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Comparison of the Effects of Individualized Postpartum Pelvic Floor Rehabilitation at Different Time Points in the Early Postpartum Period 产后早期不同时间点个体化产后盆底康复效果比较
Pub Date : 2023-06-07 DOI: 10.26689/aogr.v1i1.5008
T. Dong
Objective: To determine the clinical value of applying individualized postpartum pelvic floor rehabilitation at different time points in the early postpartum period. Methods: 184 patients admitted to the Affiliated Hospital of Jiangsu University from February 2021 to December 2022 were included in the study. Upon admission, they were divided into two groups, a conventional group (n = 46) and an intervention group (n = 138), by the random number table method. The patients in the conventional group underwent postpartum routine rehabilitation, while those in the intervention group underwent individualized postpartum pelvic floor rehabilitation. The patients in the intervention group were further divided into intervention group 1 (6–8 weeks), intervention group 2 (8–10 weeks), and intervention group 3 (10–13 weeks) according to the time of care. The rehabilitation effects were compared between the groups. Results: The pelvic floor muscle function of the patients in the intervention group was more ideal compared with those in the conventional group, and the incidence of adverse reactions was lower among patients in the intervention group; the comparison of the above indicators was statistically significant (P < 0.05); however, there was no significant difference in the relevant indicators among intervention group 1, group 2, and group 3 (P > 0.05). Conclusion: Although our study showed no significant difference in the effects of individualized postpartum pelvic floor rehabilitation at different time points in the early postpartum period, individualized postpartum pelvic floor rehabilitation in the early postpartum period has definite clinical value, as it improves pelvic floor muscle function and reduces the incidence of adverse reactions.
目的:探讨产后早期不同时间点应用个性化产后盆底康复的临床价值。方法:选取2021年2月至2022年12月江苏大学附属医院收治的184例患者作为研究对象。入院时采用随机数字表法将患者分为常规组(n = 46)和干预组(n = 138)。常规组采用产后常规康复治疗,干预组采用个体化产后盆底康复治疗。根据护理时间将干预组患者进一步分为干预组1(6-8周)、干预组2(8-10周)、干预组3(10-13周)。比较两组患者的康复效果。结果:干预组患者盆底肌功能较常规组更理想,不良反应发生率较常规组低;以上指标比较均有统计学意义(P < 0.05);干预组1、干预组2、干预组3间相关指标比较,差异均无统计学意义(P > 0.05)。结论:虽然我们的研究显示,产后早期不同时间点的产后盆底个体化康复效果无显著差异,但产后早期的产后盆底个体化康复改善了盆底肌肉功能,减少了不良反应的发生,具有一定的临床价值。
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引用次数: 0
Cushing’s Disease in Pregnancy and Cabergoline Use: Obstetric and Neonatal Outcomes 妊娠库欣病和卡麦角林的使用:产科和新生儿结局
Pub Date : 2023-05-15 DOI: 10.26689/aogr.v1i1.4947
Natacha B. Murillo, C. Ramacciotti, Carolina Fux-Otta, L. Cecenarro
Pregnancy in patients with Cushing’s disease (CD) is rare and is associated with significant maternal and fetal complications. We report a case of CD who achieved uncomplicated pregnancy and delivery after treatment with low-dose cabergoline. A 29-year-old woman was diagnosed with CD (adrenocorticotropic hormone-secreting macrotumor that causes displacement of the optic chiasm, infiltrates the right cavernous sinus, and engulfs the internal carotid artery) and underwent transsphenoidal surgery with incomplete tumor resection. After a year of clinical stability, her symptoms recurred, and cabergoline was initiated. During the treatment, the patient conceived, and the medication was suspended. In the first trimester, clinical and biochemical parameters indicate active CD, so cabergoline was reinstated at a low dose for the rest of the pregnancy. With the dopaminergic agonist, her clinical and laboratory parameters normalized, and the patient gave birth to a healthy girl at 38 weeks, within normal percentiles and without complications. Pregnancy in patients diagnosed with CD is a rare event, and the consequences of maternal-fetal exposure to hypercortisolism can be severe. Our experience with the use of cabergoline at low doses in a pregnant woman with CD contributes favorable data to the scarce existing literature reports, adding evidence on the safety profile of the drug in this population.
