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https://www.readbyqxmd.com/read/29147816/development-of-pseudoaneurysm-in-cesarean-section-scar-pregnancy-a-case-report-and-literature-review
#1
Shunki Kiyokawa, Tatsuyuki Chiyoda, Kazunori Ueno, Keiko Saotome, Seon-Hye Kim, Sakura Nakada
Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy. It is becoming more common, but it can lead to uterine rupture and severe hemorrhage. Here, we report a case of a 37-year-old woman with CSP complicated with pseudoaneurysm. The pseudoaneurysm emerged following focal injection of methotrexate (MTX) and potassium chloride with systemic MTX treatment. Due to a risk of sudden bleeding, uterine artery embolization (UAE) was recommended, but the patient hoped to avoid this if possible. Because the serum human chorionic gonadotropin level and the gestational sac were still persistent, dilation and curettage were performed with interventional radiologists on standby...
November 16, 2017: Journal of Medical Ultrasonics
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
#2
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/29135072/measuring-human-placental-blood-flow-with-multidelay-3d-grase-pseudocontinuous-arterial-spin-labeling-at-3t
#3
Xingfeng Shao, Dapeng Liu, Thomas Martin, Teresa Chanlaw, Sherin U Devaskar, Carla Janzen, Aisling M Murphy, Daniel Margolis, Kyunghyun Sung, Danny J J Wang
BACKGROUND: Placenta influences the health of both a woman and her fetus during pregnancy. Maternal blood supply to placenta can be measured noninvasively using arterial spin labeling (ASL). PURPOSE: To present a multidelay pseudocontinuous arterial spin labeling (pCASL) combined with a fast 3D inner-volume gradient- and spin-echo (GRASE) imaging technique to simultaneously measure placental blood flow (PBF) and arterial transit time (ATT), and to study PBF and ATT evolution with gestational age during the second trimester...
November 14, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29133152/laparoscopic-assisted-uterus-retrieval-from-live-organ-donors-for-uterine-transplant
#4
Shailesh Puntambekar, Milind Telang, Pankaj Kulkarni, Sanjeev Jadhav, Ravindra Sathe, Neeta Warty, Seema Puntambekar, Sandesh Kade, Mangesh Panse, Nikhil Agarkhedkar, Giriraj Gandhi, Manoj Manchekar, Hirav Parekh, Kajal Parikh, Riddhi Desai, Mehul Mehta, Mihir Chitale, Sambit Nanda
OBJECTIVE: The authors present the first ever laparoscopic assisted uterus retrieval in live donor for uterus transplant. DESIGN: A step-by-step surgical demonstration SETTING: Galaxy CARE Laparoscopy Institute, Pune, India PATIENT(S): Two patients, ages 21 and 26 with Mayer Rokitansky Kuster Hauser (MRKH) syndrome and Ashermann's syndrome respectively, with their mothers as donors. INTERVENTION(S): A Twelve member team was formed. After review of available literature on uterine transplant a protocol was formulated and submitted to the IRB...
November 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29133151/laparoscopic-management-of-a-rudimentary-uterine-horn
#5
Emilie Faller, Jean Jacques Baldauf, François Becmeur, Anne Lehn, Cherif Youssef Akladios, Lise Lecointre
STUDY OBJECTIVE: To demonstrate a technique of laparoscopic management of a rudimentary horn in a 12-year-old girl. DESIGN: A step-by-step explanation of the surgery using video (instructive video), approved the local institutional Review Board. SETTING: A university hospital, University Hospital of Strasbourg, France. PATIENT: A 12-year-old girl with a uterine rudimentary horn. INTERVENTION: We describe the case of a 12 years old girl who had no medical history...
November 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29128204/uterine-artery-embolization-a-review-of-current-concepts
#6
REVIEW
Jonathan J Keung, James B Spies, Theresa M Caridi
Uterine artery embolization (UAE) has gained traction as a safe and effective treatment modality for symptomatic uterine leiomyomata since its introduction nearly two decades ago. This review includes an overview of current concepts with regard to patient selection, technique, and outcomes following UAE. Specific topics also include the impact of this procedure on fertility and pregnancy, the emerging role of UAE in the treatment of adenomyosis, and how UAE compares with surgical intervention for the treatment of symptomatic leiomyomata...
