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https://www.readbyqxmd.com/read/27836091/initial-management-of-postpartum-hemorrhage-a-cohort-study-in-benin-and-mali
#1
Julie Tort, Mamadou Traoré, Benjamin Hounkpatin, Cécile Bodin, Patrick Rozenberg, Alexandre Dumont
OBJECTIVE: To determine the components of initial management associated with a decreased risk of severe postpartum hemorrhage (PPH) in Benin and Mali. METHODS: A cohort study was conducted between May 2013 and September 2014 that included all women who delivered vaginally in seven participating centers and who presented excessive bleeding after birth. Severe PPH was defined as PPH that required surgical treatment (vascular ligature and/or hysterectomy), and/or blood transfusion, and/or transfer to an intensive care unit, and/or an outcome of maternal death...
November 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/27718296/which-type-of-placenta-previa-requires-blood-transfusion-more-frequently-a-new-concept-of-indiscernible-edge-total-previa
#2
Yosuke Baba, Hironori Takahashi, Akihide Ohkuchi, Rie Usui, Shigeki Matsubara
AIM: During cesarean section (CS) for placenta previa (PP), the size/area/portion of the lower uterine segment occupied by the placenta may affect the bleeding amount and the subsequent need for a blood transfusion (BT). We propose a new concept, indiscernible edge total PP (IEPP), when vaginal ultrasound does not discern the lower placental edge because the placenta covers the visible lower segment. We characterized IEPP, focusing on its allogeneic BT requirement. METHODS: We classified PP (n = 307) into four types: marginal, partial, discernible edge total PP (DEPP) and IEPP: internal ostium (os)-placental edge distance measurable or unmeasurable on vaginal ultrasound in DEPP or IEPP, respectively...
October 8, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27651652/efficacy-of-use-of-long-term-low-dose-mifepristone-for-the-treatment-of-fibroids
#3
Anupam Kapur, Ranjeeta Angomchanu, Madhusudan Dey
BACKGROUND: Fibroid or myoma is the commonest reported tumor of uterus, and is one of the important reasons for hysterectomy in our setting. Different drugs are available for medical management of fibroid uterus including mifepristone, a progesterone antagonist. Varying dosage regimen for mifepristone was studied as medical management of fibroid uterus. The aim of the project was to study the effect of mifepristone on the symptoms and size of fibroids, especially using a low-dose regimen for 6 months...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27627607/successful-conservative-treatment-of-cervical-pregnancy-with-uterine-artery-embolization-followed-by-curettage-a-report-of-19-cases
#4
J Hu, X Tao, L Yin, Y Shi
OBJECTIVE: The purpose of this retrospective study was to evaluate the safety and efficacy of uterine artery embolization (UAE) followed by curettage for conservative management of cervical pregnancy. DESIGN: Retrospective review. SETTING: Peking University First Hospital. SAMPLE: Patients with cervical pregnancy diagnosed by trans-vaginal ultrasound at Peking University First Hospital between January 2003 and December 2014...
September 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27610194/small-cell-neuroendocrine-tumour-of-the-endometrium-and-the-importance-of-pathologic-diagnosis
#5
Adriana Estruch, Lucas Minig, Carmen Illueca, Ignacio Romero, Jose Luis Guinot, Andrés Poveda
Small cell carcinoma of the endometrium is a very rare entity. They are very aggressive tumours, with a poor prognosis. They represent a clinical challenge because of a lack of a standardised treatment. We see here a case of a 67-year-old woman with a history of a lobular breast carcinoma, diagnosed in 2002. After presenting with postmenopausal vaginal bleeding in October 2014, she underwent a hysteroscopy-guided biopsy which revealed a metastasis of breast carcinoma. A hysterectomy and bilateral oophorectomy was performed because of uncontrolled uterine bleeding...
