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Background: Phytotherapy is used in developing countries to treat several gynecoobstetric disorders. Objective: This study aimed to collect information on herbal remedies traditionally used for the treatment of gyneco-obstetric disorders in the southeast region of Morocco (Tafilalet). Methods: Field work was undertaken as an ethnopharmacological survey involving 980 women, 60 herbalists and 20 midwives in 6 different areas of the Tafilalet region. Data was compiled using a semi-structured questionnaire via face-to-face interviews. Three quantitative ethnopharmacological indices (the use value (UV), informant consensus factor (ICF) and fidelity levels (Fl)) were calculated. Results: A total of 115 species of plants, belonging to 47 families were identified in this study. The most important species according to their use value were Rosmarinus officinalis (0.40), Lavandula angustifolia (0.35), Origanum vulgare (0.22), Cinnamomum cassia (0.18) and Phoenix dactylifera (0.15). Among the obstetric disorders, the highest ICF values were recorded for menstruation (0.95), female infertility (0.9), and maintenance of pregnancy as well as well-being of fetus (0.87). The analysis showed that the highest Fl value for menstruation was found for Origanum vulgare. (94.07 %) followed by Rosmarinus officinalis (87.29%). For female fertility, the highest Fl value was found in Phoenix dactylifera (77.50%) followed by Lepidium sativum (77.17%). Conclusion: This explorative survey emphasizes the need to preserve and document the traditional healing practices for managing gyneco-obstetric disorders and the valorization of this potential could be important for the improvement of women reproductive health.

Background: Recent studies have found that women with obstetric disorders are at increased risk for a variety of long-term complications. However, the underlying pathophysiology of these connections remains undetermined. A network-based view incorporating knowledge of other diseases and genetic associations will aid our understanding of the role of genetics in pregnancy-related disease complications. Methods: We built a disease–disease network (DDN) using UK Biobank (UKBB) summary data from a phenome-wide association study (PheWAS) to elaborate multiple disease associations. We also constructed egocentric DDNs, where each network focuses on a pregnancy-related disorder and its neighboring diseases. We then applied graph-based semi-supervised learning (GSSL) to translate the connections in the egocentric DDNs to pathologic knowledge. Results: A total of 26 egocentric DDNs were constructed for each pregnancy-related phenotype in the UKBB. Applying GSSL to each DDN, we obtained complication risk scores for additional phenotypes given the pregnancy-related disease of interest. Predictions were validated using co-occurrences derived from UKBB electronic health records. Our proposed method achieved an increase in average area under the receiver operating characteristic curve (AUC) by a factor of 1.35 from 55.0% to 74.4% compared to the use of the full DDN. Conclusion: Egocentric DDNs hold promise as a clinical tool for the network-based identification of potential disease complications for a variety of phenotypes.

Preeclampsia (PE) is a common obstetric disorder typically affecting 2–8% of all pregnancies and can lead to several adverse obstetric outcomes for both mother and fetus with the greatest burden of severe outcomes in low middle-income countries (LMICs), therefore, screening for PE is vital. Globally, screening is based on maternal characteristics and medical history which are nonspecific for the disorder. In 2004, the World Health Organization acknowledged that no clinically useful test was able to predict the onset of PE, which prompted a universal search for alternative means of screening. Over the past decade or so, emphasis has been placed on the use of maternal characteristics in conjunction with biomarkers of disease combined into predictive algorithms, however these are yet to transition into the clinic and are cost prohibitive in LMICs. As a result, the screening paradigm for PE remains unchanged. It is evident that novel approaches are needed. Vibrational spectroscopy, specifically Raman spectroscopy and Fourier-transform infrared spectroscopy (FTIR), could provide better alternatives suited for implementation in low resource settings as no specialized reagents are required for conventional approaches and there is a drive to portable platforms usable in both urban and rual community settings. These techniques are based on light scattering and absorption, respectively, allowing detailed molecular analysis of samples to produce a unique molecular fingerprint of diseased states. The specificity of vibrational spectroscopy might well make it suited for application in other obstetric disorders such as gestational diabetes mellitus and obstetric cholestasis. In this review, we summarize current approaches sought as alternatives to current screening methodologies and introduce how vibrational spectroscopy could offer superior screening and diagnostic paradigms in obstetric care. Additionally, we propose a real benefit of such tools in LMICs where limited resources battle the higher prevalence of obstetric disorders.