September 29, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29125627/placental-development-and-function-in-women-with-a-history-of-placenta-related-complications-a-systematic-review
#7
Ignatia F Reijnders, Annemarie G M G J Mulders, Maria P H Koster
INTRODUCTION: Women with a history of placenta-related pregnancy complications, such as preeclampsia, intra-uterine growth restriction or preterm delivery, have an increased risk for recurrence of such complications. This recurrence is likely the result of underlying endothelial dysfunction that leads to abnormal placentation, especially in complications with an early onset. This study provides an overview of biomarkers of placental development and function in pregnancies from women with a history of pregnancy-related complications...
November 10, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29124818/diagnosis-and-management-of-patients-with-enhanced-myometrial-vascularity-associated-with-retained-products-of-conception
#8
Yvette S Groszmann, Amie Lynn Healy Murphy, Beryl R Benacerraf
OBJECTIVES: We performed this study to assess the complication rate, including the estimated amount of blood loss, in patients who underwent dilation and curettage for treatment of retained products of conception with markedly enhanced myometrial vascularity mimicking arteriovenous malformations. METHODS: This is a retrospective medical records review study of patients with retained products of conception with enhanced myometrial vascularity presenting to our ultrasound unit between August 1, 2015 and August 1, 2017...
November 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29124344/three-dimensional-computed-tomography-angiography-reconstruction-of-the-origin-of-the-uterine-artery-and-its-clinical-significance
#9
Alexandra Arfi, Julia Arfi-Rouche, Vincent Barrau, Krystel Nyangoh Timoh, Cyril Touboul
PURPOSE: In women, the uterine artery is the main branch of the internal iliac artery, vascularizing most of the uterus. Knowledge of its origin and variations is essential during extensive gynaecological surgery and interventional radiological procedures. We aimed to investigate its origin and explore its anatomical variations by three-dimensional (3D) reconstructed computed tomography (CT) angiography. METHODS: This was a retrospective, monocentric observational study involving CT scans of the abdomen and lower limbs of women < 50 years old with 3D reconstructed CT images of the internal and external iliac arterial axes...
November 9, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29122954/pregnancy-adapted-uterine-artery-endothelial-cell-ca2-signaling-and-its-relationship-with-membrane-potential
#10
Roxanne E Alvarez, Derek S Boeldt, Bikash R Pattnaik, Hannah L Friedman, Ian M Bird
Pregnancy-derived uterine artery endothelial cells (P-UAEC) express P2Y2 receptors and at high cell density show sustained and synchronous [Ca2+]i burst responses in response to ATP Bursts in turn require coupling of transient receptor potential canonical type3 channel (TRPC3) and inositol 1,4,5-triphosphate receptor type 2 (IP3R2), which is upregulated in P-UAEC in a manner dependent on connexin 43 (Cx43) gap junctions. While there is no known direct interaction of TRPC3 with Cx43, early descriptions of TRPC3 function showed it may also be influenced by altered membrane potential (Vm)...
November 2017: Physiological Reports
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
#11
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/29117499/preclinical-chorioamnionitis-dysregulates-cxcl1-cxcr2-signaling-throughout-the-placental-fetal-brain-axis
#12
REVIEW
Tracylyn R Yellowhair, Shahani Noor, Jessie R Maxwell, Christopher V Anstine, Akosua Y Oppong, Shenandoah Robinson, Erin D Milligan, Lauren L Jantzie
In the United States, perinatal brain injury (PBI) is a major cause of infant mortality and childhood disability. For a large proportion of infants with PBI, central nervous system (CNS) injury begins in utero with inflammation (chorioamnionitis/CHORIO) and/or hypoxia-ischemia. While studies show CHORIO contributes to preterm CNS injury and is also a common independent risk factor for brain injury in term infants, the molecular mechanisms mediating inflammation in the placental-fetal-brain axis that result in PBI remain a gap in knowledge...
