32,175 results match your criteria vaginal bleeding


A Case of Rapid Transformation from Hydatidiform Mole to Invasive Mole: The Importance of β-hCG (Human Chorionic Gonadotropin) Serum Levels in Follow-Up Evaluation.

Am J Case Rep 2021 Jun 15;22:e931156. Epub 2021 Jun 15.

Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia.

BACKGROUND Gestational trophoblastic disease (GTD) is a spectrum of disorders consisting of premalignant (ie, complete [CHM] and partial hydatidiform moles [PHM]) and malignant conditions (ie, invasive moles, choriocarcinoma, placental site trophoblastic tumors, and epithelioid trophoblastic tumor). If GTD persists after initial treatment and has persistent elevated beta human chorionic gonadotropin (ß-hCG), it is referred to as post-molar gestational trophoblastic neoplasia (pGTN). To date, there is no detailed information regarding how fast invasive moles can develop from CHM. Read More

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Safety and Effectiveness of SEP-363856 in Schizophrenia: Results of a 6-Month, Open-Label Extension Study.

CNS Spectr 2021 Apr;26(2):148-149

Sunovion Pharmaceuticals Inc., Marlborough, MA, USA.

Background: SEP-363856 is a novel psychotropic agent without dopamine D2 receptor occupancy. Although its mechanism of action has not been fully elucidated, preclinical data suggest that agonism at trace amine receptor 1 (TAAR1) and the serotonin 5-H1A receptor contributes to its efficacy. In a double-blind (DB), placebo-controlled study, SEP-363856 demonstrated significant efficacy in the treatment of an exacerbation of schizophrenia (Koblan et al, NEJM 2020; 82:1497-1506). Read More

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Utilization of Educational Videos to Improve Communication and Discharge Instructions.

West J Emerg Med 2021 Apr 27;22(3):644-647. Epub 2021 Apr 27.

University of California Irvine, Department of Emergency Medicine, Irvine, California.

Introduction: When discharging a patient from the emergency department (ED), it is crucial to make sure that they understand their disposition and aftercare instructions. However, numerous factors make it difficult to ensure that patients understand their next steps. Our objective was to determine whether patient understanding of ED discharge and aftercare instructions could be improved through instructional videos in addition to standard written discharge instructions. Read More

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The pattern of human papillomavirus infection and genotypes among Nigerian women from 1999 to 2019: a systematic review.

Ann Med 2021 Dec;53(1):944-959

WHO National Polio Reference Laboratory, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.

Background: There are no robust national prevalence of Human Papillomavirus (HPV) genotypes in Nigerian women despite the high burden of cervical cancer morbidity and mortality.

The Objective Of Study: This study aims to determine the pooled prevalence and risk factors of genital HPV infection in Nigeria through a systemic review protocol.

Methods: Databases including PubMed, Scopus, Google Scholar and AJOL were searched between 10 April to 28 July 2020. Read More

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December 2021

Implications of Ehlers Danlos Syndrome in a Patient with Mayer-Rokitansky-Küster-Hauser Syndrome.

J Pediatr Adolesc Gynecol 2021 Jun 10. Epub 2021 Jun 10.

Baylor College of Medicine, Division of Pediatric and Adolescent Gynecology, Houston, TX, USA.

Background: Ehlers Danlos syndromes (EDS) are a heterogenous group of connective tissue disorders characterized by defective collagen production. Patients with EDS have lax and fragile connective tissue in their joints, skin, blood vessels and hollow organs. This can lead to, among other complications, joint hypermobility, aneurysms, organ prolapse and musculoskeletal chronic pain. Read More

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Correlates of Adherence to the Dapivirine Vaginal Ring for HIV-1 Prevention.

AIDS Behav 2021 Jun 11. Epub 2021 Jun 11.

University of Washington, Seattle, USA.

Understanding characteristics associated with adherence to pre-exposure prophylaxis (PrEP) methods for HIV-1 prevention may assist with optimizing implementation efforts. The dapivirine vaginal ring is a novel topical PrEP delivery method. Using data from a randomized, double-blind, placebo-controlled, phase III trial of the dapivirine vaginal ring conducted in four African countries, generalized estimating equation models were used to evaluate correlates of ring adherence. Read More

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Surgical repair of a cesarean scar defect using a vaginal approach.

Fertil Steril 2021 Jun 8. Epub 2021 Jun 8.

Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Objective: To discuss the signs and symptoms of a cesarean section (C-section) scar defect, and to describe the techniques to repair the defect using a vaginal approach.

Design: A video review of a 32-year-old woman with abnormal bleeding and a C-section scar defect managed surgically by vaginal repair. The patient provided consent for video recording and publication. Read More

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Phosphodiesterase-5 inhibitors in Pregnancy: Systematic review and meta-analysis of maternal and perinatal safety and clinical outcomes.

Am J Obstet Gynecol 2021 Jun 8. Epub 2021 Jun 8.

Mater Research Institute - University of Queensland, Level 3 Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia; Faculty of Medicine, University of Medicine, Whitty Building, Annerley Road, South Brisbane, Queensland 4101, Australia; NHMRC Stillbirth Centre For Research Excellence, Mater Research Institute, South Brisbane, Queensland 4101, Australia. Electronic address:

Objective: Phosphodiesterase-5 inhibitors have recently been used for the treatment of severe early onset pre-eclampsia and fetal growth restriction. There are however concerns that they may increase the risk of neonatal morbidity and mortality. The aim of this systematic review was to assess the safety profile and clinical outcomes of phosphodiesterase-5 inhibitors use in pregnancy. Read More

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Cervical Cancer-Associated Suffering: Estimating the Palliative Care Needs of a Highly Vulnerable Population.

JCO Glob Oncol 2021 Jun;7:862-872

Department of Non-communicable Diseases, World Health Organization, Geneva, Switzerland.

Purpose: To enable design of optimum palliative care for women with cervical cancer, we studied the most common types of suffering and their severity, prevalence, and duration.

Methods: We first reviewed the literature on the major types, severity, prevalence, and duration of suffering associated with cervical cancer. We then conducted a modified Delphi process with experts in cervical cancer care to supplement the literature. Read More

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A New Modified Hysteroscopic-Laparoscopic Surgery for Cesarean Scar Pregnancy of Stable Type III.

Int J Gen Med 2021 3;14:2289-2295. Epub 2021 Jun 3.

Department of Gynecology and Obstetrics, Renmin Hospital of Wuhan University, Hubei, People's Republic of China.

Objective: To introduce a modified hysteroscopic-laparoscopic operation for cesarean scar pregnancy (CSP) of stable type III.

Patients And Methods: We retrospectively studied the case notes of 31 patients with stable type III cesarean scar pregnancy who underwent hysteroscopic-laparoscopic surgery in our hospital. Thirteen patients received the modified hysteroscopic-laparoscopic surgery (modified surgery group), and eighteen patients received traditional hysteroscopic-laparoscopic surgery (traditional surgery group). Read More

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Predicting the need for blood transfusion requirement in postpartum hemorrhage.

J Matern Fetal Neonatal Med 2021 Jun 9:1-6. Epub 2021 Jun 9.

Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Objective: We aimed to assess the role of lactate and hemoglobin levels as predictors for the need for blood transfusion in post-partum hemorrhage (PPH).

Methods: A retrospective cohort study of women with PPH in a single university-affiliated tertiary medical center between August 2018 and June 2020. PPH was defined as an estimated excessive blood loss (of more than 500 ml following vaginal delivery and 1000 ml following a cesarean delivery) requiring at least one uterotonic drug and fluid resuscitation. Read More

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Oral versus Vaginal Micronized Progesterone for the Treatment of Threatened Miscarriage.

Pak J Med Sci 2021 May-Jun;37(3):628-632

Sajjad Masood, FCPS (OBG). Department of Obstetrics and Gyne, Unit-II, Nishtar Medical University Hospital, Multan, Pakistan.

Objectives: This study was planned with an aim to find out the effectiveness of oral versus vaginal micronized progesterone for the treatment of threatened miscarriage.

Methods: This randomized controlled trial was conducted at The Department of Obstetrics and Gynaecology, Nishtar Hospital Multan, from August 2019 to January 2020. A total of 136 pregnant women, aged 18 to 45 years having vaginal bleeding were included and divided into two groups (68 women in each group). Read More

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Atypical Polypoid Adenomyoma (APAM).

J Coll Physicians Surg Pak 2021 Jun;30(6):719-721

Department of Gynae Unit 1, Jinnah Hospital, Lahore, Pakistan.

