Follistatin during pregnancy and its potential role as an ovarian suppressing agent Ovarian quiescence is a common condition during pregnancy. In vitro, follistatin, an antagonist of follicle-stimulating hormone, blocks follicular development at early stages, and its serum levels increase during pregnancy. A possible surrogate biomarker of ovarian arrest during pregnancy is a decrease in anti-mullerian hormone (AMH) levels followed by an increase in these levels on the second day after labor. The purpose of this study was to determine whether follistatin could act as an ovarian-suppressing agent during pregnancy.
Rotational forceps versus manual rotation and direct forceps: A retrospective cohort study Rotational forceps and manual rotation followed by direct forceps are techniques used in the management of malposition of the fetal head in the second stage of labor. However, there is widespread debate regarding their relative safety and utility.We aimed to compare the effectiveness and safety of rotational forceps with manual rotation followed by direct forceps, for management of fetal malposition at full dilation.
Incidence of urinary tract injury and utility of routine cystoscopy during total laparoscopic hysterectomy for endometrial cancer Current literature reports indicate an incidence of 0.7–4.0% for urinary tract injuries during minimally-invasive hysterectomy [1–5]. However, there is limited information for urinary tract injuries for patients undergoing these procedures for cancer diagnoses. Given a paradigm shift towards minimally-invasive hysterectomy for endometrial cancer due to its benefits in decreased surgical morbidity, examining the utility of routine cystoscopy during total laparoscopic hysterectomy (TLH) is of utmost importance in the management of women with endometrial cancer.
The Impact of Anal Sphincter Injury on Perceived Body Image Obstetric anal sphincter injury is common but the effect on body image is unreported. The aim of this study was to explore patient perceived changes in body image and other psychological aspects in women attending a perineal follow-up clinic.
Value of the 68Ga-DOTATATE PET-CT in the diagnosis of endometriosis. A pilot study The non-invasive diagnosis of endometriosis remains challenging. Recent data suggested that somatostatin might be involved in its pathogenesis. High sensitive visualization of somatostatin receptors expression is possible using PET-CT imaging after the administration of a 68Ga-labeled somatostatin analog (DOTATATE) that will bind to the somatostatin receptor sub-types 2 and 5. The aim of the present study was to assess the usefulness of 68Ga-DOTATATE PET-CT in the diagnosis of endometriosis.
Spontaneous uterine artery rupture during pregnancy: About two cases A thirty-year-old woman, expecting a spontaneous bichorial biamniotic at twenty-seven week of gestation was admitted in the gynecologic emergency department for an hypovolemic shock following a loss of consciousness secondary to an acute abdominal pain while carrying heavy loads. Patient had no particular back ground and it was her third pregnancy but she was primipare.
Embryo transfer day does not affect the initial maternal serum β-hCG levels: A retrospective cohort study The aim of this study is to compare the serum β-hCG values post transfer of a cleavage stage embryo versus a blastocyst stage embryo at equal time intervals post oocyte retrieval (OR) in clinically pregnant patients, and to ascertain a β-hCG value to predict pregnancy outcomes. This is a retrospective cohort study of 560 women with clinical pregnancy who underwent an embryo transfer performed at either the cleavage stage or the blastocyst stage of embryo development between January 2003 and June 2014 at the Center for Assisted Reproduction (CARE), Singapore General Hospital.
Complete hydatidiform mole with co-existing fetus: Predictors of live birth Multiple gestation consisting of complete hydatidiform mole with co-existing fetus (CHMCF) is unusual. From our institution, we reported two cases with unfavorable obstetric consequences. The recommendation for antenatal management is still not distinctly determined. Therefore, the aim of this article was to review the literature according to the predictors of infant survival and to develop a management guidance for pregnancy with CHMCF. Between January 1, 1993 and May 31, 2016, 12 case series and 89 case reports comprising of 204 pregnant women were identified.
In vitro activity of farnesol against vaginal Lactobacillus spp. Farnesol, a quorum-sensing molecule in Candida albicans, can affect the growth of certain microorganisms. The objective of this study was to evaluate the in vitro activity of farnesol against vaginal Lactobacillus spp., which play a crucial role in the maintenance of vaginal health.
