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Case report of spontaneous hemoperitoneum secondary to uterine myomatosis and adenomyosis 子宫肌瘤病继发自发性腹膜出血1例
IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-04 DOI: 10.1016/j.gine.2025.101066
J.C. Ramírez , K. Cepeda , F. Carmona

Introduction

Myomatosis and uterine adenomyosis are the most common benign uterine pathologies suffered by women of reproductive age and the symptoms they produce are mainly abnormal vaginal bleeding, dysmenorrhea and pelvic pain, but they are rarely associated with spontaneous peritoneal bleeding. The existence of this entity and its etiology is little known in the literature, limited to case reports, generating a difficulty in diagnosis. The objective of this article is to report an infrequent case of spontaneous hemoperitoneum secondary to uterine myomatosis and adenomyosis.

Main symptoms

Prior informed consent and certification from the institution's ethics committee. This is a 50-year-old Colombian patient, in a state of symptomatic perimenopause with hormone replacement therapy, who came to the emergency department with a history of pain in the lower abdomen of three days of severe intensity, only associated with diarrhea.

Main diagnoses

Abdominal computed tomography and transvaginal ultrasound diagnosed hemoperitoneum associated with a probable left adnexal mass, suggestive of a ruptured hemorrhagic cyst.

Therapeutic interventions and results

Exploratory laparoscopy was performed and identify hemoperitoneum secondary to a highly vascularized subserosal fibroid with bleeding from its base, hypervascularized uterus, without obvious ovarian pathology, associated with multiple adhesions between the fibroid, uterine tube and ipsilateral ovary. Due to the patient's age and continuous uncontrolled bleeding, it was decided to perform a total hysterectomy plus unilateral left salpingo-oferectomy.

Conclusion

This case demonstrates that, although extremely rare, uterine fibroids (still coexisting with adenomyosis) can cause spontaneous hemoperitoneum. It is essential to consider this diagnosis within the acute gynecological abdomen, since timely recognition and treatment improve the prognosis.
子宫肌瘤病和子宫血栓是育龄妇女最常见的子宫良性病变,其症状主要为阴道异常出血、痛经和盆腔疼痛,但很少伴有自发性腹膜出血。这种实体的存在及其病因在文献中知之甚少,仅限于病例报告,产生诊断困难。本文的目的是报告一例罕见的自发性腹膜出血继发于子宫肌瘤病和子宫腺肌症。主要症状:事先知情同意并获得机构伦理委员会的认证。这是一名50岁的哥伦比亚患者,处于有症状的围绝经期,接受激素替代治疗,他来到急诊科,有三天的下腹剧烈疼痛史,仅伴有腹泻。主要诊断:腹部计算机断层扫描和经阴道超声诊断腹腔积血可能伴有左附件肿块,提示出血性囊肿破裂。治疗措施及结果:行探查腹腔镜检查,发现浆膜下肌瘤继发于浆膜下肌瘤,其底部出血,子宫血管充血,卵巢无明显病理,肌瘤、输卵管和同侧卵巢之间存在多发粘连。由于患者的年龄和持续不受控制的出血,我们决定进行全子宫切除术加单侧左侧输卵管-子宫切除术。结论本病例表明,虽然极为罕见,但子宫肌瘤(仍与子宫腺肌症共存)可引起自发性腹膜出血。在急腹症中考虑这种诊断是必要的,因为及时识别和治疗可以改善预后。
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引用次数: 0
Ablación por radiofrecuencia exitosa de miomas uterinos muy grandes: estudio de 2 casos 成功射频切除非常大的子宫肌瘤:2例研究
IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-09-02 DOI: 10.1016/j.gine.2025.101065
C. Torrijo Rodrigo, V. Gómez García, C. Giménez Molina

Introduction

Radiofrequency ablation (RFA) is one of the latest minimally invasive treatment options for symptomatic uterine fibroids. The primary goal is to evaluate the feasibility and effectiveness of RFA as a minimally invasive treatment for large uterine fibroids, preserving the uterus and fertility.

