Pub Date : 2021-12-29DOI: 10.33696/gynaecology.2.022
M. Chamagne, I. Naoura, G. Conte, J. Ayoubi
The pregnancy was normal. The patient was consulted at 26 weeks of amenorrhea (SA) + 2 days of lateral abdominal pain in the right iliac fossa. The patient was apyretic. A clinical examination found no uterine contractions; the fetal heart rate was normo-oscillating and normo-reactive, the cervix was clinically closed, measuring 43 mm by an endo-vaginal ultrasound. The fetus was estimated to weigh 1054 g (90° to 97° percentile according to the “Collège Français d’Echographie Fœtal”). The blood analysis showed no inflammation (leukocytes 10 g/l and protein c reactive at 8 mg/l). The persistent pain was not relieved with level 2 analgesics and required a titration of morphine without point of call found; thus, an abdominal ultrasound was carried out. Liver and kidney scans were normal, the appendix was not visualized. Magnetic resonance imaging (MRI) showed a right ovarian teratoma 55 mm x 73 mm in size, with an ovary projected forward to the sub-parietal (Figure 1a).
怀孕是正常的。患者在闭经（SA）26周+右髂窝侧腹痛2天时接受咨询。这个病人是无抽搐的。临床检查未发现子宫收缩；胎儿心率为正常振荡和正常反应，宫颈临床闭合，阴道内超声测量43mm。据估计，胎儿体重为1054克（根据“Collège Français d’Echographice Fœtal”，为90°至97°的百分位）。血液分析显示没有炎症（白细胞10g/l，蛋白质c在8mg/l时具有反应性）。使用2级止痛药并不能缓解持续的疼痛，需要在没有发现呼叫点的情况下滴定吗啡；因此，进行了腹部超声检查。肝脏和肾脏扫描正常，阑尾未显示。磁共振成像（MRI）显示右侧卵巢畸胎瘤大小为55 mm x 73 mm，卵巢向前突出至顶叶下（图1a）。
{"title":"Adnexal Torsion During the Second Trimester of Pregnancy: Mc Burney Incision and Management Strategy","authors":"M. Chamagne, I. Naoura, G. Conte, J. Ayoubi","doi":"10.33696/gynaecology.2.022","DOIUrl":"https://doi.org/10.33696/gynaecology.2.022","url":null,"abstract":"The pregnancy was normal. The patient was consulted at 26 weeks of amenorrhea (SA) + 2 days of lateral abdominal pain in the right iliac fossa. The patient was apyretic. A clinical examination found no uterine contractions; the fetal heart rate was normo-oscillating and normo-reactive, the cervix was clinically closed, measuring 43 mm by an endo-vaginal ultrasound. The fetus was estimated to weigh 1054 g (90° to 97° percentile according to the “Collège Français d’Echographie Fœtal”). The blood analysis showed no inflammation (leukocytes 10 g/l and protein c reactive at 8 mg/l). The persistent pain was not relieved with level 2 analgesics and required a titration of morphine without point of call found; thus, an abdominal ultrasound was carried out. Liver and kidney scans were normal, the appendix was not visualized. Magnetic resonance imaging (MRI) showed a right ovarian teratoma 55 mm x 73 mm in size, with an ovary projected forward to the sub-parietal (Figure 1a).","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49479682","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}
Pub Date : 2021-09-22DOI: 10.33696/gynaecology.2.016
I. Albahlol
For a long time, it was rare to see a case of cervical pregnancy (CP) throughout the journey in the field of obstetrics. Recently, the circumstances showed dramatic changes and I think not uncommonly every one elsewhere in the field may face this problem to some extent and the CP term strikes his/her ears. This may be attributed to an actual increase in CP rate that go parallel to widespread application of Assisted Reproduction Techniques (ART) procedures all over the world on one hand and earlier diagnosis owing to liberal utilization and more familiarity with Transvaginal Sonography (TVS) on the other hand [1]. Totally, CP was reported to be one in nine thousand pregnancies while it represented about two percent of ART ectopic pregnancies [2]. The maternal impact of this calamity is markedly variable. It may pass unnoticed, causing a little harm or catastrophic with late discovery and presentation with a life-threatening hemorrhage. The exact etiology is still unexplained and the patient commonly presented by delayed menstruation with or without bleeding and infrequent pain. Diagnosis of a pure CP is based on TVS. Sonographic criteria’s specific to the case include empty uterine corpus while cervix is enlarged and barrel shaped, presence of gestational sac below the internal os, Color Doppler demonstrated a peritrophoblastic blood flow around the gestational sac and no sliding sign. Management is greatly different depending upon timing of diagnosis, case presentation, operator experience and available health facilities [1].
