Disparities across the CREOG Districts —Variations of Wellness and Inclusivity Efforts in Obstetrics & Gynecology Residency Websites between Two Consecutive Years

Background: Few studies have focused on the geographic and chronologic assessment of inclusivity and wellness in Obstetrics and Gynecology residency websites across the US. Objective: To identify variations in wellness and inclusivity website depictions across CREOG districts over the past two years. Methods: This is a cross-sectional analysis of the websites of ACGME-accredited OB/GYN residency programs across the United States between April 2022 and April 2023. The assessment was based on a compilation of 22 attributes devised and piloted by 49 medical students. A racially, geographically, and gender-diverse cohort of 11 students performed data collection. Results: A total of 560 websites were analyzed over two years. Wellness efforts remained unchanged in both years (website content, dedicated support personnel, and group activities). In 2023, a reduction in referencing of wellness (22%) and inclusivity (30%) occurred in leadership messaging. However, a 7% increase in the use of inclusive pronouns was noted. A reduction in gender diversity was identified (9% in faculty, 5% in residents), with programs favoring female-only teams. Similarly, a 7% reduction in the number of underrepresented in medicine faculty and residents was noted. A 15% reduction was noted in curricula referencing inclusivity in their mission statement and inclusivity focused research. Conclusions: This study suggests the variations across websites relative to inclusivity and wellness over the past two years. Updated websites may provide an accurate reflection of the offerings of programs and their investment in wellness and inclusivity across the nation.

Evaluation of The Effectiveness of Abdominal and Vaginal B-Ultrasound in The Diagnosis of Acute Abdomen in Obstetrics and Gynecology

Objective: To explore the clinical effect of the combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen in obstetrics and gynecology. Methods: Eighty patients admitted to our hospital from March 2023 to March 2024 were selected, all of whom were acute abdomen patients admitted to the Department of Obstetrics and Gynecology. In this study, the patients were divided into two groups. One group of 40 patients was given a simple abdominal B-ultrasound diagnosis (control group). The other group of 40 patients was given both abdominal and vaginal B-ultrasound examinations (experimental group). The diagnostic accuracy between the two groups was compared. Results: Patients in the experimental group had higher consistency rates with pathological diagnosis results in ectopic pregnancy rupture, embryonic arrest, acute pelvic inflammation, corpus luteum rupture, and intrauterine adhesions as compared to the control group. At the same time, the inspection accuracy rate of the experimental group (92.50%) was higher than that of the control group (70.00%) (P < 0.05). Conclusion: The combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen was of great significance in improving the accuracy of clinical diagnosis and guiding doctors to provide effective treatment.

Misuse of prophylactic antibiotics and prevalence of postoperative wound infection in obstetrics and gynecology department in a Sudanese hospital

Purpose: This study was conducted to audit prophylactic antibiotic use and to quantify the rate of wound infection. Methods: Across-sectional prospective study was conducted in the Obstetrics and Gynecology Department in Khartoum Teaching Hospital, Sudan during March 1st to 31st October 2010. All Patients (aged >18 years) were included. Results: Overall 725 patients were included. The performed surgical procedures were 751;of these 578 (76.9%) were Caesarean sections. Overall rate of wound infection was 7.8%. The rate of wound infection among patients operated on for caesarean section and abdominal hysterectomy was 8.3%, and 9.2%, respectively. Multivariate logistic analysis showed that body mass index [BMI] ≥ 30 kg/m2 OR 2.1, 95% CI (1.1 - 4.0), (P = 0.019) was the major independent risk factor for occurrence of wound infection. Evaluation of prescriptions’ parameters against the stated criteria showed that 113 (15.8%) patients were given antibiotics with adequate spectrum of activity, 611 (85.3%) given sub-dose/s, 83 (11.6%) received the first preoperative dose/s in a proper time window, and 716 (100%) had prophylaxis for extended duration. Overall conformity to the stated criteria for the evaluation of prescription’s parameters was not achieved in all prescriptions. Conclusions: In this setting, antibiotics were irrationally used and wound infection rate was high, and the situation calls for multiple interventions to correct the situation, through the activation of the infection control committee in the hospital and development of antimicrobial subcommittee to develop policies for the use and auditing of prophylactic antibiotics.

