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Utero-Vesical Fistula Closure after 3 Weeks Treatment with Intravenous Mesenchymal Stem Cells Infusion: Case Report 静脉间充质干细胞输注治疗3周后子宫膀胱瘘闭合:1例报告
Pub Date : 2023-04-29 DOI: 10.33696/gynaecology.4.041
M. Di Silvio, J. E. Luján-Irastorza, C. Durand-Montaño, Roberto Henández-Ramos, J. Barrón-Vallejo, Daniela Ávila-Rebollar, Julio Myslabodski, Maruxa Pariente-Fernández, Jorge Mario Tagle-Rodríguez, Miguel Ángel Ramírez-Amezcua, María Angélica Paredes-Núñez, V. Vargas-Hernández
Objective: To describe the evolution of Utero-Vesical Fistula (UVF) of one patient who received conservative treatment using intravenous (IV) infusion of 120x106 Adipose tissue Mesenchymal Stem Cells (ADMSCs). Clinical case report: A 36-year-old female presented with postcesarean hematuria 3 hours after an emergency c-section was performed consequently to placental abruption during labor. The primary measure was to use a transurethral Silastic 18F Foley catheter to prevent bladder expansion. The catheter remained for 21 days. Evaluation through Computerized Tomography Cystography (Cysto-CT) revealed failure to close the fistula. The decision to inject ADMSCs as an IV single dose was done. Three weeks after this intervention no blood was seen in the urine drainage bag. Complete resolution of UVF was confirmed with a control CT urogram. Result: Total closure of UVF. Conclusions: The IV infusion of ADMSCs proved to be a plausible and effective conservative treatment of UVF.
目的:描述1例经静脉(IV)输注120x106脂肪组织间充质干细胞(ADMSCs)保守治疗的患者子宫膀胱瘘(UVF)的演变。临床病例报告:一名36岁女性在分娩过程中因胎盘早剥紧急剖腹产3小时后出现剖宫产后血尿。主要措施是使用经尿道硅胶18F Foley导尿管来防止膀胱扩张。导管放置21天。通过计算机断层膀胱造影(膀胱ct)评估显示瘘关闭失败。决定以单剂量静脉注射ADMSCs。干预后三周,尿引流袋内未见血。通过对照CT检查证实UVF完全消退。结果:UVF完全闭合。结论:静脉输注ADMSCs是一种可行且有效的UVF保守治疗方法。
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引用次数: 0
Hemostatic Pelvic Irradiation: A Rarely Reported Approach to Benign Gynecological Bleeding 止血性盆腔照射:一种罕见的治疗妇科良性出血的方法
Pub Date : 2023-04-29 DOI: 10.33696/gynaecology.4.042
F. Bouguerra, E. Boudhina, H. Chahdoura, M. Souissi, S. Tbessi, N. Bouzid, S. Belajouza, S. Tebra
Background: Ovarian cysts are usually treated using medical or surgical interventions. However, in some cases, these treatments may not be feasible or effective, and alternative options need to be considered.Case presentation: We report a case of a 43-year-old woman with a history of recurrent hemorrhagic ovarian cysts, who was on anticoagulant therapy due to tight mitral stenosis and had multiple autoimmune disorders. Surgical castration was not a viable option due to the bleeding risk, and intramuscular injection of analogues was not preferred. Therefore, external ovarian radiotherapy for hemostasis was planned.Conclusion: Our case highlights that external ovarian radiotherapy can be an effective option for hemostasis in patients with bleeding ovarian cysts, especially when other treatments are contraindicated or have failed.
