Taiwanese Journal of Obstetrics & Gynecology最新文献

英文中文

Medical treatment for pelvic congestion syndrome with flavonoid: A pilot study

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-03-01 DOI: 10.1016/j.tjog.2024.12.008

I-Hui Lee , Tzu-Yin Lin , Shen Sun , Chun-Jui Sun

Objective

To investigate the efficacy of medical management by flavonoid in women with pelvic congestion syndrome (PCS) by comparison of the changes in venous size and quality of life (QoL) before and after treatment.

Materials and methods

Eleven women who met the diagnostic criteria of PCS were enrolled in the study. Flavonoid 500 mg twice or 1000 mg once daily was prescribed. Objective outcome was evaluated by measurement of ovarian vein diameter via transvaginal ultrasound in each case before and after 3–6 months of the treatment. PCS related symptoms were evaluated by Pelvic Varicose Vein Questionnaire (PVVQ), and Visual Analog Scale (VAS) as subjective outcomes. Wilcoxon signed rank test was used to compare the differences pre- and post-treatment. Data analysis was performed using SPSS 22.0. Statistical significance was defined as P value < 0.05.

Results

From January 2022 to September 2023, 11 women met the criteria and were diagnosed with pelvic congestion syndrome. The age ranged from 40 to 72 years old with mean of 57 y/o. 90.9 % of the subjects (10/11) reported significant decreases in VAS (mean = 5.9 pre-vs. 2.5 post-treatment, p = 0.005) and PVVQ (mean = 51.6 pre-vs. 30.5 post-treatment, p = 0.005). Transvaginal ultrasound also showed significant decreases in ovarian vein diameter, from 8.1 mm to 6.2 mm (p = 0.016).

Conclusion

Our study demonstrated that medical treatment with flavonoids significantly reduced of ovarian venous diameter in patients with pelvic congestion syndrome. Additionally, the impaired quality of life was markedly improved proven by the significant decreases of PVVQ and VAS scores following treatment. Based on these findings, we suggest that flavonoids may be considered as first-line treatment for patients with pelvic congestion syndrome in routine clinical practice.

{"title":"Medical treatment for pelvic congestion syndrome with flavonoid: A pilot study","authors":"I-Hui Lee , Tzu-Yin Lin , Shen Sun , Chun-Jui Sun","doi":"10.1016/j.tjog.2024.12.008","DOIUrl":"10.1016/j.tjog.2024.12.008","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the efficacy of medical management by flavonoid in women with pelvic congestion syndrome (PCS) by comparison of the changes in venous size and quality of life (QoL) before and after treatment.</div></div><div><h3>Materials and methods</h3><div>Eleven women who met the diagnostic criteria of PCS were enrolled in the study. Flavonoid 500 mg twice or 1000 mg once daily was prescribed. Objective outcome was evaluated by measurement of ovarian vein diameter via transvaginal ultrasound in each case before and after 3–6 months of the treatment. PCS related symptoms were evaluated by Pelvic Varicose Vein Questionnaire (PVVQ), and Visual Analog Scale (VAS) as subjective outcomes. Wilcoxon signed rank test was used to compare the differences pre- and post-treatment. Data analysis was performed using SPSS 22.0. Statistical significance was defined as P value < 0.05.</div></div><div><h3>Results</h3><div>From January 2022 to September 2023, 11 women met the criteria and were diagnosed with pelvic congestion syndrome. The age ranged from 40 to 72 years old with mean of 57 y/o. 90.9 % of the subjects (10/11) reported significant decreases in VAS (mean = 5.9 pre-vs. 2.5 post-treatment, p = 0.005) and PVVQ (mean = 51.6 pre-vs. 30.5 post-treatment, p = 0.005). Transvaginal ultrasound also showed significant decreases in ovarian vein diameter, from 8.1 mm to 6.2 mm (p = 0.016).</div></div><div><h3>Conclusion</h3><div>Our study demonstrated that medical treatment with flavonoids significantly reduced of ovarian venous diameter in patients with pelvic congestion syndrome. Additionally, the impaired quality of life was markedly improved proven by the significant decreases of PVVQ and VAS scores following treatment. Based on these findings, we suggest that flavonoids may be considered as first-line treatment for patients with pelvic congestion syndrome in routine clinical practice.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 2","pages":"Pages 293-297"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence of premenstrual syndrome and its relationship to depression among Korean adolescents: A nationwide cross-sectional study

