Background.Trachelectomy is a conservative but locally radical procedure associated with a high risk of preterm delivery.Case.A 28-year-old patie nt with cervical can-cer FIGO stage IB1was treated with la paroscopic p...Background.Trachelectomy is a conservative but locally radical procedure associated with a high risk of preterm delivery.Case.A 28-year-old patie nt with cervical can-cer FIGO stage IB1was treated with la paroscopic pelvic lymphadenectomy followed by trachelectomy.Three years later,she conceived spontaneously.In consideration of thehigh risk of preterm delivery,the cervical status was eval-uated by transvaginal ultrasonogra phy.At 16weeksges-tation,we observed the cerclage sut ure correctly placed at the level of the internal cervical os and a "neo-cervical"segment length of 1.5cm.Thereafter,serial ultrasound measurements showed preservation o f the cervical compe-tence.The patient achieved an uneve ntful pregnancy and delivered by elective cesarean section at 37weeks.Con-clusion.Transvaginal scans to evaluate the competence of the"neo-cervix"may contribute to themanagement and counseling of patients after trachelectomy.展开更多
Objective: We studied the long-term outcome after an anal sphincter tear. Study design: From a cohort of 4569 women who gave birth in 1982 to 1983, we identified 445 (9.7% ) who sustained a sphincter tear and 445 cont...Objective: We studied the long-term outcome after an anal sphincter tear. Study design: From a cohort of 4569 women who gave birth in 1982 to 1983, we identified 445 (9.7% ) who sustained a sphincter tear and 445 controls. Eighteen years after the delivery, we mailed them a questionnaire and graded fecal incontinence with the Wexner score, a summary of incontinence to flatus, liquid, or solid stools; need to wear a pad; and lifestyle alterations. We predefined severe incontinence as a score above 4 of 20. Results: Five hundred forty of 890 women (61% ) returned the questionnaire. Severe fecal incontinence was reported by 34 of 259 women (13.1% ) after a sphincter tear and 22 of 281 controls (7.8% ) (risk ratio 1.7, 95% confidence interval 1.0 to 2.8). Only 6.4% of the reports of fecal incontinence were attributable to a sphincter tear. Conclusion: Fecal incontinence is frequently reported, even by women who have not sustained an anal sphincter tear. Only a small fraction of fecal incontinence can be attributed to sphincter tears.展开更多
文摘Background.Trachelectomy is a conservative but locally radical procedure associated with a high risk of preterm delivery.Case.A 28-year-old patie nt with cervical can-cer FIGO stage IB1was treated with la paroscopic pelvic lymphadenectomy followed by trachelectomy.Three years later,she conceived spontaneously.In consideration of thehigh risk of preterm delivery,the cervical status was eval-uated by transvaginal ultrasonogra phy.At 16weeksges-tation,we observed the cerclage sut ure correctly placed at the level of the internal cervical os and a "neo-cervical"segment length of 1.5cm.Thereafter,serial ultrasound measurements showed preservation o f the cervical compe-tence.The patient achieved an uneve ntful pregnancy and delivered by elective cesarean section at 37weeks.Con-clusion.Transvaginal scans to evaluate the competence of the"neo-cervix"may contribute to themanagement and counseling of patients after trachelectomy.
文摘Objective: We studied the long-term outcome after an anal sphincter tear. Study design: From a cohort of 4569 women who gave birth in 1982 to 1983, we identified 445 (9.7% ) who sustained a sphincter tear and 445 controls. Eighteen years after the delivery, we mailed them a questionnaire and graded fecal incontinence with the Wexner score, a summary of incontinence to flatus, liquid, or solid stools; need to wear a pad; and lifestyle alterations. We predefined severe incontinence as a score above 4 of 20. Results: Five hundred forty of 890 women (61% ) returned the questionnaire. Severe fecal incontinence was reported by 34 of 259 women (13.1% ) after a sphincter tear and 22 of 281 controls (7.8% ) (risk ratio 1.7, 95% confidence interval 1.0 to 2.8). Only 6.4% of the reports of fecal incontinence were attributable to a sphincter tear. Conclusion: Fecal incontinence is frequently reported, even by women who have not sustained an anal sphincter tear. Only a small fraction of fecal incontinence can be attributed to sphincter tears.