库欣病(CD)患者的妊娠是罕见的,并且与显著的母体和胎儿并发症相关。我们报告一例乳糜泻患者在接受低剂量卡麦角林治疗后顺利怀孕和分娩。一名29岁的女性被诊断为CD(促肾上腺皮质激素分泌大肿瘤,导致视交叉移位,浸润右侧海绵窦,吞噬颈内动脉),并接受了经蝶窦手术并不完全切除肿瘤。临床稳定一年后,她的症状复发,开始使用卡麦角林。在治疗过程中,患者怀孕,暂停用药。在妊娠的前三个月,临床和生化指标显示活动性CD,因此在妊娠的其余时间恢复低剂量的卡麦角林。使用多巴胺能激动剂后,她的临床和实验室参数恢复正常,患者在38周时生下了一个健康的女孩,在正常的百分位数内,没有并发症。诊断为乳糜泻的患者怀孕是一件罕见的事情,而母亲和胎儿暴露于高皮质醇血症的后果可能是严重的。我们在患有乳糜泻的孕妇中使用低剂量卡麦角林的经验为稀缺的现有文献报道提供了有利的数据,为该药物在该人群中的安全性提供了证据。
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引用次数: 0
Actual Sleep Conditions from the Last Trimester of Pregnancy to Three Months Postpartum and the Associated Minor Problems 从怀孕最后三个月到产后三个月的实际睡眠状况和相关的小问题
Pub Date : 2023-05-15 DOI: 10.26689/aogr.v1i1.4942
Yumi Takagi, Kyoko Hanahara, Yumiko Tateoka
Objective: To investigate the actual sleep conditions at four time points from the last trimester of pregnancy to 3 months postpartum, and to examine the relationship between sleep and minor problems affecting sleep. Methods: A cross-sectional survey on the frequency of minor problems, Pittsburgh Sleep Quality Index (PSQI), and observations in a sleep diary was carried out on women at the end of pregnancy, 2 weeks postpartum, 1 month postpartum, and 3 months postpartum. The questionnaires were distributed to 165 participants. Correlation coefficients were obtained for each item and each scale, and the associations were analyzed. Results: The number of valid responses was 127. In the evaluation of sleep, sleep duration was the shortest and sleep quality was the lowest in the first month after delivery based on the PSQI score. In the correlation between “psychiatric symptoms” and sleep, women with anxiety and nervousness at the end of pregnancy were associated with poorer sleep quality. At all time-points, there was a significant association between “psychiatric symptoms” and poor sleep quality. Conclusion: An association exists between “psychiatric symptoms” and poor sleep quality in women from the last trimester of pregnancy to 3 months postpartum.
目的:调查妊娠末3个月至产后3个月四个时间点的实际睡眠状况,探讨睡眠与影响睡眠的小问题之间的关系。方法:对妊娠末期、产后2周、产后1个月和产后3个月妇女进行小问题发生频率、匹兹堡睡眠质量指数(PSQI)和睡眠日记观察的横断面调查。调查问卷被分发给165名参与者。获得各项目及各量表的相关系数,并分析其相关性。结果:有效问卷127份。在睡眠评价中,以PSQI评分衡量,产后第一个月的睡眠时间最短,睡眠质量最低。在“精神症状”与睡眠之间的关系中,怀孕末期焦虑和紧张的女性睡眠质量较差。在所有时间点上,“精神症状”与睡眠质量差之间都存在显著关联。结论:妊娠末3个月至产后3个月妇女的“精神症状”与睡眠质量差存在关联。
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引用次数: 0
Exposure to Pesticides in Pregnant Women: An Integrative Review 孕妇暴露于农药:一项综合综述
Pub Date : 2023-05-15 DOI: 10.26689/aogr.v1i1.4941
Thayná Champe da Silva, Maria Goreti Finkler, Letícia Slodkowski, Jaíne Gabriela Frank, Poliana Ribas Tolfo, Dionéia Dalcin, Iara Denise Endruweit Battisti, Z. Anastácio
Background: Considering the development model adopted in Brazilian agriculture, which is based on the increasing demand for chemicals, studies that analyze the impact of pesticide use are relevant to measure the developments in affected populations. Objective: The aim of this study was to conduct a literature review using the digital platform, searching for scientific publications from 2009–2019 on exposure of pregnant women to pesticides. Methods: We used PubMed to search for scientific articles published between January 1, 2009, and December 31, 2019, and related to exposure of pregnant women to pesticides in rural areas. Results: Initially, 207 publications were selected considering the titles and abstracts. Literature works that did not meet the inclusion criteria were excluded. After selection, 15 studies remained. According to the publications on the exposure of pregnant women to pesticides in rural areas from 2009 to 2019, it was found that the damage caused by pesticide exposure to the health of pregnant women and their babies includes problems in gestational weight gain, premature birth, low birth weight, presence of pesticides in blood of both mother and newborn, presence of agricultural pesticides in the cerebral cortex of fetus, and miscarriages. Conclusion: Future prospective studies at individual level are needed to better assess the potential impact of pesticide exposure on the health of pregnant women and newborns.
