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https://www.readbyqxmd.com/read/28625299/managing-major-obstetric-haemorrhage-pharmacotherapy-and-transfusion
#1
REVIEW
Rachel Collis, Emilia Guasch
Major obstetric haemorrhage is a leading cause of maternal mortality. A prescriptive approach to early recognition and management is critical to improving outcomes. Uterine atony is the primary cause of post-partum haemorrhage. First-line prevention and treatment include the administration of uterine tonic agents; other conservative measures include uterine cavity tamponade and uterine compression sutures. Interventional radiology procedures have been used for both prophylaxis and treatment, but a hysterectomy may be necessary if conservative measures fail...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28613035/total-laparoscopic-hysterectomy-for-endometrial-cancer-in-a-renal-transplantation-patient-receiving-peritoneal-dialysis-case-report-and-literature-review
#2
Mamoru Kakuda, Eiji Kobayashi, Yusuke Tanaka, Yutaka Ueda, Kiyoshi Yoshino, Tadashi Kimura
Improved surgical techniques and immunosuppressant medications for organ transplantation have resulted in a significant increase in the number of women undergoing renal transplantation. Peritoneal dialysis (PD), a common supportive therapy for chronic renal failure, is also used in cases of renal transplantation failure. Herein, we report the first case of a rare total conventional laparoscopic gynecologic hysterectomy performed for endometrial cancer in a patient undergoing life-supportive PD as a result of renal transplantation failure...
June 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28608722/comparative-analysis-of-inpatient-costs-for-obstetrics-and-gynecology-surgery-patients-treated-with-iv-acetaminophen-and-iv-opioids-versus-iv-opioid-only-analgesia-for-postoperative-pain
#3
Ryan N Hansen, An T Pham, Belinda Lovelace, Stela Balaban, George J Wan
BACKGROUND: Recovery from obstetrics and gynecology (OB/GYN) surgery, including hysterectomy and cesarean section delivery, aims to restore function while minimizing hospital length of stay (LOS) and medical expenditures. OBJECTIVE: Our analyses compare OB/GYN surgery patients who received combination intravenous (IV) acetaminophen and IV opioid analgesia with those who received IV opioid-only analgesia and estimate differences in LOS, hospitalization costs, and opioid consumption...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28603722/external-beam-techniques-to-boost-cervical-cancer-when-brachytherapy-is-not-an-option-theories-and-applications
#4
REVIEW
Omar Mahmoud, Sarah Kilic, Atif J Khan, Sushil Beriwal, William Small
The management of locally advanced cervical cancer relies on brachytherapy (BT) as an integral part of the radiotherapy delivery armamentarium. Occasionally, intracavitary BT is neither possible nor available. In these circumstances, post-external beam radiotherapy (EBRT) interstitial brachytherapy and/or hysterectomy may represent viable options that must be adequately executed in a timely manner. However, if these options are not applicable due to patient related or facility related reasons, a formal contingency plan should be in place...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28599164/impact-of-power-morcellator-removal-on-hysterectomy-practice-patterns
#5
Adrianne Wesol, Shauna Woolley
OBJECTIVE: This study was a quality improvement project investigating patterns of hysterectomy practice including changes in surgical techniques and patient outcomes after manufacturer withdrawal of a laparoscopic power morcellator from our hospitals in July 2014. STUDY DESIGN: This time-series pre and post retrospective review examined data from electronic health records, comparing one year when a laparoscopic power morcellator was available (Year 1, mid-2013 to mid-2014) to one year after withdrawal (Year 2, mid-2014 to mid-2015)...
May 21, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28590029/treatment-of-heterotopic-caesarean-scar-pregnancy-complicated-with-post-termination-increase-in-size-of-residual-mass-and-morbidly-adherent-placenta
#6
Andre Hadyme Miyague, Adriano Pienaro Chrisostomo, Sergio Luis Costa, Edson Tetsuya Nakatani, William Kondo, Claudio Corrêa Gomes
We report a case of a secundipara with heterotopic cesarean scar pregnancy (HCSP) treated with potassium chloride injection into the ectopic embryo followed by sac aspiration. The remaining "mass" increased in size threefold and was surrounded by a rich vascular network. An arteriovenous malformation was suspected; however, appropriate treatment was precluded because of the viability of the ectopic gestation. Sonographic examination revealed a morbidly adherent placenta, and attempt to resect the mass laparoscopically was complicated by bleeding that required hysterectomy...
June 7, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28580061/disseminated-peritoneal-leiomyomatosis-status-post-laparoscopic-hysterectomy-with-morcellation
#7
Neil Anand, Marci Handler, Ahsan Khan, Allison Wagreich, Sean Calhoun
Uterine leiomyomas (fibroids) are common benign neoplasms, which develop from the muscular tissue of the uterus with an estimated incidence of 20-40% in women of reproductive age. In the early nineties, power morcellators were introduced and became commonly used during hysterectomy for symptomatic fibroids. However, if all fragments are not removed, they may parasitize to other blood supply and present as abdominal or pelvic masses. Unfortunate cases have also been reported in which uterine sarcomas seeded throughout the abdomen and pelvis secondary to morcellation...
