Current Issue : July-September Volume : 2025 Issue Number : 3 Articles : 5 Articles
Background Weight-biased clinical practices and institutional characteristics can have a wide impact on the quality of care provided to women with obesity. This may substantially increase their risks for poor birth outcomes. The current study assessed experienced weight stigma by women during childbirth in maternity care settings in Switzerland. We aimed to identify frequencies, sources, and manifestations of weight-related stigmatization, hypothesizing that such stigma impacts birth outcomes, specifically cesarean birth (CB). Methods Data from a nationwide cross-sectional online survey was used to investigate the frequencies, sources, and manifestations of experienced weight stigma during childbirth. Binomial logistic regression was applied to predict CB from experienced weight stigma. Mediation analysis assessed the role of experienced weight stigma in the association between body mass index (BMI) and CB. Results In a total of 1352 women who gave birth in the last five years, women with obesity (BMI ≥ 30 kg/m2) experienced weight stigma more often than their peers with healthy weight (BMI 18.5–24.9 kg/m2). Obstetricians were identified as a major source of weight stigma, accounting for 77.8% of stigmatization experienced by women, compared to stigmatization perceived from nurses (21.7%) and midwives (23.8%). Overall, weight stigma was mostly experienced in the form of dismissive or critical comments towards a woman’s figure or weight. Significantly more women with obesity indicated being blamed for weight-related risks during childbirth than their healthy-weighted peers (χ²(2) = 22.2, P < 0.001). An increase in the frequency of experienced weight stigma was related to higher odds of intrapartum CB ([aOR], 1.08; 95% CI, 1.02,1.15; P < 0.05), and it partially mediated the relationship between increased pre-pregnancy BMI and CB (b = 0.07, SE = 0.029; P < 0.05). Conclusion Women with obesity reported the highest proportion of weight stigmatization during childbirth, experiencing stigma more frequently than women without obesity. This increased frequency of weight stigma was associated with higher odds of CB. Raising awareness among healthcare providers and reducing potential biases and stigmatization may improve care quality and health outcomes for women with obesity....
The increasing rate of cesarean delivery has become a widespread concern worldwide, nearly half of which is due to previous cesarean deliveries, and elective repeat cesarean delivery (ERCD), which is the main option for women who have a second pregnancy after cesarean section, is a major factor in this increase. The trial of labor after cesarean section (TOLAC) is considered to be the best method, and the safety and feasibility of TOLAC have been confirmed by numerous studies, but in clinical practice, there are many factors that make TOLAC unsuccessful. This article reviews the factors that influence the choice of delivery method after cesarean section as follows....
Renal masses are uncommon during pregnancy; they represent the most frequently encountered urological cancer in pregnant patients and require careful surgical planning. The introduction of robotic surgical systems aims to address these challenges by simplifying intra-corporeal suturing and reducing technical complexity. Robot-assisted laparoscopic renal surgery offers potential benefits over both open surgery and conventional laparoscopy, providing greater precision and reduced invasiveness, particularly in tumor excision and suturing. Although urological tumors during pregnancy are rare, early detection significantly improves outcomes by enabling intervention before the tumor advances and while the uterus remains relatively small. The decision regarding the timing and necessity of surgery in pregnant patients requires a careful assessment of maternal health, fetal development, and the progression of the disease. Risks for adverse pregnancy outcomes should be explained, and the patient’s decision about pregnancy termination should be considered. Radical nephrectomy or nephron-sparing surgery are essential treatments for the management of renal tumors. Effective management demands close collaboration between a multidisciplinary team and the patient to ensure individualized care. The aim of this review was to evaluate the renal tumors during pregnancy in terms of epidemiology, risk factors, diagnosis and the safety of a robot-assisted laparoscopic approach in the management of these tumors....
Introduction: Considering a disease of postmenopausal women, there is a noted trend of increasing breast cancer cases among premenopausal women. Our study aimed to determine the main risk factors for breast cancer in women aged 40 and under. Materials and Methods: This was a case-control study with exhaustive sampling of all respondents with histological proof over a 12-month period, matched by age. For all statistical tests, we used a significance threshold of 5%. Additionally provided are the ORs and their 95% confidence intervals, the mean, and standard deviation. Results: We collected 65 cases and 130 controls. The frequency of breast cancer in women aged 40 and under was 35.5%. The mean age was 35.6 ± 4.5 years among cases compared to 32.1 ± 7.9 years among controls. A significantly positive association was detected in both univariate and multivariate analysis between age and breast cancer [(OR) = 10.30; 95% CI (1.99 - 53.23)] and [(OR) = 7.53; 95% CI (1.82 - 31.23)]; family history of breast cancer and breast cancer [(OR) = 9.99; 95% CI (1.43 - 69.58)]; smoking and breast cancer [OR = 13.11; 95% CI (1.05 - 163.30)]; sedentary lifestyle and breast cancer [OR = 3.36; 95% CI (1.01 - 11.17)]; and night work and breast cancer [(OR) = 72.05; 95% CI (8.15 - 637.25)]. Conclusion: Earlier systematic screening and regular follow-up should be conducted in young women in our context....
Introduction Gestational diabetes mellitus (GDM), or hyperglycemia first diagnosed in pregnancy, affects 7–10% of all pregnancies worldwide. Perinatal risk rises with increasing glycemia at oral glucose tolerance test (OGTT). The new (2013) WHO criteria recommend a lower fasting, and a higher post-load threshold for GDM diagnosis in comparison to the old (1999) WHO criteria. To date, however, outcomes of GDM treatment for those affected by the altered diagnostic criteria, has not been well investigated. We hypothesized that intensive GDM treatment according to the new (2013) GDM criteria would result in a reduction in infants with birth weight > 90th centile (large for gestational age, LGA), in comparison to treatment according to the old criteria (1999). Methods The TANGO-DM trial is an open label, multicenter randomized controlled trial. Participants are pregnant with a gestational age between 16 + 0 and 32 + 0 weeks, who underwent a 1-step venous 2- or 3-point 75-gram oral OGTT, were eligible if they had glucose concentrations discordant between the old (1999) and the new (2013) criteria. After informed consent, women are randomized to either intensive GDM treatment, consisting of dietary advice and glucose monitoring and, if euglycemia is not reached, antihyperglycemic agents, or normal obstetric care without GDM treatment. The primary outcome is large-for-gestational-age infants (birth weight > 90th percentile). Secondary outcome measures include maternal complications, obstetric complications, neonatal complications, obstetric interventions, quality of life, and healthcare and societal costs. Outcomes will be analyzed according to the intentionto- treat principle. The study is powered to detect a reduction in LGA from 16% in the untreated to 10% in the treated group, which requires 1032 participants (516 per arm; alpha-error 5% for 80% power). Discussion The TANGO-DM trial will provide high-level evidence to support or refute the use of the new 2013 WHO diagnostic criteria in terms of their ability to lower the number of large for gestational age infants and/or improve maternal and perinatal outcomes and/or costs in women with gestational diabetes....
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