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https://www.readbyqxmd.com/read/29139552/critical-evaluation-of-the-palm-coein-classification-system-among-women-with-abnormal-uterine-bleeding-in-low-resource-settings
#1
Divya Shubham, Anjali S Kawthalkar
OBJECTIVE: To assess the feasibility of the PALM-COEIN system for the classification of abnormal uterine bleeding (AUB) in low-resource settings and to suggest modifications. METHODS: A prospective study was conducted among women with AUB who were admitted to the gynecology ward of a tertiary care hospital and research center in central India between November 2014 and October 2016. All patients were managed as per department protocols. The causes of AUB were classified before treatment using the PALM-COEIN system (classification I) and on the basis of the histopathology reports of the hysterectomy specimens (classification II); the results were compared using classification II as the gold standard...
November 15, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29139105/preoperative-medical-therapy-before-surgery-for-uterine-fibroids
#2
REVIEW
Anne Lethaby, Lucian Puscasiu, Beverley Vollenhoven
BACKGROUND: Uterine fibroids occur in up to 40% of women aged over 35 years. Some are asymptomatic, but up to 50% cause symptoms that warrant therapy. Symptoms include anaemia caused by heavy menstrual bleeding, pelvic pain, dysmenorrhoea, infertility and low quality of life. Surgery is the first choice of treatment. In recent years, medical therapies have been used before surgery to improve intraoperative and postoperative outcomes. However, such therapies tend to be expensive.Fibroid growth is stimulated by oestrogen...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29138742/hysterectomy-pathway-as-the-global-engine-of-practice-change-implications-for-value-in-care
#3
Amin Sanei-Moghaddam, Sharon Goughnour, Robert Edwards, John Comerci, Joseph Kelley, Nicole Donnellan, Faina Linkov, Suketu Mansuria
Introduction: In 2012, University of Pittsburgh Medical Center (UPMC) introduced a hysterectomy clinical pathway to reduce the number of total abdominal hysterectomies performed for benign gynecological indications. This study focused on exploring physician and patient factors impacting the utilization of hysterectomy clinical pathways. Methods: An online survey with 24 questions was implemented to explore physicians' attitudes and perceived barriers toward implementing the pathway...
2017: Central Asian Journal of Global Health
https://www.readbyqxmd.com/read/29136193/early-first-trimester-uteroplacental-flow-and-the-progressive-disintegration-of-spiral-artery-plugs-new-insights-from-contrast-enhanced-ultrasound-and-tissue-histopathology
#4
V H J Roberts, T K Morgan, P Bednarek, M Morita, G J Burton, J O Lo, A E Frias
STUDY QUESTION: Does the use of a vascular contrast agent facilitate earlier detection of maternal flow to the placental intervillous space (IVS) in the first trimester of pregnancy? SUMMARY ANSWER: Microvascular filling of the IVS was demonstrated by contrast-enhanced ultrasound from 6 weeks of gestation onwards, earlier than previously believed. WHAT IS KNOWN ALREADY: During placental establishment and remodeling of maternal spiral arteries, endovascular trophoblast cells invade and accumulate in the lumen of these vessels to form 'trophoblast plugs'...
