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Obstetric Versus Traumatic Vulvar Hematoma: Two Case Report and Review 产科与外伤性外阴血肿:两例报告与回顾
Pub Date : 2021-05-15 DOI: 10.31579/2578-8965/069
Carmen E Badillo-Bercebal, Sonia De-Miguel-Manso, Victoria Pascual-Escudero, Cristina Álvarez-Colomo, Dakota Viruega-Cuaresma, E. García-García
Background: Vulvar hematomas are more frequent in the obstetric population generally as a consequence of episiotomies, precipitated or instrumental deliveries. The most common causes in the general population are accidental trauma or spontaneous rupture of blood vessels. Management in both etiologies depends on size, involvement of adjacent organs, hemodynamic compromise, and the existence of fractures or lacerations that need to be repaired. Edema is a common complication usually resolved with conservative management. Clinical presentation: We present two cases. A traumatic vulvar hematoma in a 22-year-old patient and an obstetric vulvar hematoma in a 30-year-old primigravida which already presented pitting edema prior to delivery. Both cases required surgical drainage due to clinical evolution and poor pain control. Conclusions: The approach can be conservative or surgical depending on several factors but the use of intravenous analgesia is essential for pain management. Although hematomas related with traumatic causes are less frequent than puerperal ones, they can be very dangerous if they are associated with arterial bleeding that leads to hemodynamic instability.
背景:外阴血肿在产科人群中更为常见,通常是外阴切开术、沉淀或器械分娩的结果。在一般人群中最常见的原因是意外创伤或自发血管破裂。这两种病因的处理取决于大小、邻近器官的受损伤、血流动力学的损害以及是否存在需要修复的骨折或撕裂伤。水肿是一种常见的并发症,通常通过保守治疗来解决。临床表现:我们报告两例。一例22岁外阴血肿患者和一例30岁初产妇产科外阴血肿在分娩前已经出现了凹陷性水肿。由于临床进展和疼痛控制不佳,两例患者均需手术引流。结论:该方法可保守或手术取决于几个因素,但使用静脉镇痛是必不可少的疼痛管理。虽然与创伤相关的血肿比产褥期的血肿少,但如果与动脉出血相关,导致血流动力学不稳定,血肿是非常危险的。
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引用次数: 0
Acupuncture Application in Seconder amenorrhea Obese female Patient 针刺在肥胖女性继发性闭经中的应用
Pub Date : 2021-05-15 DOI: 10.31579/2578-8965/072
H. Alp
Obesity is a disease caused by excessive fat storage in the body. It is an energy balance problem. Obesity can prepare the ground for many diseases. Secondary amenorrhea is the condition of not having menstruation for 6 months. In Traditional Chinese Medicine, it is thought to be caused by Qi and blood deficiency. The 43-year-old nurse applied due to obesity, inability to have menstruation, edema and nodules in goiter. TSH was 4.25, T3 2.87, T4 1.07mU/L. The 78.6 kg 150cm tall TA was 100/70 mmHg.Ten sessions of acupuncture were performed. Yin-tan, DU-20,21, LU-9, H-7, PC-6, SI-3, ST-24,25, REN-7,9, KID-3-6, SP -6.9 uterus, zero, jerome, shen-men hunger, kidney, points were pinned with disposable acupuncture needles. The patient, whose edema was resolved in the second session, started to have menstruation in the third session and lost 9kg in total. The patient had regular periods during the 1-year follow-up. TSH fell to 3.18mU/L.
