The cervical function and pregnancy outcomes after hysteroscopic resection of the complete uterine septum,duplicate cervix and vaginal septum

Objective:To evaluate cervical function and pregnancy outcomes after hysteroscopic resection of the complete uterine septum,duplicate cervix and vaginal septum with Metzenbaum scissors.Methods:Between January 2010 and December 2016,13 patients admitted to the Department of Obstetrics and Gynecology of Sir Run Run Shaw Hospital with complete uterine septum,duplicate cervix and vaginal septum,were enrolled into this study.The cervical and corporal septum was cut by Metzenbaum scissors,and residual septum was cut by micro scissors under hysteroscopy.The vaginal septum was cut with the unipolar electric knife.Results:The operation time was about 10±1.31 min.All the 13 patients present normal uterine cavities without scar formation under hysteroscopy at 3 months after operation,there was mild adhesions between anterior and posterior intrauterine wall on 2 cases.After operation,there were 13 pregnancies naturally conceived in 11 patients,10 deliveries.The live birth rate was 76.92%,the early miscarriage rate was 23.08%.The cesarean section ratewas 30%,the vaginal delivery ratewas 70%,and all were term births.Conclusion:The operation was simple,convenient,and fast,without any complications and cervical insufficiency.It was easy to have vaginal deliveries.

“颈五针”穴位埋线治疗椎动脉型颈椎病疗效及对血流动力学的影响:随机临床试验

Objective:To observe the effect of catgut-embedding therapy at five neck points in the treatment of cervical spondylotic arteriopathy(CSA)and analyze its effects on the hemodynamics of patients with CSA.Methods:Using the computer randomization method,72 patients with CSA were divided into a catgutembedding therapy group(n=36,none dropped out)and a western medication group(n=36,none dropped out).In the catgut-embedding therapy group,the therapy was applied to five neck points,i.e.bilateral Jǐngjiājǐ(颈夹脊)at C5,bilateral Jǐngjiājǐ(颈夹脊)at C6,and Dàzhuī(大椎GV14)once a week.One3-week treatment session was required.In the western medication group,flunarizine hydrochloride 5 mg capsules were administered orally once daily for 3 weeks.Efficacy was assessed before and after 3 weeks treatment using a functional evaluation scale for cervical spondylotic arteriopathy(FS-CSA).Changes in vertebral-basilar arterial hemodynamics,serum nitric oxide(NO)level,and plasma endothelin(ET)level were detected.Results:Efficacy was assessed when the treatment session was completed.The total efficacy rate was significantly higher in the catgut-embedding therapy group(86.1%)than in the western medication group(61.1%;P<0.01).The after treatment FS-CSA score was reduced compared with baseline score in both groups(P<0.05),and the reduction in the catgut-embedding therapy group was superior to that in the Western medication group(P<0.05).Compared with baseline,the flow velocity and pulsatility index of the bilateral vertebral and basilar arteries increased at each period in both groups(P<0.05)except for the left systolic velocity of the vertebral artery after treatment.The increase in the catgut-embedding therapy group was greater than that in the western medication group(P<0.05).After treatment,the serum NO concentration was increased and the plasma ET concentration was reduced compared to baseline in both groups(P<0.05),while the improvements in the catgut-embedding therapy group were superior to those in the western medication group(P<0.05).Conclusion:The clinical efficacy in the catgut-embedding therapy group was superior to that in the western medication group.Catgut-embedding therapy at five neck points may effectively improve psychological and functional conditions,promote vertebral basilar arterial supply,and relieve clinical symptoms in patients with CSA.