November 10, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29130675/-severe-adverse-pregnancy-outcomes-in-placenta-previa-and-prior-cesarean-delivery
#5
Mi Zhou, Meng Chen, Li Zhang, Guo-Lin He, Lei He, Qiang Wei, Tao Li, Xing-Hui Liu
OBJECTIVE: To investigate the severe adverse pregnancy outcomes in pregnancies with placenta previa and prior cesarean delivery and its risk factors. METHODS: This retrospective casecontrol study reviewed all pregnancies with placenta previa and prior cesarean delivery delivered by repeat cesarean section in our institution between January 2005 and June 2015,and investigated the incidence of severe adverse pregnancy outcome. A composite of severe adverse pregnancy outcomes (including transfusion of 10 units or more red blood cells,maternal ICU admission,unanticipated injuries,repeat operation,hysterectomy,and maternal death) and other maternal and neonatal outcomes were described...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29128439/robotic-splenectomy-for-isolated-splenic-recurrence-of-endometrial-adenocarcinoma
#6
Valerio Gallotta, Marco D'Indinosante, Camilla Nero, Maria Teresa Giudice, Carmine Conte, Claudio Lodoli, Gian Franco Zannoni, Anna Fagotti, Giovanni Scambia
OBJECTIVES: We present a rare case of an isolated intraparenchymal splenic metastasis of endometrial cancer managed with robotic-assisted surgery. METHODS: A 55-year-old patient with a history of endometrial cancer was found to have a splenic lesion during her follow-up exams. She underwent surgical staging (total hysterectomy, bilateral salpingo-oopherectomy, pelvic lymphadenectomy and peritoneal washing) in 2014 and the final pathologic findings showed an endometrioid endometrial adenocarcinoma, FIGO Stage IB G2...
November 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29122786/a-nationwide-population-based-cohort-study-of-peripartum-hysterectomy-and-arterial-embolisation-in-belgium-results-from-the-belgian-obstetric-surveillance-system
#7
Griet Vandenberghe, Marine Guisset, Iris Janssens, Virginie Van Leeuw, Kristien Roelens, Myriam Hanssens, Erika Russo, Joachim Van Keirsbilck, Yvon Englert, Hans Verstraelen
OBJECTIVES: To assess the prevalence of major obstetric haemorrhage managed with peripartum hysterectomy and/or interventional radiology (IR) in Belgium. To describe women characteristics, the circumstances in which the interventions took place, the management of the obstetric haemorrhage, the outcome and additional morbidity of these women. DESIGN: Nationwide population-based prospective cohort study. SETTING: Emergency obstetric care. Participation of 97% of maternities covering 98...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29121880/comparison-of-different-therapeutic-strategies-for-complete-hydatidiform-mole-in-women-at-least-40%C3%A2-years-old-a-retrospective-cohort-study
#8
Peng Zhao, Qinqing Chen, Weiguo Lu
BACKGROUND: There are three main therapeutic strategies, namely expectant management (dilation and curettage only), prophylactic chemotherapy and prophylactic total hysterectomy for treating older women with complete hydatidiform mole (CHM). However, the scientific community has so far, not unanimously accepted the above-mentioned methods. The objective of this study was to evaluate the effectiveness of these therapeutic strategies in preventing post-molar gestational trophoblastic neoplasia (GTN) pertaining to patients with CHM who were at least 40 years old...
November 9, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29116934/expectant-management-of-caesarean-scar-ectopic-pregnancy-a-systematic-review
#9
REVIEW
Pradeep Jayaram, Gbemisola Okunoye, Abdullah Awad Al Ibrahim, Rauf Ghani, Karim Kalache
AIM: The purpose of this review is to systematically review all the reported cases and case series of caesarean scar pregnancy (CSP) managed expectantly without any intervention in order to understand the outcomes of pregnancy which will guide clinicians and patients in making treatment choices. METHODS: An electronic search on PubMed, EMBASE and Cochrane databases and a manual search from references of the articles were performed. Studies were selected based on inclusion and exclusion criteria...