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-03-01 DOI: 10.1016/j.tjog.2024.08.013

Hooyeon Lee , Kui Son Choi , Yumie Rhee

Objective

To investigate the prevalence of PMS and depressive symptoms and to determine their association among Korean adolescent girls using a nationally representative cross-sectional survey.

Materials and methods

The Korean Study of Women's Health Related Issues (K-Stori)was used. Of the 3000 adolescent girls aged 14–17 years, the study subjects were 2970 girls after menarche. Depressive symptom was assessed with the PHQ-9. Multivariable logistic regression analysis was used to investigate factors associated with depressive symptom.

Results

The prevalence of PMS was 70.5 %. Irritability (43.8 %), abdominal bloating (32.8 %), and breast tenderness (27.5 %) were the most predominant symptoms. The prevalence of depressive symptom was 15.5 %. Girls with PMS were more likely to be depressed than those who did not experience PMS (OR, 1.70; CI, 1.31–2.20). BMI was not associated with depressive symptom. However, a significant association was noted between satisfaction with one's body image and depressive symptom. Ever-smokers were more likely to be depressed than never-smokers (OR, 1.64; CI, 1.10–2.45).

Conclusions

PMS were significantly associated with depressive symptom. PMS should be taken into account in the management of depression. Our study emphasized the significance of a multidisciplinary approach.

{"title":"Prevalence of premenstrual syndrome and its relationship to depression among Korean adolescents: A nationwide cross-sectional study","authors":"Hooyeon Lee , Kui Son Choi , Yumie Rhee","doi":"10.1016/j.tjog.2024.08.013","DOIUrl":"10.1016/j.tjog.2024.08.013","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the prevalence of PMS and depressive symptoms and to determine their association among Korean adolescent girls using a nationally representative cross-sectional survey.</div></div><div><h3>Materials and methods</h3><div>The Korean Study of Women's Health Related Issues (K-Stori)was used. Of the 3000 adolescent girls aged 14–17 years, the study subjects were 2970 girls after menarche. Depressive symptom was assessed with the PHQ-9. Multivariable logistic regression analysis was used to investigate factors associated with depressive symptom.</div></div><div><h3>Results</h3><div>The prevalence of PMS was 70.5 %. Irritability (43.8 %), abdominal bloating (32.8 %), and breast tenderness (27.5 %) were the most predominant symptoms. The prevalence of depressive symptom was 15.5 %. Girls with PMS were more likely to be depressed than those who did not experience PMS (OR, 1.70; CI, 1.31–2.20). BMI was not associated with depressive symptom. However, a significant association was noted between satisfaction with one's body image and depressive symptom. Ever-smokers were more likely to be depressed than never-smokers (OR, 1.64; CI, 1.10–2.45)<strong>.</strong></div></div><div><h3>Conclusions</h3><div>PMS were significantly associated with depressive symptom. PMS should be taken into account in the management of depression. Our study emphasized the significance of a multidisciplinary approach.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 2","pages":"Pages 319-324"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetic counseling of prenatally detected familial 15q13.2q13.3 microdeletion encompassing CHRNA7 and OTUD7A with asymptomatic carriers in the family

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-03-01 DOI: 10.1016/j.tjog.2024.12.015

Chih-Ping Chen , Fang-Tzu Wu , Yen-Ting Pan , Peih-Shan Wu , Wayseen Wang

Objective

A case of prenatal diagnosis of familial 15q13.2q13.3 microdeletion is presented.