Obstetrical Fistula: Clinical, Therapeutic and Prognostic Aspects at the Gynecology and Obstetrics Department of Borgou University Hospital Center in Benin

Introduction: Obstetric Fistula (OF) is a tragedy and a public health problem (physical, social, moral and psychological). Objective: To determine the clinical, therapeutic and prognostic aspects of obstetric fistula at CHUD/B-A maternity ward in 2016. Study Method: This is a descriptive, analytic study with prospective data collection from March 07 to December 31, 2016. Patients with obstetric fistula were the study population. Results: A total of 37 patients were treated including 35 operated, the other two not operated for pyuria and bladder calculus after examination under spinal anesthesia. The average age was 36.6 ± 10.5 years with the extremes of 21 years and 65 years. The mean age of onset of Obstetric Fistula (OF) was 28.9 ± 6.5 years. Patients came from southern Benin (51.4%), were married (67.6%), peasant (35.1%) and out of school (81.1%). The types of OF were vesico-vaginal fistula (VVF) (62.2%), urethro-vaginal fistula (24.3%), vesico-uterine fistula (VUF) (5.4%), and uretero-vaginal fistula (2.7%). The fistula site was supra trigonal (54.1%), urethral (18.9%), trigonal (10.8%), vesico-uterine (10.8%), cervical urethral (2.7%), ureteroid vaginal (2.7%). Fistulas were complex (70.3%), complicated (24.3%) and simple (5.4%). The vaginal route was one of the first routes (64.9%). The operative techniques used were CHASSAR MOIR hysterorrhaphy (74.3%). The cure with continence was 68.6%. Conclusion: OF is observed in young women of childbearing age. VVF is the most common. The management is surgical with several operating techniques. Healing is possible. Hence the importance of paying special attention to these patients for their care.

Bacteriology of Healthcare-Associated Infections in the Gynecology and Obstetrics Department of CHU Gabriel Touré

Introduction: Healthcare-associated infections (HAIs) are a public health issue. An infection is said to be associated with the care if it occurs during or after the care of a patient, and if it was neither present nor incubation at the beginning of the care. Objective: The purpose of this work was to study the bacteriology of infections associated with obstetric care in the gynecology-obstetrics department of CHU Gabriel Touré. Patients and Methods: This is an epidemiological, descriptive, analytical study conducted in the gynecology-obstetrics department of the CHU Gabriel Touré, from April 11th, 2016 to August 29th, 2016 (5 months). Data collection focused on the clinical and laboratory characteristics of healthcare-associated infections in patients during their hospitalization. Included in the study were any patients hospitalized in the Gynecology and Obstetrics Department who agreed to participate in the study. The criteria used to diagnose the associated infection were those of the Atlanta CDC. Operative wound monitoring was done up to the 30th postoperative day. Results: We have recorded 200 patients, out of whom 138 were operated on and 23 cases of bacterial infection associated with care (11.50%). The average age of the patients was 32.52 years ± 13.36 years against 29.36 years ± 10.28 years for the patients who did not present the infection. Seven point five percent of the evacuated patients had an infection associated with care. The most common types of infection were surgical site infection (60.86%), urinary tract infection (26.08%), endometritis and sepsis with 13.04% each. The isolated organisms were all resistant to Amoxicillin, to Amoxicillin + Clavulanic acid (88.88%) and to Ciprofloxacin (77.77%). The average duration of hospitalization for patients who developed the infection was 14.70 days. The lethality was 1.50%. The average cost of management of patients who developed the surgical site infection was 119,837 FCFA. Conclusion: The bacterial infections associated with the care remain frequent in our service and dominated by the infections of the operating site. Isolated organisms were all resistant to amoxicillin in 88.88% case ciprofloxacin.