Celiac disease (CD) is an autoimmune disorder that occurs in genetically predisposed people in which the ingestion of gluten leads to damage in the small intestine that clinically presents with malabsorption-related symptoms. CD can also be the underlying cause of several non-gastrointestinal symptoms. This review summarizes evidence on the relationship between CD and gynecological/obstetric disorders like reproductive failures. Although much has been reported on such a linkage, the pathogenic mechanisms remain unclear, especially those underlying extra-gastrointestinal clinical manifestations. Studies conducted on celiac subjects presenting gynecological/obstetric disorders have pointed to intestinal malabsorption, coagulation alterations, immune-mediated tissue damage, and endometrial inflammation as the main responsible pathogenic mechanisms. Currently, however, the knowledge of such mechanisms is insufficient, and further studies are needed to gain a more thorough understanding of the matter.

Pre-existing conditions at reproductive age, and complications arising during pregnancy can be detrimental to maternal and fetal health. Current therapies to combat obstetric disorders are limited due to the inherent complexity of pregnancy, and can have harmful effects on developing fetus. Emerging research shows intricate signaling between the cells from mother and fetus at maternal-fetal interface, providing unique opportunities for interventions specifically targeted to the mother, fetus, or placenta. Advancements in nanotechnology, stem-cell biology and gene therapy have resulted in target-specific treatments with promising results in pre-clinical maternal and fetal disorder models. Comprehensive understanding of the effect of physicochemical properties of delivery systems on their uptake, retention and accumulation across placenta will help in the better diagnosis and treatment of perinatal disorders. This review describes the factors leading to obstetric complications along with their effect on pregnancy outcomes, and discusses key targeted therapeutic strategies for addressing conditions related to maternal and fetal health.

The article presents data of the pathogenesis, clinical peculiarities and treatment of anemia of chronic disease observed in inflammatory, infectious and oncological diseases. The main biomarkers, diagnostic tools, and risks of anemia of chronic disease in pregnant women with chronic diseases are analyzed in the article. Anemia of chronic disease makes a significant contribution to increasing incidence of obstetric disorders in pregnants with inflammatory, autoimmune, infectious, malignant diseases. The pathogenesis of anemia of chronic disease, with the key role of hepcidin in the regulation of iron absorption and release is presented. Proper analysis of inflammation and anemia biomarkers allows developing the efficacious therapeutic approach to anemia of chronic disease in pregnant women. The intravenous iron therapy in this group of pregnant women is appropriate and allows to achieve the rapid effect in the treatment of anemia with a high safety profile.

Celiac disease is an autoimmune disorder that occurs in genetically predisposed people in which the ingestion of gluten leads to a damage in the small intestine that clinically presents with malabsorption related symptoms. However it is known that celiac disease can also be the underlying cause of several non-gastrointestinal symptoms. This review summarizes the studies and data acquired on the relationship between celiac disease and gynecological/obstetric disorders.

La asociación entre los órganos genitales y urinarios ha sido establecida desde hace muchos años. El papiro de Kahum, escrito en el antiguo Egipto 2000 años AC se dedica exclusivamente a las enfermedades de la mujer. En ese documento, las enfermedades de los órganos genitales femeninos son consideradas en conjunto con las enfermedades de la vejiga. En la sección 67 del papiro de Ebers, escrito 1500 años AC se describe las alteraciones de la micción con relación a su frecuencia, retención y la "quemazón"; así como el "tratamiento de la mujer que sufre enfermedades de su orina y útero". En la sección 24 de este mismo papiro se describe alteraciones ginecológicas y obstétricas, y contiene prescripciones sobre el tratamiento de las úlceras y de la inflamación de la vulva, del prolapso, de la esterilidad y de las menorragias, asimismo prescripciones sobre alteraciones de las vías urinarias.

Background: Achyranthes aspera is used mostly in Nigerian and other folklore medicines to stop bleeding from wounds and in the treatment of other conditions such as dog bite, scorpion bite, gonorrhoea, obstetric disorders and diabetes mellitus. Objectives: The present study evaluated the toxicological and haemostatic effects of the leaves extract of Achyranthes aspera in adult Wistar albino rats and Swiss mice using experimental

Summary 1. Herba Leonuri, a traditional Chinese medicine, has a long history of development and application in China. In particular, Herba Leonuri has been widely used in the treatment of gynaecological and obstetric disorders for thousands of years. Recent studies have shown that Herba Leonuri has many different effects. 2. Herba Leonuri contains several active components, including alkaloids, flavonoids, diterpenes compounds and fatty acids. Recent studies have shown that these molecules exert beneficial effects in coronary artery disease and cerebral ischaemia. Thus, these molecules may become novel candidates for drug discovery and development. 3. The present review provides an overview of the chemical composition, with a focus on biological activity, of Herba Leonuri to stimulate new studies on traditional Chinese medicine.

