Antenatal dexamethasone use and respiratory distress in late preterm infants: results from first Vietnamese matched cohort study.

BACKGROUND: Respiratory distress syndrome (RDS) is one of the leading causes of early neonatal morbidity and mortality in late preterm infants (LPIs) worldwide. This matched cohort study aimed to assess how the antenatal dexamethasone use affect the respiratory distress (RD) proportion in preterm newborns between 34 0/7 weeks and 36 6/7 weeks of gestation. METHODS: This was a prospective cohort study on 78 women with singleton pregnancy who were in threatened preterm birth and had not received prior dexamethasone, who were admitted between 34 0/7 weeks and 36 6/7 weeks at Hue University of Medicine and Pharmacy Hospital from June 2018 to May 2020. The matched control group without dexamethasone use included 78 pregnant women diagnosed with threatened late preterm births who were at similar gestational ages and estimated fetal weights as the treatment group. The treatment group received 6 mg intramuscular dexamethasone every 12 h for a total of 4 doses or until delivery. Primary outcome was the rate of neonatal RD. Secondary neonatal outcomes included the need for respiratory support, neonatal intensive care unit (NICU) admission, hypoglycemia, necrotizing enterocolitis, intraventricular hemorrhage, and neonatal death. Statistical analyses were performed by using SPSS software, version 26.0. RESULTS: The proportion of RD in LPI was significantly lower in the treatment group than in the matched control group (10.3% vs. 23.1%, respectively), adjusted Odds Ratio [aOR] 0.29; 95% confidence interval [CI] 0.10 - 0.83 and p = 0.021. Neonatal hypoglycemia was more common in the dexamethasone group than in the matched group (25.6% vs. 12.8%, respectively; aOR, 2.59; 95% CI, 1.06 - 6.33; p = 0.037). There were no significant between-groups differences in the incidence of respiratory support, NICU admission or length of hospital stay. CONCLUSIONS: Administration of antenatal dexamethasone to women at risk for late preterm birth could help to lower the proportion of respiratory distress in late preterm infants.

Assessment of myocardial performance index in late-onset fetal growth restriction.

The aim of this study is to determine whether the myocardial performance index (MPI) is increased in fetal growth restriction (FGR) fetuses and if increased MPI is related to adverse outcomes of FGR. This is a prospective cross-sectional study. Seventy-three late-onset FGR fetuses and 97 gestational-age matched control fetuses were enrolled in this study. Fetal blood flow parameters including MPI values were measured and compared between the two groups. For the effect of severity of growth restriction on MPI value, they were also compared with < 3rd and 3rd - 10th centile groups. FGR fetuses were divided into two groups by favorable and adverse outcome and ultrasound parameters were compared between these two groups. Moreover, significant factors related to adverse outcomes by univariate analysis were analyzed by multivariate logistic regression analysis. Pulsatility index of umbilical arterial flow (UA-PI), MPI and amniotic fluid index in the FGR were significantly different from the control fetuses. However, no significant difference between < 3rd and 3rd - 10th centile groups was detected in MPI and UA-PI. The increased levels of MPI and UA-PI were independently related with adverse outcome of late-onset FGR pregnancy. In conclusion, MPI values were increased in late-onset FGR pregnancy, and the higher level of MPI could predict adverse outcome as well as the measurement of UA-PI. Clinicians should consider cardiac dysfunction in FGR through increased MPI.

Validation of the Vietnamese Translation Version of the Female Sexual Function Index in Infertile Patients.

INTRODUCTION: The Female Sexual Function Index (FSFI) is regarded as a self-administered screening questionnaire for assessing the presence of any type of sexual dysfunction. AIM: The aim of this study was to investigate the psychometric properties of the Vietnamese translation version of the Female Sexual Function Index (VN-FSFI) in a sample of infertile Vietnamese women. METHODS: An existing Vietnamese translated-FSFI version was used as a first-step approach to back-translate into English. Based on the comparison of the original English version and the back-translation script, a modified version of the FSFI was revised. This version was evaluated for "content validity" by a panel of 3 experts and for "face validity" by a pilot study that was based on its results to refine to reach the last Vietnamese FSFI version (VN-FSFI version). A cross-sectional survey to investigate psychometric reliability and validity of the last VN-FSFI version was conducted with 271 infertile Vietnamese women from January 2017 through February 2018, at a hospital located in a central region of Vietnam. Construct validity was evaluated by principal component analysis using varimax rotation and factor analysis. Reliability studies on internal consistency (Cronbach's alpha coefficient, domain inter-correlations, and domain-total correlations) and on test-retest (Intraclass correlation coefficient). MAIN OUTCOME MEASURE: Construct validity and the reliability of the VN-FSFI version. RESULTS: Based on principal component analysis, a 5-factor model was established, consisting of arousal/orgasm, satisfaction, pain, lubrication, and desire that explained 72.32% of the total variance. The factorial structure supported to 6 retrieved domains that corresponded to the original version. The Cronbach's alpha coefficients were 0.92 for the total scale and 0.72-0.89 for the domains. Domain inter-correlations ranged from 0.36-0.73 and domain-total correlation coefficients ranged from 0.67-0.84. Test-retest correlation coefficients over 2-4 weeks were 0.97 (P < .001) for the total scale and 0.84-0.96 for the domains. CONCLUSION: With good psychometric properties, which are almost similar to the original English version, this Vietnamese translation version of the Female Sexual Function Index (VN-FSFI version) was proved to be a valid and reliable instrument to measure multidimensional aspects of sexual function in infertile Vietnamese women. Ho TTT, Le MT, Truong QV, et al. Validation of the Vietnamese Translation Version of the Female Sexual Function Index in Infertile Patients. Sex Med 2019;8:57-64.

