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The Rhythm of the Normal and Abnormal Deliveries of the Mongolian Womens

Enkhtsetseg Jamsran ; Munkhtsetseg Davaatseren ; Lkhagva L ; Jav Baldan

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2007;2007(1):28-34.

The Rhythm of the Normal and Abnormal Deliveries of the Mongolian Womens Normal deliveries of mongolian women have orderly rhythmic oscillations which can be characterized by 24 hours, months, seasons and years. In the complicated deliveries the phases of biorhythms have been shifted and resulted in desynchronosis. Climatic and geliogeophizic factors had also effect on the frequency of complicated deliveries. Among common complications of the delivery and childbirth, preeclampsia, prolonged labor or dystocia due to insufficient labor and delivery forces, obstetric hemorrhage show seasonal and multi-year rhythms' characteristic to geographical regions and climatic conditions.
Delivery ; Obstetric ; Uterine Contraction

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Early Diagnosis of the Trophoblastic Disease

Yanjinsuren Daram ; Jav Baldan ; Avirmed Damdin

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2007;2007(1):35-42.

Early Diagnosis of the Trophoblastic Disease The study comprised 40 cases (15.7%) of chorionepithelioma and 214 cases (84.3%) of hydatidiform mole. According to our study (1992-2001), the incidence of trophoblastic disease, including chorionepithelioma, does not appear to reduce. Clinical characteristics of the trophoblastic disease strongly depend on the type of clinical variant. Chorionepitheliomas were associated with uterine bleeding and rapid spread to lungs, while hydatidiform moles were associated with expulsion of vesicles along with blood from the uterus and disagreement between the uterine size and gestational dates. Women older than 40 years (OR=2.31), and with history of 5 and more pregnancies and deliveries (OR=1.21 and OR=2.38), induced abortions (OR=1.41), and miscarriages (OR=1.03) have a greater chance of presenting with chrioepitheliomas than with hydatidiform moles. Because uterine bleeding is the main symptom of trophoblastic disease, which therefore can be confused with miscarriage, dysfunctional uterine bleeding, retained placenta and endometritis, evacuation of the uterus and sending the evacuate to pathology for confirmation is an important practice (Р<0.01). During trophoblastic disease, blood B-hCG levels dramatically increase. Levels of -hCG are higher and take more time decreasing to normal levels in chorionepitheliomas compared with hydatidiform moles, indicating that measuring B-hCG provides many advantage in monitoring the disease and treatment outcomes.

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Causes and clinical features of vulvovaginitis in prepubertal girls

Baigalma G ; Erdenetungalag R ; Nortmaa A

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2007;2007(1):43-46.

Causes and Clinical Features of Vulvovaginitis in Prepubertal Girls Reproductive Tract Infections are serious health problem especially in developing countries with a young population since the undetected and untreated infections are associated serious sequel such as infertility, ectopic pregnancy, cancer, premature labor and delivery and congenital infection. Today’s girls are the future’s mothers as well as the key persons in their family. In order to fulfill their responsibilities, the girls should be healthy. Moreover, they should be well educated and psychologically prepared on their future lives. One of the main gynecological diseases among children is vulvovaginitis which is estimated at 42-80%. (24, 9) The cases of vulvovaginitis are usually detected during the targeted gynecological examinations with preventive purposes among young and school age children. Particularly, vulvovaginitis is more prevalent among prepubertal girls and young girls aged 8-11 years.

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The level of reproductive hormone analyis with Cryptorchidism boys

Amarjargal Olzvoi ; Erdenetuya Ganbaatar

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2007;2007(1):47-50.

The level of reproductive hormone analyis with Cryptorchidism boys Backgrounds: The prevalence of Cryptorchidism is 1-5% of among pediatric abnormalities. Cryptorchidism is congenital abnormality in which one or two testis can be found in inguinal and abdominal cavities (Undescended testis). According to they last year statistics; 10% of annual visits to surgical cabinet and 22% of impatient in surgical department were children with cryptorchidism. Study objective: To identify risk factors and level of reproductive hormones. Materials and method: The case control study which was done. Cases were 81 cases with cryptorchidism aged 4-18 years. Controls 77 healthy children visited to adolescent cabinet. Results: Median age of children at the time of surgery 92.64 year. The 66.7% children had orchidopexy in between ages of 5-15 years. Hormone profiles had should no significant difference between cases and controls of children aged 11 years. But, there was significant difference were found in FSH and testosterone levels older than 11 years old. It meanest higher FSH-(2.40.14U/l) (p=0.018), and lower testosterone-4.80.22nmol/l (p=0.09) level in children with cryptorchidism. Correliation analysis had should that possible risk factors for cryptorchidism are premature births (23.7%), severe gestose (72.8%), pregnancy associated medical condition(46.9%). There was no significant difference of hormone levels in children with inguinal and abdominal cryptorchidism. Conclusion: On the basis of above study, it is recommended that early screening and early correction before 2 years will prevent from further atrofic changes of testis. It is also recommended that reproductive hormone level screening more useful for the children older than 11 years old.

