The latest medical research on Obstetrics And Gynecology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about obstetrics and gynecology gathered by our medical AI research bot.

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Capsule robot for gut microbiota sampling using shape memory alloy spring.

Int J Med

Human gut microbiota can provide lifelong health information and even influence mood and behaviour. We currently lack the tools to obtain a microbial sample, directly from the small intestine, without contamination.

Shape memory alloy springs are used in concentric configuration to develop an axial actuator. A novel design of sampling mechanism is fabricated for collecting the sample from the gut. Storage chamber (500 µl) is used to protect the sample from downstream contamination.

The developed actuator occupies a small space (5 × Ø5.75 mm) and produces sufficient output force (1.75 N) to operate the sampling mechanism. A non-invasive capsule robot was tested ex vivo on the animal intestine, and it captured an average of 134 µl content which was sufficient for microbiome assessment.

Laboratory testing revealed that the collected sample had an amino acid signature indicative of microbiota, mucus and digesta, which provided a proof of concept for the proposed design.

Deep learning-based X-ray inpainting for improving spinal 2D-3D registration.

Int J Med

2D-3D registration is challenging in the presence of implant projections on intraoperative images, which can limit the registration capture range. Here we investigate the use of deep-learning-based inpainting for removing implant projections from the X-rays to improve the registration performance.

We trained deep-learning based inpainting models that can fill in the implant projections on X-rays. Clinical datasets were collected to evaluate the inpainting based on six image similarity measures. The effect of X-ray inpainting on capture range of 2D-3D registration was also evaluated.

The X-ray inpainting significantly improved the similarity between the inpainted images and the ground truth. When applying inpainting before the 2D-3D registration process, we demonstrated significant recovery of the capture range by up to 85%.

Applying deep-learning-based inpainting on X-ray images masked by implants can markedly improve the capture range of the associated 2D-3D registration task. This article is protected by copyright. All rights reserved.

Automatic Segmentation of Temporal Bone Structures from Clinical Conventional CT Using a CNN Approach.

Int J Med

Automatic segmentation of temporal bone structures from patients' conventional CT data plays an important role in the image-guided cochlear implant surgery. Existing convolutional neural network approaches have difficulties in segmenting such small tubular structures.

We propose a light-weight 3D CNN referred to as W-Net to achieve multi-objective segmentation of temporal bone structures including the cochlear labyrinth, ossicular chain and facial nerve from conventional temporal bone CT images. Data augmentation with morphological enhancement is proposed to increase the segmentation accuracy of small tubular structures. Evaluation against the state-of-the-art methods is performed.

Our method achieved mean Dice similarity coefficients (DSCs) of 0.90, 0.85 and 0.77 for the cochlear labyrinth, ossicular chain and facial nerve, respectively. These results were also close to the DSCs between human expert annotators (0.91, 0.91, 0.72).

Our method achieves human-level accuracy in the segmentation of the cochlear labyrinth, ossicular chain and facial nerve. This article is protected by copyright. All rights reserved.

Competing-risks model for prediction of small-for-gestational-age neonates from estimated fetal weight at 19-24 weeks' gestation.

Ultrasound in Obstetrics and Gynecology

To develop further a new competing risks model for the prediction of small for gestational age (SGA) neonates, by including second trimester ultrasonographic estimated fetal weight (EFW).

This is a prospective observational study in 96,678 women with singleton pregnancies undergoing routine ultrasound examination at 19 - 24 weeks' gestation. All pregnancies had ultrasound biometry assessment and EFW was calculated according to the Hadlock formula. We refitted in this large dataset a previously described competing risks model for the joint distribution of gestational age at delivery (GA) and birth weight Z score (Z), according to maternal demographic characteristics and medical history, to obtain the prior distribution. The continuous likelihood of the EFW was fitted conditionally to GA and Z and modified the prior distribution, according to Bayes theorem, to obtain individualized distribution for GA and Z and therefore patient specific risks for any cut-offs for Z and GA. We assessed the discrimination ability of the model for predicting SGA with, without or independently of preeclampsia (PE) occurrence. A calibration study was carried out. Performance of screening was evaluated for SGA defined according to the Fetal Medicine Foundation (FMF) birth weight charts.

