International Journal of Women’s Health and Reproduction Sciences
Volume:12 Issue: 4, Oct 2024

Women’s satisfaction with their childbirth experience is crucial in determining their likelihood of undergoing a cesarean section (CS) in future pregnancies. However, there is a significant gap in investigating the effectiveness of maternity care methods during childbirth on women’s satisfaction. This systematic review and meta-analysis aimed to fill this gap by assessing the impact of care methods on women’s satisfaction with the childbirth experience.

We conducted an extensive literature search using electronic databases such as Medline, Embase, Scopus, CINAHL, ProQuest, Cochrane library, Web of Science, Google Scholar, PubMed, SID and Magiran from 1990 to June 2023. Studies were included if they were published in English, examined the effect of childbirth care interventions on women’s satisfaction, and reported sufficient data to calculate the mean difference or standardized mean difference. The quality of the studies was assessed using the Cochran’s risk of bias tool.

Our search yielded 9 relevant studies with moderate quality. These interventions were categorized into three types as follows: continuous care, respectful care, and care based on effective communication. The meta-analysis revealed that communication-based care methods significantly improved women’s satisfaction with the childbirth experience (mean difference [MD]: 4.73; 95% CI: 1.35 to 8.11; P = 0.001) and overall childbirth experience (MD: 11.04; 95% CI: -4.34 to 26.42; P = 0.001). The heterogeneity among the studies was high (I2 = 98%).

Our findings suggested that the methods of childbirth care play a substantial role in creating a pleasant experience and improving women’s satisfaction. However, more studies with robust methodology and standardized instruments are required to determine the efficacy of such care in diverse cultural contexts, particularly in countries with high CS rates. Moreover, healthcare providers and policymakers must prioritize communicative dignity-based care during childbirth to enhance women’s experiences and reduce the likelihood of CS.

This study aimed to determine the impact of COVID-19 on the menstrual cycle of Saudi females in Jeddah City.

In this cross-sectional study, we conducted a total of 421 online surveys and phone call interviews with participants between 19 and 45 years of age, living in Jeddah City, Saudi Arabia, who were not pregnant, and had no gynecological problems or abnormalities. Interviews and surveys were conducted between January to April 2022, and the data were analyzed using SPSS version 23.

Most responders were single and had a normal body mass index (BMI). During the COVID-19 pandemic, the majority (75.8%) did not have heavy, unpleasant periods (54.6%), or missed periods (54.6%, 78.1%, respectively). The majority reported changes observed in terms of premenstrual symptoms (PMS) (61.5%), and libido/sex drive remained unchanged for most (88.1%). Of those who reported heavy periods (n=125), 18.4% (n=23) reported changes. Of the 239 females who did not experience pain before COVID-19, nine (3.8%) reported experiencing it during the pandemic.

There were significant changes in the menstrual period of women in terms of bleeding, heavy and painful periods, and small differences in psychological challenges during the COVID-19 pandemic.

This study aims to analyze the effects of three types of triggers— human chorionic gonadotropin (hCG), GnRH-a, or a combination of them (dual)—on the quality of oocytes, embryos, and ovarian hyper-stimulation syndrome (OHSS) in the ICSI cycle.

A prospective case-control study was conducted on 320 women referred to Milad IVF Center, Mashhad, Iran, between May 2016 and June 2019. All the participants underwent an antagonist protocol and were classified according to the trigger type into three groups: 118 patients in the GnRH-a group, 49 in the hCG group, and 153 in a dual group. The outcome measures included the number of metaphase I and metaphase II oocytes, germinal vesicle (GV) oocytes, high-quality embryos, and the rate of OHSS.

The three groups did not exhibit statistically significant differences concerning the quantities of retrieved oocytes: M II oocytes, M I oocytes, GV oocytes, and embryos. The dual trigger method resulted in significantly higher embryo quality (P=0.017). In comparison to dual and GnRH-a group triggers, it was observed that women administered with the hCG group trigger displayed an increased occurrence of OHSS, and the number of severe OHSS in the dual trigger was higher than in the GnRH-a and hCG groups.

The GnRH agonist alone and the dual trigger can be as effective as the hCG trigger. A GnRH agonist is preferable in high-risk patients. Therefore, it is imperative to administer the treatment based on the patient’s status.

Hot flush (HF) is a common menopausal symptom and can cause dysfunction in different aspects of living. Due to the concerns about hormonal treatment, non-medical methods, including acupuncture, are suggested for managing HFs. This study aimed to assess the effect of acupuncture on HF episodes and sleep quality in menopausal women.

