Atypical polypoid adenomyoma(APA)is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands.It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal...Atypical polypoid adenomyoma(APA)is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands.It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding.In our current case,a 76-year-old woman presented with irregular vaginal bleeding.The final pathological diagnosis of the mass was APA.APA is not easy to diagnose before surgery.On the one hand,there was no obvious particularity in imaging features and clinical features,especially for uncomfortably identifying endometrial cancer.On the other hand,APA has a pedicle,attaching to any part of the uterine cavity,which can cause pseudocoel between the mass with the uterine cavity wall.So,when it comes to getting the pathological tissue in the absence of hysteroscopy,it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass.Therefore,preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA.In the meantime,pathological tissue of APA can be obtained by hysteroscopy in visual conditions.展开更多
Objective: To evaluate the risk of preterm delivery with vaginal touch in opposition with transvaginal ultrasound in pregnant women who present signs and symptoms of threatened preterm labour. Methods: A prospective s...Objective: To evaluate the risk of preterm delivery with vaginal touch in opposition with transvaginal ultrasound in pregnant women who present signs and symptoms of threatened preterm labour. Methods: A prospective study was conducted with descriptive and comparative aims at the University Hospital of Porto-Novo, Benin Republic between 1 March and 31 August 2016. Every pregnant woman admitted to the emergencies of the maternity between 28 and 34 of WA (weeks of amenorrhoea) and attended for preterm delivery risk with intact membranes was included. The risk of preterm delivery was evaluated using vaginal touch and ultrasound examination of cervical length. Results: The risk of preterm delivery was obvious and identical with the cervical dilatation ≥2 cm when the vaginal touch was applied [RR 2.34 IC 95% (1.71 - 3.20)] and ultrasound examination of cervical length - 4.16)]. The cervix obliteration was not statistically linked to preterm delivery. The ultrasound examination of cervical length had a better sensitivity (87.76%) and a negative predictive value (81.54%) against 59.18% and 74.68% respectively for cervical dilatation at vaginal touch. Bishop score also had a better specificity with the one of the ultrasound examination of cervical length (79.11% vs. 33.54%) whereas both of them had almost identical negative predictive value (81.17% vs. 81.54%). Conclusion: Vaginal touch was also as relevant as transvaginal ultrasound while evaluating the risk of preterm delivery. For the lack of ultrasound in emergency rooms, a good physical examination would be sufficient by its own to decide of an adequate management when there is a threat of preterm delivery.展开更多
BACKGROUND Numerous variables are linked to the success of vaginal delivery,including the subpubic arch angle(SPAA)during labor,the importance of which has not yet been fully elucidated.AIM To examine the SPAA distrib...BACKGROUND Numerous variables are linked to the success of vaginal delivery,including the subpubic arch angle(SPAA)during labor,the importance of which has not yet been fully elucidated.AIM To examine the SPAA distributional characteristics and to ascertain SPAA’s ability to predict the type and duration of labor.METHODS We determined the SPAA and analyzed the corresponding data.We also evaluated the relationship between the SPAA and the mode of delivery and the duration of labor by regression.The present study comprised a total of 301 pregnant women who had given birth at Beijing Tiantan Hospital of the Capital Medical University between January and December of 2021.RESULTS Our analysis of 301 pregnant women revealed that the SPAA measured using three-dimensional trans-perineal ultrasound had a minimum angle of 81°and a maximum angle of 122.2°.The angle in the normal vaginal delivery group was greater than that in the labor cesarean group(P=0.000).The SPAA was a highly significant positive predictor of normal vaginal delivery(P=0.000)with an area under the curve of 0.782(P=0.000;95%CI:0.717-0.848).We found the length of the second stage of labor to be positively influenced by the SPAA using linear regression analysis(P=0.045).CONCLUSION The SPAA was a highly significant positive predictor of normal vaginal delivery.The length of the second stage of labor and normal vaginal birth were predicted by SPAA.展开更多
BACKGROUND: Sub-endometrial junction zone (JZ) plays an important role in most of reproductive functions. OBJECTIVE: To find out the effect of the sub-endometrial JZ thickness assessment by 3-D trans-vaginal ultrasoun...BACKGROUND: Sub-endometrial junction zone (JZ) plays an important role in most of reproductive functions. OBJECTIVE: To find out the effect of the sub-endometrial JZ thickness assessment by 3-D trans-vaginal ultrasound (TVUS) on intracytoplasmic sperm injection (ICSI) outcomes in patients with unexplained recurrent implantation failure (RIF). SETTING: ART Unit of Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Qena, Egypt. DURATION: From April 2016 to October 2018. STUDY DESIGN: A prospective observational study. METHDS: Fifty couples with history of unexplained RIF in previous ICSI cycles and prepared for another ICSI cycle (group I) and fifty couples with unexplained infertility prepared for ICSI for the first time (group II) had been included in this study. At time of ovum pick up, 3-DTVUS was done for all cases in both groups for assessment of sub endometrial junction zone thickness and correlated with ICSI outcome. RESULTS: There were statistically significant differences between group I and group II in JZ thickness in the 3 uterine regions (fundus, anterior and posterior walls) with p 0.001, but there were mildly statistically significant differences between both groups in chemical and clinical pregnancy rates with p < 0.01. CONCLUSIONS: The thickness of JZ in patients with history of unexplained RIF was higher than those with unexplained infertility scheduled for ICSI. The JZ thickness was inversely correlated with increased embryo implantation rates in ICSI procedures, the thinner the JZ thickness was associated with higher pregnancy rates (both chemical and clinical pregnancy rates).展开更多
