These results were replicated by Olayemi et al[31] as well as Eras et al[32] who assessed the risk associated with pre-eclampsia and found that women with an aborted pregnancy of the same paternity experienced the same protective effect against pre-eclampsia (Table 1) . Need et al[33] in 1983 were the first to suggest a higher incidence of preeclampsia in pregnancies resulting from insemination with donor sperm.
CONCLUSION
The inverse relationship between length of sexual cohabitation and pregnancy-induced hypertension was later demonstrated by Robillard et al [7]. Available data support the hypothesis that the incidence of pre-eclampsia and pregnancy-induced hypertension decreases with increasing length of sexual cohabitation.
We reviewed the evidence that the source of gametes and previous exposure may be associated with the risk of preeclampsia. Correlation between oral sex and a low incidence of preeclampsia: a role for soluble HLA in seminal fluid.
Prevention of shoulder dystocia related birth injuries: Myths and facts
Abstract
INTRODUCTION
Prevention of shoulder dystocia-related birth injuries: myths and facts. of pure science if researchers were to push to solve this problem through this respected gold standard of research. Fortunately, monetary compensation has replaced the death penalty, which was favored in the Nile Valley three thousand years ago. The author's group accessed these resources and collected 338 medical records detailing shoulder dystocia-related fetal injuries or deaths.
The lack of a documented diagnosis is considered by some investigators to be evidence that brachial plexus palsy has occurred without shoulder arrest[3]. Therefore, for the purposes of their studies, the participants of this research included in their material those cases where there was a brachial plexus injury, but the diagnosis of shoulder dystocia was not documented.
DEFINITION OF SHOULDER DYSTOCIA
The robust demand for experimental evidence delayed the clinical implementation of "asepsis" to prevent bed fever for four decades, at the cost of tens, if not hundreds, of thousands of lives. Similar to ancient Egypt, doctors in the United States face legal action if their treatment results in a bad outcome. As a result, a wealth of medical records of birth injury cases can be found scattered across hundreds of hospitals, in the files of malpractice attorneys and insurance companies.
In those cases where court proceedings followed, the records were added to the database only after the court proceedings had ended. This distinction is only relevant in a medico-legal context, as the injury was never attributed to a shoulder stop, but to traction applied by the responsible doctor or midwife.
FETAL EFFECTS OF ARREST OF THE SHOULDERS
At the Perinatal Center in Newark, head and body were delivered during separate uterine contractions in about 1 in 3 cases. Therefore, the impression gained from the literature, namely that approximately 1 in 10 cases of shoulder dystocia result in permanent fetal damage, is at best an educated guess. The characteristic damage associated with arrest of the shoulders is Erb's and less often Klumpke's palsy.
Fractures of the skull, clavicle and humerus are relatively frequent as are intracranial hemorrhage and hypoxic brain damage[16]. Minor brachial plexus lesions that are visible at birth usually disappear after a few weeks or months.
PREDISPOSING FACTORS FOR ARREST OF THE SHOULDERS
In a significant minority of deliveries, contraction stops after the appearance of the head but before external rotation. It therefore follows that traction immediately after delivery of the head leads to arrest of the shoulders and can lead to Erb's palsy. External rotation occurred shortly after head expansion and the delivery process stopped at that point.
However, review of the literature made it clear that in the 5000 g danger zone, ultrasound examinations underestimated the fetal weight in 80% of the cases [46-48]. Although approximately two-thirds of the deliveries were spontaneous in the entire material, the incidence of central nervous system (CNS) damage in the spontaneous and instrumental delivery groups was close to equal (37 vs 33).
EFFECTS OF PRACTICE PATTERNS
In light of the reviewed data, routine diabetes screening of all pregnant women and careful treatment of the disease are considered absolutely necessary. Although good management must take into account many important factors, including pelvic dimensions, previous births, maternal diet and others, in most cases an estimated fetal weight of 4000-4200 g represents for the author the most accurate limit. high for vaginal birth in case of confirmed mother. diabetes. Assessment of fetal weight and size by ultrasound should be considered a mandatory routine in case of suspected LGA fetal status.
MISCELLANEOUS FACTORS AFFECTING INCIDENCE OF SHOULDER DYSTOCIA
Thus, rather than remaining stable, the incidence of shoulder arrest and its neonatal sequelae increased exponentially in the United States since the 1970s. Aware of the clinical implications of their research, their attention was focused on infants who encountered shoulder dystocia. Investigations by Gurewitsch[88] based on more than 200 cases found that it caused delays in body delivery.
Although the United Kingdom remained unaffected by the US shoulder dystocia crisis, in 2005 the RCOG endorsed the idea that the fetus should be extracted from the birth canal after delivery of the head[42]. In fact, members of the CESDI committee emphasized that the adverse outcomes were not related to the head-to-body delivery intervals.
PREVENTION OF SHOULDER DYSTOCIA AND BRACHIAL PLEXUS INJURIES
Guidelines” from the College cited the so-called CESDI report in support of this advice, which stated that the study found that 47% of babies who died after deliveries complicated by shoulder dystocia “died within 5 minutes of the head being born. ”. They explained that the newborn deaths were the result of poor labor management and inadequate skills of the doctors in charge[92]. Using advanced methodology, Allen produced evidence supporting a link between aggressive management of the birth process and neurological birth injuries[96].