Case report

A 35-year-old, gravida 2, para 1, woman was referred for genetic counseling because of 15q13.2q13.3 microdeletion in the fetus and the mother. The carrier mother was asymptomatic and normal in phenotype. The woman underwent amniocentesis at 17 weeks of gestation because of short nasal bone on fetal ultrasound. Amniocentesis revealed a karyotype of 46,XX. Simultaneous array comparative genomic hybridization (aCGH) analysis on the DNA extracted from uncultured amniocytes revealed the result of arr [GRCh37] 15q13.2q13.3 (30,954,726–32,509,926) × 1 with a 1.56-Mb 15q13.2q13.3 microdeletion encompassing six OMIM genes of FAN1, TRPM1, MIR211, KLF13, OTUD7A and CHRNA7. Prenatal ultrasound was normal. The woman had a 4-year-old healthy daughter. Four years ago, during her first pregnancy, she underwent expanded non-invasive prenatal testing (NIPT) in the first trimester, and the result was 15q13.2q13.3 deletion. Subsequent amniocentesis revealed a karyotype of 46,XX, and aCGH analysis on uncultured amniocytes revealed no genomic imbalance. However, no further genetic test in the woman and her husband had been made. Therefore, the woman was not aware of her carrier status when she was pregnant again. During this pregnancy, subsequent aCGH analysis on the parental bloods revealed a 1.56-Mb 15q13.2q13.3 microdeletion in the mother and no genomic imbalance in the father. The woman was hesitant to keep the baby. However, following the genetic counseling, the woman's parents were advised to receive genetic testing for 15q13.2q13.3 microdeletion. The 68-year-old asymptomatic healthy grandfather carried the same 15q13.2q13.3 microdeletion, and the grandmother did not have such a microdeletion. The woman finally decided to continue the pregnancy, and a healthy 2750-g baby was delivered at term with no phenotypic abnormalities.

Conclusion

Familial 15q13.2q13.3 microdeletion may present no phenotypic abnormalities in three generations.

{"title":"Genetic counseling of prenatally detected familial 15q13.2q13.3 microdeletion encompassing CHRNA7 and OTUD7A with asymptomatic carriers in the family","authors":"Chih-Ping Chen , Fang-Tzu Wu , Yen-Ting Pan , Peih-Shan Wu , Wayseen Wang","doi":"10.1016/j.tjog.2024.12.015","DOIUrl":"10.1016/j.tjog.2024.12.015","url":null,"abstract":"<div><h3>Objective</h3><div>A case of prenatal diagnosis of familial 15q13.2q13.3 microdeletion is presented.</div></div><div><h3>Case report</h3><div>A 35-year-old, gravida 2, para 1, woman was referred for genetic counseling because of 15q13.2q13.3 microdeletion in the fetus and the mother. The carrier mother was asymptomatic and normal in phenotype. The woman underwent amniocentesis at 17 weeks of gestation because of short nasal bone on fetal ultrasound. Amniocentesis revealed a karyotype of 46,XX. Simultaneous array comparative genomic hybridization (aCGH) analysis on the DNA extracted from uncultured amniocytes revealed the result of arr [GRCh37] 15q13.2q13.3 (30,954,726–32,509,926) × 1 with a 1.56-Mb 15q13.2q13.3 microdeletion encompassing six OMIM genes of <em>FAN1</em>, <em>TRPM1</em>, <em>MIR211</em>, <em>KLF13</em>, <em>OTUD7A</em> and <em>CHRNA7</em>. Prenatal ultrasound was normal. The woman had a 4-year-old healthy daughter. Four years ago, during her first pregnancy, she underwent expanded non-invasive prenatal testing (NIPT) in the first trimester, and the result was 15q13.2q13.3 deletion. Subsequent amniocentesis revealed a karyotype of 46,XX, and aCGH analysis on uncultured amniocytes revealed no genomic imbalance. However, no further genetic test in the woman and her husband had been made. Therefore, the woman was not aware of her carrier status when she was pregnant again. During this pregnancy, subsequent aCGH analysis on the parental bloods revealed a 1.56-Mb 15q13.2q13.3 microdeletion in the mother and no genomic imbalance in the father. The woman was hesitant to keep the baby. However, following the genetic counseling, the woman's parents were advised to receive genetic testing for 15q13.2q13.3 microdeletion. The 68-year-old asymptomatic healthy grandfather carried the same 15q13.2q13.3 microdeletion, and the grandmother did not have such a microdeletion. The woman finally decided to continue the pregnancy, and a healthy 2750-g baby was delivered at term with no phenotypic abnormalities.</div></div><div><h3>Conclusion</h3><div>Familial 15q13.2q13.3 microdeletion may present no phenotypic abnormalities in three generations.</div></div>","PeriodicalId":49449,"journal":{"name":"Taiwanese Journal of Obstetrics & Gynecology","volume":"64 2","pages":"Pages 361-363"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fistula formation after excision of extraperitoneal paravaginal teratoma 腹膜外阴道旁畸胎瘤切除后瘘管形成。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2023.10.018