2016: Ecancermedicalscience
https://www.readbyqxmd.com/read/27597909/bleeding-versus-clotting-a-complex-case-of-a-large-fibroid-uterus-causing-menorrhagia-and-a-dvt
#6
Sangeeta Ramanan, Jude Chapman-Wardy, Roy Watson
A 43-year-old woman presented with severe anaemia secondary to menorrhagia. Pelvic ultrasound showed a large intramural posterior fundal fibroid. Hysteroscopy showed the fibroid distorting the endometrial cavity, precluding Mirena® device insertion. As she was initially hesitant to have a hysterectomy, medical management with the oral contraceptive pill (OCP) and tranexamic acid was instituted, with good effect. Months later, after a long road trip, she presented with left leg swelling, and a Doppler ultrasound confirmed an extensive deep vein thrombosis (DVT)...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27579179/analysis-of-a-standardized-technique-for-laparoscopic-cuff-closure-following-1924-total-laparoscopic-hysterectomies
#7
Katherine A O'Hanlan, Pamela L Emeney, Alfred Peters, Margaret S Sten, Stacey P McCutcheon, Danielle M Struck, Joseph K Hoang
Objective. To review the vaginal cuff complications from a large series of total laparoscopic hysterectomies in which the laparoscopic culdotomy closure was highly standardized. Methods. Retrospective cohort study (Canadian Task Force Classification II-3) of consecutive total and radical laparoscopic hysterectomy patients with all culdotomy closures performed laparoscopically was conducted using three guidelines: placement of all sutures 5 mm deep from the vaginal edge with a 5 mm interval, incorporation of the uterosacral ligaments with the pubocervical fascia at each angle, and, whenever possible, suturing the bladder peritoneum over the vaginal cuff edge utilizing two suture types of comparable tensile strength...
2016: Minimally Invasive Surgery
https://www.readbyqxmd.com/read/27578036/a-case-of-uterine-leiomyosarcoma-with-long-term-disease-control-by-pazopanib
#8
Satoshi Nagamata, Yasuhiko Ebina, Yumika Yamano, Takeo Miyamoto, Mitsuhiro Nishijima, Hideto Yamada
Uterine leiomyosarcoma (ULMS) is an aggressive tumor associated with high rates of progression, recurrence, and mortality. Pazopanib is the only approved molecular targeted drug for advanced soft tissue sarcoma, and it has been proven to prolong progression-free survival relative to placebo. We herein report a case of ULMS with multiple lung metastases treated with pazopanib, which led to sustained disease control for 44 weeks. A 53-year-old woman was referred to our hospital due to massive uterine bleeding from a uterine corpus tumor mass...
July 5, 2016: Kobe Journal of Medical Sciences
https://www.readbyqxmd.com/read/27485234/the-manchester-procedure-versus-vaginal-hysterectomy-in-the-treatment-of-uterine-prolapse-a-review
#9
Cæcilie Krogsgaard Tolstrup, Gunnar Lose, Niels Klarskov
INTRODUCTION AND HYPOTHESIS: Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus-preserving alternatives including the Manchester procedure (MP) are available. The objective was to evaluate if VH and the MP are equally efficient treatments for uterine prolapse with regard to anatomical and symptomatic outcome, quality of life score, functional outcome, re-operation and conservative re-intervention rate, complications and operative outcomes...