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Safety and effectiveness of COVID 19 vaccine among pregnant woman

Nomin-Erdene L ; Nasantogtokh E ; Narantungalag L ; Jargalsaikhan B ; Altantuya Sh

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;30(2):2168-2172.

Safety and effectiveness of COVID 19 vaccine among pregnant woman Introduction: Major International Organizations such as the World Health Organization (WHO), Centers for Disease and Prevention (CDC), American College of Obstetrics and Gynecology (ACOG) recommend that use of COVID 19 vaccine for people who are pregnant, breastfeeding and trying to get pregnant. Objective: To determine the safety and effectiveness of COVID 19 vaccine among pregnant woman. Materials and methods: In this prospective study, we collected data from pregnant woman who are receiving their antenatal care at the general hospitals of Ulaanbaatar city and National Center for Maternal and Child Health of Mongolia between July 1, 2021 and August 20, 2021. The survey data were collected four categories of questionnaires. An ultrasound scan performed to screening of fetal anomalies and to assess fetal growth at 12, 20, 28, 36 weeks of pregnancy. Results: Among the total of 420 pregnant woman, 193 (46.0%) have received COVID 19 vaccine and 227 (54.0%) were not. (1:1) The most commonly reported adverse events in pregnant participants were injection site pain (63.2%), myalgia (45.2%), headache (44.9%) and fatigue (40%). Furthermore, complications of pregnancy were 11.5% of vaccinated group and 7.8% of the other group and it has shown that pregnancy complications was not statistically significant in differentiating to the study groups (x^2 = 1.62, p = 0.205) Pregnant woman with COVID 19 infections were 73.6% (n=39) of unvaccinated group and 26.4% (n=14) of vaccinated group. Whether to relate between COVID 19 vaccination and COVID 19 infections were statistically significant in differentiating to the study groups. According to the result, COVID 19 vaccine has an effectiveness of 91% for the pregnant woman if they continue to administer the prevention method of COVID 19 infections (same as before the vaccination: wearing a mask, keep a safe distance). The risk of fetal anomalies at first trimester and 20 weeks gestation were not statistically significant in differentiating to the study groups. These results demonstrate that the COVID 19 vaccine does not affects fetus by now. Conclusions: In this study, COVID 19 vaccine does not increase a risk of pregnancy and medical complications. The prevalence of COVID 19 infection was statistically significant in differentiating to the both vaccinated and unvaccinated groups. It shows that COVID19 vaccines have became a crucial tools for reducing the incidence of COVID 19 infection in pregnancy.

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Velopharyngeal function: a comparison result of primary palatoplasty by various techniques

Erdenetsogt J ; Ayanga G ; Munkhdul A ; Khentii L

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;30(2):2173-2179.

Velopharyngeal function: a comparison result of primary palatoplasty by various techniques Introduction: The main purpose of primary cleft palate repair is to reconstruct anatomical structure with minimal impairment of maxillary growth and normalize velopharyngeal function and feeding process. One of the most common complications after the primary cleft palate repair is velopharyngeal insufficiency, which leads to the subsequent surgery. The velopharyngeal function assessment characterizes speech development in children. Researches noted that velopharyngeal insufficiency causes in 5-86% after primary cleft palate repair. Therefore, it is essential to choose an adequate primary surgical method for each particular type of cleft palate. To compare velopharyngeal function using nasopharyngoscopy after primary CP repair Materials and methods: The patients who with congenital cleft palate and, underwent primary cleft palate repair in the Department of Maxillofacial surgery of the National Centre for Maternal and Child Health and had velopharyngeal function assessment were recruited to the study. Patients with wound dehiscence and oronasal fistula postoperatively were excluded from the study. Cleft palate was classified according to the Veau system and Golding-Kushner scale of nasopharyngoscopy was used to assess patient’s velopharyngeal function in order to associate with cleft types and the primary palatoplasty techniques. Pearson’s chi-squared analysis and Fisher exact test were used for statistical analysis. Results: A total of 335 patients were included in the study. The mean age at primary palate repair was 22.9±13.6 months. There were 56, 42, 177, and 60 patients with Veau-I type, Veau-II type, Veau-III type and Veau- IV type respectively, whereas for primary palatoplasty 65 patients underwent Furlow technique, 148 patients – Mongolian technique, 108 patients – Two flap technique, 34 patients – Von Langenbeck technique. Nasopharyngoscopy assessment of adequate velopharyngeal function was as followed as by “Furlow” technique in 89.4% cases, ”Mongolian” technique in 62.2% cases but by “Two flap” technique only in 48.1% and Von Langenbeck technique in 47.1% cases. Conclusions: The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after primary palatoplasty.

