BACKGROUND: Intimate partner violence (IPV) is a public health problem and human rights concern that has an enormous impact on physical, mental, reproductive and socioeconomic aspects of health. Several health professional organizations recommend screening for violence though current screening rates tend to be low because healthcare providers are generally hesitant to be involved in dealing with women who are victims of violence.

OBJECTIVE: This study therefore attempted to assess the knowledge, attitudes, and practices of obstetricians and gynecologists on screening for intimate partner violence in a private tertiary hospital.

MATERIALS AND METHODS: The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool was utilized among 123 obstetricians and gynecologists in a private tertiary hospital in Pasig, Metro Manila, with a response rate of 65.8% (81/123).

RESULTS: Results showed that the sample participants did not have adequate knowledge on IPV; majority of the sample participants were not fully prepared and equipped to handle patients who are victims of IPV; and the sample participants did not routinely screen for IPV.

CONCLUSION: In the Philippines, the obstetricians and gynecologists generally act as the primary care physicians to the general female population. This provides them a good opportunity to be involved in the secondary prevention of IPV. Recognition of barriers to screening for IPV, development of strategies for increasing awareness to IPV, and education and training of physicians and allied health care professionals may improve the screening practices for IPV. These in turn will help them to provide appropriate, effective, and holistic care to their patients who are victims of violence. 

Human ; Physicians, Primary Care ; Tertiary Care Centers ; Spouse Abuse ; Public Health ; Secondary Prevention ; Philippines ; Violence ; Intimate Partner Violence ; Attitude ; Human Rights

BACKGROUND: The consequences of preterm birth not only for the baby but also for the mother has been well documented over the years. Numerous interventions have been tried and tested and yet it is still a significant problem to date. Progesterone has been documented to be an effective prophylactic drug against preterm labor for those considered at high risk for developing the condition. However, little is known its effectiveness when given in oral form as a maintenance tocolysis for those who already suffered from an acute episode or preterm labor.
OBJECTIVE:To evaluate the effectiveness of oral progesterone in the prevention of preterm birth after being diagnosed of preterm labor
DESIGN: Meta-analysis
SUBJECTS: The study population consisted of women with singleton gestation who were diagnosed with preterm labor, defined as having contractions associated with corresponding cervical dilatation, which were treated with oral progesterone as a maintenance tocolytic until delivery.
DATA COLLECTION: Journals were searched in different journal databases. Reviewers independently assessed the eligibility of the articles included in this study. Methodologic quality was reviewed using the Cochrane handbook for systematic reviews of interventions. Version 5.1.0 (updated March 2011). Data extracted were analysed using the Review Manager 5.3 Software (Revman 2014) and the Comprehensive Meta-Analysis Software (CMA3 2016).
RESULTS: No statistical difference was noted in terms of latency prolongation, gestational age at birth, occurrence of preterm birth, and on neonatal outcomes such as APGAR Score < 7 at birth, neonatal death between those who received progesterone and those who did not. However, babies in the progesterone group had a mean birthweight higher than their placebo counterparts.
CONCLUSION: The use of oral progesterone as a maintenance tocolysis after arrested preterm labor showed no statistically significant benefit except for higher birthweight in babies upon delivery.

Human ; Female ; Tocolysis ; Tocolytic Agents ; Gestational Age ; Premature Birth ; Progesterone ; Perinatal Death ; Obstetric Labor, Premature ; Birth Weight ; Delivery, Obstetric

Background: Preeclampsia (PE) has significant health and economic burden. Early screening for PE through first trimester screening (FTS) can direct decision-making on early initiation of aspirin (ASA) therapy, which has been known to reduce the incidence of PE. Objectives: The objective of the study is to evaluate the cost-effectiveness of FTS and early initiation of ASA for disease prevention. Methodology: A population of 1916 women who delivered in a private tertiary hospital from January 2019 to March 2020 was categorized based on the risk of developing PE, results of FTS, initiation of ASA therapy, development of PE, and mode of delivery. Descriptive statistics using counts and percentages were used to summarize the data. Association between ASA therapy and PE was assessed using the Chi-square test. Costs of screening, ASA therapy, inpatient management, and delivery were computed. Results and Conclusion Results showed that PE was prevented in 71.4% of those high-risk patients who underwent FTS and started on ASA therapy. Total cost of urgent care of PE and delivery was P119,687.02 to P149,687.02 for early PE, and P103,587.02 to P133,587.02 for late PE. Prevention of early PE and late PE results in net cost savings of P69,694.02 and P53,594.02, respectively, with the investment of P9,993.00 on FTS and ASA therapy. Implementation of FTS and initiation ASA therapy is an effective and cost-saving approach that can prevent PE.
Aspirin ; Pre-Eclampsia

Background: Proper assessment and efficient diagnosis of central nervous system anomalies is essential in antenatal surveillance of pregnant patients. These anomalies are usually associated with genetic syndromes or severe malformations requiring timely intervention and antenatal counseling of the expectant couple. Objective: The study aims to evaluate the agreement of cranial biometric measurements and to determine if there is a significant difference in the time needed to complete the evaluation using standard 2D and semi-automated 5D ultrasound. Methods: An analytical cross-sectional study was employed on 93 women who underwent pelvic ultrasound scans from August to October 2022 in a tertiary hospital. Basic biometric fetal central nervous system (CNS) measurements were acquired using 2D ultrasound followed by 5D CNS ultrasound. Bland-Altman plots were used to evaluate the agreement of the measurements obtained. The difference in the time to completion was determined using independent t-test. Results and Conclusions Our study found that 5D CNS ultrasound measurements showed 96.8% agreement with 2D ultrasound in 90 out of 93 fetuses. The 5D CNS ultrasound takes a shorter time of 90 seconds (s) to completion in comparison to 99 s using the 2D method (p=0.076). Upon stratification of the study population per trimester, in the second trimester, it took 76 s with 5D CNS vs 89 s with 2D, resulting to a statistically significant 13-second difference (p=0.044). In the third trimester, 5D CNS took 105 s vs 108 s with 2D (p=0.614). The time to completion of the scan using this technology is faster when used for second trimester pregnancies but could be affected by fetal-dependent and operator-dependent factors. Therefore, application of this new technology has the potential to improve workflow efficiency after the necessary training on 3D sonography and 5D CNS ultrasound software.
Artificial Intelligence