Visualization analysis of the research status of FU Qingzhu’s Obstetrics and Gynecology based on bibliometrics

Objective This study examined the research status and development process of FU Qingzhu’s Obstetrics and Gynecology(Fu Qing Zhu Nv Ke,《傅青主女科》,FQZNK)in the past 40 years with bibliometrics and visual analysis.Methods Retrieved all related literature in the research field of FQZNK from the domestic and foreign databases:China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database(VIP),Wanfang Database,and Web of Science(WOS)core database,including Science Citation Index Expanded(SCIE),Social Sciences Citation Index(SSCI),and Arts&Humanities Citation Index(A&HCI).The search range was from January 1,1980 to March 10,2021.In addition,bibliometrics and CiteSpace 5.7.R2 software were used to analyze literature types,published journals,cited literature,the number of author publica-tions,co-author networks,co-institution networks,keyword co-occurrence networks,keyword clusters,and keyword bursts.Results A total of 678 valid records were included in the final dataset.Literature types,high publication journals,highly cited literature,high-yield institutions,high-yield research teams,and high-productivity scholars in this research field were found through bibliometrics.Liter-ature types can be divided into four categories,among which 451 are theoretical studies on academic thoughts of FQZNK,accounting for 66.5%of the included journals.The Journal of Shanxi Traditional Chinese Medicine had the largest volume of published articles(61),ac-counting for 9.0%of the total number of the included journals.The most cited literature was ZHOU Mingxin’s article“Using the quantitative method to discuss author’s authenticity and formula characteristics of FU Qingzhu’s Obstetrics and Gynecology”,which was cited 94 times.Hunan University of Chinese Medicine,the institution with the most publications,published 45 articles,and YOU Zhaoling,the most published author,published 33 articles.Moreover,it was found that most high-yield researchers came from high-yield institutions and that Hun-an University of Chinese Medicine had the most research on FQZNK.Keyword co-occur-rence analysis revealed that the keyword“FQZNK”had the highest frequency(597 times)and the highest centrality(1.00).Keyword cluster analysis used the Log-Likelihood Ratio(LLR)al-gorithm to form eleven important clusters:#0 treatment aiming at its root causes,#1 gynecopathy,#2 Siwu Decoction(四物汤),#3 FU Qingzhu,#4 post-partum,#5 infertility,#6 dysmenorrhea,#7 sterility,#8 coordinate the heart and kidney,#9 Danggui Buxue Decoction(当归补血汤),and#10 treatment.It was found that the prescriptions of FQZNK were studied mainly before 2000,the theoretical studies were mainly conducted before 2010,and its clinic-al application was mainly explored from 2010 until now.Diseases such as dysmenorrhea,morbid vaginal discharge,infertility,metrorrhagia,and polycystic ovarian syndrome(PCOS)have recently become popular topics in this field.Conclusion The current study provides more scientific,accurate,and comprehensive sci-entific support for further research and development of traditional Chinese medicine(TCM)in FQZNK.With this foundation,people can use burst detection to ascertain the current hot-spots in research,get their development trends,and forecast future research directions.In ad-dition,infertility,morbid vaginal discharge,flooding,and PCOS treatments based on TCM syndrome differentiation are currently popular research topics for FQZNK.

Retrospective Cohort Study on Acute Care in Obstetrics and Gynecology: Analogies and Differences When Compared to Emergency Medicine

Introduction: the demand for urgent obstetric and gynecology care has progressively increased: in the United States approximately 1.4 million gynecologic visits are made to the emergency department (ED) annually, while almost 75% of women make at least 1 unscheduled visit during pregnancy. Moreover, research has recently focused on setting standards in unscheduled care, and developing quality indicators to improve patients’ health. Therefore, we investigated the characteristics of women with acute gynecological or pregnancy complaints using quality indicators developed for emergency medicine, to better define the needs of this population and improve care. Methods: Retrospective cohort study on ED, and Obstetrics and Gynecology (ObGyn) triage visits, at a tertiary care hospital in Italy, during 2012. Data were analyzed with population-averaged logistic regression and Poisson regression. Results: When compared to the 33,557 ED visits, the 9245 ObGyntriage referrals were more frequently associated with pregnancy (≤12 weeks’ gestation, OR: 30.7, 95%CI;24.5 - 38.4;>12 weeks’ gestation, OR 81.2, 95%CI;64.8 - 101.4), vaginal bleeding (OR 156.6, 95%CI;82.7 - 294.4), diurnal (night access OR 0.87, 95% CI;0.78 - 0.96) and weekday access (holiday access OR 0.87, 95%CI;0.78 - 0.95), frequent users (recurrent ED visits IRR 0.87, 95%CI;0.83 - 0.9) and lower hospital admissions (ED admission OR 1.6, 95%CI;1.4 - 1.8). Conclusion: ObGyn triage patients differed from ED users, and were at higher risk of “crowding”. Such diversities should be considered to improve female healthcare services and allocate resources more efficiently.