肥胖是一种由体内脂肪储存过多引起的疾病。这是一个能量平衡问题。肥胖可以为许多疾病埋下伏笔。继发性闭经是指6个月没有月经的情况。在中医中,它被认为是由气血不足引起的。这名43岁的护士因肥胖、不能来月经、水肿和甲状腺肿大结节而申请了申请。TSH 4.25, T3 2.87, T4 1.07mU/L。78.6公斤150cm高TA为100/70 mmHg。进行10次针灸治疗。用一次性针刺针针刺阴潭、DU-20、21、LU-9、H-7、PC-6、SI-3、ST-24、25、REN-7、9、kid3 -6、SP -6.9子宫、零、jerome、肾门饥饿、肾、穴。患者第2期水肿消退,第3期开始月经,共减轻9kg。随访1年,患者月经规律。TSH降至3.18mU/L。
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引用次数: 0
Severe ovarian hyperstimulation syndrome with GnRH agonist trigger during the COVID pandemic: lessons learned from an unusual case COVID大流行期间GnRH激动剂引发的严重卵巢过度刺激综合征:从一个不寻常病例中吸取的教训
Pub Date : 2021-05-15 DOI: 10.31579/2578-8965/070
Bradley S Hurst, Evan A. Schrader, Tanner Hurley, Lariena Welch, Y. Ying, A. Eskew
Background: Injectable gonadotropins stimulate multi-follicular recruitment and allows retrieval of multiple oocytes for assisted reproduction. The widespread utilization of gonadotropin releasing hormone agonist (GnRHa) to induce oocyte maturation for oocyte retrieval has nearly eliminated the risk of severe ovarian hyperstimulation syndrome (OHSS), and only a few cases have been reported in the literature. The rarity of severe OHSS may lead to the mistaken conclusion that gonadotropin stimulation can be safely administered with limited monitoring, even in high-risk patients. We present an unusual case of a woman with limited monitoring due to the COVID pandemic who developed severe OHSS before GnRH agonist trigger and oocyte. Case Presentation: A 29-year-old nulliparous woman with polycystic ovarian syndrome (PCOS) initiated ovarian stimulation for oocyte retrieval. She had a robust initial response, and developed worsening abdominal pain, bloating, nausea, vomiting, and decreased appetite before retrieval. GnRH agonist was given to “trigger ovulation and retrieval scheduled due to the low reported incidence of severe OHSS. Symptoms progressed, and on the morning of retrieval, ultrasound demonstrated bilaterally enlarged ovaries >10cm and 48 oocytes were retrieved for a planned cryo-all cycle. She was hospitalized on the day of retrieval for severe OHSS and had two large-volume paracenteses. She was stable and discharged home by day 5, and symptoms markedly improved with the onset of menses. She has an ongoing pregnancy from her first frozen embryo transfer. Conclusion: We add a rare case of severe OHSS with a GnRHa trigger and cryo-all protocol with the onset of symptoms before GnRH agonist administration. Although rare, severe OHSS may still occur with a GnRHa trigger, and caution is needed when an initial robust response is identified. Here we also provide an opportunity to review the important patient risk factors for the development of OHSS and measures to reduce the risk in excessive responders.
背景:可注射的促性腺激素刺激多卵泡募集,并允许多个卵母细胞用于辅助生殖。广泛应用促性腺激素释放激素激动剂(GnRHa)诱导卵母细胞成熟以获取卵母细胞,几乎消除了严重卵巢过度刺激综合征(OHSS)的风险,文献中仅有少数病例报道。严重卵巢过度刺激症的罕见性可能导致一个错误的结论,即即使在高风险患者中,也可以在有限的监测下安全地给予促性腺激素刺激。我们提出了一个不寻常的病例,一名妇女由于COVID大流行而监测有限,在GnRH激动剂触发和卵母细胞之前发生了严重的OHSS。病例介绍:一名29岁的未生育女性,患有多囊卵巢综合征(PCOS),开始卵巢刺激以获取卵母细胞。患者最初反应强烈,但在取药前腹痛、腹胀、恶心、呕吐和食欲下降加剧。由于严重OHSS的发生率较低,GnRH激动剂被用于“触发排卵和恢复计划”。症状逐渐加重,在取卵的早晨,超声显示双侧卵巢增大>10cm,取卵48个卵母细胞进行计划的全冷冻周期。她因严重OHSS入院,并有两个大容量的输卵管。患者病情稳定,第5天出院,症状随月经开始明显改善。第一次冷冻胚胎移植后,她一直在怀孕。结论:我们增加了一例罕见的GnRH触发和cro -all方案的严重OHSS,在GnRH激动剂使用前出现症状。虽然罕见,但严重的OHSS仍可能在GnRHa触发下发生,当确定最初的强烈反应时,需要谨慎。在这里,我们也提供了一个机会来回顾OHSS发展的重要患者风险因素和减少过度反应者风险的措施。
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引用次数: 0
Homeopathic Approach in the Case of Secondary Infertility and Anosmia 顺势疗法治疗继发性不孕症和嗅觉缺失
Pub Date : 2021-05-15 DOI: 10.31579/2578-8965/073
H. Alp
A 38-year-old female patient diagnosed as secondary infertility, anosmia, myoma uteri, Hashimoto thyroiditis with the history of many unsuccessful IVF attempts regained her ability of smell, her thyroid antibody levels normalised, her basal hormones, AMH levels, ovarian follicular development and ovulation improved after 6 months of treatment with homeopathy and nutritional supports. In this case report, it is observed that many gynecological problems accompanied with infertility, anosmia and autoimmune problems like Hashimoto’s thyroiditis can be improved with a holistic approach to individual supportive therapies and homeopathy. It is hoped that this case report can be a reference for future studies in this field.
