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Abnormal uterine bleeding

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https://www.readbyqxmd.com/read/28829973/feasibility-and-efficacy-of-repeated-hysteroscopic-cesarean-niche-resection
#1
Shlomo B Cohen, Roy Mashiach, Alexandra Baron, Motti Goldenberg, Eyal Schiff, Raoul Orvieto, Jerome Bouaziz
OBJECTIVE: Cesarean-induced niche can cause symptoms such as abnormal postmenstrual bleeding, pain and associated infertility. Hysteroscopic niche resection is usually a successful treatment, but can result in a failure to improve symptoms or symptoms can recur. In the present study we aim to evaluate the feasibility, effectiveness, and safety of a second hysteroscopic niche resection for patients in whom an initial hysteroscopic resection failed to improve symptoms. STUDY DESIGN: This retrospective cohort study (Canadian Task Force classification II-2) hospital tell hashomer (tertiary center) included all patients who underwent a second hysteroscopic niche resection between 2011 and 2015...
August 12, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28829510/clinical-outcomes-after-resectoscopic-treatment-of-cesarean-induced-isthmocele-a-prospective-case-control-study
#2
L Muzii, L Domenici, F Lecce, M Di Feliciantonio, R Frantellizzi, C Marchetti, M Monti, P Benedetti Panici
OBJECTIVE: Isthmocele represents a reservoir on the anterior wall of the uterine isthmus or of the cervical canal at the site of a previous cesarean delivery scar. Recently, it has been clarified that it might be the cause of several gynecologic symptoms, as most common abnormal uterine bleeding. Hysteroscopy and trans-vaginal ultrasound are considered the gold standard for the diagnosis of this defect. Resectoscopic treatment can be considered effective in small size defects, but no randomized clinical trials are available...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28815020/advances-on-minimally-invasive-approach-for-benign-total-hysterectomy-a-systematic-review
#3
REVIEW
Marina de Paula Andres, Giuliano Moysés Borrelli, Mauricio Simões Abrão
Hysterectomy is one of the most commonly performed gynecologic surgeries, mainly for uterine myomas, abnormal uterine bleeding, and prolapses. It can be performed through several routes, each of which has its advantages and disadvantages. We conducted this systematic review to evaluate recent advances in surgical outcomes of benign total hysterectomies by any route: vaginal (VH), laparoscopic (LH), laparoscopically assisted vaginal (LAVH), single-port (SP), and robotic-assisted laparoscopy (RH). The search was applied to the PubMed electronic database by using keywords "hysterectomy" and "uterine benign disease", "adenomyosis", and "myoma"...
2017: F1000Research
https://www.readbyqxmd.com/read/28803811/office-operative-hysteroscopy-an-update
#4
REVIEW
Christina Alicia Salazar, Keith Isaacson
Hysteroscopy is considered the gold standard for evaluation of intracavitary pathology associated with both pre- and postmenopausal patients with abnormal uterine bleeding as well as part of the evaluation of infertility patients with suspected cavity abnormalities. Office-based operative hysteroscopy allows patients to resume activities immediately and successfully integrates clinical practice into a "see and treat" modality, avoiding the added risks of undergoing anesthesia and the inconvenience of going to the operating room...
August 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28796898/comparison-of-the-levonorgestrel-releasing-intrauterine-system-hysterectomy-and-endometrial-ablation-for-heavy-menstrual-bleeding-in-a-decision-analysis-model
#5
REVIEW
Michelle Louie, Jennifer Spencer, Stephanie Wheeler, Victoria Ellis, Tarek Toubia, Lauren D Schiff, Matthew T Siedhoff, Janelle K Moulder
BACKGROUND: A better understanding of the relative risks and benefits of common treatment options for abnormal uterine bleeding (AUB) can help providers and patients to make balanced, evidence-based decisions. OBJECTIVES: To provide comparative estimates of clinical outcomes after placement of levonorgestrel-releasing intrauterine system (LNG-IUS), ablation, or hysterectomy for AUB. SEARCH STRATEGY: A PubMED search was done using combinations of search terms related to abnormal uterine bleeding, LNG-IUS, hysterectomy, endometrial ablation, cost-benefit analysis, cost-effectiveness, and quality-adjusted life years...
