Human ; Female ; Pregnancy ; Carboprost ; Uterine Inertia ; Postpartum Hemorrhage ; Oxytocin ; Maternal Mortality ; Cesarean Section ; Drug-related Side Effects And Adverse Reactions

Human ; Female ; Influenza, Human

OBJECTIVE: To determine and analyze the demographic data, clinical, presentation and course, as well as maternal and neotal outcome of pregnant Filipino patients with influenza-like illness (ILI) versus confirmed cases of Influenza AH1N1 during the 2009-2010 pandemic who presented at the Influenza-like-illness (ILI) Clinic at a tertiary hospital in the Philippines from May 2009 until February 2010.
DESIGN: Cohort study
SETTING: The Medical City
PATIENTS: Pregnant patients who presented with influenzalike illness (ILI) and were seen at the Influenza-like-illness (ILI) Clinic from May 2009 until February 2010.
METHODOLOGY: This is a cohort study that reviewed the charts of pregnant patients who presented with influenza-like illness, diagnosed as Case under Observation (CUO) at the Influenza-like Illness (ILI) Clinic at The Medical City, from May 2009 until February 2010. The pregnant patients were classified into two groups: those who tested positive and those who tested negative to the H1N1-rRT-PCR (realtime reverse transcriptase polymerase chain reaction) throat swab test. Demographic characteristics, course and management of illness as well as prenatal and peripartum course were compared between the two groups. Followup was also done by phone calls. Any history of preterm labor, hospital admissions, respiratory illness, and complications were gathered. Maternal and neonatal outcome were documented including mode of delivery, birthweight, maturity and any neonatal complications.
MAIN OUTCOME: Pregnant women presenting with influenzalike illness (ILI) and confirmed Influenza A H1N1 infection have a higher rate of hospital admission (59.1% and 61.5%) compared to non-pregnant women of reproductive age (19.1% and 29.4%) with similar conditions (P = 0.05). Pregnant women who presented with influenza-like illness and with a positive throat swab result were significantly younger than those with negative results, with a 2.25 times higher risk for pregnant women aged 30 years old to have a positive throat swab test result (RR - 2.25; 95% CI = 1.08-4.67; P = 0.005). Difficulty of breathing was significantly more common among those with negative throat swab test result (44.4%) (P = 0.02). Association between the types of specimen collected with throat swab test results among pregnant patients with ILI showed a significantly higher proportion of subjects to have a positive result with nasooropharyngeal samples (P = 0.03).
CONCLUSION: Pregnant women with influenza-like illness (ILI) and confirmed cases of Influenza A H1N1 have a higher rate of hospitalization compared to non-pregnant women of reproductive age with similar conditions. Pregnant women who presented with influenza-like illness and with a positive throat swab result were significantly younger than those with negative results. Difficulty of breathing was significantly more common among those with negative throat swab test result. A significantly higher proportion of subjects have a positive result with naso-oropharyngeal samples. The issue of protecting the Filipino pregnant women from this vaccine-preventable disease remains a challenge to every healthcare worker in this country.

Human ; Female ; Adult ; Influenza, Human ; Influenza A Virus, H1n1 Subtype ; Peripartum Period ; Pharynx ; Delivery, Obstetric ; Health Personnel ; Vaccines

Objective: To determine the ovulatory response of a cystectomized ovary sonographically in the first three cycles post-op in terms of the number and diameter of pre-ovulatory follicles, development of 18 mm follicle, development of corpus luteum, and their correlation to the type of operation, use of cautery, type of ovarian pathology, and use of ovulatory drugs. Design: Prospective study Methods: Thirty (30) patients who underwent ovarian cystectomy either by laparoscopy of laparotomy from February to May 1998 were included in the study. These patients had follicular monitoring for three cycles post-op at days 14, 16 and 18. The number of pre-ovulatory follicles (/- 12 mm), the diameter (mm) of the largest follicle, onset of development of 18 mm follicle, and onset of development of corpus luteum were noted. The onset of development of 18 mm follicle was correlated to the type of operation (laparoscopy versus laparotomy), use of cautery, type of ovarian pathology (endometrial versus dermoid), and use of ovulatory drugs post-op. Statistical analysis used was student t-test. Results: The mean number of pre-ovulatory follicles (/- 12 mm) during the first three cycles was 1-2 follicles. The mean diameter of the largest follicle during the first cycle post-op was 12-16 mm and increased to 14-18 mm during the second and third cycles. The earliest 18 mm follicle was observed on day 14 of the first cycle but 75.1 percent of patients had an 18 mm follicle by day 18 of the first cycle. The type of operation, use of cautery, type of ovarian pathology, and use of ovulatory drugs post-op did not significantly alter the onset of development of an 18 mm folicle. The earliest corpus luteum was noted on day 18 of the first cycle. Conclusion: There is an adequate ovulatory response after ovarian cystectomy in the first three cycles post-op.
CYSTECTOMY