- Email: [email protected]
AIDS in Bangladesh
S350
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
and androgenic activity using a yeast-based hormone-dependent reporter assay. Results: No differences were seen in serum concentrations of estradiol, FSH, LH and SHBG between baseline, Maca treatment and placebo (P > 0.05). The Greene Climacteric Scale revealed a significant reduction in scores in the areas of psychological symptoms, including the sub-scales for anxiety and depression, and sexual dysfunction following Maca consumption compared to both baseline and placebo (P < 0.05). These findings did not correlate with estrogenic or androgenic activity present in the Maca. Conclusion: Preliminary findings show that Maca reduces psychological symptoms, including anxiety and depression, and lowers measures of sexual dysfunction in postmenopausal women independent of estrogenic and androgenic activity. O901 Lactate and the normally developing fetal brain L. Story1 , M. Damodaram1 , J. Allsop1 , A. McGuinness1 , M. Wylezinksa-Arridge1 , S. Kumar2 , M. Rutherford1 . 1 Imperial College London, 2 Queen Charlotte’s and Chelsea Hospital London
complication were recorded. EPH was defined as one performed for hemorrhage unresponsive to other treatment less than 24 hour after delivery. Multiple logistic regression analysis was used to identify independent risk factors for EPH. Results: During the past 10 years 70 patients were performed EPH, 27 cases were hospitalized patients and 43 were transformed from other hospitals. The incidence of EPH is 0.12% (27/21824, 42 cases were performed total hysterectomy, 28 cases were performed subtotal hysterectomy). Indications for EPH were placenta accrete (30.00%, 21/70), uterine atony (25.71%, 18/70), coagulopathy (24.29%, 17/70), genital tract laceration (20.00%, 14/70); 5 patients underwent re-operation (7.14%, 5/70), and 8 (11.43%, 8/70) patients dead after all kinds of remedy. Independent risk factors for e EPH were multipara (OR 3.00, 95%CI 1.08–8.32). Combination use of uterine contraction agents (OR 0.09, 95%CI 0.03–0.27) and regular prenatal care (OR 0.05, 95%CI 0.02–0.14) were protect factors. Conclusions: Placenta accrete was the most common cause of EPH. Multipara, home delivery, less prenatal care were high risk factors for EPH. The re-operation and the mortality might be related to the model of operation and the operation skill.
Background: The role of lactate in the developing brain is controversial. Neonatal studies have identified lactate in the normally developing preterm brain using proton Magnetic Resonance Spectroscopy (1HMRS). This is a variant of MRI, which non invasively analyses the metabolic profile of tissue. Fetal 1H-MRS studies are limited. However, the presence of lactate in the normally developing fetal brain has not previously been reported. Methods: 19 women with appropriately grown (AGA) fetuses 23–37+5 weeks gestation (GA) (median 29) and 15 pregnancies with Intrauterine Growth Restriction 22–34+1 weeks GA (median 28) were scanned using a 1.5T MR system. Conventional imaging was obtained followed by spectral acquisition from the fetal brain with a PRESS sequence at three echo times. Spectral analysis was performed using JMRUI software. Signals were summed, spectra phased and referenced to the water peak and peaks identified by chemical shift. Results: 59 spectral acquisitions were analysable. N-acetylaspartate, choline, creatine and Myo-inositol were identified in all fetuses. Lactate was identified in 5 AGA fetuses (23–37+5 weeks GA median 26+6) and 2 IUGR fetuses (29+1, 30 weeks GA). Conclusions: Lactate has been detected in the fetal brain using 1H-MRS in case reports of IUGR and was proposed to be due to hypoxia and anaerobic metabolism. However, this is the first study to identify lactate in the normally developing fetal brain. The role of and detection of lactate therefore remains obscure. Lactate may play a role in brain development, serving as fuel as well having a role in myelin synthesis. However, it is not present in all fetuses. The detection of lactate in both IUGR and AGA fetuses implies its presence is not a specific marker of hypoxia.
