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Dilation and curettage

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https://www.readbyqxmd.com/read/29184874/persistent-low-level-elevation-of-serum-human-chorionic-gonadotropin-after-termination-of-pregnancy-a-rare-case-of-peritoneal-trophoblastic-implant
#1
Hye Won Seo, Min Jin Jeong, Jung Namkung, Chan Joo Kim, Ji Young Kwon
Peritoneal trophoblastic implant can occur after treatment of ectopic pregnancy. Similarly, after termination of intrauterine pregnancy, trophoblastic implants are rare but can be a complication of perforation during dilatation and curettage. We report an extremely rare case of trophoblastic implant on the myometrium, ovarian surface, and peritoneal wall 4 months after uncomplicated dilatation and curettage. To the best of our knowledge, this is the first case of peritoneal trophoblastic implant following dilatation and curettage without uterine perforation...
November 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29181211/placenta-percreta-in-first-trimester-after-multiple-rounds-of-failed-medical-management-for-a-missed-abortion
#2
Jaimin Shah, Eduardo Matta, Fernando Acosta, Natalia Golardi, Cristina Wallace-Huff
Background: The detection of a morbidly adherent placenta (MAP) in the first trimester is rare. Risk factors such as multiparity, advanced maternal age, prior cesarean delivery, prior myomectomy, placenta previa, or previous uterine evacuation place patients at a higher risk for having abnormal placental implantation. If these patients have a first trimester missed abortion and fail medical management, it is important that providers have a heightened suspicion for a MAP. Case: A 24-year-old G4P3003 with 3 prior cesarean deliveries underwent multiple rounds of failed medical management for a missed abortion...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29154933/opioid-prescription-and-patient-use-following-gynecologic-procedures-a-survey-of-patients-and-providers
#3
Kendall C Griffith, Nisse V Clark, Andrea L Zuckerman, Tanaz R Ferzandi, Kelly N Wright
STUDY OBJECTIVE: To describe opioid distribution and patient use following gynecologic procedures. DESIGN: This is a survey study of physicians and patients composed of two parts: 1) a physician survey on opioid prescribing practices following gynecologic procedures, and 2) a patient survey on opioid consumption following hysterectomy. DESIGN CLASSIFICATION: III SETTING: An urban academic tertiary care hospital. SUBJECTS: 96 gynecologists in the Boston-area...
November 14, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29147816/development-of-pseudoaneurysm-in-cesarean-section-scar-pregnancy-a-case-report-and-literature-review
#4
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/29138602/improved-adequacy-of-endometrial-tissue-sampled-from-postmenopausal-women-using-the-myosure-lite-hysteroscopic-tissue-removal-system-versus-conventional-curettage
#5
Peter Rosenblatt, Sara Barcia, Anthony DiSciullo, Hussein Warda
Objective: To compare the diagnostic suitability of endometrial tissues obtained from postmenopausal women using the MyoSure Lite tissue removal system versus conventional curettage. Materials and methods: Endometrial tissue was sampled in hysteroscopically normal extirpated uteri from seven postmenopausal women (65.9±6.6 years old) using both hysteroscopicguided morcellation and curettage (two quadrants/uterus with each method). Endometrial sampling was performed immediately after hysterectomy for benign reasons unrelated to uterine pathology...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/29124818/diagnosis-and-management-of-patients-with-enhanced-myometrial-vascularity-associated-with-retained-products-of-conception
#6
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/29121880/comparison-of-different-therapeutic-strategies-for-complete-hydatidiform-mole-in-women-at-least-40%C3%A2-years-old-a-retrospective-cohort-study
#7
Peng Zhao, Qinqing Chen, Weiguo Lu
BACKGROUND: There are three main therapeutic strategies, namely expectant management (dilation and curettage only), prophylactic chemotherapy and prophylactic total hysterectomy for treating older women with complete hydatidiform mole (CHM). However, the scientific community has so far, not unanimously accepted the above-mentioned methods. The objective of this study was to evaluate the effectiveness of these therapeutic strategies in preventing post-molar gestational trophoblastic neoplasia (GTN) pertaining to patients with CHM who were at least 40 years old...