Follow-up of pregnancy-related carpal tunnel syndrome symptoms at 12 months postpartum: A prospective study Carpal tunnel syndrome (CTS) is a common condition among pregnant women. In a previous study, we found a prevalence of 34% during the last trimester in a large cohort of pregnant women . Severity of CTS symptoms generally decreases quickly after childbirth. Only few studies have investigated persisting pregnancy-related CTS symptoms in the postpartum period. According to the current literature, 4% to 54% of women with CTS symptoms during pregnancy still report symptoms at one year postpartum [2,3].
Patient safety: A comparison of systems to improve outcomes Safety initiatives in obstetrics have been demonstrated to improve outcomes  and teamwork among employees , as well as decrease legal claims . As patient risk profiles increase , international collaboration in the area of healthcare quality may lead to gains in safety.
Whole-exome sequencing identifies compound heterozygous LHX4 mutations in a fetus with early-onset growth restriction Fetal growth restriction (FGR) refers to failure of a fetus to reach its growth potential. It is a common clinical problem that has a significant effect on perinatal morbidity and mortality. The origin may be multifactorial. There is growing evidence that genetic causes play a role in the pathogenesis. Karyotypic abnormalities or pathogenic copy number variations (CNVs), affecting both the fetus and the placenta, are known to be associated with FGR . With advances in molecular techniques, it is likely that newer genetic testing methods will benefit patients diagnosed with FGR.
Actinomycetoma due to Nocardia brasiliensis with extension to the ovaries We report the case of a 24-year-old-woman who came to the General Hospital of Mexico presenting with severe pain in the perineal region and right renal fossa on both inguinal regions. At physical examination the labia, perineum, inner thighs and lower buttocks had retractile and atrophic scars, hyperpigmented patches and nodules with draining sinus, in the right labia, a 5×5cm induration was also noted. Smooth walls, eutrophic punctate cervix, 11×9×3cm uterus retroflexion, fornix was observed vaginal examination with no definable bilateral adnexal masses smooth, soft, mobile, no transvaginal bleeding or discharge, rectal examination confirms previous findings.
Development of a regional urogenital pain network: Sharing good practice Within the North East of England, there are an increasing number of complex patients presenting with urogenital pain; many of whom are under the care of multiple specialities.To understand and plan a cohesive strategy for this cohort, we have established a multi-disciplinary regional urogenital pain network meeting. The quarterly meetings allow us to share expertise, best practice and identify areas for improvement with the aim of therefore streamlining the patient journey and enhancing the quality of care patients with urogenital pain receive.
Subsequent pregnancy outcome of tubal ectopic pregnancies treated by methotrexate and salpingectomy Two common themes emerge during the discussion of management options for women presenting with a tubal ectopic pregnancy : concerns about the effect of salpingectomy on future fertility and the risk of subsequent ectopic pregnancy after tubal sparing treatment. We therefore conducted a retrospective cohort analysis of subsequent pregnancies (until August 2016) of women who presented to a large UK teaching hospital with a tubal ectopic pregnancy between January 2010 and May 2012 (n=225).
Bowel injury resulting from vaginal vault closure with a barbed suture: An underestimated risk We read with interest the article by Lin et al. regarding vaginal cuff closure with barbed sutures . Barbed sutures are easier to use and result in less operating time, less blood loss, shorter hospital stay and reduced vaginal cuff granulomatous six months after surgery [1,2]. In general, however, the postoperative complications with barbed sutures are significantly higher . Recently we were confronted with two cases of bowel obstruction within 4 weeks after a minimal invasive hysterectomy.
Pregnancies within the first year following sleeve gastrectomy: Impact on maternal and fetal outcomes A recent review found that the prognosis of pregnancy following bariatric surgery is good , and there is no excess risk of congenital malformations. However, most of the studies included in this review only reported results for Roux-en-Y gastric bypass surgery. A Korean study  of 13 pregnancies occurring >1 year after sleeve gastrectomy (SG) concluded that SG was a safe option for morbidly obese women of childbearing age.
EBCOG position statement on violence against women Violence against women is a major public health problem as well as being a violation of women's human rights . The United Nations defines violence against women as "any act of gender-based violence that results in physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life". In the family, it includes battering, sexual abuse of female children, dowry-related violence, marital rape, female genital mutilation, and violence related to exploitation.
