Current Issue : October - December Volume : 2017 Issue Number : 4 Articles : 7 Articles
Background: 70% of all gynecological consultations are for abnormal uterine\nbleeding. Any approach to optimal management begins with an appropriate\ndiagnosis. 40% of premenopausal women with abnormal uterine bleeding\nwere found to have some intrauterine pathology. This study aims to compare\nthe diagnostic value of transvaginal ultrasonography in comparison to hysteroscopy\nin detecting uterine abnormalities in patients with abnormal uterine\nbleeding. Methods: Retrospective observational cross sectional study of 250\nwomen presented with abnormal uterine bleeding. The patients who fulfilled\nthe selection criteria and have been sequentially investigated by transvaginal\nultrasound (TVS) and hysteroscopy were included. Results: 90% of patients\nwere from 35 - 49 yrs. 81.2% of patients have body mass index above 25 kg/m2.\nTransvaginal ultrasound (TVS) compared well with high sensitivity as regards\nnormal endometrium. (TVS) missed 4 patients of endometrial polyps and one\npatient of sub mucous fibroid. Three patients of adenomyosis were only diagnosed\nby (TVS); they were reported as being normal by hysteroscopy. Conclusion:\n(TVS) is considered as an excellent approach to the initial evaluation\nof uterine pathologies in patients with abnormal uterine bleeding....
Objective: Evaluating the effect of perineal length on the duration of the\nsecond stage of labor, the mode of delivery, the need for episiotomy and the\npossibility of perineal and vaginal tears needing repair. Participants and\nMethods: It is a prospective hospital-based observational study done on 483\nparturient women in a university hospital. Personal, medical and obstetric\ndata together with the measurement of perineal length were recorded in the\nfirst stage of labor. We followed up the progress of labor until delivery. Regression\nmodels were used to consider possible risk factors of episiotomy or\ntears needed repair. Results: The mean duration of the second stage of labor\nwas significantly longer among women with a perineum of â�¥4 cm length\nwhen compared with those with a perineal length of <4 cm (36.7 �± 13.05 vs.\n26.9 �± 10.4 minutes; respectively). Regression analysis of possible risk factors\nshowed that circumcised primigravida with long perineum (â�¥ 4 cm) are more\nliable to have episiotomy (OR (95%CI) 1.96 (1.1 - 3.5); 20.9 (11.1 - 39.5); 4.8\n(2.5 - 9.2); respectively). Tears needed to repair are however, more common\nin circumcised women with short perineum (<4 cm) who delivered without\nepisiotomy (OR (95%CI) 14.16 (8.1 - 24.9); 4.54 (1.5 - 14) respectively. Conclusion:\nLonger perineum is associated with increase in the duration of the\nsecond stage of labor. Obstetricians should expect the need of episiotomy\nwhen confronted with circumcised primigravida with long perineum. However,\nif the perineum is short they should not be deceived, short perineum is\nmore probably torn....
The present study aims to determine the gynecologic health status of asymptomatic\nwomen at a unique Japanese Health Check-up Institute, Ningen Dock.\nMedical records of Japanese women, who underwent gynecological medical\n(health) examinations between January 2011 and December 2016, were retrospectively\nreviewed. Of the cervical smears from 8927 women aged 18 - 85\nyears, 50 (0.6%) were classified as dysplastic and malignant changes: 18 of\nlow-grade squamous intraepithelial lesion, 10 high-grade squamous intraepithelial\nlesion, 21 atypical squamous cells of undetermined significance and 1\ncervical squamous cell carcinoma. No case of cervical adenocarcinoma was\nfound. Ultrasonographic examination detected uterus enlargements and ovary\ntumors in 2.0% and 0.9% of cases, respectively. Most of participants (95.6%)\nrevealed no gynecologic abnormalities. The present study based on the\nrecords of Ningen Dock, where asymptomatic participants undergo a medical\nexamination at their own expense, showed very low incidence of abnormal\ncytologic and/or ultrasonographic findings....
