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https://www.readbyqxmd.com/read/28755018/outcomes-of-nonsurgical-versus-surgical-treatment-of-cesarean-scar-pregnancies-in-the-first-trimester
#1
Erin E Washburn, Katherine Pocius, Daniela Carusi
PURPOSE: To compare outcomes of nonsurgical versus surgical treatment of Cesarean scar pregnancies (CSP) in the first trimester and identify optimal treatment methods for CSP. METHODS: Retrospective cohort study of all women diagnosed and treated with CSP in the first trimester at a single tertiary care center from 2000-2012. Main outcome measures were need for additional treatments, hemorrhage, or emergent hysterectomy. Future pregnancy outcomes were considered secondarily...
July 28, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28736365/-blighted-ovum-in-subfertile-patients-undergoing-assisted-reproductive-technology
#2
Qing-Wen Nie, Rui Hua, Yao Zhou, Hong Li, Yan-Hong Yu
OBJECTIVE: To explore the incidence and risk factors of blighted ovum in subfertile patients undergoing assisted reproductive technology (ART). METHODS: This retrospective analysis was conducted among 2378 patients who were pregnant following embryo transfer at our center from January, 2012 to December, 2015, including cases of early pregnancy losses and simultaneous live births. The cases with early pregnancy losses were divided into embryonic pregnancy and blighted ovum groups based on the presence or absence of an embryonic pole before dilation and curettage...
July 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28717722/gestational-trophoblastic-neoplasia-treatment-at-the-butaro-cancer-center-of-excellence-in-rwanda
#3
Ignace Nzayisenga, Roanne Segal, Natalie Pritchett, Mary J Xu, Paul H Park, Edgie V Mpanumusingo, Denis G Umuhizi, Donald P Goldstein, Ross S Berkowitz, Vedaste Hategekimana, Clemence Muhayimana, Fidel Rubagumya, Temidayo Fadelu, Neo Tapela, Tharcisse Mpunga, Rahel G Ghebre
PURPOSE: Gestational trophoblastic neoplasia (GTN) is a highly treatable disease, most often affecting young women of childbearing age. This study reviewed patients managed for GTN at the Butaro Cancer Center of Excellence (BCCOE) in Rwanda to determine initial program outcomes. PATIENTS AND METHODS: A retrospective medical record review was performed for 35 patients with GTN assessed or treated between May 1, 2012, and November 30, 2014. Stage, risk score, and low or high GTN risk category were based on International Federation of Gynecology and Obstetrics staging and the WHO scoring system and determined by beta human chorionic gonadotropin level, chest x-ray, and ultrasound per protocol guidelines for resource-limited settings...
December 2016: Journal of Global Oncology
https://www.readbyqxmd.com/read/28692888/underlying-mechanisms-of-retained-placenta-evidence-from-a-population-based-cohort-study
#4
Shirley Greenbaum, Tamar Wainstock, Doron Dukler, Elad Leron, Offer Erez
OBJECTIVE: To determine risk factors for retained placenta, and to identify supporting epidemiologic evidence for the three previously-proposed mechanisms: (i) invasive placentation, (ii) placental hypo-perfusion, and (iii) inadequate uterine contractility. DESIGN: A retrospective population-based cohort study. SETTING AND POPULATION: Israeli population in the southern district. METHODS: Data were analyzed from a tertiary hospital database, between 1989 and 2014, using univariate tests and generalized estimating equation (GEE) multivariable models...