背景:考虑到巴西农业采用的发展模式是基于对化学品不断增长的需求,分析农药使用影响的研究对于衡量受影响人群的发展是相关的。目的:本研究的目的是利用数字平台进行文献综述,检索2009-2019年有关孕妇接触农药的科学出版物。方法:我们使用PubMed检索2009年1月1日至2019年12月31日期间发表的与农村孕妇接触农药相关的科学文章。结果:综合题目和摘要,初步筛选出207篇文献。不符合纳入标准的文献作品被排除。经过筛选,剩下15项研究。根据2009年至2019年农村地区孕妇接触农药情况的出版物,发现农药接触对孕妇及其婴儿健康造成的损害包括妊娠期体重增加、早产、低出生体重、母亲和新生儿血液中存在农药、胎儿大脑皮层中存在农业农药以及流产等问题。结论:为了更好地评估农药暴露对孕妇和新生儿健康的潜在影响,未来需要在个体水平上进行前瞻性研究。
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引用次数: 0
Investigation of the Relationship Between Immunohistochemical Mismatch Repair (MMR) Protein Expression and Prognostic Parameters in Endometrial Carcinomas 子宫内膜癌免疫组化错配修复(MMR)蛋白表达与预后参数关系的研究
Pub Date : 2023-05-15 DOI: 10.26689/aogr.v1i1.4943
G. Serin, P. Savaş, N. Özdemir, O. Zekioğlu, L. Akman
Objective: Molecular classification has been the most important development in endometrial carcinomas in recent years. This classification divides tumors into four groups: (i) POLE mutant group, (ii) microsatellite instable (MSI) group, (iii) high copy number group (P53 mutation), and (iv) low copy number group. Among these groups, POLE and MSI groups stand out with their better prognosis and potential to benefit from immune-control inhibitor therapy. In our study, we aimed to compare the prognostic parameters of patients with and without nuclear expression loss in MMR proteins (MLH-1, PMS-2, MSH-2, MSH-6) by immunohistochemical (IHC) method. Methods: Between 2017 and 2020, 80 patients who were diagnosed with endometrial carcinoma in hysterectomy material and whose MMR proteins were evaluated as IHC were included in the study. Patients with and without MMR loss were compared in terms of tumor size, histological grade (HD), depth of myometrial invasion, lymphovascular invasion (LVI), and cervical involvement. Results: Loss of any of the MMR proteins was present in 37 cases (46.3%), while 43 cases (53.7%) had no loss. When the cases were compared in terms of loss of MMR protein nuclear expression, 45.9% (17/37) of the cases with loss and 27.9% (12/43) of the cases without loss had histologic grade III (P = 0.03). There was no statistically significant difference between the two groups in terms of myometrium 1/2 external invasion, cervical stromal involvement, and LVI. Conclusion: Approximately half of the patients in our study lost at least one of the MMR proteins. The most common losses were MLH-1 and PMS-2. The HD of patients with loss of nuclear expression of MMR proteins tended to be statistically significantly higher than those without loss.
