A novel triad for the diagnosis of endometriosis, the short anogenital distance combines with high endometrial BCL2 and low endometrial FASL.

OBJECTIVE: To investigate the anogenital distance from the upper verge of the anus to the posterior fourchette (AGDAF), FASL, and BCL2 combination as a reliable and non-invasive tool for the diagnosis of endometriosis. METHODS: This study included 100 women with endometriosis and 50 women without endometriosis as the control group. All cases underwent history taking, body mass index (BMI) measurement, AGD measurement, and FASL and BCL2 immunohistochemical staining of the eutopic endometrial tissue. RESULTS: This study included 150 women divided into endometriosis and control groups. Endometriosis cases significantly had shorter AGDAF, 22.9 ± 2.6 mm, compared with the control group, 27.3 ± 3.5 mm (P < 0.001). Lower FASL and higher BCL2 expression were associated with endometriosis (P < 0.001). The combined measurement of AGDAF (cut-off point 24.55 mm) with FASL and BCL2 was associated with endometriosis (P < 0.001). The combined diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of AGDAF, FASL, and BCL2 were 83%, 78%, 87.3%, and 69.6%, respectively. The area under the curve was greater for AGDAF, FASL, and BCL2 in combination than for individual measurements. CONCLUSION: Combining short AGDAF with high BCL2 and low FASL is a highly sensitive, non-invasive diagnostic tool for endometriosis.

Effect of Premarital Education on the Quality of Life of Female Partners: A Cross-Sectional Study.

Background A happy and satisfied marriage is the result of two happy spouses. Getting premarital education is one of the most significant reasons for marital and sexual satisfaction. This study aimed to assess the effect of premarital education on the quality of life of Saudi women. Methodology A cross-sectional study was conducted on 596 Saudi women married for ≤15 years selected from the general population. Data on participants' demographics were collected, and the quality of life was assessed using the World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). Results Only 37.2% of the participants had premarital counseling and education, even though 86.4% thought it was crucial before marriage. When this study was conducted, most participants with shorter mean marriage durations had received premarital education or counseling. The mean WHOQOL-BREF score, which measures the quality of life, was considerably higher for participants who indicated that premarital education significantly impacted the quality of their marriage and those who received premarital counseling or attended any form of premarital education. Conclusions Even though premarital education was viewed favorably, only 37.2% of couples obtained it. There is a need to increase public awareness of premarital education's significance and incorporate it into the education curriculum due to the positive associations between receiving it and a higher quality of life.

Correction: Effect of Premarital Education on the Quality of Life of Female Partners: A Cross-Sectional Study.

[This corrects the article DOI: 10.7759/cureus.32186.].

Is uterine depth measurement by trans-vaginal ultrasound alone as accurate as measurement carried out by trans-abdominal ultrasound-guided trial transfer?

OBJECTIVES: To assess the reliability of trans-vaginal-scan (TVS) in measuring the uterine depth (UD) in comparison with ultrasound-guided trial-transfer (UTT). METHODS: This prospective study was conducted in 66 consecutive patients undergoing in-vitro fertilization and embryo transfer (IVF-ET). The study took place in a private IVF center in Jeddah, Saudi Arabia between November 2013 and January 2014. The patients underwent UD measurements using TVS and UTT, sequentially. All scans were performed by a single sonographer, and all UTT were carried out by a single physician who was blinded to the TVS measurement. RESULTS: The median (95% confidence interval) UD measurement using the TVS method was 6.9 cm (5.0-12.5) and UTT was 7.1 cm (5.9-13.5), (p<0.0001). Fifteen patients (22.7%) had a difference of >1 cm between the 2 measurement modalities (group-B). When measured by UTT, 93.3% of patients in group-B had UD >/-8cm, compared with 9.8% of patients in group-A, (p<0.0001). Group-B had a significantly longer uterine cavity when measured by UTT (p<0.0001), and a trend towards significance when measured by TVS (p=0.055). The TVS measurements generally underestimated UD when compared with UTT. CONCLUSION: Trans-vaginal-scan is less reliable than UTT and should not be used as a substitute. Larger sample-size studies involving different personnel, and equipment is needed. 

Trichorionic quadruplet delivered beyond 36 weeks of gestation: a case report and literature review.

Following one year of secondary fertility, a couple conceived with a quadruplet after transfer of three embryos through IVF-ICSI. At 36 weeks and 2 days of gestation, the mother developed gestational induced hypertension and delivered the next day by caesarean section. Pathology confirmed the zygosity to be trichorionic quadramniotic and all four babies were discharged home with their mother on postoperative day 3. Herein, we describe a successfully managed high-risk pregnancy case. A review of the literature was conducted and to our knowledge no other cases with similar criteria ever reached such advanced gestational age.

Predictors of cesarean section following elective post-dates induction of labor in nullipara with uncomplicated singleton vertex pregnancies.

OBJECTIVE: Although post-dates is among the most common indications for induction of labor, no studies have identified the predictors of cesarean section (C/S) in that population. The high cesarean rate in our institution for this group of women triggered us to assess different induction practices to elicit potential causes. METHODS: We conducted a hospital-based retrospective cohort analysis using chart reviews of all nullipara women with induced labor at the Children's and Women's Health Centre of British Columbia, Vancouver, Canada, during the 2-year period, April 1998 to March 2000. The C/S rate was compared among 3 groups of women who were divided according to their induction method. RESULTS: Three hundred and thirty-nine women meeting the inclusion criteria were induced. Of the 25 women who received oxytocin ideally and the 111 women who did not, 7 (28%) and 53 (48%) were delivered by C/S, (x2=3.228 p=0.07; relative risks 0.59 [95% confidence interval 0.30, 1.13]). A significantly lower C/S rate (x2=21.9, p<0.0005) was found among women induced with prostaglandin (PG) alone (19.4%) compared with those induced with PG and oxytocin, whether oxytocin was given ideally (38.3%) or not ideally (45.4%). Of women who received oxytocin, there was no difference in chorioamnionitis (x2=0.485, p=0.49) between those who had an early membrane rupture (with or pre-oxytocin, 22.4%) and those who had membrane rupture following a period of oxytocin infusion (18.5%). CONCLUSION: The need for oxytocin or less than 2 doses of PG is associated with increased risk of C/S. Whether oxytocin was given according to protocol (ideally) or not, made no difference to the C/S risk in this population.