Ting-Chien Lin , Po-Chuan Chen , Wan-Chen Liu , Chun-Ting Chiang , Yu-Fang Huang

Objective

Mature extragonadal teratomas, particularly at the pelvic extraperitoneal site, are rare. Herein, we report a case of paravaginal teratoma and fistula formation five years post-operation.

Case Report

A 23-year-old woman (G4P3A1) presented with a left paravaginal cystic tumor. After transvaginal tumor excision, histopathology revealed a paravaginal dermoid cyst. Five years post-operation, she returned with recurrent symptoms, including fever and perineal pain. Pelvic magnetic resonance imaging showed abscess at the surgical site, with tract-like extensions through the levator ani and vaginal wall. Treatment was administered without surgical intervention. Seven years post-operation, the patient underwent debridement of the left paravaginal abscess via the left perineal route. The patient was diagnosed with an abscess and an epidermal keratinous cyst with a vaginoperineal fistula. No recurrent abscess or fistula formation was encountered four years after debridement and fistulectomy.

Conclusion

Preoperative and postoperative counseling should be conducted with long-term follow-up for such patients.

目的：成熟性腺外畸胎瘤，特别是在盆腔腹膜外部位，是罕见的。在此，我们报告一例阴道旁畸胎瘤和瘘管形成术后五年。病例报告：一名23岁女性（G4P3A1）表现为左侧阴道旁囊性肿瘤。经阴道肿瘤切除后，组织病理学显示为阴道旁皮样囊肿。术后5年，患者复发出现发热和会阴疼痛等症状。盆腔磁共振成像显示手术部位脓肿，经肛提肌和阴道壁呈束状延伸。治疗无需手术干预。术后7年，患者经左会阴路行左侧阴道旁脓肿清创术。患者被诊断为脓肿和表皮角性囊肿并阴道会阴瘘。在清创和瘘管切除术后的四年里，没有复发的脓肿或瘘管形成。结论：对此类患者应进行术前、术后咨询并长期随访。

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引用次数: 0

Genetic investigations of autosomal recessive inherited ichthyosis impressed by fetal ultrasound: Exome sequencing and haplotype linkage analysis 胎儿超声常染色体隐性遗传鱼鳞病的遗传学研究：外显子组测序和单倍型连锁分析。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.03.026

Ting-Yu Chang , Zhu Wei Lim , Yi-Tzu Chu , Wan-Ju Wu , Mei-Hui Lee , Shun-Ping Chang , Dong-Jay Lee , Wen-Hsiang Lin , Ming Ho , Jin-Chung Shih , Gwo-Chin Ma , Ming Chen

Objective

Ichthyosis are complex skin diseases, characterized by hyperkeratosis with various degrees of thickening, desquamation, and erythema. The prenatal diagnosis of ichthyosis is challenged due to the clinical and genetic heterogeneity and the late-onset of fetal features on ultrasound scan. Here, we reported two fetuses with Harlequin ichthyosis (HI), a severe subtype of autosomal recessive congenital ichthyosis (ARCI), who were diagnosed prenatally by images and genetic investigations. Preimplantation genetic testing (PGT) was also performed in one case and the family to prevent the transmission of this condition.

