Relevant bibliographies by topics / Vaginal Bleeding and Gravidity

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  2. Dissertations / Theses
  3. Books
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Academic literature on the topic 'Vaginal Bleeding and Gravidity'

Author: Grafiati
Published: 3 June 2025
Last updated: 7 July 2025

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Journal articles on the topic "Vaginal Bleeding and Gravidity"

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Dr., Amna Rashid Dr Saba Khalid Dr Sadia Abdulrazzaq. "A CROSS-SECTIONAL RESEARCH ON THE ASSOCIATION OF FIRST TRIMESTER BLEEDING PER VAGINAL AND PELVIC PAIN FREQUENCY." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 05, no. 04 (2018): 2451–57. https://doi.org/10.5281/zenodo.1218647.

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Objective: Aim of the research was the determination of pelvic pain frequency and bleeding per vaginal during 1st trimester. Methods: We included 150 pregnant cases in the age limit of 18 – 35 years who were in their 1st trimester of pregnancy, research design was cross-sectional and it was completed from July, 2015 to July, 2016 in the time span of one year. SPSS-20 was used for the data entry and analysis. Results: Average age was (26.33 ± 4.23), pelvic pain frequency was 29.33% and per vaginal bleeding was 12%. There was no statistical significant difference observed in the vaginal bleeding and pelvic pain in various groups of age as per the research stratification analysis. Pelvic pain rate was high in the primigravida women in comparison to the multigravida with a p-value of (0.003). Conclusion: Research concludes that significant women strength experienced vaginal bleeding and pelvic pain in the 1st trimester, for a practitioner it is important to practice sound diagnostic and clinical expertise for the treatment of pregnancy complications as these abnormalities are potent instrument of distress in the women and their partners. Keywords: Pelvic pain, 1st Pregnancy Trimester, Vaginal Bleeding and Gravidity.
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Neha, Singh, Kumari Chanchala, and Singh Chandni. "A Comparative Study of Maternal and Perinatal Outcome Between Normal Pregnant Women and Women with First Trimester Vaginal Bleeding." International Journal of Pharmaceutical and Clinical Research 14, no. 6 (2022): 36–43. https://doi.org/10.5281/zenodo.13624440.

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<strong>Introduction:</strong>&nbsp;First trimester bleeding may indicate an underlying placental dysfunction, which may manifest later in pregnancy causing adverse outcomes such as increased risk of pre-eclamptic toxemias, preterm delivery, prelabour rupture of membranes (PROM), and IUGR. It is also known that maternal age, systemic diseases such as diabetes mellitus, hypothyroidism, infertility treatment, thrombophilia, maternal weight, and uterine structural anomalies increase the risk of abortus imminens.&nbsp;<strong>Aim and objective:&nbsp;</strong>To establish the relation between first trimester vaginal bleeding and its effect on maternal and fetal outcome.&nbsp;<strong>Material and methods:&nbsp;</strong>This study is a comparative cohort study. I included 100 women aged between 18-45 years with first trimester vaginal bleeding as case group, who met the inclusion and exclusion criteria and 100 normal pregnant women without first trimester vaginal bleeding as control. All the women in the study group were followed from the first visit till delivery. The characteristics of all the patients related to their age, gravidity, period of gestation, duration of bleed, ultrasound results, duration of hospital stay, treatment modalities and final fetal and maternal outcome were determined, and data were collected on the basis of proforma.&nbsp;<strong>Result:&nbsp;</strong>In our study 21% patients had abortion in cases group whereas, 9% had abortion in control group, 62% had Full term vaginal delivery in cases whereas, 80% had full term vaginal delivery in control group 17% delivered preterm in case group as compared to 11% in control group. These differences were statistically significant with p value &lt;0.02. There was statistically significant difference between cases and control for the mode of delivery. Majority of patients, about 64% in cases and 71% in control had vaginal delivery whereas 15% of cases and 20% of control had caesarean section.&nbsp;<strong>Conclusion:&nbsp;</strong>First trimester vaginal bleeding can be a predicting factor for adverse outcome of mother and infant. It is necessary to increase the knowledge of pregnant women in this regard for observation. Also, because the clinical intervention of attentive obstetrician has important role in not only, the continuation of pregnancy but also decreasing fetal complications in these high-risk pregnancies. &nbsp; &nbsp; &nbsp;
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Rehman Shinwari, Kausar, Heema, Bakhtawar Rehman, Sana Rehman Shinwari, Habiba Khalid, and Fahmida Sattar. "SPONTANEOUS MISCARRIAGES AND ITS ASSOCIATION WITH RISK DETERMINANTS IN PREGNANT OBESE WOMEN VISITING KHYBER TEACHING HOSPITAL PESHAWAR." Khyber Journal of Medical Sciences 17, no. 1 (2024): 29–33. https://doi.org/10.70520/kjms.v17i1.497.

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Background: This study aims to determine the frequency of spontaneous miscarriages among pregnant obese women as well as to find the possible association between increasing age, parity, gravidity and gestation period with spontaneous miscarriages. Methods: This cross-sectional study includes 163 obese pregnant women. Sample size was calculated using WHO sample size calculator. All the pregnant women fulfilling inclusion criteria were enrolled in the study. The demographic information was recorded in pre-designed proforma. Spontaneous miscarriage was considered positive if the patient has spontaneous loss of pregnancy prior to viability that is gestational age of 23 weeks and 6 days. It was diagnosed by history of vaginal bleeding (bleeding ? 300 ml) &amp; abdominal pain (assessed as VAS scale, score greater than 3) &amp; confirmed on ultrasound scan of pelvis (absence of fetal heart beat). Data was analyzed using SPSS version 22.0. Results: The mean age of the study participants was 31±8.18 years where 59 (36%) of the participants were in between 18-30 years while 104 (64%) patients were in the age range of 31-40 years. Similarly, 62 (38%) patients were primigravida, 65 (40%) women had Primipara and 67 (41%) patients had &lt;12 weeks of gestation period. The frequencies of miscarriages were high in patients with increasing age, multi gravidity, multiparity and gestation period greater than 12 weeks. However, the results were not statistically significant. Conclusion: The frequencies of spontaneous miscarriages were 14%. The rates of spontaneous miscarriages were higher in women with increasing age, multi-parity, multi-gravidity and higher gestation period.
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Rzońca, Ewa, Agnieszka Bień, Grażyna Bączek, Patryk Rzońca, Michał Filip, and Robert Gałązkowski. "Suspected Miscarriage in the Experience of Emergency Medical Services Teams—Preliminary Study." International Journal of Environmental Research and Public Health 18, no. 23 (2021): 12305. http://dx.doi.org/10.3390/ijerph182312305.