目的:分子分型是近年来子宫内膜癌研究的重要进展。这种分类将肿瘤分为四组:(i) POLE突变组,(ii)微卫星不稳定(MSI)组,(iii)高拷贝数组(P53突变),(iv)低拷贝数组。在这些组中,POLE和MSI组以其更好的预后和从免疫控制抑制剂治疗中获益的潜力而突出。在我们的研究中,我们旨在通过免疫组化(IHC)方法比较MMR蛋白(MLH-1, PMS-2, MSH-2, MSH-6)核表达缺失和非核表达缺失患者的预后参数。方法:2017年至2020年,80例子宫切除术材料中诊断为子宫内膜癌且MMR蛋白评估为IHC的患者纳入研究。在肿瘤大小、组织学分级(HD)、肌层浸润深度、淋巴血管浸润(LVI)和颈椎受累方面,比较了MMR丢失和非MMR丢失患者。结果:37例(46.3%)患者出现MMR蛋白缺失,43例(53.7%)患者未出现MMR蛋白缺失。比较MMR蛋白核表达缺失的病例时,45.9%(17/37)的丢失病例和27.9%(12/43)的未丢失病例的组织学级别为III级(P = 0.03)。两组在肌层1/2外侵、宫颈间质受累和LVI方面无统计学差异。结论:在我们的研究中,大约一半的患者至少丢失了一种MMR蛋白。最常见的损失是MLH-1和PMS-2。MMR蛋白核表达缺失患者的HD倾向于高于未缺失患者。
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引用次数: 0
High Uterosacral Ligament Suspension with Nonabsorbable Sutures in Apical Prolapse: A 24-Month Follow-Up 高位子宫骶韧带悬吊术治疗根尖脱垂:24个月随访
Pub Date : 2023-05-15 DOI: 10.26689/aogr.v1i1.4944
Rodolfo E. Lopez-Orellana, Francisco J. Kaplan-Delmar, Andres I. Yuivar-Santana, Tiare A. Hevia-Grez
Background: Pelvic organ prolapse (POP) is a common pathology affecting up to 60% of women. Transvaginal high uterosacral ligament suspension (HUSLS) is an alternative treatment for apical prolapse. HUSLS has short operative and recovery time, as well as low complication rate. Objective: To evaluate the objective and subjective success rates in patients with apical prolapse who underwent HUSLS at Quilpué Hospital over a 24-month follow-up. Materials: A retrospective, observational, descriptive study was carried out, and all symptomatic patients with apical prolapse ? stage 2 POP-Q classification who underwent HUSLS between September 2014 and October 2019 were included in the study. Data were obtained from the database of the Urogynecology Unit of Quilpué Hospital, after approval by the ethics committee. Objective success was defined as C-point at 1 cm above the hymen, while subjective success was defined as “better” or “much better” in the Patient Global Impression of Improvement (PGI-I) scale and/or a visual analog scale (VAS) greater than 80% at 24 months of follow-up. Results: Of the 46 patients included in the study, the objective success rate was 84%, while the subjective success rate was 70%. Conclusion: Transvaginal HUSLS with permanent sutures is an excellent alternative treatment for apical prolapse, with a success rate similar to the gold standard at 24 months follow-up.
背景:盆腔器官脱垂(POP)是一种常见的病理,影响多达60%的女性。经阴道高位子宫骶韧带悬吊术(HUSLS)是根尖脱垂的另一种治疗方法。手术时间短,恢复时间短,并发症发生率低。目的:通过24个月的随访,评价在quilpu医院行根尖脱垂手术的患者的主观和客观成功率。资料:回顾性、观察性、描述性研究,所有有症状的根尖脱垂患者?在2014年9月至2019年10月期间接受HUSLS的第二阶段POP-Q分类纳入研究。经伦理委员会批准,数据来源于quilpu医院泌尿妇科数据库。客观成功定义为处女膜上方1 cm处的c点,而主观成功定义为患者总体改善印象(PGI-I)量表和/或视觉模拟量表(VAS)在24个月随访时大于80%时“更好”或“更好”。结果:纳入研究的46例患者,客观成功率为84%,主观成功率为70%。结论:经阴道阴道脱垂联合永久缝合线是治疗根尖脱垂的一种很好的替代方法,随访24个月成功率接近金标准。
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引用次数: 0
Uterine Torsion Due to Uterine Fibroid in Non-Pregnant Women: A Case Report 非妊娠妇女子宫肌瘤所致子宫扭转1例
Pub Date : 2023-05-05 DOI: 10.26689/aogr.v1i1.4922
Yuri Kim, Y. Ku, Y. Won
Uterine torsion is a rare gynecological emergency. It occurs mainly in gravid uterus and extremely rarely in non-gravid uterus. In this article, we report a case of torsion of non-gravid uterus accompanied by a large intramural leiomyoma with focus on computed tomography and magnetic resonance imaging.