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Effects of COVID-19 on pregnancy and delivery outcome: systematic review with meta-analysis

Nasantogtokh E ; Baljinnyam B ; Enkhmaa D ; Altantuya Sh

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;30(2):2180-2185.

Effects of COVID-19 on pregnancy and delivery outcome: systematic review with meta-analysis Introduction: The impact of Coronavirus infection disease (COVID-19) on during pregnancy, maternal outcome, and neonatal health is unclear. We aimed to measure about effect of Coronavirus infection to pregnancy, maternal outcome, and newborn health in systematic review with meta-analysis. Materials and methods: The systematic review and meta-analysis conducted PRISMA guidelines, recommended from Cochrane, based on database of studies and a hypothesis to determine the impact of COVID-19 on pregnancy, maternal, and neonatal outcome. We searched for eligible studies of databases from December 2019 to April 2021. Our dependent variables were preeclampsia, preterm birth and stillbirth. Independent variables were infection of COVID during pregnancy, and outcomes. We measured for primary outcome that are preeclampsia, preterm birth, and secondary stillbirth. The meta-analysis evaluated the quality of the observational study (Newcastle – Ottawa Scale) and included the results. Statistical analysis was performed using Rev Man 5.0 software. The ratio (OR) in meta-analysis was calculated using a meta-regression model (Random effect meta-analysis). The mean difference was measured and weighed 95.0% confidence interval. Results: We included 46 studies involving 459,789 participants. Coronavirus infection maybe associated with increase the risks of preeclampsia in pregnancy (B: 1.21, 95.0% CI: 1.01 - 1.25), premature birth (B: 1.91, 95.0% CI: 1.62–2.15), stillbirth (B: 2.2, 95.0% CI: 2.12–2.31. Conclusions: Coronavirus infection increases the risk of preeclampsia, premature birth and stillbirth. Furthermore, the studies are needed to collect more robust data to validate or substantiate these findings, better understand the impact of COVID on pregnancy in experiment, intervention, and cohort studies with Meta-Analysis.

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The study of clinical and epidemiological characteristics of coronavirus infection in children ages 0-18

Bolormaa T ; Amarjargal O ; Baljinnyam B ; Altantuya Sh

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;30(2):2186-2190.

The study of clinical and epidemiological characteristics of coronavirus infection in children ages 0-18 Introductions: The coronavirus disease (COVID-19) has been spreading in Wuhan, Hebei Province, China since late 2019, and was declared a pandemic by the World Health Organization on March 11, 2020. Since the outbreak of the pandemic, the SARS-CoV-2 virus has been constantly mutating, and several new variants have emerged, dominating the world. These variants are characterized by differences in transmission, toxicity, and pathogenicity. Due to the lack of research on pediatric COVID-19 in Mongolia. Our goal was to study the symptoms and severity of children with COVID-19 and to compare clinical characteristics between Alpha and Delta of SARS-CoV-2 occurred in children. Material and methods: Clinical characteristics, laboratory and diagnostic test results of 450 children aged 0-18 years, confirmed by laboratory tests from March 30, 2021 to December 1, 2022 in the Isolation Department of COVID-19 infected children of the NCMCH, treatment and complications were studied retrospectively. Result: The study involved 450 children aged 0-18 years with laboratory-confirmed COVID-19 infection. According to the demographic variables, 263 (58.4%) boys and 189 (41.6%) girls. In terms of age group, 62.4% were aged 0-4 years, 17.5% were aged 5-9 years, 16.2% were aged 10-15 years, and 3.7% were children over 15 years old. Of these children, 231 (51.3%) were clinically confirm signs of alpha and 219 (48.7%) delta variant. In 8 cases, COVID-19 was vaccinated but became infected. Clinical features of alpha-type physical examination were 117 (51.6%), pale face and paleness (29.6%), and respiratory distress (40.0.0%). Clinical features of delta-variant bruising, pallor, and chest depression were predominant on physical examination. Conclusion: COVID-19 In children with alpha and delta variants, the most common symptoms of respiratory viral infections, such as fever and cough, were respiratory distress in alpha variant and respiratory and circulatory abnormalities signs in delta variant.