August 10, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28796688/optimal-order-of-successive-office-hysteroscopy-and-endometrial-biopsy-for-the-evaluation-of-abnormal-uterine-bleeding-a-randomized-controlled-trial
#6
Papri Sarkar, Emad Mikhail, Robyn Schickler, Shayne Plosker, Anthony N Imudia
OBJECTIVE: To estimate the optimal order of office hysteroscopy and endometrial biopsy when performed successively for evaluation of abnormal uterine bleeding. METHODS: Patients undergoing successive office hysteroscopy and endometrial biopsy were included in a single-blind, prospective, randomized trial. The primary outcome was to evaluate the effect of order of procedures on patients' pain score. Prespecified secondary outcomes include procedure duration, hysteroscopic visualization of the uterine cavity, endometrial sample adequacy, and number of attempts at biopsy...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28795408/novasure-radiofrequency-endometrial-ablation-for-the-management-of-acute-abnormal-uterine-bleeding
#7
Shamma Al-Inizi
Radiofrequency endometrial ablation resulted in abrupt cessation of acute abnormal uterine bleeding in one case, avoiding emergency hysterectomy. Acute abnormal uterine bleeding (AUB) unrelated to pregnancy is defined as an episode of bleeding that is sufficient in volume in the opinion of the treating clinician to require urgent or emergency intervention.(1) Acute AUB is a distressing condition that poses a challenge for clinicians and consumes healthcare resources. This article is protected by copyright. All rights reserved...
August 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28794456/activated-nk-cells-cause-placental-dysfunction-and-miscarriages-in-fetal-alloimmune-thrombocytopenia
#8
Issaka Yougbaré, Wei-She Tai, Darko Zdravic, Brigitta Elaine Oswald, Sean Lang, Guangheng Zhu, Howard Leong-Poi, Dawei Qu, Lisa Yu, Caroline Dunk, Jianhong Zhang, John G Sled, Stephen J Lye, Jelena Brkić, Chun Peng, Petter Höglund, B Anne Croy, S Lee Adamson, Xiao-Yan Wen, Duncan J Stewart, John Freedman, Heyu Ni
Miscarriage and intrauterine growth restriction (IUGR) are devastating complications in fetal/neonatal alloimmune thrombocytopenia (FNAIT). We previously reported the mechanisms for bleeding diatheses, but it is unknown whether placental, decidual immune cells or other abnormalities at the maternal-fetal interface contribute to FNAIT. Here we show that maternal immune responses to fetal platelet antigens cause miscarriage and IUGR that are associated with vascular and immune pathologies in murine FNAIT models...
August 9, 2017: Nature Communications
https://www.readbyqxmd.com/read/28782473/importance-of-hemolysis-and-its-clinical-detection-in-neonates-with-hyperbilirubinemia
#9
Ronald J Wong, Vinod K Bhutani, David K Stevenson
Neonatal hyperbilirubinemia is generally a benign transitional phenomenon, and may even be a protective antioxidant mechanism for human neonates who may be vulnerable to the oxidative stress (compared to life in utero) encountered during birth an extra-uterine oxidative environment (1, 2). The pathophysiologic impact of neonatal unconjugated hyperbilirubinemia has been well reviewed in this supplement (see Jon fill-in). The severity of hyperbilirubinemia varies due to the magnitude of an imbalance between two major contributing processes: (i) an increase bilirubin production rate due to an increase in heme turnover (two to three times that of an adult) due to the degradation of fetal red blood cells (RBCs), which have a shortened lifespan, after birth (3, 4); and/or (ii) a diminished ability of the immature newborn liver to conjugate bilirubin and therefore excrete bilirubin in bile...
August 7, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28780893/abnormal-uterine-bleeding-in-perimenopause
#10
S R Goldstein, M A Lumsden
Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office or primary-care setting. The wider availability of diagnostic tools has allowed prompt diagnosis and treatment of an increasing number of menstrual disorders in an office setting. This White Paper reviews the advantages and disadvantages of transvaginal ultrasound, blind endometrial sampling and diagnostic hysteroscopy. Once a proper diagnosis has been established, appropriate therapy may be embarked upon...
