- A case report of Ggeneralized uterine arteriovenous malformation after molar pregnancy in an infertile woman. [Journal Article]
- IJInt J Reprod Biomed (Yazd) 2018; 16(2):119-122
- CONCLUSIONS: UAVM is one of the molar pregnancy complications. The first step for diagnosis of UAVM is transvaginal ultrasonography and color Doppler assessment. Embolization is the best treatment for women who intend to preserve fertility.
- The application of uterine wall local resection and reconstruction to preserve the uterus for the management of morbidly adherent placenta: Case series. [Journal Article]
- TJTaiwan J Obstet Gynecol 2018; 57(2):276-282
- CONCLUSIONS: Combined with prophylactic abdominal aorta balloon occlusion and tourniquet, uterine wall local resection and reconstruction is highly effective to reduce the intraoperative blood loss and hysterectomy in morbidly adherent placenta.
- Risk of synchronous endometrial disorders in women with endometrioid borderline tumors of the ovary. [Journal Article]
- JOJ Ovarian Res 2018 Apr 19; 11(1):30
- CONCLUSIONS: Synchronous endometrial disorders are common in women with EBOT, especially in those who are younger, nulliparous, and have experienced abnormal vaginal bleeding. Thus, endometrial sampling should be performed in women with EBOT undergoing conservative surgery, and a hysterectomy should be performed in cases requiring radical treatment.
- Coexistence of Cervical Leiomyosarcoma and Gastric-Type Adenocarcinoma In Situ with Extensive Extension to the Endometrium and Fallopian Tube. [Journal Article]
- CRCase Rep Pathol 2018; 2018:5848629
- Cervical leiomyosarcoma is known to be rare from the previous reviews of a large number of malignant cervical tumors. The patient was a 66-year-old woman with irregular vaginal bleeding. She underwen...
Cervical leiomyosarcoma is known to be rare from the previous reviews of a large number of malignant cervical tumors. The patient was a 66-year-old woman with irregular vaginal bleeding. She underwent modified radical hysterectomy and bilateral salpingooophorectomy. Histopathologically, we diagnosed the coexistence of uterine cervical leiomyosarcoma and cervical gastric-type adenocarcinoma in situ with endometrial lesions that had continuous and skip patterns and fallopian tubal lesions with a partial lesion. To the best of our knowledge, cases of synchronous leiomyosarcoma and cancers have not often been reported; only two cases of synchronous cervical leiomyosarcoma and cervical squamous cell carcinoma have been published. This case is the first presentation of coincidental primary cervical leiomyosarcoma and cervical gastric-type adenocarcinoma in situ. Additionally, we considered cervical gastric-type adenocarcinoma in situ with continuous lesions on the endometrium and skip lesions on the left fallopian tube.
- A 34-Week Size Uterus with a Complete Hydatidiform Mole: Hook Effect and Severe Anemia with No Vaginal Bleeding. [Journal Article]
- CRCase Rep Obstet Gynecol 2018; 2018:8201949
- Complete hydatidiform mole is an abnormal pregnancy that usually presents with vaginal bleeding and markedly elevated serum β-hCG levels. We report a rare case of complete hydatidiform mole occurring...
Complete hydatidiform mole is an abnormal pregnancy that usually presents with vaginal bleeding and markedly elevated serum β-hCG levels. We report a rare case of complete hydatidiform mole occurring in a 16-year-old nulligravid who presented with a 34-week size uterus and a relatively low serum β-hCG level (722 IU/L)-likely related to the "hook effect"-and severe anemia (hemoglobin: 6.1 g/dL) despite the absence of vaginal bleeding. She also reported right flank pain and was diagnosed with moderate right hydronephrosis owing to the compression exerted by the enlarged uterus on the right ureter. The patient received a total of 6 units of packed red blood cells and was managed by dilation and evacuation followed by serial monitoring of serum β-hCG levels. Therefore, complete mole can present with symptoms related to an enlarged uterus and severe anemia before the occurrence of vaginal bleeding. It is also important to note that a negative urine pregnancy test or relatively low serum β-hCG level should prompt repeating the measurement on diluted sample to prevent the "hook effect."
- Which Patients With Cervical Squamous Cell Carcinoma Might Benefit From Neoadjuvant Chemotherapy? [Journal Article]
- JCJ Clin Oncol 2018 Apr 18; :JCO2017773416
- The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management ch...
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 55-year-old postmenopausal woman, gravida 5 para 5, with past medical history significant for hypertension, presented to the emergency department with profuse vaginal bleeding and a hemoglobin level of 9 g/dL. The biopsy from an irregular 6-cm cervical mass was consistent with moderately differentiated cervical squamous cell carcinoma. The physical examination did not reveal vaginal or parametrial extension of the tumor. Pelvic magnetic resonance imaging disclosed the known carcinoma, as well as a 9.2 × 7.7 × 6.7 cm anterior uterine fibroid (Fig 1). A staging positron emission tomography scan was negative for metastatic disease. After blood transfusion and vaginal packing, the patient was referred to discuss the immediate management of her newly diagnosed bleeding bulky cervical cancer. In the absence of parametrial or vaginal extension and in the absence of lymph node metastasis (both on clinical examination and imaging), she was classified as having International Federation of Gynecology and Obstetrics stage IB2 disease.