Main symptoms and/or clinical findings

Two women, aged 47 and 40, with very large fibroids (approximately 10 cm in length) exhibited symptoms such as hypermenorrhea, urinary symptoms, back pain, and a painful mass.

Main diagnoses, therapeutic interventions, and outcomes

Uterine leiomyomas or fibroids. RFA was performed using a 35 cm monopolar electrode with a 17 gauge and a 10 mm active tip. The sizes of the fibroids were reduced by more than half, and symptoms disappeared after the procedure.
Case 1: A 47-year-old woman with a 10 cm fibroid showed a significant reduction in fibroid size (from 437 to 9 cm3) and complete resolution of symptoms within one year.
Case 2: A 40-year-old woman with a 10.5 cm fibroid experienced a notable reduction in fibroid size (from 472 to 33 cm3) and resolution of symptoms within six months.

Conclusion

These cases demonstrate that RFA is a safe and effective method for treating large uterine fibroids, with significant reductions in fibroid volume and resolution of symptoms. The procedure should be performed by gynecologists experienced in minimally invasive techniques.
射频消融(RFA)是治疗症状性子宫肌瘤的最新微创治疗方法之一。主要目的是评估RFA作为一种微创治疗大子宫肌瘤的可行性和有效性,保留子宫和生育能力。主要症状和/或临床表现2例女性,年龄47岁和40岁,患有超大肌瘤(长约10厘米),表现出痛经、尿路症状、背痛和疼痛肿块等症状。子宫平滑肌瘤或肌瘤的主要诊断、治疗措施及结果。RFA使用35 cm单极电极,17 gauge和10 mm有源尖端。肌瘤的大小缩小了一半以上,手术后症状消失。病例1:一名47岁女性,肌瘤为10厘米,肌瘤大小明显减小(从437厘米减小到9厘米),一年内症状完全缓解。病例2:一名患有10.5 cm肌瘤的40岁女性在6个月内肌瘤大小明显减小(从472减小到33 cm3),症状得到缓解。结论RFA是一种安全有效的治疗大肌瘤的方法,肌瘤体积明显缩小,症状明显缓解。手术应由具有微创技术经验的妇科医生进行。
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引用次数: 0
Adaptación de un sistema de presión negativa con succión central de bajo costo para el tratamiento de heridas ginecoobstétricas infectadas. Un estudio de cohorte retrospectivo 采用低成本中央抽吸负压系统治疗受感染的妇产科伤口。回顾性队列研究
IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-08-25 DOI: 10.1016/j.gine.2025.101064
Carlos Dragonas-Romo , Silvia Caballero-Delgado , Jorge Luis Rodríguez-Sánchez , José Juan Quilantán-Cabrera , Karla Fabiola Rodríguez-Gómez , Luis Enrique Colunga-Lozano

Background

The objective is to describe a technique for placing a negative pressure wound therapy system using central suction as a treatment for infected surgical wounds in low-resource settings.

Methods

A retrospective cohort study was conducted at the General Hospital of Zapopan from November 2021 to May 2023. We included patients from the Gynecology and Obstetrics Department with infected and dehiscence surgical wound who consented underwent placement of a central suction system. Surgical time, intraoperative bleeding, complications, morbidity, and mortality were analyzed. We evaluated the patients in the preoperative, immediate postoperative, and 3-month follow-up.

Results

Ten patients were included, comprising 8 post-cesarean section patients, one post-hysterectomy patient, and one patient with Fournier's gangrene. The mean age was 29.91 years (± 12.97), with 5 patients having comorbidities. All patients with infected surgical wounds had wound dehiscence. Variations in the results of wound secretion cultures were found with the following pathogens: Staphylococcus lugdunensis, Staphylococcus epidermidis, Streptococcus gallolyticus and Klebsiella oxytoca, indicating no particular etiological agent. Length of hospital stay depended on the case, wound extent and depth, and the number of required changes.