{"title":"Critical Appraisal OF Cervical Pregnancy Management","authors":"I. Albahlol","doi":"10.33696/gynaecology.2.016","DOIUrl":"https://doi.org/10.33696/gynaecology.2.016","url":null,"abstract":"For a long time, it was rare to see a case of cervical pregnancy (CP) throughout the journey in the field of obstetrics. Recently, the circumstances showed dramatic changes and I think not uncommonly every one elsewhere in the field may face this problem to some extent and the CP term strikes his/her ears. This may be attributed to an actual increase in CP rate that go parallel to widespread application of Assisted Reproduction Techniques (ART) procedures all over the world on one hand and earlier diagnosis owing to liberal utilization and more familiarity with Transvaginal Sonography (TVS) on the other hand [1]. Totally, CP was reported to be one in nine thousand pregnancies while it represented about two percent of ART ectopic pregnancies [2]. The maternal impact of this calamity is markedly variable. It may pass unnoticed, causing a little harm or catastrophic with late discovery and presentation with a life-threatening hemorrhage. The exact etiology is still unexplained and the patient commonly presented by delayed menstruation with or without bleeding and infrequent pain. Diagnosis of a pure CP is based on TVS. Sonographic criteria’s specific to the case include empty uterine corpus while cervix is enlarged and barrel shaped, presence of gestational sac below the internal os, Color Doppler demonstrated a peritrophoblastic blood flow around the gestational sac and no sliding sign. Management is greatly different depending upon timing of diagnosis, case presentation, operator experience and available health facilities [1].","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44797131","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}
Pub Date : 2021-09-22DOI: 10.33696/gynaecology.2.015
Karlijn De Vocht, J. Verguts, G. Orye, T.R.A.H. Tuytten
In 2019, 12 experts invited by the Society of European Robotic Gynaecological Surgery (SERGS), agreed on 39 recommendations about education in robot-assisted surgery (RAS) in gynaecology. The same was done by the British and Irish Association of Robotic Gynaecological Surgeons (BIARGS) in 2020 [1]. The idea of these consensuses was to offer a guidebook for the development of a curriculum or a guideline to standardise the education for RAS [2] to improve surgical quality and outcome.