November 5, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/29109771/selective-targeting-of-a-novel-vasodilator-to-the-uterine-vasculature-to-treat-impaired-uteroplacental-perfusion-in-pregnancy
#13
Natalie Cureton, Iana Korotkova, Bernadette Baker, Susan Greenwood, Mark Wareing, Venkata R Kotamraju, Tambet Teesalu, Francesco Cellesi, Nicola Tirelli, Erkki Ruoslahti, John D Aplin, Lynda K Harris
Fetal growth restriction (FGR) in pregnancy is commonly caused by impaired uteroplacental blood flow. Vasodilators enhance uteroplacental perfusion and fetal growth in humans and animal models; however, detrimental maternal and fetal side effects have been reported. We hypothesised that targeted uteroplacental delivery of a vasodilator would enhance drug efficacy and reduce the risks associated with drug administration in pregnancy. Phage screening identified novel peptides that selectively accumulated in the uteroplacental vasculature of pregnant mice...
2017: Theranostics
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
#14
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/29105383/hypoxia-and-placental-development
#15
REVIEW
Michael J Soares, Khursheed Iqbal, Keisuke Kozai
Hemochorial placentation is orchestrated through highly regulated temporal and spatial decisions governing the fate of trophoblast stem/progenitor cells. Trophoblast cell acquisition of specializations facilitating invasion and uterine spiral artery remodeling is a labile process, sensitive to the environment, and represents a process that is vulnerable to dysmorphogenesis in pathologic states. Hypoxia is a signal guiding placental development, and molecular mechanisms directing cellular adaptations to low oxygen tension are integral to trophoblast cell differentiation and placentation...
October 16, 2017: Birth defects research
https://www.readbyqxmd.com/read/29104668/uterine-artery-blood-flow-and-microvessel-density-by-vaginal-color-doppler-ultrasonography-in-embryo-implantation-failure
#16
Zhen Li, Xingling Wang, Yichun Guan, Xiaona Yu, Jing Liu, Zhan Zhang
The purpose of this study was to investigate the clinical application of uterine artery blood flow parameters by vaginal color Doppler ultrasonography in patients with repeated embryo implantation failure and to examine the correlation between uterine artery blood flow parameters and microvessel density (MVD). We monitored the outcomes of in vitro fertilization and embryo transfer in eighty patients. We divided the patients into two groups: Pregnancy (successful pregnancy, n=50) and repeated implantation failure (more than two failures of in vitro fertilization-embryo transfer, n=30)...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29102934/regional-immunoreactivity-of-pax6-in-the-neurogenic-zone-after-chronic-prenatal-hypoxia
#17
Keumyoung So, Yoonyoung Chung, Sun-Kyoung Yu, Yonghyun Jun
BACKGROUND/AIM: Neurogenesis is a complex process to generate new neurons from neural progenitor cells. Neural progenitor cells are observed in two principal neurogenic regions of the forebrain, the subventricular zone and the subgranular zone of the hippocampal dentate gyrus. The cerebral cortex also plays a role as the neurogenic zone under hypoxic conditions. Hypoxia has many effects on neurogenesis, but the effect of chronic prenatal hypoxia on paired box 6 (Pax6), a protein that plays an important role in neurogenesis, has not been studied in vivo...
November 2017: In Vivo
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#18
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy (HDP) is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in HDP considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome. OBJECTIVES: This study aimed to examine cardiovascular parameters in a cohort of patients affected by HDP according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of HDP...
November 1, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29099026/cost-and-distribution-of-hysterectomy-and-uterine-artery-embolization-in-the-united-states-regional-rural-urban-disparities
#19
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/29097177/first-trimester-screening-for-early-and-late-preeclampsia-using-maternal-characteristics-biomarkers-and-estimated-placental-volume
#20
Jiri Sonek, David Krantz, Jon Carmichael, Cathy Downing, Karen Jessup, Ziad Haidar, Shannon Ho, Terrence Hallahan, Harvey J Kliman, David McKenna
BACKGROUND: Preeclampsia is a major cause of perinatal morbidity and mortality. First-trimester screening has been shown to be effective in selecting patients at an increased risk for preeclampsia in some studies. OBJECTIVE: We sought to evaluate the feasibility of screening for preeclampsia in the first trimester based on maternal characteristics, medical history, biomarkers, and placental volume. STUDY DESIGN: This is a prospective observational nonintervention cohort study in an unselected US population...
October 31, 2017: American Journal of Obstetrics and Gynecology
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