Purpose: The study aimed to show differences in temporal recovery of pelvic floor function within 6 months postpartum between women having their first delivery at an advanced age and those having their first delivery ...Purpose: The study aimed to show differences in temporal recovery of pelvic floor function within 6 months postpartum between women having their first delivery at an advanced age and those having their first delivery at a younger age. Methods: Seventeen women (age: 35.5 ± 3.5, BMI: 21.1 ± 3.2) were studied at about 6 weeks, 3 months, and 6 months after vaginal delivery. Urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire-Short Form. Pelvic floor function was assessed by the anteroposterior diameter of the levator hiatus using transperineal ultrasound. Women who delivered for the first time at 35 years and/or older were defined as being of advanced maternal age. Results: Nine of 17 women (52.9%) were of advanced maternal age and 5 experienced postpartum stress urinary incontinence. Four of these 5 women (80.0%) were of advanced maternal age. The anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 3 and 6 months postpartum (p < 0.01). Among the continent women, the anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 6 months postpartum (p = 0.004). However, among the advanced maternal age women, all parameters of the anteroposterior diameter of the levator hiatus were not significantly different between the women with and without stress urinary continence. Conclusion: Recovery of pelvic floor function following delivery may be delayed in women of advanced maternal age at first delivery because of the damage to the pelvic floor during pregnancy and vaginal delivery, resulting in increase in the incidence of stress urinary incontinence.展开更多
Background: The unaesthetic appearance of the female intimate area (vulva, “mound of venus” and perianal region) is a triggering factor of negative psychological responses, embarrassment, anxiety and insecurity in m...Background: The unaesthetic appearance of the female intimate area (vulva, “mound of venus” and perianal region) is a triggering factor of negative psychological responses, embarrassment, anxiety and insecurity in many women. Using rejuvenating equipment for vaginal structure or for the intimate area as a whole is already widespread in the literature, and High-Intensity Focused Ultrasound (HIFU) has proven to be very effective in the clinical practice of many professionals. This study, therefore, aims to describe the fundamentals and applicability that guide the use of HIFU in vulvar rejuvenation. Materials and Methods: Exploratory research was carried out, presented in a narrative review, to highlight the action of HIFU in female intimate rejuvenation. The review explored scientific articles published and available in the following databases: MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed (National Library of Medicine), SCIELO (Scientific Electronic Library Online), and LILACS (Latin Literature American and the Caribbean in Health Sciences). In addition, some clinical findings obtained through a retrospective analysis of medical records were added to describe the authors’ clinical experience in the use of Focused Ultrasound (HIFU) for vulvar rejuvenation. Results: We verified that the tissues of female external genitalia respond very well to the stimuli of the focused sound waves of the HIFU, being able to produce immediate and lasting results through isolated applications or in association with intradermotherapy or other therapeutic resources. Conclusion: We conclude that using High Intensity Focused Ultrasound aimed at vulvar rejuvenation is safely indicated and assures excellent aesthetic results at the end of the treatment because similarly to other treatment techniques, the thermal stimuli of HIFU are also able to produce an excellent therapeutic response in the dermal tissue of the female intimate area, promoting intense neocollagenesis and generating great aesthetic improvement.展开更多
文摘Atypical polypoid adenomyoma(APA)is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands.It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding.In our current case,a 76-year-old woman presented with irregular vaginal bleeding.The final pathological diagnosis of the mass was APA.APA is not easy to diagnose before surgery.On the one hand,there was no obvious particularity in imaging features and clinical features,especially for uncomfortably identifying endometrial cancer.On the other hand,APA has a pedicle,attaching to any part of the uterine cavity,which can cause pseudocoel between the mass with the uterine cavity wall.So,when it comes to getting the pathological tissue in the absence of hysteroscopy,it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass.Therefore,preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA.In the meantime,pathological tissue of APA can be obtained by hysteroscopy in visual conditions.
