Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the proc...Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the procedure is a serious risk that is often mitigated with a uterine tourniquet. Aim and Objectives: To evaluate the effect of uterine artery occlusion with a tourniquet during open myomectomy on ovarian reserve using serial anti-Mullerian hormone (AMH) measurements. Materials and Methods: This was a prospective longitudinal study with a quasi-experimental design and a convenient sampling technique. The study enrolled 47 women who had abdominal myomectomy between September 1, 2021, and March 31, 2022, at the University of Port Harcourt Teaching Hospital. Blood samples were collected before anaesthesia was administered in theatre, on day two, and three months after open abdominal myomectomy for anti-Mullerian hormone assay. The data was collected using a semi-structured proforma, entered into an Excel spreadsheet, and analyzed using SPSS version 25.0 with a 95% confidence interval. Statistical significance level was set at 0.05. Results: The pre-surgery AMH mean value was 1.67 ± 1.44 ng/ml, while the values after using a uterine tourniquet at myomectomy on the second day and three months later were 1.22 ± 1.24 ng/ml and 1.59 ± 1.43 ng/ml, respectively. There was no statistically significant change in AMH levels, and there was no statistically significant relationship between blood loss and tourniquet time and AMH after open abdominal myomectomy. Conclusion: The use of a uterine tourniquet and blood loss during open myomectomy has no effect on ovarian reserve.展开更多
Background: Anaemia is a common medical disorder in pregnancy especially in developing countries. Iron deficiency anaemia during pregnancy may be associated with adverse pregnancy outcomes Objectives: To?determine the...Background: Anaemia is a common medical disorder in pregnancy especially in developing countries. Iron deficiency anaemia during pregnancy may be associated with adverse pregnancy outcomes Objectives: To?determine the cord blood haemoglobin and the correlation between maternal haemoglobin concentration and perinatal outcome at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a prospective cross-sectional study of 155 pregnant women who presented at the labour ward of the department of Obstetrics and Gynaecology from October 1, 2018 to December 31, 2018. Blood sample was collected from the women in labour into ethylenediamine tetra-acetic acid (EDTA) bottles, red blood cell haemoglobin was determined. Umbilical cord blood sample was also collected at delivery and red cell haemoglobin was done. Socio-demographic characteristics, risk factors and perinatal outcome were obtained, entered into a spreadsheet and analyzed using SPSS 22.0. Bivariate logistic regression analysis was performed for multivariate analysis and statistical significance was considered at p Results: The mean age of the women was 31.08 ± 4.39 years, the mean maternal haemoglobin concentration was 11.54 ± 1.86 g/dl while the mean umbilical cord haemoglobin concentration was 12.92 ± 1.92 g/dl. Majority (86.45%) of the women were compliant with the prescribed haematinics. Moderate anaemia was observed in 17.42% of the women, followed by mild anaemia (15.48%) and severe anaemia (1.29%) respectively. Maternal complications were observed in 24.5% of women. There was a significant association between maternal haemoglobin concentration and cord blood haemoglobin concentration (p = 0.001). However, the study did not show an association between parity, mode of delivery, birth weight, Apgar scores, gestational age and maternal haemoglobin concentration (p > 0.05). Conclusion: The mean Haemoglobin in our newborns was less than previously reported values. Cord blood haemoglobin decreases significantly with decreasing maternal haemoglobin, thus there is a linear relationship between maternal and cord blood haemoglobin.展开更多
文摘Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the procedure is a serious risk that is often mitigated with a uterine tourniquet. Aim and Objectives: To evaluate the effect of uterine artery occlusion with a tourniquet during open myomectomy on ovarian reserve using serial anti-Mullerian hormone (AMH) measurements. Materials and Methods: This was a prospective longitudinal study with a quasi-experimental design and a convenient sampling technique. The study enrolled 47 women who had abdominal myomectomy between September 1, 2021, and March 31, 2022, at the University of Port Harcourt Teaching Hospital. Blood samples were collected before anaesthesia was administered in theatre, on day two, and three months after open abdominal myomectomy for anti-Mullerian hormone assay. The data was collected using a semi-structured proforma, entered into an Excel spreadsheet, and analyzed using SPSS version 25.0 with a 95% confidence interval. Statistical significance level was set at 0.05. Results: The pre-surgery AMH mean value was 1.67 ± 1.44 ng/ml, while the values after using a uterine tourniquet at myomectomy on the second day and three months later were 1.22 ± 1.24 ng/ml and 1.59 ± 1.43 ng/ml, respectively. There was no statistically significant change in AMH levels, and there was no statistically significant relationship between blood loss and tourniquet time and AMH after open abdominal myomectomy. Conclusion: The use of a uterine tourniquet and blood loss during open myomectomy has no effect on ovarian reserve.
文摘Background: Anaemia is a common medical disorder in pregnancy especially in developing countries. Iron deficiency anaemia during pregnancy may be associated with adverse pregnancy outcomes Objectives: To?determine the cord blood haemoglobin and the correlation between maternal haemoglobin concentration and perinatal outcome at the University of Port Harcourt Teaching Hospital. Materials and Methods: This was a prospective cross-sectional study of 155 pregnant women who presented at the labour ward of the department of Obstetrics and Gynaecology from October 1, 2018 to December 31, 2018. Blood sample was collected from the women in labour into ethylenediamine tetra-acetic acid (EDTA) bottles, red blood cell haemoglobin was determined. Umbilical cord blood sample was also collected at delivery and red cell haemoglobin was done. Socio-demographic characteristics, risk factors and perinatal outcome were obtained, entered into a spreadsheet and analyzed using SPSS 22.0. Bivariate logistic regression analysis was performed for multivariate analysis and statistical significance was considered at p Results: The mean age of the women was 31.08 ± 4.39 years, the mean maternal haemoglobin concentration was 11.54 ± 1.86 g/dl while the mean umbilical cord haemoglobin concentration was 12.92 ± 1.92 g/dl. Majority (86.45%) of the women were compliant with the prescribed haematinics. Moderate anaemia was observed in 17.42% of the women, followed by mild anaemia (15.48%) and severe anaemia (1.29%) respectively. Maternal complications were observed in 24.5% of women. There was a significant association between maternal haemoglobin concentration and cord blood haemoglobin concentration (p = 0.001). However, the study did not show an association between parity, mode of delivery, birth weight, Apgar scores, gestational age and maternal haemoglobin concentration (p > 0.05). Conclusion: The mean Haemoglobin in our newborns was less than previously reported values. Cord blood haemoglobin decreases significantly with decreasing maternal haemoglobin, thus there is a linear relationship between maternal and cord blood haemoglobin.