Routine abortion training matters for obstetrics and gynecology residents

Background: We set out to compare resident perspective regarding self-rated ability to perform abortion procedures, abortion attitudes and satisfaction with training at programs with routine and optional abortion training. Methods: We distributed surveys and conducted 1-h focus groups for 62 residents at six New York City OB/GYN programs;three offer routine abortion training. We compared resident survey responses at programs with routine versus optional training regarding self-rated ability to perform abortion procedures, abortion attitudes and satisfaction with training. We reviewed focus group transcripts to understand differences related to satisfaction with abortion training. Results: Residents at routine programs reported higher proportions of self-rated ability to perform abortion procedures (all surveyed procedures p ≤ 0.05) and were more likely to fully participate in abortion services than residents at optional programs (42/45 vs. 12/17, p = 0.03). Residents at routine programs were more likely to be “very satisfied” with training (44/45 vs. 12/17, p < 0.001) based on three aspects of training: patient care management, self-rated ability to perform abortion procedures and rotation characteristics. Conclusion: Residents who received routine abortion training have higher rates of self-reported procedural competency and are more likely to be satisfied with training than residents who were offered optional training.

Application of Serum Ferritin Combined with Blood Routine Testing in the Screening of Obstetrics and Gynecology Diseases

Objective: To understand the application of serum ferritin combined with blood routine testing in the screening of obstetrics and gynecology diseases in this region. Methods: From January 1, 2017, to October 28, 2020, all obstetric pregnant women, inpatient maternal, gynecological outpatient, and gynecological inpatients in our hospital’s outpatient and inpatient clinics were collected for serum ferritin determination and blood routine related index detection and analysis Changes in results. The application value of serum special protein in gynecological and obstetrical disease screening was put forward. Results: A total of 15,656 cases of obstetrics and gynecology patients were collected, of which 15,300 were pregnant women. Comparing maternity checkups with hospitalized puerpera, the difference of all indexes except RBC was statistically significant (P < 0.05);Comparison of various indicators between gynecological outpatient clinics and gynecological hospitalizations, maternity checkups and gynecological outpatient clinics, inpatient maternal and gynecological hospitalizations, etc.;there was no statistically significant difference in all indicators (P > 0.05). Comparison of hospitalized puerpera and gynecological hospitalization, the difference of other indexes except for MCV, MCH was statistically significant (P < 0.05);Comparing hospitalized puerpera and gynecological clinics, the difference of HGB results was statistically significant (P < 0.05), but the difference of other indexes was not statistically significant (P > 0.05). Conclusion: During the maternity check-up period, the ferritin consumption is too large, the blood volume increases, and the blood routine-related items are reduced. The consumption is greater for a period of time after delivery, and recovery requires a certain process, which is relatively low;The ferritin in the body slowly recovered and the ferritin concentration increased. This process is a process of physiological change and does not involve related diseases, but from this result, we are also required to strengthen nutrition for pregnant women in order to give birth to healthier babies. The ferritin test of gynecological patients is mainly a screening of related diseases, and the results of this time did not screen out serious diseases.

Lean Management in Obstetrics and Gynecology: Application in the Ambulatory Clinic Pre- and Post-Kaizen

OBJECTIVE: The ambulatory clinic was an important departmental problem. Providers hated working there and patients complained about the wait times there. It seemed there were equal numbers of patients and provider complaints. In the spirit of solving the problem, data was gathered, a LEAN intervention was planned, and data was collected. METHODS: We defined the service families in the clinic as registration, vital signs, provider or ultrasound visit, nursing visit, and registration for the return visit. We walked the Gemba engaging all the staff in the process. Many observations pointed to long waits between and among the five stations. In order to study the current state, time data was collected by attaching a sheet of paper to a folder that the patient would carry themselves to all the clinical steps. On the sheet of paper each station logged the time that patient appeared and the time the patient left their sight. Data was gathered each day and every day from October 2016 to the summer of 2017. The data was analyzed. Leadership met and identified value and waste in the process. A Kaizen event was scheduled after the first set of measurements engaging all the staff. After the data was thoroughly analyzed and digested, brainstorming occurred. Together we determined our future state. We created a vision and strategic goals to reach our future state. RESULTS: The data pre-Kaizen event showed that the process of arrival to leaving took 124 minutes. We discovered that not every patient passed through each station. We learned the patients were on time or early for their visit most of the time. The providers were late most of the time by 1 - 1.5 hours. We learned how long each station took from the patient’s point of view. There were no statistically significant differences between ultrasound and provider visits;there were no statistically significant differences between midwife and physician visits. Each day of the week was similar. The arrival rate was higher in the morning because of the template. After the event, the total time in clinic did not change however the variability in time between and among each station decreased in variance. We informed the staff of these findings so that they could take responsibility for their part in the process. The atmosphere in clinic changed dramatically and the complaints from both providers and patients stopped. CONCLUSION: LEAN management was used to improve the clinic. It yielded important results, got the staff engaged in the process, and provided a way for the patients to see the efforts made by staff to improve.