November 8, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29112660/opioid-prescribing-patterns-patient-use-and-postoperative-pain-after-hysterectomy-for-benign-indications
#10
Sawsan As-Sanie, Sara R Till, Erika L Mowers, Courtney S Lim, Bethany D Skinner, Laura Fritsch, Alex Tsodikov, Vanessa K Dalton, Daniel J Clauw, Chad M Brummett
OBJECTIVE: To quantify physician prescribing patterns and patient opioid use in the 2 weeks after hysterectomy at an academic institution and to determine whether patient factors predict postsurgical opioid use and pain recovery. METHODS: We conducted a prospective quality initiative study by recruiting all English-speaking patients undergoing hysterectomy for benign, nonobstetric indications at a university hospital between August 2015 and December 2015, excluding those with major medical morbidities or substance abuse...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29112594/sexual-activity-and-vaginal-symptoms-in-the-postintervention-phase-of-the-women-s-health-initiative-hormone-therapy-trials
#11
Margery Gass, Joseph Larson, Barbara Cochrane, JoAnn E Manson, Dorothy Lane, Vanessa Barnabei, Judith Ockene, Marcia L Stefanick, Charles Mouton
OBJECTIVE: To assess the impact of discontinuing oral hormone therapy (HT) on sexual activity, vaginal symptoms, and sexual activity components among participants in the estrogen-progestin therapy (EPT) and estrogen therapy (ET) trial of the Women's Health Initiative. METHODS: Surveys were sent postintervention to those who were still taking study pills and agreed to continue in the study when the trials were stopped. Comparisons between former HT and placebo users were accomplished with chi-square tests for categorical variables and t tests for continuous variables...
November 13, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/29109629/peripartum-hysterectomy-in-a-tertiary-care-hospital-epidemiology-and-outcomes
#12
Bharti Sharma, Pooja Sikka, Vanita Jain, Kajal Jain, Rashmi Bagga, Vanita Suri
Background and Aims: Peripartum hysterectomy is associated with significant maternal morbidity and mortality. We reviewed all peripartum hysterectomies at our institute over a 1-year period. The aim of this study was to determine the incidence, surgery and anesthesia-related issues of peripartum hysterectomies and to compare outcomes of emergency and electively planned peripartum hysterectomies. Material and Methods: This was a retrospective analysis of records of women who underwent emergency or elective peripartum hysterectomy in a tertiary care hospital...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29107951/the-effect-of-tranexamic-acid-on-blood-loss-and-maternal-outcome-in-the-treatment-of-persistent-postpartum-hemorrhage-a-nationwide-retrospective-cohort-study
#13
Ada Gillissen, Dacia D C A Henriquez, Thomas van den Akker, Camila Caram-Deelder, Merlijn Wind, Joost J Zwart, Jos van Roosmalen, Jeroen Eikenboom, Kitty W M Bloemenkamp, Johanna G van der Bom
BACKGROUND: Recent results show a protective effect of tranexamic acid on death due to bleeding in patients with postpartum hemorrhage in low- and middle-resource countries. We quantify the association between early administration of tranexamic acid compared to late or no administration and severe acute maternal morbidity and blood loss among women suffering from persistent severe postpartum hemorrhage in a high-income country. METHODS AND FINDINGS: We performed a nationwide retrospective cohort study in 61 hospitals in the Netherlands...
2017: PloS One
https://www.readbyqxmd.com/read/29107119/the-impact-of-carbon-dioxide-pneumoperitoneum-on-ovarian-ischemia-reperfusion-injury-during-laparoscopic-surgery-a-preliminary-study
#14
Ali Akdemir, Enes Taylan, Cagdas Sahin, Banu Ozgurel, Ayfer Karlitepe, Osman Zekioglu, Gulinnaz Ercan
STUDY OBJECTIVE: To investigate whether carbon dioxide (CO2) pneumoperitoneum cause ischemia-reperfusion injury to the ovaries during laparoscopic surgery. DESIGN: Prospective controlled clinical study (Canadian Task Force classification II-1). SETTING: Tertiary Academic Center. PATIENTS: Premenopausal women who underwent hysterectomy with bilateral salpingo-oophorectomy (HSO) via open abdominal and laparoscopic approaches between 2014 and 2015...
October 26, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29105982/trends-in-the-diffusion-of-robotic-surgery-a-retrospective-observational-study
#15
Hani J Marcus, Archie Hughes-Hallett, Christopher J Payne, Thomas P Cundy, Dipankar Nandi, Guang-Zhong Yang, Ara Darzi
BACKGROUND: Recent studies have suggested that the use of robotic surgery for prostatectomy has been increasing, but characterization of the diffusion of robotic surgery in other procedures has not been available. METHODS: Data were analysed for the years 2006-2014 using hospital episode statistics (HES), a database of all admissions to National Health Service (NHS) hospitals in England. OPCS codes were used to determine the annual number of prostatectomy, partial nephrectomy, and total abdominal hysterectomy procedures...