Uterine artery Doppler velocimetry has revolutionized the investigation of the developing placental vasculature. Abnormal placental vascular development is the basis of common obstetric disorders such as preeclampsia and intrauterine growth restriction. Uterine artery Doppler velocimetry by itself or in combination with other biochemical markers seems to be an effective first-trimester screening tool for preeclampsia and in particular early-onset preeclampsia. The diagnostic accuracy although statistically significant, is not as high for the prediction of intrauterine growth restriction unrelated to preeclampsia. In the future, first-trimester prophylaxis using antiplatelet agents in Doppler identified high-risk groups could suppress the development of these disorders.

Preeclampsia, eclampsia, and hemolysis, elevated liver enzymes, and low platelets syndrome are major obstetric disorders that are associated with substantial maternal and perinatal morbidities. As a result, it is important that clinicians make timely and accurate diagnoses to prevent adverse maternal and perinatal outcomes associated with these syndromes. In general, most women will have a classic presentation of preeclampsia (hypertension and proteinuria) at20 weeks of gestation and/or48 hours after delivery. However, recent studies have suggested that some women will experience preeclampsia withoutor = 1 of these classic findings and/or outside of these time periods. Atypical cases are those that develop at20 weeks of gestation and48 hours after delivery and that have some of the signs and symptoms of preeclampsia without the usual hypertension or proteinuria. The purpose of this review was to increase awareness of the nonclassic and atypical features of preeclampsia-eclampsia. In addition, a stepwise approach toward diagnosis and treatment of patients with these atypical features is described.

While gynaecological and obstetric disorders have been reported among women with coeliac sprue, their true prevalence and relationship to the coeliac disease process has not been completely elucidated. Our aims were to determine: (1) the prevalence of gynaecological and obstetric problems in patients with coeliac disease and the influence of strict gluten restriction on their occurrence, (2) the effect of pregnancy on the clinical course of coeliac disease and (3) the clinical features of those patients with onset of coeliac disease during pregnancy and the puerperium.The gynaecological and obstetric history of 130 coeliac patients and 130 age-matched healthy female controls were compared in a case-control study.In comparison to the controls, untreated coeliac disease patients exhibited significantly later menarche, an earlier menopause, an increased prevalence of secondary amenorrhoea and a greater incidence of spontaneous abortions. Patients who had adhered, in the long term, to a gluten-free diet had gynaecological and obstetric history indistinguishable from controls. Clinical deterioration of coeliac disease was observed in untreated patients during 17% of their pregnancies. In 14% of those untreated patients who were pregnant symptoms related to coeliac disease were manifested for the first time during either pregnancy (n = 7) or the puerperium (n = 4). Nine of these patients had underestimated features suggestive of coeliac disease.The early diagnosis and treatment of coeliac disease may avoid significant gynaecological and obstetric complications in affected women. Celiac sprue must always be borne in mind among patients who develop diarrhoea and weight loss during pregnancy and/or the puerperium.

BLEEDING tendencies secondary to thrombopenia are of increasing frequency in medical, surgical and obstetric disorders. This has been attributed to diverse causes: chemotherapeutic agents1 , 2; insecticides3; increased incidence of leukemia4; radioisotopes; cytotoxic agents in industry5; complete blood replacement by transfusion during pulmonary or cardiovascular surgery6; and the alarm reaction secondary to surgery and anesthesia.7 The clinical management of such thrombopenia necessitates a clear understanding of the etiologic mechanisms that produce a decrease in circulating platelets. Within recent years, it has become clear that many cases of purpura, especially idiopathic thrombocytopenic purpura and hypersplenism, are due to . . .

This paper presents the first data available on drinking and reproductive dysfunction from a representative national sample of women. In this stratified household sample of 917 women (weighted n = 2552), dysmenorrhea, heavy menstrual flow, and premenstrual discomfort increased with drinking level and were particularly strongly associated with reported consumption of 6 or more drinks a day at least once a week. Women who consumed 6 or more drinks/day at least 5 times a week had elevated rates of gynecologic surgery other than hysterectomy, but hysterectomy was less common among women averaging 2 oz or more of ethanol/day, with age effects controlled. Lifetime rates of obstetric disorders showed significant elevations at upper levels of drinking (6 or more drinks/day at least 3 times a week for miscarriage or stillbirth and prematurity, and 6 or more drinks/day at least 5 times a week for infertility and birth defects). An unexpected finding was the high rates of menstrual disorders, hysterectomy, miscarriage or stillbirth, and prematurity among temporary abstainers (women reporting alcohol consumption in the past 12 months but not the past 30 days) who had previously drunk only infrequently.

