Awareness and perceptions of Filipino obstetrician-gynecologists on fertility preservation: a cross-sectional survey.

BACKGROUND: The demand for fertility preservation has increased substantially over the past decade as more women wish to delay childbearing and with improved survival outcomes of various medical conditions. This study evaluated the awareness and perceptions of Filipino obstetrician-gynecologists on fertility preservation. METHODS: A cross-sectional survey was conducted among diplomates and fellows of the Philippine Obstetrical and Gynecological Society from September to December 2021. A self-administered questionnaire with 24 items was distributed online. Univariate descriptive statistics were reported as means for continuous variables and frequencies with percentage for categorical variables. Differences in responses were tested using the chi-square test. RESULTS: A total of 215 respondents completed the survey. Majority of the respondents were female, general obstetrician-gynecologists practicing in the National Capital Region. There was an overall positive perception of fertility preservation, with 98.60% agreeing that discussions about childbearing intentions should be initiated. Most participants (98.60%) were aware of fertility preservation but had varying levels of awareness of the different techniques. Fifty-nine percent of the respondents were unaware of regulations on fertility preservation. Setting up dedicated centers for fertility preservation and offering it as a public service were viewed as necessary by the respondents. CONCLUSIONS: This study underscored the need to increase awareness of fertility preservation techniques among Filipino obstetrician-gynecologists. Meeting the need for comprehensive guidelines and centers is essential to promote fertility preservation in the country. Efficient referral systems and multidisciplinary approaches should be established for holistic care.

Newborn Screening Knowledge, Attitudes and Practices among Obstetrics-Gynecology Residents, Pediatric Residents, and Newborn Screening Nurses in a Tertiary Government Hospital in the Philippines during the COVID-19 Pandemic.

Newborn Screening (NBS) saves babies from mental retardation and death. In the Philippines, it was formally established by law in 2004. Program success requires physicians, nurses, and midwives to educate and motivate parents. The COVID-19 pandemic reduced NBS coverage from 91.6% to 80% between December 2019 and December 2020. This study aimed to (1) determine the knowledge, attitudes, and practices of residents and nurses relative to NBS during the COVID-19 pandemic; and (2) identify possible factors that may have affected NBS services at the Philippine General Hospital during the pandemic. Participants' demographics were also compared with NBS practices. The study enrolled 189 participants employed during 2020. The results of a self-administered online questionnaire were evaluated. Only 31% of participants scored above a mean passing level for NBS knowledge set by experts. Most participants expressed a favorable attitude towards NBS. Knowledge scores were a significant factor in favorable attitude. Obstetrics-gynecology residents had lower attitude scores than Pediatric residents and NBS Nurses. Prenatal parent education was only practiced by 1/3 of participants. Despite the obstacles of the COVID-19 pandemic, participants appreciated the value of the NBS and were willing to perform specimen collection using safety precautions. Participants identified the need for additional NBS training. The challenges identified provide an avenue for further research with the goal of strengthening NBS, especially during a public health emergency.

Assessment of the knowledge, attitudes, and perceptions of Filipino obstetrics and gynecology residents on fertility preservation: A cross-sectional study.

