https://www.clinsurggroup.us/journals/journal-of-gynecological-research-and-obstetrics A Peertechz Open Access Journal en-us 26 Sep, 2025 https://www.clinsurggroup.us/articles/JGRO-11-234.php It has been well-established that as science advances, genetic and inherited conditions that could not have been detected centuries ago will become detectable, and affected individuals will have at least a diagnosis in hopeless situations. Such was very apparent in this case. For decades, the three main chromosomal trisomies, Turner’s syndrome, Fragile X syndrome, and Triple-X syndrome, have been dominant in the medical literature, in relation to prenatal diagnosis. However, with recent advances in prenatal diagnosis, the scientific community is now able to detect and analyze new rare conditions that could not have been detected 50 or more years ago. Rare diseases are often known to be life-threatening and chronic, and on average, it takes four years or more to receive an accurate diagnosis of a rare disease. Most rare diseases currently have no effective treatment. Autosomal dominant (de novo) mutations in the PBX1 gene, which are rare, are known to cause congenital abnormalities of the kidney and urinary tract (CAKUT), with or without extra‐renal abnormalities. We present a rare case of PBX1 disorder, in which an extensive literature search with the search term “PBX1-related disorders in the UK” did not reveal significant local or national publications. 09 Aug, 2025 https://www.clinsurggroup.us/articles/JGRO-11-233.php Background: Mifepristone is a synthetic antagonist of progesterone and glucocorticoid receptors that is sometimes used for the induction of labour. However, because it is licensed as an abortive agent, its safety profile in healthy deliveries may be of concern. Therefore, this study aimed to evaluate the maternal and neonatal safety of mifepristone for the preparation of labour induction. Methods: This was a retrospective cohort study of 105 women with singleton pregnancies who received 600mg mifepristone for preparation for induction of labour between 24 and 42 weeks of gestation in the Department of Gynaecology and Obstetrics of the Klinic Donaustadt, Austria, from April 2017 until March 2022. Maternal, pregnancy, induction, delivery, and foetal characteristics were collected and compared between very preterm (24-31 weeks of gestation, n=10), moderate/late preterm (32-36 weeks of gestation, n = 45), and term (37-42 weeks of gestation, n = 50) groups. Results: The women were aged 31.3±5.6 years, the mean gestational age at delivery was 35.9±3.3 weeks, and all deliveries resulted in a live birth. Fifty-three (50%) of women in the cohort required no other agent for the inductiosn of labour. Spontaneous delivery was possible for 48 (46%) women, 12 (11%) required vacuum delivery, and 45 (43%) Caesarean section. The very preterm group had 100% admission to NICU, the moderate/late preterm group had 43% admission, and the term group had 16% admission (P<0.001). Two women were admitted to the ICU in the term group. Hospital stay in the very preterm group was 57 (32-160) days compared to 10 (1-49) days in the moderate/late preterm group and 4 (2-60) days in the term group (P<0.001). There were no cases of uterine hyperstimulation, abnormal foetal heart rate patterns, neonatal hypoglycaemia, or polysytole. There were two cases of neonatal death after live birth, one in the early preterm group and one in the moderate/late preterm group. Conclusions: This analysis of women and newborn infants who received 600mg mifepristone for induction of labour identified no safety concerns for mother or newborn infant and could be a new strategy to reduce the number of caesarean sections. 02 May, 2025 https://www.clinsurggroup.us/articles/JGRO-11-232.php Background: Patients with high reproductive risk have important risk factors for the development of complications, including maternal death. Rejection of contraceptive methods is influenced by biological, cultural, and social factors. Objective: Identify the main sociocultural and demographic factors associated with not choosing a contraceptive method in women at high reproductive risk. Material and methods: it is an observational, cross-sectional, analytical and prospective study using non-probabilistic sampling of pregnant women with high reproductive risk who were offered contraception through a questionnaire. Results: 75 patients with high reproductive risk (20%) were included, with a mean age of 27 years and 48% identifying as housewives, living in an urban area (66.7%), complete primary schooling (22.67%), Catholic religion (72%), married (57.3%), middle class (72%); alcoholism in 2 patients (2.67%) and 2 other drugs (2.67%); 68% rejected contraception; for personal reasons (76.4%). A significant relationship was found with the Jehovah’s Witness religion (p = 0.018). Conclusion: Rejection of contraception was significantly associated with personal history and religious beliefs, with implications for reproductive health. 01 Apr, 2025 https://www.clinsurggroup.us/articles/JGRO-11-231.php Introduction: Endometriosis is a chronic inflammation that represents one of the most common benign gynecological diseases. It is a condition in which endometrial-like tissue grows outside the uterine cavity, implanting itself in tissues and organs, causing pelvic pain, dysmenorrhea and infertility. The increase in Escherichia coli and bacterial endotoxins are associated with the proliferation of endometriotic lesions by activating inflammatory factors. In the cervicovaginal microbiome, the dominance of Lactobacillus is associated with gynecological and reproductive health. Objective: To perform a synthesis of systematic reviews and meta-analyses published on the association of dysbiosis with the development of endometriosis . Methodology: Systematic literature search in the PubMed, BVS, Scielo and Cochrane library platforms, using the descriptors Dysbiosis OR “microbiota imbalance” OR “vaginal microbiome” OR “gut microbiota” AND Bacterial Vaginosis OR “bacterial vaginosis” OR “Gardnerella vaginalis” OR “vaginal dysbiosis” AND Endometriosis OR “endometriotic lesions” OR “chronic pelvic pain” OR “ectopic endometrium” and their combinations. Results: A total of 383 productions were found in the searched platforms, after selection stages, two articles were selected, both of which are systematic reviews or meta-analyses that met the eligibility criteria. Conclusion: The association between endometriosis and the presence of dysbiosis in samples collected from the intestine, vagina and peritoneal fluid of patients with endometriosis was shown to be significant. 24 Dec, 2024 https://www.clinsurggroup.us/articles/JGRO-10-230.php Prune Belly Syndrome (PBS) is an extremely rare anatomo-radiological syndrome that combines aplasia of the muscles of the anterior wall of the abdomen, dilatations of the urinary tract, and testicular malformations, forming the classic triad of the syndrome. However, up to 75% of patients with PBS present with pulmonary, skeletal, cardiac, and gastrointestinal malformations. We report the case of a male neonate born at term to a mother with no particular pathological history, in whom the clinical examination at birth revealed hypoplasia of the muscles of the anterior abdominal wall and congenital dislocation of the hip. Hypoplasia of the abdominal wall muscles was confirmed by abdominal ultrasound and abdominal CT scan, and cardiac malformations were also found on transthoracic ultrasound. The outcome can vary widely, from stillbirth due to major renal and respiratory dysplasia to a virtually normal child. All this explains the great diversity of opinions on the attitude to adopt when faced with this syndrome. 06 Nov, 2024 https://www.clinsurggroup.us/articles/JGRO-10-229.php Hamman Syndrome is defined as a self-limiting syndrome, characterized by the coexistence of free air in the mediastinum without an identifiable cause or secondary to trauma, intrathoracic infections, or medical procedures. Clinical manifestations commonly present abruptly and consist mainly of substernal chest pain of a pleuritic nature (forced inspiration), dyspnea, facial pain, odynophagia, cough, dysphagia, and others. A case of Hamman syndrome during labor in a 21-year-old woman is presented. 24 Oct, 2024 https://www.clinsurggroup.us/articles/JGRO-10-228.php Purpose: Mild Ovarian Stimulation (MOS) is an effective form of Assisted Reproductive Technology (ART) for Advanced Maternal Age (AMA) women. Taking either Clomiphene (CC) or Letrozole (LTZ) with MOS reduces the amount of gonadotropin that must be used. It has remained uncertain, however, whether LTZ or CC is more effective in combination with MOS. Therefore, we evaluated the choice of combination of either CC or LTZ with MOS and quantified the obtainment of euploid blastocysts for AMA women. Methods: This retrospective study was conducted between January 2020 and April 2021. In this study, we stimulated 286 women with MOS, 153 of these women used CC (CC group) and 133 were given LTZ (LTZ group). All women took either 100 mg of CC or 5 mg of LTZ daily for 7 days between MC 3 and MC 9, and 225 IU of recombinant-FSH were administered on MC 3, MC 5, MC 7, and MC 9. The euploid rates were compared between these two groups. Among them, the women who were ≥ 40 years old were divided into two groups, the CC-O40 group (n = 61) and LTZ-O40 group (n = 54), and the euploid rates were evaluated. Results: For AMA women, the blastocyst formation rate in the LTZ-O40 group (58.5%) was significantly higher than that in the CC-O40 group (46.6%, p < 0.05). The euploid rate in the LTZ group was 53.4%, which was significantly higher than that in the CC group (38.0%, p < 0.05). The AMA euploid rate in the LTZ-O40 group was 40.5%, which also was significantly higher than that in the CC-O40 group (16.7%, p < 0.05). Conclusions: For AMA women, a regimen of LTZ combined with MOS is the most effective ovarian stimulation method for obtaining euploid blastocysts. 29 Aug, 2024 https://www.clinsurggroup.us/articles/JGRO-10-227.php Background: In carriers of reciprocal translocations, gametes with unbalanced chromosomes can be created during the reproductive period, which reduces the reproductive ability of the carriers. The reproductive risk of carriers of reciprocal translocations depends on the length of the translocation segment. The aim of this study was to evaluate the reproductive risk of reciprocal translocations with segments of different lengths for couples carrying these translocations. Methods: Chromosome analysis was performed using the Moorhead and Seabright method. For the exact identification of chromosomes, the standard method of G bands was used. Results: A cytogenetic diagnosis of reciprocal translocations with segments of different lengths was confirmed on 20 couples. Among the examined cases the most frequent (55%) were those with reciprocal translocations having a long translocated segment on one chromosome and a short translocated segment on another non-homologous chromosome. In total 64 pregnancies were conceived among the examined couples with reciprocal translocation. These pregnancies showed a higher risk of miscarriages and congenital anomalies: 59.4% resulted in recurrent miscarriages, 14.1% in stillborn babies, 10.9% in babies with congenital malformations, and 15.6% in normal birth. All three groups of subjects with different types of reciprocal translocations had a high risk for recurrent miscarriages. The three couples with reciprocal translocations had primary infertility. Conclusion: In our study population reciprocal translocations were identified as the main cause of impaired reproductive health in 17 couples and the primary cause of infertility in 3 couples. Among couples with reciprocal translocations involving long and short translocated segments, a higher risk of congenital anomalies and recurrent miscarriages was observed. 05 Aug, 2024 https://www.clinsurggroup.us/articles/JGRO-10-226.php Endometriosis is an inflammatory pathology characterized by the growth of endometrial tissue outside the uterus, resulting in chronic pelvic pain and infertility. As a result, it has been observed that diet can influence the pathophysiology of this disease by attenuating the inflammatory environment. In this context, this study aims to summarize the influence of diet as a complementary therapy for endometriosis. To this end, a narrative review was carried out using the BVS, Embase, and Cochrane databases, including articles available in full in Portuguese, English, and Spanish published in the last 5 years. According to the literature, a diet can have pro-inflammatory properties in patients with endometriosis, such as a diet rich in saturated fatty acids, and anti-inflammatory properties, involving polyunsaturated fatty acids, in order to influence the metabolism of prostaglandins. It is concluded that endometriosis is a chronic inflammatory disease that can be modulated with the adoption of anti-inflammatory dietary habits that can impact women’s quality of life in the long term. 27 Jul, 2024 https://www.clinsurggroup.us/articles/JGRO-10-225.php Background: Pregnancies at advanced ages are increasingly common in society, which represents a concern for the health system, since they are associated with complications and different comorbidities during pregnancy, which can negatively impact its course, due to the occurrence of adverse maternal-fetal events. Therefore, this study aims to summarize the main complications of advanced maternal age and their repercussions. Methods: An integrative review was developed, using the LILACS, MEDLINE, and PubMed databases and the search formula: (“complications”) AND (“pregnancy”) AND (“maternal age”), including articles in Portuguese, English, and Spanish from 2018 to 2023, excluding duplicates and review articles. Results: 484 articles were filtered and, after applying the inclusion and exclusion criteria, 28 articles were selected to compose the study. From them, a higher incidence of gestational diabetes mellitus was evidenced in mothers over 35 years of age due to the progressive depletion of pancreatic β-cell function. In addition, pre-eclampsia was found to be seven times more common in pregnant women aged 40 years than in those under 30 years of age, as the gastro-omental arteries reduce compliance, affecting blood pressure regulation. Conclusion: Therefore, advancing age is related to the emergence of metabolic alterations and cardiovascular diseases that can harm maternal and fetal health, since pregnant women over 35 years of age are more prone to comorbidities that can result in adverse maternal and neonatal outcomes. 