August 7, 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/28763739/risk-of-malignancy-on-suspicion-of-polyps-in-menopausal-women
#11
Sandra Bel, Camille Billard, Julien Godet, Victor Viviani, Cherif Akladios, Aline Host, Emilie Faller, Thomas Boisrame, Michel Hummel, Jean-Jacques Baldauf, Lise Lecointre, Olivier Garbin
Improved performances in gynaecological ultrasonography have enabled an increasing number of often asymptomatic endometrial polyps to be detected. Most of these polyps are removed surgically, as a precautionary measure, so as not to miss a case of endometrial cancer. Nonetheless, this management strategy is based solely on the sonographer's judgement and a number of these operations, which are probably of no benefit, could be avoided. In order to do so, risk factors for malignancy need to be identified. OBJECTIVE: Estimate the prevalence of lesions in menopausal patients with a pre-operative diagnosis of endometrial polyp...
July 15, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28750966/the-effectiveness-of-osteopathic-manipulative-treatment-in-an-abnormal-uterine-bleeding-related-pain-and-health-related-quality-of-life-hr-qol-a-case-report
#12
Kanu Goyal, Manu Goyal, Kanimozhi Narkeesh, Asir John Samuel, Sorabh Sharma, Subhasish Chatterjee, Narkeesh Arumugam
Abnormal uterine bleeding is characterized by painful and/or excessive menorrhea, chronic pelvic pain due to the endometriosis (Em). Osteopathic treatment is commonly used in the gynecological dysfunctions. The aim of the present case study was to explore the effect of osteopathic treatment (OT) for a woman with abnormal uterine bleeding related pain and quality of life (QoL). We reported a case of 29 year old female who presented with chief complaints of increased flow during periods, lower abdominal pain, leukorrhoea, lower back pain and with occasional constipation for the last 3 years...
July 2017: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/28739414/conservative-surgery-for-adenomyosis-and-results-a-systematic-review
#13
REVIEW
Grace Younes, Togas Tulandi
The traditional treatment for women with symptomatic adenomyosis is hysterectomy. However, reproductive aged women should be managed with less invasive treatments including medical treatment. For patients who are refractory or unsuitable to long term medical treatment, or those with focal adenomyoma, conservative surgeries could be offered. The objective of our study was to review available conservative surgeries for the treatment of adenomyosis, their complications, and the rates of success and recurrence...
July 21, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28730844/correlation-between-uterine-artery-doppler-indices-and-menstrual-irregularities-among-levonorgestrel-releasing-intrauterine-system-and-depot-medroxyprogesterone-acetate-users-a-prospective-observational-study
#14
Mohamed Rezk, Alaa Al-Halaby, Mohamed Emarh, Mohamed Shawky
OBJECTIVE: To ascertain whether menstrual irregularities among users of levonorgestrel releasing intrauterine system (LNG-IUS) and depot medroxyprogesterone acetate (DMPA), were associated with changes in uterine artery Doppler indices or not. METHODS: This three-year prospective observational study included 102 women using LNG-IUS and 104 women using DMPA for contraception. Participants were followed at regular intervals over three years with performance of transvaginal ultrasound to measure uterine artery pulsatility index (PI) and resistance index (RI) before starting the method and at six months, 12 months, two and three years thereafter...