Atypical polypoid adenomyoma (APAM) is a rare polypoidal benign tumor of uterus, which usually presents with irregular vaginal bleeding in women of reproductive age. It has the potential of malignant transformation but does not metastasise. It may coexist with endometrial hyperplasia and adenocarcinoma; and so, is usually misdiagnosed. Read More

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Pain scores at the insertion of the 52 MG levonorgestrel-releasing intrauterine system among nulligravidas and parous women.

Eur J Contracept Reprod Health Care 2021 Jun 7:1-5. Epub 2021 Jun 7.

Department of Obstetrics and Gynecology, Federal University of Minas Gerais, Belo Horizonte, Brazil.

Purpose: This study aimed to assess the pain scores at the insertion of the 52 mg levonorgestrel-releasing intrauterine system (LNG-IUS) among nulligravidas, parous women with previous vaginal delivery and parous women with elective caesarean-delivery without any previous labour or cervix dilation.

Materials And Methods: The present research is a prospective, single-cohort study that included 413 women aged 15-49 years who opted for LNG-IUS placement for contraception or treatment of heavy menstrual bleeding. Women who participated in the present study were not submitted to any pharmacological pain-relieving intervention to perform the procedure. Read More

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Massive hemoperitoneum without peritoneal signs: An unusual presentation of omental ectopic rupture. A case report.

Case Rep Womens Health 2021 Jul 15;31:e00327. Epub 2021 May 15.

West Virginia University School of Medicine, United States of America.

Background: Extrauterine ectopic pregnancy is a rare form of ectopic pregnancy, accounting for roughly 1:10,000-30,000 of all pregnancies. Primary omental pregnancy is the least common form of abdominal ectopic pregnancies, making it extremely rare. Typical presentation includes pelvic pain, secondary amenorrhea, with or without vaginal bleeding. Read More

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"The bagel and blob signs in tubal ectopic pregnancy".

Radiol Case Rep 2021 Jul 21;16(7):1851-1853. Epub 2021 May 21.

Department of Radiology and Imaging Sciences, University of Utah, 30 North 1900 East #1A71, Salt Lake City, UT 84132.

An ectopic pregnancy carries the potential for disastrous maternal complications. Early first trimester pelvic ultrasound examinations are frequently obtained in cases of pelvic pain and vaginal bleeding to assess for such diagnoses. The "bagel sign" and the "blob sign" described two sonographic appearances of tubal ectopic pregnancy with positive predictive values of > 95%. Read More

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The Etonogestrel Implant in Adolescents: Factors Associated with Removal for Bothersome Bleeding in the First Year after Insertion.

J Pediatr Adolesc Gynecol 2021 Jun 2. Epub 2021 Jun 2.

Children's Hospital Colorado, Department of Pediatrics, Section of Adolescent Medicine, 13123 E. 16(th) Ave, Box -25, Aurora, Colorado 80045, USA; University of Colorado School of Medicine, 13001 E. 17th Pl, Aurora, CO 80045, USA. Electronic address:

Study Objective: Hormonal pills can temporarily improve the side effect of breakthrough bleeding on the etonogestrel implant. The aims of this study were to determine demographic factors that are associated with bothersome bleeding and to evaluate the impact of prescribing temporizing measures on implant continuation.

Design: Retrospective chart review SETTING: The research was conducted in an Adolescent Medicine primary and specialty care clinic, an adolescent family planning clinic, and a clinic that cares for parenting adolescents. Read More

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Solitary vulvar metastasis from early-stage endometrial cancer: Case report and literature review.

Medicine (Baltimore) 2021 Jun;100(22):e25863

Unit of Surgical Gynecol Oncology.

Rationale: Endometrial cancer (EC) is the most common gynecological malignancy in developed countries. It is usually diagnosed at early-stage and presents a favorable prognosis. Conversely, advanced or recurrent disease shows poor outcome. Read More

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Autoantibodies in association with subchorionic haematoma in early pregnancy.

Ann Med 2021 12;53(1):841-847

Reproductive Medicine Center, Ningbo First Hospital, Ningbo, China.

Objective: To explore the possible aetiology of subchorionic haematoma (SCH), especially its association with autoantibodies.

Material And Methods: Early pregnant women who were detected SCH through ultrasonography were identified as the study group and those without SCH at comparable ages who visited the clinic at the same period of time were compared as the control group. Indexes of laboratory immune tests were compared between the two groups, as well as their pregnancy outcomes. Read More

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December 2021

Vaginal cancer as a late complication of radiotherapy for endometrial cancer and ileo-perineal fistula after total pelvic exenteration.

