The Effect of Aging on Pelvic Floor Pressure Measurements in Nulliparous Women

Aims: To investigate the correlation between age and 3-dimensional pelvic floor manometry parameters, sexual function, and urinary status in old post-menopausal versus young nulliparous women. Methods: This was a cross-sectional study. Two groups of young (18 - 40 years) and old (52 - 85 years) nulliparous volunteers completed Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), and Female Sexual Function Inventory (FSFI-19) and underwent a 3-dimensional pelvic floor manometry. Results: The study included 9 young participants with a mean age of 28.6, and 10 old participants with a mean age of 61.8. All the older participants were postmenopausal and all the young participants were premenopausal. Mean PFDI-20 score was significantly higher in the older group: 52 ± 12 versus 4 ± 4, p= 0.001. Urinary Distress Inventory score (UDI-6, part of PFDI questionnaire) was higher amongst the older group: 28 ± 26 versus 3 ± 8, p= 0.006. All young participants scored zero in their PFIQ-7 while the older participants averaged 31 out of maximal score of 300. While sexual activity was higher in the younger group (89% versus 60%), sexual function assessed through the FSFI-19, was not significantly different between the two groups. Valsalva pressures obtained from manometry measurements were significantly higher in the older group (mean 230 mm Hg versus 161, p= 0.015). Conclusions: Post-menopausal women have higher pelvic floor and urinary symptoms associated with increased Valsalva pressures as measured by vaginal manometry.

Obese Nulliparous Women and the Risk for Maternal and Fetal Complications

Obesity is becoming a global health care problem and an increasing number of obese female patients are getting pregnant. Aim of our study was to know the prevalence of obesity in nulliparous women and its impact on pregnancy as well as fetus. Patients and Methods: All nulliparous women with single pregnancy and gestational age of 37 weeks and above were included in the study. Primigradvida with multiple pregnancies, fetal abnormalities, and gestational age less than 37 weeks were excluded. Patients were divided into normal, overweight and obese group according to their prepragnancy body mass index (BMI). Results: Total 2243 nulliparous women were included in the study, majority (56.8%) of patients were in the normal BMI group and only 24.8% were obese. But a significantly higher number of obese nulliparous women were in the age group of 18 to 29 years (P < 0.05). Comorbidities were significantly higher in obese primigravida. The incidence of gestational diabetes and pregnancy induced hypertension was significantly higher (P 0.05) in obese nulliparous women. Overweight and obese nulliparous patients required significantly higher emergency caesarean section and assisted vaginal deliveries compared to the normal BMI nulliparous women (P < 0.03). Conclusion: Maternal obesity leads to prepartum, peripartum as well as fetal complication. Obese pregnant patients had a significant risk of developing gestational diabetes and pregnancy induced hypertension. In these patients the prevalence of assisted vaginal and cesarean deliveries is significantly high.

Effects of aromatherapy with Rosa damascena on nulliparous women's pain and anxiety of labor during first stage of labor

Background： Reducing labor pain and anxiety is one of the most important goals of maternity care. Objective： This study aimed to assess the effects of aromatherapy with Rosa damascena on pain and anxiety in the first stage of labor among nulliparous women. Design, setting, participants and interventions： This was a randomized clinical trial of 110 nulliparous women. The eligible participants were randomly assigned to two groups of aromatherapy and control in an Iranian maternity hospital. The participants received 0.08 mL of Rosa damascena essence in the aro- matherapy group and 0.08 mL of normal saline in the control group, every 30 min. Pain was measured 3 times, once each at three stages of cervical dilation （4-5, 6-7, and 8-10 cm）. Anxiety was measured twice, once each at two stages of cervical dilation （4-7 and 8-10 cm）. The tools for data collection were the Spielberger anxiety questionnaire, numerical pain rating scale, demographic and obstetric questionnaire, and an observational checklist. Data analyses included the t-test, Mann-Whitney U test and Chi-square test. Main outcome measures： Severity of labor pain and severity of anxiety were used as primary outcome measures. Labor and delivery characteristics （including number of contractions, duration of contractions in second stage, Bishop score, augmentation by oxytocin, Apgar score, and mode of delivery）, demographic characteristics, and fertility information were used as secondary outcome measures. Results： Pain severity in the group receiving aromatherapy with R. damoscena was significantly lower than in the control group after treatment at each pain assessment （cervical dilation of 4-5, 6-7, and 8-10 cm; P 〈 0.05）. Anxiety levels were also significantly lower in the treatment group than in the control group after treatment at each time of measurement （cervical dilation of 4-7 and 8-10 cm; P 〈 0.05）. Conclusion： Aromatherapy with R. damascena reduced the severity of pain and anxiety in the first stage of labor. Aromatherapy with R. damascena is a convenient and effective method for pain and anxiety reduc- tion during the first stage of labor.

A new device for deep cervical artificial insemination in gilts reduces the number of sperm per dose without impairing final reproductive performance

Background: The aim of this study was to evaluate the reproductive performance of a new artificial insemination(AI) device specifically designed for gilts(Deep cervical AI, Dp-CAI) by means of which the sperm is deposited deeply in the cervix(8 cm more cranial than in traditional cervical insemination-CAI). New AI techniques have arisen in recent decades in the porcine industry, such as post-cervical artificial insemination(PCAI), which involves depositing the sperm in the body of the uterus [through a catheter(outer tube)-cannula(inner tube)] rather than by CAI. Although the PCAI method has been successfully applied in farm conditions to reduce sperm doses without impairing the reproductive performance, this technique has limitations in gilts mainly because of the difficulty involved in introducing the inner cannula through the cranial part of the cervix. For this reason, the Dp-CAI method described herein may be considered as an alternative to CAI and PCAI methods in gilts.Results: Gilts were divided in two experimental groups: 1) Dp-CAI: gilts(n = 1166) inseminated using 1.5 × 109 sperm/45 m L;2) CAI(as a control group): gilts(n = 130) inseminated using 2.5 × 10~9 sperm/85 mL. The Dp-CAI method was successfully applied in 88.90% of the gilts, with no differences detected between gilts with 1 or 2 previous oestrus cycles, although the catheter could be introduced more deeply in 2 oestrus gilts(P < 0.05). As the length of the insemination device that could not be introduced increased(at the moment of insemination), so the success rate of the Dp-CAI device fell, as did the total number of piglets born. When the reproductive output in CAI and Dp-CAI was compared, none of the parameters analysed [pregnancy and farrowing rates(%), and number of piglets born(total and live)] showed significant differences.Conclusions: The use of the Dp-CAI technique provides a new AI method as an alternative to CAI and PCAI for pigs. The device, especially designed for gilts, was used with a high degree of success reducing conventional sperm doses without impairing reproductive parameters.