背景:卵巢囊肿通常采用医疗或外科干预措施进行治疗。然而,在某些情况下,这些治疗方法可能不可行或无效,需要考虑其他选择。病例介绍:我们报告一例43岁女性,有复发性出血性卵巢囊肿病史,因二尖瓣狭窄正在接受抗凝治疗,并患有多种自身免疫性疾病。由于出血风险,手术阉割不是一个可行的选择,肌肉注射类似物也不是首选。因此,计划进行卵巢外照射止血。结论:我们的病例强调,卵巢外放疗可以是卵巢囊肿出血患者止血的有效选择,尤其是在其他治疗禁忌或失败的情况下。
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引用次数: 0
Association between Maternal Serum Leptin Level and Preterm Birth among Parturients in Lagos, Nigeria 尼日利亚拉各斯产妇血清瘦素水平与早产之间的关系
Pub Date : 2023-04-29 DOI: 10.33696/gynaecology.4.040
Olubunmi Ogein, Adeyemi A Okunowo, G. Olorunfemi, Benedetto Osunwusi, O. Adegbola
Background: Preterm birth is one of the major causes of neonatal morbidity and mortality worldwide. The association between occurrence of preterm birth and biomarkers measured in the maternal serum maybe helpful in predicting preterm birth especially in low resource settings.Aim: We aimed to examine the association between maternal serum leptin level and occurrence of preterm birth.Materials and Methods: This was an analytical cross-sectional study of women with preterm and term births in Lagos, Nigeria. One hundred and ninety women comprising of 95 women with preterm and term births respectively recruited. Maternal serum leptin levels were determined using Enzyme-linked immunosorbent assay (ELISA) technique. Data was analyzed by Stata version 16 (StataCorp, USA) statistical software with significance level set at p-value <0.05.Results: The mean serum leptin levels were significantly lower in women with preterm delivery compared to women with term delivery (1.48 ng/ml ± 0.72 vs. 1.75 ng/ml ± 0.67, p-value=0.007). On further analysis, women with very preterm birth had significantly lower serum leptin levels compared with women with moderate to late preterm and term births (1.28 ± 0.73 vs 1.55 ± 0.70 vs 1.75ng/ml ± 0.67, p-value=0.006). There was 57% reduction in the odds of having preterm delivery for every unit increase in serum leptin level on multivariate analysis (adjusted OR: 0.43, 95%CI: 0.26 – 0.71, P-value=0.001).Conclusion: Serum leptin concentration was significantly lower in women who had preterm births compared to women who had term births. Longitudinal studies are required to determine the predictive value of maternal serum leptin level with regards to preterm birth.
背景:早产是全世界新生儿发病和死亡的主要原因之一。早产发生与母体血清中测量的生物标志物之间的关联可能有助于预测早产,特别是在资源匮乏的环境中。目的:探讨孕妇血清瘦素水平与早产发生的关系。材料和方法:这是一项对尼日利亚拉各斯早产和足月妇女的分析性横断面研究。共招募了190名妇女,其中95名早产妇女和95名足月分娩妇女。采用酶联免疫吸附法(ELISA)检测孕妇血清瘦素水平。数据分析采用Stata version 16 (StataCorp, USA)统计软件,显著性水平设为p值<0.05。结果:早产妇女的平均血清瘦素水平明显低于足月分娩妇女(1.48 ng/ml±0.72 vs. 1.75 ng/ml±0.67,p值=0.007)。进一步分析,重度早产妇女的血清瘦素水平明显低于中度至晚期早产和足月分娩妇女(1.28±0.73 vs 1.55±0.70 vs 1.75ng/ml±0.67,p值=0.006)。多因素分析显示,血清瘦素水平每升高一个单位,早产的几率降低57%(校正OR: 0.43, 95%CI: 0.26 - 0.71, p值=0.001)。结论:早产妇女的血清瘦素浓度明显低于足月分娩妇女。需要进行纵向研究来确定母亲血清瘦素水平对早产的预测价值。
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引用次数: 0
Early Cumulus Cell Removal Increases Cumulative Live Birth Rate while Having No Negative Effect on the Malformation Rate in In vitro Fertilization: A Propensity Score-Matched Cohort Study 早期去除积云细胞增加了体外受精的累计活产率,同时对畸形率没有负面影响:一项倾向评分匹配的队列研究
Pub Date : 2023-04-29 DOI: 10.33696/gynaecology.4.043
Li Juan Sun, Shan Shan Liang, Min Hao Liu, Jia Ping Pan, Mei Yuan Huang, Xiao Ming Teng, Hai Xia Wu
Objective: The aim of this study was to investigate the efficacy and safety of early cumulus cell removal (ECCR) during human in vitro fertilization (IVF). Methods: A retrospective analysis was performed between January 2011 and December 2019. The study enrolled 1,131 couples who underwent IVF treatment with ECCR. After propensity score matching at a 1:1 ratio, 1,131 couples who underwent overnight coincubation of gametes were selected. The main outcome measure was the cumulative live birth rate. Secondary outcome measures included the cumulative pregnancy rate, polyspermy rate, available embryo rate, miscarriage rate, malformation rate, time to live birth, and oocyte-to-baby rate. Results: There were no significant differences found between the two groups in the polyspermy rate, available embryo rate, miscarriage rate, time to live birth, oocyte-to-baby rate, and neonatal congenital anomalies rate. The results of the study showed that ECCR was associated with a significantly higher cumulative live birth rate and cumulative pregnancy rate, along with a significantly lower fertilization rate. Conclusion: ECCR tended to confer increased cumulative live birth rate and had no negative effect on the neonatal malformation rate.
