Objective.- To evaluate the results of laparoscopic surgery in the management of ovarian cysts in pregnant patients. Patients and methods.-Retrospective study including 26 pregnant patients who underwent the laparosco...Objective.- To evaluate the results of laparoscopic surgery in the management of ovarian cysts in pregnant patients. Patients and methods.-Retrospective study including 26 pregnant patients who underwent the laparoscopic management of ovarian cysts. The indications for surgery were persistent adnexal mass, abnormal ovarian cysts revealed by ultrasound examination, suspicion of cyst complications. The technique used, the immediate postoperative results and obstetrical outcomes were studied. Results.-Twelve patients were operated during the first trimester of pregnancy,13 in the second, and one in the third trimester. A 12 mmHg CO2 pneumoperitoneum was created, using a Veress needle in 22 cases, and an open technique in 4 cases. Trocar sites were decided according to the uterine size and to the cyst situation. A cystectomy was performed in 11 cases, an adnexectomy in 7 cases, an oophorectomy in one case, a cyst aspiration with a biopsy of the cyst wall in 6 cases and an ovarian torsion removal in one case. A conversion to laparotomy was necessary in 3 cases. There were no immediate postoperative complications and obstetrical outcomes were good in all cases. Discussion and conclusion.-In pregnant patients, laparoscopic management of adnexal masses appears to be safe for both mother and child.展开更多
Objective. To determine the prevalence of fecal incontinence after childbirth and to identify the risk factors. Methods. This was a prospective observational study with a consecutive inclusion of 525 women who deliver...Objective. To determine the prevalence of fecal incontinence after childbirth and to identify the risk factors. Methods. This was a prospective observational study with a consecutive inclusion of 525 women who delivered over a three months period. Women were questioned about their fecal continence four days and six weeks after delivery. Results. The incidence of fecal incontinence four days and six weeks after childbirth was respectively 8.8% and 3.3% . The risk factors for fecal incontinence at 4 days after childbirth were instrumental delivery by forceps (adjusted odds ratio 8.64, 95% confidence interval 3.55- 21.0, p < 0.001) and unassisted delivery at home (adjusted OR 8.06, 95% CI 1.30- 50.0, p=0.025). Independent risk factors for the presence of fecal incontinence 6 weeks later were: instrumental forceps delivery (adjusted OR 10.8, 95% CI 2.82- 41.3, p=0.001), unassisted delivery at home (adjusted OR 50.0, 95% CI 3.09- 802, p=0.006), bi parietal diameter of the newborn >93mm (adjusted OR 4.56, 95% CI 1.46- 14.1, p=0.009) and maternal age >30 years (adjusted OR 4.60, 95% CI 1.11- 19.1, p=0.036). Conclusion. Fecal incontinence is common after childbirth and its prevalence is predominantly associated with instrumental delivery, unassisted delivery at home, bi parietal diameter of the newborn and maternal age.展开更多
文摘Objective.- To evaluate the results of laparoscopic surgery in the management of ovarian cysts in pregnant patients. Patients and methods.-Retrospective study including 26 pregnant patients who underwent the laparoscopic management of ovarian cysts. The indications for surgery were persistent adnexal mass, abnormal ovarian cysts revealed by ultrasound examination, suspicion of cyst complications. The technique used, the immediate postoperative results and obstetrical outcomes were studied. Results.-Twelve patients were operated during the first trimester of pregnancy,13 in the second, and one in the third trimester. A 12 mmHg CO2 pneumoperitoneum was created, using a Veress needle in 22 cases, and an open technique in 4 cases. Trocar sites were decided according to the uterine size and to the cyst situation. A cystectomy was performed in 11 cases, an adnexectomy in 7 cases, an oophorectomy in one case, a cyst aspiration with a biopsy of the cyst wall in 6 cases and an ovarian torsion removal in one case. A conversion to laparotomy was necessary in 3 cases. There were no immediate postoperative complications and obstetrical outcomes were good in all cases. Discussion and conclusion.-In pregnant patients, laparoscopic management of adnexal masses appears to be safe for both mother and child.
文摘Objective. To determine the prevalence of fecal incontinence after childbirth and to identify the risk factors. Methods. This was a prospective observational study with a consecutive inclusion of 525 women who delivered over a three months period. Women were questioned about their fecal continence four days and six weeks after delivery. Results. The incidence of fecal incontinence four days and six weeks after childbirth was respectively 8.8% and 3.3% . The risk factors for fecal incontinence at 4 days after childbirth were instrumental delivery by forceps (adjusted odds ratio 8.64, 95% confidence interval 3.55- 21.0, p < 0.001) and unassisted delivery at home (adjusted OR 8.06, 95% CI 1.30- 50.0, p=0.025). Independent risk factors for the presence of fecal incontinence 6 weeks later were: instrumental forceps delivery (adjusted OR 10.8, 95% CI 2.82- 41.3, p=0.001), unassisted delivery at home (adjusted OR 50.0, 95% CI 3.09- 802, p=0.006), bi parietal diameter of the newborn >93mm (adjusted OR 4.56, 95% CI 1.46- 14.1, p=0.009) and maternal age >30 years (adjusted OR 4.60, 95% CI 1.11- 19.1, p=0.036). Conclusion. Fecal incontinence is common after childbirth and its prevalence is predominantly associated with instrumental delivery, unassisted delivery at home, bi parietal diameter of the newborn and maternal age.