Preterm birth and small for gestational birthweight in relation to maternal relative hypoglycemia and chronic hypertension The risk of having a small-for-gestational age newborn is higher in women with chronic hypertension . Neonatal mortality is 5–13 times greater among small-for-gestational age infants who are born preterm, than in term small-for-gestational age infants . A fair proportion of small-for-gestational age infants are born to mothers without chronic hypertension [1,2], such as in the setting of poor nutrition or low maternal weight , and they tend to experience less morbidity [1,2]. Langer et al.
The impact on women’s health and the cervical cancer screening budget of primary HPV screening with dual-stain cytology triage in Belgium Dual stain cytology, or “diagnostic cytology”, offers a significant increase in sensitivity compared to cytology, with a slight decrease in specificity. This can reduce additional investigations like colposcopies, biopsies, and follow-up visits. Cervical cancer screening for women between 25 and 65 years of age with diagnostic cytology is estimated to reduce the incidence of cervical cancer by 36% and reduce annual cervical cancer mortalities by 40%. The reduced number of screening visits and the decrease in incidence and mortality will improve quality of life.
Prenatal sonographic images of left pulmonary artery sling A 25-year-old gravida 0, para 0 woman was referred to our hospital due to suspicious of a cardiac anomaly at 32 weeks of gestation. Fetal echocardiography demonstrated the abnormal cardiac axis (i.e. mesocardia) associated with persistent left superior vena cava (Fig. 1a). However, the vascular arrangement was not well determined because of inappropriate fetal position.
Evaluation of a labour ward management teaching programme in obstetrics We wish to present the results of educational programme aimed at postgraduate trainees in Obstetrics and Gynaecology in Ireland. Obstetric complications, while rare, may occur in previously healthy women and are often unexpected [1–3]. Reviews of maternal deaths have shown issues in substandard care of management of these emergencies, with common themes identified including lack of recognition, failure to involve other disciplines and senior care and lack of communication . Obstetricians and midwives undergo regular training to maintain competency in management of obstetric emergencies such as post-partum haemorrhage, sepsis, eclampsia, shoulder dystocia and uterine rupture or inversion.
Preoperative anemia in gynaecological surgery We thank the authors for their attentive reading  of our article concerning guidelines for hysterectomy for benign lesions . We fully agree that the pre-operative identification of anemia is required before scheduling hysterectomy. However, the question that we were dealing with was precisely: “What treatment is recommended to treat anemia pre-operatively?” We did not provide any conclusion since, to our knowledge, no study has compared the different options (iron therapy, induction of amenorrhea using progestins, gonadotropin-releasing hormone [GnRH] agonists, selective progesterone receptor modulators [SPRMs], estrogen/progestin combinations, tranexamic acid, etc.) in the specific setting of hysterectomy for benign lesions.
Conjoined twins after in-vitro fertilization We would like to present a case of extremely rare pathology: conjoined twins after in-vitro fertilization (IVF). The current data show that assisted reproductive technologies (ART) increase the frequency of monozygotic (MZ) twins [1–3] from the natural frequency of 0.4–0.45% of live births [4,5]. This increase is most likely to be associated with intracytoplasmic sperm injection (ICSI) and the transfer of blastocysts. The mechanisms behind the increase remain unknown, although ovarian stimulation, hardening and manipulation of the zona pellucida, prolonged culture and suboptimal culture conditions have been proposed as causative agents .
Use of the cell salvage for re-infusion of autologous blood retrieved vaginally in a case of major postpartum haemorrhage We report an index case which describes usage of vaginally retrieved autologous blood for cell salvage as a life-saving measure in the context of a major postpartum haemorrhage in a Jehovah’s Witness patient refusing donor blood transfusion. Intraoperative blood cell salvage is a well established efficacious technique for blood replacement and can be life-saving particularly in patients refusing allogeneic blood products [1–3]. Despite initial concerns of its use in obstetrics because of the theoretical risk of amniotic fluid embolism and haemolytic disease in future pregnancies, it is considered to be safe when used during caesarean sections [1–3].
Aviso para pacientes:
Esta página contiene información urológica dirigida a profesionales de la sanidad.
Si tiene algún problema relacionado con esta patología,
consulte con su urólogo o médico de familia.
Si desea información diseñada para pacientes y público general. puede visitar:
Portal de Información Urológica para Pacientes