Materials and methods

Fetal images were analyzed by detailed fetal ultrasound. Genetic defects in affected fetuses were detected using whole exome sequencing (WES) and confirmed by Sanger sequencing. PGT for monogenic disease (PGT-M) was performed using short tandem repeat (STR) markers and amplification refractory mutation system quantitative polymerase chain reaction (ARMS-qPCR).

Results

WES identified pathogenic mutations in ABCA12 gene in both fetuses. Genome Analysis ToolKit (GATK 4 version 4.2.1.0) was merged using a setting of the trio model for exome variation analysis. Confirmatory Sanger sequencing of ABCA12 gene was also applied to both parents. Disease-cause haplotyping by STR markers and ARMS-qPCR for PGT-M strategy were conducted in family 1. Linkage analysis in conjunction with STR was used in the first case, whereas unequal coverage of WES was deciphered with the inspiration of the second case a few years later. Both cases were diagnosed by high coverage WES and led to successful subsequent pregnancies by preimplantation genetic diagnosis and genetic amniocentesis.

Conclusion

Preimplantation genetic testing using STR linkage analysis can rescue cases with autosomal recessive inheritance when only one mutation is found in the putative gene, while reanalysis of high-coverage WES by optimized updated bioinformatics should always be considered in addition to whole genome sequencing.

目的：鱼鳞病是一种复杂的皮肤病，以角化过度为特征，伴有不同程度的增厚、脱屑和红斑。由于临床和遗传异质性以及超声扫描胎儿特征的晚发性，鱼鳞病的产前诊断受到挑战。在这里，我们报告了两个患有Harlequin鱼鳞病（HI）的胎儿，这是一种常染色体隐性先天性鱼鳞病（ARCI）的严重亚型，他们通过产前图像和遗传调查被诊断出来。还对一例患者及其家庭进行了胚胎植入前基因检测（PGT），以防止这种疾病的传播。材料和方法：采用详细的胎儿超声对胎儿图像进行分析。利用全外显子组测序（WES）检测患病胎儿的遗传缺陷，并通过Sanger测序证实。采用短串联重复（STR）标记和扩增难解突变系统定量聚合酶链反应（ARMS-qPCR）对单基因疾病进行PGT （PGT- m）检测。结果：WES在两个胎儿中均检测到ABCA12基因的致病性突变。基因组分析工具包（GATK 4版本4.2.1.0）采用三重奏模型的设置合并进行外显子组变异分析。对父母双方进行ABCA12基因验证性Sanger测序。用STR标记和ARMS-qPCR进行PGT-M策略的致病单倍型分析。在第一个病例中使用了结合STR的连锁分析，而在几年后的第二个病例的启发下，WES的不平等覆盖被破译。两例均通过高覆盖率的WES诊断，并通过植入前遗传学诊断和遗传羊膜穿刺术成功妊娠。结论：胚胎植入前基因检测STR连锁分析能有效挽救常染色体隐性遗传的病例，而在全基因组测序的基础上，应考虑采用优化更新的生物信息学方法对高覆盖率WES进行再分析。

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引用次数: 0

Prenatal diagnosis and genetic counselling of a rare maternal inherited chromosome 1q21.1q21.2 microduplication with no phenotypic abnormalities 无表型异常的罕见母体遗传染色体1q21.1q21.2微重复的产前诊断和遗传咨询。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.10.009

Mingxia Xie , Xinfang He , Tou Tou , Ruixue Liu

引用次数: 0

Transcervical resection of myoma (TCRM): Part I 经宫颈肌瘤切除术（TCRM）：第一部分。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.11.002