O903 Women living with HIV/AIDS in Bangladesh
O902 Emergency peripartum hysterectomy in a tertiary hospital of mainland China: 10 years review
Background: The Gambia is a small West African Country with high perinatal and maternal mortality, despite many years’ efforts to improve services. Antenatal care attendance is relatively high (90%), but most of deliveries are either at home, with or without trained traditional birth assistants, or in a facility with basic services. Only thrree to four institutions can perform emergency obstatric care. Until recently, the midwives, mostly male, were the backbone of the prodfessional health care system. Method: Since 1993, Norwegian researchers have collaborated with the Departement of State for health in building capacity in maternal and reproductive health research. The method has been to recruit Gambian nurse-midvives for a two year masters training, including research thesis. The thematic areas have been: Prevalence and care for infertility, maternal mortality causes and care, maternal morbidity and its association with stillbirths, neonatal morbidity and mortality, reasons for preference for home delivery, willingness to have a HIV test in antenatal care, the cost of maternal care, male
X. Su, Y. Wang, H. Liu. Guangzhou Obstetric and Gynecology Institute, Obstetric Critical Care Center of GuangZhou, The Third Affiliated Hospital of Guangzhou Medical College, Guangzhou, China Objectives: To review 10 years’ experience and to estimate the incidence, indications and high risk factors associated with emergency peripartum hysterectomy (EPH). Materials and Methods: A retrospective case control study. All cases who performed EPH in Obstetric Critical Care Center of GuangZhou, from 1 January 1999 to 30 December 2008. The same number postpartum hemorrhage patients who were not perform EPH were randomly carried out as control group. Demographic data and clinical details including gestational age, mode of delivery, indication and type of hysterectomy, blood loss and
N. Sultana1 , N. Begum2 , S. Badiuzzaman3 . 1 Dhaka National Medical College, 2 Asher alo, 3 Mukto Akash In Bangladesh persons with HIV and AIDS are increasing day by day. Increasing number of women with HIV is being identified. This observational study was conducted among 209 women infected with HIV. Objectives were to assess their health status and to evaluate their social status. They are the members of two organizations working throughout the country who provide them all sorts of supports. All of them are married and with their family members. Most of them were infected through sexual transmission and a very few percentage through unscreened blood transfusion. Gastroenteritis, fungal skin infection, tuberculosis, recurrent respiratory tract infection are usual opportunistic infections. Most of them are getting antiretroviral therapy. Some of them became pregnant and delivered in selected hospitals. They received vocational training from their organization and now working as one of the earning members in the family. Sometimes they are discriminated in getting treatment. Regular health check up, treatment of opportunistic infections and antiretroviral therapy will keep them healthy along with sympathetic attitude towards them and cooperation instead of stigmatization. O904 Capacity building in maternal health research in an African country – 15 years of experience J. Sundby, M. Cham
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
and androgenic activity using a yeast-based hormone-dependent reporter assay. Results: No differences were seen in serum concentrations of estradiol, FSH, LH and SHBG between baseline, Maca treatment and placebo (P > 0.05). The Greene Climacteric Scale revealed a significant reduction in scores in the areas of psychological symptoms, including the sub-scales for anxiety and depression, and sexual dysfunction following Maca consumption compared to both baseline and placebo (P < 0.05). These findings did not correlate with estrogenic or androgenic activity present in the Maca. Conclusion: Preliminary findings show that Maca reduces psychological symptoms, including anxiety and depression, and lowers measures of sexual dysfunction in postmenopausal women independent of estrogenic and androgenic activity. O901 Lactate and the normally developing fetal brain L. Story1 , M. Damodaram1 , J. Allsop1 , A. McGuinness1 , M. Wylezinksa-Arridge1 , S. Kumar2 , M. Rutherford1 . 1 Imperial College London, 2 Queen Charlotte’s and Chelsea Hospital London
complication were recorded. EPH was defined as one performed for hemorrhage unresponsive to other treatment less than 24 hour after delivery. Multiple logistic regression analysis was used to identify independent risk factors for EPH. Results: During the past 10 years 70 patients were performed EPH, 27 cases were hospitalized patients and 43 were transformed from other hospitals. The incidence of EPH is 0.12% (27/21824, 42 cases were performed total hysterectomy, 28 cases were performed subtotal hysterectomy). Indications for EPH were placenta accrete (30.00%, 21/70), uterine atony (25.71%, 18/70), coagulopathy (24.29%, 17/70), genital tract laceration (20.00%, 14/70); 5 patients underwent re-operation (7.14%, 5/70), and 8 (11.43%, 8/70) patients dead after all kinds of remedy. Independent risk factors for e EPH were multipara (OR 3.00, 95%CI 1.08–8.32). Combination use of uterine contraction agents (OR 0.09, 95%CI 0.03–0.27) and regular prenatal care (OR 0.05, 95%CI 0.02–0.14) were protect factors. Conclusions: Placenta accrete was the most common cause of EPH. Multipara, home delivery, less prenatal care were high risk factors for EPH. The re-operation and the mortality might be related to the model of operation and the operation skill.