{"title":"Practical Considerations Regarding Recommendations for an Educational Program in Robot Assisted Gynaecological Surgery","authors":"Karlijn De Vocht, J. Verguts, G. Orye, T.R.A.H. Tuytten","doi":"10.33696/gynaecology.2.015","DOIUrl":"https://doi.org/10.33696/gynaecology.2.015","url":null,"abstract":"In 2019, 12 experts invited by the Society of European Robotic Gynaecological Surgery (SERGS), agreed on 39 recommendations about education in robot-assisted surgery (RAS) in gynaecology. The same was done by the British and Irish Association of Robotic Gynaecological Surgeons (BIARGS) in 2020 [1]. The idea of these consensuses was to offer a guidebook for the development of a curriculum or a guideline to standardise the education for RAS [2] to improve surgical quality and outcome.","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42730650","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}
Pub Date : 2021-09-22DOI: 10.33696/gynaecology.2.018
C. O. Figueira, Helena M Gomide, J. P. Guida, Tabata Z Dias, G. Lajos, R. Tedesco, M. Nomura, P. M. Rehder, J. Cecatti, R. Passini, F. Surita, M. L. Costa
Camilla O. Figueira1, Helena M Gomide1, José P. Guida1, Tabata Z. Dias1, Giuliane J. Lajos1, Ricardo P. Tedesco2, Marcelo L. Nomura1, Patrícia M. Rehder1, José G. Cecatti1,3, Renato Passini Jr1, Fernanda G. Surita1, Maria Laura Costa1,3*, Brazilian Multicenter Study on Preterm Birth study group* 1Department of Obstetrics and Gynecology, University of Campinas, Campinas/SP, Brazil 2Department of Obstetrics and Gynecology, Jundiaí School of Medicine, Jundiaí, Brazil 3Centre for Studies in Reproductive Health of Campinas (CEMICAMP)
Camilla O. Figueira1, Helena M Gomide1, jos P. Guida1, Tabata Z. Dias1, Giuliane J. Lajos1, Ricardo P. Tedesco2, Marcelo L. Nomura1, Patrícia M. Rehder1, jos G. cecatti1,3, Renato Passini j1, Fernanda G. Surita1, Maria Laura costa1,3 *，巴西多中心早产研究研究组* 1巴西坎皮纳斯大学妇产科，坎皮纳斯/SP 2 Jundiaí医学院妇产科，Jundiaí巴西3坎皮纳斯生殖健康研究中心(CEMICAMP)
{"title":"The Role of Anemia in Term and Preterm Pregnancies: Evidence from the Brazilian Multicenter Study on Preterm Birth (EMIP)","authors":"C. O. Figueira, Helena M Gomide, J. P. Guida, Tabata Z Dias, G. Lajos, R. Tedesco, M. Nomura, P. M. Rehder, J. Cecatti, R. Passini, F. Surita, M. L. Costa","doi":"10.33696/gynaecology.2.018","DOIUrl":"https://doi.org/10.33696/gynaecology.2.018","url":null,"abstract":"Camilla O. Figueira1, Helena M Gomide1, José P. Guida1, Tabata Z. Dias1, Giuliane J. Lajos1, Ricardo P. Tedesco2, Marcelo L. Nomura1, Patrícia M. Rehder1, José G. Cecatti1,3, Renato Passini Jr1, Fernanda G. Surita1, Maria Laura Costa1,3*, Brazilian Multicenter Study on Preterm Birth study group* 1Department of Obstetrics and Gynecology, University of Campinas, Campinas/SP, Brazil 2Department of Obstetrics and Gynecology, Jundiaí School of Medicine, Jundiaí, Brazil 3Centre for Studies in Reproductive Health of Campinas (CEMICAMP)","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43578534","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}
Pub Date : 2021-09-22DOI: 10.33696/gynaecology.2.017
K. Techatraisak
Natural menopause occurs at different ages in different countries ranging from as young as 46.9-47.8 years in the Middle-East region to 50.0-51.1 years in the European countries [1], and previously reported at the approximate age of 50 years in Thailand [2]. Natural menopausal age is reported to be influenced by both factors; host factors such as genetic factors, ethnicity, or body-mass index; and environmental factors such as smoking, parity, etc. Age at natural menopause was associated with subsequent risk of cardiovascular disease, low bone mass density, osteoporosis, and all-cause mortality [3]. However, surgical menopause from bilateral oophorectomy with or without hysterectomy before the age of natural menopause, which occurs at a much younger age than natural menopause, causes a more abrupt decline in ovarian hormones production especially estrogens. The majority of bilateral oophorectomy cases were reported at the ages between 3545 years or younger [4,5]. In general, surgical menopause also results in subsequent adverse health consequences such as: sleep problems [6-8], genitourinary syndrome of menopause, metabolic diseases and cardiovascular events, dementia, osteoporosis, etc. [9-16]. On the contrary, surgical menopause for benign diseases with or without estrogen therapy was also reported to improve sexuality and psychological well-being as the results of reliefs from prior depression or sexual problems [17]. In recent years, surgical menopause has been globally an area of healthcare interest and much more studied and reviewed. A retrospective cohort study of 1,000 consecutive surgical menopause patients who underwent premenopausal surgery before age 50 years for benign indications from a tertiary-care hospital in Bangkok was performed, and the results were published in 2020 [18]. The results showed that 85.5% of the patients used menopausal hormonal therapy (MHT) after surgery. From that study, those with MHT initiated soon after surgery (87% initiated within the first postsurgical year, at the mean age of 42.6 ± 5.1 years, with a median follow-up time of 12.0 years) possibly prevented subsequent osteopenia compared with MHT non-users.
