Current Women's Health Reviews - Volume 19, Issue 4, 2023

Background: Sonographic visualization of intrauterine pregnancy after multiple embryo transfers does not preclude the coexistence of an ectopic pregnancy, which should be excluded routinely. Heterotopic pregnancy carries high morbidity and mortality. Therefore, it needs high index of suspicion to diagnose and manage accordingly. Case Presentation: Our case reports a 39-year-old woman who presented with heterotopic triplet pregnancy at 5 weeks and 5 days of gestation. It resulted in a successful delivery of intrauterine monozygotic twins at 37 weeks. This pregnancy is an outcome of ICSI treatment due to low ovarian reserve. Only two embryos were obtained through the protocol and double frozen embryo transfer was done afterwards. Tubal pregnancy was successfully managed expectantly. Conclusion: Our case highlights the importance of early surveillance and close monitoring of patients undergoing multiple embryo transfers. Thus, keeping the possibility of heterotopic pregnancy in mind after ART cannot be over-emphasized.

Background: The current United Nations sustainable development goal 3 sets to reduce maternal mortality to less than 70 per 100 000 live births by 2030. To monitor whether India is on track to attaining sustainable development goals, it is essential to routinely assess trends of health indicators. Objectives: This study was conducted to assess trends of maternal mortality and cause-specific maternal death in tertiary care hospitals in Southern India. Methods: This is a retrospective study of hospital records and death summaries of all maternal deaths between January 1, 2009, and December 31, 2018, at the tertiary care hospital in Southern India. The demographic, clinical, and delivery details of all the maternal deaths were collected. Causes of maternal deaths were classified as direct, indirect, and nonspecific. To observe trends of maternal death, the maternal mortality ratio was calculated for each year, and Pearson’s chi-square test was used. Results: Maternal mortality ratio was 555/100000 and had a decreasing trend from its highest in 2010 of 1230/100000 to its lowest of 229/100000 in 2017 (t = 7.71 p = 0.02). The majority of women who died were aged 21-35 years, resided in rural, were primigravidae, and had operative delivery. Most of the maternal deaths had been referred to our facility (90.8%) from other healthcare units. Obstetric hemorrhage (27.8%) and puerperal sepsis (37.7%) among direct causes; H1N1 pneumonia (34.8%) among indirect causes were the major causes of maternal death. The number of maternal deaths due to sepsis increased from the beginning until the end of the study from 10% to 50% (t = 5.9, p = 0.01). On the contrary, there was a decline in maternal deaths due to obstetric hemorrhage from 50% to 25% (t = 4.2, p = 0.03). Conclusion: Although the maternal mortality ratio has reduced over the years, sepsis was an important cause of maternal deaths.

Background: The study aimed to evaluate the impact of a health education intervention on nutritional status among adolescent girls in government secondary schools in Maiduguri Metropolitan Council. Methods: The study was a randomized control trial among 417 adolescent girls aged 10-19 years old. Data were collected from October 2019 to March 2020 using KoBo collect toolbox. Chi-square and Fisher exact were used to compare baseline differences between the intervention and control group, a generalized estimating equation was used to evaluate the impact of health education intervention. Results: There was no significant difference in nutritional status (body mass index for age percentile and mid-upper arm circumference) between the intervention and control group at baseline. There was a statistically significant difference at three and six-months post-intervention for body mass index for age percentile p = 0.005; p < 0.001, while the mid-upper arm circumference was statistically significant at three months post-intervention p < 0.001, but not statistically significant at six months post-intervention. Conclusion: It is clear that health education intervention has an important role in improving the nutritional status of adolescents.

Background: In addition to physical discomfort, recurrent vulvovaginal candidiasis imposes a significant financial and psychosocial burden, such as lower levels of self-esteem, a higher level of stress, clinical depression, and less satisfaction with their life. Recurrent vulvovaginal candidiasis interferes with emotional and sexual relationships. Objective: This study aimed to compare the effect of vaginal Salvia officinalis, clotrimazole, and their combination on the prevention of recurrent vulvovaginal candidiasis. Methods: This randomized triple-blinded trial was conducted on 111 women aged 18-49 years with vulvovaginal candidiasis. Participants were randomly assigned into one of the three groups of vaginal tablets of Salvia officinalis 400 mg and placebo of clotrimazole 100 mg, clotrimazole 100 mg and placebo of Salvia officinalis 400 mg, or Salvia officinalis and clotrimazole that were applied every night for 7 consecutive days. A recurrence rate of vulvovaginal candidiasis was evaluated by WET test and vaginitis symptoms examination after 12 weeks. In the case of positive evaluation, the culture of vaginal discharge was performed. Results: Totally, 29 patients (80.6%) in group clotrimazole, 33 patients (94.3%) in group Salvia officinalis and 35 patients (97.2%) in group Salvia officinalis-clotrimazole were treated (P = 0.43). Out of cured patients, 4 (13.8%) patients in the group clotrimazole, 1 patient (3%) in group Salvia officinalis, and no case in group Salvia officinalis-clotrimazole experienced the recurrence of infection. There was a significant difference among the 3 groups in terms of recurrence (P = 0.023). Moreover, no adverse event during the 12 weeks after treatment was observed. Conclusion: Adjuvant therapy of Salvia officinalis alongside routine vaginal clotrimazole could successfully prevent recurrent vulvovaginal candidiasis after three months.