS: Patient informed consent should be sought before any decision in neonatology, even if conflicting with the medical team's knowledge and the pregnant mother's benefits. Decisions to accept or decline pregnancy termination depend on the patients' psychological character, ideologies, convictions, and mistrust in the diagnosis/prognosis, or hope in the fetus survival.


Subject(s)
Abortion, Induced , Decision Making , Fetal Diseases , Heart Diseases , Informed Consent , Pregnant Women/psychology , Prenatal Diagnosis , Abortion, Induced/ethics , Adult , Female , Fetus , Humans , Infant , Infant Death , Infant, Newborn , Longitudinal Studies , Motivation , Paris , Perinatal Death , Personal Autonomy , Pregnancy , Prospective Studies , Spouses , Young Adult
5.
Gynecol Obstet Invest ; 81(4): 333-8, 2016.
Article in English | MEDLINE | ID: mdl-26588025

ABSTRACT

OBJECTIVE: The study aims to compare the safety and effectiveness of 200 and 400 µg of oral misoprostol for cervical priming before hysteroscopy. METHODS: A double-blinded randomized study included 70 patients scheduled for hysteroscopy in a Lebanese University Hospital. Two dosages of oral misoprostol (200 or 400 µg) were randomly distributed to these patients 1 h before surgery under general anesthesia. Subjective assessment of the ease of dilatation, size of the first used Hegar, cervical injuries, bleeding or uterine perforation, duration of the procedure and misoprostol adverse effect were all noted and compared. RESULTS: The difficulty of dilation until a Hegar 10 was similar for both treatment groups. Operative time was not reduced with a higher misoprostol dosage. We found 2 uterine perforations within the 200 µg group (6.7%), and none within the 400 µg group. Cervical lacerations and bleeding were similar (20%) for both treatment groups. A 2-fold increase in side effects (nausea, vomiting and cramps) is reported among the 400 µg group. CONCLUSIONS: Increasing the dose of misoprostol from 200 to 400 mg doubled the rate of side effects while no clinical benefit was noted. Larger trials are needed to assess rates of uterine perforation with the 200 µg dosage.


Subject(s)
Cervix Uteri/drug effects , Hysteroscopy/methods , Misoprostol/administration & dosage , Adult , Cervix Uteri/injuries , Colic/chemically induced , Dilatation/methods , Dose-Response Relationship, Drug , Double-Blind Method , Female , Humans , Hysteroscopy/adverse effects , Lacerations , Middle Aged , Misoprostol/adverse effects , Nausea/chemically induced , Oxytocics , Pregnancy , Preoperative Care , Uterine Perforation/epidemiology , Uterine Perforation/etiology , Vomiting/chemically induced
6.
J Med Liban ; 63(4): 228-31, 2015.
Article in English | MEDLINE | ID: mdl-26821407

ABSTRACT

BACKGROUND: Intracranial hemorrhage due to arteriovenous malformation or intracranial aneurysm is a rare but severe complication of pregnancy with maternal and fetal mortality of 20% and 33% respectively. Whether to deliver the patient first, or to treat the aneurysm first is still controversial, but an emergency cesarean section followed by aneurismal treatment appears to be a widely accepted strategy in pregnant women with cerebral aneurysmal complications. CASE: A 38-year-old patient, G3P2A0, presented at 36 gestational weeks with a diffuse bilateral subarachnoid hemorrhage with fourth ventricle bleeding and hydrocephalus. She had a cerebral aneurysm of the left posterior communicating artery on arteriography. A cesarean section was performed on the first day of admission, and an external ventricular derivation with clipping of the aneurysm on the left posterior communicating artery were done immediately after the cesarean section. Mother and newborn were discharged from hospital in a good health status except Broca's aphasia in the mother. CONCLUSION: In the absence of categorical recommendations, we stress the role of combined care by both neurosurgeons and obstetricians, on a case to case basis according to gestational age, mother neurological status and experience of caregivers.


Subject(s)
Aneurysm, Ruptured , Intracranial Aneurysm , Pregnancy Complications, Cardiovascular , Subarachnoid Hemorrhage , Adult , Aneurysm, Ruptured/diagnosis , Female , Humans , Intracranial Aneurysm/diagnosis , Pregnancy , Pregnancy Complications, Cardiovascular/diagnosis , Subarachnoid Hemorrhage/diagnosis
8.
J Med Liban ; 56(1): 27-34, 2008.
Article in English | MEDLINE | ID: mdl-19534088

ABSTRACT

Ectopic pregnancy (EP) has a variable and misleading clinical presentation contributing to the confusion with medical or other gynecological disorders. The rapid recourse to diagnostic methods, human chorionic gonadotropin (beta-hCG) titers and transvaginal ultrasonography, represents the best approach not only in the early diagnosis but also in the management and monitoring of patients with diagnosed EP. The purpose of this article is to provide a pictorial essay about EP and its multiple ultrasound (US) patterns. We present a large spectrum of EP aspects diagnosed on US and confirmed by pathology. We also review miscellaneous gynecologic diseases that may mimic EP on US. Although endovaginal US combined with quantitative (beta-hCG) analysis is an excellent tool for identifying EP, it may be normal sometimes in early pregnancies. Knowledge of all these patterns is helpful in establishing an early correct diagnosis, therefore leading to elective and conservative management in stable patients and preventing tubal rupture or substantial hemorrhage.