June 27, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28676733/evaluation-of-paracervical-block-and-iv-sedation-for-pain-management-during-hysteroscopic-polypectomy-a-randomized-clinical-trial
#5
Zahra Asgari, Maryam Razavi, Reihaneh Hosseini, Masoumeh Nataj, Mahroo Rezaeinejad, Mahdi Sepidarkish
BACKGROUND: The aim of this study was to compare the effectiveness of paracervical block (PB) and IV sedation (IVS) on women's pain perception during operative hysteroscopy. METHODS: A total of 84 patients with uterine polyps were randomized to either PB or IV sedation or general anesthesia (GA) as control group. In PB group, the patients received oral diazepam 10 mg and 100 mg diclofenac Na suppository 60 min before surgery and 10 cc of 2% buffered lidocaine was injected at cervix...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28666477/management-of-persistent-caesarean-scar-pregnancy-after-curettage-treatment-failure
#6
Zhi-Da Qian, Yue Weng, Yong-Jiang Du, Chun-Fen Wang, Li-Li Huang
BACKGROUND: Caesarean scar pregnancy (CSP) is a late serious complication of caesarean section. The incidence of CSP has increased worldwide in recent years. Early diagnosis and prompt therapy are crucial to avoid catastrophic complications. There are various strategies for CSP treatment, but there is no consensus on the best management for CSP. Dilation and curettage (D&C) and hysteroscopy are common and effective treatments with their advantages and disadvantages. No in-depth study of the clinical effects of hysteroscopic management of CSP after D&C treatment failure has been conducted...
July 1, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28634754/value-of-endometrial-thickness-assessed-by-transvaginal-ultrasound-for-the-prediction-of-endometrial-cancer-in-patients-with-postmenopausal-bleeding
#7
Amelie Schramm, Florian Ebner, Emanuel Bauer, Wolfgang Janni, Ulrike Friebe-Hoffmann, Miriam Pellegrino, Nikolaus De Gregorio, Thomas W P Friedl
PURPOSE: Histological confirmation of endometrial cancer by dilatation/curettage (D/C) in women with postmenopausal bleeding (PMB) can be challenging due to anesthesiological and/or surgical risks. Thus, less invasive methods for diagnostics are required to identify patients with minimal risk for endometrial cancer (EC) to avoid unnecessary surgical intervention. The objective of this single-center cohort study was to assess the diagnostic validity of transvaginal ultrasound (TVUS) measurements of endometrial thickness (ET) in patients with PMB for the detection of EC...
August 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28634752/comparison-of-three-treatment-strategies-for-cesarean-scar-pregnancy
#8
Guangquan Liu, Jiacong Wu, Jian Cao, Yunping Xue, Chencheng Dai, Juan Xu, Xuemei Jia
PURPOSE: To explore the optimal treatment for cesarean scar pregnancy. METHOD: In total, 86 women diagnosed with a cesarean scar pregnancy were divided into three groups according to treatment. The human chorionic gonadotrophin (hCG) decline percentage, intraoperative blood loss and success rate were analyzed in Group A [combination of uterine arterial embolization (UAE), local methotrexate (MTX) injection and dilation & curettage (D&C)], Group B (combination of UAE and local MTX injection) and Group C (D&C)...
August 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28634558/plesiomonas-shigelloides-an-unusual-cause-of-septic-abortion
#9
Gilbert Cornut, Xavier Marchand-Senecal, Christiane Gaudreau, Jeremie Berdugo, Gilles Gariepy, Catherine Tremblay, Patrice Savard
Plesiomonas shigelloides, the only oxidase-positive Enterobacteriaceae, is an inhabitant of freshwater and estuary ecosystems. We report the first possible case of Plesiomonas shigelloides-induced septic abortion. This 24-year-old female was successfully treated by dilatation and curettage as well as antimicrobial therapy.
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28631355/quantitative-risk-assessment-to-guide-the-treatment-of-cesarean-scar-pregnancy
#10
Qingxian Fang, Li Sun, Yunhui Tang, Cuifeng Qian, Xiaoying Yao
OBJECTIVE: To develop a risk-factor scoring system for the prediction of bleeding during ultrasound-guided dilation and curettage (D&C) for cesarean scar pregnancy (CSP). METHODS: The retrospective study included patients with a CSP of 31-67 days who underwent transabdominal ultrasound-guided D&C in 2010-2014. Binary logistic regression analysis was used to identify risk factors for the need of Foley catheter hemostasis. The predictive accuracy of a risk-scoring system based on significant factors was evaluated by receiver operating curve analysis...