November 9, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29078976/abnormal-uterine-bleeding-including-coagulopathies-and-other-menstrual-disorders
#8
REVIEW
Efthimios Deligeoroglou, Vasileios Karountzos
Abnormal Uterine Bleeding (AUB) is a frequent cause of visits to the emergency department and a major reason for concern among adolescents and their families. The most common cause of AUB, in otherwise healthy adolescents, is ovulatory dysfunction, although 5-36% of adolescents who present with heavy menstrual bleeding, have an underlying bleeding disorder (BD). The most common form of BDs is von Willebrand Disease, reflecting 13% of adolescents with AUB. Management of AUB depends on the underlying etiology, the bleeding severity, as well as the need for hospitalization...
October 9, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29059454/new-evidence-to-guide-ectopic-pregnancy-diagnosis-and-management
#9
Paula C Brady
Importance: Ectopic pregnancy is a leading source of morbidity and mortality in pregnancy, accounting for 1% to 2% of all pregnancies. Timely diagnosis and management of these abnormal gestations are vital to patient safety. Objective: The objective of this study was to describe recent evidence in the risk factors, diagnosis, and management of ectopic pregnancy. Evidence Acquisition: Comprehensive review of the published literature. Results: Recent literature describes newly identified risk factors for ectopic pregnancy, particularly those specific to assisted reproduction...
October 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29057431/is-routine-performance-of-the-uterine-cervix-canal-curettage-prior-to-the-curettage-of-the-uterine-cavity-justified
#10
Szymon Piątek, Jacek Lipa, Monika Górska, Katarzyna Malecha, Grzegorz Panek, Mirosław Wielgoś
OBJECTIVES: Endocervical curettage (ECC) together with the dilatation and curettage of the uterine cavity (D & C) is routinely performed in everyday clinical practice. The aim of this study is to assess the rationale of the performance of ECC prior to D & C in indications other than abnormal uterine bleeding (AUB). MATERIAL AND METHODS: Case histories of 736 patients after ECC performed in the 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, were analyzed retrospectively, the indications for the procedure - age, menopausal status, parity, procedure operator's experience - as well as the result of the histopathology examination were taken into account...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/29052024/multimodality-imaging-in-secondary-postpartum-or-postabortion-hemorrhage-retained-products-of-conception-and-related-conditions
#11
REVIEW
Yuko Iraha, Masahiro Okada, Masafumi Toguchi, Kimei Azama, Keiko Mekaru, Tadatsugu Kinjo, Wataru Kudaka, Yoichi Aoki, Hajime Aoyama, Akiko Matsuzaki, Sadayuki Murayama
Secondary postpartum hemorrhage (PPH) and postabortion hemorrhage are rare complications. Retained products of conception (RPOC) is among the most common causes of both secondary PPH and postabortion hemorrhage. Other less common causes of secondary PPH are uterine vascular abnormalities such as arteriovenous malformations and pseudoaneurysms. These are usually related to a history of a procedure such as dilation and curettage or cesarean delivery. Subinvolution of the placental site is an idiopathic cause of secondary PPH; this condition may be underrecognized and therefore could have a higher incidence than currently reported...
October 19, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/29027718/hypervascular-retained-product-of-conception-characteristic-magnetic-resonance-imaging-and-possible-relationship-to-placental-polyp-and-pseudoaneurysm
#12
Yuji Shiina, Takatomo Itagaki, Hiroya Ohtake
The cases of two patients who developed myometrial vascularization following dilatation and curettage are described. In case 1, pathological diagnosis was possible with the resected specimens. This patient had hypervascular retained products of conception (RPOC). In case 2, the natural course of this pathological condition was observed, confirming a process of regression during repeated withdrawal bleeding. The three principal magnetic resonance imaging (MRI) findings in these cases were: (i) presence of a remnant; (ii) breaking of the junctional zone in contact with the remnant; and (iii) vascularization/flow voids infiltrating into the myometrium from the broken junctional zone...