- Labor Onset, Oxytocin Use, and Epidural Anesthesia for Vaginal Birth after Cesarean Section and Associated Effects on Maternal and Neonatal Outcomes in a Tertiary Hospital in China: A Retrospective Study. [Journal Article]
- CMChin Med J (Engl) 2018 Apr 20; 131(8):933-938
- CONCLUSIONS: The administration of oxytocin during labor and birth was identified as a protective factor for PPH in VBAC while birth mode was identified as a risk factor. Finally, the duration of total labor and the gestational week of delivery were identified as risk factors for fetal distress in cases of VBAC. This information might help obstetricians provide appropriate interventions during labor and birth for VBAC.
- Follicular Lymphoma mimicking Metastatic Nodes on the F-18 FDG PET/CT and MRI for Staging of Endometrial Cancer. [Journal Article]
- NMNucl Med Mol Imaging 2018; 52(2):159-161
- A 53-year-old woman was diagnosed with endometrial carcinoma by vaginal bleeding. F-18 fluorodeoxy glucose positron emission tomography PET/CT (F-18 FDG PET/CT) scan for staging showed intense focal ...
A 53-year-old woman was diagnosed with endometrial carcinoma by vaginal bleeding. F-18 fluorodeoxy glucose positron emission tomography PET/CT (F-18 FDG PET/CT) scan for staging showed intense focal FDG uptake in the endometrium suggesting endometrial malignancy. PET/CT showed multiple node uptakes in the pericaval region, paraaortic region, common iliac, and both internal iliac and external iliac regions suggesting multiple pelvic and retroperitoneal node metastases. MRI showed multiple metastatic lymphadenopathy in the retroperitoneum and pelvic cavity. Pathologic diagnosis performed with dissected pelvic and paraaortic nodes was confirmed as a follicular malignant lymphoma positive for B-cell lymphoma-2(Bcl-2) stain, not the metastatic node of primary endometrioid carcinoma.
- Clinical analysis of 50 patients with heterotopic pregnancy after ovulation induction or embryo transfer. [Journal Article]
- EJEur J Med Res 2018 Apr 16; 23(1):17
- CONCLUSIONS: Ovulation induction or embryo transfer increased the risk of HP greatly and clinician should raise high suspicious during the whole first trimester. Although the most ectopic site was ampullary, other sites such as cornual, cervical, abdominal especially interstitial or tubal stumps should also be assessed by ultrasound even in patients with bilateral salpingectomy or tubal obstructed. Repeated ultrasound tests 2 weeks after the diagnosis of intrauterine pregnancy with heart beating was very necessary to find the missed ones in suspicious patients. Compared with surgery, embryo suction with or without proper local drug injection would be more advisable for patients with cervical, cornual, or interstitial pregnancy in order to reserve the intrauterine pregnancy.
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- Thrombin Alters Human Endometrial Stromal Cell Differentiation During Decidualization. [Journal Article]
- RSReprod Sci 2018 Jan 01; :1933719118768705
- Vaginal bleeding and subchorionic hematomas are associated with increased risk of both early and late pregnancy loss. Thrombin generation may play a pivotal role in the development of these complicat...
Vaginal bleeding and subchorionic hematomas are associated with increased risk of both early and late pregnancy loss. Thrombin generation may play a pivotal role in the development of these complications. To determine the effects of thrombin on human endometrial stromal cells (hESCs), cells were treated with thrombin at baseline or during decidualization with cyclic adenosine monophosphate (cAMP)+medroxyprogesterone acetate (MPA). Next-generation RNA sequencing revealed that markers of decidualization (IGF-1, IGFBP-1, and prolactin [PRL]) were induced after the initiation of decidualization, whereas thrombin suppressed insulin-like growth factor ( IGF)-1, Insulin-like growth factor binding protein ( IGFBP)-1, and PRL gene expression at baseline and during decidualization. These effects were mediated through protease activated receptor (PAR)-1- and PAR-1-independent pathways. Thrombin decreased the secretion of a key marker of decidualization (PRL), altered the morphological transformation of decidualizing hESCs, and activated genes involved in matrix degradation and proinflammatory chemokines ( Interleukin-8 and Interleukin-6). Genes encoding factors important for matrix stability ( Col1α1, LOX) were suppressed. We suggest that intrauterine bleeding and generation of thrombin accentuates leukocyte extravasation and endometrial inflammation, impairs decidualization, and endometrial support of early pregnancy.