15 Mar, 2024 https://www.clinsurggroup.us/articles/JGRO-10-224.php Inflammatory Breast Cancer (IBC) is the most aggressive form of primary breast cancer. IBC has an incidence of approximately 2.5 cases per 100,000 women. Malignant neoplasms arising from burn scars are well-known but rarely encountered. The subject was reviewed in a comprehensive publication that reviewed the literature between 1923 and 2007 and found 412 well-documented cases of squamous cell carcinoma (71%), basal cell carcinoma (12%), melanoma (6%), sarcoma (5%), other neoplasms (4%), squamo-basal cell carcinoma (1%), and squamous cell-melanoma (1%). In 2008, two cases were reported by Losanof, et al. both female, who were diagnosed with advanced breast cancer many years after severe thermal injury to their breasts. Bilateral synchronous or metachronous breast cancer is well-known and documented except for IBC. To our knowledge, our search using Medline and other searches did not reveal any post-burn IBC or bilateral IBC cases reported in the literature that occurred till 2006. There are only 2 cases reported in 2010 and 2016. We report our 3 case reports presented from one patient; who was diagnosed in 2006; a case of post-burn breast cancer, and to our knowledge the first case report of post-burn IBC type and a rare case report of bilateral metachronous IBC. 11 Jan, 2024 https://www.clinsurggroup.us/articles/JGRO-10-223.php Polycystic ovary syndrome is one of the most common hormonal disorders in women of reproductive age, causing alterations in the reproductive, metabolic, and psychological systems. Although its pathophysiology is not fully understood, it is possible to determine the symptoms through genetic, endocrine, and lifestyle factors. The aim of this study was therefore to analyze the association between depression and anxiety in women with PCOS. To this end, a qualitative, descriptive methodological approach was adopted through a literature review in the PubMed, Embase, and VHL databases. The inclusion criteria were: clinical trial articles, randomized or non-randomized, cohort studies, case-control studies, and open access, published in Portuguese, English, and Spanish, between 2018 and 2023 with topics associated with polycystic ovary syndrome, depression, and anxiety. The exclusion criteria were bibliographic and editorial reviews, as well as texts that were not available in full or free of charge. In this context, based on the bibliographic findings, polycystic ovary syndrome is a common disease among women of reproductive age characterized by hyperandrogenism, chronic anovulation, and the presence of polycystic ovaries on ultrasound. Metabolic alterations cause a variety of PCOS symptoms, including chronic anovulation or amenorrhea, infertility, hirsutism, and obesity. In this way, PCOS is related to body dissatisfaction, depression, anxiety, decreased sexual satisfaction, eating disorders, and lower health-related quality of life. In addition, the risk of depression and anxiety increases with prolonged exposure to hyperandrogenism. In addition, people with PCOS are four to seven times more likely to have moderate to severe depressive and anxiety symptoms. Therefore, women with PCOS experience significant social pressure, which maximizes the prevalence of mental disorders associated with the syndrome, such as anxiety and depression. 30 Dec, 2023 https://www.clinsurggroup.us/articles/JGRO-9-222.php Infertility influences 15% of reproductive-aged couples in the world and the same percentage has been counted in Italy. Male and female causes of infertility are identified in 20% - 30% and 20% - 35% of couples, respectively; in 10% - 20% of cases, no cause is found. Until the last decade, a lot of studies have analyzed both modifiable factors (tobacco, alcohol, diet factors, overweight, infections) and non-modifiable factors (parental age, low ovarian reserve, etc.). Probably there is a connection between modifiable and non-modifiable causes of infertility, that together increase the failure of reproduction. This review aims to analyze the influence of the microenvironment in the female genital tract, particularly to highlight the current literature, published in Italy, on reproductive tract microbiome in different anatomical locations, vagina, endometrium, Fallopian tubes, the intestinal microbiome, and the possible interaction between such microbial communities and infertility. Finally, based on the data presented in this review, we try to encourage future perspectives and research directions in Italy. 24 Aug, 2023 https://www.clinsurggroup.us/articles/JGRO-9-221.php Introduction: Breast cancer is the leading neoplasia metastasizing to genital organs. Uterine metastases are seldom reported and those limited to endometrium account for 3.8% of patients with uterine spread. We reported on a woman with breast cancer metastasizing to endometrium and up-date of literature. Presentation of case: In July 2022, a 59 years-old woman with breast cancer was referred to Gynecological consultation due to Positron Emission Tomography showing an enhanced signal to the endometrium. Throughout the four previous years, she underwent bilateral surgery due to metachronous lobular cancers and adjuvant therapies consisting of Letrozole, Exemestane, chemotherapy, and Tamoxifen. In May 2022, bony metastases were found and she shifted to Abemaciclib/Fulvestrant therapy. No gynecological complaints were recorded, and physical examination was uneventful while Transvaginal Ultrasound demonstrated an enhanced endometrial thickness as a unique abnormality. Hysteroscopy showed mucosal thickenings attributed to Tamoxifen-related cysts formation. The biopsy pathology reported stromal infiltration of neoplastic cells staining for Cytokeratins and GATA-3. Negative staining was reported for PAX-8 and CD-10. On these findings, a breast cancer metastasis was established. Four months later the patients died from metastatic brain progression. Discussion: Endometrial metastasis from breast cancer is anecdotal. The case described supports that uterine spread is a late event, often concurrent with extragenital metastases and mostly associated with lobular histology. A hysteroscopic view can be misleading and a careful pathological study is needed for a differential diagnosis against endometrial primitiveness. Conclusion: Endometrial abnormalities in breast cancer patients might be caused by metastasis. The management of these patients is challenging and must be tailored to the clinical background. 08 Feb, 2023 https://www.clinsurggroup.us/articles/JGRO-9-220.php Ovarian Cancer (OC) is the leading cause of gynecologic cancer-related deaths worldwide. The leading risk factors for OC-related death are OC recurrence and the development of chemotherapy resistance. Investigation into molecular differences that distinguish primary from recurrent disease and the role of the tumor microenvironment (TME) in OC progression may help identify therapeutic targets. Gene expression microarray data comparisons between 21 primary and 21 recurrent OC specimens (16 matched pairs) showed significantly increased expression of Matrix Metallopeptidase 1 (MMP1) in the recurrent specimens (p = 0.03). We, therefore, investigated MMP1 expression regulation and how endogenous and exogenous MMP1 expression influences OC cell proliferation, migration/invasion and chemosensitivity. Both endogenous MMP1 knockdown and low levels of exogenous MMP1 increased cell proliferation of the OC cell line, CAOV2 (p < 0.01 and p < 0.001, respectively). Furthermore, CAOV2 cells cultured with low exogenous MMP1 exhibited increased invasion (p = 0.04 and p = 0.002, respectively, for two shRNA-conditioned mediums, shMMP1-1 or shMMP1-2) and faster migration by wound healing assay relative to controls without MMP1 knockdown. CAOV2 MMP1 knockdown cells were also more resistant than controls to carboplatin (p = 0.04) and paclitaxel (p = 0.017). To explore the functions of cancer environmental MMP1 in different cancer cells, 3 OC cell lines (CAOV2, HEYA8 and SKOV3) were tested for their proliferation when cultured under a low MMP1 conditioned medium. Interestingly, while the proliferation was increased in CAOV2 and HEYA8 cells, it was reduced when SKOV3 OC cells were cultured with low exogenous MMP1 (CAOV2: * p = 0.01, HEYA8: **** p = 0.0004, SKOV3: ** p = 0.002). These results likely reflect inherent MMP1 expression variability in OC tissues and cell lines that is at least partly dependent on other endogenous parameters of the TME, including pH, metabolic state, and oxygenation, all of which were found to alter levels of endogenous MMP1. Given the ability of MMP1 to promote oncogenic or tumor-suppressive behaviors, further study will be necessary to better understand how MMP1 contributes to promoting or restraining tumor progression in an individualized manner. 19 Jan, 2023 https://www.clinsurggroup.us/articles/JGRO-9-219.php Siamese or conjoined twins represent a rare but specific malformation occurring in monozygotic and mono-amniotic twin pregnancies. We report a case of xiphopagic conjoined twins and compare the contribution and correlation between ante- and post-mortem imaging for the detailed evaluation of the malformation. Our case highlights the importance of postnatal imaging to better understand this complex type of fetal malformation. 06 Jan, 2023 https://www.clinsurggroup.us/articles/JGRO-9-218.php Severe acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2), the single strain RNA virus, infection causes the global pandemic coronavirus disease 2019 (COVID‐19), in which the immune escape ability of SARS‐CoV‐2 has an important role by inhibiting antiviral innate immunity. Pattern-Recognition Receptors (PRRs), such as Retinoic acid-Inducible Gene I (RIG-I), induce antiviral innate immune responses by sensing viral nucleotides and producing type I interferons. Epidemiological investigation reveals there is sex disaggregation in that males experience more severe symptoms and suffer higher mortality from COVID‐19 than females. This review discusses the different roles of sex hormones in the immune response to SARS‐CoV‐2 infection to explain the mechanism of sex disaggregation and explore novel preventive strategies. 11 Nov, 2022 https://www.clinsurggroup.us/articles/JGRO-8-217.php Background: The purpose of this study is to investigate the effect of an adsorbent-antioxidant vaginal gel, which contains micronized silicon dioxide and antioxidant deflamin, on high-risk human papillomavirus (hr-HPV) clearance within the follow-up periods specified in the guidelines. Methods: In the study, the data of 52 patients infected with hr-HPV using vaginal gel for 3 months and 115 patients who were not using vaginal gel were analyzed retrospectively. Demographic characteristics, Liquid-Based Cytology (LBC) at the time of presentation, colposcopy findings, and cervical biopsy results of both groups were investigated. After the LBC and hr-HPV results were evaluated at the end of the control period, both groups were compared in terms of hr-HPV clearance. The level of statistical significance was taken as 0.05 in all tests. Results: The two groups had similar demographic data, cytological findings, colposcopy findings, and cervical biopsy results (p > 0.05). During similar follow-up periods (13.6 ± 3.2 vs. 14.1 ± 3.4 months; p > 0.05), there was no significant difference in terms of hr-HPV clearance (46.2% vs. 51.3%; p > 0.05). Furthermore, the initial and follow-up cytology results of the patients were similar (p > 0.05). Conclusions: A significant effect of the absorbent antioxidant vaginal gel on hr-HPV clearance at approximately 1-year follow-up could not be demonstrated. 