The distribution of EFW, conditional to both GA and Z, was best described by a regression model. For earlier gestations the association between EFW and birth weight was steeper. The prediction of SGA by maternal factors and EFW improved for increasing degree of prematurity and higher severity of smallness but not for co-existence of PE. Screening by maternal factors predicted 31%, 34% and 39% of SGA neonates with birth weight <10th percentile delivered at ≥37, <37 and <30 weeks' gestation, at 10% false positive rate, and after addition of EFW these rates increased to 38%, 43% and 59%, respectively; the respective rates for birth weight <3rd percentile were 43%, 50% and 64%. The addition of EFW improved the calibration of the model.

In the competing risks model for prediction of SGA the performance of screening by maternal characteristics and medical history is improved by the addition of second trimester EFW. This article is protected by copyright. All rights reserved.

A Novel Manipulator with Needle Insertion Forces Feedback for Robot-Assisted Lumbar Puncture.

Int J Med

The use of lumbar puncture for pediatric diagnosis and treatment, such as cerebrospinal fluid sampling and intracranial pressure measurements, is s...

Implementation of robot-assisted total mesorectal excision by multiple surgeons in a large teaching hospital: morbidity, long-term oncological and functional outcome.

Int J Med

Robot-assisted total mesorectal excision (TME) might offer benefits in less morbidity, better functional and long-term outcome over laparoscopic TME. However its implementation is often described by large single surgeon series using surrogate short-term outcome.

All consecutive patients undergoing robot-assisted TME for rectal cancer during implementation between May 2015 and December 2019 performed by five surgeons in a single centre were included. Outcomes included local recurrence rate at 3 years, conversion rate, circumferential resection margin (CRM) positivity rate, 30-day postoperative morbidity, and outcomes of low anterior resection syndrome (LARS) questionnaires.

In 105 robot-assisted TME, local recurrence rate at 3 years was 7.4%, conversion to open surgery rate was 8.6%, CRM positivity rate was 5.7% and, 73.3% had good quality specimen, postoperative morbidity rate was 47.6% and anastomotic leakage rate was 9.0%. Incidence of major low anterior resection syndrome (LARS) was 55.3%.

Results of this study described acceptable morbidity, functional and long-term outcome during implementation of robotic TME for rectal cancer by multiple surgeons in a single centre. This article is protected by copyright. All rights reserved.

Robot-assisted percutaneous vertebroplasty under local anesthesia for osteoporotic vertebral compression fractures: a retrospective, clinical, nonrandomized, controlled study.

Int J Med

A retrospective, clinical, nonrandomized, controlled study.

To evaluate the application of a new spinal navigation robot on percutaneous vertebroplasty under local anesthesia.

The result of inserting the puncture needle into the simulated pedicle was observed in vitro. 30 patients with thoracolumbar fractures were enrolled. The basic data, operation-related data, and clinical effect scores were recorded. The learning curve of robot-guided surgery was analyzed.

The maximum yaw angle of the puncture needle implanting into the simulated pedicle is 0.5 °. The operation time (33.93 ± 5.97 min vs 53.75 ± 14.08 min, P = 0.000) and the average X-ray exposure time (31.43 ± 4.93 s vs 54.69 ± 2.15 s, P = 0.000) was significantly less in the robot group. The surgeons quickly mastered the technique of robot-guided pedicle puncture after three surgeries.

Robot-assisted percutaneous vertebroplasty could performed under local anesthesia with the new robot. This article is protected by copyright. All rights reserved.

Evaluating the risks and benefits of ketorolac in transoral robotic surgery.

Journal of Robotic Surgery

Transoral Robotic Surgery (TORS) is increasingly used for oropharyngeal neoplasms and obstructive sleep apnea. Post-operative pain and bleeding rem...