文摘Objective: To evaluate the risk of preterm delivery with vaginal touch in opposition with transvaginal ultrasound in pregnant women who present signs and symptoms of threatened preterm labour. Methods: A prospective study was conducted with descriptive and comparative aims at the University Hospital of Porto-Novo, Benin Republic between 1 March and 31 August 2016. Every pregnant woman admitted to the emergencies of the maternity between 28 and 34 of WA (weeks of amenorrhoea) and attended for preterm delivery risk with intact membranes was included. The risk of preterm delivery was evaluated using vaginal touch and ultrasound examination of cervical length. Results: The risk of preterm delivery was obvious and identical with the cervical dilatation ≥2 cm when the vaginal touch was applied [RR 2.34 IC 95% (1.71 - 3.20)] and ultrasound examination of cervical length - 4.16)]. The cervix obliteration was not statistically linked to preterm delivery. The ultrasound examination of cervical length had a better sensitivity (87.76%) and a negative predictive value (81.54%) against 59.18% and 74.68% respectively for cervical dilatation at vaginal touch. Bishop score also had a better specificity with the one of the ultrasound examination of cervical length (79.11% vs. 33.54%) whereas both of them had almost identical negative predictive value (81.17% vs. 81.54%). Conclusion: Vaginal touch was also as relevant as transvaginal ultrasound while evaluating the risk of preterm delivery. For the lack of ultrasound in emergency rooms, a good physical examination would be sufficient by its own to decide of an adequate management when there is a threat of preterm delivery.
文摘BACKGROUND Numerous variables are linked to the success of vaginal delivery,including the subpubic arch angle(SPAA)during labor,the importance of which has not yet been fully elucidated.AIM To examine the SPAA distributional characteristics and to ascertain SPAA’s ability to predict the type and duration of labor.METHODS We determined the SPAA and analyzed the corresponding data.We also evaluated the relationship between the SPAA and the mode of delivery and the duration of labor by regression.The present study comprised a total of 301 pregnant women who had given birth at Beijing Tiantan Hospital of the Capital Medical University between January and December of 2021.RESULTS Our analysis of 301 pregnant women revealed that the SPAA measured using three-dimensional trans-perineal ultrasound had a minimum angle of 81°and a maximum angle of 122.2°.The angle in the normal vaginal delivery group was greater than that in the labor cesarean group(P=0.000).The SPAA was a highly significant positive predictor of normal vaginal delivery(P=0.000)with an area under the curve of 0.782(P=0.000;95%CI:0.717-0.848).We found the length of the second stage of labor to be positively influenced by the SPAA using linear regression analysis(P=0.045).CONCLUSION The SPAA was a highly significant positive predictor of normal vaginal delivery.The length of the second stage of labor and normal vaginal birth were predicted by SPAA.
