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Dilation and curettage

Loren Fields, Alison Hathaway
Pregnancy of unknown location (PUL) is a descriptive term for when a woman with a positive pregnancy test has a transvaginal ultrasound that cannot determine the site of the pregnancy. While the majority of women with PUL are subsequently diagnosed with a spontaneous abortion or viable intrauterine pregnancy, 7% to 20% of these women have an ectopic pregnancy. The potential for morbidity and mortality related to an ectopic pregnancy means that considerable care is necessary in the evaluation and management of women with PUL...
October 25, 2016: Journal of Midwifery & Women's Health
Erin Pearson, Kamal Kanti Biswas, Kathryn L Andersen, Caroline Moreau, Rezwana Chowdhury, Sharmin Sultana, S M Shahidullah, Pamela J Surkan, Michele R Decker
OBJECTIVES: Using the social determinants framework as a guide, this study sought to understand correlates of post-abortion contraceptive use at the individual, family and abortion service delivery levels. STUDY DESIGN: This prospective study assessed correlates of contraceptive use four months post-abortion and timing of initiation using a facility-based sample of 398 abortion clients who selected pills, condoms, injectables or no method immediately following the procedure...
October 12, 2016: Contraception
Maryam Niknejadi, Firoozeh Ahmadi, Farnaz Akhbari
Placental site trophoblastic tumor (PSTT) is a very rare variant of gestational trophoblastic tumor. It can occur after normal termination of pregnancy or spontaneous abortion and ectopic or molar pregnancy. There is a wide range of clinical manifestations from a benign condition to an aggressive disease with fatal outcome. One of the most important characteristics of PSTT, unlike other forms of gestational trophoblastic diseases (GTD) is the presence of low beta-subunit of human chorionic gonadotropin (β-hCG) levels because it is a neoplastic proliferation of intermediate trophoblastic cells...
April 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
Da Hee Kim, Seok Ju Seong, Mi Kyoung Kim, Hyo Sook Bae, Mi La Kim, Bo Seong Yun, Yong Wook Jung, Jeong Yun Shim
OBJECTIVE: To determine whether less invasive endometrial (EM) aspiration biopsy is adequately accurate for evaluating treatment outcomes compared to the dilatation and curettage (D&C) biopsy in early-stage endometrial cancer (EC) patients treated with high dose oral progestin and levonorgestrel intrauterine system (LNG-IUS). METHODS: We conducted a prospective observational study with patients younger than 40 years who were diagnosed with clinical stage IA, The International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid adenocarcinoma and sought to maintain their fertility...
August 2, 2016: Journal of Gynecologic Oncology
Yasushi Yamada, Satoshi Ohira, Teruyuki Yamazaki, Tanri Shiozawa
Ectopic molar pregnancy is extremely rare, and preoperative diagnosis is difficult. Our literature search found only one report of molar pregnancy diagnosed preoperatively. Moreover, there is no English literature depicting magnetic resonance image (MRI) findings of ectopic molar pregnancy. We report a case of ectopic molar pregnancy preoperatively diagnosed using MRI. A literature review of 31 cases of ectopic molar pregnancy demonstrated that lesions have been found in the fallopian tube (19 cases, 61%), ovary (5 cases, 16%), cornu (3 cases, 10%), peritoneum (2 cases, 6%), uterine cervix (1 case, 3%), and cesarean scar (1 case, 3%)...
2016: Case Reports in Obstetrics and Gynecology
Yanli Li, Liyan Gong, Xufeng Wu, Han Gao, Hongbing Zheng, Weishun Lan
OBJECTIVE: To compare the complication rates after uterine artery chemoembolization (UACE) followed by dilation and curettage (D&C) guided by different types of monitoring for treatment of cesarean scar pregnancy (CSP). METHODS: A randomized controlled trial was undertaken of women with CSP attending a hospital in Wuhan, China, between June 1, 2010, and June 30, 2014. Using sealed opaque envelopes containing random numbers, participants were randomly allocated to undergo D&C with hysteroscopy monitoring, ultrasonography monitoring, or no monitoring...
