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https://www.readbyqxmd.com/read/29145319/primary-myelofibrosis-and-pregnancy-outcomes-after-low-molecular-weight-heparin-administration-a-case-report-and-literature-review
#1
Roxana Elena Bohîlţea, Monica Mihaela Cîrstoiu, Crîngu Antoniu Ionescu, Emilia Niculescu-Mizil, Ana Maria Vlădăreanu, Irina Voican, Mihai Dimitriu, Natalia Turcan
RATIONALE: Primary myelofibrosis is encountered with the myeloproliferative diseases and is the least prevalent among women of childbearing age. The prognosis is guided by pancytopenia, leukemic transformation and thrombosis which are the dominant complications. PATIENT CONCERNS: Data regarding protocol management during pregnancy in the context of myelofibrosis are insufficient. Fewer than ten cases have been described until now and half of this cases have resulted in fetal death due to placental infarction during the second and third trimesters...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29142797/cervical-funneling-potential-pitfall-of-point-of-care-pelvic-ultrasound
#2
Lori A Stolz, Richard Amini, Elaine H Situ-LaCasse, Faryal Shareef, Heather A Reed, Srikar Adhikari
Though point-of-care ultrasound applications continue to expand, there are findings that are not within the scope of emergency ultrasound. It is important for emergency physicians to be aware of incidental findings that can be identified on comprehensive ultrasounds performed by other imaging departments in order to fully understand the limitations of bedside ultrasound. In this case, a gravid patient presented to the emergency department with pelvic cramping and vaginal bleeding. Point-of-care transabdominal pelvic ultrasound examination was performed and demonstrated cervical funneling...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29141365/-effect-of-short-acting-combined-oral-contraceptives-on-bleeding-after-induced-abortion
#3
X F Wang, M Zhong, J Liu
Objective: To explore the effect of short-acting combined oral contraceptives on vaginal bleeding after induced abortion. Methods: A total of 726 patients, who had took induced abortion from July 2016 to September 2016 in obstetrics and gynecology outpatient department of Nanfang Hospital, Southern Medical University, were included and divided into the observation group and the control group according to whether they took short-acting combined oral contraceptives after induced abortion, with 312 cases, 414 cases respectively...
November 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29139352/-contraception-for-young-women-with-focus-on-long-acting-reversible-contraceptives
#4
EDITORIAL
Pernille Ravn, Kresten Rubeck Petersen
Long-acting, reversible contraceptives are about 20 times more effective in terms of contraceptive efficacy than oral hormonal contraceptives, patch or vaginal ring are. Long-acting, reversible contraceptives are not associated with serious adverse events but induce changes in menstrual bleeding pattern in about 75% of the users. The progestogen intrauterine device is effective in the treatment of menor-rhagia and dysmenorrhoea. Increased use of long-acting reversible contraceptives is expected to reduce unplanned pregnancies and legal abortions in all ages...
November 13, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29139277/tailor-management-to-the-patient-with-fibroids
#5
Marie O'Sullivan, Caroline Overton
Fibroids are benign, hormone-dependent tumours of uterine smooth muscle and connective tissue. They are commonly asymptomatic, but can cause symptoms such as heavy menstrual bleeding and pelvic pressure symptoms. Between 20 to 30% of women with heavy menstrual bleeding have fibroids. Fibroids are most prevalent in women aged 30-50 years and there may be a genetic predisposition. They are more common in black women than white women. Other risk factors include obesity and nulliparity. Asymptomatic women should only be referred if their uterus is palpable abdominally, if fibroids distort the uterine cavity or the uterus is larger than 12 cm in length...
