Generally, hysteroscopy is not appropriate for pregnant women without an indication. What if a patient undergoes hysteroscopy accidentally during the early gestational period? We here report a rare case of a woman who...Generally, hysteroscopy is not appropriate for pregnant women without an indication. What if a patient undergoes hysteroscopy accidentally during the early gestational period? We here report a rare case of a woman who continued pregnancy after a diagnostic hysteroscopy was performed in early pregnancy and delivered a healthy baby. The patient had a history of infertility and oligomenorrhea, probably due to a previous induced abortion. A hysteroscopy was performed after the end of her "menstruation" for assessment of her uterine cavity. Early pregnancy, instead of the expected intrauterine adhesions, was suspected, and the procedure was immediately ceased. Subsequent tests confirmed the diagnosis of pregnancy. She had a fullterm delivery by elective caesarean section. The success of this case was attributed to the use of vaginoscopic techniques in hysteroscopy and correct judgment and decision-making during the procedure. This case report provides some useful methods and experience that might be helpful when a similar situation occurs in clinical practice.展开更多
BACKGROUND Cervical pregnancy is increasing in morbidity,and a definite diagnosis in early stages is challenging due to its specific onset site.Surgery is the mainstay of treatment for cervical pregnancy,but it may re...BACKGROUND Cervical pregnancy is increasing in morbidity,and a definite diagnosis in early stages is challenging due to its specific onset site.Surgery is the mainstay of treatment for cervical pregnancy,but it may result in the loss of natural fertility.Therefore,it is a great challenge to pursue a safe and effective treatment for cervical pregnancy.CASE SUMMARY We report the case of a cervical pregnancy successfully treated by ultrasoundguided cervical-intramuscular lauromacrogol injection combined with hysteroscopy.A 23-year-old woman with minor irregular vaginal bleeding was admitted to our department with suspected ectopic pregnancy.Transvaginal ultrasound revealed a gestational sac(approximately 22 mm x 13 mm)situated in the cervical canal with a yolk sac and blood flow signals.No cardiac activity was detected.Serum beta progesterone was 17.06 ng/m L,and serum beta human chorionic gonadotropin(β-HCG)was 5077.0 IU/L.The patient was diagnosed with cervical pregnancy.She was treated by ultrasound-guided cervicalintramuscular injections of lauromacrogol(3 m L)in combination with aborting under hysteroscopic visualization.A gradual decrease inβ-HCG levels and normal ultrasound findings were observed.Postoperative pathologic examination showed the presence of villi and changes in the endometrium in the secretory phase.The patient was discharged on day 6,and herβ-HCG level was 0.67 m IU/m L after 1 wk.There was no statistical difference between baseline and 1-week postoperative data in terms of serum indices including liver function,renal function,and routine blood analysis after treatment.The patient subsequently became pregnant 2 mo later and no abnormalities were detected on routine screening during pregnancy.CONCLUSION Ultrasound-guided cervical-intramuscular lauromacrogol injection combined with hysteroscopy may be effective and safe in the treatment of cervical pregnancy.展开更多
目的:基于网络药理学与分子对接探究五子散治疗宫腔镜术后疼痛的作用机制。方法:在中药系统药理学数据库与分析平台(Traditional Chinese Medicine Systems Pharmacology,TCMSP)检索五子散活性成分,利用Swiss Target Prediction平台预...目的:基于网络药理学与分子对接探究五子散治疗宫腔镜术后疼痛的作用机制。方法:在中药系统药理学数据库与分析平台(Traditional Chinese Medicine Systems Pharmacology,TCMSP)检索五子散活性成分,利用Swiss Target Prediction平台预测靶点。采用GeneCards、OMIM等数据库获取宫腔镜术后疼痛相关疾病靶点。基于String平台构建蛋白互作网络。通过David数据库,进行基因本体论(Gene ontology,GO)与京都基因与基因组百科全书(Kyoto encyclopedia of genes and genomes,KEGG)富集分析。最后,利用分子对接验证核心靶点及成分。结果:筛选出20种有效活性成分,获得1582个相关疾病靶点,确定治疗宫腔镜术后疼痛的潜在靶点153个。治疗宫腔镜术后疼痛的主要活性成分为槲皮素(Quercetin)、6-羟基吴茱萸次碱(6-OH-Luteolin)、木犀草素(Luteolin)、异鼠李素(Isorhamnetin)和山柰酚(Kaempferol),预测关键靶点为甘油醛-3-磷酸脱氢酶(glyceraldehyde-3-phosphate dehydrogenase,GAPDH)、AKT丝氨酸/苏氨酸激酶1(AKT serine/threonine kinase 1,AKT1)、信号传导及转录激活因子3(Signal transducer and activator of transcription3,STAT3)、表皮生长因子受体(Epidermal growth factor receptor,EGFR)和半胱天冬酶3(Caspase 3,apoptosis-related cysteine peptidase,CASP3)。治疗宫腔镜术后疼痛主要通过调控AGE-RAGE信号通路发挥抗炎、抗氧化及镇痛等作用。结论:五子散通过多成分协同-多靶点-多通路协同介导镇痛,初步揭示五子散治疗宫腔镜术后疼痛的机制。展开更多