November 2016: International Journal of Gynaecology and Obstetrics
Yan Ouyang, Yueqiu Tan, Yan Yi, Fei Gong, Ge Lin, Xihong Li, Guangxiu Lu
STUDY QUESTION: Do early pregnancy losses (EPLs) with and without embryos differ in chromosomal distributions? SUMMARY ANSWER: The chromosomal abnormality rate is significantly higher in miscarriages with embryos than without after in vitro fertilization (IVF)-embryo transfer. WHAT IS KNOWN ALREADY: Chromosomal abnormalities are the main causes of EPLs, the rate of which is up to 24-30% in the IVF population. Little research has been conducted on the correlations between the chromosomal distributions of EPL and the existence of an embryo or with the postmortem embryonic pole length, and the existing results have been inconsistent...
October 2016: Human Reproduction
Olga Bikou, Alexander Delides, Aggeliki Drougou, Afroditi Nonni, Efstratios Patsouris, Kitty Pavlakis
BACKGROUND/AIM: Fractal dimension (FD) is widely used in medicine and biology as a tool for defining features of structure. This study aimed to compare pathological endometrium (simple-complex hyperplasia and endometrial carcinoma), as well as the endometrial changes, during the phases of the menstrual cycle. The main goal was the objective measurement of fractal dimension and to refrain from subjective evaluation. MATERIALS AND METHODS: Two thousand cases of endometrial tissue from patients who underwent dilatation and curettage (D&C) were reviewed...
September 2016: In Vivo
Jiang Du, Yaling Li, Shulan Lv, Qing Wang, Chao Sun, Xin Dong, Ming He, Qurat Ulain, Yongxing Yuan, Xiaoqian Tuo, Nasra Batchu, Qing Song, Qiling Li
PURPOSE: Endometrial carcinoma is the most common gynecologic malignancy in both developed and some developing countries. Unlike cervical cancer, for which there is routine screening, only patients symptomatic for endometrial carcinoma typically seek medical help for its diagnosis and treatment. Dilatation and curettage (D&C) has been the standard procedure for evaluating suspicious endometrial lesions. The discomfort and injury caused by the D&C procedure, however, restrict its use as a screening method for early diagnosis of endometrial lesions...
August 11, 2016: Journal of Cancer Research and Clinical Oncology
C Quesnel-García-Benítez, A Sánchez-Aranda, M J López-Rioja
BACKGROUND: Traditionally, the treatment for menorrhagia includes pharmacological therapies (hormones and uterotonics) or surgical (dilatation/curettage and hysterectomy). Recently the FDA approved a non-invasive therapeutic option, known as endometrial ablation. Which it consists in a thermal balloon delivers (ThermaChoice y Thermablate EAS) which energy destroys the uterine lining, thus reducing the bleeding and even producing amenorrhea. And could offer other benefits such as reduction of the surgical time, and therefore: anesthesia time, postoperative complications and costs...
April 2016: Ginecología y Obstetricia de México
Akshaya Kumar Mahapatro, Kundavi Shankar, Thankam Varma
Cases of Caesarean Scar Ectopic Pregnancy (CSEP) are becoming increasingly common at tertiary care hospitals because of increase in rate of CS. This condition is often complicated by life threatening bleeding, uterine rupture, which might require hysterectomy leading to permanent infertility. Management can be medical, surgical or combined depending on the clinical presentation. It includes systemic methotrexate or local uterine artery chemoembolisation, dilatation and curettage, excision of trophoblastic tissue either by laparoscopy or laparotomy with uterine repair...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Kavitha Krishnamoorthy, Sabrina Gerkowicz, Usha Verma
A complete hydatidiform mole with a viable coexisting fetus (CMCF) is a rare occurrence. Similarly, Mullerian anomalies such as a bicornuate uterus are uncommon variants of normal anatomy. We report a case of a 40-year-old female with a known bicornuate uterus presenting at 13 weeks gestation with vaginal bleeding. Ultrasound findings showed a healthy viable pregnancy in the right horn with complete molar pregnancy in the left horn. After extensive counseling, the patient desired conservative management, however, was unable to continue due to profuse vaginal bleeding...
2016: Journal of Clinical Imaging Science
Suji Uhm, Rachel Pope, Amy Schmidt, Corinne Bazella, Lisa Perriera
OBJECTIVE: To evaluate whether home visits for contraceptive implant insertion result in an increase in postpartum uptake compared to clinic insertion and to assess the feasibility of home insertions. STUDY DESIGN: We randomized women within ten weeks of a birth or dilation and curettage for abortion or miscarriage to home or standard office insertion. The primary outcome was successful insertion of the implant. To achieve 80% power to detect a 40% difference in visit attendance, 20 women were assigned to each group...
