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https://www.readbyqxmd.com/read/28080921/uterine-adenomyosis-and-an-endometrial-polyp-in-a-rock-hyrax-procavia-capensis
#1
Holly J Holman, Katherine Gailbreath
An 8-yr-old nulliparous, female rock hyrax ( Procavia capensis ) had intermittent mucoid to bloody discharge late winter-early spring for two consecutive years. Fragments of necrotic tissue, suspected to be vaginal or rectal in origin, were passed on two occasions. Physical examination, radiographs, and ultrasound did not identify the source of the tissue. Exploratory laparotomy and ovariohysterectomy were performed. On histopathology, a diagnosis of adenomyosis with a uterine polyp was made. Postsurgical complications included incisional infection and renal compromise that were medically managed and resolved...
December 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28079767/primary-gastric-choriocarcinoma-presenting-as-a-pregnancy-of-unknown-location
#2
Alyssa Larish, Amanika Kumar, Sarah Kerr, Carrie Langstraat
BACKGROUND: Pregnancy of unknown location presents a diagnostic challenge, in rare occasions leading to the diagnosis of malignancy. We describe a case of β-hCG-secreting nongestational primary gastric choriocarcinoma presenting as a pregnancy of unknown location. CASE: A 37-year-old woman, gravida 4 para 3013, presented with several days of vaginal bleeding and rising β-hCG level without ultrasound localization of pregnancy. The diagnosis of pregnancy of unknown location was made and methotrexate administered at a β-hCG level of 7,779 milli-international units/mL...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28078670/levator-ani-muscle-avulsion-is-a-risk-factor-for-vaginal-pessary-expulsion-within-1-year-for-pelvic-organ-prolapse
#3
Rachel Yau Kar Cheung, Jacqueline Ho Sze Lee, Lai Loi Lee, Tony Kwok Hung Chung, Symphorosa Shing Chee Chan
OBJECTIVE: The aim of this study was to investigate whether presence of levator ani muscle (LAM) avulsion was associated with expulsion of vaginal pessary for women with pelvic organ prolapse (POP). METHODS: This prospective observational study recruited consecutive women with symptomatic POP. Vaginal pessary was offered and offline analysis of the 3D/4D transperineal ultrasound volume data of women was performed. Volume acquisition had been performed before pessary insertion...
January 12, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28076877/ultrasound-imaging-for-ovarian-and-deep-infiltrating-endometriosis
#4
Caterina Exacoustos, Errico Zupi, Emilio Piccione
The main challenges of imaging for endometriosis are the detection of nonovarian disease and the evaluation of the extension of the disease into pelvic structures. Transvaginal ultrasonography (TVS) has been proposed as the first-line imaging technique because it allows extensive exploration of the pelvis. The "typical" endometrioma is a unilocular cyst with homogeneous low-level echogenicity (ground glass echogenicity) of the cyst fluid. The use of color Doppler helps avoid classifying malignancies as endometriomas, defining the presence of vascular flow in papillations...
January 11, 2017: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/28068594/prevention-of-spontaneous-preterm-birth-guidelines-for-clinical-practice-from-the-french-college-of-gynaecologists-and-obstetricians-cngof
#5
REVIEW
Loïc Sentilhes, Marie-Victoire Sénat, Pierre-Yves Ancel, Elie Azria, Guillaume Benoist, Julie Blanc, Gilles Brabant, Florence Bretelle, Stéphanie Brun, Muriel Doret, Chantal Ducroux-Schouwey, Anne Evrard, Gilles Kayem, Emeline Maisonneuve, Louis Marcellin, Stéphane Marret, Nicolas Mottet, Sabine Paysant, Didier Riethmuller, Patrick Rozenberg, Thomas Schmitz, Héloïse Torchin, Bruno Langer
In France, 60,000 neonates are born preterm every year (7.4%), half of them after the spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated with decreased prematurity (level of evidence [LE]1). It is therefore recommended (Grade A). Routine screening and treatment of vaginal bacteriosis is not recommended in the general population (Grade A). The only population for which vaginal progesterone is recommended is that comprising asymptomatic women with singleton pregnancies, no history of preterm delivery, and a short cervix at 16-24 weeks of gestation (Grade B)...
December 30, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28067746/increasing-age-is-a-risk-factor-for-decreased-postpartum-pelvic-floor-strength
#6
Lieschen H Quiroz, Stephanie D Pickett, Jennifer D Peck, Ghazaleh Rostaminia, Daniel E Stone, S Abbas Shobeiri
OBJECTIVES: This study aimed to determine factors associated with decreased pelvic floor strength (PFS) after the first vaginal delivery (VD) in a cohort of low-risk women. METHODS: This is a secondary analysis of a prospective study examining the risk of pelvic floor injury in a cohort of primiparous women. All recruited participants underwent an examination, three-dimensional ultrasound and measurement of PFS in the third trimester and repeated at 4 weeks to 6 months postpartum using a perineometer...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28059844/gynecologic-surgery-preoperative-assessment-with-ultrasound
#7
Laurel Stadtmauer, Akhil Shah
Ultrasonography, especially 3D, is essential in the diagnosis and preoperative evaluation of gynecologic surgeries and is important in surgical planning and counseling of patients. In addition, it is useful during hysteroscopic procedures, particularly difficult Asherman syndrome cases, resection of transverse vaginal septum, and treatment of hematometria. 3D ultrasound is especially helpful for fibroid mapping as the simultaneous visualization of the endometrium and myometrium with the coronal view is possible, it can be done by the gynecologist and at a lower cost than an magnetic resonance imaging...
