Low-dose acetylsalicylic acid does not modify maternal vascular reactivity in nulliparas.

OBJECTIVE: To assess if the low-dose acetylsalicylic acid (ASA) would be capable of modifying endothelial function throughout pregnancy in nulliparous patients. METHODS: A double-blind, randomized clinical trial with 277 were included. A total of 139 were orally administered 100 mg/day of ASA, and 138 received placebo. Endothelial function was assessed by flow-mediated dilation (FMD) in the brachial artery before the start of medication (11-14 weeks) and 20-24 and 30-34 weeks of gestation. The intervention was maintained until 34 weeks. The Mann-Whitney U test was used to compare the placebo and ASA groups. The comparison of FMD during pregnancy was performed using the Friedman test. RESULTS: The groups (ASA and placebo) were similar regarding to age, weight, height, and body mass index (BMI) (p > .005). The comparison of values of FMD (%) between placebo vs. ASA at 11 and 14 weeks (8.9 vs. 9.7%, p: .253), 20 and 24 weeks (8.8 vs. 10.7%, p: .152), and 30 and 34 weeks (10.7 vs. 9.8%, p: .314) did not show significant changes throughout pregnancy. We observed a significant prevalence of PE in the placebo regarding to ASA group [14 (10.2%) vs. 8 (5.8%), p: .171]. CONCLUSION: Acetylsalicylic acid did not modify the endothelial function assessed by FMD of the brachial artery during pregnancy in nulliparous women.

Comparison of Measurements of Bone Mineral Density in Young and Middle-Aged Adult Women in Relation to Dietary, Anthropometric and Reproductive Variables.

The objective of this study was to compare current measurements of bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN), and total femur (TF) regions with initial values recorded 12 years ago in women from Northwest Mexico, and evaluate their correlation with dietary, anthropometric, and reproductive variables. BMD was assessed by Dual-energy X-ray absorptiometry. Participants were grouped as follows: Nulliparous (G1); women who were mothers 12 years ago (G2); and women who were nulliparous 12 years ago, but are now mothers (G3). In all three groups, current LS BMD was higher than initial (p ≤ 0.05) and current TF BMD in G2 was higher than initial values (p ≤ 0.05). When comparing current FN and TF BMD among the three groups, G2 had higher values than G3 (p ≤ 0.05). G2 also showed higher LS BMD than G1 and G3 (p = 0.006). Age at menarche was inversely-correlated with FN and TF BMD in G1 (p < 0.01), while the body mass index (BMI) correlated positively with all three bone regions in G2 (p < 0.05). This study shows that in women without and with children, age at menarche, BMI, and age were factors associated to BMD in healthy subjects in reproductive age.

Correlation between electromyography and perineometry in evaluating pelvic floor muscle function in nulligravidas: A cross-sectional study.

OBJECTIVE: To correlate the results of electromyography and perineometry in the assessment of PFM function in nulligravidas. METHODS: The cross-sectional observational study was approved by the internal review board of the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) and was conducted in the Instituto Paraibano de Pesquisa Professor Joaquim Amorim Neto (IPESQ). Thirty-eight nulligravidas aged 18-39 years of age, who had already initiated their sexual life, participated in the study. Exclusion criteria consisted of the presence of genital prolapse, a history of pelvic or urogenital surgery and the presence of neurological disease producing muscle disorders. For the evaluation procedure, the women were submitted to a clinical evaluation of the pelvic floor muscles followed by electromyography. Perineometry was performed 72 h later. Prior to electromyography and perineometry, the women were given standardized training with electromyographic biofeedback to teach them to contract only their pelvic floor muscles. RESULTS: A highly positive, statistically significant correlation (r = 0.968; P < 0.001) was found between the electromyographic and perineometric findings. CONCLUSIONS: A strong correlation was found between perineometric and electromyographic findings of pelvic floor muscle function.