目的:探讨体外受精(IVF)早期积云细胞去除(ECCR)的有效性和安全性。方法:对2011年1月至2019年12月进行回顾性分析。该研究招募了1131对接受ECCR体外受精治疗的夫妇。按照1:1的比例进行倾向评分匹配后,选择了1131对进行配子过夜共孵育的夫妇。主要结局指标为累计活产率。次要结局指标包括累积妊娠率、多精率、可用胚胎率、流产率、畸形率、活产时间和卵母细胞对婴儿率。结果:两组患者在多精率、有效胚率、流产率、活产时间、卵对儿率、新生儿先天性异常率等方面差异无统计学意义。研究结果表明,ECCR与显著较高的累计活产率和累计妊娠率相关,与显著较低的受精率相关。结论:ECCR倾向于提高累计活产率,对新生儿畸形率无负面影响。
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引用次数: 0
Can the Systemic Immune Inflammation Index Predict the Treatment of Ectopic Pregnancy? 全身免疫炎症指数能否预测异位妊娠的治疗?
Pub Date : 2023-04-28 DOI: 10.33696/gynaecology.4.039
Sevcan Sarıkaya, E. Uysal, O. Günenç
Objective: The aim of this study was to predict the selection of treatment for ectopic pregnancy (EP) using the values of platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR) and systemic immune inflammation index (SII) obtained from hematological parameters routinely used in clinical practice.Design: Retrospective observational study.Place & duration of study: This retrospective, cross-sectional study was conducted in the Department of Obstetrics and Gynecology of Konya City Hospital, between August 2020 and August 2022.Methodology: The study included 140 patients who were diagnosed with EP in our hospital. The patients were separated as those who received medical treatment with methotrexate (MTX) (Group I) and those who underwent surgical procedures (Group II). The two groups were compared with respect to demographic characteristics and pre-treatment laboratory parameters.Results: Of the 140 patients diagnosed with EP, 75 were in Group I, treated with MTX, and 65 were in Group II, treated with surgery. No significant difference was determined between the groups with respect to age, body mass index, and gravida-parity of the patients (p>0.05). The incidence of extrauterine mass, presence of yolk sac, and fetal heartbeat on ultrasonography was significantly higher in Group II than in Group I (p<0.05). NLR and MLR values in Group II were significantly lower than in Group I (p<0.05). The PLR value did not differ significantly between the groups (p>0.05). The SII value was significantly higher in Group II than in Group I (p<0.05).Conclusion: NLR and MLR were found to be lower, and the SII was significantly higher in the patients who underwent surgery. Hematological parameters, especially SII, are potential markers that can be used in EP treatment selection.