August 2, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27444140/breast-metastasis-from-vaginal-cancer
#10
Neeraja Chandrasekaran, Daniel Scharifker, George Varsegi, Zoyla Almeida
Vaginal cancer is a rare malignancy accounting for 1-2% of all pelvic neoplasms. Dissemination usually occurs through local invasion and rarely metastasises to distal locations. Metastasis of vaginal cancer to the breast is extremely infrequent and unique. A 66-year-old Asian woman presented with vaginal bleeding and was found to have a vaginal mass and a left breast mass. Pathological assessment of the biopsies revealed identical squamous cell characteristics of both masses. We describe a very rare and novel case of a distally located vaginal carcinoma with metastasis to the breast Federation of Gynecology and Obstetrics (FIGO) stage IV (FIGO IVB)...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27399986/robotic-assisted-laparoscopic-hysterectomy-for-women-with-endometrial-cancer-complications-women%C3%A2-s-experiences-quality-of-life-and-a-health-economic-evaluation
#11
Suzanne Forsyth Herling
This thesis contains four studies all focusing on women with endometrial cancer undergoing robotic-assisted laparoscopic hysterectomy (RALH). Women with endometrial cancer are typically elderly with co-morbidities. RALH is a relatively new treatment option which has been introduced and adopted over the last decade without randomised controlled trials (RCTs) to prove superiority over other surgical alternatives. The purpose of the thesis was to explore and describe patient and health economic outcomes of RALH for women with endometrial cancer using different research approaches...
July 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27393268/uterine-artery-embolization-vs-hysterectomy-in-the-treatment-of-symptomatic-uterine-fibroids-10-year-outcomes-from-the-randomized%C3%A2-emmy-trial
#12
Annefleur M de Bruijn, Willem M Ankum, Jim A Reekers, Erwin Birnie, Sanne M van der Kooij, Nicole A Volkers, Wouter J K Hehenkamp
BACKGROUND: Since 1995 uterine artery embolization has been described as an alternative for hysterectomy in patients with symptomatic fibroids. Many studies including several randomized controlled trials established uterine artery embolization as a valuable treatment. These randomized controlled trials reported outcomes in terms of health-related quality of life, clinical outcomes, efficacy, and cost-effectiveness after 1, 2, and 5 years of follow-up. OBJECTIVE: The purpose of this study was to compare clinical outcome and health-related quality of life 10 years after uterine artery embolization or hysterectomy in the treatment of heavy menstrual bleeding caused by uterine fibroids in a randomized controlled trial...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27355003/robotically-assisted-delayed-total-laparoscopic-hysterectomy-for-placenta-percreta
#13
Devon M Rupley, Ana I Tergas, Katherine L Palmerola, William M Burke
BACKGROUND: The prevalence of morbidly adherent placenta has dramatically increased in the setting of the rising cesarean rate in the United States. Delayed surgical management of placenta accreta and its variants is emerging as methods that may significantly decrease bleeding and perioperative complications; however, optimal surgical approaches have not yet been determined. In this report, we present a case of robotic-assisted delayed interval hysterectomy in a patient with placenta percreta...
August 2016: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/27225535/diagnostic-workup-for-postmenopausal-bleeding-a-randomised-controlled-trial
#14
N van Hanegem, M C Breijer, S A Slockers, M H Zafarmand, Pmaj Geomini, R Catshoek, Jma Pijnenborg, L F van der Voet, Fphlj Dijkhuizen, Gcr van Hoecke, N Reesink-Peters, S Veersema, Mha van Hooff, Pjm van Kesteren, J A Huirne, B C Opmeer, M Y Bongers, Bwj Mol, A Timmermans
OBJECTIVE: To evaluate the effectiveness of hysteroscopy for the detection and treatment of endometrial polyps versus expectant management in women with postmenopausal bleeding (PMB), a thickened endometrium and benign endometrial sampling. DESIGN: Multicentre, randomised controlled trial. SETTING: Three academic hospitals and nine non-academic teaching hospitals in the Netherlands. POPULATION: Women with PMB, an endometrial thickness >4 mm and benign result from endometrial sampling...
May 26, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27073665/carcinosarcoma-of-the-uterus-a-case-report
#15
Yasushi Adachi, Hirofumi Nonogaki, Sachiko Minamiguchi, Ming Li, Susumu Ikehara
Carcinosarcoma is a rare malignant tumor of the uterus with a poor prognosis. We herein present a case of uterine carcinosarcoma in a 67-year-old woman suffering from pervaginal bleeding for 3 months, with progressive anemia. Upon biopsy of the endometrium, the tumor was diagnosed as endometrioid adenocarcinoma. Total hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection were performed. The histological examination revealed that the tumor consisted of serous adenocarcinoma and sarcoma of homologous components...
