International Journal of Research and Reports in Gynaecology

Exploring Maternal Biomarkers and Risk Factors in Preeclampsia: Insights from a Ghanaian Case-control Study

2024-03-01T11:02:56+00:00

Aims: The involvement of maternal sociodemographic, obstetric, clinical, anthropometric and biochemical variables in preeclampsia has been demonstrated in previous studies. However, there are intra- and inter-population variabilities in study findings due to differences in genetic and environmental factors. This requires population-specific studies to aid the formulation of local protocols for the early detection and management of preeclampsia.

Study Design: This was a case-control study

Place and Duration of Study: The study was conducted at the Bolgatanga Regional Hospital between January and December 2022. The women were aged between 16 and 41 years and were receiving antenatal care at the hospital.

Aim of Work: The current study sought to determine variations in maternal sociodemographic, clinical, obstetric and biochemical characteristics in preeclampsia. To achieve this, women with and without preeclampsia were recruited and compared.

Methodology: The study included 100 and 150 pregnant women with and without preeclampsia respectively. Sociodemographic, birth outcomes and obstetric data were collected from participants’ medical records. Venous and placental blood samples were collected at delivery and analyzed for biochemical variables and malaria parasites.

Results: The results showed that the maternal and gestational ages did not differ between the pregnant women with and without preeclampsia. However, caesarean delivery (ꭓ2=14.275, P<0.001), preterm birth (ꭓ2=12.209, P=0.001) and .placental malaria (ꭓ2=5.335, P=0.032) were associated with preeclampsia. In addition, maternal body mass index and lipid variables such as total cholesterol, and LDL cholesterol were significantly higher in preeclampsia. The study also observed higher serum levels of aspartate and alanine aminotransferases in preeclampsia. Moreover, serum creatinine, blood urea nitrogen, urea and uric acid levels were also higher in preeclampsia. However, preeclampsia was characterized by lower serum HDL cholesterol as well as a lower estimated glomerular filtration rate.

Conclusion: Maternal anthropometric, obstetric and clinical variables are associated with preeclampsia. In addition, there are variations in serum lipids and renal and hepatic variables between preeclampsia and normotensive pregnancy. These findings are useful for assessing the risk of preeclampsia in the local population.

Epidemiological Trends, Clinical Characteristics and Outcomes of Ovarian Germ Cell Tumours at a Tertiary Hospital in Port Harcourt, Southern Nigeria

2024-03-02T10:31:26+00:00

Background: Ovarian germ cell tumours originate from the germ cell of the ovary. They are usually benign tumours, but occasionally can be malignant. The tumours are rare and commonly seen in young women.

Aim: To determine the prevalence of ovarian germ cell tumours at the University of Port Harcourt Teaching Hospital (UPTH).

Materials and Methods: This was a retrospective study of all cases of ovarian germ cell tumours managed at UPTH from 1st January 2013 to 31st December 2022. The case notes of the patients were retrieved, and data on socio-demographic characteristics, surgical options and management outcome, and the histopathology report was extracted and analysed.

Results: There was a total of 5,322 gynaecological admissions over the study period, 515 of these admissions were ovarian tumours. There were 68 cases of ovarian germ cell tumours and of these, 61 patients’ case records were retrieved, giving the case retrieval rate of 89.7%. The prevalence of ovarian germ cell tumour was 13.2% and accounted for 1.3% of all the gynaecological admissions. The mean age of the patients was 27.15±7.60 years and the peak age of the disease was between 20 and 29 years which was 26 (42.6%) of the cases. The disease was highest amongst nulliparous women, 44 (72.1%). The most frequent presenting complaints were abdominal pain, 28 (45.9%) and abdominal swelling, 23 (37.7%). The condition involved the left ovary in 21 (34.4%) cases and the right in 20 (32.8%) cases. Twenty (32.8%) of cases involved both ovaries. Only 5 (8.2%) cases were malignant, while mature cystic teratoma accounted for 56 (91.8%) cases. The malignant variants were the immature cystic teratoma and yolk sac tumour, which accounted for 4 (6.6%) and 1 (1.6%) respectively.

Conclusion: The mature cystic teratomas were the commonest germ cell tumour seen in our environment and the most frequent presenting complaint was abdominal pain. It is important to emphasize that doctors should have a very high index of suspicion, whenever women present with recurrent gastrointestinal symptoms.

Prevalence of High-risk HPV Infection in Women Presenting with Chronic Leucorrhoea at Kenyatta National Hospital, Nairobi City County, Kenya

2024-03-14T09:33:25+00:00

Background: Chronic leucorrhoea is the most common symptom caused by infections of the vagina itself or infections/inflammation of the cervix. These inflammations are mostly associated with Candida spp, the parasite Trichomonas vaginalis infection, and the human papillomavirus. Oncogenic HPV sub-types 16,18,31,33 and 45 have been greatly associated and contributed to nearly 70% of all cervical cancers. HPV infections may clear within a period of up to 2 years. However, for every 1 million women infected with the virus, approximately 10% (100,000) will develop cervical dysplasia. Persistent infections with high-risk HPV lead to chronic inflammation through various mechanisms. This inflammation induces oxidative stress on the infected host cells thus leading to the release of molecules that may cause cellular damage e.g. white, creamy discharge that is known as leucorrhoea.

