BACKGROUND: Adult vaccination is necessary in the prevention of many of the most common infectious diseases because immunity from infant vaccination typically wanes in adulthood In the female population the obstetrician gynecologist is placed at the forefront of health promotion and disease prevention In 2011 the Philippine Obstetrics and Gynecology Society POGS released a Clinical Practice Guideline on Immunization for Filipino Women but no study has been done to determine its impact
OBJECTIVE: This study determined the awareness and practices of OB GYN specialists on adult vaccination and their perceived hindrances to routine administration of the recommended vaccines METHODS: A self administered questionnaire was given to the POGS fellows through email phone and personal visits
RESULTS: Almost all of the respondents 95 were aware of Clinical Practice Guideline on Immunization but only 4 of the OB GYNs routinely administered all the vaccines The most common vaccinne administered was Human Papilloma Virus HPV vaccine 42 7 followed by Influenza virus vaccine 28 1 and Hepatitis B vaccine 27 3 There is no significant relationship between age of the respondent the number of years in practice place of practice affiliation with a teaching hospital or subspeciality training and vaccine recommendation and administration There is a significant positive relationship between awareness of the guidelines and the frequency of recommending the Tetanus Diphtheria Pertussis Tdap vaccine and the Influenza vaccine Similarly awareness of the guidelines was related to increased frequency of administering the Human Papilloma Virus HPV vaccine and the Influenza vaccine
CONCLUSION: Hence adult vaccination coverage may be promoted by increasing the awareness of the obstetrician gynecologists of the POGS Clinical Practice Guidelines on Immunization Although cost remains to be an issue identified by 93 of the respondents increasing awareness among OB GYNs on the importance of adult vaccination through the CPG on Immunization and or through attendance of the Vaccinology 101 Course through vaccinology courses may ultimately help decrease the incidence of some of the most coomon infectious diseases affecting the Filipino women and their children.

Human ; Male ; Female ; Middle Aged ; Adult ; Diphtheria-tetanus-pertussis Vaccine ; Influenza Vaccines ; Hepatitis B Vaccines ; Tetanus ; Diphtheria ; Vaccination ; Immunization ; Papillomavirus Vaccines ; Papillomaviridae

BACKGROUND: Uterine arteriovenous malformation (AVM) is a web of arteries and veins lacking an intervening capillary network. Color flow Doppler is a popular method of diagnosis of uterine AVM. The definitive management is hysterectomy. However, for patients desirous of pregnancy, transarterial embolization is a safe and effective option. Although rare, uterine AVM can complicate pregnancy with torrential bleeding due to hormonal changes and significant remodeling of the myometrium.
CASE: We report a case of a term pregnancyin a 33 year old with a uterine AVM and a previous transarterial embolization procedure who developed a uterine AVM during multi-agent chemotherapy for gestational trophoblastic disease. She consulted for prenatal checkup. Due to the risk of massive bleeding during labor, she underwent elective cesarean section at term and delivered a baby with good outcome.
CONCLUSION: This case suggests that uterine AVM in pregnancy can be managed conservatively with serial ultrasound monitoring and close follow up.

Human ; Female ; Adult ; Pregnancy ; Myometrium ; Uterine Anomalies ; Uterus ; Urogenital Abnormalities ; Arteriovenous Malformations ; Gestational Trophoblastic Disease ; Hysterectomy ; Cesarean Section ; Arteries

A cervical length <25 mm is correlated with an increased risk of preterm delivery. Pessaries have been used in patients with a short cervix to prevent preterm birth. Compared to cerclage, it is seen as a novel approach, which is more affordable, less invasive, and can be inserted at a later gestational age. We present our experience on the use of pessaries for shortened cervix. In this case series, we inserted a pessary in pregnant patients from 10 to 30 weeks of age of gestation (mean 23 weeks) with cervical length of 0.9 cm to 2.1 cm. We were able to prolong the pregnancy in 5 of the 7 cases with a mean interval to delivery of 14 weeks. One proposed mechanism of a pessary for shortened cervix is that it directs the inclination of the cervix posteriorly, which allows majority of the weight of the pregnancy to lie on the anterior segment of the uterus instead of on the internal cervical os. Based on the cases presented, we have proposed some guidelines in offering a pessary for patients with a shortened cervix: (1) recommend a pessary in patients with a cervical length <25 mm or a diagnosis of cervical insufficiency; (2) exclude infection or active labor; and (3) remove the pessary if there is rupture of membranes, significant vaginal bleeding, or persistent uterine contractions.
Pessaries