RESUMEN
This paper aims to study antepartum and postpartum bleeding manifestations of patients with factor VII (FVII) deficiency, their management, and feto-maternal outcomes, to establish danger signs and management protocols. We describe a case series of nine pregnancies in four patients with FVII deficiency diagnosed at a tertiary care referral center in India between 2012 and 2023. Out of nine pregnancies, six had cesarean deliveries, two had vaginal deliveries, and one had dilatation and curettage for unwanted pregnancies. One out of nine pregnancies (11.11%) with an unknown FVII deficiency had antepartum hemorrhage (abruption) necessitating multiple transfusions, ICU stay, and neonatal loss. Three patients with no prior history of obstetric hemorrhage were diagnosed with severe deficiencies and received prophylactic recombinant FVII preoperatively, averting the potential loss of lives. In patients with no history of bleeding, no hemorrhage was reported with or without prophylaxis while 33.33% of hemorrhage was reported in patients with a history of bleeding. Factors like the history of bleeding, FVII levels, mode of delivery, and other risk factors for hemorrhage should all be considered to predict the risk of bleeding in delivery. Cesarean is a surgical procedure, and prophylactic use of recombinant FVII concentrate (rFVIIa) should be considered.
RESUMEN
Sexual function in cervical cancer survivors declines significantly after treatments irrespective of the modality used. Only a few studies have looked at their psychosexual needs, perception, and acceptance of psychosexual support. This review summarizes findings of current qualitative as well as quantitative studies to understand the plight of cervical cancer survivors regarding sexual dysfunction and the management issues. The effect of gynecologic cancers on sexuality depends on multiple factors such as psychosexual factors, biologic factors, and age. Younger patients have poorer outcomes with a more pronounced impact on sexual well-being. Radicality of surgery has direct correlation with sexual dysfunction. Low or no sexual interest, lack of lubrication, dyspareunia, and reduced vaginal caliber are frequently found. For too long, researchers have focused on defining the prevalence and types of sexual problems after various cancer treatments. The area that continues to be neglected is the evaluation of effective interventions to prevent or treat cancer-related sexual dysfunction. In particular, mental health and medical specialists need to collaborate to create cost-effective treatment programs. Collaborative intervention with gynecologists, sexologists, radiotherapists, and nursing staff would be beneficial to optimize the sexual wellness of cancer survivors and their spouses.
RESUMEN
OBJECTIVE: To know the prevalence of immunology as a cause of unexplained repeated pregnancy loss (RPL) by comparing T helper cell 1(Th1) and T helper cell 2 (Th2) in the decidua of women with RPL, at the time of miscarriage with the decidua of women, at the time of induced abortion. STUDY DESIGN: case control study SETTING: Academic medical centre SUBJECTS: 36 Women requiring surgical evacuation, with history of previous one or more spontaneous abortions enrolled as cases. 37 patients undergoing surgically induced termination of pregnancy taken as control. Inclusion criteria- women who presented to the hospital with signs of abortion requiring surgical evacuation, with history of previous one or more spontaneous abortion. Exclusion criteria- women who had taken progesterone for present pregnancy, prior to this miscarriage. Also women who had clinical evidence of autoimmune disease, who were critically ill and who had biohazard exposures like HIV, HCV, HBsAg. INTERVENTION: The decidual tissue obtained was subjected to histopathology and immunohistochemistry staining for Th1 and Th2 cells. STATISTICAL ANALYSIS: Data entered in MS EXCEL spreadsheet and analysis done using Statistical Package for Social Sciences (SPSS) version 21.0. RESULTS: The Th1 cells were found to be positive in 25 % women in cases and 29.73 % women in controls group whereas Th2 cells were positive in 16.67 % women in cases and 8.11 % in control group. Both Th1 and Th2 cells were seen in 16.44 % of total women. (p- 0.678) CONCLUSION: No statistically significant difference in Th1 and Th2 cells in the decidua of patients undergoing recurrent abortion when compared to women undergoing medical termination of pregnancy. Therefore, routine screening for immunological factors and cytokine testing is not recommended. Patients of RPL should not be offered immune treatment routinely.
