Clinical obstetrics, gynecology and reproductive medicine最新文献

{"title":"Metastatic colorectal carcinoma to one ovary with vanishing primary: A case report in an 18-year- old patient","authors":"J. Mehawej, N. Helou, T. Pejovic, P. Mhawech-Fauceglia","doi":"10.15761/cogrm.1000286","DOIUrl":"https://doi.org/10.15761/cogrm.1000286","url":null,"abstract":"An 18-year-old young woman with chief complaint of left rib pain and increasing girth. An abdominal CT-scan showed a 34 x 26 cm complex right pelvic mass. Due to the young patient’s age, a fertility preservation surgery was recommended, and unilateral salpingo-oophorectomy was planned but then proceeded to tumor staging. Microscopically, the mass was composed of back to back glands, lined by hyperchromatic nuclei and prominent nucleoli, with ample mucin cytoplasm. Immunohistochemistry showed tumor positive for pan cytokeratin (AE1/3), CK20, CDX2 and negative for CK7, CD30, calretinin, glypican, PAX8, ER/PR, α fetoprotein (AFP), α -inhibin, Placental phosphatase protein (PLAP), OCT4, EMA and p53. There was no loss of mismatch repair proteins in tumor cells. The final diagnosis was metastatic adenocarcinoma from colorectal primary. Subsequently, the search for the primary carcinoma returned negative. The patient just finished 5 cycles of adjuvant FOLFOX therapy (5-fluorouracil and Oxaliplatin) with no side effects.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90030523","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}

{"title":"Is focused ultrasound surgery (FUS) a new way to treat persistent high-risk HPV infection and CINI","authors":"Chengzhi Li, F. Wong","doi":"10.15761/COGRM.1000315","DOIUrl":"https://doi.org/10.15761/COGRM.1000315","url":null,"abstract":"This paper presents the use of non-invasive focused ultrasound surgery (FUS) for persistent high-risk human papillomavirus (HR-HPV) infection and cervical intraepithelial neoplasia (CIN1). Although diagnostic uses of ultrasound are well known, its potential to treat persistent HR-HPV infection and CINI noninvasively is a relatively new area of clinical research interest. Focused ultrasound surgery (FUS) could be a future alternative treatment for HPV and CINI to other current invasive surgical techniques. We aim here to provide an updated review related to the role of FUS in treating persistent HR-HPV infection and CINI, and to outline the progress of research done on this topic. Also included is a review of the safety and effectiveness of FUS in clinical trials.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74615599","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}

{"title":"Poor response in ART is associated with pregnancy complications","authors":"Sivan Farladansky-Gershnabel, Maya Sharon Weiner, Y. Furman, I. Heusler, Gal Cohen, Anat Klement-Hershko, A. Wiser, A. Berkovitz, A. Shulman","doi":"10.15761/COGRM.1000297","DOIUrl":"https://doi.org/10.15761/COGRM.1000297","url":null,"abstract":"Introduction : It is generally accepted that obstetric and perinatal complications such as gestational diabetes, preeclampsia and IUGR are more common in older women. The results of studies that investigated this issue were inconclusive. The term \"poor responder\" refers to patients with diminished ovarian reserve, usually older women. Our study aimed to study whether there is an association between poor ovarian response in artificial reproductive technology and pregnancy complications. Material and methods: Retrospective, case-control study , at a tertiary, university-affiliated IVF centre, from 2011 to 2017. Patients who conceived and delivered after ART treatment were analysed. 75 poor responders (≤3 oocytes retrieved) after stimulation with gonadotropins (study group) were matched by day of ovum pick-up (OPU) to 75 normo-responders (≥4 oocytes retrieved). Main outcome measures were incidence of preeclampsia, gestational diabetes mellitus (GDM) and neonatal birth weight. Results: There were no significant differences in maternal age, gravidity, parity, BMI, gestational age at delivery, mode of delivery and Apgar score between groups. Poor responders had higher incidence of GDM (27% compared to 6.8%, P=0.001) and of intrauterine growth restriction (IUGR) (13.5% compared to 4.1%, P=0.04) than did normo-responders. Although poor responder patients experienced higher incidence of preeclampsia (8.1% compared to 5.4%), this did not achieve statistically significance (P=0.74). Poor responders with GDM were of similar age (34.6 ± 5.6 vs. 34.4 ± 5.1, P=0.8) and BMI (27.8 ± 6 vs. 24.8 ± 5.4, P=0.06) as poor responders without GDM. However, normo-responders with GDM were older (34.6 ± 3.7 vs. 32.4 ± 5.8, P=0.01) and had higher BMI (29.5 ± 0.6 vs. 22.9 ± 4.7, P=0.008) than normo-responders without GDM. Conclusions: Poor responders had higher incidence of GDM and IUGR compared to women with normal ovarian response. Poor response in ART is an independent risk factor for GDM and IUGR. This finding may have wider implications on the mother and the fetus, and appropriate counselling should be considered.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76603372","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}