{"title":"After Surgical Menopause, Should Menopausal Hormonal Therapy Started Only Before the Age of 45 Years?","authors":"K. Techatraisak","doi":"10.33696/gynaecology.2.017","DOIUrl":"https://doi.org/10.33696/gynaecology.2.017","url":null,"abstract":"Natural menopause occurs at different ages in different countries ranging from as young as 46.9-47.8 years in the Middle-East region to 50.0-51.1 years in the European countries [1], and previously reported at the approximate age of 50 years in Thailand [2]. Natural menopausal age is reported to be influenced by both factors; host factors such as genetic factors, ethnicity, or body-mass index; and environmental factors such as smoking, parity, etc. Age at natural menopause was associated with subsequent risk of cardiovascular disease, low bone mass density, osteoporosis, and all-cause mortality [3]. However, surgical menopause from bilateral oophorectomy with or without hysterectomy before the age of natural menopause, which occurs at a much younger age than natural menopause, causes a more abrupt decline in ovarian hormones production especially estrogens. The majority of bilateral oophorectomy cases were reported at the ages between 3545 years or younger [4,5]. In general, surgical menopause also results in subsequent adverse health consequences such as: sleep problems [6-8], genitourinary syndrome of menopause, metabolic diseases and cardiovascular events, dementia, osteoporosis, etc. [9-16]. On the contrary, surgical menopause for benign diseases with or without estrogen therapy was also reported to improve sexuality and psychological well-being as the results of reliefs from prior depression or sexual problems [17]. In recent years, surgical menopause has been globally an area of healthcare interest and much more studied and reviewed. A retrospective cohort study of 1,000 consecutive surgical menopause patients who underwent premenopausal surgery before age 50 years for benign indications from a tertiary-care hospital in Bangkok was performed, and the results were published in 2020 [18]. The results showed that 85.5% of the patients used menopausal hormonal therapy (MHT) after surgery. From that study, those with MHT initiated soon after surgery (87% initiated within the first postsurgical year, at the mean age of 42.6 ± 5.1 years, with a median follow-up time of 12.0 years) possibly prevented subsequent osteopenia compared with MHT non-users.","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48858561","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}
Pub Date : 2021-09-22DOI: 10.33696/gynaecology.2.014
L. Rugeri, S. Désage, S. Meunier
The medical care of patients with inherited bleeding disorders requires a greater understanding and attention, especially in women who can be exposed to specific hemorrhagic complications such as menorrhagia or complications during pregnancies and deliveries. These potential complications have to be taken into account, and specific procedures or treatment regimens must be provided. Among the general population with bleeding disorders, hemophilia A and B along with von Willebrand disease represent about 95% to 97% of cases. The remaining disorders, called rare bleeding disorders (RBDs), are due to fibrinogen, or factor II, V, VII, X, XI, or XIII (FXIII) deficiencies [1]. Among these RBDs, the congenital FXIII deficiency (FXIIID) is a very rare life-threatening autosomal recessive bleeding disorder and also a cause of recurrent miscarriages. Due to the rarity of these diseases and the consequent absence of randomized controlled studies investigating treatment, recommendations for their management are mainly based on expert consensus rather than on evidence-based guidelines [2]. Since 2012, the European Network and the United Kingdom Haemophilia Centre Doctors’ Organization (UKHCDO) have published recommendations for the management of RBDs, including the management of FXIIID [3-5]. In parallel, other authors published specific recommendations regarding FXIIID treatment [6,7].
