zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2022-19-1-01zdor-2169Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESТуберкулез у женщин репродуктивного возрастаTuberculosis in women of reproductive agehttps://orcid.org/0000-0001-9965-7755ГопонякоС. B.GoponiakoS. V.

Гопоняко Светлана Владимировна, старший преподаватель кафедры фтизиопульмонологии с курсом ФПКиП

Гомель

 

Svetlana V. Goponiako, Senior Lecturer at the Phthisiopulmonology Department with the course of the Faculty of Professional Development and Retraining

Gomel

indigomind@mail.ruГомельский государственный медицинский университетGomel State Medical University202230032022191512Copyright © Гопоняко С.B., 20222022Гопоняко С.B.Goponiako S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/2169

В обзоре литературы представлены данные по проблеме туберкулеза органов дыхания у женщин репродуктивного возраста. Рассмотрены вопросы по эпидемиологии туберкулеза у молодых женщин, их медико-социальная характеристика, факторы, предрасполагающие к развитию заболевания, клинические особенности и лекарственная устойчивость возбудителя.

The literature review presents data on the problem of respiratory tuberculosis in women of reproductive age. The review focuses on the epidemiology of tuberculosis in young women, their medical and social characteristics, factors predisposing to the disease, clinical peculiarities and drug resistance of the pathogen.

туберкулезженское здоровьебеременность.tuberculosiswomen’s healthpregnancyReferencesTuberculosis profile: Belarus [Electronic resource]. World Health Organization. [date of access 2021 December 10]. Available from: https://worldhealthorg.shinyapps.io/tb_profiles/?_inputs_&entity_type=%22country%22&lan=%22RU%22&iso2=%22BY%22Tuberculosis profile: Belarus [Electronic resource]. World Health Organization. [date of access 2021 December 10]. Available from: https://worldhealthorg.shinyapps.io/tb_profiles/?_inputs_&entity_type=%22country%22&lan=%22RU%22&iso2=%22BY%22Technical Brief. Tuberculosis, Gender and Human Rights [Electronic resource]. February 2020, Geneva, Switzerland. TheGlobalFund. [date of access 2021 December 10]. Available from: https://www.theglobalfund.org/media/6349/core_tbhumanrightsgenderequality_technicalbrief_en.pdfTechnical Brief. Tuberculosis, Gender and Human Rights [Electronic resource]. February 2020, Geneva, Switzerland. TheGlobalFund. [date of access 2021 December 10]. Available from: https://www.theglobalfund.org/media/6349/core_tbhumanrightsgenderequality_technical-brief_en.pdfTuberculosis in women. [Electronic resource]. World Health Organization [date of access 2021 December 10]. Available from: http://www.who.int/tb/publications/tb_women_factsheet.pdfTuberculosis in women. [Electronic resource]. World Health Organization [date of access 2021 December 10]. Available from: http://www.who.int/tb/publications/tb_women_factsheet.pdfWHO, UNICEF, UNFPA Trends in Maternal Mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, the World Bank and the United Nations Population Division. [Electronic resource] Publication date: 12 Sep 2014. United Nations Population Fund [date of access 2021 December 10]. Available from: https://www.unfpa.org/publications/trends-maternal-mortality-1990-2013WHO, UNICEF, UNFPA Trends in Maternal Mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, the World Bank and the United Nations Population Division. [Electronic resource] Publication date: 