Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, i...Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. Re, salts CSP constituted 1.05 % of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1 ： 1 221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging （MRI）. The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.展开更多
This is a case report with discussion of the maternal-fetal outcome of pregnant women with uncorrected transposition of the great arteries （TGA） associated with pulmonary arterial hypertension and a large ventricula...This is a case report with discussion of the maternal-fetal outcome of pregnant women with uncorrected transposition of the great arteries （TGA） associated with pulmonary arterial hypertension and a large ventricular septal defect. This case draws attention to the severity of the pathology and maternal symptoms prior to gestation, and how an adequate clinical management of both obstetrics and cardiology can provide a favorable outcome for mother and fetus.展开更多
Purpose： Seatbelt use during pregnancy is important to improve maternal and fetal survival after motor vehicle collisions. However, because the rear seatbelt of a motor vehicle tends to make contact with the neck, ev...Purpose： Seatbelt use during pregnancy is important to improve maternal and fetal survival after motor vehicle collisions. However, because the rear seatbelt of a motor vehicle tends to make contact with the neck, even if it is adequately used, some pregnant women sitting in the rear seat opt not to fasten the belt. The purpose of this study is to explore seatbelt-neck contact for pregnant women sitting in the rear seat of a motor vehicle. Methods： We carried out an anthropometric study. Japanese women who were _〉30 weeks pregnant （n = 12） sat in the left side of the rear seat of a typical mid-size passenger sedan and fastened the seatbelt. Seating posture was investigated by measuring the coordinates of the anthropometric data points of the pregnant women （head, shoulder, hip joint, and knee joint）. The belt path was analyzed by measuring the clearance between the belt and the sternum or navel. Results： Among the 12 pregnant women at 33.9 week _＋ 3.3 week gestation, the shoulder belt deviated to the right side and subsequently contacted to the neck in four pregnant women （Contact group）. The height of the Contact group was significantly shorter than that of Non-contact group （152.3 cm ~ 3.0 cm vs. 159.0 cm ＋ 3.3 cm, p = 0.008）. Regarding the relative position of the seatbelt to the subject＇s body, the distances from the top of the sternum to the center of the shoulder belt were significantly shorter in Contact group （3.9 cm ~ 3.5 cm） than that in the Non-contact group （8.0 cm ~ 1.6 cm, p = 0.03）. However, no significant difference was found for the distance from the umbilicus to the center of the lap belt. Conclusion： Our findings show that because of short height and late term of pregnancy with protrusion of the abdomen, the shoulder belt deviates to the right or left, avoiding the protruded uterus, and subsequently makes contact with the neck. Seatbelt systems for rear seats need to be developed to improve passenger safety, especially for pregnant women.展开更多
文摘Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. Re, salts CSP constituted 1.05 % of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1 ： 1 221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging （MRI）. The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.
文摘This is a case report with discussion of the maternal-fetal outcome of pregnant women with uncorrected transposition of the great arteries （TGA） associated with pulmonary arterial hypertension and a large ventricular septal defect. This case draws attention to the severity of the pathology and maternal symptoms prior to gestation, and how an adequate clinical management of both obstetrics and cardiology can provide a favorable outcome for mother and fetus.
文摘Purpose： Seatbelt use during pregnancy is important to improve maternal and fetal survival after motor vehicle collisions. However, because the rear seatbelt of a motor vehicle tends to make contact with the neck, even if it is adequately used, some pregnant women sitting in the rear seat opt not to fasten the belt. The purpose of this study is to explore seatbelt-neck contact for pregnant women sitting in the rear seat of a motor vehicle. Methods： We carried out an anthropometric study. Japanese women who were _〉30 weeks pregnant （n = 12） sat in the left side of the rear seat of a typical mid-size passenger sedan and fastened the seatbelt. Seating posture was investigated by measuring the coordinates of the anthropometric data points of the pregnant women （head, shoulder, hip joint, and knee joint）. The belt path was analyzed by measuring the clearance between the belt and the sternum or navel. Results： Among the 12 pregnant women at 33.9 week _＋ 3.3 week gestation, the shoulder belt deviated to the right side and subsequently contacted to the neck in four pregnant women （Contact group）. The height of the Contact group was significantly shorter than that of Non-contact group （152.3 cm ~ 3.0 cm vs. 159.0 cm ＋ 3.3 cm, p = 0.008）. Regarding the relative position of the seatbelt to the subject＇s body, the distances from the top of the sternum to the center of the shoulder belt were significantly shorter in Contact group （3.9 cm ~ 3.5 cm） than that in the Non-contact group （8.0 cm ~ 1.6 cm, p = 0.03）. However, no significant difference was found for the distance from the umbilicus to the center of the lap belt. Conclusion： Our findings show that because of short height and late term of pregnancy with protrusion of the abdomen, the shoulder belt deviates to the right or left, avoiding the protruded uterus, and subsequently makes contact with the neck. Seatbelt systems for rear seats need to be developed to improve passenger safety, especially for pregnant women.
