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Research paper thumbnail of 1389 Impact of Maternal Sexual Habits and Hygiene Behaviours on Gbs Neonatal Colonization

Pediatric Research, 2010

ABSTRACT Background and aims: Early onset neonatal sepsis due to vertical transmission of Group B... more ABSTRACT Background and aims: Early onset neonatal sepsis due to vertical transmission of Group B streptococci (GBS) is responsible for severe morbidity and mortality of newborns. The aim of study was to determine the prevalence of neonatal GBS colonization and to evaluate the impact of maternal sexual habits and hygiene behaviours on neonatal GBS colonization.Methods: A prospective cross-sectional study was carried out at the Departments of Obstetrics & Gynecology and Neonatology Kaunas University Hospital in 2006-2007. Data of 970 women and 827 newborns were analyzed. A lower vaginal and rectal swab were obtained from each women at 35- 37 weeks of gestation or on admission for PROM or at delivery. Cultures of neonates were sampled from the ear canal and throat within 5-15 min of their lives. Study participants were asked to complete a questionnaire described their sexual habits and hygiene behaviours.Results: Overall 148 (15.3%) women were carriers of GBS. Neonatal GBS colonization rate was 6.4%. Overall vertical transmission rate of GBS was 28.4%. Univariate analysis revealed that neonatal GBS colonization was associated with oral sex male-tofemale (60.0 vs 36.3%, p < 0.001), female-to-male (56.0 vs 38.2% p< 0.05), male not douching before sex (8.0 vs 0.9%, p< 0.001). The other maternal sexual habits like condom use, anal sex, number of sexual partners, time of first sexual experience, hand washing frequency were not significantly associated with neonatal GBS colonization.Conclusions: We consider that changing of sexual habits and improvement of hygiene behaviours could help to facilitate the neonatal GBS colonization.

Research paper thumbnail of ROLE OF HYSTEROSCOPY TO RULE OUT ENDOMETRIAL CANCER IN POSTMENOPAUSAL WOMEN

Research paper thumbnail of P517 Group B Streptococcus (GBS) and Escherichia coli (E. coli) colonization in Lithuanian pregnant women and the impact of colonization on early onset neonatal infections

International Journal of Gynecology & Obstetrics, 2009

Research paper thumbnail of O868 Uterine artery grade II diastolic notch in predicting unfavorable perinatal outcome in hypertensive women

International Journal of Gynecology & Obstetrics, 2009

Research paper thumbnail of Vaginal misoprostol for cervical priming before hysteroscopy in perimenopausal and postmenopausal women

International Journal of Gynecology & Obstetrics, 2005

To evaluate the effectiveness and possible adverse effects of vaginal misoprostol for cervical pr... more To evaluate the effectiveness and possible adverse effects of vaginal misoprostol for cervical priming before hysteroscopy in perimenopausal and postmenopausal women. A total of 105 women scheduled for hysteroscopy were randomly assigned to 2 groups. The study group (n=51) received 400 microg of vaginal misoprostol at least 12 h before the procedure and the control group (n=54) received no cervical priming agent. The primary outcome measure was the number of women who required cervical dilation. Secondary outcomes were cervical width (the largest size of Hegar dilator inserted without resistance) as well as complications and adverse effects. In the misoprostol group 27 women (52.9%) required cervical dilation vs. 53 (98.1%) in the control group (P<0.0001). The largest size of Hegar dilator inserted without resistance was 7.6+/-1.4 mm in the misoprostol group vs. 5.0+/-1.1 mm in the control group (P<0.0001). A similar effect of misoprostol on cervical dilation was also found in the subgroup of treated postmenopausal women. Only 2 women (3.9%) experienced mild lower abdominal pain after misoprostol application. Vaginal misoprostol applied before hysteroscopy reduced cervical resistance and the need for cervical dilation in perimenopausal and postmenopausal women, with only mild adverse effects.

Research paper thumbnail of Oral, vaginal and sublingual misoprostol for induction of labor