The surgical pathology report provides the histopathologic diagnosis and specific information relating to prognosis and treatment. Accordingly, the surgical pathologist must have sufficient familiarity with the management of gynecologic and obstetric disorders that clinically relevant information is the focus of the report. This chapter provides an approach to the processing of gynecologic and obstetric tissue specimens. The techniques of the gross examination and the method of reporting the pathologic findings are guided by the clinical principles on which patient management is based.

Publisher Summary This chapter focuses on the disorders of amniotic fluid. Throughout pregnancy, amniotic fluid is a heterogeneous system consisting of a solution with suspended particulate material. However, as with volume and so with composition, what is normal at one stage of pregnancy may be abnormal at another, but for most constituents, the range of normal is wide and only broad trends can be discerned. The electrolyte composition resembles that of extracellular or transcellular fluid. However, the sodium concentration, which equals maternal and fetal plasma levels in early pregnancy, falls steadily from at least as early as 20 weeks, and this fall correlates with diminishing osmolality. Throughout pregnancy, amniotic fluid has a lower pH and higher pCO2 than maternal plasma. pH falls and pCO2 rises with maturity from at least 20 weeks and more extensively but erratically in labor when levels show a good correlation with umbilical arterial values. Tests on the amniotic fluid are tests on the fetus and its environment. There are a large number of obstetric disorders in which the fetus is known to be at some statistical risk. This problem highlights the need for techniques by which risks can be individualized so that the needs and management of each baby can be specified as accurately as possible. The most common contaminants of the amniotic cavity—meconium and blood, either fresh or degraded—are known to invalidate certain tests on amniotic fluid, for instance, spectrometry in haemolytic disease.

The express aim of this volume is to stress the application of pathology to gynecologic disease for the benefit of medical students and clinicians. The author omits consideration of obstetric disorders, including ectopic pregnancy and abortion, even though these conditions are commonly encountered by the gynecologist. The text of approximately 160 pages is equally divided between clinical and pathological discussion, with over half the page space allotted to black and white photographs. The number of illustrations is excessive and their teaching value in many instances limited. Some of the gross photographs (eg, the 20 depicting the external and cut surfaces of various ovarian tumors) are much less informative than colorful word pictures might have been. The photomicrographs are generally of suboptimal quality, often repetitive in their aims and sometimes extravagantly disproportionate, in both size and number, to the related text. Thus, there are over six pages of photomicrographs of mixed

Throughout pregnancy, maternal hemodynamic adaptation is needed to ensure proper uterine perfusion and fetal development. When the uteroplacental vascular system is formed, starting with reduced resistance to uterine arterial flow, this results in decreased total vascular resistance, an activation of neuroendocrine vasoactive peptides, an increase in circulating blood and changes in the cardiovascular system morphophysiology to respond to the increasing demands of uterine perfusion. There has been considerable study of hemodynamic adaptation in pregnant women and this assessment has become a diagnostic tool for fatal obstetric disorders. However, in bitches the available information in this regard is limited; therefore a parallel was drawn between other species of animals and women, in order to subsidize the paucity of information about this process and facilitate the understanding of maternal-fetal hemodynamic adaptation in pregnant bitches. This review and literature analysis aimed\ to discuss morphophysiological cardiovascular adaptations during pregnancy and the possible disorders that can affect this process in pregnant female dogs. RESUMO: Durante a gestação, a adaptação hemodinâmica materna é necessária para garantir adequada perfusão uterina e desenvolvimento fetal. A formação de um leito vascular uteroplacentário a partir da redução na resistência ao fluxo da artéria uterina reflete na diminuição da resistência vascular total, ativação de fatores neuroendócrinos vasoativos, aumento do volume de sangue circulante e modificações na morfofisiologia do sistema cardiovascular para responder as demandas crescentes de perfusão uterina. Em mulheres gestantes o estudo da adaptação hemodinâmica encontra-se bastante desenvolvido e esta avaliação tem se convertido em uma ferramenta diagnóstica de desordens obstétricas que podem comprometer a relação do binômio materno-fetal. Não obstante, em cadelas a informação disponível a este respeito é limitada e por isso traçou-se um paralelo entre outras espécies de animais e mulheres, de maneira que subsidiassem a carência de informações a este respeito e facilitassem o processo de compreensão da adaptação hemodinâmica materno-fetal em cadelas gestantes. Esta revisão e análise da literatura visa abordar a adaptação morfofisiológica cardiovascular frente à gestação e as possíveis desordens que possam acometer este processo em cães.