A 27-year-old patient was diagnosed by hysteroscopy with uterine diverticulum in pregnancy and admitted to the hospital. Under the guidance of hysteroscopy combined with methotrexate, the scraping of the uterus was do...A 27-year-old patient was diagnosed by hysteroscopy with uterine diverticulum in pregnancy and admitted to the hospital. Under the guidance of hysteroscopy combined with methotrexate, the scraping of the uterus was done and operation successfully completed. The management of this case showed that hysteroscopy was a kind of valuable approach to the diagnosis and treatment of uterine diverticulum and curettage of the uterus under hysteroscope combined with drug was a safe, effective and conservative treatment.展开更多
Postmenopausal bleeding is a very common and alarming symptom accounting for 5 percent of all gynecological outpatients’ clinic attendances. This cross-section study was conducted in the Department of Obstetrics and ...Postmenopausal bleeding is a very common and alarming symptom accounting for 5 percent of all gynecological outpatients’ clinic attendances. This cross-section study was conducted in the Department of Obstetrics and Gynecology </span><span style="font-family:Verdana;">at University Hospitals and included 176 patients with perimenopausal bleeding </span><span style="font-family:Verdana;">who attended a patient clinic during the period from January 2017 to May 2019. All patients were subjected to transvaginal ultrasound, saline sonohysterography and out-patient endometrial sampling using pipelle;all the results were compared to histopathology obtained by hysteroscopic guided biopsy and/or hysterectomy. </span><b><span style="font-family:Verdana;">Result: </span></b><span style="font-family:Verdana;">In comparing the validity of TVS and SHG we found highly significant decrease in malignancy assessment in </span><span><span style="font-family:Verdana;">the TVS method compared to hysteroscopic-guided biopsy. According to the validity of pipelle in detection of malignant lesion, it was found to detect 80 cases out of 88 cases of malignancy with sensitivity 90.9%, specificity 100% and 95.45% accuracy with respect to histopathology by hysteroscopy guided biopsy and/or hysterectomy. Combination tests were done between SHG and pipelle and we found that the validity of combination tests in detecting malignancy improves the sensitivity and specificity in detection of malignancy sensitivity = 100% and specificity = 100% and this was found to be as an effective method in detection of malignancy. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> When SHG combined to outpatient endometrial sampling “pipelle”, the results were the same as hysteroscopy.展开更多
Objective: The purpose of this study was to evaluate the efficacy, safety, and benefits of hysteroscopic surgery in the treatment of dysfunctional uterine bleeding (DUB) or intrauterine lesions causing uterine bleedin...Objective: The purpose of this study was to evaluate the efficacy, safety, and benefits of hysteroscopic surgery in the treatment of dysfunctional uterine bleeding (DUB) or intrauterine lesions causing uterine bleeding. Methods: This study prospectively enrolled 100 patients who underwent operative hysteroscopy in tertiary referral university center because of uterine bleeding due to endometrial polyps or uterine submucosal leiomyomas diagnosed by transvaginal ultrasonogram. Indications for the operative hysteroscopies included abnormal uterine bleeding (AUB), ultrasound findings indicative of intrauterine lesions, and DUB. After operative hysteroscopic management, we inserted anti-adhesive solution, sodium hyaluronate