11 Nov, 2022 Background: Cytomegalovirus (CMV) is a rare cause of Immune Thrombocytopenic Purpura (ITP) and even rarer during pregnancy. Case: A 27-year-old pregnant woman presented with severe thrombocytopenia in the latent phase of labor. She was treated with dexamethasone and platelet transfusions and underwent a successful vaginal delivery. The neonate had severe thrombocytopenia as well. Serology assays of the mother revealed CMV seroconversion with a negative Polymerase Chain Reaction (PCR). The neonate had a positive PCR and was treated with Intravenous Immunoglobulin (IVIG), steroids, platelets and Valganciclovir with a good response. The mother’s platelet count normalized three months later. Conclusions: CMV infection should be considered as a potential cause for severe thrombocytopenia during pregnancy and can lead to early detection and treatment for Congenital CMV. 11 Nov, 2022 https://www.clinsurggroup.us/articles/JGRO-8-216.php As pathologists, cytotechnologists, and professors of pathology and cytology, we find ourselves disconcerted because we turn, in disbelief, to an unprecedented situation that could affect patient care and we refer to the exact opposite of that which could be considered in any medical treatise or scientific article from the 20th century. 29 Oct, 2022 https://www.clinsurggroup.us/articles/JGRO-8-214.php Objectives: Endometriosis is a common disease that affects about 10% - 15% of women in their reproductive years worldwide with no curative treatment. The most common symptom of endometriosis is debilitating pelvic/abdominal pain. Current therapeutic options have limited insight into the disease mechanism and include drugs and/or surgery, which may be ineffective over the long term with unwanted side effects. We aimed at establishing a translational rodent endometriosis model that can be used to identify novel therapies. The validity of the model was confirmed by investigating the effect of the clinically-used GnRH agonist, leuprolide. Methods: Endometriosis was induced by a surgical procedure in adult non-pregnant female Sprague Dawley rats in the diestrus or estrus stage (cycle determination by vaginal smear). One group of rats received a subcutaneous injection of leuprolide at 1mg/kg, every 4 weeks. Following the treatment period, we performed a direct assessment of the endometriosis-induced abdominal pain using the Von-Frey method and spontaneous pain using the abdominal licking test. Then, the lesions were excised and measured. Results: Abdominal pain threshold was decreased by more than 2 fold in rats with surgically-induced endometriosis compared to sham rats. Leuprolide treatment significantly increased the threshold force required to elicit a behavioral withdrawal response in rats suffering from endometriosis. The observed pelvic floor mechanical hyperalgesia has not been correlated to the growth of endometriosis lesions. The hormonal cycle at the surgery induction influenced the endometriosis lesions growth. Leuprolide significantly inhibited the growth of endometriosis-like lesions. Conclusions: we have established, based on previously reported rodent models, a model of endometriosis-associated pain that responds to clinically active drugs and can, therefore, be used to identify novel therapies and investigate some of the pathophysiological mechanisms involved in endometriosis. 26 Oct, 2022 https://www.clinsurggroup.us/articles/JGRO-8-213.php Assisted Zona Hatching (AZH) like most add-ons was introduced to In Vitro Fertilization and Embryo transfer (IVF/ET) in the early 1990s, when the live birth rate (LBR) in older women, age 35-39, was only 6%. 26 Oct, 2022 Background: Hysteroscopic surgeries have become the standard treatment for uterine septa, synechiae, submucous myomas and endometrial polyps. It is considered a safe procedure: the incidence of surgical complications, including uterine perforation, is low (0.95% - 2.7%). Uterine rupture secondary to operative hysteroscopy is rare but potentially catastrophic. It can occur both before the onset of labor or during labor, severely compromising fetal and maternal outcomes.  An operative hysteroscopy for retained placenta done one month after a normal vaginal delivery was complicated by a fundal uterine perforation whilst the removal of the abnormal tissue. The perforation was assessed laparoscopically and minimal bleeding was electrocoagulated. The patient was counseled that this complication should not affect future deliveries. In her subsequent pregnancy, an emergency cesarean hysterectomy was performed during advanced labor due to cornua-to-cornua fundal uterine rupture. Conclusion: There are many potential risk factors for uterine rupture in pregnancy. While previous cesarean delivery is the most well-known, prior complex hysteroscopy appears to also be a risk factor. While the exact relative risk is still unclear we feel that patients undergoing hysteroscopy for uterine septum and cases complicated by fundal uterine perforation during hysteroscopy must be informed about the risk of future uterine rupture, both during labor and during pregnancy. Out: We then summarize previous literature regarding hysteroscopy and uterine rupture focusing on risk factors such as surgery for uterine septum, use of electrocautery and uterine perforation. The Time interval between hysteroscopy and pregnancy does not appear to be a risk factor. Precis: Operative hysteroscopy complicated by fundal uterine perforation is a risk factor for uterine rupture both during pregnancy and labor. 15 Sep, 2022 https://www.clinsurggroup.us/articles/JGRO-8-211.php Extravilluos Trophoblast (EVT) is a truly special cell. It has a temporary character and tumor-like behavior and tumor-like appearance, all of which seem to belong to the malignancy field [1,2]. It is also known as intermediate trophoblast, derived from cytotrophoblast [3-5], having formed between the latter and the syncytiotrophoblast. 08 Sep, 2022 https://www.clinsurggroup.us/articles/JGRO-8-210.php Background: The effects of Coronavirus disease 2019 in women during the second trimester of pregnancy and the health of the fetus, remain very poorly explored. This report describes a case in which the normal development of pregnancy was complicated immediately after the patient had experienced COVID-19 at the 21st week of gestation. Specific conditions included critical blood flow in the fetal umbilical artery, fetal growth restriction and hydramnios in the 25th week of gestation. After informed consent, we decided just to wait and interrupted all examinations (CTG, Ultrasound) because of the high risk of severe adverse events at such an early premature birth. The patient finally delivered a healthy boy in the 39th week of gestation. Methods: We performed a histological examination of the placenta and analyzed the placenta for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through molecular and immunohistochemical assays and measured the fetal antibody response in the blood to this infection. Results: In the immunohistochemical examination with antibodies against SARS-CoV-2 a partial positivity in the villious throphoblastic epithel cells could be demonstrated. The PCR swab of the placenta which was obtained was positive for SARS-CoV-2 with a crossing threshold value of 22,8. The histological examination of the placenta showed a Massive Perivillous Fibrinoid Deposition (MPFD) with multiple focal placental infarctions in the intervillious space, intervillious thrombus, and a localized chorangiomatosis. Conclusion: According to many clinical and laboratory findings in this patient, the histopathological features and viral infection of the placenta suggest a prominent role for COVID-19 in this patient’s presentation. This is highlighted by the presence of levels of SARS-CoV-2 RNA. In this patient, an infection with Sars-CoV-2 might have caused the development of the MPFD. These findings suggest that COVID-19 may have contributed to placental dysfunction and fetal growth retardation. Also with a SARS-CoV-2 PCR test with a crossing threshold value of 22,8, it must be assumed that the placenta has been potentially infectious. 29 Aug, 2022 https://www.clinsurggroup.us/articles/JGRO-8-209.php Background: Period poverty, which includes a lack of access to menstrual products, can lead to poor menstrual hygiene by wearing pads or tampons for too long to manage what they have, absorbing menstrual blood with newspapers or dirty clothes, and not washing or washing the vagina with dirty water these unhealthy practices can lead to things like fungal infection, bacterial infection, yeast infection and Urinary Tract Infections (UTIs). Period poverty is a serious issue in Nigeria but is overlooked and understudied. The study assessed the level of period poverty among the respondents and the factors influencing period poverty. Methods: This study adopted a descriptive design to describe the factors associated with period poverty among public secondary school students in Ede, Osun state. A multistage sampling technique was used for the study. Descriptive and bivariate statistics were used to analyze the quantitative data, and the level of significance was α0.05. Results: The mean age was 14.2 ± 3.8 years. 29.8% were from JSS1, 25.3% were from JSS2, 25.0% were from SSS1, and 19.9% were from SSS2. Results revealed that the majority 79.5% experienced intense period poverty, 14.1% were rated average, and 6.4% experienced less intense period poverty. 72.4% had personal factors that can influence period poverty, while 27.6% had personal factors that might not influence period poverty. 70.6% gave responses that show the school having conditions that can contribute to period poverty while 29.4% gave responses that show the school having conditions that would not contribute to period poverty. 76.6% had background factors that could influence Period Poverty, while 23.4% had background factors that might not influence period poverty. Conclusion: Curbing these factors that influence (increase) the rate of period poverty would reduce its effects. 27 Jan, 2022 https://www.clinsurggroup.us/articles/JGRO-8-208.php Pregnancy is a specific and critical period in a woman’s life. Some pregnant women face difficulty when performing effective oral hygiene care due to pregnancy-related vomiting symptoms. A hypersensitive vomit reaction in the third trimester of pregnancy is not frequent and may prevent the dental provider from successfully completing critical clinical stages resulting in poor treatment outcomes. Once pregnant women suffer an unpleasant gag reflex experience in a dental office, they may become phobic, delaying or postponing their dental treatment. The purpose of this article is to report a case of a 32-year-old woman, primigravida in the third trimester of pregnancy (32 weeks), partially edentulous with an exaggerated vomiting reaction, focusing on successful clinical management using a simple but effective table salt technique and proper fixed prosthesis design, as also to discuss the etiology, clinical symptoms and consequences of vomiting associated with late pregnancy during the dental, especially prosthodontics , treatment in such cases. 29 Dec, 2021 https://www.clinsurggroup.us/articles/JGRO-7-206.php Background: Labor is a physiological process during which the fetus, the membranes, the umbilical cord, and the placenta are expelled from the uterus and water delivery has become popular, although its prevalence is unknown, it is supported by healthy women with full-term pregnancies, without complications; although there is insufficient evidence to support or discourage it. Objective : To identify obstetric and neonatal outcomes and complications in women who delivered in water and to compare them with traditional deliveries. Material and methods: It is a retrospective, observational and cross-sectional study, where 2486 women were included from a database of 4223 women assisted from 2004 to 2020 in private hospitals; Of the 2486 patients included, 1025 had a water delivery and 1461 had a conventional delivery, discarding 1737 women who underwent caesarean section from the study. The information obtained from the patients, their data obtained for this study were kept in the anonymity of the patients, where they were analyzed: non-parametric data reported in percentages using Chi-square ; Parametric, perinatal and neonatal data are reported as mean plus Standard Deviation (± SD) and analyzed using Student’s T, using the SPSS version 25 statistical package. Results: A total of 2486 women were included in this study, the birth in 1025 was water delivery (24%) and 1461 was conventional delivery (35%), 1737 caesarean section (41%) were excluded from the study, no difference was observed maternal age; unlike weight, height, body mass index; they were higher in women with water birth compared to conventional. No difference was demonstrated between nulliparous (45.99%) and multiparous (53.86%) when comparing both births in water and conventional; only increase in previous cesarean sections (9.36 vs 6.5%, p = 0.008) and decrease in previous abortions (16.19 vs 20.94%, p = 0.002) in water delivery with the conventional one; complications were not different: administration of oxytocin (3.2 vs 3.1) or postpartum hemorrhage (0.29 vs 0.13) in both deliveries; no differences in first degree perineal tears (21.4 vs 18.5%); Only for the second and third-degree was it greater in conventional delivery than in water delivery (6.6 vs 11.4%, p = 0.00), (0 vs 2.8%) respectively, only 1.9% of deliveries in water that required epidural block ended in delivery conventional. Conclusion : Water birth reduces stress, pain sensation, second and third-degree perineal lacerations and contributes to better newborn outcomes; the selection and inclusion of patients with low-risk pregnancies allow better perinatal results than conventional delivery; but, further studies are required to use it routinely. 