This single-arm clinical trial was performed on 26 menopausal women who were referred to the gynecologic clinic of a tertiary hospital in Mashhad, Iran between December 2018 and December 2019. The menopausal state was documented based on hormonal tests. Participants underwent acupuncture 3 times a week (7 acupuncture points based on traditional Korean medicine) for 4 weeks. The duration of each session was 20 min. Pittsburgh Sleep Quality Index (PSQI) was filled for each participant at baseline, at the end of the intervention, and after 6 and 12 weeks of follow-up.

The mean age of participants was 51.96 ± 3.53. Moderate and low knowledge about menopause were reported in 50% and 34.6% of the participants, respectively. Reduced spousal interest was reported by 15.4% of the participants. Acupuncture significantly improved HFs, sleep disorders and sleep quality, and sleep latency subscales of PSQI (P<0.05).

Acupuncture could reduce HFs and improve sleep quality in menopausal women. The effects of acupuncture with medical interventions should be evaluated in future studies.

Because of the higher frequency of dystocic labor in nulliparous pregnant women, a supplementary test is highly important for predicting the probability of the cesarean intervention. The aim of this study was to evaluate the correlation between the amniotic fluid lactate (AFL) level and the outcome of delivery in nulliparous term pregnant women referring with the complaint of the spontaneous rupture of membranes.

Nulliparous women with term pregnancies and single cephalic presentation, presenting with the spontaneous rupture of membranes and active phase of labor, were enrolled in this study. The AFL was evaluated by a portable device. In addition, the partogram curve, labor progression, and delivery method were recorded for each patient. Finally, the association between the need for cesarean delivery and the AFL level was investigated as well.

In general, 200 nulliparous pregnant women were enrolled in this study. The mean age of women and the mean AFL were 29.12±7.54 years and 7.32±3.63 mmol/L, respectively. Among 144 patients with AFL below 10.1 mmol/L, 33 patients (22.9%) had a cesarean delivery. Further, among 56 patients with AFL above 10.1 mmol/L, 42 patients (75%) had a cesarean delivery (P<0.001). Eventually, an AFL level higher than 10.1 mmol/L in predicting the cesarean section had a sensitivity of 85.6% and a specificity of 82.7%.

Amniotic lactate levels >10.1 mmol/L in nulliparous women with single-term pregnancy can be used as a marker for predicting cesarean delivery.

Changes in maternal hemoglobin during pregnancy affect preterm delivery and liver birth weight. The aim of this study was to investigate the relation between the second and third trimester hemoglobin levels and the incidence of live birth weight and preterm delivery.

Six hundred patients at Milad hospital in 2011 were evaluated in this study. The second and third trimester hemoglobin levels were measured, in addition to investigating the relationship between the maternal hemoglobin level and the incidence rate of low birth weight and preterm delivery. Finally, the relation between the second and third trimester hemoglobin levels and education, job, history of abortion, and the use of calcium, folic acid, iron, and multivitamin pills was evaluated as well.

The results indicated that the second trimester maternal hemoglobin levels were high in patients with preterm delivery and low birth weight. The relative risk of preterm delivery in the second trimester of pregnancy was 1.89 times higher in the high hemoglobin group compared to the normal hemoglobin group (CI = 1.15-3.01), and it was 1.16 times higher in the third trimester. Based on the results, the relative risk of low birth weight in the high hemoglobin group was 2.7 times the normal one (CI = 1.15-5.01), and it was 1.03 higher in the third trimester.

In general, high hemoglobin, especially in the second trimester, is associated with a higher risk of subsequent preterm delivery and low birth weight. Hence, it is recommended that women with high hemoglobin levels in their second trimester should be check up timely to reduce the undesirable effects of pregnancy

Synchronized endometrial and ovarian cancer (SEOC) is a condition in which there is both primary endometrial and primary ovarian cancer at the same time in a patient. These tumors have a better prognosis than metastatic ones. Most of them are diagnosed in the early stages and are low-grade tumors. So differentiation of this kind of rare tumor from others is essential. No adjuvant chemotherapy seems to be reasonable in cases with low-grade tumors both in endometrioid and non-endometrioid types. High-grades tumors have been described less, but, in some studies, genetic mutations were found in these tumors, which have been the basis of targeted therapy after surgery.

In this report, two rare non-endometrioid types of SEOC cases are discussed. The first case is a low-grade papillary serous carcinoma of the ovary and uterus endometrium. In contrast, the second case is a clear cell carcinoma of the ovary and endometrioid adenocarcinoma of the uterus. We also review the literature in this field.

We conclude that in these cases, chemotherapy with routine regimens does not seem to be helpful in early stages with low-grade tumors. Also, in high-grade tumors, targeted therapy may be more effective than adjuvant chemotherapy.