June 29, 2016: Contraception
Atim Udoh, Emmanuel E Effa, Olabisi Oduwole, Babasola O Okusanya, Obiamaka Okafo
BACKGROUND: A septic abortion refers to any abortion (spontaneous or induced) complicated by upper genital tract infection including endometritis or parametritis. The mainstay of treatment of septic abortion is antibiotic therapy alone or in combination with evacuation of retained products of conception. Regimens including broad-spectrum antibiotics are routinely recommended for treatment. However, there is no consensus on the most effective antibiotics alone or in combination to treat septic abortion...
July 1, 2016: Cochrane Database of Systematic Reviews
M J Kanis, J Rahaman, E L Moshier, K Zakashansky, L Chuang, V Kolev
PURPOSE: To evaluate sensitivity and specificity of pre-operative and frozen section pathologic evaluation (FSA) in predicting high-risk (HR) histology endometrial cancer. MATERIALS AND METHODS: A retrospective analysis was performed on all patients diagnosed with endometrial cancer at a single institution. Medical records were abstracted for baseline characteristics, surgical reports for staging, and final histology was confirmed by a gynecologic pathologist. RESULTS: 868 patients were identified...
2016: European Journal of Gynaecological Oncology
Hsiu-Huei Peng, Zooi-Ping Ng, Yun-Hsin Tang, Angelica Anne A Chua, Kuan-Gen Huang
OBJECTIVE: Term pregnancy with choriocarcinoma is a rare condition that can be a serious health threat to both the mother and the fetus. We present a rare case of term pregnancy with choriocarcinoma presenting as severe fetal anemia and postpartum hemorrhage. CASE REPORT: A 34-year-old woman, gravida 3 para 2, was admitted for profuse vaginal bleeding 2 weeks after cesarean delivery of a full-term anemic baby. Transvaginal sonography revealed a 4.7-cm×10.6-cm heterogenous lesion in the endometrial cavity...
June 2016: Taiwanese Journal of Obstetrics & Gynecology
Melissa Lavecchia, Stephanie Klam, Haim Arie Abenhaim
OBJECTIVES: Medical management is commonly used among women with early pregnancy failure. The purpose of our study was to evaluate uterine content sonographic measurements for predicting medical management failure in early pregnancy loss. METHODS: We conducted a retrospective cohort study in a university-affiliated hospital center including all women discharged from the emergency department (ED) with a diagnosis of early pregnancy failure who had medical management with misoprostol between 2011 and 2013...
August 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Aashima Arora, Ajitabh Shukla, Subhas Chander Saha
PURPOSE OF STUDY: Dilatation and curettage (D&C) and fractional curettage (F/C) are commonly performed gynecological procedures. Randomized controlled trials have concluded that topical anesthesia effectively reduces pain in endometrial sampling and hysteroscopy. Our study was aimed at investigating this modality of pain relief in setting of a developing country where, due to lack of resources, successful completion of these procedures in an outpatient setting is a necessity. METHODS: This study was a prospective, randomized, placebo-controlled, double-blind study conducted in 84 patients...
June 2016: Journal of Obstetrics and Gynaecology of India
Hui Zhang, Jia Wen, Pi-Li Xu, Rui Chen, Xi Yang, Lian-Er Zhou, Ping Jiang, An-Xia Wan, Qin-Ping Liao
BACKGROUND: Liquid-based cytology (LBC) offers an alternative method to biopsy in screening endometrial cancer. Cell block (CB), prepared by collecting residual cytological specimen, represents a novel method to supplement the diagnosis of endometrial cytology. This study aimed to compare the specimen adequacy and diagnostic accuracy of LBC and CB in the diagnosis of endometrial lesions. METHODS: A total of 198 women with high risks of endometrial carcinoma (EC) from May 2014 to April 2015 were enrolled in this study...
June 20, 2016: Chinese Medical Journal
Ashley R Gilman, Kathryn M Dewar, Stephanie A Rhone, Margo R Fluker
OBJECTIVE: To examine the incidence of intrauterine adhesions (IUA) following the management of miscarriage in women with previously documented normal uterine cavities. METHODS: We conducted a retrospective cohort study from two fertility clinics with standard practice protocols for evaluating the uterine cavity prior to infertility treatment and following clinical pregnancy loss. A database query and manual chart review identified 144 women with normal uterine cavities who experienced a miscarriage between January 2010 and November 2012 and returned to the clinic for follow-up hysteroscopy...
May 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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