Conclusion

Our technique is a cost-effective alternative for managing surgical wounds with favorable outcomes, suitable for replication in low-resource hospitals. However, further studies with a larger number of patients are needed.
目的是描述一种技术,放置负压伤口治疗系统使用中心吸引作为治疗感染的外科伤口在低资源设置。方法回顾性队列研究于2021年11月至2023年5月在Zapopan总医院进行。我们纳入了来自妇产科的手术伤口感染和裂开并同意放置中央吸引系统的患者。分析手术时间、术中出血、并发症、发病率和死亡率。我们在术前、术后即刻和3个月的随访中对患者进行评估。结果共纳入10例患者,其中剖宫产术后8例,子宫切除术后1例,富尼耶坏疽1例。平均年龄29.91岁(±12.97岁),合并合并症5例。手术创面感染患者均出现创面裂开。伤口分泌物培养结果的变化与以下病原体有关:葡萄球菌、表皮葡萄球菌、溶胆链球菌和产氧克雷伯菌,表明没有特定的病原。住院时间长短取决于病例、伤口的范围和深度以及需要改变的次数。结论本技术是一种经济有效的外科创面处理方法,效果良好,适合在资源匮乏的医院推广应用。然而,需要对更多的患者进行进一步的研究。
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引用次数: 0
Escalas de evaluación de la actividad lúpica en el embarazo 孕期狼疮活动量表
IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-07-04 DOI: 10.1016/j.gine.2025.101054
D. Guavita-Navarro , L.C. Guavita , V. Barbosa-Prieto , C. Sanmiguel-Reyes
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that frequently experiences flares during pregnancy due to the physiological and immunological changes characteristic of this period. These alterations can present as lupus activity or obstetric complications, particularly hypertensive disorders, necessitating precise clinical assessment and multidisciplinary management to minimize maternal and fetal risks. Given the importance of accurately identifying disease activity during pregnancy and the postpartum period, this review examines the main available indices for evaluating lupus activity in pregnant patients.
系统性红斑狼疮(SLE)是一种多系统自身免疫性疾病,由于妊娠期的生理和免疫变化,经常在妊娠期发作。这些改变可以表现为狼疮活动或产科并发症,特别是高血压疾病,需要精确的临床评估和多学科管理,以尽量减少产妇和胎儿的风险。鉴于在怀孕期间和产后准确识别疾病活动的重要性,本文综述了评估怀孕患者狼疮活动的主要可用指标。
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引用次数: 0
From fasting to feasting: Unraveling the postoperative benefits of preoperative carbohydrate intake in cesarean delivery—A systematic review and meta-analysis 从禁食到盛宴:揭示剖宫产术前碳水化合物摄入的术后益处——一项系统回顾和荟萃分析
IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-05-20 DOI: 10.1016/j.gine.2025.101039
R.A. Kasem , A. Attalla , A. Ramadan , A. Tawfik , A. Salmona , M.K. AbdElhaseeb

Objectives

Preoperative fasting is a common practice in cesarean section deliveries, but prolonged fasting can have negative effects on patient outcomes. Preoperative carbohydrate intake has been proposed as a way to mitigate these effects. The purpose of this systematic review and meta-analysis is to assess the potential benefits and complications of preoperative oral carbohydrates in women undergoing cesarean section (CS).

Methods

A comprehensive search was conducted in PubMed, Cochrane, Web of Science, and Scopus databases until August 2023. Randomized controlled trials (RCTs) that compared preoperative oral carbohydrates to a placebo or fasting group in pregnant women undergoing CS were included. The outcomes included vomiting, insulin resistance, amount of bleeding, plasma glucose and serum insulin.

Results

We included five RCTs with a total of 2275 cases. According to the meta-analysis results, preoperative oral carbohydrates significantly reduced postoperative serum insulin levels (SMD = −0.58, 95% CI [−0.95 to −0.21], P = 0.002) and insulin resistance (SMD = −0.32, 95% CI [−0.58 to −0.07], P = 0.01) compared to control groups. However, preoperative oral carbohydrates did not have a significant effect on postoperative vomiting (RR = 0.96, 95% CI [0.77–1.20], P = 0.73), the amount of bleeding (SMD = −0.17, 95% CI [−0.52 to 0.18], P = 0.34) or plasma glucose levels (SMD = −0.12, 95% CI [−0.29 to 0.05], P = 0.17).