{"title":"A rare malignant tumor of corpus uterine: peripheral nerve sheath tumor (MPNST): Review and our experience","authors":"Tsikouras Panagiotis, M. Kouroupi, S. Zervoudis, G. Iatrakis, X. Athoulaki, A. Bothou, A. Chalkidou, S. Michalopoulos, M. Koutsogiannis, Pelagia Chloropoulou, A. Lazarou, Panagiotis Petsidis, Arsou Chalil Bouratzan, Ioannis Tsirkas, F. Gaitatzi, Natalia Sachnova, A. Giatromanolaki, N. Nikolettos","doi":"10.15761/COGRM.1000303","DOIUrl":"https://doi.org/10.15761/COGRM.1000303","url":null,"abstract":"Soft tissue and visceral sarcomas are rare tumors which often develop in muscles, joints, nerves, fat, skin, or vessels. In a significant proportion, they appear in the abdomen and in the female reproductive system. Considering that early-stage sarcomas do not give symptoms, there are often late diagnosed in a quite advanced and/or metastatic stage. Malignant peripheral nerve sheath tumors (MPNSTs) are an uncommon type of malignant soft tissue sarcomas. In this report, we refer to a rare case of histologically confirmed MPNST arisen from corpus uterus in a 74 years old woman. The above-mentioned patient was admitted with abdominal pain and severe vaginal bleeding. Firstly, she underwent emergency endometrial ablation and removal of the tumor that was protruding from the endometrial cavity. Immediately after receiving histological diagnosis, abdominal hysterectomy was performed with bilateral oophorectomy. Considering that the available published literature has only a few reports of MPNST mainly arising from the uterine cervix, with no established treatment, our contribution could help the scientific community in adding data to MPNSTs arising from the uterine body.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72923046","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}

{"title":"Why are influenza vaccination rates low and Tdap vaccination rates average in a large military treatment facility? Survey results from providers and patients","authors":"Heather Jinks, Megan E Pagan, Leighann Black, A. Adams, T. Plowden, E. Magann, K. Wilson","doi":"10.15761/COGRM.1000322","DOIUrl":"https://doi.org/10.15761/COGRM.1000322","url":null,"abstract":"Objective: The study objective was to determine why vaccination rates in a Military Treatment Facility, where patients have ready access to care at no cost, differ from the general population. Methods: Influenza and Tdap vaccination rates for pregnant women were analyzed at Womack Army Medical Center from October 1, 2015 to September 30, 2018. Provider and patient surveys were conducted to evaluate barriers. All analyses were descriptive and conducted using SAS 9.4 (SAS Institute, Cary NC) or SPSS 25 (IBM Corp, Armock NY). Results: 9,448 pregnancies were included. The influenza vaccination rate was 36.7% and 56.4% for Tdap. Providers reported offering vaccinations at >90% of visits, whereas only 60% of patients reported being offered vaccination. 73.4% and 64.4% of patients declining vaccination reported the risks and benefits were not discussed for influenza and Tdap, respectively. Patients reported “provider recommendation” was the most important factor when choosing to receive vaccinations. Conclusion: Our influenza vaccination rate was lower and Tdap rate was average compared to the general population. The surveys suggest that provider and patient communication is a significant barrier to vaccination during pregnancy. Providers lending strong support to vaccinations during pregnancy and taking time to address concerns may be key to improving vaccination rates. *Correspondence to: Megan Pagan, MD, University of Arkansas for Medical Sciences, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, 4301 W. Markham Street, Little Rock, AR 72202, USA, E-mail: mpagan@uams.edu","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85604916","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}

{"title":"COVID-19, an infertility risk?","authors":"Ai Tsuji, Yuka Ikeda, Mutsumi Murakami, S. Matsuda","doi":"10.15761/COGRM.1000291","DOIUrl":"https://doi.org/10.15761/COGRM.1000291","url":null,"abstract":"","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86272884","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}