March 2017: Practitioner
https://www.readbyqxmd.com/read/29096583/comparison-of-svcam-1-and-sicam-1-levels-in-maternal-serum-and-vaginal-secretion-between-pregnant-women-with-preterm-prelabour-ruptures-of-membranes-and-healthy-pregnant-women
#6
Sibel Sak, Mert Barut, Adnan Incebiyik, Elif Ağaçayak, Adnan Kirmit, Ismail Koyuncu, Muhammet Sak
OBJECTIVE: The study aims to evaluate the maternal serum and the vaginal fluid levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecular (sICAM-1) in pregnant women complicated by preterm prelabour ruptures of membranes (PPROM). MATERIALS AND METHODS: The prospective case control study included 34 pregnant women with PPROM and 34 healthy pregnant women. Patients with additional diseases, a smoking habit and vaginal bleeding, as well as those using antibiotics, during the study period were not included in the study...
November 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29094453/uterine-metastasis-of-lung-adenocarcinoma-under-molecular-target-therapy-with-epidermal-growth-factor-receptor-tyrosine-kinase-inhibitors-a-case-report-and-review-of-the-literature
#7
Mayu Shibata, Masato Shizu, Kazuko Watanabe, Akihiro Takeda
A 63-year-old woman presented with abnormal vaginal bleeding. Her disease history was significant, and included advanced lung adenocarcinoma with a deletion mutation in exon 19 of the epidermal growth factor receptor (EGFR) gene, which was managed by concurrent chemoradiotherapy, followed by molecular targeted therapy with tyrosine kinase inhibitors (TKIs) for a two-year period. Contrast-enhanced computed tomography showed the enlargement of a previously suspicious myoma node, with peripheral enhancement. Hemorrhagic necrosis was also observed on magnetic resonance imaging...
November 2, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29094093/use-of-palliative-cisplatinum-for-advanced-cervical-cancer-in-a-resource-poor-setting-a-case-series-from-kenya
#8
Elkanah Orang'o, Peter Itsura, Philip Tonui, Hellen Muliro, Barry Rosen, Luc van Lonkhuijzen
Purpose: To evaluate the effectiveness and feasibility of cisplatinum for palliative treatment of advanced cervical cancer in a resource-poor setting. Methods: An observational case series is reported from a university teaching hospital in Kenya. All women presenting with advanced cervical cancer and planned for palliative cisplatinum therapy from 2010 to 2014 were included. Women were treated with cisplatinum 50 mg/m(2) every 4 weeks in an outpatient setting. Data on tumor stage and symptoms control were prospectively collected in an electronic database...
October 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/29090103/unilateral-atraumatic-expulsion-of-an-ectopic-pregnancy-in-a-case-of-bilateral-ectopic-pregnancy
#9
Victoria Sampson, Oluremi Mogekwu, Ammar Ahmed, Farida Bano
Ectopic pregnancy occurs in 1-2% of pregnancies. The fallopian tube is the most common site; however, bilateral tubal ectopic pregnancy is an extremely rare phenomenon, seen in approximately 1/200,000 pregnancies. It is usually the result of assisted reproductive techniques (ART). Ultrasound (USS) and serial beta-hCG levels have shown poor efficacy for accurate diagnosis. Laparoscopy is the diagnostic gold standard. The majority of cases are managed surgically with bilateral salpingectomy. A 26-year-old female presented to our early pregnancy unit with pain and vaginal bleeding at 5-week gestation after IVF...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29080723/no-351-transvaginal-mesh-procedures-for-pelvic-organ-prolapse
#10
Maryse Larouche, Roxana Geoffrion, Jens-Erik Walter
OBJECTIVE: This guideline reviews the evidence related to the risks and benefits of using transvaginal mesh in pelvic organ prolapse repairs in order to update recommendations initially made in 2011. INTENDED USERS: Gynaecologists, residents, urologists, urogynaecologists, and other health care providers who assess, counsel, and care for women with pelvic organ prolapse. TARGET POPULATION: Adult women with symptomatic pelvic organ prolapse considering surgery and those who have previously undergone transvaginal mesh procedures for the treatment of pelvic organ prolapse...
