Management of Labor Complicated with Extensive Uterine Prolapse

Management of severe uterine prolapsus during active labor is challenging. Detrimental complications are inevitable unless preventive measures have been taken. Active labor may result with uneventful vaginal delivery, nevertheless impeded cervical dilation, cervical dystocia and obstructive labor are all potential outcomes. Enlarged and edematous cervix accompanying prolapse in such cases may obstruct course of labor and may result with dystocia. In this instance, C-section stands as feasible and safe option for both mother and the fetus. Also, it is more likely to provide normal anatomic texture during C-section with effective prolapse reduction. Moreover, spontaneous resolution of the uterine prolapse is possible following C-section and considering suspension procedures till complete recovery of the pelvic anatomy seems reasonable. In this case report, succesful management of an active labor complicated with extensive uterus prolapse have been described along with current literature findings

DNA fragmentation index and human papilloma virus in males with previous assisted reproductive technology failures

Objective: This study was designed to evaluate the prevalence of Human Papilloma Virus (HPV) in semen and document the cycle outcomes in couples with previous intra-cytoplasmic sperm injection (ICSI) failures

Electrocardiographic P-Wave Duration, QT Interval, T Peak to End Interval and Tp-e/QT Ratio in Pregnancy with Respect to Trimesters

Background: P-wave duration helps to determine the risk of atrial arrhythmia, especially atrial fibrillation. QT interval, T peak to end interval (Tp-e), and Tp-e/QT ratio are electrocardiographic indices related to ventricular repolarization which are used to determine the risk of ventricular arrhythmias. We search for any alterations in electrocardiographic indices of arrhythmia in the pregnancy period with respect to trimesters. Methods: We enrolled 154 pregnant and 62 nonpregnant, healthy women into this cross-sectional study. Maximum and minimum P-wave durations (Pmax, Pmin), and QT intervals (QTmax, QTmin) were measured from 12 leads. QT measurements were corrected using Fridericia (QTc-Fr) and Bazett's (QTc-Bz) correction. Tp-e interval was obtained from the difference between QT interval, and QT peak interval (QTp) measured from the beginning of the QRS until the peak of the T wave. Tp-e/QT ratio was calculated using these measurements. Results: Pmax were 93.0 +/- 9.1, 93.9 +/- 8.9, 97.9 +/- 5.6, 99.0 +/- 6.1 in nonpregnant women, first, second, third trimesters of pregnancy, respectively (P = 0.001); whereas Pmin values were not significantly different. QTc-Fr max were 407.4 +/- 14.2, 408.5 +/- 16.1, 410.1 +/- 13.1, 415.1 +/- 10.1 (P = 0.007); Tp-e were 72.7 +/- 6.2, 73.2 +/- 6.5, 77.2 +/- 8.9, 87.2 +/- 9.6 (P < 0.001); and Tp-e/QT were 0.17 (0.14-0.20), 0.17 (0.14-0.20), 0.18 (0.15-0.23), 0.20 (0.16-0.25) in nonpregnant women, first, second, and third trimesters of pregnancy respectively (P < 0.001). None of the participants experienced any arrhythmic event. Conclusions: P-wave duration is prolonged in the second trimester, and resumes a plateau thereafter. Maximum QTc interval, Tp-e interval and Tp-e/QT ratio are increased in the late pregnancy. Although these indices are altered during the course of pregnancy, they all remain in the normal ranges