December 2016: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/28576693/direct-laparoscopic-trocar-insertion-lessons-learned-from-nine-litigated-cases
#8
George A Vilos, Artin Ternamian, Angelos G Vilos, Basim Abu-Rafea, Cici Zhu
STUDY OBJECTIVE: To report circumstances and clinical and medico-legal outcomes of nine litigated cases associated with direct trocar insertion (DTI) injuries to bowel (7 cases) and major vessel (2 cases) during primary laparoscopic access. DESIGN: Case series from 1990 through 2015. PATIENTS: Nine litigated cases. INTERVENTION: Retrospective review of medical and legal records of litigated cases in Canada reviewed by the primary author (GAV)...
May 30, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28547098/obstetrical-and-perinatal-morbidity-and-mortality-among-in-vitro-fertilization-pregnancies-a-population-based-study
#9
Hussein Sabban, Andrew Zakhari, Valerie Patenaude, Togas Tulandi, Haim A Abenhaim
PURPOSE: To compare patient characteristics and obstetrical/neonatal outcomes of in-vitro fertilization (IVF) and spontaneously conceived pregnancies. METHODS: Using the Nationwide Inpatient Sample, we conducted a retrospective cohort study from 2008 to 2011 comparing IVF conceptions to spontaneous ones. Patient characteristics were descriptively compared, and after adjusting for baseline characteristics with logistic regression, obstetrical/neonatal outcomes were also compared...
May 25, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28546709/salvage-surgery-for-cervical-cancer-recurrences
#10
P Rema, Arun Peter Mathew, S Suchetha, Iqbal Ahmed
Cervical cancer usually presents in advanced stages and is treated with chemoradiation. About 15-20 % patients present with local recurrence after chemoradiation. Radical surgical resection is the only treatment modality offering long term survival benefit in recurrent cervical cancer. The most common surgical option for these patients is pelvic exenteration. Radical hysterectomy may be done for patients with a small centrally located recurrence in the cervix with no infiltration of adjacent structures. The aim of this study was to evaluate the morbidity and survival outcome following radical hysterectomy and pelvic exenteration for recurrent cancer cervix...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28534016/analysis-of-surgeries-performed-after-hysteroscopic-sterilization-as-tabulated-from-3-803-essure-patient-experiences
#11
E Scott Sills, Xiang Li, Samuel H Wood, Christopher A Jones
OBJECTIVE: Although previous research has suggested that risk for reoperation among hysteroscopic sterilization (HS) patients is more than ten times higher than for patients undergoing standard laparoscopic tubal ligation, little has been reported about these subsequent procedures. METHODS: This descriptive cohort study used a confidential online questionnaire to gather data from women (n=3,803) who volunteered information on HS followed by device removal surgery performed due to new symptoms developing after Essure placement...
May 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28517240/imaging-after-treatment-in-uterine-malignancies-spectrum-of-normal-findings-and-most-common-complications
#12
REVIEW
Maura Miccò, Anna Maria Telesca, Benedetta Gui, Pier Paolo Grimaldi, Francesco Cambi, Maria Giulia Marini, Anna Lia Valentini, Lorenzo Bonomo
Uterine malignancies account for the majority of gynaecologic cancers. Different treatment options are available depending on histology, disease grade and stage. Hysterectomy is the most frequent surgical procedure. Chemotherapy and radiation therapy (CRT) represents the preferred therapeutic choice for locally advanced uterine and cervical malignancies. Imaging of the female pelvis following these treatments is particularly challenging due to alteration of the normal anatomy. Radiologists should be familiar with both the expected post-treatment imaging findings and the imaging features of possible complications to make the correct interpretation and avoid possible pitfalls...
May 18, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28516272/uterine-artery-embolization-for-symptomatic-adenomyosis-7-year-clinical-follow-up-using-ufs-qol-questionnaire
#13
Annefleur M de Bruijn, Marieke Smink, Wouter J K Hehenkamp, Robbert J Nijenhuis, Albert J Smeets, Focco Boekkooi, Paul J H M Reuwer, Willem J Van Rooij, Paul N M Lohle
PURPOSE: The purpose of this study was to assess clinical outcomes 7 years after uterine artery embolization (UAE) in the treatment of symptomatic adenomyosis. MATERIALS AND METHODS: In this prospective cohort study, one specialized hospital in the Netherlands recruited patients with symptomatic adenomyosis or adenomyosis in combination with fibroids for UAE. The 7-year post-intervention outcomes were health-related quality of life (HRQOL), symptom severity scores (SSS), satisfaction, menopause and re-interventions...