24 Dec, 2021 https://www.clinsurggroup.us/articles/JGRO-7-205.php Background: Ovarian germ cell tumors are derived from the primordial germ cells of the ovary, they can be benign or malignant. Non-gestational ovarian choriocarcinoma is extremely rare and aggressive that is of gestational or non-gestational origin, its prevalence is less than 0.6% of all ovarian germ cell tumors. Due to the rarity of the tumor, there is a lack of information on the clinical-pathological characteristics, diagnosis and treatment. Objective: A case of non-gestational ovarian choriocarcinoma and a review of the literature are presented. Clinical case: We present the case of a 20-year-old woman who presented with an acute abdomen, due to abdominal pain and distention, with scant vaginal bleeding and pain on cervical mobilization; An ultrasound was performed with a right annex with a lesion measuring 114x83x79mm and a total volume of 394cc, heterogeneous with linear images inside punctiform and human chorionic beta-gonadotropin levels, elevated 112.337 mUI/mL, the patient underwent an exploratory laparotomy with the finding of an ovarian tumor; performing salpingo-oophorectomy and the histopathological report of the definitive surgical specimen and immunohistochemical study, the diagnosis of non-gestational ovarian choriocarcinoma was made. Conclusion: Non-gestational choriocarcinoma is an extremely rare malignant neoplasm that can present clinically as an acute abdomen and requires differential diagnoses. Management is the combination of surgery and adjuvant chemotherapy, our patient responded. 27 Oct, 2021 https://www.clinsurggroup.us/articles/JGRO-7-204.php Background: Antenatal care for pregnant and postnatal mothers is the main entry gate for maternal Tetanus Toxoid (TT) vaccination. In developing countries including Tanzania, pregnant and postnatal mothers especially in rural communities have been experiencing barriers to maternal vaccination. The study aimed to explore perspectives of pregnant and postnatal mothers on accessing TT vaccine in Hai District Kilimanjaro Region Tanzania. Methods: A descriptive qualitative study was conducted during baseline assessment from October 2020 to May 2021, in 10 remote villages. Pregnant and postnatal mothers attending antenatal and postnatal services were selected purposively based on their availability and convenience, A semi-structured interview guide relevant to the study objectives was used to guide the interviews. Focus Group Discussion (FGD) and In-depth interviews (IDIs) were conducted; and thematic analysis was used to obtain themes and subthemes. Results: A total of 15 mothers aged 18 to 40 years participated in the study. Most of the mothers were Christians, married with 1 to 5 children. Majority had completed primary level education engaged in small-scale farming. Main themes were extracted namely: Unreliable vaccine information, Healthcare workers attitude, Overworked with household activities, adherence of appointment dates for vaccination after delivery and role of Traditional medicine during pregnancy. Conclusion: The role of healthcare providers are critical component for the appropriate transfer of vaccine information to the mothers and their spouses during clinic visits, to eliminate vaccine misconceptions hence improving overall tetanus vaccine uptake. Quality of information from reliable sources could be an important factor to upgrade the awareness of pregnant mothers on maternal vaccination. 14 Oct, 2021 https://www.clinsurggroup.us/articles/JGRO-7-203.php Pregnancy marks a unique milestone in woman’s life cycle enriched with an array of physical, psychological, social and even spiritual needs. In this context, an optimal level of oral health status has become fundamental to overall health and well-being of a pregnant woman. This is evident more than ever before, for preventing exacerbation of poor oral health in pregnancy, possible control of adverse pregnancy outcomes whilst ensuring low risk for early childhood dental caries for the offspring. Nevertheless, pregnancy renders special oral health needs for a woman compounded by changes in dietary habits, oral hygiene practices and hormonal changes thereby increasing the risk of dental caries and periodontitis. The possible link between Periodontitis and adverse outcomes in pregnancy is well known. The pandemic caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compounded by emergence more virulent strains not only indelibly impacted on population, countries, economies and health systems across the globe but exposed vulnerable population groups to pervasive health catastrophes. There is accumulating concerns on periodontitis linking with severe complications of Covid-19 attributed to commonalities of exacerbated inflammatory responses. Moreover, adverse Covid-19 induced maternal and fetal outcomes has garnered attention of researchers based on the previous knowledge indicating adverse outcomes attributed to epidemics of human corona viruses. However, it is not known how maternal oral hygiene status and burden of periodontitis impact on Covid-19 induced adverse outcomes in pregnancy. However, it could be rational to argue that poor oral health of a pregnant woman could elevate her risks for adverse health outcomes. Oral health care in pregnancy has received recognition as an essential element of comprehensive antenatal health care provision. However, the persistent global public health emergency of Covid-19 has profoundly impacted on availability of and accessibility to routine oral health care services. Therefore, accessing routine oral health care services poses serious causes for concern among pregnant women. Against this backdrop, present opinion attempts to explore and expound the potential of preventive oral health care could offer to mitigate the potential risks of Covid-19 induced adverse maternal outcomes embracing the context of Sri Lanka: a developing lower middle-income country. 23 Aug, 2021 https://www.clinsurggroup.us/articles/JGRO-7-202.php Introduction: Caesarean Section use is growing in a progressive rate globally, accounting for 21% worldwide in 2012 up from 12% in 2000.The trend in Albania follow the same pattern with the overall rate rising steadily. Specifically, in “Koco Gliozheni” Hospital the rate went up from 29.5% in 2010 to 40.35% in 2017. The World Health Organization recommends the Robson Classification as an effective caesarean analysis and monitoring too. Objective: The aim of this article is to evaluate the cesarean section rate of University Hospital of Obstetric-Gynecology “Koco Gliozheni”. Material and method: This is a retrospective cross sectional study conducted at obstetric department of Obstetric-Gynecology University Hospital “Koco Gliozheni” in Tirana from January 2016 to May 2017. All women admitted for childbirth were categorized into relative contribution made by each group. Results: 1918 out of 4838 births were performed by caesarean section, which corresponds to a rate of 39.6 %. According to Robson classification the largest group was the group 5 (multiparous women at term, with a single cephalic presentation pregnancy) with a relative contribution of 31.6%. On second and third place were group 1(nulliparous women, at term with a single cephalic pregnancy, during spontaneous labor) and 2(nulliparous women at term,with single, cephalic presentation, who either had labor induced or CS before labor, especially the 2b subgroup with an elective CS) with relative contribution of 22.5% and 16.7% respectively. Groups 1;2;5 made an account of relative contribution of 76.2%. All other groups had altogether a relative contribution of 23.8% . Conclusions: In our study, Robson Groups 5(multiparous women at term, with a single cephalic presentation pregnancy), 1(nulliparous women, at term with a single cephalic pregnancy,during spontaneous labor), 2(nulliparous women at term,with single cephalic presentation,who either had labor induced or CS before labor) were identified as the main contributors to the overall CS rate at the University Hospital of Obstetric-Gynecology “Koco Gliozheni”. It is important that efforts to reduce the overall CS rate should mainly be focused on the primary CS rate (group 1 and 2) and on increasing vaginal birth trail after CS (group 5). 13 Jul, 2021 https://www.clinsurggroup.us/articles/JGRO-7-201.php The incidence of Tuberculosis (TB) is rising worldwide, despite the efficacy of the BCG vaccination. Populations at greatest risk of contracting TB are migrant communities, as well as immunocompromised individuals. The diagnosis of intestinal tuberculosis can often present as a diagnostic conundrum, due to its nonspecific and varied presentation, often mimicking inflammatory bowel disease or malignancy. Free perforation is one of the most feared complications of the intestinal tuberculosis. The terminal ileum is the most common site of perforation, while the majority of (90%) perforations are solitary. We present a 25 year old 17 weeks primi presented with peritonitis with solitary perforation of terminal ileum with miscarriage of fetus and subsequent surgical wedge resection of ileum and ileo-ileal anastomosis. Histology revealed presence of Langerhan’s cell with caseating granulomatous inflammation. There was no radiological evidence of pulmonary tuberculosis. Patient was started on anti-tubercular therapy and responded well. This present case underscores the importance of biopsy specimens taken from the margins of patients with ileal perforation to avoid the misdiagnosis of such condition. 10 May, 2021 https://www.clinsurggroup.us/articles/JGRO-7-200.php Gestational gigantomastia is a rare pathology resulting in diffuse and excessive breast growth during pregnancy. Its incidence is estimated at 1 case / 100,000 pregnancies. It is thought to be linked to an exaggeration of the physiological hyperplastic phenomena of pregnancy caused by an increase in oestrogen or progesterone receptors. It is associated with the appearance of ulcerations and cutaneous necrosis of the breast, which brings into play the maternal prognosis and the pregnancy. Although benign, it can lead to a great social, emotional and physical handicap. In the rare cases reported in the literature, the treatment of gestational gigantomastia has varied on a case-by-case basis depending on the team and the presence or absence of complications. Medical treatments have been proposed mainly based on bromocriptine and reduction or radical surgical interventions (bilateral mastectomy) have been justified in cases which do not regress or which present significant complications. We report the case of a 32 year old patient who presented a gestational gigantomastia from the 14th week of amenorrhoea and who was put on bromocriptine with the result of a good neonatal outcome and a very favourable evolution in post partum with total regression of the volume of both breasts. 03 May, 2021 https://www.clinsurggroup.us/articles/JGRO-7-199.php Background: Pelvic organ prolapse is common among women above 50 years. The literature on intraoperative interventions to reduce blood loss during vaginal prolapse surgery is very limited. Vasopressin infiltration, shown to reduce blood loss during non-descent vaginal hysterectomy, has adverse effects. Objectives: To compare blood loss between saline hydrodissection and no infiltration native tissue surgery for pelvic organ prolapse. Methods and Materials: Settings and Design: Randomized controlled trial conducted in the Department of Obstetrics and Gynaecology of a tertiary care teaching hospital in South India. Women with stage 2 or higher prolapse involving at least two components, undergoing vaginal hysterectomy and reconstruction were included. Block randomization was used to study 22 women in each group. 60-80ml saline was instilled in sub-mucosa before vaginal wall dissection. The mean actual, average, and clinically estimated blood loss in the two groups during surgery was compared by Mann Whitney test. Results: The mean age, stage of prolapse, and duration of surgery were comparable in the two groups. The Saline group had significantly higher parity, lower preoperative haemoglobin and a higher mean Ba point. Average blood loss was significantly lower in the saline dissection group 294.8 (+96.87) ml compared to 507.31(+348.37) ml in the no infiltration group (z=-2.04 p=0.04). Conclusions: Saline dissection significantly reduces blood loss by approximately 200 ml in comparison to dissection with no infiltration without increasing any intra-operative and post-operative complications. We recommend its use during vaginal surgery for stage 2 or more uterovaginal prolapse involving more than one component Key Messages: saline infiltration in vaginal submucosa before dissection significantly reduces blood loss (by 200ml) compared to no infiltration traditional dissection, during vaginal prolapse surgery with native tissue. Clinical Trial Registry of India (CTRI) registration reference number: CTRI/2017/10/010193. 