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Vaginal bleeding and abdominal pain are symptoms indicative of a threat to pregnancy that prompt women to seek assistance from health care professionals. The purpose of the study was to present the characteristics of Emergency Medical Services (EMS) team interventions in cases of suspected miscarriage. The study involved a retrospective analysis of EMS team interventions in cases of suspected miscarriage carried out between January 2018 and December 2019 in Poland. Data obtained from Poland’s National Monitoring Center of Emergency Medical Services included emergency medical procedure records and EMS team dispatch records in electronic format. The mean patient age was 30.53 years. Most were primiparous (48.90%) and up to the 13th gestational week (76.65%). The most commonly reported symptom was vaginal bleeding (80.71%). EMS teams were most commonly dispatched in the winter (27.03%), between 7 A.M. and 6:59 P.M. (51.87%), in urban areas (69.23%), with urgency code 2 (55.60%), and in most cases, they transferred the patient to a hospital (97.53%). The present study addresses very important issues concerning the characteristics of Polish suspected miscarriage cases handled by different EMS team types, in different locations (urban vs. rural areas), and concerning patients in a different obstetric situation (gestational week, gravidity, parity). Our findings suggest a need for further studies in this field and for gestational health promotion activities to be implemented, specifically including actions to reduce the risk of vaginal bleeding during pregnancy.
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Arif, Gash, and Chro Fattah. "CESAREAN SCAR ECTOPIC PREGNANCY IN RELATION TO PREVIOUS OBSTETRICAL HISTORY." JOURNAL OF SULAIMANI MEDICAL COLLEGE 13, no. 1 (2023): 83–88. http://dx.doi.org/10.17656/jsmc.10400.

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Background &#x0D; Cesarean scar ectopic pregnancy (CSEP) is the implantation of a gestational sac inside the scar of a previous cesarean section (C/S). CSEP is a life-threatening condition that needs early management.&#x0D; Objectives &#x0D; The study aimed to know the associations between CSEP and previous obstetrical history.&#x0D; Patients and Methods&#x0D; Twenty-seven women with CSEP who were admitted to the Sulaimani Maternity Teaching Hospital from September 2019 to October 2021 were collected for this cross-sectional study. Complete obstetrical history, clinical features, the interval between the last C/S and CSEP, mode of diagnosis, and types of management were recorded.&#x0D; Results&#x0D; The mean of maternal age, gravidity and parity were 32.14±4.63 years (range, 24 to 40 years), 3.73±1.75 (range, 1 to 8) and 2.36±1.33 (range, 1 to 6), respectively. The majority (74.1%) had no significant medical diseases. The mean interval between the last C/S and CSEP was 2.6±1.8 years, and 92.6% complained of vaginal bleeding. The association of gravidity with CSEP presentation was statistically significant. Only 22.2% had a history of one prior C/S alone; however, 74.1, 14.8%, and 3.7% of patients had two, three, and four previous C/Ss, respectively. Besides, the associations of first and second C/Ss with obstetricians’ experience who performed the C/Ss were statistically significant. &#x0D; Conclusion&#x0D; The risk of CSEP increases when the frequency of gravidity and previous C/S increases.
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Abdur Raqib, Moosa, Aliya Nasim, Muhammad Ashir Shafique, Muhammad Saqlain Mustafa, and Abdul Haseeb. "From Challenges to Discovery: A Case Report on Recurrent Molar Pregnancy in a 30-Year-Old Woman with Multiple Pregnancy Losses." Clinical Case Reports and Studies 3, no. 3 (2023): 1–3. http://dx.doi.org/10.59657/2837-2565.brs.23.072.

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This case report presents the unique case of a 30-year-old woman with a recurrent molar pregnancy, a condition characterized by abnormal growth of placental trophoblasts. The patient, with a gravidity of 3 and parity of 0+2, experienced difficulties in conceiving a viable fetus despite ovulation induction drug treatment. Molar pregnancy is rare, and cases with recurrent miscarriages are even more uncommon. Common symptoms of molar pregnancy include vaginal bleeding, abdominal pain, and pelvic pressure during the first trimester. Diagnosis typically involves assessing HCG serum levels, performing an ultrasound of the uterus, and conducting a biopsy of the aborted specimen. Miscarriage is a common outcome, and in cases of diagnosis, dilation, and curettage are often performed. This report highlights the rarity of recurrent molar pregnancy and emphasizes its potential occurrence.
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Samantaray, Subha Ranjan, Ipsita Mohapatra, and Achanta Vivekanada. "A clinical study of ectopic pregnancy at a tertiary care centre in Telangana, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 2 (2020): 682. http://dx.doi.org/10.18203/2320-1770.ijrcog20200358.

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Background: Ectopic pregnancy (EP) is a life-threatening obstetrics emergency in early trimester, associated with a high morbidity and mortality if not timely intervened. High index of clinical suspicion is required for early diagnosis, specifically in women presenting with amenorrhoea, pain abdomen and vaginal bleeding. Aim of this study is to determine the incidence, risk factors, clinical presentation, management and outcome of ectopic pregnancy.Methods: This retrospective observational study was conducted in the department of obstetrics and gynaecology, at Prathima institute of medical sciences, Telangana from July 2012 to June 2019, for a period of 7 years. A total of 53 cases of ectopic pregnancy were analyzed for parameters like age, gravidity, gestational age, risk factors, clinical presentation, management and morbidity.Results: Incidence of ectopic pregnancy was 5.3 per thousand deliveries. Majority of cases were in age group of 20 to 25 years (52.8%) and were gravida 3 and above (68%). The commonest risk factors identified were history of previous pelvic surgeries (37.7%) followed by history of abortion (18.8%). Commonest symptoms were abdominal pain (90.6%), amenorrhoea (75.5%) and vaginal bleeding (47.2%). Only 41.5 % of cases had triad of symptoms. Fallopian tube (92.4%), specifically ampulla (62.3%) was the most frequent site affected. About 73.6% cases presented with ruptured tube. Surgery (94.3%) was the mainstay of therapy.Conclusions: ectopic pregnancy is a life-threatening emergency, early diagnosis and treatment will improve the prognosis.
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Ghaemmaghami, Fatemeh, and Mojgan Karimi Zarchi. "Early Onset of Metastatic Gestational Trophoblastic Disease after Full-Term Pregnancy." International Journal of Biomedical Science 4, no. 1 (2008): 74–77. http://dx.doi.org/10.59566/ijbs.2008.4074.