Background: As primary reproductive healthcare providers, residents-in-training must be equipped with the knowledge of proven and available methods for fertility preservation. The study evaluated Filipino obstetrics and gynecology residents' current knowledge, attitudes, and perceptions about fertility preservation. Methods: A cross-sectional survey was conducted among obstetrics and gynecology residents in the Philippines. A 24-item questionnaire was distributed to the different accredited training institutions of the Philippine Obstetrical and Gynecological Society by electronic mail. Univariate descriptive statistics were reported as mean for continuous variables and frequency with percentage for categorical variables. The chi-square test was used to determine differences in responses. Results: A total of 143 respondents from different year levels of training were enrolled in the study. Most were female trainees (88.11%) from the National Capital Region (44.76%). Most respondents agreed that discussions about childbearing intentions (99.30%) and age-related fertility decline (98.60%) should be initiated during a patient's gynecological consult. Residents were most familiar with oocyte freezing (84.62%), fertility-sparing surgeries (83.22%), and the use of GnRH agonists (80.42%) as fertility preservation techniques. Despite being most familiar with oocyte freezing, the respondents have mainly referred patients for fertility-sparing surgeries (48.95%) and the use of GnRH agonists (48.25%). Conclusions: There was an overall reassuring perception and attitude of obstetrics and gynecology residents on fertility preservation. A standardized curriculum with teaching-learning activities on fertility preservation may be used to improve trainees' knowledge. There was a disparity in the knowledge and actual referral or utilization of the different methods, reflecting the inaccessibility of the procedures specific to their institutions. This highlights the need to improve accessibility and offer fertility preservation as a public health service.

Myomatous erythrocytosis syndrome: A case series.

Uterine leiomyomas are tumor-associated causes of secondary erythrocytosis. Ectopic erythropoietin production by fibroid smooth muscles has been proposed and demonstrated in the literature. Here, we present three cases of large leiomyomas with an incidental finding of isolated erythrocytosis on preoperative workup. Two patients underwent total abdominal hysterectomy while one patient underwent a myomectomy. Both histologic examination confirming the diagnosis of leiomyoma and serial complete blood counts showing normalization of postoperative hemoglobin levels together with isolated erythrocytosis constitute the criteria to fulfill a diagnosis of myomatous erythrocytosis syndrome. All three criteria were observed in the three cases described. To date, fewer than 40 cases have been reported worldwide. These are the first reported cases of myomatous erythrocytosis syndrome in the Philippines.

A modification of the fenton's technique as a vaginal reconstructive surgery in the correction of congenital partial vaginal atresia

Sexual function is an important aspect of an individual's well being. The inability to have sexual intercourse for any reason, when one chooses to, is a concern that will cause distress. It's the kind that does not only affect the individual who is unable to, but also the partner who is able to. Dyspareunia is one reason for this. The pain during coitus may be severe enough, and thus cause frustration everytime it is attempted. Reported here is a 31 year old nulligravid who has an incomplete form of congenital atresia of the outer third of the vagina on which a modified Fenton's procedure was done. The Fenton's surgical technique was originally conceptualized to "widen a tight vagina" in patients with postpartum dyspareunia caused by scar tissue formation and contacture after an episiorrapy. The above mentioned congenital defect, its incidence, embryogenesis, presentation and management are discussed in this case report. The innovation in surgical intervention is also described.

A second - look hysteroscopy after treatment of genital tuberculosis in an amenorrheic woman

A 32 year old G2P1 (1011) presented with amenorrhea of 2 years duration. Both sister and grandfather were diagnosed with Pulmonary Tuberculosis 10 years ago and adequately treated for 9 months with quadruple anti-Koch`s medications. Patient presented with no sign nor symptoms highly suspicious for tuberculosis. Physical and Pelvic examinations, complete endocrinologic investigations, chest X-ray and transvaginal ultrasound all revealed normal results. Progesterone challenge test failed to elicit withdrawal bleeding. Hyteroscopy showed a globularly fibrotic endometrial cavity, while endometrial biopsy revealed chronic granulomatous inflammation with Langhan`s giant cell typical of genital tuberculosis. She was subsequently started on anti-Koch`s medications for 6 months, with prompt resumption of menses after treatment. Second-look hysteroscopy on readmission showed normal, healthy-looking endometrium with no areas of fibrosis. Repeat endomentrial biopsy revealed benign secretory phase endometrium, with absolutely no evidence of chronic granulomatous inflammation. This paper aimed to underscore the value of hysteroscopy as a vital tool in the work-up amenorrhea, and to demonstrate, using second look hysteroscopy, the efficacy of anti-tuberculosis treatment on the uterine cavity in an amenorrheic woman diagnosed with genital tuberculosis.