目的:本研究的目的是通过从临床常用的血液学参数中获得的血小板/淋巴细胞比率(PLR)、中性粒细胞/淋巴细胞比率、单核细胞/淋巴细胞比值(MLR)和全身免疫炎症指数(SII)来预测异位妊娠(EP)的治疗选择。设计:回顾性观察研究。研究地点和持续时间:这项回顾性横断面研究于2020年8月至2022年8月在科尼亚市医院妇产科进行。方法:该研究纳入了我院140名诊断为EP的患者。将患者分为接受甲氨蝶呤(MTX)治疗的患者(第一组)和接受外科手术的患者(第二组)。比较两组患者的人口学特征和治疗前实验室参数。结果:在140例诊断为EP的患者中,75例在第一组接受MTX治疗,65例在第二组接受手术治疗。两组患者的年龄、体重指数和产程差异无统计学意义(p>0.05),超声检查胎儿心跳Ⅱ组明显高于Ⅰ组(p0.05),SII值Ⅱ组明显大于Ⅰ组(p<0.05)。血液学参数,尤其是SII,是可用于EP治疗选择的潜在标志物。
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引用次数: 0
Evaluation of Sexual Dysfunction in Brazilian Women with Infertility Undergoing Assisted Reproduction Treatment 巴西不孕妇女接受辅助生殖治疗的性功能障碍评估
Pub Date : 2023-03-06 DOI: 10.33696/gynaecology.4.037
Ana Carolina Sater, R. Nisihara, Danielle Medeiros Teixeira Miyague, A. Schuffner, A. H. Miyague
Purpose: The increase in infertility around the world has a negative impact on sexual desire and function. The objective of this study was to evaluate the presence of sexual dysfunction in women diagnosed with infertility, comparing them with healthy controls.Methods: This is a cross-sectional study based on online questionnaire. Infertile women and healthy controls filled a questionnaire about epidemiological and assisted reproduction data. The infertile patients answered the Female Sexual Function Index (FSFI) and the Short-Form Health Survey (SF-12) questionnaires to assess sexual performance, physical, and mental health. The control group answered only to the FSFI.Results: The survey was completed by 357 subjects: 157 infertility patients and 200 matched controls. All medians of the FSFI domains of patients in the infertility group are lower (p=0.036) when compared to controls, especially the scores in the arousal and lubrication domains (p=0.003 and p<0.0001, respectively). In this group, most are in good physical health and half are in good mental health. The depression rate was 12.7%. Patients who have depression have worse FSFI scores (p=0.009). Depression and sexual dysfunction were experienced by 27.4% (n=17) patients (p<0.0001). Worse mental health was related to patients at higher risk for sexual dysfunction (p<0.0001).Conclusion: In our sample of women undergoing infertility treatment, we found that the FSFI scores were significantly lower than in the control group, mainly in the arousal and lubrication domains. Additionally, it was found that the worse the mental health, the greater the possibility of sexual dysfunction in this group.
目的:世界各地不孕不育的增加对性欲和性功能产生了负面影响。本研究的目的是评估被诊断为不孕的女性是否存在性功能障碍,并将其与健康对照组进行比较。方法:这是一项基于在线问卷的横断面研究。不孕妇女和健康对照者填写了一份关于流行病学和辅助生殖数据的问卷。不孕患者回答了女性性功能指数(FSFI)和简短健康调查(SF-12)问卷,以评估性表现、身体和心理健康。对照组只回答FSFI。结果:357名受试者完成了调查:157名不孕患者和200名匹配的对照组。与对照组相比,不孕组患者FSFI域的所有中位数均较低(p=0.036),尤其是唤醒和润滑域的得分(分别为p=0.003和<0.0001)。在这一群体中,大多数人身体健康,一半人心理健康。抑郁症发生率为12.7%。患有抑郁症的患者FSFI评分更差(p=0.009)。27.4%(n=17)的患者经历过抑郁症和性功能障碍(p<0.0001)。更糟糕的心理健康状况与性功能障碍风险更高的患者有关(p<0.00001)。结论:在我们接受不孕不育治疗的女性样本中,我们发现FSFI评分显著低于对照组,主要在唤醒和润滑领域。此外,研究发现,心理健康状况越差,这一群体发生性功能障碍的可能性就越大。
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引用次数: 0
Novel Treatment for Interstitial Cystitis Pilot Study 间质性膀胱炎新疗法的初步研究
Pub Date : 2023-03-06 DOI: 10.33696/gynaecology.4.036
Timothy J Hardy
Background and aims: Use of platelet-rich plasma (PRP) is well established in treatment of orthopedic patients. This pilot study aims to determine the efficacy of using instillation of PRP paired with hydrodistention of the bladder to treat patients with interstitial cystitis (IC).Methods: Patients with a diagnosis of interstitial cystitis were recruited to this study. Patients completed Pelvic Pain and Urgency/Frequency (PUF) patient symptom scale, which quantified a symptom and bother score. Patients were treated with hydrodistention with instillation of PRP. Patients completed the PUF questionnaire weekly for six weeks following treatment.Results: 12 patients underwent hydrodistention with instillation of PRP. The patients were all women, ranging in age from 23 to 71. The mean symptom score went from 13.167 to 7.417 and the mean bother score decreased from 6.833 to 4.41, showing a statistically significant reduction in symptom and bother scores.Conclusions: Hydrodistention with instillation of PRP is an effective treatment of interstitial cystitis.