J Gynecol Oncol 2021 Jul;32(4):e63

Department of Obstetrics and Gynecology, Karadeniz Technical University Hospital, Trabzon, Turkey.

Pelvic exenteration is a highly morbid operation and remains one of the most catastrophic surgical procedures in gynecological oncology. We would like to present the case of total pelvic exenteration for vaginal cancer after radiotherapy for endometrial cancer as a secondary cancer. A 62-year-old woman, whose gravida: 3, parity: 2, body mass index: 35. Read More

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Warm distension fluid reduces pain severity in office hysteroscopy: a randomized controlled trial.

Ann Saudi Med 2021 May-Jun;41(3):135-140. Epub 2021 Jun 1.

From the Department of Obstetrics and Gynecology, Nigde Omer Halisdemir University, Merkez Nigde, Turkey.

Background: Abnormal uterine bleeding (AUB) affects approximately 14% to 25% of women of reproductive age. The most common use of office hysteroscopy is to evaluate pathologies related to AUB and reproductive health, but office hysteroscopy can also be used for the diagnosis and treatment of other intrauterine pathologies.

Objective: Investigate the effects of the temperature of the distension fluid on pain severity in patients undergoing diagnostic office hysteroscopy due to AUB. Read More

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Safety of daily low-dose aspirin use during pregnancy in low-income and middle-income countries.

AJOG Glob Rep 2021 Feb 27;1(1). Epub 2021 Jan 27.

Department of Obstetrics/Gynecology, Thomas Jefferson University, Philadelphia, PA (Drs Short and Derman); Department of Obstetrics and Gynecology, Christiana Care, Newark, DE (Dr Hoffman); KLE Academy of Higher Education and Research Jawaharlal Nehru Medical College, Belagavi, Karnataka, India (Drs Metgud, Kavi, and Goudar); Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo (Drs Okitawutshu and Tshefu); University of North Carolina at Chapel Hill, Chapel Hill, NC (Dr Bose); University Teaching Hospital, Lusaka, Zambia (Drs Mwenechanya and Chomba); Department of Obstetrics/Gynecology, University of Alabama at Birmingham, Birmingham, AL (Dr Carlo); Instituto de Nutrición de Centro América y Panamá, Guatemala City, Guatemala (Drs Figueroa and Garces); University of Colorado School of Medicine, Aurora, CO (Dr Krebs); Aga Khan University, Karachi, Pakistan (Drs Jessani and Saleem); Department of Obstetrics/Gynecology, Columbia University, New York, NY (Dr Goldenberg); Lata Medical Research Foundation, Nagpur, India (Drs Das and Patel); Department of Global Health, Boston University School of Public Health, Boston, MA (Dr Hibbert); Department of Child Health and Paediatrics, Moi University School of Medicine, Eldoret, Kenya (Ms Achieng, Mr Nyongesa, and Dr Esamai); Indiana University School of Medicine, Indianapolis, IN (Dr Bucher); Research Triangle Institute International, Research Triangle Park, NC (Ms Nowak); Social, Statistical and Environmental Health Sciences, Research Triangle Institute International, Research Triangle Park, NC (Mr Goco, and Drs Nolen and McClure); Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (Drs Koso-Thomas and Miodovnik).

Background: The daily use of low-dose aspirin may be a safe, widely available, and inexpensive intervention for reducing the risk of preterm birth. Data on the potential side effects of low-dose aspirin use during pregnancy in low- and middle-income countries are needed.

Objective: This study aimed to assess differences in unexpected emergency medical visits and potential maternal side effects from a randomized, double-blind, multicountry, placebo-controlled trial of low-dose aspirin use (81 mg daily, from 6 to 36 weeks' gestation). Read More

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February 2021

Pregnancy with Paroxysmal Nocturnal Hemoglobinuria: A Case Series with Review of the Literature.

Saudi J Med Med Sci 2021 May-Aug;9(2):178-189. Epub 2021 Apr 29.