子宫扭转是一种罕见的妇科急症。它主要发生在妊娠子宫,在非妊娠子宫极为罕见。在这篇文章中,我们报告了一例非妊娠子宫扭转伴大子宫壁内平滑肌瘤的病例,并重点介绍了计算机断层扫描和磁共振成像。
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引用次数: 0
Guishen Yugong Decoction Combined with Sequential Hormone Replacement Therapy in the Treatment of Premature Ovarian Failure and Its Effect on Serum Sex Hormones 归肾育宫汤联合序贯激素替代疗法治疗卵巢早衰及对血清性激素的影响
Pub Date : 2023-03-28 DOI: 10.26689/aogr.v1i1.5081
Limei Qin, Jia-Xin Qin
Objective: To analyze the therapeutic effect of Guishen Yugong Decoction + sequential hormone (estrogen and progesterone) replacement therapy and its effect on serum sex hormones in patients with premature ovarian failure. Methods: From July 2020 to July 2022, 100 patients with premature ovarian failure were included in the study. Random number table method was used to divide the patients into groups: the control group received sequential hormone replacement therapy, whereas the treatment group received Guishen Yugong Decoction + sequential hormone replacement therapy. The curative effect, traditional Chinese medicine (TCM) syndrome scores, serum sex hormone levels, and incidence of adverse reactions of both groups of patients were compared. Results: The total effective rate in the treatment group was higher than that in the control group, P < 0.05; the TCM syndrome scores in the treatment group were lower than those in the control group, P < 0.05; the serum sex hormone indices in the treatment group were better than those in the control group (P < 0.05); the treatment group had lower incidence of adverse reactions, as compared to the control group (P < 0.05). Conclusion: Guishen Yugong Decoction + sequential hormone replacement therapy can regulate serum sex hormone levels and relieve symptoms of premature ovarian failure. This treatment is not only effective, but also safe for clinical use.
目的:分析归肾育宫汤+序贯激素(雌激素、孕激素)替代治疗对卵巢早衰患者血清性激素的影响。方法:选取2020年7月~ 2022年7月100例卵巢早衰患者作为研究对象。采用随机数字表法将患者分为两组:对照组采用序贯激素替代疗法,治疗组采用归神愚公汤+序贯激素替代疗法。比较两组患者的疗效、中医证候评分、血清性激素水平及不良反应发生率。结果:治疗组总有效率高于对照组,P < 0.05;治疗组中医证候评分低于对照组,P < 0.05;治疗组血清性激素指标优于对照组(P < 0.05);治疗组不良反应发生率低于对照组(P < 0.05)。结论:归肾育宫汤+序贯激素替代疗法可调节血清性激素水平,缓解卵巢早衰症状。这种治疗方法不仅有效,而且临床使用安全。
{"title":"Guishen Yugong Decoction Combined with Sequential Hormone Replacement Therapy in the Treatment of Premature Ovarian Failure and Its Effect on Serum Sex Hormones","authors":"Limei Qin, Jia-Xin Qin","doi":"10.26689/aogr.v1i1.5081","DOIUrl":"https://doi.org/10.26689/aogr.v1i1.5081","url":null,"abstract":"Objective: To analyze the therapeutic effect of Guishen Yugong Decoction + sequential hormone (estrogen and progesterone) replacement therapy and its effect on serum sex hormones in patients with premature ovarian failure. Methods: From July 2020 to July 2022, 100 patients with premature ovarian failure were included in the study. Random number table method was used to divide the patients into groups: the control group received sequential hormone replacement therapy, whereas the treatment group received Guishen Yugong Decoction + sequential hormone replacement therapy. The curative effect, traditional Chinese medicine (TCM) syndrome scores, serum sex hormone levels, and incidence of adverse reactions of both groups of patients were compared. Results: The total effective rate in the treatment group was higher than that in the control group, P < 0.05; the TCM syndrome scores in the treatment group were lower than those in the control group, P < 0.05; the serum sex hormone indices in the treatment group were better than those in the control group (P < 0.05); the treatment group had lower incidence of adverse reactions, as compared to the control group (P < 0.05). Conclusion: Guishen Yugong Decoction + sequential hormone replacement therapy can regulate serum sex hormone levels and relieve symptoms of premature ovarian failure. This treatment is not only effective, but also safe for clinical use.","PeriodicalId":269611,"journal":{"name":"Advances in Obstetrics and Gynecology Research","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122148800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Advances in Obstetrics and Gynecology Research
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