背景和目的:富血小板血浆(PRP)在骨科患者的治疗中得到了很好的应用。本初步研究旨在确定使用PRP灌注配合膀胱水扩张治疗间质性膀胱炎(IC)患者的疗效。方法:将诊断为间质性膀胱炎的患者纳入本研究。患者完成盆腔疼痛和急迫性/频率(PUF)患者症状量表,量化症状和困扰评分。患者用PRP灌注治疗腹水膨胀。患者在治疗后的六周内每周完成PUF问卷。结果:12例患者经PRP灌注后出现腹水膨胀。患者均为女性,年龄从23岁到71岁不等。平均症状评分从13.167分下降到7.417分,平均烦恼评分从6.833分下降到4.41分,症状和烦恼评分均有统计学意义。结论:PRP液胀术是治疗间质性膀胱炎的有效方法。
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引用次数: 0
COVID-19 Vaccine Acceptance during Pregnancy: Lessons Learned and How to Design the Best Strategy to Increase Vaccination Acceptance in the Future 妊娠期COVID-19疫苗接受度:经验教训及如何设计未来提高疫苗接受度的最佳策略
Pub Date : 2023-03-06 DOI: 10.33696/gynaecology.4.038
I. Tsiaousi, M. Theodora, P. Antsaklis, A. Psarris, Michalis I. Sindos, P. Koutroumanis, Dimitrios N. Zaharakis, George Daskalakis
Objective: The present study aimed to study the vaccination acceptance of COVID-19 vaccine in the Hellenic pregnant population and make a high relative analysis of the factors that contribute to decision-making concerning the acceptance of the vaccine during pregnancy. Findings could be leveraged for improving the vaccination communication strategy to pregnant women to increase the vaccination acceptance rate.Study design: The present study is a prospective cross-sectional study conducted from October 1, 2021 until March 2022 to 800 pregnant women receiving prenatal care at a tertiary University Hospital. Data was gathered through a face-to-face questionnaire and documented via the official vaccination certificate.Results: The vaccination coverage rate was 53.9%. Employment, older age, and higher monthly income were significantly and positively associated with vaccination (p<0.001). Information provided by health professionals (p=0.004) and scientific sites (p=0.028); sufficient knowledge of vaccines were also positively related to vaccination (p<0.001); pediatric vaccination of their children in the family (p=0.003); vaccination against influenza during pregnancy (past: p<0.001 and present pregnancy: p<0.001); and vaccination against pertussis during pregnancy (present pregnancy: p<0.001) were also positively associated with vaccination. Intention to vaccinate their children in the future with all recommended vaccines; belief in the safety of the vaccines; and belief that vaccination protects children from serious diseases were positively related with vaccine acceptance. Reduced vaccination hesitancy due to the pandemic; and fear of severity of COVID-19 infection (p<0.001 in each case) associated also positively with COVID-19 vaccination.Conclusion: In conclusion we need to improve the face-to-face communication with pregnant women, focusing more on safety and effectiveness data, sharing information about surveillance programs, using clinical experience from other maternal vaccination, and presenting the benefits from vaccination to the mother and the offspring.