and carboxymethyl cellulose into the uterine cavity. Results: Operative hysteroscopy was a successful procedure in 100 of 100 cases (100%) but it needed to be repeated in three cases with large uterine submucosal leiomyoma and after two endometrial polypectomy. Mean duration of the procedure was 23.2 minutes (range 5 - 67) and postoperative hospital stay was 7 hours (range 3 - 48). Most common indication was DUB (39%), submucosal leiomyoma was 21%, and endometrial polyp was 17%. There were five cases with postoperative uterine bleeding and none with fluid overload syndrome. During postoperative follow-up (3 - 28 months) the majority of patients (90/100, 90%) were free of symptoms. Conclusion: Hysteroscopic procedure is an effective and safe method for the management of benign intracavitary pathology or the treatment of dysfunctional uterine bleeding. Although sodium hyaluronate and carboxymethyl cellulose seems to be effective in the prevention of adhesion in uterine cavity, further study will be needed to prove the effectiveness of anti-adhesive solution.展开更多
文摘Generally, hysteroscopy is not appropriate for pregnant women without an indication. What if a patient undergoes hysteroscopy accidentally during the early gestational period? We here report a rare case of a woman who continued pregnancy after a diagnostic hysteroscopy was performed in early pregnancy and delivered a healthy baby. The patient had a history of infertility and oligomenorrhea, probably due to a previous induced abortion. A hysteroscopy was performed after the end of her "menstruation" for assessment of her uterine cavity. Early pregnancy, instead of the expected intrauterine adhesions, was suspected, and the procedure was immediately ceased. Subsequent tests confirmed the diagnosis of pregnancy. She had a fullterm delivery by elective caesarean section. The success of this case was attributed to the use of vaginoscopic techniques in hysteroscopy and correct judgment and decision-making during the procedure. This case report provides some useful methods and experience that might be helpful when a similar situation occurs in clinical practice.
文摘BACKGROUND Cervical pregnancy is increasing in morbidity,and a definite diagnosis in early stages is challenging due to its specific onset site.Surgery is the mainstay of treatment for cervical pregnancy,but it may result in the loss of natural fertility.Therefore,it is a great challenge to pursue a safe and effective treatment for cervical pregnancy.CASE SUMMARY We report the case of a cervical pregnancy successfully treated by ultrasoundguided cervical-intramuscular lauromacrogol injection combined with hysteroscopy.A 23-year-old woman with minor irregular vaginal bleeding was admitted to our department with suspected ectopic pregnancy.Transvaginal ultrasound revealed a gestational sac(approximately 22 mm x 13 mm)situated in the cervical canal with a yolk sac and blood flow signals.No cardiac activity was detected.Serum beta progesterone was 17.06 ng/m L,and serum beta human chorionic gonadotropin(β-HCG)was 5077.0 IU/L.The patient was diagnosed with cervical pregnancy.She was treated by ultrasound-guided cervicalintramuscular injections of lauromacrogol(3 m L)in combination with aborting under hysteroscopic visualization.A gradual decrease inβ-HCG levels and normal ultrasound findings were observed.Postoperative pathologic examination showed the presence of villi and changes in the endometrium in the secretory phase.The patient was discharged on day 6,and herβ-HCG level was 0.67 m IU/m L after 1 wk.There was no statistical difference between baseline and 1-week postoperative data in terms of serum indices including liver function,renal function,and routine blood analysis after treatment.The patient subsequently became pregnant 2 mo later and no abnormalities were detected on routine screening during pregnancy.CONCLUSION Ultrasound-guided cervical-intramuscular lauromacrogol injection combined with hysteroscopy may be effective and safe in the treatment of cervical pregnancy.
