The aim of our study was to connect the possible complications of early pregnancy (miscarriage and symptomatic ectopic pregnancy) up to the 12th week of gestation with biometeorological conditions ...while assuming a greater number of incidents with an unfavorable biometeorological forecast. We performed a retrospective observational study using medical data of a single medical center of Department of Gynecology and Obstetrics, Sveti Duh University Hospital and meteorological data from the Croatian Meteorological and Hydrometeorological Service in Zagreb. We tracked the number of visits to the gynecology and obstetrics emergency unit on a daily basis during 2017. Days with five or more visits were selected and underwent further analysis, during which the number of miscarriages and symptomatic ectopic pregnancies was noted. The information from the biometeorological forecast was then extracted and added to the database. Our results did not show a statistically significant difference between the groups determined by biometeorological forecast in the number of spontaneous abortions or ectopic pregnancy. Also, statistically significant results did not follow the expected trend of the increasing number of complications related to worse biometeorological forecast, or vice versa, a decreased number of complications with better forecast. Our single-center retrospective analysis of emergency unit visits related to weather conditions did not show a connection between the complications of early pregnancy and biometeorological conditions. However, different results could emerge in future studies. Considering the large and high-quality database collected for this study, efforts in researching the connection between other gynecologic pathologies and weather conditions will be feasible.
Lateral episiotomy is a widely used procedure, although it is rarely mentioned in the literature and its effects on the pelvic floor are largely unexplored. The purpose of this study is to evaluate ...the impact of lateral episiotomy on the incidence of urinary incontinence (UI) after vaginal delivery in primiparas.
The study design is a prospective cohort study. The primiparas were divided into two groups. The first group consisted of women who gave birth with lateral episiotomy, while the second group included women who gave birth with an intact perineum or with perineal tears of first and second degree. Assessments of UI were performed at 5 and 8 months after childbirth using the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) questionnaire followed by the stress test.
The results revealed no significant differences (
> 0.05) in emergence of stress urinary incontinence (SUI) between the groups at the two time points. There were no statistically significant differences in overall rate of UI, urge urinary incontinence (UUI), or mixed urinary incontinence according to the ICIQ-SF questionnaire. The overall incontinence rate on the first examination was 24% in the episiotomy group and 36% in the perineal laceration group, although the difference was not statistically significant (
= 0.064). On the second examination, rates were similar and without a statistically significant difference.
Lateral episiotomy has a neutral effect on the onset of UI in primiparous women in the first year after delivery.
To report a rare uterine anomaly of a septate uterus, double cervix and double vagina in patient who conceived spontaneously and delivered vaginaly.
Case report.
Department of Obstetrics and ...Gynecology, Zagreb University School of Medicine, Clinical Hospital “Sveti Duh”, Zagreb, Croatia.
A 34-year-old nulligravida who underwent clinical, radiological, surgical and intrapartal workup.
Clinical examination and intrapartal surgical resection of vaginal septum followed by vaginal delivery.
Description and treatment for a rare Müllerian anomaly and a subsequent literature search.
Successful intrapartal resection of longitudinal vaginal septum and double cervix followed by vaginal delivery without complication.
Reconstructive surgical procedures may be considered for providing spontaneous pregnancies and intrapartal surgical technique could be taken into consideration in order to prevent unnecessary cesarean sections, upon strict estimation of the obstetrician.
•We present a rare anomaly of a septate uterus, double cervix and double vagina.•Reconstructive procedures may be considered for providing spontaneous pregnancies.•Intrapartal resection of longitudinal vaginal septum and double cervix was done.•Intrapartal procedures could prevent unnecessary cesarean sections.•If vaginal delivery is indicated experienced obstetrical team should supervise it.
The aim is to present the 60-year experience in modified Ritgen maneuver according to perineal injuries. This retrospective clinical observational study (1950-2010) analyzed the impact of modified ...Ritgen maneuver delivery technique (controlled fetal head deflexion with left hand and synchronous reduction of perineal strain with extended right hand thumb along the right side of the vulva and perineum without pushing) on peripartum perineal tears at the Maternity Ward, Bjelovar General Hospital in Bjelovar, Croatia, divided into five-year intervals. The rate of perineal tear in general was less than 5% until 2000. The rate of perineal tear grade I was very low until 1995, then increased to 8.6% in 2010, yet never exceeding 10%. The rate of perineal tear grade II never exceeded 2%, whereas perineal tear grade III was a sporadic event never exceeding 0.4% of the study material with a single case of grade IV tear. The rate of intact perineum in vaginal deliveries without episiotomy ranged from 96.2% to 100% in the 1950-1960 period, with a decrease to 46% in 2010. The study revealed the modification of Ritgen maneuver described to have resulted in significant re-duction of all grades of perineal tear over decades.
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