January 4, 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28052947/primitive-neuroectodermal-tumour-of-the-cervix-a-rare-diagnosis
#8
Irfan Ahmad, Kundan Singh Chufal, Amit Bhargava, Irfan Bashir
A 48-year-old woman presented with symptoms of lower abdominal pain and vaginal discharge for 6 months. Clinical examination and pelvic ultrasound scan suggested a diagnosis of infected Gartner's cyst, for which she underwent vaginal cystectomy. However, histopathology and immunohistochemistry revealed a diagnosis of primitive neuroectodermal tumour of the cervix. Further investigations revealed the stage to be FIGO IIIB, which was inoperable. She received neoadjuvant chemotherapy (vincristine, adriamycin, cyclophosphamide alternating with ifosfamide, cisplatin and etoposide, every 21 days), but the tumour did not respond to treatment and she was started on radiotherapy with definitive intent (55...
January 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28050900/planned-early-birth-versus-expectant-management-waiting-for-prelabour-rupture-of-membranes-at-term-37-weeks-or-more
#9
REVIEW
Philippa Middleton, Emily Shepherd, Vicki Flenady, Rosemary D McBain, Caroline A Crowther
BACKGROUND: Prelabour rupture of membranes (PROM) at term is managed expectantly or by planned early birth. It is not clear if waiting for birth to occur spontaneously is better than intervening, e.g. by inducing labour. OBJECTIVES: The objective of this review is to assess the effects of planned early birth (immediate intervention or intervention within 24 hours) when compared with expectant management (no planned intervention within 24 hours) for women with term PROM on maternal, fetal and neonatal outcomes...
January 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28035460/usefulness-of-anorectal-and-endovaginal-3d-ultrasound-in-the-evaluation-of-sphincter-and-pubovisceral-muscle-defects-using-a-new-scoring-system-in-women-with-fecal-incontinence-after-vaginal-delivery
#10
Sthela M Murad-Regadas, Graziela Olivia da S Fernandes, Francisco Sergio Pinheiro Regadas, Lusmar Veras Rodrigues, Francisco Sergio Pinheiro Regadas Filho, Iris Daiana Dealcanfreitas, Adjra da Silva Vilarinho, Mariana Murad da Cruz
PURPOSE: This study aims to evaluate pubovisceral muscle and anal sphincter defects in women with previous vaginal delivery and fecal incontinence and to correlate the findings with the severity of symptoms using the combined anorectal and endovaginal 3D ultrasonography with a new ultrasound scoring system. METHODS: Consecutive female patients with previous vaginal delivery and fecal incontinence symptoms were screened. Fecal incontinence was assessed with the Cleveland Clinic Florida fecal incontinence scale, and the extent of defects was assessed by an ultrasound score based on results of anorectal and endovaginal 3D ultrasound...
December 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28029462/-prediction-of-preterm-delivery-in-symptomatic-women-preterm-labor
#11
G Benoist
OBJECTIVES: To evaluate the predictors of spontaneous preterm birth in case of preterm labor. MATERIALS AND METHODS: Literature search in Medline and Cochrane databases and recommendations of international societies. Selection of studies in symptomatic women (with preterm labor). RESULTS: Preterm labor is defined as a clinical situation occurring between 22 and 36 weeks + 6 days, in which cervical changes are observed associated with uterine contractions, evolving spontaneously or not to preterm delivery (Professional consensus)...
October 28, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#12
L Marcellin
OBJECTIVE: To review the scientific literature on cervical insufficiency and indications of cervical cerclage cervix. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and international obstetrical societies between 1972 and June 2016 have been consulted. RESULTS: Cervical insufficiency is a pathophysiological concept and to date no consensual definition is available: the diagnosis is clinical and discussed retrospectively in case of patients with a history of late miscarriages and/or spontaneous preterm delivery, with asymptomatic dilatation of the cervix (professional consensus)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28012405/an-assessment-of-mode-of-delivery-in-history-indicated-versus-ultrasound-indicated-vaginally-placed-cervical-cerclage
#13
Lisa Story, Andrew Shennan
OBJECTIVE: Treatment modalities to reduce the incidence of preterm birth are currently limited. Cerclage, is a common and established intervention in most obstetrics units worldwide, however, many questions regarding its efficacy, with respect to pregnancy outcomes remain unanswered. This study aims to investigate whether an antenatal placed cerclage affects the subsequent mode of delivery in women at high risk of preterm birth who labour. STUDY DESIGN: A retrospective case controlled study was performed at St Thomas's Hospital London...