{"title":"Long-distance aeromedical repatriation of women at risk for preterm labor and delivery","authors":"A. Veldman, R. Hodges, M. Diefenbach, C. Rohrbeck, Ruby Pannu, Sophie Schmitt-Kästner, D. Fischer","doi":"10.15761/COGRM.1000294","DOIUrl":"https://doi.org/10.15761/COGRM.1000294","url":null,"abstract":"Pregnant women, like everyone else, travel internationally for business and pleasure. However, since preterm labor is experienced in 8-30% of all pregnancies, a significant number of women are admitted to hospitals with signs and symptoms of threatening preterm delivery while traveling abroad. Repatriation requests represent a difficult scenario for insurance and assistance companies as well as for physicians in referring and admitting hospitals. Here, we present a comprehensive literature review and an analysis of possibilities and limitations when transporting pregnant women on international, long-distance fixed-wing Air Ambulance. While no Air Ambulance environment can provide the necessary safety for mother and baby during a delivery in-flight, available data suggests that in-flight deliveries can be successfully avoided. In this review, we propose a risk based approach, taking factors such as locally available perinatal services, transport distance and routing, presence or absence of chorioamnionitis and contractions, cervical length and cervical dilatation as well as molecular markers (fFN, PAMG-1, phIGFBP-1), if locally available, into account. wing Abbreviations: CAMTS: Commission on Accreditation of Medical Transport Systems, COXII: Cyclooxygenase-2, EURAMI: European Aeromedical Institute, fFN: fetal Fibronectin, GA: Gestational Age, HFO: High Frequency Oscillation, ICU: Intensive Care Unit, iNO: inhaled Nitric Monoxide, PAMG-1: Placental alpha-microglobulin-1, phIGFBP-1: Cervical phosphorylated insuline-like growth factor binding protein-1, PROM: Premature Rupture of Membranes, RCT: Randomized Controlled Trial, RFDS: Royal Flying Doctor Service, ROM: Rupture of Membranes.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75347993","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}

{"title":"Secondary Prevention of Intrauterine Adhesions Following Hysteroscopic Surgery in Women With Asherman Syndrome: Is Something Better Than Nothing?","authors":"A. S. Kelley, E. Giuliani, S. Schon","doi":"10.1097/GRF.0000000000000510","DOIUrl":"https://doi.org/10.1097/GRF.0000000000000510","url":null,"abstract":"Asherman syndrome is a reproductive disorder characterized by intrauterine adhesions and amenorrhea, infertility, abnormal placentation, or pregnancy loss. Treatment of Asherman syndrome involves hysteroscopic lysis of adhesions. Many surgeons utilize postoperative measures such as hormone therapy, solid mechanical devices, or barrier gels to prevent recurrent adhesions in this setting. However, there is limited high-quality evidence to support their use. Additional research is needed on the safety and efficacy of these commonly used methods to guide patient care.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83769607","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}

{"title":"Can Testicular Size Be a Predictive Factor for Successful Sperm Retrieval in Patients with Non Obstructive Azoospermia?","authors":"O. Yumuşak, M. Cinar, S. Kahyaoglu, Y. Taşçı, G. Buyuk, A. Oksuzoglu","doi":"10.21613/GORM.2018.890","DOIUrl":"https://doi.org/10.21613/GORM.2018.890","url":null,"abstract":"Objective: Non-obstructive azoospermia, defined as absence of spermatozoa in the ejaculate caused by impaired spermatogenesis, is the most severe cause of male infertility. It is typically presented as high serum follicle stimulating hormone levels and atrophic testis. The combination of intracytoplasmic sperm injection and Microdissection testicular sperm extraction allows these infertile men the opportunity to have their own children from their own testis. Our aim was to evaluate the outcomes of micro-Testicular sperm extraction in men with atrophic testis.Study Design: The medical records of 80 non-obstructive men with azoospermia who underwent micro-TESE were retrospectively evaluated. We assessed clinical parameters; age, duration of infertility, smoking, chromosomal karyotype, Y chromosome microdeletion, follicle stimulating hormone, luteinizing hormone, total testosterone and testicular volume in relation with Microdissection testicular sperm extraction results.Results: Testicular sperm retrieval rate was 53% in 80 patients. Testicular volume, serum follicle stimulating hormone and total testosterone concentrations showed correlation with the results of sperm retrieval. These three parameters were found to be significant risk factors with testicular sperm extraction negative patients (p<0.001). The odds ratios (95% CI) were 6.39 (1.25–26.58), 1.24 (1.11-1.36), 1.13 (0.99-1.21) respectively. Testicular volume was found to be a discriminative parameter in patients with negative sperm retrieval. The cut-off point was established as 6.75 ml for testicular volume with 88.1% sensitivity, 62.1% specificity.Conclusion: Microdissection testicular sperm extraction is the most effective procedure for patients with non-obstructive azoospermia. Testicular volume, serum follicle stimulating hormone and testosterone levels can be predictive factors for sperm retrieval in men with non-obstructive azoospermia.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87712077","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}

{"title":"Urinary Incontinence: Evaluation and Management.","authors":"S. Handler, A. Rosenman","doi":"10.1097/GRF.0000000000000488","DOIUrl":"https://doi.org/10.1097/GRF.0000000000000488","url":null,"abstract":"Urinary incontinence is a major public health issue in the United States with physical, mental, social, and economic repercussions. History and in-office evaluation are paramount to diagnosis and formation of an appropriate treatment plan. Lifestyle modifications, which include pelvic floor muscle training and behavioral changes, are appropriate for initial management. Patients with overactive bladder syndrome whose symptoms are not adequately controlled with conservative treatment can be offered medical or procedural management. Stress urinary incontinence refractory to first-line treatment can be treated with surgical options such as mesh midurethral slings.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73967230","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}