12 Sep 2014. Unit- ed Nations Population Fund [date of access 2021 December 10]. Available from: https://www.unfpa.org/publications/trends-maternal-mortality-1990-2013Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014 Jun;2(6):e323-333. https://doi.org/10.1016/S2214-109X(14)70227-XSay L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014 Jun;2(6):e323-333. https://doi.org/10.1016/S2214-109X(14)70227-XSugarman J, Colvin C, Moran AC, Oxlade O. Tuberculosis in pregnancy: an estimate of the global burden of disease. Lancet Glob Health. 2014 Dec;2(12):e710-716. https://doi.org/10.1016/S2214-109X(14)70330-4Sugarman J, Colvin C, Moran AC, Oxlade O. Tuberculosis in pregnancy: an estimate of the global burden of disease. Lancet Glob Health. 2014 Dec;2(12):e710-716. https://doi.org/10.1016/S2214-109X(14)70330-4Bates M, Ahmed Y, Kapata N, Maeurer M, Mwaba P, Zumla A. Perspectives on tuberculosis in pregnancy. Int J Infect Dis. 2015 Mar;32:124-127. https://doi.org/10.1016/j.ijid.2014.12.014Bates M, Ahmed Y, Kapata N, Maeurer M, Mwaba P, Zumla A. Perspectives on tuberculosis in pregnancy. Int J Infect Dis. 2015 Mar;32:124-127. https://doi.org/10.1016/j.ijid.2014.12.014Getahun H, Sculier D, Sismanidis C, Grzemska M, Raviglione M. Prevention, diagnosis, and treatment of tuberculosis in children and mothers: evidence for action for maternal, neonatal, and child health services. J Infect Dis. 2012 May 15;205 Suppl 2:S216-27. https://doi.org/10.1093/infdis/jis009Getahun H, Sculier D, Sismanidis C, Grzemska M, Raviglione M. Prevention, diagnosis, and treatment of tuberculosis in children and mothers: evidence for action for maternal, neonatal, and child health services. J Infect Dis. 2012 May 15;205 Suppl 2:S216-227. https://doi.org/10.1093/infdis/jis009Галкин ВБ, Мушкин АЮ, Муравьев АН, Сердобинцев МС, Белиловский ЕМ, Синицын МВ. Половозрастная структура заболеваемости туберкулезом различных локализаций в Российской Федерации: динамика в XXI в. Туберкулез и болезни легких. 2018;96(11):17-26. https://doi.org/10.21292/2075-1230-2018-96-11-17-26Galkin VB, Mushkin AYu, Muraviev AN, Serdobintsev MS, Belilovsky EM, Sinitsyn MV The gender and age structure of the incidence of tuberculosis (various localizations) in the Russian Federation: changes over the XXIth century. Tuberculosis and Lung Diseases. 2018;96(11):17-(In Russ.). https://doi.org/10.21292/2075-1230-2018-96-11- 17-26Игембаева КС, Игембаева РС, Токпаева АЖ, Селиханова НК, Саламатов А. Туберкулез легких у женщин репродуктивного возраста. Наука и здравоохранение. 2014;(3):74-75. [дата обращения 2021 декабрь 10]. Режим доступа: https://cyberleninka.ru/article/n/tuberkulez-legkih-u-zhenschin-reproduktivnogo-vozrastaIgembaeva KS, Igembaeva RS, Tokpayeva AZh, Selikhanova NK, Salamatov A. Tuberculosis in women of reproductive age. Science and Healthcare. 2014;(3):74-75. [cited 2021 Dec 10]. Available from: https://cyberleninka.ru/article/n/tuberkulez-legkih-u-zhenschin-reproduktivnogo-vozrasta (In Russ.)Демидик СН, Вольф СБ, Алексо ЕН. Медико– социальные аспекты и результаты лечения туберкулеза женского населения Гродненской области. Журнал Гродненского государственного медицинского университета. 2020;18(1):11-16. [дата обращения 2021 декабрь 10]. Режим доступа: http://elib.grsmu.by/handle/files/16726Demidik SN, Wolf SB, Alekso EN. Medical and social aspects and results of treatment of tuberculosis of the female population of the Grodno region. Journal of Grodno State Medical University. 