20 Apr, 2021 https://www.clinsurggroup.us/articles/JGRO-7-198.php Objectives: To appreciate the education on the use of intimate protection products and the prevention of menstrual toxic shock syndrome by French health professionals. Methods: Fourteen semi-structured interviews with health professionals involved in women’s health (midwives, school nurses, general practitioners, and obstetrician-gynecologists) were conducted over a period of six months (March 2019 to September 2019) in the Ile-de-France region in France. Their ages ranged from 26 to 67 years. All the interviews were recorded and typed to extract a qualitative analysis. Results: The healthcare professionals interviewed surveyed report little involvement in educating their patients about intimate protection products and the prevention of menstrual toxic shock syndrome. Conclusion: It would seem useful to increase the awareness of the healthcare professionals involved of the importance of educating their patients about the proper use of intimate protection products. The aim is to prevent the occurrence of infectious pathologies, particularly menstrual toxic shock syndrome the main microbiological risk identified as being associated with the misuse of internal intimate protection products. 30 Mar, 2021 https://www.clinsurggroup.us/articles/JGRO-7-197.php Introduction: Pregnancy is considered a risk factor for Gastroesophageal Reflux (GERD). However, studies on GERD during pregnancy are rare in Korea. We aimed to evaluate the efficacy and clinical outcomes of GERD in late pregnancy in Korea. Methods: Data from a total of 94 pregnant women in the second or third trimester at the SMG-SNU Boramae Medical Center for prenatal testing were analyzed in this study. The GERD questionnaire and Quality of Life in Reflux and Dyspepsia questionnaire were used to diagnose GERD and Quality of Life (QoL). Obstetric delivery records were utilized for pregnancy outcomes. Results: Approximately 30 percent (30%) of pregnant women had GERD. The incidence of GERD during pregnancy was higher in pregnant women with a history of GERD (p=0.041) or low Body Mass Index (BMI) (p=0.036). However, the incidence of GERD during pregnancy did not increase in proportion to the weight gain. QoL was significantly different between pregnant women with and without GERD: emotional stress (p=0.014), sleep problems (p=0.015), food/drink problems (p=0.004), and vitality (p=0.029). There was no significant difference in pregnancy outcomes between the two groups. Conclusion: This study shows that pregnant women with GERD and low BMI tend to present with GERD symptoms during pregnancy. GERD adversely affects the QoL of pregnant women. 05 Mar, 2021 https://www.clinsurggroup.us/articles/JGRO-7-196.php Anencephaly is a lethal fetal neurological malformation. This malformation accounts for 40% of neural tube malformations. The diagnosis is based on the ultrasound of the 1st trimester between the 11th and the 14th weeks of amenorrhea by the discovery of an exencephaly which results in the visualization of the ossification of the cranial box and therefore of the impossibility to measure the biparietaldiameter. The objective of our work is to highlight the importance of an early ultrasonic diagnosis of anencephaly, which could help in a thorough evaluation and active management. Also, the main role of folic acid in the prevention in neural tube defects. 19 Jan, 2021 https://www.clinsurggroup.us/articles/JGRO-7-195.php Premarital screening is a worldwide activity that aims to diagnose and treat unrecognized disorders and reduce the transmission of diseases to couples and children. This study was aimed at assessing the perception and acceptance of premarital fertility screening among final year students of the college of health sciences, University of Ilorin, Kwara state. A descriptive research design with a structured, self-designed questionnaire was employed in the study to select a sample of 220 final year students purposively. Results showed that the respondents had adequate knolewdge of pre-marital fertility screening but some of the respondents still have negative perception. The majority 79.5% of the respondents were positive about going for premarital fertility screening if it was available. Conclusively, policymakers should implement policies that support hitch-free screening processes. Nurses should comply with ethical principles and be able to health educate people to undergo fertility screening before marriage. 17 Nov, 2020 https://www.clinsurggroup.us/articles/JGRO-6-194.php The intrinsic quality of mammalian cumulus-oocyte complexes (COCs) is a determinant factor for pregnancy and fertility in general. The efficiency of assisted reproductive techniques required selection of good quality COCs. Despite the efforts that has been made during the last decades until now worldwide, there is no a reliable non-invasive method or even a reliable marker for oocyte selection. Generally, oocyte quality evaluated based on its morphological features such as thickness, compactness of the cumulus investment and the homogeneity of the ooplasm, which is relatively popular and convenient. However, results derived from this tool are often conflicting largely due to subjectivity and inaccuracy. Thus, the morphological evaluation alone is insufficient to distinguish competent oocytes that have the ability to bring about full-term pregnancy. Biochemical constituents of the follicular fluid represent sensors of the microenvironment condition surrounding the oocyte. Few efforts have given an attention for follicular fluid to be used as oocyte biomarker. Noteworthy, intensive application of assisted reproductive biotechnologies in human and domestic animal species require a good method for selecting good quality oocytes. Recently, global assessment strategies of omics approaches (transcriptomics, miRNAomics, proteomics, lipidomics and metabolomics) have been applied to profile the follicular fluid, oocytes, and granulosa or cumulus cells in several animal species in addition to human. Integration of more than one tool could be a window for finding reliable judging method. Although the great contribution of oocyte quality in controlling fertility the efforts done in finding reliable biological markers is still in the infancy stage. The current short review will shed highlight on attempts has been made in this field. 17 Nov, 2020 https://www.clinsurggroup.us/articles/JGRO-6-193.php Takayasu arteritis is a large vessel vasculitis, and very rare in occurrence with pregnancy. It usually complicates the latter half of pregnancy and causes hypertension, organ dysfunction, fetal growth restriction. Its management during pregnancy is a medical challenge. Here we present a case of 25-year old primigravida presented to us at 30 weeks with Takayasu arteritis and its successful management with good fetomaternal outcome. 08 Oct, 2020 https://www.clinsurggroup.us/articles/JGRO-6-191.php 75Background: Gastric-type endocervical adenocarcinoma (ECAC) represents a unique variant of endocervical adenocarcinoma that is distinguished by lack of HPV association and an aggressive clinical course with unfavorable prognosis. In this review, we will discuss the clinical and pathologic aspects of gastric-type ECAC, as well as recently described molecular alterations which may be harnessed in future diagnostic and therapeutic strategies. Results: Clinically, gastric-type ECAC tends to present at an advanced stage with higher rates of extrauterine spread and distant metastasis. Microscopically, gastric-type ECAC is characteristically composed of cells with abundant clear to eosinophilic vacuolated cytoplasm with distinct cell borders, and may demonstrate deceptively benign-appearing morphology. The prognosis of gastric-type ECAC is poor compared to other subtypes of ECAC, as it tends to present with advanced disease and show resistance to conventional chemoradiation therapy. Recent studies have reported a range of molecular alterations in gastric-type ECAC which may have implications in future treatment, including CDKN2A, BRCA2, ERBB2, PIK3CA, ARID1A, and NTRK1/NTRK3 mutations. Conclusions: Gastric-type ECAC is a relatively recently defined subtype of ECAC with an array of clinical and pathological characteristics that distinguish it from other subtypes of ECAC. As this entity continues to pose difficulties in diagnosis and treatment for pathologists and clinicians alike, continued future investigation is crucial to further our understanding and optimize management of this disease. 28 Sep, 2020 https://www.clinsurggroup.us/articles/JGRO-6-190.php In clinical research, of worldwide interest, some medical devices are being studied as a new reproductive technology, which can both guarantee the implantation of the embryo or support the premature newborn outside the maternal uterus (human and animal); in focusing attention on the second aspect , exclusively, together with the ethical aspects widely debated by experts in the field, it is necessary to examine how much some researchers , belonging to many world groups, have created postnatal support mechanisms for animals extremely premature. On this ground, a group of experienced scientists are working now, using different technologies, to create an artificial womb, within the next decade, resembles the conditions in a human uterus more closely. Based on the fundamental concept, that every week of extra-uterine suitable care allows to get significant results for preterm newborn outcome and life, the “ medical unit” will have to be studied and then implemented in details, to be used on human premature infants, even born at 22 weeks of gestation, who need specific assistance to ensure the development of severe immature fundamental organs and, therefore, normal cardiorespiratory functions, that are the cause of morbidity and mortality in these frail patients; the scientists will be develop a model destined for clinical use. Unlike current incubators, the prototypes will envelope the preterm babies in liquid and will provide them with oxygen and nutrition via an artificial placenta connected to newborns ‘s umbilical cord. 24 Sep, 2020 https://www.clinsurggroup.us/articles/JGRO-6-189.php Embryo implantation, an essential prelude for the establishment of pregnancy, is successful upon the interaction of a high-quality embryo with a receptive uterus. Nevertheless, ‘inadequate uterine receptivity’ which has been pointed out as the cause for approximately two-thirds of repeated implantation failures (RIF, [1-3]), combined with the low rate of implantation (~25%) obtained upon transfer of good embryos in IVF, makes implantation the rate-limiting step for the success of ART. 14 Sep, 2020 https://www.clinsurggroup.us/articles/JGRO-6-188.php Background: Sex hormones may play a role in excess male lethality from coronavirus disease-2019 (COVID-19). Objective: To clarify the implications of testosterone and estradiol in the course and prognosis of COVID-19 in men and women. Methods: PUBMED search until September 7, 2020. Search terms included: COVID-19, sex hormones, testosterone, estrogen, androgen-deprivation, mortality. Due to lack of randomized trials, we included retrospective trials, case series, and pre-print studies. Results: In men hospitalized with COVID-19, circulating testosterone levels are generally decreased and inversely correlated with pro-inflammatory cytokines. Low testosterone levels may be associated with severe COVID-19 and high mortality. Yet, androgen deprivation therapy as treatment of prostate cancer may be associated with decreased hospitalization and favorable clinical outcomes in COVID-19. In women hospitalized with COVID-19, high testosterone levels directly correlate with pro-inflammatory cytokines. In premenopausal women, estradiol serum levels above 70 pg/ml were associated with decreased risk of having severe COVID-19. Pre-menopausal women using combined oral contraceptives may have decreased risk of COVID-19. Conversely, post-menopausal women taking hormone replacement therapy may have increased risk. In general, pregnant women with COVID-19 seem to have similar disease course as non-pregnant women, but studies were lacking adequate control subjects. Conclusions: Preliminary data suggest that androgen deprivation therapy and estrogen could be beneficial as potential treatment of COVID-19 in men and women, respectively. However, the possible therapeutic role of these agents will be only confirmed by randomized trials. 31 Aug, 2020 https://www.clinsurggroup.us/articles/JGRO-6-187.php Background: Congenital Mullerian duct anomaly is a common cause of infertility, preterm labor, first trimester abortion. Its estimated percentage varies between 0.1% - 3% in the general population and between 3% to 38% in patients with recurrent spontaneous pregnancy loss or with infertility. The use of 3-D ultrasound with image reconstruction in the diagnosis of congenital uterine anomalies has already been described [1]. Objective: To test the validity of 3D ultrasound in the diagnosis of different anatomical and structural lesions of the uterus in patients presented with reproduction failure, taking the combined diagnostic laparoscopy & diagnostic hysteroscopy as a gold standard method for diagnosis. Material and methods: Patients who came to our hospital with uterine structural anomalies, suspected by 2D ultrasound or Hysterosalpingogram (HSG), were subjected to 3D ultrasound before undergoing combined laparoscopy and hysteroscopy. Results: This study included 42 patients selected from 463 cases that presented to Minia University Hospital, Egypt. Sensitivity of 3D Ultrasound was 100% for Double system, submucous fibroid, Subseptae uterus, Unicornuate uterus, Bicornuate uterus, Arcuate uterus. As regards Asherman’s syndrome it was 50% sensitivity , As regards polypi it was 67% While the specificity of 3D Ultrasound was: 100% in Double system, Subseptae uterus, Unicornuate uterus, Bicornuate uterus, Asherman’s syndrome, polypi . As regards Arcuate uterus it was 95.2%, As regards Submucous fibroid it was 92%. The age of patients ranged from 21-35 years (mean age 28.4±4.3), 52.4% of the patients had primary infertility while 47.6% had secondary infertility. Conclusion: Three Dimensional Ultrasound is a reliable diagnostic tool in cases of reproductive failure; it is superior to HSG in the diagnosis of all intracavitary lesions or anomalies, but not yet superior to laparoscopy & hysteroscopy. 