{"title":"Challenges Regarding the Management of Gynecological and Obstetric Complications in Women with Inherited Factor XIII Deficiency","authors":"L. Rugeri, S. Désage, S. Meunier","doi":"10.33696/gynaecology.2.014","DOIUrl":"https://doi.org/10.33696/gynaecology.2.014","url":null,"abstract":"The medical care of patients with inherited bleeding disorders requires a greater understanding and attention, especially in women who can be exposed to specific hemorrhagic complications such as menorrhagia or complications during pregnancies and deliveries. These potential complications have to be taken into account, and specific procedures or treatment regimens must be provided. Among the general population with bleeding disorders, hemophilia A and B along with von Willebrand disease represent about 95% to 97% of cases. The remaining disorders, called rare bleeding disorders (RBDs), are due to fibrinogen, or factor II, V, VII, X, XI, or XIII (FXIII) deficiencies [1]. Among these RBDs, the congenital FXIII deficiency (FXIIID) is a very rare life-threatening autosomal recessive bleeding disorder and also a cause of recurrent miscarriages. Due to the rarity of these diseases and the consequent absence of randomized controlled studies investigating treatment, recommendations for their management are mainly based on expert consensus rather than on evidence-based guidelines [2]. Since 2012, the European Network and the United Kingdom Haemophilia Centre Doctors’ Organization (UKHCDO) have published recommendations for the management of RBDs, including the management of FXIIID [3-5]. In parallel, other authors published specific recommendations regarding FXIIID treatment [6,7].","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44182874","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}
Pub Date : 2021-09-15DOI: 10.33696/gynaecology.2.019
H. Odendaal
The survival probability of early human conceptions is very low. At least 73% of natural single conceptions have no real chance of surviving six weeks of gestation [1]. After six weeks, survival rates improve rapidly as 90% of the remainder will survive to term. This low fetal loss rate is close to the low rates of 1% 2.9% for different methods of artificial reproduction [2]. From 16 weeks the rate of loss reduces further, to around 1% [3,4]. Miscarriage is the loss of pregnancy before fetal viability and has a pooled risk of 15.3% (95% CI: 12.5-18.7) [5]. The population prevalence of women who have had one miscarriage is 10.8% (95% CI: 10.3 -11.4). As there is a great need for better knowledge and services, a recent editorial article in The Lancet pleaded for worldwide reform to improve the care of women who have had a miscarriage [6].
{"title":"Strong Association Between Placental Pathology and Second-trimester Miscarriage","authors":"H. Odendaal","doi":"10.33696/gynaecology.2.019","DOIUrl":"https://doi.org/10.33696/gynaecology.2.019","url":null,"abstract":"The survival probability of early human conceptions is very low. At least 73% of natural single conceptions have no real chance of surviving six weeks of gestation [1]. After six weeks, survival rates improve rapidly as 90% of the remainder will survive to term. This low fetal loss rate is close to the low rates of 1% 2.9% for different methods of artificial reproduction [2]. From 16 weeks the rate of loss reduces further, to around 1% [3,4]. Miscarriage is the loss of pregnancy before fetal viability and has a pooled risk of 15.3% (95% CI: 12.5-18.7) [5]. The population prevalence of women who have had one miscarriage is 10.8% (95% CI: 10.3 -11.4). As there is a great need for better knowledge and services, a recent editorial article in The Lancet pleaded for worldwide reform to improve the care of women who have had a miscarriage [6].","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":"2 1","pages":"51 - 56"},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47644066","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}
Pub Date : 2021-07-19DOI: 10.33696/gynaecology.2.010
A. Mehanna
{"title":"Recommendation of Tetanus Toxoid Vaccination for Pregnant Females in a Country that Achieved Elimination of Maternal and Neonatal Tetanus","authors":"A. Mehanna","doi":"10.33696/gynaecology.2.010","DOIUrl":"https://doi.org/10.33696/gynaecology.2.010","url":null,"abstract":"","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69670449","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}
Pub Date : 2021-07-19DOI: 10.33696/gynaecology.2.012
J. Aarts, Plm Zusterzeel
In 2020 we published a series of 18 patients who underwent neoadjuvant chemotherapy (NACT) and vaginal radical trachelectomy (VRT) as a fertility sparing alternative in stage 1B2 cervical cancer [1]. We concluded that this could be a safe fertility-sparing option in a selected group of women with stage 1B2 cervical cancer. We found a recurrence rate of 21% (three patients). All these patients had adenocarcinoma, lymphovascular space invasion (LVSI) present and a partial response to NACT. In our cohort in 78% of the women who were eligible fertility preservation was achieved. In this overview we provide an update of the data including an additional number of patients who have received this treatment in the meantime. Finally, we give advice about options for fertility sparing surgery.