November 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29080126/perinatal-periods-of-risk-analysis-disentangling-race-and-socioeconomic-status-to-inform-a-black-infant-mortality-community-action-initiative
#11
Catherine L Kothari, Camryn Romph, Terra Bautista, Debra Lenz
Objectives The goal of this study is to use Perinatal Periods of Risk (PPOR) analysis to differentiate broad areas of risk (Maternal-Health/Prematurity, Maternal Care, Newborn Care, and Infant Health) associated with being Black from those associated with being poor. Methods Phase I PPOR compared two target populations (Black women/infants and poor women/infants) against a gold standard reference group (White, non-Hispanic women, aged 20+ years with 13+ years of education), then against each other. Phase II PPOR further partitioned excess risk into (1) Very-low-birthweight-risk and (2) Birthweight-specific-mortality-risk and identified individual-level risk factors...
October 27, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29079144/society-for-maternal-fetal-medicine-smfm-consult-series-44-management-of-bleeding-in%C3%A2-the-late-preterm-period
#12
Cynthia Gyamfi-Bannerman
Third-trimester bleeding is a common complication arising from a variety of etiologies, some of which may initially present in the late preterm period. Previous management recommendations have not been specific to this gestational age window, which carries a potentially lower threshold for delivery. The purpose of this document is to provide guidance on management of late preterm (34 0/7-36 6/7 weeks of gestation) vaginal bleeding. The following are Society for Maternal-Fetal Medicine recommendations: (1) we recommend delivery at 36-37 6/7 weeks of gestation for stable women with placenta previa without bleeding or other obstetric complications, such as preeclampsia or fetal growth restriction (Grade 1B); (2) we do not recommend routine cervical length screening for women with placenta previa in the late preterm period because of a lack of data on an appropriate management strategy (Grade 2C); (3) we recommend a planned delivery between 34 and 37 weeks of gestation for stable women with placenta accreta (Grade 1C); (4) we recommend delivery between 34 and 37 weeks of gestation for stable women with vasa previa (Grade 1C); (5) we recommend that in women with active hemorrhage in the late preterm period, delivery should not be delayed for the purpose of administering antenatal corticosteroids (Grade 1B); (6) we recommend that fetal lung maturity testing should not be used to guide management in the late preterm period when an indication for delivery is present (Grade 1B); and (7) we recommend that antenatal corticosteroids should be administered to women who are eligible and are managed expectantly if delivery is likely within 7 days, the gestational age is between 34 0/7 and 36 6/7 weeks of gestation, and antenatal corticosteroids has not previously been administered (Grade 1A)...
October 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29077194/metformin-for-endometrial-hyperplasia
#13
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
https://www.readbyqxmd.com/read/29072789/abnormally-invasive-placentation-in-a-woman-with-congenital-myotonic-dystrophy
#14
Lise-Marie Dorcier, Frédéric Coatleven, Hugo Madar, Loïc Sentilhes
The present report describes the case of a woman with myotonic dystrophy aged 32 years, with a gravidity of 1, whose spontaneous pregnancy was complicated by vaginal bleeding at 36 weeks. The patient's medical history was unremarkable except for the myotonic dystrophy. Ultrasonography revealed a low-lying posterior placenta. This article is protected by copyright. All rights reserved.
October 26, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29072372/misoprostol-treatment-vs-expectant-management-in-early-non-viable-pregnancy-in-women-with-vaginal-bleeding-a-pragmatic-randomized-controlled-trial
#15
A Fernlund, L Jokubkiene, P Sladkevicius, L Valentin
OBJECTIVES: To compare vaginal misoprostol treatment with expectant management in early non-viable pregnancies with vaginal bleeding with regard to complete evacuation of the uterine cavity within 10 days. METHODS: Parallel randomized controlled, open label, trial conducted in Skåne university hospital, Sweden. Patients with anembryonic pregnancy or early fetal demise (crown-rump length <33mm) and vaginal bleeding were randomly allocated to either expectant management or single dose 800μg of misoprostol vaginally...