What is the purpose of launching the World Journal of Obstetrics and Gynecology ?

World Journal of Obstetrics and Gynecology （WJOG） is a new member of the World Series journals and is launched in June 10, 2012. WJOG is an open access peer-reviewed bimonthly journal that will cover obstet-rics and gynecology including reproductive medicine. The intention of WJOG is to publish papers that de-scribe and infuence the situation all around the world. The journal will publish both basic research and well as clinical fndings. The focus shall be on translational work. Please send your important findings and com-ments to WJOG.

Gynecological and Obstetrical Emergencies at the University Clinic of Gynecology-Obstetrics of the National Hospital Donka Guinea

Gynecological and obstetrical emergencies are found all over the world, especially in developing countries where women pay a heavy price for giving birth. They can occur at any time during pregnancy and outside of pregnancy often in a socio-economic context. The objectives of this study were to describe the sociodemographic characteristics and the maternal and fetal prognosis of gynecological and obstetric emergencies. Patients and Methods: This was a descriptive cross-sectional study with prospective data collection, conducted at the University Clinic of Gynecology and Obstetrics of the Donka National Hospital between June 1 and September 30, 2015. It involved all patients admitted to our department in emergency for a gynecological or obstetrical complaint. Results: We collected 361 cases of gynecological and obstetrical emergencies out of a total of 1779 consultations, i.e. a frequency of 20.29%. Obstetrical emergencies were predominant with 91.41% and gynecological emergencies represented 8.59%. The average age of patients was 29.5 with extremes of 14 and 47. Nulliparous women were the most numerous (34.35%). More than half of the patients did not attend school (52.08%) and 56.70% were evacuees. Abdominopelvic pain and hemorrhage were the main reasons for consultation (54.29% and 49.58%). Admission diagnoses were dominated by acute fetal distress and hemorrhage in the last quarter of pregnancy (52.3% and 36.01%). The caesarean section rate was high (82.12%). Maternal and perinatal lethality rates were high (5.2% and 30.3%). Conclusion: Gynecological and obstetrical emergencies are a public health issue because of the severity of the prognosis they impose on the mother and child. Maternal and perinatal mortality was very high. The prevention of these serious emergencies must be done through good quality prenatal consultations. Laparoscopy equipment and staff training are necessary for a minimal invasive surgery of gynecological emergencies.

Sexual Experience of Women after Gynecological Hysterectomy in the Department of Obstetrics and Gynecology of Yalgado Ouedraogo Teaching Hospital, Burkina Faso

Objective: To study the sexual experience of women after gynecological hysterectomy in the obstetrics and gynecology department of Yalgado Ouedraogo University Teaching Hospital in Burkina Faso. Patient and Method: We conducted a cross-sectional study from October 1, 2016 to March 30, 2017. It included any patient who had a gynecological indication for a hysterectomy in the Department of Obstetrics and Gynecology of Yalgado Ouedraogo University Teaching Hospital (CHU-YO) during the study period. A total of 85 patients were included. We collected information from the consultation records, clinical records, and operating room registries and by surveying the patients themselves. Result: The frequency of hysterectomy in the gynecological period was 3.9%. The mean age of the patients was 51.71 (extremes: 35 and 66 years) and the mean parity was 4.8. Married women were the majority. Fibromyoma and genital prolapse accounted for 56.47% and 23.53% respectively of operative indications. Regarding postintervention sexuality, 29.41% of women declared no longer having sexual desire. Also, they complained of vaginal dryness (31.8%), decreased frequency of orgasm (42.3%), dyspareunia (37.65). Sexual dysfunction was present in 82.35% of women. There was a statistically significant difference between global sexual functioning and geographic origin, educational attainment, socio-economic level, surgical approach, preintervention sexual counseling, women’s psychological profile and their emotional relationship with their spouses. Conclusion: The psychosexual soundness of hysterectomy is important. A diagnosis of sexual disorders prior to the intervention and psychological follow-up throughout the therapeutic process of the pathology indicative of a hysterectomy is necessary for successful postoperative sexuality.