GnRH Agonist versus hCG Trigger in Ovulation Induction with Intrauterine Insemination: A Randomized Controlled Trial.

This study is aimed at comparing clinical pregnancy rates (CPRs) in patients who are administered either gonadotropin-releasing hormone agonist (GnRHa) or human chorionic gonadotropin (hCG) for ovulation trigger in intrauterine insemination (IUI) cycles. A prospective randomized comparative study was conducted at Hue University Hospital in Vietnam. A total of 197 infertile women were randomly assigned to receive either GnRHa trigger (n = 98 cycles) or hCG trigger (n = 99 cycles) for ovulation trigger. Patients returned for ultrasound monitoring 24 hours after IUI to confirm ovulation. A clinical pregnancy was defined as the presence of gestational sac with fetal cardiac activity. There was no difference in ovulation rates in either group receiving GnRHa or hCG trigger for ovulation. Biochemical and CPR were higher in patients who received hCG (28.3% and 23.2%) versus GnRHa (14.3% and 13.3%) (p = 0.023, OR 0.42, 95%CI = 0.21 - 0.86 and p = 0.096, OR 0.51, 95%CI = 0.24 - 1.07, respectively). After adjusting for body mass index (BMI) and infertility duration, there was no difference in CPR between the two groups (OR 0.58, 95% CI 0.27-1.25, p = 0.163). In conclusion, the use of the GnRHa to trigger ovulation in patients undergoing ovulation induction may be considered in patients treated with IUI.

Metabolic Syndrome and Insulin Resistance Syndrome among Infertile Women with Polycystic Ovary Syndrome: A Cross-Sectional Study from Central Vietnam.

BACKGROUND: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive-age women. Its metabolic features often overlap with those associated with metabolic syndrome (MS) and insulin resistance syndrome (IRS). The objective of this study was to determine the prevalence and predictors of MS and IRS in infertile Vietnamese women with PCOS. METHODS: A cross-sectional study was conducted at a tertiary fertility centre at Hue University Hospital from June 2016 to November 2017. A total of 441 infertile women diagnosed with PCOS based on the revised 2003 Rotterdam consensus criteria were enrolled. MS and IRS were defined based on the National Heart, Lung, and Blood Institute/American Heart Association Adult Treatment Panel III 2005 and American College of Endocrinology IRS 2003 criteria, respectively. Complete clinical and biochemical measurements of 318 women were available for analysis. Independent predictors of MS and IRS were identified using multivariate logistic regression. RESULTS: The overall prevalence of MS and IRS in women with PCOS was 10.4% and 27.0%, respectively. We identified older age (>30 years) and obesity as independent predictors of MS and IRS. Elevated anti-Müllerian hormone levels increased the risk of IRS, but not that of MS. CONCLUSION: MS and IRS are prevalent disorders among infertile Vietnamese women with PCOS. PCOS is not solely a reproductive problem. Screening and early intervention for MS and/or IRS based on anthropometric, metabolic, and reproductive hormone risk factors should be an integral part of fertility care.

Community-based prevalence versus hospital-based incidence of genital Human Papillomavirus infection in Central Vietnam.

INTRODUCTION: This study aims to determine the genital HPV prevalence in reproductive-age women in Thua Thien Hue Province and comparison with HPV incidence in Hue University Hospital, Vietnam. METHODOLOGY: Cross-sectional study on 1,034 women of reproductive age from 11 communes/wards of three districts representing three different geographic areas of Thua Thien Hue Province, Vietnam. The hospital-based group included 102 women with cervicitis and/or abnormal Pap smear result coming to Hue University Hospital. Extracting DNA from cervical samples, performing the real-time PCR for detecting HPV and the reverse dot-blot assay for HPV typing in HPV positive cases. RESULTS: In community, HPV prevalence was 0.9%. Mean-age of HPV positive group was 37.9 ± 6.2 years. The detected low-risk types were 6 and 11; high-risk types include 16, 18, 33, 45, 52, and 58. Single-type infection was found in 66.7% of cases. In hospital-based group, 41.2% of women have been infected with HPV, 6 different HPV types were detected. HPV18 was the most frequent high-risk type (33.3%), followed by HPV16 (15.1%); HPV6 was the most frequent among low-risk HPV types (31.2%). Single-type infection rate was 33,3%; 2 and 3 types co-infections were 28,6% and 38.1%, respectively. CONCLUSIONS: Routine screening of high-risk HPV infection in women with symptomatic gynecologic infection and/or abnormal Pap smear appears to be benefit in early detection and prevention of cervical cancer, due to the high incidence of HPV infection.