2020;18(1):11-16. [cited 2021 Dec 10]. Available from: http://elib.grsmu.by/handle/files/16726 (In Russ.).Мордык АВ, Пузырева ЛВ, Кравченко ЕН, Валеева ГА. Влияние беременности на течение специфического процесса в легких. Сибирское медицинское обозрение. 2015;(4)94. [дата обращения 2021 декабрь 10]. Режим доступа: https://cyberleninka.ru/article/n/vliyanie-beremennosti-na-techenie-spetsificheskogo-protsessa-v-legkihMordyk AV, Puzyreva LV, Kravchenko EN, Valeeva GA. The influence of pregnancy on the course of a specific process in the lungs. Siberian Medical Review. 2015;(4)94. [cited 2021 Dec 10]. Available from: https://cyberleninka.ru/article/n/vliyanie-beremennosti-na-techenie-spetsificheskogo-protsessa-v-legkih (In Russ.).Bothamley GH, Ehlers C, Salonka I., Skrahina A, Orcau A, Codecasa LR, et al. Confalonieri M. Pregnancy in patients with tuberculosis: a TBNET cross-sectional survey. BMC Pregnancy Childbirth. 2016;(16)304. https://doi.org/10.1186/s12884-016-1096-4Bothamley GH, Ehlers C, Salonka I., Skrahina A, Orcau A, Codecasa LR, [et al.]. Pregnancy in patients with tuberculosis: a TBNET cross-sectional survey. BMC Pregnancy Childbirth. 2016;(16)304. [cited 2021 Dec 10]. Available from: https://doi.org/10.1186/s12884-016-1096-4Киселевская-Бабинина ВЯ, Санникова ТЕ, Романюха АА, Каркач АС. Моделирование влияний гендерных различий на заболеваемость туберкулёзом. Матем биология и биоинформ. 2018;13(2):308-321. https://doi.org/10.17537/2018.13.308Kiselevskaya-Babinina VYa, Sannikova TE, Romanyukha AA, Karkach AS. Мodeling of gender differences in tuberculosis prevalence. Math. Biol. Bioinf. 2018;13(2):308-321. [cited 2021 Dec 10]. Available from: https://doi.org/10.17537/2018.13.308 (In Russ.).Корецкая НМ, Наркевич АА, Наркевич АН. Гендерные особенности впервые выявленного инфильтративного туберкулеза легких. Пульмонология. 2014;(1):77-80. https://doi.org/10.18093/0869-0189-2014-0-1-77-80Koretskaya NM, Narkevich AA, Narkevich AN. Gender features of newly diagnosed infiltrative pulmonary tuberculosis. Pulmonologiya. 2014;(1):77-80. (In Russ.). https://doi.org/10.18093/0869-0189-2014-0-1-77-80Neyrolles O, Quintana-Murci L. Sexual inequality in tuberculosis. PLoS Med. 2009 Dec;6(12):e1000199. https://doi.org/10.1371/journal.pmed.1000199Neyrolles O, Quintana-Murci L. Sexual inequality in tuberculosis. PLoS Med. 2009 Dec;6(12):e1000199. https://doi.org/10.1371/journal.pmed.1000199McClelland EE, Smith JM. Gender specific differences in the immune response to infection. Arch Immunol Ther Exp (Warsz). 2011 Jun;59(3):203-213. https://doi.org/10.1007/s00005-011-0124-3McClelland EE, Smith JM. Gender specific differences in the immune response to infection. Arch Immunol Ther Exp (Warsz). 2011 Jun;59(3):203-213. https://doi.org/10.1007/s00005-011-0124-3Guerrini V. Sex hormones and innate immunity in tuberculosis. National Institutes of Health. Newark, NJ. U.S. [дата обращения 2021 декабрь 10]. Режим доступа: https://grantome.com/grant/NIH/R21–AI153660–01Guerrini V. Sex hormones and innate immunity in tuberculosis. National Institutes of Health. Newark, NJ.U.S. [cited 2021 Dec 10]. Available from: https://grantome.com/grant/NIH/R21–AI153660–01Zhao Y, Ying H, Demei J, Xie J. Tuberculosis and sexual inequality: the role of sex hormones in immunity. Crit Rev Eukaryot Gene Expr. 2012;22(3):233-41. https://doi.org/10.1615/critreveukargeneexpr.v22. i3.60Zhao Y, Ying H, Demei J, Xie J. Tuberculosis and