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Intrauterine Device Embedment Resulting in Its Fracture: A Case Series 宫内节育器嵌入导致其破裂:一个案例系列
Pub Date : 2021-01-01 DOI: 10.33696/gynaecology.2.009
C. Fernandez, E. Levine, M. Cabiya, I. Ansari, Leah Delfinado
As gynecologic providers continue to provide intrauterine devices (IUDs) for long-acting reversable contraception (LARC) with insertion of those devices, the associated complication rate needs to be well-understood, so that patients can make properly informed shared healthcare decisions. There appears to be IUD embedment into the uterine wall that can occur over time, which can cause its fracture when retrieving it with grasp of its string. The authors previously published a case series [1] that described situations in which fractured IUDs were encountered after attempts at their removal occurred. Given that patients continue to be referred to the Director of Gynecologic Sonography at our institution for assistance in managing such complications when they are encountered, this case series was continued, and the authors believe it important to report these findings at this time.
随着妇科医生继续为长效可逆避孕(LARC)提供宫内节育器(iud)并插入这些节育器,需要充分了解相关的并发症发生率,以便患者能够做出适当的知情共享医疗保健决策。随着时间的推移,宫内节育器可能会嵌入子宫壁,这可能会导致宫内节育器在取出时断裂。作者之前发表了一个病例系列[1],描述了在试图取出宫内节育器后遇到断裂的情况。考虑到患者在遇到此类并发症时继续被转介到我院妇科超声检查主任处寻求帮助,本病例系列继续进行,作者认为在此时报告这些发现很重要。
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引用次数: 2
Strong Association Between Placental Pathology and Second-trimester Miscarriage. 胎盘病理学与二胎流产密切相关。
H J Odendaal
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引用次数: 0
Evaluation and Management of chronic Hypertension in Pregnancy 妊娠期慢性高血压的评价与处理
Pub Date : 2021-01-01 DOI: 10.33696/gynaecology.2.011
S. Yadav, Neeta Singh, M. Pradhan
Hypertension is a major health issue in pregnancy contributing to significant maternal and neonatal morbidity and mortality. Hypertensive disorders of pregnancy can be classified as chronic hypertension, gestational hypertension and preeclampsia. Chronic hypertension is present in 1-2% of pregnant women [1,2]. Prevalence of chronic hypertension increases with advancing maternal age and obesity. Chronic hypertension during pregnancy is defined as hypertension (blood pressure of more than 140/90 mmHg on 2 occasions 4 hours apart) present before pregnancy or 20 weeks of gestation or hypertension diagnosed during pregnancy that does not resolve in postpartum period after 12 weeks [3].
高血压是妊娠期的一个主要健康问题,是孕产妇和新生儿发病率和死亡率的重要原因。妊娠期高血压疾病可分为慢性高血压、妊娠期高血压和先兆子痫。1-2%的孕妇存在慢性高血压[1,2]。慢性高血压患病率随着产妇年龄和肥胖而增加。妊娠期慢性高血压定义为妊娠前或妊娠20周出现的高血压(2次血压超过140/90 mmHg,间隔4小时)或妊娠期间诊断的高血压,12周后产后未缓解。
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引用次数: 0
Preliminary Study Assessing the Efficiency of a New Singleuse Obstetrical Vacuum Device: Icup2® 一种新型单用途产科真空装置:Icup2®的有效性评估初步研究
Pub Date : 2020-12-31 DOI: 10.33696/GYNAECOLOGY.1.008
A. D'Antona, N. Mottet, P. Lenoir, C. Toubin, A. Bourtembourg, R. Ramanah, D. Riethmuller
In France, the most commonly used vacuum extraction devices are the multi-use cup by Drapier-Faure (Minicup®) (Collin-Gentile-Drapier, Paris, France) and the single-use Kiwi Omnicup® suction Cup. The Minicup® is made of a rigid metal cup with a suction system which is independent of the traction system [3]. The main disadvantage of this vacuum device is that it must be sterilized and requires the use of a motor to create the vacuum. The Kiwi Omnicup® (Clinical Innovations, Heathrow, UK) is a single-use vacuum device with a rigid plastic cup connected to a hand pump for suction and traction [4]. The cost of this vacuum device, which is made in the USA, is relatively high (about 55 € excl. VAT).