Conclusion

Preoperative oral carbohydrates can improve metabolic outcomes, specifically reducing postoperative serum insulin levels and insulin resistance in women undergoing CS, without increasing the risk of vomiting. However, they did not significantly affect the amount of bleeding or plasma glucose levels.
目的术前禁食是剖宫产的常见做法,但长时间禁食会对患者的预后产生负面影响。术前碳水化合物摄入被认为是减轻这些影响的一种方法。本系统综述和荟萃分析的目的是评估剖宫产(CS)妇女术前口服碳水化合物的潜在益处和并发症。方法截至2023年8月,在PubMed、Cochrane、Web of Science、Scopus等数据库中进行综合检索。随机对照试验(rct)比较术前口服碳水化合物与安慰剂组或禁食组在接受CS的孕妇中。结果包括呕吐、胰岛素抵抗、出血量、血浆葡萄糖和血清胰岛素。结果纳入5项随机对照试验,共2275例。meta分析结果显示,与对照组相比,术前口服碳水化合物显著降低了术后血清胰岛素水平(SMD = - 0.58, 95% CI [- 0.95 ~ - 0.21], P = 0.002)和胰岛素抵抗(SMD = - 0.32, 95% CI [- 0.58 ~ - 0.07], P = 0.01)。然而,术前口服碳水化合物对术后呕吐(RR = 0.96, 95% CI [0.77-1.20], P = 0.73)、出血量(SMD = - 0.17, 95% CI[- 0.52至0.18],P = 0.34)或血浆葡萄糖水平(SMD = - 0.12, 95% CI[- 0.29至0.05],P = 0.17)没有显著影响。结论术前口服碳水化合物可改善CS患者的代谢结局,特别是降低术后血清胰岛素水平和胰岛素抵抗,且不增加呕吐风险。然而,它们并没有显著影响出血量或血浆葡萄糖水平。
{"title":"From fasting to feasting: Unraveling the postoperative benefits of preoperative carbohydrate intake in cesarean delivery—A systematic review and meta-analysis","authors":"R.A. Kasem ,&nbsp;A. Attalla ,&nbsp;A. Ramadan ,&nbsp;A. Tawfik ,&nbsp;A. Salmona ,&nbsp;M.K. AbdElhaseeb","doi":"10.1016/j.gine.2025.101039","DOIUrl":"10.1016/j.gine.2025.101039","url":null,"abstract":"<div><h3>Objectives</h3><div>Preoperative fasting is a common practice in cesarean section deliveries, but prolonged fasting can have negative effects on patient outcomes. Preoperative carbohydrate intake has been proposed as a way to mitigate these effects. The purpose of this systematic review and meta-analysis is to assess the potential benefits and complications of preoperative oral carbohydrates in women undergoing cesarean section (CS).</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Cochrane, Web of Science, and Scopus databases until August 2023. Randomized controlled trials (RCTs) that compared preoperative oral carbohydrates to a placebo or fasting group in pregnant women undergoing CS were included. The outcomes included vomiting, insulin resistance, amount of bleeding, plasma glucose and serum insulin.</div></div><div><h3>Results</h3><div>We included five RCTs with a total of 2275 cases. According to the meta-analysis results, preoperative oral carbohydrates significantly reduced postoperative serum insulin levels (SMD<!--> <!-->=<!--> <!-->−0.58, 95% CI [−0.95 to −0.21], <em>P</em> <!-->=<!--> <!-->0.002) and insulin resistance (SMD<!--> <!-->=<!--> <!-->−0.32, 95% CI [−0.58 to −0.07], <em>P</em> <!-->=<!--> <!-->0.01) compared to control groups. However, preoperative oral carbohydrates did not have a significant effect on postoperative vomiting (RR<!