Magnitude and Determinants of the Late Request for Safe Abortion Care Among Women Seeking Abortion Care at a Tertiary Referral Hospital in Ethiopia: A Cross-Sectional Study.

International Journal of Epidemiology

Second-trimester abortions disproportionately contribute to the increased medical cost, maternal morbidity, and mortality compared to the first trimester. Therefore, the aim of the current study was to determine the magnitude and determinants of late presentation for safe abortion care at a tertiary hospital in Ethiopia.

We conducted a cross-sectional study among pregnant women who requested safe abortion care from January 2019 to April 2020. Participants were selected using systematic sampling and data were collected using the interviewer-administered questionnaire. P-value adjusted odds ratios (AOR) with their 95% confidence interval (CI) were used to determine the association between variables.

The prevalence of second-trimester abortion was 53.4%. Young age, ≤ 19 years (AOR= 6.37, 95% CI=1.84-22.06), decision ambivalence (AOR=5.64, 95% CI=1.71-18.61), delay to suspect pregnancy (AOR= 8.56, 95% CI=2.11-34.57), delay to diagnose pregnancy (AOR=3.83, 95% CI=1.51-9.75), lack of awareness on pregnancy signs and symptoms (AOR=4.22, 95% CI=1.59-11.23), delay to get the service (AOR =4.43, 95% CI=1.43-13.67), and lack of information where to get the abortion service (AOR=3.90, 95% CI=1.53-9.96) were significantly associated with presentation in second trimester.

More than half of women who request safe abortion at Saint Paul's Hospital Millennium Medical College do so in the second trimester. Young age, delay in diagnosis of pregnancy, delayed decision, and lack of information where to get service were contributing factors. Therefore, comprehensive adolescent sexuality education, increasing access to contraception, and safe abortion service including self-care interventions are very imperative to avert late gestation abortion and its consequences.

Knowledge, Attitude, and Practice on Cervical Cancer Screening and Associated Factors Among Women Aged 15-49 Years in Adigrat Town, Northern Ethiopia, 2019: A Community-Based Cross-Sectional Study.

International Journal of Epidemiology

Cervical cancer, mainly attributed to persistent infection with a high-risk oncogenic human papillomavirus (HPV), is one of the most common types of women's cancer globally, with more than 90% of new cases occurring in developing and resource-limited countries. In Ethiopia, cervical cancer ranks as the most frequent cancer among women and cause for 4732 deaths annually.

To assess knowledge, attitude, practice towards screening on cervical cancer and associated factors among women aged 15-49 years in Adigrat town, northern Tigray Ethiopia.

A community based quantitative study design was conducted among 617 samples in Adigrat town, northern Tigray Ethiopia. Data were collected using a structured, semi-structured, and pre-tested questionnaire. Associations between dependent and independent variables were tested using logistic regression with the assumptions of p-values <0.05 and confidence interval 95% and considered to be statistically significant.

This study indicated that 46.4%, 53.3%, 38.1% of participants had knowledge, positive attitude, and screened on cervical cancer, respectively. Diploma and above [AOR=3.7, 95% CI (1.443, 9.433) were significant factors associated with knowledge of cervical cancer screening utilization. Primary school (1-8) [AOR=2.7, 95% CI (1.297, 5.699)], greater than 500 ETB household income [AOR = 4.8, 95% CI (2.783, 8.577)] were significant factors associated with attitude of cervical cancer screening utilization. Secondary school (9-12) [AOR = 3.4, 95% CI (1.565, 7.458)], not knowledgeable of cervical cancer [AOR = 1.8, 95% CI (1.156, 2.698)] were significant factors associated with practice of cervical cancer screening utilization.

Factors like age, educational status, anyone knowing with cervical cancer and ever received cancer information had a significant association with knowledge of cervical cancer screening utilization. Educational status and perceived income of the household had a significant association with an attitude of cervical cancer screening utilization. Educational status perceived income of the household, anyone knowing with cervical cancer, ever received cancer information, and knowledge of cervical cancer screening utilization were predictors of cervical cancer screening practice.