一例38岁女性患者,诊断为继发性不孕、嗅觉缺失、子宫肌瘤、桥本甲状腺炎,多次IVF失败,经顺势疗法和营养支持治疗6个月后,嗅觉恢复,甲状腺抗体水平恢复正常,基础激素、AMH水平、卵巢卵泡发育和排卵改善。在本病例报告中,我们观察到许多伴随不孕、嗅觉缺失和自身免疫性问题的妇科问题,如桥本甲状腺炎,可以通过个体支持治疗和顺势疗法的整体方法得到改善。希望本病例报告能为今后该领域的研究提供参考。
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引用次数: 0
Varicella Infection During Pregnancy- Maternal and Fetal Outcome; Case Series and Analysis in a Tertiary Centre in South India! 妊娠期水痘感染——母婴结局;南印度某高等教育中心的案例系列与分析!
Pub Date : 2021-05-15 DOI: 10.31579/2578-8965/071
N. Navakumar, M. Sambangi, V. Ranganayaki
Background: This is a retrospective study undertaken to analyse the maternal and fetal outcome of varicella infection during pregnancy. Methods: This is a retrospective observational study done in Kerala Institute of Medical Sciences, Trivandrum, a tertiary care hospital in South India. Sixty nine women infected with chickenpox during pregnancy from January 2009 to February 2018 (9 years) were taken for the study. Results: The incidence of chickenpox during pregnancy in our study was 33.7 in 10000 pregnancies. There were no spontaneous miscarriages. The incidence of congenital anomalies was 7.2% and when compared to the overall obstetric population of the nine year study period in which the incidence was 6.5 %, there was no statistical significance (p- 0.99). The incidence of preterm labour was 4.7% and when compared to the overall obstetric population in which the incidence was 15 %, there was a statistically significant less incidence (p- 0.035). The incidence of polyhydramnios was 4.7% and when compared to the overall obstetric population in which the incidence was 1%, there was a statistically significant increased incidence (p - 0.018). The incidence of fetal growth restriction was 13% and when compared to the overall obstetric population in which the incidence was 12.4%, there was no statistically significant difference (p- 0.963) Conclusions: The maternal and fetal complications with chickenpox infection during pregnancy were more when infected in the first trimester. Early treatment, screening and followup will reduce the maternal and fetal morbidity
背景:这是一项回顾性研究,旨在分析妊娠期水痘感染的母婴结局。方法:这是一项回顾性观察性研究,在喀拉拉邦医学科学研究所,特里凡得琅,在印度南部的三级保健医院。在2009年1月至2018年2月(9年)期间,69名怀孕期间感染水痘的妇女被纳入研究。结果:1万例妊娠期水痘发生率为33.7例。没有自然流产。先天性异常的发生率为7.2%,与9年研究期间的总产科人口发生率6.5%相比,无统计学意义(p- 0.99)。早产的发生率为4.7%,与总体产科人群中15%的发生率相比,有统计学意义的降低(p- 0.035)。羊水过多的发生率为4.7%,与总产科人群的发生率为1%相比,有统计学意义的增加(p - 0.018)。胎儿生长受限发生率为13%,与总体产科人群12.4%的发生率相比,差异无统计学意义(p- 0.963)。结论:妊娠期感染水痘的母胎并发症在妊娠早期感染时较多。早期治疗、筛查和随访将降低孕产妇和胎儿的发病率
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引用次数: 0
Spontaneous Pregnancy following Treatment of Symptomatic Uterine Myomatosis with Ulipristal Acetate without Surgery 无手术治疗症状性子宫肌瘤后自然妊娠
Pub Date : 2021-04-29 DOI: 10.31579/2578-8965/059
Vicente Spinoso Cruz, M. Colechá Morales, L. Gil Melgosa, Aída López
Uterine fibroids are the most frequent gynaecological benign tumors in women of reproductive age and can cause infertility. Their treatment may be medical, surgical or a combination of both, but they may compromise future fertility in patients in which their wish to conceive has not yet been fulfilled. In this report we present two patients with symptomatic uterine myomas and who wanted to preserve their fertility. Treatment with one or two 12-week courses of 5 mg of ulipristal acetate was prescribed. A decrease in the size of the fibroids was observed, along with adequate control of the symptoms. Spontaneous pregnancies led to two live births without significant complications. Treatment with Ulipristal Acetate may be an effective option to take into account in the management of patients with symptomatic uterine fibroids who refuse surgery or in those in which it is contraindicated and who wish to preserve their fertility.