--> <!-->=<!--> <!-->0.96, 95% CI [0.77–1.20], <em>P</em> <!-->=<!--> <!-->0.73), the amount of bleeding (SMD<!--> <!-->=<!--> <!-->−0.17, 95% CI [−0.52 to 0.18], <em>P</em> <!-->=<!--> <!-->0.34) or plasma glucose levels (SMD<!--> <!-->=<!--> <!-->−0.12, 95% CI [−0.29 to 0.05], <em>P</em> <!-->=<!--> <!-->0.17).</div></div><div><h3>Conclusion</h3><div>Preoperative oral carbohydrates can improve metabolic outcomes, specifically reducing postoperative serum insulin levels and insulin resistance in women undergoing CS, without increasing the risk of vomiting. However, they did not significantly affect the amount of bleeding or plasma glucose levels.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101039"},"PeriodicalIF":0.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090266","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
Radiofrequency treatment value for uterine fibroids in pregnant and infertile women 妊娠和不孕症妇女子宫肌瘤的射频治疗价值
IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-05-13 DOI: 10.1016/j.gine.2025.101052
M. Bonet-Sánchez , I. Pelayo-Delgado
Radiofrequency ablation of uterine fibroids is a technique based on the application of a high-frequency electrical current, causing a coagulative necrosis of the fibroid. The aim of this review is to analyse the influence of radiofrequency treatment of fibroids in women with gestational desire and its influence on pregnancy, through the compilation and study of recent articles. Radiofrequency has achieved a similar number of full-term births compared to that of surgical myomectomy, which until now has been the gold standard treatment for women with myomas desiring pregnancy. It also seems to increase obstetric security in pregnant women previously treated compared to other techniques, with fewer rate of preterm deliveries, spontaneous abortions and placental changes. However, more randomized clinical trials focusing specifically on pregnancy are necessary to reach definitive conclusions.
子宫肌瘤的射频消融是一种基于高频电流应用的技术,引起肌瘤的凝固性坏死。本综述的目的是通过对近期文章的汇编和研究,分析射频治疗子宫肌瘤对妊娠的影响及其对妊娠的影响。与手术子宫肌瘤切除术相比,射频治疗的足月分娩数量与手术子宫肌瘤切除术相似,到目前为止,子宫肌瘤切除术一直是希望怀孕的子宫肌瘤妇女的黄金标准治疗方法。与其他技术相比,它似乎也增加了以前接受过治疗的孕妇的产科安全性,早产、自然流产和胎盘改变的发生率更低。然而,需要更多针对妊娠的随机临床试验来得出明确的结论。
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引用次数: 0
Impact of deep endometriosis with and without ovarian involvement on quality of life compared to exclusive ovarian endometriosis 与排他性卵巢子宫内膜异位症相比,伴有和不伴有卵巢受累的深部子宫内膜异位症对生活质量的影响
IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-05-10 DOI: 10.1016/j.gine.2025.101053
M.d.P. Marín Sánchez , M. Martínez-Esparza , P. García-Peñarrubia , A.J. Ruiz-Alcaraz , J.J. Arense-Gonzálo