文摘BACKGROUND: Sub-endometrial junction zone (JZ) plays an important role in most of reproductive functions. OBJECTIVE: To find out the effect of the sub-endometrial JZ thickness assessment by 3-D trans-vaginal ultrasound (TVUS) on intracytoplasmic sperm injection (ICSI) outcomes in patients with unexplained recurrent implantation failure (RIF). SETTING: ART Unit of Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Qena, Egypt. DURATION: From April 2016 to October 2018. STUDY DESIGN: A prospective observational study. METHDS: Fifty couples with history of unexplained RIF in previous ICSI cycles and prepared for another ICSI cycle (group I) and fifty couples with unexplained infertility prepared for ICSI for the first time (group II) had been included in this study. At time of ovum pick up, 3-DTVUS was done for all cases in both groups for assessment of sub endometrial junction zone thickness and correlated with ICSI outcome. RESULTS: There were statistically significant differences between group I and group II in JZ thickness in the 3 uterine regions (fundus, anterior and posterior walls) with p 0.001, but there were mildly statistically significant differences between both groups in chemical and clinical pregnancy rates with p < 0.01. CONCLUSIONS: The thickness of JZ in patients with history of unexplained RIF was higher than those with unexplained infertility scheduled for ICSI. The JZ thickness was inversely correlated with increased embryo implantation rates in ICSI procedures, the thinner the JZ thickness was associated with higher pregnancy rates (both chemical and clinical pregnancy rates).
文摘Purpose: The study aimed to show differences in temporal recovery of pelvic floor function within 6 months postpartum between women having their first delivery at an advanced age and those having their first delivery at a younger age. Methods: Seventeen women (age: 35.5 ± 3.5, BMI: 21.1 ± 3.2) were studied at about 6 weeks, 3 months, and 6 months after vaginal delivery. Urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire-Short Form. Pelvic floor function was assessed by the anteroposterior diameter of the levator hiatus using transperineal ultrasound. Women who delivered for the first time at 35 years and/or older were defined as being of advanced maternal age. Results: Nine of 17 women (52.9%) were of advanced maternal age and 5 experienced postpartum stress urinary incontinence. Four of these 5 women (80.0%) were of advanced maternal age. The anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 3 and 6 months postpartum (p < 0.01). Among the continent women, the anteroposterior diameter of the levator hiatus at rest was significantly greater in the advanced maternal age women than in the younger maternal age women at 6 months postpartum (p = 0.004). However, among the advanced maternal age women, all parameters of the anteroposterior diameter of the levator hiatus were not significantly different between the women with and without stress urinary continence. Conclusion: Recovery of pelvic floor function following delivery may be delayed in women of advanced maternal age at first delivery because of the damage to the pelvic floor during pregnancy and vaginal delivery, resulting in increase in the incidence of stress urinary incontinence.
文摘Background: The unaesthetic appearance of the female intimate area (vulva, “mound of venus” and perianal region) is a triggering factor of negative psychological responses, embarrassment, anxiety and insecurity in many women. Using rejuvenating equipment for vaginal structure or for the intimate area as a whole is already widespread in the literature, and High-Intensity Focused Ultrasound (HIFU) has proven to be very effective in the clinical practice of many professionals. This study, therefore, aims to describe the fundamentals and applicability that guide the use of HIFU in vulvar rejuvenation. Materials and Methods: Exploratory research was carried out, presented in a narrative review, to highlight the action of HIFU in female intimate rejuvenation. The review explored scientific articles published and available in the following databases: MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed (National Library of Medicine), SCIELO (Scientific Electronic Library Online), and LILACS (Latin Literature American and the Caribbean in Health Sciences). In addition, some clinical findings obtained through a retrospective analysis of medical records were added to describe the authors’ clinical experience in the use of Focused Ultrasound (HIFU) for vulvar rejuvenation. Results: We verified that the tissues of female external genitalia respond very well to the stimuli of the focused sound waves of the HIFU, being able to produce immediate and lasting results through isolated applications or in association with intradermotherapy or other therapeutic resources. Conclusion: We conclude that using High Intensity Focused Ultrasound aimed at vulvar rejuvenation is safely indicated and assures excellent aesthetic results at the end of the treatment because similarly to other treatment techniques, the thermal stimuli of HIFU are also able to produce an excellent therapeutic response in the dermal tissue of the female intimate area, promoting intense neocollagenesis and generating great aesthetic improvement.