Background: The role of lactate in the developing brain is controversial. Neonatal studies have identified lactate in the normally developing preterm brain using proton Magnetic Resonance Spectroscopy (1HMRS). This is a variant of MRI, which non invasively analyses the metabolic profile of tissue. Fetal 1H-MRS studies are limited. However, the presence of lactate in the normally developing fetal brain has not previously been reported. Methods: 19 women with appropriately grown (AGA) fetuses 23–37+5 weeks gestation (GA) (median 29) and 15 pregnancies with Intrauterine Growth Restriction 22–34+1 weeks GA (median 28) were scanned using a 1.5T MR system. Conventional imaging was obtained followed by spectral acquisition from the fetal brain with a PRESS sequence at three echo times. Spectral analysis was performed using JMRUI software. Signals were summed, spectra phased and referenced to the water peak and peaks identified by chemical shift. Results: 59 spectral acquisitions were analysable. N-acetylaspartate, choline, creatine and Myo-inositol were identified in all fetuses. Lactate was identified in 5 AGA fetuses (23–37+5 weeks GA median 26+6) and 2 IUGR fetuses (29+1, 30 weeks GA). Conclusions: Lactate has been detected in the fetal brain using 1H-MRS in case reports of IUGR and was proposed to be due to hypoxia and anaerobic metabolism. However, this is the first study to identify lactate in the normally developing fetal brain. The role of and detection of lactate therefore remains obscure. Lactate may play a role in brain development, serving as fuel as well having a role in myelin synthesis. However, it is not present in all fetuses. The detection of lactate in both IUGR and AGA fetuses implies its presence is not a specific marker of hypoxia.
O903 Women living with HIV/AIDS in Bangladesh
O902 Emergency peripartum hysterectomy in a tertiary hospital of mainland China: 10 years review
Background: The Gambia is a small West African Country with high perinatal and maternal mortality, despite many years’ efforts to improve services. Antenatal care attendance is relatively high (90%), but most of deliveries are either at home, with or without trained traditional birth assistants, or in a facility with basic services. Only thrree to four institutions can perform emergency obstatric care. Until recently, the midwives, mostly male, were the backbone of the prodfessional health care system. Method: Since 1993, Norwegian researchers have collaborated with the Departement of State for health in building capacity in maternal and reproductive health research. The method has been to recruit Gambian nurse-midvives for a two year masters training, including research thesis. The thematic areas have been: Prevalence and care for infertility, maternal mortality causes and care, maternal morbidity and its association with stillbirths, neonatal morbidity and mortality, reasons for preference for home delivery, willingness to have a HIV test in antenatal care, the cost of maternal care, male
X. Su, Y. Wang, H. Liu. Guangzhou Obstetric and Gynecology Institute, Obstetric Critical Care Center of GuangZhou, The Third Affiliated Hospital of Guangzhou Medical College, Guangzhou, China Objectives: To review 10 years’ experience and to estimate the incidence, indications and high risk factors associated with emergency peripartum hysterectomy (EPH). Materials and Methods: A retrospective case control study. All cases who performed EPH in Obstetric Critical Care Center of GuangZhou, from 1 January 1999 to 30 December 2008. The same number postpartum hemorrhage patients who were not perform EPH were randomly carried out as control group. Demographic data and clinical details including gestational age, mode of delivery, indication and type of hysterectomy, blood loss and
N. Sultana1 , N. Begum2 , S. Badiuzzaman3 . 1 Dhaka National Medical College, 2 Asher alo, 3 Mukto Akash In Bangladesh persons with HIV and AIDS are increasing day by day. Increasing number of women with HIV is being identified. This observational study was conducted among 209 women infected with HIV. Objectives were to assess their health status and to evaluate their social status. They are the members of two organizations working throughout the country who provide them all sorts of supports. All of them are married and with their family members. Most of them were infected through sexual transmission and a very few percentage through unscreened blood transfusion. Gastroenteritis, fungal skin infection, tuberculosis, recurrent respiratory tract infection are usual opportunistic infections. Most of them are getting antiretroviral therapy. Some of them became pregnant and delivered in selected hospitals. They received vocational training from their organization and now working as one of the earning members in the family. Sometimes they are discriminated in getting treatment. Regular health check up, treatment of opportunistic infections and antiretroviral therapy will keep them healthy along with sympathetic attitude towards them and cooperation instead of stigmatization. O904 Capacity building in maternal health research in an African country – 15 years of experience J. Sundby, M. Cham