July 21, 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/28727125/usefulness-of-saline-infusion-sonohysterography-and-feeding-artery-imaging-in-endometrial-polyp-diagnosis
#15
Marcin Anioł, Grażyna Dec, Katarzyna Wojda, Piotr Sieroszewski
OBJECTIVES: The aim of this study was to assess the usefulness of sonohysterography with feeding artery visualization using transvaginal sonography to diagnose endometrial polyps. MATERIAL AND METHODS: We conducted an observational study of 60 perimenopausal patients referred to the Department of Fetal Medicine and Gynaecology, Medical University of Lodz with abnormal uterine bleeding or suspicion of endometrial pathology based on sonography scan. In all 60 patients transvaginal sonography scan showed a possibility of an endometrial polyp...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28716637/update-on-the-management-of-abnormal-uterine-bleeding
#16
Y Levy-Zauberman, A-G Pourcelot, P Capmas, H Fernandez
Abnormal uterine bleeding (AUB) is a common complaint that affects large numbers of women from puberty to menopause. It negatively affects health by causing anemia, and impacts the quality of life of women affected. AUB also has an economic impact for both women and society. Therefore, it should not be under- or overestimate and diagnosis, investigations and treatment should be proposed, taking into account the scientific data available in the current state of medical knowledge. Using the new terminology and etiologic classification of AUB is essential to communicate properly around the subject...
July 15, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28711132/additional-conditions-amenable-to-observation-care
#17
REVIEW
Matthew A Wheatley
ED observation units (EDOUs) are designed for patients who require diagnostics or therapeutics beyond the initial ED visit to determine the need for hospital admission. Best evidence is that this care be delivered via ordersets or protocols. Occasionally, patients present with conditions that are amenable to EDOU care but fall outside the commonly used protocols. This article details a few of these conditions: abnormal uterine bleeding, allergic reaction, alcohol intoxication, acetaminophen overdose and sickle cell vaso-occlusive crisis...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28706412/uterine-adenofibroma-an-unsual-cause-of-nonpuerperal-uterine-inversion-in-postmenopausal-female
#18
Latika Chawla, Richa Vatsa, Kallol Kumar Roy, Sunesh Kumar
Uterine adenofibroma is an extremely rare benign mixed mullerian tumor, most often presenting as vaginal mass with pain and abnormal uterine bleeding in postmenopausal females. Nonpuerperal uterine inversion is also an uncommon entity. We present a rare case of nonpuerperal uterine inversion due to a uterine adenofibroma. A 56-year-old postmenopausal female presented to us with bleeding and discharge per vaginum. Examination showed a polyp. Due to associated comorbidities, polypectomy was chosen as management modality failing which laparotomy was done, and the uterus was found to be inverted through the cervix, hysterectomy was done...
April 2017: Journal of Mid-life Health
https://www.readbyqxmd.com/read/28693952/pathogenesis-of-adenomyosis-an-update-on-molecular-mechanisms
#19
REVIEW
Silvia Vannuccini, Claudia Tosti, Francisco Carmona, S Joseph Huang, Charles Chapron, Sun-Wei Guo, Felice Petraglia
Adenomyosis is a uterine disorder becoming more commonly diagnosed in women of reproductive age because of diagnostic imaging advancements. The new epidemiological scenario and the clinical evidence of pelvic pain, abnormal uterine bleeding and infertility are changing the classic perspective of adenomyosis as a premenopausal disease. In the last decade, the evaluation of multiple molecular mediators has improved our knowledge of pathogenic mechanisms of adenomyosis, supporting that this is an independent disease from endometriosis...
June 27, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28661021/outcome-of-cesarean-scar-pregnancy-a-systematic-review-and-meta-analysis
#20
REVIEW
Giuseppe Calì, Ilan E Timor-Trisch, Josè Palacios-Jaraquemada, Ana Monteaugudo, Danilo Buca, Francesco Forlani, Alessandra Familiari, Giovanni Scambia, Ganesh Acharya, Francesco D'Antonio
OBJECTIVE: To explore the outcome of women managed expectantly following a diagnosis of caesarean scar pregnancy (CSP). METHODS: The outcomes observed were: severe first trimester vaginal bleeding, clinical symptoms (abdominal pain, vaginal bleeding) requiring treatment, uncomplicated miscarriage, complicated miscarriage requiring intervention, first or second trimester uterine rupture, first or second trimester hysterectomy, third trimester bleeding, third trimester uterine rupture, third trimester hysterectomy, maternal death, occurrence of abnormally invasive placenta (AIP), prevalence of placenta percreta, ultrasound signs suggestive of AIP, liveborn fetuses...
June 29, 2017: Ultrasound in Obstetrics & Gynecology
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