June 20, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28600047/maternal-outcome-after-conservative-management-of-abnormally-invasive-placenta
#11
Hsiu-Wei Su, Yu-Chiao Yi, Jenn-Jhy Tseng, Wei-Chih Chen, Ya-Fang Chen, Hsiao-Fan Kung, Min-Min Chou
OBJECTIVE: The purpose of this study was to describe our preliminary experience of the efficacy and safety of a conservative strategy for abnormally invasive placenta. MATERIALS AND METHODS: A retrospective review of eight pregnant women with abnormally invasive placenta (one with placenta previa accrete, three with placenta previa increta, and four with previa percreta) was performed. The diagnosis was made by prenatal ultrasonography, and was confirmed by operative and histopathological findings...
June 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28599886/cesarean-scar-pregnancies-a-systematic-review-of-treatment-options
#12
REVIEW
Sarah Maheux-Lacroix, Ms Fiona Li, Emmanuel Bujold, Erin Nesbitt-Hawes, Rebecca Deans, Jason Abbott
The objective of this systematic review is to assess the efficacy and safety of treatment options of cesarean scar pregnancies (CSP). We searched Medline, Embase, and Cochrane Library from inception to June 2016 as well as reference lists. We included English publications reporting treatment outcomes of at least 10 cases of CSP. Two authors screened for eligibility, extracted data and assessed the quality of included studies. Treatment was considered successful if no subsequent intervention was required following index treatment...
June 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28585139/relationship-between-placenta-location-and-resolution-of-second-trimester-placenta-previa
#13
Yun Feng, Xue-Yin Li, Juan Xiao, Wei Li, Jing Liu, Xue Zeng, Xi Chen, Kai-Yue Chen, Lei Fan, Su-Hua Chen
This prospective study was conducted to assess the rate of resolution of second trimester placenta previa in women with anterior placenta and posterior placenta, and that in women with and without previous cesarean section. In this study, placenta previa was defined as a placenta lying within 20 mm of the internal cervical os or overlapping it. We recruited 183 women diagnosed with previa between 20(+0) weeks and 25(+6) weeks. They were grouped according to their placenta location (anterior or posterior) and history of cesarean section...
June 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28555323/liquid-based-endometrial-cytology-associated-with-curettage-in-the-investigation-of-endometrial-carcinoma-in-a-population-of-1987-women
#14
Xi Yang, Ke Ma, Rui Chen, Jian Zhao, Cheng Wu, Naiyi Zhang, Xiuhua Ma, Ying Dong, Sainan Zhu, Qinping Liao
PURPOSE: The aim of this study was to investigate the diagnostic accuracy of liquid-based endometrial cytology, in comparison with histology. METHODS: 1987 patients scheduled for hysteroscopy were enrolled in this study. All patients proceeded sequentially through endometrial cytology, hysteroscopy and then dilatation and curettage (D&C). Cytology sampling was performed by brushing the uterus cavity using SAP-1 and the sample was prepared to liquid-based smear using SurePath technology...
May 29, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28550508/metastatic-gestational-choriocarcinoma-a-masquerader-in-obstetrics
#15
REVIEW
C M McCarthy, J Unterscheider, C Burke, J Coulter
We describe a case of a 36-year-old woman presenting with vaginal bleeding and suboptimally rising serum human chorionic gonadotropin levels, who was investigated for a pregnancy of unknown location. Ultrasonography, laparoscopy and dilatation and curettage failed to reveal signs of an intra-uterine or intra-abdominal pregnancy. Following computed tomography imaging, a mediastinal mass was histologically determined to be a gestational choriocarcinoma. Following surgical resection and chemotherapy, the patient recovered and proceeded to have a successful intra-uterine pregnancy...