子宫肌瘤是育龄妇女最常见的妇科良性肿瘤,可引起不孕症。他们的治疗可能是药物、手术或两者结合,但他们可能会影响到尚未实现怀孕愿望的患者未来的生育能力。在这个报告中,我们提出了两个有症状的子宫肌瘤的病人,他们想要保留他们的生育能力。治疗方法为1或2个疗程,每次服用5毫克醋酸乌普利司坦,疗程为12周。观察到肌瘤大小减小,同时症状得到充分控制。自然妊娠导致两例活产,无明显并发症。对于拒绝手术的有症状的子宫肌瘤患者或有手术禁忌并希望保留其生育能力的患者,醋酸乌普利司妥治疗可能是一种有效的选择。
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引用次数: 0
Call for Alleviating Sexual Issues among Cervical Cancer Survivors' Women in Northern Upper Egypt 呼吁减轻上埃及北部宫颈癌幸存者妇女的性问题
Pub Date : 2021-04-29 DOI: 10.31579/2578-8965/066
H. Hassan, Ragaa Mohammed, Soad Abd El Salam Ramadan, Hagar kamal masaud
Background: Cervical cancer affects all aspects of a patient’s life, including sexual functioning, body image, and intimacy. Aim: The present study aimed to evaluate the impact of a protocol of nursing intervention on sexual dysfunction and body image among cervical cancer survivors' women. Methods; Design: Α quаsi-experimentаl research design was conducted. Setting: out-patient clinic in the oncology unit at Ɓeni-Suef University Hospital. Subjects: A purposive sample of 70 women. Tools: Data was collected through а structured interviewing questionnаire sheet, femаle sexuаl function index, femаle sexuаl distress scаle, and body image scаle. Results: The results of the study reveаled that there was а high statistically significаnt difference in the women's totаl score of knowledge аbout cervical cancer, total scores of female sexuаl function index, female sexual distress scаle, аnd body image scale at post-intervention compared to pre-intervention (р<0.001). Conclusion: The study concluded that educational protocol, which provided to cervical cancer survivors' women, have a positive effect on their own knowledge, body image, and sexual function. Recommendations: disseminate the multidisciplinary collaboration approach for addressing sexual problems related to cervical cancer, and preparing health classes for cervical cancer women regarding sexual dysfunction with cervical cancer.
背景:宫颈癌影响患者生活的方方面面,包括性功能、身体形象和亲密关系。目的:本研究旨在评估护理干预方案对宫颈癌幸存者女性性功能障碍和身体形象的影响。方法;设计:Α进行准四实验研究设计。地点:Ɓeni-Suef大学医院肿瘤科门诊。对象:有目的的70名女性样本。工具:采用结构化访谈问卷、女性性功能指数、女性性焦虑量表和身体形象量表收集数据。结果:研究结果显示,干预后女性宫颈癌知识总分、女性性功能指数总分、女性性困扰量表总分、身体形象量表总分与干预前比较,差异均有统计学意义(p <0.001)。结论:研究得出结论,向宫颈癌幸存者妇女提供的教育方案对她们自身的知识、身体形象和性功能都有积极的影响。建议:传播多学科合作方法,以解决与宫颈癌有关的性问题,并为宫颈癌妇女开设关于宫颈癌性功能障碍的健康课程。
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引用次数: 6
High Complexity Fertilization in Cuba: Egg Donation 古巴的高复杂性受精:卵子捐赠
Pub Date : 2021-04-29 DOI: 10.31579/2578-8965/068
G. Medina
The decades of the 70s and 80s of the last century in our country, allowed us to glimpse that the possibilities of treatment for the infertile couple were considerably expanded. Until that moment, infertile couples had very limited options such as adoption, insemination using a donor or conforming to not having children. In Cuba, since 1979, the first steps were taken in the field of assisted reproduction in animals. Human reproduction studies have been carried out at the National Institute of Endocrinology and the Ramón González Coro Gyneco-obstetric Hospital, the first birth having occurred in 1986. Since 2006 and with the aim of guaranteeing perinatological care specialized in pregnant patients as a result of in vitro fertilization, it was decided to create a consultation at the Ramón González Coro Hospital given the high rate of twin and triple pregnancies, preterm births and complications. The number of patients treated had to proceed with high complexity in vitro fertilization and sometimes ICSI and it was not until 2014 after the approval by our constitution, the family code and medical ethics that egg donation began.