sexual inequality: the role of sex hormones in immunity. Crit Rev Eukaryot Gene Expr. 2012;22(3):233-241. https://doi.org/10.1615/critreveukargeneexpr.v22. i3.60Nhamoyebonde S, Leslie A. Biological differences between the sexes and susceptibility to tuberculosis. J Infect Dis. 2014 Jul 15;209 Suppl 3:S100-6. https://doi.org/10.1093/infdis/jiu147Nhamoyebonde S, Leslie A. Biological differences between the sexes and susceptibility to tuberculosis. J Infect Dis. 2014 Jul 15;209 Suppl 3:S100-6. https://doi.org/10.1093/infdis/jiu147Chu Y, Soodeen-Lalloo AK, Huang J, Yang G, Chen F, Yin H, Sha W, et al. Sex Disparity in Severity of Lung Lesions in Newly Identified Tuberculosis Is AgeAssociated. Front Med (Lausanne). 2019 Jul 17;6:163. https://doi.org/10.3389/fmed.2019.00163Chu Y, Soodeen-Lalloo AK, Huang J, Yang G, Chen F, Yin H, Sha W, Huang X, Shi J, Feng Y. Sex Disparity in Severity of Lung Lesions in Newly Identified Tuberculosis Is Age-Associated. Front Med (Lausanne). 2019 Jul 17;6:163. https://doi.org/10.3389/fmed.2019.00163Bini EI, Mata Espinosa D, Marquina Castillo B, Barrios Payán J, Colucci D, Cruz AF, et al. The influence of sex steroid hormones in the immunopathology of experimental pulmonary tuberculosis. PLoS One. 2014 Apr 10;9(4):e93831. https://doi.org/10.1371/journal.pone.0093831Bini EI, Mata Espinosa D, Marquina Castillo B, Barrios Payán J, Colucci D, Cruz AF, [et al.] The influence of sex steroid hormones in the immunopathology of experimental pulmonary tuberculosis. PLoS One. 2014 Apr 10;9(4):e93831. https://doi.org/10.1371/journal.pone.0093831Fish EN. The X-files in immunity: sex-based differences predispose immune responses. Nat Rev Immunol. 2008 Sep;8(9):737-744. https://doi.org/10.1038/nri2394Fish EN. The X-files in immunity: sex-based differences predispose immune responses. Nat Rev Immunol. 2008 Sep;8(9):737-744. https://doi.org/10.1038/nri2394O’Garra A, Redford PS, McNab FW, Bloom CI, Wilkinson RJ, Berry MP. The immune response in tuberculosis. Annu Rev Immunol. 2013;31:475-527. https://doi.org/10.1146/annurev-immunol-032712-095939O’Garra A, Redford PS, McNab FW, Bloom CI, Wilkinson RJ, Berry MP. The immune response in tuberculosis. Annu Rev Immunol. 2013;31:475-527. https:// doi.org/10.1146/annurev-immunol-032712-095939Герлинская ЛА, Варлачев АВ, Кротов ГИ, Концевая ГВ, Мошкин МП. Иммуногенетический диалог матери и эмбрионов как фактор становления иммунного статуса потомков. Вавиловский журнал генетики и селекции. 2018;22(8):1009-1019. https://doi.org/10.18699/VJ18.444Gerlinskaya LA, Varlachev AV, Krotov GI, Kontsevaya GV, Moshkin MP. Mother-fetus immunogenetic dialogue as a factor of progeny immune system development. Vavilov Journal of Genetics and Breeding. 2018;22(8):1009-1019. (In Russ.). https://doi.org/10.18699/VJ18.444Hall OJ, Klein SL. Progesterone-based compounds affect immune responses and susceptibility to infections at diverse mucosal sites. Mucosal Immunol. 2017 Sep;10(5):1097-1107. https://doi.org/10.1038/mi.2017.35Hall OJ, Klein SL. Progesterone-based compounds affect immune responses and susceptibility to infections at diverse mucosal sites. Mucosal Immunol. 2017 Sep;10(5):1097-1107. https://doi.org/10.1038/mi.2017.35Nashold FE, Spach KM, Spanier JA, Hayes CE. Estrogen controls vitamin D3-mediated resistance to experimental autoimmune encephalomyelitis by controlling vitamin D3 metabolism and receptor expression. J Immunol. 