May 26, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28491172/acquired-uterine-arteriovenous-fistula-following-dilatation-and-curettage-an-uncommon-cause-of-vaginal-bleeding
#16
Adam Evans, Roland E Gazaille, Richard McKenzie, Meghan Musser, Robert Lemming, Jarrod Curry, William Meyers, Nicholas Austin
Dysfunctional uterine bleeding is a common presentation of women in the emergency department. We describe the case of a 33-year-old female who presented with intermittent spotting due to an acquired uterine AVF. The patient underwent a transvaginal pelvic ultrasound as well as a CT angiogram. The patient was treated conservatively and elected to undergo uterine artery embolization in an effort to preserve fertility. She successfully delivered a healthy baby boy at 39-week gestation via an emergent caesarian section due to a prolapsed umbilical cord 17 months after undergoing the uterine artery embolization...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28487015/macroscopic-and-microscopic-morphology-of-first-trimester-miscarriage-and-subsequent-pregnancy-outcome-an-exploratory-study
#17
Isabelle M A van Gruting, Moira A Müller, Krijn van Groningen, Niek Exalto
INTRODUCTION: Reduced chorionic villous vascularization is associated with first trimester miscarriage and second trimester fetal loss. Differences in villous vascularization have been observed in combination with complications in the third trimester of pregnancy. The aim of this study was to investigate whether abnormal morphology and reduced chorionic villous vascularization in first trimester miscarriages are associated with an increased risk on adverse outcome and/or pregnancy complications in subsequent pregnancy...
May 2017: Placenta
https://www.readbyqxmd.com/read/28471117/antepartum-hemorrhage-from-previous-cesarean-sectioned-uterus-as-a-potential-sign-of-uterine-artery-pseudoaneurysm
#18
Ning Zhang, Wei-Hua Lou, Xue-Bin Zhang, Jian-Hua Lin, Wen Di
Postpartum hemorrhage (PPH), a leading cause of maternal mortality, can occur within 24 h of delivery (primary PPH), or during the period from 24 h after delivery to Week 6 of puerperium (secondary PPH). It requires health professionals to be alert to the symptoms to ensure prompt diagnosis and treatment, especially in the case of rupture of a uterine artery pseudoaneurysm (UAP) due to its life-threatening consequence (Baba et al., 2014). Most of the published case reports or case serials describe UAP as a possible cause of delayed PPH after traumatic procedures during delivery or pregnancy termination, including cesarean section (CS), manual removal of the placenta, or dilation and curettage (D&C) (Wald, 2003)...
May 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28462440/safety-and-efficacy-of-uterine-artery-embolization-in-ectopic-pregnancies-refractory-to-systemic-methotrexate-treatment-a-single-center-study
#19
Joon Ho Kwon, Gyoung Min Kim, Kichang Han, Man Deuk Kim, Jong Yun Won, Do Yun Lee
BACKGROUND: To investigate the use of uterine artery embolization (UAE) to manage ectopic pregnancies that are refractory to systemic methotrexate (MTX) therapy and plagued by persistently high serum β-human chorionic gonadotrophin (hCG) levels and vaginal bleeding. The safety and efficacy of UAE were addressed. MATERIALS AND METHODS: A retrospective review was conducted for thirteen patients (mean age 35.2 years; range 28-41 years), who were treated between December 2006 and June 2016...
May 1, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28441840/-atypical-polypoid-adenomyoma-of-the-uterus-a-clinicopathological-review-of-27-cases
#20
T J Bai, D M Bao, Y Li, Y Wang, H Cui, H L Zhu
Objective: To investigate the clinical and pathological characteristics of atypical polypoid adenomyoma (APA) for improvement of the diagnosis, different diagnosis and treatment of the disease. Methods: The clinical data, pathological characteristics, and the follow-up information were retrospectively analyzed in 27 cases of APA admitted in Peking Univeristy People's Hospital from 2007 to 2016. Results: The median age was 42.6 years old (range 25-60 years old). Fifteen patients were nullipara, 2 patients were postmenopausal...
April 25, 2017: Zhonghua Fu Chan Ke za Zhi
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