在法国,最常用的真空抽吸设备是Drapier-Faure (Minicup®)(colin - gentile - drapier, Paris, France)的多用途吸盘和Kiwi Omnicup®一次性吸盘。Minicup®由刚性金属杯制成,具有独立于牵引系统[3]的吸力系统。这种真空装置的主要缺点是它必须经过消毒,并且需要使用电机来产生真空。Kiwi Omnicup®(临床创新,希思罗机场,英国)是一种一次性真空装置,其刚性塑料杯连接到用于吸吸和牵引[4]的手泵。这种真空装置的成本,这是在美国制造的,是相对较高的(约55€不含增值税)。
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引用次数: 3
Impact of Estradiol Supplementation during Luteal Phase Support on the In vitro Fertilization Clinical Outcome: Systematic Review and Meta-Analysis 黄体期支持期间补充雌二醇对体外受精临床结果的影响:系统评价和荟萃分析
Pub Date : 2020-06-16 DOI: 10.33696/gynaecology.1.005
J. Hao, Bin xu, Yonggang Wang, Yanping Li, J. Zhao
This study aimed to clarify whether estradiol (E2) supplementation as luteal phase support (LPS) has benefit effect on the clinical outcomes after IVF/ICSI. A meta-analysis was conducted. E2+P group had significant higher CPR and ongoing PR than that of P-only group. GnRH-a protocol group had a significant higher CPR and ongoing PR with E2+P, whereas GnRH-ant protocol group had no difference in CPR, ongoing PR, IR, and AR among E2+P and Ponly groups. So, E2 supplementation as LPS has beneficial effect on the clinical outcomes only during cycles with GnRH-a protocol. Background
本研究旨在阐明补充雌二醇(E2)作为黄体期支持(LPS)是否对IVF/ICSI后的临床结果有益处。进行了荟萃分析。E2+P组心肺复苏和持续性PR明显高于单纯P组。GnRH-a方案组的CPR和持续PR显著高于E2+P组,而GnRH-ant方案组在E2+P和Ponly组之间的CPR、持续PR、IR和AR没有差异。因此,补充E2作为LPS仅在GnRH-a方案的周期内对临床结果有有益影响。背景
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引用次数: 1
Family Planning Laboratory Review of Factors Affecting the Choice of Contraceptive Methods in Three Teenagers Populations in Thrace, Greece 希腊色雷斯三名青少年避孕方法选择影响因素的计划生育实验室调查
Pub Date : 2020-06-16 DOI: 10.33696/gynaecology.1.003
P. Tsikouras, G. Galazios, X. Anthoulaki, A. Chalkidou, A. Bothou, Theodora Deuteraiou, M. Koutsogiannis, I. Babageorgaka, F. Gaitatzi, K. Nikolettos, S. Zervoudis, N. Nikolettos
Contraception was applied for decades on an empirical basis but the discovery of contraceptive pills has brought a real revolution on this field because with the use of scientific techniques, we managed to prevent ovulation which is the cornerstone of reproduction. [1,2]. Since the AIDS outbreak, the use of contraceptive pills has decreased due to the fact that they do not offer any protection against sexually transmitted diseases [3,4]. On the other hand, barrier contraception which offers protection against STDs prevents direct contact. Birth control pill continues to be a unique scientific achievement and at the same time an invaluable contribution to every woman, which if combined with intrauterine devices creates a protective shield to unwanted pregnancy [3-5]. The clinical application of oral contraception dates back to the 1960s, but its history goes back to the early 20th century, when experimental data showed that the ovaries were organs with hormonal activity [3-5].
几十年来,避孕都是在经验的基础上进行的,但避孕药的发现给这一领域带来了真正的革命,因为通过使用科学技术,我们成功地阻止了排卵,而排卵是生殖的基石。[1,2]。自艾滋病爆发以来,避孕药的使用有所减少,因为它们不能提供任何防止性传播疾病的保护[3,4]。另一方面,屏障避孕可以预防性病,防止直接接触。避孕药仍然是一项独特的科学成就,同时也是对每个女性的宝贵贡献,如果与宫内节育器结合使用,就会形成一个防止意外怀孕的保护性屏障[3-5]。口服避孕药的临床应用始于20世纪60年代,但其历史可以追溯到20世纪初,当时的实验数据表明卵巢是具有激素活性的器官[3-5]。
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引用次数: 1
Low-level Progesterone on the Day of hCG Injection Has No Detrimental Effect on the Pregnancy Outcome after IVF with GnRH-a Protocol: A Retrospective Study 注射hCG当天低水平孕酮对GnRH-a方案体外受精后妊娠结局无不良影响:一项回顾性研究
Pub Date : 2020-06-16 DOI: 10.33696/gynaecology.1.004
J. Hao, Bin xu, Yonggang Wang, Yanping Li, J. Zhao
In addition, animal experiments have indicated that the P level during the late follicular phase is important for the maturation of oocyte [15], fertilization of oocyte [16], and luteinization of theca / granulosa [17,18]. Additionally, P is important to support the endometrium in the luteal phase. Therefore, we suppose that low level P in the phase of late follicular may compromise pregnancy outcome after IVF cycles. Abstract
此外,动物实验表明,卵泡后期的P水平对卵母细胞[15]的成熟、卵母细胞[16]的受精和卵泡/颗粒的黄体化很重要[17,18]。此外,P对黄体期子宫内膜的支持也很重要。因此,我们认为卵泡晚期的低水平P可能会影响IVF周期后的妊娠结局。摘要
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引用次数: 1
Ultrasound in Obstetrics and Gynecology 超声在妇产科
Pub Date : 2020-06-16 DOI: 10.1002/(issn)1469-0705
Elliot M. Levine
We are witnessing the evolution of the diagnostic imaging that is rapidly becoming available to Women’s Health physicians (OB/GYN’s), enabling the use of technology to augment our ability to medically palpate on examination of the patient, to identify conditions which we were unable to appreciate a short time ago. Threedimensional transvaginal sonography (3DTVS), along with power Doppler angiography (PDA), are examples of such technologies. Clinicians have long appreciated the ability to view a three-dimensional image from the use of X-Rays (e.g. in computed tomography [CT] scans), or with magnetic resonance imaging (MRI). We can now create 3-D images with the use of ultrasound, in an easier and less costly way, and with possibly lesser harmful radiation. The tissue which is an ideal target of this imaging is found in the pelvis. Naturally, looking at the uterus, fallopian tubes, and ovaries is within the province of the OB/GYN.