25 Aug, 2020 https://www.clinsurggroup.us/articles/JGRO-6-186.php The existing paradigm for understanding the pathogenesis of both breast and ovarian cancer is that a small percentage of these neoplasias involve a genetic predisposition. The balance is lacking an attribution. The author proposes that the function of the lymphatic system in both areas is influenced by changed muscle strain patterns. When the muscle activity changes in the presence of altered strain patterns, there is a diminution of lymphatic drainage function affecting those tissues. The drainage function is augmented by muscle activity and the distribution of lymph node aggregation sites is weighted toward shoulder, 10 Jun, 2020 https://www.clinsurggroup.us/articles/JGRO-6-185.php Introduction: Adjunctive ozone therapy for COVID-19 is being used successfully in China, Spain, Italy, and South America. One proposed mechanism is by improving blood / tissue oxygenation thus averting multiorgan system failure due to hypoxia. The purpose of this study was to determine if ozonated-saline administered intravenously affects the oxygenation and duration of time spent in a hypoxia chamber. 08 Jun, 2020 Introduction: Induction of labour is one of the most commonly practiced interventions in obstetrics all over the world with incidence rates between 10-25% in industrialized countries. Misoprostol, a synthetic prostaglandin analogue, is an effective agent for inducing uterine contractions. We undertook this study to compare the efficacy of high dose (50mcg) oral misoprostol and intracervical dinoprostone gel in induction of labour and compare the safety of the drugs in induction of labour. 27 May, 2020 https://www.clinsurggroup.us/articles/JGRO-6-183.php Background: Birth-preparedness and complication-readiness is the process of planning for normal birth and anticipating the actions needed in case of an emergency. The involvement of husband during pregnancy and its complication helps an expectant mother to make timely decisions to avoid delays: The present study aim was to explore ways how husband can involve in birth preparedness and complication readiness plan, among husband living in Arba Minch Town. Materials: Qualitative study was conducted among purposely selected husbands. The data was collected using focus group discussion. A progressive approach was used to analyze the data as Miles and Huberman suggested. All focus group discussions were recorded, translated, and transcribed verbatim. An inductive approach was used in coding the substantive themes. 07 May, 2020 https://www.clinsurggroup.us/articles/JGRO-6-182.php Brazil is among the leaders in the ranking of the number of elective cesarean sections, and such a procedure, when unnecessary, can have serious consequences for the health of the mother and the newborn, which is generally not cleared up satisfactorily to the pregnant woman before the procedure. This study aimed to verify the incidence of cesarean sections in cities that integrate the 20th Regional Health Coordination of Ceará (RHCC), in the period of 2008-2018. This is a descriptive and retrospective study, with a quantitative approach, using data from the Hospital Information System of the Unified Health System (HIS/ SUS) of the SUS IT Department (DATASUS). This study demonstrated an increase in the number of cesarean sections in the cities of the 20th RHCC, and sometimes exceeding the number of vaginal deliveries. It is necessary to overcome the medicalization of childbirth, facilitate women’s access to health services and encourage the strengthening of educational activities, especially in primary care services, in order to encourage pregnant women to choose vaginal delivery. 07 May, 2020 https://www.clinsurggroup.us/articles/JGRO-6-181.php Background: The professional resistance to childbirth in water and the limitation of robust scientific evidence to support its safety constitute a context prone to the restriction of women’s freedom of choice. The elaboration of the birth plan by pregnant women who wish to experience a birth immersed in water can be an important instrument for the exercise of their choice and autonomy. This qualitative and descriptive case study aim to realize how women experienced their birth plan in two hospitals in Portugal. 05 May, 2020 https://www.clinsurggroup.us/articles/JGRO-6-180.php As an important factor of chromosome abnormality in offspring, elderly pregnant women have attracted more and more attention. Studies have confirmed that the offspring of older pregnant women, whether conceived naturally or through assisted reproductive technology, are more likely to develop chromosome abnormalities than younger pregnant women, and the reasons have not been fully explained. The spindle assembly checkpoint monitors the correct connection between all mobile axes and the spindle. The bipolar spindle is the key to cell division to guide the correct separation of chromosomes and is the main gatekeeper to prevent the development of oocytes carrying DNA damage. Older pregnant women lead to the error of sister chromatid separation and the decrease of chromosome cohesion. The integrity of telomeres also affects the folding of DNA and the ability of cells to replicate. In addition, more oxidative stress makes the ovaries of older pregnant women unable to support fertilization and embryonic development. With the oxygen free radicals increase, the pathway of ovarian cell apoptosis and mitochondrial repair were changed. Therefore, the analysis of the causes of fetal chromosome abnormalities in elderly pregnant women is helpful to improve the understanding of the particularity of pregnancy in elderly pregnant women, so as to reduce the birth of defective babies and improve the birth quality. 05 May, 2020 https://www.clinsurggroup.us/articles/JGRO-6-179.php Hymenal imperforation is a fairly rare malformation, and severe when ignored. Based on the literature data on this malformation, a retrospective study was conducted on 7 cases of haematocolpos on imperforated hymen, collected to the uro-visceral pediatric surgery departments, Children’s Hospital, Oujda-Rabat (MOROCCO), over a period from January 2011 to January 2019. It appears from this work that this anomaly is the prerogative of patients in the peripubertal period. The clinical signs is dominated by abdominal and pelvic pain. The existence of an abdominal-pelvic tumefaction in all our patients and by urinary complications such as acute urine retention in 3 of our 7 cases. The diagnosis is mainly clinical and is oriented by ultrasound. Hymene imperforation remains the most frequent etiology, it is found in our 7 patients, The surgical treatment is simple carried out on an incision of the obturating diaphragm, and a drainage of the collection. 05 May, 2020 https://www.clinsurggroup.us/articles/JGRO-6-178.php Introduction: Age at menarche reflects the beginning of sexual maturation and is affected by nutritional status and prevailing environmental conditions. This study examined the age at menarche, breast and pubic hair development of girls in Southern Nigeria and explored their menstrual pattern Method: A cross-sectional descriptive study design was adopted, with structured questionnaire. Descriptive statistics was used to analyze data collected from 648 randomly selected girls in high school. Analysis was supported with SPSS software package. 30 Apr, 2020 https://www.clinsurggroup.us/articles/JGRO-6-177.php Ovarian torsion refers to the complete or partial rotation of the ovary on its ligamentous supports, often resulting in impedance of its blood supply. It is one of the most common gynecologic surgical emergencies and may affect females of all ages. Torsion of the ovary in the pregnancy is very rare and it commonly occurs during the third trimester. It is frequently associated with ovary stimulation in In-vitro-fertilisation (IVF)or Ovary masses. 27 Apr, 2020 https://www.clinsurggroup.us/articles/JGRO-6-176.php Objective: To establish the sensitivity of ultrasonography as a diagnostic tool in the early identification of molar pregnancies and to develop a sonographic diagnostic criterion in earlier detection of molar pregnancies. Methods: A case series study was implemented for 69 patients who were found to have a diagnosis of molar pregnancy, confirmed histologically by the pathology department. This retrospective study investigated these patients at Mount Sinai Hospital between 2014-2016. Study groups were defined and compared by sonographic findings based on the presence of a gestational sac, yolk sac, fetal pole and appearance of the uterine cavity. Additionally, the presence of theca- luteal cysts, size of the ovaries, uterine size, and endometrial thickness were examined as well. 24 Apr, 2020 https://www.clinsurggroup.us/articles/JGRO-6-175.php Cancer patients require attention after COVID-19. ACEI and/or ectoine could represent potential adjuvant therapy. Clinical trials are required to investigate this hope to mitigate COVID-19 infectivity and cell invasion. 25 Jan, 2020 https://www.clinsurggroup.us/articles/JGRO-6-174.php Polycystic Ovary Syndrome (PCOS) is a common reproductive health problem among women worldwide. It is associated with androgen excess, anovulation, abnormal menstruation, and sub-infertility. Other manifestations of PCOS are acne, abnormal hair growth, alopecia, and male-pattern baldness. 28 Oct, 2019 https://www.clinsurggroup.us/articles/JGRO-5-173.php Endometrial Ablation (EA) refers to a group of minimally invasive approach that produces irreversible destruction of the endometrium. These procedures provide a satisfactory alternative to hysterectomy when medical treatment is contraindicated or unsatisfactory. 28 Aug, 2019 https://www.clinsurggroup.us/articles/JGRO-5-172.php Contraceptive counselling is seen as a major part of public health care, maternal and child health care. Therefore, antenatal and postnatal periods are regarded as the appropriate opportunities for women to receive education on contraceptives. However, not much attention has been given to the contents, materials used and frequency of the contraceptive education women receive as this is critical in understanding the contraceptive behaviour of these women. 14 Aug, 2019 https://www.clinsurggroup.us/articles/JGRO-5-171.php Introduction: Ensuring access to quality caesarean section (CS) care is a key millenium development strategy and the next sustainable development goal to reduce maternal and infant mortality. The WHO recommends that the caesarean section rate should not exceed 10-15%. The objective of our analysis is to document the variability of caesarean section rates in Sub- Saharan Africa. 13 Aug, 2019 https://www.clinsurggroup.us/articles/JGRO-5-170.php The female genital area is the fi rst site of malignant lymphoma; is a very rare localization.While most genital lymphomas occur in the vagina or cervix, uterine corpus is very rare [1]. 12 Aug, 2019 https://www.clinsurggroup.us/articles/JGRO-5-169.php Chronic pelvic pain (CPP) is defi ned as intermittent or persistent pain not associated with pregnancy, menstruation or coitus, which is localized in the abdomen or pelvis lasting at least three to six months. 02 Aug, 2019 https://www.clinsurggroup.us/articles/JGRO-5-168.php Aim: To evaluate the effi cacy and safety of vaginal specifi c lactobacilli strain in management of bacterial vaginosis. Method: A non-randomized, open labeled, non-comparative, multi-centric, study was conducted in total of 58 female patients suffering from bacterial vaginosis. Each patient was administered a combination of four strains of Lactobacilli. Vaginal pH, discharge, odor, itching and painful urination were performed at baseline, week 2 and week 4 as assessment parameters. 22 Jul, 2019 https://www.clinsurggroup.us/articles/JGRO-5-167.php Most women feel pain or discomfort before, as well as during the period, which is mostly caused by the contraction of the uterus to release the uterine pledget. The pain that slightly reminds of cramps is very common occurrence just before the period and usually lasts one or two days. It can feel in the pelvis, back, thighs or abdomen. Usually begins immediately under the navel and spreads to the thighs and backs. The intensity of these menstrual cramps differs from woman to woman. 19 Jul, 2019 https://www.clinsurggroup.us/articles/JGRO-5-166.php Background: A case of “Near miss maternal” or severe obstetric condition is defi ned as the patient at risk of dying, which survives the complication that occurred during pregnancy, delivery or at the end of the puerperium; or women who have survived the risks that endanger their lives. 24 May, 2019 https://www.clinsurggroup.us/articles/JGRO-5-165.php The number of surgeries performed with robotic equipment has increased ever since its release by the Food and Drug Administration (FDA) in 2005 [1]. Robotic surgery is well accepted and seems to be as effective as laparoscopy in the treatment of endometrial and cervix cancers [2,3]. Some of the advantages of using this method over the traditional laparoscopic technique include 3D visualization, tremor filtration, greater dexterity, better ergonomics, lower blood loss and lower post-operative pain index [4]. 