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Choriocarcinoma is a curable malignancy that occurred approximately 50% after term pregnancies, and prognosis in this form of gestational trophoblastic Disease (GTD) is Poor. The earliest onset choriocarcinoma after term pregnancy in one study was reported 3 weeks after delivery, but in current study, choriocarcinoma was diagnosed 2 weeks after delivery. 28 years-old women gravidity 2, parity 2 delivered a healthy infant at term. Frequent episodes of vaginal bleeding occurred after 10 days of delivery. On admission to hospital, she had lesions in the lungs. The pretreatment human chorionic gonadotropin (HCG) level was 84,000 mIU/ml and her FIGO risk factor score was 8 (high risk group). The EMA/CO regimen was administered as first line chemotherapy and the patient achieved complete remission after 7 courses. Although early onset postpartum hemorrhage is due to complication of delivery, but gestational trophoblastic disease (GTD) may be occurred and assessment of human chorionic gonadotropin could be help to early diagnose of GTD.
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Rodriguez, Ana, Yong-Fang Kuo, and Enshuo Hsu. "ASSESSING RISK FOR ENDOMETRIAL CANCER AMONG HISPANIC FEMALES AGE 50 YEARS AND OLDER." Innovation in Aging 3, Supplement_1 (2019): S460. http://dx.doi.org/10.1093/geroni/igz038.1720.

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Abstract Endometrial cancer is the most common gynecological cancer in the US, with most women diagnosed between 55 and 64 years old. Seventy-five percent of women with endometrial cancer are postmenopausal, and the most common symptom is postmenopausal bleeding. Only a few studies have addressed the lack of knowledge and awareness of risk factors and/or health care utilization for early signs and symptoms of endometrial cancer. The objective of this study was to evaluate health care utilization among Hispanic women aged ≥50 years who are at risk for endometrial cancer. This retrospective cohort study used a combination of diagnosis and procedure codes from UTMB’s electronic health records to identify Texas Hispanic females who had a health encounter at ≥50 years of age between 2012 and 2016. Risk factors included conditions/treatments affecting hormone levels, age, body mass index, diabetes, gravidity, parity, family history of endometrial or colorectal cancer, previous diagnosis of breast or ovarian cancer or endometrial hyperplasia, smoking or alcohol use, and treatment with radiation therapy in the pelvis area. Multivariate logistic regression models evaluated for predictors of endometrial cancer. The study included 11,563 Hispanic females aged ≥50 years (median age=57). Most women were overweight. Currently, we identified 705 Hispanic females (6.1%) with possible endometrial cancer with validation underway. Females who have a history of vaginal spotting/bleeding, pelvic bleeding, and pelvic pain are at higher risk for endometrial cancer. It is important for physicians to educate patients on recognizing the signs and symptoms of endometrial cancer.
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Tarawah, Raghad A., and Ahmad M. Tarawah. "Pregnancy and Delivery Outcome Among Ladies with Glanzmann Thrombasthenia: A Report from Glanzmann Thrombasthenia Registry of Al-Madinah, Saudi Arabia." Blood 142, Supplement 1 (2023): 3968. http://dx.doi.org/10.1182/blood-2023-190438.

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Introduction Glanzmann's thrombasthenia (GT) is an autosomal recessive bleeding disorder due to functional platelet defects impairing platelet aggregation. AlMadinah has reported the highest prevalence of GT globally, with a prevalence of 1:10,000. Pregnancy had been reported among ladies with GT with different outcomes. As a bleeding disorder, Pregnancy among ladies with GT carries a higher risk for bleeding either during pregnancy or intra and postpartum. Neonates have an increased risk for hemorrhage, either due to alloimmunization or they may carry the gene of GT. Many GT ladies got pregnant earlier when GT diagnosis was difficult, and they did not know their diagnosis; even after the diagnosis was possible, ceasing the menstrual cycle was not culturally acceptable. In this study, we are describing the pregnancies among GT ladies and their outcomes. Methods This is a report from the AlMadinah GT registry in the Madinah Hemophilia Comprehensive Care Center. The registry covers a period of 20 years and includes all patients with a confirmed diagnosis of GT. 136 GT patients were identified. 11 patients had no data available. A spreadsheet designed to collect detailed data about pregnancy, delivery, and neonates. Electronic and hard copy medical records have been accessed to collect data. Data was analyzed by the statistical package of social sciences (SPSS) version 23. The research and ethical committee approved the study. Results Twenty-eight pregnancies have been identified. The median age of mothers at the time of pregnancy was 30 ± 5.7 years (20 - 42 years). Mothers' Gravidity was 1-7 (median 2.5 ± 1.6), and parity was 1-6 (median 2 ±1.4). Five miscarriages (18%) identified occurred at the 17 th, 11 th, 13 th and 15 th gestational weeks. In contrast, 5 th one is not on record. Three miscarriages took place after moderate to severe vaginal bleeding. Mild to severe post-abortion bleeding was controlled with platelets transfusion, activated human recombinant factor 7 (rFVIIa), and tranexamic acid. Thirty-two bleeding episodes occurred during 16 pregnancies, with 1-5 bleeding episodes per pregnancy (Median of 2 episodes). Seven (22%) bleeding episodes were vaginal bleeds, while 25 (78%) were GT-related bleeds such as gum bleeding or epistaxis. Two patients must undergo plasma exchange and be on steroids due to alloimmunization development during pregnancy. Delivery occurred at the gestational age of 34-40 weeks (median 38 ± 2 weeks). Sixteen (70%) deliveries were vaginal, and 7(30%) were cesarean sections. The indications for cesarean sections were family request in 4 cases, fetal distress in two instances, and precautional section in one case. Prophylactic platelets transfusion had given pre-delivery on four occasions, rFVIIa on 4, and a combination of rFVIIa and platelets transfusion on six occasions. Tranexamic acid was used in all cases. Ten deliveries were conducted with no prophylaxis. Post-partum hemorrhage (PPH) occurred in 18 (64%) cases, 13 (72%) cases of primary PPH, and 5 (28%) cases of secondary PPH. We could not find a correlation between pre-delivery prophylaxes and PPH (P=0.2). PPH had controlled successfully with platelets transfusion and rFVIIa though red blood cell transfusion was needed on eight occasions. Twenty-eight pregnancies produced 24 babies (13 girls and 11 boys). Four babies had bleeding (2 intracranial hemorrhages, one subdural hematoma, and one gum oozing), and 9 had alloimmunization with mild to severe thrombocytopenia. Of all babies tested for GT, 6 of them were GT. Conclusions Pregnancy among ladies with GT carries a higher risk of bleeding. Management of pregnancy in women with GT has to be in a Multidisciplinary approach. The high rate of PPH among GT ladies makes it essential to treat it promptly. Pregnancy among ladies with GT should be studied in multi-centers sitting to learn more about clinical courses and management.
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Dissertations / Theses on the topic "Vaginal Bleeding and Gravidity"