Longitud de vagina, hiato genital y cuerpo perineal en mujeres nulíparas

Objetivo: Estimar la longitud promedio de vagina, del hiato genital y cuerpo perineal en mujeres nulíparas. Diseño: Estudio descriptivo transversal con muestreo por conveniencia. Institución: Departamento de Ginecología y Obstetricia, Hospital Nacional Cayetano Heredia, Lima, Perú. Participantes: Mujeres nulíparas. Métodos: En 85 mujeres nulíparas atendidas en el Hospital entre enero y marzo 2014, en edad fértil, que habían iniciado relaciones coitales vaginales y que requerían evaluación ginecológica, se realizó medición del peso y talla. En posición de litotomía, se midió con un hisopo milimetrado la longitud total de la vagina, hiato genital y el cuerpo perineal. Las mediciones fueron realizadas por un solo examinador. La participación fue completamente voluntaria y con firma de consentimiento informado. Principales medidas de resultados: Longitud total de la vagina, hiato genital y el cuerpo perineal. Resultados: La media de la longitud total de vagina fue 8,1 ± 1,4 cm (DE), del hiato genital 2,2 ± 0,5 cm (DE) y del cuerpo perineal 2,3 ± 0,5 cm (DE). Conclusiones: Las medidas estimadas no difieren con resultados de estudios internacionales. Se requiere estudiar una mayor muestra de pacientes de las diferentes regiones para tener un estimado más representativo de estas medidas en pacientes nulíparas del Perú.

Objectives: To determine vaginal, genital hiatus and perineal body length in nulliparous women. Design: Cross-sectional descriptive study with convenience sample. Setting: Department of Obstetrics and Gynecology, Hospital Nacional Cayetano Heredia, Lima, Peru. Participants: Nulliparous women. Methods: From January through March 2014 in 85 nulliparous women in childbearing age who had coital sex and required gynecological evaluation, weight and height were obtained and length of vagina, genital hiatus and perineal body were measured with a graph swab in lithotomy position. Measurements were obtained by one single examiner. Participation was voluntary with signed informed consent. Main outcome measures: Length of vagina, genital hiatus and perineal body. Results: Average length of patients vagina was 8.1 ± 1.4 cm (SD), genital hiatus 2.2 ± 0.5 cm (SD), and perineal body 2.3 ± 0.5 cm (SD). Conclusions: Measures obtained did not differ from international studies. A broad population study is suggested to better estimate these measures in nulliparous Peruvian women.

Misoprostol for intrauterine device insertion in nulliparous women: a randomized controlled trial.

OBJECTIVE: To examine the effects of preprocedure misoprostol on intrauterine device (IUD) placement in nulliparous women. STUDY DESIGN: In this randomized controlled double-blind trial at the University of New Mexico reproductive health clinic, nulliparous women requesting an IUD were randomized to 400 mcg of buccal misoprostol or placebo 2-8 hours before insertion. Primary outcomes included pain on a 10-cm visual analog scale and women's perception of the value of delaying insertion for an effective medication. Provider ease of insertion and need for adjunctive insertion measures were also assessed, on a visual analog scale. Participants indicated maximum pain after IUD insertion, pain level they would tolerate to avoid delay in IUD insertion, and preference for IUD insertion without delay if an effective medication was available. RESULTS: Of 85 women enrolled, 3 were ineligible; 42 were randomized to misoprostol and 40 to placebo. There were no differences between groups in worst insertion pain, (5.8 ± 2.0 vs 5.9 ± 2.0, P = .94), provider ease of insertion (2.2 ± 2.2 vs 2.5 ± 2.2; P = .54) or adjunctive measures (14% vs 25%; P = .27). The groups were willing to tolerate the same mean pain (4.9 ± 2.5 vs 5.7 ± 2.4, P = .18) to avoid waiting for medication. The majority of women (85%) preferred to wait for an effective medication. CONCLUSION: Misoprostol for nulliparous women did not decrease pain or improve the ease of insertion of an IUD. Most women were willing to wait for a medication that decreases pain, indicating a need to pursue alternatives for pain control with IUD insertion.