Objective

To evaluate potential differences in quality of life between patients with deep endometriosis, with or without ovarian involvement (DE), and those with exclusive ovarian endometriosis (OMA).

Material and method

A prospective observational study was conducted on patients diagnosed with endometriosis through clinical assessment and imaging techniques, or histological confirmation. Patients were labeled as OMA or DE. Clinical data such as pain (visual analogue scale), demographic and anthropometric data, and QoL (SF-12v2 scale) were evaluated. Statistical analysis was performed using IBM SPSS 25.0.

Results

A total of 307 patients were enrolled, 109 with OMA and 198 with DE. Patients with OMA were younger than those with DE. QoL in the physical domain was lower in DE compared to OMA (46 ± 11.91 vs 49.9 ± 9.4; p < 0.02). No statistically significant differences were observed in the mental domain (41.5 ± 10.2 vs 42.8 ± 11; p < 0.276). Pain scores on the visual analogue scale did not differ significantly between groups. However, in the pain domain of the SF-12v2 scale, significant differences were found, with lower scores in DE (61.4 ± 32.7 vs 73.6 ± 28.6; p < 0.001).

Conclusion

QoL scales should be utilized in clinical practice as they provide valuable insights into how the disease impacts patients’ lives. Patients with deep endometriosis have a poorer QoL in the physical domain compared to those with exclusive ovarian endometriosis.
目的评价深部子宫内膜异位症伴或不伴卵巢受累(DE)患者与排他性卵巢子宫内膜异位症(OMA)患者生活质量的潜在差异。材料与方法对经临床评估、影像学检查或组织学证实的子宫内膜异位症患者进行前瞻性观察研究。将患者标记为OMA或DE。评估临床数据,如疼痛(视觉模拟量表)、人口统计学和人体测量数据以及生活质量(SF-12v2量表)。采用IBM SPSS 25.0进行统计学分析。结果共纳入307例患者,其中OMA患者109例,DE患者198例,OMA患者年龄小于DE患者,DE患者的生理生活质量低于OMA患者(46±11.91 vs 49.9±9.4;p & lt;0.02)。两组在心理领域的差异无统计学意义(41.5±10.2 vs 42.8±11;p & lt;0.276)。视觉模拟量表疼痛评分组间无显著差异。然而,在SF-12v2量表的疼痛域,发现有显著差异,DE得分较低(61.4±32.7 vs 73.6±28.6;p & lt;0.001)。结论生活质量量表对疾病如何影响患者生活提供了有价值的见解,值得在临床实践中使用。与排他性卵巢子宫内膜异位症患者相比,深部子宫内膜异位症患者在物理领域的生活质量较差。
{"title":"Impact of deep endometriosis with and without ovarian involvement on quality of life compared to exclusive ovarian endometriosis","authors":"M.d.P. Marín Sánchez ,&nbsp;M. Martínez-Esparza ,&nbsp;P. García-Peñarrubia ,&nbsp;A.J. Ruiz-Alcaraz ,&nbsp;J.J. Arense-Gonzálo","doi":"10.1016/j.gine.2025.101053","DOIUrl":"10.1016/j.gine.2025.101053","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate potential differences in quality of life between patients with deep endometriosis, with or without ovarian involvement (DE), and those with exclusive ovarian endometriosis (OMA).</div></div><div><h3>Material and method</h3><div>A prospective observational study was conducted on patients diagnosed with endometriosis through clinical assessment and imaging techniques, or histological confirmation. Patients were labeled as OMA or DE. Clinical data such as pain (visual analogue scale), demographic and anthropometric data, and QoL (SF-12v2 scale) were evaluated. Statistical analysis was performed using IBM SPSS 25.0.</div></div><div><h3>Results</h3><div>A total of 307 patients were enrolled, 109 with OMA and 198 with DE. Patients with OMA were younger than those with DE. QoL in the physical domain was lower in DE compared to OMA (46<!--> <!-->±<!--> <!-->11.91 vs 49.9<!--> <!-->±<!--> <!-->9.4; <em>p</em> <!-->&lt;<!--> <!-->0.02). No statistically significant differences were observed in the mental domain (41.5<!--> <!-->±<!--> <!-->10.2 vs 42.8<!--> <!-->±<!--> <!-->11; <em>p</em> <!-->&lt;<!