Peng-Hui Wang , Szu-Ting Yang , Wen-Hsun Chang , Hung-Hsien Liu , Wen-Ling Lee

Uterine fibroids occur frequently in women during the reproductive age, and they are rarely associated with clinical meaning because of their benign characteristics and asymptomatic clinical presentation. Sometimes, uterine fibroids are symptomatic and associated with compression syndrome, infertility, chronic pelvic pain and heavy menstrual bleeding. All need further intervention and treatment. Medication is often preferred and frequently applied but symptom-control rate is varied, resulting the need of further active treatment. An effective but minimally invasive procedure such as surgery is sometimes used as back up strategy in the management of women with no response to medical treatment. Additionally, fertility-sparing or uterus-preservation is the main goal and becomes very popular in both physicians and patients. Conservative surgical treatment can be made according to myoma location. Simply, myoma is classified as submucosal, intramural and subserous types. However, to offer a practical standardized consensus for the description and categorization of myomas, the International Federation of Gynaecology & Obstetrics (FIGO) classification system from type 0 to type 8 is established, which is often used for guiding patient management and offering prognostic information, because submucosal myoma (FIGO type 0, 1, probable 2, and possible 3) is frequently associated with symptoms or signs, needing a further intervention. Transcervical resection of myoma (TCRM, also called as hysteroscopic myomectomy: HM) is the treatment of choice for submucosal myoma, and this increased trend is secondary to its nearly non-trauma in nature, even compared to other MIS, such as mini-laparotomy and laparoscopic or robotic approach. Although TCRM is becoming more and more popular in modern clinical practice, the risks and limitations of TCRM are often overlooked. In this review as part I, we will focus on the rationale, efficacy, complication, and limitation of using TCRM in the management of women with symptomatic uterine fibroids. Under the well-training and carefully performing TCRM, TCRM not only provides the less traumatic injury to the uterus, but also offers an effective and safe strategy in dealing with symptomatic submucosal myoma.

子宫肌瘤多见于育龄期妇女，因其良性特点和临床无症状表现，很少与临床意义相关。有时，子宫肌瘤是有症状的，并与压迫综合征、不孕症、慢性盆腔疼痛和大量月经出血有关。所有人都需要进一步的干预和治疗。通常首选药物治疗，但症状控制率参差不齐，需要进一步积极治疗。在治疗无效的妇女中，外科手术等有效但微创的治疗方法有时被用作备用策略。此外，保留生育能力或保留子宫是主要目标，在医生和患者中都很受欢迎。可根据肌瘤的部位进行保守性手术治疗。简单地说，肌瘤分为粘膜下型、壁内型和浆膜下型。然而，为了对肌瘤的描述和分类提供一个实用的标准化共识，建立了国际妇产科联合会（International Federation of gyna& Obstetrics， FIGO）从0型到8型的分类体系，通常用于指导患者管理和提供预后信息，因为粘膜下肌瘤（FIGO分0型、1型、可能2型和可能3型）经常伴有症状或体征，需要进一步干预。经宫颈肌瘤切除术（TCRM，也称为宫腔镜子宫肌瘤切除术：HM）是粘膜下肌瘤的首选治疗方法，这种增加的趋势是由于其几乎无创伤的性质，甚至与其他MIS相比，如小剖腹手术、腹腔镜或机器人入路。虽然TCRM在现代临床实践中越来越普及，但TCRM的风险和局限性往往被忽视。在这篇综述中，我们将重点讨论TCRM治疗有症状的子宫肌瘤的基本原理、疗效、并发症和局限性。在良好的训练和精心的操作下，TCRM不仅可以减少对子宫的创伤性损伤，而且可以为治疗症状性粘膜下肌瘤提供有效和安全的策略。

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First-trimester application of non-invasive prenatal testing in the genetic investigation of fetal cystic hygroma and hydrops fetalis associated with Turner syndrome 妊娠早期应用无创产前检测对与特纳综合征相关的胎儿囊性水肿和胎儿水肿进行遗传调查。

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Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.10.008

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引用次数: 0

Artificial intelligence in writing manuscripts: Concerns about hindering human primitive feeling 人工智能在写稿中的应用：对阻碍人类原始情感的担忧。

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology

Pub Date : 2025-01-01 DOI: 10.1016/j.tjog.2024.08.010

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引用次数: 0

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