2009 Sep 15;183(6):3672-81. https://doi.org/10.4049/jimmunol.0901351Nashold FE, Spach KM, Spanier JA, Hayes CE. Estrogen controls vitamin D3-mediated resistance to experimental autoimmune encephalomyelitis by controlling vitamin D3 metabolism and receptor expression. J Immunol. 2009 Sep 15;183(6):3672-81. https://doi.org/10.4049/jimmunol.0901351Shah NM, Lai PF, Imami N, Johnson MR. Progesterone-Related Immune Modulation of Pregnancy and Labor. Front Endocrinol (Lausanne). 2019 Mar 29;10:198. https://doi.org/10.3389/fendo.2019.00198Shah NM, Lai PF, Imami N, Johnson MR. Progesterone-Related Immune Modulation of Pregnancy and Labor. Front Endocrinol (Lausanne). 2019 Mar 29;10:198. https://doi.org/10.3389/fendo.2019.00198AbdulHussain G, Azizieh F, Makhseed M, Raghupathy R. Effects of Progesterone, Dydrogesterone and Estrogen on the Production of Th1/Th2/Th17 Cytokines by Lymphocytes from Women with Recurrent Spontaneous Miscarriage. J Reprod Immunol. 2020 Aug;140:103132. https://doi.org/10.1016/j.jri.2020.103132AbdulHussain G, Azizieh F, Makhseed M, Raghupathy R. Effects of Progesterone, Dydrogesterone and Estrogen on the Production of Th1/Th2/Th17 Cytokines by Lymphocytes from Women with Recurrent Spontaneous Miscarriage. J Reprod Immunol. 2020 Aug;140:103132. https://doi.org/10.1016/j.jri.2020.103132Molloy EJ, O’Neill AJ, Grantham JJ, SheridanPereira M, Fitzpatrick JM, Webb DW, Watson RW. Sex-specific alterations in neutrophil apoptosis: the role of estradiol and progesterone. Blood. 2003 Oct 1;102(7):2653-2659. https://doi.org/10.1182/blood-2003-02-0649Molloy EJ, O’Neill AJ, Grantham JJ, Sheridan-Pereira M, Fitzpatrick JM, Webb DW, Watson RW. Sex-specific alterations in neutrophil apoptosis: the role of estradiol and progesterone. Blood. 2003 Oct 1;102(7):2653-2659. https://doi.org/10.1182/blood-2003-02-0649Yang CT, Cambier CJ, Davis JM, Hall CJ, Crosier PS, Ramakrishnan L. Neutrophils exert protection in the early tuberculous granuloma by oxidative killing of mycobacteria phagocytosed from infected macrophages. Cell Host Microbe. 2012 Sep 13;12(3):301-312. https://doi.org/10.1016/j.chom.2012.07.009Yang CT, Cambier CJ, Davis JM, Hall CJ, Crosier PS, Ramakrishnan L. Neutrophils exert protection in the early tuberculous granuloma by oxidative killing of mycobacteria phagocytosed from infected macrophages. Cell Host Microbe. 2012 Sep 13;12(3):301-12. https://doi.org/10.1016/j.chom.2012.07.009Schurz H, Salie M, Tromp G, Hoal EG, Kinnear CJ, Möller M. The X chromosome and sex-specific effects in infectious disease susceptibility. Hum Genomics. 2019 Jan 8;13(1):2. https://doi.org/10.1186/s40246-018-0185-zSchurz H, Salie M, Tromp G, Hoal EG, Kinnear CJ, Möller M. The X chromosome and sex-specific effects in infectious disease susceptibility. Hum Genomics. 2019 Jan 8;13(1):2. https://doi.org/10.1186/s40246-018-0185-zLoto OM, Awowole I. Tuberculosis in pregnancy: a review. J Pregnancy. 2012;2012:379271. https://doi.org/10.1155/2012/379271Loto OM, Awowole I. Tuberculosis in pregnancy: a review. J Pregnancy. 2012;2012:379271. https://doi.org/10.1155/2012/379271Cain MA, Whiteman VE, Buhari MA, Louis JM. Positive interferon-γ release assay leading to a diagnosis of Mycobacterium tuberculosis pericarditis in pregnancy. Obstet Gynecol. 2014 Aug;124(2 Pt 2 Suppl 1):475-477. https://doi.org/10.1097/AOG.0000000000000272Cain MA, Whiteman VE, Buhari MA, Louis JM. Positive interferon-γ release assay leading to a diagnosis of Mycobacterium tuberculosis pericarditis in pregnancy. Obstet Gynecol. 