文摘目的:基于网络药理学与分子对接探究五子散治疗宫腔镜术后疼痛的作用机制。方法:在中药系统药理学数据库与分析平台(Traditional Chinese Medicine Systems Pharmacology,TCMSP)检索五子散活性成分,利用Swiss Target Prediction平台预测靶点。采用GeneCards、OMIM等数据库获取宫腔镜术后疼痛相关疾病靶点。基于String平台构建蛋白互作网络。通过David数据库,进行基因本体论(Gene ontology,GO)与京都基因与基因组百科全书(Kyoto encyclopedia of genes and genomes,KEGG)富集分析。最后,利用分子对接验证核心靶点及成分。结果:筛选出20种有效活性成分,获得1582个相关疾病靶点,确定治疗宫腔镜术后疼痛的潜在靶点153个。治疗宫腔镜术后疼痛的主要活性成分为槲皮素(Quercetin)、6-羟基吴茱萸次碱(6-OH-Luteolin)、木犀草素(Luteolin)、异鼠李素(Isorhamnetin)和山柰酚(Kaempferol),预测关键靶点为甘油醛-3-磷酸脱氢酶(glyceraldehyde-3-phosphate dehydrogenase,GAPDH)、AKT丝氨酸/苏氨酸激酶1(AKT serine/threonine kinase 1,AKT1)、信号传导及转录激活因子3(Signal transducer and activator of transcription3,STAT3)、表皮生长因子受体(Epidermal growth factor receptor,EGFR)和半胱天冬酶3(Caspase 3,apoptosis-related cysteine peptidase,CASP3)。治疗宫腔镜术后疼痛主要通过调控AGE-RAGE信号通路发挥抗炎、抗氧化及镇痛等作用。结论:五子散通过多成分协同-多靶点-多通路协同介导镇痛,初步揭示五子散治疗宫腔镜术后疼痛的机制。
文摘A 27-year-old patient was diagnosed by hysteroscopy with uterine diverticulum in pregnancy and admitted to the hospital. Under the guidance of hysteroscopy combined with methotrexate, the scraping of the uterus was done and operation successfully completed. The management of this case showed that hysteroscopy was a kind of valuable approach to the diagnosis and treatment of uterine diverticulum and curettage of the uterus under hysteroscope combined with drug was a safe, effective and conservative treatment.
文摘Postmenopausal bleeding is a very common and alarming symptom accounting for 5 percent of all gynecological outpatients’ clinic attendances. This cross-section study was conducted in the Department of Obstetrics and Gynecology </span><span style="font-family:Verdana;">at University Hospitals and included 176 patients with perimenopausal bleeding </span><span style="font-family:Verdana;">who attended a patient clinic during the period from January 2017 to May 2019. All patients were subjected to transvaginal ultrasound, saline sonohysterography and out-patient endometrial sampling using pipelle;all the results were compared to histopathology obtained by hysteroscopic guided biopsy and/or hysterectomy. </span><b><span style="font-family:Verdana;">Result: </span></b><span style="font-family:Verdana;">In comparing the validity of TVS and SHG we found highly significant decrease in malignancy assessment in </span><span><span style="font-family:Verdana;">the TVS method compared to hysteroscopic-guided biopsy. According to the validity of pipelle in detection of malignant lesion, it was found to detect 80 cases out of 88 cases of malignancy with sensitivity 90.9%, specificity 100% and 95.45% accuracy with respect to histopathology by hysteroscopy guided biopsy and/or hysterectomy. Combination tests were done between SHG and pipelle and we found that the validity of combination tests in detecting malignancy improves the sensitivity and specificity in detection of malignancy sensitivity = 100% and specificity = 100% and this was found to be as an effective method in detection of malignancy. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> When SHG combined to outpatient endometrial sampling “pipelle”, the results were the same as hysteroscopy.
文摘Objective: The purpose of this study was to evaluate the efficacy, safety, and benefits of hysteroscopic surgery in the treatment of dysfunctional uterine bleeding (DUB) or intrauterine lesions causing uterine bleeding. Methods: This study prospectively enrolled 100 patients who underwent operative hysteroscopy in tertiary referral university center because of uterine bleeding due to endometrial polyps or uterine submucosal leiomyomas diagnosed by transvaginal ultrasonogram. Indications for the operative hysteroscopies included abnormal uterine bleeding (AUB), ultrasound findings indicative of intrauterine lesions, and DUB. After operative hysteroscopic management, we inserted anti-adhesive solution, sodium hyaluronate and carboxymethyl cellulose into the uterine cavity. Results: Operative hysteroscopy was a successful procedure in 100 of 100 cases (100%) but it needed to be repeated in three cases with large uterine submucosal leiomyoma and after two endometrial polypectomy. Mean duration of the procedure was 23.2 minutes (range 5 - 67) and postoperative hospital stay was 7 hours (range 3 - 48). Most common indication was DUB (39%), submucosal leiomyoma was 21%, and endometrial polyp was 17%. There were five cases with postoperative uterine bleeding and none with fluid overload syndrome. During postoperative follow-up (3 - 28 months) the majority of patients (90/100, 90%) were free of symptoms. Conclusion: Hysteroscopic procedure is an effective and safe method for the management of benign intracavitary pathology or the treatment of dysfunctional uterine bleeding. Although sodium hyaluronate and carboxymethyl cellulose seems to be effective in the prevention of adhesion in uterine cavity, further study will be needed to prove the effectiveness of anti-adhesive solution.
