Clinica e Investigacion en Ginecologia y Obstetricia最新文献_第9页

Conceptos actuales en cirugía histeroscópica: superando barreras y ampliando límites 宫腔镜手术的当前概念：克服障碍和扩大界限

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100853

S. Haimovich Segal , E. Moratalla Bartolome , C. Ross Cerro , C. Vidal Mazo , C. Pérez Sagaseta

引用次数: 0

Endometriosis: papel del láser de CO2 en el abordaje quirúrgico 子宫内膜异位症：二氧化碳激光在手术入路中的作用

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100855

M. Rius, F. Carmona

{"title":"Endometriosis: papel del láser de CO2 en el abordaje quirúrgico","authors":"M. Rius, F. Carmona","doi":"10.1016/j.gine.2023.100855","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100855","url":null,"abstract":"<div><p>The surgical treatment of choice for endometrioma is cystectomy or endometrioma decapsulation. However, there is sufficient scientific evidence showing that this technique is associated with a decrease in ovarian reserve, either due to the removal of healthy ovarian tissue during the procedure or due to thermal damage performed during the control of haemostasis. For this reason, new surgical approaches have been described to alleviate this negative effect on ovarian reserve. The use of the CO<sub>2</sub> laser in gynecology has been known since the 1980s, and vaporization of the endometrioma capsule using this laser is a simple, easy-to-use, easily reproducible, and technically accessible technique. Although it was initially thought that the recurrence rate with this technique was higher, several studies show the opposite. Likewise, the damage to the ovarian reserve is less compared to decapsulation, in terms of better follicular count and antimullerian hormone level. Although the rates of spontaneous pregnancy and assisted reproductive techniques are similar, in assisted reproductive techniques patients treated with CO<sub>2</sub> laser vaporization have a higher follicular count and antimullerian hormone level compared to patients treated with decapsulation. To this day, the treatment of endometrioma continues to be a matter of discussion. However, the studies reviewed below favor ablative techniques in terms of better preserving ovarian reserve without increased risk of recurrence.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49832932","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}

引用次数: 0

Prevalencia e impacto del sangrado menstrual abundante en España: resultados de una encuesta nacional 西班牙月经大出血的患病率和影响:一项全国性调查的结果

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-07-01 DOI: 10.1016/j.gine.2023.100877

J. Perelló-Capo , J.C. Quílez-Conde , P. Lobo-Abascal , M. Andeyro-García , I. Cristóbal-García , J. Gutiérrez-Alés , M. Herrero-Conde , I. Parra-Ribes , J. Estadella-Tarriela , J. Rius-Tarruella , J. Calaf

{"title":"Prevalencia e impacto del sangrado menstrual abundante en España: resultados de una encuesta nacional","authors":"J. Perelló-Capo , J.C. Quílez-Conde , P. Lobo-Abascal , M. Andeyro-García , I. Cristóbal-García , J. Gutiérrez-Alés , M. Herrero-Conde , I. Parra-Ribes , J. Estadella-Tarriela , J. Rius-Tarruella , J. Calaf","doi":"10.1016/j.gine.2023.100877","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100877","url":null,"abstract":"<div><h3>Background</h3><p>Heavy menstrual bleeding (HMB) is a common gynecological complaint. Data on its prevalence and impact in Spain are limited.</p></div><div><h3>Material and methods</h3><p>A voluntary web-based survey was conducted in Spain among women aged 23–49. The survey covered several aspects of menstruation, including the characteristics and impact. The information was gathered using a semi-structured questionnaire sent by email. Results were weighted by age and geographic distribution.</p></div><div><h3>Results</h3><p>Of the 4478 women invited to participate, 1206 (26.9%) responded, of whom 1169 (96.9%) were menstruating. 32.7% (<em>n</em>     <!-->see a doctor for this reason.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49870557","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}

引用次数: 0

Decubito Prono En El Tercer Trimestre Del Embarazo Durante La Era Covid-19: Un Abordaje Transdisciplinar 新型冠状病毒时代妊娠晚期俯卧：跨学科方法

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-06-01 DOI: 10.1016/j.gine.2023.100906

Aurio Fajardo, Asariel Rodríguez, Carmen Chica, Carmelo Dueñas, R. Carrillo, Ximena Olaya, F. Vera

引用次数: 0

Conceptos actuales en dolor y endometriosis: diagnóstico y manejo del dolor pélvico crónico 疼痛和子宫内膜异位症的当前概念：慢性盆腔疼痛的诊断和管理

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-04-01 DOI: 10.1016/j.gine.2023.100843