2014 Aug;124(2 Pt 2 Suppl 1):475-477. https://doi.org/10.1097/AOG.0000000000000272Lighter-Fisher J, Surette AM. Performance of an interferon-gamma release assay to diagnose latent tuberculosis infection during pregnancy. Obstet Gynecol. 2012 Jun;119(6):1088-1095. https://doi.org/10.1097/AOG.0b013e3182546affLighter-Fisher J, Surette AM. Performance of an interferon-gamma release assay to diagnose latent tuberculosis infection during pregnancy. Obstet Gynecol. 2012 Jun;119(6):1088-1095. https://doi.org/10.1097/AOG.0b013e3182546affLaCourse SM, Cranmer LM, Matemo D, Kinuthia J, Richardson BA, Horne DJ, John-Stewart G. Effect of Pregnancy on Interferon Gamma Release Assay and Tuberculin Skin Test Detection of Latent TB Infection Among HIV-Infected Women in a High Burden Setting. J Acquir Immune Defic Syndr. 2017 May 1;75(1):128-136. https://doi.org/10.1097/QAI.0000000000001298LaCourse SM, Cranmer LM, Matemo D, Kinuthia J, Richardson BA, Horne DJ, John-Stewart G. Effect of Pregnancy on Interferon Gamma Release Assay and Tuberculin Skin Test Detection of Latent TB Infection Among HIV-Infected Women in a High Burden Setting. J Acquir Immune Defic Syndr. 2017 May 1;75(1):128-136. https://doi.org/10.1097/QAI.0000000000001298Постановление Министерства здравоохранения Республики Беларусь №26 от 04.04.2019 «Об утверждении клинического протокола «Диагностика и лечение пациентов с туберкулезом (взрослое, детское население». [Electronic resource]. Pravo.by. [date of access 2021 December 18]. Available from: https://www.bsmu.by/downloads/vrachu/belnom/klin_tuberkulez.pdfResolution of the Ministry of Health of the Republic of Belarus No.26 dated 04.04.2019 “About the approval of the clinical protocol on the diagnosis and treatment of patients with tuberculosis (adult and children population)”. [Electronic resource]. Pravo.by. [date of access 2021 December 18]. Available from: https://www.bsmu.by/downloads/vrachu/belnom/klin_tuberkulez.pdf (In Russ.).World Health Organization. Global Tuberculosis Report 2021. [date of access 2021 Dec 10]. Available from: https://reliefweb.int/sites/reliefweb.int/files/resources/9789240037021-eng.pdfWorld Health Organization. Global Tuberculosis Report 2021. [cited 2021 Dec 10]. Available from: https://reliefweb.int/sites/reliefweb.int/files/resources/9789240037021-eng.pdfКаторгин НА, Стаханов ВА, Гедымин ЛЕ. Диссеминированный туберкулез легких у молодой женщины: ошибки диагностики. Лечебное дело. 2012; (1):85-94.[дата обращения 2021 декабрь 10]. Режим доступа: https://cyberleninka.ru/article/n/disseminirovannyy-tuberkulez-legkih-u-molodoy-zhenschiny-oshibki-diagnostikiКаторгин НА, Стаханов ВА, Гедымин ЛЕ. Диссеминированный туберкулез легких у молодой женщины: ошибки диагностики. Лечебное дело. 2012; (1):85-94. [дата обращения 2021 декабрь 10]. Режим доступа: https://cyberleninka.ru/article/n/disseminirovannyy-tuberkulez-legkih-u-molodoy-zhenschiny-oshibki-diagnostikiNabulsi BK, Kadi M, AlAbadi H, Alnabulsi RK, Badeghiesh A, et al. Pregnant Woman with Fulminant Disseminated TB to the Omentum and Placenta. Gynecol Obstet (Sunnyvale). 2014; 4:225. https://doi.org/10.4172/2161-0932.1000225Nabulsi BK, Kadi M, AlAbadi H, Alnabulsi RK, Badeghiesh A, et al. Pregnant Woman with Fulminant Disseminated TB to the Omentum and Placenta. Gynecol Obstet (Sunnyvale). 2014;4:225. https://doi.org/10.4172/2161-0932.1000225

The authors declare that there are no conflicts of interest present.