October 13, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28971636/comparison-between-lornoxicam-and-paracetamol-for-pain-management-after-dilation-and-curettage-for-abortion
#13
Susana Mustafa-Mikhail, Sharon Assaraf, Philippe Abecassis, Hanin Dabaja, Samer Jarrous, Salim Hadad, Lior Lowenstein
BACKGROUND: Management of postoperative pain has become a growing concern, even for minor gynecological procedures. Proper postoperative pain management has been shown to lead to earlier mobilization, shortened hospital stay, and increased patient satisfaction. The optimal means of reducing the pain of pregnancy termination has not yet been determined. OBJECTIVES: To compare the efficiency in pain management of two drugs, lornoxicam and paracetamol, given intravenously postoperatively to women who underwent abortion with dilation and curettage...
September 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28953115/frequency-of-adequate-endometrial-biopsy-in-evaluation-of-postmenopausal-women-with-benign-endometrial-cells-on-pap-test
#14
Jeffrey W Hastings, Meredith J Alston, Sara E Mazzoni, Elaine Stickrath
OBJECTIVE: The aim of the study was to determine the frequency that endometrial biopsies (EMBs) performed on postmenopausal (PMP) women with benign endometrial cells (BECs) on Pap test are adequate for assessing malignancy or hyperplasia. METHODS: This is a case series including all PMP women older than 55 years at a single academic institution between January 2008 and September 2015 with a Pap test result including BEC. Patients were identified via an internal cytology database...
October 2017: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/28939480/hysteroscopic-removal-of-retained-products-of-conception-implanted-over-a-focal-area-of-adenomyosis-a-case-report
#15
Luis Alonso, Laura Nieto, Jose Carugno
STUDY OBJECTIVE: To describe a technique for hysteroscopic removal of retained products of conception (RPOC) implanted over an area of adenomyosis. DESIGN: A case report (Canadian Task Force classification III). SETTING: RPOC is an unfortunate complication that may occur after the resolution of a normal pregnancy; it is more common after early pregnancy termination or spontaneous miscarriage [1]. Immediate consequences of RPOC include persistent vaginal bleeding, abdominal pain, pelvic infection, fever, and dilated cervix...
September 20, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28885397/accuracy-of-endometrial-sampling-in-endometrial-carcinoma-a-systematic-review-and-meta-analysis
#16
REVIEW
Nicole C M Visser, Casper Reijnen, Leon F A G Massuger, Iris D Nagtegaal, Johan Bulten, Johanna M A Pijnenborg
OBJECTIVE: To assess the agreement between preoperative endometrial sampling and final diagnosis for tumor grade and subtype in patients with endometrial carcinoma. DATA SOURCES: MEDLINE, EMBASE, ClinicalTrials.gov, and the Cochrane library were searched from inception to January 1, 2017, for studies that compared tumor grade and histologic subtype in preoperative endometrial samples and hysterectomy specimens. METHODS OF STUDY SELECTION: In eligible studies, the index test included office endometrial biopsy, hysteroscopic biopsy, or dilatation and curettage; the reference standard was hysterectomy...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28827296/septic-abortion-presenting-as-a-right-lower-trapezius-abscess-secondary-to-bacteroides-fragilis-bacteraemia
#17
Yusuke Yamanaka, Akira Shimabukuro
A 43-year-old Japanese woman was evaluated in the outpatient department for right shoulder pain and fever, which began 5 days earlier. MRI of the right shoulder revealed a high-intensity area deep in the right trapezius muscle. Aspiration revealed purulent fluid, and Gram staining of the fluid showed Gram-negative bacilli. The patient was also found to be profoundly anaemic and to have a positive urine pregnancy test. On admission, we initiated intravenous ampicillin-sulbactam and aztreonam. She underwent dilatation and curettage for septic abortion and surgical drainage of the right shoulder abscess...
August 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28755018/outcomes-of-nonsurgical-versus-surgical-treatment-of-cesarean-scar-pregnancies-in-the-first-trimester
#18
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
#19
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
#20
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
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