Objective: This study aimed to investigate the prevalence of high-risk HPV infection in women presenting with chronic leucorrhoea at Kenyatta National Hospital, Nairobi City County in the Gynecology and Obstetrics department.

Study Design: The study adopted a prospective cross-sectional design.

Place and Duration of Study: Department of Gynecology and Obstetrics Kenyatta National Hospital between October and December 2023.

Methodology: The study included 107 women presenting with chronic leucorrhoea aged 18 years and above who were purposely sampled and screened for high-risk HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68 and 73 using real-time PCR.

Results: Among the 107 women in this study, 38 (35.5%) tested positive for high-risk HPV strain whereas 69 (64.5%) tested negative. The highest positives were observed in HPV 16 (42.1%), then other hrHPV (36.8%), and finally HPV 18 at 21.0% Out of all the risk factors analyzed (age, history of substance abuse, number of lifetime sexual partners, age at sexual debut, marital status, level of education, status of income, and choice of family planning) none was found to have a statistically significant association with HPV infection.

Conclusion: The prevalence of high-risk HPV infection in women presenting with chronic leucorrhoea was 35.5% in this study with genotype 16 being the most prevalent. Of all the risk factors analyzed, none had a statistically significant association with high-risk HPV infection.

An Appraisal of the Quality of Life of Gynaecological Cancer Patients at a Teaching Hospital in Southern Nigeria

2024-04-17T13:24:42+00:00

Background: As newer treatment modalities improve survival; quality of life (QoL) issues takes on increasing importance for survivors. Adequate knowledge is required for psychosocial interventions and designing programmes aimed at improving the QoL of cancer patients.

Objectives: To assess the QoL and its association with socio-demographic characteristics and disease-related variables among gynaecological cancer patients.

Methods: A prospective cross-sectional study was carried out between January 1, and December 31, 2023, among gynaecological cancer patients. A semi-structured questionnaire was used to obtain socio-demographic, reproductive, and clinical characteristics. The European Organization for Research and Treatment of Cancer QoL Score 30 (EORTC QLQ-C30) version 3 was used to evaluate their perceptions about QoL. The QoL domains, socio-demographic and clinical variables were analyzed with SPSS 25. The association between socio-demographic and clinical factors with QoL was analyzed using one-way ANOVA. P value of ≤ 0.05 was considered significant.

Results: The mean age was 55.29±10.77 years, only 26 (53.1%) have had a pap test. Cervical cancer was the most prevalent gynaecological cancer 31 (63.2%), many 27 (55.1%) of them presented with stage III disease. The mean QoL score was 68.20±23.61. Respondents had good level of physical (81.77 ±16.43), cognitive (78.91 ±25.18), and social functioning (71.43 ±27.85) with high mean scores ≥ 66.7 and an average level of role (66.67±24.76) and emotional functioning (64.79 ±26.53) with mean score between 33.3-66.6. The mean pain score was 43.88±35.95. The major problem experienced was financial difficulties (72.11±33.57). A significant association was observed between QoL and age (p=0.027), occupational status (p=0.024), type of cancer (p=0.001), stage of cancer (p=0.007), length of diagnosis (p=0.033) and number of chemotherapies received (p=0.001).

Conclusions: As cancer incidence is increasing and post treatment survival is improving among cancer patients, the focus is now on their quality of life.

Hysteroscopic Adhesiolysis for Intra-Uterine Adhesions: Implications and Limitations in a Low Resource Setting

2024-02-01T10:00:27+00:00

Background: The advent of hysteroscopy has radically changed the treatment modality for intra-uterine adhesion (IUA) which is a challenge for women of reproductive age, causing menstrual abnormalities and infertility and occurring in about 1.5% of the general population. Hysteroscopic techniques are now considered the gold standard for the treatment of IUA but it is unfortunately neither readily accessible nor affordable in resource poor settings.

Aim: To present the efficacy of this treatment modality and advocate for its popularization in resource poor settings.

Case Report: A 38-year-old housewife, P2⁺¹(2 alive, 2 previous caesarean sections), presented with features of IUA and 6 months amenorrhoea following dilatation and curettage (D&C) for a blighted ovum. She had hysteroscopic adhesiolysis, Foleys catheter insertion and hormonal therapy. Resumption of menstruation occurred within one month of the procedure and post operative investigation results suggests a capacious uterine cavity.

Conclusion: Hysteroscopy is the way forward in the treatment of IUAs instead of the traditional method of blind D&C but advocacy is needed to bring it within the reach of women in resource poor settings.