Parity 3 or More at Haiphong Hospital of Obstetrics and Gynecology in 2016

Background： Although increasing parity increased the risk of pregnancy complications and despite of Vietnam’s family planning policy of two-child, the percent of women having three or more children has tended for five years. Objectives： （1） Find out the prevalence of parity ≥ 3 and their reasons at Haiphong Hospital of Obstetrics and Gynecology in 2016; （2） Describe the methods of labor and its adverse outcomes. Materials and methods： A cross-sectional in 485 women had delivered three or more infants at Haiphong Hospital of Obstetrics and Gynecology from June to August, 2016. Results： The prevalence of parity ≥ 3 is 11.9%, no relation to geopraphy, education and career. The main reasons are unplanned pregnancy and desire to have a baby boy. The sex ratio at birth is 162. The proportion of cesarean delivery is 53.4%, in which is due to an old C-section. Conclusion： serious gender is imbalance among women having three or more baby （162 baby boys per hundred baby girls）.

Factors Associated with Maternal Mortality at Gynecology and Obstetrics Department in Departmental University Hospital Center of Borgou

Introduction: Maternal mortality is a robust indicator of human development. Most of it occurs in developing countries. Objectives: This study aims to determine the factors associated with maternal mortality in Gynecology and Obstetrics Department of Borgou Departmental University Hospital Center (CHUD-B). Study method: Our study took place at Gynecology and Obstetrics Department in Borgou Departmental University Hospital Center. This was a descriptive and analytical case-control study, covering a period of 7 years from January 1, 2012 to December 31, 2018. Results: Two hundred and twelve patients have been recruited consisting of 106 deceased women and 106 controls. The intra-hospital mortality ratio was 1100 deaths per 100,000 live births (LB). The mean age of deceased women was 27.06 ± 6.45 years with the extremes of 15 and 45 years. Direct obstetric causes were the most frequent causes of maternal death. They were dominated by immediate postpartum hemorrhage (32.93%), followed by High Blood Pressure (26.83%) and infections (17.07%). The general condition of patients on admission (p-0.000) and inadequate management (p-0.001) was associated with maternal mortality. Conclusion: Patients’ general condition on admission and inadequate management was factors associated with maternal mortality.

Blood Transfusion Practices at the Gynecology-Obstetrics Department of the Sylvanus Olympio University Hospital in Lomé: A Study of 254 Cases

Objective:?To describe blood transfusion practices in obstetric at the Sylvanus Olympio University Hospital in Lomé. Patients and method: Prospective, cross-sectional and descriptive study, conducted from 1 June 2017 to 31 May 2018 at the gynecology-obstetrics department. The study focused on transfused pregnant, parturient and delivered women. Study parameters were sociodemographic, clinical, therapeutic and prognostic. Results: 252 patients, aged 16 to 49 with an average age of 30.4 years, referred in 74% of cases. Hemorrhage was observed in 238 cases (94.4%) and anemia in 14 cases (5.6%). Blood transfusion was urgently used in 89.7% of cases and hemorrhagic abortion was the main indication. Blood group O+ (34.5%) was the most used and blood products were obtained after two hours in 81% of cases. Conclusion: Blood transfusion is often performed urgently and for bleeding. But the Gynecology-Obstetrics department does not have any blood in reserve, whereas the Sylvanus Olympio University Hospital collection and distribution station covers less than 10% of the needs.