--> <!-->0.276). Pain scores on the visual analogue scale did not differ significantly between groups. However, in the pain domain of the SF-12v2 scale, significant differences were found, with lower scores in DE (61.4<!--> <!-->±<!--> <!-->32.7 vs 73.6<!--> <!-->±<!--> <!-->28.6; <em>p</em> <!-->&lt;<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>QoL scales should be utilized in clinical practice as they provide valuable insights into how the disease impacts patients’ lives. Patients with deep endometriosis have a poorer QoL in the physical domain compared to those with exclusive ovarian endometriosis.</div></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 3","pages":"Article 101053"},"PeriodicalIF":0.1,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143929403","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
How to perform a fetal neurosonography: Key points 如何进行胎儿神经超声检查:要点
IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-05-10 DOI: 10.1016/j.gine.2025.101050
B. Puerto , P. Azumendi , C. Corrales , G. Azumendi
Congenital anomalies of the Central Nervous System are one of the most important and numerous groups of congenital malformations. They constitute the second cause of disability in childhood and more than 95% occur in a population without known risk. The most effective strategy for its detection is to differentiate between 2 levels of care. The first level, the BASIC ULTRASONOGRAPHY, is performed on all pregnant women, while the second level, the DETAILED FETAL NEUROSONOGRAPHY, is performed in cases selected due to the risk of anomaly based on a list of indications or because an abnormality has been detected or suspected. CNS abnormality on basic ultrasound. Its purpose is to perform a complete morphological and biometric multiplanar analysis of all accessible and recognizable brain structures from the axial, coronal and sagittal planes, ideally through transabdominal and transvaginal access. In the 3 plans, an attempt should be made to evaluate the same structures, assuming the limitations posed by the different perspective provided by each of them. When performing it, it is essential to take into account the indication and gestational age, know the morphological patterns, have reference tables of the normality of the different intracranial structures for GD and follow the systematics proposed by scientific societies. The objective of this article is to describe the different planes and provide readers with the key points for the ultrasound detection of the most important and frequent malformations of the CNS.
中枢神经系统先天性异常是最重要的先天性畸形之一,数量众多。它们是儿童致残的第二大原因,95%以上发生在没有已知风险的人群中。最有效的检测策略是区分两个级别的护理。第一阶段,基本超声检查,对所有孕妇进行,而第二阶段,详细胎儿神经超声检查,在根据一系列适应症选择的异常风险或因为检测到或怀疑异常的病例中进行。基础超声显示中枢神经系统异常。其目的是从轴、冠状面和矢状面对所有可接近和可识别的脑结构进行完整的形态学和生物特征多面分析,理想情况下通过经腹和经阴道通道。在这3个计划中,应该尝试评估相同的结构,假设每个计划所提供的不同视角所带来的限制。在进行GD手术时,应考虑适应症和胎龄,了解形态学模式,有GD颅内不同结构正常程度的参考表,并遵循科学学会提出的分类学。本文的目的是描述不同的平面,并为读者提供超声检测中枢神经系统最重要和最常见的畸形的关键点。
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引用次数: 0
Abdominal access following insufflation with Veress needle at high pressure: A security maneuver for the reduction of surgical complications during laparoscopic access 在高压下用Veress针注入腹部通路:在腹腔镜通路中减少手术并发症的安全操作
IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-05-09 DOI: 10.1016/j.gine.2025.101051
F. Palomo-Rodriguez , J. Gallardo-Martinez , R.D. Brenner-Anidjar , Z. Frias-Sanchez , S. Rojo-Novo , M. Pantoja-Garrido , F.J. Pantoja-Rosso , J.J. Fernandez-Alba