F. Artacho-Cordón , E. Lorenzo Hernando , A. Pereira Sánchez , L. Quintas-Marquès

{"title":"Conceptos actuales en dolor y endometriosis: diagnóstico y manejo del dolor pélvico crónico","authors":"F. Artacho-Cordón , E. Lorenzo Hernando , A. Pereira Sánchez , L. Quintas-Marquès","doi":"10.1016/j.gine.2023.100843","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100843","url":null,"abstract":"<div><p>Pain is an unpleasant sensory and emotional experience. There are several ways to classify pain. It can be classified according to its temporality, distinguishing acute pain from chronic pain. Chronic pain can be classified according to its pathophysiology as nociceptive, neuropathic, or nociplastic. Most chronic pain will be classified as mixed, because it has characteristics of the three subgroups.</p><p>In patients who present chronic pain, we will frequently find peripheral and central sensitization due to a nervous system dysfunction, which, in turn, will explain why these patients have a worse prognosis and worse response to treatments provided. It is necessary to identify these sensitized patients, because they will require specific treatments with a multimodal approach.</p><p>In chronic pelvic patients, it is vitally important to perform a good and detailed anamnesis and an extended physical examination, not only focused on the gynaecological sphere, to diagnose the cause of the pain correctly.</p><p>Patients with chronic pelvic pain present highly complex pictures. Treatments proposed must be aetiological, for example, when the pain is associated with endometriosis, but we must also treat chronic pain as a disease. Treatments should be multidisciplinary and individualized for each patient and must target central sensitization.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49842339","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}

引用次数: 0

Diagnóstico ecográfico de la endometriosis y los miomas 子宫内膜异位症和肌瘤的超声诊断

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-04-01 DOI: 10.1016/j.gine.2023.100844

C. Ros Cerro , J.M. Puente Águeda

{"title":"Diagnóstico ecográfico de la endometriosis y los miomas","authors":"C. Ros Cerro , J.M. Puente Águeda","doi":"10.1016/j.gine.2023.100844","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100844","url":null,"abstract":"<div><p>Transvaginal ultrasound is considered the first-line imaging diagnostic test in the study of women with fibroids, adenomyosis, and ovarian and deep endometriosis. It is recommended that the ultrasound should follow the MUSA consensus for myometrial pathology, and the IDEA consensus for endometriosis.</p><p>To diagnose adenomyosis, it is necessary to identify at least one «direct» criterion (hyperechogenic buds or island or intramyometrial cysts), as well as one or several «indirect» criteria (globulous uterine morphology, «fan-shaped» shadowing, asymmetry, or non-defined junctional zone). It is recommended to specify if the adenomyosis is internal or external. Translesional vascularization of adenomyosis is different from circumferential vascularization of fibroids, of which the measurement of the 3 diameters should be reported, the echogenicity should be described, and the number and location defined according to the FIGO classification.</p><p>Ultrasound for endometriosis is performed by systematic examination of the uterus and ovaries (endometriomas), soft markers (periadnexal pseudocysts, tabicated fluid in the pouch of Douglas, fixed ovaries, tenderness-guide areas, and comma-shaped uterus), sliding sign (anterior, retrouterine, and retrocervical) and the detection and description of deep endometriotic nodules in the anterior (bladder, ureters) or posterior compartment (uterosacral ligaments, parametria, vaginal fornix, rectovaginal septum, and rectosigma).</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49842805","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}

引用次数: 1

Dolor pélvico en mujeres con episiotomía versus mujeres con desgarro perineal de segundo grado 会阴切开术女性与二级会阴撕裂女性的盆腔疼痛

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-04-01 DOI: 10.1016/j.gine.2023.100848

I. Asorey Veiga , I. Aparicio Rodríguez , M. Macía Cortiñas

{"title":"Dolor pélvico en mujeres con episiotomía versus mujeres con desgarro perineal de segundo grado","authors":"I. Asorey Veiga , I. Aparicio Rodríguez , M. Macía Cortiñas","doi":"10.1016/j.gine.2023.100848","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100848","url":null,"abstract":"<div><h3>Introduction</h3><p>Pelvic pain is one of the most common pelvic floor dysfunctions in the postpartum period, depending on the degree of injury and the time at which it is assessed. The degree of involvement of a mediolateral episiotomy is similar to that of a second degree perineal tear, therefore it was decided to conduct a study to collect the degree of pain reported using the McGill Pain Questionnaire.</p></div><div><h3>Material and methods</h3><p>An observational, prospective longitudinal epidemiological study of dynamic cohorts was conducted among 384 women, of whom 255 had a second-degree tear and 129 had undergone an episiotomy. An assessment of the pelvic floor was carried out, together with data collection (performance or not of perineal massage, pelvic floor muscle exercises, presence of Kristeller, type of suture) as well as the degree and type of pain using the McGill Questionnaire, in the immediate puerperium, at six weeks, and six months of postpartum.</p></div><div><h3>Results</h3><p>In the immediate puerperium more than 50% of women reported some type of painful sensation, without finding significant differences between both cohorts. However, as the study evolved, there was a progressive decrease in pain in both cohorts. By six weeks postpartum, less than 33% of women reported a painful sensation, considered as absence of pain according to the criteria of the McGill questionnaire.</p></div><div><h3>Conclusion</h3><p>The presence of episiotomy or second degree perineal tear was not related to perineal pain.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49879208","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}