Adult Hematology/Bone Marrow Transplantation Section, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired hematopoietic stem cell disorder, and eculizumab and ravulizumab are its two approved therapies. Only few case series/reports have reported the outcomes of pregnancies in patients with PNH despite the increased risk of thrombosis. Similarly, there is limited knowledge regarding the effect of the approved treatments on conception and pregnancy outcomes. Read More

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Endovascular management of episiotomy site hematoma: Two cases and a brief review

Turk J Obstet Gynecol 2021 06;18(2):163-166

All India India Institute of Medical Sciences, Department of Radiology, New Delhi, India

Episiotomy site hematoma, though uncommon, can be associated with serious maternal morbidity. It arises mostly due to tissue trauma or injury to blood vessels, leading to the formation of a pseudoaneurysm. Sometimes, when surgical management fails, embolization of the bleeding vessel is a lifesaving option. Read More

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Experiences and outcomes of women with bleeding in early pregnancy presenting to the Emergency Department: An integrative review.

Australas Emerg Care 2021 May 31. Epub 2021 May 31.

Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia; Molly Wardaguga Research Centre, CDU, Darwin, Australia.

Background: Bleeding in early pregnancy occurs in approximately a quarter of all pregnancies and is a common reason for presentation to the Emergency Department (ED). This review combined current knowledge about experiences, interventions, outcomes and frequency of women presenting to the ED with per vaginal (PV) bleeding in the first 20 weeks of pregnancy.

Methods: This integrative literature review was conducted using electronic database and hand searching methods for primary research published from 2000; followed by screening and appraisal. Read More

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Delivery method of the placenta in cesarean deliveries and the effect of uterine incision repair area on morbidity: A randomized controlled study

Turk J Obstet Gynecol 2021 06;18(2):92-102

Adana Acıbadem Hospital, Clinic of Obstetrics and Gynecology, Adana, Turkey

Objective: We evaluated the effects of spontaneous or manual delivery of the placenta and repair of uterine incision inside or outside the abdomen on intraoperative blood loss, postoperative infection morbidity, and postoperative hospitalization time.

Materials And Methods: We conducted a prospective randomized controlled study with 150 patients among 160 patients who were indicated to undergo emergency cesarean procedures in our tertiary hospital. We divided the patient population into four groups. Read More

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A novel low uterine segment sandwich technique (Caliskan's technique) for the management of post-cesarean hemorrhage due to placenta previa accreta

Turk J Obstet Gynecol 2021 06;18(2):79-84

Okan University School of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey

Objective: Placenta previa (PP) and placenta accreta spectrum (PAS) disorders are major causes of postpartum hemorrhage (PPH). There is a variety of surgical management options with inexplicit reported success rates. Uterine sandwich is a combination of uterine compression sutures and intrauterine balloon placement to achieve hemostasis. Read More

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Timing of oxytocin administration to prevent post-partum hemorrhage in women delivered by cesarean section: A systematic review and metanalysis.

PLoS One 2021 3;16(6):e0252491. Epub 2021 Jun 3.

Department of Reproductive Health and Research, World Health Organization, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland.

Background: There is no consensus on the best timing for prophylactic oxytocin administration during cesarean section (CS) to prevent post-partum hemorrhage (PPH).

Objectives: Assess the effects of administrating prophylactic oxytocin at different times during CS.

Methods: We searched nine databases to identify relevant randomized controlled trials (RCT). Read More

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Systematic screening for vasa previa at the 20-week anomaly scan.

Acta Obstet Gynecol Scand 2021 Jun 2. Epub 2021 Jun 2.

Ambulatorium für Fetalmedizin Feldkirch, Feldkirch, Austria.

Introduction: The presence of vasa previa carries a high risk for severe fetal morbidity and mortality due to fetal bleeding caused by injury to unprotected fetal vessels when rupture of membranes occurs. Previously, it has been shown that prenatal diagnosis significantly improves the outcome. However, systematic screening for vasa previa is not generally performed, and clinical studies demonstrating the performance of systematic screening for vasa previa in routine clinical practice are rare. Read More

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The Pattern and Spectrum of Severe Maternal Morbidities in Nigerian tertiary Hospitals.

Afr J Reprod Health 2020 Jun;24(2):115-122

Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.

Maternal morbidities are precursors to maternal mortality as well as potential causes of life time disability and poor quality of life. This study aimed to determine the pattern and spectrum of life-threatening maternal morbidities seen in tertiary reproductive health facilities in Nigeria. All cases of severe maternal outcome (SMO), maternal near-misses (MNM), or maternal death (MD), attending 42 tertiary hospitals across all geopolitical zones of Nigeria were prospectively identified using the WHO criteria over a period of 14 months. Read More

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