我们目睹了诊断成像技术的发展,妇女保健医生(OB/GYN)正在迅速获得诊断成像技术,使我们能够利用技术增强我们在检查患者时进行医学触诊的能力,以确定我们不久前无法理解的疾病。三维阴道超声(3DTVS)和功率多普勒血管造影(PDA)都是此类技术的例子。长期以来,临床医生一直赞赏使用x射线(例如计算机断层扫描[CT]扫描)或磁共振成像(MRI)查看三维图像的能力。我们现在可以用超声波制作三维图像,以一种更简单、更便宜的方式,而且有害的辐射可能更少。骨盆组织是这个成像的理想目标。当然,检查子宫、输卵管和卵巢是妇产科的工作范围。
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引用次数: 11
Early Onset Fetal Growth Restriction: Does Path to Diagnosis Impact Outcomes and Pathology? 早发性胎儿生长受限:诊断途径会影响结果和病理吗?
Pub Date : 2020-01-01 DOI: 10.33696/gynaecology.1.002
Brian Burnett, Linda Street, Kristen Quinn, Jeff M Denney

Objective: To evaluate demographics and outcomes of maternal-fetal pairs in early onset fetal growth restriction (FGR) requiring delivery prior to 34 weeks' gestation based on ultrasound indication leading to diagnosis.

Study design: This is a descriptive study of maternal-fetal pairs with early FGR diagnosed prior to 30 weeks' gestation and delivering between 22w0d and 34w0d under the care of Wake Forest University Perinatology 01/2012-12/2016. Serial ultrasounds to assess fetal growth and umbilical artery flow Doppler velocimetry were evaluated. Pairs were dichotomized into those with maternal comorbidities leading to ultrasound diagnosis, and those with ultrasound indicated only by appreciation of uterine size less than dates on exam. Patient characteristics and outcomes were tracked. Univariate and multivariate analyses were performed as appropriate.

Results: 56 pregnancies were identified with FGR prior to 30 weeks and subsequent delivery prior to 34 weeks. Common comorbidities present in the group with maternal comorbidities included chronic hypertension (30.5%), hypertensive disorders of pregnancy (36.1%), preexisting diabetes (13.9%), gestational diabetes (5.6%). None of the women in the S

Conclusion: Women measuring size less than dates in the mid-trimester should be evaluated by ultrasound without delays. Early FGR carries a high mortality rate in all cases and in our pilot data, women measuring small were diagnosed later with fetal growth restriction and may represent a severe phenotype with poor fetal-placental circulation. These pregnancies often met criteria for urgent delivery in a short time frame, especially if abnormal umbilical artery Doppler velocimetry was noted.