Introduction

Up to 50% of laparoscopic complications arise during access maneuvers to abdominal cavity. Our aim is to determine whether elevated pressures of 20–25 mmHg during these maneuvers, by increasing the distance between the abdominal wall and intracavitary organs, can help reduce the risk of entry-related complications, without an increase in anesthetic adverse effects.

Methods and materials

Prospective observational analytic multi-centered cohort study with 703 patients. The exposed-cohort consisted of patients undergoing gynecological laparoscopic surgeries in which an intra-abdominal pressure of 20–25 mmHg was used (group 20–25 mmHg) as opposed to the unexposed-cohort, in which usual < 15 mmHg pressures (group < 15 mmHg) were used. All surgeries were performed using the Veress needle as the method of insufflation.

Results

Patients in whom access was performed at pressures < 15 mmHg had a higher risk of complications than those in whom elevated pressures of 20–25 mmHg were used, which was statistically significant (OR 3.08, 95% CI95% 1.42–6.65, p = 0.004), without finding differences regarding anesthetic complications (p = 0.9).

Conclusion

The use of high intraabdominal pressure during access maneuvers serves as an effective technique for the prevention of complications, especially major complications, when compared with standard-used pressures, without increasing the incidence of anesthetic adverse effects, due to their temporary maintenance.
高达50%的腹腔镜并发症发生在进入腹腔的过程中。我们的目的是确定在这些操作中,通过增加腹壁和腔内器官之间的距离,将压力升高20-25 mmHg是否有助于减少与进入相关的并发症的风险,而不会增加麻醉剂的不良反应。方法与材料703例患者的前瞻性观察分析多中心队列研究。暴露队列由接受妇科腹腔镜手术的患者组成,其中使用20-25 mmHg的腹内压(20-25 mmHg组)与未暴露队列相反,其中通常使用<;15毫米汞柱压力(组<;15 mmHg)。所有手术均采用Veress针作为充气方法。结果在压力下进行访问的患者;15 mmHg组的并发症风险高于20-25 mmHg组,差异有统计学意义(OR 3.08, 95% CI95% 1.42-6.65, p = 0.004),麻醉并发症无差异(p = 0.9)。结论与标准压力相比,使用高腹内压可有效预防并发症,特别是主要并发症的发生,且由于其暂时性维持,不会增加麻醉不良反应的发生率。
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引用次数: 0
Peripartum anxiety symptoms and breastfeeding duration: Prospective observational study 围产期焦虑症状与母乳喂养持续时间:前瞻性观察研究
IF 0.1 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2025-04-28 DOI: 10.1016/j.gine.2025.101038
M.J. Rol , M.J. Cuerva , A. Briones , J.L. Bartha

Introduction

There's a lack of effective screening methods to predict early breastfeeding cessation. Our study aimed to assess whether a simple screening of anxiety symptoms after the early postpartum period could help identify those families who discontinue exclusive and mixed breastfeeding early, despite their desire to breastfeed.

Methods

This prospective observational study, conducted at a single center, included women who were admitted to the postpartum ward following vaginal term births. Each participant was accompanied by their companions and babies and expressed a desire to breastfeed. Participants were divided into two groups based on whether they exhibited peripartum anxiety symptoms, assessed using the Hospital Anxiety and Depression scale (HADS). Follow-up assessments of the breastfeeding practices were conducted up to three years postpartum.

Results

A total of 113 eligible women participated in the study, with 92 women successfully followed up for three years. At six months postpartum, 56.5% of the women were exclusively breastfeeding, and 78.3% were still breastfeeding. No significant differences were observed in breastfeeding practices between the group exhibiting peripartum anxiety symptoms and the group without such symptoms.

Conclusion

Our approach, which concentrated on anxiety, did not yield an implementable screening tool for early breastfeeding cessation.
目前缺乏有效的筛查方法来预测母乳喂养的早期停止。我们的研究旨在评估产后早期焦虑症状的简单筛查是否有助于识别那些早期停止纯母乳喂养和混合母乳喂养的家庭,尽管他们希望母乳喂养。方法:本前瞻性观察性研究在单中心进行,纳入阴道足月分娩后入住产后病房的妇女。每个参与者都有他们的同伴和婴儿陪同,并表达了母乳喂养的愿望。参与者根据是否表现出围产期焦虑症状分为两组,使用医院焦虑和抑郁量表(HADS)进行评估。对母乳喂养做法进行随访评估,直至产后三年。结果共有113名符合条件的女性参与了这项研究,其中92名女性成功随访了三年。产后6个月,56.5%的妇女是纯母乳喂养,78.3%的妇女仍在母乳喂养。在有围生期焦虑症状的组和没有这种症状的组之间,观察到母乳喂养的做法没有显著差异。结论:我们的方法集中在焦虑上,并没有产生一个可实施的早期停止母乳喂养的筛查工具。
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引用次数: 0
期刊
Clinica e Investigacion en Ginecologia y Obstetricia
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