Subject(s)
Endosonography , Pregnancy, Ectopic/diagnostic imaging , Pregnancy, Tubal/diagnostic imaging , Ultrasonography, Prenatal , Algorithms , Chorionic Gonadotropin/blood , Diagnosis, Differential , Fallopian Tubes/diagnostic imaging , Fallopian Tubes/pathology , Female , Genital Diseases, Female/diagnostic imaging , Humans , Pregnancy , Pregnancy, Ectopic/pathology , Pregnancy, Multiple , Pregnancy, Tubal/pathology , Sensitivity and Specificity
9.
J Reprod Med ; 52(3): 223-4, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17465291

ABSTRACT

BACKGROUND: Mesenchymal vulvar tumors are rare, and a benign lipoblastomalike tumor may be confused with malignancy. CASE: A 15-year-old patient consulted for a right labium tumefaction measuring 15 cm. After excision, histologic examination revealed a well-circumscribed and lobulated tumor. The lobules were composed of slender spindle cells showing slightly eosinophilic cytoplasm with indistinct boundaries, uniform nuclei with finely granular chromatin and no nucleoli. Scattered Signet-ring-type lipoblasts were observed. The background was myxoid, with a "chickenwire" capillary vascular network mimicking a myxoid liposarcoma. No mitotic figures, necrosis or pleomorphism was noted. CONCLUSION: This mesenchymal tumor had adipocytic differentiation and no patent sign of malignancy, akin to infantile lipoblastoma. Because of the benign behavior of this tumor, complete excision without radiation is recommended.


Subject(s)
Lipoma/pathology , Mesenchymoma/pathology , Vulvar Neoplasms/pathology , Adolescent , Cell Division , Female , Humans , Immunohistochemistry , Lipoma/surgery , Mesenchymoma/surgery , Treatment Outcome , Vulvar Neoplasms/surgery
10.
J Magn Reson Imaging ; 24(4): 880-5, 2006 Oct.
Article in English | MEDLINE | ID: mdl-16969789

ABSTRACT

PURPOSE: To determine whether recent progress in imaging has made it possible to diagnose spontaneous detorsion, which is an accepted concept in the gynecological literature but until now has been a presumptive diagnosis that could not be confirmed because of the lack of imaging proof. MATERIALS AND METHODS: We searched for patients who had a diagnosis of spontaneous detorsion on MRI between January 2000 and January 2003, and selected only patients who met a selection of strict criteria, including mainly enlargement and hyperintensity of ovarian stroma on T2-weighted (T2W) images, clinical findings compatible with torsion and detorsion, and return of the stroma to normal size on follow-up examinations. Other signs of torsion, such as tubal thickening, were appreciated but not mandatory. Clinical follow-up for at least three years was available. RESULTS: Four patients met the study criteria. No stabilizing procedure was performed in the ovaries. One patient recurred and lost her ovary. CONCLUSION: The diagnosis of torsion followed by spontaneous detorsion was made with high probability in a selected number of patients. The clinical management of such patients remains a matter of debate. Laparoscopy with oophoropexy would be useful for young patients in whom close follow-up cannot be achieved.


Subject(s)
Magnetic Resonance Imaging/methods , Ovarian Diseases/diagnosis , Adult , Female , Humans , Ovarian Diseases/diagnostic imaging , Ovarian Diseases/physiopathology , Retrospective Studies , Torsion Abnormality/diagnosis , Ultrasonography
11.
J Magn Reson Imaging ; 20(3): 451-62, 2004 Sep.
Article in English | MEDLINE | ID: mdl-15332253

ABSTRACT

PURPOSE: To evaluate ultrasound (US) and magnetic resonance (MR) findings in the viable twisted adnexa. MATERIALS AND METHODS: Ten patients underwent US and MR studies before surgical detorsion. Corrected cross-sectional area of the ovary was defined as cross-sectional area minus areas of cysts and follicles superior to 1 cm. On T2-weighted images, signal intensity of the stroma was graded as type 1 when it was equal to that of urine and type 2 when it was less than that of urine but markedly more than the contralateral side. RESULTS: The tube was twisted in six cases and the ovary in nine cases. All adnexa were viable. The largest ovarian cross-sectional area and the largest corrected ovarian cross-sectional area of the twisted ovary were significantly larger than those of the contralateral ovary (P = 0.043 for US; P = 0.012 and 0.017, respectively, for MR). These ovaries contained types 1 and 2 hyperintensity in six cases and only type 2 hyperintensity in three cases. Tubal thickening was seen on MR in five cases. CONCLUSION: Tubal thickening, enlargement of ovarian stroma as reflected by the corrected cross-sectional area, and hyperintensity of this stroma on T2-weighted images probably related to edema were useful findings in these viable torsions.


Subject(s)
Adnexa Uteri/pathology , Magnetic Resonance Imaging/methods , Ovarian Diseases/diagnosis , Adnexa Uteri/diagnostic imaging , Adult , Female , Humans , Ovarian Cysts/diagnosis , Ovarian Cysts/diagnostic imaging , Ovarian Diseases/diagnostic imaging , Retrospective Studies , Torsion Abnormality/diagnosis , Ultrasonography
SELECTION OF CITATIONS
SEARCH DETAIL
...