Purpose. To examine the uterine involution period after uncomplicated delivery in primiparous andmultiparous women. Methods.\nLongitudinal prospective study. Repeated parameters were measured and endometrial contents and diastolic notch were observed.\nMeasurements of primiparous and multiparous women were carried out after labour on the 1st, 3rd, 10th, 30th, 42nd, and\n60th postpartum days. The analysis was performed using SPSS version 21. Results. The median uterus parameters are bigger in\nmultiparous group in physiological puerperium, but the decreasing trend is the same. The endometrial cavity on the 10th day\nwas significantly wider in multiparous women and mainly echo-negative view of the uterine cavity was observed. The evaluation\nof the uterine angle deviation changes from an extremely retroverted position to a more anteverted position. RI of the uterine\nartery in both groups was low immediately after labour and significantly increased onemonth postpartum. Notching of the uterine\nartery undergoes changes, but diastolic notch does not appear in all postpartum women even after two months following labour.\nConclusions.The puerperium period after normal vaginal delivery depends on parity.The trend of involution in primiparous and\nmultiparous women follows a similar pattern, yet, it lasts longer in the multiparous women. Ultrasound of uterine is certainly a\nuseful tool after labour and may be important in facilitating an early detection of postpartum uterine complications....
A 75-year-old woman complained of anuria and a sense of discomfort with\nsevere pelvic organ prolapse (POP). We planned tension-free vaginal mesh\n(TVM) surgery after curing mucosal defects and completing treatment for\ndiabetes mellitus. Anuria and pyelonephritis relapsed repeatedly due to the\nfailure of ring pessary therapy. Surgical treatment was required emergently.\nWe performed a total laparoscopic hysterectomy and uterosacral ligament\ncolpo-suspension (Shull�s method). Although the vaginal apex was supported\nto a good position, cystocele occurred six months after the initial surgery. A\nTVM procedure for recurrent cystocele was performed after curing the mucosal\ndefects, and after the improvement of glycemic control. Transvaginal\nnative tissue repair has the advantages of low risk of ureter injury, firm colpo-\nsuspension, and no need for mesh usage. On the other hand, it is not good\nat treating cystocele. Transvaginal native tissue repair should prove to be a\nuseful surgical option for apical support without mesh....
Endometriosis is strongly associated with infertility. Endometrial polyps are prevalent in infertile women and they have similar\npathological characteristics to endometriosis, suggesting a possible association. Uterine malformations as uterine septum and\nhypoplastic uterus are also linked to endometriosis. Hysterosalpingogram and transvaginal ultrasonography are used to diagnose\nendometrial lesions. Hysteroscopy can detect small lesions that might be missed. Recently, 4D ultrasonography is being used,\nbut which is superior has not been established yet. We aim to compare 4D ultrasonography to office hysteroscopy in evaluating\nuterine cavity in cases with endometriosis; also we aim at correlating these findings with the stage of endometriosis. 50 cases of\nendometriosis diagnosed by laparoscopy were randomly selected from El Shatby fertility clinic, Alexandria University, Egypt, with\nexclusion of cases with any previous intrauterine surgery or any hormonal treatment. Transvaginal 4D ultrasonography and office\nhysteroscopy were done. 4D ultrasonography agreed with office hysteroscopy in diagnosing abnormal uterine findings in 14 cases\nand four additional cases were diagnosed by hysteroscopy alone. Conclusion. Endometrial polyps, septate uterus, and hypoplastic\nuterus are more prevalent among infertile women who happen to have endometriosis. 4D ultrasonography and office hysteroscopy\nare equally successful in assessing the uterine cavity....
Background.Three nomogrammodels for early stage uterine cervical cancer have been developed (KROG 13-03 for overall survival\n[OS], SNUH/AMC for disease-free survival [DFS], and KROG 12-08 for distant metastases-free survival [DMFS]) after radical\nhysterectomy (RH) and pelvic lymph node dissection (PLND). This study aimed to validate these models using our cohort with\nadjuvant radiotherapy. Methods. According to the eligibility criteria of nomogram studies, patients were enrolled in Group A (...
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