November 6, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29103887/thrombosis-after-aortic-balloon-occlusion-during-cesarean-delivery-for-abnormally-invasive-placenta
#16
F Luo, Z Wu, J Mei, J Yue, X Yu, L Xie
BACKGROUND: Abnormally invasive placenta is a major cause of postpartum hemorrhage and cesarean hysterectomy. An increasing number of obstetricians worldwide employ prophylactic aortic balloon occlusion to manage bleeding during cesarean delivery in these patients. However, the safety of this procedure in pregnant women has not been confirmed. METHODS: The clinical records of patients who were suspected of having abnormally invasive placenta and who received prophylactic aortic balloon catheterization before cesarean delivery were retrospectively studied for thrombotic complications...
September 22, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29099026/cost-and-distribution-of-hysterectomy-and-uterine-artery-embolization-in-the-united-states-regional-rural-urban-disparities
#17
Marquisette Glass Lewis, Olúgbémiga T Ekúndayò
Hysterectomy, the driving force for symptomatic uterine fibroids since 1895, has decreased over the years, but it is still the number one choice for many women. Since 1995, uterine artery embolization (UAE) has been proven by many researchers to be an effective treatment for uterine fibroids while allowing women to keep their uteri. The preponderance of data collection and research has focused on care quality in terms of efficiency and effectiveness, with little on location and viability related to care utilization, accessibility and physical availability...
May 16, 2017: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29097232/cancer-risk-reducing-opportunities-in-gynecologic-surgery
#18
REVIEW
Carolyn Piszczek, Jun Ma, Claire H Gould, Paul Tseng
This review article discusses cancer risk-reducing opportunities in gynecologic surgery. We cover strategies to reduce ovarian and uterine cancer risk by presenting general practice guidelines and expanding on the literature behind clinical decision points. We address populations of women at increased hereditary risk and those at population risk. We present discussions on the role of gynecologic surgery, specifically, risk-reducing salpingo-oophorectomy, prophylactic salpingectomy with delayed oophorectomy, concomitant hysterectomy, opportunistic salpingectomy, and bilateral tubal ligation...
October 30, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29096564/management-of-peripartum-hysterectomies-performed-on-patients-with-placenta-percreta-in-a-tertiary-central-hospital
#19
Sibel Sak, Mert Barut, Adnan Incebiyik, Hacer Uyanikoglu, Nese Hilali, Muhammet Sak
OBJECTIVE: The main objective of this study is to analyse the circumstances and management of peripartum hysterectomies performed on patients with placenta percreta. METHODS: This study included 37 patients who were diagnosed with placenta percreta, a condition in which the placenta invades the uterine wall, and who therefore underwent a peripartum hysterectomy. Their demographic characteristics, history of past caesareans, uterine surgery and curettage, duration of hospitalization, admission to an intensive care unit, neonatal outcomes, skin and uterus incision type, hypogastric artery ligation (HAL), complications, quantities of transfused ES (erythrocyte suspensions), and FFP (fresh frozen plasma), maternal morbidity and mortality and postoperative pathology results were retrospectively reviewed...
November 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29077194/metformin-for-endometrial-hyperplasia
#20
REVIEW
Naomi S Clement, Thomas Rw Oliver, Hunain Shiwani, Juliane Rf Sanner, Caroline A Mulvaney, William Atiomo
BACKGROUND: Endometrial cancer is one of the most common gynaecological cancers in the world. Rates of endometrial cancer are rising, in part because of rising obesity rates. Endometrial hyperplasia is a precancerous condition in women that can lead to endometrial cancer if left untreated. Endometrial hyperplasia occurs more commonly than endometrial cancer. Progesterone tablets currently used to treat women with endometrial hyperplasia are associated with adverse effects in up to 84% of women...
October 27, 2017: Cochrane Database of Systematic Reviews
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