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The result of a study of prevalence, type and degrees Of hearing impairment in newborns and infants

Saruul Ch ; Zolzaya Ts ; Ariuntuya D ; Delgermaa B ; Bayalag B

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;30(2):2191-2198.

The result of a study of prevalence, type and degrees Of hearing impairment in newborns and infants Introduction: Significant bilateral hearing loss is the most common congenital disorder of the newborn, occurring 2-3 times per 1000 live infants. In December 2012, for the first time in Mongolia, neonatal hearing screening was introduced at the National Center for Maternal and Child Health. We aimed at investigated the outcomes of neonatal hearing screening and diagnostics of type and degree of hearing loss in neonates and infants. Materials and methods: During the study period, 2019-2020, a total of 70,614 infants born in Urguu, Khuree, Amgalan maternity hospitals, Baganuur district health center, Intermed hospital, and the National Center for Maternal and Child Health were included in the prospective cohort study. The study was performed in three phases, following the clinical guidelines for neonatal hearing screening. Results from the well-baby newborn hearing screening program and diagnostic follow-up of referred children from 2019 to 2021 were included in calculating prevalence rates. Hearing loss was classified according to the degree and type. Results: A total of 94.1% of 70,614 children eligible for screening were included. A prevalence rate of bilateral hearing loss 2.23 per 1000 children was found. A prevalence rate of bilateral severe and profound hearing loss 1 per 1000 children was found. The mild sensorineural hearing loss 28 (26.0%) was most common in children, followed by moderate 19 (17,6%), severe 21 (19.4%), profound 19 (17.6%) and deaf 21 (19.4%). Conclusions: The coverage of hearing screening in maternity hospitals in Ulaanbaatar is relatively good (94.1%), but there is a repeat screening (62.1%) and follow-up and diagnostic tests (49.9%). shows that the system needs to be improved. Because of the well-by hearing screening program, reported results approximate prevalence rates of permanent hearing loss by severity.

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Correlation between delay time of surgery of congenital cataract and postoperative visual acuity

Shamsiya M ; Nasantogtokh E ; Uranchimeg D ; Davaa G ; Erdenetuya G

Mongolian Journal of Obstetrics, Gynaecology and Pediatrics.2021;29(1):2096-2100.

Correlation between delay time of surgery of congenital cataract and postoperative visual acuity Introduction: Worldwide, child cataract is 1 to 15 cases per 100,000 children are diagnosed. In the International Classification of Diseases, pediatric cataracts are classified as congenital (Q12) and developmental (H26.0). Congenital cataract occurs in 1–3 out of 10,000 children, and if diagnosed, surgery is required without delay. International researchers report that congenital cataracts require semi-emergency surgery. It is also recommended that children with congenital cataracts be diagnosed after 3 months of age without surgery. Congenital cataracts are recommended for surgery in one eye within 6 weeks and in both eyes within 10 weeks. Early detection of congenital cataracts and emergency surgical treatment are important to improve postoperative visual outcome and quality of life. To investigate the correlation between the surgical delay time and postoperative visual acuity in children diagnosed with congenital cataracts. Material and methods: This study conduct based on the ophthalmic surgery department of the National Center for Maternal and Child Health, performed for a retrospective longitudinal study design. The study examined cases of congenital cataracts in both eyes and retrospectively follow patients who had congenital cataract surgery in 2018-2020 from the onset of symptoms to the postoperative period. The sample size was calculated using open.epi. We sampled participants for non-probabilistic purposes. The study included children 1 year of age and younger or with nystagmus, cataract with nuclear and polar morphology , and bilateral cataracts Statistical analysis was performed using STATA 16.0 software. The risk of delay time to visual acuity was determined by an ordinal regression model. Results: The study included 46 cases of congenital cataracts, under the age of 16. 61 percent of the children were male and 58.7 percent were from rural areas. The postoperative visual acuity of the children in the study was <0.09 in 52.2% (n = 24) and 0.1

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