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Singal, Sakshi, Rossa Khalaf, Sara Masood, and Devapiran Jaishankar. "BURKITT’S LYMPHOMA MASQUERADING AS ACUTE CHOLECYSTITIS AND VAGINAL BLEEDING." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/asrf/2018/schedule/11.

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Burkitt lymphoma is a highly aggressive B cell non-Hodgkin lymphoma characterized by the translocation t(8,14) and deregulation of the MYC gene on chromosome 8. The endemic (African) form presents classically as an expanding mass in the jaw. The nonendemic (European/North American) form often presents with an abdominal mass. We present an interesting case of Burkitt’s Lymphoma with atypical features. A thirty-five-year-old lady with no significant medical history presented to the hospital with a three week complaint of vaginal bleeding and lower abdominal pain/cramps associated with night sweats and chills. She underwent gynecologic workup with an ultrasound revealing endometrial thickening followed by a hysteroscopic Dilatation and Curettage procedure. Laboratory workup revealed direct hyperbilirubinemia and elevated liver enzymes. MRCP showed gallbladder wall thickening but no biliary obstruction. A diagnosis of acalculous cholecystitis was considered and she underwent a laproscopic cholecystectomy and liver biopsy. Her initial complete blood count revealed mild leukocytosis. Follow up lab work revealed worsening leukocytosis and a hematology consultation was sought. A peak WBC of 81,000 with peripheral blood blasts as high as 31% was noted. Peripheral smear exam revealed moderate sized immature wbc precursors/blasts with high nuclear-cytoplasmic ratio. Further hematological work up including bone marrow aspirate and biopsy was expedited. Pathology resulted positive for Burkitt's lymphoma/leukemia, positive molecular studies, t(8,14), involving bone marrow, gallbladder, liver and endometrium. Patient was emergently treated with dexamethasone and nitrogen mustard as elevated bilirubin levels precluded standard treatment. She was started on Rituxan as this neoplasm is a CD 20+ B cell malignancy but could not tolerate it. HyperCVAD multi-agent chemotherapy was subsequently initiated along with intrathecal chemotherapy (cytarabine and methotrexate). CSF cytology remained negative for lymphoma. Patient’s clinical condition has improved after 2 cycles of chemotherapy and she is currently receiving on going therapy. Burkitt’s lymphoma is one of the most aggressive neoplasms with a tumor doubling time of a few days. The usual presentation is with constitutional symptoms and adenopathy or a mass lesion, and sometimes may manifest solely in the peripheral circulation as an L3 variant of acute lymphoblastic leukemia. Hepatic parenchymal involvement is rare, but reported. Gallbladder involvement with endoluminal deposits is even rarer. Simultaneous hepatic, gallbladder, uterine, nodal and leukemic involvement at presentation is unique. Treatment is primarily with systemic chemotherapy and multi agent regimens effective in acute lymphoblastic leukemia and/or aggressive lymphomas have been used successfully in this condition with a complete response rate of 80%-90% with a long-term survival rate of approximately 60%. Therapy is fraught with risks of fatal tumor lysis syndrome, pancytopenia, infection/sepsis, and bleeding. Potential progression/relapse in the CNS with the CSF serving as a sanctuary site has been well documented necessitating prophylactic intra thecal chemotherapy administration as in our patient. Aggressive biology of this disease required urgent treatment, as delay in institution of combination chemotherapy could result in poor outcome. This case highlights the need to maintain an open mind while evaluating apparently routine symptoms and the importance of rapid diagnosis and treatment of a hematologic-oncologic emergency.
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Hasan, Reem Baird Donna Day. "Vaginal bleeding in early pregnancy patterns, predictors, and association with miscarriage /." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2009. http://dc.lib.unc.edu/u?/etd,2452.

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Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2009.<br>Title from electronic title page (viewed Sep. 3, 2009). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Epidemiology." Discipline: Epidemiology; Department/School: Public Health.
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Naeem-ur-Rehman. "A statistical investigation of methods for the comparison of vaginal bleeding patterns in contracepting women." Thesis, University of Strathclyde, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.401454.

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Ekangaki, Abie. "An assessment of vaginal bleeding disturbances in women from different cultural groups using different contraceptive methods." Thesis, University of Southampton, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259504.

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Μιχαήλ, Γεώργιος Δ. "Ανάλυση χαρακτηριστικών περιεμμηνοπαυσιακού και μετεμμηνοπαυσιακού ενδομητρίου στην δισδιάστατη υπερηχοτομογραφία με χρήση τεχνικών ανάλυσης εικόνας". Thesis, 2007. http://nemertes.lis.upatras.gr/jspui/handle/10889/1195.