During the operation the surgeon found extensive adhesions in the cross-sectional area of the anterior lower segment. The authors noted that all peak births involved extensive manipulation and concluded that none of the cases could be attributed to "intrauterine maladaptation."
CONTROVERSIAL ISSUES
If uterine activity caused a significant proportion of brachial plexus injuries, then Erb's palsy should be common in infants delivered by cesarean section due to obstructed labor activity. Whether the overextension is done during or without a shoulder hold has no bearing on the mechanism of injury; (2) In traditional childbirth, the criteria for shoulder dystocia are unequivocal. Without the influence of such apparent interpretation, more than 90% of the records in the author's database, which came from hundreds of different geographic locations, showed that shoulder dystocia and brachial plexus palsy occurred by chance.
That the condition of the fetus does not deteriorate between contractions has been proven beyond any doubt. Because the topic had previously been neglected, the role of the method of delivery in the causation of birth defects has been emphasized in this review.
EPILOGUE
Can a customized standard for large for gestational age identify women at risk of operative delivery and shoulder dystocia. Shoulder dystocia-related fetal neurological injuries: the predisposing roles of forceps and ventouse extractions. High birth weight and shoulder dystocia: the strongest risk factors for obstetric brachial plexus palsy in a Swedish population-based study.
Use of a birth weight threshold for macrosomia to identify fetuses at risk for shoulder dystocia in a Chinese population. Correlation between head-to-body birth intervals in shoulder dystocia and umbilical artery acidosis.
Gynecological malignancies and hormonal therapies
Clinical management and recommendations
The association of Progestin creates a down-regulation of these receptors and moreover an induction of the activity of the 17 β-estradiol dehydrogenase which converts Estradiol into Estrone which has an inferior activity. Under the progestin influence, the histology of the endometrium changes from proliferative to secretive, and this reduces the risk of ensuring hyperplasia [9]. Women treated for gynecological cancer always suffer the consequences of estrogen deficiency due to the surgical resection of the ovaries, radiation and chemotherapy [12].
Because of the underlying fear of cancer survivors, the uncertainty of clinicians, the lack of national or societal guidelines, and the possibility of litigation if a woman develops a recurrence while receiving estrogen therapy, most clinicians do not prescribe HRT to these patients.[12] regardless of tumor type and disease stage[13]. This is much more intense than the natural onset due to both the sudden drop in estrogen/androgen levels and the younger age of the patients[14-16].
RESEARCH
Over the past 10 years, much confusion has arisen regarding the use of HRT in the general population [10]. In fact, HRT has caused some significant risks such as breast cancer, venous thromboembolic events, stroke and coronary artery events[11]. Following the publication of the “International Menopause Society's 2013 updated recommendations on menopausal hormone therapy and preventive strategies for midlife health” [11], a general consensus on HRT was reached.
This has led to many women being refused HRT, increasing the number of young patients experiencing the effects of iatrogenic menopause. The purpose of this review is to analyze the possibility of using ERT or EPT in patients treated for gynecological malignancies, with the aim of formulating recommendations for clinical practice.
OVARIAN CANCER
Because of the important role that estrogens play in the development of the most common endometrial cancer, HRT can stimulate the growth of occult tumor cells that remain after surgical treatment. The control group had a higher rate of relapse due to higher-risk disease (Grade 1C, Grade 3). These results were shown in a 2010 review by Singh et al[23]; however, the author pointed out that in endometrioid endometrial cancer, the reason why HRT showed no adverse effects may be the radical excision of the tumor due to the early stage.
In fact, in advanced stage Type I of endometrial cancer, there may be some residual cells after surgical treatment that can be stimulated by HRT and subsequently change the prognosis of the patient. The use of estrogen-progestogen HRT is likely to suppress estrogen-stimulated cell growth due to the progestogen combination, but there is no clear evidence data on this theory [23].
![Table 1 Epithelial ovarian cancer Ref.Study designHRT vs controlStageType of HRTMonths HRTMonths follow upRecurrence HRT vs controlsStudy conclusions Eeles et al[37]Retrospective case-control 78/2951-2: 55% 3-4: 45%Oral EstrogenMedian 28Median 42-No ef](https://thumb-ap.123doks.com/thumbv2/123dok/11492564.0/30.892.104.698.109.1184/epithelial-controlstagetype-hrtmonths-uprecurrence-controlsstudy-conclusions-retrospective-estrogenmedian.webp)
CERVICAL CANCER
BRCA MUTATION CARRIERS AFTER SALPINGO-OOPHORECTOMY
Manuscripts must be submitted via the Online Submission System at: http://www.wjgnet.com/2218-6220office. Authorship: Authorship credit must be in accordance with the standard proposed by the ICMJE, based on (1) significant contributions to conception and design, acquisition of data, or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; and (3) final approval of the version to be published. Data should be presented in the main text or in figures and tables, but not in both.
Scale bars should be used instead of magnification factors, with the length of the bar defined at the leg end rather than on the bar itself. For citation content that is part of the narrative, the code number and square brackets should normally be provided. If references are cited directly in the text, they should be joined in the text, e.g.
Standard abbreviations should be defined in the abstract and at first mention in the text.