Retained placenta is a known cause of post-partum haemorrhage and maternal mortality. A recent systemic review has confirmed that the incidence of retained placenta had increased all over the world, which is more comm...Retained placenta is a known cause of post-partum haemorrhage and maternal mortality. A recent systemic review has confirmed that the incidence of retained placenta had increased all over the world, which is more common in developed countries. Failure of retroplacental myometrium contraction is the main cause of retained placenta. Maternal age greater than 35 years, grandmultipara, preterm labor, history of previous retained placenta, and caesarean section were the risk factors for retained placenta. Manual removal of the placenta has been the treatment of choice. Attempts had been made by clinician and researchers to find a safe, effective and reliable method to avoid the need for surgical intervention. The efficacy and safety of prostaglandin, nitroglycerin or acupuncture in the management of retained placenta are yet to be further evaluated. Nonetheless, till date only intraumbilical vein oxytocin has been studied extensively but with varied success. More randomized clinical trials are needed to address this issue. However, if immediate manual placenta removal service is unavailable, a trial of intra-umbilical vein oxytocin 100 IU at a totalvolume of at least 40 m L while preparing for transfer to a tertiary center or theatre may result in spontaneous expulsion of the placenta.展开更多
Background:Ovarian torsion is commonly seen in young girls.Unfortunately it is often misdiagnosed because of its non-specific symptoms and lack of diagnostic modalities.This article focuses on the diagnostic challenge...Background:Ovarian torsion is commonly seen in young girls.Unfortunately it is often misdiagnosed because of its non-specific symptoms and lack of diagnostic modalities.This article focuses on the diagnostic challenge and also the changes in the management of ovarian torsion.Data sources:We reviewed original reports on the management of ovarian torsion in young girls published from 1984 till 2014.A literature search was conducted by electronic scanning of five electronic database:MEDLINE,EMBASE,SCI,SSCI and CINAHL.In addition,relevant papers and review articles were hand-searched.The search was limited to English language and human studies.The search was conducted by combining the textwords"ovarian torsion","adnexal torsion","adolescents"and"oophoropexy".Results:There are no specific symptoms that can be identified as a pathognomonic feature of ovarian torsion.Ultrasound is a useful diagnostic tool,but it is not always reliable in absence of an enlarged ovary.Laparoscopic detorsion is recognized as the mainstay of treatment regardless the condition of the ovaries.Reports have shown favorable ovarian function after detorsion.The role of oopheropexy remains controversial.Conclusions:Clinicians should be aware of ovarian torsion in girls presenting with abdominal pain.A timely management in this young population can help preserve their ovaries and fertility.展开更多
文摘Retained placenta is a known cause of post-partum haemorrhage and maternal mortality. A recent systemic review has confirmed that the incidence of retained placenta had increased all over the world, which is more common in developed countries. Failure of retroplacental myometrium contraction is the main cause of retained placenta. Maternal age greater than 35 years, grandmultipara, preterm labor, history of previous retained placenta, and caesarean section were the risk factors for retained placenta. Manual removal of the placenta has been the treatment of choice. Attempts had been made by clinician and researchers to find a safe, effective and reliable method to avoid the need for surgical intervention. The efficacy and safety of prostaglandin, nitroglycerin or acupuncture in the management of retained placenta are yet to be further evaluated. Nonetheless, till date only intraumbilical vein oxytocin has been studied extensively but with varied success. More randomized clinical trials are needed to address this issue. However, if immediate manual placenta removal service is unavailable, a trial of intra-umbilical vein oxytocin 100 IU at a totalvolume of at least 40 m L while preparing for transfer to a tertiary center or theatre may result in spontaneous expulsion of the placenta.
文摘Background:Ovarian torsion is commonly seen in young girls.Unfortunately it is often misdiagnosed because of its non-specific symptoms and lack of diagnostic modalities.This article focuses on the diagnostic challenge and also the changes in the management of ovarian torsion.Data sources:We reviewed original reports on the management of ovarian torsion in young girls published from 1984 till 2014.A literature search was conducted by electronic scanning of five electronic database:MEDLINE,EMBASE,SCI,SSCI and CINAHL.In addition,relevant papers and review articles were hand-searched.The search was limited to English language and human studies.The search was conducted by combining the textwords"ovarian torsion","adnexal torsion","adolescents"and"oophoropexy".Results:There are no specific symptoms that can be identified as a pathognomonic feature of ovarian torsion.Ultrasound is a useful diagnostic tool,but it is not always reliable in absence of an enlarged ovary.Laparoscopic detorsion is recognized as the mainstay of treatment regardless the condition of the ovaries.Reports have shown favorable ovarian function after detorsion.The role of oopheropexy remains controversial.Conclusions:Clinicians should be aware of ovarian torsion in girls presenting with abdominal pain.A timely management in this young population can help preserve their ovaries and fertility.