01 Apr, 2019 https://www.clinsurggroup.us/articles/JGRO-5-164.php Introduction and Hypothesis: There is variable evidence on predictors of successful fitting of vaginal pessary for female pelvic organ prolapse (POP). This study evaluates measures that may predict successful pessary fitting for POP. We hypothesized that previous hysterectomy and higher body mass index (BMI) do not affect the ability to retain a pessary and that POPQ measures cannot predict a successful pessary fitting. Methods: This is a retrospective observational study of women with POP referred to the urogynaecology clinic between October 2012 and Oct 2015, who agreed to have pessary insertion. The option of vaginal pessary is routinely offered to these women. Patient demographics, pelvic organ prolapse quantification (POPQ), size and type of pessary use and its outcome were recorded. 28 Mar, 2019 https://www.clinsurggroup.us/articles/JGRO-5-163.php Objective: To analyze the status used in prenatal assistance on pregnant women infected with syphilis, of São Vicente, general region of Santos, SP, Brazil. Methods: This was a descriptive cross-sectional study, retrospective study in the medical records of 162 patientes, between 2014 and 2016, in basic health units. 26 Feb, 2019 https://www.clinsurggroup.us/articles/JGRO-5-162.php Objective: During the postmenopausal period, visceral fat tissue is responsible not only for increased cardiometabolic risk, but also for endocrine function leading to increased endometrial thickness (ET). The current study aimed to 1) determine the predictive value of ultrasonographic visceral fat thickness (VFT) and the visceral adiposity index (VAI), which is defined as «an indicator of visceral adipose function,» for the prediction of an ET>5 mm and 2) to search for a correlation between these two measures. Materials and Methods: In 79 postmenopausal women, VFT and VAI measurements were compared between a group of patients with an ET>5 mm and a group with an ET ≤ 5 mm. The diagnostic performances of VFT and VAI were investigated. 18 Feb, 2019 https://www.clinsurggroup.us/articles/JGRO-5-161.php The midwife provides health care for pregnant women and womans in labor and take care for newborn childs and infants. It can also work in gynecological departments by providing basic nursing care to women with reproductive system diseases. The midwife is a health care professional whose field of work is maternity and gynecological health care. It plays an important role in the counseling and education of healthy and ill insured persons and their families. 05 Jan, 2019 https://www.clinsurggroup.us/articles/JGRO-5-160.php Introduction: Ovarian masses quite frequently appear before us in gynecological practice. In the present study, our purpose was to determine the types and age range of masses detected in ovarian surgeries in and around the city of Kırsehir. Material and Methods: The study was conducted in the retrospective fashion on the pathology reports of 93 patients, who had histopathological examination in the pathology clinic due to ovarian mass between January 2015 and July 2018. The diagnoses of the patients were divided in pathological terms into 5 groups as the epithelial tumors, sex-cord stromal tumors, germ-cell tumors, other primary tumor groups, and ovarian pathologies that were not neoplastic. 31 Dec, 2018 https://www.clinsurggroup.us/articles/JGRO-4-159.php A common and very difficult issue to overcome as a clinical embryologist during an IVF cycle is the event of severe embryonic fragmentation or, more rarely, full developmental arrest. The current approach to bypass these phenomena is oocyte donation, but this raises several ethical concerns from the couple’s side, since the offspring will bear only 50% of the biological characteristics of the parents. Apart from spindle and polar body transfer, the emerging technique in order to overcome these obstacles is called Pronuclear Transfer (PNT). PNT is safest to perform with improved results than spindle or polar body transfer. In PNT, the two parental pronuclei are being transferred into a donor’s enucleated zygote and after a fusion process has been achieved, the newly constructed embryo may result into a newborn bearing both the paternal and maternal biological characteristics. This process opens a whole new horizon in assisted reproduction and will probably replace the traditional oocyte donation in the form we know it today. 27 Dec, 2018 https://www.clinsurggroup.us/articles/JGRO-4-158.php Introduction: Polycystic ovary syndrome (PCOS) involves expression of chronic anovulation and hyperandrogenism. Role of environmental and genetic factors in PCOS is strongly supported but the genes that are positively involved in the etiology of the PCOS have not been fully investigated until now. 20 Dec, 2018 https://www.clinsurggroup.us/articles/JGRO-4-157.php Objective: To evaluate the role of measuring umbilical cord thickness, interventricular septum thickness and HbA1c level in prediction of fetal macrosomia in patients with gestational diabetes mellitus. Methods: This prospective case-control study included 80 pregnant women. They were divided into two groups: 40 pregnant women as case group with gestational diabetes mellitus and 40 non-diabetic pregnant women as control group. Ultrasound examination was performed where the sonographic cross sectional area of umbilical cord. The umbilical arteries and the umbilical vein were measured in a free loop of the umbilical cord, using the software of the ultrasound machine. The cross-sectional area of Wharton’s jelly was computed by subtracting the cross sectional area of the vessels from that of the umbilical cord and the interventricular septum thickness was measured. HbA1c level was measured for diabetic patients. 29 Nov, 2018 https://www.clinsurggroup.us/articles/JGRO-4-156.php As FHR rises by the fetal brain excitation with fetal movement, and FHR falls by the excitation of fetal vagus nerve center with hypoxic stimulation, hypoxic grade is numerically known by the hypoxia index, which is the sum of FHR deceleration duration (min) divided by the lowest FHR (bpm), and multiplied by 100, where all of 6 cerebral palsy cases’ hypoxia index were 25 or more, while the hypoxia index of all 16 no cerebral cases were 24 or less, thus, cerebral palsy is prevented, if the hypoxia index is 24 or less in full course of fetal monitoring. It is the first numeric threshold setting to prevent cerebral palsy in 50 years’ history of fetal monitoring. 16 Nov, 2018 https://www.clinsurggroup.us/articles/JGRO-4-155.php Introduction: Extreme Preterm Premature Rupture of Membranes (PPROM) is a condition that increases maternal, fetal and neonatal morbidity and mortality to a large extent. In this study, we aimed at prolonging the gestational periods of 3 patients with extreme PPROM by way of sealing the cervical os using PGA mesh and fibrin glue to stop physical amniotic discharge. 20 Oct, 2018 https://www.clinsurggroup.us/articles/JGRO-4-154.pdf At present most of studies showed that the duration of labor of women is longer than in the past making it necessary to conduct the study to confirm the sensitivity of the Friedman Curve in the prediction of labor progress in the first stage of labor. This study used convenient sampling to recruit primiparous women in a labor room at a central hospital in southern Thailand among which 350 women were used in the analysis for the sensitivity prediction of the Friedman Curve. 18 Oct, 2018 https://www.clinsurggroup.us/articles/JGRO-4-153.php Background: Low birth weight is a reflection of the health care infrastructure and human development in a country. Elimination of low birth weight is essential to achieve a greater life expectancy and quality of life. There are several risk factors for low birth weight which range from maternal, nutritional, genetic and other factors. This study was carried out to evaluate the antenatal predictors of low birth weight. 30 Aug, 2018 https://www.clinsurggroup.us/articles/JGRO-4-152.php Objective: To evaluate placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) as early predictors of pre-eclampsia. Methods: Cohort study at Department of Obstetrics and Gynecology, Ain Shams University Hospitals, enrolling eighty pregnant women between 14 and 19 weeks’ gestation, sera were collected, and stored at -80°C. Thirty women developed pre-eclampsia, fifty continued to be normotensive and their second blood samples were collected. Serum sFlt-1 and PlGF were assayed using chemiluminescence. All enrolled subjects were divided into Q1, Q2, Q3 and Q4 according to serum levels of sFlt-1, PlGF and sFlt-1/PlGF. 20 Jun, 2018 https://www.clinsurggroup.us/articles/JGRO-4-151.php The reproductive health of a woman is vital not only for her general health, but also for that of her partner and child. Bacterial infections can affect pregnant women from implantation of the fertilized ovum through the time of delivery and peripartum period. They 23 May, 2018 https://www.clinsurggroup.us/articles/JGRO-4-150.php Background: PET is a systemic disorder of vascular endothelial dysfunction and vasospasm that occurs after 20 weeks’ gestational age and can present as late as 4-6 weeks postpartum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema. Maternal obesity is a prominent hazardous risk factor for the pathological development of PET. Aim: To determine the correlation between the raised body mass index and the risk of PET. 30 Apr, 2018 https://www.clinsurggroup.us/articles/JGRO-4-149.php According to official data of World Health Organization, every year, an estimated 21 million girls aged 15 to 19 years, and 2 million girls aged under 15 years become pregnant in developing regions. Approximately 16 million girls aged 15 to 19 years and 2.5 million girls under 16 years give birth each year in developing regions. 13 Mar, 2018 https://www.clinsurggroup.us/articles/JGRO-4-148.php It was strange that fetal outcome was vigorous in 3 late decelerations, but ominous when it repeated. It was thought that FHR decelerations expresses hypoxia, because the heart rate was fully parallel to rabbit PaO2, if it is below 50mmHg, and human fetal PaO2 is 50mmHg or less. 13 Feb, 2018 https://www.clinsurggroup.us/articles/JGRO-4-147.php Health is a state of complete physical, mental and social well-being, and not just freedom from disease or disability is defi nition of the World Health Organization means that the quality of health care must not only individuals but also society as a whole. When considering the issues of health, there is no dilemma for medical professionals because every man, regardless of gender or skin color, who seeks professional medical assistance approaches the same way or practices according to the profession’s rules to help him with his competences. 21 Nov, 2017 https://www.clinsurggroup.us/articles/JGRO-3-146.php Objective: The present study examines the hypothesis that the clinical and ultrasonography data reported at baseline visit can predict the responsiveness of ibuprofen in controlling heavy menstrual bleeding with Cu-IUDs at 3 months follow-up visit. 17 Aug, 2017 https://www.clinsurggroup.us/articles/JGRO-3-145.php Cervical cancer is the leading cause of morbidity and mortality among gynecological cancers worldwide. Cervical cancer is the main cancer found in developing countries. There are risk factors for cervical cancer worldwide, 15 Jul, 2017 https://www.clinsurggroup.us/articles/JGRO-3-144.php Preterm labor is defi ned as the presence of uterine contractions of suffi cient frequency and intensity to effect progressive effacement and dilation of the cervix prior to term gestation (between 20 and 37 completed weeks) [1]. 03 Jul, 2017 https://www.clinsurggroup.us/articles/JGRO-3-143.php Various hemostatic agents are currently available for routine laparoscopic procedures, avoiding thermal lesions due to energy devices and the complexity of intracorporeal sutures, however, evidence of complications in immunocompromised patients is still lacking. 09 Jun, 2017 https://www.clinsurggroup.us/articles/JGRO-3-142.php In our study, the aims are typing and investigating of Human Papillomavirus (HPV) in cervical swab samples by multiplex real time polymerase chain reaction (PCR). Besides PCR results and cytological evaluation of the samples were compared. 31 May, 2017 https://www.clinsurggroup.us/articles/JGRO-3-141.php Objective: Urinary incontinence (UI) is a common condition and a global health concern, the burden of this condition is greatest in developing countries of Asia, South America and Africa. The current study aims to assess and compare the psychological symptoms and quality of life (Qol) of women with UI in Assiut (Egypt) and Sana’a (Yemen). 25 May, 2017 https://www.clinsurggroup.us/articles/JGRO-3-140.php Uterine sarcomas are neoplastic malignancies that typically arise in tissues of a mesenchymal origin in uterine body. The identifi cation of novel molecular mechanisms leading to sarcoma formation, and the establishment of new therapies and biomarkers has been hampered by several critical factors. 19 May, 2017 https://www.clinsurggroup.us/articles/JGRO-3-139.php Aim: of the study was to investigate the difference of distribution and expression of the lysyl oxidase enzymes (LOX), the pro-collagen C proteinase (PCP) and the myofi broblasts in the vaginal tissue of postmenopausal women, with and without prolapse. 