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Για τις Ευρωπαίες γυναίκες ο καρκίνος του σώματος της μήτρας αποτελεί το τέταρτο συχνότερο νεόπλασμα και την δέκατη σε σειρά αιτία θανάτου από καρκίνο. Ανεξάρτητα από το εάν η διακολπική υπερηχογραφία (TVS) αποτελεί δόκιμο μέσο διαλογής (screening) για την ανίχνευση ενδομητρικού καρκίνου σε ασυμπτωματικές μετεμμηνοπαυσιακές γυναίκες, εντούτοις κυριαρχεί στους διαγνωστικούς αλγόριθμους διερεύνησης κάθε μητρορραγίας προς αποκλεισμό του καρκίνου αυτού. Παράλληλα με τα πιθανά οφέλη από την ενσωμάτωση τεχνικών Υπερηχοϋστερογραφίας (SIS) και Doppler στην ενδομητρική απεικόνιση, η δισδιά- στατη “gray scale” διακολπική υπερηχογραφία οφείλει μεγάλο μέρος της προόδου της στην ώθηση από τις εξελίξεις της τεχνολογίας. Μετά την εισαγωγή των διακολπικών ηχοβολέων πολλαπλών συχνοτήτων (multifrequency) και της “αρμονικής” (harmonic) απεικόνισης, τα σύγχρονα υπερηχογραφικά μηχανήματα διαθέτουν επιλογές λογισμι- κού για ενίσχυση της ανάλυσης της αντίθεσης δομών, λεπτών ρυθμίσεων για εξέταση διαφορετικών τύπων ιστών, πολλαπλού εύρους εστίασης, μετάδοσης της δέσμης σε πλάγια διεύθυνση ως προς το ακουστικό παράθυρο, κ.α. Τα παραπάνω, καθώς και φίλτρα μείωσης του θορύβου βελτιστοποιούν την απεικόνιση του ενδομητρίου διευκολύνοντας την αποτίμησή του, ακόμη και στα χέρια άπειρων εξεταστών. Το πάχος της διπλής ενδομητρικής στιβάδας αποτελεί ιστορικά τον πλέον αδιαμφισβήτητο ποσοτικό δείκτη ενδομητρικού καρκίνου, ειδικά στην παρουσία μετεμμηνοπαυσιακής μητρορραγίας. Η συνδυασμένη μελέτη της ενδομητρικής μορφο- λογίας και πάχους παρέχει περισσότερες πληροφορίες, ειδικά στην αποτίμηση της “γκρίζας ζώνης” των 4-10 χιλιοστών ενδομητρικού πάχους, αν και τα ευρήματα των “μορφολογικών” αυτών μελετών δεν υπήρξαν πάντα σταθερά. Με δεδομένη τη σημασία της μορφολογίας στην αποτίμηση του ενδομητρικού ιστού, και αποσκοπώντας στην υπέρβαση του υποκειμενικού χαρακτήρα της ποιοτικής εκτίμησης της υπερηχογραφικής εικόνας, θα ήταν χρήσιμη η εφαρμογή αυτοματοποιημένων τεχνικών που αξιολογούν αντικειμενικά μορφολογικά χαρακτη- ριστικά, όπως η υποβοηθούμενη από υπολογιστή ανάλυση υφής, (“computerized texture analysis”). Στις ψηφιακές εικόνες, η υφή αντικατοπτρίζει τονικές (ένταση των εικονο- στοιχείων) και δομικές (χωρική κατανομή της έντασης των εικονοστοιχείων) ιδιότητες. Η “ανάλυση υφής” αναφέρεται σε αλγόριθμους που ποσοτικοποιούν περιεχόμενο και στοιχεία υφής που πιθανόν, ή όχι, να γίνονται αντιληπτά με το γυμνό μάτι. Δεδομένου ότι στην ιατρική απεικόνιση οι εικόνες περιλαμβάνουν πολλαπλές ιδιότητες των βιολογικών δομών, η ανάλυση υφής των εικόνων αυτών παρέχει ποσοτικές πληροφο- ρίες σχετικές με τα χαρακτηριστικά, τη μορφολογία και τις ιδιότητες των δομών αυτών. Σχήματα ταξινόμησης στηριζόμενα στην υφή έχουν χρησιμοποιηθεί με επιτυχία σε ποικιλία υπερηχογραφικών εφαρμογών. Η βασισμένη σε υπολογιστή αποτίμηση εικόνων του ενδομητρίου έχει βρει κυρίως εφαρμογή στη Υποβοηθούμενη Αναπαραγωγή, αλλά δεν έχει χρησιμοποιηθεί για τη διάγνωση ενδομητρικών κακοηθειών στην δισδιάστατη υπερηχογραφία. Σκοπός της διδακτορικής αυτής διατριβής είναι η αξιολόγηση του εφικτού της υποβοηθούμενης από υπολογιστή ανάλυσης υφής του ενδομητρικού ιστού όπως απεικονίζεται σε δισδιάστατες “gray scale” υπερηχογραφικές εικόνες. Περαιτέρω, διερευνήθηκε το αποτέλεσμα μιας τεχνικής επεξεργασίας βασισμένης σε μετασχη- ματισμό κυματίου (wavelet) στη διαδικασία τμηματοποίησης και χαρακτηρισμού του ενδομητρικού ιστού.<br>Cancer of the corpus uteri represents the fourth commonest neoplasm among European women and the tenth most common cause of death attributed to cancer. Irrespective whether the use of transvaginal ultrasonography (TVS) as a screening tool for detecting endometrial cancer in asymptomatic postmenopausal women is warranted, TVS dominates most diagnostic algorithms in assessing metrorrhagias to exclude this cancer. Alongside the potential benefits stemming from the integration of Saline Infusion Sonography) and Doppler modalities in endometrial imaging, gray scale TVS showed remarkable advances in the previous decades, largely attributed to the evolution in computer sciences. Following the introduction of multifrequency transvaginal probes and harmonic imaging, modern scanners are equipped with software options that enhance the resolution or the contrast between different structures, fine tune while assessing different types of tissue, implement different depth of focusing, transmit the ultrasonic beam in oblique directions to the acoustic window; all these features, in addition to de-speckle filters optimize the endometrial depiction, facilitating its assessment, even in the hands of moderately skilled operators. Double stripe endometrial thickness has illustrated a remarkable robustness over time as a quantitative indicator of endometrial cancer, especially in the presence of postmenopausal bleeding. The combined consideration of endometrial morphology and thickness has proven particularly beneficial, especially in the assessment of the 4-10 mm endometrial thickness “grey zone”, although the findings of the “morphologic” studies haven’t always been consistent. Given the importance of morphology in assessing endometrial tissue, and aiming to overcome the inherent subjectivity of the qualitative consideration of ultrasonic images, implementation of automated techniques assessing objective morphologic features such as “computerized texture analysis” would be beneficial. In digital images, texture reflects tonal (intensities of image pixels) and structural (spatial distribution of pixel intensities) properties. Texture analysis refers to algorithms that quantify texture content that may, or may not, be visually perceived. Since medical images capture various properties of biological structures, texture analysis of medical images can provide quantitative metrics relevant to structure, morphology and status of biological tissues. Texture based classification schemes have been successfully implemented in a variety of ultrasound applications. Computerized TVS assessment of endometrial morphology, has been applied mainly in assisted reproduction techniques; however, computerized texture analysis has not been implemented for diagnosing endometrial malignancies in grey scale TVS. The aim of this study is to investigate the feasibility of computerized texture analysis in characterizing endometrial tissue as depicted in 2D grey scale TVS images. Furthermore, we assess the effect of a wavelet-based image processing technique in the segmentation and subsequent characterization tasks of endometrial tissue.
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Books on the topic "Vaginal Bleeding and Gravidity"