目的:本研究旨在了解希腊妊娠人群COVID-19疫苗接种接受情况,并对妊娠期疫苗接受决策的影响因素进行高相关性分析。研究结果可用于改进对孕妇的疫苗接种宣传策略,以提高疫苗接种率。研究设计:本研究是一项前瞻性横断面研究,于2021年10月1日至2022年3月对在某三级大学医院接受产前护理的800名孕妇进行研究。通过面对面的问卷调查收集数据,并通过官方疫苗接种证书进行记录。结果:接种率为53.9%。就业、年龄和较高的月收入与疫苗接种显著正相关(p<0.001)。卫生专业人员(p=0.004)和科学站点(p=0.028)提供的信息;充分的疫苗知识也与疫苗接种呈正相关(p<0.001);家庭中儿童的儿科疫苗接种(p=0.003);怀孕期间接种流感疫苗(过去:p<0.001,现在:p<0.001);怀孕期间接种百日咳疫苗(当前妊娠:p<0.001)也与疫苗接种呈正相关。将来有意为子女接种所有推荐的疫苗;相信疫苗的安全性;相信接种疫苗可以保护儿童免受严重疾病的侵害与疫苗接受度呈正相关。减少了大流行造成的疫苗接种犹豫;对COVID-19感染严重程度的恐惧(每例p<0.001)也与COVID-19疫苗接种呈正相关。结论:总之,我们需要加强与孕妇的面对面沟通,更多地关注安全性和有效性数据,分享监测项目信息,利用其他母亲接种疫苗的临床经验,并向母亲和后代展示接种疫苗的好处。
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引用次数: 0
Racial/Ethnic Bias and Its Role in Severe Maternal Morbidity 种族/民族偏见及其在严重产妇发病率中的作用
Pub Date : 2023-01-25 DOI: 10.33696/gynaecology.4.035
E. Levine, Leah Delfinado, C. Fernandez
Racial and ethnic health disparities have been identified by many information sources in recent years, and a specific example of this is severe maternal morbidity and mortality, which includes mortality from postpartum hemorrhage. It is this racial/ethnic health disparity that has been highlighted in news reports that should be of concern to all physicians and healthcare providers, recognizing that women of color have more than three times the risk of dying in childbirth than white women. The details about this are worthy of further examination.
近年来,许多信息来源发现了种族和族裔健康差异,其中一个具体例子是严重的孕产妇发病率和死亡率,其中包括产后出血造成的死亡率。新闻报道中强调的这种种族/民族健康差异应该引起所有医生和医疗保健提供者的关注,因为他们认识到有色人种女性在分娩中死亡的风险是白人女性的三倍多。这方面的细节值得进一步研究。
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引用次数: 0
A Review of the Applications of Intraoperative Ultrasound Guidance in Cervical Cerclage and Selected Gynecological Procedures 术中超声引导在宫颈环扎术及部分妇科手术中的应用综述
Pub Date : 2022-12-12 DOI: 10.33696/gynaecology.4.034
Noa Leybovitz-Haleluya, R. Hershkovitz
Introduction: Many gynecologic procedures may benefit from the use of real-time ultrasonography. The goal of this review is to summarize the use of ultrasound in some of the main gynecologic procedures, with focus on cervical cerclage procedure.Recent findings: Ultrasound guidance has been shown to decrease both operative time and complication rates in curettage procedures. In addition, intraoperative ultrasound use reduces recurrence rates after hysteroscopic resection of uterine myoma or septa. Ultrasound guidance may improve the efficiency of cervical cerclage by direct visualization of tightening and assist in measures of prognostic factors following the procedure.Conclusion: Intraoperative ultrasound guidance appears to be a safe and valuable tool for the gynecologic surgeon. It may reduce complication and re-operation rates and may improve the efficacy of some procedures.
许多妇科手术可能受益于实时超声检查的使用。本综述的目的是总结超声在一些主要妇科手术中的应用,重点是宫颈环切术。最近发现:超声引导已被证明可以减少刮宫手术的手术时间和并发症发生率。此外,术中超声可降低宫腔镜下子宫肌瘤或隔切除术后的复发率。超声引导可以提高宫颈环扎术的效率,通过直接观察收紧和辅助测量手术后的预后因素。结论:术中超声引导对妇科外科医生来说是一种安全、有价值的工具。它可减少并发症和再手术率,并可提高某些手术的疗效。
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引用次数: 0
期刊
Archives of obstetrics and gynaecology
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