Intra-Hospital Delay in Emergency Care at the Obstetrics and Gynecology Department in the University Teaching Hospital of Ouagadougou(UTH-YO),Burkina Faso

Objective: To investigate the intra-hospital delay in the treatment of gynecological and obstetric emergencies in the obstetrics and gynecology department at the UTH-YO. Patients and methods: It has been a prospective and descriptive study over a period of four months from 1 May to 31 August 2015 in the obstetrics and gynecology department at the UTH-YO. All patients and their escorts were included in our study, admitted to gynecological or obstetric emergencies who have accepted to participate in the survey. Data were entered and analyzed using a PC equipped with the SPSS 16.0 software English version. Results: During the study period, we recorded 2627 admissions. Delays in the management involved 216 patients or a frequency of 8.2%. The average age of patients was 26.6 ± 6.2 years, ranging from 16 and 46 years. Patients had no income in 165 cases (that is to say 76.4%). The referred patients accounted for 165 admissions (85.7%). The intake patterns were dominated by obstetric acute fetal distress in 44 cases (20.4%), pre-failure syndrome in 27 cases (that is to say 12.8%) and in gynecology by the ectopic pregnancy in 171 cases (79.3%). The average waiting period between the arrival of a patient and the beginning of first aid was 2 hours and 23 minutes with extremes of 16 min and 546 min. The main reason for the delay was the unavailability of the operating room in 61.1% of cases. The opinion of escorts was dominated by improving communication with the creation of a post of information in 47% of cases. Maternal prognosis was marked by a maternal death in 0.1% of cases and maternal morbidity in 13.4% of cases. The fetal prognosis was dominated by death at birth in 13.8% of newborns. Conclusion: Despite the subsidy of the government in obstetric and neonatal emergencies, there remain intra-hospital delays in the management of emergencies. The opening of discussions between the various stakeholders responsible for the implementation of this grant is urgent to contribute more effectively to the fight against maternal mortality.

Risk Stratification in Obstetrics: An Integrated Approach to Maternal Health

Introduction: Prenatal care is crucial for maternal and fetal health, highlighting the importance of obstetric risk stratification. This enables personalized care, avoiding unnecessary interventions and reducing costs. Conditions such as first trimester bleeding, spontaneous abortion, gestational trophoblastic disease, and ectopic pregnancy require specific approaches. Early identification of these complications is vital, especially in urgent and emergency obstetric cases, which demand immediate hospital attention. Objective: Comprehensive review of first trimester pathologies and gestational hypertension, focusing on obstetric risks and personalized prenatal management. Methods: Literature review on bleeding and gestational hypertension. Results: The study provides a detailed analysis of pathologies associated with first trimester uterine bleeding and hypertensive disorders, focusing on obstetric risk stratification. The main causes of maternal and fetal mortality are hypertensive disorders, hemorrhages, infections, childbirth complications, and abortion. Spontaneous abortion is common, with different classifications, ranging from threatened to missed abortion. Infected abortion is a severe complication. Brazil has restrictive abortion laws, but many unsafe abortions occur, resulting in high public health costs. Pharmacological treatment with misoprostol is a safe option. Other pathologies include gestational trophoblastic disease, ectopic pregnancy, and placenta previa. Preeclampsia and eclampsia are severe conditions requiring immediate treatment to avoid complications. Conclusion: Early identification and management of obstetric risk factors, such as uterine bleeding, are essential for positive maternal and fetal outcomes. A multidisciplinary approach is fundamental.

Application of Guizhi Fuling Pill in Gynecology

This paper reviews the research progress of Guizhi Fuling Pill in the clinical application of gynecology,such as the treatment of uterine leiomyoma,ovarian cyst,infertility and dysmenorrhea,in order to provide further research ideas for clinical researchers.

Application of transcutaneous electrical acupoint stimulation in perioperative gynecology

Transcutaneous electrical acupoint stimulation(TEAS)is also known as low-frequency pulsed electrophysiological technology.TEAS is an enhanced recovery after surgery,which covers the preoperative,intraoperative,and postoperative phases of the perioperative period,and the core concept is to promote the rapid recovery of patients.TEAS helps to repair local smooth muscle as well as nerves caused by surgery,increase blood circulation in the damaged area,restore innervation and vascular function,restore the balance of local venous and lymphatic circulation,reduce local pain as well as local tissue edema,reduce the occurrence of complications,reduce surgical discomfort,enhance therapeutic effects,and promote rapid recovery from surgery.