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Parker, James N., and Philip M. Parker. Vaginal bleeding: A medical dictionary, bibliography, and annotated research guide to Internet references. ICON Health Publications, 2004.

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Publications, ICON Health. Vaginal Bleeding - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. ICON Health Publications, 2004.

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Bowker, Lesley K., James D. Price, Ku Shah, and Sarah C. Smith. Genitourinary medicine. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198738381.003.0019.

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This chapter provides information on the ageing genitourinary system, presentation of benign prostatic hyperplasia, treatment of benign prostatic hyperplasia, presentation of prostatic cancer, prostate-specific antigen, treatment of prostatic cancer, post-menopausal vaginal bleeding, vaginal prolapse, illustrations of prolapse, vulval disorders, sexual function, and HIV in older people.
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Stacey, Victoria. Obstetrics and gynaecology. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199592777.003.0008.

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Abdominal pain in women - Ectopic pregnancy - Pelvic inflammatory disease (PID) - Other gynaecological causes of abdominal pain - Abnormal vaginal bleeding - Emergency contraception - Bleeding in pregnancy - Hyperemesis gravidarum - Pre-eclampsia and eclampsia - Rhesus prophylaxis—anti-D immunoglobulin - Emergency delivery - Postpartum haemorrhage - Pregnancy and trauma - SAQs
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Doumouchtsis, Stergios K., S. Arulkumaran, Edwin Chandraharan, et al. Obstetric complications. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199651382.003.0003.

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This chapter explores obstetric complications during pregnancy, including leakage of fluid, bleeding in late pregnancy, leg pain and swelling, fainting episodes, pyrexia, painful uterine contractions, abnormal vaginal discharge, frequency of micturition, and acute retention of urine.
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Holst, John. Pelvic Inflammatory Disease and Tubo-Ovarian Abscess. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0040.

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Pelvic inflammatory disease (PID) consists of inflammation in various parts of the upper genital tract and includes endometritis, salpingitis, tubo-ovarian abscess (TOA), and/or pelvic peritonitis. Overt acute PID patients typically present as ill-appearing with pain, fever, chills, purulent vaginal discharge, nausea, vomiting, and elevated white blood cells. “Silent” PID presents with dyspareunia, irregular bleeding, and urinary and gastrointestinal complaints. Bacterial vaginosis (BV) and associated microorganisms are present in acute PID patients. PID coverage is focused on a polymicrobial infection. HIV patients typically have more severe symptoms and are more likely to have a TOA than an immunocompetent patient, but HIV alone does not mandate hospital admission nor does parenteral therapy improve outcomes compared to non-HIV patients. Gonorrhea and chlamydia cases must be reported to the local health department; it is not mandatory for PID patients to remove an intrauterine device at the time of diagnosis.
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Book chapters on the topic "Vaginal Bleeding and Gravidity"

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Bradley, Linda D. "Vaginal Bleeding." In Encyclopedia of Women’s Health. Springer US, 2004. http://dx.doi.org/10.1007/978-0-306-48113-0_456.

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Ratts, Valerie S. "Vaginal Bleeding." In Practical Pediatric and Adolescent Gynecology. Blackwell Publishing Ltd., 2013. http://dx.doi.org/10.1002/9781118538555.ch4.

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Tatford, Patrick. "Excessive vaginal bleeding." In Problems in Gynaecology. Springer Netherlands, 1986. http://dx.doi.org/10.1007/978-94-009-4125-0_3.

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O’Brien, Shaughn, and Mark Doyle. "Abnormal vaginal bleeding." In Common Conditions in Gynaecology. Springer US, 1997. http://dx.doi.org/10.1007/978-1-4899-3346-1_4.

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Shamil, Eamon, Praful Ravi, and Ashish Chandra. "Abnormal Vaginal Bleeding." In 100 Cases in Clinical Pathology and Laboratory Medicine, 2nd ed. CRC Press, 2022. http://dx.doi.org/10.1201/9781003242697-55.

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Brigham, Kathryn S. "Abnormal Vaginal Bleeding." In The MassGeneral Hospital for Children Adolescent Medicine Handbook. Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-45778-9_15.

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Sel, Görker. "Vaginal Bleeding in Pregnancy." In Practical Guide to Oral Exams in Obstetrics and Gynecology. Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-29669-8_12.