International Journal of Gynecology & Obstetrics, 2005

To evaluate the effectiveness and safety of different administration routes of misoprostol for in... more To evaluate the effectiveness and safety of different administration routes of misoprostol for induction of labor. PubMed, Cochrane Library and EMBASE searches were carried out using the keywords oral, vaginal, sublingual, buccal, misoprostol, labor induction, identifying randomized case-controlled trials comparing different routes for giving misoprostol to induce labor, published in English between 1994 and 2004. Seventeen studies (3549 participants) were included. Compared to vaginal administration, oral misoprostol was associated with higher failure rates for achieving vaginal delivery within 24 h (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.23-2.10), higher rates of uterine hyperstimulation without fetal heart rate (FHR) changes (OR 2.21, 95% CI 1.12-4.34) and lower cesarean section rates (OR 0.74, 95% CI 0.56-0.97). A lower dose of oral misoprostol (50 microg) compared to the 25-50 microg administered vaginally was associated with a higher rate of vaginal delivery not being achieved within 24 h (OR 3.60, 95% CI 2.10-6.18), more need for oxytocin augmentation (OR 2.19, 95% CI 1.65-2.92), less uterine hyperstimulation both without FHR changes (OR 0.58, 95% CI 0.42-0.80) and with FHR changes (OR 0.34, 95% CI 0.17-0.67) and fewer cesarean sections (OR 0.69, 95% CI 0.51-0.91). Compared to vaginal administration, buccal misoprostol resulted in a higher rate of failure to achieve vaginal delivery after 24 h, more frequent uterine hyperstimulation and lower rates of cesarean section, but these differences were not significant. When 50 mug of misoprostol used sublingually was compared to oral administration, the sublingual misoprostol was associated with less failure to achieve vaginal delivery after 24 h, less oxytocin augmentation and reduced cesarean section, but none of the differences were statistically significant. Vaginal misoprostol appears more effective than the equivalent dosage administered orally. However, the vaginal route appears to be associated with a higher risk of uterine hyperstimulation. Sublingual misoprostol seems an effective route of administration, but a lack of data necessitates more clinical trials to establish the effectiveness and safety of the buccal/sublingual route.

Research paper thumbnail of Sublingual compared with vaginal misoprostol for labour induction at term: a randomised controlled trial

BJOG: An International Journal of Obstetrics & Gynaecology, 2006

Objective To compare the efficacy and safety of 50 mg of sublingual misoprostol with 25 mg of vag... more Objective To compare the efficacy and safety of 50 mg of sublingual misoprostol with 25 mg of vaginal misoprostol administered for labour induction at term.

Research paper thumbnail of M223 PREOPERATIVE AND OPERATIVE FINDINGS ASSOCIATED WITH RESTORATION OF THE MENSTRUATION IN MAYER-ROKITANSKY-KUSTER-HAUSER SYNDROME

International Journal of Gynecology & Obstetrics, 2012

Research paper thumbnail of 1389 Impact of Maternal Sexual Habits and Hygiene Behaviours on Gbs Neonatal Colonization

Pediatric Research, 2010

ABSTRACT Background and aims: Early onset neonatal sepsis due to vertical transmission of Group B... more ABSTRACT Background and aims: Early onset neonatal sepsis due to vertical transmission of Group B streptococci (GBS) is responsible for severe morbidity and mortality of newborns. The aim of study was to determine the prevalence of neonatal GBS colonization and to evaluate the impact of maternal sexual habits and hygiene behaviours on neonatal GBS colonization.Methods: A prospective cross-sectional study was carried out at the Departments of Obstetrics & Gynecology and Neonatology Kaunas University Hospital in 2006-2007. Data of 970 women and 827 newborns were analyzed. A lower vaginal and rectal swab were obtained from each women at 35- 37 weeks of gestation or on admission for PROM or at delivery. Cultures of neonates were sampled from the ear canal and throat within 5-15 min of their lives. Study participants were asked to complete a questionnaire described their sexual habits and hygiene behaviours.Results: Overall 148 (15.3%) women were carriers of GBS. Neonatal GBS colonization rate was 6.4%. Overall vertical transmission rate of GBS was 28.4%. Univariate analysis revealed that neonatal GBS colonization was associated with oral sex male-tofemale (60.0 vs 36.3%, p < 0.001), female-to-male (56.0 vs 38.2% p< 0.05), male not douching before sex (8.0 vs 0.9%, p< 0.001). The other maternal sexual habits like condom use, anal sex, number of sexual partners, time of first sexual experience, hand washing frequency were not significantly associated with neonatal GBS colonization.Conclusions: We consider that changing of sexual habits and improvement of hygiene behaviours could help to facilitate the neonatal GBS colonization.

