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Biomedical subjects

C Chaliha

Publications and source records attributed to C Chaliha.

12 recordsLinked to original sources
PubMed2002

Urological problems in pregnancy.

During pregnancy the urinary tract undergoes extensive anatomical and physiological changes. These changes can result in many symptoms and pathological conditions that may affect the mother and fetus. It is well documented that childbirth may result in urinary tract damage which may predispose to postpartum symptoms. This review describes the physiological and pathological consequences of pregnancy and delivery on the urinary tract, and how these may be minimized.

Female↗
PubMed2001

Anal function: effect of pregnancy and delivery.

OBJECTIVE: To investigate the effect of pregnancy and delivery on anal continence, sensation, manometry, and sphincter integrity. STUDY DESIGN: Two hundred eighty-six nulliparous women in the third trimester completed a symptom questionnaire and underwent anorectal sensation and manometric evaluations. Three months postpartum, 161 women returned and the questionnaires and investigations were repeated together with anal endosonographic examinations. RESULTS: The prevalence of fecal urgency before, during, and after pregnancy was 1%, 9.4%, and 10.5%, respectively; the prevalence of anal incontinence before, during, and after pregnancy was 1.4%, 7.0%, and 8.7%, respectively. Vaginal delivery, particularly instrumental, resulted in a decrease in anal squeeze pressures (P =.015) and resting pressures (P =.002) but had no effect on anal sensation. Postpartum anal endosonographic examination revealed sphincter disruption in 38% of women. There was no relationship between symptoms and anal manometry, sensation, or sphincter integrity. Vaginal delivery (P <.0001) and perineal trauma (P <.001) were significantly associated with sphincter defects. CONCLUSION: Vaginal delivery is associated with a decrease in anal pressures and increased anal sphincter trauma but has no effect on anal sensation. These changes were not related to anal symptoms.

Anal Canal↗
PubMed2000

Pregnancy and delivery: a urodynamic viewpoint.

OBJECTIVE: The aims of this study were to establish prospectively the prevalence of objective bladder dysfunction before and after delivery by means of urodynamic investigations and to assess the effect of obstetric variables on bladder function. DESIGN: Prospective longitudinal study. Twin channel subtracted cystometry was performed in the standing and sitting position, with a cough stress test at the end of filling. The investigations were repeated three months postpartum. PARTICIPANTS: Two hundred and eighty-six nulliparae with singleton pregnancies who were delivered between April 1996 and November 1997 attended for antenatal assessment after 34 weeks of gestation and 161 who returned postpartum. SETTING: Department of Obstetrics and Gynaecology in a London teaching hospital. RESULTS: The mean urodynamic values both in pregnancy and postpartum lower than values defined in a non-pregnant population. The prevalence of genuine stress incontinence and detrusor instability were antenatally 9% and 8%, respectively, and postpartum 5% and 7%, respectively. Obstetric and neonatal factors were not related to urodynamic variables. CONCLUSIONS: Despite the reported high prevalence of urinary incontinence related to pregnancy and childbirth, neither pregnancy nor delivery resulted in any consistent effects on objective bladder function. Postpartum urodynamic measurements were not related to either obstetric or neonatal variables, but were dependent on antenatal values.

Adolescent↗
PubMed1999

The ethnic cultural and social aspects of incontinence--a pilot study.

This cross-sectional study aimed to study the religious and cultural practices of ethnic minorities that might affect the experience and ideas that sufferers of incontinence have. Subjects were multiparous women from the local community who suffered from incontinence. Structured and unstructured interviews were conducted to assess the effect of incontinence and menstruation on home life, sexual life, personal and communal prayer, rules and customs associated with menstruation, and the ability to discuss problems with their doctor and partners. Individual women differed in how they rated their daily activities, and this was not related to religious or ethnicity. Higher restrictions on activity were perceived for fecal than for urinary incontinence. Sexual relationships were restricted for Jewish and Muslim women during menses. Incontinence led to religious restriction, which was most marked for Jewish and Muslim women, and this was related to the need for cleanliness for prayer. Less then 50% of patients sought help, and this was not related to duration and severity of symptoms. Only Muslim women had a strong preference for female doctors, and this was for cultural reasons.