28 Apr, 2017 https://www.clinsurggroup.us/articles/JGRO-3-138.php Pregnancy, another state or gravidity, is the state of a woman who carries a new being. The fertilization and ends with childbirth. The fertilized egg develops and goes through several different stages of development: embryo and fetus. 25 Apr, 2017 https://www.clinsurggroup.us/articles/JGRO-3-137.php Objective: The study aims to test the effect of tranexamic acid (TA) on uterine vasculature and blood loss after vaginal delivery. 15 Apr, 2017 https://www.clinsurggroup.us/articles/JGRO-3-136.php Objective: The aim of this study is to identify the role of sFlt-1/PIGF ratio as a prognostic marker for cases of preeclampsia. Patients and methods: The current study is a case control study that was conducted over 90 cases of primigravida patients, 24-34 weeks of gestation, randomly selected patients from outpatient clinic and ER of Ain Shams Maternity Hospital 15 Apr, 2017 https://www.clinsurggroup.us/articles/JGRO-3-135.php Placenta percreta in early pregnancy is rare and only few cases are documented. We report a case of placenta percreta at 10 weeks gestation. Sonography revealed absence of line of demarcation between trophoblast and myometrium extending to the urinary bladder region. 13 Apr, 2017 https://www.clinsurggroup.us/articles/JGRO-3-134.php Intrauterine devices (IUD) are a highly effective and safe form of contraception. However, many individuals, particularly nulligravidas, elect against IUD use due to fear of pain associated with insertion. Misoprostol has been proposed as an agent to ease IUD insertion and decrease associated pain. 08 Apr, 2017 https://www.clinsurggroup.us/articles/JGRO-3-133.php Objectives: To evaluate awareness and acceptability of HPV vaccine amongst medical students in a tertiary teaching hospital. Materials and methods: This was a cross sectional descriptive study carried out in a tertiary hospital in South India in January 2015. 30 Mar, 2017 https://www.clinsurggroup.us/articles/JGRO-3-132.php Ectopic pregnancy remains an important cause of morbidity and mortality in the first trimester of pregnancy, and has become a major public health challenge among women in the reproductive age group in this environment. 18 Mar, 2017 https://www.clinsurggroup.us/articles/JGRO-3-131.php Background: Antepartum fetal death (AFD) contributes signifi cantly to stillbirths (SB) in low- and middle-income countries (LMIC). Modifying locally-prevalent demographic risk factors could lessen the burden of SB in the region. 03 Mar, 2017 https://www.clinsurggroup.us/articles/JGRO-3-130.php Objective: The primary goal of this study was to assess the G-CSF effects on IVF outcomes in women with normal endometrial thickness. Patients and Methods: This was a randomized controlled study performed at Assisted Reproductive Techniques Center of Ain Shams University Maternity Hospital, over a 2-year period, between Jan 2014 and Jan 2016, and included 60 infertile women with normal endometrial thickness. 21 Feb, 2017 https://www.clinsurggroup.us/articles/JGRO-3-129.php Stem cells isolated from menstrual fl uid have mesenchymal stem cell like properties and have multilineage differentiation capacity. Menstrual fl uid has ease of access in collection and repeated sampling is possible in a noninvasive manner. 31 Jan, 2017 https://www.clinsurggroup.us/articles/JGRO-3-128.php Introduction: Paget’s disease of the vulva (PDV) is a very rare malignancy originating in vulvar apocrinegland- bearing skin cells. Based on multi centric nature of Paget’s disease, it’s a chronic and relapsing course. The aim of this report is to introduce a case of multi centric Paget’s disease and review of literature. 25 Jan, 2017 https://www.clinsurggroup.us/articles/JGRO-3-127.php Background: The aim of this study was to evaluate ovarian damage following laparoscopic endometrioma cystectomy using ultrasound and pathologic samples. 21 Dec, 2016 https://www.clinsurggroup.us/articles/JGRO-2-126.php Mature cystic teratomas form approximately 20% of all ovarian tumours. Of these, approximately 15% include benign thyroid tissue. When thyroid tissue comprises more than 50% of the ovarian teratoma, it is termed ‘‘struma ovarii’’. 22 Sep, 2016 https://www.clinsurggroup.us/articles/JGRO-2-125.php Rudimentary horn pregnancy (RHP) as a rare incidence has been estimated at 1:76,000- 1:150,000 pregnancies. It has been also reported that 80-90% of RHP lead to uterine rupture in second trimester. Early diagnosis with the use of 3-dimentional ultrasonography (3-DUS) that is followed by laparoscopic resection of RH and ipsilateral fallopian tube is likely to be considered as the best management strategy that prevents maternal morbidity and mortality. We present a case of 9-week pregnancy in a non-communicating rudimentary horn with positive fetal heart rate (FHR) that was diagnosed by 3-DUS and successfully treated with laparoscopic resection. 13 Sep, 2016 https://www.clinsurggroup.us/articles/JGRO-2-124.php Objective: This study was done to evaluate the maternal morbidities and perinatal outcomes of delivery in women with preterm pre-labor rupture of the membranes who delivered before and after 34 week along a period of five years in Al-Arish General Hospital. 29 Aug, 2016 https://www.clinsurggroup.us/articles/JGRO-2-123.php Objective: The primary goal of this study was to compare the ovulation and pregnancy rates in women with unexplained infertility undergoing intrauterine insemination utilizing an antagonist (cetrolix) protocol versus the commonly used clomiphene citrate regimen. 17 Aug, 2016 https://www.clinsurggroup.us/articles/JGRO-2-122.php Objective: The aim of this study was to evaluate the potential predictive value of day-3 serum estradiol for follicle growth, ovulation, and pregnancy rate in women with premature ovarian insufficiency. 05 Aug, 2016 https://www.clinsurggroup.us/articles/JGRO-2-121.php Introduction: Fetomaternal haemorrhage (FMH) refers to the passage of fetal erythrocytes to the maternal circulation. In most pregnancies, small amounts of fetal erythrocytes can cross over to the maternal circulation without causing problems for the fetus. In rare occasions, the FMH can result in fetal anaemia or in fetal death. 25 Jul, 2016 https://www.clinsurggroup.us/articles/JGRO-2-120.php Background: Pseudomembranous colitis is a rarely reported condition in obstetrics. The clinical presentation varies from a self-limiting diarrhea to a severe pseudomembranous colitis with toxic megacolon and subsequent death. The process of this disease is mainly associated with prior antibiotic intake. 15 Jul, 2016 https://www.clinsurggroup.us/articles/JGRO-2-119.php Background: primary ectopic pregnancy (EP), with 0.001-0.013% incidence rate, is a very scarce obstetrical condition. Among EPs Ovarian EP is more rarely seen? 04 Jul, 2016 https://www.clinsurggroup.us/articles/JGRO-2-118.php Objective: One of the major causes of carcinogenesis is loss of genome stability. The double- strand break DNA repair pathway, including X-ray repair cross complementing group 2 ( XRCC2) gene, is implicated in maintenance integrity of genome and therefore could affect endometrial cancer (EC) risk. The purpose of this study was to evaluate the clinical significance of the XRCC2 4234G/C (rs3218384 ) gene single nucleotide polymorphism (SNP) in endometrial cancer patients. 29 Jun, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-117.php Introduction : Tuberculosis affects about a third of world population. Genitourinary tuberculosis is one of the most common manifestations of extra pulmonary tuberculosis. Postmenopausal tubercular endometritis is an uncommon condition that usually occurs with abnormal vaginal bleeding. 21 Jun, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-116.php Objective: To explore the level of apolipoprotein A1 expression in human endometrial tissues in women with polycystic ovary syndrome compared to fertile women. 02 Jun, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-115.php A 72 year old lady attended for elective administration of intravesical Botulinum A toxin (Botox 200iu) injections, as a day- case procedure, for the treatment of detrusor over activity. The procedure was undertaking without any complications. A few hours after the operation the patient developed severe constant generalized abdominal pain and distension. There were no other associated features. She underwent a computerized tomography (CT) scan of her abdomen and pelvis which was normal, followed by a Cystogram which was also normal. 12 May, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-114.php Objective: To assess the effect of high level of circulating antimullerian hormone on the outcome of gonadotrophin ovulation induction in women with polycystic ovarian syndrome. 02 May, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-113.php Introduction: Tubal dysfunction is diagnosed as an underlying cause of infertility in more than one third of cases. Laparoscopy dye is the gold standard procedure to detect tubal patency, but hysterosalpingography (HSG) and hystero-contrast-sonography (HyCoSy) is also used. Office hysteroscopy guided selective chromopertubation (OHSC-SPT) is a less invasive and reproducible method, which can be performed in an outpatient setting without anesthesia, therefore it can be carried out as an outpatient procedure. 20 Apr, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-112.php Objective: To explore the validity of hysteroscopy in detection of uterine cavity abnormalities in women with recurrent pregnancy loss. 18 Mar, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-111.php Objectives: To assess the accuracy of 5D automated measurement of long bones, three dimensional VOCAL measurement of fetal thigh volume in prediction of fetal weight in comparison to the conventional two dimensional Hadlock formulas. 18 Mar, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-110.php Objective: To assess the response and evolution of vaginal intraepithelial neoplasia (VAIN) after CO 2 laser treatment. 08 Mar, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-109.php Objective: To explore the role of estimating endometrial volume by Virtual Organ Computer-aided AnaLysis (VOCAL) and it’s correlation with endometrial thickness, on the day of hCG, in prediction of IVF/ICSI success. 08 Feb, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-108.php Objective: To evaluate Plavix impact on the perfusion of the uterine artery compared to low dose aspirin in women with unexplained recurrent miscarriage 29 Jan, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-107.php Background: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of supraphysiologic ovarian stimulation but infrequently has been described in spontaneous pregnancy. 08 Jan, 2016 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-2-106.php Recurrent pregnancy loss (RPL) is one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown. Hyperinsulinemia ascribed to PCOS and insulin resistance (IR) seem to be a contributing factor to RPL. 28 Dec, 2015 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-1-105.php “One drop of its water reflects the whole ocean.” The December 2, 2015 issue of the “American Medical Association Morning Rounds” reminded me to this old dictum. It announced that as a result of coordinated efforts by several national health care agencies, the rate of hospital acquired conditions diminished by 17% during the years of 2010 - 2014. With the exception of side effects of drugs, the “hospital acquired conditions” were invariably infections: “Urinary tract infection, central line associated blood stream infection, pressure ulcer and surgical site infection”. 24 Dec, 2015 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-1-104.php Background: Ovarian granulosa cell tumours are low-grade malignant sex cord-stromal tumours. They represent 2 to 3% of all ovarian cancers and occur mainly within the adult population. 09 Nov, 2015 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-1-103.php Introduction: Due to strong religious faith and beliefs against blood transfusions, Jehovah’s Witness patients often pose tight spot for obstetrician-gynecologists. Myelosuppressive effects of chemotherapy in gynecology-oncology settings are additional source of worry. 07 Aug, 2015 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-1-102.php Objective: To determine the prevalence and laparoscopic features of endometriosis in women investigated for infertility using laparoscopy and dye test. 29 Jun, 2015 https://www.clinsurggroup.us/Gynecological-Research-Obstetrics/JGRO-1-101.php Medicine is a fast evolving even if inexact science. Built in ancient times upon insightful observations of Egyptian, Greek and Arabic physicians [11. Lyons AS, Petrucelli RJ II (1978) Medicine. An Illustrated History. Harry N. Abrams, Inc., New York.], its progress was spearheaded by European (mainly British, French, German and Austrian) scientists after the middle ages. If the assignment of Nobel prizes is a guideline is this regard, in the last century the leadership was taken over by the United States. Both physicians and lay persons may be inclined to assume therefore, that the achievements of medical research are utilized in America in everyday practice and that progress runs parallel in all branches of medicine. As far as obstetrics is concerned these assumptions have limited validity at best.