我国上个世纪70年代和80年代的几十年,让我们看到治疗不育夫妇的可能性大大扩大了。在那之前,不孕夫妇的选择非常有限,比如收养、使用捐赠者进行人工授精,或者选择不生孩子。自1979年以来,古巴在动物辅助生殖领域迈出了第一步。在国家内分泌研究所和Ramón González科罗妇产医院进行了人类生殖研究,第一个婴儿于1986年出生。自2006年以来,考虑到双胎和三胎妊娠、早产和并发症的高发生率,决定在Ramón González Coro医院开设会诊服务,目的是确保为体外受精孕妇提供专门的围产期护理。接受治疗的患者数量必须进行高度复杂的体外受精,有时进行ICSI,直到2014年,在我们的宪法,家庭法典和医学伦理批准后,卵子捐赠才开始。
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引用次数: 0
Women's Body Image Distress Associated with Cervical Cancer 女性的身体形象困扰与子宫颈癌有关
Pub Date : 2021-04-29 DOI: 10.31579/2578-8965/062
H. Hassan, S. Ramadan, Hagar Masaud, Ragaa Mohammed
Background: Cervical cancer diagnosis and treatment can bring changes related to а woman's body image; which in turn can have a devastating on intimate relationships. Aim: The present study aimed to assess women's body image distress associated with cervical cancer. Methods; Design: A descriptive design was conducted. Setting: out-patient clinic in the oncology unit at Beni-Suef University hospital. Subjects: A purposive sample of 70 women. Tools: Data was collected through a structured interviewing questionnaire sheet, and body image scale. Results: The results of the study indicate that the majority (90%) of the studied women had body image distress. There is a statistically significant relationship between age and marriage age of women and their total body image scores. Conclusion: There is a statistical association between body image statuses amongst those women who were undergoing cervical cancer treatment concerning their socio-demographic characteristics. Recommendations: Implement an educational program to improve the self-body image for women with cervical cancer
背景:宫颈癌的诊断和治疗能带来与女性身体形象相关的改变;这反过来又会对亲密关系造成毁灭性的影响。目的:本研究旨在评估宫颈癌患者的身体形象困扰。方法;设计:进行描述性设计。地点:贝尼-苏夫大学医院肿瘤科门诊。对象:有目的的70名女性样本。工具:通过结构化访谈问卷和身体形象量表收集数据。结果:研究结果表明,大多数(90%)被研究的女性有身体形象困扰。女性的年龄和结婚年龄与她们的身体形象总分之间存在统计学上显著的关系。结论:接受宫颈癌治疗的妇女的身体形象状况与她们的社会人口特征之间存在统计学关联。建议:实施一项教育计划,以改善宫颈癌妇女的自我形象
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引用次数: 5
Women with Cervical Cancer: Impact of an Educational Program their Knowledge 患有子宫颈癌的妇女:教育计划对她们知识的影响
Pub Date : 2021-03-20 DOI: 10.31579/2578-8965/063
Hanan Elzeblawy, Ragaa Ali, Soad Abd El Salam, Hagar Kamal
Background: Cervical cancer occurs when the cells of the cervix grow abnormally and invade other tissues and organs of the body. Aim: study the impact of an educational program on knowledge of women with cervical cancer Methods; Design: A quasi-experimental design. Setting: out-patient clinic in the oncology unit at Beni-Suef University Hospital. Subjects: А purposive sample of 70 women. Tools: A structured interviewing questionnaire sheet, а scoring system for women’s knowledge аbout cervical cancer, and supportive educational booklet. Results: The results of the study revealed improving in women's knowledge regarding cervical cancer post-program compared to pre-one. Conclusion: The teaching program was very effective in women's knowledge improvement. Recommendations: Women's counseling activities for women regarding cervical cancer need to be popularized and facilities and decision-making aids are made available to those who need them.
背景:宫颈细胞异常生长并侵犯身体其他组织和器官时,就会发生宫颈癌。目的:研究教育项目对妇女宫颈癌防治知识的影响;设计:准实验设计。地点:贝尼-苏夫大学医院肿瘤科门诊。对象:А有目的的70名女性样本。工具:结构化访谈问卷,妇女宫颈癌知识评分系统,支持性教育小册子。结果:研究结果显示,与计划前相比,计划后妇女对宫颈癌的认识有所提高。结论:该教学方案对提高妇女的知识水平有较好的效果。建议:需要推广针对妇女的宫颈癌咨询活动,并向有需要的人提供设施和决策辅助工具。
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引用次数: 7
期刊
Obstetrics Gynecology and Reproductive Sciences
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