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Wheeler, Marsha. "First Trimester Vaginal Bleeding." In Protocols for High-Risk Pregnancies. Wiley-Blackwell, 2010. http://dx.doi.org/10.1002/9781444323870.ch45.

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Erez, Offer, Idit Erez-Weiss, Ruth Beer-Weisel, Vered Kleitman-Meir, and Moshe Mazor. "Vaginal Bleeding and Preterm Delivery." In Bleeding During Pregnancy. Springer New York, 2011. http://dx.doi.org/10.1007/978-1-4419-9810-1_6.

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Barroilhet, Lisa M., Donald Peter Goldstein, and Ross S. Berkowitz. "Vaginal Bleeding and Gestational Trophoblastic Disease." In Bleeding During Pregnancy. Springer New York, 2011. http://dx.doi.org/10.1007/978-1-4419-9810-1_4.

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Conference papers on the topic "Vaginal Bleeding and Gravidity"

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Broomfield, R., and R. Pryce. "G160(P) Prepubertal vaginal bleeding – an unusual cause." In Royal College of Paediatrics and Child Health, Abstracts of the Annual Conference, 24–26 May 2017, ICC, Birmingham. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2017. http://dx.doi.org/10.1136/archdischild-2017-313087.159.

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Patnaik, Sourav S., Benjamin Weed, Ali Borazjani, et al. "Biomechanical Characterization of Sheep Vaginal Wall Tissue: A Potential Application in Human Pelvic Floor Disorders." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80886.

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Pelvic Organ Prolapse (POP) is a leading women’s health issue affecting a significant portion of the population and has been recently coined as a “silent epidemic”. POP leads to a considerable reduction in women’s quality of life and can cause chronic pelvic pain, sexual dysfunction, and social/psychological issues. The lifetime risk for having surgery for POP is approximately 11% with 200,000 POP procedures performed each year in USA, with an annual direct cost of over $1000 million. Exact etiology of POP is unclear, but it is understood that POP is multi-factorial in nature. Risk factors for POP include increasing age, obesity, multiple vaginal births, gravidity, history of hysterectomy, smoking, chronic cough conditions, frequent heavy lifting, and some genetic factors. POP results due to loss or damage of structural supports that support the pelvic organs (i.e. rectum, bowel, bladder, etc). Vaginal wall prolapse (anterior and posterior) is the most common presentation. This can result from weakening of the levator ani muscle and other connective tissue structures which not only control the mechanical function, but also help support neurological and anatomical function[1].
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Kovac, L., B. Cvjetićanin, M. Jakimovska, M. Velikonja, and M. Barbič. "EP1171 A rare cause of postmenopausal bleeding - vaginal melanoma- case report." In ESGO Annual Meeting Abstracts. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/ijgc-2019-esgo.1212.

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"Gestational choriocarcinoma after term pregnancy: A case report." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685341.

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Choriocarcinoma coexisting with or after a “normal” pregnancy has an incidence of one per 1,60,000 pregnancies. In case of choriocarcinoma after term pregnancy, early diagnosis by histopathological examination of the placenta is very important, the precocity of the diagnosis influencing the prognosis and tumor response to chemotherapy. In, this paper we report the case of a 28-year-old woman parity 2 with metastatic choriocarcinoma after term pregnancy, diagnosed at four months after the delivery of a healthy baby. An episode of abundant vaginal bleeding occurred after four months from delivery. The local examination revealed a vaginal tumor whose pathological examination on biopsy sample was inconclusive. Subsequently, she was admitted in our hospital with abundant vaginal bleeding, severe anemia and fever. Abdominal ultrasonography revealed an intracavitary uterine tumoral mass with signe of myometrial invasion to the uterine serosa, strong Doppler signal and moderate ascites. Pulmonary X-Ray and computed tomography scan excluded extrapelvic tumoral masses. The pretreatment human chorionic gonadotropin (HCG) level was 310300 Miu/ml and her FIGO risk factor score was 8 (high–risk group). Total hysterectomy with bilateral salpingo-oophorectomy and omentectomy was performed as an optimal cytoreduction. Postoperative remaining presented by the metastasis located in the lower two-thirds of vagina. Histopatholgical examination revealed uterine choriocarcinoma. Postoperative was initiated four courses of polychemotherapy. Case evaluation was favorable, with the normalization of the Beta-HCG value in two months postoperative and complete remission of vaginal metastasis in six weeks posteoperative.
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Koneru, Sahitya, Silky Jain, Shalini Mishra, Sandeep Jain, and Gauri Kapoor. "Pediatric vaginal rhabdomyosarcoma: Report of 2 cases." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685381.

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Introduction: Rhabdomyosarcoma (RMS) arising in the female genital tract is rare accounting for 3.5% of all RMS cases. Approximately half these occur in the vagina, a site that has been associated with a favorable prognosis. Optimal loco-regional treatment for patients with vaginal RMS remains controversial since wide local excision is mutilating and often not done. Two cases of vaginal RMS are reported who underwent chemotherapy and local control with brachytherapy. Methods: Retrospective chart review was done between 2011 and 2015. During this interval, out of 31 cases of pediatric RMS managed at our institution, 2 had vaginal RMS. Their management and outcome is detailed below. Results - Case Materials: Two patients, both aged 2 years at the time of diagnosis, presented with grape-like mass protruding from vaginal orifice and bleeding for 1-2 months. Characteristic MRI features were of a heterogeneously enhancing polypoidal soft tissue mass filling vaginal lumen and protruding out of introitus confirming Botryoidal RMS. Biopsy and histopathology was suggestive of embryonal RMS (IHC positive for desmin, myogenin and focally for myo-D1). Tumor in both the patients was staged as Stage1 Group 3 (low risk). They were started on neo-adjuvant chemotherapy as per IRS-? Protocol with 3 weekly cycles of vincristine, dactinomycin and cyclophosphamide for 33 weeks. They had near complete regression of tumor and received brachytherapy for residual thickening of the vaginal wall. They have been followed up for 24 months and 57 months respectively from presentation, and are disease free. They are on close surveillance with periodic examination under anesthesia and imaging. One patient developed post radiation vaginal synechiae requiring vaginal dilatation. Conclusion: In patients with non-resected vaginal RMS, good outcome can be achieved by the use of brachytherapy for local control.
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Jones, Eleanor, Nadira Narine, Helena O’Flynn, et al. "2022-RA-604-ESGO Urine and vaginal cytology detects endometrial cancer in women with postmenopausal bleeding." In ESGO 2022 Congress. BMJ Publishing Group Ltd, 2022. http://dx.doi.org/10.1136/ijgc-2022-esgo.153.