October 26, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29065743/a-maternal-death-from-self-induced-medical-abortion-a-call-for-action
#16
Nino Berdzuli, Ekaterine Pestvenidze, Nino Lomia, Babill Stray-Pedersen
OBJECTIVES: In Georgia, which has a longstanding, liberalised abortion law, the abortion procedure is generally safe if it is performed in a medical facility. However, when socioeconomic barriers prevent women from seeking safe abortion services, some risk their life by self-terminating an unintended pregnancy. We present a case of maternal mortality after a self-induced medical abortion, with the aim to investigate the underlying non-clinical causes of maternal death and the relevant policy implications...
October 25, 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/29065701/postpartum-hemorrhage-from-non-uterine-arteries-clinical-importance-of-their-detection-and-the-results-of-selective-embolization
#17
Jeong-Eun Kim, Young Ho So, Byoung Jae Kim, Sun Min Kim, Young Ho Choi, Chang Kyu Sung
Background Identification of the source of postpartum hemorrhage (PPH) is important for embolization because PPH frequently originates from non-uterine arteries. Purpose To evaluate the clinical importance of identifying the non-uterine arteries causing the PPH and the results of their selective embolization. Material and Methods This retrospective study enrolled 59 patients who underwent embolization for PPH from June 2009 to July 2016. Angiographic findings and medical records were reviewed to determine whether non-uterine arteries contributed to PPH...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/29061036/diagnosing-ectopic-pregnancy-in-the-emergency-setting
#18
Robert Lee, Carolyn Dupuis, Byron Chen, Andrew Smith, Young H Kim
Ectopic pregnancy is the implantation of a fertilized egg outside the uterine endometrial cavity. For women presenting to the emergency department with abdominal pain and/or vaginal bleeding, ectopic pregnancy is an important diagnostic consideration. The diagnosis is made based on laboratory values and ultrasound imaging findings. The ultrasound appearance of both normal early pregnancy and ectopic pregnancy are variable and often subtle, presenting diagnostic challenges for radiologists. This pictorial essay describes and illustrates the sonographic findings of ectopic pregnancy and reviews the differential diagnoses that can mimic ectopic pregnancy on ultrasound...
August 19, 2017: Ultrasonography
https://www.readbyqxmd.com/read/29059609/a-case-of-laparoscopy-assisted-vaginal-cuff-suturing-for-vaginal-cuff-dehiscence-after-total-laparoscopic-hysterectomy
#19
Tomoatsu Jimi, Rumiko Yamamoto, Koji Seo, Mari Matsuoka, Saori Hata, Yukiko Ando, Hiromi Miyata, Yuki Kozono, Natsuki Tsuji, Akiko Okuda, Kentaro Sekiyama, Koichi Terakawa, Tadayoshi Nagano
INTRODUCTION: Vaginal cuff dehiscence after hysterectomy is a rare complication and occurs in less than 1% of patients. It can present with serious complications, such as bowel evisceration and peritonitis. PRESENTATION OF CASE: A 51-year-old multigravida Korean woman underwent total laparoscopic hysterectomy for leiomyoma. Six months later, she reported lower abdominal pain and vaginal bleeding. Physical examination revealed rebound tenderness in the lower abdomen, and pelvic examination showed a small amount of vaginal bleeding with an evisceration of the small intestine through the vagina that exhibited healthy peristalsis...
October 18, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29056745/sex-hormone-metabolism-and-threatened-abortion
#20
Qianhua Xu, Juan Chen, Zhaolian Wei, Theodore R Brandon, David T Zava, Yuenian Eric Shi, Yunxia Cao
BACKGROUND The aim of this study was to evaluate changes in sex hormone metabolism in patients with threatened miscarriage. MATERIAL AND METHODS We recruited 73 women in early pregnancy (6-8 weeks of gestation) and divided them into the following 2 groups based on whether they had vaginal bleeding: group A (n=34), the threatened abortion group; and group B (n=39), the normal pregnancy group. Human chorionic gonadotrophin (hCG), estradiol (E2), progesterone (P4), and testosterone (T) serum levels were tested and sex hormone metabolites in the urine were detected using gas chromatography-triple quadrupole mass spectrometry (GC-MS/MS)...
October 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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