Research paper thumbnail of ROLE OF HYSTEROSCOPY TO RULE OUT ENDOMETRIAL CANCER IN POSTMENOPAUSAL WOMEN

Research paper thumbnail of P517 Group B Streptococcus (GBS) and Escherichia coli (E. coli) colonization in Lithuanian pregnant women and the impact of colonization on early onset neonatal infections

International Journal of Gynecology & Obstetrics, 2009

Research paper thumbnail of O868 Uterine artery grade II diastolic notch in predicting unfavorable perinatal outcome in hypertensive women

International Journal of Gynecology & Obstetrics, 2009

Research paper thumbnail of Vaginal misoprostol for cervical priming before hysteroscopy in perimenopausal and postmenopausal women

International Journal of Gynecology & Obstetrics, 2005

To evaluate the effectiveness and possible adverse effects of vaginal misoprostol for cervical pr... more To evaluate the effectiveness and possible adverse effects of vaginal misoprostol for cervical priming before hysteroscopy in perimenopausal and postmenopausal women. A total of 105 women scheduled for hysteroscopy were randomly assigned to 2 groups. The study group (n=51) received 400 microg of vaginal misoprostol at least 12 h before the procedure and the control group (n=54) received no cervical priming agent. The primary outcome measure was the number of women who required cervical dilation. Secondary outcomes were cervical width (the largest size of Hegar dilator inserted without resistance) as well as complications and adverse effects. In the misoprostol group 27 women (52.9%) required cervical dilation vs. 53 (98.1%) in the control group (P<0.0001). The largest size of Hegar dilator inserted without resistance was 7.6+/-1.4 mm in the misoprostol group vs. 5.0+/-1.1 mm in the control group (P<0.0001). A similar effect of misoprostol on cervical dilation was also found in the subgroup of treated postmenopausal women. Only 2 women (3.9%) experienced mild lower abdominal pain after misoprostol application. Vaginal misoprostol applied before hysteroscopy reduced cervical resistance and the need for cervical dilation in perimenopausal and postmenopausal women, with only mild adverse effects.

Research paper thumbnail of Oral, vaginal and sublingual misoprostol for induction of labor

International Journal of Gynecology & Obstetrics, 2005

To evaluate the effectiveness and safety of different administration routes of misoprostol for in... more To evaluate the effectiveness and safety of different administration routes of misoprostol for induction of labor. PubMed, Cochrane Library and EMBASE searches were carried out using the keywords oral, vaginal, sublingual, buccal, misoprostol, labor induction, identifying randomized case-controlled trials comparing different routes for giving misoprostol to induce labor, published in English between 1994 and 2004. Seventeen studies (3549 participants) were included. Compared to vaginal administration, oral misoprostol was associated with higher failure rates for achieving vaginal delivery within 24 h (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.23-2.10), higher rates of uterine hyperstimulation without fetal heart rate (FHR) changes (OR 2.21, 95% CI 1.12-4.34) and lower cesarean section rates (OR 0.74, 95% CI 0.56-0.97). A lower dose of oral misoprostol (50 microg) compared to the 25-50 microg administered vaginally was associated with a higher rate of vaginal delivery not being achieved within 24 h (OR 3.60, 95% CI 2.10-6.18), more need for oxytocin augmentation (OR 2.19, 95% CI 1.65-2.92), less uterine hyperstimulation both without FHR changes (OR 0.58, 95% CI 0.42-0.80) and with FHR changes (OR 0.34, 95% CI 0.17-0.67) and fewer cesarean sections (OR 0.69, 95% CI 0.51-0.91). Compared to vaginal administration, buccal misoprostol resulted in a higher rate of failure to achieve vaginal delivery after 24 h, more frequent uterine hyperstimulation and lower rates of cesarean section, but these differences were not significant. When 50 mug of misoprostol used sublingually was compared to oral administration, the sublingual misoprostol was associated with less failure to achieve vaginal delivery after 24 h, less oxytocin augmentation and reduced cesarean section, but none of the differences were statistically significant. Vaginal misoprostol appears more effective than the equivalent dosage administered orally. However, the vaginal route appears to be associated with a higher risk of uterine hyperstimulation. Sublingual misoprostol seems an effective route of administration, but a lack of data necessitates more clinical trials to establish the effectiveness and safety of the buccal/sublingual route.

Research paper thumbnail of Sublingual compared with vaginal misoprostol for labour induction at term: a randomised controlled trial

BJOG: An International Journal of Obstetrics & Gynaecology, 2006

Objective To compare the efficacy and safety of 50 mg of sublingual misoprostol with 25 mg of vag... more Objective To compare the efficacy and safety of 50 mg of sublingual misoprostol with 25 mg of vaginal misoprostol administered for labour induction at term.

Research paper thumbnail of M223 PREOPERATIVE AND OPERATIVE FINDINGS ASSOCIATED WITH RESTORATION OF THE MENSTRUATION IN MAYER-ROKITANSKY-KUSTER-HAUSER SYNDROME

International Journal of Gynecology & Obstetrics, 2012