引用次数: 0

Estudio descriptivo sobre la satisfacción de las usuarias de Implanon® y los motivos para su retirada 关于Implanon®用户满意度和退出原因的描述性研究

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-04-01 DOI: 10.1016/j.gine.2022.100825

J.D. Zuheros Montes , Y. Nieto Espinar , M.C. Zuheros Montes

{"title":"Estudio descriptivo sobre la satisfacción de las usuarias de Implanon® y los motivos para su retirada","authors":"J.D. Zuheros Montes , Y. Nieto Espinar , M.C. Zuheros Montes","doi":"10.1016/j.gine.2022.100825","DOIUrl":"https://doi.org/10.1016/j.gine.2022.100825","url":null,"abstract":"<div><h3>Introduction</h3><p>Implanon® is a subdermal contraceptive implant that is inserted on an outpatient basis. It contains 68mg of etonogestrel, and is a long-acting reversible contraception method.</p></div><div><h3>Methodology</h3><p>Longitudinal and retrospective descriptive study of the patients who had Implanon® inserted in our centre between 2015 and 2016. The variables analysed were age, reasons for insertion and removal, time until removal, degree of patient satisfaction, and unwanted pregnancy during the period of use.</p></div><div><h3>Results</h3><p>In 97.3% of the cases, the reason for insertion was contraception, but there was one case of insertion to control heavy menstrual bleeding. The mean age of insertion was 27.2 years. The percentage continuing with the method after 3 years of follow-up was 43.6%. The most frequent reasons for requesting removal were frequent uterine bleeding (16.2%) and gestational desire (13.5%). Regarding satisfaction, overall 75.7% of the users were satisfied with the method. No pregnancy occurred in the users.</p></div><div><h3>Conclusions</h3><p>Implanon® is a highly effective contraceptive method, mainly used by patients around the third decade of life. The most frequent side effects observed relate to alterations in the menstrual bleeding pattern, and are among the most frequent reasons for requesting removal of the device.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49880166","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}

引用次数: 0

Inducción del parto en gestaciones gemelares: estudio comparativo de oxitocina vs dinoprostona 双胎引产:催产素与迪诺前列酮的比较研究

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-04-01 DOI: 10.1016/j.gine.2023.100847

E. Rodríguez González, A. Olalla Gómez, M.J. Cuerva González, J.L. Bartha Rasero, M. de la Calle Fernández-Miranda

{"title":"Inducción del parto en gestaciones gemelares: estudio comparativo de oxitocina vs dinoprostona","authors":"E. Rodríguez González, A. Olalla Gómez, M.J. Cuerva González, J.L. Bartha Rasero, M. de la Calle Fernández-Miranda","doi":"10.1016/j.gine.2023.100847","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100847","url":null,"abstract":"<div><h3>Introduction</h3><p>In the last few years the number of twin gestations that reach term has increased. Although vaginal delivery route has proven to be a safe alternative to caesarean section when first foetus is in cephalic presentation, available evidence on induction methods applied to this type of pregnancies is limited.</p></div><div><h3>Methods</h3><p>Retrospective observational study conducted in a tertiary hospital. Forty-four pregnant twins, with gestational age greater than 34weeks, and with the first twin in cephalic presentation, who underwent induction of labour, were included. Vaginal prostaglandins (dinoprostone) were used in 17 cases and intravenous oxytocin in 27 cases, indication was randomised according to daily clinical practice. Results of both groups were compared in terms of safety and efficacy.</p></div><div><h3>Results</h3><p>No significant differences were found in the rate of caesarean section due to induction failure between oxytocin and prostaglandins (42.9% vs. 57.1%; <em>P</em>    =.001) and pre-induction Bishop's index ≤6 (RR: 2.06) (<em>P</em>    <!-->30 are associated with higher probability of induction failure.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49895761","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}

引用次数: 0

Manejo quirúrgico del endometrioma en pacientes con deseo genésico 有生殖欲望的子宫内膜瘤患者的手术治疗

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Clinica e Investigacion en Ginecologia y Obstetricia Pub Date : 2023-04-01 DOI: 10.1016/j.gine.2023.100851

M. Pineda Mateo, M. Arnáez de la Cruz

引用次数: 0