April 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27004231/postmenopausal-vaginal-bleeding-as-initial-presentation-of-gastric-cancer-a-case-report-with-literature-review-of-prognostic-factors-and-treatment-of-krukenberg-tumor
#16
Mehandar Kumar, Abhishek Kumar, Michael Maroules, Vanessa Abrina, Vinod Kumar
Postmenopausal vaginal bleeding is a rare presentation of Krukenberg tumor (KT). Here we report a very unusual presentation of gastric cancer in a postmenopausal female patient, who presented with complaint of vaginal bleeding. She was found to have KT of the left ovary after total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO). She was subsequently diagnosed with primary gastric cancer. To the best of our knowledge, this is the first case report of KT with a primary T1a gastric cancer and no evidence of metastasis anywhere else except for large ovarian mass...
February 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/26995947/-placenta-percreta-a-severe-obstetric-complication-despite-correct-diagnosis-a-case-report
#17
Karolina Gruca-Stryjak, Mariola Ropacka-Lesiak, Grzegorz Breborowicz
This paper presents a case of a pregnant woman with a history of two cesarean sections. The patient was admitted to the hospital because of vaginal bleeding. The ultrasound revealed a placenta covering the internal os. The placenta was characterized by heterogeneous echogenicity with visible irregular hypoechogenic areas and blurred border between the placenta and the cervix. Rich vascularity was observed on the border of the placenta, urethra and the urinary bladder. Cystoscopy showed severe congestion around the urethra...
December 2015: Ginekologia Polska
https://www.readbyqxmd.com/read/26979630/a-new-minimally-invasive-treatment-for-cesarean-scar-pregnancy-and%C3%A2-cervical-pregnancy
#18
Ilan E Timor-Tritsch, Ana Monteagudo, Terri-Ann Bennett, Christine Foley, Joanne Ramos, Andrea Kaelin Agten
BACKGROUND: Cesarean scar pregnancy and cervical pregnancy are unrelated forms of pathological pregnancies carrying significant diagnostic and treatment challenges, with a wide range of treatment effectiveness and complication rates ranging from 10% to 62%. At times, life-saving hysterectomy and uterine artery embolization are required to treat complications. Based on our previous success with using a single-balloon catheter for the treatment of cesarean scar pregnancy after local injection of methotrexate, we evaluated the use of a double-balloon catheter to terminate the pregnancy while preventing bleeding without any additive treatment...
September 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26977831/diagnosis-and-management-of-endometrial-cancer
#19
Michael M Braun, Erika A Overbeek-Wager, Robert J Grumbo
Endometrial cancer is the most common gynecologic malignancy. It is the fourth most common cancer in women in the United States after breast, lung, and colorectal cancers. Risk factors are related to excessive unopposed exposure of the endometrium to estrogen, including unopposed estrogen therapy, early menarche, late menopause, tamoxifen therapy, nulliparity, infertility or failure to ovulate, and polycystic ovary syndrome. Additional risk factors are increasing age, obesity, hypertension, diabetes mellitus, and hereditary nonpolyposis colorectal cancer...
March 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/26943477/complication-rate-of-uterine-morcellation-in-laparoscopic-supracervical-hysterectomy-a-retrospective-cohort-study
#20
Roos M Smits, Jan H De Kruif, Cathelijne F Van Heteren
BACKGROUND: Over the last decades minimally invasive surgical techniques are increasingly used to treat symptomatic leiomyomas, providing the patient decreased morbidity and more rapid return to daily activities. Morcellation is the fragmentation of a large mass into smaller pieces to make resection through port incisions possible. Over the last year there has been a discussion worldwide about the safety of morcellation. OBJECTIVE: The aim of our study was to identify the complication rate of power morcellation at our institution...
April 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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