目的:根据超声指征诊断,评估早发性胎儿生长受限(FGR)需要分娩的母胎对的人口统计学特征和结局。研究设计:本研究是一项描述性研究,研究对象是在妊娠30周前诊断为早期FGR的母胎,分娩时间在22 - 34天之间,于2012年1月- 2016年12月在维克森林大学围产医学中心进行。评估了一系列超声评估胎儿生长和脐动脉血流多普勒测速仪。这些患者被分为两组,一组有母体合并症,需要超声诊断,另一组只有超声显示子宫尺寸小于检查日期。跟踪患者的特征和结果。适当时进行单因素和多因素分析。结果:56例妊娠在30周前确诊为FGR,随后在34周前分娩。孕妇合并症组中常见的合并症包括慢性高血压(30.5%),妊娠期高血压疾病(36.1%),既往糖尿病(13.9%),妊娠期糖尿病(5.6%)。结论:在妊娠中期测量尺寸小于日期的妇女应立即用超声检查。在所有病例中,早期FGR的死亡率都很高,在我们的试点数据中,测量小的妇女后来被诊断为胎儿生长受限,可能代表胎儿-胎盘循环不良的严重表型。这些妊娠通常在短时间内符合紧急分娩的标准,特别是如果注意到脐动脉多普勒速度测量异常。
{"title":"Early Onset Fetal Growth Restriction: Does Path to Diagnosis Impact Outcomes and Pathology?","authors":"Brian Burnett,&nbsp;Linda Street,&nbsp;Kristen Quinn,&nbsp;Jeff M Denney","doi":"10.33696/gynaecology.1.002","DOIUrl":"https://doi.org/10.33696/gynaecology.1.002","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate demographics and outcomes of maternal-fetal pairs in early onset fetal growth restriction (FGR) requiring delivery prior to 34 weeks' gestation based on ultrasound indication leading to diagnosis.</p><p><strong>Study design: </strong>This is a descriptive study of maternal-fetal pairs with early FGR diagnosed prior to 30 weeks' gestation and delivering between 22w0d and 34w0d under the care of Wake Forest University Perinatology 01/2012-12/2016. Serial ultrasounds to assess fetal growth and umbilical artery flow Doppler velocimetry were evaluated. Pairs were dichotomized into those with maternal comorbidities leading to ultrasound diagnosis, and those with ultrasound indicated only by appreciation of uterine size less than dates on exam. Patient characteristics and outcomes were tracked. Univariate and multivariate analyses were performed as appropriate.</p><p><strong>Results: </strong>56 pregnancies were identified with FGR prior to 30 weeks and subsequent delivery prior to 34 weeks. Common comorbidities present in the group with maternal comorbidities included chronic hypertension (30.5%), hypertensive disorders of pregnancy (36.1%), preexisting diabetes (13.9%), gestational diabetes (5.6%). None of the women in the S<D group developed hypertensive disorders of pregnancy or GDM. Other background characteristics were similar. Pregnancies evaluated for size less than dates were diagnosed on average 3 weeks later in gestation, had higher incidence of reverse end diastolic flow on Doppler evaluation both at diagnosis (80% vs. 22.9%, p=0.01, OR 0.08 (<0.01,0.74) and were more likely to be delivered for an urgent indication. Both groups of babies had similar survival to discharge rates and length of stay in the NICU. A subanalysis evaluating only babies with abnormal Doppler studies showed a shorter diagnosis to delivery interval and continued to show increased risk of urgent delivery due to fetal status in those pregnancies diagnosed based on size<dates.</p><p><strong>Conclusion: </strong>Women measuring size less than dates in the mid-trimester should be evaluated by ultrasound without delays. Early FGR carries a high mortality rate in all cases and in our pilot data, women measuring small were diagnosed later with fetal growth restriction and may represent a severe phenotype with poor fetal-placental circulation. These pregnancies often met criteria for urgent delivery in a short time frame, especially if abnormal umbilical artery Doppler velocimetry was noted.</p>","PeriodicalId":93076,"journal":{"name":"Archives of obstetrics and gynaecology","volume":"1 1","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38725390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ultrasound in Obstetrics and Gynecology 超声在妇产科
Pub Date : 1900-01-01 DOI: 10.33696/GYNAECOLOGY.1.001
E. Levine
We are witnessing the evolution of the diagnostic imaging that is rapidly becoming available to Women’s Health physicians (OB/GYN’s), enabling the use of technology to augment our ability to medically palpate on examination of the patient, to identify conditions which we were unable to appreciate a short time ago. Threedimensional transvaginal sonography (3DTVS), along with power Doppler angiography (PDA), are examples of such technologies. Clinicians have long appreciated the ability to view a three-dimensional image from the use of X-Rays (e.g. in computed tomography [CT] scans), or with magnetic resonance imaging (MRI). We can now create 3-D images with the use of ultrasound, in an easier and less costly way, and with possibly lesser harmful radiation. The tissue which is an ideal target of this imaging is found in the pelvis. Naturally, looking at the uterus, fallopian tubes, and ovaries is within the province of the OB/GYN.
我们目睹了诊断成像技术的发展,妇女保健医生(OB/GYN)正在迅速获得诊断成像技术,使我们能够利用技术增强我们在检查患者时进行医学触诊的能力,以确定我们不久前无法理解的疾病。三维阴道超声(3DTVS)和功率多普勒血管造影(PDA)都是此类技术的例子。长期以来,临床医生一直赞赏使用x射线(例如计算机断层扫描[CT]扫描)或磁共振成像(MRI)查看三维图像的能力。我们现在可以用超声波制作三维图像,以一种更简单、更便宜的方式,而且有害的辐射可能更少。骨盆组织是这个成像的理想目标。当然,检查子宫、输卵管和卵巢是妇产科的工作范围。
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引用次数: 0
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Archives of obstetrics and gynaecology
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