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Gupta, Bindiya, Shalini Rajaram, Sandhya Jain, Neerja Goel, and Naveen Tanwar. "Collision tumor of endometrial stromal sarcoma and squamous cell cancer: A rare entity." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685363.

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A collision tumor is defined by the presence of two separate tumors in one organ on gross, microscopic, and immunohistochemical studies and they should be distinguished from malignant mullerian mixed tumors. A 60 year old lady P8L8 presented with blood stained vaginal discharge and post menopausal bleeding. Examination revealed a 1 x 2 cm cervical growth which was reported as squamous cell carcinoma cervix. Imaging revealed myohyperplasia with normal uterine cavity. The patient underwent Type III radical hysterectomy, bilateral salphingo-oophorectomy and bilateral pelvic lymphadenectomy. The uterine corpus revealed 5 cm growth in uterine cavity which was reported as high grade endometrial stromal sarcoma and the cervical growth was non keratinising squamous cell carcinoma infiltrating the former. The lymph nodes, parametria and vaginal cuff were free of tumor. The patient was referred for adjuvant chemotherapy and radiation therapy.
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Christiaens, G. C. M. L. "DIAGNOSIS AND MANAGEMENT OF ITP DURING THE PERINATAL PERIOD." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644762.

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Although maternal and perinatal mortality and morbidity in pregnant patients with ITP are lower than previously assumed, they are not negligable. Significant postpartum hemorrhage occurs in 7% of the mothers with ITP. Thrombocytopenia is found in 51% of the newborns born from mothers with ITP and 6% of these have serious bleeding problems. Tests which predict which fetuses are at risk, are not yet available. Thrombocyte counts in a fetal blood sample are falsely low in 40% of cases.A prospective controlled randomized study done in the Netherlands failed to show an effect of antenatal corticosteroid treatment on neonatal platelet counts. Elective caesarean section has not been shown to protect against intracranial bleeding in thrombocytopenic newborns. The choice between vaginal delivery and caesarean section in ITP patients should be made on obstetric grounds with one exception: no other assisted vaginal delivery than the easy outlet forceps should be done. All cases of slow progress of the second stage of labour with insufficient descent should be terminated by caesarean section as well as breech delivery with suboptimal progress. Newborn thrombocyte counts should be done daily during the first week of life, since lowest platelet counts are often found between the 3rd and 5th postpartum day. Newborn thrombocytopenia is transient and does not warrant splenectomy, but can necessitate treatment with corticosteroids and/or high doses of immunoglobulin 6. Current data do not justify to dissuade breastfeeding.The recurrence of neonatal thrombocytopenia in subsequent patients is unknown.
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Hassan, Mohamed, Meena Ashworth, Swati Gupta, and Ling Tan. "779 Management of Pre-pubertal Girls with Vaginal Discharge or Bleeding and Children with Genital warts, guidance from practice and literature review." In Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference, Glasgow, 23–25 May 2023. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2023. http://dx.doi.org/10.1136/archdischild-2023-rcpch.440.

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Mangla, Akanksha, and Renuka Sinha. "Role of complementary cytology, colposcopy and histopathology in detecting premalignant and malignant lesions of cervix." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685253.

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Objective: Cervical cancer is the second most common gynecologic malignancy worldwide. India alone accounts for one fifth of total number of cases worldwide. The aim of our study was to calculate sensitivity, specificity, positive predictive value, negative predictive value, false positive rate and false negative rate of complementary cytology and colposcopy with histopathology as gold standard for detection of premalignant and malignant cervical lesions. Methods: A cross sectional study was conducted at Vardhman Mahavir Medical College and Safdarjung hospital, Delhi, India. 100 non pregnant females with complaint of post coital or irregular vaginal bleeding and those who had unhealthy cervix on visual inspection were included in study. Results: Colposcopy exhibited a high degree of accuracy in diagnosis of high grade lesions. Overall sensitivity of cytology was 50% whereas that of colposcopy was 83.3%. Cytology had specificity of 93.4% whereas colposcopy had specificity of 89.4%. 100% of high grade and invasive cancers on colposcopy were associated with similar findings on histology. The degree of agreement between cytology and colposcopy with histology was significant (p&lt;0.001). Conclusion: Colposcopy is sensitive method as compared to cytology, especially in the higher grade lesions and combination of both methods appears to be of higher diagnostic importance.
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Reports on the topic "Vaginal Bleeding and Gravidity"

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Intravenous oxytocin reduces severe bleeding after vaginal delivery. National Institute for Health Research, 2018. http://dx.doi.org/10.3310/signal-000685.

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Burkina Faso and Mali: Female genital cutting harms women's health. Population Council, 2000. http://dx.doi.org/10.31899/rh2000.1019.

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In collaboration with the Ministries of Health (MOH) of Burkina Faso and Mali, the Population Council conducted two studies in 1998 to describe the occurrence and severity of health problems related to female genital cutting (FGC). Study participants were consenting women who received a pelvic exam during prenatal, family planning (FP), obstetric, or gynecological consultations at MOH clinics. Providers were trained to observe the types and complications of FGC. To assess their potential role as change agents, providers in Mali also received training on the health effects of FGC and client counseling. In Burkina Faso, health providers recorded information on 1,920 women at 21 health centers in the rural provinces of Bazega and Zoundweogo. In Mali’s Bamako district and Segou region, providers recorded information on 5,390 women in 14 urban and rural health centers. As noted in this brief, women in Burkina Faso and Mali who have had their genitals cut are more likely to have gynecological and obstetrical problems, including bleeding, internal scarring, vaginal narrowing, and childbirth complications. More severe cutting increases a woman’s risk of other reproductive health problems.
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