November 27, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28007589/rectovaginal-splenosis-an-unexpected-cause-of-dyspareunia-approached-by-laparoscopy
#14
Hélder Ferreira, Cristina Maciel, Alexandre Morgado, António Pereira
STUDY OBJECTIVE: To demonstrate the technique of laparoscopic approach in a rare case of rectovaginal splenosis with severe dyspareunia and dyschesia. DESIGN: A step-by-step explanation of the patient's condition, diagnosis, surgical technique, and postoperative results. SETTING: Splenosis consists of ectopic functioning splenic tissue that can be located anywhere within the abdomen or pelvis. Fragments are often multiple and range in diameter from a few millimeters to a few centimeters...
December 19, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27994874/pelvic-congestion-syndrome-masquerading-as-osteoarthritis-of-the-hip
#15
Scott J Dos Santos, Mark S Whiteley
OBJECTIVES: Pelvic congestion syndrome (PCS) is associated with pelvic vein reflux (PVR), occasionally secondary to venous compression. Its symptoms, usually intra-pelvic, are alleviated following the abolition of this reflux by pelvic vein embolisation (PVE). The objective of this report is to present two cases of left hip pain, erroneously diagnosed as osteoarthritis, which disappeared after successful PVE and abolition of PVR. METHODS: Two females presented with lower limb varicose veins, and also had a history of left-sided hip pain...
2016: SAGE open medical case reports
https://www.readbyqxmd.com/read/27981624/neonatal-subgaleal-hematoma-from-trauma-during-vaginal-delivery-without-instrument-use
#16
Lucy Y Liu, Richard J Antaya
Neonatal subgaleal hematomas (SGHs) are rare but potentially life-threatening complications of vacuum extraction deliveries. We report a rare case of four enlarging SGHs in an 11-day-old boy born without use of instruments during delivery. It is likely that trauma from the provider's fingers caused these SGHs during a normal vaginal delivery. Ultrasound findings confirmed the diagnosis of SGH, distinct from other birth trauma such as cephalohematoma or caput succedaneum.
January 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/27980522/ultrasound-imaging-in-urogynecology-state-of-the-art-2016
#17
Michał Bogusiewicz
The role of ultrasound imaging in urogynecology is not clearly defined. Despite significant developments in visualization techniques and interpretation of images, pelvic ultrasound is still more a tool for research than for clinical practice. Structures of the lower genitourinary tract and pelvic floor can be visualized from different approaches: transperineal, introital, transvaginal, abdominal or endoanal. According to contemporary guidelines and recommendations, the role of ultrasound in urogynecology is limited to the measurement of post-void residue...
November 2016: Przeglad Menopauzalny, Menopause Review
https://www.readbyqxmd.com/read/27977408/use-of-translabial-three-dimensional-power-doppler-ultrasound-for-cervical-assessment-before-labor-induction
#18
Sertac Esin, Bulent Yirci, Serdar Yalvac, Omer Kandemir
OBJECTIVE: To compare translabial three-dimensional (3D) power Doppler ultrasound with Bishop score and transvaginal ultrasound measurements for cervical assessment before induction of labor with dinoprostone or cervical ripening balloon. MATERIALS AND METHODS: Translabial cervical volume and length, vascularization indices and transvaginal cervical length were measured. Results were compared among women who had vaginal delivery at 24 h or less and more than 24 h after the insertion of the dinoprostone vaginal insert or cervical ripening balloon and among women who had vaginal delivery and cesarean delivery for failure to go into labor or failure to progress...
December 15, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27943496/the-treatment-of-cervical-pregnancy-with-ultrasound-guided-local-methotrexate-injection
#19
Munekage Yamaguchi, Ritsuo Honda, Chimeddulam Erdenebaatar, Mahina Monsur, Tomoko Honda, Isao Sakaguchi, Yoshinori Okamura, Takashi Ohba, Hidetaka Katabuchi
OBJECTIVES: Cervical pregnancy (CP) is a rare type of ectopic pregnancy. Methotrexate (MTX) appears to be the first-line therapy for clinically stable women; however, there is still no consensus on the most appropriate treatment for this abnormal pregnancy. The aim of the present study was to investigate the efficacy of a single local MTX injection under transvaginal ultrasound guidance for the initial treatment of CP and to assess the post-treatment fertility. METHODS: We retrospectively reviewed 15 CP patients treated with local MTX injection under transvaginal ultrasonography...
December 10, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27939329/pelvic-floor-morphometry-and-function-in-women-with-and-without-puborectalis-avulsion-in-the-early-postpartum-period
#20
Marie-Pierre Cyr, Jennifer Kruger, Vivien Wong, Chantale Dumoulin, Isabelle Girard, Mélanie Morin
BACKGROUND: Pelvic floor muscles are subject to considerable stretching during vaginal birth. In 13-36% of women, stretching results in avulsion injury whereby the puborectalis muscle disconnects from its insertion points on the pubis bone. Until now, few studies have investigated the effect of this lesion on pelvic floor muscles in the early postpartum period. OBJECTIVE: The primary aim of this study was to compare pelvic floor muscle morphometry and function in primiparous women with and without puborectalis avulsion in the early postpartum period...
December 9, 2016: American Journal of Obstetrics and Gynecology
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