Adult↗
PubMed1999

Antenatal prediction of postpartum urinary and fecal incontinence.

OBJECTIVE: To investigate the effect of pregnancy and delivery on continence and to assess whether physical markers of collagen weakness can predict postpartum urinary and fecal incontinence (including incontinence of flatus). METHODS: In a prospective, longitudinal study in a London teaching hospital, 549 nulliparas were interviewed after 34 weeks' gestation and again 3 months postpartum regarding urinary and fecal symptoms before and during pregnancy and after delivery. Family histories of incontinence, prolapse, and collagen abnormalities were recorded also. Physical examination was done to assess markers of collagen weakness such as striae, hernia, varicose veins, and joint mobility. RESULTS: The prevalence of urinary incontinence before, during, and after pregnancy was 3.6%, 43.7%, and 14.6%, and rates of fecal incontinence were 0.7%, 6.0%, and 5.5%, respectively. Fecal urgency was more common in women who had spontaneous and instrument-assisted vaginal deliveries (n = 413) compared with cesareans (n = 131) (7.3% versus 3.1%; P = .046). Postnatal urinary or fecal dysfunction was not related to antenatal body mass index, smoking, race, striae, varicose veins, hemorrhoids, or family history of incontinence. Higher joint-mobility scores were associated with incontinence of flatus (P = .021) but not with other urinary or fecal symptoms. CONCLUSION: Although collagen weakness was previously implicated in the pathogenesis of incontinence, physical markers in this study could not predict postpartum urinary and fecal incontinence. Either those markers were not representative of collagen weakness, or a larger study with longer follow-up is necessary.

Adolescent↗
PubMed1999

Trisomy 2 in an acardiac twin in a triplet in-vitro fertilization pregnancy.

A case is reported of twin reversed arterial perfusion (TRAP) sequence in a triamniotic dichorionic triplet pregnancy conceived by in-vitro fertilization which was diagnosed at 25 weeks of gestation by colour Doppler sonography. It highlights the risk of monochorionicity-associated morbidity in multiple pregnancies obtained by assisted conception and stresses the importance of chorionicity determination by early ultrasound examination. Cytogenetic analysis of skin from the acardius showed trisomy 2 in all cells, whereas the karyotype in the monochorionic triplet was normal. This is an example of heterokaryotypic monozygotism where the chromosomal abnormality must have occurred during the early cleavage divisions. Aneuploidy as a possible aetiological factor of TRAP sequence is discussed.

Adult↗
PubMed1998

Nine year survey of 138 ectopic pregnancies.

During the nine years (1986-1994), 138 women underwent surgery for ectopic pregnancies (One for every 213 deliveries). The commonest presenting symptom was abdominal pain (96%) followed by vaginal bleeding (83%). Four patients were asymptomatic and were diagnosed at a routine antenatal ultrasound scan. The most frequent physical findings were abdominal tenderness (87%) and followed by adnexal tenderness (57%). Histories of infertility in 17%, use of intrauterine contraceptive device (13%), and previous ectopic pregnancy in 11% were elicited. Eleven patients (8%) had a false negative urinary pregnancy test and subsequently required surgery. The ectopic pregnancies were tubal in 97% of the cases. There were 3 ovarian ectopics and one cervical ectopic.

Abdominal Pain↗
PubMed1997

Female urethral diverticula.

Most urethral diverticula should be diagnosed on clinical grounds alone, but investigations may be used to confirm the diagnosis in difficult cases, delineate the extent of the disease and investigate other entities such as stress incontinence. A high index of suspicion is required when assessing women with lower urinary tract symptoms to ensure that cases of urethral diverticulum are not missed. The cases presented demonstrate that greater awareness of the signs and symptoms of this not uncommon disease may facilitate early diagnosis. Our cases also show that surgical treatment is effective and worthwhile.

Journal Article↗