{"title":"Neoadjuvant Chemotherapy Followed by Fertility Sparing Surgery in Stage 1B2 Cervical Cancer","authors":"J. Aarts, Plm Zusterzeel","doi":"10.33696/gynaecology.2.012","DOIUrl":"https://doi.org/10.33696/gynaecology.2.012","url":null,"abstract":"In 2020 we published a series of 18 patients who underwent neoadjuvant chemotherapy (NACT) and vaginal radical trachelectomy (VRT) as a fertility sparing alternative in stage 1B2 cervical cancer [1]. We concluded that this could be a safe fertility-sparing option in a selected group of women with stage 1B2 cervical cancer. We found a recurrence rate of 21% (three patients). All these patients had adenocarcinoma, lymphovascular space invasion (LVSI) present and a partial response to NACT. In our cohort in 78% of the women who were eligible fertility preservation was achieved. In this overview we provide an update of the data including an additional number of patients who have received this treatment in the meantime. Finally, we give advice about options for fertility sparing surgery.","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45916188","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}
Pub Date : 2021-07-19DOI: 10.33696/gynaecology.2.013
N. Ginsberg, L. P. Schulman
Sickle cell disease (SCD) is the consequence of the formation of hemoglobin S (HbS), typically resulting from homozygosity or compound heterozygosity for pathogenic variants in the sickle cell gene. Under low oxygen pressure, sickle hemoglobin molecules affected by sickle cell pathogenic variants interact with one another to deform the red cell and give the cell its classic “sickle” appearance. This defect in the beta chain forms a hump that fits into another complimentary spot on another hemoglobin molecule, thereby allowing them to hook together and form tetrahedral crystals. These ridged aggregates go on to precipitate out of solution and lead to collapse of erythrocyte and result in loss of cellular function and ensuing anemia. The main determinant of cell deformation is the rate and extent of HbS formation [1].
{"title":"Gene Therapy for Sickle Cell Disease: Start of a New Era","authors":"N. Ginsberg, L. P. Schulman","doi":"10.33696/gynaecology.2.013","DOIUrl":"https://doi.org/10.33696/gynaecology.2.013","url":null,"abstract":"Sickle cell disease (SCD) is the consequence of the formation of hemoglobin S (HbS), typically resulting from homozygosity or compound heterozygosity for pathogenic variants in the sickle cell gene. Under low oxygen pressure, sickle hemoglobin molecules affected by sickle cell pathogenic variants interact with one another to deform the red cell and give the cell its classic “sickle” appearance. This defect in the beta chain forms a hump that fits into another complimentary spot on another hemoglobin molecule, thereby allowing them to hook together and form tetrahedral crystals. These ridged aggregates go on to precipitate out of solution and lead to collapse of erythrocyte and result in loss of cellular function and ensuing anemia. The main determinant of cell deformation is the rate and extent of HbS formation [1].","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47611489","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}
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