Seroprevalence of Hepatitis B Virus and Associated Factors Among Pregnant Women Attending Antenatal Care in Public Health Facilities in Jigjiga Town, Eastern Ethiopia.

International Journal of Epidemiology

Hepatitis B virus (HBV) remains a major global public health problem affecting millions of people across the world. The risk of developing a chronic hepatitis B virus infection is affected by the age at the time of acquiring infection. For instance, around 95% of these infections are acquired during the perinatal period. Although evidences indicate the wider effects of hepatitis B virus and its negative consequences, there are limited studies and a scarcity of data in Eastern Ethiopia. Therefore, this study was aimed at determining seroprevalence of HBV and associated factors among pregnant women attending antenatal care in the public health facilities of Jigjiga town, Eastern Ethiopia, from March 4 to April 4, 2019.

A facility-based cross-sectional study was employed among pregnant women in the public health facilities of Jigjiga town, Eastern Ethiopia. A total of 589 pregnant women were enrolled in the study using a systematic sampling technique. Data were collected using a pretested interviewer administered questionnaire. Five milliliters of venous blood samples was collected and tested for HBV using ELISA diagnostic test. The collected data were entered in to Epidata version 3.1 and exported to SPSS version 20 for statistical analysis. Descriptive statistics was carried out using frequency tables and summary measures. Multivariable analysis was done to identify the true effects of the selected predictor variables on the outcome variable after controlling for possible confounders. Statistical significance was declared at p-value <0.05.

Overall, 8.5% (95% CI: 6.5-10.7) of the study participants were seropositive for HBsAg. Having any surgical history [AOR = 3.41, 95% CI (1.26-9.24)], family history of HBV [AOR = 4.96, 95% CI (2.11-10.60)], history of sharing sharps [AOR = 2.78, 95% CI (1.13-6.83)] and having multiple sexual partners [AOR = 6.12, 95% CI (2.12-17.64)] were significant predictors of HBV infection.

The seroprevalence of HBV was relatively high in this study area. Having a history of surgery, family history of hepatitis, history of sharing sharps and multiple sexual partners were significantly associated with HBV infection. Therefore, health information dissemination and awareness creation on mode of transmission of HBV are very crucial.

Calcium Consumption During Pregnancy: A Multicenter Study in a Middle-Income Country in Southeast Asia.

International Journal of Epidemiology

To perform a cross-sectional observational study of calcium consumption among pregnant women from multicenter tertiary care hospitals in the middle-income country in Southeast Asia.

A cross-sectional observational study.

The study was conducted in four geographical regions (northern, northeastern, southern, and central) of Thailand. Five participating hospitals consisted of one university hospital in each region and one additional tertiary care hospital in the central region.

A cross-sectional study was performed nationwide from 1st November 2017 to 31st January 2019. All singleton aged 19-40 years were included. Exclusion criteria were any conditions that influenced calcium-containing food consumption. Dietary intake self-records immediately after eating for two working days and one holiday were analyzed via INMUCAL-NV3.0 dietary program.

The 1549 records were obtained. The mean age was 29 ± 5.7 years. Most participants were primigravida (48.6%). The average gestational age was 20.6 ± 8.8 weeks. Mean calcium consumption was 602.4 mg/day (95% CI; 589.2615.6 mg/day) mg/dL. Inadequate calcium consumption prevalence based on the Thai dietary reference intake (less than 800 mg/day) and US Institute of Medicine (less than 1000 mg/day) were 82.0% and 93.4%, respectively.

The mean calcium consumption among pregnant women in the middle-income country in Southeast Asia was 602.4 mg/day (95% CI 589.2-615.6 mg/day). Inadequate calcium consumption of Thai pregnant women prevalence was 82.0% and 93.4% according to Thai dietary reference intake in pregnancy and the US Institute of Medicine.