May 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28501452/promoting-same-day-discharge-for-gynecologic-oncology-patients-in-minimally-invasive-hysterectomy
#14
Cynthia R Fountain, Laura J Havrilesky
BACKGROUND: Despite clear data demonstrating feasibility, safety, and cost-effectiveness of same-day discharge after minimally invasive hysterectomy, there is a paucity of data suggesting ways to increase same-day discharge rates. OBJECTIVE: To promote same-day discharge following minimally invasive hysterectomy using preoperative patient education videos, provider same-day discharge awareness initiatives, and standardization of postoperative management. To investigate reasons for overnight admission after surgery (non-same-day discharge)...
May 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28469838/rhabdomyosarcoma-of-the-genital-tract-in-an-18-month-old-girl
#15
Nourah ALSaleh, Hadeel ALwadie, Abdulrahim Gari
Embryonal Rhabdomyosarcoma 'Botryoid Type' is a rare soft tissue tumor that arises within the wall of the bladder or vagina and seen almost exclusively in infants. Treatment is combination of surgery with adjuvants chemotherapy and radiotherapy. We report a case of an 18-month-old Saudi girl presented with history of abdo-pelvic mass, bleeding per vagina and a mass protruding through the introitus. Computed tomography (CT) done reveling large heterogeneous pelvic mass arising from the uterus, biopsy of mass confirmed the diagnosis (sarcomabotryoidal)...
April 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28465851/borderline-clear-cell-adenofibroma-of-the-ovary
#16
Pilaiwan Kleebkaow, Apiwat Aue-Aungkul, Amornrat Temtanakitpaisan, Chumnan Kietpeerakool
Borderline clear cell tumors are extremely rare, and few cases have been reported in the literature. Herein, we present a case of borderline clear cell adenofibroma of the ovary in a 58-year-old woman who presented with a pelvic mass and constipation. Physical examination revealed a 10 cm solid midline pelvic mass. Computed tomography showed an 8 cm heterogeneous enhancing mass attached to the left posterolateral wall of the uterus. The patient's serum CA 125 levels were slightly elevated (80.9 U/ml)...
2017: Case Reports in Pathology
https://www.readbyqxmd.com/read/28458627/vaginal-mccall-culdoplasty-versus-laparoscopic-uterosacral-plication-to-prophylactically-address-vaginal-vault-prolapse
#17
Kathy Niblock, Emily Bailie, Geoff McCracken, Keith Johnston
BACKGROUND: Studies have shown that vaginal vault prolapse can affect up to 43% of women following hysterectomy for pelvic organ prolapse. Many techniques have been described to prevent and treat vaginal vault prolapse. The primary objective of our study was to compare McCall's culdoplasty (when performed along side vaginal hysterectomy) with laparoscopic uterosacral plication (when performed along side total laparoscopic hysterectomy) for prevention of vaginal vault prolapse. Secondary outcomes included inpatient stay and perioperative complications...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/28456509/effect-of-early-tranexamic-acid-administration-on-mortality-hysterectomy-and-other-morbidities-in-women-with-post-partum-haemorrhage-woman-an-international-randomised-double-blind-placebo-controlled-trial
#18
(no author information available yet)
BACKGROUND: Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. METHODS: In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries...
May 27, 2017: Lancet
https://www.readbyqxmd.com/read/28453958/the-novel-technique-of-post-hysterectomy-vaginal-vault-prolapse-repair-apical-sling-and-neocervix-formation
#19
Dmitry Shkarupa, Nikita Kubin, Ekaterina Shapovalova, Anastasiya Zaytseva, Alexey Pisarev, Olga Staroseltseva
OBJECTIVE: We primarily aimed to evaluate the effectiveness of the novel technique: bilateral sacrospinous fixation by monofilament polypropylene apical sling combined with "neocervix" formation in surgical treatment of post - hysterectomy vaginal vault prolapse. The secondary objective was to estimate the impact of the surgery on voiding function and quality of life. STUDY DESIGN: This prospective study involved 61 women suffering from post-hysterectomy prolapse...
April 23, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28451705/demonstration-of-a-box-stitch-technique-for-laparoscopic-uterosacral-ligament-suspension
#20
Allison M Wyman, Lindsey Hahn, Emad Mikhail, Stuart Hart
AIM: We demonstrate a novel box stitch technique of laparoscopic post-hysterectomy uterosacral ligament suspension for apical prolapse in restorative pelvic reconstructive surgery. MATERIAL AND METHODS: We present a case of a 58yo female with symptomatic stage III pelvic organ prolapse with a history of a total abdominal hysterectomy 30 years prior. She strongly desired the usage of no synthetic or biologic mesh for her restorative surgical repair. This video provides a step-by-step guide on how to perform a laparoscopic box stitch as a technique for uterosacral ligament suspension as an apical native tissue option for patients with the need for post hysterectomy apical prolapse...
April 27, 2017: International Urogynecology Journal
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